Atypical presentation of shoulder brucellosis misdiagnosed as subacromial bursitis: A case report

paythelady.612 shared this article with you from Inoreader Atypical presentation of shoulder brucellosis misdiagnosed as subacromial bursitis: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):927-934. doi: 10.12998/wjcc.v9.i4.927. ABSTRACT BACKGROUND: Brucella infections in the shoulder joint are uncommon, and few have been reported in the literature. CASE SUMMARY: A 26-year-old male was admitted to our hospital with complaint of recurrent pain and limited movement of the right shoulder. The patient reported the pain to have first occurred as an isolated event 6 mo previously and to have reoccurred 5 mo later, when it was accompanied by limited movement of the shoulder. Findings from physical examination and magnetic resonance imaging (referred to as MRI) suggested the diagnosis of subacromial bursitis, and diagnostic paracentesis and arthroscopic debridement were performed. Surprisingly, synovial fluid culture detected brucella, and the finding was confirmed by mass spectrometry of a colony sample. The diagnosis was corrected to brucellosis of the shoulder joint, and antibiotic dru g treatment (oral rifampicin and doxycycline) was administrated for 6 wk. The 4-mo postoperative follow-up examination (MRI) yielded normal findings. The 2-year follow-up showed no signs of recurrence. CONCLUSION: This rare case of brucellosis infection in shoulder highlights the importance of increasing awareness to help avoid misdiagnosis. PMID:33585641 | PMC:PMC7852647 | DOI:10.12998/wjcc.v9.i4.927 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical characteristics and ABCC2 genotype in Dubin-Johnson syndrome: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Clinical characteristics and <em>ABCC2</em> genotype in Dubin-Johnson syndrome: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):878-885. doi: 10.12998/wjcc.v9.i4.878. ABSTRACT BACKGROUND: Dubin-Johnson syndrome (DJS) is a benign autosomal recessive liver disease involving mutations of the ABCC2 gene. It is characterized by chronic or intermittent conjugated hyperbilirubinemia, with chronic idiopathic jaundice as the main clinical manifestation. Genetic alterations of the ABCC2 gene are commonly used for diagnosing DJS; however, the causative ABCC2 point mutation in Chinese patients remains unknown. Research on ABCC2 mutations in Chinese DJS patients is extremely rare, and the diagnosis of DJS remains limited. The routine analysis of ABCC2 mutations is helpful for the diagnosis of DJS. Here, we report the clinical characteristics and ABCC2 genotype of an adult female DJS patient. This article is to expound the discovery of more potentially pathogenic ABCC2 variants will that con tribute to DJS identification. CASE SUMMARY: This study investigated a woman referred for DJS and involved clinical and genetic analyses. ABCC2 mutations were identified by next-generation sequencing (NGS). The patient showed intermittent jaundice and conjugated hyper-bilirubinemia. Histopathological examinations were consistent with the typical phenotype of DJS. Genetic diagnostic analysis revealed an ABCC2 genotype exhibiting a pathogenic variant, namely c.2443C>T (p.Arg815*), which has not been reported previously in the domestic or foreign literature. CONCLUSION: Pathogenic ABCC2 mutations play an important role in the diagnosis of DJS, especially in patients with atypical presentations. Currently, NGS is used in the routine analysis of DJS cases and such tests of further cases will better illuminate the relationship between various genotypes and phenotypes of DJS. PMID:33585635 | PMC:PMC7852649 | DOI:10.12998/wjcc.v9.i4.878 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Retroperitoneal teratoma resection assisted by 3-dimensional visualization and virtual reality: A case report

paythelady.612 shared this article with you from Inoreader Retroperitoneal teratoma resection assisted by 3-dimensional visualization and virtual reality: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):935-942. doi: 10.12998/wjcc.v9.i4.935. ABSTRACT BACKGROUND: Primary retroperitoneal tumor is a rare type of tumor with insidious onset, large tumor size at the time of diagnosis, and often extensive involvement of surrounding tissues and blood vessels in the retroperitoneum. Surgery for primary retroperitoneal tumors is technically challenging. Preoperative imaging evaluation is critical for the selection of the optimal surgical approach and can influence complete resection and recurrence rates. Three-dimensional model reconstruction combined with virtual reality is useful for preoperative assessment. CASE SUMMARY: A 17-year-old female patient was admitted for abdominal pain lasting for half a year that had been worsening for half a month. Abdominopelvic enhanced helical computed tomography revealed a retroperitoneal space-occupying lesion about 11.3 cm × 9.1 cm in size, with well-defined bord ers in the upper left quadrant of the abdomen. The lesion compressed the left renal artery and vein resulting in vascular displacement and deformation. A multidisciplinary team decided on the optimal treatment approach. Preoperative three-dimensional visualization and virtual reality technology were used to assess and simulate the surgical procedure. Then, retroperitoneal tumor resection along with renal artery reconstruction was decided as the treatment. Complete resection of the retroperitoneal tumor was performed. Stable blood flow was established after renal artery reconstruction. The tumor was diagnosed as mature cystic teratoma (retroperitoneal tumor) by postoperative pathologic analysis. The patient, who recovered well, was discharged after 2 wk and maintains regular follow-ups. CONCLUSION: A combination of three-dimensional reconstruction and virtual reality technology before surgery improves the rate of complete resection of retroperitoneal teratoma. PMID:33585642 | PMC:PMC7852646 | DOI:10.12998/wjcc.v9.i4.935 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of biofeedback combined with high-quality nursing in treatment of functional constipation

paythelady.612 shared this article with you from Inoreader Effect of biofeedback combined with high-quality nursing in treatment of functional constipation Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):784-791. doi: 10.12998/wjcc.v9.i4.784. ABSTRACT BACKGROUND: Functional constipation (FC) is a common functional gastrointestinal disease with various clinical manifestations. It is a physical and mental disease, which seriously affects patient physical and mental health and quality of life. Biofeedback therapy is the treatment of choice for FC, especially outlet obstructive constipation caused by pelvic floor dysfunction. High-quality nursing is a new nursing model in modern clinical work and a new concept of modern nursing service. AIM: To explore the effect of biofeedback combined with high-quality nursing in the treatment of FC. METHODS: A total of 100 patients with FC admitted to our hospital from March 2015 to July 2019 were selected for clinical observation. These patients were randomly divided into two groups of 50: Experimental group (biofeedback combined with high-quality nursing treatment group) and control group (biofeedback group). RESULTS: The constipation symptom score of the experimental group was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05). The anal canal resting pressure and initial defecation threshold of the experimental group were significantly lower than those of the control group, and the maximum squeeze systolic pressure of the anal canal of the experimental group was significantly higher than that of the control group (P < 0.05). The Self-Rating Anxiety Scale and Zung's Self-Rating Depression Scale scores of the two groups were significantly lower than before treatment. The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the experimental group were significantly lower than those of the control group (P < 0.05). The patient satisfaction score of the experimental group was significantly higher than that of the control gro up (P < 0.05). CONCLUSION: The application of biofeedback combined with high-quality nursing in the treatment of FC has significant advantages over pure biofeedback treatment, and it is worthy of promotion in clinical work. PMID:33585624 | PMC:PMC7852631 | DOI:10.12998/wjcc.v9.i4.784 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Renal failure and hepatitis following ingestion of raw grass carp gallbladder: A case report

paythelady.612 shared this article with you from Inoreader Renal failure and hepatitis following ingestion of raw grass carp gallbladder: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):943-950. doi: 10.12998/wjcc.v9.i4.943. ABSTRACT BACKGROUND: Fish gallbladder has long been used as a folk remedy in Asian countries. Multiple organ damage after ingestion of fish gallbladder resulting in near mortality has been known to us. Here, we describe a case of acute renal failure (ARF) and hepatitis due to grass carp gallbladder poisoning and review the literature. CASE SUMMARY: A previously healthy, 50-year-old woman was admitted to our hospital with a 2-d history of generalized abdominal pain and repeated vomiting following ingestion of two raw grass carp gallbladders in an attempt to alleviate her cough. She developed anuria on day 4 with markedly elevated serum creatinine, urea, bilirubin, alanine aminotransferase, and aspartate aminotransferase. Based on thorough evaluation of her history and prompt biochemical investigations, we diagnosed her with ARF and hepatitis secondary to fi sh gallbladder poisoning. Her renal biopsy revealed acute tubular necrosis, following which she underwent six sessions of conventional hemodialysis due to renal failure. Supportive treatment with gastric mucosal protectant and liver protectant was administered for targeted organ protection. The patient's liver function gradually recovered, and serum creatinine was 164 mmol/L at discharge on day 24. Over a follow-up period of 2 wk, her renal function completely recovered. CONCLUSION: Physicians should be mindful of toxic complications of raw grass carp gallbladder ingestion and we should promote awareness to reduce incidences of food poisoning. PMID:33585643 | PMC:PMC7852650 | DOI:10.12998/wjcc.v9.i4.943 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Usefulness of prenatal magnetic resonance imaging in differential diagnosis of fetal congenital cystic adenomatoid malformation and bronchopulmonary sequestration

paythelady.612 shared this article with you from Inoreader Usefulness of prenatal magnetic resonance imaging in differential diagnosis of fetal congenital cystic adenomatoid malformation and bronchopulmonary sequestration Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):822-829. doi: 10.12998/wjcc.v9.i4.822. ABSTRACT BACKGROUND: Congenital cystic adenomatoid malformation (CCAM) and bronchopulmonary sequestration (BPS) are the most common lung diseases in fetuses. There are differences in the prognosis and treatment of CCAM and BPS, and the clinical diagnosis and treatment plan is usually prepared prior to birth. Therefore, it is quite necessary to make a clear diagnosis before delivery. CCAM and BPS have similar imaging features, and the differentiation mainly relies on the difference in supply vessels. However, it is hard to distinguish them due to invisible supplying vessels on some images. AIM: To explore the application value of magnetic resonance imaging (MRI) in the differential diagnosis of fetal CCAM and BPS. METHODS: Data analysis for 32 fetuses with CCAM and 14 with BPS diagnosed by prenatal MRI at Huzhou Maternal and Child Health Care Hospital and Anhui Provincial Children's Hospital from January 2017 to January 2020 was performed to observe the source blood vessels of lesions and their direction. Pathological confirmation was completed through CT examination and/or operations after birth. RESULTS: After birth, 31 cases after birth were confirmed to be CCAM, and 15 were confirmed to be BPS. The CCAM group consisted of 21 macrocystic cases and 10 microcystic cases. In 18 cases, blood vessels were visible in lesions. Blood supply of the pulmonary artery could be traced in eight cases, and in 10 cases, only vessels running from the midline to the lateral down direction were observed. No lesions were found in four macrocystic cases and one microcystic case with CCAM through CT after birth; two were misdiagnosed by MRI, and three were misdiagnosed by prenatal ultrasonography. The BPS group consisted of 12 intralobar cases and three extralobar cases. Blood vessels were visible in lesions of nine cases, in four of which, the systemic circulation blood supply could be traced, and in five of which, only vessels running from the midline to the lateral up direction were observed. Three were misdiagnosed by MRI, and four were misdiagnosed by prenatal ultrasonography. CONCLUSION: CCAM and BPS can be clearly diagnosed based on the origin of blood vessels, and correct diagnosis can be made according to the difference in the direction of the blood vessels, but it is hard distinguish microcystic CCAM and BPS without supplying vessels. In some CCAM cases, mainly the macrocystic ones, the lesions may disappear after birth. PMID:33585628 | PMC:PMC7852640 | DOI:10.12998/wjcc.v9.i4.822 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pheochromocytoma as a cause of repeated acute myocardial infarctions, heart failure, and transient erythrocytosis: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Pheochromocytoma as a cause of repeated acute myocardial infarctions, heart failure, and transient erythrocytosis: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):951-959. doi: 10.12998/wjcc.v9.i4.951. ABSTRACT BACKGROUND: Pheochromocytoma is a rare catecholamines-secreting tumor arising from chromaffin cells in the adrenal medulla. It classically presents with paroxysmal hypertension, headaches, palpitations, sweating, and metabolic disorders. Atypical presentations such as acute myocardial infarction, heart failure, cardiomyopathy, stroke, and transient erythrocytosis have been infrequently documented. CASE SUMMARY: We describe the case of a 72-year-old man diagnosed with pheochromocytoma presenting with non-ST segment elevation myocardial infarction, heart failure, and transient erythrocytosis with nonobstructed coronary arteries. This was his second heart attack. The patient was previously diagnosed with myocardial infarction, and an immense mass was found on the left adrenal gland 3 years prior. Based on clinical and laboratory findings, a diagnosis of pheochromocytoma was confirmed. His coronary angiogram showed nonobstructed coronary arteries except for a myocardial bridge in the left anterior descending branch. This was a form of type-2 myocardial infarction. The myocardial cell lesions were caused by sudden secretion of catecholamines by the pheochromocytoma. Even more atypically, his hemoglobin level was obviously elevated at admission, but after a few days of treatment with an alpha-adrenergic receptor blocker, it dropped to normal levels without additional treatment. CONCLUSION: Pheochromocytoma may be a cause of acute myocardial infarction, heart failure, and transient erythrocytosis. PMID:33585644 | PMC:PMC7852630 | DOI:10.12998/wjcc.v9.i4.951 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term survival in a patient with Hutchinson-Gilford progeria syndrome and osteosarcoma: A case report

paythelady.612 shared this article with you from Inoreader Long-term survival in a patient with Hutchinson-Gilford progeria syndrome and osteosarcoma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):854-863. doi: 10.12998/wjcc.v9.i4.854. ABSTRACT BACKGROUND: Hutchinson-Gilford progeria syndrome (HGPS) is an extremely rare disease characterized by the rapid appearance of aging with an onset in childhood. Serious cardiovascular complications can be life-threatening events for affected patients and the cause of early death. Herein we report a HGPS patient with osteosarcoma hat was successfully managed and is alive 13 years after the diagnosis. This is the first report describing the detailed surgical procedure and long-term follow-up of osteosarcoma in a patient with HGPS. CASE SUMMARY: The patient was diagnosed with HGPS at 5 years of age with typical features and was referred to our department with a suspected bone tumor of the left proximal tibia at the age of 18. Open biopsy of the tibial bone tumor revealed a conventional fibroblastic osteosarcoma. We have developed and performed a freez ing technique using liquid nitrogen for tumor reconstruction. This technique overcame the small size of the tibia for megaprosthesis and avoided amputation and limb salvage was achieved 13 years post-operatively. Although the patient had a number of surgical site complications, such as wound dehiscence, and superficial and deep infections due to vulnerable skin in HGPS, no recurrence or metastases were detected for 13 years, and she walks assisted by crutches. Her general health was good at the latest follow-up at 31 years of age. CONCLUSION: A HGPS patient with osteosarcoma was successfully managed and she was alive 13 years after the diagnosis. PMID:33585632 | PMC:PMC7852653 | DOI:10.12998/wjcc.v9.i4.854 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immediate implant placement in combination with platelet rich-fibrin into extraction sites with periapical infection in the esthetic zone: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Immediate implant placement in combination with platelet rich-fibrin into extraction sites with periapical infection in the esthetic zone: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):960-969. doi: 10.12998/wjcc.v9.i4.960. ABSTRACT BACKGROUND: In this case, platelet-rich fibrin (PRF) was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection. CASE SUMMARY: With the history of endodontic failure in maxillary central incisor, a 34-year-old female patient required the extraction of maxillary anterior residual root and immediate implantation. Cone beam computed tomography and clinical observation were used to assess the regeneration of soft and bone tissue. Before operation, cone beam computed tomography showed the anterior residual root had serious periapical periodontitis with insufficient labial bone in the aesthetic zone. The patient underwent immediate implant placement and reconstruction of the bone substitution by modified guided bone regeneration. The barrier was a three-layer structure of P RF-collagen membrane-PRF that covered the mixture of PRF and Bio-Oss to promote both osteogenesis and soft tissue healing. At 6 mo postoperatively, the definitive crown was placed after accomplished finial impression. One-year follow-up showed a satisfactory aesthetic effect with no obvious absorption of the labial bone and soft tissue. CONCLUSION: The use of PRF in combination with guided bone regeneration can serve as a reliable and simple adjuvant for immediate implanting in infected socket and result in a stable osteogenic effect with good aesthetic outcome. PMID:33585645 | PMC:PMC7852644 | DOI:10.12998/wjcc.v9.i4.960 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chiari malformations in children: An overview

paythelady.612 shared this article with you from Inoreader Chiari malformations in children: An overview Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):764-773. doi: 10.12998/wjcc.v9.i4.764. ABSTRACT Chiari malformations encompass various radiological and clinical entities, sharing the herniation of the rhombencephalic structures through the foramen magnum as a common characteristic. They can be symptomatic or asymptomatic. The therapeutic strategies for these malformations differ on the basis of the diverse pathophysiologic processes that cause them. As Chiari malformations are caused by various pathophysiologic processes, they must be recognized promptly to select the best treatment for each single case. PMID:33585622 | PMC:PMC7852648 | DOI:10.12998/wjcc.v9.i4.764 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.