Medicine
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We report the efficacy of combination prednisolone and intravenous (IV) rituximab as an immunosuppressive regimen for a young male presenting with extensive venous thromboembolism including a submassive pulmonary embolism secondary to life-threatening nephrotic syndrome from very high risk anti-phospholipase-A2 receptor (PLA2R) positive membranous nephropathy. Initial treatment was with mechanical thrombectomy and anticoagulation. Thereafter, oral prednisolone was initiated to induce remission, during a period of uninterrupted anticoagulation. He subsequently underwent a kidney biopsy for histological confirmation and IV rituximab was administered as definitive treatment. ⋯ This case demonstrates that preemptive treatment in patients with anti-PLA2R positive membranous nephropathy can initiated without a histological diagnosis when there are strong contraindications against a kidney biopsy. Treatment with a combination of steroids and IV rituximab could be a viable treatment option for patients with very high-risk membranous nephropathy over conventional therapy with cyclophosphamide.
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This study investigates the genetic cause of primary infertility and short stature in a woman, focusing on maternal X chromosome pericentric inversion and its impact on offspring genetic outcomes, including deletions at Xp22.33 and Xp22.33p11.3, and duplications spanning Xq27.3 to the distal end of the X chromosome's long arm. ⋯ Maternal X chromosome pericentric inversion significantly affects offspring genetic outcomes. Assisted reproductive technologies, including in vitro fertilization with preimplantation genetic testing, are recommended to reduce recurrence risks in future pregnancies. Prenatal genetic testing is advised for natural conception to ensure fetal genetic health.
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Observational Study
Analysis of factors affecting early necrosis of the affected finger after surgery in patients with reimplantation of severed fingers.
The study aimed to investigate the factors associated with early necrosis of the finger after reimplantation of broken fingers. Sixty-seven cases of reimplantation of severed fingers in our hospital between January 2023 and December 2023 were retrospectively analyzed. All patients underwent reimplantation of severed fingers and were divided into early necrosis group and non-necrosis group according to the presence or absence of early necrosis of the finger body 7 days after surgery. ⋯ Multifactorial analysis showed that smoking history (OR = 7.255, 95% CI: 1.767-29.782), little finger (OR = 7.040, 95% CI: 1.897-26.130), preoperative ischemia ≥ 8 hours (OR = 15.714, 95% CI: 3.095-79.798), vasospasm (OR = 5.850, 95% CI: 1.563-21.894), crush injury (OR = 5.667, 95% CI: 1.393-23.059), postoperative infection (OR = 5.600, 95% CI: 1.544-20.312), and postoperative hypothermia of the skin (OR = 7.096, 95% CI: 1.872-26.906) were the necrotic post-replantation necrosis after amputation of the finger high-risk factors (OR > 1, P < .05). The risk of early necrosis of the affected finger after reimplantation of an amputated finger is closely related to smoking history, pinky size, preoperative ischemic time of more than 8 hours, vasospasm, crush injuries, postoperative infections, and postoperative hypothermic skin temperature. Preventive measures need to be taken in advance to reduce the risk of necrosis in the affected finger.
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Disease-related fatalities in Saudi Arabia (SA) are on the rise, with 28% of all deaths attributed to cardiovascular diseases, followed by cancer, diabetes, and chronic respiratory disorders. In response to this issue, pharmacy dispensing practices have been significantly altered. One such innovative approach is the drive-through pharmacy service. ⋯ Furthermore, individuals with children had a lower perception (8.94) compared with those without children, indicating a statistically significant difference in mean perceptions of drive-through pharmacy based on gender (P = .002), age (P = .006), employment (P = .081), and presence of children (P = .001). Most respondents were aware of the drive-through pharmacy services and agreed that they would benefit the nation's entire population. The majority of individuals also supported the expansion of drive-through pharmacy services.
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Endosomes play a pivotal role in cellular biology, orchestrating processes such as endocytosis, molecular trafficking, signal transduction, and recycling of cellular materials. This study aims to construct an endosome-related gene (ERG)-derived risk signature for breast cancer prognosis. Transcriptomic and clinical data were retrieved from The Cancer Genome Atlas and the University of California Santa Cruz databases to build and validate the model. ⋯ Ultimately, risk score and age were identified as independent prognostic factors for breast cancer, and these factors were incorporated into a nomogram that demonstrated excellent performance in prognosis assessment. Finally, external cohort validated the dysregulation of the risk score-associated ERGs in breast cancer cells and tissues. This study successfully established an ERG-derived breast cancer risk signature and nomogram, elucidating their potential value in prognosis prediction and evaluation of therapeutic response.