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  • Ovid Technologies (Wolters Kluwer Health)  (3)
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  • Ovid Technologies (Wolters Kluwer Health)  (3)
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  • 1
    Online Resource
    Online Resource
    Clinical analysis of the serum muscle enzyme spectrum of patients with newly diagnosed Sheehan’s syndrome
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Medicine Vol. 101, No. 39 ( 2022-09-30), p. e30834-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 101, No. 39 ( 2022-09-30), p. e30834-
    Abstract: We investigated the factors associated with serum muscle enzyme elevation in patients with Sheehan’s syndrome. A total of 48 patients who were newly diagnosed with Sheehan’s syndrome were included and divided into 3 groups: Group 1, creatine kinase (CK) ≥ 1000 U/L; Group 2, 140  〈  CK  〈  1000 U/L; and Group 3, CK ≤ 140 U/L. Differences in serum muscle enzymes, serum electrolytes, blood glucose and hormones were compared among the 3 groups. A Spearman correlation analysis and multiple linear regression analysis were performed on serum muscle enzymes and the other variables. Four patients in Group 1 underwent electromyography. Fourteen, 26 and 8 patients were divided into Group 1, Group 2, and Group 3, respectively. The levels of plasma osmolality, serum sodium, free triiodothyronine (FT3) and free thyroxine (FT4) in Group 1 were lower than those in Group 3 at admission ( P   〈  .05). There were significant differences in CK, CK-MB, aspartate aminotransferase, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase among the three groups ( P   〈  .05). CK was correlated with serum sodium ( r  = −0.642, P   〈  .001), serum potassium ( r  = −0.29, P  = .046), plasma osmolality ( r  = −0.65, P   〈  .001), FT3 ( r  = −0.363, P  = .012), and FT4 ( r  = −0.450, P  = .002). Moreover, creatine kinase isoenzyme-MB (CK-MB) was correlated with serum sodium ( r  = −0.464, P  = .001) and plasma osmolality ( r  = −0.483, P   〈  .001). The multiple linear regression showed that serum sodium was independently and negatively correlated with CK ( r  = −0.352, P  = .021). The electromyogram results supported the existence of myogenic injury. Sheehan’s syndrome is prone to be complicated by nontraumatic rhabdomyolysis, with both a chronic course and acute exacerbation. Serum muscle enzymes should be routinely measured. For patients with CK levels  〉  1000 U/L, a CK-MB/CK ratio  〈  6% can be a simple indicator to differentiate rhabdomyolysis from acute myocardial infarction. Abnormal serum muscle enzymes observed in Sheehan’s syndrome may be associated with hypothyroidism and with hyponatremia in particular.
    Type of Medium: Online Resource
    ISSN: 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000030834
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2049818-4
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  • 2
    Online Resource
    Online Resource
    A study on the puncture method of extrapedicular infiltration anesthesia applied during lumbar percutaneous vertebroplasty or percutaneous kyphoplasty
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Medicine Vol. 98, No. 33 ( 2019-08), p. e16792-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 98, No. 33 ( 2019-08), p. e16792-
    Abstract: Extrapedicular infiltration anesthesia (EPIA) was reported for percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) and provided good local anesthetic effects. Because of differences in anatomical morphology at each lumbar level, the puncture method of EPIA is not uniform in each lumbar vertebrae. To accurately insert the anesthetic needle into the extrapedicular region, we researched the puncture method of EPIA at each lumbar level. We retrospectively analyzed computed tomography (CT) images in 230 patients with lumbar osteoporotic fractures, including 59 L1 fractures, 54 L2 fractures, 50 L3 fractures, 36 L4 fractures, and 31 L5 fractures. The puncture of EPIA was simulated in every fractured vertebrae through CT, and the skin puncture point, puncture direction, and puncture depth of the anesthetic needle were observed. These specific parameters were the distance from the skin puncture point to the superior border of the pedicle projection on the skin (distance AD), distance from the skin puncture point to the lateral border of the pedicle projection on the skin (distance BC), sagittal section angle (SSA), transverse section angle (TSA), and depth of EPIA. As the lumbar ordinal number increased, the SSA, distance AD, TSA, and distance BC for each lumbar level gradually increased, and the puncture depth gradually decreased, all these parameters showed significant differences among the 5 lumbar levels ( P   〈  .001). The recommended puncture methods for EPIA at each lumbar level, including distance AD, distance BC, SSA, and TSA, were as follows: in L1, 4 mm, 8 mm, 9° and 8°; in L2, 6 mm, 10 mm, 11° and 10°; in L3, 9 mm, 13 mm, 12° and 12°; in L4, 12 mm, 18 mm, 16° and 18°; and in L5, 20 mm, 26 mm, 24° and 24°. The depth of EPIA was 13 mm in L1-L3 and 11 mm in L4-L5. By confirming the skin puncture point and puncture direction of the anesthetic needle, from an anatomical perspective, EPIA is feasible for lumbar PVP (PKP).
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000016792
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2049818-4
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Cardiovascular risk in primary aldosteronism : A systematic review and meta-analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Medicine Vol. 98, No. 26 ( 2019-06), p. e15985-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 98, No. 26 ( 2019-06), p. e15985-
    Abstract: This study aimed to evaluate whether the increased cardiovascular risk and the incidence of cerebrovascular (CCV) events in hypertensive patients were related to primary aldosteronism (PA). Methods: The PubMed, EmBase, and the Cochrane Central Register of Controlled Trials were searched to evaluate the risk of CCV in PA patients and compared to essential hypertension (EH) patients. The mean differences (MD) and the risk ratios (RR) were calculated to assess the risk of main outcomes, such as stroke, coronary artery disease, left ventricular hypertrophy (LVH), levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, and urinary potassium. Results: We identified 31 individual studies including 4546 patients in PA group and 52,284 patients in EH group. Our results revealed that PA was significantly associated with increased risk of stroke (RR=2.03, 95% CI = 1.71–2.39, P heterogeneity  = .331, I 2  = 12.7%), coronary artery disease (RR = 1.67, 95% CI = 1.23–2.25, P heterogeneity  = .043, I 2  = 48.3%), and LVH (RR = 1.54, 95% CI = 1.29–1.83, P heterogeneity  = .004, I 2  = 62.6%) when compared with those in the EH group. Moreover, PA group had significantly increased levels of SBP (WMD = 4.14, 95% CI = 2.60–5.68, P heterogeneity   〈  .001, I 2  = 84.3%), DBP (WMD = 2.65, 95% CI = 1.83–3.47, P heterogeneity   〈  .001, I 2  = 77.7%), and urinary potassium (SMD = 0.04, 95% CI = -0.03–0.11, P heterogeneity  = .827, I 2  = 0%) when compared to EH group. However, no significant difference was observed in the levels of blood glucose between the groups. Conclusions: These findings suggested that PA significantly increased the risk of cardiac and cerebrovascular complications. In addition, patients with PA might benefit from a periodic assessment of CCV risk.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000015985
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2049818-4
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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