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Qi PQ, Zeng YJ, Peng W, Kuai J. Lung imaging characteristics in a patient infected with Elizabethkingia miricola following cerebral hemorrhage surgery: A case report. World J Clin Cases 2024; 12:169-175. [PMID: 38292629 PMCID: PMC10824168 DOI: 10.12998/wjcc.v12.i1.169] [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: 09/13/2023] [Revised: 11/12/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Elizabethkingia miricola is a non-fermenting gram-negative bacterium, which was first isolated from the condensate of the Russian peace space station in 2003. Most studies on this bacterium have been carried out in the laboratory, and clinical case studies are rare. To date, a total of 6 clinical cases have been reported worldwide. CASE SUMMARY We present the first case of postoperative pulmonary infection in a patient with intracerebral hemorrhage due to Elizabethkingia miricola. The imaging characteristics of pulmonary infection were identified and the formulation and selection of the clinical treatment plan for this patient are discussed. CONCLUSION Elizabethkingia miricola infection is rare. When pulmonary infection occurs, computed tomography imaging may show diffuse distribution of a ground glass density shadow in both lungs, the air containing bronchial sign in local areas, thickening of bronchial vascular bundle, and pleural effusion.
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Affiliation(s)
- Ping-Qiang Qi
- Department of Neurosurgery, The Third Affiliated Hospital of Chengdu Medical College Pidu District People’s Hospital, Chengdu 611730, Sichuan Province, China
| | - Yi-Jun Zeng
- Department of Neurosurgery, The Third Affiliated Hospital of Chengdu Medical College Pidu District People’s Hospital, Chengdu 611730, Sichuan Province, China
| | - Wei Peng
- Department of Neurosurgery, The Third Affiliated Hospital of Chengdu Medical College Pidu District People’s Hospital, Chengdu 611730, Sichuan Province, China
| | - Juan Kuai
- Department of Neurosurgery, The Third Affiliated Hospital of Chengdu Medical College Pidu District People’s Hospital, Chengdu 611730, Sichuan Province, China
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202
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Juneja D, Nasa P, Chanchalani G, Jain R. Nasogastric tube syndrome: A Meta-summary of case reports. World J Clin Cases 2024; 12:119-129. [PMID: 38292636 PMCID: PMC10824182 DOI: 10.12998/wjcc.v12.i1.119] [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: 10/28/2023] [Revised: 12/07/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Since its description in 1790 by Hunter, the nasogastric tube (NGT) is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral feeding. However, the risks associated with its placement are often underestimated. Upper airway obstruction with a NGT is an uncommon but potentially life-threatening complication. NGT syndrome is characterized by the presence of an NGT, throat pain and vocal cord (VC) paralysis, usually bilateral. It is potentially life-threatening, and early diagnosis is the key to the prevention of fatal upper airway obstruction. However, fewer cases may have been reported than might have occurred, primarily due to the clinicians' unawareness. The lack of specific signs and symptoms and the inability to prove temporal relation with NGT insertion has made diagnosing the syndrome quite challenging. AIM To review and collate the data from the published case reports and case series to understand the possible risk factors, early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway obstruction. METHODS We conducted a systematic search for this meta-summary from the database of PubMed, EMBASE, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Google scholar, from all the past studies till August 2023. The search terms included major MESH terms "Nasogastric tube", "Intubation, Gastrointestinal", "Vocal Cord Paralysis", and "Syndrome". All the case reports and case series were evaluated, and the data were extracted for patient demographics, clinical symptomatology, diagnostic and therapeutic interventions, clinical course and outcomes. A datasheet for evaluation was further prepared. RESULTS Twenty-seven cases, from five case series and 13 case reports, of NGT syndrome were retrieved from our search. There was male predominance (17, 62.96%), and age at presentation ranged from 28 to 86 years. Ten patients had diabetes mellitus (37.04%), and nine were hypertensive (33.33%). Only three (11.11%) patients were reported to be immunocompromised. The median time for developing symptoms after NGT insertion was 14.5 d (interquartile range 6.25-33.75 d). The most commonly reported reason for NGT insertion was acute stroke (10, 37.01%) and the most commonly reported symptoms were stridor or wheezing 17 (62.96%). In 77.78% of cases, bilateral VC were affected. The only treatment instituted in most patients (77.78%) was removing the NG tube. Most patients (62.96%) required tracheostomy for airway protection. But 8 of the 23 survivors recovered within five weeks and could be decannulated. Three patients were reported to have died. CONCLUSION NGT syndrome is an uncommon clinical complication of a very common clinical procedure. However, an under-reporting is possible because of misdiagnosis or lack of awareness among clinicians. Patients in early stages and with mild symptoms may be missed. Further, high variability in the presentation timing after NGT insertion makes diagnosis challenging. Early diagnosis and prompt removal of NGT may suffice in most patients, but a significant proportion of patients presenting with respiratory compromise may require tracheostomy for airway protection.
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Affiliation(s)
- Deven Juneja
- Department of Critical Care Medicine, Max Super Speciality Hospital, New Delhi 110017, India
| | - Prashant Nasa
- Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
| | - Gunjan Chanchalani
- Department of Critical Care Medicine, Karamshibhai Jethabhai Somaiya Hospital and Research Centre, Mumbai 400022, India
| | - Ravi Jain
- Department of Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur 302022, Rajasthan, India
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Fang LZ, Jin HX, Zhao N, Wu YP, Shi YQ. Successful management of severe hypoglycemia induced by total parenteral nutrition in patients with hepatocellular injury: Three cases reports. World J Clin Cases 2024; 12:157-162. [PMID: 38292637 PMCID: PMC10824187 DOI: 10.12998/wjcc.v12.i1.157] [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: 11/07/2023] [Accepted: 12/19/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Glucose imbalance is common in total parenteral nutrition (TPN). Hypoglycemia seems to be less frequent than hyperglycemia, but it influences the clinical outcome to a greater extent. Therefore, it should be effectively prevented and treated. However, there is no relevant report on how to treat hypoglycemia caused by TPN in patients with liver cell injury. CASE SUMMARY We present three patients with liver cell injury who developed severe hypoglycemia during or after TPN infusion. The causes of severe hypoglycemia and glucose-raising strategies were discussed. According to the physiological characteristics of the hepatocellular injury, the ratio of nutrition components prescribed in TPN was appropriately adjusted for the three cases. We simultaneously reduced the dose of insulin and fat emulsion, and increased the dose of glucose in TPN. The blood glucose level was restored to normal range and clinical symptoms were eliminated. CONCLUSION When hypoglycemia occurs during or after TPN in patients with hepatocellular injury, physicians need to simultaneously reduce insulin and fat emulsion, and increase glucose, and correct severe hypoglycemia in time to reduce its adverse consequences.
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Affiliation(s)
- Ling-Zhi Fang
- Department of Pharmacy, Hebei Key Laboratory of Clinical Pharmacy, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Hui-Xin Jin
- Department of Pharmacy, Hebei Key Laboratory of Clinical Pharmacy, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Na Zhao
- Department of Pharmacy, Hebei Key Laboratory of Clinical Pharmacy, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Yu-Pei Wu
- Department of Pharmacy, Hebei Key Laboratory of Clinical Pharmacy, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Ying-Qin Shi
- Department of Pharmacy, Hebei Key Laboratory of Clinical Pharmacy, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
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Lin HCA, Lee KF, Huang TH. Gastric IgG4-related disease mimicking a gastrointestinal stromal tumor in a child: A case report. World J Clin Cases 2024; 12:176-179. [PMID: 38292633 PMCID: PMC10824196 DOI: 10.12998/wjcc.v12.i1.176] [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: 09/24/2023] [Revised: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Gastric IgG4-related disease (IgG4-RD) is rarely encountered in clinical practice, and especially more so among pediatric patients. To our knowledge, this is the first report of IgG4-RD presenting as a calcifying gastric mass in a child. We describe how this entity was difficult to differentiate from a gastrointestinal stromal tumor (GIST) imaging-based approaches. Therefore, this case highlights the importance of considering IgG4-RD in the differential diagnosis of gastric tumor before performing surgical resection, especially to distinguish it from malignancy to avoid unnecessary surgery. CASE SUMMARY The patient suffered from epigastric pain for several days. Panendoscopy and computed tomography scan revealed a submucosal tumor. Differential diagnoses included GIST, leiomyoma, teratoma, and mucinous adenocarcinoma. However, laparoscopic proximal gastrectomy allowed for the definitive diagnosis of IgG4-related stomach disease. CONCLUSION We emphasize the importance of considering IgG4-RD in the differential diagnosis of gastric submucosal tumors before performing surgical resection.
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Affiliation(s)
- Hsin-Chia Angela Lin
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Kam-Fai Lee
- Department of Anatomic Pathology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Tzu Hao Huang
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
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205
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Liang GF, Chao S, Sun Z, Zhu KJ, Chen Q, Jia L, Niu YL. Pleural empyema with endobronchial mass due to Rhodococcus equi infection after renal transplantation: A case report and review of literature. World J Clin Cases 2024; 12:224-231. [PMID: 38292625 PMCID: PMC10824171 DOI: 10.12998/wjcc.v12.i1.224] [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: 11/05/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Kidney transplantation is the best option for patients with end-stage renal disease. However, the need for lifelong immunosuppression results in renal transplant recipients being susceptible to various infections. Rhodococcus equi (R. equi) is a rare opportunistic pathogen in humans, and there are limited reports of infection with R. equi in post-renal transplant recipients and no uniform standard of treatment. This article reports on the diagnosis and treatment of a renal transplant recipient infected with R. equi 21 mo postoperatively and summarizes the characteristics of infection with R. equi after renal transplantation, along with a detailed review of the literature. CASE SUMMARY Here, we present the case of a 25-year-old man who was infected with R. equi 21 mo after renal transplantation. Although the clinical features at the time of presentation were not specific, chest computed tomography (CT) showed a large volume of pus in the right thoracic cavity and right middle lung atelectasis, and fiberoptic bronchoscopy showed an endobronchial mass in the right middle and lower lobe orifices. Bacterial culture and metagenomic next-generation sequencing sequencing of the pus were suggestive of R. equi infection. The immunosuppressive drugs were immediately suspended and intravenous vancomycin and azithromycin were administered, along with adequate drainage of the abscess. The endobronchial mass was then resected. After the patient's clinical symptoms and chest CT presentation resolved, he was switched to intravenous ciprofloxacin and azithromycin, followed by oral ciprofloxacin and azithromycin. The patient was re-hospitalized 2 wk after discharge for recurrence of R. equi infection. He recovered after another round of adequate abscess drainage and intravenous ciprofloxacin and azithromycin. CONCLUSION Infection with R. equi in renal transplant recipients is rare and complex, and the clinical presentation lacks specificity. Elaborate antibiotic therapy is required, and adequate abscess drainage and surgical excision are necessary. Given the recurrent nature of R. equi, patients need to be followed-up closely.
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Affiliation(s)
- Guo-Fu Liang
- Department of Organ Transplantation, School of Clinical Medicine, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Sheng Chao
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Zhou Sun
- Department of Organ Transplantation, School of Clinical Medicine, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Ke-Jing Zhu
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Qian Chen
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Lei Jia
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Yu-Lin Niu
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
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Jia XH, Kong S, Gao XX, Cong BC, Zheng CN. Intestinal malrotation complicated with gastric cancer: A case report. World J Clin Cases 2024; 12:210-216. [PMID: 38292641 PMCID: PMC10824180 DOI: 10.12998/wjcc.v12.i1.210] [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: 10/31/2023] [Revised: 11/22/2023] [Accepted: 12/15/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Intestinal malrotation is a congenital defect of embryonic development caused by various teratogenic factors. In this condition, the intestinal tube, along with the superior mesenteric artery serving as the axis for the counterclockwise movement, is incomplete or abnormally rotated due to incomplete attachment of the mesentery and abnormal intestinal tube position. Such a case is usually asymptomatic and thus difficult to detect. Therefore, similar variant malformations are only found during an operation required for other abdominal diseases. CASE SUMMARY An elderly male patient was admitted to the hospital due to gastric cancer. An abdominal computed tomography (CT) scan with contrast revealed that the ascending and descending colon were parallel on the right side of the abdominal cavity, while the sigmoid colon extended into the right iliac fossa, allowing the diagnosis of congenital midgut malrotation. Following thorough preoperative preparation, the patient underwent laparoscopic radical gastrectomy to treat his gastric cancer. Intraoperatively, an exploration of the abdominal cavity uncovered the absence of the transverse colon. The distal colon at the hepatic flexure, along with the ascending colon, extended into the right iliac fossa, where it continued as the sigmoid colon. As planned, the laparoscopic radical gastrectomy was performed, and the patient was discharged from the hospital 7 d after the surgery. CONCLUSION Asymptomatic intestinal malrotation is best detected by CT, requiring no treatment but possibly interfering with the treatment of other diseases.
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Affiliation(s)
- Xiang-Hao Jia
- School of Clinical Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
| | - Shuai Kong
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
| | - Xin-Xin Gao
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
| | - Bi-Cong Cong
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
| | - Chun-Ning Zheng
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
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Liu K, Li ZH. Efficacy and safety of Nafamostat mesylate in patients with end-stage renal failure. World J Clin Cases 2024; 12:68-75. [PMID: 38292627 PMCID: PMC10824189 DOI: 10.12998/wjcc.v12.i1.68] [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: 11/10/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Recent studies on dialysis anticoagulation therapy in patients with renal failure have shown that Nafamostat mesylate, a broad-spectrum potent serine protease inhibitor, has strong anticoagulation and anti-fiber activity. AIM To evaluate the efficacy and safety of Nafamostat mesylate in patients with end-stage renal failure. METHODS Seventy-five patients with end-stage renal failure who received hemodialysis at our hospital between January 2020 and August 2021 were selected and divided into the observation group (Nafamostat mesylate for injection, n = 33) and control group (heparin sodium injection, n = 32). General patient data, indicators of clinical efficacy, dialyzer hemocoagulation parameters, coagulation function indices, and hemoglobin concentration and platelet count before and after treatment, and the occurrence of adverse reactions after treatment were compared between the two groups. RESULTS The two groups showed no significant differences in general patient data (P > 0.05). The post-treatment effectiveness rate in the control group was lower than that in the observation group (P < 0.05). The two groups showed no significant difference in the number of patients in grade I (P > 0.05), while the number of patients in grade 0 was lower in the control group, and the number of patients in grades II and III was higher in the control group (P < 0.05). The post-treatment prothrombin time, activated partial thromboplastin time, thrombin time, and international normalized ratio values in the control group were higher than those in the observation group, while the fibrinogen level in the control group was lower than that in the observation group (P < 0.05). The two groups showed no significant difference in the platelet count and hemoglobin level before and after treatment (P > 0.05). The total number of post-treatment adverse reactions in the observation group was lower than that in the control group (P < 0.05). CONCLUSION Treatment of patients showing end-stage renal failure with Nafamostat mesylate can significantly improve therapeutic efficacy and has high safety and clinical value.
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Affiliation(s)
- Kun Liu
- Department of Critical Care Medicine, The Third People's Hospital Of Hubei Province, Wuhan 430030, Hubei Province, China
| | - Zhen-Hua Li
- Department of Critical Care Medicine, General Hospital of The Yangtze River Shipping, Wuhan Brain Hospital, Wuhan 430015, Hubei Province, China
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208
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Xu TC, Liu Y, Yu Z, Xu B. Gut-targeted therapies for type 2 diabetes mellitus: A review. World J Clin Cases 2024; 12:1-8. [PMID: 38292634 PMCID: PMC10824172 DOI: 10.12998/wjcc.v12.i1.1] [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: 08/27/2023] [Revised: 11/24/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia and insulin resistance. The global prevalence of T2DM has reached epidemic proportions, affecting approximately 463 million adults worldwide in 2019. Current treatments for T2DM include lifestyle modifications, oral antidiabetic agents, and insulin therapy. However, these therapies may carry side effects and fail to achieve optimal glycemic control in some patients. Therefore, there is a growing interest in the role of gut microbiota and more gut-targeted therapies in the management of T2DM. The gut microbiota, which refers to the community of microorganisms that inhabit the human gut, has been shown to play a crucial role in the regulation of glucose metabolism and insulin sensitivity. Alterations in gut microbiota composition and diversity have been observed in T2DM patients, with a reduction in beneficial bacteria and an increase in pathogenic bacteria. This dysbiosis may contribute to the pathogenesis of the disease by promoting inflammation and impairing gut barrier function. Several gut-targeted therapies have been developed to modulate the gut microbiota and improve glycemic control in T2DM. One potential approach is the use of probiotics, which are live microorganisms that confer health benefits to the host when administered in adequate amounts. Several randomized controlled trials have demonstrated that certain probiotics, such as Lactobacillus and Bifidobacterium species, can improve glycemic control and insulin sensitivity in T2DM patients. Mechanisms may include the production of short-chain fatty acids, the improvement of gut barrier function, and the reduction of inflammation. Another gut-targeted therapy is fecal microbiota transplantation (FMT), which involves the transfer of fecal material from a healthy donor to a recipient. FMT has been used successfully in the treatment of Clostridioides difficile infection and is now being investigated as a potential therapy for T2DM. A recent randomized controlled trial showed that FMT from lean donors improved glucose metabolism and insulin sensitivity in T2DM patients with obesity. However, FMT carries potential risks, including transmission of infectious agents and alterations in the recipient's gut microbiota that may be undesirable. In addition to probiotics and FMT, other gut-targeted therapies are being investigated for the management of T2DM, such as prebiotics, synbiotics, and postbiotics. Prebiotics are dietary fibers that promote the growth of beneficial gut bacteria, while synbiotics combine probiotics and prebiotics. Postbiotics refer to the metabolic products of probiotics that may have beneficial effects on the host. The NIH SPARC program, or the Stimulating Peripheral Activity to Relieve Conditions, is a research initiative aimed at developing new therapies for a variety of health conditions, including T2DM. The SPARC program focuses on using electrical stimulation to activate peripheral nerves and organs, in order to regulate glucose levels in the body. The goal of this approach is to develop targeted, non-invasive therapies that can help patients better manage their diabetes. One promising area of research within the SPARC program is the use of electrical stimulation to activate the vagus nerve, which plays an important role in regulating glucose metabolism. Studies have shown that vagus nerve stimulation can improve insulin sensitivity and lower blood glucose levels in patients with T2DM. Gut-targeted therapies, such as probiotics and FMT, have shown potential for improving glycemic control and insulin sensitivity in T2DM patients. However, further research is needed to determine the optimal dose, duration, and safety of these therapies.
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Affiliation(s)
- Tian-Cheng Xu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Yun Liu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Zhi Yu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Bin Xu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
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Wang SS, Liu WH. Impact of frailty on outcomes of elderly patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis. World J Clin Cases 2024; 12:107-118. [PMID: 38292628 PMCID: PMC10824195 DOI: 10.12998/wjcc.v12.i1.107] [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: 10/27/2023] [Revised: 11/30/2023] [Accepted: 12/15/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention (PCI). However, how frailty affects clinical outcomes in this group is unclear. AIM To assess the link between frailty and the outcomes, such as in-hospital complications, post-procedural complications, and mortality, in elderly patients post-PCI. METHODS The PubMed/MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were screened for publications up to August 2023. The primary outcomes assessed were in-hospital and all-cause mortality, major adverse cardiovascular events (MACEs), and major bleeding. The Newcastle-Ottawa Scale was used for quality assessment. RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included. Frailty was consistently associated with adverse outcomes. Frail patients had significantly higher risks of in-hospital mortality [risk ratio: 3.45, 95% confidence interval (95%CI): 1.90-6.25], all-cause mortality [hazard ratio (HR): 2.08, 95%CI: 1.78-2.43], MACEs (HR: 2.92, 95%CI: 1.85-4.60), and major bleeding (HR: 4.60, 95%CI: 2.89-7.32) compared to non-frail patients. CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality, development of MACEs, and major bleeding in elderly individuals undergoing percutaneous coronary intervention.
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Affiliation(s)
- Shi-Shi Wang
- Department of Emergency Medicine, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
| | - Wang-Hao Liu
- Department of Geriatrics, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
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210
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Zhang TX, Xu HY, Ma W, Zheng JB. Addison's disease caused by adrenal tuberculosis may lead to misdiagnosis of major depressive disorder: A case report. World J Clin Cases 2024; 12:217-223. [PMID: 38292640 PMCID: PMC10824194 DOI: 10.12998/wjcc.v12.i1.217] [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: 10/30/2023] [Revised: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Addison's disease (AD) is a rare but potentially fatal disease in Western countries, which can easily be misdiagnosed at an early stage. Severe adrenal tuberculosis (TB) may lead to depression in patients. CASE SUMMARY We report a case of primary adrenal insufficiency secondary to adrenal TB with TB in the lungs and skin in a 48-year-old woman. The patient was misdiagnosed with depression because of her depressed mood. She had hyperpigmentation of the skin, nails, mouth, and lips. The final diagnosis was adrenal TB that resulted in the insufficient secretion of adrenocortical hormone. Adrenocortical hormone test, skin biopsy, T cell spot test of TB, and adrenal computed tomography scan were used to confirm the diagnosis. The patient's condition improved after hormone replacement therapy and TB treatment. CONCLUSION Given the current status of TB in high-burden countries, outpatient doctors should be aware of and pay attention to TB and understand the early symptoms of AD.
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Affiliation(s)
- Tian-Xiang Zhang
- Department of Tuberculosis, The Tuberculosis Hospital of Shaanxi Province, Xi’an 710100, Shaanxi Province, China
| | - Hong-Yan Xu
- Department of Tuberculosis, The Tuberculosis Hospital of Shaanxi Province, Xi’an 710100, Shaanxi Province, China
| | - Wei Ma
- Department of Tuberculosis, The Tuberculosis Hospital of Shaanxi Province, Xi’an 710100, Shaanxi Province, China
| | - Jian-Bao Zheng
- Department of Tuberculosis, The Tuberculosis Hospital of Shaanxi Province, Xi’an 710100, Shaanxi Province, China
- Department of General Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
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Wu NN, Yan GL, Zhang HY, Sun L, Hou M, Xu GM. Interaction between adolescent sleep rhythms and gender in an obese population. World J Clin Cases 2024; 12:86-94. [PMID: 38292647 PMCID: PMC10824193 DOI: 10.12998/wjcc.v12.i1.86] [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: 08/29/2023] [Revised: 09/27/2023] [Accepted: 12/01/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND The obesity rate of adolescents is gradually increasing, which seriously affects their mental health, and sleep plays an important role in adolescent obesity. AIM To investigate the relationship between sleep rhythm and obesity among adolescents and further explores the interactive effect of sleep rhythm and gender on adolescent obesity, providing a theoretical basis for developing interventions for adolescent obesity. METHODS Research data source Tianjin Mental Health Promotion Program for Students. From April to June 2022, this study selected 14201 students from 13 middle schools in a certain district of Tianjin as the research subject using the convenient cluster sampling method. Among these students, 13374 accepted and completed the survey, with an effective rate of 94.2%.The demographic data and basic information of adolescents, such as height and weight, were collected through a general situation questionnaire. The sleep rhythm of adolescents was evaluated using the reduced version of the morningness-eveningness questionnaire. RESULTS A total of 13374 participants (6629 females, accounting for 49.56%; the average age is 15.21 ± 1.433 years) were analyzed. Among them, the survey showed that 2942 adolescent were obesity, accounting for 22% and 2104 adolescent were overweight, accounting for 15.7%. Among them, 1692 male adolescents are obese, with an obesity rate of 25.1%, higher than 18.9% of female adolescents. There is a statistically significant difference between the three groups (χ2 = 231.522, P < 0.000). The obesity group has the smallest age (14.94 ± 1.442 years), and there is a statistical difference in age among the three groups (F = 69.996, P < 0.000).Obesity rates are higher among individuals who are not-only-child, have residential experience within six months, have family economic poverty, and have evening-type sleep (P < 0.05). Logistic regression analysis shows a correlation between sleep rhythm and adolescent obesity. Evening-type sleep rhythm can increase the risk of obesity in male adolescents [1.250 (1.067-1.468)], but the effect on female obesity is not remarkable. Further logistic regression analysis in the overall population demonstrates that the interaction between evening-type sleep rhythm and the male gender poses a risk of adolescent obesity [1.122 (1.043-1.208)]. CONCLUSION Among adolescents, the incidence of obesity in males is higher than in females. Evening-type sleep rhythm plays an important role in male obesity but has no significant effect on female obesity. Progressive analysis suggests an interactive effect of sleep rhythm and gender on adolescent obesity, and the combination of evening-type sleep and the male gender promotes the development of adolescent obesity. In formulating precautions against adolescent obesity, obesity in male adolescents with evening-type sleep should be a critical concern.
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Affiliation(s)
- Nan-Nan Wu
- Department of Laboratory Medicine, Tianjin Chest Hospital, Tianjin 300222, China
| | - Guo-Li Yan
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Hong-Yu Zhang
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Ling Sun
- Department of Child and Adolescent Psychology, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Min Hou
- Department of Laboratory Medicine, Tianjin Chest Hospital, Tianjin 300222, China
| | - Guang-Ming Xu
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
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Wang JM, Guo LF, Ma LQ, Zhang J. Labial inverse dilaceration of bilateral maxillary central incisors: A case report. World J Clin Cases 2024; 12:180-187. [PMID: 38292621 PMCID: PMC10824192 DOI: 10.12998/wjcc.v12.i1.180] [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: 10/07/2023] [Revised: 11/29/2023] [Accepted: 12/14/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Dilaceration is a rare dental developmental anomaly characterized by an abrupt deviation along the longitudinal axis of the root in which an angulation forms between the root and the crown. Here, we report on dilacerated bilateral maxillary central incisors in mixed dentition. CASE SUMMARY A 10-year-old girl presented with a chief complaint of unerupted central incisors. An oral examination and radiography provided the basis for a diagnosis of dilaceration of the maxillary central incisors. After surgical exposure of the impacted teeth, a button with an attached chain was applied to the palatal surface of teeth 11 and 21. After 8 mo, a button was bonded to the labial surface of the crown to fix an elastic chain and move the teeth toward the maxillary arch. Finally, a fixed appliance was applied to tooth alignment to Class 1 malocclusion using a 0.019 × 0.025-inch nickel-titanium wire. After 3 years of follow-up, the clinical findings and radiographic assessment showed that the roots had developed with vital dental pulp and healthy periodontium, were acceptable aesthetically, and showed no resorption. CONCLUSION The rare occurrences of dilacerated bilateral maxillary central incisors can be successfully treated through surgical exposure and orthodontics.
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Affiliation(s)
- Jun-Min Wang
- Stomatological Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Li-Feng Guo
- Stomatological Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Li-Qiong Ma
- Stomatological Hospital and College, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Jing Zhang
- Stomatological Hospital and College, Anhui Medical University, Hefei 230032, Anhui Province, China
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213
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Song Z, Zhou Q, Zhang JL, Ouyang J, Zhang ZY. Marker Ki-67 is a potential biomarker for the diagnosis and prognosis of prostate cancer based on two cohorts. World J Clin Cases 2024; 12:32-41. [PMID: 38292624 PMCID: PMC10824173 DOI: 10.12998/wjcc.v12.i1.32] [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: 08/21/2023] [Revised: 11/30/2023] [Accepted: 12/15/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Prostate cancer (PCa) is a widespread malignancy, predominantly affecting elderly males, and current methods for diagnosis and treatment of this disease continue to fall short. The marker Ki-67 (MKI67) has been previously demonstrated to correlate with the proliferation and metastasis of various cancer cells, including those of PCa. Hence, verifying the association between MKI67 and the diagnosis and prognosis of PCa, using bioinformatics databases and clinical data analysis, carries significant clinical implications. AIM To explore the diagnostic and prognostic efficacy of antigens identified by MKI67 expression in PCa. METHODS For cohort 1, the efficacy of MKI67 diagnosis was evaluated using data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases. For cohort 2, the diagnostic and prognostic power of MKI67 expression was further validated using data from 271 patients with clinical PCa. RESULTS In cohort 1, MKI67 expression was correlated with prostate-specific antigen (PSA), Gleason Score, T stage, and N stage. The receiver operating characteristic (ROC) curve showed a strong diagnostic ability, and the Kaplan-Meier method demonstrated that MKI67 expression was negatively associated with the progression-free interval (PFI). The time-ROC curve displayed a weak prognostic capability for MKI67 expression in PCa. In cohort 2, MKI67 expression was significantly related to the Gleason Score, T stage, and N stage; however, it was negatively associated with the PFI. The time-ROC curve revealed the stronger prognostic capability of MKI67 in patients with PCa. Multivariate COX regression analysis was performed to select risk factors, including PSA level, N stage, and MKI67 expression. A nomogram was established to predict the 3-year PFI. CONCLUSION MKI67 expression was positively associated with the Gleason Score, T stage, and N stage and showed a strong diagnostic and prognostic ability in PCa.
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Affiliation(s)
- Zhen Song
- Department of Urology, Taixing People’s Hospital, Taizhou 225400, Jiangsu Province, China
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Qi Zhou
- Department of Reproductive Medicine Center, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Jiang-Lei Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Jun Ouyang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Zhi-Yu Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
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214
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Cheng L, Li LP, Zhang YY, Deng F, Lan TT. Clinical nursing value of predictive nursing in reducing complications of pregnant women undergoing short-term massive blood transfusion during cesarean section. World J Clin Cases 2024; 12:51-58. [PMID: 38292622 PMCID: PMC10824185 DOI: 10.12998/wjcc.v12.i1.51] [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: 10/11/2023] [Revised: 11/08/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Cesarean hemorrhage is one of the serious complications, and short-term massive blood transfusion can easily cause postoperative infection and physical stress response. However, predictive nursing intervention has important clinical significance for it. AIM To explore the effect of predictive nursing intervention on the stress response and complications of women undergoing short-term mass blood transfusion during cesarean section (CS). METHODS A clinical medical record of 100 pregnant women undergoing rapid mass blood transfusion during sections from June 2019 to June 2021. According to the different nursing methods, patients divided into control group (n = 50) and observation group (n = 50). Among them, the control group implemented routine nursing, and the observation group implemented predictive nursing intervention based on the control group. Moreover, compared the differences in stress response, complications, and pain scores before and after the nursing of pregnant women undergoing rapid mass blood transfusion during CS. RESULTS The anxiety and depression scores of pregnant women in the two groups were significantly improved after nursing, and the psychological stress response of the observation group was significantly lower than that of the control group (P < 0.05). The heart rate and mean arterial pressure (MAP) of the observation group during delivery were lower than those of the control group, and the MAP at the end of delivery was lower than that of the control group (P < 0.05). Moreover, different pain scores improved significantly in both groups, with the observation group considerably less than the control group (P < 0.05). After nursing, complications such as skin rash, urinary retention, chills, diarrhea, and anaphylactic shock in the observation group were 18%, which significantly higher than in the control group (4%) (P < 0.05). CONCLUSION Predictive nursing intervention can effectively relieve the pain, reduce the incidence of complications, improve mood and stress response, and serve as a reference value for the nursing of women undergoing rapid mass transfusion during CS.
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Affiliation(s)
- Li Cheng
- Department of Obstertrics, Wuhan Third Hospital, Wuhan 430000, Hubei Province, China
| | - Li-Ping Li
- Department of Gynaecology, Wuhan No. 1 Hospital, WuHan 430030, Hubei Province, China
| | - Yuan-Yuan Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
| | - Fang Deng
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
| | - Ting-Ting Lan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
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Lin JM, Yuan XJ, Li G, Gan XR, Xu WH. Subarachnoid hemorrhage misdiagnosed as acute coronary syndrome leading to catastrophic neurologic injury: A case report. World J Clin Cases 2024; 12:148-156. [PMID: 38292644 PMCID: PMC10824174 DOI: 10.12998/wjcc.v12.i1.148] [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: 09/05/2023] [Revised: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Elevated levels of cardiac troponin and abnormal electrocardiogram changes are the primary basis for clinical diagnosis of acute coronary syndrome (ACS). Troponin levels in ACS patients can often be more than 50 times the upper reference limit. Some patients with subarachnoid hemorrhage (SAH) also show electrocardiogram abnormalities, myocardial damage, and elevated cardiac biomarkers. Unlike ACS patients, patients with SAH only have a slight increase in troponin, and the use of anticoagulants or antiplatelet drugs is prohibited. Because of the opposite treatment modalities, it is essential for clinicians to distinguish between SAH and ACS. CASE SUMMARY A 56-year-old female patient was admitted to the emergency department at night with a sudden onset of severe back pain. The final diagnosis was intraspinal hematoma in the thoracic spine. We performed an emergency thoracic spinal canal hematoma evacuation procedure with the assistance of a microscope. Intraoperatively, diffuse hematoma formation was found in the T7-T10 spinal canal, and no obvious spinal vascular malformation changes were observed. Postoperative head and spinal magnetic resonance imaging (MRI) showed a small amount of SAH in the skull, no obvious abnormalities in the cervical and thoracic spinal canals, and no abnormal signals in the lumbar spinal canal. Thoracoabdominal aorta computed tomography angiography showed no vascular malformation. Postoperative motor system examination showed Medical Research Council Scale grade 1/5 strength in both lower extremities, and the patient experienced decreased sensation below the T12 rib margin and reported a Visual Analog Scale score of 3. CONCLUSION Extremely elevated troponin levels (more than 50 times the normal range) are not unique to coronary artery disease. SAH can also result in extremely high troponin levels, and antiplatelet drugs are contraindicated in such cases. Emergency MRI can help in the early differential diagnosis, as a misdiagnosis of ACS can lead to catastrophic neurological damage in patients with spontaneous spinal SAH.
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Affiliation(s)
- Jun-Ming Lin
- Department of Orthopaedic Surgery, People's Hospital of Yichun City, Yichun 336000, Jiangxi Province, China
| | - Xiao-Jun Yuan
- Department of Orthopaedic Surgery, People's Hospital of Yichun City, Yichun 336000, Jiangxi Province, China
| | - Guang Li
- Department of Orthopaedic Surgery, People's Hospital of Yichun City, Yichun 336000, Jiangxi Province, China
| | - Xin-Rong Gan
- Department of Orthopaedic Surgery, People's Hospital of Yichun City, Yichun 336000, Jiangxi Province, China
| | - Wen-Hua Xu
- Department of Orthopaedic Surgery, People's Hospital of Yichun City, Yichun 336000, Jiangxi Province, China
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Lee GW, Park SB. Congestive ischemic colitis successfully treated with anti-inflammatory therapy: A case report. World J Clin Cases 2024; 12:142-147. [PMID: 38292639 PMCID: PMC10824190 DOI: 10.12998/wjcc.v12.i1.142] [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: 08/28/2023] [Revised: 12/03/2023] [Accepted: 12/14/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Congestive ischemic colitis is a rare subtype of ischemic colitis with an unknown pathophysiology. Excluding conservative management, such as fasting, no established treatment exists; therefore, surgical intervention should be considered in some cases if symptoms worsen. Current literature suggests that anti-inflammatory agents may effectively treat congestive ischemic colitis. CASE SUMMARY We present the case of a 68-year-old female patient who underwent laparoscopic left hemicolectomy for transverse colon cancer 3 years ago. Postoperatively, follow-up included an annual colonoscopy and abdominal computed tomography (CT) at a local clinic. However, progressive erythema and edema of the sigmoid colon were observed 1 year postoperatively. Upon admission to our hospital, she complained of abdominal pain and diarrhea. Abdominal CT showed thickening of the sigmoid colon walls, and colonoscopy revealed erythema, edema, and multiple ulcers with exudate in the sigmoid colon. CT angiography showed engorgement of the sigmoid vasa recta without any vascular abnormalities. The diagnosis was congestive ischemic colitis, and we treated the patient with anti-inflammatory agents. After 2 mo of glucocorticoid therapy (20 mg once daily) and 7 mo of 5-aminosalicylate therapy (1 g twice daily), the ulcers completely healed. She has not experienced any recurrence for 2 years. CONCLUSION Anti-inflammatory therapy, specifically glucocorticoids and 5-aminosalicylate, has demonstrated promising efficacy and introduces potential novel treatment options for congestive ischemic colitis.
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Affiliation(s)
- Geon Woo Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Su Bum Park
- Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
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217
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Sakai Y, Tsuyuguchi T, Ohyama H, Kumagai J, Kaiho T, Ohtsuka M, Kato N, Sakai T. Natural history of asymptomatic gallbladder stones in clinic without beds: A long-term prognosis over 10 years. World J Clin Cases 2024; 12:42-50. [PMID: 38292642 PMCID: PMC10824178 DOI: 10.12998/wjcc.v12.i1.42] [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: 09/03/2023] [Revised: 10/31/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Several studies have explored the long-term prognosis of patients with asymptomatic gallbladder stones. These reports were primarily conducted in facilities equipped with beds for addressing symptomatic cases. AIM To report the long-term prognosis of patients with asymptomatic gallbladder stones in clinics without bed facilities. METHODS We investigated the prognoses of 237 patients diagnosed with asymptomatic gallbladder stones in clinics without beds between March 2010 and October 2022. When symptoms developed, patients were transferred to hospitals where appropriate treatment was possible. We investigated the asymptomatic and survival periods during the follow-up. RESULTS Among the 237 patients, 214 (90.3%) remained asymptomatic, with a mean asymptomatic period of 3898.9279 ± 46.871 d (50-4111 d, 10.7 years on average). Biliary complications developed in 23 patients (9.7%), with a mean survival period of 4010.0285 ± 31.2788 d (53-4112 d, 10.9 years on average). No patient died of biliary complications. CONCLUSION The long-term prognosis of asymptomatic gallbladder stones in clinics without beds was favorable. When the condition became symptomatic, the patients were transferred to hospitals with beds that could address it; thus, no deaths related to biliary complications were reported. This finding suggests that follow-up care in clinics without beds is possible.
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Affiliation(s)
- Yuji Sakai
- Department of Gastroenterology, Sakai Clinic, Kimistu 299-1162, Japan
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan
| | - Toshio Tsuyuguchi
- Department of Gastroenterology, Chiba Prefectural Sawara Hospital, Chiba Prefectural Sawara Hospital, Sawara 287-0003, Japan
| | - Hiroshi Ohyama
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan
| | - Junichiro Kumagai
- Department of Gastroenterology, Kimitsu Central Hospital, Kisarazu 292-8535, Japan
| | - Takashi Kaiho
- Department of Surgery, Kimitsu Central Hospital, Kisarazu 292-8535, Japan
| | - Masayuki Ohtsuka
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan
| | - Naoya Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan
| | - Tadao Sakai
- Department of Gastroenterology, Sakai Clinic, Kimistu 299-1162, Japan
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218
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Huang LW, Zhong Y. Endoscopic submucosal dissection vs transanal endoscopic surgery for rectal tumors: A systematic review and meta-analysis. World J Clin Cases 2024; 12:95-106. [PMID: 38292620 PMCID: PMC10824170 DOI: 10.12998/wjcc.v12.i1.95] [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: 10/13/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) and transanal endoscopic submucosal dissection (TES) are widely employed surgical techniques. However, the comparative efficacy and safety of both remain inconclusive. AIM To comprehensively analyze and discern differences in surgical outcomes between ESD and TES. METHODS We conducted a systematic search of the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, and CINAHL from inception till August 2023. We analyzed outcomes including recurrence rate, en bloc resection, R0 resection rate, perforation rate, procedure length, and hospital stay length applying a random-effects inverse-variance model. We assessed publication bias by conducting an Egger's regression test and sensitivity analyses. RESULTS We pooled data from 11 studies involving 1013 participants. We found similar recurrence rates, with a pooled odds ratio of 0.545 (95%CI: 0.176-1.687). En bloc resection, R0 resection, and perforation rate values were also similar for both ESD and TES. The pooled analysis for procedure length indicated a mean difference of -4.19 min (95%CI: -22.73 to 14.35), and the hospital stay was on average shorter for ESDs by about 0.789 days (95%CI: -1.671 to 0.093). CONCLUSION Both ESD and TES displayed similar efficacy and safety profiles across multiple outcomes. Our findings show that individualized patient and surgeon preferences, alongside specific clinical contexts, can be considered when selecting between these two techniques.
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Affiliation(s)
- Long-Wu Huang
- Department of Gastroenterology, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
| | - Ying Zhong
- Department of Gastroenterology, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
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219
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Tao LL, Wen HT, Wang ZY, Cheng J, Zhao L. Azacitidine maintenance therapy for blastic plasmacytoid dendritic cell neoplasm allograft: A case report. World J Clin Cases 2024; 12:136-141. [PMID: 38292626 PMCID: PMC10824186 DOI: 10.12998/wjcc.v12.i1.136] [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: 08/25/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, highly invasive malignant neoplasm. There is no universally accepted standard of care because of its rarity and the dearth of prospective research. It is still challenging for some patients to achieve persistent clinical remission or cure, despite the success of allogeneic hematopoietic stem cell transplantation (allo-HSCT), indicating that there is still a significant recurrence rate. We report a case of prevention of BPDCN allograft recurrence by azacitidine maintenance therapy and review the relevant literature. CASE SUMMARY We report a 41-year-old man with BPDCN who was admitted to hospital due to skin sclerosis for > 5 mo' duration. BPDCN was diagnosed by combined clinical assessment and laboratory examinations. Following diagnosis, the patients underwent induction consolidation chemotherapy to achieve the first complete remission, followed by bridging allo-HSCT. Post-transplantation, azacitidine (75 mg/m2 for 7 d) was administered as maintenance therapy, with repeat administration every 4-6 wk and appropriate extension of the chemotherapy cycle. After 10 cycles, the patient has been disease free for 26 mo after transplantation. Regular assessments of bone marrow morphology, minimal residual disease, full donor chimerism, Epstein-Barr virus, and cytomegalovirus all yielded normal results with no abnormalities detected. CONCLUSION Azacitidine may be a safe and effective maintenance treatment for BPDCN following transplantation because there were no overt adverse events during the course of treatment.
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Affiliation(s)
- Li-Li Tao
- Department of Hematology, The First Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Hui-Ting Wen
- Department of Hematology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Zi-Yi Wang
- Department of Hematology, The First Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Juan Cheng
- Department of Hematology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Li Zhao
- Department of Hematology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
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220
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Zhou DB, Cheng J, Zhang XH. Evaluating combined bevacizumab and XELOX in advanced colorectal cancer: Serum markers carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 199 analysis. World J Clin Cases 2024; 12:15-23. [PMID: 38292648 PMCID: PMC10824169 DOI: 10.12998/wjcc.v12.i1.15] [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: 10/30/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] [Imported: 01/02/2024] Open
Abstract
BACKGROUND Colorectal cancer ranks third and second among common and fatal cancers. The treatment of metastatic colorectal cancer (mCRC) is generally based on XELOX in clinical practice, which includes capecitabine (CAP) and oxaliplatin. Serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125 and CA199 are prognostic factors for various tumors. AIM To investigate evaluating combined bevacizumab (BEV) and XELOX in advanced colorectal cancer: Serum markers CEA, CA125, CA199 analysis. METHODS In this retrospective study, a total of 94 elderly patients diagnosed with mCRC were recruited and subsequently categorized into two groups based on the distinct treatment modalities they received. The control group was treated with XELOX plus CAP (n = 47), while the observation group was treated with XELOX plus CAP and BEV (n = 47). Several indexes were assessed in both groups, including disease control rate (DCR), incidence of adverse effects, serum marker levels (CEA, CA125, and CA19) and progression-free survival (PFS). RESULTS After 9 wk of treatment, the serum levels of CEA, CA199 and CA125 in the observation group were significantly lower than those in the control group (P < 0.05). Moreover, the PFS of the observation group (9.12 ± 0.90 mo) was significantly longer than that of the control group (6.49 ± 0.64 mo). Meanwhile, there was no statistically significant difference in the incidence of adverse reactions and DCR between the two groups during maintenance therapy (P > 0.05). CONCLUSION On the basis of XELOX treatment, the combination of BEV and CAP can reduce serum tumor marker levels and prolong PFS in patients with mCRC.
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Affiliation(s)
- Dong-Bing Zhou
- Department of Gastroenterology, The Second People's Hospital of Jingzhou Hubei, Jingzhou 434000, Hubei Province, China
| | - Jun Cheng
- Department of Gastrointestinal Surgery, Qianjiang Central Hospital, Qianjing 433100, Hubei Province, China
| | - Xiong-Hui Zhang
- Department of Gastroenterology, Xiantao First People's Hosepital Affiliated to Yangtze University, Xiantao 433000, Hubei Province, China
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Wang CY, Chiu SH, Chang WC, Ho MH, Chang PY. Cholecystoenteric fistula in a patient with advanced gallbladder cancer: A case report and review of literature. World J Clin Cases 2023; 11:8519-8526. [PMID: 38188217 PMCID: PMC10768506 DOI: 10.12998/wjcc.v11.i36.8519] [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: 08/29/2023] [Revised: 10/12/2023] [Accepted: 12/07/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Cholecystoenteric fistula (CEF) involves the formation of a spontaneous anomalous tract between the gallbladder and the adjacent gastrointestinal tract. Chronic gallbladder inflammation can lead to tissue necrosis, perforation, and fistulogenesis. The most prevalent cause of CEF is chronic cholelithiasis, which rarely results from malignancy. Because the symptoms and laboratory findings associated with CEF are nonspecific, the condition is often misdiagnosed, presenting a challenge to the surgeon when detected intraoperatively. Therefore, a preoperative diagnosis of CEF is crucial. CASE SUMMARY We present the case of a 57-year-old male with advanced gallbladder cancer (GBC) who arrived at the emergency room with persistent vomiting, abdominal pain, and diarrhea. An abdominopelvic computed tomography scan revealed a contracted gallbladder with bubbles in the fundus connected to the second portion of the duodenum and transverse colon. We suspected that GBC had invaded the adjacent gastrointestinal tract through a cholecystoduodenal fistula (CDF) or a cholecystocolonic fistula (CCF). He underwent multiple examinations, including esophagogastroduodenoscopy, an upper gastrointestinal series, colonoscopy, and magnetic resonance cholangiopancreatography; the results of these tests confirmed a diagnosis of synchronous CDF and CCF. The patient underwent a Roux-en-Y gastrojejunostomy and loop ileostomy to address the severe adhesions that were previously observed to cover the second portion of the duodenum and hepatic flexure of the colon. His symptoms improved with supportive treatment while hospitalized. He initiated oral targeted therapy with lenvatinib for further anticancer treatment. CONCLUSION The combination of imaging and surgery can enhance preoperative diagnosis and alleviate symptoms in patients with GBC complicated by CEF.
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Affiliation(s)
- Chun-Yu Wang
- Department of General Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Sung-Hua Chiu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Chou Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Meng-Hsing Ho
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Ping-Ying Chang
- Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
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Lee SS. Post-laparotomy heterotopic ossification of the xiphoid process: A case report. World J Clin Cases 2023; 11:8568-8573. [PMID: 38188202 PMCID: PMC10768515 DOI: 10.12998/wjcc.v11.i36.8568] [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: 11/24/2023] [Accepted: 12/13/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Heterotopic ossification (HO) represents all types of extraskeletal ossification in the body. It occurs in various areas, including the skin, subcutaneous tissue, muscle, and joints. Surgical excision is recommended for symptomatic HO. Postoperative radiotherapy, oral nonsteroidal anti-inflammatory drugs, and topical sealants, such as bone wax, have been recommended as preventive measures. As HO is rare in occurrence, these recommendations are based on personal experiences, and there is a lack of information on individualized treatments depending on its location. CASE SUMMARY A 62-year-old male was admitted for symptomatic HO along a laparotomy scar. Surgical excision was performed for an 11 cm-sized ossification originating from the xiphoid process, and bone wax was applied to the excisional margin. However, the surgical wound failed to heal. After several weeks of saline-soaked gauze dressing, delayed wound closure was performed. The patient was finally discharged eight weeks after the excision. Because HO can occur in various areas of the body, a treatment strategy that may be effective for some may not be for others. Bone wax has been used as a topical sealant over excisional margins in the shoulder, elbow, and temporomandibular joints. However, in our case, its application on an abdominal surgical wound delayed its primary healing intention. The valuable lesson was that, when choosing a treatment method for HO based on available research data, its location must be considered. CONCLUSION Complete excision should be the priority treatment option for symptomatic HO along the laparotomy scar. Bone wax application is not recommended.
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Affiliation(s)
- Seung Soo Lee
- Department of Surgery, Kyungpook National University Hospital, Daegu 41944, South Korea
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
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Song XL, Ma JY, Zhang ZG. Colonoscopy-induced acute appendicitis: A case report. World J Clin Cases 2023; 11:8563-8567. [PMID: 38188211 PMCID: PMC10768519 DOI: 10.12998/wjcc.v11.i36.8563] [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: 11/11/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Colonoscopy is widely used for examination, diagnosis, and treatment because of its low incidence of associated complications. Post-colonoscopy appendicitis (PCA) is very rare and is easily misdiagnosed as electrocoagulation syndrome or colon perforation. Therefore, clinicians should pay close attention to this complication. CASE SUMMARY A 47-year-old female patient underwent a colonoscopy for a systematic physical examination, and the procedure was uneventful with normal endoscopic and histologic findings. However, the bowel preparation was suboptimal (Boston 2-3-2). After the examination, the patient experienced pain in the lower abdomen, which progressively worsened. Computed tomography of the lower abdomen and pelvis revealed appendiceal calcular obstruction and appendicitis. As the patient refused surgery, she was managed with antibiotics and recovered well. CONCLUSION In the current literature, the definition of PCA remains unclear. However, abdominal pain after colonoscopy should be differentiated from acute appendicitis.
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Affiliation(s)
- Xiao-Ling Song
- Department of Gastroenterology, Sunshine Union Hospital, Weifang 261000, Shandong Province, China
| | - Jin-You Ma
- Department of Gastroenterology, Sunshine Union Hospital, Weifang 261000, Shandong Province, China
| | - Zhi-Gao Zhang
- Department of Gastroenterology, Sunshine Union Hospital, Weifang 261000, Shandong Province, China
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Mohd Iqbal HA, Ho WS, Zanudin A, Hisham H, Mohd Nordin NA. Effects of video game-based therapy in an adolescent with cerebral palsy: A case report. World J Clin Cases 2023; 11:8595-8602. [PMID: 38188206 PMCID: PMC10768514 DOI: 10.12998/wjcc.v11.i36.8595] [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: 11/03/2023] [Revised: 11/25/2023] [Accepted: 12/07/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Herein, we report the case of a 13-year-old boy with spastic quadriplegia cerebral palsy (CP) at Gross Motor Function Classification System (GMFCS) level II, engaging in a 6-wk video game-based therapy (VBT) program. This study aimed to offer essential insights regarding VBT's impact on enhancing the physical function and improving the quality of life (QoL) of adolescents diagnosed with CP. This report provides a distinctive viewpoint that can inform and direct future clinical practices and research endeavors. CASE SUMMARY The boy presented with moderate mobility, balance, and overall well-being. He faced challenges with diminished lower limb strength, which affected his daily living and physical fitness capabilities. Our participant was diagnosed with spastic quadriplegic CP at GMFCS level II. He participated in a 6-wk program of VBT using a play station. This innovative approach incorporates warm-up exercises, interactive activities, and cool-down routines, targeting various movements, including single-leg stance, weight shifting, kicking, jumping, marching, and squatting. After VBT, the strength of the left hip extensor significantly increased from 199.3 N to 541.3 N. Distance covered as part of a 6-min walk test increased by 82 m. His Paediatric QoL Inventory score increased dramatically by 25.9%. CONCLUSION VBT is an innovative, individualized therapy that enhances physical function and QoL in CP, emphasizing its role in ambulatory patients.
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Affiliation(s)
- Huda Aliah Mohd Iqbal
- Physiotherapy Programme, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Wei Sheng Ho
- Physiotherapy Programme, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Asfarina Zanudin
- Physiotherapy Programme, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Hafifi Hisham
- Physiotherapy Programme, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Nor Azlin Mohd Nordin
- Physiotherapy Programme, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
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225
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AlGhamdi FK, Altoijry A, AlQahtani A, Aldossary MY, AlSheikh SO, Iqbal K, Alayadhi WA. Synchronous carotid endarterectomy and coronary artery bypass graft: Four case reports. World J Clin Cases 2023; 11:8581-8588. [PMID: 38188208 PMCID: PMC10768504 DOI: 10.12998/wjcc.v11.i36.8581] [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: 11/19/2023] [Accepted: 12/13/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND One of the major perioperative complications for coronary artery bypass graft (CABG) is stroke. The risk of perioperative stroke after CABG is approximately 2%. Carotid stenosis (CS) is considered an independent predictor of perioperative stroke risk in CABG patients. The optimal management of such patients has been a source of controversy. One of the possible surgical options is synchronous carotid endarterectomy (CEA) and CABG. Here, we have presented 4 cases of successful synchronous CEA and CABG. CASE SUMMARY Our center's experience with 4 cases of significant carotid artery stenosis, which were successfully managed with combined CEA and CABG, are detailed. The first case was a female who presented for CABG after a ST-elevation myocardial infarction. She had right internal carotid artery (ICA) occlusion and 90% left ICA stenosis. The second case was a male who was electively admitted for CABG. It was discovered that he had left ICA occlusion and 90% right ICA stenosis. The third case was a male with a history of stroke, two months prior to admission. He presented with non-ST-elevation myocardial infarction. Preoperatively, it was discovered that he had > 90% right ICA stenosis. The final case was a male who was electively admitted for CABG. It was discovered that he had bilateral > 90% ICA stenosis. We have also reviewed the current evidence and guidelines for managing CS in patients undergoing CABG. CONCLUSION Our case series demonstrated that synchronous CEA and CABG was safe. A multicenter study with additional patients is needed. It is necessary for clinicians to screen for CS in high-risk patients with features.
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Affiliation(s)
| | | | - Abdulrahman AlQahtani
- King Fahad Cardiac Center, King Saud University Medical City, Riyadh 11322, Saudi Arabia
| | - Mohammed Yousef Aldossary
- Department of General Surgery, King Saud University, Riyadh 11322, Saudi Arabia
- Department of Surgery, Dammam Medical Complex, Dammam 32245, Saudi Arabia
| | | | - Kaisor Iqbal
- Department of Surgery, King Saud University, Riyadh 11322, Saudi Arabia
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226
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Cocca S, Carloni L, Marocchi M, Grande G, Bianchini M, Colecchia A, Conigliaro R, Bertani H. Post-trans-arterial chemoembolization hepatic necrosis and biliary stenosis: Clinical charateristics and endoscopic approach. World J Clin Cases 2023; 11:8434-8439. [PMID: 38188216 PMCID: PMC10768501 DOI: 10.12998/wjcc.v11.i36.8434] [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: 11/09/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
Liver cancer is the fifth most common tumor and the second highest death-related cancer in the world. Hepatocarcinoma (HCC) represents 90% of liver cancers. According to the Barcelona Clinic Liver Cancer group, different treatment options could be offered to patients in consideration of tumor burden, liver function, patient performance status and biochemical marker serum concentration such as alpha-fetoprotein. Trans-arterial chemoembolization (TACE) is the treatment of choice in patients with diagnosis of unresectable HCC not eligible for liver transplantation, and preserved arterial supply. TACE is known to be safe and its complications are generally mild such as post-TACE syndrome, a self-resolving adverse event that occurs in about 90% of patients after the procedure. However, albeit rarely, more severe adverse events such as biloma, sepsis, hepatic failure, chemoagents induced toxicities, and post-TACE liver necrosis can occur. A prompt diagnosis of these clinical conditions is fundamental to prevent further complications. As a result, biliary stenosis could be a rare post-TACE necrosis complication and can be difficult to manage. Complications from untreated biliary strictures include recurring infections, jaundice, chronic cholestasis, and secondary biliary cirrhosis.
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Affiliation(s)
- Silvia Cocca
- Gastroenterology and Endoscopy Unit, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena 41121, Italy
| | - Lorenzo Carloni
- Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 00100, Italy
| | - Margherita Marocchi
- Gastroenterology and Endoscopy Unit, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena 41121, Italy
| | - Giuseppe Grande
- Gastroenterology and Endoscopy Unit, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena 41121, Italy
| | - Marcello Bianchini
- Department of Internal Medicine, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena 41121, Italy
| | - Antonio Colecchia
- Department of Internal Medicine, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena 41121, Italy
| | - Rita Conigliaro
- Gastroenterology and Endoscopy Unit, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena 41121, Italy
| | - Helga Bertani
- Gastroenterology and Endoscopy Unit, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena 41121, Italy
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227
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Yan R, Zhang Z, Wu L, Wu ZP, Yan HD. Iatrogenic flexor tendon rupture caused by misdiagnosing sarcoidosis-related flexor tendon contracture as tenosynovitis: A case report. World J Clin Cases 2023; 11:8512-8518. [PMID: 38188214 PMCID: PMC10768516 DOI: 10.12998/wjcc.v11.i36.8512] [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: 08/26/2023] [Revised: 11/18/2023] [Accepted: 12/07/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Sarcoidosis is a multisystem disease characterized by granuloma formation in various organs. Sarcoidosis-related flexor tendon contractures are uncommon in clinical settings. This contracture is similar to stenosing tenosynovitis and potentially leads to misdiagnosis and mistreatment. Herein, we report a rare case of sarcoidosis-related finger flexor tendon contracture that was misdiagnosed as tenosynovitis. CASE SUMMARY A 44-year-old woman presented to our department with flexion contracture of the right ring and middle fingers. The patient was misdiagnosed with tenosynovitis and underwent acupotomy release of the A1 pulley of the middle finger in another hospital that resulted in iatrogenic rupture of both the superficial and profundus flexors. Radiological presentation showed multiple sarcoid involvements in the pulmonary locations and ipsilateral forearm. A diagnosis of sarcoidosis was made based on the presence of non-caseating granulomas with tubercles consisting of Langhans giant cells with lymphocyte infiltration on biopsy, and the patient underwent surgical repair for the contracture. After 2 mo, the patient experienced another spontaneous rupture of the repaired middle finger tendon and underwent surgical re-repair. Satisfactory results were achieved at the 10 mo follow-up after reoperation. CONCLUSION Sarcoidosis-related finger contractures are rare; thus, caution should be exercised when dealing with such patients to avoid incorrect treatment.
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Affiliation(s)
- Rui Yan
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Zhe Zhang
- Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325026, Zhejiang Province, China
| | - Long Wu
- Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325026, Zhejiang Province, China
| | - Zhi-Peng Wu
- Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325026, Zhejiang Province, China
| | - He-De Yan
- Department of Hand Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325026, Zhejiang Province, China
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228
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Kakinuma K, Kakinuma T, Ueyama K, Shinohara T, Okamoto R, Yanagida K, Takeshima N, Ohwada M. LiNA OperaScope TM for microwave endometrial ablation for endometrial polyps with heavy menstrual bleeding: A case report. World J Clin Cases 2023; 11:8557-8562. [PMID: 38188210 PMCID: PMC10768509 DOI: 10.12998/wjcc.v11.i36.8557] [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: 10/03/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND The procedure for microwave endometrial ablation (MEA) follows established MEA practice guidelines but requires hysteroscopic observation of the uterine lumen before and after MEA. When a luminal uterine lesion is recognized, its removal requires preoperative dilation of the cervix because the outer diameter of a conventional rigid hysteroscope is 8.7 mm. Recently, a fully disposable rigid hysteroscope (LiNA OperaScopeTM) with a narrow diameter (4.4 mm) and forceps capable of extracting endometrial lesions has become available. CASE SUMMARY Here, we report a case of heavy menstrual bleeding (HMB) complicated by endometrial polyps where MEA was performed after removing endometrial polyps using the LiNA OperaScopeTM device. A 48-year-old woman with three prior pregnancies and three deliveries was referred to our hospital for further examination and treatment after being diagnosed with HMB 2 years earlier. The patient underwent MEA following endometrial polypectomy using LiNA OperaScopeTM. After MEA, endometrial cauterization was again examined using the LiNA OperaScopeTM, and the procedure was completed. No preoperative cervical dilation was performed. The patient's clinical course was favorable, and she was discharged 3 h after surgery. One month after surgery, menstruation resumed, and both HMB and dysmenorrhea improved markedly from 10 preoperatively to 1 postoperatively, as assessed subjectively using the visual analog scale. The patient's postoperative course was uneventful with no complications. CONCLUSION LiNA OperaScopeTM can be a minimally invasive treatment for MEA of HMB with uterine lumen lesions.
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Affiliation(s)
- Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Kyouhei Ueyama
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Takumi Shinohara
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Rora Okamoto
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Kaoru Yanagida
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
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Kourek C, Briasoulis A, Giamouzis G, Skoularigis J, Xanthopoulos A. Lyophilized recombinant human brain natriuretic peptide: A promising therapy in patients with chronic heart failure. World J Clin Cases 2023; 11:8603-8605. [PMID: 38188212 PMCID: PMC10768513 DOI: 10.12998/wjcc.v11.i36.8603] [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: 09/13/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
Lyophilized recombinant brain natriuretic peptide (BNP) is an exogenous peptide synthesized by artificial recombination technology, with a similar structure and similar physiological effects with the endogenous natriuretic peptide secreted by the human body. It's main mechanism of action is to increase cyclic guanosine monophosphate by binding with its corresponding receptor in the body, regulating, thus, the imbalance of the vascular system and cardiac hemodynamics, improving the heart's pumping capacity, and inhibiting sympathetic excitability and myocardial remodeling. Moreover, it can promote mitochondrial metabolism and enhance the use of adenosine triphosphate in cardiomyocytes. In the present study, 102 chronic heart failure (HF) patients were randomly assigned to a control and an observation group consisting of 51 patients each. Patients of the control group were treated with standard HF therapy for 3 d including oral metoprolol tartrate tablets, spironolactone, and olmesartanate while patients of the observation group were administered the recombinant human BNP injection for the same time-period, plus the standard HF therapy. The recombinant human BNP group (observation group) demonstrated better physical, emotional, social, and economic scores, as well as cardiac and inflammatory biomarkers such as serum hypersensitive C-reactive protein, N-terminal pro BNP and troponin I levels, compared to the control group. Moreover, cardiac function was also improved, as left ventricular ejection fraction and stroke volume were significantly higher in the observation group than in the control group. Interestingly, adverse reactions were not different between the 2 groups. However, these results are not generalizable and the need of large multicenter randomized controlled trials examining the safety and efficacy of recombinant human BNP in HF patients is of major importance.
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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
| | - Grigorios Giamouzis
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, 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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Wang TT, Chen XY, Min QY, Han YZ, Zhao HF. Iris metastasis from clear cell renal cell carcinoma: A case report. World J Clin Cases 2023; 11:8535-8541. [PMID: 38188215 PMCID: PMC10768508 DOI: 10.12998/wjcc.v11.i36.8535] [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: 09/06/2023] [Revised: 11/14/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Clear cell renal cell carcinoma (ccRCC) is a common type of tumor that can metastasize to any organs and sites. However, it is extremely rare for ccRCC to metastasize to the iris. Here, we describe a rare case of iris metastasis from ccRCC with a history of left nephrectomy in 2010. CASE SUMMARY A 62-year-old male was admitted to the hospital due to blurred vision and red eyes, and a mass was found on the iris in the right eye. B-scan ultrasonography revealed a well-bounded high-density lesion at the corner of the anterior chamber at the 3-4 o'clock position. Phacoemulsification with simultaneous intraocular lens implantation and iridocyclectomy was performed in the right eye. The lesion was confirmed to be metastatic ccRCC by histological and immunohistochemical analyses. The patient was still alive at 9 mo after surgical treatment. Ocular metastasis can be an initial sign with a poor prognosis. Timely detection and treatment may improve survival. Clinicians should pay attention to similar metastatic diseases to prevent misdiagnosis leading to missed treatment opportunities. CONCLUSION This report of the characteristics and successful management of a rare case of iris metastasis from ccRCC highlights the importance of a comprehensive medical history, histopathology, immunohistochemistry, and clinical manifestation for successful disease diagnosis.
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Affiliation(s)
- Tong-Tong Wang
- Department of Graduate School, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
- Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Xiao-Yue Chen
- Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Qiao-Yun Min
- Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
- School of Basic Medicine, Hebei North University, Zhangjiakou 075000, Hebei Province, China
| | - Yi-Ze Han
- Department of Graduate School, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Huan-Fen Zhao
- Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
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Öztürk H, Karapolat İ. Evaluation of response to gemcitabine plus cisplatin-based chemotherapy using positron emission computed tomography for metastatic bladder cancer. World J Clin Cases 2023; 11:8447-8457. [PMID: 38188218 PMCID: PMC10768499 DOI: 10.12998/wjcc.v11.i36.8447] [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: 09/22/2023] [Revised: 11/10/2023] [Accepted: 12/06/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND The purpose of the present study was to examine retrospectively the contribution of 18Fluorodeoxyglucose positron emission tomography computed tomography (18FDG-PET/CT) to the evaluation of response to first-line gemcitabine plus cisplatin-based chemotherapy in patients with metastatic bladder cancer. AIM To evaluate the response to Gemcitabine plus Cisplatin -based chemotherapy using 18FDG-PET/CT imaging in patients with metastatic bladder cancer. METHODS Between July 2007 and April 2019, 79 patients underwent 18FDG-PET/CT imaging with the diagnosis of Metastatic Bladder Carcinoma (M-BCa). A total of 42 patients (38 male, 4 female) were included in the study, and all had been administered Gemcitabine plus Cisplatin-based chemotherapy. After completion of the therapy, the patients underwent a repeat 18FDG-PET/CT scan and the results were compared with the PET/CT findings before chemotherapy according to European Organisation for the Research and treatment of cancer criteria. Mean age was 66.1 years and standard deviation was 10.7 years (range: 41-84 years). RESULTS Of the patients, seven (16.6%) were in complete remission, 17 (40.5%) were in partial remission, six (14.3%) had a stable disease, and 12 (28.6%) had a progressive disease. The overall response rate was 57.1 percent. CONCLUSION 18FDG-PET/CT can be considered as a successful imaging tool in evaluating response to first-line chemotherapy for metastatic bladder cancer. Anatomical and functional data obtained from PET/CT scans may be useful in the planning of secondline and thirdline chemotherapy.
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Affiliation(s)
- Hakan Öztürk
- Department of Urology, Izmir University of Economics, Karsiyaka Izmir 35330, Turkey
| | - İnanç Karapolat
- Department of Nuclear Medicine, School of Medicine, İzmir Tınaztepe University, Izmir 35000, Turkey
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Gao JW, Shi ZY, Zhu ZB, Xu XR, Chen W. Intraperitoneal hyaline vascular Castleman disease: Three case reports. World J Clin Cases 2023; 11:8527-8534. [PMID: 38188201 PMCID: PMC10768503 DOI: 10.12998/wjcc.v11.i36.8527] [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: 09/01/2023] [Revised: 11/27/2023] [Accepted: 12/13/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Castleman disease (CD) was first reported in 1954. It is a rare non-malignant lymphoproliferative disease with unclear etiology. As the clinical manifestations of CD are different, there are difficulties in its diagnosis and treatment. Therefore, for patients with CD, it is important to establish the diagnosis in order to choose the appropriate treatment. CASE SUMMARY In this report, three patients with intraperitoneal CD treated at our center from January 2018 to June 2023 were reviewed, and the clinical and paraclinical examinations, diagnosis, and treatment were analyzed, and all three patients were diagnosed with CD by routine histopathological and immunohistochemical examinations. CONCLUSION CD is a complex and rare disease. Because there are no special clinical symptoms and laboratory abnormalities, the diagnosis often depends on routine pathological and immunohistochemical findings.
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Affiliation(s)
- Jia-Wei Gao
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Zhe-Yi Shi
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Zhao-Bi Zhu
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
| | - Xiang-Rong Xu
- Department of General Surgery, Kunshan Hospital Affiliated to Jiangsu University, Suzhou 215300, Jiangsu Province, China
| | - Wei Chen
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
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233
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Yang DC, Xu J, Jian L, Yu Y. Impact of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on the mortality in sepsis: A meta-analysis. World J Clin Cases 2023; 11:8498-8506. [PMID: 38188199 PMCID: PMC10768505 DOI: 10.12998/wjcc.v11.i36.8498] [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: 10/12/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND The effect of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on the mortality of patients with sepsis is not well characterized. AIM To elucidate the association between prior ACEI or ARB exposure and mortality in sepsis. METHODS The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for all studies of premorbid ACEI or ARB use and sepsis mortality until November 30 2019. Two reviewers independently assessed, selected, and abstracted data from studies reporting ACEIs or ARBs, sepsis, and mortality. The primary extracted data consisted of premorbid ACEI or ARB exposure, mortality, and general patient data. Two reviewers independently assessed the risk of bias and quality of evidence. RESULTS A total of six studies comprising 281238 patients with sepsis, including 49799 cases with premorbid ACEI or ARB exposure were eligible for analysis. Premorbid ACEIs or ARBs exposure decreased the 30-d mortality in patients with sepsis. Moreover, the use of ACEIs or ARBs was associated with approximately a 6% decreased risk of 30-d mortality. CONCLUSION The results of this systematic review suggest that ACEI or ARB exposure prior to sepsis may be associated with reduced mortality. Further high-quality cohort studies and molecular mechanism experiments are required to confirm our results.
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Affiliation(s)
- Deng-Can Yang
- Department of Anesthesiology, The Central Hospital of Shaoyang, Shaoyang 422000, Hunan Province, China
| | - Jian Xu
- Department of Critical Care Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Li Jian
- Department of Critical Care Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Yi Yu
- Department of Critical Care Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510006, Guangdong Province, China
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234
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Oleson CV, Olsen AC, Shermon S. Spinal cord infarction attributed to SARS-CoV-2, with post-acute sequelae of COVID-19: A case report. World J Clin Cases 2023; 11:8542-8550. [PMID: 38188200 PMCID: PMC10768511 DOI: 10.12998/wjcc.v11.i36.8542] [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: 09/08/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND While stroke and lower extremity venous thromboemboli have been commonly reported following acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spinal cord infarction or ischemia has been extremely rare. Findings of long coronavirus disease (COVID) in this select population have not been studied. CASE SUMMARY We present the case of a 70-year-old female with sudden onset of trunk and lower extremity sensorimotor loss due to spinal cord infarction, attributed to acute infection with SARS-CoV-2. Diagnostic work up confirmed a T3 complete (ASIA impairment Scale A) paraplegia resulting from a thrombotic infarct. Her reported myalgias, neuropathic pain, spasticity, bladder spasms, and urinary tract infections exceeded the frequency and severity of many spinal cord injury (SCI) individuals of similar age and degree of neurologic impairment. In her first year after contracting COVID-19, she underwent 2 separate inpatient rehabilitation courses, but also required acute hospitalization 6 additional times for subsequent infections or uncontrolled pain. Yet other complications of complete non-traumatic SCI (NTSCI), including neurogenic bowel and temperature hypersensitivity, were mild, and pressure injuries were absent. She has now transitioned from the acute to chronic phase of spinal cord injury care, with subsequent development of post-acute sequelae of SARS-CoV-2 infection (PASC). CONCLUSION This individual experienced significant challenges with the combined effects of acute T3 NTSCI and acute COVID-19, with subsequent progression to PASC.
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Affiliation(s)
- Christina V Oleson
- Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth Rehabilitation Institute, Cleveland, OH 44109, United States
| | - Andrew C Olsen
- Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth Rehabilitation Institute, Cleveland, OH 44109, United States
| | - Suzanna Shermon
- Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth Rehabilitation Institute, Cleveland, OH 44109, United States
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235
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Wen GJ, Chen J, Zhang SF, Zhou ZS, Jiao GL. Multiple sparganosis spinal infections mainly in the thoracic region: A case report. World J Clin Cases 2023; 11:8507-8511. [PMID: 38188209 PMCID: PMC10768500 DOI: 10.12998/wjcc.v11.i36.8507] [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: 08/20/2023] [Revised: 11/14/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Spinal infection with sparganosis is rarely seen, and multiple spinal infections with sparganosis in the thoracic spine have not been reported. CASE SUMMARY In this case report, a 56-year old male patient suffered from back pain for 3 mo. Computed tomography examination of the thoracic spine showed bone destruction of the T4-5 vertebral body, as well as the right pedicle and lamina of T5. Magnetic resonance imaging showed high signals on T2W1 images and fat-suppressed images in the right vertebral body of T4-5 and the right pedicle and lamina of T5, a high signal in the vertebral canal, and similar high signals in the paravertebral and subcutaneous regions of the whole spine. Puncture biopsy showed sparganosis. Following definite diagnosis, the patient was treated with debridement of T4-5 infected lesions under a microscope, bone grafting and internal fixation. Postoperatively, the patient's back pain symptoms were significantly relieved; the incision healed after one-stage treatment, and albendazole antiparasitic treatment was administered. CONCLUSION Puncture biopsy is the most reliable method to diagnose infection by sparganum. Removal of infected lesions under the microscope and albendazole for antiparasitic treatment are safe and effective.
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Affiliation(s)
- Gan-Jun Wen
- Department of Orthopaedics, The Sixth Affiliated Hospital of Jinan University, Dongguan 523573, Guangdong Province, China
| | - Jian Chen
- Department of Orthopaedics, The Sixth Affiliated Hospital of Jinan University, Dongguan 523573, Guangdong Province, China
| | - Shi-Fei Zhang
- Department of Orthopaedics, The Sixth Affiliated Hospital of Jinan University, Dongguan 523573, Guangdong Province, China
| | - Zhi-Sen Zhou
- Department of Orthopaedics, The Sixth Affiliated Hospital of Jinan University, Dongguan 523573, Guangdong Province, China
| | - Gen-Long Jiao
- Department of Orthopaedics, The Sixth Affiliated Hospital of Jinan University, Dongguan 523573, Guangdong Province, China
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Stoyanov D, Paunova R, Dichev J, Kandilarova S, Khorev V, Kurkin S. Functional magnetic resonance imaging study of group independent components underpinning item responses to paranoid-depressive scale. World J Clin Cases 2023; 11:8458-8474. [PMID: 38188204 PMCID: PMC10768520 DOI: 10.12998/wjcc.v11.i36.8458] [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: 09/26/2023] [Revised: 11/10/2023] [Accepted: 12/05/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Our study expand upon a large body of evidence in the field of neuropsychiatric imaging with cognitive, affective and behavioral tasks, adapted for the functional magnetic resonance imaging (MRI) (fMRI) experimental environment. There is sufficient evidence that common networks underpin activations in task-based fMRI across different mental disorders. AIM To investigate whether there exist specific neural circuits which underpin differential item responses to depressive, paranoid and neutral items (DN) in patients respectively with schizophrenia (SCZ) and major depressive disorder (MDD). METHODS 60 patients were recruited with SCZ and MDD. All patients have been scanned on 3T magnetic resonance tomography platform with functional MRI paradigm, comprised of block design, including blocks with items from diagnostic paranoid (DP), depression specific (DS) and DN from general interest scale. We performed a two-sample t-test between the two groups-SCZ patients and depressive patients. Our purpose was to observe different brain networks which were activated during a specific condition of the task, respectively DS, DP, DN. RESULTS Several significant results are demonstrated in the comparison between SCZ and depressive groups while performing this task. We identified one component that is task-related and independent of condition (shared between all three conditions), composed by regions within the temporal (right superior and middle temporal gyri), frontal (left middle and inferior frontal gyri) and limbic/salience system (right anterior insula). Another component is related to both diagnostic specific conditions (DS and DP) e.g. It is shared between DEP and SCZ, and includes frontal motor/language and parietal areas. One specific component is modulated preferentially by to the DP condition, and is related mainly to prefrontal regions, whereas other two components are significantly modulated with the DS condition and include clusters within the default mode network such as posterior cingulate and precuneus, several occipital areas, including lingual and fusiform gyrus, as well as parahippocampal gyrus. Finally, component 12 appeared to be unique for the neutral condition. In addition, there have been determined circuits across components, which are either common, or distinct in the preferential processing of the sub-scales of the task. CONCLUSION This study has delivers further evidence in support of the model of trans-disciplinary cross-validation in psychiatry.
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Affiliation(s)
- Drozdstoy Stoyanov
- Department of Psychiatry, Medical University Plovdiv, Plovdiv 4000, Bulgaria
| | - Rositsa Paunova
- Research Institute, Medical University, Plovdiv 4002, Bulgaria
| | - Julian Dichev
- Faculty of Medicine, Medical University, Plovdiv 4002, Bulgaria
| | - Sevdalina Kandilarova
- Department of Psychiatry and Medical Psychology, Medical University, Plovdiv 4002, Bulgaria
| | - Vladimir Khorev
- Baltic Center for Artificial Intelligence and Neurotechnology, Immanuel Kant Baltic Federal University, Kaliningrad 236041, Russia
| | - Semen Kurkin
- Baltic Center for Artificial Intelligence and Neurotechnology, Immanuel Kant Baltic Federal University, Kaliningrad 236041, Russia
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237
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Eseadi C, Amedu AN, Aloh HE. Significance of fostering the mental health of patients with diabetes through critical time intervention. World J Clin Cases 2023; 11:8486-8497. [PMID: 38188207 PMCID: PMC10768517 DOI: 10.12998/wjcc.v11.i36.8486] [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: 11/23/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Critical time intervention (CTI) is an evidence-based model of practice that is time-limited and aims to provide support for most susceptible individuals during a transition period. AIM To examine the significance of fostering the mental health of diabetes patients through CTI using the scoping review methodology. METHODS As part of the scoping review process, we followed the guidelines established by the Joanna Briggs Institute. The search databases were Google Scholar, PubMed, Scopus, PsycINFO, Reference Citation Analysis (https://www.referencecitationanalysis.com/), and Cochrane Library. From these databases, 77 articles were retrieved with the aid of carefully selected search terms. However, 19 studies were selected after two reviewers appraised the full texts to ensure that they are all eligible for inclusion, while 54 papers were excluded. RESULTS This study revealed that diabetic patients who had experienced homelessness were at higher risk of being diagnosed with mental illness and that social support services are impactful in the management of the comorbidity of diabetes and mental health problems. In addition, this review reveals that CTI is impactful in enhancing the mental health of homeless patients during the transitional period from the hospital through social support services. CONCLUSION CTI is a promising intervention for alleviating mental health symptoms in homeless patients. Empirical studies are needed across the globe, involving both hospitalized and community-based patients, to determine how clinically effectively CTI is in managing the mental health of diabetics.
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Affiliation(s)
- Chiedu Eseadi
- Department of Educational Psychology, Faculty of Education, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Amos Nnaemeka Amedu
- Department of Educational Psychology, Faculty of Education, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Henry Egi Aloh
- Department of Health Services, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 482131, Ebonyi State, Nigeria
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Budimir I, Žulec M, Eljuga K, Židak M, Lisek V. Spontaneous gastric hematoma as a rare cause of acute abdomen: A case report. World J Clin Cases 2023; 11:8551-8556. [PMID: 38188220 PMCID: PMC10768510 DOI: 10.12998/wjcc.v11.i36.8551] [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: 09/23/2023] [Revised: 12/02/2023] [Accepted: 12/08/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Spontaneous gastric hematoma is an exceedingly rare condition characterized by the accumulation of blood within the gastric wall without any apparent iatrogenic or traumatic cause. Coagulopathies are the most frequent cause of gastric hematomas. However, other causes include amyloidosis, pancreatitis, visceral vascular aneurysms, endoscopy complications and others. The pathophysiology of spontaneous gastric hematoma is not completely understood. However, it is postulated that it is caused by disruption of submucosal vessels that leads to dissection of the muscularis layer and formation of false lumen. The rarity of this condition increases the challenge of diagnosis, and there is no standard treatment protocol. CASE SUMMARY We present the case of a spontaneous gastric hematoma in a 22-year-old male. He presented to our emergency department complaining of pain in the left flank area lasting for 2 wk. There was no history of trauma, anticoagulant medications or endoscopy procedures. His hemoglobin and hematocrit levels were slightly lower than normal. Multi-slice computed tomography, ultrasound and endoscopy confirmed a gastric intramural hematoma. We recommended conservative treatment because there was no hemodynamic instability nor significant bleeding. The patient responded well, and there were no unexpected events. At the 3-mo follow-up, the ultrasound examination revealed complete regression of the hematoma. CONCLUSION After reviewing the literature and our experience, we recommend that more of these cases should be treated conservatively. The tendency to treat these cases with potentially burdensome procedures such as total or subtotal gastrectomy should be significantly reduced.
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Affiliation(s)
- Ivan Budimir
- Department for Plastic and Reconstructive Surgery, University Hospital Dubrava, Zagreb 10000, Croatia
- Zagreb School of Medicine, University of Zagreb, Zagreb 10000, Croatia
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia
| | - Mirna Žulec
- Department of Nursing, Catholic University of Croatia, Zagreb 10000, Croatia
| | - Ksenija Eljuga
- Department of Nursing, Bjelovar University of Applied Sciences, Bjelovar 43000, Croatia
| | - Marcel Židak
- Department of Surgery, University of Zagreb, Dubrava University Hospital, Zagreb 10000, Croatia
| | - Valentino Lisek
- Department of Abdominal Surgery, University Hospital Dubrava, Zagreb 10000, Croatia
- Doctoral Study of Biomolecular Sciences, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia
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Lin S, Tang J, Li X, Wu G, Lin YF, Li YF. Mendelian randomization provides evidence for a causal effect of serum insulin-like growth factor family concentration on risk of atrial fibrillation. World J Clin Cases 2023; 11:8475-8485. [PMID: 38188205 PMCID: PMC10768518 DOI: 10.12998/wjcc.v11.i36.8475] [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: 10/01/2023] [Revised: 11/10/2023] [Accepted: 12/07/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is one of the most common persistent arrhythmias among adult cardiovascular diseases. It is important to identify potential risk factors for AF. Members of the insulin-like growth factor (IGF) family exert a variety of effects on various cell types in the context of the pathogenesis of cardiovascular diseases, and previous population-based studies indicate associations between IGF family members and AF. However, the causal effects of IGF family members in AF have not been evaluated. AIM In the current study two-sample Mendelian Randomization (MR) was used to assess genetic relationships between IGF family members and AF. METHODS MR was performed based on genome-wide association study (GWAS) datasets, and concentration levels of 14 IGF family members were retrieved. An initial MR analysis was conducted to identify single nucleotide polymorphisms potentially associated with IGF serum concentrations. A GWAS meta-analysis including 60620 AF cases and 970216 control participants of European ancestry was then conducted to identify AF causal effects. Two-sample MR packages were used to perform MR analysis in R. MR-Egger, weighted median (WM), and inverse variance weighted (IVW) methods were used. RESULTS In two-sample MR assessments there were lower levels of circulating IGF binding protein 3 in both WM [odds ratio (OR) 0.964, 95% confidence interval (CI) 0.940-0.960, P = 0.006] and IVW (OR 0.968, 95%CI: 0.947-0.987, P = 0.001) analyses. Higher serum levels of IGF2 receptor were associated with AF (OR 1.045, 95%CI: 1.016-1.076, P = 0.039). In reverse MR analysis conducted to investigate casual effects, elevated levels of circulating CYR61 were associated with AF (OR 1.060, 95%CI: 1.005-1.119, P = 0.031). CONCLUSION The results of the present study provide novel insights into the pathogenesis of AF, and the implications of serum IGF family member concentrations when assessing the risk of AF. The study generated evidence on the potential roles of developmental pathological effects in the pathogenesis of AF. Further observational and experimental studies are critically needed.
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Affiliation(s)
- Sha Lin
- Department of Pediatrics and Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jie Tang
- Department of Pediatrics and Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xing Li
- Department of Pediatrics and Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Gang Wu
- Department of Pediatrics and Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi-Fei Lin
- Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi-Fei Li
- Department of Pediatrics and Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Ji CY, Yang LR. Perioperative nursing care for hip arthroplasty patients with concomitant hypertension: A minireview. World J Clin Cases 2023; 11:8440-8446. [PMID: 38188203 PMCID: PMC10768512 DOI: 10.12998/wjcc.v11.i36.8440] [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: 09/21/2023] [Revised: 10/18/2023] [Accepted: 12/08/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
Hip replacement (HA) is mainly indicated for the elderly, who generally suffer from various underlying diseases such as hypertension. This article provides a review of the key points of perioperative nursing care for patients with hypertension undergoing HA. It analyzes the key points of care during the perioperative period (preoperative, intraoperative, and postoperative) and proposes directions for the development of perioperative nursing care for HA. The prognosis for patients can be improved through the modification of traditional medical approaches and the application of new technologies and concepts.
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Affiliation(s)
- Chang-Yue Ji
- Department of Orthopedic Sports Medicine Joint Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Li-Ru Yang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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241
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Hsu CW, Chang CC, Lin CS. Intraoperative cardiogenic shock induced by refractory coronary artery spasm in a patient with myasthenia gravis: A case report. World J Clin Cases 2023; 11:8589-8594. [PMID: 38188219 PMCID: PMC10768507 DOI: 10.12998/wjcc.v11.i36.8589] [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: 10/26/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND Coronary artery spasm (CAS) is a rare but critical condition during surgery. Clinical manifestations can vary from only subtle electrocardiography change to sudden death. In this case report, we present the case of a patient with myasthenia gravis (MG) who developed refractory CAS-related cardiogenic shock during thymoma surgery. CASE SUMMARY A 61-year-old man had a history of cigarette smoking and coronary artery disease with a bare metal stent placed. Three months ago, he suffered from coronary spasms, with three vessels involved, after surgery for cervical spine injury. He started having progressive dysphagia 4 wk prior and was diagnosed with MG via serologic tests, and computed tomography declared a thymoma in the anterior mediastinum. After the symptoms of MG subsided, he was referred for thymectomy. The operation was uneventful until the closing of the sternal wound. Electrocardiography showed sudden onset ST elevation, followed by ventricular tachycardia and severe hypotension. Cardiopulmonary cerebral resuscitation was initiated immediately with electrical defibrillation, extracorporeal membrane oxygenation was performed due to refractory cardiogenic shock, and the patient was transferred to an angiography room. Angiography showed diffuse CAS with three vessels involved. Intracoronary isosorbide dinitrate and adenosine were administered, and then the patient was transferred to the intensive care unit. CONCLUSION Our case highlights the importance of being prepared for clinical situations such as the one described here and suggests the necessity of developing an appropriate anesthesia plan that includes proactive analgesia and preemptive coronary vasodilators.
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Affiliation(s)
- Cheng-Wei Hsu
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chuen-Chau Chang
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chao-Shun Lin
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei 110, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
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Gu DF, Deng C. Balloon displacement during caesarean section with pernicious placenta previa: A case report. World J Clin Cases 2023; 11:8574-8580. [PMID: 38188213 PMCID: PMC10768502 DOI: 10.12998/wjcc.v11.i36.8574] [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: 10/17/2023] [Revised: 11/26/2023] [Accepted: 12/15/2023] [Indexed: 12/22/2023] [Imported: 12/22/2023] Open
Abstract
BACKGROUND For the past few years, preventive interventional therapy has been widely used domestically and overseas, bringing great benefits to pregnant women at high-risk for complications, such as pernicious placenta previa (PPP) and placenta accreta. Nevertheless, there are still few reports on surgical complications related to interventional therapy, and its safety should be a concern. CASE SUMMARY We report a 36-year-old pregnant woman with PPP who underwent balloon implantation in the lower segment of the abdominal aorta before caesarean section. However, the balloon shifted during the operation, which damaged the arterial vessels after filling, resulting in severe postpartum haemorrhage in the patient. Fortunately, after emergency interventional stent implantation, the patient was successfully relieved of the massive haemorrhage crisis. CONCLUSION It seems that massive postoperative bleeding has been largely avoided in preventive interventional therapy in high-risk pregnant women with placenta-related diseases, but surgical complications related to intervention therapy can also cause adverse consequences. It is equally important for clinical doctors to learn how to promptly identify and effectively treat these rare complications.
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Affiliation(s)
- Deng-Feng Gu
- Department of Anesthesiology, The First Affiliated Hospital of Shihezi University, Shihezi 832000, Xinjiang Uighur Autonomous Region, China
| | - Chao Deng
- Department of Anesthesiology, The First Affiliated Hospital of Shihezi University, Shihezi 832000, Xinjiang Uighur Autonomous Region, China
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243
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Wu RT, Zhang JC, Fang CN, Qi XY, Qiao JF, Li P, Su L. Anlotinib in combination with pembrolizumab for low-grade myofibroblastic sarcoma of the pancreas: A case report. World J Clin Cases 2023; 11:8385-8391. [PMID: 38130609 PMCID: PMC10731194 DOI: 10.12998/wjcc.v11.i35.8385] [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: 09/05/2023] [Revised: 11/25/2023] [Accepted: 12/01/2023] [Indexed: 12/14/2023] [Imported: 12/14/2023] Open
Abstract
BACKGROUND Low-grade myofibroblastic sarcoma (LGMS) is a rare spindle cell sarcoma especially in the pancreas, with myofibroblastic differentiation. Hitherto, only a few cases have been reported. CASE SUMMARY Herein, we report a case involving the discovery of a pancreatic mass detected during a routine physical examination. Subsequent imaging and pathological tests of the patient led to the diagnosis of LGMS of the pancreas. Following surgical intervention, the patient experienced recurrence and metastasis. Conventional treatment is not effective for postoperative recurrent pancreatic LGMS with multiple metastases. After communicating with the patients and their families, informed consent was obtained for the treatment of anlotinib combined with pembrolizumab. Evaluation of imaging and clinical symptoms post-treatment revealed a relatively favorable response to the combination of anlotinib and pembrolizumab. CONCLUSION Based on the comprehensive literature review, our report aimed to provide evidence for a better understanding of the disease characteristics, diagnostic criteria, imaging findings, and identification of LGMS. And explore novel treatment strategies for this disease.
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Affiliation(s)
- Rong-Ting Wu
- Graduate School of Anhui University of Chinese Medicine, Anhui University of Chinese Medicine, Hefei 230022, Anhui Province, China
- Department of Chinese Integrative Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Ji-Cheng Zhang
- Oncology and General Practice, Suzhou Hospital of Traditional Chinese Medicine, Suzhou 234000, Anhui Province, China
| | - Cheng-Nan Fang
- The First Clinical College of Anhui Medical University, Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Xiao-Yu Qi
- Graduate School of Anhui University of Chinese Medicine, Anhui University of Chinese Medicine, Hefei 230022, Anhui Province, China
- Department of Chinese Integrative Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Jin-Fei Qiao
- Graduate School of Anhui University of Chinese Medicine, Anhui University of Chinese Medicine, Hefei 230022, Anhui Province, China
- Department of Chinese Integrative Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Ping Li
- Department of Chinese Integrative Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Li Su
- Department of Chinese Integrative Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
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244
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Tian L, Ye ZB, Du YL, Li QF, He LY, Zhang HZ. Inflammatory cutaneous metastases originating from gastric cancer: A case report. World J Clin Cases 2023; 11:8411-8415. [PMID: 38130616 PMCID: PMC10731189 DOI: 10.12998/wjcc.v11.i35.8411] [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: 09/24/2023] [Revised: 10/22/2023] [Accepted: 12/04/2023] [Indexed: 12/14/2023] [Imported: 12/14/2023] Open
Abstract
BACKGROUND Cutaneous metastasis with gastric cancer (GC) origin is extremely rare and associated with poor prognosis. Nodular type is the most common type, while other forms are extremely rare. CASE SUMMARY This study describes severe skin redness, swelling, pain, and fever in a 65-year-old man diagnosed with GC, whose left chest wall, left upper limb, and left back were mainly affected. Firstly, the patient was diagnosed with "lymphangitis" and treated to promote lymphatic return. However, the symptoms were constantly deteriorating, and skin thickening and scattered small nodules gradually appeared. Finally, the skin biopsy confirmed cutaneous metastases, and the patient died 7 d later. CONCLUSION Our case highlights that cutaneous metastasis should be considered when skin lesions appear in patients with GC.
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Affiliation(s)
- Lei Tian
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Zhi-Bin Ye
- Department of Gastrointestinal Surgery, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Yun-Lei Du
- Department of Emergency, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Qiao-Fang Li
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Li-Ya He
- 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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245
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Jung HY, Kim GU, Joh YW, Lee JS. Ankle and toe weakness caused by calcified ligamentum flavum cyst: A case report. World J Clin Cases 2023; 11:8392-8398. [PMID: 38130625 PMCID: PMC10731209 DOI: 10.12998/wjcc.v11.i35.8392] [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: 09/05/2023] [Revised: 11/06/2023] [Accepted: 12/04/2023] [Indexed: 12/14/2023] [Imported: 12/14/2023] Open
Abstract
BACKGROUND Ligamentum flavum cysts, which are most common in mobile junctional levels of the spine, can be a rare cause of spinal stenosis. There have been several case reports of ligamentum flavum cysts. However, there is yet to be a documented case report of a calcified ligamentum flavum cyst. Herein, we report the first case of a calcified ligamentum flavum cyst causing ankle and toe weakness. CASE SUMMARY A 66-year-old male visited our hospital complaining of claudication as well as thigh and calf pain in his left leg, all beginning two weeks prior. Physical examination revealed motor weakness of the left ankle dorsiflexion and great toe dorsiflexion. Lumbar spinal computed tomography scans showed spinal stenosis combined with a calcified mass at the left side of the L4-5 level. Magnetic resonance imaging showed dural sac compression caused by the calcified mass at the left ligamentum flavum of the L4-5 level. We performed decompressive laminectomy and excision of the calcified mass combined with posterior lumbar interbody fusion at the L4-5 level. Intra-operatively, we found a firm and nodule like mass originating from the ventral surface of ligamentum flavum. Pathological examination suggested a calcified pseudocyst without a capsular lining. After the operation, the patient's motor weakness in the ankle and great toe improved gradually. CONCLUSION The patient's ankle and great toe weakness were improved successfully after surgical removal of the calcified cyst.
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Affiliation(s)
- Ho-Young Jung
- Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, South Korea
| | - Geon-U Kim
- Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, South Korea
| | - Yong-Won Joh
- Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, South Korea
| | - Jun-Seok Lee
- Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, South Korea
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246
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Yamamoto S, Kamezaki M, Ooka J, Mazaki T, Shimoda Y, Nishihara T, Adachi Y. Balloon venoplasty for disdialysis syndrome due to pacemaker-related superior vena cava syndrome with chylothorax post-bacteraemia: A case report. World J Clin Cases 2023; 11:8364-8371. [PMID: 38130610 PMCID: PMC10731190 DOI: 10.12998/wjcc.v11.i35.8364] [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: 10/21/2023] [Accepted: 12/04/2023] [Indexed: 12/14/2023] [Imported: 12/14/2023] Open
Abstract
BACKGROUND Although superior vena cava (SVC) syndrome has also been reported as a late complication of pacemaker (PM) implantation, acute onset of SVC syndrome caused by disdialysis syndrome in patients with PM implantation is very rare. There are no specific therapies or guidelines. CASE SUMMARY A 96-year-old woman receiving dialysis was implanted with a PM due to sick sinus syndrome. She was referred to our facility for chest discomfort experienced during dialysis. Upon examination, unilateral pleural effusion on the right side was cloudy with a foul odour. The patient was diagnosed with pyothorax and treated with antibiotics. After the effusion was reduced, it gradually reaggravated and remained cloudy. In this case, SVC syndrome, which is generally considered a late complication after PM implantation, rapidly developed following the bacteraemia, resulting in impaired venous return, chylothorax, and disdialysis syndrome. After catheter intervention for SVC stenosis, the patient's symptoms promptly improved. The patient has been recurrence-free for a year. CONCLUSION Acute SVC syndrome can cause dysdialysis in PM-implanted patients. Catheter intervention alone has improved this condition for a traceable period.
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Affiliation(s)
- Satomi Yamamoto
- Department of Nephrology, Kobe Central Hospital, Kobe 651-1145, Japan
| | | | - Junichi Ooka
- Department of Cardiology, Kobe Central Hospital, Kobe 651-1145, Japan
| | - Toru Mazaki
- Department of Cardiology, Kobe Central Hospital, Kobe 651-1145, Japan
| | - Yoshiaki Shimoda
- Department of Cardiology, Kobe Central Hospital, Kobe 651-1145, Japan
| | - Takaaki Nishihara
- Department of Nephrology, Kobe Central Hospital, Kobe 651-1145, Japan
| | - Yoko Adachi
- Department of Nephrology, Kobe Central Hospital, Kobe 651-1145, Japan
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247
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Ariam E, Richter V, Bermont A, Sandler Y, Cohen DL, Shirin H. Prior abdominal surgery as a potential risk factor for colonic diverticulosis or diverticulitis. World J Clin Cases 2023; 11:8320-8329. [PMID: 38130607 PMCID: PMC10731208 DOI: 10.12998/wjcc.v11.i35.8320] [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: 09/18/2023] [Revised: 11/15/2023] [Accepted: 12/04/2023] [Indexed: 12/14/2023] [Imported: 12/14/2023] Open
Abstract
BACKGROUND Abnormal colonic pressure profiles have been associated with an increased risk of colonic diverticulosis. A surgical history is a known risk factor for abdominal adhesions and these may lead to increased intraluminal colonic pressure. AIM To assess whether previous abdominal surgery is associated with colonic diverticulosis or diverticulitis. METHODS We analyzed data from a study of patients undergoing colonoscopy for different indications from 2020 through 2021. Patients completed a structured questionnaire concerning previous abdominal surgeries, dietary and lifestyle exposures including smoking, alcohol use and co-morbidities. RESULTS Three hundred and fifty-nine patients were included in the study. The mean age was 67.6 and 46% were females. Diabetes mellitus, hypertension, ischemic heart disease, chronic obstructive pulmonary disease, chronic renal failure, and body mass index were similar in the diverticulosis and control groups. The overall prevalence of colonic diverticulosis was 25% (91/359) and 48% of the patients had previous abdominal surgery. As expected, the prevalence of diverticulosis increased with age. There was no difference in the rate of previous abdominal surgery between patients with or without diverticulosis (49% vs 47%, P = 0.78). In regards to specific surgeries, inguinal hernia repair was significantly associated with diverticulosis (52% vs 20%, P = 0.001), but not diverticulitis. In contrast, appendectomy was not associated with diverticulosis (6% vs 14%, P = 0.048). CONCLUSION These findings suggest that post-operative abdominal adhesions inducing high colonic intraluminal pressures do not appear to be the mechanism for diverticula formation. Rather, inguinal hernia and diverticulosis may share similar connective tissue pathologies with no causative relationship between them.
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Affiliation(s)
- Eran Ariam
- Department of Gastroenterology, Kaplan Medical Center, Rehovot 76100, Israel
| | - Vered Richter
- The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center, Zerifin 70300, Israel and the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anton Bermont
- The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center, Zerifin 70300, Israel and the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Sandler
- Department of Surgery Division, Shamir Medical Center, Zerifin 70300, Israel
| | - Daniel L Cohen
- The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center, Zerifin 70300, Israel and the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Shirin
- The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center, Zerifin 70300, Israel and the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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248
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Li S, Yin D, Guo XC. Influence of standardized nursing intervention combined with mindfulness stress reduction training on the curative effect in patients with acute pancreatitis. World J Clin Cases 2023; 11:8276-8283. [PMID: 38130611 PMCID: PMC10731205 DOI: 10.12998/wjcc.v11.i35.8276] [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: 09/27/2023] [Revised: 11/18/2023] [Accepted: 11/30/2023] [Indexed: 12/14/2023] [Imported: 12/14/2023] Open
Abstract
BACKGROUND Acute pancreatitis (AP) is a common inflammatory disease of the pancreas with high mortality rates. It is of great significance to take scientific intervention measures for patients with AP in time. AIM To explore the effect of standardized nursing combined with mindfulness stress reduction training on the curative effect, negative emotion, and quality of life in patients with acute pancreatitis. METHODS A total of 80 patients with acute pancreatitis admitted to The First People's Hospital of Jiangxia District Hospital from May 2021 to May 2023 were randomly divided into control group and observation group (n = 40). Patients in control group were given the standardized nursing intervention, and the observation group were given standardized nursing plus mindfulness stress reduction training intervention. The time of clinical symptom disappeared or improved, complication occurrence rate, emotional state, and quality of life score of the two groups were observed and compared. RESULTS In comparison with the control group, the bowel sound recovery time, ventosity and abdominal pain improvement time, and venting and cacation time in observation group were shorter, and the total incidence rate of complications was reduced, showing statistically significant difference (P < 0.05). The scores of anxiety and depression in observation group were lower than those in control group (P < 0.05). Serum levels of tumour necrosis factor alpha, interleukin (IL)-6, IL-1β and IL-8 in observation group were lower than those in control group (P < 0.05). The scores of life quality in physiology, psychology, environment and social relations in observation group were higher than those in control group, and the differences were statistically significant (P < 0.05). CONCLUSION The application of standardized nursing intervention combined with mindfulness stress reduction training in patients with acute pancreatitis has a definite effect, which can help to ameliorate the clinical symptoms, anxiety and depression of patients, reduce the incidence rate of complications, and improve the prognosis of patients.
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Affiliation(s)
- Sha Li
- Department of Gastroenterology, Wuhan Third Hospital, Wuhan 430000, Hubei Province, China
| | - Dan Yin
- The Critical Care Medicine Department, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Xiao-Chun Guo
- Department of Gastroenterology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
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249
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Meng MJ, Hu L, Fan Y, Gao H, Chen HZ, Chen CM, Qi Z, Liu B. Efficacy of prednisone combined with mycophenolate mofetil for immunoglobulin A nephropathy with moderate-to-severe renal dysfunction. World J Clin Cases 2023; 11:8300-8309. [PMID: 38130628 PMCID: PMC10731213 DOI: 10.12998/wjcc.v11.i35.8300] [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: 11/03/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/14/2023] [Imported: 12/14/2023] Open
Abstract
BACKGROUND Immunoglobulin A nephropathy (IgAN) is a common form of chronic glomerulonephritis. Currently, IgAN is one of the main causes of chronic renal failure in China; its prognosis varies greatly between patients, with renal function at the time of diagnosis and prognosis being strongly correlated. Mycophenolate mofetil (MMF) is a drug with a good immunomodulatory effect and is commonly used clinically. However, its effects in IgAN have not yet been clearly demonstrated. Therefore, herein, we retrospectively compared the effectiveness and safety of prednisone alone or combined with MMF for the treatment of primary IgAN with moderate-to-severe renal impairment. AIM To evaluate the effectiveness and safety of prednisone and MMF in treating IgAN with moderate-to-severe renal dysfunction. METHODS Between January 2011 and December 2020, 200 patients with moderate-to-severe IgAN were included in this study, all of whom were admitted to Wuxi People's Hospital affiliated with Nanjing Medical University. All patients underwent a renal puncture biopsy, which revealed primary IgAN with a glomerular filtration rate (GFR) of 30-60 mL/min. The patients were divided into a glucocorticoid therapy group (GTG) and an immunosuppressive therapy group (ITG) according to the different treatment regimens, with 100 patients in each group. Based on general treatments, such as angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers, patients in the GTG were administered prednisone 0.5-0.8 mg/ (kg·d-1) for 4-8 wk, which was reduced by 5 mg every two weeks until the maintenance(30 mg/d) dose was reached and maintained for 12 mo. In the ITG, MMF was administered at 1.0 g/d for 6-12 mo, followed by a maintenance dosage of 0.5 g/d for 12 mo. Age, sex, blood pressure, 24-h urinary egg white measurement, serum creatinine (Scr), blood uric acid, blood albumin, blood potassium (K), hemoglobin, GFR, alanine aminotransferase, total cholesterol (T-CHO), fasting blood glucose, and body mass index were recorded. The 24-h urinary protein, Scr, and GFR levels were recorded 3, 6, 9, and 12 mo after treatment. Follow-up data were also collected. RESULTS No discernible differences existed between the two groups in terms of age, sex, blood pressure, creatinine, 24-h urinary protein level, GFR, or other biochemical indicators at the time of enrollment. Both regimens significantly reduced the 24-h urinary protein quantitation and stabilized renal function. Nine months after treatment, the 24-h urinary protein and Scr of the ITG decreased more significantly than those of the GTG. By the 12th month of treatment, the 24-h urinary protein and Scr in both groups continued to decrease compared to those by the 9th month. In addition, the overall response rate in the ITG was significantly higher than that in the GTG. The occurrence of side effects did not vary significantly between the two regimens; however, endpoint events were significantly more common in the GTG than in the ITG. The follow-up time for the GTG was noticeably lower than that for the ITG. CONCLUSION Prednisone combined with MMF was effective for the treatment of IgAN with moderate-to-severe renal dysfunction.
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Affiliation(s)
- Mei-Juan Meng
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Ling Hu
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Yun Fan
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Han Gao
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Han-Zhi Chen
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Cai-Mei Chen
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Zhen Qi
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Bin Liu
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
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Yamashiro H, Morii N. Abemaciclib-induced lung damage leading to discontinuation in brain metastases from breast cancer: A case report. World J Clin Cases 2023; 11:8425-8430. [PMID: 38130622 PMCID: PMC10731188 DOI: 10.12998/wjcc.v11.i35.8425] [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: 10/11/2023] [Revised: 11/04/2023] [Accepted: 11/30/2023] [Indexed: 12/14/2023] [Imported: 12/14/2023] Open
Abstract
BACKGROUND This case report addresses the dearth of effective therapeutic interventions for central nervous system metastases in patients with HER2-negative breast cancer. It presents a unique case of a woman with estrogen receptor-positive, HER2-negative breast cancer who developed brain metastasis. The report highlights her initial favorable response to abemaciclib and letrozole therapy prior to the discontinuation due to drug-induced lung damage (DILD). CASE SUMMARY In this comprehensive case summary, we present the clinical course of a woman in her 60s, who 11 years following primary breast cancer surgery, was diagnosed with multiple brain metastases. As a third-line systemic therapy, she underwent treatment with abemaciclib and letrozole. This treatment approach yielded a near-partial response in her metastatic brain lesions. However, abemaciclib administration ceased due to the emergence of DILD, as confirmed by a computed tomography scan. The DILD improved after 1 mo of cessation. Despite ongoing therapeutic efforts, the patient's condition progressively deteriorated, ultimately resulting in death due to progression of the brain metastases. CONCLUSION This case underscores the challenge of managing adverse events in responsive brain metastasis patients, given the scarcity of therapeutic options.
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Affiliation(s)
- Hiroyasu Yamashiro
- Department of Breast Surgery, Tenri Hospital, Nara, Tenri 632-8552, Japan
| | - Nao Morii
- Department of Breast Surgery, Tenri Hospital, Nara, Tenri 632-8552, Japan
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