International Journal of Clinical Practice最新文献

{"title":"Metabolic Syndrome and Its Determinants in Patients Undergoing Obesity Screening Within the Scope of the Disease Management Platform","authors":"Esranur Yayın,&nbsp;Hasan Esad Yayın","doi":"10.1155/ijcp/3827904","DOIUrl":"https://doi.org/10.1155/ijcp/3827904","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> We aimed to detect rates of metabolic syndrome and overweight, patients screened for obesity within the scope of the Disease Management Platform (DMP).</p>\u0000 <p><b>Methods:</b> This cross-sectional study was completed with 387 patients who were examined for fasting plasma glucose, triglyceride, and high-density lipoprotein levels, waist circumference, blood pressure measurements, chronic diseases, body mass index, and medication use.</p>\u0000 <p><b>Results:</b> In total of whom 387 underwent blood tests as recommended by the DMP. The mean age and body mass index were 55.26 ± 14.50 years and 27.02 ± 3.69 kg/m², respectively. While 26.6% of the patients had normal weight, 56.1% had overweight. Metabolic syndrome was present in 52.2% of the patients.</p>\u0000 <p><b>Conclusion:</b> The significant increases in the rates of overweight and metabolic syndrome have drawn attention in the community. Therefore, family physicians necessitate additional platforms, such as the DMP, to effectively combat metabolic syndrome and overweight, a pivotal initial step in tackling obesity.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3827904","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristic and Prognostic Value of Serum Bone Turnover Markers in Pregnant Women With Pre-Eclampsia: A Prospective Cohort Study","authors":"Fan Yu,&nbsp;Xiaocui Huang,&nbsp;Yuanting Tang,&nbsp;Yiduo Zhang,&nbsp;Qing Li,&nbsp;Yongmei Jiang","doi":"10.1155/ijcp/8816587","DOIUrl":"https://doi.org/10.1155/ijcp/8816587","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Pre-eclampsia is a severe pregnancy complication affecting about 4%–5% of pregnancies, but the causes and clinical management were full of controversial. Bone turnover markers (BTMs) were sensitive indicators for estimating bone metabolism and were found to be changed in many pregnancy-related diseases. However, the characteristic and prognostic value of serum BTMs with pre-eclampsia was uncovered.</p>\u0000 <p><b>Methods:</b> A multicenter prospective cohort study was performed in three different hospitals in West China. Pre-eclampsia patients and healthy pregnant women were recruited from January 2023 to January 2024. Clinical information of included participants was collected, and serum BTM levels were detected by electrochemiluminescence immunoassay. Clinical outcomes including disease aggravation (severe pre-eclampsia, eclampsia, and HELLP syndrome), low live birth weight (LBW), and premature delivery were followed up.</p>\u0000 <p><b>Results:</b> A total of 69 pre-eclampsia patients and 75 healthy pregnant women were recruited finally, and 48 pre-eclampsia patients and 48 healthy controls who matched for age and gestational weeks were selected among them. The pre-eclampsia patients had elevated BTM levels compared with healthy controls. ß-CTX was an independent risk factor for disease aggravation, LBW, and premature delivery among pre-eclampsia patients. ß-CTX was a valuable predictive factor for disease aggravation, LBW, and premature delivery among pre-eclampsia patients (AUC were 0.772, 0.768, and 0.930, respectively, and <i>p</i> values were 0.001, 0.002, and &lt; 0.001, respectively).</p>\u0000 <p><b>Conclusion:</b> Pre-eclampsia patients may have an activated bone metabolism status compared with healthy controls. Pre-eclampsia patients with elevated bone resorptive marker ß-CTX should pay more attention to the risk of disease aggravation and adverse pregnancy outcomes.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8816587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NT5E Mediates Cisplatin Resistance in NSCLC Through the PI3K-AKT Signaling Pathway","authors":"Liangfeng Zheng,&nbsp;Jian Liu,&nbsp;Feiyue Ji,&nbsp;Chunxiang Li,&nbsp;Ye Qian,&nbsp;Lili Shao,&nbsp;Xiaomin Lu","doi":"10.1155/ijcp/3920444","DOIUrl":"https://doi.org/10.1155/ijcp/3920444","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> The aim of this study was to investigate the role of NT5E and its mechanism in cisplatin (diamminedichloroplatinum, DDP) resistance in non-small cell lung cancer (NSCLC) and to explore the value of NT5E in the clinical prognosis of NSCLC patients.</p>\u0000 <p><b>Methods:</b> First, the genes related to drug resistance were identified by constructing an A549/DDP cell line with DDP resistance and performing transcriptome sequencing and bioinformatics analysis. Gene ontology (GO) as well as the Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways were enriched for the related genes using the Metascape database. The STRING database was further applied to construct protein–protein interaction networks (PPIs), and heatmaps were used to visualize the coexpression relationships of genes in the modules, as well as to screen for key genes. Subsequently, immunohistochemistry and molecular biology experiments were conducted to confirm the expression levels of NT5E in DDP-resistant NSCLC tissues and cells. Additionally, its effects on cell proliferation, migration, and invasion were assessed through NT5E knockdown assays. Finally, RNA sequencing and signaling pathway analyses revealed that NT5E regulates DDP resistance in NSCLC cells through the PI3K-AKT signaling pathway and analyzed the correlation between the expression of NT5E and survival outcomes in NSCLC patients.</p>\u0000 <p><b>Results:</b> NT5E was found to be upregulated in drug-resistant cells and increased in DDP-resistant NSCLC tissues and cells. The drug-resistant genes were primarily involved in cell adhesion and the extracellular matrix. Functional experiments confirmed that the knockdown of NT5E inhibited cell proliferation, migration, and invasion. Signaling pathway analysis indicated that NT5E mediated the resistance of NSCLC cells to DDP through the PI3K/AKT signaling pathway. Moreover, high NT5E expression was found to be negatively correlated with the overall survival of NSCLC patients.</p>\u0000 <p><b>Conclusion:</b> NT5E may be a key gene for DDP resistance in NSCLC cells, while its high expression may indicate a poor prognosis for patients. This finding provides important insights for a deeper understanding of the mechanism of drug resistance in lung cancer and serves as a theoretical basis for the development of new therapeutic strategies and drugs.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3920444","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Model of Tibial Nerve Depth for Needle-Based Interventions With Broader Applications: An Observational Study in a Spanish Cohort","authors":"Isabel Mínguez-Esteban,&nbsp;Carlos Romero-Morales,&nbsp;Jorge Hugo Villafañe,&nbsp;Juan Antonio Valera-Calero,&nbsp;Gustavo Plaza-Manzano,&nbsp;Ángel González-de-la-Flor","doi":"10.1155/ijcp/1451340","DOIUrl":"https://doi.org/10.1155/ijcp/1451340","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> To develop a predictive model for estimating the depth of the tibial nerve using anthropometric and demographic data to improve the safety and accuracy of needle-based interventions.</p>\u0000 <p><b>Design:</b> Cross-sectional observational study.</p>\u0000 <p><b>Setting:</b> European University of Madrid, Spain.</p>\u0000 <p><b>Methods:</b> Fifty volunteers aged 18–45 years, without any conditions affecting muscle tone, significant lower limb asymmetries, or history of lower limb surgeries. Demographic and anthropometric data, including sex, age, height, weight, BMI, and measurements of leg length and circumference at specific points, were collected. Ultrasound imaging was used to measure the depth of the tibial nerve at the popliteal fossa and mid-third of the leg.</p>\u0000 <p><b>Results:</b> The predictive model identified leg girth at the mid-third as a significant predictor of tibial nerve depth, explaining 22.3% of the variance (<i>R</i>² = 0.223, <i>p</i> &lt; 0.05). Gender and leg girth together explained up to 17.8% of the variance for proximal tibial nerve depth (<i>R</i>² = 0.178, <i>p</i> &lt; 0.05). Additionally, males exhibited greater leg length (mean = 95.9 cm) compared to females (mean = 90.8 cm, <i>p</i> = 0.01), with no significant difference in tibial nerve depth between genders (<i>p</i> &gt; 0.05). Strong correlations were observed between tibial nerve depth and BMI at both the proximal and mid-third levels (<i>r</i> = 0.4–0.5, <i>p</i> &lt; 0.001).</p>\u0000 <p><b>Conclusion:</b> This predictive model shows that leg girth and gender are significant predictors of tibial nerve depth in a healthy cohort. However, its clinical utility remains preliminary and requires external validation in larger, diverse, and pathology-specific populations to confirm broader applicability in clinical settings.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1451340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143119622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Protective Role of PGC-1α in Cystitis Glandularis: Mitigating Mitochondrial Injury and Inflammation","authors":"Min Chen,&nbsp;Yongbo Tang,&nbsp;Yue Fu,&nbsp;Haiwei Hu,&nbsp;Ende Cui,&nbsp;Zhouliang Wen,&nbsp;Wei Zhong,&nbsp;Jimin Su,&nbsp;Bo Ge","doi":"10.1155/ijcp/8164243","DOIUrl":"https://doi.org/10.1155/ijcp/8164243","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Peroxisome proliferator-activated receptor-gamma coactivator-1α (PGC-1α), a regulator of mitochondrial function, plays a critical role in inflammation and may be involved in cystitis glandularis (CG) development.</p>\u0000 <p><b>Methods:</b> LPS was administered to establish a CG model in female Sprague–Dawley (SD) rats and to induce cellular injury in the human urothelial cell line SV-HUC-1. Subsequently, to elucidate the role of PGC-1α signaling in CG, both the animal and cellular models were treated with ZLN005, a specific activator of PGC-1α. Cell viability was assessed using the cell-counting kit-8 (CCK8) assay. Mitochondrial damage was quantified by measuring reactive oxygen species (ROS), assessing mitochondrial membrane potential, and examining mitochondrial ultrastructure via transmission electron microscopy (TEM). Enzyme-linked immunosorbent assays (ELISA) were utilized to determine the levels of inflammatory cytokines, namely, IL-1β, IL-6, and TNF-α. Furthermore, the protein expression of silent information regulation 1 (SIRT1), PGC-1α, mitochondrial transcription factor A (TFAM), nuclear respiratory factor 1 (NRF1), and nuclear respiratory factor 2 (NRF2) was evaluated using immunohistochemistry and/or Western blot analysis.</p>\u0000 <p><b>Results:</b> LPS-treated rat bladder exhibited histological characteristics of CG, including increased urothelial proliferation and inflammation. PGC-1α protein levels were downregulated in human CG tissues, LPS-treated rat bladders, and SV-HUC-1 cells. Mitochondrial damage was observed in both rat CG and LPS-irritated cells with elevated ROS and diminished mitochondrial membrane potential. TEM documented mitochondrial morphological injury of the urothelium in rat CG. ZLN005 attenuated LPS-induced epithelial hyperplasia and inflammatory cytokine secretion in the rat CG model. Furthermore, ZLN005 partially reversed LPS-induced mitochondrial damage, as indicated by reduced ROS levels, restored mitochondrial membrane potential, and mitigated mitochondrial morphological injury in both rat CG and LPS-stimulated cells. In addition, ZLN005 restored the expression of PGC-1α and its associated signaling proteins SIRT1, TFAM, NRF1, and NRF2.</p>\u0000 <p><b>Conclusions:</b> The downregulation of PGC-1α suggests its potential as a molecular marker for the progression of CG. Targeting the PGC-1α signaling pathway may offer an effective therapeutic intervention for the clinical management of CG.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8164243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143119199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Nanocurcumin Supplementation on Inflammatory and Biochemical Indicators in Hospitalized Patients With COVID-19: A Randomized Controlled Clinical Trial","authors":"Sedigheh Ahmadi,&nbsp;Mohsen Mohit,&nbsp;Zeinab Mehrabi,&nbsp;Mohammad Reza Heydari,&nbsp;Seyed Nooreddin Faraji,&nbsp;Shoeleh Yaghoubi,&nbsp;Morteza Zare,&nbsp;Seyed Jalil Masoumi","doi":"10.1155/ijcp/6675459","DOIUrl":"https://doi.org/10.1155/ijcp/6675459","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> The prior studies showed that nanocurcumin (NC) has potential anti-viral properties against a wide range of viral infections, making it a promising candidate for treating COVID-19. This study aimed to investigate the effect of NC supplementation on the acute phase proteins, including interleukin-6 (IL-6), C-reactive protein (CRP), albumin (ALB) and Erythrocyte Sedimentation Rate (ESR), and biochemical markers including lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine transaminase (ALT) and complete blood cells (CBC) in the hospitalized patients with Coronavirus disease 2019 (COVID-19).</p>\u0000 <p><b>Methods and Materials:</b> In a double-blind placebo-controlled clinical trial conducted at Ali-Asghar Hospital of Shiraz University of Medical Sciences, 76 COVID-19 patients with mild to moderate disease severity were randomly assigned to two groups. All patients received the national treatment guideline for COVID-19. The intervention group was administered 160 mg/day of NC for a period of 2 weeks. Blood samples were obtained at the start and the end of the research, and nutritional consumption was determined using a 24 h dietary recall.</p>\u0000 <p><b>Results:</b> The mean age of participants in the NC and placebo groups was 54.69 ± 13.44 and 53.94 ± 11.62 years, respectively. In the NC group, compared with placebo group, the levels of IL-6 (<i>p</i> = 0.017) and LDH (<i>p</i> = 0.004) was significantly reduced. There was no significant difference in the mean changes of AST (<i>p</i> = 0.197), ALT (<i>p</i> = 0.086), ALB (<i>p</i> = 0.560), CRP (<i>p</i> = 0.197), ESR (<i>p</i> = 0.298), hemoglobin (Hb) (<i>p</i> = 0.372), white blood cells (WBC) (<i>p</i> = 0.995), neutrophils (<i>p</i> = 0.264), and lymphocyte (<i>p</i> = 0.418) between two groups.</p>\u0000 <p><b>Conclusion:</b> According to the research results, it seems that adding NC supplementation to the treatment plan for COVID-19 patients who are hospitalized and have mild to moderate illness severity might possibly reduce inflammation.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: IRCT20211126053183N1.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6675459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143118489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Analysis of Nonmetastatic Nasopharyngeal Carcinoma in Older Patients Undergoing Intensity-Modulated Radiotherapy","authors":"Shuangyue Wang,&nbsp;Heqing Huang,&nbsp;Fengqiao Huang,&nbsp;Haiyan Wu,&nbsp;Zhiru Li,&nbsp;Ziyan Zhou,&nbsp;Min Kang","doi":"10.1155/ijcp/8833803","DOIUrl":"https://doi.org/10.1155/ijcp/8833803","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> We investigated a visual model for estimating prognosis in older patients with nonmetastatic nasopharyngeal carcinoma (NPC) and analyzed the survival rates in different patient groups during intensity-modulated radiotherapy (IMRT).</p>\u0000 <p><b>Methods:</b> Between January 2012 and March 2021, patients with NPC aged &gt; 65 years who received IMRT and were initially diagnosed with no distant metastases were enrolled. Propensity score analysis with 1:1 matching was used to balance baseline characteristics, including age, sex, tumor stage, and comorbidities. Kaplan–Meier analysis was used to calculate survival. Cox regression analysis was used to identify independent prognostic factors for overall survival (OS). A nomogram was constructed based on the determined prognostic factors, and prediction accuracy was evaluated using receiver operating characteristic (ROC) and calibration curves.</p>\u0000 <p><b>Results:</b> In total, 140 patients were included in the analysis (median age: 69 years; range: 66–81 years). The median follow-up was 84.9 (26.2–131.5) months. Compared with radiotherapy (RT) alone, chemotherapy during RT failed to improve OS (54.2% vs. 50.0%, respectively; <i>p</i> = 0.969), cancer-specific survival (CSS) (59.1% vs. 60.5%, respectively; <i>p</i> = 0.712), distant metastasis–free survival (DMFS) (66.7% vs. 70.5%, respectively; <i>p</i> = 0.824), or locoregional relapse–free survival (LRFS) (85.0% vs. 86.9%, respectively; <i>p</i> = 0.811). After the final regression analysis, age, age-adjusted Charlson comorbidity index (ACCI) score, N stage, and total stage were identified as independent factors affecting OS prognosis. The OS nomogram was applied to the data and, based on the value of the area under the ROC and calibration curves, demonstrated satisfactory predictive performance.</p>\u0000 <p><b>Conclusions:</b> Survival outcomes in older patients with NPC treated with RT alone were similar to those in patients treated with both chemotherapy and RT. Our nomogram had good performance in predicting OS in older patients with NPC and may benefit the clinical decision-making process.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8833803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143118570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influencing Factors for Depression and Depression Aggravation in Hospitalized Elderly Patients With Chronic Heart Failure","authors":"Tao Wang,&nbsp;Lina Ma,&nbsp;Luling Wang,&nbsp;Zheng Wang,&nbsp;Wenliang Zhai,&nbsp;Fangyan Liu,&nbsp;Zhongying Zhang,&nbsp;Yun Li","doi":"10.1155/ijcp/1535446","DOIUrl":"https://doi.org/10.1155/ijcp/1535446","url":null,"abstract":"<div>\u0000 <p>Studies on depression aggravation in hospitalized elderly patients with chronic heart failure (CHF) are scarce. This study analyzed the influencing factors for depression and depression aggravation in elderly CHF patients in China. A total of 196 elderly CHF patients admitted to Xuanwu Hospital from March 2019 to October 2022 were consecutively selected. Information such as demographics, comorbidities, primary disease and etiology, elderly hospitalization assessment, laboratory test outcomes, cardiac function, oral medications for CHF, and management during hospitalization were collected on admission. The patients were divided into the depressed and nondepressed groups according to their depression scores, and the independent predictors for depression were analyzed using multivariable logistic regression. Another depression assessment was performed at discharge, and independent factors for worsened depression during hospitalization were also analyzed. A high frailty index score was an independent predictor for depression in elderly CHF patients. The overall depression score of the patients at discharge was significantly higher than that on admission. Low educational attainment, a low left ventricular ejection fraction, long hospitalization, and admission to the intensive care unit (ICU) were independent predictors for depression exacerbation during hospitalization. Clinical assessment of depression is necessary for elderly hospitalized CHF patients, particularly for those who have low education, a high frailty index score, a low left ventricular ejection fraction, ICU admission, and long hospitalization. The findings of this study may deepen our understanding of depression in elderly CHF patients.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1535446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Prevalence of Unrecorded Stage 3 Chronic Kidney Disease in Australia, Brazil, Canada, England, and Spain: The Multinational, Observational REVEAL-CKD Study","authors":"Roberto Pecoits-Filho,&nbsp;Kean-Seng Lim,&nbsp;Maria Cristina Ribeiro de Castro,&nbsp;Ana Cebrian,&nbsp;Rafael Santamaria,&nbsp;Naresh Kanumilli,&nbsp;Christian S. Alvarez,&nbsp;Matthew Arnold,&nbsp;Salvatore Barone,&nbsp;Hungta Chen,&nbsp;Krister Järbrink,&nbsp;Navdeep Tangri","doi":"10.1155/ijcp/5138534","DOIUrl":"https://doi.org/10.1155/ijcp/5138534","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Chronic kidney disease (CKD) is a global public health concern, affecting approximately 850 million people worldwide. Guidelines recommend early identification and management of CKD to mitigate disease progression and delay the onset of complications. Recording a CKD diagnosis in medical records is associated with improved kidney function and blood pressure monitoring, better use of disease-modifying therapy, and reduced risk of CKD progression. REVEAL-CKD is a multinational, observational study that aims to estimate the prevalence of stage 3 CKD which is unrecorded in administrative databases.</p>\u0000 <p><b>Methods:</b> Data were extracted from country-specific databases of patient medical records in Australia, Brazil, Canada, England, and Spain. Included patients (aged ≥ 18 years) had two consecutive estimated glomerular filtration rate (eGFR) measurements between 30 and &lt; 60 mL/min/1.73 m² taken 91–730 days apart. Patients were considered to have unrecorded CKD if they had no CKD diagnosis code (any stage) at any time before and up to 6 months after study index (date of second qualifying eGFR).</p>\u0000 <p><b>Results:</b> Across countries, median age was 72–78 years, median eGFR was 46.5–53.5 mL/min/1.73 m², and availability of urinary albumin—creatinine ratio testing ranged from 4.9% (Brazil) to 53.5% (Canada). The prevalence of unrecorded stage 3 CKD was 90.0% (1002/1113 patients) in Australia, 97.0% (10,925/11,262) in Brazil, 92.0% (42,226/45,914) in Canada, 56.9% (84,237/148,153 in England, and 84.8% (27,035/31,866) in Spain.</p>\u0000 <p><b>Conclusions:</b> More than half of the patients with laboratory evidence of stage 3 CKD lacked a CKD diagnosis code in all countries examined. Substantial intercountry variations in rates of CKD recording and testing were observed. International sharing of best practice guidance, systematic changes to improve data quality, and increased awareness of the importance of timely coding among healthcare professionals will help to improve accurate recording of stage 3 CKD.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT04847531.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5138534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Urea Nitrogen to Albumin Ratio Was Associated With Mortality in Critically Ill Septic Patients: A Multicenter Retrospective Propensity–Adjusted Analysis","authors":"Tsai-Jung Wang,&nbsp;Shang-Yi Lee,&nbsp;Li-Ting Wong,&nbsp;Wen-Cheng Chao","doi":"10.1155/ijcp/5202122","DOIUrl":"https://doi.org/10.1155/ijcp/5202122","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Sepsis is a leading cause of mortality worldwide, and increasing studies have found that high ratio of blood urea nitrogen to blood albumin ratio (BAR) was associated with mortality in inflammatory diseases. We used a multicenter database and propensity score–adjusted approach to address the mortality association of BAR in critically ill septic patients.</p>\u0000 <p><b>Methods:</b> Using the eICU Collaborative Research Database, we enrolled adult septic patients who fulfilled the sepsis-3 criteria. We used Cox proportional hazards analysis and propensity score–adjusted analyses, consisting of propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and covariate balancing propensity score (CBPS) to determine hazard ratios (HRs) and 95% confidence intervals (CIs) of in-hospital all-cause mortality.</p>\u0000 <p><b>Results:</b> We analyzed data from 8069 critically ill septic patients in 335 ICUs. The median age was 67 (interquartile range, 56–79) years, with 46.9% being female. The nonsurvivors (31.4%) were older and had higher APACHE IV scores, more shock, and more mechanical ventilation usage. Cox regression identified that higher BAR was independently associated with increased mortality (adjusted HR 1.247, 95% CI 1.142–1.361) after adjusting for covariates. The propensity score–based approach found a consistent and robust association, with adjHRs in the PSM, IPTW, and CBPS populations were 1.191 (95% CI 1.074–1.321), 1.178 (95% CI 1.068–1.299), and 1.215 (95% CI 1.111–1.329), respectively.</p>\u0000 <p><b>Conclusions:</b> This multicenter study demonstrated that high BAR, which is a ready-for-use biomarker in critical care, correlated with increased mortality in critically ill septic patients, and more studies are warranted to explore the underlying mechanism.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5202122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}