Segmental zoster paresis of the upper extremity: a case report

Segmental zoster paresis, a rare complication of herpes zoster, is characterized by focal, asymmetric motor weakness in the myotome that corresponds to the dermatome of the rash. The pathogenesis of segmental zoster paresis is inflammation caused by the spread of the herpes virus. Motor damage may affect the root, plexus, or peripheral nerve. A woman in her early seventies with right shoulder pain and shoulder girdle muscle weakness was diagnosed with involvement of the C5-7 motor roots and upper truncus of the brachial plexus as a complication of herpes zoster. Recognition of herpes zoster as a cause of acute motor weakness is important in avoiding unnecessary interventions as well as in determining the treatment and outcome of the patient. This case is presented to emphasize that herpes zoster infection may be complicated by segmental paresis, which should be considered in the differential diagnosis of acute painful motor weakness of the upper extremity.     

Sun-burn induced upper limb lymphedema 11 years following breast cancer surgery: A case report

BACKGROUNDUpper arm lymphedema is a common complication one year after breast cancer surgery, which profoundly impacts patients'' quality of life.CASE SUMMARYWe reported a case of lymphedema induced by prolonged sun exposure 11 years after breast cancer surgery.CONCLUSIONBreast screening, patient education and follow-up after hospital discharge could help to prevent upper-arm lymphedema.     

上肢运动操改善乳腺癌淋巴水肿患者上肢功能的效果观察

目的探讨上肢运动操改善乳腺癌术后淋巴水肿患者上肢功能的效果。方法选取52例乳腺癌术后淋巴水肿行压迫治疗的患者,采用自编的上肢运动操指导患者进行上肢锻炼,运动操包括手指、肘部及肩关节的运动以及联合器具的锻练,在锻炼的同时绑定胸式呼吸训练。比较干预前后患者上肢功能和淋巴水肿的程度。结果干预后上肢功能评定得分下降(t=3.771,P0.001);干预后1例重度水肿减轻至中度,9例中度水肿减轻至轻度。结论运用上肢运动操,可能改善乳腺癌术后淋巴水肿患者行压迫治疗期间的上肢功能,并利于水肿缓解。     

空气波压力治疗乳腺癌术后上肢淋巴水肿的临床观察

目的 探讨空气波压力治疗配合传统方法 治疗乳腺癌术后上肢淋巴水肿的临床效果.方法 对收治的40例乳腺癌术后上肢淋巴水肿患者随机分为试验组和对照组,每组20例,实验组用空气波压力治疗配合常规传统治疗,对照组采用常规传统治疗.结果 治疗前与治疗2 w后上臂周径差值两组分别为(4.7±0.6)cm、(3.9±0.4)cm,前臂周径差值两组分别为(2.0±0.7)cm、(1.1±0.4)cm,两组对比都有统计学意义(P<0.05);两组症状消失时间分别为(7.5±1.4)d、(12.6±2.8)d(P<0.05).结论 空气波压力治疗配合传统治疗,在乳腺癌术后上肢淋巴水肿的治疗中疗效明显、安全且经济实用.     

Congenital brucellosis: A case report

Although rare, brucellosis is endemic in the Kingdom of Saudi Arabia (KSA). In the case presented here, a neonate was born at 29 weeks gestation with severe respiratory depression, pyrexia; hypotension and an elevated white blood cell count. Her mother was a 19-year-old pregnant woman who developed premature rupture of the membranes and went into labour early. Sepsis was suspected and so the neonate received dobutamine and empiric ampicillin/gentamicin. The mother reported visiting a farm during her pregnancy and so congenital brucellosis was considered a possibility. Blood cultures were positive for Gram-negative coccobacilli and serology confirmed the presence of Brucella abortus and B. meltiness. Antibiotic treatment was changed to rifampin/gentamicin/ciprofloxacin but on day 17 the baby deteriorated and gentamicin was discontinued and meropenem was added. The neonate gradually improved; meropenem was discontinued on day 24 and the baby was discharged from hospital on day 38.     

Bilateral upper extremity thrombophlebitis related to intravenous amiodarone: a case report

A 47-year-old male had bilateral upper extremity thrombophlebitis after use of intravenous amiodarone for sustained ventricular tachycardia complicating myocardial infarction. Intravenous amiodarone has been widely used since it was introduced 20 years ago for severe intractable arrhythmias. Superficial thrombophlebitis was frequently noted in the early case reports when high-dose intravenous amiodarone was used. Superficial thrombophlebitis could extend hospitalization and become a significant source of distress to our patients. Some authors recommend insertion of a central line to administer intravenous amiodarone especially with expected extended use of therapy. The treating physician should be vigilant and switch from intravenous therapy to oral therapy as soon as the patient's condition stabilizes and oral therapy can be started.     

医护人员对乳癌术后上肢淋巴水肿的认知状况调查

目的了解医护人员对乳癌术后淋巴水肿诊治与预防行为的认知现状。方法采用自制问卷对6家三甲医院5个普外科和1个乳腺外科的117名医护人员进行调查。调查内容包括乳癌术后淋巴水肿的病因、诊断、防治等知识。结果调查对象对淋巴水肿的病因、诊断、治疗、预防和危险因素的知晓率分别为:95.7%、82.1%、89.7%、88.9%和93.2%,对淋巴水肿发病率的知晓率为43.6%。仅有18.8%的医护人员告知患者淋巴水肿的预防方法,只有22.2%的医护人员建议患者自我监测患肢症状,定期监测患肢的肿胀程度的医护人员占16.2%。结论医护人员对淋巴水肿的认知水平较高,但对发病原因认识不足,对上肢淋巴水肿预防工作重视不够,临床应加强对患者的健康教育工作。     

A case of rhabdomyolysis with compartment syndrome in the right upper extremity

Dear editor,Acute compartment syndrome refers to a series of symptoms of muscles and nerves in the compartment of the fascia due to acute ischaemia and hypoxia.It is more common in the volar and calf of the forearm.[1]Due to long-term ischaemia of muscles and nerves in the fascia,muscle necrosis and neurological dysfunction can occur,causing serious irreversible damage to the limbs.However,rhabdomyolysis is one of the major complications in the absence of fractures or other trauma.     

Congenital chylothorax: a case report.

A case of unilateral congenital hydrothorax diagnosed at 21 weeks and treated with a pleuro-amniotic shunt at 23 weeks' gestation is presented. The rapid production of pleural fluid led to the development of polyhydramnios which was treated with a selective Cox inhibitor. Due to worsening of the hydrothorax, a third thoracocentesis was performed at 30 weeks' gestation prior to a Cesarean section. The neonate responded well to mechanical ventilation, a thoracic drainer that was inserted between days 5 and 14, fluid and protein replacement and gradual transition from parenteral to intestinal nutrition. Early diagnosis of chylothorax should be treated by thoraco-amniotic drainage to prevent fetal pulmonary hypoplasia and congestive cardiac failure. Polyhydramnios is a complication of this therapy and may require treatment with a Cox inhibitor.     

乳腺癌术后上肢淋巴水肿护理管理的应用效果

目的分析乳腺癌术后上肢淋巴水肿护理管理的应用效果。方法选定本院2018年1月至2019年6月收治的120例乳腺癌术后上肢淋巴水肿患者,将其随机分为试验组和参照组,每组60例。参照组给予常规护理,试验组给予护理管理。比较两组护理效果。结果干预1个月后,试验组肩关节前屈、外展活动度、上肢功能优良率均明显高于参照组,双上肢周径差、上肢总感染率明显低于参照组(P<0.05)。结论护理管理可有效改善乳腺癌术后上肢淋巴水肿患者的上肢功能,扩大关节活动度,降低感染率。     

乳腺癌术后患肢淋巴水肿的康复护理

患肢淋巴水肿是乳腺癌根治术后常见的慢性并发症,发生率为10%～37%[1].淋巴水肿时由于患肢肿胀、变形,可导致上肢功能障碍,影响病人生活自理能力,严重的可导致无法工作;同时病人容易产生自卑心理和精神压抑,使身心遭受极大痛苦,严重影响术后生活质量[2,3].我科对乳腺癌术后并发患肢淋巴水肿的病人采取一系列有针对性的康复措施,疗效明显.现报告如下.     

Primary lymphedema in the nephrotic syndrome: case report

The aim of this case report is to discuss possible connections between the development of a hypoproteinaemic oedema due to the nephrotic syndrome and the occurrence of lymphoedema. Two patients (a three year-old girl and a seven year-old boy) developed lymphoedema of one leg one year after the onset of the nephrotic syndrome. The case of the six year-old girl is presented. Malignancy was excluded by clinical investigation. Direct lymphography failed to show any peripheral lymph-vessels; indirect lymphography (i.c. infusion of a newly-developed contrast medium) revealed hypoplasia of the peripheral lymph-collectors. The development of lymphoedema 12-18 months after the appearance of the nephrotic syndrome supports the hypothesis that the increase in extravascular fluid, which is caused by a reduced oncotic pressure in the plasma, may trigger off the development of lymphoedema if there is a primary defect of the lymphatic system.     

核素淋巴显像在下肢淋巴水肿诊断中的应用

本文对44名下肢水肿患者进行了核素淋巴显像,以探讨下肢淋巴显像的应用价值。图像按正常回流、不完全性梗阻及完全性梗阻进行分型与分析,结果表明:淋巴显像诊断下肢淋巴性水肿的灵敏度及特异性分别为88.4％及95.6％,15例患者按显像所示淋巴管梗阻部位进行了静脉一淋巴管吻合术,治疗总有效率达93.3％。研究提示核素淋巴显像不但具有安全、无创与简便的优点,而且能准确显示淋巴回流功能及梗阻部位,为治疗方法选择提供指导,具有较高的临床应用价值。     

Congenital absence of scaphoid and flexor pollicis longus. A case report

Congenital absence of scaphoid with or without other anomalies like hypoplastic thenar muscle, hypoplastic thumb, carpal anomalies, radial ray defects and VATER (Vertebral defects, Anal atresia, Tracheo oesophageal fistula, Renal dysplasia) anomalies are rare and has been reported [1,2,3,4,5,6]. We are reporting this rare combined defect of absent scaphoid, hypolastic thumb with thenar muscles and absent flexor pollicis longus. We are not aware of any similar case report in English literarure.     

乳腺癌术后上肢淋巴水肿护理评估的研究进展

上肢淋巴水肿是乳腺癌术后常见的慢性并发症,其发生率大约为30%[1].淋巴水肿可导致上肢功能障碍和精神压抑,严重影响术后生存质量.研究表明,淋巴水肿对自理活动,如拉背部拉链、梳头等造成影响,甚至导致无法工作[2];肿胀的上肢甚至比乳房切除术更令患者紧张、情绪低落,因为后者容易掩盖,而变形的手、上肢容易引起自己和旁人的注意[3].     

Physical therapy management of primary lymphedema in the lower extremities: A case report

ABSTRACT

Lymphedema is the tissue fluid accumulation that arises as a consequence of impaired lymphatic drainage. Lymphedema can result from either congenital (primary) or acquired (secondary) anomalies. Primary lymphedema affects 1–2 million people in the United States. Women are more affected by this disorder than men. The management of lymphedema by physical therapists usually includes a combination of skin care, external pressure, isotonic exercise, and massage. This case report describes the course of treatment for a 24-year-old female with stages 2 and 3 primary lymphedema. The goals of physical therapy intervention were as follows: 1) to reduce total limb girth circumference for both lower extremities; 2) to improve skin texture; 3) to promote independence with skin care to reduce the risk of infection; and 4) to facilitate independence with self-management. Following intervention, the patient met and exceeded all goals to decrease limb circumference. She had minimal fibrosis in the lower extremities, and she exhibited no signs and/or symptoms of infection. Decongestive lymphedema therapy was effective in treating this patient with primary lymphedema of the lower extremities. Continuous maintenance is required to ensure that the patient's limb size continues to reduce.     

Congenital absence of the right coronary artery: A case report

BACKGROUNDAs a rare anomaly, congenital absence of the right coronary artery (RCA) occurs during the development of coronary artery. Patients with congenital absence of the RCA often show no clinical symptoms, and this disease is considered benign. The left coronary artery gives blood supply to the whole myocardium. The prevalence of congenital absence of the RCA is approximately 0.024%-0.066%. There are few cases reported as for this disease. In this work, a patient, with congenital absence of the RCA diagnosed by coronary angiography (CAG), was described. CASE SUMMARYA 41-year-old man arrived at our hospital for treatment, due to the repeated palpitations for a duration of one year. Considering the possibility of coronary heart disease, the patient underwent CAG that indicated the congenital absence of the RCA. Unfortunately, the patient refused to accept computed tomography coronary angiography (CTCA), to further confirm the congenital absence of the RCA.CONCLUSIONSingle coronary artery is a rare type of coronary artery abnormality, which usually has no obvious clinical manifestations and is considered as a benign disease. CAG is the main means by which congenital absence of the RCA can be diagnosed, and the disease can also be further confirmed by CTCA.