Medicine
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Case Reports
Uncommon yet critical: Pulmonary embolism in a 14-year-old Nigerian child: A case report.
Pulmonary embolism is a rare life-threatening condition in pediatric populations. Diagnosis is often challenging in resource-constrained settings suffering chronic shortages of specialist and diagnostic services. We report the prompt recognition and challenging management of pulmonary embolism in an adolescent presenting to a private specialist hospital in a resource-constrained country. Although, majority of the Nigerian population utilize private healthcare, most centers are not equipped with sophisticated radiological and advanced laboratory services. These services were outsourced to a recently equipped state-owned tertiary hospital. ⋯ The case highlights the need for low-resource settings to address diagnostic limitations and emphasizes the importance of a multidisciplinary approach to managing pulmonary embolism cases. It also adds to the growing evidence of the effective role of pharmacological therapy in the management of pulmonary embolism.
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The current diagnostic approach for urinary tract urothelial carcinoma (UTUC) relies on symptoms and imaging. Nevertheless, the diagnosis can be challenging in advanced cases presenting with atypical imaging and symptoms. This article presents an unreported case with atypical imaging and symptoms to provide some experience in diagnosing advanced UTUC. ⋯ This case is a rare and enlightening clinical scenario. When imaging reveals renal infection accompanied by varicocele or renal vein embolism, it is crucial to consider the possibility of advanced UTUC.
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Observational Study
Effect of different growth hormone pretreatment times in assisted reproductive therapy for patients with diminished ovarian reserve: A retrospective pilot cohort study.
This study aimed to evaluate the effect of different growth hormone (GH) pretreatment times in assisted reproductive therapy in patients with diminished ovarian reserve (DOR). A retrospective pilot cohort analysis was performed on patients with DOR receiving GH pretreatment in the Assisted Reproduction Unit of Sir Run Run Shaw Hospital. A total of 1459 patients met the criteria and were divided into four groups according to GH pretreatment time as follows: 53 were in the 2-month pretreatment group (GH1), 400 were in the 1-month pretreatment group (GH2), 414 were in the ovulation induction period pretreatment group (GH3), and 592 were in the non-GH pretreatment group (control group). ⋯ These findings suggest that the GH pretreatment time was appropriately prolonged, and the number of oocytes retrieved nominally increased. In patients with DOR, GH pretreatment improved treatment outcomes. More than 1 month of GH pretreatment did not increase the number of oocytes retrieved.
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Observational Study
Prevalence of and factors associated with cognitive frailty in elderly patients with chronic obstructive pulmonary disease: A cross-sectional study.
The status of cognitive frailty in elderly patients with chronic obstructive pulmonary disease (COPD) and its influencing factors in China remains unclear. This study aimed to investigate the prevalence of and factors associated with cognitive frailty in elderly patients with COPD. This cross-sectional study enrolled elderly patients with stable COPD between May and November 2022 from the Respiratory Department of the First Affiliated Hospital of Zhengzhou University and the Fifth Affiliated Hospital of Zhengzhou University. ⋯ Binary logistic regression analysis showed that sex (odds ratio [OR] = 0.009; 95%CI: 0.001-0.770; P = .038), depression (OR = 17.780; 95%CI: 1.092-289.478; P = .043), modified Medical Research Council grade 1-3 (OR = 28.394-4095.683; 95%CI: 1.086-4,592,652.211; P < .05), global initiative for chronic obstructive lung disease grade 2 and 3 (OR = 32.508-282.072; 95%CI: 1.101-12,516.874; P < .05), and frequencies of acute exacerbations of COPD and hospitalizations within 1 year of 2 times (OR = 21.907; 95%CI: 4.587-104.622; P < .001) were independently associated with cognitive frailty. The prevalence of cognitive frailty in elderly patients with stable COPD was high. Female, depression, modified Medical Research Council grade, global initiative for chronic obstructive lung disease grade, and frequencies of acute exacerbations of COPD and hospitalizations within 1 year might be the factors independently associated with cognitive frailty, educational level might be a protective associated factor for cognitive frailty.
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Because acne vulgaris has a chronic course, can cause cosmetic problems, and negatively affects the psychosocial functionality and quality of life of patients, patients with acne vulgaris can frequently resort to complementary medicine practices. This study aimed to examine the frequency of complementary medicine use in patients diagnosed with acne vulgaris, the methods they used, the reasons for practicing these methods, and the factors affecting these practices. In this descriptive cross-sectional study, 400 (81.4%) of 491 patients aged ≥13 years who were diagnosed with acne vulgaris and treated at the dermatology outpatient clinic at Konya Numune Hospital between February and October 2020 were enrolled. ⋯ These treatment methods may affect the treatments that their physicians will recommend. Therefore, to prevent ill-advised practices, patients should be informed about the CAM methods they use when planning their treatment. Considering the possible side effects of CAM practices, physicians need to be aware that acne vulgaris patients frequently use CAM methods and improve themselves in raising the desired awareness on this issue.