Annals of medicine
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Clostridioides (formerly: Clostridium) difficile infection (CDI) is a major cause of diarrhoea for inpatients as well as outpatients. Usually, CDI is healthcare-associated but the number of community-acquired infections is increasing. CDI is generally associated with changes in the normal intestinal microbiota caused by administration of antibiotics. ⋯ Metronidazole should be used only in mild-to-moderate disease in younger patients who have no or only few risk factors for recurrence. In recurrent CDI, bezlotoxumab infusion (a monoclonal antibody against C. difficile toxin B) may be considered as an adjunctive therapeutic strategy in addition to the standard care provided to patients with several risk factors for recurrence. Faecal microbiota transplantation (FMT) should be offered to patients with frequently recurring CDI.
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Comparative Study
Outcomes of anatomical versus non-anatomical resection for hepatocellular carcinoma according to circulating tumour-cell status.
Background and aims: Hepatic resection is the first-line treatment for hepatocellular carcinoma (HCC). Whether to perform anatomical (AR) or non-anatomical resection (NAR) remains controversial. This retrospective study compares the outcomes according to the number and type of circulating tumour cells (CTCs). ⋯ For patients with a high CTC count, the balance between operative risk and prognostic benefit is more important than the resection method performed. Key messagesAnatomic resection may improve the survival of HCC patients, but only those with low CTC count and negative M- and E/M-CTC phenotypes. CTC analysis before surgery can be used to better guide the choice of resection method for HCC.
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Objective: We investigated lipid concentrations, particle sizes and antibodies binding to periodontal bacteria Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis and to malondialdehyde-acetaldehyde (MAA) modified low-density lipoprotein in immunoglobulin (Ig) class A, G and M among patients with newly diagnosed rheumatoid arthritis (RA) in a population-based cohort. Methods: Concentrations and sizes of lipoprotein particles analysed by proton nuclear magnetic resonance spectroscopy and antibody levels to MAA modified low-density lipoprotein were studied at baseline and after one-year of follow-up. Serum Ig A and G class antibodies to periodontal bacteria were determined at baseline. ⋯ Key messagesPatients with drug naive rheumatoid arthritis showed proatherogenic lipid profiles. Reversible changes in lipid profiles can be achieved as response to inflammation suppression. Active therapy aimed at remission is essential in all patients with rheumatoid arthritis.
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Epidemiologically, high-density lipoprotein (HDL) cholesterol levels have been inversely associated to cardiovascular (CV) events, although a Mendelian Randomisation Study had failed to establish a clear causal role. Numerous atheroprotective mechanisms have been attributed to HDL, the main being the ability to promote cholesterol efflux from arterial walls; anti-inflammatory effects related to HDL ligands such as S1P (sphingosine-1-phosphate), resolvins and others have been recently identified. Experimental studies and early clinical investigations have indicated the potential of HDL to slow progression or induce regression of atherosclerosis. ⋯ Key messagesHigh-density lipoproteins have as a major activity that of removing excess cholesterol from tissues (particularly arteries). Knowledge on the activity of high-density lipoproteins on health have however significantly widened. HDL-therapy may help to improve stent biocompatibility and to reduce peripheral arterial resistance in heart failure.
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Randomized Controlled Trial
Deep learning-based automatic blood pressure measurement: evaluation of the effect of deep breathing, talking and arm movement.
Objectives: It is clinically important to evaluate the performance of a newly developed blood pressure (BP) measurement method under different measurement conditions. This study aims to evaluate the performance of using deep learning-based method to measure BPs and BP change under non-resting conditions. Materials and methods: Forty healthy subjects were studied. ⋯ Key messagesAccurate and reliable blood pressure measurement is clinically important. We evaluated the performance of our developed deep learning-based blood pressure measurement method under resting and non-resting measurement conditions. The deep learning-based method could achieve accurate BP measurement under both resting and non-resting measurement conditions.