Clinimetric properties of the Perme Intensive Care Unit Mobility Score -a multicenter study for minimum important difference and responsiveness analysis

Background: The use of instruments in clinical practice with measurement properties tested is highly recommended, in order to provide adequate assessment and measurement of outcomes. Objective: To calculate the minimum clinically important difference (MCID) and responsiveness of the Perme Intensive Care Unit Mobility Score (Perme Score). Methods: This retrospective, multicentric study investigated the clinimetric properties of MCID, estimated by constructing the Receiver Operating Characteristic (ROC). Maximizing sensitivity and specificity by Youden's, the ROC curve calibration was performed by the Hosmer and Lemeshow goodness-of-fit test. Additionally, we established the responsiveness, floor and ceiling effects, internal consistency, and predictive validity of the Perme Score. Results: A total of 1.200 adult patients records from four mixed general intensive care units (ICUs) were included. To analyze which difference clinically reflects a relevant evolution we calculated the area under the curve (AUC) of 0.96 (95% CI: 0.95-0.98), and the optimal cut-off value of 7.0 points was established. No substantial floor (8.8%) or ceiling effects (4.9%) were observed at ICU discharge. However, a moderate floor effect was observed at ICU admission (19.3%), in contrast to a very low incidence of ceiling effect (0.6%). The Perme Score at ICU admission was associated with hospital mortality, OR 0.86 (95% CI: 0.82-0.91), and the predictive validity for ICU stay presented a mean ratio of 0.97 (95% CI: 0.96-0.98). Conclusion: Our findings support the establishment of the minimum clinically important difference and responsiveness of the Perme Score as a measure of mobility status in the ICU.

Antecedentes: Se recomienda encarecidamente el uso de instrumentos en la práctica clínica con propiedades de medición probadas, con el fin de proporcionar una evaluación y medición adecuada de los resultados. Objetivo: Calcular la diferencia mínima clínicamente importante (MCID) y la capacidad de respuesta de la puntuación de movilidad de la unidad de cuidados intensivos de Perme (Perme Score). Métodos: Este estudio multicéntrico retrospectivo investigó las propiedades clinimétricas de MCID, estimadas mediante la construcción de la característica operativa del receptor (ROC). Maximizando la sensibilidad y especificidad mediante la prueba de Youden, la calibración de la curva ROC se realizó mediante la prueba de bondad de ajuste de Hosmer y Lemeshow. Además, establecimos la capacidad de respuesta, los efectos suelo y techo, la consistencia interna y la validez predictiva del Perme Score. Resultados: Se incluyeron un total de 1,200 registros de pacientes adultos de cuatro unidades de cuidados intensivos (UCI) generales mixtas. Para analizar qué diferencia refleja clínicamente una evolución relevante calculamos el área bajo la curva (AUC) de 0.96 (95% CI: 0.95-0.98); y se estableció el valor de corte óptimo de 7.0 puntos. No se observaron efectos suelo (8.8%) o techo (4.9%) sustanciales al alta de la UCI. Sin embargo, se observó un efecto suelo moderado al ingreso en la UCI (19.3%), en contraste con una incidencia muy baja del efecto techo (0.6%). El Perme Score al ingreso en UCI se asoció con la mortalidad hospitalaria, OR 0.86 (95% CI: 0.82-0.91), y la validez predictiva de estancia en UCI presentó una relación media de 0.97 (95% CI: 0.96-0.98). Conclusiones: Nuestros hallazgos respaldan el establecimiento de la diferencia mínima clínicamente importante y la capacidad de respuesta de el Perme Score como medida del estado de movilidad en la UCI.

Determination of Gender using Discriminant Analysis of Hand Dimensions among Adult Participants

Background: The estimation of gender using hand dimensions is a crucial role in forensic investigation and legal sciences. Objectives: In this study, the mean score of hand measurements have been derived and linear discriminant analysis has been applied to predict gender from hand dimensions. An Independent t-test has been employed to know discrimination between male and female. The accuracy of gender estimation has been derived and checked by ROC curve. Material and Methods: A sample of 150 participants has been collected for the completion of this study, where 78 males and 72 females were found aged between 18 and 24 years. The breadths and lengths of left and right hands of the participants have been measured. Results: Respondents’ mean score of length and breadth of left hand were found 17.69 ± 1.30 and 7.56 ± 1.17, respectively. It was found to be significantly different in the respondents’ mean scores of males and females. Conclusions: The hand dimensions of males were higher than females. The prediction of a number of females and males were 76 and 74, respectively, and its accuracy was observed 0.87. This research can be applied for larger sample and would be helpful in predicting gender discrimination among adults through hand dimensions.

Precisión diagnóstica de una versión abreviada de las pruebas de patrones de frecuencia y patrones de duración para la evaluación del ordenamiento auditivo temporal

Introducción: Las pruebas de patrones de frecuencia y patrones de duración son consideradas los gold standard de evaluación del ordenamiento auditivo temporal. A pesar de su amplia difusión, la extensión y duración de estas pruebas dificultan su utilización dentro de baterías de evaluación del procesamiento auditivo. Sin embargo, dadas sus características estructurales, pareciera ser posible reducirlas sin perder su precisión diagnóstica. Objetivo: Determinar las propiedades diagnósticas de versiones abreviadas de las pruebas de patrones de frecuencia y patrones de duración. Material y Método: Se realizó un estudio transversal de diseño observacional analítico. Se evaluaron 166 oídos de 88 sujetos con edades entre 18 y 33 años, los cuales fueron clasificados con normalidad o alteración del ordenamiento auditivo temporal. Se utilizaron las pruebas originales de Auditec de 30 ítems por oído como referencia y los primeros 10 ítems de cada oído como versión abreviada. Resultados: La versión abreviada de la prueba de patrones de frecuencia obtuvo una sensibilidad de un 94,33%, una especificidad del 94,29% y un área bajo la curva ROC de 0,980. La versión abreviada de la prueba de patrones de duración obtuvo una sensibilidad de un 89,58%, especificidad del 71,88% y un área bajo la curva ROC de 0,916. Ambas versiones tuvieron un índice de concordancia adecuado. Conclusiones: Las versiones abreviadas de la prueba de patrones de frecuencia y patrones de duración cuentan con excelentes propiedades diagnósticas para la evaluación del ordenamiento auditivo temporal y pueden ser utilizadas de manera intercambiable con las versiones originales.

Introduction: The frequency and duration pattern tests are considered the gold standard for assessing auditory temporal ordering. Despite their wide dissemination, the length and duration of these tests make it difficult to use them within auditory processing assessment batteries. However, given their structural characteristics, reducing them without losing their diagnostic accuracy seems possible. Aim: Determine the diagnostic properties of abbreviated versions of the Frequency Patterns and Duration Patterns tests. Material and Method: A cross-sectional study with an analytical observational design was carried out. 166 ears of 88 subjects aged between 18 and 33 years were evaluated, classified as normal or altered in temporal auditory order. The original Auditec tests of 30 items per ear were used as a reference, and the first 10 items of each ear as an abbreviated version. Results: The abbreviated version of the frequency patterns test obtained a sensitivity of 94.33%, a specificity of 94.29%, and an area under the ROC curve of 0.980. The abbreviated version of the duration pattern test obtained a sensitivity of 89.58%, a specificity of 71.88%, and an area under the ROC curve of 0.916. Both versions had an adequate concordance index. Conclusion: The abbreviated versions of the frequency patterns and duration patterns test have excellent diagnostic properties for assessing auditory temporal ordering and can be used interchangeably with the original versions.

Triglyceride-glucose index is associated with poor sleep quality in apparently healthy subjects: A cross-sectional study

ABSTRACT Objectives: We aimed to evaluate the association between the triglyceride glucose index (TyG index) and sleep quality and to establish a cut-off value for the TyG index based on the prevalence of subjects with insulin resistance (IR). Materials and methods: This cross-sectional study involved Brazilian health professionals (20-59 years). A total of 138 subjects answered the Pittsburgh Sleep Quality questionnaire to evaluate sleep quality. They were categorized into two groups: good sleep quality (global score ≤ 5 points) and poor sleep quality (global score ≥ 6 points). Also, we classified the subjects as having a high (>8.08 or >4.38) or low TyG index (≤8.08 or ≤4.38). Results: The majority of the subjects (70%) with high TyG index values (>8.08 or >4.38) reported poor sleep quality (p ≤ 0.001). Those with poor sleep quality had a 1.44-fold higher prevalence of IR (TyG index >8.08 or >4.38) compared to those with good sleep quality, regardless of sex, total cholesterol, LDL/HDL ratio, insulin, complement C3, CRP, and adiponectin (p ≤ 0.001). Conclusion: Our data showed a positive and significant association between the TyG index and poor sleep quality. Thus, these findings support the association between poor sleep quality and IR.

Simple model construction of arteriovenous fistula classification in maintenance hemodialysis patients / 中国实用护理杂志

Objective:To construct a simple model of arteriovenous fistula classification,and to achieve the classification of arteriovenous fistula in hemodialysis patients.Methods:The study was a retrospective analysis, a total of 304 hemodialysis patients with internal fistula in People′s Hospital of Deyang City from January 2016 to January 2021 were selected by convenience sampling method,depending on whether the internal fistula was dysfunctional, patients were divided into 64 in the internal fistula failure group and 240 in the internal fistula patency group. Independent influence factors and their regression coefficient were obtained by single-factor analysis and logistic regression analysis, The risk score formula was established based on the regression coefficient to form a simple model of internal fistula classification.The model was evaluated by receiver operating characteristic curve and the scoring criteria for internal fistula classification was determined.Results:Logistic regression analysis showed that diabetes mellitus, hypotension, age≥60 years old, compression time≥30 min, blood phosphorus>1.78 mmol/L, triglyceride>1.71 mmol/L and fibrinogen>4 g/L were independent influencing factors of internal fistula failure (all P<0.05).The area under the receiver operating characteristic curve was 0.858(95% CI 0.789-0.928, P<0.01), and the best critical value of the internal fistula classification was 7.5, the sensitivity was 80.4% and the specificity was 84.8%. Conclusions:By obtaining the predictors of internal fistula failure, conducted the risk score, and constructed a simple model of internal fistula classification, which can effectively predicted the risk of internal fistula failure. It is conducive to the implementation of internal fistula classification management and the puncture of corresponding grade, to ensure the pathway safety of patients.

Establishment and validation of a nomogram model for detect the risk of anemia after chemotherapy for the triple-negative breast cancer patients with Fukangning / 国际中医中药杂志

Objective:To explore the risk factors analysis and validation of anemia after triple-negative breast cancer (TNBC) and risk prediction model, to provide reference for reducing the incidence of anemia after TNBC-NAC.Methods:Retrospectively, 316 female TNBC-NAC patients in the breast department of our hospital from January 2016 to July 2021 were selected as the study subjects (modeling set), and the condition of anemia after the last chemotherapy was set as the observation group. In addition, 98 breast cancer patients in 2022 were selected for validation. Multivariate Logistic regression was used to analyze the effect of Fukangning capsule on TNBC-NAC anemia. We established the risk nomogram prediction model and calibration curve of anemia after chemotherapy by using R software and conducted internal and external verification. Hosmer-Lemeshow test was used to evaluate the prediction deviation between the risk prediction value of the nomogram model and the actual observed value, and the ROC curve was used to evaluate the prediction effect of the model.Results:A total of 75 (23.73%) among 316 patients developed anemia. The results of multivariate Logistic regression analysis showed that menopause [ OR (95% CI)=26.739 (5.063-141.227)], RBC [ OR (95% CI)=0.168 (0.098-0.286)], Hb level [ OR (95% CI)=0.952 (0.929-0.976)], and pathological stage Ⅲ[ OR (95% CI)=4.182 (1.759-9.946)] were independent risk factors for anemia after TNBC-NAC ( P<0.05). The nomogram prediction model established based on the above factors. Hosmer-Lemeshow test results showed that the difference between the risk prediction value and the actual observed value is ( χ2=3.68, P=0.885). The correction curve approaches to the ideal curve and the average absolute error was 0.012. The area under the ROC curve was 0.945, 95% CI was 0.918-0.972, sensitivity was 0.921 and specificity was 0.853, suggesting that the model has good differentiation and calibration degree. The external validation results showed that the nomogram predicted anemia with sensitivity of 88.7%, spectificity of 85.45% and accuracy of 86.73%. Conclusion:Menopausal status, RBC, Hb level before chemotherapy and pathological stage are independent risk factors for anemia after taking TNBC-NAC. The nomogram prediction model based on the above indicators had good discrimination and calibration, and accurately predicted the possibility of anemia after TNBC-NAC.

Effect of bariatric surgery on cardiac morphology and function in obese patients / 国际外科学杂志

Objective:To investigate the changes of cardiac morphology and function in obese patients after bariatric surgery.Methods:The clinical data of 100 patients who underwent bariatric surgery, including gastric sleeve resection and gastric bypass in Beijing Friendship Hospital, Capital Medical University from January 2018 to December 2021 were selected for retrospective analysis, including 67 females and 33 males, aged from 18 to 65 years, with average of (36.7±9.5) years. The software of SPSS 26.0 was used to conduct data analysis. Univariate and Logistic regression analysis was performed on the indicators of patients before bariatric surgery and 1 year after surgery, and ROC curves were drawn to determine the changes of cardiac morphology and cardiac function after bariatric surgery.Results:Compared with preoperative, one year after bariatric surgery, patients′ body weight [(112.2±30.2) kg vs(80.7±23) kg, P<0.001] and body mass indes [(38.77±8.26) kg/m 2vs (27.98±6.54) kg/m 2, P<0.001] were significantly decreased, and systolic and diastolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, blood uric acid, and resting heart rate were also significantly decreased ( P<0.05), cardiac ejection fraction was significantly improved [(65.5±5.9)% vs (67.9±4.7)%, P<0.001], ventricular septum, left ventricular posterior wall, left atrial diameter, left ventricular systolic and end-diastolic diameter were significantly reduced ( P<0.05), while the inner diameter of the ascending aorta was not significantly changed [(3.14±0.39) cm vs (3.09±0.38) cm, P=0.125]. In addition, there were no significant differences in cardiac morphology between gastric bypass and gastric sleeve resection. Logistic regression analysis showed that pre-bariatric BMI value, postoperative BMI reduction value, whether suffering from hypertension, and whether the inner diameter of the ascending aorta was widened were the important influencing factors for the improvement of ejection fraction after bariatric surgery ( P<0.05). The area under the ROC curve for predicting the improvement of ejection fraction was 0.772 (95% CI: 0.669-0.875), the specificity was 85%, the sensitivity was 66%, and the best cut-off point was 0.545. Conclusions:One year after bariatric surgery in obese patients, cardiac ejection fraction was significantly improved, and ventricular septum, left ventricular posterior wall, left atrial diameter, left ventricular systolic and end-diastolic diameter were significantly reduced compared with those before surgery. There was no significant difference between gastric sleeve resection and gastric bypass in the improvement of cardiac function and the effect on cardiac morphology. The combined prediction model composed of preoperative body mass index value, decreased body mass index value at 1 year after operation, whether suffering from hypertension, whether the inner diameter of the ascending aorta is widened and other indicators has a good predictive value for the improvement of ejection fraction in bariatric patients at 1 year after operation.

Evaluation of Four Predictive Models for Identifying Malignancy of Solitary Pulmonary Nodules in Health Check-up Population / 肿瘤防治研究

Objective To compare and validate the efficiency of four models predicting the malignancy of solitary pulmonary nodules (SPN). Methods Patients diagnosed with SPN during health check-up were selected as the research subjects. Risk assessment was conducted using four predictive models. Outcomes were obtained through prospective follow-up. Statistical description and univariate analysis were performed for all risk factors of the four models. ROC curve was applied to compare the efficiency of the four predictive models. Results A total of 479 cases were included in this study. Among these patients, 82 were diagnosed with lung tumor, and the malignant rate was 17.12%. Age, nodule diameter, smoking, family history of tumor, history of extrapulmonary tumor ≥5 years, upper lobe site, unclear boundary, and spiculation rates were higher in the malignancy group than those in the benign group (P < 0.05). The efficiency of Brock model was the best. Its AUC was 0.833, sensitivity was 80.49%, and specificity was 74.31%. Its Youden index, positive likelihood ratio, positive predictive value, and negative predictive value were the highest, and its negative likelihood ratio was the lowest. The AUC, sensitivity, and specificity of Mayo model were 0.815, 81.71%, and 67.51%, respectively; those of PKUPH model were 0.754, 69.51%, and 73.55%, respectively; and those of VA model were 0.738, 68.29%, and 67.55%, respectively. Conclusion The Brock model might be the most appropriate predictive model for the risk assessment of SPN among the health check-up population, and the VA model is the worst. The combination of Brock, Mayo, and PKUPH models requires further study.

Timed Up and Go na avaliação da fragilidade de pessoas idosas agricultoras do Rio Grande do Sul: estudo transversal / Timed Up and Go in assessing the frailty of older farmers in Rio Grande do Sul: cross-sectional study

Resumo Objetivos Avaliar a sensibilidade do teste Timed Up and Go test (TUG) como preditor da síndrome da fragilidade do idoso (SFI) da população rural idosa do Rio Grande do Sul (RS) e identificar a prevalência de SFI nessa população. Método Estudo transversal, realizado com 604 agricultores com mais de 60 anos de idade (321 homens e 283 mulheres) identificados por meio de conglomerados estruturados a partir das regionais da Federação dos Trabalhadores da Agricultura do Rio Grande do Sul (FETAG-RS) e respectivos sindicatos. Além de variáveis demográficas (sexo, idade), foi avaliada a mobilidade funcional mediante a realização do TUG e a fragilidade referida. A curva Receiver-Operating Characteristic (ROC) foi construída para avaliar um ponto de corte do teste TUG para fragilidade. Resultados A SFI ou fragilidade foi identificada em 52,5% (n=317) da população pesquisada; 35,1% (n=212) pré-frageis e 12,4% (n=75) não-frágeis. E o tempo médio de realização do TUG em relação ao sexo foi de 11,6 segundos para mulheres e 10,8 segundos para homens (p=0,0001). A progressão da idade esteve relacionada com maior tempo de realização do teste (idosos jovens - 60-64 anos; idosos mais velhos -75-79 e longevos - 80+ - p=0,0001). A curva ROC indicou 10 segundos na execução do teste TUG como melhor ponto de corte para diagnóstico da SF em idosos rurais. Conclusão A frequência de fragilidade e pré-fragilidade nesta pesquisa, indicam uma condição de vulnerabilidade do trabalhador rural do RS no seu processo de envelhecimento. Demonstrando, a partir do teste TUG, características de mobilidade funcional e risco de fragilidade dos agricultores mais velhos, importantes para considerações futuras sobre as singularidades da saúde dessa população e intervenções profissionais necessárias.

Abstract Objectives To evaluate the sensitivity of the Timed Up and Go test (TUG) as a predictor of frailty syndrome in the elderly (IFS) in the elderly rural population of Rio Grande do Sul (RS) and to identify the prevalence of IFS in this population. Method Cross-sectional study, carried out with 604 farmers over 60 years of age (321 men and 283 women) identified through clusters structured from the regions of the Federation of Agricultural Workers of Rio Grande do Sul (FETAG-RS) and respective unions. In addition to demographic variables (gender, age), functional mobility was assessed by performing the TUG and reported frailty. The Receiver-Operating Characteristic (ROC) curve was constructed to assess a TUG test cutoff point for frailty. Results IFS or frailty was identified in 52.5% (n=317) of the surveyed population; 35.1% (n=212) pre-frail and 12.4% (n=75) non-frail. And the mean time to perform the TUG varied according to gender was 11.6 seconds for women and 10.8 seconds for men - (p=0.0001). The progression of age was related to longer time spent on the age test (young elderly - 60-64 years old; older elderly -75-79 and oldest old - 80+ - p=0.0001). The ROC curve indicated 10 seconds in the execution of the TUG test as the best cutoff point for diagnosing the SF frailty syndrome in rural elderly. Conclusion The frequency of frailty and pre-frailty in this research indicates a condition of vulnerability of rural workers in RS in their aging process. Demonstrating, from the TUG test, characteristics of functional mobility and risk of frailty of older farmers, important for future considerations on the singularities of the health of this population and necessary professional interventions.

Teste de força máxima de preensão palmar em pessoas idosas longevas do sudeste brasileiro: definição de pontos de corte / Maximum handgrip strength test in long-lived elderly people from southeastern Brazil: definition of cutoff points

Resumo Objetivo Definir pontos de corte para os valores do teste de força máxima de preensão palmar (FMPP) em pessoas idosas longevas. Método Estudo transversal com amostra de pessoas idosas longevas, octogenárias e nonagenárias, saudáveis e independentes funcionais (grupo robusto) e frágeis (grupo frágil). O teste de FMPP foi realizado em triplicata, sendo considerado o maior valor obtido. Os valores de sensibilidade, especificidade e os pontos de corte foram calculados por meio da Curva Característica de Operação do Receptor (ROC). Foram utilizados os pontos de corte brasileiros e os do Consenso Europeu de Sarcopenia para estudo da comparação. Resultados Foram avaliadas 121 pessoas idosas, com idade média de 84,5±5,3 anos, 65 (53,7%) do sexo feminino, sendo 46 (38%) do grupo frágil e 75 (62%) do grupo robusto. Foram encontrados os pontos de corte para FMPP de 27 kgf para homens e 19 kgf para mulheres. Os valores de sensibilidade e especificidade para os pontos de corte masculinos foram 94,44 e 65,79, respectivamente. Para o sexo feminino foram de 85,71 e 67,57. A partir desses pontos de corte, 23 (38,3%) pessoas idosas do grupo robusto foram classificadas com força inadequada, e, portanto, com provável sarcopenia, ao passo que, de acordo com os pontos de corte brasileiros e europeus, o número é de 35 (44,3%) e 14 (33,3%), respectivamente. Conclusão O estudo definiu pontos de corte para a população longeva e mostrou que os pontos de corte definidos até o momento para a população idosa brasileira não se mostraram adequados para longevos.

Abstract Objective To define cut-off points for the values ​​of the Maximum Handgrip Strength (MGS) test in long-lived elderly people. Method Cross-sectional study with a sample of long-lived elderly people, octogenarians and nonagenarians, healthy and functionally independent (robust group) and frail (fragile group). The MHS test was performed in triplicate, with the highest value obtained being considered. Sensitivity, specificity and cut-off values ​​were calculated using the Receiver Operating Characteristic Curve (ROC). The Brazilian cut-off points and those of the European Consensus on Sarcopenia were used for the comparison study. Results 121 elderly people were evaluated, with a mean age of 84.5±5.3 years, 65 (53.7%) female, 46 (38%) from the frail group and 75 (62%) from the robust group. Cut-off points for MHS of 27 kgf for men and 19 kgf for women were found. Sensitivity and specificity values ​​for men's cutoffs were 94.44 and 65.79, respectively. For woman, they were 85.71 and 67.57. Based on these cutoff points, 23 (38.3%) individuals from the robust group were classified as having competitive strength, and therefore with probable sarcopenia, while according to the Brazilian and European cutoff points, the number is 35 (44.3%) and 14 (33.3%). Conclusion The study defined cut-off points for the oldest-old population and showed that the cut-off points defined so far for the Brazilian elderly population were not adequate for the oldest-old.

Risk of sarcopenia in older adults with type 2 diabetes mellitus: evaluation of the SARC-F and SARC-CalF as screening tools / Risco de sarcopenia em idosos com diabetes mellitus tipo 2: avaliação do SARC-F e SARC-CalF como ferramentas para rastreamento

Objective: To evaluate the diagnostic power of SARC-F and SARC-CalF as screening tools for sarcopenia risk in older adults with type 2 diabetes mellitus. Methods: This cross-sectional study of 128 patients was conducted at the endocrinology outpatient clinic of a hospital in Recife, Brazil between July 2022 and February 2023. Sarcopenia was diagnosed according to original and updated European Consensus criteria for older adults. Muscle mass was assessed with electrical bioimpedance, muscle strength was assessed with a handgrip test, and physical performance was assessed with gait speed. Sarcopenia risk was assessed using the SARC-F and SARC-CalF instruments. The sensitivity, specificity, positive and negative predictive values, receiver operating characteristic curve, and area under the curve were analyzed to determine the best diagnostic performance. Results: According to the original and updated versions of the European Consensus criteria, the prevalence of sarcopenia was 25.00% and 10.90%, respectively. Sarcopenia risk was 17.20% according to the SARC-F and 23.40% according to the SARC-CalF. The sensitivity and specificity of the SARC-F ranged from 12.55% to 36.11% and 71.87% to 92.39%, respectively, while those of the SARC-CalF ranged from 47.22% to 85.71% and 82.46% to 88.89%, respectively. The area under the curve for the SARC-F and SARC-CalF varied between 0.51 and 0.71 and 0.67 and 0.86, respectively. Conclusions: The SARC-CalF had better diagnostic performance for all analyzed diagnostic criteria. Adding calf circumference to the SARC-F was an effective screening method for sarcopenia risk in the study population

Objetivo: Avaliar o poder diagnóstico do SARC-F e SARC-CalF como ferramentas de rastreamento para o risco de sarcopenia em idosos com diabetes mellitus tipo 2. Metodologia: Estudo transversal com 128 pacientes desenvolvido no ambulatório de endocrinologia de um hospital do Recife entre julho de 2022 e fevereiro de 2023. A sarcopenia foi diagnosticada de acordo com os critérios do Consenso Europeu para sarcopenia em pessoas idosas e sua versão atualizada. Foi realizada bioimpedância elétrica para avaliar a massa muscular, teste de preensão palmar para a força muscular e teste de velocidade de marcha para a performance física. O risco para sarcopenia foi avaliado por meio do SARC-F e SARC-CalF. Realizou-se análise de sensibilidade, especificidade, valores preditivos positivos e negativos, curva Característica de Operação do Receptor (ROC) e área sob a curva (AUC) para determinar a melhor performance diagnóstica. Resultados: A prevalência de sarcopenia foi de 25,00% de acordo com a primeira versão do Consenso Europeu e 10,90% considerando a versão atualizada. O risco para sarcopenia foi de 17,20% (SARC-F) e 23,40% (SARC-CalF). A sensibilidade do SARC-F variou entre 12,55 e 36,11%, e a espec ificidade entre 71,87 e 92,39%, enquanto o SARC-CalF apresentou sensibilidade entre 47,22 e 85,71% e especificidade entre 82,46 e 88,89%. A AUC do SARC-F variou entre 0,51 e 0,71, enquanto o SARC-CalF ficou entre 0,67 e 0,86. Conclusões: O SARC-CalF apresentou melhor performance diagnóstica quando comparado a todos os critérios diagnósticos analisados. A adição da circunferência da panturrilha é um método eficaz para o rastreamento do risco de sarcopenia na população do estudo

Correlation between serological screening of human T-lymphotropic virus antibodies and confirmatory tests / 中国输血杂志

【Objective】 To explore the correlation between serological screening of human T-lymphotropic virus antibodies (anti HTLV) and Western blot(WB) confirmatory tests among blood donors, so as to explore the infection status of HTLV Ⅰ/Ⅱ in Guangzhou. 【Methods】 The anti HTLV Ⅰ/Ⅱ enzyme-linked immunosorbent assay(ELISA) kit was used to screen voluntary blood donors from Guangzhou Blood Center from July 2016 to August 2022. WB was used to confirm 395 reactive blood samples by ELISA. The correlation between the S/CO values of anti HTLV Ⅰ/Ⅱ ELISA reagents and the confirmatory test was analyzed using ROC curves. 【Results】 The results showed that 25 out of 395 initially screened reactive blood donor samples were confirmed as HTLV positive by WB, while 16 were uncertain. ROC curve analysis showed a correlation between the S/CO values by ELISA and the confirmatory test results: the S/CO value at the highest Youden index was 3.789, which was the optimal threshold. The S/CO value had a certain correlation with the predicted positive rate of confirmatory results (P<0.05): the larger the S/CO value, the higher the predicted positive value. The overall prevalence of HTLV in Guangzhou is relatively low. 【Conclusion】 The prevalence of HTLV among blood donors in Guangzhou is low.Since the false positive rate of HTLV Ⅰ/Ⅱ antibody by ELISA serological screening is high, the confirmatory testing is particularly important.

Evaluation of brainstem function using vestibular evoked myogenic potentials in patients with early-stage Parkinson′s disease / 中华神经科杂志

Objective:To investigate whether vestibular-evoked myogenic potentials (VEMP) can be used to assess brainstem and its supplementary diagnostic value in patients with early-stage Parkinson′s disease (PD).Methods:A total of 123 patients with early-stage PD (PD group) diagnosed in the Department of Neurology of the Second Affiliated Hospital of Soochow University from January 2019 to January 2022 were consecutively enrolled, and 122 healthy controls (healthy control group) were included. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) examinations were performed on all subjects. VEMP parameters between the 2 groups were compared, and receiver operating characteristic curve was used to evaluate the auxiliary diagnostic efficacy of VEMP for early-stage PD. Correlations between VEMP parameters and motor and non-motor symptoms such as autonomic dysfunction were analyzed in the PD group using Spearman correlation analysis.Results:Bilateral latencies of cVEMP [left P1 latency (Lp13): 19.0 (16.4, 20.9) ms vs 13.1(12.0, 14.2) ms, Z=-11.18, left N1 latency (Ln23): 27.4 (24.6, 29.9) ms vs 21.2 (19.8, 23.0) ms, Z=-10.14; right P1 latency (Rp13): 18.8 (16.2, 20.9) ms vs 13.0 (11.7, 14.1) ms, Z=-10.84, right N1 latency (Rn23): 27.7 (24.3, 29.7) ms vs 21.1 (19.6, 22.9) ms, Z=-10.50] and bilateral latencies of oVEMP [left N1 latency (Ln10): 12.7 (10.7, 14.4) ms vs 10.4 (9.7, 11.4) ms, Z=-8.02, left P1 latency (Lp15): 16.5 (15.1, 18.3) ms vs 14.5 (13.4, 15.3) ms, Z=-7.96; right N1 latency (Rn10): 12.8 (11.4, 14.0) ms vs 10.5 (9.7, 11.5) ms, Z=-8.85, right P1 latency (Rp15): 16.7 (15.3, 18.3) ms vs 14.4 (13.3, 15.1) ms, Z=-9.39] of the PD group significantly prolonged compared to the healthy control group (all P<0.001). Compared to the healthy control group, the area under the curve (AUC) values of Lp13, Ln23, Rp13 and Rn23 of cVEMP in the PD group were all greater than 0.7, and the AUC values of Lp13 and Rp13 in the PD group were greater than 0.9 (all P<0.001); the AUC values of Ln10, Lp15, Rn10, and Rp15 of oVEMP in the PD group were all greater than 0.7 (all P<0.001). The Rn10-p15 corrected amplitude in PD patients was positively correlated with levodopa equivalent dose ( r=0.21, P=0.020). The Rn10 in PD patients was positively correlated with the Non-Motor Symptoms Questionnaire scores ( r=0.21, P=0.023). The Lp13-n23 corrected amplitude was negatively correlated with the Scale for Outcomes in Parkinson′s Disease-Autonomic scores ( r=-0.20, P=0.023). There was no significant correlation between VEMP parameters and Unified Parkinson′s Disease Rating Scale part Ⅲ score ( P>0.05). Conclusion:VEMP, especially cVEMP, as a non-invasive neuroelectrophysiological index, is an objective marker for brainstem damage and could be used for screening early-stage PD patients.

Application value of serum pepsinogen and Helicobacter pylori combined with endoscopic Kimura-Takemoto classification in the diagnosis of early gastric cancer / 中国基层医药

Objective:To investigate the application value of pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification in the diagnosis of early gastric cancer. Methods:Sixty patients with gastric cancer who received treatment in the Department of Gastroenterology, the First People's Hospital of Huzhou from January to June 2022 were included in the gastric cancer group. An additional 60 patients with benign gastric lesions (benign gastric lesion group) and 60 patients with precancerous lesions of the stomach (precancerous lesion group) were also included in this study. Serologic testing for pepsinogen and Helicobacter pylori antibody combined with endoscopic Kimura-Takemoto classification was performed to evaluate their application value in the diagnosis of early gastric cancer. Results:Compared with the benign gastric lesion and precancerous lesion groups, the pepsinogen I/pepsinogen II ratio was significantly lower, and the pepsinogen II level and Helicobacter pylori infection rate [71.67% (43/60)] were significantly higher in the gastric cancer group ( F = 108.14, 71.75, 38.43, χ2 = 6.89, all P < 0.05). Compared with the benign gastric lesion and precancerous lesion groups, the Kimura-Takenmoto classification in the gastric cancer group was significantly higher ( H = 38.91, P < 0.05). In the gastric cancer group, pepsinogen I level and pepsinogen I/pepsinogen II ratio decreased and pepsinogen II level increased with the increase of pathological stage ( F = 65.79, 5.66, 53.32, all P < 0.01). There was no significant difference in Helicobacter pylori infection rate between different stages of gastric cancer ( P < 0.05) in the gastric cancer group. There was no significant difference in Kimura-Takenmoto classification between different stages of gastric cancer (all P > 0.05) in the gastric cancer group. The area under the receiver operating characteristic curve plotted for evaluating pepsinogen I, pepsinogen II, and pepsinogen I/pepsinogen II ratio for diagnosis of gastric cancer was 0.865, 0.664, and 0.881, respectively. Conclusion:Serum pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification can increase the diagnostic rate of early gastric cancer. The Kimura Takemoto classification is helpful for risk stratification in the endoscopic screening of gastric cancer, and its results are consistent with pepsinogen levels. The combined application is of a high application value.

The value of CHA2DS2-VASc score for predicting percutaneous coronary intervention prognosis in patients with coronary chronic total occlusion / 中国基层医药

Objective:To investigate the value of CHA2DS2-VASc score for predicting percutaneous coronary intervention (PCI) prognosis in patients with coronary chronic total occlusion.Methods:The clinical data of 139 patients with coronary chronic total occlusion who underwent PCI at the Second Hospital of Anhui Medical University from January 2019 to December 2020 were retrospectively analyzed. These patients were divided into good prognosis and poor prognosis groups according to prognosis outcomes. Univariate and multivariate Cox regression analysis was performed to evaluate the influential factors of adverse events after PCI in patients with coronary chronic total occlusion. The receiver operating characteristic curves were plotted to evaluate the value of the CHA2DS2-VASc score for predicting the occurrence of adverse events in patients with coronary chronic total occlusion undergoing PCI.Results:Among the 139 patients with coronary chronic total occlusion, the average follow-up time was (19.88 ± 7.90) months, 19 (13.7%) patients had a poor prognosis, and 120 (86.3%) patients had a good prognosis. The age, uric acid, and CHA2DS2-VASc score in the poor prognosis group were 73 (65.0, 77.0) years, (383.26 ± 120.60) μmol/L, and 4 (3, 5) points, respectively, which were significantly higher than 66 (57.0, 71.8) years, (322.68 ± 91.88) μmol/L, and 3 (2, 4) points in the good prognosis group ( U = -2.74, t = 2.24, U = -3.09, all P < 0.05). However, the proportion of patients with the successful opening of the occluded coronary artery and albumin, hemoglobin, and triacylglycerol levels in the poor prognosis group were 11 (57.9%), 36.7 (34.4, 38.3) g/L, (120.26±19.74) g/L, and 1.03 (0.85, 1.49) mmol/L, respectively, which were significantly lower than 98 (81.7%)( χ2 = 4.16, P = 0.041), 39.3 (36.78, 42.1) g/L ( U = -2.85, P = 0.004), (133.62 ± 16.84) g/L ( t = 1.52, P = 0.002), and 1.52 (1.09, 2.25) mmol/L ( U =-2.13, P = 0.033) in the good prognosis group. Multivariate Cox regression analysis showed that CHA2DS2-VASc score was a risk factor for poor prognosis of patients with coronary chronic total occlusion undergoing PCI (95% CI: 1.137-2.274, P = 0.007). The receiver operating characteristic curve analysis results showed that the area under the receiver operating characteristic curve plotted for CHA2DS2-VASc score predicting poor prognosis in patients with coronary chronic total occlusion undergoing PCI was 0.716 (95% CI: 0.588-0.844, P = 0.003), with the cut-off point of 3.5, the sensitivity of 68.4%, and specificity of 66.7%, respectively. Conclusion:Compared with those with a good prognosis, patients with a poor prognosis have a higher CHA2DS2-VASc score. The CHA2DS2-VASc score has a certain application value for predicting mid- and long-term prognosis in patients with coronary chronic total occlusion who undergo PCI.

Expression and significance of microRNA-21 and microRNA-181b in peripheral blood of patients with schizophrenia / 中国基层医药

Objective:To investigate the expression and significance of microRNA-21 (miRNA-21) and microRNA-181b (miRNA-181b) in the peripheral blood of patients with schizophrenia.Methods:A total of 100 patients with schizophrenia who received treatment in Shaoxing 7 th People's Hospital from March 2020 to March 2022 were included in the study group. An additional 30 healthy controls who concurrently underwent physical examination were included in the control group. The expression of miRNA-21 and miRNA-181b in peripheral blood was compared between the two groups. The 100 patients with schizophrenia received standardized clinical treatment. Their mental symptoms were evaluated with the Positive and Negative Symptom Scale (PANSS). miRNA-21 and miRNA-181b expression and PANSS scores before and 1, 4, 8, and 12 weeks after treatment were collected and compared between the two groups. The receiver operating characteristic curve was plotted to analyze the value of miRNA-21 and miRNA-181b expression in the diagnosis of schizophrenia. Results:Serum miRNA-21 and miRNA-181b expression in the study group were (2.41 ± 1.12) and (15.62 ± 2.26), respectively, which were significantly higher than (0.73 ± 0.37) and (8.11 ± 0.98) in the control group ( t = 8.07,17.67, both P < 0.05). With the prolongation of treatment time, serum miRNA-21 and miRNA-181b expression and PANSS score in the study group gradually decreased (all P < 0.001). The area under the receiver operating characteristic curve plotted for evaluating the value of miRNA-21 and miRNA-181b expression in the diagnosis of schizophrenia was 0.616 and 0.683, respectively. The area under the receiver operating characteristic curve plotted for evaluating the value of miRNA-21 combined with miRNA-181b expression in the diagnosis of schizophrenia was 0.788, which was markedly higher than that for the detection of miRNA-21 or miRNA-181b expression alone. Conclusion:miRNA-21 and miRNA-181b are abnormally highly expressed in the peripheral blood of patients with schizophrenia. Both of them can be used as objective and effective indicators for early diagnosis of schizophrenia. Combined detection of miRNA-21 and miRNA-181b provides higher accuracy in the diagnosis of schizophrenia than the detection of miRNA-21 or miRNA-181b alone.

Value of serum IgG4 and IgG4/IgG ratio in differential diagnosis of autoimmune diseases / 中国基层医药

Objective:To investigate the value of immunoglobulin G4 (IgG4) and IgG4/ immunoglobulin G (IgG) ratio in the differential diagnosis of IgG4-related diseases (IgG4-RD) and other autoimmune diseases.Methods:A total of 35 patients with IgG4-RD and 937 patients with autoimmune diseases who received treatment in Beijing Hospital from January 2021 to July 2022, and 200 subjects who concurrently underwent health checkups in the same hospital were included in this study. The IMMAGE 800 and BN II automatic special protein analyzers were used to detect IgG and IgG4. The receiver operating characteristic (ROC) curve of IgG4 and IgG4/IgG ratio was plotted.Results:Serum IgG4 level and IgG4/IgG ratio in the IgG4-RD group were 2.83 (2.01, 5.07) g/L and 25% (18%, 43%) respectively, which were higher than 0.35 (0.16, 0.72) g/L, 3% (1%, 6%) in the autoimmune disease group and 0.27 (0.14, 0.49) g/L, 2% (1%, 4%) in the healthy control group ( U = 795.50, 82.50, 1 744.50, 205.50, all P < 0.001). Taking IgG4 ≥ 1.35 g/L as the standard, patients with IgG4 ≥ 1.35 g/L in the three groups were screened out. There was a statistically significant difference in IgG4/IgG ratio between the IgG4-RD group and the non-IgG4-RD group ( U = 453.50, P < 0.001). The ROC curve of IgG4 and IgG4/IgG ratio showed that when IgG4 was 1.47 g/L, the sensitivity was 91.7%, the specificity was 83.5%, and the area under the ROC curve was 0.96. When IgG4/IgG was 12.5%, the sensitivity was 91.4%, the specificity was 85%, and the area under the ROC curve was 0.96. Taking IgG4 ≥ 1.47 g/L and IgG4/IgG ≥ 12.5% as the diagnostic criteria of IgG4-RD, the sensitivity was 94.3%, the specificity was 85.9%, and the area under the ROC curve was 0.96, which were higher than the sensitivity (87.2%) and diagnostic specificity (82.6%) provided by IgG4 alone. Conclusion:Because non-IgG4-RD diseases can also have the phenomenon of increased IgG4, when IgG4 ≥ 1.47 g/L is taken as the diagnostic criteria, its diagnostic sensitivity and specificity are the highest. Combined detection of IgG4 and IgG4/IgG ratio can increase the diagnostic efficacy of IgG4-RD.

Application value of the aortic dissection detection risk score plus D-dimer for the early diagnosis of acute aortic dissection / 中国基层医药

Objective:To investigate the application value of aortic dissection detection risk score (ADD-RS) combined with D-dimer (DD) in the early diagnosis of acute aortic dissection (AAD).Methods:The clinical data of 70 patients with suspected aortic dissection detection admitted to The Second Hospital of Jiaxing from August 2019 to April 2020 were collected. All patients were scored using the ADD-RS, and grouped according to the scoring results. The sensitivity and specificity of ADD-RS plus DD in the early diagnosis of AAD were calculated. The areas under the receiver operating characteristic (ROC) curves that were plotted for drADD-RS plus DD versus DD alone to screen AAD were compared to evaluate efficacy. Results:CT angiography results showed that among 70 patients with suspected AAD, 29 patients had AAD and 41 patients had no AAD. A total of 21 patients were scored 0, 41 patients were scored > 1, and 8 patients were scored > 0. ADD-RS > 0 had an overall sensitivity of 79.31% and a specificity of 36.59% for AAD diagnosis. DD test results had an overall sensitivity of 86.20% and a specificity of 36.50% for AAD diagnosis. The area under the ROC curve of ADD-RS = 0 plus DD-negative result and the area under the ROC curve of DD-negative result alone in ruling out AAD were 0.885 with 95% CI (0.786-0.949) and 0.787 with 95% CI (0.673-0.876), respectively. The difference between the two groups was statistically significant ( P = 0.024). Conclusion:Compared with DD-negative result alone, the ADD-RS = 0 plus DD-negative result strategy offers greater specificity to rule out AAD. The combined strategy has a greater efficacy in ruling out AAD. However, a multi-center study involving a large sample is required for in-depth evaluation.

Third Molar Maturity Index as an Efficient Tool for Prediction of Age in a Sample Indian Population - A Retrospective Study

Introduction: The age of 18 years is an important milestone for legal matters, and developmental parameters of teeth are often used for estimation of this age. The aim of this study is to assess the efficiency of third molar maturity index (I3M) in establishing age of 18 years in Dakshina Kannada population. Methods: A total of 700 orthopantomograms were retrieved from the archives of the radiology department of Manipal College of Dental Sciences, Mangalore. The length and the width of the open apex of the mandibular left third molar was assessed using Image J software and the Third molar maturity Index (I3M) was calculated and correlated with the age of the individual. Results: Receiver operating characteristic (ROC) curve analysis showed the Area under curve of 0.94 and 0.96 in females and males, respectively, for prediction of age of 18 years. The cut?off of 0.08 predicted the 18?year cut?off with 97% specificity and 90.2% negative predictive value. The percentage of the accuracy was 80.23% if the I3M was <0.08. Conclusion: The efficiency of the cut?off of 0.08 of I3M has been tested in various population including Kosovar, Peruvian, South Indian, Libyan, Montenegro, Croatian, African (Botswana), Albanian, and Serbian. Our study also shows the efficiency of the same in South Indian Dakshina Kannada population.

Fiberoptic endoscopic evaluation of swallowing and the Brazilian version of the Eating Assessment Tool-10 in resistant hypertensive patients with obstructive sleep apnea

Abstract Objective: The aim of this study was to describe the prevalence and characteristics of OD through Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and the Eating Assessment Tool-10 (EAT-10) in hypertensive patients with OSA, as well as to describe the sensitivity of EAT-10 for the detection of OD in this population. Methods: This study included a convenience sample in which 85 resistant hypertensive patients diagnosed with OSA in an university hospital participated. Participants were subjected to the EAT-10 (index test) and FEES (reference standard). Results: The median EAT-10 score was 2 (0-5.5). According to the FEES, 27 participants did not have dysphagia, 42 had mild dysphagia and 16 had mild to moderate dysphagia. The sensitivity of the EAT-10 was 70.7% (95% CI: 57.3-81.9) at a cutoff score ≤1, with a discriminatory power of 67.4% (p = 0.005). The most prevalent symptom in this population was "food stuck in the throat", while the most prevalent signs were delayed initiation of the pharyngeal phase of swallowing, premature bolus spillage and pharyngeal residue. Conclusion: In our study, the cutoff score for the EAT-10 for screening for OD in this population was ≥ 1. In conclusion, this population presented a high prevalence of dysphagia detected in FEES and its severity is associated with higher EAT-10 scores.