Complex regional pain syndrome type I is treated symptomatically. A protective effect of vitamin C (ascorbic acid) has been reported previously. A dose-response study was designed to evaluate its effect in patients with wrist fractures. In a double-blind, prospective, multicenter trial, 416 patients with 427 wrist fractures were randomly allocated to treatment with placebo or treatment with 200, 500, or 1500 mg of vitamin C daily for fifty days. The effect of gender, age, fracture type, and cast-related complaints on the occurrence of complex regional pain syndrome was analyzed. Three hundred and seventeen patients with 328 fractures were randomized to receive vitamin C, and ninety-nine patients with ninety-nine fractures were randomized to receive a placebo. The prevalence of complex regional pain syndrome was 2.4% (eight of 328) in the vitamin C group and 10.1% (ten of ninety-nine) in the placebo group (p=0.002); all of the affected patients were elderly women. Analysis of the different doses of vitamin C showed that the prevalence of complex regional pain syndrome was 4.2% (four of ninety-six) in the 200-mg group (relative risk, 0.41; 95% confidence interval, 0.13 to 1.27), 1.8% (two of 114) in the 500-mg group (relative risk, 0.17; 95% confidence interval, 0.04 to 0.77), and 1.7% (two of 118) in the 1500-mg group (relative risk, 0.17; 95% confidence interval, 0.04 to 0.75). Early cast-related complaints predicted the development of complex regional pain syndrome (relative risk, 5.35; 95% confidence interval, 2.13 to 13.42). answer: Vitamin C reduces the prevalence of complex regional pain syndrome after wrist fractures. A daily dose of 500 mg for fifty days is recommended.

Fournier's gangrene is known to have an impact in the morbidity and despite antibiotics and aggressive debridement, the mortality rate remains high. To assess the morbidity and mortality in the treatment of Fournier's gangrene in our experience. The medical records of 14 patients with Fournier's gangrene who presented at the University Hospital Center 'Mother Teresa' from January 1997 to December 2006 were reviewed retrospectively to analyze the outcome and identify the risk factor and prognostic indicators of mortality. Of the 14 patients, 5 died and 9 survived. Mean age was 54 years (range from 41-61): it was 53 years in the group of survivors and 62 years in deceased group. There was a significant difference in leukocyte count between patients who survived (range 4900-17000/mm) and those died (range 20.300-31000/mm3). Mean hospital stay was about 19 days (range 2-57 days). answer: The interval from the onset of clinical symptoms to the initial surgical intervention seems to be the most important prognostic factor with a significant impact on outcome. Despite extensive therapeutic efforts, Fournier's gangrene remains a surgical emergency and early recognition with prompt radical debridement is the mainstays of management.

Gallbladder carcinoma is characterized by delayed diagnosis, ineffective treatment and poor prognosis. Surgical resection has been thought to be the treatment of choice, while the role of radiotherapy as adjuvant or palliative treatment has not been fully clarified in the literature. We present the case of a 45-year-old female, with unresectable gallbladder carcinoma, grade IV, histologically diagnosed during laparotomy. The patient was treated with palliative intent with percutaneous transhepatic biliary drainage. Furthermore, she received external radiotherapy by (60)Co, using a three-field technique (anterior-posterior and right lateral). The total dose was 3,000 cGy in 10 fractions, with 300 cGy per fraction, 5 days weekly. The patient showed clinico-laboratory improvement and was discharged with a permanent percutaneous transhepatic endoprosthesis. During follow-up (10 and 12 months postirradiation), abdominal CTs showed no local extension of the tumor, while the patient had a good performance status. So far, 1 year after the diagnosis of gallbladder cancer she is still alive. answer: External radiotherapy seems to be a safe and effective method of palliative management of gallbladder carcinoma. However, further studies are necessary to determine the role of radiotherapy in palliative or adjuvant treatment of gallbladder carcinoma.

This study aims to evaluate the efficacy of closed reduction and the effects of timing and fracture types on patient satisfaction. Only patients with isolated nasal fractures were included in the study. Patients with additional maxillofacial fractures and patients whose application time to our clinic was more than 10 days after the trauma were excluded. Patients were classified into 5 types according to their fracture. All patients underwent closed reduction and external fixation under local anesthesia. Patients were asked about their satisfaction in a survey at 28th day and sixth month after the surgery. Patients were divided into groups according to fracture type and intervention time, and the results of the survey were evaluated. Of the 43 patients included in the study, 38 were male, 5 were female, and the average age was 24.9. The average intervention time of the patients was 5.44 days. Twenty-eight (65%) of 43 patients were satisfied with the result, whereas 15 (35%) patients were not happy with their operation. In a comparison of patient satisfaction rates according to fracture type, the mild fracture group had a higher satisfaction rate compared to the severe fracture group. answer: Closed reduction is an easy and sufficient treatment for nasal fractures, especially for mild nasal fractures. Early intervention raises the patient satisfaction rate.

To compare children's, parents' and physicians' perceptions of children's body size. We administered a structured questionnaire of body size perception using a descriptive Likert scale keyed to body image figures to children ages 12 to 18 years. The same scale was given to parents of children ages 5 to 18 years. The sample consisted of 91 children and their parents being seen in the Pediatric Gastroenterology Clinic for concerns unrelated to overweight. Weight and height of the children were measured, and body mass index (BMI) was calculated. The children's BMI percentiles were categorized as underweight (<15th), normal (15th-85th), overweight (85th-95th), and obese (95th and above). The attending physician independently completed the body image and description scale and indicated the figure that most accurately represented the patient without reference to BMI standards. Accuracy of the patients', parents', and doctors' estimates were statistically compared. The sample population consisted of 6.4% underweight, 70.5% normal weight, 7.7% overweight, and 15.4% obese. Forty-four percent of parents underestimated children's body size using word descriptions and 47% underestimated using figures. Forty percent of the children underestimated their own body size using descriptions and 43% underestimated using figures. The physicians in this study had a higher percentage of correct estimates; however, they underestimated 33% of the patients using both word descriptions and figures. Some obese children were not recognized, and several average children were perceived as underweight. answer: Many children underestimated their degree of overweight. Their parents and even their attending physicians shared this misperception. This study demonstrates the need to further educate physicians to recognize obesity and overweight so that they can counsel children and their families.

BioGPT: Question and Answer - PubMed is a language model fine-tuned to answer yes/no/maybe questions for biomedical tasks.

Teaching machines to understand human language

Biomedical Language Models

Microsoft

BioGPT: Question and Answer - PubMed is a language model fine-tuned on the expert annotated PubMedQA dataset which is a biomedical question-answering dataset, to answer yes/no/maybe questions for biomedical tasks. BioGPT outperforms larger, more general language models in biomedical language benchmarks. Example use case:&nbsp;&nbsp;Answering academic questions. See examples below. Technology:&nbsp;&nbsp;GPT-2 Backbone Metrics: 78.2% Accuracy &nbsp;&nbsp; Note: For better results, queries are separated into a question and a context for the question. See examples below.