Medicine
-
A high prevalence of bronchiectasis was found by chest computed tomography (CT) in patients with moderate-severe chronic obstructive pulmonary disease (COPD), and it was shown to be associated with more severe symptoms, higher frequency of exacerbations and mortality. The risk factors for bronchiectasis in COPD are not yet clarified. High-resolution computed tomography (HRCT) of chest was performed in patients with moderate-severe COPD, and the presence and the extent of bronchiectasis were evaluated by two radiologists. ⋯ More notably, the level of serum T-IgE [log10(T-IgE)] was positively correlated with the extent of bronchiectasis in COPD patients (r = 0.208, P = 0.05). Higher serum T-IgE, male gender, and previous tuberculosis are independent risk factors for coexistent bronchiectasis in COPD. The association of T-IgE with the extent of bronchiectasis also suggests that further investigations are needed to explore the potential role of IgE in the pathogenesis of bronchiectasis in COPD.
-
The primary aim of this study was to evaluate metabolically healthy status (MHS) among participants in obesity, overweight, and normal weight groups and characteristics associated with this phenotype using baseline data of Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The secondary aim was to investigate agreement among 4 different MHS criteria. This cross-sectional study included 14,545 participants aged 35 to 74 years with a small majority (54.1%) being women. ⋯ The agreement between all the 4 MHS criteria was strong (kappa 0.73 P < 0.001). In final logistic models, MHS was associated with lower age, female sex, lower body mass index (BMI), and weight change from age 20 within all BMI categories. This study showed that, despite differences in prevalence among the 4 criteria, MHS was associated with common characteristics at every BMI category.
-
Comparative Study
Risk factors for renal impairment revealed after unilateral adrenalectomy in patients with primary aldosteronism.
Primary aldosteronism (PA) may induce significant decline of renal function and structural damage of kidney. However, it is difficult to evaluate accurate renal function in patients with PA, because glomerular hyperfiltration and aldosterone escape can conceal renal impairment. In this retrospective cohort study, we compared changes in renal function after unilateral adrenalectomy between patients with PA and patients with other adrenal diseases. ⋯ Our study demonstrates that patients with PA with old age, low serum potassium, long-standing hypertension, and high serum uric acid or cholesterol are at risk of renal impairment after surgical treatment. High preoperative eGFR was also a risk factor for postoperative renal impairment, whereas low preoperative eGFR was a risk factor for postoperative CKD. Close monitoring of renal function and adequate management are required for patients with these risk factors.
-
Comparative Study
Autograft versus sterilized allograft for lateral calcaneal lengthening osteotomies: Comparison of 50 patients.
Sterilized allografts may be less resistant to collapse and prone to nonunion leading to loss of correction in open wedge osteotomies. These adverse events usually occur at early time points (i.e., < 9 months postoperatively). The goal of this study was to compare sterilized allografts to autologous grafts in respect to secondary loss of hindfoot alignment and graft incorporation after lateral calcaneal lengthening osteotomies. ⋯ However, loss of correction was associated with failure of graft incorporation. Compared with autografts, sterilized allografts do not increase the risk for loss of hindfoot alignment in lateral column lengthening of the calcaneus. With respect to mechanical resistance, allografts thus mean an equal and valid alternative without risk of donor site morbidities.
-
Comparative Study
Comparison of the prognostic values of the 2010 WHO classification, AJCC 7th edition, and ENETS classification of gastric neuroendocrine tumors.
The ability of the European Neuroendocrine Tumor Society (ENETS) system, 2010 World Health Organization (WHO) grading system, and American Joint Committee on Cancer (AJCC) staging system to predict survival after gastric neuroendocrine tumor (NET) resection has not yet been validated. We retrospectively evaluated 175 gastric NETs from 1996 to 2014. WHO grade 3 (G3) patients (n = 66) had a lower survival rate than grade 1 (G1) (n = 39) or grade 2 (G2) (n = 13) patients, with similar high survival rates for G1 and G2 patients. ⋯ Our findings strongly suggested that the WHO and ENETS classification systems have shown a low prognostic value. The AJCC TNM system showed a low prognostic value for well-differentiated NETs (G1 or G2). In contrast, the AJCC TNM system had a high prognostic value for G3 or mixed tumors.