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Chai XD, Jiang H, Tang LL, Zhang J, Yue LF. Factors influencing Frey syndrome after parotidectomy with acellular dermal matrix. World J Clin Cases 2024; 12:1578-1584. [PMID: 38576730 PMCID: PMC10989425 DOI: 10.12998/wjcc.v12.i9.1578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/22/2024] [Accepted: 02/25/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Frey syndrome, also known as ototemporal nerve syndrome or gustatory sweating syndrome, is one of the most common complications of parotid gland surgery. This condition is characterized by abnormal sensations in the facial skin accompanied by episodes of flushing and sweating triggered by cognitive processes, visual stimuli, or eating. AIM To investigate the preventive effect of acellular dermal matrix (ADM) on Frey syndrome after parotid tumor resection and analyzed the effects of Frey syndrome across various surgical methods and other factors involved in parotid tumor resection. METHODS Retrospective data from 82 patients were analyzed to assess the correlation between sex, age, resection sample size, operation time, operation mode, ADM usage, and occurrence of postoperative Frey syndrome. RESULTS Among the 82 patients, the incidence of Frey syndrome was 56.1%. There were no significant differences in sex, age, or operation time between the two groups (P > 0.05). However, there was a significant difference between ADM implantation and occurrence of Frey syndrome (P < 0.05). ADM application could reduce the variation in the incidence of Frey syndrome across different operation modes. CONCLUSION ADM can effectively prevent Frey syndrome and delay its onset.
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Affiliation(s)
- Xian-Da Chai
- Department of Oral and Maxillofacial Surgery, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| | - Huan Jiang
- Department of Oral and Maxillofacial Surgery, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| | - Ling-Ling Tang
- Department of Oral and Maxillofacial Surgery, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| | - Jing Zhang
- Department of Oral and Maxillofacial Surgery, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| | - Long-Fei Yue
- Department of General Practice, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
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Wang XJ, Shi YP, Wang L, Li YN, Xu LJ, Zhang Y, Han S. Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis. World J Clin Cases 2024; 12:1597-1605. [PMID: 38576734 PMCID: PMC10989432 DOI: 10.12998/wjcc.v12.i9.1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/17/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) constitutes a prevalent emergency within Gastroenterology, encompassing 80%-90% of all gastrointestinal hemorrhage incidents. This condition is distinguished by its abrupt onset, swift progression, and notably elevated mortality rate. AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis. METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023, utilizing our medical record system. Data pertaining to general patient information, etiological factors, disease outcomes, and other relevant variables were meticulously collected and analyzed. RESULTS Among the 532 patients diagnosed with ANVUGIB, the male-to-female ratio was 2.91:1, with a higher prevalence among males. Notably, 43.6% of patients presented with black stool as their primary complaint, while 27.4% had hematemesis as their initial symptom. Upon admission, 17% of patients exhibited both hematemesis and black stool, while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding. Urgent routine blood examinations at admission revealed that 75.8% of patients had anemia, with 63.4% experiencing moderate to severe anemia, and 1.5% having extremely severe anemia (hemoglobin < 30 g/L). With regard to etiology, 53.2% of patients experienced bleeding without a definitive trigger, 24.2% had a history of using gastric mucosa-irritating medications, 24.2% developed bleeding after alcohol consumption, 2.8% attributed it to improper diet, 1.7% to emotional excitement, and 2.3% to fatigue preceding the bleeding episode. Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals, while bleeding due to alcohol consumption showed the opposite trend. Additionally, diet-related bleeding was more common among the young age group compared to the middle-aged group. Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB (73.3%), followed by gastrointestinal malignancies (10.9%), acute gastric mucous lesions (9.8%), and androgenic upper gastrointestinal bleeding (1.5%) among inpatients with ANVUGIB. Of the 532 patients with gastrointestinal bleeding, 68 underwent endoscopic hemostasis, resulting in an endoscopic treatment rate of 12.8%, with a high immediate hemostasis success rate of 94.1%. CONCLUSION ANVUGIB patients exhibit diverse characteristics across different age groups, and endoscopic hemostatic treatments have demonstrated remarkable efficacy.
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Affiliation(s)
- Xiao-Juan Wang
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Yu-Peng Shi
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Li Wang
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Ya-Ni Li
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Li-Juan Xu
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Yue Zhang
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Shuang Han
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
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Ali AM, Mohamed YG, Mohamud AA, Mohamed AN, Ahmed MR, Abdullahi IM, Saydam T. Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction: A case report and review of literature. World J Clin Cases 2024; 12:1536-1543. [PMID: 38576818 PMCID: PMC10989457 DOI: 10.12998/wjcc.v12.i8.1536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/12/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Mycobacterium tuberculosis (TB) is the causative agent of TB, a chronic granulomatous illness. This disease is prevalent in low-income countries, posing a significant global health challenge. Gastrointestinal TB is one of the three forms. The disease can mimic other intra-abdominal conditions, leading to delayed diagnosis owing to the absence of specific symptoms. While gastric outlet obstruction (GOO) remains a frequent complication, its incidence has declined with the advent of proton pump inhibitors and Helicobacter pylori eradication therapy. Gastroduodenal TB can cause upper gastrointestinal hemorrhage, obstruction, and malignancy-like tumors. CASE SUMMARY A 23-year-old male presented with recurrent epigastric pain, distension, nausea, vomiting, and weight loss, prompting a referral to a gastroenterologist clinic. Endoscopic examination revealed distorted gastric mucosa and signs of chronic inflammation. However, treatment was interrupted, possibly owing to vomiting or comorbidities such as human immunodeficiency virus infection or diabetes. Subsequent surgical intervention revealed a dilated stomach and diffuse thickening of the duodenal wall. Resection revealed gastric wall effacement with TB. CONCLUSION Primary gastric TB is rare, frequently leading to GOO. Given its rarity, suspicions should be promptly raised when encountering relevant symptoms, often requiring surgical intervention for diagnosis and treatment.
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Affiliation(s)
- Abdihamid Mohamed Ali
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Yahye Garad Mohamed
- Department of Radiology, Mogadishu Somali Turkey, Training and Research Hospital, Mogadishu 2526, Somalia
| | - Abdirahman Ahmed Mohamud
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Abdulkadir Nor Mohamed
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Mohamed Rage Ahmed
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Ismail Mohamud Abdullahi
- Department of Pathology, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Tuba Saydam
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
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Yu XH, Wang WX, Yang DS, Gong LH. Left lower lobe sleeve resection for the clear cell variant of pulmonary mucoepidermoid carcinoma: A case report. World J Clin Cases 2024; 12:1422-1429. [PMID: 38576804 PMCID: PMC10989443 DOI: 10.12998/wjcc.v12.i8.1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/08/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignancy that arises from minor salivary glands within the tracheobronchial tree. The clear cell variant of PMEC is exceptionally uncommon and presents notable diagnostic challenges, primarily attributable to its morphological similarity to other tumors containing clear cells. CASE SUMMARY A 22-year-old male, formerly in good health, came in with a two-month duration of persistent cough and production of sputum. Subsequent imaging and bronchoscopy examinations revealed a 2 cm tumor in the distal left main bronchus, which resulted in complete atelectasis of the left lung. Further assessment via positron emission tomography/computed tomography scans and endoscopic biopsy confirmed the primary malignant nature of the tumor, characterized by clear cell morphology in most of the tumor cells. The patient underwent a left lower lobe sleeve resection accompanied by systematic mediastinal lymph node dissection. Molecular pathology analysis subsequently revealed a CRTC3-MAML2 gene fusion, leading to a definitive pathological diagnosis of the clear cell variant of PMEC, staged as T2N0M0. After surgery, the patient experienced a smooth recovery and exhibited no signs of recurrence during the one-and-a-half-year follow-up period. CONCLUSION This article describes an unusual case of a clear cell variant of PMEC characterized by the presence of a CRTC3-MAML2 gene fusion in a 22-year-old male. The patient underwent successful left lower lobe sleeve resection. This case underscores the distinctive challenges associated with diagnosing and treating this uncommon malignancy, underscoring the importance of precise diagnosis and personalized treatment strategies.
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Affiliation(s)
- Xiao-Hui Yu
- Department of Pathology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - Wen-Xiang Wang
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - De-Song Yang
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - Liang-Hui Gong
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
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105
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Cao WL, Yu CP, Zhang LL. Serum proteins differentially expressed in gestational diabetes mellitus assessed using isobaric tag for relative and absolute quantitation proteomics. World J Clin Cases 2024; 12:1395-1405. [PMID: 38576811 PMCID: PMC10989458 DOI: 10.12998/wjcc.v12.i8.1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/08/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND As a well-known fact to the public, gestational diabetes mellitus (GDM) could bring serious risks for both pregnant women and infants. During this important investigation into the linkage between GDM patients and their altered expression in the serum, proteomics techniques were deployed to detect the differentially expressed proteins (DEPs) of in the serum of GDM patients to further explore its pathogenesis, and find out possible biomarkers to forecast GDM occurrence. AIM To investigation serum proteins differentially expressed in GDM were assessed using isobaric tag for relative and absolute quantitation (iTRAQ) proteomics and bioinformatics analyses. METHODS Subjects were divided into GDM and normal control groups according to the IADPSG diagnostic criteria. Serum samples were randomly selected from four cases in each group at 24-28 wk of gestation, and the blood samples were identified by applying iTRAQ technology combined with liquid chromatography-tandem mass spectrometry. Key proteins and signaling pathways associated with GDM were identified by bioinformatics analysis, and the expression of key proteins in serum from 12 wk to 16 wk of gestation was further verified using enzyme-linked immunosorbent assay (ELISA). RESULTS Forty-seven proteins were significantly differentially expressed by analyzing the serum samples between the GDM gravidas as well as the healthy ones. Among them, 31 proteins were found to be upregulated notably and the rest 16 proteins were downregulated remarkably. Bioinformatic data report revealed abnormal expression of proteins associated with lipid metabolism, coagulation cascade activation, complement system and inflammatory response in the GDM group. ELISA results showed that the contents of RBP4, as well as ANGPTL8, increased in the serum of GDM gravidas compared with the healthy ones, and this change was found to initiate from 12 wk to 16 wk of gestation. CONCLUSION GDM symptoms may involve abnormalities in lipid metabolism, coagulation cascade activation, complement system and inflammatory response. RBP4 and ANGPTL8 are expected to be early predictors of GDM.
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Affiliation(s)
- Wei-Li Cao
- Department of Women’s Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, Hubei Province, China
| | - Cui-Ping Yu
- Obstetrical Department, The First People’s Hospital of Jiangxia District Wuhan City (Union Jiangnan Hospital Huazhong University of Science and Technology), Wuhan 430200, Hubei Province, China
| | - Ling-Li Zhang
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, Hubei Province, China
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Wu ZW, Zhu WJ, Huang S, Tan Q, You C, Hu DG, Li LN. Eccrine porocarcinoma in the tempus of an elderly woman: A case report. World J Clin Cases 2024; 12:1523-1529. [PMID: 38576807 PMCID: PMC10989442 DOI: 10.12998/wjcc.v12.i8.1523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/19/2024] [Accepted: 02/22/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Eccrine porocarcinoma (EPC) is a rare skin tumor that mainly affects the elderly population. Tumors often present with slow growth and a good prognosis. EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry. However, surgical management alone may be inadequate if the tumor has metastasized. However, currently, surgical resection is the most commonly used treatment modality. CASE SUMMARY A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area, with no obvious itching or pain, for more than four months. Histopathological examination showed small columnar and short spindle-shaped cells; thus, basal cell carcinoma was suspected. However, immunohistochemical analysis revealed the expression of cytokeratin 5/6, p63 protein, p16 protein, and Ki-67 antigen (40%), and EPC was taken into consideration. The skin biopsy was repeated, and hematoxylin and eosin staining revealed ductal differentiation in some cells. Finally, the patient was diagnosed with EPC, and Mohs micrographic surgery was performed. We adapted follow-up visits in a year and not found any recurrence of nodules. CONCLUSION This case report emphasizes the diagnosis and differentiation of EPC.
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Affiliation(s)
- Zhi-Wei Wu
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Wen-Jie Zhu
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Shan Huang
- Department of Laser and Cosmetic Dermatology, Ganzhou Dermatology Hospital, Ganzhou 341000, Jiangxi Province, China
| | - Qi Tan
- Department of Dermatology, Tongxiang Dermatology Hospital, Jiaxing 314000, Zhejiang Province, China
| | - Cong You
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Dian-Gui Hu
- Department of Infectious Diseases, The Fifth people’s Hospital of Ganzhou, Ganzhou 341000, Jiangxi Province, China
| | - Long-Nian Li
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
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El Labban M, Surani S. Immunoglobulin A glomerulonephropathy: A review. World J Clin Cases 2024; 12:1388-1394. [PMID: 38576821 PMCID: PMC10989439 DOI: 10.12998/wjcc.v12.i8.1388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/27/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
In this editorial, we comment on the article by Meng et al published in the World Journal of Clinical Cases. We comprehensively review immunoglobulin A nephropathy (IgAN), including epidemiology, clinical presentation, diagnosis, and management. IgAN, also known as Berger's disease, is the most frequent type of primary glomerulonephritis (GN) globally. It is mostly found among the Asian population. The presentation can be variable, from microscopic hematuria to a rapidly progressive GN. Around 50% of patients present with single or recurring episodes of gross hematuria. An upper respiratory infection and tonsillitis often precede these episodes. Around 30% of patients present microscopic hematuria with or without proteinuria, usually detected on routine examination. The diagnosis relies on having a renal biopsy for pathology and immunofluorescence microscopy. We focus on risk stratification and management of IgAN. We provide a review of all the landmark studies to date. According to the 2021 KDIGO (kidney disease: Improving Global Outcomes) guidelines, patients with non-variant form IgAN are first treated conservatively for three to six months. This approach consists of adequate blood pressure control, reduction of proteinuria with renin-angiotensin system blockade, treatment of dyslipidemia, and lifestyle modifications (weight loss, exercise, smoking cessation, and dietary sodium restrictions). Following three to six months of conservative therapy, patients are further classified as high or low risk for disease progression. High-risk patients have proteinuria ≥ 1 g/d or < 1 g/d with significant microscopic hematuria and active inflammation on kidney biopsy. Some experts consider proteinuria ≥ 2 g/d to be very high risk. Patients with high and very high-risk profiles are treated with immunosuppressive therapy. A proteinuria level of < 1 g/d and stable/improved renal function indicates a good treatment response for patients on immunosuppressive therapy.
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Affiliation(s)
- Mohamad El Labban
- Department of Internal Medicine, Mayo Cliic Health System, Mankato, MN 56001, United States
| | - Salim Surani
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
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Gou YP, Huang Y, Chen L, Zheng W, Zheng YH. Analysis and monitoring of drug therapy in a patient with peptic ulcer complicated by infection: A case report. World J Clin Cases 2024; 12:1530-1535. [PMID: 38576803 PMCID: PMC10989448 DOI: 10.12998/wjcc.v12.i8.1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND The role of primary-level medical pharmacists in medical institutions in China is limited; therefore, it is necessary to explore the role of pharmacists in the process of drug treatment. CASE SUMMARY A Chinese pharmacist participated in the complete treatment of a patient with a duodenal ulcer. The rationale for drug treatment was evaluated, and adjustments were made to the antacid and anti-infective regimen, as well as the dose and frequency of administration. Body temperature, routine blood examination, and adverse drug reactions were strictly monitored. During treatment, the pharmacist recommended anti-infective therapy with ampicillin-sulbactam, which effectively controlled the infection. Additionally, the pharmacist suggested changing famotidine to lansoprazole for acid suppression and gastroprotective treatment, combined with Chinese patent medicine such as Kangfuxin Liquid. This is the first case report of a pharmacist in primary-level medical institutions adjusting drug use for patients with duodenal ulcer and pulmonary infection. CONCLUSION A pharmacist participated in the treatment process, provided individualized medication adjustment, and achieved good clinical results.
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Affiliation(s)
- Yan-Ping Gou
- The Second People’s Hospital of Meishan City & Renshou County People’s Hospital, Meishan 620500, Sichuan Province, China
| | - Yue Huang
- Quality Evaluation and Medical Record Management, The Affiliated Hospital of Southwest Jiaotong University & The Third People's Hospital of Chengdu, Chengdu 610000, Sichuan Province, China
| | - Li Chen
- Quality Evaluation and Medical Record Management, The Affiliated Hospital of Southwest Jiaotong University & The Third People's Hospital of Chengdu, Chengdu 610000, Sichuan Province, China
| | - Wei Zheng
- Patriotic Health Campaign, Qionglai City Health Bureau, Chengdu 610000, Sichuan Province, China
| | - Yun-Hua Zheng
- Quality Evaluation and Medical Record Management, The Affiliated Hospital of Southwest Jiaotong University & The Third People's Hospital of Chengdu, Chengdu 610000, Sichuan Province, China
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Sun J, Yang QN, Guo Y, Zeng P, Ma LY, Kong LW, Zhao BY, Li CM. Multilocular thymic cysts can be easily misdiagnosed as malignant tumor on computer tomography: A case report. World J Clin Cases 2024; 12:1474-1480. [PMID: 38576812 PMCID: PMC10989449 DOI: 10.12998/wjcc.v12.i8.1474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/29/2023] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Multilocular thymic cyst (MTC) is a rare mediastinal lesion which is considered to occur in the process of acquired inflammation. It is usually characterized by well-defined cystic density and is filled with transparent liquid. CASE SUMMARY We report on a 39-year-old male with a cystic-solid mass in the anterior mediastinum. Computer tomography (CT) imaging showed that the mass was irregular with unclear boundaries. After injection of contrast agent, there was a slight enhancement of stripes and nodules. According to CT findings, it was diagnosed as thymic cancer. CONCLUSION After surgery, MTC accompanied by bleeding and infection was confirmed by pathological examination. The main lesson of this case was that malignant thymic tumor and MTC of the anterior mediastinum sometimes exhibit similar CT findings. Caution is necessary in clinical work to avoid misdiagnosis.
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Affiliation(s)
- Jun Sun
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Qing-Ning Yang
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Yi Guo
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Ping Zeng
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Long-Yan Ma
- Department of Pathology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Ling-Wen Kong
- Department of Cardiothoracic Surgery, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Bo-Ying Zhao
- Department of Cardiothoracic Surgery, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Chuan-Ming Li
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
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Tang GC, He M, Huang ZZ, Cheng Y. Safety and effectiveness of butorphanol in epidural labor analgesia: A protocol for a systematic review and meta-analysis. World J Clin Cases 2024; 12:1416-1421. [PMID: 38576817 PMCID: PMC10989441 DOI: 10.12998/wjcc.v12.i8.1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/09/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Epidural analgesia is the most effective analgesic method during labor. Butorphanol administered epidurally has been shown to be a successful analgesic method during labor. However, no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor. AIM To assess butorphanol's safety and efficacy for epidural labor analgesia. METHODS The PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure, and Google Scholar databases will be searched from inception. Other types of literature, such as conference abstracts and references to pertinent reviews, will also be reviewed. We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor. There will be no language restrictions. The primary outcomes will include the visual analog scale score for the first stage of labor, fetal effects, and Apgar score. Two independent reviewers will evaluate the full texts, extract data, and assess the risk of bias. Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot, and heterogeneity will be evaluated using the Cochran Q test, P values, and I2 values. Meta-analysis, subgroup analysis, and sensitivity analysis will be performed using RevMan software version 5.4. This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols statement, and the PRISMA statement will be used for the systematic review. RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor. CONCLUSION To support clinical practice and development, this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.
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Affiliation(s)
- Guan-Cheng Tang
- Department of Anesthesiology, Yongkang Hospital of Traditional Chinese Medicine, Jinhua 321301, Zhejiang Province, China
| | - Man He
- Department of Gynecology and Obstetrics, Yongkang Hospital of Traditional Chinese Medicine, Jinhua 321301, Zhejiang Province, China
| | - Zhen-Zhao Huang
- Department of Anesthesiology, Hangzhou United Liger Sixth Medical Beauty Hospital, Hangzhou 311215, Zhejiang Province, China
| | - Yan Cheng
- Department of Ultrasound, Hangzhou Women’s Hospital, Hangzhou 310008, Zhejiang Province, China
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Long Y, Xiang YN, Huang F, Xu L, Li XY, Zhen YH. Appendiceal intussusception complicated by adenocarcinoma of the cecum: A case report. World J Clin Cases 2024; 12:1461-1466. [PMID: 38576819 PMCID: PMC10989461 DOI: 10.12998/wjcc.v12.i8.1461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/06/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Appendiceal intussusception is a pathological condition in which the appendix is inverted into the cecum, which may cause symptoms that resemble those of other gastrointestinal disorders and may induce intestinal obstruction. The rarity of this case presentation is the co-occurrence of appendiceal intussusception and cecal adenocarcinoma, a combination that to our knowledge has not previously been reported in the medical literature. This case provides new insights into the complexities of diagnosing and managing overlapping pathologies. CASE SUMMARY A 25-year-old woman presented with persistent periumbilical pain and bloody stools. An initial biopsy showed cecal cancer; however, subsequent colonoscopy and computed tomography findings raised the suspicion of appendiceal intussusception, which was later confirmed postoperatively. This unique case was characterized by a combination of intussusception and adenocarcinoma of the cecum. The intervention included a laparoscopic right hemicolectomy, which led to the histopathological diagnosis of mucinous adenocarcinoma with appendiceal intussusception. The patient recovered well postoperatively and was advised to initiate adjuvant chemotherapy. This case highlights not only the importance of considering appendiceal intussusception in the differential diagnosis, but also the possibility of appendicitis and the atypical presentation of neoplastic lesions. CONCLUSIONS Physicians should consider the possibility of appendiceal intussusception in cases of atypical appendicitis, particularly when associated with neoplastic presentation.
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Affiliation(s)
- Yu Long
- Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
- Department of Colorectal Surgery, Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Yi-Ning Xiang
- Department of Pathology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Fei Huang
- Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
| | - Lei Xu
- Department of Colorectal Surgery, Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Xiao-Yun Li
- Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
| | - Yun-Huan Zhen
- Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
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Luo MR, Dai SM, Li Y, Wang Q, Liu H, Gao P, Liu JY, Chen J, Zhao SJ, Yin GY. 3M syndrome patient with a novel mutation: A case report. World J Clin Cases 2024; 12:1454-1460. [PMID: 38576808 PMCID: PMC10989460 DOI: 10.12998/wjcc.v12.i8.1454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/29/2023] [Accepted: 01/30/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND A rare autosomal recessive genetic disorder, 3M syndrome, is characterized by severe intrauterine and postnatal growth retardation. Children with 3M syndrome typically exhibit short stature, facial deformities, long tubular bones, and high vertebral bodies but generally lack mental abnormalities or other organ damage. Pathogenic genes associated with 3M syndrome include CUL7, OBSL1 and CCDC8. The clinical and molecular characteristics of patient with 3M syndrome are unique and serve as important diagnostic indicators. CASE SUMMARY In this case, the patient displayed square shoulders, scoliosis, long slender tubular bones, and normal neurological development. Notably, the patient did not exhibit the typical dysmorphic facial features, relative macrocephaly, or growth retardation commonly observed in individuals with 3M syndrome. Whole exon sequencing revealed a novel heterozygous c.56681+1G>C (Splice-3) variant and a previously reported nonsense heterozygous c.3341G>A (p.Trp1114Ter) variant of OBSL1. Therefore, it is important to note that the clinical features of 3M syndrome may not always be observable, and genetic confirmation is often required. Additionally, the identification of the c.5683+1G>C variant in OBSL1 is noteworthy because it has not been previously reported in public databases. CONCLUSION Our study identified a new variant (c.5683+1G>C) of OBSL1 that contributes to expanding the molecular profile of 3M syndrome.
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Affiliation(s)
- Ming-Ran Luo
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Si-Ming Dai
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yin Li
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Qian Wang
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Hao Liu
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Peng Gao
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Jia-Yun Liu
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Jian Chen
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Shu-Jie Zhao
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Guo-Yong Yin
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
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Hou F, Li Y, Jin H. Clinical manifestations and the prenatal diagnosis of trisomy 7 mosaicism: Two case reports. World J Clin Cases 2024; 12:1544-1548. [PMID: 38576814 PMCID: PMC10989444 DOI: 10.12998/wjcc.v12.i8.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/08/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND The clinical manifestations of trisomy 7 mosaicism are diverse and nonspecific, so prenatal diagnosis is very difficult. CASE SUMMARY Two pregnant women with abnormal prenatal screening results were included. One was a 22-year-old woman (G1P0). At 31st week of gestation, ultrasound revealed that the posterior horn of the left lateral ventricle was 10 mm and the right renal pelvis had a separation of 7 mm. The other pregnant woman was 33 years old (G2P1L1A0), and her fetus was found to have a cardiac malformation at the 24th week of gestation. Copy number variation sequencing, whole-exome sequencing and karyotype analysis were carried out after amniocentesis, and both fetuses were diagnosed with trisomy 7 mosaicism. After parental counseling, one woman continued the pregnancy, and the other woman terminated the pregnancy. CONCLUSION In trisomy 7 mosaicism, the low proportion of trisomy does not lead to abortion, but can result in abnormal fetal development, which can be detected via ultrasound. Therefore, clinicians need to pay more attention to various aspects of fetal growth and development, combining with imaging, cellular, molecular genetics and other methods to perform comprehensive evaluations of fetuses to provide more reliable genetic counseling for pregnant women.
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Affiliation(s)
- Fei Hou
- Department of Prenatal Diagnosis, Jinan Maternal and Child Health Hospital, Jinan 250001, Shandong Province, China
| | - Yan Li
- Department of Prenatal Diagnosis, Jinan Maternal and Child Health Hospital, Jinan 250001, Shandong Province, China
| | - Hua Jin
- Department of Prenatal Diagnosis, Jinan Maternal and Child Health Hospital, Jinan 250001, Shandong Province, China
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Lee YJ, Chen MQ, Dong J. Effect of foot reflexology on an infant with sensorineural hearing loss: A case report. World J Clin Cases 2024; 12:1437-1441. [PMID: 38576800 PMCID: PMC10989455 DOI: 10.12998/wjcc.v12.i8.1437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/15/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Our study contributes to the further understanding of the mechanism of foot reflexology. Foot reflexology has been reported to affect hearing recovery, but no physiological evidence has been provided. This lack of evidence hampers the acceptance of the technique in clinical practice. CASE SUMMARY A girl was taken to North Sichuan Medical University Affiliated Hospital for a hearing screen by her parents. Her parents reported that her hearing level was the same as when she was born. The girl was diagnosed with sensorineural hearing loss (SNHL) by a doctor in the otolaryngology department. After we introduced the foot reflexology project, the parents agreed to participate in the experiment. After 6 months of foot reflexology treatment, the hearing threshold of the girl recovered to a normal level, below 30 dB. CONCLUSION Foot reflexology should be encouraged in clinical practice and for families of infants with SNHL.
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Affiliation(s)
- Yu-Jun Lee
- Graduate School, Xi'an International Studies University; North Sichuan Medical University, Xi'an 710061, Shaanxi Province, China
- Department of Neural Disease, North Sichuan Medical University, Nanchong 635200, Sichuan Province, China
| | - Mao-Qing Chen
- Department of Nursing, North Sichuan Medical University, Nachong 635200, Sichuan Province, China
| | - Jie Dong
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi’an International Studies University, Xi’an 710128, Shaanxi Province, China
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Zhu R, Chen TZ, Sun MT, Zhu CR. Advanced cervix cancer patient with chemotherapy-induced grade IV myelosuppression achieved complete remission with cadonilimab: A case report. World J Clin Cases 2024; 12:1510-1516. [PMID: 38576806 PMCID: PMC10989456 DOI: 10.12998/wjcc.v12.i8.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/18/2024] [Accepted: 02/22/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND The prognosis for patients with advanced metastatic cervix cancer (MCC) is poor, and this disease continues to pose a considerable therapeutic challenge. Despite the administration of first-line regimens consisting of cisplatin, paclitaxel, and bevacizumab, survival rates for patients with metastasis remain poor. The emergence of bispecific antibodies (BsAbs) offers a novel treatment option for patients diagnosed with MCC. CASE SUMMARY In this report, we present a patient with MCC who was treated with cadonilimab monotherapy at a dose of 6 mg/kg every two weeks after chemotherapy was proven to be intolerable. The patient exhibited a sustained complete response for a duration of 6 months, demonstrating an optimistic outlook. CONCLUSION This case illustrates the considerable efficacy of cadonilimab for treating advanced MCC. Therefore, BsAb therapy is a promising strategy for effectively treating patients with advanced MCC and should be considered as an option when patients are intolerant to standard chemotherapy.
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Affiliation(s)
- Rui Zhu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Tian-Ze Chen
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Meng-Ting Sun
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Chun-Rong Zhu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
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Zhu XJ, Zhao L, Peng N, Luo JM, Liu SX. Lower extremity peripherally inserted central catheter placement ectopic to the ascending lumbar vein: A case report. World J Clin Cases 2024; 12:1430-1436. [PMID: 38576810 PMCID: PMC10989445 DOI: 10.12998/wjcc.v12.i8.1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/29/2023] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Peripherally inserted central catheters (PICCs) are an essential infusion route for oncology patients receiving intravenous treatments, but lower extremity venipuncture is the preferred technique for patients with superior vena cava syndrome (SVCS). We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein, to indicate and verify PICC catheterisation in the lower extremity is safe and feasible. And hope to provide different perspectives for clinical PICC venipuncture to get the attention of peers. CASE SUMMARY On 24 August 2022, a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month, which worsened 10 d prior. Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS. Chemotherapy was not an absolute contraindication in this patient. Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head, neck, and upper extremities. The patient and his family were informed about the procedure, and informed consent was obtained. After successful puncture and prompt treatment, the patient was discharged, experiencing some relief from symptoms. CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS, particularly in complex situations involving ectopic placement.
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Affiliation(s)
- Xiao-Ju Zhu
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Ling Zhao
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Na Peng
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jia-Min Luo
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Shui-Xia Liu
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
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Hu HF, Sang YF, Xiao YQ. Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke. World J Clin Cases 2024; 12:1406-1415. [PMID: 38576809 PMCID: PMC10989452 DOI: 10.12998/wjcc.v12.i8.1406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/23/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Ischemic stroke (IS) is a widely recognized disease characterized by high prevalence, mortality, morbidity, disability, and recurrence rates. It ranks prominently in terms of mortality, constituting 60%-80% of stroke cases. AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS. METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021. The participants were divided into two groups, namely the control group (n = 80) receiving routine care and the research group (n = 92) receiving comprehensive care. Various assessment scales, including the standard swallowing function assessment scale (SSA), National Institutes of Health Stroke scale (NIHSS), European stroke scale (ESS), self-rating anxiety scale (SAS), self-rating depression scale (SDS), Barthel index (BI), and the motor function assessment scale (MAS), were employed to evaluate the improvement in swallowing function, neurological deficits, clinical outcomes, anxiety, depression, daily living activities, and motor function before and after care. Furthermore, the study compared the occurrence of adverse reactions during the nursing period, life quality before and after the intervention, rehabilitation compliance, and nursing satisfaction between the two groups. RESULTS After the nursing intervention, the research group exhibited significantly improved SSA and NIHSS scores compared to the control group (P < 0.05). Moreover, both groups demonstrated significant reductions in SAS and SDS scores (P < 0.05), with the research group showing more obvious advantages (P < 0.05). Compared to the control group, the research group displayed significantly better ESS, BI, and MAS scores (P < 0.05), coupled with a lower incidence of adverse reactions (P < 0.05). Additionally, the research group demonstrated markedly higher levels of life quality, rehabilitation compliance, and nursing satisfaction compared to the control group (P < 0.05). CONCLUSION Comprehensive nursing effectively improved swallowing function, quality of life, and patient satisfaction, highlighting its clinical significance.
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Affiliation(s)
- Heng-Fen Hu
- Medical School, Hunan Vocational and Technical College of Environmental Biology, Hengyang 421005, Hunan Province, China
| | - Yu-Fei Sang
- Medical Team, The Unit 95246 Of Chinese People’s Liberation Army, Nanning 530007, Guangxi Zhuang Autonomous Region, China
| | - Yan-Qing Xiao
- Department of Gynecology and Obstetrics, Hengyang Maternal and Child Health Hospital, Hengyang 421001, Hunan Province, China
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Furuya N, Yamaguchi A, Kato N, Sugata S, Hamada T, Mizumoto T, Tamaru Y, Kusunoki R, Kuwai T, Kouno H, Kuraoka K, Shibata Y, Tazuma S, Sudo T, Kohno H, Oka S. High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings: A case report. World J Clin Cases 2024; 12:1487-1496. [PMID: 38576815 PMCID: PMC10989451 DOI: 10.12998/wjcc.v12.i8.1487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND High-grade pancreatic intraepithelial neoplasia (PanIN) exhibits no mass and is not detected by any examination modalities. However, it can be diagnosed by pancreatic juice cytology from indirect findings. Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct (MPD) and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography (ERCP). We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range, but without caudal MPD dilatation on magnetic resonance cholangiopancreatography (MRCP). CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision, which revealed pancreatic cysts. MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation. Thus, course observation was performed. After 24 mo, MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst. We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination. We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN. Pancreatic parenchyma invasion was not observed, and curative resection was achieved. CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.
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Affiliation(s)
- Nao Furuya
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima 734-8551, Hiroshima, Japan
| | - Atsushi Yamaguchi
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Naohiro Kato
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Syuhei Sugata
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Takuro Hamada
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima 734-8551, Hiroshima, Japan
| | - Takeshi Mizumoto
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Yuzuru Tamaru
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Ryusaku Kusunoki
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Toshio Kuwai
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Hirotaka Kouno
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Kazuya Kuraoka
- Department of Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Yoshiyuki Shibata
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Sho Tazuma
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Takeshi Sudo
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Hiroshi Kohno
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Shiro Oka
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima 734-8551, Hiroshima, Japan
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Yang HJ, Kim D, Lee WS, Oh SH. Malignant triton tumor in the abdominal wall: A case report. World J Clin Cases 2024; 12:1467-1473. [PMID: 38576801 PMCID: PMC10989446 DOI: 10.12998/wjcc.v12.i8.1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Malignant triton tumors (MTTs) comprise a subgroup of malignant peripheral nerve sheath tumors (MPNSTs) that exhibits rhabdomyosarcomatous differentiation and follow an aggressive course. MTTs are primarily located along peripheral nerves. Cases of MTTs in the abdominal wall have not been reported. MTT has a poorer prognosis than classic MPNSTs, and accurate diagnosis necessitates a keen understanding of the clinical history and knowledge of its differential diagnosis intricacies. Treatment for MTTs mirrors that for MPNSTs and is predominantly surgical. CASE SUMMARY A 49-year-old woman presented with a subcutaneous mass in her lower abdominal wall and a pre-existing surgical scar that had grown slowly over 3-4 months before the consultation. She had previously undergone radical hysterectomy and concurrent chemo-radiotherapy for cervical cancer approximately 5 years prior to the consultation. Abdominal computed tomography (CT) showed a 1.3 cm midline mass in the lower abdomen with infiltration into the rectus abdominis muscle. There was no sign of metastasis (T1N0M0). An incisional biopsy identified sporadic MTT of the lower abdomen. A comprehensive surgical excision with a 3 cm margin inclusive of the peritoneum was executed. Subsequently, the general surgeon utilized an approach akin to the open peritoneal onlay mesh technique. The patient underwent additional treatment with an excision shaped as a mini-abdominoplasty for the skin defect. No complications arose, and annual follow-up CTs did not show signs of recurrence or metastasis. CONCLUSION An abdominal MTT was efficaciously treated with extensive excision and abdominal wall reconstruction, eliminating the need for postoperative radiotherapy.
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Affiliation(s)
- Ho Jik Yang
- Department of Plastic and Reconstructive Surgery, Chungnam National University Sejong Hospital, Sejong 30099, South Korea
| | - Donghyun Kim
- Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon 35015, South Korea
| | - Won Suk Lee
- Department of Emergency, Eulji University Hospital, Daejeon 35233, South Korea
| | - Sang-Ha Oh
- Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine, Daejeon 35015, South Korea
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Ju UC, Kang WD, Kim SM. Development of immature ovarian teratoma after mature teratoma in a girl with familial ovarian teratoma: A case report. World J Clin Cases 2024; 12:1442-1447. [PMID: 38576805 PMCID: PMC10989438 DOI: 10.12998/wjcc.v12.i8.1442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/15/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Immature ovarian teratoma is a rare and aggressive neoplasm that affects young women. This report is the first to describe the development of immature teratoma after ovarian cystectomy for mature teratoma of the ovary in an adolescent female with a family history of ovarian teratoma. CASE SUMMARY A 16-year-old girl who had undergone bilateral ovarian cystectomy for mature teratomas 3 years ago showed bilateral adnexal tumors during her regular ultrasonography follow-up every 6 months. She received laparoscopic bilateral ovarian cystectomy, and final histopathology showed grade-1 immature teratoma of the left ovary and mature teratoma of the right ovary. Laparoscopic left salpingo-oophorectomy and staging procedures were performed again. Her mother, maternal aunt, and maternal grandmother had also received surgeries for mature ovarian teratomas. CONCLUSION It is important to have guidance on management of patient and family members with familial ovarian teratomas.
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Affiliation(s)
- U Chul Ju
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - Woo Dae Kang
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - Seok Mo Kim
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
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Alsinan TA, Altokhais TI. Multiple thoracic and abdominal foregut duplication cysts: A case report. World J Clin Cases 2024; 12:1504-1509. [PMID: 38576813 PMCID: PMC10989454 DOI: 10.12998/wjcc.v12.i8.1504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/19/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Congenital enteric duplication cysts are tubular or cystic structures that normally lie alongside the gastrointestinal (GI) tract. Enteric duplication cysts are typically solitary lesions that occur anywhere near the GI tract from the neck to the rectum, but having multiple duplication cysts is rare, and presentation within the pancreas is extremely rare. CASE SUMMARY We herein demonstrate a case of esophageal, gastric, and gastric-type duplication cyst of the pancreas in a seventeen-month-old girl who presented with failure to thrive, abdominal pain, vomiting, hematemesis, and melena since the age of three months. The cysts were excised by thoracoscopy and laparoscopy in the same setting. To our knowledge, no such case has been published. CONCLUSION Enteric duplications can occur throughout the entire alimentary tract. When they occur in the pancreas, they present a formidable challenge in both diagnosis and treatment. Due to the risk of complications and malignant transformation, surgical removal is the recommended treatment of all duplication cysts.
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Affiliation(s)
- Tuqa Adil Alsinan
- Department of Pediatric Surgery, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Tariq Ibrahim Altokhais
- Devision of Pediatric Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 4545, Saudi Arabia
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Liu JB, Zhang SL, Jiang WL, Sun HK, Yang HC. Chronic infectious unilateral giant thyroid cyst related to diabetes mellitus: A case report. World J Clin Cases 2024; 12:1497-1503. [PMID: 38576820 PMCID: PMC10989447 DOI: 10.12998/wjcc.v12.i8.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/07/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Patients rarely develop complicated infections in thyroid cysts. Here, we describe a patient with chronic infected unilateral giant thyroid cyst related to diabetes mellitus (DM). CASE SUMMARY A 66-year-old male was admitted due to an evident neck lump for 5 d after approximately 40 years of gradually progressive neck mass and 7 years of DM. Doppler ultrasound and computed tomography scan showed a giant lump in the left thyroid gland lobe. He was diagnosed with a large thyroid nodule complicated by tracheal dislocation and had surgical indications. Surgical exploration revealed evident inflammatory edema and exudation between the left anterior neck muscles, the nodule and glandular tissue. Fortunately, inflammatory lesions did not affect major neck vessels. Finally, a left partial thyroidectomy was performed. Macroscopic observation showed that the cystic thyroid mass consisted of extensive cystic wall calcification and was rich in massive rough sand-like calculi content and purulent matter. Postoperative pathology confirmed benign thyroid cyst with chronic infection. CONCLUSION The progression of this chronic infectious unilateral giant thyroid cyst may have been related to DM, and identifying blood vessels involvement can prevent serious complications during operation.
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Affiliation(s)
- Jiang-Bo Liu
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
| | - Shi-Lei Zhang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
| | - Wen-Long Jiang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
| | - Hai-Kuan Sun
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
| | - Hao-Chen Yang
- Clinical Medicine School, The First Clinical College, Chongqing Medical University, Chongqing 400016, China
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Kourek C, Briasoulis A, Magouliotis DE, Skoularigis J, Xanthopoulos A. Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure. World J Clin Cases 2024; 12:1382-1387. [PMID: 38576816 PMCID: PMC10989450 DOI: 10.12998/wjcc.v12.i8.1382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/24/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
Chronic heart failure (HF) is a clinical syndrome with high morbidity and mortality worldwide. Cardiac rehabilitation (CR) is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF, recommended by both American and European guidelines. A CR program consists of a multispecialty group including physicians, nurses, physiotherapists, trainers, nutritionists, and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF patients. Physical activity, lifestyle, and psychological support are core components of a successful CR program. CR has been shown to be beneficial in all ejection fraction categories in HF and most patients, who are stable under medication, are capable of participating. An individualized exercise prescription should be developed on the basis of a baseline evaluation in all patients. The main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and frequency. It is important to set the appropriate clinical outcomes from the beginning, in order to assess the effectiveness of a CR program. There are still significant limitations that prevent patients from participating in these programs and need to be solved. A significant limitation is the generally low quality of research in CR and the presence of negative trials, such as the rehabilitation after myocardial infarction trial, where comprehensive rehabilitation following myocardial infraction had no important effect on mortality, morbidity, risk factors, or health-related quality of life or activity. In the present editorial, we present all the updated knowledge and recommendations in CR programs.
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Affiliation(s)
- Christos Kourek
- Medical School of Athens, National and Kapodistrian University of Athens, Athens 15772, Greece
| | - Alexandros Briasoulis
- Department of Clinical Therapeutics, Alexandra Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
| | | | - John Skoularigis
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
| | - Andrew Xanthopoulos
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
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Kaya I. Detection of 4p16.3 deletion and 11p15.5p15.4 gain in a boy by comparative genomic hybridization array: A case report. World J Clin Cases 2024; 12:1517-1522. [PMID: 38576798 PMCID: PMC10989453 DOI: 10.12998/wjcc.v12.i8.1517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/03/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Nonallelic homologous recombination (NAHR) of segmental duplications or low copy repeats (LCRs) result in DNA gain/loss and play an important role in the origin of genomic disorders. CASE SUMMARY A 3-year- old boy was referred for genetic analysis. Comparative genomic hybridization array analysis revealed a loss of 3776 kb in the 4p16.3 chromosomal region and a gain of 3201 kb in the 11p15.5p15.4 chromosomal region. CONCLUSION Genomic imbalances caused by NAHR in LCRs result in deletion and duplication syndromes.
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Affiliation(s)
- Işın Kaya
- Medical Genetics, Bakırçay University Çiğli Education ve Training Hospital, İzmir 35620, Turkey
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125
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Liu YJ, Zou C, Wu YY. Metastatic clear cell sarcoma of the pancreas: A rare case report. World J Clin Cases 2024; 12:1448-1453. [PMID: 38576799 PMCID: PMC10989459 DOI: 10.12998/wjcc.v12.i8.1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/11/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Clear cell sarcoma (CCS) is a rare soft-tissue sarcoma. The most common metastatic sites for CCS are the lungs, bones and brain. CCS is highly invasive and mainly metastasizes to the lung, followed by the bone and brain; however, pancreatic metastasis is relatively rare. CASE SUMMARY We report on a rare case of CCS with pancreatic metastasis in a 47-year-old man. The patient had a relevant medical history 3 years ago, with abdominal pain as the main clinical manifestation. No abnormalities were observed on physical examination and the tumor was found on abdominal computed tomography. Based on the medical history and postoperative pathology, the patient was diagnosed with CCS with pancreatic metastasis. The patient was successfully treated with surgical interventions, including distal pancreatectomy and splenectomy. CONCLUSION This report summarizes the available treatment modalities for CCS and the importance of regular postoperative follow-up for patients with CCS.
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Affiliation(s)
- Yu-Jing Liu
- General Surgery II, Suzhou Hospital, The Affiliated Hospital of Medical School, Nanjing University, Suzhou 215000, Jiangsu Province, China
| | - Chen Zou
- Department of General Surgery, The Affiliated People's Hospital of Jiangsu University, Suzhou 215000, Jiangsu Province, China
| | - Yong-You Wu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215008, Jiangsu Province, China
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Lou JX, Wu Y, Huhe M, Zhang JJ, Jia DW, Jiang ZY. Diagnosis of poorly differentiated adenocarcinoma of the stomach by confocal laser endomicroscopy: A case report. World J Clin Cases 2024; 12:1481-1486. [PMID: 38576802 PMCID: PMC10989440 DOI: 10.12998/wjcc.v12.i8.1481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/20/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND In recent years, confocal laser endomicroscopy (CLE) has become a new endoscopic imaging technology at the microscopic level, which is extensively performed for real-time in vivo histological examination. CLE can be performed to distinguish benign from malignant lesions. In this study, we diagnosed using CLE an asymptomatic patient with poorly differentiated gastric adenocarcinoma. CASE SUMMARY A 63-year-old woman was diagnosed with gastric mucosal lesions, which may be gastric cancer, in the small curvature of the stomach by gastroscopy. She consented to undergo CLE for morphological observation of the gastric mucosa. Through the combination of CLE diagnosis and postoperative pathology, the intraoperative CLE diagnosis was considered to be reliable. According to our experience, CLE can be performed as the first choice for the diagnosis of gastric cancer. CONCLUSION CLE has several advantages over pathological diagnosis. We believe that CLE has great potential in the diagnosis of benign and malignant gastric lesions.
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Affiliation(s)
- Jia-Xin Lou
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| | - Yong Wu
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| | - Muren Huhe
- Medical Innovation Center, The Fourth Military Medical University, Xi'an 710000, Shaanxi Province, China
| | - Jing-Jie Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| | - Dong-Wu Jia
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| | - Zhen-Yu Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
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Oh S, Jang JS, Jeon AR, Kim G, Kwon M, Cho B, Lee N. Effectiveness of sensory integration therapy in children, focusing on Korean children: A systematic review and meta-analysis. World J Clin Cases 2024; 12:1260-1271. [PMID: 38524513 PMCID: PMC10955541 DOI: 10.12998/wjcc.v12.i7.1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/27/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development. Currently, various sensory integration interventions are being applied, but research methodological problems are arising due to unsystematic protocols. This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis. AIM To prove the effectiveness of sensory integration therapy, examine the latest trend of sensory integration studies in Korea, and provide clinical evidence for sensory integration therapies. METHODS The database of Korean search engines, including RISS, KISS, and DBpia, was used to search for related literature published from 2001 to October 2020. The keywords, "Children", "Sensory integration", "Integrated sensory", "Sensory-motor", and "Sensory stimulation" were used in this search. Then, a meta-analysis was conducted on 24 selected studiesRISS, KISS, and DBpia, was used to search for related literature published from 2001 to October 2020. The keywords, "Children", "Sensory integration", "Integrated sensory", "Sensory-motor", and "Sensory stimulation" were used in this search. Then, a meta-analysis was conducted on 24 selected studies. RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy, autism spectrum disorder, attention deficit/hyperactivity disorder, developmental disorder, and intellectual disability in relation to the diagnosis of children. Regarding sensory integration therapies, 1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective. In terms of dependent variables, sensory integration therapy effectively promoted social skills, adaptive behavior, sensory processing, and gross motor and fine motor skills. CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children, and can help to present standards for sensory integration intervention protocols.
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Affiliation(s)
- Seri Oh
- Department of Occupational Therapy, Kangwon National University Graduate School, Samcheok 25949, South Korea
| | - Jong-Sik Jang
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, South Korea
| | - A-Ra Jeon
- Department of Occupational Therapy, Ju-Ju Children Development Center, Nonsan-si 32985, Chungcheongnam-do, South Korea
| | - Geonwoo Kim
- Department of Occupational Therapy, Kangwon National University Graduate School, Samcheok 25949, South Korea
| | - Mihwa Kwon
- Department of Occupation Therapy, Suwon Women’s University, Gyeonggi-do 16632, South Korea
| | - Bahoe Cho
- Hijam Center for Development of Children, Ochang 28117, South Korea
| | - Narae Lee
- Department of Occupational Therapy, U1 University, Chung-cheong bukdo 25949, South Korea
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128
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Yan RZ, Chen C, Lin CR, Wei YH, Guo ZJ, Li YK, Zhang Q, Shen HY, Sun HL. Delayed neurological dysfunction following posterior laminectomy with lateral mass screw fixation: A case report and review of literature. World J Clin Cases 2024; 12:1356-1364. [PMID: 38524505 PMCID: PMC10955538 DOI: 10.12998/wjcc.v12.i7.1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 12/27/2023] [Accepted: 02/02/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND While most complications of cervical surgery are reversible, some, such as symptomatic postoperative spinal epidural hematoma (SEH), which generally occurs within 24 h, are associated with increased morbidity and mortality. Delayed neurological dysfunction is diagnosed in cases when symptoms present > 3 d postoperatively. Owing to its rarity, the risk factors for delayed neurological dysfunction are unclear. Consequently, this condition can result in irreversible neurological deficits and serious consequences. In this paper, we present a case of postoperative SEH that developed three days after hematoma evacuation. CASE SUMMARY A 68-year-old man with an American Spinal Injury Association (ASIA) grade C injury was admitted to our hospital with neck pain and tetraplegia following a fall. The C3-C7 posterior laminectomy and the lateral mass screw fixation surgery were performed on the tenth day. Postoperatively, the patient showed no changes in muscle strength or ASIA grade. The patient experienced neck pain and subcutaneous swelling on the third day postoperatively, his muscle strength decreased, and his ASIA score was grade A. Magnetic resonance imaging showed hypointense signals on T1 weighted image (T1WI) and T2WI located behind the epidural space, with spinal cord compression. Emergency surgical intervention for the hematoma was performed 12 h after onset. Although hypoproteinemia and pleural effusion did not improve in the perioperative period, the patient recovered to ASIA grade C on day 30 after surgery, and was transferred to a functional rehabilitation exercise unit. CONCLUSION This case shows that amelioration of low blood albumin and pleural effusion is an important aspect of the perioperative management of cervical surgery. Surgery to relieve the pressure on the spinal cord should be performed as soon as possible to decrease neurological disabilities.
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Affiliation(s)
- Rui-Zhong Yan
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Chao Chen
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Chu-Ran Lin
- Department of Orthopedics, Graduate School Shanxi University of Traditional Chinese Medicine, Taiyuan 030024, Shanxi Province, China
| | - Yan-Hui Wei
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Zhi-Jian Guo
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Ya-Kun Li
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Quan Zhang
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - He-Yi Shen
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Hao-Lin Sun
- Department of Orthopedics, Peking University First Hospital, Beijing 100034, China
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Liang JL, Bu YQ, Peng LL, Zhang HZ. Heterochronous multiple primary prostate cancer and lymphoma: A case report. World J Clin Cases 2024; 12:1333-1338. [PMID: 38524523 PMCID: PMC10955537 DOI: 10.12998/wjcc.v12.i7.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/17/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Multiple primary malignant tumors (MPMTs) are rare type of cancer, especially when solid tumors are the first and lymphoma is the second primary malignancy. We report a patient with heterochronous MPMTs consisting of prostate cancer and rectal diffuse large B-cell lymphoma (DLBCL). CASE SUMMARY We report a 77-year-old male patient diagnosed with prostate cancer who was treated with radiation therapy and one year of endocrine therapy with bicalutamide (50 mg per day) and an extended-release implant of goserelin (1/28 d). Seven years later, rectal DLBCL with lung metastases was found. CONCLUSION Although rare, the possibility of prostate cancer combined with a double primary cancer of DLBCL can provide a deeper understanding.
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Affiliation(s)
- Jin-Long Liang
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Yu-Qing Bu
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Li-Li Peng
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Hong-Zhen Zhang
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
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130
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Yu XX, Chen JY, Zhan HS, Liu MD, Li YF, Jia YY. Treatment of bilateral developmental dysplasia of the hip joint with an improved technique: A case report. World J Clin Cases 2024; 12:1320-1325. [PMID: 38524521 PMCID: PMC10955540 DOI: 10.12998/wjcc.v12.i7.1320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/08/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Developmental dysplasia of the hip (DDH) is a common osteoarticular deformity in pediatric orthopedics. A patient with bilateral DDH was diagnosed and treated using our improved technique "(powerful overturning acetabuloplasty)" combined with femoral rotational shortening osteotomy. CASE SUMMARY A 4-year-old girl who was diagnosed with bilateral DDH could not stand normally, and sought surgical treatment to solve the problem of double hip extension and standing. As this child had high dislocation of the hip joint and the acetabular index was high, we changed the traditional acetabuloplasty to "powerful turnover acetabuloplasty" combined with femoral rotation shortening osteotomy. During the short-term postoperative follow-up (1, 3, 6, 9, 12, and 15 months), the child had no discomfort in her lower limbs. After the braces and internal fixation plates were removed, formal rehabilitation training was actively carried out. CONCLUSION Our "powerful overturning acetabuloplasty" combined with femoral rotational shortening osteotomy is feasible in the treatment of DDH in children. This technology may be widely used in the clinic.
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Affiliation(s)
- Xing-Xing Yu
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Jian-Ye Chen
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Hong-Sheng Zhan
- Shi's Traumatology Medical Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ming-Da Liu
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Yun-Fei Li
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Yu-Yan Jia
- College of Traditional Chinese Medicine, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, Jilin Province, China
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Majic Tengg A, Cigrovski Berkovic M, Zajc I, Salaric I, Müller D, Markota I. Expect the unexpected: Brown tumor of the mandible as the first manifestation of primary hyperparathyroidism. World J Clin Cases 2024; 12:1200-1204. [PMID: 38524508 PMCID: PMC10955545 DOI: 10.12998/wjcc.v12.i7.1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/10/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
Hyperparathyroidism (HPT) is a condition in which one or more parathyroid glands produce increased levels of parathyroid hormone (PTH), causing disturbances in calcium homeostasis. Most commonly HPT presents with asymptomatic hypercalcemia but the clinical spectrum may include disturbances reflecting the combined effects of increased PTH secretion and hypercalcemia. Brown tumors are rare, benign, tumor-like bone lesions, occurring in 1.5% to 4.5% of patients with HPT, as a complication of an uncontrolled disease pathway, and are nowadays rarely seen in clinical practice. The tumor can appear either as a solitary or multifocal lesion and usually presents as an asymptomatic swelling or a painful exophytic mass. Furthermore, it can cause a pathological fracture or skeletal pain and be radiologically described as a lytic bone lesion. The diagnosis of a brown tumor in HPT is typically confirmed by assessing the levels of serum calcium, phosphorus, and PTH. Although when present, brown tumor is quite pathognomonic for HPT, the histologic finding often suggests a giant cell tumor, while clinical presentation might suggest other more frequent pathologies such as metastatic tumors. Treatment of brown tumors frequently focuses on managing the underlying HPT, which can often lead to regression and resolution of the lesion, without the need for surgical intervention. However, in refractory cases or when dealing with large symptomatic lesions, surgical treatment may be necessary.
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Affiliation(s)
- Ana Majic Tengg
- Department of Endocrinology, Diabetes, Metabolic Diseases and Clinical Pharmacology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
| | - Maja Cigrovski Berkovic
- Department for Sport and Exercise Medicine, Faculty of Kinesiology University of Zagreb, Zagreb 10000, Croatia
| | - Ivan Zajc
- Department of Oral Surgery, Clinical Hospital Dubrava, Zagreb 10000, Croatia
- University of Zagreb School of Dental Medicine, Zagreb 10000, Croatia
| | - Ivan Salaric
- Department of Oral Surgery, Clinical Hospital Dubrava, Zagreb 10000, Croatia
- University of Zagreb School of Dental Medicine, Zagreb 10000, Croatia
| | - Danko Müller
- Clinical Department of Pathology and Cytology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
| | - Iva Markota
- Clinical Department of Pathology and Cytology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
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Liu YX, Xu Y. Enhancing competency of clinical research nurses: A comprehensive training and evaluation framework. World J Clin Cases 2024; 12:1378-1381. [PMID: 38524510 PMCID: PMC10955526 DOI: 10.12998/wjcc.v12.i7.1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/19/2024] [Accepted: 02/04/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
The Sun et al's training program for clinical research nurses (CRNs) in the World Journal of Clinical Cases is a comprehensive and scientific approach. It includes structured frameworks for CRN training, aiming to improve CRN competency. This program emphasizes practical abilities, updates training content, and improves evaluation methods. The cultivation of CRN talents focuses on enhancing the training system, establishing a multifaceted evaluation framework, and continuously refining the training programs. Regular feedback and evaluation are essential to improve CRNs' competency in practical settings.
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Affiliation(s)
- Yang-Xi Liu
- Tumor Interventional Department, Taizhou Municipal Hospital, Taizhou 318099, Zhejiang Province, China
| | - Yi Xu
- Tumor Interventional Department, Taizhou Municipal Hospital, Taizhou 318099, Zhejiang Province, China
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Gómez Mireles JC, Martínez Carrillo EK, Alcalá Barbosa K, Gutiérrez Cortés E, González Ramos J, González Gómez LA, Bayardo González RA, Lomelí Martínez SM. Microsurgical management of radicular cyst using guided tissue regeneration technique: A case report. World J Clin Cases 2024; 12:1346-1355. [PMID: 38524520 PMCID: PMC10955527 DOI: 10.12998/wjcc.v12.i7.1346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/09/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Radicular cyst is a lesion of odontogenic origin that arises from epithelial remains due to periapical periodontitis caused by inflammatory reactions generated at the apex of affected teeth with infected or necrotic pulps. The therapeutic management of radicular cysts is controversial. There is only one case report of enucleation of a radicular cyst managed with microsurgery and apicoectomy, but without the use of the guided tissue regeneration (GTR) technique in the same surgical procedure. The present clinical case describes the management of a radicular cyst with microsurgical approach, performance of an apicoectomy of the tooth associated with the entity, application of GTR technique, use of a resorbable membrane of type I bovine collagen, and bovine xenograft. CASE SUMMARY A 68-year-old patient presented with a radicular cyst from an upper lateral incisor. The microsurgical management used was aimed at enucleating the chemical membrane, performing apicoectomy of the tooth along with careful and precise retrograde filling, and implementing GTR technique using a resorbable collagen membrane and bovine xenograft. The diagnosis of radicular cyst was confirmed using histopathological analysis. The patient underwent follow-up evaluations at 10 and 30 d postoperatively. At 4 months postoperative evaluation, she remained asymptomatic, and radiographs showed significant periapical healing with adequate bone formation. CONCLUSION These results suggest that microsurgical management using the GTR technique with collagen membrane and xenograft, contributes to bone regeneration.
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Affiliation(s)
- Juan Carlos Gómez Mireles
- Periodontics Specialty, Department of Integral Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Eugenia Karina Martínez Carrillo
- Endodontics Specialty, Department of Integral Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Katia Alcalá Barbosa
- Endodontics Specialty, Department of Clinics, Centro Universitario de Los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, Mexico
| | - Evangelina Gutiérrez Cortés
- Specialty in Oral Pathology, Surgical-Stomatological Department, Autonomous University of Guadalajara, Zapopan 45129, Mexico
| | | | - Luis Antonio González Gómez
- Periodontics Specialty, Department of Integral Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Rubén Alberto Bayardo González
- Department of Integral Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Sarah Monserrat Lomelí Martínez
- Department of Integral Dentistry Clinics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- Department of Medical and Life Sciences, Centro Universitario de la Ciénega, Universidad de Guadalajara, Ocotlán 47810, Mexico
- Master of Public Health, Department of Well-being and Sustainable Development, Centro Universitario del Norte, Universidad de Guadalajara, Colotlán 46200, Mexico
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Zhang S, Zeng N, Wu S, Wu HH, Kong MW. Research progress in spasmodic torticollis rehabilitation treatment. World J Clin Cases 2024; 12:1205-1214. [PMID: 38524504 PMCID: PMC10955543 DOI: 10.12998/wjcc.v12.i7.1205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/31/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
Spasmodic torticollis (ST) is a focal dystonia that affects adults, causing limited muscle control and impacting daily activities and quality of life. The etiology and curative methods for ST remain unclear. Botulinum toxin is widely used as a first-line treatment, but long-term usage can result in reduced tolerance and adverse effects. Rehabilitation therapy, with its minimal side effects and low potential for harm, holds significant clinical value. This article explores the effectiveness of adjunctive therapies, including exercise therapy, transcranial magnetic stimulation, shockwave therapy, neuromuscular electrical stimulation, vibration therapy, electromyographic biofeedback, and acupuncture, in the treatment of ST. The aim is to provide clinicians with additional treatment options and to discuss the efficacy of rehabilitation therapy for ST.
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Affiliation(s)
- Shuang Zhang
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Ni Zeng
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Shuang Wu
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Hui-Hui Wu
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Mo-Wei Kong
- Department of Cardiology, Guiqian International General Hospital, Guiyang 550018, Guizhou Province, China
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135
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Gang XH, Duan YY, Zhang B, Jiang ZG, Zhang R, Chen J, Teng XY, Zhang DB. Clinical characteristics of testicular torsion and factors influencing testicular salvage in children: A 12-year study in tertiary center. World J Clin Cases 2024; 12:1251-1259. [PMID: 38524506 PMCID: PMC10955544 DOI: 10.12998/wjcc.v12.i7.1251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/09/2024] [Accepted: 02/04/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Testicular torsion is the most common acute scrotum worldwide and mainly occurs in children and adolescents. Studies have demonstrated that the duration of symptoms and torsion grade lead to different outcomes in children diagnosed with testicular torsion. AIM To predict the possibility of testicular salvage (TS) in patients with testicular torsion in a tertiary center. METHODS We reviewed the charts of 75 pediatric patients with acute testicular torsion during a 12-year period from November 2011 to July 2023 at the Suzhou Hospital of Anhui Medical University. Univariate and multivariate logistic regression analyses were used to determine independent predictors of testicular torsion. The data included clinical findings, physical examinations, laboratory data, color Doppler ultrasound findings, operating results, age, presenting institution status, and follow-up results. RESULTS Our study included 75 patients. TS was possible in 57.3% of all patients; testicular torsion occurred mostly in winter, and teenagers aged 11-15 years old accounted for 60%. Univariate logistic regression analyses revealed that younger age (P = 0.09), body mass index (P = 0.004), torsion angle (P = 0.013), red blood cell count (P = 0.03), neutrophil-to-lymphocyte ratio (P = 0.009), and initial presenting institution (P < 0.001) were associated with orchiectomy. In multivariate analysis, only the initial presenting institution predicted TS (P < 0.05). CONCLUSION The initial presenting institution has a predictive value for predicting TS in patients with testicular torsion. Children with scrotal pain should be admitted to a tertiary hospital as soon as possible.
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Affiliation(s)
- Xiang-Hui Gang
- Department of Urology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Yuan-Yuan Duan
- Department of Ultrasound Diagnosis, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Bin Zhang
- Department of Urology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Zheng-Gan Jiang
- Department of Urology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Rong Zhang
- Department of Urology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Jun Chen
- Department of Urology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
| | - Xiang-Yu Teng
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
| | - Duo-Bing Zhang
- Department of Urology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
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136
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Zhao HH, Ma Z, Guan DS. Causal role of immune cells in obstructive sleep apnea hypopnea syndrome: Mendelian randomization study. World J Clin Cases 2024; 12:1227-1234. [PMID: 38524502 PMCID: PMC10955532 DOI: 10.12998/wjcc.v12.i7.1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/02/2024] [Accepted: 01/29/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Despite being one of the most prevalent sleep disorders, obstructive sleep apnea hypoventilation syndrome (OSAHS) has limited information on its immunologic foundation. The immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies (GWAS) and genotyping techniques using high-density genetic markers (e.g., SNP or CNVs). But this tactic hasn't yet been applied to OSAHS. Using a Mendelian randomization analysis, we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of OSAHS. AIM To investigate the immune cells' association with OSAHS via genetic methods, guiding future clinical research. METHODS A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and OSAHS. Summary statistics for each immune cell feature were obtained from the GWAS catalog. Information on 731 immune cell properties, such as morphologic parameters, median fluorescence intensity, absolute cellular, and relative cellular, was compiled using publicly available genetic databases. The results' robustness, heterogeneity, and horizontal pleiotropy were confirmed using extensive sensitivity examination. RESULTS Following false discovery rate (FDR) correction, no statistically significant effect of OSAHS on immunophenotypes was observed. However, two lymphocyte subsets were found to have a significant association with the risk of OSAHS: Basophil %CD33dim HLA DR- CD66b- (OR = 1.03, 95%CI = 1.01-1.03, P < 0.001); CD38 on IgD+ CD24- B cell (OR = 1.04, 95%CI = 1.02-1.04, P = 0.019). CONCLUSION This study shows a strong link between immune cells and OSAHS through a gene approach, thus offering direction for potential future medical research.
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Affiliation(s)
- Huang-Hong Zhao
- Department of Encephalopathy, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
| | - Zhen Ma
- Department of Personnel, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
| | - Dong-Sheng Guan
- Department of Neurology, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450000, Henan Province, China
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137
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Yang LW, Zhang LJ, Zhou BB, Lin XY, Chen YT, Qin XY, Tian HY, Ma LL, Sun Y, Jiang LD. Efficacy of borneol-gypsum in skin regeneration and pain control in toxic epidermal necrolysis: A case report. World J Clin Cases 2024; 12:1290-1295. [PMID: 38524518 PMCID: PMC10955549 DOI: 10.12998/wjcc.v12.i7.1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/18/2023] [Accepted: 02/07/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Toxic epidermal necrolysis (TEN) is a life-threatening dermatological emergency mainly induced by drug hypersensitivity reactions. Standard management includes discontinuation of culprit drug and application of immunomodulatory therapy. However, mortality remains high due to complications like septic shock and multiorgan failures. Innovative approaches for skin care are crucial. This report introduces borneol-gypsum, a traditional Chinese drug but a novel dressing serving as an adjuvant of TEN therapy, might significantly improve skin conditions and patient outcomes in TEN. CASE SUMMARY A 38-year-old woman diagnosed with eosinophilic granulomatosis with polyangiitis experienced gangrenous complications and motor nerve involvement. After initial treatment of high-dose corticosteroids and cyclophosphamide, symptom of foot drop improved, absolute eosinophil counts decreased, while limb pain sustained. Duloxetine was added to alleviate her symptom. Subsequently, TEN developed. Additional topical application of borneol-gypsum dressing not only protected the skin lesions from infection but also significantly eased localized pain. This approach demonstrated its merit in TEN management by promoting skin healing and potentially reducing infection risks. CONCLUSION Borneol-gypsum dressing is a promising adjuvant that could significantly improve TEN management, skin regeneration, and patient comfort.
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Affiliation(s)
- Lu-Wei Yang
- Department of Rheumatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
| | - Li-Juan Zhang
- Department of Rheumatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
| | - Bin-Bin Zhou
- Department of Rheumatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
| | - Xin-Yu Lin
- Department of Dermatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
| | - Yu-Ting Chen
- Department of Dermatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
| | - Xiao-Yu Qin
- Department of Ophthalmology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
| | - Hui-Ying Tian
- Department of Nursing, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
| | - Li-Li Ma
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai 200030, China
| | - Ying Sun
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai 200030, China
| | - Lin-Di Jiang
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai 200030, China
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138
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Wu D, Wang Q, Yan S, Sun X, Qin Y, Yuan M, Wang NY, Huang XT. Extended survival with metastatic pancreatic cancer under fruquintinib treatment after failed chemotherapy: Two case reports. World J Clin Cases 2024; 12:1296-1304. [PMID: 38524525 PMCID: PMC10955531 DOI: 10.12998/wjcc.v12.i7.1296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/02/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Pancreatic cancer is a highly malignant disease. After decades of treatment progress, the current five-year survival rate for patients is still less than 10%. For later-line treatment, the treatment options are even more limited. Anti-angiogenic drugs can improve progression-free survival in patients with advanced pancreatic cancer. Preclinical data show that fruquintinib might improve the prognosis of advanced pancreatic cancer by targeting angiogenesis and lymphopoiesis, improving the abnormal vascular structure, and modulating the tumour immune microenvironment. CASE SUMMARY We present two cases of third-line fruquintinib monotherapy that brought an extraprolonged progress-free survival (PFS) of 10 months. Patient 1 took adjuvant gemcitabine-based and first-line nab-paclitaxel-based chemotherapy and then used local radiotherapy combined with programmed cell death 1 receptor (PD-1). Each line lasted approximately 7 months. Moreover, the patient took third-line fruquintinib, which was followed by stable disease for 10 months, during which no additional adverse effect was observed. The patient later refused to take fruquintinib due to difficulty urinating and lower abdominal pain after the coronavirus disease 2019 (COVID-19) infection. The patient died in February 2023. Patient 2 also took two prior lines of chemotherapy and then local radiotherapy combined with S-1. After confirmed disease progression, the patient experienced a continuous partial response after using fruquintinib monotherapy in the third line. After the patient had COVID-19 in December 2022, fruquintinib was discontinued. The patient died in January 2023 due to disease progression. CONCLUSION Both cases achieved a PFS benefit from later-line single-agent fruquintinib therapy. With its better safety profile, fruquintinib may be worth exploring and studying in more depth as a later-line treatment for pancreatic cancer patients.
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Affiliation(s)
- Dan Wu
- Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
| | - Qiong Wang
- Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
| | - Shuai Yan
- Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
| | - Xia Sun
- Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
| | - Ya Qin
- Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
| | - Ming Yuan
- Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
| | - Nan-Yao Wang
- Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
| | - Xian-Ting Huang
- Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
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139
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Li D, Zeng WT, Jiang JG, Chen JC. Translocation of a fish spike from the pharynx to the thyroid gland: A case report. World J Clin Cases 2024; 12:1365-1370. [PMID: 38524516 PMCID: PMC10955535 DOI: 10.12998/wjcc.v12.i7.1365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/17/2024] [Accepted: 02/03/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND A fish spike stuck in the throat is a common ear, nose, and throat (ENT) emergency. However, it is very rare for a fish spike to reach the thyroid tissue through the throat, which is very dangerous and can lead to pharyngeal fistula, cervical abscess, mediastinal abscess, and thyroid abscess. Proper and timely management can help reduce complications, especially in elderly patients. CASE SUMMARY In the case presented here, the causative factor was dentures, but improper management aggravated the condition. In the case presented here, an elderly woman with a history of accidentally swallowing fish bones for 20 d had a sensation of foreign bodies in her throat. Eventually, computed tomography (CT) of the neck showed that the left side of the thyroid gland had a dense shadow in the form of a stripe. CONCLUSION If a fishbone foreign body is not visible during endoscopic examination but the patient has significant symptoms, the surgeon should be aware that the fishbone may be lodged in the thyroid. To avoid a misdiagnosis, ultrasound, CT, and other tests can be used to clarify the diagnosis. T The first step in treating a fish bone in the thyroid gland is to determine the position of the foreign body and the extent of the infection, and to develop a personalized surgical plan for its removal. At the same time, scientific information should be made available to the general public so that people know that if a fish bone is accidentally lodged, they should not force it to be swallowed or be spit out by inducing vomiting, which are incorrect methods and may aggravate the condition or even cause it to migrate outside the cavity, leading to serious complications, as in this reported case.
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Affiliation(s)
- Deng Li
- Department of Otolaryngology Head and Neck Surgery, Army Medical Center of PLA, Chongqing 400042, China
| | - Wan-Ting Zeng
- Department of Otolaryngology Head and Neck Surgery, Army Medical Center of PLA, Chongqing 400042, China
| | - Jian-Guo Jiang
- Department of Otolaryngology Head and Neck Surgery, Army Medical Center of PLA, Chongqing 400042, China
| | - Ji-Chuan Chen
- Department of Otolaryngology Head and Neck Surgery, Army Medical Center of PLA, Chongqing 400042, China
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140
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Nag DS, Swain A, Sahu S, Chatterjee A, Swain BP. Relevance of sleep for wellness: New trends in using artificial intelligence and machine learning. World J Clin Cases 2024; 12:1196-1199. [PMID: 38524514 PMCID: PMC10955542 DOI: 10.12998/wjcc.v12.i7.1196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/16/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
Sleep and well-being have been intricately linked, and sleep hygiene is paramount for developing mental well-being and resilience. Although widespread, sleep disorders require elaborate polysomnography laboratory and patient-stay with sleep in unfamiliar environments. Current technologies have allowed various devices to diagnose sleep disorders at home. However, these devices are in various validation stages, with many already receiving approvals from competent authorities. This has captured vast patient-related physiologic data for advanced analytics using artificial intelligence through machine and deep learning applications. This is expected to be integrated with patients' Electronic Health Records and provide individualized prescriptive therapy for sleep disorders in the future.
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Affiliation(s)
- Deb Sanjay Nag
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
| | - Amlan Swain
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
| | - Seelora Sahu
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
| | - Abhishek Chatterjee
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
| | - Bhanu Pratap Swain
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
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141
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Xiao XP, Dai YJ, Zhang Y, Yang M, Xie J, Chen G, Yang ZJ. Investigating the causal associations between five anthropometric indicators and nonalcoholic fatty liver disease: Mendelian randomization study. World J Clin Cases 2024; 12:1215-1226. [PMID: 38524522 PMCID: PMC10955530 DOI: 10.12998/wjcc.v12.i7.1215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/14/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Although the etiology of nonalcoholic fatty liver disease (NAFLD) has not been thoroughly understood, the emerging roles of anthropometric indicators in assessing and predicting the risk of NAFLD have been highlighted by accumulating evidence. AIM To evaluate the causal relationships between five anthropometric indicators and NAFLD employing Mendelian randomization (MR) design. METHODS The Anthropometric Consortium provided genetic exposure data for five anthropometric indicators, including hip circumference (HC), waist circumference (WC), waist-to-hip ratio (WHR), body mass index (BMI), and body fat percentage (BF). Genetic outcome data for NAFLD were obtained from the United Kingdom Biobank and FinnGen Consortium. Genome-wide significant single nucleotide polymorphisms were chosen as instrumental variables. Univariable MR (UVMR) and multivariable MR (MVMR) designs with analytical approaches, including inverse variance weighted (IVW), MR-Egger, weighted median (WM), and weighted mode methods, were used to assess the causal relationships between anthropometric indicators and NAFLD. RESULTS Causal relationships were revealed by UVMR, indicating that a higher risk of NAFLD was associated with a per-unit increase in WC [IVW: odds ratio (OR) = 2.67, 95%CI: 1.42-5.02, P = 2.25 × 10-3], and BF was causally associated with an increased risk of NAFLD (WM: OR = 2.23, 95%CI: 1.07-4.66, P = 0.033). The presence of causal effects of WC on the decreased risk of NAFLD was supported by MVMR after adjusting for BMI and smoking. However, no causal association between BF and NAFLD was observed. In addition, other causal relationships of HC, WHR (BMI adjusted), and BMI with the risk of NAFLD were not retained after FDR correction. CONCLUSION This study establishes a causal relationship, indicating that an increase in WC is associated with a higher risk of NAFLD. This demonstrates that a suitable decrease in WC is advantageous for preventing NAFLD.
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Affiliation(s)
- Xian-Pei Xiao
- Department of Oncology, Luojiang District People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China
| | - Yong-Jun Dai
- Department of Orthopaedics, Luojiang District People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China
| | - Yu Zhang
- Department of Oncology, Luojiang District People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China
| | - Meng Yang
- Department of Oncology, Luojiang District People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China
| | - Jian Xie
- Department of Oncology, Luojiang District People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China
| | - Guo Chen
- Department of Infectious Diseases, Hospital of Chengdu University of Traditional Chinese Medical, Chengdu 610500, Sichuan Province, China
| | - Zheng-Jun Yang
- Department of Oncology, Luojiang District People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China
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Cheng RX, Dai N, Wang YM, Qi P, Chen F. Perioperative and long-term results of ultrasonography-guided single- and multiple-tract percutaneous nephrolithotomy for staghorn calculi. World J Clin Cases 2024; 12:1243-1250. [PMID: 38524503 PMCID: PMC10955536 DOI: 10.12998/wjcc.v12.i7.1243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/29/2023] [Accepted: 01/17/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND It is possible that this condition will lead to urosepsis and progressive deterioration of renal function in the absence of surgical intervention. Several recent clinical studies have shown that multi-tract percutaneous nephrolithotomy (M-PCNL) has a similar stone free rate (SFR) as standard percutaneous nephrolithotomy (S-PCNL). As a result, M-PCNL was also recommended as a treatment option for staghorn calculi. AIM To examine the perioperative and long-term results of ultrasonography-guided single- and M-PCNL. METHODS This was a retrospective cohort study. Between March 2021 and January 2022, the urology department of our hospital selected patients for the treatment of staghorn calculi using percutaneous nephrolithotomy. The primary outcomes were complication rate and SFR, and the characteristics of patients, operative parameters, laboratory measurements were also collected. RESULTS In total, 345 patients were enrolled in the study (186 in the S-PCNL group and 159 in the M-PCNL group). The SFR in the M-PCNL group was significantly higher than that in the S-PCNL group (P = 0.033). Moreover, the incidence rates of hydrothorax (P = 0.03) and postoperative infection (P = 0.012) were higher in the M-PCNL group than in the S-PCNL group. Logistic regression analysis demonstrated that post-operative white blood cell count (OR = 2.57, 95%CI: 1.90-3.47, P < 0.001) and stone size (OR = 1.59, 95%CI: 1.27-2.00, P < 0.001) were associated with a higher overall complication rate in the S-PCNL group. Body mass index (OR = 1.22, 95%CI: 1.06-1.40, P = 0.004) and stone size (OR = 1.70, 95%CI: 1.35-2.15, P < 0.001) were associated with increased overall complications in the M-PCNL group. CONCLUSION Multiple access tracts can facilitate higher SFR while slightly increasing the incidence of acceptable complications.
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Affiliation(s)
- Rui-Xiang Cheng
- Department of Urology, Wuhan Ninth Hospital, Wuhan 430081, Hubei Province, China
| | - Ni Dai
- Department of Urinary Pain, Wuhan Hankou Hospital, Wuhan 430000, Hubei Province, China
| | - Yan-Min Wang
- Pre-hospital Emergency Department, Wuhan Puren Hospital, Wuhan 430081, Hubei Province, China
| | - Pei Qi
- Department of Orthopedic Trauma Surgery, Wuhan Hankou Hospital, Wuhan 430000, Hubei Province, China
| | - Fen Chen
- Department of Ultrasound, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan 430015, Hubei Province, China
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143
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Cho W, Jang EA, Kim KN. Reconstruction of cervical necrotizing fasciitis defect with the modified keystone flap technique: Two case reports. World J Clin Cases 2024; 12:1305-1312. [PMID: 38524511 PMCID: PMC10955528 DOI: 10.12998/wjcc.v12.i7.1305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/25/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Cervical necrotizing fasciitis (CNF) is a rare, aggressive form of deep neck space infection with significant morbidity and mortality rates. Serial surgical debridement acts as the cornerstone of CNF treatment; however, it often results in defects requiring complex reconstructions. CASE SUMMARY We report two cases in which the keystone flap (KF) was used for CNF defect coverage: Case 1, an 85-year-old patient with CNF in the anterior neck, and Case 2, a 54-year-old patient with CNF in the posterior neck. Both patients received empirical intravenous antibiotic therapy and underwent serial debridement, enabling adequate wound preparation and stabilization. The final defect size measured 5.5 cm × 12 cm in Case 1 and 6 cm × 11 cm in Case 2. For defect coverage, we employed an 8 cm × 19 cm type II KF based on perforators from the superior thyroid artery in Case 1 and a 9 cm × 18 cm type II KF based on perforators from the transverse cervical artery in Case 2. Both flaps showed complete survival. No postoperative complications occurred in both cases, and favorable outcomes were observed at 7- and 6-month follow-ups in case 1 and 2, respectively. CONCLUSION We effectively treated CNF-associated defects using the KF technique; KF is viable for covering CNF defects in carefully selected cases.
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Affiliation(s)
- Wonseok Cho
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea
| | - Eun A Jang
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea
| | - Kyu Nam Kim
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea
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144
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Xu SS, Hao LH, Guan YM. Reversal of complete atrioventricular block in dialysis patients following parathyroidectomy: A case report. World J Clin Cases 2024; 12:1313-1319. [PMID: 38524519 PMCID: PMC10955533 DOI: 10.12998/wjcc.v12.i7.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/18/2024] [Accepted: 02/04/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Refractory secondary hyperparathyroidism (SHPT) is a common complication observed in patients with end-stage renal disease and can result in ectopic calcification. Metastatic calcification involving the heart valves and the conduction system can easily lead to arrhythmias, including atrioventricular block. This case report describes a maintenance hemodialysis patient with refractory SHPT resulting in a complete atrioventricular block (CAVB), which was eventually reversed to a first-degree atrioventricular block. CASE SUMMARY We present the case of a 31-year-old Asian female who was receiving maintenance hemodialysis because of lupus nephropathy. She developed SHPT, and an electrocardiogram revealed a first-degree atrioventricular block. Then, she underwent parathyroidectomy (PTX) with autotransplantation. Unfortunately, a few years later, she developed SHPT again, and an electrocardiogram revealed a CAVB. A few years after the second PTX surgery, the calcification of the left atrium and left ventricle improved, and her CAVB was reversed. CONCLUSION This case revealed that metastatic cardiac calcification can result in complete atrioventricular blockage. Following parathyroid surgery, calcification of the cardiac conduction system improved, leading to reversal of the atrioventricular block. It is important for dialysis patients to optimize intact parathyroid hormone therapy and pay attention to calcification metastasis.
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Affiliation(s)
- Shan-Shan Xu
- Hemodialysis Center, Weifang People’s Hospital, Weifang 261041, Shandong Province, China
| | - Li-Hai Hao
- Hemodialysis Center, Weifang People’s Hospital, Weifang 261041, Shandong Province, China
| | - Yan-Meng Guan
- Hemodialysis Center, Weifang People’s Hospital, Weifang 261041, Shandong Province, China
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145
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Wang L, Long DY. Significant risk factors for intensive care unit-acquired weakness: A processing strategy based on repeated machine learning. World J Clin Cases 2024; 12:1235-1242. [PMID: 38524515 PMCID: PMC10955529 DOI: 10.12998/wjcc.v12.i7.1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/20/2024] [Accepted: 02/18/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Intensive care unit-acquired weakness (ICU-AW) is a common complication that significantly impacts the patient's recovery process, even leading to adverse outcomes. Currently, there is a lack of effective preventive measures. AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment. METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission. Relevant data from the initial 14 d of ICU stay, such as age, comorbidities, sedative dosage, vasopressor dosage, duration of mechanical ventilation, length of ICU stay, and rehabilitation therapy, were gathered. The relationships between these variables and ICU-AW were examined. Utilizing iterative machine learning techniques, a multilayer perceptron neural network model was developed, and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve. RESULTS Within the ICU-AW group, age, duration of mechanical ventilation, lorazepam dosage, adrenaline dosage, and length of ICU stay were significantly higher than in the non-ICU-AW group. Additionally, sepsis, multiple organ dysfunction syndrome, hypoalbuminemia, acute heart failure, respiratory failure, acute kidney injury, anemia, stress-related gastrointestinal bleeding, shock, hypertension, coronary artery disease, malignant tumors, and rehabilitation therapy ratios were significantly higher in the ICU-AW group, demonstrating statistical significance. The most influential factors contributing to ICU-AW were identified as the length of ICU stay (100.0%) and the duration of mechanical ventilation (54.9%). The neural network model predicted ICU-AW with an area under the curve of 0.941, sensitivity of 92.2%, and specificity of 82.7%. CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation. A primary preventive strategy, when feasible, involves minimizing both ICU stay and mechanical ventilation duration.
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Affiliation(s)
- Ling Wang
- Intensive Care Unit, People's Hospital of Qiandongnan Miao and Dong Autonomous Prefecture, Kaili 556000, Guizhou Province, China
| | - Deng-Yan Long
- Intensive Care Unit, People's Hospital of Qiandongnan Miao and Dong Autonomous Prefecture, Kaili 556000, Guizhou Province, China
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146
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Tan YW, Liu LP, Zhang K. Double plasma molecular adsorption system for Stevens-Johnson syndrome/toxic epidermal necrolysis: A case report. World J Clin Cases 2024; 12:1371-1377. [PMID: 38524512 PMCID: PMC10955548 DOI: 10.12998/wjcc.v12.i7.1371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/19/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are very serious skin allergies, with an etiology related to infections and medication. Since the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus-2 has also been considered to cause SJS/TEN. CASE SUMMARY We report the case of a woman in her thirties who took acetaminophen after contracting COVID-19. After 3 d of fever relief, she experienced high fever and presented with SJS/TEN symptoms, accompanied by intrahepatic cholestasis. Three days of corticosteroid treatment did not alleviate the skin damage; therefore, double plasma molecular adsorption system (DPMAS) therapy was initiated, with treatment intervals of 48 h. Her skin symptoms improved gradually and were resolved after seven DPMAS treatments. CONCLUSION DPMAS therapy is beneficial for abrogating SJS/TEN because plasma adsorption and perfusion techniques reduce the inflammatory mediators (e.g., tumor necrosis factor-alpha and interleukin-10 and-12) speculated to be involved in the pathology of the skin conditions.
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Affiliation(s)
- You-Wen Tan
- Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China
| | - Li-Ping Liu
- Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China
| | - Kai Zhang
- Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China
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147
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Li FZ, Zhao C, Tang YX, Liu JT. Safety and efficacy comparison of remimazolam and propofol for intravenous anesthesia during gastroenteroscopic surgery of older patients: A meta-analysis. World J Clin Cases 2024; 12:1272-1283. [PMID: 38524507 PMCID: PMC10955534 DOI: 10.12998/wjcc.v12.i7.1272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/21/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Remimazolam is characterized by rapid action and inactive metabolites. It is used as the general anesthetic for many clinical surgeries. In this study, we performed a meta-analysis to evaluate whether remimazolam is superior to propofol for gastroenteroscopy in older patients. AIM To compare the adverse events and efficacy of remimazolam and propofol during gastroenteroscopy in older adults. METHODS The PubMed, Web of Science, the Cochrane Library databases were queried for the relevant key words "remimazolam," "and propofol," "and gastrointestinal endoscopy or gastroscopy." The search scope was "Title and Abstract," and the search was limited to human studies and publications in English. Seven studies wherein remimazolam and propofol were compared were included for the meta-analysis. RESULTS We selected seven randomized controlled trials involving 1445 cases for the analysis. Remimazolam reduced the hypotension (relative risk, RR = 0.44, 95%CI: 0.29-0.66, P = 0.000), respiratory depression (RR = 0.46, 95%CI: 0.30-0.70, P = 0.000), injection pain (RR = 0.12, 95%CI: 0.05-0.25, P = 0.000), bradycardia (RR = 0.37, 95%CI: 0.24-0.58, P = 0.000), and time to discharge [weighted mean difference (WMD) = -0.58, 95%CI: -0.97 to -0.18, P = 0.005], compared to those after propofol administration. No obvious differences were observed for postoperative nausea and vomiting (RR = 1.09, 95%CI: 0.97-1.24, P = 0.151), dizziness (RR = 0.77, 95%CI: 0.43-1.36, P = 0.361), successful sedation rate (RR = 0.96, 95%CI: 0.93-1.00, P = 0.083), or the time to become fully alert (WMD = 0.00, 95%CI: -1.08-1.08, P = 0.998). CONCLUSION Remimazolam appears to be safer than propofol for gastroenteroscopy in older adults. However, further studies are required to confirm these findings.
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Affiliation(s)
- Fang-Zhuo Li
- Department of Anesthesiology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), Changsha 410005, Hunan Province, China
| | - Cheng Zhao
- Department of Anesthesiology, Zhangjiajie People's Hospital, Zhangjiajie 427000, Hunan Province, China
| | - Yi-Xun Tang
- Department of Anesthesiology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), Changsha 410005, Hunan Province, China
| | - Ji-Tong Liu
- Department of Anesthesiology, The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People’s Hospital), Changsha 410005, Hunan Province, China
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148
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Gao DK, Ye XL, Duan Z, Zhang HY, Xiong T, Li ZH, Pei HF. Cardiac remodeling in patients with atrial fibrillation reversing bradycardia-induced cardiomyopathy: A case report. World J Clin Cases 2024; 12:1339-1345. [PMID: 38524509 PMCID: PMC10955547 DOI: 10.12998/wjcc.v12.i7.1339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/09/2024] [Accepted: 02/07/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Bradycardia-induced cardiomyopathy (BIC), which is a disease resulting from bradycardia, is characterized by cardiac chamber enlargement and diminished cardiac function. The correction of bradycardia can allow for significant improvements in both cardiac function and structure; however, this disease has been infrequently documented. In this case, we conducted a longitudinal follow-up of a patient who had been enduring BIC for more than 40 years to heighten awareness and prompt timely diagnosis and rational intervention. CASE SUMMARY A woman who presented with postactivity fatigue and dyspnea was diagnosed with bradycardia at the age of 7. Since she had no obvious symptoms, she did not receive any treatment to improve her bradycardia during the 42-year follow-up, except for the implantation of a temporary pacemaker during labor induction surgery. As time progressed, the patient's heart gradually expanded due to her low ventricular rate, and she was diagnosed with BIC. In 2014, the patient developed atrial fibrillation, her ventricular rate gradually increased, and her heart shape gradually returned to normal. This report describes the cardiac morphological changes caused by the heart rate changes in BIC patients older than 40 years, introduces another possible outcome of BIC, and emphasizes the importance of early intervention in treating BIC. CONCLUSION BIC can induce atrial fibrillation, causing an increased ventricular rate and leading to positive cardiac remodeling.
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Affiliation(s)
- De-Kui Gao
- Department of Cardiology, Jiangyou Second People's Hospital, Jiangyou 621701, Sichuan Province, China
| | - Xiang-Lin Ye
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
- Department of Clinical Medicine, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Zhen Duan
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
| | - Hong-Yang Zhang
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
- Department of Clinical Medicine, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Tao Xiong
- Department of Cardiology, Jiangyou Second People's Hospital, Jiangyou 621701, Sichuan Province, China
| | - Zheng-Hong Li
- Department of Special Inspection, Jiangyou Second People's Hospital, Jiangyou 621701, Sichuan Province, China
| | - Hai-Feng Pei
- Department of Cardiology, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
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149
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Chen QN, Bai BQ, Xu Y, Mei Q, Liu XC. Sporadic gastrinoma with refractory benign esophageal stricture: A case report. World J Clin Cases 2024; 12:1284-1289. [PMID: 38524517 PMCID: PMC10955546 DOI: 10.12998/wjcc.v12.i7.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/25/2023] [Accepted: 02/05/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Gastrinoma is characterized by an excessive release of gastrin, leading to hypersecretion of gastric acid, subsequently resulting in recurrent peptic ulcers, chronic diarrhea, and even esophageal strictures. This case report aims to improve awareness and facilitate early diagnosis and treatment of gastrinoma by presenting a rare case of gastrinoma with refractory benign esophageal stricture (RBES). Additionally, it highlights the persistent challenges that gastroenterologists encounter in managing RBES. CASE SUMMARY This case demonstrates a patient with gastrinoma who developed RBES and complete esophageal obstruction despite management with maximal acid suppressive therapy, multiple endoscopic bougie dilations and endoscopic incisional therapy (EIT). CONCLUSION It is essential to diagnose gastrinoma as early as possible, as inadequately controlled acid secretion over an extended period increases the risk of developing severe esophageal strictures. In patients with esophageal strictures causing complete luminal obstruction, blind reopening EIT presents challenges and carries a high risk of perforation.
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Affiliation(s)
- Qian-Nan Chen
- Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Bing-Qing Bai
- Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Yan Xu
- Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Qiao Mei
- Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Xiao-Chang Liu
- Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
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150
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Zhou Y, Sun YW, Liu XY, Shen DH. Misdiagnosis of synovial sarcoma - cellular myofibroma with SRF-RELA gene fusion: A case report. World J Clin Cases 2024; 12:1326-1332. [PMID: 38524524 PMCID: PMC10955539 DOI: 10.12998/wjcc.v12.i7.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/06/2024] [Accepted: 01/25/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Cellular myofibroma is a rare subtype of myofibroma that was first described in 2017. Its diagnosis is often challenging because of its relative rarity, lack of known genetic abnormalities, and expression of muscle markers that can be confused with sarcomas that have myogenic differentiation. Currently, scholars have limited knowledge of this disease, and published cases are few. Further accumulation of diagnostic and treatment experiences is required. CASE SUMMARY A 16-year-old girl experienced left upper limb swelling for 3 years. She sought medical attention at a local hospital 10 months ago, where magnetic resonance imaging revealed a 5-cm soft tissue mass. Needle biopsy performed at a local hospital resulted in the diagnosis of a spindle cell soft tissue sarcoma. The patient was referred to our hospital for limb salvage surgery with endoprosthetic replacement. She was initially diagnosed with a synovial sarcoma. Consequently, clinical management with chemotherapy was continued for the malignant sarcoma. Our pathology department also performed fluorescence in situ hybridization for result validation, which returned negative for SS18 gene breaks, indicating that it was not a synovial sarcoma. Next-generation sequencing was used to identify the SRF-RELA rearrangement. The final pathological diagnosis was a cellular/myofibroblastic neoplasm with an SRF-RELA gene fusion. The patient had initially received two courses of chemotherapy; however, chemotherapy was discontinued after the final diagnosis. CONCLUSION This case was misdiagnosed because of its rare occurrence, benign biological behavior, and pathological similarity to soft tissue sarcoma.
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Affiliation(s)
- Ying Zhou
- Department of Pathology, Peking University People’s Hospital, Beijing 100044, China
| | - Yi-Wen Sun
- Department of Pathology, Peking University People’s Hospital, Beijing 100044, China
| | - Xiao-Yang Liu
- Department of Pathology, Peking University People’s Hospital, Beijing 100044, China
| | - Dan-Hua Shen
- Department of Pathology, Peking University People’s Hospital, Beijing 100044, China
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