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Connection in between multimorbidity styles along with disability amongst the elderly covered by long-term treatment insurance coverage within Shanghai, China.
BACKGROUND endocrine changes in midlife women produce an increase in central obesity and oxidative stress, thus it is possible that obese postmenopausal women exhibit a higher oxidative stress than premenopausal women. OBJECTIVE to evaluate the relationship between central obesity and oxidative stress in premenopausal compared with postmenopausal women using different indices. METHODS this is a cross-sectional study that included 237 pre- and 255 post-menopausal women (40-60 years old). As oxidative stress markers we measured plasma malondialdehyde and serum uric acid levels, erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx), and total plasma antioxidant status. We also measured height, weight, and waist and hip circumferences, and we calculated body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). RESULTS we found over 30% of women within the obesity range, whereas 50% were placed in the overweight category in both groups. Plasma malondialdehyde and serum uric acid levels were higher in women with overweight or obesity than in women with normal weight regardless of menopausal status. We found a positive correlation between WHtR and malondialdehyde level (r = 0.298, p 0.6, malondialdehyde and uric acid levels increase regardless of menopausal status. The other indices measured did not show any relationship. CONCLUSION our findings suggest that there is an association between central obesity, as measured with WHtR, and increased oxidative stress regardless of menopausal status.We present the clinical case of a 34-year-old woman with a history of stage IV choriocarcinoma, after her diagnostic debut two years ago, a hysterectomy and resection of the right single pulmonary nodule with anatomopathological confirmation of both as uterine choriocarcinoma and pulmonary nodule compatible with metastatic choriocarcinoma, subsequently the patient received chemotherapy treatment with stability of her disease until now.INTRODUCTION ESD in the colon is an increasingly important technique in Occidental countries. There are few studies that include long term follow-up. AIM to analyze the long term recurrence free survival rate after ESD and to compare recurrence rates according to different variables. METHODS this was a prospective observational study of patients with a planned ESD from September 2008 to December 2015. When it was not possible to achieve an ESD, hybrid ESD was performed, either en bloc or piecemeal. Kaplan-Meier survival curves were used to assess the five year local recurrence free survival rate and the recurrence rate. The results were compared according to different factors. RESULTS of the 89 patients scheduled for ESD who were initially enrolled in the study, 69 were finally included for follow-up. ESD was performed in 31 (45%) patients, KAR in eleven (16%) and pKAR in 27 (39%). The median follow-up was 27 months (range 6-60). The five year disease free survival rate was 81%. The average number of endoscopies needed to eliminate recurrence was two (range 2-7) and no patient required surgery for this reason. The recurrence rate was significantly higher in piecemeal resections vs en bloc resections (27% vs 15%, p = 0.036) and R1 resections vs R0 resections (26% vs 0%, p = 0.034). The presence of affected or unknown lateral margins in en bloc resections without other poor prognosis factors had higher recurrence rates but the difference was not statistically significant (28% vs 0%, p = 0.09). CONCLUSIONS in our study, the five year disease free survival rate was 81% and no patient required surgery during follow-up. Piecemeal and R1 resections had significantly higher recurrence rates, as well as LM involvement, although this was not statistically significant.Melanoma metastasizes to the gastrointestinal tract in 2-4% of cases. In addition, it is the tumor that most frequently metastasizes to the gallbladder (50-67% of metastasis at this level). Even so, these metastases are infrequent. The indication of cholecystectomy will be provided by the patient performance status, extension and prognosis of disease. Although open surgery is preferred to treat melanoma metastasis at this level, laparoscopic surgery could be a safe technique that allows a fast recovery of the patient. We present the case of a 48-year-old man with melanoma metastases in the gallbladder treated by laparoscopic cholecystectomy.Olmesartan is an angiotensin II receptor antagonist used for the treatment of blood hypertension. Long-term use has been associated with diarrhea and sometimes intestinal involvement may mimic enteropathies such as celiac disease. Clinicians should consider drugs within the differential diagnosis of enteropathies. We report the case of a female who sought medical help for malabsorptive symptoms and was finally diagnosed with olmesartan-associated gastritis and atrophic enteropathy.A 72-year-old female presented with abdominal pain and constipation and intestinal dilation was found. Akt inhibitor Abdominal computed tomography showed two areas of thickening and stenosis in the proximal jejunum and preterminal ileum, with an unknown etiology. Exploratory laparotomy was proposed but the patient suffered a sudden and progressive decrease in consciousness. Cranial computed tomography showed an ischemic area and a midline shift. Brain biopsies suggested infection by Aspergillus Fumigatus. Despite antifungal drugs, the patient had a progressive clinical deterioration and died. The autopsy concluded a systemic infection due to Aspergillus Fumigatus. Invasive aspergillosis is a serious fungal infection and usually occurs in immunocompromised patients. It mainly affects the lungs, followed by the gastrointestinal tract. The most frequent location in gastrointestinal involvement is the small bowel. Gastrointestinal involvement is more frequent in invasive disease. Although, there are case reports of isolated gastrointestinal aspergillosis, even in immunocompetent patients without risk factors. The prognosis is poor.BACKGROUND AND OBJECTIVE there are no studies in the literature about the effectiveness of adalimumab biosimilar ABP 501 in Crohn's disease. The aim of this study was to evaluate its effectiveness and safety. METHODS an observational study was performed in Crohn's disease patients treated with ABP 501, with the classic induction and maintenance regimen and in Crohn's disease patients who were switched from the adalimumab originator to ABP 501. RESULTS eighty-seven patients were included in the study, of which 25 were naïve to the adalimumab originator and 62 were switched to ABP 501. In adalimumab-naïve patients, clinical response at three months was 60% (15/25) and clinical remission at three months was 56% (14/25). At six months, 95.2% (59/62) of the patients switched to ABP 501 were still in therapy, without a significant increase of clinical activity (Harvey-Bradshaw index from 3.4, 95% CI = 2.4-4.4, to 3.8, 95% CI = 2.7-4.9, p = 0.23) and inflammatory biomarkers (C-reactive protein from 4.2 mg/l, 95% CI = 2.
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