bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of autoimmune diseases with celiac disease and its risk factors
Authors: Kayar Yusuf , Dertli Ramazan 
Published: October 2019

Objectives: Autoimmune Diseases (AIDs) are detected in celiac patients. Our purpose was to determine the AIDs that are associated with celiac disease and related risk factors in the Turkish population.
Methods: The study included 230 celiac patients who were diagnosed and followed-up in our clinics between 2015-2019. All AIDs that accompanied the celiac disease were recorded, and their association with risk factors was analyzed.
Results: The mean age of the patients was 35.6±10.6 years (age range:18-72). A total of 58(25.2%) patients were male and the mean age at onset of disease was 29.1±6.5 years. The duration of disease follow-up was 6.5±4.6 years. One hundred and twenty two (53%) patients were on a strict diet, and 72(31.3%) patients had accompanying AID. Hashimoto thyroiditis was found in 39(17%) patients, asthma in 16(7%) patients as the most common comorbidities. There was a significant relation between AID and female gender, age of diagnosis being <40 years, duration of disease, non-GIS symptoms at the time of admission, and non-employment status.
Conclusion: Screening other AIDs in celiac patients are important, especially in individuals who have risk factors. Considering that many AIDs may develop in the future despite dietary compliance, patients should be followed with a multidisciplinary approach.
doi: https://doi.org/10.12669/pjms.35.6.821
How to cite this:Kayar Y, Dertli R. Association of autoimmune diseases with celiac disease and its risk factors. Pak J Med Sci. 2019;35(6):1548-1553. doi: https://doi.org/10.12669/pjms.35.6.821
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Understanding bariatric surgery to support patients in primary care
Authors: Abraham Jenny , Shah Neha , Levine Fridi , Graham Yitka 
Published: October 2019

The relatively new field of bariatric surgery is increasingly used as an option to address issues linked to obesity. Practice nurses must understand how they can manage patients who have undergone these procedures Obesity is steadily rising, with 64% of adults in England in 2017 being classified as overweight or obese. Obesity is strongly linked to metabolic diseases such as cardiovascular disease, type 2 diabetes mellitus (T2DM), non-alcoholic fatty liver disease (NAFLD), polycystic ovary syndrome (PCOS), musculoskeletal and respiratory disorders, cancer as well as psychological illness ( World Health Organization (WHO), 2018 ). Therefore every opportunity should be taken to support patients to lose weight and maintain weight loss. Practice nurses are in a unique and pivotal position to guide patients in a variety of options to assist in their weight loss. Bariatric surgery in England is relatively new, with its usage having increased dramatically in the last 10 years. Practice nurses require knowledge of bariatric surgery to undertake their role effectively. This article provides information to assist practice nurses in providing care and support to patients who have had a surgical intervention. This paper also highlights signs and symptoms of physical and psychological complications including pregnancy and excess skin and recommended action and advice including nutritional monitoring and supplementation.
PENGARUH SUGARCANE STREAK MOSAIC VIRUS TERHADAP ANATOMI DAN KADAR KLOROFIL DAUN BEBERAPA AKSESI TEBU (Sacharrum officinarum)
Authors: Hamida Ruly , Suhara Cece 
Published: October 2019

As one of the most important crops in Indonesia, sugarcane productivity is currently still hampered by Sugarcane Streak Mosaic Virus (SCSMV), with the intensity of leaf damage reach 60% . The symptoms of this disease are the occurrence of irregular pattern between light green to pale in sugarcane leaves. The information about SCSMV in plant anatomy and physiology was still lacking. Therefore the objective of this studies was to determine the effect of SCSMV infection to morphological, anatomical and physiological characters of sugarcane leaves. The research was performed on 30 sugarcane clones by using a randomized block design with three replications. The results showed that there was change in the morphology of leaves, but leaf color did change. The decrease in the ratio of chlorophyll a / b leaves 65% higher in the resistant clones, i.e. clones PS 06 103 and PS 06 199. The number of stomata also decreased in clones by SCSMV.
PARAMETER POPULASI IKAN BETOK (Anabas testudineus (BLOCH, 1792)) DI EKOSISTEM PAPARAN BANJIR SUNGAI MUSI, Lubuk Lampam
Authors: Nurdawati Syarifah , Fahmi Zulkarnaen , Supriyadi Freddy 
Published: October 2019

Anabas testudineus Bloch, 1792 is economically important fish species found in Lubuk Lampam floodplains of Musi River. Fishing activities that take place throughout the year can affect reproduction patterns and recruitment (new additions) of fish. This study aims to evaluate several parameters of betok fish populations that can be used as input for fish resource management policies in floodplains of Musi river. A total of 3271 samples of betok fish caught by fishermen from March to November 2011 were collected to obtain data on fish length and weight. Growth parameters (L∞, K, Z dan M) were calculated using FiSAT II based on the length frequency distribution of fish. The values of L∞ and K were obtained at 204.75 mm and 0.24 / year respectively while the maximum age of fish was estimated to be 4.36 years. The total mortality (Z) and natural mortality (M) of betok fish is 0.99 / year and 0.42 / year, Fishing mortality (0.56/year). The exploitation rate (0.57) was slightly lower than the predicted value (Emax= 0.69) indicating that Anabas testudineus was near fully exploited in the Lubuk Lampam floodplain ecosystem.
THE MACROFUNGI DIVERSITY AND THEIR POTENTIAL UTILIZATION IN TANGALE NATURE RESERVE GORONTALO PROVINCE
Authors: Arini Diah Irawati Dwi , Christita Margaretta , Kinho Julianus 
Published: October 2019

Tangale Nature reserve is a conservation area located in Gorontalo that have the biodiversity typical of Wallacea bioregion including macroscopic fungi. The purpose of this study was to identify the fungal species diversity found in the Tangale Nature reserve as well as its potential use, considering that the information on species diversity of fungi in the Wallacea region is very limited. This research was conducted using the cruise method by identifying macroscopic fungi along the hiking trail of Tangale Nature Reserve. The macroscopic fungi were observed for its morphological characteristic include the colour, diameter, surface of the veil, the shape of the stem, the length and diameter of the stem, the lamella, including ring and pore, type of lamella and the type of volva. The research recorded the substrates and the location where the fungus was found. Data were analyzed descriptively qualitative. The results of the research identified 28 species of macroscopic fungi that included to the division Ascomycota and Basidiomycota. It belongs to 16 families and 8 orders are Pezizales, Agaricales, Auriculariales, Boletales, Cantharellales, Gomphales, Polyporales, dan Russulales. Based on place to grow as much as 57,14% were found growing on decaying wood and 42,86% found growing in the soil/litter. Based on the potential of use, it has identified four species of mushrooms potentially as edible mushroom are Pleurotus ostreatus, Auricularia auricula, Ramaria formosa, and Polyporus arcularius. 11 species of mushrooms potentially as medicinal mushroom are Calvatia craniiformis, Scleroderma citrinum, Lenzites betulina, Microporus flabelliformis, Coriolus versicolor, Microporus xanthopus, and Albatrellus confluens.
NISHAH KELAMIN, HUBUNGAN PANJANG-BERAT DAN UKURAN REPRODUKSI HIU Hexanchus spp. DI PERAIRAN SELATAN NUSA TENGGARA
Authors: Sentosa Agus Arifin 
Published: October 2019

Hexanchus spp. are shark species that are often caught in the Indian Ocean southern Nusa Tenggara and its status is Near Threatened, but the information is still relatively limited. This study aimed to sex ratio, length-weight relationship and reproductive size of sixgill shark, Hexanchus spp. caught from southern Nusa Tenggara waters. This study had been carried out during 2016 at the Fishing Port of Tanjung Luar, East Lombok, West Nusa Tenggara. Shark data collection was done by measuring the length, weight, maturity and fishing data. Data were analyzed by formula of sex ratio, length-weight relationship, length at first maturity (Lm) and length at first catch (Lc). The results showed that Hexanchus spp. caught in the southern Nusa Tenggara waters consisted of H. nakamurai (81.82%) and H. griseus (18.18%). The sex ratio of both sharks was dominated by the female. The average of the total length of H. griseus (218.3 ± 96.08 cm). It was longer than H. nakamurai (127.6 ± 30.35 cm). The length-weight relationship of H. griseus was formulated as W = 0.0195 LT 2,6344 (R² = 0,9265) and H. nakamurai with the formula W = 0.002 LT 3,1098 (R² = 0.902). Both species have the size of Lm was bigger than the size of Lc which indicated to their population vulnerability.
35 Is Weekend Admission Associated With Increased Risk of Post-ERCP Pancreatitis?
Authors: Goyal Abhinav , Chatterjee Kshitij , Rangaswami Janani , Singh Shailender 
Published: October 2019

INTRODUCTION:
Pancreatitis is one of the most common complications of Endoscopic Retrograde Cholangiopancreatography (ERCP). There are endoscopist related factors and patient related factors that increase the risk of post-ERCP pancreatitis. However, epidemiologic factors that increase the risk of same are not well known. We aim to study the association between various epidemiologic factors especially weekend admission and post- ERCP pancreatitis.

METHODS:
National Inpatient Sample for years 2009–2013 was used for this study. It is the largest ICD-9 code based inpatient database in the US. ICD-9-CM procedure code 51.10 was used to identify all adults who underwent ERCP. Post-ERCP pancreatitis was identified with ICD-9-CM code 577.0 listed as secondary diagnosis. All hospitalizations with missing age & gender information, or primary diagnosis of pancreatitis were excluded. Mean and percentages were used to summarize continuous and categorical variables respectively. Multivariate logistic regression was used to identify the predictors of post-ERCP pancreatitis. Demographic & hospital characteristics, clinically relevant Elixhauser co-morbidites, pancreatic stent placement, and sphincterotomy were used as covariates for regression model.

RESULTS:
Total of 140859 ERCP(s) were performed during five years. Of these 18870 (13.4%) patients developed post-ERCP pancreatitis and 430 (2.3%) of these died during the hospitalization. Pancreatic duct stent was placed in 4356 patients and 943 (21.6%) of these patients developed post-ERCP pancreatitis. Demographic, hospital characteristics, and outcomes of patients who developed post-ERCP pancreatitis compared to those who didn't are shown in Table 1. On multivariate regression weekend admission (OR = 1.12, P = 0.01), sphincterotomy (OR = 1.48, P < 0.001), pancreatic stent placement (OR = 1.47, P = 0.01), obesity (OR = 1.45, P < 0.001) were some of the factors associated with increased risk of post-ERCP pancreatitis. Teaching hospitals (OR = 0.81, P < 0.001) were associated with lower risk of pancreatitis.

CONCLUSION:
Pancreatic stent placement has been shown to be protective for post-ERCP pancreatitis, however, in our study there were higher odds of pancreatitis in patients receiving pancreatic. This was likely because of pancreatic stents being placed in patients felt to be at higher risk of post ERCP pancreatitis. In conclusion, weekend admission was associated with higher risk, and teaching hospitals with lower risk of developing post-ERCP pancreatitis.
37 Depot Medroxyprogesterone Acetate in the Management of Recurrent Acute Pancreatitis in Patients With Cystic Fibrosis Gene Mutations
Authors: Haydek Christopher , Robbins Gordon , Ahmed Awais , Freedman Steven , Willingham Field 
Published: October 2019

INTRODUCTION:
In patients presenting with recurrent acute pancreatitis, cystic fibrosis (CF) gene variants are found at an increased frequency. Pancreatitis also occurs in patients being followed with CF mutations, generally occurring in patients with less severe mutations or in the setting of CF-related sorder (CFRD). There are no established treatment options for CF mutation-related pancreatitis. Some evidence has suggested that lung function fluctuates during the menstrual cycle, and in CF, that estradiol may inhibit chloride secretion. It has been hypothesized that hormonal contraceptives could play a role in modulating the disease process in women with CF. This study examined the impact of depot medroxyprogesterone acetate on the course of recurrent pancreatitis in female patients with established CF gene mutations.

METHODS:
In this single center retrospective study, medical records of all adult female patients with CF and acute recurrent pancreatitis between 2008–2018 were reviewed. Patients were included if they had experienced at least two episodes of acute pancreatitis, had been started on depot medroxyprogesterone, and had at least one CF gene mutation. Patients were excluded if they had developed pancreatitis from gallstones or heavy alcohol use. Total hospitalizations, episodes of pancreatitis, and average lipase values were examined and compared before and after the initiation of the depot medroxyprogesterone.

RESULTS:
A total of 13 patients met the study screening criteria and were recommended to start depot medroxyprogesterone. All patients were Caucasian females with a mean age of 45 years. The average time of treatment from which the endpoints were collected was 5.6 months. After the initiation of the depot medroxyprogesterone, there were no episodes of acute pancreatitis and one hospitalization unrelated to pancreatitis. The average lipase values were significantly decreased (261 units/L vs 41 units/L, P = 0.039) after the patients had been started on depot medroxyprogesterone.

CONCLUSION:
In this cohort, there were no further episodes of recurrent acute pancreatitis following the initiation of depot medroxyprogesterone in female patients with CF mutations. This data will be combined with other institutions shortly to examine the outcomes in a larger retrospective sample. A multicenter prospective study is being developed to study the outcomes being seen clinically and reported here in this sample.
77 Post-ERCP Pancreatitis Rates and NSAID Use in a Community Hospital
Authors: Hyder Jeffrey , Srinivasan Sachin , Agha Yasmine Hussein , Wuthnow Chelsea , Salyers William , Tofteland Nathan 
Published: October 2019

INTRODUCTION:
Endoscopic retrograde cholangiopancreatography (ERCP) has been consistently used for more than 50 years as a diagnostic and therapeutic procedure in pancreaticobiliary diseases. However, its use is associated with several adverse effects including bleeding, cholangitis, pancreatitis, intestinal perforation, and death. Of these, post-ERCP pancreatitis (PEP) is the leading cause of morbidity and mortality with an estimated incidence of 1.6–15%. Endoscopic techniques, patient characteristics, and the hospital setting have been noted to put patients at higher risk of developing PEP. Williams et al. reported a significantly increased risk of PEP in community hospitals compared to university hospitals. Rectal NSAIDs, including diclofenac and indomethacin, have shown promising results in several high-quality clinical trials and meta-analysis, especially in high-risk patients. More recent trials failed to show a significant reduction of PEP after NSAID use. There is scant data on the efficacy of rectal NSAIDs in higher risk patients in community hospitals. The aim of this study is to determine if there is an increased risk of PEP in a community hospital and if the use of rectal NSAIDs for high-risk patients is beneficial within a community hospital.

METHODS:
After obtaining IRB approval, the charts of every adult patient admitted to a Wichita, KS community hospital for ERCP in a 2-year time period were reviewed. Primary endpoint was percentage of patients developing PEP. Secondary endpoints included NSAID use in high-risk individuals (Table 1) and the change in incidence of PEP in this group with the use of rectal NSAID.

RESULTS:
422 patients underwent ERCP during the study period. Of these, about 212 (50.2%) were noted to have at least 1 high risk factor to develop PEP. 24 (5.6%) of the patients received rectal NSAIDs, of which 10 patients were noted to be high-risk for PEP. 9 patients (2.1%) developed PEP during the study time period. Of the nine patients, 3 patients were high risk and did not receive any NSAIDs. The use of NSAIDs did not cause a significant reduction in PEP in the high-risk group (p-value 0.7) or overall (P-value 0.66).

CONCLUSION:
PEP rates in a community hospital setting have not been well established. Our study reports an incidence of 2.1%, comparable to the PEP incidence described in academic trials. Despite the unstandardized use of rectal NSAIDs noted in the study population, there appears to be no significant benefit in their use overall or in the high-risk population.
128 Prevalence and Predictors of Adenomas in Young Adults Undergoing Diagnostic Colonoscopy in a Multicenter Midwest U.S. Cohort
Authors: Dave Devashree , Lu Ray , Klair Jagpal S. , Kassim Thamer , Ashfaq Muhammad , Chandra Subhash , Murali Arvind 
Published: October 2019

INTRODUCTION:
Colorectal cancer incidence in population younger than 50 years of age is increasing in the United States. Data on prevalence of colon neoplastic polyps in young adults remains spars, especially in population <40 years of age. We aimed to identify the prevalence of adenoma, sessile serrated polyp and advanced adenoma in young adults undergoing diagnostic colonoscopy stratified by age 20–30, 31–40 and 41–49 years.

METHODS:
We reviewed diagnostic colonoscopies performed for lower gastrointestinal symptoms in young adult ≤49 years by 18 gastroenterologists at two institutions in the Midwest from October 2016 to April 2019. Patients with strong family history of colorectal carcinoma were excluded.

RESULTS:
We included 575 patients, mean age 34 (8) years, 220 (38%) were males, and mean BMI 30 (8), Table 1. Colon neoplastic polyps (adenoma and/or sessile serrated polyps) were noted in 116 (20%) patients, adenomas in 110 (19%), SSP/A in 30 (5%) patients and advanced adenoma was in 29 (5%). The prevalence of neoplastic polyps was 5% in patients <30 years of age, 24% in age 30–40, and 37% in age 40–49 years. Similar trend was noted for each of adenomas, SSP/A, and advanced adenomas (Table 2). Mix of adenoma and SSP/A were seen in 25 (4%) patients; with prevalence of 0.5% for age <30, 5.8% for age 30–40, and 7.4% for age 41–49 (Table 2). Males had a significantly higher adenoma prevalence (P < 0.001); no significant gender differences were noted in the prevalence of SSP/A (P = 0.17) (Table 3).

CONCLUSION:
Patients between 30 to 49 years of age undergoing diagnostic colonoscopy in US Midwest population is significantly higher than previously reported prevalence of neoplastic colon polyps. This is consistent with the reported increase in the incidence of colorectal neoplasia in this population. Therefore, a careful inspection for colon polyps is recommended during diagnostic colonoscopies in this population.
197 Annual Hospitalization and Mortality Trends Among Patients With Sickle Cell Disease and Clostridioides difficile Infection
Authors: Sharma Prabin , Hundt Melanie , Aguilar Rodrigo , Nader Mark , Yadav Siddhartha , Rawlings Ruth , Feuerstadt Paul 
Published: October 2019

INTRODUCTION:
Frequent hospitalizations, antibiotic exposure, dysbiosis and impaired immune function associated with Sickle Cell Disease (SCD) predisposes pts to Clostridioides difficile infection (CDI). As a result, we hypothesize that the incidence of CDI in those with SCD has been increasing in the United States and that those with SCD and CDI have worse outcomes.

METHODS:
Using ICD-9 codes within the National Inpatient Sample Database, we identified pts between 2005–2012 with SCD. For each pt, we obtained various factors (e.g., demographics, medical co-morbidities and outcomes), grouped them as SCD and CDI (SCD + CDI) or those with SCD without CDI (SCD − CDI) and statistically compared. Using propensity score matching, SCD + CDI pts were matched with SCD − CDI in 1:1 ratio. All categorical variables were compared with Pearson's χ2 test and continuous variables were analyzed with paired t-test (SAS 9.4, Cary, NC).

RESULTS:
Among 747,127 hospitalized pts with SCD, 804 (0.1%) had SCD + CDI. SCD + CDI were more likely to be African Americans (88.0% v 32.7%, P < 0.0001), smokers (10.5% v 7.1%, P < 0.0001), and had a higher association with HIV (2.2% v 0.9%, P = 0.0001), Hepatitis C (1.6% v 0.8%, P = 0.007), chronic liver disease (6.0% v 2.8%, P < 0.0001), cholelithiasis (4.0% v 2.2%, P < 0.001), acute pancreatitis (2.5% v 1.4%, P < 0.0001) and chronic pancreatitis (2.0% v 0.6%, P < 0.0001). SCD + CDI were less likely to be associated with atrial fibrillation (4.9% v 15.1%, P < 0.0001), CHF (13.9% v 18.5%, P = 0.001) and hypothyroidism (3.7% v 9.4%, P < 0.0001). SCD + CDI had significantly higher complication rates including acute chest syndrome (4.4% v 1.8%, P < 0.0001), splenic sequestration (1.6% v 0.3%, P < 0.0001), and vaso-occlusive crises (2.7% v 1.4%, P < 0.0001). Though prematch inpatient mortality was not different between the two groups (5.9% v 6.5%, P = 0.43), SCD + CDI pts had significantly higher inpatient mortality than SCD − CDI pts after match (5.6% v 3.3%, P = 0.04). Over time, we noted increases in hospitalization-requirement and inpatient mortality for SCD + CDI pts (Tables 1 and 2).

CONCLUSION:
Ours is the largest study exploring the association of CDI in SCD patients. Hospitalization rates and mortality rates for hospitalized SCD pts with CDI has been rising in the United States and it seems that hospitalized SCD pts with CDI are more likely to develop SCD related complications and have a higher mortality. In SCD+CDI pts, clinicians should consider more aggressive initial treatment to minimize these poor outcomes.