Clinical features and prognostic factors in patients with cancer-associated multiple ischemic stroke: A retrospective observational study

ObjectivesTo investigate the patient demographics, survival after diagnosis, and prognostic factors among patients with multiple-territory cerebral infarctions due to cancer-associated ischemic stroke (multiple CAIS).Materials and methodsWe performed a retrospective review of the medical records from a 10-year period of consecutive patients with multiple CAIS, defined as (1) newly developed multiple cerebral infarctions involving two or more cerebrovascular territories, (2) association with active cancer diagnosed or treated <6 months before or after stroke, and (3) exclusion of obvious etiologies other than cancer-associated coagulopathy in routine screening. We extracted demographic features, stroke severity and characteristics, cancer characteristics, comorbidities, and laboratory data. Univariable Cox proportional hazards regression was used to idenify the prognostic factors.ResultsThe median age was 74 years (interquartile range, 68.3–80.5), and the median survival after diagnosis was 44.5 (27.3–76.8) days in 26 patients with complete follow-up. The median National Institutes of Health Stroke Scale was 5.5 (2.0–9.0). Twenty (76.9%) patients had received a cancer diagnosis prior to the diagnosis of multiple CAIS, and most patients (25 patients, 96.2%) had stage IV cancer. Univariate analysis showed that high serum albumin (hazard ratio, 0.31; 95% confidence interval, 0.11–0.88) was significantly associated with prolonged survival, whereas stroke severity and comorbidities were not associated with survival.ConclusionMultiple CAIS predominantly occurred in elderly patients with advanced cancer, and their survival was short. Serum albumin levels were significantly associated with prognosis, indicating the poor general condition associated with cancers may affect prognosis.     

Low-molecular-weight heparin followed by rivaroxaban for acute occlusive portomesenteric vein thrombosis in a cirrhotic patient treated with multiple endoscopic variceal procedures

Acute portomesenteric vein thrombosis is potentially lethal. In the present paper, a cirrhotic patient with a previous history of esophageal variceal bleeding presented with acute occlusive portomesenteric vein thrombosis, but achieved complete recanalization by low-molecular-weight heparin followed by rivaroxaban. Notably, no bleeding episode occurred during anticoagulation therapy. This case supported early initiation of anticoagulation in such patients.     

基于数据挖掘的深静脉血栓形成动物模型建立与分析

目的 探讨深静脉血栓形成（deep venous thrombosis，DVT）动物模型建立的要素，提高造模成功率，为深静脉血栓形成的研究提供规范化的动物模型。方法 以中国知网、万方数据库、维普数据库、PubMed数据库收录的期刊文献为资料来源，以动物模型的应用、实验动物种类、造模的方法、检测指标为分类依据建立数据库，使用SPSS Modeler 18.0、SPSS Statistics 22.0软件对导入的数据进行关联规则分析和因子分析。结果 对纳入的246篇符合标准的文献数据进行分析，造模主要用于DVT机制研究，实验动物使用雄性C57BL/6小鼠最多，通常运用下腔静脉结扎法造模，检测最多的指标为血栓质量/长度。通过关联规则及因子分析得出4组关联强度高的检测指标，并提取10个公因子。结论 结合现代信息技术，将实验动物模型的关键指标数据进行更深层次的整合与分析，有助于建立更加科学、标准化的动物模型，对进一步探究DVT的发病机制及治疗方法具有重要意义。     

Inferior vena cava syndrome in neonates: An evidence‐based systematic review of the literature

Neonatal inferior vena cava syndrome (IVCS), though uncommon, is associated with significant morbidity and mortality. Information on risk factors, diagnosis, treatment, and outcomes is limited. This review comprised 61 neonates across 33 reports. Thrombosis occurred in 98% and 42% involved a central venous catheter. Diagnosis was mainly established by ultrasound in 82%. Therapeutically, heparin was employed in 36% and thrombolysis in 18% of the cases. The overall mortality was 23%. An algorithm of clinical signs, investigation, and management is presented. Well‐designed prospective studies are needed to establish a concrete investigational approach to neonatal IVCS and institute safe, evidence‐based treatment.     

Imaging of COVID-19: An update of current evidences

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been reported as a global emergency. As respiratory dysfunction is a major clinical presentation of COVID-19, chest computed tomography (CT) plays a central role in the diagnosis and management of patients with COVID-19. Recent advances in imaging approaches using artificial intelligence have been essential as a quantification and diagnostic tool to differentiate COVID-19 from other respiratory infectious diseases. Furthermore, cardiovascular involvement in patients with COVID-19 is not negligible and may result in rapid worsening of the disease and sudden death. Cardiac magnetic resonance imaging can accurately depict myocardial involvement in SARS-CoV-2 infection. This review summarizes the role of the radiology department in the management and the diagnosis of COVID-19, with a special emphasis on ultra-high-resolution CT findings, cardiovascular complications and the potential of artificial intelligence.