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Jara-Prado A, Guerrero-Camacho JL, Ángeles-López QD, Ochoa-Morales A, Dávila-Ortiz de Montellano DJ, Ramírez-García MÁ, Breda-Yepes M, Durón RM, Delgado-Escueta AV, Barrios-González DA, Martínez-Juárez IE. Association of variants in the ABCB1, CYP2C19 and CYP2C9 genes for Juvenile Myoclonic Epilepsy. Neurol Sci 2024; 45:1635-1643. [PMID: 37875597 DOI: 10.1007/s10072-023-07124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023]
Abstract
Juvenile myoclonic epilepsy (JME) is the most common of the generalized genetic epilepsies, with multiple causal and susceptibility genes; however, its etiopathogenesis is mainly unknown. The toxic effects caused by xenobiotics in cells occur during their metabolic transformation, mainly by enzymes belonging to cytochrome P450. The elimination of these compounds by transporters of the ABC type protects the central nervous system, but their accumulation causes neuronal damage, resulting in neurological diseases. The present study has sought the association between single nucleotide genetic variants of the CYP2C9, CYP2C19, and ABCB1 genes and the development of JME in patients compared to healthy controls. The CC1236 and GG2677 genotypes of ABCB1 in women; allele G 2677, genotypes GG 2677 and CC 3435 in men; the CYP2C19*2A allele, and the CYP2C19*3G/A genotype in both sexes were found to be risk factors for JME. Furthermore, carriers of the TTGGCC genotype combination of the ABCB1 gene (1236/2677/3435) have a 10.5 times higher risk of developing JME than non-carriers. Using the STRING database, we found an interaction between the proteins encoded by these genes and other possible proteins. These findings indicate that the CYP450 system and ABC transporters could interact with other genes in the JME.
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Affiliation(s)
- Aurelio Jara-Prado
- Genetics Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | | | | | - Adriana Ochoa-Morales
- Genetics Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | | | | | - Michelle Breda-Yepes
- National Institute of Neurology and Neurosurgery, Epilepsy Clinic, Mexico City, Mexico
| | - Reyna M Durón
- Universidad Tecnológica Centroamericana (UNITEC), Tegucigalpa, Honduras
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Kim S, Won SJ, Lee NK, Chang CB. Life Expectancy of Patients Undergoing Total Knee Arthroplasty: Comparison With General Population. J Korean Med Sci 2024; 39:e106. [PMID: 38529576 DOI: 10.3346/jkms.2024.39.e106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/01/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND This study aimed to analyze the life expectancy and cause of death in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) and to identify risk factors that affect long-term mortality rate after TKA. METHODS Among 601 patients, who underwent primary TKA due to OA by a single surgeon from July 2005 to December 2011, we identified patients who died after the operation using data obtained from the National Statistical Office of Korea. We calculated 5-, 10-, and 15-year survival rates of the patients and age-specific standardized mortality ratios (SMRs) compared to general population of South Korea according to the causes of death. We also identified risk factors for death. RESULTS The 5-year, 10-year, and 15-year survival rates were 94%, 84%, and 75%, respectively. The overall age-specific SMR of the TKA cohort was lower than that of the general population (0.69; P < 0.001). Cause-specific SMRs for circulatory diseases, neoplasms, and digestive diseases after TKA were significantly lower than those of the general population (0.65, 0.58, and 0.16, respectively; all P < 0.05). Male gender, older age, lower body mass index (BMI), anemia, and higher Charlson comorbidity index (CCI) were significant factors associated with higher mortality after TKA. CONCLUSION TKA is a worthwhile surgery that can improve life expectancy, especially from diseases of the circulatory system, neoplasms, and digestive system, in patients with OA compared to the general population. However, careful follow-up is needed for patients with male gender, older age, lower BMI, anemia, and higher CCI, as these factors may increase long-term mortality risk after TKA. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Sanghyo Kim
- Department of Orthopaedic Surgery, Busan Mirae Hospital, Busan, Korea
| | - Samuel Jaeyoon Won
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Na-Kyoung Lee
- Department of Orthopaedic Surgery, National Medical Center, Seoul, Korea.
| | - Chong Bum Chang
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
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Karaye KM, Sa'idu H, Ishaq NA, Balarabe SA, Ahmed BG, Mohammed IY, Habib AG, Henein MY. Selenium Deficiency as a Risk Factor for Peripartum Cardiomyopathy. West Afr J Med 2024; 41:209-214. [PMID: 38583094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
BACKGROUND Peripartum cardiomyopathy (PPCM) is a multifactorial disease. Although the specific aetiology and pathogenesis of PPCM are unknown, several hypotheses have been proposed, including selenium deficiency. However, the risk of PPCM from selenium deficiency was not previously quantified. This posthoc analysis of peripartum cardiomyopathy in Nigeria (PEACE) registry data aimed to determine if selenium deficiency is an independent risk factor for PPCM. METHODS Apparently healthy women who delivered within the previous 8 weeks and PPCM patients in Kano, Nigeria, were compared for selenium deficiency (<70µg/L) and other relevant socio-demographic and clinical characteristics. Selenium level was measured at recruitment for each subject. Independent predictors of PPCM were determined using logistic regression models. RESULTS 159 PPCM patients and 90 age-matched controls were consecutively recruited. 84.9% of the patients and 3.3% of controls had selenium deficiency. Selenium deficiency independently increased the odds for PPCM by 167-fold while both unemployment and lack of formal education independently increased the odds by 3.4-fold. CONCLUSION Selenium deficiency was highly prevalent among PPCM patients in Kano, Nigeria, and significantly increased the odds for PPCM. These results could justify screening of women in their reproductive years for selenium deficiency, particularly those living in regions with high incidence of PPCM. The results also call for the setting up of a definitive clinical trial of selenium supplementation in PPCM patients with selenium deficiency, to further define its benefits in the treatment of PPCM.
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Affiliation(s)
- K M Karaye
- Department of Medicine, Bayero University, Kano, Nigeria
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
- Department of Public Health and Clinical Medicine, Umea University, Sweden
| | - H Sa'idu
- Department of Medicine, Bayero University, Kano, Nigeria
- Department of Medicine, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - N A Ishaq
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - S A Balarabe
- Department of Medicine, Muhammad Abdullahi Wase Specialist Hospital, Kano, Nigeria
| | - B G Ahmed
- Department of Medicine, Muhammad Abdullahi Wase Specialist Hospital, Kano, Nigeria
| | - I Y Mohammed
- Department of Chemical Pathology, Bayero University and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - A G Habib
- Department of Medicine, Bayero University, Kano, Nigeria
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - M Y Henein
- Department of Public Health and Clinical Medicine, Umea University, Sweden
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Jeong SH, Hurh K, Park EC, Leigh JH, Kim SH, Jang SI. Risk of Pancreatic Cancer After Acute Pancreatitis: A Retrospective Analysis of the Korean National Sample Cohort. J Korean Med Sci 2024; 39:e21. [PMID: 38288535 PMCID: PMC10825454 DOI: 10.3346/jkms.2024.39.e21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/22/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Acute pancreatitis may increase the risk of pancreatic cancer, although this association remains unclear. Therefore, we aimed to investigate this association. METHODS We retrospectively analyzed the 2002-2019 Korean National Health Insurance Service-National Sample Cohort using 1:3 propensity score matching for sex and age (acute pancreatitis, n = 4,494; matched controls, n = 13,482). We calculated the hazard ratio (HR) for pancreatic cancer risk in patients with acute pancreatitis using Cox proportional hazards regression. RESULTS Acute pancreatitis was significantly associated with an increased risk of pancreatic cancer throughout the study period (adjusted HR, 7.56 [95% confidence interval, 5.00-11.41]), which persisted for 2, 2-5, and > 5 years post-diagnosis (19.11 [9.60-38.05], 3.46 [1.35-8.33], and 2.73 [1.21-6.15], respectively). This pancreatitis-related pancreatic cancer risk became insignificant beyond 10 years of follow-up (1.24 [0.24-6.49]). Furthermore, this risk notably increased as the number of recurrent acute pancreatitis episodes increased (1 episode: 5.25 [3.31-8.33], 2 episodes: 11.35 [6.38-20.19], ≥ 3 episodes: 24.58 [13.66-44.26]). CONCLUSION Following an acute pancreatitis diagnosis, the risk of pancreatic cancer increases significantly in the initial years, with a rapid increase further accentuated with recurrent acute pancreatitis episodes. Additional study is needed to evaluate whether this increased risk of carcinogenesis is attributed to accumulated inflammation.
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Affiliation(s)
- Sung Hoon Jeong
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Kyungduk Hurh
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ja-Ho Leigh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Seung Hoon Kim
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Preventive Medicine, Eulji University School of Medicine, Daejeon, Korea.
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Choi C, Kang M, Seo SI, Suh J, Song C, Chung J, Kim SH, Park JY, Hwang EC, Jeong CW, Kwak C, Kim JK, Hong SH. Retrospective Multicenter Analysis of Prognostic Risk Factors for One Year Recurrence in Patient With Renal Cell Carcinoma After Partial or Radical Nephrectomy: Results of Korean Renal Cancer Study Group (KRoCS) Database. J Korean Med Sci 2024; 39:e11. [PMID: 38258358 PMCID: PMC10803202 DOI: 10.3346/jkms.2024.39.e11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/10/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND We sought to identify prognostic risk factors for one year recurrence in patient with renal cell carcinoma (RCC) after partial or radical nephrectomy. METHODS We performed a retrospective study of 1,269 patients with RCC after partial or radical nephrectomy and diagnosed recurrence using Korean Renal Cancer Study Group (KRoCS) database between January 1991 and March 2017. Recurrence-free survival (RFS), and overall survival (OS) were calculated using the Kaplan-Meier method and multivariate Cox regression analysis were performed to evaluate independent prognostic factors for recurrence. RESULTS The median patient age was 56 years and median follow-up period was 67 months. Multivariable analysis demonstrated BMI greater than or equal to 23 and less than 30 (vs. BMI less than 23, hazard ratio [HR]: 0.707, P = 0.020) reduced recurrence one year postoperatively. Eastern Cooperative Oncology Group performance status (ECOG PS) greater than or equal to 1 (vs. ECOG PS 0, HR: 1.548, P = 0.007), high pathological T stage (pT2 vs. pT1, HR: 2.622, P < 0.001; pT3 vs. pT1, HR: 4.256, P < 0.001; pT4 vs. pT1, HR: 4.558, P < 0.001), and tumor necrosis (vs. no tumor necrosis, HR: 2.822, P < 0.001) were independent predictive factors for early recurrence within one year in patients with RCC. Statistically significant differences on RFS and OS were found among pathological T stages (pT2 vs. pT1; pT3 vs. pT1; pT4 vs. pT1, all P < 0.001). CONCLUSION This large multicenter study demonstrated ECOG PS greater than or equal to 1, high pathological T stage, tumor necrosis and BMI less than 23 were significant prognostic risk factors of early recurrence within one year in patients with RCC who underwent nephrectomy.
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Affiliation(s)
- Changil Choi
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Minyong Kang
- Department of Urology, Samsung Medical Center, Seoul, Korea
| | - Seong Il Seo
- Department of Urology, Samsung Medical Center, Seoul, Korea
| | - Jungyo Suh
- Department of Urology, Asan Medical Center, Seoul, Korea
| | - Cheryn Song
- Department of Urology, Asan Medical Center, Seoul, Korea
| | - Jinsoo Chung
- Department of Urology, National Cancer Center, Goyang, Korea
| | - Sung Han Kim
- Department of Urology, National Cancer Center, Goyang, Korea
| | - Jae Young Park
- Department of Urology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Jung Kwon Kim
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung-Hoo Hong
- Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
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Lembas A, Załęski A, Peller M, Mikuła T, Wiercińska-Drapało A. Human Immunodeficiency Virus as a Risk Factor for Cardiovascular Disease. Cardiovasc Toxicol 2024; 24:1-14. [PMID: 37982976 PMCID: PMC10838226 DOI: 10.1007/s12012-023-09815-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Abstract
The developments in HIV treatments have increased the life expectancy of people living with HIV (PLWH), a situation that makes cardiovascular disease (CVD) in that population as relevant as ever. PLWH are at increased risk of CVD, and our understanding of the underlying mechanisms is continually increasing. HIV infection is associated with elevated levels of multiple proinflammatory molecules, including IL-6, IL-1β, VCAM-1, ICAM-1, TNF-α, TGF-β, osteopontin, sCD14, hs-CRP, and D-dimer. Other currently examined mechanisms include CD4 + lymphocyte depletion, increased intestinal permeability, microbial translocation, and altered cholesterol metabolism. Antiretroviral therapy (ART) leads to decreases in the concentrations of the majority of proinflammatory molecules, although most remain higher than in the general population. Moreover, adverse effects of ART also play an important role in increased CVD risk, especially in the era of rapid advancement of new therapeutical options. Nevertheless, it is currently believed that HIV plays a more significant role in the development of metabolic syndromes than treatment-associated factors. PLWH being more prone to develop CVD is also due to the higher prevalence of smoking and chronic coinfections with viruses such as HCV and HBV. For these reasons, it is crucial to consider HIV a possible causal factor in CVD occurrence, especially among young patients or individuals without common CVD risk factors.
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Affiliation(s)
- Agnieszka Lembas
- Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warsaw, Poland
- Hospital for Infectious Diseases, Warsaw, Poland
| | - Andrzej Załęski
- Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warsaw, Poland.
- Hospital for Infectious Diseases, Warsaw, Poland.
| | - Michał Peller
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Mikuła
- Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warsaw, Poland
- Hospital for Infectious Diseases, Warsaw, Poland
| | - Alicja Wiercińska-Drapało
- Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warsaw, Poland
- Hospital for Infectious Diseases, Warsaw, Poland
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Go GM, Oh HJ, Han K, Kim YH, Lee HJ, Lee JH. Hormone Replacement Therapy and Psoriasis Risk: A Nationwide Population-Based Cohort Study. J Korean Med Sci 2023; 38:e377. [PMID: 38111280 PMCID: PMC10727922 DOI: 10.3346/jkms.2023.38.e377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/24/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Hormone replacement therapy (HRT) is used to relieve menopause symptoms, but has been reported to be associated with coronary heart disease and cancers in women. However, a link between HRT and psoriasis has yet to be established. The aim of this study was to determine the association between HRT and the risk of psoriasis. METHODS We executed a nationwide population-based study. A total of 1,130,741 post-menopause women were enrolled in the national health care insurance database based on the enrollment criteria. The study population was classified into four groups based on the duration of the HRT, and the risk of psoriasis was analyzed. RESULTS The incidence rates of psoriasis per 1,000 person-years were 3.36 and 4.09 in the no history of HRT and ≥ 5 years of HRT, respectively. After adjustment for age, smoking, alcohol intake, regular exercise, body mass index, diabetes mellitus, hypertension, and dyslipidemia, the most prolonged duration of the HRT group (≥ 5 years) exhibited significantly increased risk of developing psoriasis (hazard ratio, 1.22; 95% confidence interval, 1.16-1.29). CONCLUSION We propose that HRT in post-menopausal women is associated with an increased likelihood of psoriasis development.
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Affiliation(s)
- Gang Min Go
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Ju Oh
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Yeong Ho Kim
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Ji Lee
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hyun Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Sato Y, Aoki T, Sadashima E, Nakamoto Y, Kobayashi K, Yamauchi A, Yamada A, Omori J, Ikeya T, Aoyama T, Tominaga N, Kishino T, Ishii N, Sawada T, Murata M, Takao A, Mizukami K, Kinjo K, Fujimori S, Uotani T, Fujita M, Sato H, Suzuki S, Narasaka T, Hayasaka J, Funabiki T, Kinjo Y, Mizuki A, Kiyotoki S, Mikami T, Gushima R, Fujii H, Fuyuno Y, Gunji N, Toya Y, Narimatsu K, Manabe N, Nagaike K, Kinjo T, Sumida Y, Funakoshi S, Kobayashi K, Matsuhashi T, Komaki Y, Maehata T, Tateishi K, Kaise M, Nagata N. Long-term Risks of Recurrence After Hospital Discharge for Acute Lower Gastrointestinal Bleeding: A Large Nationwide Cohort Study. Clin Gastroenterol Hepatol 2023; 21:3258-3269.e6. [PMID: 37276989 DOI: 10.1016/j.cgh.2023.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/11/2023] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND & AIMS Currently, large, nationwide, long-term follow-up data on acute lower gastrointestinal bleeding (ALGIB) are scarce. We investigated long-term risks of recurrence after hospital discharge for ALGIB using a large multicenter dataset. METHODS We retrospectively analyzed 5048 patients who were urgently hospitalized for ALGIB at 49 hospitals across Japan (CODE BLUE-J study). Risk factors for the long-term recurrence of ALGIB were analyzed by using competing risk analysis, treating death without rebleeding as a competing risk. RESULTS Rebleeding occurred in 1304 patients (25.8%) during a mean follow-up period of 31 months. The cumulative incidences of rebleeding at 1 and 5 years were 15.1% and 25.1%, respectively. The mortality risk was significantly higher in patients with out-of-hospital rebleeding episodes than in those without (hazard ratio, 1.42). Of the 30 factors, multivariate analysis showed that shock index ≥1 (subdistribution hazard ratio [SHR], 1.25), blood transfusion (SHR, 1.26), in-hospital rebleeding (SHR, 1.26), colonic diverticular bleeding (SHR, 2.38), and thienopyridine use (SHR, 1.24) were significantly associated with increased rebleeding risk. Multivariate analysis of colonic diverticular bleeding patients showed that blood transfusion (SHR, 1.20), in-hospital rebleeding (SHR, 1.30), and thienopyridine use (SHR, 1.32) were significantly associated with increased rebleeding risk, whereas endoscopic hemostasis (SHR, 0.83) significantly decreased the risk. CONCLUSIONS These large, nationwide follow-up data highlighted the importance of endoscopic diagnosis and treatment during hospitalization and the assessment of the need for ongoing thienopyridine use to reduce the risk of out-of-hospital rebleeding. This information also aids in the identification of patients at high risk of rebleeding.
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Affiliation(s)
- Yoshinori Sato
- Division of Gastroenterology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan
| | - Tomonori Aoki
- Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Eiji Sadashima
- Department of Medical Research Institute, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Yusuke Nakamoto
- Division of Gastroenterology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan
| | - Katsumasa Kobayashi
- Department of Gastroenterology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Atsushi Yamauchi
- Department of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Atsuo Yamada
- Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Jun Omori
- Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan
| | - Takashi Ikeya
- Department of Gastroenterology, St Luke's International University, Tokyo, Japan
| | - Taiki Aoyama
- Department of Gastroenterology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Naoyuki Tominaga
- Department of Gastroenterology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Takaaki Kishino
- Department of Gastroenterology and Hepatology, Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan
| | - Naoki Ishii
- Department of Gastroenterology, Tokyo Shinagawa Hospital, Tokyo, Japan
| | - Tsunaki Sawada
- Department of Endoscopy, Nagoya University Hospital, Aichi, Japan
| | - Masaki Murata
- Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Akinari Takao
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Ken Kinjo
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Shunji Fujimori
- Department of Gastroenterology, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan
| | - Takahiro Uotani
- Department of Gastroenterology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Minoru Fujita
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Hiroki Sato
- Division of Gastroenterology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Sho Suzuki
- Department of Gastroenterology and Hepatology, Center for Digestive Disease and Division of Endoscopy, University of Miyazaki Hospital, Miyazaki, Japan
| | - Toshiaki Narasaka
- Department of Gastroenterology, University of Tsukuba, Ibaraki, Japan; Division of Endoscopic Center, University of Tsukuba Hospital, Ibaraki, Japan
| | | | - Tomohiro Funabiki
- Department of Emergency Medicine, Fujita Health University Hospital, Aichi, Japan; Emergency and Critical Care Center, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
| | - Yuzuru Kinjo
- Department of Gastroenterology, Naha City Hospital, Okinawa, Japan
| | - Akira Mizuki
- Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Shu Kiyotoki
- Department of Gastroenterology, Shuto General Hospital, Yamaguchi, Japan
| | - Tatsuya Mikami
- Division of Endoscopy, Hirosaki University Hospital, Aomori, Japan
| | - Ryosuke Gushima
- Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroyuki Fujii
- Department of Gastroenterology and Hepatology, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Yuta Fuyuno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naohiko Gunji
- Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan
| | - Yosuke Toya
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Kazuyuki Narimatsu
- Department of Internal Medicine, National Defense Medical College, Saitama, Japan
| | - Noriaki Manabe
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan
| | - Koji Nagaike
- Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan
| | - Tetsu Kinjo
- Department of Endoscopy, University of the Ryukyus Hospital, Okinawa, Japan
| | - Yorinobu Sumida
- Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Sadahiro Funakoshi
- Department of Gastroenterological Endoscopy, Fukuoka University Hospital, Fukuoka, Japan
| | - Kiyonori Kobayashi
- Department of Gastroenterology, Kitasato University, School of Medicine, Kanagawa, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yuga Komaki
- Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tadateru Maehata
- Division of Gastroenterology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan
| | - Keisuke Tateishi
- Division of Gastroenterology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan
| | - Mitsuru Kaise
- Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan
| | - Naoyoshi Nagata
- Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan; Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
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9
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Cook ME, Bruun NH, Davidsen L, Drewes AM, Olesen SS. Multistate Model of the Natural History of Inflammatory Pancreatic Diseases: A Nationwide Population-based Cohort Study. Gastroenterology 2023; 165:1547-1557.e4. [PMID: 37659669 DOI: 10.1053/j.gastro.2023.08.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/18/2023] [Accepted: 08/26/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND & AIMS Understanding the nature of inflammatory pancreatic diseases is essential for planning health care system requirements and interventions. The aim of this study was to quantify the trajectories of inflammatory pancreatic diseases and their association with pancreatic cancer in a population-based setting. METHODS National health registries were used to identify all Danish residents (18 years or older) in the period from 2000 through 2018 with incident cases of acute pancreatitis (AP), recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), and pancreatic cancer. We used a multistate model to examine transitions from a healthy state to intermediate states of acute pancreatic inflammation (AP and RAP) to chronic states (CP and pancreatic cancer) and, ultimately, death. Results were reported as transition incidence rates per 1000 person-years with 95% CIs. RESULTS There were 4,663,864 individuals included (mean age, 46 years; 51% were women). During a mean follow-up of 16.8 years, 31,396 individuals were diagnosed with incident AP, 5546 with RAP, 8898 with CP, and 18,182 with pancreatic cancer. The cumulative incidence of pancreatitis (acute and chronic) during the study period was 0.80% (95% CI, 0.79%-0.80%). The transition incidence rates to CP were 12.1 (95% CI, 8.1-18.1) from AP, 46.8 (95% CI, 31.6-69.3) from RAP, and 0.07 (95% CI, 0.04-0.13) from a healthy state. Similar patterns were observed for transitions to pancreatic cancer. Most patients diagnosed with CP (64.2%) and pancreatic cancer (96.4%) transitioned directly from a healthy state. Among patients with pancreatitis, 41.0% (95% CI, 40.5%-41.5%) died during follow-up. CONCLUSIONS The study findings revealed an increased risk of CP and pancreatic cancer in patients with a history of AP. However, most patients with CP and pancreatic cancer transitioned directly from a healthy state.
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Affiliation(s)
- Mathias Ellgaard Cook
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Line Davidsen
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Asbjørn Mohr Drewes
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Søren Schou Olesen
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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10
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Kim Y, Chang Y, Cho Y, Chang J, Kim K, Park DI, Park SK, Joh HK, Kim MK, Kim C, Wild SH, Byrne CD, Ryu S. Serum 25-Hydroxyvitamin D Levels and Risk of Colorectal Cancer: An Age-Stratified Analysis. Gastroenterology 2023; 165:920-931. [PMID: 37429364 DOI: 10.1053/j.gastro.2023.06.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 06/10/2023] [Accepted: 06/19/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND & AIMS The role of circulating 25-hydroxyvitamin D (25(OH)D) in the prevention of early-onset colorectal cancer (CRC) in young adults aged <50 years is uncertain. We evaluated the age-stratified associations (<50 vs ≥50 years) between circulating 25(OH)D levels and the risk of CRC in a large sample of Korean adults. METHODS Our cohort study included 236,382 participants (mean age, 38.0 [standard deviation, 9.0] years) who underwent a comprehensive health examination, including measurement of serum 25(OH)D levels. Serum 25(OH)D levels were categorized as <10, 10 to 20, and ≥20 ng/mL. CRC, along with the histologic subtype, site, and invasiveness, was ascertained through linkage with the national cancer registry. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CRC according to the serum 25(OH)D status, with adjustment for potential confounders. RESULTS During the 1,393,741 person-years of follow-up (median, 6.5 years; interquartile range, 4.5-7.5 years), 341 participants developed CRC (incidence rate, 19.2 per 105 person-years). Among young individuals aged <50 years, serum 25(OH)D levels were inversely associated with the risk of incident CRC with HRs (95% CIs) of 0.61 (0.43-0.86) and 0.41 (0.27-0.63) for 25(OH)D 10 to 19 ng/mL and ≥20 ng/mL, respectively, with respect to the reference (<10 ng/mL) (P for trend <.001, time-dependent model). Significant associations were evident for adenocarcinoma, colon cancer, and invasive cancers. For those aged ≥50 years, associations were similar, although slightly attenuated compared with younger individuals. CONCLUSIONS Serum 25(OH)D levels may have beneficial associations with the risk of developing CRC for both early-onset and late-onset disease.
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Affiliation(s)
- Yejin Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea.
| | - Yoosun Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jiwon Chang
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungeun Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Il Park
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Republic of Korea
| | - Soo-Kyung Park
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hee-Kyung Joh
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Family Medicine, Seoul National University Health Service Center, Seoul, Republic of Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Chanmin Kim
- Department of Statistics, Sungkyunkwan University, Seoul, Republic of Korea
| | - Sarah H Wild
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Christopher D Byrne
- Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; National Institute for Health and Care Research Southampton Biomedical Research Center, University Hospital Southampton, Southampton, United Kingdom
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea.
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11
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Rico-Fernández E, Fraire-Martínez MI, Gutiérrez-Palomares ML, Núñez-Enríquez JC, Rico-Fernández MDLP. [Electroencephalographic findings in preterm neonates]. Rev Med Inst Mex Seguro Soc 2023; 61:603-609. [PMID: 37769006 PMCID: PMC10599772 DOI: 10.5281/zenodo.8316443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/03/2023] [Indexed: 09/30/2023]
Abstract
Background The electroencephalogram (EEG) in the newborn period is highly superior to the clinical exam in the detection and prognosis of brain dysfunctions, since it allows continuous functional documentation of the brain at the patient's bedside in a non-invasive way. However, there is still some disagreement about these findings. Objective To describe the electroencephalographic findings in newborns with a history of prematurity. Material and methods Cross-sectional, descriptive, retrospective study. The inclusion criteria were: newborns with a history of prematurity, regardless of gender, who underwent an EEG from June 2017 to June 2021. Patients with incomplete electroencephalographic records or clinical records without complete data were excluded; patients using sedatives (thiopental, fentanyl, midazolam, diazepam) were eliminated from the study. Results 107 patients (37 women and 70 men) with a history of prematurity were included, with a mean gestational age at birth of 30.9 WOG ± 3.25. Electroencephalographic findings were normal in 40%, abnormal in 32%, and immature in 28%. The most frequent abnormal finding was focal paroxysmal activity in 86%. 93.4% of the participants presented comorbidities, the most frequent being neurological. Conclusion Preterm neonates are at high risk of neurologic sequelae, and EEG is a sensitive method for assessing neuromotor and cognitive prognosis. In our study population, one-third had abnormal findings. Early postnatal screening is helpful, but additional records are usually needed to detect high-risk newborns. It would be important to continue studying this line of research in pediatrics.
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Affiliation(s)
- Eduardo Rico-Fernández
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Pediatría “Dr. Silvestre Frenk Freund”, Departamento de Neurofisiología Clínica. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - María Inés Fraire-Martínez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Pediatría “Dr. Silvestre Frenk Freund”, Departamento de Neurofisiología Clínica. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - María Luisa Gutiérrez-Palomares
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Pediatría “Dr. Silvestre Frenk Freund”, Departamento de Neurofisiología Clínica. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Juan Carlos Núñez-Enríquez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Pediatría “Dr. Silvestre Frenk Freund”, División de Investigación en Salud. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - María de la Paz Rico-Fernández
- Instituto Politécnico Nacional, Centro de Investigación y de Estudios Avanzados. Ciudad de México, MéxicoInstituto Politécnico NacionalMéxico
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Amaya-Rodriguez I, Larburu N, Martinez-Herrera MR, Rebescher K, Macia I, Armengol De La Hoz MA, Rubio-Escudero C, Garin-Muga A. PDSS: A Pharmacological Decision Support System for Diabetics Patients with COVID-19. Stud Health Technol Inform 2023; 302:521-525. [PMID: 37203740 DOI: 10.3233/shti230197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
With the advent of SARS-CoV-2, several studies have shown that there is a higher mortality rate in patients with diabetes and, in some cases, it is one of the side effects of overcoming the disease. However, there is no clinical decision support tool or specific treatment protocols for these patients. To tackle this issue, in this paper we present a Pharmacological Decision Support System (PDSS) providing intelligent decision support for COVID-19 diabetic patient treatment selection, based on an analysis of risk factors with data from electronic medical records using Cox regression. The goal of the system is to create real world evidence including the ability to continuously learn to improve clinical practice and outcomes of diabetic patients with COVID-19.
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Affiliation(s)
| | - Nekane Larburu
- Biodonostia Health Research Institute, (Bioengineering Area), eHealth Group, San Sebastián 20014, Spain
| | | | - Kristin Rebescher
- Biodonostia Health Research Institute, (Bioengineering Area), eHealth Group, San Sebastián 20014, Spain
| | - Iván Macia
- Biodonostia Health Research Institute, (Bioengineering Area), eHealth Group, San Sebastián 20014, Spain
| | | | | | - Alba Garin-Muga
- Biodonostia Health Research Institute, (Bioengineering Area), eHealth Group, San Sebastián 20014, Spain
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13
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He X, Chen F, Li J, Dong X, Zhang H, Guo L. MRI-Related Risk Factors for Distal Radioulnar Joint Instability. Orthop Surg 2023; 15:1289-1297. [PMID: 37052068 PMCID: PMC10157713 DOI: 10.1111/os.13720] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVE Instability of the dorsal radioulnar ligament (DRUL) is caused by multiple factors from bony and soft tissue structures. Studies of DRUJ instability based on MRI have rarely been reported. This study aims to investigate related instability factors in the distal radioulnar joint (DRUJ) after trauma based on MRI imaging. METHODS The MRI imaging was performed on 121 post-traumatic patients with or without DRUJ instability from April 2021 to April 2022. All patients demonstrated pain or attenuated wrist ligamentous tissue quality with physical examination. The interesting variables, including age, sex, the distal radioulnar transverse shape, the triangular fibrocartilage complex (TFCC), DRUL, the volar radioulnar ligament (VRUL), distal interosseus membrane (DIOM), the extensor carpi ulnaris (ECU), and pronator quadratus (PQ), were analyzed using univariable and multivariable logistic regression model. The different variables were compared in radar plots and bar chart. RESULTS An average age of 121 patients was 42.16 ± 16.07 years. The 50.4% DRUJ instability existed in all patients and the distal oblique bundle (DOB) presented in 20.7% of patients. The TFCC (p = 0.03), present DIOM (p = 0.001), and PQ (p = 0.006) were identified to be significant in final multivariable logistic model. The percentage of patients with ligament injuries were general higher in DRUJ instability group. The patients with absent DIOM had a higher rate in DRUJ instability, TFCC, and ECU injury. There was higher stability in shape of C-type, intact TFCC, and present DIOM. CONCLUSION DRUJ instability is closely associated with TFCC, DIOM, and PQ. It could provide a potential for early detection of potential instability risk and taking necessary preventive measures.
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Affiliation(s)
- Xin He
- Department of Pediatric Orthopaedics and Department of Radiology, Tianjin Hospital, Tianjin University, Tianjin, 300211, China
| | - Fei Chen
- Department of Pediatric Orthopaedics and Department of Radiology, Tianjin Hospital, Tianjin University, Tianjin, 300211, China
| | - Jian Li
- Department of Pediatric Orthopaedics and Department of Radiology, Tianjin Hospital, Tianjin University, Tianjin, 300211, China
| | - Xiaoman Dong
- Department of Pediatric Orthopaedics and Department of Radiology, Tianjin Hospital, Tianjin University, Tianjin, 300211, China
| | - Hanzhi Zhang
- Department of Pediatric Orthopaedics and Department of Radiology, Tianjin Hospital, Tianjin University, Tianjin, 300211, China
| | - Lin Guo
- Department of Pediatric Orthopaedics and Department of Radiology, Tianjin Hospital, Tianjin University, Tianjin, 300211, China
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14
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Lertwises S, Rattanasupar A, Chang A. Factors Predictive of In-Hospital Mortality in Patients with Systemic Lupus Erythematosus: A Single-Centre Retrospective Analysis. Acta Med Acad 2023; 52:37-46. [PMID: 37326396 DOI: 10.5644/ama2006-124.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/13/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE We aimed to investigate the causes and factors predictive of in-hospital death among patients with systemic lupus erythematosus (SLE) admitted to a tertiary care hospital in Thailand. MATERIALS AND METHODS We retrospectively reviewed the records of patients with SLE admitted between 2017 and 2021. We collected data related to age, sex, body mass index, comorbidities, disease duration, medication usage, clinical symptoms, vital signs, laboratory results, evidence of infection, presence of systemic inflammatory response syndrome, quick sepsis-related organ assessment scores, and SLE disease activity on the date of admission. The length of hospitalization, treatment administered, and subsequent clinical outcomes (including in-hospital complications and death) were also recorded. RESULTS Among 267 enrolled patients, the overall in-hospital mortality rate was 25.5%, and infection was the most common cause of death (75.0%). Multivariate analysis revealed that prior hospitalization within 3 months (odds ratio [OR]: 2.311; 95% confidence interval [CI]: 1.002-5.369; P=0.049), initial infection on admission (OR: 2.764; 95% CI: 1.006-7.594; P=0.048), use of vasopressor drugs (OR: 2.940; 95% CI: 1.071-8.069; P=0.036), and mechanical ventilation (OR: 5.658; 95% CI: 2.046-15.647; P=0.001) were independent risk factors for in-hospital mortality. CONCLUSION Infection was the major cause of mortality in patients with SLE. Prior hospitalization within 3 months, initial infection on admission, vasopressor use, and mechanical ventilation during admission are independent risk factors for in-hospital mortality in patients with SLE.
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Affiliation(s)
- Sujin Lertwises
- Division of Rheumatology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
| | - Attapon Rattanasupar
- Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
| | - Arunchai Chang
- Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
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15
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Dong X, Luo Z, Wu Z, Hang D, Xia C, Wang F, Zheng Y, Yu Y, Xu Y, Cao W, Qin C, Zhao L, Li J, Ren J, Shi J, Du M, Chen W, Shen H, Li N, He J; Cancer Screening Program in Urban China (CanSPUC) Group. Risk-Adapted Starting Age for Personalized Colorectal Cancer Screening: Validated Evidence From National Population-Based Studies. Clin Gastroenterol Hepatol 2023; 21:819-826.e13. [PMID: 36403728 DOI: 10.1016/j.cgh.2022.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIMS A one-size-fits-all approach to colorectal cancer (CRC) screening that does not account for CRC risk factors is not conducive to personalized screening. On the basis of the principle of equal management of equal risks, we aimed to tailor and validate risk-adapted starting ages of CRC screening for individuals with different CRC risk factors. METHODS A multi-center community-based population cohort (N = 3,165,088) was used to evaluate the starting age of CRC screening with comprehensive consideration of risk factors. Age-specific 10-year cumulative risk curves were used to determine when individuals at greater risk for CRC reached the same risk level as the 50-year-old general population, which is currently the recommended starting age for CRC screening in China. RESULTS During the study follow-up period (2013-2021), 4,840 incident CRCs were recorded. Family history of CRC, adverse lifestyle, and comorbidities demonstrated heterogeneous associations with CRC risk (hazard ratios, 1.05-1.55; P < .05). Men and women with CRC family history and at least 2 risk factors reached the standard benchmark risk (0.28%) for screening at the age of 40, 10 years earlier than their peers without risk factors in the general population. Proposed starting ages for CRC screening were validated in an independent community-based population cohort (N = 1,023,367). CONCLUSIONS We determined a risk-adapted CRC screening starting age for individuals with various CRC risk factors. Earlier, personalized screening based on these findings could allow for scarce health resources to be dedicated to individuals who benefit most.
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Cui X, Xu C, Chen C, Su Y, Li J, He X, Wang D. New-Onset Post-Operative Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Grafting Surgery - A Retrospective Case-Control Study. Braz J Cardiovasc Surg 2023; 38:149-156. [PMID: 35436075 PMCID: PMC10010719 DOI: 10.21470/1678-9741-2021-0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION New-onset postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG) surgery. OBJECTIVE To explore predictive factors and potential mechanisms of new-onset POAF in isolated off-pump CABG patients. METHODS Retrospective observational case-control study of 233 patients undergoing isolated off-pump CABG surgery between August 2018 and July 2020 at the Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School. Associations between predictor variables and new-onset POAF were identified. The main outcome was new-onset POAF after CABG surgery. RESULTS A total of 75 (32.19%) patients developed new-onset POAF after CABG surgery. The new-onset POAF patients had advanced age, higher baseline systolic blood pressure, more preoperative use of diuretic drug, more transfusion of blood products, atrial dilation and postoperative positive inotropic drug treatment. Nineteen variates entered the multivariable logistic regression model with a Hosmer-Lemeshow test score of 7.565 (P=0.477). Postoperative left atrial enlargement, postoperative drainage in the first 24 hours and total length of hospital stay were statistically significant, while postoperative right atrial enlargement (OR and 95% CI, 7.797 [0.200, 304.294], P=0.272) and left atrial enlargement (3.524 [1.141, 10.886], P=0.029) assessed by echocardiography had the largest OR value. CONCLUSION Atrial enlargement is strongly associated with new-onset POAF in patients with isolated off-pump CABG, thus it highlights the advantage of echocardiography as a useful tool for predicting new-onset POAF. Careful monitoring and timely intervention should be considered for these patients.
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Affiliation(s)
- Xuehui Cui
- Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Can Xu
- Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Cheng Chen
- Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yunyan Su
- Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jie Li
- Department of Cardiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiaojun He
- Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shangai, China
| | - Dongjin Wang
- Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
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Wei W, Tan B, Yan Y, Li W, Zeng X, Chen Q, Wang R, He H, Qin L, Li T, Chen W. Hip Preservation or Total Hip Arthroplasty? A Retrospective Case-Control Study of Factors Influencing Arthroplasty Decision-Making for Patients with Osteonecrosis of the Femoral Head in China. Orthop Surg 2023; 15:731-739. [PMID: 36625784 PMCID: PMC9977578 DOI: 10.1111/os.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE At present, there is no consensus or guidance on indications for osteonecrosis of the femoral head (ONFH) patients to receive hip arthroplasty (THA) treatment. This study aims to explore the factors that influence the decision-making for THA in patients with ONFH, and to provide references for clinical decision for ONFH patients to be indicated for THA or hip preservation. METHODS This retrospective case-control study involved data for ONFH patients from July 2016 to October 2021 from the China Osteonecrosis of the Femoral Head Database (CONFHD). The patients with ONFH, and unilateral hip affected at the first visit were divided into THA group and non-THA group according to if they had undergone THA treatment. The differences between the two groups of patients in terms of gender, age at the time of consultation, body mass index (BMI), etiology, onset side, association research circulation osseous (ARCO) stage, hip joint function, visual analog scale (VAS), etc. were analyzed. Multivariate binomial logistic regression analysis was then applied to evaluate the risk factors of ONFH patients who underwent THA during the first visit. RESULTS A total of 640 patients were recruited for analysis, including 209 cases from the THA group and 431 cases from the non-THA group. The results of univariate analysis showed that the two groups of patients were significantly different in the following six indicators: age (59 vs. 46, Z = -9.58, p < 0.001), duration of disease (78 vs. 17, Z = -16.14, p < 0.001), gender composition (χ2 = 8.09, p = 0.004), disease etiology (χ2 = 33.04, p < 0.001), ARCO stage (χ2 = 334.86, p < 0.001), flexion of hip joint (χ2 = 172.33, p < 0.001). However, the comparison between the two groups on VAS (Z = -0.82, p = 0.41), BMI (Z = -1.35, p = 0.18), and onset side (χ2 = 1.53, p = 0.22) did not obviously differ. The results regression analysis showed that the age at the time of consultation, duration of disease, ARCO stage, and the hip joint function affected the decision making if the patients should undergo THA. The results of receiver operating characteristic curve (ROC) analysis showed that aforementioned indicators were satisfactory in predicting whether patients with ONFH would be treated with THA. The regression model using the above four indicators as comprehensive indicators has satisfactory performance in predicting whether to perform THA, and the area under the curve (AUC) is 93.94%. CONCLUSION These factors such as age, duration of disease, ARCO stage, and hip flexion function should be considered comprehensively before making decisions to perform THA or not in our clinical practice.
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Affiliation(s)
- Wei Wei
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Biao Tan
- Chongqing Traditional Chinese Medicine HospitalChongqingChina,Wangjing HospitalChina Academy of Chinese Medical SciencesBeijingChina
| | - Yan Yan
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | | | - Xiangrong Zeng
- Guizhou University of Traditional Chinese MedicineGuiyangChina
| | - Qianglong Chen
- Guizhou University of Traditional Chinese MedicineGuiyangChina
| | - Rongtian Wang
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Haijun He
- Wangjing HospitalChina Academy of Chinese Medical SciencesBeijingChina
| | - Ling Qin
- Department of Orthopaedics & Traumatology, Musculoskeletal Research LaboratoryInnovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health, The Chinese University of Hong Kong, Hong Kong Special Administrative RegionChina,Translational Medicine R&D CenterShenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhenChina
| | - Taixian Li
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Weiheng Chen
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
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18
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Lee J, Byun HK, Im SH, Son WJ, Roh YH, Kim YB. Risk factors for lower extremity lymphedema after surgery in cervical and endometrial cancer. J Gynecol Oncol 2022; 34:e28. [PMID: 36562134 PMCID: PMC10157345 DOI: 10.3802/jgo.2023.34.e28] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Lower extremity lymphedema (LEL) is a well-known adverse effect related to cervical and endometrial cancer (CEC); however, very few studies have elucidated the clinicopathologic risk factors related to LEL. We investigated the incidence and risk factors in patients who received primary surgery and/or adjuvant radiotherapy (RT) or chemotherapy for CEC. METHODS We retrospectively reviewed 2,565 patients who underwent primary surgery following CEC diagnosis between January 2007 and December 2020. LEL diagnosis was based on objective and subjective assessments by experts. We identified important predictors of LEL to construct a nomogram predicting individual risks of LEL. For internal validation of the nomogram, the original data were separated using the split-sample method in a 7:3 ratio of training data and test data. RESULTS Overall, 858 patients (33.5%) received RT, 586 received external beam RT (EBRT), and 630 received intracavitary RT. During follow-up period, LEL developed in 331 patients, with an overall cumulative 5-year incidence of 13.3%. In multivariate analysis, age at primary treatment, use of docetaxel-based chemotherapy, type of hysterectomy, type of surgical pelvic lymph node (LN) assessment, number of dissected pelvic and para-aortic LNs, and EBRT field were the independent predictors of LEL. We subsequently developed the nomogram showing excellent predictive power for LEL. CONCLUSION LEL is associated with various treatment modalities, and their interactions may increase the possibility of occurrences. De-escalation strategies for treatment modalities should be considered to reduce LEL in patients with CEC.
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Affiliation(s)
- Joongyo Lee
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hwa Kyung Byun
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hee Im
- Department of Rehabilitation Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Jeong Son
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Yun Ho Roh
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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19
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Sperandio M, Warnakulasuriya S, Soares AB, Passador-Santos F, Mariano FV, Lima CSP, Scarini JF, Dominguete MHL, Moraes PDC, Montalli VAM, Hellmeister L, Araújo VCD. Oral epithelial dysplasia grading: comparing the binary system to the traditional 3-tier system, an actuarial study with malignant transformation as outcome. J Oral Pathol Med 2022; 52:418-425. [PMID: 36177736 DOI: 10.1111/jop.13365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/09/2022] [Accepted: 08/23/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Establishing the risk of malignant transformation (MT) in oral leukoplakia is usually based on grading oral epithelial dysplasia (OED) on biopsy tissue, for which two systems are proposed: a 3-tier and a binary system. Only very few actuarial studies have tested the accuracy of such methods in predicting MT, especially for the binary system. This study aimed to assess the accuracy of the two grading systems in predicting MT in a cohort of oral leukoplakia (OL) from Brazil, with follow-up data METHODS: The sample comprised 878 individuals diagnosed with OL from 2005 to 2018. Follow-up data were obtained both locally and from the regional cancer registry. All lesions were graded using both the 3-tier and the binary systems. Kaplan-Meier curves (Log-rank Mantel-Cox) were used to assess risk and kappa to assess interobserver agreement RESULTS: Thirty-five individuals underwent MT (4%). Both systems demonstrated prognostic value, though the 3-tier system proved superior, with OR 9.23 (3.42-23.69), PPV 0.152, NPV 0.98, compared to binary OR 3.49 (1.79-6.79), PPV 0.079, NPV 0.976. Interobserver agreement was also superior in the 3-tier system (0.47, p<0.05) compared to the binary system (0.139, p=0.39). Combining the two systems enhanced prognostic values (OR 14.28, PPV 0.217, NPV 0.981). CONCLUSION The 3-tier system presented superior prognostic value to the binary system. Combining both systems to double-grade intermediate lesions might enhance risk assessment.
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Affiliation(s)
- Marcelo Sperandio
- Department of Oral Medicine and Pathology, Faculdade São Leopoldo Mandic, Research Institute, Campinas, São Paulo, Brazil
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.,WHO Collaborating Centre for Oral Cancer, London, UK
| | - Andresa Borges Soares
- Department of Oral Medicine and Pathology, Faculdade São Leopoldo Mandic, Research Institute, Campinas, São Paulo, Brazil
| | - Fabrício Passador-Santos
- Department of Oral Medicine and Pathology, Faculdade São Leopoldo Mandic, Research Institute, Campinas, São Paulo, Brazil
| | - Fernanda Viviane Mariano
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | | | - João Figueira Scarini
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.,Department of Oral Diagnosis, School of Dentistry, University of Campinas (FOP/UNICAMP), Piracicaba, São Paulo, Brazil
| | | | - Paulo de Camargo Moraes
- Department of Oral Medicine and Pathology, Faculdade São Leopoldo Mandic, Research Institute, Campinas, São Paulo, Brazil
| | - Victor Angelo Martins Montalli
- Department of Oral Medicine and Pathology, Faculdade São Leopoldo Mandic, Research Institute, Campinas, São Paulo, Brazil
| | - Luiza Hellmeister
- Department of Oral Medicine and Pathology, Faculdade São Leopoldo Mandic, Research Institute, Campinas, São Paulo, Brazil
| | - Vera Cavalcanti de Araújo
- Department of Oral Medicine and Pathology, Faculdade São Leopoldo Mandic, Research Institute, Campinas, São Paulo, Brazil
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20
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Al-Otaiby M, Krissaane I, Al Seraihi A, Alshenaifi J, Qahtani MH, Aljeri T, Zaatari E, Hassanain M, Algwizani A, Albarrag A, Al-Mozaini M, Alabdulaali M. SARS-CoV-2 Reinfection Rate and Outcomes in Saudi Arabia: A National Retrospective Study. Int J Infect Dis 2022; 122:758-66. [PMID: 35840098 DOI: 10.1016/j.ijid.2022.07.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/11/2022] [Accepted: 07/07/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The characterization of reinfection with SARS-CoV-2 has been a subject of concern and controversy, especially with the surge of infections with highly transmissible variants worldwide. METHODS This retrospective national study used comorbidities, vaccination status, SARS-CoV-2 variants of concern, and demographics data to profile participants who were reinfected with SARS-CoV-2, defined as having two reverse transcriptase-polymerase chain reaction-positive SARS-CoV-2 tests within at least 90 days apart. A multivariate logistic regression model assessed the risk factors associated with reinfection . Two control groups were selected: nonreinfected participants reporting a positive test (control group one) and those reporting a negative test (control group two). RESULTS Between March 2020 and December 2021, 4454 reinfected participants were identified in Saudi Arabia (0.8%, 95% confidence interval [CI] 0.7-0.8). The majority (67.3%) were unvaccinated (95% CI 65.9-68.7) and 0.8% (95% CI 0.6-1.1) had severe or fatal SARS-CoV-2 disease. COVID-19 vaccines were 100% effective against mortality in reinfected individuals who received at least one dose, whereas it conferred 61% (odds ratio [OR] 0.4, 95% CI 0.1-1.0) additional protection against severe disease after the first dose and 100% after the second dose. In the risk factor analysis, reinfection was highly associated with comorbidities, such as HIV (OR 2.5, 95% CI 1.3-5.2; P = 0.009), obesity (OR 2.3, 95% CI 1.3-3.9; P = 0.003), pregnancy (OR 3.2, 95% CI 1.4-7.4; P = 0.005), and working in health care facilities (OR 6.1, 95% CI 3.1-12.9; P <0.0001). The delta variant (B.1.617.2) was the most frequent variant of concern among the reinfected cohort. CONCLUSION This in-depth study of the reinfection profile identified risk factors and highlighted the associated SARS-CoV-2 variants. Results showed that naturally acquired immunity to SARS-CoV-2 through multiple reinfections together with vaccine-induced immunity provided substantial protection against severe SARS-CoV-2 disease and mortality.
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21
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Gerstein HC, Ramasundarahettige C, Avezum A, Basile J, Conget I, Cushman WC, Dagenais GR, Franek E, Lakshmanan M, Lanas F, Leiter LA, Pogosova N, Probstfield J, Raubenheimer PJ, Riddle M, Shaw J, Sheu WHH, Temelkova-Kurktschiev T, Turfanda I, Xavier D. A novel kidney disease index reflecting both the albumin-to-creatinine ratio and estimated glomerular filtration rate, predicted cardiovascular and kidney outcomes in type 2 diabetes. Cardiovasc Diabetol 2022; 21:158. [PMID: 35996147 PMCID: PMC9396793 DOI: 10.1186/s12933-022-01594-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background The estimated glomerular filtration rate (eGFR) and the albumin-to-creatinine ratio (ACR) are risk factors for diabetes-related outcomes. A composite that captures information from both may provide a simpler way of assessing risk. Methods 9115 of 9901 Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) participants with both an ACR and eGFR at baseline were included in this post hoc epidemiologic analysis. The hazard of higher baseline levels of 1/eGFR and natural log transformed ACR (calculated as ln [ACR × 100] to eliminate negative values) and their interaction for incident major adverse cardiovascular events (MACE), kidney outcomes, and deaths was estimated. The hazard of the geometric mean of these two baseline measures (the kidney disease index or KDI) was also assessed. Results A non-linear relationship was observed between 1/eGFR and all three outcomes, and between ln [ACR × 100] and the kidney outcome. There was also a negative interaction between these two risk factors with respect to MACE and death. Conversely, a linear relationship was noted between the KDI and all three outcomes. People in the highest KDI fifth experienced the highest incidence of MACE, death, and the kidney outcome (4.43, 4.56, and 5.55/100 person-years respectively). C statistics for the KDI were similar to those for eGFR and albuminuria. Conclusions The KDI combines the baseline eGFR and ACR into a novel composite risk factor that has a simple linear relationship with incident serious outcomes in people with diabetes and additional CV risk factors. Trial Registration clinicaltrials.gov NCT01394952. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01594-6.
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Affiliation(s)
- Hertzel C Gerstein
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada. .,Department of Medicine, McMaster University, HSC 3V38, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | | | - Alvero Avezum
- International Research Center, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil
| | - Jan Basile
- Medical University of South Carolina, Charleston, SC, USA
| | - Ignacio Conget
- Endocrinology and Nutrition Department, University of Barcelona, Barcelona, Spain
| | - William C Cushman
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Gilles R Dagenais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, Canada
| | - Edward Franek
- Mossakowski Clinical Research Center, Polish Academy of Sciences, Warsaw, Poland
| | | | | | - Lawrence A Leiter
- St. Michael's Hospital, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Canada
| | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia
| | | | | | - Matthew Riddle
- Department of Medicine, Oregon Health & Science University Portland, Oregon, USA
| | - Jonathan Shaw
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | | | - Ibrahim Turfanda
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Denis Xavier
- St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
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22
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Kabbaha S, Al-Azzam S, Karasneh RA, Khassawneh BY, Al-Mistarehi AH, Lattyak WJ, Aldiab M, Hasan SS, Conway BR, Aldeyab MA. Predictors of invasive mechanical ventilation in hospitalized COVID-19 patients: a retrospective study from Jordan. Expert Rev Respir Med 2022; 16:945-952. [PMID: 35929952 DOI: 10.1080/17476348.2022.2108796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To identify early indicators for invasive mechanical ventilation utilization among COVID-19 patients. METHODS This retrospective study evaluated COVID-19 patients who were admitted to hospital from September 20, 2020, to August 8, 2021. Patients' clinical characteristics, demographics, comorbidities, and laboratory results were evaluated. Multivariable logistic regression and machine learning (ML) methods were employed to assess variable significance. RESULTS Among 1,613 confirmed COVID-19 patients, 365 patients (22.6%) received invasive mechanical ventilation (IMV). Factors associated with IMV included older age >65 years (OR,1.46; 95%CI, 1.13 - 1.89), current smoking status (OR, 1.71; 95%CI, 1.22-2.41), critical disease at admission (OR, 1.97; 95%CI, 1.28-3.03), and chronic kidney disease (OR, 2.07; 95%CI, 1.37-3.13). Laboratory abnormalities that were associated with increased risk for IMV included high leukocyte count (OR, 2.19; 95%CI, 1.68 - 2.87), low albumin (OR, 1.76; 95%CI, 1.33 - 2.34) and high AST (OR, 1.71; 95%CI, 1.31 - 2.22). CONCLUSION Our study suggests that there are several factors associated with the increased need for IMV among COVID-19 patients including older age, current smoking status, critical disease status on admission, and chronic kidney disease. In addition, laboratory markers such as high leukocyte count, low albumin and high AST were determined. These findings will help in early identification of patients at high risk for IMV and reallocation of hospital resources towards patients who need them the most to improve their outcomes.
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Affiliation(s)
- Suad Kabbaha
- Department of Health Research Methods, Evidence & Impact (HEI), McMaster University, Hamilton, Canada
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Reema A Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Basheer Y Khassawneh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Motasem Aldiab
- Department of Computing, British Columbia Institute of Technology, Vancouver, Canada
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Barbara R Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom.,Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, United Kingdom
| | - Mamoon A Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
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23
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Kataoka T, Fukamoto A, Hotta Y, Sanagawa A, Maeda Y, Furukawa-Hibi Y, Kimura K. Effect of High Testosterone Levels on Endothelial Function in Aorta and Erectile Function in Rats. Sex Med 2022; 10:100550. [PMID: 35939869 PMCID: PMC9537240 DOI: 10.1016/j.esxm.2022.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Testosterone is an important hormone for the physical and mental health of men; however testosterone administration has also been suggested to adversely affect the cardiovascular system. AIM To investigate the effects of excessive testosterone administration on vascular endothelial and erectile function in rats. METHODS A total of seventy-five 12-week-old rats were divided into the following groups: Sham, castrated (Cast), castrated with subcutaneous administration of 100 mg/kg/month testosterone (Cast + T1), and castrated with subcutaneous administration of 100 mg/kg/week testosterone (Cast + T4). To observe the changes in testosterone level after the administration, rats were further divided into the following groups: control; T(6.25), wherein the rats were subcutaneously injected with 6.25 mg/kg testosterone; T(25) per week, wherein the rats were subcutaneously injected with 25 mg/kg testosterone per week; and T(100), wherein the rats were subcutaneously injected with 100 mg/kg testosterone per week. The relaxation responses of aorta were measured in these rats using standardized methods, and their erectile function was also evaluated. Statistical analysis of the obtained data was performed using two-way analysis of variance (ANOVA), Tukey-Kramer's multiple comparison test, or Student's t-test. OUTCOMES At the end of the study period, endothelial function was evaluated through measurement of isometric tension, while erectile function was assessed using intracavernosal pressure (ICP), mean arterial pressure (MAP), and the expression of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), sirtuin 1 (Sirt1) and vascular endothelial growth factor A. RESULTS The ICP/MAP ratio in the Cast group (0.42 ± 0.04) was significantly lower than that in the Sham group (0.79 ± 0.07). The ICP/MAP ratio in the Cast + T1 group (0.73 ± 0.06) was significantly higher than that in the Cast group (P < .01) and that of the Cast + T4 (0.38 ± 0.01) group was unchanged (P > .05). The T(25) and T(100) groups exhibited significantly lower responses to ACh than the control group at 4 weeks (P < .01). Meanwhile, the ICP/MAP ratios in the T(25) group (0.44 ± 0.07) and T(100) group (0.47 ± 0.03) were significantly lower than that in the control group (0.67 ± 0.05) at stimulation frequencies of 16 Hz (P < .05). The expression of androgen receptor, Sirt1, and eNOS were significantly lower while that of iNOS was higher in the T(25) group compared with the control group (P < .05). CLINICAL TRANSLATION The results based on this animal model indicate that extremely high testosterone levels may affect endothelial and erectile function. STRENGTHS AND LIMITATIONS We found that high-dose testosterone administration decreased endothelial function in aorta and erectile function in rats. A major limitation of this study is that the blood concentration may not be representative of that in humans, and further research is needed. CONCLUSION The findings suggest that high doses of testosterone may cause endothelial dysfunction in the aorta and erectile dysfunction in rats and that the blood concentration should be monitored after testosterone administration. Kataoka T, Fukamoto A, Hotta Y, et al. Effect of High Testosterone Levels on Endothelial Function in Aorta and Erectile Function in Rats. Sex Med 2022;XX:XXXXXX.
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Affiliation(s)
- Tomoya Kataoka
- Department of Clinical Pharmaceutics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan; Department of Pharmacology, Kataoka's lab, Graduate School of Pharmaceutical Sciences, Chiba Institute of Science, Chiba, Japan.
| | - Ayako Fukamoto
- Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Yuji Hotta
- Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Akimasa Sanagawa
- Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Yasuhiro Maeda
- Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Yoko Furukawa-Hibi
- Department of Clinical Pharmaceutics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan; Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Kazunori Kimura
- Department of Clinical Pharmaceutics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan; Department of Hospital Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan.
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24
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Naghibzadeh-Tahami A, Khosravi Y, Es'haghi M, Haghdoost AA. Scoping Review of 5 Common Occupational Cancers and Their Related Exposures. Med J Islam Repub Iran 2022; 36:84. [PMID: 36128290 PMCID: PMC9448458 DOI: 10.47176/mjiri.36.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/27/2022] [Indexed: 11/12/2022] Open
Abstract
Background: Occupational cancers can be avoided by removing dangerous chemicals from the workplace or limiting occupational exposure. Approximately, 10 major risk factors account for 85% of all occupational cancers. This scoping review study aimed to determine the most important chemical carcinogens related to 5 known occupational cancers. Methods: In this scoping review, we followed Arksey and O'Malley's 5-step framework. Four databases (PubMed, Web of Science, Google Scholar, Scopus) were systematically reviewed for relevant published papers from January 2000 to September 2021. Studies were included in this scoping review, which examined the effect of carcinogenic (definite and probable) chemical exposures on 5 known occupational cancers (lung, bladder, laryngeal, leukemia, and liver). We reported the types of occupational carcinogens, the geographical diversity of studies, extraction of relative risks (RRs), hazard ratios (HRs), or odds ratios (ORs), and identified gaps in the existing literature. Results: The highest number of studies was related to lung cancer (LC) (n = 26), bladder cancer (BC) (n = 11), laryngeal cancer (LaC) (n = 8), leukemia (LeC) (n = 3), and primary liver cancer (PLC) (n = 2), respectively. Most studies were performed in France and Canada (n = 8), Germany (n = 4), Finland (n = 3), Netherlands (n = 2), and Finland (n = 2), respectively. Furthermore, the most common occupational chemical carcinogens associated with the 5 known occupational cancers were asbestos, benzene, crystalline silica, polycyclic aromatic hydrocarbons (PAH), and diesel motor exhausts (DME). Conclusion: Although the attributable risk of occupational cancers in developing countries is much higher, a small proportion of studies were performed in these countries.
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Affiliation(s)
- Ahmad Naghibzadeh-Tahami
- Department of Biostatistics and Epidemiology, School of Public Health, Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Yahya Khosravi
- Department of Occupational Health and Safety Engineering, School of Health, Research Center for Health, Safety and Environment, Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahboubeh Es'haghi
- Department of Occupational Health Engineering, School of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali-Akbar Haghdoost
- Department of Biostatistics and Epidemiology, School of Public Health, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,Corresponding author: Dr Ali-Akbar Haghdoost,
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25
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Liu Y, Ma J, Zhang N, Xiao JY, Wang JX, Li XW, Wang J, Zhang Y, Gao MD, Zhang X, Wang Y, Wang JX, Xu SB, Gao J. Latent class cluster analysis of knowledge on acute myocardial infarction in community residents: a cross-sectional study in Tianjin, China. BMJ Open 2022; 12:e051952. [PMID: 35697448 PMCID: PMC9196158 DOI: 10.1136/bmjopen-2021-051952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Public knowledge of early onset symptoms and risk factors (RF) of acute myocardial infarction (AMI) is very important for prevention, recurrence and guide medical seeking behaviours. This study aimed to identify clusters of knowledge on symptoms and RFs of AMI, compare characteristics and the awareness of the need for prompt treatment. DESIGN Multistage stratified sampling was used in this cross-sectional study. Latent GOLD Statistical Package was used to identify and classify the respondent subtypes of the knowledge on AMI symptoms or modifiable RFs. Multivariable logistic regression was performed to identify factors that predicted high knowledge membership. PARTICIPANTS A structured questionnaire was used to interview 4200 community residents aged over 35 in China. 4122 valid questionnaires were recovered. RESULTS For AMI symptoms and RFs, the knowledge levels were classified into two or three distinct clusters, respectively. 62.7% (Symptom High Knowledge Cluster) and 39.5% (RF High Knowledge Cluster) of the respondents were able to identify most of the symptoms and modifiable RFs. Respondents who were highly educated, had higher monthly household income, were insured, had regular physical examinations, had a disease history of AMI RFs, had AMI history in immediate family member or acquaintance or had received public education on AMI were observed to have higher probability of knowledge on symptoms and RFs. There was significant difference in awareness of the prompt treatment in case of AMI occurs among different clusters. 'Calling an ambulance' was the most popular option in response of seeing others presenting symptoms of AMI. CONCLUSIONS A moderate or relatively low knowledge on AMI symptoms and modifiable RFs was observed in our study. Identification of Knowledge Clusters could be a way to detect specific targeted groups with low knowledge of AMI, which may facilitate health education, further reduce the prehospital delay in China and improve patient outcomes.
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Affiliation(s)
- Yin Liu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
| | - Jing Ma
- Tianjin Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Nan Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Jian-Yong Xiao
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Ji-Xiang Wang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Xiao-Wei Li
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Jing Wang
- Department of Nursing, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Yan Zhang
- Department of Nursing, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Ming-Dong Gao
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Xu Zhang
- Tianjin Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, Tianjin, China
| | - Yuan Wang
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
| | - Jing-Xian Wang
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
| | - Shi-Bo Xu
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
| | - Jing Gao
- Thoracic Clinical College, Tianjin Medical University, Tianjin, Tianjin, China
- Tianjin Cardiovascular Institute, Tianjin Chest Hospital, Tianjin, Tianjin, China
- Chest Hospital, Tianjin University, Tianjin, Tianjin, China
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Suvorov V, Filipchuk V. Salter pelvic osteotomy for the treatment of Developmental Dysplasia of the Hip: assessment of postoperative results and risk factors. Orthop Rev (Pavia) 2022; 14:35335. [PMID: 35769652 PMCID: PMC9235433 DOI: 10.52965/001c.35335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/14/2022] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND If non-surgical treatment of Developmental Dysplasia of the Hip (DDH) fails or if DDH is late-detected, surgery is necessary. Salter pelvic osteotomy (SPO) is an effective surgical option for such cases. OBJECTIVES To study the results after SPO; to evaluate risk factors; to reveal radiological parameters that may correlate with results. METHODS Results analysis in 17 patients (22 hips). Risk factors included those that do not depend on the surgeon (patient's age, value of the acetabular index (AI) preoperatively, DDH Tonnis grade) and those that depend on the surgeon (amount of AI correction). To radiological parameters which may correlate with the amount of AI correction we referred distance "d" and the lateral rotation angle. RESULTS SPO allows performing AI correction in ranges 24.1 ± 6.5°. Excellent and good clinical results were obtained in 95.5% of patients; excellent and good radiological results in 86.4% of patients. Risk factors that do not depend on the surgeon were older patient's age and higher preoperative AI values (p <0.05). The risk factor that depends on the surgeon was the amount of AI correction (p <0.05). The distance "d" was recognized as a radiological parameter that may indicate sufficient AI correction (p <0.05). CONCLUSION In older patients with a higher preoperative AI value the results will be predictably worse. The surgeon may influence the result with a greater amount of AI correction (which may also be indicated radiologically by the distance "d" values). LEVEL OF EVIDENCE IV, therapeutic, case series.
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Affiliation(s)
- Vasyl Suvorov
- Department of Joint Diseases in Children and Adolescents, SI «The Institute of Traumatology and Orthopedics by NAMS of Ukraine»
| | - Viktor Filipchuk
- Department of Joint Diseases in Children and Adolescents, SI «The Institute of Traumatology and Orthopedics by NAMS of Ukraine»
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Rohani C, Jafarpoor H, Mortazavi Y, Esbakian B, Gholinia H. Mortality in patients with myocardial infarction and potential risk factors: A five-year data analysis. ARYA Atheroscler 2022; 18:1-8. [PMID: 36815954 PMCID: PMC9931944 DOI: 10.48305/arya.v18i0.2427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/27/2021] [Indexed: 02/24/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) is among the most common causes of death in almost all countries across the world. Awareness of risk factors for the management and prevention of the disease can reduce complications and mortality rates. This study was conducted with the aim to investigate the mortality and potential risk factors of myocardial infarction (MI) as well as their relationships in patients who were admitted to one university hospital in the North of Iran from 2014 to 2018. METHODS This study had retrospective descriptive design. Using a checklist, all necessary information was extracted from 5-year medical records data of MI patients in the university hospital from 2014 to 2018 (n = 564). The data analysis was performed in SPSS software using descriptive statistics and two binary logistic regression analyses. RESULTS The results showed that the mean age of the patients was 62.78 ± 13.38 years, and most of them were men (66.3%). The patients' mortality was 18.6% in a 5-year analysis. However, the number of mortalities was higher in the women (P = 0.001). Descriptive analysis showed that the most common risk factors of the disease in both genders were hypertension (46.6%), diabetes mellitus (DM) (38.5%), hyperlipidemia (24.1%), smoking (20%), and family history of CVDs (18.8%), respectively. However, the results of the adjusted regression model showed that the odds ratio (OR) of the patients' mortality increased in diabetic MI patients (OR: 2.33; 95%CI: 1.42-3.81; P = 0.001), but this ratio decreased in MI patients with a history of hyperlipidemia (OR: 0.23; 95%CI: 0.11-0.44; P ˂ 0.001). CONCLUSION Based on the results, individual- and population-based prevention strategies by focusing on hypertension and diabetes are recommended in our health programs. Surprisingly, the mortality rate of MI patients was lower among those with a history of hyperlipidemia. There are different hypotheses for the cause of this. Therefore, laboratory studies with animal models and prospective cohorts are suggested for future studies.
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Affiliation(s)
- Camelia Rohani
- Affiliated Researcher, Department of Health Care Sciences, Palliative Care Center, Marie Cederschiöld Högskola (Ersta Sköndal Bräcke University College), Campus Ersta, Stockholm, Sweden AND Associate Professor, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hasanali Jafarpoor
- Assistant Professor, Department of Anesthesiology and Operating Room, School of Allied Medical Sciences, Babol University of Medical Sciences, Babol, Iran,Address for correspondence: Hasanali Jafarpoor; Assistant Professor, Department of Anesthesiology and Operating Room, School of
Allied Medical Sciences, Babol University of Medical Sciences, Babol, Iran;
| | - Yousef Mortazavi
- Assistant Professor, Department of Anesthesiology and Operating Room, School of Allied Medical Sciences, Babol University of Medical Sciences, Babol, Iran
| | - Behnam Esbakian
- MSc in Nursing, Department of Anesthesiology and Operating Room, School of Allied Medical Sciences, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- MSc in Biostatistics, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Bandola C, Clément MÈ, Bérubé A. [Responding to children's emotional and cognitive needs: Applying the cumulative model to the general population]. Can J Psychiatry 2022; 67:250-258. [PMID: 34109836 PMCID: PMC9014672 DOI: 10.1177/07067437211020597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Several risk factors are associated with neglectful behaviors. Yet their cumulative effect, which refers to the accumulation of risk regardless of the presence or absence of specific factors, remains unknown. This study aims to determine whether risk accumulation predicts caregivers' responses to children's emotional and cognitive needs in the general population and to examine the presence of clinical thresholds. METHOD A total of 1102 maternal figures of children aged 5 to 9 years old living in Quebec were questioned through a telephone survey. The response to children's emotional and cognitive needs was measured using a validated version of the Parent-Report Multidimensional Neglectful Behavior Scale. Ten individual, family and socioeconomic risk factors were combined to compute a cumulative risk index. RESULTS Results indicate that the cumulative index predicts the response to children's emotional and cognitive needs in the general population. This effect is observed for families exposed to at least two risk factors and it increases considerably when risk exposure reaches 5 factors. CONCLUSIONS This study supports the cumulative risk hypothesis, which until now had mainly been examined in vulnerable or clinical samples. It fosters a better statistical understanding of contexts compromising an optimal response to school age children's emotional and cognitive needs in the general population. This breakthrough is particularity important considering the challenges of identifying children at risk of having their needs neglected.
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Affiliation(s)
- Camille Bandola
- Candidate au doctorat en psychologie clinique Université du Québec en Outaouais
| | - Marie-Ève Clément
- Professeure au Département de psychoéducation et de psychologie et titulaire de la Chaire de recherche du Canada sur la violence faite aux enfants Université du Québec en Outaouais
| | - Annie Bérubé
- Professeure au Département de psychoéducation et de psychologie Université du Québec en Outaouais
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Farhadipour M, Fallahzadeh H, Ghadiri-Anari A, Mirzaei M. Evaluation of the Risk Factors for Type 2 Diabetes Using the Generalized Structure Equation Modeling in Iranian Adults based on Shahedieh Cohort Study. J Diabetes Metab Disord 2022; 21:919-930. [PMID: 35673503 PMCID: PMC9167270 DOI: 10.1007/s40200-021-00940-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/17/2021] [Indexed: 12/14/2022]
Abstract
Objective Diabetes mellitus (DM) is an important global health risk factor in the twenty-first century and one of the 10 major causes of mortality world wide. The generalized structural equation model (GSEM) is a family of statistical techniques in the analysis of multivariate data, classified and sequential, which measures the hidden variables and the relationships between them. Finding risk factors for type 2 diabetes and providing a model for lifestyle changes is the aim of the study.. Methods This exploratory, cross-sectional study was performed to evaluate the risk factors in a cohort of Iranian diabetic patients aged over 35 years (N = 9975). Among 9975 people over 35 years old participating in the first phase of the Yazd cohort study, 1736 people (17.95%) with diabetes and people who were unaware of their diabetes status and pregnant women were excluded and finally we selected 7431 non-diabetics who had FBG test. By presenting the model of initial generalized structural equations using stata software (version 15), we investigated the risk factors affecting type 2 diabetes. Results The risk factors of BMI (Impact coefficients0.010), triglyceride (0.005), hypertension (0.086), and high cholesterol level (0.005) directly affected the DM status (P < 0.001). Meanwhile, BMI and triglyceride played a mediating role in this regard, and the factors of high-density lipoprotein cholesterol, physical activity (-0.23), and diet (0.001) indirectly affected the DM status. Conclusion Using a large sample, this study provides a clear and direct model of the risk factors for diabetes. The main finding is that the risk factors for diabetes 2 that directly affect Iranians in this study are high blood pressure, BMI, triglycerides and cholesterol.
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Affiliation(s)
- Marzieh Farhadipour
- grid.412505.70000 0004 0612 5912Department of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossien Fallahzadeh
- grid.412505.70000 0004 0612 5912Research Center of Prevention & Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Akram Ghadiri-Anari
- grid.412505.70000 0004 0612 5912Department of Internal Medicine, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- grid.412505.70000 0004 0612 5912Research Center of Prevention & Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has been the most important global issue since December 2019. Although the clinical course of COVID-19 is known to be milder in children than in adults, associated hospitalizations among children have increased since the emergence of contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and the achievement of a high vaccination rate in adults. Considering these global and domestic situations, we believe that risk stratification in children with COVID-19 is urgently needed for decision making regarding hospitalization priority in children infected with SARS-CoV-2 and vaccination priority against COVID-19. METHODS This systematic review and meta-analysis was performed by comprehensively searching the PubMed, EMBASE, Scopus and KoreaMed databases through August 25, 2021. The criteria for enrollment were "severe COVID-19" as poor outcomes (intensive care unit admission, invasive mechanical ventilation, and/or death) and underlying comorbidities before SARS-CoV-2 infection. RESULTS Among 872 screened studies, 17 articles were included in the systematic review, and 10 articles were included in the meta-analysis. Neonate (risk ratio [RR], 2.69; 95% confidence interval [CI], 1.83-3.97), prematurity in young infants (RR, 2.00; 95% CI, 1.63-2.46), obesity (RR, 1.43; 95% CI, 1.24-1.64), diabetes (RR, 2.26; 95% CI, 1.95-2.62), chronic lung disease (RR, 2.62; 95% CI, 1.71-4.00), heart disease (RR, 1.82; 95% CI, 1.58-2.09), neurologic disease (RR, 1.18; 95% CI, 1.05-1.33), and immunocompromised status (RR, 1.44; 95% CI, 1.01-2.04) were significant risk factors for severe COVID-19 in children. In the subgroup analysis, age younger than 3 months (RR, 0.26; 95% CI, 0.11-0.66), asthma (RR, 1.08; 95% CI, 0.98-1.20), and neurodevelopmental disorders (RR, 0.88; 95% CI, 0.75-1.04) were not risk factors for severe COVID-19. CONCLUSION Children with comorbidities such as obesity, diabetes, heart disease, chronic lung diseases other than asthma, seizure disorders, and an immunocompromised status had a high prevalence of severe COVID-19. Neonate and premature infants had a high risk of severe COVID-19. Defining the high-risk group for severe COVID-19 could help to guide hospital admission and priority for vaccination against SARS-CoV-2.
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Affiliation(s)
- Jae Hong Choi
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Soo-Han Choi
- Department of Pediatrics, Pusan National University Hospital, Busan, Korea
| | - Ki Wook Yun
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
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Choe JW, Jung YK, Yim HJ, Seo GH. Clinical Effect of Hepatitis B Virus on COVID-19 Infected Patients: A Nationwide Population-Based Study Using the Health Insurance Review & Assessment Service Database. J Korean Med Sci 2022; 37:e29. [PMID: 35075828 PMCID: PMC8787805 DOI: 10.3346/jkms.2022.37.e29] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/23/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Several studies have recently suggested that liver disease and cirrhosis were risk factors for poor outcomes in patients with coronavirus disease 2019 (COVID-19) infections. However, no large data study has reported the clinical course of COVID-19 patients with chronic hepatitis B virus (HBV) infections. This study investigated whether HBV infection had negative impacts on the clinical outcomes of COVID-19 patients. METHODS We performed a nationwide population-based cohort study with 19,160 COVID-19-infected patients in 2020 from the Korean Health Insurance Review and Assessment database. The clinical outcomes of COVID-19 patients with chronic HBV infections were assessed and compared to those of non-HBV-infected patients. RESULTS Of the 19,160 patients diagnosed with COVID-19, 675 (3.5%) patients had chronic HBV infections. The HBV-infected patients were older and had more commodities than the non-HBV infected COVID-19 patients. During the observation period, COVID-19-related mortality was seen in 1,524 (8.2%) of the non-HBV-infected 18,485 patients, whereas 91 (13.5%) in HBV-infected 675 patients died of COVID-19 infection. Compared to patients without HBV infections, a higher proportion of patients with chronic HBV infections required intensive care unit (ICU) admission and had organ failures. However, odds ratios for mortality, ICU admission, and organ failure were comparable between the two groups after adjusting for age, sex, and comorbid diseases including liver cirrhosis and hepatocellular carcinoma. CONCLUSION COVID-19-infected patients with HBV infections showed worse clinical courses than non-HBV-infected COVID-19 patients. However, after adjustment, chronic HBV infection itself does not seem to affect the clinical outcomes in COVID-19 patients.
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Affiliation(s)
- Jung Wan Choe
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Young Kul Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
| | - Gi Hyeon Seo
- Health Insurance Review and Assessment Service, Wonju, Korea.
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Bianco E, Skipalskyi A, Goma F, Odeh H, Hasegawa K, Zawawi MA, Stoklosa M, Dalmau R, Dorotheo EU, Berteletti F, Mwangi J, Wang Y. E-Cigarettes: A New Threat to Cardiovascular Health - A World Heart Federation Policy Brief. Glob Heart 2021; 16:72. [PMID: 34900563 DOI: 10.5334/gh.1076] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 01/27/2023] Open
Abstract
Tobacco is widely recognized as a leading cause of cardiovascular morbidity and mortality, accounting for approximately seventeen percent of all cardiovascular disease deaths globally. Electronic nicotine delivery systems such as e-cigarettes have been developed and advertised as safer alternatives to traditional tobacco cigarettes. Aggressive marketing strategies, as well as misleading claims by manufacturers, have largely contributed to the belief that e-cigarettes are harmless. In reality, e-cigarettes are far from innocuous. E-cigarette solutions and aerosols generally contain harmful substances that are commonly found in tobacco cigarette emissions. A growing body of literature suggests that e-cigarettes are associated with an increased risk of cardiovascular morbidity and mortality. In addition, the effectiveness of e-cigarettes as smoking cessation tools has yet to be determined. Concerningly, most smokers do not give up on tobacco cigarettes and eventually become dual users. Unregulated, e-cigarettes constitute a serious threat to established tobacco control policies. Fortunately, many countries have demonstrated that strong regulations were effective in protecting their populations from the dangers of e-cigarettes. The World Heart Federation recommends applying the precautionary principle and a set of measures to protect vulnerable populations, prevent exposure to second-hand smoking, and address misleading claims. In this regard, we recommend that governments, policymakers, and other relevant stakeholders enact or support the following measures, among others: Prohibit the sale and distribution of e-cigarettes to minors, as well as the use of flavouring agents. Prohibit the use of e-cigarettes anywhere tobacco cigarettes have been banned. Prohibit marketing, advertising, and misleading claims regarding e-cigarettes. Apply excise taxes on e-cigarettes. Conduct more research regarding the long-term effects of e-cigarettes on cardiovascular health.
Lastly, countries that have banned the commercialization of e-cigarettes should maintain these measures.
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Xia B, Yang M, Nguyen LH, He Q, Zhen J, Yu Y, Di M, Qin X, Lu K, Kuo ZC, He Y, Zhang C, Meng W, Yuan J. Regular Use of Proton Pump Inhibitor and the Risk of Inflammatory Bowel Disease: Pooled Analysis of 3 Prospective Cohorts. Gastroenterology 2021; 161:1842-1852.e10. [PMID: 34389338 DOI: 10.1053/j.gastro.2021.08.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS Proton pump inhibitors (PPIs) have a major impact on gut microbiome and immune function, which in turn, may increase the risk of inflammatory bowel disease (IBD). Our aim in this study was to evaluate PPI use and subsequent risk of IBD and subtypes (ie, Crohn's disease and ulcerative colitis). METHODS This was a pooled analysis of the Nurses' Health Study (NHS, n = 82,869), NHS II (n = 95,141), and UK Biobank (n = 469,397). We included participants with information on personal use of PPIs and free of IBD or cancer at baseline. We evaluated hazard ratios and 95% confidence intervals (CIs) with Cox regression adjusting for lifestyle factors, PPI indications, comorbidities, and other medications. RESULTS We documented 271 cases of IBD (median follow-up, 12 years) in the pooled NHS cohorts and 1419 cases (median follow-up, 8.1 years) in the UK Biobank. For both pooled NHS cohorts and UK Biobank, regular use of PPIs consistently showed a significantly positive association with IBD, Crohn's disease, and ulcerative colitis risk. Combined analyses of 3 cohorts showed that regular PPI users had an increased risk of IBD as compared with nonusers (hazard ratio, 1.42; 95% CI, 1.22-1.65; number needed to harm, 3770; 95% CI, 3668-4369). Direct comparison with H2 receptor antagonist, a less potent acid suppressor, showed that PPI use was also associated with higher IBD risk (hazard ratio, 1.38; 95% CI, 1.16-1.65). CONCLUSIONS Regular use of PPIs was associated with an increased risk of IBD and its subtypes. The findings should be interpreted with caution because the absolute risk was low and the clinical benefits of PPIs are substantial.
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Affiliation(s)
- Bin Xia
- Clinical Research Center, Big Data Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Man Yang
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Long H Nguyen
- Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Qiangsheng He
- Clinical Research Center, Big Data Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Jie Zhen
- MRC Integrative Epidemiology Unit, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Yuanyuan Yu
- Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Mengyang Di
- Department of Hematology and Medical Oncology, Yale New Haven Hospital, Yale School of Medicine, New Haven, Connecticut
| | - Xiwen Qin
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Science, Monash University, Melbourne, Australia; Victorian Heart Institute, Monash University, Melbourne, Australia; School of Population and Global Health, Faculty of Medicine, Density and Health Sciences, University of Western Australia, Perth, Australia
| | - Kuiqing Lu
- Clinical Research Center, Big Data Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Zi Chong Kuo
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yulong He
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Changhua Zhang
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
| | - Wenbo Meng
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
| | - Jinqiu Yuan
- Clinical Research Center, Big Data Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
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Abstract
BACKGROUND The aim of this study was to assess the prevalence of dementia as an underlying disease in elderly patients with hip fracture, to investigate the effect of dementia on postoperative mortality after surgery of hip fracture, and to analyze the differences in postoperative mortalities according to the severity of dementia through subgroup analysis. METHODS This study selected 2,346 elderly patients who were diagnosed with unilateral intertrochanteric or femoral neck fractures who underwent surgery between January 2004 and December 2018. The patients were classified into the non-dementia group (2,196 patients) and dementia group (150 patients; no-medication [66 patients] and medication [84 patients] subgroups). The cumulative crude mortality rate was calculated, and 30-day, 60-day, 3-month, 6-month, and 1-year mortality rates were compared between the groups. A univariate regression test was performed using age, sex, diagnosis, surgery type, and Charlson's comorbidity index (CCI), as these variables had P values of < 0.10. Multivariate regression analysis was performed to identify independent risk factors associated with mortality. RESULTS The 30-day, 60-day, 3-month, 6-month, and 1-year postoperative cumulative mortality rates were 1.8%, 3.8%, 5.6%, 8.9%, and 13.6%, respectively, in the non-dementia group, and 2%, 7.3%, 14%, 19.3%, and 24%, respectively, in the dementia group (P = 0.748, P = 0.048, P < 0.001, P < 0.001, and P = 0.001). The factors that affected the 1-year mortality were age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02-1.08; P < 0.001), sex (OR, 2.68; 95% CI, 2.07-3.47; P < 0.001), CCI (OR, 1.34; 95% CI, 1.23-1.47; P < 0.001), and dementia (OR, 1.70; 95% CI, 1.46-1.08; P = 0.016). In subgroup analysis, severity of dementia influenced the 6-month mortality (OR, 1.41; 95% CI, 1.70-2.01; P = 0.018), and 1-year mortality (OR, 1.30; 95% CI, 1.17-1.90; P = 0.027). CONCLUSION In elderly hip fracture patients, the comparison between patients with and without dementia revealed that dementia was an independent risk factor for mortality at a minimum of 1 year of follow-up, and the severity of dementia in hip fracture patients was a risk factor for mortality within 6 months and 1 year, postoperatively.
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Affiliation(s)
- Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yonghan Cha
- Department of Orthopaedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea.
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Jiyoon Lee
- Department of Orthopaedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
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Al-Saadi AN, Al-Muqbali AH, Dawi E. Women's Knowledge of Cervical Cancer: A cross-sectional study in Al Buraimi Governorate, Oman. Sultan Qaboos Univ Med J 2021; 21:450-456. [PMID: 34522412 PMCID: PMC8407910 DOI: 10.18295/squmj.4.2021.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/20/2020] [Accepted: 11/19/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives This study aimed to assess knowledge of cervical cancer and its prevention among Omani women aged 20-65 years. Methods This cross-sectional study took place across eight primary healthcare institutions in Al Buraimi Governorate, Oman, between November 2018 and February 2019. It was carried out on the basis of a predesigned, validated and self-administered questionnaire containing 55 questions. Results Data from 791 completed questionnaires were included in the final analysis, which represents a response rate of 79.1%. The results indicated that 86.7% of surveyed women had previously heard of cervical cancer and 13.0% expected this disease to affect them in the future. The results also showed that women were less aware of the association between the human papillomavirus (HPV) and cervical cancer (24.7%). The participants considered the HPV infection and initiation of sexual intercourse below 17 years of age as the lowest risks associated with cervical cancer. Moreover, 63.8% of the participants were unaware of the availability of a vaccination 'against HPV-related cervical cancer' and many respondents were unaware of a Pap test. Those women aged over 30 years, married and with a high level of education were more likely to be aware of cervical cancer. Conclusion Generally, there was inadequate knowledge and awareness of cervical cancer among women aged 20-65 years. Young women aged 20-30 years showed relatively lesser knowledge of cervical cancer as compared to their older counterparts. Thus, concerted efforts are needed to promote such awareness among women in Oman.
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Affiliation(s)
- Aisha N Al-Saadi
- Department of Studies and Research, Directorate General of Planning and Studies, Ministry of Health, Muscat, Oman
| | - Aisha H Al-Muqbali
- Buraimi Polyclinic, Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Eihab Dawi
- Department of Biostatistics, Arab Open University, Khaitan, Kuwait
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DeLang MD, Salamh PA, Farooq A, Tabben M, Whiteley R, van Dyk N, Chamari K. The dominant leg is more likely to get injured in soccer players: systematic review and meta-analysis. Biol Sport 2021; 38:397-435. [PMID: 34475623 DOI: 10.5114/biolsport.2021.100265] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 12/26/2022] Open
Abstract
In soccer (football), dominant limb kicking produces higher ball velocity and is used with greater frequency than the non-dominant limb. It is unclear whether limb dominance has an effect on injury incidence. The purpose of this systematic review with meta-analysis is to examine the relationship between limb dominance and soccer injuries. Studies were identified from four online databases according to PRISMA guidelines to identify studies of soccer players that reported lower extremity injuries by limb dominance. Relevant studies were assessed for inclusion and retained. Data from retained studies underwent meta-analyses to determine relative risk of dominant versus non-dominant limb injuries using random-effects models. Seventy-four studies were included, with 36 of them eligible for meta-analysis. For prospective lower extremity injury studies, soccer players demonstrated a 1.6 times greater risk of injury to the dominant limb (95% CI [1.3-1.8]). Grouped by injury location, hamstring (RR 1.3 [95% CI 1.1-1.4]) and hip/groin (RR 1.9 [95% CI 1.3-2.7]) injuries were more likely to occur to the dominant limb. Greater risk of injury was present in the dominant limb across playing levels (amateurs RR 2.6 [95% CI 2.1-3.2]; youths RR 1.5 [95% CI 1.26-1.67]; professionals RR 1.3 [95% CI 1.14-1.46]). Both males (RR 1.5 [95% CI 1.33-1.68)] and females (RR 1.5 [95% CI 1.14-1.89]) were more likely to sustain injuries to the dominant limb. Future studies investigating soccer injury should adjust for this confounding factor by using consistent methods for assigning limb dominance and tracking use of the dominant versus non-dominant limb.
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Bidari A, Hassanzadeh M, Naderkhani M, Gholizadeh Mesgarha M, Pour Mohammad A, Azadeh A, Hossein H, Zarei E, Khodadost M. Predictors of critical COVID-19 in an Iranian population: Age and disabilities play a special role. Med J Islam Repub Iran 2021; 35:94. [PMID: 34956940 PMCID: PMC8683779 DOI: 10.47176/mjiri.35.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Ever since coronavirus disease 2019 (COVID-19) has emerged as a global public health problem, risk factors for severe disease have been reported in studies from Western countries. However, apart from studies of Chinese origin, few reports are available on COVID-19 severity among the Asian population. This study investigates potential risk factors for development of critical COVID-19 in an Iranian population. Methods: In this retrospective cohort study, we included all adults with COVID-19 from 2 tertiary centers in Iran who had been diagnosed between February 20 and April 1, 2020, in either inpatient or outpatient settings. "Critical COVID-19" was proposed when a hospitalized patient was scheduled for admission to intensive care unit, assisted by mechanical ventilation, or pronounced dead. We used univariable and multivariable logistic and linear regression models to explore the potential risk factors associated with critical COVID-19, admission to hospital, and length of hospital stay. Results: Of the 590 recruited patients, 427 (72.4%) were hospitalized, 186 (31.5%) had critical COVID-19, and 107 (18.2%) died. In the multivariable regression analysis, age >60 years and physical/mental disabilities were associated with critical COVID-19 (odds ratio (OR), 2.33 and 7.03; 95% CI, 1.51-3.60 and 2.88-17.13, respectively); and history of renal, heart, or liver failure was associated with both COVID-19 hospitalization (OR, 4.13; 95% CI 1.91-8.95; p<0.001) and length of hospital stay (Beta 1.90; 95% CI, 0.76-3.04; p=0.001). Conclusion: Age >60 years and physical/mental disabilities can predict development of critical COVID-19 in the Iranian population. Also, the presence of renal, heart, or liver failure might predict both COVID-19 hospitalization and length of hospital stay.
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Affiliation(s)
- Ali Bidari
- Department of Rheumatology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Hassanzadeh
- Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahya Naderkhani
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Arash Pour Mohammad
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Azadeh
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hasti Hossein
- Physiology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Zarei
- Ali-Asghar Children Hospital, Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Khodadost
- Department of Epidemiology, School of Public Health, Larestan University of Medical Sciences, Larestan, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Lee KS, Choi YJ, Cho J, Lee H, Lee H, Park SJ, Park JS, Hong YC. Environmental and Genetic Risk Factors of Congenital Anomalies: an Umbrella Review of Systematic Reviews and Meta-Analyses. J Korean Med Sci 2021; 36:e183. [PMID: 34282604 PMCID: PMC8289720 DOI: 10.3346/jkms.2021.36.e183] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/15/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The prevalence of congenital anomalies in newborns in South Korea was 272.9 per 100,000 in 2005, and 314.7 per 100,000 in 2006. In other studies, the prevalence of congenital anomalies in South Korea was equivalent to 286.9 per 10,000 livebirths in 2006, while it was estimated 446.3 per 10,000 births during the period from 2008 to 2014. Several systematic reviews and meta-analyses analyzing the factors contributing to congenital anomalies have been reported, but comprehensive umbrella reviews are lacking. METHODS We searched PubMed, Google Scholar, Cochrane, and EMBASE databases up to July 1, 2019, for systematic reviews and meta-analyses that investigated the effects of environmental and genetic factors on any type of congenital anomalies. We categorized 8 subgroups of congenital anomalies classified according to the 10th revision of the International Statistical Classification of Diseases (ICD-10). Two researchers independently searched the literature, retrieved the data, and evaluated the quality of each study. RESULTS We reviewed 66 systematic reviews and meta-analyses that investigated the association between non-genetic or genetic risk factors and congenital anomalies. Overall, 269 associations and 128 associations were considered for environmental and genetic risk factors, respectively. Congenital anomalies based on congenital heart diseases, cleft lip and palate, and others were associated with environmental risk factors based on maternal exposure to environmental exposures (air pollution, toxic chemicals), parental smoking, maternal history (infectious diseases during pregnancy, pregestational and gestational diabetes mellitus, and gestational diabetes mellitus), maternal obesity, maternal drug intake, pregnancy through artificial reproductive technologies, and socioeconomic factors. The association of maternal alcohol or coffee consumption with congenital anomalies was not significant, and maternal folic acid supplementation had a preventive effect on congenital heart defects. Genes or genetic loci associated with congenital anomalies included MTHFR, MTRR and MTR, GATA4, NKX2-5, SRD5A2, CFTR, and 1p22 and 20q12 anomalies. CONCLUSION This study provides a wide perspective on the distribution of environmental and genetic risk factors of congenital anomalies, thus suggesting future studies and providing health policy implications.
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Affiliation(s)
- Kyung Shin Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Jung Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jinwoo Cho
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hyunji Lee
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Heejin Lee
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Soo Jin Park
- Department of Surgery, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Joong Shin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea.
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Affiliation(s)
- Xiajun Li
- School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China.
| | - Albert Jiarui Li
- Edgemont High School, 200 White Oak Lane, Scarsdale, NY 10583, USA
| | - Bin Du
- State Key Laboratory of Rare, Complex and Critical Diseases, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, China.
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Weimert S, Kuhn S, Rommens PM, Beutel ME, Reiner IC. [Symptoms of Adjustment Disorder after an accidental injury: risk and protective factors]. Z Psychosom Med Psychother 2021;:OA9. [PMID: 34180356 DOI: 10.13109/zptm.2021.67.oa9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Symptoms of Adjustment Disorder after an accidental injury: risk and protective factors Objectives: The identification of protective and risk factors for symptoms of adjustment disorder (AD) after an accident injury. Methods: In this prospective long-term study, data from 73 patients with ankle and lower leg fractures were analyzed. Symptoms of AD were assessed at enrollment (T0), 1 month (T1) and 12 months (T2) after injury. In addition, questionnaires regarding adverse childhood experiences, coping strategies and the number of stressors during the last year were obtained. The Structured Clinical Interview for DSM-IV (SCID) was conducted at T1 and T2. Results: 4.1 % of patients met the criteria for AD at T1 and 2.7 % at T2. Acceptance coping predicted a lower level of AD symptoms 1 year after the injury (β = -.42, p <.001). Conclusions: It could be confirmed that the selection of coping strategies predicts the level of AD symptoms 12 months after the injury. The results show that acceptance is a protective factor for AD and contribute to a better understanding of a little-researched diagnosis.
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Kim JE, Kim SH, Han RJW, Kang MH, Kim JH. Postdural Puncture Headache Related to Procedure: Incidence and Risk Factors After Neuraxial Anesthesia and Spinal Procedures. Pain Med 2021; 22:1420-1425. [PMID: 33675230 DOI: 10.1093/pm/pnaa437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Postdural puncture headache (PDPH) is a potential complication of certain neuraxial anesthesia and spinal procedures, and some risk factors for PDPH have been identified. However, there have been no detailed analyses of rates and risk factors of PDPH after various spinal and neuraxial anesthesia procedures. METHODS Patient data from January 1, 2015, to December 31, 2017, were retrospectively analyzed. The patients underwent dural puncture procedures (spinal anesthesia, lumbar puncture [spinal tap], lumbar cerebrospinal fluid [CSF] drainage) or nondural puncture procedures (transforaminal epidural injection, interlaminar epidural injection, epidural catheterization with patient-controlled analgesia for delivery). PDPH incidence and risk factors were evaluated. RESULTS For dural puncture procedures, PDPH incidence was 2.96%, and risk factors were younger age, female sex, and lumbar puncture. Larger needle gauge was a risk factor according to Student t-test but not during logistic regression analysis. PDPH incidence was higher after lumbar puncture using a 22 G Tuohy needle (4.63%) than after lumbar CSF drainage using an 18 G Tuohy needle (3.05%). For nondural puncture procedures, PDPH incidence was 0.53% and did not differ between procedure types; no risk factors were identified. CONCLUSIONS PDPH incidence and risk factors depended on the type of neuraxial anesthesia and spinal procedures. PDPH incidence after lumbar puncture using a 22 G Tuohy needle was higher than that after lumbar CSF drainage using an 18 G Tuohy needle, suggesting that catheter insertion may reduce PDPH risk. In non-dural puncture procedures, PDPH risk did not differ according to type of procedure, and no risk factors were found.
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Affiliation(s)
- Jung Eun Kim
- Kangnam Sacred Heart Hospital, Hallym University College of Medicine
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Weinberg EM, Trinh HN, Firpi RJ, Bhamidimarri KR, Klein S, Durlam J, Watkins S, Reddy KR, Weiss M, Zink RC, Lok AS. Lean Americans With Nonalcoholic Fatty Liver Disease Have Lower Rates of Cirrhosis and Comorbid Diseases. Clin Gastroenterol Hepatol 2021; 19:996-1008.e6. [PMID: 32629123 DOI: 10.1016/j.cgh.2020.06.066] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/08/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Nonalcoholic fatty liver disease (NAFLD) is typically associated with obesity. Little is known about the prevalence of cirrhosis in patients with NAFLD and a normal body mass index (BMI). METHODS We determined prevalence of cirrhosis, cardiovascular disease (CVD), and metabolic abnormalities among participants in all BMI categories in the TARGET-NASH study. A total of 3386 patients with NAFLD were enrolled from August 2016 through March 2019. The odds ratios of cirrhosis, CVD, and metabolic abnormalities were estimated by age and race, adjusting for sex and center type. RESULTS Based on standard BMI cutoff values, 12.8% of study subjects were lean, 27.1% were overweight, 26.5% had class 1 obesity, and 33.7% had class 2 or 3 obesity. Asians accounted for 48.7% of lean participants, and proportions decreased as BMI categories increased (P < .0001). Lower proportions of lean participants had cirrhosis (22.6% vs 40.2% of non-lean participants), CVD history (9.0% vs 14.8% of nonlean participants), diabetes (32.6% vs 53.5% of non-lean participants), hypertension (47.8% vs 67.4% of non-lean participants), or dyslipidemia (54.0% vs 64.1% of non-lean participants). Asian participants had a lower prevalence of cirrhosis, history of CVD, cardiovascular events, and diabetes compared with non-Asians, independent of BMI category. After we adjusted for age, sex, and center type and site, the odds of NAFLD-associated cirrhosis in Asians who were lean was almost half the odds of NAFLD-associated cirrhosis in non-Asians who were lean (odds ratio, 0.47; 95% CI, 0.29-0.77). CONCLUSIONS More than 10% participants in a cohort of persons with NAFLD in the United States are lean; Asians account for almost half of the lean persons with NAFLD. Lean participants had a lower prevalence of cirrhosis, CVD, and metabolic abnormalities than non-lean persons with NAFLD. Asian participants had a significantly lower prevalence of cirrhosis, CVD, and metabolic abnormalities than non-Asians in all BMI categories. ClinicalTrials.gov, Number: NCT02815891.
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Wijnands AM, de Jong ME, Lutgens MWMD, Hoentjen F, Elias SG, Oldenburg B. Prognostic Factors for Advanced Colorectal Neoplasia in Inflammatory Bowel Disease: Systematic Review and Meta-analysis. Gastroenterology 2021; 160:1584-1598. [PMID: 33385426 DOI: 10.1053/j.gastro.2020.12.036] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/12/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer (CRC). We performed a systematic review and meta-analysis to identify all prognostic factors for advanced colorectal neoplasia (aCRN, high-grade dysplasia, or CRC) in patients with IBD. METHODS A systematic literature search was conducted according to the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Risk of bias was assessed using the Quality in Prognostic Studies tool. Random-effects models were created separately for odds and hazard ratios, different study designs, and univariable or multivariable data. The evidence for all prognostic factors was categorized as "weak", "moderate", or "strong", based on estimate of effect sizes, heterogeneity, and risk of bias. RESULTS A total of 164 studies were included, allowing pooled analysis of 31 potential prognostic factors. In the univariable analysis, the evidence for extensive disease was classified as strong while evidence for low-grade dysplasia, strictures, primary sclerosing cholangitis, post-inflammatory polyps, family history of CRC, and ulcerative colitis versus Crohn's disease was considered moderate. Evidence for any dysplasia, colon segment resection, aneuploidy, male sex, and age was classified as weak. In addition, histologic inflammation was identified as a risk factor in multivariable analysis (weak evidence). The evidence for the protective factors colonoscopic surveillance, 5-Aminosalicylic Acid, thiopurines, and smoking was moderate in univariable analysis. Multivariable analysis provided weak evidence for statin use. CONCLUSIONS In this systematic review and meta-analysis, we identified 13 risk factors and 5 protective factors for aCRN in IBD patients, based on univariable and/or multivariable pooled analyses. These findings might lay the groundwork for an improved CRC risk stratification-based surveillance in IBD.
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Affiliation(s)
- Anouk M Wijnands
- Inflammatory Bowel Disease Centre, Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Michiel E de Jong
- Inflammatory Bowel Disease Centre, Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Maurice W M D Lutgens
- Department of Gastroenterology and Hepatology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Frank Hoentjen
- Inflammatory Bowel Disease Centre, Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Sjoerd G Elias
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Bas Oldenburg
- Inflammatory Bowel Disease Centre, Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Lau ES, Paniagua SM, Liu E, Jovani M, Li SX, Takvorian K, Suthahar N, Cheng S, Splansky GL, Januzzi JL, Wang TJ, Vasan RS, Kreger B, Larson MG, Levy D, de Boer RA, Ho JE. Cardiovascular Risk Factors are Associated with Future Cancer. JACC CardioOncol 2021; 3:48-58. [PMID: 33870217 PMCID: PMC8045786 DOI: 10.1016/j.jaccao.2020.12.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background The extent to which co-occurrence of cardiovascular disease (CVD) and cancer is due to shared risk factors or other mechanisms is unknown. Objectives This study investigated the association of standard CVD risk factors, CVD biomarkers, pre-existing CVD, and ideal cardiovascular (CV) health metrics with the development of future cancer. Methods This study prospectively followed Framingham Heart Study and PREVEND (Prevention of Renal and Vascular End-Stage Disease) study participants free of cancer at baseline and ascertained histology-proven cancer. This study assessed the association of baseline CV risk factors, 10-year atherosclerotic (ASCVD) risk score, established CVD biomarkers, prevalent CVD, and the American Heart Association (AHA) Life’s Simple 7 CV health score with incident cancer using multivariable Cox models. Analyses of interim CVD events with incident cancer used time-dependent covariates. Results Among 20,305 participants (mean age 50 ± 14 years; 54% women), 2,548 incident cancer cases occurred over a median follow-up of 15.0 years (quartile 1 to 3: 13.3 to 15.0 years). Traditional CVD risk factors, including age, sex, and smoking status, were independently associated with cancer (p < 0.001 for all). Estimated 10-year ASCVD risk was also associated with future cancer (hazard ratio [HR]: 1.16 per 5% increase in risk; 95% confidence interval [CI] 1.14 to 1.17; p < 0.001). The study found that natriuretic peptides (tertile 3 vs. tertile 1; HR: 1.40; 95% CI: 1.03 to 1.91; p = 0.035) were associated with incident cancer but not high-sensitivity troponin (p = 0.47). Prevalent CVD and the development of interim CV events were not associated with higher risk of subsequent cancer. However, ideal CV health was associated with lower future cancer risk (HR: 0.95 per 1-point increase in the AHA health score; 95% CI: 0.92 to 0.99; p = 0.009). Conclusions CVD risk, as captured by traditional CVD risk factors, 10-year ASCVD risk score, and natriuretic peptide concentrations are associated with increased risk of future cancer. Conversely, a heart healthy lifestyle is associated with a lower risk of future cancer. These data suggest that the association between CVD and future cancer is attributable to shared risk factors.
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Affiliation(s)
- Emily S. Lau
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Samantha M. Paniagua
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Elizabeth Liu
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Manol Jovani
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Shawn X. Li
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Katherine Takvorian
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Navin Suthahar
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Susan Cheng
- Department of Cardiology, Cedars Sinai Medical Center, Los Angeles, California, USA
| | | | - James L. Januzzi
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Thomas J. Wang
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ramachandran S. Vasan
- Framingham Heart Study, Framingham, Massachusetts, USA
- Cardiovascular Medicine Section, Department of Medicine ad Section of Preventive Medicine and Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Bernard Kreger
- Cardiovascular Medicine Section, Department of Medicine ad Section of Preventive Medicine and Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Martin G. Larson
- Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Mathematics and Statistics, Boston University, Boston, Massachusetts, USA
| | - Daniel Levy
- Framingham Heart Study, Framingham, Massachusetts, USA
- Center for Population Studies of the National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Rudolf A. de Boer
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jennifer E. Ho
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Address for correspondence: Dr. Jennifer E. Ho, Massachusetts General Hospital, 185 Cambridge Street, CPZN #3192, Boston, Massachusetts 02114, USA. @JenHoCardiology@JJheartdoc
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Lewis MD, Talluri J, Wilcox CM, Abberbock JN, Tang G, Conwell DL, Banks PA, Cote GA, Sherman S, Alkaade S, Gardner TB, Anderson MA, Sandhu BS, Muniraj T, Forsmark CE, Guda N, Gelrud A, Romagnuolo J, Brand R, LaRusch J, Amann ST, Slivka A, Whitcomb DC, Yadav D. Differences in Age at Onset of Symptoms, and Effects of Genetic Variants, in Patients With Early vs Late-Onset Idiopathic Chronic Pancreatitis in a North American Cohort. Clin Gastroenterol Hepatol 2021; 19:349-57. [PMID: 32240833 DOI: 10.1016/j.cgh.2020.03.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/13/2020] [Accepted: 03/22/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Idiopathic chronic pancreatitis (ICP) is the second most common subtype of CP. In 1994, researchers reported the bimodal age at onset of ICP symptoms: early onset ICP (EO-ICP; median age, 19.2 y) and late-onset ICP (LO-ICP; median age, 56.2 y). Ages of onset and clinical features of ICP differed from those of alcohol-related CP (ACP). However, variants in PRSS1 had not yet been associated with ICP. We reexamined ages of onset of ICP in a large, North American cohort of patients, and investigated the effects of genetic factors and alcohol use in patients with EO-ICP, LO-ICP, and ACP. METHODS We performed a cross-sectional analysis of patients with CP of European ancestry enrolled in the North American Pancreatitis Study 2, a prospective study of 1195 patients with CP from 26 centers in the United States from August 2000 through December 2014. We compared age at onset of symptoms for 130 patients with CP who were lifetime abstainers from alcohol (61 patients with early onset and 69 patients with late onset), 308 light to moderate alcohol drinkers with CP, and 225 patients with ACP and heavy to very heavy alcohol use. DNA from available patients was analyzed for variants associated with CP in SPINK1, CFTR, and CTRC. The Kruskal-Wallis test was used to compare continuous variables across groups and based on genetic variants. RESULTS Median ages at onset of symptoms were 20 years for patients with EO-ICP and no alcohol use, 58 years for patients with LO-ICP and no alcohol use, 47 years for light to moderate alcohol drinkers with CP, and 44 years for patients with ACP. A higher proportion of patients with EO-ICP had constant pain (65%) than patients with LO-ICP (31%) (P = .04). A higher proportion of patients with ACP had pseudocysts (43%) than patients with EO-ICP (11%) (P = .001). A higher proportion of patients with EO-ICP had pathogenic variants in SPINK1, CFTR, or CTRC (49%) than patients with LO-ICP (23%), light to moderate alcohol drinking with CP (26%), or ACP (23%) (P = .001). Among patients with variants in SPINK1, those with EO-ICP had onset of symptoms at a median age of 12 years, and light to moderate alcohol drinkers with CP had an age at onset of 24 years. Among patients with variants in CFTR, light to moderate alcohol drinkers had an age at onset of symptoms of 41 years, but this variant did not affect age at onset of EO-ICP or ACP. CONCLUSIONS We confirmed previously reported ages at onset of symptoms for EO-ICP and LO-ICP in a North American cohort. We found differences in clinical features among patients with EO-ICP, LO-ICP, and ACP. Almost half of patients with EO-ICP have genetic variants associated with CP, compared with approximately one quarter of patients with LO-CP or ACP. Genetic variants affect ages at onset of symptoms in some groups.
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Kumar S, Metz DC, Kaplan DE, Goldberg DS. Low Rates of Retesting for Eradication of Helicobacter pylori Infection After Treatment in the Veterans Health Administration. Clin Gastroenterol Hepatol 2021; 19:305-313.e1. [PMID: 32272245 PMCID: PMC7541590 DOI: 10.1016/j.cgh.2020.03.059] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/23/2020] [Accepted: 03/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Expert consensus mandates retesting for eradication of Helicobacter pylori infection after treatment, but it is not clear how many patients are actually retested. We evaluated factors associated with retesting for H pylori in a large, nationwide cohort. METHODS We performed a retrospective cohort study of patients with H pylori infection (detected by urea breath test, stool antigen, or pathology) who were prescribed an eradication regimen from January 1, 1994 through December 31, 2018 within the Veterans Health Administration (VHA). We collected data on demographic features, smoking history, socioeconomic status, facility poverty level and academic status, and provider specialties and professions. The primary outcome was retesting for eradication. Statistical analyses included mixed-effects logistic regression. RESULTS Of 27,185 patients prescribed an H pylori eradication regimen, 6486 patients (23.9%) were retested. Among 7623 patients for whom we could identify the provider who ordered the test, 2663 patients (34.9%) received the order from a gastroenterological provider. Female sex (odds ratio, 1.22; 95% CI, 1.08-1.38; P = .002) and history of smoking (odds ratio, 1.24; 95% CI, 1.15-1.33; P < .001) were patient factors associated with retesting. There was an interaction between method of initial diagnosis of H pylori infection and provider who ordered the initial test (P < .001). There was significant variation in rates of retesting among VHA facilities (P < .001). CONCLUSIONS In an analysis of data from a VHA cohort of patients with H pylori infection, we found low rates of retesting after eradication treatment. There is significant variation in rates of retesting among VHA facilities. H pylori testing is ordered by nongastroenterology specialists two-thirds of the time. Confirming eradication of H pylori is mandatory and widespread quality assurance protocols are needed.
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Affiliation(s)
- Shria Kumar
- Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - David C. Metz
- Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania
| | - David E. Kaplan
- Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania,Division of Gastroenterology, Veterans Health Administration
| | - David S. Goldberg
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine
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Azadnajafabad S, Mohammadi E, Aminorroaya A, Fattahi N, Rezaei S, Haghshenas R, Rezaei N, Naderimagham S, Larijani B, Farzadfar F. Non-communicable diseases' risk factors in Iran; a review of the present status and action plans. J Diabetes Metab Disord 2021:1-9. [PMID: 33500879 PMCID: PMC7821170 DOI: 10.1007/s40200-020-00709-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/25/2020] [Accepted: 12/15/2020] [Indexed: 01/12/2023]
Abstract
Non-communicable Diseases (NCDs) are the leading causes of death globally, imposing a heavy burden on the healthcare systems, especially in low- and middle-income countries. Iran is a country in the Middle-East region with an aging population and changing disease risk factors, and now is facing NCDs as the major health problem of the country. Investigating NCDs' risk factors and tackling preventable ones is the main intervention to control their heavy burden. In this review, we discussed the most critical risk factors in Iran and the implemented programs and action plans to control them. A better knowledge on current status of risk factors and plans to tackle them, could help policymakers effectively rule policies and allocate resources to curb heavy burden of NCDs in Iran.
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Affiliation(s)
- Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arya Aminorroaya
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network, Tehran, Iran
| | - Nima Fattahi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahabeddin Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Lee HS, Nagra N, La Selva D, Kozarek RA, Ross A, Weigel W, Beecher R, Chiorean M, Gluck M, Boden E, Venu N, Krishnamoorthi R, Larsen M, Lin OS. Nurse-Administered Propofol Continuous Infusion Sedation for Gastrointestinal Endoscopy in Patients Who Are Difficult to Sedate. Clin Gastroenterol Hepatol 2021; 19:180-188. [PMID: 32931961 DOI: 10.1016/j.cgh.2020.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/06/2020] [Accepted: 09/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Patients who chronically use alcohol, marijuana, or opioids, or suffer from post-traumatic stress disorder (PTSD), can be difficult to sedate with midazolam and fentanyl, and often are referred for monitored anesthesia care during endoscopy. Nurse-administered propofol continuous infusion sedation (NAPCIS), which confers the benefit of propofol-based sedation without the added expense of anesthesia, is effective and safe for sedation of healthy patients. We investigated whether NAPCIS also is effective for patients who are difficult to sedate. METHODS We performed a retrospective study of patients who underwent upper endoscopy or colonoscopy with NAPCIS at a single center from January 2018 through April 2018. We reviewed records from patients who were heavy users of alcohol (n = 105), daily users of marijuana (n = 267) or opioids (n = 178), had a diagnosis of PTSD (n = 91), or were none of these (controls, n = 786). We compared mean fentanyl and propofol doses (adjusted for body weight), procedure and recovery times, procedure success rates, and adverse events. RESULTS Compared with the controls, the marijuana group required higher mean adjusted sedative doses for colonoscopies (0.6 vs 0.4 mcg/kg fentanyl and 5.0 vs 4.7 mg/kg propofol; P ≤ .025 for both) and upper endoscopies (0.8 vs 0.3 mcg/kg fentanyl and 3.7 vs 3.2 mg/kg propofol; P ≤ .021 for both), the PTSD group required a higher dose of fentanyl for colonoscopies (0.6 vs 0.4 mcg/kg; P = .009), and the alcohol group required a higher dose of fentanyl for upper endoscopies (0.7 vs 0.3 mcg/kg; P < .001). Procedure success rates were high (95.1%-100%) and did not differ significantly between the difficult-to-sedate groups and controls; mean procedure times (7.0-9.0 minutes for upper endoscopies, 21.1-22.9 minutes for colonoscopies) and recovery times (22.5-29.6 minutes) also were similar among groups. Upper endoscopies were associated with lower sedative doses and shorter procedure and recovery times than colonoscopies. Sedation-related adverse events were rare in all groups (only 26 cases total), and there were no serious complications or deaths. CONCLUSIONS NAPCIS seems to be a safe and effective means of providing sedation for endoscopy to patients who may be difficult to sedate owing to alcohol, marijuana, or opioid use, or PTSD.
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Affiliation(s)
- Hyun Seok Lee
- Digestive Disease Institute; Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | | | | | | | | | - Wade Weigel
- Department of Anesthesia, Virginia Mason Medical Center, Seattle, Washington
| | - Ryan Beecher
- Department of Anesthesia, Virginia Mason Medical Center, Seattle, Washington
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Chen Y, Yu C, Liu X, Xi T, Xu G, Sun Y, Zhu F, Shen B. PCLiON: An Ontology for Data Standardization and Sharing of Prostate Cancer Associated Lifestyles. Int J Med Inform 2021; 145:104332. [PMID: 33186790 DOI: 10.1016/j.ijmedinf.2020.104332] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Researches on Lifestyle medicine (LM) have emerged in recent years to garner wide attention. Prostate cancer (PCa) could be prevented and treated by positive lifestyles, but the association between lifestyles and PCa is always personalized. OBJECTIVES In order to solve the heterogeneity and diversity of different data types related to PCa, establish a standardized lifestyle ontology, promote the exchange and sharing of disease lifestyle knowledge, and support text mining and knowledge discovery. METHODS The overall construction of PCLiON was created in accordance with the principles and methodology of ontology construction. Following the principles of evidence-based medicine, we screened and integrated the lifestyles and their related attributes. Protégé was used to construct and validate the semantic framework. All annotations in PCLiON were based on SNOMED CT, NCI Thesaurus, the Cochrane Library and FooDB, etc. HTML5 and ASP.NET was used to develop the independent Web page platform and corresponding intelligent terminal application. The PCLiON also uploaded to the National Center for Biomedical Ontology BioPortal. RESULTS PCLiON integrates 397 lifestyles and lifestyle-related factors associated with PCa, and is the first of its kind for a specific disease. It contains 320 attribute annotations and 11 object attributes. The logical relationship and completeness meet the ontology requirements. Qualitative analysis was carried out for 329 terms in PCLiON, including factors which are protective, risk or associated but functional unclear, etc. PCLiON is publicly available both at http://pcaontology.net/PCaLifeStyleDefault.aspx and https://bioportal.bioontology.org/ontologies/PCALION. CONCLUSIONS Through the bilingual online platforms, complex lifestyle research data can be transformed into standardized, reliable and responsive knowledge, which can promote the shared-decision making (SDM) on lifestyle intervention and assist patients in lifestyle self-management toward the goal of PCa targeted prevention.
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Saha J, Chouhan P. Indoor air pollution (IAP) and pre-existing morbidities among under-5 children in India: are risk factors of coronavirus disease (COVID-19)? Environ Pollut 2020; 266:115250. [PMID: 32693324 PMCID: PMC7362832 DOI: 10.1016/j.envpol.2020.115250] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/05/2020] [Accepted: 07/12/2020] [Indexed: 05/09/2023]
Abstract
Globally, the Coronavirus disease (COVID-19) outbreak is linked with air pollution of both indoor and outdoor environments and co-morbidities conditions of human beings. To find out the risk factor zones associated with Coronavirus disease among under-five children using pre-existing morbidity conditions and indoor air pollution (IAP) environmental factors and also with current fatality and recovery rate of COVID-19 disease in India. Data was utilized from the 4th round of the National Family Health Survey (NFHS), 2015-16, and from the Ministry of Health and Family Welfare (MoHFW) on 18th May 2020. Mean, standard deviation, and Z-score statistical methods have been employed to find out the risk factor zones i.e. to execute the objective. Findings of this study are, the states and UTs which have more likely to very higher to higher risk factors or zones of Coronavirus disease (COVID-19) are Mizoram (1.4), Meghalaya (1.27), Uttarakhand (0.92), West Bengal (0.73), Uttar Pradesh (0.66), Jammu and Kashmir (0.44), Odisha (0.33), Madhya Pradesh (0.21), Jharkhand (0.20), Bihar (0.19), Maharashtra (0.16 risk score), compared to UTs like Assam (-0.12), Rajasthan (-0.13), Goa (-0.14), Manipur (-0.17), Chandigarh (-0.19), Haryana (-0.22), Delhi (-0.27) have moderate risk factors of COVID-19, and the states and UTs like Daman and Diu (-1.18), Sikkim (-0.98), Andaman and Nicobar Islands (-0.84), Kerala (-0.69), Dadra and Nagar Haveli (-0.68), Arunachal Pradesh ( 0.-53), Karnataka (-0.42), and Nagaland (-0.36) have very low-risk zones of COVID-19 deaths. From a research viewpoint, there is a prerequisite need for epidemiological studies to investigate the connection between indoor air pollution and pre-existing morbidity which are associated with COVID-19. Well-built public health measures, including rapidly searching in high focus areas and testing of COVID-19, should be performed in vulnerable areas of COVID-19.
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Affiliation(s)
- Jay Saha
- Department of Geography, University of Gour Banga (UGB), Malda, West Bengal, 732103, India.
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga (UGB), Malda, West Bengal, 732103, India.
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