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Risk for stroke and chronic kidney disease in patients with sleep apnea syndrome and heart failure with different ejection fractions

artery disease; HF; arrhythmias; stroke; nasal septum deviation; polyposis; hypertrophic uvula; smoking status and SAS score. The somnographic recording was done with Stardust Respironics and Porti. Several parameters were measured: the number of central, obstructive, mixed apnea and hypopnea; both the total number of events and the number of events per hour; the apnea–hypopnea index (AHI); the desaturation index; the mean saturation; the lowest saturation; and the longest desaturation period. The somnographic recording was performed and scored manually according to

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Awake sedation thoracoscopy for the diagnosis of malignant mesothelioma: a service review

(VATS). Safety analysis involved determining the rate of major and minor complications. In addition, we analysed the 6-point patient-perceived comfort score, which was introduced to the service in 2013, to examine how well the procedure was tolerated. Results This service review included 104 consecutive patients who underwent thoracoscopy over a 5-year period from April 2010 to April 2015. Seventy-one were male (68%), and 33 were female (32%). The age range varied widely from 36 to 92 years (mean 70.4 years, median 71 years). Thoracoscopy was performed on the

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Asthma–COPD–Bronchiectasis combination: an unstudied triplet

, Holland SM, Prevots R. Trends in bronchiectasis among Medicare beneficiaries in the United States, 2000 to 2007. Chest 2012;142: 432–439. 22302301 10.1378/chest.11-2209 Seitz AE Olivier KN Adjemian J Holland SM Prevots R Trends in bronchiectasis among Medicare beneficiaries in the United States, 2000 to 2007 Chest 2012 142 432 439 3 Padilla-Galo A, Olveira C, Fernández de Rota-Garcia L, Marco-Galve I, Plata AJ, Alvarez A, et al. Factors associated with bronchiectasis in patients with uncontrolled asthma; the NOPES score: A study in 398

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Sleep apnea syndrome and heart failure—mechanisms and consequences

with continuous positive airway pressure. Journal of Cardiac Failure 2010;16(2): 164–174. 20142029 10.1016/j.cardfail.2009.08.006 Chowdhury M Adams S Whellan DJ Sleep-disordered breathing and heart failure: Focus on obstructive sleep apnea and treatment with continuous positive airway pressure Journal of Cardiac Failure 2010 16 2 164 174 11 Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, et al. Rules for scoring respiratory events in sleep: Update of the 2007 AASM manual for the scoring of sleep and associated events

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Decreased plasma epidermal growth factor (EGF) levels in patients with severe chronic obstructive pulmonary disease

bronchoalveolar lavage levels of EGF ( 21 ). Sputum HB-EGF expression was significantly increased in patients with COPD compared with nonsmokers and smokers without COPD. There was a significant positive correlation between sputum HB-EGF and COPD assessment test (CAT) score. HB-EGF expression was significantly increased in the lung tissue samples of patients with COPD and associated with collagen deposition and N- and E-cadherin, and vimentin expression. In vitro, HB-EGF promoted collagen production in lung fibroblasts. Moreover, HB-EGF induced the EMT process through induction

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Prognosing a severe course of asthma in children following the study of endothelial function

propensity score matching. The quality of the elaborated model was tested using the percent concordant (PC). This figure is equal to the fraction of observations that were correctly reclassified into separate subgroups of the dependent index using the logistic regression equation. The closer this indicator to 100%, the higher the quality of the resulting model is. Mathematically, the logistic regression model is represented as the dependence of the logarithm of the chance of the onset of the predicted event (logit) on the linear combination of factor variables

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The Relationship between Hepatic Steatosis, inflammation and insulin Resistance in type 2 Diabetes with Metabolic Imbalance

. Diabetes Care, 2004; 27(6):1487-1495. DOI: 10.2337/diacare.27.6.1487 10. “Fatty Liver Index - Mdcalc”. Mdcalc.Com, Available from: https://www.mdcalc.com/fatty-liver-index (accessed at 28 December 2018) 11. “Hepatic Steatosis Index (HSI) Calculator”. Available from: https://www.mdapp.co/hepatic-steatosis-index-hsi-calculator-357/ (accessed at 28 December 2018) 12. “Non-Alcoholic Fatty Liver Disease - Liver Fat Score (NAFLD-LFS) Calculator”. Available from: https://www.mdapp.co/non-alcoholic-fatty-liver-disease-liver-fat-score

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Family Quality of Life Among Families with a Member Diagnosed with CLD – What to Expect?

Abstract

Background and objectives. Health-related quality of life (HRQoL) is a very important outcome in patients with chronic liver disease. Thus, the present study attempts to assess the family quality of life of these patients, since it is well known that families have always represented the primary environment of most people.

Matherial and methods. A sample of 30 participants with a family member who had CLD were recruited to be interviewed through the Romanian adaptation of the Family Quality of Life Survey – general version 2006 (FQOLS-2006), an evaluation tool developed in Canada with the purpose of studying families’ quality of life among. Primary caregivers completed the FQOL Survey. The data was analysed to describe population characteristics and to explore the relationship between the main domains and dimensions of QoL and the patients and caregivers characteristics.

Results. The findings showed highest domain scores for Support from services and Family relationships and lowest for Support from others. Dimension scores were highest for Importance and lowest for Stability. Overall FQOL approximated average (78.5±13.4). Younger patients scored lower rates of FQOL domains. Alcohol-related liver disease led to lower rates of all the domains, except from Support from others and Leisure and Recreation activities. Patients with liver cirrhosis or liver cancer negatively influence their caregiver’s success in career. Also, families of liver cirrhosis patients reported the lowest level of satisfaction among all respondents.

Conclusions. The results of this study suggest that there are some significant areas of family life highly influenced by a chronic liver disease diagnosis in one of their members.

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A Rare Cause of Chronic Hepatitis: Celiac Disease

Abstract

Introduction. Celiac disease is a chronic bowel disease with a prevalence of 1% in the general population. This condition, immune-mediated, may exhibit multiple extra-intestinal changes, including the liver.

Case presentation. We present the case of a 43-year-old patient presenting in our clinic for fatigue, associated with cytolytic and cholestatic hepatic syndrome with an onset of 10 years. During this time, the patient performed multiple investigations with the exclusion of viral, autoimmune etiology, primitive biliary cirrhosis and Wilson's disease. An abdominal ultrasound recorded an elongated, with an infundibular septum gallbladder. Abdominal computer tomography did not detect any changes. The final diagnosis is chronic alithiasic cholecystitis receiving hepatoprotective treatment with symptom relief and improved hepatic disorders. Over the past 2 years, the patient was diagnosed with osteoporosis (T score = -2.7 followed by treatment with Calcium and Vitamin D and improvement in T score to -2.1), and an iron deficiency anemia corrected with oral iron treatment. Upon resuming the anamnesis, we notice the presence of an intermittent bloating associated with diarrhea. Positive anti-transglutaminase antibodies required upper endoscopy with biopsy witch confirmed celiac disease.

Conclusion. Despite the rather low prevalence of celiac disease in the etiology of hepatocytolysis, it is important to investigate its presence in the context of hepatic changes with uncertain etiology. This case motivates us to be rigorous in looking for secondary causes of hepatic impairment even in patients with apparently benign changes.

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Comparative Analysis Between the Basdai and Mini-Basdai Indices in Patients with Ankylosing Spondylitis

Abstract

Objectives. The aim of this paper is to compare the degree of accuracy between the BASDAI and mini-BASDAI indices in assessing the activity of ankylosing spondylitis (AS), especially in patients without peripheral manifestations.

Materials and method. Our cross-sectional study consisted of a group of 124 patients with AS, according to the modified New York criteria. All patients offered their informed consent. All the individual characteristics of the patients were documented, both demographic and disease-related. The activity of the disease was measured using the BASDAI questionnaire, from which we calculated the mini-BASDAI by eliminating the questions about peripheral arthritis and entesitis. The functional impairment of mobility in the spine and sacro-iliac joints was measured by the Schober index, lateral spinal flexion, occiput-wall, menton-sternum and finger-ground index.

Results. The mean age of the patients was 43.43 +/− 13.27 years, mean height 174.3 +/− 8.46 cm, weight 78.23 +/− 14.19 kg, duration of disease in years 15.06 +/− 9.19 and number of years from initiation of biological therapy 6.42 +/− 3.08. The BASDAI score was 1.26 +/− 1.93, while the mini-BASDAI score was 1.51 +/− 2.08. In the group of patients without peripheral manifestations, both BASDAI and mini-BASDAI correlated significantly with the occiput-wall index, besides ESR, CRP, ASDAS-CRP and the Schober index.

Conclusion. Mini-BASDAI is not superior to BASDAI in evaluating patients with ankylosing spondylitis without peripheral manifestations, but it has shown a better correlation in addition to BASDAI with the indices of flexion of the cervico-dorsal spine.

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