Medicine
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Refeeding syndrome (RS) is a fatal condition caused by rapid calorie intake during starvation. Self-neglected fasting in psychiatric disorders is associated with RS. However, overeating resulting from circumventing the clinician's instructions does not have a reportedly high risk of RS. ⋯ When undernourished patients have psychiatric disorders, including borderline personality disorder or schizophrenia, the occurrence of RS should be considered based on the patients' poor adherence to physicians' instructions.
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Case Reports
Cerebral venous thrombosis after high-dose steroid in patient with multiple sclerosis: A case report.
Multiple sclerosis (MS) is a central nervous system disease mainly mediated by immunity, which is one of the most common causes of neurological dysfunction in young people worldwide. In the acute phase, high-dose steroid therapy is effective. There are few reports about cerebral venous thrombosis (CVT) after high-dose steroid therapy. ⋯ High-dose steroid therapy may be a risk factor for CVT in patients with MS. MS patients who develop headaches during high-dose steroid therapy should undergo further cranial CTV to rule out CVT.
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Major trauma is defined as a significant injury or injury that has the potential to be life-threatening and is quantitatively identified as an injury severity score (ISS) >15. Spinal injuries are common in patients with major trauma; however, because spinal injury is not independently included in the ISS calculation, the impact of spinal injury on mortality in patients with major trauma has not been fully elucidated. The purpose of this study is to identify the association between spinal injury and mortality in patients with major trauma. ⋯ The mortality was significantly lower in the spinal injury group compared with the matched cohort (4.0% vs 7.9%, P = .001), and the ICU LOS was longer than the matched cohort (8.8 ± 17.4 days vs 7.2 ± 11.7 days, P = .028). In the spinal injury group, multiple organ failure (MOF) was the most common cause of death (41.9%), while that in the matched cohort was central nervous system (CNS) damage (61.3%). In patients with major trauma, spinal injury may act as a shock absorber for internal organs, which is thought to lower the mortality rate.
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Ossification of the pterygoalar ligament, which lies inferolateral to the exocranial opening of the foramen ovale, is traditionally considered to be a bony bar that could obstruct percutaneous needle access to the foramen ovale using the Hartel approach. We herein present two case reports of successfully penetrating the foramen ovale by a needle across the pterygoalar bar. Lack of knowledge of this type of presentation might lead to a change in the surgical approach. ⋯ During percutaneous radiofrequency thermocoagulation for the treatment of trigeminal neuralgia, the Hartel approach can still be used when the foramen ovale is blocked by a pterygoalar bar. To our knowledge, this is the first report of such a treatment. Moreover, we herein provide specific technical recommendations to assist surgeons who may encounter such cases in the future.
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Case Reports
Recurrent intestinal ulcer with bloody stool for >10 years in an adolescent boy of 15 years: A case report.
Infectious diseases, autoimmune diseases and vascular diseases can lead to intestinal ulcers, and inflammatory bowel disease is typically suspected as the underlying cause of ulcer and bleeding from the intestinal ulcers leading to bloody stool, and malnutrition. Here we report a rare case of successfully treated case of intestinal ulcer, bloody stool, and malnutrition by dietary modification and avoidance of long term barbecued spicy food and carbonated drinks. ⋯ Pay attention to healthy diet in life and avoid long-term consumption of spicy food and carbonated drinks.