Medicine
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To explore the risk factors of postoperative fever in elderly patients undergoing endoscopic submucosal dissection (ESD). A total of 439 patients who met the inclusion criteria were enrolled in this study and randomly divided into training (n = 311) and validation (n = 128) cohorts at a ratio of 7:3. Independent risk factors were screened by single-factor and multiple-factor logistic regression analyses, and a nomogram was established using them. ⋯ The study included 439 patients. Female (OR = 2.55, 95% CI: 1.5-4.33), diabetes (OR = 2.38, 95% CI: 1.17-4.85), operation time (OR = 1.01, 95% CI: 1-1.02) were lesion located in the esophagus (OR = 2.37, 95% CI: 1.44-3.88), maximum tumor diameter (OR = 1.3, 95% CI: 1.07-1.57), and placement of a urinary catheter (OR = 7.09, 95%CI: 1.43-35.17) were independent risk factors for postoperative fever in elderly ESD patients (P < .05). Female sex, diabetes, lesions located in the esophagus, lesion size, operation time, and placement of a urinary catheter are risk factors for postoperative fever in ESD patients, and patients with these risk factors should be vigilant for postoperative fever and receive appropriate treatment.
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Patients who have myasthenia gravis or dermatomyositis show clinical signs of muscular weakening. Ocular muscle involvement is uncommon, and symmetrical proximal limb weakness is the typical presentation of dermatomyositis. However, the earliest and most noticeable sign in those with myasthenia gravis is extraocular muscular paralysis. Dermatomyositis is frequently complicated by malignancy, and the common malignancies associated with dermatomyositis vary by region and ethnicity, while thymoma is relatively rare. About 10% to 15% of people with myasthenia gravis have thymoma, which is involved in the etiology of the disease. ⋯ Ocular muscle weakness and thymoma are more common in myasthenia gravis, but we cannot ignore the possibility of dermatomyositis. To further establish the diagnosis, a thorough physical examination and laboratory findings are required. Further tumor screening should be performed for patients with dermatomyositis. Early detection and management of possible tumors are essential to the treatment of dermatomyositis linked to malignancies.
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Excessive dynamic airway collapse (EDAC) is a form of dynamic central airway obstruction, with characteristic of excessive dynamic invagination of airway posterior wall membrane and structurally intact airway cartilage. We report a rare case of EDAC with a marked positional component. ⋯ Dyspnea may present as a diagnostic challenge, and it is rarely accompanied with a positional component. EDAC is an uncommon cause of dyspnea. This case illustrates the possible role of bronchoscopy and dynamic CT in dynamic evaluation of airway.
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Concerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. ⋯ Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.
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The "micro-course" and "flipped classroom" are emerging tools for medical education but little is known about their utility for emergency medicine teaching. The suitability of the micro-course combined with flipped classroom is investigated for delivery of an emergency medicine course in West Anhui Health Vocational College. Students from Class A and Class B of the Clinical Department of West Anhui Health Vocational College, Grade 2000, were assigned to experimental (micro-course plus flipped classroom, n = 102) and control (traditional, didactic teaching, n = 104) groups, respectively. ⋯ General satisfaction of students who had participated in the micro-course plus flipped classroom exceeded that of those who had received traditional teaching. Enthusiasm, efficiency, and learning facility was self-reported to be enhanced by students in the experimental group relative to controls. Use of the micro-course combined with flipped classroom successfully increased the outcome of emergency medicine teaching and may be considered as an approach to reform emergency medicine teaching in medical colleges and universities.