Medicine
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Review Case Reports
Atezolizumab and bevacizumab-induced encephalitis in advanced hepatocellular carcinoma: Case report and literature review.
On the basis of the results of the IMBRAVE-150 trial, the combination of atezolizumab, a programmed cell death ligand 1 (PD-L1) antibody, as well as bevacizumab, a vascular endothelial growth factor (VEGF) antibody, represents a promising novel first-line therapy in patients with advanced hepatocellular carcinoma (HCC). Despite favorable safety data, serious adverse events have been described. However, central nervous system complications such as encephalitis have rarely been reported. We present the case of a 70-year-old woman with hepatitis C virus (HCV)-related liver cirrhosis and advanced HCC who developed severe encephalitis after only one cycle of atezolizumab/bevacizumab. ⋯ This case illustrates that rapid immunosuppressive treatment with prednisolone can result in remission even of severe encephalitis. We discuss this case in the context of available literature and previously reported cases of atezolizumab-induced encephalitis in different tumor entities, highlighting the diagnostic challenges in oncologic patients treated with immune checkpoint-inhibitors.
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Multicenter Study Comparative Study
Does a combination treatment of repetitive transcranial magnetic stimulation and occupational therapy improve upper limb muscle paralysis equally in patients with chronic stroke caused by cerebral hemorrhage and infarction?: A retrospective cohort study.
The clinical presentation of stroke is usually more severe in patients with intracerebral hemorrhage (ICH) than in those with cerebral infarction (CI); recovery of stroke-related muscle paralysis is influenced and limited by the type of stroke. To date, many patients have been treated by neurorehabilitation; however, the changes in the recovery of motor paralysis depending on the type of stroke, ICH or CI, have not been established. This study aimed to determine this difference in improvement of upper extremity paralysis using 2-week in-hospital NovEl intervention Using Repetitive transcranial magnetic stimulation combined with Occupational therapy (NEURO). ⋯ The type of stroke had no effect on the outcomes (changes in the FMA-upper extremity score, F[4,14.0] = 2.05, P = .09, partial η2 = 0.01). Patients from all 5 groups equally benefited from the treatment (improvement in FMA scores) according to the sensitivity analysis-stratified analysis (F = 0.08 to 1.94, P > .16, partial η2 < 0.001). We conclude that NEURO can be recommended for chronic stroke patients irrespective of the type of stroke.
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Observational Study
Cross-cultural adaptation and psychometric validation of the Korean version of rehabilitation complexity scale for the measurement of complex rehabilitation needs.
The aim of this study was to translate and cross-culturally adapt the Rehabilitation Complexity Scale-Extended version 13 (RCS-E v13) to develop the Korean version of the Rehabilitation Complexity Scale (KRCS), and to explore its reliability, and concurrent and construct validity. This research was an observational study of a series of consecutive rehabilitation inpatients who were previously assessed with KRCS and grouped with the Korean rehabilitation patient group version 1.1 (KRPG v1.1). Translation and cross-cultural adaptation of the RCS-E v13 were implemented according to internationally recognized standards. ⋯ The KRCS was associated with a higher explanatory power for rehabilitation resources and length of stay than the KRPG v1.1. Our data suggest that the KRCS is a feasible, reliable, and valid tool that is appropriate for the measurement of clinical complexity in Korean intensive rehabilitation units. Further, it may provide case-mix adjustment to improve the rehabilitation delivery system in Korea.
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In recent years, a variety of long noncoding RNA (lncRNA) has been confirmed to be involved in the initiation and progression of osteosarcoma. Taurine-up regulated gene 1 (TUG1) plays an important role in the formation, invasion, and metastasis of osteosarcoma. Therefore, perhaps TUG1 is a potential biomarker for the prognosis of patients suffering from osteosarcoma. In this study, meta-analysis and bioinformatics were adopted to further explore the effects of TUG1 on the prognosis of patients with osteosarcoma and its potential molecular mechanism. ⋯ DOI 10.17605/OSF.IO/CW4BF.
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Observational Study
Comparative analysis of ischemic changes in electrocardiogram and coronary angiography results: A retrospective study.
To improve the correct diagnosis rate of coronary heart disease and to explore the guiding value of electrocardiogram (ECG) ST-T ischemic changes in the clinical diagnosis of coronary heart disease. A retrospective analysis was conducted on a total of 310 cases who underwent a conventional 12-lead ECG, 12-lead dynamic ECG (DECG, Holter) with ST-T ischemic changes, and then coronary angiography (CA) within 1 week in Qingdao Sttarr Heart Hospital from June 2015 to April 2020 in the study. Ischemic ST-T changes were evaluated using conventional diagnostic criteria, and Judkins diagnostic criteria were used in CA. ⋯ The sensitivity of DECG in the diagnosis of myocardial ischemia in women and the elderly was slightly higher than that in men and young cases. ST-T ischemic changes in ECG are more significant for the diagnosis of coronary heart disease in male patients. Smoking, hypertension, diabetes, and family history are all high-risk factors for coronary heart disease.