Irritable bowel syndrome
(IBS) is a functional gastrointestinal disorder characterized by chronic abdominal pain associated with a change in frequency and form of stool. IBS is common, with a population prevalence of around 10%, and causes a reduction in quality of life. Its pathophysiology remains incompletely understood, although abnormal communications within the brain –gut axis are considered to be important. IBS can be subclassified according to predominant bowel habit and/or pain. Treatments are directed towards improving symptoms and are multifaceted. (Source: Medicine)
Source: Medicine - May 8, 2019 Category: Internal Medicine Authors: Adam D. Farmer, James K. Ruffle Tags: Motility and functional bowel disease Source Type: research

Anorectal function testing
Faecal incontinence and evacuation disorders are common conditions that cause significant morbidity. Patient-reported symptoms are poor predictors of underlying pathophysiology, so anorectal function testing is a key component of the clinical evaluation when initial management strategies fail. A number of investigations are available to assess anorectal structure (endoanal ultrasound, defaecography) and function (anorectal manometry, rectal sensory test, balloon expulsion test, defaecography). This review article outlines the usefulness and relevance of these investigations for the investigation of patients with faecal inc...
Source: Medicine - May 8, 2019 Category: Internal Medicine Authors: Emma V. Carrington, S Mark Scott Tags: Motility and functional bowel disease Source Type: research

Ulcerative colitis
is a chronic idiopathic inflammatory disease affecting the large intestine. In this chapter, we review current concepts in its assessment and management. (Source: Medicine)
Source: Medicine - May 7, 2019 Category: Internal Medicine Authors: Helen Steed Tags: Inflammatory bowel disease Source Type: research

Immunodeficiency and the gut
Gastrointestinal diseases associated with impaired immunity are largely infectious, although an increased incidence of extranodal lymphoma is also found in the context of HIV infection. The range of such infections is related to the role of CD4+ T cells in their eradication. Infections tend to occur with organisms of limited virulence and to be recurrent, and are associated with disseminated infection. The symptoms they produce are usually pain on swallowing, weight loss or diarrhoea. Abdominal pain can be associated with Mycobacterium avium-intracellulare or sclerosis of the bile ducts secondary to infection. (Source: Medicine)
Source: Medicine - May 7, 2019 Category: Internal Medicine Authors: Brian Gazzard Tags: Infection Source Type: research

Microscopic colitis
describes a condition of chronic watery diarrhoea in the absence of macroscopic evidence of colonic inflammation but with characteristic microscopic appearances. It comprises the two separate but related conditions of lymphocytic and collagenous colitis. Disease severity ranges from mild and self-limiting to severe and refractory. Whereas mild disease can be managed adequately with loperamide, severe disease requires budesonide over the short term and, occasionally, immunomodulatory therapy with azathioprine. (Source: Medicine)
Source: Medicine - May 3, 2019 Category: Internal Medicine Authors: Miles Parkes Tags: Inflammatory bowel disease Source Type: research

Centrally mediated abdominal pain syndromes
Centrally mediated abdominal pain and the associated narcotic bowel syndrome are functional bowel disorders that are challenging to manage and associated with significant medical harm, including unnecessary investigations, opioids and surgeries. They are distinguished from more common conditions, such as irritable bowel syndrome, by the near-continuous nature of the pain, irrespective of gastrointestinal physiological functioning. Their pathophysiology is obscure and incompletely understood, but they have features consistent with central sensitization. (Source: Medicine)
Source: Medicine - May 3, 2019 Category: Internal Medicine Authors: Peter Paine Tags: Motility and functional bowel disease Source Type: research

Infectious diarrhoea
remains a major cause of morbidity and mortality worldwide. Viruses, bacteria and protozoa are responsible for most infections, which are most commonly transmitted by the faecal –oral route through water, food and person-to-person transmission. Clinical presentation of infectious diarrhoea conforms to three patterns: acute watery diarrhoea; bloody diarrhoea (dysentery); and persistent diarrhoea, which can include steatorrhoea. Diagnosis still rests heavily on stool micros copy and culture, although faecal antigen tests and molecular assays are increasingly used. (Source: Medicine)
Source: Medicine - May 3, 2019 Category: Internal Medicine Authors: Paul Kelly Tags: Infection Source Type: research

Oesophageal motility testing and 24-hour  reflux studies
High-resolution manometry (HRM) and 24-hour pH/impedance studies of the oesophagus have become more widely available and are a useful tool for investigating symptoms, leading to better decision-making and ultimately improved outcomes. Advances in technology have made analysis more intuitive, and efforts have been made to better classify motility disorders and reflux exposure. However, pitfalls remain for the novice, and care is needed that the correct diagnosis is made before being applied to clinical management. (Source: Medicine)
Source: Medicine - May 3, 2019 Category: Internal Medicine Authors: Andres Vales, Anthony Hobson Tags: Motility and functional bowel disease Source Type: research

Gastric, small bowel and colonic motility and breath-testing
The organs of the gastrointestinal (GI) tract are responsible for digestion, absorption and excretion of ingested food and drink. From ingestion to excretion, movement of luminal contents is regulated by the enteric and central nervous systems, which stimulate contractions of the smooth muscle of the stomach, small intestine and colon. Dysfunction of GI motility can relate to pathology of these neural complexes or changes to the smooth muscle, or appear idiopathic. When dysmotility occurs, individuals can experience a diverse array of symptoms including abdominal symptoms, change in bowel habit and serious consequences suc...
Source: Medicine - May 3, 2019 Category: Internal Medicine Authors: Sam Treadway, Anthony Hobson Tags: Motility and functional bowel disease Source Type: research

Crohn's disease
is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract from mouth to anus, although the ileum, colon and perineum are most commonly involved. It is characterized by transmural granulomatous inflammation. Crohn's disease is thought to result from a complex interplay of multiple genetic and environmental factors. Alterations in the microbiota signature with reduced microbiota diversity are observed. Diarrhoea, abdominal pain, fatigue, weight loss and fever are hallmarks of Crohn's disease. (Source: Medicine)
Source: Medicine - May 3, 2019 Category: Internal Medicine Authors: Wing Yan Mak, Ailsa L. Hart, Siew C. Ng Tags: Inflammatory bowel disease Source Type: research

Self –assessment/CPD answers
Correct answer: D. Amoebiasis is an infection that needs to be treated as a priority, so option C is sub-optimal (though may also be necessary in addition to D). Immediate colonoscopy (A) is unlikely to provide diagnostic information and could be dangerous. The feared complication in this situation is toxic dilatation of the colon with loperamide if severe ulceration is present, so loperamide (B) is not a good choice. Ciprofloxacin (E) is not an effective treatment for amoebiasis. (Source: Medicine)
Source: Medicine - May 3, 2019 Category: Internal Medicine Tags: Self –assessment/cpd answers Source Type: research

Tumor laterality in renal cancer as a predictor of survival in large patient cohorts: A STROBE compliant study: Erratum
No abstract available (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Erratum Source Type: research

KLHL3 single-nucleotide polymorphism is associated with essential hypertension in Chinese Han population
Hypertension, including secondary and essential hypertension (EH) variants, is a multifactorial disease, affecting more than one billion people worldwide. Secondary hypertension results from mutations in the putative gene KLHL3 (Kelch-like protein 3); however, it has not been reported whether the KLHL3 gene polymorphisms are associated with EH. Here, we investigated the association between KLHL3 (rs2301708 and rs7444370) polymorphisms and EH in the Chinese Han population. This case–control study included 522 subjects—260 patients with EH and 262 normotensive controls matched for age, gender, body mass index (B...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Efficacy of anti-PD-1 antibody SHR-1210 as second-line treatment in hepatocellular carcinoma patient with sorafenib resistance: A case report
Rationale: Hepatocellular carcinoma (HCC), one of the most common cancers worldwide, is an aggressive tumor with very poor prognosis. Regorafenib was the first agent to show a survival benefit over placebo in patients who showed progression while being treated with sorafenib, but it remains an unsatisfactory agent owing to its serious side effects. Therefore, more efficient and milder therapies are needed. Patient concerns: Herein, we report a patient with advanced HCC with many lung metastases who showed progression during sorafenib treatment. Diagnoses: HCC with lung metastases (stage IVB). Interventions: SHR-...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

ECMO support in cardiac intervention of severe pulmonary stenosis: A case report
Conclusion: V-A ECMO is capable of preventing hypoxemia and providing effective circulation support during cardiac intervention in patients of severe pulmonary stenosis. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Synchronous occurrence of benign mesothelioma and adenomatoid tumor of uterus: A case report and review of literature
Introduction: Synchronous occurrence of benign cystic mesothelioma and adenomatoid tumor of uterus (UAT) are very rare and few cases have been published in the English literature. They are easily misdiagnosed as malignant by clinicians, due to the lack of reports. Patient concerns: A case of benign mesothelial combined with uterus adenomatoid tumor (UAT) in a 48-year-old Chinese woman was reported. Our patient presented with abdominal pain and surgery showed a large subserous mass (12.0 × 11.4 × 9.8 cm) combined with a small intramural solid nodule (2.0 × 1.0 × 1.0 cm), and ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

A randomized trial comparing the efficacy of single-dose and double-dose administration of rectal indomethacin in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis
Conclusions: Single-dose rectal indomethacin administration immediately after ERCP in general population is good enough to prevent PEP, but difficult cannulation could induce the PEP frequency up to 15.4% even under rectal indomethacin use. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Information experiences, needs, and preferences of colonoscopy patients: A pre-colonoscopy survey
Better pre-colonoscopy education may lead to improved bowel preparation, decreased anxiety, and a willingness to go direct-to-colonoscopy. We assessed information experiences, needs, and preferences of patients undergoing colonoscopy. A self-administered survey was distributed between 08/2015 and 06/2016 to patients in Winnipeg, Canada when they attended an outpatient colonoscopy. The amount, type, helpfulness, and satisfaction with information provided were analyzed. Linear and logistic regression analyses were used to assess predictors of satisfaction with various aspects of the information received, as well as overall ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Expression of circular RNAs in gynecological tumors: A systematic review
Conclusions: Circular RNA has been found to play a role in gynecological tumors diseases. Meanwhile, we reviewed the studies on how CircularRNA participate in gynecological tumors, which provides a basis for the study of CircularRNA in gynecological tumors. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Intravitreal ranibizumab injection at the end of vitrectomy for diabetic vitreous hemorrhage (Observational Study)
To evaluate the outcomes and complications of intravitreal injections of ranibizumab in patients during pars plana vitrectomy for treatment of diabetic vitreous hemorrhage. This retrospective, observational, comparative study included 103 patients (103 eyes) who underwent pars plana vitrectomy for treatment of diabetic vitreous hemorrhage. Sixty-six patients received an intravitreal injection of 0.05 mg (0.05 cc) of ranibizumab at the end of surgery. Main outcome measures were the occurrence of recurrent early vitreous hemorrhage, reoperation, intraocular pressure, best corrected visual acuity. Mean follow-up time was 6 ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Carotid duplex parameters to predict long term outcomes of ischemic stroke patients receiving intra-arterial thrombectomy treatment
Early treatment of acute ischemic stroke with intravenous thrombolysis therapy (ITT) followed by intra-arterial thrombectomy (IAT) is a promising new treatment option for improving functional outcomes. Identifying patients who will benefit from this treatment combination is important. A total of 92 acute ischemic stroke patients who received ITT and IAT with a minimum of 1-year follow-up were included in the study. All parameters of clinical and imaging examinations at baseline were examined which parameters were significantly correlated with the 1-year functional outcomes (modified Rankin scale [mRS], National Institute ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Pregnancy outcomes in patients with primary antiphospholipid syndrome: A systematic review and meta-analysis
Conclusion: This analysis showed APS to be associated with significantly worse pregnancy outcomes when compared to the control group. A significantly higher risk of maternal and fetal complications was observed in this category of patients. Therefore, intense care should be given to pregnant women with APS to monitor unwanted outcomes and allow a successful pregnancy. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Risk of dermatologic and mucosal adverse events associated with PD-1/PD-L1 inhibitors in cancer patients: A meta-analysis of randomized controlled trials
Conclusion: Our meta-analysis concluded that anti PD-1/PD-L1 drugs have different dermatological and mucosal safety profile compared to conventional therapy, and differences of dermatological toxicity between PD-1 and PD-L1 inhibitor warrant further investigation. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Association between outdoor air pollution and semen quality: Protocol for an updated systematic review and meta-analysis
Conclusions: This meta-analysis and systematic review will generate evidence for judging whether outdoor air pollution can impair semen quality. PROSPERO registration number: PROSPERO CRD 42019126060 (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Proposal of a multidimensional strategic-management dashboard for use in a rehabilitation respiratory unit
Health information systems are the core support to decision-making in health organizations. Economic and clinical managements often function separately, while a governance system for quality and safety functions with quality checks and performance accountability, could improve efficiency. The aims of this study were, within a respiratory rehabilitation unit (RRU), to: develop a management-strategy dashboard based on key performance areas (KPAs), identify key performance indicators (KPIs) for each KPA which allow multidimensional assessment; estimate the expected results from the implementation of this dashboard using the b...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research

Percutaneous osteoplasty for the management of a humeral head metastasis: Two case reports
In this study, we described 2 patients with humeral head metastases treated with POP in our hospital. Patient concerns: Case 1 was a 79-year-old man with vertebral and right humeral head metastasis after radical surgery or and periods of chemotherapy for bladder cancer. He suffered constant severe back and right shoulder joint pain even if taking much non-steroidal anti-inflammatory drugs. Case 2 was a 59-year-old woman with vertebral and right humeral head metastasis from lung cancer. She received regular radiotherapy and took much painkillers to relieve pain. However, the pain could not be relieved any more after 1 mo...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Anti-N-methyl-D-aspartate receptor encephalitis associated with reactivated Epstein–Barr virus infection in pediatric patients: Three case reports
Rationale: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most frequent autoimmune encephalitis in children, and its presentation is various. The disease can be triggered by various infections. Patient concerns: Case 1 was a 7-year-old female with the presentation of seizure, repeated fever, language disorder, and decreased muscle strength of the right limbs; Case 2 was a 7-year-old male with the manifestation of repeated emesis, headache, involuntary movement, altered personality, seizures, and cognitive impairment; Case 3 was a 2-year-old female with repeated fever, emesis, seizures, coma, and decrea...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Epidemiology of sepsis in Taiwan
This study is a retrospective national claim database analysis. Hospitalized adult patients with sepsis between 2010 and 2014 were identified from the Two-Million-Sample Longitudinal Health and Welfare Database (LHWD) by the International Classification of Diseases 9th Edition Clinical Modification (ICD-9-CM). The patients were divided into 3 severity groups based on their medical records during hospitalization. The study results showed that in Taiwan, there were 643 new cases of sepsis in 100,000 Taiwanese. The mortality of all septic patients in Taiwan was 287 per 100,000 people, and the case fatality was 29.2%. It was ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Haptic fracture and dislocation of polyimide intraocular lens after neodymium: YAG laser capsulotomy: A case report
We report a case of haptic fracture of polyimide intraocular lens (IOL) and its dislocation after neodymium:YAG (Nd:YAG) laser capsulotomy. To the best of our knowledge, this is the first report of both the fracture and dislocation of the IOL after laser posterior capsulotomy. Patient concerns: A 78-year-old male was referred to our clinic with a history of decreased visual acuity after Nd:YAG laser posterior capsulotomy in the right eye. A dislocated IOL was observed on slit lamp examination. Diagnosis: On slit-lamp examination, dislocated IOL with intact anterior capsulorrhexis margin was observed in the right eye....
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Top-100 highest-cited original articles in inflammatory bowel disease: A bibliometric analysis
Conclusions: This highly cited list of papers identifies the subjects and authors who have had the greatest impact on IBD research in the last decades, which serves as a reference for researchers and clinicians “highly citable” manuscripts. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Percutaneous vertebroplasty with granulated allogeneic bone grafting using screw-view model of navigation for thoracolumbar compressive fracture: A case report
Rationale: The aim of this study was to assess the accuracy of percutaneous puncture needle with screw view model of navigation (SVMN) and the effect of periacetabular vertebroplasty (PVP) with granulated allogeneic bone grafting in thoracolumbar compressive fracture (TCF). Patient concerns: A 46-year-old female patient associated with high fall injury showed symptoms characterized by back pain and restricted movement of the right lower extremity. Diagnoses: The patient was diagnosed with a TCF, right femoral neck fracture, and lumbar vertebrae hyperosteogeny. Interventions: A SVMN was used to guide our puncture...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Iatrogenic Kaposi sarcoma of the terminal ileum following short-term treatment with immunomodulators for Crohn disease: A case report
We report the case of a 45-year-old young woman with abdominal pain, episodic diarrhea and a mild weight loss. The patient was treated with immunosuppressive therapy for a parietal thickening of the terminal ileum, wrongly diagnosed as Crohn disease. After 9 months after the beginning of antitumor necrosis factor-α, the patient was admitted for obstructive symptoms. A computed tomography suspected neoplasia of ileocecal region. The patient underwent an uneventful ileocecal surgical resection. Diagnoses: The histopathology showed endometriosis of the ileal wall and an irrefutable diagnosis of KS by immunohistochemi...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Safety and efficacy of combined use of propofol and etomidate for sedation during gastroscopy: Systematic review and meta-analysis
Background: Sedation with etomidate or propofol alone during gastroscopy has many side effects. A systematic review and meta-analysis were conducted to evaluate the safety and efficacy of the combined use of propofol and etomidate for sedation during gastroscopy. Methods: PubMed, Embase, Medline (via Ovid SP), Cochrane library databases, CINAHL (via EBSCO), China Biology Medicine disc (CBMdisc), Wanfang, VIP, and China National Knowledge Infrastructure (CNKI) databases were systematically searched. We included randomized controlled trials (RCTs) comparing the combined use of propofol and etomidate vs etomidate or prop...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Systematic reviews of pharmacological and nonpharmacological treatments for patients with chronic urticaria: An umbrella systematic review
A wide range of pharmacological and nonpharmacological interventions for chronic urticaria (CU) have been evaluated in systematic reviews (SRs). We conducted an umbrella review of SRs of the effectiveness and safety of pharmacological and nonpharmacological interventions for CU, which allow the findings of separate reviews to be compared and contrasted and thereby provide decision makers in healthcare with the evidence they need. We included SRs evaluating pharmacological and nonpharmacological interventions for CU. Comprehensive searches were conducted in 7 bibliographic databases, relevant journals up to July 2018. Two ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research

Efficacy of traditional Chinese medicine for chronic gastritis: A meta-analysis of randomized controlled trials
Background: To systematically evaluate efficacy of traditional Chinese medicine (TCM) in treating chronic gastritis (CG). Methods: Data sources from PubMed, Embase, Springer Link, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Chinese Biomedicine Database, and Wan-fang database were searched up to July 5, 2018. Review Manager software version 5.3, the Cochrane Collaboration's risk of bias tool, and the Grading of Recommendations Assessment, Development, and Evaluation profiler software were conducted for this meta-analysis. Results: Sixteen studies involving 1673 participants (906 vs...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Autoimmune encephalitis with anti-IgLON5 and anti-GABAB-receptor antibodies: A case report
Rationale: Anti-IgLON5 disease is a complex neurological illness which is characterized by progressive sleep and movement disorders and defined by specific autoantibodies to IgLON5. We here describe the first case of a patient with coexisting anti-IgLON5 as well as anti-γ-aminobutyric acid B (GABAB)-receptor antibodies and predominant clinical features of anti-IgLON5 disease. Patient concerns: The patient initially presented with subacute symptoms of severe sleep disorder, gait stability, dysarthria, cognitive impairment, depressive episode and hallucinations. Diagnoses: The patient was diagnosed with autoimm...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Efficacy of low-dose rivaroxaban in an 88-year-old female with pulmonary embolism: A case report
We present an 88-year-old female with dyspnea and fatigue, which became increasingly worse over a month in the absence of medication. Her weight was 64 kg. Routine coagulation assays and renal function were normal at time of admission. Diagnosis: Deep vein thrombosis and pulmonary embolism were confirmed by venous compression ultrasonography and computed tomography pulmonary angiography. Interventions: Oral rivaroxaban 10 mg twice daily was administered, but the patient developed hemoptysis and gum bleeding 5 days later. The dose of rivaroxaban was reduced to 10 mg once daily, and bleeding gradually disappeared...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Associations between serum apolipoproteins, urinary albumin excretion rate, estimated glomerular filtration rate, and diabetic retinopathy in individuals with type 2 diabetes
The published data regarding the role of serum apolipoprotein (apo) A-I, apoB, and the apoB/A-I ratio in the risk of diabetic retinopathy remain inconsistent, and there is limited information about the effect of renal status on their associations in individuals with type 2 diabetes. The aim of this study was to investigate whether serum apoA-I, apoB, and the apoB/A-I ratio are associated with the presence of diabetic retinopathy in type 2 diabetes and to explore whether the relationships between these apolipoproteins and diabetic retinopathy are modified by urinary albumin excretion rate (UACR) and estimated glomerular fil...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Platelet–lymphocyte ratio is not a prognostic predictor for acute paraquat-intoxicated patients: A retrospective analysis
This study aimed to investigate the prognostic predictive value of the platelet–lymphocyte ratio (PLR) in patients with acute paraquat (PQ) intoxication. A total of 107 patients with acute PQ intoxication via oral ingestion were admitted in Cangzhou Central Hospital from May 2012 to September 2018. Valuable detection indices were screened out by using Cox proportional hazard regression and receiver operating characteristic (ROC) curve analyses, and their diagnostic efficiency was evaluated by using Kaplan–Meier curve. The 90-day mortality was 58.9% (63/107). The Kaplan–Meier curve showed that PLR was no...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Dose-related healing of artificial ulcers after endoscopic submucosal dissection using esomeprazole: A randomized controlled study
Conclusions: Both 40 and 20-mg esomeprazole have similar effects on ESD-induced ulcer area reduction, suggesting that strong acid suppression does not necessarily result in rapid artificial ulcer healing. Trial registration number: RCT no.: KCT0002885 (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Intranasal lidocaine for acute migraine: A protocol for the systematic review of randomized clinical trials
Conclusion: The findings of this systematic review will summarize the latest evidence of intranasal lidocaine for acute migraine. The results will provide implications for clinical practice and further research. Prospero registration number: CRD42018116226 (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

A phase II study of biweekly oxaliplatin plus S-1 combination chemotherapy as a first-line treatment for patients with metastatic or advanced gastric cancer in China
The objective response rate was 30.43%, and the disease control rate was 76.08%. The observed adverse events of Grade 3/4 included were leukocytopenia (13.04%); anemia (13.04%); neutropenia (15.22%); neurological toxicity (2.17%); diarrhea (2.17%). The biweekly SOX regimen as first-line treatment was active and well tolerated in Chinese patients with metastatic or advanced gastric cancer. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Scrambler therapy for the treatment of diabetic peripheral neuropathy pain: A case report
Rationale: Neuropathy secondary to diabetes mellitus often does not respond well to conventional therapy. Scrambler therapy may be an alternative treatment for otherwise intractable neuropathy. Patient concerns: A 45-year-old female complained of bilateral plantar foot pain. She had been treated for diabetes mellitus for 5 years. Oral analgesics did not resolve her pain. Even nerve block therapy did not adequately relieve her pain. Diagnoses: Diabetic peripheral neuropathy. Intervention: Scrambler therapy. Outcome: Pain reduction; the treatment effect was based around the location of the scrambler patch. Les...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

The biomarkers and potential pathogenesis of lung cancer related cerebral hemorrhage
Cerebral hemorrhage is one of the common complications in patients with lung cancer (LC). Although cancer related cerebral hemorrhage was aware, the pathogenesis and biomarkers of lung cancer related cerebral hemorrhage (LCRCH) remained not well known. The aim of this study was to investigate the pathogenesis and plasma biomarkers of LCRCH. A retrospective review was conducted on acute cerebral hemorrhage patients with active LC who was admitted to the hospital between January 2007 and December 2017. A total of 56 patients with LCRCH (active LC patients with acute cerebral hemorrhage but without conventional vascular risk...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Identification of pathogenic mutations in 6 Chinese families with multiple exostoses by whole-exome sequencing and multiplex ligation-dependent probe amplification: Case series
Rationale: Hereditary multiple exostoses (HMEs) is an autosomal dominant skeletal disorder. Patient concerns: Six probands of the 6 unrelated Han Chinese families were identified as having HME. These patients had exostoses at multiple sites and significantly affected joints malformation and movement. Diagnoses: Hereditary multiple exostoses. Interventions: To detect the genetic mechanism of HME in 6 unrelated Chinese families, whole-exome sequencing (WES) and multiplex ligation-dependent probe amplification (MLPA) were used after genomic DNA was isolated from peripheral blood leucocytes. Point mutations identifi...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cervical langerhans cell histiocytosis mimicking cervical tuberculosis: A Case report
Rationale: Langerhans cell histiocytosis (LCH) involving adult cervical vertebrae is relatively rare clinically. Patient concerns: An 18-year-old male patient exhibited a 1-month history of neck pain, restricted neck mobility, and numbness and weakness of both upper limbs. The patient reported no pain at other sites, exhibited no fever or night sweats, and was unable to recall any recent injury. Diagnoses: On the basis of the radiological features of the lesion and laboratory tests, there was a high possibility that the patient had a tuberculosis lesion. Postoperative GeneXpert and Mycobacterium tuberculosis (MTB) ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Giant cell carcinoma of the lung presenting as an isolated cyst containing air: A case report
Conclusion: A solitary pulmonary parenchymal cystic lesion usually suggests an infectious disease or congenital abnormality; however, a cystic lesion is occasionally encountered in GCCL. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Treatment of urinary incontinence after total hysterectomy with acupuncture: A case report
Rationale: Acupuncture is a significant feature of traditional Chinese medicine, which can dredge the channels, harmonize qi and blood, replenish deficiency and relieve excess, strengthen the body and remove pathogens to treat urinary incontinence after hysterectomy, and improve the quality of life, which is simple, convenient, inexpensive, and practical. Patient concerns: After a total hysterectomy, the catheter was retained every day, causing urinary incontinence and elderly urine wetness for 30 days. Diagnoses: Postoperative urinary incontinence for 1 month; type 2 diabetes for 4 years. Hypertension for 2 years....
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Treatment of open chest rib fractures with the matrix rib internal fixation system: A case report
Rationale: Rib fractures are common among patients with blunt chest wall trauma and often represent life-altering injuries. Patient concerns: A 31-year-old woman presented with right chest trauma, with pain and bleeding as a result of a traffic accident 1 hour previously. Diagnoses: Chest computed tomography showed open chest trauma, multiple rib fractures, flail chest, hemopneumothorax, and lung contusion on the right side. Interventions: We decided to perform debridement via emergency, thoracoscopic exploration to remove blood and contaminants from the chest cavity. Thereafter, the third to seventh fractured r...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Efficacy and safety of moxibustion in patients with chronic prostatitis/chronic pelvic pain syndrome: A systematic review protocol
Conclusion: This study will provide a clear basis for understanding the efficacy and adverse reactions of moxibustion treatment for CP/CPPS. PROSPERO registration number: CRD42019121338. (Source: Medicine)
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research