Medical Principles and Practice最新文献

{"title":"Outcomes of Intermittent Hemodialysis vs. Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study.","authors":"Ali AlSahow, Omar Alkandari, Yousif Bahbahani, Anas Alyousef, Bassam AlHelal, Heba AlRajab, Ahmed AlQallaf, Monther AlSharekh, Abdulrahman AlKandari, Gamal Nessim, Bassem Mashal, Ahmad Mazroue, Alaa Abdelmoteleb, Mohamed Elabbadi, Ali Abdelzaher, Emad Abdallah, Mohamed Abdellatif, Ziad ElHusseini, Ahmed Abdelrady","doi":"10.1159/000543882","DOIUrl":"https://doi.org/10.1159/000543882","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous dialysis in hemodynamically stable patients with acute kidney injury (AKI) may impact outcomes differently than intermittent dialysis. We evaluated differences in patient and kidney outcomes between the two modalities.</p><p><strong>Methods: </strong>Clinical and 30-day outcome data for inpatients with AKI who were hemodynamically stable and not on ventilation and who received intermittent hemodialysis (IHD) or continuous kidney replacement therapy (CKRT) in public hospitals in Kuwait from January 1 to December 31, 2021, were prospectively collected.</p><p><strong>Results: </strong>We recruited 229 patients (age: 59.9 years; males, 60.3%; baseline eGFR, 56 ml/min). CKRT accounted for 72.9% of cases due to lack of access to water treatment. No statistically significant differences were observed between groups in terms of age, baseline eGFR, sex, comorbidities, cause of AKI, or fluid administration. Intensive care unit contributed 21% of cases, with no significant difference between groups. More IHD patients received diuretics (62.9% vs. 43.1% for CKRT, p = 0.008). At 30 days, 21.8% of patients had died. There was no statistically significant difference in mortality between groups (16.1% for IHD vs. 24% for CKRT, p = 0.2). Final eGFR was 53.2 ml/min, with no difference between groups. Complete kidney recovery was greater with CKRT (33.1% vs. 13.5%, p = 0.009). Baseline eGFR < 60 ml/min did not influence mortality or kidney recovery.</p><p><strong>Conclusion: </strong>Compared with IHD, CKRT did not lower mortality at 30 days, which is similar to that of randomized trials; however, it was associated with better complete kidney recovery, which was reported in observational studies.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-17"},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Distal Radial Artery Access versus Proximal Radial Artery Access for Cardiac Procedures: A Systematic Review and Meta-analysis.","authors":"Mohammad Ebad Ur Rehman, Hafsa Arshad Azam Raja, Muhammad Osama, Aisha Kakakhail, Muhammad Hassan Waseem, Muhammad Mukhlis, Muhammad Abdullah Ali, Zain Ul Abideen, Muhammad Shoaib, Zahir Ud Din, Ammara Tahir, Muhammad Zohaib Ul Hassan, Usman Mazhar, Syed Tehseen Haider, Sajeel Saeed, Abdulqadir J Nashwan","doi":"10.1159/000543817","DOIUrl":"https://doi.org/10.1159/000543817","url":null,"abstract":"<p><strong>Objective: </strong>Cardiac catheterization using the distal radial artery access (DRA), at the level of the anatomical snuff box post radial artery bifurcation, may be linked to a lower rate of arterial occlusion and better hemostasis. In this meta-analysis, we compare DRA versus proximal radial artery access (PRA) in cardiac catheterization or angiography.</p><p><strong>Methods: </strong>A detailed literature search was performed on PubMed, Cochrane, Embase and Clinicaltrials.gov from inception till June 2024. Risk ratios (RR) and mean differences (MD) were pooled for categorical and continuous outcomes, respectively. Random effects meta-analysis was undertaken on Revman.</p><p><strong>Results: </strong>Our meta-analyses include 21 randomized controlled trials with 9,539 patients (DRA 4,761, PRA 4,778). DRA significantly reduced 24-hour radial artery occlusion (RAO) rates (RR 0.30, 95% CI 0.23 to 0.40, p ≤ 0.00001), and time to hemostasis (minutes) (MD -44.46, 95% CI -50.64 to -38.92, p < 0.00001), whereas PRA was significantly superior in terms of the puncture success rate (RR 0.96, 95% CI 0.93 to 0.99, p < 0.01), the crossover rate (RR 2.89, 95% CI 2.02 to 4.15, p < 0.00001, and puncture attempts (MD 0.69, 95% CI 0.37 to 1.00, p = 0.00001).</p><p><strong>Conclusion: </strong>DRA was associated with a lower risk of occlusion and lower time to hemostasis, but required a greater number of puncture attempts and had lower success rate. Further research is required to elucidate the most optimal approach.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Dose Escalation of Ustekinumab in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.","authors":"Mohammad Ebad Ur Rehman, Ammara Tahir, Amna Hussain, Aizaz Ali, Abu Huraira Bin Gulzar, Abdul Qadeer Khan, Maha Sajjad, Fatima Shahid, Shahroon Zahid, Ummara Aslam, Talha Bin Yasin, Aqsa Bilal, Tehreem Fatima, Muhammad Sheraz Hameed, Tehseen Haider, Sajeel Saeed, Abdulqadir J Nashwan","doi":"10.1159/000543831","DOIUrl":"https://doi.org/10.1159/000543831","url":null,"abstract":"<p><strong>Background: </strong>Ustekinumab is an effective drug in the treatment of inflammatory bowel disease (IBD), but inadequate response or loss of response is reported in several patients. Dose escalation by intravenous reinduction or interval shortening may be a suitable option to recapture response. We undertook a systematic review and meta-analysis to assess the efficacy of dose escalation in IBD patients receiving ustekinumab.</p><p><strong>Methods: </strong>A systematic literature search was conducted on PubMed, Embase, Clinicaltrails.gov and Cochrane from inception to June 1st, 2024. We conducted a proportional meta-analysis on MetaXL. Our primary outcomes were clinical response and clinical remission.</p><p><strong>Results: </strong>Twenty-eight articles were included (n = 2,129 patients). Eighteen studies (692 patients out of 1,218) reported clinical response, with pooled prevalence of 55% (95% CI: 46% - 65%). Out of 1,041 patients, 524 showed clinical remission with pooled prevalence of 51% (95%CI: 42% - 59%).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis showcased promising results, in terms of clinical response and remission, in IBD patients receiving dose escalation of ustekinumab.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-16"},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaled Aviptadil is a New Hope for Recovery of Lung Damage due to COVID-19.","authors":"Dorina Esendagli, Nuran Sarı, Sıla Akhan, Sonay Arslan, İrem Asena Doğan Öntaş, Gürdal Yılmaz, Firdevs Aksoy, Aydın Kant, Kadriye Kart Yasar, Esra Canbolat Ünlü, Işıl Kibar Akıllı, Mustafa Kemal Çelen, Çiğdem Mermutluoğlu, Saim Dayan, Emre Kara, Gamze Durhan, Serhat Ünal, Barış Demirkol, Levent Arafat, Erdoğan Çetinkaya, Mustafa Çörtük, Nagihan Durmuş Koçak, Elif Torun Parmaksız, Ahmet Çağkan İnkaya","doi":"10.1159/000543773","DOIUrl":"https://doi.org/10.1159/000543773","url":null,"abstract":"<p><strong>Objective: </strong>We are still in search of new therapeutic options for COVID-19 to prevent new infections, enable fast recovery and reduce the long-lasting symptoms or sequelae. This study aimed to investigate the short- and long-term effects of inhaled aviptadil on hospitalized, adult COVID-19 patients.</p><p><strong>Methods: </strong>A multicenter, prospective, placebo-controlled, comparative, randomized, double-blind clinical trial was conducted. Patients were randomized 1:1 to either inhaled aviptadil or placebo, in addition to the standard care. The primary endpoint is the time from hospitalization to discharge within 30 days of treatment. The secondary endpoints are clinical and radiological score improvements.</p><p><strong>Results: </strong>The study involved 80 patients enrolled from 9 clinical centers. The mean age was 55.8 ± 18.5 years and 27 of them (33.8%) were female. The average time to discharge was 7.8±4.0 days in aviptadil group and 10±5.0 days in placebo (p = 0.049). Modified-Borg Scales were not statistically different on Day 3 (p = 0.090), but significantly lower in the aviptadil group on Day 7 (p = 0.033). The CT lung damage score was not different on Day 1 for both groups (p = 0.962); improvement on Day-28 was significantly greater in the aviptadil group (p = 0.028). The death rate was also lower in the aviptadil group (5.1%) when compared to the placebo (12.2%). There was no drop-out due to side effects.</p><p><strong>Conclusion: </strong>Study shows that inhaled aviptadil is well-tolerated and can be used as a supplementary intervention to fasten the recovery of respiratory manifestations in hospitalized patients for COVID-19 pneumonia.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in Valproate Therapy for Seizures, Migraines and Bipolar Disorders.","authors":"Laxminarayana Kurady Bairy, Sampath Madhyastha","doi":"10.1159/000543555","DOIUrl":"https://doi.org/10.1159/000543555","url":null,"abstract":"<p><p>Valproate, a widely utilized medication for epilepsy, mood disorders, and migraines, has attracted attention for its potential therapeutic benefits extending beyond its traditional uses. This review article compiles recent findings on the expanded utility of valproate outside of epilepsy, mood disorders, and migraines. The review acknowledges conflicting results, discusses opportunities for future research, and underlines both well-established and lesser-known adverse effects, along with possible interventions to mitigate these side effects. In addition to treating generalized and focal epilepsy, valproate has shown efficacy in managing status epilepticus, migraines, and manic episodes of bipolar disorder in conjunction with lithium. Anticipated as a valuable resource, this review aims to furnish researchers and clinicians with the most current and comprehensive information on the uses of valproate.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-19"},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Age, Creatinine, and Ejection Fraction I and II Scores for Postoperative Atrial Fibrillation in Isolated On-Pump Coronary Artery Bypass Grafting Surgery: A Multicenter Retrospective Study.","authors":"Sameh Alagha, Serkan Mola, Mehmet Çeber, Alp Yıldırım","doi":"10.1159/000543188","DOIUrl":"10.1159/000543188","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the predictive performance of age, creatinine, and ejection fraction (ACEF) I and II scores for the development of postoperative atrial fibrillation (PoAF) after isolated on-pump coronary artery bypass grafting (CABG) surgery and compared them with a novel nomogram model developed for PoAF prediction.</p><p><strong>Subjects and methods: </strong>This retrospective multicenter study involved 511 patients who underwent isolated on-pump CABG. Their ACEF scores were calculated, and multivariate logistic regression analysis was performed to develop a nomogram model. The discriminative performance of the ACEF scores and the novel nomogram model was assessed using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Of the 511 patients, 169 (33.1%) developed PoAF. The ACEF I and II scores showed moderate discriminative ability (AUC = 0.642 and 0.647, respectively), with no significant difference between them (p = 0.787). Logistic regression analyses identified age, preoperative hemoglobin levels, emergency procedure, chronic kidney disease or need for dialysis, preoperative β-blocker use, preoperative angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, inotrope requirement, postoperative stroke, and postoperative potassium levels as independent predictors of PoAF. The novel nomogram model demonstrated greater predictive ability than the ACEF scores (AUC = 0.742, p < 0.001).</p><p><strong>Conclusion: </strong>ACEF scores could be helpful risk stratification tools for PoAF after on-pump CABG procedures. Additional validation studies are required to confirm their clinical utility in diverse surgical procedures and patient populations.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Approach of Oxidative Stress and Bronchopulmonary Dysplasia: Relationship of GSTM1 and GSTT1 Genes.","authors":"Luana Vilches Cagnim Nuevo, Vânia Belintani Piatto, Luís Cesar Fava Spessoto","doi":"10.1159/000543466","DOIUrl":"10.1159/000543466","url":null,"abstract":"<p><p>Bronchopulmonary dysplasia (BPD) is a chronic lung disease, with its own clinical, radiological, and histopathological characteristics, which mainly affects premature newborns (NBs), resulting from a combination of factors that include immaturity, inflammation, and lung injury, in addition to therapy with mechanical ventilation and exposure to high concentrations of oxygen. However, even with advances in care for critically ill NBs, BPD continues to be a challenge for the care team and family members. This has been identified as one of the most important causes of morbidity and mortality due to prematurity and can have significant impacts on the quality of life of the affected patients. While interactions between the risk factors associated with BPD characterize it as multifactorial, its real pathogenesis still remains uncertain, as some NBs, despite having similar risk factors, do not develop it, suggesting, therefore, that susceptibility to BPD is genetically determined. Genetic variants in the glutathione S-transferase Mu-1/glutathione S-transferase theta-1-null (GSTM1/GSTT1) genes may be associated with a greater risk of developing BPD in premature NBs, as they affect the function of glutathione S-transferases (GSTs) enzymes and, consequently, the body's ability to eliminate toxic or harmful pro-inflammatory substances. GSTM1/GSTT1-null individuals, due to the absence of gene expression, present loss of enzymatic activity of the respective GST enzymes, triggering failures in the detoxification process and the consequent development of numerous diseases resulting from oxidative damage such as infertility, chronic kidney disease, eryptosis, retinopathy of prematurity, necrotizing enterocolitis, periventricular leukomalacia, intraventricular hemorrhage. The objective of this narrative review was to highlight the role of genetic variants in the GSTM1/GSTT1 genes in the onset of BPD.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Urinary Tract Infections and Antibiotic Susceptibility Patterns of Uropathogens among Neonates in Maternity Hospital, Kuwait: A Six-year Retrospective Study.","authors":"Ola H Moghnia, Hessah S Al Otaibi, Aisha M Al Haqqan, Elie S Sokhn, Seema S Pathan, Nawar E Abdulaziz, Habiba Y Mohammed, Noura A Al-Sweih","doi":"10.1159/000543368","DOIUrl":"https://doi.org/10.1159/000543368","url":null,"abstract":"<p><strong>Objective: </strong>Urinary tract infections (UTIs) are common in neonates. Understanding the changes in the prevalence of common uropathogens is essential for early diagnosis and effective treatment of UTIs. This study aims to identify etiological agents and determine the local antibiotic susceptibility patterns of uropathogens causing UTIs.</p><p><strong>Subjects and methods: </strong>A retrospective cross-sectional descriptive study from January 2017 to December 2022 was conducted on hospitalized neonates at Maternity Hospital, Kuwait. Urine samples from neonates were analyzed to identify isolates, and antimicrobial susceptibility testing was determined using the VITEK® 2 system.</p><p><strong>Results: </strong>Out of 3996 urine samples processed, 282 (7%) samples yielded significant bacteriuria, mostly from male 185 (65.6%). Gram-negative isolates were the most common 141 (50%), followed by yeasts 84 (29.8%) and Gram-positive isolates 57 (20.2%). The common uropathogens were Klebsiella pneumoniae 50 (17.7%), followed by Escherichia coli 47 (16.8%), Candida albicans 39 (13.8%), Enterococcus faecalis 34 (12%) and Staphylococcus epidermidis 17 (6%). High resistance rates were observed among Enterobacterales against ampicillin, cephalothin, cefuroxime, cefotaxime, nitrofurantoin, amoxicillin-clavulanic acid, ceftazidime and trimethoprim-sulfamethoxazole. A total of 28 (56%) K. pneumoniae and 18 (38.3%) E. coli were ESBL producers.</p><p><strong>Conclusion: </strong>Gram-negative isolates are considered the predominant causative agents of UTIs in neonates at Maternity Hospital. Reduced antibiotic susceptibility to commonly used antibiotics poses a notable challenge in the clinical management of neonates with UTIs. This study underscores the importance of proactive surveillance in monitoring causative organisms and antibiotic susceptibility in neonates.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-21"},"PeriodicalIF":2.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Oral Adverse Effects following COVID-19 Vaccination and Similarities with Oral Symptoms in COVID-19 Patients: Taste and Saliva Secretory Disorders.","authors":"Hironori Tsuchiya, Maki Mizogami","doi":"10.1159/000543182","DOIUrl":"10.1159/000543182","url":null,"abstract":"<p><p>Although coronavirus disease 2019 (COVID-19) vaccines exhibit diverse side effects, taste and saliva secretory disorders have remained poorly understood despite their negative impact on the overall quality of life. The present study aimed to characterize oral adverse effects following COVID-19 vaccination and assess their similarities with oral symptoms in COVID-19 patients. A literature search was conducted in databases, including PubMed, LitCovid, and Google Scholar, to retrieve relevant studies. The narrative review indicated that a certain number of vaccinated people develop ageusia, dysgeusia, hypogeusia, xerostomia, and dry mouth, while they are rare compared with COVID-19 oral symptoms. The prevalence of oral adverse effects varies by country/region and such geographical differences may be related to the type of vaccine used. Similar to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, COVID-19 vaccination adversely affects taste perception and salivary secretion in females and older subjects more frequently than in males and younger subjects. Their impairments mostly appear within 3 days of vaccination, and bitter taste is specifically impaired in some cases. Considering that oral adverse effects following COVID-19 vaccination share some characteristics with oral symptoms in COVID-19 patients, it is speculated that the spike protein derived from COVID-19 vaccination and SARS-CoV-2 infection may be pathophysiologically responsible for taste and saliva secretory disorders. This is because such spike protein has the potential to interact with ACE2 expressed on the relevant cells, produce proinflammatory cytokines, and form antiphospholipid antibodies. Our results do not deny the advantages of COVID-19 vaccination, but attention should be paid to post-vaccination oral effects in addition to COVID-19 oral symptoms.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-20"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Discrimination and Multiple Health Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses.","authors":"Jun Hyuk Lee, Hyeri Lee, Yejun Son, Hyeon Jin Kim, Jaeyu Park, Hayeon Lee, Guillaume Fond, Laurent Boyer, Lee Smith, Masoud Rahmati, Damiano Pizzol, Jiseung Kang, Dong Keon Yon, Hans Oh","doi":"10.1159/000542988","DOIUrl":"10.1159/000542988","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to systematically investigate the associations between racial discrimination and various health outcomes and to evaluate the certainty of evidence from existing meta-analyses of observational studies.</p><p><strong>Method: </strong>We systemically searched the associations between racial discrimination and health outcomes for PubMed/MEDLINE, Embase, WoS, and Google Scholar up until January 31, 2024. Notably, the included studies were predominantly conducted in the USA and Europe, limiting the generalizability of our findings to a global context.</p><p><strong>Results: </strong>Eight meta-analyses of observational studies involving over 1 million individuals were included, describing 15 potential health outcomes related to racial discrimination. The quality assessment revealed that most included meta-analyses were of low quality. For oncological health outcomes, significant associations were found with the mortality of hepatocellular carcinoma (HCC); black patients had a higher risk, while Asian patients had a lower risk when compared to white patients. In addition, black patients with disparities on the cancer care continuum are a protective factor for early-stage HCC diagnosis. For gastroenterological health outcomes, Hispanic patients with nonalcoholic fatty liver disease and black patients with socioeconomic status/differential access to health care, compared to white patients (reference), showed significant associations. For mental health outcomes, racial discriminations were significantly associated with increased odds of psychotic experiences, suicidal ideation, and suicidal attempts. Numerous significant associations were from weak to suggestive evidence levels, indicating variability in the evidence.</p><p><strong>Conclusion: </strong>Despite the complexity of measuring its impact, racial discrimination shows a profound influence across clinical areas, including an unexpected protective association in early-stage HCC diagnosis among black patients.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-14"},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}