Medicine
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Case Reports
Epidermolysis bullosa acquisita as an adverse effect from rituximab therapy: A case report.
Rituximab is a monoclonal antibody directed against B cells and is a first-line agent for the treatment of B cell lymphoma and a second-line agent for the treatment of idiopathic thrombocytopenic purpura (ITP). It has also been used for the treatment of several other autoimmune diseases. Epidermolysis bullosa acquisita (EBA) has never been reported as an adverse effect resulted from rituximab therapy. ⋯ Physicians should consider this diagnosis when a patient develops bullous skin eruptions while undergoing Rituximab therapy.
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MiR-143 and miR-145 were down-regulated in papillary thyroid carcinoma (PTC) involving in cell proliferation, apoptosis, migration, invasion, and epithelial to mesenchymal transition. In this study, we aimed to investigate the association between 2 functional polymorphisms (ie, rs4705342 and rs353292) in the flanking region of miR-143/145 and risk of PTC. A case-control study including 316 PTC patients and 347 controls was performed. ⋯ No significant difference was found in the genotypic distributions of the rs353292 between cases and controls. These findings indicate that the rs4705342 in the flanking region of miR-143/145 may be a protective factor against the occurrence of PTC. Further study is therefore required to investigate the correlation between the genotype and V-raf murine sarcoma viral oncogene homolog B1 V600E, rat sarcoma viral oncogene homolog mutations, rearranged in transformation/PTC1 and rearranged in transformation/PTC3.
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Direct current cardioversion (DCCV) is one of the basic methods for restoring sinus rhythm (SR) in patients with atrial fibrillation (AF). Left atrial (LA) strain is one of the parameters used to assess the risk of AF recurrence following DCCV. Assessing the strain also allows for the detection of segmental disorders of LA wall contractility, including dispersion or dyskinesia. ⋯ LA dyskinesia was observed less frequently in the 4c view in patients who maintained SR (59.57 vs 17.5%; P < .001). Multivariable logistic regression showed that the LASct4c (odds ratio (OR) 0.78; 95%CI 0.63-0.97; P = .027) and LA dyskinesia observed in the 4c view (OR 3.53; 95%CI 1.16-10.76; P = .027) were significant independent predictors of AF recurrence at 12 months. We conclude that LA dyskinesia observed in the 4c view and LASct4c are independent risk factors for AF recurrence following DCCV.
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Meta Analysis
Wrist ankle acupuncture in the treatment of acute lumbar sprain: A protocol for systematic review and meta-analysis.
Acute lumbar sprain (ALS) frequently occurs in the young and middle-aged people, causing great harm to people's quality of life. The systematic review program was designed to describe a meta-analysis to evaluate the efficacy and safety of wrist-ankle acupuncture (WAA) in treating patients with ALS. ⋯ PROSPERO CRD42020162945.
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The aim of this study was to determine the factors that are associated with prolonged mechanical ventilation in elderly patients. Retrospective cohort studySingle tertiary hospital in JapanWe retrospectively identified 228 patients aged 75 years or older who were admitted to a single tertiary care center in Japan between January 1, 2014 and December 31, 2017 because of endogenous diseases and underwent mechanical ventilation. The primary outcome was extubation difficulty, which was defined as the need for mechanical ventilation for more than 14 days after intubation, reintubation within 72 hours after extubation, tracheotomy or extubation, or death within 14 days after intubation. ⋯ However, there were statistically significant differences in extubation difficulty between patients with diabetes mellitus (OR = 2.3; 95%CI = 1.01-5.12; P = .04) and those with cardiovascular disease diagnosis on admission (OR = 0.31; 95%CI = 0.1-0.97; P = .04). Diabetes mellitus and cardiovascular disease diagnosis on admission were factors that were associated with prolonged mechanical ventilation in the elderly. The results of this study may help to support shared decision making with patients or surrogate decision makers at the start of intensive care in the elderly.