Medicine最新文献

{"title":"Early impaired insulin tolerance among Vietnamese diabetes with or without dyslipidemia.","authors":"Mai Ly Thi Nguyen, Khac Cuong Bui, Thu Hang Ngo, Tai Suc Nguyen, Phuong Linh Thi Nham, Chi Pham, Thi Minh Hoang, Quang Thuan Huynh, Thanh Thuy Tang, Thanh Chung Dang, Thuy Linh Dang, Linh Toan Nguyen, Van Mao Can","doi":"10.1097/MD.0000000000040212","DOIUrl":"10.1097/MD.0000000000040212","url":null,"abstract":"<p><p>This study aims to evaluate impaired insulin tolerance among Vietnamese diabetes with or without dyslipidemia. Diabetes mellitus (DM) remains the serious global health and social burden that has increased over the past few decades. It progresses silently to vascular injury and disability of injured vascular-perfused tissues/organs. Insulin intolerance and dyslipidemia exacerbate and accelerate the implications of DM. Thus, early detection and more evidence of early insulin intolerance and dyslipidemia is needed for proactive management. This cross-sectional descriptive study recruited 100 healthy control (HC) and 297 DM patients in Military Hospital 103 from 2021 to 2023. Patients with DM were subgrouped into lipid metabolism disorder (LMD, n = 98) and non-LMD (NLMD, n = 99). The biochemists' serum levels were measured automatically and the accuracy of the test result was strictly controlled. Insulin tolerance indices (HOMA2-IR, HOMA2-%S and HOMA2-%B) were compared between HC, DM with or without dyslipidemia as well as correlated with lipid ingredients (total Cholesterol, triglyceride, LDL-C and HDL-C). Among DM patients, HOMA2-IR was significantly high and HOMA2-%S and HOMA2-%B were significantly low. HOMA2-IR was higher and HOMA2-%S and HOMA2-%B were lower in DM with LMD than in DM without LMD. In addition, HOMA2-IR was positively correlated with serum cholesterol, triglyceride and LDL-C concentration, and negatively correlated to HDL-C concentration. In contrast, HOMA2-%S and HOMA2-%B was negatively correlated with serum cholesterol, triglyceride and LDL-C, and positively correlated with HDL-C. Impaired insulin intolerance occurred in early stage of DM, and more serious among DM with LMD, compared to DM with NLMD.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576516","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":"Zolpidem-related euphoria, addiction and detoxification: A case report and review of the literature.","authors":"Fangfei Xie, Bo Liu, Liqiu Yang, Junqiang Huang, Bin Li, Yuanyuan Li","doi":"10.1097/MD.0000000000040280","DOIUrl":"10.1097/MD.0000000000040280","url":null,"abstract":"<p><strong>Rationale: </strong>Zolpidem, a non-benzodiazepine sedative-hypnotic, is considered safer for the treatment of insomnia compared to benzodiazepines. However, in recent years, there have been growing reports of Zolpidem dependence, addiction, and withdrawal symptoms. We reported a case of Zolpidem addiction and successful detoxification, reviewed similar cases in the literature, and proposed a potential mechanism underlying Zolpidem addiction.</p><p><strong>Patient concerns: </strong>The patient was a 46-year-old Tibetan woman who had been using Zolpidem intermittently to treat insomnia for at least 8 years. She was overweight, with a BMI of 28.04 kg/m², and had hypertension, diabetes, a 20-year smoking history, and several years of alcohol abuse, often seeking instant gratification. She voluntarily increased both the dosage and frequency of Zolpidem, experiencing euphoria, anxiolysis, and increased appetite at higher doses, which led her to gradually escalate her dosage to 280 mg per day in divided doses. However, upon stopping Zolpidem, she experienced withdrawal symptoms, including insomnia, tension, and palpitations.</p><p><strong>Diagnoses: </strong>She was diagnosed with a combination of hypnotic use disorder, anxiety disorder, hypertension, and diabetes.</p><p><strong>Interventions: </strong>She underwent diazepam replacement therapy, along with antianxiety medications and mindfulness-based cognitive therapy, to address Zolpidem addiction.</p><p><strong>Outcomes: </strong>After 13 days of inpatient treatment, the patient successfully quit Zolpidem. During a 3-month follow-up, she returned to work and remained free from Zolpidem use.</p><p><strong>Lessons: </strong>We speculate that Zolpidem addiction is likely linked to the drug's euphoric effects and certain patient characteristics, such as sensation-seeking behavior. A comprehensive approach, involving both pharmacological and psychological interventions, is essential for an effective detoxification strategy for Zolpidem addiction.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576524","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":"Dose-response effects of 8-week resistance training on body composition and muscular performance in untrained young women: A quasi-experimental design.","authors":"Dondu Ugurlu, Mehmet Gülü, Hakan Yapici, Fatma Hilal Yagin, Ertan Comertpay, Oguz Eroglu, José Afonso, Monira I Aldhahi","doi":"10.1097/MD.0000000000040322","DOIUrl":"10.1097/MD.0000000000040322","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the effects of 8-week resistance training with different training volumes on body composition, maximum strength, peak power, and muscle thickness in non-training women.</p><p><strong>Methods: </strong>This was a 3-arm, prospectively designed, randomized controlled trial. A total of 45 adult women aged 20.7 ± 1 years, the mean heights of the participants were 166 ± 0.07 cm, body weight was measured as 54.5 ± 8.8 kg, and body mass index was 19.9 ± 2.1 kg/m2. They were randomized to low-volume training resistance training (LVT; n = 15, 3 sessions of 12 exercises per week), moderate-volume training resistance training (MVT; n = 15; 4 sessions of 12 exercises per week), and high-volume resistance training (HVT; n = 15; 5 sessions of 12 exercises per week) for 8 weeks. The muscle thickness (MT) of the vastus lateralis was assessed at baseline and 8 weeks later using a portable ultrasound device.</p><p><strong>Results: </strong>A total of 39 adult women completed the study, with 2 participants from each group lost to follow-up. All experimental groups 1RM increased (P = .001, effect size (ES) = 0.463) All groups showed improved muscle thickness (MT) (P = .001) and CMJ (P = .004). The group × time interaction is statistically significant (P = .001) suggests that the changes in muscle thickness over time differ significantly between the different training volume groups (ηp²) is 0.368.</p><p><strong>Conclusion: </strong>In untrained young women, resistance training improved muscle hypertrophy, maximal strength, power, and body composition in untrained young women. However, 4 sessions MVT per week were superior to LVT and HVT sessions, suggesting a nonlinear dose-response relationship favoring moderate volume over low or high volumes, at least in previously untrained young women.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT06449300).</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576570","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":"Efficacy and mechanism of Tiaoshu Anshen Decoction in treating insomnia with spleen and stomach Qi dysfunction: A retrospective study.","authors":"Fang Zhou, Lei Du, Liping Yu, Dong Zhang, Haitao Jin, Zhijie Li","doi":"10.1097/MD.0000000000040160","DOIUrl":"10.1097/MD.0000000000040160","url":null,"abstract":"<p><p>This study investigates the clinical efficacy of Tiaoshu Anshen Decoction in treating insomnia characterized by spleen and stomach Qi dysfunction. According to the differences of previous treatment, 94 patients were divided into treatment group and control group. The treatment group was treated with Tiaoshu Anshen Decoction, and the control group was treated with oral esazolam for 2 weeks. We compared serum levels of 5-hydroxyindoleacetic acid (5-HIAA), 5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA), DASS-21, and HAMD scores before and after treatment. We also evaluated gastrointestinal function, traditional Chinese medicine syndrome scores, quality of life, and adverse reactions, with statistical analysis conducted using SPSS 25.0. The overall efficacy and clinical outcomes were comparable between the 2 groups. Both groups showed increased serum factor levels and decreased Pittsburgh Sleep Quality Index (PSQI), HAMD, and DASS-21 scores post-treatment. Notably, the treatment group exhibited significant improvement in stool consistency, digestive symptoms, DOB < 4 and DOB ≥ 4 distribution, and TCM syndrome scores, outperforming the control group. No adverse reactions were reported in either group. This study suggests that spleen and stomach Qi dysfunction significantly contribute to insomnia, affecting its occurrence, type, and severity. Tiaoshu Anshen Decoction effectively enhances 5-HIAA, 5-HT, NE, and DA levels, reduces inflammatory factors, and improves sleep quality, gastrointestinal function, and overall quality of life. The decoction may exert its effects by regulating Qi dynamics and gastrointestinal function, indicating the gastrointestinal system as a potential key target in treating sleep disorders.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575162","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":"Pretreatment systemic immune-inflammation index and lymphocyte-to-monocyte ratio as prognostic factors in oral cavity cancer: A meta-analysis.","authors":"Jianghan Xu, Yanjun Lin, Jingbo Yang, Yifeng Xing, Xiaojie Xing","doi":"10.1097/MD.0000000000040182","DOIUrl":"10.1097/MD.0000000000040182","url":null,"abstract":"<p><strong>Background: </strong>The predictive implications of the pretreatment systemic immune-inflammation index (SII) and lymphocyte-to-monocyte ratio (LMR) in oral cavity cancer have been investigated extensively, however, the findings are conflicting.</p><p><strong>Methods: </strong>To assess the predictive importance of SII and LMR in patients with oral cavity cancer, a comprehensive Meta-analysis of the literature was conducted using the databases from PubMed, Embase, and the Cochrane Library. To determine the link between SII and LMR and overall survival (OS) and disease-free survival (DFS), hazard ratio (HR) and 95% confidence interval (CI) were retrieved.</p><p><strong>Results: </strong>The analysis comprised a total of 18 papers, covering 19 trials (SII = 5, LMR = 12, SII + prognostic nutritional index (PNI) = 2). According to pooled data, increased SII predicted poor OS (HR: 1.61, 95% CI: 1.38-1.87, P < .001) and DFS (HR: 1.90, 95% CI: 1.11-3.27, P = .02) while high LMR was linked with improved OS (HR: 0.64, 95% CI: 0.54-0.77, P < .001) and DFS (HR: 0.69, 95% CI: 0.61-0.79, P < .001). In addition, subgroup analysis indicated that high SII and low LMR negatively correlated with OS regardless of country, cutoff value, sample size, or types of Cox regression analysis.</p><p><strong>Conclusions: </strong>High SII and low LMR may predict worse survival in patients with oral cavity cancer. SII and LMR may therefore represent effective indicators of prognosis in oral cavity cancer.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576169","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 literature review of Chinese traditional Baduanjin qigong for perimenopausal and postmenopausal symptoms.","authors":"Hong-Yan Liu, Ya-Ge Luo, Jin Zhang, Yue-Han Hu, Han-Yu He, Jie Li, Hao-Ping Mao, Shu-Fei Fu","doi":"10.1097/MD.0000000000040235","DOIUrl":"10.1097/MD.0000000000040235","url":null,"abstract":"<p><p>This review aimed to evaluate the effectiveness and safety of Baduanjin qigong on perimenopausal and postmenopausal symptoms based on clinical trials. A literature search was conducted in 7 databases up to June 30, 2023. The information of study design and observed indicator based on perimenopausal and postmenopausal stage was extracted. We mainly analyzed the effectiveness, safety and the methodology quality. Thirty-five trials were selected, and 17 original studies were considered good methodological quality. During perimenopause, Baduanjin was mainly to treat mood disorders (63.64%, 14/22), among which 6 (42.86%, 6/14) were depression, 2 (14.29%, 2/14) were depression and anxiety, and 1 (7.14%, 1/14) was anxiety, as well as 5 (35.71%, 5/14) sleep disorders. And the exercise program had a duration of 45 to 50 minutes (57.14%, 8/14), 7 times (71.43%, 10/14) a week. The programs lasting 3 months (42.86%, 6/14), accounted for the highest proportion of the exercise program. In the postmenopausal stage, Baduanjin was used to treat osteoporosis (84.62%, 11/13). From the data available, the program with 2 to 3 times a day (81.82%, 9/11) reported the highest number of significant effects, with a maximum duration of 12 months (55.56%, 5/9), followed by 6 months (33.33%, 3/9). A total of 8 trials mentioned the adverse reactions, but none was related to Baduanjin, and the dropout of participants (1.96%, 57/2912) was also not associated with Baduanjin. There is evidence for positive effects of Baduanjin in addressing perimenopausal mental disorders and postmenopausal osteoporosis, but more research is necessary to clarify best practices and quantify results.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576335","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 intracranial malignant melanomas: A case series with literature review.","authors":"Lifeng Chen, Yang Yang, Dongmei Li, Bo Bu","doi":"10.1097/MD.0000000000040334","DOIUrl":"10.1097/MD.0000000000040334","url":null,"abstract":"<p><strong>Rationale: </strong>There is a high chance of misdiagnosis and limited knowledge regarding therapeutic strategies owing to the rarity of primary intracranial malignant melanoma (PIMM). The objective of the present study was to evaluate the clinical features, treatment modalities, and outcomes of patients with histologically proven PIMM.</p><p><strong>Patient concerns: </strong>Data of 15 patients with PIMM admitted to the Chinese People's Liberation Army General Hospital in a 14-year period between January 2005 and January 2019 were collected. Clinical presentations, pathology, surgical strategies, adjuvant treatment, and prognosis were retrospectively analyzed.</p><p><strong>Diagnoses: </strong>CT showed iso- or high-density lesions in 12 cases (80%). MRI revealed short T1 and slightly short T2 in 14 cases (93.3%).The tumors showed mild or no enhancement on enhanced MRI. The patients were eventually diagnosed with PIMM through pathological examination.</p><p><strong>Interventions: </strong>The treatment modalities included radical resection followed by conventional radiotherapy (RT, n = 12) and subtotal resection followed by stereotactic radiosurgery (n = 3).</p><p><strong>Outcomes: </strong>All 15 patients had either recurrence or metastasis at an average of 14.7 months (range, 6-23 months) after surgery. In total, 14 patients (93.3%) succumbed to disease, with a mean overall survival of 22 months (range, 6-36 months). The median survival time was 23 months. The overall survival rates at 1, 2, and 3 years were 80, 47, and 13%, respectively. Radical resection with RT was associated with longer overall survival (log-rank, P < .05) than subtotal resection followed by stereotactic radiosurgery.</p><p><strong>Lessons: </strong>PIMM is an extremely rare tumor with a poor prognosis. Radical resection with RT may result in a longer overall survival rate. Targeted immunotherapy may be a promising treatment option for PIMM.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576357","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 pulmonary alveolar soft part sarcoma with ASPSCR1-TFE3 gene fusion: Case report and literature review.","authors":"Xijian Hu, Jing Chai, Bin Zhang, Chengguang Hu","doi":"10.1097/MD.0000000000040249","DOIUrl":"10.1097/MD.0000000000040249","url":null,"abstract":"<p><strong>Rationale: </strong>Primary pulmonary alveolar soft part sarcoma (ASPS) is an extremely rare disease characterized by a specific genetic abnormality - the ASPSCR1-TFE3 gene fusion.</p><p><strong>Patient concerns: </strong>This study presented a 27-year-old male patient who experienced persistent chest tightness for over 6 months.</p><p><strong>Diagnoses: </strong>The computed tomography (CT) scan and enhanced CT scan revealed a mass in the medial segment of the right middle lobe of his lung. The patients then underwent further diagnosis. Pathological examination showed the tumor to be consisting of polygonal cells with abundant eosinophilic or transparent cytoplasm arranged in nests. Next-generation sequencing reported ASPSCR1-TFE3 gene fusion, confirming the final diagnosis of primary pulmonary ASPS. Regular follow-ups of 12 months showed no signs of tumor recurrence.</p><p><strong>Interventions: </strong>The patients underwent the medial segment resection of the right middle lobe for treatment.</p><p><strong>Outcomes: </strong>A CT examination 3 months after the operation showed that the patient had improved. The last review showed no recurrence or metastasis.</p><p><strong>Lessons: </strong>This case report highlights the importance of detailed diagnosis, prompt treatment, and close monitoring of patients with ASPS.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576361","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 myocardial infarction and atrial fibrillation: A bidirectional Mendelian randomization study.","authors":"Jin Rao, Yue Yu, Pengchao Cheng, Xuefu Wang, Pei Wang, Zhinong Wang","doi":"10.1097/MD.0000000000040252","DOIUrl":"10.1097/MD.0000000000040252","url":null,"abstract":"<p><p>Many studies have shown that myocardial infarction (MI) is significantly associated with atrial fibrillation (AF), but the causal relationship between MI and AF has not been established. Therefore, we performed this Mendelian randomization (MR) study to investigate the relationship between MI and AF. We used a publicly available summary statistical dataset for MI based on genome-wide analysis studies (GWAS; ebi-a-GCST011364; 14,825 cases and 2680 controls) and a summary statistical dataset for AF based on an European GWAS (finn-b-I9_AF_REIMB; 10,516 cases and 116,926 controls). The 2-sample bidirectional MR analysis was performed using the inverse-variance weighted (IVW), MR-Egger, and weighted median methods. The causal effect of MI on AF was analyzed using 30 MI-specific single nucleotide polymorphisms (SNPs) that were characterized as instrumental variables (IVs) based on the GWAS data. The causal effect of MI on AF was confirmed by the IVW (odds ratio [OR] 1.42; 95% confidence interval [CI] 1.27-1.58; P < .001), MR-Egger (OR: 1.49; 95% CI: 1.15-1.93; P = .005), and weighted median (OR: 1.42; 95% CI: 1.24-1.63; P < .001) analyses. Furthermore, in the reverse MR analyses, the causal effect of AF on MI was analyzed using 20 AF-specific SNPs that were screened as IVs. The causal effect of AF on MI was significant based on the results from the IVW method (OR: 1.05; 95% CI: 1.00-1.09; P = .033). In conclusion, the bidirectional MR analyses demonstrated a clear bidirectional causal association between MI and AF.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576382","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":"Rescue of a spontaneous subcapsular hepatic hematoma associated with HELLP syndrome: A case report.","authors":"Chenze Yan, Zhong Jia, Yuanwei Liu, Weijiang Zhou, Heshan Zhou","doi":"10.1097/MD.0000000000040285","DOIUrl":"10.1097/MD.0000000000040285","url":null,"abstract":"<p><strong>Rationale: </strong>Spontaneous subcapsular hepatic hematoma (SSHH) is a rare yet severe complication of hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome that can lead to life-threatening situations for both the mother and fetus. Determining an appropriate therapeutic strategy remains challenging, as it involves choosing between surgery, microinvasive percutaneous transhepatic drainage, or conservative treatment alone. Further successful cases are needed to support the optimal option. We retrospectively collected a patient's clinical record and imaging data to elucidate the natural progression, response to noninvasive treatment, and outcome of SSHH associated with HELLP syndrome.</p><p><strong>Patient concerns: </strong>A 34-year-old woman, who underwent a cesarean section due to suspected fetal distress, developed SSHH accompanied by the potential risk of rupture and deteriorated serology within the first 24 hours after delivery.</p><p><strong>Diagnoses: </strong>Emergency blood routine examination, serum biochemistry analysis, and computed tomography of the abdomen revealed a SSHH associated with HELLP syndrome.</p><p><strong>Interventions: </strong>The main rescue measures included the use of corticosteroids, antihypertensive drugs, and platelet transfusion.</p><p><strong>Outcomes: </strong>A positive effect on the patient's condition was exhibited within 24 to 48 hours. The majority of the subcapsular hepatic hematoma could be absorbed without any sequelae over a period of 7 months.</p><p><strong>Lessons: </strong>For patients with pregnancy-induced hypertension, there is a heightened risk of HELLP syndrome occurrence in subsequent pregnancies. The assessment and treatment of SSHH should be conducted by an experienced multidisciplinary team. In addition to timely delivery, the administration of corticosteroids, usage of antihypertensive medication, and platelet transfusion are necessary, particularly within the first 48 hours if the patient's condition permits. This approach would provide valuable insights for further therapeutic decisions and facilitate a preliminary prognosis assessment.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576385","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}