Bedside cardiopulmonary ultrasonography evaluates lung water content in very low-weight preterm neonates with patent ductus arteriosus

paythelady.612 shared this article with you from Inoreader Bedside cardiopulmonary ultrasonography evaluates lung water content in very low-weight preterm neonates with patent ductus arteriosus Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1827-1834. doi: 10.12998/wjcc.v9.i8.1827. ABSTRACT BACKGROUND: Patent ductus arteriosus (PDA) is a common congenital heart abnormality in preterm neonates with a high incidence in neonates with very low birth weights. When PDA persists, interstitial lung water content increases, which could lead to abnormal circulation hemodynamics and pulmonary edema. It is important to perform early and reliable assessment of lung water content in very low-weight preterm neonates with persistent PDA. AIM: To evaluate the role of bedside cardiopulmonary ultrasonography in the lung water content assessment in very low-weight preterm neonates with persistent PDA. METHODS: From January 2018 to March 2020, 69 very low-weight preterm neonates with echocardiography-confirmed PDA were selected as the PDA group. At the same time, 89 very low-weight preterm neonates without PDA were randomly selected as the cont rol group. All neonates underwent echocardiography and 6-segment lung ultrasonography on the fourth day after birth. The clinical characteristics and main ultrasonography results were compared between the two groups. Pearson's analysis was used to analyze the correlation between lung ultrasonography score (LUS) and other related clinical and ultrasonography results in all neonates. In the PDA group, PDA diameters were recorded, and the correlation with LUS and left atrium to aortic (LA/AO) dimension ratio were also analyzed. LA/AO ratio is one of the ultrasonic diagnostic criteria for hemodynamically significant PDA. When the ratio is ≥ 1.5, it suggests the possibility of hemodynamic changes in persistent PDA. A receiver operating characteristic curve was established using the sensitivity of LUS to predict the hemodynamic changes in neonates with PDA as the ordinate and 1-specificity as the abscissa. RESULTS: A total of 158 neonates were enrolled in this study, including 69 in the PDA group and 89 in the control group. There were no statistical differences in sex, gestational age, birth weight, ventilator dependence, hospitalization length and left ventricular ejection fraction between the two groups (P > 0.05). The LUS and LA/AO ratio in the PDA group were higher than those in the control group (P < 0.05), but there was no difference of LUS in neonates with or without use of the ventilator (t = 0.58, P = 0.16). In all cases, LUS was negatively correlated with gestational age (r = -0.28, P < 0.01) and birth weight (r = -0.36, P < 0.01), while positively correlated with the LA/AO ratio (r = 0.27, P < 0.01). In the PDA group, PDA diameter was positively correlated with the LA/AO ratio (r = 0.39, P < 0.01) and LUS (r = 0.31, P < 0.01). Receiver operating characteristic results showed that LUS had the moderate accuracy for predicting hemod ynamic changes in PDA (area under the curve = 0.741; sensitivity = 93.75%; specificity = 50.94%). CONCLUSION: Bedside cardiopulmonary ultrasonography can evaluate lung content in neonates with PDA and predict the possibility of hemodynamic changes in persistent PDA. PMID:33748231 | PMC:PMC7953406 | DOI:10.12998/wjcc.v 9.i8.1827 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between homeobox protein transcript antisense intergenic ribonucleic acid genetic polymorphisms and cholangiocarcinoma

paythelady.612 shared this article with you from Inoreader Association between homeobox protein transcript antisense intergenic ribonucleic acid genetic polymorphisms and cholangiocarcinoma Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1785-1792. doi: 10.12998/wjcc.v9.i8.1785. ABSTRACT BACKGROUND: Cholangiocarcinoma (CCA) represents a rare but highly aggressive malignancy that is often challenging to diagnose, especially in early stages. The role of existing tumor biomarkers for CCA diagnosis, remains controversial due to their low sensitivity and specificity. Increasing evidence has implicated long non-coding ribonucleic acid polymorphisms with cancer susceptibility in a variety of tumor types. The association between long non-coding ribonucleic acid homeobox protein transcript antisense intergenic ribonucleic acid (HOTAIR) polymorphisms and CCA risk has not been reported yet. AIM: To investigate the influence of HOTAIR variants on the risk of CCA development. METHODS: We conducted a case-control study in which three HOTAIR single nucleotide polymorphisms (rs920778, rs4759314 and rs7958904) were genotyped in a Greek c ohort. Our study population included 122 CCA patients (80 males and 42 females) and 165 healthy controls. The polymorphisms under investigation were examined in peripheral blood samples. RESULTS: HOTAIR rs4759314 AG and GG genotypes were associated with a significantly increased CCA risk [P = 0.004, odds ratio: 3.13; 95% confidence interval: 1.65-5.91 and P = 0.005, odds ratio: 12.31; 95% confidence interval: 1.48-101.87, respectively]. However, no significant associations of HOTAIR rs920778, and rs7958904 were detected. Similarly, we found no significant associations between rs4759314 AA genotype and CCA susceptibility. CONCLUSION: HOTAIR rs4759314 AG and GG genotypes may be implicated with CCA development and may serve as a potential diagnostic biomarker. PMID:33748227 | PMC:PMC7953393 | DOI:10.12998/wjcc.v9.i8.1785 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral common peroneal neuropathy due to rapid and marked weight loss after biliary surgery: A case report

paythelady.612 shared this article with you from Inoreader Bilateral common peroneal neuropathy due to rapid and marked weight loss after biliary surgery: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1909-1915. doi: 10.12998/wjcc.v9.i8.1909. ABSTRACT BACKGROUND: The causes of peroneal neuropathy are various, but are rarely due to weight loss. Bilateral peroneal neuropathy caused by weight loss after surgery has been reported only after bariatric surgery and there were no reports associated with other abdominal surgery. In this report, we describe a case of the bilateral peroneal neuropathy that occurred due to marked weight loss after biliary surgery. CASE SUMMARY: A 58-year-old male did not receive adequate nutritional support after biliary surgery, and showed a massive weight loss over a short period of time (body mass index; 24.1 kg/m2 to 20.5 kg/m2 for 24 d). Then, foot drop occurred on both sides. Physical examination, electromyography (EMG) and magnetic resonance imaging studies were conducted and he was diagnosed as bilateral common peroneal neuropathy around t he fibular head level. The patient was treated electrical stimulation therapy on both lower legs along with exercise therapy, and received sufficient oral nutritional support. The patient gradually recovered to his original weight, and the power of the dorsiflexor of bilateral ankles improved after conservative treatment. In addition, the follow-up EMG showed signs of improvement. CONCLUSION: Any abdominal surgery that may have rapid and marked weight loss can lead to peroneal neuropathy as a complication. PMID:33748241 | PMC:PMC7953405 | DOI:10.12998/wjcc.v9.i8.1909 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes of laparoscopic bile duct exploration for choledocholithiasis with small common bile duct

paythelady.612 shared this article with you from Inoreader Outcomes of laparoscopic bile duct exploration for choledocholithiasis with small common bile duct Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1803-1813. doi: 10.12998/wjcc.v9.i8.1803. ABSTRACT BACKGROUND: Laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct (CBD) exploration (LCBDE) is one of the main treatments for choledocholithiasis with CBD diameter of larger than 10 mm. However, for patients with small CBD (CBD diameter ≤ 8 mm), endoscopic sphincterotomy remains the preferred treatment at present, but it also has some drawbacks associated with a series of complications, such as pancreatitis, hemorrhage, cholangitis, and duodenal perforation. To date, few studies have been reported that support the feasibility and safety of LCBDE for choledocholithiasis with small CBD. AIM: To investigate the feasibility and safety of LCBDE for choledocholithiasis with small CBD. METHODS: A total of 257 patients without acute cholangitis who underwent LC + LCBDE for cholecystolithiasis from January 2013 to Decemb er 2018 in one institution were reviewed. The clinical data were retrospectively collected and analyzed. According to whether the diameter of CBD was larger than 8 mm, 257 patients were divided into large CBD group (n = 146) and small CBD group (n = 111). Propensity score matching (1:1) was performed to adjust for clinical differences. The demographics, intraoperative data, short-term outcomes, and long-term follow-up outcomes for the patients were recorded and compared. RESULTS: In total, 257 patients who underwent successful LC + LCBDE were enrolled in the study, 146 had large CBD and 111 had small CBD. The median follow-up period was 39 (14-86) mo. For small CBD patients, the median CBD diameter was 0.6 cm (0.2-2.0 cm), the mean operating time was 107.2 ± 28.3 min, and the postoperative bile leak rate, rate of residual CBD stones (CBDS), CBDS recurrence rate, and CBD stenosis rate were 5.41% (6/111), 3.60% (4/111), 1.80% (2/111), and 0% (0/111), respectively; the mean postoperative hospital stay was 7.4 ± 3.6 d. For large CBD patients, the median common bile duct diameter was 1.0 cm (0.3-3.0 cm), the mean operating time was 115.7 ± 32.0 min, and the postoperative bile leak rate, rate of residual CBDS, CBDS recurrence rate, and CBD stenosis rate were 5.41% (9/146), 1.37% (2/146), 6.85% (10/146), and 0% (0/146), respectively; the mean postoperative hospital stay was 7.7 ± 2.7 d. After propensity score matching, 184 patients remained, and all preoperative covariates except diameter of CBD stones were balanced. Postoperative bile leak occurred in 11 patients overall (5.98%), and no difference was found between the small CBD group (4.35%, 4/92) and the large CBD group (7.61%, 7/92). The incidence of CBDS recurrence did not differ significantly between the small CBD group (2.17%, 2/92) and the large CBD group (6.52%, 6/92). CONCLUSION: LC + LCBDE is safe and feasible for choledocholithiasis patients with small CBD and did not increas e the postoperative bile leak rate compared with chole-docholithiasis patients with large CBD. PMID:33748229 | PMC:PMC7953400 | DOI:10.12998/wjcc.v9.i8.1803 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Retroperitoneal laparoscopic partial resection of the renal pelvis for urothelial carcinoma: A case report

paythelady.612 shared this article with you from Inoreader Retroperitoneal laparoscopic partial resection of the renal pelvis for urothelial carcinoma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1916-1922. doi: 10.12998/wjcc.v9.i8.1916. ABSTRACT BACKGROUND: The standard treatment of transitional cell carcinoma of the upper urinary tract consists of radical nephroureterectomy with bladder cuff removal, which can be performed either in open or laparoscopy or robot-assisted laparoscopy. Treatment of chronic renal insufficiency patients with upper urothelial tumor is in a dilemma. Urologists weigh and consider the balance between tumor control and effective renal function preservation. European Association of Urology guidelines recommend that select patients may benefit from endoscopic treatment, but laparoscopic treatment is rarely reported. CASE SUMMARY: In this case report, we describe a case of 79-year-old female diagnosed with urothelial carcinoma of the renal pelvis and adrenal adenoma with chronic renal insufficiency. The patient was treated with retroperitoneal laparoscopic partia l resection of the renal pelvis and adrenal adenoma resection simultaneously. CONCLUSION: Retroperitoneal laparoscopic partial resection of the renal pelvis is an effective surgical procedure for the treatment of urothelial carcinoma of the renal pelvis. PMID:33748242 | PMC:PMC7953403 | DOI:10.12998/wjcc.v9.i8.1916 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Interstitial lung disease induced by the roots of Achyranthes japonica Nakai: Three case reports

paythelady.612 shared this article with you from Inoreader Interstitial lung disease induced by the roots of <em>Achyranthes japonica Nakai</em>: Three case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):2015-2021. doi: 10.12998/wjcc.v9.i8.2015. ABSTRACT BACKGROUND: The roots of Achyranthes japonica Nakai (AJN), called "Useul-puli," has been traditionally used to control pain and improve dysfunction in osteoarthritis patients in South Korea. CASE SUMMARY: We described 3 patients diagnosed with herbal medicine induced interstitial lung disease after consuming boiled the roots of AJN. They were referred to our hospital because of the modified Medical Research Council grade 4 dyspnea. Chest computed tomography showed bilateral ground-glass opacities with patchy consolidation. After treatment with systemic glucocorticoid therapy and discontinuation of the roots of AJN, their symptoms improved, and almost all ground-glass opacities and patchy consolidations on chest radiography and chest computed tomography resolved. CONCLUSION: We present three cases of interstitial lung disease induc ed by the roots of AJN. PMID:33748255 | PMC:PMC7953409 | DOI:10.12998/wjcc.v9.i8.2015 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

17α-hydroxylase/17,20 carbon chain lyase deficiency caused by p.Tyr329fs homozygous mutation: Three case reports

paythelady.612 shared this article with you from Inoreader 17α-hydroxylase/17,20 carbon chain lyase deficiency caused by p.Tyr329fs homozygous mutation: Three case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1923-1930. doi: 10.12998/wjcc.v9.i8.1923. ABSTRACT BACKGROUND: p.Tyr329fs is a cytochrome P450c17 mutation among Chinese individuals. However, data on 17-α-hydroxylase deficiency caused by cytochrome P450c17 p.Tyr329fs homozygous mutation are lacking. This paper is a case report of three patients homozygous for p.Tyr329fs who were diagnosed with 17-α-hydroxylase deficiency between 2005 and 2019. CASE SUMMARY: Case 1 presented with hypertension, hypokalemia, sexual infantilism and delayed bone age. The patient had a 46, XY karyotype, was homozygous for p.Tyr329fs and was recently treated with dexamethasone 0.375 mg qn. Case 2 presented with hypokalemia, sexual infantilism, osteoporosis and delayed bone age. The patient had a 46, XY karyotype, was homozygous for p.Tyr329fs and was treated with dexamethasone 0.75 mg qn at the last follow-up. Serum potassium and blood pressure could be maintaine d within normal range for cases 1 and 2. Case 3 presented with amenorrhea, sexual infantilism, osteopenia and delayed bone age. The patient had a 46, XX karyotype, was homozygous for p.Tyr329fs and was treated with dexamethasone 0.75 mg qn and progynova 1 mg qd. Outpatient follow-up revealed an adrenocorticotropic hormone (8 AM) of < 5.00 pg/mL. CONCLUSION: The homozygous p.Tyr329fs mutation usually manifests as a combined deficiency, and definitive diagnosis depends primarily on genetic testing. PMID:33748243 | PMC:PMC7953410 | DOI:10.12998/wjcc.v9.i8.1923 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Brain magnetic resonance imaging findings and radiologic review of maple syrup urine disease: Report of three cases

paythelady.612 shared this article with you from Inoreader Brain magnetic resonance imaging findings and radiologic review of maple syrup urine disease: Report of three cases Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1844-1852. doi: 10.12998/wjcc.v9.i8.1844. ABSTRACT BACKGROUND: Maple syrup urine disease (MSUD) is a rare autosomal-recessive disorder that affects branched-chain amino acid (BCAA) metabolism and is named after the distinctive sweet odor of affected infants' urine. This disease is characterized by the accumulation of BCAAs and corresponding branched-chain ketoacids of leucine, isoleucine, and valine in the plasma, urine, and cerebrospinal fluid. However, the mechanisms of MSUD-induced brain damage remain poorly defined. The accumulation of BCAAs in the brain inhibits the activity of pyruvate dehydrogenase and α-ketoglutarate, disrupting the citric acid cycle and consequently impacting the synthesis of amino acids, causing cerebral edema and abnormal myelination. CASE SUMMARY: We report three neonates admitted to our hospital with the classic subtype of MSUD. All three patients, with a transie nt normal period, presented with poor feeding, vomiting, poor weight gain, and increasing lethargy after birth. Laboratory testing revealed metabolic acidosis. The serum tandem mass spectrometry amino acid profile showed elevated plasma levels of BCAAs (leucine, isoleucine, and valine). Brain magnetic resonance imaging (MRI) presented abnormal signals mainly involving the globus pallidus, thalamus, internal capsule, brainstem, and cerebellar white matter, which represent the typical myelinated areas in normal full-term neonates. CONCLUSION: In our patients, MRI showed typical features, in concordance with the available literature. Early detection and timely treatment are very helpful for the prognosis of MSUD patients. Therefore, we discuss the neuroimaging features of MSUD to enhance the knowledge of pediatricians about this disease. PMID:33748233 | PMC:PMC7953394 | DOI:10.12998/wjcc.v9.i8.1844 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epithelioid angiomyolipoma of the pancreas: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Epithelioid angiomyolipoma of the pancreas: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1931-1939. doi: 10.12998/wjcc.v9.i8.1931. ABSTRACT BACKGROUND: Angiomyolipomas (AMLs), belonging to the family of mesenchymal tumors, are considered benign lesions that occur mostly in the kidney or as a part of tuberous sclerosis. Epithelioid AML (EAML) is a rare type of AML that appears to have malignant potential. Extrarenal AMLs usually occur in the liver according to the retrieved literature reports. There have been only two previous reports of monofocal primary AML of the pancreas; however, no cases of primary monotypic EAML of the pancreas have been reported. CASE SUMMARY: An asymptomatic 59-year-old woman incidentally revealed a tumor during abdominal ultrasound examination. Routine blood tests and physical examination were within normal limits. Abdominal ultrasound revealed a 1.9-cm hypoechogenic mass in the tail of the pancreas, clearly visualized by endoscopic ultrasound. However, c ontrast-enhanced abdominal computed tomography scans did not demonstrate the lesion. A subsequent gadolinium-enhanced magnetic resonance imaging scan showed that the lesion had some characteristic manifestations. The lesion was initially thought to be a neuroendocrine tumor (asymptomatic PanNET). After surgical resection, histopathology and immunohistochemistry confirmed the diagnosis of EAML. At the 6-mo follow-up, no recurrence, spread, or metastasis was identified on computed tomography or magnetic resonance imaging. CONCLUSION: The preoperative diagnosis of pancreatic AML is extremely difficult. Imaging techniques are essential for providing valuable morphological features for differential diagnosis. PMID: 33748244 | PMC:PMC7953389 | DOI:10.12998/wjcc.v9.i8.1931 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intradural osteomas: Report of two cases

paythelady.612 shared this article with you from Inoreader Intradural osteomas: Report of two cases Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1863-1870. doi: 10.12998/wjcc.v9.i8.1863. ABSTRACT BACKGROUND: Intradural osteoma is very rarely located in the subdural or subarachnoid space. Unfortunately, intradural osteoma lacks specificity in clinical manifestations and imaging features and there is currently no consensus on its diagnosis method or treatment strategy. Moreover, the pathogenesis of osteoma without skull structure involvement remains unclear. CASE SUMMARY: We describe two cases of intradural osteomas located in the subdural and subarachnoid spaces, respectively. The first case involved a 47-year-old woman who presented with a 3-year history of intermittent headache and dizziness. Intraoperatively, a bony hard mass was found in the left frontal area, attached to the inner surface of the dura mater and compressing the underlying arachnoid membrane and brain. The second case involved a 56-year-old woman who had an intracrani al high-density lesion isolated under the right greater wing of the sphenoid. Intraoperatively, an arachnoid-covered bony tumor was found in the sylvian fissure. The pathological diagnosis for both patients was osteoma. CONCLUSION: Surgery and pathological examination are required for diagnosis of intradural osteomas, and craniotomy is a safe and effective treatment. PMID:33748235 | PMC:PMC7953386 | DOI:10.12998/wjcc.v9.i8.1863 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.