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Swain Hsu posted an update 6 months, 1 week ago
decreased, and numbers of outpatient department visits per patient were highest for hospitals and lowest for health agencies. Over the study period, hospital costs per patient in tertiary and general hospitals increased gradually. Preschool and school-aged children are vulnerable to trauma. Male patients outnumbered female patients by a factor of more than 2. The “T-shaped'” area around forehead is vulnerable to injury. Total cost of medical care benefits per patient in tertiary hospitals was about 7 times on average than in health agencies. Regarding functional, behavioral, and aesthetic outcomes, more attention should be paid to epidemiologic data and hospital costs for facial lacerations.
Liver resection (LR) is a major treatment modality in select patients with stage I-III Intrahepatic cholangiocarcinoma (ICC), yet many studies demonstrated low rates of resection. The aim of the present study is to evaluate whether increasing resection rates would result in an increase in average survival in patients with stage I-III ICC.Surveillance, Epidemiology, and End Results 18 registry database for 2004 through 2015 was retrieved for the present study. Propensity score matching was performed to eliminate possible bias. In addition, instrumental variable (IV) analysis was utilized to adjust for both measured and unmeasured confounders.Among 2341 patients with clinical stage I-III ICC, we identified 1577 (67.4%) and 764 (32.6%) patients who received no treatment or LR, respectively. In the multivariable adjusted cohort, a clear prognostic advantage of LR was observed in overall survival (OS) (P < .001) and disease-specific survival (DSS) (P < .001) compared to patients who received no treatment. l variable (IV) analysis was utilized to adjust for both measured and unmeasured confounders.Among 2341 patients with clinical stage I-III ICC, we identified 1577 (67.4%) and 764 (32.6%) patients who received no treatment or LR, respectively. In the multivariable adjusted cohort, a clear prognostic advantage of LR was observed in overall survival (OS) (P less then .001) and disease-specific survival (DSS) (P less then .001) compared to patients who received no treatment. Estimates based on the IV analysis indicated that patients treated with LR had a significantly longer OS (P less then .001) and DSS (P less then .001) after adjusting confounding factors. In IV analyses stratified by American Joint Committee on Cancer tumor stage, we found that the better survival effects of LR on OS and DSS were consistent across all subgroups.Our outcomes indicated that LR was associated with a survival benefit for marginal patients with stage I-III ICC.
We report on a patient with hypoxic-ischemic brain injury (HI-BI) who showed recovery from a minimally consciousness state over 6 years concurrent with recovery of an injured ascending reticular activating system (ARAS), which was demonstrated on diffusion tensor tractography (DTT).A 31-year-old female patient, who suffered from HI-BI, showed impaired consciousness with a minimally conscious state intermittently obeying simple motor tasks, such as “please grasp my hand.” Her consciousness showed recovery with the passage of time; rapid recovery was observed during the recent 2 years.In the upper ARAS, the neural connectivity to both the basal forebrain and prefrontal cortex had increased on 8-year DTT compared with 1.5-year DTT. In the lower dorsal and ventral ARAS, no significant change was observed between 1.5 and 8 years DTTs.Recovery of an injured ARAS was demonstrated in a patient who showed recovery from a minimally consciousness state over 6 years following HI-BI. Our results suggest the brain targetonsciousness state over 6 years following HI-BI. Our results suggest the brain target areas for recovery of impaired awareness in patients with disorders of consciousness.
Colonoscopy is an uncomfortable procedure. Distraction is thought to reduce pain by decreasing the amount of attention a person spends on a painful stimulus. selleck chemicals We aimed to assess the usefulness of smartphones on discomfort associated with the colonoscopy.
We designated 360 enrolled patients according to prospective randomized controlled study into two groups, including smartphone (SP) group (Relaxation by smartphones) and Control group (No relaxation). Measured outcomes included the discomfort, satisfaction, polyp detection rate and the willingness to repeat colonoscopy were analyzed between groups.
The pain and distension scores of SP group patients were significantly lower than those of the Control group (2.18 ± 2.80 vs 3.55 ± 3.07, P < .001; 4.15 ± 2.35 vs 4.79 ± 2.36, P = .011, respectively). Importantly, patient-reported satisfaction scores of the SP group were significantly higher than those of the Control group (96.45 ± 7.17 vs 91.12 ± 10.49, respectively; P < .001). Moreover, although there were no statistical differences, patients using smartphones were more likely to have shorter reach cecum times (09m11 s vs 07m37 s, P = .116) and more polyp detection rate (13.3% vs 9.4%, P = .246). In addition, more patients using smartphones were willing to repeat colonoscopy but no statistical difference (85.0% vs 81.7%, P = .396).
Patient using smartphone is a special manner to increase satisfaction during colonoscopy with a less discomfort and is more likely to be polyp detection rate.
Patient using smartphone is a special manner to increase satisfaction during colonoscopy with a less discomfort and is more likely to be polyp detection rate.
Changeover phases are essential and inevitable times in professional life, which let the learners adapt and grasp emerging opportunities for learning based on the past experiences with the catering of novel creativity as required in the present as well as emerging time. This study was carried out to examine the effectiveness of a professionalism course, during the transition from a non-clinical to clinical setting, within the context of undergraduate medical education.This observational study was conducted during 2019 to 2020, with pre- and post-professionalism course evaluation. We used the Dundee Poly-professionalism inventory-1 Academic Integrity, among the undergraduate medical students.Our results are based on the medical student’s professional progress with the transition from 2nd year to 3rd year. During the 1st phase of the study, the participants at their Pre-Professionalism Course (PrPC) level in their 2nd medical year (only attended the introductory lectures for professionalism), showed a good understanding of professionalism.