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Journal of Gastrointestinal and Liver... Jun 2024The environmental factors, apart from gluten ingestion predisposing to coeliac disease are poorly known. Smoking is associated with many immune-mediated diseases, but...
BACKGROUND AND AIMS
The environmental factors, apart from gluten ingestion predisposing to coeliac disease are poorly known. Smoking is associated with many immune-mediated diseases, but research on coeliac disease is scarce. This study aims to investigate how smoking affects the clinical presentation, presence of comorbidities and response to gluten-free diet in coeliac disease.
METHODS
Altogether 815 adults with coeliac disease participated in a nationwide cross-sectional study. Participants were interviewed and smoking habits (never, former, or current smoker), clinical presentation of coeliac disease and presence of comorbidities were elicited. Serology and severity of small bowel mucosal lesions at diagnosis were gathered from the participants' medical records and follow-up serology was measured. Gastrointestinal symptoms and psychological well-being were assessed using validated questionnaires.
RESULTS
Current smokers were more often male and were diagnosed at younger ages than never or former smokers. There were no differences between the groups in clinical presentation, severity of symptoms or mucosal lesions at diagnosis or in dietary compliance and clinical, serological, and histological recovery. Musculoskeletal disorders, particularly osteoporosis and osteopenia, were more common in never smokers than in other groups (14.5% vs. 5.1% and 4.1%, p<0.001), and cardiovascular disorders were diagnosed more often in former smokers (36.2% vs. 23.5% and 21.9%, p=0.003).
CONCLUSIONS
Smoking does not seem to have an impact on the clinical presentation, severity of symptoms or mucosal damage in coeliac disease. Histological and clinical recovery as well as seroconversion on gluten-free diet are not affected by smoking status.
Topics: Humans; Celiac Disease; Male; Female; Cross-Sectional Studies; Middle Aged; Diet, Gluten-Free; Adult; Cigarette Smoking; Aged; Treatment Outcome; Comorbidity; Risk Factors; Smokers; Ex-Smokers; Intestinal Mucosa
PubMed: 38944862
DOI: 10.15403/jgld-5364 -
Advances in Gerontology = Uspekhi... 2024Communication is considered as one of the basic human needs. For a long time, loneliness and social isolation were mainly considered as a psychosocial problem. However,... (Review)
Review
Communication is considered as one of the basic human needs. For a long time, loneliness and social isolation were mainly considered as a psychosocial problem. However, in the recent years, there has been increasing evidence of the possible impact of loneliness and social isolation on the development and clinical course of somatic diseases. Research objectives were studying and analysis of current literature data about the medical consequences of loneliness and social isolation in the elderly cases. An analysis of the literature data shows that loneliness and social isolation affect not only the psycho-emotional status of elderly patients, but also their physical health. It has been shown that the number of available social connections affects the development and clinical course of diabetes mellitus, cardiovascular diseases, and outcomes of the brain stroke, immune system reactions, average life expectancy, and the risk of death caused by any causes. It has been established that the influence of social ties on the risk and clinical course of chronic non-communicable diseases is comparable to the effect of such generally accepted risk factors like smoking, alcohol consumption, physical inactivity, hypertension, obesity, hypercholesterolemia, environmental pollution, as well as various medical interventions (vaccination, drug therapy, etc.). Social isolation affects the risk of hospitalization and the frequency of outpatient care, poor socialization increases the risk of death from a heart attack. The results of the study show that loneliness and social isolation of the elderly cases have certain medical consequences that need to be taken into account when managing such patients.
Topics: Humans; Loneliness; Social Isolation; Aged; Risk Factors; Aging; Health Status
PubMed: 38944783
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024Physical activity and mindfulness techniques, such as exercise and Kapalbhati Pranayama, are known to have positive effects on health and well-being. However, limited... (Comparative Study)
Comparative Study
Comparative Analysis of the Effects of Exercise and Kapalbhati Pranayama on Heart Rate Variability and Electroencephalogram Activity: Unveiling Physiological and Cognitive Insights.
Physical activity and mindfulness techniques, such as exercise and Kapalbhati Pranayama, are known to have positive effects on health and well-being. However, limited research has directly compared their impact on physiological and psychological parameters. This study aimed to investigate and compare the effects of exercise and Kapalbhati Pranayama on Heart Rate Variability (HRV) and Electroencephalogram (EEG) activity, shedding light on their contributions to overall health and mental well-being. The study was conducted at All India Institute of Medical Sciences (AIIMS) in Bhopal, India, from 2018 to 2022. A prospective interventional design was employed over two months, involving 20 participants with normal BMI and no respiratory or cardiac conditions. Exclusion criteria included lung or cardiac diseases, smoking history, dyspnoea during physical activity, pedal edema, and high blood pressure. The Kapalbhati Pranayama intervention was supervised and limited to 5 minutes. HRV was assessed using the HRV Brain Tap Neuralchek Machine before, during, and after Kapalbhati. For exercise, a mild-intensity cycling protocol was performed on healthy volunteers aged 20 to 50. HRV was recorded before, during, and after exercise. The EEG analysis revealed notable changes in brain wave patterns. At baseline, participants exhibited higher levels of delta, theta, and alpha waves, indicating a state of relaxation and calmness. During exercise, there was a significant increase in beta waves and a decrease in delta, theta, and alpha waves, reflecting heightened brain activity and alertness. After Kapalbhati, beta wave levels remained elevated, while delta and theta wave suppression was more pronounced, suggesting a stimulating effect on the brain similar to exercise. The changes in beta and gamma EEG waves could be attributed to factors such as exercise intensity, duration, frequency, and the release of endorphins during both exercise and Kapalbhati. The HRV analysis demonstrated distinct responses to exercise and Kapalbhati. Exercise led to a significant reduction in HRV parameters, characterized by increased heart rate and decreased time-domain HRV measures, aligning with the typical sympathetic nervous system dominance during physical activity. In contrast, Kapalbhati's impact on HRV parameters was milder, with minor changes in heart rate and subtle alterations in time-domain HRV measures. The high LF/HF ratio during Kapalbhati suggested a potential stimulation of the sympathetic nervous system. More comprehensive research is required to confirm these findings and understand the long-term effects of Kapalbhati on HRV and cardiovascular health. This study contributes to the understanding of how exercise and Kapalbhati Pranayama affect both cognitive and cardiovascular aspects of health. It highlights that both interventions increase brain activity and alertness, but Kapalbhati may have a more potent effect. Exercise significantly reduces HRV parameters, indicating sympathetic nervous system dominance, while Kapalbhati has milder HRV effects. Further research with larger and more diverse populations is essential to confirm and expand on these findings, providing insights into optimizing cognitive function and cardiovascular health through tailored approaches of exercise and Kapalbhati Pranayama.
Topics: Humans; Heart Rate; Electroencephalography; Adult; Male; Exercise; Female; Prospective Studies; Middle Aged; India; Young Adult; Mindfulness; Yoga; Cognition
PubMed: 38944738
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024Obesity is associated with metabolic disorders such as dyslipidaemia, diabetes mellitus (DM), hypertension (HTN) and cardiovascular disease (CVD). There has been rising... (Observational Study)
Observational Study
Obesity is associated with metabolic disorders such as dyslipidaemia, diabetes mellitus (DM), hypertension (HTN) and cardiovascular disease (CVD). There has been rising burden of childhood and adolescent obesity in most developing countries in recent years. Changes in dietary habits, junk and fast food, physical inactivity and smoking habits increases among adolescent students, which causes obesity and simultaneously increases risk of metabolic diseases. The objective of the study is to determine the correlation between Body Mass Index (BMI) and lipid profile among adolescent students of Bangladesh. This cross-sectional observational study was conducted among 79 undergraduate healthy adolescent students, aged 10-18 years who were selected through purposive sampling. The study was conducted from July 2022 to June 2023 in urban and rural areas of Dhaka, Narayanganj and Rangpur. Data was collected using a semi-structured questionnaire. Correlation of dyslipidemia and BMI was analyzed by Pearson Coefficient. Data was analyzed using SPSS version 22.0 with level of statistical significance at p<0.05. Mean age of the respondents was 14.9±4.5 years. Male and female ratio was 2.16:1. Among respondents, 46.8% had BMI 18.5-23.0 (normal), 31.6% had BMI 23.1-25.0 (overweight) and 21.5% had BMI >25.0 (obese). Prevalence of dyslipidaemia was 34.1%. Overweight and obese respondents had raised total cholesterol (TC) level 209.51±48.6 mg/dl and 218.36±80.0 mg/dl respectively. Mean high density lipoprotein (HDL) cholesterol level was 38.91±10.51 mg/dl in overweight and 36.54±10.04 mg/dl in obese. Mean low density lipoprotein (LDL) cholesterol level was 135.23±44.5 mg/dl in overweight and 143.61±56.0 mg/dl in obese. Among obese cases, 94.1% respondents had borderline triglyceride (TG) with mean 164.46±111.0 mg/dl. Among the study respondents, overweight and obesity (higher BMI) tend to have abnormal lipid profile. It is recommended that assessment of BMI should be incorporated into school health programme and those with overweight and obesity should be subjected to routine lipogram in order to apply timely preventive as well as therapeutic measures to save lives.
Topics: Humans; Adolescent; Male; Female; Bangladesh; Body Mass Index; Cross-Sectional Studies; Child; Dyslipidemias; Students; Lipids; Pediatric Obesity; Obesity; Overweight
PubMed: 38944735
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024This study was intended to evaluate the pathological outcome of cardiopulmonary bypass whilst considering socio-demographic variables and surgical technique on early... (Observational Study)
Observational Study
This study was intended to evaluate the pathological outcome of cardiopulmonary bypass whilst considering socio-demographic variables and surgical technique on early postoperative results following coronary artery bypass graft (CABG) surgery in patients at a tertiary level hospital in Bangladesh. This observational study evaluated a total of 880 patients with ischemic heart disease in Bangabandhu Sheikh Mujib Medical University, Bangladesh from 2011 to 2019 who were undergoing an isolated CABG surgery. In this current study, the population divided into two groups- Group A: Off-pump CABG (n=440) and Group B: On-pump CABG (n=440). The mean age of the patients was 55.25±5.0 years in off-pump and 50.75±5.2 years in the on-pump group. Risk factors, including smoking, hypertension, and hyperlipidemia, were predominant in both study groups. Total operative time was notably higher in the on-pump CABG group. However, grafting time was more in the off-pump CABG procedures. Postoperative neurological deficits were higher amongst the on-pump CABG population. The mean time of mechanical ventilation, intensive care unit (ICU) stay, total hospital stay, and mortality was notably higher in the on-pump CABG group. Moreover, the number of mortalities in on-pump CABG patients was primarily due to the low output syndrome, failure of weaning from cardiopulmonary bypass (CPB) and sudden cardiac arrest. Off-pump CABG is now more acceptable due to its potentiality to avoid CPB induced complications, aortic cannulation, and cross-clamping. Cardiac arrest in on-pump CABG induces global ischemia and reperfusion injury to the cardiac muscle. Besides, the Off-pump CABG provides a conspicuous survival advantage compared to the on-pump CABG, in association with a notable reduction in postoperative morbidity and mortality.
Topics: Humans; Middle Aged; Male; Female; Bangladesh; Coronary Artery Bypass; Risk Factors; Postoperative Complications; Coronary Artery Bypass, Off-Pump; Length of Stay; Myocardial Ischemia; Operative Time; Treatment Outcome
PubMed: 38944722
DOI: No ID Found -
Updates in Surgery Jun 2024Malignancy risk calculation models were developed using the clinical and radiological features. It was aimed to compare pulmonary nodule risk calculation models and...
Malignancy risk calculation models were developed using the clinical and radiological features. It was aimed to compare pulmonary nodule risk calculation models and evaluate their effectiveness and applicability for the Turkish population. Between 2014 and 2019, 351 patients who were operated on for pulmonary nodules were evaluated with the following data: age, gender, smoking history, family history of lung cancer, extrapulmonary malignancy and granulomatous disease, nodule diameter, attenuation character, side, localization, spiculation, nodule count, presence of pulmonary emphysema, FDG uptake in PET/CT of the nodule, and definitive pathology data. Malignancy risk scores were calculated using the equations of the Brock, Mayo, and Herder models. The results were evaluated statistically. The mean age of the 351 patients (236 men, 115 women) was 57.84 ± 10.87 (range 14-79) years, and 226 malignant and 125 benign nodules were observed. Significant correlations were found between malignancy and age (p < 0.001), nodule diameter (p < 0.001), gender (p < 0.009), speculation (p < 0.001), emphysema (p < 0.05), FDG uptake (p < 0.001). All three models were found effective in the differentiation (p < 0.001). The ideal threshold value was determined for the Brock (19.5%), Mayo (23.1%), and Herder (56%) models. All models were effective for nodules of > 10 mm, but none of them were for 0-10 mm. Brock was effective in ground-glass nodules (p = 0.02) and all models were effective for semi-solid and solid nodules. None of the groups could provide AUC values as high as those achieved in the original studies. This suggests the need to optimize models and malignancy risk thresholds for Turkish population.
PubMed: 38944649
DOI: 10.1007/s13304-024-01901-8 -
Archivos de Bronconeumologia Jun 2024To estimate the cumulative incidence of COVID-19 and its determinants among a nationally representative sample of adults from Spain who smoke.
OBJECTIVE
To estimate the cumulative incidence of COVID-19 and its determinants among a nationally representative sample of adults from Spain who smoke.
METHODS
This is a prospective cohort study that uses data from two waves (Wave 2 in 2018 and Wave 3 in 2021) of the ITC EUREST-PLUS Spain Survey. At baseline (Wave 1 in 2016), all respondents were adults (aged ≥18) who smoked. In total, 1008 respondents participated in Wave 2, and 570 out of 888 eligible participants were followed up in Wave 3 (64.2%). We estimated the cumulative incidence and the relative risk of COVID-19 (RR) and 95% confidence intervals (CI) during follow-up using self-reported information on sociodemographic, smoking-related and health-related characteristics and identified associated factors using multivariable Poisson models with robust variance adjusted for the independent variables.
RESULTS
The overall cumulative incidence of self-reported COVID-19 was 5.9% (95% CI: 3.9-8.0%), with no significant differences between males (6.3%; 95% CI: 3.6-9.0%) and females (5.6%; 95% CI: 3.2-8.0%). After adjusting for age, sex, and educational level, COVID-19 incidence was positively associated with moderate nicotine dependence (RR: 2.37; 95% CI: 1.04-5.40) and negatively associated with having a partner who smoked (RR: 0.12; 95% CI: 0.03-0.42), and having friends but not a partner who smoked (RR: 0.28; 95% CI: 0.14-0.56).
CONCLUSION
The correlates of having had COVID-19 among people who smoke should be considered when tailoring information and targeted non-pharmacological preventive measures.
PubMed: 38944617
DOI: 10.1016/j.arbres.2024.05.037 -
Urologic Oncology Jun 2024Penile cancer (PeCa) is a rare disease. HPV infection, smoking, phimosis, and lichen sclerosus represent well-known associated risk factors.
BACKGROUND
Penile cancer (PeCa) is a rare disease. HPV infection, smoking, phimosis, and lichen sclerosus represent well-known associated risk factors.
OBJECTIVES
Primary aim of our study is to evaluate the incidence and risk factors of PeCa and to outline the adopted diagnostic and therapeutic approaches. Secondary aim is to investigate risk factors associated with aggressive disease and to identify the complications arising from its surgical treatment.
MATERIALS AND METHODS
We conducted a retrospective analysis using the PearlDiver™ Mariner database, from January 1, 2011, to December 31, 2021, identifying all patients diagnosed with PeCa and PeIN, evaluating comorbidities, risk factors, and social and economic conditions. We evaluated the imaging modalities employed for staging as well as the treatment strategies. Finally, we evaluated the most frequent complications associated with inguinal lymphadenectomy (ILND).
RESULTS
During the study period, 17,494 patients were diagnosed with PeCa and 5,965 with penile intraepithelial neoplasia (PeIN). US was the most frequently utilized imaging modality, followed by PET and PET/CT. Use of CT and MRI was around 5%. Surgical treatment was the predominant strategy, utilized in 31.3% of PeCa and 22.9% of PeIN. Wide Local Excision/Glansectomy emerged as the most common surgical procedures. MLR analysis identified smoking as a risk factor for metastatic PeCa (OR; 95% CI = 1.49; 1.379-1.609), HPV infections were associated with a 35% decrease in risk (OR; 95% CI = 0.65; 0.562-0.744) (all P < 0.001). Lichen sclerosus and phimosis were associated with a doubled risk of demolitive surgery. Approximately 40% of patients experienced complications associated with ILND.
CONCLUSION
Despite advances in PeCa management, there's no significant move toward more conservative treatments. Surgical treatments are still marked by high rates of complications, potentially affect the sexual and psychosocial health of patients. These issues may foster a tendency toward avoidance behaviors, contributing to a delayed clinical presentation and treatment.
PubMed: 38944595
DOI: 10.1016/j.urolonc.2024.05.013 -
Atherosclerosis Jun 2024Patients with myocardial ischemia without obstructive coronary artery disease often have coronary microvascular dysfunction (CMD) and associated increased risk of...
BACKGROUND
Patients with myocardial ischemia without obstructive coronary artery disease often have coronary microvascular dysfunction (CMD) and associated increased risk of cardiovascular (CV) events and anginal hospitalizations. Epicardial adipose tissue (EAT) covers much of the myocardium and coronary arteries and when dysfunctional, secretes proinflammatory cytokines and is associated with CV events. While oxidative stress and systemic inflammation are associated with CMD, the relationship between EAT and CMD in women is not well known.
METHODS
Women diagnosed with CMD (n = 21) who underwent coronary computed tomography with coronary artery calcium (CAC) scoring were compared to a reference group (RG) of women referred for CAC screening for preventive risk assessment (n = 181). EAT attenuation (Hounsfield units (HU)) was measured adjacent to the proximal right coronary artery, along with subcutaneous adipose tissue (SCAT). Two-sample t-tests with unequal variances were utilized.
RESULTS
Mean age of the CMD group was 56 ± 8 years and body mass index (BMI) was 31.6 ± 6.8 kg/m. CV risk factors in the CMD group were prevalent: 67 % hypertension, 44 % hyperlipidemia, and 33 % diabetes. Both CMD and RG had similar CAC score (25.86 ± 59.54 vs. 24.17 ± 104.6; p = 0.21. In the CMD group, 67 % had a CAC of 0. Minimal atherosclerosis (CAD-RADS 1) was present in 76 % of women with CMD. The CMD group had lower EAT attenuation than RG (-103.3 ± 6.33 HU vs. -97.9 ± 8.3 HU, p = 0.009, respectively). There were no differences in SCAT attenuation. Hypertension, smoking history, age, BMI, and CAC score did not correlate with EAT in either of the groups.
CONCLUSIONS
Women with CMD have decreased EAT attenuation compared to RG women. EAT-mediated inflammation and changes in vascular tone may be a mechanistic contributor to abnormal microvascular reactivity. Clinical trials testing therapeutic strategies to decrease EAT may be warranted in the management of CMD.
PubMed: 38944545
DOI: 10.1016/j.atherosclerosis.2024.118520 -
Journal of AAPOS : the Official... Jun 2024Thyroid eye disease (TED) can result in proptosis and ocular misalignment, leading to eye pain, diplopia, and vision loss. Teprotumumab, a humanized antibody against...
BACKGROUND
Thyroid eye disease (TED) can result in proptosis and ocular misalignment, leading to eye pain, diplopia, and vision loss. Teprotumumab, a humanized antibody against insulin-like growth factor 1 receptor, was approved in 2020 for the treatment of TED. The purpose of this study was to describe the effect of a full course of teprotumumab on ocular misalignment.
METHODS
The medical records of patients who underwent treatment with teprotumumab for active moderate-to-severe TED at a single institution from April 2020 to September 2023 were reviewed retroactively. Sensorimotor examination was performed at each visit using simultaneous prism-cover testing. Demographic information and previous history of radioactive iodine, steroids, strabismus surgery, and smoking were extracted from the record for analysis.
RESULTS
A total of 19 patients were treated during the study period, of whom 11 had strabismus and diplopia. The initial absolute horizontal misalignment in these 11 was 6.0 ± 1.5, vertical misalignment was 7.7 ± 2.4, and total misalignment was 11.5 ± 2.0. On completion of treatment, these measurements decreased by 2.0 ± 1.5, 2.2 ± 1.0, and 3.2 ± 1.6, respectively (P = 0.10, 0.02, and 0.04, resp.). Eight patients (73%) had a decrease in their strabismus, and 5 (46%) reported complete resolution of their diplopia at the final visit. No factors were predictive of which patients would have resolution of their misalignment. Of the remaining 3 patients who had no improvement in ocular alignment, 2 (66%) underwent strabismus surgery. Of the 8 patients with improvement of strabismus, only a single patient (13%) underwent strabismus surgery for persistent diplopia.
CONCLUSIONS
In our study cohort, a full course of teprotumumab coincided with complete resolution of diplopia in 46% of patients and a decrease in strabismus in 73% of patients.
PubMed: 38944235
DOI: 10.1016/j.jaapos.2024.103959