Medicine
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Shenfu injection is a traditional Chinese medicine formulation that alleviates ischemia-reperfusion injury through multiple pharmacologic effects. However, there is lack of evidence regarding its efficacy in myocardial infarction. We performed a protocol for systematic review and meta-analysis to evaluate the efficacy and safety of Shenfu injection for ST segment elevation myocardial infarction after primary percutaneous coronary intervention. ⋯ This systematic review will provide evidence to judge whether Shenfu injection is effective and safe in patients undergoing percutaneous coronary intervention for ST segment elevation myocardial infarction.
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Acute kidney injury (AKI) is a life-threatening complication of acute type A aortic dissection (ATAAD) patients. Increasing evidence suggests that histamine ameliorates the pathology of renal injury. However, data on the association between histamine levels and postoperative AKI in ATAAD patients are limited. ⋯ Subgroup analysis revealed that low preoperative plasma histamine level was independently associated with postoperative ATAAD-AKI (stage 3) (OR, 1.38; 95% CI, 1.10-1.73; P = .005) and CRRT (OR, 1.44; 95% CI, 1.13-1.79; P = .008). Low preoperative plasma histamine level was an independent prognostic indicator of postoperative AKI in patients with ATAAD, especially for postoperative AKI (stage 3) and CRRT. Preoperative plasma histamine levels may serve as potential protective biomarkers of postoperative ATAAD-AKI.
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Case Reports
Idiopathic intracranial hypertension in patients with cerebral small vessel disease: A case report.
Idiopathic intracranial hypertension (IIH) is a clinical syndrome characterized by increased intracranial pressure (ICP) without any identifiable cause. However, restrictions of cerebrospinal fluid absorption from the cerebral venous system, the glymphatic system overflow, and the cerebrospinal fluid's lymphatic pathways may be involved in the pathophysiology of IIH. Furthermore, an impaired glymphatic system is also implicated in the initiation and progression of cerebral small vessel disease (CSVD). Here, we reported a case of CSVD with concomitant IIH, possibly associated with the brain's glymphatic and lymphatic system dysfunction. ⋯ In this case, we speculate that the normal glymphatic outflow pathway may serve as a compensatory mechanism for regulating increased ICP in patients with bilateral venous sinus obstruction, indicating impaired venous outflow pathway, possibly associated with dysfunction of the glymphatic and lymphatic systems in patients with CSVD.
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Drug-induced aseptic meningitis (DIAM) is an uncommon meningitis and trimethoprim with or without sulfamethoxazole is the most involved antibiotic. Although DIAM is easily treated with the discontinuation of the causative drug, the diagnosis is a big challenge for physicians, as it remains a diagnosis of exclusion. Here, we present a case report of trimethoprim-sulfamethoxazole induced aseptic meningitis in a woman with acute osteomyelitis. ⋯ Although DIAM can be easily managed with the withdrawal of the causative drug, it can be difficult to recognize if it is not included in the differential diagnosis. An antimicrobial stewardship program with a strict monitoring of patients by infectious disease specialists is essential, not only to optimize the appropriate use of antimicrobials, but also to improve patient outcomes and reduce the likelihood of adverse events.
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The apolipoprotein B (Apo B), Apo B/A1 ratio, lipoprotein (a), and low-density lipoprotein cholesterol (LDL-C)/Apo B ratio are associated with coronary artery disease (CAD). However, the association between these parameters and CAD in non-diabetic patients without high LDL-C levels is unclear. Our goal was to assess which parameter was most strongly associated with CAD in non-diabetic patients without high LDL-C levels. ⋯ The LDL-C/Apo B ratio was significant for the incidence of revascularization in multivariate analysis after adjustment for standard risk factors. The degree of coronary calcification and plaque burden according to the tertile of LDL-C/Apo B showed significant differences between the groups. Our data indicate that LDL-C/Apo B ratio is the most predictive parameter for coronary atherosclerosis in non-diabetic patients without high LDL-C levels.