Medicine
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As a paraneoplastic syndrome, Trousseau syndrome (TS) is a collective term for various thromboembolic events caused by clotting and fibrinolytic abnormalities in patients with tumors, clinically manifesting as venous and arterial thromboembolism, as well as disseminated intravascular coagulation (DIC). The incidence rate of arterial thrombosis in patients with TS is 2% to 5%. ⋯ Here, the clinical characteristics and treatment of these 2 TS patients are analyzed and the relevant literature is reviewed to improve understanding, diagnosis, and treatment of the disease. Cerebral infarction is the initial symptom in some patients with malignancies. For unexplained multiple cerebral infarctions, we should screen for occult malignancies to facilitate early diagnosis and treatment, as early and accurate identification of the cause of the disease may improve prognosis.
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Observational Study
Study on the predictive value of APACHE II score and neurogenic dysphagia in carbapenem-resistant Klebsiella pneumoniae.
Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a growing challenge in clinical treatment globally. Early identification of high-risk patients is essential to control infection spread and improve treatment outcomes. This retrospective study analyzed 152 patients with K pneumoniae infections at the Second People's Hospital of Hefei City, Anhui Province, dividing them into carbapenem-resistant and non-carbapenem-resistant groups. ⋯ Receiver operating characteristic curve analysis showed an area under the curve of 0.824 (95% confidence interval: 0.749-0.898) for the APACHE II score, with an optimal threshold of 14.5 points. A new predictive model combining neurogenic dysphagia with APACHE II scores improved classification performance, as demonstrated by Net Reclassification Improvement (NRI = 0.0967, 95% confidence interval: -0.0477 to 0.2410) and reclassification probability analysis, correctly reclassifying 24.32% of individuals into a higher risk category. The findings highlight the combined predictive value of APACHE II scores and neurogenic dysphagia for early identification and intervention in high-risk CRKP patients.
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Case Reports
Primary intracranial neuroendocrine tumor at the sphenoid ridge with metastasis to the spinal cord: A case report.
Neuroendocrine tumors (NETs) originate from neuroendocrine cells and they are depicted with both nerve cells as well as hormone-producing cells. These tumors were initially discovered in extracranial locations and central nervous system involvement is often a result of metastasis. Herein, we present a very rare case of primary intracranial neuroendocrine tumor (PINET) that masqueraded as meningioma at the sphenoid ridge with metastasis to the spinal cord in a patient without a known history of extracranial NET at the time of diagnosis. ⋯ PINET may be capable of metastasizing to spinal cord.
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Case Reports
Undiagnosed mirror syndrome with maternal hypoxemia onset during an emergency cesarean section: A case report.
Mirror syndrome is a rare pregnancy condition in which maternal edema is associated with fetal hydrops. Because of its rarity and overlapping symptoms, this condition is often misdiagnosed as another pregnancy complication. ⋯ This case reports on Miller syndrome with maternal hypoxemia onset during an emergency cesarean section and highlights the potential for better perioperative management and improvement in maternal mortality through prompt diagnosis and appropriate treatment shared not only among obstetricians and pediatricians but also among anesthesiologists.
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Case Reports
A colon cancer patient with splenic metastasis associated with a splenic abscess and thrombocytopenia: A case report.
Splenic metastases concomitant with abscesses are rare and challenging for clinicians. The primary treatment options include splenectomy and ultrasound-guided percutaneous perforation and drainage. ⋯ Spleen metastasis in tumor patients necessitates vigilance for the potential development of spleen abscess. A less invasive procedure can be feasible in cases of low platelet count without significant coagulation dysfunction. When there is no alternative therapeutic schedule, doctors should fully evaluate the risks and benefits.