Medicine
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Case Reports
Chorea associated with nonketotic hyperglycemia: A case report with atypical imaging changes.
This is a unique case of nonketotic hyperglycemic (NKH) chorea in 84-year-old Asian woman. The patient had a history of type 2 diabetes mellitus more than 30 years, but had a poor control of blood sugar. She complained of acute onset of bilateral limb involuntary activities, and being easy to fall within a week. Laboratory testing disclosed hyperglycemia (669 mg/dL), glycated hemoglobin (14%), and normal ketones. The brain computed tomography scan and magnetic resonance imaging did not disclose any abnormality in the basal ganglion unlike most cases. The patient was then diagnosed with NKH chorea. Her symptoms improved quickly. ⋯ NKH chorea with normal imaging may represent a new subtype.
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Case Reports
Bilateral femoral posterior neurocutaneous perforater flap successfully treating Fournier gangrene: A case report.
Necrotizing fasciitis (NF), characterized by widespread fascial necrosis, is a rare disease in clinic. Fournier gangrene (FG) is a special type of NF involved of perineum and scrotum. To our knowledge, no article has reported on bilateral femoral posterior neurocutaneous perforater flap treating for FG. ⋯ FG is rare. Bilateral femoral posterior neurocutaneous perforater flap is an effective procedure to treat FG. The outcome of combined therapy is satisfactory.
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The operative procedure for Achilles tendon rupture is relatively simple, but venous thromboembolism is serious complication with a high incidence after Achilles tendon rupture. However, the guideline for thromboprophylaxis in Achilles tendon rupture is unclear. ⋯ Although the incidence of venous thromboembolism in Achilles tendon rupture is higher than that in lower leg injury patients, guideline for thromboprophylaxis is unclear. We suggest that thromboprophylaxis for Achilles tendon rupture should be considered and appropriate guidelines should be established.
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The initial symptoms and signs of Takayasu arteritis vary due to the heterogeneity of affected vessels. Moreover, the vascular lesions are difficult to detect at initial presentation, making diagnosis even more challenging. Although cases of aortic dissection with arteritis history have been reported, Takayasu arteritis in men with aortic dissection as initial presentation is very rare. ⋯ Timely therapy (glucocorticoid and immunosuppressive) and corrective surgery (endovascular graft exclusion) for Takayasu arteritis with aortic dissection at the inactive stage is essential and beneficial.
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We studied the efficacy of prophylactic internal iliac artery balloon catheterization for managing severe hemorrhage caused by pernicious placenta previa. This prospective observational study was conducted in Tongji Hospital, Wuhan, China. One hundred sixty-three women past 32-week's gestation with placenta previa-accreta were recruited and managed. ⋯ Mean radiation dose was 29.2 mGy and mean exposure time was 92.2 seconds. Neonatal outcomes and follow-up data did not have significant difference. Prophylactic internal iliac artery balloon catheterization is an effective method for managing severe hemorrhage caused by placenta previa-accreta as it reduced intraoperative blood loss, lessened perioperative hemostatic measures and intraoperative red cell transfusions, and reduce hysterectomies.