Wednesday, July 7, 2021

Neonatal syringocystadenoma papilliferum: A case report

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World J Clin Cases. 2021 Jun 26;9(18):4772-4777. doi: 10.12998/wjcc.v9.i18.4772.

ABSTRACT

BACKGROUND: Syringocystadenoma papilliferum (SCAP) represents a rare, noncancerous adnexal tumor predominantly presenting at birth or in early childhood.

CASE SUMMARY: In this study, a 35-day-old girl was admitted to Kunming Children's Hospital in October 2019 due to a lesion in the right frontotemporal region since birth. The surface of the lesion was bright red, granular, and papillary and easily bled upon touch, with about 1.5 cm × 4 cm in size. A subcutaneous mass was felt at the base of the lesion, with a size of about 3 cm × 5 cm. Dermatoscopy showed that the skin lesion was lobular and crumby. The lesion center was reddish or white, while the edges were white or yellowish band-like. There were polymorphic vascular structures and white radial streaks in the lesion, with some vascular clusters scattered. Pathological examination showe d papilloma-like hyperplasia of the epidermis, with the epidermis partly sinking into the dermis to form several cystic depressions. Combining clinical and histopathological features, the child was diagnosed with SCAP. Follow-up is ongoing, and surgical resection will be performed.

CONCLUSION: This was a special clinical manifestation of SCAP, which complements the clinical manifestations of the disease and provides new insights for the diagnosis and differentiation of neonatal skin tumors.

PMID:34222446 | PMC:PMC8223827 | DOI:10.12998/wjcc.v9.i18.4772

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AWGS2019 vs EWGSOP2 for diagnosing sarcopenia to predict long-term prognosis in Chinese patients with gastric cancer after radical gastrectomy

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World J Clin Cases. 2021 Jun 26;9(18):4668-4680. doi: 10.12998/wjcc.v9.i18.4668.

ABSTRACT

BACKGROUND: Sarcopenia is a nutrition-related disease and has a profound effect on the long-term overall survival (OS) of patients with gastric cancer. Its diagnostic criterion is critical to clinical diagnosis and treatment. However, previous research reported widely differing sarcopenia prevalence due to different criteria. AWGS2019 and EWGSOP2 are the two latest and widely adopted criteria.

AIM: To compare the effects of AWGS2019 and EWGSOP2 on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.

METHODS: An observational study was conducted from July 2014 to January 2017, which included 648 consecutive gastric cancer patients who underwent radical gastrectomy. The sarcopenia elements (skeletal muscle index, handgrip strength, and gait speed) were measured within 1 mo or 7 d before surgery. The patients were followed at fixed intervals to gain the outcomes. Multivariate Cox regression analysis was performed to determine the association between sarcopenia and the long-term OS of these patients according to the two criteria separately. The predictive performance of the models with AWGS2019 and EWGSOP2 were evaluated by the concordance index (C-index) and area under the time-dependent receiver operating characteristic curve (AUC). The Akaike information criterion (AIC) was applied to compare model fits.

RESULTS: The prevalence of sarcopenia was 20.5% and 11.3% according to AWGS2019 and EWGSOP2, respectively. Sarcopenia was an independent risk factor for the long-term OS no matter based on AWGS2019 or EWGSOP2, but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio (HR) [2.150 (1.547-2.988)] than EWGSOP2-sarcopenia [HR 1.599 (1.092-2.339)]. Meanwhile, the model with AWGS2019-sarcopenia [C-index 0.773 (0.742-0.804); AIC 2193.7; time-dependent AUC 0.812 (0.756-0.867) fo r 1-year OS, 0.815 (0.778-0.852) for 3-year OS, and 0.809 (0.759-0.859) for 5-year OS] had better predictive power and model fits than the model with EWGSOP2-sarcopenia [C-index 0.762 (0.729-0.795); AIC 2215.2; time-dependent AUC 0.797 (0.741-0.854) for 1-year OS, 0.804 (0.767-0.842) for 3-year OS, and 0.799 (0.748-0.850) for 5-year OS].

CONCLUSION: Sarcopenia is an independent risk factor for the long-term OS in Chinese gastric cancer patients undergoing radical gastrectomy. The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia. AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.

PMID:34222433 | PMC:PMC8223822 | DOI:10.12998/wjcc.v9.i18.4668

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Disappeared intralenticular foreign body: A case report

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World J Clin Cases. 2021 Jun 26;9(18):4778-4782. doi: 10.12998/wjcc.v9.i18.4778.

ABSTRACT

BACKGROUND: Intralenticular foreign body is rarely encountered in ophthalmic practice. In most cases, subsequent traumatic cataract requires cataract surgery for visual rehabilitation.

CASE SUMMARY: A 35-year-old man was injured by iron filings in his left eye. After the injury, the patient tried to draw the object out by himself using a magnet; however, the foreign body (FB) was pushed to the equator of the lens. The FB was removed by a magnet through the anterior chamber accessed through the original capsular wound. Since most of the lens was transparent and only partially opaque after the operation, the lens was kept under close observation. After the surgery, the patient's visual acuity reached 20/20 from 2/20, visual function recovered very well, and local opacity of the lens remained stable.

CONCLUSION: For intralenticular FB in the anterior cortex under the capsule, magnet may be a more advantageous way to remove the object.

PMID:34222447 | PMC:PMC8223859 | DOI:10.12998/wjcc.v9.i18.4778

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Tenofovir disoproxil fumarate in Chinese chronic hepatitis B patients: Results of a multicenter, double-blind, double-dummy, clinical trial at 96 weeks

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World J Clin Cases. 2021 Jun 26;9(18):4690-4699. doi: 10.12998/wjcc.v9.i18.4690.

ABSTRACT

BACKGROUND: Tenofovir disoproxil fumarate (TDF) is a prodrug of a nucleotide analogue. As an antiviral drug, TDF has been proposed in the first-line treatment of chronic hepatitis B (CHB). Qingzhong, a brand name of TDF, commercialized by Jiangsu Chia-tai Tianqing Pharmaceutical Co Ltd., and Viread, another brand name of TDF, commercialized by GlaxoSmithKline, have both been approved by the State Food and Drug Administration, China.

AIM: To investigate the efficacy and safety of the two TDF agents in the treatment of Chinese CHB patients.

METHODS: This trial was registered at ClinicalTrials.gov with the identifier number of NCT02287857. A total of 330 Chinese CHB patients, among which 232 were hepatitis B e antigen (HBeAg)-positive, were included in this 5-year-long, multicenter, double-blinded, double-dummy, randomized-controlled, non -inferiority phase III trial. The participants were initially randomized into two groups: Group A (n = 161), in which the participants received 300 mg Qingzhong once a day for 48 wk; and Group B, in which the participants received 300 mg Viread once a day for 48 wk. Starting from week 49, all the participants in Groups A and B received 300 mg Qingzhong once a day until the 96th week. In this study, the primary endpoint was the decrease in plasma level of hepatitis B virus (HBV) DNA at the 96th week, while the secondary endpoints were suppression of HBV replication, alanine aminotransferase (ALT) normalization, HBeAg loss, and HBeAg seroconversion rates.

RESULTS: For the participants with HBeAg-positive CHB, the decrease in mean HBV DNA level relative to the baseline value was comparable between Groups A and B (5.77 vs 5.73 log10 IU/mL, P > 0.05) at the 96th week. In addition, similar percentages of HBeAg-posit ive participants in the two groups exhibited undetectable levels of HBV DNA, HBeAg loss, and HBeAg seroconversion (71.05% vs 77.97%, 31.00% vs 27.27%, and 20.22% vs 15.79%, respectively, in Group A vs Group B; P > 0.05). For the participants with HBeAg-negative CHB, the decrease in mean HBV DNA level relative to the baseline value was also comparable between Groups A and B (4.46 vs 4.70 log10 IU/mL, P > 0.05) at the 96th week. In addition, similar percentages of HBeAg-negative participants in the two groups exhibited undetectable levels of HBV DNA (87.23% vs 94.12% in Group A vs Group B, respectively; P > 0.05). Finally, similar percentages of CHB patients (HBeAg-positive or HBeAg-negative) in the two groups exhibited normalization of ALT (80.14% vs 84.57% in Group A vs Group B, respectively; P > 0.05), and similar incidences of adverse events were observed (1 06 vs 104 in Group A vs Group B, respectively; P > 0.05).

CONCLUSION: Both Qingzhong and Viread are effective and safe in the treatment of Chinese CHB patients according to the results of our clinical trial.

PMID:34222435 | PMC:PMC8223849 | DOI:10.12998/wjcc.v9.i18.4690

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Femoral neck stress fractures after trampoline exercise: A case report

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World J Clin Cases. 2021 Jun 26;9(18):4783-4788. doi: 10.12998/wjcc.v9.i18.4783.

ABSTRACT

BACKGROUND: Femoral neck stress fractures (FNSFs) are commonly found in long-distance running athletes. For FNSFs, early diagnosis and proper treatment are important. The objective of this study was to report FNSFs that occurred after excessive exercise using trampoline in middle-aged women.

CASE SUMMARY: The patient was a 43-year-old woman who exercised jumping on a trampoline for 6 wk for 1-3 h a day to diet. Exercise includes repeated flexion-extension of the hip joint. The patient was admitted to the hospital due to sudden bilateral groin pain that occurred suddenly during a trampoline exercise. Hip magnetic resonance imaging (MRI) revealed bilateral FNSFs. After 2 wk of follow-up with conservative treatment, the pain slightly decreased. However, it did not disappear completely. It was determined that it was difficult to control symptoms only by conservation treatment. Thus, closed reduction and internal fixation using a cannulated screw were performed for the more painful left hip joint. After operation, the pain was improved. Walking using crutches was possible. Follow-up MRI showed that the right femoral head signal was decreased compared to the left femoral head signal. Therefore, nonsteroidal anti-inflammatory drug and conservative treatment were provided.

CONCLUSION: In middle-aged people, excessive trampoline exercise can repeat hip flexion and extension for a short period of time, leading to FNSFs.

PMID:34222448 | PMC:PMC8223852 | DOI:10.12998/wjcc.v9.i18.4783

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Listeria monocytogenes bacteremia in a centenarian and pathogen traceability: A case report

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World J Clin Cases. 2021 Jun 26;9(18):4873-4880. doi: 10.12998/wjcc.v9.i18.4873.

ABSTRACT

BACKGROUND: Early diagnosis and appropriate antibiotic treatment are important to survival of Listeria monocytogenes (L. monocytogenes) bacteremia. Penicillin tends to be the most commonly used antibiotic. However, there are limited data on antibiotic use in elderly patients with serious complications. We describe the clinical presentation, antibiotic therapy, and traceability of L. monocytogenes in a centenarian with a history of eating frozen food.

CASE SUMMARY: A 102-year-old man suffered from high fever with chill after hematochezia. Tentative diagnoses were lower gastrointestinal hemorrhage and localized peritonitis. Meropenem and ornidazole were the empirical therapy. The patient did not respond and developed multiple system dysfunction even after teicoplanin was added to the therapy. L. monocytogenes was id entified from blood cultures on day 5 of admission. The patient had a history of consuming frozen dumplings. Meropenem/ornidazole/teicoplanin were replaced with meropenem/linezolid. The patient gradually became afebrile. He received meropenem/linezolid for 10 d, and piperacillin/tazobactam was applied as step-down treatment for 2 wk with good clinical results. There was no sign of relapse during follow-up after discharge. L. monocytogenes isolates from the patient and frozen dumplings belonged to different serotypes and sequence types (STs): 1/2b and ST5 from the patient and 1/2c and ST9 from the dumplings.

CONCLUSION: More awareness of listeriosis should be raised. Linezolid might be an option for listeriosis in elderly people with serious complications.

PMID:34222461 | PMC:PMC8223858 | DOI:10.12998/wjcc.v9.i18.4873

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Collision carcinoma of the rectum involving neuroendocrine carcinoma and adenocarcinoma: A case report

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World J Clin Cases. 2021 Jun 26;9(18):4789-4796. doi: 10.12998/wjcc.v9.i18.4789.

ABSTRACT

BACKGROUND: Collision carcinoma is a rare histological pattern, and includes two or more different types of tumors coexisting in the same organ as one neoplasm. Different to the combined type, the two adjacent tumors of collision carcinoma are histologically distinct. Collision carcinoma may occur from any origin or organ, including the cecum, liver, cervix, thyroid, stomach, kidney, and esophagus. In the rectum, adenocarcinoma is the most common pathological type, the combined type is rare, and collision tumors are even rarer. To date, only a limited number of collision carcinoma cases originating from the rectum have been reported. Due to the scarcity of rectal collision carcinoma, more cases need to be reported to fully understand the clinico-pathological features and biological behavior of the tumor.

CASE SUMMARY: Here we report a 40-yea r-old female who presented with the chief complaints of persistent changes in bowel habits and hematochezia for 10 d. She underwent Miles' operation which revealed a collision carcinoma of the rectum, showing a "side by side" pattern, composed of a high grade neuroendocrine carcinoma, (small cell carcinoma) and moderately differentiated adenocarcinoma, based on its clinico-pathological features and biological behavior. The patient remained disease-free at 12 mo follow-up. We also focused on the related literature and expert opinion.

CONCLUSION: Collision carcinoma is a rare tumor with ambiguous biological behavior. Greater attention should be paid to its clinico-pathologic diagnosis. Regular and adequate follow-up is essential to help rule out metastasis and assess the prognosis.

PMID:34222449 | PMC:PMC8223825 | DOI:10.12998/wjcc.v9.i18.4789

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Dynamics of host immune responses to SARS-CoV-2

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World J Clin Cases. 2021 Jun 26;9(18):4480-4490. doi: 10.12998/wjcc.v9.i18.4480.

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the most recent global health threat, is spreading throughout the world with worrisome speed, and the current wave of coronavirus disease 2019 (COVID-19) seems to have no mercy. While this mysterious virus challenges our ability to control viral infections, our opportunities to control the COVID-19 pandemic are gradually fading. Currently, pandemic management relies on preventive interventions. Although prevention is a good strategy to mitigate SARS-CoV-2 transmission, it still cannot be considered an absolute solution to eliminate this pandemic. Currently, developing a potent immunity against this viral infection seems to be the most promising strategy to drive down this ongoing global tragedy. However, with the emergence of new challenges in the context of immune responses to COVID-19 , the road to control this devastating pandemic seems bumpier; thus, it is pivotal to characterize the dynamics of host immune responses to COVID-19, in order to develop efficient prophylactic and therapeutic tools. This begs the question of whether the effector mechanisms of the immune system are indeed potent or a possible contributing factor to developing more severe and lethal forms of COVID-19. In this review, the possible role of the immunopathologic phenomena including antibody-dependent enhancement, cytokine storm, and original antigenic sin in severity and mortality of COVID-19 will be discussed.

PMID:34222416 | PMC:PMC8223819 | DOI:10.12998/wjcc.v9.i18.4480

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Therapeutic effect of autologous concentrated growth factor on lower-extremity chronic refractory wounds: A case report

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World J Clin Cases. 2021 Jun 26;9(18):4797-4802. doi: 10.12998/wjcc.v9.i18.4797.

ABSTRACT

BACKGROUND: Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons. Because of poor blood supply, less tissue coverage, and easy exposure, the lower leg is a common site for chronic refractory wounds. The current therapeutic regimens often lead to prolonged hospital stay and higher healthcare costs. Concentrated growth factor (CGF) is a novel blood extract that contains various growth factors, platelets, and fibrins to promote wound healing process. However, there has been little research reported on the treatment of lower extremity wounds with CGF.

CASE SUMMARY: A 37-year-old man, without any past medical history, presented an ulcerated chronic wound on his right lower leg. The skin defect exhibited clear boundaries, with a size of 2.0 cm × 3.5 cm. The depth of wound was up to the layer of deep fasc ia. Staphylococcus aureus was detected by bacterial culture. The final diagnosis was right lower extremity ulcers with infection. Cefathiamidine, silver sulfadiazine, and mupirocin cream were applied to control the infection. CGF gel was prepared from the patient's blood sample, and was used to cover the wound after thorough debridement. The skin wound was successfully healed after three times of CGF treatment.

CONCLUSION: CGF displays an excellent wound healing promoting effect in patients with lower-extremity chronic refractory wounds.

PMID:34222450 | PMC:PMC8223823 | DOI:10.12998/wjcc.v9.i18.4797

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Therapeutic effect of autologous concentrated growth factor on lower-extremity chronic refractory wounds: A case report

paythelady.612 shared this article with you from Inoreader

World J Clin Cases. 2021 Jun 26;9(18):4797-4802. doi: 10.12998/wjcc.v9.i18.4797.

ABSTRACT

BACKGROUND: Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons. Because of poor blood supply, less tissue coverage, and easy exposure, the lower leg is a common site for chronic refractory wounds. The current therapeutic regimens often lead to prolonged hospital stay and higher healthcare costs. Concentrated growth factor (CGF) is a novel blood extract that contains various growth factors, platelets, and fibrins to promote wound healing process. However, there has been little research reported on the treatment of lower extremity wounds with CGF.

CASE SUMMARY: A 37-year-old man, without any past medical history, presented an ulcerated chronic wound on his right lower leg. The skin defect exhibited clear boundaries, with a size of 2.0 cm × 3.5 cm. The depth of wound was up to the layer of deep fasc ia. Staphylococcus aureus was detected by bacterial culture. The final diagnosis was right lower extremity ulcers with infection. Cefathiamidine, silver sulfadiazine, and mupirocin cream were applied to control the infection. CGF gel was prepared from the patient's blood sample, and was used to cover the wound after thorough debridement. The skin wound was successfully healed after three times of CGF treatment.

CONCLUSION: CGF displays an excellent wound healing promoting effect in patients with lower-extremity chronic refractory wounds.

PMID:34222450 | PMC:PMC8223823 | DOI:10.12998/wjcc.v9.i18.4797

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