Medicine
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Colorectal cancer (CRC) is one of the most common cancers all over the world, and approximately 70% of the newly diagnosed patients are over 65 years old. Due to the aging of society, there will be more and more elderly patients of CRC in the future. Treatment of CRC in elderly patients is much more challenging thanks to multiple factors including disabling comorbidities as well as declines in organs function, especially in advanced or metastatic settings. ⋯ Capecitabine monotherapy may be an effective treatment in advanced or metastatic colorectal cancer (mCRC) for elderly patients.
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Knee joint infection caused by isolated primary Candida is extremely rare, with only a few cases reported. It occurs most often in patients with predisposing factors (e.g., immunosuppression, malignancy, drug abuse) or fungal invasion during traumatic procedures, including surgery. We report an unusual case of Candida parapsilosis infection in the knee joint with no predisposing factors. ⋯ If there were suspected symptoms of primary Candida infection cases, imaging and microscopic examinations, tissue cultures, and pathological examination of the puncture knee joint fluid were required.
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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.