Internal herniation through the broad ligament is extremely rare. We report a case in which radiologic examinations including computed tomography (CT) were performed. A strangulated loop in the Douglas fossa was well-demonstrated by CT. CT can provide some clues to the diagnosis of this condition.
BackgroundIt remains unclear whether a relationship exists between elevated C‐reactive protein (CRP) levels and delirium. The primary aim was to investigate the relationship between CRP and delirium in advanced cancer.MethodsThis study was a multicenter prospective cohort study conducted in palliative care units. At baseline, the physicians diagnosed delirium. On the seventh day, they evaluated whether new delirium had occurred. Subjects were divided into four groups according to CRP levels. We assessed the associations between CRP levels and proportions of delirium. To evaluate the relationship between CRP and delirium, adjusted odd ratios (ORs) and 95% confidence intervals (CIs) were calculated in the logistic models.ResultsAmong 1896 patients, 1354 patients were eligible for analyses. We classified them into four groups: low (CRP < 1 mg/dl) (n = 170), moderate (1 ≤ CRP < 5 mg/dl) (n = 453), high (5 ≤ CRP < 10 mg/dl) (n = 334), and very high (10 mg/dl ≤ CRP) (n = 397). The incidence of delirium significantly increased with increasing CRP levels (P = 0.02). In model 1, significantly higher adjusted ORs than in the low CRP group were observed in the high CRP and very high CRP groups (1.63 [95% CI 1.06–2.50], P = 0.03; 1.72 [95% CI 1.13–2.62], P = 0.01, respectively). In model 2, a significantly higher adjusted OR than in the low CRP group was observed in the very high CRP group (1.61 [95% CI 1.05–2.45], P = 0.03).ConclusionsRelationships existed between elevated CRP levels and delirium.
Background & Aims: The prevalence of artificially administered nutrition and hydration (AANH) in different age groups among patients with advanced cancer remains unknown. The present study investigated the current utilization of AANH according to age groups in palliative care units. Methods: This was a secondary analysis of a prospective cohort study. We obtained information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate or total calorie intake on the 7th day of admission. Patients were divided into five age groups ( 18e39, 40e59, 60e74, 75e89, and 90-years). Among patients receiving AANH, the proportions of higher-calorie AANH were compared between the five age groups. Results: A total of 1453 patients were included. The proportion of patients categorized as receiving nutrition and hydration via the parenteral route was the highest in the 18e39 and 40e59 groups (52.4 and 41.1%, respectively). Among patients receiving AANH (n ¼ 534), the proportions of patients categorized into the <25% or <250 kcal/day group were 57.9% in all groups, 18.2% in the 18e39 group, and 50.0e66.4% in the other groups. The proportions of 50% or 500 kcal/day and 25% or 250 kcal/day in each age group significantly decreased with age (p ¼ 0.003 and 0.002, respectively).
Conclusion:The present results revealed large variations in the use of AANH in different age groups and indicate that AANH was more frequently utilized in younger age groups in palliative care units.
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