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Continuous glucose monitoring metrics in pregnancy with type 1 diabetes mellitus 1 型糖尿病孕妇的连续血糖监测指标
Pub Date : 2024-03-20 DOI: 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.
妊娠期糖尿病对母体和胎儿的健康都有很大风险,因此管理好妊娠期糖尿病是一项挑战。传统方法包括毛细血管自我监测血糖水平和定期检测 HbA1c,而连续血糖监测(CGM)系统的出现彻底改变了这一方法。这些设备提供了一种安全可靠的实时跟踪血糖水平的方法,使妊娠期糖尿病妇女和医护人员都能从中受益。此外,CGM 系统在糖尿病并发妊娠中使用时,副作用小,可行性高,尤其是与作为混合闭环设备的连续皮下胰岛素输注泵搭配使用时。事实证明,这种联合方法可改善整体血糖控制,减少子痫前期和新生儿低血糖的发生,并最大限度地缩短新生儿重症监护室的住院时间。本文旨在全面评估专门为受 1 型糖尿病影响的孕妇量身定制的 CGM 指标。
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引用次数: 0
Billroth II anastomosis combined with brown anastomosis reduce reflux gastritis in gastric cancer patients 比洛斯 II 型吻合器联合棕色吻合器可减少胃癌患者的反流性胃炎
Pub Date : 2024-03-20 DOI: 10.5662/wjm.v14.i1.89709
G. Christodoulidis, Marina-Nektaria Kouliou, Konstantinos-Eleftherios Koumarelas, Konstantinos Argyriou, Garyfallia-Apostolia Karali, Konstantinos Tepetes
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。
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引用次数: 0
Technical note for intraoperative determination of proper acetabular cup size in primary total hip arthroplasty 初级全髋关节置换术中术中确定合适髋臼杯尺寸的技术说明
Pub Date : 2024-03-20 DOI: 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.
背景:在进行初级全髋关节置换术时,选择最佳尺寸的组件至关重要。植入准确尺寸的髋臼组件有时会非常困难,主要是对经验不足的外科医生而言,而髋臼尺寸不精确或过大的并发症可能会造成严重后果。目的 通过一种简单、可重复的提示,帮助临床医生在术中阐明在确定合适的髋臼组件尺寸时无法直接实现的矛盾心理,特别是当外科医生缺乏经验或术前没有模板时。方法 从 2021 年 6 月到 2022 年 12 月,我们科室在 263 例手术中采用了这种方法。所有手术均由同一组关节重建外科医生采用典型的髋关节后入路技术完成。植入的髋臼壳类型有Dynasty®髋臼杯系统(MicroPort Orthopedics,中国上海)和R3®髋臼系统(Smith & Nephew,英国沃特福德),均采用无骨水泥压入式设计。结果 我们计算了所有病例的平均值,并进行了核对。当植入的髋臼壳的尺寸比髋臼尺寸指示器(ASIR)的尺寸大2毫米以上,或植入的髋臼壳比术前计划的髋臼杯大4毫米以上时,我们将其区分为超大髋臼壳。植入的髋臼外壳的中位尺寸为 52(48-54)毫米,而术前计划的髋臼杯的中位尺寸为 50(48-56)毫米,ASIR 的中位尺寸为 52(50-54)毫米。ASIR 尺寸与植入髋臼组件尺寸之间的相关系数为 r = 0.719(P < 0.001),呈高度正相关。相反,在 245 个病例中,术中 ASIR 测量值可精确预测植入髋臼杯的尺寸,或仅相差一个尺寸(2 毫米)。结论 在我们的研究中,我们证明了第一个不能自由进入髋臼边缘的髋臼铰刀的尺寸与最终植入的髋臼组件尺寸相吻合。在大多数病例中,这与传统的术前模板也是一致的。它可以作为一种有效的工具,避免在初级全髋关节置换术中出现髋臼杯过大和过小的潜在并发症。它是一种简单且可重复的技术说明,可用于术前确认预测的髋臼杯大小;因此,即使在没有术前模板的情况下,也可考虑将其作为常规应用。
{"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}
引用次数: 0
Convenient model of hard tissue simulation for dental radiographic research and instruction 用于牙科放射学研究和教学的方便的硬组织模拟模型
Pub Date : 2024-03-20 DOI: 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.
背景 作者描述了一种使用牙科石膏和大米制作替代颌骨模型的技术,用于研究和牙科放射学教学。目的 研究一种替代模型在根尖周X光片中模拟人类上颌骨骨小梁方面的潜力。方法 用石膏磨成的大米制成半颌骨模型,将其暴露在 X 射线下,并将得到的图像(实验组)与用干燥的人类上颌骨(对照组)(n = 7)制作的标准化放射图像进行比较。图像由三名检查人员根据严格的标准对周围骨小梁的通常情况进行盲评,并使用费雪精确检验和卡帕检验(α = 0.05)比较组间差异和评估可靠性的显著差异。结果 组间骨小梁方面的差异无统计学意义。此外,对照组和实验组观察者之间的一致性分别为 0.43 和 0.51,而观察者内部的一致性分别为 0.71 和 0.73。结论 测试的模型似乎证明了在上颌骨根尖周X光片上模拟骨小梁图像的潜力。
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引用次数: 0
Can propensity score matching replace randomized controlled trials? 倾向得分匹配能否取代随机对照试验?
Pub Date : 2024-03-20 DOI: 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.
长期以来,随机对照试验(RCT)一直被认为是临床研究中确定因果关系的黄金标准。尽管如此,随机对照试验的各种局限性阻碍了它的广泛应用,其中包括拒绝为一组患者提供可能挽救生命的治疗的道德问题,以及由于严格的纳入标准而导致的相对较差的外部有效性等等。然而,随着倾向评分匹配(PSM)作为一种回顾性统计工具的引入,为临床研究中因果关系的确定开辟了新的领域。倾向得分匹配利用登记册或电子健康记录等现有来源的观察数据预测治疗效果,根据倾向得分(考虑年龄、性别和合并症等特征)创建接受或未接受干预的匹配样本。由于 PSM 具有回顾性的特点,而且使用的是现有来源的观察数据,因此可以规避上述 RCT 所面临的伦理问题。大多数研究性临床试验都将老年人、孕妇和幼儿排除在外,因此,针对这些人群的疗效证据很少能通过可靠的临床研究得到证实。另一方面,通过将研究患者的特征与相关人群(包括老年人、孕妇和幼儿)的特征相匹配,PSM 可以将结果推广到更广泛的人群中,从而大大提高外部有效性。PSM 与 RCT 的协同整合并不能取代 RCT,而是两种方法相辅相成,提供更好的研究成果。例如,在一项研究甘露醇对 "急性脑出血强化降压试验 "参与者预后影响的 RCT 中,尽管采用了随机化方案,但治疗组和对照组之间的合并症和当前用药的基线特征存在显著差异。因此,在其分析中加入了 PSM,以创建与这些基线特征相匹配的治疗组和对照组样本,从而更公平地比较甘露醇的影响。本文献综述报告了在 RCT 中使用 PSM 的应用、优势和注意事项,说明了 PSM 在完善随机化、提高外部效度和考虑不遵守方案情况方面的作用。未来的研究应考虑在 RCT 中整合 PSM 的使用,以便更好地将结果推广到临床实践的目标人群,从而使更多患者受益,同时保持 RCT 所提供的随机化的稳健性。
{"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}
引用次数: 0
Duodenal Crohn’s disease: Case report and systematic review 十二指肠克罗恩病:病例报告和系统回顾
Pub Date : 2024-03-20 DOI: 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.
背景炎症性肠病,包括溃疡性结肠炎、微小结肠炎和克罗恩病(CD),具有全球性影响。本综述侧重于十二指肠 CD(DCD),这是一种影响十二指肠的罕见亚型。DCD 的罕见性和无症状性给诊断带来了挑战,影响了预后和患者的健康。延迟诊断会恶化 DCD 的预后。目的 报告一例罕见的 DCD 病例,讨论诊断难题及其对预后的影响。方法 按照 PRISMA 声明进行了系统的文献检索。使用 PubMed/MEDLINE、《美国胃肠病学杂志》和南威尔士大学数据库中的特定医学主题词 (MeSH) 对相关研究进行了识别和分析。数据收集包括放射学扫描、内窥镜检查、活检和组织病理学结果等信息。结果 该综述考虑了 8 个病例报告和 1 个观察性研究,涉及 44 名被诊断为 DCD 的患者,其中一些患者因诊断延误而出现并发症。由于 DCD 尚无金标准检查方法,因此采用了多种诊断方法。这些方法包括放射扫描(磁共振成像(MRI)、计算机断层扫描(CT)和上消化道 X 光)、内窥镜检查(结肠镜检查和食管胃十二指肠镜检查)、活组织检查和临床怀疑。结论 本综述讨论了 DCD 诊断的挑战以及 CT、MRI 和透视的作用。它指出了它们的局限性,并将研究结果与内窥镜检查和组织病理学研究进行了比较。需要进一步开展研究以改进诊断,强调扫描解读、内窥镜检查程序和活检,尤其是在常规内窥镜检查期间对高危患者的诊断。
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引用次数: 0
Gut microbiome in alcohol use disorder: Implications for health outcomes and therapeutic strategies-a literature review 酒精使用障碍中的肠道微生物组:对健康结果和治疗策略的影响--文献综述
Pub Date : 2024-03-20 DOI: 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.
酒精使用障碍(AUD)是一个重大的公共卫生问题,影响着全球数百万人,它是一种慢性复发性疾病,与严重的发病率和死亡率有关。肠道微生物组在维持整体健康方面发挥着至关重要的作用,并已成为各种精神疾病病理生理学的重要因素。最近的证据表明,肠道微生物组与 AUD 的发生和发展密切相关,饮酒会直接影响其组成和功能。这篇综述文章旨在探讨肠道微生物组与 AUD 之间错综复杂的关系,重点是对精神健康结果和潜在治疗策略的影响。我们讨论了肠道微生物组和大脑之间的双向交流,强调了微生物组衍生代谢物在神经炎症、神经传递和情绪调节中的作用。此外,我们还研究了与 AUD 相关的因素(如酒精引起的肠道菌群失调和肠道渗透性增加)对心理健康结果的影响。最后,我们探讨了针对肠道微生物组治疗 AUD 的新兴治疗途径,包括益生菌、益生菌和粪便微生物群移植。了解肠道微生物组与 AUD 之间复杂的相互作用有望开发出新型干预措施,从而改善 AUD 患者的心理健康结果。
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引用次数: 0
Artificial night light and thyroid cancer 人造夜光与甲状腺癌
Pub Date : 2024-03-20 DOI: 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。
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引用次数: 0
Update on the gut microbiome in health and diseases 健康与疾病中的肠道微生物组的最新情况
Pub Date : 2024-03-20 DOI: 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.
人类微生物组计划、地球微生物组计划和下一代测序技术推动了新型基因组关联、宿主基因联系和病原体鉴定。微生物组是微生物、其遗传信息和生态位的总和。这项研究将描述肠道中数以百万计的细菌如何影响人体的健康和疾病。肠道微生物组随着年龄的增长而变化,类杆菌和固着菌增多。影响肠道微生物组的宿主和环境因素包括饮食、药物、年龄、吸烟、运动和宿主遗传。此外,肠道微生物组的变化可能会影响局部肠道免疫系统和全身免疫系统。在本研究中,我们将讨论微生物组如何影响健康受试者的新陈代谢,或如何影响新陈代谢引发的代谢性疾病的发病机制。由于有关该论点的论文数量较多,从方法论的角度出发,我们决定选择近三年发表在参考期刊上的优秀论文。然后,我们再对之前发表的论文进行筛选。我们研究的主要目标是阐明哪些微生物组和哪些途径与健康和疾病状况有关。
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引用次数: 0
Rikkunshito increases peripheral incretin-hormone levels in humans and rats 利口酒能提高人类和大鼠外周增量激素的水平
Pub Date : 2024-03-20 DOI: 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.
背景 据报道,里坤实多(TJ-43)可改善顺铂诱导的血浆中胃泌素活性形式的下降,但尚未研究其对胃肠激素的其他影响。目的 研究 TJ-43 对人类和大鼠外周增量激素水平的影响,包括胃抑制多肽(GIP)和胰高血糖素样多肽-1(GLP-1)。方法 将患者分为两组,即术后立即接受 TJ-43 的患者[TJ-43(+)组]和术后第 21 天接受 TJ-43 的患者[TJ-43(-)组],并评估血浆中活性 GIP 和活性 GLP-1 的水平。在动物实验中,大鼠灌胃 TJ-43 [大鼠 (r)TJ-43(+) 组] 或不灌胃 TJ-43 [rTJ-43(-)组] 4 周,并测定血浆中活性 GIP 和活性 GLP-1 的水平。免疫组化法检测了胃肠道增量激素和胰腺中胰岛素的表达。此外,还评估了体内使用或不使用 TJ-43 的大鼠胰腺组织的环磷酸腺苷活性,并在口服葡萄糖耐量试验中测量了使用或不使用 TJ-43 的大鼠的血糖水平和血浆胰岛素水平。结果 在人体内,活性增量素激素水平升高,TJ-43(+)组的值明显高于 TJ-43(-)组。在大鼠中,与 rTJ-43(-)组相比,rTJ-43(+)组的血浆活性增量素水平明显增加。TJ-43治疗增强了GIP和GLP-1的表达。此外,rTJ-43(+)组血浆胰岛素水平升高,血糖水平降低。结论 结果表明,TJ-43 可能对接受胰腺手术的患者有益。
{"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}
引用次数: 0
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World journal of methodology
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