Objective: To determine the efficacy of the Mortality in Emergency Department Sepsis (MEDS) score in the stratification of patients who presented to the emergency department (ED) with severe sepsis. Methods: Adults who presented to the ED with severe sepsis were retrospectively recruited and divided into group A (MEDS score ,12) and group B (MEDS score >12). Their outcomes were evaluated with 28 day hospital mortality rate, length of hospital stay, Kaplan-Meier survival analysis, and receiver operating characteristic (ROC) analysis. Discriminatory power of the MEDS score in mortality prediction was further compared with the Acute Physiology and Chronic Health Evaluation (APACHE) II model. Results: In total, 276 patients (44.6% men and 55.4% women) were analysed, with 143 patients placed in group A and 133 patients in group B. Patients with MEDS score >12 had a significantly higher mortality rate (48.9% v 17.5%, p,0.01) and higher median APACHE II score (25 v 20 points, p,0.01). Significant difference in mortality risk was also demonstrated with Kaplan-Meier survival analysis (log rank test, p,0.01). No difference in the length of hospital stay was found between the groups. ROC analysis indicated a better performance in mortality prediction by the MEDS score compared with the APACHE II score (ROC 0.75 v 0.62, p,0.01). Conclusion: Our results showed that mortality risk stratification of severe sepsis patients in the ED with MEDS score is effective. The MEDS score also discriminated better than the APACHE II model in mortality prediction.
To evaluate the prevalence, awareness, treatment and control of hypertension and its risk factors in Dehui City of Jilin Province in China. The study was performed among 3778 subjects (male=1787) in Dehui City, Jilin Province of China. The subjects completed a standard questionnaire, biochemical tests and physical examinations. Logistic regression analyses were used to identify risk factors for hypertension. The prevalence of hypertension was 41.00% in this area. The awareness, treatment and the control of hypertension were 21.82, 15.56 and 1.10%, respectively, with city areas being significantly higher than rural areas. Significant risk factors for hypertension included age, sex, central obesity, alcohol consumption, family history of hypertension, dyslipidemia, education level and type of work. Further analysis showed that diabetes for urban participants and cigarette smoking for rural participants were risk factors but were not statistically significant at the multi-variate level. The prevalence of hypertension in Dehui Ctiy of Jilin Province is higher than in other areas of China. In addition, rates of awareness and treatment of the condition are much lower than in other populations, with the control rate only 1.10%.
OBJECTIVE: To investigate whether retinoid X receptor agonists act as insulin sensitizers and compare their effects with that of thiazolidinedione BRL 49653 in obese Zucker rats. DESIGN: In two independent studies, obese Zucker rats were dosed orally once daily for 14 days with one of the following treatments: LG 100268 (20 mgakg), LG 100324 (20 mgakg), BRL 49653 (3 mgakg) or vehicle. MEASUREMENTS: Daily food intake and body weight gain, blood glucose, plasma and pancreatic insulin, whole body glucose disposal (by euglycaemic ± hyperinsulinaemic clamp) and tissue glucose utilization. RESULTS: The retinoid X receptor agonists (rexinoids) LG 100268 and LG 100324 caused a reduction in the food intake of obese Zucker rats relative to controls and to rats receiving BRL 49653. The two rexinoids also produced a marked decrease in the body weight gain, whereas the growth rate of rats treated with BRL 49653 tended to increase. Both rexinoids and BRL 49653 reduced the plasma insulin concentration of fed rats.LG 100268 and LG 100324 also signi®cantly lowered blood glucose concentrations after 1 week of treatment. The 5 h fasted plasma insulin concentration was signi®cantly lower in the rexinoid-treated groups and the terminal insulin level (at the end of the clamp) tended to be lower in all treated groups compared with animals given the dosing vehicle. However, pancreatic insulin content was not affected by any of the treatments. Under euglycaemic ± hyperinsulinaemic clamp conditions, there were no signi®cant differences in the rate of hepatic glucose output and whole body glucose disposal, except that, in experiment 1, BRL 49653 caused signi®cant increase in the glucose infusion rate and muscle glucose utilization. In experiment 2, a similar glucose infusion rate to the controls was achieved in all treatment groups but the steady-state insulin concentration in the treated animals was only about 50% of that in the control animals, despite the fact that all rats received a similar insulin infusion concentration. This suggests that both the rexinoids and BRL 49653 increased insulin clearance. CONCLUSIONS: Chronic administration of retinoid X receptor agonists LG 100268 and LG 100324 to Zucker faafa rats reduces food intake and body weight gain, lowers plasma insulin concentrations while maintaining normoglycaemia, indicating an improvement of insulin sensitivity.
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.