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Purpose To investigate the long-term changes in body weight and serum albumin levels in patients with respiratory failure, and those with chronic heart failure, who were treated with home long-term oxygen therapy (LTOT) to understand the current status and contribute to future measures. Methods Patients with chronic obstructive pulmonary disease (COPD), those with interstitial pneumonia (IP), and those with chronic heart failure (CHF) undergoing home LTOT for 6 months or more between January 2011 and January 2019 were included in the study. Body weight and serum albumin levels were assessed at the start of home LTOT and at the end of the observation period, a minimum of 6 months after commencing home LTOT. Results Sixty-two patients (29 COPDs, 23 IPs, and 10 CHFs) were included. In COPD patients and IP patients, body weight decreased (P = 0.0017, P = 0.0018, respectively, Wilcoxon signed-rank test). Serum albumin levels decreased in IP patients (P = 0.0185) but not in COPD patients. There was neither significant decrease in body weight nor serum albumin levels in patients with CHF. Conclusion Chronic respiratory failure patients who have home LTOT were likely to have a decreased nutritional status. In order to provide prolonged home LTOT, medical staff need to pay close attention to the nutritional status of patients receiving home LTOT.Background Proper nutrition is an essential component to both physical and emotional health. Food insecurity (FI) is a potentially critical public health problem. The link between FI and elevated risk for depression has been well documented. Yet, it is largely unknown how diverse older adult populations experience FI differently. Therefore, the aims of this study were to examine how gender, race/ethnicity, and nativity may impact the magnitude of the association between FI and depression. Methods We used a nationally representative sample of the Asian American population from the National Latino and Asian American Study (NLAAS). We built logistic regression models with major depression in the past 12 months as the dependent variable, and FI as the independent variable. Several demographic and socioeconomic characteristics were added to the models to control for potential biases. All statistical estimates were weighted, using the recommended NLAAS sampling weight, to ensure representativeness of the US population. Results About 35% (weighted adjusted 95% CI 29.49-39.00) of Asian Americans experienced some level of FI at the time of survey. Experiencing FI over the past 12 months increased the likelihood of having clinical depression (weighted adjusted odds ratio 1.44, weight adjusted confidence interval 0.79-2.10). The magnitude of associations between FI and depression varied by race/ethnicity (F (7, 47) = 6.53, p (3, 41) = 10.56, p (3, 41) = 9.85). Conclusions Food insecurity significantly increases the likelihood of clinical depression among Asian Americans. Greater attention is needed towards food-insecure Asian Americans and their mental health.
Although appendicectomy is still the classical and standard treatment for acute appendicitis, initial conservative antibiotic only treatment for simple uncomplicated cases has been proposed and tried as a feasible and effective approach. The objective of this study was to evaluate the efficacy and outcomes of antibiotics treatment for acute simple uncomplicated appendicitis.
This is a prospective controlled nonrandomized study in which a total of 156 patients whose ages range from 16 to 54 years presenting with clinical diagnosis of acute uncomplicated appendicitis were assigned for conservative antibiotics treatment, which consists of ceftriaxone I gram twice daily and metronidazole infusions, 500 mg in 100 ml, 3 times daily for 48 to 72 hours to be converted on oral antibiotics after clinical improvement for 5 to 7 days. click here Patients who failed to initial conservative treatment and those who had recurring symptoms of appendicitis were presented for appendectomy.
Antibiotic treatment was successful and feasible in 138 (88.5%) patients. Progression of the signs and symptoms despite full medical treatment was observed in 11 (7%) patients during the same admission. Further 7 (4.5%) patients showed recurrence of the symptoms during follow-up period of 6-12 months after successful initial conservative treatment and also proceeded for appendicectomy.
Nonoperative antibiotic treatment of acute simple appendicitis is safe, feasible, and effective for properly selected cases, thus avoiding unnecessary surgery with its possible complications.
Nonoperative antibiotic treatment of acute simple appendicitis is safe, feasible, and effective for properly selected cases, thus avoiding unnecessary surgery with its possible complications.
Intra-abdominal fat is a metabolically active tissue that can undergo necrosis due to torsion, infarction, or trauma. Despite being asymptomatic in most cases, fat necrosis or steatonecrosis can cause abdominal pain.
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This article describes the case of a male patient admitted to the emergency department with diffuse abdominal pain for the past month. The patient had a past medical history of antiphospholipid syndrome with multiple venous thromboembolic events and one episode of lower limb vasculitis, currently under anticoagulation treatment. Imaging studies with computed tomography and magnetic resonance revealed a mesenteric mass-like lesion adjacent to the ileal bowel loops. The patient underwent surgical resection, and the microscopic analysis revealed extensive organizing fat necrosis with reactive panniculitis and hemorrhage.
This article describes a rare case of a mesenteric mass-like encapsulated fat necrosis in a patient with antiphospholipid syndrome, with very atypical location and imaging features.
This article describes a rare case of a mesenteric mass-like encapsulated fat necrosis in a patient with antiphospholipid syndrome, with very atypical location and imaging features.The liver is usually affected in advanced stages of lympho-proliferative diseases, but primary liver lymphomas (PLLs) are rare. The diagnosis is usually late, especially in patients without identifiable risk factors, with consequent worse prognosis. We report the case of a 59-year-old female with progressive worsening pain in the right hypochondrium and weight loss. She was previously healthy and had a family history of gastrointestinal and gynecologic neoplasms. During the initial investigation, three liver nodules suggestive of liver metastases were found. Nevertheless, no primary neoplasm was identified in a subsequent evaluation with imaging and endoscopic exams. Laboratory exams excluded hepatic infections, metabolic diseases, and acquired immunosuppression. Biopsy of the lesions revealed diffuse large B-cell lymphoma. Lymph node and medullar involvement were excluded, and the diagnosis of PLL was assumed. The patient started chemotherapy with R-CHOP. With this case, we intend to alert for this differential diagnosis of liver nodules, even in the absence of predisposing conditions for lymphoma.
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