Medicine最新文献

{"title":"Comprehensive analysis of GDFs as therapeutic targets and prognosis biomarkers in gastric cancer.","authors":"Minjie Zhu, Jiawei Hong, Xianfang Liu, Haiming Wang, Longquan Lou","doi":"10.1097/MD.0000000000041976","DOIUrl":"10.1097/MD.0000000000041976","url":null,"abstract":"<p><p>Growth/differentiation factors (GDFs, GDF1-3, GDF5-7, GDF9-11, and GDF15) belong to a subfamily of the transforming growth factor-β. GDFs play an important role in morphogenetic and developmental activities in many tissues. And many GDFs family numbers have been observed to be correlated with various types of tumors. However, the diverse expression patterns and prognostic values of ten GDFs in gastric cancer (GC) have yet to be analyzed. Herein we investigated the transcriptional and survival data of GDFs in patients with GC from the Gene Expression Profiling Interactive Analysis, The Cancer Genome Atlas, cBioPortal, Tumor Immune Estimation Resource, Tumor Immune Syngeneic Mouse, UALCAN, Human Protein Atlas Gene Expression Omnibus and The Database for Annotation, Visualization and Integrated Discovery databases. We found that multiple GDF family members are highly expressed in GC, which can prompt diagnosis and evaluate prognosis, and can be used as target points for GC immunotherapy.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41976"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735987","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":"Impact of different doses of intravenous alteplase on neuroinjury biomarker levels in patients with acute ischemic stroke and stress hyperglycemia.","authors":"Wei Yang, Wu Chen, Shengmei Lu","doi":"10.1097/MD.0000000000041825","DOIUrl":"10.1097/MD.0000000000041825","url":null,"abstract":"<p><p>Intravenous alteplase thrombolysis is a primary treatment for acute ischemic stroke (AIS), but the optimal dose remains uncertain in patients with stress hyperglycemia. This study aims to compare the changes in neuroinjury biomarker levels, as well as the efficacy and safety, between low-dose (0.6 mg/kg) and standard-dose (0.9 mg/kg) intravenous alteplase treatment in patients with AIS and stress hyperglycemia. This study included 150 patients with AIS and stress hyperglycemia, who were divided into a low-dose group (n = 78) and a standard-dose group (n = 72). Differences between the 2 groups were analyzed in terms of neuroinjury biomarkers (neuro-specific enolase, S100β, glial fibrillary acidic protein, myelin basic protein), neurological recovery (National Institutes of Health Stroke Scale score), clinical outcomes (modified Rankin Scale score), and the incidence of adverse events. Multivariate regression analysis was conducted to evaluate the relationship between the dose and a favorable prognosis (modified Rankin Scale ≤ 2). We found that, within 24 hours post-treatment, the levels of neuroinjury biomarkers (neuro-specific enolase, S100β, glial fibrillary acidic protein, myelin basic protein) were significantly lower in the low-dose group compared with the standard-dose group (P < .05), and the improvement in National Institutes of Health Stroke Scale scores was more pronounced (P < .01). Three months after thrombolysis, the favorable prognosis rate in the low-dose group was 63.5%, higher than the 47.2% in the standard-dose group, with a near-significant difference (P = .09). Multivariate regression analysis indicated that low-dose treatment was an independent protective factor for a favorable prognosis (odds ratio = 2.34, 95% confidence interval = 1.29-4.23, P = .006). There were no significant differences in the incidence of adverse events between the 2 groups, though the proportion of mild bleeding was slightly lower in the low-dose group compared with the standard-dose group. Low-dose intravenous alteplase thrombolysis demonstrates more significant neuroprotective effects in patients with AIS and stress hyperglycemia, promoting neurological recovery and improving long-term prognosis without increasing the risk of adverse events. Low-dose thrombolysis may be a safer and more effective treatment option, but its efficacy and safety require further validation through large-scale, randomized controlled trials.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41825"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736036","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":"Mendelian randomization study of circulating leukocytes counts reveals causal associations with inflammatory bowel disease.","authors":"Chengtao Liang, Zhibin Wang, Yuhe Mai, Junxiang Li, Qiuhong Dai, Yali Yuan, Muyuan Wang, Yuyue Liu, Wenji Zhang, Yitong Li, Xinyu Lu, Zhengdao Lin, Tangyou Mao","doi":"10.1097/MD.0000000000041969","DOIUrl":"10.1097/MD.0000000000041969","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic recurrent IBD, whose cause involves the interaction between genetic and environmental factors. Although there is a recognized link between immune response and IBD, the causal relationship between circulating immune cell counts and IBD remains controversial. This study aimed to elucidate the causal relationship between genetically predicted circulating immune cell counts and IBD. We conducted a bidirectional 2-sample Mendelian randomization (MR) study using aggregated statistics from genome-wide association studies. The causal relationship between 5 circulating leukocytes cells (monocytes, lymphocytes, eosinophils, basophils and neutrophils) counts and IBD, including ulcerative colitis (UC) and Crohn disease (CD) was analyzed. Horizontal pleiotropy test and heterogeneity test were used to ensure the stability of the results. Our findings indicated that monocytes, lymphocytes, eosinophils, and basophils count were not significantly associated with IBD, however, elevated circulating neutrophils count was significantly associated with higher risk of IBD [odds ratio (OR) = 1.0017; 95% confidence interval (CI) = 1.0004-1.003; P = .009] and UC [OR = 2.465; 95% CI = 1.236-4.916; P = .01]. In addition, we also found that IBD [OR: 12.07; 95% CI = 1.909-76.316; P = .008] and CD [OR = 1.014; 95% CI = 1.004-1.023; P = .005] were significantly associated with higher circulating neutrophils count in reverse MR. This MR study provides genetic evidence for the causal relationship between the genetically predicted increase in circulating neutrophils count and the risk of IBD (UC and CD). This finding stresses the need for further exploring physiological functions of neutrophils in order to develop effective strategies against IBD.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41969"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736058","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":"Comparison of vitamin B levels in febrile children with and without febrile seizures: A prospective single-center study.","authors":"Ying Huang, Xinxin Wen, Hongxuan Guo, Jianwei Cao","doi":"10.1097/MD.0000000000041891","DOIUrl":"10.1097/MD.0000000000041891","url":null,"abstract":"<p><p>Febrile seizures (FS) are among the most common neurological disorders in childhood, and their pathogenesis may be influenced by multiple factors. As scientific research progresses, the significant role of B vitamins in the nervous system has become progressively clearer. In this study, children clinically diagnosed with FS were selected as the experimental group, and febrile children without a history of convulsions or a family history of seizures were selected as the control group to investigate the potential correlation between FS and whole-blood B vitamin levels. The concentrations of B vitamins in whole blood were measured using liquid chromatography-mass spectrometry, and statistical analyses were conducted using SPSS 25.0, followed by significance testing. The levels of vitamins B1, B2, B5, B6, B7, and B12 in the experimental group were significantly higher than those in the control group, particularly vitamins B5 and B7 (P < .05). Additionally, statistically significant differences were observed between sodium and calcium ion levels. These results suggest that febrile convulsions are the complex outcome of multiple factors, including known ion channel defects. Vitamin B may play a role in febrile convulsions and warrants further investigation.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41891"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699569","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":"Revealing the effects of various immune cells in anorexia nervosa: Evidence from Mendelian randomization.","authors":"Juan Deng, Yunfeng Yu, Yuman Yin, Gang Hu, Xinyu Yang, Cong Chen, Chenlu Guo, Zhengguo Tang","doi":"10.1097/MD.0000000000041817","DOIUrl":"10.1097/MD.0000000000041817","url":null,"abstract":"<p><p>The aim of this study was to assess the causal relationship between immune cells and anorexia nervosa (AN) by Mendelian randomization (MR). Data on immune cell phenotypes and AN were obtained from genome-wide association studies. Next, single nucleotide polymorphisms included in the MR analysis were screened according the basic assumptions. Furthermore, inverse variance weighted was used as the main method for MR analysis to evaluate the causal effect of immune cell phenotypes on AN. Finally, MR-Egger intercept, Cochran Q, and leave-one-out sensitivity analyses were used to assess horizontal pleiotropy, heterogeneity, and robustness, respectively. The MR analysis showed that NKT %lymphocyte (OR 1.201, 95% CI = 1.021-1.411, P = .027), NKT %T cell (OR 1.258, 95%CI 1.043-1.519, P = .017), double negative (DN) (CD4-CD8-) NKT %lymphocyte (OR 1.235, 95%CI 1.074-1.420, P = .003), DN (CD4-CD8-) NKT %T cell (OR 1.222, 95%CI 1.060-1.410, P = .006), CD8dim NKT absolute count (OR 1.225, 95%CI 1.045-1.436, P = .012), CD8dim NKT %lymphocyte (OR 1.214, 95%CI 1.043-1.414, P = .012), CD8dim NKT %T cell (OR 1.215, 95%CI 1.035-1.425, P = .017), CD16-CD56 on NKT (OR 1.193, 95%CI 1.014-1.402, P = .033), CD28 + CD45RA + CD8br %T cell (OR 1.020, 95%CI 1.002-1.037, P = .025) were associated with increased genetic susceptibility to AN. MR-Egger showed no horizontal pleiotropy (P ≥ .05). Cochran Q and sensitivity analysis showed that the results were not heterogeneous and were robust. This MR analysis revealed 9 immune cell phenotypes related to increased genetic susceptibility to AN, emphasizing the importance of NKT and CD8 in AN. This finding provides new insights for understanding the pathogenesis of AN and developing immune-targeted drugs.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41817"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700722","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 the coronavirus disease 2019 pandemic on beliefs and practices regarding hand hygiene among intensive care nurses: A repeated cross-sectional study.","authors":"Yasemin Ay Karadas, Sibel Yilmaz Sahin, Elif Dönmez, Gamze Temiz","doi":"10.1097/MD.0000000000041903","DOIUrl":"10.1097/MD.0000000000041903","url":null,"abstract":"<p><p>Hand hygiene is an important factor in the prevention of healthcare-associated infections. Studies show healthcare professionals' hand hygiene practices vary and are not at sufficient levels. This study aimed to examine the effect of the COVID-19 pandemic on the beliefs and practices of nurses working in intensive care units (ICU) towards hand hygiene. This was longitudinal, repeated, and cross-sectional study. The study was conducted in 2 phases between January 2,2020 and March 10,2021 in the intensive care unit of a university hospital in northern Turkey. No sampling method was used. The objective was to reach the entire population. The first phase of this study was completed with 119 (76% of the population) ICU nurses and the second phase with 85 (70% of the population) ICU nurses. The data were collected with the personal information form, hand hygiene belief scale (HHBS), hand hygiene practices inventory (HHPI) and the views of the intensive care nurses related to COVID-19. Descriptive statistics such as mean and standard deviations, frequency, and percentages and analytical statistics such as t-test, Mann-Whitney U test, Kruskal-Wallis test were used for data analysis at the significance level of P < .05. The majority of the nurses who participated in the study were female (75.6%; 69.4%), with a mean age of 30.82 ± 5.51 and 30.58 ± 5.51 years, respectively. There was a significant difference (P < .05) between the median HHBS (P = .002) and HHPI (P = .001) scores before and after COVID-19. All nurses (100%) reported that the pandemic was effective in hand hygiene practices. In this study, it was determined that the hand hygiene beliefs and practices of nurses were high, and the scores of nurses' hand hygiene beliefs and practices after COVID-19 increased significantly. Healthcare professionals must always adhere to stringent standards of hand hygiene, rather than merely during periods of heightened challenges. To ensure the sustainability of optimal hand hygiene practices, it is recommended that motivational interventions that strengthen beliefs and practices related to hand hygiene should be implemented and that studies should be conducted to evaluate their effectiveness.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41903"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700756","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":"Effects of a mobile health coaching intervention on symptom experience, self-management, and quality of life in breast cancer survivors: A quasi-experimental study.","authors":"Jin-Hee Park, Sun Hyoung Bae, Yong Sik Jung, Min Hee Hur, Ji Young Kim, Su Jin Jung","doi":"10.1097/MD.0000000000041894","DOIUrl":"10.1097/MD.0000000000041894","url":null,"abstract":"<p><strong>Background: </strong>Patients diagnosed with breast cancer in South Korea have a longer post-diagnosis survival period compared to those in the United States and Europe. Therefore, it is essential to establish an effective posttreatment care system to enhance their quality of life (QOL). This study aimed to evaluate the effectiveness of a mobile health coaching intervention designed to improve symptom experience, self-management, and QOL in patients with breast cancer following the active phase of their treatment.</p><p><strong>Methods: </strong>This study was a quasi-experimental, pre-post design conducted with breast cancer patients receiving treatment at a tertiary general hospital in Korea from July 2021 to June 2022. Participants were sequentially assigned to the control and intervention groups. Those in the intervention group participated in a 12-week mobile health coaching intervention comprising education sessions, peer support groups, and recording a health diary. The outcome variables were symptom experience, self-management, and QOL. Data were collected at baseline (T0), after the intervention (T1), and 3 months after the intervention (T2) and compared using repeated analysis of variance.</p><p><strong>Results: </strong>Seventy-four participants (mean age 46.93 years) who had completed the active phase of cancer treatment were included. The intervention group showed a significant decrease in symptom experience, from 1.57 ± 0.46 (T0) to 1.03 ± 0.46 (T1) (P = .006), and a decrease in psychological symptoms from 1.71 ± 0.93 (T0) to 1.66 ± 0.69 (T2) (P = .049). Self-management scores significantly increased from 74.43 ± 10.72 (T0) to 76.90 ± 11.99 (T2) (P = .028). QOL improved from 95.83 ± 18.62 (T0) to 96.40 ± 15.35 (T2) (P = .015), and emotional well-being increased from 17.42 ± 4.91 (T0) to 17.50 ± 3.63 (T2) (P < .001), with all showing significant group × time interactions.</p><p><strong>Conclusions: </strong>The 12-week mobile health coaching program significantly reduced symptoms, improved self-management, and enhanced overall QOL and emotional well-being in breast cancer survivors who had completed primary treatment. These findings highlight the program's potential to support posttreatment recovery. Further research is needed to assess its long-term effects across diverse patient populations and cancer types to validate its broader effectiveness.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41894"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700762","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":"Surgical resection of a lipoma of the right atrium: A case report.","authors":"Yifan Yan, Chen Ma, Bhushan Sandeep, Xiufang Su, Zongwei Xiao","doi":"10.1097/MD.0000000000041848","DOIUrl":"10.1097/MD.0000000000041848","url":null,"abstract":"<p><strong>Rationale: </strong>Cardiac tumors are relatively rare, with an incidence rate of 0.17% to 0.19% according to autopsy reports. The tumors may be detected through transthoracic echocardiography, computed tomography (CT), magnetic resonance imaging (MRI), and other examinations. The treatment plan is determined based on the nature of the tumor.</p><p><strong>Patient concerns: </strong>In this article, we report a case of a 61-year-old male who was found to have an occupying lesion in the right atrium and superior vena cava during a cardiac ultrasound examination.</p><p><strong>Diagnoses: </strong>Enhanced CT and MRI suggested the possibility of a lipoma during admission.</p><p><strong>Interventions: </strong>The patient underwent video-assisted thoracoscopic cardiac tumor resection under extracorporeal circulation. The postoperative pathology was consistent with lipoma.</p><p><strong>Outcomes: </strong>The recurrence rate after cardiac lipoma excision is low, and the prognosis is generally good. However, for patients with cardiac lipomas involving ventricles and myocardial infiltration, intraoperative excision is more challenging, and the long-term outcome is poor.</p><p><strong>Lessons: </strong>Cardiac lipomas are generally asymptomatic even in large dimensions. Echocardiograms can identify tumors, but cardiac MRI or cardiac CT can differentiate cardiac lipomas from other cardiac tumors.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41848"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700850","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 application and effect evaluation of continuity precision nursing in patients undergoing coronary angiography and stent implantation: A study of clinical outcomes.","authors":"Limin Tan, Xiaojing Tan, Cangyun Zhang, Lei Tao, Yuan Liao","doi":"10.1097/MD.0000000000041879","DOIUrl":"10.1097/MD.0000000000041879","url":null,"abstract":"<p><p>Coronary artery disease is a major global health burden, with percutaneous coronary intervention (PCI) serving as a key treatment strategy. Despite its efficacy, challenges such as in-stent restenosis, medication nonadherence, unhealthy lifestyles, and psychological distress hinder optimal recovery. Continuity-based precision nursing, which integrates personalized care and multidisciplinary support, offers a potential solution. Therefore, the purpose of this study is to evaluate the effectiveness of continuity-based precision nursing compared to conventional nursing in improving postoperative outcomes for PCI patients. This includes assessing its impact on cardiac function recovery, complication prevention, medication adherence, lifestyle modifications, psychological well-being, and overall quality of life. This study included 112 PCI patients treated from January 2023 to January 2024, divided into an experimental group (continuity-based precision nursing) and a control group (conventional nursing). Propensity score matching resulted in 45 matched pairs. Data collected included demographics, postoperative cardiac function, medication adherence, lifestyle changes, psychological status, complications, satisfaction, and health-related quality of life. Statistical analyses were performed using SPSS, with P < .05 considered significant. Continuity-based precision nursing showed significant benefits over conventional nursing. At 1 month post-PCI, the experimental group had higher left ventricular ejection fraction ≥ 50% rates (86.7% vs 75.6%) and lower in-stent restenosis (6.7% vs 17.8%) and residual stenosis rates (8.9% vs 24.4%, P = .048). Medication adherence was improved (86.7% vs 66.7%, P = .02), with higher rates eof smoking cessation (77.8% vs 55.6%, P = .01), healthy eating (84.4% vs 66.7%, P = .03), and regular exercise (80.0% vs 62.2%, P = .02). Anxiety and depression scores were significantly lower in the experimental group post-intervention. Patient satisfaction (92.5 ± 4.2 vs 85.7 ± 6.1, P < .01) and health-related quality of life (88.4 ± 5.0 vs 81.2 ± 6.0, P < .01) were also markedly higher. Continuity-based precision nursing significantly enhances postoperative outcomes in PCI patients, improving cardiac function, adherence, lifestyle behaviors, and psychological well-being. This model provides a comprehensive framework for coronary artery disease care, with potential for broader clinical application. Further research should evaluate its long-term impact and scalability in diverse settings.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41879"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700880","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":"Abdominal bleeding secondary to isolated mesenteric injury following blunt abdominal trauma: A case report.","authors":"Zhiqiang Ming, Chao Xiao, Rui Xiao, Yongtao Zhang, Xiaoli Hu","doi":"10.1097/MD.0000000000041920","DOIUrl":"10.1097/MD.0000000000041920","url":null,"abstract":"<p><strong>Rationale: </strong>Isolated mesenteric injury often results from traffic accidents causing blunt abdominal trauma, exhibit nonspecific symptoms and signs. Most mesenteric injuries occur concurrently with injuries to other organs, such as the liver and spleen. As a result, the incidence of isolated mesenteric injury is very low and often misdiagnosed.</p><p><strong>Patient concerns: </strong>A 49-year-old male patient presented with abdominal pain following a traffic accident more than 5 hours before admission. Upon admission, his blood pressure was normal but dropped sharply in a short time and presented with shock. Anemia, abrasions in the upper abdomen, cold skin on the dorsum of the foot, rebound pain, muscle tension, and noncoagulation of abdominal blood were all observed during the physical examination. Emergency plain and contrast-enhanced abdominal computed tomography (CT), and mesenteric artery CT angiography revealed a large volume of blood accumulated in the abdomen, pelvis, and jejunal mesentery. The jejunal wall and mesentery were edematous, with mesenteric distortion, and some branches of the inner jejunal artery were not clearly visualized. We found no evidence of liver or splenic rupture.</p><p><strong>Diagnoses: </strong>Mesenteric injury of the jejunum caused acute hemorrhagic anemia and hemorrhagic shock.</p><p><strong>Interventions: </strong>An emergency laparotomy was performed.</p><p><strong>Outcomes: </strong>An emergency laparotomy showed 3 hematomas close to the perforation site, 2 fully split tears in the jejunal mesentery, bleeding from partially exposed veins, a significant amount of blood and clots in the abdominal cavity, and serosal damage at the jejunal mesentery's root. The patient recovered well after we performed abdominal cavity drainage and jejunal mesenteric hemostasis and repair.</p><p><strong>Lessons: </strong>Isolated mesenteric injuries are very rare in clinical practice, and their clinical symptoms and signs are nonspecific, which makes them prone to misdiagnosis and oversight. When a patient satisfies the 4 requirements listed below: abdominal hemorrhage or hematoma; a history of abdominal trauma; no damage to high-risk organs like the liver or spleen; the CT-detected signs of mesenteric injury. Abdominal paracentesis or laparoscopy should be conducted to confirm the diagnosis and initiate further treatment.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41920"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700892","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}