Medicine
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Randomized Controlled Trial
Efficacy of repetitive transcranial magnetic stimulation combined with peripheral magnetic stimulation on movement symptom and exploration of the optimal population in Parkinson's disease: A randomized controlled trial.
This study explores the efficacy of repetitive transcranial magnetic stimulation (rTMS) and rTMS combined with repetitive peripheral magnetic stimulation (rPMS) (hereinafter referred to as rTMS + rPMS) on motor symptoms and quality of life in Parkinson's disease (PD), and explores whether there are differences between the two treatment methods; At the same time, analyze data from different subgroups to explore the influencing factors, in order to find the most suitable treatment group. ⋯ Both rTMS and rTMS + rPMS can improve movement symptoms and quality of life in patients with PD. rTMS + rPMS was more beneficial for improving the overall motor function. Patients with rigidity-based type as the main type may be the most suitable for these two treatment methods. The therapies work in all age groups, all gender and irrespective of the disease stage with varying levodopa equivalent daily doses as well.
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Observational Study
Risk factors of acute urinary retention after spine surgery.
Acute postoperative urinary retention (APOUR) is 1 of the most common complications of spinal surgery, impacting both postoperative care and the patients' quality of life. This study is designed to investigate the risk factors and the incidence of APOUR after spinal surgery in Taiwan. We conducted a retrospective analysis using the Taiwanese National Health Insurance Research Database (NHIRD), a nationwide cohort of patients who underwent spinal surgery from the year 2000 to 2013. ⋯ Multivariate logistic regression analysis revealed that age (adjusted odds ratio [OR] = 1.02, 95% CI = 1.01-1.02), male gender (adjusted OR = 1.35, 95% CI = 1.10-1.60) and undergoing spinal surgery more than 2 times (adjusted OR = 4.78, 95% CI = 2.49-9.20) were statistically significant risk factors for APOUR after spinal surgery. The results of this retrospective cohort study suggest that patients undergoing spinal surgery more than 2 times, male gender and advanced age are significantly associated with an increased risk of APOUR after spinal surgery. This information may assist surgeons to identify patients who have a high risk of APOUR after spinal surgery and proactively provide them with early intervention.
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We reported a rare case of recurrent cerebral infarction, intracerebral hemorrhage, and purulent meningitis, culminating in the diagnosis of a young patient with infective endocarditis who had been treated in 3 hospitals for a long course of illness for 8 months prior to diagnosis. It aims to enhance clinicians' understanding of the neurological complications caused by infective endocarditis. ⋯ Febrile patients should be aware of infective endocarditis, particularly if the fever is persistent of unknown origin or structural changes in the heart with neurologic lesions. Cardiogenic neurological diseases are relatively more severe, have a worse prognosis, and have a higher recurrence rate than primary neurological diseases, so early diagnosis and treatment are more urgently needed.
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Observational Study
Effects of genetic variants of organic cation transporters on metformin response in newly diagnosed patients with type 2 diabetes.
Type 2 diabetes mellitus (T2DM) is a chronic disease that affects millions of people worldwide. Metformin is the optimal initial therapy for patients with T2DM. Genetic factors play a vital role in metformin response, including variations in drug efficacy and potential side effects. ⋯ However, no statistically significant associations were observed for the other tested SNPs. Our study provides evidence of an association between STK11 (rs2301759) and response to metformin in Saudi patients with T2DM. The need for targeted studies on specific gene-drug associations is emphasized, and further studies with a larger population should be conducted.
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Case Reports
Fatal abdominal hemorrhage following surgery to remove a retroperitoneal MPNST associated with NF1: A case report.
Individuals diagnosed with neurofibromatosis type I (NF1) commonly present with neurofibromas, and a subset may progress to develop malignant peripheral nerve sheath tumors (MPNST) during their lifetime. Diagnosing and treating MPNST, typically linked to NF1, poses challenges for clinicians due to its histopathological complexity. ⋯ It is crucial to assess the potential for heterogeneous differentiation in MPNST during pathological diagnosis. In the treatment of MPNST with heterogeneous differentiation, particularly in cases with significant tumor bulk, surgeons must anticipate potential hemorrhagic complications and adopt a cautious approach to surgical intervention.