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Initiation of Type 2 Diabetes Mellitus Medications in the NGHA Healthcare System in Saudi Arabia: Contemporary Trends 沙特阿拉伯NGHA医疗保健系统中2型糖尿病药物的启动:当代趋势
IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01 DOI: 10.1016/j.curtheres.2025.100809
Mesnad S. Alyabsi PhD , Lolwah Almousa BS , Anwar H. Alqarni BS , Asma Aldawsari MS , Lubna Alnasser PhD , Adel F. Almutairi PhD

Background

Continuous updates in management guidelines for type 2 diabetes mellitus (T2DM) have affected treatment patterns. In this study, we aimed to identify the prevalence of initiating various antidiabetic medications and analyze differences in patient characteristics based on the type of treatment initiated.

Methods

This cross-sectional study used data retrieved from the electronic medical records of the National Guard Health Affairs for all patients diagnosed with T2DM who initiated any antidiabetic therapy between January 2018 and May 2022. Patient data were presented using frequencies, percentages, means, and standard deviations where applicable. The antidiabetic classes investigated include metformin, insulin, sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, and sodium–glucose cotransporter-2 inhibitors.

Results

In total, 433 patients with T2DM were included in this study, most of whom were females (55.66% vs 44.34%) and obese (61.20%), with a mean age of 53.29 years (SD ± 15.22). Monotherapy was the most commonly initiated approach (66.28%), with insulin being the most prescribed monotherapy (29.10%). The most frequent combination therapy was metformin and sulfonylureas (7.16%). Overall, the most initiated medication was metformin, accounting for 37.12% of all prescriptions. Additionally, there was an increasing trend in prescribing newer medications, such as GLP-1 receptor agonists (8.70%) and SGLT-2 inhibitors (11.11%), for newly diagnosed patients in 2021.

Conclusion

The initiation of novel antidiabetic medications has increased over the study period, reflecting recent updates in T2DM management guidelines. However, further understanding of their benefits is required for optimal patient care.
背景:2型糖尿病(T2DM)治疗指南的不断更新影响了治疗模式。在本研究中,我们旨在确定开始使用各种降糖药物的患病率,并根据开始使用的治疗类型分析患者特征的差异。方法:本横断面研究使用国民警卫队卫生事务电子病历中检索的数据,用于2018年1月至2022年5月期间开始任何降糖治疗的所有诊断为T2DM的患者。使用频率、百分比、平均值和标准偏差(如适用)来呈现患者数据。研究的抗糖尿病药物包括二甲双胍、胰岛素、磺脲类药物、噻唑烷二酮类药物、二肽基肽酶-4抑制剂、胰高血糖素样肽-1受体激动剂和钠-葡萄糖共转运蛋白-2抑制剂。结果共纳入T2DM患者433例,以女性(55.66% vs 44.34%)和肥胖(61.20%)居多,平均年龄53.29岁(SD±15.22)。单药治疗是最常见的方法(66.28%),胰岛素是最常用的单药治疗(29.10%)。最常见的联合治疗是二甲双胍和磺脲类药物(7.16%)。总体而言,最开始使用的药物是二甲双胍,占所有处方的37.12%。此外,2021年新诊断患者使用GLP-1受体激动剂(8.70%)和SGLT-2抑制剂(11.11%)等新药的趋势也在增加。在研究期间,新型抗糖尿病药物的使用有所增加,这反映了最近T2DM管理指南的更新。然而,为了获得最佳的患者护理,需要进一步了解它们的益处。
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引用次数: 0
Effect of Intravenous Lidocaine on Postoperative Cognitive Dysfunction in Patients Undergoing Laparoscopic Colorectal Surgery: A Two-Center, Randomized, Double-Blind Controlled Trial 静脉注射利多卡因对腹腔镜结直肠手术患者术后认知功能障碍的影响:一项双中心、随机、双盲对照试验
IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01 DOI: 10.1016/j.curtheres.2025.100808
Ke-peng Liu , Jing Dai , Fu-rong Huang , Hui-wei Deng , Qi Wang , Yun Liu , Yong Chen , Lilong Mo , Fangni Cao , Yan Zhang , Hua-jing Guo , Xian-xue Wang

Background

In patients undergoing gastrointestinal surgery, enhancing perioperative cognitive function and facilitating expedited postoperative recovery are critical components for achieving swift rehabilitation. Intravenous administration of lidocaine has been shown to mitigate the perioperative inflammatory response in surgical patients; however, its influence on postoperative cognitive performance remains unassessed. Consequently, this study was conducted to investigate the impact of intravenous lidocaine on postoperative cognitive function in participants undergoing laparoscopic surgery for colorectal cancer.

Methods

We performed a prospective, randomized controlled trial at The First People’s Hospital of Changde City and Zhongshan People’s Hospital to assess the impact of intravenous lidocaine on postoperative cognitive dysfunction (POCD) in patients undergoing laparoscopic radical resection for colorectal carcinoma. The primary endpoints of our investigation included Mini-Mental State Examination (MMSE) scores measured preoperatively and 7 days postoperatively, as well as the incidence of POCD at the 7-day mark following surgery. Secondary outcomes comprised an evaluation of recovery parameters in the postanesthesia care unit, overall length of hospitalization, and the prevalence of postoperative complications in both study cohorts.

Results

The occurrence of POCD at day 7 postsurgery was significantly lower in the lidocaine group compared to the placebo group (P < 0.05). When stratified by age, both elderly patients (≥65 years) and nonelderly patients in the lidocaine group exhibited a significantly reduced incidence of POCD on the seventh day postoperatively compared to the placebo group (P < 0.05). Preoperative MMSE scores were comparable between the two groups; however, on the seventh day after surgery, the lidocaine group had significantly higher MMSE scores than the placebo group (P < 0.05). In the nonelderly cohort, MMSE scores were also significantly elevated in the lidocaine group compared to the placebo group at day 7 postsurgery (P < 0.05). Mediation analysis indicated that lidocaine’s influence on the incidence of POCD on the seventh postoperative day was partially mediated by propofol. Furthermore, there were no significant differences observed in intraoperative medication, postoperative recovery, or perioperative adverse events between the groups (P > 0.05).

Conclusions

Perioperative administration of intravenous lidocaine has been shown to significantly enhance cognitive function on the seventh postoperative day following laparoscopic colorectal surgery. The mediating influence of propofol on the association between lidocaine and the occurrence of POCD at this time point was determined to be 10%.
背景对于胃肠手术患者,增强围手术期认知功能和促进术后快速恢复是实现快速康复的关键组成部分。静脉注射利多卡因已被证明可以减轻手术患者围手术期的炎症反应;然而,其对术后认知能力的影响仍未得到评估。因此,本研究旨在探讨静脉注射利多卡因对结肠直肠癌腹腔镜手术患者术后认知功能的影响。方法在常德市第一人民医院和中山市人民医院进行前瞻性、随机对照试验,评估静脉注射利多卡因对腹腔镜大肠癌根治术患者术后认知功能障碍(POCD)的影响。我们研究的主要终点包括术前和术后7天的迷你精神状态检查(MMSE)评分,以及术后7天POCD的发生率。次要结果包括评估麻醉后护理单元的恢复参数、住院总时间和两个研究队列的术后并发症发生率。结果利多卡因组术后第7天POCD发生率明显低于安慰剂组(P < 0.05)。当按年龄分层时,利多卡因组的老年患者(≥65岁)和非老年患者在术后第7天的POCD发生率均明显低于安慰剂组(P < 0.05)。两组术前MMSE评分具有可比性;但术后第7天,利多卡因组MMSE评分显著高于安慰剂组(P < 0.05)。在非老年队列中,利多卡因组术后第7天MMSE评分也显著高于安慰剂组(P < 0.05)。中介分析表明,利多卡因对术后第7天POCD发生率的影响部分是由异丙酚介导的。此外,两组在术中用药、术后恢复、围手术期不良事件方面均无显著差异(P > 0.05)。结论术中静脉注射利多卡因可显著提高腹腔镜结直肠癌术后第7天患者的认知功能。在此时间点,异丙酚对利多卡因与POCD发生的关联的中介作用确定为10%。
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引用次数: 0
Surgical Antibiotic Prophylaxis Used in A University Clinics Hospital and Antibiotic Costs: A 3-year Survey 某大学医院外科抗生素预防使用与抗生素费用:一项为期3年的调查
IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01 DOI: 10.1016/j.curtheres.2025.100807
Vianney N. Ntabaza PhD , Antonelle Pardo PhD , Amandine Nachtergael PhD , Julien Bamps MSc , Salvius A. Bakari PhD , Pierre Duez PhD , Stephanie Patris PhD , Byanga Kahumba PhD

Background

Surgical Site Infections (SSIs) represent one of the most common post-operative complications and are the third most prevalent nosocomial infections.

Objective

The objective of this study was to analyze the conditions of using antibiotics in surgery at the University Clinics of Lubumbashi.

Methods

A retrospective study was conducted, collecting data from medical registers over a 3-year period, from 2017 to 2019. Parameters have been analyzed according to the European Centre for Disease Prevention and Control (ECDC), National Institute for Health and Care Excellence (NICE) and World Health Organization (WHO) guidelines.

Results

Shortcomings in registered data and the application of exclusion criteria allowed to include only 256 of the 977 retrospective procedures recorded during this period, with around 50% of the cases in 2019. A little more than half of them concerned men with a sex ratio of 1.28. Among these patients, 66% were aged between 16 and 40 years. Of these, 37.1% underwent visceral surgery. Over 38.7% of patients were hospitalized for more than 30 days, with 4.3% staying over 4 months. After the surgery, metronidazole 1.5 g, ceftriaxone 1 g and cefotaxime 1 g were the most used (89%) antibiotics followed by amoxicillin 1 g, all mainly parenterally. In 38,7% of cases, a series of other antibiotics were used in combination over a long period (7 days). A 32.8% rate of surgical site infection was recorded, with antibiotic-related costs of around 62,311 ± 30,417 CDF (31 ± 15 €). A comparison of the characteristics of patients with and without infections showed a significant influence of the sex and type of surgery. Men were 4.7 times more likely to develop a surgical site infection than women, and orthopedic surgery had a higher risk of infection than other surgeries.

Conclusion

These retrospective data suggest that the use of antibiotics before and after surgery at the University Clinics of Lubumbashi does not meet accepted standards (ECDC, NICE and WHO guidelines) and would not be efficient for their intended purpose.
背景手术部位感染(ssi)是最常见的术后并发症之一,也是第三大常见的医院感染。目的分析卢本巴希大学诊所外科手术中抗生素的使用情况。方法采用回顾性研究方法,收集2017 - 2019年3年间的医疗登记数据。根据欧洲疾病预防和控制中心(ECDC)、国家健康和护理卓越研究所(NICE)和世界卫生组织(世卫组织)的指导方针分析了参数。结果:在此期间记录的977例回顾性手术中,登记数据的缺陷和排除标准的应用仅允许纳入256例,其中约50%的病例发生在2019年。其中一半多一点是男性,男女性别比为1.28。在这些患者中,66%的年龄在16至40岁之间。其中,37.1%的患者接受了内脏手术。超过38.7%的患者住院时间超过30天,4.3%的患者住院时间超过4个月。术后使用甲硝唑1.5 g、头孢曲松1 g、头孢噻肟1 g最多(89%),其次是阿莫西林1 g,均以肠外注射为主。在38.7%的病例中,长期(7天)联合使用一系列其他抗生素。手术部位感染率为32.8%,抗生素相关费用约为62,311±30,417 CDF(31±15€)。对感染和未感染患者的特征进行比较,发现性别和手术类型对其有显著影响。男性发生手术部位感染的可能性是女性的4.7倍,而骨科手术的感染风险高于其他手术。这些回顾性数据表明,卢本巴希大学诊所手术前后抗生素的使用不符合公认的标准(ECDC、NICE和WHO指南),无法达到预期目的。
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引用次数: 0
The Efficacy of Sublingual Immunotherapy in Patients With House Dust Mite Allergic Asthma—A Systematic Review 舌下免疫治疗屋尘螨变应性哮喘疗效的系统评价
IF 1.6 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01 DOI: 10.1016/j.curtheres.2025.100785
Pernille Vigand Hegner MSt , Anne Sofie Rysgaard MSt , Alma Holm Rovsing MD, PhD , Charlotte Suppli Ulrik MD, DMSc, FERS

Background and objective

Patients’ with allergy-driven symptoms of asthma may not achieve adequate symptom control on inhaled pharmacotherapy alone, therefore, allergen-immunotherapy may be a relevant add-on treatment. The aim of the present review is to provide an update on the current evidence of efficacy of sublingual immunotherapy (SLIT) for the treatment of house dust mite (HDM)-driven allergic asthma.

Methods

Systematic review performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses-Statement (PRISMA) guidelines.

Results

A total of 15 studies fulfilled the predefined criteria and were included, all assessing the efficacy of the HDM SLIT-tablet in patients with HDM-driven asthma. Of the 15 studies, 13 reported significant improvements in asthma symptoms, while 2 found no changes. Ten studies assessed lung function (that is FEV1, PEF and FEV1/FVC) with 6 reporting significant improvements and 4 reporting no significant changes. Eight of the 15 studies measured the impact on prescribed asthma controller medication, of which 6 studies reported a significant reduction in daily mean dose of inhaled corticosteroid (ICS) (up to a reduction of 300+ µg/day), 1 found a significant reduction in medication use (according to the GINA steps), while 1 showed no significant reduction.

Conclusion

In the majority of studies, HDM SLIT was associated with improvements in asthma symptom control and a reduction in daily dose of ICS. On the other hand, the findings addressing treatment induced changes in lung function are conflicting.
背景与目的单纯吸入药物治疗可能无法有效控制哮喘患者的症状,因此,过敏原免疫治疗可能是一种相关的辅助治疗。本综述的目的是提供舌下免疫疗法(SLIT)治疗屋尘螨(HDM)引起的过敏性哮喘疗效的最新证据。方法按照系统评价和荟萃分析声明(PRISMA)指南的首选报告项目进行系统评价。结果共有15项研究符合预先设定的标准并被纳入,所有研究都评估了HDM slat片对HDM驱动哮喘患者的疗效。在这15项研究中,13项报告了哮喘症状的显著改善,而2项没有发现任何变化。10项研究评估了肺功能(即FEV1、PEF和FEV1/FVC),其中6项报告有显著改善,4项报告无显著变化。15项研究中有8项研究测量了处方哮喘控制药物的影响,其中6项研究报告了吸入皮质类固醇(ICS)的日平均剂量的显着减少(最多减少300+µg/天),1项研究发现了药物使用的显着减少(根据GINA步骤),而1项研究没有显示显着减少。结论:在大多数研究中,HDM SLIT与哮喘症状控制的改善和ICS日剂量的减少有关。另一方面,治疗引起的肺功能改变的研究结果是相互矛盾的。
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引用次数: 0
Relationship Between Dietary Acid Load and Risk of Metastatic Colorectal Cancer: A Case-Control Study 膳食酸负荷与转移性结直肠癌风险的关系:一项病例对照研究
IF 1.6 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01 DOI: 10.1016/j.curtheres.2025.100790
Fatemeh Babaee Kiadehi MSc , Niayesh Naghshi MSc , Fatemeh Farz MSc , Pedram pam PhD , Arash Tandorost MSc , Alireza Ostadrahimi MD, PhD , Reza Eghdam Zamiri MD

Purpose

Colorectal cancer (CRC) is a type of cancer affecting the colon and rectum, primarily originating from intestinal polyps. Recently, increasing attention has been given to the role of dietary acid-base balance in cancer development. This study aimed to investigate the relationship between dietary acid load and the risk of metastatic colorectal cancer (mCRC).

Design/methodology/approach

This hospital-based case-control study was conducted on 120 adults with mCRC and 240 non-neoplastic adults in the control group, matched for age and gender. Dietary intake was assessed using a food frequency questionnaire. Net endogenous acid production (NEAP) and potential renal acid load (PRAL) were calculated using predetermined formulas. Odds ratios (ORs) were used to estimate the risk of mCRC across PRAL and NEAP tertiles.

Findings

There were no significant differences between the two groups in terms of demographic characteristics, anthropometric measures, smoking, and alcohol consumption. However, energy intake and energy-adjusted carbohydrate, fiber, potassium, magnesium, and calcium intake were significantly higher in the control group compared to the case group (P < 0.05). The mean PRAL in the case group (10.5 ± 1 mEq/day) was significantly higher than in the control group (5.2 ± 0.5 mEq/day) (P < 0.001). However, no significant difference was observed between the groups regarding NEAP (35 ± 7 mEq/day in the control group vs. 36 ± 5.5 mEq/day in the case group, P = 0.12). The second and third tertiles of PRAL were associated with an increased risk of mCRC compared to the first tertile (OR = 3.4, 95% CI: 1.6–7; OR = 4.1, 95% CI: 2–8.5, respectively) (P < 0.001).

Originality/value

High PRAL levels were associated with an increased risk of mCRC, whereas NEAP scores were not linked to mCRC risk.
目的结肠直肠癌(CRC)是一种影响结肠和直肠的癌症,主要起源于肠息肉。近年来,人们越来越关注饮食酸碱平衡在癌症发展中的作用。本研究旨在探讨膳食酸负荷与转移性结直肠癌(mCRC)风险之间的关系。设计/方法/方法:这项以医院为基础的病例对照研究对年龄和性别匹配的120名成年mCRC患者和240名非肿瘤性成人进行了研究。使用食物频率问卷评估饮食摄入量。净内源性产酸量(NEAP)和潜在肾酸负荷(PRAL)采用预定公式计算。比值比(ORs)用于估计PRAL和NEAP两组患者发生mCRC的风险。研究结果:两组在人口统计学特征、人体测量、吸烟和饮酒方面没有显著差异。然而,与病例组相比,对照组的能量摄入量和能量调节碳水化合物、纤维、钾、镁和钙的摄入量显著高于病例组(P <;0.05)。病例组平均PRAL(10.5±1 mEq/d)显著高于对照组(5.2±0.5 mEq/d) (P <;0.001)。然而,在NEAP方面,两组之间没有显著差异(对照组为35±7 mEq/天,病例组为36±5.5 mEq/天,P = 0.12)。与第一分位数相比,PRAL的第二和第三分位数与mCRC的风险增加相关(OR = 3.4,95% CI: 1.6-7;OR = 4.1,95% CI分别为2-8.5)(P <;0.001)。原创性/价值高PRAL水平与mCRC风险增加有关,而NEAP评分与mCRC风险无关。
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引用次数: 0
IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01
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引用次数: 0
IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01
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引用次数: 0
IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01
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引用次数: 0
IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01
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引用次数: 0
IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-01
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引用次数: 0
期刊
Current Therapeutic Research-clinical and Experimental
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