Medicine
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The objective of this study was to define the frequency of the bovine aortic arch in patients with coarctation using the tomographic studies. This is a descriptive retrospective study involving analysis of reports of computed tomographic angiography done at the Prince Sultan Cardiac center for 700 children with congenital heart diseases over a span of about 10 years from April 1, 2008, to August 1, 2018. Cases with coarctation of aorta were chosen to determine the frequency of the bovine aortic arch using the tomographic studies. ⋯ Among the 117 patients with coarctation, the total number of patients with bovine arch was 7 patients representing 5.98%, while in patients without coarctation we found a total number of bovine arches of 12 out of 583 patients representing 2.06%. Patients having coarctation with normal branching pattern were at a slight increased incidence of atrial septal defect, ventricular septal defect and anomalous pulmonary venous return than patients having coarctation with bovine arch. In the face of increased incidence of bovine aortic arch in patients with coarctation, we recommend multislice computed tomographic angiography as a noninvasive and potentially safe and accurate method to precisely delineate the branching pattern of the arch of aorta in patients with coarctation before the interventional procedures and surgeries.
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Seasonal variations in vestibular neuritis (VN) could support the etiology of viral infection. However, several recent studies revealed no significant seasonal variations in VN. Further studies are necessary to determine the etiology of VN. ⋯ There were also no significant differences in monthly and seasonal distributions in male and female patients or in older and younger patients. There were no significant differences in monthly or seasonal distributions of patients with VN. Factors other than viruses, such as vascular ischemia, should also be considered in the incidence of VN, especially in older patients.
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Case Reports
Efficacy of subcutaneous Levothyroxine in a case of refractory hypothyroidism: A case report.
Daily oral synthetic levothyroxine (LT4) is the main treatment for hypothyroidism, which, in most cases, allows the regression of symptoms and the normalization of the thyroid function. However, rarely, despite a high dose of oral LT4, hypothyroidism persists and is called refractory hypothyroidism. Intravenous or intramuscular treatment is then often necessary. We report the case of a patient with refractory hypothyroidism successfully treated with subcutaneous LT4. ⋯ In this case of unexplained oral LT4 malabsorption, subcutaneous injection allowed a self-administrated physiological dose of LT4 3 times weekly. Considering the efficacy of subcutaneous injection of LT4, this treatment could be a safe and easy alternative for patients with malabsorption.
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As the population continues to age, dementia is becoming a huge social, economic, and healthcare burden. However, the risk factors for in-hospital death in elderly patients over 65 years of age with dementia are not well understood. Identifying factors that affect their prognosis could help clinicians with scientific decision-making. ⋯ Mortality in hospitalized older patients with dementia is low, but some risk factors may be easily ignored. These findings could raise awareness among clinicians and caregivers about risk factors in hospitalized older patients, particularly hospitalized elderly patients with multiple comorbidities. Therefore, to reduce mortality, early prevention and management of potential risks are necessary.
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Transdermal delivery is very important in pharmaceutics. However, the barrier function of the stratum corneum hinders drugs absorption. How to improve transdermal delivery efficiency is a hot topic. The key advantages of physical technologies are their wide application for the delivery of previously nonappropriate transdermal drugs, such as proteins, peptides, and hydrophilic drugs. Based on the improved permeation of drugs delivered via multiple physical techniques, many more diseases may be treated, and transdermal vaccinations become possible. However, their wider application depends on the related convenient and portable devices. Combined products comprising medicine and devices represent future commercial directions of artificial intelligence and 3D printing. ⋯ This review will provide more useful guidance for efficient transdermal delivery. More therapeutic agents by transdermal routes become possible with the assistance of various physical techniques.