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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Stüve-Wiedemann syndrome (SWS) is a rare, severe autosomal recessive disorder (#OMIM 601559) caused by pathogenic variants in the LIFR gene. It is characterized by skeletal dysplasia and dysautonomia and carries a high mortality rate in infancy, which decreases significantly after the age of 2. Detailed case descriptions enhance understanding of this rare condition. ⋯ SWS is a rare genetic disorder with a wide phenotypic spectrum. Early recognition and multidisciplinary management are crucial to addressing the high mortality risk associated with dysautonomia in infancy. Case reports of novel variants contribute to a deeper understanding of SWS and highlight the importance of tailored clinical care for improved outcomes.
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Peritoneal dialysis (PD)-associated peritonitis (PDAP) is the leading cause of PD failure and discontinuation of PD. Several zoonotic pathogens could lead to the development of PDAP. Coxiella burnetii (C. burnetii) was a zoonotic pathogen and the cause of Q fever. However, reports of PDAP caused by C. burnetii are rare. We herein report the first case of PDAP caused by C. burnetii in mainland China. ⋯ Vigilance should be heightened for PDAP cases with negative culture of PD fluid and poor response to standard broad-spectrum antibiotic treatment, along with a history of cattle and sheep breeding. In such conditions, PD effluent should be tested to detect possible peritonitis caused by C. burnetii, even in patients without symptoms of fever. Prompt pathogen identification and appropriate treatment are crucial for clinical improvement of such cases.