Alcohol Abuse and Cardiac Disease

Background

Understanding the relationship between alcohol abuse, a common and theoretically modifiable condition, and the most common cause of death in the world, cardiovascular disease, may inform potential prevention strategies.

棘球蚴病临床领域相关中文专业术语专家共识

棘球蚴病(亦称包虫病)研究领域几乎包括了所有不同学科,在研究过程中规范使用相关领域专业术语至关重要。为了规范相关术语,世界棘球蚴病学会秉承语言精炼、科学严谨的原则启动了专业术语共识编撰工作,并于2020年在Parasite杂志刊登成果,引起学术界共鸣。撰写这版棘球蚴病领域术语英文版的专家来自不同国家和地区、不同研究领域。作为世界卫生组织棘球蚴病预防与管理合作中心和中国医师协会外科分会包虫病外科委员会主持机构,笔者参与撰写英文版专家共识,现将棘球蚴病临床领域相关术语共识中文版与国内专家研究者分享。此项工作包含了棘球蚴病临床诊治的各个领域,是寄生虫病尤其是棘球蚴病相关领域的科学和医学术语规范化的初次尝试。     

Haemangioma or vascular malformation of the tympanic membrane? a case report and review of literature

Benign vascular lesions are rarely found on the tympanic membrane. We report a case of such a lesion in a novel location, with review of the relevant literature. We also highlight the significance of accurate classification of such lesions, proposing adoption of more pathophysiologically-correct nomenclature of “haemangioma” and “vascular malformation”.     

Accuracy of administrative claims data to identify dose specific rotavirus vaccination information: Implications for studies of vaccine safety

BackgroundThe accuracy of vaccine administration information recorded in administrative claims databases is uncertain.MethodsWe conducted a retrospective cohort study using the HealthCore Integrated Research Database^SM among infants who received at least 1 RotaTeq^® (RV5) dose during the first year of life between February 1, 2006 and November 30, 2012 and were enrolled in the health plan at birth. We reviewed medical records for a sample of infants to validate vaccine administration information.ResultsWe identified 169,560 infants who received at least 1 RV5 dose. Medical records were obtained for 85 infants, of which 74 (PPV1 87.1%; 95% CI 78.0–93.4%) had a corresponding first RV5 vaccination in the medical record with the same or similar administration date.ConclusionsAdministrative claims contained inaccuracies in dose number or administration date for 13% of RV5 first doses identified.     

中医术语翻译的国际标准与文化传承——从经络部分谈起

根据2007年10月世界卫生组织两太区颁布的<传统医学名词术语国际标准>,就其经络部分的中医术语的翻译,探讨中医术语翻译中的文化传承问题并提出相关策略.     

Clinical impact of combination therapy with baricitinib,remdesivir, and dexamethasone in patients with severe COVID-19

BackgroundCoronavirus disease 2019 (COVID-19) has spread worldwide and is also an important disease in Japan. Thus, the optimal treatment strategy for severe COVID-19 should be established urgently. The effects of combination treatment with baricitinib—a Janus kinase inhibitor, remdesivir, and dexamethasone (BRD) are unknown.MethodsPatients who received combination therapy with BRD at the Japanese Red Cross Medical Center were enrolled in the study. All patients received baricitinib (≤14 d), remdesivir (≤10 d), and dexamethasone (≤10 d). The efficacy and adverse events were evaluated.ResultsIn total, 44 patients with severe COVID-19 were enrolled in this study. The 28-d mortality rate was low at 2.3% (1/44 patients). The need for invasive mechanical ventilation was avoided in most patients (90%, 17/19 patients). Patients who received BRD therapy had a median hospitalization duration of 11 d, time to recovery of 9 d, duration of intensive care unit stay of 6 d, duration of invasive mechanical ventilation of 5 d, and duration of supplemental oxygen therapy of 5 d. Adverse events occurred in 15 patients (34%). Liver dysfunction, thrombosis, iliopsoas hematoma, renal dysfunction, ventilator-associated pneumonia, infective endocarditis, and herpes zoster occurred in 11%, 11%, 2%, 2%, 2%, 2%, and 2% of patients, respectively.ConclusionsCombination therapy with BRD was effective in treating severe COVID-19, and the incidence rate of adverse events was low. The results of the present study are encouraging; however, further randomized clinical studies are needed.     

The impact of long-term corticosteroid use on acute postoperative complications following lumbar decompression surgery

BackgroundCorticosteroids have a negative impact on the human immune system’s ability to function at an optimal level. Studies have shown that patients on long-term corticosteroids have higher infection rates. However, the rates of infection and other complications following lumbar decompression surgery remains under-investigated. The aim of our study was to determine the impact of preoperative long-term corticosteroid usage on acute, 30-day postoperative complications in a subset of patients undergoing lumbar spine decompression surgery, without fusion or instrumentation. We hypothesize that patients on long-term corticosteroids will have higher rates of infection and other postoperative complications after undergoing lumbar decompression surgery of the spine.MethodsA retrospective cohort study was conducted using data collected from the National Surgical Quality Improvement Program database data from 2005 to 2016. Lumbar decompression surgeries, including discectomies, laminectomies, and others were identified using CPT codes. Chi-square analysis was used to evaluate differences among the corticosteroid and non-corticosteroid groups for demographics, preoperative comorbidities, and postoperative complications. Logistic regression analysis was done to determine if long-term corticosteroid use predicts incidence of postoperative infections following adjustment.Results26,734 subjects met inclusion criteria. A total of 1044 patients (3.9%) were on long-term corticosteroids prior to surgical intervention, and 25,690 patients (96.1%) were not on long-term corticosteroids. Patients on long-term corticosteroids were more likely to be older (p < 0.001), female (p < 0.001), nonsmokers (p < 0.001), and have a higher American Society of Anesthesiologist class (p < 0.001). Multivariate analysis demonstrated that long-term corticosteroid usage was associated with increased overall complications (odds ratio [OR]: 1.543; p < 0.001), and an independent risk factor for the development of minor complications (OR: 1.808; p < 0.001), urinary tract infection (OR: 2.033; p = 0.002), extended length of stay (OR: 1.244; p = 0.039), thromboembolic complications (OR: 1.919; p = 0.023), and sepsis complications (OR: 2.032; p = 0.024).ConclusionLong-term corticosteroid usage is associated with a significant increased risk of acute postoperative complication development, including urinary tract infection, sepsis and septic shock, thromboembolic complications, and extended length of hospital stay, but not with superficial or deep infection in patients undergoing lumbar decompression procedures. Spine surgeons should remain vigilant regarding postoperative complications in patients on long-term corticosteroids, especially as it relates to UTI and propensity to decompensate into sepsis or septic shock. Thromboembolic risk attenuation is also imperative in this patient group during the postoperative period and the surgeon should weigh the risks and benefits of more intensive anticoagulation measures.     

Haemangioma or vascular malformation of the tympanic membrane? a case report and review of literature

Benign vascular lesions are rarely found on the tympanic membrane. We report a case of such a lesion in a novel location, with review of the relevant literature. We also highlight the significance of accurate classification of such lesions, proposing adoption of more pathophysiologically-correct nomenclature of “haemangioma” and “vascular malformation”.