Medicine
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Observational Study
Factors predicting asymptomatic splenic artery aneurysm expansion in patients managed conservatively: A single-center, retrospective, observational study.
Although splenic artery aneurysms (SAAs) are relatively rare in the general population, they represent the most prevalent type among visceral artery aneurysms. This study aimed to identify predictors of SAA expansion during follow-up and to contribute to a more comprehensive understanding of the natural history of SAAs. This single-center, retrospective, observational study included 137 patients with SAAs who were managed conservatively with computed tomography follow-up for a minimum of 1 year. ⋯ Multivariable Cox proportional hazards modeling revealed that SAA expansion was more likely to occur in current smokers (hazard ratio [HR], 4.34 [95% confidence interval [CI], 1.41-13.34]; P = .01) and in those with an initial maximum SAA diameter >14 mm (HR, 3.13 [95% CI, 1.61-6.08]; P < .01), but expansion was less likely to occur in patients with SAA wall calcification (HR, 0.27 [95% CI, 0.12-0.61]; P < .01). SAA expansion was associated with wall calcification and initial maximum SAA diameters >14 mm. Further larger-scale studies are required to ascertain risk factors for rapid expansion, which could ultimately identify which categories of patients benefit most from early prophylactic intervention.
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Complex chromosomal rearrangements (CCRs) frequently lead to unfavorable reproductive consequences, such as recurrent miscarriage. Preimplantation genetic testing for structural rearrangements (PGT-SR) has become a successful method for embryo diagnosis in CCR families. ⋯ For CCR carriers, particularly couples with a history of recurrent abortion, PGT-SR has the potential to address their reproductive predicament by enhancing their likelihood of achieving a successful pregnancy.
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Umbilical vein catheterization (UVC) is a common procedure in neonatal intensive care units (NICU) but carries risks of severe complications such as portal vein thrombosis (PVT). Extrahepatic biliary atresia (EHBA), a leading cause of neonatal cholestasis, often progresses to end-stage liver disease. This case report discusses the rare coexistence of PVT and EHBA in a 3-month-old infant, highlighting the critical need for timely diagnosis and intervention. ⋯ This case underscores the significant risks of PVT associated with UVC and the importance of monitoring NICU graduates for early detection of complications. The early onset of portal hypertension and esophageal varices in this case challenges existing beliefs about EHBA's clinical progression. Greater awareness and routine follow-up imaging are essential to improve outcomes in similar scenarios.
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Associations of autoimmune diseases are rare but interesting and challenging situations from a diagnostic, pathophysiological, and therapeutic point of view. This article studies a rare association of autoimmune diseases by discussing the pathophysiological hypotheses and an original therapeutic management. The coexistence of antineutrophil cytoplasmic antibody-associated vasculitis and spondyloarthritis has rarely been described. ⋯ We discuss the pathogenic, diagnostic, and therapeutic implications of this rare but intriguing association between these 2 inflammatory conditions.
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A Disintegrin And Metalloproteinase 8 (ADAM8) has been implicated in the development and progression of several cancers. However, further studies are needed to determine the value of ADAM8 in ccRCC. The research aimed to investigate the prognostic and immunologic significance of ADAM8 in ccRCC from the perspective of bioinformatics. ⋯ Our research found that ADAM8 could have a significant impact on the development, progression, immunotherapy and prognosis of patients with ccRCC, and may be a promising prognostic and immunotherapeutic target. The study provides a new insights that may be useful in helping to manage ccRCC.