Medicine
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Observational Study
Impact of COVID-19 pandemic on emergency department length of stay and clinical outcomes of patients with severe pneumonia: A single-center observational study.
We examined the impact of COVID-19 pandemic on the emergency department length of stay (EDLOS) and clinical outcomes of patients with severe pneumonia admitted to the intensive care unit (ICU) through the emergency department (ED). This single-center retrospective observational study included adult patients with pneumonia admitted to the ICU through the ED between January and December 2019 (pre-pandemic) and between March 2020 and February 2021 (during-pandemic). We compared and analyzed the EDLOS by dividing it into pre-, mid-, and post-EDLOS and in-hospital mortality of patients with pneumonia admitted to the ICU according to the time of ED visits before and during the COVID-19 pandemic. ⋯ Mid-EDLOS (ED time to assess, care, and ICU admission decision) was an independent risk factor for in-hospital mortality of patients with pneumonia admitted to the ICU during the COVID-19 pandemic (OR = 1.835, 95% CI: 1.089-3.092, P = .023). During the pandemic of emerging respiratory infectious diseases, to reduce in-hospital mortality of severe pneumonia patients, it is necessary to shorten the ED waiting time for admission by increasing the number of isolation ICU beds. It is also necessary to accelerate the assessment and care process in the ED, and make prompt decisions regarding admission to the ICU.
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Prediction of malignancy in branch duct (BD)-type intraductal papillary mucinous neoplasms (BD-IPMNs) is difficult. In this retrospective study, we showed the performance of imaging biomarker and biochemical biomarker in identifying the malignant BD-IPMNs. A total of 97 patients with pathological proved BD-IPMNs were included in this study. ⋯ The combined model of mural nodule and tumor size showed good performance in identifying malignant BD-IPMNs (area under the curve [AUC] = 0.82, 95%CI: 0.67-0.97). Our data show that mural nodule and cystic size can be used as predictor of malignancy in BD-IPMN. The predictive performance is acceptable.
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Case Reports
Metastasis of the Mucionous adenocarcinoma of breast to the mandibular gingiva: Rare case report.
Mucinous adenocarcinoma (MAC) is a rare type of cancer in which more than 50% of the tumor is composed of extracellular mucin and malignant epithelial cells. MACs account for only 1.8% of all breast cancer cases. Most breast cancers present as localized diseases and are well-differentiated. Breast MAC has a better 5- and 10-year survival rate than ductal and lobular carcinomas. Distant metastasis in breast MAC is rare, especially in the oral cavity. Only 1% of all oral malignancies present with metastases to the oral cavity. The bony structures are more involved than the soft tissues. Involvement of the oral soft tissue is rare, accounting for less than 0.1% of oral metastases. ⋯ The clinical presentation of oral metastasis is not pathognomonic, and pyogenic granuloma, periodontal abscesses, sarcomas, and squamous carcinoma must be considered in the differential diagnosis. This is a rare case of oral metastasis of breast MAC, which was indicated for detection of the primary tumor.
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Case Reports
Patients with blastic plasmacytoid dendritic cell neoplasm in pregnancy: A rare case report.
Previous clinical reports of patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN) in pregnancy are rare. ⋯ Pregnant women diagnosed with BPDCN in the third trimester should terminate the pregnancy promptly for further treatment.
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Retrospective cross-sectional study To evaluate the validity and obtain optimal cutoff values of 3 radiologic measurements for the diagnosis of basilar invagination (BI). Two hundred seventy-six patients (46 patients who underwent atlantoaxial fusion for BI and 230 patients who were treated for minor cervical trauma) seen in a single institution from January 2010 to December 2016 were included in this study. Age, sex, and body mass index were adjusted for the patients. ⋯ The validity of these measurements depends on sex and particular radiologic measurement. The optimized cutoff values of RI, MRM, and RJM were 14, 26, and 32 mm in women and 15, 29, and 37 mm in men. These cutoff values showed high validity when compared to the CT and MRI findings.