Medicine
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Review Case Reports
Zolpidem-related euphoria, addiction and detoxification: A case report and review of the literature.
Zolpidem, a non-benzodiazepine sedative-hypnotic, is considered safer for the treatment of insomnia compared to benzodiazepines. However, in recent years, there have been growing reports of Zolpidem dependence, addiction, and withdrawal symptoms. We reported a case of Zolpidem addiction and successful detoxification, reviewed similar cases in the literature, and proposed a potential mechanism underlying Zolpidem addiction. ⋯ We speculate that Zolpidem addiction is likely linked to the drug's euphoric effects and certain patient characteristics, such as sensation-seeking behavior. A comprehensive approach, involving both pharmacological and psychological interventions, is essential for an effective detoxification strategy for Zolpidem addiction.
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Randomized Controlled Trial
The effect of a subclinical dose of esketamine on depression and pain after cesarean section: A prospective, randomized, double-blinded controlled trial.
The aim of this randomized, double-blind placebo-controlled clinical trial was to study the effects of subclinical doses of esketamine on postpartum depression and pain following elective cesarean sections. ⋯ Subclinical doses of esketamine did not reduce the incidence of PPD at 14 days postpartum but did significantly lower VAS scores at 24 hours post-surgery. The experimental group experienced temporary increases in adverse reactions and Ramsay sedation scores shortly after administration.
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As the elderly population grows, the number of joint arthroplasty surgeries is also increasing. Periprosthetic joint infection (PJI) is a postoperative complication that occurs in 1%-2% of the arthroplasties. Once it occurs, PJI is refractory to treatment. Similar symptoms of PJI, including joint synovitis and elevated body temperature, sometimes arise because of crystal arthritis, rheumatoid arthritis, or other inflammatory diseases. Precise diagnosis is essential for determining the optimal treatment strategy. ⋯ High fever and synovitis after joint arthroplasty do not necessarily indicate an infectious condition. Clinicians should be familiar with the occurrence of RS3PE, regardless of whether arthroplasty is performed.
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Review Case Reports
Breast tumor with giant borderline phyllodes: Case report and literature review.
Giant phyllodes tumors are rare fibroepithelial neoplasms, accounting for less than 1% of all primary breast tumors. Their main features are a single-round mass, progressive enlargement, and a high rate of local recurrence. A phyllodes tumor measuring more than 10 cm in diameter is usually defined as a "giant" tumor. Surgery remains the primary treatment option, although the efficacy of adjuvant radiotherapy needs to be confirmed by further studies. ⋯ The most effective treatment for phyllodes tumors of breast is wide local excision with clean margins greater than 1 cm. Simple mastectomy is recommended for borderline or malignant cases, especially when it is difficult to achieve reliable negative margins. Although adjuvant radiotherapy and chemotherapy after surgery are not generally recommended as first-line treatments, it raises the question of whether the recurrence could have been delayed if the patient had received postoperative radiation therapy.
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Review Case Reports
Catheter ablation in a monochorionic diamniotic twin pregnancy: A case report and literature review.
Preexcitation syndrome is an uncommon congenital cardiac disorder that impairs the normal cardiac conduction system. Radiofrequency ablation is one of the most effective treatments for this condition. Nevertheless, radiofrequency ablation is rare in women with preexcitation syndrome during pregnancy. ⋯ Preexcitation syndrome may result in life-threatening arrhythmias such as supraventricular tachycardia during pregnancy and delivery. It might be efficiently controlled through optimal treatment by a multidisciplinary team, which would effectively minimize arrhythmia risk events during pregnancy and improve maternal-fetal outcomes. Based on the patient's individual situation, radiofrequency ablation may be a procedure in pregnant women with preexcitation syndrome.