Postgraduate medicine
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Postgraduate medicine · May 2022
Is it all about age? Clinical characteristics of Kawasaki disease in the extremely young: PeRA research group experience.
In the evaluation of children with Kawasaki disease (KD), the age of onset is important and complications may occur if the distinctive features are not assessed accordingly. The objective of the study is to define the clinical and laboratory presentations and treatment outcomes of KD in infants ≤6 months of age compared to those >6 months multicentrically. ⋯ Since clinical presentations and laboratory features of KD may vary with age, and the frequency of atypical and incomplete presentations is high, awareness of KD in young children should be raised among pediatricians.
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Postgraduate medicine · May 2022
Noninvasive fibrosis tools in NAFLD: validation of APRI, BARD, FIB-4, NAFLD fibrosis score, and Hepamet fibrosis score in a Portuguese population.
The burden of nonalcoholic fatty liver disease (NAFLD) is increasing, with an estimated prevalence in Europe of 20-30%. Although most patients present with simple steatosis, some progress to advanced fibrosis, cirrhosis, and hepatocellular carcinoma. Definite diagnosis and staging require liver biopsy, which is not feasible given the high prevalence of NAFLD. As such, several noninvasive tools have been formulated. However, to date, none have been validated in the Portuguese population. The aim of this study was to determine the diagnostic accuracy of the aspartate aminotransferase to platelet ratio (APRI), the BMI, AST/ALT ratio and Diabetes (BARD), the FIB-4 Index (FIB-4), the Hepamet fibrosis score (HFS), and the NAFLD fibrosis score (NFS) in a Portuguese population. ⋯ APRI - aspartate aminotransferase to platelet ratio, ALT - alanine aminotransferase, AST - aspartate aminotransferase, BARD - BMI, AST/ALT ratio and Diabetes, BMI - body mass index, FIB-4 - FIB-4 index, HCC - hepatocellular carcinoma, HFS - Hepamet fibrosis score, HOMA-IR - homeostatic model assessment for insulin resistance, IQR - interquartile range, MAFLD - metabolic associated fatty liver disease, NAFLD - nonalcoholic fatty liver disease, NASH - nonalcoholic steatohepatitis, NFS - NAFLD fibrosis score, OMIC - genomics, transcriptomics, proteomics, and metabolomics, T2DM - type 2 diabetes mellitus.
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Postgraduate medicine · May 2022
Observational StudyClinical spectrum of immunoglobulin A vasculitis in children and determining the best timing of urine examination to predict renal involvement.
Immunoglobulin A (IgA) vasculitis (also known as Henoch-Schonlein purpura) is the most common small vessel vasculitis of childhood. The long-term prognosis depends on renal involvement. The aim of this study was to evaluate the risk factors associated with renal involvement in children with IgA vasculitis and to investigate the best timing of urine examination to predict the presence of renal involvement at the sixth month after the diagnosis. ⋯ This study has demonstrated that the optimal date to predict the presence of hematuria and/or proteinuria in the sixth month is the urine examination performed in the first month of the disease. Therefore, we think that patients with IgA vasculitis who show a presence of hematuria and/or proteinuria in the first-month urine examination should be followed more closely.
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Postgraduate medicine · May 2022
Adjuvant radiotherapy did not increase the risk of coronary heart disease in patients with non-metastatic breast cancer.
Adjuvant radiotherapy (RT) in patients with breast cancer can adversely cause the heart to receive some radiation doses, which may lead to cardiovascular diseases. The results of previous research regarding this issue are not consistent. Therefore, we conducted a nationwide population-based study in Taiwan to evaluate whether adjuvant RT for breast cancer patients increased the risk of developing coronary heart disease (CHD). ⋯ This large, nationwide cohort study suggests that adjuvant RT in patients with breast cancer did not increase the risk of CHD.
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Postgraduate medicine · Apr 2022
Observational StudyThe descending pain modulation system predicts short term efficacy of multimodal pain therapy - an observational prospective cohort study.
Treating chronic pain patients with multimodal pain therapy (MMPT) alters perception, awareness, and processing of pain at multiple therapeutic levels. Several clinical observations suggest that the effects of therapy may go beyond the possible sum of each level of therapy and may be due to a central descending inhibitory effect measurable by conditioned pain modulation (CPM). Thus, we investigated whether CPM is able to identify a group of patients that benefit particularly from MMPT. ⋯ In conclusion, this study shows that while a heterogeneous group of patients with chronic pain disorders does sustainably benefit from MMPT in general, patients with a sufficient CPM effect do show a more pronounced decrease in pain ratings directly after therapy in comparison to those without.