مرض الكبد الدهني غير الكحولي هو مصدر قلق كبير في الصحة العامة، ولكن تأثيره على نوعية الحياة لم يتم التحقيق فيه بشكل كاف. تقيم هذه الدراسة تأثير العلاج القياسي لمرض الكبد الدهني غير الكحولي على نوعية ...حياة المرضى المصابين.
أجريت هذه الدراسة المستقبلية على المرضى الذين يعانون من مرض الكبد الدهني غير الكحولي، المراجعين لعيادة أمراض الجهاز الهضمي في مستشفى سينا طهران. خضع جميع المرضى لبروتوكول علاج قياسي. وتم تقييم المعالم الديموغرافية والمادية والبيوكيميائية، ودرجة الدهون في مرض الكبد الدهني غير الكحولي، ونوعية درجات الحياة من خلال استبانة منظمة الصحة العالمية بشأن جودة الحياة واستبانة أمراض الكبد المزمنة عند خط الأساس، بعد ثلاثة وستة أشهر من العلاج. تم تصنيف المرضى إلى مجموعتين; فقدان الوزن (>٥٪) وفقدان الوزن غير كبير (<٥٪)، ستة أشهر بعد بدء العلاج.
تم تقييم ما مجموعه ٤٠٠ مريضا (٥٢.١٪ من النساء، ومتوسط العمر ٤٩.٩٣±٣.٠١سنة). لاحظنا أن ١٢٧ مريضا حققوا خسارة كبيرة في الوزن (٣١.٧٥٪) خلال فترة ٦ أشهر، في حين أن ٢٧٣ مريضا لم يحققوا هدف فقدان الوزن (٦٨.٢٥٪). ولم توجد فروق كبيرة بين الفئات في المعالم الديمغرافية. وقد أظهرت استبانة منظمة الصحة العالمية بشأن جودة الحياة واستبانة أمراض الكبد المزمنة تحسينات كبيرة في مجموعة "فقدان الوزن بشكل كبير" مقارنة بمجموعة "فقدان بسيط للوزن". وأظهر تحليل الانحدار أن درجة الدهون في مرض الكبد الدهني غير الكحولي وتحليل ناقلة أمين الألانين الأساسية كانت مرتبطة بشكل كبير بنتائج استبانة منظمة الصحة العالمية بشأن جودة الحياة. وارتبطت نتائج استبانة أمراض الكبد المزمنة بشكل كبير بمرحلة التليف، ودرجة نشاط مرض الكبد الدهني غير الكحولي ووجود داء السكري.
خلصت هذه الدراسة إلى أن نظام العلاج القياسي وفقدان الوزن يمكن أن يحسن بشكل كبير من نوعية الحياة في مرضى مرض الكبد الدهني غير الكحولي.
Given that non-alcoholic fatty liver disease (NAFLD) is a major concern in public health, this study evaluates the impact of a standard treatment for NAFLD on the quality of life of affected patients.
We conducted this study on patients suffering from NAFLD at the gastroenterology clinic of Sina Hospital, Tehran. All patients underwent a standard treatment protocol. We collected information about the demographic, physical, biochemical parameters and the NAFLD fat and quality of life scores using the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and Chronic Liver Disease Questionnaire (CLDQ) and evaluated the data at the baseline, three months, and six months post-treatment. Patients were categorized into two groups, namely those with significant weight loss (>5%) and non-significant weight loss (<5%) six months after the start of the treatment. The statistical analysis was performed via SPSS 22.
A total of 400 patients (52.1% women, mean age of 49.93 ± 3.01 years) were evaluated. We noticed that 127 patients achieved significant weight loss (31.75%) during the six-month period, while 273 patients did not achieve the weight loss goal (68.25%). No significant differences in demographic parameters were found between the groups. As per the WHOQOL-BREF questionnaire and CLDQ, there were significant improvements in the significant weight loss group compared to the non-significant weight loss group. Regression analysis showed that the NAFLD fat scores and baseline alanine aminotransferase (ALT) levels were significantly correlated with WHOQOL-BREF outcomes. The CLDQ outcomes were significantly associated with the fibrosis stage, NAFLD activity score, and the presence of diabetes mellitus.
This study concludes that a standard treatment protocol and weight loss regime can significantly improve the quality of life of NAFLD patients.
Palisaded neutrophilic and granulomatous dermatitis (PNGD) is characterized by erythematous papules or plaques on trunk or limbs and is frequently associated with rheumatological, autoimmune or ...hematological malignancies. Histopathology shows interstitial granulomas composed of epitheloid histiocytes in the reticular dermis with surrounding foci of collagen degeneration and variable neutrophilic inflammation. We report three cases of generalized PNGD associated with chronic myelomonocytic leukemia (CMML), a myelodysplastic/myeloproliferative neoplasm, which may show a variety of cutaneous manifestations. SRSF2 P95 hotspot mutations, found in 40–50% of CMML cases, were retrospectively detected in skin and bone marrow (BM) biopsies of all three patients, in one of them already five years before CMML diagnosis. Generalized PNGD may represent a type of cutaneous manifestation of CMML. Since diagnosis of CMML is frequently difficult in cases with isolated persistent monocytosis and minimal dysplasia in the BM, patients with a generalized PNGD should be evaluated for the presence of hematological disorders including CMML, ideally supported by mutational analyses.
Background The Nod-like receptor NACHT, LRR, and PYD domain–containing protein 3 (NLRP3) and Bruton tyrosine kinase (BTK) are protagonists in innate and adaptive immunity, respectively. NLRP3 senses ...exogenous and endogenous insults, leading to inflammasome activation, which occurs spontaneously in patients with Muckle-Wells syndrome; BTK mutations cause the genetic immunodeficiency X-linked agammaglobulinemia (XLA). However, to date, few proteins that regulate NLRP3 inflammasome activity in human primary immune cells have been identified, and clinically promising pharmacologic targeting strategies remain elusive. Objective We sought to identify novel regulators of the NLRP3 inflammasome in human cells with a view to exploring interference with inflammasome activity at the level of such regulators. Methods After proteome-wide phosphoproteomics, the identified novel regulator BTK was studied in human and murine cells by using pharmacologic and genetic BTK ablation. Results Here we show that BTK is a critical regulator of NLRP3 inflammasome activation: pharmacologic (using the US Food and Drug Administration–approved inhibitor ibrutinib) and genetic (in patients with XLA and Btk knockout mice) BTK ablation in primary immune cells led to reduced IL-1β processing and secretion in response to nigericin and the Staphylococcus aureus toxin leukocidin AB (LukAB). BTK affected apoptosis-associated speck-like protein containing a CARD (ASC) speck formation and caspase-1 cleavage and interacted with NLRP3 and ASC. S aureus infection control in vivo and IL-1β release from cells of patients with Muckle-Wells syndrome were impaired by ibrutinib. Notably, IL-1β processing and release from immune cells isolated from patients with cancer receiving ibrutinib therapy were reduced. Conclusion Our data suggest that XLA might result in part from genetic inflammasome deficiency and that NLRP3 inflammasome–linked inflammation could potentially be targeted pharmacologically through BTK.
This paper provides a new perspective on the performance of ASEAN member countries' banks as proxied by CAMELS rating system in the light of information reliability. A comprehensive MCDM approach is ...developed based on alternative methods to handle expert preference uncertainties regarding banking ideal performance levels and relative CAMELS variable efficiency. While expert preferences are collected using structured interviews, the partial bank rankings are defined upon Fuzzy TOPSIS with the primary relative efficiency weights obtained from SWARA. Z-numbers are utilized to address the inherent fuzziness in how banking performance and financial distress are associated with information reliability of positive-ideal banking performance and CAMELS variables efficiency functions generated from expert preferences or perceptions. The empirical findings demonstrated that employing information reliability methodologies applied to a proxy of the CAMELS rating system, the ambiguous influence of ASEAN banking performance on financial hardship can be adequately handled.
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