Chest
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Exacerbated immunopathology is a frequent consequence of TB that is complicated by diabetes mellitus (DM); however, the underlying mechanisms are still poorly defined. ⋯ Hemostasis and dyslipidemia are associated with granuloma necrosis and fibroplasia leading to exacerbated lung damage in TB, especially in patients with DM-TB.
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Gait speed is used increasingly to predict function and future well-being among healthy elderly people as well as for those with long-term medical conditions. When selecting outcome measures such as walking speed, it is important to include the circumstances under which the measurement is made to avoid bias and ensure accurate recommendations. We completed a retrospective chart review of walking test results from patients with chronic lung disease to demonstrate the practical implications of reporting gait speed from either a standing or walking start. ⋯ The standing start speed incorrectly identified some patients as at higher risk for poor health. In a practical example, gait speed from a standing start produced 11 false-negative evaluations of the ability to complete a road crossing at usual speed. We present walking speeds using both methods, which illustrate the importance of construct validity and measurement protocol.
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A 38-year-old right-handed woman presented to the hospital with subtle right facial palsy and global aphasia of 4 days' duration. She found that she had aphasia when she suddenly woke up at midnight and reported a headache lasting for several hours. ⋯ She was not taking any medication and was a nondrinker and nonsmoker. She had no other significant medical background and family history.
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There has been considerable controversy between sepsis-1 and sepsis-3 criteria. ⋯ Sepsis-3 diagnostic criteria narrow the sepsis population at the expense of sensitivity, and the resulting false negatives may delay disease diagnosis. It may be inappropriate to compare the prediction performance of SIRS and SOFA criteria when sepsis-3 is defined.