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
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
目的分析2型糖尿病患者血清肿瘤坏死因子受体相关因子3(TRAF3)的表达水平与胰岛功能和胰岛素抵抗(IR)的相关性。方法选取2022年8月至2023年12月收治的148例2型糖尿病患者,根据胰岛素抵抗指数(HOMA-IR)值分为无IR组75例和IR组73例;另选8...目的分析2型糖尿病患者血清肿瘤坏死因子受体相关因子3(TRAF3)的表达水平与胰岛功能和胰岛素抵抗(IR)的相关性。方法选取2022年8月至2023年12月收治的148例2型糖尿病患者,根据胰岛素抵抗指数(HOMA-IR)值分为无IR组75例和IR组73例;另选80例同期体检健康者作为对照组。酶联免疫吸附法测定血清TRAF3的表达水平;Pearson和Spearman法分析血清TRAF3表达水平与空腹胰岛素(FINS)、餐后2 h血糖(2 h PG)、胰岛β细胞功能指数(HOMA-β)、胰岛素敏感指数(ISI)相关性;多元线性回归分析2型糖尿病患者发生IR的影响因素;受试者工作特征(ROC)曲线分析血清TRAF3表达水平对2型糖尿病患者IR的预测价值。结果2型糖尿病患者血清TRAF3水平高于体检健康者,无IR组患者血清TRAF3水平低于IR组(P<0.01)。2型糖尿病患者无IR组和IR组FINS、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、2 h PG、HOMA-IR、HOMA-β、ISI比较差异有统计学意义(P<0.05,P<0.01);2型糖尿病患者血清TRAF3水平与FINS、2 h PG、HOMA-β、FPG呈显著正相关(P<0.05);多元线性回归分析结果显示,TRAF3、FINS、FPG、2 h PG、LDL-C、HbA1c均为2型糖尿病患者IR的影响因素(P<0.05,P<0.01);ROC曲线分析结果显示,血清TRAF3表达水平评估2型糖尿病患者IR的曲线下面积为0.818,敏感度和特异度分别为78.08%和73.00%。结论血清TRAF3表达水平与2型糖尿病患者胰岛功能和IR密切相关。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.
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.
文摘目的分析2型糖尿病患者血清肿瘤坏死因子受体相关因子3(TRAF3)的表达水平与胰岛功能和胰岛素抵抗(IR)的相关性。方法选取2022年8月至2023年12月收治的148例2型糖尿病患者,根据胰岛素抵抗指数(HOMA-IR)值分为无IR组75例和IR组73例;另选80例同期体检健康者作为对照组。酶联免疫吸附法测定血清TRAF3的表达水平;Pearson和Spearman法分析血清TRAF3表达水平与空腹胰岛素(FINS)、餐后2 h血糖(2 h PG)、胰岛β细胞功能指数(HOMA-β)、胰岛素敏感指数(ISI)相关性;多元线性回归分析2型糖尿病患者发生IR的影响因素;受试者工作特征(ROC)曲线分析血清TRAF3表达水平对2型糖尿病患者IR的预测价值。结果2型糖尿病患者血清TRAF3水平高于体检健康者,无IR组患者血清TRAF3水平低于IR组(P<0.01)。2型糖尿病患者无IR组和IR组FINS、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、2 h PG、HOMA-IR、HOMA-β、ISI比较差异有统计学意义(P<0.05,P<0.01);2型糖尿病患者血清TRAF3水平与FINS、2 h PG、HOMA-β、FPG呈显著正相关(P<0.05);多元线性回归分析结果显示,TRAF3、FINS、FPG、2 h PG、LDL-C、HbA1c均为2型糖尿病患者IR的影响因素(P<0.05,P<0.01);ROC曲线分析结果显示,血清TRAF3表达水平评估2型糖尿病患者IR的曲线下面积为0.818,敏感度和特异度分别为78.08%和73.00%。结论血清TRAF3表达水平与2型糖尿病患者胰岛功能和IR密切相关。
