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Malignant superior vena cava obstruction. BMJ Case Rep 2024; 17:e260690. [PMID: 38719256 PMCID: PMC11085706 DOI: 10.1136/bcr-2024-260690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
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2
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Massive hemoptysis with end stage renal disease (ESRD): An initial symptom of rare disease. Clin Case Rep 2024; 12:e8614. [PMID: 38455858 PMCID: PMC10918702 DOI: 10.1002/ccr3.8614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/18/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
Microscopic polyangiitis is a rare autoimmune vasculitis, that could present with renal-pulmonary symptoms, posing diagnostic challenges in patients with preexisting kidney disease. Timely diagnosis is crucial to improve patient outcomes.
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An atorvastatin-induced positive anti-HMGCR immune-mediated necrotizing myopathy case. Clin Case Rep 2024; 12:e8563. [PMID: 38435506 PMCID: PMC10901786 DOI: 10.1002/ccr3.8563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024] Open
Abstract
Statins can commonly cause myopathy. Most of the time, stopping the culprit drug should solve the problem. However, if the drug has been discontinued but muscle weakness continues to worsen, immune-mediated myopathy should be taken into consideration.
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Pulmonary coccidioidomycosis mimicking malignancy associated with Sweet's syndrome (acute febrile neutrophilic dermatosis). Clin Case Rep 2024; 12:e8651. [PMID: 38464569 PMCID: PMC10920303 DOI: 10.1002/ccr3.8651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024] Open
Abstract
A suspicious malignant lung nodule with cutaneous reaction is not always cancer, especially in low risk for malignancy patients. A lung biopsy should be taken into consideration. The associated cause of Sweet's syndrome directs the treatment in each patient.
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SpyGlass DS system-assisted retrieval of proximally migrated pancreatic duct stent in a patient with chronic pancreatitis. JGH Open 2023; 7:1009-1011. [PMID: 38162846 PMCID: PMC10757486 DOI: 10.1002/jgh3.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/30/2023] [Indexed: 01/03/2024]
Abstract
Pancreatic duct (PD) stent migration is among the recognized complications of endoscopic retrograde cholangiopancreatography (ERCP) with PD stent placement. Proximal stent migration poses a challenge for removal due to risks of PD damage, smaller caliber, and possible stricture. Here, we present a case of SpyGlass DS system-assisted PD stent repositioning after failure with traditional tools.
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Pre-bariatric surgery acute kidney injury: Can this be prevented? Clin Case Rep 2023; 11:e8070. [PMID: 37900717 PMCID: PMC10600357 DOI: 10.1002/ccr3.8070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/24/2023] [Accepted: 10/09/2023] [Indexed: 10/31/2023] Open
Abstract
Key Clinical Message Pre-bariatric surgery dietary recommendations should take into account daily protein intake and other risk factors for kidney injury. This is important because a high protein intake can potentially lead to kidney injury. Abstract Bariatric surgery has been shown to be a highly effective intervention for achieving weight loss and reducing obesity related-comorbidities. Acute kidney injury (AKI) is considered one of the common complications in perioperative and post-bariatric surgery. However, pre-bariatric surgery AKI has never been reported. Several studies demonstrated that pre-bariatric surgery weight loss improved surgical outcomes and decrease postoperative complications. Some diet regimens have been introduced including low-caloric diet (LCD), very-low caloric diet (VLCD), and very-low caloric ketogenic diet (VLCKD). We present a patient who develops AKI after 10 days of having a high-protein diet from a pre-bariatric weight loss strategy.
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Thrombocytopenia and hyperthyroidism: A case report and literature review. Clin Case Rep 2023; 11:e7960. [PMID: 37780929 PMCID: PMC10533372 DOI: 10.1002/ccr3.7960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023] Open
Abstract
Key Clinical Message Immune thrombocytopenic purpura (ITP) is very challenging to diagnose with concurrent comorbidities affecting platelet count including PAH and autoimmune thyroid disease. ITP resolution can be achieved with tailored treatment of the underlying conditions to avoid adverse events. Abstract Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a platelet count of <100 × 109/L in the absence of other causes of thrombocytopenia. It is classified as primary or idiopathic and secondary due to various coexisting conditions, including autoimmune thyroid diseases. It is especially challenging when the patient has comorbidities that affect platelet count easily, leading to anchoring bias. The first-line treatment of ITP is corticosteroids, and it is also recommended to treat the primary causes of secondary ITP. Here, the authors report a case of secondary ITP in a patient with a recent diagnosis of Grave's disease and a history of idiopathic pulmonary hypertension with baseline chronic thrombocytopenia, possible mechanisms, and treatment strategies with a multidisciplinary approach.
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Pulmonary artery aneurysm in a young female with Takayasu arteritis. Clin Case Rep 2023; 11:e8002. [PMID: 37808580 PMCID: PMC10551108 DOI: 10.1002/ccr3.8002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/27/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023] Open
Abstract
Key Clinical Message In suspected cases of systemic vasculitis, imaging studies should include the pulmonary artery. This is a rare case of Takayasu arteritis with a large pulmonary aneurysm. Medical management is the first line and vascular intervention if fails prior. Abstract Takayasu arteritis (TA) should be suspected in young women presented with hypertension, carotidynia, and claudications. Pulmonary artery involvement is frequent, occurring in 20%-50% of patients with TA. However, this case highlights the rare presentation of TA with a large pulmonary aneurysm and minimal aortic involvement. Medical management including immunosuppressive agents and biological therapies remains an important role, with vascular intervention remains as an option if medical therapy failed.
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Atypical Femoral Fracture in Hypophosphatasia: A Systematic Review. Int J Endocrinol 2023; 2023:5544148. [PMID: 37731773 PMCID: PMC10508997 DOI: 10.1155/2023/5544148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/03/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023] Open
Abstract
Objective To summarize the characteristics of all reported patients with hypophosphatasia (HPP) who sustained atypical femoral fracture (AFF) and identify all available evidence to quantify the rate of coexistence between HPP and AFF. Methods Potentially eligible articles were identified from the MEDLINE and EMBASE databases from its inception to September 2022, using a search strategy consisting of terms related to "Hypophosphatasia" and "Atypical femoral fracture." Eligible articles must report one of the following information: (1) individual data of patients diagnosed with HPP and AFF, (2) prevalence of HPP among patients with AFF, or (3) prevalence of AFF among patients of HPP. Characteristics of patients reported in each study were extracted. Results A total of 148 articles were identified. After the systematic review, 24 articles met the eligibility criteria. A total of 28 patients with AFF and HPP were identified. The mean ± SD age of the reported patients was 53.8 ± 12.5 years, and 22 patients (78.6%) were female. Nine patients (32.1%) received antiresorptive medication (bisphosphonate and/or denosumab), and two patients (7.1%) received teriparatide prior to the development of AFF. Seven (25.0%) and eighteen (64.3%) patients sustained unilateral and bilateral AFF, respectively (laterality not reported in three cases). Thirteen patients (46.4%) had a history of fractures at other sites. Four (14.3%) and seven (25.0%) patients received asfotase alfa and teriparatide after sustaining AFF. Two studies reported the prevalence of AFF among patients with HPP of approximately 10%. One study reported one HPP patient in a cohort of 72 patients with AFF. Conclusions Based on the limited evidence, AFF occurred in up to 10% of patients with HPP. Based on the 28 case reports, about two-thirds did not receive antiresorptive treatment, suggesting that the HPP itself could potentially be a risk factor for AFF.
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Eosinophilia with Lung Involvement in an Elderly Patient with a History of Chronic Obstructive Pulmonary Disease. J Community Hosp Intern Med Perspect 2023; 13:101-104. [PMID: 37868676 PMCID: PMC10589042 DOI: 10.55729/2000-9666.1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/09/2023] [Accepted: 07/05/2023] [Indexed: 10/24/2023] Open
Abstract
Eosinophilia with pulmonary involvement is characterized by the presence of peripheral blood eosinophilia, typically >500 cells/mm3, nonspecific pulmonary symptoms, and radiographic evidence of pulmonary disease. Clinical, laboratory, and radiologic features can be overlapping in these diseases, thus, it is wise to approach eosinophilia with pulmonary involvement systematically to determine the diagnosis and provide definitive treatment for a better outcome. The authors present a case of idiopathic chronic eosinophilic pneumonia in a patient with a long history of chronic obstructive pulmonary disease (COPD) which was resolved by corticosteroid.
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11
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IgG4-related disease presents as a nasopharyngeal mass. BMJ Case Rep 2023; 16:e256043. [PMID: 37524512 PMCID: PMC10391819 DOI: 10.1136/bcr-2023-256043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
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12
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Rumpel-Leede Phenomenon Following Radial Artery Catheterisation. Eur J Case Rep Intern Med 2023; 10:003990. [PMID: 37554476 PMCID: PMC10405879 DOI: 10.12890/2023_003990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 08/10/2023] Open
Abstract
UNLABELLED Rumpel-Leede phenomenon is a rarely diagnosed entity that can be seen in patients following the application of tourniquet-like forces to the extremities. This phenomenon describes petechiae and purpura secondary to venous compression and congestion, with its underlying aetiology involving the fragility of capillary vessels within the dermis. This condition is associated with chronic medical conditions such as diabetes mellitus, hypertension, dyslipidemia, peripheral vascular disease and systemic inflammatory diseases, including infections. In addition, patients with coagulopathy including thrombocytopenia or platelet dysfunction from antiplatelet use, or those with thrombotic thrombocytopenic purpura and idiopathic thrombocytopenic purpura, are predisposed to capillary haemorrhage and petechiae formation. In this report, we present a case of a patient who developed Rumpel-Leede phenomenon following catheterisation of the right radial artery with spontaneous resolution - where only five cases have been reported to date - with the aim to make clinicians aware of this condition and to avoid unnecessary interventions. LEARNING POINTS Rumpel-Leede phenomenon is a benign condition that can be seen after tourniquet-like compression of a limb in those with capillary fragility.Dermatologists and other practitioners should remain aware of the phenomenon, helping to avoid unnecessary investigation.Rumpel-Leede phenomenon self-resolves, with only supportive treatment required with no reported lingering effects to date.
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Severe Acute Respiratory Distress Syndrome Secondary to Concomitant Influenza A and Rhinovirus Infection Complicated by Methicillin-resistant Staphylococcus aureus Pneumonia in an Early Pregnancy Patient With Vaping-induced Lung Injury. J Community Hosp Intern Med Perspect 2023; 13:91-96. [PMID: 37868245 PMCID: PMC10589014 DOI: 10.55729/2000-9666.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 10/24/2023] Open
Abstract
Acute respiratory distress syndrome (ARDS) is a life-threatening lung injury characterized by rapid onset of widespread inflammation in the lungs. Multiple risk factors, including pneumonia, non-pulmonary sepsis, aspiration of gastric contents or inhalation injury, have been reported, to cause ARDS. We present a case of a healthy young woman in her first trimester with vaping-induced lung injury who presented with spontaneous pneumothorax and acute respiratory distress syndrome with concomitant influenza A and rhinovirus infection followed by methicillin-resistant Staphylococcus aureus pneumonia.
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Effect of Continuous Positive Airway Pressure Therapy in Patient with Obstructive Sleep Apnea and Pulmonary Hypertension: A literature review. Cardiol Rev 2023:00045415-990000000-00108. [PMID: 37158998 DOI: 10.1097/crd.0000000000000564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Patients with obstructive sleep apnea (OSA) and pulmonary hypertension (PH) have a reduced functional capacity and potential survival. Continuous positive airway pressure (CPAP) is the primary treatment for OSA, and this improves sleep parameters, functional activity, and possibly pulmonary artery pressures (PAPs). This literature review summarizes the available studies that have measured changes in PAPs in patients with sleep apnea following the institution of CPAP. The PubMed.gov database was searched with a combination of keywords including: "Pulmonary Hypertension," "Obstructive Sleep Apnea," and "Continuous Positive Airway Pressure." Specific inclusion and exclusion criteria were applied to select prospective studies, and data were carefully extracted from each study. Seven unique studies were identified from a list of 272 search results. The studies included a range of CPAP treatments; all showed significant improvement in PAP. The average improvement in PAP across all studies when weighted for a number of participants was 9.33 ± 7.71 mm Hg. This systematic literature review demonstrates that CPAP treatment reduces PAPs in patients with OSA. The study intervals ranged from 48 hours to 6 months to determine the effects of CPAP on PH in these patients. The literature review undertaken during the analysis of these original studies on OSA and PH provides information about vascular remodeling during OSA and the effect of apnea on O2 saturation, intrathoracic pressure swings, and sympathetic surges post apnea. Patients with OSA frequently have significant comorbidity, including hypertension, obesity, and overlap syndromes with other pulmonary disorders and/or cardiac disorders. This comorbidity increases the complexity of management and likely contributes to poor outcomes. The gold standard for making a diagnosis of PH requires right heart catheterization, but practical issues dictate the need for frequent echocardiograms to evaluate right ventricular systolic pressures and right atrial and ventricle chamber sizes. A better understanding of the association between OSA and PH and its treatment with CPAP will require long-term perspective studies.
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Chronic diarrhea as a presentation of Behçet's disease. Clin Case Rep 2023; 11:e7359. [PMID: 37215967 PMCID: PMC10196402 DOI: 10.1002/ccr3.7359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/22/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
Key Clinical Messages Behçet's disease (BD) or syndrome is a chronic, recurrent, multisystem, inflammatory vasculitis disorder with findings of oral aphthous ulcers, genital ulcers, and uveitis. Gastrointestinal (GI) involvement can be the initial presentation as presented in this case. Abstract Behçet's disease (BD) or syndrome is a chronic, recurrent, multisystem, inflammatory vasculitis disorder of unknown etiology with classical findings of oral aphthous ulcers, genital ulcers, and ocular involvements including chronic anterior, intermediate, posterior, and even panuveitis. Gastrointestinal involvement in BD usually presents with chronic diarrhea, hematochezia as the disease affects ileocecal area which might be similar to presentation of inflammatory bowel diseases. Here, we report a case of undiagnosed BD who presented with chronic diarrhea for 4 months, leading to the diagnosis of BD and responded well to corticosteroid therapy.
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Pemphigus vulgaris presenting with epigastric pain. Clin Case Rep 2023; 11:e7299. [PMID: 37151949 PMCID: PMC10160808 DOI: 10.1002/ccr3.7299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/06/2023] [Accepted: 04/19/2023] [Indexed: 05/09/2023] Open
Abstract
Pemphigus vulgaris is an autoimmune mucocutaneous disease with an involvement in gastrointestinal tract especially in oral cavity and esophagus. Ulcers can be the initial presentation even before visible mucosal or cutaneous lesions. The presenting symptoms will be in accordance with the affected organ such as throat pain, hoarseness, dysphagia, odynophagia, or even bleeding. Here, we report a case of undiagnosed pemphigus vulgaris presenting with epigastric pain whose endoscopy showed oropharyngeal involvement and isolate esophageal ulcer, which failed proton pump inhibitor treatment.
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Gallbladder containing incisional hernia in an elderly woman. Clin Case Rep 2023; 11:e7240. [PMID: 37155421 PMCID: PMC10122686 DOI: 10.1002/ccr3.7240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/20/2023] [Accepted: 04/07/2023] [Indexed: 05/10/2023] Open
Abstract
Gallbladder herniation is a rare phenomenon with risk factors of being female, older age, and previous history of hernias. Imaging modalities can confirm the diagnosis. Cholecystectomy and hernia repair to prevent strangulation may be warranted.
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Acute onset of bullous skin rash and acute kidney injury after exposure to radiocontrast: Sweet's syndrome. Eur J Case Rep Intern Med 2023; 10:003781. [PMID: 37051479 PMCID: PMC10084799 DOI: 10.12890/2023_003781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/11/2023] [Indexed: 03/17/2023] Open
Abstract
Sweet's syndrome or acute febrile neutrophilic dermatosis is characterized by an acute inflammatory skin eruption of oedematous and erythematous papules, plaques or nodules, accompanied by fever, and leucocytosis with possible extracutaneous involvement. Aetiologies include infections, inflammatory bowel disease, pregnancy or malignancy, or the syndrome may be drug-induced by many classes of medications or very rarely, radiocontrast exposure. Herein, the authors report a case of radiocontrast-induced bullous Sweet's syndrome and contrast-induced acute kidney injury in a woman in her 60s with a complex medical history.
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Menopause is associated with increased prevalence of nonalcoholic fatty liver disease: a systematic review and meta-analysis. Menopause 2023; 30:348-354. [PMID: 36728528 DOI: 10.1097/gme.0000000000002133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
IMPORTANCE Data are inconsistent on whether menopause is a risk for nonalcoholic fatty liver disease (NAFLD). OBJECTIVE Using systematic review and meta-analysis, we aimed to collect all available data to determine the association between menopause and NAFLD. EVIDENCE REVIEW Potentially eligible studies were identified from EMBASE, MEDLINE, and Web of Science databases from inception to December 2021 using a search strategy that was composed of the terms for "NAFLD" and "menopause." Eligible study must contain two groups of participants: one group of postmenopausal women and another group of premenopausal women. Then, the study must report the association between menopause and prevalent NAFLD. We extracted such data from each study and calculated pooled odds ratio (OR) by combining effect estimates of each study using a random-effects model. Funnel plot was used to assess for the presence of publication bias. FINDINGS A total of 587 articles were identified. After two rounds of independent review by two investigators, 12 cross-sectional studies fulfilled the eligibility criteria. The meta-analysis of 12 studies revealed the significant association between menopause and NAFLD with a pooled OR of 2.37 (95% CI, 1.99-2.82; I2 = 73%). The association remained significant in a sensitivity meta-analysis of six studies that reported the association with adjustment for age and metabolic factors with a pooled OR of 2.19 (95% CI, 1.73-2.78; I2 = 74%). The funnel plot was fairly symmetric and was not suggestive of publication bias. CONCLUSIONS AND RELEVANCE The meta-analysis reveals that menopausal status was associated with approximately 2.4 times higher odds of NAFLD.
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Serositis: an extraintestinal manifestation of undiagnosed ulcerative colitis? Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00173-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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A Rare Cause of Recurrent Haemolytic Anaemia: Carboplatin and Paclitaxel-induced Autoimmune Haemolytic Anaemia. Eur J Case Rep Intern Med 2023; 10:3740. [PMID: 36970161 PMCID: PMC10035619 DOI: 10.12890/2023_003740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 01/28/2023] Open
Abstract
Drug-induced immune haemolytic anaemia (DIIHA) is a rare but serious complication affecting approximately 1 in 1,000,000 patients, but its incidence might be underestimated due to misdiagnosis. Several factors should be considered to ensure an accurate diagnosis, including previous medical history, comorbidities, drug history, the temporal relationship between drug exposure and symptom onset, haemolytic features, and comorbidities in suspected cases. The authors report a case of DIIHA caused by combination chemotherapy with carboplatin and paclitaxel complicated with haeme pigment-induced acute kidney injury.
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Increased Prevalence of Gastroesophageal Reflux Disease Among Patients With Rheumatoid Arthritis: A Systematic Review and Meta-analysis. Curr Rheumatol Rev 2023; 19:496-503. [PMID: 37066776 DOI: 10.2174/1573397119666230414103624] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE This study was conducted to determine the association between gastroesophageal reflux disease (GERD) and rheumatoid arthritis (RA) by pooling the evidence from all available studies. METHODS Potentially eligible studies were identified from MEDLINE and EMBASE database from inception to April 2021 employing a search strategy that consisted of terms for "Rheumatoid Arthritis" and "Gastroesophageal Reflux Disease". Eligible studies for the meta-analysis were recruited with conditions of being cohort studies that included rheumatoid arthritis and without rheumatoid arthritis individuals. Together with this, prevalence of GERD in both groups and the odds ratio (OR) comparing the prevalence of GERD between the two cohorts have been reported. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model and generic inverse variance method as described by DerSimonian and Laird. RESULTS A total of 3,646 articles were identified. After two rounds of independent review by two investigators, five cohort studies were included in the meta-analysis as they met the eligibility criteria. The pooled analysis demonstrated a significant association between RA and GERD with the pooled odds ratio of 1.98 (95% CI, 1.49 - 2.65). High statistical heterogeneity with I2 of 83% was observed. The funnel plot was symmetric and publication bias was not observed. CONCLUSION This systematic review and meta-analysis found a significant association between GERD and RA.
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COVID-19 Infections and Inflammatory Markers in Patients Hospitalized During the First Year of the Pandemic. J Prim Care Community Health 2023; 14:21501319231206911. [PMID: 37864436 PMCID: PMC10590050 DOI: 10.1177/21501319231206911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/05/2023] [Accepted: 09/25/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The clinical presentations in patients with SARS-CoV-2 (COVID-19) infections range from asymptomatic upper respiratory infections to acute respiratory failure with bilateral pulmonary infiltrates requiring mechanical ventilation. Clinicians often measured inflammatory markers in hospitalized patients to characterize the severity of the infection. Multiple studies published in 2020 reported information on the frequency of elevated inflammatory markers in hospitalized patients in various categories of disease severity. METHODS The PubMed database was searched using the terms "Inflammatory markers in COVID-19 patients" and "Clinical features of patients infected with COVID-19." Thirty-three publications were analyzed in detail to determine which inflammatory markers were increased and the frequency of these increases in various clinical classifications, including patients requiring hospitalization, patients with pneumonia, patients with severe infection, patients requiring intensive care unit admission, and patients who died. RESULTS C-reactive protein (CRP) was the most frequently elevated inflammatory marker in all categories. Ferritin, D-dimer, and erythrocyte sedimentation rate levels were also frequently elevated. In general, frequencies were higher in patients with more severe infections. For example, 24 out of 24 patients who died had an elevated CRP level. CONCLUSION This review provides concrete information about the frequency of various inflammatory markers in patients with COVID-19 infection who required hospitalization. It also provides us some insight into the approach clinicians took in the early phase of this pandemic in their efforts to characterize these patients and perhaps understand the disease process better. However, these results might suggest that clinicians and laboratory directors should develop protocols to optimize laboratory testing.
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Solitary Neurocysticercosis Presenting with Focal Seizure and Secondary Generalized Tonic-Clonic Seizure. AMERICAN JOURNAL OF CASE REPORTS 2022; 23:e935483. [PMID: 35283475 PMCID: PMC8931703 DOI: 10.12659/ajcr.935483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Patient: Male, 25-year-old
Final Diagnosis: Neurocysticerosis
Symptoms: Generalized tonic-clonic seizures
Medication: —
Clinical Procedure: Cyst ramoval under CT brain navigation with duraplasty
Specialty: Infectious Diseases • General and Internal Medicine • Neurology
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Psoriatic Arthritis and Risk of Vertebral Fracture: A Systematic Review and Meta-analysis. Curr Rheumatol Rev 2021; 18:64-71. [PMID: 34496734 DOI: 10.2174/1573397117666210908094349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 05/18/2021] [Accepted: 06/07/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study was conducted in order to determine the association between psoriatic arthritis and risk of vertebral fracture by pooling the evidence from previous studies. METHODS Potentially eligible studies were identified from MEDLINE and EMBASE database from inception to March 2020 using search strategy that comprised of terms for "Psoriatic Arthritis" and "Vertebral Fracture". Studies were eligible for the meta-analysis if they were cohort studies that included psoriatic arthritis and individuals without psoriasis and followed them for incident vertebral fracture. Studies were also required to report standardized incidence ration, hazard risk ratio or relative risk with related 95% confidence intervals (CI) comparing the incidence of vertebral fracture between the two cohorts. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model, generic inverse variance method. RESULTS A total of 26,090 articles were identified. After two rounds of independent review by three investigators, we included five cohort studies that met the eligibility criteria in the meta-analysis. PsA is significantly associated with VF the pooled odds ratio of 2.09 (95% CI, 1.11 - 3.96; I2 70%). The funnel plot was fairly asymmetric, thus, the publication bias in favor of studies may present. CONCLUSIONS This systematic review and meta-analysis indicates that psoriatic arthritis patients have a significantly elevated risk of developing vertebral fracture.
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The Association Between Asthma and Risk of Myasthenia Gravis: A Systematic Review and Meta-analysis. Lung 2021; 199:273-280. [PMID: 33987703 DOI: 10.1007/s00408-021-00444-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to investigate the association between asthma and risk of myasthenia gravis (MG) using the method of systematic review and meta-analysis. METHODS Potentially eligible studies were identified from Medline and EMBASE databases from inception to July 2020 using search strategy that comprised terms for "Asthma" and "Myasthenia Gravis". Eligible cohort study must consist of one cohort of individuals with asthma and another cohort of individuals without asthma. Then, the study must report relative risk (RR) with 95% confidence intervals (95% CIs) of incident MG between the groups. Eligible case-control studies must include cases with MG and controls without MG. Then, the study must explore their history of asthma. Odds ratio (OR) with 95% CIs of the association between asthma status and MG must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method. RESULTS A total of 6,835 articles were identified. After two rounds of independent review by five investigators, two cohort studies and three case-control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed that asthma was significantly associated with risk of MG with the pooled risk ratio of 1.38 (95% CI 1.02-1.86). Funnel plot was symmetric, which was not suggestive of publication bias. CONCLUSION The current study found a significant association between asthma and increased risk of MG.
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