Medicine
-
Thoracic endovascular aortic repair (TEVAR) is a new alternative surgical treatment for aortic pathologies, which is more minimally invasive. The aim of current study was to summarize the single-center experience of general anesthesia for patients undergoing TEVAR. In adult patients undergoing surgery for congenital heart disease, the strategy of "fast-track" anesthesia with early extubation in theater is associated with a shorter intensive care unit (ICU) stay, and lower health-care-related costs. ⋯ Fast-track anesthesia is feasible and safe in patients underwent TEVAR. This management strategy is associated with shorter LOS of ICU and total postoperative hospital stays. An early extubation strategy should be implemented for hemodynamically stable patients.
-
Remimazolam, a benzodiazepine drug, has recently been developed and is currently used for the induction and maintenance of anesthesia. Remimazolam provides hemodynamic stability during anesthesia induction. However, in patients with cardiac tamponade, it is unclear how hemodynamic stability is maintained during the induction and maintenance of general anesthesia with remimazolam. ⋯ Remimazolam may induce severe hemodynamic instability during induction of general anesthesia in patient with cardiac tamponade.
-
The adult granulosa cell tumor of the testis is a rare sex-cord/stromal tumor, with a potentiality for late recurrence and metastasis. Because of its rarity, this tumor is poorly understood, particularly in terms of its molecular features. As a result, it is necessary to register each occurrence in order to study the evolution of this rare malignancy and develop therapeutic strategies. ⋯ Surgery together with adjuvant chemotherapy may be useful treatment options for these individuals with malignant tendencies who are unable to visit the hospital for a follow-up appointment on time. Adult testicular granulosa cell tumors have a relatively complex genetic profile; their etiology is linked to a number of common driver genes, including TERT, CDKN2A, TP53, and H3F3A.
-
To analyze the misdiagnosis or delayed diagnosis of leprosy in Hubei Province, China during the past 30 years, which can provide a scientific basis for improving the prevention and treatment of leprosy by proposing targeted intervention measures. A retrospective study was conducted to compile 161 cases of misdiagnosed or delayed diagnosis of leprosy in Hubei Province during 1990 to 2020 from the National Leprosy Prevention and Control Management Information System and the background information of regional leprosy control centers in Hubei Province. Among 161 study subjects, the shortest delay period was 25.30 months for cases aged 15 to 20 years, the longest delay period was 67.09 months for cases aged 51 to 60 years, the shortest delay period was 35.33 months for type TN cases, and the longest delay period was 75.17 months for type I cases. ⋯ Top 5 misdiagnosed cases were rash 23 (32.39%), rheumatism 10 (14.08%), skin ulceration 9 (12.68%), dermatitis 9 (12.68%), neuritis 9 (12.68%). In the prophet prediction, the overall trend of leprosy misdiagnosis was increasing and within 1 year the number is fluctuant. The training of medical personnel at all levels on leprosy prevention and treatment should be strengthened, and the public awareness of leprosy prevention and treatment should be enhanced.
-
This study aimed to evaluate the effectiveness of combined pelvic floor muscle exercise (PFME) and duloxetine treatment in the recovery from postprostatectomy urinary incontinence (PPUI). Participants were patients who underwent radical prostatectomy (RP) between 2018 and 2021 and who were able to attend follow-up appointments every 3 months for at least 12 months. Continence was defined as the use of ≤1 pad per day. ⋯ However, no significant differences were found in the incontinence rates between the 2 groups at each follow-up period after 3 months. Compared to PFME monotherapy, the combination therapy of PFME and duloxetine has short-term effectiveness in improving PPUI, but it does not have a significant long-term impact. Therefore, for early recovery from PPUI, duloxetine should be administered for a short period during PFME.