Cystic duct dilation through endoscopic retrograde cholangiopancreatography for treatment of gallstones and choledocholithiasis: Six case reports and review of literature

paythelady.612 shared this article with you from Inoreader Cystic duct dilation through endoscopic retrograde cholangiopancreatography for treatment of gallstones and choledocholithiasis: Six case reports and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jan 26;9(3):736-747. doi: 10.12998/wjcc.v9.i3.736. ABSTRACT BACKGROUND: Choledocholithiasis removal via endoscopic retrograde cholangiopancreatography (ERCP) then followed by laparoscopic cholecystectomy (LC) has gradually become the principal method in the treatment of gallstones and choledocholithiasis. We use ERCP through the cystic duct to treat gallstones combined with choledocholithiasis, with the aim to preserve the normal function of the gallbladder while simultaneously decreasing risk of biliary tract injury. CASE SUMMARY: A total of six cases of patients diagnosed with gallstones and choledocholithiasis were treated with ERCP. The efficacy was evaluated via operation success rate, calculus removal rate, postoperative hospital stay and average hospitalization costs; the safety was evaluated through perioperative complication probability, gallbladder function detection and gallstones recrudesce. The calculus removal rate reached 100%, and patients had mild adverse events, including 1 case of postoperative acute cholecystitis and another of increased blood urinary amylase; both were relieved after corresponding treatment, the remaining cases had no complications. The average hospital stay and hospitalization costs were 6.16 ± 1.47 d and 5194 ± 696 dollars. The 3-11 mo follow-up revealed that gallbladder contracted well, without recurrence of gallstones. CONCLUSION: This is the first batch of case reports for the treatment of gallstones and choledocholithiasis through ERCP approached by natural cavity. The results and effects of six reported cases proved that the new strategy is safe and feasible and is worthy of further exploration and application. PMID:33553415 | PMC:PMC7829737 | DOI:10.12998/wjcc.v9.i3.736 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nephrotic syndrome in syngeneic hematopoietic stem cell transplantation recipients: A case report

paythelady.612 shared this article with you from Inoreader Nephrotic syndrome in syngeneic hematopoietic stem cell transplantation recipients: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jan 26;9(3):614-622. doi: 10.12998/wjcc.v9.i3.614. ABSTRACT BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is widely used in the treatment of hematological diseases. However, complications after transplantation, such as acute and chronic graft-vs-host disease (GVHD), still seriously affect the quality of life and even threaten the lives of patients. There is evidence that glomerular diseases can manifest as GVHD. However, GVHD should not occur as a result of syngeneic HSCT. CASE SUMMARY: A 20-year-old male diagnosed with T lymphoblastic lymphoma (stage IIIA, aaIPI 1) in September 2013 was treated with six cycles of hyper-CVAD and achieved complete remission. He underwent syngeneic HSCT in June 2014, and had no kidney disease history before the transplant. However, nephrotic syndrome occurred 24 mo later in the patient after syngeneic HSCT. Renal biopsy was performed, which led to a diag nosis of atypical membranous nephropathy. After treatment with glucocorticoids combined with cyclophosphamide and cyclosporine, the nephrotic syndrome was completely relieved. CONCLUSION: We report a case of delayed nephrotic syndrome after syngeneic HSCT. Antibody-mediated autoimmune glomerular disease may be the underlying mechanism. After treatment with immunosuppressive agents, the nephrotic syndrome was completely relieved but further long-term follow-up is still needed. PMID:33553399 | PMC:PMC7829719 | DOI:10.12998/wjcc.v9.i3.614 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Infectious complications during immunochemotherapy of post-transplantation lymphoproliferative disease-can we decrease the risk? Two case reports and review of literature

paythelady.612 shared this article with you from Inoreader Infectious complications during immunochemotherapy of post-transplantation lymphoproliferative disease-can we decrease the risk? Two case reports and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jan 26;9(3):748-757. doi: 10.12998/wjcc.v9.i3.748. ABSTRACT BACKGROUND: Post-transplant lymphoproliferative disease (PTLD) is a heterogeneous group of diseases that develop after solid organ and hematopoietic stem cells transplantation related to intensive immunosuppression regimen, T-cell depletion and Epstein-Barr virus infection. Despite the improvement in the management of PTLD, the prognosis remains poor. Here we report the management of two transplanted patients with PTLD and infections during immunochemotherapy (ICTH). CASE SUMMARY: Of 65-year-old woman 11 years after kidney transplantation (first case) presented with diffuse large B-cell lymphoma (DLBCL) CS III and started ICHT according to R-CHOP protocol. Despite the secondary prevention of neutropenic fever, the patient developed grade 4 neutropenia with urinary and pulmonary tract infections after the fifth cycle. ICTH was continued in reduced doses up to 7 cycles followed by involved-field radiation therapy of the residual disease. The second case presents a 49-year-old man, 8 years after liver transplantation due to cirrhosis in the course of chronic hepatitis B, who started ICTH for DLBCL Burkitt-like CS IV. The patient received four cycles of ICTH according to R-CODOX/R-IVAC protocol, with reduced doses. In both cases initially undertaken reduction of immunosuppression was ineffective to prevent infectious complications. Despite one incomplete ICHT treatment due to recurrent infections, both our patients remain in complete remission. CONCLUSION: Reduction of immunosuppression and the doses of chemotherapeutics may be insufficient to prevent infectious complications during ICTH in PTLD patients. PMID:33553416 | PMC:PMC7829726 | DOI:10.12998/wjcc.v9.i3.748 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Restenosis of a drug eluting stent on the previous bioresorbable vascular scaffold successfully treated with a drug-coated balloon: A case report

paythelady.612 shared this article with you from Inoreader Restenosis of a drug eluting stent on the previous bioresorbable vascular scaffold successfully treated with a drug-coated balloon: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jan 26;9(3):758-763. doi: 10.12998/wjcc.v9.i3.758. ABSTRACT BACKGROUND: The in-stent restenosis (ISR) rates are reportedly inconsistent despite the increased use of second-generation drug eluting stent (DES). Although bioresorbable vascular scaffold (BVS) have substantial advantages with respect to vascular restoration, the rate of scaffold thrombosis is higher with BVS than with DES. Optimal treatment strategies have not been established for DES-ISR to date. CASE SUMMARY: We report on a case of a 60-year-old man patient with acute coronary syndrome. He had a history of ST-segment elevation myocardial infarction associated with very late scaffold thrombosis and treated with a DES. Coronary angiography revealed significant stenosis, suggesting DES-ISR on the previous BVS. Optical coherence tomography (OCT) identified a plaque rupture and a disrupted scaffold strut in the neointimal proliferation of DES. To treat the DES-ISR on the previous BVS, we opted for a drug-coated balloon (DCB) after a balloon angioplasty using a semi-compliant and non-compliant balloon. The patient did not experience adverse cardiovascular events on using a DCB following the use of intensive dual antiplatelet therapy and statin for 24 mo. CONCLUSION: This case highlights the importance of OCT as an imaging modality for characterizing the mechanism of target lesion failure. The use of a DCB following the administration of optimal pharmacologic therapy may be an optimal strategy for the treatment and prevention of recurrent BVS thrombosis and DES-ISR. PMID:33553417 | PMC:PMC7829740 | DOI:10.12998/wjcc.v9.i3.758 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment of cervical spine metastasis with minimally invasive cervical spondylectomy: A case report and literature review

paythelady.612 shared this article with you from Inoreader Treatment of cervical spine metastasis with minimally invasive cervical spondylectomy: A case report and literature review Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jan 26;9(3):644-650. doi: 10.12998/wjcc.v9.i3.644. ABSTRACT BACKGROUND: Cervical spondylectomy for the treatment of cervical tumors is traumatic, causes bleeding, and is risky. This study reports on the experience with minimally invasive cervical spondylectomy for a cervical metastasis and reviewed the literature on cervical spondylectomy. The purpose was to reduce the risk and trauma of spondylectomy. CASE SUMMARY: A 60-year-old woman presented with cervical pain and radiating pain in the left upper limb for more than 2 mo. Preoperative diagnosis was C4 metastasis of thyroid cancer. Preoperative visual analogue scale score was 5. American Spinal Cord Injury Association (ASIA) grade was E. Tomita classification was 7. Weinstein-Boriani-Biagini (WBB) classification was A-D, 3-9. Tomita score was 5. Modified Tokuhashi score was 9. Spinal instability neoplastic score (SINS) was 13. The patient underwent mini mally invasive cervical spondylectomy on September 28, 2017. The operative time was 200 min; the estimated blood loss was 1200 mL. The operation was successful, without complications. The postoperative visual analogue scale score was 0. The patient remained classified as ASIA grade E at the last follow-up. She accepted regular iodine-131 therapy postoperatively. The serum thyroglobulin (Tg) level of this patient was 299.02 ng/mL at 1 mo after the operation and was 13.57 ng/mL at the last follow-up. There was no local recurrence at the 25-mo follow-up, according to images, single-photon emission computed tomography, and serum Tg levels. Obvious ossification and solid fusion of C3-C5 were found at the last follow-up. CONCLUSION: Minimally invasive cervical spondylectomy with tubular retractor could minimize soft tissue trauma, intraoperative traction injury, and paraspinal muscle injury, accelerating postoperative recovery. This technique requires a rich experience in cervical s pine surgery with tubular retractors, so that surgeons can visualize the anatomical structure in a small field. PMID:33553403 | PMC:PMC7829725 | DOI:10.12998/wjcc.v9.i3.644 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radioactive 125I seed implantation for pancreatic cancer with unexpected liver metastasis: A preliminary experience with 26 patients

paythelady.612 shared this article with you from Inoreader Radioactive <sup>125</sup>I seed implantation for pancreatic cancer with unexpected liver metastasis: A preliminary experience with 26 patients Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):792-800. doi: 10.12998/wjcc.v9.i4.792. ABSTRACT BACKGROUND: Preoperative diagnosis rate of pancreatic cancer has increased year by year. The prognosis of pancreatic cancer patients with unexpected liver metastasis found by intraoperative exploration is very poor, and there is no effective and unified treatment strategy. AIM: To evaluate the therapeutic effect of radioactive 125I seed implantation for pancreatic cancer patients with unexpected liver metastasis. METHODS: The demographics and perioperative outcomes of patients who underwent 125I seed implantation to treat pancreatic cancer with unexpected liver metastasis between January 1, 2017 and June 1, 2019 were retrospectively analyzed. During the operation, 125I seeds were implanted into the pancreatic tumor under the guidance of intraoperative ultrasound, with a spacing of 1.5 cm and a row spacing of 1.5 cm. For patients with obstructive jaundice and digestive tract obstruction, choledochojejunostomy and gastroenterostomy were performed simultaneously. After operation, the patients were divided into a non-chemotherapy group and a chemotherapy group that received gemcitabine combined with albumin-bound paclitaxel treatment. RESULTS: Preoperative imaging evaluation of all patients in this study showed that the tumor was resectable without liver metastasis. There were 26 patients in this study, including 18 males and 8 females, aged 60.5 ± 9.7 years. The most common tumor site was the pancreatic head (17, 65.4%), followed by the pancreatic neck and body (6, 23.2%) and pancreatic tail (3, 11.4%). Fourteen patients (53.8%) underwent palliative surgery and postoperative pain relief occurred in 22 patients (84.6%). The estimated blood loss in operation was 148.3 ± 282.1 mL and one patient received blood transfusion. The postoperative hospital stay was 7.6 ± 2.8 d. One patient had biliary fistula, one had pancreatic fistula, and all recovered after conservative treatment. After operation, 7 patients received chemotherapy and 19 did not. The 1-year survival rate was significantly higher in patients who received chemotherapy than in those who did not (68.6% vs 15.8%, P = 0.012). The mean overall survival of patients in the chemotherapy group and non-chemotherapy group was 16.3 mo and 10 mo, respectively (χ 2 = 7.083, P = 0.008). CONCLUSION: Radioactive 125I seed implantation combined with postoperative chemotherapy can prolong the survival time and relieve pain of pancreatic cancer patients with unexpected liver metastasis. PMID:33585 625 | PMC:PMC7852643 | DOI:10.12998/wjcc.v9.i4.792 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness, discharge education quality, and blood glucose control

paythelady.612 shared this article with you from Inoreader Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness, discharge education quality, and blood glucose control Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):774-783. doi: 10.12998/wjcc.v9.i4.774. ABSTRACT BACKGROUND: Type 1 diabetes is one of the most common chronic diseases in childhood. The number of type 1 diabetes patients in China still ranks fourth in the world. Therefore, children with type 1 diabetes in China are a group that needs attention. The management of type 1 diabetes mellitus (T1DM) involves many aspects of daily life. It is extremely challenging for children and their families. T1DM children have complex medical care needs. Despite the continuous development of therapeutic medicine and treatment technologies, blood glucose control in children with T1DM is still not ideal. They and their parents need to acquire more knowledge and skills before being discharged. AIM: To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness, quality of discharge education and blood glucose control level. METHODS: In total, 102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time. Fifty cases from February to June 2019 were selected as the control group, and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan. The Readiness for Hospital Discharge Scale, Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation, discharge education quality and blood glucose control between the two groups of children and their parents. RESULTS: On the day of discharge, the two groups of children had the following scores of readiness for discharge: The intervention group score was 225.34 ± 32.47, and the control group score was 208.68 ± 29.31. The P value was 0.007, and the difference was statistically significant. The discharge education quality scores were as follows: The intervention group score was 135.11 ± 19.86, the control group score was 124.13 ± 15.56, the P value was 0.002 and the difference was statistically significant. Three months after discharge, the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was (7.45% ± 1.04%), and that of the control group was (8.04% ± 1.27%), P = 0.012. Therefore, the improvement of parents' readiness for discharge, quality of discharge education and blood glucose metabolism indicators (glycosylated hemoglobin, fasting blood glucose and postprandial blood glucose) in the intervention group were better than those in the control group (P < 0.05), and the difference was statistically significant. CONCLUSION: The discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents' readiness for dis charge, thereby improving children's blood glucose control levels. PMID:33585623 | PMC:PMC7852642 | DOI:10.12998/wjcc.v9.i4.774 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adult-onset Still's disease evolving with multiple organ failure and death: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Adult-onset Still's disease evolving with multiple organ failure and death: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):886-897. doi: 10.12998/wjcc.v9.i4.886. ABSTRACT BACKGROUND: Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease, which is characterized by daily fever and arthritis, with an evanescent rash and neutrophilic leukocytosis. To date, there has been no definite laboratory or imaging test available for diagnosing AOSD; the diagnosis is one of exclusion, which can be very challenging. In particular, AOSD patients may experience different complications affecting their clinical picture, management, and prognosis. The treatment of AOSD remains largely empirical and involves therapeutic agents. CASE SUMMARY: We report the case of a 36-year-old woman who presented with fever, red rash, arthralgia, and sore throat. Her serum ferritin level and white blood cell count were markedly elevated, and the first diagnosis 22 years prior was "juvenile rheumatoid arthritis of systemic type". The patient was treated with prednisone, sulfasalazine, methotrexate, and leflunomide. After remission of her symptoms, the patient stopped taking the medications, and the disease recurred. Ultimately, the patient was diagnosed with adult-onset Still's disease. Relapse occurred several times due to self-medication withdrawal, and an interleukin-6 antagonist (tocilizumab/Actemra) was administered to control the disease. Recently, she was hospitalized because an incision did not heal, and the patient suddenly developed high fever and diarrhea during hospitalization. The patient's disease progressed violently and quickly developed into macrophage activation syndrome, disseminated intravascular coagulation, shock, and multiple organ failure. The patient had sudden cardiac arrest, and she died despite emergency rescue efforts. CONCLUSION: AOSD patients need regular follow-up in the long-term treatment process, and must press formulary standard medication, and do not voluntarily withdr aw or reduce the dose. Otherwise it may cause disease back-and-forth or serious life-threatening complications. Meanwhile, strict management of trauma, infections, tumors, and other diseases may contribute to improved outcomes in patients with complications. PMID:33585636 | PMC:PMC7852636 | DOI:10.12998/wjcc.v9.i4.886 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Isolated interrupted aortic arch in an adult: A case report

paythelady.612 shared this article with you from Inoreader Isolated interrupted aortic arch in an adult: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):992-998. doi: 10.12998/wjcc.v9.i4.992. ABSTRACT BACKGROUND: Interrupted aortic arch (IAA) is a rare congenital heart disease defined by an interruption of the lumen and anatomical continuity between the ascending and descending major arteries. It is usually found within a few hours or days of birth. Without surgery, the chances of survival are low. If IAA patients have an effective collateral circulation established, they can survive into adulthood. However, IAA in adults is extremely rare, with few reported cases. CASE SUMMARY: A 27-year-old woman presented with a 6-year history of progressively worsening shortness of breath and chest tightness on exertion. She had cyanotic lips and clubbing of the fingers. A transthoracic echocardiogram revealed an enlarged heart and dilation of the main pulmonary artery. There was an abnormal 9 mm passage between the descending aorta and pulmonary artery. Th e ventricular septal outflow tract had a 14 mm defect. Doppler ultrasound suggested a patent ductus arteriosus and computed tomographic angiography showed the absence of the aortic arch. The diagnoses were ventricular septal defect, patent ductus arteriosus, and definite interruption of the aortic arch. Although surgical correction was recommended, the patient declined due to the surgical risks and was treated with medications to reduce pulmonary artery pressure and treat heart failure. Her condition has been stable for 12 mo of follow-up. CONCLUSION: Although rare, IAA should be considered in adults with refractory hypertension or unexplained congestive heart failure. PMID:33585649 | PMC:PMC7852638 | DOI:10.12998/wjcc.v9.i4.992 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Open reduction and Herbert screw fixation of Pipkin type IV femoral head fracture in an adolescent: A case report

paythelady.612 shared this article with you from Inoreader Open reduction and Herbert screw fixation of Pipkin type IV femoral head fracture in an adolescent: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):898-903. doi: 10.12998/wjcc.v9.i4.898. ABSTRACT BACKGROUND: Femoral head fracture is extremely rare in children. This may be the youngest patient with femoral head fracture ever reported in the literature. There are few pediatric studies that focus on cases treated with open reduction via the modified Hardinge approach. CASE SUMMARY: A 14-year-old female adolescent suffered a serious traffic accident when she was sitting on the back seat of a motorcycle. A pelvic radiograph and computed tomography revealed a proximal femoral fracture and slight acetabular rim fracture. This was diagnosed as a Pipkin type IV femoral head fracture. An open reduction and Herbert screw fixation was performed via a modified Hardinge approach. After 1-year follow-up, the patient could walk without aid and participate in physical activities. The X-ray results showed that the fractures healed well with no evidence of complications. CONCLUSION: Open reduction and Herbert screw fixation is an available therapy to treat Pipkin type IV femoral head fractures in children. PMID:33585637 | PMC:PMC7852633 | DOI:10.12998/wjcc.v9.i4.898 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.