Medicine
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Although Klebsiella pneumoniae pneumonia is an insidious threat among the elderly, the role of radiological features has not been elucidated. We aimed to evaluate thin-section chest computed tomography (CT) features and assess its associations with disease prognosis in elderly patients with acute K. pneumoniae pneumonia. We retrospectively included elderly patients, admitted for acute K. pneumoniae pneumonia, and investigated thin-section CT findings to determine whether bronchopneumonia or lobar pneumonia was present. ⋯ Twenty-five (29%) patients died in hospital, and they had a greater incidence of lobar pneumonia pattern (40% in nonsurvivors vs 10% in survivors; P = .008), low albumin level (2.7 g/dL, range, 1.6-3.8 in nonsurvivors vs 3.0 g/dL, range, 1.7-4.2 in survivors; P = .026) and higher levels of aspartate aminotransferase (30 U/L, range, 11-186 in nonsurvivors vs 23 U/L, range, 11-102 in survivors, P = .017) and C-reactive protein (8.0 mg/dL, range, 0.9-26.5 in nonsurvivors vs 4.7 mg/dL, range, 0.0-24.0 in survivors; P = .047) on admission. Multivariate analysis showed that lobar pneumonia pattern was independently associated with increased in-hospital mortality (adjusted hazard ratio, 3.906; 95% CI, 1.513-10.079; P = .005). In elderly patients with acute K. pneumoniae pneumonia, the lobar pneumonia pattern may be less commonly observed, and this pattern could relate to poor prognosis.
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Age variances in systemic lupus erythematosus (SLE) may reflect different patterns and consequences. Monocyte differentiation is critical, and cytokine and chemokine milieu may be associated with long term outcome and treatment responses. This study aims to evaluate the inflammatory cellular and serology pathways associated with age in our lupus registry. ⋯ We found significant M2b polarization in adult SLE patients, and several cytokines and chemokines were significantly higher in SLE patients ≤ 18 years old. Peripheral blood mononuclear cell differentiation and cytokine milieu could represent composite harm from both Type 2 helper T cells (Th2) and Type 17 helper T cells (Th17) pathways and may thus be a potential therapeutic target in younger SLE patients.
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Case Reports
Two cases of aldosterone and cortisol producing adenoma with different histopathological features: A case report.
Primary aldosteronism (PA), including aldosterone and cortisol producing adenoma (A/CPA), is the most common trigger of secondary hypertension. The prevalence of A/CPA may be higher than what we could recognize previously with similar studies, but only a few relevant immunohistochemical reports have confirmed this information. Collecting more clinical features and immunohistochemistry data may help us to understand A/CPA, which is very important for avoiding misdiagnosis and improving outcomes in patients with A/CPA. ⋯ The occurrence of A/CPA may be related to calcium metabolism disorders. For A/CPA, the diversity in immunohistochemistry suggests many uncertainties regarding the pathogenesis of the disease. A/CPA should be considered in new clinical and pathological classifications of PA to gain more attention from the medical community.
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Peripheral blood of Neutrophil-to-Lymphocyte ratio (NLR), carcinoma embryonic antigen (CEA), cancer antigen 125 (CA125) and cancer antigen 15-3 (CA15-3) could be used as prognostic indicators for several types of tumors. The purpose of this study was to evaluate the predictive value of inflammatory cell ratio and tumor markers for postoperative breast cancer patients. Clinical data concerning 190 breast cancer patients who underwent radical surgery in Zhejiang Provincial Hospital of Chinese Medicine from 2013 and 2016 were retrospectively analyzed. ⋯ Univariate analysis and Kaplan-Meier survival analysis revealed that the serum NLR, CEA, CA125, and CA15-3 were related to postoperative 5-year DFS (P < .05). In addition, multivariate survival analysis identified the following independent prognostic factors: NLR (P < .001), CA125 (P = .045) and ki-67 (P = .020). Preoperative serum inflammatory biomarker of NLR and tumor marker of CA125 have potential prognostic value for breast carcinoma.
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Observational Study
Correlation between goniometric measurements of range of motion and radiographic scores in osteoarthritis knee: An observational study among females.
Osteoarthritis (OA) is a chronic degenerative joint disease. Different radiological changes are found according to grades. Range of motions (ROMs) of knee decreases with severity of OA. ⋯ Extension values were moderately correlated with patellofemoral scores (r = -0.560, P < .001) and weakly correlated with rest of radiographic scores. Internal and external rotation were more related with medial compartment (r= -0.469, P < .001) and lateral compartment scores (r = -0.481, P < .001), respectively, than other compartment scores. There were significant negative correlations between goniometric measurements of knee ROM and radiographic scores in osteoarthritis knee in female patients.