Evolutionary medicine emerged in the late twentieth century, integrating principles of natural selection and adaptation with the health sciences. Today, with a rapidly widening gap between the biology of and its environment, maladaptation or maladaptive disorders can be detected in almost all diseases, including liver dysfunction. However, in hepatology, as in most medical specialties, evolutionary considerations are neglected because the majority of the medical community is not familiar with evolutionary principles.
View Article and Find Full Text PDFInner dialogue and inner speech are normal systems of cerebral intrapersonal communication, crucial to self-awareness. Lesions affecting the cerebral network involved in these systems have been associated with the occurrence of Auditory Verbal Hallucinations (AVHs). These are regarde as a continuum phenomenon experienced by healthy, individuals, as well as those with psychiatric disorders.
View Article and Find Full Text PDFBackground: The clinical implications and prognostic outcomes associated with tumor upstaging in invasive melanoma have not been well established.
Objectives: To determine the frequency of tumor upstaging in invasive melanoma, identify risk factors, and assess its impact on clinical management and outcomes.
Methods: A retrospective study using data from a statewide Surveillance Endpoints and End Results-affiliated cancer registry between 2014 and 2018 was performed.
Inadequate adherence to a gluten-free diet in coeliac disease triggers autoimmune reactions and can reduce the quality of life. The strict diet requires constant vigilance, which can cause psychological distress. Our research aimed to assess the quality of life in adult patients with coeliac disease and to find a correlation between quality of life, dietary intervention, and adherence.
View Article and Find Full Text PDFBackground: Despite national testing guidelines, rates of testing for HIV, sexually transmitted infections (STIs), and hepatitis C remain lower than recommended for men who have sex with men in the United States. To help address this, the TakeMeHome (TMH) program was started in March 2020 by Building Healthy Online Communities, a consortium of public health organizations and dating apps, to work with health departments to increase access to HIV testing for men who have sex with men on dating apps.
Methods: Users of participating dating apps were sent messages about opportunities for testing with self-collected specimens through TMH.
Long-term data on ustekinumab in real-life Crohn's disease patients are still missing, though randomized controlled trials demonstrated it as a favorable therapeutic option. We aimed to evaluate ustekinumab's clinical efficacy, drug sustainability, and safety in a prospective, nationwide, multicenter Crohn's disease patient cohort with a three-year follow-up. Crohn's disease patients on ustekinumab treatment were consecutively enrolled from 9 Hungarian Inflammatory Bowel Disease centers between January 2019 and May 2020.
View Article and Find Full Text PDFBackground: High-risk cutaneous squamous cell carcinoma (cSCC) is associated with poor clinical outcomes. Traditionally, preoperative clinical tumor size ≥2 cm, based on Brigham and Women's Hospital (BWH) staging criteria, is high risk.
Objective: To compare outcomes of cSCC treated with Mohs micrographic surgery (MMS) with a preoperative size ≥2 cm (clinically ≥2 cm) versus cSCC with preoperative size <2 cm and postoperative defect size ≥2 cm (histologically ≥2 cm).
Pneumonia is a common nosocomial complication in transplant patients. Stenotrophomonas maltophilia is recognized as a common cause and is typically seen in immunocompromised and critically ill patients. S.
View Article and Find Full Text PDFSituation awareness (SA) in complex socio-technical systems is considered a key cognitive activity, as control crews are often engaged in simultaneous task processes and are required to monitor and evaluate system parameters, making decisions and projections for the future accordingly. However, measuring SA at the team level is still a challenging area of research within the topic. In our research, we applied verbal protocol analysis as an alternative method to assess nuclear power plant control room crews' team SA.
View Article and Find Full Text PDFBackground: PrEP was approved for HIV prevention in the US in 2012; uptake has been slow. We describe relative equity with the PrEP Equity Ratio (PER), a ratio of PrEP-to-Need Ratios (PnRs).
Methods: We used commercial pharmacy data to enumerate PrEP users by race and ethnicity, sex, and US Census region from 2012 to 2021.
Background: Lasers may present an alternative treatment modality for the management of nonmelanoma skin cancer (NMSC).
Objective: To investigate lasers as a definitive treatment of NMSC.
Methods: A comprehensive search was performed on MEDLINE, the Cochrane Library, and the National Institutes of Health ( www.
Introduction: Within 5 years of having acute pancreatitis (AP), approximately 20% of patients develop diabetes mellitus (DM), which later increases to approximately 40%. Some studies suggest that the prevalence of prediabetes (PD) and/or DM can grow as high as 59% over time. However, information on risk factors is limited.
View Article and Find Full Text PDFBackground: Mohs micrographic surgery (MMS) is used for melanoma in situ (MIS) and thin invasive melanomas, particularly on the head and neck, during which a debulk section is typically prepared. Tumor upstaging occurs if the debulking specimen meets criteria for an increased tumor (T) stage per the American Joint Committee on Cancer 8th edition compared with the initial biopsy. Upstaging can alter survival and recurrence outcomes, resulting in increased patient morbidity and mortality.
View Article and Find Full Text PDFHealthcare access greatly impacts skin cancer diagnosis and mortality rates. Recognition of current disparities in Mohs micrographic surgery (MMS) access can assist future policy and clinical decisions to correct them. For the years 2014-2018, the CPT codes for MMS (17,311 and 17,313) were counted on a per county level across the United States per the Medicare Centers for Medicare & Medicaid Services (CMS) Medicare Prescriber Database.
View Article and Find Full Text PDFBackground: There are limited survival data on cutaneous angiosarcoma (CAS), dermatofibrosarcoma protuberans (DFSP), Merkel cell carcinoma (MCC), and sebaceous carcinoma (SC).
Objective: To analyze survival trends in CAS, DFSP, MCC, and SC among a racially diverse, insured cohort of patients.
Methods: Using data from the Kaiser Permanente Southern California Cancer Registry, we identified adults diagnosed with CAS, DFSP, MCC, or SC between January 1, 1988 and December 31 2018, followed through December 31, 2021.
Background: With an improved understanding of tumor biology and behavior, the recommended margins for the surgical treatment of melanoma have evolved.
Objective: We describe the progression of these surgical margins, detailing the historical basis for the 5-cm margin and transitioning to current practice, in which Mohs micrographic surgery (MMS) with immunohistochemistry (IHC) has become increasingly used.
Methods/materials: We searched PubMed and Google Scholar for articles published between January 2019 and April 2023 describing the use of MMS for melanoma in situ (MIS) and invasive melanomas.
United European Gastroenterol J
October 2023
Background: Microscopic colitis (MC) is a chronic inflammatory disease of the large bowel characterized by watery diarrhea, substantially decreasing the patient's quality of life. Scarce data suggest that MC is associated with low bone density (LBD).
Objectives: We aimed to assess whether MC is a risk factor for LBD and the proportion of patients with MC having LBD.