Medicine
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The indwelling ureteral stents is a common procedure in routine urological practice. The double-J (D-J) stent is the most common type of stents used and is indicated mainly for short-term urinary drainage and prevention of obstruction and infection. However, prolonged indwelling stents may result in disastrous complications, such as hematuria, infection, encrustation, and stone formation. In this context, the persistence of stent in situ might play a key role as a nidus in deposition of urinary sediment, then forming calculus. Although the encrustation may become more serious as time goes on, large bladder stones are relatively rare. However, the serious encrustation and giant stone may complicate or exacerbate the conditions in turn. ⋯ This case reminds us that it is crucial to take various measures to avoid the forgotten ureteral stent and its unfortunate late complication.
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Observational Study
Admitted AIDS-associated Kaposi sarcoma patients: Indications for admission and predictors of mortality.
Kaposi sarcoma (KS) is an AIDS-defining angioproliferative malignancy associated with high morbidity and mortality. Most KS patients in regions with high incidence such as sub-Saharan Africa present late with advanced stage disease. Admitted KS patients have high mortality rates. ⋯ However, only sepsis (or signs and symptoms of sepsis) were independently associated with mortality after controlling for confounders. In conclusion, common reasons for admission of epidemic KS patients include advanced disease, severe anemia, respiratory tract infections, and signs and symptoms of sepsis. Signs and symptoms of sepsis are independent predictors of mortality in these patients.
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Observational Study
Nomogram to predict risk for early ischemic stroke by non-invasive method.
Stroke is the acute onset of neurological deficits and is associated with high morbidity, mortality, and disease burden. In the present study, we aimed to develop a scientific, nomogram for non-invasive predicting risk for early ischemic stroke, in order to improve stroke prevention efforts among high-risk groups. Data were obtained from a total of 2151 patients with early ischemic stroke from October 2017 to September 2018 and from 1527 healthy controls. ⋯ A nomogram predicting ischemic stroke for all patients had an internally validated concordance index of 0.911. The area under the ROC curve for the logistic regression model was 0.782 (95% confidence interval [CI]: 0.766-0.799, P < .001), with a cutoff value of 2.5. The nomogram developed in this study can be used as a primary non-invasive prevention tool for early ischemic stroke and is expected to provide data support for the revision of current guidelines.
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There are many treatments for chronic hemorrhagic radiation colorectal inflammation, but only a few treatments are supported by high-quality research evidence. Studies have shown that the occurrence and development of radiation proctitis are closely associated with the intestinal flora. Animal studies have indicated that faecal microbiota transplantation (FMT) can improve radiation enteropathy in a mouse model. ⋯ This case report shows that FMT can relieve the symptoms of hematochezia and diarrhea by changing the bacterial community structure in patients with chronic hemorrhagic radiation proctitis.
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The clinical treatment is complicated for patients with placenta previa who must terminate pregnancy due to fetal malformation, death, or inevitable abortion in the second trimester. It is difficult to manage excessive bleeding during pregnancy termination; and those patients face risks of removing the uterus, infection and other complications. ⋯ This new method using a cervical ripening balloon could be a quick and effective way to reduce the risks during pregnancy termination for patients with placenta previa. It is especially helpful in emergency situations with minimal requirements of personnel and equipment. Our study showed great potential of this new utilization of a cervical ripening balloon, and is worthy of further research.