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Background: Fistula formation is a known complication of diverticulitis. Treatment of a diverticular fistula depends on the comorbidity of the patient and the severity of the disease. Case report: A 59-year-old man presented to the Emergency Department with chronic lower back pain that was being treated with a neurostimulator. He presented with severe sepsis, and an abscess formation near the neurostimulator. An abdominal and pelvic computed tomography scan revealed diverticulitis complicated by fistula formation to the neurostimulator and bladder. He was successfully treated by a two-stage procedure: first, exploration and drainage of the abscess, with removal of the foreign body, followed by a sigmoid resection 1 week later. Conclusion: In rare but severe presentations of diverticular disease, it is very important to limit initial treatment to the most threatening disorder. 相似文献
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Providers should remain vigilant of autoimmune polyglandular syndrome type II in the context of persistent low blood sugar in type I diabetes. Correction of adrenal insufficiency is key for regulation of blood sugar and thyroid function. 相似文献
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《Annals of physical and rehabilitation medicine》2022,65(1):101600
COVID-19 has been associated with multiple neurological manifestations. Coronaviruses are known to have a neurotropic propensity, possibly leading to various neurological complications, including peripheral facial paralysis (PFP). However, the pathogenic mechanisms underlying neurological symptoms in COVID-19 are not completely understood. This report presents the first published case of facial palsy in an otherwise healthy child secondary to infection with the novel coronavirus SARS-Cov-2, with reflections on the natural course and the role of physical and rehabilitation medicine in this form of PFP. Thus, PFP may also be a manifestation of COVID-19 and in the current epidemiological context, physicians evaluating patients with facial palsy should exclude infection with SARS-Cov-2 to prevent diagnostic delays and further transmission of the disease. These patients may have a slower recovery and worse prognosis as compared with those with Bell's palsy. Thus, rehabilitation needs to be initiated promptly, and close follow-up must be assured to identify and address early complications. 相似文献
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First successful use of leukocyte apheresis as maintenance therapy for Crohn's disease in the United Kingdom 下载免费PDF全文
David Tate Vida Cairnes Roland Valori Richard Makins 《Journal of clinical apheresis》2014,29(3):181-182
We describe the case of a 24 year old male with severe fistulating Crohn's disease who failed mutliple modalities of medical and surgical therapy. We present objective and subjective evidence of disease remission after induction and maintenance treatment with leukocyte apheresis. This is the first described case of successful maintenance treatment of severe Crohn's disease with leukocyte apheresis in the United Kingdom. J. Clin. Apheresis 29:181–182, 2014. © 2013 Wiley Periodicals, Inc. 相似文献
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Athina Asimakopoulou Marinela Tzanela Ageliki Koletti George Kontogeorgos Stylianos Tsagarakis 《Clinical Case Reports》2014,2(1):1-3
The clinical course of our patient, who sustained remission status for at least 18 months highlights the chance of long‐term hormonal and tumor remission and demonstrates the efficacy and safety of discontinuation of temozolomide therapy. Prospective studies are required in order to define predictors of long‐term remission of this promising therapeutic modality. 相似文献
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ObjectivesTo preliminarily assess the effects of Bushen Huoxue Granule (BHG) on Parkinson’s Patients with Parkinson’s Disease Questionnaire-39 (PDQ-39)and to provide data for further research.DesignA randomized, double-blinded, placebo controlled study with a 3-month intervention period and a 6-month follow-up.InterventionsParticipants were patients with Parkinson’s Disease (PD) of age ranging from 50 to 80 years and Hoehn and Yahr (H–Y) stage I–IV of the disease.120 participants were allocated to BHG group or placebo group at a 1:1 ratio. The BHG group received BHG twice a day for 3 months, and was followed-up for 6 months after treatment; the placebo group did not receive any Chinese Herb treatment for 9 months. All the patients were given the conventional therapy of levodopa (Madopar).Main outcome measuresPrimary outcome measure was PDQ-39 comprises 39 questions with five different options of answer related to the frequency of the disease manifestation.ResultsSignificant statistical difference appeared in the following PDQ-39 dimensions: mobility; emotional well-being; stigma; cognition (P < 0.01) and bodily discomfort (P < 0.05).There was no statistical difference in the dimensions of social support, ADL and communication between the data of these two group patients (P ≥ 0.05). We found that the sum index of PDQ-39 was significantly different between two groups.ConclusionThe results of this study show that BHG treatment makes significant effects in most domains of PD patients life quality,especially in mobility, emotional well-being, stigma and cognition. The affected factors should be confirmed in larger studies. 相似文献
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Marco Di Serafino Chiara Gullotto Chiara Gregorini Claudia Nocentini 《Journal of Ultrasound》2014,17(4):303-306
Fournier’s gangrene is a rapidly progressing necrotizing fasciitis involving the perineal, perianal, or genital regions and constitutes a true surgical emergency with a potentially high mortality rate. Although the diagnosis of Fournier’s gangrene is often made clinically, emergency ultrasonography and computed tomography lead to an early diagnosis with accurate assessment of disease extent. The Authors report their experience in ultrasound diagnosis of one case of Fournier’s gangrene of testis illustrating the main sonographic signs and imaging diagnostic protocol. 相似文献
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Participant attrition in randomized trials can reduce statistical power and bias outcomes. However, elective withdrawals are seldom discussed in trial reports. We examined factors associated with elective withdrawals for the first 131 Alzheimer's disease (AD) and Parkinson's disease (PD) caregiver participants that entered Project ASSIST (Assistance, Support and Self-health Initiated through Skill Training), an on-going trial of caregiver skill training interventions. After 20 months of recruitment, 14 (11%) of the 131 ASSIST participants had electively withdrawn before completing the final assessment. Survival analysis demonstrated AD caregivers and non-spousal caregivers dropped out earlier than PD and spousal caregivers, even after controlling for selected baseline covariates. Findings suggest caregiver trial contact strategies may need to be tailored to retain different caregiver groups. 相似文献
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目的:对比分析阿尔茨海默病与帕金森病痴呆的认知功能及精神行为的异同点。方法:选取本院接诊的阿尔茨海默病患者52例(AD组)和帕金森病痴呆患者32例(PDD组),采用相关量表(CDR、MMSE、MoCA、CDT、CNPI)评估两组患者的认知功能、精神行为症状,总结各组的认知功能及精神行为特征。结果:两组的痴呆严重程度、MMSE、MoCA总分比较,差异均无统计学意义(P0.05)。与AD组相比,PDD组的CDT评分更低、CNPI评分更高(P0.05)。AD组与PDD组在命名、注意、语言、抽象思维、定向维度的评分比较,差异均无统计学意义(P0.05)。与PDD组相比,AD组的视空间/执行功能评分更高,记忆维度、延迟记忆维度评分更低(P0.05)。两组的妄想、欣快、脱抑制、异常运动行为、睡眠夜间行为、食欲进食障碍发生率比较,差异均无统计学意义(P0.05)。与AD组相比,PDD组的幻觉、激越、抑郁发生率更高,焦虑、淡漠、易激惹发生率更低(P0.05)。结论:相比AD,PDD的执行功能和视空间功能损伤更为严重,PDD的精神行为症状以幻觉、激越、抑郁居多,而AD多见焦虑、淡漠、易激惹。 相似文献
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