ObjectiveNon-invasive disease indicators are currently limited and need further research due to the increased non-alcoholic fatty liver disease (NAFLD) prevalence worldwide. The serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) has been recognized as a novel inflammatory and metabolic marker. Herein, we explored the correlation between UHR and the risk of NAFLD in-depth.MethodsA total of 3,766 participants were included in our survey, and the National Health and Nutrition Examination Survey (NHANES) 2017–2018 cycle provided the cross-sectional study population. Weighted multivariable logistic regression and multivariate linear regression analyses were performed to assess the association between the UHR and the odds of NAFLD and liver steatosis and fibrosis severity, respectively. Moreover, we explored the non-linear relationship between the UHR and NAFLD by the generalized additive model.ResultsNAFLD probabilities were statistically demonstrated to be positively correlated with the UHR (OR = 1.331 per SD increase, 95% CI: 1.100, 1.611). The positive connection of the UHR with NAFLD risk persisted significantly in female subjects but not in male subjects in subgroup analyses stratified by gender. The non-linear relationship analysis demonstrated that a UHR between ~20 and 30% suggested a saturation effect of NAFLD risk. Furthermore, a dramatically positive correlation was found between the UHR and hepatic steatosis severity but not fibrosis. Finally, the receiver operating characteristic analysis suggested that UHR had a better predictive value for NAFLD than either serum uric acid (sUA) or high-density lipoprotein cholesterol (HDL) alone [UHR (area under curve): 0.6910; 95% CI: 0.6737–0.7083; P < 0.0001].ConclusionOur investigation revealed that the elevated UHR level was independently related to an increased NAFLD risk and the severity of liver steatosis in American individuals. The correlation differed according to sex. This non-invasive indicator may enhance the capacity to predict the onset of NAFLD and may uncover alternative therapeutic interventional targets.
DesignThere is a strong correlation between dietary intake and allergic diseases. Ultra-processed foods (UPFs) are gradually becoming dominant worldwide and causing health problems for children and adults. We hope to determine whether links exist between UPFs and allergic symptoms.MethodsWe investigated data from 2,736 children (16–19 years) and 4,256 adults (≥20 years) from the National Health and Nutritional Examination Survey (NHANES) 2005–2006. The associations between the mean UPFs contribution to total energy intake and all allergic symptoms (IgE, current asthma, allergy, rash, sneeze, wheeze, eczema, and hay fever) were estimated by weighted multivariate logistic regression.ResultsLogistic regression analysis showed UFPs were negatively associated with IgE levels in children. Those with higher quartiles had a reduced risk from 16% (OR, 0.84, 95%CI, 0.55 to 1.28) to 34% (OR, 0.66, 95%CI, 0.49 to 0.89), p for trend = 0.006. UPFs were also positively related to current asthma in children with an increased risk of 11% (OR, 1.11, 95%CI, 0.79 to 1.56) to 76% (OR, 1.76, 95%CI, 1.10 to 2.82), p for trend = 0.0393. UPFs were also associated with eczema in girls. But there was no association observed between UPFs and allergic symptoms in adults.ConclusionOur results suggested that UPFs assessed by the NOVA system were associated with IgE, current asthma in children, and eczema in girls. These results further support the need to test the association of modern dietary patterns with allergic symptoms.
Although alectinib is a well-tolerated and highly effective inhibitor of a second-generation anaplastic lymphoma kinase, special attention should be paid to the possibility of potentially severe and fatal adverse events such as interstitial pneumonia. We report a case of a patient with advanced non-small cell lung cancer treated with alectinib who developed immunohistochemically positive anaplastic lymphoma kinase (ALK(IHC +)) . However, due to the rapid emergence of drug-induced interstitial lung disease, alectinib treatment was halted. Once the interstitial lung disease had been successfully treated, we reluctantly chose crizotinib as a second-line treatment for ALK + NSCLC in this patient as he refused all other available treatments. Contrary to expectation, crizotinib performed well both in terms of its safety and efficacy. Our results suggest that crizotinib may provide a promising therapy option for patients with ALK + NSCLC accompanied by alectinib-induced interstitial lung disease. To our knowledge, this is a rare report of successful treatment of ALK + NSCLC with crizotinib after alectinib-induced interstitial lung disease.
T-SPOT.TB is a novel screening method for Mycobacterium tuberculosis infection. However, it is controversial whether T-SPOT.TB should become an alternative method to the tuberculin skin test (TST) for screening M. tuberculosis infections. The present study aimed to evaluate this issue based on the retrospective analysis of clinical cases. TST and T-SPOT.TB tests were used on patients with suspected M. tuberculosis infection on admission. Demographic data and clinical information, including previous history of M. tuberculosis infection, were collected. A total of 118 patients were included in the analysis, among whom 30 (25.4%) were diagnosed with active M. tuberculosis infection, and seven patients (5.9%) were currently receiving immunosuppressive treatment. The overall sensitivity and specificity of the TST were 76.7 and 77.3%, respectively, while they were 88.3 and 68.1%, respectively, for the T-SPOT.TB test. Patients with large TST indurations had a higher number of gamma interferon-producing T cells among peripheral blood mononuclear cells compared with those of TST-negative patients. In conclusion, the T-SPOT.TB test had a higher sensitivity than the TST, but the difference was not statistically significant. Neither the T-SPOT.TB test nor the TST was sufficiently accurate to detect active M. tuberculosis infection. Materials and methods Participants and data collection. A retrospective analysis was performed on patients diagnosed at the Respiratory Department of Ningbo First Hospital (Ningbo, China) between October 2016 and 2017. A total of 118 patients who were suspected of active TB infection on admission were included in the analysis. Each patient was subjected to the TST as well as the T-SPOT.TB test. The patients' demographics and clinical information, including previous history of TB, were collected. Definitions and diagnoses. Final diagnoses were made considering all clinical, radiological, microbiological and pathological information. Patients who had clinical, bacteriological and/or
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