Journal of investigative medicine : the official publication of the American Federation for Clinical Research
-
Multicenter Study
Preoperative vitamin D deficiency is associated with increased risk of postoperative hypocalcemia after total thyroidectomy.
Prior single-institution studies suggest that preoperative vitamin D deficiency (VDD) is associated with postoperative hypocalcemia and a prolonged length of hospital stay following total thyroidectomy. In this study, we employ a multi-institutional, de-identified electronic health records database to address this issue. We hypothesize that total thyroidectomy patients with preoperative VDD will be at an increased associated risk of postoperative hypocalcemia and hospitalization. ⋯ Although the length of hospital stay after thyroidectomy was longer in the VDD group compared with the non-VDD group (p=0.03), VDD is not an independent risk factor for prolonged hospitalization following thyroidectomy (p=0.13). VDD is associated with a higher risk of hypocalcemia following total thyroidectomy. Prethyroidectomy operative screening for VDD should be considered.
-
Arterial stiffness has been identified as a powerful and independent risk factor for cardiovascular disease. Obesity is associated with an increased risk of aortic stiffness (AS) and adverse cardiovascular events. Herein, we aimed to evaluate the effects of weight loss after laparoscopic sleeve gastrectomy (LSG) on AS in individuals with morbid obesity by using the transthoracic echocardiography (TTE). ⋯ When the elastic parameters of the aorta were compared, no significant differences were detected regarding aortic strain (%) ((16.28±4.11) vs (16.68±4.56), p=(0.998)), distensibility (cm2/dyn) ((6.74±1.78) vs (7.03±2.31), p=(0.997)) and Aortic Stiffness Index values ((10.73±3.84) vs (10.63±3.34), p=0.998) between baseline and first month after surgery. In the 12-month follow-up, it was determined that the aortic strain ((16.28±4.11) vs (22.74±5.79), p≤0.001) and distensibility ((6.74±1.78) vs (10.34±3.059), p<0.001)) values increased at significant levels. Weight loss by LSG improves arterial stiffness parameters in patients with obesity over a 1-year follow-up.
-
How to give full play to the positive function of constructive conflicts (task conflicts and process conflicts) in the science and technology innovation team, give appropriate stimulation, mobilize the enthusiasm of employees and improve the team's innovative ability to improve team performance and organizational effectiveness are issues that deserve both team leaders' and scholars' attention. Through selecting multiple medical technology R&D personnel from a specific science and technology innovation team of health organization, the research studies the constructive conflicts among the members of the science and technology innovation team, constructs and analyzes the conflict evolution game model, proposes countermeasures and suggestions for improving the innovation ability of the science and technology innovation team and discusses the innovation management mechanism of the science and technology innovation team. ⋯ However, on the one hand, constructive conflicts can be controlled to maintain a moderate state of control. On the other hand, it is also necessary to establish a mutually trusting communication environment and convenient communication channels in the science and technology innovation team, combined with modern information management technology, to handle the problems that were difficult to be found or accumulated for a long time under the previous management mechanism and cooperate with the science and technology innovation team to improve the technology innovation team's innovation capability.
-
This study aimed to assess the diagnostic value of serum and urinary netrin-1 in patients with type 2 diabetes mellitus (T2DM) at different stages of diabetic nephropathy (DN) and to compare its efficacy of estimation in serum with that in the urine. This study was carried out on 135 patients with T2DM and 45 healthy subjects. The patients with diabetes were divided according to urinary albumin creatinine ratio (UACR) into: T2DM with normoalbuminuria, incipient DN with microalbuminuria, and overt DN with macroalbuminuria groups. ⋯ In T2DM groups, the urinary and serum netrin-1 correlated with each other and were independently related to fasting blood glucose, UACR, and estimated glomerular filtration rate. Receiver operating characteristic curve analysis showed that the area under the curve of urinary netrin-1 was 0.916 which is significantly higher than that of serum netrin-1 (0.812) for the detection of incipient DN and reached 0.938 on coestimation of both urinary and serum netrin-1. In conclusion, netrin-1 is a potential diagnostic marker for early detection of DN with its estimation in urine has higher accuracy than that of serum.