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Yamada T, Minami T, Yoshino S, Emoto K, Mabuchi S, Hanazawa R, Hirakawa A, Hashimoto M. Diaphragm Ultrasonography: Reference Values and Influencing Factors for Thickness, Thickening Fraction, and Excursion in the Seated Position. Lung 2024; 202:83-90. [PMID: 38019290 PMCID: PMC10896853 DOI: 10.1007/s00408-023-00662-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/19/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION Measurements of diaphragm function by ultrasonography are affected by body position, but reference values in the seated position have not been established for an Asian population. This study aimed to determine reference values for diaphragm thickness, thickening fraction, and dome excursion by ultrasonography and to investigate the effects of sex, height, and body mass index. METHODS Diaphragm ultrasonography was performed on 109 seated Japanese volunteers with normal respiratory function who were enrolled between March 2022 and January 2023. Thickness, thickening fraction, and excursion were measured. Reference values and the measurement success rate were calculated. Multivariate analysis adjusted for sex, height, and body mass index was performed. RESULTS The measurement success rate was better for thickness than for excursion. The mean (lower limit of normal) values on the right/left sides were as follows. During quiet breathing, thickness at end expiration(mm) was 1.7 (0.9)/1.6 (0.80), thickening fraction(%) was 50 (0.0)/52 (0.0), and excursion(cm) was 1.7 (0.5)/1.9 (0.5). During deep breathing, the thickening fraction was 111 (24)/107 (22), and the excursion was 4.4 (1.7)/4.1 (2.0). In multivariate analysis, body mass index was positively associated with thickness but not with the thickening fraction. CONCLUSION The reference values in this study were smaller than those in previous reports from Europe. Considering that thickness is influenced by body mass index, using Western reference values in Asia, where the average body mass index is lower, might not be appropriate. The thickening fraction in deep breathing is unaffected by other items and can be used more universally.
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Affiliation(s)
- Toru Yamada
- Department of General Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Taro Minami
- Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Syumpei Yoshino
- General Internal Medicine, Iizuka Hospital, Iizuka, 135-0041, Fukuoka, Japan
| | - Ken Emoto
- General Internal Medicine, Kaita Hospital, Iizuka, 820-1114, Fukuoka, Japan
| | - Suguru Mabuchi
- Department of General Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Ryoichi Hanazawa
- Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Akihiro Hirakawa
- Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Masayoshi Hashimoto
- Department of General Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8510, Japan
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Lee HW, Lee JK, Hwang YI, Seo H, Ahn JH, Kim SR, Kim HJ, Jung KS, Yoo KH, Kim DK. Spirometric Interpretation and Clinical Relevance According to Different Reference Equations. J Korean Med Sci 2024; 39:e20. [PMID: 38288534 PMCID: PMC10825457 DOI: 10.3346/jkms.2024.39.e20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/21/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Global Lung Function Initiative (GLI)-2012 reference equation is currently suggested for interpretation of spirometry results and a new local reference equation has been developed in South Korea. However, lung function profiles according to the different reference equations and their clinical relevance have not been identified in chronic obstructive pulmonary disease (COPD) patients. METHODS Our cross-sectional study evaluated Choi's, Korean National Health and National Examination Survey (KNHANES)-VI, and GLI-2012 reference equations. We estimated the percentages of predictive forced expiratory volume in one second (FEV1) and airflow limitation severity according to reference equations and analyzed their associations with patient reported outcomes (PROs): COPD assessment test (CAT) score, St. George's Respiratory Questionnaire for COPD patients (SGRQ-C) score, and six minute walk distance (6MWD). RESULTS In the eligible 2,180 COPD patients, lower predicted values of FEV1 and forced vital capacity (FVC) were found in GLI-2012 compared to Choi's and KNHANES-VI equations. GLI-2012 equation resulted in a lower proportion of patients being classified as FEV1 < 80% or FVC < 80% compared to the other equations. However, the Z-scores of FEV1 and FVC were similar between the KNHANES-VI and GLI-2012 equations. Three reference equations exhibited significant associations between FEV1 (%) and patient-reported outcomes (CAT score, SGRQ-C score, and 6MWD). CONCLUSION GLI-2012 reference equation may not accurately reflect FEV1 (%) in the Korean population, but the Z-score using GLI-2012 equation can be a viable option for assessing FEV1 and airflow limitation in COPD patients. Similar to the other two equations, the GLI-2012 equation demonstrated significant associations with PROs.
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Affiliation(s)
- Hyun Woo Lee
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Kyu Lee
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Yong-Il Hwang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hyewon Seo
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - June Hong Ahn
- Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sung-Ryeol Kim
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Hyun Jung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea
| | - Ki-Suck Jung
- Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kwang Ha Yoo
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Deog Kyeom Kim
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
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Al Risi E, Zadjali F, Mula-Abed WAS. Reference Ranges of Serum Anti-Müllerian Hormone in Healthy Reproductive-aged Omani Women. Oman Med J 2023; 38:e508. [PMID: 37476475 PMCID: PMC10354694 DOI: 10.5001/omj.2023.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 11/19/2022] [Indexed: 07/22/2023] Open
Abstract
Objectives Anti-Müllerian hormone (AMH), a glycoprotein that belongs to the transforming growth factor-beta superfamily, is important for women's health. We aimed to determine the age-specific reference range of serum AMH in healthy Omani women from reproductive ages to menopause. Methods This cross-sectional cohort study was conducted among a group of healthy 20-50 years old Omani women. The participants were required to have body mass index < 32 kg/m2, regular periods, no history of chronic illness, polycystic ovary syndrome, or gynecological operation. They were also required to not be using any hormonal contraceptive. Serum concentrations of AMH, follicle-stimulating hormone, luteinizing hormone, progesterone, and hemoglobin A1c were measured. AMH-age nomogram and AMH levels were compared between the six selected age groups. Results The subjects were 319 Omani women aged 20-50 years. Serum AMH concentrations were found to decrease progressively with increasing age. An exponential model defined as √AMH = 479.02 × 0.91age was selected to explain the reduction in AMH with age (R2 = 0.298). The median AMH levels were 26.61 pmol/L for those aged 20-25 years, 20.89 pmol/L for 26-30 years, 19.92 pmol/L for 31-35 years, 13.71 pmol/L for 36-40 years, 9.24 pmol/L for 41-45 years, and 0.68 pmol/L for 46-50 years. The recommended 2.5th to 97.5th percentiles of AMH level, as reference ranges for various age groups, were found to be: 10.63-55.64 pmol/L (20-25 years), 3.74-61.88 pmol/L (26-30 years), 5.49-47.56 pmol/L (31-35 years), 2.15-48.91 pmol/L (36-40 years), 0.92-41.26 pmol/L (41-45 years), and 0.14-5.10 pmol/L (46-50 years). Conclusions This study (the first in Oman) determined the age-specific reference ranges of serum AMH in healthy Omani women in the age range of 20-50 years.
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Affiliation(s)
- Elham Al Risi
- Department of Pathology and Blood Bank, Sohar Hospital, Sohar, Oman
| | - Fahad Zadjali
- Center of Studies and Research, Ministry of Health, Muscat, Oman
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Schorling DC, Rawer R, Kuhlmann I, Müller C, Pechmann A, Kirschner J. Mechanographic analysis of the timed 4 stair climb test - methodology and reference data of healthy children and adolescents. J Musculoskelet Neuronal Interact 2023; 23:4-25. [PMID: 36856096 PMCID: PMC9976186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVES The timed 4 stair climb test (4SC) is an accepted and widely used tool to assess motor function of patients with neuromuscular diseases. We aimed to establish reference data for the 4SC, and for mechanographic analysis of ascent (4SC-Up) and descent (4SC-Dn) in healthy children and adolescents. METHODS We used a custom-made staircase measuring device to assess force, power and velocity during the ascent of 4 stairs in healthy subjects. Secondary outcome measures included mechanographic analyses such as the Chair-Rising-test and the myometric Grip Force-test. RESULTS Data of 288 participants aged 4 to 16 years (144 males, 144 females) were analyzed. A simple algorithm integrating the minimal applied force was used to compensate for different movement strategies. Percentiles for average power, force and horizontal velocity were calculated. While results of the 4SC-Up test showed no age or gender dependency, we found 4SC-Dn results to be age dependent. Mean device measured times were significantly shorter than manually measured times (mean difference -0.19 s; p<0.001). CONCLUSIONS Mechanographic analysis of the 4SC appears to be a promising tool for evaluation of muscle strength and function of the lower extremities as it enables physically exact measurements of a highly relevant activity of daily living.
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Affiliation(s)
- David C Schorling
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | | | - Imke Kuhlmann
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Cornelia Müller
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Astrid Pechmann
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Janbernd Kirschner
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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Punnose J, Malhotra RK, Sukhija K, Rijhwani RM, Sharma A, Choudhary N, Vij P, Joseph R. Establishing Trimester-Specific Haemoglobin A1c Reference Intervals in Pregnant Women: A retrospective study of healthy South Asian women with normal pregnancy outcomes. Sultan Qaboos Univ Med J 2023; 23:81-89. [PMID: 36865418 PMCID: PMC9974038 DOI: 10.18295/squmj.3.2022.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 12/05/2021] [Accepted: 02/20/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives This study aimed to define trimester-specific haemoglobin A1c (HbA1c) reference intervals in healthy, pregnant South Asian women. Methods This retrospective study was conducted at St. Stephen's Hospital, Delhi, India, between January 2011 and December 2016. Healthy pregnant women were compared to a control group of healthy non-pregnant women. Pregnant participants had term deliveries of babies with appropriate gestational weights. The HbA1c levels were calculated in terms of non-parametric 2.5 and 97.5 percentiles for women in first (T1), second (T2) and third (T3) trimester groups. Statistical tests were used to obtain the normal HbA1c reference values and were considered significant when P <0.05. Results This study included a total of 1,357 healthy pregnant women and a control group of 67 healthy, non-pregnant women. Pregnant women had a median HbA1c of 4.8% (4-5.5%) or 32 mmol/mol (20-39 mmol/mol); non-pregnant women had a median HbA1c of 5.1% (4-5.7%) or 29 mmol/mol (20-37 mmol/mol; P <0.001). The HbA1c levels for the T1, T2 and T3 groups were 4.9% (4.1-5.5%) or 30 mmol/mol (21-37 mmol/mol), 4.8% (4.5-5.3%) or 29 mmol/mol (20-34 mmol/mol) and 4.8% (3.9-5.6%) or 29 mmol/mol (19-38 mmol/mol), respectively. The HbA1c values were significant when comparing T1 versus T2 (P <0.001), T1 versus T3 (P = 0.002) and T1 versus the non-pregnant group (P = 0.001). However, T2 versus T3 was not significant (P = 0.111). Conclusion Compared to non-pregnant women, HbA1c levels were lower in pregnant women, despite women in the T2 and T3 groups having a higher body mass index than the women in the T1 and non-pregnant groups. Further research is recommended to understand the factors responsible and validate these findings.
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Affiliation(s)
- John Punnose
- Department of Endocrinology, St. Stephen’s Hospital, New Delhi, India,Corresponding Author’s e-mail:
| | | | - Komal Sukhija
- Department of Endocrinology, St. Stephen’s Hospital, New Delhi, India
| | | | - Asha Sharma
- Department of Obstetrics & Gynecology, St. Stephen’s Hospital, New Delhi, India
| | - Naimaa Choudhary
- Department of Obstetrics & Gynecology, St. Stephen’s Hospital, New Delhi, India
| | - Prassan Vij
- Department of Reproductive Medicine, St. Stephen’s Hospital, New Delhi, India
| | - Renuka Joseph
- Department of Biochemistry, St. Stephen’s Hospital, New Delhi, India
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de Souza Moreira B, de Souza Andrade AC, Lustosa Torres J, de Souza Braga L, de Carvalho Bastone A, de Melo Mambrini JV, Lima-Costa MF. Nationwide handgrip strength values and factors associated with muscle weakness in older adults: findings from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). BMC Geriatr 2022; 22:1005. [PMID: 36585620 PMCID: PMC9805021 DOI: 10.1186/s12877-022-03721-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Handgrip strength (HGS) is a simple, quick, inexpensive, and highly reliable method for the assessment of muscle strength in clinical practice and epidemiological studies. This study aimed at describing the HGS values by age group and sex in Brazilians aged 50 years and over, determining age group- and sex-specific cutoff points for muscle weakness, and investigating sociodemographic and anthropometric variables associated with muscle weakness for each sex. METHODS Data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed. HGS was measured in the dominant hand using a hydraulic hand dynamometer. Fractional polynomial regression models were fitted to estimate the percentiles (P5, P10, P20, P25, P50, P75, P90, and P95) of HGS by age group and sex. The P20 of the maximum HGS by age group and sex was used to define muscle weakness. Associations between sociodemographic (racial self-classification, place of residence, schooling, and monthly household income per capita in tertiles) and anthropometric variables (body mass index and waist circumference) and muscle weakness, by sex, were evaluated using logistic regression. RESULTS The analytical sample included 7905 participants (63.1 ± 9.1 years; 60% women). HGS reduced with increasing age in both sexes. Men presented higher HGS than women in all age groups. The cutoff points for muscle weakness ranged from 28 to 15 kg for men and from 17 to 9 kg for women. In the adjusted analyses, low schooling (0-4 years) was positively associated with muscle weakness in both sexes (in men, odds ratio (OR) 2.45, 95% confidence interval (CI) 1.46-4.12; in women, OR 1.90, 95%CI 1.18-3.06). Low and middle monthly household income per capita also had a positive association with muscle weakness among women (OR 1.78, 95%CI 1.37-2.32; OR 1.32, 95%CI 1.01-1.73, respectively). Overweight had a negative association with muscle weakness among men (OR 0.66, 95%CI 0.52-0.83), and obesity was inversely associated with muscle weakness in both sexes (in men, OR 0.49, 95%CI 0.31-0.78; in women, OR 0.69, 95%CI 0.52-0.92). CONCLUSIONS This study provides HGS values and cutoff points for muscle weakness by age group and sex from a nationally representative sample of older Brazilian adults. The variables associated with muscle weakness slightly differed between men and women. HGS values and cutoff points generated can be used as benchmarks in clinical settings and foster future epidemiological research.
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Affiliation(s)
- Bruno de Souza Moreira
- grid.8430.f0000 0001 2181 4888Núcleo de Estudos Em Saúde Pública E Envelhecimento, Universidade Federal de Minas Gerais E Fundação Oswaldo Cruz - Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Cristina de Souza Andrade
- grid.411206.00000 0001 2322 4953Programa de Pós-Graduação Em Saúde Coletiva, Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso Brazil
| | - Juliana Lustosa Torres
- grid.8430.f0000 0001 2181 4888Núcleo de Estudos Em Saúde Pública E Envelhecimento, Universidade Federal de Minas Gerais E Fundação Oswaldo Cruz - Minas Gerais, Belo Horizonte, Minas Gerais, Brazil ,grid.8430.f0000 0001 2181 4888Faculdade de Medicina, Programa de Pós-Graduação Em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana de Souza Braga
- grid.8430.f0000 0001 2181 4888Núcleo de Estudos Em Saúde Pública E Envelhecimento, Universidade Federal de Minas Gerais E Fundação Oswaldo Cruz - Minas Gerais, Belo Horizonte, Minas Gerais, Brazil ,grid.8430.f0000 0001 2181 4888Faculdade de Medicina, Programa de Pós-Graduação Em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alessandra de Carvalho Bastone
- grid.411287.90000 0004 0643 9823Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Minas Gerais Brazil
| | - Juliana Vaz de Melo Mambrini
- grid.418068.30000 0001 0723 0931Programa de Pós-Graduação Em Saúde Coletiva, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Fernanda Lima-Costa
- grid.8430.f0000 0001 2181 4888Núcleo de Estudos Em Saúde Pública E Envelhecimento, Universidade Federal de Minas Gerais E Fundação Oswaldo Cruz - Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Orçun A, Yildiz Z, Köroğlu Dağdelen L. Pediatric reference intervals for Free Testosterone, 17-OH Progesterone, Androstenedione, and IGF-1 with chemiluminescence immunoassay. Steroids 2022; 186:109078. [PMID: 35792152 DOI: 10.1016/j.steroids.2022.109078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/21/2022] [Accepted: 06/30/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The aim of the study was to produce age and sex specific pediatric reference intervals (RIs) on a fully automated chemiluminescent immunoassay (CLIA) system. MATERIAL AND METHOD A total of 1586 patients' remnant sera were included in the study and free testosterone (FT), 17-OH progesterone (17OHP), androstenodione (A4) and insulin-like growth factor-1 (IGF-1) parameters were measured on MAGLUMI 2000 (Shenzhen New Industries Biomedical Engineering Co., Ltd. (Snibe), Shenzhen, China) CLIA analyser. After appropriate age and gender partitioning, specific intervals were calculated according to Clinical Laboratory Standart Institute's (CLSI) C28-A3 protocol. RESULTS All analytes showed sex and age dependent concentrations requiring several subgroups with specific reference intervals. 17OHP and A4 were found high with birth, declined thereafter: 17OHP by the end of 12 months and A4 by 6 months. So this period was also partitioned for these two hormones. All showed gradual increases by the end of 18 years. 17OHP, A4 and IGF-1 of girls were higher than boys around puberty as the result of earlier sexual development and maturation. FT values of boys and girls didn't differ from each other upto 10 years of age but boys had significantly higher values than girls afterwards. IGF-1 values gradually increase in both sexes upto the ages of 13, girls with significantly higher values than boys. In 13-18 years no significant gender difference was found. CONCLUSIONS We present method specific pediatric RIs, which are comparable with medical literature, necessary for interpretation of patient results.
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Affiliation(s)
- A Orçun
- Dr Lutfi Kirdar City Hospital, Department of Biochemistry Laboratory, İstanbul, Turkey.
| | - Z Yildiz
- Dr Lutfi Kirdar City Hospital, Department of Biochemistry Laboratory, İstanbul, Turkey
| | - L Köroğlu Dağdelen
- Dr Lutfi Kirdar City Hospital, Department of Biochemistry Laboratory, İstanbul, Turkey
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Pilz F, Vill K, Rawer R, Bonfert M, Tacke M, Heussinger N, Müller-Felber W, Blaschek A. Mechanography in children: pediatric references in postural control. J Musculoskelet Neuronal Interact 2022; 22:431-454. [PMID: 36458382 PMCID: PMC9716303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To establish pediatric age- and sex-specific references for measuring postural control with a mechanography plate in a single centre, prospective, normative data study. METHODS 739 children and adolescents (396 male/343 female) aged 4 to 17 years were studied. Each participant completed the following test sequence three times: Romberg, semi-tandem, tandem, each with eyes open and closed, and a one-leg stand with eyes open, and a single two-legged jump. Normal ranges were determined based on percentile calculations using the LMS method. Results from the two-legged jump were compared to a reference population the single two-legged jump (s2LJ) assessment in 2013. RESULTS 38 different equilibrium parameters calculated were analysed. Of all parameters Path Length, vCoFmean, Equilibrium Score and Sway Angle showed a low variation within the same age group but high dependency on age and were thus chosen for automated balance assessment. CONCLUSION Standard values of postural control in healthy children derived from automated balance testing using a mechanography plate were successfully acquired and a subset of parameters for automated balance assessment identified.
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Affiliation(s)
- Franziska Pilz
- Children’s Hospital, University Augsburg, Augsburg, Germany,Corresponding author: Astrid Blaschek, Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children’s Hospital, Lindwurmstr. 4, 80337 München, Germany E-mail:
| | - Katharina Vill
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| | | | - Michaela Bonfert
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| | - Moritz Tacke
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| | - Nicole Heussinger
- Paracelsus Medical University, Department of Pediatrics, Nuremberg General Hospital, Germany
| | - Wolfgang Müller-Felber
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
| | - Astrid Blaschek
- Ludwig Maximilian University of Munich (LMU), Hauner Children’s Hospital, Department of Paediatric Neurology and Developmental Medicine, Munich, Germany
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Vissing Landgrebe A, Asp Vonsild Lund M, Lausten-Thomsen U, Frithioff-Bøjsøe C, Esmann Fonvig C, Lind Plesner J, Aas Holm L, Jespersen T, Hansen T, Christian Holm J. Population-based pediatric reference values for serum parathyroid hormone, vitamin D, calcium, and phosphate in Danish/North-European white children and adolescents. Clin Chim Acta 2021; 523:483-490. [PMID: 34695445 DOI: 10.1016/j.cca.2021.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 10/16/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Parathyroid hormone (PTH) and vitamin D are essential hormones in bone metabolism, especially during pediatric growth. Vitamin D insufficiency is often asymptomatic and is prevalent in high-latitude countries. METHODS In a Danish population-based cohort of 2211 6-18-year-olds, sex- and age-specific pediatric reference values for fasting concentrations of intact serum PTH, vitamin D (25-hydroxycholecalciferol, 25-OH-D), total calcium, and phosphate were generated in accordance with Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. The effect of season on these biomarkers of bone metabolism was evaluated. RESULTS In boys, PTH concentrations increased with age, while the vitamin D and phosphate concentrations decreased (all p < .001). In girls, a peak in PTH concentrations and a nadir in vitamin D concentrations were observed in the 10-14-year-olds (both p < .001). Calcium and phosphate decreased with age for both sexes (girls: both p < .001; boys calcium: p < .05, boys phosphate: p < .001). Vitamin D was 20% lower in winter than summer for both sexes (both p < .001). Individuals with vitamin D sufficiency (25-OH-D > 50 nmol/L) exhibited a 5% lower level of PTH compared to the whole sample population (p < .001). CONCLUSION The concentrations of PTH, vitamin D, calcium, and phosphate vary during childhood and adolescence, and is dependent on sex and season. These factors should be considered when screening for and treating imbalances in bone metabolism.
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Affiliation(s)
- Ann Vissing Landgrebe
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Asp Vonsild Lund
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Lausten-Thomsen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christine Frithioff-Bøjsøe
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Cilius Esmann Fonvig
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Kolding Hospital a part of Lillebælt Hospital, Kolding, Denmark
| | - Johanne Lind Plesner
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Louise Aas Holm
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Jespersen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jens Christian Holm
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Åhman HB, Berglund L, Cedervall Y, Giedraitis V, McKee KJ, Rosendahl E, Åberg AC. Timed "Up & Go" Dual-Task Tests: Age- and Sex-Specific Reference Values and Test-Retest Reliability in Cognitively Healthy Controls. Phys Ther 2021; 101:6323192. [PMID: 34272869 PMCID: PMC8557829 DOI: 10.1093/ptj/pzab179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/22/2021] [Accepted: 05/20/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of the study was to establish reference values for the Uppsala-Dalarna Dementia and Gait (UDDGait) Timed "Up & Go" dual-task (TUGdt) test variables in cognitively healthy adults and to assess these variables' test-retest reliability. METHODS For reference values, 166 participants were recruited with approximately equal numbers and proportions of women and men in the age groups 50 to 59, 60 to 69, 70 to 79, and 80+ years (mean age = 70 years, age range = 50-91 years, 51% women). For reliability testing, 43 individuals (mean age = 69 years, age range = 50-89 years, 51% women) were recruited. Two dt tests were carried out: TUGdt naming animals and TUGdt months backward, representing 8 test variables: time scores, costs (the relative difference between single-task and dt time scores), "number of animals," "number of months," "animals/10 seconds ," and "months/10 seconds ." Reference ranges for the variables were established by quantile regression in age- and sex-specific groups. For reliability, intraclass correlation coefficients (ICCs), standard error of measurement, minimal detectable change, and Bland-Altman plots were used. RESULTS Reference values for the TUGdt test variables are presented for the 2.5th and 97.5th percentiles. The reliability of TUGdt time scores was excellent (ICCs between 0.85 and 0.86). "Number of animals" and "animals/10 seconds" as well as "months/10 seconds" showed fair to good levels of reliability (ICCs between 0.45 and 0.58), whereas the reliability for both cost measures and "number of months" was poor (ICCs between 0.34 and 0.39). CONCLUSION Normative reference values, potentially useful for clinical and research purposes, were presented in 4 age- and sex-specific groups from 50 years and older. Reliability for the test variables varied between poor and excellent, the lower estimates partly explained by some variables being the ratio of 2 other variables. In UDDGait, TUGdt tests are intended for diagnostic and predictive purposes, for which these tests are promising and require further investigations. IMPACT Normative reference values and test-retest reliability results for the UDDGait TUGdt test variables were presented. These results should be useful for both clinical and research purposes.
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Affiliation(s)
- Hanna B Åhman
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden,Address all correspondence to Ms Åhman at:
| | - Lars Berglund
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Ylva Cedervall
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Vilmantas Giedraitis
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Kevin J McKee
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Anna Cristina Åberg
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden,School of Health and Welfare, Dalarna University, Falun, Sweden
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11
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Köse S, Avşar G. Impact of Early and Regular Mobilization on Vital Signs and Oxygen Saturation in Patients Undergoing Open-Heart Surgery. Braz J Cardiovasc Surg 2020; 36:506-514. [PMID: 33355786 PMCID: PMC8522321 DOI: 10.21470/1678-9741-2019-0481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction This quasi-experimental study aimed to evaluate the impact of early and regular mobilization on vital signs and oxygen saturation in open-heart surgery patients. Methods The study universe comprised patients undergoing open-heart surgery in the cardiovascular intensive care unit of a heart center. The study sample consisted of patients who underwent open-heart surgery from November 2016 to April 2017, met the inclusion criteria, and voluntarily agreed to participate in the study. The study included 75 patients. Of these, 67 completed the mobilization program in two days, starting on the first postoperative day. Each patient was mobilized three times: twice on the first postoperative day and once on the second postoperative day. Vital signs and oxygen saturation for each patient were measured 10 minutes before and 20 minutes after each mobilization. Results The difference between pulse and systolic blood pressure values measured before and after the first mobilization was statistically significant (P<0.05). In addition, the difference between the mean systolic blood pressure values before the first mobilization and after the third mobilization (123.43±14.09 mmHg and 117.94±14.05 mmHg, respectively) was statistically significant (P<0.05). The other parameters measured in relation to the mobilizations were in the normal range. Conclusion Early and frequent mobilization did not cause vital signs and oxygen saturation to deviate from normal limits in open-heart surgery patients.
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Affiliation(s)
- Sema Köse
- Nursing Services Directorate, Coordinator Nurse, Atatürk University Hospital, Erzurum, Turkey
| | - Gülçin Avşar
- Department of Nursing Fundamentals, Atatürk University Faculty of Nursing, Erzurum, Turkey
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Kurt IH, Şen Ö, Kuçükosmanoğlu M, Salkın FÖ, Urgun ÖD, Şahin Ş, Çolak S, Kılıç S. The Influence of Aortic Pulse Wave Velocity on Short-Term Functional Capacity in Patients with Mild Paravalvular Regurgitation Following Transcatheter Aortic Valve Implantation. Braz J Cardiovasc Surg 2020; 35:504-511. [PMID: 32864931 PMCID: PMC7454626 DOI: 10.21470/1678-9741-2019-0454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Recently, the clinical significance of mild paravalvular aortic regurgitation (PAR) has been evaluated and suggested that it can be predictor of clinical outcomes. In our study, we aimed to investigate the interaction of aortic pulse wave velocity (PWV) and mild PAR and their effects on the functional status of patients after transcatheter aortic valve implantation (TAVI). METHODS A total of 109 consecutive patients with symptomatic severe aortic stenosis were enrolled prospectively. After TAVI procedure, they were divided in to three groups according to PAR and PWV measurements. Patients without PAR were defined as the NonePAR group (n=60), patients with mild PAR and normal PWV were defined as the MildPAR-nPWV group (n=23), and patients with mild PAR and high PWV were defined as the MildPAR-hPWV group (n=26). RESULTS Compared with other groups, the MildPAR-hPWV group was older (P<0.001), hypertensive (P=0.015), and had a higher pulse pressure (P=0.018). In addition to PWV, this group had lower aortic regurgitation index (ARI) (P=0.010) and higher rate of New York Heart Association (NYHA) class II (at least) patients (P<0.001) in 30-day follow-up period. On multivariate regression analysis, the MildPARhPWV group (odds ratio=1.364, 95% confidence interval 1.221-1.843; P=0.011) as well as N-terminal-pro-brain natriuretic peptide levels and ARI were independently related with 30-day functional NYHA classification. However, NonePAR or MildPAR-nPWV group was not an independent predictor of early functional status. CONCLUSION It was concluded that high PWV may adversely affect early functional status in patients with mild PAR in contrast to normal values following TAVI.
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Affiliation(s)
- Ibrahim Halil Kurt
- Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana, Turkey
| | - Ömer Şen
- Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana, Turkey
| | - Mehmet Kuçükosmanoğlu
- Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana, Turkey
| | - Fatma Özge Salkın
- Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana, Turkey
| | - Örsan Deniz Urgun
- Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana, Turkey
| | - Şeyda Şahin
- Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana, Turkey
| | - Salih Çolak
- Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana, Turkey
| | - Salih Kılıç
- Department of Cardiology, Health Sciences University, Adana Research and Training Hospital, Adana, Turkey
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Macedo Silva S, Carvalho A, Lopes-Pereira M, Fernandes V. [Subclinical Hypothyroidism on the Elderly]. ACTA MEDICA PORT 2018; 31:766-773. [PMID: 30684374 DOI: 10.20344/amp.10991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/02/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Subclinical hypothyroidism, defined as an increase of thyroid stimulating hormone levels with normal levels of thyroid hormones, could have a multiorgan impact. There seem to be differences in the elderly (over 65 years of age) which indicate that there should be a different approach in terms of diagnosis and the treatment. MATERIAL AND METHODS Electronic database search and narrative bibliographical review. RESULTS Different case studies showing the multiorgan consequences of subclinical hypothyroidism suggest that, in the elderly, there is a minor impact or even a lack of repercussion, especially in those over 80 - 85 years old. Additionally, there is evidence indicating that the levels of thyroid stimulating hormone rise with the age of the patient. The standard treatment, in the beginning, is a low dose of levothyroxine when the levels of thyroid stimulating hormone are over 10.0 mIU/L, when there are noticeable symptoms or positive anti-thyroid antibodies. However, the treatment is not consensual when the levels of thyroid stimulating hormone are between 4.5 and 10.0 mIU/L, in such a way that the TRUST study concluded that no benefits have outcome from treating these patients. DISCUSSION The non-definition of the reference range and the age gap are the key factors that contribute the most to biased results. However, there is consensus regarding non-treatment of mild thyroid dysfunctions (4.5 - 7.0 mIU/L) in the elderly, particularly above 80 years of age. Nevertheless, for positive anti-thyroid antibodies, suggestive ultrasound changes or iatrogenic side effects, the reference level should be 4.5 mIU/L. CONCLUSION The general impact of subclinical hypothyroidism is different in elderly people, meaning that an individualized therapeutic approach and long-term monitoring is the appropriate strategy.
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Affiliation(s)
| | | | | | - Vera Fernandes
- Serviço de Endocrinologia. Hospital de Braga. Braga. Portugal
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Messchendorp AL, van Londen M, Taylor JM, de Borst MH, Navis G, Casteleijn NF, Gaillard CA, Bakker SJ, Gansevoort RT. Kidney Function Reserve Capacity in Early and Later Stage Autosomal Dominant Polycystic Kidney Disease. Clin J Am Soc Nephrol 2018; 13:1680-1692. [PMID: 30254028 PMCID: PMC6237049 DOI: 10.2215/cjn.03650318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 08/20/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES It is assumed that in autosomal dominant polycystic kidney disease (ADPKD), kidney function remains in the normal range for several decades because of hyperfiltration of remnant nephrons. In this study, we investigate the extent to which patients with ADPKD hyperfilter. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In this cross-sectional study, we measured GFR as urinary clearance using continuous infusion of 125I-iothalamate. Kidney function reserve capacity was determined as increase in measured GFR after adding a dopamine infusion of 4.4-6 mg/h. Potential kidney donors were used as healthy controls and matched by age and sex to patients with ADPKD for comparisons across age groups and CKD stages. Hyperfiltration was defined by a loss of kidney function reserve capacity compared with healthy controls. RESULTS A total of 300 participants were studied. In the youngest age group (18-29 years), measured GFR was not different between patients with ADPKD and healthy controls (103±21 versus 111±9 ml/min per 1.73 m2; P=0.14). In this age group kidney function reserve capacity was higher compared with healthy controls (11.1%±8.3% versus 5.3%±6.5%; P=0.04). Moreover, kidney function reserve capacity was similar to healthy controls in patients with ADPKD with early-stage disease (eGFR≥60 ml/min per 1.73 m2), either overall or when divided into fast or slow progressors according to their Mayo height-adjusted total kidney volume class. However, in patients with ADPKD, lower measured GFR was associated with lower kidney function reserve capacity (β=1.0 [95% confidence interval, 0.5 to 1.5] % per 10 ml/min per 1.73 m2; P<0.001). Kidney function reserve capacity was therefore lower compared with healthy controls at older age and later CKD stages. CONCLUSIONS Patients with early-stage ADPKD, either classified as having rapidly or slowly progressive disease, are able to increase their GFR in response to dopamine. Hyperfiltration, defined by a loss of kidney function reserve capacity, may therefore not be an early phenomenon in ADPKD.
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Affiliation(s)
| | | | | | | | | | - Niek F. Casteleijn
- Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Carlo A.J.M. Gaillard
- Division of Internal Medicine and Dermatology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | | | | | - on behalf of the DIPAK Consortium
- Departments of Nephrology and
- Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
- Division of Internal Medicine and Dermatology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
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Jiménez-Ramírez C, Rosas-Montañez C, Romero-Vázquez J, Juárez-Pérez CA, Aguilar-Madrid G, Romero-Leguizamo H, Castillo-Mercado I. [Determination of reference ranges for coagulation tests in Mexican-mestizo population]. Rev Med Inst Mex Seguro Soc 2018; 56:231-238. [PMID: 30376272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND It is necessary to establish biological parameters for each population. OBJECTIVE To establish reference values for prothrombin time (PT), activated partial thromboplastin time (PTT) and fibrinogen in healthy population and to determine intra- and inter-assay concordance. METHODS Cross-sectional study that included 204 women and 202 men from the Blood Donor service. Coagulation tests were carried out in order to obtain reference ranges. All procedures were made according to the Clinical & Laboratory Standards Institute guidelines. RESULTS Mean PT, PTT and fibrinogen were 14.1 s, 28.8 s and 381 mg/dL in men, and 15.1 s, 29.0 s and 381 mg/dL in women. The proposed PT, PTT and fibrinogen reference ranges for men were 12.7 to 16.3 s, 24.2 to 36.3 s and 239 to 276 mg/dL, respectively; for women, 12.7 to 16.6 s, 23.5 to 35.4 s and 276 to 598 mg/dL. The latter was statistically significant (p ≤ 0.001). CONCLUSIONS Reference values for blood coagulation tests were determined. This is of great importance for fast medical diagnosis and treatment. The results from this study can be adopted by other clinic laboratories after appropriate validation procedures.
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Affiliation(s)
| | | | | | | | | | | | - Isabel Castillo-Mercado
- Instituto Mexicano del Seguro Social, Hospital de Traumatología “Victorio de la Fuente Narváez”, Laboratorio de Análisis Clínicos. Ciudad de México, México
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Tian XY, Liu CH, Wang DX, Ji XL, Shi H, Zheng CY, Xie MS, Xiao W. Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60-84 Years. Chin Med J (Engl) 2018; 131:1016-1022. [PMID: 29553052 PMCID: PMC5937307 DOI: 10.4103/0366-6999.227840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: The interpretation of spirometry varies on different reference values. Older people are usually underrepresented in published predictive values. This study aimed at developing spirometric reference equations for elderly Chinese in Jinan aged 60–84 years and to compare them to previous equations. Methods: The project covered all of Jinan city, and the recruitment period lasted 9 months from January 1, 2017 to September 30, 2017, 434 healthy people aged 60–84 years who had never smoked (226 females and 208 males) were recruited to undergo spirometry. Vital capacity (VC), forced VC (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, FEV1/VC, FEV6, peak expiratory flow, and forced expiratory flow at 25%, 50%, 75%, and 25–75% of FVC exhaled (FEF25%, FEF50%, FEF75%, and FEF25–75%) were analyzed. Reference equations for mean and the lower limit of normal (LLN) were derived using the lambda-mu-sigma method. Comparisons between new and previous equations were performed by paired t-test. Results: New reference equations were developed from the sample. The LLN of FEV1/FVC, FEF25–75% computed using the 2012-Global Lung Function Initiative (GLI) and 2006-Hong Kong equations were both lower than the new equations. The biggest degree of difference for FEV1/FVC was 19% (70.46% vs. 59.29%, t = 33.954, P < 0.01) and for maximal midexpiratory flow (MMEF, equals to FEF25–75%) was 22% (0.82 vs. 0.67, t = 21.303, P < 0.01). The 1990-North China and 2009-North China equations predicted higher mean values of FEV1/FVC and FEF25–75% than the present model. The biggest degrees of difference were −4% (78.31% vs. 81.27%, t = −85.359, P < 0.01) and −60% (2.11 vs. 4.68, t = −170.287, P < 0.01), respectively. Conclusions: The newly developed spirometric reference equations are applicable to elderly Chinese in Jinan. The 2012-GLI and 2006-Hong Kong equations may lead to missed diagnoses of obstructive ventilatory defects and the small airway dysfunction, while traditional linear equations for all ages may lead to overdiagnosis.
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Affiliation(s)
- Xin-Yu Tian
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - Chun-Hong Liu
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - De-Xiang Wang
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - Xiu-Li Ji
- Department of Pulmonary Disease, Jinan Traditional Chinese Medicine Hospital, Jinan, Shandong 250012, China
| | - Hui Shi
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - Chun-Yan Zheng
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - Meng-Shuang Xie
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
| | - Wei Xiao
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China
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Yeshanew AG, GebreSilasie YM, Mengesha HT. Establishment of Immunohematological Reference Values among HIV Sero-negative Pregnant Women at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. Ethiop J Health Sci 2018; 27:641-650. [PMID: 29487473 PMCID: PMC5811943 DOI: 10.4314/ejhs.v27i6.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Normal pregnancy is characterized by profound changes in almost every organ and system. Immunohematological parameters are important in clinical practice for the assessment of health and disease. Therefore, this study was aimed to establish immunohematological reference range among HIV sero-negative pregnant women. Methods A cross-sectional study was conducted among HIV sero-negative pregnant women at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia, from 20/1-30/6/ 2016. Whole blood was collected and immunological and hematological parameters were measured following the standard procedure. Data were entered in to Epi Info version 3.5, checked for completeness and exported to SPSS version 20 software for analysis. The mean ± SD and 95% Confidence Interval (95% CI) values were calculated for different immunohematological parameters. Results A total of 400 women with mean age ±SD (27.3 ±4.7) ranging from 18-40 years were enrolled. The mean ± SD reference value of white blood cells count with 95% CI was 8.3 ±2.3 (8.1-8.6) ×109 cells/L and for CD4+, CD8+, and CD4 to CD8 ratio cells absolute count with 95% CI were 906 ±404 (867-946), 698± 378 (662-736) cell/µl, and 1.5±0.9 (1.4-1.6), respectively.The mean ± SD reference values for red blood cells count with 95% CI was 4.5±0.5(4.4-4.5) 1012/L, for hemoglobin 14±7.2(13.3-14.7) gm/dl, and for hematocrite was 39.5± 4(39-39.9). Conclusions These values were lower than the one from developed countries but not lower than the one from other African studies. It suggests the need for further large study.
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Affiliation(s)
- Addisu Gize Yeshanew
- Microbiolgy department, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Hirut Tadesse Mengesha
- Laboratory department, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Abstract
A reliable determination of blood pH, PCO2, and [HCO3-] is necessary for assessing the acid-base status of a patient. However, most acid-base disorders are first recognized through abnormalities in serum total CO2 concentration ([TCO2]) in venous blood, a surrogate for [HCO3-]. In screening patients on the basis of serum [TCO2], we have been concerned about the wide limits of normal for serum [TCO2], 10-13 mEq/L, reported by many clinical laboratories. Indeed, we have encountered patients with serum [TCO2] values within the lower or upper end of the normal range of the reporting laboratory, who subsequently were shown to have a cardinal acid-base disorder.Here, we present a patient who had a serum [TCO2] within the lower end of the normal range of the clinical laboratory, which resulted in delayed diagnosis of a clinically important "hidden" acid-base disorder. To better define the appropriate limits of normal for serum [TCO2], we derived the expected normal range in peripheral venous blood in adults at sea level from carefully conducted acid-base studies. We then compared this range, 23 to 30 mEq/L, to that reported by 64 clinical laboratories, 2 large commercial clinical laboratories, and the major textbook of clinical chemistry. For the most part, the range in the laboratories we queried was substantially different than that we derived and that published in the textbook, with some laboratories reporting values as low as 18-20 mEq/L and as high as 33-35 mEq/L. We conclude that the limits of values of serum [TCO2] reported by clinical laboratories are very often inordinately wide and not consistent with the range of normal expected in healthy individuals at sea level. We suggest that the limits of normal of serum [TCO2] at sea level be tightened to 23-30 mEq/L. Such correction will ensure recognition of the majority of "hidden" acid-base disorders.
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Affiliation(s)
- Jeffrey A. Kraut
- Medical and Research Services, Veterans Administration Greater Los Angeles Healthcare System, University of California at Los Angeles Membrane Biology Laboratory
- Division of Nephrology, Veterans Administration Greater Los Angeles Healthcare System and David Geffen School of Medicine, Los Angeles, California
| | - Nicolaos E. Madias
- Division of Nephrology, Department of Medicine, St. Elizabeth’s Medical Center, Boston, Massachusetts; and
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
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Jo BS, Myong JP, Rhee CK, Yoon HK, Koo JW, Kim HR. Reference Values for Spirometry Derived Using Lambda, Mu, Sigma (LMS) Method in Korean Adults: in Comparison with Previous References. J Korean Med Sci 2018; 33:e16. [PMID: 29215803 PMCID: PMC5729644 DOI: 10.3346/jkms.2018.33.e16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/14/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The present study aimed to update the prediction equations for spirometry and their lower limits of normal (LLN) by using the lambda, mu, sigma (LMS) method and to compare the outcomes with the values of previous spirometric reference equations. METHODS Spirometric data of 10,249 healthy non-smokers (8,776 females) were extracted from the fourth and fifth versions of the Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2009; V, 2010-2012). Reference equations were derived using the LMS method which allows modeling skewness (lambda [L]), mean (mu [M]), and coefficient of variation (sigma [S]). The outcome equations were compared with previous reference values. RESULTS Prediction equations were presented in the following form: predicted value = e{a + b × ln(height) + c × ln(age) + M - spline}. The new predicted values for spirometry and their LLN derived using the LMS method were shown to more accurately reflect transitions in pulmonary function in young adults than previous prediction equations derived using conventional regression analysis in 2013. There were partial discrepancies between the new reference values and the reference values from the Global Lung Function Initiative in 2012. CONCLUSION The results should be interpreted with caution for young adults and elderly males, particularly in terms of the LLN for forced expiratory volume in one second/forced vital capacity in elderly males. Serial spirometry follow-up, together with correlations with other clinical findings, should be emphasized in evaluating the pulmonary function of individuals. Future studies are needed to improve the accuracy of reference data and to develop continuous reference values for spirometry across all ages.
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Affiliation(s)
- Bum Seak Jo
- Department of Occupational and Environmental Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Jun Pyo Myong
- Department of Occupational and Environmental Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Chin Kook Rhee
- Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Hyoung Kyu Yoon
- Department of Internal Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea
| | - Jung Wan Koo
- Department of Occupational and Environmental Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Hyoung Ryoul Kim
- Department of Occupational and Environmental Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
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Mehri A, Mousavi SZ, Kamali M, Maroufizadeh S. Normative data for the Pyramids and Palm Trees Test in literate Persian adults. Iran J Neurol 2018; 17:18-23. [PMID: 30186555 PMCID: PMC6121202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Semantic test of Pyramids and Palm Trees (PPT) is the most common test for assessing memory. Since this test is related to language and culture, normative data in different populations are needed. Methods: This study was conducted on 270 literate men and women Persian adults aged from 20 to 69 years. Subjects must select a picture or word between two pictures or words that was closer to target. Results: The word score was significantly positively correlated with the picture score (r = 0.508, P < 0.001). Word scores (median = 50, Q1-Q3 = 49-51) were higher than the picture scores (median = 50, Q1-Q3 = 48-51), although the difference was small (P < 0.001). Conclusion: Demographic variables such as age, gender, and level of education were not significant predictors for both versions in Persian population.
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Affiliation(s)
- Azar Mehri
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyede Zohreh Mousavi
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kamali
- Rehabilitation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saman Maroufizadeh
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research, Tehran, Iran
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van der Sande NG, Visseren FL, van der Graaf Y, Nathoe HM, de Borst GJ, Leiner T, Blankestijn PJ. Relation between Kidney Length and Cardiovascular and Renal Risk in High-Risk Patients. Clin J Am Soc Nephrol 2017; 12:921-928. [PMID: 28487344 PMCID: PMC5460708 DOI: 10.2215/cjn.08990816] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 02/15/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Kidney length is often measured during routine abdominal ultrasonography and may be of use to identify patients at high vascular and renal risk. We aimed to explore patient characteristics related to kidney length, from which reference values were derived, and evaluate the relationship between kidney length and the risk of cardiovascular events and ESRD in high-risk patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The study population consisted of 10,251 patients with clinical manifest arterial disease or vascular risk factors included in the Second Manifestations of ARTerial disease (SMART) Study cohort between 1996 and 2014. Linear regression was used to explore patient characteristics of kidney length. The relationship between kidney length and cardiovascular events (myocardial infarction, stroke, and cardiovascular mortality), all-cause mortality, and ESRD was analyzed using Cox regression. Kidney length was analyzed in tertiles, using the second tertile as the reference category. RESULTS Kidney length was strongly correlated with body surface area (2.04 mm; 95% confidence interval [95% CI], 1.95 to 2.13 per 0.1 m2 increase) and eGFR (1.62 mm; 95% CI, 1.52 to 1.73 per 10 ml/min per 1.73 m2 increase). During the median follow-up of 6.3 years, 1317 patients experienced a cardiovascular event, including 711 myocardial infarctions, 369 strokes, and 735 vascular cause deaths. A total of 1462 patients died of any cause and 52 patients developed ESRD. Irrespective of eGFR, patients in the third tertile of kidney length (11.7-16.1 cm) were at higher risk of cardiovascular mortality (hazard ratio, 1.33; 95% CI, 1.05 to 1.67) and cardiovascular events (hazard ratio, 1.28; 95% CI, 1.09 to 1.50). Patients in the first tertile of kidney length (7.8-10.8 cm) were not at higher risk of cardiovascular adverse events. CONCLUSIONS Large kidney length is related to higher risk of cardiovascular events and mortality in high-risk patients, irrespective of eGFR. Kidney length may serve as a clinical marker to further identify patients at high cardiovascular risk.
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Affiliation(s)
| | | | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Lee JY, Ahn S, Lee JR, Jee BC, Kim CH, Seo S, Suh CS, Kim SH. Reference Values for the Revised Anti-Müllerian Hormone Generation II Assay: Infertile Population-based Study. J Korean Med Sci 2017; 32:825-829. [PMID: 28378557 PMCID: PMC5383616 DOI: 10.3346/jkms.2017.32.5.825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 01/30/2017] [Indexed: 11/20/2022] Open
Abstract
Anti-Müllerian hormone (AMH) is now accepted as an important clinical marker of ovarian reserve and is increasingly measured as an initial evaluation at infertility clinics. The aim of this study was to establish reference values for the revised second generation (Gen II) assay using population-based data. In this population-based cohort study, AMH data from unselected infertile women aged 25-45 years from June 2013 to June 2014 (n = 15,801) were collected. The AMH values were measured using the revised Gen II assay. We established and validated 5 AMH-age regression models. Based on the optimal AMH-age model, reference values and centile charts were obtained. The quadratic model (log AMH = 0.410 × age -0.008 × age² -3.791) was the most appropriate for describing the age-dependent decrease in AMH measured using the revised Gen II assay. This is the largest population-based study to establish age-specific reference values of AMH using the revised Gen II assay. These reference values may provide more specific information regarding the ovarian reserve estimation of infertile women.
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Affiliation(s)
| | - Soyeon Ahn
- Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | | | - Soyeon Seo
- Samkwang Medical Laboratories, Seoul, Korea
| | - Chang Suk Suh
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
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Hughes-Austin JM, Rifkin DE, Beben T, Katz R, Sarnak MJ, Deo R, Hoofnagle AN, Homma S, Siscovick DS, Sotoodehnia N, Psaty BM, de Boer IH, Kestenbaum B, Shlipak MG, Ix JH. The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals. Clin J Am Soc Nephrol 2017; 12:245-252. [PMID: 28143865 PMCID: PMC5293337 DOI: 10.2215/cjn.06290616] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/10/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Hyperkalemia is associated with adverse outcomes in patients with CKD and in hospitalized patients with acute medical conditions. Little is known regarding hyperkalemia, cardiovascular disease (CVD), and mortality in community-living populations. In a pooled analysis of two large observational cohorts, we investigated associations between serum potassium concentrations and CVD events and mortality, and whether potassium-altering medications and eGFR<60 ml/min per 1.73 m2 modified these associations. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Among 9651 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS), who were free of CVD at baseline (2000-2002 in the MESA and 1989-1993 in the CHS), we investigated associations between serum potassium categories (<3.5, 3.5-3.9, 4.0-4.4, 4.5-4.9, and ≥5.0 mEq/L) and CVD events, mortality, and mortality subtypes (CVD versus non-CVD) using Cox proportional hazards models, adjusting for demographics, time-varying eGFR, traditional CVD risk factors, and use of potassium-altering medications. RESULTS Compared with serum potassium concentrations between 4.0 and 4.4 mEq/L, those with concentrations ≥5.0 mEq/L were at higher risk for all-cause mortality (hazard ratio, 1.41; 95% confidence interval, 1.12 to 1.76), CVD death (hazard ratio, 1.50; 95% confidence interval, 1.00 to 2.26), and non-CVD death (hazard ratio, 1.40; 95% confidence interval, 1.07 to 1.83) in fully adjusted models. Associations of serum potassium with these end points differed among diuretic users (Pinteraction<0.02 for all), such that participants who had serum potassium ≥5.0 mEq/L and were concurrently using diuretics were at higher risk of each end point compared with those not using diuretics. CONCLUSIONS Serum potassium concentration ≥5.0 mEq/L was associated with all-cause mortality, CVD death, and non-CVD death in community-living individuals; associations were stronger in diuretic users. Whether maintenance of potassium within the normal range may improve clinical outcomes requires future study.
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Affiliation(s)
- Jan M Hughes-Austin
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
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Kim K, Kim HG, Song D, Yoon JY, Chung ME. Ultrasound Dimensions of the Rotator Cuff and Other Associated Structures in Korean Healthy Adults. J Korean Med Sci 2016; 31:1472-8. [PMID: 27510393 PMCID: PMC4974191 DOI: 10.3346/jkms.2016.31.9.1472] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 05/29/2016] [Indexed: 01/28/2023] Open
Abstract
In evaluating patients complaining of shoulder pain, ultrasonography is an emerging imaging tool due to convenience, low cost, high sensitivity and specificity. However, normative values of ultrasound dimensions of the shoulder to be compared with pathologic findings in Korean adults are not provided yet. We evaluated the ultrasound dimensions of the rotator cuff, long head of biceps tendon, deltoid muscle and acromioclavicular joint in Korean healthy adults. Shoulder ultrasonography was performed on 200 shoulders from 100 healthy adults. The dimensions of the thickness of rotator cuff (supraspinatus, infraspinatus, subscapularis tendon), deltoid muscle, long head of biceps tendon, subacromial subdeltoid bursa, and acromioclavicular joint interval were measured in a standardized manner. Differences in measurements among sex, age, and dominant arms were compared. The thickness of rotator cuff tendons (supraspinatus, infraspinatus, subscapularis) and deltoid muscle were significantly different between men and women. The thickness of subacromial subdeltoid bursa was significantly different between men and women for non-dominant side. In rotator cuff tendon measurements, the differences between dominant and non-dominant shoulders were not significant, which means the asymptomatic contralateral shoulder can be used to estimate the normal reference values. When stratified by age divided by 10 years, the measurements of supraspinatus, subscapularis and deltoid thickness showed tendency of increase with the age. The acromioclavicular joint interval, on the other hand, revealed decreasing tendency. This report suggests normative values of ultrasound dimensions of healthy Korean population with varying age, and can be useful as reference values in evaluating shoulder pathology, especially in rotator cuff tendon pathology.
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Affiliation(s)
- Kyeongwon Kim
- Department of Rehabilitation Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hong Geum Kim
- Department of Rehabilitation Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Daeheon Song
- Department of Rehabilitation Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Yoon Yoon
- Department of Rehabilitation Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myung Eun Chung
- Department of Rehabilitation Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Mattox R, Battaglia PJ, Welk AB, Maeda Y, Haun DW, Kettner NW. Reference Values for the Scalene Interval Width During Varying Degrees of Glenohumeral Abduction Using Ultrasonography. J Manipulative Physiol Ther 2016; 39:662-667. [PMID: 28327294 DOI: 10.1016/j.jmpt.2016.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 05/04/2016] [Accepted: 08/04/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to establish reference values for the width of the interval between the anterior and middle scalene muscles using ultrasonography during varying degrees of glenohumeral joint (GH) abduction. Reliability and body mass index (BMI) data were also assessed. METHODS Interscalene triangles of asymptomatic participants were scanned bilaterally in the transverse plane. Images were obtained at 0°, 90°, and 150° of GH abduction with the participant seated. Width measurements were taken between the anterior and middle scalene muscle borders by bisecting the C6 nerve root as it passed superficial to the posterior tubercle of the C7 transverse process. Intra- and interexaminer reliability and BMI correlation were studied. Statistical significance was defined as P ≤ .05. RESULTS Images of 42 scalene intervals were included from 21 participants (11 female). Mean participant age was 25.3 ± 3.9 years; mean BMI was 25.4 ± 2.7 kg/m2. Scalene interval measurements at 0°, 90°, and 150° of GH abduction were 4.5 ± 0.5 mm, 4.6 ± 0.5 mm, and 4.4 ± 0.7 mm, respectively, without a significant difference (P = .07). Intraexaminer reliability was excellent (0°: intraclass correlation coefficient [ICC] = 0.82; 90°: ICC = 0.89; 150°: ICC = 0.90). Interexaminer reliability was good to excellent (0°: ICC = 0.59; 90°: ICC = 0.85; 150°: ICC = 0.89). Body mass index was positively correlated only at 0° of GH abduction. CONCLUSIONS This study establishes previously unreported reference ultrasonography values for the width of the scalene interval. Intraexaminer reliability was excellent at all glenohumeral positions, and interexaminer reliability was determined to be good to excellent. Body mass index was positively correlated only at 0° of GH abduction.
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Affiliation(s)
- Ross Mattox
- Department of Radiology, Logan University, Chesterfield, MO.
| | | | - Aaron B Welk
- Department of Radiology, Logan University, Chesterfield, MO
| | - Yumi Maeda
- Department of Radiology, Logan University, Chesterfield, MO; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA
| | - Daniel W Haun
- Department of Radiology, Logan University, Chesterfield, MO
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Kim HS, Kim BJ, Oh S, Lee DY, Hwang KR, Jeon HW, Lee SM. Gestational Age-specific Cut-off Values Are Needed for Diagnosis of Subclinical Hypothyroidism in Early Pregnancy. J Korean Med Sci 2015; 30:1308-12. [PMID: 26339172 PMCID: PMC4553679 DOI: 10.3346/jkms.2015.30.9.1308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 06/01/2015] [Indexed: 11/21/2022] Open
Abstract
During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, P<0.001), whereas the diagnosis rate was 5% in all GA with the use of a GA-specific cut-off value (P=0.995). Therefore, GA-specific criteria might be more appropriate for the diagnosis of subclinical hypothyroidism.
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Affiliation(s)
- Hye Sung Kim
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Byoung Jae Kim
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Da Young Lee
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Kyu Ri Hwang
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hye Won Jeon
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seung Mi Lee
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
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Karimian A, Jafari S. A New Method to Segment the Multiple Sclerosis Lesions on Brain Magnetic Resonance Images. J Med Signals Sens 2015; 5:238-44. [PMID: 26955567 PMCID: PMC4759840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Automatic segmentation of multiple sclerosis (MS) lesions in brain magnetic resonance imaging (MRI) has been widely investigated in the recent years with the goal of helping MS diagnosis and patient follow-up. In this research work, Gaussian mixture model (GMM) has been used to segment the MS lesions in MRIs, including T1-weighted (T1-w), T2-w, and T2-fluid attenuation inversion recovery. Usually, GMM is optimized by using expectation-maximization (EM) algorithm. The drawbacks of this optimization method are, it does not converge to optimal maximum or minimum and furthermore, there are some voxels, which do not fit the GMM model and have to be rejected. So, GMM is time-consuming and not too much efficient. To overcome these limitations, in this research study, at the first step, GMM was applied to segment only T1-w images by using 100 various starting points when the maximum number of iterations was considered to be 50. Then segmentation results were used to calculate the parameters of the other two images. Furthermore, FAST-trimmed likelihood estimator algorithm was applied to determine which voxels should be rejected. The output result of the segmentation was classified in three classes; White and Gray matters, cerebrospinal fluid, and some rejected voxels which prone to be MS. In the next phase, MS lesions were detected by using some heuristic rules. This new method was applied on the brain MRIs of 25 patients from two hospitals. The automatic segmentation outputs were scored by two specialists and the results show that our method has the capability to segment the MS lesions with dice similarity coefficient score of 0.82. The results showed a better performance for the proposed approach, in comparison to those of previous works with less time-consuming.
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Affiliation(s)
- Alireza Karimian
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran,Address for correspondence: Dr. Alireza Karimian, Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran. E-mail:
| | - Simin Jafari
- Department of Telecommunication Engineering, Faculty of Electrical Engineering, Islamic Azad University of Najafabad, Isfahan, Iran
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Lee KS, Bae SH, Lee SH, Lee J, Lee DR. New reference data on bone mineral density and the prevalence of osteoporosis in Korean adults aged 50 years or older: the Korea National Health and Nutrition Examination Survey 2008-2010. J Korean Med Sci 2014; 29:1514-22. [PMID: 25408583 PMCID: PMC4234919 DOI: 10.3346/jkms.2014.29.11.1514] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 07/28/2014] [Indexed: 11/20/2022] Open
Abstract
This cross-sectional study was performed to investigate the reference values for bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and the prevalence of osteoporosis in the Korean population by applying domestic reference data. In total, 25,043 Korean adults ≥20 yr of age (11,792 men and 13,251 women) participated in the study. The BMDs of the total hip, femoral neck, and lumbar spine were measured by DXA (Discovery-W, Hologic Inc.), and subjects with a BMD - 2.5 standard deviations or lower than the mean BMD for young adults (20-29 yr old) were considered to have osteoporosis. When applying the new reference values determined in this study from Korean subjects, the overall prevalence of osteoporosis increased in men aged ≥50 yr compared with that provided by the DXA manufacturer from Japanese subjects (12.2% vs. 7.8%, P<0.001) and decreased in postmenopausal women aged ≥50 yr (32.9% vs. 38.7%, P<0.001). According to the findings of this study, use of the reference values provided by the DXA manufacturer has resulted in the underdiagnosis of osteoporosis in Korean men and the overdiagnosis of osteoporosis in Korean women. Our data will serve as valuable reference standards for the diagnosis and management for osteoporosis in the Korean population.
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Affiliation(s)
- Kyung-Shik Lee
- Department of Family Medicine, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Su-Hyun Bae
- Department of Family Medicine, Ajou University Hospital, Suwon, Korea
| | - Seung Hwa Lee
- Department of Family Medicine, Ajou University Hospital, Suwon, Korea
| | - Jungun Lee
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
| | - Dong Ryul Lee
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
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Kim AL, Kwon JC, Park I, Kim JN, Kim JM, Jeong BN, Yu SK, Lee BK, Kim YJ. Reference equations for the six-minute walk distance in healthy korean adults, aged 22-59 years. Tuberc Respir Dis (Seoul) 2014; 76:269-75. [PMID: 25024720 PMCID: PMC4092158 DOI: 10.4046/trd.2014.76.6.269] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 03/20/2014] [Accepted: 04/07/2014] [Indexed: 01/06/2023] Open
Abstract
Background The six-minute walk test has been widely used in people with chronic cardiopulmonary disorders as an outcome assessment with regards to therapeutic or prognostic determinants. This study was undertaken to determine the six-minute walk distance (6MWD) in a sample of healthy Koreans and to create a reference equation. We also compared the 6MWD of our cohort with previously published equations. Methods Two hundred fifty-nine healthy subjects (95 males) aged 22-59 years performed two walking tests using a standardized protocol. 6MWD was defined as the greatest distance achieved from the two tests. The effect of anthropometrics on the 6MWD was also investigated. Results The average 6MWD was 598.5±57.92 m, with significantly longer distances by males (628.9±59.51 m) than females (580.9±47.80 m) (p<0.001). Age, height, weight, and body mass index were significantly correlated with 6MWD in univariate analysis. Stepwise multiple regression showed height to be single independent predictor of 6MWD (r2=0.205, p<0.001). The reference equations derived in Caucasian and North African populations tend to overestimate the distance walked by Korean subjects, while Asian equations underestimate it. Conclusion The average 6MWD in these Korean populations was 600 m. The regression equation revealed that individual's height was the most significant predictor of distance, explaining 20.5% of the distance variance.
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Affiliation(s)
- Ah Lim Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jae Choon Kwon
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - In Park
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Ji Na Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jong Min Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Bi Na Jeong
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Sung Ken Yu
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Byung Ki Lee
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Yeon Jae Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
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Abstract
OBJECTIVE To provide accurate population normative data documenting cross-sectional, age-specific sleep patterns in Australian children aged 0-9 years. DESIGN AND SETTING The first three waves of the nationally representative Longitudinal Study of Australian Children, comprising two cohorts recruited in 2004 at ages 0-1 years (n=5107) and 4-5 years (n=4983), and assessed biennially. PARTICIPANTS Children with analysable sleep data for at least one wave. MEASURES At every wave, parents prospectively completed 24-h time-use diaries for a randomly selected week or weekend day. 'Sleeping, napping' was one of the 26 precoded activities recorded in 15-min time intervals. RESULTS From 0 to 9 years of age, 24-h sleep duration fell from a mean peak of 14 (SD 2.2) h at 4-6 months to 10 (SD 1.9) h at 9 years, mainly due to progressively later mean sleep onset time from 20:00 (SD 75 min) to 21:00 (SD 60 min) and declining length of day sleep from 3.0 (SD 1.7) h to 0.03 (SD 0.2) h. Number and duration of night wakings also fell. By primary school, wake and sleep onset times were markedly later on weekend days. The most striking feature of the centile charts is the huge variation at all ages in sleep duration, sleep onset time and, especially, wake time in this normal population. CONCLUSIONS Parents and professionals can use these new centile charts to judge normalcy of children's sleep. In future research, these population parameters will now be used to empirically determine optimal child sleep patterns for child and parent outcomes like mental and physical health.
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Affiliation(s)
- Anna M H Price
- Murdoch Childrens Research Institute, , Parkville, Victoria, Australia
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Tauseef Bukhari K, Zafar H. Reference range variation in haematological indices amongst five different age groups of less than one year in Islamabad, Pakistan. Pak J Med Sci 2013; 29:577-80. [PMID: 24353580 PMCID: PMC3809234 DOI: 10.12669/pjms.292.3067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 01/04/2013] [Accepted: 01/05/2013] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The objective of the current study was to establish the reference ranges of haematological indices amongst five healthy infantile (<1 year) age groups. METHODOLOGY It was a descriptive cross sectional study carried out at the Department of Haematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi. Non probability convenience sampling was adopted for the proceedings for the study. A sample size was 2000 which was equally distributed as 400 samples for all the five age groups i.e. <27 days, 3 month, 6 month, 9 month and one year. One thousands were males and 1000 were the females. An informed consent from the guardian was the pre requisite of study, while those candidates having an evidence of any systemic illness were not excluded. Results : The values of haematological indices i.e. MCV, MCHC, MCH, PCV and RDW varies with growing age of an infant. A decrease in all these values was observed from <27days to one year of age infants. Conclusion : A decrease in all these values was observed from <27days to one year of age infants. The values reported in this study can be used as a local reference for the newborn aged between <27 days and 1 year of age.
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Affiliation(s)
- Kiran Tauseef Bukhari
- Dr. Kiran Tauseef Bukhari, MBBS, M.Phil-Haematology, Assistant Professor of Haematology, Al Nafees Medical College, Islamabad, Pakistan
| | - Humaira Zafar
- Dr. Humaira Zafar, MBBS, M.Phil-Microbiology, Assistant Professor of Microbiology, Al Nafees Medical College, Islamabad, Pakistan
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Eom SY, Kim H. Reference values for the pulmonary function of Korean adults using the data of Korea National Health and Nutrition Examination Survey IV (2007-2009). J Korean Med Sci 2013; 28:424-30. [PMID: 23487361 PMCID: PMC3594607 DOI: 10.3346/jkms.2013.28.3.424] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 01/11/2013] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to develop new spirometric reference equations for the Korean population using the raw data of the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2009). A total of 4,753 healthy lifelong nonsmokers without respiratory diseases and symptoms were selected as the reference population. Spirometric reference equations were derived through multiple regression analysis. The newly developed reference equations for spirometry parameters were as follows: FEV1 (L) = -0.00025410 × (Age [years])(2) + 0.00012644 × (Height [cm])(2) - 0.00262 × Weight (kg) + 0.61493 (Men); FEV1 (L) = -0.00017538 × Age(2) + 0.00009598 × Height(2) - 0.00231 × Weight + 0.46877 (Women); FVC (L) = -0.00000219 × Age(3) + 0.0000006995642 × Height(3) + 1.19135 (Men); FVC (L) = 0.0167 × Age - 0.00030284 × Age(2) + 0.0000005850287 × Height(3) + 0.77609 (Women); FEV1/FVC (%) = -0.00289 × Age(2) - 0.16158 × Height(3) + 114.13736 (Men); FEV1/FVC (%) = -0.21382 × Age - 0.00000143 × Height(3) + 97.62514 (Women). The newly developed spirometric reference equation in this study can be used as criteria for the interpretation of spirometry results and the diagnosis of respiratory diseases in Korean adults.
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Affiliation(s)
- Sang-Yong Eom
- Department of Preventive Medicine and Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Heon Kim
- Department of Preventive Medicine and Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
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Eom SY, Moon SI, Yim DH, Lee CH, Kim GB, Kim YD, Kang JW, Choe KH, Kim SJ, Choi BS, Yu SD, Chang SH, Park JD, Kim H. Goodness-of-Fits of the Spirometric Reference Values for Koreans and USA Caucasians to Spirometry Data from Residents of a Region within Chungbuk Province. Tuberc Respir Dis (Seoul) 2012; 72:302-9. [PMID: 23227070 PMCID: PMC3510280 DOI: 10.4046/trd.2012.72.3.302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 12/29/2011] [Accepted: 01/30/2012] [Indexed: 11/24/2022] Open
Abstract
Background Korean regression models for spirometric reference values are different from those of Americans. Using spirometry results of Korean adults, goodness-of-fits of the Korean and the USA Caucasian regression models for forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were compared. Methods The number of study participants was 2,360 (1,124 males and 1,236 females). Spirometry was performed under the guidelines of the American Thoracic Society and the European Respiratory Society. After excluding unsuitable participants, spirometric data for 729 individuals (105 males and 624 females) was included in the statistical analysis. The estimated FVC and FEV1 values were compared with those measured. Goodness-of-fits for Korean and USA Caucasian models were compared using an F-test. Results In males, the expected values of FVC and FEV1 using the Korean model were 12.5% and 5.7% greater than those measured, respectively. The corresponding values for the USA Caucasian model were 3.5% and 0.6%. In females, the difference in FVC and FEV1 were 13.5% and 7.7% for the Korean model, and 6.3% and 0.4% for the USA model, respectively. Goodness-of-fit for the Korean model regarding FVC was not good to the study population, but the Korean regression model for FEV1, and the USA Caucasian models for FVC and FEV1 showed good fits to the measured data. Conclusion These results suggest that the USA Caucasian model correlates better to the measured data than the Korean model. Using reference values derived from the Korean model can lead to an overestimation regarding the prevalence of abnormal lung function.
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Affiliation(s)
- Sang Yong Eom
- Department of Preventive Medicine and Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
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Youn YJ, Lee NS, Kim JY, Lee JW, Sung JK, Ahn SG, You BS, Lee SH, Yoon J, Choe KH, Koh SB, Park JK. Normative values and correlates of mean common carotid intima-media thickness in the Korean rural middle-aged population: the Atherosclerosis RIsk of Rural Areas iN Korea General Population (ARIRANG) study. J Korean Med Sci 2011; 26:365-71. [PMID: 21394304 PMCID: PMC3051083 DOI: 10.3346/jkms.2011.26.3.365] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 12/06/2010] [Indexed: 01/01/2023] Open
Abstract
Carotid intima-media thickness (CIMT) is considered as a surrogate marker for cardiovascular disease (CVD). We determined the normative value of CIMT and correlates of CVD risk factors and Framingham risk score (FRS) in Korean rural middle-aged population. We measured CIMT with a B-mode ultrasonography in 1,759 subjects, aged 40 to 70 yr, in a population-based cohort in Korea. A healthy reference sample (n = 433) without CVD, normal weight and normal metabolic parameters was selected to establish normative CIMT values. Correlates between CIMT and conventional CVD risk factors were assessed in the entire population. Mean values of CIMT (in mm) for healthy reference sample aged 40-49, 50-59, and 60-70 yr were 0.55, 0.59, and 0.66 for men and 0.48, 0.55, and 0.63 for women, respectively. In multivariate regression analysis, CIMT was correlated with older age, higher BMI, male gender, higher LDL-cholesterol level and history of diabetes mellitus. The mean CIMT was also correlated with FRS in both gender (r(2) = 0.043, P < 0.01 for men; r(2) = 0.142, P < 0.01 for women). We identified normative value of CIMT for the healthy Korean rural middle-aged population. The CIMT is associated with age, obesity, gender, LDL-cholesterol, diabetes mellitus and FRS.
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Affiliation(s)
- Young Jin Youn
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Nam Seok Lee
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang-Young Kim
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Institute of Genomic Cohort, Yonsei University, Wonju, Korea
| | - Jun-Won Lee
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Joong-Kyung Sung
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung-Gyun Ahn
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung-Su You
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung-Hwan Lee
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Junghan Yoon
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung-Hoon Choe
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sang Baek Koh
- Institute of Genomic Cohort, Yonsei University, Wonju, Korea
- Department of Preventive Medicine and Institute of Occupational Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jong Ku Park
- Department of Preventive Medicine and Institute of Occupational Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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Budhiraja S, Singh D, Pooni PA, Dhooria GS. Pulmonary functions in normal school children in the age group of 6-15 years in north India. Iran J Pediatr 2010; 20:82-90. [PMID: 23056687 PMCID: PMC3445999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 08/18/2009] [Accepted: 10/20/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Lung function tests have become an integral part of assessment of pulmonary disease. As few studies on pulmonary function tests have been carried out in young children in India, the study was carried out in normal urban and rural school children in Ludhiana district of North India to determine pulmonary functions in the age group 6-15 years and to find its correlation with regards to age, sex, height and weight. METHODS The study group included 600 normal children between 6-15 years age from different urban and rural schools in the region. A preformed questionnaire was interviewed and detailed general physical and systemic examination was done. Pulmonary function tests were measured by using Micromedical Gold standard fully computerized portable auto spirometer (Superspiro Cat No. SU 6000). FINDINGS The present study shows, all the three independent variables (age, weight and height) have linear positive correlation with lung function parameters, both for boys and girls. Lung function values in boys were significantly higher as compared to that of girls. Urban children had higher lung function parameters than rural children except IRV, FEF(25%). Among all anthropometric parameters, height was the most independent variable with maximum coefficient of correlation. CONCLUSION Equations derived from the present study for estimation of the expected values of lung function will help to interpret the observed lung function values in children of North India.
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Affiliation(s)
- Sandeep Budhiraja
- Corresponding Author:Address: Department of Pediatrics, Dayanand Medical College, Ludhiana, Punjab, India - 141001. E-mail:
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Kim GH, Huh KC, Lee YC, Lee KJ, Choi SC, Shim KN, Kim JH, Lee IS, Lee HL, Jung HY, Park HJ. Normal ambulatory 24-hour esophageal pH values in Koreans -a multicenter study-. J Korean Med Sci 2008; 23:954-8. [PMID: 19119435 PMCID: PMC2610658 DOI: 10.3346/jkms.2008.23.6.954] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2007] [Accepted: 04/03/2008] [Indexed: 11/20/2022] Open
Abstract
Ambulatory 24-hr esophageal pH monitoring is considered the gold standard for diagnosing gastroesophageal reflux disease. The aim of this study was to establish normal values for gastroesophageal acid exposure in healthy Koreans. Fifty healthy volunteers (24 males and 26 females; mean age, 45 yr) without reflux symptoms and without reflux esophagitis or hiatal hernia on upper endoscopy underwent ambulatory 24-hr esophageal pH monitoring after esophageal manometry. The 95th percentiles for the reflux parameters were: the percent total time pH <4, 3.7%; the percent upright time pH <4, 5.7%; the percent supine time pH <4, 1.0%; the number of reflux episodes with pH <4, 76.5; the number of reflux episodes with pH <4 for >5 min, 1.5; the duration of the longest episode, 12.5 min; and the composite score, 14.2. Age and gender were not associated with any of the pH parameters. In conclusion, physiological gastroesophageal reflux occurs in healthy Koreans. These normal esophageal pH values will provide reference data for clinical and research studies in Korea.
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Affiliation(s)
- Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kyu Chan Huh
- Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Yong Chan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Jae Lee
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Suck Chei Choi
- Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Korea
| | - Ki Nam Shim
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Jeong Hwan Kim
- Department of Internal Medicine, Konkuk University School of Medicien, Seoul, Korea
| | - In Seok Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hang Lak Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hwoon-Yong Jung
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hyo Jin Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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