Medicine
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To evaluate the value of lymph node status of primary tumors in predicting the prognosis of synchronous resectable metastatic colorectal cancer (mCRC). The characteristics of resectable mCRC are substantially different from other cancers, and the prognostic factors of resectable mCRC are still controversial. The data of 2007 patients with mCRC who received resection of the primary tumors and metastatic lesions synchronously were reviewed from the Surveillance, Epidemiology and End-Result database. ⋯ The mRNA profile was not associated with lymph node involvement. Both the N-stage according to the 7th AJCC TNM staging system and LNR had the capacity to subclassify synchronous resectable mCRC with different prognoses. The lymph node might be integrated into the AJCC staging system as a diagnose-delay prognostic factor for stage IV disease.
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Our objective was to compare obesity prevalence among human immunodeficiency virus (HIV)-infected adults receiving care and the U. S. general population and identify obesity correlates among HIV-infected men and women. Cross-sectional data was collected in 2009 to 2010 from 2 nationally representative surveys: Medical Monitoring Project (MMP) and National Health and Nutrition Examination Survey (NHANES). ⋯ Among HIV-infected men, correlates of obesity included black or African American race/ethnicity, annual income >$20,000 and <$50,000, heterosexual orientation, and geometric mean CD4+ T-lymphocyte cell count >200 cells/μL. Obesity is common, affecting 2 in 5 HIV-infected women and 1 in 5 HIV-infected men. Correlates of obesity differ for HIV-infected men and women; therefore, different strategies may be needed for the prevention and treatment.
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Observational Study
The Association of Hematological Malignancy and End-of-Life Expenditure in Cancer Decedents: A Population-Based Study in an Asian Country.
Within the overall National Health Insurance (NHI) budget in Taiwan, there has been a remarkable increase in expenditure for cancer patients. This study was designed to explore whether hematological malignancy is associated with higher end-of-life (EOL) medical expenditure in their last 6 months of life. We used data from the Taiwan NHI Research Database to do a retrospective cohort and population-based study. ⋯ The primary physician's specialty between acute leukemia, lymphoma, and nonhematological malignancy patients had statistically difference. The medical expenditure of cancer patients in acute leukemia and lymphoma was more than nonhematological malignancy. Treatment strategies for acute leukemia should be studied further in order to save the health care budget.
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We employed a population-based cohort sample to explore the risk of coronary heart disease (CHD) in relation to osteoporosis in an Asian population. We designed a retrospective population-based cohort study from 2000 to 2010 with data obtained from Taiwan's Longitudinal Health Insurance Database. A total of 19,456 patients aged 45 years or older who had no history of CHD and had a diagnosis of osteoporosis were identified as the osteoporosis cohort. ⋯ The hazard ratio (HR) for developing CHD during follow-up was 1.30 (95% confidence interval [CI], 1.23-1.38) for the osteoporosis cohort compared with the comparison cohort after adjusting for age, sex, comorbidities, and estrogen medication. Patients with osteoporosis who received treatment with bisphosphonates or with both bisphosphonates and estrogen exhibited a significantly lower risk for CHD (adjusted HR = 0.37 and 0.23) than those who did not receive either of these 2 medications. The results support an association between osteoporosis and CHD in Asian population.
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To perform a systematic review assessing accuracy and completeness of diagnostic studies of procalcitonin (PCT) for early-onset neonatal sepsis (EONS) using the Standards for Reporting of Diagnostic Accuracy (STARD) initiative. EONS, diagnosed during the first 3 days of life, remains a common and serious problem. Increased PCT is a potentially useful diagnostic marker of EONS, but reports in the literature are contradictory. ⋯ Authors should be aware of the STARD criteria before starting a study in this field. We welcome stricter adherence to this guideline. Well-reported studies with appropriate designs will provide more reliable information to guide decisions on the use and interpretations of PCT test results in the management of neonates with EONS.