The American journal of the medical sciences
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Polycythemia vera (PV) is a common type of Philadelphia chromosome-negative chronic myeloproliferative disorder. PV-associated kidney disease is rarely reported and remains poorly understood. It has been observed that chronic kidney disease could be a risk factor for poor prognosis in PV. ⋯ Patients with untreated or uncontrolled PV could have massive proteinuria and advanced CKD, pathologically showing ischemic, sclerosing glomerular lesions with hypercellurity, glomerular crescents and endocapillary proliferation. IgA nephropathy was most commonly diagnosed. These findings deserve attention because early screening and effective control of PV may benefit the long-term kidney prognosis.
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A 77-year-old woman presented with a 2-year history of denture sores at the left mandibular gingiva. She had no smoking history or alcohol use. Intraoral examination showed a cauliflower-like, 28 × 20 mm mass on the left mandibular gingiva without induration. ⋯ An incisional biopsy was performed, and she was diagnosed with squamous cell carcinoma (SCC)(cT2N1M0, stage 2). She underwent segmental mandibulectomy, selective neck dissection, and immediate reconstruction under general anesthesia. At the 2 years follow-up, she remained free of disease.
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Observational Study
Hip Fracture Risk in Elderly with Non-End-Stage Chronic Kidney Disease: A Fall Related Analysis.
The aim of this study was to evaluate the risk of fracture as a consequence of trauma and its association with kidney function status in a cohort of elderly patients. ⋯ Our study confirms that patients with non-end stage CKD have an increased risk of femur fracture after a fall. Our data supports the hypothesis that this risk could be associated with increased bone fragility in CKD patients. Active osteoporosis therapy was found to be an effective preventive factor in our cohort.
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Benzodiazepines are the gold standard for alcohol withdrawal treatment but choice and dosing vary widely. In 2015, our institution implemented a Minnesota detoxification scale (MINDS) and single standardized high-dose diazepam based protocol for treatment of alcohol withdrawal to replace multiple Clinical Institute Withdrawal Assessment for Alcohol (CIWA) based protocols using lower dose benzodiazepines. We compared use of MINDS versus CIWA assessment protocols with high front loading diazepam treatment in care of patient experiencing alcohol withdrawal during hospitalization. ⋯ Higher dose front loading long acting benzodiazepine can be safely used with beneficial outcomes in hospitalized alcohol withdrawal patients.
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Screening of Biomarkers Involved in Idiopathic Pulmonary Fibrosis and Regulation of Upstream miRNAs.
Idiopathic pulmonary fibrosis (IPF) is the most common type of fatal interstitial lung disease and IPF patients usually have a poor prognosis. Biomarkers that can predict the occurrence, process and prognosis of IPF will be useful for its diagnosis and treatment. This study aimed to identify the potential biomarkers of IPF and analyze the regulation of upstream miRNAs. ⋯ CLDN18, COL6A3, MYRF, PRSS8, RRAS, and SBNO1 might be potential IPF biomarkers. However, the specific role of these genes and miRNA in IPF needs further experimental research.