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Yunan Wang Chang Liu Aihua Yin Xin Zhao Wei He Ying Xiong Liyuan Fang Jing Wu 《The Journal of international medical research》2021,49(1)
BackgroundCongenital ventricular diverticulum is a rare abnormality that may occur as an isolated malformation. Most cases are accompanied by pericardial effusion. Prenatal counseling can be difficult because the prognosis is uncertain and there is no consensus approach to prenatal management.Case presentation: We describe a case of congenital cardiac diverticulum complicated by large pericardial effusion in one of monochorionic diamniotic twins. The case was diagnosed by ultrasonography at 21 weeks of gestation. Therapeutic pericardiocentesis at 22 weeks resulted in complete resolution of the effusion and led to a favorable fetal outcome. We summarize the interventions and pregnancy outcomes in cases of cardiac diverticula reported in the literature.ConclusionsBetter awareness of clinical features, in utero therapies, and pregnancy outcomes could help define and improve prenatal management of congenital ventricular diverticula. 相似文献
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《Revista brasileira de otorrinolaringologia (English ed.)》2022,88(5):803-811
ObjectivesTo review the evidence pertaining to the association between cow’s milk protein allergy and recurrent acute otitis media and otitis media with effusion.MethodsThe CENTRAL, Web of Science, EMBASE, MEDLINE, LILACS databases, and gray literature were searched.ResultsFour studies were included, identifying the prevalence rates: 0.2% of delayed speech due to chronic otitis media with effusion in 382 children with cow’s milk protein allergy, 10.7% of cow’s milk protein allergy in 242 children who underwent ENT procedures, 40% of cow’s milk protein allergy in 25 children with recurrent otitis media with effusion and higher tendency to otitis media in children with cow’s milk protein allergy of 186 children (1.5 + 0.6 vs. 0.4 + 0.1; p < 0.1).ConclusionConsidering the characteristics and methodological variations of the identified studies, it is not possible to state that there is reliable evidence of an association between cow’s milk protein allergy and otitis media. 相似文献
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目的评估猪尾巴导管在单孔胸腔镜肺肿瘤手术中应用的有效性。方法回顾性分析2020年1月至12月上海交通大学医学院附属仁济医院东院接受单孔胸腔镜肺肿瘤手术的患者共441例,根据是否放置猪尾巴导管分为胸管组和猪尾巴管组,通过倾向性评分匹配法进行1∶1匹配,对比两组患者围手术期的各项指标。结果匹配后每组143例配对成功,匹配后两组间基线特征无统计学差异。对比两组围手术期指标发现,猪尾巴管组患者术后3天胸腔引流总量显著多于胸管组(375.49 ml对285.03 ml,P<0.001),术后两周复查CT示胸腔积液量显著少于胸管组(131.77 ml对178.84 ml,P=0.032),两组术后疼痛评分、引流天数及住院天数无明显统计学差异。结论加放猪尾巴导管可有效改善单孔胸腔镜肺肿瘤术后胸腔引流情况,且不增加患者术后疼痛,不延长胸腔引流及住院天数。 相似文献
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《中国现代医生》2019,57(6):63-66
目的探讨胫骨平台后外侧柱骨折手术患者发生切口感染的手术室相关因素及对策分析。方法选择2015年1月~2018年6月在我院治疗的胫骨平台后外侧柱骨折的患者383例的临床资料进行回顾性分析,根据术后是否发生切口感染分为感染组(n=36)与非感染组(n=347)。统计切口病原菌分布情况,分析影响患者术后切口感染手术室相关因素,并探讨预防对策。结果 36例患者共分离出病原菌48株。革兰阳性菌比例最高,占66.7%,其中金黄色葡萄球菌构成比最高,其次为表皮葡萄球菌。革兰阴性菌中铜绿假单胞菌是主要菌株,分离出1例真菌。多因素分析结果显示:急诊手术、有参观人员、接台手术、手术时间≥3 h是胫骨平台后外侧柱骨折患者术后切口感染的独立危险因素,而层流室是保护因素(P0.05)。结论胫骨平台后外侧柱骨折手术患者术后切口感染的手术室相关因素包括急诊手术、有参观人员、接台手术、手术时间≥3 h,应加强手术室相关管理,采取必要的措施,降低术后切口感染风险。 相似文献
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目的分析早期颅骨修补治疗颅脑损伤大骨瓣减压术后顽固性硬膜下积液的效果及机制。
方法选取解放军第二五一医院神经外科自2014年1月至2019年1月收治的因颅脑损伤术后行去骨瓣减压并发硬膜下积液患者20例,给予皮下或颅骨钻孔引流、局部加压、腰大池引流及大脑外侧裂池开放等方法后效果不明显,4~6周后行颅骨修补后观察硬膜下积液变化。
结果2例患者术后出现局部伤口感染,经过积极换药抗生素治疗后甚至痊愈;5例患者术后1个月复查CT硬膜下积液减少不明显,术后3、6个月后随访发现积液逐渐减少消失;其余患者均取得良好的效果,神经功能障碍不同程度恢复,随访硬膜下积液未再复发。
结论早期颅骨修补术能有效治疗顽固性性硬膜下积液。 相似文献
8.
Background
Blastomycosis is caused by a fungus endemic to states and providences bordering the Lawrence Rivers and the Great Lakes. It can lead to significant pathology in both immunocompetent and immunocompromised hosts. This case report describes disseminated blastomycosis in an otherwise healthy 16-year-old patient.Case Report
A 16-year-old male presented with a chief complaint of flank pain. In the Emergency Department he described additional symptoms of emesis, cough, and weight loss. His vitals were appropriate; however, he had absent lung sounds in the left lower lung field, splenomegaly, a left thigh abscess, and lower-extremity edema. Imaging studies showed a left pleural effusion, mediastinal shift to the right, splenomegaly, a left psoas abscess, and undifferentiated bony involvement of L1 transverse process and the left 12th rib. Abscess cultures grew Blastomyces dermatitides. He was treated with amphotericin B, demonstrated clinical improvement, and was discharged on itraconazole.Why Should an Emergency Physician Be Aware of This?
The case fatality rate of blastomycosis is estimated at between 4.3% and 6.4%. Patients with solid organ transplant and associated immune suppression had a mortality of 33–38%. Given the nonspecific nature of this condition, a high level of suspicion is required for diagnosis, and early diagnosis is essential, as end organ damage in disseminated disease can include high-severity illness, including acute respiratory distress syndrome and central nervous system dysfunction. If any patient presents with symptomatology involving both skin and pulmonary systems, blastomycosis must be entertained as a possible diagnosis. Prompt diagnosis and treatment will significantly improve morbidity and mortality. 相似文献9.
Uday Yanamandra Prateek Deo Kamal Kant Sahu Ram Vasudevan Nampoothiri Nalini Gupta Anusree Prabhakaran Deb Prasad Dhibhar Alka Khadwal Gaurav Prakash Man Upadesh Singh Sachdeva Deepesh Lad Neelam Varma Subhash Varma Pankaj Malhotra 《Clinical Lymphoma, Myeloma & Leukemia》2019,19(3):183-189.e1
Background
Multiple myeloma (MM) is a hematologic malignancy of plasma cell origin. MM primarily affects bone marrow, but extramedullary sites can also be involved. Myelomatous pleural effusion (MPE) is an atypical and rare complication of MM. We aimed to systematically study the incidence and clinicopathologic profile of patients with MPE in a real-world setting.Patients and Methods
In this retrospective study, 415 consecutive patients with MM managed at a tertiary care center in North India during a study period of January 1, 2010 to December 31, 2015 were evaluated for MPE. The patients with MPE were analyzed for their clinical profile, diagnosis, treatment, and outcomes.Results
Of these 415 patients, 11 (2.65%) patients had MPE. The median age of the study population was 50 years with male preponderance. The majority of these patients had immunoglobin (Ig)G Kappa disease. All patients had higher than International Staging System stage I disease. MPE was a presenting feature at MM diagnosis in 45.45% (n = 5) of the patients, whereas the rest developed MPE during follow-up. MPE presented predominantly (81.8%) as a unilateral effusion. Concurrent extramedullary involvement at other site was seen in 45.45% (n = 5), with 3 (27%) patients having concurrent myelomatous ascites. Six of these were managed aggressively, whereas 5 patients opted for palliation. The outcomes were dismal (90.9% mortality), with a median survival of 2.47 months.Conclusion
MPE is a rare entity, and positive outcomes of therapy remain low with dismal prognosis. 相似文献10.