Obesity Can Contribute to Severe Persistent Allergic Rhinitis in Children through Leptin and Interleukin-1β

2021 ◽  
pp. 1-7
Author(s):  
Myung Woul Han ◽  
Song Hee Kim ◽  
Inbo Oh ◽  
Yang Ho Kim ◽  
Jiho Lee
Keyword(s):  
Allergic Rhinitis ◽  
Significant Risk ◽  
Fold Increase ◽  
Normal Weight ◽  
Persistent Symptoms ◽  
Persistent Allergic Rhinitis ◽  
Group A ◽  
Active Inflammation ◽  
Increase In Risk

Background: Obesity/overweight is associated with a higher risk of allergic rhinitis (AR) in children. Objective: This study aimed at exploring the mechanisms by which obesity affects the severity of AR through leptin and interleukin (IL)-1β were investigated. Methods: In all, 210 subjects with AR and 82 subjects without AR were included in this study. The levels of leptin and inflammatory biomarkers were measured in the serum to investigate the correlation with the severity of AR. Additionally, we analyzed whether changes in BMI regulate the severity of AR through serial follow-up of obese children. Results: IL-1β, which is a biomarker of active inflammation in AR, was significantly higher in individuals with AR than in those without and higher in subjects in the obesity group than in those in the normal weight group. A regression analysis showed that the leptin level was associated with increased IL-1β expression in children with AR. In the multivariate analysis, only parental AR (9.2-fold increase in risk), elevated leptin (11.3-fold increase in risk), and high expression of IL-1β (5.8-fold increase in risk) emerged as significant risk factors of moderate to severe persistent allergic rhinitis. We also found that children with an increase or decrease in BMI showed changes in IL-1β and AR symptoms, which these changes were dependent on leptin and BMI. Conclusions: These results suggest that obesity is an important risk factor for the exacerbation of symptoms and leptin can exacerbate inflammation as well as severe and persistent symptoms through IL-1β in AR.

scholarly journals Obesity, Aspirin, and Risk of Colorectal Cancer in Carriers of Hereditary Colorectal Cancer: A Prospective Investigation in the CAPP2 Study

2015 ◽  
Vol 33 (31) ◽  
pp. 3591-3597 ◽  
Author(s):  
Mohammad Movahedi ◽  
D. Timothy Bishop ◽  
Finlay Macrae ◽  
Jukka-Pekka Mecklin ◽  
Gabriela Moeslein ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Reference Group ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Normal Weight ◽  
Obese People ◽  
Msh6 Mutation

Purpose In the general population, increased adiposity is a significant risk factor for colorectal cancer (CRC), but whether obesity has similar effects in those with hereditary CRC is uncertain. This prospective study investigated the association between body mass index and cancer risk in patients with Lynch syndrome (LS). Patients and Methods Participants with LS were recruited to the CAPP2 study, in which they were randomly assigned to receive aspirin 600 mg per day or aspirin placebo, plus resistant starch 30 g per day or starch placebo (2 × 2 factorial design). Mean intervention period was 25.0 months, and mean follow-up was 55.7 months. Results During follow-up, 55 of 937 participants developed CRC. For obese participants, CRC risk was 2.41× (95% CI, 1.22 to 4.85) greater than for underweight and normal-weight participants (reference group), and CRC risk increased by 7% for each 1-kg/m2 increase in body mass index. The risk of all LS-related cancers in obese people was 1.77× (95% CI, 1.06 to 2.96; P = .03) greater than for the reference group. In subgroup analysis, obesity was associated with 3.72× (95% CI, 1.41 to 9.81) greater CRC risk in patients with LS with MLH1 mutation, but no excess risk was observed in those with MSH2 or MSH6 mutation (P = .5). The obesity-related excess CRC risk was confined to those randomly assigned to the aspirin placebo group (adjusted hazard ratio, 2.75; 95% CI, 1.12 to 6.79; P = .03). Conclusion Obesity is associated with substantially increased CRC risk in patients with LS, but this risk is abrogated in those taking aspirin. Such patients are likely to benefit from obesity prevention and/or regular aspirin.

scholarly journals Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication

2021 ◽  
pp. jrheum.201005
Author(s):  
Reto D. Kurmann ◽  
Edward A. El-Am ◽  
Yasser A. Radwan ◽  
Avneek S. Sandhu ◽  
Cynthia S. Crowson ◽  
...  
Keyword(s):  
Heart Disease ◽  
Systemic Sclerosis ◽  
Valvular Heart Disease ◽  
Cardiac Involvement ◽  
Significant Risk ◽  
Fold Increase ◽  
Significant Risk Factor ◽  
Increased Risk ◽  
Incident Cases

Objective Cardiac involvement is a poor prognostic marker in systemic sclerosis (SSc). While diastolic dysfunction, myocardial fibrosis, and arrhythmias are traditionally considered features of primary cardiac involvement in SSc, the incidence of valvular heart disease (VHD) is not well reported. Our objective was to examine the prevalence of VHD at time of SSc diagnosis and incidence of VHD during follow up compared to non-SSc subjects. Methods Medical records of patients with suspicion of SSc were reviewed to identify incident cases. SSc subjects were matched 1:2 by age- and sex to non-SSc subjects. Results The study included 78 incident SSc cases and 156 non-SSc comparators [56 years (± 15.7), 91% female]. A nearly 4-fold increase in the prevalence of moderate/severe VHD prior to SSc diagnosis compared to non-SSc subjects (6% vs. 0%; P=0.004) was identified. During follow up, 18 SSc and 12 non-SSc patients developed moderate/severe VHD. The cumulative incidence of VHD at 10 years after SSc incidence/index was 17.9% (95% CI: 10.7-29.9%) in patients with SSc compared with 2.3% (95% CI: 0.7-6.3%) in non-SSc subjects (HR: 4.23; 95% CI: 2.03-8.83). Coronary heart disease was the only significant risk factor for VHD. Conclusion SSc patients have a 4-fold increase in the prevalence of moderate/severe VHD at diagnosis compared to non-SSc patients. They also have a 4-fold increased risk of developing moderate/severe VHD after diagnosis of SSc. Aortic stenosis and mitral regurgitation have a much higher prevalence in SSc patients, besides secondary tricuspid regurgitation. Underlying mechanisms for this association require further elucidation.

After Elective Sigmoid Colectomy for Diverticulitis, Does Recurrence-Free Mean Symptom-Free?

2020 ◽  
Vol 86 (1) ◽  
pp. 49-55
Author(s):  
Karmina K. Choi ◽  
Kevin Krautsak ◽  
Jessica Martinolich ◽  
Jonathan J. Canete ◽  
Brian T. Valerian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Irritable Bowel Syndrome ◽  
Relative Risk ◽  
Significant Risk ◽  
Sigmoid Colectomy ◽  
Persistent Symptoms ◽  
Abdominal Symptoms ◽  
Increased Risk ◽  
Irritable Bowel

After elective sigmoidectomy for diverticulitis, patients may experience persistent abdominal symptoms. This study aimed to determine the incidence and characteristics of persistent symptoms (PSs) and their risk factors in patients who had no reported recurrence after elective sigmoidectomy. Patients who underwent elective sigmoidectomy for diverticulitis from 2002 to 2016 at a tertiary academic colorectal surgery practice were included. After retrospective review of medical records, patients were contacted with a questionnaire to inquire about recurrence of diverticulitis and persistent abdominal symptoms since resection. Outcomes examined were prevalence of and risk factors for PSs after elective sigmoidectomy. Of 662 included patients, 346 completed the questionnaire and had no recurrent diverticulitis. PSs were reported by 43.9 per cent of the patients. The mean follow-up was 87 months. Female gender and preoperative diagnosis of irritable bowel syndrome were independent risk factors for PSs (Relative Risk 1.65, P < 0.001 and Relative Risk 1.41, P = 0.014). Previous IVantibiotics treatment was associated with PSs ( P = 0.034) but not with a significant risk factor. As the follow-up interval increased, prevalence of PSs decreased ( P = 0.006). More than 40 per cent of patients experienced persistent abdominal symptoms after sigmoidectomy for diverticulitis. Female patients and those with irritable bowel syndrome were at significantly increased risk.

scholarly journals Efficacy and safety of 5-fluorouracil in infrared monitor guided bleb revision

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rumi Kawashima ◽  
Kenji Matsushita ◽  
Ryo Kawasaki ◽  
Kohji Nishida
Keyword(s):  
Proportional Hazards ◽  
Anterior Segment ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Subconjunctival Injection ◽  
Success Rates ◽  
Additional Surgery ◽  
Group A ◽  
Group B

Abstract Purpose Infrared monitor-guided bleb revision (IRGBR), an alternative needling system, visualizes anterior-segment tissues around the bleb not visible during needle revision after trabeculectomy. This study determined the safety and efficiency of 5-fluorouracil (5-FU) as an adjunctive anti-metabolite in IRGBR. Methods We retrospectively analyzed 43 consecutive eyes (40 patients; 14 eyes, primary open-angle; 29 eyes, secondary glaucoma) treated with IRGBR for failing filtering blebs. The patients were divided into two groups. The first one had IRGBR without adjunctive 5-FU subconjunctival injection, and the second one had IRGBR with 5-FU. We performed Kaplan-Meier survival analysis using log-rank tests after 2 years of follow-up and Cox proportional hazards regression model to analyze the dependence of the survival time on predictor variables. Two failure criteria were defined as the need for additional surgery for intraocular pressure (IOP) reduction and the IOP at two consecutive follow-up visits based on definition 1, IOP ≧22 mmHg and definition 2, IOP ≧17 mmHg. Results Thirty eyes (29 cases) underwent IRGBR with subconjunctival 5-FU injection (group A in the second term) and 13 eyes (11 cases) without 5-FU (group B in the first term). The success rates 24 months after IRGBR were 73.3 and 23.1%, respectively, in groups A and B based on the definition 1 failure and 56.7 and 7.7% based on the definition 2 failure. Complications included transient bleb leaks (group A, 3 eyes; group B, none) and choroidal detachment (group A, 1 eye; group B, none). No use of 5-FU and IOPs ≧10 mmHg 1 week after IRGBR were significant risk factors. Conclusions Adjunctive 5-FU in IRGBR achieved a better success rate for failing trabeculectomy blebs.

scholarly journals Efficacy and Safety of Sanfu Herbal Patch at Acupoints for Persistent Allergic Rhinitis: Study Protocol for a Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Xiankun Chen ◽  
Chuanjian Lu ◽  
Cecilia Stålsby-Lundborg ◽  
Yunying Li ◽  
Xiaoyan Li ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Controlled Trial ◽  
Treatment Session ◽  
Waiting List ◽  
Life Questionnaire ◽  
Efficacy And Safety ◽  
Persistent Allergic Rhinitis ◽  
One Year ◽  
Group B

Background. The Sanfu herbal patch (SHP) has been widely used to treat allergic rhinitis (AR) in China. SHP has been reported to be effective for managing the symptoms of AR, but the evidence suffers from methodological limitations. Therefore, we designed a three-armed, randomized, and placebo-controlled trial to evaluate the efficacy and safety of SHP for persistent allergic rhinitis (PAR).Methods. The trial consists of 5 treatment sessions along with a one-year follow-up. This process is then repeated in the second and third years. Eligible participants diagnosed with PAR were randomized at a ratio of 2 : 2 : 1 into one of three groups: (a) SHP group; (b) placebo group; or (c) waiting-list group. The waiting-list group will receive no treatment in the first year but will receive SHP in the following two years. The primary outcome, total nasal symptoms score, is self-assessed at the beginning of each treatment session and during each annual follow-up. Secondary outcomes include the Rhinoconjunctivitis Quality-of-Life Questionnaire, allergic rhinitis attacks, and relief medications. The trial will be stopped if early termination criteria are met during the interim analysis.Ethics. This protocol has been approved by site ethics committee (number B2014-014-01) and is registered with ClinicalTrials.govNCT02192645.

scholarly journals Glasgow Aneursym Score: A Predictor of Long-Term Mortality Following Endovascular Repair of Abdominal Aortic Aneurysm?

2021 ◽  
Author(s):  
Anıl Özen ◽  
Metin Yılmaz ◽  
Görkem Yiğit ◽  
İsa Civelek ◽  
Mehmet Ali Türkçü ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Survival Rates ◽  
Fold Increase ◽  
Mortality Rates ◽  
Abdominal Aortic ◽  
Point Increase ◽  
Increase In Risk ◽  
Long Term Mortality

Abstract Background To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods A retrospective single-center study of 257 patients with non-ruptured AAA undergoing EVAR between January 2013 and 2021. GAS scores were compared between the survivors and the long term mortality groups. Receiver operating characteristic curve (ROC) analysis was used to determine the optimum cut-off values of GAS values to determine the effect on late-mortality. Results 257 patients with a mean age of 69.75 ± 7.75 (46–92) underwent EVAR due to AAA. Forty-nine mortalities were observed, 4 (1.5%) were in-hospital mortalities. Fourty-five (17.8%) of the mortalities occured during the long-term follow-up. The average follow up period was 18.98 ± 22.84 months (0–88). GAS values were higher in the long-term mortality group compared to the survivors group (81.02 ± 10.33 vs 73.73 ± 10.46; p < 0.001). The area under the ROC curve for GAS was 0.682 and for a 56% sensitivity rate, the cut-off value for GAS was 77.5 with a specificity of 64% (p < 0.001). The number of patients with GAS values < 77.5 was 155, whilst 98 had GAS values > 77.5. The mortality rates in patients with GAS < 77.5 and GAS > 77.5 were: 12.8% (n = 20) and 24.8% (n = 25), respectively (p = 0.014). Every 1 point increase in GAS score resulted in a 1.06 fold increase in risk of late mortality (OR: 1.06, 95% CI, 1.03–1.09; p < 0.001). Moreover, every 10 point increase in GAS score resulted in almost a 2 fold increase in risk of long-term mortality (OR: 1.8, 95% CI, 1.3–2.5; p < 0.001). The mean survival rate of the patients during the follow up period was 90.6% for the 1st year, 82.6% for the 3rd year and 70.0% for the 5th year. Five year survival rates in patients with GAS < 77.5 and > 77.5 were 75.7% and 61.7%, respectively (p = 0.013). Conclusion Every 10 point increase in GAS score resulted in almost a 2 fold increase in risk of long-term mortality. Moreover, the mortality rates in patients above the GAS cut off value almost doubled compared to those below. Five year survival rates were 14% higher in those with GAS below the cut off value when compared to those above.

scholarly journals Weight Status Change From Adolescence to Young Adulthood and the Risk of Hypertension and Diabetes Mellitus

Hypertension ◽  
2020 ◽  
Vol 76 (2) ◽  
pp. 583-588
Author(s):  
Min Zhao ◽  
Pascal Bovet ◽  
Bo Xi
Keyword(s):  
Diabetes Mellitus ◽  
Young Adulthood ◽  
Weight Status ◽  
Significant Risk ◽  
Normal Weight ◽  
Excess Weight ◽  
Status Change ◽  
Increased Risk ◽  
The Us

It is still unclear whether the risk of hypertension and diabetes mellitus in adulthood remains increased if excess weight in adolescence recedes later in life. This study examines the effect of change in weight status from adolescence to young adulthood on the risk of hypertension and diabetes mellitus. A total of 4454 adolescents aged 12 to 19 years from the US National Longitudinal Study of Adolescent Health (1994–1995) were followed up to young adulthood (25–32 years, 2007–2008). After a median follow-up time of 13 years, compared with normal weight in both adolescence and young adulthood (n=1328, 29.8%), excess weight in the 2 periods (n=1077, 24.2%) was associated with an increased risk of hypertension (odds ratio, 3.72 [95% CI, 2.86–4.84]) and diabetes mellitus (3.32 [2.11–5.21]). Normal weight in adolescence but excess weight in young adulthood (n=1983, 44.5%) was associated with a lower but still significant risk of hypertension (2.49 [1.98–3.15]) and diabetes mellitus (1.59 [1.01–2.51]). In contrast, the risk of hypertension (1.37 [0.64–2.95]) and diabetes mellitus (1.65 [0.45–6.05]) was low in the few participants with excess weight in adolescence but normal weight in young adulthood (n=66, 1.5%). In conclusion, excess weight in young adulthood was associated with an increased risk of hypertension and diabetes mellitus, irrespective of weight status in adolescence. In contrast, excess weight in adolescence but normal weight in young adulthood did not seem to be associated with an increased cardiovascular risk in young adulthood.

scholarly journals Immunotherapy and probiotic treatment for allergic rhinitis in children

2018 ◽  
Vol 58 (6) ◽  
pp. 280-5
Author(s):  
Sumadiono Sumadiono ◽  
Cahya Dewi Satria ◽  
Nurul Mardhiah ◽  
Grace Iva Susanti
Keyword(s):  
Allergic Rhinitis ◽  
Standard Therapy ◽  
Clinical Symptoms ◽  
Therapy Group ◽  
Controlled Trial ◽  
Standard Therapy Group ◽  
Persistent Allergic Rhinitis ◽  
Probiotic Treatment ◽  
Group A ◽  
Group B

Background Allergic rhinitis is a global health problem that is increasing in prevalence. Many kinds of therapy have been tried, such as antihistamines, probiotics, and immunotherapy. Immunotherapy may restore the patient’s normal immunity against the specific allergen, while probiotics may modify the natural course of allergy. Objective To evaluate probiotics and immunotherapy for improving clinical symptoms of allergic rhinitis. Methods This randomized controlled trial (RCT) involved 64 patients, aged 3-18 years, and diagnosed with persistent allergic rhinitis in the Department of Child Health, Sardjito General Hospital from April 2016 until May 2017. Patients were randomly allocated into three therapy groups: group A (standard therapy/cetirizine only), group B (standard and probiotic therapy), and group C (standard therapy and immunotherapy). Clinical symptoms of allergic rhinitis including sneezing, rhinorrhea, and itchy nose, were evaluated for 7 weeks and classified as improved or not improved. The significance of the data was analyzed using proportion test. Results Sixty-four patients completed 7 weeks of therapy, 15 subjects in group A, 26 in group B, and 23 in group C. Group C showed significantly more improvement of sneezing and rhinorrhea compared to both group A (Z=5.71; Z=7.57, respectively) and group B (Z=2.82; Z=6.90, respectively). However, itchy nose was not significantly improved in group C compared to group B (Z=0.50), but was significantly improved in group C compared to group A (Z=10.91). Group B had significant improvement of sneezing, rhinorrhea, and itchy nose compared to group A (Z=3.81, Z=2.86, and Z=10.91, respectively). Conclusion The combined standard-immunotherapy group has significantly superior improvement compared to the combined standard-probiotic group and the standard therapy group, in terms of sneezing and rhinorrhea in children with persistent allergic rhinitis.

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

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