case reports

病例报告
  • 文章类型: Journal Article
    大多数关于依库珠单抗的安全性数据来自临床试验,而其在现实世界中的安全信息仍然有限。
    收集并分析了依库珠单抗在FDA不良事件报告系统(FAERS)数据库中的数据(从2007年第一季度到2023年第一季度)。PubMed中与依库珠单抗相关的药物不良反应(ADR)的病例报告,对2023年5月之前的Embase和WebofScience进行了系统审查。
    在FAERS数据库中确定了总共464例依库珠单抗的ADR。比例报告比率(PRR)最高的前五名ADR是总补体活性下降,血管外溶血,血红蛋白尿症,总补体活性增加和突破性溶血。从44篇出版物中发现51例与依库珠单抗相关的ADR。观察到病例报告中依库珠单抗相关淋病奈瑟菌感染病例数与脑膜炎奈瑟菌感染病例数相当。
    临床医生必须密切关注接受eculizumab的患者的感染风险,包括严重的脑膜炎奈瑟氏球菌感染和其他可能致命的感染,如淋病奈瑟氏球菌感染。此外,临床用药时应警惕可能出现的新的ADR。
    UNASSIGNED: Most of the safety data regarding eculizumab came from clinical trials, while its safety information in the real world is still limited.
    UNASSIGNED: The data of eculizumab in the FDA Adverse Event Reporting System (FAERS) database (from the first quarter of 2007 to the first quarter of 2023) was collected and analyzed. The case reports of adverse drug reactions (ADRs) related to eculizumab in PubMed, Embase and Web of Science before May 2023 were systematically reviewed.
    UNASSIGNED: A total of 464 ADRs of eculizumab were identified in the FAERS database. The top five ADRs with the highest proportional reporting ratio (PRR) are total complement activity decreased, extravascular hemolysis, hemoglobinuria, total complement activity increased and breakthrough hemolysis. Fifty-one cases of ADR related to eculizumab were identified from 44 publications. The number of reported cases of eculizumab associated Neisseria gonorrhoeae infection in case reports was observed to be comparable to the number of cases of Neisseria meningitidi infection.
    UNASSIGNED: Clinicians must pay close attention to the risk of infections in patients receiving eculizumab, including severe N. meningitidis infection and other potentially fatal infections such as N. gonorrhoeae infection. In addition, The possible emergence of new ADRs should be vigilant during clinical medication.
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  • 文章类型: Case Reports
    此病例报告着重于发生神经系统创伤并导致重症监护(ICU)谵妄时患者和家庭成员可能会经历的情况。它是患者(A.B.)和配偶(R.G.B.)观点的个人账户,当患者(A.B)在ICU中22天后出现椎动脉动脉瘤和出血,并经历了重症监护病房(ICU)谵妄。本病例报告提供了患者和配偶关于谵妄的观点,即,A.B.无法辨别现实,失去记忆,妄想症和幻觉,代理和恢复,ICU后综合征,和创伤后应激障碍(PTSD)。神经外科医生的临床诊断为谵妄,治疗包括睡眠镇静和不间断睡眠。A.B.能够恢复意识,但经历了长达一年的创伤后应激障碍。家庭一致参与患者的谵妄护理至关重要。家庭成员护理和以家庭为中心的策略对未来的研究和医疗保健具有重要意义。
    This case report focuses on what patients and family members may experience when a neurological trauma transpires and resultant intensive care (ICU) delirium occurs. It is the personal account of the patient (A.B.) and spouse\'s (R.G.B.) perspectives when the patient (A.B) suffered a vertebral artery aneurysm and hemorrhage and experienced intensive care unit (ICU) delirium after being in the ICU for 22 days. This case report provides the patient\'s and spouse\'s perspectives regarding delirium, i.e., A.B.\'s inability to discern reality, loss of memory, paranoia and hallucinations, agency and recovery, post-ICU syndrome, and post-traumatic stress disorder (PTSD). Clinical diagnosis by the neurosurgeon indicated delirium, with treatment consisting of sleep sedation and uninterrupted sleep. A.B. was able to regain consciousness yet experienced post-traumatic stress disorder up to one year afterward. Consistent family participation in the patient\'s delirium care is crucial. Family member care and family-centered strategies are provided with implications for future research and health care.
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  • 文章类型: Case Reports
    肺鳞状细胞癌(LUSC)的特点是转移和复发率高,导致患者预后不良。LUSC肠转移是临床罕见的发生。LUSC肠转移患者的治疗选择有限,并且没有管理这些病例的标准治疗指南。在这次审查中,我们讨论临床特征,诊断,并治疗LUSC肠转移患者,目前罕见的LUSC肠转移病例。我们描述了一名患有严重咳嗽和胸痛并被诊断患有LUSC和骨肿瘤的患者。最初,原发性LUSC和骨肿瘤通过标准治疗得到控制.然而,原发性LUSC在治疗后不久复发,这次是肠道转移,缺乏有效的治疗方法。我们从该病例的观察表明,LUSC转移到肠道与预后较差有关。
    Lung squamous cell carcinoma (LUSC) is characterized by a high rate of metastasis and recurrence, leading to a poor prognosis for affected patients. Intestinal metastasis of LUSC is a rare clinical occurrence. Treatment options for LUSC patients with intestinal metastasis are limited, and no standard therapy guidelines exist for managing these cases. In this review, we discuss the clinical features, diagnosis, and treatment of LUSC patients with intestinal metastasis and present a rare case of LUSC with intestinal metastasis. We describe a patient who presented with a severe cough and chest pain and diagnosed with LUSC and bone tumor. Initially, the primary LUSC and bone tumor were controlled with standard treatments. However, the primary LUSC reoccurred shortly after treatment, this time with intestinal metastasis, for which effective treatments are lacking. Our observation from the case suggests that LUSC metastasizing to intestinal tract is associated with a poorer prognosis.
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  • 文章类型: Journal Article
    病例报告的出版格局发生了重大转变,许多高影响力的期刊取消优先次序或完全停止出版。这一趋势导致了基于案例的审查的出现,作为传统案例报告的替代方案。有几个因素推动了这一转变。与单例病例报告相比,基于病例的综述提供了更全面的文献综合。他们采用系统的搜索方法,降低排除相关数据的风险,并提供有力的证据。从出版商的角度来看,基于案例的评论有更大的引用潜力。虽然存在撰写传统病例报告的建议,例如CASE报告(CARE)指南,对于撰写基于案例的评论,缺乏已发布的建议。本次审查旨在通过为起草高质量的基于案例的审查提供指导来弥补这一差距。
    The publication landscape for case reports has undergone a significant shift, with many high-impact journals deprioritizing or ceasing their publication altogether. This trend has led to the emergence of case-based reviews as an alternative to traditional case reports. Several factors drive this shift. Case-based reviews offer a more comprehensive synthesis of the literature compared to single case reports. They employ systematic search methodologies, reducing the risk of excluding relevant data, and providing robust evidence. From a publisher\'s perspective, case-based reviews have a greater potential for citation. While recommendations exist for writing traditional case reports, such as the CAse REports (CARE) guidelines, there is a lack of published recommendations for composing case-based reviews. This review aims to address this gap by providing guidance on drafting high-quality case-based reviews.
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  • 文章类型: Case Reports
    T1直肠癌的侧淋巴结(LLN)转移发生率低于1%。然而,其临床特征在很大程度上是未知的。我们报告1例LLN在T1直肠癌中的转移并复习相关文献。一名56岁女性2年前因低位直肠癌接受直肠切除术(pT1bN0M0)。随访期间,记录到肿瘤标志物CA19-9升高.增强CT和MRI显示骨盆壁左侧2cm大小的圆形结节。PET-CT显示同一病灶内有大量的FDG,导致孤立LLN复发的诊断。因为没有发现其他复发部位,对LLN进行了手术切除。显微镜检查结果与源自近期直肠癌的转移性淋巴结一致。给予六个月的辅助化疗,LLN切除后7个月,患者仍无复发疾病。尽管T1直肠癌手术后LLN复发很少见,不应省略术后随访。当在CT上怀疑LLN转移时,建议使用MRI和/或PET-CT。T1直肠癌患者LLN转移的手术切除可能会导致良好的结果,当其他区域未观察到复发时。
    Lateral lymph node (LLN) metastasis in T1 rectal cancer has an incidence of less than 1%. However, its clinical features are largely uncharted. We report a case of LLN metastasis in T1 rectal cancer and review the relevant literature. A 56-year-old female underwent rectal resection for lower rectal cancer 2 years previously (pT1bN0M0). During follow-up, an elevated tumor marker CA19-9 was documented. Enhanced CT and MRI showed a round shape nodule 2 cm in size on the left side of pelvic wall. PET-CT showed high accumulation of FDG in the same lesion, leading to a diagnosis of isolated LLN recurrence. Because no other site of recurrence was detected, surgical resection of the LLN was performed. Microscopic findings were consistent with metastatic lymph node originating from the recent rectal cancer. Adjuvant chemotherapy for six months was given, and patient remains free of recurrent disease seven months after LLN resection. Although LLN recurrence after surgery for T1 rectal cancer is rare, post-surgical follow-up should not be omitted. When LLN metastasis is suspected on CT, MRI and/or PET-CT will be recommended. Surgical resection of LLN metastasis in patients with T1 rectal cancer may lead to favorable outcomes, when recurrence in other areas is not observed.
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  • 文章类型: Journal Article
    伴有嗜酸性粒细胞增多的血管淋巴样增生(ALHE)是一种罕见的疾病,其特征是主要在头颈部区域的结节性病变。经常引起不适或疼痛。由于治疗的稀有性和缺乏既定的指导方针,治疗仍然具有挑战性。本报告介绍了一例ALHE影响耳垂的病例,该病例通过耳小叶减少手术和随后的病灶内类固醇注射成功治疗。一名31岁的女性有复发性耳垂肿块的病史,接受了部分切除术,以避免耳垂丢失。组织病理学检查证实木村病,ALHE的变体。随后的局部甲基强的松龙注射有效控制了剩余的病变,导致在没有缺口的情况下显著的尺寸减小。对于这种情况,已经尝试了各种治疗方式;然而,复发率仍然很高。手术切除结合病灶内皮质类固醇注射是首选方法。在这种情况下,耳垂复位的耳垂下沟技术被用来保留耳小叶的外侧边缘,尽量减少畸形的风险,并实现可预测的结果。亚反耳沟技术提供了一种在不影响美观的情况下减小耳垂尺寸的方法。需要进一步的研究来阐明ALHE的发病机理,并建立针对这种罕见疾病的标准化治疗方案。
    Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare condition characterized by nodular lesions predominantly in the head and neck region, often causing discomfort or pain. Treatment remains challenging because of its rarity and the lack of established guidelines. This report presents a case of ALHE affecting the earlobes that was successfully managed using ear lobule reduction surgery and subsequent intralesional steroid injections. A 31-year-old woman with a history of recurrent earlobe masses underwent a partial excision to avoid the loss of the earlobe. Histopathological examination confirmed Kimura disease, a variant of ALHE. Subsequent local methylprednisolone injections effectively controlled the remaining lesions, resulting in significant size reduction without notching. Various treatment modalities have been attempted for this condition; however, recurrence rates remain high. Surgical resection combined with intralesional corticosteroid injections is the preferred approach. In this case, a sub-antitragal groove technique for earlobe reduction was employed to preserve the lateral edge of the ear lobule, minimize the risk of deformity, and achieve a predictable outcome. The sub-antitragal groove technique offers an approach to reduce earlobe size without compromising aesthetics. Further research is required to elucidate the pathogenesis of ALHE and establish standardized treatment protocols for this rare condition.
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  • 文章类型: Journal Article
    用于治疗多发性硬化(MS)的疾病改善疗法(DMT)可与血液学病症的发生有关。本系统综述旨在概述这些事件在现实生活中发生的情况,通过描述文献中发表的病例报告和系列。
    在Medline和Embase数据库上对截至2024年1月5日的所有出版物进行了文献检索。结果在文本和表格中呈现。
    本综述包括67例病例报告/系列,其中一半以上与阿仑单抗有关,那他珠单抗和奥克瑞珠单抗。纳入研究的发表日期为2006年至2024年。大多数病例报告和系列描述了迟发性血液病的发生(首次DMT给药后30天以上发生的事件),主要表现为中性粒细胞减少症,自身免疫性溶血性贫血和免疫性血小板减少症。所有病例都报告了有利的结果,除了一个病例报告描述了一个致命的病例。在包括的案件中,4条,都和那他珠单抗有关,描述了接受DMT的母亲的13名新生儿的骨髓性疾病的发生。
    考虑到大多数纳入研究的局限性,需要进一步的研究来更好地评估DMT的血液系统疾病.同时,强烈建议对接受治疗的患者严格监测这些毒性的发生。
    UNASSIGNED: Disease modifying therapies (DMTs) used to treat multiple sclerosis (MS) can be associated to the occurrence of hematological disorders. This systematic review aims to provide an overview of these events occurring in real-life conditions, by describing case reports and series published in the literature.
    UNASSIGNED: A literature search of all publications up to January 5th 2024 on the Medline and Embase databases was carried out. The results were presented both in the text and in tables.
    UNASSIGNED: Sixty-seven case reports/series were included in this review, of which more than half related to alemtuzumab, natalizumab and ocrelizumab. The publication date of included studies ranged from 2006 to 2024. The majority of case reports and series described the occurrence of late-onset hematological disorders (events that occurred more than 30 days after the first DMT administration), mainly represented by case of neutropenia, autoimmune hemolytic anemia and immune thrombocytopenia. All cases reported a favorable outcome, apart one case report that described a fatal case. Among included cases, 4 articles, all related to natalizumab, described the occurrence of myeloid disorders in 13 newborns from mother receiving the DMT.
    UNASSIGNED: Considering the limitations identified in the majority of included studies, further ad hoc studies are strongly needed to better evaluate the hematological disorders of DMTs. Meantime, the strict monitoring of treated patients for the occurrence of these toxicities should be highly recommended.
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  • 文章类型: Case Reports
    这是子宫切除术后阴道动脉假性动脉瘤的第一份报告,与其他已发表的有关分娩后子宫或阴道动脉假性动脉瘤的研究不同。
    一名51岁妇女在子宫切除术后7天出现大量阴道出血,导致血红蛋白下降。根据超声检查,患者怀疑患有阴道动脉假性动脉瘤。她的左髂内动脉结扎后出血停止。
    UNASSIGNED: This was the first report of a pseudoaneurysm in a vaginal artery after hysterectomy, unlike other published studies that were of pseudoaneurysms in uterine or vaginal arteries after delivery.
    UNASSIGNED: A 51-year-old woman presented with massive vaginal bleeding 7 days after a hysterectomy, which caused hemoglobin to drop. The patient was suspicious of having a vaginal artery pseudoaneurysm according to the sonography. Her bleeding was stopped after the ligation of her left internal iliac artery.
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  • 文章类型: Journal Article
    丹麦莱姆关节炎(LA)的发病率或患病率未知,并被认为非常低。不存在来自丹麦的聚合酶链反应(PCR)证实的LA的公开病例。临床上,LA与其他风湿性小关节炎疾病没有区别,构成了鉴别诊断挑战。回顾我们所知的LA的发病率和患病率,并介绍一系列来自丹麦的PCR确认的LA病例。我们通过MEDLINE和EMBASE进行了系统的文献综述,以探讨LA的发病率和患病率。此外,我们介绍了丹麦6例诊断为LA的患者。我们的文献综述确定了23项报告患病率或发病率的研究,然而,只有10项研究在一般人群中提供了1.1至280/100.000的估计值.我们的病例系列从丹麦南部的一个局部区域确定了六名LA患者;所有这些都通过滑液中的疏螺旋体特异性实时PCR证实。诊断延迟长达38个月。除一名患者外,所有患者均有以前的蜱叮咬史;没有红斑偏头痛病变。都出现了膝关节复发性关节炎,两个人的手腕有关节炎.文献综述显示,在欧洲,LA的发病率为1.1至15.8/100.000。我们的病例系列表明,丹麦的LA患病率可能比以前认为的要高。缺乏蜱虫暴露史,滑液中伯氏疏螺旋体的抗体评估和DNA检测可能导致误诊病例,这可能解释了丹麦LA的低发病率.
    The incidence or prevalence of Lyme arthritis (LA) in Denmark is unknown and assumed very low. No published cases of polymerase chain reaction (PCR)-confirmed LA from Denmark exist. Clinically, LA does not differ from other rheumatic oligoarthritic disorders posing a differential diagnostic challenge. To review the incidence and prevalence of LA to our knowledge and to present a case series of PCR-confirmed LA cases from Denmark. We conducted a systematic literature review via MEDLINE and EMBASE to explore incidence and prevalence rates of LA. Additionally, we present six cases of patients diagnosed with LA in Denmark. Our literature review identified 23 studies reporting prevalence or incidence, yet only ten studies provided estimates ranging from 1.1 to 280/100.000 in the general population. Our case series identified six patients with LA from a localized region in Southern Denmark; all confirmed by Borrelia-specific real-time PCR from synovial fluid. The diagnostic delay was up to 38 months. All patients except one had a history of previous tick bites; none had erythema migrans lesions. All presented with recurrent arthritis in the knee joint, and two had arthritis in the wrist. The literature review showed an incidence of LA ranging from 1.1 to 15.8 per 100.000 in Europe. Our case series suggests a potentially higher prevalence of LA in Denmark than previously believed. Lack of tick exposure history, antibody assessments and test of Borrelia burgdorferi sensu lato DNA in synovial fluid might lead to misdiagnosed cases potentially explaining the assumed low incidence of LA in Denmark.
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  • 文章类型: Journal Article
    常规疗法通常用于治疗炎症性皮肤病,但是不良影响,如红斑,干燥度,皮肤变薄,和对治疗的抵抗力,可能导致患者依从性差。因此,患者可能会寻求草药植物产品,包括精油(EO)的补充治疗。本范围审查旨在对用于治疗炎症性皮肤病的EO进行广泛的概述,即,寻常痤疮,皮炎和湿疹,牛皮癣,还有酒渣鼻,在临床环境中。质量,功效,以及各种EO的安全性,以及他们准备的方式,被审查,和潜力,以及局限性,讨论了用于治疗炎性皮肤病的EOs。29项符合条件的研究(案例研究,不受控制的临床研究,和随机临床研究)从科学电子数据库(PubMed,Embase,Scopus,和Cochrane图书馆)。作为最初的结果,茶树(互叶白千层)油成为研究最多的EO。茶树油凝胶治疗痤疮的临床研究显示,与常规治疗相比,不良反应少。不受控制的研究表明ajwain(Trachyspermumammi)油的潜在功效,桉树油,和雪松(Cedruslibani)油在治疗痤疮,但是需要进一步的研究才能得出确凿的证据。安慰剂对照研究揭示了卡努卡(Kunzeaericoides)油和乳香(Boswelliaspp。)用于治疗牛皮癣和湿疹的油。EO产品的质量验证不一致,一些研究缺乏分析和透明度。一些研究的质量限制包括样本量小,持续时间短,没有对照组.本次审查强调了延长,精心设计的临床研究,以进一步评估EO治疗炎症性皮肤疾病的疗效和安全性,并进一步阐明所涉及的作用机制。
    Conventional therapy is commonly used for the treatment of inflammatory skin conditions, but undesirable effects, such as erythema, dryness, skin thinning, and resistance to treatment, may cause poor patient compliance. Therefore, patients may seek complementary treatment with herbal plant products including essential oils (EOs). This scoping review aims to generate a broad overview of the EOs used to treat inflammatory skin conditions, namely, acne vulgaris, dermatitis and eczema, psoriasis, and rosacea, in a clinical setting. The quality, efficacy, and safety of various EOs, as well as the way in which they are prepared, are reviewed, and the potential, as well as the limitations, of EOs for the treatment of inflammatory skin conditions are discussed. Twenty-nine eligible studies (case studies, uncontrolled clinical studies, and randomized clinical studies) on the applications of EOs for inflammatory skin conditions were retrieved from scientific electronic databases (PubMed, Embase, Scopus, and the Cochrane Library). As an initial result, tea tree (Melaleuca alternifolia) oil emerged as the most studied EO. The clinical studies with tea tree oil gel for acne treatment showed an efficacy with fewer adverse reactions compared to conventional treatments. The uncontrolled studies indicated the potential efficacy of ajwain (Trachyspermum ammi) oil, eucalyptus (Eucalyptus globulus) oil, and cedarwood (Cedrus libani) oil in the treatment of acne, but further research is required to reach conclusive evidence. The placebo-controlled studies revealed the positive effects of kānuka (Kunzea ericoides) oil and frankincense (Boswellia spp.) oil in the treatment of psoriasis and eczema. The quality verification of the EO products was inconsistent, with some studies lacking analyses and transparency. The quality limitations of some studies included a small sample size, a short duration, and the absence of a control group. This present review underscores the need for extended, well-designed clinical studies to further assess the efficacy and safety of EOs for treating inflammatory skin conditions with products of assured quality and to further elucidate the mechanisms of action involved.
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