J Formos Med Assoc
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The association of chronic hepatitis B virus (HBV) infection and decreased levels of high-density lipoprotein cholesterol (HDL-C) has been well documented. However, the relationship between dyslipidemia and asymptomatic chronic HBV infection is still unclear. ⋯ Asymptomatic chronic HBV infection was associated with lower serum levels of TC and HDL-C. Elevation of ALT was also an indicator of lower levels of HDL-C in patients with chronic hepatitis B and lower serum HDL-C and higher TG levels in patients without HBV infection. These findings also indicated the need to monitor the risk of atherosclerotic diseases in patients with asymptomatic chronic HBV infection, especially those with lower HDL-C levels.
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Case Reports
Ludwig's angina following herpetic gingivostomatitis in a toddler with tetralogy of Fallot.
Ludwig's angina is a rare but potentially lethal cellulitis of the submandibular space that occurs most often in young adults with predisposing odontogenic infection. In contrast to adult cases, most children with Ludwig's angina have no initiating factor. ⋯ This case illustrates that Ludwig's angina can develop in association with herpetic gingivostomatitis, which is a common and usually self-limited disease in pediatric patients. Prompt recognition and aggressive management of this rare and severe secondary bacterial infection are the keys to avoiding unnecessary morbidity and mortality.
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The diagnostic yield of flexible fiberoptic bronchoscopy for peripheral lung cancers is still limited. This study evaluated whether endobronchial ultrasound (EBUS) may help localize and improve the diagnostic yield of bronchoscopic transbronchial lung biopsy in peripheral lung cancer. ⋯ Under EBUS guidance, the diagnostic yield of transbronchial lung biopsy in peripheral lung cancer by bronchoscopic examination was significantly improved without difference in the complication rate.
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Clinical Trial Controlled Clinical Trial
Continuous lateral rotational therapy in the medical intensive care unit.
The efficacy of continuous lateral rotational therapy (CLRT) for mechanically ventilated patients is not well established. This study investigated the effect of CLRT on gas exchange and the incidence of ventilator-associated pneumonia (VAP) in mechanically ventilated patients in a medical intensive care unit (ICU). ⋯ Mechanically ventilated patients in the medical ICU who received CLRT had improved oxygenation and reduced incidence of VAP compared to controls.
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Case Reports
Total descending thoracic and abdominal aorta grafting in type III aortic dissection with aneurysm.
Single-stage complete replacement of the descending thoracic aorta and the abdominal aorta is a surgical challenge. A 65-year-old man developed acute DeBakey type IIIB aortic dissection and was treated medically. The affected aorta dilated progressively, reaching a maximal diameter of 7 cm 2 years later. ⋯ The descending thoracic aorta and the abdominal aorta were completely replaced with a Hemashield graft under deep hypothermic circulatory arrest. The postoperative course was complicated with transient left hemiparesis and upper gastrointestinal bleeding which were successfully treated by transarterial embolization. The results of this case indicate that complete replacement of the descending thoracic and abdominal aorta can adequately and safely treat type III aortic dissection.