Medicine
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Case Reports
A case of posterior urethral valve diagnosed by ultrasound in antenatal and pathology: A case report.
Posterior urethral valve is a rare disease, prenatal diagnosis and prognosis evaluation are particularly important. ⋯ Prenatal ultrasonography can diagnose posterior urethral valve through typical image manifestations and can make a certain judgment for prognosis evaluation.
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Chronic obstructive pulmonary disease (COPD) is a common respiratory condition with high morbidity and mortality. Noninvasive mechanical ventilation (NIV) is often used to manage acute COPD exacerbations, but failure can lead to worse outcomes. This systematic review aimed to evaluate risk prediction models for NIV failure in patients with COPD. ⋯ Existing risk prediction models for failure in NIV among patients with COPD demonstrated overall good predictive performance, but exhibited a risk of bias. Further validation is needed to assess the clinical applicability of these models.
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Case Reports
Bilateral thalamic infarction with posterior cerebral artery variant (the arcade artery): A case report.
Bilateral thalamic infarction is a rare type of posterior circulation stroke, and it often presents with a reduced level of consciousness in the elderly. Arteriosclerosis is the primary etiology of bilateral thalamic infarction, including conditions such as native vessel stenosis or arterial-to-arterial embolism. Cardiogenic or paradoxical embolism can also lead to thrombosis of the perforator branches innervating the thalamus, and these emboli tend to disintegrate and lead to multiple lesions, even in elderly patients. ⋯ The elderly experiencing a sudden drop in consciousness should be evaluated for thalamic lesions, primarily cerebral infarction in the posterior circulation. Anatomical artery variations may be helpful in attributing multiple and bilateral lesions to a single source of embolism. Digital subtraction angiography and transesophageal echocardiography can help to clarify the etiological categorization and formulate a secondary prevention strategy for cerebral infarction. Paradoxical embolism is a diagnostic dilemma in the elderly population, and treatment principles must be integrated with guidelines, the prospectively validated patent foramen ovale-associated stroke causal likelihood risk stratification system, interdisciplinary collaboration and customized analysis.
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Ultrasound-guided fine-needle aspiration biopsy (FNAB) is an essential diagnostic tool for detecting malignancy in thyroid nodules. The objective of this study was to evaluate the necessity of FNAB in the treatment decision-making process for thyroid nodules exceeding 3 cm in size. The records of patients who underwent thyroidectomy in our center between 2018 and 2023 were retrospectively reviewed. ⋯ Both the incidence of malignancy and the rate of FNAB false negatives were higher in nodules measuring 4 cm or larger. This study identified a high malignancy rate and a significant rate of false negatives in FNAB of thyroid nodules larger than 3 cm. These findings highlight the importance of carefully considering these factors in the surgical planning of such nodules.
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Cardiac arrest (CA) is an acute emergency with high mortality and is closely associated with the risk of brain damage or systemic ischemia-reperfusion injury, post-traumatic stress symptoms. ⋯ Individualized targeted temperature management under the guidance of multimodal brain monitoring plays an important role in brain protection of patients with CA.