Medicine
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Observational Study
Effectiveness of integrase strand transfer inhibitors among treatment-naive people living with HIV/AIDS in Guangdong, China: A real-world, retrospective cohort study.
Integrase strand transfer inhibitors (INSTIs) in anti-retroviral therapy (ART) have been recommended by the World Health Organization for their higher efficacy, favorable safety and tolerability. However, the clinical evidence supporting switching to INSTI-containing regimens in low-and-middle-income countries (LMICs) is limited, as few patients have access to these regimens. We aimed to assess the effectiveness of INSTI-containing regimens in real-world settings in China compared to government-provided free ART. ⋯ Our study suggests that patients initiating ART with INSTI-containing regimens have worse physical status at baseline than patients starting with free ART drugs. Furthermore, we found better virological performances of INSTI-containing regimens in the short-term but not in the long-term due to a high rate of drug changes. Our findings have clinical implications and provide new evidence regarding the effectiveness of INSTI-containing regimens in LMICs.
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ChatGPT is perceived as a potential tool for patients diagnosed with herniated lumbar disc (HLD) to ask questions concerning desired information, with provision for necessary responses. In this preliminary study, we assessed the validity, safety, and utility of ChatGPT in patients with HLD. Two physicians specializing in the treatment of musculoskeletal disorders discussed and determined the 12 most frequently asked questions by patients with HLD in clinical practice. ⋯ Regarding utility, ChatGPT responses exhibited 4 points for 9 questions (9/12, 75.0%) and 3 points for 3 questions (3/12, 25.0%). ChatGPT demonstrates a tendency to offer relatively valid, safe, and useful information regarding HLD. However, users should exercise caution as ChatGPT may occasionally provide incomplete answers to some questions on HLD.
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With advances in artificial intelligence, machine learning (ML) has been widely applied to predict functional outcomes in clinical medicine. However, there has been no attempt to predict walking ability after spinal cord injury (SCI) based on ML. In this situation, the main purpose of this study was to predict gait recovery after SCI at discharge from an acute rehabilitation facility using various ML algorithms. ⋯ In addition, we could provide a simple DSS based on strong predictors such as the initial FAC, American Spinal Injury Association Impairment Scale grades, and neurological level of injury. In conclusion, we provide that ML can accurately predict gait recovery after SCI for the first time. By focusing on important variables and DSS, we can guide early prognosis and establish personalized rehabilitation strategies in acute rehabilitation hospitals.
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Meta Analysis
Efficacy and safety of electroacupuncture for urinary retention: A systematic review and meta-analysis.
Electroacupuncture (EA) is considered as an effective treatment for urinary retention (UR). ⋯ EA has significant advantages in treating UR, but the efficacy and safety are still needed to be further verified through large-sample and high-quality RCTs.
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Review Case Reports
Placement of a drainage tube in the ileac lumen following laparoscopic appendectomy: A case report and literature review.
Ileal perforation caused by the insertion of a drainage tube is a rare complication. Hence, the utilization of surgical drains in abdominal surgery remains controversial. At present, there is a trend to reduce the utilization of drains in abdominal surgery, although certain situations may necessitate their application. ⋯ Ileal perforation due to an abdominal drainage tube following laparoscopic appendectomy constitutes a rare but serious complication. However, due to the adhesion and inflammatory changes around the abscess, laparoscopic dissection becomes a challenging and risky process, and the surgical skills and experiences are particularly important. Removing the abdominal drainage tube promptly based on the characteristics of the drainage fluid is recommended. The findings provide valuable insights for surgeons navigating similar challenges.