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Sj ögren's syndrome
Sj ögren's syndrome (SS) is a systemic autoimmune disorder characterized by focal inflammation of the exocrine glands, leading to dry eyes and dry mouth. Two forms of the syndrome have been defined: primary (pSS), in which dysfunction of the exocrine glands occurs in the absence of other autoimmune di seases, and secondary, in which patients suffer additional autoimmune processes, especially connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus and scleroderma. About 70% of patients with pSS have anti-Ro and/or anti-La autoantibodies. (Source: Medicine)
Source: Medicine - January 12, 2018 Category: Internal Medicine Authors: Alexandre Dumusc, Vijay Rao, Simon J. Bowman Tags: Other autoimmune disorders Source Type: research

Medium vessel vasculitis
Polyarteritis nodosa (PAN) and Kawasaki's disease are primary systemic vasculitides with predominant medium-sized vessel involvement. PAN typically affects muscular arteries, causing aneurysms (nodosa). There are no specific serological markers, and diagnosis depends on clinical presentation, angiography and tissue biopsy. Exclusion of hepatitis B infection is important. Treatment with corticosteroids and immunosuppressive drugs is usually effective, but PAN can pursue a relapsing course. Kawasaki's disease affects children, usually under the age of 5 years, and presents as an acute, febrile exanthematous disease. (Source: Medicine)
Source: Medicine - January 12, 2018 Category: Internal Medicine Authors: Peter Hewins, Catherine King Tags: Systemic vasculitides Source Type: research

Systemic vasculitides: an overview
The systemic vasculitides are a group of uncommon but serious multisystem autoimmune disorders characterized by blood vessel inflammation. Timely diagnosis and intervention are crucial in preserving organ function and reducing mortality and morbidity. Immunosuppressive agents are the cornerstone of treatment and have revolutionized outcomes. Nevertheless, disease relapse is common, and individuals with vasculitides accumulate significant risks of infection, cardiovascular disease and malignancy over time compared with the general population, and invariably report poor quality of life. (Source: Medicine)
Source: Medicine - January 11, 2018 Category: Internal Medicine Authors: Dana Kidder, Paula Dospinescu, Maria Karabayas, Neil Basu Tags: Systemic vasculitides Source Type: research

Autoantibodies in autoimmune rheumatic disease
Initial characterization of autoimmune rheumatic disease through clinical assessment and investigation including serological measurements offers a vital opportunity to personalize treatment regimens, contributes to accurate prognosis and therefore optimizes outcomes. Disease monitoring using serological tests as biomarkers also contributes to earlier recognition of disease relapse or remission, and allows appropriate titration of medication. All rheumatic diseases have typical antibody associations, and understanding how to request tests appropriately and thereafter analyse them forms an important part of disease managemen...
Source: Medicine - January 11, 2018 Category: Internal Medicine Authors: Corrado Campochiaro, Emma C. Derrett-Smith Tags: Assessing the patient Source Type: research

Idiopathic inflammatory myopathies
represent a rare group of diseases characterized by a central role of autoimmune processes and the inflammation of skeletal muscle. There has been significant recent progress in understanding disease pathogenesis, phenotyping subtypes of disease and investigating effective therapeutic options. Patients typically present with progressive, proximal weakness and functional impairment, and elevated muscle enzymes. There can also have extramuscular manifestations, including skin, respiratory, articular, gastrointestinal and cardiovascular involvement, which can precede or occur in the absence of clinically detectable muscle in...
Source: Medicine - January 11, 2018 Category: Internal Medicine Authors: Matthew J.S. Parker, James B. Lilleker, Mark E. Roberts, Hector Chinoy Tags: Other autoimmune disorders Source Type: research

Antiphospholipid syndrome
(APS) is an acquired autoimmune thrombophilia characterized by venous or arterial thrombosis, and/or pregnancy loss or complications in the presence of persistently positive antiphospholipid antibodies. Patients can also develop other organ involvement, referred to as non-criteria manifestations, including livedo reticularis, thrombocytopenia and nephropathy. Non-thrombotic inflammatory mechanisms are increasingly identified in the pathogenesis of APS, alongside a recognition that obstetric APS may be a specific subset of APS. (Source: Medicine)
Source: Medicine - January 11, 2018 Category: Internal Medicine Authors: Kristina E.N. Clark, Ian Giles Tags: Other autoimmune disorders Source Type: research

The autoimmune rheumatic diseases – an introduction
We have brought together opinion leaders to provide up to date reviews on common autoimmune rheumatic diseases with clinically relevant diagnostic and management strategies, as well as insightful updates on pathogenesis, classification and outcomes. (Source: Medicine)
Source: Medicine - January 11, 2018 Category: Internal Medicine Authors: Ian Giles, Alan D Salama Tags: Introduction Source Type: research

Advances in systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a heterogeneous course and systemic involvement. It is the result of a complex pathogenic pathway that culminates in autoantibody formation. The interaction between environmental triggers and genetic susceptibility is key in this process. Genome-wide association study technology has allowed the recognition of>80 loci associated with SLE that lead to the formation of key proteins, each contributing a small increase to the risk. (Source: Medicine)
Source: Medicine - January 11, 2018 Category: Internal Medicine Authors: Su-Ann Yeoh, Sofia Sapeta Dias, David A. Isenberg Tags: Systemic lupus erythematosus Source Type: research

Small vessel vasculitides
Following the 2012 Chapel Hill Consensus Conference, small vessel vasculitides have recently been recategorized into two major groups. The first comprises antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides, which are pauci-immune, with minimal immune deposits in vessel walls. ANCA-associated vasculitides are the most common cause of rapidly progressive glomerulonephritis. The second group comprises immune complex vasculitides, associated with immune complex deposition in the vasculature, including antiglomerular basement membrane disease, IgA vasculitis (Henoch –Schönlein purpura) and vasculitide...
Source: Medicine - January 11, 2018 Category: Internal Medicine Authors: Alvin H.K. Karangizi, Lorraine Harper Tags: Systemic vasculitides Source Type: research

Self assessment/CPD answers
Question 1 (Source: Medicine)
Source: Medicine - January 5, 2018 Category: Internal Medicine Tags: Self assessment/CPD answers Source Type: research

Delayed diagnosis of xanthogranulomatous pyelonephritis in a quadriplegic patient with uncontrolled cutaneous fistula: A case report
AbstractRationale:Xanthogranulomatous pyelonephritis (XGP) is a chronic destructive granulomatous inflammation that is characterized by urinary tract obstruction and invasion of the renal parenchyma. Although rare, XGP can lead to fatal complications, including perinephric inflammation, psoas abscess, and cutaneous fistula.Patient concerns:A quadriplegic patient initially presented to the hospital with a chronic open wound and cutaneous fistula.Diagnoses:Abdominal computed tomography revealed a renal obstructing stone and enlarged right kidney with a perinephric fluid collection that communicated with the cutaneous fistula...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cheiro-Oral syndrome caused by thalamus hemorrhage: A case report
AbstractRationale:Cheiro-Oral syndrome (COS) is a pure sensory deficit confined to the perioral area and ipsilateral distal fingers or hand. Owing to relatively minor clinical findings and various presentations in different cases, the insidious and severe illness it implies may be overlooked at acute settings.Patient concerns:A 70-year-old man with history of hypertension and type II diabetes mellitus under regular medication control came to our emergency department with chief complaint of sudden onset of right perioral region and right upper limb numbness. General physical and neurological examinations were normal except ...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Computed tomography findings of primary pulmonary meningioma: A case report
We present the case of a 54-year-old male patient with cough and sputum lasting for 20 years. This was a case of primary pulmonary meningioma with initial suspicion of a chest wall intercostal neurinoma.Diagnoses:A lung lesion was detected on chest computed tomography (CT) imaging 4 years ago. This case appeared as a solitary well-defined round nodule close to the left chest wall, with heterogeneous enhancement on CT, which inaccurately led to the suspicion of a chest wall intercostal neurinoma.Interventions:A thoracoscopic wedge resection was performed.Outcomes:The postoperative histological diagnosis was primary pulmonar...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Candida pneumonia with severe clinical course, recovery with antifungal therapy and unusual pathologic findings: A case report
Conclusion:Candida can rarely cause clinically significant pneumonia in adults, and should be considered in the differential diagnosis of suppurative granulomas in the lung. Background: Candida is frequently isolated from the respiratory tract and usually reflects airway colonization. True Candida pneumonia is rare. Our aim is to document a case of Candida pneumonia confirmed by cultures, molecular techniques, and surgical lung biopsy, and to highlight a previously unreported pathologic manifestation of this infection. Case summary: A 59-year-old man with a history of chronic obstructive pulmonary disease (COPD) pre...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Marginal zone lymphoma of palatine tonsil with prominent plasmacytic differentiation: A CARE-compliant article and review of literature
AbstractRationale:The palatine tonsil is an important component of Waldeyer's ring and a site commonly involved by lymphoma. Interestingly, although it is a site of mucosa-associated lymphoid tissue (MALT), primary MALT lymphoma of the palatine tonsil is rare, especially with prominent plasmacytic differentiation.Patient concerns:A 59-year-old woman presented to the hospital with a 1-month history of odynophagia. The patient had no fever or pruritus during this period and she declared no family history of hematolymphoid malignancy.Diagnosis:Histopathological examination demonstrated effacement of tonsil architecture; norma...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Hepatoblastoma with pure fetal epithelial differentiation in a 10-year-old boy: A rare case report and review of the literature
AbstractRationale:Hepatoblastoma is a rare malignant embryonal tumor that only accounts for approximately 1% of all pediatric cancers and mostly develops in children younger than 5 years old. Moreover, the occurrence of hepatoblastoma in adults is extremely rare.Patient concerns:Herein, we present a rare case of hepatoblastoma with pure epithelial differentiation in a 10-year-old boy.Pathological examination was performed. The tumor was 15 cm × 15 cm in size with clear margins. The cut surface was multiple nodular and grey-yellow. Histologically, the small cuboidal tumor cells were arranged in trabeculae with...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Patients’ demographics of a convenient clinic located in a large railway station in metropolitan Tokyo area
Hidden barriers to visit a medical facility especially for young busy workers have been neglected in the aging society. The aim of this cross-sectional study is to analyze demographics of patients who had visited the first known convenient clinic located inside a railway station, which is adjusted to the lifestyle of working generations. We analyzed de-identified data of patients who had visited the department of internal medicine of a clinic, which is located inside a railway station building and offers primary care with after-hours accessibility in Tokyo, between August 2013 and June 2016. Data were collected on patient...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Evidence supports blind screening for internal malignancy in dermatomyositis: Data from 2 large US dermatology cohorts
The association between dermatomyositis and internal malignancy is well established, but there is little consensus about the methods of cancer screening that should be utilized. We wished to analyze the prevalence and yield of selected cancer screening modalities in patients with dermatomyositis. We performed a retrospective analysis of 2 large US dermatomyositis cohorts comprising 400 patients. We measured the frequency of selected screening tests used to search for malignancy. Patients with a biopsy-confirmed malignancy were identified. Prespecified clinical and laboratory factors were tested for association with mali...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone applicationStudy protocol
The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated.Methods:Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5–40 kg/m2), who are clinically classif...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Low incidence of adjacent segment disease after posterior lumbar interbody fusion with minimum disc distraction: A preliminary report
AbstractStudy Design:A retrospective review of prospectively collected data.Objective:To investigate the incidence of radiographic and symptomatic adjacent segment disease (ASD) and identify possible risk factors for ASD after posterior lumbar interbody fusion (PLIF) with minimum disc distraction by selecting low-height interbody cages.Summary of Background Data:Excessive disc space distraction is reportedly 1 of the risk factors for ASD after PLIF; however, the incidence and other risk factors of ASD after PLIF with minimum disc distraction remain unclear.Methods:Forty-one consecutive patients who underwent PLIF at L4-L5 ...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Generate the scale-free brain music from BOLD signals
In this study, we used a neural mass model, the Jansen–Rit model, to simulate activity in several cortical brain regions. The interactions between different brain regions were represented by the average normalized diffusion tensor imaging (DTI) structural connectivity with a coupling coefficient that modulated the coupling strength. Seventy-eight brain regions were adopted from the Automated Anatomical Labeling (AAL) template. Furthermore, we used the Balloon–Windkessel hemodynamic model to transform neural activity into a blood-oxygen-level dependent (BOLD) signal. Because the fMRI BOLD signal changes slowly, ...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research

Association of vitamin D receptor BsmI rs1544410 and ApaI rs7975232 polymorphisms with susceptibility to adolescent idiopathic scoliosis: A systematic review and meta-analysis
Conclusion:VDR BsmI was significantly associated with AIS susceptibility in the overall and Asian populations, while the VDR ApaI polymorphism only played a key role in AIS etiology and development in Asian populations. Background: AIS is the most common spinal deformity disease, yet its etiology remains uncertain. Significant associations have been found between AIS risk and vitamin D receptor (VDR) gene polymorphisms; however, some of these results are controversial. The aim of this study was to determine whether VDR BsmI rs1544410 and ApaI rs7975232 polymorphisms are correlated with AIS. Methods: Databases, inclu...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

The clinical effect of rehabilitation following arthroscopic rotator cuff repair: A meta-analysis of early versus delayed passive motion
Conclusion:The meta-analysis suggests that the EPM protocol results in superior ROM recovery after arthroscopic rotator cuff repair but may adversely affect the shoulder function, which should be supported by further research. The healing rate at long-term follow-up is not clearly affected by the type of rehabilitation, but the EPM protocol might result in lower rates of tendon healing in the shoulder with large-sized tendon tears. Background: The argument on the recommended rehabilitation protocol following arthroscopic rotator cuff repair remains to be resolved. So this meta-analysis was presented to evaluate the dif...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

A case report of phosphaturic mesenchymal tumor-induced osteomalacia: Erratum
No abstract available (Source: Medicine)
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Erratum Source Type: research

Mesalazine as a cause of fetal anemia and hydrops fetalis: A case report Erratum
No abstract available (Source: Medicine)
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Erratum Source Type: research

Use of Univent tube for intermittent lung isolation during thoracoscopic mediastinal tracheal resection and reconstruction: A case report Erratum
No abstract available (Source: Medicine)
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Erratum Source Type: research

Prevalence and mortality of chronic kidney disease in lymphoma patients: A large retrospective cohort study
This study aimed to evaluate the prevalence of CKD and its impact on mortality in those patients. This was a retrospective cohort study of 429 consecutive lymphoma patients who were admitted or regularly visited our hospital from January 2013 to October 2016. CKD was defined as estimated glomerular filtration rate (eGFR)  (Source: Medicine)
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Therapeutic effect of chidamide on relapsed refractory angioimmunoblastic T-cell lymphoma: A case report and literature review
Discussion and conclusions:Chidamide has good therapeutic effect in the treatment of AITL, which provides a novel therapeutic strategy for relapsed refractory AITL. However, more cases are still needed to further validate its efficacy. Introduction: Angioimmunoblastic T-cell lymphoma (AITL) is a kind of rare peripheral T cell lymphoma, which usually has acute onset at old age. Materials and methods: Here we report a case of relapsed refractory AITL, which has achieved obvious curative effect after treatment with chidamide. Results: Initially, the patient received 7 courses of treatment with recombinant human endo...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Retrograde gastroesophageal intussusception after peroral endoscopic myotomy in a patient with achalasia cardia: A case report
AbstractRationale:Retrograde gastroesophageal intussusception (RGEI) is a relatively rare gastrointestinal (GI) disorder in which a portion of the stomach wall invaginates into the esophagus. More recently, peroral endoscopic myotomy (POEM) has emerged as an endoscopic alternative to surgical myotomy for achalasia, and, to the best of our knowledge, our case is the first RGEI after POEM to be reported.Patient concerns:A 22-year-old male was presented with a history of vomiting, intractable retching and hematemesis for 3 days. He had a history of achalasia and underwent POEM 3 years ago caused by symptoms of severe dysphagi...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Tongue diagnosis indices for upper gastrointestinal disorders: Protocol for a cross-sectional, case-controlled observational study
AbstractBackground:Upper gastrointestinal disorders are common in clinical practice, for example, gastritis, peptic ulcer disease, and gastroesophageal reflux disease. Panendoscopy or upper gastrointestinal endoscopy is viewed as the primary tool for examining the upper gastrointestinal mucosa, and permitting biopsy and endoscopic therapy. Although panendoscopy is considered to be a safe procedure with minimal complications, there are still some adverse effects, and patients are often anxious about undergoing invasive procedures. Traditional Chinese medicine tongue diagnosis plays an important role in differentiation of sy...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Refractory chyle leakage after laparoscopic cholecystectomy for gallstone disease: A case report and literature review
We present a rare case of refractory chyle leakage post-LC for acute cholecystitis that is successfully treated in a 40-year-old man, and review current literature on the prevalence, diagnosis, and management of this complication.Diagnoses:Refractory chyle leakage post-LC, a rare but serious complication after laparoscopic cholecystectomy.Interventions:Conservative treatment was given initially; however, the outcome was frustrating. Surgical intervention was given without further delay.Outcomes:After the reoperation, conservative treatment was still maintained. After nearly 8 months of treatment, the patient recovered and ...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Evaluation of a central venous catheter tip placement for superior vena cava–subclavian central venous catheterization using a premeasured length: A retrospective study
Subclavian central venous catheterization is a common procedure for which misplacement of the central venous catheter (CVC) is a frequent complication that can potentially be fatal. The carina is located in the mid-zone of the superior vena cava (SVC) and is considered a reliable landmark for CVC placement in chest radiographs. The C-length, defined as the distance from the edge of the right transverse process of the first thoracic spine to the carina, can be measured in posteroanterior chest radiographs using a picture archiving and communication system. To evaluate the placement of the tip of the CVC in subclavian centra...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The radiosensitive effect of apatinib for hepatocellular carcinoma patient with big paraspinal metastasis: A case report
AbstractRationale:Hepatocellular carcinoma (HCC) is a highly invasive cancer associated with great mortality rates. The prognosis of advanced HCC is very poor.Patient concerns:Here, we report a HCC patient with a big paraspinal metastasis with 10 cm in diameter who failed the treatment of sorafenib.Diagnoses:Sorafenib refractory HCC with big paraspinal metastasis.Interventions:The concurrent treatment of apatinib with stereotactic body radiotherapy (SBRT).Outcomes:The paraspinal metastasis with 10 cm in diameter showed nearly complete response.Lessons:We think that the apatinib may be a good choice for HCC and it may f...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Sequential occurrence of diffuse large B-cell lymphoma and carcinoma in the nasopharynx: A case report
Conclusion:The presentation with diffuse large B-cell lymphoma (BCL) and NPC in this patient was perhaps caused by dual EBV infection or a different oncogenic mechanism. Background: The sequential occurrence of the 2 malignancies development of nasopharyngeal carcinoma (NPC) and lymphoma is extremely rare and their coexistence raises the question of a common etiologic factor. Clinical findings/clinical concerns: A 71-year-old previously healthy man presented with diffuse large B-cell lymphoma (BCL) followed by NPC almost 2 years later with Epstein–Barr virus (EBV) positive. Diagnosis: Endoscopic examination...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Internal jugular vein aneurysm: A case report
Conclusion:Despite the lack of guidelines, intervention was necessary because the patient was anxious regarding the increase in the size of the swelling, which she felt had a negative psychosocial impact. Moreover, because the sizable venous aneurysm harbored a mural thrombus that increased the risk of embolization and pulmonary embolism, surgery was offered.Indication for surgery includes pain, swelling, and cosmetic concerns. Conservative management of the condition is described in the literature. Introduction: Aneurysm is a localized dilatation of an artery of at least 1.5 times the normal diameter that occurs when ...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Electrophysiological examination and high frequency ultrasonography for diagnosis of radial nerve torsion and compression
This study aims to evaluate the value of electrophysiological examination and high frequency ultrasonography in the differential diagnosis of radial nerve torsion and radial nerve compression. Patients with radial nerve torsion (n = 14) and radial nerve compression (n = 14) were enrolled. The results of neurophysiological and high frequency ultrasonography were compared. Electrophysiological examination and high-frequency ultrasonography had a high diagnostic rate for both diseases with consistent results. Of the 28 patients, 23 were positive for electrophysiological examination, showing decreased amplitude and d...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Association analysis between thrombospondin-2 gene polymorphisms and intervertebral disc degeneration in a Chinese Han population
The aim of this study is to determine the contribution of 2 single nucleotide polymorphisms (SNPs) in thrombospondin 2 (THBS2) gene to the development of intervertebral disc degeneration (IDD) in a Chinese Han population. We studied 138 patients with radiographically proven IDD and 136 healthy volunteers with no history of back problems. Magnetic resonance images (MRIs) were obtained for all the patients and controls. Image evaluation for IDD was performed to evaluate the severity of IDD. All patients and controls were genotyped for rs6422747 and rs6422748. Associations between genotypes and development of IDD were analyz...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Does pedicle screw density matter in Lenke type 5 adolescent idiopathic scoliosis?
The aim of this study is to compare the effects of high versus low implant density on correction in Lenke type 5 adolescent idiopathic scoliosis (AIS) patients. A retrospective study of 59 Lenke type 5 AIS patients treated at a single institution were divided into to 2 groups according to implant density. Implant density, preoperative, early postoperative, and last follow-up thoracolumbar/lumbar (TL/L) curves were measured. Thirty-one constructs were high and 28 constructs were low density. The groups were similar in terms of age, sex, Cobb angle, and follow-up time. Mean implant density in low density group and high densi...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Hypercalcemic pancreatitis a rare presentation of sarcoidosis: A case report
We present a case that presented with 1-day history of vomiting, diffuse abdominal pain, and altered mental status.Diagnoses:Initial investigations showed highly elevated calcium levels, acute pancreatitis, and kidney failure. Possible causes entertained were malignancy, hyperparathyroidism, hypervitaminosis D, and granulomatous diseases. Full work-up including a hilar lymph node biopsy revealed noncaseating granuloma. After excluding other diseases capable of producing a similar picture, a diagnosis of sarcoidosis was made.Interventions and outcomes:The patient was started on aggressive intravenous fluid hydration and int...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Effects of remote ischemic preconditioning on contrast induced nephropathy after percutaneous coronary intervention in patients with acute coronary syndrome
Conclusions:RIPC can reduce PCI-related CIN and protect renal function in patients with ACS. The benefits of these patients by RIPC may be related to the reduction of the NGAL and CysC. Objective: The aim of this study was to explore the clinical effects of remote ischemic preconditioning (RIPC) on contrast-induced nephropathy after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Patients and Methods: The study was a single-center, prospective, randomized, controlled study. A total of 161 patients with ACS and the rate of estimate glomerular filtration (eGFR) 15 to 70 mL/mi...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Combined analysis of endometrial thickness and pattern in predicting clinical outcomes of frozen embryo transfer cycles with morphological good-quality blastocyst: A retrospective cohort study
This study suggested neither individual nor combined analysis of endometrial thickness and pattern had predicting effects on live birth following IVF treatments, and embryo quality might be the one that really has effects. (Source: Medicine)
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Validation of the Peripheral Ultrasound-guided Vascular Access Rating Scale
In this study, we explored the validity of the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale. We recruited 3 groups of physicians (5 novices, 5 intermediates, and 5 experts) of increasing proficiency in peripheral ultrasound-guided intravenous access. All participants performed 3 peripheral ultrasound-guided intravenous accesses on three different patients. Performance was video-recorded by 3 cameras and the ultrasound image. Synchronized and anonymized split-screen film clips were rated using the P-UGVA rating scale by 2 assessors, which also assessed overall performance on a 1–5 Likert-scale. ...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Functional analysis of cell-free RNA using mid-trimester amniotic fluid supernatant in pregnancy with the fetal growth restriction
This study also suggested possible genes related to fetal development such as B-cell lymphoma, LRP10, and IGF-2. To monitor the fetal development, further study may be needed to elucidate the role of the genes identified. (Source: Medicine)
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Patient safety culture perceptions in the college of dentistry
A positive safety culture is essential to patient safety because it improves quality of care. The aim of this study was to assess staff and student perceptions of the patient safety culture in the clinics of the College of Dentistry at King Saud University in Saudi Arabia. A cross-sectional study was conducted in the College of Dentistry at King Saud University in Saudi Arabia. It included 4th and 5th year students, interns, general practitioners, and dental assistants. The data were collected by using paper-based questionnaire of modified version of the Agency for Healthcare Research and Quality Hospital Survey on Patien...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Exenatide once weekly for smoking cessation: study protocol for a randomized clinical trial
AbstractBackgroundCigarette smoking is the greatest preventable cause of morbidity and premature mortality in the United States. Approved pharmacological treatments for smoking cessation are marginally effective, underscoring the need for improved pharmacotherapies. A novel approach might use glucagon-like peptide-1 (GLP-1) agonists, which reduce alcohol and drug use in preclinical studies. GLP-1 is produced in the intestinal L-cells and in the hindbrain. The peptide maintains glucose homeostasis and reduces food intake. Several GLP-1 agonists are used clinically to treat type 2 diabetes and obesity, but none have been tes...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Paternal exposure to medical-related radiation associated with low birthweight infants: A large population-based, retrospective cohort study in rural China
This study was a population-based, retrospective cohort study performed in 30 Chinese provinces. We used data from the free National Pre-pregnancy Checkups Project, which is a countrywide population-based retrospective cohort study. To identify regional differences in LBW incidence, we used the Qinling-Huaihe climate line to divide China into northern and southern sections and the Heihe-Tengchong economic line to divide it into eastern and western sections. Multivariate unconditional logistic regression analysis with SAS 9.4 was used for data analysis. P  (Source: Medicine)
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Supratentorial intracerebral cerebellar liponeurocytoma: A case report and literature review
AbstractRationale:Cerebellar liponeurocytoma is a rare tumor of the central nervous system (CNS) characterized by low proliferation but high likelihood of recurrence. Because of its rarity and the paucity of systematic follow-up, the biological behaviors and clinical features of this tumor are still poorly understood. We herein reported a case of cerebellar liponeurocytoma originating in the cerebral hemisphere.Patient concerns:A 11-year-old male with intermittent headache, nausea, and vomiting. The first computed tomography revealed a large mass in the right cerebral hemisphere. He was transferred to our institution for n...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Association of rs2279744 and rs117039649 promoter polymorphism with the risk of gynecological cancer: A meta-analysis of case–control studies
Conclusions:We found that rs2279744 (SNP309) and rs117039649 (SNP285) were both associated with the risk of gynecological cancers. Subgroup analysis showed that rs2279744 (SNP309) was associated with the risk of gynecological cancers in Caucasian and Asian according to the ethnicity and cancer type, especially for endometrial cancer. Background: Increasing evidence has suggested that rs2279744 is associated with rs117039649 polymorphism, which can increase the risk of gynecological cancers, including cervical, ovarian, breast, and endometrial cancer. The results are inconsistent so that we performed a meta-analysis of ...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Solitary duodenum metastasis from breast cancer with 8 years’ latency: A case report
This report intends to alert people to heed this type of breast cancer metastasis and not treat it as a primary gastrointestinal tumor. Rationale: Advanced breast cancer frequently metastasizes to the lungs, liver, and bones. Metastatic involvement of the duodenal bulb is extremely rare and difficult to detect by endoscopy. Patient concerns: A 51-year-old menopausal woman presented with abdominal fullness and obstructive symptoms, and was diagnosed with adenocarcinoma in the duodenal bulb. The patient had undergone modified radical mastectomy of the left breast for infiltrating ductal carcinoma (IDC) 8 years previou...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Efficacy of early rehabilitation therapy on movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident
This study aims to investigate the efficacy of early rehabilitation therapy on the movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident (CVA). A total of 86 patients who suffered from acute CVA were selected and divided into 2 groups, according to random number tables: control group, and research group. Patients in the control group received routine primary therapy, while patients in the research group received rehabilitation based on the basic therapy. The recovery of hemiplegic limb movement ability and the improvement of daily living ability before and after treatment were eval...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research