Medicine
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The aim was to study the validity of free-standing position using modifiers for assessing cervical spine alignment. A total of 26 asymptomatic subjects (45 ± 11years) and 13 with spinal deformities (30 ± 21years) underwent lateral radiographs using EOS®, while adopting 3 different positions, in 2 sequences, without mirror and then with mirror (m) placed in front of them: first, the neutral standing position (upper extremities positioned on the sides of the body, P1 and P1m), then free-standing (P2 and P2m) and modified free-standing (P3 and P3m) positions (shoulders flexed at 90° and fingers placed on clavicles then cheeks, respectively). Participants were asked not to move their trunk and shoulders when moving from P1 to P2 and then P3. ⋯ Concerning the effect of shoulder flexion, C2-C7 and T1 slopes were significantly decreased in P2 and P2m (C2-C7 = 10° and 8°; T1 slope = 26° and 24°, respectively) and P3 and P3m (C2-C7 = 9° and 9°; T1 slope = 25° and 26°, respectively) compared to P1 and P1m (C2-C7 = 14°and 14°; T1 slope = 29°and 30°, respectively), without exceeding the uncertainty level. Assessment of cervical alignment is valid on whole-spine radiographs when the shoulders are flexed (free-standing position). Clear instructions regarding the shoulder position at 90°, without moving the trunk, neck, and head before placing the fingers on the clavicles or cheeks, can ensure a cervical alignment comparable to that obtained with the neutral position, which is considered the most physiological one.
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Horn pregnancy is a rare subtype of ectopic pregnancy that presents a diagnosis and treatment challenge due to its nonspecific symptoms and high risk of rupture. ⋯ This case highlights the success of combining low molecular weight heparin with traditional Chinese medicine in the treatment of cornual pregnancy. Factors affecting horn pregnancy, diagnostic challenges, and treatment considerations are discussed. Further research is necessary to determine the best management strategy and to ensure safe delivery for patients with impaired fertility but a strong desire to conceive.
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Stereotactic body radiotherapy (SBRT) and immune checkpoint inhibitors (ICIs) could obtain a certain synergistic effect on bone and soft tissue sarcoma (BSTS). Given its low radiosensitivity, BSTS usually require an irradiation dose >65 Gy to achieve local control. Herein, we developed a non-classical SBRT technique called "onion-shaped simultaneous boost (OSB)," and reported a patient with prostatic leiomyosarcoma which received non-classical SBRT and other systemic treatments. ⋯ In this clinical case, we have observed that the OSB technique, which employs an increased per-fraction radiotherapy dose without the need to match the single-fraction doses typical of conventional SBRT, effectively enhances the therapeutic impact on leiomyosarcoma without an increase in radiotherapy-related side effects. By integrating the OSB technique with a multidisciplinary array of antineoplastic strategies, we can more effectively manage sarcomas in clinical practice.
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The incidence of venous thromboembolism is increasing, and it is more common in older than in younger patients. Inferior vena cava (IVC) thrombosis is a rare subtype of deep vein thrombosis, and it is associated with a high incidence of arterial and venous thrombosis in patients with systemic lupus erythematosus (SLE). We present the case of a 25-year-old female patient with a large IVC thrombosis caused by SLE that was intractable to thrombolytic therapy. ⋯ We found a large IVC thrombus secondary to SLE in a young female patient. In this case, systemic thrombolysis or CDT did not improve the thrombus. The thrombus only improved after immunosuppressive treatment for SLE. Our case highlights the importance of treatment for etiologic disease in an intractable thrombosis developed by provoked cause.
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Exercise rehabilitation is crucial for the recovery after hematopoietic stem cell transplantation (HSCT). This study aimed to investigate knowledge, attitude, and perception (KAP) of exercise among post-HSCT patients. This cross-sectional study was conducted at Zhujiang Hospital, Southern Medical University between January 2020 and December 2022 among post-HSCT patients, using a self-designed questionnaire. ⋯ Post-HSCT patients had adequate knowledge, moderate attitude and perception of exercises, even 1 year after HSCT. Patients inactive in exercises exhibited significant differences in knowledge and exercise perception from active patients. Healthcare professionals should tailor education, target attitude, and personalize exercise plans to facilitate effective recovery post-HSCT.