Brit J Hosp Med
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Observational Study
Drug exposure characteristics and related pregnancy outcomes in pregnant women: an observational cohort study.
Aims/Background The relationship between drug exposure and pregnancy outcomes is still unclear. The study was designed to characterise the overall condition of drug exposure during pregnancy and uncover related pregnancy outcomes. Methods Pregnant women were enrolled in the study from 1 October 2019 to 31 April 2022, at a tertiary hospital in Jiangsu Province, China. ⋯ Compared to the second and third trimester, unrecommended drugs are used more frequently in the first trimester. Drug exposure is associated with adverse pregnancy outcomes and these associations need to be further confirmed. It is vital to fully consider treatment benefits and potential risks before medication initiation during pregnancy.
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We report a case of a 6-year-old boy with autism spectrum disorder presenting with new-onset squint and 'ptosis' following a recent infection. Clinical examination revealed ataxia and areflexia alongside a dilated pupil poorly reactive to light. Subsequently, his eye movements deteriorated to near-complete ophthalmoplegia at 1-week review. ⋯ The clinical triad of progressive ophthalmoplegia, areflexia and areflexia alongside albuminocytologic dissociation led to the diagnosis of Miller Fisher syndrome. The patient was commenced on intravenous immunoglobulin and his symptoms showed significant improvement. We use this interesting case to provide context for key learning points about diagnosing Miller Fisher syndrome in children.
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Aims/Background: Portal vein tumor thrombus (PVTT) is a common complication of primary hepatocellular carcinoma (HCC). HCC typically infiltrates intrahepatic vessels, particularly the portal vein, leading to the formation of PVTT, marking advanced-stage HCC and correlating with poor prognosis. PVTT often complicates local treatment strategies such as surgical resection and affects the efficacy of interventions. ⋯ In addition, no adverse effects were observed during the treatment process. However, despite the manageable safety profile demonstrated by combination therapy, further clinical research is needed to validate its long-term efficacy and safety. Conclusion: Camrelizumab + apatinib produced satisfactory efficacy and safety among the HCC patients with PVTT, providing clinical evidence for future treatment.
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A 21-year-old gentleman presented with low responsiveness and an unwitnessed tonic-clonic seizure. A 3-day history of fevers, headaches, and poor sleep was reported. He was initially treated for meningoencephalitis. ⋯ Ergo, this encourages an early multidisciplinary approach in presentations of headaches and seizures as clinical suspicion for CVST is high. Ultimately, this will appropriately identify patients for neuroimaging with computed tomography/magnetic resonance venogram. Furthermore, 5-year follow-up is presented in this case highlighting the importance of long-term follow-up in view of variable long-term complications that remain difficult to predict.
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Aims/Background Generally, pelvic osteosarcoma has a worse prognosis compared with limb osteosarcoma. This study aims to create and validate a new nomogram for predicting the prognosis of pelvic osteosarcoma. Methods Clinical data of 62 patients derived from the Surveillance, Epidemiology, and End Results (SEER) database and 31 Chinese patients diagnosed with pelvic osteosarcoma were gathered. ⋯ A predictive nomogram was developed based on the data from the SEER cohort and validated in the Chinese cohort. The areas under the curves (AUCs) that are used to predict 1-year, 2-year, and 3-year survival rates were 0.81 (95% CI: 0.68-0.94), 0.75 (95% CI: 0.63-0.86), and 0.80 (95% CI: 0.70-0.89) in the training cohort, and 0.67 (95% CI: 0.30-1.04), 0.66 (95% CI: 0.43-0.90) and 0.71 (95% CI: 0.50-0.93) in the validation cohort. Conclusion The predictive nomogram constructed in this study facilitates accurate and effective prediction of the overall survival of patients with pelvic osteosarcoma and helps enhance the clinical decision-making process.