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Causal relationship between hypertension and epilepsy:a mendelian randomization study

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Acta Epileptologica 2024年第1期7卷 53-59页

作者： Zhen Sun Tong Jiang Mengwen Zhang Yulong Li Jing Zhang Yanping Sun Xiaofeng Yu department of Neurology The Affiliated Hospital of Qingdao UniversityQingdao266000China department of Endocrinology and Metabolism The Affiliated Hospital of Qingdao UniversityQingdao266000China department of Neurology Qingdao Eighth People’s HospitalQingdao266000China

Background Recent studies suggest that hypertension may increase the risk of epilepsy onset,revealing intricate interactions between cardiovascular health and neurological disorders,thus emphasizing the significance of conducting further investigations into their *** study aimed to investigate the potential causality between hypertension,either in systolic or diastolic blood pressure,and epilepsy,using a Mendelian randomization *** A two-sample Mendelian randomization design was used in this *** extracted data from the UK Biobank,FinnGen,and the International Consortium of Blood Pressure,utilizing blood pressure-related single nucleotide polymorphisms as instrumental variables to evaluate the influence of hypertension on the risk of *** variance weighted,weighted median,and MR-Egger approaches were used for *** There was a potential association between hypertension,primarily in systolic blood pressure,and an elevated epilepsy risk,while the relationship between hypertension in diastolic blood pressure and epilepsy risk remained *** analyses suggest an absence of substantial heterogeneity and confounding effects,suggesting the reliability of our *** Our study lays the groundwork for further investigations into the mechanisms of this causal relationship,which may potentially involve vascular change,neuroinflammatory pathways,and alterations in cerebral blood flow,which are crucial for understanding the complex hypertension-epilepsy nexus.

关键词： Mendelian randomization Epilepsy hypertension Systolic blood pressure

Outcomes of endoscopic sclerotherapy for jejunal varices at the site of choledochojejunostomy (with video): Three case reports

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World Journal of Gastroenterology 2024年第14期30卷 2059-2067页

作者： Jun Liu Peng Wang Li-Mei Wang Jing Guo Ning Zhong department of Gastroenterology Qilu Hospital of Shandong UniversityJinan 250012Shandong ProvinceChina

BACKGROUND Hemorrhage associated with varices at the site of choledochojejunostomy is an unusual,difficult to treat,and often fatal manifestation of portal *** far,no treatment guidelines have been *** SUMMARY We reported three patients with jejunal varices at the site of choledochojejun-ostomy managed by endoscopic sclerotherapy with lauromacrogol/α-butyl cyanoacrylate injection at our institution between June 2021 and August *** reviewed all patient records,clinical presentation,endoscopic findings and treatment,outcomes and *** patients who underwent pancre-aticoduodenectomy with a Whipple anastomosis were examined using conven-tional upper gastrointestinal endoscopy for suspected hemorrhage from the afferent jejunal *** with stigmata of recent hemorrhage or active he-morrhage were observed around the choledochojejunostomy site in all three *** injection of lauromacrogol/α-butyl cyanoacrylate was carried out at jejunal varices for all three *** bleeding ceased and patency was observed for 26 and 2 months in two *** one patient with multiorgan failure and internal environment disturbance,rebleeding occurred 1 month after endoscopic sclerotherapy,and despite a second endoscopic sclero-therapy,repeated episodes of bleeding and multiorgan failure resulted in eventual *** We conclude that endoscopic sclerotherapy with lauromacrogol/α-butyl cyanoac-rylate injection can be an easy,effective,safe and low-cost treatment option for jejunal varicose bleeding at the site of choledochojejunostomy.

关键词： Endoscopic sclerotherapy Jejunal varices Choledochojejunostomy Portal vein hypertension Case report

Alanine aminotransferase predicts incident steatotic liver disease of metabolic etiology: Long life to the old biomarker!

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World Journal of Gastroenterology 2024年第24期30卷 3016-3021页

作者： Amedeo Lonardo department of Internal Medicine Azienda Ospedaliero-Universitaria of Modena(2023)Modena 41126Italy

Alanine aminotransferase(ALT)serum levels increase because of hepatocellular *** dysfunction-associated fatty liver disease(MAFLD),which identifies steatotic liver disease(SLD)associated with≥2 metabolic abnormalities,has prominent sexual *** Metabolic Syndrome defines a cluster comprising abdominal obesity,altered glucose metabolism,dyslipidemia,and *** sex,body mass index,glucose,lipids,ferritin,hypertension,and age independently predict ALT levels among blood *** the last few decades,the reference range of ALT levels has been animatedly debated owing to attempts to update sex-specific reference *** this backset,Chen et al have recently published a study which has two main ***,>80%of indi-viduals with MAFLD had normal ALT ***,there was a linear increa-sing trend in the association between cumulative excess high-normal ALT levels and the rate of incident *** study has biologically credible ***,it inaccurately considered sex differences in the MAFLD ***,future studies on SLD owing to metabolic dysfunction should adopt locally determined and prospectively validated reference ranges of ALT and carefully consider sex differences in liver enzymes and MAFLD pathobiology.

关键词： Alanine aminotransferase Biomarker History of medicine Metabolic dysfunction-associated fatty liver disease Metabolism Nonalcoholic fatty liver disease Reference range Sex differences Steatotic liver disease

Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer

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World Journal of Gastroenterology 2024年第23期30卷 2991-3004页

作者： Li-Qun Cai Da-Qing Yang Rong-Jian Wang He Huang Yi-Xiong Shi department of Colorectal and Anal Surgery Whenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina department of Colorectal and Anorectal Surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina

BACKGROUND Colorectal cancer significantly impacts global health,with unplanned reoperations post-surgery being key determinants of patient *** predictive models for these reoperations lack precision in integrating complex clinical *** To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer *** Data of patients treated for colorectal cancer(n=2044)at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively *** were divided into an experimental group(n=60)and a control group(n=1984)according to unplanned reoperation *** were also divided into a training group and a validation group(7:3 ratio).We used three different machine learning methods to screen characteristic variables.A nomogram was created based on multifactor logistic regression,and the model performance was assessed using receiver operating characteristic curve,calibration curve,Hosmer-Lemeshow test,and decision curve *** risk scores of the two groups were calculated and compared to validate the *** More patients in the experimental group were≥60 years old,male,and had a history of hypertension,laparotomy,and hypoproteinemia,compared to the control *** logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation(Phypertension,or stroke,hypoproteinemia,age,tumor-node-metastasis staging,surgical time,gender,and American Society of Anesthesiologists *** operating characteristic curve analysis showed that the model had good discrimination and clinical *** This study used a machine learning approach to build a model that accurately predicts the risk of postoperative unplanned reoperation in patients with colorectal cancer,which can improve tr

关键词： Colorectal cancer Postoperative unplanned reoperation Unplanned reoperation Clinical validation Nomogram Machine learning models

Hematochezia due to rectal invasion by an internal iliac artery aneurysm: A case report

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World Journal of Clinical Cases 2024年第11期12卷 1980-1989页

作者： Fang Li Bin Zhao Yong-Qiang Liu Guo-Qing Chen Rong-Feng Qu Chao Xu Zhui Long Jin-Song Wu Mao Xiong Wei-Hang Liu Li Zhu Xiao-Ling Feng Lei Zhang department of General Surgery Chongqing General HospitalChongqing 401147China

BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula,expanding the differential diagnosis for gastrointestinal *** emphasizes the importance of considering vascular origins in cases of atypical hematochezia,particularly in the absence of common gastrointestinal causes,and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual *** SUMMARY A 75-year-old man with a history of hypertension presented with 12 d of hematochezia,experiencing bloody stools 7-8 times per *** computed tomography(CT)scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma *** levels progressively decreased to 7 g/*** arterial angiography and iliac arterycovered stent placement were performed,followed by balloon *** initial stabilization,minor rectal bleeding and abdominal pain persisted,leading to further diagnostic *** identified a neoplasm and potential perforation at the proximal *** exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall,necessitating partial rectal resection,intestinal anastomosis,and *** recovery was successful,with no further bleeding incidents and normal follow-up CT and colonoscopy results after six *** In cases of unusual gastrointestinal bleeding,it is necessary to consider vascular causes for effective diagnosis and intervention.

关键词： Iliac artery aneurysm Hematoma Rectum Hematochezia Case report

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

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Journal of Integrative Nursing 2024年第2期6卷 127-135页

作者： Feyisayo Iyabo BAMIDELE Cecilia Bukola BELLO Oladayo Damilola AKINWALE Mubo Stella FALANA department of Nursing Afe Babalola UniversityAdo‑EkitiEkiti StateNigeria department of Nursing Redeemer’s UniversityEdeOsun StateNigeria

hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence *** review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with *** study design was a systematic review of empirical research articles using a well-defined *** journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the *** selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research *** of 180 studies initially identified in the database search,20 studies were ultimately included in the *** findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care *** review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

关键词： Health literacy intervention health-related quality of life people living with hypertension self-management

Overview of the Association Between Non-Alcoholic Fatty Liver Disease and hypertension

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Cardiology Discovery 2024年第1期4卷 30-37页

作者： Niki S.Kakouril Costas G.Thomopoulos Eirini P.Siafi Angeliki E.Valatsoul Kyriakos S.Dimitriadis Iliana P.Mani Sotirios P.Patsilinakos Dimitrios M.Tousoulis Konstantinos P.Tsioufis First department of Cardiology Medical SchoolNational and Kapodistrian University of AthensHippokration HospitalAthens 11527Greece department of Cardiology Elena Venizelou HospitalAthens 11521Greece department of Cardiology General Hospital Agia OlgaAthens 14233Greece

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, and its prevalence is rising. NAFLD is closely associated with metabolic syndrome, with both conditions sharing common clinical characteristics such as obesity, insulin resistance, type 2 diabetes mellitus, hypertension, and hypertriglyceridemia. Several observational studies have evaluated the relationship between NAFLD and hypertension, with the overall evidence suggesting a bidirectional relationship. It is hypothesized that activation of the sympathetic nervous and renin-angiotensin systems, observed in NAFLD with or without insulin resistance promotes the development of hypertension. In patients with hypertension, activation of these systems can lead to hepatic fibrosis and progressive inflammation through increased oxidative stress and activation of hepatic stellate cells and Kupffer cells. The present review examines the pathophysiologic and clinical evidence supporting the bidirectional association between NAFLD and hypertension.

关键词： hypertension Non-alcoholic fatty liver disease Insulin resistance Sympathetic nervous system Metabolic syndrome

Factors affecting length of stay according to bronchopulmonary dysplasia severity:a nationwide cohort study in Korea

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World Journal of Pediatrics 2024年第5期20卷 470-480页

作者： Hye Mi Lee Jeongmin Shin Sae Yun Kim So Young Kim department of Pediatrics College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea department of Pediatrics Yeouido St.Mary’s HospitalCollege of MedicineThe Catholic University of Korea1063-roYeongdeungpo-guSeoul07345Republic of Korea

Background Longer hospitalizations for preterm infants with bronchopulmonary dysplasia(BPD)delay developmental outcomes,increase the risk for hospital-acquired complications,and exert a substantial socioeconomic *** study aimed to identify factors associated with an extended length of stay(LOS)at different levels of severity of *** A cohort study was conducted using the Korean Neonatal Network registry of very low birth weight infants with BPD between 2013 and 2017 through retrospective *** A total of 4263 infants were diagnosed with *** mild BPD,infants requiring surgical treatment for patent ductus arteriosus needed a longer LOS[eadjustedβcoefficients(adjβ)1.041;95%confidence interval(CI):0.01–0.08]and hydrocephalus(eadjβ1.094;95%CI 0.01–0.17).In moderate BPD,infants administered steroids or with intraventricular hemorrhage required a longer LOS(eadjβ1.041;95%CI 0.00–0.07 and eadjβ1.271;95%CI 0.11–0.38,respectively).In severe BPD,infants with comorbidities required a longer LOS:pulmonary hypertension(eadjβ1.174;95%CI 0.09–0.23),administrated steroid for BPD(eadjβ1.116;95%CI 0.07–0.14),sepsis(eadjβ1.062;95%CI 0.01–0.11),patent ductus arteriosus requiring surgical ligation(eadjβ1.041;95%CI 0.00–0.08),and intraventricular hemorrhage(eadjβ1.016;95%CI 0.05–0.26).Additionally,the higher the clinical risk index score,the longer the LOS needed for infants in all *** The factors affecting LOS differed according to the severity of *** approaches to reducing LOS may be devised using knowledge of the various risk factors affecting LOS by BPD severity.

关键词： Bronchopulmonary dysplasia Length of stay Very low birth weight

Risk factors for cognitive impairment in patients with chronic kidney disease

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World Journal of Psychiatry 2024年第2期14卷 308-314页

作者： Xiao-Hui Wang Yong He Huan Zhou Ting Xiao Ran Du Xin Zhang department of Nephrology The Fifth Hospital of WuhanWuhan 430050Hubei ProvinceChina department of Nephrology The Central Hospital of Enshi Tujia and Miao Autonomous PrefectureEnshi 445000Hubei ProvinceChina

BACKGROUND Chronic kidney disease(CKD)patients have been found to be at risk of concurrent cognitive dysfunction in previous studies,which has now become an important public health issue of widespread *** To investigate the risk factors for concurrent cognitive dysfunction in patients with *** This is a prospective cohort study conducted among patients with CKD between October 2021 and March 2023.A questionnaire was formulated by literature review and expert consultation and included questions about age,sex,education level,per capita monthly household income,marital status,living condition,payment method,and *** Logistic regression analysis showed that patients aged 60-79 years[odds ratio(OR)=1.561,P=0.015]and≥80 years(OR=1.760,P=0.013),participants with middle to high school education(OR=0.820,P=0.027),divorced or widowed individuals(OR=1.37,P=0.032),self-funded patients(OR=2.368,P=0.008),and patients with hypertension(OR=2.011,P=0.041)had a higher risk of cognitive *** risk of cognitive impairment was lower for those with a college degree(OR=0.435,P=0.034)and married *** The risk factors affecting cognitive dysfunction are age,60-79 years and≥80 years;education,primary school education or less;marital status,divorced or widowed;payment method,selffunded;hypertension;and CKD.

关键词： Cognitive impairment Cognitive dysfunction Chronic kidney disease