1
|
Colwill M, Baillie S, Pollok R, Poullis A. Using clinical cases to guide healthcare. World J Clin Cases 2024; 12:1555-1559. [DOI: 10.12998/wjcc.v12.i9.1555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/26/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
Evidence-based practice (EBP) has been the gold standard in healthcare for nearly three centuries and aims to assist physicians in providing the safest and most effective healthcare for their patients. The well-established hierarchy of evidence lists systematic reviews and meta-analyses at the top however these methodologies are not always appropriate or possible and in these instances case-control studies, case series and case reports are utilised to support EBP. Case-control studies allow simultaneous study of multiple risk factors and can be performed rapidly and relatively cheaply. A recent example was during the Coronavirus pandemic where case-control studies were used to assess the efficacy of personal protective equipment for healthcare workers. Case series and case reports also play a role in EBP and are particularly useful to study rare diseases such as inflammatory bowel disease in transgender and gender non-conforming individuals. They are also vital in generating and disseminating early signals and encouraging further research. Whilst these methodologies have weaknesses, particularly with regards to bias and loss of patient confidentiality for rare pathologies, they have an important part to play in EBP and when appropriately utilised can significantly impact upon clinical practice.
Collapse
Affiliation(s)
- Michael Colwill
- Department of Gastroenterology, St George's University Hospital NHS Foundation Trust, London SW17 0QT, United Kingdom
| | - Samantha Baillie
- Department of Gastroenterology, St George's University Hospital NHS Foundation Trust, London SW17 0QT, United Kingdom
| | - Richard Pollok
- Department of Gastroenterology, St George's University Hospital NHS Foundation Trust, London SW17 0QT, United Kingdom
| | - Andrew Poullis
- Department of Gastroenterology, St George's University Hospital NHS Foundation Trust, London SW17 0QT, United Kingdom
| |
Collapse
|
2
|
Zhang T, Li M, Tan L, Li X. Pulmonary alveolar proteinosis induced by X-linked agammaglobulinemia: A case report. World J Clin Cases 2024; 12:1644-1648. [DOI: 10.12998/wjcc.v12.i9.1644] [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: 10/20/2023] [Revised: 01/20/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Pulmonary alveolar proteinosis (PAP) and X-linked agammaglobulinemia (XLA) are rare diseases in children. Many theories infer that immunodeficiency can induce PAP, but these reports are almost all review articles, and there is little clinical evidence. We report the case of a child with both PAP and XLA.
CASE SUMMARY A 4-month-old boy sought medical treatment due to coughing and difficulty in breathing for > 2 wk. He had been hospitalized multiple times due to respiratory infections and diarrhea. Chest computed tomography and alveolar lavage fluid showed typical PAP-related manifestations. Genetic testing confirmed that the boy also had XLA. Following total lung alveolar lavage and intravenous immunoglobulin replacement therapy, the boy recovered and was discharged. During the follow-up period, the number of respiratory infections was significantly reduced, and PAP did not recur.
CONCLUSION XLA can induce PAP and improving immune function contributes to the prognosis of children with this type of PAP.
Collapse
Affiliation(s)
- Ting Zhang
- Department of Respiratory Medicine, Kunming Children´s Hospital, Kunming 650228, Yunnan Province, China
| | - Ming Li
- Department of Respiratory Medicine, Kunming Children´s Hospital, Kunming 650228, Yunnan Province, China
| | - Li Tan
- Department of Respiratory Medicine, Kunming Children´s Hospital, Kunming 650228, Yunnan Province, China
| | - Xin Li
- Department of Emergency, Kunming Children's Hospital, Kunming 650228, Yunnan Province, China
| |
Collapse
|
3
|
Zhao JL, Jin X, Huang HT, Yang WY, Li JH, Luo MH, Liu J, Pan JK. Analysis of the causes of primary revision after unicompartmental knee arthroplasty: A case series. World J Clin Cases 2024; 12:1560-1568. [DOI: 10.12998/wjcc.v12.i9.1560] [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: 10/05/2023] [Revised: 02/02/2024] [Accepted: 02/26/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Unicompartmental knee arthroplasty (UKA) has great advantages in the treatment of unicompartmental knee osteoarthritis, but its revision rate is higher than that of total knee arthroplasty.
AIM To summarize and analyse the causes of revision after UKA.
METHODS This is a retrospective case series study in which the reasons for the first revision after UKA are summarized. We analysed the clinical symptoms, medical histories, laboratory test results, imaging examination results and treatment processes of the patients who underwent revision and summarized the reasons for primary revision after UKA.
RESULTS A total of 13 patients, including 3 males and 10 females, underwent revision surgery after UKA. The average age of the included patients was 67.62 years. The prosthesis was used for 3 d to 72 months. The main reasons for revision after UKA were improper suturing of the surgical opening (1 patient), osteophytes (2 patients), intra-articular loose bodies (2 patients), tibial prosthesis loosening (2 patients), rheumatoid arthritis (1 patient), gasket dislocation (3 patients), anterior cruciate ligament injury (1 patient), and medial collateral ligament injury with residual bone cement (1 patient).
CONCLUSION The causes of primary revision after UKA were gasket dislocation, osteophytes, intra-articular loose bodies and tibial prosthesis loosening. Avoidance of these factors may greatly reduce the rate of revision after UKA, improve patient satisfaction and reduce medical burden.
Collapse
Affiliation(s)
- Jin-Long Zhao
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
| | - Xiao Jin
- Department of Chinese Medicine, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
| | - He-Tao Huang
- The Second School of Clinical Medical Sciences, Guangzhou University of Chinese Medicine, Guangdong Academy of Traditional Chinese Medicine, Guangzhou 510405, Guangdong Province, China
| | - Wei-Yi Yang
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, Guangdong Province, China
| | - Jia-Hui Li
- The Affiliated TCM Hospital, Guangzhou Medical University, Guangzhou 510405, Guangdong Province, China
| | - Ming-Hui Luo
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, Guangdong Province, China
| | - Jun Liu
- The Research Team on Bone and Joint Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510405, Guangdong Province, China
| | - Jian-Ke Pan
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, Guangdong Province, China
| |
Collapse
|
4
|
Chen JX, Xu LL, Cheng JP, Xu XH. Challenging anticoagulation therapy for multiple primary malignant tumors combined with thrombosis: A case report and review of literature. World J Clin Cases 2024; 12:1704-1711. [DOI: 10.12998/wjcc.v12.i9.1704] [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: 01/24/2024] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Venous thromboembolism significantly contributes to patient deterioration and mortality. Management of its etiology and anticoagulation treatment is intricate, necessitating a comprehensive consideration of various factors, including the bleeding risk, dosage, specific anticoagulant medications, and duration of therapy. Herein, a case of lower extremity thrombosis with multiple primary malignant tumors and high risk of bleeding was reviewed to summarize the shortcomings of treatment and prudent anticoagulation experience.
CASE SUMMARY An 83-year-old female patient was admitted to the hospital due to a 2-wk history of left lower extremity edema that had worsened over 2 d. Considering her medical history and relevant post-admission investigations, it was determined that the development of left lower extremity venous thrombosis and pulmonary embolism in this case could be attributed to a combination of factors, including multiple primary malignant tumors, iliac venous compression syndrome, previous novel coronavirus infection, and inadequate treatment for prior thrombotic events. However, the selection of appropriate anticoagulant medications, determination of optimal drug dosages, and establishment of an appropriate duration of anticoagulation therapy were important because of concurrent thrombocytopenia, decreased quantitative fibrinogen levels, and renal insufficiency.
CONCLUSION Anticoagulant prophylaxis should be promptly initiated in cases of high-risk thrombosis. Individualized anticoagulation therapy is required for complex thrombosis.
Collapse
Affiliation(s)
- Jia-Xin Chen
- Department of Gerontology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China
- Medical College, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China
| | - Ling-Ling Xu
- Department of Gerontology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China
- Medical College, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China
| | - Jing-Ping Cheng
- Department of Gerontology, China Resources and Wisco General Hospital, Wuhan 430080, Hubei Province, China
| | - Xun-Hua Xu
- Department of Radiology, China Resources and Wisco General Hospital, Wuhan 430080, Hubei Province, China
| |
Collapse
|
5
|
Chen YY, Xu XZ, Xu XJ. Low interleukin-10 level indicates a good prognosis in Salmonella enterica serovar typhimurium-induced pediatric hemophagocytic lymphohistiocytosis: A case report. World J Clin Cases 2024; 12:1660-1668. [DOI: 10.12998/wjcc.v12.i9.1660] [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: 01/10/2024] [Accepted: 03/05/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Secondary hemophagocytic lymphohistiocytosis (sHLH) triggered by Salmonella enterica serovar Typhimurium is rare in pediatric patients. There is no consensus on how to treat S. typhimurium-triggered sHLH.
CASE SUMMARY A 9-year-old boy with intermittent fever for 3 d presented to our hospital with positive results for S. typhimurium, human rhinovirus, and Mycoplasma pneumoniae infections. At the time of admission to our institution, the patient’s T helper 1/T helper 2 cytokine levels were 326 pg/mL for interleukin 6 (IL-6), 9.1 pg/mL for IL-10, and 246.7 pg/mL for interferon-gamma (IFN-γ), for which the ratio of IL-10 to IFN-γ was 0.04. In this study, the patient received meropenem, linezolid, and cefoperazone/sulbactam in combination with high-dose methylprednisolone therapy (10 mg/kg/d for 3 d) and antishock supportive treatment twice. After careful evaluation, this patient did not receive HLH chemotherapy and recovered well.
CONCLUSION S. Typhimurium infection-triggered sHLH patient had a ratio of IL-10 to IFN-γ ≤ 1.33, an IL-10 concentration ≤ 10.0 pg/mL, and/or an IFN-γ concentration ≤ 225 pg/mL at admission. Early antimicrobial and supportive treatment was sufficient, and the HLH-94/2004 protocol was not necessary under these conditions.
Collapse
Affiliation(s)
- Yuan-Yuan Chen
- Division/Center of Pediatric Hematology Oncology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Xiang-Zhi Xu
- Pediatric Intensive Care Unit, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Xiao-Jun Xu
- Division/Center of Pediatric Hematology Oncology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| |
Collapse
|
6
|
Gong ZZ, Li T, Yan H, Xu MH, Lian Y, Yang YX, Wei W, Liu T. Exploring the autophagy-related pathogenesis of active ulcerative colitis. World J Clin Cases 2024; 12:1622-1633. [DOI: 10.12998/wjcc.v12.i9.1622] [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: 01/07/2024] [Revised: 01/23/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND The pathogenesis of ulcerative colitis (UC) is complex, and recent therapeutic advances remain unable to fully alleviate the condition.
AIM To inform the development of novel UC treatments, bioinformatics was used to explore the autophagy-related pathogenesis associated with the active phase of UC.
METHODS The GEO database was searched for UC-related datasets that included healthy controls who met the screening criteria. Differential analysis was conducted to obtain differentially expressed genes (DEGs). Autophagy-related targets were collected and intersected with the DEGs to identiy differentially expressed autophagy-related genes (DEARGs) associated with active UC. DEARGs were then subjected to KEGG, GO, and DisGeNET disease enrichment analyses using R software. Differential analysis of immune infiltrating cells was performed using the CiberSort algorithm. The least absolute shrinkage and selection operator algorithm and protein-protein interaction network were used to narrow down the DEARGs, and the top five targets in the Dgree ranking were designated as core targets.
RESULTS A total of 4822 DEGs were obtained, of which 58 were classified as DEARGs. SERPINA1, BAG3, HSPA5, CASP1, and CX3CL1 were identified as core targets. GO enrichment analysis revealed that DEARGs were primarily enriched in processes related to autophagy regulation and macroautophagy. KEGG enrichment analysis showed that DEARGs were predominantly associated with NOD-like receptor signaling and other signaling pathways. Disease enrichment analysis indicated that DEARGs were significantly linked to diseases such as malignant glioma and middle cerebral artery occlusion. Immune infiltration analysis demonstrated a higher presence of immune cells like activated memory CD4 T cells and follicular helper T cells in active UC patients than in healthy controls.
CONCLUSION Autophagy is closely related to the active phase of UC and the potential targets obtained from the analysis in this study may provide new insight into the treatment of active UC patients.
Collapse
Affiliation(s)
- Zhuo-Zhi Gong
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Teng Li
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - He Yan
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Min-Hao Xu
- College of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing 100102, China
| | - Yue Lian
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Yi-Xuan Yang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Wei Wei
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Tao Liu
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
| |
Collapse
|
7
|
Nag DS, Swain A, Sahu S, Sahoo A, Wadhwa G. Multidisciplinary approach toward enhanced recovery after surgery for total knee arthroplasty improves outcomes. World J Clin Cases 2024; 12:1549-1554. [DOI: 10.12998/wjcc.v12.i9.1549] [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: 11/30/2023] [Revised: 01/26/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
Knee osteoarthritis is a degenerative disorder of the knee, which leads to joint pain, stiffness, and inactivity and significantly affects the quality of life. With an increased prevalence of obesity and greater life expectancies, total knee arthroplasty (TKA) is now one of the major arthroplasty surgeries performed for knee osteoarthritis. When enhanced recovery after surgery (ERAS) was introduced in TKA, clinical outcomes were enhanced and the economic burden on the healthcare system was reduced. ERAS is an evidence-based scientific protocol aimed at ameliorating the surgical stress response. ERAS aims to enhance the recovery phase, which encompasses multidisciplinary strategies at every step of perioperative care, including the rehabilitation phase. Implementation of ERAS in TKA aids in reducing the length of hospital stay, improving pain management, reducing perioperative complications, and enhancing patient satisfaction. Multidisciplinary collaboration, integrating the expertise of anesthesiologists, orthopedic surgeons, nursing personnel, and other healthcare professionals, is the cornerstone of ERAS in patients undergoing TKA.
Collapse
Affiliation(s)
- Deb Sanjay Nag
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, India
| | - Amlan Swain
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, India
| | - Seelora Sahu
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, India
| | - Ayaskant Sahoo
- Department of Anaesthesiology, Manipal Tata Medical College, Jamshedpur 831001, India
| | - Gunjan Wadhwa
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, India
| |
Collapse
|
8
|
Xu LL, Chen JX, Cheng JP, Luo N. Exogenous insulin autoimmune syndrome: A case report and review of literature. World J Clin Cases 2024; 12:1691-1697. [DOI: 10.12998/wjcc.v12.i9.1691] [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: 01/24/2024] [Revised: 02/23/2024] [Accepted: 03/06/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Insulin autoimmune syndrome (IAS) is a severe manifestation of spontaneous hypoglycemia. It is characterized by elevated levels of immune-reactive insulin and highly potent insulin autoantibodies (IAAs), which are induced by endogenous insulin circulating in the bloodstream. It is distinguished by recurring instances of spontaneous hypoglycemia, the presence of IAA within the body, a substantial elevation in serum insulin levels, and an absence of prior exogenous insulin administration. Nevertheless, recent studies show that both conventional insulin and its analogs can induce IAS episodes, giving rise to the notion of non-classical IAS. Therefore, more attention should be paid to these diseases.
CASE SUMMARY In this case report, we present a rare case of non-classical IAS in an 83-year-old male patient who present with symptoms of a psychiatric disorder. Upon symptom onset, the patient exhibited Whipple's triad (including hypoglycemia, blood glucose level less than 2.8 mmol/L during onset, and rapid relief of hypoglycemic symptoms after glucose administration). Concurrently, his serum insulin level was significantly elevated, which contradicted his C-peptide levels. After a comprehensive examination, the patient was diagnosed with exogenous insulin autoimmune syndrome. Considering that the patient had type 2 diabetes mellitus and a history of exogenous insulin use before disease onset, it was presumed that non classical IAS was induced by this condition. The PubMed database was used to search for previous cases of IAS and non-classical IAS to analyze their characteristics and treatment approaches.
CONCLUSION The occurrence of non-classical IAS is associated with exogenous insulin or its analogs, as well as with sulfhydryl drugs. Symptoms can be effectively alleviated through the discontinuation of relevant medications, administration of hormones or immunosuppressants, plasma exchange, and lifestyle adjustments.
Collapse
Affiliation(s)
- Ling-Ling Xu
- Medical College, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China
| | - Jia-Xin Chen
- Medical College, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China
| | - Jing-Ping Cheng
- Department of Gerontology, CR & WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China
| | - Ni Luo
- Department of Gerontology, CR & WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China
| |
Collapse
|
9
|
Yuan YY, Wu H, Chen QY, Fan H, Shuai B. Construction of the underlying circRNA-miRNA-mRNA regulatory network and a new diagnostic model in ulcerative colitis by bioinformatics analysis. World J Clin Cases 2024; 12:1606-1621. [DOI: 10.12998/wjcc.v12.i9.1606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/02/2024] [Accepted: 03/04/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Circular RNAs (circRNAs) are involved in the pathogenesis of many diseases through competing endogenous RNA (ceRNA) regulatory mechanisms.
AIM To investigate a circRNA-related ceRNA regulatory network and a new predictive model by circRNA to understand the diagnostic mechanism of circRNAs in ulcerative colitis (UC).
METHODS We obtained gene expression profiles of circRNAs, miRNAs, and mRNAs in UC from the Gene Expression Omnibus dataset. The circRNA-miRNA-mRNA network was constructed based on circRNA-miRNA and miRNA-mRNA interactions. Functional enrichment analysis was performed to identify the biological mechanisms involved in circRNAs. We identified the most relevant differential circRNAs for diagnosing UC and constructed a new predictive nomogram, whose efficacy was tested with the C-index, receiver operating characteristic curve (ROC), and decision curve analysis (DCA).
RESULTS A circRNA-miRNA-mRNA regulatory network was obtained, containing 12 circRNAs, three miRNAs, and 38 mRNAs. Two optimal prognostic-related differentially expressed circRNAs, hsa_circ_0085323 and hsa_circ_0036906, were included to construct a predictive nomogram. The model showed good discrimination, with a C-index of 1(> 0.9, high accuracy). ROC and DCA suggested that the nomogram had a beneficial diagnostic ability.
CONCLUSION This novel predictive nomogram incorporating hsa_circ_0085323 and hsa_circ_0036906 can be conveniently used to predict the risk of UC. The circRNa-miRNA-mRNA network in UC could be more clinically significant.
Collapse
Affiliation(s)
- Yu-Yi Yuan
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Hui Wu
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Qian-Yun Chen
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Heng Fan
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Bo Shuai
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| |
Collapse
|
10
|
Wang TG, Tian L, Zhang XL, Zhang L, Zhao XL, Kong DS. Gradient inflammation in the pancreatic stump after pancreaticoduodenectomy: Two case reports and review of literature. World J Clin Cases 2024; 12:1649-1659. [DOI: 10.12998/wjcc.v12.i9.1649] [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: 10/29/2023] [Revised: 12/26/2023] [Accepted: 03/07/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Postoperative pancreatic fistula (POPF) contributes significantly to morbidity and mortality after pancreaticoduodenectomy (PD). However, the underlying mechanisms remain unclear. This study explored this pathology in the pancreatic stumps and elucidated the mechanisms of POPF following PD.
CASE SUMMARY Pathological analysis and 16S rRNA gene sequencing were performed on specimens obtained from two patients who underwent complete pancreatectomy for grade C POPF after PD. Gradient inflammation is present in the pancreatic stump. The apoptosis was lower than that in the normal pancreas. Moreover, neutrophil-dominated inflammatory cells are concentrated in the ductal system. Notably, neutrophils migrated through the ductal wall in acinar duct metaplasia-formed ducts. Additionally, evidence indicates that gut microbes migrate from the digestive tract. Gradient inflammation occurs in pancreatic stumps after PD.
CONCLUSION The mechanisms underlying POPF include high biochemical activity in the pancreas, mechanical injury, and digestive reflux. To prevent POPF and address pancreatic inflammation and reflux, breaking the link with anastomotic dehiscence is practical.
Collapse
Affiliation(s)
- Tie-Gong Wang
- Department of Surgery, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Liang Tian
- Department of Pathology, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Xiao-Ling Zhang
- Department of Pathology, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Lei Zhang
- Department of Surgery, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - Xiu-Lei Zhao
- Department of Surgery, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| | - De-Shuai Kong
- Department of Surgery, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
| |
Collapse
|
11
|
Ni HY, Zhang Y, Huang DH, Zhou F. Multi-systemic melioidosis in a patient with type 2 diabetes in non-endemic areas: A case report and review of literature. World J Clin Cases 2024; 12:1669-1676. [DOI: 10.12998/wjcc.v12.i9.1669] [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: 11/08/2023] [Revised: 01/05/2024] [Accepted: 02/25/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Melioidosis, an infectious disease caused by Burkholderia pseudomallei (B. pseudomallei), occurs endemically in Southeast Asia and Northern Australia and is a serious opportunistic infection associated with a high mortality rate.
CASE SUMMARY A 58-year-old woman presented with scattered erythema on the skin of her limbs, followed by fever and seizures. B. pseudomallei was isolated successively from the patient’s urine, blood, and pus. Magnetic resonance imaging showed abscess formation involving the right forehead and the right frontal region. Subsequently, abscess resection and drainage were performed. The patient showed no signs of relapse after 4 months of follow-up visits post-treatment.
CONCLUSION We present here a unique case of multi-systemic melioidosis that occurs in non-endemic regions in a patient who had no recent travel history. Hence, it is critical to enhance awareness of melioidosis in non-endemic regions.
Collapse
Affiliation(s)
- Huan-Yu Ni
- Department of Endocrinology, Puren Hospital, Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China
- School of Medicine, Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China
| | - Ying Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
| | - Dong-Hai Huang
- Department of Rheumatology and Immunology, Puren Hospital, Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China
| | - Feng Zhou
- Department of Endocrinology, Puren Hospital, Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China
| |
Collapse
|
12
|
Shan D, Li T, Tan X, Hu YY. Low-molecular-weight heparin and preeclampsia — does the sword cut both ways? Three case reports and review of literature. World J Clin Cases 2024; 12:1634-1643. [DOI: 10.12998/wjcc.v12.i9.1634] [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: 10/20/2023] [Revised: 02/03/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Low-molecular-weight heparins (LMWH) are the most commonly used anticoagulants during pregnancy. It is considered to be the drug of choice due to its safety in not crossing placenta. Considering the beneficial effect in the improvement of microcirculation, prophylactic application of LMWH in patients with preeclampsia became a trend. However, the bleeding risk related with LMWH in preeclampsia patients has seldomly been evaluated. This current study aimed to identify the potential risks regarding LMWH application in patients with preeclampsia.
CASE SUMMARY Herein we present a case series of three pregnant women diagnosed with preeclampsia on LMWH therapy during pregnancy. All the cases experienced catastrophic hemorrhagic events. After reviewing the twenty-one meta-analyses, the bleeding risk related with LMWH seems ignorable. Only one study analyzed the bleeding risk of LMWH and found a significantly higher risk of developing PPH in women receiving LMWH. Other studies reported minor bleeding risks, none of these were serious enough to stop LMWH treatment. Possibilities of bleeding either from uterus or from intrabdominal organs in preeclampsia patients on LMWH therapy should not be ignored. Intensive management of blood pressure even after delivery and homeostasis suture in surgery are crucial.
CONCLUSION Consideration should be given to the balance between benefits and risks of LMWH in patients with preeclampsia.
Collapse
Affiliation(s)
- Dan Shan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610000, Sichuan, China
| | - Tao Li
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610000, Sichuan, China
| | - Xi Tan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610000, Sichuan, China
| | - Ya-Yi Hu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
| |
Collapse
|
13
|
Qin X, Chen C, Liu Y, Hua XH, Li JY, Liang MJ, Wu F. Efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer. World J Clin Cases 2024; 12:1569-1577. [DOI: 10.12998/wjcc.v12.i9.1569] [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: 11/30/2023] [Revised: 01/04/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world, and the choice of its treatment is very important for the survival rate and prognosis of patients. Traditional open surgery is the main treatment for ovarian cancer, but it has the disadvantages of big trauma and slow recovery. With the continuous development of minimally invasive technology, minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery. However, the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.
AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.
METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively. According to the different surgical treatment methods, patients were divided into study group and control group (45 cases in each group). The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer, while the control group received traditional open surgery for ovarian cancer. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), clinical efficacy and safety of the two groups were compared.
RESULTS The intraoperative blood loss, length of hospital stay, postoperative gas evacuation time, and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group (P < 0.05). The incidence of postoperative complications in the study group was significantly lower than in the control group (P < 0.05). The two groups had no significant differences in the preoperative adrenocorticotropic hormone (ACTH), androstenedione (AD), cortisol (Cor), cluster of differentiation 3 positive (CD3+), and cluster of differentiation 4 positive (CD4+) indexes (P > 0.05). In contrast, postoperatively, the study group's ACTH, AD, and Cor indexes were lower, and the CD3+ and CD4+ indexes were higher than those in the control group (P < 0.05).
CONCLUSION Minimally invasive laparoscopic surgery under general anesthesia in patients with early ovarian cancer can significantly improve the efficacy and safety, improve the short-term prognosis and quality of life of patients, and is worth popularizing.
Collapse
Affiliation(s)
- Xian Qin
- Department of Anesthesiology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Chen Chen
- Department of Anesthesiology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Yang Liu
- Department of Anesthesiology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Xian-Hong Hua
- Department of Anesthesiology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Jia-Yi Li
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Meng-Jie Liang
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Fang Wu
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| |
Collapse
|
14
|
Zabuliene L, Ilias I. Epinephrine also acts on beta cells and insulin secretion. World J Clin Cases 2024; 12:1712-1713. [DOI: 10.12998/wjcc.v12.i9.1712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/30/2024] [Accepted: 03/04/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
In a recent review examining neurotransmitter modulation of insulin secretion, the significant impact of epinephrine was not addressed. Its primary action involves inhibiting insulin release via alpha-adrenergic receptors, thereby reducing the response to insulin secretion stimulators, through the activation of K+ channels and resulting in membrane hyperpolarization in beta cells.
Collapse
Affiliation(s)
- Lina Zabuliene
- Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania
| | - Ioannis Ilias
- Department of Endocrinology, “Hippokration” General Hospital, Athens GR-11527, Greece
| |
Collapse
|
15
|
Wang H, Duan RZ, Bai XJ, Zhang BT, Wang J, Song WX. Unexplained fetal tachycardia: A case report. World J Clin Cases 2024; 12:1698-1703. [DOI: 10.12998/wjcc.v12.i9.1698] [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: 01/06/2024] [Revised: 01/23/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND This study aimed to explore the possible etiology and treatment of severe fetal tachycardia in the absence of organic disease and provide a reference for clinical management of severe fetal tachycardia.
CASE SUMMARY A 29-year-old pregnant woman, with a gravidity 1 parity 0, presented with a fetal heart rate (FHR) of 243 beats per minute during a routine antenatal examination at 31 + 2 wk of gestation. Before termination of pregnancy at 38 wk of gestation, the FHR repeatedly showed serious abnormalities, lasting more than 30 min. However, the pregnant woman and the fetus had no clinical symptoms, and repeated examination revealed no organic lesions. The mother and the baby were regularly followed up.
CONCLUSION This was a case of severe fetal tachycardia with no organic lesions and management based on clinical experience.
Collapse
Affiliation(s)
- Hui Wang
- Department of Nutrition, Changzhi Maternal and Child Health Care Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi Province, China
| | - Run-Zi Duan
- Department of Obstetrics, Changzhi Maternal and Child Health Care Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi Province, China
| | - Xin-Jiu Bai
- Department of Gynaecology, Changzhi Maternal and Child Health Care Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi Province, China
| | - Bing-Ting Zhang
- Department of Obstetrics, Changzhi Maternal and Child Health Care Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi Province, China
| | - Jie Wang
- Department of Obstetrics, Changzhi Maternal and Child Health Care Hospital Affiliated to Changzhi Medical College, Changzhi 046000, Shanxi Province, China
| | - Wen-Xia Song
- Department of Medical Genetic, Changzhi Maternal and Child Health Care Hospital Affiliated to Changzhi Medical College, Changzhi 046011, Shanxi Province, China
| |
Collapse
|
16
|
Boyalı O, Kabatas S, Civelek E, Ozdemir O, Bahar-Ozdemir Y, Kaplan N, Savrunlu EC, Karaöz E. Allogeneic mesenchymal stem cells may be a viable treatment modality in cerebral palsy. World J Clin Cases 2024; 12:1585-1596. [DOI: 10.12998/wjcc.v12.i9.1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/11/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Cerebral palsy (CP) describes a group of disorders affecting movement, balance, and posture. Disturbances in motor functions constitute the main body of CP symptoms. These symptoms surface in early childhood and patients are affected for the rest of their lives. Currently, treatment involves various pharmacotherapies for different types of CP, including antiepileptics for epilepsy and Botox A for focal spasticity. However, none of these methods can provide full symptom relief. This has prompted researchers to look for new treatment modalities, one of which is mesenchymal stem cell therapy (MSCT). Despite being a promising tool and offering a wide array of possibilities, mesenchymal stem cells (MSCs) still need to be investigated for their efficacy and safety.
AIM To analyze the efficacy and safety of MSCT in CP patients.
METHODS Our sample consists of four CP patients who cannot stand or walk without external support. All of these cases received allogeneic MSCT six times as 1 × 106/kg intrathecally, intravenously, and intramuscularly using umbilical cord-derived MSCs (UC-MSC). We monitored and assessed the patients pre- and post-treatment using the Wee Functional Independence Measure (WeeFIM), Gross Motor Function Classification System (GMFCS), and Manual Ability Classification Scale (MACS) instruments. We utilized the Modified Ashworth Scale (MAS) to measure spasticity.
RESULTS We found significant improvements in MAS scores after the intervention on both sides. Two months: Right χ2 = 4000, P = 0.046, left χ2 = 4000, P = 0.046; four months: Right χ2 = 4000, P = 0.046, left χ2 = 4000, P = 0.046; 12 months: Right χ2 = 4000, P = 0.046, left χ2 = 4000, P = 0.046. However, there was no significant difference in motor functions based on WeeFIM results (P > 0.05). GMFCS and MACS scores differed significantly at 12 months after the intervention (P = 0.046, P = 0.046). Finally, there was no significant change in cognitive functions (P > 0.05).
CONCLUSION In light of our findings, we believe that UC-MSC therapy has a positive effect on spasticity, and it partially improves motor functions.
Collapse
Affiliation(s)
- Osman Boyalı
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Turkey
| | - Serdar Kabatas
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Turkey
- Center for Stem Cell & Gene Therapy Research and Practice, University of Health Sciences Turkey, Istanbul 34360, Turkey
| | - Erdinç Civelek
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Turkey
| | - Omer Ozdemir
- Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Turkey
| | - Yeliz Bahar-Ozdemir
- Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Istanbul 34668, Turkey
| | - Necati Kaplan
- Department of Neurosurgery, Istanbul Rumeli University, Çorlu Reyap Hospital, Tekirdağ 59860, Turkey
| | - Eyüp Can Savrunlu
- Department of Neurosurgery, Nevşehir State Hospital, Nevşehir 50300, Turkey
| | - Erdal Karaöz
- Center for Regenerative Medicine and Stem Cell Research & Manufacturing (LivMedCell), Liv Hospital, Istanbul 34340, Turkey
- Department of Histology and Embryology, Istinye University, Faculty of Medicine, İstanbul 34010, Turkey
- Center for Stem Cell and Tissue Engineering Research and Practice, Istinye University, Istanbul 34340, Turkey
| |
Collapse
|
17
|
Kim KH, Park CH, Cho E, Lee Y. Endoscopic ultrasound-guided tissue sampling induced pancreatic duct leak resolved by the placement of a pancreatic stent: A case report. World J Clin Cases 2024; 12:1677-1684. [DOI: 10.12998/wjcc.v12.i9.1677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/03/2024] [Accepted: 03/05/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Pancreatic ductal leaks complicated by endoscopic ultrasonography-guided tissue sampling (EUS-TS) can manifest as acute pancreatitis.
CASE SUMMARY A 63-year-old man presented with persistent abdominal pain and weight loss. Diagnosis: Laboratory findings revealed elevated carbohydrate antigen 19-9 (5920 U/mL) and carcinoembryonic antigen (23.7 ng/mL) levels. Magnetic resonance imaging of the pancreas revealed an approximately 3 cm ill-defined space-occupying lesion in the inferior aspect of the head, with severe encasement of the superior mesenteric artery. Pancreatic ductal adenocarcinoma was confirmed after pathological examination of specimens obtained by EUS-TS using the fanning method. Interventions and outcomes: The following day, the patient experienced severe abdominal pain with high amylase (265 U/L) and lipase (1173 U/L) levels. Computed tomography of the abdomen revealed edematous wall thickening of the second portion of the duodenum with adjacent fluid collections and a suspicious leak from either the distal common bile duct or the main pancreatic duct in the head. Endoscopic retrograde cholangiopancreatography revealed dye leakage in the head of the main pancreatic duct. Therefore, a 5F 7 cm linear plastic stent was deployed into the pancreatic duct to divert the pancreatic juice. The patient’s abdominal pain improved immediately after pancreatic stent insertion, and amylase and lipase levels normalized within a week. Neoadjuvant chemotherapy was then initiated.
CONCLUSION Using the fanning method in EUS-TS can inadvertently cause damage to the pancreatic duct and may lead to clinically significant pancreatitis. Placing a pancreatic stent may immediately resolve acute pancreatitis and shorten the waiting time for curative therapy. When using the fanning method during EUS-TS, ductal structures should be excluded to prevent pancreatic ductal leakage.
Collapse
Affiliation(s)
- Ki-Hyun Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, South Korea
| | - Chang Hwan Park
- Department of Gastroenterology, Chonnam National University Hospital, Gwangju 61469, South Korea
| | - Eunae Cho
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, South Korea
| | - Yohan Lee
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, South Korea
| |
Collapse
|
18
|
Chai XD, Jiang H, Tang LL, Zhang J, Yue LF. Factors influencing Frey syndrome after parotidectomy with acellular dermal matrix. World J Clin Cases 2024; 12:1578-1584. [DOI: 10.12998/wjcc.v12.i9.1578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/22/2024] [Accepted: 02/25/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Frey syndrome, also known as ototemporal nerve syndrome or gustatory sweating syndrome, is one of the most common complications of parotid gland surgery. This condition is characterized by abnormal sensations in the facial skin accompanied by episodes of flushing and sweating triggered by cognitive processes, visual stimuli, or eating.
AIM To investigate the preventive effect of acellular dermal matrix (ADM) on Frey syndrome after parotid tumor resection and analyzed the effects of Frey syndrome across various surgical methods and other factors involved in parotid tumor resection.
METHODS Retrospective data from 82 patients were analyzed to assess the correlation between sex, age, resection sample size, operation time, operation mode, ADM usage, and occurrence of postoperative Frey syndrome.
RESULTS Among the 82 patients, the incidence of Frey syndrome was 56.1%. There were no significant differences in sex, age, or operation time between the two groups (P > 0.05). However, there was a significant difference between ADM implantation and occurrence of Frey syndrome (P < 0.05). ADM application could reduce the variation in the incidence of Frey syndrome across different operation modes.
CONCLUSION ADM can effectively prevent Frey syndrome and delay its onset.
Collapse
Affiliation(s)
- Xian-Da Chai
- Department of Oral and Maxillofacial Surgery, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| | - Huan Jiang
- Department of Oral and Maxillofacial Surgery, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| | - Ling-Ling Tang
- Department of Oral and Maxillofacial Surgery, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| | - Jing Zhang
- Department of Oral and Maxillofacial Surgery, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| | - Long-Fei Yue
- Department of General Practice, People’s Hospital of Anshun, Anshun 561000, Guizhou Province, China
| |
Collapse
|
19
|
Xu X, Jiang JW, Lu BY, Li XX. Upadacitinib for refractory ulcerative colitis with primary nonresponse to infliximab and vedolizumab: A case report. World J Clin Cases 2024; 12:1685-1690. [DOI: 10.12998/wjcc.v12.i9.1685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/22/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Many patients with ulcerative colitis (UC) do not respond well to, or tolerate conventional and biological therapies. There is currently no consensus on the treatment of refractory UC. Studies have demonstrated that the selective Janus kinase 1 inhibitor upadacitinib, a small-molecule drug, is effective and safe for treating UC. However, no studies have revealed that upadacitinib is effective in treating refractory UC with primary nonresponse to infliximab and vedolizumab.
CASE SUMMARY We report the case of a 44-year-old male patient with a chief complaint of bloody diarrhoea with mucus and pus, in addition to dizziness. The patient had recurrent disease after receiving mesalazine, prednisone, azathioprine, infliximab and vedolizumab over four years. Based on the endoscopic findings and pathological biopsy, the patient was diagnosed with refractory UC. In particular, the patient showed primary nonresponse to infliximab and vedolizumab. Based on the patient’s history and recurrent disease, we decided to administer upadacitinib. During hospitalisation, the patient was received upadacitinib under our guidance. Eight weeks after the initiation of upadacitinib treatment, the patient’s symptoms and endoscopic findings improved significantly. No notable adverse reactions have been reported to date.
CONCLUSION Our case report suggests that upadacitinib may represent a valuable strategy for treating refractory UC with primary nonresponse.
Collapse
Affiliation(s)
- Xuan Xu
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, Guangdong Province, China
- The First Clinical Medical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Jing-Wen Jiang
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, Guangdong Province, China
- The First Clinical Medical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Bing-Yun Lu
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, Guangdong Province, China
| | - Xia-Xi Li
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen 518100, Guangdong Province, China
| |
Collapse
|
20
|
Wang XJ, Shi YP, Wang L, Li YN, Xu LJ, Zhang Y, Han S. Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis. World J Clin Cases 2024; 12:1597-1605. [DOI: 10.12998/wjcc.v12.i9.1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/17/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024] [Imported: 03/25/2024] Open
Abstract
BACKGROUND Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) constitutes a prevalent emergency within Gastroenterology, encompassing 80%-90% of all gastrointestinal hemorrhage incidents. This condition is distinguished by its abrupt onset, swift progression, and notably elevated mortality rate.
AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.
METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023, utilizing our medical record system. Data pertaining to general patient information, etiological factors, disease outcomes, and other relevant variables were meticulously collected and analyzed.
RESULTS Among the 532 patients diagnosed with ANVUGIB, the male-to-female ratio was 2.91:1, with a higher prevalence among males. Notably, 43.6% of patients presented with black stool as their primary complaint, while 27.4% had hematemesis as their initial symptom. Upon admission, 17% of patients exhibited both hematemesis and black stool, while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding. Urgent routine blood examinations at admission revealed that 75.8% of patients had anemia, with 63.4% experiencing moderate to severe anemia, and 1.5% having extremely severe anemia (hemoglobin < 30 g/L). With regard to etiology, 53.2% of patients experienced bleeding without a definitive trigger, 24.2% had a history of using gastric mucosa-irritating medications, 24.2% developed bleeding after alcohol consumption, 2.8% attributed it to improper diet, 1.7% to emotional excitement, and 2.3% to fatigue preceding the bleeding episode. Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals, while bleeding due to alcohol consumption showed the opposite trend. Additionally, diet-related bleeding was more common among the young age group compared to the middle-aged group. Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB (73.3%), followed by gastrointestinal malignancies (10.9%), acute gastric mucous lesions (9.8%), and androgenic upper gastrointestinal bleeding (1.5%) among inpatients with ANVUGIB. Of the 532 patients with gastrointestinal bleeding, 68 underwent endoscopic hemostasis, resulting in an endoscopic treatment rate of 12.8%, with a high immediate hemostasis success rate of 94.1%.
CONCLUSION ANVUGIB patients exhibit diverse characteristics across different age groups, and endoscopic hemostatic treatments have demonstrated remarkable efficacy.
Collapse
Affiliation(s)
- Xiao-Juan Wang
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Yu-Peng Shi
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Li Wang
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Ya-Ni Li
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Li-Juan Xu
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Yue Zhang
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Shuang Han
- Department of Gastroenterology, Honghui Hospital Affiliated to Medicine College of Xi’an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| |
Collapse
|
21
|
Ali AM, Mohamed YG, Mohamud AA, Mohamed AN, Ahmed MR, Abdullahi IM, Saydam T. Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction: A case report and review of literature. World J Clin Cases 2024; 12:1536-1543. [DOI: 10.12998/wjcc.v12.i8.1536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Mycobacterium tuberculosis (TB) is the causative agent of TB, a chronic granulomatous illness. This disease is prevalent in low-income countries, posing a significant global health challenge. Gastrointestinal TB is one of the three forms. The disease can mimic other intra-abdominal conditions, leading to delayed diagnosis owing to the absence of specific symptoms. While gastric outlet obstruction (GOO) remains a frequent complication, its incidence has declined with the advent of proton pump inhibitors and Helicobacter pylori eradication therapy. Gastroduodenal TB can cause upper gastrointestinal hemorrhage, obstruction, and malignancy-like tumors.
CASE SUMMARY A 23-year-old male presented with recurrent epigastric pain, distension, nausea, vomiting, and weight loss, prompting a referral to a gastroenterologist clinic. Endoscopic examination revealed distorted gastric mucosa and signs of chronic inflammation. However, treatment was interrupted, possibly owing to vomiting or comorbidities such as human immunodeficiency virus infection or diabetes. Subsequent surgical intervention revealed a dilated stomach and diffuse thickening of the duodenal wall. Resection revealed gastric wall effacement with TB.
CONCLUSION Primary gastric TB is rare, frequently leading to GOO. Given its rarity, suspicions should be promptly raised when encountering relevant symptoms, often requiring surgical intervention for diagnosis and treatment.
Collapse
Affiliation(s)
- Abdihamid Mohamed Ali
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Yahye Garad Mohamed
- Department of Radiology, Mogadishu Somali Turkey, Training and Research Hospital, Mogadishu 2526, Somalia
| | - Abdirahman Ahmed Mohamud
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Abdulkadir Nor Mohamed
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Mohamed Rage Ahmed
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Ismail Mohamud Abdullahi
- Department of Pathology, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| | - Tuba Saydam
- Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu 2526, Somalia
| |
Collapse
|
22
|
Yu XH, Wang WX, Yang DS, Gong LH. Left lower lobe sleeve resection for the clear cell variant of pulmonary mucoepidermoid carcinoma: A case report. World J Clin Cases 2024; 12:1422-1429. [DOI: 10.12998/wjcc.v12.i8.1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/08/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignancy that arises from minor salivary glands within the tracheobronchial tree. The clear cell variant of PMEC is exceptionally uncommon and presents notable diagnostic challenges, primarily attributable to its morphological similarity to other tumors containing clear cells.
CASE SUMMARY A 22-year-old male, formerly in good health, came in with a two-month duration of persistent cough and production of sputum. Subsequent imaging and bronchoscopy examinations revealed a 2 cm tumor in the distal left main bronchus, which resulted in complete atelectasis of the left lung. Further assessment via positron emission tomography/computed tomography scans and endoscopic biopsy confirmed the primary malignant nature of the tumor, characterized by clear cell morphology in most of the tumor cells. The patient underwent a left lower lobe sleeve resection accompanied by systematic mediastinal lymph node dissection. Molecular pathology analysis subsequently revealed a CRTC3-MAML2 gene fusion, leading to a definitive pathological diagnosis of the clear cell variant of PMEC, staged as T2N0M0. After surgery, the patient experienced a smooth recovery and exhibited no signs of recurrence during the one-and-a-half-year follow-up period.
CONCLUSION This article describes an unusual case of a clear cell variant of PMEC characterized by the presence of a CRTC3-MAML2 gene fusion in a 22-year-old male. The patient underwent successful left lower lobe sleeve resection. This case underscores the distinctive challenges associated with diagnosing and treating this uncommon malignancy, underscoring the importance of precise diagnosis and personalized treatment strategies.
Collapse
Affiliation(s)
- Xiao-Hui Yu
- Department of Pathology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - Wen-Xiang Wang
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - De-Song Yang
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| | - Liang-Hui Gong
- The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
| |
Collapse
|
23
|
Cao WL, Yu CP, Zhang LL. Serum proteins differentially expressed in gestational diabetes mellitus assessed using isobaric tag for relative and absolute quantitation proteomics. World J Clin Cases 2024; 12:1395-1405. [DOI: 10.12998/wjcc.v12.i8.1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/08/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND As a well-known fact to the public, gestational diabetes mellitus (GDM) could bring serious risks for both pregnant women and infants. During this important investigation into the linkage between GDM patients and their altered expression in the serum, proteomics techniques were deployed to detect the differentially expressed proteins (DEPs) of in the serum of GDM patients to further explore its pathogenesis, and find out possible biomarkers to forecast GDM occurrence.
AIM To investigation serum proteins differentially expressed in GDM were assessed using isobaric tag for relative and absolute quantitation (iTRAQ) proteomics and bioinformatics analyses.
METHODS Subjects were divided into GDM and normal control groups according to the IADPSG diagnostic criteria. Serum samples were randomly selected from four cases in each group at 24-28 wk of gestation, and the blood samples were identified by applying iTRAQ technology combined with liquid chromatography-tandem mass spectrometry. Key proteins and signaling pathways associated with GDM were identified by bioinformatics analysis, and the expression of key proteins in serum from 12 wk to 16 wk of gestation was further verified using enzyme-linked immunosorbent assay (ELISA).
RESULTS Forty-seven proteins were significantly differentially expressed by analyzing the serum samples between the GDM gravidas as well as the healthy ones. Among them, 31 proteins were found to be upregulated notably and the rest 16 proteins were downregulated remarkably. Bioinformatic data report revealed abnormal expression of proteins associated with lipid metabolism, coagulation cascade activation, complement system and inflammatory response in the GDM group. ELISA results showed that the contents of RBP4, as well as ANGPTL8, increased in the serum of GDM gravidas compared with the healthy ones, and this change was found to initiate from 12 wk to 16 wk of gestation.
CONCLUSION GDM symptoms may involve abnormalities in lipid metabolism, coagulation cascade activation, complement system and inflammatory response. RBP4 and ANGPTL8 are expected to be early predictors of GDM.
Collapse
Affiliation(s)
- Wei-Li Cao
- Department of Women’s Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, Hubei Province, China
| | - Cui-Ping Yu
- Obstetrical Department, The First People’s Hospital of Jiangxia District Wuhan City (Union Jiangnan Hospital Huazhong University of Science and Technology), Wuhan 430200, Hubei Province, China
| | - Ling-Li Zhang
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, Hubei Province, China
| |
Collapse
|
24
|
Wu ZW, Zhu WJ, Huang S, Tan Q, You C, Hu DG, Li LN. Eccrine porocarcinoma in the tempus of an elderly woman: A case report. World J Clin Cases 2024; 12:1523-1529. [DOI: 10.12998/wjcc.v12.i8.1523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/19/2024] [Accepted: 02/22/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Eccrine porocarcinoma (EPC) is a rare skin tumor that mainly affects the elderly population. Tumors often present with slow growth and a good prognosis. EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry. However, surgical management alone may be inadequate if the tumor has metastasized. However, currently, surgical resection is the most commonly used treatment modality.
CASE SUMMARY A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area, with no obvious itching or pain, for more than four months. Histopathological examination showed small columnar and short spindle-shaped cells; thus, basal cell carcinoma was suspected. However, immunohistochemical analysis revealed the expression of cytokeratin 5/6, p63 protein, p16 protein, and Ki-67 antigen (40%), and EPC was taken into consideration. The skin biopsy was repeated, and hematoxylin and eosin staining revealed ductal differentiation in some cells. Finally, the patient was diagnosed with EPC, and Mohs micrographic surgery was performed. We adapted follow-up visits in a year and not found any recurrence of nodules.
CONCLUSION This case report emphasizes the diagnosis and differentiation of EPC.
Collapse
Affiliation(s)
- Zhi-Wei Wu
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Wen-Jie Zhu
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Shan Huang
- Department of Laser and Cosmetic Dermatology, Ganzhou Dermatology Hospital, Ganzhou 341000, Jiangxi Province, China
| | - Qi Tan
- Department of Dermatology, Tongxiang Dermatology Hospital, Jiaxing 314000, Zhejiang Province, China
| | - Cong You
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Dian-Gui Hu
- Department of Infectious Diseases, The Fifth people’s Hospital of Ganzhou, Ganzhou 341000, Jiangxi Province, China
| | - Long-Nian Li
- Department of Dermatology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| |
Collapse
|
25
|
El Labban M, Surani S. Immunoglobulin A glomerulonephropathy: A review. World J Clin Cases 2024; 12:1388-1394. [DOI: 10.12998/wjcc.v12.i8.1388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/27/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
In this editorial, we comment on the article by Meng et al published in the World Journal of Clinical Cases. We comprehensively review immunoglobulin A nephropathy (IgAN), including epidemiology, clinical presentation, diagnosis, and management. IgAN, also known as Berger's disease, is the most frequent type of primary glomerulonephritis (GN) globally. It is mostly found among the Asian population. The presentation can be variable, from microscopic hematuria to a rapidly progressive GN. Around 50% of patients present with single or recurring episodes of gross hematuria. An upper respiratory infection and tonsillitis often precede these episodes. Around 30% of patients present microscopic hematuria with or without proteinuria, usually detected on routine examination. The diagnosis relies on having a renal biopsy for pathology and immunofluorescence microscopy. We focus on risk stratification and management of IgAN. We provide a review of all the landmark studies to date. According to the 2021 KDIGO (kidney disease: Improving Global Outcomes) guidelines, patients with non-variant form IgAN are first treated conservatively for three to six months. This approach consists of adequate blood pressure control, reduction of proteinuria with renin-angiotensin system blockade, treatment of dyslipidemia, and lifestyle modifications (weight loss, exercise, smoking cessation, and dietary sodium restrictions). Following three to six months of conservative therapy, patients are further classified as high or low risk for disease progression. High-risk patients have proteinuria ≥ 1 g/d or < 1 g/d with significant microscopic hematuria and active inflammation on kidney biopsy. Some experts consider proteinuria ≥ 2 g/d to be very high risk. Patients with high and very high-risk profiles are treated with immunosuppressive therapy. A proteinuria level of < 1 g/d and stable/improved renal function indicates a good treatment response for patients on immunosuppressive therapy.
Collapse
Affiliation(s)
- Mohamad El Labban
- Department of Internal Medicine, Mayo Cliic Health System, Mankato, MN 56001, United States
| | - Salim Surani
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
| |
Collapse
|
26
|
Gou YP, Huang Y, Chen L, Zheng W, Zheng YH. Analysis and monitoring of drug therapy in a patient with peptic ulcer complicated by infection: A case report. World J Clin Cases 2024; 12:1530-1535. [DOI: 10.12998/wjcc.v12.i8.1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/20/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND The role of primary-level medical pharmacists in medical institutions in China is limited; therefore, it is necessary to explore the role of pharmacists in the process of drug treatment.
CASE SUMMARY A Chinese pharmacist participated in the complete treatment of a patient with a duodenal ulcer. The rationale for drug treatment was evaluated, and adjustments were made to the antacid and anti-infective regimen, as well as the dose and frequency of administration. Body temperature, routine blood examination, and adverse drug reactions were strictly monitored. During treatment, the pharmacist recommended anti-infective therapy with ampicillin–sulbactam, which effectively controlled the infection. Additionally, the pharmacist suggested changing famotidine to lansoprazole for acid suppression and gastroprotective treatment, combined with Chinese patent medicine such as Kangfuxin Liquid. This is the first case report of a pharmacist in primary-level medical institutions adjusting drug use for patients with duodenal ulcer and pulmonary infection.
CONCLUSION A pharmacist participated in the treatment process, provided individualized medication adjustment, and achieved good clinical results.
Collapse
Affiliation(s)
- Yan-Ping Gou
- The Second People’s Hospital of Meishan City & Renshou County People’s Hospital, Meishan 620500, Sichuan Province, China
| | - Yue Huang
- Quality Evaluation and Medical Record Management, The Affiliated Hospital of Southwest Jiaotong University & The Third People's Hospital of Chengdu, Chengdu 610000, Sichuan Province, China
| | - Li Chen
- Quality Evaluation and Medical Record Management, The Affiliated Hospital of Southwest Jiaotong University & The Third People's Hospital of Chengdu, Chengdu 610000, Sichuan Province, China
| | - Wei Zheng
- Patriotic Health Campaign, Qionglai City Health Bureau, Chengdu 610000, Sichuan Province, China
| | - Yun-Hua Zheng
- Quality Evaluation and Medical Record Management, The Affiliated Hospital of Southwest Jiaotong University & The Third People's Hospital of Chengdu, Chengdu 610000, Sichuan Province, China
| |
Collapse
|
27
|
Tang GC, He M, Huang ZZ, Cheng Y. Safety and effectiveness of butorphanol in epidural labor analgesia: A protocol for a systematic review and meta-analysis. World J Clin Cases 2024; 12:1416-1421. [DOI: 10.12998/wjcc.v12.i8.1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/09/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Epidural analgesia is the most effective analgesic method during labor. Butorphanol administered epidurally has been shown to be a successful analgesic method during labor. However, no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor.
AIM To assess butorphanol's safety and efficacy for epidural labor analgesia.
METHODS The PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure, and Google Scholar databases will be searched from inception. Other types of literature, such as conference abstracts and references to pertinent reviews, will also be reviewed. We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor. There will be no language restrictions. The primary outcomes will include the visual analog scale score for the first stage of labor, fetal effects, and Apgar score. Two independent reviewers will evaluate the full texts, extract data, and assess the risk of bias. Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot, and heterogeneity will be evaluated using the Cochran Q test, P values, and I2 values. Meta-analysis, subgroup analysis, and sensitivity analysis will be performed using RevMan software version 5.4. This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols statement, and the PRISMA statement will be used for the systematic review.
RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.
CONCLUSION To support clinical practice and development, this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.
Collapse
Affiliation(s)
- Guan-Cheng Tang
- Department of Anesthesiology, Yongkang Hospital of Traditional Chinese Medicine, Jinhua 321301, Zhejiang Province, China
| | - Man He
- Department of Gynecology and Obstetrics, Yongkang Hospital of Traditional Chinese Medicine, Jinhua 321301, Zhejiang Province, China
| | - Zhen-Zhao Huang
- Department of Anesthesiology, Hangzhou United Liger Sixth Medical Beauty Hospital, Hangzhou 311215, Zhejiang Province, China
| | - Yan Cheng
- Department of Ultrasound, Hangzhou Women’s Hospital, Hangzhou 310008, Zhejiang Province, China
| |
Collapse
|
28
|
Sun J, Yang QN, Guo Y, Zeng P, Ma LY, Kong LW, Zhao BY, Li CM. Multilocular thymic cysts can be easily misdiagnosed as malignant tumor on computer tomography: A case report. World J Clin Cases 2024; 12:1474-1480. [DOI: 10.12998/wjcc.v12.i8.1474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/29/2023] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Multilocular thymic cyst (MTC) is a rare mediastinal lesion which is considered to occur in the process of acquired inflammation. It is usually characterized by well-defined cystic density and is filled with transparent liquid.
CASE SUMMARY We report on a 39-year-old male with a cystic-solid mass in the anterior mediastinum. Computer tomography (CT) imaging showed that the mass was irregular with unclear boundaries. After injection of contrast agent, there was a slight enhancement of stripes and nodules. According to CT findings, it was diagnosed as thymic cancer.
CONCLUSION After surgery, MTC accompanied by bleeding and infection was confirmed by pathological examination. The main lesson of this case was that malignant thymic tumor and MTC of the anterior mediastinum sometimes exhibit similar CT findings. Caution is necessary in clinical work to avoid misdiagnosis.
Collapse
Affiliation(s)
- Jun Sun
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Qing-Ning Yang
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Yi Guo
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Ping Zeng
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Long-Yan Ma
- Department of Pathology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Ling-Wen Kong
- Department of Cardiothoracic Surgery, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Bo-Ying Zhao
- Department of Cardiothoracic Surgery, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Chuan-Ming Li
- Department of Radiology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| |
Collapse
|
29
|
Hou F, Li Y, Jin H. Clinical manifestations and the prenatal diagnosis of trisomy 7 mosaicism: Two case reports. World J Clin Cases 2024; 12:1544-1548. [DOI: 10.12998/wjcc.v12.i8.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/23/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND The clinical manifestations of trisomy 7 mosaicism are diverse and nonspecific, so prenatal diagnosis is very difficult.
CASE SUMMARY Two pregnant women with abnormal prenatal screening results were included. One was a 22-year-old woman (G1P0). At 31st week of gestation, ultrasound revealed that the posterior horn of the left lateral ventricle was 10 mm and the right renal pelvis had a separation of 7 mm. The other pregnant woman was 33 years old (G2P1L1A0), and her fetus was found to have a cardiac malformation at the 24th week of gestation. Copy number variation sequencing, whole-exome sequencing and karyotype analysis were carried out after amniocentesis, and both fetuses were diagnosed with trisomy 7 mosaicism. After parental counseling, one woman continued the pregnancy, and the other woman terminated the pregnancy.
CONCLUSION In trisomy 7 mosaicism, the low proportion of trisomy does not lead to abortion, but can result in abnormal fetal development, which can be detected via ultrasound. Therefore, clinicians need to pay more attention to various aspects of fetal growth and development, combining with imaging, cellular, molecular genetics and other methods to perform comprehensive evaluations of fetuses to provide more reliable genetic counseling for pregnant women.
Collapse
Affiliation(s)
- Fei Hou
- Department of Prenatal Diagnosis, Jinan Maternal and Child Health Hospital, Jinan 250001, Shandong Province, China
| | - Yan Li
- Department of Prenatal Diagnosis, Jinan Maternal and Child Health Hospital, Jinan 250001, Shandong Province, China
| | - Hua Jin
- Department of Prenatal Diagnosis, Jinan Maternal and Child Health Hospital, Jinan 250001, Shandong Province, China
| |
Collapse
|
30
|
Long Y, Xiang YN, Huang F, Xu L, Li XY, Zhen YH. Appendiceal intussusception complicated by adenocarcinoma of the cecum: A case report. World J Clin Cases 2024; 12:1461-1466. [DOI: 10.12998/wjcc.v12.i8.1461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/06/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Appendiceal intussusception is a pathological condition in which the appendix is inverted into the cecum, which may cause symptoms that resemble those of other gastrointestinal disorders and may induce intestinal obstruction. The rarity of this case presentation is the co-occurrence of appendiceal intussusception and cecal adenocarcinoma, a combination that to our knowledge has not previously been reported in the medical literature. This case provides new insights into the complexities of diagnosing and managing overlapping pathologies.
CASE SUMMARY A 25-year-old woman presented with persistent periumbilical pain and bloody stools. An initial biopsy showed cecal cancer; however, subsequent colonoscopy and computed tomography findings raised the suspicion of appendiceal intussusception, which was later confirmed postoperatively. This unique case was characterized by a combination of intussusception and adenocarcinoma of the cecum. The intervention included a laparoscopic right hemicolectomy, which led to the histopathological diagnosis of mucinous adenocarcinoma with appendiceal intussusception. The patient recovered well postoperatively and was advised to initiate adjuvant chemotherapy. This case highlights not only the importance of considering appendiceal intussusception in the differential diagnosis, but also the possibility of appendicitis and the atypical presentation of neoplastic lesions.
CONCLUSIONS Physicians should consider the possibility of appendiceal intussusception in cases of atypical appendicitis, particularly when associated with neoplastic presentation.
Collapse
Affiliation(s)
- Yu Long
- Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
- Department of Colorectal Surgery, Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Yi-Ning Xiang
- Department of Pathology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Fei Huang
- Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
| | - Lei Xu
- Department of Colorectal Surgery, Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Xiao-Yun Li
- Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
| | - Yun-Huan Zhen
- Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
| |
Collapse
|
31
|
Luo MR, Dai SM, Li Y, Wang Q, Liu H, Gao P, Liu JY, Chen J, Zhao SJ, Yin GY. 3M syndrome patient with a novel mutation: A case report. World J Clin Cases 2024; 12:1454-1460. [DOI: 10.12998/wjcc.v12.i8.1454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/29/2023] [Accepted: 01/30/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND A rare autosomal recessive genetic disorder, 3M syndrome, is characterized by severe intrauterine and postnatal growth retardation. Children with 3M syndrome typically exhibit short stature, facial deformities, long tubular bones, and high vertebral bodies but generally lack mental abnormalities or other organ damage. Pathogenic genes associated with 3M syndrome include CUL7, OBSL1 and CCDC8. The clinical and molecular characteristics of patient with 3M syndrome are unique and serve as important diagnostic indicators.
CASE SUMMARY In this case, the patient displayed square shoulders, scoliosis, long slender tubular bones, and normal neurological development. Notably, the patient did not exhibit the typical dysmorphic facial features, relative macrocephaly, or growth retardation commonly observed in individuals with 3M syndrome. Whole exon sequencing revealed a novel heterozygous c.56681+1G>C (Splice-3) variant and a previously reported nonsense heterozygous c.3341G>A (p.Trp1114Ter) variant of OBSL1. Therefore, it is important to note that the clinical features of 3M syndrome may not always be observable, and genetic confirmation is often required. Additionally, the identification of the c.5683+1G>C variant in OBSL1 is noteworthy because it has not been previously reported in public databases.
CONCLUSION Our study identified a new variant (c.5683+1G>C) of OBSL1 that contributes to expanding the molecular profile of 3M syndrome.
Collapse
Affiliation(s)
- Ming-Ran Luo
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Si-Ming Dai
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yin Li
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Qian Wang
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Hao Liu
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Peng Gao
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Jia-Yun Liu
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Jian Chen
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Shu-Jie Zhao
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Guo-Yong Yin
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| |
Collapse
|
32
|
Lee YJ, Chen MQ, Dong J. Effect of foot reflexology on an infant with sensorineural hearing loss: A case report. World J Clin Cases 2024; 12:1437-1441. [DOI: 10.12998/wjcc.v12.i8.1437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/15/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Our study contributes to the further understanding of the mechanism of foot reflexology. Foot reflexology has been reported to affect hearing recovery, but no physiological evidence has been provided. This lack of evidence hampers the acceptance of the technique in clinical practice.
CASE SUMMARY A girl was taken to North Sichuan Medical University Affiliated Hospital for a hearing screen by her parents. Her parents reported that her hearing level was the same as when she was born. The girl was diagnosed with sensorineural hearing loss (SNHL) by a doctor in the otolaryngology department. After we introduced the foot reflexology project, the parents agreed to participate in the experiment. After 6 months of foot reflexology treatment, the hearing threshold of the girl recovered to a normal level, below 30 dB.
CONCLUSION Foot reflexology should be encouraged in clinical practice and for families of infants with SNHL.
Collapse
Affiliation(s)
- Yu-Jun Lee
- Graduate School, Xi'an International Studies University; North Sichuan Medical University, Xi'an 710061, Shaanxi Province, China
- Department of Neural Disease, North Sichuan Medical University, Nanchong 635200, Sichuan Province, China
| | - Mao-Qing Chen
- Department of Nursing, North Sichuan Medical University, Nachong 635200, Sichuan Province, China
| | - Jie Dong
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi’an International Studies University, Xi’an 710128, Shaanxi Province, China
| |
Collapse
|
33
|
Zhu R, Chen TZ, Sun MT, Zhu CR. Advanced cervix cancer patient with chemotherapy-induced grade IV myelosuppression achieved complete remission with cadonilimab: A case report. World J Clin Cases 2024; 12:1510-1516. [DOI: 10.12998/wjcc.v12.i8.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/18/2024] [Accepted: 02/22/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND The prognosis for patients with advanced metastatic cervix cancer (MCC) is poor, and this disease continues to pose a considerable therapeutic challenge. Despite the administration of first-line regimens consisting of cisplatin, paclitaxel, and bevacizumab, survival rates for patients with metastasis remain poor. The emergence of bispecific antibodies (BsAbs) offers a novel treatment option for patients diagnosed with MCC.
CASE SUMMARY In this report, we present a patient with MCC who was treated with cadonilimab monotherapy at a dose of 6 mg/kg every two weeks after chemotherapy was proven to be intolerable. The patient exhibited a sustained complete response for a duration of 6 months, demonstrating an optimistic outlook.
CONCLUSION This case illustrates the considerable efficacy of cadonilimab for treating advanced MCC. Therefore, BsAb therapy is a promising strategy for effectively treating patients with advanced MCC and should be considered as an option when patients are intolerant to standard chemotherapy.
Collapse
Affiliation(s)
- Rui Zhu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Tian-Ze Chen
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Meng-Ting Sun
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Chun-Rong Zhu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| |
Collapse
|
34
|
Zhu XJ, Zhao L, Peng N, Luo JM, Liu SX. Lower extremity peripherally inserted central catheter placement ectopic to the ascending lumbar vein: A case report. World J Clin Cases 2024; 12:1430-1436. [DOI: 10.12998/wjcc.v12.i8.1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/28/2023] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Peripherally inserted central catheters (PICCs) are an essential infusion route for oncology patients receiving intravenous treatments, but lower extremity venipuncture is the preferred technique for patients with superior vena cava syndrome (SVCS). We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein, to indicate and verify PICC catheterisation in the lower extremity is safe and feasible. And hope to provide different perspectives for clinical PICC venipuncture to get the attention of peers.
CASE SUMMARY On 24 August 2022, a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month, which worsened 10 d prior. Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS. Chemotherapy was not an absolute contraindication in this patient. Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head, neck, and upper extremities. The patient and his family were informed about the procedure, and informed consent was obtained. After successful puncture and prompt treatment, the patient was discharged, experiencing some relief from symptoms.
CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS, particularly in complex situations involving ectopic placement.
Collapse
Affiliation(s)
- Xiao-Ju Zhu
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Ling Zhao
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Na Peng
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jia-Min Luo
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Shui-Xia Liu
- Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
| |
Collapse
|
35
|
Hu HF, Sang YF, Xiao YQ. Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke. World J Clin Cases 2024; 12:1406-1415. [DOI: 10.12998/wjcc.v12.i8.1406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/23/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Ischemic stroke (IS) is a widely recognized disease characterized by high prevalence, mortality, morbidity, disability, and recurrence rates. It ranks prominently in terms of mortality, constituting 60%-80% of stroke cases.
AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.
METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021. The participants were divided into two groups, namely the control group (n = 80) receiving routine care and the research group (n = 92) receiving comprehensive care. Various assessment scales, including the standard swallowing function assessment scale (SSA), National Institutes of Health Stroke scale (NIHSS), European stroke scale (ESS), self-rating anxiety scale (SAS), self-rating depression scale (SDS), Barthel index (BI), and the motor function assessment scale (MAS), were employed to evaluate the improvement in swallowing function, neurological deficits, clinical outcomes, anxiety, depression, daily living activities, and motor function before and after care. Furthermore, the study compared the occurrence of adverse reactions during the nursing period, life quality before and after the intervention, rehabilitation compliance, and nursing satisfaction between the two groups.
RESULTS After the nursing intervention, the research group exhibited significantly improved SSA and NIHSS scores compared to the control group (P < 0.05). Moreover, both groups demonstrated significant reductions in SAS and SDS scores (P < 0.05), with the research group showing more obvious advantages (P < 0.05). Compared to the control group, the research group displayed significantly better ESS, BI, and MAS scores (P < 0.05), coupled with a lower incidence of adverse reactions (P < 0.05). Additionally, the research group demonstrated markedly higher levels of life quality, rehabilitation compliance, and nursing satisfaction compared to the control group (P < 0.05).
CONCLUSION Comprehensive nursing effectively improved swallowing function, quality of life, and patient satisfaction, highlighting its clinical significance.
Collapse
Affiliation(s)
- Heng-Fen Hu
- Medical School, Hunan Vocational and Technical College of Environmental Biology, Hengyang 421005, Hunan Province, China
| | - Yu-Fei Sang
- Medical Team, The Unit 95246 Of Chinese People’s Liberation Army, Nanning 530007, Guangxi Zhuang Autonomous Region, China
| | - Yan-Qing Xiao
- Department of Gynecology and Obstetrics, Hengyang Maternal and Child Health Hospital, Hengyang 421001, Hunan Province, China
| |
Collapse
|
36
|
Ju UC, Kang WD, Kim SM. Development of immature ovarian teratoma after mature teratoma in a girl with familial ovarian teratoma: A case report. World J Clin Cases 2024; 12:1442-1447. [DOI: 10.12998/wjcc.v12.i8.1442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/15/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Immature ovarian teratoma is a rare and aggressive neoplasm that affects young women. This report is the first to describe the development of immature teratoma after ovarian cystectomy for mature teratoma of the ovary in an adolescent female with a family history of ovarian teratoma.
CASE SUMMARY A 16-year-old girl who had undergone bilateral ovarian cystectomy for mature teratomas 3 years ago showed bilateral adnexal tumors during her regular ultrasonography follow-up every 6 months. She received laparoscopic bilateral ovarian cystectomy, and final histopathology showed grade-1 immature teratoma of the left ovary and mature teratoma of the right ovary. Laparoscopic left salpingo-oophorectomy and staging procedures were performed again. Her mother, maternal aunt, and maternal grandmother had also received surgeries for mature ovarian teratomas.
CONCLUSION It is important to have guidance on management of patient and family members with familial ovarian teratomas.
Collapse
Affiliation(s)
- U Chul Ju
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - Woo Dae Kang
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| | - Seok Mo Kim
- Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju 61469, South Korea
| |
Collapse
|
37
|
Yang HJ, Kim D, Lee WS, Oh SH. Malignant triton tumor in the abdominal wall: A case report. World J Clin Cases 2024; 12:1467-1473. [DOI: 10.12998/wjcc.v12.i8.1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Malignant triton tumors (MTTs) comprise a subgroup of malignant peripheral nerve sheath tumors (MPNSTs) that exhibits rhabdomyosarcomatous differentiation and follow an aggressive course. MTTs are primarily located along peripheral nerves. Cases of MTTs in the abdominal wall have not been reported. MTT has a poorer prognosis than classic MPNSTs, and accurate diagnosis necessitates a keen understanding of the clinical history and knowledge of its differential diagnosis intricacies. Treatment for MTTs mirrors that for MPNSTs and is predominantly surgical.
CASE SUMMARY A 49-year-old woman presented with a subcutaneous mass in her lower abdominal wall and a pre-existing surgical scar that had grown slowly over 3-4 months before the consultation. She had previously undergone radical hysterectomy and concurrent chemo-radiotherapy for cervical cancer approximately 5 years prior to the consultation. Abdominal computed tomography (CT) showed a 1.3 cm midline mass in the lower abdomen with infiltration into the rectus abdominis muscle. There was no sign of metastasis (T1N0M0). An incisional biopsy identified sporadic MTT of the lower abdomen. A comprehensive surgical excision with a 3 cm margin inclusive of the peritoneum was executed. Subsequently, the general surgeon utilized an approach akin to the open peritoneal onlay mesh technique. The patient underwent additional treatment with an excision shaped as a mini-abdominoplasty for the skin defect. No complications arose, and annual follow-up CTs did not show signs of recurrence or metastasis.
CONCLUSION An abdominal MTT was efficaciously treated with extensive excision and abdominal wall reconstruction, eliminating the need for postoperative radiotherapy.
Collapse
Affiliation(s)
- Ho Jik Yang
- Department of Plastic and Reconstructive Surgery, Chungnam National University Sejong Hospital, Sejong 30099, South Korea
| | - Donghyun Kim
- Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon 35015, South Korea
| | - Won Suk Lee
- Department of Emergency, Eulji University Hospital, Daejeon 35233, South Korea
| | - Sang-Ha Oh
- Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine, Daejeon 35015, South Korea
| |
Collapse
|
38
|
Furuya N, Yamaguchi A, Kato N, Sugata S, Hamada T, Mizumoto T, Tamaru Y, Kusunoki R, Kuwai T, Kouno H, Kuraoka K, Shibata Y, Tazuma S, Sudo T, Kohno H, Oka S. High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings: A case report. World J Clin Cases 2024; 12:1487-1496. [DOI: 10.12998/wjcc.v12.i8.1487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND High-grade pancreatic intraepithelial neoplasia (PanIN) exhibits no mass and is not detected by any examination modalities. However, it can be diagnosed by pancreatic juice cytology from indirect findings. Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct (MPD) and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography (ERCP). We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range, but without caudal MPD dilatation on magnetic resonance cholangiopancreatography (MRCP).
CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision, which revealed pancreatic cysts. MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation. Thus, course observation was performed. After 24 mo, MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst. We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination. We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN. Pancreatic parenchyma invasion was not observed, and curative resection was achieved.
CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.
Collapse
Affiliation(s)
- Nao Furuya
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima 734-8551, Hiroshima, Japan
| | - Atsushi Yamaguchi
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Naohiro Kato
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Syuhei Sugata
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Takuro Hamada
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima 734-8551, Hiroshima, Japan
| | - Takeshi Mizumoto
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Yuzuru Tamaru
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Ryusaku Kusunoki
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Toshio Kuwai
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Hirotaka Kouno
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Kazuya Kuraoka
- Department of Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Yoshiyuki Shibata
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Sho Tazuma
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Takeshi Sudo
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Hiroshi Kohno
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Hiroshima, Japan
| | - Shiro Oka
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima 734-8551, Hiroshima, Japan
| |
Collapse
|
39
|
Alsinan TA, Altokhais TI. Multiple thoracic and abdominal foregut duplication cysts: A case report. World J Clin Cases 2024; 12:1504-1509. [DOI: 10.12998/wjcc.v12.i8.1504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/19/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Congenital enteric duplication cysts are tubular or cystic structures that normally lie alongside the gastrointestinal (GI) tract. Enteric duplication cysts are typically solitary lesions that occur anywhere near the GI tract from the neck to the rectum, but having multiple duplication cysts is rare, and presentation within the pancreas is extremely rare.
CASE SUMMARY We herein demonstrate a case of esophageal, gastric, and gastric-type duplication cyst of the pancreas in a seventeen-month-old girl who presented with failure to thrive, abdominal pain, vomiting, hematemesis, and melena since the age of three months. The cysts were excised by thoracoscopy and laparoscopy in the same setting. To our knowledge, no such case has been published.
CONCLUSION Enteric duplications can occur throughout the entire alimentary tract. When they occur in the pancreas, they present a formidable challenge in both diagnosis and treatment. Due to the risk of complications and malignant transformation, surgical removal is the recommended treatment of all duplication cysts.
Collapse
Affiliation(s)
- Tuqa Adil Alsinan
- Department of Pediatric Surgery, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Tariq Ibrahim Altokhais
- Devision of Pediatric Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 4545, Saudi Arabia
| |
Collapse
|
40
|
Kourek C, Briasoulis A, Magouliotis DE, Skoularigis J, Xanthopoulos A. Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure. World J Clin Cases 2024; 12:1382-1387. [DOI: 10.12998/wjcc.v12.i8.1382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/24/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
Chronic heart failure (HF) is a clinical syndrome with high morbidity and mortality worldwide. Cardiac rehabilitation (CR) is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF, recommended by both American and European guidelines. A CR program consists of a multispecialty group including physicians, nurses, physiotherapists, trainers, nutritionists, and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF patients. Physical activity, lifestyle, and psychological support are core components of a successful CR program. CR has been shown to be beneficial in all ejection fraction categories in HF and most patients, who are stable under medication, are capable of participating. An individualized exercise prescription should be developed on the basis of a baseline evaluation in all patients. The main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and frequency. It is important to set the appropriate clinical outcomes from the beginning, in order to assess the effectiveness of a CR program. There are still significant limitations that prevent patients from participating in these programs and need to be solved. A significant limitation is the generally low quality of research in CR and the presence of negative trials, such as the rehabilitation after myocardial infarction trial, where comprehensive rehabilitation following myocardial infraction had no important effect on mortality, morbidity, risk factors, or health-related quality of life or activity. In the present editorial, we present all the updated knowledge and recommendations in CR programs.
Collapse
Affiliation(s)
- Christos Kourek
- Medical School of Athens, National and Kapodistrian University of Athens, Athens 15772, Greece
| | - Alexandros Briasoulis
- Department of Clinical Therapeutics, Alexandra Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece
| | | | - John Skoularigis
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
| | - Andrew Xanthopoulos
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
| |
Collapse
|
41
|
Kaya I. Detection of 4p16.3 deletion and 11p15.5p15.4 gain in a boy by comparative genomic hybridization array: A case report. World J Clin Cases 2024; 12:1517-1522. [DOI: 10.12998/wjcc.v12.i8.1517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/22/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Nonallelic homologous recombination (NAHR) of segmental duplications or low copy repeats (LCRs) result in DNA gain/loss and play an important role in the origin of genomic disorders.
CASE SUMMARY A 3-year- old boy was referred for genetic analysis. Comparative genomic hybridization array analysis revealed a loss of 3776 kb in the 4p16.3 chromosomal region and a gain of 3201 kb in the 11p15.5p15.4 chromosomal region.
CONCLUSION Genomic imbalances caused by NAHR in LCRs result in deletion and duplication syndromes.
Collapse
Affiliation(s)
- Işın Kaya
- Medical Genetics, Bakırçay University Çiğli Education ve Training Hospital, İzmir 35620, Turkey
| |
Collapse
|
42
|
Liu JB, Zhang SL, Jiang WL, Sun HK, Yang HC. Chronic infectious unilateral giant thyroid cyst related to diabetes mellitus: A case report. World J Clin Cases 2024; 12:1497-1503. [DOI: 10.12998/wjcc.v12.i8.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/07/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Patients rarely develop complicated infections in thyroid cysts. Here, we describe a patient with chronic infected unilateral giant thyroid cyst related to diabetes mellitus (DM).
CASE SUMMARY A 66-year-old male was admitted due to an evident neck lump for 5 d after approximately 40 years of gradually progressive neck mass and 7 years of DM. Doppler ultrasound and computed tomography scan showed a giant lump in the left thyroid gland lobe. He was diagnosed with a large thyroid nodule complicated by tracheal dislocation and had surgical indications. Surgical exploration revealed evident inflammatory edema and exudation between the left anterior neck muscles, the nodule and glandular tissue. Fortunately, inflammatory lesions did not affect major neck vessels. Finally, a left partial thyroidectomy was performed. Macroscopic observation showed that the cystic thyroid mass consisted of extensive cystic wall calcification and was rich in massive rough sand-like calculi content and purulent matter. Postoperative pathology confirmed benign thyroid cyst with chronic infection.
CONCLUSION The progression of this chronic infectious unilateral giant thyroid cyst may have been related to DM, and identifying blood vessels involvement can prevent serious complications during operation.
Collapse
Affiliation(s)
- Jiang-Bo Liu
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
| | - Shi-Lei Zhang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
| | - Wen-Long Jiang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
| | - Hai-Kuan Sun
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471000, Henan Province, China
| | - Hao-Chen Yang
- Clinical Medicine School, The First Clinical College, Chongqing Medical University, Chongqing 400016, China
| |
Collapse
|
43
|
Lou JX, Wu Y, Huhe M, Zhang JJ, Jia DW, Jiang ZY. Diagnosis of poorly differentiated adenocarcinoma of the stomach by confocal laser endomicroscopy: A case report. World J Clin Cases 2024; 12:1481-1486. [DOI: 10.12998/wjcc.v12.i8.1481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/20/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND In recent years, confocal laser endomicroscopy (CLE) has become a new endoscopic imaging technology at the microscopic level, which is extensively performed for real-time in vivo histological examination. CLE can be performed to distinguish benign from malignant lesions. In this study, we diagnosed using CLE an asymptomatic patient with poorly differentiated gastric adenocarcinoma.
CASE SUMMARY A 63-year-old woman was diagnosed with gastric mucosal lesions, which may be gastric cancer, in the small curvature of the stomach by gastroscopy. She consented to undergo CLE for morphological observation of the gastric mucosa. Through the combination of CLE diagnosis and postoperative pathology, the intraoperative CLE diagnosis was considered to be reliable. According to our experience, CLE can be performed as the first choice for the diagnosis of gastric cancer.
CONCLUSION CLE has several advantages over pathological diagnosis. We believe that CLE has great potential in the diagnosis of benign and malignant gastric lesions.
Collapse
Affiliation(s)
- Jia-Xin Lou
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| | - Yong Wu
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| | - Muren Huhe
- Medical Innovation Center, The Fourth Military Medical University, Xi'an 710000, Shaanxi Province, China
| | - Jing-Jie Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| | - Dong-Wu Jia
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| | - Zhen-Yu Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014030, Inner Mongolia Autonomous Region, China
| |
Collapse
|
44
|
Liu YJ, Zou C, Wu YY. Metastatic clear cell sarcoma of the pancreas: A rare case report. World J Clin Cases 2024; 12:1448-1453. [DOI: 10.12998/wjcc.v12.i8.1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/11/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] [Imported: 03/12/2024] Open
Abstract
BACKGROUND Clear cell sarcoma (CCS) is a rare soft-tissue sarcoma. The most common metastatic sites for CCS are the lungs, bones and brain. CCS is highly invasive and mainly metastasizes to the lung, followed by the bone and brain; however, pancreatic metastasis is relatively rare.
CASE SUMMARY We report on a rare case of CCS with pancreatic metastasis in a 47-year-old man. The patient had a relevant medical history 3 years ago, with abdominal pain as the main clinical manifestation. No abnormalities were observed on physical examination and the tumor was found on abdominal computed tomography. Based on the medical history and postoperative pathology, the patient was diagnosed with CCS with pancreatic metastasis. The patient was successfully treated with surgical interventions, including distal pancreatectomy and splenectomy.
CONCLUSION This report summarizes the available treatment modalities for CCS and the importance of regular postoperative follow-up for patients with CCS.
Collapse
Affiliation(s)
- Yu-Jing Liu
- General Surgery II, Suzhou Hospital, The Affiliated Hospital of Medical School, Nanjing University, Suzhou 215000, Jiangsu Province, China
| | - Chen Zou
- Department of General Surgery, The Affiliated People's Hospital of Jiangsu University, Suzhou 215000, Jiangsu Province, China
| | - Yong-You Wu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215008, Jiangsu Province, China
| |
Collapse
|
45
|
Oh S, Jang JS, Jeon AR, Kim G, Kwon M, Cho B, Lee N. Effectiveness of sensory integration therapy in children, focusing on Korean children: A systematic review and meta-analysis. World J Clin Cases 2024; 12:1260-1271. [PMID: 38524513 PMCID: PMC10955541 DOI: 10.12998/wjcc.v12.i7.1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/27/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development. Currently, various sensory integration interventions are being applied, but research methodological problems are arising due to unsystematic protocols. This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis. AIM To prove the effectiveness of sensory integration therapy, examine the latest trend of sensory integration studies in Korea, and provide clinical evidence for sensory integration therapies. METHODS The database of Korean search engines, including RISS, KISS, and DBpia, was used to search for related literature published from 2001 to October 2020. The keywords, "Children", "Sensory integration", "Integrated sensory", "Sensory-motor", and "Sensory stimulation" were used in this search. Then, a meta-analysis was conducted on 24 selected studiesRISS, KISS, and DBpia, was used to search for related literature published from 2001 to October 2020. The keywords, "Children", "Sensory integration", "Integrated sensory", "Sensory-motor", and "Sensory stimulation" were used in this search. Then, a meta-analysis was conducted on 24 selected studies. RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy, autism spectrum disorder, attention deficit/hyperactivity disorder, developmental disorder, and intellectual disability in relation to the diagnosis of children. Regarding sensory integration therapies, 1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective. In terms of dependent variables, sensory integration therapy effectively promoted social skills, adaptive behavior, sensory processing, and gross motor and fine motor skills. CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children, and can help to present standards for sensory integration intervention protocols.
Collapse
Affiliation(s)
- Seri Oh
- Department of Occupational Therapy, Kangwon National University Graduate School, Samcheok 25949, South Korea
| | - Jong-Sik Jang
- Department of Occupational Therapy, Kangwon National University, Samcheok 25949, South Korea
| | - A-Ra Jeon
- Department of Occupational Therapy, Ju-Ju Children Development Center, Nonsan-si 32985, Chungcheongnam-do, South Korea
| | - Geonwoo Kim
- Department of Occupational Therapy, Kangwon National University Graduate School, Samcheok 25949, South Korea
| | - Mihwa Kwon
- Department of Occupation Therapy, Suwon Women’s University, Gyeonggi-do 16632, South Korea
| | - Bahoe Cho
- Hijam Center for Development of Children, Ochang 28117, South Korea
| | - Narae Lee
- Department of Occupational Therapy, U1 University, Chung-cheong bukdo 25949, South Korea
| |
Collapse
|
46
|
Yan RZ, Chen C, Lin CR, Wei YH, Guo ZJ, Li YK, Zhang Q, Shen HY, Sun HL. Delayed neurological dysfunction following posterior laminectomy with lateral mass screw fixation: A case report and review of literature. World J Clin Cases 2024; 12:1356-1364. [PMID: 38524505 PMCID: PMC10955538 DOI: 10.12998/wjcc.v12.i7.1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 12/27/2023] [Accepted: 02/02/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND While most complications of cervical surgery are reversible, some, such as symptomatic postoperative spinal epidural hematoma (SEH), which generally occurs within 24 h, are associated with increased morbidity and mortality. Delayed neurological dysfunction is diagnosed in cases when symptoms present > 3 d postoperatively. Owing to its rarity, the risk factors for delayed neurological dysfunction are unclear. Consequently, this condition can result in irreversible neurological deficits and serious consequences. In this paper, we present a case of postoperative SEH that developed three days after hematoma evacuation. CASE SUMMARY A 68-year-old man with an American Spinal Injury Association (ASIA) grade C injury was admitted to our hospital with neck pain and tetraplegia following a fall. The C3-C7 posterior laminectomy and the lateral mass screw fixation surgery were performed on the tenth day. Postoperatively, the patient showed no changes in muscle strength or ASIA grade. The patient experienced neck pain and subcutaneous swelling on the third day postoperatively, his muscle strength decreased, and his ASIA score was grade A. Magnetic resonance imaging showed hypointense signals on T1 weighted image (T1WI) and T2WI located behind the epidural space, with spinal cord compression. Emergency surgical intervention for the hematoma was performed 12 h after onset. Although hypoproteinemia and pleural effusion did not improve in the perioperative period, the patient recovered to ASIA grade C on day 30 after surgery, and was transferred to a functional rehabilitation exercise unit. CONCLUSION This case shows that amelioration of low blood albumin and pleural effusion is an important aspect of the perioperative management of cervical surgery. Surgery to relieve the pressure on the spinal cord should be performed as soon as possible to decrease neurological disabilities.
Collapse
Affiliation(s)
- Rui-Zhong Yan
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Chao Chen
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Chu-Ran Lin
- Department of Orthopedics, Graduate School Shanxi University of Traditional Chinese Medicine, Taiyuan 030024, Shanxi Province, China
| | - Yan-Hui Wei
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Zhi-Jian Guo
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Ya-Kun Li
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Quan Zhang
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - He-Yi Shen
- Department of Orthopedics, Taiyuan Central Hospital, Taiyuan 030009, Shanxi Province, China
| | - Hao-Lin Sun
- Department of Orthopedics, Peking University First Hospital, Beijing 100034, China
| |
Collapse
|
47
|
Liang JL, Bu YQ, Peng LL, Zhang HZ. Heterochronous multiple primary prostate cancer and lymphoma: A case report. World J Clin Cases 2024; 12:1333-1338. [PMID: 38524523 PMCID: PMC10955537 DOI: 10.12998/wjcc.v12.i7.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/17/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Multiple primary malignant tumors (MPMTs) are rare type of cancer, especially when solid tumors are the first and lymphoma is the second primary malignancy. We report a patient with heterochronous MPMTs consisting of prostate cancer and rectal diffuse large B-cell lymphoma (DLBCL). CASE SUMMARY We report a 77-year-old male patient diagnosed with prostate cancer who was treated with radiation therapy and one year of endocrine therapy with bicalutamide (50 mg per day) and an extended-release implant of goserelin (1/28 d). Seven years later, rectal DLBCL with lung metastases was found. CONCLUSION Although rare, the possibility of prostate cancer combined with a double primary cancer of DLBCL can provide a deeper understanding.
Collapse
Affiliation(s)
- Jin-Long Liang
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Yu-Qing Bu
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Li-Li Peng
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Hong-Zhen Zhang
- Department of Oncology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| |
Collapse
|
48
|
Yu XX, Chen JY, Zhan HS, Liu MD, Li YF, Jia YY. Treatment of bilateral developmental dysplasia of the hip joint with an improved technique: A case report. World J Clin Cases 2024; 12:1320-1325. [PMID: 38524521 PMCID: PMC10955540 DOI: 10.12998/wjcc.v12.i7.1320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/08/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
BACKGROUND Developmental dysplasia of the hip (DDH) is a common osteoarticular deformity in pediatric orthopedics. A patient with bilateral DDH was diagnosed and treated using our improved technique "(powerful overturning acetabuloplasty)" combined with femoral rotational shortening osteotomy. CASE SUMMARY A 4-year-old girl who was diagnosed with bilateral DDH could not stand normally, and sought surgical treatment to solve the problem of double hip extension and standing. As this child had high dislocation of the hip joint and the acetabular index was high, we changed the traditional acetabuloplasty to "powerful turnover acetabuloplasty" combined with femoral rotation shortening osteotomy. During the short-term postoperative follow-up (1, 3, 6, 9, 12, and 15 months), the child had no discomfort in her lower limbs. After the braces and internal fixation plates were removed, formal rehabilitation training was actively carried out. CONCLUSION Our "powerful overturning acetabuloplasty" combined with femoral rotational shortening osteotomy is feasible in the treatment of DDH in children. This technology may be widely used in the clinic.
Collapse
Affiliation(s)
- Xing-Xing Yu
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Jian-Ye Chen
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Hong-Sheng Zhan
- Shi's Traumatology Medical Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ming-Da Liu
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Yun-Fei Li
- College of Traditional Chinese Medicine, Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Yu-Yan Jia
- College of Traditional Chinese Medicine, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, Jilin Province, China
| |
Collapse
|
49
|
Majic Tengg A, Cigrovski Berkovic M, Zajc I, Salaric I, Müller D, Markota I. Expect the unexpected: Brown tumor of the mandible as the first manifestation of primary hyperparathyroidism. World J Clin Cases 2024; 12:1200-1204. [PMID: 38524508 PMCID: PMC10955545 DOI: 10.12998/wjcc.v12.i7.1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/10/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
Hyperparathyroidism (HPT) is a condition in which one or more parathyroid glands produce increased levels of parathyroid hormone (PTH), causing disturbances in calcium homeostasis. Most commonly HPT presents with asymptomatic hypercalcemia but the clinical spectrum may include disturbances reflecting the combined effects of increased PTH secretion and hypercalcemia. Brown tumors are rare, benign, tumor-like bone lesions, occurring in 1.5% to 4.5% of patients with HPT, as a complication of an uncontrolled disease pathway, and are nowadays rarely seen in clinical practice. The tumor can appear either as a solitary or multifocal lesion and usually presents as an asymptomatic swelling or a painful exophytic mass. Furthermore, it can cause a pathological fracture or skeletal pain and be radiologically described as a lytic bone lesion. The diagnosis of a brown tumor in HPT is typically confirmed by assessing the levels of serum calcium, phosphorus, and PTH. Although when present, brown tumor is quite pathognomonic for HPT, the histologic finding often suggests a giant cell tumor, while clinical presentation might suggest other more frequent pathologies such as metastatic tumors. Treatment of brown tumors frequently focuses on managing the underlying HPT, which can often lead to regression and resolution of the lesion, without the need for surgical intervention. However, in refractory cases or when dealing with large symptomatic lesions, surgical treatment may be necessary.
Collapse
Affiliation(s)
- Ana Majic Tengg
- Department of Endocrinology, Diabetes, Metabolic Diseases and Clinical Pharmacology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
| | - Maja Cigrovski Berkovic
- Department for Sport and Exercise Medicine, Faculty of Kinesiology University of Zagreb, Zagreb 10000, Croatia
| | - Ivan Zajc
- Department of Oral Surgery, Clinical Hospital Dubrava, Zagreb 10000, Croatia
- University of Zagreb School of Dental Medicine, Zagreb 10000, Croatia
| | - Ivan Salaric
- Department of Oral Surgery, Clinical Hospital Dubrava, Zagreb 10000, Croatia
- University of Zagreb School of Dental Medicine, Zagreb 10000, Croatia
| | - Danko Müller
- Clinical Department of Pathology and Cytology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
| | - Iva Markota
- Clinical Department of Pathology and Cytology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
| |
Collapse
|
50
|
Liu YX, Xu Y. Enhancing competency of clinical research nurses: A comprehensive training and evaluation framework. World J Clin Cases 2024; 12:1378-1381. [PMID: 38524510 PMCID: PMC10955526 DOI: 10.12998/wjcc.v12.i7.1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/19/2024] [Accepted: 02/04/2024] [Indexed: 02/29/2024] [Imported: 02/29/2024] Open
Abstract
The Sun et al's training program for clinical research nurses (CRNs) in the World Journal of Clinical Cases is a comprehensive and scientific approach. It includes structured frameworks for CRN training, aiming to improve CRN competency. This program emphasizes practical abilities, updates training content, and improves evaluation methods. The cultivation of CRN talents focuses on enhancing the training system, establishing a multifaceted evaluation framework, and continuously refining the training programs. Regular feedback and evaluation are essential to improve CRNs' competency in practical settings.
Collapse
Affiliation(s)
- Yang-Xi Liu
- Tumor Interventional Department, Taizhou Municipal Hospital, Taizhou 318099, Zhejiang Province, China
| | - Yi Xu
- Tumor Interventional Department, Taizhou Municipal Hospital, Taizhou 318099, Zhejiang Province, China
| |
Collapse
|