Medicine
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Gout occurs mainly in joints, but rarely in the spine. In the spine, urate crystals can cause intervertebral space instability but rarely lead to retrolisthesis. Here, we present an extremely rare disease with gout invaded the intervertebral disc with lumbar retrolisthesis. ⋯ Gouty spondylodiscitis can cause intervertebral space instability. Sagittal imbalance and degeneration of disc with decreasing of segmental disc height are considered as the main factors of retrolisthesis. The appearance may lead to misdiagnose a patient with gout history with a destruction of the intervertebral space. Surgery is a compromise method for gouty spondylodiscitis patients with urgent neurological symptoms.
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Observational Study
Prognostic value of serum albumin for patients with acute aortic dissection: A retrospective cohort study.
Serum albumin (SA) is associated with inflammation and thrombosis, which are involved in acute aortic dissection (AAD). Our aim was to investigate the effect of SA level on survival in patients with AAD. We analyzed 777 patients with AAD. ⋯ Kaplan-Meier analysis showed that survival was significantly lower in patients with hypoalbuminemia compared to those without, regardless of AAD type (type A: log-rank χ = 14.71; P <.001; Type B: log-rank χ = 10.42; P = .001). After adjusting for confounding factors, hypoalbuminemia was an independent predictor of in-hospital mortality in patients with either type A (HR, 2.492; 95% confidence interval [CI], 1.247-4.979; P = .010) or type B (HR, 8.729; 95% CI, 1.825-41.736; P = .007). SA is independently associated with increased in-hospital mortality in both type A and B AAD.
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Observational Study
Prognostic significance of neutrophil-lymphocyte ratio and carbohydrate antigen 19-9 in patients with gallbladder carcinoma.
The neutrophil-lymphocyte ratio (NLR) is an immune response-related indicator and it is associated with poor prognosis of various cancers. The carbohydrate antigen19-9 (CA19-9) is a tumor-associated antigen and it has prognostic relevance in gallbladder carcinoma (GBC). We aimed to analyze whether preoperative NLR and serum CA19-9 were associated with outcomes of GBC patients after surgery with curative intent. ⋯ The median survival time in low NLR and CA19-9 group was better than high NLR and CA19-9 group (P < .05). The preoperative NLR and serum CA19-9 are associated with prognosis of patients with GBC. High NLR and high CA19-9 were predictors of poor long-term outcome among patients with GBC undergoing curative surgery.
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Pregnancy after spinal cord injury, hip resection, leg amputation, and scoliosis is an uncommon event. Given the specific pathophysiological changes in this patient, an aesthetic management presented a particular challenge. The effects on the physiological changes associated with pregnancy, aesthetic methods, blood loss, autotransfusion from uterine contractions and thrombotic risk had to be considered. ⋯ Anesthetic management of a pregnant woman with a spinal injury, scoliosis, left total leg and right below-knee amputations, and left hip resection requires considerable attention. Advances in medical technology have provided clinicians with insights into managing patients with this condition.
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Trio family-based whole exome sequencing (WES) is a powerful tool in the diagnosis of rare neurodevelopmental diseases, even in patients with the unclear diagnosis. There have been previous reports of variants in the phosphatidylinositol glycan anchor biosynthesis class T (PIGT) gene associated with multiple congenital anomalies, with a total of 14 affected individuals across 8 families. ⋯ Most of the clinical features of the patient are in agreement with the previously described PIGT cases corroborating the usefulness of WES as a diagnostic tool.