Medicine
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Meta Analysis
Clinical efficacy of botulinum toxin type A in the treatment of fasciitis pain: A systematic review and meta-analysis.
The purpose of this meta-analysis was to assess the effectiveness of botulinum toxin type A (BoNT-A) in reducing pain associated with fasciitis. By synthesizing the findings from multiple studies, we aimed to provide a comprehensive evaluation of the current evidence regarding the efficacy of BoNT-A in the treatment of fasciitis pain. ⋯ BoNT-A has a significant analgesic effect on fasciitis pain. Therefore, BoNT-A presents a promising alternative treatment option for fasciitis (PROSPERO 2022: CRD42022382805).
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Review Case Reports
Antenatal diagnosis and management of pregnancy luteoma: A case report and literature review.
Pregnancy luoteomas are tumor-like ovarian lesions that emerge during pregnancy and spontaneously regress after delivery. Antenatal diagnosis is infrequently reported, and unnecessary surgery appears to be common in literature reports. ⋯ Prenatal diagnosis of pregnancy luteoma poses a challenge, requiring hormonal examinations, ultrasound, magnetic resonance imaging, and gastrointestinal endoscopy for identification. Caution must be exercised to avoid overtreatment. While additional cases are needed to summarize the imaging features and effects of excess hormones on the both mother and fetus, further research is necessary for a comprehensive understanding.
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Previous studies have suggested a correlation between low preoperative hemoglobin (Hb) levels and postoperative pneumonia (POP) in elderly patients with hip fractures. However, the exact inflection point of Hb level that increases the risk of POP remains unclear. This study aimed to investigate the quantitative relationship between preoperative Hb levels and the incidence of POP in this patient population. ⋯ On the left side of the inflection point, Hb levels were negatively correlated with the incidence of POP (OR: 0.91, 95% CI: 0.86-0.97, P = .0030). There was a nonlinear relationship between preoperative Hb level and POP in elderly patients with hip fractures. When Hb levels were lower than 83.5 g/L, preoperative Hb levels were negatively correlated with POP.
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Approved direct-acting antiviral (DAA) regimens against hepatitis C virus (HCV) can cure nearly all patients; however, socioeconomic disparities may impact access and outcome. This study assesses socioeconomic factors, differences in insurance coverage and the drug prior authorization process in HCV-infected patients managed in community practices partnered with a dedicated pharmacy team with expertise in liver disease. This Institutional Review Board-approved, ongoing study captures data on a cohort of 2480 patients from community practices. ⋯ DAA therapy resulted in cure in 95.3% of patients (sustained virologic response = 94.8% HW, 94.0% BAA, 96.5% NHW). Despite having more advanced diseases and more negative socioeconomic factors, >94% of HW and BAA patients were cured. Continued patient education and communication with the healthcare team can lead to high adherence and > 94% HCV cure rates regardless of race/ethnicity or underlying socioeconomic factors in the community setting.
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CT-based flow reserve fraction (CT-FFR) and CT perfusion (CTP), as a complement to coronary computed tomographic angiography (CCTA) have been revealed to be associated with the prognosis of patients with obstructive coronary artery disease (CAD). However, the prognostic value of coronary stenosis combined with CT-FFR and resting-state CTP based on CCTA for major adverse cardiac events (MACE) is not known and requires further investigation. Fifty-two patients with obstructive CAD (50%-90% stenosis) examined by CCTA were retrospectively collected and followed-up for the occurrence of MACE. ⋯ Logistic regression analysis showed that coronary artery stenosis ≥ 70%, CT-FFR ≤ 0.80, and perfusion index (PI) were independent predictors for MACE in patients with obstructive CAD (P < .05). The model based on coronary stenosis combined with PI and CT-FFR (AUC = 0.944) was better than those based on the degree of coronary stenosis combined with PI (AUC = 0.874), coronary stenosis degree combined with CT-FFR (AUC = 0.895), and any single index (P < .05). The combined model established by coronary stenosis, CT-FFR, and resting-state CTP based on a "1-stop" CCTA examination for predicting MACE among patients with obstructive CAD has good diagnostic efficacy and shows incremental discriminatory power.