Growth hormone cocktail improves hepatopulmonary syndrome secondary to hypopituitarism: A case report

paythelady.612 shared this article with you from Inoreader Growth hormone cocktail improves hepatopulmonary syndrome secondary to hypopituitarism: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4852-4858. doi: 10.12998/wjcc.v9.i18.4852. ABSTRACT BACKGROUND: Metabolic associated fatty liver disease frequently occurs in patients with hypopituitarism and growth hormone (GH) deficiency. Some patients may develop to hepatopulmonary syndrome (HPS). HPS has a poor prognosis and liver transplantation is regarded as the only approach to cure it. CASE SUMMARY: A 29-year-old man presented with progressive dyspnea for 1 mo. At the age of 10 years, he was diagnosed with panhypopituitarism associated with pituitary stalk interruption syndrome. Levothyroxine and hydrocortisone were given since then. To achieve ideal height, he received GH treatment for 5 years. The patient had an oxygen saturation of 78% and a partial pressure of arterial oxygen of 37 mmHg with an alveolar-arterial oxygen gradient of 70.2 mmHg. Abdominal ultrasonography showed liver cirrhosis and an enlarged spleen. Perfusion lung scan demonstrated intrapulmonary arteriovenous right-to-left shunt. HPS (very severe) was our primary consideration. His hormonal evaluation revealed GH deficiency and hypogonadotropic hypogonadism when thyroid hormone, cortisol, and desmopressin were administrated. After adding with long-acting recombinant human GH and testosterone for 14 mo, his liver function and hypoxemia were improved and his progressive liver fibrosis was stabilized. He was off the waiting list of liver transplantation. CONCLUSION: Clinicians should screen HPS patients' anterior pituitary function as early as possible and treat them primarily with GH cocktail accordingly. PMID:34222458 | PMC:PMC8223853 | DOI:10.12998/wjcc.v9.i18.4852 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Significance of highly phosphorylated insulin-like growth factor binding protein-1 and cervical length for prediction of preterm delivery in twin pregnancies

paythelady.612 shared this article with you from Inoreader Significance of highly phosphorylated insulin-like growth factor binding protein-1 and cervical length for prediction of preterm delivery in twin pregnancies Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4553-4558. doi: 10.12998/wjcc.v9.i18.4553. ABSTRACT BACKGROUND: A twin pregnancy can carry greater risks than singleton pregnancies. About 60 in 100 twin pregnancies result in spontaneous birth before 37 wk, which is associated with several complications in the premature babies. Clinical detection of biomarkers may help to predict the possibility of premature birth so that corresponding interventions can be given to the pregnant women in a timely manner, in order to reduce the risk of preterm birth and improve the outcomes of the newborn infants. AIM: To explore the clinical value of transvaginal ultrasound measurement of cervical length combined with insulin-like growth factor binding protein-1 (IGFBP-1) hyperphosphorylation in cervical secretions as predictors of preterm delivery in twin pregnancies. METHODS: A total of 254 pregnant women with twin pregnancies, who were admitted to Ha inan General Hospital and underwent maternity examination, were selected as the study subjects from January 2015 to December 2018. All participants received transvaginal ultrasound measurement of cervical length and phosphorylated IGFBP-1 (phIGFBP-1) test between 24 and 34 wk gestation. The pregnancy outcomes were analyzed. RESULTS: Of the women with a positive phIGFBP-1 test result, preterm birth rate was higher in those with a cervical length ≤ 25 mm than those with a cervical length > 25 mm (all P < 0.05). Similarly, in women with a negative phIGFBP-1 test result, preterm birth rate was higher in those with a cervical length ≤ 25 mm than those with a cervical length > 25 mm (all P < 0.05). The sensitivity, specificity, and positive and negative predictive values of the phIGFBP-1 test combined with the cervical length test were 95.71%, 91.21%, 95.12% and 92.22%, respectively, for the prediction of preterm birth. CONCLUSION: Cervical length combined with phIGFBP-1 tests is of value for the prediction of outcomes of preterm delivery in twin pregnancies. PMID:34222422 | PMC:PMC8223815 | DOI:10.12998/wjcc.v9.i18.4553 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Low symptomatic COVID-19 in an elderly patient with follicular lymphoma treated with rituximab-based immunotherapy: A case report

paythelady.612 shared this article with you from Inoreader Low symptomatic COVID-19 in an elderly patient with follicular lymphoma treated with rituximab-based immunotherapy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4859-4865. doi: 10.12998/wjcc.v9.i18.4859. ABSTRACT BACKGROUND: Follicular lymphoma is an indolent lymphoma that may progress to a highly aggressive form requiring immunochemotherapy. Most regimens utilize rituximab, an anti-CD20 monoclonal antibody, which may affect the clinical course of novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections [coronavirus disease 2019 (COVID-19)]. Here we describe the first case of mild COVID-19 during ongoing oncological treatment without significant deterioration after rituximab administration. CASE SUMMARY: A 74-year-old female with an enlargement of her right palatine tonsil was diagnosed with follicular lymphoma following tonsillectomy and started immunochemotherapy according to the rituximab, cyclophosphamide, vincristine, prednisone regimen. At home before the fourth cycle, she developed nonspecific symptoms (excess ive fatigue, loss of appetite and nausea), misdiagnosed as adverse effects of chemotherapy. Unexpectedly, interim positron emission tomography-computed tomography scan, performed shortly before rituximab administration, revealed previously nonexistent pulmonary changes, potentially of infectious etiology. SARS-CoV-2 infection was confirmed by a nasopharyngeal swab (with reverse transcriptase polymerase chain reaction test) performed the following day. Despite rituximab infusion, the patient remained oligosymptomatic and was discharged home for self-isolation. Having reached a negative SARS-CoV-2 status before the subsequently scheduled regimen, the patient successfully received six cycles of rituximab, cyclophosphamide, vincristine, prednisone and obtained complete remission by positron emission tomography-computed tomography. CONCLUSION: Our case shows that rituximab-based immunotherapy due to follicular lymphoma may have no evident negative effect on the COVID-19 clinical co urse. PMID:34222459 | PMC:PMC8223830 | DOI:10.12998/wjcc.v9.i18.4859 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgery for pancreatic tumors in the midst of COVID-19 pandemic

paythelady.612 shared this article with you from Inoreader Surgery for pancreatic tumors in the midst of COVID-19 pandemic Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4460-4466. doi: 10.12998/wjcc.v9.i18.4460. ABSTRACT The spread of the new coronavirus (COVID-19) infection in 2020 has had a significant impact on the treatment of cancer worldwide. During the COVID-19 pandemic, the biggest challenge for pancreatic surgeons is the difficulty in providing oncological care. In this review article, from the standpoint of surgeons, we explain the concept of triaging of patients with pancreatic tumors under the COVID-19 pandemic, and the actual impact of COVID-19 on the treatment of patients with pancreatic tumors. The most vital points in selecting the best therapeutic approach for patients with pancreatic tumors during this pandemic are (1) Oncologists need to tailor the treatment plan based on the COVID-19 phase, tumor malignant potential, and patients' comorbidities; and (2) Optimal treatment for pancreatic cancer should be planned according to the condition of each patient and tumor resectability based on national comprehensive cancer network resectability criteria. To choose the best therapeutic approach for patients with pancreatic tumors during this pandemic, we need to tailor the treatment plan based on elective surgery acuity scale (ESAS). Newly established ESAS for pancreatic tumor and flowchart indicating the treatment strategy of pancreatic cancer, are feasible to overcome this situation. PMID:34222414 | PMC:PMC8223860 | DOI:10.12998/wjcc.v9.i18.4460 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adult rhabdomyosarcoma originating in the temporal muscle, invading the skull and meninges: A case report

paythelady.612 shared this article with you from Inoreader Adult rhabdomyosarcoma originating in the temporal muscle, invading the skull and meninges: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4866-4872. doi: 10.12998/wjcc.v9.i18.4866. ABSTRACT BACKGROUND: Rhabdomyosarcoma (RMS) is a rare malignant tumor of mesenchymal origin that mainly affects children. Spindle cell/sclerosing RMS (SSRMS) is even rarer. It is a new subtype that was added to the World Health Organization disease classification in 2013. To the best of our knowledge, this is the first reported case of adult SSRMS disease classification originating in the temporal muscle. CASE SUMMARY: SSRMS originating in the temporal muscle of a male adult enlarged rapidly, destroyed the skull, and invaded the meninges. The tumor was completely removed, and the postoperative pathological diagnosis was SSRMS. Postoperative recovery was good and chemotherapy and radiotherapy were given after the operation. Followed up for 3 mo, no tumor recurred. CONCLUSION: RMS is one of the differential diagnoses for head soft tissue tumors w ith short-term enlargement and skull infiltration. Preoperative computed tomography or magnetic resonance imaging is necessary for early detection of tumor invasion of the skull and brain tissue. PMID:34222460 | PMC:PMC8223841 | DOI:10.12998/wjcc.v9.i18.4866 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of ocular axis and corneal diameter between entropion and non-entropion eyes in children with congenital glaucoma

paythelady.612 shared this article with you from Inoreader Comparison of ocular axis and corneal diameter between entropion and non-entropion eyes in children with congenital glaucoma Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4637-4643. doi: 10.12998/wjcc.v9.i18.4637. ABSTRACT BACKGROUND: Children with congenital glaucoma are often accompanied by acquired epiblepharon in the lower eyelid, which causes entropion of the lower eyelid and damages the cornea. AIM: To infer the possible causes of lower eyelid entropion by comparing the difference of ocular axis and corneal diameter between inverted and non-inverted ciliary eyes in children with congenital glaucoma. METHODS: A total of 15 patients (11 males and 4 females) diagnosed with congenital glaucoma between July 2016 and January 2019 at Tongren Hospital were included. Five patients had bilateral glaucoma, and ten had unilateral glaucoma. Each patient had only one eye with lower eyelid entropion which is associated with congenital glaucoma. All the patients had no entropion in another eye. The clinical data were collected. Main outcome measures were the ocula r axis and corneal diameter. RESULTS: The average age of the 15 patients was 1.85 ± 0.49 years. Paired t-test showed that the average ocular axis of congenital glaucoma eyes with lower eyelid entropion (24.86 ± 3.44 mm) was significantly longer than that of congenital glaucoma eyes without lower eyelid entropion (20.79 ± 1.34 mm; P < 0.001). The average corneal diameter of congenital glaucoma eyes with lower eyelid entropion (13.61 ± 0.88 mm) was also significantly greater than that of congenital glaucoma eyes without lower eyelid entropion (11.63 ± 0.48; P < 0.001). CONCLUSION: The rapid growth of the ocular axis and corneal diameter may be the main cause of congenital glaucoma with acquired lower eyelid entropion. Therefore, children with poor control of intraocular pressure and excessive growth of ocular axis and corneal diameter must be observed for the existence of acquired epiblepharon. PMID:34222430 | PMC:PMC8223843 | DOI:10.12998/wjcc.v9.i18.4637 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.