Medicine
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Observational Study
Risk factor analysis and nomogram model establishment for in-hospital death of elderly patients with surgically treated traumatic acute subdural hematoma.
The purpose of this study was to investigate the risk factors for in-hospital death in elderly patients with surgically treated traumatic acute subdural hematoma (ASDH) and to construct a nomogram model for in-hospital death risk prediction. We analyzed 104 elderly patients who underwent decompressive craniotomy (DC) for isolated traumatic ASDH between May 2013 and May 2021 in our department. Independent factors for in-hospital death were identified via univariate and multivariate logistic regression analyses, and a nomogram model was constructed and validated. ⋯ Decision curve analysis (DCA) demonstrated that the nomogram was clinically beneficial. The most important risk factors for in-hospital death in elderly patients with surgically treated traumatic ASDH were sex, dilated pupils, and SAH. The nomogram constructed from these data could be a promising and convenient tool to predict in-hospital death risk, but further external validation is needed.
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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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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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Observational Study
fMRI used to observe the acute craniocerebral response of esophageal cancer related depressive patients treated by rTMS: Initial experience.
To observe the immediate craniocerebral response, changes of spontaneous nerve activity and functional connection after repeated transcranial magnetic stimulation (rTMS) in esophageal cancer patients with depression (ECPD) by functional magnetic resonance imaging (fMRI), and to explore the therapeutic effect, neuroactivity response and mechanism. Eleven patients with ECPD were enrolled to treated with single rTMS. The patients were examined by fMRI before and after the treatment. ⋯ Compared with those before rTMS treatment, the Hamilton Depression Rating Scale (HAMD) score decreased significantly after rTMS treatment (t = -7.63, P = .0001). The ALFF of bilateral putamen, left thalamus, left posterior cingulate gyrus and right middle temporal gyrus decreased significantly (P = .02). In addition, the functional connection between the cortex-limbic system-striatum-thalamus nerve loop increased in patients after rTMS treatment. rTMS may achieve the effect of rehabilitation treatment by improving the spontaneous neural activity and regulating the neural connection network of cortical-limbic systems-triatum-thalamus loop in ECPD.