Medicine
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Observational Study
Procalcitonin, C-reactive protein, and white blood cell count levels in end-stage cancer patients: A retrospective study on inflammatory markers and their prognostic value.
Procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) are commonly recognized as inflammatory markers. Some studies showed that these markers were also related to some cancers. This study aimed to investigate whether these markers were exhibited aberrations in end-stage cancer patients and to assess their correlation with infection and prognosis. ⋯ The PCT, WBC, and CRP levels of end-stage cancer patients were significantly elevated, regardless of infection. An increase in PCT and WBC was associated with an increased risk of death. These findings suggest that monitoring PCT and WBC levels in end-stage cancer patients may provide valuable prognostic information, aiding in clinical decision-making.
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A systematic retrospective analysis of patients with lumbar disc herniation treated with percutaneous endoscopic discectomy was performed to identify key risk factors for postoperative recurrence, and a Nomogram prediction model was constructed based on them. The data of patients with lumbar disc herniation who were treated in our hospital between January 2021 and December 2023 were included in this study. Statistical tools, including univariate and multivariate logistic regression analyses, were used to accurately screen independent risk factors significantly associated with postoperative recurrence. ⋯ The model performance was evaluated by plotting the receiver operating characteristic curve and calculating the area under the curve, supplemented by calibration curve and decision curve analysis, to ensure the predictive accuracy and clinical practicability of the model. 286 patients with lumbar disc herniation were included in the study, and 29 patients had a postoperative recurrence, with a recurrence rate of 10.14%. After univariate and multivariate logistic regression analyses, a total of 5 variables were identified as independent risk factors for postoperative recurrence of lumbar disc herniation: age > 60 years (OR = 2.831; 95% CI = 1.089-5.430), body mass index (BMI) > 24 kg/m2 (OR = 4.632; 95% CI = 1.183-14.337), The type of lumbar disc herniation was herniation (OR = 5.064; 95% CI = 1.198-15.364), degeneration grade III-IV (OR = 5.916; 95% CI = 1.357-16.776), and postoperative high-intensity activity (OR = 4.731; 95% CI = 1.341-14.024). The nomogram constructed in this study for postoperative recurrence of lumbar disc herniation by percutaneous endoscopic discectomy has good predictive accuracy, and this tool can effectively assist orthopedic surgeons in identifying high-risk patients with recurrence after percutaneous endoscopic discectomy, providing a scientific basis for early intervention and individualized management strategies, thus optimizing patient prognosis.
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Observational Study
Role of the hemoglobin, albumin, lymphocyte, and platelet score in predicting thrombophlebitis among patients undergoing peripherally inserted central catheter.
This study analyzes the role of the hemoglobin, albumin, lymphocyte, and platelet score (HALP), a pre-catheterization blood parameter, in predicting the occurrence of thrombophlebitis. We recruited 268 in-hospital patients who visited the Department of Oncology of our hospital and underwent peripherally inserted central catheter between January 2021 and January 2024. The cutoff value of the HALP score was defined using receiver's operating characteristic curve, and the differences were analyzed with log-rank test. ⋯ Receiver's operating characteristic curve analysis showed the area under the curve of the HALP score was 0.718 (95% confidence interval 0.638-0.798), which was significantly larger than the other 3 parameters. Hence, we believe the predictive efficiency of HALP is higher than other parameters. The pre-catheterization HALP score can be used as a simple, accessible, and reliable tool for predicting thrombophlebitis in patients to undergo peripherally inserted central catheter.
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Case Reports
Persistent and severe hypotension during radical transabdominal ovarian cancer surgery: A case report.
In radical surgery for ovarian cancer (OC), hypotension that is difficult to correct is usually rare unless there is significant blood loss. We recently encountered a patient who developed persistent and severe hypotension during radical transabdominal OC surgery. ⋯ Based on this case, we suggest that in OC patients experiencing mild intraoperative bleeding and minimal heart rate variation but persistent refractory hypotension, hypoalbuminemia should be considered even if preoperative biochemical tests (including serum albumin levels) are normal. Confirming hypoalbuminemia warrants HSA administration to alleviate hypovolemic shock symptoms. Additionally, it is important to be cautious of potential coagulation issues with albumin use, possibly requiring plasma infusion to address coagulopathy.
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This study investigates the causal relationship between diastolic blood pressure (DBP) and Alzheimer disease (AD) using 2-sample Mendelian randomization (MR) analysis with publicly available genome-wide association study (GWAS) data and empirical validation. Automated screening identified DBP as a factor related to AD. Two-sample MR analyses were conducted using inverse variance weighting (IVW), MR-Egger regression, weighted median, simple mode, and weighted mode methods. ⋯ The validation results indicate that the aforementioned findings are stable within the normal range of DBP. MR analysis supports a potential causal link between higher DBP and a lower risk of AD. The screening exposure method used could enhance MR study efficiency.