Mendezeskesen7090
Systemic inflammation and organ dysfunction/failure can complicate acute decompensation (AD) of cirrhosis with progression to acute-on-chronic liver failure (ACLF), leading to increased mortality. There are few studies on serum biomarkers predicting renal dysfunction (RD) or ACLF in AD. Serum cystatin C (CysC) and interleukin-6 (IL-6) were evaluated for predicting RD, ACLF, and mortality in AD patients.
Consecutive AD patients seen from January 2018 to June 2019 were included. IL-6 and CysC were measured in serum at the time of index presentation. Patients were followed for 90 days or until primary (development of RD) or secondary outcomes (development of ACLF or mortality). Multivariate analysis was performed to find whether CysC and IL-6 can independently predict primary and secondary outcomes.
A total of 124 patients were screened; 88 patients were included. On follow up, 22 (27.3%) developed RD, 11 (11/57, 19.3%) developed ACLF, and 21 (24%) died. Zenidolol mw The CysC predicted RD (odds ratio [OR] 7.97, 95% confidence interval [CI] 2.70-23.53,
= 0.001) and ACLF (OR 5.486, 95% CI 1.456-20.6,
= 0.012) development. IL-6 was not an independent predictor of RD (
= 0.315), ACLF (
= 0.168), and mortality (
= 0.225).
Serum CysC can predict the development of RD and ACLF in patients of cirrhosis with AD.
Serum CysC can predict the development of RD and ACLF in patients of cirrhosis with AD.
Objective measurements are not available for determining bowel sounds. The present study sought to evaluate the efficacy of a novel bowel sound monitoring system for perioperative use in patients undergoing gastric surgery.
The study enrolled 14 patients who underwent surgery for gastric cancer at Kochi Medical School from 2017 to 2018. Preoperative and postoperative bowel sounds were recorded using a newly developed real-time analysis system in the operating theater and recovery room. Clinical information and bowel sound count data were obtained to compare preoperative and postoperative measures.
The median preoperative and postoperative bowel sound counts across all patients were 1.4 and 2.5 counts per minute (cpm), respectively. In patients who underwent laparoscopic gastrectomy, the postoperative bowel sound count was significantly higher than that recorded preoperatively (2.3 vs. 1.6 cpm,
= 0.005). The findings also revealed a significant negative correlation between postoperative bowel sound count and operation time (
= -0.714,
= 0.003).
The real-time bowel sound analysis system tested herein presents a promising diagnostic tool to quantitatively evaluate bowel movements associated with surgery. Our results suggested a need for shorter operation times for gastric procedures with respect to peristalsis recovery and supported the use of minimally invasive surgery.
The real-time bowel sound analysis system tested herein presents a promising diagnostic tool to quantitatively evaluate bowel movements associated with surgery. Our results suggested a need for shorter operation times for gastric procedures with respect to peristalsis recovery and supported the use of minimally invasive surgery.
There are no globally approved, distinguishing criteria enabling the classification of gastric adenomas and intramucosal carcinomas for differential diagnosis of noninvasive neoplasia (NIN).
Next-generation sequencing of 50 cancer-related genes was undertaken on 68 pathologically diagnosed microdissected gastric neoplasms (25 adenomas, 27 intramucosal carcinomas, and 16 submucosal carcinomas) obtained during endoscopic submucosal dissection. Findings from magnifying endoscopy with narrow-band imaging (M-NBI) of 52 NINs (the 25 adenomas and 27 intramucosal carcinomas) were compared with these data.
Among all 68 neoplasms, the most frequently mutated genes were
(76% in adenoma, 11.1% in intramucosal carcinoma, and 0% in submucosal carcinoma;
< 0.001) and
in intramucosal and submucosal carcinomas (8% in adenoma, 48.1% in intramucosal carcinoma, and 75% in submucosal carcinoma;
< 0.001). Dividing the NIN neoplasms into five groups according to their mutational status (A1
mutation, A2
+ α mutation, B
+
mutation, C
mutation, D no mutation in either
or
) resulted in almost identical diagnoses by pathology and M-NBI for groups A1 (12/13, 92%), C (12/13, 92%), and D (16/17, 94%) but not for groups A2 (3/7, 43%) or B (0/2, 0%). This finding implies that NINs with the
+ α mutation have carcinoma-like endoscopic features despite most being judged as adenomas by pathology.
A diagnosis of NINs by pathology or M-NBI in the subset of gastric tumors classified by cancer-related mutations is not completely identical, suggesting the possible additional role of M-NBI in diagnosing NINs. Further studies are needed to confirm this.
A diagnosis of NINs by pathology or M-NBI in the subset of gastric tumors classified by cancer-related mutations is not completely identical, suggesting the possible additional role of M-NBI in diagnosing NINs. Further studies are needed to confirm this.
Non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS) are prevalent conditions sharing common pathogenic factors. We performed a systematic literature review and meta-analysis aiming to investigate the association between NAFLD and PCOS among premenopausal PCOS patients.
Relevant studies were systematically identified from scientific databases until 2019. We calculated pooled odds ratio (OR) using a random-effect model, and heterogeneity was addressed through
. Subgroup analyses and meta-regression for various covariates were performed.
Of the 1833 studies retrieved, 23 studies with 7148 participants qualified for quantitative synthesis. The pooled result showed that women with PCOS had a 2.5-fold increase in the risk of NAFLD compared to controls (pooled OR 2.49, 95% confidence interval [CI] 2.20-2.82). In subgroup analyses comparing PCOS to controls, South American/Middle East PCOS patients had a greater risk of NAFLD (OR 3.55, 95% CI 2.27-5.55) compared to their counterpart from Europe (OR 2.22, 95% CI 1.85-2.67) and Asia (OR 2.63, 95% CI 2.20-3.15). Insulin resistance and metabolic syndrome were more frequent in the PCOS group (OR 1.97, 95% CI 1.44-2.71 and OR 3.39, 95% CI 2.42-4.76, respectively). Study quality and body mass index (BMI) were the only covariates that showed a relationship with the outcome in the meta-regression, with a regression coefficient of -2.219 (95% CI -3.927 to -0.511) and -1.929 (95% CI -3.776 to -0.0826), respectively.
This meta-analysis indicates that premenopausal PCOS patients are associated with 2.5-fold increase in the risk of NAFLD, and BMI seems to be the main cofactor.
This meta-analysis indicates that premenopausal PCOS patients are associated with 2.5-fold increase in the risk of NAFLD, and BMI seems to be the main cofactor.