Medicine
-
Case Reports
Bivalirudin anticoagulation for an infant with heparin resistance on ECMO: A case report.
Extracorporeal membrane oxygenation (ECMO) technology in the field of intense care for children in China has developed rapidly, and it has become a key strategy for the rescue treatment of critically ill children and an advanced extracorporeal life support system. Compared with adults and children, neonatal respiratory disease with ECMO support has the best prognosis, with an average survival rate of 74%. Bleeding and thrombotic events during ECMO are common, morbid, and potentially lethal. Therefore, how to balance the coagulation state is the key to ECMO management. ⋯ Due to the unique physiological characteristics of newborns, the hemostatic changes differ significantly from those in adults. Precise monitoring of anticoagulation becomes a critical and challenging task. Bivalirudin can be effectively used for anticoagulation management in neonatal ECMO; however, due to its unique characteristics, precise dose adjustment poses a challenge. Selecting the optimal laboratory monitoring indicators is crucial in this regard. In some cases, bedside ACT may not be the optimal anticoagulation monitoring parameter, and when necessary, comparative analysis can be conducted using anticoagulant-sample ACTs such as thrombela stogram-ACT. Traditional markers such as D-dimer/fibrinogen degradation products and newer indicators like TAT can reflect the activation of coagulation and assist in monitoring the anticoagulation effect, especially when there is conflicting information among the monitoring parameters.
-
Intracranial atherosclerotic stenosis (ICAS) represents a prevalent global cause of stroke, posing a notably higher risk of stroke recurrence than other stroke etiologies. Herein, we report a case of a 39-year-old male patient diagnosed with ICAS, treated through an integrated approach incorporating Chinese and Western medicine with significant efficacy and satisfied clinical safety. ⋯ This case report shows that a combination of traditional Chinese and Western medicine is safe and effective in the treatment of ICAS and is worthy of promotion in the clinic.
-
Case Reports
Transvaginal double-layer parallel in-situ suturing for early complex vesicovaginal fistula repair: Case report.
Complex vesicovaginal fistulas (VVFs) with large defects pose significant surgical challenges. Traditional repair methods often require extensive tissue separation and multilayer suturing, risking local blood supply and healing. This study introduces a novel modified transvaginal repair technique that simplifies the procedure while preserving tissue vascularity. It employs double-layer parallel in situ suturing for early repair of complex VVF. ⋯ The modified transvaginal repair technique using double-layer parallel in situ suturing is a simple and effective approach for early repair of complex VVF, highlighting its potential for broader clinical application. Future studies with larger cohorts are needed to validate these findings.
-
Cadmium (Cd) and lead (Pb) exposure have been identified as risk factors for Helicobacter pylori seropositivity, possibly due to the immune suppression by Cd and Pb. Physical activity (PA) can induce an immune response. However, whether PA can reduce the effect of Cd and Pb on H pylori infection remains elusive. ⋯ Exposure to Cd and Pb are positively linked to H pylori infection. PA may alleviate the effect of Cd on H pylori infection but may enhance H pylori infection under Pb exposure. Therefore, PA should be recommended in the appropriate season or region.
-
A stressful condition such as the emergence of the coronavirus and its related lockdown measures might trigger alterations in college students' behaviors. This cross-sectional study aimed to identify the changes in college students' dietary and lifestyle behaviors during the lockdown and the effect of lockdown-related stressors on health-risk behaviors. A web-based survey was conducted among undergraduate college students in Jordan. ⋯ Additionally, weight changes were associated with perception of other types of stressors (OR = 3.39, CI: 1.39-8.28, P = .007). Overall, there was a considerable increase in malnutrition and health-risk behaviors among students during the lockdown. Understanding students' responses to these stressful conditions and the role of stress in driving behavioral changes are crucial for developing interventions that enhance college students' adaptation to such changes and maintaining healthy dietary and lifestyle behaviors in the future.