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Influence of comorbidity on outcomes of older patients with acute pancreatitis based on a national administrative database

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Hepatobiliary & Pancreatic Diseases International 2015年第4期14卷 422-428页

作者： Atsuhiko Murata Makoto Ohtani Keiji Muramatsu Shinya Matsuda department of preventive medicine and community Health School of Medicine University of Occupational and Environmental Health

Little information is available on the influ- ence of comorbidities on outcomes of older patients with acute pancreatitis. This study aimed to investigate the influence of co- morbidities on outcomes of older patients with acute pancreati- tis using data from a national Iapanese administrative database. METHODS： A total of 14 322 older patients （〉70 years） with acute pancreatitis were referred to 1090 hospitals between 2010 and 2012 in Japan. We collected patients＇ data from the administrative database to compare the in-hospital mortal- ity and length of stay of older patients with acute pancreatitis. The patients were categorized into four groups according to comorbidity level using the Charlson Comorbidity Index （CCI）： none （CCI score=0; n=6890）; mild （1; n=3874）; moder- ate （2; n=2192） and severe （〉3; n=1366）. RESULTS： Multiple logistic and linear regression analyses revealed that severe comorbidity was significantly associated with higher in-hospital mortality and longer length of stay [odds ratio （OR）=2.26; 95% confidence interval （CI）： 1.75-2.92, P〈0.001 and coefficient 4.37 days; 95% CI： 2.89-5.85, P〈0.001, respectively]. In addition, cardiovascular and renal diseases were the most significant comorbidities affecting outcomes of the older patients. ORs of cardiovascular and renal diseases for mortality were 1.44 （95% CI： 1.13-1.85, P=0.003） and 2.69 （95% CI： 1.88-3.85, P〈0.001）, respectively, and coefficients forlength of stay were 3.01 days （95% CI： 1.34-4.67, P〈0.001） and 3.72 days （95% CI： 1.01-6.42, P=0.007）, respectively. CONCLUSION： This study demonstrated that comorbidities significantly influenced outcomes of older patients with acute pancreatitis and cardiovascular and renal comorbidities were significant factors affecting outcomes.

关键词： acute pancreatitis comorbidity length of stay databases

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Inhibitory gamma-aminobutyric acidergic neurons in the anterior cingulate cortex participate in the comorbidity of pain and emotion

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Neural Regeneration Research 2025年第10期20卷 2838-2854页

作者： Lu Guan Mengting Qiu Na Li Zhengxiang Zhou Ru Ye Liyan Zhong Yashuang Xu Junhui Ren Yi Liang Xiaomei Shao Jianqiao Fang Junfan Fang Junying Du department of Neurobiology and Acupuncture Research Third School of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouZhejiang ProvinceChina Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases Third School of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouZhejiang ProvinceChina Fuchun community Health Service Center of Fuyang District HangzhouZhejiang ProvinceChina

Pain is often comorbid with emotional disorders such as anxiety and *** of the anterior cingulate cortex has been implicated in pain and pain-related negative emotions that arise from impairments in inhibitory gamma-aminobutyric acid *** review primarily aims to outline the main circuitry(including the input and output connectivity)of the anterior cingulate cortex and classification and functions of different gamma-aminobutyric acidergic neurons;it also describes the neurotransmitters/neuromodulators affecting these neurons,their intercommunication with other neurons,and their importance in mental comorbidities associated with chronic pain *** understanding on their role in pain-related mental comorbidities may facilitate the development of more effective treatments for these ***,the mechanisms that regulate gamma-aminobutyric acidergic systems remain *** is also unclear as to whether the mechanisms are presynaptic or *** exploration of the complexities of this system may reveal new pathways for research and drug development.

关键词： anterior cingulate cortex anxiety chronic pain circuit communication comorbidity depression gamma-aminobutyric acidergic neurons parvalbumin neurons synaptic transmission

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Seroprevalence of hepatitis A antibodies among children in a Saudi community

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Asian Pacific Journal of Tropical medicine 2010年第4期3卷 278-282页

作者： Abdel-Hady El-Gilany Sabry Hammad Khaled Refaat Reda Al-Enazi Family and community medicine department College of Medicine in Al-HassaKing Faisal UniversitySaudi Arabia preventive medicine Directorate of Health of the Northern BordersSaudi Arabia Arar Central Hospital Saudi Arabia

Objective:To determine the current seroprevalence of antibodies against hepatitis A virus in selected group of children aged 1-6 years in Northern borders region,Saudi Arabia,and to identify risk factors for ***:A cross-sectional sero-epidemiological study of 950 children who attended 10 randomly selected primary health care centers(5 urban and 5 rural) was *** of all children were subjected to a questionnaire including sociodemographic and housing environmental *** determination of anti-HAV antibodies was carried out by ***:The prevalence of HAV-IgG was 33.8%overall,35.5%among males and 32.0%among females with no statistically significant *** logistic regression analysis revealed that increasing age,rural residence,non Saudi nationality,and non availability of safe municipal water source were the most important independent predictors for HAV seropositivity in the studied ***:There is a clear decrease in hepatitis A prevalence in the studied children particularly in urban areas and indicates that a transition may be underway to intermediate endemicity and possible shift of the risk to the adult age with increased ***,we recommend including Hepatitis A in the schedule of routine childhood vaccinations.

关键词： Hepatitis A Seroprevalence Risk factors

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Ansa pancreatica as a predisposing factor for recurrent acute pancreatitis

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World Journal of Gastroenterology 2016年第40期22卷 8940-8948页

作者： Takana Yamakawa Hayashi Wataru Gonoi Takeharu Yoshikawa Naoto Hayashi Kuni Ohtomo department of Radiology Graduate School of Medicine The University of Tokyo department of Computational Diagnostic Radiology and preventive medicine The University of Tokyo

AIM To determine the non-biased prevalence and clinical significance of ansa pancreatica in patients with acute pancreatitis using magnetic resonance imaging(MRI).METHODS Our institutional review board approved this crosssectional study, which consisted of a community-based cohort of 587 consecutive participants in a whole-body health-check program, and 73 subjects with episode of acute pancreatitis(55 patients with a single episode of acute pancreatitis, and 18 patients with recurrent acute pancreatitis). All of the subjects underwent abdominal MRI including magnetic resonance cholangiopancreatography, medical examinations, and blood tests. Two board-certified, diagnostic, abdominal radiologists evaluated the images, and ansa pancreatica was diagnosed based on its characteristic anatomy on *** Compared with the community group [5/587(0.85%)], patients with recurrent acute pancreatitis had a significantly higher frequency of ansa pancreatica [2/18(11.1%)](P = 0.016; OR = 14.3; 95%CI: 1.27-96.1), but not compared with patients with single-episode acute pancreatitis [1/55(1.8%)](P = 0.42; OR = 2.1; 95%CI: 0.44-19.7). Multiple logistic regression analysis using age, alcohol intake, presence of ansa pancreatica, and presence of autoimmune disease as independent covariates, revealed a significant relationship between the presence of ansa pancreatica and recurrent acute pancreatitis. The presence of autoimmune disease was also significantly associated with the onset of recurrent acute pancreatitis. On the other hand, neither age nor alcohol intake were significantly related to the onset of recurrent acute *** The present study is the first to provide robust evidence that the presence of ansa pancreatica is significantly associated with recurrent acute pancreatitis.

关键词： Anatomy Cholangiopancreatography Pancreatitis Magnetic resonance imaging Pancreatic duct

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community Needs Assessment in Relation to Urban Heat Effects: A Study in Greater Kuala Lumpur, Malaysia

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Biomedical and Environmental Sciences 2018年第9期31卷 705-711页

作者： Li Ping WONG Haridah Alias Nasrin Aghamohammadi Nik Meriam Nik Sulaiman Julius Centre University of Malaya (JCUM) Department of Social and Preventive Medicine Faculty of Medicine University of Malaya Centre for Occupational and Environmental Health Department of Social and Preventive Medicine Faculty of Medicine University of Malaya department of Chemical Engineering Faculty of Engineering University of Malaya

Urban areas usually experience higher temperatures compared with their rural surroundings; this is characterized as urban heat islands （UHIs）, which are the result of environmental overheating due to anthropic activities. Urban areas,which are characterised by massive construction that reduce local vegetation coverage, are subject to the absorption of a large amount of solar radiation,which is only partially released into the atmosphere by radiation in the thermal infrared.

关键词： A Study in Greater Kuala Lumpur community Needs Assessment in Relation to Urban Heat Effects Malaysia

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The use of outcome feedback by emergency medicine physicians: Results of a physician survey

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World Journal of Emergency medicine 2019年第1期10卷 14-18页

作者： Rakesh Gupta Isaac Siemens Sam Campbell Division of Emergency medicine McMaster University department of Family and community medicine University of Toronto department of Emergency medicine Dalhousie University

BACKGROUND: Feedback on patient outcomes is invaluable to the practice of emergency medicine but examples of effective forms of feedback have not been well characterized in the literature. We describe one system of emergency department(ED) outcome feedback called the return visit report(RVR) and present the results of a survey assessing physicians' perceptions of this novel form of feedback. METHODS: An Opinio web-based survey was conducted in 81 emergency physicians(EPs) at three ***: Of the 81 physicians surveyed, 40(49%) responded. Most participants indicated that they frequently review their RVRs(83%), that RVRs are valuable to their practice of medicine(80%), and that RVRs alter their practice in future encounters(57%). Respondents reported seeking other forms of outcome feedback including speaking with other EPs(83%) and reviewing discharge summaries of admitted patients(87%). There was no correlation between demographic data and use of ***: EPs value RVRs as a form of feedback. RVRs could be improved by reducing the observational interval and optimizing report relevance and differential weighting.

关键词： Return visit reports Emergency medicine Outcome feedback Emergency department information system

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Prevalence of intestinal parasitic infections and its relationship with socio-demographics and hygienic habits among male primary schoolchildren in Al-Ahsa,Saudi Arabia

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Asian Pacific Journal of Tropical medicine 2010年第11期3卷 906-912页

作者： Hamdan Ibrahim Al-Mohammed Tarek Tawfik Amin Elsayed Aboulmagd Hatem Refaat Hablus Burhan Omar Zaza department of Medical Microbiology and Parasitology College of MedicineKing Faisal UniversitySaudi Arabia department of community medicine Faculty of MedicineCairo UniversityEgypt department of Paediatrics College of MedicineKing Faisal UniversitySaudi Arabia Technical Director School Health Preventive ServicesMinistry of EducationAl-Hofuf DirectorateSaudi Arabia

Objective:To investigate the prevalence of different intestinal parasitic infections among male primary schoolchildren in Al-Ahsa,Saudi Arabia,and to explore the possible relative socioeconomic, environmental and behavioural sanitary ***:A cross-sectional descriptive study was performed.A total of 1 289 male students aged from 7 to 12 years were selected randomly from 20 urban and 12 rural primary schools by multistage sampling method. Data collection was carried out by self administered questionnaire form to the parents/guardians of students and included inquires about socio-demographics,environmental conditions,and behavioural sanitary *** analysis was carried out to examine the presence of intestinal parasitic ***:Overall prevalence of parasitic infections was 27.2%,more among rural *** encountered infections included Entamoeba histolytica/dispar(8.2%), Giardia lamblia(6.5%),Entamoeba coli(4.0%) and Enterobius vermicularis(1.6%).Logistic regression revealed that lower maternal educational level and occupational status,low family income,big family size,poor personal hygienic practices and positive history of previous intestinal infections among family members increased the likelihood of ***: Although of low magnitude,intestinal parasitic infections still represent a public health concern among male schoolchildren in Al-Ahsa ***-demographic and poor personal hygienic habits are the main predictors for these infections.

关键词： Intestinal parasitic infections Schoolchildren Epidemiological correlates Hygiene Saudi Arabia

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Extracellular vesicles and angiotensin-converting enzyme 2 in COVID-19 disease

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BIOCELL 2024年第1期48卷 1-8页

作者： YU LIU ROBERT J.KASPER NATALIE J.S.CHOI department of Family and community medicine Northwestern University Feinberg School of MedicineChicagoIllinois

Extracellular vesicles(EVs)are membranous vesicular structures released from almost all eukaryotic cell types under different physiological or pathological *** evidence demonstrates that EVs can serve as mediators of intercellular communication between donor and recipient cells or microorganism-infected and noninfected *** disease 2019(COVID-19)disease is caused by infection of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)of host cells in the respiratory system and various extra-pulmonary tissue/organs,resulting in complications of multiple organ *** the cell surface receptor,angiotensin-converting enzyme 2(ACE2)mediates cellular entry of SARS-CoV-2 into the host cells in patients with *** studies have found that ACE2 can be released with EVs,which have been shown to interfere with the entry of the virus into host cells and thus may be involved in COVID-19 *** addition,ACE2,neprilysin(NEP),and thimet oligopeptidase(TOP)are the key enzymes that regulate angiotensin metabolism by converting angiotensin II or angiotensin I to angiotensin 1-7,the latter of which has protective effects in counterbalancing the harmful effects of angiotensin II in COVID-19 *** review summarizes the recent research progress regarding EV-associated ACE2,NEP,and TOP and the perspectives of their potential involvement in the pathophysiology of COVID-19 disease.

关键词： Extracellular vesicles COVID-19 Angiotensin converting enzyme 2 Thimet oligopeptidase

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Efect of early feeding practices and eating behaviors on body composition in primary school children

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World Journal of Pediatrics 2022年第9期18卷 613-623页

作者： Omneya Magdy Omar Mohamed Naguib Massoud Afaf Gaber Ibrahim Nada Atef Khalaf department of Pediatrics Faculty of MedicineAlexandria UniversityAlexandria 21321Egypt department of community medicine and Public Health Faculty of MedicineAlexandria UniversityAlexandriaEgypt

Background Understanding children’s feeding practices and eating behaviors is important to determine etiology of childhood *** study aimed to explore the relationship between early feeding practices,eating behavior and body composition among primary school *** The data were collected from 403 primary school *** were administered structured questionnaire,including sociodemographic characteristics,early feeding practices and Child’s Eating Behavior *** and blood pressure(BP)measurements were *** Children with obesity and overweight showed higher food approach subscales and lower food avoidance subscales compared to a healthy and underweight *** who were exclusively or predominantly breast fed during the frst 6 months had the lowest scores for the food approach subscales,food responsiveness(FR)and emotional overeating(EOE)and had the highest scores for the food avoidance subscales,satiety responsiveness(SR)and emotional under eating(EUE).Children who were introduced solid food after 6 months showed lower scores for FR,enjoyment of food and EOE but scored highest for SR,slowness in eating(SE)and *** anthropometric measurements were positively correlated with all food approach subscales and negatively with SE,SR and food *** food approach subscales were positively correlated with BP *** food avoidance subscales were negatively correlated with both BP percentiles,except for EUE,which was negatively correlated with diastolic BP percentile ***,SR,SE and FR were predictors for child body mass *** Early feeding practices and eating behavior are considered as prevention approaches for obesity.

关键词： Blood pressure Child eating behaviors Childhood obesity Feeding practices Waist circumference

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Diabetes self-care in primary health facilities in India-challenges and the way forward

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World Journal of Diabetes 2019年第6期10卷 341-349页

作者： Saurav Basu Nandini Sharma department of community medicine Maulana Azad Medical College

India has approximately 73 million people living with diabetes and another 37 million with prediabetes while nearly 47% of the diabetes cases are undiagnosed. The high burden of poor glycemic control and early onset of complications with associated economic costs indicates a high prevalence of poor self-management practices. It is well-established that achieving patient-centered primary care consistent with a chronic care model ensures optimum diabetes self-management support and improves long-term clinical and health outcomes in diabetes patients. The public sector primary care system in India provides services free of cost to beneficiaries but lacks patient-centered care that undermines diabetes selfmanagement education and support. Furthermore, factors like poor patient knowledge of diabetes, suboptimal medication adherence, persistent clinical inertia, lack of data for monitoring and evaluation through clinical audit worsens the standards of diabetes care in primary care settings of India. There is a need for government initiatives to be directed towards the provision of comprehensive outpatient care that is inclusive of uninterrupted supply of drugs, provision of essential laboratory investigators, training and availability of qualified diabetes educators and availability of specialist support when required. Furthermore, the integration of depression screening and smoking cessation services at the primary care level is warranted.

关键词： Primary care Diabetes Self-care Adherence India

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