BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced i...BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced in assessing the severity of hepatic decompensation with the most frequent ones are Child-Pugh score,model of end-stage liver disease(MELD)score,and MELD-Na score.Anemia is frequently observed in cirrhotic patients and is linked to worsened clinical outcomes.Although studies have explored anemia in liver disease,few have investigated the correlation of hemoglobin level with the severity of hepatic decompensation.AIM To determine the relationship between hemoglobin levels and the severity of decompensated liver disease and comparing the strength of this correlation using the Child-Pugh,MELD,and MELD-Na scores.METHODS This cross-sectional study was conducted at a tertiary care hospital with 652 decompensated liver disease patients enrolled in the study.Data was collected on demographics,clinical history,and laboratory findings,including hemoglobin levels,bilirubin,albumin,prothrombin time(international normalized ratio),sodium,and creatinine.The Child-Pugh,MELD,and MELD-Na scores were calculated.Statistical analysis was performed using Statistical Package for the Social Sciences version 26,and correlations between hemoglobin levels and severity scores were assessed using Spearman's correlation coefficient.RESULTS The study included 405 males(62.1%)and 247 females(37.9%)with an average age of 58.8 years.Significant inverse correlations were found between hemoglobin levels and Child-Pugh,MELD,and MELD-Na scores(P<0.01),with the MELD scoring system being the strongest correlator among all.One-way analysis of variance revealed significant differences in hemoglobin levels across the severity groups of each scoring system(P=0.001).Tukey's post hoc analysis confirmed significant internal differences among each severity group.CONCLUSION Understanding the correlation between hemoglobin and liver disease severity can improve patient management by offering insights into prognosis and guiding treatment decisions.展开更多
To the Editor:Klebsiella pneumoniae(KP)is a common opportunistic pathogen causing potentially life-threatening illness and organ failure.Surveillance data from the 2023 China Antimicrobial Surveillance Network(CHINET)...To the Editor:Klebsiella pneumoniae(KP)is a common opportunistic pathogen causing potentially life-threatening illness and organ failure.Surveillance data from the 2023 China Antimicrobial Surveillance Network(CHINET)revealed that the KP isolation rate from clinical respiratory specimens in China was the highest(18.1%)among all bacteria.[1]Both classical(cKP)and hypervirulent KP(hvKP)exert significant effects on the systemic inflammatory response,causing infection-related anemia and high mortality to host.The main gap in current research is that the specific virulence factors of KP that cause host infectious anemia have not been identified.展开更多
We were unable to find reports in the published medical literature of any cases of bowel surgery being successfully performed at such a low hemoglobin level,without blood transfusion or blood products pre or post-surg...We were unable to find reports in the published medical literature of any cases of bowel surgery being successfully performed at such a low hemoglobin level,without blood transfusion or blood products pre or post-surgery,with the patient’s uncomplicated recovery.This study is about such a case.A patient presenting with severegastrointestinal bleeding was diagnosed with enteric fever and multiple ileal ulcers.He had an extremely low hemoglobin level(2 g/dL) and mild renal and hepatic impairment.He was immediately admitted for right hemicolectomy under general anesthesia though he refused transfusion of blood or blood products prior to,during,or after surgery on religious grounds(Jehovah’ s Witnesses).After the surgery and having survived these potentially life-threatening circumstances,he left the hospital without major complications.In such circumstances,lives may be saved by prompt clinical decision-making,collaboration and swift surgical intervention coupled with the immediate consultation and input of the patient and family.展开更多
Introduction: Artemisinin-based combination therapies are the first-line antimalarial drugs used to treat uncomplicated Plasmodium falciparum malaria in many endemic countries worldwide. In Chad, since the adoption of...Introduction: Artemisinin-based combination therapies are the first-line antimalarial drugs used to treat uncomplicated Plasmodium falciparum malaria in many endemic countries worldwide. In Chad, since the adoption of artemisinin-based combination therapy (ACTs) in its first-line treatment policy for uncomplicated malaria in 2005, Artemether-Lumefantrine and Artesunate-Amodiaquine have been used in many hospitals and health centers. The main objective of this study was to provide the baseline data of Artemether-Lumefantrine and Artesunate-Amodiaquine efficacy in three regions where many people suffered from malaria disease. Material and Methods: The baseline efficacy of two combination therapies was evaluated between January and April 2020 in Mosoro, Mondou and Dourbali Provinces in Chad. A two-arm single cohort study was conducted to assess the clinical efficacy of artesunate-amodiaquine and artemether-lumefantrine for the treatment of 1113 children aged from 6 to 59 months with uncomplicated Falciparum malariae diagnosed by thick blood smear examination, using the World Health Organization validated protocol. Results: On day 3, all patients in both groups had cleared parasitemia, after treatment, the patients presented a higher hemoglobin level in both groups artemether-lumefantrine (10.97 ± 1.39) and artesunate-amodiaquine (11.87 ± 1.81), respectively. On day 28, all patients had adequate clinical and parasitological responses with 99.82% of artesunate-amodiaquine and 99.10% of artemether-lumefantrine. Overall, both drugs were well tolerated at the clinical and biological level, no late parasitological failures have been recorded in artemether-lumefantrine and artesunate-amodiaquine groups, also both forms of Artemisinin-based combination therapy were still effective and safe in the treatment of uncomplicated P. falciparum malaria in Chad.展开更多
<strong>OBJECTIVE</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-...<strong>OBJECTIVE</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span></span><span><span><span><b><span style="font-family:""> </span></b></span></span></span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">To compare maternal preoperative and postoperative hemoglobin variation after cord clamping. </span><b><span style="font-family:Verdana;">METHODS: </span></b><span style="font-family:Verdana;">Randomized clinical trial performed in Porto Alegre, RS from January to December 2012. It was included 356 women with habitual risk gestations. In the immediate cord clamping group</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span></span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> the umbilical cord section was realized between 0 and 60 s (group 1) while in the delayed cord clamping group it was realized >60 s (group 2). </span><b><span style="font-family:Verdana;">RESULTS:</span></b><span style="font-family:Verdana;"> The mean (±standard deviation [SD]) preoperative hemoglobin was 12.13 ± 1.06 in the group 1 and 12.13 ± 1.11 in the group 2. The mean (±SD) postoperative day 2 hemoglobin level was 10.19 ± 1.46 in the group 1 and 10.24 ± 1.42 in the group 2. </span><b><span style="font-family:Verdana;">CONCLUSIONS: </span></b><span style="font-family:Verdana;">Delayed umbilical cord clamping resulted in a similar maternal hemoglobin level reduction at postoperative day 2.</span></span></span></span></span>展开更多
文摘BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced in assessing the severity of hepatic decompensation with the most frequent ones are Child-Pugh score,model of end-stage liver disease(MELD)score,and MELD-Na score.Anemia is frequently observed in cirrhotic patients and is linked to worsened clinical outcomes.Although studies have explored anemia in liver disease,few have investigated the correlation of hemoglobin level with the severity of hepatic decompensation.AIM To determine the relationship between hemoglobin levels and the severity of decompensated liver disease and comparing the strength of this correlation using the Child-Pugh,MELD,and MELD-Na scores.METHODS This cross-sectional study was conducted at a tertiary care hospital with 652 decompensated liver disease patients enrolled in the study.Data was collected on demographics,clinical history,and laboratory findings,including hemoglobin levels,bilirubin,albumin,prothrombin time(international normalized ratio),sodium,and creatinine.The Child-Pugh,MELD,and MELD-Na scores were calculated.Statistical analysis was performed using Statistical Package for the Social Sciences version 26,and correlations between hemoglobin levels and severity scores were assessed using Spearman's correlation coefficient.RESULTS The study included 405 males(62.1%)and 247 females(37.9%)with an average age of 58.8 years.Significant inverse correlations were found between hemoglobin levels and Child-Pugh,MELD,and MELD-Na scores(P<0.01),with the MELD scoring system being the strongest correlator among all.One-way analysis of variance revealed significant differences in hemoglobin levels across the severity groups of each scoring system(P=0.001).Tukey's post hoc analysis confirmed significant internal differences among each severity group.CONCLUSION Understanding the correlation between hemoglobin and liver disease severity can improve patient management by offering insights into prognosis and guiding treatment decisions.
基金supported by Beijing Key Clinical Specialty Funding(No.010071)the Clinical Cohort Construction Program of Peking University Third Hospital(No.BYSYDL2019007)+1 种基金Clinical Key Project of Peking University Third Hospital(No.BYSYZD2022007)Peking University Outstanding Doctoral Student Innovation Funding(No.BMU2024BSS001).
文摘To the Editor:Klebsiella pneumoniae(KP)is a common opportunistic pathogen causing potentially life-threatening illness and organ failure.Surveillance data from the 2023 China Antimicrobial Surveillance Network(CHINET)revealed that the KP isolation rate from clinical respiratory specimens in China was the highest(18.1%)among all bacteria.[1]Both classical(cKP)and hypervirulent KP(hvKP)exert significant effects on the systemic inflammatory response,causing infection-related anemia and high mortality to host.The main gap in current research is that the specific virulence factors of KP that cause host infectious anemia have not been identified.
文摘We were unable to find reports in the published medical literature of any cases of bowel surgery being successfully performed at such a low hemoglobin level,without blood transfusion or blood products pre or post-surgery,with the patient’s uncomplicated recovery.This study is about such a case.A patient presenting with severegastrointestinal bleeding was diagnosed with enteric fever and multiple ileal ulcers.He had an extremely low hemoglobin level(2 g/dL) and mild renal and hepatic impairment.He was immediately admitted for right hemicolectomy under general anesthesia though he refused transfusion of blood or blood products prior to,during,or after surgery on religious grounds(Jehovah’ s Witnesses).After the surgery and having survived these potentially life-threatening circumstances,he left the hospital without major complications.In such circumstances,lives may be saved by prompt clinical decision-making,collaboration and swift surgical intervention coupled with the immediate consultation and input of the patient and family.
文摘Introduction: Artemisinin-based combination therapies are the first-line antimalarial drugs used to treat uncomplicated Plasmodium falciparum malaria in many endemic countries worldwide. In Chad, since the adoption of artemisinin-based combination therapy (ACTs) in its first-line treatment policy for uncomplicated malaria in 2005, Artemether-Lumefantrine and Artesunate-Amodiaquine have been used in many hospitals and health centers. The main objective of this study was to provide the baseline data of Artemether-Lumefantrine and Artesunate-Amodiaquine efficacy in three regions where many people suffered from malaria disease. Material and Methods: The baseline efficacy of two combination therapies was evaluated between January and April 2020 in Mosoro, Mondou and Dourbali Provinces in Chad. A two-arm single cohort study was conducted to assess the clinical efficacy of artesunate-amodiaquine and artemether-lumefantrine for the treatment of 1113 children aged from 6 to 59 months with uncomplicated Falciparum malariae diagnosed by thick blood smear examination, using the World Health Organization validated protocol. Results: On day 3, all patients in both groups had cleared parasitemia, after treatment, the patients presented a higher hemoglobin level in both groups artemether-lumefantrine (10.97 ± 1.39) and artesunate-amodiaquine (11.87 ± 1.81), respectively. On day 28, all patients had adequate clinical and parasitological responses with 99.82% of artesunate-amodiaquine and 99.10% of artemether-lumefantrine. Overall, both drugs were well tolerated at the clinical and biological level, no late parasitological failures have been recorded in artemether-lumefantrine and artesunate-amodiaquine groups, also both forms of Artemisinin-based combination therapy were still effective and safe in the treatment of uncomplicated P. falciparum malaria in Chad.
文摘<strong>OBJECTIVE</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span></span><span><span><span><b><span style="font-family:""> </span></b></span></span></span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">To compare maternal preoperative and postoperative hemoglobin variation after cord clamping. </span><b><span style="font-family:Verdana;">METHODS: </span></b><span style="font-family:Verdana;">Randomized clinical trial performed in Porto Alegre, RS from January to December 2012. It was included 356 women with habitual risk gestations. In the immediate cord clamping group</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span></span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> the umbilical cord section was realized between 0 and 60 s (group 1) while in the delayed cord clamping group it was realized >60 s (group 2). </span><b><span style="font-family:Verdana;">RESULTS:</span></b><span style="font-family:Verdana;"> The mean (±standard deviation [SD]) preoperative hemoglobin was 12.13 ± 1.06 in the group 1 and 12.13 ± 1.11 in the group 2. The mean (±SD) postoperative day 2 hemoglobin level was 10.19 ± 1.46 in the group 1 and 10.24 ± 1.42 in the group 2. </span><b><span style="font-family:Verdana;">CONCLUSIONS: </span></b><span style="font-family:Verdana;">Delayed umbilical cord clamping resulted in a similar maternal hemoglobin level reduction at postoperative day 2.</span></span></span></span></span>
