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Key treating cervical radiculopathy: anterior cervical decompression as well as fusion compared with rear foraminotomy: examine standard protocol for any randomized controlled trial.
TB physicians' KAP on smoking cessation was limited. Interventions targeting physicians' knowledge and skills, and formalization of tobacco dependence treatment within TB care, are core for improving their smoking cessation practices in Armenia.
TB physicians' KAP on smoking cessation was limited. Interventions targeting physicians' knowledge and skills, and formalization of tobacco dependence treatment within TB care, are core for improving their smoking cessation practices in Armenia.Electronic health records (EHR) are a potential resource for identification of clinical trial participants. We evaluated how accurately a commercially available EHR Research Platform, InSite, is able to identify potential trial participants from the EHR system of a large tertiary care hospital. Patient counts were compared with results obtained in a conventional manual search performed for a reference study that investigated the associations of atrial fibrillation (AF) and cerebrovascular incidents. The Clinical Data Warehouse (CDW) of Turku University Hospital was used to verify the capabilities of the EHR Research Platform. The EHR query resulted in a larger patient count than the manual query (EHR Research Platform 5859 patients, manual selection 2166 patients). This was due to the different search logic and some exclusion criteria that were not addressable in structured digital format. The EHR Research Platform (5859 patients) and the CDW search (5840 patients) employed the same search logic. The temporal relationship between the two diagnoses could be identified when they were available in structured format and the time difference was longer than a single hospital visit. Searching for patients with the EHR Research Platform can help to identify potential trial participants from a hospital's EHR system by limiting the number of records to be manually reviewed. EHR query tools can best be utilized in trials where the selection criteria are expressed in structured digital format.Ocular complications of coronavirus disease 2019 (COVID-19) do not essentially cause serious visual loss. However, due to the characteristics of this disease, delays in diagnosis and treatment in hospitalized patients may leave them with serious visual impairment. If conjunctivitis is suspected, ophthalmological follow-up is needless because it is expected spontaneous healing. TP-0903 supplier Diplopia is often complicated for extra-ocular neurological findings and need neurological consults. Ophthalmologists should be consulted for ocular surface disease, high intraocular pressure, and ocular inflammation that may cause visual loss if patients complain of blurred vision, visual loss, and ocular pain. The problem is unconscious patients with risk of developing high intraocular pressure or keratitis. link2 An ophthalmologist should be consulted as soon as possible if eye redness or pupil abnormalities appear in these patients. We developed a flowchart for ophthalmic consultations in hospitalized patients with COVID-19, for facilities where an ophthalmologist is not always present, and for third or fourth waves or, a pandemic of another infectious disease.Once novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, China in December 2019 and the first case in Japan was reported the following month, telephone inquiries to the Infectious Disease Outpatient Clinic increased. During the first wave of the epidemic, before medical measures for this emerging infectious disease were in place, the Outpatient Clinic received a significant amount of inquiries, reflecting the prevailing social turmoil. During the second wave, inquiries did not increase because a proper system of medical care was in place in hospitals and communities. Therefore, in the early stages of an emerging infectious disease, relevant information needs to be quickly consolidated and it needs to be linked to measures that are appropriate to the situation.Bronchial thermoplasty (BT) is an interventional endoscopic treatment for severe bronchial asthma. Some studies have shown the clinical efficacy of this intervention, but its cost-effectiveness is unclear. The aim of this study was to evaluate the cost-effectiveness of BT. link3 We collected data from the medical records of 16 Japanese patients who were treated with BT between February 2015 and April 2017, and compared asthma-related medical expenses between the year preceding and the year following BT. Four patients were Global Initiative for Asthma (GINA) treatment step 4, and 12 were step 5. In 8 patients who had a successful response to BT, the annual asthma-related medical expenses decreased because of a reduction in hospitalization and emergency outpatient visits due to asthma attacks, and termination of the use of biologics. Most patients in the non-responder group had increased asthma-related medical costs postoperatively. The main reason for the increase in medical costs was the add-on treatment of biologics. BT was cost-effective in the responder group. If its effects continue for more than 10 years, BT will be a cost-effective treatment. Medical costs will be reduced if those who respond to BT can be identified prior to commencement of treatment.Nucleos(t)ide reverse transcriptase inhibitor (NRTI)-sparing regimens have often been selected as antiretroviral therapy (ART) for HIV-1 infection recently, but data for characteristics have been lacking. This study aimed to document the current status of NRTI-sparing regimens in the era of standard 3-drug combination therapies. We cross-sectionally compared characteristics of patients treated with NRTI-sparing regimens (NRTI-sparing group) with dolutegravir plus tenofovir alafenamide fumarate/emtricitabine as a standard ART group in 2018. The NRTI-sparing and the standard ART groups included 61 and 469 patients, respectively. The mean (± standard deviation) age and serum creatinine of the NRTI-sparing group were significantly higher than those of the standard ART group (57.6 ± 12.8 years vs 42.8 ± 10.4 years (p less then 0.05) and 2.09 ± 3.10 mg/dL vs. 0.93 ± 0.19 mg/dL (p less then 0.05), respectively. The percentage of patients with NRTI-sparing regimens increased with age; with less than 5% in their 50s or younger, 8.4% in their 60s, and 14.1% aged ≥ 70 years. The primary reason for switching to the NRTI-sparing regimen was due to reduced renal function. According to the limited data, viral suppression was achieved at week 48 in all patients in the NRTI-sparing group. No patient had treatment failure nor developed drug resistance. The use of NRTI-sparing regimens increased with age. They were more frequently used in patients aged ≥ 60 years and those with decreased renal function.The Brief Coping Orientation to Problem Experienced (Brief COPE) inventory is one of the most widely used instruments in coping research; however, no study has evaluated the psychometric properties of the Brief COPE in the Vietnamese population. This study aimed to validate a culturally appropriate Vietnamese version of the Brief COPE for the evaluation of coping strategies in people living with HIV/AIDS in Vietnam. We translated the Brief COPE into Vietnamese, and it was self-administered among 1,164 HIV-infected patients receiving antiretroviral therapy at a large HIV outpatient clinic in Hanoi between January 2019 and March 2020. Data on demographics and HIV-related information, depression and social support were also collected. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to assess construct validity. Content validity, internal consistency, and convergent validity were also assessed. The CFA of a 14-factor structure of the original Brief COPE revealed acceptable model fitness, but poor internal consistency for some subscales. In the subsequent EFA, we found a revised 26-item version which had a six-factor structure consisting of problem-solving, avoidance, humor, social support, religion, and substance use. The final CFA found that the model fitness of the revised scale with fewer factor structures was comparable to that of the original Brief COPE; the internal consistency of the revised scale was even better than that of the original scale. Furthermore, six factors of the revised scale showed anticipated associations with depression and social support.To determine the prevalence of coronary artery stenosis (CAS) in Japanese hemophiliacs living with HIV- 1 (JHLH), a prospective study at AIDS Clinical Center, Tokyo, which provides care and treatment to nearly 10% of the JHLH was conducted. The study subjects were 76 JHLH who visited our clinic and received coronary computed tomography angiography (CCTA) between January through December 2019. CCTA with radiographic contrast media was used for CAS screening. Coronary artery calcium score (CACS) by CCTA, pulse wave velocity (PWV), electrocardiography, echocardiography, and chest radiography were also included to the screening process. Stenosis of 50% or more by CCTA was defined as moderate to severe CAS. All patients diagnosed with moderate to severe CAS were recommended to undergo coronary angiography (CAG). Among the 76 JHLH, 19 were excluded. Among the enrolled 57 patients, only 5 had complained of chest symptoms. Their median age was 47 years (interquartile range 44-55 years), prevalence of hypertension 42.1%, diabetes mellitus 14.0%, dyslipidemia 38.6%, and smoking history 52.6%. Moderate to severe CAS was diagnosed in 14 patients by CCTA (24.6% of CCTA tested). Twelve patients agreed to undergo CAG. Seven patients were diagnosed as severe CAS by CAG (12.3% of CCTA received), although only 2 (28.6%) had chest symptoms. PWV and CACS were useful and significant non-invasive markers of moderate to severe CAS (p = 0.016, p less then 0.001, respectively). In conclusions, our study identified high prevalence of severe CAS among JHLH. We recommend screening of all HIV-1-infected hemophiliacs with PWV and CACS, regardless of chest symptoms.In Japan, the first pancreas transplantation was performed in 1984 from a brain-dead donor; subsequently, however, the concept of brain death became a social issue. Thereafter, the "Organ Transplant Act", which enables brain-dead transplantation, was enacted in 1997, and then revised in 2010 so that donation after brain death became possible only with the consent of the family. Under the recipient selection and registration system developed after the enactment of the "Organ Transplant Act", more than 400 pancreas transplants have been carried out at facilities certified for brain-dead pancreas transplantation in Japan. Of the 410 total cadaveric pancreas transplants performed by the end of 2019, the patient survival and pancreatic and kidney graft survival rates were considered to be comparable to those in the United States and Europe despite the high frequency of marginal donors. Minimally invasive allogenic islet transplantation came to be covered by national health insurance in 2020 following good outcomes of a recent trial. Furthermore, to overcome the serious donor shortage in Japan, development of xenogeneic islet transplantation and regenerative medicine using stem cells is in progress, with xenotransplantation using porcine islets appearing particularly promising.
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