Therapeutic Advances in Chronic Disease最新文献

{"title":"The evidence for ketamine treatment in older adults with psychiatric illness: a scoping review.","authors":"Kayla Murphy, Julia Golden, Haley Schuster, Rajesh Tampi","doi":"10.1177/20406223251384803","DOIUrl":"https://doi.org/10.1177/20406223251384803","url":null,"abstract":"<p><strong>Background: </strong>Ketamine, an N-methyl-D-aspartate antagonist, has been used for decades as an anesthetic agent, but more recently it has been studied in psychiatric illness. Though ketamine has been investigated for use in the general population, fewer studies have investigated the efficacy and tolerability of this treatment for older (age >60) adults.</p><p><strong>Objectives: </strong>This review sought to compile the randomized controlled trials (RCTs) investigating the evidence for ketamine treatment in older adults with psychiatric disorders.</p><p><strong>Eligibility criteria: </strong>Only RCTs published in English language journals, or with official English language translations, and human studies were included.</p><p><strong>Sources of evidence: </strong>Our team searched PubMed, Cochrane Database, and Ovid with the terms ketamine, depression, suicidal ideation, bipolar disorder, mania, anxiety, schizophrenia, psychotic disorders, dementia, delirium, and post-traumatic stress disorder.</p><p><strong>Charting methods: </strong>Covidence was used to extract and organize included studies.</p><p><strong>Results: </strong>Our review yielded 14 RCTs and 2 post-hoc analyses evaluating ketamine treatment in older patients. Eight of these studies examined ketamine for the treatment of delirium, while the remaining eight examined its use in depression. The studies had significant heterogeneity so direct comparisons of the results were challenging. However, five studies showed no significant impact of ketamine on delirium incidence. Two studies showed a lower incidence of delirium in the ketamine group, but another study showed a higher incidence of delirium with ketamine. Four studies showed improvement in depressive symptoms with ketamine treatment, while the others showed a lack of improvement. Most reported side effects were mild.</p><p><strong>Conclusion: </strong>Several studies have investigated ketamine for depression and delirium in older adults and show mixed results. This review reveals the paucity of current data on ketamine for other psychiatric conditions in older adults. It reaffirms that use of ketamine in older adults with psychiatric illness, including depression and delirium, remains an individual risk versus benefit analysis using shared decision making.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251384803"},"PeriodicalIF":2.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12541176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of use and dose optimization of renin-angiotensin system modulators among chronic heart failure patients with reduced ejection fraction in resource-limited settings: a multicenter cohort study.","authors":"Sisay Sitotaw Anberbr, Samuel Berihun Dagnew, Getachew Yitayew Tarekegn, Fisseha Nigussie Dagnew, Zufan Alamrie Asmare, Teklie Mengie Ayele, Eskedar Dires Gebremeskel, Samuel Agegnew Wondm, Tilaye Arega Moges","doi":"10.1177/20406223251384514","DOIUrl":"https://doi.org/10.1177/20406223251384514","url":null,"abstract":"<p><strong>Background: </strong>Optimal use of renin-angiotensin system (RAS) modulators plays a crucial role in improving the outcomes for chronic heart failure (CHF) patients with reduced ejection fraction (rEF). Despite their established benefits, there is limited evidence regarding real-world prescribing patterns, dose optimization, and factors influencing RAS modulator use in this population.</p><p><strong>Objective: </strong>This study aimed to evaluate the patterns of use, dose optimization, and associated factors affecting the administration of RAS modulators among CHF patients with rEF at Public Comprehensive Specialized Hospitals (PCSHs).</p><p><strong>Design: </strong>A hospital-based, multicenter cohort study was conducted from February 1, 2020, to May 31, 2024, at PCSHs among CHF patients with rEF.</p><p><strong>Methods: </strong>A total sample size of 385 patients was determined using a systematic random sampling technique at the Northwest Ethiopian PCSHs during the study period. Data were collected from medical records and interviews using standardized questionnaires. Data analysis was performed using SPSS version 27.0, and binary logistic regression analysis was employed to identify factors associated with the use and optimization of RAS modulators. The study strictly adhered to the most recent guideline recommendations from the American Heart Association (2022) and the European Society of Cardiology (2021).</p><p><strong>Results: </strong>Of 385 patients, 263 (68.3%) were prescribed RAS modulators; however, only 86 (32.7%) of these patients were receiving an optimal dose. Predictors significantly associated with the use of RAS modulators included a duration of CHF with rEF of ⩾3 years (AOR: 1.79, 95% CI: 1.02-3.15), the presence of ischemic heart disease (AOR: 8.23, 95% CI: 4.23-16), hypertension (AOR: 2, 95% CI: 1.09-3.69), diabetes mellitus (AOR: 7.34, 95% CI: 1.48-36.34), chronic kidney disease (AOR: 4.35, 95% CI: 1.32-14.34), and a furosemide dose of ⩾40 mg (AOR: 0.26, 95% CI: 0.013-0.49). Regarding suboptimal RAS modulator dosing, significant predictors identified were age ⩾65 years (AOR: 2.83, 95% CI: 1.46-5.50), a previous history of hospitalization (AOR: 2.05, 95% CI: 1.07-3.95), the use of diuretics (AOR: 5.34, 95% CI: 2.73-10.44), a furosemide dose of ⩾40 mg (AOR: 3.88, 95% CI: 1.89-7.97), and CHF with rEF for ⩾3 years (AOR: 0.31, 95% CI: 0.16-0.63).</p><p><strong>Conclusions: </strong>The majority of CHF patients with rEF received suboptimal doses of RAS modulators, with only one-third receiving optimal therapy. This highlights a critical gap in treatment that must be urgently addressed. Targeted interventions are needed to identify and mitigate modifiable predictors contributing to suboptimal dosing, thereby improving therapeutic outcomes and reducing the burden of CHF with rEF.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251384514"},"PeriodicalIF":2.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12541160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Level of medication non-adherence among ambulatory patients with dyslipidemia and comorbid illness in Northwest Ethiopia: a multicenter cross-sectional study.","authors":"Tilaye Arega Moges, Samuel Berihun Dagnew, Sisay Sitotaw Anberbr, Bayih Endalew Bitew, Mekdes Kiflu, Yared Andargie Ferede, Tesfagegn Gobezie Yiblet, Woretaw Sisay Zewdu","doi":"10.1177/20406223251381590","DOIUrl":"10.1177/20406223251381590","url":null,"abstract":"<p><strong>Background: </strong>Antilipidemic therapy adherence to medication among patients with dyslipidemia and type 2 diabetes mellitus (T2DM) remains suboptimal, particularly in developing countries. Poor adherence to lipid-lowering therapy is associated with a significantly higher risk of major adverse cardiovascular outcomes in this population than in the general population.</p><p><strong>Objectives: </strong>This study aimed to assess the level of non-adherence to antilipidemic medications and associated socio-demographic and clinical factors among patients attending comprehensive specialized hospitals (CSHs) in Northwest Ethiopia.</p><p><strong>Design: </strong>This multicenter, prospective, cross-sectional study was conducted at CSHs in Northwest Ethiopia from November 10, 2023 to January 30, 2024.</p><p><strong>Methods: </strong>Data were entered using EpiData version 4.6.0.0 and analyzed using STATA version 17.0. The Adherence in Chronic Diseases Scale was used to assess medication adherence. Multinomial logistic regression analysis was used to identify factors associated with non-adherence, and model fitness was checked before interpretation.</p><p><strong>Results: </strong>The study included 398 patients, yielding a response rate of 98.76%. Of these patients, 290 (72.9%) were classified as non-adherent to their antilipidemic medications. Factors significantly associated with medium and low medication adherence included female sex (adjusted odds ratio (AOR) for medium: 2.94, 95% confidence interval (CI): 1.61-5.38; AOR for low: 3.09, 95% CI: 1.66-5.76), unmarried status (AOR for medium: 2.83, 95% CI: 1.52-5.27; AOR for low: 2.72, 95% CI: 1.43-5.17), current smoking (AOR for medium: 3.25, 95% CI: 1.20-8.82; AOR for low: 6.54, 95% CI: 2.46-17.36), presence of comorbidities (AOR for medium: 3.01, 95% CI: 1.65-5.49; AOR for low: 2.41, 95% CI: 1.29-4.47), and polypharmacy (⩾5 medications) (AOR for medium: 3.00, 95% CI: 1.60-5.63; AOR for low: 4.87, 95% CI: 2.56-9.24).</p><p><strong>Conclusion: </strong>This study revealed a high prevalence of medication non-adherence among patients with T2DM with dyslipidemia in Northwest Ethiopia. Non-adherence was significantly associated with female gender, unmarried status, smoking, comorbid conditions, and polypharmacy. These findings emphasize the need for targeted strategies to improve adherence in high-risk populations to enhance lipid control and lower the likelihood of cardiovascular complications.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251381590"},"PeriodicalIF":2.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short- and long-term complications of insulin pump therapy in children and adolescents with type 1 diabetes: a multicenter cross-sectional study from Saudi Arabia.","authors":"Ayman Bakkar, Enad Althobaiti, Ibtisam Alqahtani, Lujain A Abualkhair, Naglaa M Kamal, Mohammed Althobaiti, Turki Alotaibi, Lura Habib, Lujain Alharthi, Saad Aljuaid, Maha Althuwaybi, Haneen Alshehri, Muhannad Alotaibi, Wael Kamal, Mutlaq Aljuaid, Samia Almalki, Abdulaziz Alsaedi","doi":"10.1177/20406223251381573","DOIUrl":"10.1177/20406223251381573","url":null,"abstract":"<p><strong>Background: </strong>Insulin pump therapy improves glycemic control in children with type 1 diabetes but is associated with technical and dermatological complications that can impact adherence. Research on these adverse effects in pediatric populations is limited.</p><p><strong>Objectives: </strong>This study aimed to evaluate short- and long-term complications of insulin pump therapy in pediatric patients in Saudi Arabia, focusing on technical malfunctions, dermatological issues, and patient satisfaction.</p><p><strong>Design: </strong>A cross-sectional survey-based study conducted in multiple centers in Taif, Saudi Arabia.</p><p><strong>Methods: </strong>Fifty-nine parents of children with type 1 diabetes who used insulin pumps provided data for the study. Participants reported technical issues, skin-related complications, and overall satisfaction. IBM SPSS Statistics version 27.0.1 was used to conduct the statistical analysis.</p><p><strong>Results: </strong>Technical complications were frequent, with 64.4% experiencing tube blockages, 39.0% reporting needle dislodgment, and 39.0% observing air bubbles in the tubing. Dermatological issues included discomfort at the infusion site (54.2%), skin pigmentation (45.8%), and scarring (55.9%), with lipohypertrophy (22.0%) posing a concern for insulin absorption. Longer pump use was significantly associated with increased complications, particularly tube blockages and skin pigmentation. Despite these challenges, 84.7% of participants recommended insulin pumps over multiple daily injections.</p><p><strong>Conclusion: </strong>Technical and dermatological complications were common, increasing with longer pump use. Proper infusion site rotation, infusion set management, and improved patient education are key to reducing adverse effects. To improve safety and efficacy, future studies should concentrate on infusion set change patterns, newer pump technologies, and standardized guidelines.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251381573"},"PeriodicalIF":2.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of body mass index on periodontitis: a cross-sectional study.","authors":"Soumya Vishwanath, Vishwanath Gurumurthy, Ravinder S Saini, Mario Alberto Alarcón-Sánchez, Sarah Monserrat Lomelí-Martínez, Artak Heboyan, Armen A Muradyan","doi":"10.1177/20406223251383319","DOIUrl":"10.1177/20406223251383319","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a significant public health concern linked to various health complications, including periodontitis. This study uniquely integrates multiple obesity indicators (body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR)) alongside clinical periodontal parameters and considers sociodemographic factors to provide a comprehensive analysis of the relationship between obesity and periodontitis.</p><p><strong>Objectives: </strong>To determine the association between BMI, WC, and WHR with periodontal clinical parameters, and to explore the role of sociodemographic and behavioral factors.</p><p><strong>Design: </strong>Transversal study.</p><p><strong>Methods: </strong>A total of 1000 adults (579 males and 421 females) with ⩾15 teeth were enrolled using systematic random sampling. Sociodemographic variables (age, sex, marital status, income, education level), behavioral factors (brushing frequency, smoking status), and anthropometric measurements (BMI, BP, WHR) were considered. Clinical periodontal parameters included probing pocket depth (PPD), bleeding on probing, clinical attachment loss (CAL), plaque index, and gingival index. Associations were assessed using multivariate regression models adjusted for age, sex, education, income, and oral hygiene habits.</p><p><strong>Results: </strong>The study population comprised 579 males and 421 females, predominantly aged 19-30 years. BMI classifications were 46.2% normal, 30.5% overweight, and 4.5% obese. Elevated BMI and WC were significantly associated with increased PPD and CAL (<i>p</i> < 0.001*). In univariate analysis, overweight (odds ratio (OR) = 2.28, <i>p</i> < 0.001*) and obesity (OR = 6.46, <i>p</i> < 0.001*) were significantly associated with periodontitis. In multivariate analysis, obesity remained significantly associated with periodontitis (adjusted OR = 3.42, <i>p</i> < 0.01*), as did WC (adjusted OR = 1.84, <i>p</i> < 0.01*). The WHR was associated with periodontitis in univariate but not in multivariate analysis.</p><p><strong>Conclusion: </strong>Obesity, as measured by BMI and central adiposity indicators, is independently positively associated with greater periodontitis severity. The findings highlight the importance of assessing obesity in estimating periodontal risk and structuring targeted interventions that consider both metabolic status and sociodemographic factors to optimize periodontal health benefits.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251383319"},"PeriodicalIF":2.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between MAFLD and CVD in a health check-up Chinese population: a prospective cohort study.","authors":"Yao Dou, Jiawei Cui, Qi Gu, Xiwei Yuan, Mengmeng Hou, Wenjing Ni, Chen Dong, Chudi Chang, Jinhua Shao, Qiuling Wang, Jie Li, Liang Qiao, Yuemin Nan","doi":"10.1177/20406223251378867","DOIUrl":"10.1177/20406223251378867","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) has emerged as the most significant complication and leading cause of death among metabolic-associated fatty liver disease (MAFLD).</p><p><strong>Objectives: </strong>This study aims to investigate the CVD risk among MAFLD subgroups.</p><p><strong>Design: </strong>Data of participants from June 2017 to January 2023 in the Physical Examination Center of the Third Hospital of Hebei Medical University were collected. MAFLD were divided into four subgroups: metabolic healthy lean/normal weight MAFLD (MHL), metabolic healthy overweight/obese MAFLD (MHO), metabolic dysfunctional lean/normal weight MAFLD (MDL), and metabolic dysfunctional overweight/obese MAFLD (MDO).</p><p><strong>Methods: </strong>The risk assessment for atherosclerotic CVD was performed based on the flowchart for primary prevention risk assessment in Chinese adults.</p><p><strong>Results: </strong>The proportions of MHL, MHO, MDL, and MDO were 0.77% (<i>n</i> = 185), 10.05% (<i>n</i> = 2406), 1.29% (<i>n</i> = 310), and 16.86% (<i>n</i> = 4038), respectively. After adjustment for gender, age, smoking history, drinking history, and significant liver fibrosis, the subgroup of MAFLD was still an independent risk factor for high adverse cardiovascular events (HACE). Compared with the MHL, the MDL had the highest risk, followed by MDO (all <i>p</i> < 0.05), and there was no significant difference between MHO and MHL. We performed regression analysis according to age (65 years) and gender (male or female), respectively, and the results were similar to those of the total population.</p><p><strong>Conclusion: </strong>MAFLD is associated with a higher risk of CVD, especially in MDO. Classification of MAFLD based on body mass index and metabolic status helps in risk stratification, which will mitigate or prevent the development of CVD.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251378867"},"PeriodicalIF":2.8,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic dysfunction-associated steatotic liver disease: an emerging comorbidity in COPD.","authors":"Ali Al Dailaty, Ahmad Ghanem, Ghaydaa Abou Daher, Toufic Chaaban, Rajaa Chatila","doi":"10.1177/20406223251378868","DOIUrl":"10.1177/20406223251378868","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are highly prevalent conditions that frequently coexist. MASLD, now the leading cause of chronic liver disease globally, affects up to 25% of the population and is increasingly recognized in COPD patients. Shared cardiometabolic risk factors, chronic inflammation, and lipid-mediated injury underpin their pathophysiological link. This review outlines the epidemiology, shared mechanisms, and clinical impact of MASLD in COPD, as well as diagnostic strategies and current management approaches. Recognizing MASLD as a clinically significant comorbidity in COPD may offer new opportunities for risk stratification, integrated care, and targeted therapeutic interventions, underscoring the need for further research into their mechanistic interplay and bidirectional impact.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251378868"},"PeriodicalIF":2.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practitioner's perception of myasthenia gravis management recommendations in clinical practice: a cross-sectional survey study.","authors":"Elena Cortés-Vicente, Antonio Guerrero-Sola, Fernando Caballero-Martínez, Francisco Javier Campos-Lucas, Juan Gómez-Salgado, Diana Monge-Martín, Rodrigo Álvarez-Velasco","doi":"10.1177/20406223251368063","DOIUrl":"10.1177/20406223251368063","url":null,"abstract":"<p><strong>Background: </strong>Myasthenia gravis (MG) is a chronic, fluctuating disease whose unique natural history complicates designing therapeutic trials. The evidence on which many MG management recommendations are based is limited.</p><p><strong>Objective: </strong>To determine the degree of knowledge, agreement, and application of internationally recognized recommendations for managing MG in actual practice.</p><p><strong>Design: </strong>A cross-sectional survey was conducted among Spanish neurologists specializing in MG.</p><p><strong>Methods: </strong>The survey assessed knowledge, agreement, and application of recommendations, along with the degree of agreement with international consensus definitions from the Myasthenia Gravis Foundation of America.</p><p><strong>Results: </strong>Fifty-three neurologists (mean age 45.4 years, 53% men) attended an average of 3.6 patients with MG daily. In 40 out of 61 recommendations, at least 90% of the neurologists were aware of the recommendation. The least known recommendations dealt with juvenile MG and MG in pregnancy. There was no majority agreement in two recommendations (for MG in pregnancy and the use of intravenous immunoglobulin in mild or ocular MG). The implementation of the recommendations was high except for the ones related to plasma exchange, thymectomy, methotrexate, or eculizumab.</p><p><strong>Conclusion: </strong>The recommendations are well-known, agreed upon, and applied. However, the evidence, consensus, and knowledge dissemination need reinforcement regarding aspects such as the management of juvenile MG, MG in pregnancy, or the use of certain treatments.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251368063"},"PeriodicalIF":2.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint effects of prognostic nutritional index and skeletal muscle index on prognosis of decompensated cirrhosis: a retrospective cohort study.","authors":"Shuangzhe Yao, Binbin Peng, Jia Li, Ziyi Yang, Chao Sun","doi":"10.1177/20406223251369763","DOIUrl":"10.1177/20406223251369763","url":null,"abstract":"<p><strong>Background: </strong>Liver cirrhosis, characterized by chronic inflammation, is frequently complicated by malnutrition. Nutritional indices, such as the prognostic nutritional index (PNI) and the skeletal muscle index (SMI), calculated as the muscle area quantified via CT scans at the third lumbar vertebra level divided by the square of the patient's height in meters (cm²/m²), are associated with outcomes in inflammatory diseases.</p><p><strong>Objectives: </strong>We aimed to evaluate the diagnostic efficacy of the PNI both independently and in combination with the SMI for identifying malnutrition in cirrhosis and to explore their prognostic implications.</p><p><strong>Design: </strong>A single-center retrospective cohort study of 262 hospitalized cirrhotic patients (2018-2023). Malnutrition was assessed using PNI, PNI-SMI, and Global Leadership Initiative on Malnutrition (GLIM) criteria, respectively.</p><p><strong>Methods: </strong>Nutritional status was defined by PNI (<28.85), PNI-SMI (either reduced PNI or SMI), and GLIM criteria. SMI was quantified via third lumbar vertebra CT scans. Diagnostic performance was evaluated using sensitivity, specificity, and area under the curve (AUC). Cox regression and Kaplan-Meier analyses assessed associations with 1-year mortality.</p><p><strong>Results: </strong>The prevalence of malnutrition, as determined by various criteria, was considerably heterogeneous: 26.72% by the PNI, 56.11% by the PNI-SMI, and 51.14% by the GLIM criteria. Patients classified as malnourished demonstrated inferior clinical parameters and a higher 1-year mortality rate. The PNI-SMI combination exhibited favorable diagnostic performance in detecting malnutrition, with a sensitivity of 75.51%, specificity of 80%, along with an area under the curve of 0.774. Multivariate Cox analysis indicated that all three malnutrition criteria were independently associated with 1-year all-cause mortality, with hazard ratios of 2.56, 4.20, and 7.20, respectively.</p><p><strong>Conclusion: </strong>The PNI, particularly when integrated with the SMI, offers a streamlined yet moderately accurate tool for nutritional and prognostic assessment in decompensated cirrhosis. This combined approach may serve as a practical supplement to GLIM criteria in select clinical contexts, potentially improving outcomes through targeted nutritional interventions.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251369763"},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking, alcohol consumption, and new-onset impaired glucose metabolism in male patients with type 1 autoimmune pancreatitis: a retrospective cohort study.","authors":"Wenfeng Xi, Xiaoyin Bai, Tao Guo, Hanze Du, Yueyi Zhang, Xinyuan Cao, Qingwei Jiang, Yunlu Feng, Aiming Yang","doi":"10.1177/20406223251371512","DOIUrl":"10.1177/20406223251371512","url":null,"abstract":"<p><strong>Background: </strong>Type 1 autoimmune pancreatitis (AIP) is more prevalent among males, a significant proportion of whom are known to smoke and consume alcohol, both of which can cause damage to the pancreas. AIP is associated with the new-onset impaired glucose metabolism (NO-IGM). However, it remains unclear whether smoking and alcohol consumption exacerbate this risk.</p><p><strong>Objectives: </strong>The present study aims to clarify the potential impact of smoking and alcohol consumption on the risk of NO-IGM in male patients with type 1 AIP.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Methods: </strong>This retrospective cohort study included 305 male patients with type 1 AIP. The participants were categorized into four groups based on smoking and drinking status: neither, smoking-only, drinking-only, and both group. The impact of smoking and heavy drinking on AIP-related IGM was analyzed using multivariate modified Poisson regression.</p><p><strong>Results: </strong>The prevalence of NO-IGM was 40.66% in the study. In the multivariate modified Poisson regression analysis, smoking-only group (relative risk (RR), 2.44; 95% CI, 1.70-3.51) and both smoking and drinking (RR, 2.84; 95% CI, 1.93-4.19) were associated with an increased risk of type 1 AIP-related NO-IGM. Drinking only (estimated RR >1) also appeared to elevate this risk.</p><p><strong>Conclusion: </strong>In male patients with type 1 AIP, smoking and heavy drinking may increase the risk of AIP-related NO-IGM.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251371512"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}