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Dupilumab in Atopic Dermatitis Linked to Reduced Irritable Bowel Syndrome Risk: A Real-World Cohort Study
No full textAnnual Homicide Rate as a Proxy for Overall Gun-Related Violent Crime: A Retrospective Study
No full textIntroduction The annual reporting of homicides often captures the nation\u27s attention, with the unspoken assumption that this serves as a proxy for overall gun-related violent crime. The purpose of this study is to evaluate whether the overall trend in homicide rates accurately reflects the overall trend in gun-related violent crime over time. Methods Using police crime incident data from a large urban city in the southern United States, the total number of gun-related violent crimes, gunshot victims treated at the trauma center, and homicides per year from 2014 to 2020 were recorded. Rates of gunshot victims, gun-related violent crimes, and homicides per 100,000 population were stratified by year and compared over time using simple linear regression. Analysis of covariance (ANCOVA) was then used to compare the rate of increase of homicides to gun-related violent crimes. Results There were 4,928 gun-related violent crimes and 567 homicides over the study period. Linear regression analysis identified a significant increase in gun-related crime rate (201.92 to 447.3 incidents per 100,000 population, p = 0.01) and homicide rate (25.90 to 50.24 incidents per 100,000 population, p = 0.028) from 2014 to 2020. The rate of gunshot victims treated at the trauma center appeared to increase during the study period, although the increase was not statistically significant (57.94 to 125.6 incidents per 100,000 population, p = 0.0624). ANCOVA revealed that gun-related violent crimes increased at a greater rate compared to homicides, with respective slopes of 34.01 (95% CI: 20.49 to 47.54) and 3.36 (95% CI: -15.77 to 36.03). The interaction between year and crime type was statistically significant (p = 0.005), indicating different rates of increase. Conclusion Annual homicide rates should be interpreted with caution, as they may not accurately reflect the true extent of gun violence in communities. Broadening our understanding represents the first step in preventing continued increases in this major public health problem
The sodium-glutamate antagonist riluzole improves outcome after acute spinal cord injury: results from the RISCIS randomised controlled trial analysed using a global statistical analytic technique
No full textBackground: Spinal cord injury (SCI) clinical trials typically rely on a single primary endpoint to assess drug efficacy. This strategy fails to adequately capture the full impact of treatment in heterogenous neurological conditions like SCI. A more patient-centric analysis requires assessment of neurological function, functional capacity, and quality of life, incorporating meaningful patient-reported outcomes. The global statistical test (GST) addresses this challenge using a unified statistical conclusion regarding the superiority of a treatment strategy over another by evaluating multiple trial endpoints simultaneously. Methods: The RISCIS trial (Safety and Efficacy of Riluzole in Acute Spinal Cord Injury Study) data was analysed using a multivariate nonparametric GST, integrating the total American Spinal Injury Association (ASIA) motor score (TOTM), Spinal Cord Independence Measure (SCIM), and SF-36 PCS (Short Form-36 Physical Component Scale) scores. In the RISCIS trial, patients with severe cervical SCI (AIS A, B, and C) were randomised to receive riluzole or placebo within 12 h of injury in a double blinded fashion. We compared six-month outcomes between groups using a modified O\u27Brien\u27s rank sum test with sample variance adjustment. Higher summed ranks represent better global outcomes. The overall probability of improvement was computed using a summary estimate, the global treatment effect (GTE). Findings: A total of 131 patients (mean age 45.8 years old, 82% males) completed the six-month outcome assessment. Among these, 49.6% were classified as AIS A, 20.6% as AIS B, and 29% as AIS C. Riluzole was administered within 12 h from injury for 14 days in 65 patients, while 66 received a placebo. The unadjusted mean change from baseline to six months showed a favourable response in the riluzole group compared to placebo across TOTM (p = 0.28 by t-test; p = 0.26 by Wilcoxon test), SCIM (p = 0.04 by t-test; p = 0.02 by Wilcoxon test), or SF-36 PCS (p = 0.23 by t-test; p = 0.21 by Wilcoxon test) scores. Using the GST to simultaneously assess these measures, the riluzole group exhibited a higher rank sum compared to placebo [median rank sum = 207 (IQR: 166–246) in riluzole vs 185 (IQR: 146–236) in placebo, p = 0.04]. Subgroup analysis revealed the greatest treatment benefit among patients with AIS A injuries (GTE = 0.16, 95% CI: 0.01–0.31, p = 0.02). At six months, the probability that riluzole treatment resulted in overall better outcomes than placebo across all assessed outcomes was 58%. Interpretation: Riluzole was associated with improved global outcomes in patients with severe traumatic SCI, based on a composite score integrating ASIA total motor scores, SCIM, and SF36 outcomes at six months. Riluzole is a promising therapeutic option in SCI, but further investigation through higher-quality studies incorporating multidimensional assessments is warranted. Funding: No funding was received for the present work. The original clinical trial (NCT01597518) was funded by the AO Foundation, United States Department of Defense (DOD), and the Praxis Spinal Cord Institute
Dietary Nitrogen and Its Role in the Gut Microbiome and Inflammatory Bowel Disease: A Narrative Review
No full textIn recent years, gut microbiota has emerged as a critical regulator of gastrointestinal health and disease, with its role in inflammatory bowel disease (IBD)—including Crohn’s disease and ulcerative colitis—being particularly significant. Among the many factors influencing the gut microbiota, dietary components such as fibers, fats, and polyphenols have received substantial attention. However, nitrogen-containing compounds, such as amino acids, nitrates, urea, and even nucleic acids, such as purines, remain underexplored despite their integral role in shaping microbial ecology, host metabolism, and immune responses. Some of these compounds are metabolized by gut bacteria into bioactive molecules such as short-chain fatty acids, ammonia, and nitric oxide, which exert diverse effects on mucosal integrity and inflammation. IBD pathophysiology is characterized by chronic inflammation, microbial dysbiosis, and compromised epithelial barriers. Nitrogen metabolism contributes significantly to these processes by influencing microbial composition, metabolite production, and host immune pathways. The breakdown of various nitrogen-containing compounds in the body leads to the production of byproducts, such as ammonia and hydrogen sulfide, which have been implicated in mucosal damage and immune dysregulation. At the same time, nitrogen-derived molecules, such as short-chain fatty acids and nitric oxide, exhibit protective effects, underscoring the dual role of dietary nitrogen in health and disease. This narrative review highlights the complex interactions between dietary nitrogen sources, gut microbiota, and IBD pathogenesis. We summarize the mechanisms by which nitrogen compounds influence microbial dynamics, identify their contributions to inflammation and barrier dysfunction, and explore their therapeutic potential. Multidisciplinary approaches integrating clinical, metabolomic, and microbiome research are essential to unravel the full scope of nitrogen’s role in gut health and identify novel therapeutic targets
Awake Bronchoscopic Intubation: A Survey of Practicing Members of the American Society of Anesthesiologists
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Hurricane Katrina Archive: Faculty Publications Bibliography 2005-2009
Get PDFThis bibliography includes 91 articles about Hurricane Katrina written by authors affiliated with LSU Health – New Orleans between January 2005 and December 2009.https://digitalscholar.lsuhsc.edu/biblio/1000/thumbnail.jp
Mediation Analysis to Investigate Differences in Prostate Cancer Diagnosis Stage Through Environmental Risk Factors in Louisiana
Get PDFProstate Cancer (PCa) is the most commonly diagnosed cancer and the second leading cause of cancer death among men. In Louisiana (LA), Black men are disproportionately diagnosed at later stages compared to White men. This study explores environmental risk factors as potential intermediate variables linking race to cancer diagnosis stage. The Louisiana Tumor Registry data included 24,647 male patients diagnosed with PCa in LA between 2010 and 2018. Among them, 15,875 (64.40%) were Caucasian American (CA) and 8772 (35.59%) African American (AA). Mediation analysis using multiple additive regression trees (MART) identified possible intermediate variables that potentially explain the observed disparity. The study found that individual characteristics and environmental factors jointly explained 84% (95% CI: 44.1%, 94.6%) and 18.6% (95% CI: 7.3%, 53.7%) of the observed racial disparity in PCa stage at diagnosis, respectively. Individual factors included BMI (35.9%), marital status (28.5%), CDI (8.2%), female-headed households (2.3%), comorbidity (3.9%), and insurance status (6.3%). Environmental contributors included cancer risk due to air toxicity exposure (7.2%), asthma prevalence (6.6%), acetaldehyde levels (2.1%), railroad proximity (2.1%), walkability (0.3%), and ozone level (-0.1%). Environmental factors jointly played a significant role in the observed racial disparity. The factors such as air toxicity, acetaldehyde levels, and asthma prevalence highlight the need to address industrial pollutants to reduce the differences
Pregnancy in IBD: keeping mom healthy for a healthy baby
No full textInflammatory bowel disease (IBD) can impact reproductive planning. Achieving disease remission prior to conception is advised, as it can reduce risks for both the mother and the infant. Flare-ups during pregnancy can lead to complications, such as preterm birth. Therefore, managing the disease effectively with the right medications is crucial for optimal outcomes. Most IBD medications (except small molecules and methotrexate) carry minimal risks to the fetus and are safe during breastfeeding, so it is important for individuals to understand the potential dangers of discontinuing treatment and the significance of maintaining remission. Given the rapid change in medical therapies, this review highlights the latest evidence to ensure successful pregnancy outcomes
Factors Associated With Symptom Burden Among Pediatric Patients With Cancer
No full textPURPOSE The objective was to identify factors associated with self-reported symptom burden measured using Symptom Screening in Pediatrics Tool (SSPedi) in pediatric patients with cancer.METHODS This was a secondary analysis of a cluster randomized trial enrolling pediatric patients newly diagnosed with cancer. Twenty sites were randomized to routine symptom screening versus usual care. Intervention included thrice-weekly symptom screening with SSPedi, delivery of severely bothersome scores to health care teams, and implementation of locally adapted symptom management care pathways. Primary outcome was total SSPedi scores, 0 (no bothersome symptoms) to 60 (worst bothersome symptoms), obtained at baseline, week four, and week eight in 430 patients (n = 217 intervention and n = 213 usual care). We created a mixed linear regression model evaluating design (including time point), patient/guardian, and site characteristics for their associations with symptom burden after controlling for treatment assignment.RESULTSSS Pedi scores were significantly lower at weeks 4 and 8 compared with baseline (P \u3c .0001 overall), and at intervention versus control sites (P \u3c .0001). In the full model, males (estimate, -3.3 [95% CI, -4.6 to -2.0]; P \u3c .0001) and sites with higher physician staffing ratios (each physician full-time equivalent per 100 new diagnoses estimate -0.20 [95% CI, -0.5 to 0.0]; P =.024) had significantly lower total SSPedi scores.CONCLUSION Total symptom burden was reduced by time, intervention (symptom screening and care pathways), and greater physician staffing ratio. Females had higher symptom burden. These data may inform programmatic implementation of routine symptom screening in pediatric patients with cancer