Medicine
-
Observational Study
Optimal duration of progesterone before cryopreserved embryo transfer in hormone replacement therapy cycles: A prospective pilot study.
This prospective pilot cohort study aimed to ascertain the optimal duration of progesterone supplementation prior to frozen embryo transfer (FET) in women undergoing hormone replacement therapy (HRT) cycles. A total of 127 participants were enrolled and divided into 2 cohorts. The first cohort, comprising of 39 women, was used to determine the peak period of endometrial receptivity. ⋯ Notably, the maximal expression of endometrial receptivity markers was observed on day P + 6 within the HRT cycles, which is consistent with previous research that correlated day 6 embryos with peak endometrial receptivity. Therefore, a 3-day progesterone lead-in may enhance synchrony between D3 embryos and the endometrium. Our findings suggest that initiating D3 embryo transfer after 3 days of progesterone administration may optimize embryo-endometrial synchronization, thereby potentially enhancing clinical outcomes in FET cycles.
-
Observational Study
Evaluation of retinal microvascular changes with OCT-A in Parkinson disease and essential tremor.
This study aimed to evaluate the presence and comparison of microvascular abnormalities in essential tremor (ET) and Parkinson disease (PD) using optical coherence tomography angiography (OCT-A) and to show the relationship between retinal microvascular changes and disease stage in the patient group. A total of 176 eyes, including 26 PD diagnosed according to the United Kingdom PD Society Brain Bank criteria, 31 ET diagnosed according to the Washington heights-inwood genetic study of ET (WHIGET) criteria and 31 healthy controls, were included in the study. Unified PD assessment scale (UPDRS) motor scores, non-motor symptom scale (NMS), modified Hoehn&Yahr stages (mH&Y) and Fahn-Toloso-Marin grading scale were recorded. ⋯ In both eyes, OD radial peripapillary capillarity inside the disc small values of PD were significantly lower than those of ET and controls (P < .05). In our study, deep macular vascular density, RNFL and radial peripapillary capillarity were significantly lower in PD compared with ET and control groups, and radial peripapillary capillarity was lower in ET compared with control group. This study provides valuable information regarding the potential of OCT-A as a diagnostic tool for PD and ET.
-
Observational Study
Age-dependent effects of lockdown and post-lockdown periods on HbA1c during the COVID-19 pandemic: A 3-year longitudinal cohort study.
The impact of COVID-19 lockdown on glycemic control in patients with diabetes mellitus (DM) remains unclear. This study aimed to investigate the effects of lockdown measures on the metabolic parameters of patients with DM, with particular emphasis on geriatric populations. In this retrospective, longitudinal cohort study, 1224 patients were analyzed. ⋯ However, there was no change in HbA1c levels for patients over 85 years old during the lockdown. These findings highlight the need for careful monitoring of elderly patients with DM during lockdown periods, facilitated via home care or telehealth services. Structured diet and exercise programs should also be provided for at home adherence.
-
Lipoma arborescens (LA) is a rare, benign proliferative disorder of the synovial lining that typically affects middle-aged individuals, predominantly in the knee joint. However, its occurrence in younger patients is unusual and may pose unique diagnostic and therapeutic challenges. This case report aims to highlight the clinical, imaging, and therapeutic aspects of LA in a young adult, thereby expanding the understanding of its presentation in this age group. ⋯ This case report underscores the diagnostic and therapeutic challenges associated with LA in a young patient, highlighting the importance of considering LA in differential diagnoses of acute knee swelling, especially when initial evaluations are inconclusive. Through a combination of imaging, arthroscopic intervention, and histopathological confirmation, this case illustrates an effective approach for accurately diagnosing and managing LA. By documenting this atypical presentation in a young adult, this report contributes to the limited literature on LA in younger populations, aiming to enhance clinical awareness and guide future cases involving similar joint lesions.
-
Case Reports
Resolution of acute motor axonal neuropathy in a patient after treatment with efgartigimod: A case report.
Guillain-Barré syndrome (GBS) is an acute autoimmune neuropathy characterized by progressive muscle weakness, often caused by immunoglobulin G (IgG) autoantibodies. There are several subtypes of GBS, of which acute motor axonal neuropathy (AMAN) is one of the most severe subtypes associated with axonal damage. It is well known that the current clinical standard of treatment is intravenous immunoglobulin (IVIg) and plasma exchange (PLEX), but some patients often show limited response or experience persistent disability. Efgartigimod, an Fc fragment of human IgG antibody, provides a way to target and reduce pathogenic IgG antibodies as a natural ligand Fc receptor (FcRn). The purpose of this study was to observe the therapeutic effect of efgartigimod on axonal GBS, which is expected to be a potential therapeutic method for GBS and AMAN. ⋯ Efgartigimod at a dose of 10 mg/kg weekly for 4 weeks demonstrated promising results in this case of AMAN. While further research is warranted, our findings suggest that efgartigimod may represent a valuable addition to the therapeutic armamentarium for AMAN and potentially other autoimmune neurological conditions. Well-designed clinical trials are crucial to confirm these findings and establish optimal treatment protocols for efgartigimod in AMAN.