Medicine
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Accumulating data have shown that immune and inflammatory factors are involved in the pathogenesis of multiple sclerosis (MS), and loss of polyunsaturated fatty acids from plasma and blood cell membranes has also been reported in patients with MS, contributing to the variation of erythrocyte deformability. Therefore, the aim of this investigation was to assess the association between red blood cell distribution width (RDW) and MS. A total of 109 patients with MS and 130 healthy individuals were enrolled into the study, and MS patients receiving treatment of subcutaneous recombinant Rebif (IFN-β1a) were followed retrospectively. ⋯ RDW was associated independently with MS in logistic regression analysis (odds ratio = 7.007; 95% confidence interval [CI] 3.461-14.187; P < 0.001), and receiver-operating characteristics (ROC) analysis showed that a RDW measurement >13.11% evaluated MS with a sensitivity of 70.0% and a specificity of 84.7%, and the area under the ROC curve for RDW was calculated as 0.80 (95% CI 0.739-0.859, P < 0.001). The level of RDW was decreased in treatment responders with the reduction of EDSS score; a strong relationship was also observed in treatment responders between RDW and EDSS score (r = 0.733, P < 0.001), and covariance analysis indicated RDW values decreased significantly in treatment responders (P = 0.025). Our results suggest that elevated RDW values are associated with EDSS score in patients with MS, and the relationship is remarkably influenced by Rebif treatment; RDW may be a useful marker to estimate disability status and treatment effectiveness in patients with MS.
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Case Reports
Pancreatic Adenocarcinoma Treated With Irreversible Electroporation Case Report: First Experience and Outcome.
Irreversible electroporation (IRE) is a new nonthermal tumor ablation modality that induces apoptosis in the treated tissue without affecting collagen. Its use is particularly indicated for tumors involving major structures, such as encompassed or infiltrated vessels and/or ducts, which need to be preserved and hinder or preclude surgical resection. We report a 66-year-old male patient with locally advanced pancreatic adenocarcinoma, treated with IRE. ⋯ This procedure is more costly than other techniques and is not free of complications. The percutaneous transgastric access is feasible and without serious complications. In our case, complications were resolved and the patient presented a good short/medium-term outcome.
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The purpose of this population-based study was to determine the change of glucose metabolism in patients undergoing pancreaticoduodenectomy (PD). We conducted a nationwide cohort study using data from Taiwan's National Health Insurance Research Database collected between 2000 and 2010. Our sample included 861 subjects with type 2 diabetes mellitus (DM) and 3914 subjects without DM. ⋯ In the 3914 subjects without diabetes, the only statistically significant comorbidity contributing to pancreatogenic diabetes was chronic pancreatitis (odds ratio, 1.446; 95% CI, 1.146-1.823; P = 0.002). Subjects with comorbid chronic pancreatitis and use of insulin had lower rates of resolution of DM after PD. In subjects without diabetes, chronic pancreatitis contributed significantly to the development of pancreatogenic DM.
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Observational Study
Epidemiological and Clinicopathological Trends of Breast Cancer in Chinese Patients During 1993 to 2013: A Retrospective Study.
This study aimed to summarize the epidemiological and pathological trends of breast cancer in Chinese women. The clinical data of 4968 breast cancer patients treated at the Chinese PLA General Hospital from 1993 to 2013 were retrospectively reviewed. The mean ± standard deviation (SD) age was 47.4 ± 11.3 years before the year 2001, 49.2 ± 11.2 years during 2001 to 2010, and 50.6 ± 11.4 years after the year 2010, respectively (P < 0.001). ⋯ The proportion of DCIS/LCIS and stage I increased with time during the 20 years from 14.6% to 33.2%, whereas the proportion of stage III to IV decreased. The proportion of Luminal A-like subtype gradually reduced and Luminal B-like (HER2-negative) increased and developed to the predominant type. Older age and earlier stage at diagnosis, as well as the alternation of predominant molecular subtypes, have become the developed trends of breast cancer.
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Monopolar electrocautery is a fast and elegant cutting option. However, as it creates surgical smoke containing polycyclic aromatic hydrocarbons (PAHs), it may be hazardous to the health of the surgical team. Although new technologies, such as feedback mode (FM) and Teflon-coated blades (TBs), reduce tissue damage, their impact on surgical smoke creation has not yet been elucidated. ⋯ Furthermore, different modes revealed higher temperature variations with the use of SETB (P = 0.004) and TB (P = 0.005) during cutting, but not SSB (P = 0.789). We found that the use of both TBs and FM was associated with reduced amounts of surgical smoke created during cutting. Thus, the surgical team may benefit from the adoption of such new technologies, which could contribute to the primary prevention of smoke-related diseases.