Long-standing Diseases Research Articles

COVID-19 induced thrombotic thrombocytopenic purpura in a patient with systemic lupus erythematosus: A rare case report

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a severe and rare disease, and its complexity increases in the presence of underlying autoimmune disease and COVID-19 infection, making differential diagnosis and treatment more challenging. Patient’s concerns: A 43-year-old patient presented with high fever, intermittent cough, and tea-colored urine. Diagnoses: The patient had a long-term history of systemic lupus erythematosus (SLE) and lupus nephritis (LN). The nasopharyngeal swab confirmed the diagnosis of COVID-19 by RT-PCR, and plasma ADAMTS-13 activity was completely deficient (0%). It was considered that COVID-19 infection occurred on the basis of SLE disease and was then complicated with TTP. Interventions: The patient was successfully treated with plasma exchange, followed by a combination of biologics and immunosuppressants. Outcomes: After 1 year of follow-up, the patient had completely recovered from COVID-19 infection and TTP, meeting the cure criterion. In addition, the LN was in remission, with an SLEDAI-2K score of 0, indicating a low disease activity state. Lessons: This article indicates that the patient suffers from both long-standing underlying diseases and the sudden occurrence of SARS-CoV-2 infection, which complicates the determination of the etiology and diagnosis of TTP. Consequently, after thorough analysis of the disease progression, clinical manifestations, laboratory results, and treatment outcomes, it was primarily concluded that COVID-19 was the catalyst for the onset of TTP in this patient.

Prospective study of complications and sequelae of glucocorticoid therapy in ANCA-associated vasculitis

ObjectiveGlucocorticoids (GC) are a cornerstone in treating antineutrophil cytoplasmic antibodies-associated vasculitides (AAV), however, they add to morbidity and mortality. To date, GC toxicity in AAV has rarely been systematically investigated.MethodsPatients...

Learning prevalent patterns of co-morbidities in multichronic patients using population-based healthcare data

The prevalence of longstanding chronic diseases has increased worldwide, along with the average age of the population. As a result, an increasing number of people is affected by two or more chronic conditions simultaneously, and healthcare systems are facing the challenge of treating multimorbid patients effectively. Current therapeutic strategies are suited to manage each chronic condition separately, without considering the whole clinical condition of the patient. This approach may lead to suboptimal clinical outcomes and system inefficiencies (e.g. redundant diagnostic tests and inadequate drug prescriptions). We develop a novel methodology based on the joint implementation of data reduction and clustering algorithms to identify patterns of chronic diseases that are likely to co-occur in multichronic patients. We analyse data from a large adult population of multichronic patients living in Tuscany (Italy) in 2019 which was stratified by sex and age classes. Results demonstrate that (i) cardio-metabolic, endocrine, and neuro-degenerative diseases represent a stable pattern of multimorbidity, and (ii) disease prevalence and clustering vary across ages and between women and men. Identifying the most common multichronic profiles can help tailor medical protocols to patients’ needs and reduce costs. Furthermore, analysing temporal patterns of disease can refine risk predictions for evolutive chronic conditions.

The natural infection rates of vaccine-preventable diseases among children: A literature review

Background: Indonesia currently faces a triple burden of various disease problems, outbreaks of infectious diseases, and an increase in long-standing infectious diseases, new infectious diseases, and non-communicable diseases (NCDs). A report released in 2020 by the United Nations International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) indicated that during the Covid-19 pandemic, the postponement of routine vaccinations resulted in approximately 80 million children aged less than or equal to 12 months being susceptible to diphtheria, measles, and polio.Purpose: To review previous research in analyzing the relationship between incomplete basic vaccination and the occurrence of vaccine-preventable disease (VPD) cases.Method: This study employed a literature review design, conducting a systematic review by selecting relevant articles pertaining to the research objective. The literature study selection process was adapted from the Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Inclusion criteria for this research encompassed originality, usage of both English and Indonesian languages, keywords covering basic vaccination, adverse events following vaccination, Integrated Healthcare Centervisits, education, and the role of Integrated Healthcare Centercadres.Results: Generally, community knowledge, attitudes, family support, and the role of cadres correlated with vaccination coverage achievement. However, some studies indicated no correlation between specific variables and the infants' basic vaccination status. To enhance vaccination coverage and client satisfaction, improving community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, as well as increasing vaccine availability and vaccination guidelines, are necessary.Conclusion: To improve vaccination coverage and client satisfaction, enhancements in community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, alongside increased vaccine availability and vaccination guidelines, are essential.Suggestion: It is advisable for the community to enhance knowledge, attitudes, and support for vaccination, especially among mothers and families. The active involvement of cadres in vaccination programs and public dialogue regarding the moral ethics of vaccination also need improvement.

Disease activity and disease-related factors are drivers of patient global assessment in rheumatoid arthritis: a real-life cross-sectional study

Despite that the Patient Global Assessment (PGA) is widely used for measuring Rheumatoid Arthritis (RA) disease activity to define the remission state of the disease, the primary contributors influencing patients’ ratings are still debated. This study aims to determine which clinical, sociodemographic and lifestyle-related contextual factors might be key drivers of PGA in RA. This single-center cross-sectional study recruited 393 consecutive adult RA patients. Median age 60 years, females 306 (77.9%). Data related to disease activity were assessed by using Simplified Disease Activity Index (SDAI), severity by Health Assessment Questionnaire (HAQ), and impact by RA Impact of Disease (RAID). Sociodemographic/lifestyle features were collected. Disease remission was calculated using Boolean-based criteria 1.0 and 2.0. Quantile regression models were used for univariate and multivariate analysis. The remission rate progressively increased from 15% by using SDAI with a Boolean 1.0-based definition to 43.5% using a Boolean 2.0-based remission. Among factors related to disease activity, the use of low-dose corticosteroids, the RAID items pain and sleep difficulties were predictive for worse PGA scores (p = 0.01). Among factors related to disease severity HAQ score and RAID total were independent factors associated with higher median PGA (p = 0.02 and p < 0.001). RAID’s physical well-being was related to PGA scores (p = 0.01). An increasing trend in PGA was observed in longstanding diseases (> 15 years). Our results confirmed that there is no unambiguous interpretation of the PGA score. It is a measure related to some disease activity parameters, but it is also influenced by contextual factors related to disease severity and impact. These data highlighted that PGA should have a broad interpretation, thus supporting the proposal of a dual targets (biological and impact) approach to obtain a more accurate estimate of disease activity.

Does surgery cause anxiety, stress and fear in geriatric patients?

Because of physiological changes in geriatric patients, their surgical process differs from that of young adults. In this regard, the perioperative period is an extremely risky time for geriatric patients. The present study examined preoperative fear, anxiety, and perceived stress levels as well as the factors affecting them in elderly patients prior to surgical intervention. This study adopted a cross-sectional descriptive design. The study sample consisted of geriatric patients (n = 407) scheduled for elective laparoscopic cholecystectomy in a research and training hospital in northeast Turkey. Data were collected by the researchers using the personal information form, Perceived Stress Scale (PSS-10), Surgical Fear Questionnaire (SFQ) and Anxiety Specific to Surgery Questionnaire (ASSQ). In the data analysis, descriptive statistics, the t-test in independent groups, one-way analysis of variance (ANOVA), correlation analysis and Bonferroni tests for post hoc analyses were used. On the PSS-10, the mean score was higher for the 75-and-older age group, single patients, patients with a disease requiring medication, and those who had previously undergone surgery (P < 0.05). On the ASSQ, the mean score was lower for patients aged 65-69, university graduates, patients without children, and those without a disease requiring medication (P < 0.05). On the SFQ, the mean score was higher for the 75-and-older age group, primary school graduates, and single patients (P < 0.05). It was determined that being single, having a chronic disability, and advancing age had an effect on the patients' surgery-specific anxiety, perceived stress, and fear of surgery. Long-standing chronic diseases can negatively affect both stress and anxiety levels of individuals.

Data-Driven Models Informed by Spatiotemporal Mobility Patterns for Understanding Infectious Disease Dynamics

Data-driven approaches predict infectious disease dynamics by considering various factors that influence severity and transmission rates. However, these factors may not fully capture the dynamic nature of disease transmission, limiting prediction accuracy and consistency. Our proposed data-driven approach integrates spatiotemporal human mobility patterns from detailed point-of-interest clustering and population flow data. These patterns inform the creation of mobility-informed risk indices, which serve as auxiliary factors in data-driven models for detecting outbreaks and predicting prevalence trends. We evaluated our approach using real-world COVID-19 outbreaks in Beijing and Guangzhou, China. Incorporating the risk indices, our models successfully identified 87% (95% Confidence Interval: 83–90%) of affected subdistricts in Beijing and Guangzhou. These findings highlight the effectiveness of our approach in identifying high-risk areas for targeted disease containment. Our approach was also tested with COVID-19 prevalence data in the United States, which showed that including the risk indices reduced the mean absolute error and improved the R-squared value for predicting weekly case increases at the county level. It demonstrates applicability for spatiotemporal forecasting of widespread diseases, contributing to routine transmission surveillance. By leveraging comprehensive mobility data, we provide valuable insights to optimize control strategies for emerging infectious diseases and facilitate proactive measures against long-standing diseases.

Characteristics, Clinical Outcomes, and Prognosis of Anal and Pouch-related Carcinoma in Patients With Crohn's Disease.

This study described the clinical characteristics, outcomes, and prognosis of Crohn's disease (CD) patients with anal cancer in a tertiary referral center. The electronic medical records of 35 adult CD patients, including CD of the pouch, with anal carcinoma evaluated at Mayo Clinic Rochester, Florida, or Arizona between January 1989 and August 2022 were retrospectively reviewed. Before cancer diagnosis, patients with pouch-related carcinoma had a shorter median duration of inflammatory bowel disease than those with anal carcinoma (10 vs 26 years). Twenty-six patients (74%) had perianal diseases or rectovaginal fistula, and 35% had a history of human papillomavirus infection. Twenty-one patients (60%) were diagnosed with cancer by anal examination under anesthesia (EUA). More than half of adenocarcinomas were mucinous. Sixteen patients (47%) were American Joint Committee on Cancer (AJCC) Tumor Nodes Metastasis (TNM) stage 3, and 83% were treated by surgery. At last follow-up, 57% of patients were alive without cancer. The 1-, 3- and 5-year overall survival rates were 93.8% (95% confidence interval [CI], 85.7%-100%), 71.5% (95% CI, 56.4%-90.7%), and 67.7% (95% CI, 51.2%-87.7%), respectively. Advanced AJCC TNM stage (hazard ratio, 3.20 per stage; 95% CI, 1.05-9.72; P = .040) was significantly associated with increased risk of death, whereas the period of cancer diagnosis in 2011-2022 (HR, relative to 1989-2000, 0.16; 95% CI, 0.04-0.72; P = .017) was significantly related to decreased risk of death. Anal and pouch-related carcinomas were rare complications of CD, and long-standing perianal diseases were an important risk factor. Anal EUA improved the diagnostic yield. Newer cancer treatment strategies and surgery were associated with excellent survival outcome.

Factors Influencing the Level of Depression and Anxiety of Community-Dwelling Patients with Schizophrenia in China during the COVID-19 Pandemic.

Using a cross-sectional survey, we collected 15,165 questionnaires. Assessments included demographic information, concern about COVID-19-related information, sleep status, anxiety and depressive symptoms, and accompanying illnesses. The 7-item Generalized Anxiety Disorder (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) were used to evaluate depression and anxiety levels. Group comparison was conducted by t-test, ANOVA, or chi-square test wherever suitable, with Bonferroni pairwise correction. Multivariate logistic regression was performed to identify predictors for anxiety and depression. 16.9% of patients had at least moderate anxiety, and 34.9% had at least moderate depression. T-test showed that females scored higher on GAD-7 and PHQ-9 than males, and patients without accompanying long-standing diseases, who were not concerned about COVID-19, had lower GAD-7 and PHQ-9 scores. ANOVA showed that participants aged from 30 to 39, with higher education scored higher on GAD-7, and patients with better sleep, and having less concern about COVID-19, had lower GAD-7 and PHQ-9 scores. Regression analysis indicated that participant ages of 30-39 and 40-49 positively predicted anxiety, whereas patient ages of 30-39 years positively predicted depression. Patients with poor sleep, accompanying diseases, and concern about the COVID-19 pandemic were more likely to experience anxiety and depression. During the pandemic, Chinese community-dwelling patients with schizophrenia had high rates of anxiety and depression. These patients deserve clinical attention and psychological intervention, especially those with risk factors.

A case report: a renal squamous cell carcinoma presenting as a nephrocutaneous fistula

BackgroundPrimary renal squamous cell carcinoma is a scarce entity, and its presentation as a discharging sinus is still exceptionally rare. We hereby report a case of a renal cell carcinoma in a young gentleman.Case presentationWe report a case of a 20-year-old gentleman who presented with clinical features suggestive of left side xanthogranulomatous pyelonephritis (XGPN). He had undergone multiple endourological procedures for left side renal calculi in the past. We present the clinical presentation, diagnostic dilemmas and treatment for this patient. We performed an open radical nephrectomy for this patient. Our case report is unique from the point of view of nature of presentation to the final histopathological outcome in terms of age group of the patient.Here we present the clinical management and dilemmas in the management of this unusual and rare case.ConclusionsOur case report and presentation has taught us that we as clinicians must have a high index of suspicion for a renal malignancy when treating patients who present with pyonephrosis associated with long-standing calculi diseases, irrespective of the age group of the patient.

Main mites associated with dermatopathies present in dogs and other members of the Canidae family.

Dermatological diseases of parasitic origin are one of the most frequent in the clinical practice of dogs and cats. Mites such as Sarcoptes scabiei, Otodectes cynotis, Demodex canis, and Cheyletiella spp., commonly affect domestic dogs. However, the impact generated by these mites on populations of wildlife animals and the mechanisms involved in their epidemiological dynamics are still not clear. In recent decades, the migration of populations and their interaction with domestic environments and vice versa have generated a worrying threat due to the transmission of some of these ectoparasites. Some reports have suggested that sarcoptic mange represents an emerging threat to wildlife. Given the outbreaks of greater magnitude and geographical extension. The objective of this review is to contribute to the state of the art of the main mites that cause dermatopathies in members of the Canis lupus familiaris family and other members of the Canidae family. For this, a systematic search was carried out in the Embase and PubMed databases. Infections caused by mites, mainly scabies, continue to be diseases with a worldwide distribution, affecting mammals and humans. Although they are long-standing diseases, the effects that are generated in wild canids are still unknown. A comprehensive evaluation is required to generate guidelines in favor of the conservation of some species of foxes and wolves present in different regions of the world.

Regression-based Model Deciphers Progression on Health Management for Two Long-standing and Unresolved Infectious Diseases in Indonesia: Integration of Outpatient Data by the National Universal Health Care (BPJS) and Fluctuation of Registered HIV and Malaria Cases

Although the COVID-19 outbreak was recently declared overcome COVID-19 is not the sole life-threatening infectious disease for which we direct our all resources. HIV and malaria are, on the other hand, two long-standing national health issues that are yet to find a proper solution. We query how these two infectious diseases load volume on National Burden as represented by the claims National Health Resilience and how far our efforts paid thus far affect the progression on optimally putting the cases in a break. We approach these mathematically as we hardly found integrated reports on this matter. Hence, we employed regression linear to model the Health Resilience of Indonesia based on the dynamics of outpatients and inpatients across facility categories (class) provided by National Universal Health Care (BPJS) in the context of HIV and malaria infection cases respectively. The estimation of the two regression parameters was done via the ordinary least square (OLS) method. We used pandas 1.3.5 for performing the data analysis, seaborn 0.11.2 and matplotlib 3.5.1 for the data visualization, and scipy 1.7.3 and statmats 0.31.2 for the statistical analysis. Our results show that the number of outpatients declines as the number of HIV and malaria cases increase. Furthermore, we obtained significant associations between the increased HIV rate and decreased number of outpatients in class 2 (P=0.030), class 3 (P=0.002), and the total outpatients (P=0.0019). These patterns are not observed for malaria cases. Meanwhile, the increase in HIV cases was found to be associated with the decreased number of registered BPJS in class 1 (P=4e-4), class 3 (P=1.5e-6), and total participants in all classes (P=3.6e-6). Less strong associations were found between the malaria cases with decreased number of participants in BPJS class 1 (P=0.010), class 3 (P=0.042), and the total registered to BPJS (P=0.045). Our data suggest that the higher the HIV incidence rate the lesser likelihood of the affected patients being treated as outpatients using facility classes 2 and 3 since this may lose the transmission control intervention. Intriguingly, in the sense of the BPJS facility category where an increased HIV rate is seen to be strongly associated with a decreased registration number for class 1 and class 3, the monthly dues and the adequateness of expected facility items may be the most abductive reasoning. Despite our understanding that these require validation cohort, taken altogether our data hint the threat of HIV is steady and demands a new approach to strategizing for the sake of limiting the transmission as well as maintaining the quality of life of the affected patients.

Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance.

To assess the impact of COVID-19 on the morbidity and mortality associated with drug-resistant tuberculosis (DR-TB). A comprehensive review of articles published in international databases since December 2019 was conducted. The findings are presented in a narrative format, supplemented with tables, diagrams, and a map created using ArcGIS software. Thirty-five studies were selected, highlighting the significant consequences of COVID-19 on TB and DR-TB treatment progress. Four main thematic areas were identified: Clinical and epidemiological aspects of the interaction between COVID-19 and DR-TB; Management of physical resources and the team; Challenges and circumstances; Perspectives and possibilities. This study revealed that the COVID-19 pandemic significantly negatively impacted the control of long-standing diseases like TB, particularly in the context of morbidity and mortality related to DR-TB.

Evaluation of Tp-e interval and Tp-e/QTc ratio in patients with inflammatory bowel disease.

Inflammatory bowel disease (IBD), amultisystemic inflammatory disorder, has been associated with increased risk of cardiovascular problems, including complications such as conduction defects and arrhythmias. Therefore, the early assessment of the risk factors predisposing to ventricular arrhythmias is crucial, since it can improve clinical outcomes. The objective of the present study is to evaluate ventricular repolarization by using Tp‑e interval and Tp-e/QTc ratio as candidate markers of ventricular arrhythmias in patients with IBD. The presented study was designed as asingle-center prospective cohort study. The study population consisted of 175patients with IBD and 175 healthy volunteers. The Tp‑e interval, corrected QT (QTc), and Tp-e/QTc ratio were measured from the 12-lead electrocardiogram. These parameters were compared between groups. The groups were similar in terms of electrocardiographic findings such as heart rate, QRS interval, and QTc interval. However, Tp‑e interval (87.0 ms, interquartile range, IQR 81.0-105.0 ms vs. 84.0 ms, IQR 74.0-92.0 ms; p < 0.001) and Tp-e/QTc ratio (0.21 ± 0.04 vs. 0.19 ± 0.05; p < 0.001) were significantly increased in IBD patient group compared to control group. Notably, apositive correlation was demonstrated between Tp‑e interval, Tp-e/QTc ratio and disease duration (Spearman's Rho = 0.36, p < 0.001 for Tp‑e; Spearman's Rho = 0.28, p < 0.001 for Tp-e/QTc). This study demonstrated that IBD patients are at increased risk of disrupted ventricular repolarization (increased Tpe, Tpe/QTc ratio). In addition, apositive correlation was demonstrated between Tp‑e interval, Tp-e/QTc ratio, and disease duration. Therefore, IBD patients, especially those with long-standing diseases, should be more closely screened for ventricular arrhythmias.

Chronic Pelvic Pain: A Comprehensive Review

Chronic pelvic pain (CPP) is explained as a complaint of cyclic or non-cyclic pelvic pain lasting for at least six months with or without dysmenorrhea, dyspareunia, dysuria, and dyschezia. The etiology of symptoms can be categorized according to organ system involvement. Gynecological causes typically involve endometriosis-related pain, pelvic congestion syndrome, pelvic inflammatory disease, adenomyosis, hydrosalpinx, etc. Endometriosis-related pain is seldom non-cyclic and may present due to recurrent bleeding in endometriotic implants. Engorgement of veins leads to inadequate venous washout and presents chronic pelvic pain in pelvic congestion syndrome. The pressure effect of benign lesions of the uterus and cervix may lead to cyclic pain, as in uterine fibroids. Often presentation of diseases like hydrosalpinx may not present until it has overdistended or may at times present as acute pelvic pain if it undergoes torsion. Long-standing untreated pelvic inflammatory diseases in sexually active females is another cause of pelvic pain. The complaint of CPP is also shared due to the involvement of the gastrointestinal system in conditions like irritable bowel syndrome, inflammatory bowel diseases, long-standing abdominal hernias, colorectal cancer, etc. Alteration of the gut biome and dysregulated brain-gut associations lead to typical manifestations of chronic lower back pain and pelvic pain in irritable bowel syndrome. Colorectal tumors, when in the advanced stage, may spread to nearby tissues creating fistulas and affecting nearby nerves, causing pelvic, perineal, and sacral pain. Abdominal hernias with small bowel prolapse are always related to pelvic pain symptoms. Infections in the urinary tract like urethral syndrome, chronic prostatitis, and chronic recurrent cystitis present with CPP and voiding problems. Musculoskeletal etiologies, though varying in degrees, are responsible for isolated complaints of CPP. Examples include pelvic girdle pain, levator syndrome, coccygodynia, and pelvic floor prolapse.

Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing Chromoendoscopy.

Simple SummaryPatients with long-standing and extensive/left-sided colonic inflammatory bowel diseases (IBD) have enhanced risk of developing colorectal cancer with respect to the general population. Dye-based chromoendoscopy (DCE) is now considered as the best surveillance strategy to prevent colon cancer in such patients, even though the endoscopic features of the DCE-evidenced lesions that predict neoplasia are not fully clarified. This study was aimed at identifying predictive factors of dysplastic/neoplastic lesions in IBD patients undergoing DCE. Our study shows that polypoid lesions with specific morphologic features and size greater than 7 mm are frequently dysplastic/neoplastic and, therefore, must be removed.Dye-based chromoendoscopy (DCE) with targeted biopsies is recommended for surveillance of patients with long-standing inflammatory bowel diseases (IBD), but endoscopic features that predict dysplasia are not fully clarified. We here aimed at identifying predictive factors of dysplastic/neoplastic lesions in IBD patients undergoing DCE. Two-hundred-and-nineteen patients were consecutively and prospectively enrolled from October 2019 to March 2022. One-hundred-and-forty-five out of 219 patients underwent DCE, and 148 lesions were detected in 79/145 (54%) patients. Thirty-nine lesions (26%) were dysplastic and one of them contained a CRC. Among these lesions, 7 (17.9%) had Kudo pit pattern I-II and 32 (82.1%) had a neoplastic pit pattern (Kudo III-IV). Multivariate analysis showed that neoplastic lesions Kudo III-IV (OR: 5.8, 95% CI: 2.3–14.6; p = 0.0002), lesion’s size (OR 1.16, 95% CI: 1.06–1.26; p = 0.0009), and polypoid lesions according to Paris Classification (OR 7.4, 95% CI: 2.7–20.2; p = 0.0001) were independent predictors of dysplasia. A cut-off of lesion’s size > 7 mm was identified as the best predictor of dysplasia. Among such features, Kudo pit pattern III-IV had the highest sensitivity and specificity to predict dysplasia (79% and 80%, respectively). Lesions with all three endoscopic features had a sensitivity of 90% and specificity of 100% to predict dysplasia. In contrast, non-polypoid lesions were inversely associated with dysplasia (OR 0.13, 95% CI: 0.05–0.36; p = 0.0001). These findings indicate that, in IBD patients, DCE-evidenced polypoid lesions with Kudo pit pattern III-IV and size > 7 mm are frequently dysplastic.

Potential effects of fructus aurantii ethanol extracts against colitis-associated carcinogenesis through coordination of Notch/NF-κB/IL-1 signaling pathways.

Colitis-associated cancer (CAC) is the colorectal cancer (CRC) subtype that is difficult to treat, and shows high mortality. The consumption of flavonoid-rich fructus aurantii extracts (FAE) has been associated with multiple beneficial effects including anti-inflammatory and anti-cancer properties, but the potential effects on the colitis-associated carcinogenesis have not been thoroughly investigated. Recent clinical data show that, as yet, few agents clearly inhibited CRC development in long-standing inflammatory bowel diseases. Here, we identified that FAE showed significant efficiency to inhibit HT-29 cell proliferation. The potential of FAE in vivo was further evaluated in an AOM/DSS-induced CAC mouse model. Intriguingly, FAE diminished the number of polyps in mice. Furthermore, FAE inhibited CAC by regulating the gene expression of Notch/ NF-κB/IL-1 signaling pathways. Collectively, these results were indicative of FAE has great potential in CAC prevention and treatment.

Restrictive Pulmonary Disease in Diabetes Mellitus Type II Patients.

BackgroundThe present study aimed to evaluate the proportion of restrictive pulmonary disease in individuals with diabetes mellitus type II patients.MethodologyA cross-sectional study was performed at Liaquat University of Medical & Health Sciences between May 2020 and June 2021. All individuals aged between 40 and 65 years, irrespective of gender were included in the study. While those individuals with known obstructive lung diseases, blood disorders, or malignancy were excluded. Spirometry, total lung capacity (TLC), and carbon monoxide diffusing capacity (DLCO) measurements were conducted to obtain a pattern of restrictive disease in patients. Patients were divided into three main groups; i) prediabetes, ii) newly diagnosed cases of diabetes, iii) longstanding diabetes mellitus type II, and iv) control group. The parameters like the patients’ age, sex, medication, history of smoking, and cardiac diseases, among other demographics were recorded. The data collected was recorded on a predesigned proforma.ResultsThe majority of the newly diagnosed cases, as well as long-standing diseases, were elderly males (p=0.014 and p<0.0001). Dyspnea was significantly correlated with longstanding diabetes mellitus type II as indicated by a higher mean score of 0.65 ± 0.10 (p=0.006). Smoking did not significantly correlate with diabetes mellitus type II. In patients with longstanding diabetes, 27 (14.4%) had a modified Medical Research Council (mMRC) score of greater than two while none of the controls had severe breathlessness. Reduced forced vital capacity (FVC) was detected in 16.0% of patients with longstanding diabetes and 12.8% in patients with newly diagnosed disease. Similar results were obtained for total lung capacity (TLC) and diffusing capacity (DLCO) (p=0.003 and p=0.02).ConclusionDiabetes mellitus type II is significantly associated with restrictive lung disease in patients as indicated by a high number of patients with longstanding diabetes in our study who were found to have restrictive lung disease and severe dyspnea. Screening for lung dysfunction could aid in optimum management of this debilitating disease.

서간문을 통해서 본 소세키(漱石)와 시키(子規)의 교류에 관한 고찰

This paper examined the life and death of Shiki and Soseki, as well as their friendship and passion for literature over 13 years. Soseki and Shiki, who recognized each other’s literary talents as classmates during their preliminary period at Tokyo University, exchanged Haiku corrections and various literary reviews through a letter. The two, who both liked Rakugo and writing letters, were together for the rest of their lives-enough to share their daily lives through letters.<BR> The relationship, which began at the age of 22, had them spending a short time together until the age of 35, leaving a great mark on modern Japanese literature and enjoying an era as literary companions. Shiki lived a short life of 35 years, but he launched a Haiku innovation movement to instill new energy into the modern Haiku literary circle. Soseki has been called Daemunho enough and has been also called the Shakespeare of Japan for writing novels steadily for 12 years, and is still loved by several citizens as a national writer.<BR> Soseki and Shiki fought against long-standing diseases and always crossed the boundary between life and death, but reformed literature and left a gem-like article until death due to their passion for literature. Even after a long time, their great achievement remains unforgettable with the epistle they left, which is still loved by many people.

서간문을 통해서 본 소세키(漱石)와 시키(子規)의 교류에 관한 고찰

This paper examined the life and death of Shiki and Soseki, as well as their friendship and passion for literature over 13 years. Soseki and Shiki, who recognized each other’s literary talents as classmates during their preliminary period at Tokyo University, exchanged Haiku corrections and various literary reviews through a letter. The two, who both liked Rakugo and writing letters, were together for the rest of their lives-enough to share their daily lives through letters.<BR> The relationship, which began at the age of 22, had them spending a short time together until the age of 35, leaving a great mark on modern Japanese literature and enjoying an era as literary companions. Shiki lived a short life of 35 years, but he launched a Haiku innovation movement to instill new energy into the modern Haiku literary circle. Soseki has been called Daemunho enough and has been also called the Shakespeare of Japan for writing novels steadily for 12 years, and is still loved by several citizens as a national writer.<BR> Soseki and Shiki fought against long-standing diseases and always crossed the boundary between life and death, but reformed literature and left a gem-like article until death due to their passion for literature. Even after a long time, their great achievement remains unforgettable with the epistle they left, which is still loved by many people.