Brit J Hosp Med
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Renal tubular acidosis is a group of disorders characterised by metabolic acidosis, hyperchloraemia, normal anion gap, and potassium imbalance. Genetic mutations, drugs or acquired disorders disrupt the function of various transport proteins and enzymes in the renal tubules, causing diminished bicarbonate reabsorption or inability to excrete hydrogen ions, leading to proximal (type 2) and distal (type 1) renal tubular acidosis, respectively. These conditions are typically associated with hypokalaemia, which, if severe, can cause muscle paralysis and dangerous cardiac arrhythmias. ⋯ If untreated, renal tubular acidosis can lead to long-term severe complications such as growth retardation, osteoporosis, rickets, osteomalacia, and renal calculi. Moreover, renal tubular acidosis might be the initial presentation of a more severe underlying pathology, such as autoimmune disease or plasma cell dyscrasias. A better understanding of the condition can help physicians diagnose and treat it early and prevent adverse outcomes.
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Review
Advances in Research on the Anticancer Properties and Mechanisms of Metformin in Lung Cancer.
Lung cancer is a leading cause of death globally with high mortality and morbidity. Patients are often diagnosed at an advanced stage. Metformin has become a primary medication used in the clinical management of type 2 diabetes mellitus (T2DM) due to its relative safety, low cost, and effectiveness, mainly exerting its hypoglycemic effect by inhibiting hepatic gluconeogenesis and insulin resistance. ⋯ Metformin lowers the risk of tumour development through various mechanisms, including the adenosine 5'-monophosphate-activated protein kinase/liver kinase B1/mechanistic target of rapamycin (AMPK/LKB1/mTOR) pathway, insulin-like growth factor-1 receptor pathway, apoptosis, and autophagy. However, research findings are not entirely consistent. This article reviews the research progress of metformin in terms of lung cancer treatment within the past few years, aiming to provide a more comprehensive understanding of how metformin exerts its anti-cancer impact and how it can be clinically applied, as well as provide new insights for lung cancer treatment.
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Aims/Background Femoral neck fractures in elderly patients carry a high risk of developing deep vein thrombosis (DVT) due to prolonged immobilization and surgical intervention. This study examines the effectiveness of combining intermittent pneumatic compression (IPC) with low-molecular-weight heparin (LMWH) for preventing DVT in elderly patients following femoral neck fracture surgery. Methods A total of 150 elderly patients with femoral neck fractures, admitted between January 2022 and January 2024, were retrospectively selected, and their clinical data were analyzed. ⋯ Additionally, the activated partial thromboplastin time (APTT) and prothrombin time (PT) were longer, while the D-dimer (D-D) level was lower in the study group (p < 0.05). The study group also exhibited lower levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8) (p < 0.05). Conclusion The results indicate that combining IPC with LMWH effectively reduces the incidence of postoperative DVT in elderly patients with femoral neck fractures, improves venous blood flow in the lower limbs, reduces vascular inflammation, and ensures safety.
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Identifying Prostatic Utricle Translucent Membrane in Hematospermia Patients Using a Novel Nomogram.
Aims/Background Hematospermia, characterized by blood in the ejaculate, is a common and distressing condition in urology. Identifying the underlying causes, including translucent membranes in the prostatic utricle, is crucial for effective management. Despite advancements in diagnostic techniques, reliable predictive tools are needed to enhance preoperative planning and patient outcomes. ⋯ The nomogram demonstrated strong predictive capability, as evidenced by its performance in ROC and calibration curve analyses. Furthermore, the DCA indicated that the nomogram offered significant clinical net benefits in predicting the presence of a translucent membrane. Conclusion Clinical use of the developed nomogram can assist clinicians in identifying patients with hematospermia who have translucent membrane in the prostatic utricle and in developing individualized treatment.
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Aims/Background Pregnancy may cause physiological and pathological changes in multiple organs in a woman's body, including the heart, liver, and eyes. With rapid advances in societies and economies, the proportion of advanced maternal age (AMA) women has significantly increased. Here, we aimed to investigate the changes in arteriole retinal diameter, venule diameter, macular layer thickness, and arteriole to venule ratio (AVR) in this population. ⋯ Age was significantly correlated with CRVE and AVR in both eyes of pregnant women (CRVE: p < 0.0001; AVR: p < 0.01). Conclusion This study reports variations in the diameter of the retinal vasculature and the thickness of the macula in women of AMA. It is important to consider these changes when interpreting the adverse eye outcomes experienced by women of AMA.