Medicine
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We report a man with amyopathic dermatomyositis (ADM) complicated by severe interstitial lung disease (ILD) received extracorporeal membrane oxygenation (ECMO) in combination with double filtration plasmapheresis (DFPP). This is the first report of the utility of ECMO in combination with DFPP in ADM related ILD in adults. ⋯ When get a rapid progressive interstitial lung disease for no apparent reason, amyopathic dermatomyositis should be considered, especially with suspected skin lesions. ECMO, in combination with DFPP, should be considered as a supportive therapy and initiated early in patients in acute respiratory failure secondary to ADM-ILD. Prompt initiation of DFPP in dermatomyositis patients with ILD might help reduce the occurrence of spontaneous pneumomediastinum or pneumothorax.
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Clinical Trial Observational Study
Predictors and prognosis for incident in-hospital heart failure in patients with preserved ejection fraction after first acute myocardial infarction: An observational study.
Patients with acute myocardial infarction (AMI) complicated by heart failure with preserved ejection fraction (HFpEF) are likely to have more adverse cardiovascular events and higher mortality. The purpose of this study was to examine the predictors and outcomes in AMI patients complicated by HFpEF. We examined the demographics, clinical data, and clinical outcomes in 405 consecutive subjects who firstly presented with AMI after undergoing emergency percutaneous coronary intervention from January 2013 to June 2016. ⋯ Moreover, patients with HFpEF had a higher probability of developing the in-hospital incident cardiovascular complications and death than non-HF patients. Two routine biomarkers, levels of hypersensitive C-reactive protein and N-terminal-pro brain natriuretic peptide, and number of diseased-vessels were independent predictors for in-hospital HFpEF incidence in AMI patients with preserved LVEF. AMI patients with HFpEF had a higher probability of in-hospital cardiovascular outcomes and mortality.
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Case Reports
Unusual location of the glomus tumour in the liver: A case report and literature review.
Liver glomus tumor is very rare, and only 6 cases have been reported. Herein, we report another case of liver glomus tumor and the clinicopathological features are summarized. ⋯ Primary liver glomus tumor has no specific clinical manifestations, and imaging examinations have limitations for its diagnosis. Immunostaining for SMA and vimentin is necessary to prove the diagnosis. Complete resection is strongly advised and it has a favorable prognosis.
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Case Reports
Transient ischemic attack characterized by external strabismus of the left eye: A case report.
Patients rarely display eye movement dysfunctions as the primary symptom in transient ischemic attack. ⋯ Atypical symptoms of transient ischemic attack are easy to be overlooked. Early diagnosis and timely treatments are keys to reverse the neurological symptoms and can be highly beneficial for patients with this condition.
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Median arcuate ligament (MAL) may compress the coeliac trunk inducing median arcuate ligament syndrome (MALS). MALS is a risk factor for hepatic artery thrombosis (HAT) in liver transplant recipients. ⋯ MALS can cause HAT after liver transplantation. Before the liver transplantation, we should use Doppler B ultrasonography and sagittal CT imaging to judge whether the patient is with MALS. Also, before arterial anastomosis in liver transplantation is conducted, we should observe the impacts on the HA caused by pre-blocking gastroduodenal artery, which determines if we are supposed to do MAL dissection or bridge HA with aorta.