Medicine
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The application of large language models in clinical decision support (CDS) is an area that warrants further investigation. ChatGPT, a prominent large language models developed by OpenAI, has shown promising performance across various domains. However, there is limited research evaluating its use specifically in pediatric clinical decision-making. This study aimed to assess ChatGPT's potential as a CDS tool in pediatrics by evCDSaluating its performance on 8 common clinical symptom prompts. Study objectives were to answer the 2 research questions: the ChatGPT's overall grade in a range from A (high) to E (low) compared to a normal sample and the difference in assessment of ChatGPT between 2 pediatricians. ⋯ This study demonstrates the feasibility of utilizing ChatGPT as a CDS tool for patients presenting with common pediatric symptoms. The findings suggest that ChatGPT has the potential to enhance clinical workflow and aid in responsible clinical decision-making. Further exploration and refinement of ChatGPT's capabilities in pediatric care can potentially contribute to improved healthcare outcomes and patient management.
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Environmental pollutants could be implicated in the cause of female infertility beyond traditional factors. Until now, no study has focused on the association of environmental exposure to aldehydes with female infertility. This study intended to investigate the possible impact of serum levels of aldehyde on female infertility. ⋯ Women in the highest tertile of exposure to benzaldehyde had a 66% (odds ratio [OR] = 0.34, 95% confidence interval [CI] = 0.14-0.79) lower risk of infertility compared to those in the lowest tertile, after adjusting for other variables. Restricted cubic spline indicated a linear and negative association of benzaldehyde with female infertility (p for nonlinearity = 0.74), while other aldehydes did not exhibit a significant correlation. In summary, this cross-sectional study indicates that higher benzaldehyde level correlated with a lower rate of female infertility, which could help guide future research and contribute to the development of interventions to prevent or treat infertility and improve reproductive health outcomes.
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Case Reports
Cerebral venous thrombosis after high-dose steroid in patient with multiple sclerosis: A case report.
Multiple sclerosis (MS) is a central nervous system disease mainly mediated by immunity, which is one of the most common causes of neurological dysfunction in young people worldwide. In the acute phase, high-dose steroid therapy is effective. There are few reports about cerebral venous thrombosis (CVT) after high-dose steroid therapy. ⋯ High-dose steroid therapy may be a risk factor for CVT in patients with MS. MS patients who develop headaches during high-dose steroid therapy should undergo further cranial CTV to rule out CVT.
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New psychoactive substances (NPS) are emerging illegal substances or synthetic drugs that pose public health threats worldwide. This study was aimed at reporting the clinical characteristics of NPS and classical illicit substances used by patients who presented to the emergency room. We conducted a retrospective cohort study on patients with suspected illicit substance use who visited the emergency department (ED) with the suspicion of illicit substance use. ⋯ The heartbeats of INPS group were also significantly faster than those with a negative result in toxicology screen (119.6 vs 93.5 beats per minute, P = .024). Those who used classical illicit drugs combined with NPS had significantly higher palpitation than those with negative results of toxic testing (27.3% vs 3.1%, P = .017). Patients who were highly suspicious of NPS use were younger, had tachycardia, felt palpitations, and had fair oxygen saturation compared to patients who were negative for urine toxicity screening.
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Malignant melanoma (MM) is notorious for its remarkable morphological variation and aberrant histopathological patterns. In addition, Malignant Periopheral Nerve Sheath Tumor (MPNST) is an uncommon but aggressive soft tissue sarcoma. Because of the common embryological origin of melanocytes and Schwann cells in the neural crest, discriminating between a particular type of MM and MPNST can be difficult, particularly when they are amelanotic. Our goal is to increase awareness among clinicians of the rare variations of MM and the importance of medical history in improving the accuracy of the final clinical diagnosis. ⋯ Clinical data, immunohistochemisty biomarkers and genes detection results can serve as valuable evidence for pathologists and clinicians in identifying the disease process. Collaborative efforts between clinicians and scientists are crucial in order to identify specific markers that can effectively differentiate between the 2 tumors, thereby enhancing the conclusiveness of the diagnosis.