Brit J Hosp Med
-
Aims/Background Secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare, rapidly progressive and highly lethal disease. This retrospective cohort study aims to analyze the factors influencing the mortality risk in adult patients with sHLH, which are instrumental to improving our understanding of the high mortality risks associated with sHLH. Methods This study included 85 patients diagnosed with sHLH who were admitted and treated in the Department of Emergency, Peking University People's Hospital between April 2015 and July 2023. ⋯ Conclusion Patients with sHLH have frequently atypical clinical presentation, with early death risk and notably elevated mortality rate. Independent risk factors influencing mortality risk in sHLH patients include age ≥63.5 years, AST ≥111 U/L, ALT ≥41 U/L, and TNI ≥2.15 ng/mL. With high accuracy and efficacy, the risk prediction model constructed can facilitate timely identification of sHLH patients at elevated risk of mortality, which is critical for optimizing clinical interventions.
-
Aims/Background Symptomatic abdominal aortic aneurysms carry significant mortality risk. This is supplemented by the Royal College of Emergency Medicine guidelines which suggest imaging for patients 50 years of age or older presenting with unexplained abdominal, flank, or back pain. This study aimed to evaluate the prevalence and mortality rates of patients with symptomatic abdominal aortic aneurysms in a high-risk population and to assess scanning rates in the accident and emergency department. ⋯ However, this study reveals that scanning rates in the emergency department are low. The encouragement of scanning and improved ultrasound skills among emergency medicine clinicians can reduce missed diagnoses. Additionally, we recommend further studies to assess the mortality rates of emergent abdominal aortic aneurysm presentations.
-
Aims/Background Peripheral nerve injury affects some people with multiple myeloma; this condition can be brought on by the disease itself or by the treatments they receive. Such a complication increases patients' financial burden, causes treatment to be interrupted or delayed, and reduces treatment efficacy. However, opinions regarding the risk factors for peripheral neuropathy are currently divided. ⋯ We discovered that PN was strongly correlated with age, haemoglobin, and levels of creatinine (p = 0.039, p = 0.045, and p = 0.030, respectively). Conclusion Age, haemoglobin and creatinine levels are associated with the occurrence of PN. Investigation of the incidence and risk factors of multiple myeloma-associated PN can provide a better theoretical basis for the selection of treatment options and the enhancement of patient well-being and satisfaction.
-
Aims/Background Decompensated cirrhosis is characterized by the progression of cirrhosis from an asymptomatic state to elevated portal pressure and marked deterioration of liver function. This pathological condition progresses rapidly following onset, significantly raising the risk for mortality. The aim of this study is to explore the association between serum lactate concentrations and mortality rates in individuals with hepatitis B-induced decompensated cirrhosis and to evaluate its potential as a clinical prognostic indicator. ⋯ In summary, serum lactate concentration is a prognostic indicator of mortality in individuals with decompensated cirrhosis due to hepatitis B, exhibiting higher predictive significance in female patients. Conclusion Deceased patients with decompensated cirrhosis linked to hepatitis B exhibit markedly increased serum lactate levels. Thus, monitoring serum lactate levels offers an effective tool for predicting patient prognosis, exhibiting higher sensitivity for disease detection in female patients.
-
Application of Whole-Exome Sequencing in the Genetic Diagnosis of Prenatal Ultrasound Abnormalities.
Aims/Background Prenatal diagnosis is a crucial tool in reducing birth defects. Research indicates that whole-exome sequencing (WES) is particularly effective for detecting abnormalities associated with structural ultrasound findings. This study aimed to evaluate the utility of WES in the genetic diagnosis of prenatal ultrasound abnormalities. ⋯ The detection rates for specific abnormalities were as follows: skeletal abnormalities (41.7%), cardiovascular abnormalities (54.5%), central nervous system abnormalities (30%), urinary system abnormalities (50%), nuchal translucency thickening/hygroma colli (20%), and facial anomalies/cleft lip and palate (25%). The genetic detection rates for monosystemic and multisystemic abnormalities were 34.2% and 50%, respectively. Conclusion WES is crucial in the genetic diagnosis of prenatal ultrasound abnormalities, enhancing the accuracy of prenatal diagnostics and facilitating informed genetic counseling.