Therapeutic Advances in Chronic Disease最新文献

{"title":"Systemic monotherapy with acitretin for erythrodermic psoriasis: results of a retrospective study of 81 patients.","authors":"Chenyang Yu,&nbsp;Chao Wu,&nbsp;Yuyan Yang,&nbsp;Hongzhong Jin","doi":"10.1177/20406223231178412","DOIUrl":"https://doi.org/10.1177/20406223231178412","url":null,"abstract":"<p><strong>Background: </strong>Erythrodermic psoriasis (EP) remains challenging to manage because it is rare and has complex complications. Although acitretin is recommended as an appropriate choice for EP, there is a lack of large-scale evidence.</p><p><strong>Objectives: </strong>This study aims to assess the efficacy and safety of acitretin as systemic monotherapy in EP patients.</p><p><strong>Design: </strong>We retrospectively analyzed data from patients with EP who received at least 3 months of acitretin as systemic monotherapy during hospitalization and out-patient follow-up from January 2005 to May 2021 at the Peking Union Medical College Hospital, China.</p><p><strong>Methods: </strong>The efficacy was clinically evaluated after 1, 2, 4, and 12 weeks of treatment, which was classified as a good response (>75% of lesions cleared), partial response (50%-75% cleared), moderate response (25-50% cleared), or no response (<25% cleared). Safety was assessed on the basis of physical examination results and significant changes in laboratory examination results after 12 weeks of treatment.</p><p><strong>Results: </strong>Overall, 81 patients (79.0% men; mean age, 47.9 years) were included. The acitretin dose ranged from 20 to 60 mg/day (0.3 to 0.8 mg/kg/day). The rates of good, partial, and moderate responses were 0.0%, 2.5%, and 42.0% at 1 week; 3.7%, 34.6%, and 61.7% at 2 weeks; 29.6%, 58.0%, and 12.4% at 4 weeks; and 85.2%, 13.6%, and 1.2% at 12 weeks after treatment initiation, respectively. EP patients transformed from psoriasis vulgaris showed a higher good/partial response rate compared with that of EP patients that developed from pustular or articular psoriasis (44.6% <i>vs.</i> 14.3%, <i>p</i> = 0.035). Patients with concurrent infection showed a lower rate of good/partial response compared with that of those without concurrent infection (16.7% <i>vs.</i> 44.4%, <i>p</i> = 0.049). Adverse effects were seen in 45 (55.6%) patients in 12 weeks, and dyslipidemia (<i>n</i> = 31; 38.3%), xerosis (<i>n</i> = 24; 29.6%), and elevated liver enzymes (<i>n</i> = 6; 7.4%) were most commonly reported. Twenty-three patients were followed up for over 3 years, and six (26.1%) patients had EP recurrence.</p><p><strong>Conclusions: </strong>Acitretin as a systemic monotherapy showed satisfactory effectiveness for EP, especially in patients developed from psoriasis vulgaris and without infection.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231178412"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/8b/10.1177_20406223231178412.PMC10286161.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291737","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 early diagnostic value of optical coherence tomography (OCT) and OCT angiography in thyroid-associated ophthalmopathy.","authors":"Bei Xu,&nbsp;Sha Wang,&nbsp;Lu Chen,&nbsp;Jia Tan","doi":"10.1177/20406223231166802","DOIUrl":"https://doi.org/10.1177/20406223231166802","url":null,"abstract":"<p><strong>Background: </strong>The retinal microvascular density changes have been identified in thyroid-associated ophthalmopathy (TAO) patients. Whereas a lack of research has been done on the diagnostic ability of optical coherence tomography (OCT) combined with optical coherence tomography angiography (OCTA) parameters.</p><p><strong>Objectives: </strong>This study aims to evaluate the retina perfusion variations in eyes with active and stable TAO and its diagnostic abilities using OCT and OCTA.</p><p><strong>Design: </strong>This is cohort longitudinal retrospective study.</p><p><strong>Methods: </strong>A total of 51 patients with TAO and 39 healthy controls (HCs) were recruited. The TAO eyes were divided into active and stable stage groups. The foveal avascular zone (FAZ), macular perfusion density (mPD), and peripapillary PD were measured by OCTA. The peripapillary retinal nerve fiber layer (RNFL), central retinal thickness (CRT), and whole macular volume (wMV) were measured by OCT. Visual evoked potential (VEP) and visual field (VF) were also assessed.</p><p><strong>Results: </strong>The mPD of the superficial retinal capillary plexus (SRCP) was significantly different in all subfields among active, stable, and HC groups (<i>p</i> < 0.05) except for the temporal inner (<i>p</i> = 0.137), and the active group achieved the lowest PD. The FAZ size increased significantly in the active and stable groups compared with the HC group (<i>p</i> < 0.001). Significant difference was observed in mPD of deep retinal capillary plexus (DRCP) in all quadrants among three groups (<i>p</i> < 0.05). Moreover, PD parameters of optic nerve head (ONH) and radial peripapillary capillary plexus (RPCP) showed a different trend among three groups (<i>p</i> < 0.05). The <i>r</i>-value of visual field-mean deviation (VF-MD) of TAO with DRCP-whole PD (wPD) and RPCP-wPD was 0.421 and 0.299, respectively (<i>p</i> < 0.05). The DRCP-wPD in OCTA and RNFL in OCT were significantly higher in area under the receiver operating characteristic curve (AUC) than that of HC eyes.</p><p><strong>Conclusion: </strong>OCT and OCTA can noninvasively detect the peripapillary and macular changes in various stages of TAO patients, and it might be a high diagnostic value tool to monitor the TAO progression.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231166802"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/37/10.1177_20406223231166802.PMC10176590.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10301087","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":"Shared decision-making in multiple sclerosis physical symptomatic care: a systematic review.","authors":"Aliza Bitton Ben-Zacharia,&nbsp;Jong-Mi Lee,&nbsp;Jennifer S Kahle,&nbsp;Bonnie Lord","doi":"10.1177/20406223231172920","DOIUrl":"https://doi.org/10.1177/20406223231172920","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic autoimmune inflammatory, demyelinating, and neurodegenerative disease affecting young adults. People with MS are highly interested in engaging in physical symptom management and decision-making but are often not actively engaged in symptom management discussions. Research examining the benefit of shared decision-making in the management of physical MS symptoms is sparse.</p><p><strong>Objectives: </strong>This study aimed to identify and synthesize the evidence on the use of shared decision-making in physical MS symptom management.</p><p><strong>Design: </strong>This study is a systematic review of published evidence on the use of shared decision-making in physical MS symptom management.</p><p><strong>Data sources and methods: </strong>MEDLINE, CINAHL, EMBASE, and CENTRAL databases were searched in April 2021, June 2022, and April 2, 2023, for primary, peer-reviewed studies of shared decision-making in the management of MS physical symptoms. Citations were screened, data extracted, and study quality assessed according to Cochrane guidelines for systematic reviews, including risk of bias assessment. Statistical synthesis of the included study results was not appropriate; results were summarized in a nonstatistical manner using the vote-counting method to estimate beneficial versus harmful effects.</p><p><strong>Results: </strong>Of 679 citations, 15 studies met the inclusion criteria. Six studies addressed shared decision-making in the management of pain, spasms, neurogenic bladder, fatigue, gait disorder, and/or balance issues, and nine studies addressed physical symptoms in general. One study was a randomized controlled trial; most studies were observational studies. All study results and study author conclusions indicated that shared decision-making is important to the effective management of physical MS symptoms. No study results suggested that shared decision-making was harmful or delayed the management of physical MS symptoms.</p><p><strong>Conclusion: </strong>Reported results consistently indicate that shared decision-making is important in effective MS symptomatic care. Further rigorous randomized controlled trials are warranted to investigate the effectiveness of shared decision-making associated with MS physical symptomatic care.</p><p><strong>Registration: </strong>PROSPERO: CRD42023396270.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231172920"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/06/0a/10.1177_20406223231172920.PMC10265321.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10351451","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":"Distinguishing bronchoscopically observed anatomical positions of airway under by convolutional neural network.","authors":"Chongxiang Chen,&nbsp;Felix Jf Herth,&nbsp;Yingnan Zuo,&nbsp;Hongjia Li,&nbsp;Xinyuan Liang,&nbsp;Yaqing Chen,&nbsp;Jiangtao Ren,&nbsp;Wenhua Jian,&nbsp;Changhao Zhong,&nbsp;Shiyue Li","doi":"10.1177/20406223231181495","DOIUrl":"https://doi.org/10.1177/20406223231181495","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) technology has been used for finding lesions <i>via</i> gastrointestinal endoscopy. However, there were few AI-associated studies that discuss bronchoscopy.</p><p><strong>Objectives: </strong>To use convolutional neural network (CNN) to recognize the observed anatomical positions of the airway under bronchoscopy.</p><p><strong>Design: </strong>We designed the study by comparing the imaging data of patients undergoing bronchoscopy from March 2022 to October 2022 by using EfficientNet (one of the CNNs) and U-Net.</p><p><strong>Methods: </strong>Based on the inclusion and exclusion criteria, 1527 clear images of normal anatomical positions of the airways from 200 patients were used for training, and 475 clear images from 72 patients were utilized for validation. Further, 20 bronchoscopic videos of examination procedures in another 20 patients with normal airway structures were used to extract the bronchoscopic images of normal anatomical positions to evaluate the accuracy for the model. Finally, 21 respiratory doctors were enrolled for the test of recognizing corrected anatomical positions using the validating datasets.</p><p><strong>Results: </strong>In all, 1527 bronchoscopic images of 200 patients with nine anatomical positions of the airway, including carina, right main bronchus, right upper lobe bronchus, right intermediate bronchus, right middle lobe bronchus, right lower lobe bronchus, left main bronchus, left upper lobe bronchus, and left lower lobe bronchus, were used for supervised machine learning and training, and 475 clear bronchoscopic images of 72 patients were used for validation. The mean accuracy of recognizing these 9 positions was 91% (carina: 98%, right main bronchus: 98%, right intermediate bronchus: 90%, right upper lobe bronchus: 91%, right middle lobe bronchus 92%, right lower lobe bronchus: 83%, left main bronchus: 89%, left upper bronchus: 91%, left lower bronchus: 76%). The area under the curves for these nine positions were >0.98. In addition, the accuracy of extracting the images <i>via</i> the video by the trained model was 94.7%. We also conducted a deep learning study to segment 10 segment bronchi in right lung, and 8 segment bronchi in Left lung. Because of the problem of radial depth, only segment bronchi distributions below right upper bronchus and right middle bronchus could be correctly recognized. The accuracy of recognizing was 84.33 ± 7.52% by doctors receiving interventional pulmonology education in our hospital over 6 months.</p><p><strong>Conclusion: </strong>Our study proved that AI technology can be used to distinguish the normal anatomical positions of the airway, and the model we trained could extract the corrected images <i>via</i> the video to help standardize data collection and control quality.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231181495"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/9b/10.1177_20406223231181495.PMC10457519.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10100822","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":"Risk factors for the long-term incidence and progression of knee osteoarthritis in older adults: role of nonsurgical injury.","authors":"Jean-Pierre Pelletier,&nbsp;Patrice Paiement,&nbsp;Marc Dorais,&nbsp;Jean-Pierre Raynauld,&nbsp;Johanne Martel-Pelletier","doi":"10.1177/20406223231169715","DOIUrl":"https://doi.org/10.1177/20406223231169715","url":null,"abstract":"<p><strong>Background: </strong>For one of the most chronic medical conditions, osteoarthritis, uncertainties remain on the impact of injury chronology, the role of repeat injury on the incidence/progression of this disease and the need for knee arthroplasty.</p><p><strong>Objectives: </strong>To explore, in an older adult population, how nonsurgical knee injuries relate to osteoarthritis incidence/progression and the weight of independent risk factors for arthroplasty.</p><p><strong>Design: </strong>A cohort study design evaluates the long-term impact of injuries on knee osteoarthritis outcomes.</p><p><strong>Methods: </strong>Knees with no prior injury (<i>n</i> = 6358) and with at least one injury (<i>n</i> = 819) ⩽20 years before study inclusion were from the Osteoarthritis Initiative cohort. Sociodemographic, clinical and structural [X-ray, magnetic resonance imaging (MRI)] data at study inclusion and changes within 96 months were analysed. Statistics included a mixed model for repeated measurements, generalized estimating equations and multivariable Cox regression with covariates.</p><p><strong>Results: </strong>At inclusion, knees with prior injury demonstrated greater incidence and severity of osteoarthritis (<i>p</i> ⩽ 0.001). At 96 months, there was a greater increase in symptoms [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, <i>p</i> = 0.002], joint space width (JSW, <i>p</i> = 0.039) loss, medial cartilage volume loss (CVL, <i>p</i> ⩽ 0.001) and bone marrow lesion size (BML, <i>p</i> ⩽ 0.049). Knees with/without injury at inclusion but with new ones over time had a pronounced increase in symptoms (all WOMAC scores, <i>p</i> ⩽ 0.001), JSW loss, lateral (without) and medial CVL, lateral (without) and medial meniscal extrusion and medial BML (without; all <i>p</i> ⩽ 0.030). Levels of lateral and medial meniscal extrusion (without) and symptoms (with/without; all WOMAC scores, <i>p</i> ⩽ 0.001) were all accentuated with a repeated new injury. Risk factors associated with the highest knee arthroplasty occurrence are new meniscal extrusion and new injury (<i>p</i> ⩽ 0.001).</p><p><strong>Conclusion: </strong>This study highlights the importance of nonsurgical knee injury in older adults as an independent risk factor for knee osteoarthritis and arthroplasty. These data will be beneficial in clinical practice as they will help identify individuals at greater risk of significant disease progression and worst disease outcomes for a customized therapeutic approach.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231169715"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/c8/10.1177_20406223231169715.PMC10184209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10290161","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":"Trends in mortality from infection among patients with hematologic malignancies: differences according to hematologic malignancy subtype.","authors":"Xuejiao Yin,&nbsp;Xuelian Hu,&nbsp;Hongyan Tong,&nbsp;Liangshun You","doi":"10.1177/20406223231173891","DOIUrl":"https://doi.org/10.1177/20406223231173891","url":null,"abstract":"<p><strong>Background: </strong>Infection is the most important cause of non-relapse mortality in hematologic malignancy patients, leading to increased costs and prolonged hospitalization times. However, comprehensive and comparable reports on infection-specific mortality (ISM) trends in hematologic malignancy patients are lacking.</p><p><strong>Objectives: </strong>We aimed to provide updated ISM trends and factors associated with ISM among hematologic malignancy patients.</p><p><strong>Design: </strong>This is a retrospective study.</p><p><strong>Methods: </strong>Patients diagnosed with the five most common hematologic malignancies from 1983 to 2016 from the Surveillance, Epidemiology, and End Results database were included. Joinpoint regression was used to analyze mortality trends.</p><p><strong>Results: </strong>ISM decreased beginning in 1983, 1988, and 1994, with yearly decreases of -2.1% for acute leukemia (AL), -1.3% for Hodgkin lymphoma (HL), and -14.3% for non-Hodgkin lymphoma (NHL). In contrast, ISM in patients with chronic leukemia (CL) and multiple myeloma (MM) increased dramatically beginning in 2000, with yearly increases of 2.8% and 3.3%, respectively. ISM rates were higher in males than in females across all hematologic malignancy subtypes. The mortality trends significantly differed according to race, age, sex, and stage, which could help in further etiological investigations. Moreover, male sex, older age at diagnosis, black race, and unmarried status were poor prognostic factors for ISM across all hematologic malignancy subtypes.</p><p><strong>Conclusion: </strong>A promising downward trend in ISM in recent years occurred in patients with AL, HL, and NHL; however, ISM increased dramatically in patients with CL and MM. Our data suggest that risk assessment and careful infection monitoring are recommended for hematologic malignancy patients, particularly those with CL and MM.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231173891"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/36/10.1177_20406223231173891.PMC10288445.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291738","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":"Mineralocorticoid receptor antagonist treatment improved arterial stiffness in patients with primary aldosteronism: a cohort study compared with adrenalectomy.","authors":"Che-Wei Liao,&nbsp;Yen-Tin Lin,&nbsp;Cheng-Hsuan Tsai,&nbsp;Yi-Yao Chang,&nbsp;Zheng-Wei Chen,&nbsp;Ching-Chu Lu,&nbsp;Chien-Ting Pan,&nbsp;Chin-Chen Chang,&nbsp;Bo-Ching Lee,&nbsp;Yu-Wei Chiu,&nbsp;Wei-Chieh Huang,&nbsp;Kuo-How Huang,&nbsp;Tai-Shuan Lai,&nbsp;Chi-Shen Hung,&nbsp;Vin-Cent Wu,&nbsp;Xue-Ming Wu,&nbsp;Yen-Hung Lin","doi":"10.1177/20406223221143233","DOIUrl":"https://doi.org/10.1177/20406223221143233","url":null,"abstract":"<p><strong>Background: </strong>Elevated arterial stiffness in patients with primary aldosteronism (PA) can be reversed after adrenalectomy; however, the effect of medical treatment with mineralocorticoid receptor antagonist (MRAs) is unknown.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the effect of MRAs and compare both treatment strategies on arterial stiffness in PA patients.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>We prospectively enrolled PA patients from 2006 to 2019 who received either adrenalectomy or MRA treatment (spironolactone). We compared their baseline and 1-year post-treatment biochemistry characteristics and arterial pulse wave velocity (PWV) to verify the effects of treatment and related determinant factors.</p><p><strong>Results: </strong>A total 459 PA patients were enrolled. After 1:1 propensity score matching for age, sex and blood pressure (BP), each group had 176 patients. The major determinant factors of baseline PWV were age and baseline BP. The adrenalectomy group had greater improvements in BP, serum potassium level, plasma aldosterone concentration, and aldosterone-to-renin ratio. The MRA group had a significant improvement in PWV after 1 year of treatment (1706.2 ± 340.05 to 1613.6 ± 349.51 cm/s, <i>p</i> < 0.001). There were no significant differences in post-treatment PWV (<i>p</i> = 0.173) and improvement in PWV (<i>p</i> = 0.579) between the adrenalectomy and MRA groups. The determinant factors for an improvement in PWV after treatment were hypertension duration, baseline PWV, and the decrease in BP.</p><p><strong>Conclusion: </strong>The PA patients who received medical treatment with MRAs had a significant improvement in arterial stiffness. There was no significant difference in the improvement in arterial stiffness between the two treatment strategies.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223221143233"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/70/10.1177_20406223221143233.PMC9846303.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10583361","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":"Association between sensitivity to thyroid hormone indices and osteoporosis in euthyroid patients with type 2 diabetes mellitus.","authors":"Xuelun Wu,&nbsp;Furui Zhai,&nbsp;Ailing Chang,&nbsp;Jing Wei,&nbsp;Yanan Guo,&nbsp;Jincheng Zhang","doi":"10.1177/20406223231189230","DOIUrl":"https://doi.org/10.1177/20406223231189230","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormones are known to regulate bone metabolism and may influence bone mineral density (BMD), as well as the risk of osteoporosis (OP) and fractures in patients with type 2 diabetes mellitus (T2DM). Recently, sensitivity to thyroid hormone indices has been linked with T2DM and OP independently. However, the relationship between thyroid hormone sensitivity and OP in euthyroid T2DM patients has yet to be investigated.</p><p><strong>Objectives: </strong>The aim of this study was to determine the association between sensitivity to thyroid hormone indices and the risk of OP in euthyroid patients with T2DM.</p><p><strong>Design: </strong>This study employed a retrospective, cross-sectional design and utilized data acquired from the Cangzhou Central Hospital in China between 2019 and 2020.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 433 patients with T2DM for anthropometric measurements, clinical laboratory test results, and BMD. The thyroid-stimulating hormone index, thyrotroph thyroxine resistance index, and thyroid feedback quantile-based index (TFQI) were calculated to determine thyroid hormone sensitivity. Finally, multivariable logistic regression, generalized additive models, and subgroup analysis were performed to detect the association between sensitivity to thyroid hormone indices and the risk of OP in these patients.</p><p><strong>Results: </strong>We did not observe a statistically significant linear relationship between sensitivity to thyroid hormones indices and OP after covariate adjustment. However, a nonlinear relationship existed between TFQI and the prevalence of OP. The inflection point of the TFQI was at -0.29. The effect sizes (odds ratio) on the left and right of the inflection point were 0.07 [95% confidence interval (CI): 0.01-0.71; <i>p</i> = 0.024] and 2.78 (95% CI: 1.02-7.58; <i>p</i> = 0.046), respectively. This trend was consistent in older female patients with higher body mass index (BMI; 25-30 kg/m²).</p><p><strong>Conclusion: </strong>An approximate U-shaped relationship was observed between sensitivity to thyroid hormone indices and OP risk in euthyroid patients with T2DM with variations in sex, age, and BMI. These findings provide a new perspective to elucidate the role of thyroid hormones in OP, specifically in patients with T2DM.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231189230"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/83/10.1177_20406223231189230.PMC10395177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10649812","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":"Clinical characteristics of hospitalized patients with metabolic-associated fatty liver disease-related liver cancer: data from a single center, 2010-2019.","authors":"Guishuang Wang,&nbsp;Hong Zhao,&nbsp;Lei Sun,&nbsp;Gang Wan,&nbsp;Wen Xie","doi":"10.1177/20406223231173896","DOIUrl":"https://doi.org/10.1177/20406223231173896","url":null,"abstract":"<p><strong>Background: </strong>Metabolic-associated fatty liver disease (MAFLD) has become an important cause of liver cancer. The current understanding of MAFLD-related liver cancer is not sufficient, however.</p><p><strong>Objective: </strong>The objective of this study was to investigate the clinical and metabolic characteristics of inpatients with MAFLD-related liver cancer.</p><p><strong>Design: </strong>This is a cross-sectional investigation.</p><p><strong>Methods: </strong>An investigation was conducted to collect the cases of hepatic malignant tumor hospitalized in Beijing Ditan Hospital, Capital Medical University from 1 January 2010 to December 31 2019. The basic information, medical history, laboratory examination results, and imaging examination results of 273 patients diagnosed with MAFLD-related liver cancer were recorded. The general information and metabolic characteristics of patients with MAFLD-related liver cancer were analyzed.</p><p><strong>Results: </strong>In total, 5958 patients were diagnosed with hepatic malignant tumor. Among them, liver cancer due to other causes accounted for 6.19% (369/5958), MAFLD-related liver cancer was diagnosed in 273 cases of them. From 2010 to 2019, MAFLD-related liver cancer showed an increasing trend. Among 273 patients with MAFLD-related liver cancer, 60.07% were male, 66.30% were ⩾60 years old, and 43.22% had cirrhosis. The 273 patients were comprised by 38 patients with evidence of fatty liver and 235 patients without evidence of fatty liver. There was no significant difference in the proportions of sex, age, overweight/obesity, type 2 diabetes, and the presence of ⩾2 metabolic-related factors between the two groups. In the group without evidence of fatty liver, 47.23% patients had cirrhosis, which was significantly higher than 18.42% in the group with evidence of fatty liver (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>MAFLD-related liver cancer should be considered in liver cancer patients with metabolic risk factors. Half of MAFLD-related liver cancer occurred in the absence of cirrhosis.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231173896"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/7c/10.1177_20406223231173896.PMC10278433.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664077","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":"AES-CSFS: an automatic evaluation system for corneal sodium fluorescein staining based on deep learning.","authors":"Shaopan Wang,&nbsp;Jiezhou He,&nbsp;Xin He,&nbsp;Yuwen Liu,&nbsp;Xiang Lin,&nbsp;Changsheng Xu,&nbsp;Linfangzi Zhu,&nbsp;Jie Kang,&nbsp;Yuqian Wang,&nbsp;Yong Li,&nbsp;Shujia Guo,&nbsp;Yunuo Zhang,&nbsp;Zhiming Luo,&nbsp;Zuguo Liu","doi":"10.1177/20406223221148266","DOIUrl":"https://doi.org/10.1177/20406223221148266","url":null,"abstract":"<p><strong>Background: </strong>Corneal fluorescein sodium staining is a valuable diagnostic method for various ocular surface diseases. However, the examination results are highly dependent on the subjective experience of ophthalmologists.</p><p><strong>Objectives: </strong>To develop an artificial intelligence system based on deep learning to provide an accurate quantitative assessment of sodium fluorescein staining score and the size of cornea epithelial patchy defect.</p><p><strong>Design: </strong>A prospective study.</p><p><strong>Methods: </strong>We proposed an artificial intelligence system for automatically evaluating corneal staining scores and accurately measuring patchy corneal epithelial defects based on corneal fluorescein sodium staining images. The design incorporates two segmentation models and a classification model to forecast and assess the stained images. Meanwhile, we compare the evaluation findings from the system with ophthalmologists with varying expertise.</p><p><strong>Results: </strong>For the segmentation task of cornea boundary and cornea epithelial patchy defect area, our proposed method can achieve the performance of dice similarity coefficient (DSC) is 0.98/0.97 and Hausdorff distance (HD) is 3.60/8.39, respectively, when compared with the manually labeled gold standard. This method significantly outperforms the four leading algorithms (Unet, Unet++, Swin-Unet, and TransUnet). For the classification task, our algorithm achieves the best performance in accuracy, recall, and F1-score, which are 91.2%, 78.6%, and 79.2%, respectively. The performance of our developed system exceeds seven different approaches (Inception, ShuffleNet, Xception, EfficientNet_B7, DenseNet, ResNet, and VIT) in classification tasks. In addition, three ophthalmologists were selected to rate corneal staining images. The results showed that the performance of our artificial intelligence system significantly outperformed the junior doctors.</p><p><strong>Conclusion: </strong>The system offers a promising automated assessment method for corneal fluorescein staining, decreasing incorrect evaluations caused by ophthalmologists' subjective variance and limited knowledge.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223221148266"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/e0/10.1177_20406223221148266.PMC9926379.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738705","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}