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101.
Ryu Kanzaki Eriko Fukui Takashi Kanou Naoko Ose Soichiro Funaki Masato Minami Yasushi Shintani Meinoshin Okumura 《Journal of thoracic disease》2021,13(4):2590
Pulmonary metastasectomy (PM) is an established treatment that can provide improved long-term survival for patients with metastatic tumor(s) in the lung. In the current era, where treatment options other than PM such as stereotactic body radiation therapy (SBRT), immunotherapy, and molecular-targeted therapy are available, thoracic surgeons should review the approach to the preoperative evaluation and the indications. Preoperative evaluation consists of history and physical examinations, physiological tests, and radiological examinations. Radiological examinations serve to identify the differential diagnosis of the pulmonary nodules, evaluate their precise number, location, and features, and search for extra thoracic metastases. The indication of PM should be considered from both physiological and oncological points of view. The general criteria for PM are as follows; (I) the patient has a good general condition, (II) the primary malignancy is controlled, (III) there is no other extrapulmonary metastases, and (IV) the pulmonary lesion(s) are thought to be completely resectable. In addition to the general eligibility criteria of PM, prognostic factors of each tumor type should be considered when deciding the indication for PM. When patients have multiple poor prognostic factors and/or a short disease-free interval (DFI), thoracic surgeons should not hesitate to observe the patient for a certain period before deciding on the indication for PM. A multidisciplinary discussion is needed in order to decide the indication for PM. 相似文献
102.
Osama Hamid Ahmed Eltelbany Abdul Mohammed Khaled Alsabbagh Alchirazi Sushrut Trakroo Imad Asaad 《Annals of hepatology》2022,27(5):100727
Introduction and objectivesNon-alcoholic steatohepatitis (NASH) is a severe form of non-alcoholic fatty liver disease (NAFLD) that can progress to liver cirrhosis, liver failure and hepatocellular carcinoma. It is the second leading cause of liver transplant in the US. We aim to investigate the prevalence, demographics and risk factors NASH patients in the US.Patients and methodsWe used a large database (Explorys IBM) that aggregates electronic health records from 26 nationwide healthcare systems. We identified adults with NASH between 2010-2020. Demographics including age, gender and race were collected. NASH risk factors including Diabetes Millets (DM), Hyperlipidemia (HLD), Hypertension (HTN) and Obesity were also collected. Cochran-Armitage test was used to assess the statistical significance of year-by-year trend. Univariable and multivariable logistic regression were used to estimate the odds ratio (OR) of risk factors.ResultsNASH annual prevalence rate increased from 1.51% in 2010 to 2.79% in 2020 (p < 0.0001). The proportion of patients with NASH by gender was 54.1% female vs 45.9% male (OR 1.04 [0.91-1.11]). Caucasian had higher odds of NASH than non-Caucasian (OR 1.42 [1.31-1.54]). NASH is strongly associated with DM and obesity (OR 18.61 [17.35-19.94]) and (OR 20.97 [17.87-23.21]), respectively. Other components of metabolic syndrome were associated with NASH to a lesser degree; HTN (OR 3.24 [3.20-3.28]) and HLD (OR 4.93 [4.85-4.01]).ConclusionThe prevalence of NASH has significantly increased in the US in the last decade. This is likely related to the increased prevalence of risk factors as well as increased awareness of the disease. 相似文献
103.
H.-W. Zhang X. Zhao Y.-L. Guo Y. Gao C.-G. Zhu N.-Q. Wu J.-J. Li 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2018,28(10):980-986
Background and aims
The role of lipoprotein (a) [Lp(a)] in coronary artery diseases (CAD) with special clinical background such as type 2 diabetes mellitus (T2DM) has not been fully determined. The aim of the present study was to investigate the relation of Lp(a) to type 2 diabetic patients with or without CAD.Methods and results
A total of 2040 consecutive patients with T2DM who received selective coronary angiography (CAG) due to angina-like chest pain were enrolled. The patients were subsequently divided into CAD and non-CAD groups according to the results of CAG. The severity of CAD was evaluated by the Gensini Score (GS), number of stenotic vessels, and history of myocardial infarction (MI). Data showed that Lp(a) levels were higher in the CAD group than in the non-CAD group (median: 15.00 mg/dL vs. 11.88 mg/dL, P = 0.025). The results from CAD subgroup analysis indicated that the patients with MI, multiple-vessel disease and high GS had higher Lp(a) levels compared with those in their matched subgroups (P < 0.05, respectively). After adjustment for confounders, Lp(a) levels were independently related to the presence and severity of CAD (CAD:OR = 1.564; MI:OR = 1.523; high GS:OR = 1.388; multiple-vessel disease:OR = 1.455; P < 0.05, respectively).Conclusion
Elevated Lp(a) levels were independently associated with the presence and severity of CAD in patients with T2DM. More studies are necessary to confirm our findings. 相似文献104.
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105.
Aims
Type 2 diabetes is associated with insulin resistance, adipose hypertrophy and increased lipolysis. The heritability of these traits has been determined by associating them with a family history of diabetes.Methods
Abdominal subcutaneous fat biopsies were obtained from 581 subjects in a cross-sectional study. Fat cells were isolated, and the difference between measured and expected fat-cell volume was used to determine adipose morphology (degree of hypertrophy or hyperplasia). Spontaneous lipolytic activity was determined in explants of adipose tissue by measuring glycerol release. Insulin-stimulated lipogenesis was assessed by measuring the incorporation of radiolabelled glucose into fat-cell lipids. Information on parental history of diabetes was gathered by a questionnaire.Results
Adipose morphology correlated positively with lipolysis (P < 0.0001) and inversely with insulin-stimulated lipogenesis (P < 0.008). Also, 24% of probands had a family history of diabetes, which was associated with higher body mass index (BMI) scores, and more insulin resistance (HOMAIR) and adipose hypertrophy. Lipolytic activity was increased, and insulin-stimulated lipogenesis decreased, in probands with a parental history of diabetes. The results for HOMAIR, lipolysis and adipose morphology remained significant after adjusting for proband BMI. A maternal history of diabetes was associated with increased adipose lipolytic activity in probands.Conclusion
A family history of diabetes is independent of proband BMI, but associated with adipocyte hypertrophy and enhanced lipolysis, which suggests that these factors are genetically linked to diabetes. Moreover, the influence on lipolysis was only observed in probands with a maternal history of diabetes, thereby supporting an epigenetic impact. 相似文献106.
Kumiko T. Kanatani Motonori Okumura Susumu Tohno Yuichi Adachi Keiko Sato Takeo Nakayama 《Environmental health and preventive medicine》2014,19(1):81-88
Objective
Asian dust storms originating from arid regions of Mongolia and China are a well-known springtime phenomenon throughout East Asia. Evidence is increasing for the adverse health effects caused by airborne desert dust inhalation. Given that people spend approximately 90 % of their time indoors, indoor air quality is a significant concern. The present study aimed to examine the influence of outdoor particulate matter (PM) levels on indoor PM levels during Asian dust events under everyday conditions.Methods
We simultaneously monitored counts of particles larger than 0.3, 0.5, 1, 2, and 5 μm using two direct-reading instruments (KC-01D1 airborne particle counter; Rion), one placed in an apartment room and another on the veranda, under everyday conditions before and during an Asian dust event. We also examined how indoor particle counts were affected by opening a window, crawling, and air purifier use.Results
An Asian dust event on 24 April 2012 caused 50- and 20-fold increases in PM counts in outdoor and indoor air, respectively. A window open for 10 min resulted in a rapid increase of indoor PM counts up to 70 % of outside levels that did not return to baseline levels after 3 h. An air purifier rapidly reduced PM counts for all particle sizes measured.Conclusions
It is important to account for occupant behavior, such as window-opening and air purifier use, when estimating residential exposure to particulate matter. 相似文献107.
目的:探讨血栓前状态标志物在2型糖尿病早期动脉硬化中的作用。方法:结合糖尿病及动脉硬化检测结果将60例患者分成正常对照组、糖尿病非动脉硬化组、糖尿病动脉硬化组,分别检测血栓前状态标志物TG、TC、LDL、HDL、WBC、血小板聚集率FIB、DD、PC、PS和血小板聚集率。结果:糖尿病非动脉硬化组、糖尿病动脉硬化组中TG、WBC、FIB、VWF与正常组比较差异均有统计学意义(P〈0.05),糖尿病非动脉硬化组、糖尿病动脉硬化组中BMI、TCH、HDL、LDL、DD、PLT、PS、PC与正常组比较差异均无统计学意义(P〉0.05)。结论:血脂代谢紊乱、慢性炎症刺激、高凝等血栓前状态的危险因素在糖尿病的发生、发展中起着重要的作用,然而是否在糖尿病早期动脉硬化中起作用有待进一步的研究。 相似文献
108.
目的分析济宁市居民对PM2.5相关知识知晓情况,为政府以及相关部门制定科学合理的政策及措施提供科学依据。方法 2013年4月对400名调查对象进行问卷调查。调查居民对PM2.5的主要来源、化学成分、健康危害等的认知情况,对空气质量的关注程度,济宁雾霾天气的好发季节,在雾霾天气时所采取的防护措施以及对如何有效减少雾霾天气的建议和意见。根据数据类型采用统计描述、t检验、单因素方差分析等统计学方法,P0.05为差异有统计学意义。结果发放问卷400份,实际收回369份,有效问卷369份,回收率为92.3%。被调查的369名居民中,关于PM2.5主要来源完全了解的70名,占19.0%;非常了解的107名,占29.0%;一般了解的163名,占44.2%;完全不了解的29名,占7.8%。关于化学成分完全了解的12名,占3.3%;非常了解的42名,占11.4%;一般了解的256名,占69.4%;完全不了解的59名,占15.9%。对PM2.5的健康危害认知平均得分(3.01±1.87)分。不同性别的居民对PM2.5健康危害认知得分差异无统计学意义(P0.05),不同年龄、文化程度、职业的居民对PM2.5健康危害认知的得分差异均有统计学意义(F=2.332、3.906、3.409,均P0.05)。被调查的369名居民中在雾霾天气时绝大多数人都采取了相应的防护措施,未采取任何防护措施仅42名,占11.4%。结论政府和相关部门有必要加强雾霾天气危害的宣传力度和采取相关措施,引起社会各方重视,提高居民在雾霾天气时的防护意识。 相似文献
109.
目的调查分析2012年北京市丰台区公共场所集中空调通风系统卫生状况,探讨其影响因素并为卫生管理提供技术支持。方法依据《公共场所集中空调通风系统卫生规范》,检测集中空调送风中细菌总数、真菌、β-溶血性链球菌及PM10,风管内表面细菌总数、真菌总数、积尘量,冷却(凝)水中嗜肺军团菌。结果丰台区集中空调通风系统送风中细菌总数、真菌总数、β-溶血性链球菌、PM10合格率分别为61.42%、88.89%、100.00%、90.91%,风管内表面积尘量、细菌总数、真菌总数合格率分别为100.00%、100.00%、99.20%,冷却(凝)水中嗜肺军团菌合格率为98.20%,血清分型以LP1型为主。集中空调送风中细菌总数存在着明显的季节性差异(χ^2=12.338,P〈0.01),而送风中真菌、PM10未见明显的季节性差异(χ^2=3.155,P〉0.05;χ^2=6.976,P〉0.05)。不同类型集中空调送风中细菌总数、真菌未见明显差异(χ^2=5.782,P〉0.05;χ^2=2.653,P〉0.05)。结论细菌总数、真菌总数、PM10是丰台区集中空调送风卫生质量的主要影响因素,应加强集中空调管理,定期清洗消毒,并主动开展卫生委托监测。 相似文献