Shared decision-making in gout treatment: a national study of rheumatology provider opinion and practice

Clinical Rheumatology - To assess rheumatologists’ views and practices related to shared decision-making (SDM) in gout treatment. We performed a cross-sectional electronic survey of...     

Effects of Angiotensin Receptor-Neprilysin Inhibitor in Arrhythmogenicity Following Left Atrial Appendage Closure in an Animal Model

Cardiovascular Drugs and Therapy - Left atrial appendage (LAA) closure decreases atrial natriuretic peptide (ANP) levels, which indirectly increases the risk of arrhythmogenicity. We aimed to...     

Assessing the Evolution of Intracranial Hematomas by using Animal Models: A Review of the Progress and the Challenges

Metabolic Brain Disease - Stroke has become the second leading cause of death in people aged higher than 60 years, with cancer being the first. Intracerebral hemorrhage (ICH) is the most...     

Methotrexate use does not increase the prevalence of hepatic steatosis: a real-world retrospective nested case-control study

Clinical Rheumatology - We aimed to determine whether methotrexate (MTX) treatment in patients with rheumatoid arthritis (RA) leads to the development of non-alcoholic fatty liver (NAFL). Data were...     

Lower risk of primary Sjogren’s syndrome in patients with dengue virus infection: a nationwide cohort study in Taiwan

Clinical Rheumatology - The data concerning the association between dengue viruses (DV) infection and autoimmune diseases (ADs) remain unclear and are scarce. This nationwide population-based...     

HIV Prevention and Treatment Behavior Change and the Situated Information Motivation Behavioral Skills (sIMB) Model: A Qualitative Evaluation of a Community Health Worker Intervention in Rakai,Uganda

AIDS and Behavior - A community health worker (CHW) model can promote HIV prevention and treatment behaviors, especially in highly mobile populations. In a fishing community in Rakai, Uganda, the...     

No difference of accuracy between capillary and venous blood in rapid whole blood test for diagnosis of Helicobacter pylori infection

The aims of the study were to evaluate the diagnostic accuracy of a rapid whole blood test (one-step BM-Test Helicobacter pylori) in different blood collections and compare it with a quantitative ELISA test (HEL-p TEST II). One hundred four dyspeptic patients were studied, and 53 (51%) were H. pylori-positive as determined by [¹³C] urea breath test. The area under the ROC curve was higher for HEL-pTEST II compared to the one-step BM-Test with either fingerstick or venipuncture (0.972 vs 0.721 and 0.714, P = 0.000). The most appropriate cutoff reading time was 5 min for the one-step BM-Test. The sensitivity, specificity, and accuracy were 52.8%, 88.2%, 70.2% for fingerstick; 62.3%, 80.4%, 71.2% for venipuncture; and 90.6%, 92.2%, 91.3% for HEL-pTEST II. We conclude that there is no difference in diagnostic performance between capillary and venous blood for rapid whole blood test, and extending the reading time beyond the manufacturer's suggestion for the one step BM-Test does not improve its accuracy.     

Clinical significance of intrahepatic biliary stricture in efficacy of hepatic resection for intrahepatic stones

In the Far East, hepatic resection is the definitive treatment for complicated intrahepatic stones (IHS). However, many investigators have reported that the associated intrahepatic biliary stricture is the main cause of treatment failure. A retrospective comparative study was undertaken to clarify the long-term efficacy of hepatic resection for treatment of IHS and to investigate the clinical significance of intrahepatic biliary stricture in treatment failure after hepatic resection performed in 44 patients with symptomatic IHS. The patients were divided into two study groups: group A, with intrahepatic biliary stricture (n = 28) and group B, without stricture (n = 16). Residual or recurrent stones, recurrence of intrahepatic biliary stricture, late cholangitis, and final outcomes were analyzed and compared statistically between the two groups. The patients were followed up for a median duration of 65 months after hepatectomy. The overall incidence of residual or recurrent stones was 36% and 11%, respectively, in groups A and B. The initial treatment failure rate was 50% in group A and 31% in group B. Intrahepatic biliary stricture recurred in 46% of patients in group A, while none of the group B patients had biliary stricture recurrence (P = 0.001). More than two-thirds of the restrictures in group A were identified at the primary site. The incidence of late cholangitis was higher in group A (54%) than in group B (6%) (P = 0.002). Three-quarters of the patients with cholangitis in group A had severe cholangitis, that was recurrent, and related to stones and strictures (n = 11). They and 2 asymptomatic patients in group B required secondary procedures done at a median of 12 months after hepatectomy. Final outcomes after hepatectomy with or without secondary management were good in 80%, fair in 16%, and poor in 4% of our 44 patients. Most recurrent cholangitis after hepatectomy in patients with IHS was related to recurrent intrahepatic ductal strictures. Therefore, to be effective, hepatic resection should include the strictured duct. However, with hepatectomy alone it is difficult to clear the IHS or relieve the ductal strictures completely, particularly in patients with bilateral IHS, so perioperative team approaches that include both radiologic and cholangioscopic interventions should be combined for the effective management of IHS.     

An adult case of Chryseobacterium meningosepticum meningitis

Chryseobacterium meningosepticum is an uncommon pathogen causing adult bacterial meningitis. Herein, we report the case history of one 21-year-old woman with this uncommon central nervous system infection. A diagnosis of adult C. meningosepticum meningitis can only be confirmed by a positive cerebrospinal fluid (CSF) culture. The patient had insulin-dependent diabetes mellitus as the underlying condition associated with this infection. The clinical presentations were fever, headache, consciousness disturbance, and seizure. CSF analysis revealed a purulent inflammatory reaction. After a 21-day course of intravenous cefepime (6 g/day) treatment, this patient was discharged in a state of complete recovery.