Over the last 20 years, more than 15 medical practice guidelines and clinical prediction rules have emerged to assist physicians in assessing the prognosis of adult patients with community-acquired pneumonia (CAP) and selecting an appropriately matched initial site of care. Most of these guidelines and rules suffer from major methodological flaws. One, the Pneumonia Patient Outcomes Research Team (PORT) clinical prediction rule, has satisfied rigorous methodological standards for the derivation and validation of high-quality prediction rules. This rule was incorporated into the Infectious Disease Society of America medical practice guideline for the management of adults with CAP. Strengths of the rule include its derivation and validation in over 50,000 inpatients and outpatients; stratification of all immunocompetent adult patients into one of five risk strata for short-term mortality and other unambiguous adverse medical outcomes; initial site of care recommendations for all patients, particularly those at low risk; and reliance on predictor variables readily available to clinicians at the time of initial patient presentation. A recent small-scale intervention trial demonstrates that the pneumonia PORT rule can reduce admissions for adult patients with CAP without compromising patient outcomes.
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http://dx.doi.org/10.1016/s0891-5520(05)70208-7 | DOI Listing |
J Prev Alzheimers Dis
February 2025
Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China, 154 Anshan Road Tianjin 300052, PR China; Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin 300052, PR China. Electronic address:
Background: Changes in cerebral blood flow (CBF) may contribute to the initial stages of the pathophysiological process in patients with Alzheimer's disease (AD). Hypoperfusion has been observed in several brain regions in patients with mild cognitive impairment (MCI). However, the clinical significance of CBF changes in the early stages of AD is currently unclear.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Head and Neck Surgery, Institut de Cancérologie de Lorraine, 6 avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France; CRAN, CNRS, UMR 7039, Université de Lorraine, Vandœuvre-lès-Nancy, France; Faculté d'odontologie de Lorraine, Université de Lorraine, Vandœuvre-lès-Nancy, France.
Introduction: Large melanomas, while relatively uncommon, present significant diagnostic challenges due to their size and potential to mimic other malignancies, leading to delays in appropriate treatment. Initial misdiagnosis is a substantial concern, impacting patient outcomes. This case highlights the importance of immunohistochemistry in cancer diagnosis, and of appropriate therapeutic management, which here included excision surgery of the tumor mass.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Obstetrics and Gynecology, Moriya Daiichi General Hospital, Moriya, Ibaraki, Japan.
Introduction And Importance: Fallopian tube cancer, particularly the carcinosarcoma subtype, is a rare malignancy posing diagnostic challenges.
Case Presentation: Our patient was an 83-year-old, nulligravida woman, presented to our outpatient clinic with one month of pelvic pain. On examination, a pelvic mass was detected.
Purpose: To evaluate the safety, diagnostic accuracy, and factors influencing the diagnostic yield of ultrasound (US)-guided omental biopsies.
Materials And Methods: This retrospective study included 109 patients who underwent US-guided omental biopsies between June 2020 and June 2024. Pre-biopsy diagnostic images (CT, MRI, or [18 F]FDG PET/CT) were reviewed.
Nord J Psychiatry
January 2025
Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland.
Purpose: Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition that affects approximately 5% of the pediatric population, with increased prevalence among those with type 1 diabetes (T1D). Reports suggest that unrecognized and untreated ADHD impairs T1D control and that ADHD may be underdiagnosed in the Polish population. The International Society for Pediatric and Adolescent Diabetes recommends neurodevelopmental assessments in children with T1D, but specific guidelines on procedures and implementation are lacking.
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