J Formos Med Assoc
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To investigate the association of skeletal muscle mass and quality with survival outcomes in patients with advanced hepatocellular carcinoma (HCC) treated with lenvatinib (LEN). ⋯ LSMM and myosteatosis are independent prognostic factors for PFS and OS in advanced patients with HCC who received LEN and may exert synergistic effects on these survival outcomes.
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Shortened door-to-balloon time (D2B) has been documented to confer cardiovascular benefits for ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). However, prolonged myocardial ischemic duration usually negates the beneficial effects due to delayed symptom-to-door time (S2D). In this study, we sought to investigate the joint effect of S2D-D2B in predicting clinical outcomes. ⋯ The reductions of both D2B and S2D were associated with improved mortality rates in STEMI patients receiving PPCI, especially in younger populations. The findings call for community and healthcare system efforts to address these critical time intervals to enhance survival rates in STEMI patients.
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The competency-based Internal Medicine Milestones (IMM) assesses physician training outcomes through six key competencies. This pilot study introduced IMM concepts through an echocardiography report interpretation course for postgraduate students (PGYs) and residents (Rs). We aimed to help young physicians understand and track competency development as they receive cardiovascular training, with a view to expanding IMM usage for all junior physicians. ⋯ The significant post-course scores improvements indicate that the course was taught effectively and the test questions were well-formulated. Course participants showed improvements in IMM scores as they continued clinical training. Our results offer a reference for future curriculum design and competency development for junior physicians in internal medicine.
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Ethanol ablation (EA) has been proposed as a first-line treatment modality for recurrent symptomatic cystic thyroid nodules following initial aspiration. The efficacy of EA can be compromised when the initial nodule volume exceeds 10 mL. This study assessed the efficacy of single-session EA in managing thyroid cysts with an initial volume of ≥10 mL. ⋯ Single-session EA effectively reduces volume and improves symptoms and cosmetic outcomes for cystic thyroid nodules ≥10 mL, though larger, solid, and vascular nodules may require tailored treatment strategies.