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1.
Acta Cardiol Sin ; 40(3): 300-311, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38779159

RESUMO

Background: Serum D-dimer level has been associated with worsening outcomes in patients with acute myocardial infarction. This study aimed to explore the association between serum D-dimer level and clinical outcomes in Taiwanese patients with acute myocardial infarction. Methods: We analyzed Tri-Service General Hospital-Coronary Heart Disease registry data related to patients with acute myocardial infarction who were admitted between January 2014 and December 2018. A total of 748 patients were enrolled and categorized into high (≥ 495 ng/ml) and low (< 495 ng/ml) D-dimer groups. The primary endpoint was in-hospital mortality, and secondary endpoints were post-discharge mortality and post-discharge major adverse cardiovascular events. Results: Overall, 139 patients died, with 77 from cardiovascular causes and 62 from non-cardiovascular causes. In-hospital mortality was higher in the high D-dimer group than in the low D-dimer group. Among the patients alive at discharge, those with a high D-dimer level had higher cardiovascular mortality and future major adverse cardiovascular events than those with a low D-dimer level. Multivariate Cox regression analysis revealed that higher serum D-dimer levels were significantly associated with higher risks of in-hospital mortality [hazard ratio (HR) = 1.11; 95% confidence interval (CI), 1.06-1.16, p < 0.001], subsequent cardiovascular mortality after discharge (HR = 1.15; 95% CI, 1.08-1.22, p < 0.001), and major adverse cardiovascular events (HR = 1.10; 95% CI, 1.04-1.16, p < 0.001). Conclusions: This is the first study in Taiwan to demonstrate that a higher baseline serum D-dimer level was independently associated with higher risks of in-hospital mortality, post-discharge mortality, and major adverse cardiovascular events in patients with acute myocardial infarction.

2.
Opt Lett ; 48(23): 6340-6343, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38039262

RESUMO

This Letter demonstrates the successful use of free-space optics (FSO) as a transition channel for an air segment in transmitting Raman backscattering signals for distributed temperature sensing (DTS). A barrier-free air segment link shaped by an FSO is part of the Raman-based DTS (RDTS) fiber optic transmission route. For this plan, the FSO enables delivery of the RDTS's pulse with the low-loss transmission over the air segment while also returning to the RDTS the varied Raman backscattered signals from the probing temperature variations for signal interpretation. The difference between various temperatures sensed and the referential air temperature remains nearly the same before and after passing the FSO. The viability of this technology provides a crucial basis for tackling the high expense of installing and repairing DTS cables and the challenges associated with doing so owing to topographical restrictions.

3.
Medicina (Kaunas) ; 58(10)2022 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-36295621

RESUMO

Background and Objectives: Although human papillomavirus (HPV) is a major etiology of cervical and anogenital cancers, whether it is associated with colorectal carcinogenesis is yet undetermined. Materials and Methods: The longitudinal association of HPV infection with colorectal cancer (CRC) was evaluated using 2000-2013 data from a nationwide Taiwanese claims database. In this retrospective cohort study, 358 patients with primary HPV diagnoses (HPV-infected cohort) and 1432 patients without such a diagnosis (HPV-uninfected cohort) were recruited between 2000 and 2006. Both cohorts were followed up to identify CRC incidences from 2006 to 2013. Hazard ratios (HRs) and their 95% confidence intervals (CIs) derived from Cox proportional hazards models were used to estimate the association between HPV and CRC risk. Results: The HPV-infected cohort had a significantly higher cumulative incidence of CRC than the HPV-uninfected cohort. The presence of HPV was associated with an increased risk of CRC (adjusted HR, 1.63; 95% CI, 1.02-3.62). Furthermore, the significant HPV-CRC risk association was evident in both sexes. Conclusions: This population-based cohort study reveals longitudinal evidence that HPV is associated with an increased risk of CRC. Further studies are required to verify the role of HPV in colorectal carcinogenesis.


Assuntos
Alphapapillomavirus , Neoplasias Colorretais , Infecções por Papillomavirus , Masculino , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Estudos de Coortes , Estudos Retrospectivos , Incidência , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/diagnóstico , Carcinogênese , Fatores de Risco
4.
Acta Cardiol Sin ; 37(4): 365-376, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34257486

RESUMO

BACKGROUND: The Taiwan Society of Cardiology (TSOC) has established multicenter registries for coronary artery disease (CAD) to investigate clinical characteristics, management and risks for mortality. However, the impacts of newly-emerged evidence-based therapies, including the use of drug-eluting stents (DESs), on patients with CAD in Taiwan remain unclear. METHODS: The Tri-Service General Hospital-Coronary Heart Disease (TSGH-CHD) registry is a single-center, prospective, longitudinal registry in Taiwan containing data from 2014-2016. Individuals who were admitted for coronary angiography were enrolled. Patient profiles, management and in-hospital outcome data were collected. RESULTS: We included 3352 patients: 2349 with stable angina and 1003 with acute coronary syndrome (ACS). In the stable angina group, both patients receiving stenting and those receiving medical treatment had a 0.7% mortality rate; DESs were used in 70.4% of the patients receiving stenting. In the ACS group, the patients receiving stenting and those receiving medical treatment had a 4.9% and 10.7% mortality rate, respectively; DESs were used in 63.1% of the patients receiving stenting. In the 2008-2010 Taiwan ACS registry, DESs were used in only 28% of all stenting procedures, and the estimated hospital mortality rate was 1.8%. Multivariate analysis indicated that older age, prior stroke, and cardiogenic shock on admission were associated with an increased risk of in-hospital mortality in the ACS group. CONCLUSIONS: Compared with the Taiwan ACS cohort, the TSGH-CHD registry revealed increased DES use and increased disease complexity and severity after 2010. Although unlikely to significantly improve survival, interventionists seemed to perform high-risk procedures for complex CAD more often in the new DES era.

5.
Acta Cardiol Sin ; 36(6): 611-619, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33235417

RESUMO

BACKGROUND: Sex differences in heart failure mortality might be affected by age, race, and treatment response. Many large studies in Western countries have shown conflicting results, however few studies have been conducted in Asian patients. OBJECTIVES: We prospectively investigated the mortality risk in a multicenter cohort of 1,093 male and 416 female heart failure patients with reduced ejection fraction (HFrEF) hospitalized for worsening symptoms in Taiwan between 2013 and 2015. METHODS: Kaplan-Meier curve and Cox proportional regression analyses were used to determine the one-year mortality risk by sex. RESULTS: There were no significant differences in major adverse cardiovascular events, re-admission rate, and mortality between sexes in the overall cohort and the young subgroup during one-year of follow-up. In the elderly subgroup, the overall and cardiac mortality rate of the male patients were higher than those of the female patients (p = 0.035, p = 0.049, respectively). We found that the prognostic effect of old age on overall mortality rate appeared to be stronger in the male patients (p < 0.0001) than in the female patients (p = 0.69) in Cox regression analysis and Kaplan-Meier survival curves. Male sex was a risk factor for all-cause mortality in the elderly (hazard ratio: 1.50, 95% confidence interval 1.02-2.25) independently of systolic blood pressure, diabetes mellitus, hemoglobin concentration, kidney function, and medications. CONCLUSIONS: In the Taiwan HFrEF registry, the highest mortality risk was observed in male patients aged 65 years or more. Clinicians need to pay more attention to these patients.

6.
Crit Care ; 20(1): 373, 2016 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-27855722

RESUMO

BACKGROUND: New-onset atrial fibrillation (NeOAF) is a common type of tachyarrhythmia in critically ill patients and is associated with increased mortality in patients with sepsis. However, the prognostic impact of restored sinus rhythm (SR) in septic patients with NeOAF remains unclear. METHODS: A total of 791 patients with sepsis, who were admitted to a medical intensive care unit from January 2011 to January 2014, were screened. NeOAF was detected by continuous electrocardiographic monitoring. Patients were categorized into three groups: no NeOAF, NeOAF with restored SR (NeOAF to SR), and NeOAF with failure to restore SR (NeOAF to atrial fibrillation (AF)). The endpoint of this study was in-hospital mortality. Patients with pre-existing AF were excluded. RESULTS: We reviewed the data of 503 eligible patients, including 263 patients with no NeOAF and 240 patients with NeOAF. Of these 240 patients, SR was restored in 165 patients, and SR could not be restored in 75 patients. The NeOAF to AF group had the highest in-hospital mortality rate of 61.3% compared with the NeOAF to SR and no NeOAF groups (26.1% and 17.5%, respectively). Moreover, multivariate logistic regression analysis revealed that failure of restored SR was independently associated with increased in-hospital mortality in patients with sepsis and NeOAF. CONCLUSIONS: Failure to restore a sinus rhythm in patients with new-onset atrial fibrillation may be associated with increased in-hospital mortality in patients with sepsis. Further prospective studies are needed to clarify the effects of restoration of sinus rhythm on survival in patients with sepsis and new-onset atrial fibrillation.


Assuntos
Fibrilação Atrial/diagnóstico , Fibrilação Atrial/mortalidade , Frequência Cardíaca/fisiologia , Mortalidade Hospitalar/tendências , Sepse/diagnóstico , Sepse/mortalidade , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/fisiopatologia , Estudos de Coortes , Feminino , Humanos , Unidades de Terapia Intensiva/tendências , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Sepse/fisiopatologia
7.
Acta Cardiol Sin ; 31(5): 461-3, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27122908

RESUMO

UNLABELLED: A 57-year-old male with type 2 diabetes mellitus presented to the emergency department with sudden onset of chest pain. Shock status and considerably low right arm blood pressure were detected. The patient underwent contrast-enhanced computed tomography (CT) which revealed dependent contrast pooling and layering of contrast material within the inferior vena cava. Post-processing CT angiography depicted total occlusion of the left main coronary artery. Sudden cardiac arrest developed after CT examination, and following emergency coronary angiography we confirmed the diagnosis of left main coronary artery occlusion and cardiogenic shock. Clinical physicians should recognize these CT findings of imminent cardiovascular decompensation and provide prompt medical management to prevent further patient deterioration. KEY WORDS: Cardiogenic shock; Dependent pooling; Layering; Left main coronary artery disease.

9.
Acta Cardiol Sin ; 31(5): 414-28, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27122901

RESUMO

BACKGROUND: Endothelial progenitor cells (EPCs) play a fundamental role in vascular repair and angiogenesis- related diseases. It is well-known that the process of angiogenesis is faulty in patients with diabetes. Long-term exposure of peripheral blood EPCs to high glucose (HG-EPCs) has been shown to impair cell proliferation and other functional competencies. Far infrared (FIR) therapy can promote ischemia-induced angiogenesis in diabetic mice and restore high glucose-suppressed endothelial progenitor cell functions both in vitro and in vivo. However, the detail mechanisms and global transcriptome alternations are still unclear. METHODS: In this study, we investigated the influences of FIR upon HG-EPC gene expressions. EPCs were obtained from the peripheral blood and treated with high glucose. These cells were then subjected to FIR irradiation and functional assays. RESULTS: Those genes responsible for fibroblast growth factors, Mitogen-activated protein kinases (MAPK), Janus kinase/signal transducer and activator of transcription and prostaglandin signaling pathways were significantly induced in HG-EPCs after FIR treatment. On the other hand, mouse double minute 2 homolog, genes involved in glycogen metabolic process, and genes involved in cardiac fibrosis were down-regulated. We also observed complex genetic networks functioning in FIR-treated HG-EPCs, in which several genes, such as GATA binding protein 3, hairy and enhancer of split-1, Sprouty Homolog 2, MAPK and Sirtuin 1, acted as hubs to maintain the stability and connectivity of the whole genetic network. CONCLUSIONS: Deciphering FIR-affected genes will not only provide us with new knowledge regarding angiogenesis, but also help to develop new biomarkers for evaluating the effects of FIR therapy. Our findings may also be adapted to develop new methods to increase EPC activities for treating diabetes-related ischemia and metabolic syndrome-associated cardiovascular disorders. KEY WORDS: Endothelial progenitor cell; Far infrared; Microarray; Systems biology.

10.
J Pers Med ; 13(4)2023 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-37108962

RESUMO

Colorectal cancer (CRC) is a major public health issue, and there are limited studies on the association between 17ß-hydroxysteroid dehydrogenase type 4 (HSD17B4) polymorphism and CRC. We used two national databases from Taiwan to examine whether HSD17B4 rs721673, rs721675, and alcohol intake were independently and interactively correlated with CRC development. We linked the Taiwan Biobank (TWB) participants' health and lifestyle information and genotypic data from 2012 to 2018 to the National Health Insurance Database (NHIRD) to confirm their medical records. We performed a genome-wide association study (GWAS) using data from 145 new incident CRC cases and matched 1316 healthy, non-CRC individuals. We calculated the odds ratios (OR) and 95% confidence intervals (CI) for CRC based on multiple logistic regression analyses. HSD17B4 rs721673 and rs721675 on chromosome 5 were significantly and positively correlated with CRC (rs721673 A > G, aOR = 2.62, p = 2.90 × 10-8; rs721675 A > T, aOR = 2.61, p = 1.01 × 10-6). Within the high-risk genotypes, significantly higher ORs were observed among the alcohol intake group. Our results demonstrated that the rs721673 and rs721675 risk genotypes of HSD17B4 might increase the risk of CRC development in Taiwanese adults, especially those with alcohol consumption habits.

12.
Materials (Basel) ; 15(19)2022 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-36233994

RESUMO

Eu1-xBaxTi1-yMyO3 (M = Co or Ni) was sintered at 1400 °C under a reduction atmosphere. X-ray photoelectron spectroscopy revealed the mixed valences of Eu2+/Eu3+ and Ti4+/Ti3+ in EuTiO3 and Eu0.7Ba0.3TiO3, as well as some oxygen vacancies required to keep the charge neutrality. The co-doping of Co2+/Ni2+ in Eu0.7Ba0.3TiO3 resulted in the disappearance of oxygen vacancies, as a result of a reduction in Ti3+ numbers and an increase in Eu3+ numbers. On the other hand, Ba2+ doping led to an increased lattice parameter due to its larger ionic size than Eu2+, whereas the Co2+/Ni2+ co-doping resulted in smaller lattice parameters because of the combined effects of ionic size and variation in the oxygen-vacancy numbers. Eu0.7Ba0.3TiO3 exhibited a clear ferroelectricity, which persisted in the Co2+/Ni2+ co-doped samples until the doping levels of y = 0.05 and 0.10, respectively. Eu0.7Ba0.3TiO3 remained to be antiferromagnetic with a reduced transition temperature of 3.1 K, but co-doping of Co2+/Ni2+ turned the samples from antiferromagnetic to ferromagnetic with transition temperatures of 2.98 K and 2.72 K, respectively. The cause for such a transition could not be explained by the larger lattice volume, oxygen vacancies and mixed valences of Eu2+/Eu3+, which were proposed in previous works. Instead, it was more likely to arise from a large asymmetric distortion of the Eu-O polyhedron introduced by the aliovalent doping, which promotes the admixture of Eu 5d and 4f states.

13.
World J Clin Cases ; 10(34): 12631-12636, 2022 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-36579099

RESUMO

BACKGROUND: A "cannot intubate, cannot oxygenate (CICO)" situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen desaturation. In this paper, we describe airway management in a patient with an extended parotid tumor that invaded the airways during CICO using the endotracheal tube tip in the pharynx (TTIP) technique. CASE SUMMARY: A 43-year-old man was diagnosed with parotid tumor for > 10 years. Computed tomography and nasopharyngeal fiberoptic examination revealed a substantial mass from the right parotid region with a deep extension through the lateral pharyngeal region to the retropharyngeal region and obliteration of the nasopharynx to the oropharynx. Tumor excision was arranged. However, we encountered CICO during anesthesia induction. An endotracheal tube was used as an emergency supraglottic airway device (TTIP) to ventilate the patient in a CICO situation where other tools such as laryngeal mask airway or mask ventilation were not suitable for this complicated and difficult airway. The patient did not experience desaturation despite sudden loss of definite airway. During tracheostomy, the pulse oximetry remained 100% with our technique of ventilating the patient. The arterial blood gas analysis revealed PaCO2 35.7 mmHg and PaO2 242.5 mmHg upon 50% oxygenation afterward. CONCLUSION: Using an endotracheal tube as a supraglottic airway device, patients may have increased survival without experiencing life-threatening desaturation.

14.
J Orthop Surg Res ; 17(1): 335, 2022 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-35765082

RESUMO

BACKGROUND: Osteolysis is one of the most prevalent clinical complications affecting people who undergo total joint replacement (TJR). Wedelolactone (WDL) is a coumestan compound derived from the Wedelia chinensis plant and has been demonstrated to exhibit anti-inflammatory properties. This study aimed to investigate the oral administration of WDL as a potential treatment for particle-induced osteolysis using a well-established mice calvarial disease model. METHODS: Thirty-two C57BL/6 J mice were randomized into four groups: Sham, vehicle, osteolysis group with oral WDL treatment for 4 weeks (WDL 4w), and osteolysis group treated for 8 weeks (WDL 8w). Micro-CT was used to quantitatively analyze the bone mineral density (BMD), bone volume/tissue volume (BV/TV) and trabecular bone thickness (Tb.Th). Osteoclast numbers were also measured from histological slides by two investigators who were blind to the treatment used. RESULTS: The results from micro-CT observation showed that BMD in the WDL 8w group improved significantly over the vehicle group (p < 0.05), but there was no significant difference between WDL 4w and 8w for BV/TV and Tb.Th. Osteoclast numbers in the WDL 4w group were also lower than the vehicle group (p < 0.05), but the difference between WDL 8w and 4w groups was not significant. CONCLUSIONS: Particle-induced osteolysis is an inevitable long-term complication after TJR. The results of this animal study indicate that an oral administration of WDL can help reduce the severity of osteolysis without adverse effects.


Assuntos
Osteólise , Animais , Cumarínicos , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Osteólise/induzido quimicamente , Osteólise/diagnóstico por imagem , Osteólise/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Projetos de Pesquisa
15.
PLoS One ; 17(8): e0269978, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35951520

RESUMO

BACKGROUND: The association between elevated serum uric acid (UA) levels and the risk of developing colonic diverticulosis has not yet been investigated. Thus, this cross-sectional study aimed to examine this correlation in individuals from Taiwan. METHODS: From Jan. 1, 2010, to Dec. 31, 2016., approximately 5,605 patients (aged >20 years) from Tri-Service General Hospital who met the inclusion criteria according to colonoscopy and laboratory test findings were included in this research. The correlation between serum UA levels and colonic diverticulosis was investigated via regression analyses. RESULTS: Participants with elevated serum UA levels were at a higher risk of colonic diverticulosis. The area under the curve for serum UA levels was significantly higher in women than in men (0.651 [95% confidence interval: 0.596-0.707] vs. 0.55 [0.507-0.593]). There were specific trends in female-specific indicators for colonic diverticulosis across increasing quartiles of serum UA levels. CONCLUSIONS: Patients with elevated serum UA levels should be cautious regarding the development of colonic diverticulosis disorder in female. Moreover, prospective studies may provide additional information on the relationship between elevated serum UA levels and colonic diverticulosis.


Assuntos
Diverticulose Cólica , Ácido Úrico , Colonoscopia , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco
16.
Artigo em Inglês | MEDLINE | ID: mdl-35954622

RESUMO

Introduction: Sleep disorders, depression, and cancer have become increasingly prevalent worldwide. However, it is unknown whether coexistence of sleep disorders and depression influences the risk of cancer development. Therefore, we conducted a nationwide population-based study to examine this association among patients in Taiwan. Materials and Methods: A total of 105,071 individuals diagnosed with cancer and 420,284 age- and sex-matched patients without a diagnosis of cancer between 2000 and 2015 were identified from Taiwan's National Health Insurance Research Database. The underlying chronic diseases of patients that may developed cancer were gathered and studied as the predictor. A multivariate Cox proportional odds model was used to estimate the crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) to estimate the interaction effect between sleep disorders and depression on the risk of cancer. Results: After adjusting for age, sex, comorbidities, and other covariates, the cancer group was associated with increased exposure to sleep disorders than the non-cancer group (aOR = 1.440, 95% CI = 1.392−1.489, p < 0.001). In addition, patients with both sleep disorders and depression were at an even higher risk for cancer than the general population (aOR = 6.857, p < 0.001). Conclusions: This retrospective cohort study shows that patients with both sleep disorders and depression are at a higher risk of cancer. Clinically, a meticulous cancer risk evaluation is recommended for patients with both sleep disorders and depression.


Assuntos
Neoplasias , Transtornos do Sono-Vigília , Depressão/epidemiologia , Humanos , Incidência , Neoplasias/complicações , Neoplasias/epidemiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , Taiwan/epidemiologia
17.
Nanotoxicology ; 16(1): 1-15, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35085045

RESUMO

Graphene is a novel material which has recently been gaining great interest in the biomedical fields. Our previous study observed that graphene-derived particles help induce bone formation in a murine calvarial model. Here, we further developed a blended graphene-contained polycaprolactone (PCL/G) filament for application in a 3D-printed bone scaffold. Since implants are expected to be for long-term usage, in vitro cell culture and in vivo scaffold implants were evaluated in a critical-size bone defect calvarial model for over 60 weeks. Graphene greatly improved the mechanical strength by 30.2% compared to pure PCL. The fabricated PCL/G scaffolds also showed fine cell viability. In animal model, an abnormal electroencephalogram power spectrum and early signs of aging, such as hair graying and hair loss, were found in the group with a PCL/G scaffold compared to pure PCL scaffold. Neither of the abnormal symptoms caused death of all animals in both groups. The long-term use of graphene-derived biomaterials for in-vivo implants seems to be safe. But the comprehensive biosafety still needs further evaluation.


Assuntos
Grafite , Alicerces Teciduais , Animais , Materiais Biocompatíveis , Grafite/toxicidade , Camundongos , Osteogênese , Poliésteres/farmacologia , Crânio
19.
Front Psychiatry ; 12: 537137, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33613335

RESUMO

Background: The association between attention-deficit hypersensitivity disorder (ADHD) and the risk of developing colorectal cancer (CRC) is, as yet, to be investigated, and thus, we have conducted this nationwide, cohort study to examine the association in patients from Taiwan. Methods: In this study, 798 individuals with newly diagnosed ADHD and 2,394 (1:3) age-, gender-, and index year- matched controls without ADHD were enrolled, between 2000 and 2013, from the Longitudinal Health Insurance Database, a subset of the National Health Insurance Research Database in Taiwan. The cumulative incidence of CRC was assessed in each cohort by the Kaplan-Meier method. The multivariate Cox proportional hazards model was used to estimate the crude, and the adjusted hazards ratios (HRs) with 95% confidence intervals (CIs), was conducted to estimate the association between ADHD and CRC. Results: The Kaplan-Meier analysis revealed that the cumulative incidence of CRC was significantly higher in patients with ADHD than in those without it (log rank test, p < 0.001). After adjustments for age, gender, comorbidities, and other covariates, the ADHD group was associated with an increased risk of CRC in comparison to the non-ADHD group (adjusted HR = 3.458, 95% CI = 1.640-7.293, p < 0.001). In addition, the usage of methylphenidate was not associated with the risk of developing CRC in patients with ADHD. Conclusion: This retrospective cohort study depicts the evidence that ADHD was associated with the increased risk of CRC. Further studies are needed to confirm the association and the underlying mechanisms.

20.
World J Gastroenterol ; 27(22): 3121-3129, 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34168413

RESUMO

BACKGROUND: Slow transit constipation (STC) has traditionally been considered as a functional disorder. However, evidence is accumulating that suggests that most of the motility alterations in STC might be of a neuropathic etiology. If the patient does not meet the diagnosis of pelvic outlet obstruction and poorly response to conservative treatment, surgical intervention with subtotal colectomy may be effective. The most unwanted complication of the procedure is anastomotic leakage, however, preservation of the superior rectal artery (SRA) may reduce its incidence. AIM: To evaluate the preservation of the SRA in laparoscopically assisted subtotal colectomy with ileorectal anastomosis in STC patients. METHODS: This was a single-center retrospective observational study. STC was diagnosed after a series of examinations which included a colonic transit test, anal manometry, a balloon expulsion test, and a barium enema. Eligible patients underwent laparoscopically assisted total colectomy with ileorectal anastomosis and were examined between January 2016 and January 2018. The operation time, blood loss, time to first flatus, length of hospital days, and incidence of minor or major complications were recorded. RESULTS: A total of 32 patients (mean age, 42.6 years) who had received laparoscopic assisted subtotal colectomy with ileorectal artery anastomosis and preservation of the SRA. All patients were diagnosed with STC after a series of examinations. The mean operative time was 151 min and the mean blood loss was 119 mL. The mean day of first time to flatus was 3.0 d, and the mean hospital stay was 10.6 d. There were no any patients conversions to laparotomy. Post-operative minor complications including 1 wound infection and 1 case of ileus. There was no surgical mortality. No anastomosis leakage was noted in any of the patients. CONCLUSION: Laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the SRA can significantly improve bowel function with careful patient selection. Sparing the SRA may protect against anastomosis leakage.


Assuntos
Colectomia , Reto , Adulto , Anastomose Cirúrgica , Colectomia/efeitos adversos , Constipação Intestinal/etiologia , Constipação Intestinal/cirurgia , Trânsito Gastrointestinal , Humanos , Artéria Mesentérica Inferior , Reto/diagnóstico por imagem , Reto/cirurgia , Resultado do Tratamento
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