Medicine
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Case Reports
The "criminal" artery of de Winter may be the left circumflex artery: A CARE-compliant case report.
De Winter et al first described a new ST-segment elevation myocardial infarction (STEMI)-equivalent pattern associated with acute occlusion of the left anterior descending coronary artery (LAD). Studies show that this pattern has a positive predictive value of 95.2% to 100%. However, some cases of non-STEMI, caused by acute right coronary artery or LAD diagonal branch occlusion, have been reported, which exhibit electrocardiogram (ECG) changes similar to the de Winter pattern. Few cases of de Winter ECG pattern caused by left circumflex artery (LCX) stenosis have been reported. ⋯ De Winter ECG pattern cannot be presumed to be associated with LAD stenosis and 18-lead ECG is required to support the identification of the "criminal" artery and to rule out posterior myocardial infarction.
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Observational Study
Bone defect reconstruction with autologous bone inactivated with liquid nitrogen after resection of primary limb malignant tumors: An observational study.
Surgical treatment of malignant bone tumors comprises tumor resection and reconstruction. The most commonly used reconstruction method is prosthesis replacement, which achieves good early function, but has a high long-term incidence of complications. Another reconstruction option is autologous bone replantation, which has the advantages of anatomical matching and no need for large bone bank support. ⋯ The average Muscle and Skeletal Tumor Society score was 28 ± 3 (21-30) in the 18 survivors. Liquid nitrogen-inactivated autologous bone replantation for primary malignant limb tumor was safe and effective, as shown by the relatively low complication rate, high bone healing rate, and satisfactory postoperative function. This is a reliable biological reconstruction method for malignant bone tumors with specific site and bone destruction characteristics.
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Observational Study
Geographic risk assessment of COVID-19 transmission using recent data: An observational study.
The US Centers for Disease Control and Prevention (CDC) regularly issues "travel health notices" that address disease outbreaks of novel coronavirus disease (COVID)-19 in destinations worldwide. The notices are classified into 3 levels based on the risk posed by the outbreak and what precautions should be in place to prevent spreading. What objectively observed criteria of these COVID-19 situations are required for classification and visualization? This study aimed to visualize the epidemic outbreak and the provisional case fatality rate (CFR) using the Rasch model and Bayes's theorem and developed an algorithm that classifies countries/regions into categories that are then shown on Google Maps. ⋯ We created an online algorithm that used the CFRs to display the geographic risks to understand COVID-19 transmission. The app was developed to display which countries had higher travel risks and aid with the understanding of the outbreak situation.
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Observational Study
Developing a template matching algorithm for benchmarking hospital performance in a diverse, integrated healthcare system.
Template matching is a proposed approach for hospital benchmarking, which measures performance based on matching a subset of comparable patient hospitalizations from each hospital. We assessed the ability to create the required matched samples and thus the feasibility of template matching to benchmark hospital performance in a diverse healthcare system. Nationwide Veterans Affairs (VA) hospitals, 2017. ⋯ Although most other variables could be balanced, we were unable to identify a matching algorithm that balanced more than ∼20 variables simultaneously. We were unable to identify a template matching approach that could balance hospitals on all measured characteristics potentially important to benchmarking. Given the magnitude of case-mix variation across VA hospitals, a single template is likely not feasible for general hospital benchmarking.
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X-linked hyper-IgM syndrome is a type of primary combined immunodeficiency disorder caused by mutations in CD40 ligand. Opportunistic infections caused by P jirovecii, cytomegalovirus (CMV), or fungi are frequently the first presenting symptom of the patients with X-linked hyper-IgM syndrome. ⋯ Opportunistic infections should be suspected in infants presenting with severe interstitial pneumonia. Primary immune deficiency diseases should also be considered in infants diagnosed with opportunistic infections.