Medicine
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Comparative Study
Pediatric deep burn management after split-thickness autologous skin transplantation: A comparative study.
Treatment of pediatric deep burns remains a challenge for healthcare personnel. After skin grafting, several treatment options are available, but comparative studies of the different options are scarce. Here, we compared the effectiveness of 2 postoperative dressings used to treat deep pediatric burns after split-thickness skin grafting. ⋯ Complete healing (dressing removal) was on the 10th day, and the mean length of hospitalization was 12.38 days. In the intervention group, the need for anesthesia significantly decreased by 43% (P = .004), and they required 84% fewer dressing changes after transplantation (P = .001). Moreover, the dressing could be removed 3 days earlier, and the length of hospitalization was reduced by 45% on average.
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According to the International Diabetes Federation, Turkey will be among the top 10 countries in the world with the highest prevalence of diabetes mellitus (DM) by 2045, with a speculated number of cases of 10.4 million. This study aimed to predict the 10-year risk of type 2 DM in a Turkish population, assess potential factors of the 10-year risk of DM, and assess the outcomes of Turkey's 2015 to 2020 program for DM. Individuals aged 20-64 years were categorized and stratified according to age (in ranges of 5 years), sex, and populations of family medicine centers to reflect the whole population. ⋯ Low levels of education (odds ratio [OR]: 2.054; 95% confidence interval [CI]: 1.011-4.174), smoking cessation (OR: 2.636; 95% CI: 1.260-5.513), a waist-to-height ratio >0.5 (OR: 6.885; 95% CI: 2.301-20.602), body fat percentage (OR: 1.187; 95% CI: 1.130-1.247), high systolic blood pressure (OR: 1.025; 95% CI: 1.009-1.041), and alcohol consumption (beta-estimation: -0.690; OR: 0.501; 95% CI: 0.275-0.914) affect the 10-year risk of type 2 DM. Individuals at risk for DM can be easily identified using risk assessment tools in primary care; however, there is no active screening program in the healthcare system, and only proposals exist. In addition to screening, preventive measures should focus on raising awareness of DM, reducing body fat percentage and systolic blood pressure, and decreasing the waist-to-height ratio to <0.5.
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Primary nasopharyngeal papillary adenocarcinoma is a rare nasopharyngeal neoplasm with a good prognosis and a low propensity for regional recurrence. To date, only few cases of primary nasopharyngeal papillary adenocarcinoma have been reported in the literature. ⋯ We aim at highlighting the importance of a thorough differential diagnosis of nasopharyngeal tumor. Further investigation is still needed for providing evidence to standardize the treatment protocol.
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Case Reports
Bilateral spontaneous massive renal hemorrhage in a peritoneal dialysis patient: A case report.
Non-traumatic bilateral spontaneous massive renal hemorrhage confined to the subcapsular and perirenal space, also known as Wünderlich syndrome, can occur suddenly and insidiously and cause serious consequences if not properly identified and managed. We report a case of bilateral spontaneous massive renal hemorrhage in a series of devastating episodes. ⋯ Bilateral spontaneous massive renal hemorrhage is rare and generally occurs in patients undergoing dialysis. Known studies appear primarily in case reports. Most patients can be treated successfully with TAE when diagnosed early.
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Observational Study
Risk factors of vesicoureteral reflux and urinary tract infections in children with imperforate anus: A population-based case-control study in Taiwan.
Imperforate anus (IA) is associated with several urological anomalies, including vesicoureteral reflux (VUR), a major contributor to high morbidity in patients with anorectal malformations. This retrospective study was performed to elucidate the risk factors of vesicoureteral reflux (VUR) and UTI in children with IA. We used the National Health Insurance Research Database (NHIRD) to estimate the frequency of congenital anomalies of the kidney and urinary tract (CAKUT) in children with IA. ⋯ Patients with a high-position IA had a greater risk of VUR, particularly those with CAKUT, hydronephrosis, or UTI. Such patients must periodically undergo urinalysis to screen for UTI and early voiding cystourethrogram to rule out VUR and prevent consequent renal damage. Chromosomal analysis is suggested to rule out Down syndrome.