Medicine
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Review Case Reports
Isolated interrupted of aortic arch diagnosed using CT angiography: A case report and literature review.
Interrupted aortic arch (IAA) is defined as a complete luminal and anatomical interruption between the ascending and descending aortas. The majority of patients with IAA rarely reach adulthood. In most cases, IAA is associated with an intracardiac malformation, such as ventricular septal defect, bicuspidaortic valve, and patent ductus arteriosus. We reported a 70-year-old man with isolated IAA diagnosed using computed tomography angiography (CTA) without previous intervention. ⋯ IAA can present in adulthood with different clinical symptoms. Careful physical examination of the lower and upper peripheral pulses in adults with a chief complaint of hypertension is of outmost importance. CTA is a useful noninvasive imaging modality for the morphologic evaluation of aortic interruption and collateral circulation.
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Multicenter Study Observational Study
Use of trastuzumab as an adjuvant/neoadjuvant therapy in patients with HER2-positive breast cancer in China: The Nvwa study.
The aim of this study was to understand current trends in trastuzumab use in China as a neoadjuvant/adjuvant therapy for human epidermal growth factor receptor-2 positive (HER2+) breast cancer and identify factors influencing trastuzumab use. This was a retrospective, multicenter, cross-sectional study of patients diagnosed with HER2+ breast cancer (stage I-III), between July 2013 and June 2014, at 155 hospitals in 29 provinces/cities in China. Demographic and clinical data, including tumor characteristics and details of adjuvant/neoadjuvant therapies used, were collected. ⋯ Subgroup analysis revealed that patients receiving neoadjuvant therapy were likely to be younger, premenopausal and non-local, and had lymph node metastases, more advanced tumor, and progesterone receptor positive tumor. Trastuzumab use in patients with HER2+ breast cancer is relatively low in China, especially for neoadjuvant therapy. Insurance coverage seems to be the most correlated factor that influences the use of trastuzumab in Chinese patients with HER2+ breast cancer.
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Randomized Controlled Trial
The effects of an educational program on depression literacy and stigma among students of secondary schools in Jazan city, 2016: A cluster-randomized controlled trial study protocol.
Depression is a serious mental health disorder and characterized by sadness, loss of interest in activities, and decreased energy. The aim of this study is to assess the effectiveness of the school intervention program on depression literacy and stigma among students of secondary schools. ⋯ The results of the study will provide evidence of the efficacy of educational intervention programs on increasing depression literacy among students of secondary schools in Jazan City. The expected outcome of this study is to increase the depression literacy rate among high school students in the intervention group.
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Randomized Controlled Trial
Design of a comparative effectiveness randomized controlled trial testing a faith-based Diabetes Prevention Program (WORD DPP) vs. a Pacific culturally adapted Diabetes Prevention Program (PILI DPP) for Marshallese in the United States.
Pacific Islander populations, including Marshallese, face a disproportionately high burden of health disparities relative to the general population. ⋯ Both interventions aim to cause weight loss through improving physical activity and healthy eating, with the goal of preventing the development of T2D. The clustered RCT will determine which intervention is most effective with the Marshallese population. The utilization of a CBPR approach that involves local stakeholders and engages faith-based institutions in Marshallese communities will increase the potential for success and sustainability. This study is registered at clinicaltrials.gov (NCT03270436).
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Observational Study
Study of the evolution and variability of nontraumatic orthopedic surgeries in Brazil-9 years of follow-up: A database study.
In Brazil, there are no epidemiological statistics that map nontraumatic orthopedic injuries, their rate of variability, distribution by specialty, fatality rate, and the economic impact that these lesions and their consequences can bring to the country. The objective of this study was to evaluate the rates of variability for skills, deaths, mortality, and the economic impact of nontraumatic orthopedic surgeries in Brazil from 2008 to 2016. This is a descriptive study conducted through the analysis of data relating to the indicators of hospital production regarding orthopedic procedures of the Department of Informatics of the Unified Health System (Departamento de Informática do Sistema Único de saúde-DATASUS) between 2008 and 2016. ⋯ In general, there is a national increase in the number of orthopedic surgeries performed, accompanied by a concomitant increase in the number of deaths and mortality of the population exposed. We observed a growing demand for hospitalization with a consequent increase in lethality and deaths. We can conclude that between 2008 and 2016, the number of hospitalizations for elective nontraumatic orthopedic surgical procedures increased significantly, driven mainly by lower limb surgeries, along with the cost of the Unified Health System (Sistema Único de Saúde-SUS) for these surgeries.