Medicine
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Autoimmune hepatitis (AIH) is a form of liver inflammation in which immune cells target hepatocytes, inducing chronic inflammatory states. Bariatric surgery (BS) was shown to reduce inflammation in severely obese patients. We hypothesize that obese patients with AIH and BS have lower prevalence of liver-related complications and in-patient mortality compared to those without BS. ⋯ The prevalence of ascites was higher in the BS group compared to the control (odds ratio 1.73, 95% confidence interval (CI) 1.27-2.36). The prevalence of cirrhosis (36.8% vs 33.2%), portal hypertension (7.4% vs 10.0%), hepatic encephalopathy (10.6% vs 8.7%), and varices and variceal bleeding (3.9% vs 5.5%) was not statistically different from case controls, (P > .05). BS was an independent risk factor for ascites (adjusted odds ratio (aOR) 1.87; 95% CI 1.36-2.56) and hepatic encephalopathy (aOR 1.42; 95% CI 1.03-1.97) but was an independent protective factor against in-patient mortality (aOR 0.21, 95% CI 0.08-0.55) once adjusted for age, sex, race, and comorbidities.
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Myeloid cell leukemia-1 (Mcl-1) plays an important role in the clearance of Mycobacterium tuberculosis (MTB) infection. It has the effect of anti-apoptosis, protecting macrophages that have engulfed pathogens and preventing pathogen clearance. Meanwhile, the MAPK signaling pathway plays a significant role in regulating Mcl-1 expression during tuberculosis infection. In the case of latent infection and active infection, the apoptosis and polarization of macrophages have a great influence during MTB infection, so we discussed the effect of Mcl-1 on apoptosis and polarization. Then, further discussed its mechanism. ⋯ We found that Mcl-1 affected the apoptosis and polarization of macrophages infected by Mycobacterium tuberculosis, mainly M1 in the early stage and M2 in the later stage. In addition, mitochondria played a crucial role in this process.
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Observational Study
A second C-reactive protein (CRP) test to detect inflammatory burst in patients with acute bacterial infections presenting with a first relatively low CRP.
A first C-reactive protein (CRP) test, as often performed by clinicians during the presentation of patients with an acute bacterial infection, might be misleading. The aim of our study was to explore the dynamic between a second CRP test taken within 12 hours from admission CRP test in a cohort of patients diagnosed with acute bacterial infection in comparison to CRP in a control group of apparently healthy individuals. This was a historical cohort study comprised of all patients admitted to the Sourasky Tel-Aviv Medical Center, Israel, between July 2007 and March 2016. ⋯ A first single low CRP result cannot exclude the presence of a significant bacterial infection. Patients with acute bacterial infection might present with a relatively low CRP value that at times correspond to normal limit CRP concentrations. A second test, obtained within 12 hours of admission, might serve as an important tool to identify patient with an evolving inflammatory burst commonly seen during acute bacterial infection.
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Even being equipped with advanced surgical navigation systems, thorough analysis of patient's imaging diagnosis before procedures is still of great necessity for the operators. This study aimed to explore the morphological changes of sphenoid sinus lesions as observed on computed tomography (CT), and further carry out the fenestration of sphenoid sinus under guidance of the CT. A retrospective analysis of the characteristics of CT images was performed. ⋯ No significant difference was observed in the curative effects among the 3 groups. CT of the paranasal sinus can guide the procedures of sphenoid sinus fenestration. No statistically significant differences were exhibited in terms of the amount of bleeding, surgical time and days of hospitalization among the 3 groups.
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Observational Study
Surgical treatment of compensatory hyperhidrosis: Retrospective observational study.
Compensatory hyperhidrosis is a debilitating postoperative condition occurring in 30% to 90% of patients with primary hyperhidrosis. The most appropriate treatment for compensatory hyperhidrosis remains controversial. Between January 2018 and December 2019, 44 patients with intractable compensatory hyperhidrosis underwent diffuse sympathicotomy (DS). ⋯ Thermographic images obtained before/after surgery in 10 patients showed successful denervation and sweat diminishment. This study shows the safeness and effectiveness of DS for treating compensatory hyperhidrosis, representing a new treatment option. Future research should be directed at confirming a promising result of extended DS with further follow-up.