Articles: disease.
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Social Risk and Dialysis Facility Performance in the First Year of the ESRD Treatment Choices Model.
The End-Stage Renal Disease Treatment Choices (ETC) model randomly selected 30% of US dialysis facilities to receive financial incentives based on their use of home dialysis, kidney transplant waitlisting, or transplant receipt. Facilities that disproportionately serve populations with high social risk have a lower use of home dialysis and kidney transplant raising concerns that these sites may fare poorly in the payment model. ⋯ In the first year of the Centers for Medicare & Medicaid Services' ETC model, dialysis facilities serving higher proportions of patients with social risk features had lower performance scores and experienced markedly higher receipt of financial penalties.
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Case Reports
The green bad omen in blood smear and the potential of blood purification therapy: A case report.
Green inclusions (GI) are distinct morphological features found in phagocytic cells like neutrophils and monocytes. These intracellular structures exhibit bright green color with unclear boundaries, and their origin and clinical significance are still not fully understood. GI carriers, often middle-aged to elderly with liver dysfunction, face higher mortality rates, earning them the nickname "inclusions of death." This report presents a rare GI-related pediatric case, demonstrating a favorable response to blood purification therapy. ⋯ This case underscores the complexities in managing GI-related pediatric cases. Moreover, it emphasizes the potential benefits of blood purification therapy in such scenarios. Notably, this study highlights a potential correlation between the level of GI in peripheral blood and disease severity, particularly in pediatric cases. While these findings hold clinical significance for the treatment and management of GI-related patients, further research focusing on middle-aged and elderly individuals is imperative to elucidate the fundamental relationship between peripheral blood GI quantity and clinical presentation and to evaluate the efficacy of blood purification in GI-related cases.
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Case Reports
Severe disseminated Nocardia brasiliensis pneumonia with normal immune function: A case report.
Members of the genus Nocardia brasiliensis are Gram-positive, aerobic bacteria and exist ubiquitously in most environments. In recent years, the incidence of Nocardia brasiliensis has increased significantly and become a global concern. It may be predominantly caused pulmonary infections in immunocompromised hosts. Interestingly, however, we found that it can be present not only on immunocompromised hosts, but also to infect patients with a normal immune system. ⋯ Our report highlights when cold pus appears in soft tissues such as the lower limbs, neck, nose, scalp, etc, should prompt timely evaluation and biopsy for definitive diagnosis. Be alert to a normally immunocompetent, disseminated Nocardia brasiliensis infection. Early recognition and effective treatment are necessary conditions for successful results. This would allow for better disease prognostication while enabling physicians to develop more effective treatment strategies.
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Metastatic hepatocellular carcinoma (HCC) is an aggressive disease which usually have a poor prognosis. Early mortality and risk factors in patients with metastatic HCC are poorly understood. Our study sought to identify associated risk factors and develop the nomograms for predicting early death in metastatic HCC patients. ⋯ The nomograms demonstrated good predictive power and clinical utility under receiver operating characteristic curves and decision curve analysis. We developed 2 novel comprehensive nomograms to predict early death among metastatic HCC patients. Nomograms may help oncologists develop better treatment strategies and implementation of individualized treatment plans.
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Rheumatoid arthritis (RA) is a prevalent autoimmune disorder with a significant global economic burden. Epigenetic modifications, particularly DNA methylation, play a crucial role in RA. This study conducted a bibliometric analysis to explore the evolving trends and predominant themes in RA and DNA methylation research over the past two decades. ⋯ The significance of DNA methylation in shaping research directions for RA management is increasingly evident. Recent investigations have shed light on the pivotal role of DNA methylation in RA, particularly in characterizing synovial tissue and exploring the underlying mechanisms of disease pathogenesis. This study provides valuable insights into the landscape of DNA methylation research in RA and highlights the importance of epigenetics in autoimmune diseases.