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  • Ovid Technologies (Wolters Kluwer Health)  (118)
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  • 1
    Online Resource
    Online Resource
    Abstract 30: Body Mass Index Is Associated With Markers Of Inflammation And Liver Damage Among Healthy Adolescents
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 129, No. suppl_1 ( 2014-03-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. suppl_1 ( 2014-03-25)
    Abstract: Objectives: Obesity is the main cause of non-alcoholic fatty liver disease. Clinical studies reported that adolescent obesity is also associated with elevated levels of inflammatory markers and liver enzymes. However, it is unclear whether adolescents’ body mass index (BMI) within the normal range is associated with inflammatory marker or liver enzyme levels. Thus we investigated the association of BMI with C-reactive protein (CRP) and alanine aminotransferase (ALT) levels in healthy Korean adolescents. Methods: The JSHS Study is a prospective cohort study to investigate the risk factors for vascular change in early life. The current cross-sectional analysis enrolled 540 boys and 506 girls, aged 15-16 years old, who participated in the baseline examinations between 2007 and 2012. Baseline measurements included anthropometrics, physical examinations, questionnaires, and fasting blood analysis. Spearman correlation and linear regressions analyses were used to investigate the association of BMI with CRP and ALT. All statistical analyses were performed separately for males and females. Results: CRP levels were positively correlated with BMI in males (correlation coefficient r=0.175, p 〈 0.001) and females (r=0.206, p 〈 0.001). After adjustment for age, smoking and alcohol consumption, higher BMI was positively associated with increased CRP levels (β=0.157, p 〈 0.001 for male; β=0.195, p 〈 0.001 for female). But this association was attenuated (β=0.091, p=0.074 for male; β=0.085, p=0.091 for female), when the analysis was limited to adolescents with normal range of BMI (18.5 to 25.0 kg/m2). ALT levels were positively correlated with BMI only in males (correlation coefficient r=0.337, p 〈 0.001) but not in females (r=0.072, p=0.104). After adjustment for age, smoking and alcohol consumption, higher BMI was positively associated with increased ALT levels (β=0.436, p 〈 0.001 for male; β=0.094, p=0.034 for female). But this association was significant only in males (β=0.190, p 〈 0.001) not in females (β=0.074, p=0.143), when the analysis was limited to adolescents with normal range of BMI. Conclusion: Higher BMI was positively associated with increased levels of CRP and ALT among healthy Korean adolescents. The positive association between BMI and ALT levels was observed even in male adolescents with normal range of BMI.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.129.suppl_1.30
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
    Online Resource
    Risk factors of postoperative complications following total knee arthroplasty in Korea : A nationwide retrospective cohort study
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Medicine Vol. 100, No. 48 ( 2021-12-03), p. e28052-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 48 ( 2021-12-03), p. e28052-
    Abstract: The number of patients undergoing total knee arthroplasty (TKA) is gradually increasing and there is also increase in postoperative complications. The patient's demographic, socio-economic factors, hospital and clinical factors are all factors that can influence postoperative complications. The purpose of this study was to determine the risk factors associated with complications following TKA in a large national cohort. Methods: Among patients diagnosed with primary knee arthrosis, a total of 560,954 patients older than 50 years who underwent TKA from January 1, 2005 to December 31, 2018 were included in the study. The risk of postoperative complications (surgical site infection, sepsis, cardiovascular complications, respiratory complications, pulmonary embolism, stroke, acute renal failure, periprosthetic joint infection, and periprosthetic fracture) were assessed with eight independent variables: gender, age, place of residence, household income, hospital bed size, procedure type (unilateral or bilateral, primary or revision TKA), length of stay (LOS), use of transfusion. Multivariable Cox Proportional Hazard model analysis was used. The significant predictors for complications ( P   〈  .05) were as follows. Results: Surgical site infection: male, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Sepsis: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Cardiovascular complications: male, age, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Respiratory complications: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Pulmonary embolism: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Stroke: male, age, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Acute renal failure: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Periprosthetic joint infection: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Periprosthetic fracture: male, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Conclusion: In summary, male, procedure type (bilateral, revision), LOS (≥35 days), and use of transfusion were shown to be risk factors of postoperative complications following TKA.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000028052
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2049818-4
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  • 3
    Online Resource
    Online Resource
    High-sensitivity C-reactive Protein Level is an Independent Predictor of Poor Prognosis in Cirrhotic Patients With Spontaneous Bacterial Peritonitis
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Journal of Clinical Gastroenterology Vol. 48, No. 5 ( 2014-05), p. 444-449
    Details
    In: Journal of Clinical Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. 5 ( 2014-05), p. 444-449
    Type of Medium: Online Resource
    ISSN: 0192-0790
    URL: Article
    DOI: 10.1097/MCG.0b013e3182a6cdef
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 2041558-8
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  • 4
    Online Resource
    Online Resource
    Percutaneous ethanol injection therapy is comparable to radiofrequency ablation in hepatocellular carcinoma smaller than 1.5 cm : A matched case–control comparative analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Medicine Vol. 95, No. 35 ( 2016-08), p. e4551-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 95, No. 35 ( 2016-08), p. e4551-
    Type of Medium: Online Resource
    ISSN: 0025-7974
    URL: Article
    DOI: 10.1097/MD.0000000000004551
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2049818-4
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  • 5
    Online Resource
    Online Resource
    Antiplatelet therapy and the risk of hepatocellular carcinoma in chronic hepatitis B patients on antiviral treatment
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Hepatology Vol. 66, No. 5 ( 2017-11), p. 1556-1569
    Details
    In: Hepatology, Ovid Technologies (Wolters Kluwer Health), Vol. 66, No. 5 ( 2017-11), p. 1556-1569
    Abstract: Antiplatelet therapy has shown protective effects against hepatocellular carcinoma (HCC) in preclinical studies. However, it is unclear whether antiplatelet therapy lowers the risk of HCC in patients with chronic hepatitis B. A retrospective analysis was conducted of data from 1,674 chronic hepatitis B patients, enrolled between January 2002 and May 2015, whose serum hepatitis B virus DNA levels were suppressed by antivirals to 〈 2,000 IU/mL. The primary and secondary outcomes were development of HCC and bleeding events, respectively. Risk was compared between patients with antiplatelet treatment (aspirin, clopidogrel, or both; antiplatelet group) and patients who were not treated (non‐antiplatelet group) using a time‐varying Cox proportional hazards model for total population and propensity score–matching analysis. The antiplatelet group included 558 patients, and the non‐antiplatelet group had 1,116 patients. During the study period, 63 patients (3.8%) developed HCC. In time‐varying Cox proportional analyses, the antiplatelet group showed a significantly lower risk of HCC (hazard ratio [HR], 0.44; 95% confidence interval [CI] , 0.23–0.85; P =  0.01), regardless of antiplatelet agent. In propensity score–matched pairs, antiplatelet therapy significantly reduced the risk of HCC (HR, 0.34; 95% CI, 0.15‐0.77; P =  0.01). However, the overall risk of bleeding was higher in the antiplatelet group (HR, 3.28; 95% CI, 1.98‐5.42; P  〈   0.001), particularly for clopidogrel with or without aspirin. Treatment with aspirin alone was not associated with a higher bleeding risk (HR, 1.11; 95% CI, 0.48‐2.54; P =  0.81). Conclusion : Antiplatelet therapy reduces the risk of HCC in chronic hepatitis B patients whose hepatitis B virus is effectively suppressed. However, antiplatelet therapy containing clopidogrel may increase the risk of bleeding. (H epatology 2017;66:1556–1569)
    Type of Medium: Online Resource
    ISSN: 0270-9139 , 1527-3350
    URL: Article
    DOI: 10.1002/hep.29318
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1472120-X
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  • 6
    Online Resource
    Online Resource
    The Model to Estimate Survival in Ambulatory Hepatocellular Carcinoma Patients Aids in the Decision for TACE Retreatment
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Journal of Clinical Gastroenterology Vol. 54, No. 4 ( 2020-04), p. 370-377
    Details
    In: Journal of Clinical Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. 4 ( 2020-04), p. 370-377
    Abstract: Transarterial chemoembolization (TACE) is a major therapeutic modality for patients with unresectable hepatocellular carcinoma, which needs repeated treatments. Model to Estimate Survival in Ambulatory Hepatocellular carcinoma patients (MESIAH) was recently developed as a model for predicting survival. We aimed to develop a novel index for TACE retreatment using MESIAH scores. Patients and Methods: From 2005 to 2008, 783 patients with hepatocellular carcinoma who had undergone 1 previous TACE procedure were enrolled. We calculated their pre-TACE and post-TACE-MESIAH and calculated the MESIAH ratio by dividing the post-TACE by pre-TACE score. The discriminatory abilities of the MESIAH ratio and post-TACE-MESIAH were compared with ART and ABCR scores. Results: Among 783 patients, 355 (45.3%) received a second TACE (test set), and 195 (24.9%) patients received a third TACE treatment (validation set). In the test set, patients with a MESIAH ratio 〈 0.9 obtained longer overall survival than patients with a MESIAH ratio ≥0.9 [26.0 vs. 9.0 mo, respectively; hazard ratio 1.66 (1.29-2.14)], and patients with a post-TACE-MESIAH 〈 4.5 showed longer overall survival than patients with a post-TACE-MESIAH≥4.5 [38.0 vs. 7.0 mo, respectively; hazard ratio, 3.17 (2.45-4.09)]. The post-TACE-MESIAH [C-index 0.663 (0.628-0.697)] was better than the ART [C-index 0.596 (0.554-0.638)] and ABCR scores [C-index 0.576 (0.536-0.617)] at estimating prognosis. Our results were confirmed by the validation set. Conclusions: A MESIAH score ≥4.5 after TACE identifies patients with a poor prognosis. Randomized studies are needed to establish whether additional TACE may affect survival.
    Type of Medium: Online Resource
    ISSN: 0192-0790
    URL: Article
    DOI: 10.1097/MCG.0000000000001148
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 7
    Online Resource
    Online Resource
    Dynamics of liver stiffness-based risk prediction model during antiviral therapy in patients with chronic hepatitis B
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  European Journal of Gastroenterology & Hepatology Vol. 33, No. 6 ( 2021-06), p. 885-893
    Details
    In: European Journal of Gastroenterology & Hepatology, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 6 ( 2021-06), p. 885-893
    Abstract: The liver stiffness-based risk prediction models predict hepatocellular carcinoma (HCC) development. We investigated the influence of antiviral therapy (AVT) on liver stiffness-based risk prediction model in patients with chronic hepatitis B (CHB). Methods Patients with CHB who initiated AVT were retrospectively recruited from 13 referral Korean institutes. The modified risk estimation for hepatocellular carcinoma in chronic hepatitis B (mREACH-B) model was selected for the analysis. Results Between 2007 and 2015, 1034 patients with CHB were recruited. The mean age of the study population (639 men and 395 women) was 46.8 years. During AVT, the mREACH-B score significantly decreased from the baseline to 3 years of AVT (mean 9.21 → 7.46, P   〈  0.05) and was maintained until 5 years of AVT (mean 7.23, P   〉  0.05). The proportion of high-risk patients (mREACH-B score ≥11) was significantly reduced from the baseline to 2 years of AVT (36.4% → 16.4%, P   〈  0.001) and was maintained until 5 years of AVT (12.2%, P   〉  0.05). The mREACH-B scores at baseline and 1 year of AVT independently predicted HCC development (hazard ratio = 1.209–1.224) (all P   〈  0.05). The cumulative incidence rate of HCC was significantly different at 5 years of AVT among risk groups (high vs. high-intermediate vs. low-intermediate vs. low) from baseline (4.5% vs. 3.2% vs. 1.5% vs. 0.8%) and 1 year (11.8% vs. 4.6% vs. 1.8% vs. 0.6%) (all P   〈  0.05, log-rank tests). Conclusions The mREACH-B score was dynamically changed during AVT. Thus, repeated assessment of the mREACH-B score is required to predict the changing risk of HCC development in patients with CHB undergoing AVT.
    Type of Medium: Online Resource
    ISSN: 0954-691X
    URL: Article
    DOI: 10.1097/MEG.0000000000001794
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2030291-5
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  • 8
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    Online Resource
    Protective role of endogenous plasmalogens against hepatic steatosis and steatohepatitis in mice
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Hepatology Vol. 66, No. 2 ( 2017-08), p. 416-431
    Details
    In: Hepatology, Ovid Technologies (Wolters Kluwer Health), Vol. 66, No. 2 ( 2017-08), p. 416-431
    Abstract: Free cholesterol (FC) accumulation in the liver is an important pathogenic mechanism of nonalcoholic steatohepatitis (NASH). Plasmalogens, key structural components of the cell membrane, act as endogenous antioxidants and are primarily synthesized in the liver. However, the role of hepatic plasmalogens in metabolic liver disease is unclear. In this study, we found that hepatic levels of docosahexaenoic acid (DHA)‐containing plasmalogens, expression of glyceronephosphate O‐acyltransferase ( Gnpat ; the rate‐limiting enzyme in plasmalogen biosynthesis), and expression of Pparα were lower in mice with NASH caused by accumulation of FC in the liver. Cyclodextrin‐induced depletion of FC transactivated Δ‐6 desaturase by increasing sterol regulatory element‐binding protein 2 expression in cultured hepatocytes. DHA, the major product of Δ‐6 desaturase activation, activated GNPAT, thereby explaining the association between high hepatic FC and decreased Gnpat expression. Gnpat small interfering RNA treatment significantly decreased peroxisome proliferator‐activated receptor α ( Pparα ) expression in cultured hepatocytes. In addition to GNPAT, DHA activated PPARα and increased expression of Pparα and its target genes, suggesting that DHA in the DHA‐containing plasmalogens contributed to activation of PPARα. Accordingly, administration of the plasmalogen precursor, alkyl glycerol (AG), prevented hepatic steatosis and NASH through a PPARα‐dependent increase in fatty acid oxidation. Gnpat +/– mice were more susceptible to hepatic lipid accumulation and less responsive to the preventive effect of fluvastatin on NASH development, suggesting that endogenous plasmalogens prevent hepatic steatosis and NASH. Conclusion : Increased hepatic FC in animals with NASH decreased plasmalogens, thereby sensitizing animals to hepatocyte injury and NASH. Our findings uncover a novel link between hepatic FC and plasmalogen homeostasis through GNPAT regulation. Further study of AG or other agents that increase hepatic plasmalogen levels may identify novel therapeutic strategies against NASH. (H epatology 2017;66:416–431).
    Type of Medium: Online Resource
    ISSN: 0270-9139 , 1527-3350
    URL: Article
    DOI: 10.1002/hep.29039
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1472120-X
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  • 9
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    Central retina thickness measured with spectral-domain optical coherence tomography in Parkinson disease: A meta-analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Medicine Vol. 102, No. 40 ( 2023-10-06), p. e35354-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 102, No. 40 ( 2023-10-06), p. e35354-
    Abstract: Optical coherence tomography (OCT) can detect visual alterations associated with Parkinson disease, such as damage to the retinal nerve fiber layer or changes in retinal vasculature. Macula thinning in association with Parkinson disease (PD) remains controversial. Therefore, we conducted a meta-analysis to investigate the central retina thickness in PD measured using spectral-domain OCT (SD-OCT). Methods: We searched PubMed and the Excerpta Medica database to identify studies that compared macular thickness between patients with PD and healthy controls published before July 31, 2021. A random-effects model was used to examine PD-associated changes in macular thickness. Meta-regression analysis was performed by assessing heterogeneity, publication bias, and study quality. Results: Thirty-two studies with a cross-sectional design were selected, including 2118 patients with PD and 2338 controls. We identified significant differences in the thickness of the ganglion cell–inner plexiform layer (standardized mean difference [SMD], –0.41; 95% confidence interval [CI] , –0.66 to –0.16; I 2 = 80%), ganglion cell complex (SMD, –0.33; 95% CI, –0.50 to –0.17; I 2 = 0%), and of all inner and outer sectors of the macula (SMD range, –0.21 to –0.56; all P 〈 .05) between patients with PD and controls. Discussion: These results corroborate the increased prevalence of changes in OCT measures in individuals with PD, highlighting the efficacy of SD-OCT–determined macular thickness as a biomarker for PD. Our findings may provide helpful guidelines for clinicians in rapidly evolving areas of PD diagnosis.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000035354
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2049818-4
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  • 10
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    Propranolol plus endoscopic ligation for variceal bleeding in patients with significant ascites : Propensity score matching analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Medicine Vol. 99, No. 5 ( 2020-01), p. e18913-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 99, No. 5 ( 2020-01), p. e18913-
    Abstract: The use of beta-blockers in decompensated cirrhosis accompanying ascites is still under debate. The aim of this study was to compare overall survival (OS) and incidence of cirrhotic complications between endoscopic variceal ligation (EVL) only and EVL + non-selective beta-blocker (NSBB) combination therapy in cirrhotic patients with significant ascites (≥grade 2). This retrospective study included 271 consecutive cirrhotic patients with ascites who were treated with EVL only or EVL + NSBB combination therapy as a primary prophylaxis of esophageal varices. The primary outcome was all-cause mortality. Propensity score matching was performed between the 2 groups to minimize baseline difference. Median observation period was 42.1 months (interquartile range, 18.4–75.1 months). All patients had deteriorated liver function: 81.1% Child-Pugh class B and 18.9% Child-Pugh class C. All-cause mortality was significantly higher in the EVL + NSBB group than in the EVL only group not only in non-matched cohort, but also in matched cohort (48.9% vs 31.2%; P  = .039). More people died from hepatic failure in the EVL + NSBB group than that in the EVL only group (40.5% vs 20.0%; P  = .020). However, the incidence of variceal bleeding, hepatorenal syndrome (HRS), or spontaneous bacterial peritonitis (SBP) was not significantly different between the 2 groups. The use of NSBB might worsen the prognosis of cirrhotic patients with significant ascites. These results suggest that EVL alone is a more appropriate treatment option for prophylaxis of esophageal varices than propranolol combination therapy when patients have significant ascites.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000018913
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2049818-4
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