Medicine
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Review Case Reports
Clinical signs of retroperitoneal abscess from colonic perforation: Two case reports and literature review.
Retroperitoneal colonic perforation is a rare cause of retroperitoneal abscess. It presents, more frequently in frail elderly patients, with heterogeneous signs and symptoms which hamper the clinical diagnosis. Subcutaneous emphysema with pneumomediastinum and iliopsoas muscle abscess are unusual signs. Colonic retroperitoneal perforation may be consequent to diverticulitis or locally advanced colon cancer. Due to the anatomy of the retroperitoneal space and different physiopathology, diverticular perforation may present with air and pus collection; on the other hand perforated colon cancer may cause groin mass and psoas abscess. We reported 2 cases of colonic retroperitoneal perforation from diverticulitis and locally advanced colon cancer, respectively. Aim of this report is to improve differential diagnosis based on clinical signs. ⋯ The spread of retroperitoneal abscess in complicated colonic diverticulitis is different from that in advanced colonic cancer. The former can present with a subcutaneous emphysema, the latter with a groin mass. Hence a thorough clinical examination and radiological studies are needed to diagnose these conditions.
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Meta Analysis
High protein diet is of benefit for patients with type 2 diabetes: An updated meta-analysis.
Currently, the prevalence of type 2 diabetes is still increasing worldwide and has become a major public health burden. This meta-analysis was performed to further assess high protein (HP) diet on body weight, glycemic control, and cardiovascular disease risk factors in type 2 diabetes. A literature search was conducted in PubMed and Embase databases up to June 2018. ⋯ However, the overall analyses showed the significant effect of HP diet on triglycerides reduction (SMD = -0.20, 95% CI = -0.35 to -0.05, P = .01) in patients with type 2 diabetes, compared with LP diet. Subgroup analyses showed that the ratio of energy from fat and carbohydrate in diet could affect the effect of HP diet on weight and triglyceride. HP diet could be indicated to obtain beneficial results in weight loss and lipid metabolism.
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Review Case Reports
Concomitant breast and axillary lymphangioma in an adult: A case report and a review of the literature.
Lymphangiomas develop in the head, neck, and axilla of patients <2 years old in more than 90% of cases. They are rarely reported in adults. ⋯ Despite the rarity of breast cystic lymphangioma, its evaluation should be considered for prompt diagnosis and definitive treatment to prevent recurrence and complications. Furthermore, this is the first case of concomitant lymphangioma of the breast parenchyma and axillary region.
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Case Reports
Combination of meshed dermis graft and cultured epithelial autograft for massive burns: Three case reports.
This study reviewed the use of a combination of meshed dermis graft and cultured epithelial autografts (CEA) made in Japan "JACE" (JACE; Japan Tissue Engineering Co., Ltd. Japan) for the treatment of massively burns. JACE is a Green-type CEA. We recently described a method in which we prepare the wound bed for burned patients by using artificial dermis and graft with JACE on a meshed 6:1 split-thickness autograft. In this report, we used a meshed 3:1 split-thickness dermis graft without epithelial cells. There are several reports of combination of using CEA on meshed split-thickness autograft, however this is the first report of using CEA on meshed split-thickness dermis graft. ⋯ We observed good results by grafting JACE on meshed 3:1 dermis graft. With this new method, it is possible to cover a large burn wound by harvesting tissue from only a small site.
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Oxidative stress may be an integral determinant of surgical stress severity. We examined whether the preoperative level of derivatives of reactive oxygen metabolites (d-ROMs), an oxidative stress biomarker based on total hydroperoxides in circulating blood, is predictive of increased risk of delayed recovery and complications after surgery, as well as the effects of anesthesia management on postoperative recovery in light of oxidative stress. ⋯ Elevated preoperative blood d-ROMs predicts greater intraoperative oxidative stress and increased postoperative complications with prolonged recovery, thus is useful for identifying high-risk patients for delayed and complicated surgical recovery. Reduction of oxidative stress is vital for enhanced recovery, with control by antioxidants such as propofol a possible solution.