HCA healthcare journal of medicine最新文献_第8页

Prophylactic Mesh Reinforcement for Non-Midline Incisions: A Systematic Review. 非中线切口的预防性网片加固：系统回顾

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1576

Rainna Coelho, Oluwatunmininu Anwoju, Ali Siddiqui, Andrew Youssef, Oscar A Olavarria, Naila H Dhanani, Karla Bernardi, Zuhair Ali, Mike K Liang

{"title":"Prophylactic Mesh Reinforcement for Non-Midline Incisions: A Systematic Review.","authors":"Rainna Coelho, Oluwatunmininu Anwoju, Ali Siddiqui, Andrew Youssef, Oscar A Olavarria, Naila H Dhanani, Karla Bernardi, Zuhair Ali, Mike K Liang","doi":"10.36518/2689-0216.1576","DOIUrl":"10.36518/2689-0216.1576","url":null,"abstract":"Background: Many abdominal-pelvic surgeries utilize incisions not along the linea alba, such as transverse, laparoscopic, ostomy reversal, or ostomy formation incisions. The prevalence of ventral incisional hernias (VIH) at these sites and the efficacy of prophylactic mesh in preventing VIH remains unclear.Methods: PubMed, Embase, Scopus, and Cochrane databases were systematically reviewed from inception to September 2022. We included published randomized controlled trials (RCTs) that compared prophylactic mesh reinforcement versus no mesh. The primary outcome was the incidence of VIH at postoperative follow-up equal to or greater than 24 months. Secondary outcomes included surgical site infection (SSI) and surgical site occurrence (SSO).Results: Of 3186 screened articles, only 3 RCTs with at least an 80% 2-year follow-up, encompassing a total of 901 patients, were included for analysis of non-midline VIH. Fifteen additional RCTs were included for analysis of secondary outcomes. The rate of parastomal hernias with prophylactic mesh was 21%, while it ranged from 44%-64% in the control group. The rate of incisional hernia after ostomy reversal with prophylactic mesh was 10%, and 16% in the control group. No clear evidence of a difference was found in rates of SSI or SSO between groups.Conclusion: There is limited evidence on the role of prophylactic mesh in preventing non-midline VIH. More studies at low risk for bias are needed to elucidate the balance of the long-term risks and benefits of prophylactic mesh for non-midline incisions.","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"5 2","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comfort Care. 舒适护理

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1877

Saptarshi Biswas

引用次数: 0

Management of Keloid-Associated Pruritus With Topical Crisaborole 2% Ointment: A Case Report. 用 2% 克利沙伯罗局部软膏治疗瘢痕疙瘩相关性瘙痒症：病例报告。

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1596

Daniel A Nguyen, Elizabeth Thai, Stephen E Weis

引用次数: 0

Ischemic Colitis in a Middle-Aged Man With COVID-19: Case Report and Review of Literature. 一名患有 COVID-19 的中年男子的缺血性结肠炎：病例报告与文献综述

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1362

Lara Appiah, Stephen Jones, Subhasis Misra

{"title":"Ischemic Colitis in a Middle-Aged Man With COVID-19: Case Report and Review of Literature.","authors":"Lara Appiah, Stephen Jones, Subhasis Misra","doi":"10.36518/2689-0216.1362","DOIUrl":"10.36518/2689-0216.1362","url":null,"abstract":"Introduction: Coronavirus disease 2019 (COVID-19) was a pandemic that began in 2019 and continues to have morbid and deadly consequences throughout the world. During the beginning of the pandemic, many considered older adults and immunocompromised younger adults to be the only populations at risk for the severe consequences of COVID-19. Throughout the pandemic, this was proven wrong with several case reports and studies showing that relatively younger adults can also suffer serious consequences from this perplexing virus.Case presentation: We report a rare case of ischemic colitis in a 42-year-old obese man who presented to the emergency department with quintessential COVID-19 symptoms. During his hospital course, he developed not only respiratory failure but also ischemic colitis, although he had no past medical history of any coagulopathy and was never on any pressors.Conclusion: As more case reports are being published, it has become evident that COVID-19 has the ability to cause serious extrapulmonary consequences due to an imposed state of hypercoagulability, and younger adults are at risk of facing these consequences, especially if they are obese. Thus, it is imperative that younger adults seek out the COVID-19 vaccine when available to them not only to protect those most vulnerable around them but also to protect themselves from these complications.","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"5 2","pages":"125-128"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Presentations of Cutaneous Disease in Various Skin Pigmentations: Seborrheic Dermatitis. 各种皮肤色素沉着的皮肤病表现：脂溢性皮炎。

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1631

Christian J Scheufele, Christopher M Wong, Daniel A Nguyen, Michael Carletti, Stephen E Weis

引用次数: 0

COVID-19 in the Setting of HIV and Severe Hemophilia A: A Case Report. COVID-19 在艾滋病和严重血友病 A 中的应用：病例报告。

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1615

Ryan Wilson, Chae Ko, Rahul Kashyap

{"title":"COVID-19 in the Setting of HIV and Severe Hemophilia A: A Case Report.","authors":"Ryan Wilson, Chae Ko, Rahul Kashyap","doi":"10.36518/2689-0216.1615","DOIUrl":"10.36518/2689-0216.1615","url":null,"abstract":"Introduction: A hyperactive immune response is the driving force behind severe Coronavirus disease 2019 (COVID-19). Complications of severe COVID-19 include acute respiratory distress syndrome, acute respiratory failure, and increased risk of venous thromboembolism (VTE). The management of patients with COVID-19 includes respiratory support, decreasing immune response to the virus to prevent the progression of disease, and anticoagulation to prevent VTE.Case presentation: We present the case of a patient with a history of human immunodeficiency virus (HIV) and hemophilia A admitted with COVID-19. This case demonstrates the difficulties present when managing COVID-19 in patients with specific comorbidities. Anticoagulation is a recommended component of COVID-19 treatment but is contraindicated in patients with severe hemophilia due to increased risk for bleeding. Research has also shown that dexamethasone decreases mortality in patients with COVID-19, but doctors should use dexamethasone cautiously in patients with HIV since it is an immunosuppressant. Taking certain antiretroviral therapies, such as rilpivirine, also contraindicates the use of dexamethasone.Conclusion: In this case, it is important to monitor for the risk and presence of superimposed bacterial or opportunistic infections. Treating a patient with these comorbidities who is infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) highlights the importance of balancing the risks and benefits.","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"5 2","pages":"145-150"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Actinic Granuloma Complicated by Secondary Syphilis: A Case Report. 继发性梅毒并发放线菌肉芽肿：病例报告。

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1636

Kevin H Nguyen, Christopher M Wong, Ethan Q Nguyen

{"title":"Actinic Granuloma Complicated by Secondary Syphilis: A Case Report.","authors":"Kevin H Nguyen, Christopher M Wong, Ethan Q Nguyen","doi":"10.36518/2689-0216.1636","DOIUrl":"10.36518/2689-0216.1636","url":null,"abstract":"Introduction: Actinic granuloma (AG) is a rare skin eruption thought to result from a sun-induced inflammatory response attracting giant cells, which are large, multinucleated, and inflammatory, to form granulomas and degrade surrounding elastic material. Clinically, lesions begin on sun-exposed skin as pink papules and nodules that coalesce into demarcated annular plaques with a hypopigmented center. Histologically, actinic elastosis surrounds the outer annulus ring, with histiocytes and giant cells within the raised border, and the innermost central zone is filled with minimal to absent elastic fibers.Case presentation: We present a middle-aged female with a pruritic eruption of diffuse erythematous macules and papules coalescing into plaques with mild scale involving the scalp, face, neck, torso, and upper and lower extremities, including the palms and soles, but sparing the ears, bilateral axillae, elbows, and knees. Skin biopsies revealed solar elastosis and abundant multinucleated foreign body giant cells with ingested elastic fibers. The patient's clinical presentation and histopathology were consistent with a diagnosis of AG. Furthermore, spirochete immunostaining of the specimens revealed multiple Treponema pallidum spirochetes throughout the epidermis and dermis. Secondary syphilis with primary chancre was added to the diagnosis. Treatment included oral and topical steroids followed by intravenous penicillin G. After 1 month, all lesions had resolved with post-inflammatory erythema.Conclusion: Our patient differs from the typical presentation in describing intense pruritus with her eruption. This interesting collision reminds clinicians to retain a high index of suspicion for multiple diagnoses in a single patient.","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"5 2","pages":"165-169"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case Series of Unusual IgA Vasculitis. 非同寻常的 IgA 血管炎病例系列。

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1627

Jared Bradley, Ian Whitaker, Brittany Lyons, Amy Mangla

{"title":"A Case Series of Unusual IgA Vasculitis.","authors":"Jared Bradley, Ian Whitaker, Brittany Lyons, Amy Mangla","doi":"10.36518/2689-0216.1627","DOIUrl":"10.36518/2689-0216.1627","url":null,"abstract":"Introduction: Immunoglobulin A vasculitis (IgA)is a rare condition characterized by palpable purpura, often involving the skin, gastrointestinal tract, joints, and kidneys. Presentation is usually acute and is more common in children and adolescents of Southeast Asian and European descent. In the adult population, it is less common and therapies are not as well-established.Case presentation: Disease prevalence of IgA vasculitis outside Southeast Asian and European populations is not well-documented. In this case series, we present 2 cases of IgA vasculitis in 2 older adult males, one of Native American descent and one of African American descent.Conclusion: IgA vasculitis must be considered within the adult population, and it is not limited to certain ethnic groups. Further research is needed to give clarity on the best treatment options for adults with IgA vasculitis. We believe that patients presenting with IgA vasculitis are best managed in a multidisciplinary approach, especially those patients with limited improvement despite the initiation of corticosteroids. Our 2 cases should raise awareness of IgA vasculitis in patients with skin rashes and elevated creatinine levels.","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"5 2","pages":"157-164"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mpox-Induced Proctitis. Mpox诱发的直肠炎。

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1585

Saif Ghias, Niyati Joshi, Dzenana Cabaravdic, Ramesh Nathan, Jasprit Takher

{"title":"Mpox-Induced Proctitis.","authors":"Saif Ghias, Niyati Joshi, Dzenana Cabaravdic, Ramesh Nathan, Jasprit Takher","doi":"10.36518/2689-0216.1585","DOIUrl":"10.36518/2689-0216.1585","url":null,"abstract":"Introduction: Mpox, formerly known as monkeypox, is a zoonotic virus in the genus Orthopoxvirus, which has a variable incubation period and an extensive array of symptoms. While those infected with Mpox have displayed generalized viral prodromal symptoms, atypical symptoms such as proctitis have also been seen. Proctitis associated with Mpox is a relatively infrequent initial presenting symptom with a reported incidence of 14-32.9% that has seen an uptick in prevalence since the 2022 global endemic.Case presentation: We present a confirmed case of Mpox in a 27-year-old male who presented with 3 days of intermittent anorectal bleeding and various forms of cutaneous lesions at different stages of healing. He had engaged in unprotected sexual intercourse 8 days prior to the onset of his symptoms in New York, which at the time was the epicenter of the endemic. Computed tomography imaging showed thickening of the rectum with associated lymphadenopathy, consistent with findings of acute proctitis.Conclusion: The intent of this case report is to acknowledge the prevalence of the Mpox virus. Since the endemic, increased cases of Mpox have led to more complications that have been identified and studied by public health experts. The complication of proctitis due to Mpox in a certain subset of patients is important to fully understand that while this virus presents with a generalized prodrome like other viruses, these unique gastrointestinal presentations and findings may be the first step in identifying this infection and ensuring rapid treatment if future endemics arrive.","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"5 2","pages":"129-132"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Colon Cancer Metastasis to Spermatic Cord Presenting as an Inguinal Hernia. 结肠癌转移至精索，表现为腹股沟疝。

HCA healthcare journal of medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.36518/2689-0216.1593

Jessica G Laenger, Eamon Ff Rooney, Patrick F Dial, Candie T Le, Sanda A Tan

引用次数: 0