Medicina
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Case Reports
Perirectal Abscess with Anterior Extension to the Extraperitoneum and Space of Retzius: A Case Report.
Introduction-This report illuminates the distinctive features of a successfully managed Retzius space infection arising from a complex perirectal abscess. It adds novel insights to the scientific literature by addressing the rarity of such occurrences, highlighting the diagnostic complexities associated with extraperitoneal spread, and underscoring the crucial role of a nuanced understanding of anatomy in navigating clinical scenarios involving anorectal abscesses. Patient's Main Concerns and Important Clinical Findings-A 68-year-old male presented with dizziness and diffuse lower abdominal pain, accompanied by intermittent perianal pain for one month. ⋯ Conclusions-This case report emphasizes the importance of early consideration and identification of extraperitoneal abscesses for timely intervention. The complexity of anatomical planes in extraperitoneal spaces poses diagnostic challenges, necessitating a strategic treatment. The successful management of this case underscores the significance of a multidisciplinary approach, including prompt diagnosis, appropriate antibiotic therapy, and timely surgical interventions, ultimately contributing to improved outcomes in cases involving complex anorectal abscesses.
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Background and Objectives: Typically, the external carotid artery (ECA) sends off separate anterior branches: the superior thyroid, lingual, and facial arteries. These could, however, form common trunks: thyrolinguofacial, linguofacial (LFT), or thyrolingual. Although known, the LFT variant was poorly detailed previously, and most authors just counted the variant. ⋯ A case-by-case presentation of results further demonstrated the diversity of the LFT. Conclusions: In conclusion, the morphology and topography of the LFT are individually specific and unpredictable. It can be anticipated case-by-case by surgeons on CT or MR angiograms.
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Background and Objectives: Herpes simplex viruses (HSV-1 and HSV-2) are one of the most widespread causes of human viral infections. In Croatia, only two published studies have analyzed the seroprevalence of HSV infections in childbearing-aged and pregnant women (2005-2010), while more recent data are lacking. This study aimed to analyze the prevalence and risk factors for HSV-1 and HSV-2 infections among pregnant women in Croatia in the period from 2011 to 2021. ⋯ Conclusions: HSV-1 infection is widely prevalent among pregnant women with a stable trend over time. However, a declining trend in the HSV-2 seroprevalence was observed compared to 2005-2010. Serological screening in pregnant women is important in identifying seronegative women who are susceptible to HSV infection as well as seropositive women who are at risk for genital herpes recurrence during delivery.
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Chronic stress and chronic pain share neuro-anatomical, endocrinological, and biological features. However, stress prepares the body for challenging situations or mitigates tissue damage, while pain is an unpleasant sensation due to nociceptive receptor stimulation. When pain is chronic, it might lead to an allostatic overload in the body and brain due to the chronic dysregulation of the physiological systems that are normally involved in adapting to environmental challenges. ⋯ Moreover, we described the most relevant interventions used to manage stress and pain in the neurological population. In conclusion, this review sheds light on the connection between chronic stress and chronic pain and their impact on the neurorehabilitation pathway. Our results emphasize the need for tailored rehabilitation protocols to effectively manage pain, improve treatment adherence, and ensure comprehensive patient care.
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Case Reports
Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series.
Background: Borderline personality disorder (BPD) is a heterogeneous and highly comorbid disorder. Suicidality, aggression and substance abuse are common presentations of BPD. Our case series is the first to highlight the role of brexpiprazole in improving these symptoms in patients with BPD. ⋯ Conclusions: Our case series provides anecdotal evidence of the potential role of brexpiprazole in attenuating suicidality, aggression and substance abuse in patients with BPD. We postulate that brexpiprazole's high affinity for the 5HT1A/5HT2A receptors, coupled with its low intrinsic effect on the D2/D3 receptor system, is fundamental in its actions to stabilise the aberrant dopaminergic and serotonergic signalling in BPD. Future research should focus on well-designed clinical trials investigating the efficacy of brexpiprazole in patients with BPD.