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1.
Clin Pediatr (Phila) ; : 99228231206708, 2023 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-37881962

RESUMO

The purpose of this study was to investigate the risk factors for delayed chemotherapy-induced vomiting (DCIV) in pediatric oncology patients. We collected data on pediatric patients from a tertiary care pediatric hospital in an Asian urban center. We analyzed the risk factors for DCIV in patients by univariate analysis and logistic regression. Patients were grouped according to age by the Youden index, and differences in clinical features between the high-risk and low-risk groups were calculated. In the univariate analysis, the number of chemotherapy days, pH, and blood glucose levels were significantly associated with DCIV. In the logistic regression analysis, patient age was an independent risk factor (odds ratio [OR] = 1.013, 95% confidence interval [CI] = 1.005-1.021, P = .002). Children in the high-risk group had a higher grade of vomiting (P < .05). Age is an important risk factor for DCIV in pediatric patients, with older children tending to experience more frequent and more severe vomiting.

2.
Front Nutr ; 9: 970253, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36276823

RESUMO

Background: Predicting the duration of dysphagia after acute ischemic stroke (AIS) is important for clinical treatment decisions. Objective: The purpose of this study is to assess the swallowing function of AIS patients and to develop and validate a prognostic model for the need for nasogastric tube (NGT) in these patients. Materials and methods: We included 554 AIS patients during 2018-2019 as the development group and had 186 AIS patients as the external validation group. The primary end point of the study was the retention of NGT in patients 1 week after admission (Functional Oral Intake Scale ≤ 4). Swallowing function and stroke-associated pneumonia (SAP) at 1 month post-onset were also the objectives of this study. The volume-viscosity swallow test (V-VST) was used to assess the patient's impaired swallowing function. The Predictive model was built by logistic regression. Results: Overall, a total of 104 patients required indwelling NGT at 1 week of AIS onset in development group. The final prognostic model includes 5 variables: age (OR: 1.085, 95%CI: 1.049-1.123), neutrophil-to-lymphocyte ratio (NLR) (OR: 1.332, 95%CI: 1.090-1.626), NIHSS (OR: 1.092, 95%CI: 1.025-1.164), history of drinking (OR: 2.532, 95%CI: 1.452-4.417) and stroke location (Subtentorial vs. Supratentorial, OR: 1.954, 95%CI: 1.088-3.509). The prediction model had an AUC of 0.810, while the external validation group was 0.794. Conclusion: In stroke patients, it is very important to decide early whether to indwell a NGT. The nomogram will support decision making for NGT insertion and help these patients recover from their condition.

3.
Medicine (Baltimore) ; 98(5): e14308, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30702605

RESUMO

RATIONALE: Brain magnetic resonance imaging (MRI) images of atypical teratoid rhabdoid tumor (ATRT) often present heterogeneous signals of various cells without remarkable features of the disease. We describe a unique case of atypical brain MRI images presenting as an type II neurofibromatosis and explore some diagnostic hints. PATIENT CONCERNS: A 1-year-and-7-month-old boy admitted to our department with a 7-day history of drowsiness and 2-day history of emesis, and his presenting complaint was repeated vomit. On physical examination, he had drowsiness, positive sun set sign, slow light reflection, high muscular tension of limbs and 55 cm head circumference. MRI presented masses of bilateral auditory nerve distribution area, the fourth ventricle and right frontal lobe, obstructive hydrocephalus, and amplified cisterna magna. Particularly, dumbbell shape tumor in left cerebellopontine angle area and the fourth ventricle showed iso- or hypo-intensity on T1-weighted image and mix-intensity on T2-weighted image with irregular frontier, obvious mutual high and low signal on T2-weighted image, and growing along cerebrospinal fluid pathway. DIAGNOSIS: The diagnosis of type II neurofibromatosis (NF-II) was considered pre-operatively. After surgery, postoperative histopathology confirmed the diagnosis of ATRT. INTERVENTIONS: After ventriculo-peritoneal (VP) shunt, no evidence of tumor was inspected in cerebrospinal fluid, and enhancement MRI showed heterogeneous contrast signal on dumbbell shape tumor. We executed an incomplete microsurgery for dumbbell shape lesion in left auditory nerve distribution area and the fourth ventricle for differential diagnosis and facilitating further treatment. OUTCOMES: The patient did not recover well postoperatively and suffered from severe pulmonary infection. Refusing further intervention in view of poor prognosis of ATRT, the patient was transferred to another hospital for rehabilitation care. The patient died from progressive tumor and respiratory failure after 2 months. LESSONS: The diagnosis of ATRT can be challenging, in our case due to the disturbance of bilateral auditory nerve distribution area tumors. Under MRI, Irregular frontier, obvious mutual high and low signal on T2-weighted image, growing along cerebrospinal fluid pathway, and heterogeneous contrast enhancement should lead the clinician to strongly consider ATRT.


Assuntos
Neurofibromatose 2/diagnóstico , Tumor Rabdoide/diagnóstico , Tumor Rabdoide/cirurgia , Teratoma/diagnóstico , Teratoma/cirurgia , Diagnóstico Diferencial , Humanos , Lactente , Masculino
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