Journal of International Medical Research最新文献

{"title":"Removal of a trapped epidural catheter via spinal computed tomography reconstruction and optimal position simulation of the spinal model: A case report.","authors":"Yang Liu, Jin Yang, Xun Zhu, Jingjing Wu, Qi Hu, Ai Yan","doi":"10.1177/03000605251340316","DOIUrl":"10.1177/03000605251340316","url":null,"abstract":"<p><p>Continuous epidural anesthesia is a classic anesthesia method that is widely used in abdominal surgery, labor analgesia, and postoperative analgesia. A long-term analgesic effect is achieved by continuously injecting local anesthetics into the epidural space through an epidural catheter. However, the insertion of epidural catheters is associated with various complications, such as total spinal anesthesia, nerve damage, bleeding, infection, and catheter distortion with difficult catheter removal. We present the case of a parturient woman who underwent vaginal delivery under epidural analgesia. However, after delivery, the epidural catheter could not be pulled out. Spinal computed tomography and three-dimensional reconstruction revealed that the catheter was coiled but not knotted in the spinal facet joints. Using optimal position simulation, we successfully pulled out the epidural catheter. This case demonstrates that spinal computed tomography reconstruction with optimal position simulation may be the most effective noninvasive method for successfully removing a trapped epidural catheter.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 5","pages":"3000605251340316"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of unexpected thyroid storm in postpartum.","authors":"Yuxin Qin, Ying Wu, Ling Yu, Dandan Hu, Huanhuan Zang, Xiangguo Cong, Qiong Shen, Lei Chen, Xinxin Chen","doi":"10.1177/03000605251335803","DOIUrl":"https://doi.org/10.1177/03000605251335803","url":null,"abstract":"<p><p>Thyroid storm is a rare and serious endocrine crisis during the perinatal period and typically occurs in patients with Graves' disease. We present the case of a postpartum woman without prior history of thyroid disease who presented with vomiting, fever, irregular abdominal pain, and a diagnosis of intrauterine death. Despite comprehensive treatment, she showed persistent tachycardia, fever, and multi-organ failure. Diagnostic assessment revealed elevated thyroid hormone levels, and she was diagnosed with thyroid storm based on the scoring system of Burch-Wartofsky and the Japanese Thyroid Association diagnostic criteria. Treatment included plasmapheresis, β-blockers, iodine solutions, antithyroid drugs, and corticosteroids. Following successful mitigation of thyroid storm, she developed hypothyroidism and was treated with levothyroxine. For patients with no history of thyroid disease or negative thyroid autoantibodies, especially postpartum women, presenting unexplained symptoms such as tachycardia, fever, diarrhea, sweating, and altered consciousness, the possibility of thyroid storm should be considered.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251335803"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology and treatment of recurrent consciousness disorders following hepatobiliary surgery: Insights from a portosystemic shunt case study.","authors":"Yaling Jin, Yuguang Wang, Weiting Chen, Hui Wang","doi":"10.1177/03000605251334348","DOIUrl":"https://doi.org/10.1177/03000605251334348","url":null,"abstract":"<p><p>Intrahepatic portosystemic venous shunt is a rare vascular anomaly that can occur congenitally or iatrogenically, leading to hyperammonemia and neurological complications such as hepatic encephalopathy. This report presents the case of a woman in her early 70s who developed recurrent episodes of altered consciousness following hepatobiliary surgery. Subsequent magnetic resonance angiography revealed an intrahepatic portosystemic venous shunt, and the patient underwent successful treatment with percutaneous transhepatic portal vein embolization. After treatment, her symptoms resolved completely, and she remained asymptomatic during an 8-month follow-up period. This report underscores the importance of considering intrahepatic portosystemic venous shunt in the differential diagnosis of postoperative neurological symptoms. Our findings suggested that percutaneous transhepatic portal vein embolization was effective in managing this case, leading to symptom resolution and sustained improvement during follow-up. Although this approach appears promising, further investigation is needed to establish its broader applicability. Early detection and appropriate management may help improve patient outcomes in selected cases.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251334348"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of topical phosphodiesterase 4 inhibitors in children with mild-to-moderate atopic dermatitis: A systematic review and meta-analysis.","authors":"Long Wang, Lequ Zeng, Yuyu Wu, Min Zhong, Lizhen Zhang, Chen Li","doi":"10.1177/03000605251333654","DOIUrl":"https://doi.org/10.1177/03000605251333654","url":null,"abstract":"<p><p>ObjectiveTo evaluate the efficacy and adverse effects of phosphodiesterase 4 inhibitors in children with mild-to-moderate atopic dermatitis.MethodsElectronic searches were conducted based on PubMed, Cochrane Library, EMBASE, and Web of Science using Medical Subject Headings terms and relevant keywords. Using response rates as the primary outcome and adverse effects as the secondary outcome, statistical analysis was performed via Stata 15.1 SE, with Cochrane Q and <i>I</i>² statistics used for heterogeneity assessment. Publication bias and sensitivity analyses were conducted using various methods. Risk of bias was assessed using the Cochrane risk of bias tool.ResultsThe analysis included six randomized controlled trials involving 4681 children with atopic dermatitis. Phosphodiesterase 4 inhibitors were associated with significantly higher response rates than vehicle controls (odds ratio = 2.01, 95% confidence interval: 1.58 to 2.56, p < 0.001, <i>I</i>² = 54.8%), with no significant difference in adverse effect incidence (odds ratio = 1.07, 95% confidence interval: 0.87 to 1.30, p = 0.536, <i>I</i>² = 11.8%). Subgroup analysis revealed varying response rates among different phosphodiesterase 4 inhibitors, with crisaborole showing the least adverse effects.ConclusionOur meta-analysis revealed that children with atopic dermatitis treated with phosphodiesterase 4 inhibitors experienced higher remission rates and comparable adverse effect rates compared with vehicle controls. Currently, crisaborole appears to be the optimal choice for balancing safety and efficacy. As research in this area is still in its early stages, further high-quality trials are essential for establishing standards of clinical care.INPLASY registration number: INPLASY202520121.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251333654"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional digital design of orthopedic surgery for idiopathic scoliosis deformity: A case series.","authors":"Bao Liu, Lu-Lu Huang, Huan-Wen Ding, Xian-Ming Zeng, Ge-Qin Sun, Mi-Weng Jiang, Ying-Qiang Liao, Hai-Ru Qi","doi":"10.1177/03000605251335836","DOIUrl":"https://doi.org/10.1177/03000605251335836","url":null,"abstract":"<p><p>ObjectiveTo establish a new method of three-dimensional digital design for orthopedic surgery of idiopathic scoliosis deformity and evaluate its application value in surgical treatment.MethodsThe clinical data of 11 patients with idiopathic scoliosis who underwent three-dimensional digital design and three-dimensional printing from January 2021 to December 2023 were retrospectively analyzed. Patients underwent computed tomography at admission, and three-dimensional reconstruction of a spinal anatomy model was conducted. Three-dimensional digital design of deformity correction surgery was conducted before the operation, including computer simulation of the correction and internal fixation process and three-dimensional digital design of a pedicle screw-assisted positioning template and internal fixation rod template. Surgical procedures were performed accurately under template guidance.ResultsThe average preoperative Cobb angle in 11 patients with idiopathic scoliosis was 50.2°. The pedicle screws were implanted accurately and quickly. The average operation time was 4.2 h, and the average blood loss was 810 mL. The postoperative deformity correction was very satisfactory. The average Cobb angle of the lateral process was 4.2° (correction rate: 91.7%), with an excellent rate of screw placement (100%).ConclusionThis computer-assisted orthopedic surgery method has the potential to improve the safety and accuracy of surgical procedures for idiopathic scoliosis and reduce the operation time.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251335836"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-stratified analysis of delayed fixation outcomes of femoral neck fracture among adults: A retrospective study at a tertiary care trauma center.","authors":"Muhammad Gulfam Shahzad, Muhammad Hamza Dawood, Kazim Hussain, Shakeel Gul, Syed Akmal Sultan, Musab Zarar","doi":"10.1177/03000605251336110","DOIUrl":"https://doi.org/10.1177/03000605251336110","url":null,"abstract":"<p><p>ObjectiveThis study investigated the delayed fixation outcomes of femoral neck fractures stratified by age and surgical delay in adult patients at a tertiary care trauma center.MethodA retrospective study was conducted involving patients with femoral neck fractures admitted to the orthopedic ward of the Shaheed Mohtarma Benazir Bhutto Institute of Trauma between January 2019 and March 2023. Participants aged 18-60 years who underwent delayed surgery (>48 h) were included. Data on patient demographics, fracture and surgical characteristics, and outcomes were analyzed. This study utilized chi-square or Fisher's exact tests to compare outcomes between patients stratified by surgical delays as well as age.ResultsAmong 108 participants, 63.9% were aged 18-30 years and 36.1% were aged 31-60 years. Avascular necrosis was predominantly observed in older patients who underwent surgery within 7 days (P <i> </i>= 0.001), whereas other complications such as nonunion and infection were more prevalent in patients aged 18-30 years whose surgery was delayed by >7 days (P  = 0.303). Patients who underwent surgery within 7 days had shorter length of hospital stay and faster return to work in both age groups (P < 0.05), whereas those aged 18-30 years experienced the opposite when surgery was delayed beyond 7 days.ConclusionsSurgical fixation within 7 days leads to better recovery and fewer complications in adults with femoral neck fractures, whereas delayed surgery provides acceptable outcomes. Age-specific protocols are key to optimizing results.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251336110"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of schizophrenia treatment outcomes in Saudi Arabia: A preliminary pilot investigation.","authors":"Fatimah AlDosari, Shahad AlGhossen, Malka Alburaiki, Sireen Ar Shilbayeh, Nada AlBogami, Ammena Y Binsaleh, Nadia Al Mazrouei, Hayam A AlRasheed, Khlood M Aldossary, Omar Gammoh","doi":"10.1177/03000605251332443","DOIUrl":"https://doi.org/10.1177/03000605251332443","url":null,"abstract":"<p><p>ObjectivesSchizophrenia is a debilitating psychiatric illness that is often understudied due to stigma and cultural barriers. This report presents a clinical descriptive evaluation of patients with schizophrenia in Saudi Arabia, focusing on demographics, clinical information, and treatment efficacy and safety.MethodsThis single-center cross-sectional study included 42 patients on antipsychotics for at least 6 months, with a male-to-female ratio of 1:1 and a mean age of 36 years.ResultsMost patients were single (64.3%) and unemployed (51.2%), with 52.4% having only a high school education level. The median duration of antipsychotic treatment was 21.2  (1.7-227.5) months. Antipsychotic combination therapy was the most common intervention (59.5%). Efficacy results from the Positive and Negative Syndrome Scale showed complete remission in 4.8%, partial remission in 11.9%, moderate remission in 33.3%, and no improvement in 50% of the patients. Safety evaluation via the modified Simpson-Angus Scale indicated that 71.4% of the patients had normal scores, 26.2% experienced minimal movement disorders, and only 2.4% had clinically significant movement symptoms.ConclusionThis preliminary investigation examined the demographics and clinical features of patients with schizophrenia as well as efficacy and tolerability of relevant treatments. Larger studies are needed to understand this population comprehensively.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251332443"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of internal iliac artery ligation on sonographic blood changes in the uterine arteries: A case-control study in women with postpartum hemorrhage in sub-Saharan Africa.","authors":"İlkan Kayar, Özer Birge, Ferhat Çetin","doi":"10.1177/03000605251335796","DOIUrl":"https://doi.org/10.1177/03000605251335796","url":null,"abstract":"<p><p>ObjectiveInternal iliac artery ligation due to severe postpartum hemorrhage has several pathophysiological consequences in terms of blood supply of the uterus. In this context, this study aimed to evaluate the sonographic changes in the uterine arteries after internal iliac artery ligation.MethodsThe population of this case-control study consisted of women unresponsive to conservative medical treatment who underwent internal iliac artery ligation for severe postpartum hemorrhage between January 2022 and December 2022. Women who underwent internal iliac artery ligation were included in the internal iliac artery ligation group, and those with similar postpartum age, parity, and body mass index were included in the control group. This retrospective case-control study included 62 patients with postpartum hemorrhage and ongoing bleeding despite all conservative medical treatments who underwent internal iliac artery ligation as well as 86 patients who were also in the postpartum period and had similar age, body mass index, and parity but did not have a history of postpartum hemorrhage at birth and did not undergo internal iliac artery ligation. The pulsatility index, resistance index, and maximal-to-minimal diastolic flow of the uterine arteries were calculated using color and pulsed Doppler imaging at the 6-month follow-up and compared between the two groups.ResultsThere were 62 and 86 women in the internal iliac artery ligation and control groups, respectively. There was no significant difference between the two groups in terms of demographic and clinical characteristics and obstetric history (p > 0.05). There was also no significant difference between the two groups in terms of the pulsatility index, resistance index, and maximal-to-minimal diastolic flow of the uterine arteries determined at the 6-month follow-up (p > 0.05).ConclusionThe study's findings demonstrated that internal iliac artery ligation has no adverse effect on the sonographic blood flow indexes of the uterine arteries in women with postpartum hemorrhage.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251335796"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular and biological markers for assessing endometrial receptivity in infertile women: A narrative review.","authors":"Junfeng Li, Hange Liu, Justin Lim, Hang Xing, Yuan Chen, Shaozhe Yang, Xiuhong Fu","doi":"10.1177/03000605251328893","DOIUrl":"https://doi.org/10.1177/03000605251328893","url":null,"abstract":"<p><p>Successful embryo implantation relies on embryo quality, endometrial receptivity, and the synchronized development of both. In recent years, methods for assessing endometrial receptivity have considerably advanced, shifting from traditional imaging techniques to modern molecular biology approaches. The evaluation of endometrial thickness, morphology, subendometrial blood flow, and peristalsis before implantation has become less prominent, whereas molecular markers such as pinopodes, integrin αvβ3, its ligand osteopontin, and homologous box gene A10 are widely used in clinical practice for assessing endometrial receptivity. To provide a comprehensive overview, this narrative review systematically searched PubMed and Web of Science for studies on endometrial receptivity assessment in infertile women over the past two decades, with a focus on both clinical and experimental research. This narrative review has examined recent advancements in morphological markers, endometrial receptivity-related genes, endometrial microbiota, and other emerging indicators, emphasizing their potential in optimizing embryo implantation and improving the success rates of assisted reproductive technologies. Notably, endometrial receptivity array testing and uterine microbiome analysis have gained substantial attention for their potential in personalized diagnosis and treatment. This review aims to provide scientific insights for precise infertility diagnostics and individualized treatment strategies while offering recommendations for future research development.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251328893"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weekly changes in serum <b>β</b>-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in women with unexplained recurrent miscarriage.","authors":"Ruide Su, Yan Wang, Ye Lu, Bizhu Lin, Jian An","doi":"10.1177/03000605251327478","DOIUrl":"https://doi.org/10.1177/03000605251327478","url":null,"abstract":"<p><p>ObjectiveTo investigate the efficacy of weekly measurement of β-human chorionic gonadotropin, estradiol, and progesterone levels for pregnancy assessment in patients with unexplained recurrent miscarriage.MethodsWe retrospectively included patients with unexplained recurrent miscarriage whose serum β-human chorionic gonadotropin, estradiol, and progesterone levels were measured three or more times during early pregnancy. The patients were divided into two groups according to pregnancy outcomes. The Δβ-human chorionic gonadotropin, Δestradiol, and Δprogesterone levels of the two groups were compared, and the corresponding cutoff values were determined using receiver operating characteristic analyses for predicting pregnancy outcome.ResultsA total of 140 patients were analyzed. From the 6th week to 10th week, the serum β-human chorionic gonadotropin and estradiol levels of the ongoing pregnancy group were significantly higher than those of the miscarriage group. The serum Δβ-human chorionic gonadotropin levels identified ongoing pregnancy or miscarriage with an area under the receiver operating characteristic curve of 0.841 (95% confidence interval: 0.769-0.914) and diagnostic cutoff value of 30,633 mIU/mL. The Δestradiol levels identified ongoing pregnancy or miscarriage with an area under the receiver operating characteristic curve of 0.839 (95% confidence interval: 0.752-0.926) and a cutoff value of 45 pg/mL.ConclusionsWeekly remeasurement of serum β-human chorionic gonadotropin and estradiol may be useful for pregnancy risk assessment in patients with unexplained recurrent miscarriage in clinical practice.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"53 4","pages":"3000605251327478"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}