Medicine
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Cardiac arrest (CA) is a life-threatening event with a high mortality rate, and neurological injury following cardiopulmonary resuscitation (CPR) is a leading cause of death and disability in survivors. While prolonged CPR is often associated with poor neurological outcomes, there is limited evidence of successful recovery following extended resuscitation efforts. This study aims to highlight the potential for recovery after prolonged CPR by reporting a case of a patient who underwent 152 minutes of CPR, regained consciousness, and made a full recovery. The purpose is to explore whether advanced life-support techniques, such as extracorporeal CPR (ECPR), can improve survival and neurological outcomes even after prolonged CA. ⋯ This case demonstrates that prolonged CPR, when combined with advanced interventions such as ECPR, can result in favorable outcomes, including survival and neurological recovery. The findings suggest that with timely and appropriate treatment, even patients with extended resuscitation efforts may achieve full recovery, thus underscoring the potential of ECPR as a critical life-saving intervention in cases of prolonged CA.
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Observational Study
Factors predicting asymptomatic splenic artery aneurysm expansion in patients managed conservatively: A single-center, retrospective, observational study.
Although splenic artery aneurysms (SAAs) are relatively rare in the general population, they represent the most prevalent type among visceral artery aneurysms. This study aimed to identify predictors of SAA expansion during follow-up and to contribute to a more comprehensive understanding of the natural history of SAAs. This single-center, retrospective, observational study included 137 patients with SAAs who were managed conservatively with computed tomography follow-up for a minimum of 1 year. ⋯ Multivariable Cox proportional hazards modeling revealed that SAA expansion was more likely to occur in current smokers (hazard ratio [HR], 4.34 [95% confidence interval [CI], 1.41-13.34]; P = .01) and in those with an initial maximum SAA diameter >14 mm (HR, 3.13 [95% CI, 1.61-6.08]; P < .01), but expansion was less likely to occur in patients with SAA wall calcification (HR, 0.27 [95% CI, 0.12-0.61]; P < .01). SAA expansion was associated with wall calcification and initial maximum SAA diameters >14 mm. Further larger-scale studies are required to ascertain risk factors for rapid expansion, which could ultimately identify which categories of patients benefit most from early prophylactic intervention.
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A Disintegrin And Metalloproteinase 8 (ADAM8) has been implicated in the development and progression of several cancers. However, further studies are needed to determine the value of ADAM8 in ccRCC. The research aimed to investigate the prognostic and immunologic significance of ADAM8 in ccRCC from the perspective of bioinformatics. ⋯ Our research found that ADAM8 could have a significant impact on the development, progression, immunotherapy and prognosis of patients with ccRCC, and may be a promising prognostic and immunotherapeutic target. The study provides a new insights that may be useful in helping to manage ccRCC.
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Pneumonia is a respiratory disease with high pathogenicity and mortality. Traditional Chinese medicine (TCM) is a natural therapy that has proven effectiveness and safety. Although TCM has been found to be effective in treating pneumonia, further research is needed to determine the specific mechanism of action. ⋯ The study found that, according to network pharmacology prediction, 4 types of TCMs-natural active compounds, single herb medicine, Chinese patent medicines, and multi-component herbal formulations-were effective in treating pneumonia. TCM components demonstrated a multi-target and multi-pathway approach to treat the disease. The diversity of targets and signaling pathways not only facilitates the investigation of TCM's mechanism of action of TCM in pneumonia treatment but also offers novel insights and perspectives for innovative drug research and development.
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Case Reports
Antegrade horizontal stenting for endovascular coiling of wide-neck aneurysms in the basilar tip: Two case reports.
Endovascular coil embolization for wide-neck intracranial aneurysms is technically challenging and requires supporting devices. Intracranial stents are widely used as a buttress for compact coil filling and preventing coil protrusion into the parent artery. Horizontal stenting has been developed to maximize coil insertion and reduce the risk of thromboembolism. An anterograde route for horizontal stenting could be attempted for basilar tip aneurysms if the posterior communicating artery is not accessible. Here, we report 2 cases of antegrade horizontal stenting (AHS) for wide-neck aneurysm (WNA) in the basilar tip. This approach aims to maximize coil insertion and achieve complete aneurysm occlusion. ⋯ Horizontal stenting via an antegrade route may be an effective strategy for achieving compact coil embolization in selected patients with WNAs at the basilar tip. The Neuroform Atlas stent appears to be a promising tool for AHS owing to its hybrid-cell design. However, the shifting phenomenon of a jailed microcatheter after AHS warrants attention, as it may present potential challenges that require further catheterization.