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Paediatric interlabial bleeding: More than vaginal pathology 儿科唇间出血:不只是阴道病理
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-02 DOI: 10.1177/20101058221149579
Zeng Hao Joel Wong
A 10 years old girl was referred with the complaints of “per vaginal bleeding and a mass after cycling”. During the first 2 weeks of symptoms, she had visited three different doctors with possible delayed recognition of her diagnosis. Clinical examination revealed an underweight, non-dysmorphic, prepubertal girl with vulvitis and an inflamed interlabial bleeding mass with ulceration. Imaging revealed a subcentimetre arteriovenous fistula and haematoma in the vagina. After one more week (total 3 weeks) of medical therapy, the indication for surgery was worsening of symptoms and failure of medical management. Examination under anaesthesia and cystoscopy revealed a complete urethra prolapse. Dilute adrenaline was injected into the prolapsed mucosa. The prolapse was excised in elliptical segments, and the edges closed with interrupted absorbable sutures. Sub-centimetre segments of mucosa were left between the excised specimens. Bipolar diathermy was used only for hemostasis and circumferential coagulation on the mucosa was avoided. These measures prevent an iatrogenic stenosis. The urethra prolapse was reduced, with no recurrence demonstrated on Valsalva maneuver. Post-operatively, her symptoms resolved. Oral antibiotics, sitz baths, antimicrobial cream and topical estrogen were administered. There was no recurrent urethra prolapse or stricture. The aim of this case report is to increase awareness of the urethral prolapse in the paediatric population and its management.
一名10岁女孩被转诊,抱怨“骑自行车后阴道出血和肿块”。在出现症状的前两周,她拜访了三位不同的医生,可能会延迟对她的诊断。临床检查显示,一名体重不足、非畸形的青春期前女孩患有外阴炎,唇间出血团发炎并溃疡。影像显示阴道内有一个厘米以下的动静脉瘘和血肿。经过一周(总共3周)的药物治疗后,手术的指征是症状恶化和医疗管理失败。麻醉和膀胱镜检查显示尿道完全脱垂。将稀释的肾上腺素注射到脱垂的粘膜中。脱垂部分切除为椭圆形,边缘用间断可吸收缝线缝合。在切除的标本之间留下了亚厘米的粘膜片段。双极透热仅用于止血,避免了粘膜上的周向凝固。这些措施可防止医源性狭窄。尿道脱垂减少,Valsalva手法无复发。手术后,她的症状得到了缓解。口服抗生素、坐浴、抗菌霜和局部雌激素。无复发性尿道脱垂或狭窄。本病例报告的目的是提高儿科人群对尿道脱垂及其管理的认识。
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引用次数: 0
Evaluating the impact of coronavirus disease on burnout among healthcare workers using maslach burnout inventory tool: A systematic review 使用maslach倦怠量表工具评估冠状病毒疾病对医护人员倦怠的影响:一项系统综述
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221117390
Reanne Tang, Ou Feng, Jin Jian Chong, Aiwen Wang
Background Burnout has been prevalent among healthcare workers (HCWs). However, the effect of the Coronavirus Disease (COVID-19) pandemic on this phenomenon in HCWs is unclear. Objective This systematic review aims to evaluate the impact of COVID-19 on burnout of HCWs using Maslach Burnout Inventory (MBI). Methods A systematic search was performed on PubMed database for articles published between 1 December 2019 and 30 June 2021. Search strategy combined terms for HCWs, COVID-19, burnout, and MBI. The main outcome of interest was burnout, including both mean prevalence and MBI scores for high emotional exhaustion (EE), high depersonalisation (DP) and low personal accomplishment (PA). Results Four cohort studies, 90 cross-sectional studies and one randomised-controlled trial were included for review. Only one cohort study compared burnout data among HCWs before and during COVID-19. It reported a statistically significant increase in mean EE and PA scores from 21.9 to 24.8 (p = .001), and 42.7 to 48.7 (p = .001), respectively. The remaining studies only evaluated burnout data during COVID-19 but were missing burnout data prior to the pandemic for comparison. Across these studies, the overall mean prevalence of burnout among HCWs was 39.95%, with mean MBI EE scores of 22.07, DP scores of 7.83, and PA scores of 32.53. Burnout outcomes were generally comparable across specific healthcare professions such as doctors and nurses. Conclusion Whilst quality research elucidating the effect of pandemic on burnout is lacking, current burnout prevalence among HCWs during COVID-19 is notable.
背景职业倦怠在卫生保健工作者(HCWs)中普遍存在。然而,冠状病毒病(COVID-19)大流行对卫生保健工作者这一现象的影响尚不清楚。目的应用Maslach职业倦怠量表(MBI)评估新冠肺炎对医护人员职业倦怠的影响。方法系统检索PubMed数据库中2019年12月1日至2021年6月30日发表的文章。搜索策略组合了医护人员、COVID-19、倦怠和MBI的术语。主要研究结果为倦怠,包括高情绪耗竭(EE)、高人格解体(DP)和低个人成就感(PA)的平均患病率和MBI得分。结果纳入4项队列研究、90项横断面研究和1项随机对照试验。只有一项队列研究比较了COVID-19之前和期间医护人员的倦怠数据。据报道,平均情感表达和情感表达得分分别从21.9上升到24.8 (p = .001)和42.7上升到48.7 (p = .001),具有统计学意义。其余的研究仅评估了COVID-19期间的倦怠数据,但缺少大流行之前的倦怠数据进行比较。在这些研究中,医护人员的总体平均倦怠患病率为39.95%,平均MBI EE得分为22.07,DP得分为7.83,PA得分为32.53。在医生和护士等特定医疗保健职业中,倦怠的结果通常具有可比性。结论虽然缺乏高质量的研究来阐明大流行对职业倦怠的影响,但目前COVID-19期间医护人员的职业倦怠患病率值得注意。
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引用次数: 3
Hemichorea as initial presentation of newly diagnosed diabetes and acute lacunar stroke 偏瘫是新诊断的糖尿病和急性腔隙性中风的最初表现
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221147766
Thandar Oo, Wan Tin Lim
Hemichorea is one of the spectrums of involuntary, continuous, non-purposeful movement of one side of the body, a choreiform disorder. Hemichorea causes vary and include various inherited or acquired systemic conditions. There might be overlapping pathophysiology where the synergistic effects of uncontrolled hyperglycemia and vascular insufficiency cause an incomplete transient dysfunction of the striatum, leading to hemichorea. We herein describe a patient who presented with hemichorea triggered by hyperglycemia and was incidentally found to have an acute lacunar stroke. She was initiated on insulin with good glycemic control. Secondary stroke prevention therapy with aspirin and statin was also started. Her symptoms improved inpatient after stable glycemic control was achieved. After 3 months, her symptoms had completely resolved. Hemichorea is an unusual initial presentation for newly diagnosed diabetes mellitus or stroke. Hence, recognizing and diagnosing this uncommon disease entity is pertinent to make a timely and accurate diagnosis, which can lead to a rapid clinical response.
偏斜是一种不自主的、持续的、无目的的身体一侧运动,是一种舞蹈病。血凝的原因各不相同,包括各种遗传或获得性系统疾病。可能存在重叠的病理生理,其中不受控制的高血糖和血管功能不全的协同作用导致纹状体的不完全短暂功能障碍,导致血凝。我们在此描述一个病人谁提出了由高血糖引起的血凝,并偶然发现有急性腔隙性中风。她开始使用胰岛素,血糖控制良好。还开始了阿司匹林和他汀类药物的二级脑卒中预防治疗。患者住院后血糖控制稳定,症状有所改善。3个月后,她的症状完全消失。血凝是新诊断的糖尿病或中风的不寻常的最初表现。因此,认识和诊断这种罕见的疾病实体,有助于及时准确地做出诊断,从而快速做出临床反应。
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引用次数: 1
Universal COVID-19 pre-procedural swabs in children in a developing country: A comparison of findings over two transmission waves 发展中国家儿童普遍使用新冠肺炎术前拭子:两种传播波结果的比较
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221131656
Chee Yang Tan, Amelia Marie Theseira, Syukri Ahmad Zubaidi, N. Atiya, Anand Sanmugam, Srihari Singaravel, S. Nah
Aim The Coronavirus disease (COVID-19) pandemic has strained healthcare systems worldwide. Some institutions have implemented additional precautionary measures such as pre-procedural swabbing (PPS) to reduce transmission in patients and healthcare workers. We evaluate our experience with universal pre-procedural screening for COVID-19 in low-risk pediatric patients. Methods We performed a retrospective review of patients aged 18 years and below who underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription-polymerase chain reaction (rRT-PCR) assay swabs in our center over two waves (1st May 2020 to 31st July 2020 and 1st April 2021 to 30th June 2021). We included patients who underwent rRT-PCR for SARS-CoV-2 prior to any procedures requiring general anesthesia and were deemed low risk for COVID-19 according to our institutional screening criteria. All study patients were followed up for 14 days post-procedure. Results Of 2065 swabs done for patients aged 18 years and below during the study period, 645 (31.2%) were pre-procedural swabs. Patients were aged 4.2 years (median, interquartile range: 1.6 years–9.8 years). Two patients (0.3%) tested positive for COVID-19 by PPS, detected during Period 2 – both had risk criteria which were overlooked by healthcare workers. Within 14 days post-procedure, 10 patients had unscheduled readmissions and 15 required repeat rRT-PCR, all of which were negative. Conclusions In patients deemed low risk for COVID-19 infection according to our screening criteria, routine pre-procedural swabbing returns a low positive rate. Our findings can guide screening protocols at institutions that provide surgical services during the COVID-19 pandemic.
目的冠状病毒疾病(新冠肺炎)大流行使全球医疗系统紧张。一些机构已经实施了额外的预防措施,如术前拭子(PPS),以减少患者和医护人员的传播。我们评估了我们在低风险儿科患者中对新冠肺炎进行普遍术前筛查的经验。方法我们对18岁及以下的患者进行了回顾性审查,这些患者在我们中心接受了两波(2020年5月1日至2020年7月31日和2021年4月1日到2021年6月30日)的严重急性呼吸综合征冠状病毒2型(严重急性呼吸系统综合征冠状病毒冠状病毒2型)实时逆转录聚合酶链反应(rRT PCR)检测拭子。我们纳入了在任何需要全身麻醉的手术前接受了SARS-CoV-2 rRT-PCR的患者,根据我们的机构筛查标准,这些患者被认为是新冠肺炎的低风险患者。所有研究患者在术后随访14天。结果在研究期间为18岁及以下患者进行的2065次拭子检查中,645次(31.2%)为术前拭子。患者年龄为4.2岁(中位数,四分位间距:1.6岁-9.8岁)。两名患者(0.3%)的PPS检测结果呈新冠肺炎阳性,这两名患者在第2期检测到,他们都有医护人员忽视的风险标准。在手术后14天内,10名患者计划外再次入院,15名患者需要重复rRT PCR,所有结果均为阴性。结论根据我们的筛查标准,在被视为新冠肺炎感染风险较低的患者中,常规术前拭子检测的阳性率较低。我们的研究结果可以指导新冠肺炎大流行期间提供外科服务的机构的筛查方案。
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引用次数: 0
Towards zero waste in pharmacy: Challenges and opportunities in Singapore 迈向药房零浪费:新加坡的挑战与机遇
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221146323
J. Leow, Liyi Looi, Yixuan Lee, L. Chew
Background In line with zero-waste movement, there is a need for pharmacies to start reducing waste. There is no systematic waste minimization efforts by local pharmacies or studies to evaluate their effectiveness. Aim Assess behavioral change factors towards waste minimization at National Cancer Centre Singapore and evaluate effectiveness of recycling effort and patient education campaign. Methods Preliminary surveys were carried out among pharmacy staff, patients/caregivers to assess behavioral change factors. Recycling rate of staff and plastic bag consumption levels of patients/caregivers were measured. Results 46 staff members and 335 patients/caregivers were surveyed. Both populations were optimistic about the suggested green initiatives, 82.6% of staff members viewed recycling as a potential solution to reduce waste and 67.6% of patients and caregivers demonstrated willingness to participate in a Bring Your Own Bag (BYOB) campaign. Recycling efforts improved recycling rates by 53.4% while BYOB campaign resulted in no notable decrease in plastic bag consumption levels. Conclusion This study revealed the need for improvements in current waste management practices in local pharmacies, and demonstrated the effectiveness of implementing a recycling effort. BYOB campaign was not shown to be effective. Follow-up studies should be carried out to capture long-term sustainability data. Future efforts should include studies at other non-specialized local pharmacies.
背景与零浪费运动相一致,药店有必要开始减少浪费。当地药店没有系统地减少废物,也没有进行研究来评估其有效性。目的评估新加坡国家癌症中心废物最小化的行为变化因素,并评估回收工作和患者教育活动的有效性。方法对药房工作人员、患者/护理人员进行初步调查,评估行为变化因素。测量了工作人员的回收率和患者/护理人员的塑料袋消费水平。结果调查了46名工作人员和335名患者/护理人员。两个群体都对建议的绿色举措持乐观态度,82.6%的工作人员认为回收是减少浪费的潜在解决方案,67.6%的患者和护理人员表示愿意参与“自带行李”运动。回收工作使回收率提高了53.4%,而BYOB运动并没有显著降低塑料袋的消费水平。结论本研究揭示了改进当地药店当前废物管理做法的必要性,并证明了实施回收工作的有效性。BYOB运动没有被证明是有效的。应开展后续研究,以获取长期可持续性数据。未来的努力应包括在其他非专业的当地药店进行研究。
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引用次数: 0
Disability and oral health in association of south east Asians - A survey for conceptualisation and development 东南亚人的残疾和口腔健康——概念化和发展调查
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221111579
Guang Xu David Lim, Siti Hamzah, Ricca Rocco Mae Bernardino, Patcharawan Sukhumalind, N. S. Ishak, Adiningrum Wiradidjaja Adiwoso
Background All member states in the Association of South East Asians (ASEAN) are ratified signatories of the UN Convention on the Rights of Persons with Disabilities. However, disability and oral health (DOH) can be an elusive ambition for developing nations. Objectives This survey aims to conceptualise ‘barriers’, ‘improvements’, ‘challenges in dental practice’, and ‘ways to collaborate’, to inform policy development for DOH within ASEAN. Methods The survey employed a novel quasi-qualitative design. It was electronically distributed to dentists with DOH specialty training in ASEAN within the International Association of Disability and Oral Health’s network from September 2018 to June 2020. The ‘barriers’ and ‘improvements’ would be categorised into five dimensions of healthcare - a framework by Levesque and colleagues (2013). Results 21 valid responses were received from Brunei, Indonesia, Malaysia, Philippines, Singapore and Thailand. From the care provider’s perspective, adequate training (appropriateness) was most prioritised. From the patient’s aspect, low oral health literacy (ability to perceive) was the most significant. ‘Social perception’ was collectively ranked as the key ‘challenge in dental practices’. Suggested ‘ways to collaborate’ could be categorised into five areas: engagement; advocacy; policies; specialty, and; upskilling. Conclusions The findings suggest an urgent need to address low oral health prioritisation, a drive to upskill providers, a challenge of ‘social perceptions’, and a consensual appeal for state-level support. A multi-sector collaboration is needed to align current strategies in order to achieve equity for DOH in ASEAN.
东南亚联盟(东盟)的所有成员国都是《联合国残疾人权利公约》的批准签署国。然而,残疾和口腔健康(DOH)可能是发展中国家难以实现的目标。本调查旨在概念化“障碍”、“改进”、“牙科实践中的挑战”和“合作方式”,为东盟卫生部的政策制定提供信息。方法采用新颖的准定性设计。从2018年9月至2020年6月,在国际残疾和口腔健康协会的网络内,将其以电子方式分发给在东盟接受过卫生部专业培训的牙医。Levesque及其同事(2013)将“障碍”和“改进”分为医疗保健的五个维度。结果共收到来自文莱、印度尼西亚、马来西亚、菲律宾、新加坡和泰国的有效回复21份。从护理提供者的角度来看,充分的培训(适当性)是最优先考虑的。从患者的角度来看,口腔健康素养(感知能力)低是最显著的。“社会认知”被列为“牙科实践面临的主要挑战”。建议的“合作方式”可以分为五个方面:参与;宣传;政策;专业,;upskilling。研究结果表明,迫切需要解决口腔健康优先级低的问题,推动提高服务提供者的技能,挑战“社会观念”,并一致呼吁国家层面的支持。需要开展多部门合作,协调当前战略,以便在东盟实现卫生保健的公平性。
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引用次数: 0
Relationship between SARS-CoV-2 and hearing loss: A mini-review SARS-CoV-2与听力损失的关系:一项小型综述
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221139957
Sin Wai Lee, Kenneth Wei De Chua, H. Yuen
The most reported symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were initially fever, dry cough, and sore throat. However, as we continue to review the literature, the loss of taste and smell were also added as clinical symptoms of the novel SARS-CoV-2. At present, the effects of SARS-CoV-2 on the auditory system is still not well-understood. This study is mini-review and aims to find out more about the relationship between SARS-CoV-2 and hearing loss through review of the literature. From our findings, hearing loss is the primary otological symptom of SARS-CoV-2, followed by tinnitus and dizziness. In conclusion, SARS-CoV-2 may have an effect on our auditory system, but due to the small sample sizes in the existing literature, further prospective studies are warranted to determine the relationship between the virus and hearing loss.
严重急性呼吸综合征冠状病毒2型(严重急性呼吸系统综合征冠状病毒冠状病毒2型)最常见的症状最初是发烧、干咳和喉咙痛。然而,随着我们继续回顾文献,味觉和嗅觉的丧失也被添加为新型严重急性呼吸系统综合征冠状病毒2型的临床症状。目前,严重急性呼吸系统综合征冠状病毒2型对听觉系统的影响尚不清楚。这项研究是一项小型综述,旨在通过文献综述了解更多关于严重急性呼吸系统综合征冠状病毒2型与听力损失之间的关系。根据我们的研究结果,听力损失是严重急性呼吸系统综合征冠状病毒2型的主要耳科症状,其次是耳鸣和头晕。总之,严重急性呼吸系统综合征冠状病毒2型可能会对我们的听觉系统产生影响,但由于现有文献中的样本量较小,有必要进行进一步的前瞻性研究,以确定病毒与听力损失之间的关系。
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引用次数: 0
Breastfeeding With Infectious Diseases 感染性疾病的母乳喂养
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221123395
Samantha Yeo, Liying Yang, Kirsten Ong, T. Yong
Aims: Human breast milk remains an important source of protection against infection, inflammation, allergy and long-term metabolic disorders for the breastfed offspring. During cases of ongoing infection, the dilemma faced by both medical health professionals and mothers is the need to balance the risk of continuing versus temporarily or permanently ceasing to breastfeed. The aim of our article is to review existing literature regarding breastfeeding during acute infectious and non-infectious illnesses and to provide feasible evidence-based suggestions which can be implemented by medical practitioners during counselling of breastfeeding mothers. Method: A literature search was conducted on PubMed (US National Library of Medicine) using various combinations of keywords related to breastfeeding and the various infections. The citations from all selected articles were reviewed for additional studies. Results: Most ongoing infections are not contraindications for breastfeeding, with the exceptions of Human Immunodeficiency viruses (HIV), Human T-cell lymphotropic virus (HTLV) types 1 and 2. Even with HIV, there is increasing evidence to reassure that with adequate antiretroviral therapy, breastfeeding is likely to be safe. Of particular concern during the COVID-19 pandemic too, current evidence indicates that mothers with COVID-19 infection can safely breastfeed, and therefore initiation and continuation of breastfeeding should continue to protect the health of the babies and mothers. Conclusion: During this pandemic especially, there is a strong and urgent need to support mothers with acute infections who wish to breastfeed. With better awareness, physicians can play an important role in securing positive experiences for breastfeeding mothers and optimizing infant outcomes.
目的:母乳仍然是母乳喂养后代抵御感染、炎症、过敏和长期代谢紊乱的重要来源。在持续感染的情况下,医疗卫生专业人员和母亲都面临的困境是需要平衡继续母乳喂养与暂时或永久停止母乳喂养的风险。我们的文章的目的是回顾现有的关于在急性传染病和非传染病期间母乳喂养的文献,并提供可行的循证建议,这些建议可以由医生在母乳喂养母亲的咨询过程中实施。方法:在PubMed(美国国家医学图书馆)上使用与母乳喂养和各种感染相关的各种关键词组合进行文献检索。对所有入选文章的引文进行了审查,以进行进一步研究。结果:除人类免疫缺陷病毒(HIV)、人类T细胞嗜淋巴病毒(HTLV)1型和2型外,大多数持续感染都不是母乳喂养的禁忌症。即使感染了艾滋病毒,也有越来越多的证据表明,只要有足够的抗逆转录病毒治疗,母乳喂养可能是安全的。在新冠肺炎大流行期间,也特别令人担忧的是,目前的证据表明,感染新冠肺炎的母亲可以安全地母乳喂养,因此开始和继续母乳喂养应继续保护婴儿和母亲的健康。结论:特别是在这场疫情期间,迫切需要支持希望母乳喂养的急性感染母亲。有了更好的意识,医生可以在确保母乳喂养母亲的积极体验和优化婴儿结局方面发挥重要作用。
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引用次数: 1
Osimertinib 80 mg EOD? Does this work? 奥西替尼80mg EOD?这能起作用吗?
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221114743
Yeong Y Yik, Arvindran A/L Alaga, H. S. Hin
Osimertinib is a third-generation thyroxine kinase inhibitor (TKI) used in treating advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation. Osimertinib is used as a second line treatment for patients who develop EGFR T790 M resistance mutation rather than first line due to financial constraints. We present a case of a 60-year-old Chinese gentleman who diagnosed as stage 4 adenocarcinoma with EGFR Exon 19 deletion. His disease progressed after a year of treatment with afatinib. His plasma T790 M was negative and due to delay in tissue biopsy, he was empirically started on osimertinib. However, in view of financial concerns, he opted a dose reduction of 80 mg every alternate day rather than the conventional dose of 80 mg daily. Serial CT Thorax showed partial response based on RECIST 1.1 criteria and he has 9 months of progression free survival. This case report shows that Osimertinib in reduced dose may achieve good partial response and progression free survival in patients.
奥西美替尼是一种第三代甲状腺素激酶抑制剂(TKI),用于治疗表皮生长因子受体(EGFR)突变的晚期癌症(NSCLC)患者。Osimertinib被用作EGFR T790 M耐药性突变患者的二线治疗,而不是由于经济限制而产生的一线治疗。我们报告一位60岁的中国绅士的病例,他被诊断为EGFR Exon 19缺失的4期腺癌。经过一年的阿法替尼治疗,他的病情有所好转。他的血浆T790 M呈阴性,由于组织活检延迟,他凭经验开始服用奥西替尼。然而,考虑到财务问题,他选择每隔一天减少80毫克的剂量,而不是每天80毫克的常规剂量。根据RECIST 1.1标准,连续胸部CT显示部分反应,他有9个月的无进展生存期。该病例报告显示,减少剂量的奥西美替尼可以在患者中实现良好的部分反应和无进展生存。
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引用次数: 2
Concurrent facial nerve palsy and uvula deviation after paediatric dental rehabilitation–A case report 小儿口腔康复后并发面神经麻痹及小舌偏曲1例
IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-01 DOI: 10.1177/20101058221111663
M. Long, M. Khor, Satish Kumar Reddy Challa
Introduction Facial nerve palsy is a rare, but known complication resulting from local anaesthesia (LA) infiltration during dental surgery. Its incidence is reported to be 1–1.1%, with short or long-term effects. Case Report A 6 years old well child underwent elective dental rehabilitation under general anaesthesia. For extractions, he received LA infiltration to the anterior part of the hard palate. In the immediate post-operative period, he presented with left sided facial droop and uvula deviation to the left with no hoarseness of voice or ptosis. His neurological symptoms resolved within 3 h of the administration of LA. He was reviewed on the same day by the paediatric neurologist. No further investigations were required. He was discharged well the next day. Conclusion Transient facial nerve palsy and uvula deviation, while rare, can occur after a dental procedure. For paediatric patients, the neurologist’s input helps with parental assurance.
引言面神经麻痹是一种罕见但已知的并发症,由牙科手术中的局部麻醉(LA)浸润引起。据报道,其发病率为1-1.1%,有短期或长期影响。病例报告一名6岁的健康儿童在全身麻醉下接受了选择性牙科康复治疗。对于拔牙,他接受了LA浸润至硬腭前部。术后不久,他出现左侧面部下垂和悬雍垂向左偏移,没有声音嘶哑或上睑下垂。他的神经系统症状在服用LA后3小时内消失。儿科神经学家于同一天对他进行了检查。无需进一步调查。第二天他出院了。结论牙科手术后可发生短暂性面神经麻痹和悬雍垂偏斜,虽然很罕见。对于儿科患者,神经科医生的投入有助于家长的保证。
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引用次数: 0
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Proceedings of Singapore Healthcare
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