IMPORTANCE: Patients with psoriasis may experience comorbidities involving cardiovascular diseases, chronic kidney disease, uveitis, psychiatric disturbances, and metabolic syndrome. However, the ...association between psoriasis and inflammatory bowel disease (IBD) has been largely unclear. OBJECTIVE: To investigate the association of psoriasis with IBD. DATA SOURCES: For this systematic review and meta-analysis, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant studies from inception to January 17, 2018. STUDY SELECTION: Case-control, cross-sectional, or cohort studies that examined either the odds or risk of IBD in patients with psoriasis were included. No geographic or language limitations were used in the search. DATA EXTRACTION AND SYNTHESIS: The PRISMA and MOOSE guidelines were followed for data extraction. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of included studies. Crohn disease and ulcerative colitis were analyzed separately and random-effects model meta-analysis was conducted. A subgroup analysis was performed on psoriatic arthritis. MAIN OUTCOMES AND MEASURES: The risk and odds of IBD, Crohn disease, and ulcerative colitis in patients with psoriasis. RESULTS: A total of 5 case-control or cross-sectional studies and 4 cohort studies with 7 794 087 study participants were included. Significant associations were found between psoriasis and Crohn disease (odds ratio, 1.70; 95% CI, 1.20-2.40) and between psoriasis and ulcerative colitis (odds ratio, 1.75; 95% CI, 1.49-2.05). Patients with psoriasis had an increased risk of Crohn disease (risk ratio, 2.53; 95% CI, 1.65-3.89) and ulcerative colitis (risk ratio, 1.71; 95% CI, 1.55-1.89). CONCLUSIONS AND RELEVANCE: These findings suggest that psoriasis is significantly associated with IBD. Gastroenterology consultation may be indicated when patients with psoriasis present with bowel symptoms.
(1) Aim: Non-alcoholic fatty liver disease (NAFLD) is a prevalent disease worldwide. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) bear anti-inflammatory action and can ameliorate hyperlipidemia. ...We wish to appraise the effects of n-3 PUFAs supplement on NAFLD. (2) Methods: We searched CENTRAL, Embase, and MEDLINE on 29 March 2020 for randomized control trials (RCTs) on the effects of n-3 PUFAs supplementation in treating NAFLD. The Cochrane Collaboration's tool was used to assess the risk of bias of included RCTs. (3) Results: We included 22 RCTs with 1366 participants. The risk of bias of included RCTs was generally low or unclear. n-3 PUFAs supplementation significantly reduced liver fat compared with placebo (pooled risk ratio 1.52; 95% confidence interval (CI) 1.09 to 2.13). n-3 PUFAs supplementation also significantly improved the levels of triglyceride, total cholesterol, high-density lipoprotein, and body-mass index, with pooled mean difference and 95% CI being -28.57 (-40.81 to -16.33), -7.82 (-14.86 to -0.79), 3.55 (1.38 to 5.73), and -0.46 (-0.84 to -0.08), respectively. (4) Conclusions: The current evidence supports the effects of n-3 PUFAs supplementation in improving fatty liver. n-3 PUFAs supplementation may also improve blood lipid levels and obesity.
The inflammatory cytokine interleukin-6 (IL-6) is critical for the expression of octamer-binding transcription factor 4 (OCT4), which is highly associated with early tumor recurrence and poor ...prognosis of hepatocellular carcinomas (HCC). DNA methyltransferase (DNMT) family is closely linked with OCT4 expression and drug resistance. However, the underlying mechanism regarding the interplay between DNMTs and IL-6-induced OCT4 expression and the sorafenib resistance of HCC remains largely unclear.
HCC tissue samples were used to examine the association between DNMTs/OCT4 expression levels and clinical prognosis. Serum levels of IL-6 were detected using ELISA assays (n = 144). Gain- and loss-of-function experiments were performed in cell lines and mouse xenograft models to determine the underlying mechanism in vitro and in vivo.
We demonstrate that levels of DNA methyltransferase 3 beta (DNMT3b) are significantly correlated with the OCT4 levels in HCC tissues (n = 144), and the OCT4 expression levels are positively associated with the serum IL-6 levels. Higher levels of IL-6, DNMT3b, or OCT4 predicted early HCC recurrence and poor prognosis. We show that IL-6/STAT3 activation increases DNMT3b/1 and OCT4 in HCC. Activated phospho-STAT3 (STAT-Y640F) significantly increased DNMT3b/OCT4, while dominant negative phospho-STAT3 (STAT-Y705F) was suppressive. Inhibiting DNMT3b with RNA interference or nanaomycin A (a selective DNMT3b inhibitor) effectively suppressed the IL-6 or STAT-Y640F-induced increase of DNMT3b-OCT4 and ALDH activity in vitro and in vivo. The fact that OCT4 regulates the DNMT1 expressions were further demonstrated either by OCT4 forced expression or DNMT1 silence. Additionally, the DNMT3b silencing reduced the OCT4 expression in sorafenib-resistant Hep3B cells with or without IL-6 treatment. Notably, targeting DNMT3b with nanaomycin A significantly increased the cell sensitivity to sorafenib, with a synergistic combination index (CI) in sorafenib-resistant Hep3B cells.
The DNMT3b plays a critical role in the IL-6-mediated OCT4 expression and the drug sensitivity of sorafenib-resistant HCC. The p-STAT3 activation increases the DNMT3b/OCT4 which confers the tumor early recurrence and poor prognosis of HCC patients. Findings from this study highlight the significance of IL-6-DNMT3b-mediated OCT4 expressions in future therapeutic target for patients expressing cancer stemness-related properties or sorafenib resistance in HCC.
Association of psoriasis with colorectal cancer Fu, Yun; Lee, Cheng-Han; Chi, Ching-Chi
Journal of the American Academy of Dermatology,
December 2021, 2021-12-00, 20211201, Letnik:
85, Številka:
6
Journal Article
Recenzirano
The relation between psoriasis and colorectal cancer (CRC) was largely unclear.
To investigate the association of psoriasis with CRC.
A systematic review and meta-analysis of observational studies ...that examined the association of psoriasis with CRC was performed. We searched MEDLINE and Embase on March 24, 2020, for relevant studies. The Newcastle-Ottawa scale was used to evaluate the risk of bias of included studies. We conducted a random-effects model meta-analysis and subgroup analysis according to sex.
We included 9 cohort studies with 10,544,609 individuals. We found a significantly increased risk for CRC in patients with psoriasis (hazard ratio HR, 1.16; 95% confidence interval CI, 1.08-1.24). Subgroups analysis according to sex found significantly increased risk for CRC in female patients with psoriasis (HR, 1.41; 95% CI, 1.16-1.72) but not in male patients (HR, 1.18; 95% CI, 0.92-1.50).
No data on psoriatic arthritis.
Patients with psoriasis have an increased risk for CRC. Gastroenterology consultation and colonoscopic examination are indicated for patients with psoriasis presenting with bowel symptoms.
Bioelectrical impedance analysis (BIA) is a convenient and child-friendly method for longitudinal analysis of changes in body composition. However, most validation studies of BIA have been performed ...on adult Caucasians. The present cross-sectional study investigated the validity of two portable BIA devices, the Inbody 230 (BIA8MF) and the Tanita BC-418 (BIA8SF), in healthy Taiwanese children.
Children aged 7-12 years (72 boys and 78 girls) were recruited. Body composition was measured by the BIA8SF and the BIA8MF. Dual X-ray absorptiometry (DXA) was used as the reference method.
There were strong linear correlations in body composition measurements between the BIA8SF and DXA and between the BIA8MF and DXA. Both BIAs underestimated fat mass (FM) and percentage body fat (%BF) relative to DXA in both genders The degree of agreement in lean body mass (LBM), FM, and %BF estimates was higher between BIA8MF and DXA than between BIA8SF and DXA. The Lin's concordance correlation coefficient (ρc) for LBM8MF met the criteria of substantial to perfect agreement whereas the ρc for FM8MF met the criteria of fair to substantial agreement. Bland-Altman analysis showed a clinically acceptable agreement between LBM measures by BIA8MF and DXA. The limit of agreement in %BF estimation by BIA and DXA were wide and the errors were clinically important. For the estimation of ALM, BIA8SF and BIA8MF both provided poor accuracy.
For all children, LBM measures were precise and accurate using the BIA8MF whereas clinically significant errors occurred in FM and %BF estimates. Both BIAs underestimated FM and %BF in children. Thus, the body composition results obtained using the inbuilt equations of the BIA8SF and BIA8MF should be interpreted with caution, and high quality validation studies for specific subgroups of children are required prior to field research.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
IMPORTANCE: The risk of venous thromboembolism (VTE) among patients with atopic dermatitis (AD), especially when receiving treatment with Janus kinase (JAK) inhibitors, is unclear. OBJECTIVE: To ...determine the association of AD with incident VTE and evaluate the risk of incident VTE among patients with AD who were receiving treatment with JAK inhibitors. DATA SOURCES: The MEDLINE, Embase, Cochrane Library, and Web of Science databases were searched with no restrictions on language nor geographic locations from their respective inception to February 5, 2022. STUDY SELECTION: Cohort studies examining the association of AD with incident VTE and randomized clinical trials (RCTs) reporting VTE events in participants with AD receiving JAK inhibitors were included. Around 0.7% of initially identified articles met the selection criteria. DATA EXTRACTION AND SYNTHESIS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The risk of bias of included cohort studies and RCTs was assessed by the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool 2, respectively. A random-effects model meta-analysis was conducted to calculate the pooled hazard ratio (HR) and risk difference for incident VTE. MAIN OUTCOMES AND MEASURES: The HRs for incident VTE associated with AD and risk difference for incident VTE between participants with AD who were receiving treatment with JAK inhibitors and controls receiving placebo or dupilumab. RESULTS: Two cohort studies and 15 RCTs with a total of 466 993 participants were included. The meta-analysis found no significant association of AD with incident VTE (HR, 0.95; 95% CI 0.62-1.45; incidence rate of VTE, 0.23 events/100 patient-years). Overall, 3 of 5722 patients with AD (0.05%) who were receiving treatment with JAK inhibitors experienced VTE compared with 1 of 3065 patients with AD (0.03%) receiving placebo or dupilumab (Mantel-Haenszel risk difference, 0; 95% CI, 0-0). The incidence rate of VTE was 0.15 and 0.12 events per 100 patient-years in participants with AD receiving JAK inhibitors and placebo, respectively. The findings were similar in 4 unique JAK inhibitors (abrocitinib, baricitinib, upadacitinib, and SHR0302). CONCLUSIONS AND RELEVANCE: The results of this systematic review and meta-analysis suggest that the currently available evidence does not detect an increased risk of VTE associated with AD or treatment with JAK inhibitors. These findings may provide a reference for clinicians in prescribing JAK inhibitors for patients with AD.
Effects of antidiabetic drugs on psoriasis: A meta‐analysis Chi, Ching‐Chi; Lee, Chin‐Yu; Liu, Chia‐Yu ...
European journal of clinical investigation,
February 2021, 2021-Feb, 2021-02-00, 20210201, Letnik:
51, Številka:
2
Journal Article
Recenzirano
Background
Psoriasis, a chronic inflammatory skin disease, poses an elevated risk of developing diabetes mellitus.
Purpose
To investigate the effects of antidiabetic medications on psoriasis.
Data ...sources, study selection and data extraction
We conducted a systemic review and meta‐analysis and searched MEDLINE, EMBASE and CENTRAL for relevant randomized controlled trials. Our outcomes included 75% improvement in the psoriasis area and severity index from baseline (PASI 75), change in the psoriasis area and severity index (PASI) score, or change in the Dermatology Life Quality Index score under antidiabetic agents. Cochrane Collaboration's tool was used to evaluate the risk of bias of included studies. Subgroup analysis of different dosages of the antidiabetic agents was also performed.
Data synthesis
We included 10 randomized controlled studies examining the effect of antidiabetic agents. Eight studies were rated high risk of bias. Pioglitazone demonstrated significant increase in PASI 75 (risk difference = 0.42; 95% CI: 0.18‐0.65) and decrease in mean PASI (mean difference = −3.82; 95% CI: −6.05‐1.ㄍ59). In subgroup analysis, 30 mg pioglitazone group demonstrated a significantly higher portion of PASI 75 than 15 mg pioglitazone group (P = .003).
Limitations
Some biases are reported high risk in involved articles. The main limitation of the study is in the inclusion of only glitazones. The lack of effect was seen for rosiglitazone and metformin. In the case of metformin, there was only one study available, which is also an important issue.
Conclusions
The current evidence demonstrates therapeutic efficacy of pioglitazone, which may be a treatment option in patients with psoriasis and diabetes mellitus.
Early administration of appropriate antimicrobials has been correlated with a better prognosis in patients with bacteremia, but the optimum timing of early antibiotic administration as one of the ...resuscitation strategies for severe bacterial infections remains unclear.
In a retrospective cohort study, adults with community-onset bacteremia at the emergency department (ED) were analyzed. Effects of different cutoffs of time to appropriate antibiotic (TtAa) administration after arrival at the ED on 28-day mortality were examined, after adjustment for independent predictors of mortality identified by multivariate regression analysis.
Among 2349 patients, the mean (interquartile range) TtAa was 2.0 (<1 to 12) hours. All selected cutoffs of TtAa, ranging from 1 to 96 hours, were significantly associated with 28-day mortality (adjusted odds ratio (AOR), 0.54-0.65, all P < 0.001), after adjustment of the following prognostic factors: fatal comorbidities (McCabe classification), critical illness (Pitt bacteremia score (PBS) ≥4) on arrival at the ED, polymicrobial bacteremia, extended-spectrum beta-lactamase-producer bacteremia, underlying malignancies or liver cirrhosis, and bacteremia caused by pneumonia or urinary tract infections. The adverse impact of TtAa on 28-day mortality was most evident at the cutoff of 48 hours, as the lowest AOR was identified (0.54, P < 0.001). In subgroup analyses, the most evident TtAa cutoff (i.e., the lowest AOR) remained at 48 hours in mildly ill (PBS = 0; AOR 0.47; P = 0.04) and moderately ill (PBS = 1-3; AOR 0.55; P = 0.02) patients, but shifted to 1 hour in critically ill patients (PBS ≥4; AOR 0.56; P < 0.001).
The time from triage to administration of appropriate antimicrobials is one of the primary determinants of mortality. The optimum timing of appropriate antimicrobial administration is the first 48 hours after non-critically ill patients arrive at the ED. As bacteremia severity increases, effective antimicrobial therapy should be empirically prescribed within 1 hour after critically ill patients arrive at the ED.
An efficient photoelectrode is prepared by sequentially assembled CdS and CdSe quantum dots (QDs) onto a nanocrystalline TiO2 film. The CdS/CdSe co-sensitized photoelectrode was found to have a ...complementary effect in the light absorption. Furthermore, the cascade structure, TiO2/CdS/CdSe, exhibits a significant enhancement in the current−voltage response, both in dark conditions and under light illumination. On the contrary, the performance of the reverse structure, TiO2/CdSe/CdS, is much less than the electrode using a single sensitizer. The open circuit potentials measured in the dark for these electrodes indicates that a Fermi level alignment occurs between CdS and CdSe after their contact, causing downward and upward shifts of the band edges, respectively, for CdS and CdSe. A stepwise band edge structure is, therefore, constructed in the TiO2/CdS/CdSe electrode, which is responsible for the performance enhancement of this photoelectrode. The saturated photocurrent achieved by the TiO2/CdS/CdSe electrode under the illumination of UV cutoff AM1.5 (100 mW/cm2) is 14.9 mA/cm2, which is three times the value obtained by the TiO2/CdS and TiO2/CdSe electrode. When a ZnS layer is further deposited for passivating the QDs, the corresponding hydrogen evolution rate measured for the TiO2/CdS/CdSe/ZnS electrode is 220 μmol/(cm2 h) (5.4 mL/(cm2 h)). This performance is presently the highest reported for the QD-sensitized photoelectrochemical cells.
Background:
To compare the long-term clinical outcomes of different antihypertensive drugs in stable patients after acute hemorrhagic stroke (HS).
Methods:
From January 2001 to December 2013, ...patients with first-ever primary HS were identified in the National Health Insurance Research Database, Taiwan. Patients with traumatic intracerebral hemorrhage and secondary HS were excluded. Those with first-ever HS were recruited and classified into three groups: (1) angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB); (2) calcium channel blocker (CCB); and (3) other antihypertensive drugs (comparison) groups. Propensity score matching was used to balance the distribution of baseline characteristics, stroke severity, and medications between any two of the three groups. A validation study was performed using the databank of the Stroke Registry in Chang-Gung Healthcare System to reduce the bias. Primary outcomes were recurrent HS, ischemic stroke, any stroke, and all-cause mortality.
Results:
Compared to the comparison group, the ACEI/ARB group 35.4% versus 39.3%; hazard ratio (HR), 0.84; 95% confidence interval (CI), 0.74–0.95 and CCB group (33.0% versus 41.9%; HR, 0.72; 95% CI, 0.64–0.81) had a lower risk of all-cause mortality during long-term follow up. The CCB group had a similar risk of all-cause mortality to the ACEI/ARB group. Risks of recurrent HS, ischemic stroke, or any stroke were not different between the study groups.
Conclusions:
Antihypertensive drug class could be important to long-term outcomes in HS patients in addition to the target control of blood pressure. Both ACEIs/ARBs and CCBs are associated with lower risks of all-cause mortality. Our results may be applied to inform future research on hypertensive control in HS patients.
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