Medicine最新文献

{"title":"Study on secondary prevention and the impact of risk factor control on myocardial infarction events in young patients with coronary heart disease.","authors":"Yidi Liu, Naizhi Geng","doi":"10.1097/MD.0000000000041709","DOIUrl":"10.1097/MD.0000000000041709","url":null,"abstract":"<p><p>The incidence of coronary heart disease (CHD) among young adults has been steadily increasing, yet the control of risk factors and their impact on myocardial infarction (MI) events remain to be further studied. This study aims to analyze the control of major risk factors and their effects on MI events in young CHD patients. This retrospective study included 1032 young CHD patients who were followed up between January 2020 and December 2023. Baseline and follow-up data were collected, including the control status of risk factors such as smoking, diabetes, hypertension, and low-density lipoprotein cholesterol (LDL-C), as well as the occurrence of MI events. Multivariate logistic regression analysis was used to explore the association between risk factors and MI events. The study found that after risk factor interventions, the smoking rate decreased significantly from 75.1% at baseline to 36.2% at the end of follow-up (P < .001). The proportion of patients achieving HbA1c < 7.0% increased from 81.0% to 84.5% (P = .039), and the LDL-C target achievement rate (<1.8 mmol/L) improved markedly from 13.6% to 34.1% (P < .001). Multivariate regression analysis indicated that persistent smoking (OR = 2.27, P = .019) and failure to meet LDL-C targets (OR = 1.91, P = .025) were independent risk factors for MI. Furthermore, the greater the number of risk factors controlled, the lower the risk of MI. Patients achieving control of ≥ 4 risk factors had a significantly lower incidence of MI compared to those achieving control of ≤ 1 factor (P < .001). The control of risk factors in young CHD patients is closely related to the occurrence of MI events. Comprehensive interventions targeting multiple risk factors can significantly reduce the risk of MI. This study underscores the importance of smoking cessation, lipid management, and diabetes control in the secondary prevention of MI in young CHD patients, providing evidence for the optimization of clinical intervention strategies.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41709"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700927","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":"Mechanistic insights into the anticancer effects of Pinellia ternata (Thunb.) Ten. ex Breitenb. and Ligusticum chuanxiong Hort. ex S. H. Qiu & al. on papillary thyroid carcinoma: A network pharmacology approach.","authors":"Gang Wang, Jing Chen, Xiangding Kong, Kuanyu Wang","doi":"10.1097/MD.0000000000041841","DOIUrl":"10.1097/MD.0000000000041841","url":null,"abstract":"<p><p>This study aims to elucidate the mechanisms of action of Pinellia ternata (Thunb.) Ten. ex Breitenb. and Ligusticum chuanxiong Hort. ex S. H. Qiu & al. (PAL) in treating papillary thyroid carcinoma (PTC) using bioinformatics and network analysis. Compounds in PAL were identified from the HERB database. Potential herbal targets were predicted using the SwissADME and SwissTargetPrediction platforms. Differential expression genes related to PTC were extracted from the GEO database and protein-protein interaction networks were constructed using the String database and Cytoscape software. Additionally, gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were conducted, and core compound-target interactions were validated through molecular docking. Effective components identified included 32 from Pinellia ternata (Thunb.) Ten. ex Breitenb. and 105 from Ligusticum chuanxiong Hort. ex S. H. Qiu & al., comprising 825 targets. A total of 2155 differential expression genes related to PTC were selected using GEO2R software, with 71 therapeutic targets identified. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses suggest that PAL may exert effects through cancer-related pathways and signal transduction processes. Molecular docking indicated high binding affinity between several compounds and their targets. Specific active components in PAL may act through various mechanisms on PTC, offering scientific bases for further drug development and treatment strategies.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41841"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700936","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":"Pilot study of an integrative telehealth group intervention for chronic pain.","authors":"Laura Jean Priorello, Jeannie Anne Sperry, Claire Ida Yee, Shweta Kapoor, David Clarence Patchett, Cynthia Oswald Townsend","doi":"10.1097/MD.0000000000041952","DOIUrl":"10.1097/MD.0000000000041952","url":null,"abstract":"<p><p>The effectiveness of in-person psychological interventions for chronic pain populations has been widely studied. The current retrospective pilot study evaluates the effectiveness of a 10-week integrative telehealth pain group intervention consisting of cognitive, behavioral, mindfulness, and lifestyle strategies on anxiety, depression, pain catastrophizing, pain interference, and pain intensity. Participants at a large multidisciplinary hospital are referred internally from various medical departments within the hospital. The present study consists of data from 9 group cohorts from October 2020 to June 2022. The study included 86 patients, with 52 completing all 10 weeks of the intervention with post-questionnaire data available. Measures assessing anxiety, depression, pain catastrophizing, pain interference, and pain intensity at baseline and at the completion of the intervention. A series of paired samples t-tests were used to assess change in each outcome measure from baseline to after completion of the program. All the outcome variables including anxiety, depression, pain interference, pain intensity, and pain catastrophizing showed statistically significant reductions after the intervention compared to baseline assessments. There were no significant differences in any of the demographic variables (age, gender, ethnicity, education level) or chronic pain condition between participants who did and did not complete the program. Preliminary data suggest that this 10-week integrative telehealth pain group intervention significantly lowered anxiety, depression, pain catastrophizing, pain interference, and pain intensity from pre- to post-intervention. Larger, randomized controlled studies are needed to validate these results.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41952"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700683","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":"Psychosocial support and care for children with special healthcare needs and their families: A scoping review for enhancing the care system.","authors":"Tomo Nonoyama, Akiko Kadoma, Taro Kaneko, Kazuteru Niinomi, Itsuko Ozaki, Midori Asano","doi":"10.1097/MD.0000000000041944","DOIUrl":"10.1097/MD.0000000000041944","url":null,"abstract":"<p><strong>Background: </strong>Advances in medical technology have increased the identification of children with special healthcare needs (CSHCN), indicating the need to strengthen care systems. However, existing systematic reviews are outdated, over a decade old, and narrowly focused-primarily on hospital-based comprehensive care programs and family-centered care. This scoping review aimed to organize and integrate existing findings on care and support for CSHCN and their families from the available literature.</p><p><strong>Methods: </strong>We employed an extensive search in December 2023, utilizing databases such as PubMed, Web of Science, CINAHL, ERIC, and The Cochrane Library. Selected articles were thoroughly reviewed, categorized, and organized by the type of care and support addressed. The findings of the included studies were organized and integrated descriptively.</p><p><strong>Results: </strong>Following a comprehensive search and screening process, 49 articles were selected and categorized into 5 themes: care systems based on hospitals and other specialized institutions, specialized personnel or programs for care coordination/integrated care, support using telehealth technology to enhance and facilitate care, care aimed at reducing the psychological burden on the child and family, and peer and group support emphasizing the role of family and community. Publication years ranged from 1998 to 2023. The studies were conducted in 7 countries, predominantly in the United States, with additional studies from Canada, Australia, the United Kingdom, Japan, India, and Belgium.</p><p><strong>Conclusions: </strong>This study underscores the importance of establishing effective care systems that ensure continuous and smooth care coordination from multiple perspectives for the well-being of CSHCN and their families. To enhance support systems for the well-being of CSHCN and their families, it is necessary to pursue a multi-faceted approach that facilitates continuous and smooth care coordination from various perspectives.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41944"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700706","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":"Sporadic pancreatic desmoid-type fibromatosis with curative resection: A case report.","authors":"Jiayao Zhang, Chenming Liu, Fangzheng Zhou, Baochun Lu","doi":"10.1097/MD.0000000000041924","DOIUrl":"10.1097/MD.0000000000041924","url":null,"abstract":"<p><strong>Rationale: </strong>Desmoid-type fibromatosis (DF) is an uncommon, locally invasive, non-metastatic soft-tissue neoplasm with variable and unpredictable manifestations. The therapeutic arsenal of DF therapy is consistently expanding; however, there remains no standard treatment modality. Sporadic pancreatic DF is rarely described in current literature, reflecting a significant deficiency in clinical treatment experience, this case aims to share some clinical experiences that can serve as a reference for managing this rare disease.</p><p><strong>Patient concerns: </strong>A 36-year-old male presented with occasional abdominal discomfort and weight loss over a year. Ultrasound revealed a large mass in the pancreatic tail, which was not observed a year ago.</p><p><strong>Diagnoses: </strong>The diagnosis of DF was confirmed by immunohistochemistry nuclear staining of β-catenin.</p><p><strong>Interventions: </strong>Distal pancreatectomy with splenectomy was performed and the patient received no further therapy.</p><p><strong>Outcomes: </strong>After 13 months of follow-up, no recurrence or distant metastasis was observed.</p><p><strong>Lessons: </strong>DF is a distinct rare tumor entity, sporadic pancreatic DF is even rarer. It is imperative to select the individualized treatment strategy for each patient to optimize tumor control and enhance quality of life.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41924"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700841","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":"Identification of the relationship between 1400 blood metabolites and urolithiasis: A bidirectional Mendelian randomization study.","authors":"Haoyang Zhang, Haojie Mo, Peng Li, Qi Zhou, Gang Shen, Jiale Sun","doi":"10.1097/MD.0000000000041911","DOIUrl":"10.1097/MD.0000000000041911","url":null,"abstract":"<p><p>Relationships between blood metabolites and urolithiasis have been identified in few previous observational studies, and causality remains uncertain. We tried to examine whether blood metabolites were causally associated with upper and lower urinary stones in this bidirectional Mendelian randomization (MR) study. The causal relationship between 1400 blood metabolites and upper and lower urinary stones was investigated using genome-wide association study data. The primary analysis for causality analysis was the inverse variance weighted method, with 4 other methods used as complementary analyses. Intersection was then conducted to show the shared metabolites between upper and lower urinary tract stones, followed by the MR-Egger intercept test, Cochran Q test, leave-one-out analysis, MR-PRESSO and the linkage disequilibrium score regressions. The metabolic pathway analysis was conducted to identify potential metabolic pathways. Lastly, reverse MR analyses were also performed. We identified 15 metabolites as potential causal predictors of urinary stones in forward MR analyses. These metabolites consisted of 1 azole, 2 carbohydrates, 6 lipids, 1 nucleotide, 1 peptide, 1 urea, and 3 metabolites with unknown chemical properties. Additionally, urinary stones were found to be significantly associated with some of the above metabolites in reverse MR analyses. Metabolic pathway analysis identified several pathways that may be implicated in the development of urolithiasis. This MR study has established a causal relationship between 12 blood metabolites and the risk of upper and lower urinary tract stones. The identification of these blood metabolites provides valuable insights into early screening, prevention, and treatment of urolithiasis.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41911"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700891","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":"Identifying research activity on brain ultrasonography in craniocerebral diseases by bibliometric and visualized analysis of a 20-year journey of global publications.","authors":"Zaiyang Yu, Jinting Xiao, Fengqian Ma, Shengjie Li","doi":"10.1097/MD.0000000000041927","DOIUrl":"10.1097/MD.0000000000041927","url":null,"abstract":"<p><p>Brain ultrasonography has emerged as a key tool in neurocritical care. This study aimed to investigate the global research trends and future research directions in the application of brain ultrasonography for craniocerebral diseases using quantification and visualization approaches. Publications on brain ultrasonography published between 2004 and 2024 retrieved from the Web of Science Core Collection database were screened against predetermined inclusion and exclusion criteria and analyzed. The data were processed using VOSviewer and CiteSpace to identify core countries/regions, institutions, authors, journals, collaborations, and research trends. Over the past 2 decades, 1251 articles focusing on brain ultrasonography as the primary subject were published across 455 journals by 5655 authors from 1619 institutions in 84 countries/regions. Publications exhibited a fluctuating and gradually progressive trend, with the number of publications per year peaking between 2019 and 2021. The USA, the United Kingdom, and Germany emerged as leading countries in this field, demonstrating robust cooperation with other countries/regions. Additionally, the University of Leicester and Panerai RB was the most prolific institution and author, respectively. The clinical applications of brain ultrasonography have progressively broadened from neurocritical care to encompass the general intensive care unit and emergency department. Finally, recent scholarly attention has primarily been directed toward the \"deep learning framework\" and \"hypoxic-ischemic brain injury.\" Globally, publications focusing on brain ultrasonography displayed a fluctuating and gradually progressive trend over the past 2 decades. Moreover, primary clinical applications and techniques have been constantly expanding. Overall, the findings of our study expanded our understanding of the current status of brain ultrasonography, potentially guiding future development directions in this field.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41927"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700894","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":"Clinical value of blood routine and tumor markers in differentiating hepatocellular carcinoma from intrahepatic cholangiocarcinoma.","authors":"Wei Shi, Wen Jin, Lang Hong, Huo Wu, Shifeng Hu","doi":"10.1097/MD.0000000000041899","DOIUrl":"10.1097/MD.0000000000041899","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are the 2 major types of primary liver cancer, differing significantly in etiology, treatment strategies, and prognosis despite their common hepatic origin. Accurate preoperative differentiation between HCC and ICC is critical for optimizing treatment and improving patient outcomes. However, traditional diagnostic methods, including imaging and tumor markers, have limitations in sensitivity and specificity, necessitating the exploration of novel diagnostic approaches. This retrospective study included 165 patients diagnosed with HCC (n = 87) or ICC (n = 78) between January 2023 and January 2024. Preoperative data, including routine blood tests and tumor markers (e.g., alpha-fetoprotein [AFP], carbohydrate antigen 19-9 [CA19-9], carcinoembryonic antigen [CEA]), were collected. Blood routine parameters, such as white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR), were analyzed. Univariate and multivariate logistic regression analyses were conducted to identify independent diagnostic factors. A predictive model was constructed and its diagnostic performance evaluated using receiver operating characteristic curves. Subgroup analyses were performed to investigate diagnostic efficiency in different patient subsets. AFP and CA19-9 emerged as key tumor markers for differentiating HCC and ICC. AFP levels were significantly higher in HCC patients (P < .001), whereas CA19-9 levels were markedly elevated in ICC patients (P < .001). Among blood routine parameters, elevated WBC (P < .001), monocyte count (P = .005), NLR (P = .02), and monocyte ratio (P = .012) were associated with an increased risk of ICC, while a higher LMR was protective against ICC (P = .006). The multivariate logistic regression model demonstrated robust diagnostic accuracy, with an area under the curve (AUC) of 0.791. Subgroup analyses revealed superior diagnostic performance at higher levels of AFP (≥200 ng/mL, AUC = 0.90) and CA19-9 (≥37 U/mL, AUC = 0.91). The combination of blood routine parameters and tumor markers demonstrates high diagnostic efficacy in preoperatively differentiating HCC and ICC. Key markers, including AFP and CA19-9, along with inflammatory and immune-related blood parameters such as WBC, NLR, and LMR, significantly enhance diagnostic accuracy. This study provides valuable insights into refining diagnostic strategies and supports individualized treatment planning for patients with primary liver cancer.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41899"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700906","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":"Calcific tendonitis of the right epicondyle of the elbow: A case report.","authors":"Emmanuel Ackah, Deting Xue, Zhijun Pan","doi":"10.1097/MD.0000000000041604","DOIUrl":"10.1097/MD.0000000000041604","url":null,"abstract":"<p><strong>Rationale: </strong>Calcific tendinitis frequently occurs in the shoulder, and while it may also occur in other joints, such as the hip, knee, wrist, and finger joints, its occurrence in the elbow joint is relatively rare. Therefore, it is susceptible to delayed diagnosis or misdiagnosis at the initial occurrence. Appropriate imaging and treatment should be considered immediately when suspecting calcific tendonitis.</p><p><strong>Patient concerns: </strong>We detailed a young female who presented with progressive right elbow pain for the past 3 years with no past injury to the elbow. She had undergone conservative management for 2 years but was unsuccessful. Her pain became more intense 1 week prior, to the extent that she could not use her right upper limb to perform daily activities, and her sleep was severely disturbed. Therefore, she needed a possible therapeutic relief.</p><p><strong>Diagnosis: </strong>Clinical findings included elbow stiffness and tenderness of the lateral epicondyle of the humerus, and Cozen assessment was positive. Computed tomography showed a high-density macular focus and smooth edge of the lateral condyle of the right humerus and dorsal side of the ulnar olecranon. The plain radiograph showed patches in the right lateral condyle of the humerus and the dorsal part of the olecranon, indicating calcification of common extensor tendinosis.</p><p><strong>Interventions: </strong>Initially, conventional care was given to the patient with analgesics, physical therapy, or a resting regimen to decrease the pain and reduce the tedious load on the extensor tendon. Measures such as pain score, range of motion, and follow-up imaging after 8 weeks began until 2 years. However, her pain did not improve. Therefore, she was advised for surgical therapy and subsequently underwent surgical exploration of the elbow under general anesthesia. Histopathological examination of the excised tissue revealed fibrous ligament tissue with calcifications.</p><p><strong>Outcomes: </strong>At the 6-month follow-up, the postoperative plain radiograph showed complete removal of the heterotopic bony growth from the lateral epicondylar area with no recurrence of the heterotopic bone formation around the elbow joint. She had no pain with full elbow function and a full range of elbow extension and flexion (visual analog scale score of 0/10).</p><p><strong>Lessons: </strong>Calcific tendonitis of the elbow is uncommon; hence, its diagnosis and treatment may be late due to its scarcity. Therefore, appropriate imaging and treatment should be considered immediately when calcified tendonitis is suspected. A literature review is also necessary since it is not a daily condition.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41604"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700919","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":"Treatment and fertility outcomes of moss-like endometriosis with hemorrhagic ascites: A case report.","authors":"Feng Xu, Yimeng Gao, Fengxi He, Miao Zhao, Aihua Li","doi":"10.1097/MD.0000000000041872","DOIUrl":"10.1097/MD.0000000000041872","url":null,"abstract":"<p><strong>Rationale: </strong>Endometrial tissue in the greater omentum with a large amount of hemorrhagic ascites is relatively uncommon. Endometriosis is similar to ovarian malignancy in cases of hemorrhagic ascites. Hysterectomy and bilateral oophorectomy are the only effective and clear treatments, and their indications are limited by patient age and fertility. Conservative medical treatment is a viable option.</p><p><strong>Patient concerns: </strong>A 28-year-old female came to our hospital for treatment because of the discovery of a pelvic mass for 10 months. After admission, the patient underwent surgical treatment and was discharged within 1 week. She received medical treatment for 3 years after discharge. After medication withdrawal, the patient became pregnant and gave birth to a child without recurrence during the follow-up.</p><p><strong>Diagnoses: </strong>Initial diagnosis on first admission were \"'Pelvic inflammatory mass?' and 'endometriosis?'.\" After 10 months, the patient was readmitted to the hospital because of gradual enlargement of the mass, and was diagnosed with endometriosis.</p><p><strong>Interventions: </strong>The patient was treated with anti-infective rehydration therapy for the first time, and the patient was surgically treated for the second time, followed by gonadotropin-releasing hormone agonist (GnRH-α) and dienogest (DNG) treatment after surgery.</p><p><strong>Outcomes: </strong>After 6 cycles of GnRH-α treatment and 3 years of DNG treatment, a son was successfully born after discontinuation of the medication, and so far, there has been no recurrence or adverse reactions during the follow-up period.</p><p><strong>Lessons: </strong>Ascites is a rare manifestation of endometriosis and its diagnosis is difficult. Laparoscopy or exploratory laparotomy is required to confirm this diagnosis. Cyclic dysmenorrhea and abnormal menstruation warrant vigilance and should be investigated carefully. Hysterectomy and bilateral oophorectomy should be avoided as much as possible in patients with fertility needs and age adaptation, and symptoms can be successfully resolved with medical therapy.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41872"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700968","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}