Brit J Hosp Med
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Renal tubular acidosis is a group of disorders characterised by metabolic acidosis, hyperchloraemia, normal anion gap, and potassium imbalance. Genetic mutations, drugs or acquired disorders disrupt the function of various transport proteins and enzymes in the renal tubules, causing diminished bicarbonate reabsorption or inability to excrete hydrogen ions, leading to proximal (type 2) and distal (type 1) renal tubular acidosis, respectively. These conditions are typically associated with hypokalaemia, which, if severe, can cause muscle paralysis and dangerous cardiac arrhythmias. ⋯ If untreated, renal tubular acidosis can lead to long-term severe complications such as growth retardation, osteoporosis, rickets, osteomalacia, and renal calculi. Moreover, renal tubular acidosis might be the initial presentation of a more severe underlying pathology, such as autoimmune disease or plasma cell dyscrasias. A better understanding of the condition can help physicians diagnose and treat it early and prevent adverse outcomes.
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Review
Prediction of Cervical Cancer Lymph Node Metastasis via a Multimodal Transfer Learning Approach.
Aims/Background In the treatment of patients with cervical cancer, lymph node metastasis (LNM) is an important indicator for stratified treatment and prognosis of cervical cancer. This study aimed to develop and validate a multimodal model based on contrast-enhanced multiphase computed tomography (CT) images and clinical variables to accurately predict LNM in patients with cervical cancer. Methods This study included 233 multiphase contrast-enhanced CT images of patients with pathologically confirmed cervical malignancies treated at the Affiliated Dongyang Hospital of Wenzhou Medical University. ⋯ The area under the curve (AUC) was used to assess the predictive efficacy of the model. Results The results indicate that the deep transfer learning model exhibited high diagnostic performance within the internal validation set, with an AUC of 0.82, accuracy of 0.88, sensitivity of 0.83, and specificity of 0.89. Conclusion We constructed a comprehensive, multiparameter model based on the concept of deep transfer learning, by pre-training the model with contrast-enhanced multiphase CT images and an array of clinical variables, for predicting LNM in patients with cervical cancer, which could aid the clinical stratification of these patients via a noninvasive manner.
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With the rapid ageing of the population, the number of older adults with two or more chronic diseases is increasing. There are individual differences in health assessment, diagnosis, treatment, health management, and medication safety for older adults with chronic conditions and multiple morbidities. ⋯ Developing effective community health management models specifically designed for older adults with multiple chronic diseases is crucial for improving their overall health. This study provides a comprehensive review of the progress in research on community health management models for older adults with multiple chronic diseases, aiming to offer valuable insights for health management in this population.
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Review
Advances in Research on the Anticancer Properties and Mechanisms of Metformin in Lung Cancer.
Lung cancer is a leading cause of death globally with high mortality and morbidity. Patients are often diagnosed at an advanced stage. Metformin has become a primary medication used in the clinical management of type 2 diabetes mellitus (T2DM) due to its relative safety, low cost, and effectiveness, mainly exerting its hypoglycemic effect by inhibiting hepatic gluconeogenesis and insulin resistance. ⋯ Metformin lowers the risk of tumour development through various mechanisms, including the adenosine 5'-monophosphate-activated protein kinase/liver kinase B1/mechanistic target of rapamycin (AMPK/LKB1/mTOR) pathway, insulin-like growth factor-1 receptor pathway, apoptosis, and autophagy. However, research findings are not entirely consistent. This article reviews the research progress of metformin in terms of lung cancer treatment within the past few years, aiming to provide a more comprehensive understanding of how metformin exerts its anti-cancer impact and how it can be clinically applied, as well as provide new insights for lung cancer treatment.
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Liver transplantation specialist nurses provide comprehensive and safe care for liver transplant patients, which requires them to have a wide range of competencies. However, at present, there is no comprehensive understanding of the competency of liver transplantation specialist nurses in China, and there is a lack of comprehensive evaluation indicators. The purpose of this study was to construct a competency evaluation indicator system for specialist nurses in liver transplantation. ⋯ The developed competency evaluation indicator system for liver transplant specialist nurses possesses scientific validity and reliability, offering a reference for the training and assessment of liver transplant specialist nurses.