Carcinoid syndrome and neuroendocrine tumours
Neuroendocrine tumours (NETs) arise from neuroendocrine cells of the gastrointestinal tract, pancreas, bronchi or other rare primary sites and comprise a variety of different tumour types. NETs can be associated with a variety of clinical syndromes. For instance, classic symptoms of carcinoid syndrome, such as flushing and diarrhoea, occur because of the release of hormones, including serotonin, tachykinins and peptide hormones. However, most NETs are non-secretory in nature and are detected incidentally or through compression of surrounding structures. (Source: Medicine)
Source: Medicine - July 24, 2021 Category: Internal Medicine Authors: Florian Wernig, Channa N. Jayasena, Waljit S. Dhillo Tags: Endocrine cancer Source Type: research

Polycystic ovary syndrome
(PCOS) is the most common endocrine disorder in women. It typically presents with symptoms of anovulation associated with clinical and/or biochemical evidence of androgen excess, although its spectrum of presentation includes women with hyperandrogenism who have regular periods. It is the most common cause of anovulatory infertility, and is now recognized as a major risk factor for the development of type 2 diabetes mellitus. Its aetiology remains unclear, but both genetic and environmental factors are involved. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Stephen Franks Tags: Sex hormones Source Type: research

Male hypogonadism and testosterone replacement therapy
The causes of male hypogonadism can be classified into primary (testicular) and secondary (central). This review discusses the indications for testosterone replacement therapy, provides a practical clinical guide to managing this therapy and reviews its use in non-gonadal illness such as HIV. It summarizes the preparations available for testosterone replacement, with an emphasis on newer delivery systems, and discusses the adverse effects of testosterone treatment, including prostate cancer and polycythaemia. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Leighton J. Seal Tags: Sex hormones Source Type: research

Multiple endocrine neoplasia
(MEN) describes the occurrence of tumours affecting two or more endocrine glands in one individual. Two main forms are recognized: type 1 (MEN1) and type 2 (MEN2). MEN1 is characterized by the combined occurrence of parathyroid, pituitary and pancreatic neuroendocrine tumours, whereas MEN2 features medullary thyroid cancer in association with phaeochromocytoma and parathyroid tumours. Although both MEN1 and MEN2 are autosomal dominant disorders, they have contrasting molecular aetiologies: MEN1 results from inactivating germline mutations of the MEN1 tumour suppressor gene, whereas MEN2 results from activating mutations i...
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Paul J. Newey Tags: Endocrine cancer Source Type: research

Endocrine effects of immunotherapy for cancer
Immune checkpoint inhibitors (CPIs) harness the innate immune system in targeting malignant disease. CPI treatments are associated with significantly improved survival in a wide variety of malignancies. As their use increases so too does our understanding of their common side effects. These include immune-mediated endocrine organ dysfunction, with the thyroid, pituitary and pancreas glands most commonly affected. The clinical presentation of these side effects varies from asymptomatic to life threatening. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Mark Quinn, Mamta Joshi, Paul V. Carroll Tags: Endocrine cancer Source Type: research

Hypercalcaemia and primary hyperparathyroidism
Hypercalcaemia is most commonly caused by primary hyperparathyroidism (PHPT) or malignancy. PHPT is common, affects women more than men, and is usually caused by a solitary parathyroid adenoma. The most common presentation is an asymptomatic incidental finding on blood tests performed for another indication. The only curative treatment is parathyroidectomy. In 2019, National Institute for Health and Care Excellence guidelines were published regarding the management of PHPT. These recommended a surgical referral for confirmed PHPT, particularly if patients display symptoms of hypercalcaemia or show end-organ disease, or if ...
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Jian Shen Kiam, Jeremy JO Turner Tags: Calcium and bone Source Type: research

Hypocalcaemia
is encountered in all areas of clinical practice: in primary care, where vitamin D deficiency is often the cause, and in unselected secondary care, where hypocalcaemia has a prevalence of 18%, rising to 85% in intensive care environments. An understanding of the physiological basis of calcium homoeostasis is essential to deciphering the cause of underlying hypocalcaemia. Awareness of the clinical presentation, differential diagnosis and treatment of hypocalcaemia is important. Hypocalcaemia is potentially life-threatening and carries the risk of serious errors in management. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Zaki Hassan-Smith, Neil Gittoes Tags: Calcium and bone Source Type: research

Bone structure and metabolism
The bones of the skeleton provide mechanical support for joints, tendons and ligaments, protect vital organs from damage, and act as a reservoir for calcium and phosphate in preserving normal mineral homoeostasis. Bone is a dynamic tissue that undergoes renewal and repair throughout life through bone remodelling. Most bone diseases occur as the result of abnormalities in the remodelling process that compromise the bone's architecture, structure or mechanical strength, leading to clinical symptoms such as pain, deformity and fracture, and abnormalities of calcium and phosphate homoeostasis. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Stuart H. Ralston Tags: Calcium and bone Source Type: research

Prevention and management of osteoporosis
Fractures resulting from osteoporosis are a major public health problem. Physicians should be aware of the chief risk factors for osteoporosis and refer appropriately for bone densitometry. Risk factors include female sex, increased age, previous fracture, family history of fracture, slender habitus, early menopause, treatment with drugs known to affect bone (e.g. glucocorticoids) and diseases known to affect bone (e.g. rheumatoid arthritis). The diagnosis of osteoporosis can be made if the bone density T-score is −2.5 or below. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Richard Eastell, Marian Schini Tags: Bone disorders Source Type: research

Disorders of growth
Most children who have short or tall stature are healthy and simply at the extremes of the normal range. Plotting a child on a centile chart and following the growth pattern over time helps to assess whether the pattern of growth is normal. Children settle onto a centile position by 2 or 3 years of age, and after this a normal child grows fast enough to stay on the same centile until puberty. During puberty, sex steroids stimulate growth directly and increase growth hormone (GH) secretion, leading to the pubertal growth spurt. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Nicola Bridges Tags: Growth and puberty Source Type: research

Disorders of puberty
Puberty is the process of development of adult secondary sexual characteristics. Disorders of puberty can be classified into early (precocious) and late (delayed) puberty. Early (precocious) puberty can be secondary to either activation of the hypothalamo –pituitary–gonadal axis (gonadotrophin dependent, or central) or altered regulation of sex hormone production in the gonads, adrenal glands or other tissues (gonadotrophin independent or peripheral). Delayed puberty is most often constitutional, but hypogonadotropic (central) and hypergonadotrop ic (peripheral) hypogonadism should be considered. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Emile Hendriks, Philippa Prentice, Rachel Williams Tags: Growth and puberty Source Type: research

Hyperlipidaemia
includes hypercholesterolaemia, hypertriglyceridaemia and mixed hyperlipidaemia. It is a common biochemical disorder with primary (inherited) and secondary causes. All patients should be investigated for possible secondary causes. Hypercholesterolaemia is commonly polygenetically inherited, whereas familial hypercholesterolaemia is monogenic and has a high risk of cardiovascular disease (CVD). Evidence of CVD risk in hypertriglyceridaemia is weaker than in hypercholesterolaemia, but concentrations>10.0  mmol/litre are associated with a high risk of acute pancreatitis. (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Authors: Ahmed Handhle, Adrian Park Tags: Hyperlipidaemia Source Type: research

Self-assessment/CPD answers
Question 1 (Source: Medicine)
Source: Medicine - July 23, 2021 Category: Internal Medicine Tags: Self-assessment/CPD answers Source Type: research

Gwakhyangjeonggi-san for irritable bowel syndrome: A protocol for systematic review and meta-analysis
Conclusion: This systematic review will provide evidence for the efficacy and safety of GJS for IBS. OSF registration number: DOI 10.17605/OSF.IO/V93JN (https://osf.io/v93jn). (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research

Hip fractures in elderly patients with non-dialysis dependent chronic kidney disease: Outcomes in a Southeast Asian population
Chronic kidney disease (CKD) causes bone and mineral disorders and alterations in vitamin D metabolism that contribute to greater skeletal fragility. Hip fracture in elderly is associated with significant morbidity and mortality. The aim of this study was to investigate the outcome of elderly patients with non-dialysis dependent CKD and hip fracture undergoing surgery. Retrospective study with IRB approval of patients above 65 years of age, with hip fractures admitted between June 2014 to June 2016 in a Southeast Asian cohort. Data collected included demographic variables and the haematological and biochemical paramet...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Prognostic significance of molecular subtype, metastatic site and primary tumor surgery for survival in primary metastatic breast cancer: A SEER-based study
This study also substantiated that patients with only brain metastasis had poorer survival than patients with metastasis at multiple sites metastasis, not including brain metastasis (P  (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Predictors of clinical outcomes of self-expandable metal stent treatment for malignant colorectal obstruction: A Honam Association for the Study of Intestinal Disease (HASID) multicenter study
There has been increased use of self-expandable metal stents (SEMS) in treating malignant colorectal obstruction (MCO). The aim of this study was to investigate factors that are associated with the outcomes of SEMS placement for MCO. Clinical data from patients who underwent SEMS placement for MCO at 6 hospitals in Honam province of South Korea between 2009 and 2018 were reviewed retrospectively. Eight hundred two patients were identified and their data were analyzed. Technical success, clinical success, complications, and predictors of outcome were included as main outcome measures. Technical and clinical success ra...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Relationship among affective commitment, occupational stressors, and calling of psychiatrists in Shanghai
The aim of the study is to investigate the levels of affective commitment, occupational stressors and calling in psychiatrists in Shanghai and try to find the relationship among 3 variables in the participants. We enrolled 81 participants using a survey with a combination of demographic information, affective part of organizational commitment questionnaire, portion of the scale for occupational stressors on clinicians and the calling and vocation questionnaire. Correlation analysis and multiple linear regression analysis were applied to probe into the relationship among the three variables. t Test and nonparametric test...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Fracture of a covered stent–graft due to heterotopic ossification of residual hematoma after endovascular treatment of superficial femoral artery pseudoaneurysm: A case report
Conclusions: This report demonstrates that residual hematoma can induce HO, which may result in late stent fracture, and it should thus be removed timely. Patients with SFA pseudoaneurysm who have undergone EVT should be followed up regularly. (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Effects of transjugular intrahepatic portosystemic shunt treatment of patients with liver cirrhosis and portal hypertension: Case series
Rationale: Transjugular intrahepatic portosystemic shunt (TIPS) is well established as an effective treatment tool for portal hypertension. However, the effects of TIPS in patients with liver cirrhosis and portal hypertension have not been adequately verified in clinical trials. Patient Concerns: To evaluate the effects of TIPS in patients with liver cirrhosis and portal hypertension with or without portal vein thrombosis (PVT). Interventions: A total of 55 patients with liver cirrhosis and portal hypertension received TIPS treatment from December 2014 to April 2018 were enrolled. Clinical data, including...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Differential diagnosis and clinical management of isolated prolonged activated partial thromboplastin time in a patient with Hashimoto thyroiditis-associated thyroid cancer: A case report
Rationale: Patients preparing for surgery may have isolated, prolonged activated partial thromboplastin time (APTT). Cause analysis is warranted in patients who had neither bleeding symptom nor thromboembolic events because isolated prolongation of APTT may lead to unnecessary delayed surgical intervention or invasive procedure, even ineffective plasma infusion treatments. Here, we report a case of Hashimoto thyroiditis-associated thyroid cancer whose APTT was isolated prolonged and discuss the challenges of diagnosis and clinical management of this patient. Patient concerns: A 57-year-old woman was admitted to ...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute interstitial nephritis associated with ingesting a Momordica charantia extract: A case report
Conclusion s: This is the first case report of AIN associated with the ingestion of a pure M charantia extract. Recognition of the possible adverse effects of these agents by physicians is very important for early diagnosis and appropriate management. (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Posterior myocardial infarction caused by superdominant circumflex occlusion over an absent right coronary artery: Case report and review of literature
We report a case of successful percutaneous coronary intervention (PCI) in a patient with this condition. Patient concerns: A 57-year-old man was admitted to our center with chest pain that had occurred several hours prior. Since he was initially diagnosed with AMI with ST-segment elevation, we promptly commenced coronary angiography (CAG). Diagnosis: CAG revealed the absence of a right coronary artery (RCA). In the left coronary cusp area, the left circumflex coronary artery (LCX) was occluded totally. Interventions: We performed PCI for total occlusion of the proximal part of the LCX. Follow-up CAG s...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Heart rhythm-synchronized fibrin flap in a glaucoma tube shunt: The heartbeat acts as a drainage pump for the aqueous humor: A case report
Rationale: The amount of aqueous humor that is constantly produced by the ciliary processes and the equal amount that flows out through the trabecular meshwork via the drainage angle or through the uveoscleral route is very small (2–3 μg/min each), representing approximately 1% of the content of the anterior chamber; therefore, it is challenging to visualize its flow. Patient concerns: A 69-year-old man who had high intraocular pressure (IOP) (>20 mm Hg) with the maximum glaucoma eyedrop dose and presented with severe visual field loss (Humphrey Field Analyzer 30–2: –26.32 dB) had b...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

The enhanced bioavailability of free curcumin and bioactive-metabolite tetrahydrocurcumin from a dispersible, oleoresin-based turmeric formulation
Conclusion: As the first human pharmacokinetics study to apply best-practice recommendations and pharmaceutically-aligned guidance in the comprehensive evaluation of a novel curcuminoids formulation, we have established the novelty of said formulation while better standardizing for the common variances and discrepancies between curcuminoids and their derivatives in the literature and commercial marketing, alike. (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Severe bacterial infection in young infants with pyrexia admitted to the emergency department
The objectives of this study were to understand the clinical presentations of febrile young infants with severe bacterial infection (SBI), and to investigate the pathogen variations throughout the vaccine era and after antenatal group B Streptococcus (GBS) screening. All infants  (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Impact of transplantation on neutrophil extracellular trap formation in patients with end-stage renal disease: A single-center, prospective cohort study
This study aimed to characterize circulating citrullinated Histone H3 (H3cit) and Peptidyl Arginase Deiminase 4 (PAD4) in ESRD patients undergoing transplantation and evaluate the ability of their neutrophils to release NETs. This prospective cohort study included 80 healthy donors and 105 ESRD patients, out of which 95 received a transplant. H3cit and PAD4 circulating concentration was determined by enzyme-linked immunosorbent assay in healthy donors and ESRD patients at the time of enrollment. An additional measurement was carried out within the first 6 months after transplant surgery. In vitro NET formation assays we...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Personality as a predictor of HbA1c level in patients with type 2 diabetes mellitus
In this study, we examined whether certain personality traits of patients with T2DM are correlated with higher glycohemoglobin (HbA1c) levels. A total of 214 participants with T2DM were recruited from an outpatient setting. χ2 test and logistic regression analyses with 5 models were employed. The OR for the “neuroticism” trait was 3.199 (95% CI = 1.228–8.331, P = .017), and those with this trait were 3.199 times more likely to have higher HbA1c levels than those with the “openness-extraversion” personality trait. This strong relationship between neuroticism and a higher HbA1c lev...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The prevalence and associated factors of burnout among undergraduates in a university
The study aimed to evaluate the prevalence and possible factors associated with burnout (BO) among undergraduates in a university setting in Dali. This cross-sectional study involved students enrolled in different specialties. The method of stratified random sampling was used to conduct the investigation. The questionnaire included Maslach Burnout Inventory and the influencing factors. The data were analyzed using SPSS 16.0 (SPSS Inc., Chicago, IL). The quantitative data were compared using t tests or ANOVA. Multiple linear regression was used to assess the relationship between BO risk and relevant influencing factors. ...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Microvascular invasion may be the determining factor in selecting TACE as the initial treatment in patients with hepatocellular carcinoma
The aim of this study was to investigate factors affecting tumor necrosis with transcatheter arterial chemoembolization (TACE). Factors associated with early hepatocellular carcinoma recurrence after curative hepatectomy were also evaluated. Data of 51 patients who underwent surgery after a single session of TACE at a single university hospital were retrospectively analyzed. Factors that might affect tumor necrosis were determined by evaluating the TACE approach and by analyzing computed tomography and TACE findings, pathologic reports, and laboratory findings. In univariate analysis, microvascular invasion (MVI), ra...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Analysis of pediatric emergency department patient volume trends during the COVID-19 pandemic
During the early period of the COVID-19 pandemic there was a substantial decrease in pediatric emergency department (PED) visitation. The intent of this study is to report PED utilization during the COVID-19 pandemic in an urban pediatric referral center located close to the epicenter in the northeastern US. A retrospective analysis of medical records of patients visiting the PED at Robert Wood Johnson University Hospital (RWJUH) was performed. Data included: daily census, admission rate, Emergency Severity Index, and ICD-10 diagnosis codes for the period of February through July, 2018 to 2020. By the week of March 2...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

SIRT3 acts as a novel biomarker for the diagnosis of lung cancer: A retrospective study
Lung cancer (LC) is a prevalent malignancy worldwide with increased morbidity and mortality. Mitochondrial nicotinamide adenine dinucleotide-dependent deacetylase sirtuin-3 (SIRT3) has been reported to be involved in tumorigenesis. In this retrospective study, we measured the expression and diagnostic value of SIRT3 in LC patients. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to measure serum SIRT3 mRNA level in 150 LC patients and 52 healthy volunteers. SIRT3 protein level was detected using western blot for 84 pairs of LC and adjacent normal tissues. The association of SIRT3 mRNA level with...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Anterolateral thigh free flaps with T-shaped pedicles and multiple venous anastomosis for extremity reconstruction
In conclusion, T-shaped pedicle and multiple venous anastomosis is a method to improve free flap survival and useful in cases where sacrificing a dominant vessel is inevitable or those in which only 1 vessel remains. (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research

The use of an alternating magnetic field in the resorption of postoperative joint effusion following anterior cruciate ligament reconstruction: A randomized double: -: blind controlled trial
Conclusion In patients after ACL reconstruction, in whom an alternating magnetic field was used to treat postoperative joint effusion, there were no beneficial effects on the analyzed variables compared to the control group. (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Time-saving effects using helicopter transportation: comparison to a ground transportation time predicted using a social navigation software
Previous comparison studies regarding 2 types of transportation, helicopter (HEMS) versus ground emergency medical services (GEMS), have shown underlying heterogeneity as these options have completely different routes and consequent times with reference to one patient. To compare the 2 types of transportation on a case-by-case basis, we analyzed the retrospectively reviewed HEMS and predicted GEMS data using an open-source navigation software. Patients transferred by military HEMS from 2016 to 2019 were retrospectively enrolled. The HEMS records on the time of notification, injury point and destination address, and time...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Serum pepsinogen II levels are doubled with Helicobacter pylori infection in an asymptomatic population of 40,383 Chinese subjects
This study is to examine the relationship of serum PGI, PGII, and PGI/PGII ratio with Helicobacter pylori (Hp) infection, age, sex, and body mass index (BMI) in subjects in Beijing, China. A total of 40,383 asymptomatic subjects, who underwent medical examination in Beijing Rehabilitation Hospital, were included in this study. Serum PG levels were measured using chemoluminescence techniques. The age, sex, and BMI data were collected, and Hp infection was identified with 13C-urea breath test. Statistical analysis was conducted with Python, Pandas and Seaborn software. Asymptomatic subjects with Hp infection (Hp+) had ...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Safety and efficacy of left bundle branch pacing in comparison with conventional right ventricular pacing: A systematic review and meta-analysis
Background: Right ventricular pacing (RVP) has been widely accepted as a traditional pacing strategy, but long-term RVP has detrimental impact on ventricular synchrony. However, left bundle branch pacing (LBBP) that evolved from His-bundle pacing could maintain ventricular synchrony and overcome its clinical deficiencies such as difficulty of lead implantation, His bundle damage, and high and unstable thresholds. This analysis aimed to appraise the clinical safety and efficacy of LBBP. Methods: The Medline, PubMed, Embase, and the Cochrane Library databases from inception to November 2020 were searched for studi...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Contrast-enhanced CT radiomics features to predict recurrence of locally advanced oesophageal squamous cell cancer within 2 years after trimodal therapy: A case-control study
This study collected CECT and clinical data of consecutive 220 patients with pathology-confirmed locally advanced oesophageal SCC (154 in the training cohort and 66 in the validation cohort). Univariate statistical test and the least absolute shrinkage and selection operator method were performed to select the optimal radiomics features. Logistic regression was conducted to build radiomics model, clinical model, and combined model of both the radiomics and clinical features. Predictive performance was judged by the area under receiver operating characteristics curve (AUC), accuracy, and F1-score in the training and validat...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Diagnostic Accuracy Study Source Type: research

Prognostic values of procalcitonin and platelet in the patient with urosepsis
This study aimed to evaluate the value of PCT and PLT in determining the severity of urinary sepsis. Methods: A total of 120 urosepsis patients enrolled were divided into a survival group and a death group, respectively, according to their status within 14 days after admission. Changes in PCT and PLT levels between the 2 groups were compared at different time points. A receiver operating characteristic (ROC) curve was eventually obtained to predict the prognostic value of PCT and PLT. Results: The PCT levels in the survival group declined gradually after admission, and the PLT decreased at first but increas...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Expression and prognostic analyses of HDACs in human gastric cancer based on bioinformatic analysis
Gastric cancer (GC) is a common cancerous tumor, and is the third leading cause of cancer mortality worldwide. Although comprehensive therapies of GC have been widely used in clinical set ups, advanced gastric cancer carries is characterized by poor prognosis, probably due to lack of effective prognostic biomarkers. Mammalian histone deacetylase family, histone deacetylases (HDACs), play significant roles in initiation and progression of tumors. Aberrant expression of HDACs is reported in many cancer types including gastric cancer, and may serve as candidate biomarkers or therapeutic targets for GC patients. Gene Expres...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The lowest effective plasma concentration of atomoxetine in pediatric patients with attention deficit/hyperactivity disorder: A non-randomized prospective interventional study
Background: Atomoxetine (ATX) is used as a first-line, non-stimulant treatment for attention-deficit/hyperactivity disorder (ADHD), although no studies have systematically examined the relationship between plasma concentration and clinical efficacy. We conducted this non-randomized prospective interventional study to examine the relationship between plasma concentration of ATX and clinical efficacy. Methods: Forty-three ADHD pediatric patients received ATX, and the steady-state through plasma concentration of the last daily dose that was maintained for at least 4 weeks were determined by high-performance liqui...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

The prognostic value of preoperative serum albumin in patients with bladder urothelial carcinoma undergoing transurethral resection of bladder tumor: A prospective cohort study
Background: To evaluate whether the preoperative serum albumin level can predict the survival outcome in patients with bladder urothelial carcinoma (BUC) undergoing transurethral resection of bladder tumor (TURBT). Methods: Four hundred fifty six newly diagnosed patients with BUC who underwent TURBT between January 2014 and December 2017 were retrospectively enrolled. Patients were categorized into low albumin ( (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Financial burden of postoperative complications following colonic resection: A systematic review
Conclusions: Postoperative complications in colonic resection appear to be associated with a significant financial burden. Therefore, large, prospective, cost-benefit clinical trials investigating preventative strategies, with detailed and consistent methodology and reporting standards, are required to improve patient outcomes and the cost-effectiveness of our health care systems. (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Implementation of collaborative care for depressive disorder treatment among accountable care organizations
Collaborative care – primary care models combining care management, consulting behavioral health clinicians, and registries to target mental health treatment – is a cost-effective depression treatment model, but little is known about uptake of collaborative care in a national setting. Alternative payment models such as accountable care organizations (ACOs), in which ACOs are responsible for quality and cost for defined patient populations, may encourage collaborative care use. Determine prevalence of collaborative care implementation among ACOs and whether ACO structure or contract characteristics are associ...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Effects of enhanced external counterpulsation on exercise capacity and quality of life in patients with chronic heart failure: A meta-analysis
Background: This meta-analysis aimed to synthesize randomized controlled trials to evaluate the effects of enhanced external counterpulsation (EECP) on exercise capacity and quality of life in patients with chronic heart failure (CHF). Methods: Both English and Chinese databases were searched from their inception to June 30, 2020 (PubMed, EMBASE, Cochrane Library, CINAHL (EBSCO), Web of Science for English publications and Chinese Biomedical Database, China National Knowledge Infrastructure, Wanfang Data for Chinese publication). Titles, abstracts, and full-text articles were screened against study inclusion cri...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Clinicopathological and prognostic significance of long non-coding RNA-ROR in cancer patients: A systematic review and meta-analysis
Conclusions: LincRNA-ROR expression was associated with the clinicopathological features and outcome of cancer patients, which suggested that lincRNA-ROR might serve as a potential biomarker for cancer prognosis. Ethical approval: Since this study is on the basis of published articles, ethical approval and informed consent of patients are not required. (Source: Medicine)
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Identification of endometriosis-associated genes and pathways based on bioinformatic analysis
Endometriosis is associated with dysmenorrhea, chronic pelvic pain, and infertility. The specific mechanism of endometriosis remains unclear. The aim of this study was to apply a bioinformatics approach to reveal related pathways or genes involved in the development of endometriosis. The gene expression profiles of GSE25628, GSE5108, and GSE7305 were downloaded from the gene expression omnibus (GEO) database. Differentially expressed gene (DEG) analysis was performed using GEO2R. The database for annotation, visualization, and integrated discovery (DAVID) was utilized to analyze the functional enrichment, gene ontology ...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Intrapulmonary lymph node (stations 13 and 14) metastasis in peripheral non-small cell lung cancer
This study investigated intrapulmonary lymph node dissection (stations 13 and 14) on the pathological staging of peripheral NSCLC and the metastatic pattern of the lymph nodes. This retrospective study included patients with primary peripheral NSCLC who underwent radical dissection between January 2013 and December 2015. The clinical data of patients and examination results of intrapulmonary stations 12, 13, and 14 lymph nodes were analyzed. Of 3019 resected lymph nodes in a total of 234 patients (12.9/patient), 263 (8.7%) had metastasis. Ninety-nine patients had lymph node metastasis (42.3%): 40 (17.1%) were N1, 11 ...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Local anesthetic volume in ultrasound-guided interscalene block and opioid consumption during shoulder arthroscopic surgery: A retrospective comparative study
Interscalene block (ISB) is commonly performed for regional anesthesia in shoulder surgery. Ultrasound-guided ISB enables visualization of the local anesthetic spread and a reduction in local anesthetic volume. However, little is known about the appropriate local anesthetic dose for surgical anesthesia without sedation or general anesthesia. The purpose of our study was to evaluate the appropriate local anesthetic volume by comparing intraoperative analgesics and hemodynamic changes in ISB in arthroscopic shoulder surgery. Overall, 1007 patients were divided into groups 1, 2, and 3 according to the following volume of l...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Smartphone based alerting of first responders during the corona virus disease-19 pandemic: An observational study
Smartphone alerting systems (SAS) for first responders potentially shorten the resuscitation-free interval of patients with acute cardiac arrest. During the corona virus disease-19 (COVID-19) pandemic, many systems are suspended due to potential risks for the responders. Objective of the study was to establish a concept for SAS during the COVID-19 pandemic and to evaluate whether a SAS can safely be operated in pandemic conditions. A SAS had been implemented in Freiburg (Germany) in 2018 alerting nearby registered first responders in case of emergencies with suspected cardiac arrest. Due to the pandemic, SAS was stop...
Source: Medicine - July 9, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research