Medicine
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Pragmatic Clinical Trial
Burnout among doctors in China through 2018: A protocol of systematic review and meta-analysis.
Burnout negatively impacts the mental and physical health doctors. More seriously, it leads to poor patient care. In China, the situation is severe and more efforts are needed to reveal the epidemiological characteristics of doctor burnout to develop improved strategies of alleviating it. Due to the large number of heterogeneous and sample size-restricted surveys currently published, meta-analysis and systematic reviews are critical to a thorough understanding of burnout among Chinese doctors. ⋯ CRD42018104249.
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Multicenter Study
Evolution of tyrosinemia type 1 disease in patients treated with nitisinone in Spain.
Treatment with nitisinone (NTBC) has brought about a drastic improvement in the treatment and prognosis of hereditary tyrosinemia type I (HT1). We conducted a retrospective observational multicentric study in Spanish HT1 patients treated with NTBC to assess clinical and biochemical long-term evolution. We evaluated 52 patients, 7 adults and 45 children, treated with NTBC considering: age at diagnosis, diagnosis by clinical symptoms, or by newborn screening (NBS); phenotype (acute/subacute/chronic), mutational analysis; symptoms at diagnosis and clinical course; biochemical markers; doses of NTBC; treatment adherence; anthropometric evolution; and neurocognitive outcome. ⋯ Among the 12 variants identified in fumarylacetoacetate hydrolase gene, 1 of them novel (H63D), the most prevalent in Spanish population is c.554-1 G>T. After NTBC treatment a reduction in tyrosine and alpha-fetoprotein levels was observed in all the study groups, significant for alpha-fetoprotein in no NBS-group (P = .03), especially in subacute/chronic forms (P = .018). This series confirms that NTBC treatment had clearly improved the prognosis and quality of life of HT1 patients, but it also shows frequent cognitive dysfunctions and learning difficulties in medium-term follow-up, and, in a novel way, a high percentage of overweight/obesity.
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Case Reports
Spleen-preserving distal pancreatectomy and lymphadenectomy for glucagonoma syndrome: A case report.
Glucagonoma is a rare type of functional pancreatic neuroendocrine tumor that is characterized by distinctive clinical manifestations; among these, necrolytic migratory erythema represents the hallmark clinical sign of glucagonoma syndrome and is usually presented as the initial complaint of patients. ⋯ The treatment of glucagonoma should be directed according to the stage at which the disease is diagnosed. Surgery is currently the only method available to cure the tumor, although medications are given to patients who present with advanced glucagonoma and who are not candidates for operation. Multidisciplinary therapy and multimodality treatment are advised, although these have been systematically evaluated to a lesser degree.
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Heroin addiction remains a significant public health problem worldwide, and relapse to heroin use following cessation of agonist maintenance treatment is common. The problems associated with use of opioid agonists mean that non-opioid therapies need to be developed to ameliorate acute and protracted opioid withdrawal syndromes. ⋯ To investigate the effect of adjuvant laser meridian massage in men with opioid use disorder on methadone maintenance treatment.
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Comparative Study
Acupotomy versus nonsteroidal anti-inflammatory drugs for knee osteoarthritis: Protocol for a systematic review and meta-analysis.
Knee osteoarthritis (KOA), a common clinical chronic osteoarthropathy, has adverse effects on the working ability and life quality of patients. At present, acupotomy and nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely applied on KOA in China and has achieved satisfactory results. However, there is no systematic review comparing the effectiveness of these two therapies for KOA. Therefore, this study will assess the efficacy and safety of acupotomy in treating KOA. ⋯ CRD42019129089.