Medicine
-
Observational Study
Identification of risk factors involved in recurrence after common bile duct stone removal with ERCP: A retrospective observational study.
Recurrent stone detection is common after endoscopic treatment of common bile duct stones (CBDS). This study aimed to identify the risk factors for recurrence of CBDS. We retrospectively evaluated 14 patients who underwent endoscopic treatment for CBDS. ⋯ According to the multivariate analyses, being older than 65 years (odds ratio [OR] 1.084, P = .000), concomitant heart disease (OR 2.528, P = .002), concomitant lung disease (OR 1.766, P = .035), a large common bile duct diameter (OR 1.347, P = .000), presence of cholelithiasis (OR 1.752, P = .018), stent (OR 1.794, P = .023), or T-tube placement in the common bile duct (OR 47.385, P = .000), and prolongation of the procedure (OR 1.037, P = .000) increased the risk of recurrence, while having undergone cholecystectomy due to gallstones (OR 1.645, P = .042). The mean stone diameter (P = .059), nitroglycerin use (P = .129), and periampullary diverticulum (P = .891) did not increase the risk of recurrent CBDS. The probability of multiple recurrences after the first recurrence of CBDS increased with age >65 years, concomitant heart/lung diseases, stent/T-tube placement in the common bile duct, a wide common bile duct (≥10 mm), and cholelithiasis.
-
Epstein-Barr virus-associated smooth muscle tumors (EBV-SMT) are rare, virally-induced malignancies that occur almost exclusively in immunocompromised individuals. We report a very rare case of a dura-based EBV-SMT with superimposed local cryptococcal infection. ⋯ Epstein-Barr virus associated smooth muscle tumors are rare malignancies that occur in immunocompromised patients. Prognosis is largely dependent on immune reconstitution and treatment of concomitant infections.
-
This study aimed to evaluate the association of imaging signs, and to establish a predictive model through selecting highly relevant imaging signs in combination with clinical parameters for hematoma expansion. Intracerebral Hemorrhage (ICH) patients who received 2 consecutive noncontrast computed tomography scans were examined and recruited through January 2014 to December 2020. Demographic information and clinical characteristics were collected. ⋯ The logistic analysis found that radiation attenuation, liquid level, the midline shift, Glasgow Coma Scale score, history of ischemic stroke, and smoking could predict the occurrence of ICH expansion. In summary, the model combined radiological characteristics with clinical indicators showed considerable predictive performance. Further validation is needed to verify the findings and help transfer to clinical practice.
-
Cerebrovascular disease is the second commonest cause of mortality globally and among the commonest causes of disability. However, research executed to probe the heavy metal exposure-stroke incidence relationship is scarce. Accordingly, we executed our study to probe the relationship of heavy metal concentrations (ie, concentrations of lead [Pb], mercury [Hg], cadmium [Cd], and arsenic) in the serum and urine of acute ischemic stroke (AIS) patients with several patient variables. ⋯ Patients with AIS who smoked or consumed alcohol had high levels of serum Pb and serum Cd than did those who did not. Patients with AIS who consumed alcohol had significantly higher Pb and Hg urine concentrations than did those who did not. Our study indicated that serum Cd and Pb elevation increased the AIS risk in southern Taiwan patients.
-
Health literacy is a set of knowledge and skills that enables individuals to obtain, communicate, process and understand information, and services to make appropriate health decisions and to successfully navigate the health care system. Health literacy is important to quality of cancer survivorship care and patient self-management of their disease. We examined health literacy among cancer survivors, using data from the 2016 Behavioral Risk Factor Surveillance System. ⋯ The prevalence was higher among Hispanic and Black individuals, and among those with poor health status, low income and educational attainment. A sizeable percentage of cancer survivors have low health literacy which is likely to complicate their ability to self-manage their disease and navigate the health care system for optimal care. In order to ensure the quality and appropriateness of cancer survivorship care, effective interventions are needed to address low health literacy in these populations.