Medicine
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Observational Study
Predictors of secondary amputation in patients with grade IIIC lower limb injuries: A retrospective analysis of 35 patients.
The aim of this study was to identify risk factors for failure of limb salvage surgery in grade IIIC lower extremity injuries. A single-institution, retrospective review was performed of all patients with grade IIIC lower limb injuries presenting from January 2009 to April 2014. We gathered the data on each patient who underwent limb salvage and analyzed the final outcome for these patients (limb salvage vs secondary amputation). ⋯ Muscle necrosis and extensive soft tissue defect were the main reasons for secondary amputation. The findings indicate that MESS of 7 or greater, complex fractures, limb ischemia time equal to or greater than 6 hours, and osteofascial compartment syndrome were associated with an increased risk of delayed amputation. The MESS is highly prognostic but not perfect; decision-making in patients with an MESS of 7 or greater should be re-evaluated for clinical use.
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Coronary artery spasm (CAS) could cause serious lethal ventricular arrhythmias. While implantable cardioverter defibrillators (ICDs) have been recommend for secondary prevention of sudden cardiac death related to lethal ventricular arrhythmias. However, in resuscitated sudden cardiac death caused by CAS, the effect of ICD is still not well clear. ⋯ For the sudden cardiac death related to lethal ventricular arrhythmias caused by CAS, ICD therapy is an efficient secondary prevention base on administrating coronary vasodilators. Furthermore, administration of epinephrine should be avoided during cardiorespiratory resuscitation of sudden cardiac death caused by CAS.
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Observational Study
Distribution of somatic mutations of cancer-related genes according to microsatellite instability status in Korean gastric cancer.
In studies of the molecular basis of gastric cancer (GC), microsatellite instability (MSI) is one of the key factors. Somatic mutations found in GC are expected to contribute to MSI-high (H) tumorigenesis. We estimated somatic mutation distribution according to MSI status in 52 matched pair GC samples using the Ion Torrent Ion S5 XL with the AmpliSeq Cancer Hotspot panel. ⋯ This finding suggests that the accumulation of MSIs contributes to the genetic diversity and complexities of GC. In addition, targeted NGS approach allows for detection of common and also rare clinically actionable mutations and profiles of comutations in multiple patients simultaneously. Because GC shows distinctive patterns related to ethnics, further studies pertaining to different racial/ethnic groups or cancer types may reinforce our investigations.
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To estimate the numbers of new cancer cases and deaths in Hebei province in 2013 and to investigate the real cancer burden in Hebei province to develop strategies for cancer prevention and control. Data on new cancer cases and deaths in 2013 were collected from 31 population-based cancer registries of Hebei province. All data were checked and evaluated based on data quality criteria from the "Chinese Guideline for Cancer Registration" and "Cancer Incidence in Five Continents Volume IX" by the International Agency for Research on Cancer/International Association of Cancer Registration (IARC/IACR). ⋯ Lung cancer, stomach cancer, liver cancer, esophageal cancer, and colorectal cancer were the major causes of cancer death in Hebei province. The coverage of cancer registration population has rapidly increased and may reveal the cancer burden in Hebei province more comprehensively. The cancer burden in Hebei province is heavy, and prevention and control measures should be enhanced.
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The misplacement of central venous catheter (CVC) can occur more often at the left jugular vein than the right side due to anatomic differences. And many of the previously reported cases are about catheter misplacement resulting from vessel penetration associated with guidewire. This case differs that the catheter itself through the sheath introducer can cause venous injury that may lead to the malposition of CVC particularly through an approach to the left internal jugular vein. ⋯ The insertion of additional catheter through the sheath introducer needs to be carried out as carefully as the insertion of guidewire and should be confirmed with imaging study after the procedure.