Male Prevalence Research Articles

Meta-analysis of oral microbiome reveals sex-based diversity in biofilms during periodontitis.

Sex is an often overlooked, yet compulsory, biological variable when performing biomedical research. Periodontitis is a common yet progressively debilitating chronic inflammatory disorder affecting the tissues supporting teeth that ultimately leads to tooth loss if left untreated. The incidence of periodontitis is sex biased, with increased prevalence in males compared with females but with unknown etiology. We performed a sex-specific meta-analysis using publicly available oral microbiome data from different sampling sites of patients with periodontitis and periodontally healthy controls; sex balance was established for each periodontal health condition. Our results show sex-based diversity in oral biofilms of individuals with periodontitis but not in their saliva, with increased abundance of several periodontal pathogens in subgingival plaques from females compared with males. We devised a quantitative measure, uniquely defined as the Microsexome Index (MSI), which indicates that sexual dimorphism in subgingival bacterial composition is a distinct feature of reduced microbial diversity during periodontitis but not under healthy conditions. In addition, we found that smoking exacerbates microsexome diversity in supragingival biofilms, particularly during periodontitis. Taken together, we provide insights regarding sex-based diversity in periodontitis, a disease with multiorgan associations, and provide the rationale for further mechanistic, diagnostic, and therapeutic studies.

Epidemiological Aspects and Pattern of Intoxication among Elderly in Khorasan-Razavi; Northeast of Iran.

This study aimed to assess the risk factors and clinical-epidemiological patterns of acute poisoning among elderly individuals to guide prevention strategies. The epidemiological, clinical data, manner and cause of poisoning, and outcome of the registered elder cases (≥ 60 years old) in the clinical toxicology department of Imam Reza Hospital of Mashhad University of Medical Silences (CTD-IRH-MUMS) were investigated for nine months. The sex and age distribution of the patients were compared with the general population of Khorasan-Razavi using direct standardization. Among the 3064 cases registered at the hospital, 124 elderly patients were included in the study. The majority (71.8%) were male, with a mean age of 69.47. Male gender was found to be a significant risk factor for poisoning among elderly individuals compared to the general population (OR = 2.62) (1.55-4.42) (p-value < 0.001), however, it was not significant for age. Substance dependency, particularly on opiates, was common among the patients (56.5%), with a higher prevalence in males. Substance overdose (35.4%) and suicide (23.3%) were the most common methods of poisoning, with varying frequencies between genders (p-value = 0.002). Male gender was identified as a risk factor for opiate intoxication (OR = 4.68, CI = 1.70-11.83, p-value < 0.05) but not for suicide attempts. The average hospital stay duration was similar between male and female patients. The mean length of hospital stay was 3.53 ± 4.02 days (median = 3.0, range = 0.5-26 days) and was similar in both sexes. In conclusion,male gender and opiate dependency were highlighted as key factors in the poisoning of elderly individuals. These findings emphasize the importance of addressing these factors in preventive measures.

Clinical Features of Behçet’s Disease Uveitis

Abstract: Behçet’s disease (BD) is a chronic, multisystemic vasculitis first described by Professor Hulusi Behçet in 1937. It is characterized by recurrent inflammatory attacks affecting multiple organs, with uveitis being a significant and severe complication that can lead to blindness. BD typically emerges between the ages of 20 and 30 years, with a higher prevalence in males and rare occurrences in children. The prevalence and severity of BD and its ocular symptoms tend to diminish with age. In Turkey, BD is a leading cause of noninfectious uveitis, and its prevalence varies across different regions. Ocular involvement, seen in up to 90% of BD patients, often appears 2–4 years after disease onset and may be the initial sign in 10%–20% of cases. BD uveitis is characterized by recurrent nongranulomatous panuveitis and retinal vasculitis, typically affecting both eyes. Diagnostic tools such as fluorescein angiography (FA), optical coherence tomography (OCT), and laser flare photometry (LFP) are essential for monitoring disease activity and guiding treatment. FA is crucial for identifying occlusive and leaky vasculitis, while OCT helps in detecting macular complications and visualizing retinal infiltrates and their sequelae. LFP quantitatively evaluates intraocular inflammation. Recognizing the ocular manifestations of BD early is vital for accurate diagnosis and effective management. This review highlights the clinical features, diagnostic tools, and importance of early diagnosis in managing BD uveitis.

Abstract P334: Association Between Arthritis and Heart Failure Among People with Hypertension in United States

Background: Hypertension is well known for its association with cardiovascular events and arthritis. However, epidemiological data on the direct relationship between heart failure and arthritis in hypertensive patients is limited. This study examines the hypothesis that arthritis increases the risk of heart failure among patients with hypertension. Additionally, the effect of gender on these outcomes was assessed. Method: In our study, we analyzed data from 6,789 adults with hypertension aged 18 to 80 years, sourced from the National Health and Nutrition Examination Survey (NHANES) for the years 2017-2018. Arthritis was defined based on participants’ self-reported diagnosis by a doctor. We utilized logistic regression to explore the relationship between arthritis and the presence of heart failure across three different models. The first model included heart failure alone, the second model included age, gender, education, race, body mass index (BMI), smoking, and drinking, and the third model additionally included coronary artery disease and stroke. Result: The prevalence of heart failure among individuals with both arthritis and hypertension stands at 6.0%. Investigation into gender reveals a notable prevalence in males at 8.2% compared to 4.5% in females [Fig 1]. The analysis revealed a positive correlation between the two conditions across the entire population, with correlation coefficients of 2.38 (95% CI: 1.68-3.37), 1.61 (95% CI: 1.11-2.34), and 1.51 (95% CI: 1.01-2.25) for the three models, respectively. Specifically, in males, there was a notably increased association in the first and second models, with correlation coefficients of 2.77 (95% CI: 1.76-4.35) and 1.69 (95% CI: 1.05-2.74), respectively. Conversely, among females, a significant association was observed only in the first model, with a correlation coefficient of 2.24 (95% CI: 1.29-3.89) [Fig 2]. Conclusion: A robust positive correlation between arthritis and heart failure was observed in hypertensive U.S. patients. Gender was found to be a factor influencing this relationship, with males having a higher risk and prevalence of heart failure compared to the overall population.

Geospatial Mapping and Seasonal Profiling of Urinary Schistosomiasis in Ase-Niger River Settlements: A Data-Driven Population-Base Study in Delta State, Nigeria.

This study is aimed to determine the geospatial, seasonal, age and gender prevalence and intensity of UgS; and to establish disease maps in the Ase-Niger River communities for effective drug administration. This study employed a 24 months longitudinal study design for parasitological investigations in 11 riparian communities of the Ase-Niger River basin, taking into cognizance their GPS locations imported into QGIS software for schistosomiasis mapping. A total of 7,219 urine samples with WHO structured questionnaires were retrieved and subjected to parasitological evaluation using swinnex urine filtration techniques. An overall prevalence of 48.10% was established. Geospatially, prevalence ranges from 34.27% (Ivrogbo) to 52.29% (Ase) with seasonal significant difference (p < 0.05) accounting for 76.19% of the total variance. Ashaka had the highest prevalence for both males (55.73%) and females (53.32%) with significant difference in the study sites (p < 0.05) accounting for 96.47% of the total variance. Age-group 11-20 years consistently maintain a high prevalence at all sites. The peak geometric mean intensity of 105.69 was obtained in the dry season at Lagos Iyede. Ashaka, Igbuku, Iyede-Ame, and Onogboko had heavy-intensity levels in both seasons. Overall, the intensity was lower during the wet season than the dry season, with significant variations (p < 0.05) at Awah and Itobi-Ige. Geospatial prevalence and intensity have a robust and strong positive correlation (r = 0.7178; p = 0.0129), with 51.53% of intensity variability being influenced by prevalence (R2 = 0.5153). UgS is a significant public health issue in the Ase-Niger River basin, with prevalences surpassing the national average of 29.0% which calls for MDA in these settlements.

A Comprehensive Review of Bilobed Flaps in Nasal Reconstruction: Technique, Outcomes, and Considerations.

Reconstruction of nasal defects, particularly in the lower third of the nose, presents significant challenges due to the area's complex 3-dimensional structure and thicker, more sebaceous skin. The bilobed flap, a double transposition flap, has been a popular method for addressing these nasal defects. This retrospective review examines a single surgeon's experience with bilobed flaps for nasal reconstruction over the last 15 years. Demographics, defect characteristics, intraoperative details, postoperative complications, and revisionary procedures were documented, and univariate and multivariate logistic regression analyses were used to assess complication rate associations. In all, 148 bilobed reconstructions were analyzed, with a mean patient age of 62.6 years and 46.0% male prevalence. The most common indication for the procedure was basal cell carcinoma following Mohs surgery, with the majority of the defects located on the lower third of the nose. The average defect size was 1.11cm². Complications occurred in 52.0% of cases, including pincushioning, scar thickening, asymmetry, alar stenosis, and wound dehiscence. Reoperations and additional treatments such as dermabrasion, steroid injections, and laser therapy were frequently necessary to address these issues. Logistic regression analysis demonstrated significantly more postoperative complications when the defect was located on the lower third of the nose when compared with the upper two-thirds. While the bilobed flap can provide adequate skin coverage with perfect color match, it is associated with notable complications that impact esthetic outcomes. Proper patient selection and surgical technique are crucial for optimizing results.

Giant mucinous liposarcoma of the abdominal cavity: A case report.

Mucinous liposarcoma myxoid liposarcoma is a malignant mucoid soft tissue tumor derived from undifferentiated stromal cells in perivascular, subbody cavity and intermuscular space, and composed of cells at different stages of differentiation from preadipocytes to mature cells. In rare cases, it may change from lipoma malignancy. The main manifestations is painless mass, relatively slow growth, the course can last decades, the prevalence of liposarcoma in the population is 14% to 18%, mainly in adults, male prevalence is higher than women, but not significant. The main good hair part is the thigh, have mucinous sex, high differentiation type, dedifferentiation type, polymorphic type. Clinical diagnosis is difficult, and there are no obvious symptoms in the early stage, so the diagnosis should be combined with B ultrasound, MRI, CT, and other auxiliary examinations. The gold standard is pathological examination. In December 2023, our department admitted a patient with a mucinous abdominal mass. The report is as follows. Does liposarcoma metastasize? Is any chemotherapy required after surgery? Will it ever relapse in the future? What is the survival period after surgery? Mucinous liposarcoma. Surgical resection of the sarcoma. The nodule sample was 33 * 28 * 13 cm, with complete capsule, gray and yellow sections, fine texture, soft, gray, red, grayish, and yellow mucoid nodules in some areas, and the maximum diameter of the nodules was 21cm. Immunohistochemistry was: CD34 (+), CDK 4 (+), CK (-), Desmin (weak +), Ki67 (index 5%), MDM 2 (-), p16 (weak +), S-100P (+), Vimentin (+), BCL-2 (+). He was also sent to the Department of Pathology of Peking Union Medical College Hospital for consultation with Professor Lu Zhaohui, whose consultation opinion was in line with myxoliposarcoma. Retroperitoneal liposarcoma is a common retroperitoneal tumor, but it is relatively rare in clinical practice; the overall morbidity is low, mainly manifested as abdominal pain and abdominal distension, abdominal distension, and a long course of disease; it is not sensitive to radiotherapy and chemotherapy, and should be closely follow up by CT examination to understand the recurrence and metastasis.

Impact of the American Society of Anesthesiologists (ASA) classification on hip fracture surgery outcomes: insights from a retrospective analysis

BackgroundThe American Society of Anesthesiologists (ASA) classification is the most used system to assess patient health status before surgery, ranging from I to V levels. This study aims to explore the impact of different ASA risk classes (ASA II [mild risk] and ASA III [severe risk]) on clinical outcomes following hip fracture surgery, including all-cause mortality and postoperative complications.MethodsA retrospective analysis from 2019 to 2021 across three Jordanian centers was conducted. The study included patients aged 65 and above who underwent hip fracture repair surgeries. Preoperative measures, intraoperative management protocols, and postoperative care were collected. Clinical data were extracted from electronic medical records, including demographics, fracture type, intraoperative data, and postoperative outcomes.ResultsThe analysis included 1033 patients, with 501 (48.5%) in the mild anesthetic risk group (ASA I-II) and 532 (51.5%) in the severe anesthetic risk group (ASA III-V). The mean age was 73 years, with a higher prevalence of males in the severe risk group. Patients in the severe risk group had more comorbidities, higher ICU admissions (15.23% vs. 6.18%), longer hospital stays (median 7 vs. 6 days), and higher rates of postoperative thromboembolic complications (3.39% vs. 1.39%) compared to the mild risk group. Additionally, the severe risk group showed higher mortality rates both in-hospital mortality (3.38% vs. 1.39%) and all-cause mortality (16.92% vs. 10.36%). Multivariate analysis identified higher ASA score as independent risk factors for increased all-cause mortality (HR = 1.64 95%CI 1.51–2.34) and thromboembolic complications (OR = 2.85 95%CI 1.16-7). Length of hospital stay was significantly associated with higher ASA score (OR = 1.04 95%CI 0.96–1.11).ConclusionThe study underscores the significant impact of anesthetic risk on the outcomes of hip fracture surgeries. Patients with higher ASA scores associated with severe systemic diseases may have at increased risk of adverse outcomes.

Assessment of Cardiovascular Risk and Factors among Post COVID-19 Patients with Type 2 Diabetes Mellitus and Dyslipidaemia

Background: The current study aims to assess the impact of structured patient education on cardiovascular complications in post-covid patients with type-2 diabetes mellitus and dyslipidaemia. Objectives: To assess the prevalence of cardiovascular risk among type-2 diabetes mellitus with dyslipidaemia in post-covid patients. to analyse the cardiovascular risk correlated with diabetes and lipid profile. to assess the impact of patient education on cardiovascular risk complications. Method: A total of 300 patients were screened and of them, 205 were enrolled in the study based on the inclusion and exclusion criteria. Patient education was given to selected patients using structured patient leaflets and oral education after baseline. They are followed up after 2 months. Cardiovascular risk was assessed by ASCVD and Framingham risk assessment score. Results: The study analysed that there was a high prevalence in males, the age group 51-70 years, non-alcoholic, and non-smokers. At the baseline, most patients were at high risk. On comparing the baseline with the review, a 49.3% difference was seen in the high-risk category. Conclusion: The study revealed that age, gender, low density lipoprotein, total cholesterol, and random blood sugar were the important cardiovascular risk factors. The implementation of pharmacist care in collaboration with physicians and nurses may reduce cardiovascular risk complications and help in better medication management.

Hubungan Kebiasaan Merokok dengan Penyakit ISPA pada Pasien di Puskesmas Mandai Kabupaten Maros

This study aims to analyze the relationship between smoking habits and the incidence of Acute Respiratory Tract Infection (ARI) in patients at Puskesmas Mandai, Maros Regency. Using quantitative methods with a correlation analytic approach and cross-sectional design, data were collected from 105 respondents from September to October 2022. The results showed that most ARI patients were children under 10 years old (51.4%), with a higher prevalence in males (58.1%). In terms of smoking status, all secondary smokers (50.5%) and the majority of tertiary smokers (37.1%) experienced ARI, while only 7.6% of primary smokers experienced ARI. Statistical analysis showed a significant association between smoking and ARI incidence (p-value less than 0.05). This finding confirms that smoking, especially in the family environment, contributes significantly to the increased incidence of ARI. It is recommended that Puskesmas Mandai conduct socialization about the dangers of smoking and further research with more respondents for more specific and comprehensive results.

Unleashing PD-1: a duel of immunity in aortic aneurysm formation.

Aortic aneurysms, particularly abdominal aortic aneurysms (AAAs), exhibit sex differences, with higher prevalence and severity in males than females, both in humans and experimental mouse models. In fact, male sex has been considered as the most potent nonmodifiable risk factor for AAA. Currently, there are no medications approved for the treatment of aortic aneurysms, despite the high lethality of ruptured aneurysms, which account for nearly 2% of all deaths. Moreover, the underlying molecular mechanisms mediating the sexual dimorphism of aortic aneurysms remain largely unknown. In this issue of the JCI, Mu et al. revealed a mechanism by which androgens, male sex hormones, exacerbate aortic aneurysms by suppressing programmed cell death protein 1 (PD-1) expression in T cells in an aldosterone and high salt-induced aortic aneurysm mouse model.

Current advances of oral cancer in Taiwan.

To provide updated statistics of oral cancer incidence and mortality in Taiwan, and to describe recent developments for oral cancer control to reduce oral cancer incidence and mortality. The Taiwan Cancer Registry Annual Report 2023, the Taiwan Cancer Registry Online Interactive Search System, and the 2023 Health Promotion Administration Annual Report are consulted and summarized. A literature search using PubMed was also conducted to identify Taiwan oral cancer control-related studies. Taiwan, with a long history of areca/betel quid chewing, has battled with oral cancer for decades. In 2021, the male lip and oral cavity cancer incidence is 29.77 (per 100,000 persons) and mortality is 11.25. Over these years, the male chewing prevalence was reduced to 6.2% in 2018. Taiwan has a sustained national oral cancer screening programme provided to high-risk groups biennially. Although the age-standardized incidence rates have been slowly decreasing since 2009, due to Taiwan's ageing population, the actual oral cancer burden is still stringent. The collaboration of multi-ministries and agencies on promoting areca nut and betel quid control, improving oral cancer awareness, and delivering cancer care remains essential to prevent oral cancer and reduce oral cancer deaths.

Vascular Endothelial Growth Factor Receptor 2 (VEGFR2) rs2071559 Gene Polymorphism and the Risk of Gliomas: A Systematic Review and Meta-Analysis.

A glioma is a form of tumor that is abundant in blood vessels. Vascular endothelial growth factor receptor (VEGFR) and its receptor 2 (VEGFR2) are important in the process of angiogenesis. The relationship between VEGFR2 rs2071559 and glioma development is currently uncertain. The present study aims to analyze the correlation between VEGFR2 rs2071559 gene polymorphism and the susceptibility to gliomas. A thorough search was carried out in the Cochrane Library, Scopus, and Medline databases from inception until 20 February 2024 using a mix of pertinent keywords. We used random-effects models to examine the odds ratio (OR) and reported the results together with their respective 95% confidence intervals (CIs). A total of six studies were incorporated. The results of our meta-analysis indicated that all genetic models of VEGFR2 rs2071559 gene polymorphism, starting from dominant (OR 1.40; p < 0.00001), recessive (OR 1.52; p < 0.0001), CC genotype (OR 1.78; p < 0.00001), CT genotype (OR 1.30; p < 0.0001), and C allele (OR 1.41; p < 0.00001), were associated with a higher risk of developing gliomas. The subgroup analysis revealed a higher OR for studies with a sample size of ≥500, originated from Asia, with a mean age of ≥42.3 years, and a male prevalence of <57%. This study suggests that VEGFR2 rs2071559 gene polymorphism is associated with a higher risk of gliomas.

Allergic Sensitization and Psychosomatic Involvement in Outdoor and Indoor Workers: A Preliminary and Explorative Survey of Motorway Toll Collectors and Office Employees.

The incidence of respiratory and cutaneous allergic disorders may be variable if we consider work activity. These disorders are reported in the current literature to have a relevant psychosomatic involvement. The aim of the study was to submit a survey on the self-reported occurrence of allergic respiratory and cutaneous diseases in outdoor and indoor workers to verify the onset or exacerbations of such pathologies, encourage surveillance, and suggest the need for further studies. Two groups of workers were compared when exposed and not exposed to air pollutants. An outdoor population of motorway toll collectors (153 workers; M: 58.03 years old, SD: 6.1; and female prevalence of 66.01%) and an indoor group of office employees (59 workers; mean age 54.44 years, SD: 8.50; and male prevalence of 61.02%) entered the study. The results of three multivariate analyses of the obtained data, investigating contributions of external factors, including age, sex, smoking habits, working type, and seniority, on allergic conditions were significant in both workers' groups. The findings highlighted that age and smoking habits were significant contributors to allergic conditions, both independently and in combination with other factors, such as sex and working type. The data suggest the presence of phenomena related to different etiological domains, as already reported in the literature. Through the collection of these data, it was possible to highlight the need to analyze clinical signs from different perspectives.

A Comprehensive Study on Ruptured Liver Abscess in a Tertiary Care Center.

Background Bacteria and parasites cause liver abscesses (LAs), with the unusual but fatal consequence of ruptured LA. Along with the clinical signs of icterus, right upper quadrant pain, and a history of loose stools, patients present with non-specific symptoms such as fever, nausea, and generalized weakness. Consistent findings include male sex prevalence and frequent alcohol consumption. Leukocytosis, abnormal liver function, and an increased international normalized ratio have been identified by biochemical analysis; however, these findings are not specific to a ruptured LA diagnosis, and imaging is necessary to reach a definitive diagnosis. Ultrasonography usually confirms the diagnosis, and computed tomography is required in certain situations. In confined ruptures, percutaneous drainage combined with antibiotic therapy is typically the initial treatment course. Generally reserved for non-responders or moribund patients with delayed presentation, an open surgical approach may involve simple draining of a ruptured abscess or ileocecal resection, or right hemicolectomy in cases of large bowel perforations, both of which increase patient morbidity. A definite guide to management is still missing in the literature. In this article, we have discussed and correlated with data the predictors of surgery and preoperative predictors of perforation. Materials and methods This retrospective study was performed at Safdarjung Hospital, New Delhi, between January 2022 and December 2023. The study included 115 patients diagnosed with ruptured LA by ultrasound. Medical records were analyzed, and various parameters of the illness, clinical features, hematological and biochemical profiles, ultrasound features, and therapeutic measures were noted and assessed. Results Of the 115 patients, 88% (n = 101) were male. The most common symptoms were abdominal pain (114 patients) and right upper abdominal tenderness (107 patients).Fifty-two patients were treated with percutaneous drainage, and 42 underwent laparotomy. Intercostal drainage (ICD) tubes were placed in 19 patients. Sixteen patients had large bowel perforations. Twenty-three patients died (20%), including 17 patients who underwent laparotomy and nine patients who had large bowel perforation (39.1% associated with overall mortality, 52.9% associated with mortality in laparotomy). One patient with percutaneous drainage and a right ICD tube died in the intensive care unit. Four patients died before intervention. Significant associations were noted between perforation and mortality in patients who underwent surgical drainage. Loose motions, alcohol and smoking consumption, and deranged creatinine and albumin levels were found to have a significant association with surgical drainage. Conclusion The study found that a ruptured liver abscess (LA)may require surgery to drain the collection or repair the pathological bowel, which increases the morbidity, but it is a lifesaving procedure over percutaneous catheter drainage. The study also identified factors associated with a higher risk of death, such as a history of loose stools and low blood albumin levels.

Association between serum selenium and non-alcoholic fatty liver disease: Results from NHANES: An observational study.

Non-alcoholic fatty liver disease (NAFLD) encompasses a broad spectrum of diseases and stands as the second most prevalent liver disorder in the 21st century. Advanced hepatic fibrosis (AHF) is a crucial indicator of the progression of NAFLD. Selenium (Se) is an indispensable trace element for human physiology; however, excessive intake can lead to poisoning and detrimental effects. Notably, males exhibit significantly higher serum Se levels compared to females. To investigate the correlation between serum Se levels and the prevalence of NAFLD and AHF across different genders. Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020, 7271 participants were included. Through descriptive analysis, multivariable logistic regression, subgroup analysis, interaction, and restricted cubic spline regression analysis, the relationship between serum Se levels and the prevalence of NAFLD and AHF was investigated. serum Se levels were significantly higher in both male and female NAFLD groups compared to the non-NAFLD groups (Males: 187.570 vs 183.300, Z = -16.169, P < .001; Females: 184.780 vs 180.130, Z = -4.102, P < .001). After adjusting for confounders, an increase in one quartile of serum Se was associated with a 17.60% increase in NAFLD prevalence in males (OR, 1.176; 95% CI: 1.052-1.315) and a 38.50% decrease in AHF prevalence (OR, 0.615; 95% CI: 0.479-0.789). In females, each quartile increase in serum Se was associated with a 29.10% increase in NAFLD prevalence (OR,1.291;95%CI: 1.155-1.442) and a 51.60% decrease in AHF prevalence (OR, 0.484; 95% CI: 0.344-0.682). serum Se levels are positively correlated with the prevalence of NAFLD and negatively correlated with the prevalence of AHF in both males and females.

A comparative assessment of ACS NSQIP-predicted and actual surgical risk outcomes of robotic transhiatal esophagectomy for esophageal adenocarcinoma resection at a high volume institution.

Esophageal adenocarcinoma incidence is increasing in Western nations. There has been a shift toward minimally invasive approaches for transhiatal esophagectomy (THE). This study compares the outcomes of robotic THE for esophageal adenocarcinoma resection at our institution with the predicted metrics from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). With Institutional Review Board (IRB) approval, we prospectively followed 83 patients who underwent robotic THE from 2012 to 2023. Predicted outcomes were determined using the ACS NSQIP Surgical Risk Calculator. Our outcomes were compared with these predicted outcomes and with general outcomes for transhiatal esophagectomy reported in ACS NSQIP, which includes a mix of surgical approaches. The median age of patients was 70years, with a body mass index (BMI) of 26.4kg/m2 and a male prevalence of 82%. The median length of stay was 7days. The rates of any complications and in-hospital mortality were 16% and 5%, respectively. Seven patients (8%) were readmitted within a 30-day postoperative window. The median survival is anticipated to surpass 95months. Our outcomes were generally aligned with or surpassed the predicted ACS NSQIP metrics. The extended median survival of over 95months highlights the potential effectiveness of robotic THE in the resection of esophageal adenocarcinoma. Further exploration into its long-term survival benefits and outcomes is warranted, along with studies that provide a more direct comparison between robotic and other surgical approaches.

Association between osteocalcin and residual β-cell function in children and adolescents newly diagnosed with type 1 diabetes: a pivotal study.

This pivotal study aimed to evaluate circulating levels of bone remodeling markers in children and adolescents at the onset of type 1 diabetes (T1D). Additionally, we assessed their correlation with glucose control, residual β-cell function, and the severity of presentation. In this single-center cross-sectional study, we recruited children and adolescents newly diagnosed with T1D at our tertiary-care Diabetes Centre. Anamnestic, anthropometric, clinical, and biochemical data at T1D diagnosis were collected. Basal and stimulated C-peptide levels were assessed, along with the following bone remodeling biomarkers: osteocalcin (OC), alkaline phosphatase (ALP), parathormone (PTH), 25-OH Vitamin D (25OH-D), and the C-terminal cross-linked telopeptide of type 1 collagen (CTX). We enrolled 29 individuals newly diagnosed with T1D, with a slight male prevalence (51.7%). The mean age was 8.4 ± 3.7 years. A positive correlation between OC and stimulated C-peptide (R = 0.538; p = 0.026) and between PTH and serum HCO3- (R = 0.544; p = 0.025) was found. No other correlations between bone remodeling biomarkers and clinical variables were detected. Our data showed a positive correlation between OC levels and residual β-cell function in children and adolescents at T1D presentation. Further longitudinal studies evaluating OC levels in pediatric subjects with T1D are needed to better understand the complex interaction between bone and glucose metabolisms.

Prevalence of Irritable Bowel Syndrome (IBS) in the Arab World: A Systematic Review.

Irritable Bowel Syndrome (IBS) is a common functional pathology of the gastrointestinal tract (GIT) across the globe. The prevalence rate of IBS varies across the regions. In the present systematic review, we aim to investigate the prevalence of IBS in Arab countries in recent years. To identify relevant studies, a comprehensive search was undertaken in various databases including CINAHL (Cumulated Index to Nursing and Allied Health Literature) Ultimate, Scopus, PubMed, and Web of Science. Furthermore, Google Scholar was also explored to identify relevant studies. The inclusion criteria included studies that assessed IBS in the Arab world and were published in the English language. Fifty-two cross-sectional studies from seven countries, encompassing 51,683 participants, were included. The majority of the included studies were conducted in Saudi Arabia (n=40), followed by Jordan (n=4) and Egypt (n=3). The highest prevalence rates were reported by studies from Saudi Arabia, Lebanon, and Jordan. Low prevalence rates (<20%) were noted in 19 studies included in this systematic review. Female predominance in IBS prevalence was observed in most studies, while only two studies indicated higher prevalence in males. Key risk factors included family history, anxiety, depression, gastroesophageal reflux disease, low income, diabetes, low water intake, workload, occupation, food allergy, smoking, age, chronic diseases, and stress. IBS prevalence in the Arab world varies significantly. Female predominance was seen in the present systematic review as well.

Comparative Analysis of Heart Failure with Preserved Vs Reduced Ejection Fraction: Patient Characteristics, Outcomes, Mortality Prediction, and Machine Learning Model Development in the JoHFR.

Heart failure (HF) is a global health challenge affecting millions, with significant variations in patient characteristics and outcomes based on ejection fraction. This study aimed to differentiate between HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) with respect to patient characteristics, risk factors, comorbidities, and clinical outcomes, incorporating advanced machine learning models for mortality prediction. The study included 1861 HF patients from 21 centers in Jordan, categorized into HFrEF (EF <40%) and HFpEF (EF ≥ 50%) groups. Data were collected from 2021 to 2023, and machine learning models were employed for mortality prediction. Among the participants, 29.7% had HFpEF and 70.3% HFrEF. Significant differences were noted in demographics and comorbidities, with a higher prevalence of males, younger age, smoking, and familial history of premature ASCVD in the HFrEF group. HFpEF patients were typically older, with higher rates of diabetes, hypertension, and obesity. Machine learning analysis, mainly using the Random Forest Classifier, demonstrated significant predictive capability for mortality with an accuracy of 0.9002 and an AUC of 0.7556. Other models, including Logistic Regression, SVM, and XGBoost, also showed promising results. Length of hospital stay, need for mechanical ventilation, and number of hospital admissions were the top predictors of mortality in our study. The study underscores the heterogeneity in patient profiles between HFrEF and HFpEF. Integrating machine learning models offers valuable insights into mortality risk prediction in HF patients, highlighting the potential of advanced analytics in improving patient care and outcomes.