Medicine
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Simple tools, such as antigen test kits, are readily available for determining coronavirus disease 2019 infection at hospitals and homes. However, it is challenging for elderly people who are prone to dry mouth and other diseases. The main objective of this study was to investigate whether the presence or consumption of a plum pickle can facilitate salivation during coronavirus disease 2019 testing. ⋯ The strength of 3 factors, namely: direct stimulation with citric acid, saliva buffer capacity, and motor learning, may have affected the results. Our study suggests that saliva collection using the plum pickle is an effective complementary method for facilitating salivation. This technique may be useful in avoiding the risk associated with citric acid intake and for efficient specimen collection during coronavirus disease 2019 testing. In the future, we need to verify this method in elderly participants in a clinical setting.
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The Developmental Origins of Health and Disease theory suggests that early-life malnutrition is associated with an increased risk of chronic disease in adulthood. In this study, we aimed to analyze the association between exposure to the Chinese famine during fetal, childhood, and adolescence, while also exploring potential gender disparities in this association. From August 2018 to 2022 December, a 3-stage stratified random sampling method was employed to recruit 6916 eligible participants in Chongqing for this study. ⋯ There was an increased risk of dyslipidemia among females exposed to the Chinese famine during the fetal (odds ratio [OR] = 1.613, 95% confidence interval [CI]: 1.179-2.205), childhood (OR = 1.857, 95% CI: 1.384-2.491), adolescence (OR = 1.531, 95% CI: 1.137-2.060) stage, However, no significant association was observed in male adults. Exposure to the Chinese famine during fetal, childhood, and adolescence stages increases the risk of dyslipidemia in adulthood in females, but not in males. The observed gender differences may be attributed to mortality advantage and son preference in China.
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To investigate the effect of different DAPTs in patients with ACS undergoing PCI, and to identify the most efficient DAPT to reduce the risk of ischemia and bleeding after PCI. Between March 2017 and December 2021, 1598 patients with ACS who underwent PCI were included in the study. The DAPT protocol included the clopidogrel group (aspirin 100 mg + clopidogrel 75 mg), ticagrelor group (aspirin 100 mg + ticagrelor 90 mg), de-escalation Group 1 (reduced dose of ticagrelor [from 90 mg to 60 mg]) after 3 months of oral DAPT [aspirin 100 mg + ticagrelor 90 mg]), and de-escalation Group 2 (switched from ticagrelor to clopidogrel after 3 months of oral DAPT [aspirin 100 mg + ticagrelor 90 mg]). ⋯ Ticagrelor group regimen (HR 1.606; 95% CI: 1.179-2.187; P = .003) were associated with a higher risk of minor bleeding events. For patients with ACS underwent PCI, there were no significant difference in the incidence of NACEs between 3 and 12 months after PCI between de-escalation and non-de-escalation therapies. Compared with ticagrelor-based 12-month DAPT, there was no significant difference in MACCEs and bleeding events in patients receiving de-escalation treatment (ticagrelor reduction from 90 to 60 mg, 3 months after PCI).
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Although Transartial chemoembolization (TACE) is one of the recommended treatments for hepatocellular carcinoma (HCC), there is always a dispute on the selection of the best beneficiary for treatment. We studied the prognostic value of nutritional markers, obesity, visceral obesity and sarcopenia on survival outcomes under single and different combinations. In a retrospective cohort of 235 patients with HCC at different stages, more accurate comprehensive prognostic factors were obtained by combining and comparing the multifactor hazard ratios (HR) of various parameters, including skeletal muscle index (SMI) and visceral fat index (VFI) obtained by computer tomography, laboratory index albumin-to-globulin (A/G) ratio, anthropometric body mass index (BMI) and other parameters. ⋯ According to the survival outcome of HCC patients, we obtained the ideal sex cutoff value of VFI: ≥40.54 cm 2 /m 2 for males (the receiver operating characteristic curve [ROC] = 0.764, P < .001) and ≥ 43.19 cm 2 /m 2 for females (ROC = 0.718, P < .05). According to the results of multifactor analysis, sarcopenic visceral obesity (HR = 8.35, 95% confidence intervals [CI] = [4.96, 14.05], P < .001) is more effective than any single or combined prognosis assessment, including sarcopenic dystrophy (HR = 2.70, 95% CI = [1.85, 3.95], P < .001), sarcopenic obesity (HR = 5.23, 95% CI = [3.41, 8.02], P < .001), sarcopenia (HR = 5.74, 95% CI = [3.61, 9.11], P < .001) and visceral obesity (HR = 3.44, 95% CI = [2.24, 5.27], P < .001). Sarcopenic visceral obesity, defined by SMI and VFI, is a more objective and accurate prognostic indicator of HCC.
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Observational Study
Long-term effects of integrated cognitive behavioral therapy for chronic pain: A qualitative and quantitative study.
Cognitive behavioral therapy (CBT) is known to improve chronic pain management. However, past studies revealed only small to moderate benefits in short-term results, and long-term follow-up studies are lacking. This study aimed to follow an integrated CBT program's effectiveness 1.5 years after its completion. ⋯ From post-treatment to follow-up, all scores showed no significant changes ( P > .1). In the qualitative study, the analysis revealed 3 subthemes: "Autonomy," "Understanding of yourself and pain," and "Acceptance of pain." Our study suggests that integrated CBT may reduce the scores of PCS, PDAS and BDI, and this effect lasts for at least 1 year. Identified themes support the relevance of mitigative factors in managing chronic pain.