Brit J Hosp Med
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Aims/Background Patients receiving treatment in specialized cancer hospitals are particularly susceptible to multidrug-resistant organisms (MDRO) infections due to factors such as weakened immune systems caused by intensive treatments and prolonged hospital stays. This study aims to investigate the risk factors for MDRO infections in the cancer specialty hospital setting and to develop a corresponding risk prediction model. Methods Patients diagnosed with MDRO infections were selected for the MDRO infection group (n = 238), and those without for the non-MDRO infection group (n = 238). ⋯ The constructed nomogram prediction model for patients with MDRO infection has a C-index of 0.8640. The ROC curve results showed that the prediction model has a specificity of 0.7700, a sensitivity of 0.8800, and an area under the curve (AUC) of 0.8800. Conclusion This study identifies significant risk factors for MDRO infections in a cancer specialty hospital setting and offers a clinically useful prediction model, which may aid in targeted preventive measures and optimization of antibiotics usage, thereby potentially reducing the incidence and impact of these infections.
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Aims/Background Both membranous nephropathy (MN) and immunoglobulin A nephropathy (IgAN) are immune complex-mediated glomerular diseases, but the concurrent occurrence of these two conditions in the same patient is not common, a phenomenon that is currently not supported by clinical data in terms of treatment and prognosis. This study explores the clinical and pathological characteristics, as well as the treatment outcomes, of patients affected by MN and IgAN simultaneously. Methods The clinical data, pathological features, and diagnostic and therapeutic information of seven cases of MN complicated by IgAN, treated between December 2015 and December 2022, were retrospectively analyzed. ⋯ Conclusion MN accompanied by IgAN tends to occur more frequently in middle-aged and elderly individuals, with a relatively low incidence. The latent feature of the comorbidities manifests as a form of IgAN superimposed on the background of MN. Utilizing ACEI or ARB in combination with steroids or various immunosuppressive therapies represents a potentially effective treatment strategy.
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Aims/Background Gangliogliomas are grade 1 glioneuronal tumors occurring predominantly in the temporal lobe, as per the World Health Organization (WHO) classification. Gangliogliomas often harbor BRAF (v-Raf murine sarcoma viral oncogene homolog B1) p. V600E hotspot mutation or other alterations leading to activation of RAS/RAF/MAPK (rat sarcoma virus oncogene/rapidly accelerated fibrosarcoma/mitogen-activated protein kinase) signaling pathway, which is the driver factor of this tumor. ⋯ Subsequently, salvage chemotherapy with a combination of temozolomide and irinotecan was administered, resulting in effective control of the tumor. Conclusion To our knowledge, this is the first reported case of ganglioglioma with anaplastic features harboring MAP2K1 mutation and homozygous deletion of CDKN2A/B. These findings may shed light on the genetic features of ganglioglioma and offers insights into potential therapeutic approaches for this rare neoplasm.
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Aims/Background Previous studies have indicated a strong correlation between disturbances in blood pressure (BP) circadian rhythm and major cardiovascular adverse events. Similarly, blood pressure variability (BPV) has been closely linked to cerebral small vessel disease and leukoaraiosis. This study aims to investigate the relationship between BP rhythm and BPV with the short-term prognosis of patients with Type A aortic dissection, offering insights for targeted perioperative nursing interventions and improving patient outcomes. ⋯ The combination of these indicators yielded the highest AUC at 0.918. Conclusion A combination of BP rhythm and BPV indicators provides significant predictive value for poor short-term outcomes in patients with Type A aortic dissection. Clinicians and nursing staff can use these features to formulate targeted preventive measures.
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Huge advances in the medical treatment of ileocaecal Crohn's disease have occurred in the last 20 years. Consequently, surgery has become synonymous with treatment failure and is often only implemented when multiple medical interventions have been trialled. However, evidence that patients avoid surgery in the long term is questionable. ⋯ Significant barriers exist to this mindset of earlier surgery. Such barriers can only be overcome with a vigorous multidisciplinary approach. This editorial describes the debate surrounding the concept of early bowel resection in these patients.