Medicine
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Case Reports
Hypertrophic pachymeningitis with cranial nerve palsy as the initial symptom: A case report.
Hypertrophic pachymeningitis (HP) is a rare and complex condition marked by inflammation and thickening of the dura mater. It can occur either on its own or as a result of various underlying medical issues. This type of granulomatous meningitis is extremely rare and poorly understood, making diagnosis and treatment particularly challenging. Patients with HP may experience severe headaches and cranial nerve defects, but in some cases, the condition can occur without any symptoms, making it undetected. We detail the case of patient who was diagnosed with HP after presenting with abducens nerve palsy, a condition that significantly affected her vision and quality of life. Remarkably, she showed substantial recovery following a course of methylprednisolone pulse therapy, coupled with careful radiographic diagnosis and follow-up assessments. The decision to report this case stems from its rarity and the diverse clinical manifestations associated with this condition, which can vary widely among patients. ⋯ This case underscores the critical importance of imaging examinations in the clinical diagnosis of patients presenting with diplopia, as they play a vital role in both diagnosing and differentiating between various diseases. Furthermore, it is essential to rule out any infection-related factors in patients diagnosed with HP before commencing treatment with glucocorticoids, ensuring a comprehensive approach to patient care.
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Observational Study
Construction and validation of a prediction model for acute ischemic stroke patients with concomitant deep vein thrombosis.
The aim was to investigate the independent risk factors for complications of deep vein thrombosis (DVT) in patients with acute ischemic stroke (AIS), and to establish a nomogram prediction model accordingly. The data of AIS patients in our hospital were collected from January 2021 to December 2023, and single-factor and multifactorial logistic regression analyses were used to determine the independent risk factors for the complication of DVT in patients with AIS and to establish the corresponding nomogram. ⋯ After univariate and multivariate logistic regression analyses, a total of 5 variables were identified as independent risk factors for the complication of DVT in patients with AIS: age > 70 years (OR, 1.551; 95% CI, 1.189-2.751), diabetes (OR, 2.543; 95% CI, 1.322-4.265), the national institutes of health stroke scale > 16 (OR, 3.124; 95% CI, 1.314-7.003), D-dimer > 0.5 mg/L (OR, 2.303; 95% CI, 1.250-3.645), and fibrinogen > 4 g/L (OR, 1.918; 95% CI, 1.532-6.369). The nomogram constructed in this study for AIS patients with concomitant DVT has good predictive accuracy and helps physicians to intervene in advance in patients at high risk of acute AIS patients with concomitant DVT.
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The objective was to clarify the feasibility and clinical effect of 3D-printed external cranial protection devices (ECPD) in preventing complications following unilateral supratentorial decompressive craniectomy (DC). A retrospective cohort study was conducted on post-DC patients meeting inclusion and exclusion criteria. In the experimental group, head computed tomography data were collected after DC, and the ECPD were 3D-printed with photosensitive resin materials, and fixed to the bone window defect for continuous wear. ⋯ The 2 groups had no significant differences in modified Rankin Scale scores after cranioplasty. The clinical use of the 3D-printed ECPD is safe and reliable, effectively reducing the incidence of complications following DC, particularly in the prevention and treatment of subdural effusion. However, it does not significantly improve the prognosis of patients after DC, warranting further research.
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Previous observational studies have suggested that higher levels of education attainment and intelligence (IQ) are associated with better health outcomes in humans. However, the causal link between education attainment and IQ and their association with health outcomes remains unclear. This study aims to investigate the distinct impacts of intelligence and educational attainment on gastrointestinal symptoms. ⋯ Our study revealed causal relationships between gastrointestinal disorders and educational attainment. Educational attainment may mediate between intelligence and the impacts on the gastrointestinal system. However, further research is required to understand the underlying pathogenic processes completely.
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Traditional observational studies have shown that fatty acids and gut microbiota are crucial in osteoarthritis (OA) progression, but their findings are often conflicting due to biases, confounding factors, and measurement errors. We conducted a two-sample Mendelian randomization analysis using genome-wide association study data on fatty acids from 136,016 individuals, the gut microbiota from 7738 individuals, and osteoarthritis from 314,870 individuals. ⋯ Conversely, Oscillibacter (OR: 1.16; 95% CI 1.00-1.34; P = .043), Bilophila (OR: 1.28; 95% CI 1.07-1.54; P = .007), Erysipelotrichaceae (OR: 1.08; 95% CI 1.00-1.16; P = .044), and Bilophila within the Desulfovibrionaceae family (OR: 1.19; 95% CI 1.04-1.36; P = .012) were associated with an increased risk of OA. The findings indicate that modulating dietary factors and gut microbiota can independently reduce the risk and progression of OA, potentially improving the quality of life and health management in aging populations.