Corticosteroid use impacts Mucosal Disease Activity in African Americans with Ulcerative Colitis
Notice bibliographique
Résumé
To identify predictors of clinical and mucosal disease activity in African Americans (AA) with ulcerative colitis (UC). Single-center, retrospective study. We reviewed records of 50 AA patients with UC who were seen at the outpatient clinic between 2000 and 2009. Demographic and clinical variables were examined using descriptive statistics. These included body mass index (BMI), gender, age at diagnosis and last observation; duration and extent of disease; surgery and smoking. We also documented history of significant corticosteroid use and other medications. Significant use of corticosteroids was defined as use of conventional corticosteroids for an average of more than 30 days per year from the beginning of observation to the end of observation. Each day of use after one month or three month therapy with a rectal steroid or oral budesonide was added to the sum of total days of corticosteroid use respectively. Clinical outcome was based on the average Montreal class of clinical severity of UC during the last year of observation. The corresponding mucosal outcome was based on the Mayo endoscopic subscore for UC during the same period. Bivariate analysis was completed using chi square or Fisher's exact test. Multivariable analysis was performed using step-wise logistic regression. Non-parametric correlation analysis between clinical and mucosal disease was also done. Level of significance was assessed at p < 0.05. Mean ages at diagnosis and last observation were 38 and 47 years respectively. Mean duration of disease was 11 years. Mean observation period was 4 years (range 1-9 years). Men and women were equally represented with 25 patients in each group. Mean BMI was 28 mg/kg2. Mean corticosteroid use per year was 60 days (range 0-365days) with a median of 10 days. Seventeen (34%) patients had a history of significance steroid use per year. Calculation of average clinical disease activity during last year of observation revealed that 23 (46%) patients were in remission, 15 (30%) had mild disease whereas 12 (24%) had moderate to severe disease. The corresponding last outpatient endoscopic evaluation revealed that 16 (36%) patients' disease was inactive, 14(32%) had mild mucosal disease and 14 (32%) patients had moderate to severe mucosal disease. Bivariate analysis revealed that significant use of corticosteroids during the year was associated with decreased mucosal disease score (P= 0.0313 OR 0.257 95%CI 0.075-0.885). When controlling for age, gender and duration of disease, we observed that this effect remained statistically significant (P= 0.0103 OR 0.156 95% CI 0.038-0.645). Non-parametric correlation between clinical and mucosal disease was positive and statistically significant (Correlation =0.3469 P= 0.0210). However, we did not observe any statistically significant effect of corticosteroid use or any other variable on clinical disease during the last year of observation in the bivariate analysis or when controlling for age, gender and duration of disease. Corticosteroid use is associated with decreased mucosal disease activity in AA patients with UC. One must be well aware of the deleterious effects of longterm use of corticosteroids on the different body systems before subjecting UC patients to a corticosteroid maintenance regimen.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».