Medicine
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Local anesthesia is a widely used technique for emergency wound closure, with lidocaine among the most commonly employed local anesthetics. Allergic reactions to lidocaine are rare, with anaphylaxis being even more uncommon. ⋯ Although rare, anaphylaxis induced by lidocaine can be fatal. Early recognition, prompt intervention, thorough preoperative assessment, and careful postoperative monitoring are critical to improving survival rates.
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Ovarian tumor torsion is a critical gynecological emergency, predominantly affecting women of reproductive age, with benign teratomas being the most common culprits. In contrast, malignant ovarian tumors, such as mucinous cystadenocarcinoma, infrequently present with torsion due to their invasive and angiogenic characteristics. The occurrence of torsion in malignant tumors complicates diagnosis and management, particularly when associated with complications like congestion, infarction, and internal bleeding. This report details a rare case of primary ovarian mucinous cystadenocarcinoma presenting with acute torsion and significant internal bleeding. Our study highlights the diagnostic challenges and the urgent need for clear treatment guidelines, addressing an important gap in the existing literature regarding the management of torsion malignant ovarian tumors. By documenting this case, we aim to contribute to the understanding of this rare condition and provide insights that may help clinicians in similar scenarios. ⋯ Currently, there are no effective preoperative diagnostic and treatment guidelines for ruptured malignant ovarian tumors with torsion. The possibility of malignancy should be considered, and frozen section biopsy should be considered during surgery. Full detorsion before tumor resection to avoid incomplete pedicle coagulation and bleeding. Specimen removal by in-bag morcellation in minimally invasive surgery to prevent complications related to residual fragments of the specimen or dissemination of an occult malignancy.
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Parkinson's disease is a progressive neurodegenerative disease and the care burden in informal caregivers is huge. Summarizing factors associated with the informal caregivers burden can improve our understanding of providing proactive support to informal caregivers caring for patients with Parkinson's disease (PwP) at risk, and provides evidence for clinical practice. ⋯ Targeted interventions addressing those modifiable factors should be developed and investigated to lighten the care burden of informal caregivers for PwP.
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While recent studies suggested a potential causal link between type 1 diabetes mellitus (T1DM) but not type 2 diabetes mellitus (T2DM) and idiopathic pulmonary fibrosis (IPF), the involved mechanism remains unclear. Here, using a Mendelian randomization (MR) approach, we verified the causal relationship between the two types of diabetes mellitus and IPF and investigated the possible role of inflammation in the association between diabetes mellitus and IPF. Based on genome-wide association study (GWAS) summary data of T1DM, T2DM, and IPF, the univariable MR, multivariable MR (MVMR), and mediation MR were successively used to analyze the causal relationship. ⋯ In conclusion, T1DM is related to an increased risk of IPF. Notably, the causal effect was partially mediated by CXCL10 and IL-12B. Hence, monitoring T1DM patients may help in the early detection and prevention of IPF.
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Thrombus is the most common occupying lesion in the cardiac chambers, it is often distinguished from cardiac neoplastic occupations. Among them, the most common is cardiac myxoma, whose imaging manifestations are often confused with thrombus. However, the 2 types of lesions have different therapeutic strategies and are both potentially high-risk sources of embolism, so early differentiation between intracardiac thrombus and cardiac tumor is essential. In this study, we intend to investigate the value of dual-energy computed tomography (CT) in the differential diagnosis of cardiac thrombus and myxoma by retrospectively analyzing the dual-energy CT-related parameters of 2 cases of intracardiac thrombus and 1 case of cardiac myxoma. ⋯ Drawing upon existing literature, we propose combining different quantitative analysis methodologies to create a more objective foundation for distinguishing between cardiac thrombosis and myxoma.