Medicine
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Case Reports
A large forearm subcutaneous hematoma after contrast extravasation requires surgical managements: A case report.
Large extremity hematoma can rarely happen after contrast extravasation during a contrast-enhanced computed tomography scan. Some hematomas need prompt surgical managements. ⋯ Large extremity hematoma can happen after contrast extravasation during computed tomography scan, which may require surgical treatments. Careful preparation, close monitor, and prompt managements should be applied in high-risk patients.
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Observational Study
Defining of the nasal anthropometry on facial computed tomography in subjects with epilepsy and healthy subjects.
Epilepsy is a frequent chronic and genetic brain disease. In diagnose of genetic and craniofacial disease, the face is one of the gold standard phenotypic features. This study was carried out to determine the angle and linear measurements of face region in Turkish healthy and epilepsy subjects, and to apply a feature selection method to identify the most important attributes that affect epilepsy decision. ⋯ Gender related changes were found in only nasal pyramidal angle nasal root and nasal bone of healthy subjects, in nasal pyramidal angle nasal bone, nasal bone length, nasofrontal angle of epilepsy subjects. We can say epilepsy may affect the some facial parameters and these, although anthropometric measurements are affected by age and gender parameters. Comprehensive knowledge of this region's normal references ranges is essential for planning, proper selection of silicone implants or osteotomy determining the limitations of the surgical field and minimizing the risk of complication and performing aesthetic facial surgery or rhinoplasty in epilepsy patients.
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Observational Study
Clinical and laboratory characteristics of asymptomatic and symptomatic neurosyphilis in HIV-infected patients: A retrospective study in China.
There are high rates of human immunodeficiency virus (HIV) and Treponema pallidum coinfection, HIV can increase the incidence and disability rate of neurosyphilis. However, there is a lack of data about the risk factors associated with the development of symptomatic neurosyphilis (SNS). We retrospectively reviewed the medical records of inpatients with concurrent syphilis and HIV infection who underwent a lumbar puncture and completed cerebrospinal fluid (CSF) examination. ⋯ In multivariable logistic regression, high CSF WBC count (odds ratio = 1.08; P = .032) and previous treatment of syphilis (odds ratio = 0.01; P = .049) related to the SNS. Lack of antisyphilis treatment in the early stage of syphilis and a higher CSF WBC count are related risk factors for SNS in HIV-infected patients. Meningovascular neurosyphilis should get more attention in young patients with cryptogenic stroke.
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Approximately one-fifth ischemic stroke are attributed to cardioembolism. Patients with cardioembolic stroke often develop a more severe disability and a higher risk of stroke recurrence. Cardiac myxoma, although uncommon, can serve as a potentially curable cause of acute embolic strokes. ⋯ Clinicians should be vigilant for skin manifestations of cardiac embolism. In patients with acute ischemic strokes, the presence of cutaneous embolic phenomena could serve as a warning sign of cardioembolism.
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Sinus of Valsalva aneurysm (SOVA), a rare cardiac malformation, is usually congenital and rarely acquired and most commonly occurring in the right coronary sinus. The clinical presentation of patients with SOVA varies. It is usually asymptomatic when it has not ruptured, and when it compresses neighboring structures or ruptures, it can lead to heart failure or shock, at which point urgent surgical intervention is usually required. Rupture of the sinus of Valsalva aneurysm (RSOVA) during pregnancy is really hard to come by, especially if the clinical presentations resemble that of an acute myocardial infarction. This report describes a pregnant woman with severe chest pain and hypotension with aVR and V1 ST-segment elevation due to RSOVA. ⋯ Progressive aneurysm dilatation or rupture has a poor prognosis. A thorough history and physical examination are fundamental, with echocardiography being the initial diagnostic tool of choice, and other ancillary tests (e.g., computed tomography) being used to complement and confirm the diagnosis. Surgery remains the current treatment of choice for patients with RSOVA, while the continuation of pregnancy in pregnant patients with RSOVA remains a case-by-case measure.