Medicine
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Many patients with chronic pancreatitis (CP) undergo a step-up approach with interventional procedures as first-line treatment and resection reserved for later stages. The aim of this study was to identify predictive factors for a significant clinical improvement (SCI) after surgical treatment. All patients operated for CP between September 2012 and June 2017 at our center was retrospectively reviewed. ⋯ In total, 96.2% of the patients had a complete or major postoperative relief with a mean pain intensity reduction from 8.1 to 1.9 on the visual analogue scale. The results support that surgical resection for CP should be considered at early stages. Resection can effectively reduce postoperative pain intensity and improve long-term success.
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Inflammatory bowel disease (IBD) in Asia has become increasingly prevalent. As a treatment of IBD, many immunomodulators and biological agents were introduced and shown to be effective in inducing and maintaining remission. However, many cases with treatment failure were reported. ⋯ In UC patients, the results were in similar pattern, but this pattern was not observed in CD patients in our study. Our study shows that Korean IBD patients are at risk of TB, and the risk increases with usage of IBD medication; moreover, the risk is the highest if combination therapy is used. These results highlight the importance of screening for TB in IBD patients, especially in combination therapy.
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Meta Analysis
Auricular acupuncture for migraine: A protocol for systematic review and meta-analysis.
Migraines are caused by neurological and vascular dysfunction, with a side or both sides of the head pain recurrent attack, often accompanied by nausea, vomiting, light, and sound allergy as the characteristics, is the clinical common disease, frequently occurring disease. The incidence of migraine is 8.4% to 28% worldwide (highest in Germany), and the lifetime incidence is about 14.0%. About 18.2% for women and 6.5% for men, About 23 percent of families have at least one migraine sufferer. It can occur at any age, and more than half of patients have headaches that interfere with work or school, while nearly a third may miss work or school because of the headache. Therefore, how to relief headache immediately and reduce the impact on life and work, becomes the basic clinical appeal of many patients. Analgesics are the main treatment for migraine in western medicine, many patients, who worried about the side effects of drugs, often take them only when the pain is unbearable, which can only treat the symptoms rather than the root causes. Auricular acupuncture as a form of acupuncture therapy which is proved to be effective in RCTs and very suitable for patients, has been used in patients who suffer from migraine for a long time, therefore a systematic review is necessary to provide available evidence for further study. ⋯ October 2, 2020 osf.io/q6arf. (https://osf.io/q6arf/.).
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Review Case Reports Observational Study
Central nervous system aspergillosis in immunocompetent patients: Case series and literature review.
The aim of this study was to investigate the clinical characteristics of central nervous system (CNS) aspergillosis in immunocompetent patients. This study enrolled six immunocompetent patients diagnosed with CNS aspergillosis. Additionally, we reviewed the clinical profiles for 28 cases reported in the literature. ⋯ Parenchymal aspergillosis lesions are usually localized and manifest as brain abscesses with annular enhancement on magnetic resonance imaging. Biopsy, CSF culture, and next-generation sequencing are mainstream diagnostic modalities. Voriconazole is an effective treatment for Aspergillus infection, and early diagnosis and treatment should be highlighted.
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Review Case Reports
Chronic myelomonocytic leukemia (CMML)-0 with pleural effusion as first manifestation: A case report.
Extramedullary invasion of chronic myelomonocytic leukemia (CMML) usually occurs in the liver, spleen, and lymph nodes, while the pleural infiltration of CMML is rare. The presence of pleural effusion is usually associated with uncontrolled leukocytosis and increased monocytes. ⋯ The current case indicated that leukemic infiltration into pleura could occur despite mild leukocytes, while demethylation may be an effective therapy.