Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis

Background: Micronutrient deficiencies may occur after restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC), largely due to malabsorption and/or pouch inflammation. Objectives: The objective of this study was to report the frequency of iron deficiency in patients with UC who underwent RPC with IPAA and identify associated risk factors. Methods: We conducted a retrospective chart review of patients with UC or IBD-unclassified who underwent RPC with IPAA at Mount Sinai Hospital between 2008 and 2017. Patients younger than 18 years of age at the time of colectomy were excluded. Descriptive statistics were used to analyze baseline characteristics. Medians with interquartile range (IQR) were reported for continuous variables, and proportions were reported for categorical variables. Iron deficiency was defined by ferritin <30 ng/mL. Logistic regression was used to analyze unadjusted relationships between hypothesized risk factors and the outcome of iron deficiency. Results: A total of 143 patients had iron studies a median of 3.0 (IQR 1.7–5.6) years after final surgical stage, of whom 73 (51.0%) were men. The median age was 33.5 (IQR 22.7–44.3) years. Iron deficiency was diagnosed in 80 (55.9%) patients with a median hemoglobin of 12.4 g/dL (IQR 10.9–13.3), ferritin of 14 ng/mL (IQR 9.0–23.3), and iron value of 44 μg/dL (IQR 26.0–68.8). Of these, 29 (36.3%) had a pouchoscopy performed within 3 months of iron deficiency diagnosis. Pouchitis and cuffitis were separately noted in 4 (13.8%) and 13 (44.8%) patients, respectively, and concomitant pouchitis-cuffitis was noted in 9 (31.0%) patients. Age, sex, anastomosis type, pouch duration, and history of pouchitis and/or cuffitis were not associated with iron deficiency. Conclusion: Iron deficiency is common after RPC with IPAA in patients with UC. Cuffitis is seen in the majority of patients with iron deficiency; however, iron deficiency may occur even in the absence of inflammation

A Survey: To Govern, Protect, and Detect Security Principles on Internet of Medical Things (IoMT)

The integration of medical equipment into the Internet of Things (IoT) led to the introduction of Internet of Medical Things (IoMT). Variation of IoT devices have been equipped in medical facilities. These devices provided convenience to healthcare provider since they can continuously monitor their patients in real-time, while allowing them to have greater physical flexibility and mobility. However, users of healthcare services (such as patients and medical staff) often are less concerned about security issues associated with IoT. These alleviate existing problems and jeopardize the lives of their patients by making them susceptible to attacks. Furthermore, IoMT applications have direct access to healthcare services because it handles sensitive patient information. Therefore, it is extremely important to preserve and establish the security and privacy of IoMT. This further justifies the need to investigate and address the related issues. Despite existing literature on security and privacy mechanisms, the domain still requires more attention. Therefore, this paper aims to discuss the security and privacy principles, as well as challenges associated with IoMT. Besides, a comprehensive analysis of privacy and security solutions for IoMT is also presented. In addition, we introduced a novel taxonomy of IoMT security and privacy based on cyber security principles such as “govern,” “protect,” and “detect”. In conclusion, this paper provides a discussion on existing challenges and future direction for researchers

Results of Hierarchical based on seven selected features.

<p>Results of Hierarchical based on seven selected features.</p

Feature ranking using IG on DMZ 1 DARPA 2000 dataset.

<p>Feature ranking using IG on DMZ 1 DARPA 2000 dataset.</p

All features of DRAPA 2000 datasets.

<p>All features of DRAPA 2000 datasets.</p

Results of Hierarchical after feature ranking.

<p>Results of Hierarchical after feature ranking.</p

Feature ranking using IG on Inside 2 DARPA 2000 dataset.

<p>Feature ranking using IG on Inside 2 DARPA 2000 dataset.</p

Results of K-means after feature ranking.

<p>Results of K-means after feature ranking.</p

IDMEF alert format in an XML document.

<p>IDMEF alert format in an XML document.</p

List of attack steps (clusters) discovered on all dataset.

<p>List of attack steps (clusters) discovered on all dataset.</p