Medicine
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Observational Study
Real-world treatment efficacy of anti-programmed death-1 combined with anti-angiogenesis therapy in non-small cell lung cancer patients.
Anti-programmed death-1 (PD-1) therapy has been extensively used to treat cancer. Recently, the combination of immunotherapy and anti-angiogenic therapy has emerged as a novel treatment approach. Therefore, we designed a study to evaluate the real-world benefit of the combination of anti-PD-1 and anti-angiogenesis therapy in patients with non-small cell lung cancer (NSCLC). ⋯ The real-world ORR, PFS, and OS were comparable to previous clinical trials, despite the patients' different baseline characteristics. Importantly, compared with patients having identified EGFR mutations, patients without EGFR mutations had a better PFS. Furthermore, these data support the use of anti-PD-1 combined with anti-angiogenesis therapy as a novel treatment approach for patients with NSCLC.
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Comparative Study
Characteristics and surgical invervention of ovarian torsion in pregnant compared with nonpregnant women.
The aim of our study was to compare the clinical and surgical characteristics of pregnant and nonpregnant women with surgically verified ovarian torsion, as well as the differences among 3 trimesters during pregnancy. We conducted a retrospective study of patients diagnosed with surgically proven ovarian torsion in our hospital from January 2012 to June 2018. The clinical characteristics, surgical procedure, pathologic outcomes, and trimesters of pregnancy were analyzed. ⋯ Clinical presentation of ovarian torsion is relatively similar between pregnant and nonpregnant women, and among different trimesters. The tumor size was smaller in the third trimester of pregnancy than the other 2 trimesters of pregnancy. Cystectomy performed in pregnant patients is more during the third trimester compared with the other 2 trimesters.
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Observational Study
Two treatment strategies for management of Neurosymptomatic cerebrospinal fluid HIV escape in Pune, India.
Symptomatic cerebrospinal fluid (CSF) viral escape (sCVE) is reported in people with HIV, who are on ritonavir-boosted protease inhibitor (PI/r) containing antiretroviral therapy (ART). Management of sCVE includes performing genotypic HIV-1 resistance testing (GRT) on CSF and plasma HIV and changing ART accordingly. Neither GRT nor newer drugs (Dolutegravir and Darunavir/ritonavir) are routinely available in India. ⋯ Four deaths were noted, 2 of which were in individuals who interrupted ART. This is a unique sCVE cohort that was managed with 1 of 2 approaches based on treatment history and the availability of GRT. At least 75% of participants responded to either approach with virologic suppression and improvement in symptoms.
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Comparative Study
General internal medicine and family medicine journals: Comparative study of published articles using bibliometric data.
Like research in general internal medicine, family medicine research can play an important role in improving medical knowledge. We aimed to compare articles published in family medicine journals with articles published in general internal medicine journals. In this bibliometric study, we retrieved 658 randomly selected quantitative articles published in 2016 in 18 high impact factor journals of family medicine and general internal medicine. ⋯ In addition, these studies generally included more participants (>1000 vs <100: OR 3.5 [95%CI 1.4-8.6], P-value .02). There was no statistically significant difference in the study design between the two groups of articles (P-value .25). Despite some differences between the two groups of articles, studies published in family medicine journals do not appear to be any less ambitious in terms of study design and sample size than those published in general internal medicine journals.
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Comparative Study
Transparent cap-assisted endoscopic injection sclerotherapy for the treatment of patients with esophageal varices.
The aim of this study was to compare the efficacy and safety of cap-assisted endoscopic injection sclerotherapy (EIS) versus direct EIS in the management of esophageal variceal bleeding in patients with cirrhosis. This retrospective study included patients with cirrhosis and esophageal variceal bleeding who underwent EIS with or without the use of a transparent cap at Shandong Provincial Hospital between December 2014 and April 2017. Patients were divided into two groups: Group A (EIS with transparent cap, n = 50) and Group B (direct EIS, n = 45). ⋯ Only 22 patients (44%) developed complications in the cap-assisted group versus 30 patients (66.7%) in the EIS group (P = .039). The probability of survival was similar in both groups (86% versus 75.6%, P = .133). Modified EIS with the use of a transparent cap resulted in lower rates of esophageal variceal recurrence, rebleeding, and complications, compared with direct EIS.