Clinicoepidemiological user profile of lichen scrofulosorum a new 22year singlecenter retrospective study
1%). The pooled prevalence of CD in AIH was 3.5% (95% CI=1.6%-5.3%) (heterogeneity P=.874; I
=0.0%), which is clearly higher than the 1% CD seen in most general populations. When also including studies where CD had been diagnosed through positive serology without biopsy (15 studies n=1817 individuals with AIH), the pooled prevalence of CD was 2.9% (95% CI=2.1%-3.8%) (heterogeneity P<.001; I
=66.8%).
Our results demonstrate a higher prevalence of CD in individuals with AIH compared to the general population. CD screening may be considered in patients with AIH.
Our results demonstrate a higher prevalence of CD in individuals with AIH compared to the general population. CD screening may be considered in patients with AIH.
This research aimed to study the clinical and biochemical characteristics and health outcomes of patients admitted and found to have hypomagnesemia in an Australian hospital with a high proportion of Indigenous Australians.
A retrospective cohort study was conducted of all patients with hypomagnesemia hospitalised between 1st August 2008 and 31st December 2014 at Royal Darwin Hospital (RDH). All relevant demographic, clinical, and biochemical were collected from patients' medical records. The hospital database was reviewed in January 2018 for mortality of all included patients.
876 patients had been admitted with a confirmed diagnosis of hypomagnesemia during the study period, with mean follow up period of 4.0 ±2.7 years. The mean age at admission was 52.4 ± 19.1 years, 52.2% were females and, 56.5% were Indigenous Australians. Chronic kidney disease (99.7%), excessive alcohol consumption (45.7%), hypertension (43.9%), and respiratory diseases (15.0%) were the most common conditions in these patients. Carbohydrate Metabolism chemical Hypomagnesemia was associated with prolonged length of hospital stay. Most patients did not receive treatment for hypomagnesaemia during admission. During the follow-up period, 38.6% of patients died, and the most common causes of death were malignancies (29.9%).
Hypomagnesemia was a common and under-treated condition in hospitalised patients and was associated with poor health outcomes. Therefore, hospitals should develop guidelines for replacing and monitoring magnesium levels during hospitalisation, achieving better outcomes. This article is protected by copyright. All rights reserved.
Hypomagnesemia was a common and under-treated condition in hospitalised patients and was associated with poor health outcomes. Therefore, hospitals should develop guidelines for replacing and monitoring magnesium levels during hospitalisation, achieving better outcomes. This article is protected by copyright. All rights reserved.
An association between Crohn's disease (CD) and hepatic steatosis has been reported. However, the underlying mechanisms of steatosis progression in CD are not clear. Among the most effective CD treatments are agents that inhibit Tumor-Necrosis-Factor (TNF) activity, yet it is unclear why anti-TNFα agents would affect steatosis in CD. Recent studies suggest that microbiome can affect both, CD and steatosis pathogenesis. Therefore, we here analysed a potential relationship between anti-TNF treatment and hepatic steatosis in CD, focusing on the gut-liver axis.
This cross-sectional study evaluated patients with established CD, with and without anti-TNFα treatment, analysing serum markers of liver injury, measurement of transient elastography, controlled attenuation parameter (CAP) and MRI for fat detection. Changes in lipid and metabolic profiles were assessed by serum and stool lipidomics and metabolimics. Additionally, we analysed gut microbiota composition and mediators of bile acid (BA) signalling via stool and serum analysis.
Patients on anti-TNFα treatment had less hepatic steatosis as assessed by CAP and MRI. Serum FGF19 levels were significantly higher in patients on anti-TNFα therapy and associate with reduced steatosis and increased bowel motility. Neutral lipids including triglycerides were reduced in the serum of patients on anti-TNF treatment. Bacteria involved in BA metabolism and FGF19 regulation, including Firmicutes, showed group-specific alterations with low levels in patients without anti-TNFα treatment. Low abundance of Firmicutes was associated with higher triglyceride levels.
Anti-TNFα treatment is associated with reduced steatosis, lower triglyceride levels, alterations in FXR-signalling (eg FGF19) and microbiota composition in CD.
Anti-TNFα treatment is associated with reduced steatosis, lower triglyceride levels, alterations in FXR-signalling (eg FGF19) and microbiota composition in CD.
In UK universities, caries removal teaching utilises plastic teeth. This format does not enable students to learn how to distinguish between tooth layers and caries via tactile feedback. The aim of this study was to assess the applicability of a novel, 3D-printed carious tooth within caries removal teaching.
Single-material 3D-printed teeth containing simulated tactile caries were developed and 14 final-year undergraduates were briefed to remove caries and minimise damage to healthy tissue within the tooth. Students completed evaluation questionnaires for their opinion of 3D-printed teeth in comparison to plastic teeth and perceived confidence to subsequently treat patients. Cavity preparation perimeters were measured, using photographs with a standard protocol. Heat map analysis illustrated variation in location and extent of cavity preparations produced by the cohort.
Student feedback indicated the 3D-printed caries exercise was positively received, 71.4% agreed 3D-printed teeth would have better prepared students for patient treatment; 78.6% rated their preclinical stress/anxiety as 'very high' or 'high' and 57.1% agreed that if preclinical teaching incorporated 3D-printed teeth, their stress/anxiety when treating their first caries patient would have been reduced. The average perimeter of cavity preparation indicated relative variation, with a maximum perimeter of 19.6mm and a minimum of 10.7mm, and a range of 8.9mm.
Introducing 3D-printed teeth into preclinical teaching would allow students to gain confidence in clinically relevant experience in tactile aspects of caries treatment earlier in their training than currently possible.
This study demonstrates student acceptance of an alternative caries removal teaching method, with potential to increase aptitude in caries removal in a clinically relevant manner.
This study demonstrates student acceptance of an alternative caries removal teaching method, with potential to increase aptitude in caries removal in a clinically relevant manner.