Medicine
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Multicenter Study Observational Study
Effectiveness and safety of simeprevir-based regimens for hepatitis C in Italy: The STIly observational study.
The combination of the direct-acting antivirals, simeprevir (SMV) and sofosbuvir (SOF), was the first highly efficacious interferon-free combination for treating patients with hepatitis C virus (HCV), and was widely used in Italy as a result. The aim of this study was to evaluate effectiveness and safety of SMV in Italian patients with HCV genotype (GT) 1 and 4 overall, by treatment regimen [SMV/SOF and SMV/SOF+ribavirin (RBV)], cirrhosis status, and GT (GT1a, GT1b, and GT4). An observational multicenter cohort study was conducted in 46 centers across Italy. ⋯ Adverse events leading to treatment discontinuations were not observed. A high proportion of patients treated with SMV/SOF-based regimens achieved SVR12 in this study. A high SVR12 rate was also achieved in patients with cirrhosis, treatment experience, and HUV coinfected patients.
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Observational Study
Predictors of dysfunction and health-related quality of life in the flexion pattern subgroup of patients with chronic lower back pain: The STROBE study.
Findings about predictors of chronic lower-back pain (CLBP) were inconsistent and inconclusive in previous studies because patients with CLBP are heterogeneous. Subgrouping patients with CLBP, according to a CLBP classification system, might thus clarify the research findings. CLBP in the direction of lumbar flexion movement, that is, the flexion pattern, is common in clinical situations. ⋯ Thirteen variables were measured: the visual analog scale (VAS), the Oswestry Disability Index (ODI), the Short Form-36 (SF-36), the Beck Depression Inventory (BDI), hip internal rotation range of motion, hip flexion range of motion, knee extension range of motion, knee extension with dorsiflexion range of motion, ratio forward flexion, knee extension strength, hip extension strength, hip flexion strength, and lumbopelvic stability. The models for predictors of lower-back pain in the CLBP flexion pattern subgroup included knee extension and the BDI as predictor variables that accounted for 8.1% of the variance in the VAS (P < .05); predictors for disability included the BDI, age, and hip flexion strength, which accounted for 21.2% of the variance in the ODI (P < .05); predictors for health-related quality of life included the BDI, sex, knee extension with dorsiflexion range of motion, and age, which accounted for 38.8% of the variance in the SF-36 (P < .05) in multiple regression models with a stepwise selection procedure. The current results suggest that knee extension, the BDI, age, hip flexion strength, knee extension with dorsiflexion, and sex should be considered when determining appropriate prediction, prevention, and intervention in the flexion pattern subgroup of patients with CLBP.
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Natalizumab (NAT), a humanized monoclonal antibody, which binds in both α4β1 integrins and α4β7 integrins, is approved for the treatment of multiple sclerosis (MS) and Crohn's disease (CD). An uncommon but serious adverse event from NAT treatment is known as progressive multifocal leukoencephalopathy (PML). However, clinical comprehensive safety evidence of NAT is limited. ⋯ Our study will provide a comprehensive picture of AEs of NAT.
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More surgeons had noticed the importance of carbon nanoparticles (CNs) in protection of parathyroid grand in the surgery of thyroidectomy and central lymph lode dissection, but paid less attention to the injection time. The purpose of this study was to investigate whether preoperative injection of CNs can improve the dissection of lymph nodes (LNs) and protect parathyroid grand (PG) for the patients with papillary thyroid carcinoma (TC). ⋯ Preoperative injection of CNs was safe, and can help protect PG and reduce the difficulty of operation.
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Observational Study
Prevalence of previously unrecognized peripheral arterial disease in patients undergoing coronary angiography.
Coronary artery disease (CAD) and peripheral arterial disease (PAD) are serious manifestations of systemic atherosclerosis. A considerable proportion of patients with CAD have associated PAD; however, many are asymptomatic and this condition remains underdiagnosed. Little is known about the prevalence and clinical implication of PAD in patients undergoing coronary angiography in the Middle East with no history of the disease. ⋯ The prevalence of undiagnosed PAD in patients undergoing coronary angiography was 12.8% (14.7% in patients with CAD) and associated with a higher incidence of cardiovascular risk factors, multivessel disease, and left main disease. The high prevalence of PAD in patients with CAD confirms the importance of active screening for PAD by using ABI. Routine determination of ABI in the clinical evaluation of all patients with CAD may help identify high-risk patients.