共查询到20条相似文献，搜索用时 15 毫秒
1.
Maya Fayfman Georgia Davis Elizabeth W. Duggan Maria Urrutia David Chachkhiani Joanna Schindler Francisco J. Pasquel Rodolfo J. Galindo Priyathama Vellanki David Reyes-Umpierrez Heqiong Wang Guillermo E. Umpierrez 《Journal of diabetes and its complications》2018,32(12):1091-1096
Aim
We investigated if a dipeptidyl peptidase-4 inhibitor, sitagliptin, can prevent perioperative stress hyperglycemia in patients without prior history of diabetes mellitus undergoing general surgery.Methods
This double-blind pilot trial randomized general surgery patients to receive sitagliptin (n?=?44) or placebo (n?=?36) once daily, starting one day prior to surgery and continued during the hospital stay. The primary outcome was occurrence of stress hyperglycemia, defined by blood glucose (BG) >140?mg/dL and >180?mg/dL after surgery. Secondary outcomes included: length-of-stay, ICU transfers, hypoglycemia, and hospital complications.Results
BG >140?mg/dL was present in 44 (55%) of subjects following surgery. There were no differences in hyperglycemia between placebo and sitagliptin (56% vs. 55%, p?=?0.93). BG >180?mg/dL was observed in 19% and 11% of patients treated with placebo and sitagliptin, respectively, p?=?0.36. Both treatment groups had resulted in similar postoperative BG (148.9?±?29.4?mg/dL vs. 146.9?±?35.2?mg/dL, p?=?0.73). There were no differences in length-of-stay (4 vs. 3?days, p?=?0.84), ICU transfer (3% vs. 5%, p?=?1.00), hypoglycemia <70?mg/dL (6% vs. 11%, p?=?0.45), and complications (14% vs. 18%, p?=?0.76).Conclusion
Preoperative treatment with sitagliptin did not prevent stress hyperglycemia or complications in individuals without diabetes undergoing surgery. 相似文献2.
Takayuki Yamamoto Manabu Shiraki Takuya Bamba Satoru Umegae Koichi Matsumoto 《International journal of colorectal disease》2014,29(4):485-491
Purpose
This prospective study was to evaluate the significance of fecal calprotectin and lactoferrin for the prediction of ulcerative colitis (UC) relapse.Methods
Eighty UC patients in remission for ≥3 months on mesalamine as maintenance therapy were included. At entry, stool samples were collected for the measurement of calprotectin and lactoferrin. All patients were followed up for the following 12 months. To identify predictive factors for relapse, time-dependent analyses using the Kaplan-Meier graphs and Cox's proportional hazard model were applied.Results
During the 12 months, 21 patients relapsed. Mean calprotectin and lactoferrin levels were significantly higher in patients with relapse than those in remission (calprotectin—173.7 vs 135.5 μg/g, P?=?0.02; lactoferrin—165.1 vs 130.7 μg/g, P?=?0.03). A cutoff value of 170 μg/g for calprotectin had a sensitivity of 76 % and a specificity of 76 % to predict relapse, while a cutoff value of 140 μg/g for lactoferrin had a sensitivity of 67 % and a specificity of 68 %. In a multivariate analysis, calprotectin (≥170 μg/g) was a predictor of relapse (hazard ratio, 7.23; P?=?0.002). None of the following parameters were significantly associated with relapse: age, gender, duration of UC, number of UC episode, severity of the previous episode, extent of UC, extraintestinal manifestation, and lactoferrin level.Conclusions
Fecal calprotectin showed a higher sensitivity and specificity than fecal lactoferrin for predicting UC relapse. Fecal calprotectin level appeared to be a significant predictor of relapse in patients with quiescent UC on mesalamine as maintenance therapy. 相似文献3.
Mohamed A. Mekky Ahmad R. Riad Marwa A. Gaber Mohamed O. Abdel-Malek Yosef M. Swifee 《Arab Journal Of Gastroenterology》2018,19(2):76-79
Background and study aims
Many regimens are tried in managing overt hepatic encephalopathy (HE). We investigated the efficacy of rifaximin versus metronidazole in management of an acute episode of HE on top of cirrhosis.Patients and methods
An open label prospective controlled trial was conducted on patients with an acute episode of HE on top of cirrhosis who were randomly divided into metronidazole-group (M-group) and rifaximin-group (R-group) with 60 patients in each.The main outcome measure was the clinical improvement of HE, duration of hospital stay and the changes in the level of serum ammonia after 3?days of starting therapy.Results
Both M-group and R-group were comparable as regards age and sex (mean age 51?±?11?years and 49?±?12; male/female ratio 45:15 and 50:10, respectively). Forty-six patients (76.7%) in M-group compared with forty-five (75%) in R-group showed clinical improvement (p?=?0.412). Hospital stays were comparable between both group; 4.2?±?2.1 and 3.9?±?1.7 for M-group and R-group; respectively (p?=?0.435). There was no significant difference of venous ammonia levels (Mean of delta 160.77?±?185.34?µg/dL and 207.95?±?218.43?µg/dL with p 0.664 and 0.974 in M-group and R-group, respectively). No adverse events were reported throughout the whole study.Conclusion
Rifaximin and metronidazole are equally effective in management of acute episode of overt HE, therefore, re-auditing of treatment protocols of HE are warranted especially in limited resource settings. 相似文献4.
Ioannis D. Kostakis Kyriaki G. Cholidou Aristeidis G. Vaiopoulos Ioannis S. Vlachos Despina Perrea George Vaos 《Digestive diseases and sciences》2013,58(2):309-319
Background
Inflammatory bowel disease frequently begins during childhood or adolescence. Current tests and procedures for diagnosing and monitoring inflammatory bowel disease are invasive, uncomfortable and costly. Fecal calprotectin is an inflammatory marker tested in several studies including pediatric patients with inflammatory bowel disease.Methods
A search for articles published up to October 2011 was conducted using MEDLINE and EMBASE databases. We included original English-written articles referred to pediatric patients with inflammatory bowel disease and measured fecal calprotectin levels. We extracted data concerning fecal calprotectin levels in patients with inflammatory bowel disease and in the controls groups, sensitivity, specificity, positive and negative likelihood ratio.Results
Thirty-four studies were included. Fecal calprotectin levels of patients with inflammatory bowel disease are much higher than those of healthy controls or patients with functional disorders or other gastrointestinal diseases. The results vary greatly when taking all studies into consideration. Nevertheless, in cases of newly diagnosed and/or active inflammatory bowel disease, the results are more homogeneous, with high sensitivity and positive likelihood ratio, low negative likelihood ratio, but moderate specificity. Moreover, 50 μg/g seems to be the most proper cut-off point for the fecal calprotectin test.Conclusions
The fecal calprotectin test could be used for supporting diagnosis or confirming relapse of inflammatory bowel disease in pediatric patients. A positive result could confirm the suspicion of either inflammatory bowel disease diagnosis or inflammatory bowel disease relapse, due to the high sensitivity of the test, but a negative result should not exclude these conditions, due to its moderate specificity. 相似文献5.
Abdelle F. Cheres Nadine ElAsmar Aman Rajpal Warren R. Selman Baha M. Arafah 《Pituitary》2017,20(4):471-476
Background
Silent corticotroph adenomas (SCAs) are characterized by strong ACTH immunostaining without clinical manifestations of hypercortisolism. Patients with SCAs often present with mechanical symptoms related to tumor growth. This study investigates the hypothalamic pituitary adrenal axis (HPA) characteristics after adenomectomy in patients with SCAs.Methods
Biochemical parameters of HPA function were monitored frequently after surgical resection of non-functioning macroadenomas. Levels of ACTH, cortisol, DHEA and DHEA-S were measured frequently for 48 h after adenomectomy. HPA data of patients with SCAs (n?=?38) were compared to others (Controls) with non-secreting, ACTH-negative immunostaining adenomas of similar age and gender distribution (n?=?182) who had adenomectomy.Result
Plasma ACTH increased (P?<?0.0001) equally in patients with SCA and controls reaching a peak at 3 h (238?±?123 vs. 233?±?96 ng/L, respectively) after extubation declining thereafter to baseline values 24–36 h. Similarly, serum cortisol levels increased (P?<?0.0001) equally in both groups reaching a maximum at 7 h (36.8?±?13.9 vs. 39.3?±?13.3 ug/dL). Serum DHEA also increased (P?<?0.001) equally in both groups in parallel to the rise in serum cortisol. Serum DHEA-S levels similarly increased (P?<?0.001) from their respective baseline (105.9?±?67.5 and 106.5?±?58.7 ug/dL) reaching their peak (154.5?±?69.5 and 153.5?±?68.6 ug/dL; respectively) at 15 h after extubation. None of the patients acquired any hormone deficits.Conclusions
Under the maximal stimulation of the peri-operative stress, HPA function in patients with SCA behaved in an identical manner to others with ACTH-negative macroadenomas. Thus, despite the strong ACTH-positive immunostaining of these tumors, SCAs are truly non- functional.6.
Background
Few studies have focused on investigating hypoalbuminemia in patients during earlier stages of chronic kidney disease (CKD). In particular, little is known about the role of gastrointestinal (GI) symptoms. Our goal in this paper is to study how GI symptoms relate to serum albumin levels in CKD, especially in the context of and compared with inflammation.Methods
We performed a cross-sectional study of 3599 patients with chronic kidney disease enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. All subjects were asked to complete the Modification of Diet in Renal Disease (MDRD) study patient symptom form. Our main predictor is GI symptom score. Serum level of C-reactive protein (CRP) was measured as well. Main outcome measures are serum albumin levels and prevalence of hypoalbuminemia.Results
Of the participants assessed, mean serum albumin was 3.95?±?0.46 g/dL; 12.7 % had hypoalbuminemia. Patients with lower estimated glomerular filtration rate (eGFR) were likely to have more GI symptoms (apparent at an eGFR <45 ml/min/1.73 m2). Patients with worse GI symptoms had lower dietary protein intake. GI symptoms, like inflammation, were risk factors for lower serum albumin levels. However, adding GI symptom score or CRP into the multivariable regression analysis, did not attenuate the association between lower eGFR and lower albumin or hypoalbuminemia.Conclusions
Increased prevalence of GI symptoms become apparent among CKD patients at relatively high eGFR levels (45 ml/min/1.73 m2), long before ESRD. Patients with more severe GI symptoms scores are more likely to have hypoalbuminemia. But our data do not support GI symptoms/decreased protein intake or inflammation as being the main determinants of serum albumin level in CKD patients.7.
Seok-Hoon Lee Cho-Rong Kim Kyu-Nam Kim 《The American journal of the medical sciences》2019,357(1):23-28
Background
Fecal calprotectin, an indicator of colonic inflammation, is associated with nonconstipated irritable bowel syndrome. Rifaximin is an antibiotic used to treat nonconstipated irritable bowel syndrome. We performed a retrospective review of patient charts to investigate the changes in fecal calprotectin levels and intestinal symptoms following treatment with rifaximin in patients with nonconstipated irritable bowel syndrome with elevated fecal calprotectin.Methods
This study included 198 patients presenting with gastrointestinal complaints consistent with Rome III criteria for irritable bowel syndrome. We treated them with rifaximin for 4-12 weeks, until fecal calprotectin levels were normalized, and divided these into 4-, 8-, and 12-week groups according to the treatment period. Fecal calprotectin levels and gastrointestinal symptoms were assessed following rifaximin therapy.Results
A total of 162 subjects achieved normalized fecal calprotectin values. Of these, most patients who used rifaximin for 8 or 12 weeks showed a significant improvement in gastrointestinal symptoms by the fourth week of treatment, and gradually improved symptoms after 4 weeks. Fecal calprotectin levels were reduced with concomitant improvement of clinical symptoms. In addition, 36 patients who had elevated fecal calprotectin even after 12 weeks of rifaximin treatment showed a gradual reduction in gastrointestinal symptoms and fecal calprotectin during the course of treatment for 12 weeks.Conclusions
These findings suggest that fecal calprotectin might be a useful biomarker for measuring the effect of rifaximin therapy in nonconstipated irritable bowel syndrome patients with elevated fecal calprotectin values. 相似文献8.
Kaija-Leena Kolho Taina Sipponen Elsa Valtonen Erkki Savilahti 《International journal of colorectal disease》2014,29(1):43-50
Purpose
Fecal MMP-9 and human beta-defensin-2 (HBD-2) levels, potential markers of intestinal inflammation, are insufficiently explored in pediatric inflammatory bowel disease (IBD). The aim was to study fecal MMP-9 and HBD-2 in pediatric IBD to compare their performance to calprotectin and to study whether they would provide additional value in categorizing patients according to their disease subtype.Methods
Fecal calprotectin, MMP-9, and HBD-2 levels were measured with ELISA in 110 pediatric patients with IBD (Crohn’s disease, n?=?68; ulcerative colitis (UC), n?=?27; unclassified, n?=?15; median age, 14). To compare the performance of the fecal markers, the area under the receiver operating characteristics curve (±95 % CI) was used. In addition, the best cut-off values of each measure to differentiate IBD patients and controls (n?=?27 presenting with diarrhea, abdominal pain, and/or anemia) were derived by maximizing sensitivity and specificity.Results
Of the fecal markers studied, calprotectin performed best for separation of IBD and non-IBD patients with the area under curve (AUC) of 0.944 (95 % CI, 0.907 to 0.981). For MMP-9, AUC was 0.837 (95 % CI, 0.766 to 0.909), the levels being significantly higher in active IBD and in UC compared with Crohn’s disease (p?=?0.0013), but categorization of these patient groups did not take place. HBD-2 did not categorize any of the studied groups.Conclusions
Calprotectin was the best fecal marker in pediatric IBD, but MMP-9 showed almost comparable performance in UC, suggesting applicability as a surrogate marker of inflammation. Fecal HBD-2 did not bring information to the disease characteristics of pediatric IBD patients. 相似文献9.
Kazunori Sakurai Yuko Kawai Masanori Yamazaki Mitsuhisa Komatsu 《Journal of diabetes and its complications》2018,32(12):1118-1123
Aims
Continuous glucose monitoring (CGM) is not available for all patients with type 2 diabetes (T2D) at risk of nocturnal hypoglycemia (NH). This study was performed to predict the lowest nocturnal blood glucose (LNBG) levels.Methods
An LNBG prediction formula was developed by multivariate analysis using the data including self-monitoring of blood glucose from a formula making (FM) group of 29 insulin-treated T2D patients with CGM. The validity of the formula was assessed by nonparametric regression analysis of actual and predicted values in a formula validation group consisting of 21 other insulin-treated patients. The clinical impact on prediction was evaluated using a Parkes error grid.Results
In the FM group with a median age of 64.0, the following formula was established: Predicted LNBG (mg/dL)?=?127.4–0.836?×?Age (y)?+?0.119?×?Self-monitored fasting blood glucose (mg/dL)?+?0.717?×?Basal insulin dose (U/day) (standard error of calibration 17.2?mg/dL). Based on the validation results, standard error of prediction was 31.0?mg/dL. All predicted values fell within zones A (no effect on clinical action) and B (little or no effect on clinical outcome) on the grid.Conclusions
LNBG could be predicted, and may be helpful for NH prevention. 相似文献10.
Can Boga Mahmut Yeral Ciğdem Gereklioglu Suheyl Asma Erkan Maytalman Pelin Aytan Ilknur Kozanoglu Cagla Sariturk Hakan Ozdogu 《Hematology/oncology and stem cell therapy》2018,11(3):149-157
Objective/background
Anti-T lymphocyte globulin Fresenius (rATG-F; ATG-Fresenius) and antithymocyte globulin (thymoglobulin), which are included in transplant protocols, are used to reduce the risk of chronic graft-versus-host disease (cGVHD) or suppress allograft rejection. Available clinical studies have been conducted in heterogenous patient populations and with different administration protocols including stem cell sources. Additionally, the pharmacokinetics of ATG is variable, and the clinically effective dose of rATG-F, in particular, is not exactly known. The aim of the study was to investigate the clinical outcomes of acute myeloid leukemia (AML) patients who underwent hemopoietic peripheral stem cell transplantation from full-matched sibling donors and given two different doses of r-ATG-F.Methods
This was a single-center, retrospective chart review conducted between July 2005 and July 2016. Sixty-nine consecutive AML patients who underwent transplant with fludarabine- and busulfan-based conditioning were included in the study. Patients in Group 1 received 15?mg/kg body weight rATG-F to 2013 (n?=?46), and Group 2 received 30?mg/kg of rATG-F dose begining in 2013 to reduce to cGVHD (n?=?23). Cyclosporine and methotrexate were used to treat acute GVHD (aGVHD) prophylaxis. Outcome parameters were compared between the groups.Results
Although the recommended dose r-ATG-F had led to a decrease in the cumulative incidence of cGVHD (27 [58.7%] vs. 8 [34.8%]; p?=?.03), it also increased the infection rate at 1?year (3 [6.5%] vs. 4 [17.4%]; p?=?.02). The two groups were similar in terms of engraftment time, aGVHD, relapse, nonrelapse mortality, and rATG-F-related toxicity. A Cox regression model revealed that aGVHD III–IV was associated with increased nonrelapse mortality at 1?year (hazard ratio?=?18.2; 95% confidence interval, 1.667–199.255; p = <.02). No patients developed rATG-F-related severe adverse events (Common Terminology Criteria grade 4 or 5).Conclusion
Dose difference of rATG-F did not influence survival parameters; however, increasing the dose to 30?mg/kg seems to be effective for reducing cGVHD with an increase in infection rate requiring close monitoring of infections in AML patients who received myeloablative fludarabine/busulfan conditioning. 相似文献11.
Amit Akirov Hiba Masri-Iraqi Alaa Atamna Ilan Shimon 《The American journal of medicine》2017,130(12):1465.e11-1465.e19
Background
The aim of this study was to investigate the association of albumin levels on admission and change in levels during hospitalization with hospitalization outcomes.Methods
Historical prospective data of patients hospitalized between 2011 and 2013 were collected. Levels of albumin were classified as marked hypoalbuminemia (<2.5 mg/dL), mild hypoalbuminemia (2.5-3.5 mg/dL), normal albumin (3.5-4.5 mg/dL), and hyperalbuminemia (>4.5 mg/dL). Main outcomes were length of hospitalization, in-hospital mortality, and long-term mortality.Results
The cohort included 30,732 patients (mean age 67 ± 18 years, 51% male). Most patients had normal albumin levels on admission (n = 20,124, 65%), 29% of patients had hypoalbuminemia, mostly mild (n = 7,334, 24%), and 5% of patients had marked hypoalbuminemia (n = 1436). Hyperalbuminemia on admission was evident in 6% of the patients (n = 1838). Follow-up (median ± standard deviation) was 1675 ± 325 days. Compared with in-hospital mortality with normal albumin on admission (2%), mortality was higher with mild (12%) and marked hypoalbuminemia (34%) and lower with hyperalbuminemia (0.3%). Mortality rate at the end of follow-up was 29% with normal albumin levels, 67% and 83% with mild and marked hypoalbuminemia, respectively. Patients with hyperalbuminemia on admission and before discharge have the best short- and long-term survival. This pattern was similar when analyzed separately in different age groups. In patients with hypoalbuminemia on admission, normalization of albumin levels before discharge was associated with better short- and long-term survival, compared with patients with hypoalbuminemia before discharge.Conclusions
Low albumin levels on admission are associated with increased short- and long-term mortality. Normalization of albumin levels before discharge was associated with lower mortality risk, compared with hypoalbuminemia before discharge. 相似文献12.
Samia Salah-El-Din Mahmoud Doaa Ghaith Yomna Farag Bishoy Ibrahim 《The Egyptian Rheumatologist》2018,40(4):273-276
Introduction
Ferritin is an acute-phase reactant that is elevated in several autoimmune disorders. Serum ferritin levels have been correlated with disease activity scores of juvenile systemic lupus erythematosus (JSLE). Furthermore, enhanced levels of ferritin have also been described in lupus nephritis (LN).Aim of the work
To evaluate serum ferritin as a cheap and available marker of disease activity and renal involvement in Egyptian children with JSLE.Patients and methods
Forty-eight JSLE cases recruited from the Pediatric Rheumatology Clinic in Cairo University Specialized Children’s Hospital and 43 matched healthy children were enrolled in the study. SLE disease activity score-2000 (SLEDAI-2K) and renal activity score were assessed. Serum levels of ferritin, was quantified by enzyme-linked immunosorbent assay.Results
The mean age of the patients was 12.6?±?3.02?years and disease duration 3.4?±?2.5?years. Serum ferritin significantly higher in patients (416.1?±?1022.9?ng/ml) compared with control (36.1?±?18.2?ng/ml) (p?<?0.001). Serum ferritin was significantly higher in active (n?=?20) (890.4?±?1474.8?ng/ml) compared to inactive (n?=?28) (77.4?±?74.1?ng/ml) patients (p?<?0.001). A significant correlation was found between serum ferritin with SLEDAI-2K (r?=?0.35, p?=?0.014), renal-SLEDAI-2K (r?=?0.49, p?<?0.001) and with renal activity score (r?=?0.38, p?=?0.008). A significant correlation was found between serum ferritin and anti-double stranded-DNA (r?=?0.44, p?=?0.002) and complement 3 (r?=??0.42, p?=?0.003).Conclusion
Serum ferritin level can be considered a reliable biomarker for monitoring disease and renal activity in children with JSLE and LN. This may lead to improvement of management and consequently prognosis of JSLE patients as serum ferritin is an available and relatively cheap marker. 相似文献13.
Mostafa Vaghari-Tabari Soheila Moein Durdi Qujeq Mehrdad Kashifard Karimollah Hajian-Tilaki 《The American journal of the medical sciences》2018,355(5):449-455
Background
Oxidative stress occuring in patients diagnosed with inflammatory bowel disease (IBD), but the relationship between oxidative stress, disease activity and inflammatory markers has not been well established.Materials and Methods
A total of 30 patients diagnosed with IBD and 30 volunteers who had normal colonoscopies, selected as controls, were used for this study. The serum levels of antioxidant enzymes (catalase and glutathione peroxidase) and oxidative markers (malondialdehyde [MDA] and total antioxidant capacity) were compared between the 2 groups. Furthermore, their correlations with disease activity scores and inflammatory markers, especially the fecal calprotectin, were examined.Results
Catalase and glutathione peroxidase concentrations were significantly correlated with the level of fecal calprotectin in patients with IBD. Nevertheless, there were no significant correlations between the concentrations of the above-mentioned enzymes and C-reactive protein, erythrocyte sedimentation rate or the activity scores of IBD patients. It should be noted that MDA and total antioxidant capacity levels did not correlate with the inflammatory markers or the disease activity scores.Conclusions
There was a positive correlation between fecal calprotectin and serum antioxidant enzymes in patients with IBD, but, there was no correlation between antioxidant and oxidative markers in terms of disease activity scores. Hence, the observed significant correlation between the antioxidant enzymes and the fecal calprotectin may be due to either the pro-oxidant potential of calprotectin or its antioxidant role. 相似文献14.
The early natural history of albuminuria in young adults with youth-onset type 1 and type 2 diabetes
Anna R. Kahkoska Scott Isom Jasmin Divers Elizabeth J. Mayer-Davis Lawrence Dolan Amy S. Shah Maryam Afkarian David J. Pettitt Jean M. Lawrence Santica Marcovina Sharon H. Saydah Dana Dabelea David M. Maahs Amy K. Mottl 《Journal of diabetes and its complications》2018,32(12):1160-1168
Aims
To determine among adolescents and young adults with youth-onset type 1 diabetes and type 2 diabetes the rates and risk factors for albuminuria regression and progression.Methods
Data from SEARCH, a longitudinal observational study of youth-onset type 1 diabetes (N?=?1316) and type 2 diabetes (N?=?143) were analyzed. Urine albumin:creatinine ratio (UACR) was measured from random urine specimens at baseline and follow-up visits (mean 7?years later). Albuminuria regression was defined as halving of baseline UACR when baseline UACR was ≥30?μg/mg; progression was defined as doubling of baseline UACR when follow-up UACR was ≥30?μg/mg, respectively. Multivariable regression assessed risk factors associated with low-risk albuminuria category (combined persistently-low albuminuria and regression) versus moderate-risk albuminuria category (combined persistently-high albuminuria and progression).Results
Albuminuria progression was more common in type 2 diabetes versus type 1 diabetes (15.4% versus 6.0%, p<0.001). Moderate-risk albuminuria was associated with increasing HbA1c (adjusted OR (aOR)?=?1.3, 95% CI 1.1–1.6) and lack of private health insurance (aOR?=?2.7, 95%CI 1.1–6.5) in type 1 diabetes; and African American race (OR?=?4.6, 95% CI 1.2–14.2), lower estimated insulin sensitivity score (aOR?=?2.1, 95% CI 1.4–3.3), baseline UACR (aOR?=?3.2, 95% CI 1.7–5.8), and follow-up estimated glomerular filtration rate (eGFR) (10-unit increase aOR?=?1.3, 95% CI 1.0, 1.5) in type 2 diabetes.Conclusions
In the first decade of diabetes duration, kidney complications in type 2 diabetes are significantly more aggressive than in type 1 diabetes and may be associated with less modifiable risk factors including race, insulin sensitivity, and eGFR. Early interventions may help reduce long-term kidney complications. 相似文献15.
Kai-Hsiang Wu Hsin-An Shih Ming-Szu Hung Cheng-Ting Hsiao Yi-Chuan Chen 《Arab Journal Of Gastroenterology》2018,19(4):143-147
Background and study aims
Azotaemia is commonly identified among patients with upper gastrointestinal bleeding (UGIB) due to absorption of blood products in the small bowel. Previous studies have found blood urea nitrogen-to-creatinine (BUN/Cr) ratio to be significantly elevated among patients UGIB bleeding compared to patients with lower GI bleeding. However, no studies have explored the relationship between BUN/Cr ratio and mortality. This study is aimed at investigating how BUN/Cr ratio relates to outcomes for UGIB patients.Patients and methods
This study was conducted prospectively at a university-affiliated teaching hospital with approximate 70,000 annual emergency department (ED) visits. Data from a total of 258 adult UGIB patients were collected between March 1, 2011 and March 1, 2012. Cox regression analysis was used to identify risk factors for 30-day mortality.Results
Malignancy and Rockall score were associated with increased risk of 30-day mortality (Unadjusted hazard ratio (HR): 3.87, 95% CI: 1.59–9.41, p?=?0.0029; HR: 1.31, 95% CI: 1.02–1.71, p?=?0.0476, respectively). However, BUN/Cr?>?30 was associated with lower risk of 30-day mortality (HR: 0.32, 95% CI: 0.11–0.97, p?=?0.0441).Conclusions
A BUN/Cr ratio of >30 was found to be an independent risk factor for mortality and may be useful for pre-endoscopic assessment. Development of future risk scoring systems might warrant consideration of including BUN/Cr ratio as a parameter for estimating risk. 相似文献16.
Musharraf Husain Rehan Nabi Khan Babar Rehmani Hasan Haris 《Saudi Journal Of Gastroenterology》2011,17(3):208-211
Background/Aim:
Enteric perforation is a grave complication of typhoid fever. Laparotomy with primary closure is the treatment of choice depending upon the bowel condition. Fecal fistula formation is the main concern in primary closure and the incidence of this complication dramatically decreases when omentum is used as a patch over primary closure.Materials and Methods:
A total of 176 patients underwent laparotomy for enteric perforation and they were divided into two groups randomly; Group I–Primary closure with omental patch and GroupII– –Only primary closure. The outcomes were measured in relation to hospital stay, wound infection, septicemia, fecal fistula, and mortality.Results:
The incidence of complications including fecal fistula and mortality is significantly lower in the group I patients. Fecal fistula occurs in 7.7% in group II, while in only 1.1% in group I. The mortality is also lower 3.3% in group II, while 1.1% in group I.Conclusion:
Primary closure with omental patch is a better option as compared with only primary closure in enteric perforation patients. It can be recommended as an alternative method to primary closure only in enteric perforation patients. 相似文献17.
Background
Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF).Aim of work
Assessment of the extent of coronary atherosclerotic disease and lesion tissue characterization among diabetic compared to non-diabetic Egyptian patients.Methodology
IVUS studies of 272 coronary lesions in 116 patients presented with unstable angina were examined. The patients were divided into two groups: diabetic group (50 patients with 117 lesions) and non-diabetic group (66 patients with 155 lesions).Results
As compared to the non-diabetic group, the diabetic patients were more dyslipidemic (84% vs 39.4%, p?=?0.001) with higher total cholesterol level (194.6?±?35.3 vs 174.4?±?28.5?mg/dl, p?=?0.001) and higher LDL-C (145.3?±?27.1 vs 123.2?±?31.4, p?=?0.001). Regarding lesions characteristics, the diabetic group had longer lesions (19.4?±?7.4 vs 16.3?±?7.9?mm, p?=?0.002) with higher plaque burden (60.8?±?15.3 vs 54.8?±?14.0, p 0.002) and more area stenosis percentage (60.8?±?15.6 vs 55.6?±?14.1, p?=?0.008). Structurally, the diabetic group lesions had more lipid content (19.8?±?8.8 vs 16.8?±?8.7, p?=?0.008) and more necrotic core (17.6?±?7.4 vs 14.7?±?4.8, p?=?0.008) but less calcification (6.9?±?3.6 vs 11.8?±?6.3, p?=?0.001). The RI was negative in both groups, 0.95?±?0.13 in the diabetic group vs 0.98?±?0.19 in non-diabetic group (p?=?0.5). Within the diabetic group lesions, the dyslipidaemic subgroup had more lipid content (23.?±?5.2 vs 14.6?±?8.6, p?=?0.01) but less fibrotic component (48.6?±?4.7 vs 59.1?±?13.6%, p?=?0.01) and less calcification (10.9?±?6.8% vs 14.07?±?3.8%, p?=?0.02) as compared to the nondyslipidaemic subgroup.Conclusions
Diabetic patients with coronary atherosclerosis in Egypt have longer lesions with higher plaque burden and more percent area stenosis with negative remodeling index. The diabetic lesions had more lipid content and more necrotic core but less calcification. 相似文献18.
Reem Waziry Asmaa Gomaa Imam Waked Gregory J. Dore 《Arab Journal Of Gastroenterology》2018,19(1):26-32
Background and Study Aims
In this study we assessed rates and determinants of survival in people with untreated chronic HCV infection and hepatocellular carcinoma (HCC) in an Egyptian liver clinic setting.Patients and Methods
This is a prospective cohort study of patients diagnosed with HCV-related HCC and undergoing HCC management at a national liver centre in Egypt in 2013–2014 and with a follow-up through 2016.Results
A total of 345 patients diagnosed with HCV-related liver cirrhosis complicated by HCC were included. Median age at diagnosis was 57?years (IQR?=?52, 62), the majority were male (78%) and Child-Turcotte-Pugh (CTP) class A (64%). At diagnosis Barcelona Clinic Liver Cancer staging (BCLC) was 0 (8%), A (48%), B (20%), C (17%), and D (7%). Most common HCC management modalities were transarterial chemoembolization (TACE) (42%), and radiofrequency ablation (RFA) (21%). Median survival following HCC was 22.8?months. Factors associated with poorer survival in adjusted analyses were INR (HR?=?1.81, p?=?0.01), alpha-foeto protein (AFP) ≥200 (HR?=?1.41, p?=?0.02), higher CTP score (HR?=?2.48, p?<?0.01), and advanced BCLC stage (HR?=?1.85, p?<?0.01). One year survival in patients with CTP A, B, and C was 85%, 71% and 32%, respectively. One year survival following RFA, TACE, combination RFA/TACE, and sorafenib was 93%, 79%, 80% and 60%, respectively.Conclusion
Survival following HCV-HCC in Egyptian patients undergoing HCC management in a specialised clinic setting is poor, although similar to high income country settings. CTP score is a key determinant of survival, even following adjustment for BCLC stage and HCC management. 相似文献19.
Background
Acute coronary syndrome (ACS) refers to a spectrum of symptoms compatible with acute myocardial ischemia. Plasma markers of inflammation have been recently identified as diagnostic aid and risk predictors. The present study, conducted in Slemani Cardiac Hospital (SCH), Sulaimaniyah, Iraq aimed to recognize some risk factors for ACS in Iraqi adults younger than 40.Methodology
This is a prospective case-control study of 100 patients with ACS vs. a control group of 100 healthy volunteers. The study began at 1st January 2014 and ended at 31st December 2016. All patients were subjected to full history taking, clinical examination including measurement of waist circumference and body mass index (BMI). Investigations included electrocardiography (ECG), echocardiography, full blood count, measurement of lipid profile and C-reactive protein (CRP). The patients were managed by percutaneous coronary intervention (PCI).Results
The mean age of the patients was 36?years (range 28–40). Eighty-five% of patients were male. The mean BMI (29?kg/m2) and waist circumference (98?cm) of the patients were higher than the controls (24?kg/m2 and 72?cm respectively). The leukocytes, lymphocytes and neutrophil counts as well as CRP in both groups were within the normal range. The most prevalent risk factor was obesity (n?=?86). Other risk factors were smoking (n?=?62), hypertension (n?=?26), diabetes mellitus (n?=?22) and positive family history of ACS (n?=?24). Most patients (n?=?83) had multi-vessel coronary artery disease (2–3 vessels).Conclusion
ACS in young adults is an increasing health problem. Obesity was found to be the most prevalent risk factor. 相似文献20.
Mohamed Sobhy Adel El Etriby Amany El Nashar Sameh Wajih Martin Horack Philippe Brudi Dominik Lautsch Baishali Ambegaonkar Ami Vyas Anselm K. Gitt 《The Egyptian Heart Journal》2018,70(3):129-134