Journal of clinical medicine research最新文献

{"title":"Association of Small Airway Functional Indices With Respiratory Symptoms and Comorbidity in Asthmatics: A National Cross-Sectional Study.","authors":"Jia Wei Long, Yong Liang Jiang","doi":"10.14740/jocmr5158","DOIUrl":"10.14740/jocmr5158","url":null,"abstract":"<p><strong>Background: </strong>Small airway dysfunction (SAD) and airway inflammation are vital in asthma exacerbations. Type 2 inflammation (T2), mediated by cytokines from T helper 2 cell (Th2) such as interleukin (IL)-4, IL-5, and IL-13, is a potential mechanism underlying SAD. Research on small airway function in asthma is limited. We aimed to explore the correlation between small airway function and respiratory symptoms and comorbidity in T2 and non-T2 asthma.</p><p><strong>Methods: </strong>Derived from the National Health and Nutrition Examination Survey (NHANES), our study encompassed 2,420 asthma patients aged 6 - 79 years, including pulmonary function (PF) data such as forced expiratory flow between 25% and 75% of forced vital capacity (FEF_25-75), forced expiratory volume in 1 second (FEV₁), forced expiratory volume in 3 seconds (FEV₃), forced expiratory volume in 6 seconds (FEV₆), and forced vital capacity (FVC). To evaluate the small airway function, we calculated z-scores for FEF_25-75, FEF_25-75/FVC, FEV₁/FEV₆, and FEV₃/FEV₆. Logistic regression determined the adjusted odds ratios (aORs) for symptoms and comorbidity.</p><p><strong>Results: </strong>FEF_25-75, FEV₁/FEV₆, and FEV₃/FEV₆ correlated with asthmatic symptoms. FEF_25-75 had the strongest association with wheezing or whistling attacks. An increase of 1 standard deviations (SD) in FEF_25-75 reduced recurrent wheezing (aOR: 0.70; 95% confidence intervals (95% CIs): 0.65 - 0.76) and severe attacks (aOR: 0.67; 95% CI: 0.62 - 0.94). These indices were also linked to dry cough and hay fever, particularly FEV₃/FEV₆ reducing hay fever risk (aOR: 0.70; 95% CI: 0.55 - 0.91) in non-T2 asthma. FEF_25-75/FVC related to persistent (aOR: 0.78; 95% CI: 0.72 - 0.84) and severe attacks (aOR: 1.14; 95% CI: 1.08 - 1.22) in non-T2 groups. Lower indices combined with T2 exposure raised severe attack risk.</p><p><strong>Conclusions: </strong>In this nationwide study, small airway function correlated with symptom onset, especially in T2 asthma. Small airway injury differed between T2 and non-T2 asthma. Prospective research is needed to establish reference values.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 5","pages":"220-231"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297708","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":"Updated Bivalent COVID-19 Vaccines Reduce Risk of Hospitalization and Severe Outcomes in Adults: An Observational Cohort Study.","authors":"Nicholas Mielke, Steven Johnson, Charlotte O'Sullivan, Mohammad Usama Toseef, Amit Bahl","doi":"10.14740/jocmr5145","DOIUrl":"10.14740/jocmr5145","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the real-world effectiveness of updated bivalent coronavirus disease 2019 (COVID-19) vaccines in adults, as the virus evolves and the need for new vaccinations increases.</p><p><strong>Methods: </strong>In this observational, retrospective, multi-center, cohort analysis, we examined emergency care encounters with COVID-19 in metro Detroit, Michigan, from January 1, 2022, to March 9, 2023. Patients were categorized by vaccination status: unvaccinated, fully vaccinated, fully vaccinated and boosted (FV&B), or fully vaccinated and bivalent boosted (FV&BB). The primary outcome was to assess the impact of bivalent COVID-19 vaccinations on the risk of composite severe outcomes (intensive care unit (ICU) admission, mechanical ventilation, or death) among patients presenting to a hospital with a primary diagnosis of COVID-19.</p><p><strong>Results: </strong>A total of 21,439 encounters met inclusion criteria: 9,630 (44.9%) unvaccinated, 9,223 (43.0%) vaccinated, 2,180 (10.2%) FV&B, and 406 (1.9%) FV&BB. The average age was 48.8, with 59.6% female; 61.1% were White, 32.8% Black, and 6.0% other races. Severe disease affected 5.5% overall: 5.0% unvaccinated, 5.7% vaccinated, 7.0% FV&B, and 4.7% FV&BB (P = 0.001). Severe disease rates among admitted patients were 13.3% unvaccinated, 11.9% vaccinated, 12.2% boosted, and 8.1% FV&BB (P = 0.052). The FV&BB group showed a 4.0% (P = 0.0369) lower risk of severe disease compared to FV&B and a 5.1% (P = 0.0203) lower probability of hospitalization.</p><p><strong>Conclusions: </strong>As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to mutate and evolve, updated vaccines are necessary to better combat COVID-19. In a real-world hospital-based population, this investigation demonstrates the incremental benefit of the bivalent booster vaccine in reducing the risk of hospitalization and severe outcomes in those diagnosed with COVID-19 compared to all other forms of vaccination.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 5","pages":"208-219"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297715","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":"Recurring ST-Elevation Myocardial Infarction With No-Reflow Caused by Hypercoagulable State: A Behcet Disease Case Report.","authors":"Ahmed Hegazi Abdelsamie, Nayef Al-Asiri","doi":"10.14740/jocmr5132","DOIUrl":"10.14740/jocmr5132","url":null,"abstract":"<p><p>Acute myocardial infarction (AMI) in young patients is an important issue because of its impact on health and social life. The mechanisms and disease courses of ST-elevation myocardial infarction (STEMI) in young individuals may differ from those in the elderly. Behcet disease (BD) is a multisystem autoimmune disorder of unknown etiology. Cardiac involvement is rare, yet it was reported to affect 6% of patients, with 17% of the cases presenting as the first manifestation. We present the case of a 33-year-old male heavy smoker with negative medical history, who presented with acute inferior myocardial infarction. His coronary angiography showed huge thrombosis in proximal right coronary artery. He was treated with primary coronary intervention and implantation of drug-eluting stent, with subsequent intervention and implantation of two more drug-eluting stents due to acute stent thrombosis within 48 h. Rheumatologic assessment revealed the history of four different attacks of oral ulcers and one attack of genital ulcer. His workup showed positive human leukocyte antigen (HLA) allele (B51) which is strongly associated with BD. AMI in young adults due to arterial thrombosis can be attributed to hypercoagulable state related to early manifestation of BD. Increased knowledge of AMI in young adults and its presentation in BD is necessary to reduce morbidity and mortality. Corticosteroids and colchicine may improve cardiac manifestations in BD.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 5","pages":"264-271"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297714","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":"Male Breast Cancer: Imaging Considerations for Diagnosis and Surveillance.","authors":"Mathew Thomas, Hatem Al Kashroom, Shilpa Reddy, Daniel Zaccarini, Katherine Willer","doi":"10.14740/jocmr5169","DOIUrl":"10.14740/jocmr5169","url":null,"abstract":"<p><p>Male breast cancer accounts for less than 1% of all breast cancer cases. The important risk factors for the development of male breast cancer are family history, genetic mutations, obesity, liver disease, alcoholism, exogenous estrogen administration, and radiation exposure to the chest area. Despite its rarity, numerous studies have investigated the data on imaging considerations (mammogram, ultrasound, and magnetic resonance imaging (MRI)), but have addressed only certain aspects of male breast cancer. A comprehensive approach on the imaging characteristics, timing of imaging, prognostication based on imaging characteristics, and follow-up strategies in male breast cancer are still lacking. The purpose of this review article was to provide a comprehensive overview of the imaging findings, optimal timing to obtain imaging, and the appropriate follow-up strategies in male breast cancer survivors. This article also describes how imaging modalities can aid in determining prognosis. By addressing this knowledge gap, the article provides valuable insights for clinicians managing this uncommon yet clinically significant disease.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 5","pages":"197-207"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297711","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":"Feasibility Study of a Prototype Wearable Inertial Measurement Unit for Elderly Postural Sway Assessment.","authors":"Siriphan Kongsawasdi, Chakrit Wiboonsuntharangkoon, Pattaraporn Tajarernmuang, Kittichai Wantanajittikul","doi":"10.14740/jocmr5125","DOIUrl":"10.14740/jocmr5125","url":null,"abstract":"<p><strong>Background: </strong>Falls are a major public health problem among older adults since they are a primary cause of injuries, functional decline and mortality. Identifying individuals susceptible to falls enables early intervention and prevention strategies. Currently, wearable sensors have emerged as a promising tool for assessing balance and mobility due to their affordability, compact size, and established efficacy. Therefore, the objective of the present study was to evaluate inertial measurement unit (IMU)-based postural sway metrics during quiet stance with four different bases of support and compare them among elderly individuals who are at risk of falling and those who are not.</p><p><strong>Methods: </strong>A triaxial IMU prototype was developed for evaluating postural sway during quiet stance, with various bases of support. Totally, 103 elderly participants with mean age of 68.5 ± 5.7 years were included. Sway metrics, including the root mean square (RMS) of magnitude, summation of range of signal (Range), summation of sway area (SA) and summation of distance (SD) were employed to detect sway perturbations.</p><p><strong>Results: </strong>All of the sway metrics revealed a significantly increasing magnitude of signal trajectory with a decreasing base of support. When comparing IMU sway metrics between groups of individuals at potential risk and non-risk of falls, statistically significant differences were observed in some variables, including RMS, Range, and SA during semi-tandem stance, and Range and SA during one-leg standing.</p><p><strong>Conclusions: </strong>The findings support earlier studies that demonstrated the objective nature of the IMU in assessing balance and predicting future risk of falls. Limited significant findings in this study may be due to the lower sampling rate of the IMU prototype (50 Hz) compared to commonly reported frequencies (100 Hz), as well as the inclusion of elderly ambulatory participants who were capable of being independent in their daily activities. The IMU is capable of providing comprehensive data, and detecting subtle changes, early signs of balance impairment and fall tendencies.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 4","pages":"174-181"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878335","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":"Intractable Postoperative Pancreatic Fistula: Undefined Type of Pancreatic Fistula Managed by Puestow-Like Procedure.","authors":"Basel Darawsha, Subhi Mansour, Tawfik Fahoum, Naseem Azzam, Hayim Gilshtein, Yoram Kluger, Ahmad Assalia, Safi Khuri","doi":"10.14740/jocmr5123","DOIUrl":"10.14740/jocmr5123","url":null,"abstract":"<p><p>Pancreatoduodenectomy (PD) is a very complex and highly challenging operation for surgeons worldwide. It is the surgical procedure of choice for the management of benign and malignant diseases of the periampullary region. Although mortality rate following this complicated surgery has fallen to 1-3%, morbidity rate following PD remains high, with almost 30-40% of patients developing at least one complication. Postoperative pancreatic fistula (POPF) is one of the most common complications following PD. Therefore, Pancreatico-enteric anastomosis has been regarded as the \"Achilles heel\" of the modern, one-stage PD procedure. According to the International Study Group of Pancreatic Surgery (ISGPS), three types of POPF are recognized nowadays: biochemical leak, previously known as grade A POPF, grade B and grade C, with the latter being the most dangerous. Most POPFs, especially of the biochemical leak and grade B heal with non-operative management to recur later and present as an intra-abdominal abscess or pseudocyst, necessitating management by means of interventional radiology, endoscopy or surgery. These types of fistulas are undefined and occasionally intractable. Herein, we present two patients who presented with the aforementioned type of pancreatic fistula following duct occlusion PD. The first patient, a 53-year-old female patient, suffered from intolerance to oral feeding, severe weight loss and recurrent hospital admission, while the second patient, a 72-year-old patient, suffered from recurrent bouts of abdominal sepsis. Their management involved step-up approach, starting with non-operative management, followed by percutaneous drainage and operative treatment in the form of Puestow-like procedure (longitudinal pancreatojejunostomy), as a recourse due to the inadequacy of preceding therapeutic modalities.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 4","pages":"182-188"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878336","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":"The Determinants of Eosinophilia in Patients With Severe Asthma.","authors":"Racha Abi Melhem, Marc Assaad, Khalil El Gharib, Hussein Rabah, Ali Kassem, Jordyn Salak, Saif Abu-Baker, Ahmad Itani","doi":"10.14740/jocmr5162","DOIUrl":"10.14740/jocmr5162","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Asthma is defined by the Global Initiative for Asthma (GINA) as a heterogeneous disease characterized by chronic airway inflammation. The pathogenesis of the disease is better understood with the comprehension of immunological pathways. These pathways differ by the type of recruited cells and released interleukin (IL). Thus, asthma can be classified into subtypes based on the underlying immune mechanism: eosinophilic asthma (EA) and non-eosinophilic asthma (NEA). Patients with EA tend to respond better to inhaled corticosteroid as compared to those with NEA. The distinction of EA is very important in the light of emergent type 2 inflammation targeted therapies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a 1-year (2018) retrospective cohort analysis of the Nationwide Inpatient Database (NIS). We included all adult patients presenting with severe asthma. Patients were stratified into two groups: eosinophilic severe asthma and non-eosinophilic severe asthma. The primary outcomes measures were the prevalence of chronic steroid use, status asthmaticus, family history of asthma, food, drug and environmental allergies, presence of nasal polyps, allergic rhinitis, allergic dermatitis, need for mechanical ventilation, need for oxygen supplementation, gastroesophageal reflux disease, in-hospital mortality, and length of stay. We performed descriptive statistics. Continuous parametric variables were reported using a mean and standard deviation. Continuous nonparametric variables were reported using a median and interquartile range. To compare the characteristics of the two groups, we used the independent &lt;i&gt;t&lt;/i&gt;-test for continuous parametric variables and the Mann-Whitney U test for continuous nonparametric variables. The Chi-square test was used to assess differences in categorical variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 2,646 patients were included, out of which 882 belonged to the eosinophilic group and 1,764 were in the non-eosinophilic group. Comparing EA versus NEA, we have found that eosinophilic group was characterized by higher percentage of steroid use (18.3% vs. 9.5%, P &lt; 0.001). This group also had higher rates of status asthmaticus and positive family history (P = 0.009 and 0.004, respectively). The presence of allergies, allergic rhinitis, nasal polyps, and allergic dermatitis was higher among patients with eosinophilia. The need for mechanical ventilation and supplemental oxygen was also higher among this group (P &lt; 0.001 for both); however, there was no significant difference in mortality rate (P = 0.347) and the length of hospital stay was similar in both groups (P &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We showed herein that the eosinophilic subtype of asthma differs widely from the non-eosinophilic phenotype. Clinically, patients with eosinophilia might exhibit different symptomatology, more atopy, and concomitant comorbidities. However, this group might have better response to steroi","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 4","pages":"133-137"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878340","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":"Significance of Hypoalbuminemia in the Development of Thromboembolic Complications in Severe Cases of SARS-CoV-2 Coronavirus Infection.","authors":"Aida Tarzimanova, Anna Bragina, Anna Pokrovskaya, Alexander Ivannikov, Ekaterina Sokolova, Igor Cherkesov, Tatyana Safronova, Tatyana Vargina, Liubov Ponomareva, Alyona Isaeva, Karine Oganesyan, Valery Podzolkov","doi":"10.14740/jocmr5119","DOIUrl":"10.14740/jocmr5119","url":null,"abstract":"<p><strong>Background: </strong>The course of coronavirus disease 2019 (COVID-19) is associated with the progression of a wide range of complications, among which thrombosis and thromboembolism are of particular importance. The significance of hypoalbuminemia in the development of thromboembolic complications (TECs) in patients with a severe course of COVID-19 is currently under active discussion. The objective of our study was to evaluate the significance of hypoalbuminemia in the development of TECs in patients with severe SARS-CoV-2 coronavirus infection.</p><p><strong>Methods: </strong>In a single-center observational retrospective study, case histories of 1,634 patients with a verified diagnosis of SARS-CoV-2 coronavirus infection were analyzed. Patients were divided into two groups according to the presence of TECs: 127 patients with venous TECs constituted the main group and 1,507 patients, in whom the course of COVID-19 was not complicated by the development of TECs, constituted the comparison group.</p><p><strong>Results: </strong>The patients with TECs were older, and the prevalence of arterial hypertension, coronary heart disease, chronic heart failure, chronic kidney disease, and diabetes mellitus was higher than that in the comparison group. A single-factor regression analysis showed that a decrease in albumin levels of less than 35 g/L is associated with an eightfold increase in the risk of developing TECs in patients with severe SARS-CoV-2 coronavirus infection (area under the curve (AUC): 0.815, odds ratio (OR): 8.5389, 95% confidence interval (CI): 4.5637 - 15.977, P < 0.001). The sensitivity of the method was 76.34%, and the specificity was 72.58%.</p><p><strong>Conclusion: </strong>The study revealed that hypoalbuminemia is a predictor of development of TECs in severe cases of SARS-CoV-2 coronavirus infection.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 4","pages":"164-169"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878338","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":"Rheumatoid Arthritis and Its Implications on Inflammatory Bowel Disease.","authors":"Evelyn Calderon-Martinez, Diana Gavilanes, Esmeralda Vilchez, Adalberto Guzman, Wern Ng, Christian Zevallos-Delgado, Anas Atrash","doi":"10.14740/jocmr5121","DOIUrl":"10.14740/jocmr5121","url":null,"abstract":"<p><strong>Background: </strong>The association between inflammatory bowel disease (IBD) and arthritis has long been known, but it was not until the 1950s that IBD-associated arthritis was recognized as a distinct pathology independent from rheumatoid arthritis (RA). There is evidence that RA and other autoimmune conditions exist at higher rates in patients with IBD compared to the general population. We aimed to determine if the presence of RA in IBD patients is a factor for mortality and IBD-related surgery in this population.</p><p><strong>Methods: </strong>Using Epic's Slicer Dicer function, we queried the International Classification of Diseases, 10th Revision (ICD-10) codes K50 and K51 to identify patients with IBD. Duplicates and those with incomplete information were excluded, leaving a total of 3,613 patients. Data collected included basic demographic information, surgical history, and the presence of RA. We used Student's <i>t</i>-test to analyze between group differences for the continuous variables. When it was determined that variances for the comparisons of continuous data were unequal, Welch-Satterthwaite <i>t</i>-test statistics were used. We used the Chi-square test to analyze between group differences for the categorical variables. The Fisher's exact test was employed when any of the expected frequencies was 5 or less. All tests were two-sided with criterion for statistical significance at a P value less than 0.05. All the analyses were done by SAS 9.4 (SAS Institute, Cary, NC).</p><p><strong>Results: </strong>Of the approximately 2.7 million adults in Slicer Dicer, there were 3,613 patients (0.13%) identified with IBD. Patients with ulcerative colitis (UC) accounted for 37% of the total group (n = 1,343) and 2,270 patients (62.8%) had Crohn's disease (CD). From the total, 2,084 were women (57.68%) and 1,529 (42.32%) were men. More than 90% of the patients were white (n = 3,321). The mean age was 53.3 ± 18.5. Eight hundred forty-eight patients (23.47%) had documented RA. Mortality was higher in patients with IBD and RA than those with IBD alone (7.31% vs. 3.98%, P value ≤ 0.0001).</p><p><strong>Conclusions: </strong>IBD patients with RA have higher mortality rates and need for IBD-related surgery than patients with IBD alone.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 4","pages":"170-173"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878337","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":"Biliary Tract Disorders and Associated Acute Complications in Patients With Acromegaly: A Single-Center Study.","authors":"Lamiae Zarraa, Imane Assarrar, Oumaima Magouri, Zahi Ismaili, Siham Rouf, Hanane Latrech","doi":"10.14740/jocmr5140","DOIUrl":"10.14740/jocmr5140","url":null,"abstract":"<p><strong>Background: </strong>Biliary complications are frequent in patients with acromegaly. These complications may be secondary either to acromegaly or to somatostatin analogs (SAs). We aimed in this paper to assess the prevalence of biliary complications in patients with acromegaly at diagnosis and after treatment with SAs.</p><p><strong>Methods: </strong>We conducted an analytical and descriptive retrospective study of 26 patients followed up for acromegaly over 7 years. Biliary complications were screened at diagnosis and follow-up by abdominal ultrasound, biliary magnetic resonance imaging (MRI), and endoscopic ultrasonography (EUS). Data were analyzed using SPSS 21.</p><p><strong>Results: </strong>The mean age of the patients was 49.6 ± 14 years, with a female predominance (53.8%). The evaluation of biliary complications showed vesicular biliary tract lithiasis and/or sludge in seven patients (29%), including two patients at the time of diagnosis of acromegaly and five patients after an average medical treatment duration of 3 years. Six female patients (24%) had dilation of the bile ducts without the presence of obstruction on biliary MRI and EUS and lithiasis/sludge of the common bile duct, tumor or external compression have been excluded. This condition was discovered incidentally at the diagnosis in five patients and during the follow-up in one patient. The preoperative insulin-like growth factor 1 (IGF-1) levels, disease duration, and female sex were significantly correlated with biliary tract dilation occurrence. Dyslipidemia, the preoperative IGF-1 level, and lanreotide treatment duration were significantly correlated with the occurrence of biliary lithiasis (P < 0.05).</p><p><strong>Conclusion: </strong>Biliary stones are a frequent biliary adverse effect in patients with acromegaly undergoing SAs treatment. However, primary bile duct dilation has never been reported in acromegaly to the best of our knowledge. This condition could be considered as a complication or a feature of the disease.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 4","pages":"155-163"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878334","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}