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Postoperative Craniopharyngioma in a 10-Year-Old Girl Presenting with Central Precocious Puberty, Central Diabetes Insipidus, and Growth Hormone Deficiency 一名 10 岁女孩的颅咽管瘤术后症状:中枢性性早熟、中枢性糖尿病和生长激素缺乏症
Pub Date : 2023-12-15 DOI: 10.37275/bsm.v8i3.936
Nyoman Ananda Putri Prashanti, Putu Wahyu Dyatmika Tanaya, I Wayan Bikin Suryawan
Background: Hypopituitarism is the most common endocrinology complication of postoperative craniopharyngioma. However, we found a 10-year-old girl with a history of postoperative craniopharyngioma presenting with central precocious puberty (CPP), central diabetes insipidus (CDI), and growth hormone deficiency (GHD). Case presentation: A 5-year-old girl experienced breast growth followed by menstruation six months later. The patient's weight was 19 kg (weight-for-age: P25-P50), height was 109 cm (height-for-age: P10-P25), and good nutritional status (Waterlow 90%). The stage of pubertal development was M2P2. There was a history of craniopharyngioma, and it was resected at the age of 2 years. After surgery, the patient developed CDI and has received desmopressin. No new tumour growth was found from evaluation with periodic MRIs every three years. After CPP was established, with increased serum levels of LH, FSH, and estradiol, GnRH agonist therapy was given at 100 mcg/kg BW every month. During five years of follow-up, the patient experienced clinical and laboratory improvement. However, the growth is only 3-4 cm/year (
背景:垂体功能减退症是颅咽管瘤术后最常见的内分泌并发症。然而,我们发现一名 10 岁女孩在颅咽管瘤术后出现中枢性性早熟(CPP)、中枢性糖尿病(CDI)和生长激素缺乏(GHD)。病例介绍:一名 5 岁女孩乳房发育,6 个月后月经来潮。患者体重为 19 千克(体重-年龄:P25-P50),身高为 109 厘米(身高-年龄:P10-P25),营养状况良好(Waterlow 90%)。青春发育期为 M2P2。有颅咽管瘤病史,2 岁时切除了颅咽管瘤。手术后,患者出现了 CDI,并接受了去氨加压素治疗。每三年定期进行核磁共振成像评估,没有发现新的肿瘤生长。CPP 确立后,随着血清中 LH、FSH 和雌二醇水平的升高,患者开始接受 GnRH 激动剂治疗,剂量为每月 100 微克/千克体重。在五年的随访中,患者的临床和实验室指标均有所改善。然而,患者的生长速度仅为每年 3-4 厘米(
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引用次数: 0
Strangulated Incisional Hernia Post Appendectomy: A Rare Case Report 阑尾切除术后绞窄性切口疝:罕见病例报告
Pub Date : 2023-12-15 DOI: 10.37275/bsm.v8i3.927
Dewi Rahayu, Hendwell, Hendsun, Frengky Bermana
Background: Incisional hernia is a condition in which internal organs, such as the intestines, protrude through a previous surgical incision or suture. This occurs due to the failure of the abdominal wall to close properly. The closure of the abdominal wall is influenced by patient-related factors and technical factors during surgery. Incisional hernia following appendectomy is a rare condition, with an incidence rate of less than 0.12%. With this case report, the author aims to contribute to the literature on strangulated incisional hernia post-appendectomy. Case presentation: A 42-year-old male presented to the emergency department with complaints of right lower abdominal pain for the past three days. The patient reported a lump that had been intermittently present for the past nine years but became persistent three days ago. The patient had a history of appendectomy nine years ago. Vital signs were relatively stable, and physical examination revealed a bluish mass measuring 10x8x4 cm in the abdomen. Radiological abdominal assessment revealed a high-level obstructive ileus. Subsequently, the patient underwent a laparotomy, and a right hemicolectomy was performed, removing a segment measuring 50 cm from the ileocecal junction to the ascending colon. Conclusion: Incisional hernia following appendectomy is a rare complication, but it can occur due to various risk factors, such as surgical site infection, improper choice of suture material, and inappropriate wound closure technique. The management of this condition can involve the use of tension-free synthetic mesh in either laparotomy or laparoscopy.
背景:切口疝是一种内脏器官(如肠道)通过先前的手术切口或缝合线突出的病症。发生这种情况的原因是腹壁未能正常闭合。腹壁的闭合受患者相关因素和手术中技术因素的影响。阑尾切除术后切口疝是一种罕见情况,发生率低于 0.12%。作者希望通过本病例报告,为有关阑尾切除术后绞窄性切口疝的文献做出贡献。病例介绍:一名 42 岁男性因过去三天右下腹疼痛到急诊科就诊。患者称其腹部有一肿块,过去九年来一直间歇性出现,但三天前变得持续存在。患者九年前曾做过阑尾切除术。生命体征相对稳定,体格检查发现腹部有一个 10x8x4 厘米的淡蓝色肿块。腹部放射学评估显示存在高位梗阻性回肠。随后,患者接受了开腹手术,并进行了右半结肠切除术,切除了从回盲部交界处到升结肠长达 50 厘米的部分。结论阑尾切除术后切口疝是一种罕见的并发症,但它可能因各种风险因素而发生,如手术部位感染、缝合材料选择不当、伤口闭合技术不当等。处理这种情况时,可在开腹手术或腹腔镜手术中使用无张力合成网片。
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引用次数: 0
Antibiotic Management in Bacterial Pneumonia: A Narrative Literature Review 细菌性肺炎的抗生素管理:叙述性文献综述
Pub Date : 2023-12-15 DOI: 10.37275/bsm.v8i3.934
Yusri Herdika, Rohani Lasmaria
Pneumonia is an acute inflammation of the lung parenchyma caused by various types of microorganisms, such as bacteria, viruses, fungi, and parasites. The use of antibiotics is often faced with many types and inappropriate doses, and using antibiotics for too long can increase the risk of bacteria multidrug resistance (MDR). Therefore, the choice and dosage of antibiotics must be appropriate to reduce the rate of bacterial resistance. The increasing incidence of bacterial resistance is an indicator of failure in treating pneumonia because, apart from clinical improvement, optimal eradication of bacteria should also be the goal in every antibiotic administration. The aim of this literature review is to explain the basis for administering and selecting empiric antibiotics for pneumonia infections as well as appropriate antibiotic management and adequate especially in bacterial pneumonia, to provide a better prognosis.
肺炎是由细菌、病毒、真菌和寄生虫等各类微生物引起的肺实质急性炎症。抗生素的使用往往面临种类多、剂量不合适等问题,而且抗生素使用时间过长会增加细菌多药耐药性(MDR)的风险。因此,抗生素的选择和剂量必须适当,以降低细菌耐药率。细菌耐药性发生率的增加是治疗肺炎失败的一个指标,因为除了改善临床症状外,最佳根除细菌也应是每次使用抗生素的目标。本文献综述旨在解释肺炎感染中经验性抗生素的使用和选择依据,以及适当的抗生素管理,尤其是在细菌性肺炎中的适当管理,以提供更好的预后。
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引用次数: 0
Aspergillosis in Lung Cancer: A Narrative Literature Review 肺癌曲霉菌病:叙述性文献综述
Pub Date : 2023-12-15 DOI: 10.37275/bsm.v8i3.935
Pofi Risanti, Yarsy, Sri Melati Munir
Aspergillosis is one of the complications of lung cancer and lung cancer treatment. Diagnosis of Aspergillosis in lung cancer, in general, is still a challenge because clinical symptoms and examination results are not typical, and risk factors often go unnoticed. To simplify the diagnosis of Aspergillosis, several criteria have been created based on the patient's condition, clinical and radiological features, and mycological laboratory examination. Doctors' vigilance still needs to be increased, examination facilities are still limited in certain cities, and diagnostic services have not been integrated, so management is not optimal. This literature review aims to increase doctors' knowledge and awareness regarding aspergillosis in lung cancer, which is an important step to improve the appropriate management of this disease.
曲霉菌病是肺癌和肺癌治疗的并发症之一。一般来说,肺癌曲霉菌病的诊断仍是一项挑战,因为临床症状和检查结果并不典型,而且危险因素往往不被注意。为了简化曲霉菌病的诊断,已经根据患者的病情、临床和放射学特征以及真菌学实验室检查制定了若干标准。医生的警惕性仍有待提高,某些城市的检查设施仍然有限,诊断服务尚未整合,因此管理效果并不理想。本文献综述旨在提高医生对肺癌曲霉菌病的了解和认识,这也是改善该疾病适当治疗的重要一步。
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引用次数: 0
Thoracic Ultrasound: A Narrative Literature Review 胸部超声:叙述性文献综述
Pub Date : 2023-12-14 DOI: 10.37275/bsm.v8i3.933
Atikanur, Indi Esha
Ultrasonography (USG) is useful in diagnosing abnormalities in the thoracic area, such as pleural effusion, pneumothorax, consolidation, atelectasis, pulmonary edema, etc. The advantages of thoracic ultrasound are low cost, non-radiation, non-invasive, easy to carry, short examination time, and a dynamic aspect that can be seen during the examination. Thoracic ultrasound can be used to guide thoracentesis procedures, chest tube placement, and aspiration of lung abscesses. Ultrasound can be substituted as a computed tomography scan (CT-Scan) as a guide for aspiration and biopsy of the lung parenchyma, pleura, and chest wall. Portable and compact ultrasonography provides the opportunity for ultrasound examinations to become a routine part of an examination, like a stethoscope. Ultrasonography also has limitations in patients with subcutaneous emphysema, peripheral edema, and obesity. Ultrasound examination is very dependent on the experience and abilities of the operator.
超声波检查(USG)有助于诊断胸腔部位的异常情况,如胸腔积液、气胸、合并症、肺不张、肺水肿等。胸部超声检查的优点是费用低、无辐射、无创伤、携带方便、检查时间短,而且在检查过程中可以看到动态方面。胸部超声可用于指导胸腔穿刺术、胸导管置入术和肺脓肿抽吸术。超声波可替代计算机断层扫描(CT-Scan)作为肺实质、胸膜和胸壁抽吸和活检的指导。便携式紧凑型超声波检查使超声波检查有机会像听诊器一样成为常规检查的一部分。对于患有皮下气肿、周围水肿和肥胖症的患者,超声波检查也有其局限性。超声检查在很大程度上取决于操作者的经验和能力。
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引用次数: 0
Epidural Anesthesia in Management of Pregnant Eissenmenger’s Syndrome Patient Undergoing Caesarean Section 硬膜外麻醉在管理接受剖腹产手术的艾森曼格综合征孕妇中的应用
Pub Date : 2023-12-14 DOI: 10.37275/bsm.v8i2.932
I. G. N. B. Jayantha Ananda, Tjahya Aryasa, Tjokorda Gde Agung Senapathi
Background: Eisenmenger syndrome is very rare in pregnant women. Debates remain concerning the management of Eisenmenger syndrome in this patient population, and the prognosis is unclear in terms of maternal and fetoneonatal outcomes. Managing anesthesia in maternal patients with a cardiac abnormality might be particularly difficult because these individuals have inadequate circulatory reserves and altered maternal cardiovascular physiology. Case presentation: We present a 26-year-old 34 weeks pregnant woman with Eisenmenger’s syndrome (ES) scheduled for an elective caesarean section. The clinical findings reveal slight tachypnea with peripheral oxygen saturation of 82% with oxygen supplementation using a cannula at 3 lpm. The patient's baseline hemodynamics are stable, but a third-degree murmur is heard in the 3rd and 4th left intercostal space. The patient was managed with epidural anesthesia using bupivacaine 0.5% 20 ml without adjuvant. The epidural catheter was inserted in an interspinous process between L3-L4. The surgery was done in 90 minutes with stable hemodynamics, and postoperatively, the patient was monitored in the intensive cardiac care unit (ICCU). Conclusion: Epidural anesthesia has been shown to provide favorable outcomes due to its slow onset and reducing the likelihood of abrupt hemodynamic changes.
背景介绍艾森曼格综合征在孕妇中非常罕见。关于如何处理艾森曼格综合征患者,目前仍存在争议,而且就孕产妇和胎儿-新生儿的预后而言也不明确。对心脏异常的孕产妇进行麻醉可能尤其困难,因为这些患者的循环储备不足,而且母体的心血管生理结构也发生了改变。病例介绍:我们为您介绍一位 26 岁、怀孕 34 周、患有艾森曼格综合征(ES)的孕妇,她计划进行择期剖腹产手术。临床表现为轻微呼吸困难,外周血氧饱和度为 82%,使用插管以每分钟 3 升的速度补充氧气。患者的基线血流动力学稳定,但在左肋间隙第 3 和第 4 肋间听到三级杂音。医生使用 0.5% 布比卡因 20 毫升(不含辅助剂)对患者进行硬膜外麻醉。硬膜外导管插入 L3-L4 之间的棘突间。手术在 90 分钟内完成,血流动力学稳定,术后患者在心脏重症监护室(ICCU)接受监护。结论硬膜外麻醉起效缓慢,减少了血流动力学突然变化的可能性,因此已被证明能提供良好的治疗效果。
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引用次数: 0
Mixed Type Basal Cell Carcinoma Treated with Excision and Defect Closure Using Advancement Flap: A Case Report 混合型基底细胞癌采用切除术和推进皮瓣缝合术治疗:病例报告
Pub Date : 2023-12-14 DOI: 10.37275/bsm.v8i2.931
I. Gusti, Nyoman Darmaputra, Ketut Kwartantaya Winaya, Adelia Suryani, Herman Saputra, Putu Setiani
Background: Basal cell carcinoma (BCC) is a localized malignant tumor in the basal layer of the epidermis thought to be the result of prolonged sun exposure and associated with gene mutations in most cases. Although rarely metastazises, BCC can cause high levels of morbidity due to its locally destructive nature. There are several modalities for managing BCC, and the defect caused by the lesion can reconstructed by local flap. Case presentation: We present a 55-year-old woman with a chief complaint of a blackish lump on the left maxillary region, growing bigger, and frequent episodes of bleeding. The lesion was excised and followed by histopathological examination, which revealed mixed subtype BCC. Closure of the defect with an advancement flap was performed with favorable results. Conclusion: Surgical excision is the best option for managing BCC, while a skin flap is preferred to close defects for lesions on the cheek.  
背景:基底细胞癌(BCC)是表皮基底层的局部恶性肿瘤,被认为是长期日晒的结果,大多数情况下与基因突变有关。虽然 BCC 很少转移,但由于其局部破坏性,可导致高发病率。治疗 BCC 有多种方法,可通过局部皮瓣重建病变造成的缺损。病例介绍:我们接诊了一名 55 岁的女性患者,主诉是左上颌区域有一个黑色肿块,肿块越来越大,而且经常出血。切除病灶后进行组织病理学检查,结果显示为混合亚型 BCC。用推进皮瓣进行了缺损缝合,效果良好。结论手术切除是治疗 BCC 的最佳选择,而皮瓣则是关闭面颊部病变缺损的首选。
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引用次数: 0
Tuberculosis with Drug-Induced Hepatitis: A Narrative Literature Review 结核病合并药物性肝炎:文献综述
Pub Date : 2023-12-13 DOI: 10.37275/bsm.v8i2.929
Riska Yuliana, Zarfiardy Aksa, Fauzi, Article Info
Tuberculosis (TB) is an infectious disease that is a global health problem. The problem is that 5-28% of patients receiving tuberculosis treatment suffer from drug-induced hepatitis on antituberculosis drugs (OAT). The clinical picture should be differentiated from other liver diseases. The level of symptoms varies from asymptomatic to symptomatic, such as nausea, vomiting, abdominal pain, jaundice, hepatomegaly, and increased liver function. OAT use is stopped if clinical symptoms are found and ALT/AST increases ≥3 times, or if there are no symptoms but there is an increase in bilirubin ≥2 mg/dl or ALT/AST values ≥5 times without clinical symptoms. The use of OAT can be continued, but with supervision, if there are no clinical symptoms and the increase in ALT/AST is <2 times and the bilirubin value is <2 mg/dl. Treatment can be carried out again by reintroducing OATs one by one according to ATS recommendations.
结核病(TB)是一种传染性疾病,是一个全球性的健康问题。问题在于,5%-28% 接受结核病治疗的患者在服用抗结核药物(OAT)时会患上药物性肝炎。临床表现应与其他肝病相鉴别。症状程度从无症状到有症状不等,如恶心、呕吐、腹痛、黄疸、肝肿大和肝功能增高。如果发现临床症状且 ALT/AST 升高≥3 倍,或无症状但胆红素升高≥2 mg/dl 或 ALT/AST 值≥5 倍而无临床症状,则应停止使用 OAT。如果没有临床症状,ALT/AST 升高<2 倍,胆红素值<2 mg/dl,则可以继续使用 OAT,但要有监护。可根据 ATS 的建议,通过逐次重新引入 OAT 再次进行治疗。
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引用次数: 0
Flexi-rigid Pleuroscopy in Diagnostics of Malignancy: A Narrative Literature Review 诊断恶性肿瘤的柔性硬膜外腔检查:文献综述
Pub Date : 2023-12-12 DOI: 10.37275/bsm.v8i2.925
Salmiyah, Indra Yovi, Article Info
Pleuroscopy is a less invasive treatment that allows access to the pleural cavity with the use of both visual and surgical equipment. This technique can be conducted with local anesthesia and mild sedation. Pleuroscopy is a medical procedure used for both diagnosis and treatment in the pleural cavity. Pleuroscopy enables direct observation of the pleural surface, enhancing the safety of procedures such as pleural biopsy, pleural fluid drainage, and pleurodesis. One purpose is to assist in verifying the diagnosis of cancer. This review was aimed to describe the use of flexi-rigid pleuroscopy in malignancy.
胸腔镜检查是一种创伤较小的治疗方法,可通过视觉和手术设备进入胸膜腔。这项技术可在局部麻醉和轻度镇静的情况下进行。胸腔镜检查是一种用于胸膜腔诊断和治疗的医疗程序。胸腔镜可直接观察胸膜表面,提高胸膜活检、胸腔积液引流和胸膜穿刺术等手术的安全性。其目的之一是协助核实癌症诊断。这篇综述旨在描述柔性胸腔镜在恶性肿瘤中的应用。
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引用次数: 0
Pathogenesis and Minimally Invasive Management of Subcutaneous Emphysema: A Narrative Literature Review 皮下气肿的发病机制和微创治疗:文献综述
Pub Date : 2023-12-12 DOI: 10.37275/bsm.v8i2.928
Said Tryanda, Syafitra, Sri Indah Indriani, Article Info
Subcutaneous emphysema is the result of air infiltrating the subcutaneous and soft tissues. The prevalence of subcutaneous emphysema varies between 0.43% and 2.34%. Subcutaneous emphysema typically results in mild symptoms, poses no significant risk, and does not necessitate specific medical intervention. Pathologies affecting underlying tissues can exhibit greater severity and pose a risk to life. Subcutaneous emphysema is a challenge in terms of how to handle it. The treatment should initiate a focused endeavor to determine the underlying etiology of subcutaneous air dissection. This literature review focuses on subcutaneous emphysema, specifically exploring its pathogenesis and therapy strategies for people with this condition.
皮下气肿是空气渗入皮下和软组织的结果。皮下气肿的发病率介于 0.43% 和 2.34% 之间。皮下气肿通常症状轻微,不会造成重大风险,也不需要特殊的医疗干预。影响下层组织的病变会表现出更严重的症状,并对生命构成威胁。皮下肺气肿的治疗是一项挑战。治疗时应首先确定皮下气肿的病因。这篇文献综述主要关注皮下气肿,特别是探讨其发病机制和对该病患者的治疗策略。
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引用次数: 0
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Bioscientia Medicina : Journal of Biomedicine and Translational Research
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