World Journal of Clinical Cases最新文献

Background: At present, China has become the country with the largest number of individuals with diabetes mellitus (DM) in the world, with a total of approximately 140 million patients, the majority of whom have type 2 DM (T2DM). Based on conventional nursing methods, community home care has important clinical significance in controlling blood sugar and disease progression.

Aim: To explore the impact of community public health nursing on treatment effect, health cognition, and self-management in patients with T2DM.

Methods: One hundred patients with T2DM were selected as the research subjects. The patients were divided into either a conventional nursing group or community nursing (CN) group using the random number table method. The conventional nursing group (50 cases) received routine care, while the CN group (50 cases) received community public health care in addition to routine care as that for the conventional nursing group. The rate of excellent and good blood glucose control, fasting blood glucose before and after care, 2-h postprandial blood glucose, health cognition, and self-management ability, and patient satisfaction were compared between the two groups.

Results: The CN group had a higher rate of excellent blood sugar control than the conventional nursing group (88% vs 70%, P < 0.05). Before care, there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients (P > 0.05). After nursing, fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups, and both blood glucose levels in the CN group were lower than those of the conventional nursing group (P < 0.05). Compared with the scores before care, the cognitive level score for diabetes and self-management ability score improved after care in both groups. The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group (P < 0.05). The overall satisfaction of the CN group was better than that of the conventional nursing group (98% vs 86%, P < 0.05).

Conclusion: Community public health care based on conventional care of T2DM can achieve better blood sugar control, and improve patients' health cognitive level and self-management ability.

Background: Congenital cytomegalovirus (CMV) infection represents a significant public health concern as the most prevalent viral infection in newborns, potentially leading to severe neurological and developmental complications. The majority of cases are asymptomatic and remain undetected during pregnancy due to the absence of effective screening methods.

Case summary: A 27-year-old primigravida presented for early pregnancy ultrasound, which revealed an atypical finding: A normal anechoic thalamus appearing hyperechoic on the mid-sagittal view of the fetal head. Subsequent ultrasound examinations during mid and late gestation demonstrated classic intracranial features suggestive of congenital CMV infection. Chromosomal karyotyping and microarray analysis of the fetus yielded no significant abnormalities. Following comprehensive prenatal counseling regarding potential adverse fetal outcomes, the patient elected to continue her pregnancy. She ultimately underwent cesarean delivery at 42 weeks gestation at another facility, resulting in the birth of a female neonate. At five months of age, the infant presented with epilepsy and significant growth and developmental delays.

Conclusion: Congenital CMV infection occurs during the first trimester may manifest as hyperechoic thalamus which can be revealed by ultrasound in the mid-saggital view of the fetal head. Future research should investigate the correlation between echogenic thalamus and developmental outcomes, as well as explore early screening techniques for suspected congenital CMV infection cases.

Background: Fungal balls within the nasal cavity are an exceedingly rare clinical entity, typically presenting with nonspecific symptoms or being identified incidentally.

Case summary: This report presents an incidental discovery of a fungal ball in the nasal cavity during routine imaging, with no associated clinical symptoms.

Conclusion: This case underscores the importance of considering the possibility of asymptomatic presentations of nasal fungal balls, which may be detected incidentally during imaging evaluations.

The article "Secondary diabetes due to different etiologies: Four case reports" by Song et al, published in the World Journal of Clinical Cases, delves into the identification of rare causes of secondary diabetes and emphasizes the necessity for healthcare professionals to recognize these conditions. Failure to do so can result in treatment delays and compromised patient outcomes. The article discusses specific types of diabetes, including maturity onset of diabetes in young, pancreas-related diseases, endocrinopathies, drug-induced diabetes, infections, and congenital genetic syndromes associated with diabetes mellitus. Case summaries highlight how patients with secondary diabetes, stemming from conditions such as Williams-Beuren syndrome and pituitary adenoma, often exhibit distinct characteristics overlooked in clinical practice. The authors stress the importance of a holistic diagnostic approach and advocate for proactive management through early intervention, including genetic tests and antibody detection. Increased awareness and education are crucial for timely identification and proper management, ultimately improving patient well-being. These findings prompt a call to action for healthcare professionals to consider rare causes of secondary diabetes, facilitating better glycemic control and overall patient care.

Background: The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects, especially those caused by infection. Here, we report a case of chronic osteomyelitis of the radius associated with a 9 cm bone defect, which was filled with a large allogeneic cortical bone graft from a bone bank. Complete bony union was achieved after 14 months of follow-up. Previous studies have used autogenous bone as the primary bone source for the Masquelet technique; in our case, the exclusive use of allografts is as successful as the use of autologous bone grafts. With the advent of bone banks, it is possible to obtain an unlimited amount of allograft, and the Masquelet technique may be further improved based on this new way of bone grafting.

Case summary: In this study, we reported a case of repair of a long bone defect in a 40-year-old male patient, which was characterized by the utilization of allograft cortical bone combined with the Masquelet technique for the treatment of the patient's long bone defect in the forearm. The patient's results of functional recovery of the forearm were surprising, which further deepens the scope of application of Masquelet technique and helps to strengthen the efficacy of Masquelet technique in the treatment of long bones indeed.

Conclusion: Allograft cortical bone combined with the Masquelet technique provides a new method of treatment to large bone defect.

Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen that causes community-acquired pneumonia in children. The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases. Complications may occur, such as necrotizing pneumonia and respiratory failure. Extrapulmonary complications, including encephalitis, myocarditis, nephritis, hepatitis, or even multiple organ failure, can also arise. In this editorial, we discuss the clinical implications of the significant findings from the article "Serum inflammatory markers in children with M. pneumoniae pneumonia and their predictive value for mycoplasma severity" published by Wang et al. They reported that measuring lactic dehydrogenase, interleukin-6 levels, and D-dimer effectively predicts refractory M. pneumoniae pneumonia cases.

Renal anastomotic hemangioma (AH) is a rare, benign vascular tumor with unique histopathological features, a disease that is clinically rare, and existing clinical cases offer different treatment options. As reported in the text, this is a very unusual case of renal AH with AH secondary to residual renal tissue after renal clear cell carcinoma, describing a rare renal AH and a history of renal clear cell carcinoma, including ultrasound, computed tomography and magnetic resonance imaging. However, the available imaging data and the literature do not provide an effective basis for the diagnosis of the disease, raising the lack of understanding and misdiagnosis, where the patient eventually underwent nephrectomy, but the author is not the most appropriate surgical treatment. The postoperative pathological results of the patient are benign lesions, and it is undeniable that nephrectomy is suspected to be overtreated. By reading the literature, we provide different insights into the treatment of the patient, and we hope that this paper can provide some help for the future clinical diagnosis and treatment.

Oral cancer is one of the malignant neoplasms that present major global health challenge. It is the sixth most prevalent type of cancer in the world, with a high incidence and mortality rate. This letter is a review of the study by Yin et al which was published in the World Journal of Clinical Cases (2024). The study evaluated the effect of Tongluo Jiedu as an adjuvant treatment for oral cancer. Over the years, there has been a continuous search for effective and less invasive treatments for oral cancer. This article emphasizes and discusses various therapeutic options currently available, and it highlights that early intervention and multidisciplinary management are crucial for improving outcomes. Traditional Chinese medicine, particularly Tongluo Jiedu, presents potential complementary approach to conventional oral cancer therapies. Future research on Tongluo Jiedu should be focused on validation of its efficacy and safety through large, well-designed clinical trials, as well as better understanding of the molecular mechanisms involved, and optimization of therapeutic combinations. Additionally, continuous education of health professionals is key to the effective and safe integration of this traditional medicine into clinical practice. Continuous research is essential for optimization of therapeutic strategies and for addressing the challenges presented by this neoplasm.

Diabetic retinopathy (DR) remains a leading cause of vision impairment and blindness among individuals with diabetes, necessitating innovative approaches to screening and management. This editorial explores the transformative potential of artificial intelligence (AI) and machine learning (ML) in revolutionizing DR care. AI and ML technologies have demonstrated remarkable advancements in enhancing the accuracy, efficiency, and accessibility of DR screening, helping to overcome barriers to early detection. These technologies leverage vast datasets to identify patterns and predict disease progression with unprecedented precision, enabling clinicians to make more informed decisions. Furthermore, AI-driven solutions hold promise in personalizing management strategies for DR, incorporating predictive analytics to tailor interventions and optimize treatment pathways. By automating routine tasks, AI can reduce the burden on healthcare providers, allowing for a more focused allocation of resources towards complex patient care. This review aims to evaluate the current advancements and applications of AI and ML in DR screening, and to discuss the potential of these technologies in developing personalized management strategies, ultimately aiming to improve patient outcomes and reduce the global burden of DR. The integration of AI and ML in DR care represents a paradigm shift, offering a glimpse into the future of ophthalmic healthcare.