The American journal of the medical sciences最新文献_第5页

TPOAb Indicates neuroendocrine tumor in autoimmune gastritis: A retrospective study of 91 patients. 自身免疫性胃炎患者神经内分泌肿瘤的 TPOAb 指标：对 91 例患者的回顾性研究

The American journal of the medical sciences Pub Date : 2024-08-21 DOI: 10.1016/j.amjms.2024.08.009

Bo Li, Honggang Jiang, Congbo Cai, Hongtan Chen

{"title":"TPOAb Indicates neuroendocrine tumor in autoimmune gastritis: A retrospective study of 91 patients.","authors":"Bo Li, Honggang Jiang, Congbo Cai, Hongtan Chen","doi":"10.1016/j.amjms.2024.08.009","DOIUrl":"10.1016/j.amjms.2024.08.009","url":null,"abstract":"Background: The association between serological indexes and occurrence of complications in patients with autoimmune gastritis (AIG) remains unclear.Methods: 91 patients with AIG were recruited and their clinical information were collected. The differences between serological indexes and complications of AIG were analyzed. And potential biomarker for early prediction and diagnosis of AIG with complications was explored.Results: AIG patients in our study was 58.12 ± 11.68 years old, containing 31 males and 60 females. G17 was elevated in 49 of 52; PGI/II decreased in 43/49; GPA positive in 48/61; Anemia presented 28 in 80; Vitamin B12 deficiency occurred 23 in 58. Neuroendocrine tumor (NET) was the most common complication in AIG patients, accounting for 27/91. The second was polyps, making up for 14/91. There is also 9/91 of gastric mucosa neoplasia happened in AIG. No significant difference of G7, PGI, PGII, PGI/II and VB12 in AIG was found in different gastric mucosal lesions (P > 0.05). However, AIG patients with TPOAb positive had a higher risk in the occurrence of NET simultaneously (P = 0.0212). Those AIG with NET patients exhibited a significantly higher TPOAb level (P = 0.0078). ROC curve suggested that TPOAb can predict the existence of NET in AIG (AUC = 0.7410, P < 0.05).Conclusion: We found that TPOAb can serve as a predictive biomarker of NET in AIG. This accessible test is helpful for endoscopy specialists to pay attention to gastric mucosal lesions in TPOAb-positive AIG patients, improving early diagnosis and intervention of comorbidities ability.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mixed glandular neuroendocrine carcinoma of the endometrium with hypercalcemic crisis. 子宫内膜混合性腺神经内分泌癌伴高钙血症危象。

The American journal of the medical sciences Pub Date : 2024-08-21 DOI: 10.1016/j.amjms.2024.08.010

Mei Luo, Xiaoxia Yu, Zhongpei Chen, Zhenhan Li

{"title":"Mixed glandular neuroendocrine carcinoma of the endometrium with hypercalcemic crisis.","authors":"Mei Luo, Xiaoxia Yu, Zhongpei Chen, Zhenhan Li","doi":"10.1016/j.amjms.2024.08.010","DOIUrl":"10.1016/j.amjms.2024.08.010","url":null,"abstract":"Objective: To explore the ideas and research progress in diagnosing and treating hypercalcemic crisis in patients with cancer.Methods: We reviewed the clinical data, diagnosis and treatment of hypercalcemic crisis in a patient with mixed glandular neuroendocrine carcinoma of the endometrium.Results: The patient had gastrointestinal symptoms and acute renal impairment as the main manifestations, and the blood biochemical indexes suggested a hypercalcemic crisis with elevated parathyroid hormone (PTH). No lesions were seen in the parathyroid glands on imaging and nuclide imaging, but an abnormal pelvic mass was seen in the pelvis and the biopsy of the uterine cervix tissue suggested that it was an adenocarcinoma. Surgery was performed to remove the mass, and postoperative findings suggested endometrial large-cell neuroendocrine carcinoma with endometrioid adenocarcinoma. The calcium and PTH decreased to normal after surgery and chemotherapy.Conclusions: The condition of the hypercalcemia crisis is dangerous, so it is necessary to think from different aspects of the clinical diagnosis and treatment.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 of spontaneous hemoperitoneum in a bone marrow transplant recipient on VV-ECMO. 骨髓移植受者在使用 VV-ECMO 时发生自发性腹腔积血的罕见病例。

The American journal of the medical sciences Pub Date : 2024-08-19 DOI: 10.1016/j.amjms.2024.08.017

Patrick Donabedian, Amir M Emtiazjoo, Mindaugus Rackauskas, Philip Efron, Cynthia Gries, Melissa Burger, Letitia Bible, Victoria Reams, Marc O Maybauer, Biplab K Saha

{"title":"A rare case of spontaneous hemoperitoneum in a bone marrow transplant recipient on VV-ECMO.","authors":"Patrick Donabedian, Amir M Emtiazjoo, Mindaugus Rackauskas, Philip Efron, Cynthia Gries, Melissa Burger, Letitia Bible, Victoria Reams, Marc O Maybauer, Biplab K Saha","doi":"10.1016/j.amjms.2024.08.017","DOIUrl":"10.1016/j.amjms.2024.08.017","url":null,"abstract":"A 53-year-old man with acute myeloid leukemia received an allogeneic hematopoietic cell transplant (HCT) from a matched unrelated donor. One month after his transplantation, he developed ARDS requiring initiation of VV-ECMO. He suffered from pancytopenia, managed with frequent transfusions, granulocyte-colony stimulating factor (G-CSF) and weekly thrombopoietin receptor agonist. On ECMO day 17, the patient developed severe hypotension after insertion of a chest tube for a large right-sided pneumothorax. CT angiography of the abdomen showed hemoperitoneum. Exploratory laparotomy revealed approximately 4 L of blood and a ruptured splenic hilum. A splenectomy was performed. Unfortunately, the patient continued to require multiple daily blood products and his condition continued to decline despite two reoperations. His family chose to discontinue ECMO and he passed away peacefully. Spontaneous splenic rupture after GM-CSF has never been reported in patients on VV-ECMO. This manuscript reviews the literature regarding the pathophysiology and clinical manifestation of this rare occurrence.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of different shock conditions on mesenteric hemodynamics. 不同冲击条件对肠系膜血液动力学的影响。

The American journal of the medical sciences Pub Date : 2024-08-19 DOI: 10.1016/j.amjms.2024.08.018

Hao Pu, Wen Li, Gui Wang, ShuJun Zhou

{"title":"Effect of different shock conditions on mesenteric hemodynamics.","authors":"Hao Pu, Wen Li, Gui Wang, ShuJun Zhou","doi":"10.1016/j.amjms.2024.08.018","DOIUrl":"10.1016/j.amjms.2024.08.018","url":null,"abstract":"Background: Reduced effective circulating blood volume and impaired peripheral tissue perfusion play an important role in the pathophysiology of shock. However, there have been no studies examining the relationship between Doppler ultrasound of the superior mesenteric artery (SMA) under different shock conditions.Methods: We evaluated a total of 85 patients, including 63 patients with different types of shock and 22 in the control group. we included patients who were diagnosed with shock upon admission or developed shock during their hospital stay. At the same time, patients with stable hemodynamics, no use of vasoactive drugs and normal lactate levels were used as a control group. We collected SMA Doppler ultrasound parameters, including Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV), Resistance Index (RI), pulsatility index (PI), Time-Averaged Mean Velocity (TAMV), and Blood Flow (BF).Results: In the cardiac shock group, SMA PSV, TAMV, and BF were lower compared to the other groups. There was no significant difference in SMA RI and PI between the different types of shock groups, but both were significantly lower than the control group. Cardiac index (CI) is correlated with SMA PSV (r = 0.487, P = 0.000) and TAMV (r = 0.538, P = 0.000), whereas SVRI is not correlated with SMA RI and PI. Lactate levels was correlation with SMA RI (r = -0.307, P = 0.000) and PI (r = -0.287, P = 0.000). The area under the ROC curve of SMA RI and PI to predict hyperlactatemia was 0.85[0.78-0.91] and 0.83[0.76-0.90].Conclusions: The velocity parameters of SMA Doppler ultrasound such as TAMV and PSV can reflect cardiac function. The measurements of SMA RI and PI are correlated with lactate levels, having a positive predictive value for hyperlactatemia and provide guidance for fluid resuscitation in patients with shock in the future.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Elevated triglyceride-glucose index as a predictor of carotid plaque incidence: Insights from a comprehensive meta-analysis. 作为颈动脉斑块发病率预测因子的甘油三酯-葡萄糖指数升高：综合元分析的启示。

The American journal of the medical sciences Pub Date : 2024-08-19 DOI: 10.1016/j.amjms.2024.08.013

Arankesh Mahadevan, Bhavin A Patel, Sashwath Srikanth, Raja Godasi, Rupak Desai

{"title":"Elevated triglyceride-glucose index as a predictor of carotid plaque incidence: Insights from a comprehensive meta-analysis.","authors":"Arankesh Mahadevan, Bhavin A Patel, Sashwath Srikanth, Raja Godasi, Rupak Desai","doi":"10.1016/j.amjms.2024.08.013","DOIUrl":"10.1016/j.amjms.2024.08.013","url":null,"abstract":"Background: Early detection of carotid plaque (CP) can help reduce the burden of ASCVD in the general population. CP and triglyceride-glucose index (TyGi) are associated with insulin resistance.Objectives: We performed a meta-analysis exploring the association of TyGi levels with the incidence of CP.Methods: A systematic search of PubMed, Scopus, and Google Scholar till September 2023 reporting TyGi and CP identified 67 studies, of which 13 met our study criteria. TyGi was assessed both categorically and continuously. Binary random-effects models used for pooled odds ratios (OR) with 95 % confidence intervals (CI) and I2 statistic for heterogeneity.Results: Analyzed data from 163,792 patients with a mean age of 53 ± 8.9 years, primarily female (51.5 %). Common comorbidities were hypertension (42.4 %) followed by dyslipidemia (24.3 %). Multivariable analysis showed that high vs. low TyGi quartile was associated with a higher risk of CP with unadjusted OR (1.82, 95 % CI [1.5 - 2.21], p < 0.01; I² = 95.77, p < 0.01) and adjusted OR (1.3, 95 % CI [1.16 - 1.46], p < 0.01; I² = 79.71, p < 0.01). Increasing TyGi also had a higher risk of CP with unadjusted OR (1.53, 95 % CI [1.15 - 2.03], p < 0.01; I² = 98.48, p < 0.01) and adjusted OR (1.23, 95 % CI [1.11 - 1.35], p < 0.01; I² = 89.82, p < 0.01). The association was validated by sensitivity analysis.Conclusion: Our study indicates a higher risk of CP in patients with higher TyGi scores, underscoring its significance as a predictor for carotid atherosclerosis.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe hyponatremia secondary to syndrome of inappropriate antidiuretic hormone (SIADH): A rare cause of takotsubo (stress) cardiomyopathy. 继发于抗利尿激素不当综合征（SIADH）的严重低钠血症：塔克次博（应激性）心肌病的罕见病因。

The American journal of the medical sciences Pub Date : 2024-08-19 DOI: 10.1016/j.amjms.2024.08.011

Asad Mussarat, Zachary Stielper, Christopher Hayden, Shane Guillory

引用次数: 0

A simple nomogram for predicting the 90-day mortality of community-acquired pneumonia in the ICU. 用于预测重症监护病房社区获得性肺炎 90 天死亡率的简单提名图。

The American journal of the medical sciences Pub Date : 2024-08-17 DOI: 10.1016/j.amjms.2024.08.016

Ying Sheng, Huishui Dai, Qifang Shi, Wenlong Zheng

引用次数: 0

A case of Winkia neuii (Actinomyces neuii) vertebral osteomyelitis and review of the literature. 一例神经放线菌（Winkia neuii）椎骨骨髓炎病例及文献综述。

The American journal of the medical sciences Pub Date : 2024-08-16 DOI: 10.1016/j.amjms.2024.08.007

Nicholas Richwagen, Destinee Morris, Rita Paulis, Daniel Murphy, Matthew Perkins, Edwin Kamau

引用次数: 0

Visceral adipose tissue area predicts major adverse kidney events in patients with acute necrotizing pancreatitis. 内脏脂肪组织面积可预测急性坏死性胰腺炎患者的主要肾脏不良事件。

The American journal of the medical sciences Pub Date : 2024-08-08 DOI: 10.1016/j.amjms.2024.08.003

Xihong Zhang, Wenjian Mao, Lu Ke, Tiejun Wu, Minyi Xu, Yunze Tan, Yu Liu, Luyu Liu, Gang Li, Jing Zhou, Jingzhu Zhang, Bo Ye, Zhihui Tong, Jianqiang Guo, Weiqin Li

{"title":"Visceral adipose tissue area predicts major adverse kidney events in patients with acute necrotizing pancreatitis.","authors":"Xihong Zhang, Wenjian Mao, Lu Ke, Tiejun Wu, Minyi Xu, Yunze Tan, Yu Liu, Luyu Liu, Gang Li, Jing Zhou, Jingzhu Zhang, Bo Ye, Zhihui Tong, Jianqiang Guo, Weiqin Li","doi":"10.1016/j.amjms.2024.08.003","DOIUrl":"10.1016/j.amjms.2024.08.003","url":null,"abstract":"Background: Given the previously reported harmful effects of abdominal fat burden on kidney function, we aim to investigate the relationship between major adverse kidney events within 30 days (MAKE30) and abdominal obesity in acute necrotizing pancreatitis (ANP) patients and explore the underlying risk factors.Methods: A retrospective cohort study of all patients admitted within 72 h after the first episode of ANP to a tertiary center between June 2015 and June 2019 was conducted. Automatic image analysis software was used to calculate the area of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and skeletal muscle from computed tomography scans at the umbilical level. The potential risk factors of MAKE30 were analyzed by logistic regression.Results: A total of 208 eligible ANP patients were enrolled, with an incidence of 23% for MAKE30. VAT area was more closely associated with the development of MAKE30, with an area under the ROC curve of 0.69 (cutoff value 200 cm2, 63.8% sensitivity and 66.7% specificity). Multivariate logistic regression analysis demonstrated that VAT area [OR 1.01 (1.01-1.02); p < 0.001] was an independent risk factor in predicting MAKE30. Patients with a VAT area > 200 cm2 had more requirements of renal replacement therapy (32% vs. 12%, P < 0.001), and a significantly higher incidence of other poor clinical outcomes (all p < 0.05).Conclusion: Early assessment of the VAT area may help identify ANP patients at high risk of MAKE30, suggesting that it could be a potential indicator for adverse kidney events.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical characteristics of primary biliary cirrhosis - idiopathic inflammatory myopathy overlap syndrome: A single center study. 原发性胆汁性肝硬化-特发性炎症性肌病重叠综合征的临床特征：一项单中心研究

The American journal of the medical sciences Pub Date : 2024-08-08 DOI: 10.1016/j.amjms.2024.08.005

Juan Wu, Yue Yin, Xinxin Han, Hong Di, Yingdong Han, Min Shen, Yun Zhang, Xuejun Zeng

{"title":"Clinical characteristics of primary biliary cirrhosis - idiopathic inflammatory myopathy overlap syndrome: A single center study.","authors":"Juan Wu, Yue Yin, Xinxin Han, Hong Di, Yingdong Han, Min Shen, Yun Zhang, Xuejun Zeng","doi":"10.1016/j.amjms.2024.08.005","DOIUrl":"10.1016/j.amjms.2024.08.005","url":null,"abstract":"Purpose: Primary biliary cirrhosis-idiopathic inflammatory myopathy (PBC-IIM) overlap syndrome (OS) is a rare condition in which cardiac involvement is observed. We aimed to characterize the clinical features and associated factors of PBC-IIM OS patients with cardiac involvement.Methods: Patients with PBC-IIM OS that visited our hospital from January 1983 to December 2021 were enrolled. Clinical presentations and laboratory and imaging data were recorded. The clinical data of patients with and without cardiac involvement were compared. According to the first instance of a disease flare, prognostic factors were also studied.Results: Thirty-four patients with PBC-IIM OS were enrolled. A total of 58.8% of patients presented with muscle weakness at disease onset, which primarily involved skeletal muscle (85.3%). Slight liver dysfunction was discovered in this OS cohort. In patients with cardiac involvement, palpitation (63.6%) and dyspnea (36.4%) were the most common onset symptoms. Arrhythmia was a vital manifestation in OS patients, in which half of OS patients had nonsustained ventricular tachycardia (50.0%, 11/22). Compared with noncardiac involvement, myalgia (4.5%, P = 0.004) and fever (0.0%, P = 0.011) were reported relatively rarely at disease onset in the group with cardiac involvement. The prognosis analysis showed that positivity for anti-Ro52 (HR=0.00, P = 0.034) negatively correlated with relapse in OS patients.Conclusion: PBC-IIM OS has unique features. Typical clinical manifestations and early worsening cardiac indicators can be used to identify cardiac involvement and predict prognosis. Anti-Ro52 may have prognostic value for PBC-IIM OS.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0