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JOURNAL ARTICLE
Louise C Kelly, Joanne V Glinsky, Lisa A Harvey
INTRODUCTION: Historically, bladder washouts were used to instil therapeutic reagents directly into the bladder. This practice has expanded to include instillation of solutions that deal with catheter issues such as encrustation or formation of bio-film. They appear to provide a promising strategy for people with long term catheters. These products are readily available to purchase, but there is concern that people are using these solutions without a complete understanding of the purpose for the rinse and without clinical guidance to monitor response to treatment...
April 5, 2024: Spinal Cord Series and Cases
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JOURNAL ARTICLE
Michel Beauverd, Marta Mazzoli, Josiane Pralong, Martyna Tomczyk, Steffen Eychmüller, Jan Gaertner
Palliative sedation is defined as the monitored use of medications intended to induce a state of decreased or absent awareness (unconsciousness) to relieve the burden of otherwise intractable suffering in a manner ethically acceptable to the patient, their family, and healthcare providers. In Switzerland, the prevalence of continuous deep sedation until death increased from 4.7% in 2001 to 17.5% of all deceased in 2013, depending on the research method used and on regional variations. Yet, these numbers may be overestimated due to a lack of understanding of the term "continuous deep sedation" by for example respondents of the questionnaire-based study...
February 15, 2024: Swiss Medical Weekly
#23
JOURNAL ARTICLE
Seulji Kim, Hyun Jung Lee, Seung Woo Lee, Sanghyun Park, Seong-Joon Koh, Jong Pil Im, Byeong Gwan Kim, Kyung-Do Han, Joo Sung Kim
BACKGROUND: Inflammatory bowel disease (IBD) was previously regarded as a Western disease; however, its incidence is increasing in the East. The epidemiology of IBD in Asia differs significantly from the patterns in the West. AIM: To comprehensively investigate the epidemiology of IBD in South Korea, including its incidence, prevalence, medication trends, and outcomes. METHODS: We analyzed claims data from the Health Insurance Review and Assessment Service and Rare and Intractable Diseases (RIDs), operated by the National Health Insurance Service of South Korea...
March 7, 2024: World Journal of Gastroenterology: WJG
#24
JOURNAL ARTICLE
Riku Kinoshita, Naoya Inoue, Yoshinori Iwatani, Yusuke Noguchi, Yoh Hidaka, Mikio Watanabe
The prognosis of autoimmune thyroid diseases (AITDs), including Hashimoto's disease (HD) and Graves' disease (GD), is difficult to predict. DNA methylation regulates gene expression of immune mediating factors. Interleukin (IL)-10 is a Th2 cytokine that downregulates inflammatory cytokines produced by Th1 cells. To clarify the role of methylation of the IL10 gene in the prognosis of AITD, we evaluated the methylation levels of two CpG sites in the IL10 promoter using pyrosequencing. The methylation levels of the -185 CpG site of the IL10 gene were related to age and GD intractability in GD patients...
April 1, 2024: Clinical Immunology: the Official Journal of the Clinical Immunology Society
#25
Abdulrahman A Aldoseri, Rashed N Buhaza, Raafat Hammad Seroor Jadah
Autosomal Dominant Mental Retardation Type 7 is a disorder caused by pathogenic variants in the DYRK1A gene. Clinical features associated with this gene mutation include focal dysmorphism, developmental delay, and epilepsy. In this report, we present a case of an 8-year-old boy with a DYRK1A gene mutation, whose clinical manifestations underscore the rarity and clinical challenges of this genetic condition. The patient is a known case of global developmental delay with intractable epilepsy on multiple anti-epileptic medications...
April 2024: Curēus
#26
JOURNAL ARTICLE
Eun Sun Jang, Hwa Young Choi, Moran Ki, Bo Hyun Kim, Kyung-Ah Kim, Sook-Hyang Jeong
BACKGROUND: Wilson's disease (WD) is an autosomal recessive disorder in which copper (Cu) accumulates in organs, particularly in the liver and central nervous system. This study aimed to investigate the prevalence, incidence, and treatment patterns of WD patients in Korea. METHODS: National Health Insurance System (NHIS) claims data from 2010 to 2020 were analyzed. patients with WD as a primary or additional diagnosis at least once were identified using the International Classification of Diseases (ICD)-10 disease code E83...
April 1, 2024: Journal of Korean Medical Science
#27
REVIEW
Jeremy Adler, Theresa Mallick-Searle, Mark Garofoli, Amanda Zimmerman
Due to the prevalence of chronic pain and high-impact chronic pain in the US, a significant percentage of the population is prescribed opioids for pain management. However, opioid use disorder is associated with reduced quality of life, along with fatal opioid overdoses, and is a significant burden on the US economy. Considering the clinical needs of patients with intractable chronic pain and the potential harms associated with prescribed and illicit opioids in our communities, having a deep understanding of current treatment options, supporting evidence, and clinical practice guidelines is essential for optimizing treatment selections...
2024: Journal of Multidisciplinary Healthcare
#28
C LeMaster, C Schwendinger-Schreck, B Ge, W Cheung, J J Johnston, T Pastinen, C Smail
Recent studies have revealed the pervasive landscape of rare structural variants (rSVs) present in human genomes. rSVs can have extreme effects on the expression of proximal genes and, in a rare disease context, have been implicated in patient cases where no diagnostic single nucleotide variant (SNV) was found. Approaches for integrating rSVs to date have focused on targeted approaches in known Mendelian rare disease genes. This approach is intractable for rare diseases with many causal loci or patients with complex, multi-phenotype syndromes...
March 18, 2024: medRxiv
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JOURNAL ARTICLE
Hidenori Ohkubo, Takaomi Kessoku, Kosuke Tanaka, Kota Takahashi, Tomohiro Takatsu, Tsutomu Yoshihara, Noboru Misawa, Keiichi Ashikari, Akiko Fuyuki, Shingo Kato, Takuma Higurashi, Kunihiro Hosono, Masato Yoneda, Toshihiro Misumi, Satoru Shinoda, Vincenzo Stanghellini, Atsushi Nakajima
Chronic intestinal pseudo-obstruction (CIPO) is a rare intractable disease with limited treatment options. Small intestinal bacterial overgrowth (SIBO) often co-occurs with several diseases, including CIPO. While rifaximin (RFX) is effective in treating SIBO, its efficacy for CIPO remains unclear. Here, we aimed to investigate the efficacy and safety of RFX in adult patients with CIPO. Twelve patients were randomly assigned to receive RFX (400 mg three times daily, n=8) or a placebo (PBO, n=4) for 4 weeks...
2024: Bioscience of Microbiota, Food and Health
#30
JOURNAL ARTICLE
Soonwook Kwon, Kyung-Do Han, Jin Hyung Jung, Eun Bin Cho, Yeon Hak Chung, Junhee Park, Hea Lim Choi, Hong Jin Jeon, Dong Wook Shin, Ju-Hong Min
BACKGROUND: We investigated the risks of depression/anxiety in patients with multiple sclerosis (pwMS) or patients with neuromyelitis optica spectrum disorder (pwNMOSD). OBJECTIVES: MS/NMOSD cohorts were collected from Korean National Health Insurance Service, using the International Classification of Diseases-10th and information on Rare Intractable Disease program. Patients who were younger than 20 years, had a previous depression/anxiety, or died in the index year were excluded...
April 1, 2024: Multiple Sclerosis: Clinical and Laboratory Research
#31
JOURNAL ARTICLE
Chen Chen, Juan Du, Xianqiang Wang, Liang Zou
BACKGROUND: The implantation of left ventricular assist devices (LVADs) as a bridge to transplantation or as destination therapy in end-stage heart failure patients is frequently complicated by the emergence of ventricular arrhythmias (VAs). These arrhythmias have been implicated in precipitating deleterious clinical outcomes, increased mortality rates and augmented healthcare expenditures. CASE PRESENTATION: We present a challenging case of a 49-year-old male with a history of dilated cardiomyopathy who received an LVAD...
April 1, 2024: Journal of Cardiothoracic Surgery
#32
JOURNAL ARTICLE
Ryan Johnson, Annabelle Shaffer, Ashley Tang, Kathryn Tsai, Gina Guglielmi, Paul M Arnold
BACKGROUND: Spinal metastases are commonly seen in patients with cancer and often indicate a poor prognosis. Treatment can include curative or palliative surgery, chemotherapy, and radiation therapy. The surgical approach varies widely on the basis of the affected region of the spine, the location of the tumor (anterior versus posterior), the goal of surgery, the health of the patient, and surgeon preference. OBSERVATIONS: The authors present a case of a 68-year-old male with intractable lower-back pain and substantially diminished ambulation...
April 1, 2024: J Neurosurg Case Lessons
#33
Hao-Lun Hsu, Qitong Gao, Miroslav Pajic
Deep Brain Stimulation (DBS) stands as an effective intervention for alleviating the motor symptoms of Parkinson's disease (PD). Traditional commercial DBS devices are only able to deliver fixed-frequency periodic pulses to the basal ganglia (BG) regions of the brain, i.e., continuous DBS (cDBS). However, they in general suffer from energy inefficiency and side effects, such as speech impairment. Recent research has focused on adaptive DBS (aDBS) to resolve the limitations of cDBS. Specifically, reinforcement learning (RL) based approaches have been developed to adapt the frequencies of the stimuli in order to achieve both energy efficiency and treatment efficacy...
March 11, 2024: ArXiv
#34
Xusheng Gao, Caihong Ding, Dan Xie, Qing Wang, Peipei Jiang, Yuyu Wang, Yu Xiong
BACKGROUND: In recent decades, there has been a substantial surge in the incidence of non-tuberculous Mycobacteria (NTM) infections. However, the diagnosis and management of NTM globally present significant challenges, particularly in cases involving Mycobacterium abscessus complex (MABC) infection where effective therapeutic options are limited. CASE PRESENTATION: We reported a 38-year-old female patient who was infected with MABC of skin due to "beauty needle" at a beauty salon, with mass on both cheeks, accompanied by redness, and pain, and some of them was ulcered and effused...
2024: Infection and Drug Resistance
#35
Arun Kalava, Simeon V Mihaylov, Harriet Kaye Austin, Saru Acharya
Postherpetic neuralgia (PHN) is a chronic neuropathic pain syndrome that is a direct consequence of the reactivation of varicella zoster virus (VZV). It manifests as neuropathic pain, which is pain that occurs because of dysfunction or damage of the nerves that carry sensations to the brain, and this typically persists for months to years after herpes zoster. Current conservative management for PHN includes a combination of topical agents (i.e., lidocaine and capsaicin) and systemic therapy (i.e., serotonin and norepinephrine reuptake inhibitors (SNRIs), gabapentin, pregabalin, and opioids)...
February 2024: Curēus
#36
Motoyasu Kan, Yusuke Kouchi, Hiroshi Ohyama, Genki Usui, Masaki Fukuyo, Shigetsugu Takano, Takashi Kishimoto, Atsushi Kaneda, Masayuki Ohtsuka, Naoya Kato
Pancreatic cancer is an intractable malignancy associated with a dismal prognosis. Undifferentiated carcinoma, a rare subtype, poses a clinical challenge owing to a limited understanding of its molecular characteristics. In this study, we conducted genomic analysis specifically on a case of undifferentiated carcinoma of the pancreas exhibiting squamous differentiation. An 80-year-old male, previously treated for colorectal cancer, presented with a mass with central cystic degeneration in the pancreatic tail...
February 2024: Curēus
#37
JOURNAL ARTICLE
Jixue Yang, Dongming Li, Zhentao Li, Haiyan Wang, Yan Dong, Xiaoli Zhang
Objective: This study aims to analyze key factors affecting the surgical outcome of children with intractable epilepsy caused by focal cortical dysplasia, providing more effective clinical guidance. Methods: We conducted a study from March 2019 to February 2021, selecting 80 children with intractable epilepsy caused by focal cortical dysplasia who underwent surgical treatment. Comprehensive inclusion criteria were met. We collected general information and treatment outcomes before and after surgery, with a two-year postoperative follow-up...
April 1, 2024: International Journal of Neuroscience
#38
JOURNAL ARTICLE
Akiko Wakisaka, Koichi Kimura, Hiroyuki Morita, Koki Nakanishi, Masao Daimon, Masanori Nojima, Hideki Itoh, Atsuhito Takeda, Ruriko Kitao, Tomihiro Imai, Tetsuhiko Ikeda, Takashi Nakajima, Chigusa Watanabe, Toshihiro Furukawa, Ichiro Ohno, Chiho Ishida, Norihiko Takeda, Kiyonobu Komai
Duchenne muscular dystrophy (DMD) is an intractable X-linked myopathy caused by dystrophin gene mutations. Patients with DMD suffer from progressive muscle weakness, inevitable cardiomyopathy, increased heart rate (HR), and decreased blood pressure (BP). The aim of this study was to clarify the efficacy and tolerability of ivabradine treatment for DMD cardiomyopathy.A retrospective analysis was performed in 11 patients with DMD, who received ivabradine treatment for more than 1 year. Clinical results were analyzed before (baseline), 6 months after, and 12 months after the ivabradine administration...
2024: International Heart Journal
#39
JOURNAL ARTICLE
Xinrang Zhai, Honghua Hu, Miner Hu, Shunxian Ji, Tao Lei, Xiaozhao Wang, Zhiqiang Zhu, Wei Dong, Chong Teng, Wei Wei
Diabetic wound infection brings chronic pain to patients and the therapy remains a crucial challenge owing to the disruption of the internal microenvironment. Herein, we report a nano-composite hydrogel (ZnO@HN) based on ZnO nanoparticles and a photo-trigging hyaluronic acid which is modified by o-nitrobenzene (NB), to accelerate infected diabetic wound healing. The diameter of the prepared ZnO nanoparticle is about 50 nm. X-ray photoelectron spectroscopy (XPS) analysis reveals that the coordinate bond binds ZnO in the hydrogel, rather than simple physical restraint...
June 15, 2024: Carbohydrate Polymers
#40
JOURNAL ARTICLE
Junichi Nakamura, Wakaba Fukushima, Wataru Ando, Shigeo Hagiwara, Yuya Kawarai, Yuki Shiko, Yohei Kawasaki, Takashi Sakai, Kazuya Ito, Yoshiya Arishima, Etsuo Chosa, Yusuke Fujimoto, Kazuo Fujiwara, Yukiharu Hasegawa, Shinya Hayashi, Takashi Imagama, Yutaka Inaba, Yasuyuki Ishibashi, Yasuhiro Ishidou, Hideya Ito, Hiroshi Ito, Juji Ito, Tetsuya Jinno, Tamon Kabata, Nobuhiro Kaku, Ayumi Kaneuji, Shunji Kishida, Seneki Kobayashi, Setsuro Komiya, Toshikazu Kubo, Tokifumi Majima, Naohiko Mashima, Masaaki Mawatari, Hidenobu Miki, Kazumasa Miyatake, Goro Motomura, Satoshi Nagoya, Hiroaki Nakamura, Yoshihide Nakamura, Ryosuke Nakanishi, Yasuharu Nakashima, Satoshi Nakasone, Takashi Nishii, Takayuki Nishiyama, Yoichi Ohta, Kenji Ohzono, Makoto Osaki, Kan Sasaki, Taisuke Seki, Takaaki Shishido, Takeshi Shoji, Akihiro Sudo, Michiaki Takagi, Daisuke Takahashi, Masaki Takao, Sakae Tanaka, Takeyuki Tanaka, Tomonori Tetsunaga, Keiichiro Ueshima, Kengo Yamamoto, Takuaki Yamamoto, Yuji Yamamoto, Takuma Yamasaki, Yuji Yasunaga, Nobuhiko Sugano
OBJECTIVES: This study documents the time elapsed from the diagnosis of osteonecrosis of the femoral head (ONFH) to surgery, exploring the factors that influence ONFH severity. DESIGN: Retrospective observational study of a nationwide database. SETTING: The Kaplan-Meier method with log-rank tests was applied to examine the period from definitive diagnosis of ONFH to surgery using any surgery as the end point. For bilateral cases, the date of the first surgery was the endpoint...
March 29, 2024: BMJ Open
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