Δευτέρα, 7 Μαΐου 2018

A case of ischemic gastroduodenal disease in a patient who was receiving hemodialysis treatment that was managed by conservative treatment

Abstract

A 69-year-old man was under maintenance dialysis due to diabetic renal failure. He had a drop in blood pressure during dialysis, developed hematemesis, and was transported to our hospital. Emergency upper gastrointestinal endoscopy revealed diffuse erosion, mucosal sloughing, and edematous mucosa in the upper body of the stomach to the posterior wall of the antrum and to the greater curvature, which were considered to be an ischemic change. His underlying diseases included diabetic renal failure, chronic arteriosclerosis obliterans, cerebral infarction, internal carotid artery stenosis, hypertension, and myocardial infarction. Blood evaluation showed only mild inflammation and no fibrinolytic hyperactivity. Contrast-enhanced computed tomography (CECT) showed no occlusion of blood vessels. It was considered that the patient had a transient ischemic change due to blood pressure drop. The patient's condition improved with conservative treatment.



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Effects of Cage Farming on Antimicrobial and Heavy Metal Resistance of Escherichia coli, Enterococcus faecium, and Lactococcus garvieae

Microbial Drug Resistance, Ahead of Print.


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Are Clinicians Ready for Safe Use of Stratified Therapy in Primary Biliary Cholangitis (PBC)? A Study of Educational Awareness

Abstract

Background

Primary Biliary Cholangitis (PBC, formerly cirrhosis), is a chronic cholestatic liver disease which until spring 2016 had a single licensed therapy, Ursodeoxycholic acid (UDCA). Approximately 30% of patients do not respond to UDCA, and are high-risk for progressing to end stage liver disease, transplantation or death. A new era of stratified medicine with second-line therapies to treat high-risk disease is emerging, with the first such second-line agent obeticholic acid recently receiving FDA and EMA approval and entering practice. Recent experience in the USA of inappropriate use and associated deaths has highlighted concerns as to whether clinicians have the knowledge to implement second-line therapies appropriately and safely.

Methods

Online survey of knowledge regarding optimal PBC management in Gastroenterologists and Hepatologists in the USA; the first 100 completed responses from each group used for analysis.

Results

80% of Hepatologists felt they were highly competent in their understanding of the importance of early diagnosis and early UDCA therapy in PBC compared with 65% of gastroenterologists. However, only 36% of Hepatologists and 30% of gastroenterologists felt competent at assessing response to UDCA. Competence in knowledge (mode of action, efficacy, and side effects) of second-line therapies and enrollment into trials was low among both groups.

Conclusion

Significant knowledge gaps in clinicians managing PBC presents a problem in optimizing care. It is perhaps not surprising that knowledge of emerging second-line therapies is low, however more concerning is sub-optimal use of UDCA in real-life practice and the lack of confidence at assessing treatment response which should be a routine part of clinical practice to assess risk of disease progression and will be key in delivering stratified medicine.



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Stricturing and Fistulizing Crohn’s Disease Is Associated with Anti-tumor Necrosis Factor-Induced Psoriasis in Patients with Inflammatory Bowel Disease

Abstract

Background

Paradoxical development of psoriasis in patients on anti-TNF agents has been increasingly reported.

Aim

The aim was to characterize the prevalence and clinical characteristics of anti-TNF-associated psoriasis in a large cohort of inflammatory bowel disease patients.

Methods

Medical records of patients with Crohn's disease or ulcerative colitis treated with anti-TNF therapy at a single, tertiary IBD center were identified between 2004 and 2016. Patients identified as having developed psoriasis while on anti-TNF underwent detailed retrospective review of dermatologic features and changes in IBD treatment prompted by the development of psoriasis.

Results

Among 676 patients treated with anti-TNF (infliximab or adalimumab), the incidence of psoriasis was 10.7% (N = 72). Female gender (OR 1.88 [95% CI 1.12–3.17], p = 0.017), stricturing or fistulizing Crohn's disease (OR 1.83 [95% CI 1.04–3.21], p = 0.036) and upper GI Crohn's disease (OR 3.03 [95% CI 1.06–8.33], p = 0.039) were associated with psoriasis development. The median time to psoriasis onset was 569 days from initiation of anti-TNF, with onset occurring earlier in patients who developed psoriasis on adalimumab versus infliximab (457 vs. 790.5 days, p = 0.008). Overall, in 15/72 (20.8%), cases, cessation of the anti-TNF was required as a result of psoriasis. Plaque psoriasis was the most common type of psoriatic lesion (75%). Topical corticosteroids were the most common treatment for psoriasis.

Conclusion

We report a high incidence of anti-TNF-associated psoriasis that was associated with female gender, foregut disease location, and fistulizing and stricturing disease behavior. More prospective studies and genetic analyses evaluating possible pathophysiologic underpinnings of this problem are needed.



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Predicting Cholangitis with Procalcitonin: Procrastinate or Procedure?



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Health Maintenance Documentation Improves for Veterans with IBD Using a Template in the Computerized Patient Record System

Abstract

Background

Inflammatory bowel diseases (IBD) and the therapies used to treat these conditions can lead to preventable complications. In 2011, AGA developed the Adult IBD Physician Performance Measures Set to improve accountability and performance management in IBD care; however, compliance remains poor.

Aim

The aim of this study is to assess for an improvement in provider compliance with the recommended outpatient preventive care measures in our VA IBD patients after July 2014 following the implementation of a health maintenance template in the Computerized Patient Record system (CPRS).

Methods

We conducted a single-center, retrospective chart review of 139 IBD patients with at least one visit before and after the implementation of the health maintenance template through November 2016. We collected demographic data, immunosuppressive medication use, and recommendations for preventive care. For each variable analyzed, we included those patients where the preventive care measure was indicated based on age, gender, and/or medication use. The McNemar's test for paired nominal data was used to assess the significant difference in recommendation rate, pre- versus post-template implementation. A p value of < 0.05 was considered significant.

Results

We included 139 patients (46% with Crohn's disease, 53% with ulcerative colitis, 1% with indeterminate colitis) in the analysis. Seventy-eight (56%) patients were on immunosuppressants. All preventive care measures significantly improved after implementation of the CPRS template except for HPV vaccination.

Conclusions

Implementing a health maintenance template in outpatient GI clinic notes significantly improved provider documentation of the recommended outpatient preventive care in our VA IBD population.



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Profiles: Stanley W. Ashley



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Predictive Chromoendoscopy of Serrated Polyps: Is the Pendulum Swinging Toward the Pit Pattern?



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Autologous Flap Transfer for Esophageal Stricture Prevention After Endoscopic Submucosal Dissection in a Porcine Model

Abstract

Background

Esophageal stricture caused by endoscopic submucosal dissection for a mucosal defect that covers more than three quarters of the circumference of the esophagus has a high incidence. To date, no method for preventing such strictures has been widely recognized as effective in clinical practice.

Aims

We examined whether esophageal stricture caused by circumferential endoscopic submucosal dissection could be prevented by autologous flap transfer.

Methods

Six pigs (N = 6) underwent circumferential esophageal endoscopic submucosal dissection under general anesthesia. For animals in the flap group (N = 3), an autologous flap was constructed and then placed at the resection site and secured with metal clips. Animals in the control group (N = 3) underwent endoscopic submucosal dissection only. Endoscopy was performed 3 weeks postoperative to evaluate the effects of flap transfer.

Results

Animals in the flap group gained more weight than animals in the control group. At 3 weeks postoperative, animals in the flap group developed clinically slight stricture; in these animals, an endoscope could be passed through the stricture with slight resistance. In contrast, in the control group, significant stricture was observed, and the stricture was difficult to cross with an endoscope.

Conclusion

Autologous flap transfer after circumferential esophageal endoscopic submucosal dissection is a novel approach that remarkably decreases the degree of esophageal stricture that arises.



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Value of Two-Dimensional Shear Wave Elastography for Assessing Acute Liver Congestion in a Bama Mini-Pig Model

Abstract

Background

To date, liver congestion is one of the most significant clinical diseases. However, few studies have profoundly investigated the development, pathology, and prognosis of the important problems associated with acute hepatic congestion.

Aims

To explore the value of noninvasive two-dimensional shear wave elastography (2D-SWE) for assessing acute liver congestion in an animal model.

Methods

Six healthy Bama mini-pigs were used for this research and randomly divided into the experimental group and control group. We measured the basal liver stiffness (LS) by 2D-SWE and then clamped the inferior vena cava (IVC). LS was measured after 1, 5, 10, and 15 min. We reopened the IVC of experimental group pigs and detected the LS again. All pigs were killed and obtained for a pathological microscopic examination.

Results

LS was distinctly increased from 7.03 ± 0.48 to 17.18 ± 3.40 kPa (p < 0.01) within 15 min and reversed to almost normal values of 7.59 ± 0.77 kPa (p < 0.01) within 5 min. In addition, two-dimensional ultrasound images demonstrated the interesting phenomenon of spontaneous echo contrast. Most importantly, the pathologic results of experimental group pigs showed the central veins of the hepatic lobules and hepatic sinusoids were enlarged and filled with numerous erythrocytes; central lobular hepatocytic necrosis and edema were noted.

Conclusions

In conclusion, 2D-SWE is a valuable, reliable, and quantitative approach to successfully assess acute liver congestion, and it is well consistent with histopathological characteristics. Besides, acute liver congestion is an important factor influencing LS that increases LS in a reversible way.



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Establishment of a Gallbladder Cancer-Specific Survival Model to Predict Prognosis in Non-metastatic Gallbladder Cancer Patients After Surgical Resection

Abstract

Background

Gallbladder cancer is an invasive cancer with a discouraging prognosis, and early detection and active intervention are of great value.

Aims

To establish a more accurate and effective survival model to predict the prognosis of patients with non-metastatic gallbladder after surgical resection.

Methods

A retrospective analysis was conducted in non-metastatic gallbladder cancer patients who were registered in the surveillance, epidemiology and end results database from 2010 to 2014. Univariate analysis and multivariate analysis were performed for the related factors that might affect the gallbladder cancer-specific survival. A prognostic gallbladder cancer-specific survival model was established using the nomogram tool. The discrimination test was measured by the c-index, and the conformance test was performed by a calibration curve.

Results

In all, 1422 patients with non-metastatic gallbladder cancer were identified. The prognostic factors include age, gender, lymph node dissection, postoperative chemotherapy, tumor size, histological grading, pT stage and pN stage. The gallbladder cancer-specific survival model was established based on the prognostic factors. The model's c-index was 0.775, and the 7th AJCC staging c-index was 0.649. The calibration curves showed a good correlation between prediction and actual survival.

Conclusions

This study established the gallbladder cancer-specific survival model successfully. Compared with the 7th AJCC stage, this model refined the contribution of the pT stage, pN stage and other related factors and was demonstrated to be more accurate and reliable. More importantly, this model may allow clinicians to screen patients with a poor prognosis for closer follow-up or adjuvant treatment.



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Defects in the Neuroendocrine Axis Contribute to Global Development Delay in a Drosophila Model of NGLY1 Deficiency

N-glycanase 1 (NGLY1) Deficiency is a rare monogenic multi-system disorder first described in 2014. NGLY1 is evolutionarily conserved in model organisms. Here we conducted a natural history study and chemical-modifier screen on the Drosophila melanogaster NGLY1 homolog, Pngl. We generated a new fly model of NGLY1 Deficiency, engineered with a nonsense mutation in Pngl at codon 420 that results in a truncation of the C-terminal carbohydrate-binding PAW domain. Homozygous mutant animals exhibit global development delay, pupal lethality and small body size as adults. We developed a 96-well-plate, image-based, quantitative assay of Drosophila larval size for use in a screen of the 2,650-member Microsource Spectrum compound library of FDA approved drugs, bioactive tool compounds, and natural products. We found that the cholesterol-derived ecdysteroid molting hormone 20-hydroxyecdysone (20E) partially rescued the global developmental delay in mutant homozygotes. Targeted expression of a human NGLY1 transgene to tissues involved in ecdysteroidogenesis, e.g., prothoracic gland, also partially rescues global developmental delay in mutant homozygotes. Finally, the proteasome inhibitor bortezomib is a potent enhancer of global developmental delay in our fly model, evidence of a defective proteasome "bounce-back" response that is also observed in nematode and cellular models of NGLY1 Deficiency. Together, these results demonstrate the therapeutic relevance of a new fly model of NGLY1 Deficiency for drug discovery and gene modifier screens.



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Psychometric properties of neural responses to monetary and social rewards across development

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Publication date: Available online 7 May 2018
Source:International Journal of Psychophysiology
Author(s): Paige Ethridge, Anna Weinberg
Reward-related event-related potentials (ERPs) are often used to index individual differences that signal the presence or predict the onset of psychopathology. However, relatively little research has explored the psychometric properties of reward-related ERPs. Without understanding their psychometric properties, the value of using ERPs as biomarkers for psychopathology is limited. The present study, therefore, sought to establish the internal consistency reliability and convergent validity of the reward positivity (RewP) and feedback negativity (FN) elicited by two types of incentives commonly used in individual differences research – monetary and social rewards. A large, developmentally-diverse sample completed a forced-choice guessing task in which they won or lost money, as well as a social interaction task in which they received acceptance and rejection feedback. Data were analyzed at both Cz and at a frontocentral region of interest (ROI) using techniques derived from classical test theory and generalizability theory. Results demonstrated good to excellent internal consistency of the RewP and FN within 20 trials in both tasks, in addition to convergent validity between the two tasks. Results from a regression-based approach to isolating activity specific to a single response demonstrated acceptable to good internal consistency within 20 trials in both tasks, while a subtraction-based approach (∆RewP) did not achieve acceptable internal consistency in either task. Internal consistency was not moderated by age and did not differ between Cz and the frontocentral ROI; however, the magnitudes of the RewP and FN were significantly associated with age at Cz but not at the ROI. This work replicates previous studies demonstrating good psychometric properties of the monetary RewP/FN and provides novel information about the psychometric properties of the social RewP/FN. These data support the use of reward-related ERPs elicited by multiple reward types in studies of biomarkers of psychopathology.



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Geographic variation in the surgical management of lumbar spondylolisthesis: characterizing practice patterns and outcomes

The role of arthrodesis in the surgical management of lumbar spondylolisthesis remains controversial. We hypothesized that practice patterns and outcomes for this patient population may vary widely.

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A systematic review of clinical outcomes in surgical treatment of adult isthmic spondylolisthesis

A variety of surgical methods are available for the treatment of adult isthmic spondylolisthesis, but there is no consensus regarding their relative effects on clinical outcomes.Purpose: To compare the effects of different surgical techniques on clinical outcomes in adult isthmic spondylolisthesis.

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Patient phenotypes associated with outcome following surgery for mild degenerative cervical myelopathy: A principal component regression analysis

Predictors of outcome after surgery for degenerative cervical myelopathy (DCM) have been determined previously through hypothesis-driven multivariate statistical models that rely on a priori knowledge of potential confounders, exclude potentially important variables due to restrictions in model building, cannot include highly collinear variables in the same model, and ignore intrinsic correlations among variables.

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Test-retest reliability of posture measurements in adolescents with idiopathic scoliosis

Posture changes are a major consequence of IS (IS). Posture changes can lead to psychosocial and physical impairments in adolescents with IS. Therefore, it is important to assess posture but the test-retest reliability of posture measurements still remains unknown in this population.

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Spine and lower extremity kinematics during gait in cervical spondylotic myelopathy patients

CSM typically manifests with a slow, progressive stepwise decline in neurologic function, including hand clumsiness and balance difficulties. Gait disturbances are frequently seen in CSM patients, with more advanced cases exhibiting a stiff, spastic gait.

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Posterior spinal surgery for adolescent idiopathic scoliosis does not induce compensatory increases in distal adjacent segment motion: a prospective gait analysis study.

Adolescent idiopathic scoliosis (AIS) patients perform surprisingly well after spinal correction and fusion. It was previously hypothesized that, during gait, certain mechanisms compensate for the loss in spinal motion. Still, previous studies could not identify such compensatory mechanisms in the lower body.

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A response to: “Sleep and Circadian Rhythms in Severely Brain-Injured Patients – A Comment”

We can only agree with all methodological criticisms raised by Schabus et al. (2018) in their brief Letter-to-the-Editor. We conducted our study (Rossi Sebastiano et al., 2018) taking into account many limitations, including the brevity of recordings, the inclusion of nocturnal sleep only, the objective limits in sleep staging and the possibility of subjective interpretations, due to the modifications of the standard AASM criteria we applied (American Academy of Sleep Medicine & Iber et al., 2007).

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eCore Software Inc. to attend 2018 ZOLL Summit

Brought to you by eCore Software The 21st ZOLL Summit, put on by ZOLL Medical Corporation will take place from May 8th to the 10th at the Sheraton Denver Downtown Hotel in Denver, Colorado. This is an annual conference hosted by ZOLL each year for customers and individuals alike who are looking to learn more about the latest technology for data management within the EMS industry. Since being founded ...

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ePro Scheduler- New location-based time clock software

Now Available For Clients With Timekeeping : Location-Based Timeclocks with Geofencing! eCore's new Location-Based Timeclocks for mobile provide an easy solution for managing your field employees that are always on the go. The new Location-Based Timeclocks are equipped with geofencing that keeps you in control even from miles away. How it Works With the new Location-Based Timeclocks, employees ...

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Incorporate 3 C’s of Mobile Communication into your EMS scheduling processes

Brought to you by eCore Software Communicating effectively is a key skill in all professions, but in the EMS industry, it can be the difference between life and death. Effective communication encompasses much more than simply being able to talk to someone. Learning to be an active listener and picking up on non-verbal cues are great skills to have in the field, but when it comes to getting a message ...

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How do EMS agencies increase productivity with automated certification tracking?

Brought to you by eCore Software Each year more requirements are put on the EMS industry to fulfill the need for higher quality EMS professionals. As the U.S. population grows, it becomes more critical for emergency medical services and agencies to keep track of required licenses and certifications and ensure that all documentation is up to date and valid every time employees are on a shift. Usually ...

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Top 6 reasons air medical agencies need EMS employee scheduling software

Brought to you by eCore Software Efficiency and time saving are key in all air medical agencies. The need to create complex schedules and communicate that schedule out to the team in a timely manner is a critical process, which requires the most reliable software and workflows to be in place. Fortunately, with the advancements in technology, the majority of air transport organizations have transitioned ...

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Comparison of Small Versus Large Volume Split Dose Preparation for Colonoscopy: A Study of Colonoscopy Outcomes

Abstract

Background

Split dose bowel preparations (SDP) have superior outcomes for colonoscopy as compared to evening before regimens. However, the association of the actual volume of the SDP to colonoscopy outcome measures has not been well studied.

Aims

Compare adenoma detection rate (ADR), sessile serrated polyp detection rate (SDR), mean bowel cleanse score, and predictors of inadequate exams between small volume SDP and large volume SDP.

Methods

We have conducted a retrospective study in patients undergoing colonoscopy with small volume SDP versus large volume SDP between July 2014 and December 2014. Basic demographics (age, gender and BMI) along with clinical co-morbidities were recorded. Quality of the bowel preparation, ADR and SDR was compared between these groups. Univariate and multivariable logistic regressions were used to assess the determinants of inadequate exams in each group.

Results

1573 patients with split dose preparation were included in this retrospective study. 58.4% (920/1573) patients took small volume SDP. There was no difference in ADR (37.9 vs. 38.8%, p = 0.2); however, SDR was higher for small volume SDP compared to large volume SDP (11.9 vs. 7.9% p = 0.005). There was no difference in the rate of inadequate exams between the two groups (p = 0.7). A history of diabetes and constipation was associated with inadequate exams only in the small volume SDP.

Conclusions

SDR was higher in small volume SDP. There was no difference in rate of inadequate exams between the two groups. A history of diabetes and constipation was associated with inadequate exams only in patients with the small volume SDP.



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Correction to: Principles of Exercise Prescription, and How They Influence Exercise-Induced Changes of Transcription Factors and Other Regulators of Mitochondrial Biogenesis

The original article can be found online at.



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Effects and Dose–Response Relationship of Balance Training on Balance Performance in Youth: A Systematic Review and Meta-Analysis

Abstract

Background

Effects and dose–response relationships of balance training on measures of balance are well-documented for healthy young and old adults. However, this has not been systematically studied in youth.

Objectives

The objectives of this systematic review and meta-analysis were to quantify effects of balance training (BT) on measures of static and dynamic balance in healthy children and adolescents. Additionally, dose–response relations for BT modalities (e.g. training period, frequency, volume) were quantified through the analysis of controlled trials.

Data Sources

A computerized systematic literature search was conducted in the electronic databases PubMed and Web of Science from January 1986 until June 2017 to identify articles related to BT in healthy trained and untrained children and adolescents.

Study Eligibility Criteria

A systematic approach was used to evaluate articles that examined the effects of BT on balance outcomes in youth. Controlled trials with pre- and post-measures were included if they examined healthy youth with a mean age of 6–19 years and assessed at least one measure of balance (i.e. static/dynamic steady-state balance, reactive balance, proactive balance) with behavioural (e.g. time during single-leg stance) or biomechanical (e.g. centre of pressure displacements during single-leg stance) test methods.

Study Appraisal and Synthesis Methods

The included studies were coded for the following criteria: training modalities (i.e. training period, frequency, volume), balance outcomes (i.e. static and dynamic balance) as well as chronological age, sex (male vs. female), training status (trained vs. untrained), setting (school vs. club), and testing method (biomechanical vs. physical fitness test). Weighted mean standardized mean differences (SMDwm) were calculated using a random-effects model to compute overall intervention effects relative to active and passive control groups. Between-study heterogeneity was assessed using I2 and χ2 statistics. A multivariate random effects meta-regression was computed to explain the influence of key training modalities (i.e. training period, training frequency, total number of training sessions, duration of training sessions, and total duration of training per week) on the effectiveness of BT on measures of balance performance. Further, subgroup univariate analyses were computed for each training modality. Additionally, dose–response relationships were characterized independently by interpreting the modality specific magnitude of effect sizes. Methodological quality of the included studies was rated with the help of the Physiotherapy Evidence Database (PEDro) Scale.

Results

Overall, our literature search revealed 198 hits of which 17 studies were eligible for inclusion in this systematic review and meta-analysis. Irrespective of age, sex, training status, sport discipline and training method, moderate to large BT-related effects were found for measures of static (SMDwm = 0.71) and dynamic (SMDwm = 1.03) balance in youth. However, our subgroup analyses did not reveal any statistically significant effects of the moderator variables age, sex, training status, setting and testing method on overall balance (i.e. aggregation of static and dynamic balance). BT-related effects in adolescents were moderate to large for measures of static (SMDwm = 0.61) and dynamic (SMDwm = 0.86) balance. With regard to the dose–response relationships, findings from the multivariate random effects meta-regression revealed that none of the examined training modalities predicted the effects of BT on balance performance in adolescents (R2 = 0.00). In addition, results from univariate analysis have to be interpreted with caution because training modalities were computed as single factors irrespective of potential between-modality interactions. For training period, 12 weeks of training achieved the largest effect (SMDwm = 1.40). For training frequency, the largest effect was found for two sessions per week (SMDwm = 1.29). For total number of training sessions, the largest effect was observed for 24–36 sessions (SMDwm = 1.58). For the modality duration of a single training session, 4–15 min reached the largest effect (SMDwm = 1.03). Finally, for the modality training per week, a total duration of 31–60 min per week (SMDwm = 1.33) provided the largest effects on overall balance in adolescents. Methodological quality of the studies was rated as moderate with a median PEDro score of 6.0.

Limitations

Dose–response relationships were calculated independently for training modalities (i.e. modality specific) and not interdependently. Training intensity was not considered for the calculation of dose–response relationships because the included studies did not report this training modality. Further, the number of included studies allowed the characterization of dose–response relationships in adolescents for overall balance only. In addition, our analyses revealed a considerable between-study heterogeneity (I2  = 66–83%). The results of this meta-analysis have to be interpreted with caution due to their preliminary status.

Conclusions

BT is a highly effective means to improve balance performance with moderate to large effects on static and dynamic balance in healthy youth irrespective of age, sex, training status, setting and testing method. The examined training modalities did not have a moderating effect on balance performance in healthy adolescents. Thus, we conclude that an additional but so far unidentified training modality may have a major effect on balance performance that was not assessed in our analysis. Training intensity could be a promising candidate. However, future studies are needed to find appropriate methods to assess BT intensity.



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The Impact of Tumor Differentiation on the Prognosis of HBV-Associated Solitary Hepatocellular Carcinoma Following Hepatectomy: A Propensity Score Matching Analysis

Abstract

Aim

The role of tumor differentiation in the prognosis of hepatocellular carcinoma (HCC) after hepatectomy remains controversial. The present study aimed to classify the impact of tumor differentiation on solitary hepatitis B viral (HBV)-associated HCC using propensity score matching analysis.

Methods

Between January 2009 and March 2015, the data of 721 HCC patients in West China Hospital were prospectively collected and analyzed. Propensity matching analysis was applied to overcome the imbalance in baseline characteristics. Survival analysis was performed using the Kaplan–Meier method. Risk factors were identified by the Cox proportional hazards model.

Results

All HCC patients were classified into the moderately well-differentiated HCCs group (group A, n = 442, 61.3%) or poorly differentiated HCCs group (group B, n = 279, 38.7%). Patients with poorly differentiated HCCs commonly had a larger tumor size, more advanced tumors, and a higher alpha-fetoprotein (AFP) level. Patients with poorly differentiated HCCs had a poorer recurrence-free survival and overall survival before and after propensity score matching analysis. Poorly differentiated tumors, positive serum hepatitis B viral e antigen, positive hepatitis B virus deoxyribonucleic acid load, tumor size, microvascular invasion, and AFP > 400 ng/ml were risk factors of a poor outcome.

Conclusions

Our propensity model provided strong evidence that a poorly differentiated tumor had a negative impact on the recurrence and long-term survival of solitary HBV-associated HCCs after curative hepatectomy. Antiviral therapy might improve their prognosis.



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Circulating microRNA-22-3p Predicts the Malignant Progression of Precancerous Gastric Lesions from Intestinal Metaplasia to Early Adenocarcinoma

Abstract

Background

Gastric cancer has a poor outcome and identifying useful biomarkers from peripheral blood or tissue could allow its early detection, or potentially precancerous changes, thus improving the curative rates. MicroRNAs (miRNAs) have been shown to offer great potential in cancer diagnosis and prediction.

Aim

Here, we investigated the role of plasma miRNAs in the natural course of gastric cancer, from intestinal metaplasia to early cancer. The findings were used to understand whether patients at a high risk of malignancy could be given appropriate interventions in the early disease process, such as using endoscopic submucosal dissection to treat gastric dysplasia or early gastric cancer.

Methods

Participants were divided into healthy control, intestinal metaplasia (IM), and dysplasia/early cancer (pT1a/b) groups. Microarray was used to select potential markers in tissue.

Results

Quantitative real-time polymerase chain reaction data showed circulating miRNA-22-3p had significantly different expression in patients with precancerous lesions or gastric adenocarcinoma. The areas under the curve of incomplete IM versus healthy control, low-grade/high-grade dysplasia, early gastric cancer, and GED were 0.8080, 0.8040, 0.8494, and 0.8095, respectively (all P values < 0.05).

Conclusions

Circulating miRNA-22-3p could be a potential biomarker for gastric precancerous dysplasia and early cancer detection.



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Sofosbuvir plus ribavirin with or without peginterferon for the treatment of hepatitis C virus: Results from a phase 3b study in China

Journal of Gastroenterology and Hepatology

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Nonalcoholic fatty liver disease is associated with decreased lung function

Liver International

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Clinical and endoscopic evaluations of sessile serrated adenoma/polyps with cytological dysplasia

Journal of Gastroenterology and Hepatology

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A prospective randomized double-blind study of pain control by topical calcium channel blockers vs placebo after Milligan-Morgan hemorrhoidectomy

International Journal of Colorectal Disease

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Efficacy of an Attachment-Based Intervention Model on Health Indices in Children with Chronic Disease and Their Mothers

Abstract

Studies have shown significant relationship between health conditions and attachment. This study aimed to examine an attachment-based intervention model named mother–child-disease triangle (MCDT) on health indices in children with chronic disease and their mothers. This randomized trial study included 22 volunteer children aged 12–18 years undergoing medical treatment for a chronic disease and their mothers. After evaluation by 28-form General Health Questionnaire (GHQ-28), inventory of parent and peer attachment (IPPA), 28-form Child Health Questionnaire (CHQ-28) and Illness Perception Questionnaire (IPQ), the mother–child dyads were paired on the basis of IPPA scores. These pairs were then randomly assigned to an experimental or control group. The experimental group received ten 90-min sessions of MCDT over a 7-week period. Meanwhile, the control group received ten simple conversational sessions as a dummy intervention. In accordance with this study's pre-test/post-test design, both groups were evaluated once again after completing their respective treatment. Multivariate analysis of covariance (MANCOVA) showed members of the experimental group to have significantly stronger attachment and better physiological and psychosocial health than those in the control group. These findings suggest that attachment-based interventions can be used to improve the effectiveness of treatment among children with chronic disease and their mothers.



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