Journal of clinical medicine research最新文献

{"title":"Clinical Characteristics Analysis of Hospitalized Patients Infected with the Omicron Variant of the Novel Coronavirus","authors":"Chao Rui, Liyun Chen, Hui He, Fen Huang, Zhi Zhang","doi":"10.32629/jcmr.v4i3.1310","DOIUrl":"https://doi.org/10.32629/jcmr.v4i3.1310","url":null,"abstract":"Objective: It’s to analyze the clinical characteristics of hospitalized patients infected with the Omicron variant of the novel coronavirus. Methods: This study retrospectively analyzed the clinical data of 374 Omicron-infected patients admitted to The Third People's Hospital of Wuhu City from January 1, 2022, to December 31, 2022. Clinical characteristics were analyzed. Results: The mean time to nucleic acid conversion was 10.93±3.55 days, with a median of 10 days. There was no statistically significant difference in the infection rate between females and males (P>0.05). The highest proportion of patients was in the age group of 0-44 years (P<0.05). Among patients, those without underlying diseases were more prevalent (P<0.05). The majority of patients had no symptoms or mild symptoms (P<0.05). Regarding vaccination status, most patients had completed the primary immunization or booster immunization (P<0.05). The main symptoms were fever and respiratory symptoms (P<0.05). In laboratory tests, some patients showed a decrease in lymphocyte count (31.82%), elevated C-reactive protein (21.93%), elevated alanine transaminase (18.18%), and elevated creatine kinase (12.30%). Most patients had no lesions on chest CT scans (P<0.05). Traditional Chinese medicine was the primary treatment used (P<0.05). The recovery rate was 100.00%. Conclusion: During this epidemic, the nucleic acid conversion for infected patients occurred around 10 days. Female patients had a higher infection rate, and the majority of cases were asymptomatic or mild. Most patients had completed either primary or booster immunization, indicating some resistance of the Omicron variant to vaccines. The main symptoms were fever and respiratory symptoms, and patients had significantly elevated white blood cell counts, neutrophil counts, and lymphocyte counts, indicating significant infection symptoms. Traditional Chinese medicine was the primary treatment used, and the recovery rate was 100.00%, suggesting that treatment with Traditional Chinese medicine was effective for the Omicron variant.","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"135 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135322006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application Prospect of Monopolar Low-temperature Plasma Knife in Oral and Maxillofacial Surgery","authors":"Chengwei Li, Xiaosheng Fan, Yixuan Zhang, Lan Wang, Kuangzheng Li","doi":"10.32629/jcmr.v4i3.1308","DOIUrl":"https://doi.org/10.32629/jcmr.v4i3.1308","url":null,"abstract":"Oral and maxillofacial surgery is primarily responsible for the treatment of oral and maxillofacial tumors, jaw fractures, maxillary sinusitis, and other temporomandibular joint diseases using surgical techniques. With improvements in living conditions and dietary changes, the demand for diagnosis and treatment in oral and maxillofacial surgery has been steadily increasing. Simultaneously, both patients and healthcare providers have higher expectations for intraoperative effectiveness and postoperative recovery. With the advancement of technology, surgical knives in oral and maxillofacial surgery have gradually transitioned from traditional physical blades to high-frequency electric scalpels. However, high-frequency electric scalpels have drawbacks, including substantial tissue damage, the generation of intraoperative smoke, electrode adhesion, imprecise cutting, and reliance on traditional surgical blades. This paper proposes the idea of using a monopolar low-temperature plasma knife in oral and maxillofacial surgery, with a focus on research utilizing the monopolar low-temperature plasma surgical system produced by Jingyi Medical (Host Model: PSG-60A; Electrode Model: PS-01) as an example. This equipment disrupts tissue molecular bonds through the low-temperature plasma layer formed around the knife tip, allowing for tissue cutting and separation. This approach significantly reduces tissue damage compared to traditional surgical blades and high-frequency electric scalpels, while also simplifying surgical procedures, improving cutting precision, and enhancing postoperative recovery. Through this research, it can be observed that the monopolar low-temperature plasma knife has significant potential for widespread application in oral and maxillofacial surgery.","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"63 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135317205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Efficacy of Different Doses of Intensity-modulated Radiation Therapy After Breast-conserving Surgery for Early-stage Breast Cancer","authors":"Juan Deng, Chuou Yin, Hao Cheng, Gaoyuan Liu","doi":"10.32629/jcmr.v4i3.1256","DOIUrl":"https://doi.org/10.32629/jcmr.v4i3.1256","url":null,"abstract":"Objective — To investigate the efficacy of different doses of intensity modulated radiation therapy in patients with early breast cancer after breast conserving surgery in order to provide more accurate treatment guidelines for clinical practice to further improve treatment outcomes and quality of life in breast cancer patients. Methods — The main objective of this study was to evaluate the effects of different radiotherapy regimens after breast conserving surgery for early stage breast cancer. The study included 96 patients with early-stage breast cancer who were treated in our oncology department between January 2020 and May 2021. Patients were self-divided into group A and Group B by double-blind method, with 48 patients in each group. Group A received radiation therapy of 50Gy/25Fx for the whole breast after surgery, and an additional dose of 60Gy/25Fx was added to irradiate the tumor bed. Group B received whole breast radiation therapy of 50Gy/25Fx and tumor bed push of 10Gy/5Fx at the same time. The study will compare the differences between the two groups in treatment outcomes, three-year survival, and various adverse events that occur within six months of radiotherapy. Results — When comparing the two groups with different doses of IMRT, the authors focused on the difference in the percentage of the combined volume of prescription dose exposure above the percentage measurement line and the target dose uniformity index. The results showed very significant statistical differences between the two groups for both measures. In addition, it is worth noting that the probability of adverse reactions in group B patients exceeded that in group A, with a statistically significant difference. Conclusion — For patients undergoing breast conserving surgery for early stage breast cancer, receiving radiation therapy with a total dose of 60Gy can significantly improve treatment outcomes. Compared with other dosing regimens, the use of 60Gy intensity modulated radiation therapy can significantly reduce the incidence of adverse reactions while achieving the same therapeutic effect.","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"EM-11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135322007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypernatremia: Epidemiology and Predictive Role in Emerging and Established Acute Kidney Injury.","authors":"Clara Jansch,&nbsp;Igor Matyukhin,&nbsp;Marahrens Marahrens,&nbsp;Rebecca Lehmann,&nbsp;Baschar Khader,&nbsp;Oliver Ritter,&nbsp;Susann Patschan,&nbsp;Daniel Patschan","doi":"10.14740/jocmr4990","DOIUrl":"10.14740/jocmr4990","url":null,"abstract":"<p><p>Hypernatremia (plasma sodium > 145 mmol/L) reflects impaired water balance, and affected patients can suffer from severe neurologic symptoms. Hyponatremia, on the other hand, is the most frequent electrolyte disorder in hospitals. It may be diagnosed in acute kidney injury (AKI), but hyponatremia prior to the diagnosis of AKI has also predictive or prognostic value in the short term. Aim of the article was to summarize data on both, epidemiology and outcomes of in-hospital acquired hypernatremia (\"In-hospital acquired\" refers to the diagnosis of either hypo- or hypernatremia in patients, who did not exhibit any of these electrolyte imbalances upon admission to the hospital). It also aimed to discuss its predictive role in patients with emerging or established AKI. Five databases were searched for references: PubMed, Medline, Google Scholar, Scopus, and Cochrane Library. Studies published between 2000 and 2023 were screened. The following keywords were used: \"hypernatremia\", \"mortality\", \"pathophysiology\", \"acute kidney injury\", \"AKI\", \"risk prediction\", \"kidney replacement therapy\", \"KRT\", \"renal replacement therapy\", \"RRT\", \"hyponatremia\", and \"heart failure\". A total of 16 studies were deemed eligible for inclusion. Among these, 13 studies had a retrospective design, two investigations were published as secondary analyses from prospective trial cohorts, and one study was prospective in nature. Out of the 16 studies, 11 focused on the epidemiology and outcomes of hypernatremia, while five investigations were related to AKI and/or AKI-associated endpoints. The prevalence of hypernatremia diagnosed during hospitalization varied from 1.9% to 6.8%, with one exception where it was 30.8%. All studies demonstrated associations between hypernatremia and mortality, even over extended periods after discharge. In AKI patients, hypernatremia shows potential for predicting in-hospital death. In conclusion, hypernatremic individuals are at higher risk of death during in-hospital therapy. Also, the electrolyte disorder potentially qualifies as a future biomarker for AKI onset and AKI-associated mortality.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"15 8-9","pages":"399-405"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/84/jocmr-15-399.PMC10563820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224813","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":"Beyond Human Limits: Harnessing Artificial Intelligence to Optimize Immunosuppression in Kidney Transplantation.","authors":"Debargha Basuli,&nbsp;Sasmit Roy","doi":"10.14740/jocmr5012","DOIUrl":"10.14740/jocmr5012","url":null,"abstract":"<p><p>The field of kidney transplantation is being revolutionized by the integration of artificial intelligence (AI) and machine learning (ML) techniques. AI equips machines with human-like cognitive abilities, while ML enables computers to learn from data. Challenges in transplantation, such as organ allocation and prediction of allograft function or rejection, can be addressed through AI-powered algorithms. These algorithms can optimize immunosuppression protocols and improve patient care. This comprehensive literature review provides an overview of all the recent studies on the utilization of AI and ML techniques in the optimization of immunosuppression in kidney transplantation. By developing personalized and data-driven immunosuppression protocols, clinicians can make informed decisions and enhance patient care. However, there are limitations, such as data quality, small sample sizes, validation, computational complexity, and interpretability of ML models. Future research should validate and refine AI models for different populations and treatment durations. AI and ML have the potential to revolutionize kidney transplantation by optimizing immunosuppression and improving outcomes. AI-powered algorithms enable personalized and data-driven immunosuppression protocols, enhancing patient care and decision-making. Limitations include data quality, small sample sizes, validation, computational complexity, and interpretability of ML models. Further research is needed to validate and enhance AI models for different populations and longer-term dosing decisions.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"15 8-9","pages":"391-398"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/d4/jocmr-15-391.PMC10563819.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224811","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":"Opioid Free Total Intravenous Anesthesia With Dexmedetomidine-Esketamine-Lidocaine for Patients Undergoing Lumpectomy.","authors":"Xia Li Qian, Ping Li, Ya Jie Chen, Shi Qin Xu, Xian Wang, Shan Wu Feng","doi":"10.14740/jocmr5000","DOIUrl":"10.14740/jocmr5000","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to evaluate the feasibility of the opioid-free anesthesia (OFA) technique with dexmedetomidine, esketamine, and lidocaine among patients diagnosed with benign breast mass and scheduled for lumpectomy.</p><p><strong>Methods: </strong>We enrolled 80 female patients who were aged from 18 to 60 years, graded with American Society of Anesthesiologists physical status I or II, diagnosed with benign breast mass, and scheduled for lumpectomy. These patients were randomly treated with OFA or opioid-based anesthesia (OBA). Dexmedetomidine-esketamine-lidocaine and sufentanil-remifentanil were administered in OFA and OBA group, respectively. We mainly compared the analgesic efficacy of OFA and OBA technique, as well as intraoperative hemodynamics, the quality of recovery, and satisfaction score of patients.</p><p><strong>Results: </strong>There was no significant difference between the two groups with regard to visual analogue scale (VAS) score at 2, 12, and 24 h after extubation. However, the time to first rescue analgesic was prolonged in OFA group than that in OFB group (6.18 ± 1.00 min vs. 7.40 ± 0.92 min, P = 0.000). Further, mean arterial pressure and heart rate at T0 (entering operating room), T1 (before anesthesia induction), T2 (immediately after intubation), T3, T4, and T5 (1, 5, and 10 min after surgical incision, respectively) were significantly higher in OFA group than that in OBA group. Incidence of hypotension and bradycardia was lower in OFA group. Consistently, fewer patients in OFA group consumed atropine (8% vs. 32%, P = 0.019) and ephedrine (5% vs. 38%, P = 0.001) compared to OBA group. Furthermore, patients in OFA group had a longer awakening time (7.14 ± 2.63 min vs. 4.54 ± 1.14 min, P = 0.000) and recovery time of orientation (11.76 ± 3.15 min vs. 6.92 ± 1.19 min, P = 0.000). Fewer patients in the OFA group experienced postoperative nausea and vomiting (PONV) (11% vs. 51%, P = 0.000) and consumed ondansetron (5% vs. 35%, P = 0.003) compared to OBA group. And patients in OFA group had a higher satisfaction score than those in OBA group (9 (8 - 9) vs. 7 (7 - 8), P = 0.000).</p><p><strong>Conclusion: </strong>For patients undergoing lumpectomy, OFA technique with dexmedetomidine-esketamine-lidocaine showed a better postoperative analgesic efficacy, a more stable hemodynamics, and a lower incidence of PONV. However, such advantage of OFA technique should be weighed against a longer awakening time and recovery time of orientation in clinical practice.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"15 8-9","pages":"415-422"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/cb/jocmr-15-415.PMC10563822.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224814","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":"Retrospective Study of IDegLira, a New Fixed-Ratio Combination, in Japanese Patients With Type 2 Diabetes Mellitus: Analysis of Background Factors Affecting Effectiveness After 6 Months of Treatment.","authors":"Hodaka Yamada,&nbsp;Jun Morimoto,&nbsp;Shunsuke Funazaki,&nbsp;Shiori Tonezawa,&nbsp;Asuka Takahashi,&nbsp;Masashi Yoshida,&nbsp;Shuichi Nagashima,&nbsp;Kazuo Hara","doi":"10.14740/jocmr4995","DOIUrl":"10.14740/jocmr4995","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to provide real-world data on the effectiveness and safety of a new fixed-ratio combination, insulin degludec/liraglutide (IDegLira) injection in Japanese patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>The primary endpoint was the change in glycated hemoglobin (HbA1c) level 6 months after the introduction of IDegLira. We also examined the rate of achievement of target HbA1c 7% and the individualized HbA1c targets set for each patient. Baseline characteristics associated with the change in HbA1c were also assessed. Seventy-five patients with T2DM were included in the analysis.</p><p><strong>Results: </strong>After the initiation of IDegLira, HbA1c decreased significantly from baseline with a change of -1.81% (baseline 9.61% and at 6 months 7.80%; P < 0.001). At baseline, the achievement rate of 7% HbA1c was 2.67% (n = 2), which increased to 36.0% (n = 27) after 6 months of IDegLira introduction (P < 0.05). The attainment rate of individualized HbA1c targets, which were set considering each patient's characteristics, improved from 2.67% (n = 2) to 49.3% (n = 37) (P < 0.001). Regardless of sex, body mass index, estimated glomerular filtration rate, duration of diabetes, or history of glucagon-like peptide-1 receptor agonist use, IDegLira significantly reduced HbA1c, but a higher C-peptide index was associated with a greater reduction in HbA1c.</p><p><strong>Conclusion: </strong>In this study, initiation of IDegLira in a real-world clinical setting was beneficial in lowering HbA1c in Japanese T2DM patients with inadequate glycemic control with existing therapy.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"15 8-9","pages":"406-414"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/e6/jocmr-15-406.PMC10563818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224815","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":"Computer-Aided Pulmonary Fibrosis Detection Leveraging an Advanced Artificial Intelligence Triage and Notification Software.","authors":"Kavitha C Selvan, Angad Kalra, Joshua Reicher, Michael Muelly, Ayodeji Adegunsoye","doi":"10.14740/jocmr5020","DOIUrl":"10.14740/jocmr5020","url":null,"abstract":"<p><strong>Background: </strong>Improvement in recognition and referral of pulmonary fibrosis (PF) is vital to improving patient outcomes within interstitial lung disease. We determined the performance metrics and processing time of an artificial intelligence triage and notification software, ScreenDx-LungFibrosis™, developed to improve detection of PF.</p><p><strong>Methods: </strong>ScreenDx-LungFibrosis™ was applied to chest computed tomography (CT) scans from multisource data. Device output (+/- PF) was compared to clinical diagnosis (+/- PF), and diagnostic performance was evaluated. Primary endpoints included device sensitivity and specificity > 80% and processing time < 4.5 min.</p><p><strong>Results: </strong>Of 3,018 patients included, PF was present in 22.9%. ScreenDx-LungFibrosis™ detected PF with a sensitivity and specificity of 91.3% (95% confidence interval (CI): 89.0-93.3%) and 95.1% (95% CI: 94.2-96.0%), respectively. Mean processing time was 27.6 s (95% CI: 26.0 - 29.1 s).</p><p><strong>Conclusions: </strong>ScreenDx-LungFibrosis™ accurately and reliably identified PF with a rapid per-case processing time, underscoring its potential for transformative improvement in PF outcomes when routinely applied to chest CTs.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"15 8-9","pages":"423-429"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/92/jocmr-15-423.PMC10563821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224812","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":"Exploration of Clinical Characteristics and Drug Treatment of Inflammatory Bowel Disease Complicated with Autoimmune Diseases","authors":"Jiawei Guo","doi":"10.32629/jcmr.v4i3.1260","DOIUrl":"https://doi.org/10.32629/jcmr.v4i3.1260","url":null,"abstract":"Objective: To analyze the clinical characteristics and drug treatment outcomes of inflammatory bowel disease (IBD) complicated with autoimmune diseases. Methods: A total of 200 patients with IBD and autoimmune diseases were selected as the observation group from January 2022 to June 2023. In addition, 200 patients with simple IBD during the same period were selected as the control group. The general and clinical data of the two groups of patients were collected and analyzed to compare their clinical characteristics and drug treatment outcomes. Results: ① There were no significant differences in gender, age, lesion location, and clinical type between the two groups (P > 0.05). However, the two groups differed significantly in terms of disease duration, severity of the condition, and extraintestinal symptoms (P < 0.05). ② There was no significant difference in the use of microbial preparations between the two groups (P > 0.05). The observation group had a higher usage rate of steroids compared to the control group, while the usage rate of aminosalicylate suppositories was lower in the observation group than in the control group (P < 0.05). ③ There was no significant difference in treatment efficacy between the two groups (P > 0.05). Conclusion: Patients with IBD complicated by autoimmune diseases have longer disease duration, more severe conditions, and more extraintestinal symptoms compared to those with simple IBD. The usage rate of steroids is higher, while the usage rate of aminosalicylate suppositories is lower in the treatment plan for the former group. Nevertheless, the overall effectiveness is comparable to that of patients with simple IBD, and the overall prognosis is relatively favorable.","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of ABC (Hemoglobin A1c, Blood Pressure and Low-Density Lipoprotein Cholesterol) Goal Achievement With Chronic Kidney Disease in Type 2 Diabetic Patients With Preserved Kidney Function.","authors":"Satomi Minato, Akiko Takenouchi, Kaori Kitaoka, Mika Takeuchi, Ayaka Tsuboi, Miki Kurata, Keisuke Fukuo, Tsutomu Kazumi","doi":"10.14740/jocmr4001","DOIUrl":"10.14740/jocmr4001","url":null,"abstract":"<p><strong>Background: </strong>We investigated cross-sectional and prospective associations of ABC (hemoglobin A1c (HbA1c), blood pressure and low-density lipoprotein cholesterol) goal attainment with chronic kidney disease. Cross-sectional association with carotid intima-media thickness (IMT) was evaluated as well.</p><p><strong>Methods: </strong>Prevalence of low estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m²) and albuminuria (urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g) were assessed at baseline and after a median follow-up of 6.0 years in 168 patients with type 2 diabetes with preserved kidney function (aged 62.3 years, 53.6% men). Carotid IMT was measured at baseline only.</p><p><strong>Results: </strong>At baseline, 47 (28.0%), 45 (26.8%), 63 (37.5%) and 13 (7.7%) patients achieved triple-goal, dual-goal, single-goal and no-goal, respectively. Achieving more ABC targets was associated with lower log ACR (P < 0.01), lower percentage of albuminuria (P = 0.02), and lower carotid IMT (P < 0.01) at baseline. Over 6.0 years, eGFR decreased from 76 ± 16 to 67 ± 18 mL/min/1.73 m² (P < 0.01) whereas ACR levels did not change. There were 32 patients with incident reduced eGFR, eight with GFR stage progression, 15 with progression of albuminuric stages and five with doubling of ACR within the microalbuminuric range. Achieving more ABC targets decreased the percentage of deterioration of GFR stages (30.8%, 28.6%, 24.4% and 14.9%, respectively, P = 0.01). Achieving two or more (8.9% and 8.5%, respectively) compared with one or less ABC targets (15.4% and 15.9%, respectively) was associated with less deterioration of albuminuria (P < 0.001). Although achieving more ABC targets was associated with lower annual decline in eGFR, the difference was not significant.</p><p><strong>Conclusions: </strong>ABC goal achievement has shown cross-sectional and prospective associations with deterioration of chronic kidney disease in type 2 diabetic patients with preserved kidney function. Cross-sectional association with carotid IMT has been demonstrated as well. Reaching more ABC treatment targets may be important for preventing adverse renal outcomes.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"11 12","pages":"818-824"},"PeriodicalIF":1.6,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/c6/jocmr-11-818.PMC6879039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49687105","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}