Aguilarshannon1951
733), p=0.012] and % carbon monoxide diffusion capacity (%DL
) [O.R. 0.810 (95%CI 0.814-0.964), p<0.01] were independent risk factors for AE. AE was the most frequent cause of death of RA-ILD and IPF.
RA-ILD patients could develop AE, and AE was not uncommon in RA-ILD or IPF. %DL
and hypoalbuminemia were predictive factors of AE in RA-ILD. The prognosis after AE of RA-ILD was significantly better than that of IPF. The most frequent cause of death in RA-ILD and IPF was AE.
RA-ILD patients could develop AE, and AE was not uncommon in RA-ILD or IPF. %DLCO and hypoalbuminemia were predictive factors of AE in RA-ILD. The prognosis after AE of RA-ILD was significantly better than that of IPF. The most frequent cause of death in RA-ILD and IPF was AE.Comorbid bipolar disorder (BP) and borderline personality disorder (BPD) presents a diagnostic challenge in its differentiation from each condition individually. We aimed to use a machine learning (ML) approach to differentiate comorbid BP/BPD from both BP and BPD. Participants were assigned DSM diagnoses and compared on self-report measures examining personality, emotion regulation strategies and perceived parental experiences during childhood. 82 participants were assigned as BP, 52 as BPD and 53 as comorbid BP/BPD. ML-derived diagnoses had an accuracy of 79.6% in classifying BP/BPD vs. BP, and 61.7% in classifying BP/BPD vs. BPD. Stress-related paranoid ideation and other core borderline personality items were important in distinguishing BP/BPD vs. BP, whereas deficits in emotion regulation strategies were important in distinguishing BP/BPD vs. BPD. Impulsivity and anger were important across both analyses. We identified clinical variables more distinctive in comorbid BP/BPD, with superior accuracy in distinguishing from BP, and with lower accuracy compared to BPD alone. Such an additive model should assist in sharpening clinical decision making, with future machine learning examination of larger datasets likely to further improve diagnostic accuracy.The aim of this study was to conduct a systematic review and meta-analysis of observational studies to estimate the overall prevalence and prognostic value of sarcopenic obesity (SO) in patients with cancer. We searched PubMed, Embase, Web of Science and the Cochrane Library for observational studies reporting the prevalence of SO and its prognosis in patients with cancer from inception to December 2020. The pooled prevalence, hazard ratios (HRs), odds ratios (ORs) and their 95% confidence intervals (CIs) of data extracted from the studies were calculated. We included 10 004 patients with cancer from 38 studies. The pooled prevalence of SO in this group of patients was 20% (95% CI, 17%-24%). Meta-analysis showed SO was significantly associated with poor overall survival (HR, 1.83; 95% CI, 1.41-2.38), recurrence-free survival (HR, 2.10; 95% CI, 1.57-2.80), disease-free survival (HR, 1.94; 95% CI, 1.01-3.74), postoperative complications (OR, 3.01; 95% CI, 2.08-4.33), and prolonged hospital length of stay (OR, 5.69; 95% CI, 2.76-11.74). The results for the relationship between SO and chemotherapy toxicity were inconsistent and controversial. Current limited evidence suggested that SO may be associated with poor cancer-specific survival (HR, 5.00; 95% CI, 1.40-16.70), but not progression-free survival (HR, 0.61; 95% CI, 0.32-1.16). The present review indicated SO is common in patients with cancer and is significantly associated with several poor outcomes. Therefore, it is necessary to diagnose and screen for SO in patients with cancer in the future, and appropriate interventions should be further explored to improve the prognosis of cancer patients.
The aim of this study was to evaluate the diagnostic accuracy of the Geriatric Dehydration Screening Tool-Modified (GDST-M) in detecting dehydration in older people and, if possible, to simplify the tool and make it easier to use.
This was a monocentric diagnostic accuracy study. We involved people ≥65 y of age with a Mini Mental State Evaluation (MMSE) score >24 and who were hospitalized in five medical wards of a large teaching hospital in Milan (Italy). We administered the GDST-M to hospitalized older people who met the inclusion criteria and compared outcomes with the values of serum osmolarity to evaluate their dehydration status and the accuracy of the tool.
A total of 299 older people were recruited, of which 202 were dehydrated and 97 were hydrated. The GDST-M, with a cutoff value of 6, showed a sensitivity of 61.9% and a specificity of 47.2%. Multiple correspondence analysis and cluster analysis enabled extraction of 9 items from the 23 items present in the GDST-M. The new tool had a moderate diagnostic accuracy in detecting dehydration in older people aged over 75 y, with a sensitivity of 63.4% and a specificity of 69.6%.
The short form of the tool is simple and contains minimally invasive assessments of low fluid intake dehydration in older people. The new GDST could also be easily used by lay people after a short training session.
The short form of the tool is simple and contains minimally invasive assessments of low fluid intake dehydration in older people. selleck inhibitor The new GDST could also be easily used by lay people after a short training session.
Exposure to an obesogenic environment at critical stages of human development may lead to cardiovascular damage during early adulthood, such as left ventricular hypertrophy (LVH). The objective of this study is to investigate whether the consumption of diets with different levels of fat associated with fructose drink, introduced to newly weaned rats, leads to cardiovascular damage.
Male Wistar rats (age 21 d) were divided into the following groups Control (C group) fed an American Institute of Nutrition 93G diet (16.3 % kcal of lipid); high-fat diet (HF group 45% kcal of lipids), and very-high-fat diet (VHF group 60% kcal of lipids). The HF and VHF groups also received a fructose solution (10%) for hydration.
After 70 d, the animals in the HF and VHF groups presented with cardiovascular damage as a comorbidity of obesity, with increased creatine kinase-MB levels, high heart and left ventricle (LV) mass, and an increase in the LVtibia ratio. The positive correlation was observed between serum leptin levels and LV mass. In addition, the signal transducer and activator of transcription 3 content in LV was lower.
The administration of diets with different fat and carbohydrate contents associated with fructose drinks introduced to newly weaned rats leads to LVH during early adulthood. The data suggest that the change in leptin-signal transducer and activator of transcription 3 pathway signaling in the groups is related to the occurrence of LVH.
The administration of diets with different fat and carbohydrate contents associated with fructose drinks introduced to newly weaned rats leads to LVH during early adulthood. The data suggest that the change in leptin-signal transducer and activator of transcription 3 pathway signaling in the groups is related to the occurrence of LVH.The separation of two sister groups such as ants and bees in the Cretaceous involved the development of distinctive characteristics to occupy separate ecological niches. From the point of view of biology and ecology, it is important to see how different life history strategies affect the physiology of these insects. The fat body is the most metabolically important tissue in the organism of each insect. Therefore, we conducted a comparative analysis of the morphological image of the subcuticular fat body in different localisation/segments in Formica (Seviformica) cinerea and Apis mellifera mellifera foragers, because of the similarity of their functions in colonies. We observed that the fat bodies of ants and bees were composed of the same cell types trophocytes and oenocytes. However, in each of the segments, the fat body cells in ants were bigger and there were fewer of them in comparison with bees. The dorsal part of the fat body of ants had a bilayer structure, where the outer layer was formed by binucleated oenocytes. Binucleated oenocytes were also found in the inner layer near the heart and tracheole. In bees, the fat body was unilayered and the trophocytes and oenocytes were present side by side. The similarities and, in particular, the differences in the structure of the fat body are the adaptation of these sister groups to life in a diverse environment.
Postoperative cerebral embolic stroke is a serious complication of pulmonary lobectomy, occurring in 1.1% of patients undergoing lobectomy through video-assisted thoracoscopic surgery (VATS). The mechanism of this complication is thought to be embolic stroke caused by thrombus formed due to stagnation in the pulmonary vein stump after VATS lobectomy. There have been few reports demonstrating the utility of endovascular treatment (EVT) for cerebral embolic stroke after VATS lobectomy.
In our case series, cerebral embolic stroke occurred after VATS pulmonary lobectomy for lung cancer, including the left upper lobe in three cases and the right lobe in one. The median duration of ischemic stroke after VATS was 4.5 days (interquartile range, 2-9 days). The median time from stroke onset to puncture was 130min. Successful recanalization was achieved in all cases, and two patients achieved favorable clinical outcomes (modified Rankin scale, 0-2).
We report a case series of four patients who underwent EVT for acute embolic stroke after VATS lobectomy for lung cancer. EVT is considered a reasonable and feasible therapeutic option for this condition.
We report a case series of four patients who underwent EVT for acute embolic stroke after VATS lobectomy for lung cancer. EVT is considered a reasonable and feasible therapeutic option for this condition.
Contrast-enhanced ultrasound (CEUS) and gadoxetate disodium-enhanced MRI (EOB-MRI) may synergize in profiling hepatocellular carcinoma (HCC) aggressiveness considering distinct imaging traits. This study aimed to intra-individually compare CEUS and EOB-MRI with Liver Imaging Reporting and Data System (LI-RADS) in assessing HCC aggressiveness.
From January 2015 to November 2020, consecutive at-risk patients with surgically-confirmed HCC who underwent both preoperative CEUS and EOB-MRI examinations were retrospectively enrolled. Image analyses were conducted independently by two masked radiologists for CEUS and EOB-MRI, respectively. The diagnostic performance of each modality for macrovascular invasion against pathology was evaluated and compared with the McNemar's test, while Edmondson-Steiner grade and the presence of microvascular invasion (MVI) were compared between patients with and without LR-M features on each modality.
A total of 140 patients (mean age, 51.9years±11.0; 116 men) were included. Inter-modality agreement was poor (κ=-0.087∼0.139) for major LI-RADS features and moderate (κ=0.449) for overall LI-RADS categorization, and LR-TIV and LR-M were the top sources of inter-modality variations. Although CEUS demonstrated significantly higher specificity for diagnosing macrovascular invasion (96% vs. 89%, P=.02), LR-M features on EOB-MRI were more effective in identifying higher Edmondson-Steiner grades (P=.01) and MVI (P=.02).
Marked discrepancies were found between CEUS and EOB-MRI in evaluating LI-RADS features and categories. Whereas CEUS showed superior diagnostic specificity for macrovascular invasion, LR-M features on EOB-MRI provided more information regarding tumor grade and MVI status in HCC patients.
Marked discrepancies were found between CEUS and EOB-MRI in evaluating LI-RADS features and categories. Whereas CEUS showed superior diagnostic specificity for macrovascular invasion, LR-M features on EOB-MRI provided more information regarding tumor grade and MVI status in HCC patients.