Medicine
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Observational Study
Coagulation Disorders and Bleedings in Critically Ill Patients With Hemophagocytic Lymphohistiocytosis.
Reactive hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition related to a cytokine storm leading to multiorgan dysfunction. A better understanding of coagulation disorders, frequently reported in HLH patients, may improve outcomes. Critically ill HLH patients managed in a multidisciplinary national reference center were retrospectively included. ⋯ Hypofibrinogenemia or DIC was found in half of the patients and low PT in 40%. These patients require more life support and have a higher mortality rate. Fibrinogen < 2 g/L is associated with the occurrence of severe bleeding and mortality.
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To evaluate the risk of secondary primary malignancy (SPM) in patients with cervical cancer using a nationwide population-based dataset. Patients newly diagnosed with cervical cancer between 1997 and 2011 were identified using Taiwan's National Health Insurance database. Patients with antecedent malignancies were excluded. ⋯ Age ≥60 years, chemotherapy, and radiotherapy are independent risk factors. Carboplatin and fluorouracil also increased SPM risk independently. Close surveillance of patients at high risk should be considered for the early detection of SPMs.
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Observational Study
Invasive Cervical Cancer and Antidepressants: A Nationwide Population-Based Study.
To our knowledge, no prior population-based study has been published wherein the primary aim was to evaluate whether an association between psychotropic drug prescription and cervical cancer exists. Herein we have conducted the first study that primarily aimed to determine the association between antidepressants use and risk of invasive cervical cancer in the general population. This is a population-based study utilizing Taiwan's National Health Insurance Research Database. ⋯ An association between trazodone prescription and invasive cervical cancer was observed (adjusted OR = 1.22, 95% CI = 1.03-1.43). An association between the major classes of antidepressants and invasive cervical cancer was not observed herein. Our preliminary finding regarding a possible association between trazodone and cervical cancer requires replication.
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The purpose of this study was to use finite element analysis to compare the biomechanical characteristics after lateral locking plate (LLP) or LLP with a medial anatomical locking plate (LLP-MLP) fixation of proximal humeral fractures with an unstable medial column. First, a 3-dimensional, finite element analysis model was developed. Next, LLP and LLP-MLP implants were instrumented into the proximal humeral fracture models. ⋯ In contrast, the LLP method resulted in more instability in the medial column and larger magnitudes of stress. In osteoporotic bone, the LLP was more inclined to fail than LLP-MLP. The LLP-MLP method provides a strong support for the medial column and increases the stability of the region surrounding the fracture.