Irish journal of medical science
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Metformin reduces incidences of miscarriage and preterm delivery in polycystic ovary syndrome (PCOS) women, but its impact on gestational diabetes mellitus (GDM) is conflicting. Hence, this study set up selection criteria to include previously infertile women with PCOS but without pre-existing DM who became pregnant, aiming to minimize confounders and investigate the influence of metformin on GDM, miscarriage, and preterm delivery. ⋯ Metformin administration during pregnancy may reduce GDM, miscarriage, and preterm delivery risks without adverse effects on fetal outcomes in previously infertile women with PCOS.
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Multiple myeloma (MM) is defined by the excessive growth of cancerous plasma cells in the bone marrow, resulting in the production of an abnormal monoclonal paraprotein and signs of damage to vital organs. The diagnosis of multiple myeloma can be complex. This paper centers on the diagnosis of MM and examines the role of the gamma gap (GG) in prompting tests to assess treatment effectiveness. ⋯ The evaluation of GG in the serum of MM patients demonstrated elevated levels, which were significantly associated with patients post-treatment. Therefore, our findings have significant implications for the use of GG as a prognostic indicator for monitoring treatment response in MM patients.
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Male urethral stricture affects 100 in 100,000 men. These are investigated using uroflowmetry, retrograde urethrography and cystourethroscopy. Management is usually endoscopic with urethral dilation or direct visual internal urethrotomy, although they have high failure rates. It is now recommended that urethroplasty is performed earlier. In this study we have reviewed a single surgeons experience with urethroplasty and patient outcomes. ⋯ The most popular techniques for urethroplasty in the UK are augmentation urethroplasty using a buccal mucosal graft and anastomotic urethroplasty, both of which we describe. There are variations in what is deemed as successful surgery. The most widely used definition is 'the lack of need for any further operative intervention'. We have recently adopted Patient Reported Outcome Measures using a validated questionnaire to measure the patients perception of a successful outcome. Complex strictures have a higher incidence of complications. 42% of our cohort were complex and we describe results comparable to the published literature.
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People with metabolic syndrome (MetS) are at a higher risk of coronary artery disease, diabetes mellitus, stroke, osteoarthritis, and some types of cancers. Finding markers which are available and inexpensive are most useful for the prediction of MetS. The present study aimed to determine the relationship between atherogenic index and anthropometric indicators and the 10-year risk of MetS. ⋯ The results of this longitudinal study showed that increasing AC and AIP could enhance the risk of MetS. The present study also indicated that AC and AIP are useful predictors in the clinical setting for identifying individuals with MetS in the Iranian adult population.
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Review Meta Analysis
Risk of locoregional recurrence after breast cancer surgery by molecular subtype-a systematic review and network meta-analysis.
The prevention of locoregional recurrence (LRR) is crucial in breast cancer, as it translates directly into reduced breast cancer-related death. Breast cancer is subclassified into distinct intrinsic biological subtypes with varying clinical outcomes. ⋯ TNBC and HER2 subtypes are associated with the highest risk of LRR. Multidisciplinary team discussions should consider these findings to optimize locoregional control following breast cancer surgery.