Medicine
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Review Meta Analysis
Steroid Injection and Nonsteroidal Anti-inflammatory Agents for Shoulder Pain: A PRISMA Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Advantages and possible risks associated with steroid injection compared with nonsteroidal anti-inflammatory drugs (NSAIDs) for shoulder pain are not fully understood. To compare the efficiency and safety of steroid injection versus NSAIDs for patients with shoulder pain. PubMed, Embase, and the Cochrane Library were searched through July 2015. ⋯ Steroid injection, compared with oral NSAIDs, provides slightly more improvement in shoulder function without superiority in pain relief or risk of complications at 4 to 6 weeks. Treatment decision should be made based on diseases. NSAIDs injection might be a treatment method for shoulder pain.
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Observational Study
Does African American Race Impact Statin Efficacy in Renal Transplant Outcomes?
There is a lack of studies assessing if race impacts the efficacy of 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMGCR) inhibitor ("statin") therapy on renal transplantation (RTx) outcomes. We examined the association between statin therapy and RTx outcomes, while concurrently quantifying the effect modification African American (AA) race has on statin efficacy. This was a retrospective longitudinal cohort study of solitary adult RTx (n = 1176) between June 2005 and May 2013. ⋯ After stratifying by race, high statin use reduced the risk of death in AAs (HR 0.43, 95% CI 0.20-0.94), but not in non-AAs (HR 1.09, 95% CI 0.49-2.44). High statin use reduces the risk of graft loss in RTx, with a mortality benefit in AAs compared to non-AA, despite similar LDL levels. These results suggest a compelling reason to optimize statin therapy in renal transplant recipients (RTR), especially in AAs.
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Case Reports
Bochdalek Hernia With Gastric Volvulus in an Adult: Common Symptoms for an Original Diagnosis.
Bochdalek hernias in adulthood are rare. Symptomatic Bochdalek hernias in adults are rarer, but may lead to fatal complications. Patients with acute gastric volvulus on diaphragmatic hernia are a diagnostic and therapeutic emergency. ⋯ The patient recovered with accepted general condition and was discharged 9 days later. Diagnoses of Bochdalek hernias in adulthood are challenging. However, although rare, this possibility should be kept in mind to avoid fatal complications.
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The en-bloc resection of neoplasms on the abdominal wall often causes extensive defects that are difficult to manage. The anterolateral thigh (ALT) flap is a widely used flap in reconstructive surgery of defects. ⋯ We conclude that the bilateral pedicle anterolateral thigh flap is a good choice for reconstruction of large lower abdominal wall defects. It can afford sufficient soft tissue coverage without obvious donor site morbidity.
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The aim of the study was to investigate the safety and efficacy of using MLT in the treatment of open-angle glaucoma (OAG). This prospective cohort included subjects ≥18 years of age with OAG, defined as the open angle on gonioscopy with glaucomatous optic neuropathy evident from optical coherence tomography. Subjects with IOP < 21 mm Hg were classified as normal tension glaucoma and those with IOP ≥21 mm Hg were classified as primary open-angle glaucoma. ⋯ The MLT success rate was 72.9%. During the first 6 months only 2.1% required a repeated laser trabeculoplasty. MLT was effective in reducing IOP and medications in OAG with minimal postlaser inflammation and low failure rate at 6 months following laser.