Cholesterol gallstones: Focusing on the role of interstitial Cajal-like cells

paythelady.612 shared this article with you from Inoreader Cholesterol gallstones: Focusing on the role of interstitial Cajal-like cells Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3498-3505. doi: 10.12998/wjcc.v9.i15.3498. ABSTRACT Cholesterol gallstone (CG) is a common, frequent biliary system disease in China, with a complex and multifactorial etiology. Declined gallbladder motility reportedly contributes to CG pathogenesis. Furthermore, interstitial Cajal-like cells (ICLCs) are reportedly present in human and guinea pig gallbladder tissue. ICLCs potentially contribute to the regulation of gallbladder motility, and aberrant conditions involving the loss of ICLCs and/or a reduction in its pacing potential and reactivity to cholecystokinin may promote CG pathogenesis. This review discusses the association between ICLCs and CG pathogenesis and provides a basis for further studies on the functions of ICLCs and the etiologies of CG. PMID:34046450 | PMC:PMC8130069 | DOI:10.12998/wjcc.v9.i15.3498 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Needle tract seeding of papillary thyroid carcinoma after fine-needle capillary biopsy: A case report

paythelady.612 shared this article with you from Inoreader Needle tract seeding of papillary thyroid carcinoma after fine-needle capillary biopsy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3662-3667. doi: 10.12998/wjcc.v9.i15.3662. ABSTRACT BACKGROUND: Fine-needle biopsy is an accurate and cost-efficient tool for the assessment of thyroid nodules. It includes two primary methods: Fine-needle capillary biopsy (FNCB) and fine-needle aspiration biopsy. Needle tract seeding (NTS) is a rare complication of thyroid fine-needle biopsy mainly caused by fine-needle aspiration biopsy rather than FNCB. Here, we present an extremely rare case of a papillary thyroid carcinoma (PTC) patient with FNCB-derived NTS. CASE SUMMARY: We report a 32-year-old woman with PTC who showed subcutaneous NTS 1 year after FNCB and thyroidectomy. NTS was diagnosed based on clinical manifestations, biochemistry indices, and imaging (computed tomography and ultrasound). Pathological identification of PTC metastases consistent with the puncture path is the gold standard for diagnosis. Surgical resection was the main method used to treat the disease. After surgery, thyroid function tests and ultrasound scans were performed every 3-6 mo. To date, no evidence of tumor recurrence has been observed. CONCLUSION: FNCB is a safe procedure as NTS is rare, and can be easily removed surgically with no recurrence. Accordingly, NTS should not limit the usefulness of FNCB. PMID:34046467 | PMC:PMC8130087 | DOI:10.12998/wjcc.v9.i15.3662 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical treatment of hepatocellular carcinoma in the era of COVID-19 pandemic: A comprehensive review of current recommendations

paythelady.612 shared this article with you from Inoreader Surgical treatment of hepatocellular carcinoma in the era of COVID-19 pandemic: A comprehensive review of current recommendations Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3517-3530. doi: 10.12998/wjcc.v9.i15.3517. ABSTRACT The new coronavirus disease 2019 (COVID-19) pandemic has resulted in a global health emergency that has also caused profound changes in the treatment of cancer. The management of hepatocellular carcinoma (HCC) across the world has been modified according to the scarcity of care resources that have been diverted mostly to face the surge of hospitalized COVID-19 patients. Oncological and hepatobiliary societies have drafted recommendations regarding the adaptation of guidelines for the management of HCC to the current healthcare situation. This review focuses on specific recommendations for the surgical treatment of HCC (i.e., hepatic resection and liver transplantation), which still represents the best chance of cure for patients with very early and early HCC. While surgery should be pursued for very selected patients in institutions where s tandards of care are maintained, alternative or bridging methods, mostly thermoablation and transarterial therapies, can be used until surgery can be performed. The prognosis of patients with HCC largely depends on both the characteristics of the tumour and the stage of underlying liver disease. Risk stratification plays a pivotal role in determining the most appropriate treatment for each case and needs to balance the chance of cure and the risk of COVID-19 infection during hospitalization. Current recommendations have been critically reviewed to provide a reference for best practices in the clinical setting, with adaptation based on pandemic trends and categorization according to COVID-19 prevalence. PMID:34046452 | PMC:PMC8130078 | DOI:10.12998/wjcc.v9.i15.3517 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Metachronous pulmonary and pancreatic metastases arising from sigmoid colon cancer: A case report

paythelady.612 shared this article with you from Inoreader Metachronous pulmonary and pancreatic metastases arising from sigmoid colon cancer: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3668-3674. doi: 10.12998/wjcc.v9.i15.3668. ABSTRACT BACKGROUND: Metachronous pulmonary and pancreatic metastases from colorectal cancer are rare. The diagnosis of pancreatic metastases is difficult and predominantly relies on computed tomography, pathology and immunohistochemistry. Here, we describe the use of next-generation sequencing (NGS) for determination of the origin of metastasis and prognostic prediction of colorectal cancer. CASE SUMMARY: A 59-year-old man was diagnosed with sigmoid adenocarcinoma stage IIA (T3N0M0) and underwent surgery in April 2014, followed by XELOX adjuvant chemotherapy. The patient developed pulmonary metastasis in the right upper lung and underwent surgery in May 2016 without further adjuvant chemotherapy. In May 2018, pancreatic metastasis was found and he underwent pancreaticoduodenectomy. After surgery, he was treated with adjuvant S-1 chemotherapy from Ju ne 2018 to March 2019. Histopathological review of the specimens from all three lesions indicated consistent patterns characteristic of colon cancer. Concordant gene mutation profiles were observed across the three lesions that included oncogenic driver mutations most frequently seen in colon cancer (e.g., APC, TP53, KRAS and FBXW7). Blood circulating tumor (ct)DNA before adjuvant chemotherapy was undetectable with NGS, suggesting a favorable response to chemotherapy. The patient was alive and well at the latest follow-up visit, achieving a disease-free survival of 17 mo. CONCLUSION: The genetic profiles of primary tumor, metastases and ctDNA may have clinical value in auxiliary diagnosis, prognosis and therapeutic decision-making. PMID:34046468 | PMC:PMC8130074 | DOI:10.12998/wjcc.v9.i15.3668 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19: A retrospective cohort study

paythelady.612 shared this article with you from Inoreader Effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19: A retrospective cohort study Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3546-3558. doi: 10.12998/wjcc.v9.i15.3546. ABSTRACT BACKGROUND: The effectiveness of adjunctive corticosteroid use in patients with coronavirus disease 2019 (COVID-19) remains inconclusive. AIM: To investigate the effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19. METHODS: We conducted a retrospective analysis of the difference in several outcomes between patients with severe COVID-19 who received corticosteroid therapy (the corticosteroid group) and patients with severe COVID-19 who did not receive corticosteroid therapy (the non-corticosteroid group). RESULTS: Seventy-five patients were included in this study. Of these, 47 patients were in the corticosteroid group and 28 patients were in the non-corticosteroid group. There were no differences between the two groups in the total length of hospital stay, the length of intensive care unit stay, hig h-flow oxygen days, non-invasive ventilator days, invasive ventilation days, and mortality rate. Total lesion volume ratio, consolidation volume ratio and ground-glass opacity volume ratio in the corticosteroid group decreased significantly on day 14, while those in the non-corticosteroid group did not show a significant decrease. CONCLUSION: Our results show that adjunctive corticosteroid use did not significantly improve clinical outcomes in severe COVID-19 patients, but might promote the absorption of pulmonary lesions. Larger multicenter randomized controlled studies may be needed to confirm this. PMID:34046454 | PMC:PMC8130064 | DOI:10.12998/wjcc.v9.i15.3546 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Infiltrating ductal breast carcinoma with monoclonal gammopathy of undetermined significance: A case report

paythelady.612 shared this article with you from Inoreader Infiltrating ductal breast carcinoma with monoclonal gammopathy of undetermined significance: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3675-3679. doi: 10.12998/wjcc.v9.i15.3675. ABSTRACT BACKGROUND: Infiltrating ductal breast carcinoma with monoclonal gammopathy of undetermined significance (MGUS) is rare and easily misdiagnosed. Most patients are first diagnosed with MGUS. We report a rare case of MGUS secondary to infiltrating ductal breast carcinoma. We also review the literature to analyze the clinical characteristics and diagnostic methods. CASE SUMMARY: A 51-year-old woman underwent modified radical mastectomy for infiltrating ductal carcinoma of the right breast and was then treated with radiation and chemotherapy. A decreased platelet count was found on routine blood examination, and MGUS was subsequently diagnosed. This is the first report of the occurrence of MGUS after breast cancer surgery. CONCLUSION: Vigilance is required to distinguish this rare comorbidity from breast plasmacytoma. PMID:34046469 | PMC:PMC8130065 | DOI:10.12998/wjcc.v9.i15.3675 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ultrasound-guided, direct suprainguinal injection for fascia iliaca block for total hip arthroplasty: A retrospective study

paythelady.612 shared this article with you from Inoreader Ultrasound-guided, direct suprainguinal injection for fascia iliaca block for total hip arthroplasty: A retrospective study Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3567-3575. doi: 10.12998/wjcc.v9.i15.3567. ABSTRACT BACKGROUND: Peripheral regional block combined with general anesthesia might be a preferable anesthetic regimen for elderly patients undergoing total hip arthroplasty. AIM: To investigate whether ultrasound-guided, direct suprainguinal injection for fascia iliaca block accelerated recovery after general anesthesia and relieved postoperative pain after total hip arthroplasty. METHODS: Patients who underwent total hip arthroplasty under general anesthesia in 2015 or 2019 at The Second Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The patients were grouped based on whether preoperative suprainguinal fascia iliaca block was performed or not. The time to tracheal extubation and time spent in the post-anesthesia care unit (PACU), intraoperative remifentanil dosage, fentanyl consumption in the PACU, postopera tive cumulative fentanyl consumption within 48 h after operation, visual analogue scale at rest and during movement on the first and second days after surgery, and adverse reactions were compared. RESULTS: Thirty-one elderly patients who underwent total hip arthroplasty were included in the study (block group, n = 16; no-block group, n = 15). The visual analog scale scores at rest and during movement on the first and second days were significantly lower in the block group than in the no-block group (all P < 0.05). Compared with the no-block group, the intraoperative remifentanil dosage was lower, the time to tracheal extubation and the time spent in the PACU were shorter in the block group (all P < 0.01). Fentanyl consumption in the PACU and postoperative cumulative fentanyl consumption in 48 h after operation were lower in the block group (all P < 0.01). The incidence of dizziness was higher in the no-block group than in the block g roup (P = 0.037). CONCLUSION: Ultrasound-guided, direct suprainguinal injection for fascia iliaca block led to faster recovery after general anesthesia and early postoperative pain relief in elderly patients undergoing total hip arthroplasty. PMID:34046456 | PMC:PMC8130076 | DOI:10.12998/wjcc.v9.i15.3567 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Roxadustat as treatment for a blood transfusion-dependent maintenance hemodialysis patient: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Roxadustat as treatment for a blood transfusion-dependent maintenance hemodialysis patient: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3680-3688. doi: 10.12998/wjcc.v9.i15.3680. ABSTRACT BACKGROUND: Erythropoiesis-stimulating agents (ESAs) have revolutionized the therapeutic strategy for anemia in chronic kidney disease. However, some cases are resistant or hyporesponsive to ESAs. Roxadustat is an oral hypoxia-inducible factor-prolyl hydroxylase inhibitor that stimulates erythropoiesis and regulates iron metabolism. Here, we describe a hemodialysis patient with refractory anemia who did not respond to traditional treatments and depended on blood transfusion for more than 1 year. After applying Roxadustat, the patient's anemia improved significantly. CASE SUMMARY: A 44-year-old man was diagnosed with uremia accompanied by severe anemia with a hemoglobin (Hb) level ranging from 30-40 g/L. His anemia did not improve after sufficient dialysis or high doses of active ESAs; other causes of anemia were excluded. The patient require d approximately 600-1000 mL of red blood cell suspension every 15-30 d for more than 1 year. After accepting Roxadustat therapy, the patient's anemia symptoms improved significantly; his Hb level gradually increased to 50 g/L, and no further blood transfusions were administered. His Hb level reached 69 g/L by the 34th week. Although a Hb level of 60-70 g/L cannot be considered satisfactory, he no longer required blood transfusions and his quality of life was substantially improved. Roxadustat showed good efficacy and safety in this case. CONCLUSION: Roxadustat represents an innovative and effective agent for the clinical treatment of renal anemia caused by multiple complex factors. PMID:34046470 | PMC:PMC8130086 | DOI:10.12998/wjcc.v9.i15.3680 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cleansing efficacy and safety of bowel preparation protocol using sodium picosulfate/magnesium citrate considering subjective experiences: An observational study

paythelady.612 shared this article with you from Inoreader Cleansing efficacy and safety of bowel preparation protocol using sodium picosulfate/magnesium citrate considering subjective experiences: An observational study Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3586-3596. doi: 10.12998/wjcc.v9.i15.3586. ABSTRACT BACKGROUND: Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation. AIM: To observe the intestinal cleansing efficacy and safety of sodium picosulfate/magnesium citrate and to discuss the patients' experiences due to the procedure. METHODS: Subjects hospitalized in the International Medical Center Ward of Peking University International Hospital, Beijing, China, from April 29 to October 29, 2020, for whom the colonoscopy was planned, were enrolled. Bowel preparation was performed using sodium picosulfate/magnesium citrate. The effect of bowel cleansing was evaluated according to the Ottawa Bowel Preparation Scale, defecation conditions and adverse reactions were recorded, and the comfort level and subjective satisfaction concerning medication were evaluated by the visual analogue scale/score (VAS). RESULTS: The bowel preparation procedure was planned for all patients enrolled, which included 42 males and 22 females. The results showed an average liquid rehydration volume of 3000 mL, an average onset of action for the first dose at 89.04 min, an average number of bowel movements of 4.3 following the first dose, an average onset of action for the second dose at 38.90 min and an average number of bowel movements of 5.0 after the second dose. The total average Ottawa Bowel Preparation Scale score was 3.6, with 93.55% of bowel preparations in the "qualified" and 67.74% in the "excellent" grade. The average VAS score of effect on sleep was 0, and the average VAS score of perianal pain was also 0. The average VAS score for ease of taking and taste perception of the bowel cleanser was 10. Side effects included mild to moderate nausea (15.63%), mild vomiting (4.69%), mild to moderate abdominal pain (7.81%), mild to moderate abd ominal distension (20.31%), mild palpitation (7.81%) and mild dizziness (4.69%). CONCLUSION: Sodium picosulfate/magnesium citrate is effective and safe for bowel preparation before colonoscopy with high subjective patient acceptance, thus improving overall patient compliance. PMID:34046458 | PMC:PMC8130092 | DOI:10.1 2998/wjcc.v9.i15.3586 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Small bowel ulcer bleeding due to suspected clopidogrel use in a patient with clopidogrel resistance: A case report

paythelady.612 shared this article with you from Inoreader Small bowel ulcer bleeding due to suspected clopidogrel use in a patient with clopidogrel resistance: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3689-3695. doi: 10.12998/wjcc.v9.i15.3689. ABSTRACT BACKGROUND: Clopidogrel is a platelet aggregation inhibitor used for the management of cardiovascular disease. While antiplatelet therapy decreases cardiovascular events after successful coronary drug-eluting stenting, it increases the risk of gastrointestinal (GI) bleeding. About 20% of the patients who take clopidogrel exhibit resistance to the drug. CASE SUMMARY: We report the first case of a small bowel bleeding ulcer in an 86-year-old man with clopidogrel resistance. He had a history of taking clopidogrel due to unstable angina. There was no evidence of bleeding in the stomach, duodenum, or colon through upper and lower GI endoscopies. The abdominal computed tomography showed the extravasation of radiocontrast media at the ileum. Because of unstable vital signs, emergency surgery was performed. Multiple ulcers with inflammation were fou nd in the ileum. The pathologic findings revealed simple inflammation. The VerifyNow P2Y12 test showed clopidogrel resistance. One year after changing to aspirin, capsule endoscopy was performed and the small bowel ulcers were improved. CONCLUSION: Small bowel ulcers and bleeding due to clopidogrel are not very common, but the prevalence is expected to increase in older age patients with risk factors despite clopidogrel resistance. PMID:34046471 | PMC:PMC8130066 | DOI:10.12998/wjcc.v9.i15.3689 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.