Rationale. The key purpose of modern glucose meters is to ensure regular self-monitoring of glucose level when receiving outpatient management, provided that fair diabetes compensation is achieved. Although glucose meters are not intended for assessing the glucose level in severe metabolic disorders (ketosis, ketoacidosis), since these conditions have a negative effect on device accuracy, in actual life a patient (or a physician) can face a situation when a glucose meter is the only tool for evaluating carbohydrate metabolism disorders. Objective. To evaluate clinical accuracy of Satellite Express PKG-03 glucose meter in measuring the glucose level in patients with type 1 and 2 diabetes mellitus (DM) receiving insulin therapy when the disease course is complicated by ketosis or ketoacidosis. Material and methods. Capillary blood was simultaneously collected in two groups of patients receiving insulin therapy from the same drop to evaluate the glucose blood level using the Satellite Express glucose meter and a SUPER GL laboratory analyzer of glucose and lactate levels. Acid-base imbalance was the key criterion for distributing patients into groups: no disorders were detected in group 1 patients, while group 2 patients had ketosis or ketoacidosis. The results were evaluated using the Clarke error grid. Results. Comparative analysis of blood samples collected from 77 patients showed that all deviations in glucose level indices measured using the Satellite Express glucose meter from the reference values belonged to zones A (the clinically valid values) and B (safe deviations) in patients without acid-base imbalance. In patients hospitalized for ketosis and ketoacidosis (group 2), the deviations from the reference values lay in zones A and B in 97%, while lying on the boundary between zones B and C only in 3%.
Distribution of type IX adenylyl cyclase and protein phosphatase calcineurin in the brain and in cultured hippocampal neurons from albino rat was immunohistochemically studied. Both enzymes were detected simultaneously in all synaptic structures of most cerebral neurons except for presynaptic sites, where calcium-inhibited type IX adenylyl cyclase was absent.
First responders (FRs) work in complex and dangerous environments in which information is often uncertain and incomplete. Advancements in artificial intelligence technology pose great potential for supporting FRs throughout dynamic mission developments. We investigated how teamwork between FRs and an intelligent agent should be designed to facilitate adequate decision-making. For this purpose, three Team Design Patterns (TDPs) were created, each assigning different roles and responsibilities to the intelligent agents and FRs. The collaboration was evaluated by presenting two scenarios to FRs in which they had to handle an incident in simulated collaboration with the agents. The results show that preference and acceptance varied across FRs and different decisions and point towards recommending a design solution in which the intelligent agent can adapt its collaboration style to different FRs and decisions it is assisting with.
Background. In the practice of clinical research, it is traditionally accepted to evaluate parameters that characterize the degree of impairment or loss of the function of an organ or system, and not their preservation. A fundamental change in the approach distinguishes a new trend in modern medicine, which makes it possible to assess the degree of preservation of functional resources, which was the basis of this study.Study purpose: To develop a method for dynamic quantitative assessment of the severity of arterial hypertension and evaluate the relationship between a qualitative indicator of arterial hypertension and a quantitative indicator.Instruments and Data Collection Procedure. Index of adaptive aptitude (IAA) (patent for invention No. 2342900 "Method for eavaluation of the functional reserves of the body", author - Kurnikova I. A.). using automated assessment (certificates of official registration No. 2007614560 and No. 2007613898).IAA=0.011(P-P*)+0.014(S-S*)+0.008(D-D*)+0.009(W-W*),Where: P - actual heart rate (b/min.); P* - ideal pulse rate (beats/ min.); S - systolic blood pressure, actual average per day (mm Hg); S* – ideal systolic blood pressure (mm Hg); D - diastolic blood pressure, actual average per day (mm Hg); D* - ideal diastolic blood pressure (mm/Hg); W - body weight at the time of examination (kg); W* - ideal body weight (kg); H - patient's height at the time of examination (cm).Assessment of daily heart rate variability on the Valenta system, equipped with a program for computer processing of spectral analysis indicators.Results:- 143 patients with arterial hypertension (AH) were examined. The relationship between a qualitative indicator - the severity of AH and quantitative indicators - rehabilitation potential, the numerical value of which is PAS, the circadian index (CI) as an indicator of increased sensitivity of the heart rate to sympathetic stimulation, and the LF/HF vago sympathetic balance coefficient, which increases with hypersympathatic tone, was considered. Statistical analysis of the surface plot using the weighted least squares distance allowed this relationship to be clearly demonstrated. Quantitative analogue of the Framingham arterial hypertension severity scale (AHSS) in a specific patient (certificate for invention №. 201152181)AHSS = 119,31 + 2,22× (CI) - 2,03× (IAA) - 1,33×(2×(CI)) + 2,72×(CI)× (IAA) + 7,06×(IAA)where: AHSS less than 120 - normal. Mild AHSS = 121 – 130 points; average severity of AHSS = 131 – 140 points; severe AHSS - 141 points or more. The effectiveness of rehabilitation is good with AHSS less than 120, satisfactory - with 121 - 130; unsatisfactory - more than 131.For illustration, the data of 54 patients are presented. Observation group "1" - patients with AH (BMI<25), mean age - 49±1.9 years (19 people). Observation group "2" - patients with metabolic syndrome (BMI>25; HOMA index> 2.5), mean age - 50±1.7 (35 people). All patients were assessed for the severity of hypertension according to the WHO criteria and the AHSS index at the beginning of the study. Normal value was achieved in 41.8% in 1st group during treatment, in 47.1% there was a decrease in the severity of AH according to AHSS. In group 2, in patients with metabolic syndrome during treatment, it was possible to normalize blood pressure in 55.8%, and to obtain satisfactory results in 35.9%.Conclusion. Developed mathematical modeling methods, a quantitative analogue indicator of the severity of arterial hypertension - AHSS allows you to dynamically monitor the effectiveness of treatment and evaluate the achieved result based on a quantitative assessment within the severity indicated by the classification. The effectiveness of the rehabilitation of patients with hypertension is considered sufficient if the AHSS decreases below the value of 120 units or one level from the baseline
Background: The method of comparative analysis is one of the most common in science where optimal choices are required. Despite the fact the method is empirical, under the conditions of epidemics such as Covid-19, it is one of the most affordable in assessing the effectiveness of the therapy. Patients with diabetes having coronavirus infection are included in the risk group which required steroid therapy. In patients with diabetes, excessive usage of Exogenous corticosteroids creates insulin deficiency which leads to hyperglycemia and the risk of developing coma. Purpose of the study: сompare the effectiveness and safety of using corticosteroids in patients with Covid-19 and diabetes prescribed "by standards" and "method of calculation". Method: Diabetic Patients with novel coronavirus infection were screened (n = 107).All patients were divided into 3 groups.In group 1(n=35) patients received dexamethasone at a dosage of 0.1 mg/kg once a day in the morning intravenously; in group 2(n = 38), patients received dexamethasone 20 mg twice daily intravenously in the morning and evening (more than 0.2 mg/kg/day) and in group 3(n = 34) patients received dexamethasone 0.1 mg /kg once a day in the morning intramuscularly. Comparative analysis were carried out according to the criteria: the period of intoxication, glycemic variability, CRP, leukocyte counts, D-dimer, and transaminases. For analysis STATISTIC 10,0 computer program was used (Matematica®, Matlab®, HarvardGraphics®) StatSoft). Results: In all the groups after therapy it was noted redistributive leukocytosis.In patients receiving high therapeutic dose (group 2) initially suppressed production of leukocytes is activated and reaches the normative indicator (p&lt;0.001) and the indicators are comparable to the data of group 3(p&lt;0.001)in which patients received glucocorticoids at a lower dose (0.1 mg/kg/day) intramuscularly. The most significant decrease in D-dimer levels was in patients with a dosage of dexamethasone at the rate of 0.1 units/kg once a day intravenously by 80.9%(P &lt;0.0001);intramuscularly by 73.2%(P&lt;0.00001)and with intravenously at a dose of more than 0.2 units/kg there was a decrease in the level of D-dimer by 67.9% (P &lt;0.00001). Decrease in CRP (cytokine storm relief rate) did not differ significantly between the groups, which eliminates the role of inexpedient usage of dexamethasone in dosages of more than 0.2 units/kg/day.Fasting blood glucose in patients in group 3 increased by 22% (P&lt;0.0002); in group 1 only by 12% (P &lt;0.05)and in group 2 by 32% (P &lt;0.0001). In all the groups, an increase was observed in postprandial glucose, and in group 2 to the level of developing ketoacidosis and required emergency intervention by increasing the dose of insulin. Conclusion: For patients without diabetes, the dose of dexamethasone is prescribed in accordance with standards (average dose) regardless of body weight and concomitant diseases. In patients with diabetes are required to determine the dose of dexamethasone individually at the rate of 0.1 mg /kg body weight per day. This method reduces the risk of adverse outcomes and ensures the achievement of positive dynamics of clinical and laboratory parameters which ultimately reduces mortality and shortens the recovery time.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.