Association of Lipoprotein-associated phospholipase A2 With Carotid Intima-Media Thickness in Acute Cerebral Infarction Patients.

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory marker associated with atherosclerotic and cardiovascular diseases. This study aimed to explore the association of Lp-PLA2 with carotid intima-media thickness (cIMT) in patients with acute ischemic stroke (AIS) and explore a threshold level to predict the risk of vulnerable plaques. This retrospective observational study included patients with AIS in the Neurology Department of our Hospital between January 2018 and December 2019. The study included 293 patients aged 65.29 ± 12.11 years, including 212 males, of whom 124 had carotid intima-media thickening (42.32%). Multivariable logistic regression showed that Lp-PLA2 level was an independent risk factor for cIMT (odds ratio [OR] = 1.004, 95% confidence interval [95% CI] 1.001-1.008, P = .008). Threshold effect analysis showed that the risk of vulnerable carotid plaque occurrence increased by 2% for every 1 ng/mL increase in Lp-PLA2 level with serum Lp-PLA2 levels between 157 and 279 ng/mL; this increase was statistically significant (OR = 1.02, 95% CI 1.01-1.03, P < .001). Serum Lp-PLA2 is an independent risk factor for increased cIMT in patients with AIS, and a threshold Lp-PLA2 level between 157 and 279 ng/mL showed a higher risk of carotid plaque rupture.

Cutaneous and breast metastasis from colorectal adenocarcinoma: A rare case report.

Synchronous breast and cutaneous metastases from colorectal adenocarcinoma as the initial clinical manifestation, without visceral metastases, are extremely rare. We herein report the case of a 68-year-old female patient who presented with pruritic skin lesions and a breast lump 6 years after abdominoperineal resection of colorectal adenocarcinoma. Such cases can be easily misdiagnosed as cutaneous metastasis from breast cancer. However, the management of colorectal metastases differs from that of primary breast cancer, and mastectomy may be unnecessary. Timely and accurate diagnosis requires a high level of suspicion, thorough medical clinical history and biopsy followed by immunohistological examination. Specific immunohistochemical markers, such as cytokeratin (CK)7, CK20 and CDX2, may help differentiate between primary breast and metastatic colorectal adenocarcinoma.