Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indi...Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.展开更多
Objective This study explored the potentially modifiable factors for depression and major depressive disorder(MDD)from the MR-Base database and further evaluated the associations between drug targets with MDD.Methods ...Objective This study explored the potentially modifiable factors for depression and major depressive disorder(MDD)from the MR-Base database and further evaluated the associations between drug targets with MDD.Methods We analyzed two-sample of Mendelian randomization(2SMR)using genetic variant depression(n=113,154)and MDD(n=208,811)from Genome-Wide Association Studies(GWAS).Separate calculations were performed with modifiable risk factors from MR-Base for 1,001 genomes.The MR analysis was performed by screening drug targets with MDD in the DrugBank database to explore the therapeutic targets for MDD.Inverse variance weighted(IVW),fixed-effect inverse variance weighted(FE-IVW),MR-Egger,weighted median,and weighted mode were used for complementary calculation.Results The potential causal relationship between modifiable risk factors and depression contained 459 results for depression and 424 for MDD.Also,the associations between drug targets and MDD showed that SLC6A4,GRIN2A,GRIN2C,SCN10A,and IL1B expression are associated with an increased risk of depression.In contrast,ADRB1,CHRNA3,HTR3A,GSTP1,and GABRG2 genes are candidate protective factors against depression.Conclusion This study identified the risk factors causally associated with depression and MDD,and estimated 10 drug targets with significant impact on MDD,providing essential information for formulating strategies to prevent and treat depression.展开更多
BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive...BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive measures.This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.METHODS:Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023.The patients’general conditions and perinatal clinical indicators were recorded.The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum.Multivariate logistic regression analysis was performed to identify risk factors.RESULTS:A total of 276 puerperae were included,with a PTSD incidence of 20.3% at six weeks postpartum.Multivariate logistic regression analysis identified emergency cesarean section(odds ratio[OR]=2.102;95%confidence interval[CI]:1.114-3.966,P=0.022),admission to the emergency department after midnight(12:00 AM)(OR=2.245;95%CI:1.170-4.305,P<0.001),and cervical dilation(OR=3.203;95%CI:1.670–6.141,P=0.039)as independent risk factors for postpartum PTSD.Analgesia pump use(OR=0.500;95%CI:0.259–0.966,P=0.015)was found to be a protective factor against postpartum PTSD.CONCLUSION:Emergency cesarean section,admission to the emergency department after midnight,and cervical dilation were identified as independent risk factors for postpartum PTSD,while analgesic pump use was a protective factor.These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.展开更多
In this editorial,we comment on the article by Wang et al published in the recent issue of the World Journal of Gastroenterology in 2023.We focused on identifying risk factors for lymph node metastasis(LNM)in superfic...In this editorial,we comment on the article by Wang et al published in the recent issue of the World Journal of Gastroenterology in 2023.We focused on identifying risk factors for lymph node metastasis(LNM)in superficial esophageal squamous cell carcinoma(SESCC)patients and how to construct a simple and reliable clinical prediction model to assess the risk of LNM in SESCC patients,thereby helping to guide the selection of an appropriate treatment plan.The current standard treatment for SESCC is radical esophagectomy with lymph node dissection.However,esophagectomy is associated with considerable morbidity and mortality.Endoscopic resection(ER)offers a safer and less invasive alternative to surgical resection and can enable the patient's quality of life to be maintained while providing a satisfactory outcome.However,since ER is a localized treatment that does not allow for lymph node dissection,the risk of LNM in SESCC limits the effectiveness of ER.Understanding LNM status can aid in determining whether patients with SESCC can be cured by ER without the need for additional esophagectomy.Previous studies have shown that tumor size,macroscopic type of tumor,degree of differentiation,depth of tumor invasion,and lymphovascular invasion are factors associated with LNM in patients with SESCC.In addition,tumor budding is commonly associated with LNM,recurrence,and distant metastasis,but this topic has been less covered in previous studies.By comprehensively evaluating the above risk factors for LNM,useful evidence can be obtained for doctors to select appropriate treatments for SESCC patients.展开更多
BACKGROUND Duodenal cancer is one of the most common subtypes of small intestinal cancer,and distant metastasis(DM)in this type of cancer still leads to poor prognosis.Although nomograms have recently been used in tum...BACKGROUND Duodenal cancer is one of the most common subtypes of small intestinal cancer,and distant metastasis(DM)in this type of cancer still leads to poor prognosis.Although nomograms have recently been used in tumor areas,no studies have focused on the diagnostic and prognostic evaluation of DM in patients with primary duodenal cancer.AIM To develop and evaluate nomograms for predicting the risk of DM and person-alized prognosis in patients with duodenal cancer.METHODS Data on duodenal cancer patients diagnosed between 2010 and 2019 were extracted from the Surveillance,Epidemiology,and End Results database.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for DM in patients with duodenal cancer,and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors in duodenal cancer patients with DM.Two novel nomograms were established,and the results were evaluated by receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS A total of 2603 patients with duodenal cancer were included,of whom 457 cases(17.56%)had DM at the time of diagnosis.Logistic analysis revealed independent risk factors for DM in duodenal cancer patients,including gender,grade,tumor size,T stage,and N stage(P<0.05).Univariate and multivariate COX analyses further identified independent prognostic factors for duodenal cancer patients with DM,including age,histological type,T stage,tumor grade,tumor size,bone metastasis,chemotherapy,and surgery(P<0.05).The accuracy of the nomograms was validated in the training set,validation set,and expanded testing set using ROC curves,calibration curves,and DCA curves.The results of Kaplan-Meier survival curves(P<0.001)indicated that both nomograms accurately predicted the occurrence and prognosis of DM in patients with duodenal cancer.CONCLUSION The two nomograms are expected as effective tools for predicting DM risk in duodenal cancer patients and offering personalized prognosis predictions for those with DM,potentially enhancing clinical decision-making.展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
BACKGROUND Diabetic foot(DMF)complications are common and are increasing in incidence.Risk factors related to wound complications are yet to be established after transtibial amputation under the diagnosis of DMF infec...BACKGROUND Diabetic foot(DMF)complications are common and are increasing in incidence.Risk factors related to wound complications are yet to be established after transtibial amputation under the diagnosis of DMF infection.AIM To analyze the prognosis and risk factors related to wound complications after transtibial amputation in patients with diabetes.METHODS This retrospective cohort study included seventy-two patients with DMF complications who underwent transtibial amputation between April 2014 and March 2023.The groups were categorized based on the occurrence of wound complications,and we compared demographic data between the complication group and the non-complication group to analyze risk factors.Moreover,a multivariate logistic regression analysis was performed to identify risk factors.RESULTS The average follow-up period was 36.2 months.Among the 72 cases,31(43.1%)had wound complications.Of these,12 cases(16.7%)received further treatment,such as debridement,soft tissue stump revision,and re-amputation at the proximal level.In a group that required further management due to wound complications after transtibial amputation,the hemoglobin A1c(HbA1c)level was 9.32,while the other group that did not require any treatment had a 7.54 HbA1c level.The prevalence of a history of kidney transplantation with wound complications after transtibial amputation surgery in DMF patients was significantly greater than in cases without wound complications(P=0.02).Other factors did not show significant differences.CONCLUSION Approximately 43.1%of the patients with transtibial amputation surgery experienced wound complications,and 16.7%required additional surgical treatment.High HbA1c levels and kidney transplant history are risk factors for postoperative wound complications.展开更多
BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few stu...BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few studies have focused on the factors related to SI,and effective predictive models are lacking.AIM To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.METHODS The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had SI,they were divided into a SI group(n=91)and a non-SI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).RESULTS There were differences in trauma history,triggers,serum ferritin levels(SF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(P<0.05).Logistic regression analysis showed that trauma history,predisposing factors,SF,hs-CRP,and HDL-C were factors influencing SI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUSION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.展开更多
BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a cert...BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.展开更多
This editorial is intended to be a reflection on cardiovascular disease(CVD)burden in European ethnic minorities.In some European countries,ethnic minority realities,due to their recent appearance,are still to be stud...This editorial is intended to be a reflection on cardiovascular disease(CVD)burden in European ethnic minorities.In some European countries,ethnic minority realities,due to their recent appearance,are still to be studied in depth.The experience of several European countries,where the migration processes started earlier,even more than a century ago,can help by being an example.Many studies have shown that major differences in CVD burden exist not only between countries,but also within the same country when considering different social strata and ethnic groups.The CV risk factors underlying heart disease have been well established.Important epidemiological studies have helped us understand that the underlying causes of heart disease as well as the behaviors that can help prevent them are the same.We are now well aware that CVD should be treated by considering a holistic approach.This is why the social determinants(SDs)of health that may worsen the disease burden or that,vice versa,may improve the treatment,and even more significantly,the prognosis of a patient’s illness should be taken into consideration.For ethnic minority patients,this holistic,hermeneutic approach is of importance.Several SDs of health that influence CVDs have been identified but their relevance for the health of ethnic minorities has not yet been clearly defined.In some European countries,most ethnic minorities are largely also religious minorities.Only a few studies have evaluated the role of religion,which is an important SD that affects the probability of having CV risk factors and diseases.Adolescents,particularly those belonging to the second generation,seem to be the weak link.If we believe that these young people are really citizens of their country of birth,then a way of recognizing their belonging to the community starts from a will to better understand their condition,in order to assist them while they grow physically and mentally.Thinking about safeguarding the health of this population should be more than a health task,rather a goal of social justice.展开更多
BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages ...BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve choles...BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve cholesterol stones and prevent their development and reappearance by lowering the cholesterol concen-tration in bile.Despite these treatment options,there are still patients who experience stone recurrence.The clinical data of 100 patients with choledochal stones who were hospitalized at the Yixing People’s Hospital and underwent ERCP for successful stone extraction between June 2020 and December 2022 were retrospectively collected.According to the post-ERCP treatment plan,100 patients were classified into UDCA(n=47)and control(n=53)groups.We aimed to assess the clinical efficacy and rate of relapse in the two patient populations.We then collected information(basic demographic data,clinical characteristics,and serum biochemical indicators)and determined the factors contributing to relapse using logistic regression analysis.Our secondary goal was to determine the effects of UDCA on liver function after ERCP.Compared to the control group,the UDCA group demonstrated a higher clinical effectiveness rate of 92.45%vs 78.72%(P<0.05).No significant differences were observed in liver function indices,including total bilirubin,direct bilirubin,gamma-glutamyl transpeptidase,alanine aminotransferase,alkaline phosphatase,and aspartate aminotransferase,between the two groups before treatment.After treatment,all liver function indices were significantly reduced.Comparing the control vs UDCA groups,the UDCA group exhibited significantly lower levels of all indices(55.39±6.53 vs 77.31±8.52,32.10±4.62 vs 45.39±5.69,142.32±14.21 vs 189.63±16.87,112.52±14.25 vs 149.36±15.36,122.61±16.00 vs 171.33±22.09,96.98±10.44 vs 121.35±11.57,respectively,all P<0.05).The stone recurrence rate was lower in the UDCA group(13.21%)in contrast with the control group(44.68%).Periampullary diverticula(OR:6.00,95%CI:1.69-21.30),maximum stone diameter(OR:1.69,95%CI:1.01-2.85),stone quantity>3(OR:4.23,95%CI:1.17-15.26),and positive bile culture(OR:7.61,95%CI:2.07-27.91)were independent factors that influenced the relapse of common bile duct stones after ERCP(P<0.05).Furthermore,postoperative UDCA was identified as a preventive factor(OR:0.07;95%CI:0.08-0.09).CONCLUSION The intervention effect of UDCA after ERCP for common bile duct stones is adequate,providing new research directions and references for the prevention and treatment of stone recurrence.展开更多
BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older people.China has entered an aging society.However,there are still few studies on the elderly i...BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older people.China has entered an aging society.However,there are still few studies on the elderly in Chinese communities.AIM To investigate the incidence and risk factors of depression in MetS patients in China's Mainland and to construct a predictive model.METHODS Data from four waves of the China Health and Retirement Longitudinal Study were selected,and middle-aged and elderly patients with MetS(n=2533)were included based on the first wave.According to the center for epidemiological survey-depression scale(CESD),participants with MetS were divided into depression(n=938)and non-depression groups(n=1595),and factors related to depression were screened out.Subsequently,the 2-,4-,and 7-year follow-up data were analyzed,and a prediction model for depression in MetS patients was constructed.RESULTS The prevalence of depression in middle-aged and elderly patients with MetS was 37.02%.The prevalence of depression at the 2-,4-,and 7-year follow-up was 29.55%,34.53%,and 38.15%,respectively.The prediction model,constructed using baseline CESD and Physical Self-Maintenance Scale scores,average sleep duration,number of chronic diseases,age,and weight had a good predictive effect on the risk of depression in MetS patients at the 2-year follow-up(area under the curve=0.775,95%confidence interval:0.750-0.800,P<0.001),with a sensitivity of 68%and a specificity of 74%.CONCLUSION The prevalence of depression in middle-aged and elderly patients with MetS has increased over time.The early identification of and intervention for depressive symptoms requires greater attention in MetS patients.展开更多
Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompete...Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.展开更多
Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of...Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.展开更多
BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma path...BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma pathway,with limited data on the serrated pathway.AIM To evaluate the prevalence,risk factors,and BRAF mutations of SSLs in the Vietnamese population.METHODS This is a cross-sectional study conducted on patients with lower gastrointestinal symptoms who underwent colonoscopy at a tertiary hospital in Vietnam.SSLs were diagnosed on histopathology according to the 2019 World Health Organi-zation classification.BRAF mutation analysis was performed using the Sanger DNA sequencing method.The multivariate logistic regression model was used to determine SSL-associated factors.RESULTS There were 2489 patients,with a mean age of 52.1±13.1 and a female-to-male ratio of 1:1.1.The prevalence of SSLs was 4.2%[95%confidence interval(CI):3.5-5.1].In the multivariate analysis,factors significantly associated with SSLs were age≥40[odds ratio(OR):3.303;95%CI:1.607-6.790],male sex(OR:2.032;95%CI:1.204-3.429),diabetes mellitus(OR:2.721;95%CI:1.551-4.772),and hypertension(OR:1.650,95%CI:1.045-2.605).The rate of BRAF mutations in SSLs was 35.5%.CONCLUSION The prevalence of SSLs was 4.2%.BRAF mutations were present in one-third of SSLs.Significant risk factors for SSLs included age≥40,male sex,diabetes mellitus,and hypertension.展开更多
Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target ...Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.展开更多
Objective:This study aims to explore the prevalence,features,and risk factors of lower respiratory tract infections(LRTIs)in the intensive care unit(ICU)of a newly established hospital in Zunyi City.The goal is to dev...Objective:This study aims to explore the prevalence,features,and risk factors of lower respiratory tract infections(LRTIs)in the intensive care unit(ICU)of a newly established hospital in Zunyi City.The goal is to devise strategies for preventing LRTIs in the ICU of new hospitals,thereby mitigating the incidence of nosocomial LRTIs in ICU patients.Methods:A case-control study was conducted from March 2019 to December 2022 to investigate the incidence rate of LRTIs in the ICU of a newly constructed hospital in Zunyi City.Patients with LRTIs constituted the case group,while those without LRTIs constituted the control group,where a 1:1 matching principle was adhered to.A single-factor chi-square(χ2)test was employed to analyze the risk factors,with independent risk factors being explored using a multivariate logistic regression analysis.Results:A total of 169 strains of pathogenic bacteria were isolated,comprising 66.28%gram-negative bacteria,17.75%gram-positive bacteria,and 15.97%fungi.The most prevalent pathogens included Acinetobacter baumannii(43.20%),Candida albicans(10.65%),and Pseudomonas aeruginosa(8.88%).Of the 82 strains infected by multidrug-resistant bacteria in patients with LRTIs,81.7%were carbapenem-resistant Acinetobacter baumannii,9.8%were multidrug-resistant Pseudomonas aeruginosa,and 6.1%were carbapenem-resistant Escherichia coli.Identified risk factors included smoking history,total hospitalization days,ICU stay length,hypoproteinemia,indwelling gastric tube,intubation type,duration of mechanical ventilation,usage of antibacterial drugs,and administration of protein drugs(P<0.05).Multivariate logistic regression analysis demonstrated that these factors were independent risk factors for nosocomial LRTIs in ICU patients(P<0.05).Conclusion:ICU patients in our hospital were mainly infected by carbapenem-resistant Acinetobacter baumannii.To prevent LRTIs in patients,tailored preventive measures should be developed and the rational use of antibacterial drugs should be promoted.展开更多
Objective:To explore the risk factors for the progression of renal function deterioration in patients with diabetic nephropathy(DN).Methods:The clinical data and biochemical indexes of 100 diabetic patients admitted t...Objective:To explore the risk factors for the progression of renal function deterioration in patients with diabetic nephropathy(DN).Methods:The clinical data and biochemical indexes of 100 diabetic patients admitted to our hospital from October 2021 to October 2022 were retrospectively analyzed.The patients were divided into a DN group,which consisted of 55 cases,and a nondiabetic nephropathy group(NDN),which consisted of 45 cases.The urinary microalbumin to creatinine ratio,the clinical data(gender,age,duration of the disease,and BMI),and the biochemical indexes(triglycerides[TG],low-density lipoprotein cholesterol[LDL-C],high-density lipoprotein cholesterol[HDL-C],total cholesterol[TC],glycated hemoglobin A1c[HbA1c],systolic blood pressure[SBP],diastolic blood pressure[DBP])of the two groups were compared.Subsequently,the risk factors related to the progression of renal function deterioration in DN were analyzed through multifactorial logistic regression analysis.Results:No statistically significant difference was observed in the comparison of gender,age,BMI,LDL-C,and DBP between the two groups(P>0.05).The DN group demonstrated a longer disease duration and higher SBP,TC,HDL-C,HbA1c,and TG compared to the NDN group(P<0.05).Through multifactorial logistic regression analysis,it was found that the duration of the disease,the TC,the HDL-C,the HbA1c,the TG,and the SBP were independent risk factors of the deterioration of renal function in DN patients.Conclusion:Other than conventional indicators,TC,HDL-C,HbA1c,TG,and SBP are also crucial indicators in determining the progression of renal function deterioration in DN patients.展开更多
Purpose of the Research: Our study aimed to determine and understand the risk factors of surgical site infections in patients operated on in general surgery wards. Method of Research: Between May 2008 and November 200...Purpose of the Research: Our study aimed to determine and understand the risk factors of surgical site infections in patients operated on in general surgery wards. Method of Research: Between May 2008 and November 2008, 422 consecutive patients who underwent emergency and elective surgeries, excluding breast, goitre and laparoscopic surgeries, were included in the study to determine surgical site infections and risk factors. The patients’ risk factors were selected in the preoperative period, and postoperative 3<sup>rd</sup>, 7<sup>th</sup>, and 30<sup>th</sup> days were checked by the physician responsible for conducting the study regarding surgical site infection. Results and Conclusion: Surgical site infections were defined as incisional and organ/space based on NNIS data. Gender, diabetes mellitus, malignancy, degree of contamination, ASA score ≥ 3, preoperative skin cleansing, duration of intensive care unit stay, duration of hospital stay, growth in wound culture, duration of surgery and incision length were determined as risk factors increasing CAI rates. Especially the degree of contamination, duration of intensive care unit stay, hospitalisation, duration of operation, and growth in wound culture were decisive factors in the development of CAI. As a result of our study, in the light of these data, we concluded that to prevent the development of CAI can be modified, interventions to foreseeable factors can be assessed.展开更多
基金supported by the National Natural Science Foundation of China[no.81903336,Yi-de Yang]the Health Research Project of Hunan Provincial Health Commission[no.202112031516,Yi-de Yang]+3 种基金Scientific Research Fund of Hunan Provincial Education Department[no.22B0038,Yi-de Yang]the Research Team for Reproduction Health and Translational Medicine of Hunan Normal University[2023JC101]Key Project of Developmental Biology and Breeding from Hunan Province[no.2022XKQ0205]Open Project for Postgraduates of Hunan Normal University[no.KF2022019,Tianli Xiao].
文摘Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.
基金supported by Natural Science Foundation of Shandong ProvinceChina[ZR2022MH115]the National Natural Science Foundation of China[81301479,82202593]。
文摘Objective This study explored the potentially modifiable factors for depression and major depressive disorder(MDD)from the MR-Base database and further evaluated the associations between drug targets with MDD.Methods We analyzed two-sample of Mendelian randomization(2SMR)using genetic variant depression(n=113,154)and MDD(n=208,811)from Genome-Wide Association Studies(GWAS).Separate calculations were performed with modifiable risk factors from MR-Base for 1,001 genomes.The MR analysis was performed by screening drug targets with MDD in the DrugBank database to explore the therapeutic targets for MDD.Inverse variance weighted(IVW),fixed-effect inverse variance weighted(FE-IVW),MR-Egger,weighted median,and weighted mode were used for complementary calculation.Results The potential causal relationship between modifiable risk factors and depression contained 459 results for depression and 424 for MDD.Also,the associations between drug targets and MDD showed that SLC6A4,GRIN2A,GRIN2C,SCN10A,and IL1B expression are associated with an increased risk of depression.In contrast,ADRB1,CHRNA3,HTR3A,GSTP1,and GABRG2 genes are candidate protective factors against depression.Conclusion This study identified the risk factors causally associated with depression and MDD,and estimated 10 drug targets with significant impact on MDD,providing essential information for formulating strategies to prevent and treat depression.
基金Science and Technology Development Plan Project of Suzhou(SKJYD2021035)Science and Technology Development Plan Project of Suzhou(SKJYD2022078)The Key Project Research Fund of the Second Affiliated Hospital of Wannan Medical College(YK2023Z04)。
文摘BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive measures.This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.METHODS:Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023.The patients’general conditions and perinatal clinical indicators were recorded.The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum.Multivariate logistic regression analysis was performed to identify risk factors.RESULTS:A total of 276 puerperae were included,with a PTSD incidence of 20.3% at six weeks postpartum.Multivariate logistic regression analysis identified emergency cesarean section(odds ratio[OR]=2.102;95%confidence interval[CI]:1.114-3.966,P=0.022),admission to the emergency department after midnight(12:00 AM)(OR=2.245;95%CI:1.170-4.305,P<0.001),and cervical dilation(OR=3.203;95%CI:1.670–6.141,P=0.039)as independent risk factors for postpartum PTSD.Analgesia pump use(OR=0.500;95%CI:0.259–0.966,P=0.015)was found to be a protective factor against postpartum PTSD.CONCLUSION:Emergency cesarean section,admission to the emergency department after midnight,and cervical dilation were identified as independent risk factors for postpartum PTSD,while analgesic pump use was a protective factor.These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.
文摘In this editorial,we comment on the article by Wang et al published in the recent issue of the World Journal of Gastroenterology in 2023.We focused on identifying risk factors for lymph node metastasis(LNM)in superficial esophageal squamous cell carcinoma(SESCC)patients and how to construct a simple and reliable clinical prediction model to assess the risk of LNM in SESCC patients,thereby helping to guide the selection of an appropriate treatment plan.The current standard treatment for SESCC is radical esophagectomy with lymph node dissection.However,esophagectomy is associated with considerable morbidity and mortality.Endoscopic resection(ER)offers a safer and less invasive alternative to surgical resection and can enable the patient's quality of life to be maintained while providing a satisfactory outcome.However,since ER is a localized treatment that does not allow for lymph node dissection,the risk of LNM in SESCC limits the effectiveness of ER.Understanding LNM status can aid in determining whether patients with SESCC can be cured by ER without the need for additional esophagectomy.Previous studies have shown that tumor size,macroscopic type of tumor,degree of differentiation,depth of tumor invasion,and lymphovascular invasion are factors associated with LNM in patients with SESCC.In addition,tumor budding is commonly associated with LNM,recurrence,and distant metastasis,but this topic has been less covered in previous studies.By comprehensively evaluating the above risk factors for LNM,useful evidence can be obtained for doctors to select appropriate treatments for SESCC patients.
基金Supported by State Administration of Traditional Chinese Medicine Base Construction Stomach Cancer Special Fund,No.Y2020CX57Jiangsu Provincial Graduate Research and Practical Innovation Program Project,No.SJCX23-0799.
文摘BACKGROUND Duodenal cancer is one of the most common subtypes of small intestinal cancer,and distant metastasis(DM)in this type of cancer still leads to poor prognosis.Although nomograms have recently been used in tumor areas,no studies have focused on the diagnostic and prognostic evaluation of DM in patients with primary duodenal cancer.AIM To develop and evaluate nomograms for predicting the risk of DM and person-alized prognosis in patients with duodenal cancer.METHODS Data on duodenal cancer patients diagnosed between 2010 and 2019 were extracted from the Surveillance,Epidemiology,and End Results database.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for DM in patients with duodenal cancer,and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors in duodenal cancer patients with DM.Two novel nomograms were established,and the results were evaluated by receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS A total of 2603 patients with duodenal cancer were included,of whom 457 cases(17.56%)had DM at the time of diagnosis.Logistic analysis revealed independent risk factors for DM in duodenal cancer patients,including gender,grade,tumor size,T stage,and N stage(P<0.05).Univariate and multivariate COX analyses further identified independent prognostic factors for duodenal cancer patients with DM,including age,histological type,T stage,tumor grade,tumor size,bone metastasis,chemotherapy,and surgery(P<0.05).The accuracy of the nomograms was validated in the training set,validation set,and expanded testing set using ROC curves,calibration curves,and DCA curves.The results of Kaplan-Meier survival curves(P<0.001)indicated that both nomograms accurately predicted the occurrence and prognosis of DM in patients with duodenal cancer.CONCLUSION The two nomograms are expected as effective tools for predicting DM risk in duodenal cancer patients and offering personalized prognosis predictions for those with DM,potentially enhancing clinical decision-making.
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
文摘BACKGROUND Diabetic foot(DMF)complications are common and are increasing in incidence.Risk factors related to wound complications are yet to be established after transtibial amputation under the diagnosis of DMF infection.AIM To analyze the prognosis and risk factors related to wound complications after transtibial amputation in patients with diabetes.METHODS This retrospective cohort study included seventy-two patients with DMF complications who underwent transtibial amputation between April 2014 and March 2023.The groups were categorized based on the occurrence of wound complications,and we compared demographic data between the complication group and the non-complication group to analyze risk factors.Moreover,a multivariate logistic regression analysis was performed to identify risk factors.RESULTS The average follow-up period was 36.2 months.Among the 72 cases,31(43.1%)had wound complications.Of these,12 cases(16.7%)received further treatment,such as debridement,soft tissue stump revision,and re-amputation at the proximal level.In a group that required further management due to wound complications after transtibial amputation,the hemoglobin A1c(HbA1c)level was 9.32,while the other group that did not require any treatment had a 7.54 HbA1c level.The prevalence of a history of kidney transplantation with wound complications after transtibial amputation surgery in DMF patients was significantly greater than in cases without wound complications(P=0.02).Other factors did not show significant differences.CONCLUSION Approximately 43.1%of the patients with transtibial amputation surgery experienced wound complications,and 16.7%required additional surgical treatment.High HbA1c levels and kidney transplant history are risk factors for postoperative wound complications.
文摘BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few studies have focused on the factors related to SI,and effective predictive models are lacking.AIM To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.METHODS The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had SI,they were divided into a SI group(n=91)and a non-SI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).RESULTS There were differences in trauma history,triggers,serum ferritin levels(SF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(P<0.05).Logistic regression analysis showed that trauma history,predisposing factors,SF,hs-CRP,and HDL-C were factors influencing SI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUSION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.
基金Supported by the Capital’s Funds for Health Improvement and Research,No.2023-3S-002.
文摘BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.
文摘This editorial is intended to be a reflection on cardiovascular disease(CVD)burden in European ethnic minorities.In some European countries,ethnic minority realities,due to their recent appearance,are still to be studied in depth.The experience of several European countries,where the migration processes started earlier,even more than a century ago,can help by being an example.Many studies have shown that major differences in CVD burden exist not only between countries,but also within the same country when considering different social strata and ethnic groups.The CV risk factors underlying heart disease have been well established.Important epidemiological studies have helped us understand that the underlying causes of heart disease as well as the behaviors that can help prevent them are the same.We are now well aware that CVD should be treated by considering a holistic approach.This is why the social determinants(SDs)of health that may worsen the disease burden or that,vice versa,may improve the treatment,and even more significantly,the prognosis of a patient’s illness should be taken into consideration.For ethnic minority patients,this holistic,hermeneutic approach is of importance.Several SDs of health that influence CVDs have been identified but their relevance for the health of ethnic minorities has not yet been clearly defined.In some European countries,most ethnic minorities are largely also religious minorities.Only a few studies have evaluated the role of religion,which is an important SD that affects the probability of having CV risk factors and diseases.Adolescents,particularly those belonging to the second generation,seem to be the weak link.If we believe that these young people are really citizens of their country of birth,then a way of recognizing their belonging to the community starts from a will to better understand their condition,in order to assist them while they grow physically and mentally.Thinking about safeguarding the health of this population should be more than a health task,rather a goal of social justice.
文摘BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve cholesterol stones and prevent their development and reappearance by lowering the cholesterol concen-tration in bile.Despite these treatment options,there are still patients who experience stone recurrence.The clinical data of 100 patients with choledochal stones who were hospitalized at the Yixing People’s Hospital and underwent ERCP for successful stone extraction between June 2020 and December 2022 were retrospectively collected.According to the post-ERCP treatment plan,100 patients were classified into UDCA(n=47)and control(n=53)groups.We aimed to assess the clinical efficacy and rate of relapse in the two patient populations.We then collected information(basic demographic data,clinical characteristics,and serum biochemical indicators)and determined the factors contributing to relapse using logistic regression analysis.Our secondary goal was to determine the effects of UDCA on liver function after ERCP.Compared to the control group,the UDCA group demonstrated a higher clinical effectiveness rate of 92.45%vs 78.72%(P<0.05).No significant differences were observed in liver function indices,including total bilirubin,direct bilirubin,gamma-glutamyl transpeptidase,alanine aminotransferase,alkaline phosphatase,and aspartate aminotransferase,between the two groups before treatment.After treatment,all liver function indices were significantly reduced.Comparing the control vs UDCA groups,the UDCA group exhibited significantly lower levels of all indices(55.39±6.53 vs 77.31±8.52,32.10±4.62 vs 45.39±5.69,142.32±14.21 vs 189.63±16.87,112.52±14.25 vs 149.36±15.36,122.61±16.00 vs 171.33±22.09,96.98±10.44 vs 121.35±11.57,respectively,all P<0.05).The stone recurrence rate was lower in the UDCA group(13.21%)in contrast with the control group(44.68%).Periampullary diverticula(OR:6.00,95%CI:1.69-21.30),maximum stone diameter(OR:1.69,95%CI:1.01-2.85),stone quantity>3(OR:4.23,95%CI:1.17-15.26),and positive bile culture(OR:7.61,95%CI:2.07-27.91)were independent factors that influenced the relapse of common bile duct stones after ERCP(P<0.05).Furthermore,postoperative UDCA was identified as a preventive factor(OR:0.07;95%CI:0.08-0.09).CONCLUSION The intervention effect of UDCA after ERCP for common bile duct stones is adequate,providing new research directions and references for the prevention and treatment of stone recurrence.
基金Supported by Shaanxi Provincial Key Research and Development Program,No.2023-YBSF-517and National Natural Science Foundation of China,No.82301737.
文摘BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older people.China has entered an aging society.However,there are still few studies on the elderly in Chinese communities.AIM To investigate the incidence and risk factors of depression in MetS patients in China's Mainland and to construct a predictive model.METHODS Data from four waves of the China Health and Retirement Longitudinal Study were selected,and middle-aged and elderly patients with MetS(n=2533)were included based on the first wave.According to the center for epidemiological survey-depression scale(CESD),participants with MetS were divided into depression(n=938)and non-depression groups(n=1595),and factors related to depression were screened out.Subsequently,the 2-,4-,and 7-year follow-up data were analyzed,and a prediction model for depression in MetS patients was constructed.RESULTS The prevalence of depression in middle-aged and elderly patients with MetS was 37.02%.The prevalence of depression at the 2-,4-,and 7-year follow-up was 29.55%,34.53%,and 38.15%,respectively.The prediction model,constructed using baseline CESD and Physical Self-Maintenance Scale scores,average sleep duration,number of chronic diseases,age,and weight had a good predictive effect on the risk of depression in MetS patients at the 2-year follow-up(area under the curve=0.775,95%confidence interval:0.750-0.800,P<0.001),with a sensitivity of 68%and a specificity of 74%.CONCLUSION The prevalence of depression in middle-aged and elderly patients with MetS has increased over time.The early identification of and intervention for depressive symptoms requires greater attention in MetS patients.
文摘Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.
文摘Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.
文摘BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma pathway,with limited data on the serrated pathway.AIM To evaluate the prevalence,risk factors,and BRAF mutations of SSLs in the Vietnamese population.METHODS This is a cross-sectional study conducted on patients with lower gastrointestinal symptoms who underwent colonoscopy at a tertiary hospital in Vietnam.SSLs were diagnosed on histopathology according to the 2019 World Health Organi-zation classification.BRAF mutation analysis was performed using the Sanger DNA sequencing method.The multivariate logistic regression model was used to determine SSL-associated factors.RESULTS There were 2489 patients,with a mean age of 52.1±13.1 and a female-to-male ratio of 1:1.1.The prevalence of SSLs was 4.2%[95%confidence interval(CI):3.5-5.1].In the multivariate analysis,factors significantly associated with SSLs were age≥40[odds ratio(OR):3.303;95%CI:1.607-6.790],male sex(OR:2.032;95%CI:1.204-3.429),diabetes mellitus(OR:2.721;95%CI:1.551-4.772),and hypertension(OR:1.650,95%CI:1.045-2.605).The rate of BRAF mutations in SSLs was 35.5%.CONCLUSION The prevalence of SSLs was 4.2%.BRAF mutations were present in one-third of SSLs.Significant risk factors for SSLs included age≥40,male sex,diabetes mellitus,and hypertension.
文摘Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.
基金Analysis of influencing factors and direct economic losses of ICU infection in a newly built tertiary comprehensive hospital(Project No:Qiankehe Support[2021]General 043)。
文摘Objective:This study aims to explore the prevalence,features,and risk factors of lower respiratory tract infections(LRTIs)in the intensive care unit(ICU)of a newly established hospital in Zunyi City.The goal is to devise strategies for preventing LRTIs in the ICU of new hospitals,thereby mitigating the incidence of nosocomial LRTIs in ICU patients.Methods:A case-control study was conducted from March 2019 to December 2022 to investigate the incidence rate of LRTIs in the ICU of a newly constructed hospital in Zunyi City.Patients with LRTIs constituted the case group,while those without LRTIs constituted the control group,where a 1:1 matching principle was adhered to.A single-factor chi-square(χ2)test was employed to analyze the risk factors,with independent risk factors being explored using a multivariate logistic regression analysis.Results:A total of 169 strains of pathogenic bacteria were isolated,comprising 66.28%gram-negative bacteria,17.75%gram-positive bacteria,and 15.97%fungi.The most prevalent pathogens included Acinetobacter baumannii(43.20%),Candida albicans(10.65%),and Pseudomonas aeruginosa(8.88%).Of the 82 strains infected by multidrug-resistant bacteria in patients with LRTIs,81.7%were carbapenem-resistant Acinetobacter baumannii,9.8%were multidrug-resistant Pseudomonas aeruginosa,and 6.1%were carbapenem-resistant Escherichia coli.Identified risk factors included smoking history,total hospitalization days,ICU stay length,hypoproteinemia,indwelling gastric tube,intubation type,duration of mechanical ventilation,usage of antibacterial drugs,and administration of protein drugs(P<0.05).Multivariate logistic regression analysis demonstrated that these factors were independent risk factors for nosocomial LRTIs in ICU patients(P<0.05).Conclusion:ICU patients in our hospital were mainly infected by carbapenem-resistant Acinetobacter baumannii.To prevent LRTIs in patients,tailored preventive measures should be developed and the rational use of antibacterial drugs should be promoted.
文摘Objective:To explore the risk factors for the progression of renal function deterioration in patients with diabetic nephropathy(DN).Methods:The clinical data and biochemical indexes of 100 diabetic patients admitted to our hospital from October 2021 to October 2022 were retrospectively analyzed.The patients were divided into a DN group,which consisted of 55 cases,and a nondiabetic nephropathy group(NDN),which consisted of 45 cases.The urinary microalbumin to creatinine ratio,the clinical data(gender,age,duration of the disease,and BMI),and the biochemical indexes(triglycerides[TG],low-density lipoprotein cholesterol[LDL-C],high-density lipoprotein cholesterol[HDL-C],total cholesterol[TC],glycated hemoglobin A1c[HbA1c],systolic blood pressure[SBP],diastolic blood pressure[DBP])of the two groups were compared.Subsequently,the risk factors related to the progression of renal function deterioration in DN were analyzed through multifactorial logistic regression analysis.Results:No statistically significant difference was observed in the comparison of gender,age,BMI,LDL-C,and DBP between the two groups(P>0.05).The DN group demonstrated a longer disease duration and higher SBP,TC,HDL-C,HbA1c,and TG compared to the NDN group(P<0.05).Through multifactorial logistic regression analysis,it was found that the duration of the disease,the TC,the HDL-C,the HbA1c,the TG,and the SBP were independent risk factors of the deterioration of renal function in DN patients.Conclusion:Other than conventional indicators,TC,HDL-C,HbA1c,TG,and SBP are also crucial indicators in determining the progression of renal function deterioration in DN patients.
文摘Purpose of the Research: Our study aimed to determine and understand the risk factors of surgical site infections in patients operated on in general surgery wards. Method of Research: Between May 2008 and November 2008, 422 consecutive patients who underwent emergency and elective surgeries, excluding breast, goitre and laparoscopic surgeries, were included in the study to determine surgical site infections and risk factors. The patients’ risk factors were selected in the preoperative period, and postoperative 3<sup>rd</sup>, 7<sup>th</sup>, and 30<sup>th</sup> days were checked by the physician responsible for conducting the study regarding surgical site infection. Results and Conclusion: Surgical site infections were defined as incisional and organ/space based on NNIS data. Gender, diabetes mellitus, malignancy, degree of contamination, ASA score ≥ 3, preoperative skin cleansing, duration of intensive care unit stay, duration of hospital stay, growth in wound culture, duration of surgery and incision length were determined as risk factors increasing CAI rates. Especially the degree of contamination, duration of intensive care unit stay, hospitalisation, duration of operation, and growth in wound culture were decisive factors in the development of CAI. As a result of our study, in the light of these data, we concluded that to prevent the development of CAI can be modified, interventions to foreseeable factors can be assessed.
