Yun Seob Jung, Byung Hak Jin, Ju Eun Choi, Min Soo Park, Young-Woo Kim, Hyung Won Kang, Sunyoung Cho, Choon Ok Kim
Purpose: Herbal medicines are occasionally used in combination with conventional antidepressants to mitigate various depression-associated symptoms. However, there is limited information on herb–antidepressant interactions. In this study, we investigated the pharmacokinetic (PK) effects of four herbal medicines (Gami-soyosan, Banhasasim-tang, Ojeok-san, and Bojungikgi-tang) on escitalopram, a commonly used antidepressant. Patients and Methods: In this open-label, fixed-sequence, three-period, crossover study, 18 participants were enrolled and divided into two groups. Each group received a 10 mg oral dose of escitalopram in period 1. Participants took escitalopram once daily and their assigned herbal medicines thrice a day for 7 d in periods 2 (group 1: Gami-soyosan, group 2: Ojeok-san) and 3 (group 1: Banhasasim-tang; group 2: Bojungikgi-tang). The primary endpoints were Cmax,ss and AUCtau,ss of escitalopram. Cmax,ss and AUCtau,ss in period 1 were obtained using nonparametric superposition from single-dose data. The PK endpoints were classified according to the CYP2C19 phenotype. Results: Of 18 participants, 16 completed the study. Systemic exposure to escitalopram resulted in a minor increase in the presence of each herbal medicine. The geometric mean ratios (GMRs, combination with herbal medicines/escitalopram monotherapy) and their 90% confidence intervals (CIs) for Cmax,ss and AUCtau,ss were as follows: Gamisoyosan– 1.1454 (0.9201, 1.4258) and 1.0749 (0.8084, 1.4291), Banhasasim-tang– 1.0470 (0.7779, 1.4092) and 1.0465 (0.7035, 1.5568), Ojeok-san– 1.1204 (0.8744, 1.4357) and 1.1267 (0.8466, 1.4996), and Bojungikgi-tang– 1.1264 (0.8594, 1.4762) and 1.1400 (0.8515, 1.5261), respectively. Furthermore, no significant differences in the GMRs of Cmax,ss and AUCtau,ss were observed across different CYP2C19 phenotypes in any of the groups. Conclusion: The co-administration of escitalopram with Gami-soyosan, Banhasasim-tang, Ojeok-san, or Bojungikgi-tang did not exert significant PK effects on escitalopram. These findings provide valuable insights into the safe use of herbal medicines along with escitalopram.
Keywords: CYP2C19 phenotype, herb–drug interaction, antidepressant, geometric mean ratio
{"title":"Assessment of Pharmacokinetic Effects of Herbal Medicines on Escitalopram","authors":"Yun Seob Jung, Byung Hak Jin, Ju Eun Choi, Min Soo Park, Young-Woo Kim, Hyung Won Kang, Sunyoung Cho, Choon Ok Kim","doi":"10.2147/tcrm.s448090","DOIUrl":"https://doi.org/10.2147/tcrm.s448090","url":null,"abstract":"<strong>Purpose:</strong> Herbal medicines are occasionally used in combination with conventional antidepressants to mitigate various depression-associated symptoms. However, there is limited information on herb–antidepressant interactions. In this study, we investigated the pharmacokinetic (PK) effects of four herbal medicines (Gami-soyosan, Banhasasim-tang, Ojeok-san, and Bojungikgi-tang) on escitalopram, a commonly used antidepressant.<br/><strong>Patients and Methods:</strong> In this open-label, fixed-sequence, three-period, crossover study, 18 participants were enrolled and divided into two groups. Each group received a 10 mg oral dose of escitalopram in period 1. Participants took escitalopram once daily and their assigned herbal medicines thrice a day for 7 d in periods 2 (group 1: Gami-soyosan, group 2: Ojeok-san) and 3 (group 1: Banhasasim-tang; group 2: Bojungikgi-tang). The primary endpoints were C<sub>max,ss</sub> and AUC<sub>tau,ss</sub> of escitalopram. C<sub>max,ss</sub> and AUC<sub>tau,ss</sub> in period 1 were obtained using nonparametric superposition from single-dose data. The PK endpoints were classified according to the CYP2C19 phenotype.<br/><strong>Results:</strong> Of 18 participants, 16 completed the study. Systemic exposure to escitalopram resulted in a minor increase in the presence of each herbal medicine. The geometric mean ratios (GMRs, combination with herbal medicines/escitalopram monotherapy) and their 90% confidence intervals (CIs) for C<sub>max,ss</sub> and AUC<sub>tau,ss</sub> were as follows: Gamisoyosan– 1.1454 (0.9201, 1.4258) and 1.0749 (0.8084, 1.4291), Banhasasim-tang– 1.0470 (0.7779, 1.4092) and 1.0465 (0.7035, 1.5568), Ojeok-san– 1.1204 (0.8744, 1.4357) and 1.1267 (0.8466, 1.4996), and Bojungikgi-tang– 1.1264 (0.8594, 1.4762) and 1.1400 (0.8515, 1.5261), respectively. Furthermore, no significant differences in the GMRs of C<sub>max,ss</sub> and AUC<sub>tau,ss</sub> were observed across different CYP2C19 phenotypes in any of the groups.<br/><strong>Conclusion:</strong> The co-administration of escitalopram with Gami-soyosan, Banhasasim-tang, Ojeok-san, or Bojungikgi-tang did not exert significant PK effects on escitalopram. These findings provide valuable insights into the safe use of herbal medicines along with escitalopram.<br/><br/><strong>Keywords:</strong> CYP2C19 phenotype, herb–drug interaction, antidepressant, geometric mean ratio<br/>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"32 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139969524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Acute kidney injury (AKI) is prevalent in hospitalized patients with traumatic brain injury (TBI), and increases the risk of poor outcomes. We designed this study to develop a visual and convenient decision-tree-based model for predicting AKI in TBI patients. Methods: A total of 376 patients admitted to the emergency department of the West China Hospital for TBI between January 2015 and June 2019 were included. Demographic information, vital signs on admission, laboratory test results, radiological signs, surgical options, and medications were recorded as variables. AKI was confirmed since the second day after admission, based on the Kidney Disease Improving Global Outcomes criteria. We constructed two predictive models for AKI using least absolute shrinkage and selection operator (LASSO) regression and classification and regression tree (CART), respectively. Receiver operating characteristic (ROC) curves of these two predictive models were drawn, and the area under the ROC curve (AUC) was calculated to compare their predictive accuracy. Results: The incidence of AKI on the second day after admission was 10.4% among patients with TBI. Lasso regression identified five potent predictive factors for AKI: glucose, serum creatinine, cystatin C, serum uric acid, and fresh frozen plasma transfusions. The CART analysis showed that glucose, serum uric acid, and cystatin C ranked among the top three in terms of the feature importance of the decision tree model. The AUC value of the decision-tree predictive model was 0.892, which was higher than the 0.854 of the LASSO regression model, although the difference was not statistically significant. Conclusion: The decision tree model is valuable for predicting AKI among patients with TBI. This tree-based flowchart is convenient for physicians to identify patients with TBI who are at high risk of AKI and prompts them to develop suitable therapeutic strategies.
背景：急性肾损伤（AKI）是创伤性脑损伤（TBI）住院患者的常见病，会增加不良预后的风险。我们设计了这项研究，旨在开发一种基于决策树的可视化便捷模型，用于预测创伤性脑损伤患者的 AKI：方法：共纳入2015年1月至2019年6月期间华西医院急诊科收治的376例TBI患者。将人口统计学信息、入院时的生命体征、实验室检查结果、放射学体征、手术方案和药物作为变量记录。根据 "肾脏疾病改善全球结局 "标准，入院后第二天即确认为 AKI。我们分别使用最小绝对收缩和选择算子（LASSO）回归和分类回归树（CART）构建了两个 AKI 预测模型。我们绘制了这两个预测模型的接收者操作特征曲线（ROC），并计算了 ROC 曲线下面积（AUC），以比较它们的预测准确性：结果：创伤性脑损伤患者入院后第二天的AKI发生率为10.4%。拉索回归确定了五个有力的 AKI 预测因素：葡萄糖、血清肌酐、胱抑素 C、血清尿酸和新鲜冰冻血浆输注。CART 分析显示，就决策树模型的特征重要性而言，葡萄糖、血清尿酸和胱抑素 C 位居前三位。决策树预测模型的 AUC 值为 0.892，高于 LASSO 回归模型的 0.854，但差异无统计学意义：结论：决策树模型对预测创伤性脑损伤患者的 AKI 很有价值。结论：决策树模型对预测创伤性脑损伤患者的 AKI 很有价值，这种基于树的流程图便于医生识别 AKI 高风险的创伤性脑损伤患者，并提示他们制定合适的治疗策略。
{"title":"Classification and Regression Tree Predictive Model for Acute Kidney Injury in Traumatic Brain Injury Patients","authors":"Ruoran Wang, Jing Zhang, Min He, Jianguo Xu","doi":"10.2147/tcrm.s435281","DOIUrl":"https://doi.org/10.2147/tcrm.s435281","url":null,"abstract":"<strong>Background:</strong> Acute kidney injury (AKI) is prevalent in hospitalized patients with traumatic brain injury (TBI), and increases the risk of poor outcomes. We designed this study to develop a visual and convenient decision-tree-based model for predicting AKI in TBI patients.<br/><strong>Methods:</strong> A total of 376 patients admitted to the emergency department of the West China Hospital for TBI between January 2015 and June 2019 were included. Demographic information, vital signs on admission, laboratory test results, radiological signs, surgical options, and medications were recorded as variables. AKI was confirmed since the second day after admission, based on the Kidney Disease Improving Global Outcomes criteria. We constructed two predictive models for AKI using least absolute shrinkage and selection operator (LASSO) regression and classification and regression tree (CART), respectively. Receiver operating characteristic (ROC) curves of these two predictive models were drawn, and the area under the ROC curve (AUC) was calculated to compare their predictive accuracy.<br/><strong>Results:</strong> The incidence of AKI on the second day after admission was 10.4% among patients with TBI. Lasso regression identified five potent predictive factors for AKI: glucose, serum creatinine, cystatin C, serum uric acid, and fresh frozen plasma transfusions. The CART analysis showed that glucose, serum uric acid, and cystatin C ranked among the top three in terms of the feature importance of the decision tree model. The AUC value of the decision-tree predictive model was 0.892, which was higher than the 0.854 of the LASSO regression model, although the difference was not statistically significant.<br/><strong>Conclusion:</strong> The decision tree model is valuable for predicting AKI among patients with TBI. This tree-based flowchart is convenient for physicians to identify patients with TBI who are at high risk of AKI and prompts them to develop suitable therapeutic strategies.<br/><br/>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"253 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139926862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leopoldo Spadea, Lucia Di Genova, Edoardo Trovato Battagliola, Stefano Scordari
Purpose: To assess and contrast the visual and refractive results of Descemetic deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) in the treatment of advanced keratoconus. Design: Retrospective, comparative, interventional study. Methods: This study enrolled eyes affected by keratoconus with preoperative mean keratometry ≥ 60 diopters (D) that were treated with either Descemetic DALK (30 eyes) or PK (29 eyes) by using always the same corneal diameters (8.00mm recipient; 8.25mm donor cornea) and the same suture technique (10– 0 nylon double-running 12-bites continuous suture). The outcome measures were postoperative uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (CDVA), subjective refractive astigmatism (SRAst), and keratometric astigmatism at 3mm area (SimK), spherical equivalent (SEq). Results: Postoperative visual acuity significantly improved in both groups. Mean CDVA was higher in the DALK group 3 months (DALK 0.61, PK 0.42, p< 0.05), 6 months (DALK 0.69, PK 0.44, p< 0.05), and 12 months (DALK 0.72, PK 0.45, p< 0.05) postoperatively. However, 6 months after suture removal, CDVA was not statistically different between the two groups (DALK 0.71, PK 0.75, p> 0.05). Final SRAst and SimK also were comparable between the two groups (respectively DALK 2.97, PK:2.81, p> 0.05; DALK 3.91, PK 2.37, p> 0.05). No significant statistical differences were noted for UCVA and SEq data during the entire follow-up period between the two groups. Conclusion: Both methods of corneal transplantation resulted in a notable enhancement of visual and refractive outcomes in eyes afflicted by advanced keratoconus. Descemetic DALK demonstrated superior visual acuity before suture removal, whereas DALK and PK exhibited comparable results in terms of visual acuity, refractive correction, and keratometric astigmatism after suture removal.
{"title":"Descemetic Deep Anterior Lamellar Keratoplasty versus Penetrating Keratoplasty in Advanced Keratoconus: Comparison of Visual and Refractive Outcomes","authors":"Leopoldo Spadea, Lucia Di Genova, Edoardo Trovato Battagliola, Stefano Scordari","doi":"10.2147/tcrm.s441577","DOIUrl":"https://doi.org/10.2147/tcrm.s441577","url":null,"abstract":"<strong>Purpose:</strong> To assess and contrast the visual and refractive results of Descemetic deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) in the treatment of advanced keratoconus.<br/><strong>Design:</strong> Retrospective, comparative, interventional study.<br/><strong>Methods:</strong> This study enrolled eyes affected by keratoconus with preoperative mean keratometry ≥ 60 diopters (D) that were treated with either Descemetic DALK (30 eyes) or PK (29 eyes) by using always the same corneal diameters (8.00mm recipient; 8.25mm donor cornea) and the same suture technique (10– 0 nylon double-running 12-bites continuous suture). The outcome measures were postoperative uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (CDVA), subjective refractive astigmatism (SRAst), and keratometric astigmatism at 3mm area (SimK), spherical equivalent (SEq).<br/><strong>Results:</strong> Postoperative visual acuity significantly improved in both groups. Mean CDVA was higher in the DALK group 3 months (DALK 0.61, PK 0.42, p< 0.05), 6 months (DALK 0.69, PK 0.44, p< 0.05), and 12 months (DALK 0.72, PK 0.45, p< 0.05) postoperatively. However, 6 months after suture removal, CDVA was not statistically different between the two groups (DALK 0.71, PK 0.75, p> 0.05). Final SRAst and SimK also were comparable between the two groups (respectively DALK 2.97, PK:2.81, p> 0.05; DALK 3.91, PK 2.37, p> 0.05). No significant statistical differences were noted for UCVA and SEq data during the entire follow-up period between the two groups.<br/><strong>Conclusion:</strong> Both methods of corneal transplantation resulted in a notable enhancement of visual and refractive outcomes in eyes afflicted by advanced keratoconus. Descemetic DALK demonstrated superior visual acuity before suture removal, whereas DALK and PK exhibited comparable results in terms of visual acuity, refractive correction, and keratometric astigmatism after suture removal.<br/><br/><strong>Keywords:</strong> astigmatism, corneal topography, descemetic dalk, keratoconus, PK<br/>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"2 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139760024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iris N van Doorn, Filip Eftimov, Luuk Wieske, Ivo N van Schaik, Camiel Verhamme
Abstract: Diagnosing Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) poses numerous challenges. The heterogeneous presentations of CIDP variants, its mimics, and the complexity of interpreting electrodiagnostic criteria are just a few of the many reasons for misdiagnoses. Early recognition and treatment are important to reduce the risk of irreversible axonal damage, which may lead to permanent disability. The diagnosis of CIDP is based on a combination of clinical symptoms, nerve conduction study findings that indicate demyelination, and other supportive criteria. In 2021, the European Academy of Neurology (EAN) and the Peripheral Nerve Society (PNS) published a revision on the most widely adopted guideline on the diagnosis and treatment of CIDP. This updated guideline now includes clinical and electrodiagnostic criteria for CIDP variants (previously termed atypical CIDP), updated supportive criteria, and sensory criteria as an integral part of the electrodiagnostic criteria. Due to its many rules and exceptions, this guideline is complex and misinterpretation of nerve conduction study findings remain common. CIDP is treatable with intravenous immunoglobulins, corticosteroids, and plasma exchange. The choice of therapy should be tailored to the individual patient’s situation, taking into account the severity of symptoms, potential side effects, patient autonomy, and past treatments. Treatment responses should be evaluated as objectively as possible using disability and impairment scales. Applying these outcome measures consistently in clinical practice aids in recognizing the effectiveness (or lack thereof) of a treatment and facilitates timely consideration of alternative diagnoses or treatments. This review provides an overview of the current perspectives on the diagnostic process and first-line treatments for managing the disease.
{"title":"Challenges in the Early Diagnosis and Treatment of Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Adults: Current Perspectives","authors":"Iris N van Doorn, Filip Eftimov, Luuk Wieske, Ivo N van Schaik, Camiel Verhamme","doi":"10.2147/tcrm.s360249","DOIUrl":"https://doi.org/10.2147/tcrm.s360249","url":null,"abstract":"<strong>Abstract:</strong> Diagnosing Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) poses numerous challenges. The heterogeneous presentations of CIDP variants, its mimics, and the complexity of interpreting electrodiagnostic criteria are just a few of the many reasons for misdiagnoses. Early recognition and treatment are important to reduce the risk of irreversible axonal damage, which may lead to permanent disability. The diagnosis of CIDP is based on a combination of clinical symptoms, nerve conduction study findings that indicate demyelination, and other supportive criteria. In 2021, the European Academy of Neurology (EAN) and the Peripheral Nerve Society (PNS) published a revision on the most widely adopted guideline on the diagnosis and treatment of CIDP. This updated guideline now includes clinical and electrodiagnostic criteria for CIDP variants (previously termed atypical CIDP), updated supportive criteria, and sensory criteria as an integral part of the electrodiagnostic criteria. Due to its many rules and exceptions, this guideline is complex and misinterpretation of nerve conduction study findings remain common. CIDP is treatable with intravenous immunoglobulins, corticosteroids, and plasma exchange. The choice of therapy should be tailored to the individual patient’s situation, taking into account the severity of symptoms, potential side effects, patient autonomy, and past treatments. Treatment responses should be evaluated as objectively as possible using disability and impairment scales. Applying these outcome measures consistently in clinical practice aids in recognizing the effectiveness (or lack thereof) of a treatment and facilitates timely consideration of alternative diagnoses or treatments. This review provides an overview of the current perspectives on the diagnostic process and first-line treatments for managing the disease.<br/><br/><strong>Keywords:</strong> CIDP, treatment, diagnosis, NCS, imaging<br/>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"55 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139759956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Komariah, Shakira Amirah, Muhammad Fahd Abdurrahman, Mohammad Farrel Shaquille Handimulya, Hesti Platini, Sidik Maulana, Annisa Dewi Nugrahani, Aep Maulid Mulyana, Shurouq Ghalib Qadous, Henny Suzana Mediani, Arpit Mago
Background: Cerebral palsy (CP) is the most common motor disorder in childhood. CP limits movement, which can interfere with children’s daily activities. As a technology that provides intensive mass practice to children, virtual reality (VR) can create an interactive and motivating environment. With the intensity set by the therapist and feedback that can be used to produce individualized therapy, VR has great potential to improve CP patients’ quality of life, especially in a safe, enjoyable, and playful environment. Purpose: This systematic review and meta-analysis sought to determine the effectiveness of VR for children with CP. Methods: We conducted a comprehensive literature search based on the PRISMA guidelines through PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of VR in managing children with CP up to 15 September 2022. Risk assessment of bias was performed using Cochrane RoB 2. Results: Nineteen randomized controlled trials with 467 and 427 patients with CP were included in the intervention and control groups in qualitative and quantitative analyses. Participants consisted of cerebral palsy with hemiplegia (n=7), diplegia (n=2), a combination of both (n=4), and undefined (n=13). From all studies conducted, VR showed significant results where VR could improve balance (MD: 2.71[1.95, 3.48]; p < 0.00001), motor function (MD: 3.73 [1.67, 5.79]; p = 0.0004), and activity daily living (MD: 10.05 [2.89, 17.22]. However, VR showed not effective in improving upper limb function. Conclusion: With its advantages and excellent effectiveness, VR may improve functional mobility and the quality of life of children with CP.
{"title":"Effectivity of Virtual Reality to Improve Balance, Motor Function, Activities of Daily Living, and Upper Limb Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis","authors":"Maria Komariah, Shakira Amirah, Muhammad Fahd Abdurrahman, Mohammad Farrel Shaquille Handimulya, Hesti Platini, Sidik Maulana, Annisa Dewi Nugrahani, Aep Maulid Mulyana, Shurouq Ghalib Qadous, Henny Suzana Mediani, Arpit Mago","doi":"10.2147/tcrm.s432249","DOIUrl":"https://doi.org/10.2147/tcrm.s432249","url":null,"abstract":"<strong>Background:</strong> Cerebral palsy (CP) is the most common motor disorder in childhood. CP limits movement, which can interfere with children’s daily activities. As a technology that provides intensive mass practice to children, virtual reality (VR) can create an interactive and motivating environment. With the intensity set by the therapist and feedback that can be used to produce individualized therapy, VR has great potential to improve CP patients’ quality of life, especially in a safe, enjoyable, and playful environment.<br/><strong>Purpose:</strong> This systematic review and meta-analysis sought to determine the effectiveness of VR for children with CP.<br/><strong>Methods:</strong> We conducted a comprehensive literature search based on the PRISMA guidelines through PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of VR in managing children with CP up to 15 September 2022. Risk assessment of bias was performed using Cochrane RoB 2.<br/><strong>Results:</strong> Nineteen randomized controlled trials with 467 and 427 patients with CP were included in the intervention and control groups in qualitative and quantitative analyses. Participants consisted of cerebral palsy with hemiplegia (n=7), diplegia (n=2), a combination of both (n=4), and undefined (n=13). From all studies conducted, VR showed significant results where VR could improve balance (MD: 2.71[1.95, 3.48]; p < 0.00001), motor function (MD: 3.73 [1.67, 5.79]; p = 0.0004), and activity daily living (MD: 10.05 [2.89, 17.22]. However, VR showed not effective in improving upper limb function.<br/><strong>Conclusion:</strong> With its advantages and excellent effectiveness, VR may improve functional mobility and the quality of life of children with CP.<br/><br/>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"22 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139759963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-09eCollection Date: 2024-01-01DOI: 10.2147/TCRM.S438174
Jas Bindra, Ishveen Chopra, Kyle Hayes, John Niewoehner, Mary Prince Panaccio, George J Wan
Introduction: Sarcoidosis is common among African Americans in the United States. Acthar® Gel is a viable option for the treatment of advanced symptomatic sarcoidosis. This study examined patient characteristics, Acthar Gel utilization, co-medication use, and treatment response based on physicians' assessments among African Americans versus non-African Americans with advanced symptomatic sarcoidosis.
Methods: Data from the medical charts of patients were used. During data collection, patients had either completed ≥1 course or received treatment with Acthar Gel for ≥6 months.
Results: This study comprised 168 African Americans and 104 non-African Americans. On average, the time since the first diagnosis of sarcoidosis was slightly longer among African Americans than non-African Americans (5.2 versus 4.3 years). Skin, heart, eyes, and joints were the most common extrapulmonary sites involved among both race groups. Shortness of breath, fatigue, bone and joint pain, and wheezing/coughing were the most frequent symptoms among both race groups. A higher proportion of African Americans versus non-African Americans were first-time Acthar Gel users and had not completed treatment during data collection. Patients in both race groups with higher starting doses of Acthar Gel therapy had a shorter treatment duration and vice-versa. A significantly lower proportion of patients among both race groups were on any co-medication after Acthar Gel initiation (p<0.0001). Further, a higher proportion of African Americans versus non-African Americans had a reduction in any co-medication use after Acthar Gel initiation. The mean daily dose of prednisone decreased among African Americans (18.5 to 10.1 mg) and non-African Americans (17.6 to 10.0 mg) after Acthar Gel initiation. Improvement in patient health status and overall symptoms was similar for both race groups.
Conclusion: Findings suggest that Acthar Gel improves health outcomes for patients with sarcoidosis, which could help to alleviate health disparities among African Americans, who are disproportionately affected by this disease.
{"title":"Acthar Gel in African Americans versus Non-African Americans with Symptomatic Sarcoidosis: Physician Assessment of Patient Medical Records.","authors":"Jas Bindra, Ishveen Chopra, Kyle Hayes, John Niewoehner, Mary Prince Panaccio, George J Wan","doi":"10.2147/TCRM.S438174","DOIUrl":"10.2147/TCRM.S438174","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcoidosis is common among African Americans in the United States. Acthar<sup>®</sup> Gel is a viable option for the treatment of advanced symptomatic sarcoidosis. This study examined patient characteristics, Acthar Gel utilization, co-medication use, and treatment response based on physicians' assessments among African Americans versus non-African Americans with advanced symptomatic sarcoidosis.</p><p><strong>Methods: </strong>Data from the medical charts of patients were used. During data collection, patients had either completed ≥1 course or received treatment with Acthar Gel for ≥6 months.</p><p><strong>Results: </strong>This study comprised 168 African Americans and 104 non-African Americans. On average, the time since the first diagnosis of sarcoidosis was slightly longer among African Americans than non-African Americans (5.2 versus 4.3 years). Skin, heart, eyes, and joints were the most common extrapulmonary sites involved among both race groups. Shortness of breath, fatigue, bone and joint pain, and wheezing/coughing were the most frequent symptoms among both race groups. A higher proportion of African Americans versus non-African Americans were first-time Acthar Gel users and had not completed treatment during data collection. Patients in both race groups with higher starting doses of Acthar Gel therapy had a shorter treatment duration and vice-versa. A significantly lower proportion of patients among both race groups were on any co-medication after Acthar Gel initiation (p<0.0001). Further, a higher proportion of African Americans versus non-African Americans had a reduction in any co-medication use after Acthar Gel initiation. The mean daily dose of prednisone decreased among African Americans (18.5 to 10.1 mg) and non-African Americans (17.6 to 10.0 mg) after Acthar Gel initiation. Improvement in patient health status and overall symptoms was similar for both race groups.</p><p><strong>Conclusion: </strong>Findings suggest that Acthar Gel improves health outcomes for patients with sarcoidosis, which could help to alleviate health disparities among African Americans, who are disproportionately affected by this disease.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"20 ","pages":"83-94"},"PeriodicalIF":2.8,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730534","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}
Pub Date : 2024-02-09eCollection Date: 2024-01-01DOI: 10.2147/TCRM.S446113
Nguyen Ngoc Cuong, Le Hoan, Thieu Thi Tra My, Doan Tien Luu, Le Tuan Linh, Pham Hong Canh, Trieu Quoc Tinh, Tran Nguyen Khanh Chi, Nguyen Quang Trung, Tran Quoc Hoa
Objective: Chyle leak (CL) after head and neck surgery is a rare but well-known complication. In patients with high-output leakage, the treatment can be complicated. This study aims to report on a recent innovation in lymphatic intervention for treating such patients.
Materials and methods: A retrospective review of 36 patients with chyle leak after neck surgery for thyroid cancer was conducted to assess the efficacy of percutaneous lymphatic embolization and thoracic duct (TD) disruption.
Results: Antegrade catheterization of the thoracic duct was achieved in 31 of 36 patients (86.1%). Therefore, embolization of the thoracic duct and thoracic duct branches was performed in 26 and 5 patients, respectively. In 5 cases of unsuccessful antegrade catheterization into the thoracic duct, transcervical access embolization was performed in 2 patients, and TD disruption (TDD) was performed in 3 patients. The pooled overall technical success rate of lymphatic embolization was 33/36 patients (91.7%). One patient who underwent thoracic duct embolization (TDE) with technical success (1/33 patients) but clinical failure had additional treatment directly sclerosing the TD under computed tomography scan. Cervical fluid collection sclerotherapy was done in 7 patients as an additional treatment. Resolution of the chyle leak after procedures was observed in all patients (100%). The mean time to resolution was 3 days (1-7 days). There was no complication intra and after procedures.
Conclusion: TDE, selective TD branches embolization and TDD are safe and effective minimally invasive treatments for CL post-surgery for thyroid carcinoma. Sclerosing cervical fluid collection contributes to clinical success.
{"title":"Minimally Invasive Treatment of Chyle Leak After Thyroidectomy and Cervical Lymph Node Dissection in Patients with Thyroid Carcinoma: Results of a Study Involving 36 Patients.","authors":"Nguyen Ngoc Cuong, Le Hoan, Thieu Thi Tra My, Doan Tien Luu, Le Tuan Linh, Pham Hong Canh, Trieu Quoc Tinh, Tran Nguyen Khanh Chi, Nguyen Quang Trung, Tran Quoc Hoa","doi":"10.2147/TCRM.S446113","DOIUrl":"10.2147/TCRM.S446113","url":null,"abstract":"<p><strong>Objective: </strong>Chyle leak (CL) after head and neck surgery is a rare but well-known complication. In patients with high-output leakage, the treatment can be complicated. This study aims to report on a recent innovation in lymphatic intervention for treating such patients.</p><p><strong>Materials and methods: </strong>A retrospective review of 36 patients with chyle leak after neck surgery for thyroid cancer was conducted to assess the efficacy of percutaneous lymphatic embolization and thoracic duct (TD) disruption.</p><p><strong>Results: </strong>Antegrade catheterization of the thoracic duct was achieved in 31 of 36 patients (86.1%). Therefore, embolization of the thoracic duct and thoracic duct branches was performed in 26 and 5 patients, respectively. In 5 cases of unsuccessful antegrade catheterization into the thoracic duct, transcervical access embolization was performed in 2 patients, and TD disruption (TDD) was performed in 3 patients. The pooled overall technical success rate of lymphatic embolization was 33/36 patients (91.7%). One patient who underwent thoracic duct embolization (TDE) with technical success (1/33 patients) but clinical failure had additional treatment directly sclerosing the TD under computed tomography scan. Cervical fluid collection sclerotherapy was done in 7 patients as an additional treatment. Resolution of the chyle leak after procedures was observed in all patients (100%). The mean time to resolution was 3 days (1-7 days). There was no complication intra and after procedures.</p><p><strong>Conclusion: </strong>TDE, selective TD branches embolization and TDD are safe and effective minimally invasive treatments for CL post-surgery for thyroid carcinoma. Sclerosing cervical fluid collection contributes to clinical success.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"20 ","pages":"75-82"},"PeriodicalIF":2.8,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730535","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}
Pub Date : 2024-02-08eCollection Date: 2024-01-01DOI: 10.2147/TCRM.S434556
Benfa Gong, Li-Jen Cheng, Christopher H Young, Prabhuram Krishnan, Ying Wang, Hui Wei, Chunlin Zhou, Shuning Wei, Yan Li, Qiuyun Fang, Jia Zhong, Eric Q Wu, Yingchang Mi, Jianxiang Wang
Introduction: For acute myeloid leukemia (AML), prognosis is particularly poor in patients harboring FMS-like tyrosine kinase 3 (FLT3) gene mutations, though routine screening for these mutations at diagnosis has been shown to be insufficient. The understanding of the impact of FLT3 mutations on treatment decisions is limited.
Methods: In this retrospective, observational study, we investigated the key epidemiological characteristics, treatment patterns and responses among adult patients with newly diagnosed (ND) AML in China, who initiated treatment from January 1, 2015, to December 31, 2019, or progressed to relapsed/refractory (R/R) AML by December 31, 2020.
Results: Of the 853 ND AML patients included, 63.4% were screened for FLT3 status, and 20.1% tested positive (FLT3MUT) at initial diagnosis. Of 289 patients who progressed to R/R AML during the study period, 24.9% were screened at the diagnosis of R/R AML, and 19.4% tested positive; 20.5% of screened patients changed FLT3 status at first diagnosis of R/R AML. Initial treatment regimens or treatment responses did not seem to differ in patients with ND AML by FLT3 mutation status. In patients with R/R AML, there was an apparent difference in second-line treatment choices by FLT3 mutation status; however, the number of FLT3-mutated patients were limited to demonstrate any meaningful distinction. FLT3-mutated R/R AML was associated with shorter relapse time.
Conclusion: Study findings showed that there was a lack of routine testing for FLT3 mutations at first diagnosis of R/R AML, and initial treatment decisions did not differ by FLT3 mutation status. Given the clinical burden of FLT3MUT, likelihood of FLT3 status changes, and emerging FLT3 inhibitors, further routine FLT3 screening is needed to optimize treatment of R/R AML.
{"title":"Treatment Patterns and <i>FLT3</i> Mutation Testing Among Patients with Acute Myeloid Leukemia in China: A Retrospective Observational Study.","authors":"Benfa Gong, Li-Jen Cheng, Christopher H Young, Prabhuram Krishnan, Ying Wang, Hui Wei, Chunlin Zhou, Shuning Wei, Yan Li, Qiuyun Fang, Jia Zhong, Eric Q Wu, Yingchang Mi, Jianxiang Wang","doi":"10.2147/TCRM.S434556","DOIUrl":"10.2147/TCRM.S434556","url":null,"abstract":"<p><strong>Introduction: </strong>For acute myeloid leukemia (AML), prognosis is particularly poor in patients harboring FMS-like tyrosine kinase 3 (<i>FLT3</i>) gene mutations, though routine screening for these mutations at diagnosis has been shown to be insufficient. The understanding of the impact of <i>FLT3</i> mutations on treatment decisions is limited.</p><p><strong>Methods: </strong>In this retrospective, observational study, we investigated the key epidemiological characteristics, treatment patterns and responses among adult patients with newly diagnosed (ND) AML in China, who initiated treatment from January 1, 2015, to December 31, 2019, or progressed to relapsed/refractory (R/R) AML by December 31, 2020.</p><p><strong>Results: </strong>Of the 853 ND AML patients included, 63.4% were screened for <i>FLT3</i> status, and 20.1% tested positive (<i>FLT3</i><sup>MUT</sup>) at initial diagnosis. Of 289 patients who progressed to R/R AML during the study period, 24.9% were screened at the diagnosis of R/R AML, and 19.4% tested positive; 20.5% of screened patients changed <i>FLT3</i> status at first diagnosis of R/R AML. Initial treatment regimens or treatment responses did not seem to differ in patients with ND AML by <i>FLT3</i> mutation status. In patients with R/R AML, there was an apparent difference in second-line treatment choices by <i>FLT3</i> mutation status; however, the number of <i>FLT3</i>-mutated patients were limited to demonstrate any meaningful distinction. <i>FLT3</i>-mutated R/R AML was associated with shorter relapse time.</p><p><strong>Conclusion: </strong>Study findings showed that there was a lack of routine testing for <i>FLT3</i> mutations at first diagnosis of R/R AML, and initial treatment decisions did not differ by <i>FLT3</i> mutation status. Given the clinical burden of <i>FLT3</i><sup>MUT</sup>, likelihood of <i>FLT3</i> status changes, and emerging FLT3 inhibitors, further routine <i>FLT3</i> screening is needed to optimize treatment of R/R AML.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"20 ","pages":"59-73"},"PeriodicalIF":2.8,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724037","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}
Objective: The objective of this study was to utilize LASSO regression (Least Absolute Shrinkage and Selection Operator Regression) to identify key variables in septic patients and develop a predictive model for intensive care unit (ICU) mortality.
Methods: We conducted a cohort consisting of septic patients admitted to the ICU between December 2016 and July 2019. The disease severity and laboratory index were analyzed using LASSO regression. The selected variables were then used to develop a model for predicting ICU mortality. AUCs of ROCs were applied to assess the prediction model, and the accuracy, sensitivity and specificity were calculated. Calibration were also used to assess the actual and predicted values of the predictive model.
Results: A total of 1733 septic patients were included, among of whom 382 (22%) died during ICU stay. Ten variables, namely mechanical ventilation (MV) requirement, hemofiltration (HF) requirement, norepinephrine (NE) requirement, septicemia, multiple drug-resistance infection (MDR), thrombocytopenia, hematocrit, red-cell deviation width coefficient of variation (RDW-CV), C-reactive protein (CRP), and antithrombin (AT) III, showed the strongest association with sepsis-related mortality according to LASSO regression. When these variables were combined into a predictive model, the area under the curve (AUC) was found to be 0.801. The AUC of the validation group was 0.791. The specificity of the model was as high as 0.953. Within the probability range of 0.25 to 0.90, the predictive performance of the model surpassed that of individual predictors within the cohort.
Conclusion: Our findings suggest that a predictive model incorporating the variables of MV requirement, HF requirement, NE requirement, septicemia, MDR, thrombocytopenia, HCT, RDW-CV, CRP, and AT III exhibiting an 80% likelihood of predicting ICU mortality in sepsis and demonstrates high accuracy.
{"title":"LASSO-Based Identification of Risk Factors and Development of a Prediction Model for Sepsis Patients.","authors":"Chengying Hong, Yihan Xiong, Jinquan Xia, Wei Huang, Andi Xia, Shunyao Xu, Yuting Chen, Zhikun Xu, Huaisheng Chen, Zhongwei Zhang","doi":"10.2147/TCRM.S434397","DOIUrl":"https://doi.org/10.2147/TCRM.S434397","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to utilize LASSO regression (Least Absolute Shrinkage and Selection Operator Regression) to identify key variables in septic patients and develop a predictive model for intensive care unit (ICU) mortality.</p><p><strong>Methods: </strong>We conducted a cohort consisting of septic patients admitted to the ICU between December 2016 and July 2019. The disease severity and laboratory index were analyzed using LASSO regression. The selected variables were then used to develop a model for predicting ICU mortality. AUCs of ROCs were applied to assess the prediction model, and the accuracy, sensitivity and specificity were calculated. Calibration were also used to assess the actual and predicted values of the predictive model.</p><p><strong>Results: </strong>A total of 1733 septic patients were included, among of whom 382 (22%) died during ICU stay. Ten variables, namely mechanical ventilation (MV) requirement, hemofiltration (HF) requirement, norepinephrine (NE) requirement, septicemia, multiple drug-resistance infection (MDR), thrombocytopenia, hematocrit, red-cell deviation width coefficient of variation (RDW-CV), C-reactive protein (CRP), and antithrombin (AT) III, showed the strongest association with sepsis-related mortality according to LASSO regression. When these variables were combined into a predictive model, the area under the curve (AUC) was found to be 0.801. The AUC of the validation group was 0.791. The specificity of the model was as high as 0.953. Within the probability range of 0.25 to 0.90, the predictive performance of the model surpassed that of individual predictors within the cohort.</p><p><strong>Conclusion: </strong>Our findings suggest that a predictive model incorporating the variables of MV requirement, HF requirement, NE requirement, septicemia, MDR, thrombocytopenia, HCT, RDW-CV, CRP, and AT III exhibiting an 80% likelihood of predicting ICU mortality in sepsis and demonstrates high accuracy.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"20 ","pages":"47-58"},"PeriodicalIF":2.8,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10859107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724036","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}
Background: Sharp esophageal foreign body (SEFB) impaction can cause varying degrees of damage to the esophagus. There are few studies analyzing the postoperative fasting time in SEFB patients. Methods: We retrospectively collected 835 SEFB patients. According to the fasting time after the endoscopic removal (ER) of SEFBs, the patients were divided into two groups: short fasting time (SFT, fasted ≤ 24 h) and long fasting time (LFT, fasted > 24 h). Results: There were 216 and 619 patients in the SFT and LFT group, respectively. The average age of the SFT group (52.97 years) was younger than that of the LFT group (55.96 years) (p = 0.025). The LFT group had lower proportion of duration of impaction (DOI) within 12 hours (14.2% vs 22.2%, p = 0.006) and erosion rates (89.0% vs 94.0%, p = 0.034) as well as higher proportion of esophageal perforation (19.5 vs 6.5%, p = 0.010) and patients who got intravenous anesthesia (63.78% vs 31.9%, p = 0.000) than the SFT group. The longest diameter of the foreign body (Lmax) in the LFT group (2.60 ± 1.01 cm) was greater than that in the SFT group (2.41 ± 0.83 cm; p = 0.01). Multivariate regression analysis found that age (OR = 1.726[1.208– 2.465], p = 0.003), DOI (OR = 1.793[1.175– 2.737], p = 0.007), Lmax (OR = 1.477[1.033– 2.111], p = 0.032), perforation (OR = 3.698[2.038– 6.710]; p < 0.01) and intravenous anesthesia (OR = 3.734[2.642– 5.278]; p < 0.01) were the independent factors that prolonged fasting time in patients with SEFBs, while esophageal mucosal erosion (OR = 0.433[0.229– 0.820]; p = 0.01) was the influencing factor leading to shortened fasting time. Conclusion: For the first time, we analyzed factors influencing the fasting time after ER in SEFB patients. Age, DOI, Lmax, perforation and intravenous anesthesia were risk factors for a prolonged postoperative fasting time.
{"title":"Factors Influencing the Fasting Time in Adult Patients After the Endoscopic Management of Sharp Esophageal Foreign Bodies","authors":"Da-Quan Wu, Shu-Yang Chen, Ke-Guang Chen, Tan Wang, Guang-Yao Li, Xin-Sheng Huang","doi":"10.2147/tcrm.s451517","DOIUrl":"https://doi.org/10.2147/tcrm.s451517","url":null,"abstract":"<strong>Background:</strong> Sharp esophageal foreign body (SEFB) impaction can cause varying degrees of damage to the esophagus. There are few studies analyzing the postoperative fasting time in SEFB patients.<br/><strong>Methods:</strong> We retrospectively collected 835 SEFB patients. According to the fasting time after the endoscopic removal (ER) of SEFBs, the patients were divided into two groups: short fasting time (SFT, fasted ≤ 24 h) and long fasting time (LFT, fasted > 24 h).<br/><strong>Results:</strong> There were 216 and 619 patients in the SFT and LFT group, respectively. The average age of the SFT group (52.97 years) was younger than that of the LFT group (55.96 years) (p = 0.025). The LFT group had lower proportion of duration of impaction (DOI) within 12 hours (14.2% vs 22.2%, p = 0.006) and erosion rates (89.0% vs 94.0%, p = 0.034) as well as higher proportion of esophageal perforation (19.5 vs 6.5%, p = 0.010) and patients who got intravenous anesthesia (63.78% vs 31.9%, p = 0.000) than the SFT group. The longest diameter of the foreign body (Lmax) in the LFT group (2.60 ± 1.01 cm) was greater than that in the SFT group (2.41 ± 0.83 cm; p = 0.01). Multivariate regression analysis found that age (OR = 1.726[1.208– 2.465], p = 0.003), DOI (OR = 1.793[1.175– 2.737], p = 0.007), Lmax (OR = 1.477[1.033– 2.111], p = 0.032), perforation (OR = 3.698[2.038– 6.710]; p < 0.01) and intravenous anesthesia (OR = 3.734[2.642– 5.278]; p < 0.01) were the independent factors that prolonged fasting time in patients with SEFBs, while esophageal mucosal erosion (OR = 0.433[0.229– 0.820]; p = 0.01) was the influencing factor leading to shortened fasting time.<br/><strong>Conclusion:</strong> For the first time, we analyzed factors influencing the fasting time after ER in SEFB patients. Age, DOI, Lmax, perforation and intravenous anesthesia were risk factors for a prolonged postoperative fasting time.<br/><br/>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"4 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139690008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号