The recognition of insulin resistance as a principal factor in the pathogenesis of polycystic ovarian syndrome (PCOS) has led to the use of insulin-lowering agents, also called 'insulin-sensitizing drugs', for its treatment. The most extensively studied insulin-lowering agent in the treatment of PCOS is metformin: an oral antihyperglycaemic agent used initially in the treatment of type 2 diabet...

Objective. We have investigated whether there is evidence that patients with soft tissue sarcomas do better if treated in a specialist centre compared with district general hospitals.Patients. All patients diagnosed with soft tissue sarcomas who were residents of WMRHA between 1994 and 1996, with minimum follow up of 5 years, excluding head and neck or retroperitoneal tumors.Methods. We reviewe...

Relative to warfarin, non-vitamin K oral anticoagulants (NOACs) are at least as good at preventing stroke or systemic embolism, cause less haemorrhagic stroke, and result in modestly lower mortality. Thus, the European Society of Cardiology has recommended NOACs in place of vitamin K antagonists (VKAs) in most patients with atrial fibrillation (class IIa, level of evidence A). According to one ...

Be Treated More Aggressively? To the Editor: We read with great interest the recent manuscript by Chu et al,1 in which several predictors for in-hospital mortality in patients with infective endocarditis were identified. In that study, the authors found diabetes as an independent predictor for in-hospital mortality and speculated an adverse influence of hyperglycemia on immune function as a pos...

Helicobacter pylori infection affects approximately half of the world's population. In Hong Kong, approximately 55% of the population is infected with this organism. But symptoms and clinical disease develop in only a minority of infected individuals during their lifetime. Treatment should thus be appropriately targeted. It is imperative that infected patients who have either a current or past ...

Treatment of displaced midshaft clavicle fractures remains controversial despite several randomized trials and a recent meta-analysis (McKee et al. 2012, Lenza et al. 2013, Rehn et al. 2014, Wang et al. 2015). In the current issue of Acta Orthopaedica, Ban et al. present results of a survey among Scandinavian orthopedic surgeons on attitudes to treatment of displaced clavicle fractures. The res...

INTRODUCTION There is controversy in the literature about the choice of expectant medical treatment versus surgical treatment of hiatal hernias, depending on the presence or absence of symptoms. This study presents the results obtained by our group, considering disease duration and postoperative results. PATIENTS AND METHOD A total of 121 patients were included and divided by age, disease dur...

A síndrome dos ovários policísticos (SOP) é a afecção endócrina mais frequente da mulher durante o período reprodutivo, ocorrendo em porcentagens entre 4 e 16% emmulheres com fator familiar importante. Houve muito debate sobre a caracterização desta entidade nos últimos anos. Contudo, o último critério da Society for Androgen Excess estabeleceu que as mulheres deveriam ter hiperandrogenismo (hi...