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Heterologous Platelet-Rich Plasma in the Treatment of Severe Skin Damage 富含血小板的异源血浆治疗严重皮肤损伤
Pub Date : 2023-07-21 DOI: 10.3390/reports6030034
Cristina Vocca, Francesco Romano, Gianmarco Marcianò, Vincenzo Cianconi, D. Mirra, A. Dominijanni, G. De Sarro, L. Gallelli
Accidental soft tissue injuries are a frequent injury. Platelet-rich plasma (PRP) is an interesting therapeutic option for wounds and skin damage. In this case report, we describe a 37-year-old man that presented to our ward of pain medicine for an accidental severe leg injury associated with skin and soft tissue loss, with severe pain and poor sensation. History revealed the use of recreational drugs without viral infections or systemic diseases. Wound debridement, wound dressings, systemic antibiotics (amoxicillin 1000 mg tid and azithromycin 500 mg od), and non-steroidal anti-inflammatory drugs (ibuprofen 600 mg bid) reduced pain but did not improve the skin and soft tissue. A fibrin membrane with concentrated growth factors was applied, yielding an improvement in the injury in 16 months without the need for skin grafting.
意外的软组织损伤是一种常见的损伤。富含血小板的血浆(PRP)是治疗伤口和皮肤损伤的一种有趣的选择。在本病例报告中,我们描述了一名37岁的男子,他因意外严重腿部受伤,伴有皮肤和软组织损失,出现剧烈疼痛和感觉不佳,来到我们的疼痛医学病房。历史表明,使用娱乐性药物没有病毒感染或系统性疾病。伤口清创术、伤口敷料、全身性抗生素(阿莫西林1000 mg tid和阿奇霉素500 mg od)和非甾体抗炎药(布洛芬600 mg bid)减轻了疼痛,但没有改善皮肤和软组织。应用含有浓缩生长因子的纤维蛋白膜,在16个月内无需植皮即可改善损伤。
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引用次数: 0
A Multiple Synergic Treatment for Non-Healing Ulcer Management in a Patient with Klippel–Trenaunay Syndrome Klippel–Trenaunay综合征患者溃疡不愈合的多重协同治疗
Pub Date : 2023-07-20 DOI: 10.3390/reports6030033
Cristina Vocca, Gianmarco Marcianò, Vincenzo Rania, Luca Catarisano, Caterina Palleria, S. Ciranni, G. Torcia, R. Serra, Francesco Monea, G. Spaziano, G. De Sarro, R. Citraro, L. Gallelli
Klippel–Trenanauy syndrome (KTS) is a rare genetic disease determined by overexpression of the phosphatidylinositol-4-5-bisphosphate 3 kinase catalytic subunit (PIK3CA) gene. The clinical presentation is characterized by venous and capillary malformations and lymphatic malformation. To date, no definitive treatment has been suggested in order to improve the clinical symptoms related to the developments of a skin wound. In this case, we describe a young man with KTS that developed a severe skin wound in the lower right limb unresponsive to the common treatment but responsive to a treatment with oxygen-ozone therapy, pulsed magnetic fields (diamagnetic treatment), and topical fixed association of cocum caprylate, oleic acid, quercetin, and 18-β glycyrrhetinic acid. This is the first case that supports a multistep approach to treat a rare and severe disease, and we hope that other studies can support our data.
Klippel–Trenanauy综合征(KTS)是一种罕见的遗传性疾病,由磷脂酰肌醇-4-5-二磷酸3激酶催化亚基(PIK3CA)基因的过度表达决定。临床表现为静脉和毛细血管畸形以及淋巴管畸形。到目前为止,还没有提出明确的治疗方法来改善与皮肤伤口发展相关的临床症状。在这种情况下,我们描述了一名患有KTS的年轻人,他在右下肢出现了严重的皮肤伤口,对普通治疗没有反应,但对氧气臭氧治疗、脉冲磁场(抗磁性治疗)和辛酸钴、油酸、槲皮素和18-β甘草次酸的局部固定结合有反应。这是第一个支持多步骤治疗罕见和严重疾病的病例,我们希望其他研究能够支持我们的数据。
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引用次数: 0
A Case of De Novo Positional Complex Sleep Apnea Syndrome (CompSAS) 新生体位性复杂睡眠呼吸暂停综合征1例
Pub Date : 2023-07-18 DOI: 10.3390/reports6030032
A. Khalifa, M. Spielmanns
Obstructive sleep apnea (OSA) is well known to often improve with non-supine positioning as opposed to supine positioning. Emerging research supports a role for sleep position management in patients with central sleep apnea (CSA) as well. We report a case of de novo complex sleep apnea syndrome (CompSAS) in a 78-year-old female, who presented after a car accident due to unclear syncope. Diagnostic polysomnography (PSG) showed moderate OSA. A CompSAS developed under automatic positive airway pressure (APAP), while 4 years of downloaded data showed good adherence. No significant benefit was reported under adaptive servo ventilation (ASV) and BiPAP-ST, while a reduction in CSA in the non-supine position was noticed. Oxygen and sleep positional therapy (SPT) were considered, resulting in a significant improvement in CSA and sleep quality. Further research on the prevalence of positional CSA is needed.
众所周知,非仰卧位与仰卧位相比,阻塞性睡眠呼吸暂停(OSA)通常会有所改善。新兴研究也支持睡眠姿势管理在中枢性睡眠呼吸暂停(CSA)患者中的作用。我们报告了一例78岁女性的新发复杂睡眠呼吸暂停综合征(CompSAS),她在一次车祸后因不明原因晕厥而出现。诊断性多导睡眠图(PSG)显示中度OSA。CompSAS是在自动气道正压通气(APAP)下开发的,而4年的下载数据显示出良好的依从性。自适应伺服通气(ASV)和BiPAP ST没有显著的益处,而非仰卧位的CSA降低。考虑了氧气和睡眠体位疗法(SPT),从而显著改善了CSA和睡眠质量。需要进一步研究体位性CSA的患病率。
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引用次数: 0
Impact of Mechanical Ventilation and Renal Replacement Therapy on Clinical Outcomes among Critically Ill COVID-19 Patients 机械通气和肾脏替代治疗对危重新冠肺炎患者临床结局的影响
Pub Date : 2023-07-07 DOI: 10.3390/reports6030031
A. Sindi
Background: Poor clinical outcomes in patients with severe COVID-19 occur due to many factors that require elucidation. The objective of this study was to describe the outcomes of critically ill patients with COVID-19 and identify the risk factors for mortality. Materials and Methods: The study was a single-centered cross-sectional, observational study involving COVID-19 patients admitted to the intensive care units (ICUs) of a tertiary care hospital in the Middle East and North Africa (MENA) region. The patients were admitted between 1 March and 31 December 2020. Logistic regression analysis was used to identify risk factors for mortality. Results: Of 107 patients admitted, 98 (91.6%) were ≥40 years old and 84 (78.5%) were males. The mean oxygen saturation at admission was 79.6 ± 12.6%, the duration of ICU stay was 13.0 ± 11.6 days, and 65 (60.7%) of the patients received mechanical ventilation. Major comorbidities included hypertension (57%), diabetes (56%), and chronic kidney disease (CKD) (15.5%). The overall mortality rate was 51.4%; this was higher in patients who received mechanical ventilation (60 vs. 38.1%; p = 0.03) and those with co-morbid hypertension (60.7 vs. 39.1%; p = 0.03). Risk factors for mortality were: need for mechanical ventilation agent of record adjusted Odds ratio (aOR) 4.4 (1.6–12.6), co-morbid hypertension aOR 5.8 (1.6–21.1), having CKD aOR 5.4 (1.2–25.6) and receiving renal replacement therapy aOR 4.3 (1.4–13.0). Conclusions: The use of mechanical ventilation or renal replacement therapy among critically ill COVID-19 patients could potentially predict worse outcomes. Patients with existing hypertension or CKD may carry a higher mortality risk.
背景:严重新冠肺炎患者的临床结果不佳是由于许多需要阐明的因素造成的。本研究的目的是描述新冠肺炎危重患者的结局,并确定死亡率的危险因素。材料和方法:该研究是一项单中心的横断面观察性研究,涉及中东和北非地区一家三级护理医院重症监护室(ICU)的新冠肺炎患者。患者于2020年3月1日至12月31日期间入院。Logistic回归分析用于确定死亡率的危险因素。结果:107例患者中,≥40岁者98例(91.6%),男性84例(78.5%)。入院时的平均血氧饱和度为79.6±12.6%,ICU住院时间为13.0±11.6天,65名(60.7%)患者接受了机械通气。主要合并症包括高血压(57%)、糖尿病(56%)和慢性肾脏病(15.5%),总死亡率为51.4%;接受机械通气的患者(60 vs.38.1%;p=0.03)和合并高血压的患者(60.7 vs.39.1%;p=0.03)的死亡率更高。死亡的危险因素是:需要记录调整比值比(aOR)4.4(1.6-12.6)的机械通气剂,合并高血压aOR 5.8(1.6-21.1),患有CKD aOR 5.4(1.2–25.6)和接受肾脏替代治疗aOR 4.3(1.4–13.0)。结论:在危重新冠肺炎患者中使用机械通气或肾脏替代治疗可能会预测更糟糕的结果。患有高血压或CKD的患者可能具有更高的死亡风险。
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引用次数: 0
17q21.31 Microduplication Syndrome in a Patient with Autism Spectrum Disorder, Macrocephaly, and Intellectual Disability 17q21.31自闭症谱系障碍、大头畸形和智力残疾患者的微复制综合征
Pub Date : 2023-07-04 DOI: 10.3390/reports6030030
Federica Saia, Adriana Prato, Caterina Angela Florio, Vincenzo Paolo Cutrone, R. Rizzo
The chromosome 17q21.31 microduplication syndrome is a rare genetic syndrome presenting with craniofacial dysmorphisms, psychomotor delay, microcephaly, behavioral disorders, and poor social interaction. Only ten patients have been reported in the literature until today. All patients share some specific features, including psychomotor delay, behavioral disorders, and autism spectrum disorder (ASD). Here, a new case of this syndrome is reported in an 11-year-old Caucasian child who presented the classical clinical features of the 17q21.31 microduplication syndrome in association with new clinical characteristics previously unreported. The Array-Comparative Genomic Hybridization (aCGH) revealed a partial duplication of the long arm of chromosome 17. A literature review of previously studied patients with 17q21.31 microduplication syndrome is reported.
染色体17q21.31微重复综合征是一种罕见的遗传综合征,表现为颅面畸形、精神运动迟缓、小头畸形、行为障碍和不良社交。直到今天,文献中只报道了10例患者。所有患者都有一些共同的特征,包括精神运动迟缓、行为障碍和自闭症谱系障碍(ASD)。在此,报告了一例新的该综合征病例,该病例发生在一名11岁的高加索儿童身上,该儿童表现出17q21.31微重复综合征的经典临床特征,并伴有以前未报告的新临床特征。阵列比较基因组杂交(aCGH)显示17号染色体长臂部分重复。报道了一篇先前研究的17q21.31微重复综合征患者的文献综述。
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引用次数: 0
Same Incision for Simultaneous Laparoscopic Hand-Assisted Native Nephrectomy Contralateral to the Site of the Kidney Transplant 同一切口同时行腹腔镜手助原位肾切除术
Pub Date : 2023-06-16 DOI: 10.3390/reports6020029
R. Angelico, Laura Keçi, L. Tariciotti, A. Anselmo, E. Favi, T. Manzia, G. Tisone, R. Cacciola
Native nephrectomies in patients scheduled for a kidney transplant may represent a major challenge. The timing of the procedures as well as the magnitude of both surgical procedures require a risk mitigation strategy that may be restricted by the specific condition of the patients. We report a case of a simultaneous laparoscopic hand-assisted native nephrectomy contralateral to the site of the living donor kidney transplant.
对计划进行肾移植的患者进行自体肾切除术可能是一个重大挑战。手术的时间安排以及两种手术的规模都需要一种风险缓解策略,这种策略可能会受到患者具体情况的限制。我们报告了一例同时腹腔镜手助自体肾切除术对侧活体供肾移植。
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引用次数: 0
Improvement in Intestinal-Failure-Associated Liver Disease by Using Parenteral Fish Oil as Monotherapy: Case-Based Review of the Literature 肠外鱼油单药治疗改善肠衰竭相关肝病:基于病例的文献综述
Pub Date : 2023-06-12 DOI: 10.3390/reports6020028
S. Fessatou, A. Kourti, N. Zavras, S. Zouganeli, N. Kouna, E. Stefos, I. Kanavaki
Intestinal-failure-associated liver disease (IFALD) is a common complication of prolonged parenteral nutrition (PN). Risk factors for IFALD include clinical features, as well as medical interventions, and its management was initially based on the decrease or interruption of parenteral nutrition while increasing enteral nutrition. However, the tolerance of full enteral nutrition in children with intestinal failure may require prolonged intestinal rehabilitation over a period of years. As a consequence, infants unable to wean from PN are prone to develop end-stage liver disease. We describe the case of an infant receiving long-term PN who was diagnosed with IFALD wherein we were able to reverse IFALD by switching lipid emulsions to fish oil monotherapy. A systemic review of case reports and case series on reversing IFALD using fish oil lipid emulsion follows the case description.
肠衰竭相关性肝病(IFALD)是延长肠外营养(PN)的常见并发症。IFALD的危险因素包括临床特征和医疗干预措施,其管理最初是基于减少或中断肠外营养,同时增加肠内营养。然而,肠衰竭儿童对完全肠内营养的耐受性可能需要多年的肠道康复时间。因此,不能断奶的婴儿很容易发展为终末期肝病。我们描述了一个长期接受PN治疗的婴儿,他被诊断为IFALD,其中我们能够通过将脂质乳剂转换为鱼油单一疗法来逆转IFALD。在案例描述之后,对使用鱼油脂质乳剂逆转IFALD的病例报告和病例系列进行了系统回顾。
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引用次数: 0
Secondary Treatment of Mandibular Bone Fracture Using Sagittal Split Osteotomy and Segmentation of the Mandible: A Case Report 矢状劈开截骨及下颌骨分段二期治疗下颌骨骨折1例
Pub Date : 2023-06-06 DOI: 10.3390/reports6020027
P. Grab, Aldona Chloupek, Jakub Nowocień, M. Jagielak, D. Jurkiewicz
The secondary treatment of mandibular bone fractures poses a great challenge due to the complexity of several factors, such as incorrect primary fracture repositioning, inadequate internal fixation, nonunion, necrosis, local inflammation and infection, tooth loss, and malocclusion, serving as obstacles encountered by surgical teams. The aim of this case report is to detail the planning process, surgical technique, and outcome of the secondary treatment of the post-traumatic deformation, bone exposure, and partial necrosis of the mandible. The new approach described herein incorporated 3D planning and printing procedures, employing surgical techniques such as the segmentation of the mandible with unilateral sagittal split osteotomy and the vertical osteotomy of the mandibular body. New, stable occlusion; appropriate spatial relations; and proper osteosynthesis of the mandible were achieved. The encouraging results obtained demonstrate that the described method can be incorporated in similar cases of the secondary treatment of mandibular fractures and possibly lead to shorter hospitalization and convalescence and lower the associated costs.
下颌骨骨折的二次治疗由于多种因素的复杂性,如骨折复位不正确、内固定不到位、不愈合、坏死、局部炎症和感染、牙齿脱落、错牙合等,是手术团队遇到的障碍。本病例报告的目的是详细的计划过程,手术技术,以及创伤后变形,骨暴露和下颌骨部分坏死的二次治疗的结果。本文描述的新方法结合了3D规划和打印程序,采用手术技术,如单侧矢状劈开截骨和下颌骨体垂直截骨对下颌骨进行分割。新的、稳定的咬合;适当的空间关系;实现了适当的下颌骨骨愈合。所获得的令人鼓舞的结果表明,所述方法可以纳入类似的下颌骨骨折的二次治疗病例,并可能缩短住院和康复时间,降低相关费用。
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引用次数: 0
Ocular Complications of Myopia: Bibliometric Analysis and Citation Networks 近视的眼部并发症:文献计量分析和引文网络
Pub Date : 2023-06-01 DOI: 10.3390/reports6020026
M. A. Sanchez-Tena, C. Martínez-Pérez, C. Villa-Collar, C. Alvarez-Peregrina
Background: The objective of this study is to determine the relationship between publications and authors. In turn, the different areas of research on the ocular complications of myopia are also identified, and the most cited publication by citation networks is determined. Methods: The search for publications is carried out in the Web of Science database using the term “myopia OR nearsightedness AND retin* OR degenerat* OR detachment OR patholog* OR glaucoma OR cataract OR machulopathy OR “choroidal neovascularization” for the period between 1978 and December 2022. Publication analysis was performed using the Citation Network Explorer, VOSviewer and CiteSpace software. Results: A total of 9357 publications and 78,400 citation networks were found across the network, with 2021 being the year with the highest number of publications, 712. The most cited publication was “Myopia”, published in The Lancet journal in 2012 by Morgan et al. with a citation index of 1006. By using the clustering function, seven groups covering the different research areas in this field were found: axial growth of the eye; myopic maculopathy; ocular complications in patients with myopia after a surgery; glaucoma; retinal detachment; cataracts and retinopathy of prematurity. Conclusions: The citation network offers a quantitative and qualitative analysis of the main papers on ocular complications of myopia. The research on this field is multidisciplinary; however, the main topic studied is the axial growth of the eye.
背景:本研究的目的是确定出版物与作者之间的关系。反过来,还可以确定近视眼部并发症的不同研究领域,并确定被引文网络引用最多的出版物。方法:在Web of Science数据库中检索1978年至2022年12月期间的出版物,检索词为“近视或近视和视网膜*或退行性变*或脱离或病理*或青光眼或白内障或macholopathy或“脉络膜新生血管”。使用引文网络浏览器、VOSviewer和CiteSpace软件进行发表分析。结果:全网共发现9357篇文献,78,400个引文网络,其中发表文献数量最多的年份为2021年,为712篇。被引次数最多的论文是Morgan等人2012年发表在《柳叶刀》杂志上的《近视》(Myopia),被引索引为1006。通过聚类函数,发现了涵盖该领域不同研究领域的7组:眼轴向生长;近视黄斑病变;近视手术后的眼部并发症青光眼;视网膜脱离;早产儿白内障和视网膜病变。结论:引文网络对近视眼部并发症的主要论文进行了定量和定性分析。这一领域的研究是多学科的;然而,研究的主要课题是眼睛的轴向生长。
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引用次数: 0
Allergy to Cow’s Milk Proteins and Other Allergens—An Unrecognized Co-Factor of Idiopathic Nephrotic Syndrome in Children or a Factor Interfering with the Treatment of This Disease? A Case Report 牛奶蛋白和其他过敏原过敏——儿童特发性肾病综合征的一个未被认识的辅助因素还是一个干扰该疾病治疗的因素?病例报告
Pub Date : 2023-05-25 DOI: 10.3390/reports6020025
M. Kaczmarski
Idiopathic nephrotic syndrome (INS) is one of the chronic kidney diseases that occurs in childhood. Starting from a few case reports in the 1950s–1970s and up to the present, the relationship between idiopathic nephrotic syndrome (INS) and the occurrence of atopic disorders in these patients has been discussed in many medical publications. These publications show that in certain patients, mainly children and adolescents, but also in adults with INS, various clinical symptoms and laboratory indicators of an atopic allergic process may be present. This process has been shown to involve Th2 lymphocytes, to have an excessive production of interleukins (IL-4, IL-5, IL-13), and to have an increased serum level of immunoglobulin E (IgE). This leads to the development of a systemic allergic inflammatory process, of which the kidneys can also become the effector organ. The coexistence of an allergic process which may adversely affect the course of nephrotic syndrome may be confirmed by the increased serum IgE level and the hypersensitivity reaction of the patient’s body to various environmental allergens (through the presence of allergen-specific IgE /asIgE/ antibodies to food, pollen, mould, dust, or other allergens in the blood serum). High concentrations of IL-13 and other plasma mediators of this inflammation (e.g., histamine, bradykinin) structurally and functionally damage the renal filtration barrier, and in particular, the function of podocytes in the glomeruli. Podocyte dysfunction disturbs the physiological process of plasma filtration in the glomeruli, leading to excessive protein loss in the urine. These disorders initiate the development of idiopathic nephrotic syndrome in these patients. This publication presents the coexistence of an allergic process caused by allergy to cow’s milk proteins and hypersensitivity to other allergens in a child with idiopathic nephrotic syndrome. This publication also assesses whether treatment of the allergic process coexisting with INS with an elimination diet (milk-free, hypoallergenic) and anti-allergic drugs affected the course and treatment of INS in this child.
特发性肾病综合征(INS)是发生在儿童期的慢性肾脏疾病之一。从20世纪50年代至70年代的一些病例报告到现在,许多医学出版物都讨论了特发性肾病综合征(INS)与这些患者特应性疾病发生之间的关系。这些出版物表明,在某些患者中,主要是儿童和青少年,但在患有INS的成年人中,可能存在特应性过敏过程的各种临床症状和实验室指标。该过程已被证明涉及Th2淋巴细胞,具有过量产生的白细胞介素(IL-4、IL-5、IL-13),并且具有增加的血清免疫球蛋白E(IgE)水平。这导致了系统性过敏性炎症过程的发展,肾脏也可以成为其中的效应器官。可以通过血清IgE水平的升高和患者身体对各种环境过敏原的超敏反应(通过血清中存在对食物、花粉、霉菌、灰尘或其他过敏原的过敏原特异性IgE/asIgE/抗体)来证实可能对肾病综合征进程产生不利影响的过敏过程的共存。高浓度的IL-13和这种炎症的其他血浆介质(如组胺、缓激肽)在结构和功能上损害了肾过滤屏障,特别是肾小球中足细胞的功能。足细胞功能障碍扰乱了肾小球中血浆过滤的生理过程,导致尿液中蛋白质过度损失。这些疾病引发了这些患者特发性肾病综合征的发展。本出版物介绍了特发性肾病综合征儿童对牛奶蛋白过敏引起的过敏过程和对其他过敏原过敏的共存情况。本出版物还评估了与INS共存的过敏过程的治疗,包括消除饮食(无乳、低过敏性)和抗过敏药物是否影响该儿童INS的病程和治疗。
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