Medicine
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Comparative Study
Diffuse interstitial brain edema in patients with end-stage renal disease undergoing hemodialysis: a tract-based spatial statistics study.
To investigate white matter (WM) alterations and their correlation with cognition function in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) using diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS) approach. This prospective HIPAA-complaint study was approved by our institutional review board. Eighty HD ESRD patients and 80 sex- and age-matched healthy controls were included. ⋯ In some regions with lower FA, FA values showed moderate correlations with ages, NP tests, and serum urea levels. There was no correlation between FA values and HD durations, disease durations, and serum creatinine levels of ESRD patients (all P>0.05). Diffuse interstitial brain edema and moderate WM integrity disruption occurring in HD ESRD patients, which correlated with cognitive dysfunction, and serum urea levels might be a risk factor for these WM changes.
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Randomized Controlled Trial
Effect of blinding with a new pragmatic placebo needle: a randomized controlled crossover study.
Placebo control is a useful method for determining the efficacy of a therapy. In acupuncture researches, the preferred method for placebo control is acupuncture using a placebo needle that has a blunt tip and achieves no skin penetration. We performed a crossover study to validate the blinding effect of a new type of placebo needle. ⋯ The influences of age, sex, educational level, acupuncture experience, needle sensation, acupuncture pain, and needle acceptability on volunteers' perception of needle penetration were not significant. The pragmatic placebo needle is a valid control for acupuncture research. It produces a good subject blinding effect with a similar appearance to conventional acupuncture needles and no skin penetration when applied.
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Review Case Reports
Sudden death after endoscopic retrograde cholangiopancreatography (ERCP)--case report and literature review.
There are only a few cases found in literature regarding air embolism in endoscopic procedures, especially in connection to endoscopic retrograde cholangiopancreatography (ERCP). We are presenting a case of a 56-year-old female patient who suffered from non-Hodgkin lymphoma located in her right groin. She was also diagnosed with choledocholithiasis and underwent ERCP to remove the gallstones. ⋯ We reviewed literature in order to identify possible causes of death because fatal outcome following an uneventful and successful procedure was not expected. It is important to bear in mind all possible complications of ERCP. Our focus during the literature search was on air embolism.
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Randomized Controlled Trial
Effectiveness of ultrasound-guided carpal tunnel injection using in-plane ulnar approach: a prospective, randomized, single-blinded study.
The objective of this study is to evaluate the degree of symptom improvement and the change of electrophysiological and ultrasonographic findings after sonographically guided local steroid injection using an in-plane ulnar approach in carpal tunnel syndrome (CTS). Seventy-five cases of 44 patients diagnosed with CTS were included and evaluated at baseline and at 4 and 12 weeks after injection. All patients received injection with 40 mg of triamcinolone mixed with 1 mL of 1% lidocaine into the carpal tunnel using an in-plane Ultrasound (US)-guided ulnar approach, out-plane US-guided approach, and blind injection. ⋯ This improvement was still observed at 12 weeks. The flattening ratio and cross-sectional area of the median nerve showed a more significant decrease with the in-plane ulnar approach than with the out-plane ulnar approach and blind injection (P < 0.05). US-guided local steroid injection using an in-plane ulnar approach in the CTS may be more effective than out-plane or blind injection.
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Multicenter Study
Separate and joint effects of diabetes mellitus and chronic kidney disease on the risk of acute coronary syndrome: a population-based cohort study.
Patient with diabetes (DM) and chronic kidney disease (CKD) are at a higher risk of developing acute coronary syndrome (ACS). However, only a few studies have investigated the separate and joint effects of DM and CKD on the risk of ACS, especially population-based studies under age-, sex- and various cardiovascular risk factor-stratifications. By using a national diabetes cohort derived from the Taiwan National Health Insurance Research Database, we identified a total of 416,143 DM and 541,724 non-DM patients, including 51,208 DM/CKD and 8,894 non-DM/CKD patients, in 2000 who did not have a history of ACS (ICD-9: 410. ⋯ When all three selected risk factors were included, CKD was associated with a higher risk of ACS than DM (AHR: 1.43 [1.27-1.60] vs. 1.25 [1.22-1.29]). In conclusion, DM and CKD were associated with different levels of risk for ACS according to age, sex and certain cardiovascular risk factors. Strategies aimed at preventing ACS should therefore be individualized according to the presence of DM, CKD and various cardiovascular risk factors.