AIM:To understand the demographic characteristics of patients in Southwestern Ontario,Canada with ulcerative colitis(UC)in order to predict disease severity. METHODS:Records from 1996 to 2001 were exam- ined to create...AIM:To understand the demographic characteristics of patients in Southwestern Ontario,Canada with ulcerative colitis(UC)in order to predict disease severity. METHODS:Records from 1996 to 2001 were exam- ined to create a database of UC patients seen in the London Health Sciences Centre South Street Hospital Inflammatory Bowel Disease Clinic.To be included, patients'charts were required to have information of their disease presentation and a minimum of 5 years of follow-up.Charts were reviewed using standardized data collection forms.Disease severity was generated during the chart review process,and non-endoscopic Mayo Score criteria were collected into a composite. RESULTS:One hundred and two consecutive patients'data were entered into the database.Demographic analyses revealed that 51%of the patients were male, the mean age at diagnosis was 39 years,13.7%had a first degree relative with inflammatory bowel disease (IBD),61.8%were nonsmokers and 24.5%were ex-smokers.In 22.5%of patients the disease was limited to the rectum,in 21.6%disease was limited to the sigmoid colon,in 22.5%disease was limited to the left colon,and 32.4%of patients had pancolitis. Standard multiple regression analysis which regressed a composite of physician global assessment of disease severity,average number of bowel movements,and average amount of blood in bowel movements on year of diagnosis and age at time of diagnosis was significant,R 2=0.306,F(7,74)=4.66,P<0.01. Delay from symptoms to diagnosis of UC,gender, family history of IBD,smoking status and disease severity at the time of diagnosis didnot significantly predict the composite measure. CONCLUSION:UC severity is associated with younger age at diagnosis and year of diagnosis in a longitudinal cohort of UC patients,and may identify prognostic UC indicators.展开更多
Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-p...Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-polymerase chain reaction(RTPCR)is the gold standard molecular technique for diagnosing COVID-19.The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold(Ct)values.Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral load.A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity.The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated.In this review,we describe the scientific data as well as the important findings from many clinical studies globally,emphasizing how viral load may be related to disease severity in COVID-19 patients.Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients,and early anti-viral treatment will reduce the severe clinical outcomes.展开更多
<strong>Background:</strong> Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the...<strong>Background:</strong> Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the severity of COVID-19 illness and mortality. <strong>Method:</strong> Retrospective study on 259 patients with COVID-19 with measurement of average glucose during 24 hours of admission. Association of Early Hyperglycemia categorized as <180 mg/dl or >180 mg/dl;was studied with mortality, requirement of ICU stay and prognostic markers. <strong>Results: </strong>Early hyperglycemia (>180 mg/dl) revealed a higher median value for CRP (109 mg/l [IQR;48 - 199]) in comparison to <180 mg/dl group (86 mg/l [IQR;26.3 - 153]) p = 0.03. ICU stay was higher in >180 mg/dl group;24 (15.9%) vs 14 patients (13%) [p = 0.51] in the <180 mg/dl group. Mortality in the group > 180 mg/dl was 8 (5.3%) while <180 mg/dl had a mortality rate of 4 (3.7%) [p = 0.547]. <strong>Conclusion:</strong> Hyperglycemia in the first 24 hours may anticipate an increased risk of ICU stay and a higher mortality rate. It may be a possible predictor of disease severity.展开更多
Understanding how human leukocyte antigen(HLA)polymorphism affects both the susceptibility and severity of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection will help to identify individuals at high...Understanding how human leukocyte antigen(HLA)polymorphism affects both the susceptibility and severity of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection will help to identify individuals at higher risk to better manage and prioritize vaccination at the clinical level and explain the differences in epidemic trends in different regions at the epidemiological level.This study compared the frequencies of HLA class I alleles(HLA-A,B)in 214 coronavirus disease 2019(COVID-19)patients with different disease severity and 35 healthy controls and analyzed the correlations between specific HLA alleles and disease severity and T cell memory.The results showed no significant difference in HLA allele frequencies between COVID-19 patients and healthy controls(P>0.05).The allele HLA-B*13:02 was significantly correlated with the disease severity of COVID-19 patients(P=0.006).After adjustment for age and disease severity,the T cell responses of COVID-19 convalescents with the allele HLA-B*40:01 may be lower at six months(P=0.044)and 12 months(P=0.069).Moreover,these results may be due to their rare peptide anchors by analyzing the binding peptide motifs of these HLA alleles.The study may be valuable for investigating the potential association of specific HLA alleles with SARS-CoV-2 infection.展开更多
Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January an...Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.展开更多
Background:Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to...Background:Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patientassessed) and proportions of treatment cost to household income.Methods:This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (<10%, 10-30%, 31-50%, and >50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients’ treatment satisfaction.Results:When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P < 0.001). Effectiveness, side effects, and convenience scores were higher in the <10% subgroup compared to those in the >50% subgroup (all P < 0.05). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 13.183, P = 0.004). For biological diseasemodifying anti-rheumatic drugs, effectiveness and convenience scores were lower in the severe RA subgroup than those in the extremely mild RA subgroup (both P < 0.05). Convenience score was higher in the <10% subgroup compared to that in the 31% to 50% and >50% subgroups ( F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 8.794, P = 0.032). Conclusion:Higher disease severity and higher financial burden were associated with lower patient satisfaction.展开更多
Background: Sleep disorders are common but under-researched symptoms in patients with multiple system atrophy (MSA). We investigated the frequency and factors associated with sleep-related symptoms in patients with MS...Background: Sleep disorders are common but under-researched symptoms in patients with multiple system atrophy (MSA). We investigated the frequency and factors associated with sleep-related symptoms in patients with MSA and the impact of sleep disturbances on disease severity.Methods: This cross-sectional study involved 165 patients with MSA. Three sleep-related symptoms, namely Parkinson’s disease (PD)-related sleep problems (PD-SP), excessive daytime sleepiness (EDS), and rapid eye movement sleep behavior disorder (RBD), were evaluated using the PD Sleep Scale-2 (PDSS-2), Epworth Sleepiness Scale (ESS), and RBD Screening Questionnaire (RBDSQ), respectively. Disease severity was evaluated using the Unified MSA Rating Scale (UMSARS).Results: The frequency of PD-SP (PDSS-2 score of ≥18), EDS (ESS score of ≥10), and RBD (RBDSQ score of ≥5) in patients with MSA was 18.8%, 27.3%, and 49.7%, respectively. The frequency of coexistence of all three sleep-related symptoms was 7.3%. Compared with the cerebellar subtype of MSA (MSA-C), the parkinsonism subtype of MSA (MSA-P) was associated with a higher frequency of PD-SP and EDS, but not of RBD. Binary logistic regression revealed that the MSA-P subtype, a higher total UMSARS score, and anxiety were associated with PD-SP;that male sex, a higher total UMSARS score, the MSA-P subtype, and fatigue were associated with EDS;and that male sex, a higher total UMSARS score, and autonomic onset were associated with RBD in patients with MSA. Stepwise linear regression showed that the number of sleep-related symptoms (PD-SP, EDS, and RBD), disease duration, depression, fatigue, and total Montreal Cognitive Assessment score were predictors of disease severity in patients with MSA.Conclusions: Sleep-related disorders were associated with both MSA subtypes and the severity of disease in patients with MSA, indicating that sleep disorders may reflect the distribution and degree of dopaminergic/non-dopaminergic neuron degeneration in MSA.展开更多
Background: The COVID-19 pandemic emerged unexpectedly, impacting millions worldwide and, though waning in many regions, remains a significant concern. This study focused on understanding COVID-19’s clinical presenta...Background: The COVID-19 pandemic emerged unexpectedly, impacting millions worldwide and, though waning in many regions, remains a significant concern. This study focused on understanding COVID-19’s clinical presentation, disease progression, and outcomes among hospitalized pediatric patients. Additionally, it sought to investigate the impact of concurrent chronic medical conditions on disease severity. Methods: Conducted retrospectively between September 2020 and December 2021, this study observed pediatric patients (below 18 years) hospitalized with confirmed COVID-19 at an Irbid, Jordan tertiary healthcare center. Patients meeting inclusion criteria, including a positive nasal swab PCR test and hospitalization need, were analyzed. Epidemiological and clinical data were collected and segregated into two groups (A and B) based on the presence of chronic conditions. Comparative analysis encompassed presentation, disease trajectory, and outcomes between these groups. Results: Among 451 tested positive patients, 112 were included in the study. Significant differences emerged between the two pediatric groups hospitalized for COVID-19. Those with concurrent chronic illnesses exhibited heightened symptom severity—fever, dyspnea, fatigue—and a higher incidence of abnormal chest radiographs, often requiring intensive care and experiencing elevated mortality rates. Conclusion: This study underscores the criticality of prioritizing COVID-19 management strategies for pediatric patients with pre-existing chronic medical conditions. The findings highlight the increased vulnerability and poorer outcomes experienced by this subgroup, emphasizing the necessity for tailored interventions and focused care approaches.展开更多
BACKGROUND: Aspirin can decrease the incidence risk of high-risk crowdgroup of cerebral infarction, but there are still controversy if it might decrease the degree of disease in degree of patients with acute cerebral ...BACKGROUND: Aspirin can decrease the incidence risk of high-risk crowdgroup of cerebral infarction, but there are still controversy if it might decrease the degree of disease in degree of patients with acute cerebral infarction. OBJECTIVE: To observe the effect of lower dose of aspirin during taking for a long time on disease degree of disease following onset of acute cerebral infarction. DESIGN: Grouping according to the admission time and 1∶1 paired observation. SETTING: Department of Neurology, Qilu Hospital of Shandong University. PARTICIPANTS: The participants in present study were 321 patients with acute cerebral infarction who received treatments in the Department of Neurology, Qilu Hospital of Shandong University from January 1999 to June 2000. There were 190 male and 131 female ,with mean (65±11)years of age. Inclusive criteria: ① A focal neurological disturbance occurred suddenly and had lasted for more than 24 hours, patients were admitted within 3 days after onset of disease; ② A computed tomography of the brain was performed and excluded hemorrhage in all patients; ③ The patients were proved internal carotid occlusions by clinical features and image findings; ④ The functions of limbs were normal (before the first stroke) or almost normal (before the second stroke). Exclusive criteria: ①The patients who had have cardiogenic cerebral embolism; ②The patients who had taken warfarin orally and other platelet agglutination drugs. METHODS: ①All the patients were divided into 2 groups according to whether they had taken aspirin before: aspirin-treated group (n=110) and blank control group(n=211). there were 70 male and 40 female in aspirin-treated group, with average(65±10) years of age.All patients had taken 50-100 mg/d aspirin for 6 months to 10 years before onset. There were 120 male and 91 female in blank control group, with average (65±13)years of age . Patients received a clinical scoring within 3 days and similar therapeutic measures (such as anti-platelet agglutination, improving cerebral circulation and metabolism-promoting reagent). Two groups of patients had the same basic conditions except for taking aspirin or not before. ②The matched pairs were made between 50 cases selected from aspirin-treated group and 50 cases from non-aspirin-treated groups according to age, gender, and other stroke risk factors. ③ Evaluation : Degree of disease after onset was evaluated by means of Acute Cerebral Infarction Clinical Neurologic Impairment Degree Scoring Standard of Carotid Artery System. MAIN OUTCOME MEASURES: Acute Cerebral Infarction Clinical Neurologic Impairment Degree Scoring Standard of Carotid Artery System. RESULTS: All 321 patients entered the stage of analysis with no loss in the midway. ① The symptom following onset of acute cerebral infarction was evaluated with clinical neurologic impairment scoring criteria, there were no significant differences between aspirin group and blank control group [(17.39 ± 9.90) vs(16.22 ± 9.98) (t=1.025, P > 0.05)]. ② No significant differences were found in 1:1 matched pairs of 100 cases from aspirin group and blank control group (t=1.74, P > 0.05). CONCLUSION: Taking a lower dose of aspirin during long time may not decrease the degree of disease following onset of acute cerebral infarction.展开更多
BACKGROUND: Although pneumonia severity index(PSI) is widely used to evaluate the severity of community-acquired pneumonia(CAP), the calculation of PSI is very complicated. The present study aimed to evaluate the role...BACKGROUND: Although pneumonia severity index(PSI) is widely used to evaluate the severity of community-acquired pneumonia(CAP), the calculation of PSI is very complicated. The present study aimed to evaluate the role of B-type natriuretic peptide(BNP) in predicting the severity of CAP.METHODS: For 202 patients with CAP admitted to the emergency department, BNP levels, cardiac load indexes, inf lammatory indexes including C-reactive protein(CRP), white blood cell count(WBC), and PSI were detected. The correlation between the indexes and PSI was investigated. BNP levels for survivor and non-survivor groups were compared, and a receiver operating characteristic(ROC) curve analysis was performed on the BNP levels versus PSI.RESULTS: The BNP levels increased with CAP severity(r=0.782, P<0.001). The BNP levels of the high-risk group(PSI classes IV and V) were signifi cantly higher than those of the low-risk group(PSI classes I–III)(P<0.001). The BNP levels were signifi cantly higher in the non-survivor group than in the survivor group(P<0.001). In addition, there were positive correlations between BNP levels and PSI scores(r=0.782, P<0.001). The BNP level was highly accurate in predicting the severity of CAP(AUC=0.952). The optimal cut-off point of BNP level for distinguishing high-risk patients from low-risk ones was 125.0 pg/m L, with a sensitivity of 0.891 and a specifi city of 0.946. Moreover, BNP level was accurate in predicting mortality(AUC=0.823). Its optimal cut-off point for predicting death was 299.0 pg/m L, with a sensitivity of 0.675 and a specifi city of 0.816. Its negative predictive cut-off value was 0.926, and the positive predictive cut-off value was 0.426.CONCLUSION: BNP level is positively correlated with the severity of CAP, and may be used as a biomarker for evaluating the severity of CAP.展开更多
BACKGROUND Several studies have employed animal models to explore the association between microbiota and interleukin(IL) 10 signaling;however,limited information is available about the human microbiome.AIM To characte...BACKGROUND Several studies have employed animal models to explore the association between microbiota and interleukin(IL) 10 signaling;however,limited information is available about the human microbiome.AIM To characterize the microbiome in patients with IL10 RA mutations and to explore the association between gut dysbiosis and disease severity.METHODS Fecal samples were collected from patients who were diagnosed with loss-offunction mutations in the IL10 RA gene between January 2017 and July 2018 at the Children’s Hospital of Fudan University.Age-matched volunteer children were recruited as healthy controls.Patients with Crohn’s disease(CD) were used as disease controls to standardize the antibiotic exposure.Microbial DNA was extracted from the fecal samples.All analyses were based on the 16 S rRNA gene sequencing data.RESULTS Seventeen patients with IL10 RA mutations(IL10 RA group),17 patients with pediatric CD, and 26 healthy children were included.Both patients with IL10 RA mutations and those with CD exhibited a reduced diversity of gut microbiome with increased variability.The relative abundance of Firmicutes was substantially increased in the IL10 RA group(P=0.02).On further comparison of the relative abundance of taxa between patients with IL10 RA mutations and healthy children,13 taxa showed significant differences.The IL10 RA-specific dysbiosis indices exhibited a significant positive correlation with weighted pediatric CD activity index and simple endoscopic score for CD.CONCLUSION In patients with IL10 RA mutations and early onset inflammatory bowel disease,gut dysbiosis shows a moderate association with disease severity.展开更多
Faba bean is suffered with many biotic and abiotic factors. Chocolate spot disease, caused by Botrytis fabae is one of the biotic factors limiting yields of this crop resulting in yield losses up to 68% in Ethiopia. T...Faba bean is suffered with many biotic and abiotic factors. Chocolate spot disease, caused by Botrytis fabae is one of the biotic factors limiting yields of this crop resulting in yield losses up to 68% in Ethiopia. The experiment was conducted during 2020/2021 cropping season at Tach Gayint district, Ethiopia to determine the integration of faba bean varieties and fungicide rates on reducing chocolate spot disease. The experiment consisted of 12 treatments, viz. three faba bean varieties and four rate of Mancozeb fungicide in factorial arrangement. The experiment was laid out as randomized complete block design (RCBD) with three replications. Data was collected and analyzed. Results indicated that, disease incidence was reached at maximum percentage in all treatments on the last dates of assessment. But treatments were significantly difference in severity level. The least disease severity was recorded from varieties treated by 3.5 kg/ha of Mancozeb 80% WP with mean values Walki (12.7%), and (18.1% and 20.8%) on Gora and local variety respectively at the final dates of disease assessment. Similarly, the reduced AUDPC was also recorded from varieties treated by 3.5 kg/ha of Mancozeb 80% WP with mean values Walki (371.8% unit/day) and (539% and 686.4% days) on varieties Gora, and Local respectively. Whereas the maximum disease severity and AUDPC were obtained from unsprayed plots. Based on the results obtained, variety Walki treated with Mancozeb 80% WP at rate of 2.5 kg/ha and 3.5 kg/ha were effective to reduce the effect of chocolate spot disease for the study area.展开更多
BACKGROUND It has been suggested that apolipoprotein E(APOE)polymorphisms are associated with the risk of developing inflammatory bowel disease(IBD)and the early age of disease onset.However,there are no reports regar...BACKGROUND It has been suggested that apolipoprotein E(APOE)polymorphisms are associated with the risk of developing inflammatory bowel disease(IBD)and the early age of disease onset.However,there are no reports regarding the relationship with clinical characteristics and disease severity.AIM To summarise that APOE polymorphisms are associated with the risk of developing IBD and the early age of disease onset.METHODS In total,406 patients aged 3-18 with IBD(192 had ulcerative colitis and 214 had Crohn’s disease)were genotyped using the TaqMan hydrolysis probe assay.Clinical expression was described at diagnosis and the worst flare by disease activity scales,albumin and C-reactive protein levels,localisation and behaviour(Paris classification).Systemic steroid intake with the total number of courses,immunosuppressive,biological,and surgical treatment with the time and age of the first intervention were determined.The total number of exacerbation-caused hospitalisations,the number of days spent in hospital due to exacerbation,the number of relapses,and severe relapses were also estimated.RESULTS Ulcerative colitis patients with the APOEε4 allele had lower C-reactive protein values at diagnosis(P=0.0435)and the worst flare(P=0.0013)compared to patients with the APOEε2 allele and genotype APOEε3/ε3.Crohn’s disease patients with the APOEε2 allele scored lower on the Pediatric Crohn’s Disease Activity Index at diagnosis(P=0.0204).IBD patients with APOEε2 allele spent fewer days in the hospital due to relapse(P=0.0440).CONCLUSION APOE polymorphisms are associated with the risk of developing IBD and the clinical expression of IBD.However,the clinical relevance of the differences identified is rather modest.展开更多
BACKGROUND Acute pancreatitis(AP) is an inflammatory disorder of the pancreas with an unpredictable course of illness. A major challenge of AP is the early identification of patients at high-risk for organ failure and...BACKGROUND Acute pancreatitis(AP) is an inflammatory disorder of the pancreas with an unpredictable course of illness. A major challenge of AP is the early identification of patients at high-risk for organ failure and death. However, scoring systems are complicated and time consuming, and the predictive values for the clinical course are vague.AIM To determine whether the dynamic changes in presepsin levels can be used to evaluate the severity of disease and outcome of AP.METHODS In this multicentric cohort study, 133 patients with AP were included. Clinical severity was dynamically evaluated using the 2012 revised Atlanta Classification. Blood presepsin levels were measured at days 1, 3, 5 and 7 after admission by chemiluminescent enzyme immunoassay.RESULTS The median concentration of presepsin increased and the clearance rate of presepsin decreased with disease severity and organ failure in AP patients. The presepsin levels on days 3, 5 and 7 were independent predictors of moderately severe and severe AP with time-specific area under the curve(AUC) values of 0.827, 0.848 and 0.867, respectively. The presepsin levels positively correlated with bedside index of severity in AP, Ranson, acute physiology and chronic health evaluation II, computed tomography severity index and Marshall scores. Presepsin levels on days 3, 5 and 7 were independent predictors of 28-d mortality of AP patients with AUC values of 0.781, 0.846 and 0.843, respectively.CONCLUSION Blood presepsin levels within 7 d of admission were associated with and may be useful to dynamically predict the severity of disease course and 28-d mortality in AP patients.展开更多
Assessment of endoscopic disease activity can be difficult in patients with inflammatory bowel disease(IBD)[comprises Crohn's disease(CD)and ulcerative colitis(UC)].Endoscopic assessment is currently the foundatio...Assessment of endoscopic disease activity can be difficult in patients with inflammatory bowel disease(IBD)[comprises Crohn's disease(CD)and ulcerative colitis(UC)].Endoscopic assessment is currently the foundation of disease evaluation and the grading is pivotal for the initiation of certain treatments.Yet,disharmony is found among experts;even when reassessed by the same expert.Some studies have demonstrated that the evaluation is no better than flipping a coin.In UC,the greatest achieved consensus between physicians when assessing endoscopic disease activity only reached a Kappa value of 0.77(or 77%agreement adjustment for chance/accident).This is unsatisfactory when dealing with patients at risk of surgery or disease progression without proper care.Lately,across all medical specialities,computer assistance has become increasingly interesting.Especially after the emanation of machine learning–colloquially referred to as artificial intelligence(AI).Compared to other data analysis methods,the strengths of AI lie in its capability to derive complex models from a relatively small dataset and its ability to learn and optimise its predictions from new inputs.It is therefore evident that with such a model,one hopes to be able to remove inconsistency among humans and standardise the results across educational levels,nationalities and resources.This has manifested in a handful of studies where AI is mainly applied to capsule endoscopy in CD and colonoscopy in UC.However,due to its recent place in IBD,there is a great inconsistency between the results,as well as the reporting of the same.In this opinion review,we will explore and evaluate the method and results of the published studies utilising AI within IBD(with examples),and discuss the future possibilities AI can offer within IBD.展开更多
BACKGROUND In December 2019,coronavirus disease 2019(COVID-19)was reported firstly in Wuhan,China.COVID-19 is currently a global pandemic.AIM To assess the suitability of lymphocyte count as a biomarker of COVID-19 se...BACKGROUND In December 2019,coronavirus disease 2019(COVID-19)was reported firstly in Wuhan,China.COVID-19 is currently a global pandemic.AIM To assess the suitability of lymphocyte count as a biomarker of COVID-19 severity.METHODS Five literature databases(PubMed/MEDLINE,Web of Science,Google Scholar,Embase,and Scopus)were searched to identify eligible articles.A meta-analysis was performed to calculate the standard mean difference(SMD)and 95%confidence interval(CI)of lymphocyte counts in coronaviral pneumonia cases.RESULTS Eight studies,including 1057 patients,were integrated in the meta-analysis.Lymphocyte counts were associated with severe coronavirus(CoV)infection(SMD=1.35,95%CI:1.97 to 0.37,P<0.001,I2=92.6%).In the subgroup analysis stratified by prognosis,lymphocytes were associated with CoV infection mortality(n=2,SMD=0.42,95%CI:0.66 to 0.19,P<0.001,I2=0.0%),severity(n=2,SMD=0.93,95%CI:1.20 to 0.67,P<0.001,I2=0.0%),and diagnostic rate(n=4,SMD=2.32,95%CI:3.60 to 1.04,P<0.001,I2=91.2%).CONCLUSION Lymphocyte count may represent a simple,rapid,and commonly available laboratory index with which to diagnosis infection and predict the severity of CoV infections,including COVID-19.展开更多
Fusarium dry rot is considered to be the most critical soilborne and postharvest disease that damages potato tubers worldwide when they are stored for a long time.This study was performed to demonstrate the effect of ...Fusarium dry rot is considered to be the most critical soilborne and postharvest disease that damages potato tubers worldwide when they are stored for a long time.This study was performed to demonstrate the effect of crude extract,culture filtrate,and cell suspension obtained from the bacterium Bacillus subtilis Hussain T-AMU,on the net house and field.From oil-contaminated soil,through the serial dilution method,biosurfactant bacteria were isolated on nutrient agar medium.To isolate and screen the prospective biosurfactant strain,various biosurfactant screening methods were used.Standard protocols were carried out for morphological,molecular,and chemical characterization.The disease incidences were significantly decreased under net house and field conditions after treatment with biosurfactant extract(20%,70%),culture filtrate(23%,49%),and bacterial cell suspension(46%,27%),respectively.These results indicate a significant effect of B.subtilis HussainT-AMU against Fusarium oxysporum.The characterization of the partially purified extract by gas-chromatography indicated the existence of a high amount of methyl ester fatty acids.The quantitative analysis determined the presence of lipopeptide-surfactin,fengycin,and iturin in the biosurfactant extract.Scanning electron microscopy revealed that morphological variation was revealed in the structure of stomata size in leaves and in the mycelia of the pathogen that was investigated.This promising biocontrol agent can be a plausible option for further research and can also be used for the production of green biomolecules at an additional industrial level.展开更多
Objective Tricuspid regurgitation is often associated in patients with congenital heart disease. Significant morbidity and mortality are related to tricuspid valve replacement. Tricuspid valve plasty is still a prefer...Objective Tricuspid regurgitation is often associated in patients with congenital heart disease. Significant morbidity and mortality are related to tricuspid valve replacement. Tricuspid valve plasty is still a preferred choice. This report deals with our surgical experience in using edge-to-edge valve plasty technique to correct severe展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)was perhaps the most severe global health crisis in living memory.Alongside respiratory symptoms,elevated liver enzymes,abnormal liver function,and even acute liver fai...BACKGROUND The coronavirus disease 2019(COVID-19)was perhaps the most severe global health crisis in living memory.Alongside respiratory symptoms,elevated liver enzymes,abnormal liver function,and even acute liver failure were reported in patients suffering from severe acute respiratory disease coronavirus 2 pneumonia.However,the precise triggers of these forms of liver damage and how they affect the course and outcomes of COVID-19 itself remain unclear.AIM To analyze the impact of liver enzyme abnormalities on the severity and outcomes of COVID-19 in hospitalized patients.METHODS In this study,684 depersonalized medical records from patients hospitalized with COVID-19 during the 2020-2021 period were analyzed.COVID-19 was diagnosed according to the guidelines of the National Institutes of Health(2021).Patients were assigned to two groups:those with elevated liver enzymes(Group 1:603 patients),where at least one out of four liver enzymes were elevated(following the norm of hospital laboratory tests:alanine aminotransferase(ALT)≥40,aspartate aminotransferase(AST)≥40,gamma-glutamyl transferase≥36,or alkaline phosphatase≥150)at any point of hospitalization,from admission to discharge;and the control group(Group 2:81 patients),with normal liver enzymes during hospitalization.COVID-19 severity was assessed according to the interim World Health Organization guidance(2022).Data on viral pneumonia complications,laboratory tests,and underlying diseases were also collected and analyzed.RESULTS In total,603(88.2%)patients produced abnormal liver test results.ALT and AST levels were elevated by a factor of less than 3 in 54.9%and 74.8%of cases with increased enzyme levels,respectively.Patients in Group 1 had almost double the chance of bacterial viral pneumonia complications[odds ratio(OR)=1.73,P=0.0217],required oxygen supply more often,and displayed higher biochemical inflammation indices than those in Group 2.No differences in other COVID-19 complications or underlying diseases were observed between groups.Preexisting hepatitis of a different etiology was rarely documented(in only 3.5%of patients),and had no impact on the severity of COVID-19.Only 5(0.73%)patients experienced acute liver failure,4 of whom died.Overall,the majority of the deceased patients(17 out of 20)had elevated liver enzymes,and most were male.All deceased patients had at least one underlying disease or combination thereof,and the deceased suffered significantly more often from heart diseases,hypertension,and urinary tract infections than those who made recoveries.Alongside male gender(OR=1.72,P=0.0161)and older age(OR=1.02,P=0.0234),diabetes(OR=3.22,P=0.0016)and hyperlipidemia(OR=2.67,P=0.0238),but not obesity,were confirmed as independent factors associated with more a severe COVID-19 infection in our cohort.CONCLUSION In our study,the presence of liver impairment allows us to predict a more severe inflammation with a higher risk of bacterial complication and worse outcomes of COVID-19.Therefore,patients with severe disease forms should have their liver tests monitored regularly and their results should be considered when selecting treatment to avoid further liver damage or even insufficiency.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus most commonly presents with respiratory symptoms.While gastrointestinal(GI)manifestations either at pres...BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus most commonly presents with respiratory symptoms.While gastrointestinal(GI)manifestations either at presentation or during hospitalization are also common,their impact on clinical outcomes is controversial.Some studies have described worse outcomes in COVID-19 patients with GI symptoms,while others have shown either no association or a protective effect.There is a need for consistent standards to describe GI symptoms in COVID-19 patients and to assess their effect on clinical outcomes,including mortality and disease severity.AIM To investigate the prevalence of GI symptoms in hospitalized COVID-19 patients and their correlation with disease severity and clinical outcomes.METHODS We retrospectively reviewed 601 consecutive adult COVID-19 patients requiring hospitalization between May 1-15,2020.GI symptoms were recorded at admission and during hospitalization.Demographic,clinical,laboratory,and treatment data were retrieved.Clinical outcomes included all-cause mortality,disease severity at presentation,need for intensive care unit(ICU)admission,development of acute respiratory distress syndrome,and need for mechanical ventilation.Multivariate logistic regression model was used to identify independent predictors of the adverse outcomes.RESULTS The prevalence of any GI symptom at admission was 27.1%and during hospitalization was 19.8%.The most common symptoms were nausea(98 patients),diarrhea(76 patients),vomiting(73 patients),and epigastric pain or discomfort(69 patients).There was no difference in the mortality between the two groups(6.21%vs 5.5%,P=0.7).Patients with GI symptoms were more likely to have severe disease at presentation(33.13%vs 22.5%,P<0.001)and prolonged hospital stay(15 d vs 14 d,P=0.04).There was no difference in other clinical outcomes,including ICU admission,development of acute respiratory distress syndrome,or need for mechanical ventilation.Drugs associated with the development of GI symptoms during hospitalization were ribavirin(diarrhea 26.37%P<0.001,anorexia 17.58%,P=0.02),hydroxychloroquine(vomiting 28.52%,P=0.009)and lopinavir/ritonavir(nausea 32.65%P=0.049,vomiting 31.47%P=0.004,and epigastric pain 12.65%P=0.048).In the multivariate regression analysis,age>65 years was associated with increased mortality risk[odds ratio(OR)7.53,confidence interval(CI):3.09-18.29,P<0.001],ICU admission(OR:1.79,CI:1.13-2.83,P=0.012),and need for mechanical ventilation(OR:1.89,CI:1.94-2.99,P=0.007).Hypertension was an independent risk factor for ICU admission(OR:1.82,CI:1.17-2.84,P=0.008)and need for mechanical ventilation(OR:1.66,CI:1.05-2.62,P=0.028).CONCLUSION Patients with GI symptoms are more likely to have severe disease at presentation;however,mortality and disease progression is not different between the two groups.展开更多
基金Supported by A GI Section Grant from the University of Western Ontario,Ontario,Canada
文摘AIM:To understand the demographic characteristics of patients in Southwestern Ontario,Canada with ulcerative colitis(UC)in order to predict disease severity. METHODS:Records from 1996 to 2001 were exam- ined to create a database of UC patients seen in the London Health Sciences Centre South Street Hospital Inflammatory Bowel Disease Clinic.To be included, patients'charts were required to have information of their disease presentation and a minimum of 5 years of follow-up.Charts were reviewed using standardized data collection forms.Disease severity was generated during the chart review process,and non-endoscopic Mayo Score criteria were collected into a composite. RESULTS:One hundred and two consecutive patients'data were entered into the database.Demographic analyses revealed that 51%of the patients were male, the mean age at diagnosis was 39 years,13.7%had a first degree relative with inflammatory bowel disease (IBD),61.8%were nonsmokers and 24.5%were ex-smokers.In 22.5%of patients the disease was limited to the rectum,in 21.6%disease was limited to the sigmoid colon,in 22.5%disease was limited to the left colon,and 32.4%of patients had pancolitis. Standard multiple regression analysis which regressed a composite of physician global assessment of disease severity,average number of bowel movements,and average amount of blood in bowel movements on year of diagnosis and age at time of diagnosis was significant,R 2=0.306,F(7,74)=4.66,P<0.01. Delay from symptoms to diagnosis of UC,gender, family history of IBD,smoking status and disease severity at the time of diagnosis didnot significantly predict the composite measure. CONCLUSION:UC severity is associated with younger age at diagnosis and year of diagnosis in a longitudinal cohort of UC patients,and may identify prognostic UC indicators.
文摘Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-polymerase chain reaction(RTPCR)is the gold standard molecular technique for diagnosing COVID-19.The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold(Ct)values.Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral load.A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity.The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated.In this review,we describe the scientific data as well as the important findings from many clinical studies globally,emphasizing how viral load may be related to disease severity in COVID-19 patients.Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients,and early anti-viral treatment will reduce the severe clinical outcomes.
文摘<strong>Background:</strong> Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the severity of COVID-19 illness and mortality. <strong>Method:</strong> Retrospective study on 259 patients with COVID-19 with measurement of average glucose during 24 hours of admission. Association of Early Hyperglycemia categorized as <180 mg/dl or >180 mg/dl;was studied with mortality, requirement of ICU stay and prognostic markers. <strong>Results: </strong>Early hyperglycemia (>180 mg/dl) revealed a higher median value for CRP (109 mg/l [IQR;48 - 199]) in comparison to <180 mg/dl group (86 mg/l [IQR;26.3 - 153]) p = 0.03. ICU stay was higher in >180 mg/dl group;24 (15.9%) vs 14 patients (13%) [p = 0.51] in the <180 mg/dl group. Mortality in the group > 180 mg/dl was 8 (5.3%) while <180 mg/dl had a mortality rate of 4 (3.7%) [p = 0.547]. <strong>Conclusion:</strong> Hyperglycemia in the first 24 hours may anticipate an increased risk of ICU stay and a higher mortality rate. It may be a possible predictor of disease severity.
基金The National Key Research and Development Program of China (2022YFC2604100)the National Natural Science Foundation of China (92269203)supported the study.
文摘Understanding how human leukocyte antigen(HLA)polymorphism affects both the susceptibility and severity of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection will help to identify individuals at higher risk to better manage and prioritize vaccination at the clinical level and explain the differences in epidemic trends in different regions at the epidemiological level.This study compared the frequencies of HLA class I alleles(HLA-A,B)in 214 coronavirus disease 2019(COVID-19)patients with different disease severity and 35 healthy controls and analyzed the correlations between specific HLA alleles and disease severity and T cell memory.The results showed no significant difference in HLA allele frequencies between COVID-19 patients and healthy controls(P>0.05).The allele HLA-B*13:02 was significantly correlated with the disease severity of COVID-19 patients(P=0.006).After adjustment for age and disease severity,the T cell responses of COVID-19 convalescents with the allele HLA-B*40:01 may be lower at six months(P=0.044)and 12 months(P=0.069).Moreover,these results may be due to their rare peptide anchors by analyzing the binding peptide motifs of these HLA alleles.The study may be valuable for investigating the potential association of specific HLA alleles with SARS-CoV-2 infection.
文摘Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.
基金This work was supported by grants from the Chinese National Key Research R&D Program(Nos.2017YFC0907601,2017YFC0907604)。
文摘Background:Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patientassessed) and proportions of treatment cost to household income.Methods:This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (<10%, 10-30%, 31-50%, and >50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients’ treatment satisfaction.Results:When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P < 0.001). Effectiveness, side effects, and convenience scores were higher in the <10% subgroup compared to those in the >50% subgroup (all P < 0.05). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 13.183, P = 0.004). For biological diseasemodifying anti-rheumatic drugs, effectiveness and convenience scores were lower in the severe RA subgroup than those in the extremely mild RA subgroup (both P < 0.05). Convenience score was higher in the <10% subgroup compared to that in the 31% to 50% and >50% subgroups ( F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup ( F = 8.794, P = 0.032). Conclusion:Higher disease severity and higher financial burden were associated with lower patient satisfaction.
基金This study was supported by a grant from the 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project,West China Hospital,Sichuan University(No.2019HXFH016)。
文摘Background: Sleep disorders are common but under-researched symptoms in patients with multiple system atrophy (MSA). We investigated the frequency and factors associated with sleep-related symptoms in patients with MSA and the impact of sleep disturbances on disease severity.Methods: This cross-sectional study involved 165 patients with MSA. Three sleep-related symptoms, namely Parkinson’s disease (PD)-related sleep problems (PD-SP), excessive daytime sleepiness (EDS), and rapid eye movement sleep behavior disorder (RBD), were evaluated using the PD Sleep Scale-2 (PDSS-2), Epworth Sleepiness Scale (ESS), and RBD Screening Questionnaire (RBDSQ), respectively. Disease severity was evaluated using the Unified MSA Rating Scale (UMSARS).Results: The frequency of PD-SP (PDSS-2 score of ≥18), EDS (ESS score of ≥10), and RBD (RBDSQ score of ≥5) in patients with MSA was 18.8%, 27.3%, and 49.7%, respectively. The frequency of coexistence of all three sleep-related symptoms was 7.3%. Compared with the cerebellar subtype of MSA (MSA-C), the parkinsonism subtype of MSA (MSA-P) was associated with a higher frequency of PD-SP and EDS, but not of RBD. Binary logistic regression revealed that the MSA-P subtype, a higher total UMSARS score, and anxiety were associated with PD-SP;that male sex, a higher total UMSARS score, the MSA-P subtype, and fatigue were associated with EDS;and that male sex, a higher total UMSARS score, and autonomic onset were associated with RBD in patients with MSA. Stepwise linear regression showed that the number of sleep-related symptoms (PD-SP, EDS, and RBD), disease duration, depression, fatigue, and total Montreal Cognitive Assessment score were predictors of disease severity in patients with MSA.Conclusions: Sleep-related disorders were associated with both MSA subtypes and the severity of disease in patients with MSA, indicating that sleep disorders may reflect the distribution and degree of dopaminergic/non-dopaminergic neuron degeneration in MSA.
文摘Background: The COVID-19 pandemic emerged unexpectedly, impacting millions worldwide and, though waning in many regions, remains a significant concern. This study focused on understanding COVID-19’s clinical presentation, disease progression, and outcomes among hospitalized pediatric patients. Additionally, it sought to investigate the impact of concurrent chronic medical conditions on disease severity. Methods: Conducted retrospectively between September 2020 and December 2021, this study observed pediatric patients (below 18 years) hospitalized with confirmed COVID-19 at an Irbid, Jordan tertiary healthcare center. Patients meeting inclusion criteria, including a positive nasal swab PCR test and hospitalization need, were analyzed. Epidemiological and clinical data were collected and segregated into two groups (A and B) based on the presence of chronic conditions. Comparative analysis encompassed presentation, disease trajectory, and outcomes between these groups. Results: Among 451 tested positive patients, 112 were included in the study. Significant differences emerged between the two pediatric groups hospitalized for COVID-19. Those with concurrent chronic illnesses exhibited heightened symptom severity—fever, dyspnea, fatigue—and a higher incidence of abnormal chest radiographs, often requiring intensive care and experiencing elevated mortality rates. Conclusion: This study underscores the criticality of prioritizing COVID-19 management strategies for pediatric patients with pre-existing chronic medical conditions. The findings highlight the increased vulnerability and poorer outcomes experienced by this subgroup, emphasizing the necessity for tailored interventions and focused care approaches.
文摘BACKGROUND: Aspirin can decrease the incidence risk of high-risk crowdgroup of cerebral infarction, but there are still controversy if it might decrease the degree of disease in degree of patients with acute cerebral infarction. OBJECTIVE: To observe the effect of lower dose of aspirin during taking for a long time on disease degree of disease following onset of acute cerebral infarction. DESIGN: Grouping according to the admission time and 1∶1 paired observation. SETTING: Department of Neurology, Qilu Hospital of Shandong University. PARTICIPANTS: The participants in present study were 321 patients with acute cerebral infarction who received treatments in the Department of Neurology, Qilu Hospital of Shandong University from January 1999 to June 2000. There were 190 male and 131 female ,with mean (65±11)years of age. Inclusive criteria: ① A focal neurological disturbance occurred suddenly and had lasted for more than 24 hours, patients were admitted within 3 days after onset of disease; ② A computed tomography of the brain was performed and excluded hemorrhage in all patients; ③ The patients were proved internal carotid occlusions by clinical features and image findings; ④ The functions of limbs were normal (before the first stroke) or almost normal (before the second stroke). Exclusive criteria: ①The patients who had have cardiogenic cerebral embolism; ②The patients who had taken warfarin orally and other platelet agglutination drugs. METHODS: ①All the patients were divided into 2 groups according to whether they had taken aspirin before: aspirin-treated group (n=110) and blank control group(n=211). there were 70 male and 40 female in aspirin-treated group, with average(65±10) years of age.All patients had taken 50-100 mg/d aspirin for 6 months to 10 years before onset. There were 120 male and 91 female in blank control group, with average (65±13)years of age . Patients received a clinical scoring within 3 days and similar therapeutic measures (such as anti-platelet agglutination, improving cerebral circulation and metabolism-promoting reagent). Two groups of patients had the same basic conditions except for taking aspirin or not before. ②The matched pairs were made between 50 cases selected from aspirin-treated group and 50 cases from non-aspirin-treated groups according to age, gender, and other stroke risk factors. ③ Evaluation : Degree of disease after onset was evaluated by means of Acute Cerebral Infarction Clinical Neurologic Impairment Degree Scoring Standard of Carotid Artery System. MAIN OUTCOME MEASURES: Acute Cerebral Infarction Clinical Neurologic Impairment Degree Scoring Standard of Carotid Artery System. RESULTS: All 321 patients entered the stage of analysis with no loss in the midway. ① The symptom following onset of acute cerebral infarction was evaluated with clinical neurologic impairment scoring criteria, there were no significant differences between aspirin group and blank control group [(17.39 ± 9.90) vs(16.22 ± 9.98) (t=1.025, P > 0.05)]. ② No significant differences were found in 1:1 matched pairs of 100 cases from aspirin group and blank control group (t=1.74, P > 0.05). CONCLUSION: Taking a lower dose of aspirin during long time may not decrease the degree of disease following onset of acute cerebral infarction.
基金supported by a grant from the Excellent Talent Training Special Fund,Xicheng District of Beijing(20110046)
文摘BACKGROUND: Although pneumonia severity index(PSI) is widely used to evaluate the severity of community-acquired pneumonia(CAP), the calculation of PSI is very complicated. The present study aimed to evaluate the role of B-type natriuretic peptide(BNP) in predicting the severity of CAP.METHODS: For 202 patients with CAP admitted to the emergency department, BNP levels, cardiac load indexes, inf lammatory indexes including C-reactive protein(CRP), white blood cell count(WBC), and PSI were detected. The correlation between the indexes and PSI was investigated. BNP levels for survivor and non-survivor groups were compared, and a receiver operating characteristic(ROC) curve analysis was performed on the BNP levels versus PSI.RESULTS: The BNP levels increased with CAP severity(r=0.782, P<0.001). The BNP levels of the high-risk group(PSI classes IV and V) were signifi cantly higher than those of the low-risk group(PSI classes I–III)(P<0.001). The BNP levels were signifi cantly higher in the non-survivor group than in the survivor group(P<0.001). In addition, there were positive correlations between BNP levels and PSI scores(r=0.782, P<0.001). The BNP level was highly accurate in predicting the severity of CAP(AUC=0.952). The optimal cut-off point of BNP level for distinguishing high-risk patients from low-risk ones was 125.0 pg/m L, with a sensitivity of 0.891 and a specifi city of 0.946. Moreover, BNP level was accurate in predicting mortality(AUC=0.823). Its optimal cut-off point for predicting death was 299.0 pg/m L, with a sensitivity of 0.675 and a specifi city of 0.816. Its negative predictive cut-off value was 0.926, and the positive predictive cut-off value was 0.426.CONCLUSION: BNP level is positively correlated with the severity of CAP, and may be used as a biomarker for evaluating the severity of CAP.
基金Supported by the Jiujiu Charitable Trust-PIBD China.
文摘BACKGROUND Several studies have employed animal models to explore the association between microbiota and interleukin(IL) 10 signaling;however,limited information is available about the human microbiome.AIM To characterize the microbiome in patients with IL10 RA mutations and to explore the association between gut dysbiosis and disease severity.METHODS Fecal samples were collected from patients who were diagnosed with loss-offunction mutations in the IL10 RA gene between January 2017 and July 2018 at the Children’s Hospital of Fudan University.Age-matched volunteer children were recruited as healthy controls.Patients with Crohn’s disease(CD) were used as disease controls to standardize the antibiotic exposure.Microbial DNA was extracted from the fecal samples.All analyses were based on the 16 S rRNA gene sequencing data.RESULTS Seventeen patients with IL10 RA mutations(IL10 RA group),17 patients with pediatric CD, and 26 healthy children were included.Both patients with IL10 RA mutations and those with CD exhibited a reduced diversity of gut microbiome with increased variability.The relative abundance of Firmicutes was substantially increased in the IL10 RA group(P=0.02).On further comparison of the relative abundance of taxa between patients with IL10 RA mutations and healthy children,13 taxa showed significant differences.The IL10 RA-specific dysbiosis indices exhibited a significant positive correlation with weighted pediatric CD activity index and simple endoscopic score for CD.CONCLUSION In patients with IL10 RA mutations and early onset inflammatory bowel disease,gut dysbiosis shows a moderate association with disease severity.
文摘Faba bean is suffered with many biotic and abiotic factors. Chocolate spot disease, caused by Botrytis fabae is one of the biotic factors limiting yields of this crop resulting in yield losses up to 68% in Ethiopia. The experiment was conducted during 2020/2021 cropping season at Tach Gayint district, Ethiopia to determine the integration of faba bean varieties and fungicide rates on reducing chocolate spot disease. The experiment consisted of 12 treatments, viz. three faba bean varieties and four rate of Mancozeb fungicide in factorial arrangement. The experiment was laid out as randomized complete block design (RCBD) with three replications. Data was collected and analyzed. Results indicated that, disease incidence was reached at maximum percentage in all treatments on the last dates of assessment. But treatments were significantly difference in severity level. The least disease severity was recorded from varieties treated by 3.5 kg/ha of Mancozeb 80% WP with mean values Walki (12.7%), and (18.1% and 20.8%) on Gora and local variety respectively at the final dates of disease assessment. Similarly, the reduced AUDPC was also recorded from varieties treated by 3.5 kg/ha of Mancozeb 80% WP with mean values Walki (371.8% unit/day) and (539% and 686.4% days) on varieties Gora, and Local respectively. Whereas the maximum disease severity and AUDPC were obtained from unsprayed plots. Based on the results obtained, variety Walki treated with Mancozeb 80% WP at rate of 2.5 kg/ha and 3.5 kg/ha were effective to reduce the effect of chocolate spot disease for the study area.
基金The National Science Centre,Poland,No.2017/25/B/NZ5/02783(to Walkowiak J).
文摘BACKGROUND It has been suggested that apolipoprotein E(APOE)polymorphisms are associated with the risk of developing inflammatory bowel disease(IBD)and the early age of disease onset.However,there are no reports regarding the relationship with clinical characteristics and disease severity.AIM To summarise that APOE polymorphisms are associated with the risk of developing IBD and the early age of disease onset.METHODS In total,406 patients aged 3-18 with IBD(192 had ulcerative colitis and 214 had Crohn’s disease)were genotyped using the TaqMan hydrolysis probe assay.Clinical expression was described at diagnosis and the worst flare by disease activity scales,albumin and C-reactive protein levels,localisation and behaviour(Paris classification).Systemic steroid intake with the total number of courses,immunosuppressive,biological,and surgical treatment with the time and age of the first intervention were determined.The total number of exacerbation-caused hospitalisations,the number of days spent in hospital due to exacerbation,the number of relapses,and severe relapses were also estimated.RESULTS Ulcerative colitis patients with the APOEε4 allele had lower C-reactive protein values at diagnosis(P=0.0435)and the worst flare(P=0.0013)compared to patients with the APOEε2 allele and genotype APOEε3/ε3.Crohn’s disease patients with the APOEε2 allele scored lower on the Pediatric Crohn’s Disease Activity Index at diagnosis(P=0.0204).IBD patients with APOEε2 allele spent fewer days in the hospital due to relapse(P=0.0440).CONCLUSION APOE polymorphisms are associated with the risk of developing IBD and the clinical expression of IBD.However,the clinical relevance of the differences identified is rather modest.
基金Supported by Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support “Yangfan” Project,No.ZYLX201802Beijing Municipal Administration of Hospitals’ Youth Program,No.QML20170105National Natural Science Foundation of China,No.81374004 and 81773931
文摘BACKGROUND Acute pancreatitis(AP) is an inflammatory disorder of the pancreas with an unpredictable course of illness. A major challenge of AP is the early identification of patients at high-risk for organ failure and death. However, scoring systems are complicated and time consuming, and the predictive values for the clinical course are vague.AIM To determine whether the dynamic changes in presepsin levels can be used to evaluate the severity of disease and outcome of AP.METHODS In this multicentric cohort study, 133 patients with AP were included. Clinical severity was dynamically evaluated using the 2012 revised Atlanta Classification. Blood presepsin levels were measured at days 1, 3, 5 and 7 after admission by chemiluminescent enzyme immunoassay.RESULTS The median concentration of presepsin increased and the clearance rate of presepsin decreased with disease severity and organ failure in AP patients. The presepsin levels on days 3, 5 and 7 were independent predictors of moderately severe and severe AP with time-specific area under the curve(AUC) values of 0.827, 0.848 and 0.867, respectively. The presepsin levels positively correlated with bedside index of severity in AP, Ranson, acute physiology and chronic health evaluation II, computed tomography severity index and Marshall scores. Presepsin levels on days 3, 5 and 7 were independent predictors of 28-d mortality of AP patients with AUC values of 0.781, 0.846 and 0.843, respectively.CONCLUSION Blood presepsin levels within 7 d of admission were associated with and may be useful to dynamically predict the severity of disease course and 28-d mortality in AP patients.
文摘Assessment of endoscopic disease activity can be difficult in patients with inflammatory bowel disease(IBD)[comprises Crohn's disease(CD)and ulcerative colitis(UC)].Endoscopic assessment is currently the foundation of disease evaluation and the grading is pivotal for the initiation of certain treatments.Yet,disharmony is found among experts;even when reassessed by the same expert.Some studies have demonstrated that the evaluation is no better than flipping a coin.In UC,the greatest achieved consensus between physicians when assessing endoscopic disease activity only reached a Kappa value of 0.77(or 77%agreement adjustment for chance/accident).This is unsatisfactory when dealing with patients at risk of surgery or disease progression without proper care.Lately,across all medical specialities,computer assistance has become increasingly interesting.Especially after the emanation of machine learning–colloquially referred to as artificial intelligence(AI).Compared to other data analysis methods,the strengths of AI lie in its capability to derive complex models from a relatively small dataset and its ability to learn and optimise its predictions from new inputs.It is therefore evident that with such a model,one hopes to be able to remove inconsistency among humans and standardise the results across educational levels,nationalities and resources.This has manifested in a handful of studies where AI is mainly applied to capsule endoscopy in CD and colonoscopy in UC.However,due to its recent place in IBD,there is a great inconsistency between the results,as well as the reporting of the same.In this opinion review,we will explore and evaluate the method and results of the published studies utilising AI within IBD(with examples),and discuss the future possibilities AI can offer within IBD.
文摘BACKGROUND In December 2019,coronavirus disease 2019(COVID-19)was reported firstly in Wuhan,China.COVID-19 is currently a global pandemic.AIM To assess the suitability of lymphocyte count as a biomarker of COVID-19 severity.METHODS Five literature databases(PubMed/MEDLINE,Web of Science,Google Scholar,Embase,and Scopus)were searched to identify eligible articles.A meta-analysis was performed to calculate the standard mean difference(SMD)and 95%confidence interval(CI)of lymphocyte counts in coronaviral pneumonia cases.RESULTS Eight studies,including 1057 patients,were integrated in the meta-analysis.Lymphocyte counts were associated with severe coronavirus(CoV)infection(SMD=1.35,95%CI:1.97 to 0.37,P<0.001,I2=92.6%).In the subgroup analysis stratified by prognosis,lymphocytes were associated with CoV infection mortality(n=2,SMD=0.42,95%CI:0.66 to 0.19,P<0.001,I2=0.0%),severity(n=2,SMD=0.93,95%CI:1.20 to 0.67,P<0.001,I2=0.0%),and diagnostic rate(n=4,SMD=2.32,95%CI:3.60 to 1.04,P<0.001,I2=91.2%).CONCLUSION Lymphocyte count may represent a simple,rapid,and commonly available laboratory index with which to diagnosis infection and predict the severity of CoV infections,including COVID-19.
基金Science and Engineering Research Board(SERB)Govt.of India,New Delhi,under File No.SERB-DST-NPDF/2016/001409.
文摘Fusarium dry rot is considered to be the most critical soilborne and postharvest disease that damages potato tubers worldwide when they are stored for a long time.This study was performed to demonstrate the effect of crude extract,culture filtrate,and cell suspension obtained from the bacterium Bacillus subtilis Hussain T-AMU,on the net house and field.From oil-contaminated soil,through the serial dilution method,biosurfactant bacteria were isolated on nutrient agar medium.To isolate and screen the prospective biosurfactant strain,various biosurfactant screening methods were used.Standard protocols were carried out for morphological,molecular,and chemical characterization.The disease incidences were significantly decreased under net house and field conditions after treatment with biosurfactant extract(20%,70%),culture filtrate(23%,49%),and bacterial cell suspension(46%,27%),respectively.These results indicate a significant effect of B.subtilis HussainT-AMU against Fusarium oxysporum.The characterization of the partially purified extract by gas-chromatography indicated the existence of a high amount of methyl ester fatty acids.The quantitative analysis determined the presence of lipopeptide-surfactin,fengycin,and iturin in the biosurfactant extract.Scanning electron microscopy revealed that morphological variation was revealed in the structure of stomata size in leaves and in the mycelia of the pathogen that was investigated.This promising biocontrol agent can be a plausible option for further research and can also be used for the production of green biomolecules at an additional industrial level.
文摘Objective Tricuspid regurgitation is often associated in patients with congenital heart disease. Significant morbidity and mortality are related to tricuspid valve replacement. Tricuspid valve plasty is still a preferred choice. This report deals with our surgical experience in using edge-to-edge valve plasty technique to correct severe
文摘BACKGROUND The coronavirus disease 2019(COVID-19)was perhaps the most severe global health crisis in living memory.Alongside respiratory symptoms,elevated liver enzymes,abnormal liver function,and even acute liver failure were reported in patients suffering from severe acute respiratory disease coronavirus 2 pneumonia.However,the precise triggers of these forms of liver damage and how they affect the course and outcomes of COVID-19 itself remain unclear.AIM To analyze the impact of liver enzyme abnormalities on the severity and outcomes of COVID-19 in hospitalized patients.METHODS In this study,684 depersonalized medical records from patients hospitalized with COVID-19 during the 2020-2021 period were analyzed.COVID-19 was diagnosed according to the guidelines of the National Institutes of Health(2021).Patients were assigned to two groups:those with elevated liver enzymes(Group 1:603 patients),where at least one out of four liver enzymes were elevated(following the norm of hospital laboratory tests:alanine aminotransferase(ALT)≥40,aspartate aminotransferase(AST)≥40,gamma-glutamyl transferase≥36,or alkaline phosphatase≥150)at any point of hospitalization,from admission to discharge;and the control group(Group 2:81 patients),with normal liver enzymes during hospitalization.COVID-19 severity was assessed according to the interim World Health Organization guidance(2022).Data on viral pneumonia complications,laboratory tests,and underlying diseases were also collected and analyzed.RESULTS In total,603(88.2%)patients produced abnormal liver test results.ALT and AST levels were elevated by a factor of less than 3 in 54.9%and 74.8%of cases with increased enzyme levels,respectively.Patients in Group 1 had almost double the chance of bacterial viral pneumonia complications[odds ratio(OR)=1.73,P=0.0217],required oxygen supply more often,and displayed higher biochemical inflammation indices than those in Group 2.No differences in other COVID-19 complications or underlying diseases were observed between groups.Preexisting hepatitis of a different etiology was rarely documented(in only 3.5%of patients),and had no impact on the severity of COVID-19.Only 5(0.73%)patients experienced acute liver failure,4 of whom died.Overall,the majority of the deceased patients(17 out of 20)had elevated liver enzymes,and most were male.All deceased patients had at least one underlying disease or combination thereof,and the deceased suffered significantly more often from heart diseases,hypertension,and urinary tract infections than those who made recoveries.Alongside male gender(OR=1.72,P=0.0161)and older age(OR=1.02,P=0.0234),diabetes(OR=3.22,P=0.0016)and hyperlipidemia(OR=2.67,P=0.0238),but not obesity,were confirmed as independent factors associated with more a severe COVID-19 infection in our cohort.CONCLUSION In our study,the presence of liver impairment allows us to predict a more severe inflammation with a higher risk of bacterial complication and worse outcomes of COVID-19.Therefore,patients with severe disease forms should have their liver tests monitored regularly and their results should be considered when selecting treatment to avoid further liver damage or even insufficiency.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus most commonly presents with respiratory symptoms.While gastrointestinal(GI)manifestations either at presentation or during hospitalization are also common,their impact on clinical outcomes is controversial.Some studies have described worse outcomes in COVID-19 patients with GI symptoms,while others have shown either no association or a protective effect.There is a need for consistent standards to describe GI symptoms in COVID-19 patients and to assess their effect on clinical outcomes,including mortality and disease severity.AIM To investigate the prevalence of GI symptoms in hospitalized COVID-19 patients and their correlation with disease severity and clinical outcomes.METHODS We retrospectively reviewed 601 consecutive adult COVID-19 patients requiring hospitalization between May 1-15,2020.GI symptoms were recorded at admission and during hospitalization.Demographic,clinical,laboratory,and treatment data were retrieved.Clinical outcomes included all-cause mortality,disease severity at presentation,need for intensive care unit(ICU)admission,development of acute respiratory distress syndrome,and need for mechanical ventilation.Multivariate logistic regression model was used to identify independent predictors of the adverse outcomes.RESULTS The prevalence of any GI symptom at admission was 27.1%and during hospitalization was 19.8%.The most common symptoms were nausea(98 patients),diarrhea(76 patients),vomiting(73 patients),and epigastric pain or discomfort(69 patients).There was no difference in the mortality between the two groups(6.21%vs 5.5%,P=0.7).Patients with GI symptoms were more likely to have severe disease at presentation(33.13%vs 22.5%,P<0.001)and prolonged hospital stay(15 d vs 14 d,P=0.04).There was no difference in other clinical outcomes,including ICU admission,development of acute respiratory distress syndrome,or need for mechanical ventilation.Drugs associated with the development of GI symptoms during hospitalization were ribavirin(diarrhea 26.37%P<0.001,anorexia 17.58%,P=0.02),hydroxychloroquine(vomiting 28.52%,P=0.009)and lopinavir/ritonavir(nausea 32.65%P=0.049,vomiting 31.47%P=0.004,and epigastric pain 12.65%P=0.048).In the multivariate regression analysis,age>65 years was associated with increased mortality risk[odds ratio(OR)7.53,confidence interval(CI):3.09-18.29,P<0.001],ICU admission(OR:1.79,CI:1.13-2.83,P=0.012),and need for mechanical ventilation(OR:1.89,CI:1.94-2.99,P=0.007).Hypertension was an independent risk factor for ICU admission(OR:1.82,CI:1.17-2.84,P=0.008)and need for mechanical ventilation(OR:1.66,CI:1.05-2.62,P=0.028).CONCLUSION Patients with GI symptoms are more likely to have severe disease at presentation;however,mortality and disease progression is not different between the two groups.
