Laboratory Examination Research Articles

Haematology results, inflammatory haematological ratios, and inflammatory indices in cervical cancer: How is the difference between cancer stage?

BACKGROUND Cervical cancer is a prevalent form of cancer affecting women worldwide and it is the second most common cancer among women in Indonesia, accounting for 8.5% of all cancer-related deaths. Cervical cancer progression can be evaluated through laboratory tests to detect anaemia, an increased platelet count, and elevated inflammatory markers, therefore, effective laboratory examination is crucial for early detection and treatment of cervical cancer. AIM To evaluate the association between laboratory findings (haematology, haematology index, and inflammatory index) and the clinical stage of cervical cancer. METHODS This cross-sectional study analyzed adult cervical cancer patients’ data from medical records and laboratory results including sociodemographic status, histopathological finding, clinical stage, and complete haematology examination. Numerical data was analyzed by the one-way ANOVA (normal data distribution), while the Kruskal-Wallis test was used for non-parametric data (abnormal distribution), followed by appropriate post-hoc analysis. The categorical data was analyzed by the Chi-square or Fisher Exact tests. The significance level was established at a P value < 0.05. RESULTS This study involved the data of 208 adult cervical cancer patients and found no association between age, marital history, parity history, hormonal contraceptive use and cervical cancer stages. There were significant differences in the clinical laboratory test results based on the clinical stage of cervical cancer, including haemoglobin levels (P < 0.001), leucocytes (P < 0.001), neutrophils (P < 0.001), monocytes (P = 0.002), lymphocytes (P = 0.006), platelets (P < 0.001), neutrophil-lymphocyte ratio/NLR (P < 0.001), lymphocyte-monocyte ratio/LMR (P < 0.001), and platelet-lymphocyte ratio/PLR (P < 0.001). There were also significant differences in the systemic inflammatory index (SII) and systematic inflammatory response index (SIRI) between stage III + IV cervical cancer and stage II (SII P < 0.001; SIRI P = 0.001) and stage I (SII P < 0.001; SIRI P = 0.016), associated with the shifts in previously mentioned complete haematological values with cancer advancement. CONCLUSION The haematological parameters, inflammatory haematological ratios, and inflammatory indices exhibited significant differences between cervical cancer stages, therefore these tests can be utilized to evaluate cervical cancer progression.

Clinical features of Chlamydia pneumoniae pneumonia in 10 children

Objective: To summarize the clinical features of Chlamydia pneumoniae pneumonia (CPP) in children. Methods: Case series study. Clinical data of 10 children with CPP hospitalized in Department No.2 of Respiratory Medicine of Beijing Children's Hospital, Capital Medical University from January 2019 to August 2024 were retrospectively collected, including general information, clinical manifestations, chest imaging, laboratory examination and treatment. The clinical features and prognosis were summarized. Results: Among the 10 children with CPP, 7 were male and 3 were female. The age of onset was 11.2 (10.3, 13.1) years. The course were 17 (7, 23) days. Cough occurred in 9 cases with wet cough in 7 cases, while moderate and high fever occurred in 6 cases. Besides, chest pain occurred in 4 cases, rash and hemoptysis occurred in 1 case respectively. High density mass shadow was found in 7 cases chest CT imaging, accompanied by air bronchogram sign, surrounded by halo sign, 6 cases of which were distributed under the pleura, while patchy consolidation in the remaining 3 cases. Pulmonary embolism was present in 2 cases. Bilateral lung involvement was found in 3 cases and unilateral lung involvement in 7 cases. The white blood cell count was 10.21 (7.45, 11.64)×109/L and the proportion of neutrophils was 0.69 (0.63, 0.71). C-reactive protein increased in 7 cases, with the level of 33 (16, 77) mg/L. D-dimer increased slightly in 3 cases (0.393, 0.396, 0.739 mg/L). Serum Chlamydia pneumoniae-IgM antibody test was positive in 6 cases. Chlamydia pneumoniae nucleic acid test by bronchoalveolar lavage fluid (BALF) next-generation sequencing was positive in 6 cases. Both serum IgM antibody and BALF nucleic acid tests were positive in 2 cases. Azithromycin alone was used in 5 cases, while glucocorticoid was added in 1 case. Due to poor response to azithromycin in 4 cases, doxycycline was replaced in 3 cases and minocycline was replaced in 1 case, while glucocorticoid was added in 2 cases. Moxifloxacin combined with glucocorticoid therapy was adopted in 1 case with long course after the poor response to azithromycin and doxycycline. All patients were cured finally. Conclusions: CPP mostly occurs in elderly children. The main clinical manifestations include cough, fever and chest pain. The common chest imaging feature is subpleural high-density mass shadow with halo sign. Pulmonary embolism is present in a few cases. Nucleic acid detection and (or) serology is helpful for etiological diagnosis. Some cases need glucocorticoid therapy.

Clinical features and long-term outcomes of children with pneumococcal meningitis in China: a 10-year single-centre retrospective analysis

BackgroundPneumococcal meningitis is a central nervous system infection responsible for high rates of mortality and long-term disability worldwide. We aimed to summarise the clinical characteristics, as well as determine the risk factors for mortality and long-term progression of paediatric pneumococcal meningitis (PM).MethodsThis retrospective study included children with microbiologically confirmed PM who were admitted to Beijing Children's Hospital between 2012 and 2021. The laboratory examination results and clinical characteristics of the enrolled patients were analysed. All were followed-up with over the phone, and their long-term prognoses were scored based on the Glasgow Outcome Scale-Extended scale. Factors associated with long-term unfavourable outcomes were identified using single-factor and multivariate analyses.ResultsTotally 301 children with PM were included. Only 22 (7.31%) were vaccinated against Streptococcus pneumoniae (SP) prior to disease onset. The median age at admission was 12.00 (7.00–44.08) months. The median hospitalisation length was 22.00 (14.50–33.00) days. A total of 190 patients (63.12%) experienced neurological complications during their clinical course. A total of 278 children were followed up for a median of 61.61 (41.84–85.42) months, 44 (15.83%) died, and 75 (32.05%) of the 234 surviving children experienced sequelae. In terms of their Glasgow Outcome Scale-Extended (GOS-E) Scale scores, there were 199 cases (71.58%) in the good prognosis group (1–2 points) and 79 cases (28.42%) in the poor prognosis group (3–8 points). Multivariate analysis showed that sex, recurrent seizures or convulsive status, muscle tone changes, dyspnoea, and lower peripheral white blood cells (WBCs) count in the acute phase were independent risk factors for poor prognosis (all P < 0.05).ConclusionsPM is associated with high rates of fatality and morbidity in children. Approximately 1/3 of children who survive PM experiences neurological sequelae and require long-term rehabilitation training that poses significant burdens on the society and country.

Difficulties in diagnosing infectious diseases in children in outpatient settings

Infectious diseases occupy a leading place in the pathology of children and adolescents, accounting for 70–80% of the structure of morbidity and causes of mortality. Underestimation of clinical manifestations of infectious diseases by pediatricians is the reason that this pathology is not diagnosed in time, which leads to inadequate therapy, worsening of the course and chronicity of the process.Purpose of the study. Assess the nature of the pathology and the reasons for referring children by district pediatricians for consultation with an infectious disease specialist at the consultative and diagnostic center (CDC).Materials and methods. A retrospective analysis of the medical records of 532 children aged 0-17 years who sought specialized medical care from an infectious disease specialist at the Clinical Diagnostic Center of the St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation in 2021-2023 was conducted.Results and discussions. The most frequent diagnoses for referral to an infectious disease specialist were: «frequently ill child» (31.0%), «prolonged cough» (20.7%), «streptococcal infection» (15.6%), «infectious mononucleosis» (13.7%), «salmonellosis, prolonged excretion of salmonella» (10.2%), «congenital herpesvirus infection» (8.8%). The immediate reasons for seeking specialized medical care were identified: insufficient clinical effect from the therapy performed in outpatient settings (36.3%); lack of eradication of the infectious pathogen from the child’s body (25.8%): the need for in-depth laboratory and instrumental examination (24.2%), the desire of parents to receive specialized medical care in an expert-level institution (13.7%).Conclusion. In outpatient settings, pediatricians have difficulties in diagnosing patients with infectious pathology, which is due to insufficient alertness to various childhood infections and the lack of opportunity for in-depth laboratory and instrumental examination.In addition, to establish a final diagnosis, a multidisciplinary approach is often required with the participation of doctors of various specialties (otolaryngologist, allergist, neurologist, audiologist, etc.).

A clinical case of meningoencephalitis caused by achlorophyllum aquaticum Prototeca spp.

Protothecosis is a rare infectious disease caused by non-photosynthetic algae belonging to the genus Prototheca. Its clinical manifestations may be acute or chronic, localized or generalized. In humans, protothecosis is a rare and, in severe cases, highly lethal disease. Protothecosis manifests as three syndromes: skin or soft tissue infection, ulnar bursitis, or disseminated infection, including lesions of the brain membranes and substance (meningoencephalitis).The diagnosis is made on the basis of histologic examination of biopsy material and microbiologic examination of cerebrospinal fluid and affected tissues. In this paper we consider a clinical case of meningoencephalitis caused by the pathogen Prototheca spp. Current literature sources, case history, and data of laboratory examinations of the patient were analyzed.The accumulation of information about this disease, its epidemiologic and clinical features, and identification possibilities will contribute to the verification of the diagnosis, reduction of lethal outcomes, including in patients with chronic diseases and immunodeficiency states.

Clinical and laboratory characteristics of measles in children in St. Petersburg during a rise in incidence 2023–2024

Objective: to present the clinical and laboratory characteristics of measles in hospitalized children during the period of rising incidence in 2023-2024 in St. Petersburg.Materials and methods. А retrospective study was conducted at the clinic of the Federal State Budgetary Institution DNACIB FMBA of Russia, which included 68 patients aged from 3 months to 17 years 10 months hospitalized from January 2023 to April 2024. The patients underwent clinical and biochemical analyzes blood with assessment of indicators in comparison with age norms. Statistical processing of the results was carried out using Microsoft Excel and Statistica 7 for Windows. Differences were considered statistically significant at p&lt;0.05.Results. In the first four months of 2024, the number of hospitalized patients exceeded the figure for all of 2023 by 2.4 times. Boys were hospitalized more often than girls (1.2:1). The median (Me) age of the patients was 6 years 9 months (interquartile range (IQR) 2 years 11 months – 10 years 11 months). 85% of children had no history of vaccination against measles. In 54% of cases, the epidemiological history could not be clarified. 27% of children had contact with measles in the family, less often – in treatment and prophylactic (10%), educational (3%) institutions and on the front door (6%). The median duration of illness at the time of hospitalization was 5.5 days (IQR 5–6 days). One of the leading complaints was fever (Me 39.0°C (IQR 38.5° – 39.5°C). In 24% of cases, the disease proceeded without symptoms of conjunctivitis. In 97% of children, a typical course of measles was noted with staged rashes. Spots Belsky-Filatov-Koplik were not detected in 6 children (9%). Clinical blood tests revealed leukopenia (63% of cases), lymphopenia (47%) and thrombocytopenia (44%). The described changes in laboratory parameters over time persisted only in 16%, 2% and 2% of children. The differences in the levels of leukocytes, lymphocytes, platelets on admission and discharge were statistically significant (p&lt;0.001). In blood serum, the median level of C-reactive protein (CRP) was 6 mg/l (IQR 2–14 mg/l). An increase in the values of alanine (ALT) and aspartate aminotransferases (AST) was noted in 34% and 50% of the examined patients. Co-infection with other viruses (parvovirus B-19 and respiratory viruses) was detected in 14 patients (21%).Conclusion. In 2024, there was a significant increase in measles incidence. Children over 6 years of age, unvaccinated, with family contact with measles prevailed. Most patients suffered a typical form of measles with the formation of Belsky-Filatov-Koplik spots and the staged nature of maculopapular rashes. Laboratory examination revealed leukopenia, lymphopenia and thrombocytopenia, increased levels of transaminases. In 21% of cases, a combined viral-viral infection was observed.

Hubungan Antara Karakteristik Klinis Pasien TB Paru dengan Gambaran Radiologi CT Scan Thorax

Tuberculosis infection is one of the most common and dangerous human infections. Tuberculosis infection is a health problem in which one-third of the world's population is infected with Mycobacterium tuberculosis. The diagnosis of TB is still limited to the results of clinical examination, laboratory examination of BTA sputum and conventional thoracic X-rays. Meanwhile, CT scanning has not yet become a standard modality, due to its high cost and unavailability in many primary health care centres. However, CT scans are considered to have advantages in diagnosing minimal lesions, differentiating active and inactive conditions, assessing endobronchial expansion, and better diagnosing pulmonary TB with negative acid-resistant bacteria (BTA) sputum examination results. The method used was a literature review with a Narrative Review design to identify and summarise previously published articles on the relationship between clinical characteristics of pulmonary TB patients and CT scan radiological images. From the 4 articles summarised, it was found that the large number of variations that are not typical of thoracic CT scans of pulmonary TB patients make the diagnosis of pulmonary TB more complicated. It takes precision and good cooperation between radiologists and clinicians to jointly make a correct diagnosis of pulmonary TB.

Outcomes and risk factors for functional prognosis at 3 months after intravenous thrombolysis with r-tPA in patients with acute ischemic stroke: a retrospective cohort study

Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) is the preferred treatment for acute ischemic stroke (AIS). Nevertheless, only approximately half of patients undergoing IVT experience positive outcomes. The objective of the study was to examine the clinical characteristics of patients with AIS and identify predictors for unfavorable clinical outcomes at 3 months after IVT. This retrospective cohort study comprised 3805 consecutive patients diagnosed with AIS who received IVT. Patients categorized as having a poor outcome were those with a modified Rankin scale score (mRS) of 3–6, while those categorized as having a good outcome had a score of 0–2. Clinical profiles and laboratory examinations were compared among patients with differing outcomes. A logistic regression model was utilized to investigate potential factors correlated with unfavorable outcomes. Of the 3805 patients included in the study, 3176 (83.5%) were found to have a good outcome, while 629 (16.5%) experienced an poor outcome following IVT. Advancing age (OR = 1.037, P < 0.001) and higher baseline National Institutes of Health Stroke Scale (NIHSS) scores (OR = 1.156, P < 0.001) were significant independent predictors of a poor outcome. The area under curve (AUC) values for age, NIHSS score, and the combined effect of age and NIHSS score in predicting a poor response were 0.644, 0.761, and 0.777, respectively. Our research indicates that advancing age and higher baseline NIHSS score may serve as prognostic indicators for predicting early unfavorable outcomes following IVT in patients with AIS.

The Prevalence of Cerebral Malaria among Children under the Age of Ten in Selected Hospitals within Zaria Metropolis, Kaduna State, Nigeria

This study investigates the prevalence of Cerebral Malaria (CM) among children in selected hospitals within Zaria metropolis, Kaduna State, aiming to address the limited data specific to this region. It focuses on CM prevalence among children under the age of 10 in the study area. A cross-sectional study design was employed, and to ensure accurate representation of the target population and the specific condition of interest in the selected hospitals, a purposive sampling technique was adapted for this study. Data were collected through laboratory examination of participants’ blood through thick and thin blood film, after which the Plasmodium Falciparum positive slides were subjected to complete blood count test, parasite density calculation and temperature measurement. A physical clinical assessment using the Blantyre Coma Scale (BCS) to determine the altered state of consciousness or coma was used, and a well-structured questionnaire, as well as a consent form, was given to the participant’s parent or guardian to elicit data. Version 23 of IBM's Statistical Package for Social Sciences (IBM SPSS) software was used to conduct all statistical analyses and a probability value below 0.05 (p 0.05) was regarded as statistically significant. Among 240 samples, the findings identified an overall prevalence of CM to be 9.2% with higher prevalence of CM recorded in Hospital D (15.0%) compared to Hospital A, C, and B which reported a prevalence of 10.0%, 6.7% and 5.0% respectively.

Mechanism of skull base osteoradionecrosis explored through laboratory assessment with propensity score-matched analysis

Skull base osteoradionecrosis (sbORN) is a severe complication of radiotherapy (RT) in patients with nasopharyngeal carcinoma (NPC) that can severely affect quality of life (QOL) and may even be life-threatening. The etiology and pathogenesis of sbORN remain largely unknown or uncertain. Therefore, this study aimed to identify potential risk factors for sbORN by analyzing the laboratory assessments of patients to enable early clinical interventions. This retrospective case-control study reviewed NPC patients who were pathologically diagnosed with sbORN after primary radical radiotherapy. These patients were matched 1:1 with propensity scores for patients without sbORN at our center. The impact of laboratory examination indexes on sbORN occurrence was assessed using both univariate and multivariate logistic regression analyses. We reviewed 1,200 NPC patients who were followed up in our department from 2010 to 2020; a total of 57 patients met the inclusion criteria. Each patient underwent endoscopic and pathological examinations, which confirmed the diagnosis. In addition, 98 patients without sbORN were also collected and matched 1:1 by propensity score matching, resulting in the inclusion of 38 patients. Univariate logistic regression analysis revealed statistically significant differences in hemorrhage (HB), erythrocytes (RBC), albumin (Alb), platelets (PLT), indirect bilirubin (IBil), globulin (Glo), aspartate aminotransferase (AST), and fibrinogen (Fg) between the two groups (p < 0.05). Multivariate logistic regression analysis revealed statistically significant differences only for Fg (p < 0.05). Receiver operating characteristic (ROC) curve analysis further demonstrated the diagnostic utility of Fg, yielding an area under the curve (AUC) of 0.829, with specificity and sensitivity values of 0.842 and 0.711, respectively. The occurrence of sbORN was closely associated with elevated plasma Fg levels, suggesting that high plasma Fg may be a potential risk factor for sbORN. Plasma Fg has a certain diagnostic value for sbORN and can be used as a supplementary diagnostic method.

Tislelizumab-induced type 1 diabetic ketoacidosis in a patient with small cell lung cancer: a case report

This report presented a case of 71-year-old man diagnosed with extensive-stage small cell lung cancer (ES-SCLC) who developed type 1 diabetic ketoacidosis (DKA) after 3 cycles of tislelizumab plus chemotherapy for the first time. The patient had no history of diabetes mellitus (DM). According to medical history and laboratory examination, the case was definitely diagnosed new-onset type 1 diabetic ketoacidosis induced by tislelizumab, a kind of immune checkpoint inhibitor. Despite the incidence of immune checkpoint inhibitor-induced type 1 diabetes mellitus (ICI-T1DM) is rare, the development of ICI-T1DM, especially type 1 diabetic ketoacidosis is life-threating without blood glucose monitoring and insulin therapy. Early identification of hyperglycemia and C-peptide depletion, as well as routine blood glucose monitoring during ICI treatment is essential to avoid lethal endocrine immune-related adverse event (irAE).

ANALYSIS OF THE RISKS OF PANCREATITIS IN PATIENTS WITH CHOLELITHIASIS WITH MECHANICAL JAUNDICE

Backgraund: In recent decades, the number of patients with acute mechanical jaundice has increased significantly. Routine use of endoscopic retrograde cholangiopancreatography improved the results of treatment of patients with obstructive jaundice.Aims: The aim of this study is to identify risk factors for the development of acute pancreatitis after ERCP, as well as to analyze the relationship with individual anatomical features and intraoperative characteristics.Materials and methods: The data of 402 patients without cholangitis clinic and without increased amylase levels at the time of hospitalization were analyzed according to laboratory examination data. The patients were divided into 2 groups: the first – those observed after ERCP without complications, the second – patients who developed an acute pancreatitis clinic.Results: In the examined sample, 9.7% of cases of acute pancreatitis were detected, which is a fairly average indicator. The results of the comparative analysis indicated a combination of the influence of factors of anamnesis, anatomy and actions of endoscopists during the ERCP manipulation.Conclusions: The data obtained prove that the correct actions of the attending physician, consideration of risk factors and the experience of the endoscopist play a leading role in the results of treatment of patients with obstructive jaundice.

Bilateral Mumps with Orchitis : A Case Report

Background: Mumps or epidemic parotitis is an acute disease that often occurs in the salivary glands caused by infection from paramyxovirus . This virus spreads easily through airborne droplets and saliva. In the world, the incidence of mumps is 500,000 cases each year. Incomplete basic vaccination is one of the risk factors for mumps. Case Description: An 11-year-old male patient came with complaints of swelling in the right and left parotid glands. Initially the swelling was on the left. The patient had never been like this before. The patient's basic immunization history was incomplete. From physical examination, enlargement of both salivary glands was found. 2 weeks earlier at the patient's school, there were several students who experienced the same thing. The patient was referred to dr. Ramelan Central Naval Hospital after 5 days of hospitalization at the previous hospital and experienced swelling in the left scrotum. Discussion: Mumps often occurs in children aged 2-12 years. The occurrence of mumps can be caused by infection with the paramyxovirus virus which spreads from airborne droplets and salivary glands. One of the complications of mumps that often occurs in children is orchitis . Providing basic vaccines to children is one effort to prevent mumps. Bed rest, adequate fluid intake, and intravenous administration of NSAIDs and antibiotics can be options for mumps therapy. Conclusion: In this case, Mumps with Orchitis complications were diagnosed based on anamnesis, physical examination, and laboratory examination. Management of mumps is symptomatic. Incomplete basic vaccination is one of the biggest factors in the occurrence of mumps.

Value of ultrasound‑guided puncture combined with GeneXpert MTB/RIF technology in the diagnosis of pleural tuberculosis.

The aim of the present study was to analyze the pathological and laboratory findings of pleural lesions post ultrasound-guided biopsy and to assess the diagnostic utility of percutaneous ultrasound-guided puncture combined with GeneXpert Mycobacterium tuberculosis (MTB)/resistance to rifampin (RIF) in pleural tuberculosis (TB) diagnosis. A retrospective analysis was conducted on 46 patients who underwent ultrasound-guided biopsy at the Shandong Public Health Clinical Center (Shandong Chest Hospital) between April 2018 and April 2021. Of these, 27 patients were diagnosed with pleural TB, while 19 were confirmed to have non-pleural TB. Preoperative examinations were negative for all patients. Under ultrasound guidance, tissue samples were obtained through puncture for subsequent pathological and laboratory examination. All collected samples were subjected to acid fast staining, M. tuberculosis culture and GeneXpert MTB/RIF (Cepheid). The sensitivity, specificity and area under curve (AUC) value were compared across methods. Rifampicin drug susceptibility was detected using the proportional method and compared with results obtained from GeneXpert MTB/RIF. The sensitivity and specificity of acid-fast staining, M. tuberculosis culture and GeneXpert MTB/RIF in diagnosing pleural TB were 18.52 and 100.00%, 14.81 and 100.00, 96.30 and 94.74%, respectively. Consistency analysis demonstrated that the GeneXpert MTB/RIF technique exhibited good agreement (κ=0.91), whereas the agreement for acid fast staining (κ=0.16) and M. tuberculosis culture (κ=0.13) was poor. Data analysis was performed by combining the results of the three detection methods with pathological findings. The diagnostic value for pleural TB was highest for GeneXpert MTB/RIF technology combined with pathology (AUC value=0.97), followed by M. tuberculosis culture combined with pathology (AUC value=0.94) and acid-fast staining combined with pathology (AUC value=0.94). No surgical complications were observed. Of the 27 samples, 4 tested positive using the M. tuberculosis culture method. Rifampicin resistance was detected from the bacterial colonies through the proportional method, with results consistent with those obtained from the GeneXpert MTB/RIF method. Ultrasound-guided percutaneous biopsy is considered a safe and effective approach for diagnosing pleural TB, Its sensitivity is much higher than that of pleural effusion, Moreover, there is currently limited research on ultrasound-guided pleural biopsy combined with laboratory testing worldwide. Ultrasound-guided puncture combined with GeneXpert MTB/RIF technology is of significant value in the diagnosis of pleural TB and in determining rifampicin resistance.

Association between Statin use and Abdominal Aortic Calcification in Male, Non-diabetic Elderly.

Our study was to investigate the association between statin use and the prevalence of abdominal aortic calcification (AAC). The population was enrolled in the 2013-2014 cycle of the National Health and Nutrition Examination Survey (NHANES). The statin use was determined from the questionnaire inquiring the medications taken in the past month. The presence of AAC and severe AAC were assessed based on the AAC score measured by abdominal dual-energy X-ray absorptiometry (DXA). Logistic regression analysis was performed to evaluate the association between statin treatment and AAC after adjustment for potential confounders. The study included a total of 2074 individuals; the average age 61.6±11.8 years old and 922 (44.5%) were male. AAC (AAC score >0) was present in 35.4% of the population and 12.0% had severe AAC. There were 836 (40.3%) statin users. After adjustment for demographics, lifestyles, comorbidities, and laboratory examinations, statin use was associated with higher odds of AAC (OR 1.28, 95%CI 1.02-1.62; P=0.034) and severe AAC (OR 1.78, 95%CI 1.24-2.55; P=0.002), respectively. Subgroup analysis revealed that the association was stronger in male, non-diabetic participants and those aged >60 years old. Stain use was associated with a greater presence of AAC and severe AAC. This association was stronger for male, non-diabetic participants and those aged >60 years.

Stress hyperglycemia ratio: a novel predictor of left ventricular dysfunction in peripartum cardiomyopathy

Objective This study aims to assess the predictive value of the stress hyperglycemia ratio (SHR) for left ventricular (LV) systolic dysfunction in patients with peripartum cardiomyopathy (PPCM). Methods We conducted a retrospective analysis of 78 consecutive PPCM patients from January 2007 to March 2023. Their clinical, laboratory, and auxiliary examination data were collected. The estimated average glucose (eAG) was calculated using the formula: eAG = [1.59 × hemoglobin A1c (%) −%2.59]. The SHR was determined by the formula: SHR = (blood glucose at admission)/eAG. The primary outcome measured was the recovery of LV systolic function. A receiver operating characteristic (ROC) curve was used to evaluate the SHR. Logistic regression analysis was performed to identify risk factors for LV systolic dysfunction in PPCM patients. Results The mean random blood glucose level in the PPCM patients was 6.38 mmol/L, with an SHR of 1.16. Among these patients, 37 (47.4%) exhibited persistent LV systolic dysfunction during follow-up. The SHR was significantly higher in the non-recovery group than in the recovery group (1.45 vs. 0.91, p < .001). An SHR cutoff of 1.079 predicted persistent LV systolic dysfunction with a sensitivity of 81.1% and a specificity of 90.2%, yielding a Youden index of 0.713. Logistic regression identified an SHR ≥ 1.079, a left ventricular end-diastolic diameter (LVEDD) > 55 mm, and digoxin usage as risk factors for LV systolic dysfunction. Conclusions PPCM patients with an SHR of 1.079 or higher should receive increased scrutiny for persistent LV systolic dysfunction.

The use of simple tests to predict biopsy-proven steatohepatitis in people with type 2 diabetes.

Metabolic-associated steatotic liver disease (MASLD) has become the most common chronic liver disease, especially in people with type 2 diabetes mellitus (T2DM). Liver biopsy remains the gold standard method for diagnosis of MASLD subtypes, but prevalences may be under or overestimated when biopsy is performed with selection bias. The aims of this study were to define prevalence of MASLD subtypes by liver biopsy in T2DM participants not selected by abnormal exams, determine variables associated with metabolic-associated steatohepatitis (MASH), and analyze performance of aminotransferases and abdominal ultrasound in diagnosis. T2DM participants from 18 to 70 years were considered for enrollment. Of the 396 participants, 85 were included and submitted to clinical, laboratory examinations, and ultrasound. Eighty-three performed liver biopsy evaluated by two independent pathologists. Factors independently associated to MASH and significant fibrosis were assessed by hierarchical multivariate logistic regression. Prevalence of MASLD was 92% (50% simple steatosis, 42% MASH) and kappa = 0.78. Steatosis was mild in 76% of participants with simple steatosis and severe in 65% of MASH (P < 0.001). Presence of MASH or fibrosis was associated with BMI and alanine aminotransferase (ALT) [threshold of 33.5 mg/dl in predicting MASH (area under the curve = 0.82, P = 0.001)]. Prevalence of MASLD by liver biopsy in T2DM regardless of ultrasound or ALT elevation is almost 100%, with 42% of MASH. MASH was associated to severe steatosis on histology. BMI and ALT were independently associated with MASH and ALT close to the upper limit of normal gave the best cutoff point for MASH detection.

Hormones synthesized by the adrenal reticulum protect bone density in premenopausal women with Cushing syndrome.

Hormones synthesized by the adrenal reticulum protect bone density in premenopausal women with Cushing syndrome.

Preliminary study on the value of serum pepsinogen in differentiating autoimmune gastritis

Objective: This study identifies independent predictive indicators to distinguish autoimmune gastritis from Helicobacter pylori (H. pylori)-induced atrophic gastritis and validates their diagnostic performance to compare laboratory indicators of autoimmune gastritis and H. pylori-induced atrophic gastritis. Methods: A retrospective comparison of laboratory examination indicators was conducted for chronic atrophic gastritis patients with involvement of the gastric fundus and corpus, who were followed up at the Department of Gastroenterology, Xijing Hospital, from January 2014 to September 2024. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cutoff points and corresponding diagnostic thresholds. In addition, multivariate logistic regression analysis was conducted to identify independent predictive indicators for autoimmune gastritis, with further assessment in a validation cohort. Results: A total of 139 patients with autoimmune gastritis and 209 patients with H. pylori-induced atrophic gastritis were included. Pepsinogen (PG) Ⅰ levels and the PG Ⅰ/PG Ⅱ ratio in patients with autoimmune gastritis were significantly lower than in those with H. pylori-induced atrophic gastritis [11.0 (4.8, 22.5) vs. 41.8 (32.2, 59.9) μg/L, U=722.00, P<0.001; 1.24 (0.75, 3.54) vs. 5.76 (4.31, 7.12), U=817.00, P<0.001], while gastrin levels were significantly higher [375 (84, 738) vs. 49 (35, 81) ng/L, U=378.00, P<0.001]. PG Ⅰ was identified as an independent predictive variable, with an area under the ROC curve of 0.847 (95%CI 0.791-0.904), sensitivity of 77.6%, specificity of 91.8%, positive predictive value of 80.5%, and negative predictive value of 90.5%. Conclusions: Significant differences in laboratory indicators were observed between autoimmune gastritis and H. pylori-induced atrophic gastritis in chronic atrophic gastritis involving gastric fundus and corpus. Besides, PG Ⅰ demonstrated good diagnostic performance in identifying autoimmune gastritis and can effectively differentiate between different types of atrophic gastritis.

Consciousness disturbance in patients with chronic kidney disease: Rare but potentially treatable complication. Clinical and neuroradiological review.

Consciousness disturbance in patients with chronic kidney disease: Rare but potentially treatable complication. Clinical and neuroradiological review.