case reports

病例报告
  • 文章类型: Case Reports
    甲醛在2006年被国际癌症研究机构(IARC)列为第一类致癌物质。虽然IARC指出,缺乏证据表明甲醛会导致脑癌,三项荟萃分析一致报道,暴露于高浓度甲醛的工人患脑癌的风险显著增高.因此,我们报告了一例工人在造纸工业使用甲醛树脂时暴露于高浓度的甲醛后被诊断为胶质母细胞瘤。
    一名40岁的男性患者加入了一家浸渍纸制造商,并使用甲醛树脂进行了10年零2个月的浸渍工作。2017年,患者出现严重头痛,到医院进行脑部磁共振成像,这揭示了一个质量。同年,患者接受了开颅手术切除脑肿瘤,并被诊断为颞叶胶质母细胞瘤。2019年,由于脑肿瘤复发,进行了开颅手术,但他在2020年去世了.对工作环境的暴露评估确定,患者在超过10年的时间内连续暴露于高于0.3ppm暴露阈值的甲醛,并且通过在不戴呼吸器或防护手套的情况下进行工作,他有高呼吸和皮肤暴露。
    本病例报告是韩国职业安全与健康研究所的流行病学调查和评估委员会首次认识到由于长期暴露于高浓度甲醛浸渍文书工作而导致的与工作有关的脑肿瘤的科学证据。这个案例突出了正确的工作场所管理的重要性,告知工人在浸渍工作中长时间暴露于甲醛会导致脑瘤,并在类似过程中尽量减少暴露。
    UNASSIGNED: Formaldehyde was classified as a Group I Carcinogen by the International Agency for Research on Cancer (IARC) in 2006. While the IARC has stated that there is a lack of evidence that formaldehyde causes brain cancer, three meta-analyses have consistently reported a significantly higher risk of brain cancer in workers exposed to high levels of formaldehyde. Therefore, we report a case of a worker who was diagnosed with glioblastoma after being exposed to high concentrations of formaldehyde while working with formaldehyde resin in the paper industry.
    UNASSIGNED: A 40-year-old male patient joined an impregnated paper manufacturer and performed impregnation work using formaldehyde resin for 10 years and 2 months. In 2017, the patient experienced a severe headache and visited the hospital for brain magnetic resonance imaging, which revealed a mass. In the same year, the patient underwent a craniotomy for brain tumor resection and was diagnosed with glioblastoma of the temporal lobe. In 2019, a craniotomy was performed owing to the recurrence of the brain tumor, but he died in 2020. An exposure assessment of the work environment determined that the patient was exposed to formaldehyde above the exposure threshold of 0.3 ppm continuously for more than 10 years and that he had high respiratory and dermal exposure through performing work without wearing a respirator or protective gloves.
    UNASSIGNED: This case report represents the first instance where the epidemiological investigation and evaluation committee of the Occupational Safety and Health Research Institute in Korea recognized the scientific evidence of work-related brain tumors due to long-term exposure to high concentrations of formaldehyde during impregnated paperwork. This case highlights the importance of proper workplace management, informing workers that prolonged exposure to formaldehyde in impregnation work can cause brain tumors and minimizing exposure in similar processes.
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  • 文章类型: Case Reports
    关于2019年冠状病毒病(COVID-19)疫苗的不良反应有许多研究,但COVID-19疫苗接种后的尿失禁很少见。这里,我们报告了一个8岁的男孩去门诊部,泰国平医学院医院,泰语Binh,越南在过去2周内抱怨尿失禁,在第一剂信使RNA疫苗之后。他在临床和实验室检查中没有其他异常。这种临床情况表明疫苗有副作用。在没有厕所和膀胱训练的情况下,诊断后没有给予特异性治疗。随后的监测显示症状在2个月内逐渐减轻,从症状开始的第14周完全康复,不需要任何医疗干预。该案例强调需要对疫苗接种后的潜在不良反应进行全面评估和评估。包括不常见的介绍。
    There have been many studies on the adverse effects of coronavirus disease 2019 (COVID-19) vaccines but the urinary incontinence after COVID-19 vaccination is rare. Here, we report an 8-year-old boy presented to outpatient department, Thai Binh University of Medicine Hospital, Thai Binh, Vietnam with complaints of urinary incontinence for the past 2 weeks, following the first dose of the messenger RNA vaccine. He had no other abnormalities in clinical and laboratory exams. This clinical situation suggested vaccine side effects. No specific treatment was administered upon diagnosis without toilet and bladder training. Subsequent monitoring revealed a gradual reduction in symptoms over 2 months, with complete recovery achieved at the 14th week from the onset of symptoms, without necessitating any medical intervention. This case highlights the need for thorough evaluation and assessment of potential adverse effects following vaccination, including uncommon presentations.
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  • 文章类型: Journal Article
    心外膜连接为双心房折返回路提供了解剖学基础。右心房和右肺静脉之间的连接被称为“腔静脉束”,”,很少有与此束相关的房扑报告。我们介绍了一个双房性心动过速的病例,涉及腔间束。
    Epicardial connections provided the anatomical substrate for the biatrial reentry circuit. The connections between the right atrium and right pulmonary vein were called \"intercaval bundle,\" and there are few reports of atrial flutter related to this bundle. We present a case of a biatrial tachycardia, involving the intercaval bundle.
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  • 文章类型: Case Reports
    绝经前妇女的冠状动脉痉挛性心绞痛(CSA)并不常见,但也被认为与月经周期中雌激素下降有关,有时变得难治且难以控制。我们经历了两名绝经前妇女的CSA,表现出月经周期的参与。
    病例1:41岁女性在尿脓毒血症期间出现ST段抬高和胸痛,月经刚开始2天后。根据月经周期进行乙酰胆碱应激试验,并诱发多发性冠状动脉痉挛。病例2:40岁女性难治性胸痛是经前综合征(PMS)的症状。最大剂量药物的冠状动脉造影显示自发性多发性冠状动脉痉挛。血雌激素水平正常,这表明可能涉及荷尔蒙的变化,以及引入无心绞痛的低剂量药丸和减少药物剂量。
    在绝经前女性心绞痛中,雌激素可能起作用;询问月经周期和PMS病史很重要。此外,对于怀疑有CSA的绝经前女性,应考虑导管插入的时机.低剂量药丸在某些情况下可能有效,与妇科等其他部门的积极医疗合作是可取的。.
    UNASSIGNED: Coronary spastic angina (CSA) in premenopausal women is not frequent but has also been suggested to be associated with oestrogen decline during the menstrual cycle and sometimes becomes refractory and difficult to control. We experienced two premenopausal women with CSA that showed the involvement of the menstrual cycle.
    UNASSIGNED: Case 1: 41-year-old-woman had ST-segment elevation and chest pain during urosepsis, just 2 days after the onset of menstruation. The acetylcholine stress test was performed according to the menstrual cycle, and multiple coronary spasms were induced. Case 2: 40-year-old-woman had refractory chest pain as a symptom of premenstrual syndrome (PMS). Coronary angiography on drugs at the maximum dose revealed spontaneous multiple coronary spasms. Blood levels of oestrogen were normal, suggesting that hormonal change may be involved, and the introduction of low-dose pills made free from angina and the reduction of drug dose.
    UNASSIGNED: In premenopausal female angina pectoris, oestrogen may play a role; it is important to ask about the menstrual cycle and history of PMS. Besides, the timing of catheterization in premenopausal women with suspected CSA should be considered. Low-dose pills may be effective in some cases, and active medical collaboration with other departments such as gynaecology is desirable. .
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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: Case Reports
    长期以来,低级别胶质瘤的高级别转化一直是治疗期间的不良预后因素。2016年,世界卫生组织(WHO)中枢神经系统(CNS)肿瘤分类在弥漫性星形细胞瘤分类中采用了异柠檬酸脱氢酶(IDH)突变状态。2021分类将胶质母细胞瘤表示为IDH野生型,而分级IDH突变型星形细胞瘤表示为2、3或4。双胞细胞形态,大部分残留肿瘤,病人的年龄,放疗后复发是低度胶质瘤高级别转化的危险因素。我们报告了一名34岁的男性患者,根据2021年WHO中枢神经系统肿瘤分类,最初诊断为IDH突变型2级星形细胞瘤。由于第一次手术切除在术后MRI上实现了大体全切除,未给予辅助治疗,并计划定期随访.在1年的MRI随访中,在手术切除腔附近的同侧脑实质上出现了两个新的增强性结节性病变。挽救性开颅手术实现了全切除,病理诊断为IDH突变型WHO4级星形细胞瘤。我们根据先前的WHO分类来描述这种肿瘤,以评估高级别转化的风险,并讨论导致低级别星形细胞瘤高级别转化的可能风险因素。
    High-grade transformation of low-grade gliomas has long been a poor prognostic factor during therapy. In 2016, the World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS) adopted isocitrate dehydrogenase (IDH) mutation status in the classification of diffuse astrocytomas. The 2021 classification denoted glioblastomas as IDH-wildtype and graded IDH-mutant astrocytomas as 2, 3, or 4. Gemistocytic morphology, a large proportion of residual tumor, the patient\'s age, and recurrence after radiotherapy were previously mentioned as risk factors for high-grade transformation of low-grade gliomas. We report a 34-year-old male patient initially diagnosed with IDH-mutant grade 2 astrocytoma according to the 2021 WHO classification of CNS tumors. As the first surgical resection achieved gross total resection on postoperative MRI, no adjuvant therapy was given and regular follow-up was planned. On 1-year follow-up MRI, two new enhancing nodular lesions appeared at the ipsilateral brain parenchyma abutting the surgical resection cavity. Salvage craniotomy achieved gross total resection, and the pathologic diagnosis was IDH-mutant WHO grade 4 astrocytoma. We describe this tumor in terms of the previous WHO classification to evaluate the risk of high-grade transformation and discuss possible risk factors leading to high-grade transformation of low-grade astrocytoma.
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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
    背景:Herlyn-Werner-Wunderlich综合征,一种罕见的苗勒管先天性疾病,以白喉子宫为特征,失明的半阴道,和同侧肾发育不全。诊断是在年轻时通过超声和磁共振成像,预后良好.通常,并发症演变为子宫内膜异位症和继发性盆腔炎。
    方法:一名40岁女性患者,巴西,白色,primigravida,30岁时超声诊断为双形子宫,四年后,患有左卵巢子宫内膜瘤,多发性卵巢囊肿,磁共振成像显示左肾发育不全。随后,由于性交困难和肿胀的感觉,患者接受了经阴道超声检查并进行肠道准备,并发现了血液综合征,怀疑是Herlyn-Werner-Wunderlich综合征;诊断后10年,她计划怀孕。她在怀孕第15周后出现频繁的宫缩,幸运的是没有并发症或早产。在第40周和第6天引产,无进展,并指示剖宫产,无并发症。Herlyn-Werner-Wunderlich综合征经常被忽视,导致治疗不充分。患有Herlyn-Werner-Wunderlich综合征的人通常面临生育问题,如高流产率(21-33%),产科并发症,如自然流产(40%的风险),宫内生长受限,产后出血,增加胎儿死亡率,早产(21-29%),剖宫产率升高。此外,子宫内膜异位症的易感性更高,尤其是阴道半梗阻,和盆腔粘连。
    结论:早期诊断可以及时治疗,因此,并发症少。尽管如此,当这些因素不存在时,阴道分娩仍然是可能的。与Herlyn-Werner-Wunderlich综合征相关的并发症的真实患病率和发生率仍然未知。
    BACKGROUND: Herlyn-Werner-Wunderlich syndrome , a rare Müllerian ducts congenital disease, is characterized by a diphtheritic uterus, blind hemivagina, and ipsilateral renal agenesis. Diagnosis is at young age by ultrasound and magnetic resonance imaging, and the prognosis is good. Usually, complications evolve endometriosis and secondary pelvic inflammation.
    METHODS: A 40-year-old female patient, Brazilian, white, primigravida, diagnosed at 30 years with a didelphic uterus on ultrasound, and 4 years later, with a left ovarian endometrioma, multiple ovarian cysts, and left renal agenesis on magnetic resonance imaging. Subsequently, due to dyspareunia and a feeling of swelling, the patient underwent transvaginal ultrasound with bowel preparation, and a hematocolpos was found and Herlyn-Werner-Wunderlich syndrome was suspected; 10 years after the diagnosis she had a planned pregnancy. She presented frequent contractions following the 15th week of pregnancy and fortunately there were no complications or premature labor. Labor was inducted at 40 weeks and 6 days without progress and a cesarean section was indicated and performed without complications. Herlyn-Werner-Wunderlich syndrome often goes unnoticed, leading to inadequate treatment. Individuals with Herlyn-Werner-Wunderlich syndrome commonly face fertility issues, such as high miscarriage rate (21-33%), and obstetric complications, such as spontaneous abortions (40% risk), intrauterine growth restriction, postpartum hemorrhage, increased fetal mortality, preterm delivery (21-29%), and elevated rates of cesarean sections. In addition, there is higher susceptibility of developing endometriosis, especially with hemivaginal obstruction, and pelvic adhesions.
    CONCLUSIONS: Early diagnosis enables timely treatment and, consequently, fewer complications. Still, when these factors are absent, vaginal birth may still be possible. The true prevalence and incidence of complications related to Herlyn-Werner-Wunderlich syndrome are still unknown.
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  • 文章类型: Case Reports
    抗核抗体阴性的全屋狼疮性肾炎虽然以前有报道,相当罕见。一些患者在病程后期继续产生抗体。在这种情况下RO-52抗体的存在提示潜在的免疫学原因。基于强烈的临床怀疑的快速管理可以挽救患者的生命。
    狼疮肾炎(LN)是系统性红斑狼疮(SLE)的严重并发症,更有可能发展为终末期肾病(ESRD)。随着最近的EULAR/ACR标准要求抗核抗体(ANA)阳性作为进入标准,临床医生在诊断血清阴性SLE病例时面临诊断困境。我们介绍了一名25岁女性的病例,她表现出光敏性黄斑皮疹,脱发,口腔溃疡,月经过多,肾功能障碍,暗示SLE。她的ANA检测结果是阴性,引起对诊断的怀疑。活检因贫血和血小板减少而延迟,临床判断导致患者被诊断为LN,及时治疗,导致显着改善。肾活检随后证实该病例为弥漫性IV级LN伴全屋肾病。该病例突出了仅依靠ANA阳性诊断LN的局限性,并强调需要一种综合临床特征的SLE诊断方法。免疫学标记,和病人的人口统计学。ANA阴性SLE患者需要加强临床怀疑,特别是当其他诊断参数与疾病一致时。快速干预与免疫抑制治疗,正如在这种情况下看到的,可以挽救生命。
    UNASSIGNED: Antinuclear antibody-negative full-house lupus nephritis though previously reported, is fairly uncommon. Some patients go on to develop antibodies later in the disease course. The presence of RO-52 antibody in this case suggests an underlying immunological cause. Swift management based on strong clinical suspicion can be life-saving to the patient.
    UNASSIGNED: Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus (SLE) and is more likely to progress to end-stage renal disease (ESRD). With the recent EULAR/ACR criteria mandating antinuclear antibody (ANA) positivity as an entry criterion, clinicians are faced with a diagnostic dilemma in diagnosing cases of seronegative SLE. We present the case of a 25-year-old female who presented with photosensitive malar rash, hair loss, oral ulcers, menorrhagia, and kidney dysfunction, suggestive of SLE. Her ANA tests were negative, raising doubts about the diagnosis. Biopsy was delayed owing to anemia and thrombocytopenia, and clinical judgment led to the patient being diagnosed with LN, with prompt treatment resulting in significant improvement. Renal biopsy subsequently confirmed the case as diffuse class IV LN with full-house nephropathy. This case highlights the limitations of relying solely on ANA positivity in diagnosing LN and underscores the need for a comprehensive diagnostic approach for SLE that incorporates clinical features, immunological markers, and patient demographics. ANA-negative SLE patients demand heightened clinical suspicion, especially when other diagnostic parameters align with the disease. Swift intervention with immunosuppressive therapy, as seen in this case, can be life-saving.
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