In patients with oropharyngeal carcinoma uniformly treated with chemoradiation, the presence of HPV is a favorable prognostic indicator with respect to recurrence and overall survival. However, advanced T stage was an independent risk factor for recurrence and death that can to some degree offset this benefit.
To determine if obesity, blood pressure, markers of inflammation, and insulin resistance are associated with cardiac structure in African American adolescents, a cross-sectional study was conducted on a cohort oversampled for high blood pressure and obesity. Measurements included: anthropometrics, blood pressure, homeostasis model assessment to assess insulin resistance, high sensitivity C-Reactive Protein, and plasma adipokines (adiponectin, Interleukin-6, Plasminogen Activator Inhibitor-1. Echocardiogram measurements were left ventricular mass index (g/m2.7), left ventricular relative wall thickness, left atrial diameter index (mm/m) and left ventricular diastolic time intervals. Left atrial diameter index (r2 = 0.25) was associated with body mass index systolic blood pressure, and female gender. Left ventricular mass index (r2 = 0.35) variation was associated with body mass index systolic blood pressure, heart rate, age, and male gender. Left ventricular relative wall thickness (r2 = 0.05) was associated with homeostasis model assessment. Tissue diastolic intervals were not associated with any risk factor. Inflammatory markers and adipokines were associated with body mass index but were not independently associated with any echo measures. In African American adolescents, body mass index and systolic blood pressure but not inflammatory markers or adipokines are important correlates of left atrial size and left ventricular mass.
In children with metabolic uncoupling after CPB, insulin use did not shorten the time to lactate normalization or alter clinical outcomes. These findings suggest that type B hyperlactemia with hyperglycemia after CPB will resolve spontaneously and does not warrant specific treatment.
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