Medicine
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Observational Study
Clinical results for combination of fibrin glue and nasal margin suture fixation for attaching conjunctival autografts after pterygium excision in Chinese pterygium patients.
This study was designed to compare postoperative complications and postoperative discomfort when using glue combined with nasal margin suture fixation versus fibrin glue or sutures alone to attach conjunctival autografts among Chinese patients during pterygium excisions. We analyzed the medical records of 150 eyes of 150 patients with primary pterygium, in which the autografts were secured by 3 different methods after pterygium excision: 50 eyes were secured with fibrin glue, 50 eyes were secured with glue + nasal sutures, and 50 eyes were secured with sutures. The more than 6 months of follow-up observation data included postoperative complications (graft loss/displacement, dehiscence, proliferative granuloma, inflammation, and hemorrhage), recurrence, and postoperative discomfort. ⋯ The modified conjunctival autograft fixation with glue + sutures on the nasal margin resulted in more stable grafts and less graft-associated complications. There was a low level of postoperative patient discomfort in the glue + sutures group. A higher grade of pterygium led to an increased rate of complications in the glue group.
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Infective endocarditis (IE) complicated with obstructive ST elevation myocardial infarction (STEMI) has been reported in the literature and which were mostly related to coronary artery embolism, obstruction, or compression. However, there has been no reported case discussing about IE complicated with nonobstructive STEMI. ⋯ In our knowledge, this case should be the 1st case of IE complicated with nonobstructive STEMI, which reminds physicians that nonobstructive STEMI is still an extremely rare but possible complication of IE and septic embolism related ICH should be carefully surveyed in this rare patient group.
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Autosomal-recessive dopa-responsive dystonia (DRD) is a rare clinical disorder presenting as bradykinesia, dystonia, tremor and even severe encephalopathy, and caused by tyrosine hydroxylase deficiency (THD). We report a case of compound heterozygous mutations in the TH gene in a Chinese family with autosomal-recessive DRD herein. ⋯ Gene mutation analysis is helpful and necessary to diagnose DRD and has important guiding significance for the subsequent treatment.
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Observational Study
Prescription fill rates for acute and chronic medications in claims-EMR linked data.
Nonadherence to prescribed medications poses a significant public health problem. Prescription data in electronic medical records (EMRs) linked with pharmacy claims data provides an opportunity to examine the prescription fill rates and factors associated with it. Using a claims-EMR linked data, patients who had a prescription for either an antibiotic, antihypertensive, or antidiabetic in EMR were identified (index prescription). ⋯ Older age was an additional factor that was negatively associated with first time fill rate among patients without prior treatment. Significant proportions of patients, especially patients with no prior treatment history, did not fill prescriptions for antibiotics, antihypertensives, or antidiabetics. The association between patient factors and medication fill rates varied across different medication groups.
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Although the prevalence of atrial fibrillation (AF) and percutaneous coronary intervention (PCI) are increasing in Asia, there is a paucity of data concerning the effect of AF in Asian patients undergoing PCI with drug-eluting stents (DESs). Furthermore, the majority of previous studies investigating the effect of AF on prognosis following PCI have exclusively evaluated patients with myocardial infarction (MI). We aimed to evaluate the effect of AF on clinical outcomes of Asian patients undergoing PCI with DES for coronary artery disease (CAD) excluding acute MI. ⋯ During the follow-up period (mean, 2.2 years), the incidence of all-cause death (hazard ratio [HR] 1.117, 95% confidence interval [CI] 0.885-1.411, P = .35) and the composite outcome of all-cause death/MI/coronary revascularization (HR 1.004, 95% CI 0.846-1.192, P = .97) were not significantly different between 2 groups. However, the incidence of stroke was significantly increased in the AF group (HR 1.983, 95% CI 1.474-2.667, P < .001). In Asian patients undergoing PCI for stable CAD, a history of AF was not associated with mortality, but was associated with increased risk of stroke.