Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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Acute pulmonary embolism (APE) is a very common and important medical emergency in intensive care units with an unfavorable prognosis. This study aims to explore the prognostic factors of APE and to construct a prognostic prediction model. A retrospective analysis was conducted on 252 APE patients in the emergency department of our hospital from January 2020 to March 2024. ⋯ Binary Cox multivariate regression analysis indicated that age ≥ 62.5 (HR: 2.64, 95% CI: 1.23-5.63, p = 0.012), right ventricular dysfunction (RVD) (HR: 4.58, 95% CI: 1.76-11.96, p = 0.002), white blood cell count (WBC) ≥ 13.1 (HR: 2.35, 95% CI: 1.20-4.60, p = 0.013), albumin/fibrinogen ratio (AFR) < 9.15 (HR: 3.36, 95% CI: 1.76-6.42, p < 0.001), Prognostic Nutritional Index (PNI) < 50.3 (HR: 4.35, 95% CI: 1.62-11.71, p = 0.004), and Systemic Inflammation Response Index (SIRI) ≥ 1.05 (HR: 7.21, 95% CI: 3.38-15.37,p < 0.001) were independent risk factors for mortality. The nomogram model based on these factors demonstrated a good predictive value for 30-day mortality, with an AUC of 0.908. The nomogram model based on age, RVD, WBC, AFR, PNI, and SIRI has a well prognostic value for APE patients.
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Previously, many studies have reported changes in the gut microbiota of patients with colorectal cancer (CRC). While CRC is a well-described disease, the relationship between its development and features of the intestinal microbiome is still being understood. ⋯ In this review we highlight various aspects of our understanding of the relationship between the development of CRC and the alteration of intestinal microbiome, focusing specifically on the role of F. nucleatum. As the amount of F. nucleatum DNA in CRC tissue is associated with shorter survival, it may potentially serve as a prognostic biomarker, and most importantly may open the door for a role in CRC treatment.
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This study presents a comparative analysis of the publications of students participating in the Arrow Research Program in comparison to those of attending physicians and researchers at the same tertiary medical center in order to assess the impact of the Arrow Research Program on the students' scientific achievements. The study encompassed 90 Arrow Research Program students that were involved in the program at the Sheba Medical Center between 2019 and 2021. As a comparison group, 2082 attending physicians and researchers affiliated with the same center during the same period of time were considered. ⋯ Likewise, the average quartile of the journals in which the Arrow Research Program articles were published was 1.39 ± 0.59, which is similar to the comparison group's average quartile of 1.39 ± 0.63 (p = 0.997). In conclusion, the Arrow Research Program demonstrates its effectiveness in empowering young students to execute successful research projects. This study may help develop educational programs worldwide.
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Acute respiratory distress syndrome (ARDS) is a multifactorial, inflammatory lung disease with significant morbidity and mortality that predominantly requires supportive care in its management. Although initially described in adult patients, the diagnostic definitions for ARDS have evolved over time to accurately describe this disease process in pediatric and, more recently, neonatal patients. The management of ARDS in each age demographic has converged in the application of lung-protective ventilatory strategies to mitigate the primary disease process and prevent its exacerbation by limiting ventilator-induced lung injury. ⋯ Additionally, we discuss in detail the different management strategies used for each subtype of ARDS and spotlight how these strategies were applied to mitigate poor outcomes during the COVID-19 pandemic. This review is geared toward both clinicians and clinician-scientists as it not only summarizes the latest information on disease pathogenesis and patient management in ARDS across the lifespan but also highlights knowledge gaps for further investigative efforts. We conclude by projecting how future studies can fill these gaps in research and what improvements may be envisioned in the management of NARDS and PARDS based on the current breadth of literature on adult ARDS treatment strategies.
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Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal hematopoietic stem cell disease. Clinical manifestations include intravascular hemolysis, renal dysfunction, fatigue, jaundice, pulmonary hypertension, and so on. Renal injury, as a clinical feature of PNH, is difficult to diagnose and is one of the causes of death in patients with PNH. This article reviews the progress in research on PNH combined with renal injury to improve clinicians' understanding of renal injury in PNH patients, define and judge staging in a timely and accurate manner, enable patients to receive timely and appropriate treatment and reduce mortality.