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Evaluating the prognostic performance of the novel ERAP score in Vietnamese acute pancreatitis patients. 评估新型 ERAP 评分在越南急性胰腺炎患者中的预后表现。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039738
Nhan Trung Phan, Dung My Thi Vo, Tien Manh Huynh, Phat Tan Ho, Nguyen Phuoc Ma, Thong Duy Vo
{"title":"Evaluating the prognostic performance of the novel ERAP score in Vietnamese acute pancreatitis patients.","authors":"Nhan Trung Phan, Dung My Thi Vo, Tien Manh Huynh, Phat Tan Ho, Nguyen Phuoc Ma, Thong Duy Vo","doi":"10.1097/MD.0000000000039738","DOIUrl":"https://doi.org/10.1097/MD.0000000000039738","url":null,"abstract":"<p><p>Early recognition of severe acute pancreatitis (AP) is crucial for timely intervention. This study aims to evaluate the prognostic accuracy of the Emergency Room Assessment of AP (ERAP) score and compare it with the Bedside Index for Severity in AP (BISAP) score in predicting severe AP, mortality, and persistent multiple organ failure (MOF) in Vietnamese patients. This prospective cohort study included AP patients admitted to Cho Ray Hospital between August 2021 and May 2022. Patient data, including demographics, clinical presentations, and laboratory results, were collected upon admission. The ERAP and BISAP scores were calculated from these admission data. The prognostic accuracy for severe AP, mortality, and persistent MOF was assessed via the area under the receiver-operating characteristic curve (AUC). Among 167 AP patients (mean age 41.5 ± 12.0 years), hypertriglyceridemia (34.7%) and alcohol (22.2%) were the most prevalent etiologies. Severe AP accounted for 33.5% of the patients. Mortality rates were higher in persistent MOF patients (42.9%) than in persistent single-organ failure patients (3.6%), with a P value <.001. The ERAP score had AUCs for predicting severe AP, mortality, and persistent MOF of 0.899, 0.817, and 0.867, respectively, with an optimal cutoff of ≥2. The ERAP score had a better prognostic value than the BISAP score in predicting severe AP (AUC: 0.899 vs 0.820; P = .0072) and persistent MOF (AUC: 0.867 vs 0.785; P = .0193) but had a similar prognostic value for mortality (AUC: 0.817 vs 0.728; P = .0628). The ERAP score has strong predictive value for severe AP and persistent MOF, surpassing the BISAP score in these categories while maintaining similar accuracy for mortality prediction in the Vietnamese population. The ERAP score can be a valuable tool for the early identification of high-risk AP patients, enabling timely and appropriate clinical interventions.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictive value of neutrophil-to-lymphocyte ratio for adverse outcomes in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease: A retrospective study. 中性粒细胞与淋巴细胞比率对慢性阻塞性肺病急性加重住院患者不良预后的预测价值:一项回顾性研究。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039797
Nam Vu-Hoai, Duc Ly-Phuc, Ngoc Duong-Minh, Nguyen Tran-Ngoc, Khoa Nguyen-Dang
{"title":"Predictive value of neutrophil-to-lymphocyte ratio for adverse outcomes in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease: A retrospective study.","authors":"Nam Vu-Hoai, Duc Ly-Phuc, Ngoc Duong-Minh, Nguyen Tran-Ngoc, Khoa Nguyen-Dang","doi":"10.1097/MD.0000000000039797","DOIUrl":"https://doi.org/10.1097/MD.0000000000039797","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) stands as one of the leading causes of mortality worldwide. Acute exacerbations of COPD (AECOPD) lead to rapid respiratory function decline and worsened disease status. Despite recent studies, the ability of the neutrophil-to-lymphocyte ratio (NLR) to predict outcomes in patients with COPD remains controversial. We investigated the predictive value of NLR for adverse outcomes in hospitalized patients with AECOPD. A retrospective study was conducted at the Department of Pulmonary Medicine, Cho Ray Hospital (Vietnam) from November 2019 to November 2021. The study extracted data from patients diagnosed with AECOPD at discharge and met the inclusion criteria. NLR is calculated by dividing the number of neutrophils by the number of lymphocytes in the peripheral blood test. Adverse outcomes are defined as invasive mechanical ventilation, admission to intensive care unit, or in-hospital mortality. Multivariable regression analysis was conducted to identify variables predicting adverse outcomes. The cutoff, sensitivity, specificity, area under the curve, and receiver operating characteristic of NLR were determined for predicting adverse outcomes. Two hundred eighty-seven patients with AECOPD were included in the final analysis, with a mean age of 70.9, and males comprising 92.7%. The rate of adverse outcomes was 15.7%. Multivariable logistic regression identified reduced consciousness at admission (adjusted odds ratio = 0.08, 95% confidence interval [CI]: 0.02-0.38, P = .001) and high NLR (adjusted odds ratio = 1.17, 95% CI: 1.10-1.24, P < .001) as predictors of adverse outcomes. The receiver operating characteristic of NLR's predictive value yielded an area under the curve of 0.877 (95% CI: 0.83-0.93). An NLR cutoff of 11.0 predicted adverse outcomes with a sensitivity of 80.0%, specificity of 77.7%, and an odds ratio of 13.9 (95% CI: 6.3-30.7), P < .001. NLR is a simple, routine, and cost-effective tool for predicting adverse outcomes in hospitalized patients with AECOPD. Future studies should evaluate the kinetics of NLR in predicting treatment response in patients with AECOPD.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rupture of fetal membrane in ectopic tubal pregnancy: A case report and literature review. 异位输卵管妊娠胎膜破裂:病例报告和文献综述。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039713
Zhiqiang Wang, Chun Zhang
{"title":"Rupture of fetal membrane in ectopic tubal pregnancy: A case report and literature review.","authors":"Zhiqiang Wang, Chun Zhang","doi":"10.1097/MD.0000000000039713","DOIUrl":"https://doi.org/10.1097/MD.0000000000039713","url":null,"abstract":"<p><strong>Rationale: </strong>Ruptured tubal pregnancies occurring in the second trimester are rare; yet, they pose a critical risk of life-threatening hemorrhage. This study aims to highlight the importance of timely surgical intervention in such cases to prevent fatal outcomes. The case underscores the diagnostic and therapeutic challenges that arise when distinguishing between tubal and abdominal pregnancies, particularly in the presence of hemoperitoneum, which can obscure imaging results.</p><p><strong>Patient concerns: </strong>We present a case involving the spontaneous rupture of a tubal pregnancy at 15 weeks and 3 days of gestation. The patient exhibited elevated beta-human chorionic gonadotropin levels. Initial transabdominal ultrasound suggested an abdominal pregnancy, and computed tomography scans supported these findings.</p><p><strong>Diagnoses and interventions: </strong>Urgent midline laparotomy revealed the condition to be a tubal pregnancy, contrary to initial imaging. The surgical procedure included the removal of the gestational sac and the affected fallopian tube, followed by abdominal closure. Hemoperitoneum was noted to compromise the accuracy of imaging modalities, complicating the preoperative diagnosis.</p><p><strong>Outcomes: </strong>Histopathological examination confirmed the diagnosis of tubal pregnancy. The patient had an uneventful recovery and was discharged 7 days post-surgery with stable hemoglobin levels.</p><p><strong>Lessons: </strong>This case underscores the importance of considering the differential diagnosis of abdominal versus tubal pregnancy in the presence of hemoperitoneum, due to their differing clinical management needs. It offers insights that may guide clinicians in the timely diagnosis and treatment of advanced tubal pregnancies, where prompt surgical intervention is critical.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of hepatic metastasis from an unrevealed adenoid cystic carcinoma by PET/CT: A case report. 通过 PET/CT 鉴定未显示的腺样囊性癌的肝转移:病例报告。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039769
Ze Liang, Yi Ding, He Sui, Mei Wu, Yongmin Jin, Weibo Wen
{"title":"Identification of hepatic metastasis from an unrevealed adenoid cystic carcinoma by PET/CT: A case report.","authors":"Ze Liang, Yi Ding, He Sui, Mei Wu, Yongmin Jin, Weibo Wen","doi":"10.1097/MD.0000000000039769","DOIUrl":"https://doi.org/10.1097/MD.0000000000039769","url":null,"abstract":"<p><strong>Rationale: </strong>Adenoid cystic carcinoma is a rare malignant tumor of the salivary glands, with few reports of metastasis to the liver in the literature. We present a case where an isolated hepatic lesion of adenoid cystic carcinoma was identified using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).</p><p><strong>Patient concerns: </strong>A 76-year-old male experienced abdominal pain and underwent an enhanced CT scan and magnetic resonance imaging, which revealed a liver mass. Subsequent 18F-FDG PET/CT identified hypermetabolic lesions in both the left and right lobes of the liver, suggesting malignancy, with no other abnormalities detected.</p><p><strong>Diagnoses: </strong>A liver biopsy confirmed the diagnosis of adenoid cystic carcinoma.</p><p><strong>Interventions: </strong>No intervention.</p><p><strong>Outcomes: </strong>Following confirmation of the diagnosis, the patient chose to discontinue treatment and was discharged.</p><p><strong>Lessons: </strong>Hepatic metastasis from adenoid cystic carcinoma may be detected before the identification of the primary lesion. 18F-FDG PET/CT plays a critical role in differentiating benign from malignant liver tumors, selecting potential biopsy sites, and assessing the extent of metastatic disease.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19-associated autoimmune encephalitis: A case report and literature review. COVID-19相关自身免疫性脑炎:病例报告和文献综述。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039533
Yang-Chuan Chen, Shu-Ting Hong, Yuan-Feng Chen, Pan Lin, Xiao-Xin Chen, Yang-Zong Wu
{"title":"COVID-19-associated autoimmune encephalitis: A case report and literature review.","authors":"Yang-Chuan Chen, Shu-Ting Hong, Yuan-Feng Chen, Pan Lin, Xiao-Xin Chen, Yang-Zong Wu","doi":"10.1097/MD.0000000000039533","DOIUrl":"https://doi.org/10.1097/MD.0000000000039533","url":null,"abstract":"<p><strong>Rationale: </strong>This article reports a case of coronavirus disease (COVID-19)-associated autoimmune encephalitis (AE) and reviews the relevant literature to investigate the clinical manifestations, auxiliary inspection, diagnosis and treatment, and prognosis of AE associated with COVID-19.</p><p><strong>Patient concerns: </strong>A 68-year-old female with fatigue developed altered consciousness after 2 days of fever, thereafter testing positive for COVID-19. The protein levels in the lumbar puncture cerebrospinal fluid were elevated, and cranial magnetic resonance imaging (MRI) scan indicated T2-weighted hyperintensity in the temporal lobe.</p><p><strong>Diagnoses: </strong>The patient was diagnosed with COVID-19-associated AE.</p><p><strong>Interventions: </strong>After admission, the patient received pulse steroid therapy with methylprednisolone. Additionally, gastric protection, blood glucose control, nutritional support, and other treatments were administered.</p><p><strong>Outcomes: </strong>The symptoms were significantly relieved by steroid pulse therapy. At the 3-month follow-up, the patient had recovered completely without any obvious discomfort.</p><p><strong>Lessons: </strong>The possibility of AE should be considered if neurological symptoms occur a few days after infection with COVID-19, with early diagnosis and immediate steroid pulse therapy resulting in better outcomes.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical care in older adults: Research landscape and hotspots from a bibliometric perspective. 老年人的重症监护:从文献计量学角度看研究前景和热点。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039754
Zhe Du, Fang Li, Tianbing Wang
{"title":"Critical care in older adults: Research landscape and hotspots from a bibliometric perspective.","authors":"Zhe Du, Fang Li, Tianbing Wang","doi":"10.1097/MD.0000000000039754","DOIUrl":"https://doi.org/10.1097/MD.0000000000039754","url":null,"abstract":"<p><p>As the population ages, there will be an increasing demand for health care resources, particularly in intensive care. Therefore, critically ill older adults are receiving increasing attention and have been extensively studied. However, the research landscape, dynamic patterns, and emerging topics in this area have scarcely been reviewed. This study aimed to delve into the current status and emerging trends (publication volume and research topics) in critical care for older adults (including interventions, outcomes, and complications) using bibliometric analysis. We retrieved original articles and reviews focusing on critical care for older adults published between 2013 and 2022 from the Web of Science core database. To examine and present the research trends, we employed VOSviewer and CiteSpace software for analysis and visualization. The cooperative network of countries and institutions, cocited authorship network, cocited references, and cooccurrence network of keywords were analyzed. Overall, 6356 articles and reviews published between 2013 and 2022 were analyzed, revealing a noticeable upward trend in the number of publications focused on critical care for older adults. In total, 34,654 authors from 7989 institutions across 131 countries collaborated to publish 6356 papers related to critical care for older adults in 1715 academic journals. The United States of America and China were the top contributors in terms of research studies, while Bertrand Guidet was the most prolific author with the highest number of articles. A dual-map overlay of the literature revealed that research papers published in Molecular/Biology/Genetics and Health/Nursing/Medicine journals were frequently referenced in Medicine/Medical/Clinical journals. Older patients with coronavirus disease 2019, delirium, and frailty were new trends and developing areas of interest. This is the first bibliometric study focusing on critical care in older adults. The research topics indicate that a comprehensive geriatric assessment, tailored interventions, and specific therapeutic algorithms among older adults are recommended to improve outcomes. Furthermore, this study provides valuable insights for clinical decision-making, guideline development, and resource allocation in critical care settings.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of autonomic nervous dysfunction on eating during hemodialysis sessions: An observational study. 自律神经功能紊乱对血液透析期间进食的影响:一项观察性研究。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039680
Dan Xiao, Xia Li, Yi Li, Liwen Mo, Xianglian Li, Yonggang Fu, Fan Zhang, Tao Wang, Yue Cheng, Yunming Li, Pengfei Zhou
{"title":"Influence of autonomic nervous dysfunction on eating during hemodialysis sessions: An observational study.","authors":"Dan Xiao, Xia Li, Yi Li, Liwen Mo, Xianglian Li, Yonggang Fu, Fan Zhang, Tao Wang, Yue Cheng, Yunming Li, Pengfei Zhou","doi":"10.1097/MD.0000000000039680","DOIUrl":"https://doi.org/10.1097/MD.0000000000039680","url":null,"abstract":"<p><p>Although some studies have indicated that eating during hemodialysis may induce hypotension and cardiovascular events, some patients still consume food during their treatment. This prospective study was conducted to determine whether the need to eat during hemodialysis treatment was related to abnormal glucose metabolism and autonomic nerve dysfunction. Seventy patients were enrolled in this study, and their demographic features and various laboratory parameters were analyzed. At each routine hemodialysis visit, predialysis, intradialysis, and postdialysis blood pressure measurements were systematically conducted. A 24-hour ambulatory electrocardiogram (ECG) was performed during the hemodialysis interval, and heart rate variability (HRV) values were calculated. Additionally, whether the patients ate during the hemodialysis treatments was recorded. Another 20 people who underwent physical examinations during the same period and were matched for sex and age were included in the control group. The HRV values of the hemodialysis patients were generally lower than those of the control group. Univariate analysis revealed significant differences in sex, age, calcium antagonist use, blood calcium levels, insulin levels, diastolic blood pressure (DBP) measurements, and HRV indices between hemodialysis patients who ate and those who did not eat during hemodialysis (P < .05), whereas there were no significant differences in diabetes status or in the hemoglobin, albumin, blood glucose and C-peptide levels (P > .05). Multivariate analysis revealed that low values for very low frequency (VLF) and postdialysis DBP were risk factors for fasting intolerance during hemodialysis treatments. Autonomic dysfunction may affect whether hemodialysis patients tolerate fasting during dialysis. VLF evaluation may provide information that can be used to develop a more reasonable intradialytic nutritional supplementation method.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimizing adipose-derived stromal vascular fraction storage: Temperature and time impact on cell viability in regenerative medicine. 优化脂肪来源基质血管部分的储存:温度和时间对再生医学中细胞活力的影响。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039859
Darko Jović, Ljubiša Preradović, Filip Jović, Mićo Kremenović, Darko Lukić, Milica Antonić, Nikola Unčanin, Matija Jović
{"title":"Optimizing adipose-derived stromal vascular fraction storage: Temperature and time impact on cell viability in regenerative medicine.","authors":"Darko Jović, Ljubiša Preradović, Filip Jović, Mićo Kremenović, Darko Lukić, Milica Antonić, Nikola Unčanin, Matija Jović","doi":"10.1097/MD.0000000000039859","DOIUrl":"https://doi.org/10.1097/MD.0000000000039859","url":null,"abstract":"<p><strong>Background: </strong>The adipose-derived stromal vascular fraction (SVF) plays a crucial role in regenerative medicine owing to its regenerative and immunomodulatory properties. However, the effective utilization of SVF in therapeutic applications requires careful consideration of storage conditions to maintain cell viability.</p><p><strong>Methods: </strong>We conducted a research on 43 patients of different ages and sexes who were older than 18 years. This study explored the impact of different temperatures (-80, -20, and 4 °C) on SVF storage in platelet-poor plasma for 1 and 6 months. SVF extracted using a semi-UNISTATION™ system was subjected to rigorous analysis of cell count and viability using a LUNA-STEM™ Dual Fluorescence Cell Counter.</p><p><strong>Results: </strong>The results indicated a significant correlation between the storage conditions and SVF viability. Notably, storing SVF at 4 °C demonstrated the highest cell viability and count, while -80 °C storage exhibited the least favorable outcomes. This study emphasizes the importance of minimizing storage time to preserve SVF viability, as evidenced by a decline in both cell count and viability over a 6-month period. Comparisons with the existing literature underscore the need for precise protocols for SVF storage, with considerations for temperature and cryoprotective agents. These findings provide valuable insights for developing optimal SVF storage protocols to enhance therapeutic outcomes and reduce the need for repeated adipose tissue harvesting. Despite the limitations of the study, such as the use of a cell counter instead of flow cytometry, the results establish the foundation for further research on refining SVF storage methods.</p><p><strong>Conclusion: </strong>The ideal storage temperature is from 4 °C, while the length of storage time inversely affects the viability of SVF; the longer the storage time, the lower the number and the viability of SVF cells, regardless of the temperature at which they are preserved.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Construction and validation of a predictive model for preoperative lower extremity deep vein thrombosis risk in elderly hip fracture patients: An observational study. 构建并验证老年髋部骨折患者术前下肢深静脉血栓风险预测模型:一项观察性研究。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039825
Chang-Song Yang, Zhe Tan
{"title":"Construction and validation of a predictive model for preoperative lower extremity deep vein thrombosis risk in elderly hip fracture patients: An observational study.","authors":"Chang-Song Yang, Zhe Tan","doi":"10.1097/MD.0000000000039825","DOIUrl":"https://doi.org/10.1097/MD.0000000000039825","url":null,"abstract":"<p><p>The aim of this study was to identify independent risk factors for preoperative lower extremity deep vein thrombosis (DVT) in elderly hip fracture patients and to construct a nomogram prediction model based on them. We collected clinical data from elderly hip fracture patients from Ya'an Hospital of Traditional Chinese Medicine (2021-2023), and used univariate and multivariate logistic regression analyses to identify independent risk factors for preoperative DVT. In this way, a nomogram prediction model was established. In addition, external validation of the model was performed by patient data from Ya'an Mingshan District Hospital of Traditional Chinese Medicine. Receiver operating characteristic curve analysis was used to calculate the area under the curve, and calibration and decision curves were plotted to assess the predictive performance of the model. Of the 223 elderly hip fracture patients, 23 (10.31%) developed DVT of the lower extremities before surgery. A total of 6 variables were identified as independent risk factors for preoperative lower extremity DVT in elderly hip fracture patients by logistic regression analysis: age > 75 years (OR = 1.932; 95% CI: 1.230-3.941), diabetes mellitus (OR = 2.139; 95% CI: 1.149-4.342), and prolonged duration of disease (OR. 2.535; 95% CI: 1.378-4.844), surgical treatment (OR = 1.564; 95% CI: 1.389-3.278), D-dimer > 0.5 mg/L (OR = 3.365; 95% CI: 1.229-7.715) fibrinogen > 4 g/L (OR = 3.473; 95% CI: 1.702-7.078). The constructed nomogram model has high accuracy in predicting the risk of preoperative DVT in elderly hip fracture patients, providing an effective tool for clinicians to identify high-risk patients and implement early intervention.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A rare case report of endobronchial neurofibroma treated with transbronchial endoscopic resection and literature review. 经支气管内窥镜切除术治疗支气管内神经纤维瘤的罕见病例报告和文献综述。
IF 1.3 4区 医学
Medicine Pub Date : 2024-09-20 DOI: 10.1097/MD.0000000000039730
Xing Chen, Shanlu Yu, Jian Sun, Yefeng Chen, Chunyi Zhang, Hua Wang, Min Xiang, Shuying Liu
{"title":"A rare case report of endobronchial neurofibroma treated with transbronchial endoscopic resection and literature review.","authors":"Xing Chen, Shanlu Yu, Jian Sun, Yefeng Chen, Chunyi Zhang, Hua Wang, Min Xiang, Shuying Liu","doi":"10.1097/MD.0000000000039730","DOIUrl":"https://doi.org/10.1097/MD.0000000000039730","url":null,"abstract":"<p><strong>Rationale: </strong>Endobronchial neurofibroma is an extremely rare neoplastic disease. The majority of endobronchial neurofibroma are symptomatic, but nonspecific. The treatment of endobronchial neurofibroma is controversial that surgery is previously considered to be the main option. With the development of bronchoscopic intervention, most endobronchial neurofibroma can be treated with transbronchial endoscopic resection with few complications. Here we reported a case of diagnosed endobronchial neurofibroma that was successfully resected with transbronchial electrical snaring and laser coagulation. Moreover, the relevant literature was reviewed to raise awareness of this disease.</p><p><strong>Patient concerns: </strong>A 57-year-old man presented to our hospital with cough, sputum, and shortness of breath for 2 days. Physical examination was normal. Laboratory tests revealed moderately increased C-reactive protein. Chest computed tomography showed a 10 × 8 mm round, polypoid-shaped nodule located in the left main bronchus, which was heterogeneous after contrast enhancement. It demonstrated a smooth, round, hypervascularized neoplasma obstructing most of the lumen of the upper left main bronchus under bronchoscopy.</p><p><strong>Interventions and outcomes: </strong>The tumor was removed with electrical snaring and laser coagulation completely instead of surgical resection, without any complications. Pathologically, it was confirmed of endobronchial neurofibroma. Repeated bronchoscopy showed no recurrence of the tumor, and the procedure site healed with a little of fibrotic scar formation.</p><p><strong>Lessons: </strong>Endobronchial neurofibroma is rare. Although the standard treatment for endobronchial neurofibroma is surgery, transbronchial endoscopic resection (electrical snaring and laser coagulation) is an applicable option, especially for those lesions strictly in the lumen.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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