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New targets for type 2-low asthma. 2 型低哮喘的新目标。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-02-06 DOI: 10.3904/kjim.2023.299
Quang Luu Quoc, Youngwoo Choi, Gyu-Young Hur, Hae-Sim Park

Asthma is characterized by airway obstruction and inflammation, and presents significant diagnostic and treatment challenges. The concept of endotypes has improved understanding of the mechanisms of asthma and has stimulated the development of effective treatment strategies. Sputum profiles may be used to classify asthma into two major inflammatory types: type 2-high (T2H) and type 2-low (T2L) asthma. T2H, characterized by elevated type 2 inflammation, has been extensively studied and several effective biologic treatments have been developed. However, managing T2L is more difficult due to the lack of reliable biomarkers for accurate diagnosis and classification. Additionally, conventional anti-inflammatory therapy does not completely control the symptoms of T2L; therefore, further research is needed to identify effective biologic treatments. This review provides new insights into the clinical characteristics and underlying mechanisms of severe T2L and investigates potential therapeutic approaches to control the disease.

哮喘以气道阻塞和炎症为特征,给诊断和治疗带来了巨大挑战。内型的概念提高了人们对哮喘发病机制的认识,并促进了有效治疗策略的开发。痰液特征可用于将哮喘分为两大炎症类型:2 型高 (T2H) 和 2 型低 (T2L) 哮喘。T2H 以 2 型炎症升高为特征,已被广泛研究,并已开发出几种有效的生物治疗方法。然而,由于缺乏可靠的生物标志物来进行准确诊断和分类,T2L 的治疗更为困难。此外,传统的抗炎疗法并不能完全控制 T2L 的症状;因此,还需要进一步的研究来确定有效的生物疗法。本综述对重症 T2L 的临床特征和潜在机制提供了新的见解,并探讨了控制该疾病的潜在治疗方法。
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引用次数: 0
Relationship between metformin use and mortality in tuberculosis patients with diabetes: a nationwide cohort study. 糖尿病肺结核患者服用二甲双胍与死亡率之间的关系:一项全国性队列研究。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-02-06 DOI: 10.3904/kjim.2023.303
Eunki Chung, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Heejin Kim, Heesun Kim, Hongjo Choi, Young Ae Kang

Background/aims: To determine whether metformin, which is considered a host-directed therapy for tuberculosis (TB), is effective in improving the prognosis of patients with TB and diabetes mellitus (DM), who have higher mortality than those without DM.

Methods: This cohort study included patients who were registered as having TB in the National Tuberculosis Surveillance System. The medical and death records of matched patients were obtained from the National Health Information Database and Statistics Korea, respectively, and data from 2011 to 2017 were collected retrospectively. We classified patients according to metformin use among participants who used diabetes drugs for more than 28 days. The primary outcome was all-cause mortality during TB treatment. Double propensity score adjustment was applied to reduce the effects of confounding and multivariable Cox proportional hazard models were used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI).

Results: The all-cause mortality rate during TB treatment was lower (9.5% vs. 12.4%, p < 0.01) in the metformin user group. The hazard of death due to all causes after double propensity score adjustment was also lower in the metformin user group (aHR 0.76, 95% CI 0.67-0.86, p < 0.01). There was no significant difference in mortality between metformin users and non-users for TB-related deaths (p = 0.22); however, there was a significant difference in the non-TB-related deaths (p < 0.01).

Conclusion: Metformin use in patients with TB-DM co-prevalence is associated with reduced all-cause mortality, suggesting the potential for metformin adjuvant therapy in these patients.

背景/目的方法:二甲双胍被认为是肺结核(TB)的宿主导向疗法,目的是确定二甲双胍是否能有效改善肺结核合并糖尿病(DM)患者的预后:这项队列研究包括在国家结核病监测系统中登记的结核病患者。配对患者的医疗记录和死亡记录分别来自国家健康信息数据库和韩国统计局,数据收集时间为2011年至2017年,数据为回顾性数据。在使用糖尿病药物超过28天的参与者中,我们根据二甲双胍的使用情况对患者进行了分类。主要结果是结核病治疗期间的全因死亡率。为了减少混杂因素的影响,我们进行了双重倾向评分调整,并使用多变量考克斯比例危险模型来估算调整后的危险比(aHR)及95%置信区间(CI):结果:二甲双胍使用者组在结核病治疗期间的全因死亡率较低(9.5% 对 12.4%,P < 0.01)。经过双重倾向评分调整后,二甲双胍使用者组的全因死亡风险也较低(aHR 0.76,95% CI 0.67-0.86,p < 0.01)。二甲双胍使用者和非使用者在结核病相关死亡方面没有明显差异(p = 0.22);但在非结核病相关死亡方面存在明显差异(p < 0.01):结论:肺结核-结核病并发症患者服用二甲双胍可降低全因死亡率,这表明二甲双胍在这些患者中具有辅助治疗的潜力。
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引用次数: 0
Predictors of renal relapse in Koreans with lupus nephritis after achieving complete response: a 35-years of experience at a single center. 韩国狼疮性肾炎患者完全缓解后肾脏复发的预测因素:一个中心 35 年的经验。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-01-22 DOI: 10.3904/kjim.2023.255
Howook Jeon, Jennifer Lee, Su-Jin Moon, Seung-Ki Kwok, Ji Hyeon Ju, Wan-Uk Kim, Sung-Hwan Park

Background/aims: Renal relapse has known to be a poor prognostic factor in patients with lupus nephritis (LN), but there were few studies that identified the risk factors of renal relapse in real world. We conducted this study based on 35-years of experience at a single center to find out predictors of renal relapse in Korean patients with LN after achieving complete response (CR).

Methods: We retrospectively analyzed the clinical, laboratory, pathologic and therapeutic parameters in 296 patients of LN who reached CR. The cumulative risk and the independent risk factors for renal relapse were examined by Kaplan-Meier methods and Cox proportional hazards regression analyses, respectively.

Results: The median follow-up period from CR was 123 months. Renal relapse had occurred in 157 patients. Renal relapse occurred in 38.2%, 57.6% and 67.9% of patients within 5-, 10-, and 20-year, respectively. The age at diagnosis of SLE and LN were significantly younger, and the proportions of severe proteinuria and serum hypoalbuminemia were higher in patients with renal relapse. Interestingly, the proportion of receiving cytotoxic maintenance treatment was higher in patients with renal relapse. In Cox proportional hazards regression analyses, only young-age onset of LN (by 10 years, HR = 0.779, p = 0.007) was identified to independent predictor of renal relapse.

Conclusion: Young-age onset of LN was only independent predictor and the patients with severe proteinuria and serum hypoalbuminemia also tended to relapse more, despite of sufficient maintenance treatment. Studies on more effective maintenance treatment regimens and duration are needed to reduce renal relapse.

背景/目的:众所周知,肾脏复发是狼疮性肾炎(LN)患者预后不良的一个因素,但很少有研究能确定现实世界中肾脏复发的风险因素。我们根据在一个中心 35 年的经验开展了这项研究,以找出韩国狼疮肾炎患者在获得完全应答(CR)后肾脏复发的预测因素:我们回顾性分析了296例获得CR的LN患者的临床、实验室、病理和治疗参数。结果:从 CR 开始的中位随访时间为 1.5 年:从 CR 开始的中位随访时间为 123 个月。157名患者出现了肾病复发。在5年、10年和20年内,分别有38.2%、57.6%和67.9%的患者出现肾脏疾病复发。诊断为系统性红斑狼疮和LN的患者年龄明显较小,肾复发患者出现严重蛋白尿和血清低蛋白血症的比例较高。有趣的是,肾病复发患者接受细胞毒维持治疗的比例更高。在考克斯比例危险回归分析中,只有年轻的 LN 发病年龄(10 年前,HR = 0.779,P = 0.007)被确定为肾复发的独立预测因素:结论:年轻的 LN 发病年龄是唯一的独立预测因素,尽管进行了充分的维持治疗,但有严重蛋白尿和血清低白蛋白血症的患者往往复发率更高。需要研究更有效的维持治疗方案和持续时间,以减少肾病复发。
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引用次数: 0
Pregabalin-induced rhabdomyolysis in hemodialysis patient. 普瑞巴林诱导的血液透析患者横纹肌溶解。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2023-11-30 DOI: 10.3904/kjim.2023.379
Dong Eon Kim, Sang Heon Song
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引用次数: 0
Prognostic Significance Of Sequential 18f-fdg Pet/Ct During Frontline Treatment Of Peripheral T Cell Lymphomas. 外周T细胞淋巴瘤前线治疗中序贯18f-fdg Pet/Ct的预后意义
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-01-25 DOI: 10.3904/kjim.2023.323
Ga-Young Song, Sung-Hoon Jung, Seo-Yeon Ahn, Mihee Kim, Jae-Sook Ahn, Je-Jung Lee, Hyeoung-Joon Kim, Jang Bae Moon, Su Woong Yoo, Seong Young Kwon, Jung-Joon Min, Hee-Seung Bom, Sae-Ryung Kang, Deok-Hwan Yang

Background/aims: The prognostic significance of 18F-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET/CT) in peripheral T-cell lymphomas (PTCLs) are controversial. We explored the prognostic impact of sequential 18F-FDG PET/CT during frontline chemotherapy of patients with PTCLs.

Methods: In total, 143 patients with newly diagnosed PTCLs were included. Sequential 18F-FDG PET/CTs were performed at the time of diagnosis, during chemotherapy, and at the end of chemotherapy. The baseline total metabolic tumor volume (TMTV) was calculated using the the standard uptake value with a threshold method of 2.5.

Results: A baseline TMTV of 457.0 cm3 was used to categorize patients into high and low TMTV groups. Patients with a requirehigh TMTV had shorter progression-free survival (PFS) and overall survival (OS) than those with a low TMTV (PFS, 9.8 vs. 26.5 mo, p = 0.043; OS, 18.9 vs. 71.2 mo, p = 0.004). The interim 18F-FDG PET/CT response score was recorded as 1, 2-3, and 4-5 according to the Deauville criteria. The PFS and OS showed significant differences according to the interim 18F-FDG PET/CT response score (PFS, 120.7 vs. 34.1 vs. 5.1 mo, p < 0.001; OS, not reached vs. 61.1 mo vs. 12.1 mo, p < 0.001).

Conclusion: The interim PET/CT response based on visual assessment predicts disease progression and survival outcome in PTCLs. A high baseline TMTV is associated with a poor response to anthracycline-based chemotherapy in PTCLs. However, TMTV was not an independent predictor for PFS in the multivariate analysis.

背景/目的:18F-氟脱氧葡萄糖(FDG)-正电子发射断层扫描-计算机断层扫描(PET/CT)在外周T细胞淋巴瘤(PTCLs)中的预后意义尚存争议。我们探讨了PTCL患者一线化疗期间序贯18F-FDG PET/CT对预后的影响:方法:共纳入 143 例新诊断的 PTCL 患者。方法:共纳入143例新诊断的PTCL患者,分别在诊断时、化疗期间和化疗结束时进行连续的18F-FDG PET/CT检查。基线总代谢肿瘤体积(TMTV)采用标准摄取值计算,阈值法为2.5:结果:基线总代谢肿瘤体积为 457.0 cm3,以此将患者分为高代谢肿瘤体积组和低代谢肿瘤体积组。高TMTV患者的无进展生存期(PFS)和总生存期(OS)均短于低TMTV患者(PFS,9.8个月 vs. 26.5个月,p = 0.043;OS,18.9个月 vs. 71.2个月,p = 0.004)。根据多维尔标准,中期 18F-FDG PET/CT 反应评分分为 1、2-3 和 4-5。根据中期18F-FDG PET/CT反应评分,PFS和OS显示出显著差异(PFS,120.7月 vs. 34.1月 vs. 5.1月,p < 0.001;OS,未达到 vs. 61.1月 vs. 12.1月,p < 0.001):基于视觉评估的PET/CT中期反应可预测PTCL的疾病进展和生存结果。高基线TMTV与PTCL对蒽环类化疗的不良反应有关。然而,在多变量分析中,TMTV并不是预测PFS的独立因素。
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引用次数: 0
Clinical impact of pleural fluid carcinoembryonic antigen on therapeutic strategy and efficacy in lung adenocarcinoma patients with malignant pleural effusion. 胸腔积液癌胚抗原对恶性胸腔积液肺腺癌患者治疗策略和疗效的临床影响
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-02-14 DOI: 10.3904/kjim.2023.309
Jaehee Lee, Deok Heon Lee, Ji Eun Park, Yong Hoon Lee, Sun Ha Choi, Hyewon Seo, Seung Soo Yoo, Shin Yup Lee, Seung-Ick Cha, Jae Yong Park, Chang Ho Kim

Background/aims: Epidermal growth factor receptor (EGFR) mutation is important in determining the treatment strategy for advanced lung cancer patients with malignant pleural effusion (MPE). Contrary to serum carcinoembryonic antigen (S-CEA) levels, the associations between pleural fluid CEA (PF-CEA) levels and EGFR mutation status as well as between PF-CEA levels and treatment efficacy have rarely been investigated in lung adenocarcinoma patients with MPE.

Methods: This retrospective study enrolled lung adenocarcinoma patients with MPE and available PF-CEA levels and EGFR mutation results. The patients were categorized based on PF-CEA levels: < 10 ng/mL, 10-100 ng/mL, 100-500 ng/mL, and ≥ 500 ng/mL. The association between PF-CEA levels and EGFR mutation status as well as their therapeutic impact on overall survival was compared among the four groups.

Results: This study included 188 patients. PF-CEA level was found to be an independent predictor of EGFR mutation but not S-CEA level. The EGFR mutation rates were higher as the PF-CEA levels increased, regardless of cytology results or sample types. Among EGFR-mutant lung adenocarcinoma patients receiving EGFR-tyrosine kinase inhibitor (TKI) treatment, those with high PF-CEA levels had significantly better survival outcomes than those with low PF-CEA levels.

Conclusion: High PF-CEA levels were associated with high EGFR mutation rate and may lead to a favorable clinical outcome of EGFR-TKI treatment in EGFR-mutant lung adenocarcinoma patients with MPE. These findings highlight the importance of actively investigating EGFR mutation detection in patients with suspected MPE and elevated PF-CEA levels despite negative cytology results.

背景/目的:表皮生长因子受体(EGFR)突变是决定恶性胸腔积液(MPE)晚期肺癌患者治疗策略的重要因素。与血清癌胚抗原(S-CEA)水平不同,胸腔积液CEA(PF-CEA)水平与表皮生长因子受体(EGFR)突变状态之间的关系以及PF-CEA水平与治疗效果之间的关系在肺腺癌MPE患者中鲜有研究:这项回顾性研究招募了肺腺癌 MPE 患者,并提供了 PF-CEA 水平和 EGFR 突变结果。根据PF-CEA水平对患者进行分类:<10纳克/毫升、10-100纳克/毫升、100-500纳克/毫升和≥500纳克/毫升。比较了四组患者的PF-CEA水平与表皮生长因子受体突变状态之间的关系及其对总生存期的治疗影响:本研究共纳入188例患者。研究发现,PF-CEA水平是预测表皮生长因子受体突变的独立指标,而S-CEA水平则不是。无论细胞学结果或样本类型如何,PF-CEA水平越高,表皮生长因子受体突变率越高。在接受表皮生长因子受体酪氨酸激酶抑制剂(TKI)治疗的表皮生长因子受体突变肺腺癌患者中,PF-CEA水平高的患者的生存预后明显优于PF-CEA水平低的患者:结论:PF-CEA水平高与表皮生长因子受体突变率高有关,可能会导致表皮生长因子受体突变的肺腺癌MPE患者在接受表皮生长因子受体-酪氨酸激酶抑制剂(TKI)治疗后获得良好的临床结局。这些发现强调了在细胞学结果阴性的情况下,对疑似 MPE 且 PF-CEA 水平升高的患者积极进行 EGFR 突变检测的重要性。
{"title":"Clinical impact of pleural fluid carcinoembryonic antigen on therapeutic strategy and efficacy in lung adenocarcinoma patients with malignant pleural effusion.","authors":"Jaehee Lee, Deok Heon Lee, Ji Eun Park, Yong Hoon Lee, Sun Ha Choi, Hyewon Seo, Seung Soo Yoo, Shin Yup Lee, Seung-Ick Cha, Jae Yong Park, Chang Ho Kim","doi":"10.3904/kjim.2023.309","DOIUrl":"10.3904/kjim.2023.309","url":null,"abstract":"<p><strong>Background/aims: </strong>Epidermal growth factor receptor (EGFR) mutation is important in determining the treatment strategy for advanced lung cancer patients with malignant pleural effusion (MPE). Contrary to serum carcinoembryonic antigen (S-CEA) levels, the associations between pleural fluid CEA (PF-CEA) levels and EGFR mutation status as well as between PF-CEA levels and treatment efficacy have rarely been investigated in lung adenocarcinoma patients with MPE.</p><p><strong>Methods: </strong>This retrospective study enrolled lung adenocarcinoma patients with MPE and available PF-CEA levels and EGFR mutation results. The patients were categorized based on PF-CEA levels: < 10 ng/mL, 10-100 ng/mL, 100-500 ng/mL, and ≥ 500 ng/mL. The association between PF-CEA levels and EGFR mutation status as well as their therapeutic impact on overall survival was compared among the four groups.</p><p><strong>Results: </strong>This study included 188 patients. PF-CEA level was found to be an independent predictor of EGFR mutation but not S-CEA level. The EGFR mutation rates were higher as the PF-CEA levels increased, regardless of cytology results or sample types. Among EGFR-mutant lung adenocarcinoma patients receiving EGFR-tyrosine kinase inhibitor (TKI) treatment, those with high PF-CEA levels had significantly better survival outcomes than those with low PF-CEA levels.</p><p><strong>Conclusion: </strong>High PF-CEA levels were associated with high EGFR mutation rate and may lead to a favorable clinical outcome of EGFR-TKI treatment in EGFR-mutant lung adenocarcinoma patients with MPE. These findings highlight the importance of actively investigating EGFR mutation detection in patients with suspected MPE and elevated PF-CEA levels despite negative cytology results.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"318-326"},"PeriodicalIF":2.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Navigating the risks of using concomitant antipeptic agents in light of osteoporotic concerns. 考虑到骨质疏松问题,了解同时使用抗消化药的风险。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-02-28 DOI: 10.3904/kjim.2024.048
Hae Won Yoo, Su Jin Hong
{"title":"Navigating the risks of using concomitant antipeptic agents in light of osteoporotic concerns.","authors":"Hae Won Yoo, Su Jin Hong","doi":"10.3904/kjim.2024.048","DOIUrl":"10.3904/kjim.2024.048","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"39 2","pages":"201-202"},"PeriodicalIF":2.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of belimumab in patients with systemic lupus erythematosus treated with low dose or no corticosteroids. 贝利单抗在低剂量或无皮质类固醇治疗的系统性红斑狼疮患者中的作用。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2023-11-30 DOI: 10.3904/kjim.2023.229
Yeo-Jin Lee, Soo Min Ahn, Seokchan Hong, Ji-Seon Oh, Chang-Keun Lee, Bin Yoo, Yong-Gil Kim

Background/aims: Systemic lupus erythematosus (SLE) responder index (SRI)-4 response has been achieved with belimumab treatment in patients with moderate disease activity in cornerstone clinical trials and following studies. However, most studies involved patients treated with a mean prednisolone-equivalent dose of approximately 10 mg/d and focused on the steroid-sparing effect of belimumab. We aimed to identify the effect of belimumab in patients with mild-to-moderate SLE who were treated with low-dose or no corticosteroids.

Methods: We retrospectively reviewed the electronic medical records of patients treated with belimumab for at least 6 months between May 2021 and June 2022. The primary endpoint was SRI-4 response at 6 months.

Results: Thirty-one patients were included (13 low dose- and 18 steroid non-users). The mean age was 39.2 ± 11.4 years, and 90.3% of patients were female. The baseline Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score was 6.0 (4.0-9.0). The primary endpoint was achieved in 32.3% (10/31) of patients. Significant improvements in anemia, C4 levels, and SELENA-SLEDAI score were observed during treatment. Univariate analysis showed that the baseline SELENA-SLEDAI and arthritis were significantly associated with SRI-4 response at 6 months, and only the SELENA-SLEDAI remained significant (p = 0.014) in multivariate analysis.

Conclusion: This cohort study is the first to report the efficacy of belimumab after minimizing the effect of corticosteroids. Belimumab showed efficacy in improving the SELENA-SLEDAI score, anemia, and low C4 in patients who did not receive corticosteroids or received only low doses.

背景/目的:在基础临床试验和后续研究中,在中度疾病活动度的患者中,贝利单抗治疗已实现系统性红斑狼疮(SLE)应答指数(SRI)-4应答。然而,大多数研究涉及的患者平均泼尼松龙等效剂量约为10mg /d,并侧重于贝利姆单抗的类固醇节约作用。我们的目的是确定belimumab在低剂量或不使用皮质类固醇治疗的轻中度SLE患者中的作用。方法:我们回顾性回顾了2021年5月至2022年6月期间接受贝利单抗治疗至少6个月的患者的电子病历。主要终点是6个月时的SRI-4缓解。结果:纳入31例患者(13例低剂量和18例非类固醇使用者)。平均年龄39.2±11.4岁,女性占90.3%。雌激素治疗红斑狼疮的基线安全性国家评估-系统性红斑狼疮疾病活动指数(SELENA-SLEDAI)评分为6.0(4.0-9.0)。32.3%(10/31)的患者达到了主要终点。治疗期间观察到贫血、C4水平和SELENA-SLEDAI评分显著改善。单因素分析显示,基线SELENA-SLEDAI和关节炎与6个月时的SRI-4反应显著相关,在多因素分析中只有SELENA-SLEDAI仍然显著(p = 0.014)。结论:该队列研究首次报道了贝利姆单抗在皮质类固醇作用最小化后的疗效。在未接受皮质类固醇或仅接受低剂量皮质类固醇的患者中,贝利单抗显示出改善SELENA-SLEDAI评分、贫血和低C4的疗效。
{"title":"Effect of belimumab in patients with systemic lupus erythematosus treated with low dose or no corticosteroids.","authors":"Yeo-Jin Lee, Soo Min Ahn, Seokchan Hong, Ji-Seon Oh, Chang-Keun Lee, Bin Yoo, Yong-Gil Kim","doi":"10.3904/kjim.2023.229","DOIUrl":"10.3904/kjim.2023.229","url":null,"abstract":"<p><strong>Background/aims: </strong>Systemic lupus erythematosus (SLE) responder index (SRI)-4 response has been achieved with belimumab treatment in patients with moderate disease activity in cornerstone clinical trials and following studies. However, most studies involved patients treated with a mean prednisolone-equivalent dose of approximately 10 mg/d and focused on the steroid-sparing effect of belimumab. We aimed to identify the effect of belimumab in patients with mild-to-moderate SLE who were treated with low-dose or no corticosteroids.</p><p><strong>Methods: </strong>We retrospectively reviewed the electronic medical records of patients treated with belimumab for at least 6 months between May 2021 and June 2022. The primary endpoint was SRI-4 response at 6 months.</p><p><strong>Results: </strong>Thirty-one patients were included (13 low dose- and 18 steroid non-users). The mean age was 39.2 ± 11.4 years, and 90.3% of patients were female. The baseline Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score was 6.0 (4.0-9.0). The primary endpoint was achieved in 32.3% (10/31) of patients. Significant improvements in anemia, C4 levels, and SELENA-SLEDAI score were observed during treatment. Univariate analysis showed that the baseline SELENA-SLEDAI and arthritis were significantly associated with SRI-4 response at 6 months, and only the SELENA-SLEDAI remained significant (p = 0.014) in multivariate analysis.</p><p><strong>Conclusion: </strong>This cohort study is the first to report the efficacy of belimumab after minimizing the effect of corticosteroids. Belimumab showed efficacy in improving the SELENA-SLEDAI score, anemia, and low C4 in patients who did not receive corticosteroids or received only low doses.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"338-346"},"PeriodicalIF":2.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Model for end-stage liver disease-3.0 vs. model for end-stage liver disease-sodium: mortality prediction in Korea. 终末期肝病-3.0 模型与终末期肝病-钠模型:韩国的死亡率预测。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-02-01 DOI: 10.3904/kjim.2023.005
Jeong Han Kim, Yong Joon Cho, Won Hyeok Choe, So Young Kwon, Byung-Chul Yoo

Background/aims: The model for end-stage liver disease (MELD) serves as an indicator for short-term mortality among patients diagnosed with liver cirrhosis (LC) and is used to prioritize patients for liver transplantation. In 2021, the updated version of MELD, MELD-3.0, was introduced to improve the accuracy of the mortality prediction of MELD. Therefore, this study aimed to compare the efficacy of MELD 3.0 and MELD-Na in predicting mortality among Korean patients with LC.

Methods: A retrospective review was conducted using the medical records of patients diagnosed with LC who were admitted to Konkuk University Hospital From 2011 to 2021. The study calculated the predictive values of MELD-Na and MELD-3.0 for 3- and 6-months mortality using the area under the receiver operating curve (AUROC) and compared the results using the DeLong test.

Results: Of the 3,034 patients enrolled in the study, 339 (11.2%) died within 3 months and 421 (14.4%) died within 6 months. The AUROCs values for predicting 3 months mortality were 0.846 for MELD-Na and 0.851 for MELD-3.0. The corresponding AUROC values for predicting 6 months mortality were 0.843 for MELD-Na and 0.848 for MELD-3.0. MELD-3.0 exhibited better discrimination ability than MELD-Na for both 3 (p = 0.03) and 6 months mortality (p = 0.01).

Conclusion: Our study found a significant difference between the performance of MELD-3.0 and MELD-Na in Korean patients with LC.

背景/目的:终末期肝病模型(MELD)是诊断为肝硬化(LC)的患者短期死亡率的指标,用于确定肝移植患者的优先顺序。2021 年,MELD 的更新版本 MELD-3.0 问世,提高了 MELD 预测死亡率的准确性。因此,本研究旨在比较 MELD 3.0 和 MELD-Na 在预测韩国 LC 患者死亡率方面的效果:方法:使用建国大学医院 2011 年至 2021 年收治的确诊为 LC 患者的病历进行回顾性研究。研究使用接收者操作曲线下面积(AUROC)计算了 MELD-Na 和 MELD-3.0 对 3 个月和 6 个月死亡率的预测值,并使用 DeLong 检验对结果进行了比较:在 3034 名参与研究的患者中,339 人(11.2%)在 3 个月内死亡,421 人(14.4%)在 6 个月内死亡。MELD-Na 预测 3 个月死亡率的 AUROCs 值为 0.846,MELD-3.0 预测 3 个月死亡率的 AUROCs 值为 0.851。预测 6 个月死亡率的相应 AUROC 值为:MELD-Na 为 0.843,MELD-3.0 为 0.848。在 3 个月死亡率(p = 0.03)和 6 个月死亡率(p = 0.01)方面,MELD-3.0 都比 MELD-Na 表现出更好的分辨能力:我们的研究发现,在韩国 LC 患者中,MELD-3.0 和 MELD-Na 的表现存在明显差异。
{"title":"Model for end-stage liver disease-3.0 vs. model for end-stage liver disease-sodium: mortality prediction in Korea.","authors":"Jeong Han Kim, Yong Joon Cho, Won Hyeok Choe, So Young Kwon, Byung-Chul Yoo","doi":"10.3904/kjim.2023.005","DOIUrl":"10.3904/kjim.2023.005","url":null,"abstract":"<p><strong>Background/aims: </strong>The model for end-stage liver disease (MELD) serves as an indicator for short-term mortality among patients diagnosed with liver cirrhosis (LC) and is used to prioritize patients for liver transplantation. In 2021, the updated version of MELD, MELD-3.0, was introduced to improve the accuracy of the mortality prediction of MELD. Therefore, this study aimed to compare the efficacy of MELD 3.0 and MELD-Na in predicting mortality among Korean patients with LC.</p><p><strong>Methods: </strong>A retrospective review was conducted using the medical records of patients diagnosed with LC who were admitted to Konkuk University Hospital From 2011 to 2021. The study calculated the predictive values of MELD-Na and MELD-3.0 for 3- and 6-months mortality using the area under the receiver operating curve (AUROC) and compared the results using the DeLong test.</p><p><strong>Results: </strong>Of the 3,034 patients enrolled in the study, 339 (11.2%) died within 3 months and 421 (14.4%) died within 6 months. The AUROCs values for predicting 3 months mortality were 0.846 for MELD-Na and 0.851 for MELD-3.0. The corresponding AUROC values for predicting 6 months mortality were 0.843 for MELD-Na and 0.848 for MELD-3.0. MELD-3.0 exhibited better discrimination ability than MELD-Na for both 3 (p = 0.03) and 6 months mortality (p = 0.01).</p><p><strong>Conclusion: </strong>Our study found a significant difference between the performance of MELD-3.0 and MELD-Na in Korean patients with LC.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"248-260"},"PeriodicalIF":2.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metformin and tuberculosis: extraordinary stories of ordinary co-prevalent patients. 二甲双胍与肺结核:普通共患患者的非凡故事。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-03-01 Epub Date: 2024-02-28 DOI: 10.3904/kjim.2024.031
Won-Il Choi
{"title":"Metformin and tuberculosis: extraordinary stories of ordinary co-prevalent patients.","authors":"Won-Il Choi","doi":"10.3904/kjim.2024.031","DOIUrl":"10.3904/kjim.2024.031","url":null,"abstract":"","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"39 2","pages":"203-204"},"PeriodicalIF":2.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Korean Journal of Internal Medicine
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