The pathogenesis and course of recombinant Corona Virus Disease 2019 vaccine (CHO cell) associated uveitis is rarely seen in clinical practice, thus, it is difficult and time-consuming to diagnose. An adult female patient suffered from binocular visual impairment after receiving the Corona Virus Disease 2019 vaccine. The patient was healthy and had no family history of retinal dystrophy previously. This case showed the following features in multimodal imaging including scattered speckled fluorescein leakage was seen around the optic disc, and the leakage was slightly enhanced in the later stage. The macular area showed about 4 papillary diameter size discoid retinal detachment area fluorescein pool staining. Optical coherence tomography showed retinal choroidal folds above the optic disc, a small amount of fluid under the neuroepithelial layer, and serous detachment of the neuroepithelial layer in the macular area. Posterior uveitis of both eyes. Orally Maizhiling, Ginkgo biloba leaves, and multivitamins. After treatment, the symptoms of the patient were significantly improved, and optical coherence tomography reexamination showed exudation had been absorbed. The injection of a novel coronavirus-inactivated vaccine (CHO cell) can lead to potential uveitis disorders, which is worthy of clinical attention, but the prognosis of patients is good.
{"title":"A case of uveitis associated with novel corona-virus inactivated vaccine engineered CHO cells: A case report","authors":"Caihui Liu, Bozhou Zhang, Tong Bao, Nyasha Grace Mudoti, Yihan Liu, Xiaoguang Zhang, Yajun Yang, Yunlei Pang","doi":"10.1097/md9.0000000000000318","DOIUrl":"https://doi.org/10.1097/md9.0000000000000318","url":null,"abstract":"\u0000 \u0000 The pathogenesis and course of recombinant Corona Virus Disease 2019 vaccine (CHO cell) associated uveitis is rarely seen in clinical practice, thus, it is difficult and time-consuming to diagnose.\u0000 \u0000 \u0000 \u0000 An adult female patient suffered from binocular visual impairment after receiving the Corona Virus Disease 2019 vaccine. The patient was healthy and had no family history of retinal dystrophy previously. This case showed the following features in multimodal imaging including scattered speckled fluorescein leakage was seen around the optic disc, and the leakage was slightly enhanced in the later stage. The macular area showed about 4 papillary diameter size discoid retinal detachment area fluorescein pool staining. Optical coherence tomography showed retinal choroidal folds above the optic disc, a small amount of fluid under the neuroepithelial layer, and serous detachment of the neuroepithelial layer in the macular area.\u0000 \u0000 \u0000 \u0000 Posterior uveitis of both eyes.\u0000 \u0000 \u0000 \u0000 Orally Maizhiling, Ginkgo biloba leaves, and multivitamins.\u0000 \u0000 \u0000 \u0000 After treatment, the symptoms of the patient were significantly improved, and optical coherence tomography reexamination showed exudation had been absorbed.\u0000 \u0000 \u0000 \u0000 The injection of a novel coronavirus-inactivated vaccine (CHO cell) can lead to potential uveitis disorders, which is worthy of clinical attention, but the prognosis of patients is good.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1097/md9.0000000000000317
R. Kawachi, Hiyo Obikane, Daisuke Satoh, Mie Shimamura, T. Nagao, Shinobu Masuda, Hiroyuki Sakurai
Hyalinizing clear cell carcinoma (HCCC) of the bronchus is extremely rare. In addition, its rarity makes an accurate histological diagnosis difficult. Herein, we report a case of HCCC in the left main bronchus diagnosed by the detection of Ewing sarcoma breakpoint region 1::activating transcription factor 1 (EWSR1::ATF1) fusion transcript using reverse transcription-polymerase chain reaction (RT-PCR). A 56-year-old woman presented with a tumor obstructing the left main bronchus on physical examination computed tomography. A bronchoscopic biopsy confirmed a malignant tumor but did not provide a definitive diagnosis. Sleeve resection of the left main bronchus was performed. The intraoperative frozen section was negative for cancer in both the proximal and distal bronchial stumps. General immunohistochemical staining was performed, and mucoepidermoid carcinoma and HCCC were suspected. RT-PCR revealed positive results for EWSR1::ATF1 fusion transcript, and the tumor was finally diagnosed as HCCC. The patient was discharged without any postoperative complications. Sixty-five months have passed since surgery, and no cancer recurrence has been observed. Although hematoxylin and eosin staining and immunostaining alone were not sufficient to distinguish HCCC from mucoepidermoid carcinoma and other malignant tumors, adding genetic testing for EWSR1 rearrangement led to a definitive pathological diagnosis.
{"title":"Hyalinizing clear cell carcinoma of the left main bronchus diagnosed with Ewing sarcoma breakpoint region 1::activating transcription factor 1 fusion: A case report","authors":"R. Kawachi, Hiyo Obikane, Daisuke Satoh, Mie Shimamura, T. Nagao, Shinobu Masuda, Hiroyuki Sakurai","doi":"10.1097/md9.0000000000000317","DOIUrl":"https://doi.org/10.1097/md9.0000000000000317","url":null,"abstract":"\u0000 \u0000 Hyalinizing clear cell carcinoma (HCCC) of the bronchus is extremely rare. In addition, its rarity makes an accurate histological diagnosis difficult. Herein, we report a case of HCCC in the left main bronchus diagnosed by the detection of Ewing sarcoma breakpoint region 1::activating transcription factor 1 (EWSR1::ATF1) fusion transcript using reverse transcription-polymerase chain reaction (RT-PCR).\u0000 \u0000 \u0000 \u0000 A 56-year-old woman presented with a tumor obstructing the left main bronchus on physical examination computed tomography. A bronchoscopic biopsy confirmed a malignant tumor but did not provide a definitive diagnosis.\u0000 \u0000 \u0000 \u0000 Sleeve resection of the left main bronchus was performed. The intraoperative frozen section was negative for cancer in both the proximal and distal bronchial stumps.\u0000 \u0000 \u0000 \u0000 General immunohistochemical staining was performed, and mucoepidermoid carcinoma and HCCC were suspected. RT-PCR revealed positive results for EWSR1::ATF1 fusion transcript, and the tumor was finally diagnosed as HCCC.\u0000 \u0000 \u0000 \u0000 The patient was discharged without any postoperative complications. Sixty-five months have passed since surgery, and no cancer recurrence has been observed.\u0000 \u0000 \u0000 \u0000 Although hematoxylin and eosin staining and immunostaining alone were not sufficient to distinguish HCCC from mucoepidermoid carcinoma and other malignant tumors, adding genetic testing for EWSR1 rearrangement led to a definitive pathological diagnosis.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1097/md9.0000000000000319
Siao-Rong Chen, Chuen-Bin Jiang
Splenic abscess is rarely discovered during the toddler period. Although most of the cases are typically marked by fever, abdominal pain, and vomiting, some of them may suffer life-threatening situations. This study aimed to explore how early detection can prevent serious disease complications. A 2-year-old child with persisted fever and shortness of breathing was admitted. Physical examination was decreasing breathing sound on the left side. We gave empirical antibiotics use with chest tube drainage for 2 days in vain. No fever dropping and persistent left upper abdominal pain were noted. A huge mass was found on left spleen incidentally during abdominal ultrasound screen. Huge splenic abscess. High-resolution ultrasound and abdominal computer tomogram were conducted to confirm the diagnosis. Percutaneous drainage under computer tomography-guided with antibiotic use was smoothly. No obvious adverse effects were noted during the treatment course. Rapid clinical improvement with decreasing size was observed by ultrasound 10 days after the treatment and fever subsided. A period of 3-month follow-up revealed no evidence of recurrence of abscess. Early diagnosis and intervention are mandatory for splenic abscess to prevent possible ominous consequences. The case study has shown that computer tomography-guided percutaneous drainage, along with appropriate antibiotic therapy, can significantly impact solitary unilocular splenic abscesses, even if they are large. This approach demonstrates the potential to effectively manage splenic abscesses and avoid the need for more invasive procedures such as splenectomy.
{"title":"Splenic abscess presenting as pneumonia with pleural effusion initially: A rare case in a 2-year-old girl: A case report","authors":"Siao-Rong Chen, Chuen-Bin Jiang","doi":"10.1097/md9.0000000000000319","DOIUrl":"https://doi.org/10.1097/md9.0000000000000319","url":null,"abstract":"\u0000 \u0000 Splenic abscess is rarely discovered during the toddler period. Although most of the cases are typically marked by fever, abdominal pain, and vomiting, some of them may suffer life-threatening situations. This study aimed to explore how early detection can prevent serious disease complications.\u0000 \u0000 \u0000 \u0000 A 2-year-old child with persisted fever and shortness of breathing was admitted. Physical examination was decreasing breathing sound on the left side. We gave empirical antibiotics use with chest tube drainage for 2 days in vain. No fever dropping and persistent left upper abdominal pain were noted. A huge mass was found on left spleen incidentally during abdominal ultrasound screen.\u0000 \u0000 \u0000 \u0000 Huge splenic abscess.\u0000 \u0000 \u0000 \u0000 High-resolution ultrasound and abdominal computer tomogram were conducted to confirm the diagnosis. Percutaneous drainage under computer tomography-guided with antibiotic use was smoothly. No obvious adverse effects were noted during the treatment course. Rapid clinical improvement with decreasing size was observed by ultrasound 10 days after the treatment and fever subsided.\u0000 \u0000 \u0000 \u0000 A period of 3-month follow-up revealed no evidence of recurrence of abscess.\u0000 \u0000 \u0000 \u0000 Early diagnosis and intervention are mandatory for splenic abscess to prevent possible ominous consequences. The case study has shown that computer tomography-guided percutaneous drainage, along with appropriate antibiotic therapy, can significantly impact solitary unilocular splenic abscesses, even if they are large. This approach demonstrates the potential to effectively manage splenic abscesses and avoid the need for more invasive procedures such as splenectomy.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1097/md9.0000000000000323
Jared Cappelli, Amber Edwards, Jonathan Emling
Gestational trophoblastic neoplasms are rare and include multiple different types of tumors such as hydatidiform moles, placental site trophoblastic tumors, and choriocarcinoma. Metastatic choriocarcinoma is well described with an excellent prognosis when treated appropriately with chemotherapy. The most common location for metastatic disease is the lungs which can unfortunately lead to severe acute respiratory distress syndrome (ARDS) in the most severe cases. Metastatic cancer has historically been a contraindication for the use of extracorporeal life support (including extracorporeal membrane oxygenation or extracorporeal membrane oxygenation [ECMO]). With advancing technology and medicine, this contraindication has been called into question. Prior case reports describe the use of ECMO in complicated cases of metastatic cancer and even choriocarcinoma with lung metastasis and refractory ARDS. We describe a case in which a patient with choriocarcinoma in viable pregnancy developed lung metastasis and ARDS. The patient was managed with venovenous ECMO successfully. The patient was cannulated for VV-ECMO for 14 days with subsequent full pulmonary recovery. The purpose of this work is to help providers understand the broad utility of ECMO and the need to assess candidacy for this therapy on a case by case basis, even in the setting of metastatic cancer.
{"title":"Venovenous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in metastatic choriocarcinoma during systemic chemotherapy: Case report","authors":"Jared Cappelli, Amber Edwards, Jonathan Emling","doi":"10.1097/md9.0000000000000323","DOIUrl":"https://doi.org/10.1097/md9.0000000000000323","url":null,"abstract":"\u0000 \u0000 Gestational trophoblastic neoplasms are rare and include multiple different types of tumors such as hydatidiform moles, placental site trophoblastic tumors, and choriocarcinoma. Metastatic choriocarcinoma is well described with an excellent prognosis when treated appropriately with chemotherapy. The most common location for metastatic disease is the lungs which can unfortunately lead to severe acute respiratory distress syndrome (ARDS) in the most severe cases.\u0000 \u0000 \u0000 \u0000 Metastatic cancer has historically been a contraindication for the use of extracorporeal life support (including extracorporeal membrane oxygenation or extracorporeal membrane oxygenation [ECMO]). With advancing technology and medicine, this contraindication has been called into question. Prior case reports describe the use of ECMO in complicated cases of metastatic cancer and even choriocarcinoma with lung metastasis and refractory ARDS.\u0000 \u0000 \u0000 \u0000 We describe a case in which a patient with choriocarcinoma in viable pregnancy developed lung metastasis and ARDS.\u0000 \u0000 \u0000 \u0000 The patient was managed with venovenous ECMO successfully.\u0000 \u0000 \u0000 \u0000 The patient was cannulated for VV-ECMO for 14 days with subsequent full pulmonary recovery.\u0000 \u0000 \u0000 \u0000 The purpose of this work is to help providers understand the broad utility of ECMO and the need to assess candidacy for this therapy on a case by case basis, even in the setting of metastatic cancer.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intracerebral hemorrhage (ICH) is ranked as the second leading cause of death worldwide, it is essential to find appropriate complementary treatment to improve the therapeutic effect of ICH. As a traditional Chinese medicine therapy to unclog blood vessels and restore normal blood flow, many clinical studies have preliminarily proved the effectiveness of the method of promoting blood circulation and removing blood stasis (PBCRBS) in treating ICH. However, this method was once recommended to be prohibited in modern medicine. The purpose of this study was to systematically evaluate the efficacy and safety of PBCRBS in the treatment of ICH and to provide an ideal complementary therapy for ICH. All the randomized controlled trials on treating ICH by PBCRBS from Pubmed and CNKI databases from the establishment of the database to August 2023 will be screened. The subject’s data extraction and the risk of bias assessment will be analyzed. The Cochrane scale, Jadad scale, and GRADE scale will be used to assess the risk of bias, the quality of the studies and results. Revman V.5.4 will be used for meta-analysis and the results will be expressed as relative ratio for binary data and mean difference or standardized mean difference for continuous data. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. PBCRBS is an effective method for treating ICH.
脑出血（ICH）被列为全球第二大死亡原因，因此，找到合适的辅助治疗方法以提高 ICH 的治疗效果至关重要。活血化瘀法作为一种疏通血管、恢复正常血流的传统中医疗法，许多临床研究已初步证实了其治疗 ICH 的有效性。但现代医学曾一度建议禁用该方法。本研究旨在系统评估活血化瘀法治疗 ICH 的有效性和安全性，为 ICH 提供一种理想的辅助疗法。 本研究将筛选自数据库建立至 2023 年 8 月期间，Pubmed 和 CNKI 数据库中所有用 PBCRBS 治疗 ICH 的随机对照试验。将对受试者的数据提取和偏倚风险评估进行分析。将使用 Cochrane 量表、Jadad 量表和 GRADE 量表评估偏倚风险、研究质量和结果。荟萃分析将使用 Revman V.5.4，对于二元数据，结果将以相对比率表示；对于连续数据，结果将以平均差或标准化平均差表示。 系统综述和荟萃分析的结果将发表在同行评审期刊上。 PBCRBS 是治疗 ICH 的有效方法。
{"title":"The method of promoting blood circulation and removing blood stasis in the treatment of intracerebral hemorrhage: A systematic review and meta-analysis protocol of randomized controlled trials","authors":"Mengnan Liu, Ziyi Li, Jinyi Xue, Yuan Zou, Ziwen Deng, Sijin Yang","doi":"10.1097/md9.0000000000000312","DOIUrl":"https://doi.org/10.1097/md9.0000000000000312","url":null,"abstract":"\u0000 \u0000 Intracerebral hemorrhage (ICH) is ranked as the second leading cause of death worldwide, it is essential to find appropriate complementary treatment to improve the therapeutic effect of ICH. As a traditional Chinese medicine therapy to unclog blood vessels and restore normal blood flow, many clinical studies have preliminarily proved the effectiveness of the method of promoting blood circulation and removing blood stasis (PBCRBS) in treating ICH. However, this method was once recommended to be prohibited in modern medicine. The purpose of this study was to systematically evaluate the efficacy and safety of PBCRBS in the treatment of ICH and to provide an ideal complementary therapy for ICH.\u0000 \u0000 \u0000 \u0000 All the randomized controlled trials on treating ICH by PBCRBS from Pubmed and CNKI databases from the establishment of the database to August 2023 will be screened. The subject’s data extraction and the risk of bias assessment will be analyzed. The Cochrane scale, Jadad scale, and GRADE scale will be used to assess the risk of bias, the quality of the studies and results. Revman V.5.4 will be used for meta-analysis and the results will be expressed as relative ratio for binary data and mean difference or standardized mean difference for continuous data.\u0000 \u0000 \u0000 \u0000 The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.\u0000 \u0000 \u0000 \u0000 PBCRBS is an effective method for treating ICH.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The incidence of chronic kidney disease (CKD) is increasing and the progression of renal interstitial fibrosis (RIF) in end-stage renal disease is attributed to the development of various CKD. One of the treatments for RIF is an oral treatment known as Bushen-Huoxue (BSHX), which stimulates blood circulation and tonifies the kidney. Randomized controlled trials of BSHX treatment of RIF have been reported, but their efficacy and safety have not been comprehensively examined. Therefore, our study aims to describe the efficacy and safety of oral application of the traditional Chinese medicine (TCM) formula of BSHX on treating RIF in CKD by systematic analysis and meta-analysis. A total of 13 databases, including PubMed, EMBASE, MEDLINE, Web of Science, Cochrane Library, SpringerLink, WHO International Clinical Trials Registry Platform, Wanfang China database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and China’s Conference Papers Database and China Dissertation database will be searched from inception to July 2023. In addition, other suitable search strategies will be used as well to complete this review. All randomized controlled trials that use the BSHX formula for RIF to apply TCM treatments externally for CKD will be included. The eligible studies will be selected to enroll by 2 independent researchers following a predetermined protocol. The review manager software (Rev-Man 5.3) will be used to assess the risk of bias, reporting bias, and data synthesis. We will compile and discuss the recent examples of the TCM BSHX formula treatment for RIF in CKD. We will provide strong evidences for evaluating the efficacy and safety of the TCM BSHX formula treatment for RIF in CKD.
{"title":"The efficacy and safety of tonifying-kidney and invigorating-blood circulation (Bushen-Huoxue) formula on renal fibrosis in patients with chronic kidney disease: A protocol for systematic review and meta-analysis","authors":"Xiaoxiao Li, Weijie Liang, Haiyun Lu, Jiandi Wu, Xiuwen Luo, Zhi Kang, Qian He, Chenglong Jiang","doi":"10.1097/md9.0000000000000313","DOIUrl":"https://doi.org/10.1097/md9.0000000000000313","url":null,"abstract":"\u0000 \u0000 The incidence of chronic kidney disease (CKD) is increasing and the progression of renal interstitial fibrosis (RIF) in end-stage renal disease is attributed to the development of various CKD. One of the treatments for RIF is an oral treatment known as Bushen-Huoxue (BSHX), which stimulates blood circulation and tonifies the kidney. Randomized controlled trials of BSHX treatment of RIF have been reported, but their efficacy and safety have not been comprehensively examined. Therefore, our study aims to describe the efficacy and safety of oral application of the traditional Chinese medicine (TCM) formula of BSHX on treating RIF in CKD by systematic analysis and meta-analysis.\u0000 \u0000 \u0000 \u0000 A total of 13 databases, including PubMed, EMBASE, MEDLINE, Web of Science, Cochrane Library, SpringerLink, WHO International Clinical Trials Registry Platform, Wanfang China database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and China’s Conference Papers Database and China Dissertation database will be searched from inception to July 2023. In addition, other suitable search strategies will be used as well to complete this review. All randomized controlled trials that use the BSHX formula for RIF to apply TCM treatments externally for CKD will be included. The eligible studies will be selected to enroll by 2 independent researchers following a predetermined protocol. The review manager software (Rev-Man 5.3) will be used to assess the risk of bias, reporting bias, and data synthesis.\u0000 \u0000 \u0000 \u0000 We will compile and discuss the recent examples of the TCM BSHX formula treatment for RIF in CKD.\u0000 \u0000 \u0000 \u0000 We will provide strong evidences for evaluating the efficacy and safety of the TCM BSHX formula treatment for RIF in CKD.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140091597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-26DOI: 10.1097/md9.0000000000000311
Benhou Zhang, Ping Chi
Postdural puncture headache (PDPH) is a common complication in lactating mothers after cesarean delivery. It was reported that postdural puncture headache was managed through a novel approach by administration of neostigmine-atropine. Neostigmine-atropine is commonly used to reverse residual non-depolarizing neuromuscular blocking agents. The method is simple, well-tolerated, and has fewer side effects compared to epidural blood patch procedure. We report a case of a patient who presented severe side effects following treatment using this method. A 29-year-old female presented with uncontrollable head shaking (no studies reported) after using neostigmine/atropine. Based on the clinical, using of neostigmine, the patient was diagnosed with severe side effects of neostigmine. Comforted the patient until all symptoms disappeared (self-care). Approximately 10 minutes after administration of neostigmine/atropine, the patient exhibited trembling in the upper limbs, followed by severe head shaking from side to side with large amplitude above 90 degrees. The rate of head shaking was approximately 100 times min−1. The patient complained of stomachache and vomited about 20 mL light yellow liquid. After 20 minutes, the uncontrollable head shaking presented as a slight up-and-down nod. All the symptoms disappeared after approximately 50 minutes. The patient was fully conscious throughout the process and responded normally. Physical examination showed stable vital signs. The patient was discharged after 2 days. The patients were followed up for 1 year and everything was normal. There are many side effects observed with neostigmine, such as uncontrollable head shaking. Patients should be informed of all the possible side effects during the consenting process to avoid panicking; dilution of the medications, and the drugs should be administered gradually to minimize side effects.
{"title":"Uncontrollable head shaking after neostigmine-atropine for postdural puncture headache: Case report","authors":"Benhou Zhang, Ping Chi","doi":"10.1097/md9.0000000000000311","DOIUrl":"https://doi.org/10.1097/md9.0000000000000311","url":null,"abstract":"\u0000 \u0000 Postdural puncture headache (PDPH) is a common complication in lactating mothers after cesarean delivery. It was reported that postdural puncture headache was managed through a novel approach by administration of neostigmine-atropine. Neostigmine-atropine is commonly used to reverse residual non-depolarizing neuromuscular blocking agents. The method is simple, well-tolerated, and has fewer side effects compared to epidural blood patch procedure. We report a case of a patient who presented severe side effects following treatment using this method.\u0000 \u0000 \u0000 \u0000 A 29-year-old female presented with uncontrollable head shaking (no studies reported) after using neostigmine/atropine.\u0000 \u0000 \u0000 \u0000 Based on the clinical, using of neostigmine, the patient was diagnosed with severe side effects of neostigmine.\u0000 \u0000 \u0000 \u0000 Comforted the patient until all symptoms disappeared (self-care).\u0000 \u0000 \u0000 \u0000 Approximately 10 minutes after administration of neostigmine/atropine, the patient exhibited trembling in the upper limbs, followed by severe head shaking from side to side with large amplitude above 90 degrees. The rate of head shaking was approximately 100 times min−1. The patient complained of stomachache and vomited about 20 mL light yellow liquid. After 20 minutes, the uncontrollable head shaking presented as a slight up-and-down nod. All the symptoms disappeared after approximately 50 minutes. The patient was fully conscious throughout the process and responded normally. Physical examination showed stable vital signs. The patient was discharged after 2 days. The patients were followed up for 1 year and everything was normal.\u0000 \u0000 \u0000 \u0000 There are many side effects observed with neostigmine, such as uncontrollable head shaking. Patients should be informed of all the possible side effects during the consenting process to avoid panicking; dilution of the medications, and the drugs should be administered gradually to minimize side effects.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140430216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although total hip arthroplasty (THA) and total knee arthroplasty (TKA) have nowadays had good outcomes, there remain some concerns, such as complications, during and/or after surgeries. There have been some reports on the postoperative complications of joint arthroplasty. However, to the best of our knowledge, none exist on cholangitis after THA or TKA. This patients’ agreement was obtained. Here is the first kind of case series to show nine cases of cholangitis which required urgent endoscopic retrograde cholangiopancreatography after THA or TKA in the absence of preoperative abdominal ultrasound between June 2019 and May 2021. One case among 9 cases required open laparotomy for acute cholecystitis. Even 1 case of 9 cases, this study showed the importance of preoperative screening for gallbladder stones in order to evaluate the risk of cholangitis development after joint arthroplasty.
{"title":"Preoperative asymptomatic gallstone surgery might reduce the occurrence of cholangitis and cholecystitis after joint replacement surgeries – case series","authors":"Atsushi Sobajima, Yukio Nakamura, Masaki Nakano, Takashi Maeda, Takashige Momose, Shigekazu Ohyama, Kaori Yamamoto, Masashi Nawata","doi":"10.1097/md9.0000000000000303","DOIUrl":"https://doi.org/10.1097/md9.0000000000000303","url":null,"abstract":"\u0000 \u0000 Although total hip arthroplasty (THA) and total knee arthroplasty (TKA) have nowadays had good outcomes, there remain some concerns, such as complications, during and/or after surgeries. There have been some reports on the postoperative complications of joint arthroplasty. However, to the best of our knowledge, none exist on cholangitis after THA or TKA.\u0000 \u0000 \u0000 \u0000 This patients’ agreement was obtained.\u0000 \u0000 \u0000 \u0000 Here is the first kind of case series to show nine cases of cholangitis which required urgent endoscopic retrograde cholangiopancreatography after THA or TKA in the absence of preoperative abdominal ultrasound between June 2019 and May 2021.\u0000 \u0000 \u0000 \u0000 One case among 9 cases required open laparotomy for acute cholecystitis.\u0000 \u0000 \u0000 \u0000 Even 1 case of 9 cases, this study showed the importance of preoperative screening for gallbladder stones in order to evaluate the risk of cholangitis development after joint arthroplasty.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139603250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1097/md9.0000000000000304
Chul Kwon Lim, Jung Bo Yang, Jin Yu Lee, Joong Gyu Ha, Won Kyu Choi, Seung Hyun Kim, In Taek Hwang
Vaginal agenesis is a congenital anomaly that causes physical and psychosocial problems for women. Many surgical procedures for neovaginal reconstruction have been described in the literature. Using an appropriate vaginal mold is crucial for a successful surgical outcome. Here, we present an effective solution for neovaginal cavity maintenance involving the use of a customized three-dimensional (3D) printed vaginal mold created using thermoplastic polyurethane material. Here, we present a case of non-syndromic agenesis of the lower vagina in an 18-year-old girl and the postsurgical management. After a thorough evaluation, the patient was diagnosed with Mayer–Rokitansky–Küster–Hauser syndrome or Müllerian agenesis. After drainage of the pus during acute infection of a patient with vaginal agenesis, a condom and alginate were used to create a mold. The mold was then used to create a permanent, customized mold with a 3D printer. This report is the first to suggest using a 3D printer to create molds to maintain vaginal dilation after the creation of a neovagina. This approach can be applied for patients with vaginal agenesis and stenosis and can be used as a novel method for maintaining the neovaginal structure without affecting the patient’s quality of life.
阴道缺失是一种先天性畸形，会给女性带来生理和心理问题。文献中描述了许多新阴道重建的手术方法。使用合适的阴道模具是手术成功的关键。在此，我们提出了一种有效的新阴道腔维护解决方案，该方案涉及使用热塑性聚氨酯材料制作的定制化三维（3D）打印阴道模具。 在此，我们介绍了一例 18 岁女孩的非合并症下阴道缺失病例及术后处理。 经过全面评估，患者被诊断为 Mayer-Rokitansky-Küster-Hauser 综合征或 Müllerian 发育不全。 在阴道发育不全患者急性感染期间引流脓液后，使用避孕套和藻酸盐制作了一个模具。然后利用该模具通过 3D 打印机制作出一个永久性的定制模具。 该报告首次建议使用 3D 打印机制作模具，以在创建新阴道后保持阴道扩张。 这种方法可用于阴道缺失和狭窄的患者，并可作为一种新的方法来维持新阴道结构，而不会影响患者的生活质量。
{"title":"Three-dimensional printed mold for neovaginal cavity maintenance in vaginal agenesis: A case report","authors":"Chul Kwon Lim, Jung Bo Yang, Jin Yu Lee, Joong Gyu Ha, Won Kyu Choi, Seung Hyun Kim, In Taek Hwang","doi":"10.1097/md9.0000000000000304","DOIUrl":"https://doi.org/10.1097/md9.0000000000000304","url":null,"abstract":"\u0000 \u0000 Vaginal agenesis is a congenital anomaly that causes physical and psychosocial problems for women. Many surgical procedures for neovaginal reconstruction have been described in the literature. Using an appropriate vaginal mold is crucial for a successful surgical outcome. Here, we present an effective solution for neovaginal cavity maintenance involving the use of a customized three-dimensional (3D) printed vaginal mold created using thermoplastic polyurethane material.\u0000 \u0000 \u0000 \u0000 Here, we present a case of non-syndromic agenesis of the lower vagina in an 18-year-old girl and the postsurgical management.\u0000 \u0000 \u0000 \u0000 After a thorough evaluation, the patient was diagnosed with Mayer–Rokitansky–Küster–Hauser syndrome or Müllerian agenesis.\u0000 \u0000 \u0000 \u0000 After drainage of the pus during acute infection of a patient with vaginal agenesis, a condom and alginate were used to create a mold. The mold was then used to create a permanent, customized mold with a 3D printer.\u0000 \u0000 \u0000 \u0000 This report is the first to suggest using a 3D printer to create molds to maintain vaginal dilation after the creation of a neovagina.\u0000 \u0000 \u0000 \u0000 This approach can be applied for patients with vaginal agenesis and stenosis and can be used as a novel method for maintaining the neovaginal structure without affecting the patient’s quality of life.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent years, prevention of sarcopenia and frailty is a matter of concern for community dwelling older persons. The recommended protein daily intake is not fulfilled by 10% of community-dwelling elderly and 35% of residents in aged-care facilities. Furthermore, the optimum time of protein consumption is unclear because of the varying combinations of intake timing and exercise. Although it is desirable to increase protein intake at breakfast and lunch without reducing intake at supper to maximize muscle protein synthesis, this is not clear for older people. Therefore, before considering whether protein consumption at breakfast is superior to other times of the day, its effectiveness needs to be clarified in older adults. The inclusion criterion will be healthy or frail adults older than 60 years. This protocol of systematic review adhered to the PRISMA 2020 statement. A comprehensive study strategy is designed for PubMed, EMBASE, CENTRAL, and Clinical Trials.gov. Search strategies will be made using Boolean Search Logic by an experienced librarian in systematic review search formula design. Two authors will carry out independent screening of titles, abstracts, and data extraction for randomized controlled trials. Statistical heterogeneity will be assessed by meta-analysis. Assessment of the risk of bias will be conducted using the Risk-of-bias 2 tool. Integrated data will be analyzed using Review Manager software to create summary tables. Findings summary tables for primary and secondary outcomes will be produced in accordance with the procedures in the Cochrane Handbook. We believe that the effects of protein or BCAA intake at breakfast in older people analysed in this review will provide evidence that contributes to the establishment of treatment strategies to prevent frailty and sarcopenia. The benefits of protein intake at breakfast for the elderly will be clarified. This will encourage hospitals and elderly care facilities to review the content of the diet and encourage the elderly to change their own behavior. This is expected to ultimately reduce healthcare costs.
{"title":"Protein or branched-chain amino acid intake at breakfast for muscle mass gain in older persons: A protocol for systematic review and meta-analysis","authors":"Takashi Ikeda, Naonori Tashiro, Takeshi Hasegawa, Hiroki Nishiwaki, Hiroyuki Ohtsuka, Masaaki Matoba, Hisashi Noma, Erika Ota","doi":"10.1097/md9.0000000000000306","DOIUrl":"https://doi.org/10.1097/md9.0000000000000306","url":null,"abstract":"\u0000 \u0000 In recent years, prevention of sarcopenia and frailty is a matter of concern for community dwelling older persons. The recommended protein daily intake is not fulfilled by 10% of community-dwelling elderly and 35% of residents in aged-care facilities. Furthermore, the optimum time of protein consumption is unclear because of the varying combinations of intake timing and exercise. Although it is desirable to increase protein intake at breakfast and lunch without reducing intake at supper to maximize muscle protein synthesis, this is not clear for older people. Therefore, before considering whether protein consumption at breakfast is superior to other times of the day, its effectiveness needs to be clarified in older adults.\u0000 \u0000 \u0000 \u0000 The inclusion criterion will be healthy or frail adults older than 60 years. This protocol of systematic review adhered to the PRISMA 2020 statement. A comprehensive study strategy is designed for PubMed, EMBASE, CENTRAL, and Clinical Trials.gov. Search strategies will be made using Boolean Search Logic by an experienced librarian in systematic review search formula design. Two authors will carry out independent screening of titles, abstracts, and data extraction for randomized controlled trials. Statistical heterogeneity will be assessed by meta-analysis. Assessment of the risk of bias will be conducted using the Risk-of-bias 2 tool. Integrated data will be analyzed using Review Manager software to create summary tables. Findings summary tables for primary and secondary outcomes will be produced in accordance with the procedures in the Cochrane Handbook.\u0000 \u0000 \u0000 \u0000 We believe that the effects of protein or BCAA intake at breakfast in older people analysed in this review will provide evidence that contributes to the establishment of treatment strategies to prevent frailty and sarcopenia.\u0000 \u0000 \u0000 \u0000 The benefits of protein intake at breakfast for the elderly will be clarified. This will encourage hospitals and elderly care facilities to review the content of the diet and encourage the elderly to change their own behavior. This is expected to ultimately reduce healthcare costs.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139639288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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