Pub Date : 2023-03-26DOI: 10.25011/cim.v46i1.40275
Difan Lu, Wenchao Mao
Background: This study explored the efficacy of hydrocortisone combined with vitamin C and thiamine (HVT) in the treatment of sepsis/septic shock.
Methods: PubMed, EMBASE and Web of Science were searched (establishment of the database to October 31, 2022). The meta-analysis included randomized controlled trials (RCTs); comparing the efficacy of HVT regimen and placebo in the treatment of sepsis/septic shock. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias. The Review Manager 5.4 software was used for meta-analysis, and the relative risk (RR), mean difference (MD) and 95% confidence intervals (CI) were then determined. Trial sequential analysis (TSA) was then conducted.
Results: Eight RCTs with 1,572 patients were identified. Meta-analysis showed that HVT regimen did not reduce all-cause (RR=0.96, 95% CI: 0.83 - 1.11, P=0.60), hospital (RR=1.03, 95% CI: 0.83 - 1.27, P=0.80) or intensive care unit (ICU) mortalities (RR=1.05, 95% CI: 0.86 - 1.28, P=0.65). Furthermore, there was no significant difference in the change of sequential organ failure assessment score, length of ICU stay, length of hospital stay, duration of the use of vasopressors, incidence of acute kidney injury and ventilator-free days between HVT and control groups. TSA showed that more trials are needed to confirm the results.
Conclusions: HVT regimen did not reduce the mortality of patients with sepsis/septic shock and was not associated with a significant improvement in outcomes. The TSA result showed that more RCTs with high quality and large sample sizes are needed to further confirm the results.
{"title":"Hydrocortisone Combined with Vitamin C and Thiamine in the Treatment of Sepsis/Septic Shock: A Systematic Review with Meta-Analysis and Trial Sequential Analysis.","authors":"Difan Lu, Wenchao Mao","doi":"10.25011/cim.v46i1.40275","DOIUrl":"https://doi.org/10.25011/cim.v46i1.40275","url":null,"abstract":"<p><strong>Background: </strong>This study explored the efficacy of hydrocortisone combined with vitamin C and thiamine (HVT) in the treatment of sepsis/septic shock.</p><p><strong>Methods: </strong>PubMed, EMBASE and Web of Science were searched (establishment of the database to October 31, 2022). The meta-analysis included randomized controlled trials (RCTs); comparing the efficacy of HVT regimen and placebo in the treatment of sepsis/septic shock. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias. The Review Manager 5.4 software was used for meta-analysis, and the relative risk (RR), mean difference (MD) and 95% confidence intervals (CI) were then determined. Trial sequential analysis (TSA) was then conducted.</p><p><strong>Results: </strong>Eight RCTs with 1,572 patients were identified. Meta-analysis showed that HVT regimen did not reduce all-cause (RR=0.96, 95% CI: 0.83 - 1.11, P=0.60), hospital (RR=1.03, 95% CI: 0.83 - 1.27, P=0.80) or intensive care unit (ICU) mortalities (RR=1.05, 95% CI: 0.86 - 1.28, P=0.65). Furthermore, there was no significant difference in the change of sequential organ failure assessment score, length of ICU stay, length of hospital stay, duration of the use of vasopressors, incidence of acute kidney injury and ventilator-free days between HVT and control groups. TSA showed that more trials are needed to confirm the results.</p><p><strong>Conclusions: </strong>HVT regimen did not reduce the mortality of patients with sepsis/septic shock and was not associated with a significant improvement in outcomes. The TSA result showed that more RCTs with high quality and large sample sizes are needed to further confirm the results.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-26DOI: 10.25011/cim.v46i1.39561
Yang Xia, Hua Ye, Kejia Li, Bairu Shi, Xian Sun, Jiajun Wu
Purpose: The purpose of this meta-analysis is to determine the efficacy of mesenchymal stromal/stem cell (MSC) transplantation therapy on lupus nephritis (LN) and renal function of patients with systemic lupus erythematosus (SLE).
Methods: Articles that reported the data of MSC therapy on the renal function as well as disease activity of LN in patients with SLE were searched in PubMed, Web of Science, Embase and the Cochrane Library. Mean difference for disease activity and laboratory parameters were pooled to evaluate the efficacy of MSC, and incidence was pooled for clinical remission, death and severe adverse event.
Results: A total of 12 studies with 586 patients were included. The disease activity indices, including SLEDAI and BILAG, were significantly decreased within 12 months after MSC therapy (P< 0.05). Laboratory parameters for renal function and disease control including estimated glomerular filtration rate, creatinine, blood urea nitrogen, complement C3, albumin and urine protein, were also significantly improved after therapy. The pooled rate of clinical remission at 12 months was 28.1% and the total rate during follow-up was 33.7%. The pooled rate of death at 12 months was 5.2% and the total rate during follow-up was 5.5%. Severe adverse events were rare and not associated with the treatment of MSC.
Conclusions: This is the first meta-analysis that focuses on the effect of MSC on LN and renal function of patients with SLE, and the results shows a favorable safety profile and encouraging results of MSC for improving the disease activity of LN as well as the renal function of SLE patients.
目的:本荟萃分析的目的是确定间充质基质/干细胞(MSC)移植治疗对系统性红斑狼疮(SLE)患者狼疮性肾炎(LN)和肾功能的疗效。方法:检索PubMed、Web of Science、Embase、Cochrane图书馆中报道MSC治疗对SLE患者肾功能及LN疾病活动度影响的文章。汇总疾病活动性和实验室参数的平均差异来评估MSC的疗效,并汇总临床缓解、死亡和严重不良事件的发生率。结果:共纳入12项研究,586例患者。MSC治疗后12个月内,SLEDAI、BILAG等疾病活动度指标均显著降低(P< 0.05)。治疗后,肾功能和疾病控制的实验室参数包括肾小球滤过率、肌酐、血尿素氮、补体C3、白蛋白和尿蛋白也有显著改善。12个月临床总缓解率为28.1%,随访总缓解率为33.7%。12个月合并死亡率为5.2%,随访期间总死亡率为5.5%。严重不良事件罕见,与MSC治疗无关。结论:这是首个关注MSC对SLE患者LN和肾功能影响的荟萃分析,结果显示MSC在改善LN疾病活动性和SLE患者肾功能方面具有良好的安全性和令人鼓舞的结果。
{"title":"Efficacy of Mesenchymal Stem Cell Therapy on Lupus Nephritis and Renal Function in Systemic Lupus Erythematosus: A Meta-Analysis.","authors":"Yang Xia, Hua Ye, Kejia Li, Bairu Shi, Xian Sun, Jiajun Wu","doi":"10.25011/cim.v46i1.39561","DOIUrl":"https://doi.org/10.25011/cim.v46i1.39561","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this meta-analysis is to determine the efficacy of mesenchymal stromal/stem cell (MSC) transplantation therapy on lupus nephritis (LN) and renal function of patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>Articles that reported the data of MSC therapy on the renal function as well as disease activity of LN in patients with SLE were searched in PubMed, Web of Science, Embase and the Cochrane Library. Mean difference for disease activity and laboratory parameters were pooled to evaluate the efficacy of MSC, and incidence was pooled for clinical remission, death and severe adverse event.</p><p><strong>Results: </strong>A total of 12 studies with 586 patients were included. The disease activity indices, including SLEDAI and BILAG, were significantly decreased within 12 months after MSC therapy (P< 0.05). Laboratory parameters for renal function and disease control including estimated glomerular filtration rate, creatinine, blood urea nitrogen, complement C3, albumin and urine protein, were also significantly improved after therapy. The pooled rate of clinical remission at 12 months was 28.1% and the total rate during follow-up was 33.7%. The pooled rate of death at 12 months was 5.2% and the total rate during follow-up was 5.5%. Severe adverse events were rare and not associated with the treatment of MSC.</p><p><strong>Conclusions: </strong>This is the first meta-analysis that focuses on the effect of MSC on LN and renal function of patients with SLE, and the results shows a favorable safety profile and encouraging results of MSC for improving the disease activity of LN as well as the renal function of SLE patients.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-26DOI: 10.25011/cim.v46i1.39560
Katrina F Hurley, Eleanor A Fitzpatrick, Jianling Xie, Sarah Urquhart, Ken J Farion, Serge Gouin, Suzanne Schuh, Naveen Poonai, Stephen Freedman
Background: To improve our understanding of adherence to discharge medications in the ED and within research trials, we sought to quantify medication adherence and identify predictors thereof in children with acute gastroenteritis (AGE).
Methods: We conducted a secondary analysis of a randomized trial of twice daily probiotic for 5 days. The population included previously healthy children aged 3-47 months with AGE. The primary outcome was patient-reported adherence to the treatment regimen, defined a priori as having received >70% of the prescribed doses. Secondary outcomes included predictors of treatment adherence and concordance between patient-reported adherence and the returned medication sachet counts.
Results: After excluding participants with missing data on adherence, 760 participants were included in this analysis: 383 in the probiotic arm (50.4%); and 377 in the placebo arm (49.6%). Self-reported adherence was similar in both groups (77.0% in probiotic versus 80.3% in placebo). There was good agreement between self-reported adherence and sachet counts (87% within limits of agreement (-2.9 to 3.5 sachets) on the Bland-Altman plots). In the multivariable regression model, covariates associated with adherence were greater number of days of diarrhea post-emergency department visit, and the study site; covariates negatively associated with adherence were age 12-23 months, severe dehydration and greater total number of vomiting and diarrhea episodes after enrolment.
Conclusions: Longer duration of diarrhea and study site were associated with higher probiotic adherence. Age 12-23 months, severe dehydration and greater number of vomiting and diarrhea episodes post enrolment negatively predicted treatment adherence.
{"title":"Predictors of Adherence to Short-Course Probiotics Among Children with Gastroenteritis who are Enrolled in a Clinical Trial.","authors":"Katrina F Hurley, Eleanor A Fitzpatrick, Jianling Xie, Sarah Urquhart, Ken J Farion, Serge Gouin, Suzanne Schuh, Naveen Poonai, Stephen Freedman","doi":"10.25011/cim.v46i1.39560","DOIUrl":"https://doi.org/10.25011/cim.v46i1.39560","url":null,"abstract":"<p><strong>Background: </strong>To improve our understanding of adherence to discharge medications in the ED and within research trials, we sought to quantify medication adherence and identify predictors thereof in children with acute gastroenteritis (AGE).</p><p><strong>Methods: </strong>We conducted a secondary analysis of a randomized trial of twice daily probiotic for 5 days. The population included previously healthy children aged 3-47 months with AGE. The primary outcome was patient-reported adherence to the treatment regimen, defined a priori as having received >70% of the prescribed doses. Secondary outcomes included predictors of treatment adherence and concordance between patient-reported adherence and the returned medication sachet counts.</p><p><strong>Results: </strong>After excluding participants with missing data on adherence, 760 participants were included in this analysis: 383 in the probiotic arm (50.4%); and 377 in the placebo arm (49.6%). Self-reported adherence was similar in both groups (77.0% in probiotic versus 80.3% in placebo). There was good agreement between self-reported adherence and sachet counts (87% within limits of agreement (-2.9 to 3.5 sachets) on the Bland-Altman plots). In the multivariable regression model, covariates associated with adherence were greater number of days of diarrhea post-emergency department visit, and the study site; covariates negatively associated with adherence were age 12-23 months, severe dehydration and greater total number of vomiting and diarrhea episodes after enrolment.</p><p><strong>Conclusions: </strong>Longer duration of diarrhea and study site were associated with higher probiotic adherence. Age 12-23 months, severe dehydration and greater number of vomiting and diarrhea episodes post enrolment negatively predicted treatment adherence.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-26DOI: 10.25011/cim.v46i1.39997
Melissa Phuong, Robert Lao, Yujin Suk, Wenxuan Wang, Amelia Yuan
Over the past year, the leadership of the Clinician Investigator Trainee Association of Canada (CITAC), alongside our MD+ trainees, had the opportunity to further develop and implement our strategic plan in response to the evolving medical landscape. We have dedicated our efforts to the progression towards a post-pandemic environment, have taken advantage of the lessons learned during the coronavirus disease 2019 (COVID-19) health crisis and have focused on enhancing in-person career development opportunities for our members.
{"title":"Spring 2023: Clinician Investigator Trainee Association of Canada (CITAC).","authors":"Melissa Phuong, Robert Lao, Yujin Suk, Wenxuan Wang, Amelia Yuan","doi":"10.25011/cim.v46i1.39997","DOIUrl":"https://doi.org/10.25011/cim.v46i1.39997","url":null,"abstract":"<p><p>Over the past year, the leadership of the Clinician Investigator Trainee Association of Canada (CITAC), alongside our MD+ trainees, had the opportunity to further develop and implement our strategic plan in response to the evolving medical landscape. We have dedicated our efforts to the progression towards a post-pandemic environment, have taken advantage of the lessons learned during the coronavirus disease 2019 (COVID-19) health crisis and have focused on enhancing in-person career development opportunities for our members.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.25011/cim.v45i4.39274
Alexa Keeshan, Carla Coffin, Alicia Vachon, Nishi Patel, Scott Fung, Leanne Mortimer, Angela Crawley, Mang Ma, Carla Osiowy, Curtis Cooper
Purpose: There is a need for effective and affordable treatments that achieve hepatitis B virus (HBV) functional cure and prevent long-term complications. The use of immune-modulators combined with HBV antivirals is a promising therapeutic strategy to achieve these goals. Based on ribavirin (RBV) monotherapy data, we hypothesized that RBV could improve virological responses when used in combination with tenofovir. Methods: In this randomized, open label, controlled pilot trial, we evaluated RBV (n=4) dosed for the initial 24 weeks of treatment versus no RBV (n=4) in tenofovir recipients dosed over 48 weeks. Results: Although well tolerated and safe in combination with tenofovir, RBV demonstrated no beneficial effects on virologic, biochemical or immunological markers of chronic HBV infection over 48 weeks of serial evaluation. Conclusions: Our data does not suggest a HBV-specific immunomodulatory effect or an impact of RBV on HBV virological and antigen suppression.
{"title":"Ribavirin Does Not Enhance Hepatitis B Virus Nucleotide Antiviral Activity: A Pilot Study.","authors":"Alexa Keeshan, Carla Coffin, Alicia Vachon, Nishi Patel, Scott Fung, Leanne Mortimer, Angela Crawley, Mang Ma, Carla Osiowy, Curtis Cooper","doi":"10.25011/cim.v45i4.39274","DOIUrl":"https://doi.org/10.25011/cim.v45i4.39274","url":null,"abstract":"<p><strong>Purpose: </strong>There is a need for effective and affordable treatments that achieve hepatitis B virus (HBV) functional cure and prevent long-term complications. The use of immune-modulators combined with HBV antivirals is a promising therapeutic strategy to achieve these goals. Based on ribavirin (RBV) monotherapy data, we hypothesized that RBV could improve virological responses when used in combination with tenofovir. Methods: In this randomized, open label, controlled pilot trial, we evaluated RBV (n=4) dosed for the initial 24 weeks of treatment versus no RBV (n=4) in tenofovir recipients dosed over 48 weeks. Results: Although well tolerated and safe in combination with tenofovir, RBV demonstrated no beneficial effects on virologic, biochemical or immunological markers of chronic HBV infection over 48 weeks of serial evaluation. Conclusions: Our data does not suggest a HBV-specific immunomodulatory effect or an impact of RBV on HBV virological and antigen suppression.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.25011/cim.v45i4.39559
Robert Bortolussi
For over 40 years the journal of Clinical and Investigative Medicine (CIM) has published articles of interest to clinician investigators in Canada and elsewhere. We strive for the highest standards and to remain relevant to our readers, but we cannot achieve this goal without the help of our reviewers, all of whom play a vital role in maintaining the integrity of the scientific process. Without their efforts, academic excellence would falter.
{"title":"Hats Off to the CIM Reviewers Of 2022.","authors":"Robert Bortolussi","doi":"10.25011/cim.v45i4.39559","DOIUrl":"https://doi.org/10.25011/cim.v45i4.39559","url":null,"abstract":"<p><p>For over 40 years the journal of Clinical and Investigative Medicine (CIM) has published articles of interest to clinician investigators in Canada and elsewhere. We strive for the highest standards and to remain relevant to our readers, but we cannot achieve this goal without the help of our reviewers, all of whom play a vital role in maintaining the integrity of the scientific process. Without their efforts, academic excellence would falter.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10832433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.25011/cim.v45i4.39557
Jeffry Schiff, Michael Mengel
The Canadian Society of Transplantation (CST) annual scientific meeting was held in Banff Alberta September 19-23, 2022. It provided a forum for the transplantation community to share ideas, leading practices, innovative science and educational content in transplant care. The meeting brought together members of the Banff Foundation for Allograft Pathology and the CST for a hybrid event, combining both in-person and virtual experiences, and helping the two societies reach a wider audience. With over 600 Canadian and International delegates attending, the 2022 Banff-CST Meeting received outstanding educational programming, but also rare opportunities to connect with transplantation professionals from all over the world.
{"title":"2022 Joint Meeting On Transplantation: Canadian Society of Transplantation And Banff Foundation of Allograft Pathology.","authors":"Jeffry Schiff, Michael Mengel","doi":"10.25011/cim.v45i4.39557","DOIUrl":"https://doi.org/10.25011/cim.v45i4.39557","url":null,"abstract":"<p><p>The Canadian Society of Transplantation (CST) annual scientific meeting was held in Banff Alberta September 19-23, 2022. It provided a forum for the transplantation community to share ideas, leading practices, innovative science and educational content in transplant care. The meeting brought together members of the Banff Foundation for Allograft Pathology and the CST for a hybrid event, combining both in-person and virtual experiences, and helping the two societies reach a wider audience. With over 600 Canadian and International delegates attending, the 2022 Banff-CST Meeting received outstanding educational programming, but also rare opportunities to connect with transplantation professionals from all over the world.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.25011/cim.v45i4.39558
Qiang Wang, Xiaoliu Li, Jing Zhang, Lian Xiang, Jing Dong
Purpose: To measure interleukin (IL)-17 serum levels in thoracic trauma patients and to correlate these levels with other cytokines and with patient prognosis. Methods: This prospective observational study recruited 130 thoracic trauma patients who were admitted to the Zhoupu Hospital Affiliated to Shanghai Medical College of Health June 2020 to April 2022 and 100 healthy volunteers. Patients were divided into two groups based on Injury Severity Score (ISS): ISS<16 (mild/moderate trauma) and ISS ≥16 (severe trauma). Serum IL-17, tumor necrosis factor α (TNF-α), IL-6, IL-1β and C-reactive protein (CRP) levels were measured by enzyme-linked immunosorbent assay. Patients with poor prognosis were defined as those who developed serious complications or died during hospitalization or follow-up. Results: Serum levels of IL-17, TNF-α, IL-6 and IL-1β were significantly elevated in patients with ISS ≥16 (p<0.05). Serum cytokines levels increased within 48 h in both groups and then gradually decreased during subsequent treatment and rehabilitation. Pearson's analysis indicated a positive correlation among IL-17, TNF-α and IL-1β. Serum IL-17 levels in patients with poor prognoses were higher than the patients with good prognoses at all time points (p<0.05). Furthermore, for patients with poor prognoses, the serum IL-17 levels had highest diagnostic value among all the cytokines measured. Logistic regression analysis showed that IL-17 was the risk factor for thoracic trauma patients with poor prognoses. Conclusion: Serum IL-17 levels were significantly elevated in thoracic trauma patients and decreased gradually with rehabilitation. IL-17 was a risk factor for thoracic trauma patients with poor prognoses. This study suggests a new diagnostic and therapeutic target for thoracic trauma patients.
{"title":"Elevated Serum Interleukin-17 Levels in Thoracic Trauma Patients with Poor Prognosis: A Prospective Observational Study.","authors":"Qiang Wang, Xiaoliu Li, Jing Zhang, Lian Xiang, Jing Dong","doi":"10.25011/cim.v45i4.39558","DOIUrl":"https://doi.org/10.25011/cim.v45i4.39558","url":null,"abstract":"<p><strong>Purpose: </strong>To measure interleukin (IL)-17 serum levels in thoracic trauma patients and to correlate these levels with other cytokines and with patient prognosis. Methods: This prospective observational study recruited 130 thoracic trauma patients who were admitted to the Zhoupu Hospital Affiliated to Shanghai Medical College of Health June 2020 to April 2022 and 100 healthy volunteers. Patients were divided into two groups based on Injury Severity Score (ISS): ISS<16 (mild/moderate trauma) and ISS ≥16 (severe trauma). Serum IL-17, tumor necrosis factor α (TNF-α), IL-6, IL-1β and C-reactive protein (CRP) levels were measured by enzyme-linked immunosorbent assay. Patients with poor prognosis were defined as those who developed serious complications or died during hospitalization or follow-up. Results: Serum levels of IL-17, TNF-α, IL-6 and IL-1β were significantly elevated in patients with ISS ≥16 (p<0.05). Serum cytokines levels increased within 48 h in both groups and then gradually decreased during subsequent treatment and rehabilitation. Pearson's analysis indicated a positive correlation among IL-17, TNF-α and IL-1β. Serum IL-17 levels in patients with poor prognoses were higher than the patients with good prognoses at all time points (p<0.05). Furthermore, for patients with poor prognoses, the serum IL-17 levels had highest diagnostic value among all the cytokines measured. Logistic regression analysis showed that IL-17 was the risk factor for thoracic trauma patients with poor prognoses. Conclusion: Serum IL-17 levels were significantly elevated in thoracic trauma patients and decreased gradually with rehabilitation. IL-17 was a risk factor for thoracic trauma patients with poor prognoses. This study suggests a new diagnostic and therapeutic target for thoracic trauma patients.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.25011/cim.v45i4.39275
Samuel Mailhot-Larouche, Vincent Chauvette, David Bergeron, Catherine Larochelle, Geneviève Du Pont-Thibodeau, Han Wang, Héloïse Cardinal, Isabelle Bourdeau, Nathalie Auger, Nathalie Bureau Md MSc Bureau, Alexandre Prat, Didier Jutras-Aswad, François Madore, Guillaume Emeriaud, Houda Bahig, Marie-Hélène Mayrand, Rafik Tadros, Stefan Parent, Philippe Richebe Md PhD Richebe, Yahye Merhi, Dang Nguyen
Purpose: Clinician-investigators have an important role in the development and implantation of new therapies and treatment modalities; however, there have been several reports highlighting a pending shortage in the clinician-investigators' workforce. In Canada, the Royal College has promoted the development of clinician-investigators programs (CIP) to facilitate the training of these individuals. There is currently a paucity of data regarding the outcomes of such programs. This study aims to identify the strengths and areas of improvement of the Montreal University CIP. Methods: An internet-based 51-question survey was distributed to all the alumni from the University of Montreal CIP. Participation was voluntary and no incentives were provided. The response rate was 64%. Results: Among respondents, 50% (n=16) had completed their clinical residency and all CIP requirements. The majority of these individuals (63%) had become independent investigators and had secured provincial and national funding. Satisfaction of the respondents was high regarding the overall program (85%), the research skills developed during the CIP (84%) and the financial support obtained during the program (72%). The satisfaction rate regarding career planning was lower (63%). Conclusion: This survey demonstrates that, while indicators are favorable, some areas still require improvement. Several steps to improve the CIP have been identified; notably, the transition from the CIP to early independent career has been identified as critical in the development of clinician-investigators and steps have been taken to improve this progression.
{"title":"University of Montreal's Clinician-Investigator Program: A 10-Year Descriptive Evaluation.","authors":"Samuel Mailhot-Larouche, Vincent Chauvette, David Bergeron, Catherine Larochelle, Geneviève Du Pont-Thibodeau, Han Wang, Héloïse Cardinal, Isabelle Bourdeau, Nathalie Auger, Nathalie Bureau Md MSc Bureau, Alexandre Prat, Didier Jutras-Aswad, François Madore, Guillaume Emeriaud, Houda Bahig, Marie-Hélène Mayrand, Rafik Tadros, Stefan Parent, Philippe Richebe Md PhD Richebe, Yahye Merhi, Dang Nguyen","doi":"10.25011/cim.v45i4.39275","DOIUrl":"https://doi.org/10.25011/cim.v45i4.39275","url":null,"abstract":"<p><strong>Purpose: </strong>Clinician-investigators have an important role in the development and implantation of new therapies and treatment modalities; however, there have been several reports highlighting a pending shortage in the clinician-investigators' workforce. In Canada, the Royal College has promoted the development of clinician-investigators programs (CIP) to facilitate the training of these individuals. There is currently a paucity of data regarding the outcomes of such programs. This study aims to identify the strengths and areas of improvement of the Montreal University CIP. Methods: An internet-based 51-question survey was distributed to all the alumni from the University of Montreal CIP. Participation was voluntary and no incentives were provided. The response rate was 64%. Results: Among respondents, 50% (n=16) had completed their clinical residency and all CIP requirements. The majority of these individuals (63%) had become independent investigators and had secured provincial and national funding. Satisfaction of the respondents was high regarding the overall program (85%), the research skills developed during the CIP (84%) and the financial support obtained during the program (72%). The satisfaction rate regarding career planning was lower (63%). Conclusion: This survey demonstrates that, while indicators are favorable, some areas still require improvement. Several steps to improve the CIP have been identified; notably, the transition from the CIP to early independent career has been identified as critical in the development of clinician-investigators and steps have been taken to improve this progression.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10602833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To investigate the value of anteroposterior-to-transverse ratio (ATR) and the effect on features of nodules in ultrasound (US) diagnosis of thyroid nodules in different locations. Methods: The nodules were divided into three groups according to the different nodule location: isthmus group; upper and lower poles of bilobed thyroid group; and the middle of the bilobed thyroid group. The diameters of the nodules were recorded, and ATR of the nodule was calculated on the transverse and longitudinal sections. The transverse and the longitudinal sections of ATR of thyroid nodules in different groups were compared. Result: The transverse section of ATR was significantly different among the three groups (p = 0.001). In addition, there are significant differences in many US features among three groups, including nodule composition, thyroid parenchyma, morphology, echogenicity, shape, calcifications, vascularity, nodule ACR TI-RADS and histopathologic (all p < 0.05). In the group of upper and lower poles of bilobed thyroid, significant difference was found between the transverse and the longitudinal section of ATR (p = 0.019). The cut-off values of transverse section and longitudinal section of ATR were 0.967 and 0.750, respectively. Conclusion: The transverse section of ATR at different location of thyroid may be a predictor for malignancy with clinical diagnostic significance.
{"title":"Value Of Anteroposterior-To-Transverse Ratio in Ultrasonic Diagnosis of Thyroid Nodule in Different Locations.","authors":"Hai-Ning Zheng, Wei Wang Md Wang, Xiao-Qing Wang Md Wang, Wen-Jing Song, Wen-Jing Song, Rui Zhao, Meng Li, Chao-Yang Wen Md Wen","doi":"10.25011/cim.v45i4.38877","DOIUrl":"https://doi.org/10.25011/cim.v45i4.38877","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the value of anteroposterior-to-transverse ratio (ATR) and the effect on features of nodules in ultrasound (US) diagnosis of thyroid nodules in different locations. Methods: The nodules were divided into three groups according to the different nodule location: isthmus group; upper and lower poles of bilobed thyroid group; and the middle of the bilobed thyroid group. The diameters of the nodules were recorded, and ATR of the nodule was calculated on the transverse and longitudinal sections. The transverse and the longitudinal sections of ATR of thyroid nodules in different groups were compared. Result: The transverse section of ATR was significantly different among the three groups (p = 0.001). In addition, there are significant differences in many US features among three groups, including nodule composition, thyroid parenchyma, morphology, echogenicity, shape, calcifications, vascularity, nodule ACR TI-RADS and histopathologic (all p < 0.05). In the group of upper and lower poles of bilobed thyroid, significant difference was found between the transverse and the longitudinal section of ATR (p = 0.019). The cut-off values of transverse section and longitudinal section of ATR were 0.967 and 0.750, respectively. Conclusion: The transverse section of ATR at different location of thyroid may be a predictor for malignancy with clinical diagnostic significance.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}