Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report

paythelady.612 shared this article with you from Inoreader Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3644-3648. doi: 10.12998/wjcc.v9.i15.3644. ABSTRACT BACKGROUND: Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the exclusion of a patient from COVID-19 should be performed before surgery. However, patients with type A acute aortic dissection (AAD) during pregnancy can seriously endanger the health of either the mother or fetus that requires emergency surgical treatment without the test for COVID-19. CASE SUMMARY: A 38-year-old woman without Marfan syndrome was admitted to the hospital because of chest pain in the 34th week of gestation. She has diagnosed as having a Stanford type-A AAD involving an aortic arch and descending aorta via aortic computed tomographic angiography. The patient was transferred to the isolated negative pressure operating room in one hour and underwent cesarean delivery and ascending aorta replacement. All medical staff adopte d third-level medical protection measures throughout the patient transfer and surgical procedure. After surgery, the patient was transferred to the isolated negative pressure intensive care unit ward. The nucleic acid test and anti-COVID-19 immunoglobulin (Ig) G and IgM were performed and were negative. The patient and infant were discharged without complication nine days later and recovered uneventfully. CONCLUSION: The results indicated that the procedure that we used is feasible in patients with a combined cesarean delivery and surgery for Stanford type-A AAD during the COVID-19 outbreak, which was mainly attributed to rapid multidisciplinary consultation, collaboration, and quick decision-making. PMID:3404 6464 | PMC:PMC8130093 | DOI:10.12998/wjcc.v9.i15.3644 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anesthetic management of bilateral pheochromocytoma resection in Von Hippel-Lindau syndrome: A case report

paythelady.612 shared this article with you from Inoreader Anesthetic management of bilateral pheochromocytoma resection in Von Hippel-Lindau syndrome: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3711-3715. doi: 10.12998/wjcc.v9.i15.3711. ABSTRACT BACKGROUND: Von Hippel-Lindau disease (also known as VHL syndrome), is an autosomal dominant inherited disease. We describe a sporadic case of VHL syndrome where bilateral pheochromocytomas were unexpectedly identified. The patient underwent selective laparoscopic resections of the pheochromocytomas, and the anesthetic management during surgery was complex and challenging. CASE SUMMARY: A 22-year-old man presented to our hospital to seek medical advice for infertility without any other complaints. The results of computed tomography and catecholamine levels in blood and urine demonstrated adrenal gland masses which were diagnosed as pheochromocytomas. Further examination confirmed that the patient also had VHL syndrome. After thorough preparation, the patient underwent selective laparoscopic resection of the pheochromocytomas and was discharg ed 10 d after surgery. We describe the process of perioperative anesthesia management in this patient undergoing pheochromocytoma resection. CONCLUSION: This case summaries specific clinical traits and considerations in perioperative anesthesia management for VHL syndrome patients undergoing bilateral pheochromocytoma resection. PMID:34046474 | PMC:PMC8130083 | DOI:10.12998/wjcc.v9.i15.3711 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recalcitrant paradoxical pustular psoriasis induced by infliximab: Two case reports

paythelady.612 shared this article with you from Inoreader Recalcitrant paradoxical pustular psoriasis induced by infliximab: Two case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3655-3661. doi: 10.12998/wjcc.v9.i15.3655. ABSTRACT BACKGROUND: Paradoxical psoriasis induced by tumor necrosis factor alpha antagonists is a rare side effect of those drugs and has similarities with and differences from classical psoriasis in clinical and pathological characteristics. Treating severe paradoxical psoriasis is challenging because the reported cases are rare, with treatment experience being only anecdotal. CASE SUMMARY: We report 2 cases of paradoxical psoriasis caused by infliximab. Both cases manifested with a significant number of pustular lesions and had protracted and complicated clinical courses. In case 1, secukinumab alone could not control the eruptions, but colchicine supplementation markedly decreased disease activity. In case 2 miscellaneous medications were administered, including the systemic drug acitretin, the immunosuppressive drug cyclosporine, and the biologi c agent ustekinumab. However, multiple applications of those medications failed to prevent new lesions from occurring. Both cases showed moderate-to-high anti-nuclear antibody titers. CONCLUSION: Based on these cases, moderate-to-high anti-nuclear antibody titer seems to be a risk factor for paradoxical psoriasis. In addition, extensive pustular presentation may be a negative prognostic indicator and may portend a protracted clinical course refractory to therapy. PMID:34046466 | PMC:PMC8130067 | DOI:10.12998/wjcc.v9.i15.3655 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sarcomatoid carcinoma of the pancreas - a rare tumor with an uncommon presentation and course: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Sarcomatoid carcinoma of the pancreas - a rare tumor with an uncommon presentation and course: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3716-3725. doi: 10.12998/wjcc.v9.i15.3716. ABSTRACT BACKGROUND: Sarcomatoid carcinoma of the pancreas (SCP) is a rare type of pancreatic neoplasm, and only a few cases have been described in the literature. Histologically, it is composed mostly of atypical spindle cells with apparent sarcomatous features. CASE SUMMARY: This is a report of a 61-year-old Chilean woman who underwent medical investigation for acute abdominal pain. Computed tomography identified a solid tumor in the tail of the pancreas with features suspicious of malignancy. En-bloc distal pancreatectomy and splenectomy were performed to excise the tumor. Histopathology and immunohistochemistry were confirmatory of sarcomatoid carcinoma with lymphovascular invasion. After surgery, the patient did not receive chemotherapy. Previous studies indicate a poor prognosis for this type of malignancy. However, our patient has survi ved for 35 mo with no recurrence to date. CONCLUSION: The case presented herein is a patient with an SCP with a rare presentation and long-term survival after surgery despite not receiving adjuvant chemotherapy. PMID:34046475 | PMC:PMC8130075 | DOI:10.12998/wjcc.v9.i15.3716 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of hidradenitis suppurativa with Crohn's disease

paythelady.612 shared this article with you from Inoreader Association of hidradenitis suppurativa with Crohn's disease Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3506-3516. doi: 10.12998/wjcc.v9.i15.3506. ABSTRACT Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by recurrent nodules, abscesses, and sinus tracts. Crohn's disease (CD) is characterized by inflammation of the entire digestive tract and belongs to the group of inflammatory bowel diseases, and there are many extraintestinal manifestations, among which hidradenitis suppurativa is one of the rare extraintestinal manifestations. There appears to be a strong association between CD and HS based on clinical and histological similarities (sinus tract development, granulomatous inflammation, and scarring), intersections in pathogenesis (genetic loci, immune dysregulation mechanisms, and microbiome changes), and commonality in treatment. In this review, we summarize recent studies on the association between HS and CD. PMID:34046451 | PMC:PMC8130070 | DOI:10.12998/wjcc.v9.i15.3506 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fulminant amebic colitis in a patient with concomitant cytomegalovirus infection after systemic steroid therapy: A case report

paythelady.612 shared this article with you from Inoreader Fulminant amebic colitis in a patient with concomitant cytomegalovirus infection after systemic steroid therapy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3726-3732. doi: 10.12998/wjcc.v9.i15.3726. ABSTRACT BACKGROUND: Amebic colitis is an infection caused by Entamoeba histolytica and most commonly observed in regions with poor sanitation. It is also seen as a sexually transmitted disease in developed countries. While amebic colitis usually has a chronic course with repeated exacerbations and remissions, it may also manifest as a fulminant form that rapidly progresses and leads to severe, life-threatening complications, such as intestinal perforation, peritonitis, and sepsis, that have a high mortality rate. CASE SUMMARY: A 68-year-old man was admitted to our hospital with chest pain and acute dyspnea. He was diagnosed with acute coronary syndrome, acute heart failure, and bacterial pneumonia. His respiratory condition worsened despite receiving intensive care and intravenous antibiotics. On the fifth day of hospitalization, he was diagn osed with acute respiratory distress syndrome and was started on steroid therapy. He subsequently developed bloody stools and was diagnosed with cytomegalovirus (CMV) enterocolitis based on biopsy results and a peripheral blood CMV pp65 antigenemia test result. Although we started antiviral therapy with ganciclovir, which was successful in reducing his antigen titers, he continued to have bloody diarrhea. Three weeks after initiation of ganciclovir therapy and six weeks after his admission, the patient died from intestinal perforation. We only posthumously diagnosed him with amebic colitis and CMV enterocolitis based on autopsy findings of transmural necrosis of the entire colon with massive ameba infiltration. CONCLUSION: We urge clinicians to consider Entamoeba histolytica infection if severe colitis progresses after steroid therapy. Preemptive treatment is recommended then. PMID:34046476 | PMC:PMC8130080 | DOI:10.12998/wjcc.v9.i15.3726 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multifactor study of efficacy and recurrence in laparoscopic surgery for inguinal hernia

paythelady.612 shared this article with you from Inoreader Multifactor study of efficacy and recurrence in laparoscopic surgery for inguinal hernia Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3559-3566. doi: 10.12998/wjcc.v9.i15.3559. ABSTRACT BACKGROUND: Inguinal hernia is a common clinical manifestation in children with a low self-healing rate. AIM: To determine the effect of laparoscopic surgery on indirect inguinal hernia and the risk factors for postoperative recurrence and to provide a reference for the clinical treatment and prevention of recurrence. METHODS: We selected 360 children who underwent laparoscopic high ligation in our hospital as the laparoscopic group and 120 patients treated for inguinal hernia with conventional surgery as the control group. The operation time, blood loss, incision length, hospitalization time, total hospitalization cost and surgical complications were compared between the two groups. According to telephone follow-up or return visits, the children who had recurrence within 2 years after the operation in the laparoscopic group were analy zed, and the laparoscopic high ligation hernia sac level was analyzed by the logistic multifactor method. Ligation was used to treat recurrence in children with inguinal hernia. RESULTS: The operation time, blood loss, length of incision, and length of hospital stay in the laparoscopic group were lower than those in the control group (P < 0.05). The total hospitalization cost in the laparoscopic group was higher than that in the control group (P < 0.05). The operative complication rate was 1.67% lower than that in the control group (12.50%) (P < 0.05). In 360 children with laparoscopic high ligation of the hernia sac, 14 patients had recurrence within 2 years after surgery. After analysis, 14 cases in the recurrence group did not recur. The preoperative incarceration rate, inner ring diameter, ligature use and age difference were statistically significant (P < 0.05). According to logistic regression multivariate analysis, an inner ring d iameter ≥ 1.0 cm, the use of an absorbable ligature line and age > 3 years increased the risk of postoperative recurrence in children with inguinal hernia after laparoscopic high ligation of the hernia sac (P < 0.05). CONCLUSION: Laparoscopic surgery for indirect inguinal hernia in children has the advantages of low trauma and a rapid postoperative recovery. An inner ring diameter ≥ 1.0 cm, the use of absorbable ligature, and age > 3 years may increase the risk of recurrence after laparoscopic high ligation of the hernia sac. PMID:34046455 | PMC:PMC8130079 | DOI:10.12998/wjcc.v9.i15.3559 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Maisonneuve injury with no fibula fracture: A case report

paythelady.612 shared this article with you from Inoreader Maisonneuve injury with no fibula fracture: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3733-3740. doi: 10.12998/wjcc.v9.i15.3733. ABSTRACT BACKGROUND: Ankle syndesmosis injury is difficult to diagnose accurately at the initial visit. Missed diagnosis or improper treatment can lead to chronic complications. Complete syndesmosis injury with a concomitant rupture of the interosseous membrane (IOM) is more unstable and severe. The relationship between this type of injury and Maisonneuve injury, in which the syndesmosis is also injured, has not been discussed in the literature previously. CASE SUMMARY: A 16-year-old patient sustained left medial malleolar fracture, and the associated inferior tibiofibular syndesmotic instability was overlooked. After open reduction and internal fixation of the medial malleolar fracture, inferior tibiofibular syndesmosis diastasis with IOM rupture was detected by auxiliary imaging. Secondary surgical intervention was performed to reduce anatomically and fix with two trans-syndesmosis screws. Twelve weeks later, the screws were removed. At the 6-mo follow-up, the patient gained full range of motion of the ankle. CONCLUSION: Complete syndesmosis injury with IOM rupture should be considered Maisonneuve-type injury. Open reduction and internal fixation could obtain good outcomes. PMID:34046477 | PMC:PMC8130071 | DOI:10.12998/wjcc.v9.i15.3733 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinically significant endoscopic findings in patients of dyspepsia with no warning symptoms: A cross-sectional study

paythelady.612 shared this article with you from Inoreader Clinically significant endoscopic findings in patients of dyspepsia with no warning symptoms: A cross-sectional study Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3597-3606. doi: 10.12998/wjcc.v9.i15.3597. ABSTRACT BACKGROUND: Dyspepsia is one of the commonest clinical disorder. However, controversy remains over the role of endoscopy in patients with dyspepsia. No studies have evaluated the diagnostic value of endoscopy in patients with no warning symptoms according to the Rome IV criteria. AIM: To study the diagnostic value of endoscopy in dyspeptic patients with no warning symptoms. METHODS: This cross-sectional study included dyspeptic patients with no warning symptoms who met the inclusion and exclusion criteria at The First Affiliated Hospital, Zhejiang Chinese Medical University from April 2018 to February 2019. The clinical data were collected using questionnaires, including dyspeptic information, warning symptoms, other diseases, family history and basic demographic data. Based on dyspeptic symptoms, patients can be divided into epigastri c pain syndrome, postprandial distress syndrome or overlapping subtypes. RESULTS: A total of 1016 cases were enrolled, 304 (29.9%) had clinically significant findings that were detectable by endoscopy. The endoscopy findings included esophageal lesions in 180 (17.7%) cases, peptic ulcers in 115 (11.3%) cases and malignancy in 9 (0.89%) patients. Multivariate logistic regression analysis showed that males [odds ratio (OR) = 1.758, P < 0.001], body mass index > 25 (OR = 1.660; P = 0.005), epigastric pain (OR = 1.423; P = 0.019) and Helicobacter pylori infection (OR = 1.949; P < 0.001) were independently associated with risk factors for the presence of clinically significant findings on endoscopy. CONCLUSION: Chinese patients with dyspepsia with no warning symptoms should undergo endoscopy, particularly males, patients with body mass index > 25, epigastric pain or Helicobacter pylori infection. PMID:34046459 | PMC:PMC8130061 | DOI:10.12998/wjcc.v9.i15.3597 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Alopecia treatment using minimally manipulated human umbilical cord-derived mesenchymal stem cells: Three case reports and review of literature

paythelady.612 shared this article with you from Inoreader Alopecia treatment using minimally manipulated human umbilical cord-derived mesenchymal stem cells: Three case reports and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3741-3751. doi: 10.12998/wjcc.v9.i15.3741. ABSTRACT BACKGROUND: Alopecia areata (AA) is a common autoimmune disease characterized by hair loss. AA appears in extensive forms, such as progressive and diffusing hair loss (diffuse AA), a total loss of scalp hair (alopecia totalis), and complete loss of hair over the entire body (alopecia universalis). Recently, mesenchymal stem cells (MSCs) have been identified as a therapeutic alternative for autoimmune diseases. For this reason, preclinical and case studies of AA and related diseases using MSCs have been conducted. CASE SUMMARY: Case 1: A 55-year-old woman suffered from AA in two areas of the scalp. She was given 15 rounds of minimally manipulated umbilical cord-MSCs (MM-UC-MSCs) over 6 mo. The AA gradually improved 3 mo after the first round. The patient was cured, and AA did not recur. Case 2: A 30-year-old woman, with history of local stero id hormone injections, suffered from AA in one area on the scalp. She was given two rounds of MM-UC-MSCs over 1 mo. The AA immediately improved after the first round. The patient was cured, and AA did not recur. Case 3: A 20-year-old woman, who was diagnosed with alopecia universalis at the age of 12, was given 14 rounds of MM-UC-MSCs over 12 mo. Her hair began to grow about 3 mo after the first round. The patient was cured, and alopecia universalis did not recur. CONCLUSION: MM-UC-MSC transplantation potentially treats patients who suffer from AA and related diseases. PMID:34046478 | PMC:PMC8130094 | DOI:10.12998/wjcc.v9.i15.3741 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative pain due to an occult spinal infection: A case report

paythelady.612 shared this article with you from Inoreader Postoperative pain due to an occult spinal infection: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3637-3643. doi: 10.12998/wjcc.v9.i15.3637. ABSTRACT BACKGROUND: A high degree of vigilance is warranted for a spinal infection, particularly in a patient who has undergone an invasive procedure such as a spinal injection. The average delay in diagnosing a spinal infection is 2-4 mo. In our patient, the diagnosis of a spinal infection was delayed by 1.5 mo. CASE SUMMARY: A 60-year-old male patient with a 1-year history of right-sided lumbar radicular pain failed conservative treatment. Six weeks to prior to surgery he received a spinal injection, which was followed by increasing lumbar radicular pain, weight loss and chills. This went unnoticed and surgery took place with right-sided L4-L5 combined microdiscectomy and foraminotomy via a posterior approach. The day after surgery, the patient developed left-sided lumbar radicular pain. Blood cultures grew Staphylococcus aureus ( S. aureus). Magnetic resonance imaging showed inflammatory aberrations, revealing septic arthritis of the left-sided L4/L5 facet joint as the probable cause. Revision surgery took place and S. aureus was isolated from bacteriological samples. The patient received postoperative antibiotic treatment, which completely eradicated the infection. CONCLUSION: The development of postoperative lower back pain and/or lumbar radicular pain can be a sign of a spinal infection. A thorough clinical and laboratory work-up is essential in the preoperative evaluation of patients with spinal pain. PMID:34046463 | PMC:PMC8130068 | DOI:10.12998/wjcc.v9.i15.3637 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.