Medicine
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Botulinum toxin type-A (BTX-A) has been successfully utilized to treat trigeminal neuralgia. In this study, through the use of a new technique, the efficacy of the injection of BTX-A to the maxillary and mandibular nerves was evaluated. ⋯ Injection to the maxillary and mandibular roots seems to be a highly effective method. In the event of recurrence, after each injection, the pain severity and attack frequency decreased.
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Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease that is often associated with tetralogy of Fallot (TOF). Here, we report 2 cases of APVS associated with TOF diagnosed via fetal echocardiography and discuss their specific ultrasonographic characteristics. ⋯ Although APVS is a rare congenital heart disease and often associated with TOF, it has an overall poor prognosis. Nowadays, it can be easily diagnosed via ultrasonography because of its typical ultrasonographic features, such as aneurysmal dilatation of pulmonary artery, massive regurgitation of the pulmonary valve, VSD, and an overriding aorta. Therefore, early fetal echocardiography screening should be performed for every fetus.
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The aim of this study was to evaluate the outcomes after laparoscopic sleeve gastrectomy (SG) in a VA population. SG has recently gained popularity as a definitive bariatric surgery procedure. Data are lacking on long-term outcomes, particularly in a Veterans Affairs population. ⋯ Fifty percent of patients with diabetes were on insulin and 68% with OSA used continuous positive airway pressure/bilevel positive airway pressure (CPAP/BiPAP). We found significant absolute reductions in mean antihypertensive medications (-0.8), hyperlipidemic agents (-0.4), antireflux agents (-0.4), oral hypoglycemics (-0.6), insulin use (-25%), and use of CPAP/BiPAP (-55%) (all P < .001). Laparoscopic sleeve gastrectomy is a safe and effective bariatric surgery procedure, resulting in significant early weight loss up to 18 months and long-term improvement in all major obesity-related comorbid conditions.
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Metastases of nonthyroid malignancies to the thyroid gland are rare, and only sporadic cases have been reported in literature. We present our experience in treating patients with metastases to the thyroid gland at Peking Union Medical College Hospital. ⋯ Thyroid metastases are rare, and the lung was the most common primary site of origin. It seems that thyroidectomy has not been considered in cases with a high clinical stage of the neoplastic process such as lung cancer.
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Observational Study
Population-based cohort study investigating the correlation of diabetes mellitus with pleural empyema in adults in Taiwan.
We assessed the association between diabetes mellitus and the risk of pleural empyema in Taiwan. A population-based retrospective cohort study was conducted using the database of the Taiwan National Health Insurance Program. There were 28,802 subjects aged 20 to 84 years who were newly diagnosed with diabetes mellitus from 2000 to 2010 as the diabetes group and 114,916 randomly selected subjects without diabetes mellitus as the non-diabetes group. ⋯ In further analysis, even in the absence of any comorbidity, the adjusted HR was 1.99 for subjects with diabetes mellitus alone (95% CI 1.18-3.38). Diabetic patients confer a 1.71-fold increased hazard of developing pleural empyema. Even in the absence of any comorbidity, the risk remains existent.