Medicine
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The combined hyperhomocysteinemia condition is a feature of the Chinese hypertensive population. This study used the case-control method to investigate the association between plasma homocysteine and the C677T gene polymorphism of its key metabolic enzyme, 5, 10-methylenetetrahydrofolate reductase (MTHFR), and early renal damage in a hypertensive Chinese Han population. A total of 379 adult essential hypertensive patients were selected as the study subjects. ⋯ The homocysteine level and the UACR in the TT genotype group were higher than those in the CC genotype group. The binary logistic regression analysis results showed that after sex and age were adjusted, the MTHFR C677T gene polymorphism was correlated with early renal damage in hypertension in both the recessive model and in the additive model. Plasma homocysteine and the C677T gene polymorphism of its key metabolic enzyme MTHFR might be independent risk factors of early renal damage in the hypertensive Chinese Han population.
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Observational Study
Pathological Complete Remission of Pancreatic Cancer Following Neoadjuvant Chemoradiation Therapy; Not the End of Battles.
In spite of controversial issues, pancreatectomy following neoadjuvant chemoradiation therapy (NeoCRT) has been applied in treating advanced pancreatic cancer. Cases of pathological complete remission (pCR) following NeoCRT is rare, and its long-term follow-up data are still lacking. From January 2000 to December 2012, medical records of the patients who underwent pancreatectomy for pancreatic ductal adenocarcinoma were retrospectively reviewed. ⋯ Early recurrence in the pattern of liver metastasis and peritoneal seeding can be expected. However, long-term survival could be maintained in patients without recurrence. Further investigation is necessary for predicting failure of treatment.
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We investigate the feasibility of arthroscopic fixation of comminuted glenoid fractures using cannulated screws and suture anchors. We retrospectively review 11 cases of closed comminuted glenoid fractures treated at our institution from August 2010 to May 2013. The 11 patients, 8 males and 3 females, had a mean age of 41 years (range: 27-55 years). ⋯ Both ASES scores (41.4 ± 24.9, 87.3 ± 13.8) and Rowe scores (28.2 ± 18.6, 93.2 ± 11.2) were significantly increased after the surgery (P < 0.01), indicating significantly improved function and stability of the shoulder joint. Arthroscopic fixation using cannulated screws and suture anchors is feasible for the treatment of comminuted glenoid fractures. This method is minimally invasive and provides good functional recovery with a lower risk of complications.
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Observational Study
All-Cause and Cause-Specific Risk of Emergency Transport Attributable to Temperature: A Nationwide Study.
Although several studies have estimated the associations between mortality or morbidity and extreme temperatures in terms of relative risk, few studies have investigated the risk of emergency transport attributable to the whole temperature range nationwide. We acquired data on daily emergency ambulance dispatches in all 47 prefectures of Japan from 2007 to 2010. We examined the relationship between emergency transport and temperature for each prefecture using a Poisson regression model in a distributed lag nonlinear model with adjustment for time trends. ⋯ The same trends were observed for cardiovascular and respiratory diseases. The majority of temperature-related emergency transport burden was attributable to lower temperature. The effect of extremely high or low temperatures was markedly lower than that attributable to moderately nonoptimal temperatures.
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Multicenter Study Observational Study
Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial.
Transition from child to adult-oriented care is widely regarded a challenging period for young people with kidney transplants and is associated with a high risk of graft failure. We analyzed the existing transition structures in Germany and Austria using a questionnaire and retrospective data of 119 patients transferred in 2011 to 2012. Most centers (73%) confirmed agreements on the transition procedure. ⋯ The majority of pediatric nephrology centers have internal agreements on transitional care. More than half of the patients had CoV of immunosuppression trough levels consistent with good adherence. Although, 20% of the patients showed increase in serum creatinine close to transfer.