Internal medicine
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Objective Pleural infection is a significant disease that continues to pose severe problems for respiratory physicians. However, prognostic factors of pleural infection remain poorly understood. The controlling nutritional status (CONUT) score represents the immune-nutrition status of patients with chronic infectious diseases. ⋯ The incidence of 90-day mortality was higher in patients with higher CONUT scores than in those with lower scores [25.3% (21/84) vs. 2.8% (7/251), p<0.001]. In addition, after adjusting for confounders, a high CONUT score was found to be an independent prognostic factor for 90-day mortality (hazard ratio, 9.30; 95% confidence interval, 3.96-21.87; p<0.001). Conclusion Our study indicated that a high CONUT score was associated with an increased risk of 90-day mortality in patients with pleural infection and can be considered for clinical evaluations in practice.
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IgG4-related inflammatory pseudotumor is a feature of IgG4-related disease and develops in various organs. Intracranial IgG4-related inflammatory pseudotumor is rare, and data on the clinical course and response to treatment are insufficient in the literature. ⋯ Tumorectomy was discontinued because of the intraoperative rapid diagnosis, which revealed the infiltration of lymphocytes and plasma cells. She received oral prednisolone therapy for IgG4-related inflammatory pseudotumor, and the tumor size had significantly decreased after six months of treatment.
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We herein report a 76-year-old woman who developed lower cranial dystonia with a peculiar appearance of cheek inflation. The patient showed strong contraction of the orbicularis oris muscles. Consequently, her cheeks were passively inflated by expiration without exit. ⋯ We tentatively named this characteristic dystonia "lower cranial dystonia with inflated cheeks" because of its peculiar appearance of inflated cheeks. This dystonia can cause respiratory failure. Therefore, neurologists should recognize such dystonia as a movement disorder emergency.
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Case Reports
Chronic Expanding Haematoma Causing Stenosis of the Right Ventricular Outflow Tract and Pulmonary Hypertension.
A chronic expanding haematoma (CEH) is an encapsulated mass that gradually increases in size from repeated internal bleeding and neovascularization. We herein report a 69-year-old man who was admitted with dyspnoea on exertion after undergoing thymic carcinoma resection 17 years ago. ⋯ Right cardiac catheterisation revealed pulmonary hypertension that was relieved after resection of the diagnosed CEH mass. This report highlights the mechanism underlying anterior mediastinal CEH-induced stenotic compression of the right ventricle-pulmonary artery outflow and subsequent pulmonary hypertension.