Medicine
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Review Case Reports
Staged angioplasty in 2 patients with severe carotid artery stenosis: A case report and literature review.
Cerebral infarction is a common ischemic cerebrovascular disease, associated with high rates of morbidity, disability, and recurrence, that can seriously affect patient physical and mental health, as well as quality of life. Carotid artery stenosis is an independent risk factor of cerebral infarction. Following rapid developments in interventional technology and materials science, carotid artery stenting has arisen an important treatment option for carotid artery stenosis. However, surgery is associated with complications, such as postoperative hyperperfusion syndrome, which poses a serious threat to the life and health of patients. Staged angioplasty (SAP), that is, one-time revascularization of the carotid artery stenting, is divided into 2 stages. This method reduces the occurrence of hyperperfusion syndrome after stenting by increasing the ipsilateral cerebral blood flow in stages and gradually increasing the cerebral perfusion pressure. ⋯ When treating SAP, it is crucial to consider that patients with unstable carotid plaques may not be suitable for staging. Additionally, during phase II carotid stenting, it is important to assess any changes in the arterial morphology and select the appropriate device accordingly.
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Review Case Reports
Case report and literature review: A young man with giant intra-abdominal Ewing sarcoma.
Extraosseous Ewing sarcoma (EES) is a rare manifestation within the Ewing sarcoma tumor family (ESFT). Its clinical manifestations lack specificity, intestinal obstruction is the main symptom but can also present with abdominal pain, gastrointestinal bleeding, and other discomforts, making it prone to misdiagnosis as intestinal mesenchymal tumor. ⋯ Giant abdominal Ewing sarcoma with a diameter of 15 cm is rare. Considering postoperative pathology and genetic testing, abdominal Ewing sarcoma was suspected. The patient was successfully treated using surgery.
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Review Case Reports
Proton pump inhibitor-induced hypomagnesemia, a rare cause of reversible delirium: A case report with literature review.
Hypomagnesemia is associated with multiple electrolyte disturbances such as hypokalemia, hypocalcemia and hypoparathyroidism. Proton pump inhibitors (PPIs) are widely used in gastrointestinal disorders and are generally considered safe by clinicians. However, it is unusual side effect of hypomagnesemia is potentially under-recognized. Delirium is usually thought to be a clue of cerebrovascular disease, and the association between delirium and hypomagnesemia is unexpected. We describe a patient used PPI with hypomagnesemia showed normal parathyroid hormone (PTH) despite hypocalcemia and reversible delirium. To enhance clinicians' vigilance, we performed a literature review on cerebellar syndromes due to hypomagnesemia. ⋯ Hypomagnesemia is associated with a variety of neurological symptoms up to life-threatening conditions if left untreated; as Mg is not present in routine electrolyte panels, hypoparathyroidism, hypokalemia, and delirium may be a clue, and physicians must be alert to consider PPI as a potential cause of unexplained hypomagnesemia, and timely treatment to avoid sequelae.
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During pregnancy, fetal growth could lead to changes in human biomechanics. If postpartum recovery was not properly managed, it could be exacerbated, resulting in myofascial system disorders and various functional impairments. Among them, pain-related functional disorders were an important issue affecting quality of life in postpartum women. ⋯ In clinical practice, myofascial therapy could effectively alleviate postpartum pain and muscle spasms, improve excessive tension injuries in myofascial, and had a good therapeutic effect on postpartum pain-related functional disorders. The mechanism of myofascial therapy involved improving core muscle strength, restoring normal body alignment, and promoting the remodeling of myofascial mechanical structures. This article explored the positive effects of myofascial therapy on postpartum pain-related functional disorders from a biomechanical perspective, aiming to provide diverse treatment approaches for clinical practitioners.
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To elucidate the relationship between pain and cognitive decline in adults aged ≥60 years using data from the Korean Longitudinal Study of Aging survey. We included 3,287 older adults aged ≥60 years with a Korean Mini-Mental State Examination score ≥24. We assessed the presence of pain and pain interference using self-administered questionnaires. ⋯ Compared to low-impact pain, high-impact pain increased the odds of suspected dementia and cognitive impairment by approximately 2.1and 1.5 times, respectively (OR = 2.12, 95% CI: 1.76, 2.56; OR = 1.47, 95% CI: 1.31, 1.65). Pain was negatively associated with Mini-Mental State Examination scores in Korean older adults aged ≥60 years and increased the odds of suspected dementia and cognitive impairment. Furthermore, individuals with high-impact pain exhibited higher risks of both suspected dementia and cognitive impairment than those with low-impact pain.