Medicine
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Video-assisted thoracoscopic surgery (VATS) is a kind of minimally invasive surgery with the advantages of small surgical incision, less surgical bleeding, and fewer hospitalization days. However, traditional thoracotomy has advantages in lymph node dissection and radical resection of tumors and the benefits of VATS compared with thoracotomy for lung cancer are controversial. This systematic review and meta-analysis will be conducted to evaluate the advantages and disadvantages of the 2 different surgical methods. ⋯ CRD42018118427.
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Some patients with differentiated thyroid cancer (DTC) may require an initial low dose (LD) of lenvatinib. However, few studies have investigated the efficacy of LD lenvatinib. We compared the efficacy and tolerability of lenvatinib at an initial LD to those of the standard initial dose of 24 mg in patients with DTC. ⋯ There were no significant differences in the incidences of common adverse events between the 2 groups. The LD group also required dose reduction and interruption frequently. Since these findings are only the short-term results of a limited number of cases, a large number of cases and long-term observations are needed to determine whether an initial LD is effective for patients with DTC in poor general condition.
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Observational Study
Elevated serum IL-37 concentrations in patients with sepsis.
To investigate the changes and significance of IL-37 in patients with sepsis. A total of 50 patients with sepsis between September 2016 and October 2017 at the intensive care unit (ICU) of the First Affiliated Hospital of Shihezi University School of Medicine were selected as the sepsis group, 30 age and sex-matched healthy controls were selected as the control group. The levels of IL-37 in serum were measured by enzyme-linked immunosorbent assay (ELISA) on day 1 and day 7 of the sepsis patients. ⋯ A correlation analysis showed that the levels of serum IL-37 and IL-1β were positively correlated. The level of IL-37 observed in sepsis was found to correlate with the severity of the inflammatory reaction. IL-37 could be an important cytokine in the control of sepsis by suppressing the production of pro-inflammatory cytokines.
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Pleural effusions are a common medical problem not only for pulmonologists but also for general physicians, often needing thoracentesis for a definite diagnosis. However, thoracentesis cannot always reveal malignant cells or microbiological evidence. In this context, we prospectively enrolled a total of 289 patients with pleural effusions due to diverse etiologies: parapneumonic effusion (PPE) (63), empyema (22), tuberculous pleural effusion (TBPE) (54), malignant pleural effusion (MPE) (140), or chronic renal failure (CRF)/congestive heart failure (CHF) (10). ⋯ We discovered a simple method to differentiate pleural diseases based on the pleural LDH to ADA ratio and carcinoembryonic antigen (CEA). A pleural LDH to ADA ratio greater than 15.5 and a pleural CEA level of less than 5 ng/mL is indicative of PPE or empyema rather than TBPE, MPE, or transudative pleural effusion (CRF, CHF). This method has a sensitivity of 62.0%, a specificity of 91.0%, and an area under the receiver operating characteristic curve of 0.765 (95% confidence interval [CI]: 0678-0.852, P < .001), odds ratio of 16.6 (95% CI: 7.28-37.8, P < .001), a positive likelihood ratio (LR) of 6.8, and a negative LR of 0.02.
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Comparative Study Observational Study
Early oral feeding versus traditional feeding after transanal endorectal pull-through procedure in Hirschsprung's disease.
Our study questioned whether the outcome of postoperative early oral feeding is different from traditional postoperative feeding in children with Hirschsprung's disease who underwent transanal endorectal pull-through. This was an observational and comparative study. Patients were allocated into 2 groups. ⋯ We noted a significant difference regarding the duration of antibiotic treatment and intravenous fluid administration after 72 hours. This study showed that there was no difference between the outcomes of early and traditional postoperative feeding. Due to a significant difference in the antibiotics and IV fluid administration intervals between these 2 groups which cause a prolonged hospital stay and higher costs, it seems that early postoperative feeding is superior to traditional strategy.