Medicine
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Review Meta Analysis
Meta-analysis of studies using metformin as a reducer for liver cancer risk in diabetic patients.
Metformin has garnered more interest as a chemo-preventive agent given the increased liver cancer risk in diabetic patients. This work was undertaken to better understand the effect of metformin use on liver cancer risk in diabetic patients. A comprehensive literature search was performed in PubMed, Embase, BIOSIS Previews, Web of Science, and Cochrane Library through July 30, 2016. ⋯ After adjusting for hepatitis B/C virus infection, cirrhosis, obesity, behavioral factors, and time-related bias, the association was stable, pooled OR ranged from 0.42 to 0.75. A protective effect for liver cancer was found in diabetic metformin users. However, more randomized clinical evidence is still needed to verify the results.
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Review Meta Analysis
A systematic review of the keystone design perforator island flap in lower extremity defects.
The keystone design perforator island flap is useful for the reconstruction of lower extremity defects. We performed a systematic review with the objective of identifying complication rates associated with using the keystone design perforator island flap to treat such defects. ⋯ Given its high success rate and low technical complexity, if applicable, the keystone design perforator island flap should be the preferred approach for lower extremity reconstruction.
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Randomized Controlled Trial Comparative Study
A randomized comparison of volume- and pressure-controlled ventilation in children with the i-gel: Effects on peak inspiratory pressure, oropharyngeal leak pressure, and gastric insufflation.
The i-gel provides good airway sealing but gastric insufflation may occur when peak inspiratory pressure (PIP) exceeds the sealing pressure of the i-gel without a gastric tube. Pressure-controlled ventilation (PCV) provides lower PIP compared with volume-controlled ventilation (VCV) and low PIP may reduce the incidence of gastric insufflation in children during positive pressure ventilation. This study was designed to evaluate PIP, oropharyngeal leak pressure, and gastric insufflation during VCV or PCV in children undergoing general anesthesia with i-gel without a gastric tube in situ. ⋯ When i-gel was used without a gastric tube, gastric insufflation occurred regardless of the ventilation modes, which provided different PIP.
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Review Case Reports
Cannabis-induced bullous lung disease leading to pneumothorax: Case report and literature review.
Marijuana use has been increasing in the United States among college students and young adults. Marijuana use has been associated with bullous lung disease which can lead to pneumothorax. There are other recreational drugs like methylphenidate, cocaine and heroin which have been associated with pneumothorax. ⋯ Despite the beneficial effects of Marijuana there are deleterious effects which are emphasized here. This case highlights the need for further studies to establish the relationship between marijuana use and lung diseases in the absence of nicotine use.
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The zero-profile, standalone device (Zero-P, Synthes GmbH, Switzerland) has been reported to be an effective and safe treatment method with similar clinical outcomes compared with plate. Instrumental complications concerning Zero-P have been little reported. Considering the rarity, we present this amazing case to share with our spinal surgeons and instrument specialists. ⋯ Pulled-out screws re-screwed spontaneously are rare but it does occur. Insertion angle may affect the stability of the Zero-P device, and the repeated micro-motion may be the critical reason of the screw pull-out and re-screwing. The management of screws pull-out after ACDF remains individualized and a revision surgery is not necessary for every patient. Conservative treatment such as orthosis and regular follow-ups may be suitable for some asymptomatic patients.