SAGE Open Medicine最新文献

{"title":"Exploring thermal balloon endometrial ablation with Foley's catheter: Management for heavy menstrual bleeding.","authors":"Khalid Khadawardi, Hisham Nasief, Amber Hassan, Yasir A Katib, Nashwa Aldardeir, Ahmad B Alwazzan","doi":"10.1177/20503121251322325","DOIUrl":"https://doi.org/10.1177/20503121251322325","url":null,"abstract":"<p><strong>Background: </strong>Heavy menstrual bleeding is a common gynecological issue that often requires prompt treatment. Our study aimed to assess thermal balloon endometrial ablation with Foley's catheter as a viable, cost-effective, and minimally invasive procedure alternative to hysterectomy.</p><p><strong>Methods: </strong>An experimental study was carried out on 114 married women experiencing heavy menstrual bleeding who did not wish to have further children and had either failed standard treatments or were not suitable for medical treatment. These women had a uterine size of 12 cm or less and an endometrial thickness of less than 18 mm. A 3-min balloon inflation-deflation procedure was performed. After 3 months, the effectiveness of the treatment was assessed by examining overall heavy menstrual bleeding outcomes, posttreatment transvaginal ultrasound results, number of bleeding days and pain per cycle, and scores from the Menorrhagia Outcome Questionnaire.</p><p><strong>Results: </strong>The mean patient's age was 44.46 ± 4.184 years and a disease duration of 2.84 ± 1.53 years. Most patients were multiparous (86.0%) or grand multiparous (14.0%). Significant improvements were observed in endometrial thickness, Menorrhagia Outcome Questionnaire scores, pain levels, and the number of bleeding days postprocedure (<i>p</i>-value < 0.05). The majority of patients experienced a reduction in the pattern of irregular menstrual cycles. The procedure showed a success rate of 88.6%, with 11.4% of patients not responding. Some further interventions such as hysterectomy or repeated thermal balloon ablation were required due to complications like infection or balloon deflation.</p><p><strong>Conclusion: </strong>The thermal balloon endometrial ablation using Foley's catheter is an effective treatment for heavy menstrual bleeding.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251322325"},"PeriodicalIF":2.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicenter, postmarketing surveillance of elobixibat in patients with chronic constipation in Japan: A final analysis report.","authors":"Atsushi Nakajima, Minami Umeyama, Masaaki Higashikawa, Yusuke Shimada, Yuki Arai","doi":"10.1177/20503121251321659","DOIUrl":"10.1177/20503121251321659","url":null,"abstract":"<p><strong>Objective: </strong>An interim analysis of postmarketing surveillance reported the safety and efficacy of elobixibat, a laxative medication that inhibits the ileal bile acid transporter, at 4 weeks in approximately 1000 patients with chronic constipation in Japan. However, its long-term safety and efficacy in elderly patients remain unclear. This study aimed to conclude and report the final analysis of postmarketing surveillance, including 52-week safety and efficacy profiles in a clinical practice setting, using approximately 3000 patients.</p><p><strong>Methods: </strong>The overall survey period spanned from June 2018 to May 2022. Observation periods were set at 4 weeks (4-week treatment period) and 52 weeks (52-week treatment period). Adverse drug reactions and efficacy outcomes, including defecation frequency, Bristol Stool Form Scale scores, and patient satisfaction, were analyzed.</p><p><strong>Results: </strong>The 4-week safety analysis set included 3638 patients with a mean age of 70.8 years, and 73.7% were aged ⩾65 years. Most patients (62.5%) were treated with elobixibat alone, while the rest received concomitant laxatives. In total, 231 patients (6.35%) experienced adverse drug reactions, with gastrointestinal disorders (6.02%) such as diarrhea (3.35%) and abdominal pain (2.06%), being the most common adverse drug reaction. The adverse drug reaction incidence in elderly patients aged ⩾65, ⩾75, and ⩾85 years was 5.49%, 4.85%, and 2.80%, respectively. In the 52-week treatment period, adverse drug reaction incidence was 5.40% (71/1315 patients), similar to that in the 4-week treatment period. Regarding efficacy, defecation frequency and Bristol Stool Form Scale scores significantly improved from week 2 onward, regardless of the age group and administration timing (before breakfast, lunch, or dinner). Most patients reported satisfaction from week 2 onward (6.0%, 66.9%, 78.6%, and 90.4% at baseline, weeks 2, 4, and 52, respectively).</p><p><strong>Conclusion: </strong>This study confirmed the long-term safety and efficacy of elobixibat in patients with chronic constipation, including many elderly ones, in routine clinical practice.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251321659"},"PeriodicalIF":2.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to minimal retesting interval for HbA1c, vitamin D and thyrotropin in the University Hospital of Nepal.","authors":"Saroj Thapa, Meera Hada, Bhushan Tusuju, Apeksha Niraula","doi":"10.1177/20503121251321668","DOIUrl":"10.1177/20503121251321668","url":null,"abstract":"<p><strong>Background: </strong>Laboratory testing plays a critical role in healthcare decision-making; however, concerns regarding overutilization and inappropriate testing persist. Minimum retesting intervals serve as a tool to optimize testing practices and resource allocation. This study aimed to assess adherence to minimum retesting interval guidelines and estimate associated costs for commonly prescribed tests, namely HbA1c, 25 hydroxyvitamin D (Vitamin D), and thyrotropin, in a university hospital setting in Nepal.</p><p><strong>Methods: </strong>This observational study utilized secondary data from medical records covering 1 year. Adherence to minimum retesting interval guidelines was evaluated based on established recommendations, and the economic burden of inappropriate testing was estimated using cost data provided by the Health Insurance Board of Nepal.</p><p><strong>Results: </strong>Patients who underwent TSH, HbA1c, and Vitamin D testing during the study period were 27,960, 8558, and 5416 with the total number of tests being 38,718 TSH, 13,859 HbA1c, and 5977 Vitamin D, respectively. There were notable proportions of patients with minimum retesting interval breach, that is, <i>n</i> = 1317 for thyroid stimulating hormone (4.71%), <i>n</i> = 1159 for HbA1c (13.54%) and <i>n</i> = 232 for Vitamin D (4.28%). Minimum retesting interval breaches were identified across all parameters, with associated costs of $12,817 which could be saved if there were no minimum retesting interval breaches. Variations in minimum retesting interval adherence were observed between insured and noninsured patients and among tests falling within and outside reference ranges.</p><p><strong>Conclusion: </strong>The findings highlight the prevalence of minimum retesting interval breaches and inappropriate testing practices, emphasizing the need for interventions to optimize laboratory testing utilization. Addressing these challenges through context-specific strategies can enhance resource allocation and patient care while mitigating financial burdens.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251321668"},"PeriodicalIF":2.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of inflammatory biomarkers IL-6, vascular endothelial growth factor and matrix metalloproteinases-9 expression in endometriosis.","authors":"Maofang Hua, Yuan Wang, Jun Yao, Zhenxuan Zhu, Xiaoyun Liu, Fanfei Meng, ShuangHua Yu","doi":"10.1177/20503121251321625","DOIUrl":"10.1177/20503121251321625","url":null,"abstract":"<p><strong>Objective: </strong>Special attention has been paid to genetic mechanisms that might have a significant impact on the context of the risk of developing endometriosis, in recent years. The study aimed to analyze the expression levels of three inflammatory biomarkers Interleukin-6 (IL-6), vascular endothelial growth factor, and matrix metalloproteinases-9, in the increased incidence of endometriosis.</p><p><strong>Methods: </strong>The material for genetic testing was tissue slices embedded in paraffin blocks from these patients with endometriosis (I-II) (<i>n</i> = 24), endometriosis (III-IV) (<i>n</i> = 24), and the control group (<i>n</i> = 30) in Lianyungang maternal and child health hospital from January 2020 to December 2023. The expression levels of IL-6, vascular endothelial growth factor, and matrix metalloproteinases-9 genes were determined by the real-time polymerase chain reaction technique.</p><p><strong>Results: </strong>The expression levels of IL-6 and vascular endothelial growth factor gene in the peripheral blood and peritoneal fluid of these endometriosis patients were not statistically significant lower than in the control group. Besides, the significant differences were found in IL-6, vascular endothelial growth factor and matrix metalloproteinases-9 between eutopic endometrial tissues of the endometriosis group, compared to the control group; and these increased significantly with the severity of the disease. In addition, there was significant difference in the expression level of matrix metalloproteinases-9 in peripheral blood and peritoneal fluid, and the difference was statistically significant in these patients with stages III-IV, compared with these patients with stages I-II. Among them, the Revised American Society for Reproductive Medicine classification of endometriosis was used in the group of patients with endometriosis.</p><p><strong>Conclusion: </strong>These patients with endometriosis showed the significant differences in matrix metalloproteinases-9 expression in peripheral blood, peritoneal fluid, and eutopic and ectopic endometrial tissues as the condition worsens. The research suggested that the determination of matrix metalloproteinases-9 in peripheral blood has certain value in evaluating the condition of endometriosis, which might play an important role in the pathogenesis of endometriosis and be explored for postoperative recurrence monitoring.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251321625"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and genotype distribution of human papillomavirus infection among Kurdish people, Iran.","authors":"Bahram Nikkhoo, Soma Mahmoodian, Pourya Bahrami, Arshia Daraee, Farzad Soleimani, Fatemeh Zamani, Sherko Nasseri, Khaled Rahmani","doi":"10.1177/20503121251320522","DOIUrl":"10.1177/20503121251320522","url":null,"abstract":"<p><strong>Background and aim: </strong>Human papillomavirus is a common sexually transmitted infection and a health concern, being the major cause of cervical cancer and genital warts. The aim of this study was to investigate the prevalence and genotype distribution of human papillomavirus in the Kurdish population.</p><p><strong>Methods and materials: </strong>A total of 2650 samples from individuals attending central laboratories in Sanandaj, the center of Kurdistan Province in north-west Iran, were tested for human papillomavirus infection. Cervical samples were collected from women using a cervical brush, while semen samples were collected from men. Cervical samples were stored in a vial with cell preservation solution, while semen samples were stored at room temperature until complete liquefaction of the semen. Human papillomavirus DNA from positive samples was extracted using a high-purity viral nucleic acid kit, and human papillomavirus genotyping was performed using the ZYTOVISION human papillomavirus Chip1.0 genotyping system according to the manufacturer's instructions.</p><p><strong>Results: </strong>Of the 2610 samples screened, 655 were found positive for human papillomavirus and included in the human papillomavirus molecular typing analysis. The overall prevalence of human papillomavirus in the study samples was 25.1%. Of the 655 positive samples, 645 (98.5%) were women and 10 (1.5%) were men. The mean age was 35.95 years (women: 36.06 years and men: 28.81 years). The most common genotypes identified were types 6 (30.1%), 16(14.4%), and 54(9.0%). Of those affected, 387 (59.1%) had a single human papillomavirus infection and 268 (40.9%) had multiple infections.</p><p><strong>Conclusion: </strong>This study showed that the prevalence of human papillomavirus among Kurdish women is relatively high. The findings highlight the importance of targeted human papillomavirus vaccination programs and screening strategies, particularly in younger age groups, to reduce the burden of human papillomavirus-related disease in this setting. Future studies should investigate the impact of cultural and behavioral factors on human papillomavirus transmission and associated health outcomes in this population.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251320522"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcome of non-cystic fibrosis bronchiectasis in children: A tertiary care perspective.","authors":"Phanthila Sitthikarnkha, Apichaya Anekvorakul, Sirapoom Niamsanit, Leelawadee Techasatian, Suchaorn Saengnipanthkul, Rattapon Uppala","doi":"10.1177/20503121251320849","DOIUrl":"10.1177/20503121251320849","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchiectasis is a chronic respiratory disease caused by various respiratory and systemic conditions. It is now considered a potentially reversible disease, particularly when diagnosed early and managed with appropriate respiratory care strategies. Although rare in children, it typically develops in patients with recurrent lower respiratory tract infections. The etiology of bronchiectasis in children differs from that in adults. This study aims to identify the clinical features, causes, and outcomes of non-cystic fibrosis bronchiectasis in children at a tertiary center.</p><p><strong>Methods: </strong>A retrospective review was conducted among children with non-cystic fibrosis bronchiectasis who attended a university-affiliated hospital between January 2007 and December 2021. Clinical outcomes were assessed based on pulmonary function tests, exacerbation, and mortality.</p><p><strong>Results: </strong>The study included 35 children with non-cystic fibrosis bronchiectasis. The median age at diagnosis was 36 months (IQR: 24-170 months). Bronchiectasis was linked to underlying conditions in 22 cases (62.9%), such as primary immunodeficiency, chronic aspiration, and primary ciliary dyskinesia. Thirteen children had infectious-associated bronchiectasis (37.1%), with four cases related to pulmonary tuberculosis. At diagnosis, cystic bronchiectasis was most common (<i>n</i> = 17, 48.6%), followed by varicose (<i>n</i> = 13, 37.1%) and cylindrical bronchiectasis (<i>n</i> = 5, 14.3%). Pulmonary exacerbation occurred in 28 (80%) children, with a higher rate in noninfectious bronchiectasis than postinfectious bronchiectasis (90.9% vs 61.5%, <i>p</i> = 0.036). Hospitalization was required for 26 (77.1%) children, with a higher rate of noninfectious bronchiectasis than postinfectious bronchiectasis (86.3% vs 53.8%, <i>p</i> = 0.033).</p><p><strong>Conclusions: </strong>Primary immune deficiency and chronic aspiration are the most common non-infective causes of non-cystic fibrosis bronchiectasis. Noninfectious bronchiectasis leads to higher exacerbation and hospitalization rates.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251320849"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intention to use digital-based psychosocial counseling and its predictors among students in University of Gondar, Northwest Ethiopia, 2023: Using modified unified theory of acceptance and use of technology model.","authors":"Deje Sendek Anteneh, Jenberu Mekurianew Kelkay, Henok Dessie Wubneh, Miftah Abdella Beshir, Kassahun Dessie Gashu","doi":"10.1177/20503121241307136","DOIUrl":"10.1177/20503121241307136","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial problems are widely affecting the population around the world and worsening in university students. Timely access to psychosocial counseling and support remained challenging. Hence, implementing a digital-based approach to psychosocial counseling services could potentially improve access and efficiency for students in need. However, limited evidence on the intention to use digital-based psychosocial counseling and its predictors among university students in Ethiopia. This study aimed to assess the intention to use digital-based psychosocial counseling and its predictors among students at the University of Gondar, Northwest Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 759 students from 28 March until 28 April 2023 at the University of Gondar, Northwest, Ethiopia. Proportional allocation was done, and the participants were selected using stratified random sampling. The median score was used as a cutoff point. The student who scores median and above on intention to use construct was considered as intended to use digital-based psychosocial counseling otherwise unintended. The interviewer-administered questionnaire, adapted from the unified theory of acceptance and use of technology model and kobo collect app, was employed to collect the data. Data were exported to SPSS 20 for descriptive analysis and Analysis of Moment and Structure version 23 for structural equation modeling analysis to assess the significance of relationships between variables using a path coefficient and a <i>p</i>-value of <0.05.</p><p><strong>Results: </strong>A total of 750 (98.8%) responded to complete all the questionnaires. The proportion of intention to use digital-based psychosocial counseling was 54.9%, (95% CI: 51.3%-58.5%). A structural equation modeling shows that performance expectancy (β = 0.510, <i>p</i>-value < 0.001), effort expectancy (β = 0.082, <i>p</i>-value = 0.003), and social influence (β = 0.307, <i>p</i>-value < 0.001) had a direct relationship with intention to use digital-based psychosocial counseling. Gender (β = 0.545, <i>p</i>-value < 0.001) was moderate performance expectancy.</p><p><strong>Conclusion and recommendation: </strong>The study has shown a promising intention to use digital-based psychosocial counseling among university students. Performance expectancy, effort expectancy, and social influence had a positive effect on the intention to use digital-based psychosocial counseling. Thus, the implementers need to give priority to enhancing and creating awareness for students related to how to use digital-based counseling.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121241307136"},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Dolutegravir-based antiretroviral treatment in achieving an undetectable HIV-1 viral load among women attending prevention of mother-to-child transmission clinics in Addis Ababa, Ethiopia.","authors":"Belete Woldesemayat, Yimam Getaneh, Sisay Adane, Ajanaw Yizengaw, Amelework Yilma, Shambel Araya Haile, Kidist Zealiyas","doi":"10.1177/20503121251320460","DOIUrl":"10.1177/20503121251320460","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the prevalence of detectable HIV-1 viral load and associated factors among pregnant and lactating women on Dolutegravir-based and non-Dolutegravir-based regimens.</p><p><strong>Methods: </strong>HIV-positive pregnant and breastfeeding women enrolled in a cross-sectional study design incorporating Dolutegravir versus non-Dolutegravir group for comparison purposes, and the study was conducted from September 2022 to March 2023. In total, 684 women receiving antiretroviral treatment (456 on Dolutegravir-based and 228 on non-Dolutegravir-based regimens) were enrolled across 16 prevention of mother-to-child transmission clinics. An undetectable viral load was defined as <20 RNA copies/mL. Univariable and multivariable regression models were used to determine the associations of the detectable viral load with factors such as sociodemographic, clinical, obstetric, and laboratory parameters.</p><p><strong>Results: </strong>The prevalence of detectable viral load on a non-Dolutegravir-based regimen was 32.9% and on a Dolutegravir-based regimen group was 19.7%. The overall prevalence was 24.1% (95% CI: 20.9-27.6). Compared with non-Dolutegravir-based regimens, Dolutegravir-based regimens were associated with 69% (AOR: 0.31; 95% CI: 0.16-0.61) lower risk of having a detectable viral load. The median viral load was significantly lower in women on a Dolutegravir-based regimen (1.66 log copies/mL) compared to those on a non-Dolutegravir-based regimen (2.11 log copies/mL; <i>p</i> < 0.001). A lower level of adherence was associated with 2.33 times (AOR: 2.33; 95% CI: 1.06-5.12) higher odds of having a detectable viral load and women who had a WHO clinical stage II and above were 2.71 times (AOR: 2.71: 95% CI: 1.30-5.64) more vulnerable to developing a detectable viremia than their counterparts.</p><p><strong>Conclusion: </strong>Despite the scale-up of Dolutegravir-based regimens, the overall prevalence of detectable viremia was 24.1%, with a higher prevalence of 32.9% among women on non-Dolutegravir-based regimens indicating a programmatic challenge that could affect mother-to-child transmission outcomes. Strengthening adherence monitoring and maintaining World Health Organization clinical stage I is crucial for achieving undetectable viral load levels in pregnant and breastfeeding women.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251320460"},"PeriodicalIF":2.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with in-hospital mortality in octogenarians managed by geriatric service in a referral hospital in Colombia.","authors":"Carlos Mario Cortes Bahamon, Jenny Rodríguez Ángel, Jennifer Katherine Ballesteros Tapias, Diego Andrés Chavarro-Carvajal, Oscar Mauricio Muñoz","doi":"10.1177/20503121251317354","DOIUrl":"10.1177/20503121251317354","url":null,"abstract":"<p><strong>Introduction: </strong>The demographic transition has significantly increased the number of hospitalizations in octogenarian patients. Previous studies have documented the importance of clinical, functional, and cognitive variables for in-hospital mortality risk, but their frequency and importance in Latin American populations is yet to be described. It is important because Colombia has multiple ethnic races, with different types of longevity, and we have a history of social violence that affects our life expectancy. The aim of this study is to define which risk factors are associated with in-hospital mortality in octogenarians, and how frequent they are and quantify the weight of each of these factors in the outcomes.</p><p><strong>Methodology: </strong>We present an analytical observational retrospective cohort study in adult patients over 80 years of age hospitalized and followed by the geriatrics service at Hospital Universitario San Ignacio (Bogotá, Colombia). The association between in-hospital mortality and multiple clinical, functional, and cognitive variables was evaluated by means of univariate and multivariate logistic regression analysis.</p><p><strong>Results: </strong>A total of 1235 hospitalizations were analyzed (age 85.5 ± 4.4 years, 58.62% women). Malnutrition was documented in 22.4%, dependency for basic activities (Barthel ⩽ 95) in 75.9%, and positive screening for frailty (FRAIL ⩾ 3) in 55.3%. Mortality was 5.67%. Factors independently associated with mortality were history of cancer (Odds ratio (OR): 2.31; 95% Confidence interval (CI): 1.34-3.98, <i>p</i> < 0.003), delirium (OR: 2.48; 95% CI: 1.44-4.28, <i>p</i> < 0.001), malnutrition (OR: 2.50; 95% CI: 1.46-4.28; <i>p</i> = 0.001), frailty (OR: 2.25; 95% CI: 1.13-4.45, <i>p</i> = 0.019), tachypnea on admission (OR: 1.09; 95% CI: 1.03-1.14, <i>p</i> = 0.002), and creatinine elevation (OR: 2.47; 95% CI: 1.47-4.15, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Factors easily identifiable at hospital admission and amenable to intervention could predict an increased risk of mortality in octogenarian patients, such as the presence of malnutrition, frailty, and delirium. These findings facilitate the estimation of mortality risk and serve as a starting point to investigate the potential benefit of early interventions in this population.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251317354"},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bidirectional Mendelian randomization study integrating genome-wide association studies, expression quantitative trait locus, and methylation quantitative trait locus data revealed causal relationship between heavy cigarette dependence and Barrett's esophagus.","authors":"Zhou An, Meichun Zeng, Xianhua Wang","doi":"10.1177/20503121251316595","DOIUrl":"10.1177/20503121251316595","url":null,"abstract":"<p><strong>Background: </strong>The association between smoking dependence and the risk of developing Barrett's esophagus remains unclear. This study aimed to investigate whether a causal relationship exists between smoking dependence and Barrett's esophagus, using Mendelian randomization analysis.</p><p><strong>Methods: </strong>Two-sample Mendelian randomization analysis was conducted to evaluate the impact of smoking and Barrett's esophagus. Additionally, we applied summary data-based Mendelian randomization techniques to combine information from genome-wide association studies (GWAS) with expression quantitative trait locus and methylation quantitative trait locus.</p><p><strong>Results: </strong>Multivariable Mendelian randomization showed an association between smoking per day (odds ratio = 1.2, 95% confidence interval: 1.038-1.38, <i>p</i> = 0.014) or current smoking (odds ratio = 2.41, 95% confidence interval: 1.06-5.5, <i>p</i> = 0.037) and Barrett's esophagus. Inverse variance-weighted methods of bidirectional Mendelian randomization also revealed that smoking per day was significantly associated with elevated risks of Barrett's esophagus (odds ratio = 1.34, 95% confidence interval: 1.092-1.649, <i>p</i> = 0.005), while Barrett's esophagus was also a susceptibility factor for smoking per day (odds ratio = 1.05, 95% confidence interval: 1.017-1.087, <i>p</i> = 0.003). By incorporating consistent summary data-based Mendelian randomization associations between DNA methylation and smoke/Barrett's esophagus, gene expression and smoke/Barrett's esophagus, and DNA methylation and gene expression, we identified that the genetic variant-cg00935895-RBM43 (ENSG00000184898)-smoke/Barrett's esophagus axis exerted an effect on smoke/Barrett's esophagus by altering the DNA methylation level, which regulated the expression level of RBM43.</p><p><strong>Conclusions: </strong>Our study provides evidence of a bidirectional causal association between smoking and Barrett's esophagus from a genetic perspective, which sheds new light on the potential role of RBM43 as a mediator in facilitating the impact of smoking and Barrett's esophagus.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"13 ","pages":"20503121251316595"},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}