Medicine
-
Review Case Reports
Biliary atresia combined with progressive familial intrahepatic cholestasis type 3: A case report and review of the literature.
Neonatal cholestasis is one of the most serious diseases in infancy. Progressive familial intrahepatic cholestasis (PFIC) is a disease that leads to intrahepatic cholestasis. It is one of the common causes of neonatal cholestasis in addition to biliary atresia (BA). The differential diagnosis of neonatal cholestasis is clinically challenging for pediatricians. ⋯ Additional examinations, such as genetic testing, should be considered in patients with BA who had refractory jaundice after Kasai portoenterostomy in order to exclude intrahepatic cholestasis.
-
Review Case Reports
Herpes zoster involving the abducens and vagus nerves without typical skin rash: A case report and literature review.
Herpes zoster is characterized by unilateral vesicular eruption and it most often affects the trigeminal nerve. We would like to report a rare case of abducens and vagus nerves palsy caused by varicella zoster virus (VZV) without the typical vesicular rash. ⋯ In patients with abducens nerve palsy without typical vesicular lesion, herpes zoster may not be detected early. In that case, systemic examination is very important for diagnosing herpes zoster.
-
Observational Study
Clinical significance of myositis-specific autoantibody profiles in Japanese patients with polymyositis/dermatomyositis.
Myositis-specific autoantibodies, such as anti-melanoma differentiation associated gene 5 (MDA5) and anti-anti-amino acyl-tRNA synthetases (ARS) antibodies, are associated with interstitial lung diseases (ILD), which determine the prognosis of polymyositis/dermatomyositis (PM/DM) patients. However, there is a paucity of data on the clinical correlation between anti-Sjögren syndrome-related antigen A (anti-SSA)/Ro52 antibodies in PM/DM. We investigated the prevalence of myositis-specific autoantibodies including anti-SSA/Ro52 antibody and assessed the clinical significance of these antibodies in patients with PM/DM. ⋯ Furthermore, dual positivity for anti-SSA/Ro52 and anti-MDA5 antibodies was significantly higher in nonsurviving DM patients compared with survivors. Although the presence of anti-ARS or anti-MDA5 antibodies is a prognostic marker in patients with PM/DM, combined presence of anti-SSA/Ro52 and anti-MDA5 antibodies represent another marker for clinical outcome in DM patients. Our results suggest that anti-SSA/Ro52 antibody positivity in DM patients with anti-MDA5 antibody reveals a subgroup of DM patients with poor prognosis.
-
Multicenter Study
Development of model to predict end-stage renal disease after coronary artery bypass grafting: The ACHE score.
Because end-stage renal disease (ESRD) increases the risks of morbidity and mortality, early detection and prevention of ESRD is a critical issue in clinical practice. However, no ESRD-prediction models have been developed or validated in patients undergoing coronary artery bypass grafting (CABG). This is a retrospective multicenter cohort study, recruited between January 2004 and December 2015. ⋯ Through stepwise selection multivariate analyses, the following three variables were finally included in the ESRD-prediction model: postoperative Acute kidney injury, underlying Chronic kidney disease, and the number of antiHypertensive drugs (ACHE score). This model showed good performance in predicting ESRD with the following C-statistics: 0.89 (95% confidence interval [CI] 0.84-0.94) in the development cohort and 0.82 (95% CI 0.60-1.00) in the external validation cohort. The present ESRD-prediction model may be applicable to patients undergoing CABG, with the advantage of simplicity and preciseness.
-
There are a number of complementary and alternative therapies for the primary dysmenorrhea (PD) and their efficacy has been assessed by several systematic reviews. But only pair-wised drugs have been evaluated in the traditional meta-analyses and conflicting interpretation of results also existed among different studies. Here, a protocol for a network meta-analysis will be presented aimed to compare the efficacy and safety of different complementary and alternative therapies for PD. ⋯ PROSPERO CRD42018107763.