The purpose of this study was to determine the concordance between two equations used for estimating
glomerular filtration rate, in order to verify the possibility to be used interchangeably in the clinical
practice. The two equations are of Cockcroft & Gault (CG) (1976) formula and MDRD (modification of
Diet in Renal Disease) (1999) formula, these two models allow the assessment of glomerular filtration rate
(GFR) by calculating creatinine clearance (CLCR).To make a comparison between these two formulas
different models were examined for Subjects with normal renal function, Patients with renal impairment,
Diabetic patients, Age and sex, finally lean and obese patients by modeling two algorithms with the two
functions. Results show that the formula of Cockcroft & Gault remains the method of choice for estimating
renal function in clinical practice.
Cystatin C as a marker of Cardio metabolic disorder in obese South Indian ind...iosrjce
Human obesity is strongly associated with cardio metabolic disease. Cystatin C is a
naturally occurring protease inhibitor and marker of cardiovascular disease. The main objective of present
study was to estimate the serum levels of Cystatin C in individuals with normal BMI, and obese, aged between
18-39 Yrs and to compare the levels of serum Cystatin C among these individuals and to correlate the levels of
serum Cystatin C with cardio metabolic risk factors.
Material & Methods: The study population was taken from healthy volunteers of Mysore city, aged between 18-
39 years of either sex. The study population was divided into 2 groups based on BMI. Each group contains
sample size of 45. Fasting serum sample was analyzed for Blood glucose, Total cholesterol, Total Triglycerides,
Direct HDL cholesterol, Direct LDL Cholesterol by enzymatic method and serum Cystatin-C by
immunoturbidimetric method using auto analyser.
Results: The serum Cystatin C levels was significantly increased in obese groups, p value<0.001. The mean
serum Cystatin C levels in normal BMI group was 0.78±0.03, and in Obese group is 1.15±0.09. In the study
serum Cystatin C showed a positive correlation with serum glucose(r=0.61) serum triglycerides (r=0.7),
Atherogenic index of plasma (AIP) (r=0.80), TCHOL: HDL (r=0.71), HDL: LDL (r=0.70) respectively and
negative correlation with serum HDL (r=-0.52)
Clinical Usefulness of a New Equation for Estimating Body Fat
(Utilidad clínica de una nueva ecuación para estimar la grasa corporal)
Javier Gómez-Ambrosi, PHD1,2⇓, Camilo Silva, MD2,3, Victoria Catalán, PHD1,2, Amaia Rodríguez, PHD1,2, Juan Carlos Galofré, MD, PHD3, Javier Escalada, MD, PHD2,3, Victor Valentí, MD, PHD2, Fernando Rotellar, MD, PHD2, Sonia Romero, MSC2,3, Beatriz Ramírez, MSC1,2, Javier Salvador, MD, PHD2,3 and Gema Frühbeck, MD, PHD1,2,3
Corresponding author: Javier Gómez-Ambrosi, jagomez@unav.es.
Diabetes Care 2012 Feb; 35(2): 383-388. https://doi.org/10.2337/dc11-1334
Cystatin C as a marker of Cardio metabolic disorder in obese South Indian ind...iosrjce
Human obesity is strongly associated with cardio metabolic disease. Cystatin C is a
naturally occurring protease inhibitor and marker of cardiovascular disease. The main objective of present
study was to estimate the serum levels of Cystatin C in individuals with normal BMI, and obese, aged between
18-39 Yrs and to compare the levels of serum Cystatin C among these individuals and to correlate the levels of
serum Cystatin C with cardio metabolic risk factors.
Material & Methods: The study population was taken from healthy volunteers of Mysore city, aged between 18-
39 years of either sex. The study population was divided into 2 groups based on BMI. Each group contains
sample size of 45. Fasting serum sample was analyzed for Blood glucose, Total cholesterol, Total Triglycerides,
Direct HDL cholesterol, Direct LDL Cholesterol by enzymatic method and serum Cystatin-C by
immunoturbidimetric method using auto analyser.
Results: The serum Cystatin C levels was significantly increased in obese groups, p value<0.001. The mean
serum Cystatin C levels in normal BMI group was 0.78±0.03, and in Obese group is 1.15±0.09. In the study
serum Cystatin C showed a positive correlation with serum glucose(r=0.61) serum triglycerides (r=0.7),
Atherogenic index of plasma (AIP) (r=0.80), TCHOL: HDL (r=0.71), HDL: LDL (r=0.70) respectively and
negative correlation with serum HDL (r=-0.52)
Clinical Usefulness of a New Equation for Estimating Body Fat
(Utilidad clínica de una nueva ecuación para estimar la grasa corporal)
Javier Gómez-Ambrosi, PHD1,2⇓, Camilo Silva, MD2,3, Victoria Catalán, PHD1,2, Amaia Rodríguez, PHD1,2, Juan Carlos Galofré, MD, PHD3, Javier Escalada, MD, PHD2,3, Victor Valentí, MD, PHD2, Fernando Rotellar, MD, PHD2, Sonia Romero, MSC2,3, Beatriz Ramírez, MSC1,2, Javier Salvador, MD, PHD2,3 and Gema Frühbeck, MD, PHD1,2,3
Corresponding author: Javier Gómez-Ambrosi, jagomez@unav.es.
Diabetes Care 2012 Feb; 35(2): 383-388. https://doi.org/10.2337/dc11-1334
International Journal of Computational Engineering Research(IJCER) is an intentional online Journal in English monthly publishing journal. This Journal publish original research work that contributes significantly to further the scientific knowledge in engineering and Technology.
Transplantation of Autologous Bone Marrow- Derived Stromal Cells in Type 2 Di...CrimsonpublishersITERM
Type 2 Diabetes is a debilitating metabolic disorder which is also the seventh leading cause of death worldwide. Current therapeutic regimes to date have failed to achieve significant long-term glycemic control even with intensive insulin therapy as revealed by deregulated Hb1Ac and C-peptides levels. In the current study, we have evaluated the effect of regenerative cellular therapy for functional recovery from Diabetic pathophysiology. 10 patients with a median age of 51 years were selected for the study and subjected to bone marrow isolation. These samples were processed under sterile conditions for the enrichment of mononuclear cells (BM MNCs) from bone marrow. After strict quality control and characterization of cells, 2 x 106 cells/kg of BM MNCs were infused back into the patient through the anterior pancreaticoduodenal artery. We performed an evaluation of clinical parameters like Body Mass Index, Fasting Plasma Glucose, Fasting Plasma Insulin, HbA1c and C-peptide levels, and followed up the patients for 12 months. Our study showed a reduction in insulin dependency by ≥ 50%.
Background: Tuberculous meningitis is defined as an inflammatory response to mycobacterial bacterial infection of the pia, arachnoid and CSF of the subarachnoid space. It is a dangerous form of extrapulmonary tuberculosis because it can cause permanent neurological disabilities and even death. Stroke is a devastating complication which further increase the morbidity and mortality in the disease. Matrix metalloproteinases are endopeptidases which degrade all the components of the extracellular matrix and thus have potential to disrupt blood brain barrier and cause CNS damage. Matrix metalloproteinases have been associated with pathophysiology of ischemic stroke. MMP levels in serum and CSF have also been seen to rise with advancing stage of TBM. So it is postulated that MMP may have role in the pathophysiology of stroke in TBM and may serve as a biomarker to predict stroke in TBM. Aims: To compare Serum Matrix metalloproteinase-9 in patients with Tuberculous Meningitis with and without Stroke and correlate it with various clinical, biochemical and radiological features of TBM. Methods: 40 Patients of probable or definite TBM and 40 age and sex matched patients of TBM with clinical stroke were enrolled in the study and formed two groups i.e. cases and controls. The two groups were compared for various clinical parameters, biochemical parameters (CSF cytology, glucose and protein), neuroimaging parameters and serum MMP-9 levels. Serum MMP-9 was estimated by ELISA method. Results: Serum MMP-9 levels were (224 ± 261.627 ng/ml) in cases and (157.23 ± 197.155 ng/ml) controls, which though higher in cases but no difference was statistically significant (p value 0.157) between two groups. Also there was no correlation between the serum MMP-9 levels and various clinical features (duration of illness, fever, headache, vomiting, weight loss, seizure, hemiparesis), CSF characteristics (protein, sugar and cytology) and radiological findings (tuberculoma, and hydrocephalus). Conclusion: we conclude that MMP-9 levels is not correlated with occurrence of stroke in TBM. MMP-9 levels were not increased with severity of disease, complications and outcomes.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
The prevalence and severity of obesity is increasing dramatically
among children and adolescents in many parts of the
world, whereas prevalence rates are estimated to increase in
the next decades [1]. In children, excess body fat appears to
be strongly associated with the clustering of risk factors, such
as hyperglycemia, dyslipidemia, and hypertension, which
play a key role in the pathogenesis of the metabolic syndrome
(MetS) [2].
Obesity and the MetS risk in children have been
recently associated with systemic inflammatory markers,
in particular C-reactive protein (CRP) [3, 4], implying
that low-grade inflammation can already exist in childhood
and may be a potential link between the obesity and the
MetS. Among behavioral variables, cardiorespiratory fitness
has a protective role in MetS and inflammatory factors;
however, it is not entirely clear if the interrelations among
cardiorespiratory fitness, MetS risk, and inflammation in
children are independent or partly due to the mediating
effect of obesity, since the existing data are limited and
equivocal [5, 6].
Recent evidence indicates that the prevalence rates
of childhood obesity in Greece remain high [1, 7] and
often coexist with low cardiorespiratory fitness [8] and
an unfavorable cardiometabolic risk profile [9]. For the
Greek pediatric population these data suggest an increased
cardiovascular morbidity in adulthood, given that highrisk
children and adolescents are likely to become highrisk
adults [10]. Although the relationship among obesity
and dyslipidemia in Greek children has been thoroughly
investigated [9, 11], there is a paucity of data regarding the
clustering of metabolic risk factors, inflammation, and their
relationship with cardiorespiratory fitness. The present study
was undertaken in an attempt to investigate the prevalence of
theMetS and examine the associations among cardiorespiratory
fitness, MetS risk, and CRP in 11-year-old children.
International Journal of Computational Engineering Research(IJCER) is an intentional online Journal in English monthly publishing journal. This Journal publish original research work that contributes significantly to further the scientific knowledge in engineering and Technology.
Transplantation of Autologous Bone Marrow- Derived Stromal Cells in Type 2 Di...CrimsonpublishersITERM
Type 2 Diabetes is a debilitating metabolic disorder which is also the seventh leading cause of death worldwide. Current therapeutic regimes to date have failed to achieve significant long-term glycemic control even with intensive insulin therapy as revealed by deregulated Hb1Ac and C-peptides levels. In the current study, we have evaluated the effect of regenerative cellular therapy for functional recovery from Diabetic pathophysiology. 10 patients with a median age of 51 years were selected for the study and subjected to bone marrow isolation. These samples were processed under sterile conditions for the enrichment of mononuclear cells (BM MNCs) from bone marrow. After strict quality control and characterization of cells, 2 x 106 cells/kg of BM MNCs were infused back into the patient through the anterior pancreaticoduodenal artery. We performed an evaluation of clinical parameters like Body Mass Index, Fasting Plasma Glucose, Fasting Plasma Insulin, HbA1c and C-peptide levels, and followed up the patients for 12 months. Our study showed a reduction in insulin dependency by ≥ 50%.
Background: Tuberculous meningitis is defined as an inflammatory response to mycobacterial bacterial infection of the pia, arachnoid and CSF of the subarachnoid space. It is a dangerous form of extrapulmonary tuberculosis because it can cause permanent neurological disabilities and even death. Stroke is a devastating complication which further increase the morbidity and mortality in the disease. Matrix metalloproteinases are endopeptidases which degrade all the components of the extracellular matrix and thus have potential to disrupt blood brain barrier and cause CNS damage. Matrix metalloproteinases have been associated with pathophysiology of ischemic stroke. MMP levels in serum and CSF have also been seen to rise with advancing stage of TBM. So it is postulated that MMP may have role in the pathophysiology of stroke in TBM and may serve as a biomarker to predict stroke in TBM. Aims: To compare Serum Matrix metalloproteinase-9 in patients with Tuberculous Meningitis with and without Stroke and correlate it with various clinical, biochemical and radiological features of TBM. Methods: 40 Patients of probable or definite TBM and 40 age and sex matched patients of TBM with clinical stroke were enrolled in the study and formed two groups i.e. cases and controls. The two groups were compared for various clinical parameters, biochemical parameters (CSF cytology, glucose and protein), neuroimaging parameters and serum MMP-9 levels. Serum MMP-9 was estimated by ELISA method. Results: Serum MMP-9 levels were (224 ± 261.627 ng/ml) in cases and (157.23 ± 197.155 ng/ml) controls, which though higher in cases but no difference was statistically significant (p value 0.157) between two groups. Also there was no correlation between the serum MMP-9 levels and various clinical features (duration of illness, fever, headache, vomiting, weight loss, seizure, hemiparesis), CSF characteristics (protein, sugar and cytology) and radiological findings (tuberculoma, and hydrocephalus). Conclusion: we conclude that MMP-9 levels is not correlated with occurrence of stroke in TBM. MMP-9 levels were not increased with severity of disease, complications and outcomes.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
The prevalence and severity of obesity is increasing dramatically
among children and adolescents in many parts of the
world, whereas prevalence rates are estimated to increase in
the next decades [1]. In children, excess body fat appears to
be strongly associated with the clustering of risk factors, such
as hyperglycemia, dyslipidemia, and hypertension, which
play a key role in the pathogenesis of the metabolic syndrome
(MetS) [2].
Obesity and the MetS risk in children have been
recently associated with systemic inflammatory markers,
in particular C-reactive protein (CRP) [3, 4], implying
that low-grade inflammation can already exist in childhood
and may be a potential link between the obesity and the
MetS. Among behavioral variables, cardiorespiratory fitness
has a protective role in MetS and inflammatory factors;
however, it is not entirely clear if the interrelations among
cardiorespiratory fitness, MetS risk, and inflammation in
children are independent or partly due to the mediating
effect of obesity, since the existing data are limited and
equivocal [5, 6].
Recent evidence indicates that the prevalence rates
of childhood obesity in Greece remain high [1, 7] and
often coexist with low cardiorespiratory fitness [8] and
an unfavorable cardiometabolic risk profile [9]. For the
Greek pediatric population these data suggest an increased
cardiovascular morbidity in adulthood, given that highrisk
children and adolescents are likely to become highrisk
adults [10]. Although the relationship among obesity
and dyslipidemia in Greek children has been thoroughly
investigated [9, 11], there is a paucity of data regarding the
clustering of metabolic risk factors, inflammation, and their
relationship with cardiorespiratory fitness. The present study
was undertaken in an attempt to investigate the prevalence of
theMetS and examine the associations among cardiorespiratory
fitness, MetS risk, and CRP in 11-year-old children.
LIBERTAGIA è UN AZIENDA CHE OPERA A LIVELLO MONDIALE ED HA DIVERSE SEDI NEL MONDO!
PER TUTTI I NUOVI ISCRITTI UN PACK BRONZE IN OMAGGIO.
Per Maggiori info contattami su skype: vintradework
Presented at Speak Up For Libraries conference 10 November 2012. Looks at the contemporary situation for volunteers taking over public libraries, pros and cons, practicalities and questions arising.
Correlation of Serum Creatinine Based Calculation of Glomerular Filtration Ra...ijtsrd
INTRODUCTION GFR is best index of kidney function in health and disease and accurate values are needed for optimal decision making in clinical settings. Estimated GFR eGFR based on serum creatinine is first line test of kidney function. CG formula is creatinine based equation and widely applied. Tc99m DTPA Diethylene Triamine Penta Acetic acid is the most commonly used radiopharmaceutical for GFR studies. The Gate method has been most common in the routine setting. AIM AND OBJECTIVES To study correlation of serum creatinine based calculation of GFR with measured ratio isotope GFR in healthy individuals and CKD patients. To assess the accuracy of GFR as calculated by CG GFR formulae using serum creatinine against measured RI GFR Tc 99m DTPA . METHODS This study observational study, which is done in department of medicine and department of nuclear medicine at Army Hospital RandR, Delhi Cantt in CKD and healthy individuals. Our study includes a total of 100 subjects with varying renal functions which includes 50 healthy individual and 50 CKD patients. RESULTS In this study it has been observed that in healthy group CG GFR has weak correlation with DTPA GFR r = 0.104 with p 0.471 . Lt Col (Dr.) Rahul Soni | Dr. Jayita Debnath "Correlation of Serum Creatinine Based Calculation of Glomerular Filtration Rate with Measured Radio Isotope Glomerular Filtration Rate in Healthy Individuals and Chronic Kidney Disease Patients" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-2 , February 2021, URL: https://www.ijtsrd.com/papers/ijtsrd38443.pdf Paper Url: https://www.ijtsrd.com/medicine/other/38443/correlation-of-serum-creatinine-based-calculation-of-glomerular-filtration-rate-with-measured-radio-isotope-glomerular-filtration-rate-in-healthy-individuals-and-chronic-kidney-disease-patients/lt-col-dr-rahul-soni
measurement of GFR and creatinine clearence-- design of dosage for hepatic patients -- therapeutic drug monitoring and clinical pharmacokinetics fifth pharm D notes
Cystatin C - Early Risk Assessment of Renal Impairment MAY18Randox Reagents
Cystatin C is a small (13 kDa) cysteine proteinase inhibitor, produced by all nucleated cells at a constant rate. Cystatin C travels through the bloodstream to the kidneys where it is freely filtered by the glomerular membrane, resorbed and fully catabolised by the proximal renal tubes. Consequently, Cystatin C is the ideal biomarker of GFR function.
Diabetes prediction based on discrete and continuous mean amplitude of glycem...journalBEEI
Chronic hyperglycemia and acute glucose fluctuations are the two main factors that trigger complications in diabetes mellitus (DM). Continuous and sustainable observation of these factors is significant to be done to reduce the potential of cardiovascular problems in the future by minimizing the occurrence of glycemic variability (GV). At present, observations on GV are based on the mean amplitude of glycemic excursion (MAGE), which is measured based on continuous blood glucose data from patients using particular devices. This study aims to calculate the value of MAGE based on discrete blood glucose observations from 43 volunteer patients to predict the diabetes status of patients. Experiments were carried out by calculating MAGE values from original discrete data and continuous data obtained using Spline Interpolation. This study utilizes the machine learning algorithm, especially k-Nearest Neighbor with dynamic time wrapping (DTW) to measure the distance between time series data. From the classification test, discrete data and continuous data from the interpolation results show precisely the same accuracy value that is equal to 92.85%. Furthermore, there are variations in the MAGE value for each patient where the diabetes class has the most significant difference, followed by the pre-diabetes class, and the typical class.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
A modified distance regularized level set model for liver segmentation from c...sipij
Segmentation of organs from medical images is an active and interesting area of research. Liver segmentation incurs more challenges and difficulties compared with segmentation of other organs. In this paper we demonstrate a liver segmentation method for computer tomography images. We revisit the distance regularization level set (DRLS) model by deploying new balloon forces. These forces control the direction of the evolution and slow down the evolution process in regions that are associated with weak or without edges. The newly added balloon forces discourage the evolving contour from exceeding the liver
boundary or leaking at a region that is associated with a weak edge, or does not have an edge. Our
experimental results confirm that the method yields a satisfactory overall segmentation outcome. Comparing with the original DRLS model, our model is proven to be more effective in handling oversegmentation problems.
Disparity of Interstitial Glucose for Capillary Glucose in Dialysis Diabetic ...semualkaira
The prevalence of chronic kidney disease (CKD) has steadily increased and diabetes is now considered the leading cause of endstage kidney disease (ESRD). Glycemic control in chronic renal
patients on dialysis presents additional difficulties because both
uremia and dialysis can affect insulin secretion and tissue insulin
sensitivity
On DPP-Inhibitor ,case study on Linagliptin,Safe and affective class of drug for Management of Type II Diabetes as Monotherapy and add on therapy with OHA and Insulin,It can be added to SGLT2 Inhibitor also.
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
HEALTH DISPARITIES: DIFFERENCES IN VETERAN AND NON-VETERAN POPULATIONS USING ...hiij
Introduction: This study investigated self-reported health status, health screenings, vision problems, and
vaccination rates among veteran and non-veteran groups to uncover health disparities that are critical for
informed health system planning for veteran populations.
Methods: Using public-use data from the National Health Interview Survey (2015-2018), this study adopts
an ecologic cross-sectional approach to conduct an in-depth analysis and visualization of the data assisted
by Generative AI, specifically ChatGPT-4. This integration of advanced AI tools with traditional
epidemiological principles enables systematic data management, analysis, and visualization, offering a
nuanced understanding of health dynamics across demographic segments and highlighting disparities
essential for veteran health system planning.
Findings: Disparities in self-reports of health outcomes, health screenings, vision problems, and
vaccination rates were identified, emphasizing the need for targeted interventions and policy adjustments.
Conclusion: Insights from this study could inform health system planning, using epidemiological data
assessment to suggest enhancements for veteran healthcare delivery. These findings highlight the value of
integrating Generative AI with epidemiological analysis in shaping public health policy and health
planning.
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
BRIEF COMMENTARY: USING A LOGIC MODEL TO INTEGRATE PUBLIC HEALTH INFORMATICS ...hiij
The COVID-19 pandemic has been a watershed moment in public health surveillance, highlighting the
crucial role of data-driven insights in informing health actions and policies. Revisiting key concepts—
public health, epidemiology in public health practice, public health surveillance, and public health
informatics—lays the foundation for understanding how these elements converge to create a robust public
health surveillance system framework. Especially during the COVID-19 pandemic, this integration was
exemplified by the WHO efforts in data dissemination and the subsequent global response. The role of
public health informatics emerged as instrumental in this context, enhancing data collection, management,
analysis, interpretation, and dissemination processes. A logic model for public health surveillance systems
encapsulates the integration of these concepts. It outlines the inputs and outcomes and emphasizes the
crucial actions and resources for effective system operation, including the imperative of training and
capacity development.
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
AUTOMATIC AND NON-INVASIVE CONTINUOUS GLUCOSE MONITORING IN PAEDIATRIC PATIENTShiij
Glycated haemoglobin does not allow you to highlight the effects that food choices, physical activity and
medications have on your glycaemic control day by day. The best way to monitor and keep track of the
immediate effects that these have on your blood sugar levels is self-monitoring, therefore the use of a
glucometer. Thanks to this tool you have the possibility to promptly receive information that helps you to
intervene in the most appropriate way, bringing or keeping your blood sugar levels as close as possible to
the reference values indicated by your doctor. Currently, blood glucose meters are used to measure and
control blood glucose. Diabetes is a fairly complex disease and it is important for those who suffer from it
to check their blood sugar (blood sugar) periodically throughout the day to prevent dangerous
complications. Many children newly diagnosed with diabetes and their families may face unique challenges
when dealing with the everyday management of diabetes, including treatments, adapting to dietary
changes, and the routine monitoring of blood glucose. Many questions may also arise when selecting a
blood glucose meter for paediatric patients. With current blood glucose meters, even with multiple daily
self-tests, high and low blood glucose levels may not be detected. Key factors that may be considered when
selecting a meter include accuracy of the meter; size of the meter; small sample size required for testing;
ease of use and easy-to-follow testing procedure; ability for alternate testing sites; quick testing time and
availability of results; ease of portability to allow testing at school and during leisure time; easyto- read
numbers on display; memory options; cost of meter and supplies. In this study we will show a new
automatic portable, non-invasive device and painless for the daily continuous monitoring (24 hours a day)
of blood glucose in paediatric patients.
INTEGRATING MACHINE LEARNING IN CLINICAL DECISION SUPPORT SYSTEMShiij
This review article examines the role of machine learning (ML) in enhancing Clinical Decision Support
Systems (CDSSs) within the modern healthcare landscape. Focusing on the integration of various ML
algorithms, such as regression, random forest, and neural networks, the review aims to showcase their
potential in advancing patient care. A rapid review methodology was utilized, involving a survey of recent
articles from PubMed and Google Scholar on ML applications in healthcare. Key findings include the
demonstration of ML's predictive power in patient outcomes, its ability to augment clinician knowledge,
and the effectiveness of ensemble algorithmic approaches. The review highlights specific applications of
diverse ML models, including moment kernel machines in predicting surgical outcomes, k-means clustering
in simplifying disease phenotypes, and extreme gradient boosting in estimating injury risk. Emphasizing
the potential of ML to tackle current healthcare challenges, the article highlights the critical role of ML in
evolving CDSSs for improved clinical decision-making and patient care. This comprehensive review also
addresses the challenges and limitations of integrating ML into healthcare systems, advocating for a
collaborative approach to refine these systems for safety, efficacy, and equity.
BRIEF COMMENTARY: USING A LOGIC MODEL TO INTEGRATE PUBLIC HEALTH INFORMATICS ...hiij
The COVID-19 pandemic has been a watershed moment in public health surveillance, highlighting the
crucial role of data-driven insights in informing health actions and policies. Revisiting key concepts—
public health, epidemiology in public health practice, public health surveillance, and public health
informatics—lays the foundation for understanding how these elements converge to create a robust public
health surveillance system framework. Especially during the COVID-19 pandemic, this integration was
exemplified by the WHO efforts in data dissemination and the subsequent global response. The role of
public health informatics emerged as instrumental in this context, enhancing data collection, management,
analysis, interpretation, and dissemination processes. A logic model for public health surveillance systems
encapsulates the integration of these concepts. It outlines the inputs and outcomes and emphasizes the
crucial actions and resources for effective system operation, including the imperative of training and
capacity development.
INTEGRATING MACHINE LEARNING IN CLINICAL DECISION SUPPORT SYSTEMShiij
This review article examines the role of machine learning (ML) in enhancing Clinical Decision Support
Systems (CDSSs) within the modern healthcare landscape. Focusing on the integration of various ML
algorithms, such as regression, random forest, and neural networks, the review aims to showcase their
potential in advancing patient care. A rapid review methodology was utilized, involving a survey of recent
articles from PubMed and Google Scholar on ML applications in healthcare. Key findings include the
demonstration of ML's predictive power in patient outcomes, its ability to augment clinician knowledge,
and the effectiveness of ensemble algorithmic approaches. The review highlights specific applications of
diverse ML models, including moment kernel machines in predicting surgical outcomes, k-means clustering
in simplifying disease phenotypes, and extreme gradient boosting in estimating injury risk. Emphasizing
the potential of ML to tackle current healthcare challenges, the article highlights the critical role of ML in
evolving CDSSs for improved clinical decision-making and patient care. This comprehensive review also
addresses the challenges and limitations of integrating ML into healthcare systems, advocating for a
collaborative approach to refine these systems for safety, efficacy, and equity.
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
The Proposed Guidelines for Cloud Computing Migration for South African Rural...hiij
It is now overdue for the hospitals in South African rural areas to implement cloud computing technologies in order to access patient data quickly in an emergency. Sometimes medical practitioners take time to attend patients due to the unavailability of kept records, leading to either a loss of time or the reassembling of processes to recapture lost patient files. However, there are few studies that highlight challenges faced by rural hospitals but they do not recommend strategies on how they can migrate to cloud computing. The purpose of this paper was to review recent papers about the critical factors that influence South African hospitals in adopting cloud computing. The contribution of the study is to lay out the importance of cloud computing in the health sectors and to suggest guidelines that South African rural hospitals can follow in order to successfully relocate into cloud computing.The existing literature revealed that Hospitals may enhance their record-keeping procedures and conduct business more effectively with the help of the cloud computing. In conclusion, if hospitals in South African rural areas is to fully benefit from cloud-based records management systems, challenges relating to data storage, privacy, security, and the digital divide must be overcome.
SUPPORTING LARGE-SCALE NUTRITION ANALYSIS BASED ON DIETARY SURVEY DATAhiij
While online survey systems facilitate the collection on copious records on diet, exercise and other healthrelated data, scientists and other public health experts typically must download data from those systems
into external tools for conducting statistical analyses. A more convenient approach would enable
researchers to perform analyses online, without the need to coordinate additional analysis tools. This
paper presents a system illustrating such an approach, using as a testbed the WAVE project, which is a 5-
year childhood obesity prevention initiative being conducted at Oregon State University by health scientists
utilizing a web application called WavePipe. This web application has enabled health scientists to create
studies, enrol subjects, collect physical activity data, and collect nutritional data through online surveys.
This paper presents a new sub-system that enables health scientists to analyse and visualize nutritional
profiles based on large quantities of 24-hour dietary recall records for sub-groups of study subjects over
any desired period of time. In addition, the sub-system enables scientists to enter new food information
from food composition databases to build a comprehensive food profile. Interview feedback from novice
health science researchers using the new functionality indicated that it provided a usable interface and
generated high receptiveness to using the system in practice.
AN EHEALTH ADOPTION FRAMEWORK FOR DEVELOPING COUNTRIES: A SYSTEMATIC REVIEWhiij
#Health #clinic #education #StaySafe #pharmacy #healthylifestyle
call for papers..!
-----------------------------
Health Informatics: An International Journal (HIIJ)
ISSN : 2319 - 2046 (Online); 2319 - 3190 (Print)
Here's where you can reach us : hiij@aircconline.com
visit us on : https://airccse.org/journal/hiij/index.html
**************
published articles..!
AN EHEALTH ADOPTION FRAMEWORK FOR
DEVELOPING COUNTRIES: A SYSTEMATIC REVIEW
https://aircconline.com/hiij/V10N3/10321hiij01.pdf
GENDER DISPARITYOF TUBERCULOSISBURDENIN LOW-AND MIDDLE-INCOME COUNTRIES: A SY...hiij
The tuberculosis burden is higher in the population from low- and middle-income countries (LMICs) and
differently affects gender. This review explored risk factors that determine gender disparity in tuberculosis
in LMICs. The research design was a systematic review. Three databases; Google Scholar, PubMed, and
HINARI provided 69 eligible papers.The synthesized data were coded, grouped and written in a descriptive
narrative style. HIV-TB co-infected women had a higher risk of mortality than TB-HIV-infected men. The
risk of Vitamin-D deficiency-induced tuberculosis was higher in women than in men. Lymph node TB,
breast TB, and cutaneous and abdominal TB occurred commonly in women whereas pleuritis, miliary TB,
meningeal TB, pleural TB and bone and joint TB were common in men. Employed men had higher contact
with tuberculosis patients and an increased chance of getting the disease. Migrant women were more likely
to develop tuberculosis than migrant men. The TB programmers and policymakers should balance the
different gaps of gender in TB-related activities and consider more appropriate approaches to be genderbased and have equal access to every TB-associated healthcare.
BRIEF COMMUNICATIONS DATA HYGIENE: IMPORTANT STEP IN DECISIONMAKING WITH IMPL...hiij
Medical and health data that have been entered into an electronic data system in real-time cannot be
assumed to be accurate and of high quality without verification. The adoption of the electronic health
record (EHR) by many countries to the support care and treatment of patients illustrates the importance of
high quality data that can be shared for efficient patient care and the operation of healthcare systems.
This brief communication provides a high-level overview of an EHR system and practices related to high
data quality and data hygiene that could contribute to the analysis and interpretation of EHR data for use
in patient care and healthcare system administration.
Accelerate your Kubernetes clusters with Varnish CachingThijs Feryn
A presentation about the usage and availability of Varnish on Kubernetes. This talk explores the capabilities of Varnish caching and shows how to use the Varnish Helm chart to deploy it to Kubernetes.
This presentation was delivered at K8SUG Singapore. See https://feryn.eu/presentations/accelerate-your-kubernetes-clusters-with-varnish-caching-k8sug-singapore-28-2024 for more details.
Slack (or Teams) Automation for Bonterra Impact Management (fka Social Soluti...Jeffrey Haguewood
Sidekick Solutions uses Bonterra Impact Management (fka Social Solutions Apricot) and automation solutions to integrate data for business workflows.
We believe integration and automation are essential to user experience and the promise of efficient work through technology. Automation is the critical ingredient to realizing that full vision. We develop integration products and services for Bonterra Case Management software to support the deployment of automations for a variety of use cases.
This video focuses on the notifications, alerts, and approval requests using Slack for Bonterra Impact Management. The solutions covered in this webinar can also be deployed for Microsoft Teams.
Interested in deploying notification automations for Bonterra Impact Management? Contact us at sales@sidekicksolutionsllc.com to discuss next steps.
Transcript: Selling digital books in 2024: Insights from industry leaders - T...BookNet Canada
The publishing industry has been selling digital audiobooks and ebooks for over a decade and has found its groove. What’s changed? What has stayed the same? Where do we go from here? Join a group of leading sales peers from across the industry for a conversation about the lessons learned since the popularization of digital books, best practices, digital book supply chain management, and more.
Link to video recording: https://bnctechforum.ca/sessions/selling-digital-books-in-2024-insights-from-industry-leaders/
Presented by BookNet Canada on May 28, 2024, with support from the Department of Canadian Heritage.
Epistemic Interaction - tuning interfaces to provide information for AI supportAlan Dix
Paper presented at SYNERGY workshop at AVI 2024, Genoa, Italy. 3rd June 2024
https://alandix.com/academic/papers/synergy2024-epistemic/
As machine learning integrates deeper into human-computer interactions, the concept of epistemic interaction emerges, aiming to refine these interactions to enhance system adaptability. This approach encourages minor, intentional adjustments in user behaviour to enrich the data available for system learning. This paper introduces epistemic interaction within the context of human-system communication, illustrating how deliberate interaction design can improve system understanding and adaptation. Through concrete examples, we demonstrate the potential of epistemic interaction to significantly advance human-computer interaction by leveraging intuitive human communication strategies to inform system design and functionality, offering a novel pathway for enriching user-system engagements.
Key Trends Shaping the Future of Infrastructure.pdfCheryl Hung
Keynote at DIGIT West Expo, Glasgow on 29 May 2024.
Cheryl Hung, ochery.com
Sr Director, Infrastructure Ecosystem, Arm.
The key trends across hardware, cloud and open-source; exploring how these areas are likely to mature and develop over the short and long-term, and then considering how organisations can position themselves to adapt and thrive.
Generating a custom Ruby SDK for your web service or Rails API using Smithyg2nightmarescribd
Have you ever wanted a Ruby client API to communicate with your web service? Smithy is a protocol-agnostic language for defining services and SDKs. Smithy Ruby is an implementation of Smithy that generates a Ruby SDK using a Smithy model. In this talk, we will explore Smithy and Smithy Ruby to learn how to generate custom feature-rich SDKs that can communicate with any web service, such as a Rails JSON API.
Kubernetes & AI - Beauty and the Beast !?! @KCD Istanbul 2024Tobias Schneck
As AI technology is pushing into IT I was wondering myself, as an “infrastructure container kubernetes guy”, how get this fancy AI technology get managed from an infrastructure operational view? Is it possible to apply our lovely cloud native principals as well? What benefit’s both technologies could bring to each other?
Let me take this questions and provide you a short journey through existing deployment models and use cases for AI software. On practical examples, we discuss what cloud/on-premise strategy we may need for applying it to our own infrastructure to get it to work from an enterprise perspective. I want to give an overview about infrastructure requirements and technologies, what could be beneficial or limiting your AI use cases in an enterprise environment. An interactive Demo will give you some insides, what approaches I got already working for real.
Software Delivery At the Speed of AI: Inflectra Invests In AI-Powered QualityInflectra
In this insightful webinar, Inflectra explores how artificial intelligence (AI) is transforming software development and testing. Discover how AI-powered tools are revolutionizing every stage of the software development lifecycle (SDLC), from design and prototyping to testing, deployment, and monitoring.
Learn about:
• The Future of Testing: How AI is shifting testing towards verification, analysis, and higher-level skills, while reducing repetitive tasks.
• Test Automation: How AI-powered test case generation, optimization, and self-healing tests are making testing more efficient and effective.
• Visual Testing: Explore the emerging capabilities of AI in visual testing and how it's set to revolutionize UI verification.
• Inflectra's AI Solutions: See demonstrations of Inflectra's cutting-edge AI tools like the ChatGPT plugin and Azure Open AI platform, designed to streamline your testing process.
Whether you're a developer, tester, or QA professional, this webinar will give you valuable insights into how AI is shaping the future of software delivery.
GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using Deplo...James Anderson
Effective Application Security in Software Delivery lifecycle using Deployment Firewall and DBOM
The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
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All of this illustrated with link prediction over knowledge graphs, but the argument is general.
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
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Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
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- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
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- Visualization tools to display your network;
- Grid simulation tools, such as power flows, security analyses (with or without remedial actions) and sensitivity analyses;
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UiPath Test Automation using UiPath Test Suite series, part 4DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 4. In this session, we will cover Test Manager overview along with SAP heatmap.
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1. Insights into SAP testing best practices
2. Heatmap utilization for testing
3. Optimization of testing processes
4. Demo
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Execution from the test manager
Orchestrator execution result
Defect reporting
SAP heatmap example with demo
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UiPath Test Automation using UiPath Test Suite series, part 4
Modeling Algorithm of Estimation Of Renal Function by the Cockcroft and Mdrd Formulas
1. Health Informatics - An International Journal (HIIJ) Vol.2, No.2, May 2013
DOI: 10.5121/hiij.2013.2201 1
MODELING ALGORITHM OF ESTIMATION OF RENAL
FUNCTION BY THE COCKCROFT AND MDRD
FORMULAS
Boumediene Selma1
, Samira Chouraqui2
, Ahmed GHALI3
1
Department of Computer Science, Faculty of Science. University of Science and
Technology "Mohamed Boudiaf" USTO Oran. 31000, Algeria
selma.boumediene@yahoo.fr
2
Department of Computer Science, Faculty of Science. University of Science and
Technology "Mohamed Boudiaf" USTO Oran. 31000, Algeria
s_chouraqui@yahoo.fr
2
Department of Computer Science, Faculty of Science. University of Science and
Technology "Mohamed Boudiaf" USTO Oran. 31000, Algeria
ahmed.gh@hotmail.fr
ABSTRACT
The purpose of this study was to determine the concordance between two equations used for estimating
glomerular filtration rate, in order to verify the possibility to be used interchangeably in the clinical
practice. The two equations are of Cockcroft & Gault (CG) (1976) formula and MDRD (modification of
Diet in Renal Disease) (1999) formula, these two models allow the assessment of glomerular filtration rate
(GFR) by calculating creatinine clearance (CLCR).To make a comparison between these two formulas
different models were examined for Subjects with normal renal function, Patients with renal impairment,
Diabetic patients, Age and sex, finally lean and obese patients by modeling two algorithms with the two
functions. Results show that the formula of Cockcroft & Gault remains the method of choice for estimating
renal function in clinical practice.
KEYWORDS
Cockcroft-Gault formula, MDRD formula, GFR, creatinine, renal function.
1. INTRODUCTION
Glomerular filtration rate (GFR) is an important tool for kidney evaluation, in order to detect the
early impairment of renal function, to allow correct dosage of drugs cleared by the kidneys or to
evaluate patients before transplantation or before using potentially nephrotoxic radiographic
contrast media
.For clinical application, the assessment of renal function needs to be accurate, inexpensive and
easy to apply. For this reason, in an attempt to find the best method to calculate GFR, a variety of
formulas have been developed.
2. Health Informatics - An International Journal (HIIJ) Vol.2, No.2, May 2013
2
The use of these formulas is recommended by ANAES and the National Kidney Foundation for
the diagnosis of chronic renal disease [1] [2]. Overall, the MDRD formula [3] significantly
underestimates GFR "real" about 1 ml/min/1, 73m2
, while the CG formula [4] significantly
overestimates of about 2 ml/min/1,73m2
[5].
Much work has been done recently to make the comparison between these two formulas changing
in these equations [6] [7] [8] and with different conditions of patients which is relative with GFR
[9] [10] [11].
Currently, little information has been published on the performance of the CG and MDRD
equations in the elderly (age > 65 years), lean and obese, individuals with liver disease.
The paper is divided in four sections, the fist one is the introduction, secondly cover the
recognition chronic kidney disease. Cockcroft & Gault model and MDRD algorithm are presented
in section three. The last one gives Comparison of two algorithms using different cases of
patients.
2. RECOGNITION CHRONIC KIDNEY DISEASE
Recent recommendations proposed by the research group K / DOQI (Kidney Disease Outcome
Quality Initiative) of the National Kidney Foundation and American international occasions by
the group KDIGO (Kidney Disease Improving Global Outcomes), have established classification
into 5 stages of chronic kidney disease by level of GFR [12], whatever its cause. This
classification is associated with an action plan tailored to different clinical stages of kidney
disease, the goal is to slow the progression of it and treat its complications [13].
It is therefore necessary to assess the GFR of a patient to use this classification.Creatinine
depends also on its rate of production from the muscle creatine, flow is proportional to the mass
of striated muscle of the subject: it must always be interpreted in terms of this parameter. Several
formulas for estimating GFR have been developed using creatinine and correction factors
expected to take into account the interindividual variation in creatinine production by muscle
mass [14].
Table 1. Classification of determining the severity of CKD based on the GFR (ml/min/1, 73m2
)
stage description
1 Suffering kidney GFR ≥ 90 + mL/min/1,73 m2
2 Suffering kidney GFR 60-89 + mL/min/1,73 m2
3 GFR 30-59 mL/min/1,73 m2
4 GFR 15-29 mL/min/1,73 m2
5 GFR < 15 mL/min/1,73 m2
3. MODELING
Formula for estimating GFR is only usable for a stable serum creatinine and is not applicable in
case of acute variation thereof. The two most commonly used are those of Cockcroft and Gault
and the data derived from the study MDRD (Modification of Diet in Renal Disease). These
formulas dedicated to the adult population.
3. Health Informatics - An International Journal (HIIJ) Vol.2, No.2, May 2013
3
3.1. Model algorithm of Cockcroft and Gault
The CG was described in 1976 from 249 men hospitalized. It uses serum creatinine, as well as
age, weight and sex of the subject as an indicator of muscle mass [4].
The first algorithm is then written:
Input: Age, weight, creatinine
SYSTEM with the factors related to sex A and F: constants such as;
A = 1.23 in men and 1.04 in women.
F = 1 in men and 0.85 in women.
If serum creatinine then
End if
Output: the creatinine clearance (CLCR).
This formula estimates GFR not, but the renal clearance of creatinine mL / min. This is higher
than the GFR because creatinine is not only filtered by the glomeruli but also secreted by the
renal tubules, and this proportion especially as renal function is impaired. Its advantage is its ease
of calculation, but it has several limitations: it overestimates GFR in obese subjects, very thin or
edematous, and underestimated in the elderly. Indeed, age and weight are not good indicators of
muscle mass in these situations. Finally, it tends to underestimate the functional value of the
patients with normal renal function.
• It is currently recommended to estimate renal function in daily practice by a formula using
creatinine.
• This estimate only applies to a steady state of creatinine.
• The MDRD formula showed an overall performance.
3.2. Model algorithm MDRD
MDRD formula has been described as in 1999 from 1628 patients with chronic kidney disease. In
its latest version, published in 2006 [15], it uses serum creatinine, as well as age, sex and ethnicity
for African-Americans as indicators of muscle mass. In an effort to standardize assays, whose
variability has recently been recognized as significant cause errors of estimate GFR, serum
creatinine measured by the laboratory must be standardized in relation to mass spectrometry to be
used in the formula. This normalization is gradual implementation in laboratories, as was done a
few years ago.
4. Health Informatics - An International Journal (HIIJ) Vol.2, No.2, May 2013
4
The second algorithm is then written:
Input: Age, weight, creatinine
SYSTEM with a factor related to sex A and ethnicity factor S: constants such as;
A = 1 in men and 0.742 in women.
S = 1.210 if African American subject.
This formula estimates GFR in mL/min/1,73 m2
. Its performance is good in the elderly and obese.
Its boundaries are an overestimation of GFR in patients very thin, and a tendency to
underestimate in healthy subjects. There is however no systematic bias related to patient age [5].
4. COMPARISON OF TWO ALGORITHMS
4.1. Subjects with normal renal function: there is no significant difference between CG and
MDRD formulas [5], [16] despite the difference may seem large in absolute terms.
Table 2. Difference between CG and MDRD in subjects with normal renal function.
GFR gap "true"
(ml/min/1, 73m2
)
MDRD CG
[5] [16] [5] [16]
-6,2 -9 -0,3 +1,9
4.2. Patients with renal impairment: The MDRD allow a better estimate of GFR than the
CG formula.
Table 3. Difference between CG and MDRD in Patients with renal impairment
GFR gap "true"
(ml/min/1,73m2
)
MDRD CG
[5] [16] [5] [16]
>60 -0,8 -3,5 +0,9 +7,9
30-60 +0,6 -1,6 +2,6 +4,5
15-30 +2,3 -0,2 +4,9 +2,9
<15 +2,4 +5,2
5. Health Informatics - An International Journal (HIIJ) Vol.2, No.2, May 2013
5
Moreover, the classification of patients according to the severity of their renal failure was more
accurate with the MDRD formula: respectively 29.2 and 32.4% of patients were misclassified
when renal function was estimated with the MDRD formula or CG [5].
4.3. Diabetic patients: patients with and without diabetes, the MDRD GFR is closer to "true"
that the CG formula [16].
Table 3. Difference between CG and MDRD in patients with and without diabetes.
GFR gap "true"
(ml/min/1,73m2
)
MDRD CG
Diabetics -0,2 +4,2
Nondiabetic -0,9 +3,1
4.4. Age and sex [5]: in humans, the MDRD formula is better than the CG. In women, the CG
formula may be better in some cases.
Table 4. Difference between CG and MDRD in Age and sex.
GFR gap "true"
(ml/min/1,73m2
)
MDRD CG
H F H F
GFR ≥60 ≥65 ans -5,9 -1,6 -
14,5
-
10,7
<65 ans -0,6 -6,1 +3,2 +2,5
GFR <60 ≥65 ans +0,5 +1,2 -2,3 -0,1
<65 ans +1,4 +2,3 +5,9 +8,7
4.5. Lean and obese patients [5]: patients, men and women, thin, with a normal BMI or
overweight, the CG formula is better than the MDRD formula. The opposite result was observed
in obese patients.
Table 4. Difference between CG and MDRD in Lean and obese patients
GFR gap "true"
(ml/min/1,73m2
)
MDRD CG
H F H F
BMI < 18,5 +12,1 +12,3 +5,1 +7,4
18,5 < BMI < 25 +2,1 -4,1 +1,0 -2,0
25 < BMI < 30 -2,7 -1,8 +0,4 +5,0
BMI > 30 -2,8 -2,4 +5,4 +12,5
CONCLUSION
The present study confirms the existence of significant differences between CG and MDRD
equations, as a result of our study the MDRD equation is closer to the true GFR than that
calculated by Cockcroft & Gault formula and, hence, more suitable as a surrogate of renal
function. In conclusion, our study demonstrates that the differences between the MDRD and CG
formula were not only influenced by age, body mass index and serum creatinine but also affected
by gender and diabetes. In clinical practice physicians should be aware of these differences and
take them into consideration when they estimate renal functions.The MDRD formula
systematically underestimates GFR in healthy, overweight subjects, particularly in individuals
with increased BMI.
6. Health Informatics - An International Journal (HIIJ) Vol.2, No.2, May 2013
6
REFERENCES
[1] National Kidney Foundation.K/DOQI clinical practice guidelines for chronickidney
disease:evaluation, classification, and stratification. Am J Kidney Dis.2002;39:S1-266.
[2] National Agency for Accreditation and Evaluation in Health. Diagnosis of chronic renal failure in
adults. September 2002.
[3] Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate
glomerular filtration rate from serum creatinine: anew prediction equation. Modification of Diet in
Renal Disease Study Group.Ann Intern Med. 1999;130:461-70.
[4] COCKCROFT DW, GAULT MH. Prediction of creatinine clearance from serum creatinine. Nephron,
1976 ; 16 : 31-41.
[5] FROISSART M, ROSSERT J, JACQUOT C et al. Predictive performance of the modification of diet
in renal disease and Cockcroft-Gault equations for estimating renal function. J Am Soc Nephrol, 2005
; 16 : 763-73.
[6] Hermsen ED, Maiefski M, Florescu MC, Qiu F, Rupp ME. Comparison of the modification of diet in
renal disease and Cockcroft-Gault equations for dosing antimicrobials. Pharmacotherapy
2009;29:649–55.
[7] Melloni C, Peterson ED, Chen AY, et al. Cockcroft-Gault versus modification of diet in renal disease:
importance of glomerular filtration rate formula for classification of chronic kidney disease in patients
with non–ST-segment elevation acute coronary syndromes. J Am Coll Cardiol 2008;51:991–6.
[8] Moranville MP, Jennings HR. Implications of using modification of diet in renal disease versus
Cockcroft-Gault equations for renal dosing adjustments. Am J Health Syst Pharm 2009;66:154–61.
[9] Pai MP. Estimating the glomerular filtration rate in obese adult patients for drug dosing. Adv Chronic
Kidney Dis 2010;17: e53–62.
[10] Demirovic JA, Pai AB, Pai MP. Estimation of creatinine clearance in morbidly obese patients. Am J
ealth Syst Pharm 2009;66:642–8.
[11] Johnson, David W., Jones, Graham R. D., et Al. Chronic kidney disease and automatic reporting of
estimated glomerular filtration rate: new developments and revised recommendations. Medical
Journal of Australia, 2012; 197 4: 222-223.
[12] LEVEY AS, CORESH J, GREENE T. Using standardized serum creatinine values in the modification
of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med, 2006
; 145 : 247-54.
[13] LEVEYAS, ECKARDTKU, TSUKAMOTO Yet al. Definition and classification of kidney disease : a
position statement from kidney disease : improving global outcomes (KDIGO). Kidney Int, 2005 ; 67
: 2 089-100.
[14] STEVENSLA, CORESH J, GREENE Tet al.Assessing kidney function – Measured and estimated
glomerular filtration rate. N Engl J Med, 2006; 354: 2473-83.
[15] LEVEY AS, CORESH J, GREENE T. Using standardized serum creatinine values in the modification
of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med, 2006
; 145 : 247-54.
[16] Poggio ED, Wang X, Greene T, Van LF, Hall PM.: Performance of the Modification of Diet in Renal
Disease and Cockcroft-Gault equations in the estimation of GFR in health and in chronic kidney
disease. J Am Soc Nephrol 2005; 16: 459–466.
7. Health Informatics - An International Journal (HIIJ) Vol.2, No.2, May 2013
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AUTHORS
Boumediene SELMA: Has received his engineer degree in computer science from the
university of science of Mostaganem Abdelhamid Ibn Badis (Algeria) and actually is in
University of Science and technology USTO of Oran (Algeria); preparing his Magister
in systems dynamic attitude estimation and control using evolutionary techniques. His
current research interests are in the area of artificial intelligence and mobile robotics,
Pattern Recognition, neural networks, neuro-fuzzy, data-mining.
Samira CHOURAUI: Has received her MSc degree in Satellite and Systems
Communication from Surrey University UK and received the PhD in Applied
Mathematics from University of Science and technology of Oran (Algeria). She is
currently teaching Numerical Analysis and Systems Dynamics at the University of Oran
Mohamed Boudiaf USTO of Oran (Algeria).
Ahmed GHALI: Has received his engineer degree in computer science from the
university of science of Mostaganem Abdelhamid Ibn Badis (Algeria) and actually is in
University of Science and technology USTO of Oran (Algeria); preparing his Magister in
advanced optimization and artificial intelligence. His current research interests are in the
area of artificial intelligence, Pattern Recognition, neural networks and data-mining.