Medicine
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Case Reports
Percutaneous endoscopic necrosectomy in a patient with emphysematous pancreatitis: A case report.
Emphysematous pancreatitis, a rare complication of acute necrotizing pancreatitis with a high mortality rate, is associated with gas-forming bacteria. When using the step-up approach for treating emphysematous pancreatitis, it is preferable to delay drainage interventions for 4 weeks. However, percutaneous drainage may be necessary, even in the early phase of acute pancreatitis, for a patient whose sepsis deteriorates despite optimal medical management. Percutaneous drainage can then be followed by endoscopic necrosectomy through the percutaneous tract. ⋯ PCD can be used in the early phase of emphysematous pancreatitis for patients who continue to deteriorate due to sepsis. This can easily be followed, if necessary, by percutaneous pancreatic necrosectomy using an ultra-slim endoscope.
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Turner syndrome (TS) is a genetic disorder associated with abnormalities of the X chromosome related to ovarian function, but whether it is associated with endometrial abnormalities is still not clear. ⋯ To our knowledge, the present case is the first report of a patient with TS with Xp deletions and ultrasound imaging endometrial abnormalities. Our findings expand the phenotypic spectrum of TS and may provide a reference for other clinicians.
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Excessively increased training volume and/or intensity and competition can lead to development of overtraining syndrome, causing a performance decrement in athletes. Tracking individual response to exercise intensity is crucial for establishing recovery strategies. We assessed the exercise intensity-dependent variability of stress response biomarkers, namely cortisol (C), testosterone (T), s-IgA, and advanced oxidation protein products (AOPP), in saliva samples of teenage elite water polo players. ⋯ A highly significant positive correlation was found between Cortisol/Proteins and Testosterone as well as s-IgA/Proteins on day T1, and between Cortisol/Proteins and AOPP on day T2. In conclusion, we found that different types of activities, such a training or competitive session can affect the hormonal response, immunity, and oxidative stress, thereby modulating athletic performance. Our findings also confirm the usefulness of saliva testing as noninvasive way for monitoring the individual response to changes in exercise intensity in teenage elite water polo players.
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Early and appropriate antenatal care (ANC) is key for the effectiveness of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV). We evaluated the importance of ANC visits and related service costs for women receiving option B+ to prevent mother-to-child transmission (MTCT) of HIV in Tanzania. A cost analysis from a health care sector perspective was conducted using routine data of 2224 pregnant women newly diagnosed with HIV who gave birth between August 2014 and May 2016 in Dar es Salaam, Tanzania. ⋯ The potential cost-saving was 2.2 US$ per woman at ≥4 visits (84.8 US$) compared to <4 visits (87.0 US$), mainly due to less defaulter tracing. Most pregnant women living with HIV in Dar es Salaam initiated ANC late and >40% failed to adhere to the recommended minimum of 4 visits. Improved ANC attendance would likely lead to fewer HIV-infected infants and reduce both short and long-term health care costs due to less spending on defaulter tracing and future treatment costs for the children.
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Nomogram to predict contralateral breast cancer risk in breast cancer survivors: A SEER-based study.
The main purpose of this study was to build a prediction model for patients with contralateral breast cancer (CBC) using competing risks methodology. The aim is to help clinicians predict the probability of CBC in breast cancer (BC) survivors. We reviewed data from the Surveillance, Epidemiology, and End Results database of 434,065 patients with BC. ⋯ BC survivors remain at high risk of developing CBC. Patients with CBC have a worse clinical prognosis compared to those with unilateral BC. We built a predictive model for the risk of developing CBC based on a large data cohort to help clinicians identify patients at high risk, which can then help them plan individualized surveillance and treatment.