Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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Functional somatic symptoms (FSS), or medically unexplained physical symptoms, are common in children and it has been suggested that the incidence is increasing. To determine the incidence and pattern of referrals for FSS to pediatricians, we performed a retrospective analysis including newly referred pediatric patients to our secondary pediatric practice in Zwolle, The Netherlands, ultimately diagnosed with FSS between 2013 and 2018. FSS was defined as functional abdominal pain, chronic fatigue, chronic musculoskeletal pain and chronic headache without an underlying medical diagnosis. ⋯ We found clear seasonal variation with peaks in incidences in March (+31%) and November (+21%) and a nadir around August (-48%). In conclusion, FSS account for 1 in 10 non-acute pediatric referrals, without an increase in incidence in the past 6 years. The seasonal pattern is remarkable and warrants further analysis.
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Fibromyalgia is characterized by diffuse musculoskeletal pain and fatigue. There are limited data about systemic steroid treatment of patients with fibromyalgia in the English literature. Patients with fibromyalgia with ongoing diffuse musculoskeletal pain despite standard treatment, extreme fatigue and elevated C-reactive protein (CRP) levels without evidence of synovitis, or other source of inflammation, were asked to participate in our study. ⋯ Twenty-three patients were recruited and 21 completed the study. 19 patients were women with mean age of 42±10.12 and CRP level of 14.1±3.96 mg%, and all had negative rheumatoid factor and antinuclear antibodies. All patients had significant improvement in all of the FIQR parameters, at 1 and 4 weeks, except memory, anxiety and balance. It can be concluded that systemic intramuscular depot betamethasone injection seems to have a favorable effect in patients with fibromyalgia with elevated CRP levels for at least 4 weeks.
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To identify the autophagy-related long non-coding RNAs (ARlncRNAs) associated with the prognosis of kidney renal papillary cell carcinoma (KIRP), thereby establishing a clinical prognostic model. The gene expression matrix and clinical survival information of patients with KIRP were downloaded from The Cancer Genome Atlas database, and were divided into the training and testing groups. ARlncRNAs associated with the KIRP prognosis were analyzed by univariate, Least Absolute Shrinkage and Selection Operator (LASSO(, and multivariate Cox regression to construct a signature. ⋯ The area under the receiver operating characteristic curve values of 1-year, 3-year, and 5-year overall survival were 0.80, 0.78, and 0.84 in the training group, respectively. The signature had high concordance index and good accuracy in predicting the prognosis, which were confirmed by the nomogram. The prognosis-related ARlncRNAs signature we identified had a more accurate prediction for the prognosis of patients with KIRP.
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Coagulopathy, cytokine release, platelet hyperactivity and endothelial activation are regarded as potential major contributors to COVID-19 morbidity. Complement activation might provide a bridge linking these factors in severe COVID-19 illness. In this study, we investigated the prognostic significance of selected complement factors in hospitalized patients with severe COVID-19 infection. ⋯ On the other hand, it was shown that survivors had significantly lower C3a (median (IQR): 203.0 (170.3-244.0) ng/mL vs 385.0 (293.0-424.8) ng/mL, p<0.001) and sC5b-9 (median (IQR): 294.0 (242.0-318.8) ng/mL vs 393.0 (342.0-436.5) ng/mL, p<0.001) levels when compared with non-survivors. Multivariate logistic regression analysis identified C3a (OR: 0.97 (95% CI 0.96 to 0.99), p<0.001) and C4 (OR: 0.92 (95% CI 0.86 to 0.98), p=0.011) levels as significant predictors of mortality. In conclusion, serum levels of complement factors are related to mortality in severely ill patients with COVID-19.
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The aim was to descriptively analyze the clinical characteristics, cytopathology, and outcomes of pregnant patients with high-risk human papillomavirus (HPV) infection. Clinical data of 151,516 female patients with high-risk HPV infection were retrospectively collected. Baseline data, cervical cytology results, histopathology, HPV types, delivery mode, and follow-up outcomes were recorded for descriptive analysis. ⋯ However, therapeutic methods were statistically different among patients with different cytopathological types (p<0.05). Cervical alterations in pregnancy mostly go along with high-risk HPV infection. High-risk HPV infection in pregnancy with abnormal cervical cytology should be followed closely during the pregnancy and postpartum period.