Medicine
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Survival improvement in cystic fibrosis (CF) is associated with more frequent long-term complications, including CF related bone disease (CFBD). Impact of CFBD on global health outcome remains poorly described. We aimed to assess the relationship between low bone mineral density (BMD) and spinal pain, disability, and quality of life in CF adult patients. ⋯ Low BMD was not associated with spinal pain, disability and quality of life. Low BMD is frequent in CF, affecting 1-quarter of adult patients. No significant association was found between low BMD and spinal pain, disability or quality of life.
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Cowden syndrome is a rare autosomal dominant disease characterized by the development of hamartomas and increased risks of other tumors, including breast, thyroid, and uterine cancers. Most patients with Cowden syndrome show mutations of the phosphatase and tensin homolog (PTEN) gene on chromosome 10; however, some patients with mutations do not show clinical symptoms, while patients with clinical symptoms may not have detectable PTEN mutations. ⋯ The clinical symptoms of Cowden syndrome do not always correlate with the genetic results. However, recent improvements in genetic testing suggest the importance of diagnosing this disease using both clinical and genetic approaches, in collaboration with genetic experts, to ensure an accurate diagnosis and appropriate surveillance for malignant tumors.
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Sociodemographic factors have been found to be associated with the transmission of coronavirus disease 2019 (COVID-19), yet most studies focused on the period before the proliferation of vaccination and obtained inconclusive results. In this cross-sectional study, the infections, deaths, incidence rates, case fatalities, and mortalities of Virginia's 133 jurisdictions during the pre-vaccination and post-vaccination periods were compared, and their associations with demographic and socioeconomic factors were studied. The cumulative infections and deaths and medians of incidence rates, case fatalities, and mortalities of COVID-19 in 133 Virginia jurisdictions were significantly higher during the post-vaccination period than during the pre-vaccination period. ⋯ Multiple linear regression analysis suggested that demographic and socioeconomic factors contributed up to 80% of the variation in the infections, deaths, and incidence rates and up to 53% of the variation in the case fatalities and mortalities of COVID-19 in Virginia. The demographic and socioeconomic determinants differed during the pre- and post-vaccination periods. The developed multiple linear regression models could be used to effectively characterize the impact of demographic and socioeconomic factors on the infections, deaths, and incidence rates of COVID-19 in Virginia.
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Follicular carcinoma originating from struma ovarii is a clinically rare low-grade malignant tumor. The pathological diagnosis of ovarian thyroid follicular carcinoma is predominantly based on the infiltrative growth and vascular involvement of tumor cell nests of different sizes in the ovarian parenchyma. ⋯ The analysis of the microscopic morphological characteristics and immunohistochemistry deepened our understanding of the pathological characteristics of ovarian and thyroid follicular carcinoma, and further provides a diagnostic reference for other clinicians who will encounter these conditions in the future.
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Case Reports
Disseminated nontuberculous mycobacteria infection in an immunocompetent host: A case report.
Disseminated nontuberculous mycobacterial (NTM) infections are rare and occur primarily in immunocompromised hosts. Mycobacterium abscessus complex (MABC), including M abscessus subsp. massiliense (hereafter M massiliense) is a complex of rapidly growing mycobacterial (RGM) species of NTM. Here, we present a rare case of disseminated NTM infection with RGM bacteremia caused by M massiliense in an immunocompetent host. ⋯ Disseminated NTM infections with RGM bacteremia in an immunocompetent host have rarely been reported. In this case, PICC placement for more than 6 months was suspected to be an important risk factor for RGM bacteremia in an immunocompetent patient. To date, there are only insufficient case reports, moreover no clear guidelines regarding the optimal choice of antibiotics or length of treatment for disseminated NTM infection. Therefore, it is necessary to establish treatment guidelines for patients with disseminated NTM infection and bacteremia.