Brit J Hosp Med
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Aims/Background Secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare, rapidly progressive and highly lethal disease. This retrospective cohort study aims to analyze the factors influencing the mortality risk in adult patients with sHLH, which are instrumental to improving our understanding of the high mortality risks associated with sHLH. Methods This study included 85 patients diagnosed with sHLH who were admitted and treated in the Department of Emergency, Peking University People's Hospital between April 2015 and July 2023. ⋯ Conclusion Patients with sHLH have frequently atypical clinical presentation, with early death risk and notably elevated mortality rate. Independent risk factors influencing mortality risk in sHLH patients include age ≥63.5 years, AST ≥111 U/L, ALT ≥41 U/L, and TNI ≥2.15 ng/mL. With high accuracy and efficacy, the risk prediction model constructed can facilitate timely identification of sHLH patients at elevated risk of mortality, which is critical for optimizing clinical interventions.
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Aims/Background The role of heparin in sepsis therapy has been widely debated. The controversy surrounding heparin's use as an anticoagulant in sepsis may stem from differences in sepsis definitions, study designs, timing and dosage of drug administration, treatment duration, complications, and patient severity. In this study, we aimed to determine the optimal timing and dosage of heparin in patients with sepsis, identify specific subgroups that could benefit from heparin therapy, and explore laboratory markers to assess its efficacy. ⋯ The increase in platelet count had a significant mediating effect on the entire cohort (p < 0.001 for the causal mediation effect), with a mediation proportion of 14%. Conclusion Early and adequate heparin administration can significantly improve the prognosis of sepsis. An increase in platelet count may serve as a potential indicator of the effectiveness of heparin therapy in sepsis.
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Aims/Background Decompensated cirrhosis is characterized by the progression of cirrhosis from an asymptomatic state to elevated portal pressure and marked deterioration of liver function. This pathological condition progresses rapidly following onset, significantly raising the risk for mortality. The aim of this study is to explore the association between serum lactate concentrations and mortality rates in individuals with hepatitis B-induced decompensated cirrhosis and to evaluate its potential as a clinical prognostic indicator. ⋯ In summary, serum lactate concentration is a prognostic indicator of mortality in individuals with decompensated cirrhosis due to hepatitis B, exhibiting higher predictive significance in female patients. Conclusion Deceased patients with decompensated cirrhosis linked to hepatitis B exhibit markedly increased serum lactate levels. Thus, monitoring serum lactate levels offers an effective tool for predicting patient prognosis, exhibiting higher sensitivity for disease detection in female patients.
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Aims/Background Mycoplasma pneumoniae pneumonia (MPP) is typically a benign and self-limiting disease. This study aimed to investigate the effect of early oral administration of doxycycline on macrolide resistance in children with MPP. Methods This study retrospectively analyzed the clinical data of 173 MPP children treated with macrolides at the Second Affiliated Hospital of Mudanjiang Medical University from March 2020 to March 2023. ⋯ In contrast, MSMP children in both groups exhibited no significant differences in symptom disappearance time and duration of macrolides treatment (p > 0.05). Conclusion Early oral administration of doxycycline is a safe and effective treatment for MPP. It helps relieve symptoms in MRMP children, shortens the duration of macrolide use, and reduces the incidence of macrolide resistance.
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Aims/Background Chronic heart failure (CHF) is a complex clinical syndrome resulting from various cardiac diseases, characterized by weakened cardiac pumping capacity and inadequate blood supply to body tissues. This study aims to investigate the expression and clinical implications of pro-B-type natriuretic peptide (pro-BNP) and soluble suppression of tumorigenicity 2 (sST2) in CHF to explore their potential in early diagnosis and severity assessment of the pathological condition. Methods This study included 146 CHF patients treated at our hospital from January 2022 to December 2023, who were classified in the observation group, and 150 concurrent healthy people categorized in the control group. pro-BNP and sST2 levels in the observation and control groups were compared. ⋯ Additionally, pro-BNP and sST2 had an inverse connection with LVEF (r = -0.764 and r = -0.535, respectively) and a positive correlation with LAD (r = 0.752 and r = 0.535, respectively) and LVEDD (r = 0.721 and r = 0.544, respectively). Conclusion pro-BNP and sST2 exhibit good diagnostic value for CHF, owing to their close association with patients' cardiac function. These biomarkers can be used as effective indicators to evaluate the severity of heart failure.