Background: The National Institute of Health and Clinical Excellence (NICE) provide a framework of evidence-based guidelines for the management of metastatic spinal cord compression (MSCC). We aimed to compare our center's provision of service to these best practice guidelines and discuss key shortcomings with their implications for the spinal surgeon.
Methods: Patients with radiologic evidence of MSCC over a 30-month period were identified using the hospital electronic radiological database. A chart review was performed analyzing MSCC management.
Results: Forty-one patients were identified. Pain was the most common presenting complaint, occurring in 76% of patients. Radiotherapy alone was the most common therapy employed (93% of patients). A surgical opinion was sought for 51% of patients. Histological diagnosis of the causative lesion occurred in 5 patients from surgical specimens.
Conclusions: Incongruities between NICE guidelines and our practice exist. Early involvement of the spinal surgical services needs to be encouraged. Establishing a histological diagnosis of the spinal lesion should be seen as of therapeutic importance.
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http://dx.doi.org/10.14444/5051 | DOI Listing |
Hypertension
January 2025
Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University, Beijing, China (X.Z., W.X., Y.W.).
Background: Although the information on the validation status of electronic sphygmomanometer (ES) devices in use in health care institutions and households is much more clinically relevant than that of ES models available on the market, it remains insufficient.
Methods: A national survey was conducted across all administrative regions of mainland China to assess the validation status of ESs. Fifty-eight cities were selected with stratification by municipality, provincial capital, and other cities, and health care institutions and households in each city were chosen by convenience to identify ES devices in use according to the study protocol.
Emergencias
December 2024
Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, Murcia, España.
Objective: To analyze the usefulness of mean mid-regional pro-adrenomedullin (MR-proADM) level to stratify risk in emergency department patients with solid tumors attended for febrile neutropenia after chemotherapy. To compare risk prediction with MR-proADM to that of conventional biomarkers and scores on the Multinational Association for Supportive Care in Cancer (MASCC) score.
Methods: Prospective observational cohort study enrolling patients with solid tumors who developed febrile neutropenia after chemotherapy.
Cureus
December 2024
Department of Pediatric Rheumatology, Kocaeli University, Kocaeli, TUR.
Background Health literacy (HL) refers to the ability of individuals to find, understand, and use information and resources to make informed health-related decisions and actions for themselves and others. Managing chronic diseases in children and adolescents requires active family involvement. The primary objective of the study is to evaluate the HL levels of parents of children diagnosed with familial Mediterranean fever (FMF).
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Hospital Beatriz Ângelo, Lisboa, PRT.
Vitamin B12 deficiency is a potentially severe condition with clinical manifestations ranging from nonspecific symptoms, such as asthenia and glossitis, to severe hematological problems, including pancytopenia and megaloblastic anemia. One of the rare phenomena associated with this condition is pseudo-thrombotic microangiopathy (pseudo-TMA), which can mimic diseases such as thrombotic thrombocytopenic purpura (TTP), leading to possible misdiagnosis and inappropriate treatment. In this article, we present the case of a 62-year-old man with a history of intravenous drug use, untreated hepatitis C, smoking, and alcoholism.
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