World journal of methodology最新文献

There exists a complex interaction between obesity, type 2 diabetes mellitus (T2DM) and cancer, and an increase in the incidence of cancer is expected with the growing obesity-diabetes pandemic. The association of cancer with diabetes mellitus and obesity appears to be site-specific, the highest risk being for post-menopausal breast cancer, endometrial cancer, and colorectal cancer. Moreover, there is worsening of hyperglycaemia with the onset of cancer, evidencing a bi-directional link between cancer and diabetes mellitus and the need for monitoring for diabetes in cancer survivors. In this review, we look at the epidemiological evidence from observational studies and Mendelian randomization studies linking obesity, diabetes, and cancer, as well as the complex pathophysiological mechanisms involved, including insulin resistance with associated hyperinsulinaemia, the effect of chronic low-grade inflammation, and the effect of various adipokines that are associated with obesity and T2DM. Additionally, we describe the novel therapeutic strategies, based on their role on the discrete pathophysiological mechanisms involved in the tumourigenesis.

Domestic cats represent one of the most common sources of indoor allergens. All over the world, many households own cats, whose allergens are persistent and widespread. Cat allergy itself is frequent, and its symptoms vary from rhinoconjunctivitis to life-threatening asthma. In vitro diagnosis using precision medicine allergy immunoassays is important because natural cat dander extracts may differ in quality and quantity of some of the individual allergen components and other molecules. In the component-resolved diagnosis of cat allergy, singleplex and multiplex specific immunoglobulin (Ig) E assays include use of the cat-specific major allergen, secretoglobin Fel d 1 (as a species-specific molecule), other allergen components (such as lipocalins Fel d 4, cross-reacting with other animal similar molecules, and Fel d 7, present in small quantities in natural extracts), and serum albumin Fel d 2 (related to the cat-pork syndrome). IgA Fel d 5 and IgM Fel d 6 are not available as allergen components in the current commercial IgE immunoassays, but they may impair the in vitro diagnostic evaluation of cat allergy because galactose-α1,3-galactose is an IgE-binding epitope of these native feline allergens. The benefits of molecular-based cat allergy diagnosis are continually evaluated, as the role of recombinant allergen components already known is detailed and new other molecules of interest may be discovered in the future.

Olfactory dysfunction (OD) has been described in patients with antineutrophil cytoplasmic antibody-associated vasculitides (AAV), but the underlying mechanisms are not completely understood. The causes of altered smell function can generally be divided into conductive, sensorineural or others. To date no specific treatment is available for AAV-related OD and the efficacy of currently available options has not been explored. The aim of this review is to provide an overview of the causes that may lead to OD in patients with AAV. Current available treatments for OD and possible options in patients with AAV presenting with smell impairment are also mentioned.

Background: In the ongoing coronavirus disease 2019 (COVID-19) pandemic, when children remain home-confined secondary to the closure of schools, little is known of the burden of the parents being their index case.

Aim: To determine the prevalence of parents being the index case of COVID-19 infected children.

Methods: A database search in PubMed and Scopus ensued to recruit studies reporting the index case information of COVID-19 infected individuals aged ≤ 18. The reviewed articles' quality evaluation included the use of the National Heart, Lung, and Blood Institute's tool. A random-effect meta-analysis ensued to determine the prevalence of the parent being and not-being the index case. Heterogeneity was assessed by I ² and Chi ² statistics. The publication bias was evaluated by funnel plots and Egger's test.

Results: Overall, this review included 13 eligible studies sourcing data from 622 children of 33 nations. Study designs were heterogeneous and primarily included descriptive reports (38.4%). The prevalence of parent being the index case was 54% (95%CI: 0.29-0.79; I ²: 62.3%, Chi ² P < 0.001). In > 70% of children, their index-case parent was symptomatic due to COVID-19 at the time of infection transmitting. Studies for which a risk of bias assessment was possible were of fair quality.

Conclusion: There is a substantial global burden of parents being the index case of COVID-19 infected children, and frequently these parents are symptomatic. Therefore, from a public health perspective, early detection of these parents is crucial.

Background: Skin closure techniques during minimally-invasive gynecologic surgery is largely based on surgeon preference. The optimum technique would theoretically be safe, rapid, inexpensive, and result in good cosmetic appearance. Cyanoacrylate tissue adhesive (Dermabond) may be a comparable and safe option for port site closure as compared with subcuticular suture. In this randomized clinical trial, we hypothesized that operative time for skin closure would be less than subcuticular suture during robotic urogynecologic procedures.

Aim: To compare skin closure during robotic urogynecologic surgeries for tissue adhesives and subcuticular suture.

Methods: Fifty female subjects > 18 years of age undergoing robotic urogynecologic procedures were randomized to have port site closure with either cyanoacrylate tissue adhesive (n = 25) or subcuticular suture (n = 25). All procedures and postoperative evaluations were performed by the same board certified Female Pelvic Medicine and Reconstructive Surgeon. Incisional closure time was recorded. Each subject was followed for 12-wk postoperatively. Incision cosmesis was evaluated using the Stony Brook Scar Evaluation Scale.

Results: A total of 47 subjects (cyanoacrylate group, n = 23; suture group, n = 24) completed the 12-wk postoperative evaluation. Closure time was significantly less (P < 0.0005) using cyanoacrylate tissue adhesive (5.4 ± 2.0 min) than subcuticular suture (24.9 ± 5.6 min). Cosmesis scores were significantly higher in the cyanoacrylate tissue adhesive group than subcuticular suture (P = 0.025). No differences were found between bleeding, infection, or dehiscence (P = 1.00, P = 0.609, P = 0.234, respectively). No statistical demographical differences existed between the two study arms.

Conclusion: Our study supported our original hypothesis that cyanoacrylate tissue adhesive for port site closure during robotic urogynecolgic procedures uses less time than with subcuticular suture. Our study also supports that tissue adhesive is comparable to cosmetic outcome while not jeopardizing rates of bleeding, infection, or dehiscence.

Coronary artery disease (CAD) screening and diagnosis are core cardiac specialty services. From symptoms, autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coronaries artery disease as etiologies. While angina remains a clinical diagnosis, most cases require correlation with a diagnostic modality. At the onset of the evidence building process much research, now factored into guidelines were conducted among population and demographics that were homogenous and often prior to newer technologies being available. Today we see a more diverse multi-ethnic population whose characteristics and risks may not consistently match the populations from which guideline evidence is derived. While it would seem very unlikely that for the majority, scientific arguments against guidelines would differ, however from a translational perspective, there will be populations who differ and importantly there are cost-efficacy questions, e.g., the most suitable first-line tests or what parameters equate to an adequate test. This article reviews non-invasive diagnosis of CAD within the context of multi-ethnic patient populations.

The number of invasive procedures in medicine is increasing, as is the employment of new technological achievements. In the era of information-communication technology, one such achievement is also the telemedicine network. In Slovenia, it is known as the Telekap (TeleStroke) network, which was primarily designed for fast and efficient management of stroke patients. In the neurosurgical community, the system is frequently used also for conveying vital information regarding subarachnoid haemorrhage and trauma. Especially in neurosurgical emergencies, this communication system offers thorough information about the extent and location of bleeding and facilitates the preoperative planning of neurosurgical interventions. From our experience so far, the system should be expanded to other neuro-centres as well to all neurosurgery departments in order to facilitate patient management, their acute hospital care, and inter-speciality collaboration.

Radiotherapy has long been used as an adjunct to neurosurgery for the treatment of malignant and benign intracranial tumors and other intracranial lesions. Intracranial tumors can be irradiated in three different ways: I) fractional radiotherapy, II) stereotactic radiotherapy and III) stereotactic radiosurgery. The third is most often by means of a gamma knife or a specially designed linear accelerator. Additionally, radiosurgery is increasingly used in combination with systemic therapy to treat metastases.