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Medicolegal implications of radial and femoral access for coronary angiography and intervention in 2016: Focus on retroperitoneal hemorrhage

of TRA has lagged overall and now is estimated at 30% of all diagnostic and PCI procedures performed. [ 11 ] Medical malpractice litigation cases constitute an important aspect of physician daily practice with their incidence correlating to the frequency of procedures. Characteristics of medical professional liability claims in the field of cardiac catheterization have been previously described, offering invaluable advice to practicing physicians and subsequently improved patient care. [ 12 ] As TRA completely obviates the possibility of access

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Marked elevation of CA19-9 in a patient with rheumatoid arthritis-associated pulmonary fibrosis


We report a case of a 78-year-old male was admitted for 2 years of blood CA19-9 >1000 kU/L found at physical examination. Abdominal computed tomography, barium meal and gastrointestinal endoscopy did not find any malignancy. Position emission tomography indicated interstitial pulmonary fibrosis (IPF) (severe) accompanied with reactive hyperplasia of mediastinal lymph node and bilateral pleural thickening. The patient also claimed to have rheumatoid arthritis (RA) for more than 40 years. Then final diagnosis was RA with IPF. The patient’s blood CA19-9 was improved after 5-day treatment of hormone inhalation.

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Serum vitamin D levels in treatment-naïve chronic hepatitis B patients


Background and Objectives

According to the demographic health survey conducted in 2015, Egypt had 10% documented prevalence of anti-HBc positive patients aged 1-59 and 1% viremic patients amongst the population in the same age group, with a domination of genotype D. Several studies claimed the possible role of vitamin D deficiency in hepatitis B virus (HBV) replication and disease progression.

Patients and Methods

Serum vitamin D levels [25(OH D3] were assessed in 96 HBeAg negative non-cirrhotic chronic HBV patients and 25 healthy subjects classified as following: Group I: 48 chronic HBV patients with persistently normal ALT levels and HBV DNA level < 2000 IU/mL for ≥ 6 months; Group II: 48 chronic HBV patients with CHB with persistently elevated ALT and HBV DNA level ≥ 2000 IU/mL for ≥ 6 months; and Group III: 25 apparently healthy subjects with normal liver enzymes and negative hepatitis viral markers were taken as the control group.


Vitamin D was much more deficient in group II than in group I and group III being 11.55 ± 3.97 ng/mL, 15.03 ± 3.45, 27.00 ± 6.76 ng/mL (P < 0.001), respectively, and a strong negative correlation was observed between vitamin D levels and HBV DNA levels (P = 0.043) in groups I and II.


The current study showed high HBV DNA replication in patients with vitamin D deficiency suggesting the antimicrobial immunomodulatory role of vitamin D.

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Chemotherapy for elderly patients with advanced cancer: A pilot study in Institute of Oncology Bucharest

AS, Castiglione-Gertsch M, Gelber RD. Adding adjuvant CMF chemotherapy to either radiotherapy or tamoxifen: Are all CMFs alike? International Breast Cancer Study Group (IBCSG). Ann Oncol 1998;9:489-93. 11. Du X, Goodwin JS. Patterns of use of chemotherapy for breast cancer in older women: Findings from medicare claims data. J Clin Oncol 2001;19:1455-61. 12. Quoix E, Zalcman G, Oster JP, Westeel V, Pichon V, Lavole A, et al. Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with

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Data Regarding the Prevalence and Incidence of Diabetes Mellitus and Prediabetes

-epidemiological study in Sweden. Diabet Med 32: 1319–1328, 2015. 18. Heidemann C, Du Y, Paprott R, Haftenberger M, Rathmann W, Scheidt-Nave C. Temporal changes in the prevalence of diagnosed diabetes, undiagnosed diabetes and prediabetes: findings from the German Health Interview and Examination Surveys in 1997-1999 and 2008-2011. Diabet Med 2015. doi: 10.1111/dme.13008. [Epub ahead of print] 19. Huber CA, Schwenkglenks M, Rapold R, Reich O. Epidemiology and costs of diabetes mellitus in Switzerland: an analysis of health care claims data, 2006 and 2011. BMC Endocr

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Clinical conundrums in management of sepsis in the elderly

, Grealish L, Draper B, Karmel R, Gibson D, et al. Potentially preventable complications of urinary tract infections, pressure areas, pneumonia, and delirium in hospitalised dementia patients: retrospective cohort study. BMJ Open 2013;3:e002770. 11. Eliason D. It may not be “a little dementia”. MLO Med Lab Obs 2011;43:9. 12. Whittaker SA, Mikkelsen ME, Gaieski DF, Koshy S, Kean C, Fuchs BD. Severe sepsis cohorts derived from claims-based strategies appear to be biased toward a more severely ill patient population. Crit Care Med 2013

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Galileo in Bethesda: The future of gene editing

our species owns their own human genome, but they seem to imply that this means that every human should participate in deciding what medical and scientific procedures in treating genetic diseases should be undertaken. This is not possible and not desirable. They criticize the Asilomar process because they claim that it caused anger and disruption by people who opposed the development of genetically modified crops. Their opposition was not the result of the Asilomar process. In a democracy where people have the right to different opinions, one can be sure that any

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Dietary cholesterol and egg yolk should be avoided by patients at risk of vascular disease

documented by Dr. Michael Greger, the egg industry has spent hundreds of millions of dollars on propaganda, following a conviction for false advertising and loss of the appeal in the US Supreme Court. ( ). The remarkable success of egg marketing propaganda has led to widespread belief that dietary cholesterol and consumption of egg yolks are harmless. For the sake of patients at risk of cardiovascular events, it is important to recognize this propaganda for what it is. Propaganda

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Hepatitis C screening in commercially insured U.S. birth-cohort patients: Factors associated with testing and effect of an EMR-based screening alert

clinics. In comparison, the contribution of subspecialty clinics will be limited. While sobering, our results are well within the range of comparable studies in the US. For example, Isenhour and colleagues recently reported an overall HCV Ab testing rate of only 3.26% in a population of over 24 million enrollees from Truven Health’s MarkedScan Commercial and Medicare Supplemental insurance claims database. They noted a significant, 91% increase in testing rates between 2011 and 2014, but concluded that “testing remains suboptimal”.[ 28 ] The poor adherence to

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Timing of transjugular intrahepatic portosystemic stent-shunt in Budd–Chiari syndrome: A UK hepatologist's perspective

diagnosis than the patients who received TIPS. Although most TIPS were placed during the first year after diagnosis, in this study, the timing of placement was not uniform and ranged from 0 to 38 months. Regardless of the timing of TIPS, the long-term outcome after TIPS was good. The authors claimed that the approach of close clinical surveillance while reserving TIPS for those patients who progress or fail to respond to medical treatment did not have a deleterious effect on outcome. However, nearly 30% of patients who did not have any intervention died during the follow

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