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Risk of pancreatic cancer in individuals with celiac disease in the United States:A population-based matched cohort study

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World Journal of Gastrointestinal Oncology 2023年第3期15卷 523-532页

作者： Arunkumar Krishnan Yousaf Bashir Hadi Sarah Shabih Diptasree Mukherjee ruhee a patel Rushik patel Shailendra Singh Shyam Thakkar Section of Gastroenterology&Hepatology West Virginia University School of MedicineMorgantownWV 26505United States Department of Medicine Apex Institute of Medical ScienceKolkata 700075West BengalIndia

BACKGROUND Celiac disease(CD)has been associated with gastrointestinal ***,the magnitude of the risk of pancreatic cancer(PC)associated with CD is much less clear,and risks have not been estimated from large *** To assess the risk of PC in CD *** We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive patients diagnosed with CD using the TriNeTx research network *** examined the incidence of PC in patients with CD compared with a matched cohort of patients without CD(non-CD,controls).Each patient in the main group(CD)was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding *** incidence of PC was estimated using a Cox proportional hazards model with a hazard ratio(HR)and 95%confidence interval(CI).RESULTS A total of 389980 patients were included in this *** them,155877 patients had a diagnosis of CD,and the remaining 234103 individuals without CD were considered a control *** mean duration of follow-up for patients in the CD and control cohorts was 5.8±1.8 and 5.9±1.1 years,*** the follow-up,309 patients with CD developed PC,whereas 240 patients developed PC in the control group(HR=1.29;95%CI:1.09-1.53).In the secondary analyses in the first year after diagnosis of CD,patients with CD were at a significant increase in risk for PC;151 patients with CD had an incidence of PC compared with 96 incidences of PC among the patients in the non-CD control group(HR=1.56;95%CI:1.20-2.01)and sensitivity analysis showed similar magnitude to the one generated in the primary and secondary *** Patients with CD are at increased risk of *** elevation persists beyond the first year after diagnosis to reference individuals without CD from the general population.

关键词： Celiac disease Cancer Epidemiology Pancreas Pancreatic cancer Malignancy Carcinoma

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Clinical characteristics and outcomes of COVID-19 in patients with autoimmune hepatitis:A population-based matched cohort study

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World Journal of Hepatology 2023年第1期15卷 68-78页

作者： Arunkumar Krishnan ruhee a patel Yousaf Bashir Hadi Diptasree Mukherjee Sarah Shabih Shyam Thakkar Shailendra Singh Tinsay A Woreta Saleh A Alqahtani Section of Gastroenterology and Hepatology West Virginia University School of MedicineMorgantownWV 26505United States Division of Gastroenterology and Hepatology Johns Hopkins University School of MedicineBaltimoreMD 21287United States Department of Medicine Apex Institute of Medical ScienceKolkata 700075West BengalIndia Liver Transplant Center King Faisal Specialist Hospital and Research CenterRiyadh 12713Saudi Arabia

BACKGROUND Patients with autoimmune hepatitis(AIH)require life-long immunosuppressive agents that may increase the risk of poor coronavirus disease 2019(COVID-19)*** is a paucity of large data at the population level to assess whether patients with AIH have an increased risk of severe *** To evaluate the impact of pre-existing AIH on the clinical outcomes of patients with *** We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive adult patients(≥18 years)diagnosed with COVID-19 using the TriNeTx research network *** outcomes of patients with AIH(main group)were compared to a propensity score-matched cohort of patients:(1)Without chronic liver disease(CLD);and(2)Patients with CLD except AIH(non-AIH CLD)control *** patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding *** primary outcome was all-cause mortality,and secondary outcomes were hospitalization rate,need for critical care,severe disease,mechanical ventilation,and acute kidney injury(AKI).For each outcome,the risk ratio(RR)and confidence intervals(CI)were calculated to compare the association of AIH with the *** We identified 375 patients with AIH,1647915 patients with non-CLD,and 15790 patients with non-AIH CLD with COVID-19 *** to non-CLD patients,the AIH cohort had an increased risk of all-cause mortality(RR=2.22;95%CI:1.07-4.61),hospitalization rate(RR=1.78;95%CI:1.17-2.69),and severe disease(RR=1.98;95%CI:1.19-3.26).The AIH cohort had a lower risk of hospitalization rate(RR=0.72;95%CI:0.56-0.92),critical care(RR=0.50;95%CI:0.32-0.79),and AKI(RR=0.56;95%CI:0.35-0.88)compared to the non-AIH CLD *** Patients with AIH are associated with increased hospitalization risk,severe disease,and all-cause mortality compared to patients without pre-existing CLD from the diagnosis of ***,p

关键词： Autoimmune hepatitis SARS-CoV-2 COVID-19 Mortality Outcomes Liver disease Severe

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