Medicine
-
To build a practical model for predicting the progression to castration-resistant prostate cancer (CRPC) after androgen deprivation therapy (ADT). In all, 185 patients with prostate cancer who had received ADT as the primary therapy at our institution, from 2003 to 2014, were retrospectively enrolled. The following clinical variables were included in the analysis: age, clinical tumor, node, metastasis stage, Gleason score, risk groups of prostate cancer, prostate-specific antigen (PSA) at the initiation of ADT, PSA nadir after ADT, velocity of PSA decline, and the time to PSA nadir. ⋯ On univariate and multivariate analyses, the presence of distant metastasis before ADT (hazard ratio [HR] 6.030, 95% confidence interval (CI) 3.229-11.263, P = .001), higher PSA nadir (HR 1.185, 95% CI 1.080-1.301, P = .001), a velocity of PSA decline >11 ng/mL per month (HR 2.124, 95% CI 1.195-3.750, P = .001), and a time to PSA nadir ≤9 months (HR 0.276, 95% CI 0.162-0.469, P = .004) were significantly associated with an increased risk of progression to CRPC. Patients with a rapidly decreasing PSA level in the initial phase of ADT are more likely to progress to CRPC. Our findings provide a practical approach to screen patients during ADT for early identification of those likely to progress to CRPC, allowing treatment to be modified to improve outcomes.
-
This article evaluates the long-term outcome of percutaneous balloon compression (PBC) for trigeminal neuralgia (TN) patients elder than 80 years. A total of 138 elderly patients aged above 80 years with primary TN, who were admitted to Neurosurgery Department, Hangzhou First People's Hospital from January 2007 to December 2011 for PBC treatment, were retrospectively analyzed in this study. The postoperative cure rate of immediate pain was 98.6% (Barrow Neurological Institute [BNI] classes I, II); according to the follow-up, the pain cure rates at 1, 2, 3, 4, and 5 years after surgery were 93.5%, 90.4%, 84.7%, 80.4%, and 72.9%, respectively. ⋯ A total of 100% of pain-cured patients exhibited facial numbness and facial hypoesthesia. No serious complications occurred in this group of patients. PBC is an effective and safe procedure for TN treatment and can be employed as the preferred regimen for elderly TN patients aged above 80 years in poorer physical condition.
-
Hemolysis is the most common reason why coagulation test samples are rejected. However, the effects of hemolysis on plasma prothrombin time (PPT) and activated partial thromboplastin time (APTT) are rarely investigated and the results are controversial. This research aims to analyze the effects of hemolysis on PPT and APPT using the photo-optical method. ⋯ In the correlation assay, the level of hemolysis revealed a mildly significant correlation to APTT (R = 0.245; P = .02). Cut-off value for PPT was 1.55 g/dL (100% sensitivity and 87.9% specificity), while the value for APTT was 0.95 g/dL (75% sensitivity and 62.5% specificity). Not all hemolyzed samples should be rejected for PPT and APTT tests using photo-optical methods.
-
Diabetic nephropathy (DN) is a leading cause of end-stage kidney disease nowadays. Certain cancers are more common in patients with diabetes mellitus. However, there are no data concerning the cancer pattern in patients with DN. ⋯ For individual specific site, only colorectal cancer carried a significant higher mortality risk (SMR 2.45, 95% CI 1.82-3.23). Our data suggested that DN is associated with increased incidence of cancers of colorectum, liver, and larynx but decreased incidence of prostate cancer. Moreover, there is increased mortality of colorectal cancer in patients with DN.
-
Observational Study
Use of thiazolidinediones and risk of hip fracture in old people in a case-control study in Taiwan.
Little research is available on the association between use of thiazolidinediones and hip fracture in old people in Taiwan. We conducted a population-based case-control study to examine this issue. Using the database of the Taiwan National Health Insurance Program, we identified 603 type 2 diabetic subjects 65 years or older in age with newly diagnosed hip fracture in 2000 to 2013 as cases. ⋯ After adjustment for covariables, the multivariable logistic regression analysis revealed that the adjusted OR of hip fracture was 1.64 for subjects with current use of thiazolidinediones (95% CI 1.01, 2.67), when compared with subjects with never use of thiazolidinediones. Our findings suggest that current use of thiazolidinediones is associated with a 64% higher risk of hip fracture in type 2 diabetic old people in Taiwan. Clinicians should consider the possibility of thiazolidinediones-associated hip fracture among type 2 diabetic old people currently using thiazolidinediones.