Medicine
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Disparities in quality of care have always been a major challenge in health care. Providing information to patients may help to narrow such disparities. However, the relationship between level of patient information and outcomes remains to be explored. ⋯ Medical personnel did have a significantly better survival outcome and a shorter length of stay following definitive surgery than nonmedical personnel patients. The outcome disparities can be partially explained by characteristics of their treatment providers. The findings may serve as an important reference for better understanding how information may narrow gaps in quality of care through better choice of providers.
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Hemophagocytic syndrome (HPS) is a potentially life-threatening complication of systemic inflammatory disorders. Adult-onset Still disease (AOSD) is one of the systemic autoimmune diseases associated with reactive hemophagocytic syndrome (RHS). This study aimed to evaluate the characteristic findings, predictive factors, and prognosis of RHS in patients with AOSD. ⋯ RHS can be considered when an AOSD patient shows at least 2 of the following 3 findings: low platelet count, anemia, and hepatomegaly. Diagnostic confirmation by biopsy may not be essential if typical clinical findings of RHS are present. Moreover, prognosis of RHS was better than that of HLH diagnosed by the presence of trilineage cytopenia at admission.
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Portal vein (PV) occlusion after liver transplant is an uncommon clinical situation, and percutaneous interventional treatment for this condition has not been widely described. The aim of this study was to evaluate the long-term treatment effect of interventional treatment for PV occlusion after liver transplantation (LT). Follow-up data of 13 patients who received interventional treatment for PV occlusion after LT between July 2007 and April 2013 were analyzed. ⋯ No portal hypertension-related symptoms reoccurred during follow-up. In conclusion, interventional treatment for PV occlusion after LT showed a high success rate and good long-term results. Comprehensive interventional treatment should be used for extensive PV occlusion.
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Bisphenol A (BPA), a carbon-based synthetic compound, exhibits hormone-like properties and is present ubiquitously in the environment and in human tissues due to its widespread use and biological accumulation. BPA can mimic estrogen to interact with estrogen receptors α and β, leading to changes in cell proliferation, apoptosis, or migration and thereby, contributing to cancer development and progression. ⋯ Moreover, BPA may also interact with other steroid receptors (such as androgen receptor) and plays a role in prostate cancer development. This review summarizes the current literature regarding human exposure to BPA, the endocrine-disrupting effects of BPA, and the role of BPA in hormone-associated cancers of the breast, ovary, and prostate.
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Randomized Controlled Trial Multicenter Study
Prior to the oral therapy, what do we know about HCV-4 in Egypt: a randomized survey of prevalence and risks using data mining computed analysis.
Hepatitis C virus (HCV) affects over 180 million people worldwide and it's the leading cause of chronic liver diseases and hepatocellular carcinoma. HCV is classified into seven major genotypes and a series of subtypes. In general, HCV genotype 4 (HCV-4) is common in the Middle East and Africa, where it is responsible for more than 80% of HCV infections. ⋯ This study emphasizes the high prevalence of HCV infection among Egyptian population, in particular among males. Egyptians with HCV-4 infection are at a higher risk to develop cirrhotic liver and esophageal varices. Data mining, a new analytic technique in medical field, shed light in this study on the clinical importance of esophageal wall thickness as a useful predictor for risky esophageal varices using decision tree algorithm.