Clostridium perfringens bloodstream infection secondary to acute pancreatitis: A case report

paythelady.612 shared this article with you from Inoreader <em>Clostridium perfringens</em> bloodstream infection secondary to acute pancreatitis: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4357-4364. doi: 10.12998/wjcc.v9.i17.4357. ABSTRACT BACKGROUND: Clostridium perfringens (C. perfringens) is an opportunistic pathogen. It can cause infections after birth, after an abortion, and in patients with diabetes, malignancy, liver cirrhosis, or an immunosuppressive state. Here, we report a patient with C. perfringens infection secondary to acute pancreatitis, with no underlying diabetes, malignancy, or liver cirrhosis. CASE SUMMARY: A 62-year-old Han Chinese woman presented to the Tianjin Hospital of ITCWM Nankai Hospital on January 8, 2020 because of epigastric abdominal pain. Laboratory examination showed that urine amylase was 10403 U/L (reference: 47-458), and blood amylase was 1006 U/L (reference: < 100). Abdominal computed tomography showed pancreatic edema and peripancreatic exudation. She was diagnosed with mild acute pancreatitis and treated according ly. She was readmitted the next day for similar symptoms. Two hours later, she went to the lavatory and urinated, and the urine color was like soy sauce. Oxygen saturation decreased to 77%, and she developed consciousness disturbance. She was admitted to the intensive care unit. After 8 h in the hospital, she had a high fever of 40 ℃, blood was drawn for culture, and 3 g of cefoperazone/sulbactam was administered. After 12 h, she had a cardiac arrest and died shortly. Blood culture confirmed a C. perfringens infection. CONCLUSION: C. perfringens infection may be secondary to acute pancreatitis. Rapid recognition and aggressive early management are critical for the survival of patients with C. perfringens infection. PMID:34141801 | PMC:PMC8173429 | DOI:10.12998/wjcc.v9.i17.4357 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Asymptomatic traumatic rupture of an intracranial dermoid cyst: A case report

paythelady.612 shared this article with you from Inoreader Asymptomatic traumatic rupture of an intracranial dermoid cyst: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 6;9(16):4046-4051. doi: 10.12998/wjcc.v9.i16.4046. ABSTRACT BACKGROUND: Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous, and only a few were traumatic, with asymptomatic much rarer than the symptomatic ruptures. Hence, how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic. CASE SUMMARY: A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography (CT) scan due to a car accident. A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa, accompanied with lipid droplet drifts in brain sulci, fissures, cisterns, and ventricles. After 1 wk of conservative observation, no change was observed on the updated cranial CT scan. After 2 wk of conservative observation, magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts. As the patient exhibited no adverse symptoms throughout the 2 wk, a 6-mo follow-up visit was arranged for him instead of aggressive treatment. Nonetheless, the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits. CONCLUSION: Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively. PMID:34141765 | PMC:PMC8180201 | DOI:10.12998/wjcc.v9.i16.4046 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma: A case report

paythelady.612 shared this article with you from Inoreader Kidney re-transplantation after living donor graft nephrectomy due to <em>de novo</em> chromophobe renal cell carcinoma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4365-4372. doi: 10.12998/wjcc.v9.i17.4365. ABSTRACT BACKGROUND: There are few reported cases of allograft nephrectomy due to malignancy followed by successful renal re-transplantation two years later. In this paper, we report a patient who underwent kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma (ChRCC) involving the allograft kidney. CASE SUMMARY: A 34-year-old man underwent living kidney transplantation at the age of 22 years for end-stage renal disease. Maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil (MMF), and prednisone. Six years post-transplantation, at another hospital, ultrasonography revealed a small mass involving the upper pole of the graft. The patient declined further examination and treatment at this point. Seven years and three months post-transplantation, the patient experience d decreasing appetite, weight loss, gross hematuria, fatigue, and oliguria. Laboratory tests showed anemia (hemoglobin level was 53 g/L). Contrast-enhanced computed tomography revealed a large heterogeneous cystic-solid mass involving the upper pole of the renal allograft. Graft nephrectomy was performed and immunosuppressants were withdrawn. Histological and immunohistochemical features of the tumor were consistent with ChRCC. One year after allograft nephrectomy, low doses of tacrolimus and MMF were administered for preventing allosensitization. Two years after allograft nephrectomy, the patient underwent kidney re-transplantation. Graft function remained stable with no ChRCC recurrence in more than 2-years of follow-up. CONCLUSION: De novo ChRCC in kidney graft generally has a good prognosis after graft nephrectomy and withdrawal of immunosuppression. Kidney re-transplantation could be a viable treatment. A 2-year malignancy-free period may be sufficient time before re-transplantation. PMID:34141802 | PMC:PMC8173413 | DOI:10.12998/wjcc.v9.i17.4365 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rare complication of inflammatory bowel disease-like colitis from glycogen storage disease type 1b and its surgical management: A case report

paythelady.612 shared this article with you from Inoreader Rare complication of inflammatory bowel disease-like colitis from glycogen storage disease type 1b and its surgical management: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 6;9(16):4081-4089. doi: 10.12998/wjcc.v9.i16.4081. ABSTRACT BACKGROUND: Glycogen storage disease (GSD) is an autosomal recessive inborn metabolic disorder. Patients with GSD are prone to hypoglycaemia, hyperlactacidemia and bleeding. GSD type 1b (GSD-1b) patients specifically can develop neutropenia, recurrent bacterial infection and inflammatory bowel disease (IBD). Documentation of the long-term outcomes of surgical management of GSD-1b has been scarce, especially for Asian patients. We herein describe a case of GSD-1b complicated by IBD-like colitis and coloduodenal fistula. The patient was managed successfully with surgical intervention. CASE SUMMARY: A 20-year-old Chinese lady confirmed by genetic testing to have GSD-1b was initially managed with uncooked cornstarch and granulocyte-colony stimulating factor. With recurrent abdominal symptoms, her condition was treated as clinical "Crohn's disease " with mesalazine, prednisolone and azathioprine conservatively. Colonoscopy showed a tight stricture at the hepatic flexure. Subsequent computerized tomographic colonography revealed a phlegmon at the ileocaecal region with a suspected coloduodenal fistula. Eventually an exploratory laparotomy was performed and severe colitis at the ascending colon with coloduodenal fistula was confirmed. Right hemicolectomy with primary anastomosis and repair of the duodenum were performed. Surgical management of complications from GSD-1b associated IBD-like colitis has rarely been described. First-line treatment would usually be conservative. Surgical intervention like hemicolectomy is mainly reserved for refractory cases. CONCLUSION: Surgical management of coloduodenal fistula in GSD-1b patients is a feasible and safe option when failed conservative management. PMID:34141769 | PMC:PMC8180209 | DOI:10.12998/wjcc.v9.i16.4081 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pelvic lipomatosis with cystitis glandularis managed with cyclooxygenase-2 inhibitor: A case report

paythelady.612 shared this article with you from Inoreader Pelvic lipomatosis with cystitis glandularis managed with cyclooxygenase-2 inhibitor: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4373-4380. doi: 10.12998/wjcc.v9.i17.4373. ABSTRACT BACKGROUND: Pelvic lipomatosis (PL) is a rare benign condition with characteristic overgrowth of histologically benign fat and invasion and compression of pelvic organs, often leading to non-specific lower urinary tract symptoms (LUTS). Approximately 40% of patients with PL have cystitis glandularis (CG). The cause of PL combined with CG is poorly understood, and there is currently no effective treatment. Refractory CG with upper urinary tract obstruction even requires partial or radical bladder resection. CASE SUMMARY: In this case, a patient suffering from PL with CG was treated by transurethral resection of bladder tumour (TUR-BT) and oral administration of celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor. The LUTS were alleviated, and the cystoscopy results improved significantly. Immunohistochemistry showed up-regulated COX-2 e xpression in the epithelium of TUR-BT samples, suggesting that COX-2 may participate in the pathophysiological process of PL combined with CG. CONCLUSION: We report for the first time that celecoxib may be an effective treatment strategy for PL combined with refractory CG. PMID:34141803 | PMC:PMC8173416 | DOI:10.1299 8/wjcc.v9.i17.4373 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Atezolizumab-induced anaphylactic shock in a patient with hepatocellular carcinoma undergoing immunotherapy: A case report

paythelady.612 shared this article with you from Inoreader Atezolizumab-induced anaphylactic shock in a patient with hepatocellular carcinoma undergoing immunotherapy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 6;9(16):4110-4115. doi: 10.12998/wjcc.v9.i16.4110. ABSTRACT BACKGROUND: Atezolizumab is a programmed death ligand 1 (PD-L1) inhibitor, and its combination with bevacizumab has been proven an effective immunotherapy for unresectable hepatocellular carcinoma (HCC). Treatment with immune checkpoint inhibitors (ICIs) can lead to hypersensitivity reactions; however, anaphylactic shock is rare. We present a case of life-threatening anaphylactic shock during atezolizumab infusion and performed a relevant literature review. CASE SUMMARY: A 75-year-old man was diagnosed with HCC recurrence after hepatectomy. He was administered immunotherapy with atezolizumab plus bevacizumab after an allergy to a programmed death-1 (PD-1) inhibitor. The patient showed a sudden onset of dizziness, numbness, and lack of consciousness with severe hypotension during atezolizumab infusion. The treatment was stopped immediately. Th e patient's symptoms resolved after 5 mg dexamethasone was administered. Because of repeated hypersensitivity reactions to ICIs, treatment was changed to oral targeted regorafenib therapy. CONCLUSION: Further research is necessary for elucidating the hypersensitivity mechanisms and establishing standardized skin test and desensitization protocols associated with PD-1 and PD-L1 to ensure effective treatment with ICIs. PMID:34141773 | PMC:PMC81 80205 | DOI:10.12998/wjcc.v9.i16.4110 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prone position combined with high-flow nasal oxygen could benefit spontaneously breathing, severe COVID-19 patients: A case report

paythelady.612 shared this article with you from Inoreader Prone position combined with high-flow nasal oxygen could benefit spontaneously breathing, severe COVID-19 patients: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4381-4387. doi: 10.12998/wjcc.v9.i17.4381. ABSTRACT BACKGROUND: Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China in December 2019, the overall fatality rate of severe and critical patients with COVID-19 is high and the effective therapy is limited. CASE SUMMARY: In this case report, we describe a case of the successful combination of the prone position (PP) and high-flow nasal oxygen (HFNO) therapy in a spontaneously breathing, severe COVID-19 patient who presented with fever, fatigue and hypoxemia and was diagnosed by positive throat swab COVID-19 RNA testing. The therapy significantly improved the patient's clinical symptoms, oxygenation status, and radiological characteristics of lung injury during hospitalization, and the patient showed good tolerance and avoided intubation. Additionally, we did not find that medical staff wearing optimal airborne personal protect ive equipment (PPE) were infected by the new coronavirus in our institution. CONCLUSION: We conclude that the combination of PP and HFNO could benefit spontaneously breathing, severe COVID-19 patients. The therapy does not increase risk of healthcare workers wearing optimal airborne PPE to become infected with virus particles. PMID:34141804 | PMC:PMC8173438 | DOI:10.12998/wjcc.v9.i17.4381 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Why MUC16 mutations lead to a better prognosis: A study based on The Cancer Genome Atlas gastric cancer cohort

paythelady.612 shared this article with you from Inoreader Why <em>MUC16</em> mutations lead to a better prognosis: A study based on The Cancer Genome Atlas gastric cancer cohort Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4143-4158. doi: 10.12998/wjcc.v9.i17.4143. ABSTRACT BACKGROUND: MUC16, encoding cancer antigen 125, is a frequently mutated gene in gastric cancer. In addition, MUC16 mutations seem to result in a better prognosis in gastric cancer. However, the mechanisms that lead to a better prognosis by MUC16 mutations have not yet been clarified. AIM: To delve deeper into the underlying mechanisms that explain why MUC16 mutations signal a better prognosis in gastric cancer. METHODS: We used multi-omics data, including mRNA, simple nucleotide variation, copy number variation and methylation data from The Cancer Genome Atlas, to explore the relationship between MUC16 mutations and prognosis. Cox regression and random survival forest algorithms were applied to search for hub genes. Gene set enrichment analysis was used to elucidate the molecular mechanisms. Single-sa mple gene set enrichment analysis and "EpiDISH" were used to assess immune cells infiltration, and "ESTIMATE" for analysis of the tumor microenvironment. RESULTS: Our study found that compared to the wild-type group, the mutation group had a better prognosis. Additional analysis indicated that the MUC16 mutations appear to activate the DNA repair and p53 pathways to act as an anti-tumor agent. We also identified a key gene, NPY1R (neuropeptide Y receptor Y1), which was significantly more highly expressed in the MUC16 mutations group than in the MUC16 wild-type group. The high expression of NPY1R predicted a poorer prognosis, which was also confirmed in a separate Gene Expression Omnibus cohort. Further susceptibility analysis revealed that NPY1R might be a potential drug target for gastric cancer. Furthermore, in the analysis of the tumor microenvironment, we found that immune cells in the mutation group exhibited higher anti-tumor eff ects. In addition, the tumor mutation burden and cancer stem cells index were also higher in the mutation group than in the wild-type group. CONCLUSION: We speculated that the MUC16 mutations might activate the p53 pathway and DNA repair pathway: alternatively, the tumor microenvironment may be involved. PMID:34141777 | PMC:PMC8173414 | DOI:10.12998/wjcc.v9.i17.4143 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary intratracheal schwannoma misdiagnosed as severe asthma in an adolescent: A case report

paythelady.612 shared this article with you from Inoreader Primary intratracheal schwannoma misdiagnosed as severe asthma in an adolescent: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4388-4394. doi: 10.12998/wjcc.v9.i17.4388. ABSTRACT BACKGROUND: Primary intratracheal schwannoma is an extremely rare type of benign airway tumor, especially in adolescents. The presenting symptoms are typically prolonged cough and wheezing that can be misdiagnosed as asthma in adolescent patients. CASE: A 16-year-old adolescent girl admitted to a local hospital with symptoms of an irritating cough and wheezing was diagnosed with bronchial asthma and treated with budesonide and formoterol. Over the next year, the patient's wheezing and coughing symptoms gradually worsened and the antiasthma treatment was ineffective. One week prior to this admission, the patient developed dyspnea after catching a cold and was transferred to our hospital with a diagnosis of severe asthma. However, chest computed tomography and bronchoscopy showed a mass in the trachea. Primary intratracheal schwannoma was diag nosed by biopsy. Her symptoms were relieved by endoscopic resection by electrosurgical snaring combined with argon plasma coagulation. No relapse occurred during an 18 mo follow-up. CONCLUSION: Primary intratracheal schwannoma should be considered in the differential diagnosis in adolescents with recurrent asthma-like attacks. PMID:34141805 | PMC:PMC8173418 | DOI:10.12998/wjcc.v9.i17.4388 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Self-perceived burden and influencing factors in patients with cervical cancer administered with radiotherapy

paythelady.612 shared this article with you from Inoreader Self-perceived burden and influencing factors in patients with cervical cancer administered with radiotherapy Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4188-4198. doi: 10.12998/wjcc.v9.i17.4188. ABSTRACT BACKGROUND: Cervical cancer is the fourth commonest malignancy in women around the world. It represents the second most commonly diagnosed cancer in South East Asian women, and an important cancer death cause in women of developing nations. Data collected in 2018 revealed 5690000 cervical cancer cases worldwide, 85% of which occurred in developing countries. AIM: To assess self-perceived burden (SPB) and related influencing factors in cervical cancer patients undergoing radiotherapy. METHODS: Patients were prospectively included by convenient sampling at The Fifth Affiliated Hospital of Sun Yat-Sen University, China between March 2018 and March 2019. The survey was completed using a self-designed general information questionnaire, the SPB scale for cancer patients, and the self-care self-efficacy scale, Strategies Used by People to Pro mote Health, which were delivered to patients with cervical cancer undergoing radiotherapy. Measurement data are expressed as the mean ± SD. Enumeration data are expressed as frequencies or percentages. Caregivers were the spouse, offspring, and other in 46.4, 40.9, and 12.7%, respectively, and the majority were male (59.1%). As for pathological type, 90 and 20 cases had squamous and adenocarcinoma/adenosquamous carcinomas, respectively. Stage IV disease was found in 12 (10.9%) patients. RESULTS: A total of 115 questionnaires were released, and five patients were excluded for too long evaluation time (n = 2) and the inability to confirm the questionnaire contents (n = 3). Finally, a total of 110 questionnaires were collected. They were aged 31-79 years, with the 40-59 age group being most represented (65.4% of all cases). Most patients were married (91.8%) and an overwhelming number had no religion (92.7%). Total SPB score was 43.13 ± 16.65. SPB was associated with the place of residence, monthly family income, payment method, transfer status, the presence of radiotherapy complications, and the presence of pain (P < 0.05). The SPB and self-care self-efficacy were negatively correlated (P < 0.01). In multivariate analysis, self-care self-efficacy, place of residence, monthly family income, payment method, degree of radiation dermatitis, and radiation proctitis were influencing factors of SPB (P < 0.05). CONCLUSION: Patients with cervical cancer undergoing radiotherapy often have SPB. Self-care self-efficacy scale, place of residence, monthly family income, payment method, and radiation dermatitis and proctitis are factors independently influencing SPB. PMID:34141781 | PMC:PMC8173433 | DOI:10.12998/wjcc.v9.i17.4188 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.