Association between postoperative hypoalbuminemia and postoperative pulmonary imaging abnormalities patients undergoing craniotomy for brain tumors: a retrospective cohort study

Hypoalbuminemia is associated with poor outcome in patients undergoing surgery intervention. The main aim for this study was to investigate the incidence and the risk factors of postoperative hypoalbuminemia and assessed the impact of postoperative hypoalbuminemia on complications in patients undergoing brain tumor surgery. This retrospective study included 372 consecutive patients who underwent brain tumors surgery from January 2017 to December 2019. The patients were divided into hypoalbuminemia (< 35 g/L) and non-hypoalbuminemia group (≥ 35 g/L) based on postoperative albumin levels. Logistic regression analyses were used to determine risk factors. Of the total 372 patients, 333 (89.5%) developed hypoalbuminemia after surgery. Hypoalbuminemia was associated with operation time (OR 1.011, P < 0.001), preoperative albumin (OR 0.864, P = 0.015) and peroperative globulin (OR 1.192, P = 0.004). Postoperative pulmonary imaging abnormalities had a higher incidence in patients with than without hypoalbuminemia (41.1% vs 23.1%, P = 0.029). The independent predictors of postoperative pulmonary imaging abnormalities were age (OR 1.053, P < 0.001), operation time (OR 1.003, P = 0.013) and lower postoperative albumin (OR 0.946, P = 0.018). Pulmonary imaging abnormalities [OR 19.862 (95% CI 2.546–154.936, P = 0.004)] was a novel independent predictors of postoperative pneumonia. Postoperative hypoalbuminemia has a higher incidence with the increase of operation time, and may be associated with postoperative complications in patients undergoing brain tumor surgery.

Association of Mycoplasma pneumoniae coinfection with adenovirus pneumonia severity in children

Between the winter of 2018 and the end of 2019, there has been an epidemic of adenovirus infection in southern China, including Zhejiang Province. The number of children suffering from adenovirus pneumonia (AP) has significantly increased. AP can be accompanied by Mycoplasma pneumoniae in children. This study aimed to investigate the association of M. pneumoniae and identify the risk factors for coinfection on hospitalized patients with AP. The patients were classified into two groups by etiologic analysis (single AP and AP with M. pneumoniae coinfection groups). The clinical manifestations, clinical medication, and laboratory and imaging findings of the two groups were compared and analyzed. The coinfection group (n = 125) had a significantly longer duration of fever than the single AP group (n = 171; P = 0.03). Shortness of breath (P = 0.023) and pulmonary imaging findings, such as pulmonary consolidation, atelectasis, pleural effusion, and multilobe lesions (P < 0.05), were more common in the coinfection group. The patients with coinfection had more severe symptoms, significantly longer hospitalization time and an increased proportion of using glucocorticoids and/or immunoglobulin needing oxygen inhalation (P < 0.05). The incidence of AP with M. pneumoniae coinfection is high. The prolonged fever duration and pulmonary imaging findings could be used as prediction factors to predict M. pneumoniae coinfection in children with AP. Patients with AP coinfected with MP may easily develop severe illness. Hence, a reasonable change in the treatment is necessary.

Abdominal and pelvic imaging findings in COVID-19

Pulmonary imaging findings of Coronavirus disease 2019 (COVID-19) has been widely described, but recently few studies have been published about abdominal and pelvic radiological presentation. The aim of this study was to provide an overview of abdominal imaging findings in patients with COVID-19. After investigation of recent published literature we came to conclusion that most common findings are associated with gastrointestinal abnormalities with mural thickening of part of gastrointestinal tract being the most common, followed by vascular and less frequently described solid organ and gallbladder abnormalities. It is important to be familiar with abdominal COVID-19 manifestations, since they’re often implicated with the development of poor clinical outcomes.

Impact of Mycoplasma pneumoniae coinfection in children with adenovirus pneumonia

Background Since the winter of 2018 to the end of 2019, there has been an epidemic of Adenovirus infection in southern China, including Zhejiang province, and the number of children suffering from adenovirus pneumonia has increased significantly. Adenovirus pneumonia is often accompanied by other infections in children[3,4], but the effect of other Pathogenic coinfection on the AP has been reported few. Mycoplasma pneumoniae is also an important pathogen of community-acquired pneumonia, accounting for 20-40% of children's CAP[5]. As we know the Impact of Mycoplasma pneumoniae coinfection in children with adenovirus pneumonia, which has drawn the attention of the society and the Paediatrician now has not been reported before. This study aimed to investigate the impacts of MP coinfection on hospitalized AP patients, to identify the risk factors for those patients. Methods Nasopharyngeal swabs (NPSs) or sputum specimens for Culturing were collected from patients once they were admitted to our hospital. ADV-Ag, MP-IgM and MP nucleic acid was tested at the same time, then we classify under two groups(single AP groups and AP groups coinfected with MP) . The clinical manifestations, laboratory and imaging findings and clinical medication of the two groups were compared and analyzed.Results A total of 171 patients diagnosed with single AP and 125 patients diagnosed with AP coinfected with MP. Coinfection group lead to a significantly longer duration of fever than single AP group(p=0.03). Shortness of breath was more commonly found in the coinfection group(P = 0.023).there was no statistical difference in pulmonary signs and blood tests between the two groups (P > 0.05). pulmonary imaging, such as pulmonary consolidation, atelectasis, pleural effusion and multi lobe lesions were more common in the coinfection group (P < 0.05). The patients with coinfection had a more severe symptom, leading to a significantly longer hospitalization time, and increasing the proportion of patients using glucocorticoids and / or gamma globulin, needing oxygen inhalation(P < 0.05). Conclusions The occurrence of adenovirus pneumonia coinfected MP is high. prediction factors of prolonged fever duration and pulmonary imaging can be used to predict MP coinfection in children with adenovirus pneumonia. AP patients coinfected MP may easily turn into severe illness, and a reasonable change in treatment is necessary.

An unusual case of aggressive malignant spread of epithelioid hemangioendothelioma

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm which typically originates from liver, lung, or bone. Due to the low incidence of disease, the most effective treatment is not easily studied and much of the information known about EHE has been learned through case reports and case series. In this case, we will present an uncommon form of primary soft tissue EHE with local recurrence, bone metastasis, and lymphangitic spread to the lungs leading to respiratory failure. Imaging of the chest was atypical for EHE with intraseptal thickening and hilar lymphadenopathy. Respiratory failure was progressive despite aggressive multimodal treatment. This case highlights an unusually aggressive recurrence and metastasis of primary soft tissue EHE with atypical pulmonary imaging findings.