Notes

Carotid Artery Angioplasty as well as Stenting: 2-Dimensional Operative Movie.
China's estimated 114 million people with diabetes pose a massive challenge for China's health policy-makers who have significantly extended health insurance coverage over the past decade. What China is doing now, what it has achieved, and what remains to be done should be of interest to health policy-makers, worldwide. We identify the challenges posed by China's two principal strategies to tackle diabetes (1) A short-term pilot strategy of health promotion, detection and control of chronic diseases in 265 national demonstration areas (NDAs); and (2) A long-term strategy to extend health promotion and strengthen primary care capacity and health system integration throughout China. Finally, we consider how Chinese innovations in artificial intelligence (AI) and Big Data may contribute to improving diagnosis, controlling complications and increasing access to care. Health system integration in China will require overcoming the fragmentation of a system that still places excessive reliance on local government financing. Moreover, what remains to be done resembles deeper challenges faced by healthcare systems worldwide the need to upgrade primary care and reduce inequalities in access to health services. © 2020 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http//creativecommons.org/ licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Iron deficiency (ID) is recognized as an important comorbidity in patients undergoing cardiac surgery; however, it still remains under-diagnosed and under-treated in clinical practice. This study aims at comparing efficacy and the effects on exercise capacity of intravenous ferric carboxymaltose (FCM) versus ferric gluconate (FG) in patients with ID anemia (IDA) resulting from cardiac surgery. We retrospectively analyzed data from our records of in-hospital patients with IDA after cardiac surgery undergoing cardiac rehabilitation. Group I was treated with FG, group II with FCM. Efficacy measures included changes (baseline vs discharge) in hemoglobin (Hb) and in distance traveled at six-minutes walking test (6MWT). Data from 74 in-patients (mean age 67.5±10.4 years, 43% women) were analyzed. At discharge, patients treated with FCM showed higher levels of Hb (11.1±1.2g/dl vs 10.2±1.1 g/dl; p=0.001), greater distance traveled at 6MWT (279.2±108.8 meters vs 236.3±72.7 meters; p=0.048), and lower in-hospital rehabilitation length of stay (20.3±7 vs 25.3±11.7 days; p=0.043) as compared to FG group. At multivariate analysis, the most powerful predictors of Hb increase >1 g/dl at discharge were transferrin levels (p=0.019) and treatment with FCM (p100 meters) at discharge (p=0.13 and p=0.003, respectively). In patients with IDA following cardiac surgery, intravenous FCM is effective in restoring Hb levels and in improving exercise capacity after cardiac surgery.Presumptive pulmonary tuberculosis (PTB) patients whose sputum are detected to be smear negative for acid fast bacilli (AFB) present a significant challenge for a treating physician. Initiating these patients on anti tuberculous treatment (ATT) on empirical basis is not a good strategy as many were found to be sputum culture for tuberculosis negative on further evaluation according to many previous studies. In India due to resource limited settings and lack of knowledge about newest diagnostic modalities patients are often initiated only on the basis of characteristic clinical symptoms and chest radiographic abnormalities. This study was conducted to identify the advantage of application of sputum cartridge based nucleic acid amplification test (CBNAAT) in sputum AFB smear negative presumptive pulmonary TB patients. Our study concluded that clinical symptoms and radiological characteristics cannot differentiate TB patients from non-TB patients. Treating patients only on empirical basis would have resulted in unnecessary treatment of 41 patients.Objectives Since exposure to sexual contents and early sex initiation among adolescents have become serious social issues in Korea, an in-depth analysis on the prevalence of sexual experience trends among Korean adolescent is necessary to project trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on sex experience prevalence in Korean. Methods We analyzed the trend of age, period, and birth cohort specific sex experience prevalence of 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey (KYRBS). Joinpoint regression analysis was conducted to examine significant changes in prevalence of sexual experience and find optimal number and location of places where trends changed. Results Generally, the prevalence of sex experience generally increased by age in all period in both boys and girls. In boys, the prevalence of sex experience increased in recent period, especially in age group 12 and 13, while the prevalence of while the prevalence of sex experience decreased in age group 16 and 17. In girls, the age group of 12 and 13 showed increased prevalence of sex experience in recent period. However, the prevalence showed a decreasing trend in age group aged 16 and 17. Conclusions In boys and girls, sex experience increased with age. However, the tendency has slowed in the recent cohort. Therefore, early sex education is needed.Purpose Colon cancer-associated transcript 1 (CCAT1) was identified as an oncogenic long non-coding RNA (lncRNA) in a variety of cancers. However, there was a lack of understanding of the mechanism by which CCAT1 conferred cisplatin (also known as DDP) resistance in ovarian cancer cells. Materials and Methods Cell viability of A2780, SKOV3, A2780/DDP and SKOV3/DDP cells upon cisplatin treatment was monitored by MTT assay. qRT-PCR detected the expression levels of CCAT1 and miR-454. The effect of sh-CCAT1 on cisplatin response was investigated in xenografts study. Bioinformatic analysis, luciferase reporter assay and qRT-PCR were conducted to validate the direct interaction among CCAT1, miR-454 and survivin. Apoptosis was determined by flow cytometry after dual staining of Annexin-V-FITC/PI, and the expression of apoptosis-related proteins Bcl-2, Bax and survivin were detected by qRT-PCR and Western blotting. Xenograft study was conducted to monitor in vivo tumor formation. Results CCAT1 was highly expressed in cisplatin-resistant ovarian cancer cell line A2780/DDP and SKOV3/DDP. Knockdown of CCAT1 restored sensitivity to cisplatin in vitro and in vivo. Our data revealed that silencing of CCAT1 promoted cisplatin-induced apoptosis via modulating the expression of pro- or anti-apoptotic proteins Bax, Bcl-2 and survivin. CCAT1 directly interacted with miR-454, and miR-454 overexpression potentiated cisplatin-induced apoptosis. Survivin was identified as a functional target of miR-454, restoration of survivin attenuated the effect of miR-454 on cisplatin response. In addition, miR-454 inhibitor or overexpression of survivin was found to abolish sh-CCAT1-induced apoptosis upon cisplatin treatment. Conclusion CCAT1/miR-454/survivin axis conferred cisplatin resistance in ovarian cancer cells.In this study, we assessed a series of our cases in which endoscopic self-expandable metal stents (SEMSs) were used to treat malignant afferent loop obstruction (ALO) that arose after pancreaticoduodenectomy (PD). We retrospectively examined the records of 7 patients who underwent endoscopic SEMS placement for malignant ALO following PD. Clinical success was achieved in all cases. The median procedure time was 30 min (range, 15-50 min). There were no cases of stent occlusion, and no procedure-related adverse events were encountered. All patients died of their primary disease, and the median overall survival period was 155 days (range, 96-374 days). A re-intervention involving endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting was performed for obstructive jaundice and acute cholangitis in 1 case. In conclusion, endoscopic SEMS placement may be an effective and safe treatment for malignant ALO that arises after PD.PURPOSE Health improves the proficiency and output generated by individuals. It also raises physical as well as mental abilities, which are required for the growth and advancement of any economy. Many infant diseases have been recognised via contemporary technology in a bid to tackle these diseases. However, children within the African continent (Including Nigeria) die en masse from diseases. This has made the government of Nigeria allocate sizeable part of the nation's budget to healthcare system. The allocation to health is, however, yet to translate to improved health condition for Nigerians. It does not measure up to the World Health Organization's (WHO) standards for apportioning budget to the health sector. This study also analyses empirically the impact of healthcare expenses on the mortality level of infants as well as Nigeria's neonatal mortality level. DESIGN/METHODOLOGY/APPROACH The paper focuses on Nigeria. Vector auto regression model techniques, unit root tests and cointegration test were carried out using time series date for the period between 1986 and 2016. FINDINGS The outcome has revealed that expenditure on healthcare possesses a negative correlation with the mortality of infants and neonates. The study discovers that if the Nigerian government raises and maintains health expenditure specifically on activities focused on minimising infant mortality, it will translate to reduction in infant mortality in Nigeria. ORIGINALITY/VALUE This paper has contributed exhaustively to solution to poor expenditure on healthcare, especially child mortality, in Nigeria. © Emerald Publishing Limited.A previous assessment of submissions for rare disorder drugs made to the Canadian Agency for Drugs and Technologies in Health (CADTH) found that, from 2012, all positive recommendations included criteria advocating a price reduction. Since 2016, CADTH and the pan-Canadian Pharmaceutical Alliance (pCPA), which conducts drug price negotiations with manufacturers for all public drug programs, have aligned their processes. This analysis examined drugs for rare and ultra-rare disorders (DRDs and DURDs)-prevalence of ≤20 to >2 and ≤2 per 100,000, respectively-with a completed pCPA negotiation or no negotiation between 2014 and 2018, together with their reimbursement recommendations and listings in public drug programs. A positive recommendation led to a successful price negotiation for 81.8% and 78.6% of the DRD and DURD submissions and a negative recommendation to no negotiation for 100.0% and 66.7%. Less than half the recommendations for DURDs reported before 2016 mentioned the need for a substantial price reduction, but this increased to 80% in those reported from 2016 onwards. A successful price negotiation led to listing in the majority of the public drug programs and a negative recommendation usually led to no listing. The CADTH-pCPA alignment is working for the governments who own and fund public drug programs but has yet to lead to coverage for all appropriate patients in all provinces. There is still a way to go to ensure that patients with unmet needs can access high-cost innovative medicines that alleviate suffering, prevent premature death, and/or significantly improve their quality of life. © 2020 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.
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