The Effects of Instrumental Touching on Infant Pain Perception and the Effects of Eutectic Mixture of Local Anesthetics (EMLA) on the Reduction of Pain

BACKGROUND: Premature infants, who have to spend the first week of their lives in neonatal intensive care units (NICUs), experience pain and stress in numerous cases, and they are exposed to many invasive interventions. The studies have shown that uncontrolled pain experienced during early life has negative and long-term side effects, such as distress, and such experiences negatively affect the development of the central nervous system OBJECTIVES: The purpose of the study was to examine the effects of touching on infant pain perception and the effects of eutectic mixture of local anesthetic (EMLA) on the reduction of pain. PATIENTS AND METHODS: Data for the study were collected between March and August 2012 from the neonatal clinic of a university hospital located in eastern Turkey. The population of the study consisted of premature infants who were undergoing treatment, completed the first month and who were approved for Hepatitis B vaccine. The study consisted of two experimental groups and one control group. Information forms, intervention follow-up forms, and Premature Infant Pain Profile (PIPP) were used to collect the data. EMLA cream was applied on the vastus lateralis muscles of the first experimental group before the vaccination. The second experimental group was vaccinated by imitation (placebo), without a needle tip or medicine. Vaccination was carried out using instrumental touch in this group. A routine vaccination was applied in the control group. RESULTS: Mean pain scores of the group to which EMLA was applied were lower in a statistically significant way (P < 0.05) compared to the pain scores of the other groups. Moreover, it was determined that even though invasive intervention was not applied to the newborns, the touching caused them to feel pain just as in the placebo group (P < 0.005). CONCLUSIONS: The results demonstrated that EMLA was an effective method for reducing pain in premature newborns, and the use of instrumental touch for invasive intervention stimulated the pain perception in the newborns

A Novel Simultaneous Dynamic Range Compression and Local Contrast Enhancement Algorithm for Digital Video Cameras

[[abstract]]This article addresses the problem of low dynamic range image enhancement for commercial digital cameras. A novel simultaneous dynamic range compression and local contrast enhancement algorithm (SDRCLCE) is presented to resolve this problem in a single-stage procedure. The proposed SDRCLCE algorithm is able to combine with many existent intensity transfer functions, which greatly increases the applicability of the proposed method. An adaptive intensity transfer function is also proposed to combine with SDRCLCE algorithm that provides the capability to adjustably control the level of overall lightness and contrast achieved at the enhanced output. Moreover, the proposed method is amenable to parallel processing implementation that allows us to improve the processing speed of SDRCLCE algorithm. Experimental results show that the performance of the proposed method outperforms three state-of-the-art methods in terms of dynamic range compression and local contrast enhancement.[[notice]]補正完

AB0278 IN RHEUMATOID ARTHRITIS PATIENTS RECEIVING bDMARDs, THE CHARLSON COMORBIDITY INDEX IS MORE PRONOUNCED THAN PSORIATIC ARTHRITIS

BackgroundAccording to international recommendations, co-morbidities must be taken into account in the management of patients with inflammatory arthritis.ObjectivesTo evaluate the distribution of pre-treatment comorbidities in the bDMARD cohort including patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA).MethodsThe Hacettepe University biological database (HUR-BIO) was established in 2005, 581(75.4% female) patients with RA and 520 (69.4%female) patients with PsA enrolled up to 2021 were analyzed. Diagnosis of RA and PsA were based on the clinical evaluation of the rheumatologist who followed the patients. Comorbidities of the patients were reviewed retrospectively from the biological database, hospital electronic records, ICD-10 diagnostic codes and prescriptions of patients. Diabetes mellitus (DM), Hypertension (HT), Dyslipidemia (DL), Coronary artery disease (CAD), Body mass index (BMI) and smoking were recorded. DL was grouped in terms of lipid values ​​according to the classification of the Turkish Society of Endocrinology and Metabolism Dyslipidemia Guide(1). Detection of coronary artery disease before the age of 55 in men and of 65 in women was classified as premature - CAD. Data on Chronic Kidney Disease, obstructive pulmonary disease, Cerebro-vascular disease, Thyroid Diseases were also recorded. The Charlson comorbidity index (CCI) was calculated by summing the comorbidities in the patients’ medical history before the bDMARDs.ResultsThe distribution of comorbidities in patients with RA and PsA prior to initiation of bDMARDs was given in Table 1. Patients with RA were older and smoking was more common. HT(28.5% for RA, 21.9% for PsA) and thyroid diseases (22.7% for RA, 14.7% for PsA) were the most comorbidities in both groups. Compared to PsA, patients with RA had higher rate of comorbidities (64.8% vs. 40.4%, p&lt;0.001). Multimorbidity was detected in 231/581 (39.7%) of patients with RA, and it is significantly more common than the patients with PsA (21.8%) (p&lt;0.001). There was no difference between the groups in terms of cardiovascular comorbidities such as BMI, DM, and dyslipidemia. When adjusted for age, the comorbidity burden according to CCI was 3.96 (2.57-6.13, p&lt;0.001) times higher in patients with RA than in patients with PsA.Table 1.Comorbidities in RA and PsA patientsFeaturesRA n=581PsA n=520pGender, female n (%)438 (75.4)361 (69.4)0.027Age at PsA diagnosis, mean (SD) years46.7 (13.7)39.3 (12.0)&lt;0.001Age at bDMARD start, mean (SD) years49.5 (13.8)42.2 (12.3)&lt;0.001CCI-No comorbidity205/581 (35.2)290/486 (59.6)&lt;0.001-1 comorbidity145/581 (24.9)90/486 (18.5)-≥ 2 comorbidity231/581 (39.7)106/486 (21.8)CCI mean, (SD)1.56 (1.77)0.78 (1.18)&lt;0.001Smoking (ever), n292/581282/506&lt;0.001BMI, mean (SD)29.3 (6.7)29.6 (5.9)0.50BMI ≥ 30 n261/577221/4980.77Diabetes Mellitus, n68/58149/4020.30Hypertension, n166/581110/5020.012Dyslipidemia* n-High TC47/27032/1610.30-High TG62/24245/1590.79-High LDL -C53/289(43/1750.38-Low HDL-C88/26757/1570.48Uric acid (&gt;6 mg/dl), n150/554136/4370.16CAD n59/52432/4860.010Premature CAD, n39/58118/4860.030CKD, nG1 (GFR &gt; 90)437/5230&lt;0.001G2 (GFR 60-90)68/5230G3a (GFR 45-60)11/5230G3b (GFR 30-45)5/52328/370G4 (GFR 15-30)2/523342/370Lung disease, n-COPD15/5193/4850.007-Asthma66/52019/485&lt;0.001Thyroid disease, n132/58165/440&lt;0.001*TC &gt; 240, TG 150-499, LDL-C&gt; 160, HDL-C erkek &lt; 40, kadin &lt; 50CCI: Charlson comorbidity index, CAD: Coronary artery disease, CKD: Chronic Kidney Disease, COPD: Chronic Obstructive pulmonary diseaseConclusionThe burden of comorbidities in patients with RA before bDMARDs is more pronounced than in patients with PsA. Although, cardiovascular risk factors were similar, with the exception of hypertension and smoking, the age-adjusted CCI was 3.96 times higher in patients with RA than in patients with PsA.References[1]TEMD Obesity Guideline, L.M., Hypertension Working Group, TEMD Dyslipidemia Diagnosis and Treatment Guideline. 9th ed. 2021Disclosure of InterestsNone declared</jats:sec

AB0277 DYSLIPIDEMIA TREATMENT IN RHEUMATOID ARTHRITIS PATIENTS USING bDMARDs IS BETTER THAN PsA, BUT THERE IS STILL A WAY TO GO

BackgroundPatients with inflammatory arthritis have an increased risk of cardiovascular disease. Dyslipidemia is one of the primary modifiable risk factors.ObjectivesComparasion of the frequency of dyslipidemia and the use of anti-hyperlipidemic agents in patients with Rheumatoid Arthritis (RA) and Psoriatic arthritis (PsA) receiving bDMARDs.MethodsThe Hacettepe University biological database (HUR-BIO), was established in 2005 and 581 (75.4% female) patients with RA and 520 (69.4% female) patients with PsA enrolled up to 2021 were analyzed. Dyslipidemia was defined according to the Turkish Endocrine and Metabolism society criteria (TC &gt; 240, Triglycerides (Tg) &gt; 150, LDL-C &gt; 160, HDL-C (&lt; 40 in men, &lt; 50 in women) (1). The anti-hyperlipidemic (anti-HL) agents used by the patients during follow-up and at their last visit were recorded.ResultsThe mean (SD) age of the patients and diseases duration were as follows; RA vs. PsA [age: 52.1 (13.9) vs. 48.7 (12.5) years; disease duration: 5.3 (2.1) vs. 9.2 (6.4) years]. Lipid profiles were known in 289 (49.7%) patients with RA and in 175 (33.6%) patients with PsA at the initiaiton of bDMARD. Lipid profiles were evaluated in 356 (61.2%) patients with RA and 226 (43.4%) patients with PsA during follow-up and at the last visit. Lipid profiles were similar in patients with RA and PsA at the initiation of bDMARDs (Table 1). At the initiation of bDMARD, 29 (5.0%) of RA patients and 10 (3.2%) of PsA patients were receiving anti-HL agents. During the entire follow-up, 65 (12.6%) patients with RA and 22 (4.8%) patients with PsA have used anti-HL agents (p&lt;0.001).Table 1.Lipid values in patients with RA and PsA at the initiation of bDMARD and at the last visitRheumatoid arthritis, n (%)Psoriatic arthritis, n (%)p1*p2**Lipid valuesbDMARD initiationLast visitbDMARD initiationLast visitTotal Cholesterol&gt; 24047/270(17.4)98/339 (28.9)32/161(19.8)57/203 (28.1)0.300.13Triglyseride&gt; 15062/242 (25.6)108/320 (33.7)45/159 (28.3)80/193 (41.4)0.790.20HDL-C&lt; 40 (males),&lt; 50 (females)88/267 (32.9)70/343 (20.4)57/157 (36.3)20/207 (9.6)0.480.001LDL-C &gt; 16053/289 (18.3)91/356 (25.6)43/175 (24.5)65/226 (28.7)0.380.55*p1, bDMARD initiation visit comparison**p2, last visit comparisonConclusionIn real-life cohort, lipid profile was not assesed in half of the patients during entire follow-up. Although, LDL-C levels are high in about a quarter of the patients in both groups, use of anti-hyperlipidemic drug was inadequate. This is even more evident in PsA patients. Despite the significant emphasis on comorbidities in treatment guidelines, there is still a long way to go in real life.References[1]TEMD Obesity Guideline, L.M., Hypertension Working Group, TEMD Dyslipidemia Diagnosis and Treatment Guideline. 9th ed. 2021,Disclosure of InterestsNone declared</jats:sec

POS1085 FREQUENCY OF DYSLIPIDEMIA AND COMPLIANCE WITH THE TREATMENT IN PsA PATIENTS USING bDMARDs

BackgroundDyslipidemia is the leading treatable-modifiable factor among comorbidities in Psoriatic arthritis (PsA) patients. International treatment recommendations have left the management of dyslipidemia to national guidelines and especially to the rheumatologists.ObjectivesIn this study, we aimed to determine the frequency of dyslipidemia and the rates of initiation of treatment within the indication in PsA patients using bDMARDs.MethodsThe Hacettepe University biological database (HUR-BIO), was established in 2005 and data of 520 PsA patients included until 2021 were analyzed. In all included patients, the diagnosis of PsA was made by therheumatologist. Lipid profiles of PsA patients were evaluated at diagnosis, during the first bDMARD initiation, and at the last visit. Total cholesterol (TC), Triglyserides (TG), HDL-C and LDL-C values were grouped as optimal, borderline, high and severely high according to the Turkish Endocrine and Metabolism society criteria (1).ResultsLipid profile values ​​of PsA patients were known at diagnosis (n=159, 30.6%), in the initial bDMARD baseline (n=161, 30.9%), and at the last visit (n=203, 39.0%). The time to diagnosis of PsA and first bDMARD use was 2.8 years, and the time between the start of bDMARD and the last visit was 3.7 years. Accordingly, the rates of high TC, borderline TG, and high LDL increased over time. Rates at the time of PsA diagnosis, first bDMARD onset and at the last visit are as follows; high TC (14.3%, 17.1% and 28.0%), borderline TG (20.4%, 27.7% and 40.5%) and high LDL (17.0, 24.0% and 27.9%). On the other hand, low HDL-C slightly improved in men (33.3%, 29.4% and 23.1%), but did not show a significant change in women. While LDL-C level was &gt;160 in 24.0% of patients who were started on bDMARD, anti-hyperlipidemic drug was started in only 6.2% of them. A similar situation persisted at the last visit (27.9% had LDL-C levels &gt;160, but 10.8% received anti-hyperlipidemic therapy) (Table 1).Table 1.Lipid levels and changes over timeLipid levelsAt the time of diagnosis n= 159At the time of bDMARD initiation n=161bDMARD last visit n= 203Total Cholesterol (TC) mean (SD)195 (42)201 (43)214 (47)- TC &lt; 200 (optimal) (%)56.552.845.3- TC 200-239 (borderline) (%)27.230.125.7-- TC &gt; 240 (high) (%)14.317.128.0Triglyceride (TG) mean (SD)115 (52)132 (90)158 (103)- TG &lt; 150 (optimal) (%)79.671.758.0- TG 150-499 (borderline) (%)20.427.740.5- TG 500-880 (high) (%)001.0-- TG ≥ 880 (severely high) (%)00.60.5HDL-C mean (SD)51.8 (13.1)50.6 (13.0)53.2 (12.5)- ≥60 (optimal) (%)20.620.425.6- 40-59 (borderline) in men (%)54.660.852.3- 50-59 (borderline) in women (%)32.324.530.3- Male &lt; 40 (low) (%)33.329.423.1-- Women &lt; 50 (low) (%)32.339.633.8LDL-C mean (SD)126 (33)132 (37)139 (36)- LDL-C &lt; 100 (optimal) (%)21.421.114.2- LDL 130-159 (borderline) (%)22.525.127.0- LDL 160-190 (high) (%)17.024.027.9-- LDL &gt; 190 (very high) (%)4.46.38.4Anti-hyperlipidemic drug n (%)5 (3.1)10 (6.2)22 (10.8)ConclusionAmong the modifiable risk factors for cardiovascular comorbidities in PsA patients, the leading risk factor is dyslipidemia. On the other hand, dyslipidemic drug use rates in daily practice are significantly lower. Although attention is paid to the management of comorbidities in all recommendations, there is still work to be done in real life.References[1]TEMD Obezite, L.M., Hipertansiyon Çalişma Grubu, TEMD DİSLİPİDEMİ TANI VE TEDAVİ KILAVUZU. 9 ed, ed. 2021, Ankara: Türkiye Endokrinoloji ve Metabolizma Derneği. 159.Disclosure of InterestsNone declared</jats:sec