Medicine
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Iridoschisis is a rare eye disease. In this case report, we described the examination and diagnosis of a case of iridoschisis accompanied by secondary glaucoma. We also observed the effects of treating the patient with a combination of goniosynechialysis and cataract removal. ⋯ Relative to other approaches, goniosynechialysis combined with cataract removal is a better treatment option for iridoschisis complicated with closed-angle glaucoma triggered by peripheral anterior synechiae.
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This study investigated whether alcohol intoxication (AI) increases the risk of venous thromboembolism (VTE) by using the Taiwan National Health Insurance Research Database (NHIRD). Using data from the NHIRD, we assembled 61,229 patients with acute AI and randomly selected 244,916 controls. Each patient was monitored from 2000 to 2011 to identify those who were subsequently diagnosed with deep vein thrombosis (DVT) and pulmonary embolism (PE). ⋯ After adjustment for age, sex, and comorbidities, the risks of DVT and PE were 3.40 [95% confidence interval (CI) = 2.83-4.08] and 3.53 (95% CI = 2.69-4.65)-fold higher in the AI cohort than in the non-AI cohort. An increased incidence of VTE was observed among patients with AI. Therefore, physicians should carefully estimate the risk of VTE in patients with AI.
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In very rare cases, a primary infected abdominal aortic aneurysm (IAAA) is caused by a species of Brucella. In this report, we report such a case that was successfully treated with a novel approach. To the best of our knowledge, this was the first case occurring in China, in which an infection of the abdominal aortic aneurysm was caused by a Brucella species. ⋯ Our case study supports the premise that endovascular aneurysm repair is an appropriate alternative strategy to treat an infected abdominal aortic aneurysm. Compared with conventional surgical treatment, EVAR with long-term oral antibiotics is a simpler, less traumatic, and more efficient procedure. However, this needs to be further evaluated through long-term follow-up.
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Bezold-Jarisch reflex (BJR) occurs when the cardioinhibitory receptors in the walls of ventricles are activated by various stimuli, with typical features of bradycardia, vasorelaxation, and hypotension. This reflex usually happens in parturient intrathecal anesthesia, as a result of decreased venous return by compression of inferior vena cava, but it is only rarely reported during general anesthesia. ⋯ General anesthesia should be induced with great care in patients with giant intra-abdominal masses, and the patient should be kept in the left-lateral table tilt position before induction.
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Pancreatic hepatoid carcinoma (PHC) is a rare form of pancreatic malignancy mimicking hepatocellular carcinoma (HCC) in morphology, immunohistochemistry, and behavior. PHC usually has an aggressive clinical course and poor prognosis. Effective treatment strategies are lacking due to poor understanding and extreme rarity of such kind of malignancy. PATIENT CONCERNS:: we present the case of a 75-year-old man with tumors in the liver and the tail of pancreas that were detected in a routine health check-up. ⋯ PHC are often associated with early liver metastasis and a poor prognosis, surgical resection combined with neoadjuvant and adjuvant FOLFIRINOX chemotherapy is proved to be efficient in such kind of malignancy, even with liver metastasis.