Medicine
-
Case Reports
Delayed Horner's syndrome and acute stress disorder caused by a large dog bite on the neck: Case report.
The occurrence of delayed Horner's syndrome caused by a dog bite to the neck is rarely reported. Acute stress disorder (ASD) can easily be neglected when diagnosing this disease in trauma patients who cannot be effectively observed. The symptoms of Horner's syndrome may not be readily detected in patients with ASD. ⋯ Surgeons should be aware of the possibility of sympathetic nerve injury in patients with deep neck injury, especially in patients with internal jugular vein injury. Peripheral nerves should be explored during the operation. Attention should be paid to the possibility of delayed neurological symptoms and the prevention and treatment of ASD after operation.
-
Case Reports
Undiagnosed mirror syndrome with maternal hypoxemia onset during an emergency cesarean section: A case report.
Mirror syndrome is a rare pregnancy condition in which maternal edema is associated with fetal hydrops. Because of its rarity and overlapping symptoms, this condition is often misdiagnosed as another pregnancy complication. ⋯ This case reports on Miller syndrome with maternal hypoxemia onset during an emergency cesarean section and highlights the potential for better perioperative management and improvement in maternal mortality through prompt diagnosis and appropriate treatment shared not only among obstetricians and pediatricians but also among anesthesiologists.
-
The non-HDL cholesterol to HDL cholesterol ratio (NHHR) is a newly developed metric that represents the ratio of non-HDL cholesterol to HDL cholesterol. Anemia is a prevalent public health concern affecting all age groups. Our purpose is to investigate the connection between NHHR and the prevalence of anemia, as well as to explore their potential interactions. ⋯ Alcohol consumption significantly affects the relationship between NHHR and anemia (interaction P < .05). Our study revealed that NHHR is inversely proportional to the prevalence of anemia in U. S. adults.
-
Observational Study
Study on the predictive value of APACHE II score and neurogenic dysphagia in carbapenem-resistant Klebsiella pneumoniae.
Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a growing challenge in clinical treatment globally. Early identification of high-risk patients is essential to control infection spread and improve treatment outcomes. This retrospective study analyzed 152 patients with K pneumoniae infections at the Second People's Hospital of Hefei City, Anhui Province, dividing them into carbapenem-resistant and non-carbapenem-resistant groups. ⋯ Receiver operating characteristic curve analysis showed an area under the curve of 0.824 (95% confidence interval: 0.749-0.898) for the APACHE II score, with an optimal threshold of 14.5 points. A new predictive model combining neurogenic dysphagia with APACHE II scores improved classification performance, as demonstrated by Net Reclassification Improvement (NRI = 0.0967, 95% confidence interval: -0.0477 to 0.2410) and reclassification probability analysis, correctly reclassifying 24.32% of individuals into a higher risk category. The findings highlight the combined predictive value of APACHE II scores and neurogenic dysphagia for early identification and intervention in high-risk CRKP patients.
-
Observational Study
Short and long-term mortality of spontaneous bacterial peritonitis in cirrhotic patients.
Spontaneous bacterial peritonitis (SBP) remains a significant concern for patients with cirrhosis. This study aims to reevaluate the trends in both short-term and long-term mortality rates associated with SBP. A retrospective cohort study was conducted using population data obtained from Taiwan's Health and Welfare Data Science Center, Ministry of Health and Welfare. ⋯ Following Cox regression analysis with adjustments for patient age, gender, and underlying medical conditions, the short-term prognostic factors of significance were age (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 1.01-1.05, P = .001), concurrent sepsis (HR = 2.73, 95% CI = 1.82-4.08, P < .001), and renal function impairment (HR = 3.28, 95% CI = 2.07-5.18, P < .001). Although the 30-day mortality rate for SBP in cirrhotic patients is around 10%, the long-term mortality remains significantly high. Renal function impairment and the presence of concurrent sepsis serve as indicators of poor short-term prognosis in cirrhotic patients with SBP.