1.Prevalence and patient awareness of inflammatory bowel disease in Kazakhstan: a cross-sectional study
Jamilya KAIBULLAYEVA ; Aliya UALIYEVA ; Ainash OSHIBAYEVA ; Anar DUSHPANOVA ; John K. MARSHALL
Intestinal Research 2020;18(4):430-437
Background/Aims:
There has been a paucity of published data on the epidemiology of inflammatory bowel disease (IBD) in Central Asia and Kazakhstan. Therefore, we aimed to study IBD prevalence and patient awareness among adults in Kazakhstan.
Methods:
The cross-sectional study was carried out among subjects of both sexes aged 18 years and older using IBD Alert Questionnaire (CalproQuest), single fecal calprotectin test, and endoscopy with biopsy to verify IBD from January to December 2017, across regions of Kazakhstan. All participants were included in the study after providing informed consent.
Results:
Out of 115,556 subjects, there were 128 confirmed IBD cases, in which 36 Crohn’s disease (CD) and 92 ulcerative colitis (UC) cases identified. The age and sex-adjusted IBD prevalence were 113.9 (95% confidence interval [CI], 69.0–158.9) per 100,000 population. The age- and sex-adjusted prevalence for UC were 84.4 (95% CI, 44.8–123.9) and for CD were 29.5 (95% CI, 8.2–50.9) per 100,000 population.
Conclusions
This is the first report on the prevalence of IBD with a verified diagnosis in the Central Asia and could be used to better plan and allocate healthcare resources for IBD management program.
2.Cortical Thinning in High-Grade Asymptomatic Carotid Stenosis
Randolph S. MARSHALL ; David S. LIEBESKIND ; John Huston III ; Lloyd J. EDWARDS ; George HOWARD ; James F. MESCHIA ; Thomas G. BROTT ; Brajesh K. LAL ; Donald HECK ; Giuseppe LANZINO ; Navdeep SANGHA ; Vikram S. KASHYAP ; Clarissa D. MORALES ; Dejania COTTON-SAMUEL ; Andres M. RIVERA ; Adam M. BRICKMAN ; Ronald M. LAZAR
Journal of Stroke 2023;25(1):92-100
Background:
and Purpose High-grade carotid artery stenosis may alter hemodynamics in the ipsilateral hemisphere, but consequences of this effect are poorly understood. Cortical thinning is associated with cognitive impairment in dementia, head trauma, demyelination, and stroke. We hypothesized that hemodynamic impairment, as represented by a relative time-to-peak (TTP) delay on MRI in the hemisphere ipsilateral to the stenosis, would be associated with relative cortical thinning in that hemisphere.
Methods:
We used baseline MRI data from the NINDS-funded Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis–Hemodynamics (CREST-H) study. Dynamic contrast susceptibility MR perfusion-weighted images were post-processed with quantitative perfusion maps using deconvolution of tissue and arterial signals. The protocol derived a hemispheric TTP delay, calculated by subtraction of voxel values in the hemisphere ipsilateral minus those contralateral to the stenosis.
Results:
Among 110 consecutive patients enrolled in CREST-H to date, 45 (41%) had TTP delay of at least 0.5 seconds and 9 (8.3%) subjects had TTP delay of at least 2.0 seconds, the maximum delay measured. For every 0.25-second increase in TTP delay above 0.5 seconds, there was a 0.006-mm (6 micron) increase in cortical thickness asymmetry. Across the range of hemodynamic impairment, TTP delay independently predicted relative cortical thinning on the side of stenosis, adjusting for age, sex, hypertension, hemisphere, smoking history, low-density lipoprotein cholesterol, and preexisting infarction (P=0.032).
Conclusions
Our findings suggest that hemodynamic impairment from high-grade asymptomatic carotid stenosis may structurally alter the cortex supplied by the stenotic carotid artery.