Medicine
-
Fibromyalgia is a chronic disease characterized by widespread pain. Repetitive transcranial magnetic stimulation (rTMS) effectively relieves pain intensity in patients with fibromyalgia. The frequency and target site of rTMS have significant roles in therapy effectiveness. However, there is disagreement over the best rTMS protocol. Thus, we will conduct a thorough systematic review and network meta-analysis to rank the efficacy of these various rTMS protocols and determine which is most beneficial in lowering pain and enhancing the quality of life. ⋯ This study will provide systematic support of evidence-based medicine for TMS in fibromyalgia, integrate the results of direct and indirect comparisons of the efficacy of different rTMS protocol, and provide the best one.
-
Case Reports
An unusual presentation of diabetic ketoacidosis associated with ascariasis and fungal esophagitis: A case report.
Gastrointestinal symptoms are most commonly observed in patients with diabetic ketoacidosis (DKA), which usually resolves completely with therapy. However, gastrointestinal symptoms may persist after DKA is resolved. ⋯ In this case, despite the correction of metabolic acidosis, persistent nausea, vomiting and dysphagia can be a sign of esophagitis in patients with type 1 diabetes. Therefore, physicians should be aware of fungal infections associated with type 1 diabetes.
-
Intracranial vertebrobasilar dissecting aneurysms (VBDAs) are associated with a greater tendency to rupture and a greater risk of worse outcomes than anterior circulation aneurysms. Spontaneous healing of a VBDA is very rare, and there have been very few case reports of spontaneous healing of an aneurysm. We describe a case of intracranial vertebral artery dissecting aneurysm that healed spontaneously and disappeared completely on follow-up images. ⋯ This case illustrates the relatively plastic nature of a vertebral dissecting aneurysm, indicating that spontaneous healing remains possible.
-
Although thread embedding acupuncture (TEA) is widely used for facial nerve palsy (FNP) in Korea, it lacks clinical evidence. Therefore, a large-scale and long-term clinical trial is needed. It is necessary to standardize and optimize TEA treatment for clinical study. ⋯ The most frequent sequelae of FNP for which TEA was used as contracture around the mouth (75.3%). The most preferred treatment method was insertion of 6-10 monofilament threads using a 29-gauge needle at intervals of 2.2 ± 1.59 weeks in the sequelae period. The results of this survey can be used to standardize and optimize the procedure of TEA for FNP for further clinical research.
-
Meta Analysis
A meta-analysis of adjuvant EGFR-TKIs for patients with EGFR mutation of resected non-small cell lung cancer.
The role of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKIs) in improving the prognostic outcome of non-small cell lung cancer (NSCLC) cases harboring EGFR mutation following radical surgery is still controversial. This work focused on comparing EGFR-TKIs and adjuvant chemotherapy (ACT) or placebo in treating NSCLC cases, specifically on those with EGFR-mutant, being in the stage of IB-IIIA and possibly gained benefits from the above treatment after radical resection. ⋯ For NSCLC cases who had EGFR mutations and surgery, adjuvant EGFR-TKI combined with chemotherapy achieved superior effect over chemotherapy or placebo with reference to DFS and may prolong the OS up to some extent.