J Formos Med Assoc
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Observational Study
Urban-rural differences in outcomes and management of vertebral fractures: A real-world observational study.
A fracture liaison services (FLSs) and its modified services reduce refractures and mortality and can be cost-effective. Limited studies have addressed whether urban-rural differences exist in vertebral fracture outcomes and management. Therefore, the aims of the study were to investigate any urban-rural differences in refracture, mortality, prescription pattern, and associated factors of vertebral fractures after receiving assistance from an FLSs. ⋯ Our multicomponent services have similar effectiveness in osteoporosis treatment between urban and rural areas. The overall adherence rate was lower in the rural group with higher mortality but no difference in the refracture rate in one year.
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Observational Study
Effects of transjugular intrahepatic portosystemic shunt on abdominal muscle mass in patients with decompensated cirrhosis.
Sarcopenia is a common finding in patients with decompensated cirrhosis without effective therapy. We aimed to examine whether a transjugular portosystemic shunt (TIPS) could improve the abdominal muscle mass assessed by cross-sectional images in patients with decompensated cirrhosis and to investigate the association of imaging-defined sarcopenia with the prognosis of such patients. ⋯ PM mass in patients with decompensated cirrhosis may increase by 6 or 12 months after TIPS placement and imply a better prognosis. Patients with preoperative PM-defined sarcopenia may suggest poorer survival.
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Targeted temperature management (TTM) has been recommended for post-resuscitation care of cardiac arrest (CA) patients who remain comatose. However, the differences between cardiogenic and non-cardiogenic causes need further investigation. Thus, this study aimed to investigate the difference in outcomes between cardiogenic and non-cardiogenic CA patients receiving TTM. ⋯ Patients with cardiogenic CA post TTM had better survival and neurologic performance at discharge than those without cardiogenic CA. Cardiogenic etiology was a potential predictor of better cardiac arrest survival, but it was not an independent risk factor for overall outcome after adjusting for potential covariates. In the cardiogenic group, better outcomes were reported in patients with witnessed collapse, bystander cardiopulmonary resuscitation, as well as those receiving coronary intervention.
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Among the histologic types of lung cancer, adenocarcinoma is the most common. Moreover, lung adenocarcinoma with neuroendocrine differentiation (LANED) is a rare histologic character. So far, the clinical significance remains unclear. ⋯ LANED might be associated with a high proportion of RET expression, whereas EGFR mutation, ALK alteration, and PD-L1 expression were uncommon. Further large-scale prospective studies on molecular testing profile and clinical significance of LANED are warranted.
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Cardiovascular complications after Pfizer-BioNTech COVID-19 (BNT) vaccination are a concern, especially in adolescents. We analyzed the risk factors for myocarditis after BNT vaccination. ⋯ Pericarditis or myocarditis was diagnosed in 7.2% of adolescents presenting to the emergency department with cardiovascular symptoms after BNT vaccination. In addition to the troponin T level, ECG change listed above can be used as a screening tool for vaccine-induced cardiac complications.