pharmacist

Contrast-enhanced ultrasound (CEUS) is rapidly emerging as a means of diagnosing Crohn’s disease in children instead of endoscopy, which has concerns about invasion of the large intestine.

It is in the limelight as an important diagnostic tool with the advantage of being non-invasive and inexpensive. In particular, it is the first domestic study to prove its effectiveness and increase its usability.

Contrast-enhanced ultrasound is emerging as an important tool for diagnosing Crohn’s disease in children.

On the 24th, the Journal of Korean Medical Science, an international journal of the Korean Medical Association, will publish the results of a study on the effectiveness of contrast-enhanced ultrasound in diagnosing Crohn’s disease in children.

Crohn’s disease is one of the chronic inflammatory bowel diseases, which has not yet been conquered, and its prevalence is increasing significantly, becoming a challenge in the medical world.

In particular, when a child suffers from Crohn’s disease, there is a growing awareness in that it greatly affects growth and development due to nutritional imbalance. This is why the importance of early diagnosis is emphasized.

Currently, in the case of pediatric Crohn’s Hospital, endoscopy is commonly used.

However, endoscopy has the disadvantage of being invasive compared to the advantage of providing accurate mucosal information. In particular, in the case of children, it is true that they are more exposed to this risk because of the thickness of the large intestine as well as the thin mucous membrane.

Similarly, MRI, which is used as an alternative, has limitations in that a contrast agent must be taken and sedation is required according to the age of the child.

It is for this reason that contrast-enhanced ultrasound has emerged as an alternative. This is because it is non-invasive, relatively inexpensive, and easily accessible.

In particular, in the case of contrast-enhanced ultrasound, it can be used to confirm the severity of the disease, treatment response, and complications in that it can visualize the intestinal wall and mesenteric perfusion in real time.

However, unlike adult Crohn’s disease, for which evidence is being accumulated, there is still insufficient evidence on whether contrast-enhanced ultrasound can be applied to children.

Comparison of contrast-enhanced ultrasound epidemiological and clinical parameters according to disease activity

This is the background of a research team led by Professor Park So-won of Yonsei University College of Medicine conducting a study on the effectiveness of contrast-enhanced ultrasound for children with Crohn’s disease in Korea.

Accordingly, the research team performed contrast-enhanced ultrasound on pediatric Crohn’s disease patients from August 2020 to August 2021 and compared and analyzed it with a control group.

As a result, children with activated Crohn’s disease had an erythrocyte sedimentation rate (ESR) of 13.0 mm/hr on contrast-enhanced ultrasound, which was significantly higher than that of patients without (2.0 mm/hr).

C-reactive protein (CRP) showed the same trend. Children with active Crohn’s disease recorded 4.7 mg/dL, whereas children with inactive Crohn’s disease recorded only 0.55 mg/dL.

This trend was evident as the slope (gradient) at the apex (peak) on the tonic-enhanced ultrasound. The active group had a slope of 1.18 and the inactive group had a slope of 0.93, showing a clear difference.

“This study is significant in that it is the first study to show that there is a difference in the average slope at the peak according to Crohn’s disease activity,” the researchers said. “This quantification parameter is the difference in the ratio between peak height and time to peak It shows that synergy using this is possible.”

“Eventually, this means that contrast-enhanced ultrasound is very safe and inexpensive for pediatric patients and has sufficient utility as a tool that can specifically diagnose whether or not Crohn’s disease is activated,” he said.

2023-07-10 20:30:00

#Augmented #ultrasound #increase #utilization #Catch #Crohns #disease #children

A study has found that it is good for women over the age of 65 to get tested for human papillomavirus (HPV) as a catch-up form.

In the case of elderly women, it is contrary to the past practice that there is no practical benefit, and attention is paid to whether there will be any changes to the guidelines in the future.

A study has found that catch-up HPV tests are useful even for women over the age of 65.

On the 9th local time, the international journal PLoS Medicine published the results of a large-scale study on the effectiveness of HPV testing for elderly women (10.1371/journal.pmed.1004253).

Currently, HPV testing is recommended as the primary cervical cancer screening test due to its excellent sensitivity, but in the case of elderly women, it is excluded from guidelines because there is no practical benefit for it.

Although there are many recommendations for young women in each country’s guidelines, it is true that there is no specific specification for elderly women.

In particular, some studies have reported that HPV is not cost-effective in the case of elderly women, and controversy is still ongoing in the medical community.

This is also the reason why a research team led by Professor Mette Tranberg of Landers Medical University in Denmark conducted a large-scale follow-up study on this. The purpose is to find out what kind of benefits HPV testing actually gives to elderly women.

Accordingly, the research team conducted cervical cancer screening on 11,192 women aged 60 years or older and compared them with 33,387 women in the reference group and conducted a follow-up study.

As a result, there was a significant difference in the detection rate of cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN2+).

This is because 3.9 cases of CIN2+ were detected per 1,000 women who underwent cervical cancer screening, while only 0.3 cases per 1,000 in the control group.

The results showed that even elderly women benefit from being tested, given that those who develop CIN2+ or higher have a high risk of being diagnosed with terminal cancer.

In particular, the researchers explained that women who have been tested for HPV even once have a significantly higher chance of being tested again, which is a great help for health management.

Prof. Tranberg said, “Just by checking the CIN2+ detection rate, it shows that the catch-up HPV test in older women can clearly detect cancer early and even prevent it.” presents,” he said.

2023-07-10 02:36:18

#HPV #screening #recommended #years #age

A study has found that it is good for women over the age of 65 to get tested for human papillomavirus (HPV) as a catch-up form.

In the case of elderly women, it is contrary to the past practice that there is no practical benefit, and attention is paid to whether there will be any changes to the guidelines in the future.

A study has found that catch-up HPV tests are useful even for women over the age of 65.

On the 9th local time, the international journal PLoS Medicine published the results of a large-scale study on the effectiveness of HPV testing for elderly women (10.1371/journal.pmed.1004253).

Currently, HPV testing is recommended as the primary cervical cancer screening test due to its excellent sensitivity, but in the case of elderly women, it is excluded from guidelines because there is no practical benefit for it.

Although there are many recommendations for young women in each country’s guidelines, it is true that there is no specific specification for elderly women.

In particular, some studies have reported that HPV is not cost-effective in the case of elderly women, and controversy is still ongoing in the medical community.

This is also the reason why a research team led by Professor Mette Tranberg of Landers Medical University in Denmark conducted a large-scale follow-up study on this. The purpose is to find out what kind of benefits HPV testing actually gives to elderly women.

Accordingly, the research team conducted cervical cancer screening on 11,192 women aged 60 years or older and compared them with 33,387 women in the reference group and conducted a follow-up study.

As a result, there was a significant difference in the detection rate of cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN2+).

This is because 3.9 cases of CIN2+ were detected per 1,000 women who underwent cervical cancer screening, while only 0.3 cases per 1,000 in the control group.

The results showed that even elderly women benefit from being tested, given that those who develop CIN2+ or higher have a high risk of being diagnosed with terminal cancer.

In particular, the researchers explained that women who have been tested for HPV even once have a significantly higher chance of being tested again, which is a great help for health management.

Prof. Tranberg said, “Just by checking the CIN2+ detection rate, it shows that the catch-up HPV test in older women can clearly detect cancer early and even prevent it.” presents,” he said.

2023-07-10 02:36:18

#HPV #screening #recommended #years #age

The insurance industry also paid attention to the rapidly increasing prevalence of obesity and emphasized the urgency of management.

According to the medical community on the 4th, the Insurance Research Institute recently published a global issue reporter on the socioeconomic damage of obesity, urging awareness of obesity disease. The report was written by Kim Hye-ran, a researcher.

As of 2020, one out of seven people in the world is estimated to be obese, and the prevalence is increasing rapidly, especially in children and low-income countries, emphasizing the urgency of obesity management.

data photo. Insurance Research Institute pointed out the seriousness of the increasing trend of obesity prevalence.

Researcher Kim predicted, “By 2035, one out of every four people in the world will be obese, and more than half will be overweight.” Of the 10 countries that are progressing rapidly, nine are low-income countries.”

“Children want changes in eating habits such as excessive food and sugar intake, and decrease in physical activity due to increased use of mobile phones and online games,” he added.

Obesity is a major risk factor for chronic diseases, including diabetes, hypertension, hyperlipidemia and cardiovascular and cerebrovascular disease, and death rates are higher in countries with large overweight populations during COVID-19. Obesity is also related to mental health, and there is also a study that the possibility of developing a mental disorder after being diagnosed with obesity is higher than that of obesity after developing a mental disorder.

Researcher Kim said, “The probability of mental illness increased over time after being diagnosed with obesity, and there were far more cases of people suffering from mental disorders other than schizophrenia and schizoaffective disorder after being diagnosed with obesity first.” The risk of developing mental disorders, such as depression, nicotine addiction, anxiety, eating and personality disorders, increased across age groups.”

It also predicted that if obesity prevention and treatment measures are not improved, obesity will cause economic losses equivalent to about 3% of global GDP every year.

Researcher Kim said, “Economic losses of $4.32 trillion, or about 3% of global GDP, are expected every year until 2035.” “he said.

“Economic losses include direct medical costs for treating chronic diseases caused by obesity, indirect costs such as employee absenteeism due to obesity, reduced productivity at work, increased disability insurance payments in the insurance industry, and losses due to early retirement and early mortality.” This includes the loss of acceptable productivity.”

2023-07-04 02:50:11

#insurance #industry #pays #attention #obesity…concerns #economic #loss #equivalent #corona

Studies have shown that chronic inflammatory bowel disease increases the risk of spinal fractures. The risk of fracture increased by up to 1.6 times.

Long-term use of steroids, etc., has been affected, and experts suggest that vitamin D supplementation therapy should be reviewed along with continuous monitoring.

A large study has found that inflammatory bowel disease increases the risk of spinal fractures.

The results of a large-scale study on the association between inflammatory bowel disease and spinal fractures will be published on the 17th in the Journal of Korean Medical Science, an international journal of the Korean Medical Association.

Inflammatory bowel diseases represented by Crohn’s disease and ulcerative colitis have been reported to cause various complications in that they cause malabsorption due to chronic intestinal diseases.

In particular, there is a warning voice that the risk of osteoporosis or fractures may increase in that it causes deficiencies in iron, zinc, calcium, and vitamin D.

However, there was a lack of evidence on whether inflammatory bowel disease actually affects these fractures.

This is why the research team led by Professor Lee Jun-seok of the Catholic University of Medicine conducted a large-scale follow-up study on actual domestic patients.

Accordingly, the research team compared and analyzed 33,778 patients with inflammatory bowel disease and 101,265 controls from 2008 to 2018.

As a result, a total of 559 vertebral fractures occurred among inflammatory bowel disease patients during the study period. There were 444 cases of Crohn’s disease and 115 cases of ulcerative colitis.

Analysis of fracture risk in patients with inflammatory bowel disease associated with steroid use

Statistically, during the follow-up period, the vertebral fracture incidence (IRR) of patients with inflammatory bowel disease was 1.27 per 1000 per person/year, which was significantly higher than that of the control group.

Among inflammatory bowel diseases, Crohn’s disease was more influential in vertebral fractures. In fact, as a result of the multivariate analysis, Crohn’s disease patients had a 1.59 times higher risk of vertebral fractures than the control group.

In addition, patients with ulcerative colitis were found to have a 1.26-fold increased risk of spinal fracture compared to healthy people.

This tendency was higher in older age, in women than in men, and the longer the duration of steroid use.

The severity of vertebral fractures also showed a similar trend. Even after excluding all other factors through Cox regression analysis, Crohn’s disease patients were 1.82 times more likely to be exposed to severe or more vertebral fractures than the general population.

Similarly, patients with ulcerative colitis had a 1.49-fold higher risk of severe vertebral fracture compared to healthy individuals.

The main factor for this was also the long-term use of steroids. This is because patients who were prescribed steroids for longer for the treatment of inflammatory bowel disease had a higher risk of fracture.

“Inflammatory bowel disease significantly increased the risk of vertebral fractures, and this tendency was stronger in the elderly, women, and patients who were prescribed steroids for a long time,” said the research team. “In the case of patients with inflammatory bowel disease, This suggests that vitamin D supplementation therapy should be implemented along with monitoring.”

2023-07-03 20:10:00

#Inflammatory #bowel #disease #risk.. #Affects #vertebral #fractures