Rejected

Malignant hemangiopericytoma (HPC) is an uncommon disease first described by Stout and Murray in 1942. Patients with suspected renal HPC on admission sometimes complain of low back pain, hematuria, or hypertension. A combination of histochemical and anatomo-pathologic examinations is necessary to confirm the diagnosis of renal HPC. We report the case of a 41-year-old female patient who had persistent painful nodular lesion at the right lower back and gross hematuria. Based on analyses of clinical symptoms and signs plus radiological a laboratory examination, she was diagnosed with renal cell carcinoma of the right kidney. She subsequently underwent open right radical nephrectomy via transperitoneal approach. The patient was discharged from hospital in good condition on Day 5 of care after surgical intervention. Malignant HPC of the kidney is an uncommon disease that can be diagnosed based on multislice computerized tomography angiography plus histopathological examination using the periodic acid shift method. Management of malignant renal HPC requires radical nephrectomy followed by chemotherapy. This case study provides important preliminary data for further studies of patients with renal HPC in Indonesia.

To explore a minimally invasive emergency solution for acute obstruction caused by rectal cancer in patients in whom rectal stents or drainage tubes cannot be placed under the guidance of conventional colonoscopy or digital subtraction angiography (DSA). Without anesthesia, analgesia, or sedation, the prostate resection endoscopy was inserted into the rectum through the anus, and the rectal space in which the tumor caused obstruction was searched with a certain flushing pressure until it crossed the area of obstruction to reach the proximal intestinal cavity. The drainage catheter or rectal stent was inserted through the sheath of the endoscope to relieve the acute obstruction and permit further cancer treatment. In 31 patients in whom a drainage catheter or rectal stent could not be inserted using conventional colonoscopy or DSA guidance, placement of the catheter or stent into the proximal intestinal cavity was achieved in 28 patients, including drainage tube placement in 21 patients and rectal stent placement in seven patients. Three patients could not undergo placement because of their advanced age and poor general condition. The operative time ranged 15-40 min. Among the 28 patients whose obstruction was relieved, 23 patients underwent radical resection rectal cancer after 10-14 days, and five patients were discharged with stents because they were unwilling to receive further treatment. There were no postoperative complications. Transanal resection is a minimally invasive, effective, safe, and feasible emergency treatment for rectal cancer-associated obstruction.

Trigeminal ganglion stimulation is a neuromodulatory surgical procedure utilized to treat trigeminal neuropathic pain. This technique involves the placement of a stimulating electrode adjacent to the trigeminal ganglion and can be trialed before permanent implantation. Wider adoption by surgical practitioners is currently limited by complications such as lead migration from the trigeminal ganglion, which can result in loss of therapy and cannot be rectified without repeat surgery. We describe a novel surgical modification that successfully anchors the trigeminal ganglion electrode long-term.

Multiple chemical sensitivity (MCS) is a form of chemical intolerance in which various systemic symptoms are triggered by exposure to a variety of chemical substances. Although migraine has been associated with central sensitivity syndrome, the relationship between MCS and migraine has not been studied. We assessed the frequency of MCS and its related factors in patients with migraine.

Notwithstanding that unprecedented endovascular progress has been achieved in recent years, it remains unclear what is the best strategy to preserve the blood perfusion of abdominal visceral arteries and promote positive aortic remodeling in patients with distal dilatation of chronic aortic dissection in abdominal visceral part (CADAV) after aortic repair. The present study developed a Road Block Strategy (RBS) to solve this conundrum.

Herpes zoster (HZ) is a neurocutaneous disease that causes significant morbidity worldwide. The disease is caused by the reactivation of the varicella-zoster virus (VZV), which leads to the development of a painful, vesicular rash and can cause complications such as post-herpetic neuralgia and vision loss. Globally, the incidence of HZ is increasing, and it incurs billions in cost annually to the healthcare system and to society through loss of productivity. With the advent of effective vaccines such as the live attenuated vaccine, Zostavax, in 2006, and more recently the adjuvant recombinant subunit vaccine, Shingrix, in 2017, HZ has become a preventable disease. However, access to the vaccines remains mostly limited to countries with developed economies, such as the United States and Canada. Even among countries with developed economies that license the vaccine, few have implemented HZ vaccination into their national immunization schedules due to cost-effectiveness considerations. In this review, we discuss the currently available HZ vaccines, landscape of HZ vaccine guidelines, and economic burden of disease in countries with developed and developing economies, as well as barriers and considerations in HZ vaccine access on a global scale.

To understand the impact of alternate warm and cold therapy (AWCT) on uricemia, sleep, pain, functional ability, and quality of life in gout patients.

(LM), one of the most important foodborne pathogens, is an intracellular bacterium found in food and the environment. It causes listeriosis, a potentially severe disease, particularly for pregnant women, the elderly and immunocompromised patients, but in rare cases, it can cause invasive disease in immunocompetent adults and children. Community-acquired bacterial meningitis caused by LM is rare and difficult to diagnose. It carries a high mortality rate; therefore, it is essential to start appropriate antibiotic treatment as soon as possible. The first case of LM meningitis identified in our hospital over the last 10 years is that of a previously healthy 45-year-old man who presented in the emergency department with a 4-day history of diplopia, left eye medial deviation and left palpebral ptosis, with no history of fever, headache or gastrointestinal symptoms. Because of the atypical symptoms, a suspicion of meningitis vs cerebral aneurysm was raised during the admission process. The patient was diagnosed with LM meningitis and recovered fully after appropriate antibiotic treatment. The purpose of this article is to emphasise the possibility of LM invasive disease (in this case meningitis) occurring in previously healthy individuals and to raise awareness about the need for LM to be considered in the differential diagnosis of atypical presentations.

Rosacea is a chronic inflammatory dermatosis mainly involving facial skin, leading to physical and emotional problems, which greatly affect the quality of life (QoL) of patients. Dermatology Life Quality Index (DLQI) and willingness to pay (WTP) are well-established instruments assessing the health-related quality of life (HRQoL), while very few studies have been focused on this topic about rosacea in China. The present study investigated HRQoL in Chinese rosacea patients.