Medicine
-
Case Reports
Fatal Zargar grade 3b corrosive injury after hydrochloric acid ingestion: A case report.
Caustic substance ingestion is an emergency and life-threatening condition as it leads to tissue damage, acidosis, and multiorgan failure. This study presents a case report of hydrochloric acid ingestion and notably dark-red urine output due to acute tubular necrosis. ⋯ For corrosive injuries, early endoscopy was crucial in assessing the extent of the damage and guiding treatment in this patient. It is essential to perform an early endoscopic examination in cases of acute nephrotoxic tubular necrosis following hydrochloric acid ingestion. Surgical intervention is warranted if necrosis is detected in the corrosive tissue.
-
Despite the progress in surgical techniques and perioperative managements, the incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) remains high. Recently, pancreatic dissection using a linear stapler has been widely performed; however, risk factors influencing the occurrence of POPF after DP using a liner stapler is not fully understood. The purpose of this paper was to evaluate whether the relations between staple height and pancreatic thickness or main pancreatic duct (MPD) diameter influenced the incidence of POPF. ⋯ It is possible that stapler cartridge selection using our new criteria in combination with CI and SI may reduce the incidence of POPF.
-
There is a lack of health economics studies on the treatment of acute lower extremity deep venous thrombosis to measure the benefits to patients. The purpose of this study was to evaluate the cost-effectiveness of anticoagulation (AC), percutaneous mechanical thrombectomy (PMT), and catheter-directed thrombolysis (CDT). ⋯ All 3 treatment methods have good safety. Compared with AC therapy alone, both PMT and CDT therapy resulted in a higher clinical efficacy rate, reduced the severity of PTS within 2 years, and reduced the cost of PTS. From the perspective of the cost-effectiveness ratio, within a certain range of treatment efficacy, AC therapy alone incurs the lowest cost per 1% improvement in therapeutic effect. The cost-effectiveness results show that if decision-makers consider the standard for improving the cure rate of lower limb deep vein thrombosis by 1% to be lower than the ratio of incremental cost to effect, then AC therapy alone is chosen. If decision-makers consider the standard for improving the cure rate of lower limb deep vein thrombosis by 1% to be higher than the ratio of incremental cost to effect, then the choice is AC plus CDT treatment.
-
P/FP [PaO2/(FiO2*PEEP)] is associated with in-hospital mortality in patients with acute respiratory distress syndrome (ARDS). However, to the best of our knowledge, the association between P/FP after 24 hours of invasive mechanical ventilation (IMV) and in-hospital mortality in patients with ARDS due to Coronavirus Disease 2019 (COVID-19) remained unclear. This study aimed to evaluate the relationship between the P/FP after 24 hours of IMV and in-hospital mortality in patients with ARDS due to COVID-19. ⋯ After adjusting for potential confounders, the HR was 0.67 (95% CI: 0.56-0.79) for P/FP ≤ 22 mm Hg/cmH2O and 1.10 (95% CI: 0.83-1.47) for P/FP > 22 mm Hg/cmH2O. In addition, lymphocytes ≤ 1 × 109/L and acute kidney failure had a higher risk of death. After adjusting for potential confounders, the P/FP after 24 hours of IMV was nonlinearly associated with in-hospital mortality in patients with ARDS due to COVID-19.
-
Uterine carcinosarcomas (UCS) are rare aggressive biphasic tumors classified as a subtype of high-grade uterine carcinomas. However, these tumors have particular histopathological features and clinical behavior with worse prognosis than high-grade uterine carcinomas. ⋯ UCS are rare and aggressive uterine tumors with very poor prognosis especially in low-income countries.