Internal medicine
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Emphysematous cholecystitis has a poor prognosis and necessitates prompt surgery or drainage. Emphysematous cholangitis (EC) is believed to have a similar clinical course, but reports are limited. ⋯ We reviewed the background, causative organisms, treatment, and outcomes of EC through a literature search. Our findings provide insights into its similarities to emphysematous cholecystitis, emphasizing the need for expeditious drainage and anaerobic bacterial coverage during antibiotic therapy.
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Plasmablastic lymphoma (PBL) is an aggressive subtype of large B-cell lymphoma associated with immunodeficient states, such as HIV and EBV infections, and aging. PBL frequently harbor STAT3 mutations, which are crucial for their development. ⋯ Large granular lymphocytes and T-cell receptor rearrangement were detected, thus leading to the diagnosis of T-LGLL and PRCA. This is the first documented case of PBL with T-LGLL and PRCA, offering insight into PBL's pathophysiology and the complications of PBL.
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Objective Crohn's disease (CD) is a chronic inflammatory bowel disease that is associated with malnutrition. Sarcopenia is a malnutrition condition characterized by skeletal muscle loss that impairs the physical function. We investigated the clinical characteristics of patients with CD with sarcopenia and sarcopenic obesity (sarcopenic-o). ⋯ Conclusion Sarcopenia and sarcopenic-o are relatively common conditions among patients with CD. Sarcopenia can be predicted using the clinical parameters of BMI and CDAI. Sarcopenic-o can be a severe form of sarcopenia.
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Direct compression of the oculomotor nerve (OcN) is usually accompanied by OcN palsy (OcNP), with an abnormal pupillary function. We herein present the case of a 76-year-old man with pupil-sparing paresis of the right inferior rectus muscle. ⋯ Decompression of the nerve gradually improved the ocular movement. This unique case offers insights into the potential topographical arrangement of the oculomotor nerve fibers.
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Objective Dysphagia is a common and disabling symptom in patients with myasthenia gravis (MG). Moreover, it is caused by muscle weakness or fatigability in the pharynx, swallowing, and respiration discoordination. The current study aimed to establish a novel method for evaluating swallowing difficulty in patients with MG. ⋯ Results Patients with MG who presented with dysphagia had abnormal excessive expiratory flows, clusters of excessive expiratory flows, high inspiratory flows, and prolonged EMG patterns compared to healthy controls (all p <0.05). Among these parameters, the incidence of an excessive expiratory flow, cluster of excessive expiratory flows, and prolonged EMG pattern significantly improved after treatment (p <0.05). Conclusion Based on this study, the respiratory patterns and submental sEMG are likely to reflect the severity of pharyngeal muscle weakness/fatigability and thus can be used as a quantitative parameter for dysphagia in patients with MG.