Medicine
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Metabolic syndrome is a major public health problem worldwide and an independent predictor of cardiovascular disease in patients with type 2 diabetes (T2DM). This study aimed to determine the prevalence of metabolic syndrome and its individual components among Jordanian patients with T2DM. A cross-sectional design was conducted among T2DM patients at the National Center for Diabetes, Endocrinology and Genetics in Jordan. ⋯ The prevalence of metabolic syndrome among Jordanian patients with T2DM is extremely high. The main modifiable risk factors of metabolic syndrome among these patients include nonadherence to a diet regimen, insufficient physical activity, being overweight/obese and smoking. It is recommended that healthcare providers counsel patients on the importance of maintaining physical activity, smoking cessation, and adherence to a diet regimen.
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Surgical resection is the cornerstone of treatment for locally advanced gastric cancer (LAGC). Hence, downstaging of the tumor with neoadjuvant therapy is critical for R0 resection and prolongs the overall survival. Data from related studies are lacking, and the literature is scarce. ⋯ All adverse events were relieved and disappeared after symptomatic treatment, and no grade 4 adverse events were noted. PD-1 inhibitor and apatinib plus S-1 and oxaliplatin are safe and effective as neoadjuvant treatment of LAGC. Gastric transcatheter chemoembolization is useful for tumor regression during neoadjuvant therapy.
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Trans-oral robotic surgery (TORS) and trans-oral laser microsurgery (TLM) have been increasingly employed for the diagnosis and identification of primary occult cancers in the head and neck region. This systematic review and meta-analysis aimed to evaluate the application and effectiveness of tonsillectomy with TORS and TLM in detecting these cancers. ⋯ This is a latest systematic review of the detection rates of head and neck squamous cell carcinoma of unknown primary sites by tongue base mucosectomy (TBM) via TORS and TBM via TLM. This study confirmed that TBM via TLM performed better than TBM-TORS in the detection rate of the primary. In particular, TBM via TLM showed significant advantages in detecting primary lesions in HPV-positive head and neck squamous cell carcinoma of unknown primary patients.
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IgA nephropathy is the most common primary glomerular disease worldwide, with inflammation and autoimmune response mechanisms permeating the entire disease development process. The advancement of genome-wide association studies has enabled deeper understanding of the disease mechanisms and genetic susceptibility. Therefore, this study aims to explore the causal relationship between 731 immune cell types and the disease through Mendelian randomization (MR) analysis. ⋯ After adjusting for false discovery rate (FDR), the study results revealed a bidirectional causal relationship between CD8 on terminally differentiated CD8+ T cells (OR = 0.77, 95% CI = 0.67-0.88, P = .0001) and CD4 on CD28+ CD4+ T cells (OR = 0.75, 95% CI = 0.64-0.87, P = .0001) with the risk of IgA nephropathy. CD64 on CD14+ CD16+ monocytes (OR = 0.66, 95% CI = 0.51-0.85, P = .0013) is considered a protective factor, while the percentages of CD8+ and CD8dim T cells (1.38, 95% CI = 1.17-1.63, P = .0002) in leukocytes are viewed as risk factors. This study employed genetic variation as an instrumental variable to explore the genetic association between immune cells and IgA nephropathy, aiming to offer new insights into early prevention and personalized treatment of the disease.
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Observational Study
Myocardial involvement in end-stage renal disease patients with anemia as assessed by cardiovascular magnetic resonance native T1 mapping: An observational study.
Cardiovascular disease has become to the main cause of death in the patients with end-stage renal disease (ESRD), and anemia is associated with increased cardiovascular morbidity and mortality in these patients. This study aimed to explore the impact of anemia on myocardial fibrosis using T1 mapping technique in patients with ESRD. A total of 128 subjects including 98 ESRD patients (65 with anemia, 33 without anemia) and 30 normal controls were enrolled. ⋯ Global longitudinal strain was remarkably reduced in ESRD patients with anemia in comparison to those without anemia (P < .001). Diffuse myocardial fibrosis could be detected by native T1 mapping in ESRD patients with long-term anemia. Anemia is an important factor in myocardial fibrosis in ESRD patients, and the evaluation of myocardial involvement is worth considering for clinical management.