Medicine
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Case Reports
Case report: severe myoclonus associated with oral midodrine treatment for hypotension.
Midodrine is widely used in the treatment of hypotensive states, there have been no reports of myoclonus associated with midodrine use in hypotension with chronic kidney disease. ⋯ Oral midodrine is widely used in the treatment of orthostatic hypotension, recurrent reflex syncope and dialysis-associated hypotension and the adverse effects are mostly mild. However, clinicians should be alert for midodrine-induced myoclonus, especially in patients with CKD.
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Angiosarcoma is a highly invasive tumour with a low incidence rate but high rates of local recurrence and distant metastasis and a poor prognosis. Understanding the endoscopic characteristics of angiosarcoma will help with early diagnosis and treatment of this disease. ⋯ Colorectal angiosarcoma is an extremely rare and highly malignant tumour, and understanding its endoscopic morphology will help aid in its diagnosis.
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15q11.2 microdeletion syndrome is a relatively rare chromosomal abnormality with incomplete penetrance and phenotypic variability. The reports on prenatal ultrasound abnormalities of fetus with 15q11.2 microdeletion are rare. ⋯ The combined application of traditional banding technique and molecular cytogenetic techniques can not only detect chromosomal structural abnormalities, but also identify the subchromosomal imbalances, which is beneficial to genetic counselling and would offer more guidance to prenatal diagnosis.
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Giant intra-abdominal liposarcomas weighing over 20 kg often increase the intra-abdominal pressure (IAP), which has severe effects on the cardiovascular and respiratory systems. Abdominal compartment syndrome is defined typically as the combination of a raised IAP of 20 mm Hg or higher and new onset of organ dysfunction or failure. The anesthetic management and perioperative management are very challenging. ⋯ Multiple monitorings, in particular transesophageal echocardiography should be considered in patients with increased IAP due to a giant mass, while an appropriate lung protection ventilation strategy is crucial in these patients.
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Case Reports
Late-onset anastomotic leak following sweet esophagectomy: A case report and review of the literature.
Late-onset anastomotic leak (AL) is an uncommon but potentially lethal complication after esophagectomy. ⋯ Late-onset AL should be kept in mind when the patient complained of chest distress and fever during the follow up after esophagectomy. In addition, naso-leakage extraluminal drainage could be considered for the treatment of AL. Further trials for better evidence are warranted.