Medicine
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Observational Study
Self-reported motivators for HIV testing in the treat-all era among HIV positive patients in Johannesburg, South Africa.
To explore associations between self-reported ill-health as a primary motivator for HIV-testing and socio-demographic factors. Four local primary healthcare clinics in Johannesburg, South Africa. A total of 529 newly HIV diagnosed adults (≥18 years) enrolled from October 2017 to August 2018, participated in the survey on the same day of diagnosis. ⋯ Baseline predictors of symptom-related motivators for HIV testing include disclosing intention to test (aPR 1.4 for family/friend/others vs partners/spouse, 95% CI: 1.1-1.8; aPR 1.4 for not disclosing vs partners/spouse, 95% CI: 1.1-1.7), and HIV testing history (aPR 1.2 for last HIV test >12-months ago vs last test 12-months prior, 95% CI: 1.0-1.5; aPR 1.3 for never tested for HIV before vs last test 12-months prior, 95%CI:1.0-1.6). Findings indicate that newly diagnosed HIV positive patients still enter care because of ill-health, not prevention purposes. Increasing early HIV testing remains essential to maximize the benefits of expanded ART access.
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There are no reports on global research status of gastroenterology and hepatology (GI). This study was conducted to reveal the current global research status and trends in GI. ⋯ It is delightful that the global research output in GI field would be continuingly increased as the major highest-output countries showed increasing trends. However, the developing countries fell behind both in quantity and quality when compared with developed countries.
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Case Reports
A case report of acquired methemoglobinemia rescued by veno-venous extracorporeal membrane oxygenation.
Severe methemoglobinemia (Met-Hb) is rare. The delayed diagnosis and treatment often cause further damage. The management of cellular hypoxemia is challenging and the use of extra-corporeal membrane oxygenation (ECMO) has never been reported. ⋯ VV-ECMO can hyper-oxygenate the hypoxemic tissue regardless the etiology and minimize hypoxemia-reperfusion injury while awaiting the definite diagnosis and therapy.
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Nonconvulsive status epilepticus (NCSE) is a heterogeneous disease with multiple subtypes. NCSE poses great diagnostic and therapeutic challenges due to the lack of typical symptoms. Here, we report a case of NCSE manifesting as rapidly progressive dementia (RPD) and infarction in the splenium of the corpus callosum. Additionally, the relevant literature was reviewed. ⋯ NCSE manifesting as RPD and infarction in the splenium of the corpus callosum is extremely rare. Epileptic events and focal infarction are usually overlooked in patients with dementia, and the diagnostic value of MRI and EEG should be highlighted.
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Thymic carcinoma represents a rare type of malignant mediastinal tumor and has been the subject of controversy. Although independent prognostic factors related to thymic carcinoma have been investigated previously, few studies have focused specifically on the survival outcomes associated with thymic squamous cell carcinoma (TSCC). This study aims at presenting a survival analysis in this rare malignant disease at population level. ⋯ Surgery, age of diagnosis, and stage were associated with better overall survival among TSCC.