Medicine
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Multicenter Study Observational Study
Use of Traditional and Complementary Medicine as Self-Care Strategies in Community Health Centers: Cross-Sectional Study in Urban Pearl River Delta Region of China.
In China, Community Health Centers (CHCs) are major providers of primary care services, but their potential in empowering patients' self-management capacity has not been assessed. This study aims to describe self-care practice patterns amongst CHC attendees in urban China. In this cross-sectional quantitative study, 3360 CHC patients from 6 cities within the Pearl Delta Region were sampled using multistage cluster sampling. ⋯ These results suggest that CHCs should start initiatives in fostering appropriate use of OTC CHM, vitamins, and minerals. Engaging community pharmacists in guiding safe and effective use of OTC CHM amongst the uninsured is essential given their low accessibility to CHC services. Prescription of Taiji instead of physical exercises to women and older people could be more culturally appropriate, and the possibility of including this as part of the CHC services worth further exploration.
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Multicenter Study Observational Study
Dietary patterns and colorectal cancer risk in a Korean population: A case-control study.
Colorectal cancer (CRC) has been recognized as one of the major malignancies in Korea. Analyses of dietary patterns can provide insight into the complex interactions of foods, nutrients, and biologically active components within a diet, which vary among populations. We aimed to investigate the associations between dietary patterns and colorectal cancer risk in Koreans. ⋯ A decrease in CRC risk among those with the highest intake of the prudent pattern was observed in all anatomical subsites in both men [OR = 0.36 (0.19-0.68) for proximal colon; 0.21 (0.12-0.36) for distal colon; 0.28 (0.18-0.44) for rectum] and women [OR = 0.28 (0.11-0.71); 0.27 (0.13-0.54); 0.45 (0.25-0.83)]. Our results indicate that individuals who prefer the Westernized dietary pattern should be made aware of their increased CRC risk. The traditional dietary pattern and the prudent pattern, which are rich in fruits and dairy products, are recommended for the Korean population to prevent CRC.
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Randomized Controlled Trial
A 2-week Nitazoxanide-based quadruple treatment as a rescue therapy for Helicobacter pylori eradication: A single center experience.
As there are increasing reports of fluoroquinolone resistance on use as a first- or second-line treatment for Helicobacter pylori (H pylori), we aimed at evaluation of the efficacy and safety of nitazoxanide-based regimen as a rescue regimen in Egyptian patients whose previous traditional treatment for H pylori infection failed. In total, 100 patients from the outpatient clinic of the Tropical medicine department, Tanta University hospital in whom the standard triple therapy (clarithromycin-based triple therapy) failed were enrolled in the study. Nitazoxanide (500 mg bid), levofloxacin (500 mg once daily), omeprazole (40 mg bid), and doxycyclin (100 mg twice daily) were prescribed for 14 days. ⋯ However, 83 patients had successful eradication of H pylori with total eradication rates 83% (95 % CI 75.7-90.3%) and 88.30% (95 % CI 81.8-94.8%) according to an intention-to-treat and per-protocol analysis, respectively. Adverse events were reported in 21% of patients: abdominal pain (6%), nausea (9%) and constipation (12%), (2%) headache, and (1%) dizziness. A 2-week nitazoxanide-based regimen is an effective and safe rescue therapy in Egyptian patients whose previous standard triple therapy has failed.
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Multicenter Study
Mastocytosis among elderly patients: A multicenter retrospective French study on 53 patients.
Mastocytosis is a heterogeneous group of diseases with a young median age at diagnosis. Usually indolent and self-limited in childhood, the disease can exhibit aggressive progression in mid-adulthood. Our objectives were to describe the characteristics of the disease when diagnosed among elderly patients, for which rare data are available. ⋯ Additional sequencing detected significant genetic defects in 17 of 26 (65.3%) of the patients with associated hematological non-mast cell disease, including TET2, SRSF2, IDH2, and ASLX1 mutations. Death occurred in 19 (35.8%) patients, within a median delay of 9 months, despite the different treatment options available. Mastocytosis among elderly patients has a challenging early detection, rare skin involvement, and/or limited skin disease; it is heterogeneous and has often an aggressive presentation with nonfortuitous associated myeloid lineage malignant clones, and thus a poor overall prognosis.
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The relationship between dilated blood vessels in the tumor periphery and the tumor invasion depth is unclear. Therefore, the present study aimed to clarify the relationship between dilated blood vessels and the invasion depth of small-sized (<30 mm) colorectal cancer (CRC), and its implications on endoscopic treatment. We performed a single-arm observational study of the diagnostic accuracy of the existence of dilated vessels in the tumor periphery of CRC lesions as an indicator of submucosal deep (SM-d, ≥1000 μm) carcinomas. ⋯ When the dilated vessels were used as an indicator of SM-d or deeper invasion in depressed lesions, the sensitivity was 95.6%, specificity was 66.7%, and accuracy was 90.2%. No correlation was observed between the existence of dilated vessels and the lesion site, lesion diameter, and lymphovascular invasion/poorly differentiated cluster. The existence of dilated blood vessels in the tumor periphery suggests SM-d or deeper invasion in depressed lesions.