BACKGROUND: The use and abuse of designer drugs has been recognized for decades; however there are many derivatives of compounds that make their way into the community. Abuse of compound(s) known on the street as &quo...BACKGROUND: The use and abuse of designer drugs has been recognized for decades; however there are many derivatives of compounds that make their way into the community. Abuse of compound(s) known on the street as "bath salt" is on the rise.METHODS: We report the case of a 33-year-old man who complained of "flashbacks" and right arm shaking that followed a night of "bath salt" snorting. The active compound methylenedioxypyrovalerone methamphetamine(MDPV) was confirmed; however, analysis of three different "bath salt" products showed difference in their active components.RESULTS: The patient's symptoms remained stable and he was discharged home after observation in the emergency department with instructions to return for any symptom progression.CONCLUSION: Practitioners should be aware of the abuse of the compounds and that not all "bath salt" products contain MDPV.展开更多
BACKGROUND:According to the literature,generalized seizure as a presenting sign of stroke is rare,and in the reported cases it was accompanied by a focal neurological deficit.Presentation of a small ischemic atherothr...BACKGROUND:According to the literature,generalized seizure as a presenting sign of stroke is rare,and in the reported cases it was accompanied by a focal neurological deficit.Presentation of a small ischemic atherothrombotic brain infarction with convulsive generalized seizure is very rare.METHODS:We reported a patient with acute small ischemic atherothrombotic infarction associated with an episode of generalized tonic-clonic seizure,a rare clinical manifestation in this type of stroke.The patient was treated with anti-epileptic therapy after admission.RESULTS:The patient was discharged with oral administration of phenytoin 100 mg TDS,aspirin 80 mg daily,and atorvastatin 40 mg daily.CONCLUSION:Small ischemic atherothrombotic infarction can present only with a seizure without any focal neurological deficit.展开更多
BACKGROUND Pyogenic infectious spondylitis(PIS)is a rare condition,with an incidence between 0.2 and 2 cases per 100000 per annum.It’s most common symptom-back or neck pain-occurs in more than 90%of cases.Herein,we r...BACKGROUND Pyogenic infectious spondylitis(PIS)is a rare condition,with an incidence between 0.2 and 2 cases per 100000 per annum.It’s most common symptom-back or neck pain-occurs in more than 90%of cases.Herein,we reported a case of thoracic PIS accompanied by pneumothorax in a 65-year-old male patient.CASE SUMMARY A 65-year-old man presented with right chest pain and dyspnea.The initial erect posteroanterior chest radiography revealed pneumothorax,which was further evaluated by chest computed tomography,revealing pleural effusion in the right lung and a paravertebral abscess with bony destruction of vertebral body.Based on magnetic resonance imaging,the patient was diagnosed with thoracic infectious spondylitis with an anterior paravertebral abscess.He was prescribed antibiotics and underwent neurosurgery due to aggravated symptoms and neurologic deficit.Tissue examination revealed that the cause of pleural effusion and pneumothorax was Staphylococcus aureus infection contiguously spread to lung pleura.After several surgical treatments with intravenous antibiotic therapy for two months and transition to oral antibiotics(rifampin 600 mg qd and ciprofloxacin 500 mg bid),the patient received physical therapy to recover balance.One month after discharge,the patient had no chest pain or dyspnea,and exhibited no elevation in inflammatory markers or new thoracic lesions.CONCLUSION To our knowledge,this is the very first report of a case of thoracic PIS with pneumothorax.展开更多
Background:The main purpose of this article is to explore the differences between mild-to-moderate acute stroke patients with hyperhomocysteine and similar patients with normal homocysteine in risk factors,cerebral ar...Background:The main purpose of this article is to explore the differences between mild-to-moderate acute stroke patients with hyperhomocysteine and similar patients with normal homocysteine in risk factors,cerebral arterial stenosis,neurological deficit,cognitive function impairment.The subjects included gender,body mass index,whether to combine hypertension,blood glucose level,blood lipid,national institutes of health stroke scale(NIHSS)score,whether to combine cerebral arterial stenosis and Montreal cognitive assessment scores.Method:Twentyseven mild-to-moderate acute stroke patients with hyperhomocysteinemia(NIHSS score≤15 points)and 34 mildto-moderate acute stroke patients without hyperhomocysteinemia were admitted in the past year as the research objects.N=27 stroke patients with hyperhomocysteine were set as the experimental group,and N=34 patients without hyperhomocysteine were set as the control group.A retrospective study of clinical data from both groups of patients was conducted.Compare the data of the 2 groups of patients with differences in the above study data,and then explore the specific impact of hyperhomocysteinemia on the above experimental indicators.Results:(1)NIHSS scores of patients in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05).(2)The incidence of cerebrovascular stenosis(including intracranial and extracranial arteries)in the experimental group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).(3)The degree of cognitive impairment in the experimental group was significantly higher than that in the control group,with a statistically significant difference(P<0.05).(4)The proportion of male patients in the study group was significantly higher than that in the control group(P<0.05).(5)The level of homocysteine in the experimental group was positively correlated with NIHSS score(r=0.602,P<0.05)and negatively correlated with Montreal cognitive assessment score(r=−0.551,P<0.05).Conclusion:Mildto-moderate stroke patients with hyperhomocysteinemia are more likely to have severe neurological deficits,and most patients will be associated with more severe intracranial arterial and extracranial arterial stenosis.Mild-tomoderate stroke patients with high homocysteine are more likely to develop cognitive impairment.Finally,high homocysteine levels were associated with neurological impairment and cognitive impairment.Therefore,clinically,patients with acute stroke and hyperhomocysteinemia should be actively treated with hypohomocysteine,and it is recommended to improve cerebrovascular evaluation(computed tomography angiography or magnetic resonance angiography)for hospitalized patients even with hemorrhagic stroke.Stroke patients with hyperhomocysteinemia should be given more aggressive treatment(ischemic stroke patients should be given more optimized antithrombotic therapy,hemorrhagic stroke patients should be given more aggressive dehydrating cranial pressure reduction,et al.).Finally,brain protectants and cognitive function improvement therapy can be given in advance to prevent cognitive function deterioration.展开更多
Objective:The objective of this study was to investigate the effects and possible mechanisms of action of ginseng on cerebral vasospasm and early brain injury(EBI)following hemorrhagic stroke.Materials and Methods:Spr...Objective:The objective of this study was to investigate the effects and possible mechanisms of action of ginseng on cerebral vasospasm and early brain injury(EBI)following hemorrhagic stroke.Materials and Methods:Sprague-Dawley(SD)rats(n=48)were randomly divided into sham operation(sham group),subarachnoid hemorrhage(SAH)model(SAH group),normal saline(NS group),and Ginaton(Extract of Ginkgo Biloba Leaves Drops)intervention(gin group)groups.MCP-1 m RNA and tumor necrosis factor levels were detected using reverse transcription-polymerase chain reaction.The relative expression of m RNA was detected by Western blotting.Results:(1)Compared with the sham group,the SAH,NS,and gin groups had different degrees of neurological dysfunction.Compared with the SAH and NS groups,the neurological deficits in the gin group were significantly improved(P<0.05).(2)Compared with the sham group,the relative expression levels of MCP-1 m RNA in the SAH,NS,and gin groups were 5.1±0.9,3.4±0.6,and 2.5±0.4,respectively;the relative expression levels of m RNA were 13.3±2.4,11.2±1.8,and 3.8±0.6,respectively.(3)The apoptosis rates of brain tissue in the sham,SAH,NS,and gin groups were 4.8±0.7,54.2±10.3,50.1±7.4,and 28.4±4.5,respectively.(4)Western blot showed that the relative expression levels of toll-like receptor-4(TLR-4)protein in the sham,SAH,NS,and gin groups were 0.29±0.03,0.87±0.15,0.65±0.13,and 0.41±0.17,respectively;the relative expression levels of B protein were 0.21±0.04,0.96±0.14,0.73±0.18,and 0.30±0.05,respectively.Gin treatment could inhibit TLR-4 and nuclear factor-κB(NF-κB)protein expression.Conclusions:Dona tablets may inhibit activation of the NF-κB signaling pathway,and SAH-induced inflammatory response,so as to reduce cerebral vasospasm and EBI.展开更多
文摘BACKGROUND: The use and abuse of designer drugs has been recognized for decades; however there are many derivatives of compounds that make their way into the community. Abuse of compound(s) known on the street as "bath salt" is on the rise.METHODS: We report the case of a 33-year-old man who complained of "flashbacks" and right arm shaking that followed a night of "bath salt" snorting. The active compound methylenedioxypyrovalerone methamphetamine(MDPV) was confirmed; however, analysis of three different "bath salt" products showed difference in their active components.RESULTS: The patient's symptoms remained stable and he was discharged home after observation in the emergency department with instructions to return for any symptom progression.CONCLUSION: Practitioners should be aware of the abuse of the compounds and that not all "bath salt" products contain MDPV.
文摘BACKGROUND:According to the literature,generalized seizure as a presenting sign of stroke is rare,and in the reported cases it was accompanied by a focal neurological deficit.Presentation of a small ischemic atherothrombotic brain infarction with convulsive generalized seizure is very rare.METHODS:We reported a patient with acute small ischemic atherothrombotic infarction associated with an episode of generalized tonic-clonic seizure,a rare clinical manifestation in this type of stroke.The patient was treated with anti-epileptic therapy after admission.RESULTS:The patient was discharged with oral administration of phenytoin 100 mg TDS,aspirin 80 mg daily,and atorvastatin 40 mg daily.CONCLUSION:Small ischemic atherothrombotic infarction can present only with a seizure without any focal neurological deficit.
基金Supported by a Clinical Research Grant from Pusan National University Hospital in 2020.
文摘BACKGROUND Pyogenic infectious spondylitis(PIS)is a rare condition,with an incidence between 0.2 and 2 cases per 100000 per annum.It’s most common symptom-back or neck pain-occurs in more than 90%of cases.Herein,we reported a case of thoracic PIS accompanied by pneumothorax in a 65-year-old male patient.CASE SUMMARY A 65-year-old man presented with right chest pain and dyspnea.The initial erect posteroanterior chest radiography revealed pneumothorax,which was further evaluated by chest computed tomography,revealing pleural effusion in the right lung and a paravertebral abscess with bony destruction of vertebral body.Based on magnetic resonance imaging,the patient was diagnosed with thoracic infectious spondylitis with an anterior paravertebral abscess.He was prescribed antibiotics and underwent neurosurgery due to aggravated symptoms and neurologic deficit.Tissue examination revealed that the cause of pleural effusion and pneumothorax was Staphylococcus aureus infection contiguously spread to lung pleura.After several surgical treatments with intravenous antibiotic therapy for two months and transition to oral antibiotics(rifampin 600 mg qd and ciprofloxacin 500 mg bid),the patient received physical therapy to recover balance.One month after discharge,the patient had no chest pain or dyspnea,and exhibited no elevation in inflammatory markers or new thoracic lesions.CONCLUSION To our knowledge,this is the very first report of a case of thoracic PIS with pneumothorax.
文摘Background:The main purpose of this article is to explore the differences between mild-to-moderate acute stroke patients with hyperhomocysteine and similar patients with normal homocysteine in risk factors,cerebral arterial stenosis,neurological deficit,cognitive function impairment.The subjects included gender,body mass index,whether to combine hypertension,blood glucose level,blood lipid,national institutes of health stroke scale(NIHSS)score,whether to combine cerebral arterial stenosis and Montreal cognitive assessment scores.Method:Twentyseven mild-to-moderate acute stroke patients with hyperhomocysteinemia(NIHSS score≤15 points)and 34 mildto-moderate acute stroke patients without hyperhomocysteinemia were admitted in the past year as the research objects.N=27 stroke patients with hyperhomocysteine were set as the experimental group,and N=34 patients without hyperhomocysteine were set as the control group.A retrospective study of clinical data from both groups of patients was conducted.Compare the data of the 2 groups of patients with differences in the above study data,and then explore the specific impact of hyperhomocysteinemia on the above experimental indicators.Results:(1)NIHSS scores of patients in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05).(2)The incidence of cerebrovascular stenosis(including intracranial and extracranial arteries)in the experimental group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).(3)The degree of cognitive impairment in the experimental group was significantly higher than that in the control group,with a statistically significant difference(P<0.05).(4)The proportion of male patients in the study group was significantly higher than that in the control group(P<0.05).(5)The level of homocysteine in the experimental group was positively correlated with NIHSS score(r=0.602,P<0.05)and negatively correlated with Montreal cognitive assessment score(r=−0.551,P<0.05).Conclusion:Mildto-moderate stroke patients with hyperhomocysteinemia are more likely to have severe neurological deficits,and most patients will be associated with more severe intracranial arterial and extracranial arterial stenosis.Mild-tomoderate stroke patients with high homocysteine are more likely to develop cognitive impairment.Finally,high homocysteine levels were associated with neurological impairment and cognitive impairment.Therefore,clinically,patients with acute stroke and hyperhomocysteinemia should be actively treated with hypohomocysteine,and it is recommended to improve cerebrovascular evaluation(computed tomography angiography or magnetic resonance angiography)for hospitalized patients even with hemorrhagic stroke.Stroke patients with hyperhomocysteinemia should be given more aggressive treatment(ischemic stroke patients should be given more optimized antithrombotic therapy,hemorrhagic stroke patients should be given more aggressive dehydrating cranial pressure reduction,et al.).Finally,brain protectants and cognitive function improvement therapy can be given in advance to prevent cognitive function deterioration.
基金financially supported by the Xingtai Key Research Plan Project(2021zc096)。
文摘Objective:The objective of this study was to investigate the effects and possible mechanisms of action of ginseng on cerebral vasospasm and early brain injury(EBI)following hemorrhagic stroke.Materials and Methods:Sprague-Dawley(SD)rats(n=48)were randomly divided into sham operation(sham group),subarachnoid hemorrhage(SAH)model(SAH group),normal saline(NS group),and Ginaton(Extract of Ginkgo Biloba Leaves Drops)intervention(gin group)groups.MCP-1 m RNA and tumor necrosis factor levels were detected using reverse transcription-polymerase chain reaction.The relative expression of m RNA was detected by Western blotting.Results:(1)Compared with the sham group,the SAH,NS,and gin groups had different degrees of neurological dysfunction.Compared with the SAH and NS groups,the neurological deficits in the gin group were significantly improved(P<0.05).(2)Compared with the sham group,the relative expression levels of MCP-1 m RNA in the SAH,NS,and gin groups were 5.1±0.9,3.4±0.6,and 2.5±0.4,respectively;the relative expression levels of m RNA were 13.3±2.4,11.2±1.8,and 3.8±0.6,respectively.(3)The apoptosis rates of brain tissue in the sham,SAH,NS,and gin groups were 4.8±0.7,54.2±10.3,50.1±7.4,and 28.4±4.5,respectively.(4)Western blot showed that the relative expression levels of toll-like receptor-4(TLR-4)protein in the sham,SAH,NS,and gin groups were 0.29±0.03,0.87±0.15,0.65±0.13,and 0.41±0.17,respectively;the relative expression levels of B protein were 0.21±0.04,0.96±0.14,0.73±0.18,and 0.30±0.05,respectively.Gin treatment could inhibit TLR-4 and nuclear factor-κB(NF-κB)protein expression.Conclusions:Dona tablets may inhibit activation of the NF-κB signaling pathway,and SAH-induced inflammatory response,so as to reduce cerebral vasospasm and EBI.
