Medicine最新文献

{"title":"IgD-CD38br lymphocyte affect myocardial infarction by regulating the glycerol to palmitoylcarnitine (C16) ratio: A Mendelian randomization study.","authors":"Jing Wang, Ying Wang, Shuang Ding, Zhengyan Wang, Jingyuan Li, Yuyan Jia","doi":"10.1097/MD.0000000000040871","DOIUrl":"10.1097/MD.0000000000040871","url":null,"abstract":"<p><p>Myocardial infarction, a type of coronary artery disease, results from various factors such as genetic predisposition, lifestyle choices, and immune system regulation. The exact causal links between immune cells, plasma metabolites, and myocardial infarction are currently unclear. Therefore, our study employed the Mendelian randomization approach to explore these potential causal relationships. To investigate the impact of immune cells on the risk of myocardial infarction mediated by alterations in plasma metabolite levels, we employed the Mendelian randomization (MR) framework. Our analysis utilized 5 distinct MR techniques (inverse variance weighted [IVW], weighted median, MR-Egger, simple mode, and weighted mode) to evaluate causal relationships among 731 immune cell types, 1400 plasma metabolites, and myocardial infarction. Genetic instruments for immune cells and metabolites were identified using data from a meta-analysis of genome-wide association studies. Furthermore, sensitivity analyses were performed to verify the robustness of our results, identify potential heterogeneity, and examine possible pleiotropic effects. IVW results indicated that IgD-CD38br lymphocytes was a risk factor for myocardial infarction, whereas IgD-CD38br lymphocytes also acted as a protective factor against myocardial infarction. Additionally, the glycerol to palmitoylcarnitine (C16) ratio was identified as a protective factor for myocardial infarction. IgD-CD38br lymphocytes could exert a detrimental effect on myocardial infarction by negatively regulating the glycerol to palmitoylcarnitine (C16) ratio, with the mediation effect ratio being 9%. IgD-CD38br lymphocytes potentially increase the risk of myocardial infarction by negatively affecting the glycerol to palmitoylcarnitine (C16) ratio. This finding opens avenues for developing early diagnostic tools and targeted therapies for myocardial infarction.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40871"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837591","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":"Relationship between multi-nutrient intake and bone loss and osteoporosis in U.S. adults: Findings from NHANES.","authors":"Wenfeng Hu, Xiaotong Feng, Chaoqun Wen","doi":"10.1097/MD.0000000000040768","DOIUrl":"10.1097/MD.0000000000040768","url":null,"abstract":"<p><p>The relationship between dietary nutrient intake and bone mineral density (BMD) has not been clarified. In the U.S. population, we have demonstrated that dietary intake of multiple nutrients (potassium, magnesium, and sodium) is positively associated with BMD and negatively associated with the prevalence of osteopenia. This study examined whether there is an association between dietary potassium, magnesium, and sodium intake and BMD, osteopenia, and osteoporosis, using data from the National Health and Nutrition Examination Surveys from 2005 to 2010, 2013 to 2014, and 2017 to 2018. We assessed the association of dietary potassium, magnesium, and sodium intake with BMD in 10,355 National Health and Nutrition Examination Survey participants during 2005 to 2010, 2013 to 2014, and 2017 to 2018. BMD of the whole femur was estimated by dual-energy X-ray absorptiometry. We utilized multiple linear regression models to examine the associations of dietary potassium, magnesium, and sodium intake with femoral BMD, osteopenia, and osteoporosis, after adjusting for various confounders. Dietary potassium, magnesium, and sodium intake are positively correlated with femur BMD when corrected for the confounders of age, sex, race/ethnicity, smoking behavior, education level, body mass index, poverty income ratio, serum uric acid, serum cholesterol, potential renal acid load, dietary calcium intake, dietary protein intake, and dietary vitamin D intake. Dietary intake of potassium, magnesium, and sodium was adversely correlated with the development of osteopenia and osteoporosis. Our study showed that intake of dietary nutrients (potassium, magnesium, and sodium) was correlated positively to femur BMD and adversely to osteopenia and osteoporosis in the U.S. population. Further research is needed on the association of dietary elemental intake with BMD.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40768"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837615","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":"Relationship between neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio and osteoporosis in postmenopausal type 2 diabetic patients: A retrospective study.","authors":"Yuan Xue, Weichao Bao, Wenying Huang, Xin Zou, Ying Guo","doi":"10.1097/MD.0000000000040869","DOIUrl":"10.1097/MD.0000000000040869","url":null,"abstract":"<p><p>Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) are newly discovered inflammatory markers in recent years. To explore the relationship between NLR, MLR, PLR, and bone mineral density (BMD), as well as osteoporosis (OP), in postmenopausal patients with type 2 diabetes mellitus (T2DM). 320 postmenopausal patients with T2DM who were admitted to the Department of Endocrinology and Metabolic Diseases of our hospital from January 2022 to January 2024 for treatment were included in this retrospective study. The patients were divided into 3 groups according to the BMD: normal bone mass group (n = 109), osteopenia group (n = 99), and OP group (n = 112). Clinical data and blood laboratory parameters were collected from the patients. The NLR, MLR, and PLR were calculated. Statistically significant differences were found in the comparison of NLR, MLR, and PLR among the 3 groups of patients (P < .001). The OP group had higher NLR, MLR, and PLR than the normal bone mass group and the osteopenia group. NLR, MLR, and PLR were negatively correlated with BMD at the lumbar spine (L1-L4), left femoral neck, and left hip, respectively. Analysis revealed that elevated levels of NLR and PLR were independent risk factors for OP in postmenopausal patients. The results of the receiver operating characteristic curve analysis indicated that the area under the curve (AUC) for NLR was higher than that of PLR. Combined use of NLR and PLR resulting in an improved AUC of 0.904. Neutrophils produce mediators such as interferon-gamma (IFN-γ), interleukin-6 (IL-6), interleukin-1 (IL-1), and receptor activator of nuclear factor kappa-B ligand (RANKL), which increase the number and activity of osteoclasts. Peripheral blood monocytes play a vital role in osteoclastogenesis as osteoclast precursors. The BMD of postmenopausal T2DM patients is negatively correlated with NLR, MLR, and PLR. NLR and PLR can both serve as predictive indicators for the occurrence of OP in postmenopausal T2DM patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40869"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837629","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":"Bibliometric analysis of research developments in oral and maxillofacial neuralgia from 2004 to 2023.","authors":"Yuhang Cai, Keyi Liu, Junwei Xiang, Hu Zheng, Dezhi Zhang, Yuanyin Wang, Ran Chen","doi":"10.1097/MD.0000000000040715","DOIUrl":"10.1097/MD.0000000000040715","url":null,"abstract":"<p><p>This study employs bibliometric techniques to dynamically represent the research landscape of oral and maxillofacial neuralgia. Its goal is to pinpoint research hotspots and delineate forthcoming trends. A systematic search of the Web of Science Core Collection was performed using targeted keywords to retrieve literature from January 2004 to December 2023. Citespace version 6.2.6 was utilized to analyze countries, institutions, authors, co-cited journals, and keywords. The analysis indicates an annual increase in research literature on oral and maxillofacial neuralgia, albeit with a decline observed in the past 2 years. In the last 5 years, a total of 279 publications have been produced, predominantly by developed countries. The average betweenness centrality exceeds 0.1. Analysis of co-cited literature revealed 100 nodes, with research frontiers closely associated with trigeminal neuralgia, gamma knife radiosurgery, percutaneous balloon compression, among others. Keyword clustering analysis generated 61 nodes, primarily concentrated on 3 research areas: gamma knife, microvascular decompression, and hemifacial spasm. The emergence of keywords closely correlates with trigeminal neuralgia. Research frontiers in the field of oral and maxillofacial neuralgia are primarily focused on trigeminal neuralgia, with major therapeutic approaches including gamma knife radiosurgery and percutaneous balloon compression. These areas, along with botulinum toxin, represent current hotpots and are likely to drive the future direction of research in treating oral and maxillofacial neuralgia.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40715"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837664","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":"Primary sarcomatoid carcinoma of the trachea: A case report and literature review.","authors":"Xiuwen Yu, Mingqi Huang, Haiyan Ge, Junjie Yang, Bin Huang, Jialing Xu","doi":"10.1097/MD.0000000000040766","DOIUrl":"10.1097/MD.0000000000040766","url":null,"abstract":"<p><strong>Rationale: </strong>Primary sarcomatoid carcinoma of the trachea (PSCT) is a rare malignant tumor of the lower respiratory tract. Pathological types of tracheal sarcomatoid carcinoma (TSC)s include pleomorphic carcinomas, giant cell carcinomas, spindle cell carcinomas, pulmonoblastomas, and carcinosarcomas. At present, there are limited reports on PSCT, and pathologists lack sufficient knowledge about it.</p><p><strong>Patient concerns: </strong>Here, we report a case of malignant neoplasm involving the left posterior wall of the initial tracheal segment, characterized by atypical spindle cells and a small number of high-grade squamous intraepithelial neoplasia.</p><p><strong>Diagnosis: </strong>Spindle-shaped cells were moderately heterotypic, with 8/10 nuclear divisions (high-magnification field), and no obvious inflammatory cell infiltration was observed in the interstitium. Squamous epithelial cells showed moderate-to-severe atypia with regional cytoplasmic transparency. Immunohistochemistry: Fusiform tumor cells expressed vimentin, epithelial markers were negative, the Ki-67 proliferation index was 40%, and epithelial markers were expressed in squamous intraepithelial neoplasia.</p><p><strong>Interventions: </strong>After the biopsy diagnosis was confirmed, part of the tumor was removed by tracheoscopy under general anesthesia in the respiratory department of a superior hospital. A pathological diagnosis of TSC was made and local radiotherapy was performed.</p><p><strong>Outcomes: </strong>As the tumor could not be completely cured, the patient experienced repeated coughing and shortness of breath and died of the disease 15 months later.</p><p><strong>Lessons: </strong>Pathological morphology and immunohistochemical analyses deepen our understanding of the pathological features of TSC and provide a diagnostic reference for clinicians who will encounter such cases in the future.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40766"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837670","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":"Risk factors for falls in older adults with type 2 diabetes: A cross-sectional study.","authors":"Chia-Ling Lin, Hsueh-Ching Wu, Neng-Chun Yu, Yuan-Ching Liu, I-Ying Chiu, Wu-Chien Chien","doi":"10.1097/MD.0000000000040895","DOIUrl":"10.1097/MD.0000000000040895","url":null,"abstract":"<p><p>The study was to estimate the prevalence of falls with type 2 diabetes (T2D) and investigate the associated risk factors. The study design employed was cross-sectional. The participants for this study were recruited from a community-based diabetes specialist clinic. Data were collected from medical records and structured questionnaires, which included assessments of activities of daily living, instrumental activities of daily living, the Mini-Mental State Examination, the Taiwan Geriatric Depression Scale, and Chinese version of the Tilburg frailty indicator. Multivariate logistic regression was used to analyze the related factors. The study analyzed a total of 242 T2D patients with a mean age of 73.9 ± 5.9 years. The overall fall prevalence rate was 19.7%. The faller trait tendency to female, lower education, history of falls, body mass index ≥ 29 kg/m2, instrumental activities of daily living ≥ 1 task disability, cognitive impairment, depression, poor grip strength, and longer walking time. After adjusting for confounding, showed each additional unit on the depression score increases the fall risk by 11.9% (AOR, 1.19; 95% CI, 1.02-1.38, P = .027). Depression was a significant factor for falls in older adults with T2D. The study highlights the importance of targeted, multifaceted clinical interventions focusing on gender, age, and mental health to effectively reduce fall probability and improve the quality of life for the older adults.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40895"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837716","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":"The causal association of smoking, alcohol intake, and coffee intake with the risk of bacterial pneumonia: A Mendelian randomization study.","authors":"Zhendong He, Leting Zheng, Zhanrui Chen, Jing Wen, Fang Qin, Hanyou Mo","doi":"10.1097/MD.0000000000040702","DOIUrl":"10.1097/MD.0000000000040702","url":null,"abstract":"<p><strong>Background: </strong>At present, the association of smoking, alcohol intake, and coffee intake with the risk of bacterial pneumonia (BP) remains controversial. In this study, we used a 2-sample Mendelian randomization (MR) analysis to estimate the association of smoking, alcohol intake, and coffee intake with the risk of BP.</p><p><strong>Methods: </strong>We extracted genetic variants associated with smoking initiation and cigarettes per day from the Genome-Wide Association Study and Sequencing Consortium of Alcohol and Nicotine Use database (944,625 individuals). We also extracted genetic variants associated with past tobacco smoking, alcohol intake frequency, and coffee intake from the UK Biobank database (1,316,166 individuals). BP outcomes were chosen from the FinnGen genome-wide association studies (GWAS) database (7987 patients and 188,868 controls). The inverse variance-weighted method was used primarily to calculate odds ratios (OR) and 95% confidence intervals (CI). Sensitivity analysis using different approaches such as weighted median, MR Egger, and MR pleiotropy residual sum and outlier (MR-PRESSO) have been implemented, as well as leave-one-out analysis to identify pleiotropy.</p><p><strong>Results: </strong>The 2-sample MR analysis supported the causal association of genetically predicted cigarettes per day (OR: 1.23, 95% CI: [1.08-1.39], P < .01] and smoking initiation (OR: 1.22, 95% CI: [1.03-1.44], P = .02) with the risk of BP, but not past tobacco smoking, alcohol intake frequency, and coffee intake. Heterogeneity (P > .05) and pleiotropy (P > .05) tests provided confirmatory evidence for the validity of our MR estimates.</p><p><strong>Conclusion: </strong>Our findings provide relevant evidence for a favorable causal association of genetically predicted smoking initiation and cigarettes per day with BP risk. However, there may not be a causal association between past tobacco smoking, alcohol intake, and coffee intake with increased BP incidence rates.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40702"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837833","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":"Giant cell tumor of proximal femur managed by extended curettage with fibular strut allograft using long intramedullary interlocking nail: A case report and literature review.","authors":"Jiashi Song, Bing Liu, Kaipeng Jin, Quan Yao","doi":"10.1097/MD.0000000000040960","DOIUrl":"10.1097/MD.0000000000040960","url":null,"abstract":"<p><strong>Rationale: </strong>We first report a unique case of proximal femoral Giant cell tumor of bone, a subtrochanteric lesion associated with femoral neck and intertrochanteric involvement. We chose a completely new surgical approach to treat the primary tumor and preserve the hip joint. No cases of this type have ever been reported.</p><p><strong>Patient concerns: </strong>The patient, a 26-year-old man, came to our hospital for treatment of right hip pain more than 4 months ago, had no family history of similar diseases.</p><p><strong>Diagnoses: </strong>Based on the imaging results and pathology, a diagnosis of Giant cell tumor of bone was confirmed.</p><p><strong>Interventions: </strong>Based on the imaging grade and patients' wishes, the tumor managed by extended curettage and reconstructed with a fibular strut allograft and long intramedullary interlocking nail was used for prophylactic fixation of fractures. The patient did not undergo disuzumab.</p><p><strong>Outcomes: </strong>After 40 months of follow-up, although the bone defect finally reached bone healing, the hip function was good, and the tumor did not recur, there were signs of internal fixation loosening at 12 months of the surgery.</p><p><strong>Lessons: </strong>For young patients with imaging grade <3 who need limb salvage, fibular strut allograft and intramedullary nail-fixation are also an alternative treatment option for hip reconstruction after tumor surgery when the lesion involves the entire proximal femur.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40960"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837586","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":"Causal relationships between depression, emotional changes, and hiatal hernia: A Mendelian randomization analysis.","authors":"Chaofan Pan, Mingzhi Lin, Wenbin Luo, Ruoyun Li, Changjiang Luo","doi":"10.1097/MD.0000000000040859","DOIUrl":"10.1097/MD.0000000000040859","url":null,"abstract":"<p><p>Hiatal hernia (HH) is a common gastrointestinal disorder characterized by the displacement of abdominal contents, particularly the stomach, into the thoracic cavity. This condition is frequently associated with gastroesophageal reflux disease (GERD) and can lead to various symptoms, including chronic cough and respiratory issues. Despite its prevalence, the mechanisms linking psychological factors to HH are not well understood. Observational studies have suggested correlations between mental health issues - such as stress, anxiety, and depression - and gastrointestinal disorders, indicating that emotional states may influence the development of HH. This study aims to clarify the causal relationships between mood swings, depression, and the risk of developing HH using Mendelian randomization (MR), a robust method that utilizes genetic variants as instrumental variables (IVs) to infer causality. Data for this MR analysis were obtained from publicly available genome-wide association studies (GWAS). We employed a bidirectional, 2-sample MR approach, using IVs associated with mood swings, depression, feelings of tension, and feelings of misery as exposures, with HH as the outcome. A reverse MR analysis was also conducted, treating HH as the exposure and the aforementioned emotional states as outcomes. The primary analytical method used was inverse variance weighting (IVW), supplemented by sensitivity analyses, including MR-Egger and weighted median methods. Our analysis revealed significant associations: mood swings (OR = 1.014; 95% CI = 1.001-1.027; P = .032), depression (OR = 1.019; 95% CI = 1.006-1.033; P = .003), feelings of tension (OR = 1.012; 95% CI = 1.004-1.020; P = .001), and feelings of misery (OR = 1.007; 95% CI = 1.003-1.010; P = .0001) significantly increased the risk of HH. Importantly, reverse MR analysis indicated no causal influence of HH on these emotional states. This study provides evidence that mood swings, depression, feelings of tension, and feelings of misery are significant risk factors for developing HH. These findings highlight the need to address psychological factors in the clinical management and prevention strategies for HH, potentially improving patient outcomes.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40859"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836876","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":"Percutaneous nephroscopy combined with ultrasound-guided negative-pressure suction for the treatment of perirenal hematoma.","authors":"Zhonglin Zou, Rui Liu, Zhengyu Liu, Yuanzhong Deng","doi":"10.1097/MD.0000000000040857","DOIUrl":"10.1097/MD.0000000000040857","url":null,"abstract":"<p><p>Percutaneous renal puncture drainage is needed in patients with perirenal hematoma (PRH, renal around hematoma) with poor conservative treatment. Early and thorough removal of hematoma is closely related to the recovery of patients, but percutaneous renal drainage is not effective in some patients. The clinical data of 5 patients with PRH treated in the first affiliated Hospital of Chongqing Medical University from June 2020 to June 2024 were analyzed retrospectively. There were 4 males and 1 female, with an average age of 58 (43-79) years. The hematoma was located on the left in 2 cases and on the right in 3 cases. The average maximum diameter of hematoma was 10.0 (6.4-13.4) cm. There were 2 cases of fever and low back pain. Three cases were complicated with hypertension. Severe hematuria occurred in 1 case. There were 1 case of PRH after rupture of renal tumor, 1 case of PRH after percutaneous nephrolithotomy, 1 case of PRH after percutaneous renal drainage and 2 cases of PRH after ureteroscopic stent implantation. All the 5 patients underwent percutaneous nephroscopy combined with ultrasound negative pressure aspiration under general anesthesia. The operation time, postoperative drainage tube indwelling time, postoperative hospital stay, treatment effect and complications were analyzed. All the 5 operations were completed successfully, including 3 cases of single channel and 2 cases of double channel. The average operation time was (30-90) min, the average postoperative drainage tube indwelling time was 18 (6-30) days, and the average postoperative hospital stay was 15 (6-36) days. Abdominal computed tomography examination before discharge showed that the PRH was significantly reduced or even disappeared. Among them, 1 patient developed thrombocytopenia, which was related to the long-term use of teicoplanin before operation, and there were no serious complications during and after operation. The average follow-up time was 4 (1-12) months, and there was no recurrence of hematoma. Up to now, there is still no ideal treatment for large PRH. Percutaneous nephroscopy combined with ultrasound negative pressure aspiration under general anesthesia might be a feasible method for the treatment of giant renal around hematoma.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"103 50","pages":"e40857"},"PeriodicalIF":1.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837025","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}