Medicine international最新文献

{"title":"Ischemic fallopian tube necrosis with hydatid of Morgagni secondary to post‑caesarean intra‑abdominal adhesions entrapment in the 36th week of pregnancy: A case report and mini‑review of the literature.","authors":"Anna Thanasa, Efthymia Thanasa, Ioannis-Rafail Antoniou, Emmanouil Xydias, Apostolos Ziogas, Alexandros Leroutsos, Athanasios Chasiotis, Ioannis Paraoulakis, Ioannis Thanasas","doi":"10.3892/mi.2025.231","DOIUrl":"https://doi.org/10.3892/mi.2025.231","url":null,"abstract":"<p><p>Surgical adhesions in the pelvis are a well-known complication following cesarean sections. The present study describes a unique case involving acute intra-abdominal inflammation due to ischemic necrosis of the fallopian tube with a hydatid of Morgagni, resulting from entrapment in post-operative adhesions and leading to preterm labor. The patient described herein, a woman in her 36th week of pregnancy with a history of two prior lower-segment cesarean sections, presented with diffuse abdominal pain escalating in intensity and intermittent vomiting. A diagnosis of preterm labor was established, prompting a decision to proceed with cesarean section. The procedure was uneventful, revealing numerous post-operative pelvic adhesions intraoperatively. Further examination revealed ischemic necrosis of the left fallopian tube with a small hydatid of Morgagni, attributed to entrapment due to an adhesion, with no involvement of the left ovary. Upon dissecting the adhesion, tubal perfusion was promptly restored. A decision was made to preserve the affected fallopian tube and perform surgical drainage of the hydatid of Morgagni. Both the mother and newborn were discharged in excellent condition from the clinic on the 4th post-operative day. The case descrbied herein underscores the rarity of preterm labor resulting from ischemic tubal necrosis with a hydatid of Morgagni, secondary to post-cesarean section adhesions. It emphasizes the importance of an intraoperative examination for tubal and ovarian conditions to detect surgical adhesions and underscores the value of preoperative diagnosis and the prevention of post-operative adhesions in pregnant women undergoing cesarean section.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 3","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044807","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}

{"title":"Ulcerative fibroepithetial stromal polyp of the vulva with strong clinical suspicion for vulvar malignancy: A case report and mini‑review of the literature.","authors":"Efthymia Thanasa, Anna Thanasa, Ioannis-Rafail Antoniou, Emmanouil Xydias, Apostolos Ziogas, Evangelos Kamaretsos, Athanasios Chasiotis, Alexandros Leroutsos, Evangelia Simopoulou, Maria Mousia, Ioannis Thanasas","doi":"10.3892/mi.2025.230","DOIUrl":"https://doi.org/10.3892/mi.2025.230","url":null,"abstract":"<p><p>Fibroepithelial stromal polyps of the vulva are rare clinical entities, typically appearing as isolated polypoid stromal lesions, covered by squamous epithelium. The presence of non-traumatic ulcerative lesions on the tumor surface, particularly when the tumor is relatively small, necessitates the differentiation from malignant lesions of the vulva. The present study describes the case of a 44-year-old patient who presented to an outpatient gynecological clinic, reporting as her sole symptom the presence of a mass in the vulval region, which had been increasing in size over the past 12 months. Upon examination and palpation of the external genitalia, a painless pedunculated tumor measuring ~5 cm, originating from the upper third of the right labium majus, covered with normal skin, but bearing ulcerative lesions, was found. An ulcerative fibroepithelial polyp of the vulva was suspected, and surgical treatment with wide excision of the lesion was decided upon. A histological examination of the surgical specimen confirmed the diagnosis. The immunohistochemical analysis of the tumor ruled out malignancy. Following an uneventful post-operative course, the patient was discharged from the clinic the following day. At 6 months post-operatively, no recurrence of the fibroepithelial polyp was found at the site of pedicle resection. The present study, also provides a brief literature review of this rare disease entity following the case presentation, highlighting the necessity of wide surgical excision of vulvar fibroepithelial polyps and their differentiation from vulvar malignancies.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 3","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058131","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}

{"title":"Fuzzy‑set qualitative comparative analysis and fuzzy cognitive maps: Exploring pregnancy outcomes and maternal depression.","authors":"Antigoni Sarantaki, Anastasia Nomikou, Katerina Tzimourta, Eirini Orovou, Kleanthi Gourounti, Stavroula Barbounaki","doi":"10.3892/mi.2025.229","DOIUrl":"https://doi.org/10.3892/mi.2025.229","url":null,"abstract":"<p><p>The maternal antenatal attachment scale (MAAS), the pregnancy outcome questionnaire (POQ) and the Centre for Epidemiologic Studies Depression Scale (CESD), among other approaches, have been developed to address pregnancy-related psychological issues. However, the need to develop and validate effective scales to screen the complex experiences of pregnant women continues to be extensively discussed in the literature. The aim of the present study was to build and validate fuzzy models that represent the necessary and sufficient causal combinations that lead to higher levels of anxiety regarding pregnancy outcomes, maternal prenatal attachment to the unborn child and depressive symptoms, respectively. For this purpose, measurements from the MAAS, POQ and CESD scales, along with demographic data, were collected from 135 pregnant women, including cases of natural conception (NC) and assisted reproduction (ART) births. Fuzzy-set qualitative comparative analysis (FSQCA) was employed to produce sets of causal combinations, which were validated against their consistency and coverage. These combinations were then used to develop and validate fuzzy cognitive maps (FCMs) to model the fluctuations in the status of pregnant women. To the best of our knowledge, the present study is the first to utilize FSQCA or FCM to address this issue. The results indicated that the POQ was the distinguishing factor between NC and ART that led to higher MAAS levels. Marital status (MS) and state anxiety were found to lead to higher POQ levels for pregnancies derived from NC. For pregnancies following ART, the factors to consider include income, week of pregnancy, MS, MAAS intensity and trait anxiety. POQ was found to lead to higher levels of CESD for ART pregnancies, while NC, MS and state anxiety are also prerequisites. On the whole, the present study demonstrates that the proposed FSQCA- and FCM-based approach enables obstetricians and midwives to incorporate their expertise in evaluating cases on an individual basis, while also providing a framework for creating intelligent systems to support healthcare policy decisions.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 3","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001575","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}

{"title":"Frequency of vasovagal reactions in whole blood donation and contributing factors.","authors":"Sinan Demircioğlu, Ali Türk, Atilla Tomruk, Havva Demircioğlu, Atakan Tekinalp","doi":"10.3892/mi.2025.221","DOIUrl":"10.3892/mi.2025.221","url":null,"abstract":"<p><p>The aim of the present study was to identify the frequency of vasovagal reactions (VVRs) and the factors influencing their occurrence. For this purpose, a total of 742 donors who applied for whole blood donation at a blood center were included in the study. The frequency of VVR and its association with donor-related factors were assessed. The results revealed that the median age of the donors was 36 years, with 9.8% female and 90.2% male donors. VVRs were observed in 4.9% of the donors. The median age of the donors who experienced VVRs was found to be lower than that of those who did not experience VVRs. The incidence of VVRs was higher in first-time donors. The median blood donation rate for donors who experienced VVRs was 2, compared to 4 for those who did not, and the difference was statistically significant. On the whole, the present study demonstrates that the frequency of VVRs is higher in first-time blood donors, and that the blood donation rate is lower for those who experience VVRs. Preventive measures for VVRs, particularly for first-time donors, could increase the rate of blood donation.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 3","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525440","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}

{"title":"Hypokalemic periodic paralysis, a rare yet critical condition: A case report.","authors":"Saime Paydas, Mehmet Ali Gergerli, Ahmet Celik","doi":"10.3892/mi.2025.220","DOIUrl":"10.3892/mi.2025.220","url":null,"abstract":"<p><p>Hypokalemic periodic paralysis (HPP) is a rare disease. Due to channelopathy caused by mutations in skeletal muscle ion channels, episodes of sudden flaccid muscle weakness and hypokalemia develop as a result of various trigger factors. The present study reports the case of a 25-year-old male patient with HPP admitted with acute onset numbness and paralysis in the extremities accompanying hypokalemia (2.66 mEq/l). The patient became asymptomatic following treatment with a potassium (K) supplement and was diagnosed with HPP. The present study describes this case of HPP in an aim to remind colleagues of the possibility of HPP in hypokalemic patients with muscle weakness and flaccid paralysis.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 2","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517288","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}

{"title":"Myositis/myasthenia gravis caused by immune checkpoint inhibition: A report of two cases and a brief review of the literature.","authors":"Zenia Elavia, Victoria Jimenez, Roxanne Lockhart, Allison Muha, Mohamed Kazamel","doi":"10.3892/mi.2024.210","DOIUrl":"10.3892/mi.2024.210","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by enhancing the ability of the immune system to combat malignancies. Nivolumab and cemiplimab, monoclonal antibodies targeting programmed cell death protein 1, have exhibited notable therapeutic efficacy; however, they are associated with immune-related adverse events (irAEs). The present study describes the cases of 2 patients, a 71-year-old male with metastatic esophageal adenocarcinoma and a 66-year-old female with metastatic squamous cell carcinoma who developed acute/subacute onset rapidly progressive myositis/myasthenia gravis (MG) following treatment with nivolumab and cemiplimab. Both patients had negative MG antibody panels and the first had uninformative electrodiagnostic testing, rendering the diagnosis challenging. Additionally, 1 patient had myocarditis and the other had hepatitis. The mechanisms of ICI-induced myositis/MG remain unclear. Early recognition and intervention are vital for the prevention of severe morbidity and mortality. Treatment strategies, including the termination of the offending ICI medication, steroids, intravenous immunoglobulin (IVIG) and plasma exchange, should be tailored based on individual patient responses, and physicians should not hesitate to commence IVIG or plasma exchange once the diagnosis is established.. These cases underscore the importance of vigilance for myositis/MG in patients treated with ICIs, even with uninformative serological and electrodiagnostic testing, and the need for collaboration between multiple disciplines in managing complex irAEs including the associated myocarditis and hepatitis.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885948","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}

{"title":"Elevated frequency and severity of asthma in patients with hiatal hernia: A retrospective study.","authors":"Michel Abou Khalil, Khalil Hamadeh, Mario Fakhry, Elissa Chebly, Moussa Riachy, Hind Eid, Zeina Aoun Bacha","doi":"10.3892/mi.2024.209","DOIUrl":"10.3892/mi.2024.209","url":null,"abstract":"<p><p>Hiatal Hernia (HH) and gastroesophageal reflux disease (GERD) have been found to be associated with respiratory conditions, such as pulmonary fibrosis. However, their association with asthma remains ambiguous. Thus, the present cross-sectional, retrospective, monocentric study aimed to investigate the prevalence of asthma among patients with HH, evaluate its severity in these patients, and screen for associated respiratory symptoms. Additionally, the present study explored the association between the prevalence of asthma and various parameters, including sex, GERD medications and symptoms. For this purpose, a retrospective study, conducted at one central university medical center from January, 2020 to May, 2023, included patients with HH identified on a computed tomography scan. Patients were contacted and evaluated using structured questionnaires. Asthma-free patients underwent assessment for respiratory symptoms indicative of asthma using a validated questionnaire from the European Community Respiratory Health Survey. In patients with asthma, disease severity was assessed using the Global Initiative for Asthma symptom control criteria. The results revealed that out of 17,374 scans, 1,308 (7.53%) were positive for HH. Among the 453 cases eligible for analysis in the present study, 67 (14.79%) were diagnosed with asthma, of which 28 (41.79%) were diagnosed with uncontrolled asthma. Among the asthma-free patients, 136 (35.23%) reported at least one unspecified respiratory symptom. In the patients with HH, sex and GERD exhibited showed no association with asthma (P=0.07 and P=0.11, respectively). However, patients taking GERD medications exhibited a higher prevalence of asthma (P=0.03). On the whole, the present study demonstrates that the prevalence of asthma in patients with HH appears to be elevated. Hence, an ambivalence arises as regards the presence of a HH potentially associated with poorly controlled asthma and GERD medication potentially exacerbating asthma.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885588","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}

{"title":"Determination of a 'point of no return' in refractory chronic subdural hematomas: A case report and review of the literature.","authors":"Alexandros G Brotis, George Fotakopoulos, Vasiliki Epameinondas Georgakopoulou, Adamantios Kalogeras, Theodosis Spiliotopoulos, Ioannis Ioannidis, Kostas N Fountas","doi":"10.3892/mi.2024.199","DOIUrl":"10.3892/mi.2024.199","url":null,"abstract":"<p><p>Recurrence following the surgical evacuation of a chronic subdural hematoma (CSDH) occurs in up to 33% of cases. Several clinical and radiologic factors have been identified that are associated with the recurrence of hematoma. However, the optimal treatment for recurrent CSDH has not yet been determined. The present study, based on a case report, reviews the predictors and treatment options for refractory CSDHs. An 85-year-old male patient presented with a symptomatic bilateral CSDH. The hematoma was initially removed through a burr hole and closed drainage system, resulting in clinical improvement and in the radiographic resolution of the hematoma. At the first recurrence, steroids were administered and the hematoma was re-evacuated. After 1 month, the patient returned comatose due to a massive right subdural hematoma and was treated with an ipsilateral craniotomy and a membranectomy. After 2 days, the patient succumbed due to massive intraparenchymal bleeding. The treatment of refractory CSDHs is challenging. The failure of brain re-expansion and senile atrophy appear to be the key predictors of recurrence. Patients who are at high-risk need to be identified promptly and treated with a multidisciplinary approach that considers adjuvant medications, middle meningeal artery embolization and repeat hematoma evacuation, probably with a membranectomy and an endoscope.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"4 6","pages":"75"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559647","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}

{"title":"Successful treatment of osteosarcoma in a pregnant woman with survival of the gestational product: A case report and literature review.","authors":"Carlos Abraham Orpinel-González, Marcos Iglesias-González, Joel Herrera-Loya, Carlos Arturo Martínez-Méndez, Aaron Alberto Ramírez-Torres, Raúl Gerardo Ramírez-Medina","doi":"10.3892/mi.2024.197","DOIUrl":"10.3892/mi.2024.197","url":null,"abstract":"<p><p>Osteosarcoma (OS) is the most prevalent bone neoplasm of mesenchymal origin, accounting for 20% of all bone tumors worldwide. It mainly affects the marrow of long bones, and its diagnosis is more common among adolescents and the geriatric population. Histologically, it is characterized by high cellular variability, abundant osteoid and fibrotic material. In the early stages, it presents with only local symptoms such as pain, edema and limited joint mobility. This neoplasm, when detected promptly, is associated with a favorable prognosis and can be effectively treated through surgical removal and adjuvant therapy. The development of tumors in pregnant women is rare, and the occurrence of osteosarcoma is even more exceptional, with only 10 cases documented in the literature. Given its rarity, the present study describes the case of a female patient with OS diagnosed in the first trimester of pregnancy, where the patient responded well to treatment, resulting in no adverse effects on the pregnancy outcome.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"4 6","pages":"73"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560344","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}

{"title":"Predictive significance of hypertension in the incidence of complications in critically ill patients with COVID‑19: A retrospective cohort study.","authors":"Anita Katić, Nermina Rizvanović","doi":"10.3892/mi.2024.198","DOIUrl":"10.3892/mi.2024.198","url":null,"abstract":"<p><p>The association between hypertension as a pre-existing comorbidity and the severe form of coronavirus disease 2019 (COVID-19) remains unclear due to the contradictory results of previously published studies. The present study evaluated the predictive significance of hypertension in the incidence of complications among critically ill patients with COVID-19. The present study included 372 critically ill adults with COVID-19 pneumonia, hospitalized between January 1 and December 31, 2021. The study cohort was divided into the hypertension group (HTA group), which included 245 patients with a history of hypertension, or a non-HTA group (control group), which included 127 patients without hypertension. The incidence of complications was retrospectively extracted from medical records and compared between groups. Multivariate regression analysis (adjusted for potential confounders) and receiver operating characteristic (ROC) curve analysis determined the predictive significance of hypertension on the incidence of complications. The patients in the HTA group were more likely to receive invasive mechanical ventilation [odds ratio (OR), 1.696; P<0.02], develop sepsis (OR, 1.807; P<0.01) and develop complications (OR, 3.101; P<0.001). Hypertension was an independent positive predictor for invasive mechanical ventilation [area under the curve (AUC), 0.67; positive predictive value (PPV), 71.7%; P<0.05], sepsis (AUC, 0.69; PPV, 77.5%; P<0.026) and total complications per patient (AUC, 0.71; PPV, 81.4%; P<0.001). On the whole, the data of the present study indicate that a history of hypertension should be considered as an independent clinical predictor of a higher incidence of complications in critically ill patients with COVID-19. Patients with pre-existing hypertension and a diagnosis of COVID-19 require timely identification, additional attention and treatment to avoid a critical course and help improve outcomes.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"4 6","pages":"74"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559648","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}