Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.90316
M. Jeeyavudeen, Mairi Crosby, Joseph M Pappachan
Managing diabetes during pregnancy is challenging, given the significant risk it poses for both maternal and foetal health outcomes. While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests, the advent of continuous glucose monitoring (CGM) systems has revolutionized the approach. These devices offer a safe and reliable means of tracking glucose levels in real-time, benefiting both women with diabetes during pregnancy and the healthcare providers. Moreover, CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes, especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device. Such a combined approach has been demonstrated to improve overall blood sugar control, lessen the occurrence of preeclampsia and neonatal hypoglycaemia, and minimize the duration of neonatal intensive care unit stays. This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.
{"title":"Continuous glucose monitoring metrics in pregnancy with type 1 diabetes mellitus","authors":"M. Jeeyavudeen, Mairi Crosby, Joseph M Pappachan","doi":"10.5662/wjm.v14.i1.90316","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.90316","url":null,"abstract":"Managing diabetes during pregnancy is challenging, given the significant risk it poses for both maternal and foetal health outcomes. While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests, the advent of continuous glucose monitoring (CGM) systems has revolutionized the approach. These devices offer a safe and reliable means of tracking glucose levels in real-time, benefiting both women with diabetes during pregnancy and the healthcare providers. Moreover, CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes, especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device. Such a combined approach has been demonstrated to improve overall blood sugar control, lessen the occurrence of preeclampsia and neonatal hypoglycaemia, and minimize the duration of neonatal intensive care unit stays. This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The surgeon performing a distal gastrectomy, has an arsenal of reconstruction techniques at his disposal, Billroth II among them. Braun anastomosis performed during a Billroth II procedure has shown evidence of superiority over typical Billroth II, in terms of survival, with no impact on postoperative morbidity and mortality. AIM To compare Billroth II vs Billroth II and Braun following distal gastrectomy, regarding their postoperative course. METHODS Patients who underwent distal gastrectomy during 2002-2021, were separated into two groups, depending on the surgical technique used (Billroth II: 74 patients and Billroth II and Braun: 28 patients). The daily output of the nasogastric tube (NGT), the postoperative day that NGT was removed and the day the patient started per os feeding were recorded. Postoperative complications were at the same time noted. Data were then statistically analyzed. RESULTS There was difference in the mean NGT removal day and the mean start feeding day. Mean total postoperative NGT output was lower in Braun group (399.17 mL vs 1102.78 mL) and it was statistically significant (P < 0.0001). Mean daily postoperative NGT output was also statistically significantly lower in Braun group. According to the postoperative follow up 40 patient experienced bile reflux and alkaline gastritis from the Billroth II group, while 9 patients who underwent Billroth II and Braun anastomosis were presented with the same conditions (P < 0.05). CONCLUSION There was evidence of superiority of Billroth II and Braun vs typical Billroth II in terms of bile reflux, alkaline gastritis and NGT output.
背景 执行远端胃切除术的外科医生有多种重建技术可供选择,比洛斯 II 就是其中之一。有证据表明,在比洛斯 II 期手术中进行的 Braun 吻合术在存活率方面优于典型的比洛斯 II 期吻合术,而且对术后发病率和死亡率没有影响。目的 比较比洛斯 II 与比洛斯 II 和博朗远端胃切除术后的术后情况。方法 将 2002 年至 2021 年期间接受远端胃切除术的患者根据所使用的手术技术分为两组(比洛斯 II:74 例患者;比洛斯 II 和布劳恩:28 例患者)。记录了鼻胃管(NGT)的每日输出量、术后拔除鼻胃管的日期以及患者开始经口进食的日期。同时记录术后并发症。然后对数据进行统计分析。结果 拔除 NGT 的平均天数和开始进食的平均天数存在差异。布劳恩组术后 NGT 的平均总输出量较低(399.17 mL vs 1102.78 mL),且有统计学意义(P < 0.0001)。博朗组术后 NGT 每日平均输出量也明显低于博朗组,具有统计学意义(P < 0.0001)。根据术后随访,比洛斯 II 组有 40 名患者出现胆汁反流和碱性胃炎,而接受比洛斯 II 和博朗吻合术的 9 名患者出现了同样的情况(P < 0.05)。结论 有证据表明,在胆汁反流、碱性胃炎和 NGT 输出量方面,Billroth II 和 Braun 与典型的 Billroth II 相比更具优势。
{"title":"Billroth II anastomosis combined with brown anastomosis reduce reflux gastritis in gastric cancer patients","authors":"G. Christodoulidis, Marina-Nektaria Kouliou, Konstantinos-Eleftherios Koumarelas, Konstantinos Argyriou, Garyfallia-Apostolia Karali, Konstantinos Tepetes","doi":"10.5662/wjm.v14.i1.89709","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.89709","url":null,"abstract":"BACKGROUND\u0000 The surgeon performing a distal gastrectomy, has an arsenal of reconstruction techniques at his disposal, Billroth II among them. Braun anastomosis performed during a Billroth II procedure has shown evidence of superiority over typical Billroth II, in terms of survival, with no impact on postoperative morbidity and mortality.\u0000 AIM\u0000 To compare Billroth II vs Billroth II and Braun following distal gastrectomy, regarding their postoperative course.\u0000 METHODS\u0000 Patients who underwent distal gastrectomy during 2002-2021, were separated into two groups, depending on the surgical technique used (Billroth II: 74 patients and Billroth II and Braun: 28 patients). The daily output of the nasogastric tube (NGT), the postoperative day that NGT was removed and the day the patient started per os feeding were recorded. Postoperative complications were at the same time noted. Data were then statistically analyzed.\u0000 RESULTS\u0000 There was difference in the mean NGT removal day and the mean start feeding day. Mean total postoperative NGT output was lower in Braun group (399.17 mL vs 1102.78 mL) and it was statistically significant (P < 0.0001). Mean daily postoperative NGT output was also statistically significantly lower in Braun group. According to the postoperative follow up 40 patient experienced bile reflux and alkaline gastritis from the Billroth II group, while 9 patients who underwent Billroth II and Braun anastomosis were presented with the same conditions (P < 0.05).\u0000 CONCLUSION\u0000 There was evidence of superiority of Billroth II and Braun vs typical Billroth II in terms of bile reflux, alkaline gastritis and NGT output.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"41 s194","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140224435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.90930
P. Karampinas, J. Vlamis, Athanasios S. Galanis, Michail Vavourakis, Anastasia Krexi, E. Sakellariou, Christos Patilas, Spiros Pneumaticos
BACKGROUND Selecting the optimal size of components is crucial when performing a primary total hip arthroplasty. Implanting the accurate size of the acetabular component can occasionally be exacting, chiefly for surgeons with little experience, whilst the complications of imprecise acetabular sizing or over-reaming can be potentially devastating. AIM To assist clinicians intraoperatively with a simple and repeatable tip in elucidating the ambivalence when determining the proper acetabular component size is not straightforwardly achieved, specifically when surgeons are inexperienced or preoperative templating is unavailable. METHODS This method was employed in 263 operations in our department from June 2021 to December 2022. All operations were performed by the same team of joint reconstruction surgeons, employing a typical posterior hip approach technique. The types of acetabular shells implanted were: The Dynasty® acetabular cup system (MicroPort Orthopedics, Shanghai, China) and the R3® acetabular system (Smith & Nephew, Watford, United Kingdom), which both feature cementless press-fit design. RESULTS The mean value of all cases was calculated and collated with each other. We distinguished as oversized an implanted acetabular shell when its size was > 2 mm larger than the size of the acetabular size indicator reamer (ASIR) or when the implanted shell was larger than 4 mm compared to the preoperative planned cup. The median size of the implanted acetabular shell was 52 (48–54) mm, while the median size of the preoperatively planned cup was 50 (48–56) mm, and the median size of the ASIR was 52 (50–54) mm. The correlation coefficient between ASIR size and implanted acetabular component size exhibited a high positive correlation with r = 0.719 (P < 0.001). Contrariwise, intraoperative ASIR measurements precisely predicted the implanted cups’ size or differed by only one size (2 mm) in 245 cases. CONCLUSION In our study, we demonstrated that the size of the first acetabular reamer not entering freely in the acetabular rim corroborates the final acetabular component size to implant. This was also corresponding in the majority of the cases with conventional preoperative templating. It can be featured as a valid tool for avoiding the potentially pernicious complications of acetabular cup over-reaming and over-sizing in primary total hip arthroplasty. It is a simple and reproducible technical note useful for confirming the predicted acetabular cup size preoperatively; thus, its application could be considered routinely, even in cases where preoperative templating is unavailable.
{"title":"Technical note for intraoperative determination of proper acetabular cup size in primary total hip arthroplasty","authors":"P. Karampinas, J. Vlamis, Athanasios S. Galanis, Michail Vavourakis, Anastasia Krexi, E. Sakellariou, Christos Patilas, Spiros Pneumaticos","doi":"10.5662/wjm.v14.i1.90930","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.90930","url":null,"abstract":"BACKGROUND\u0000 Selecting the optimal size of components is crucial when performing a primary total hip arthroplasty. Implanting the accurate size of the acetabular component can occasionally be exacting, chiefly for surgeons with little experience, whilst the complications of imprecise acetabular sizing or over-reaming can be potentially devastating.\u0000 AIM\u0000 To assist clinicians intraoperatively with a simple and repeatable tip in elucidating the ambivalence when determining the proper acetabular component size is not straightforwardly achieved, specifically when surgeons are inexperienced or preoperative templating is unavailable.\u0000 METHODS\u0000 This method was employed in 263 operations in our department from June 2021 to December 2022. All operations were performed by the same team of joint reconstruction surgeons, employing a typical posterior hip approach technique. The types of acetabular shells implanted were: The Dynasty® acetabular cup system (MicroPort Orthopedics, Shanghai, China) and the R3® acetabular system (Smith & Nephew, Watford, United Kingdom), which both feature cementless press-fit design.\u0000 RESULTS\u0000 The mean value of all cases was calculated and collated with each other. We distinguished as oversized an implanted acetabular shell when its size was > 2 mm larger than the size of the acetabular size indicator reamer (ASIR) or when the implanted shell was larger than 4 mm compared to the preoperative planned cup. The median size of the implanted acetabular shell was 52 (48–54) mm, while the median size of the preoperatively planned cup was 50 (48–56) mm, and the median size of the ASIR was 52 (50–54) mm. The correlation coefficient between ASIR size and implanted acetabular component size exhibited a high positive correlation with r = 0.719 (P < 0.001). Contrariwise, intraoperative ASIR measurements precisely predicted the implanted cups’ size or differed by only one size (2 mm) in 245 cases.\u0000 CONCLUSION\u0000 In our study, we demonstrated that the size of the first acetabular reamer not entering freely in the acetabular rim corroborates the final acetabular component size to implant. This was also corresponding in the majority of the cases with conventional preoperative templating. It can be featured as a valid tool for avoiding the potentially pernicious complications of acetabular cup over-reaming and over-sizing in primary total hip arthroplasty. It is a simple and reproducible technical note useful for confirming the predicted acetabular cup size preoperatively; thus, its application could be considered routinely, even in cases where preoperative templating is unavailable.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"8 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140225628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.88850
E. A. Munhoz, Claudio Roberto Gaiao Xavier, Roberto Ponce Salles, A. Capelozza, A. Bodanezi
BACKGROUND The authors describe a technique for building an alternative jawbone phantom using dental gypsum and rice for research and dental radiology instruction. AIM To investigate the potential of an alternative phantom to simulate the trabecular bone aspect of the human maxilla in periapical radiographs. METHODS Half-maxillary phantoms built from gypsum-ground rice were exposed to X-rays, and the resulting images (experimental group) were compared to standardized radiographic images produced from dry human maxillary bone (control group) (n = 7). The images were blindly assessed according to strict criteria by three examiners for the usual trabecular aspects of the surrounding bone, and significant differences between groups and in assessment reliability were compared using Fisher’s exact and kappa tests (α = 0.05). RESULTS The differences in the trabecular aspects between groups were not statistically significant. In addition, interobserver agreement among observers was 0.43 and 0.51 for the control and experimental groups, respectively, whereas intraobserver agreement was 0.71 and 0.73, respectively. CONCLUSION The tested phantom seemed to demonstrate potential for trabecular bone image simulation on maxillary periapical radiographs.
{"title":"Convenient model of hard tissue simulation for dental radiographic research and instruction","authors":"E. A. Munhoz, Claudio Roberto Gaiao Xavier, Roberto Ponce Salles, A. Capelozza, A. Bodanezi","doi":"10.5662/wjm.v14.i1.88850","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.88850","url":null,"abstract":"BACKGROUND\u0000 The authors describe a technique for building an alternative jawbone phantom using dental gypsum and rice for research and dental radiology instruction.\u0000 AIM\u0000 To investigate the potential of an alternative phantom to simulate the trabecular bone aspect of the human maxilla in periapical radiographs.\u0000 METHODS\u0000 Half-maxillary phantoms built from gypsum-ground rice were exposed to X-rays, and the resulting images (experimental group) were compared to standardized radiographic images produced from dry human maxillary bone (control group) (n = 7). The images were blindly assessed according to strict criteria by three examiners for the usual trabecular aspects of the surrounding bone, and significant differences between groups and in assessment reliability were compared using Fisher’s exact and kappa tests (α = 0.05).\u0000 RESULTS\u0000 The differences in the trabecular aspects between groups were not statistically significant. In addition, interobserver agreement among observers was 0.43 and 0.51 for the control and experimental groups, respectively, whereas intraobserver agreement was 0.71 and 0.73, respectively.\u0000 CONCLUSION\u0000 The tested phantom seemed to demonstrate potential for trabecular bone image simulation on maxillary periapical radiographs.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"18 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.90590
Matthias Yi Quan Liau, En Qi Toh, Shamir Muhamed, Surya Varma Selvakumar, V. G. Shelat
Randomized controlled trials (RCTs) have long been recognized as the gold standard for establishing causal relationships in clinical research. Despite that, various limitations of RCTs prevent its widespread implementation, ranging from the ethicality of withholding potentially-lifesaving treatment from a group to relatively poor external validity due to stringent inclusion criteria, amongst others. However, with the introduction of propensity score matching (PSM) as a retrospective statistical tool, new frontiers in establishing causation in clinical research were opened up. PSM predicts treatment effects using observational data from existing sources such as registries or electronic health records, to create a matched sample of participants who received or did not receive the intervention based on their propensity scores, which takes into account characteristics such as age, gender and comorbidities. Given its retrospective nature and its use of observational data from existing sources, PSM circumvents the aforementioned ethical issues faced by RCTs. Majority of RCTs exclude elderly, pregnant women and young children; thus, evidence of therapy efficacy is rarely proven by robust clinical research for this population. On the other hand, by matching study patient characteristics to that of the population of interest, including the elderly, pregnant women and young children, PSM allows for generalization of results to the wider population and hence greatly increases the external validity. Instead of replacing RCTs with PSM, the synergistic integration of PSM into RCTs stands to provide better research outcomes with both methods complementing each other. For example, in an RCT investigating the impact of mannitol on outcomes among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial, the baseline characteristics of comorbidities and current medications between treatment and control arms were significantly different despite the randomization protocol. Therefore, PSM was incorporated in its analysis to create samples from the treatment and control arms that were matched in terms of these baseline characteristics, thus providing a fairer comparison for the impact of mannitol. This literature review reports the applications, advantages, and considerations of using PSM with RCTs, illustrating its utility in refining randomization, improving external validity, and accounting for non-compliance to protocol. Future research should consider integrating the use of PSM in RCTs to better generalize outcomes to target populations for clinical practice and thereby benefit a wider range of patients, while maintaining the robustness of randomization offered by RCTs.
{"title":"Can propensity score matching replace randomized controlled trials?","authors":"Matthias Yi Quan Liau, En Qi Toh, Shamir Muhamed, Surya Varma Selvakumar, V. G. Shelat","doi":"10.5662/wjm.v14.i1.90590","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.90590","url":null,"abstract":"Randomized controlled trials (RCTs) have long been recognized as the gold standard for establishing causal relationships in clinical research. Despite that, various limitations of RCTs prevent its widespread implementation, ranging from the ethicality of withholding potentially-lifesaving treatment from a group to relatively poor external validity due to stringent inclusion criteria, amongst others. However, with the introduction of propensity score matching (PSM) as a retrospective statistical tool, new frontiers in establishing causation in clinical research were opened up. PSM predicts treatment effects using observational data from existing sources such as registries or electronic health records, to create a matched sample of participants who received or did not receive the intervention based on their propensity scores, which takes into account characteristics such as age, gender and comorbidities. Given its retrospective nature and its use of observational data from existing sources, PSM circumvents the aforementioned ethical issues faced by RCTs. Majority of RCTs exclude elderly, pregnant women and young children; thus, evidence of therapy efficacy is rarely proven by robust clinical research for this population. On the other hand, by matching study patient characteristics to that of the population of interest, including the elderly, pregnant women and young children, PSM allows for generalization of results to the wider population and hence greatly increases the external validity. Instead of replacing RCTs with PSM, the synergistic integration of PSM into RCTs stands to provide better research outcomes with both methods complementing each other. For example, in an RCT investigating the impact of mannitol on outcomes among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial, the baseline characteristics of comorbidities and current medications between treatment and control arms were significantly different despite the randomization protocol. Therefore, PSM was incorporated in its analysis to create samples from the treatment and control arms that were matched in terms of these baseline characteristics, thus providing a fairer comparison for the impact of mannitol. This literature review reports the applications, advantages, and considerations of using PSM with RCTs, illustrating its utility in refining randomization, improving external validity, and accounting for non-compliance to protocol. Future research should consider integrating the use of PSM in RCTs to better generalize outcomes to target populations for clinical practice and thereby benefit a wider range of patients, while maintaining the robustness of randomization offered by RCTs.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"319 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140228273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.88619
Muniratu Amadu, Jonathan Soldera
BACKGROUND Inflammatory bowel disease, including ulcerative colitis, microscopic colitis, and Crohn’s disease (CD), has a global impact. This review focuses on duodenal CD (DCD), a rare subtype affecting the duodenum. DCD’s rarity and asymptomatic nature create diagnostic challenges, impacting prognosis and patient well-being. Delayed diagnosis can worsen DCD outcomes. AIM To report a rare case of DCD and to discuss the diagnostic challenges and its implications on prognosis. METHODS A systematic literature search, following the PRISMA statement, was conducted. Relevant studies were identified and analysed using specific Medical Subject Terms (MeSH) from PubMed/MEDLINE, American Journal of Gastroenterology, and the University of South Wales database. Data collection included information from radiology scans, endoscopy procedures, biopsies, and histopathology results. RESULTS The review considered 8 case reports and 1 observational study, involving 44 participants diagnosed with DCD, some of whom developed complications due to delayed diagnosis. Various diagnostic methods were employed, as there is no gold standard workup for DCD. Radiology scans [magnetic resonance imaging (MRI), computed tomography (CT), and upper gastrointestinal X-ray], endoscopy procedures (colonoscopy and esophagogastroduodenoscopy), biopsies, and clinical suspicions were utilized. CONCLUSION This review discusses DCD diagnosis challenges and the roles of CT, MRI, and fluoroscopy. It notes their limitations and compares findings with endoscopy and histopathology studies. Further research is needed to improve diagnosis, emphasizing scan interpretation, endoscopy procedures, and biopsies, especially in high-risk patients during routine endoscopy.
{"title":"Duodenal Crohn’s disease: Case report and systematic review","authors":"Muniratu Amadu, Jonathan Soldera","doi":"10.5662/wjm.v14.i1.88619","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.88619","url":null,"abstract":"BACKGROUND\u0000 Inflammatory bowel disease, including ulcerative colitis, microscopic colitis, and Crohn’s disease (CD), has a global impact. This review focuses on duodenal CD (DCD), a rare subtype affecting the duodenum. DCD’s rarity and asymptomatic nature create diagnostic challenges, impacting prognosis and patient well-being. Delayed diagnosis can worsen DCD outcomes.\u0000 AIM\u0000 To report a rare case of DCD and to discuss the diagnostic challenges and its implications on prognosis.\u0000 METHODS\u0000 A systematic literature search, following the PRISMA statement, was conducted. Relevant studies were identified and analysed using specific Medical Subject Terms (MeSH) from PubMed/MEDLINE, American Journal of Gastroenterology, and the University of South Wales database. Data collection included information from radiology scans, endoscopy procedures, biopsies, and histopathology results.\u0000 RESULTS\u0000 The review considered 8 case reports and 1 observational study, involving 44 participants diagnosed with DCD, some of whom developed complications due to delayed diagnosis. Various diagnostic methods were employed, as there is no gold standard workup for DCD. Radiology scans [magnetic resonance imaging (MRI), computed tomography (CT), and upper gastrointestinal X-ray], endoscopy procedures (colonoscopy and esophagogastroduodenoscopy), biopsies, and clinical suspicions were utilized.\u0000 CONCLUSION\u0000 This review discusses DCD diagnosis challenges and the roles of CT, MRI, and fluoroscopy. It notes their limitations and compares findings with endoscopy and histopathology studies. Further research is needed to improve diagnosis, emphasizing scan interpretation, endoscopy procedures, and biopsies, especially in high-risk patients during routine endoscopy.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"24 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140227112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.88519
Ilias Koutromanos, E. Legaki, Maria Gazouli, Efthimios Vasilopoulos, Anastasios Kouzoupis, Elias Tzavellas
Alcohol use disorder (AUD) represents a major public health issue which affects millions of people globally and consist a chronic relapsing condition associated with substantial morbidity and mortality. The gut microbiome plays a crucial role in maintaining overall health and has emerged as a significant contributor to the pathophysiology of various psychiatric disorders. Recent evidence suggests that the gut microbiome is intimately linked to the development and progression of AUD, with alcohol consumption directly impacting its composition and function. This review article aims to explore the intricate relationship between the gut microbiome and AUD, focusing on the implications for mental health outcomes and potential therapeutic strategies. We discuss the bidirectional communication between the gut microbiome and the brain, highlighting the role of microbiota-derived metabolites in neuroinflammation, neurotransmission, and mood regulation. Furthermore, we examine the influence of AUD-related factors, such as alcohol-induced gut dysbiosis and increased intestinal permeability, on mental health outcomes. Finally, we explore emerging therapeutic avenues targeting the gut microbiome in the management of AUD, including prebiotics, probiotics, and fecal microbiota transplantation. Understanding the complex interplay between the gut microbiome and AUD holds promise for developing novel interventions that could improve mental health outcomes in individuals with AUD.
{"title":"Gut microbiome in alcohol use disorder: Implications for health outcomes and therapeutic strategies-a literature review","authors":"Ilias Koutromanos, E. Legaki, Maria Gazouli, Efthimios Vasilopoulos, Anastasios Kouzoupis, Elias Tzavellas","doi":"10.5662/wjm.v14.i1.88519","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.88519","url":null,"abstract":"Alcohol use disorder (AUD) represents a major public health issue which affects millions of people globally and consist a chronic relapsing condition associated with substantial morbidity and mortality. The gut microbiome plays a crucial role in maintaining overall health and has emerged as a significant contributor to the pathophysiology of various psychiatric disorders. Recent evidence suggests that the gut microbiome is intimately linked to the development and progression of AUD, with alcohol consumption directly impacting its composition and function. This review article aims to explore the intricate relationship between the gut microbiome and AUD, focusing on the implications for mental health outcomes and potential therapeutic strategies. We discuss the bidirectional communication between the gut microbiome and the brain, highlighting the role of microbiota-derived metabolites in neuroinflammation, neurotransmission, and mood regulation. Furthermore, we examine the influence of AUD-related factors, such as alcohol-induced gut dysbiosis and increased intestinal permeability, on mental health outcomes. Finally, we explore emerging therapeutic avenues targeting the gut microbiome in the management of AUD, including prebiotics, probiotics, and fecal microbiota transplantation. Understanding the complex interplay between the gut microbiome and AUD holds promise for developing novel interventions that could improve mental health outcomes in individuals with AUD.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"81 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140224004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.89853
A. Tselebis, E. Koukkou, C. Milionis, Lina Zabuliene, A. Pachi, Ioannis Ilias
BACKGROUND The occurrence of thyroid cancer (TC) has increased in recent decades. Exposure to outdoor artificial light at night (ALN) is associated with an increased risk of cancer. AIM To investigated the impact of ALN, as a significant environmental pollutant, on TC incidence worldwide. METHODS The assessment involved analyzing satellite ALN data in conjunction with TC incidence data [adjusted standardized rate (ASR)], while considering the quality of cancer registries (QCR), gross domestic product (GDP) per person, and health expenditure per person (HEP) for each country. RESULTS Results indicated a correlation between higher ASR and ALN exposure percentages, particularly in countries with higher GDP or HEP quartiles (all P < 0.05). Significant differences in ASR were observed across QCR levels, both high and low quality (all P < 0.05), but not in countries without registry activity. However, when evaluating ASR against ALN exposure percentages while considering GDP/HEP quartiles or QCR levels, no significant associations were found (all P > 0.10). CONCLUSION The findings suggest a potential link between higher GDP and adverse health conditions, serving as possible risk factors for TC, rather than a direct association with ALN. Limitations include the use of cross-sectional data, temporal misalignment, and reliance on ALN as a socioeconomic proxy. It is proposed that light pollution might be connected to a lifestyle conducive to carcinogenesis. Additionally, the presence of higher GDP/HEP could enhance access to diagnostic resources, potentially facilitating TC diagnosis and inclusion in cancer registries.
背景 近几十年来,甲状腺癌(TC)的发病率有所上升。夜间暴露于室外人造光(ALN)与癌症风险增加有关。目的 调查 ALN 作为一种重要的环境污染物对全球甲状腺癌发病率的影响。方法 评估包括将卫星 ALN 数据与 TC 发病率数据[调整标准化率 (ASR)]结合起来进行分析,同时考虑每个国家的癌症登记质量 (QCR)、人均国内生产总值 (GDP) 和人均医疗支出 (HEP)。结果表明,较高的 ASR 与 ALN 暴露百分比之间存在相关性,尤其是在 GDP 或 HEP 四分位数较高的国家(所有 P <0.05)。在不同质量控制水平(包括高质量和低质量)的国家,ASR 存在显著差异(均为 P <0.05),但在没有登记活动的国家则不存在显著差异。然而,在考虑 GDP/HEP 四分位数或 QCR 水平的同时评估 ASR 与 ALN 暴露百分比时,没有发现显著的关联(所有 P > 0.10)。结论 研究结果表明,较高的 GDP 与不良健康状况之间存在潜在联系,可作为 TC 的风险因素,而不是与 ALN 直接相关。局限性包括使用横截面数据、时间错位以及依赖 ALN 作为社会经济替代物。有人提出,光污染可能与有利于致癌的生活方式有关。此外,较高的 GDP/HEP 可能会提高诊断资源的可及性,从而为 TC 诊断和纳入癌症登记提供潜在便利。
{"title":"Artificial night light and thyroid cancer","authors":"A. Tselebis, E. Koukkou, C. Milionis, Lina Zabuliene, A. Pachi, Ioannis Ilias","doi":"10.5662/wjm.v14.i1.89853","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.89853","url":null,"abstract":"BACKGROUND\u0000 The occurrence of thyroid cancer (TC) has increased in recent decades. Exposure to outdoor artificial light at night (ALN) is associated with an increased risk of cancer.\u0000 AIM\u0000 To investigated the impact of ALN, as a significant environmental pollutant, on TC incidence worldwide.\u0000 METHODS\u0000 The assessment involved analyzing satellite ALN data in conjunction with TC incidence data [adjusted standardized rate (ASR)], while considering the quality of cancer registries (QCR), gross domestic product (GDP) per person, and health expenditure per person (HEP) for each country.\u0000 RESULTS\u0000 Results indicated a correlation between higher ASR and ALN exposure percentages, particularly in countries with higher GDP or HEP quartiles (all P < 0.05). Significant differences in ASR were observed across QCR levels, both high and low quality (all P < 0.05), but not in countries without registry activity. However, when evaluating ASR against ALN exposure percentages while considering GDP/HEP quartiles or QCR levels, no significant associations were found (all P > 0.10).\u0000 CONCLUSION\u0000 The findings suggest a potential link between higher GDP and adverse health conditions, serving as possible risk factors for TC, rather than a direct association with ALN. Limitations include the use of cross-sectional data, temporal misalignment, and reliance on ALN as a socioeconomic proxy. It is proposed that light pollution might be connected to a lifestyle conducive to carcinogenesis. Additionally, the presence of higher GDP/HEP could enhance access to diagnostic resources, potentially facilitating TC diagnosis and inclusion in cancer registries.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"8 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140225635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.89196
Maurizio Salvadori, G. Rosso
The Human Microbiome Project, Earth Microbiome Project, and next-generation sequencing have advanced novel genome association, host genetic linkages, and pathogen identification. The microbiome is the sum of the microbes, their genetic information, and their ecological niche. This study will describe how millions of bacteria in the gut affect the human body in health and disease. The gut microbiome changes in relation with age, with an increase in Bacteroidetes and Firmicutes . Host and environmental factors affecting the gut microbiome are diet, drugs, age, smoking, exercise, and host genetics. In addition, changes in the gut microbiome may affect the local gut immune system and systemic immune system. In this study, we discuss how the microbiome may affect the metabolism of healthy subjects or may affect the pathogenesis of metabolism-generating metabolic diseases. Due to the high number of publications on the argument, from a methodologically point of view, we decided to select the best papers published in referred journals in the last 3 years. Then we selected the previously published papers. The major goals of our study were to elucidate which microbiome and by which pathways are related to healthy and disease conditions.
{"title":"Update on the gut microbiome in health and diseases","authors":"Maurizio Salvadori, G. Rosso","doi":"10.5662/wjm.v14.i1.89196","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.89196","url":null,"abstract":"The Human Microbiome Project, Earth Microbiome Project, and next-generation sequencing have advanced novel genome association, host genetic linkages, and pathogen identification. The microbiome is the sum of the microbes, their genetic information, and their ecological niche. This study will describe how millions of bacteria in the gut affect the human body in health and disease. The gut microbiome changes in relation with age, with an increase in Bacteroidetes and Firmicutes . Host and environmental factors affecting the gut microbiome are diet, drugs, age, smoking, exercise, and host genetics. In addition, changes in the gut microbiome may affect the local gut immune system and systemic immune system. In this study, we discuss how the microbiome may affect the metabolism of healthy subjects or may affect the pathogenesis of metabolism-generating metabolic diseases. Due to the high number of publications on the argument, from a methodologically point of view, we decided to select the best papers published in referred journals in the last 3 years. Then we selected the previously published papers. The major goals of our study were to elucidate which microbiome and by which pathways are related to healthy and disease conditions.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"18 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.5662/wjm.v14.i1.88518
Hiroshi Kono, S. Furuya, H. Akaike, K. Shoda, Y. Kawaguchi, H. Amemiya, Hiromichi Kawaida, D. Ichikawa
BACKGROUND It was reported that rikkunshito (TJ-43) improved the cisplatin-induced decreases in the active form of ghrelin in plasma; however, other effects on gastrointestinal hormones have not been investigated. AIM To investigate the effects of TJ-43 on peripheral levels of incretin hormones, including gastric inhibitory polypeptide (GIP) and glucagon-like polypeptide-1 (GLP-1), in humans and rats. METHODS Patients were divided into two groups, namely patients who received TJ-43 immediately following surgery [TJ-43(+) group] and those who received TJ-43 on postoperative day 21 [TJ-43(-) group], and the plasma levels of active GIP and active GLP-1 were assessed. In animal experiments, rats were treated with TJ-43 [rat (r)TJ-43(+) group] or without [rTJ-43(−) group] by gavage for 4 wk, and the plasma active GIP and active GLP-1 levels were measured. The expression of incretin hormones in the gastrointestinal tract and insulin in the pancreas were investigated by immunohistochemistry. Furthermore, the cyclic adenosine monophosphate activities were assessed in pancreatic tissues from rats treated with or without TJ-43 in vivo , and the blood glucose levels and plasma insulin levels were measured in rats treated with or without TJ-43 in oral glucose tolerance tests. RESULTS In humans, the active incretin hormone levels increased, and values were significantly greater in the TJ-43(+) group compared those in the TJ-43(-) group. In rats, the plasma active incretin levels significantly increased in the rTJ-43(+) group compared with those in the rTJ-43(-) group. GIP and GLP-1 expressions were enhanced by TJ-43 treatment. Moreover, plasma insulin levels increased and blood glucose levels were blunted in the rTJ-43(+) group. CONCLUSION The results show that TJ-43 may be beneficial for patients who undergo pancreatic surgery.
{"title":"Rikkunshito increases peripheral incretin-hormone levels in humans and rats","authors":"Hiroshi Kono, S. Furuya, H. Akaike, K. Shoda, Y. Kawaguchi, H. Amemiya, Hiromichi Kawaida, D. Ichikawa","doi":"10.5662/wjm.v14.i1.88518","DOIUrl":"https://doi.org/10.5662/wjm.v14.i1.88518","url":null,"abstract":"BACKGROUND\u0000 It was reported that rikkunshito (TJ-43) improved the cisplatin-induced decreases in the active form of ghrelin in plasma; however, other effects on gastrointestinal hormones have not been investigated.\u0000 AIM\u0000 To investigate the effects of TJ-43 on peripheral levels of incretin hormones, including gastric inhibitory polypeptide (GIP) and glucagon-like polypeptide-1 (GLP-1), in humans and rats.\u0000 METHODS\u0000 Patients were divided into two groups, namely patients who received TJ-43 immediately following surgery [TJ-43(+) group] and those who received TJ-43 on postoperative day 21 [TJ-43(-) group], and the plasma levels of active GIP and active GLP-1 were assessed. In animal experiments, rats were treated with TJ-43 [rat (r)TJ-43(+) group] or without [rTJ-43(−) group] by gavage for 4 wk, and the plasma active GIP and active GLP-1 levels were measured. The expression of incretin hormones in the gastrointestinal tract and insulin in the pancreas were investigated by immunohistochemistry. Furthermore, the cyclic adenosine monophosphate activities were assessed in pancreatic tissues from rats treated with or without TJ-43 in vivo , and the blood glucose levels and plasma insulin levels were measured in rats treated with or without TJ-43 in oral glucose tolerance tests.\u0000 RESULTS\u0000 In humans, the active incretin hormone levels increased, and values were significantly greater in the TJ-43(+) group compared those in the TJ-43(-) group. In rats, the plasma active incretin levels significantly increased in the rTJ-43(+) group compared with those in the rTJ-43(-) group. GIP and GLP-1 expressions were enhanced by TJ-43 treatment. Moreover, plasma insulin levels increased and blood glucose levels were blunted in the rTJ-43(+) group.\u0000 CONCLUSION\u0000 The results show that TJ-43 may be beneficial for patients who undergo pancreatic surgery.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"360 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140228075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}