BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression ca...BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression can help to prevent adverse outcomes.However,there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.METHODS The cross-sectional survey was conducted in Shenzhen,China from 2020 to 2024.Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale(EPDS),with a score of≥13 indicating the presence of probable antenatal depression.Theχ2 test and binary logistic regression were used to identify the factors associated with antenatal depression.Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.RESULTS Among the 44220 pregnant women,the prevalence of probable antenatal depression was 4.4%.An age≤24 years,a lower level of education(≤12 years),low or moderate economic status,having a history of mental disorders,being in the first trimester,being a primipara,unplanned pregnancy,and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression(all P<0.05).Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms.EPDS8("sad or miserable")and EPDS4("anxious or worried")showed the highest nodal strength across groups with different risk levels.CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%.Several social and obstetric factors were identified as risk factors for antenatal depression.EPDS8("sad or miserable")and EPDS4("anxious or worried")are pivotal targets for clinical intervention to alleviate the burden of antenatal depression.Early identification of highrisk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.展开更多
BACKGROUND Rabies is a zoonotic viral disease affecting the central nervous system,caused by the rabies virus,with a case-fatality rate of 100%once symptoms appear.AIM To analyze high-risk factors associated with ment...BACKGROUND Rabies is a zoonotic viral disease affecting the central nervous system,caused by the rabies virus,with a case-fatality rate of 100%once symptoms appear.AIM To analyze high-risk factors associated with mental disorders induced by rabies vaccination and to construct a risk prediction model to inform strategies for improving patients’mental health.METHODS Patients who received rabies vaccinations at the Department of Infusion Yiwu Central Hospital between August 2024 and July 2025 were included,totaling 384 cases.Data were collected from medical records and included demographic characteristics(age,gender,occupation),lifestyle habits,and details regarding vaccine type,dosage,and injection site.The incidence of psychiatric disorders following vaccination was assessed using standardized anxiety and depression rating scales.Patients were categorized into two groups based on the presence or absence of anxiety and depression symptoms:The psychiatric disorder group and the non-psychiatric disorder group.Differences between the two groups were compared,and high-risk factors were identified using multivariate logistic regression analysis.A predictive model was then developed based on these factors to evaluate its predictive performance.RESULTS Among the 384 patients who received rabies vaccinations,36 cases(9.38%)were diagnosed with anxiety,52 cases(13.54%)with depression,and 88 cases(22.92%)with either condition.Logistic regression analysis identified the following signi ficant risk factors for psychiatric disorders:Education level of primary school or below,exposure site at the head and neck,exposure classified as grade III,family status of divorced/widowed/unmarried/living alone,number of wounds greater than one,and low awareness of rabies prevention and control(P<0.05).The risk prediction model demonstrated good performance,with an area under the receiver operating characteristic curve of 0.859,a specificity of 74.42%,and a sensitivity of 93.02%.CONCLUSION In real-world settings,psychiatric disorders following rabies vaccination are relatively common and are associated with factors such as lower education level,higher exposure severity,vulnerable family status,and limited awareness of rabies prevention and control.The developed risk prediction model may aid in early identification of high-risk individuals and support timely clinical intervention.展开更多
BACKGROUND This study aimed to compare and analyze risk factors for pancreatic fistula following pancreaticoduodenectomy(PD)using different definition criteria,and to develop a predictive model for standardized pancre...BACKGROUND This study aimed to compare and analyze risk factors for pancreatic fistula following pancreaticoduodenectomy(PD)using different definition criteria,and to develop a predictive model for standardized pancreatic fistula risk assessment.AIM To identify and compare risk factors for postoperative pancreatic fistula(POPF)following PD using both the 2005 International Study Group of Pancreatic Fistula and updated 2016 International Study Group on Pancreatic Surgery diagnostic criteria,and to develop a clinically applicable predictive model based on objective preoperative parameters for standardized pancreatic fistula risk assessment and perioperative management optimization.METHODS We conducted a retrospective analysis of 303 patients who underwent PD at CR&WISCO General Hospital between January 2017 and May 2023.POPF cases were classified according to both previous and updated diagnostic standards.For statistical analysis,we employed t-tests or Mann-Whitney U tests for continuous variables andχ^(2) tests for categorical data.To identify risk factors associated with POPF under both classification systems,we performed univariate and multivariate logistic regression analyses.RESULTS Univariate analysis identified several factors associated with POPF:Main pancreatic duct diameter(χ^(2)=31.641,P<0.001),main pancreatic duct index(χ^(2)=52.777,P<0.001),portal vein invasion(χ^(2)=6.259,P=0.012),intra-abdominal fat thickness(χ^(2)=7.665,P=0.006),preoperative biliary drainage(χ^(2)=5.999,P=0.014),pancreatic characteristics(χ^(2)=5.544,P=0.019),pancreatic resection margin thickness(t=2.055,P=0.032),pancreatic computed tomography(CT)value(t=-3.224,P=0.002),and preoperative blood amylase level(Z=-2.099,P=0.036).Multivariate logistic regression identified three independent risk factors:Main pancreatic duct index[odds ratio(OR)=0.000,95%confidence interval(CI):0.000-0.011],pancreatic cancer[OR=4.843,95%CI:1.285-18.254],and pancreatic CT value[OR=0.869,95%CI:0.806-0.937](all P<0.05).CONCLUSION The main pancreatic duct index and pancreatic CT value are strongly correlated with pancreatic fistula development after PD.展开更多
BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited rese...BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited research on contributing factors in other types of surgeries.AIM To identify the risk factors for early postoperative abnormal liver function in multiple surgery types and construct a risk prediction model.METHODS This retrospective cohort study involved 3720 surgical patients from 5 surgical departments at Guangdong Provincial Hospital of Traditional Chinese Medicine.Patients were divided into abnormal(n=108)and normal(n=3612)groups based on liver function post-surgery.Univariate analysis and LASSO regression screened variables,followed by logistic regression to identify risk factors.A prediction model was constructed based on the variables selected via logistic re-gression.The goodness-of-fit of the model was evaluated using the Hosm-er–Lemeshow test,while discriminatory ability was measured by the area under the receiver operating characteristic curve.Calibration curves were plotted to visualize the consistency between predicted probabilities and observed outcomes.RESULTS The key factors contributing to abnormal liver function after surgery include elevated aspartate aminotransferase and alanine aminotransferase levels and reduced platelet counts pre-surgery,as well as the sevoflurane use during the procedure,among others.CONCLUSION The above factors collectively represent notable risk factors for postoperative liver function injury,and the prediction model developed based on these factors demonstrates strong predictive efficacy.展开更多
BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investi...BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.AIM To compare the differences in coronary imaging between patients with T2DM with and without CHD,determine the risk factors of T2DM complicated with CHD,and establish a predictive tool for diagnosing CHD in T2DM.METHODS This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024.They are categorized based on CHD occurrence into:(1)The control group,consisting of patients with T2DM without CHD;and(2)The observation group,which includes patients with T2MD with CHD.Age,sex,smoking and drinking history,CHD family history,metformin(MET)treatment pre-admission,body mass index,fasting blood glucose(FBG),triglyceride(TG),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),serum creatinine,blood urea nitrogen(BUN),alanine aminotransferase,aspartate aminotransferase,glycosylated hemoglobin(HbA1c),and coronary imaging data of both groups were collected from the medical record system.Logistic risk analysis was conducted to screen risk factors.The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.RESULTS The control and observation groups consisted of 48 and 55 cases,respectively.The two groups were statistically different in terms of age(t=2.006,P=0.048),FBG(t=6.038,P=0.000),TG(t=2.015,P=0.047),LDL-C(t=2.017,P=0.046),and BUN(t=2.035,P=0.044).The observation group demonstrated lower proportions of patients receiving MET(χ^(2)=5.073,P=0.024)and higher proportions of patients with HbA1c of>7.0%(χ^(2)=6.980,P=0.008)than the control group.The observation group consisted of 15,17,and 23 cases of moderate stenosis,severe stenosis,and occlusion,respectively,with a greater number of coronary artery occlusion cases than the control group(χ^(2)=6.399,P=0.041).The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group(χ^(2)=15.420,P=0.000).The observation group demonstrated a higher right coronary artery(RCA)stenosis index(t=6.730,P=0.000),circumflex coronary artery(LCX)stenosis index(t=5.738,P=0.000),and total stenosis index(t=7.049,P=0.000)than the control group.FBG[odds ratio(OR)=1.472;95%confidence interval(CI):1.234-1.755;P=0.000]and HbA1c(OR=3.197;95%CI:1.149-8.896;P=0.026)were independent risk factors for T2DM complicated with CHD,whereas MET(OR=0.350;95%CI:0.129-0.952;P=0.040)was considered a protective factor for CHD in T2DM.CONCLUSION Coronary artery occlusion is a prevalent complication in patients with T2DM.Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD.FBG,HbA1c,and MET treatment history are risk factors for T2DM complicated with CHD.展开更多
Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In t...Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In total,285 patients were enrolled.Data on radioactive iodine(RAI)dosage,ultrasound indexes of the thyroid,and other clinical factors were collected.Patients were divided into NHRH and non‐NHRH(hypothyroidism or euthyroidism)groups based on treatment outcomes.Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH.Sex‐specific analyses of these risk factors were also conducted.Results:There were no significant differences between the two groups in terms of sex,thyroid shear wave elastography velocity values,or pretreatment serum free thyroxine(FT4)levels.Thyroid volume and age were independently associated with NHRH,with the odds of NHRH gradually decreasing as age increased.In subgroup analyses,both age and thyroid volume were independent risk factors for NHRH in female patients(p<0.05),while in male patients,only FT4 was independently associated with NHRH(p<0.05).Conclusions:In patients of different sexes,the influence of thyroid volume,age,and FT4 on treatment outcomes exhibits distinct patterns.展开更多
Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has f...Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has focused predominantly on the adverse aspects of risk-taking(i.e.,negative risk-taking),overlooked the positive counterpart(i.e.,positive risk-taking),and lacked a detailed examination of both.This study aims to elucidate the distinct characteristics and interrelationships of positive and negative risk-taking behaviors among adoles-cents and to identify the key factors that influence these behaviors.Through a comprehensive synthesis of theoretical and empirical literature,we explore the multifaceted nature of risk-taking,highlighting its complex influencing factors,including individual traits,family dynamics,peer influence,school environment,and broader community contexts.By identifying the shared and unique factors contributing to positive and negative risk-taking behaviors,we can enable adolescents to navigate this complex stage of life and design targeted interventions.Future research directions include the application of person-centered approaches,the implementation of longitudinal tracking and the interactive effects of influencing factors,among other aspects.展开更多
BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nu...BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.展开更多
BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatm...BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.展开更多
we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cance...we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cancer progression have recently been described in extensive clinical research,and should be included in this analysis to achieve a more accurate prognosis.These factors include inflammation,gut microbiota composition,immune status and nutritional balance,as they influence the post-surgical survival profile of patients with stage II colorectal cancer.We also address the clinical implementation and limitations of these analyses.Evaluation of the patient´s entire context is essential for selection of the most appropriate therapy.展开更多
BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postope...BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.展开更多
·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case gro...·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case group of 122 children less than two years of age with CNLDO who underwent probing and irrigation treatment at the ophthalmology department of Imam Khomeini Hospital in Ahvaz,Iran,from June 2022 to June2024.A control group of 122 age-matched children without CNLDO was also included for comparison.Data was collected from the children's medical records.·RESULTS:The study found a significant correlation between the occurrence of CNLDO and several maternal factors,such as preeclampsia,the use of levothyroxine,hypothyroidism,having more than three pregnancies(gravidity>3),natural pregnancy,and gestational diabetes mellitus.Additionally,in children,factors,such as oxygen therapy,anemia,reflux,jaundice,and a family history of CNLDO in first-degree relatives were associated with CNLDO,and maternal preeclampsia and hypothyroidism were found to significantly increase the risk of developing CNLDO in children.·CONCLUSION:Given that CNLDO affects both premature and full-term children,the present findings may potentially facilitate the early identification of children and infants at risk of nasolacrimal duct obstruction,thereby preventing the onset of chronic dacryocystitis.展开更多
Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2...Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2 days. However,untreated AMS can progress to life-threatening conditions such as high-altitude cerebral and pulmonary edema(HACE and HAPE, respectively)^([1]).展开更多
BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double c...BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.展开更多
Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco ...Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco smoking,alco-hol consumption,and unhealthy diet.CRC screening methods vary considerably between countries and depend on incidence,economic resources and healthcare structure.Important aspects of screening include adherence,which can vary signi-ficantly across ethnic and socioeconomic groups.Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colono-scopy or radiologic imaging techniques.Technological capabilities for CRC scree-ning are rapidly evolving and include stool DNA test,liquid biopsy,virtual colo-nography,and the use of artificial intelligence.A CRC prevention strategy should be comprehensive and include active patient education along with targeted imple-mentation of screening.展开更多
BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD i...BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.展开更多
Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast...Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.展开更多
Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP)...Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP) may be markedly prevalent. Researchers utilized a cross-sectional design to assess HTN prevalence and its risk factors among college students (N = 123). Self-administered surveys comprising four validated questionnaires: the Perceived Stress Scale (PSS), Rapid Eating Assessment for Participants-Shortened (REAPS), Dietary Approaches to Stop Hypertension Quality (DASH-Q), and the U.S. Adult Food Security Survey (FSS) were employed. Additionally, physical measurements were conducted, including height, weight, waist circumference (WC), and BP. Results indicated that 71.6% of students had elevated BP, with 24.4% classified as Stage 1 HTN and 23.6% as Stage 2 HTN. Notably, 60% of students reported low adherence to the DASH diet and a mean REAPS score of 26.3 out of 39. Students experiencing marginal food security had higher systolic blood pressure (SBP) 131.7 ± 16.8 mm Hg compared to those with high food security 123.03 ± 11.7 mm Hg (p = 0.028). Furthermore, REAPS scores showed a negative correlation with diastolic blood pressure (DBP) (β = −0.201, p = 0.03). Significant predictors for SBP included WC (β = 0.40, p β = −0.33, p β = 0.16, p = 0.046). The findings highlight the need for BP screenings and nutrition education programs to improve dietary habits among college students, which may help reduce HTN and its associated long-term risks for CVD.展开更多
Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in ...Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in women aged 40 and under. Materials and Methods: This was a case-control study with exhaustive sampling of all respondents with histological proof over a 12-month period, matched by age. For all statistical tests, we used a significance threshold of 5%. Additionally provided are the ORs and their 95% confidence intervals, the mean, and standard deviation. Results: We collected 65 cases and 130 controls. The frequency of breast cancer in women aged 40 and under was 35.5%. The mean age was 35.6 ± 4.5 years among cases compared to 32.1 ± 7.9 years among controls. A significantly positive association was detected in both univariate and multivariate analysis between age and breast cancer [(OR) = 10.30;95% CI (1.99 - 53.23)] and [(OR) = 7.53;95% CI (1.82 - 31.23)];family history of breast cancer and breast cancer [(OR) = 9.99;95% CI (1.43 - 69.58)];smoking and breast cancer [OR = 13.11;95% CI (1.05 - 163.30)];sedentary lifestyle and breast cancer [OR = 3.36;95% CI (1.01 - 11.17)];and night work and breast cancer [(OR) = 72.05;95% CI (8.15 - 637.25)]. Conclusion: Earlier systematic screening and regular follow-up should be conducted in young women in our context.展开更多
Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year....Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year. The etiology of NEC is not yet clear, and it may be the result of multiple risk factors working together, such as premature birth, infection, formula feeding, ischemia, hypoxia, dysbiosis of intestinal flora, and immune damage. Additionally, recent reports have documented factors such as immunoglobulin treatment for hemolytic jaundice, blood transfusion therapy, and rapid achievement of adequate feeding. This article comprehensively analyzes the current research progress on high-risk factors of NEC, and provides a reference for future prevention, diagnosis, and treatment directions.展开更多
基金Supported by the Joint Funds of the National Natural Science Foundation of China,No.U23A20434National Natural Science Foundation of China,No.82301738,No.82371535,and No.82171518+1 种基金the National Key Research and Development Program of China,No.2021YFF1201204the Science and Technology Innovation Program of Hunan Province,No.2023RC3083.
文摘BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression can help to prevent adverse outcomes.However,there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.METHODS The cross-sectional survey was conducted in Shenzhen,China from 2020 to 2024.Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale(EPDS),with a score of≥13 indicating the presence of probable antenatal depression.Theχ2 test and binary logistic regression were used to identify the factors associated with antenatal depression.Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.RESULTS Among the 44220 pregnant women,the prevalence of probable antenatal depression was 4.4%.An age≤24 years,a lower level of education(≤12 years),low or moderate economic status,having a history of mental disorders,being in the first trimester,being a primipara,unplanned pregnancy,and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression(all P<0.05).Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms.EPDS8("sad or miserable")and EPDS4("anxious or worried")showed the highest nodal strength across groups with different risk levels.CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%.Several social and obstetric factors were identified as risk factors for antenatal depression.EPDS8("sad or miserable")and EPDS4("anxious or worried")are pivotal targets for clinical intervention to alleviate the burden of antenatal depression.Early identification of highrisk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.
基金Supported by the 2024 Yiwu City Research Plan Project,No.24-3-102.
文摘BACKGROUND Rabies is a zoonotic viral disease affecting the central nervous system,caused by the rabies virus,with a case-fatality rate of 100%once symptoms appear.AIM To analyze high-risk factors associated with mental disorders induced by rabies vaccination and to construct a risk prediction model to inform strategies for improving patients’mental health.METHODS Patients who received rabies vaccinations at the Department of Infusion Yiwu Central Hospital between August 2024 and July 2025 were included,totaling 384 cases.Data were collected from medical records and included demographic characteristics(age,gender,occupation),lifestyle habits,and details regarding vaccine type,dosage,and injection site.The incidence of psychiatric disorders following vaccination was assessed using standardized anxiety and depression rating scales.Patients were categorized into two groups based on the presence or absence of anxiety and depression symptoms:The psychiatric disorder group and the non-psychiatric disorder group.Differences between the two groups were compared,and high-risk factors were identified using multivariate logistic regression analysis.A predictive model was then developed based on these factors to evaluate its predictive performance.RESULTS Among the 384 patients who received rabies vaccinations,36 cases(9.38%)were diagnosed with anxiety,52 cases(13.54%)with depression,and 88 cases(22.92%)with either condition.Logistic regression analysis identified the following signi ficant risk factors for psychiatric disorders:Education level of primary school or below,exposure site at the head and neck,exposure classified as grade III,family status of divorced/widowed/unmarried/living alone,number of wounds greater than one,and low awareness of rabies prevention and control(P<0.05).The risk prediction model demonstrated good performance,with an area under the receiver operating characteristic curve of 0.859,a specificity of 74.42%,and a sensitivity of 93.02%.CONCLUSION In real-world settings,psychiatric disorders following rabies vaccination are relatively common and are associated with factors such as lower education level,higher exposure severity,vulnerable family status,and limited awareness of rabies prevention and control.The developed risk prediction model may aid in early identification of high-risk individuals and support timely clinical intervention.
文摘BACKGROUND This study aimed to compare and analyze risk factors for pancreatic fistula following pancreaticoduodenectomy(PD)using different definition criteria,and to develop a predictive model for standardized pancreatic fistula risk assessment.AIM To identify and compare risk factors for postoperative pancreatic fistula(POPF)following PD using both the 2005 International Study Group of Pancreatic Fistula and updated 2016 International Study Group on Pancreatic Surgery diagnostic criteria,and to develop a clinically applicable predictive model based on objective preoperative parameters for standardized pancreatic fistula risk assessment and perioperative management optimization.METHODS We conducted a retrospective analysis of 303 patients who underwent PD at CR&WISCO General Hospital between January 2017 and May 2023.POPF cases were classified according to both previous and updated diagnostic standards.For statistical analysis,we employed t-tests or Mann-Whitney U tests for continuous variables andχ^(2) tests for categorical data.To identify risk factors associated with POPF under both classification systems,we performed univariate and multivariate logistic regression analyses.RESULTS Univariate analysis identified several factors associated with POPF:Main pancreatic duct diameter(χ^(2)=31.641,P<0.001),main pancreatic duct index(χ^(2)=52.777,P<0.001),portal vein invasion(χ^(2)=6.259,P=0.012),intra-abdominal fat thickness(χ^(2)=7.665,P=0.006),preoperative biliary drainage(χ^(2)=5.999,P=0.014),pancreatic characteristics(χ^(2)=5.544,P=0.019),pancreatic resection margin thickness(t=2.055,P=0.032),pancreatic computed tomography(CT)value(t=-3.224,P=0.002),and preoperative blood amylase level(Z=-2.099,P=0.036).Multivariate logistic regression identified three independent risk factors:Main pancreatic duct index[odds ratio(OR)=0.000,95%confidence interval(CI):0.000-0.011],pancreatic cancer[OR=4.843,95%CI:1.285-18.254],and pancreatic CT value[OR=0.869,95%CI:0.806-0.937](all P<0.05).CONCLUSION The main pancreatic duct index and pancreatic CT value are strongly correlated with pancreatic fistula development after PD.
基金Supported by Guangdong Provincial Hospital of Chinese Medicine Science and Technology Research Special Project,No.YN2023WSSQ01State Key Laboratory of Traditional Chinese Medicine Syndrome.
文摘BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited research on contributing factors in other types of surgeries.AIM To identify the risk factors for early postoperative abnormal liver function in multiple surgery types and construct a risk prediction model.METHODS This retrospective cohort study involved 3720 surgical patients from 5 surgical departments at Guangdong Provincial Hospital of Traditional Chinese Medicine.Patients were divided into abnormal(n=108)and normal(n=3612)groups based on liver function post-surgery.Univariate analysis and LASSO regression screened variables,followed by logistic regression to identify risk factors.A prediction model was constructed based on the variables selected via logistic re-gression.The goodness-of-fit of the model was evaluated using the Hosm-er–Lemeshow test,while discriminatory ability was measured by the area under the receiver operating characteristic curve.Calibration curves were plotted to visualize the consistency between predicted probabilities and observed outcomes.RESULTS The key factors contributing to abnormal liver function after surgery include elevated aspartate aminotransferase and alanine aminotransferase levels and reduced platelet counts pre-surgery,as well as the sevoflurane use during the procedure,among others.CONCLUSION The above factors collectively represent notable risk factors for postoperative liver function injury,and the prediction model developed based on these factors demonstrates strong predictive efficacy.
基金Supported by the Science and Technology Major Project of Changzhou Science and Technology Bureau,No.CE20205047Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01F52Changzhou A Major Scientific Research Project of the Municipal Health Commission,No.ZD202220.
文摘BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.AIM To compare the differences in coronary imaging between patients with T2DM with and without CHD,determine the risk factors of T2DM complicated with CHD,and establish a predictive tool for diagnosing CHD in T2DM.METHODS This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024.They are categorized based on CHD occurrence into:(1)The control group,consisting of patients with T2DM without CHD;and(2)The observation group,which includes patients with T2MD with CHD.Age,sex,smoking and drinking history,CHD family history,metformin(MET)treatment pre-admission,body mass index,fasting blood glucose(FBG),triglyceride(TG),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),serum creatinine,blood urea nitrogen(BUN),alanine aminotransferase,aspartate aminotransferase,glycosylated hemoglobin(HbA1c),and coronary imaging data of both groups were collected from the medical record system.Logistic risk analysis was conducted to screen risk factors.The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.RESULTS The control and observation groups consisted of 48 and 55 cases,respectively.The two groups were statistically different in terms of age(t=2.006,P=0.048),FBG(t=6.038,P=0.000),TG(t=2.015,P=0.047),LDL-C(t=2.017,P=0.046),and BUN(t=2.035,P=0.044).The observation group demonstrated lower proportions of patients receiving MET(χ^(2)=5.073,P=0.024)and higher proportions of patients with HbA1c of>7.0%(χ^(2)=6.980,P=0.008)than the control group.The observation group consisted of 15,17,and 23 cases of moderate stenosis,severe stenosis,and occlusion,respectively,with a greater number of coronary artery occlusion cases than the control group(χ^(2)=6.399,P=0.041).The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group(χ^(2)=15.420,P=0.000).The observation group demonstrated a higher right coronary artery(RCA)stenosis index(t=6.730,P=0.000),circumflex coronary artery(LCX)stenosis index(t=5.738,P=0.000),and total stenosis index(t=7.049,P=0.000)than the control group.FBG[odds ratio(OR)=1.472;95%confidence interval(CI):1.234-1.755;P=0.000]and HbA1c(OR=3.197;95%CI:1.149-8.896;P=0.026)were independent risk factors for T2DM complicated with CHD,whereas MET(OR=0.350;95%CI:0.129-0.952;P=0.040)was considered a protective factor for CHD in T2DM.CONCLUSION Coronary artery occlusion is a prevalent complication in patients with T2DM.Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD.FBG,HbA1c,and MET treatment history are risk factors for T2DM complicated with CHD.
基金suported by the National High Level Hospital Clinical Research Funding(2022-NHLHCRF-LX-02-03,2023-NHLHCRF-YXHZ-ZRZD-06)Ministry ofScience and Technology of the People's Republic ofChina,and National Natural Science Foundation ofChina(82071943,82273523).
文摘Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In total,285 patients were enrolled.Data on radioactive iodine(RAI)dosage,ultrasound indexes of the thyroid,and other clinical factors were collected.Patients were divided into NHRH and non‐NHRH(hypothyroidism or euthyroidism)groups based on treatment outcomes.Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH.Sex‐specific analyses of these risk factors were also conducted.Results:There were no significant differences between the two groups in terms of sex,thyroid shear wave elastography velocity values,or pretreatment serum free thyroxine(FT4)levels.Thyroid volume and age were independently associated with NHRH,with the odds of NHRH gradually decreasing as age increased.In subgroup analyses,both age and thyroid volume were independent risk factors for NHRH in female patients(p<0.05),while in male patients,only FT4 was independently associated with NHRH(p<0.05).Conclusions:In patients of different sexes,the influence of thyroid volume,age,and FT4 on treatment outcomes exhibits distinct patterns.
基金Soft Science Special Project of Gansu Basic Research Plan,No.25JRZA072Youth Project of Philosophy and Social Science Foundation of Gansu Province,No.2024QN015+1 种基金General Project of Philosophy and Social Science Foundation of Gansu Province,No.2024YB049Lanzhou Philosophy and Social Science Planning Project,No.24-B13.
文摘Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has focused predominantly on the adverse aspects of risk-taking(i.e.,negative risk-taking),overlooked the positive counterpart(i.e.,positive risk-taking),and lacked a detailed examination of both.This study aims to elucidate the distinct characteristics and interrelationships of positive and negative risk-taking behaviors among adoles-cents and to identify the key factors that influence these behaviors.Through a comprehensive synthesis of theoretical and empirical literature,we explore the multifaceted nature of risk-taking,highlighting its complex influencing factors,including individual traits,family dynamics,peer influence,school environment,and broader community contexts.By identifying the shared and unique factors contributing to positive and negative risk-taking behaviors,we can enable adolescents to navigate this complex stage of life and design targeted interventions.Future research directions include the application of person-centered approaches,the implementation of longitudinal tracking and the interactive effects of influencing factors,among other aspects.
文摘BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.
文摘BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.
基金Supported by Consejo Nacional de Investigaciones Científicas y Técnicas,No.PIP11220200103061COAgencia Nacional de promoción Científica y Tecnológica,No.PICT-2020-SERIEA-03440Universidad Nacional del Sur,No.PGI 24/B303 and No.PGI 24/ZB01.
文摘we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cancer progression have recently been described in extensive clinical research,and should be included in this analysis to achieve a more accurate prognosis.These factors include inflammation,gut microbiota composition,immune status and nutritional balance,as they influence the post-surgical survival profile of patients with stage II colorectal cancer.We also address the clinical implementation and limitations of these analyses.Evaluation of the patient´s entire context is essential for selection of the most appropriate therapy.
文摘BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.
文摘·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case group of 122 children less than two years of age with CNLDO who underwent probing and irrigation treatment at the ophthalmology department of Imam Khomeini Hospital in Ahvaz,Iran,from June 2022 to June2024.A control group of 122 age-matched children without CNLDO was also included for comparison.Data was collected from the children's medical records.·RESULTS:The study found a significant correlation between the occurrence of CNLDO and several maternal factors,such as preeclampsia,the use of levothyroxine,hypothyroidism,having more than three pregnancies(gravidity>3),natural pregnancy,and gestational diabetes mellitus.Additionally,in children,factors,such as oxygen therapy,anemia,reflux,jaundice,and a family history of CNLDO in first-degree relatives were associated with CNLDO,and maternal preeclampsia and hypothyroidism were found to significantly increase the risk of developing CNLDO in children.·CONCLUSION:Given that CNLDO affects both premature and full-term children,the present findings may potentially facilitate the early identification of children and infants at risk of nasolacrimal duct obstruction,thereby preventing the onset of chronic dacryocystitis.
文摘Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2 days. However,untreated AMS can progress to life-threatening conditions such as high-altitude cerebral and pulmonary edema(HACE and HAPE, respectively)^([1]).
基金Supported by the Health Technology Project of Pudong New District Health Commission,No.PW2020D-12.
文摘BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.
文摘Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco smoking,alco-hol consumption,and unhealthy diet.CRC screening methods vary considerably between countries and depend on incidence,economic resources and healthcare structure.Important aspects of screening include adherence,which can vary signi-ficantly across ethnic and socioeconomic groups.Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colono-scopy or radiologic imaging techniques.Technological capabilities for CRC scree-ning are rapidly evolving and include stool DNA test,liquid biopsy,virtual colo-nography,and the use of artificial intelligence.A CRC prevention strategy should be comprehensive and include active patient education along with targeted imple-mentation of screening.
基金Supported by National Key Research and Development Program of China,No.2022YFC3600903Key Discipline Project under Shanghai's Three-Year Action Plan for Strengthening the Public Health System(2023-2025),No.GWVI-11.1-44.
文摘BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.
文摘Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.
文摘Early onset of hypertension (HTN) raises the risk of cardiovascular disease (CVD), the leading cause of death in the U.S. For university students who do not follow healthy diets or lifestyles, high blood pressure (BP) may be markedly prevalent. Researchers utilized a cross-sectional design to assess HTN prevalence and its risk factors among college students (N = 123). Self-administered surveys comprising four validated questionnaires: the Perceived Stress Scale (PSS), Rapid Eating Assessment for Participants-Shortened (REAPS), Dietary Approaches to Stop Hypertension Quality (DASH-Q), and the U.S. Adult Food Security Survey (FSS) were employed. Additionally, physical measurements were conducted, including height, weight, waist circumference (WC), and BP. Results indicated that 71.6% of students had elevated BP, with 24.4% classified as Stage 1 HTN and 23.6% as Stage 2 HTN. Notably, 60% of students reported low adherence to the DASH diet and a mean REAPS score of 26.3 out of 39. Students experiencing marginal food security had higher systolic blood pressure (SBP) 131.7 ± 16.8 mm Hg compared to those with high food security 123.03 ± 11.7 mm Hg (p = 0.028). Furthermore, REAPS scores showed a negative correlation with diastolic blood pressure (DBP) (β = −0.201, p = 0.03). Significant predictors for SBP included WC (β = 0.40, p β = −0.33, p β = 0.16, p = 0.046). The findings highlight the need for BP screenings and nutrition education programs to improve dietary habits among college students, which may help reduce HTN and its associated long-term risks for CVD.
文摘Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in women aged 40 and under. Materials and Methods: This was a case-control study with exhaustive sampling of all respondents with histological proof over a 12-month period, matched by age. For all statistical tests, we used a significance threshold of 5%. Additionally provided are the ORs and their 95% confidence intervals, the mean, and standard deviation. Results: We collected 65 cases and 130 controls. The frequency of breast cancer in women aged 40 and under was 35.5%. The mean age was 35.6 ± 4.5 years among cases compared to 32.1 ± 7.9 years among controls. A significantly positive association was detected in both univariate and multivariate analysis between age and breast cancer [(OR) = 10.30;95% CI (1.99 - 53.23)] and [(OR) = 7.53;95% CI (1.82 - 31.23)];family history of breast cancer and breast cancer [(OR) = 9.99;95% CI (1.43 - 69.58)];smoking and breast cancer [OR = 13.11;95% CI (1.05 - 163.30)];sedentary lifestyle and breast cancer [OR = 3.36;95% CI (1.01 - 11.17)];and night work and breast cancer [(OR) = 72.05;95% CI (8.15 - 637.25)]. Conclusion: Earlier systematic screening and regular follow-up should be conducted in young women in our context.
文摘Necrotizing enterocolitis (NEC) in newborns is one of the life-threatening diseases. With the continuous advancement of perinatal medicine and neonatal intensive care technology, NEC has been on the rise year by year. The etiology of NEC is not yet clear, and it may be the result of multiple risk factors working together, such as premature birth, infection, formula feeding, ischemia, hypoxia, dysbiosis of intestinal flora, and immune damage. Additionally, recent reports have documented factors such as immunoglobulin treatment for hemolytic jaundice, blood transfusion therapy, and rapid achievement of adequate feeding. This article comprehensively analyzes the current research progress on high-risk factors of NEC, and provides a reference for future prevention, diagnosis, and treatment directions.
