Successful upgrade to cardiac resynchronization therapy for cardiac implantation-associated left subclavian vein occlusion: A case report

paythelady.612 shared this article with you from Inoreader Successful upgrade to cardiac resynchronization therapy for cardiac implantation-associated left subclavian vein occlusion: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3157-3162. doi: 10.12998/wjcc.v9.i13.3157. ABSTRACT BACKGROUND: Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker, which makes the reimplantation of a new pacemaker lead difficult. Transvenous pacemaker lead implantation-related subclavian vein occlusion may present difficulty with regard to cardiac resynchronization therapy (CRT) upgrade. CASE SUMMARY: We report the case of a 46-year-old man who was admitted with total subclavian vein occlusion caused by a permanent pacemaker that had been implanted 2 years previously. We successfully treated this patient with an upgrade to a CRT pacemaker by utilizing transferable interventional coronary and radiological techniques. The patient recovered uneventfully during the follow-up period. CONCLUSION: CRT upgrade is still a viable technique for the treatment of subclavian vein obstruction caused by previous pacemaker implantation. PMID:33969103 | PMC:PMC8080731 | DOI:10.12998/wjcc.v9.i13.3157 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sclerosing polycystic adenosis of the submandibular gland: Two case reports

paythelady.612 shared this article with you from Inoreader Sclerosing polycystic adenosis of the submandibular gland: Two case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2930-2936. doi: 10.12998/wjcc.v9.i12.2930. ABSTRACT BACKGROUND: Sclerosing polycystic adenosis (SPA) is a rare disease of salivary glands, similar to fibrocystic disease of the breast. It occurs over a wide age range and exhibits a slight female preference. Most SPA cases have occurred in the parotid gland. The exact nature of SPA is unclear, but its tumor nature has recently been proposed. Although SPA has a good prognosis after adequate surgery, atypical lesions might occur, ranging from mild dysplasia to carcinoma in situ in some cases. To the best of our knowledge, only five cases of SPA in the submandibular gland have been reported to date. Here, we present two new cases of SPA involving the submandibular gland. CASE SUMMARY: A 50-year-old woman and a 52-year-old woman were referred to Tongji Hospital in Wuhan, China, with complaints of moderate pain, recurrent swelling, and a mas s in the submandibular area. After admission, the two cases of the submandibular mass were examined physically. The boundary of the submandibular tumor was clear, and the range of motion was good. After preoperative examinations, surgery was performed on a selective basis. Postoperative histopathological examination revealed a well-defined mass with acinar structures, ducts, or cystic dilated glands of various sizes scattered in a large number of proliferative sclerosing stroma. There were flat and cuboidal cells, and eosinophils in the duct epithelium. There was also a eosinophilic substance in the lumen of dilated cysts. No atypical epithelial hyperplasia, invasive growth, or carcinoma in situ was found. Based on the above findings, the mass was diagnosed as SPA. Both patients have remained asymptomatic and no recurrence or distant metastasis had occurred by the 7-mo and 5-year follow-up, respectively. CONCLUSION: SPA is a rare disease of the salivary gland. Even thou gh it has a good prognosis after adequate surgery, atypical lesions may occur from mild dysplasia to carcinoma in situ. However, no recurrence, distant metastasis, or mortality has been reported for submandibular gland SPA. Clinicians and pathologists should be familiar with the characteristics of SPA in the submandibular gland to avoid misdiagnosis and overtreatment. PMID:33969079 | PMC:PMC8058660 | DOI:10.12998/wjcc.v9.i12.2930 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sodium-glucose co-transporter-2 inhibitor-associated euglycemic diabetic ketoacidosis that prompted the diagnosis of fulminant type-1 diabetes: A case report

paythelady.612 shared this article with you from Inoreader Sodium-glucose co-transporter-2 inhibitor-associated euglycemic diabetic ketoacidosis that prompted the diagnosis of fulminant type-1 diabetes: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3163-3169. doi: 10.12998/wjcc.v9.i13.3163. ABSTRACT BACKGROUND: Fulminant type 1 diabetes mellitus (FT1DM) is a subtype of type 1 diabetes mellitus characterized by an abrupt onset and a rapid and complete functional loss of islet β cells. It is a very rare disease generally associated with ketoacidosis and the absence of circulating pancreatic islet-related autoantibodies. Diabetic ketoacidosis with normal blood glucose levels has been reported during sodium-glucose co-transporter 2 (SGLT2) inhibitor therapy. CASE SUMMARY: The patient was a 43-year-old woman that consulted a medical practitioner for malaise, thirst, and vomiting. Blood analysis showed high blood glucose levels (428 mg/dL), a mild increase of hemoglobin A1c (6.6%), and increased ketone bodies in urine. The patient was diagnosed with type 2 diabetes mellitus. The patient was initially treated with insulin, which was subsequent ly changed to an oral SGLT2 inhibitor. Antibodies to glutamic acid decarboxylase were negative. Four days after receiving oral SGLT2 inhibitor, she consulted at Mie University Hospital, complaining of fatigue and vomiting. Laboratory analysis revealed diabetic ketoacidosis with almost normal blood glucose levels. The endogenous insulin secretion was markedly low, and the serum levels of islet-related autoantibodies were undetectable. We made the diagnosis of FT1DM with concurrent SGLT2 inhibitor-associated euglycemic diabetic ketoacidosis. The patient's general condition improved after therapy with intravenous insulin and withdrawal of oral medication. She was discharged on day 14 with an indication of multiple daily insulin therapy. CONCLUSION: This patient is a rare case of FT1DM that developed SGLT2 inhibitor-associated diabetic ketoacidosis with almost normal blood glucose levels. This case report underscores the importance of considering the diagnosis of FT1DM in patients with negative circulating autoantibodies and a history of hyperglycemia that subsequently develop euglycemic diabetic ketoacidosis following treatment with a SGLT2 inhibitor. PMID:33969104 | PMC:PMC8080741 | DOI:10.12998/wjcc.v9.i13.3163 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immunotherapy for pancreatic cancer

paythelady.612 shared this article with you from Inoreader Immunotherapy for pancreatic cancer Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):2969-2982. doi: 10.12998/wjcc.v9.i13.2969. ABSTRACT Pancreatic cancer, a highly lethal cancer, has the lowest 5-year survival rate for several reasons, including its tendency for the late diagnosis, a lack of serologic markers for screening, aggressive local invasion, its early metastatic dissemination, and its resistance to chemotherapy/radiotherapy. Pancreatic cancer evades immunologic elimination by a variety of mechanisms, including induction of an immunosuppressive microenvironment. Cancer-associated fibroblasts interact with inhibitory immune cells, such as tumor-associated macrophages and regulatory T cells, to form an inflammatory shell-like desmoplastic stroma around tumor cells. Immunotherapy has the potential to mobilize the immune system to eliminate cancer cells. Nevertheless, although immunotherapy has shown brilliant results across a wide range of malignancies, only anti-programmed ce ll death 1 antibodies have been approved for use in patients with pancreatic cancer who test positive for microsatellite instability or mismatch repair deficiency. Some patients treated with immunotherapy who show progression based on conventional response criteria may prove to have a durable response later. Continuation of immune-based treatment beyond disease progression can be chosen if the patient is clinically stable. Immunotherapeutic approaches for pancreatic cancer treatment deserve further exploration, given the plethora of combination trials with other immunotherapeutic agents, targeted therapy, stroma-modulating agents, chemotherapy, and multi-way combination therapies. PMID:33969083 | PMC:PMC8080736 | DOI:10.12998/wjcc.v9.i13.2969 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perioperative massive cerebral stroke in thoracic patients: Report of three cases

paythelady.612 shared this article with you from Inoreader Perioperative massive cerebral stroke in thoracic patients: Report of three cases Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3170-3176. doi: 10.12998/wjcc.v9.i13.3170. ABSTRACT BACKGROUND: Perioperative stroke is a rare but devastating complication. The risk factors for massive cerebral stroke in surgical patients include older age, male sex, prior cerebrovascular disease, hypertension, renal failure, smoking, diabetes mellitus, and atrial fibrillation. CASE SUMMARY: We describe two cases of perioperative massive cerebral stroke following thoracic surgery and one case following bronchoscopy. Neurologic symptoms, including changes in mental status and hemiplegia, occurred within 10 h after surgery in the three patients. All three patients died after the surgery. CONCLUSION: Perioperative massive cerebral stroke may be more likely to occur in thoracic surgical patients if there are pre-existing factors including previous stroke, hypotension, and hypoxemia. Sufficient pain control after surgery and timely neurolo gy consultation and management are helpful for the diagnosis and control of stroke in high-risk patients. PMID:33969105 | PMC:PMC8080756 | DOI:10.12998/wjcc.v9.i13.3170 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level: A case report

paythelady.612 shared this article with you from Inoreader Treatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3219-3226. doi: 10.12998/wjcc.v9.i13.3219. ABSTRACT BACKGROUND: Acute severe ulcerative colitis (ASUC) is a complication of ulcerative colitis associated with high levels of circulating tumor necrosis factor alpha, due to the intense inflammation and faster stool clearance of anti-tumor necrosis factor drugs. Dose-intensified infliximab treatment can be beneficial and is associated with lower rates of colectomy. The aim of the study was to present a case of a patient with ASUC and megacolon, treated with hydrocortisone and accelerated scheme of infliximab that was monitored by drug trough level. CASE SUMMARY: A 22-year-old female patient diagnosed with ulcerative colitis, presented with diarrhea, rectal bleeding, abdominal pain, vomiting, and distended abdomen. During investigation, a positive toxin for Clostridium difficile and colonic dilatation of 7 cm consistent with megacolon were observed. She was treated with oral vancomycin for pseudomembranous colitis and intravenous hydrocortisone for severe colitis, which led to the resolution of megacolon. Due to the persistent severe colitis symptoms, infliximab 5 mg/kg was prescribed, monitored by drug trough level (8.8 μg/mL) and fecal calprotectin of 921 μg/g (< 30 μg/g). Based on the low infliximab trough level after one week from the first infliximab dose, the patient received a second infusion at week 1, consistent with the accelerated regimen (infusions at weeks 0, 1, 2 and 6). We achieved a positive clinical and endoscopic response after 6 mo of therapy, without the need for a colectomy. CONCLUSION: Infliximab accelerated infusions can be beneficial in ASUC unresponsive to the treatment with intravenous corticosteroids. Longitudinal studies are necessary to define the best therapeutic drug monitoring and treatment regimen for these patients. PMID:33969111 | PMC:PMC8080733 | DOI:10.12998/wjcc.v9.i13.3219 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Renal artery embolization in the treatment of urinary fistula after renal duplication: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Renal artery embolization in the treatment of urinary fistula after renal duplication: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3177-3184. doi: 10.12998/wjcc.v9.i13.3177. ABSTRACT BACKGROUND: Duplicate renal malformation is a congenital disease of the urinary system, with an incidence rate of 0.8%. Surgical treatment is suitable for symptomatic patients. Urinary fistula is one of the complications of heminephrectomy. Long-term urinary fistula has a great impact on patients' lives. CASE SUMMARY: This article mainly reports on a 47-year-old man with duplication of kidney deformity, long urinary fistula after partial nephrectomy, and no improvement after conservative treatment. We have achieved positive results in the arterial embolization treatment of the residual renal artery, indicating that selective arterial embolization is a good way to treat urinary fistula after partial nephrectomy. It is worth noting that this patient violated the Weigert-Meyer law, which also gave us more consideration. CONCLUSION: Renal a rtery embolization may be a simple and safe method to treat urinary fistula inefficacy with conservative treatment. PMID:33969106 | PMC:PMC8080745 | DOI:10.12998/wjcc.v9.i13.3177 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Behcet's disease manifesting as esophageal variceal bleeding: A case report

paythelady.612 shared this article with you from Inoreader Behcet's disease manifesting as esophageal variceal bleeding: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2854-2861. doi: 10.12998/wjcc.v9.i12.2854. ABSTRACT BACKGROUND: Behcet's disease (BD) is a chronic disease characterized by oral and vulvar ulcers as well as eye and skin damage and involves multiple systems. It presents as an alternating process of repeated attacks and remissions. Esophageal venous rupture and bleeding caused by BD is rarely reported at home and abroad. This paper reports a case of bleeding from oesophageal varices caused by BD, aiming to provide an additional dimension for considering the cause of bleeding from esophageal varices in the future. CASE SUMMARY: A 38-year-old female patient was admitted due to a gradual increase in shortness of breath and chest tightness after the activity, and was admitted to our hospital for treatment. After admission, relevant examinations showed that the patient had multiple blood clots. Four days after admission, she suddenly experienced m assive hematemesis. Emergency esophagogastroduodenoscopy revealed bleeding from esophageal and gastric varices. The patient had no history of viral hepatitis or drinking habits, and no history of special genetic diseases or congenital vascular diseases. There is no obvious abnormality in liver function. After reviewing the medical history, it was found that the patient had recurred oral ulcers since childhood, ulcers were visible in the perineum during menstruation, and there was an intermittent red nodular rash and uveitis. The current skin acupuncture reaction is positive, combined with the evaluation of the external hospital and our hospital, the main diagnosis is BD. She received methylprednisolone, cyclophosphamide, immunomodulation, acid suppression, gastric protection, and anticoagulation and anti-infection treatments, and was discharged from the hospital. During the 1-year follow-up period, the patient did not vomit blood again. CONCLUSION: This case highlights bleedin g from esophageal varices caused by BD, aiming to provide an additional dimension concerning the cause of bleeding from esophageal varices in the future. PMID:33969069 | PMC:PMC8058672 | DOI:10.12998/wjcc.v9.i12.2854 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical characteristics of intrahepatic biliary papilloma: A case report

paythelady.612 shared this article with you from Inoreader Clinical characteristics of intrahepatic biliary papilloma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3185-3193. doi: 10.12998/wjcc.v9.i13.3185. ABSTRACT BACKGROUND: Intrahepatic bile duct papilloma (IPNB) is a rare benign tumour from the bile duct epithelium and has a high malignant transformation rate. Early radical resection can obviously improve the prognosis of patients, but it is difficult to be sure of the diagnosis of IPNB before operating. CASE SUMMARY: This study included 28 patients with intraductal papilloma admitted to the First Hospital of Jilin University from January 2010 to November 2020 and recorded their clinical manifestations, imaging features, complications and prognosis. There were 12 males and 16 females with an average age of 61.36 ± 8.03 years. Most patients had symptoms of biliary obstruction. Biliary dilatation and cystic mass could be seen on imaging. After surgery, IPNB was diagnosed by pathology. CONCLUSION: IPNB is a rare benign tumour in the bile duct. E arly diagnosis and timely R0 resection can improve the prognosis of IPNB. PMID:33969107 | PMC:PMC8080758 | DOI:10.12998/wjcc.v9.i13.3185 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Allogeneic hematopoietic stem cell transplantation in a 3-year-old boy with congenital pyruvate kinase deficiency: A case report

paythelady.612 shared this article with you from Inoreader Allogeneic hematopoietic stem cell transplantation in a 3-year-old boy with congenital pyruvate kinase deficiency: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 26;9(12):2916-2922. doi: 10.12998/wjcc.v9.i12.2916. ABSTRACT BACKGROUND: The understanding regarding genetic variation, pathophysiology, and complications associated with pyruvate kinase deficiency (PKD) in red blood cells has been explained largely, and supportive treatment is currently the main management strategy. Etiotropic managements, including transplantation and genome editing, supplying for substitute dugs of the pyruvate kinase, are all under research. CASE SUMMARY: We herein report a 3-year-old boy with severe transfusion-dependent PKD cured by unrelated identical peripheral blood stem cell transplantation (PBSCT). Hemoglobin was corrected to a normal level by gene correction after PBSCT, with no complication related to the transplantation. CONCLUSION: Hematopoietic stem cell transplantation could be a substitute for transfusion-dependent PKD. PMID:33969077 | PMC:PMC8058671 | DOI:10.12998/wjcc.v9.i12.2916 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between scrub typhus encephalitis and diffusion tensor tractography detection of Papez circuit injury: A case report

paythelady.612 shared this article with you from Inoreader Association between scrub typhus encephalitis and diffusion tensor tractography detection of Papez circuit injury: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 6;9(13):3194-3199. doi: 10.12998/wjcc.v9.i13.3194. ABSTRACT BACKGROUND: It is difficult to restore the cognitive functions of patients with impaired cognition caused by brain injury. Diffusion tensor imaging can visualize the integrity of neural tracts in the white matter (WM) three-dimensionally. It is unclear whether encephalitis following scrub typhus damages the WM. For the first time, we aimed to report diffusion tensor tractography (DTT) findings in a chronic patient with cognitive impairment following scrub typhus encephalitis, which revealed injury to the Papez circuit of the WM. CASE SUMMARY: A 70-year-old male patient was affected by encephalitis caused by scrub typhus that occurred 23 years ago. He had poor cognition and his clinical examination findings were as follows: Mini-Mental Status Examination score, 14; and handgrip strength (right/left, kg), 32.3/31.3. DTT revealed serious injurie s of the left thalamocingulate tract and right mammillothalamic tract in the Papez circuit, and a partial injury of the anterior part of the fornix. CONCLUSION: Using DTT, we found a relationship between cognitive impairment and the integrity of the Papez circuit following scrub typhus. PMID:33969108 | PMC:PMC8080737 | DOI:10.12998/wjcc.v9.i13.3194 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.