Domain-specific physical activity, sedentary behavior, subjective health, and health-related quality of life among older adults.

PURPOSE: This study aims to investigate the association between domain-specific physical activity (PA), sedentary behavior, subjective health perception, and health-related quality of life (HR-QoL) in Korean adults aged ≥ 65 years. METHODS: This cross-sectional study analyzed 6,004 older adults from the Korean National Health and Nutrition Examination Survey 2017-2020. PA and sedentary behavior were measured using a global PA questionnaire, and HR-QoL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Multiple logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) after adjusting for confounding parameters. RESULTS: Older adults who were physically active at work showed a negative association with subjectively good health and HR-QoL, whereas those physically active in transport or leisure time showed a positive association with subjectively good health and HR-QoL. Older adults highly engaged in sedentary behavior showed a worse perception of health and HR-QoL. Compared to high sedentary behavior and physical activity during leisure time or transport, the EQ-5D index was higher than that of their counterparts. CONCLUSION: Both domain-specific PA and sedentary behavior were significantly associated with older adults' perception of health and HR-QoL. Interventions are needed to improve HR-QoL by reducing sedentary behavior and encouraging physical activity in transportation or leisure time among adults aged 65 years and above.

Implant-retained overdenture delivery in 2 visits with a digital workflow.

The conventional method of fabricating implant-retained overdentures involves multiple steps and patient visits. However, the duplication of existing complete dentures could decrease the number of visits and increase patient satisfaction. An existing maxillary implant-retained overdenture was replaced for a 78-year-old man; the existing implant-retained overdenture and his face were scanned at the first visit. The scanned intaglio image was inverted to obtain a virtual maxillary cast and used to fabricate the metal framework of the replacement implant-retained overdenture. Prefabricated artificial teeth were arranged on a 3-dimensional trial denture created from the scan data of the existing implant-retained overdenture. The replacement implant-retained overdenture was fabricated on the metal framework by using the injection molding technique. By using these digital techniques, a stable and esthetic implant-retained overdenture was delivered in 2 visits.

Digital mounting accuracy of 2 intraoral scanners with a single anterior or bilateral posterior occlusal scan: A three-dimensional analysis.

STATEMENT OF PROBLEM: Although intraoral scanners (IOSs) are popular, few studies have evaluated the accuracy of digital mounting by using IOSs. PURPOSE: The purpose of this in vitro study was to compare the accuracy of digital mounting by using 2 IOSs and 2 occlusal scanning methods. MATERIAL AND METHODS: Fourteen Ø5-mm zirconia balls were attached approximately 5 mm apical to the free gingival margin of both second molars, second premolars, and canines and between the central incisors in maxillary and mandibular epoxy casts. A polyetheretherketone hexagonal cube with a 10-mm-long edge was attached to the buccal side of the missing mandibular right first molar area, and the cube was used to set a part coordinate system. Two IOSs (TRIOS 3, Primescan) were used to assess the intra-arch and interarch accuracies. For intra-arch assessment, each IOS was used to digitally scan the mandibular epoxy cast 15 times and fabricate 15 datasets. The deviation of each zirconia ball centroid was statistically compared between the IOSs. For interarch assessment, each IOS was used to digitally scan the maxillary and mandibular epoxy casts, and the data were digitally mounted by using a single anterior occlusal scan (A) or bilateral posterior occlusal scan (P). Both occlusal scans were performed 15 times; therefore, 4 groups (15 datasets per group) of mounted digital datasets were assigned. The deviation of each maxillary zirconia ball centroid, as well as the interarch distance between the corresponding maxillary and mandibular zirconia ball centroids, were compared among the 4 groups. For statistical analysis, the Mann-Whitney U test and Kruskal-Wallis test with Bonferroni correction were used (α=.05). RESULTS: Primescan had less deviation than TRIOS 3 in the complete arch scan. When the zirconia balls were close to the origin, the bilateral posterior occlusal scan produced less deviation of their centroids. Primescan produced decreased interarch distance in the anterior and posterior dentition, while TRIOS 3 produced increased interarch distance in the anterior dentition and decreased interarch distance in the posterior dentition. CONCLUSIONS: A significant difference was noted in intra-arch accuracy between the IOSs, and the difference influenced the digital mounting accuracy. The type of occlusal scan and IOS significantly influenced the accuracy of digital mounting. Both IOSs produced decreased interarch distances in the second molar area.

Accurate detection for dental implant and peri-implant tissue by transfer learning of faster R-CNN: a diagnostic accuracy study.

BACKGROUND: The diagnosis of dental implants and the periapical tissues using periapical radiographs is crucial. Recently, artificial intelligence has shown a rapid advancement in the field of radiographic imaging. PURPOSE: This study attempted to detect dental implants and peri-implant tissues by using a deep learning method known as object detection on the implant image of periapical radiographs. METHODS: After implant treatment, the periapical images were collected and data were processed by labeling the dental implant and peri-implant tissue together in the images. Next, 300 images of the periapical radiographs were split into 80:20 ratio (i.e. 80% of the data were used for training the model while 20% were used for testing the model). These were evaluated using an object detection model known as Faster R-CNN, which simultaneously performs classification and localization. This model was evaluated on the classification performance using metrics, including precision, recall, and F1 score. Additionally, in order to assess the localization performance, an evaluation through intersection over union (IoU) was utilized, and, Average Precision (AP) was used to assess both the classification and localization performance. RESULTS: Considering the classification performance, precision = 0.977, recall = 0.992, and F1 score = 0.984 were derived. The indicator of localization was derived as mean IoU = 0.907. On the other hand, considering the indicators of both classification and localization performance, AP showed an object detection level of AP@0.5 = 0.996 and AP@0.75 = 0.967. CONCLUSION: Thus, the implementation of Faster R-CNN model for object detection on 300 periapical radiographic images including dental implants, resulted in high-quality object detection for dental implants and peri-implant tissues.

The Neutral Zone Approach with CAD-CAM Record Bases.

Lack of adequate retention, support, and stability in the complete denture can be attributed to a poor fit or incorrect shape of the polished surfaces. This article presents a case using the neutral zone technique effectively with the fabrication of computer-aided design and computer-aided manufacturing (CAD-CAM) record bases in an edentulous patient with severely resorbed alveolar ridges and discusses the overall treatment steps and clinical implications of this technique. A stable neutral zone and an accurate jaw relation were recorded using CAD-CAM record bases and stability of complete denture was optimized by arranging denture teeth and reforming polishing surfaces in the neutral zone. A new complete denture was fabricated for a patient with atrophic alveolar ridges by a technique utilizing the neutral zone with CAD-CAM record bases.

The efficacy of convenient cleaning methods applicable for customized abutments: an in vitro study.

BACKGROUND: The demand for implant dentistry, which includes customized abutments, is increasing. A lot of pollutions are generated on the customized abutment surface following milling procedure. This study evaluated the surface topography and cleanliness of customized abutments after cleaning procedures, which are simply applicable in the dental clinic. METHODS: Thirty computer-aided design and computer-aided manufacturing internal connection type titanium abutments were produced, milled, and randomly divided into 3 groups: steam cleaning (control group), chlorhexidine (CHX) scrubbing (test group 1), and ultrasonic cleaning with CHX solution, acetone, and ethyl alcohol (test group 2). Each group was evaluated using microscopic and microbial analysis. RESULTS: Foreign bodies were observed on the abutment surfaces in control group and test group 1, but not in test group 2. Bacteria were observed on 40% of the agar plates following steam cleaning; most of the colonies consisted of Bacillus cereus and Staphylococcus warneri. Colony growth was absent following test group 1 and 2. CONCLUSION: For customized abutments, cleaning with steam is ineffective. CHX scrubbing effectively eliminates only bacteria. Ultrasonic cleaning with CHX solution, acetone, and ethyl alcohol successfully removes both foreign bodies and bacteria. Thus, the ultrasonic cleaning method is conveniently applicable in the dental clinic for eliminating contamination of the customized abutment surface.

Irisin prevents dexamethasone-induced atrophy in C2C12 myotubes.

Irisin is a myokine secreted mainly from skeletal muscle that is known for having beneficial metabolic effects via enhancement of energy expenditure and insulin sensitivity. Studies show that irisin also acts as an autocrine/paracrine to promote myogenesis and muscle growth. However, the protective role of irisin against muscular wasting remains unclear. We confirmed that irisin secretion was upregulated by electrical pulse stimulation an in vitro exercise mimetic model. Next, we tested if irisin exerted an anti-atrophic effect on cultured C2C12 myotubes treated with dexamethasone (DEX), a representative inducer of muscular atrophy. Treatment of cultured myotubes with DEX reduced myotube size and increased proteasome activity, which were attenuated by irisin. Also, irisin effectively prevented dephosphorylation of forkhead box O (FoxO) 3α and upregulation of muscle-specific ubiquitin ligases in DEX-treated myotubes. The protective effect of irisin on DEX-mediated myotube atrophy was partially regulated by insulin-like growth factor-1-dependent signaling. These results suggested that irisin may prevent glucocorticoid-induced muscle atrophy by inhibiting FoxO-mediated ubiquitin-proteasome overactivity.

Leptin regulates the expression of angiopoietin-like 6.

Angiopoietin-like 6 (ANGPTL6) is a hepatokine that antagonizes obesity and insulin resistance by increasing energy expenditure. Despite its beneficial effects on metabolism, human studies have shown a paradoxical increase in ANGPTL6 level in the serum of patients with metabolic diseases, which has been interpreted as a compensatory upregulation. However, the regulatory mechanism of ANGPTL6 remains unclear. Since upregulation of ANGPTL6 is induced on metabolic stress, we investigated the hepatic expression of ANGPTL6 by leptin, a representative adipokine of obesity. Mice on a high-fat diet showed increased serum leptin levels and hepatic Angptl6 expression, which were attenuated by exercise training. A single leptin injection also induced hepatic ANGPTL6 expression and increased serum ANGPTL6 levels. In an in vitro model using primary hepatocytes, leptin treatment significantly upregulated ANGPTL6 expression at the mRNA and protein levels, as well as the amount of secreted ANGPTL6 protein in conditioned media. Similarly, exercise training on human participants also showed diminished serum levels of leptin and ANGPTL6. Altogether, these results strongly indicated that hepatic ANGPTL6 expression was determined by leptin.

Evaluating subjective domains of antipsychotic-induced adverse effects using heart rate variability.

AIMS: Antipsychotic-induced autonomic dysregulation may lead to a wide range of subjective side-effects in schizophrenia patients. Using heart rate variability (HRV) measures, we prospectively examined the relationship between subjective side-effects and cardiac autonomic regulation in unmedicated schizophrenia patients. METHODS: Forty-five unmedicated schizophrenia patients were assessed for antipsychotic-associated side-effects and HRV parameters at baseline and after 6 weeks of treatment. Psychiatric symptoms and subjective side-effects were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Liverpool University Neuroleptic Side-effect Rating Scale (LUNSERS). RESULTS: Correlations between subjective adverse effects and HRV measures at baseline and at week 6 varied. Nonetheless, the changes in the psychic side-effects domain were significantly correlated with the changes in time-domain HRV measures and sample entropy (SampEn). In addition, the change in SampEn was significantly associated with that in the scores of extrapyramidal, anticholinergic, miscellaneous, and red herring domains as well as the mean total LUNSERS score. CONCLUSION: Baseline HRV measures may predict clinical response and adverse events associated with treatment adherence. Also, subjective side-effects may correspond well with the changes in neurocardiac dynamics, and the changes in SampEn may effectively reflect subjective discomfort in patients receiving antipsychotic treatment.

Catastrophic failure of a monolithic zirconia prosthesis.

Recently, monolithic zirconia restorations have received attention as an alternative to zirconia veneered with feldspathic porcelain to eliminate chipping failures of veneer ceramics. In this clinical report, a patient with mandibular edentulism received 4 dental implants in the interforaminal area, and a screw-retained monolithic zirconia prosthesis was fabricated. The patient also received a maxillary complete removable dental prosthesis over 4 anterior roots. At the 18-month follow-up, all of the zirconia cylinders were seen to be fractured, and the contacting abutment surfaces had lost structural integrity. The damaged abutments were replaced with new abutments, and a new prosthesis was delivered with a computer-assisted design and computer-assisted manufacturing fabricated titanium framework with denture teeth and denture base resins. At the 6-month recall, the patient did not have any problems. Dental zirconia has excellent physical properties; however, care should be taken to prevent excessive stresses on the zirconia cylinders when a screw-retained zirconia restoration is planned as a definitive prosthesis.

Pattern of pharmacotherapy by episode types for patients with bipolar disorders and its concordance with treatment guidelines.

This study aimed to investigate the overall prescription pattern for patients with bipolar disorders in Korea and its relevance to the practice guidelines. Prescription records from all patients with bipolar I and II disorders who have been admitted or who started the outpatient treatment during the year of 2009 in 10 academic setting hospitals were reviewed. A total of 1447 patients with bipolar I and II disorders were included in this study. Longitudinal prescription patterns of inpatients and outpatients were analyzed by episode types and compared with the clinical practice guideline algorithms. In all phases, polypharmacy was chosen as an initial treatment strategy (>80%). The combination of mood stabilizer and atypical antipsychotics was the most favored. Antipsychotics were prescribed in more than 80% of subjects across all phases. The rate of antidepressant use ranged from 15% to 40%, and it was more frequently used in acute treatment and bipolar II subjects. The concordance rate of prescriptions for manic inpatients to the guidelines was higher and relatively more consistent (43.8%-48.7%) compared with that for depressive inpatients (18.6%-46.9%). Polypharmacy was the most common reason for nonconcordance. In Korean psychiatric academic setting, polypharmacy and atypical antipsychotics were prominently favored in the treatment of bipolar disorder, even with the lack of evidence of its superiority. More evidence is needed to establish suitable treatment strategies. In particular, the treatment strategy for acute bipolar depression awaits more consensuses.

Differential patterns of neuropsychological performance in the euthymic and depressive phases of bipolar disorders.

AIMS: Patients with bipolar disorders (BD) show a broad range of neurocognitive impairments. We compared the patterns of neuropsychological performance in depressed and euthymic patients with BD, and explored the state-dependent cognitive markers of bipolar depression. METHODS: The study participants included 32 BD patients (15 depressed and 17 euthymic) and 42 healthy controls. All of the subjects completed tests that assessed attention, psychomotor speed, verbal and visual memory, and executive functions. Between-group neuropsychological performance differences were examined. Multidimensional scaling (MDS) was used to compare the patterns of cognitive variables in euthymic and depressed BD patients. RESULTS: Compared to the euthymic BD patients and healthy controls, the depressed BD patients performed lower in verbal memory and executive functions. No significant differences were found between the three groups in attention, psychomotor speed, and visual memory. The depressed BD patients showed a lower level of association between psychomotor speed and the time to initial concept formation than the healthy controls and euthymic BD patients. In contrast, the correlation between word association and verbal memory was stronger in the depressed group than either the control or euthymic groups. CONCLUSION: The depressed BD patients showed greater impairments in verbal memory and executive functions than the euthymic BD patients. In addition, our study identified a differential pattern of correlations between the cognitive domains of euthymic and depressed BD patients, which suggests the potential role of verbal memory and executive functions as cognitive markers of BD.

Parental quality of life and depressive mood following methylphenidate treatment of children with attention-deficit hyperactivity disorder.

AIM: This naturalistic study investigated the associations between quality of life and depressive mood in parents and symptom changes in attention-deficit hyperactivity disorder (ADHD) children. METHODS: At baseline and at weeks 4 and 8, the parents evaluated their children, who were receiving treatment with osmotic-release oral system methylphenidate (mean dosage 36.3 ± 15.5 mg/day), using the Swanson, Nolan, and Pelham - Fourth Edition (SNAP-IV-18) scale. The parents evaluated themselves using the Beck Depression Inventory (BDI) and the World Health Organization Quality of Life Assessment, Brief Version (WHOQOL-BREF). RESULTS: A significant reduction in SNAP-IV-18 scores and improvements in parental BDI scores and parental WHOQOL-BREF scores were observed. The decrease in BDI scores from baseline to 8 weeks was significantly associated with increases in WHOQOL-BREF sub-domain scores from baseline to 8 weeks, with a greater decrease at 4 weeks and after. The decrease in the SNAP-IV-18 hyperactivity-impulsivity score was significantly associated with increases in WHOQOL social sub-domain scores from baseline to 8 weeks. For those patients who showed a 25% or greater decrease in the SNAP-IV-18 total scores from baseline to 8 weeks, the decreases in the SNAP-IV-18 total score and in the inattention and hyperactivity-impulsivity scores were significantly associated with a decrease in BDI scores from baseline to 8 weeks. CONCLUSION: Methylphenidate treatment for ADHD was associated with both symptom alleviation in children with ADHD and improvement in parental depressive mood and quality of life, suggesting that the effects of treatment could go beyond symptom improvement in ADHD.

An esthetic clinical approach for the management of an infrapositioned implant-retained maxillary incisor crown.

Infrapositioning of implants in the maxillary anterior region can cause esthetic complications, including soft tissue problems. These complications commonly occur in implants placed in young adults. However, there are many clinical reports of implant infrapositioning in the maxillary anterior region after the fourth decade of life. This clinical report describes a case of infrapositioning of the maxillary central incisor wherein esthetic results were obtained through surgical and prosthetic approaches. The surgical approach improved the gingiva shape using the tunnel technique, and the prosthetic approach increased gingiva thickness by adjusting the shape of the abutment, resulting in a shape similar to the natural teeth.

Sex-specific association of low-renin hypertension with metabolic and musculoskeletal health in Korean older adults.

Introduction: Low-renin hypertension (LRH) accounts for approximately one-third of patients with hypertension and are more prevalent in women and the older adult population. Previous study has found a link between the renin-angiotensin-aldosterone system (RAAS) and sex hormones. However, there are insufficient data on the relationship between LRH and metabolic or musculoskeletal outcomes in older adults. Methods and materials: Among the 343 participants from a population-based cohort study conducted between May 2018 and August 2019, a total of 256 (86 men older than 50 years and 170 postmenopausal women) were included. The presence of LRH was defined as plasma renin activity (PRA) <1 ng/mL/h and systolic blood pressure (BP) ≥130 or diastolic BP ≥80 mmHg based on the 2017 ACC/AHA guidelines. Individuals with missing data, and those who had used medications that could affect PRA within the past six months were excluded. Bone mineral density (BMD), trabecular bone score (TBS), and appendicular lean mass (ALM) index were assessed using dual-energy X-ray absorptiometry; degraded TBS was defined as partially degraded to degraded levels (≤1.350). Muscle function was assessed according to the Asian Working Group for Sarcopenia guidelines. PRA was measured using radioimmunoassay. Results: The median age was 66 [61-72] years, and the body mass index (BMI) was 24.7 [23.0-26.4] kg/m2. Individuals with LRH, accounting for 34.8%, had lower diabetes mellitus; more dyslipidemia; and poorer muscle function, BMD, and TBS than those in the non-LRH group. In addition, PRA was positively correlated with C-peptide, HOMA-IR, TBS, and ALM index. After adjusting for covariates including age and BMI, LRH was negatively associated with femur neck T-score (adjusted ß = -0.30, 95% CI [-0.55 to -0.05], p = 0.021) and the presence of LRH was significantly associated with degraded TBS in women (adjusted odds ratio = 3.00, 95% CI [1.36-6.58], p = 0.006). Conclusion: Our findings suggest that LRH can influence clinical features and metabolic risk in older adults. Notably, LRH in postmenopausal women was linked to lower femur neck T-scores and degraded TBS, indicating sex-specific effects of LRH on bone health. Larger prospective studies are required to elucidate how changes in the RAAS affect metabolic and musculoskeletal outcomes in older adults.

Examination of categorical approach to symptom assessment: cross-validation of foulds' Delusions-Symptoms-States Inventory with Korean non-patient and patient groups.

BACKGROUND: Foulds' Delusions-Symptoms-State Inventory (DSSI) has been purported to be a reliable, systematic categorical measure to assess the patients with schizophrenia according to the degree of illness. However, further cross-validations using other clinical measures and diverse samples from other cultures have not been advanced recently. We aimed to examine the validity of the DSSI hierarchical class model using both Korean non-patient and patient (schizophrenia and depression) groups. METHOD: The hypothesis of inclusive, non-reflexive relationships among the DSSI classes was tested. The power of DSSI to detect presence of symptoms was assessed via cross-validation with other clinical measures, and the differences between the clinical features among the DSSI classes were examined using the Minnesota Multiphasic Personality Inventory (MMPI). RESULTS: The high rate of model conformity (91.1%) across the samples and cross-validation with other criterion measures provided further support for the validity of DSSI. CONCLUSIONS: DSSI is a reliable self-report measure that can be applied to both patient and non-patients to assess the presence and severity of psychiatric illness. Future studies that include more diverse clinical groups are necessary to lend further support for its utility in clinical practice.

Up to a 15-Year Survival Rate and Marginal Bone Resorption of 1780 Implants with or without Microthreads: A Multi Center Retrospective Study.

The effect of microthreads at the implant neck on the amount of marginal bone resorption is controversial. This multicenter retrospective study compared the implant survival rate and amount of marginal bone resorption between two platform-switching internal connection implant systems with or without microthreads. Patient-related (age and sex), surgery-related (implant installation site, type, diameter, and length), and prosthesis-related (prosthesis type) data were collected from patient charts from the implant placement surgery to the final recall visit. A total of 1780 implants, including 1379 with microthreads and 401 without microthreads, were placed in 804 patients. For implants with and without microthreads, the longest follow-up period after prosthesis delivery was 15 and 6 years, respectively. Twenty implants failed during the 15-year follow-up period (98.8% survival rate) due to failed osseointegration, peri-implantitis, implant fractures, and non-functioning implants. The mean marginal bone loss was < 0.1 mm for both implant systems at the 1-year follow-up and 0.18 mm and 0.09 mm at the 4-year follow-up for implants with and without microthreads, respectively, without statistical significance. Microthreads did not significantly affect the amount of marginal bone loss or the implant survival rate for implants with an internal connection with a platform-switching design.

Advancements in Methods of Classification and Measurement Used to Assess Tooth Mobility: A Narrative Review.

Evaluating tooth mobility is clinically significant, not only for diagnosing periodontal tissues but also in determining the overall periodontal treatment plan. Numerous studies related to tooth mobility have been conducted over the years, including the proposal of various classifications as well as the development of electronic devices for objective measurement. However, there is still no consensus on the measurement methods and criteria for assessing tooth mobility. In this study, we provide a comprehensive review of past and current tooth mobility classification and measurement methods. In order to propose a new method to intuitively evaluate tooth mobility based on previous studies, a digital approach capable of recording tooth micromovements induced by dynamic load should be considered.

An integrative assessment of the psychophysiologic alterations in young women with recurrent major depressive disorder.

OBJECTIVE: Alterations in neuroelectrical activities coincide with major depressive disorder (MDD). This study examines the pattern of cerebral activity and cardiac autonomic parameters of euthymic women with recurrent MDD. METHODS: Resting electroencephalograms and electrocardiograms were recorded from 20 women with MDD receiving escitalopram and 40 matched and healthy women. We computed frontal alpha asymmetry to evaluate the interhemispheric balance. Parameters of heart rate variability were extracted to assess cardiac autonomic control. Sample entropy was used to assess the complexity of neurocardiac dynamics. The relationship between cardiovagal activity and alpha electroencephalogram was examined with a coherence analysis. RESULTS: Multivariable analysis of variance revealed a differential pattern of psychophysiologic variables between MDD patients and controls (p = .03). MDD was associated with a tendency toward lower left frontal activity (-0.06 [standard deviation = 0.14] versus 0.04 [0.17] lnµV(2), p = .04). Discriminant analysis demonstrated more right frontal activation, a lower high-frequency heart rate power spectrum, and a higher ratio of the low- to high-frequency heart rate power spectrum in patients with MDD compared with controls. Residual depressive symptoms (r = -0.09 to 0.11, p = .63-.99) and escitalopram dosage (r = -0.09 to 0.28, p = .22-.84) were not correlated with autonomic measures. Coherence between normalized high-frequency component of the heart rate power spectrum and alpha power was not significant (F3, p = .27; F4, p = .16). CONCLUSIONS: Euthymic women with recurrent MDD have a distinctive psychophysiologic profile. This profile may reflect altered frontal activation and a reduced cardiovagal tone in depression.

Application of Mitochondrial and Oxidative Stress Biomarkers in the Evaluation of Neurocognitive Prognosis Following Acute Carbon Monoxide Poisoning.

Mitochondrial and oxidative stress play critical roles in the pathogenic mechanisms of carbon monoxide (CO)-induced toxicity. This study was designed to evaluate whether the serum levels of specific stress biomarkers might reflect brain injury and act as prognostic markers for the development of neurocognitive sequelae following CO poisoning. We analyzed the data from 51 adult patients admitted with acute CO poisoning and measured the serum level expression of growth differentiation factor 15 (GDF15) and fibroblast growth factor 21 (FGF21), indicators of mitochondrial stress, and 8-Oxo-2'-deoxyguanosine (8-OHdG) and malondialdehyde (MDA), indicators of oxidative stress. Serum was collected upon arrival at the hospital, at 24 h post treatment, and within 7 days of HBO2 therapy. Global Deterioration Scale scores were measured 1 month post incident and used to place the patients in either favorable or poor outcome groups. Initial serum GDF15 and 8-OHdG concentrations were significantly increased in the poor-outcome group and all four biomarkers decreased at 24 h post HBO2 therapy, and were then maintained or further decreased at the 1-week mark. Notably, the degree of change in these biomarkers between baseline and 24 h post HBO2 were significantly larger in the poor-outcome group, reflecting greater CO-associated stress, confirming that post-CO poisoning serum biomarker levels and their response to HBO2 were proportional to the initial stress. We suggest that these biomarkers accurately reflect neuronal toxicity in response to CO poisoning, which is consistent with their activity in other pathologies.