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Chen J, Wu Z, Gao H, Li L, Wang Y, Han J, Zhang C, Ding P, Wu J. Association between air temperature and emergency admission for esophagogastric variceal bleeding: a case-crossover study in Beijing, China. BMC Gastroenterol 2023; 23:52. [PMID: 36841754 PMCID: PMC9960463 DOI: 10.1186/s12876-023-02683-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 02/17/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND AND AIMS Studies concerning the impact of air temperature on esophagogastric variceal bleeding (EGVB) have yielded conflicting results. Our study aimed to evaluate the correlation between air temperature and EGVB. METHODS A time-stratified case-crossover study design was performed. Patients received emergency gastroscopic hemostasis for upper gastrointestinal bleeding between Jan 1, 2014, and Dec 31, 2018 in the Fifth Medical Center of PLA General Hospital were enrolled. Conditional logistic regression analysis was applied to determine the association between air temperature and EGVB for different lag structures. RESULTS A total of 4204 cirrhotic patients diagnosed with EGVB and received emergency gastroscopic hemostasis were enrolled. The mean number of daily EGVB cases peaked in October (2.65 ± 1.69) and fell to the lowest level in July (1.86 ± 1.38), and was 2.38 ± 1.58 in spring, 2.00 ± 1.46 in summer, 2.37 ± 1.58 in autumn, and 2.45 ± 1.58 in winter, respectively (P < 0.0001). In conditional logistic regression analysis, no significant correlations between air temperature and EGVB were observed and no significant difference were found when stratified by age, sex, etiology, liver cancer status, and grade of varices. CONCLUSION Emergency admission for EGVB showed significant monthly and seasonal fluctuations, while in conditional logistic regression analysis, no association between minimum temperature and emergency admission for EGVB were observed.
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Affiliation(s)
- Jianhong Chen
- grid.24696.3f0000 0004 0369 153XDepartment of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ziting Wu
- grid.11135.370000 0001 2256 9319School of Public Health, Peking University, Beijing, China
| | - Hui Gao
- grid.8658.30000 0001 2234 550XNational Climate Center, China Meteorological Administration, Beijing, China
| | - Li Li
- grid.24696.3f0000 0004 0369 153XDepartment of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yanling Wang
- grid.414252.40000 0004 1761 8894Cirrhosis Diagnosis and Treatment Center, Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Jingjing Han
- grid.414252.40000 0004 1761 8894Cirrhosis Diagnosis and Treatment Center, Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Chuan Zhang
- Department of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
| | - Pengpeng Ding
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| | - Jing Wu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University; National Clinical Research Center for Digestive Diseases; Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China.
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Suh JI. Are there Seasonal Variations in the Incidence and Mortality of Esophageal Variceal Bleeding? Clin Endosc 2020; 53:107-108. [PMID: 32164048 PMCID: PMC7137559 DOI: 10.5946/ce.2020.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 02/25/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jeong Ill Suh
- Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University School of Medicine, Gyeongju, Korea
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Siddiqui MT, Bilal M, Haq KF, Nabors C, Schorr-Lesnick B, Wolf DC. Seasonal Impacts on the Incidence of Esophageal Variceal Hemorrhage: A Nationwide Analysis across a Decade. Clin Endosc 2019; 53:189-195. [PMID: 31878767 PMCID: PMC7137566 DOI: 10.5946/ce.2019.094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/28/2019] [Indexed: 12/17/2022] Open
Abstract
Background/Aims Seasonal variation has previously been reported in relation to the incidence of non-variceal upper gastrointestinal bleeding; however, the impact of seasonal variation on variceal bleeding is not known.
Methods We conducted a cross-sectional study using the Nationwide Inpatient Sample database from 2005 to 2014. International Classification of Diseases, Clinical Modification- 9th Revision codes were used to identify patients hospitalized with a primary or secondary diagnosis of esophageal variceal hemorrhage. The data were analyzed based on the month of hospitalization. Our primary aim was to assess seasonal variations in variceal bleeding-related hospitalizations. The secondary aims were to assess the impact of seasonal variation on outcomes in variceal bleeding including in-hospital mortality and healthcare resource utilization.
Results A total of 348,958 patients hospitalized with esophageal variceal bleeding were included. The highest number of hospitalizations was reported in December (99.3/day) and the lowest was reported in June (90.8/day). In-hospital mortality was highest in January (11.5%) and lowest in June (9.8%). There was no significant difference in hospital length of stay or total hospitalization costs across all months in all years combined.
Conclusions There appears to be a seasonal variation in the incidence and mortality of variceal hemorrhage in the United States. December was the month with the highest number of daily hospitalizations while the nadir occurred in June.
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Affiliation(s)
- Mohamed Tausif Siddiqui
- Department of Gastroenterology and Hepatology, Center for Human Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mohammad Bilal
- Department of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Khwaja Fahad Haq
- Department of Gastroenterology, Henry Ford Medical Center, Detroit, MI, USA
| | - Christopher Nabors
- Department of Internal Medicine, New York Medical College, Valhalla, NY, USA
| | | | - David C Wolf
- Department of Gastroenterology, New York Medical College, Valhalla, NY, USA
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4
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Spengler EK, Hunsicker LG, Zarei S, Zimmerman MB, Voigt MD. Transjugular intrahepatic portosystemic shunt does not independently increase risk of death in high model for end stage liver disease patients. Hepatol Commun 2017; 1:460-468. [PMID: 29404473 PMCID: PMC5721420 DOI: 10.1002/hep4.1053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 04/14/2017] [Accepted: 04/22/2017] [Indexed: 12/15/2022] Open
Abstract
Physicians often exclude patients with a model for end-stage liver disease (MELD) score ≥ 18 from a transjugular intrahepatic portosystemic shunt (TIPS) procedure due to the concern for higher risk of death. We aimed to determine if TIPS increased the risk of death in these patients. We analyzed the interaction between TIPS and MELD in 106 patients with TIPS and 79 with intractable ascites without TIPS. We performed Cox proportional hazard regression, including both TIPS and MELD as time-dependent covariates together with their interaction, to calculate the impact of TIPS on the risk of death associated with a high MELD score. We found a negative interaction between a high MELD score and a history of TIPS, with potentially important effect sizes. Patients with MELD scores ≥18 had a 51% lower incremental risk of death (lower risk than would be expected from the combined independent risks of MELD and needing/receiving TIPS) associated with TIPS than patients with MELD scores <18 (hazard ratio for TIPS, 0.49; 95% confidence interval, 0.10-2.45) in the first 6 months following TIPS. There was an 80% lower incremental risk of death among patients with a MELD score ≥18 (hazard ratio for TIPS, 0.20; 95% confidence interval, 0.03-1.23) 6 months after the TIPS procedure. Conclusion: Risk of death is associated with underlying disease severity as shown by the MELD score and the need for TIPS, and both history of TIPS and high MELD score independently increased the risk of mortality. However, the risk of death after TIPS was progressively lower than expected as the MELD score increased. (Hepatology Communications 2017;1:460-468).
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Affiliation(s)
- Erin K Spengler
- Division of Gastroenterology and Hepatology Department of Internal Medicine, The University of Iowa Hospitals and Clinics Iowa City IA.,University of Wisconsin, School of Medicine and Public Health Madison WI
| | - Lawrence G Hunsicker
- Division of Nephrology Department of Internal Medicine, The University of Iowa Hospitals and Clinics Iowa City IA
| | - Sanam Zarei
- Carver College of Medicine The University of Iowa Hospitals and Clinics Iowa City IA
| | - M Bridget Zimmerman
- Department of Biostatistics The University of Iowa Hospitals and Clinics Iowa City IA
| | - Michael D Voigt
- Division of Gastroenterology and Hepatology Department of Internal Medicine, The University of Iowa Hospitals and Clinics Iowa City IA
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5
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Wu WC, Chen YT, Chen PH, Su CW, Huang WM, Yang TC, Li SY, Chen TJ, Lin HC, Lee FY, Hou MC. Low air temperature increases the risk of oesophageal variceal bleeding: a population and hospital-based case-crossover study in Taiwan. Liver Int 2016; 36:856-64. [PMID: 26235679 DOI: 10.1111/liv.12930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 07/23/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Studies concerning seasonal variations and the impact of air temperature on oesophageal variceal bleeding have yielded conflicting results. We aimed to explore the impact of air temperature on the occurrence of variceal bleeding. METHODS A case-crossover study design was employed, and two cohorts were used, including the NHI-EVB cohort from the National Health Insurance Research Database of Taiwan from 1 January 1999 to 31 December 2010, and the VGH-EVB cohort from the Taipei Veterans General Hospital, from 4 May 2002 to 31 December 2010. A conditional logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS In total, 2542 cases from the NHI-EVB cohort and 220 cases from the VGH-EVB cohort were analysed. Our analysis showed that low air temperature (LAT) increased the risk of variceal bleeding regardless of age, sex, decompensated cirrhosis, Child-Pugh classification, aetiology of liver disease and concomitant hepatocellular carcinoma; the lag effect was also observed. The ORs per 5°C decrease in daily mean air temperature were 1.144 (95% CI, 1.060-1.235) for the NHI-EVB cohort and 1.307 (95% CI: 1.031-1.658) for the VGH-EVB cohort. Oesophageal variceal bleeding in patients with small varices, end-stage liver disease score ≧15 or those using non-selective beta blockers was not influenced by air temperature. CONCLUSIONS Patients have higher risk of oesophageal variceal bleeding at low air temperature regardless of age, sex, aetiology of cirrhosis, Child-Pugh classification, decompensated cirrhosis and concomitant hepatocellular carcinoma and can be protected by use non-selective beta blockers.
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Affiliation(s)
- Wen-Chieh Wu
- Division of Gastroenterology, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan.,School of Medicine, National Yang-Ming University School, Taipei, Taiwan
| | - Yung-Tai Chen
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Division of Nephrology, Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan
| | - Ping-Hsien Chen
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chien-Wei Su
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ming Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tsung-Chieh Yang
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Szu-Yuan Li
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Han-Chieh Lin
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- School of Medicine, National Yang-Ming University School, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
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Manabe T, Yamaoka K, Tango T, Binh NG, Co DX, Tuan ND, Izumi S, Takasaki J, Chau NQ, Kudo K. Chronological, geographical, and seasonal trends of human cases of avian influenza A (H5N1) in Vietnam, 2003-2014: a spatial analysis. BMC Infect Dis 2016; 16:64. [PMID: 26847341 PMCID: PMC4743110 DOI: 10.1186/s12879-016-1391-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background Human cases of highly pathogenic avian influenza A (H5N1) virus infection continue to occur in Southeast Asia. The objective of this study was to identify when and where human H5N1 cases have occurred in Vietnam and how the situation has changed from the beginning of the H5N1 outbreaks in 2003 through 2014, to assist with implementing methods of targeted disease management. Methods We assessed the disease clustering and seasonal variation of human H5N1 cases in Vietnam to evaluate the geographical and monthly timing trends. The clustering of H5N1 cases and associated mortality were examined over three time periods: the outbreak period (2003–2005), the post-outbreak (2006–2009), and the recent period (2010–2014) using the flexibly shaped space-time scan statistic. The most likely cases to co-cluster and the elevated risks for incidence and mortality were assessed via calculation of the relative risk (RR). The H5N1 case seasonal variation was analysed as the cyclic trend in incidence data using Roger’s statistical test. Results Between 2003 and 2005, H5N1 cases (RR: 2.15, p = 0.001) and mortality (RR: 2.49, p = 0.021) were significantly clustered in northern Vietnam. After 2010, H5N1 cases tended to occur on the border with Cambodia in the south, while H5N1 mortality clustered significantly in the Mekong delta area (RR: 6.62, p = 0.002). A significant seasonal variation was observed (p < 0.001), with a higher incidence of morbidity in December through April. Conclusions These findings indicate that clinical preparedness for H5N1 in Vietnam needs to be strengthened in southern Vietnam in December–April. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1391-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Toshie Manabe
- Teikyo University, Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. .,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. .,Waseda University, 1-21-1 Nishi-Waseda, Shinjuku-ku, Tokyo, Japan. .,University of Tsukuba, Graduate School of Comprehensive Human Sciences, Ibaraki, Japan.
| | - Kazue Yamaoka
- Teikyo University, Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Toshiro Tango
- Teikyo University, Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. .,Center for Medical Statistics, Tokyo, Japan.
| | - Nguyen Gia Binh
- Bach Mai Hospital, Intensive Care Unit, 78 Giai Phong, Dong Da, Hanoi, Vietnam.
| | - Dao Xuan Co
- Bach Mai Hospital, Intensive Care Unit, 78 Giai Phong, Dong Da, Hanoi, Vietnam.
| | - Nguyen Dang Tuan
- Bach Mai Hospital, Intensive Care Unit, 78 Giai Phong, Dong Da, Hanoi, Vietnam.
| | - Shinyu Izumi
- National Center for Global Health and Medicine, Division of Pulmonary Medicine, Tokyo, Japan.
| | - Jin Takasaki
- National Center for Global Health and Medicine, Division of Pulmonary Medicine, Tokyo, Japan.
| | - Ngo Quy Chau
- Department of Pulmonary Medicine, Bach Mai Hospital, 78 Giai Phong, Dong Da, Hanoi, Vietnam.
| | - Koichiro Kudo
- Waseda University, 1-21-1 Nishi-Waseda, Shinjuku-ku, Tokyo, Japan. .,Koto Hospital, 6-8-5 Ojima, Koto-ku, Tokyo, Japan.
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7
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Marti-Soler H, Gonseth S, Gubelmann C, Stringhini S, Bovet P, Chen PC, Wojtyniak B, Paccaud F, Tsai DH, Zdrojewski T, Marques-Vidal P. Seasonal variation of overall and cardiovascular mortality: a study in 19 countries from different geographic locations. PLoS One 2014; 9:e113500. [PMID: 25419711 PMCID: PMC4242652 DOI: 10.1371/journal.pone.0113500] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 10/24/2014] [Indexed: 01/01/2023] Open
Abstract
Background Cardiovascular diseases (CVD) mortality has been shown to follow a seasonal pattern. Several studies suggested several possible determinants of this pattern, including misclassification of causes of deaths. We aimed at assessing seasonality in overall, CVD, cancer and non-CVD/non-cancer mortality using data from 19 countries from different latitudes. Methods and Findings Monthly mortality data were compiled from 19 countries, amounting to over 54 million deaths. We calculated ratios of the observed to the expected numbers of deaths in the absence of a seasonal pattern. Seasonal variation (peak to nadir difference) for overall and cause-specific (CVD, cancer or non-CVD/non-cancer) mortality was analyzed using the cosinor function model. Mortality from overall, CVD and non-CVD/non-cancer showed a consistent seasonal pattern. In both hemispheres, the number of deaths was higher than expected in winter. In countries close to the Equator the seasonal pattern was considerably lower for mortality from any cause. For CVD mortality, the peak to nadir differences ranged from 0.185 to 0.466 in the Northern Hemisphere, from 0.087 to 0.108 near the Equator, and from 0.219 to 0.409 in the Southern Hemisphere. For cancer mortality, the seasonal variation was nonexistent in most countries. Conclusions In countries with seasonal variation, mortality from overall, CVD and non-CVD/non-cancer show a seasonal pattern with mortality being higher in winter than in summer. Conversely, cancer mortality shows no substantial seasonality.
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Affiliation(s)
- Helena Marti-Soler
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Semira Gonseth
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Cédric Gubelmann
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Silvia Stringhini
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Bovet
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Bogdan Wojtyniak
- National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Fred Paccaud
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Dai-Hua Tsai
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Tomasz Zdrojewski
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Pedro Marques-Vidal
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
- Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
- * E-mail:
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Chen J, Li D, Xu S, Sun Z, Wang B, Deng C. Influence of meteorological factors on the seasonal onset of esophagogastric variceal bleeding. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojgas.2013.32022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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9
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Garcia-Olivé I, Fiz JA, Sanz-Santos J, Andreo F, Sánchez-Martínez E, Sampere J, Muchart J, Michavila JM, Ruiz-Manzano J. Temporal patterns in severe hemoptysis requiring bronchial artery embolization. Multidiscip Respir Med 2012; 7:50. [PMID: 23217035 PMCID: PMC3541117 DOI: 10.1186/2049-6958-7-50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 11/06/2012] [Indexed: 12/02/2022] Open
Abstract
Background Although some authors have suggested that there is some seasonal periodicity in hemoptysis, temporal patterns of hemoptysis have been poorly investigated. The aim of this study is to describe the temporal pattern of severe hemoptysis which required bronchial artery embolization (BAE). Methods All consecutive patients with at least one episode of hemoptysis which required BAE during a 13-year period were included. Recurring hemoptysis requiring BAE in a patient with previous embolization was included as a new hemoptysis event, unless it occurred within one month from the prior event. Lineal regression was applied to compute the tendency of occurrence of cases along 13 years of record data. The daily and monthly distributions of embolizations were used to study the weekly and monthly seasonal indexes. Results Hemoptysis requiring BAE occurred with some monthly variation demonstrated with two monthly peaks, with the first one occurring during April and the second one during November. Conclusion Hemoptysis occurred with two monthly peaks. This seasonal trend might be due to different prevalence of respiratory tract infections or to some weather variables. Identification of significant environmental factors could be useful to improve preventive measures.
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Affiliation(s)
- Ignasi Garcia-Olivé
- Respiratory Service, Hospital Universitari Germans Trias i Pujol, Carretera del Canyetsn, Badalona, Barcelona, 08916, Spain.
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10
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Zhang SJ, Chen ZX, Jiang KP, Wu WK, Zhang CY, Gu YL. Effect of seasonal variation on the clinical course of chronic hepatitis B. J Gastroenterol 2006; 41:1107-15. [PMID: 17160522 DOI: 10.1007/s00535-006-1903-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Accepted: 08/24/2006] [Indexed: 02/04/2023]
Abstract
BACKGROUND Seasonal variation in immunity has been found in healthy individuals and in association with some diseases. It is still unknown whether seasonal variation affects the clinical course of chronic hepatitis B. Our aim in this study was to explore the effect of seasonal variation on the clinical course of chronic hepatitis B. METHODS The flare and remission time of chronic hepatitis B were observed in patients with hepatitis B virus (HBV) infection. All patients enrolled were followed up at least every 3 months for a mean follow-up time of 24.0 (range, 12-60) months. Seasonal decomposition was employed to analyze the relationship between seasonal variation and flares, remission, and hepatitis B e antigen (HBeAg) seroconversion in chronic hepatitis B patients during follow-up. RESULTS A total of 2238 patients were observed in our study. Flare and HBeAg seroconversion were seldom seen in 1076 patients (48.08%) with alanine aminotransferase (ALT) levels of less than 2.0 x upper limit of normal (ULN) during follow-up (mean, 36 months). The remaining 1162 patients (51.92%) (766, HBeAg positive; 387 anti-HBeAg positive; 9 negative for both HBeAg and anti-HBeAg) with ALT levels >or=2.0 x ULN were followed longitudinally for 12 months to judge flare, remission, and HBeAg seroconversion. Flare, remission, and HBeAg seroconversion in patients with ALT levels >or=2.0 x ULN showed clear seasonal patterns (P < 0.001), with high peaks during spring, summer, and summer, respectively. An autocorrelation correlogram showed that flares, remission, and HBeAg seroconversion occurred with distinct periodicity in winter, spring, summer, and autumn. CONCLUSIONS Seasonal variation might affect the clinical course of chronic hepatitis B. The role of seasonal triggering factors should be further investigated.
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Affiliation(s)
- Shi-Jun Zhang
- Department of Gastroenterology of Traditional Chinese Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080 Guangdong, China
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Basaranoglu M, Demirkok SS, Coker E. Considerations in seasonal variation studies in IBD and re-evaluation of Aratari et al.'s seasonality results. Dig Liver Dis 2006; 38:710-1; author reply 711. [PMID: 16730247 DOI: 10.1016/j.dld.2006.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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12
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Abstract
Due to progress in general medicine and especially in gastroenterology, the incidence of acute gastrointestinal hemorrhage could be expected to have decreased during the last 25 years. However, published epidemiological data cannot, in general, fulfill this hope. The interpretation of potential trends is, however, often limited by low study quality. For example, questionable bleeding sources such as erosions in the upper gastrointestinal tract or colon diverticula are often rather uncritically named the definitive causes of bleeding. However, there is clear evidence of changes in grouping of patients. After the almost complete disappearance of Helicobacter pylori in younger indigenous populations of most industrialized countries, it is mostly elderly comorbid people with additional risk factors (NSAID use, low-dose aspirin, anticoagulation) who are affected. Not unexpectedly, this group has generally experienced no change in incidence and in fact shows a deterioration of prognosis in case of acute bleeding.
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Affiliation(s)
- H-R Koelz
- Abteilung für Gastroenterologie, Medizinische Klinik, Stadtspital Triemli Zürich.
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13
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Affiliation(s)
- Dominique Pateron
- Service Médical d'Accueil, Fédération des Urgences Médico-Chirurgicales, CHU Jean Verdier, avenue du 14 Juillet, 93140 Bondy
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