Medicine
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Case Reports
Hemodynamic management of a patient with a huge right atrium myxoma during thoracic vertebral surgery: A case report.
Myxoma is the most common primary benign cardiac tumor, which could lead to some fatal complications because of its strategic position. ⋯ Change in body position may lead to obstruction of intracardiac blood flow in patients with giant myxoma. This clinical manifestation is rarely reported.
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Traumatic hemipelvectomy is a rare but life-threatening injury that involves separation of the pelvic ring from pubic symphysis usually results from high energy trauma and associated with other injuries. ⋯ In our case, the multimodal management through ERAS path has helped decrease stress level, decrease complication, decrease morbidity, decrease the length of stay in the hospital, and aid in faster recovery.
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The outcomes following anterior approach (AA) hepatectomy in huge hepatocellular carcinoma (HCC) patients with diaphragmatic invasion (DI) remain unclear. This study compared the outcomes of single huge right HCC patients with and without DI after AA hepatectomy. A total of 203 consecutive patients with single huge right lobe HCC who underwent AA major hepatectomy were included. ⋯ The subgroup analysis also showed that patients with tumor resection en bloc with part of the diaphragm had similar OS and RFS rates as those who underwent diaphragmatic resection after hepatectomy. Tumor diameter ≥ 15 cm, serum AFP level ≥ 400 ng/mL, and tumor grade of G4 and microvascular invasion are independent predictors of poor prognosis. For the single huge right lobe HCC patients with DI, AA major hepatectomy combined with diaphragmatic resection could offer similar OS and RFS as those without diaphragmatic invasion.
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Effective treatments for trigeminal nerve postherpetic neuralgia (PHN) are limited. Adriamycin (doxorubicin) has been applied to the treatment of neuropathic pain. This study reports a new treatment: Adriamycin injected to Gasserian ganglion for an elderly patient with the intractable trigeminal nerve PHN. ⋯ The treatment of Adriamycin injection to Gasserian ganglion is effective and safe, and may be considered as an alternative treatment for trigeminal nerve PHN. However, more research is needed to verify the validity.
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Observational Study
Mediating effects of body mass index, physical activity, and emotional distress on the relationship between short sleep and cardiovascular disease.
The current study investigated the mediating effects of body mass index (BMI), physical activity, and emotional distress on the association between short sleep duration (<7 hours per 24-hour period) and cardiovascular disease (CVD) and risk factors. We used data from the National Health Interview Survey, an ongoing nationally representative cross-sectional study of noninstitutionalized US adults (≥18 years) from 2004 to 2013 (N = 206,049). Participants provided information about anthropometric features (height and weight), sociodemographic factors, health behaviors (smoking and physical activity), emotional distress, and physician-diagnosed health conditions, including hypertension, coronary heart disease, diabetes, heart attack, stroke, kidney disease, and cancer. ⋯ The mean age of the respondents was 46.75 years (SE = 0.12), with a mean BMI of 27.11 kg/m (SE = 0.02) and approximately 32.5% reported short sleep duration. The main relationship between short sleep and CVD and risk factors was significant (β = 0.08, P < .001), as was the mediated effect via BMI (indirect effect = 0.047, P < .001), emotional distress (indirect effect = 0.022, P < .001), and physical activity (indirect effect = -0.022, P = .035), as well as after adjustment for covariates, including age, race, sex, marital status, and income: short sleep and CVD (B = 0.15; SE = 0.01; P < .001), BMI (B = 0.05; SE = 0.00; P < .001), emotional distress (B = 0.02; SE = 0.00; P < .001), and physical activity (B = 0.01; SE = 0.00; P < .001). Our findings indicate that short sleep is a risk factor for CVD and that the relationship between short sleep and CVD and risk factors may be mediated by emotional distress and obesity, and negatively mediated by physical activity.