Differential biomarker profiles between unprovoked venous thromboembolism and cancer.
CONCLUSIONS: Levels of TF-positive EVs, D-dimer and sP-selectin are able to discriminate between unprovoked VTD patients not related to cancer and cancer patients not associated with VTD. These results could lead to the application of EVs as biomarkers of both diseases.Key Messages: Circulating EVs, specifically TF-positive EVs, in combination with plasmatic markers of hypercoagulable states, such as D-dimer, sP-selectin and antigen TF, are able to discriminate between cancer patients without thrombosis and patients with unprovoked VTD. Research fields could be opened. Future studies will assess if these biomarkers togethe...
Source: Annals of Medicine - July 9, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Demographics, Comorbidities, and Outcomes in Hospitalized Covid-19 Patients in Rural Southwest Georgia.
This study aimed to describe the demographics, and outcomes of hospitalized Covid-19 patients in rural Southwest Georgia.Methods: Using electronic medical records, we analyzed data from all hospitalized Covid-19 patients who either diedor survived to discharge between March 2, 2020 and May 6, 2020.Results: Of the 522 patients, 92 died in hospital (17.6%). Median age was 63 years, 58% were females, and 87% African-Americans. Hypertension (79.7%), obesity (66.5%), and diabetes mellitus (42.3%) were the most common comorbidities. Males had higher overall mortality compared to females (23% v 13.8%). Immunosuppression [odds rat...
Source: Annals of Medicine - July 7, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

COVID-19 and venous thromboembolism: current insights and prophylactic strategies.
Authors: Ambrosino P, Di Minno A, Maniscalco M, Di Minno MND Abstract The rapidly increasing number of studies on the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) indicate that this viral agent can cause the coronavirus disease 2019 (COVID-19), a syndrome with a wide spectrum of clinical presentations, ranging from a mild disease with flu-like symptoms to a life-threatening condition that requires specialized management at Intensive Care Units (ICU). Critical patients with COVID-19 have a high risk of thromboembolic complications, as expressed by a Padua prediction score always ≥4. Moreover...
Source: Annals of Medicine - July 4, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Effect of vaccination on the use of antimicrobial agents: a systematic literature review.
Conclusions and implications of key findings: Despite the limitations of the review, the evidence indicates that improved coverage with existing vaccines may significantly reduce antimicrobial demand. This suggests it may be a valuable tool for antimicrobial stewardship.Key messagesWhile vaccines against a number of pathogens have been studied for their ability to reduce antimicrobial use, currently only vaccination against influenza or pneumococcus has generated sufficient data for analysisVaccination against either influenza or pneumococcus significantly reduced overall antimicrobial prescribing rates, both in vaccinated...
Source: Annals of Medicine - July 2, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

24-h urinary sodium excretion and the risk of adverse outcomes.
Conclusion: High sodium intake is associated with an increased incidence of CVD and DM. PMID: 32602794 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - July 2, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Vasculitides and glomerulonephritis associated with Staphylocococcus aureus infective endocarditis: cases reports and mini-review  of the literature.
We reported two cases of Staphylococcus aureus Infective Endocarditis associated with vasculitides and glomerulonephritis respectively, before conducting an online search of previously published similar cases reports. Twenty five references were selected: 15 cases of glomerulonephritis; 2 cases of vasculitis and 8 cases involving both glomerulonephritis and vasculitis. Vasculitides and glomerulonephritis associated with Staphylococcus aureus definite Infective Endocarditis have been reported since 1976. All cases except one described clinical symptoms occurring before or during initial antibiotics treatment. Except kidney,...
Source: Annals of Medicine - June 27, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Inverse time trends of peptic ulcer and reflux esophagitis show significant association with reduced prevalence of Helicobacter pylori infection.
Conclusions: The prevalence of GU and DU has gradually decreased whereas that of RE has markedly increased in Japan. Inverse time trends of peptic ulcer and reflux esophagitis are significantly associated with reduced prevalence of HP infection. Key Messages:The prevalence of gastric and duodenal ulcer has gradually decreased whereas that of reflux esophagitis has markedly increased in Japan.The prevalence of Helicobacter pylori infection in Japan has greatly decreased from 49.8% to 31.2% during the 14 years (from 1996 to 2010).Inverse time trends of peptic ulcer and reflux esophagitis are associated with reduced prevalenc...
Source: Annals of Medicine - June 17, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

NEWS and qSIRS superior to qSOFA in the prediction of 30-day mortality in emergency department patients in Hong Kong.
Conclusions: Among unselected emergency and urgent ED patients, the prognostic value for NEWS and qSIRS were greater than qSOFA, Combinations of qSOFA and SIRS could improve the predictive value for 30-day mortality for ED patients. Key Messages:NEWS ≥5 and qSIRS ≥2 were better than qSOFA ≥2 at predicting 30-day mortality in ED patients.Combinations of qSOFA and SIRS could improve the predictive value for 30-day mortality for ED patients. PMID: 32530356 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - June 13, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Unravelling the health effects of fasting: a long road from obesity treatment to healthy life span increase and improved cognition.
Authors: Wilhelmi de Toledo F, Grundler F, Sirtori CR, Ruscica M Abstract In recent years a revival of interest has emerged in the health benefits of intermittent fasting and long-term fasting, as well as of other related nutritional strategies. In addition to meal size and composition a new focus on time and frequency of meals has gained attention. The present review will investigate the effects of the main forms of fasting, activating the metabolic switch from glucose to fat and ketones (G-to-K), starting 12-16 h after cessation or strong reduction of food intake. During fasting the deactivation of mTOR re...
Source: Annals of Medicine - June 12, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Relationship of adverse events to quality of anticoagulation control in atrial fibrillation patients with diabetes: Real-world data from the FANTASIIA registry.
Authors: García-Fernández A, Esteve-Pastor MA, Rabadán IR, Muñiz J, Ruiz Ortiz M, Cequier Á, Bertomeu-Martínez V, Badimón L, Otero D, Anguita M, Lip GYH, Marín F Abstract BACKGROUND: Atrial fibrillation (AF) patients with diabetes (DM) are at increased risk of cardiovascular events and have higher related morbidity and mortality. PURPOSE: To compare clinical characteristics, cardiovascular adverse outcomes and quality of anticoagulation in AF patients with and without DM. METHODS: AF patients from the Spanish national, multicentric, prospective FANTASI...
Source: Annals of Medicine - June 7, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Lipoprotein(a) in atherosclerosis: from pathophysiology to clinical relevance and treatment options.
Authors: Rehberger Likozar A, Zavrtanik M, Šebeštjen M Abstract Lipoprotein(a) (Lp(a)) was discovered more than 50 years ago, and a decade later, it was recognized as a risk factor for coronary artery disease. However, it has gained importance only in the past 10 years, with emergence of drugs that can effectively decrease its levels. Lp(a) is a low-density lipoprotein with an added apolipoprotein(a) attached to the apolipoprotein B component via a disulfide bond. Circulating levels of Lp(a) are mainly genetically determined. Lp(a) has many functions, which include proatherosclerotic, prothrombotic, a...
Source: Annals of Medicine - May 28, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Clinical Practice Patterns in Revascularization of Diabetic Patients with Coronary Heart Disease: Nationwide Register Study.
Authors: Lehto HR, Pietilä A, Niiranen TJ, Lommi J, Salomaa V Abstract Aims: To compare diabetic patients with coronary heart disease (CHD) needing revascularization to corresponding non-diabetic patients in terms of revascularization methods, comorbidities and urgency of procedure. We also examined the impact of patient characteristics and comorbidities on the revascularization method.Methods: We identified all diabetic (n = 33,018) and non-diabetic (n = 106,224) patients with first-ever, percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) from electr...
Source: Annals of Medicine - May 21, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Role of Sodium Glucose Co-Transporter 2 Inhibitors in Patients with Heart Failure: An Elusive Mechanism.
Authors: Imran H, Nestor W, Elgendy IY, Saad M Abstract Heart failure (HF) is a major cause of morbidity and mortality worldwide, and the burden of HF continues to rise. There has been an interest in sodium-glucose co-transporter-2 (SGLT2) inhibitors for their role in reducing HF hospitalizations in pivotal trials. Since their approval by the Food and Drug Administration for the management of diabetes mellitus, multiple small trials and analyses have tried to explain the underlying beneficial mechanisms in HF across different subgroups. In this review, we discuss different mechanisms by which SGLT2 inhibitors play ...
Source: Annals of Medicine - May 14, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Multi-Tiered Screening and Diagnosis Strategy for COVID-19: A Model for Sustainable Testing Capacity in Response to Pandemic.
Authors: Pulia MS, O'Brien TP, Hou PC, Schuman A, Sambursky R Abstract Coronavirus disease 2019 (COVID-19), caused by novel enveloped single stranded RNA coronavirus (SARS-CoV-2), is responsible for an ongoing global pandemic. While other countries deployed widespread testing as an early mitigation strategy, the U.S. experienced delays in development and deployment of organism identification assays. As such, there is uncertainty surrounding disease burden and community spread, severely hampering containment efforts. COVID-19 illuminates the need for a tiered diagnostic approach to rapidly identify clinically signif...
Source: Annals of Medicine - May 8, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Prognostic value of myocardial injury-related findings onresting electrocardiography for cardiovascular risk in the asymptomatic general population: The 12-year follow-up report from the Ansan-Ansung cohort.
Authors: Shin J, Lee Y, Park JK, Shin JH, Lim YH, Ran H, Kim HJ, Park HC Abstract Background: We investigated the predictive values of myocardial injury-related findings (MIFs)including ST-T wave abnormalities (STA) and pathologic Q waves (PQ) in electrocardiography for long-term cardiovascular outcomes in an asymptomatic general population.Methods: We observed8,444 subjects without cardiovascular diseases and related symptoms biennially over a 12-year period. Major cardiovascular adverse events (MACEs) weredefined as a composite of cardiovascular death, myocardial infarction, coronary artery disease and stroke.Res...
Source: Annals of Medicine - April 28, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Clinical significance of increased PML-RARa transcripts after induction therapy for acute promyelocytic leukaemia.
Conclusions: Our studies showed the increased PML-RARa transcripts after induction treatment had different clinical significance from the decreased PML-RARa transcripts. PMID: 32323584 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - April 24, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Postpericardiotomy syndrome after cardiac surgery.
Authors: Lehto J, Kiviniemi T Abstract Postpericardiotomy syndrome (PPS) is a well-known complication after cardiac surgery. The syndrome results in prolonged hospital stay, readmissions, and invasive interventions. Previous studies have reported inconsistent results concerning the incidence and risk factors for PPS due to the differences in the applied diagnostic criteria, study designs, patient populations, and procedure types. In recent prospective studies the reported incidences have been between 21 and 29% in adult cardiac surgery patients. However, it has been stated that most of the included diagnoses in the...
Source: Annals of Medicine - April 23, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Prospective Cohort Study of Daily Alcoholic Beverage Intake as a Potential Trigger of Headaches among Adults with Episodic Migraine.
Conclusion: 1-2 servings of alcoholic beverages were not associated with higher risk of headaches the following day, but 5+ servings were associated with higher risk. Key Messages:1-2 servings of alcoholic beverages were not associated with a higher risk of headaches on the following day, but higher levels of intake may be associated with higher risk.Five or more servings were associated with 2.08 times (95% confidence interval 1.16-3.73 the odds of headache on the following day.The adjusted absolute risk of headaches was 20% (95%CI 19%-22%) on days following no alcohol consumption compared with 33% (95% CI 22%-44%) on day...
Source: Annals of Medicine - April 21, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Local ocular renin-angiotensin-aldosterone system (RAAS): any connection with intraocular pressure? A comprehensive review.
Authors: Holappa M, Vapaatalo H, Vaajanen A Abstract The renin-angiotensin system (RAS) is one of the oldest and most extensively studied human peptide cascades, well-known for its role in regulating blood pressure. When aldosterone is included, RAAS is involved also in fluid and electrolyte homeostasis. There are two main axes of RAAS; 1. Angiotensin (1-7), angiotensin converting enzyme 2 and Mas receptor (ACE2-Ang(1-7)-MasR), 2. Angiotensin II, angiotensin converting enzyme 1 and angiotensin II type 1 receptor (ACE1-AngII-AT1R). In its entirety, RAAS comprises dozens of angiotensin peptides, peptidases and seven ...
Source: Annals of Medicine - April 21, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

The diagnostic value of magnetic resonance urography for detecting ureteric obstruction: A systematic review and meta-analysis.
Conclusions: These findings suggested a relatively high diagnostic value of MRU for detecting ureteric obstruction. Moreover, the diagnostic accuracy of MRU in adults was higher than in children. Key messagesMRU in detecting ureteric obstruction has relatively better sensitivity, specificity, PLR, NLR, DOR, and AUC.The diagnostic value, including specificity, PLR, and AUC of MRU in adults, was higher than in children, while the sensitivity of MRU in adults was lower than in children. PMID: 32233669 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - April 4, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Coeliac disease: beyond genetic susceptibility and gluten. A narrative review.
Authors: Pes GM, Bibbò S, Dore MP Abstract Coeliac disease (CD) is an immune-mediated disorder triggered by the ingestion of gluten in genetically susceptible individuals. However, only a small proportion of subjects harbouring CD-related genetic risk develop the disease. Among the environmental factors that may influence CD risk, pre- and perinatal factors, delivery methods, parental lifestyle, infant feeding practices, seasonality, dietary factors, drug use, childhood infections and variability in gut microbiota are those most widely studied regarding the risk to develop CD. Although for many of these exte...
Source: Annals of Medicine - April 3, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Handgrip strength is inversely associated with fatal cardiovascular and all-cause mortality events.
Authors: Laukkanen JA, Voutilainen A, Kurl S, Araujo CGS, Jae SY, Kunutsor SK Abstract Purpose: We aimed to assess the associations of handgrip strength (HS) with cardiovascular and all-cause mortality and whether adding data on HS to cardiovascular disease (CVD) risk factors is associated with improvement in CVD mortality prediction.Design: Handgrip strength was assessed in a population-based sample of 861 participants aged 61-74 years at baseline. Relative HS was obtained by dividing the absolute value by body weight.Results: During a median (interquartile range) follow-up of 17.3 (12.6-18.4) years, 116 fatal cor...
Source: Annals of Medicine - April 1, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Associations of serum sclerostin with bone mineral density, markers of bone metabolism and thalassaemia characteristics in adult patients with transfusion-dependent beta-thalassaemia.
Authors: Sapunarova K, Goranova-Marinova V, Georgiev P, Deneva T, Tsvetkova S, Grudeva-Popova Z Abstract Aim of the study: To assess serum sclerostin in transfusion-dependent beta-thalassaemia patients versus healthy controls and to examine its associations with bone mineral density, bone metabolism markers and beta thalassaemia alterations.Material and methods: Sixty-two transfusion-dependent beta-thalassaemia (TDßT) patients and 30 healthy controls were evaluated for serum sclerostin, osteocalcin, beta-cross laps, osteoprotegerin and serum level of receptor activator of nuclear factor kappa-Β ligand (s...
Source: Annals of Medicine - March 29, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Response to commentary by Lu and Wang on "Salivary biomarkers for cancer diagnosis: a meta-analysis".
Response to commentary by Lu and Wang on "Salivary biomarkers for cancer diagnosis: a meta-analysis". Ann Med. 2020 Mar 23;:1-2 Authors: Rapado-González Ó, Martínez-Reglero C, Salgado-Barreira Á, Takkouche B, López-López R, Suárez-Cunqueiro MM, Muinelo-Romay L PMID: 32202950 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - March 25, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Comparison of inhaled nitric oxide with aerosolized prostacyclin or analogues for the postoperative management of pulmonary hypertension: a systematic review and meta-analysis.
Conclusions: Inhaled prostacyclin (or analogues)was comparable to inhaled NO in treating PH after cardiac or pulmonary surgery. Key Messages:This study compared the efficacy of inhaled prostacyclin or its analogues versus inhaledNO to treat PH after surgery.The two types of agent exhibited similar efficacy in managingMPAP, PVR, heart rate, and cardiac output was observed.Inhaled prostacyclin may serve as an alternative treatment option for PH after cardiac or pulmonary surgery. PMID: 32204626 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - March 25, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Commentary on: Salivary biomarkers for cancer diagnosis: a meta-analysis.
Authors: Lu Y, Wang Q PMID: 32167392 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - March 15, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Factors Associated with the Activity and Severity of Bullous Pemphigoid: A Review.
Authors: Liu Y, Wang Y, Chen X, Jin H, Li L Abstract Bullous Pemphigoid (BP) is the most common subepidermal autoimmune blistering disease. It usually affects people older than 70 years of age. The two main autoantigens are BP180 and BP230, both of which are components of hemidesmosomes. Immunoglobulin (Ig)G and IgE autoantibodies to BP180 detected by the enzyme-linked immunoassay (ELISA) show close associations with the activity and severity of BP [1]. In addition, inflammatory cells (eosinophils, neutrophils, mast cells) and cytokines (e.g., interleukins, CC chemokine ligands) play an important part in the pathog...
Source: Annals of Medicine - March 14, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Peptide Hormones and Risk for Future Cardiovascular Events among Prediabetics: A 20-Year Follow-Up in the Opera Study.
Authors: Galla OJ, Ylitalo A, Kiviniemi A, Huikuri H, Kesäniemi YA, Ukkola O Abstract Background: Prediabetes has proven to have many unfavorable impacts on the cardiovascular system.Methods: The OPERA (Oulu Project Elucidating Risk of Atherosclerosis) study included 1,045 middle-aged subjects followed from the years 1990-1993 to 2009. The focus was on peptide hormones.Results: Plasma resistin levels were higher among prediabetics (p = 0.001), particularly impaired glucose tolerance (IGT) (p 
Source: Annals of Medicine - March 12, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Poor adherence to beta-blockers is associated with increased long-term mortality even beyond the first year after an acute coronary syndrome event.
Authors: Allonen JJ, Nieminen MS, Sinisalo J Abstract BACKGROUND: Acute coronary syndrome (ACS) -patients are widely treated with long-term beta-blocker therapy after cardiac event. Especially for low-risk patients, the benefits of beta-blockers on survival and the optimal therapy duration remain unclear. We investigated the effect of adherence to beta-blockers on long-term survival of ACS patients. METHODS AND RESULTS: A total of 1855 consecutive ACS patients who underwent angiography and survived 30 days after were followed for a median of 8.6 years. During follow-up, 30.1% (n = 558) of patients...
Source: Annals of Medicine - March 11, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

The prevalence and prognostic significance of interatrial block in the general population.
Discussion IAB is a rather frequent finding in the general population. IAB is a risk factor for AF and is associated with an increased risk of stroke or TIA independently of associated AF. Key messagesBoth partial and advanced interatrial block are associated with increased risk of atrial fibrillation in the general population.Advanced interatrial block is an independent risk factor for stroke and transient ischemic attack.The clinical significance of interatrial block is dependent on the subtype classification. PMID: 32077319 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - February 23, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Longitudinal blood pressure patterns and cardiovascular disease risk.
Authors: Nuotio J, Suvila K, Cheng S, Langén V, Niiranen T Abstract Observational and interventional studies have unequivocally demonstrated that "present", i.e. single-occasion, blood pressure is one of the key determinants of cardiovascular disease risk. Over the past two decades, however, numerous publications have suggested that longitudinal blood pressure data and assessment of long-term blood pressure exposure provide incremental prognostic value over present blood pressure. These studies have used several different indices to quantify the overall exposure to blood pressure, such as time-aver...
Source: Annals of Medicine - February 23, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Salivary biomarkers for cancer diagnosis: a meta-analysis.
CONCLUSIONS: Salivary biomarkers may be potentially used for non-invasive diagnosis of malignant non-oral tumors. Key messages:This meta-analysis evaluates the diagnostic value of salivary biomarkers for detection of malignant non-oral tumors to better define the role of saliva as an alternative liquid biopsy.Salivary biomarkers showed 85% accuracy for cancer distant to the oral cavity.Saliva represents a promising non-invasive source of novel biomarkers in cancer. PMID: 32056455 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - February 16, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Association of rheumatoid arthritis disease activity and antibodies to periodontal bacteria with serum lipoprotein profile in drug naive patients.
CONCLUSION: Drug naive RA patients had proatherogenic changes in lipid profiles, but they were reversible, when inflammation diminished. Key messagesPatients with drug naive rheumatoid arthritis showed proatherogenic lipid profiles.Reversible changes in lipid profiles can be achieved as response to inflammation suppression.Active therapy aimed at remission is essential in all patients with rheumatoid arthritis. PMID: 32011179 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - February 6, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Endothelial function in patients with atrial fibrillation.
Authors: Khan AA, Thomas GN, Lip GYH, Shantsila A Abstract Atrial fibrillation is the most common heart arrhythmia and is associated with poor outcomes. The adverse effects of atrial fibrillation are mediated through multiple pathways, including endothelial dysfunction, as measured by flow-mediated dilatation. Flow-mediated dilatation has demonstrated endothelial dysfunction in several conditions and is associated with poor outcomes including mortality, yet can be improved with medical therapy. It is thus a useful tool in assessing endothelial function in patients.Endothelial dysfunction is present in patients with...
Source: Annals of Medicine - January 8, 2020 Category: Internal Medicine Tags: Ann Med Source Type: research

Outcomes of anatomical versus non-anatomical resection for hepatocellular carcinoma according to circulating tumor-cell status.
Conclusion: AR may be more beneficial than NAR only in patients with low CTC count and mesenchymal- and epithelial/mesenchymal-negative phenotypes. For patients with a high CTC count, the balance between operative risk and prognostic benefit is more important than the resection method performed. Key messages:Anatomic resection may improve the survival of HCC patients, but only those with low CTC count and negative M- and E/M-CTC phenotypes.CTC analysis before surgery can be used to better guide the choice of resection method for HCC. PMID: 31876201 [PubMed - as supplied by publisher] (Source: Annals of Medicine)
Source: Annals of Medicine - December 28, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Treatment of Clostridioides (Clostridium) difficile infection.
Authors: Oksi J, Anttila VJ, Mattila E Abstract Clostridioides (formerly: Clostridium) difficile infection (CDI) is a major cause of diarrhea for inpatients as well as outpatients. Usually, CDI is healthcare-associated but the number of community-acquired infections is increasing. CDI is generally associated with changes in the normal intestinal microbiota caused by administration of antibiotics. Elderly and immunocompromised patients are at greater risk for CDI and CDI recurrence. Recently, the treatment options of CDI have undergone major changes: current recommendations speak against using metronidazole for prim...
Source: Annals of Medicine - December 6, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Deep learning based automatic blood pressure measurement: Evaluation of the effect of deep breathing, talking and arm movement.
This study aims to evaluate the performance of using deep learning based method to measure BPs and BP change under non-resting conditions.Materials and Methods: 40 healthy subjects were studied. Systolic and diastolic BPs (SBPs and DBPs) were measured under four conditions using deep learning and manual auscultatory method. The agreement between BPs determined by the two methods were analysed under different conditions. The performance of using deep learning based method to measure BP changes was finally evaluated.Results: There were no significant BPs differences between two methods under all measurement conditions (all P...
Source: Annals of Medicine - November 16, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

HDL therapy today: from atherosclerosis, to stent compatibility to heart failure.
Authors: Sirtori CR, Ruscica M, Calabresi L, Chiesa G, Giovannoni R, Badimon JL Abstract Epidemiologically, high-density lipoprotein (HDL) cholesterol levels have been inversely associated to cardiovascular (CV) events, although a Mendelian Randomization Study had failed to establish a clear causal role. Numerous atheroprotective mechanisms have been attributed to HDL, the main being the ability to promote cholesterol efflux from arterial walls; anti-inflammatory effects related to HDL ligands such as S1P (sphingosine-1-phosphate), resolvins and others have been recently identified. Experimental studies and early c...
Source: Annals of Medicine - November 16, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Impaired albumin function: A novel potential indicator for liver function damage?
Authors: Sun L, Yin H, Liu M, Xu G, Zhou X, Ge P, Yang H, Mao Y Abstract Albumin is the most abundant plasma protein and albumin infusion is commonly used. Conventionally, the biologic and therapeutic effects of albumin have been thought to be due to its oncotic properties. However, albumin has a variety of biologic functions, including molecular transport, anti-oxidation, anti-inflammation, endothelial stabilization, anti-thrombotic effects, and the adjustment of capillary permeability. Despite this, the functions of albumin have not been thoroughly investigated. Recent studies have shown non-alcoholic fatty liver...
Source: Annals of Medicine - November 13, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Triglyceride glucose and haemoglobin glycation index for predicting outcomes in diabetes patients with new-onset, stable coronary artery disease: a nested case-control study.
CONCLUSIONS: Both TyG index and HGI could predict cardiovascular outcomes in T2DM patients with new-onset, stable CAD while TyG index might be better. Key messages Both TyG and HGI are predictors of cardiovascular risk. The prognostic value of TyG index and HGI in T2DM patients with stable coronary artery disease is not determined. Our study firstly indicates that TyG index might have better prognostic value than HGI in T2DM patients with new-onset, stable CAD. PMID: 30207490 [PubMed - indexed for MEDLINE] (Source: Annals of Medicine)
Source: Annals of Medicine - November 1, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Molecular aspects of hypercholesterolemia treatment: current perspectives and hopes.
Authors: Ahangari N, Ghayour Mobarhan M, Sahebkar A, Pasdar A Abstract Hypercholesterolemia is a pathological condition which has been reported in 39% of the worlds' adult population. We aimed to review molecular aspects of current and novel therapeutic approaches based on low-density lipoprotein cholesterol lowering strategies. Pathogenic mutations in the LDLR, ApoB, PCSK9 and LDLRAP genes cause deficient clearance of circulating low-density lipoprotein cholesterol particles via hepatic LDL receptor. This leads to increased plasma LDL cholesterol levels from birth, which can cause LDL depositions in the arterial w...
Source: Annals of Medicine - October 30, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Melatonin receptor 1B gene rs10830963 polymorphism, depressive symptoms and glycaemic traits.
CONCLUSIONS: Our study shows that the diabetes risk variant rs10830963 does not contribute to the known comorbidity between depression and type 2 diabetes. Key messages The association between depression and type 2 diabetes is bidirectional. We tested whether a common variant rs10830963 in the gene encoding Melatonin Receptor 1B influences the known association between depressive symptoms and glycaemic traits in a population-based sample from Western Finland. The MTNR1B genetic diabetes risk variant rs10830963 does not contribute to the known comorbidity between depression and type 2 diabetes. Depressive symptoms and rs108...
Source: Annals of Medicine - October 30, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Invasive pulmonary aspergillosis in patients with solid tumours: risk factors and predictors of clinical outcomes.
Authors: Dandachi D, Wilson Dib R, Fernández-Cruz A, Jiang Y, Chaftari AM, Hachem R, Raad I Abstract BACKGROUND: The characteristics and management of invasive pulmonary aspergillosis (IPA) in patients with hematologic malignancies are well known, but IPA in patients with solid tumours is not well described. METHODS: We retrospectively reviewed all Aspergillus-positive cultures at a tertiary cancer center during 2004-2017. We identified 101 patients with IPA and solid tumours. We analyzed the association between clinical features and treatment and 12-week mortality and response to antifungal therapy. ...
Source: Annals of Medicine - October 30, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Dietary sodium intake is associated with long-term risk of new-onset atrial fibrillation.
CONCLUSIONS: These findings indicate that sodium intake is associated with the long-term risk of new-onset AF. Further confirmatory studies are needed. Key messages Sodium consumption correlated positively with CV risk factors: age, smoking, SBP, BMI and LDL-cholesterol. When quartiles of sodium consumption were considered, the AF incidence was higher in the highest quartile compared to lower quartiles. Sodium consumption as a continuous variable was independently associated with AF events when age, BMI, smoking, SBP, LAD, LVMI and the use of any antihypertensive therapy were considered. PMID: 30442022 [PubMed - indexe...
Source: Annals of Medicine - October 30, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

The Effect of Comorbid Medical and Psychiatric Diagnoses on Chronic Fatigue Syndrome.
CONCLUSIONS: Patients with Chronic Fatigue Syndrome should be evaluated for current psychiatric conditions because of their impact on patient quality of life, but they do not act as a symptom multiplier for the illness. Other co-existing medically unexplained syndromes are more common than psychiatric co-morbidities in patients presenting for evaluation of medically unexplained fatigue and are also more associated with increased disability and the number and severity of symptoms. Key Messages When physicians see patients with medically unexplained fatigue, they often infer that this illness is due to an underlying psychiat...
Source: Annals of Medicine - October 25, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Combination of low blood pressure response, low exercise capacity and slow heart rate recovery during an exercise test significantly increases mortality risk.
Authors: Sipilä K, Tikkakoski A, Alanko S, Haarala A, Hernesniemi J, Lyytikäinen LP, Viik J, Lehtimäki T, Nieminen T, Nikus K, Kähönen M Abstract Aims: We investigated the combination of low systolic blood pressure (SBP) response, low exercise capacity (EC) and slow heart rate recovery (HRR) during an exercise test in mortality prediction. Patients and Methods: Our population consisted of 3456 patients from the Finnish Cardiovascular Study. A failure of SBP to increase>42 mmHg was defined as a low response. Low EC was defined as
Source: Annals of Medicine - October 23, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Thoracic endovascular aortic repair versus open chest surgical repair for patients with type B aortic dissection: A systematic review and meta-analysis.
Conclusions: The findings of this meta-analysis study suggested that TEVAR resulted in more short-term survival benefits. Moreover, the reduced risk of acute renal failure, respiratory failure and bleeding was detected in TEVAR group. The treatment effects of TEVAR versus OCSR on specific complications should be further verified by a study with high-level of evidence. Key message Comprehensive collected studies investigated the treatment effectiveness between TEVAR and OCSR for TBAD patients TEVAR resulted in more survival benefits, in addition to lower risk of acute renal failure, respiratory failure and bleeding The resu...
Source: Annals of Medicine - October 12, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Efficacy and safety of fecal microbiota transplantation for decolonization of intestinal multidrug-resistant microorganism carriage: Beyond Clostridioides difficile infection.
Authors: Yoon YK, Suh JW, Kang EJ, Kim JY Abstract Persistent reservoirs of multidrug-resistant microorganisms (MDRO) that are prevalent in hospital settings and communities can lead to the spread of MDRO. Currently, there are no effective decolonization strategies, especially non-pharmacological strategies without antibiotic regimens. Our aim was to evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for the eradication of MDRO. A systematic literature search was performed to identify studies on the use of FMT for the decolonization of MDRO. PubMed, EMBASE, Web of Science, and Cochrane Libra...
Source: Annals of Medicine - August 31, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Insulin resistance takes center stage: a new paradigm in the progression of bipolar disorder.
Authors: Calkin CV Abstract Bipolar Disorder (BD) is a major psychiatric illness affecting up to 5% of the population. BD can progress over time to a chronic "neuroprogressive" course with cognitive and functional impairment. Currently, there are no validated predictors indicating which patients will develop a neuroprogressive course and there are no specific treatments. This review presents data supporting a novel hypothesis on the mechanisms underlying bipolar neuroprogression. Insulin resistance (IR) is present in 52% of BD patients and is associated with chronic course, treatment nonresponse, adverse ...
Source: Annals of Medicine - August 29, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research

Contribution of non-traditional lipid profiles to reduced glomerular filtration rate in H-type hypertension population of rural China.
Authors: Wang H, Li Z, Guo X, Chen Y, Chen S, Tian Y, Sun Y Abstract BACKGROUND: Despite current interest in the unfavourable impact of non-traditional lipid profiles on cardiovascular disease, information regarding its relations to reduced glomerular filtration rate (GFR) in H-type hypertension population has not been systemically elucidated. METHODS: Analyses were based upon a cross-sectional study of 3259 participants with H-type hypertension who underwent assessment of biochemical, anthropometric and blood pressure values. Reduced GFR was considered if meeting estimated GFR
Source: Annals of Medicine - August 14, 2019 Category: Internal Medicine Tags: Ann Med Source Type: research