Acta medica (Hradec Kralove)最新文献_第4页

Current Diagnosis and Management of Acute Pulmonary Embolism: A Strategy for General Practitioners in Emergency Department. 急性肺栓塞的当前诊断和管理：急诊科全科医生的策略》。

Acta medica (Hradec Kralove) Pub Date : 2023-01-01 DOI: 10.14712/18059694.2024.8

Joshua Eldad Frederich Lasanudin, Sidhi Laksono, Hillary Kusharsamita

{"title":"Current Diagnosis and Management of Acute Pulmonary Embolism: A Strategy for General Practitioners in Emergency Department.","authors":"Joshua Eldad Frederich Lasanudin, Sidhi Laksono, Hillary Kusharsamita","doi":"10.14712/18059694.2024.8","DOIUrl":"https://doi.org/10.14712/18059694.2024.8","url":null,"abstract":"Pulmonary embolism (PE) is a disease with a relatively good prognosis when diagnosed and treated properly. This review aims to analyse available data and combine them into algorithms that physicians can use in the emergency department for quick decision-making in diagnosing and treating PE. The available data show that PE can be excluded through highly sensitive clinical decision rules, i.e. Pulmonary Embolism Rule-Out Criteria (PERC), Wells criteria, and Revised Geneva criteria, combined with D-dimer assessment. In cases where PE could not be excluded through the mentioned strategies, imaging modalities, such as compression ultrasonography (CUS), computed tomographic pulmonary angiography (CTPA), and planar ventilation/perfusion (V/Q) scan, are indicated for a definite diagnosis. Once a diagnosis has been made, treatment of PE depends on its mortality risk as patients are divided into low-, intermediate-, and high-risk cases. High-risk cases are treated for their hemodynamic instability, given parenteral or oral anticoagulant therapy, and are indicated for reperfusion therapy. Intermediate-risk PE is only given parenteral or oral anticoagulants and reperfusion is indicated when anticoagulants fail. Low-risk cases are given oral anticoagulants and based on the Hestia criteria, patients may be discharged and treated as outpatients.","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"66 4","pages":"138-145"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Commonly Misdiagnosed Facial Lesion: Pilomatricoma. 常见误诊的面部病变：乳头状瘤

Acta medica (Hradec Kralove) Pub Date : 2023-01-01 DOI: 10.14712/18059694.2024.11

Tan Ying Xin, Jeyasakthy Saniasiaya, Jeyanthi Kulasegarah, Chiew Seow Fan

引用次数: 0

Gait Disturbance … of Red Herrings, Oranges, and Lemons - A Case of Missed Vitamin C Deficiency and Lessons Learnt. 步态失调......红铁、橙子和柠檬--一例被忽视的维生素 C 缺乏症和教训。

Acta medica (Hradec Kralove) Pub Date : 2023-01-01 DOI: 10.14712/18059694.2024.5

Nadine Anne De Battista, Marie Claire Zammit, Sandro Galea Soler, Stephen Attard

{"title":"Gait Disturbance … of Red Herrings, Oranges, and Lemons - A Case of Missed Vitamin C Deficiency and Lessons Learnt.","authors":"Nadine Anne De Battista, Marie Claire Zammit, Sandro Galea Soler, Stephen Attard","doi":"10.14712/18059694.2024.5","DOIUrl":"10.14712/18059694.2024.5","url":null,"abstract":"Vitamin C deficiency resulting in scurvy, is considered to be a rare nutritional disorder in developed countries, thus leading to underdiagnosis with exposure to unnecessary investigations and delay in appropriate treatment. The wide myriad of clinical signs and symptoms with which vitamin C deficiency can present (including haematological, musculoskeletal and vague constitutional symptoms that overlap with other common medical conditions), also contributes to this diagnostic challenge. Despite scurvy being habitually thought to be present in children with neurodevelopmental conditions such as autism spectrum disorder, other important at-risk groups that frequently tend to be forgotten include children with persistent fussy eating behaviour, and children with abnormal vitamin C metabolism. We hereunder present a case of a 10-year-old boy who presented to an acute general hospital for further investigation with gait disturbance. The lack of detailed nutritional assessment on presentation in the first instance led to a missed diagnosis of vitamin C deficiency, thus exposing the child to a wide array of unnecessary investigations and treatments. The added perplexity to the case resulting from false positive results of investigations performed as part of this child's workup, is also discussed.","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"66 3","pages":"122-127"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oral Candidal Infection Misdiagnosed as a Tumour. 被误诊为肿瘤的口腔念珠菌感染

Acta medica (Hradec Kralove) Pub Date : 2023-01-01 DOI: 10.14712/18059694.2024.6

Wail Abou Assaf, Martin Kapitán, Luboš Tuček, Jan Laco

引用次数: 0

The Role of Frailty Scores to Predict the Outcomes in Non Operative Treatment of Valgus Impacted Neck of Femur Fractures. 虚弱评分在非手术治疗股骨颈外翻骨折中的预测作用

Acta medica (Hradec Kralove) Pub Date : 2023-01-01 DOI: 10.14712/18059694.2024.3

Mohammed Ali, Chryssa Neo, Aysha Rajeev, Sharad Bhatnagar

{"title":"The Role of Frailty Scores to Predict the Outcomes in Non Operative Treatment of Valgus Impacted Neck of Femur Fractures.","authors":"Mohammed Ali, Chryssa Neo, Aysha Rajeev, Sharad Bhatnagar","doi":"10.14712/18059694.2024.3","DOIUrl":"10.14712/18059694.2024.3","url":null,"abstract":"Objectives: The management of valgus-impacted neck of femur fracture is controversial between operative and conservative treatments. This study aimed to investigate the usefulness of the Clinical frailty Score for predicting the prognosis of patients who underwent non-operative treatment for the valgus-impacted neck of femur fracture (NOF).Methods: A single-centred retrospective review of patients admitted with valgus impacted NOF. Data were collected from patients' records, including demographics, Clinical Frailty Score (CFS), Nottingham Hip Fracture Score (NHFS) and Abbreviated Mental Test Score (AMTS). Patients were followed up to 24 months postoperatively.Results: Fifty-eight patients who were treated non-operatively with a mean follow-up of 2.6 years met our inclusion criteria. Twenty-nine patients failed the non-operative treatment and required replacement surgeries, while 29 had successful outcomes (50%). There were no differences between the two groups' mean age and gender distributions (P 0.527 and 0.139, respectively). The successful group had significantly higher CFS (P 0.013), worse AMTS and higher mortality risk based on the NHFS (P 0.006 and P < 0.001, respectively).Conclusion: This study demonstrates that CFS, AMTS and NHFS can be used as predictors when considering non-operative treatment for the valgus-impacted neck of femur fracture. Patients who are frail, demented and high risk based on the NHFS have higher success rates with non-operative treatment.","PeriodicalId":101400,"journal":{"name":"Acta medica (Hradec Kralove)","volume":"66 3","pages":"112-116"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0