Frailty in Older Adults with Dengue Fever.

Background and objectives: Dengue is one of the most common epidemic infections around the world. Dengue infections in older adults are related to an atypical presentation and a high mortality. Frailty is associated with poor recovery from hospitalization due to infection. However, few studies describe frailty and functional decline after dengue infection. The current case series study aims to investigate the baseline frailty status, functional decline, and time to recovery in older adults after dengue infection. Method: We studied seven patients with post-dengue frailty who had been admitted to the geriatric ward in one tertiary medical center in Taiwan during the 2023 dengue fever outbreak. Result: The mean age was 82 years old. The clinical frailty scale worsened from a mean of 4.7 at baseline to 6.3 at dengue diagnosis. The mean Katz Index of independence in activities of daily living decreased from 10.6 at baseline to 4.7 with dengue, and it recovered to 6.7 one month after discharge. Conclusions: Our preliminary data suggest that there is indeed an increase in frailty in older adults due to dengue. Post-dengue frailty and functional decline might be profound and persistent. Acute geriatric care intervention rehabilitation for frailty after dengue may benefit this population.

Dynamic changes of pulmonary arterial pressure in perinatal neonates with pulmonary and extrapulmonary acute lung injury/respiratory distress syndrome.

This study aims to explore the dynamic changes of pulmonary arterial pressure (PAP) and its clinical significance in prenatal neonates with pulmonary and extra-pulmonary acute lung injury/respiratory distress syndrome (ALI/ARDS).A prospective study was conducted in the Neonate Intensive Care Unit (NICU) between May 2015 and April 2017. A total of 78 prenatal neonates with ALI/ARDS were selected and divided into 2 groups: pulmonary group (n = 37) and extra-pulmonary group (n = 41). These neonates were further divided into 3 groups according to the OSI index: mild, moderate, and severe groups. The dynamic changes of PAP were observed in these neonates. In the moderate and severe groups, PAP was significantly higher in neonates with pulmonary ALI/ADDS (ALI/ARDSp) than in neonates with extrapulmonary ALI/ARDS(ALI/ARDSexp) (62.5 ±â€Š5.4 vs 68.0 ±â€Š6.5, 54.7 ±â€Š5.9 vs 64.2 ±â€Š4.9; t = 3.264, 3.123; P = .004,.039). Furthermore, PAP was higher in neonates with ALI/ADDSp in the severe group, compared with those in the moderate group (t = 2.420, P < .05). There was significant difference among the 3 subgroups of neonates with ALI/ADDSexp (F = 60.100, P = .000). PAP was positively correlated with the OSI index (r = 0.823). The overall dynamic PAP monitoring results revealed that PAP was higher in the pulmonary group than that in the extrapulmonary group, and this exhibited a gradually decreasing trend as the condition of the subject improved.PAP in perinatal neonates with ALI/ARDS increases in varying degrees, and its extent was related to the severity of the illness. PAP was significantly higher in neonates with ALI/ADDSp than in neonates with ALI/ADDSexp. This can be used as a monitoring indicator for the severity of illness.

[CT manifestations of the thymic carcinoid and literature review].

OBJECTIVE: To investigate the CT manifestations of thymic carcinoid and assess the diagnostic value of CT for this disease. METHODS: CT and clinical findings of 5 patients (4 males and 1 female, average age 41 years) with histologically confirmed thymic carcinoid were retrospectively analyzed. RESULTS: The clinical findings of the 5 patients showed no specificity, and none of the patients presented with carcinoid syndrome. The tumors were relatively large (mean size on the largest planar of 11.7 cm x 7.6 cm) with heterogeneous density, and showed necrosis or cystic degeneration in the tumor. The lesions showed uneven enhancement in contrast-enhanced imaging and displayed linear enhancement of the blood vessels in the tumors in 3 cases with unclear tumor margins. The adjacent major vessels were displayed in 4 cases (the superior vena cava in 2 and brachiocephalic vein in 4 cases), and 5 showed mediastinal and/or root of the neck lymphatic metastasis. None of the cases have lung or other site metastasis. CONCLUSION: The CT findings of the thymic carcinoid have some characteristics, and can be helpful in the diagnosis.

[Correlation between magnetic resonance imaging findings and proliferating cell nuclear antigen expression in peripheral lung cancer].

OBJECTIVE: To study the correlation between magnetic resonance imaging (MRI) findings and proliferating cell nuclear antigen (PCNA) expression in peripheral lung cancer. METHODS: The expression of PCNA was detected by means of SABC immunohistochemistry in 45 cases of surgically and pathologically confirmed peripheral lung cancer. The correlation between PCNA expression in the tumors and the MRI findings was analyzed. RESULTS: PCNA expression was correlated to the differentiation, tumor size, lobulation, and mediastinal lymph node metastasis of the tumors (P<0.05), but not to the histological type, clinical stage, pleural retraction, spiculation, or signal feature. CONCLUSION: Correlations are found between MRI findings of lung cancer and abnormal expression of PCNA.