病毒性脑炎作为影响世界公共卫生的主要疾病之一,是一种严重的中枢神经系统感染。白细胞计数的升高通常与感染和炎症相关,PCT是一种在感染时血浆中浓度升高的蛋白质,IL-6在急性炎症中起着重要作用,S100蛋白则往往代表了神经损伤和炎症...病毒性脑炎作为影响世界公共卫生的主要疾病之一,是一种严重的中枢神经系统感染。白细胞计数的升高通常与感染和炎症相关,PCT是一种在感染时血浆中浓度升高的蛋白质,IL-6在急性炎症中起着重要作用,S100蛋白则往往代表了神经损伤和炎症。在病毒性脑炎中,上述指标均可能发生变化。现本文对上述指标与重症病毒性脑炎的相关性做简要综述,以期为重症病毒性脑炎早期识别提供更多依据。Viral encephalitis, as one of the major diseases affecting global public health, is a serious central nervous system infection. The increase in white blood cell count is usually associated with infection and inflammation. PCT is a protein that increases in concentration in the plasma during infection, IL-6 plays an important role in acute inflammation, and S100 protein often represents nerve damage and inflammation. In viral encephalitis, the above indicators may undergo changes. This article provides a brief review of the correlation between the above indicators and severe viral encephalitis, in order to provide more evidence for early identification of severe viral encephalitis.展开更多
Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage ...Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.展开更多
Upper gastrointestinal bleeding remains a significant cause of hospital admissions. Even though the incidence of peptic ulcer disease and gastritis is decreasing, the incidence rates in neoplasm, Dieulafoy’s lesions,...Upper gastrointestinal bleeding remains a significant cause of hospital admissions. Even though the incidence of peptic ulcer disease and gastritis is decreasing, the incidence rates in neoplasm, Dieulafoy’s lesions, angiodysplasia, and esophagitis are trending up, which necessities physicians to be aware of those pathologies and their specifics. Here, we represent a case of a 62-year-old male on dual antiplatelet therapy who was transferred to our hospital due to severe melena with suspicion of upper gastrointestinal bleeding. Due to hemodynamic instability, the patient was intubated and started on vasopressors. However, several repeated EGDs and CTs of the abdomen with GI bleeding protocol did not reveal the location of active bleeding to stop it. At the same time, clinically, the patient was hemodynamically unstable with continued melena. On the last EGD, a small area of concern resembling gastric varix was clipped for identification purposes, and the patient underwent a selective angiogram with further diagnosis of Dieulafoy’s lesion, which was successfully embolized. Our case demonstrates that Dieulafoy’s lesions can present as severe life-threatening hemorrhage, hard to diagnose with traditional methods such as EGD or CTs, in which case it is recommended to proceed with an angiogram sooner rather than later for further diagnosis and treatment if needed.展开更多
文摘病毒性脑炎作为影响世界公共卫生的主要疾病之一,是一种严重的中枢神经系统感染。白细胞计数的升高通常与感染和炎症相关,PCT是一种在感染时血浆中浓度升高的蛋白质,IL-6在急性炎症中起着重要作用,S100蛋白则往往代表了神经损伤和炎症。在病毒性脑炎中,上述指标均可能发生变化。现本文对上述指标与重症病毒性脑炎的相关性做简要综述,以期为重症病毒性脑炎早期识别提供更多依据。Viral encephalitis, as one of the major diseases affecting global public health, is a serious central nervous system infection. The increase in white blood cell count is usually associated with infection and inflammation. PCT is a protein that increases in concentration in the plasma during infection, IL-6 plays an important role in acute inflammation, and S100 protein often represents nerve damage and inflammation. In viral encephalitis, the above indicators may undergo changes. This article provides a brief review of the correlation between the above indicators and severe viral encephalitis, in order to provide more evidence for early identification of severe viral encephalitis.
文摘Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.
文摘Upper gastrointestinal bleeding remains a significant cause of hospital admissions. Even though the incidence of peptic ulcer disease and gastritis is decreasing, the incidence rates in neoplasm, Dieulafoy’s lesions, angiodysplasia, and esophagitis are trending up, which necessities physicians to be aware of those pathologies and their specifics. Here, we represent a case of a 62-year-old male on dual antiplatelet therapy who was transferred to our hospital due to severe melena with suspicion of upper gastrointestinal bleeding. Due to hemodynamic instability, the patient was intubated and started on vasopressors. However, several repeated EGDs and CTs of the abdomen with GI bleeding protocol did not reveal the location of active bleeding to stop it. At the same time, clinically, the patient was hemodynamically unstable with continued melena. On the last EGD, a small area of concern resembling gastric varix was clipped for identification purposes, and the patient underwent a selective angiogram with further diagnosis of Dieulafoy’s lesion, which was successfully embolized. Our case demonstrates that Dieulafoy’s lesions can present as severe life-threatening hemorrhage, hard to diagnose with traditional methods such as EGD or CTs, in which case it is recommended to proceed with an angiogram sooner rather than later for further diagnosis and treatment if needed.
