Anti-Yo antibody-positive paraneoplastic cerebellar degeneration in a patient with possible cholangiocarcinoma: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Anti-Yo antibody-positive paraneoplastic cerebellar degeneration in a patient with possible cholangiocarcinoma: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4423-4432. doi: 10.12998/wjcc.v9.i17.4423. ABSTRACT BACKGROUND: Paraneoplastic cerebellar degeneration (PCD), which is rare in clinical practice, is closely related to autoimmunity. Cases positive for anti-Yo antibodies (anti-Purkinje cytoplasmic antibody 1) are the main subtype of PCD. PCD is subacute cerebellar degeneration, and while it progresses over weeks to months, its resultant deficits last much longer. Cancer patients with anti-Yo antibody-positive PCD are very rare. Most of them are breast cancer or ovarian cancer patients but also occasionally lung cancer patients. CASE SUMMARY: A 61-year-old woman presented with sudden vertigo, nausea, and vomiting for approximately 10 d. The patient's neurological examination showed torsion with downbeat nystagmus and ataxia of the right limb and trunk. Laboratory examination found that the patient's cerebrospinal fluid and serum were anti-Yo an tibody-positive, positron emission tomography computed tomography showed an increased metabolic rate in the retroperitoneal lymph nodes, and the pathology of lymph node punctures in the retroperitoneum and neck suggested adenocarcinoma of the pancreaticobiliary duct, which strengthens the hypothesis of paraneoplastic origin. Intravenous immunoglobulin (IVIg) 0.4 g/kg/d for 5 d and methylprednisolone 160 mg for 3 d were initiated, which was reduced to 80 mg for 3 d and then to 40 mg for 7 d. After treatment with IVIg and a steroid, the patient's vertigo and ataxia alleviated. CONCLUSION: The patient's vertigo and ataxia alleviated after treatment, suggesting that early immunotherapeutic intervention may have certain value in stopping neurological loss. PMID:34141810 | PMC:PMC8173421 | DOI:10.12998/wjcc.v9.i17.4423 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma: A case report

paythelady.612 shared this article with you from Inoreader Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4244-4252. doi: 10.12998/wjcc.v9.i17.4244. ABSTRACT BACKGROUND: Metastases from pancreas or ampullary malignancies are common, but the spread to testicle and paratesticular tissue is exceedingly rare. To the best of our knowledge, fewer than 30 cases have been reported in the literature. More rarely, metastasis to tunica vaginalis testis occurs without involvement of the testes and epididymis. CASE SUMMARY: A 65-year-old male who complained of painless swelling of the left scrotum for over 1 wk was referred to the Department of Urology. Scrotal ultrasound showed left testicular hydrocele with paratesticular masses. Chest computed tomography revealed lung metastasis and enlarged left supraclavicular lymph node.The blood tumor markersalpha-fetoprotein, human chorionic gonadotropin, and serum lactate dehydrogenase were withinnormal limits.The preoperative diagnosis was left testicular tumor with lung metastasis. Then radical orchidectomy of the left testicle and high ligation of the spermatic cord were performed, and postoperative histopathology suggested metastatic tumors that was confirmed by an abdominal computed tomographic scan. The positive computed tomography findings, in conjunction with the expression of cytokeratin 7 (CK7), CK20, CK5/6, and absence of expression of Wilms' tumor suppressor gene 1, calretinin, melanocyte, prostate-specific antigen, thyroid transcription factor-1, GATA binding protein 3, caudal type homeobox 2, and napsinA supported the diagnosis of pancreatic adenocarcinoma. The outcome of this patient was unsatisfactory, and he died 3 mo later. CONCLUSION: This case suggests that pancreatic metastatic carcinoma must be considered in the differential diagnosis of scrotal enlargement. The advanced age of the patient wassuggestive of a secondary testicular tumor.In addition, careful physical examination and ultrasonography as well as radiologic al examination have become a standard modality. PMID:34141787 | PMC:PMC8173435 | DOI:10.12998/wjcc.v9.i17.4244 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraneural ganglion cyst of the lumbosacral plexus mimicking L5 radiculopathy: A case report

paythelady.612 shared this article with you from Inoreader Intraneural ganglion cyst of the lumbosacral plexus mimicking L5 radiculopathy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4433-4440. doi: 10.12998/wjcc.v9.i17.4433. ABSTRACT BACKGROUND: Intraneural ganglion cysts are benign gelatinous masses that form within the epineurium of a peripheral nerve. Only few cases of intraneural ganglion cyst arising from the hip joint have been reported. CASE SUMMARY: A previously healthy 65-year-old woman who had been experiencing left buttock pain radiating to the dorsum of the foot for 2 years visited our clinic. Prior to visiting the clinic, she underwent lumbar spine magnetic resonance imaging and received physiotherapy, pain killers, and epidural injections based on a presumptive diagnosis of spinal stenosis for 2 years in other hospitals. Repeat magnetic resonance imaging revealed joint connection of the articular branch of the hip joint and rostral extension of the cyst along the L5 spinal nerve near the L5-S1 neural foramen. The patient was diagnosed with intraneural gangl ion cyst arising from the articular branch of the hip joint based on high-resolution magnetic resonance neurography. Using the arthroscopic approach, a cystic opening within the intra-articular space was detected, and cyst decompression was then performed. The pain in the left leg was significantly relieved during the 6-mo follow-up. CONCLUSION: Although intraneural ganglion cysts arising from the hip joint are rare, they can cause typical radicular pain and mimic common L5 radiculopathy. Typical cyst ascent phenomenon starting from the termination of the articular branch on magnetic resonance imaging is a crucial finding indicative of intraneural ganglion cysts arising from the hip joint. PMID:34141811 | PMC:PMC8173415 | DOI:10.12998/wjcc.v9.i17.4433 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Health-related quality of life after gastric cancer treatment in Brazil: Narrative review and reflections

paythelady.612 shared this article with you from Inoreader Health-related quality of life after gastric cancer treatment in Brazil: Narrative review and reflections Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4123-4132. doi: 10.12998/wjcc.v9.i17.4123. ABSTRACT In Brazil, gastric cancer is the third most common type of cancer among men and fifth among women, with an estimated 13360 new cases among men and 7870 among women each year during the 2020-2022 period. This study presents reflections and attempts to add knowledge to the theme of quality of life (QoL) in patients with gastric adenocarcinoma and describes some of its characteristics in three regions of Brazil, with an evaluation of the disease's impacts in various dimensions of life, as reported by the patients themselves. We performed a narrative review of the literature and a data analysis of studies on QoL in Brazilian patients treated for gastric adenocarcinoma from three different cities in three geographic regions: Brasília (the midwest), Jaú (the southeast), and Macapá (the north). PMID:34141775 | PMC:PMC8173417 | DOI:10.12998/wjcc.v9.i17.4123 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of patient education focusing on circadian pain rhythms: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Effectiveness of patient education focusing on circadian pain rhythms: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4441-4452. doi: 10.12998/wjcc.v9.i17.4441. ABSTRACT BACKGROUND: Neuropathic pain management should aim at improving quality of life and daily living activities of patients; therefore, emphasis should be placed on pain management including understanding the pain patterns during daily activity. Therefore, lifestyle guidance should be based on a detailed understanding of pain; however, previous studies commonly evaluated pain intensity at a single point in time. We report a case on patient education intervention based on the relationship between pain circadian rhythms and detailed physical activity during the day. CASE SUMMARY: A man in his 60s, who suffered a brachial plexus injury in a traffic accident, presented with neuropathic pain. Early assessment of the importance of daily living activities to the patient, pain rhythmicity, and physical activity, was performed. The early assessments show ed that the pain intensity was lower on days when more light-intensity physical activity (LIPA) was performed, than on days when less LIPA was performed. Consequently, patient education focused on methods to decrease the pain intensity that tended to worsen in the afternoon, and encouraged behavioral changes by suggesting the patient to take walks," which could be used to maintain LIPA in the afternoon. On reassessment, the afternoon LIPA, which had been the focus of attention, had increased and a change was noted in the circadian rhythm of pain. CONCLUSION: Patient education based on a composite assessment elicited positive results in relation to the pain circadian rhythm and physical activity. PMID:34141812< /a> | PMC:PMC8173436 | DOI:10.12998/wjcc.v9.i17.4441 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Liver injury associated with the use of selective androgen receptor modulators and post-cycle therapy: Two case reports and literature review

paythelady.612 shared this article with you from Inoreader Liver injury associated with the use of selective androgen receptor modulators and post-cycle therapy: Two case reports and literature review Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 6;9(16):4062-4071. doi: 10.12998/wjcc.v9.i16.4062. ABSTRACT BACKGROUND: Muscle growth promoters are being developed for the treatment of disease-induced loss of muscle mass. Ligandrol and ostarine are selective androgen receptor modulators (SARMs) with a non-steroidal structure and a presumably more favorable side effect profile. In recent years, these substances with or without "post-cycle therapy" (PCT) are often misused by amateur athletes aiming to promote muscle growth. At the same time, reports on their toxic effects on organ systems are emerging. CASE SUMMARY: We report two cases of liver injury in young men who used ligandrol and/or ostarine for a few weeks followed by the use of substances for PCT. Acute liver injury occurred in both cases after stopping SARMs while on PCT. The clinical picture was dominated by jaundice and fatigue. The biochemical pattern showed a mixed type of injury with n ormal alkaline phosphatase and high concentrations of bilirubin and serum bile acids. Histological evidence showed predominantly cholestatic injury with canalicular bile plugs, ductopenia, and mild hepatocellular damage without significant fibrosis. The patients recovered from the condition after 3 mo. The off target effects of SARMs were likely idiosyncratic, but our report highlights the yet unrecognized effects of other toxic substances used for PCT, supra-therapeutic doses, and the complete absence of monitoring for adverse effects. CONCLUSION: Among muscle-building amateur athletes, SARMs (ligandrol or ostarine) and/or substances in PCT may cause cholestatic liver injury with prolonged recovery. PMID:3414 1767 | PMC:PMC8180234 | DOI:10.12998/wjcc.v9.i16.4062 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of topical vs intravenous tranexamic acid in reducing blood loss and promoting wound healing in bone surgery: A systematic review and meta-analysis

paythelady.612 shared this article with you from Inoreader Efficacy of topical <em>vs</em> intravenous tranexamic acid in reducing blood loss and promoting wound healing in bone surgery: A systematic review and meta-analysis Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 16;9(17):4210-4220. doi: 10.12998/wjcc.v9.i17.4210. ABSTRACT BACKGROUND: Tranexamic acid (TXA) has been used as an anti-fibrinolytic drug for over half a century and has received much attention in recent decades. AIM: To evaluate the efficacy of topical vs intravenous TXA in reducing blood loss and promoting wound healing in bone surgery. METHODS: From the electronic resources, PubMed, Cochrane Library, Embase, ISI, and Scopus were used to perform a literature search over the last 10 years between 2010 and 2020. EndNote™ X8 was used for managing the electronic resource. Searches were performed with mesh terms. The data were retracted blindly by two independent reviewers. Random effects were used to deal with potential heterogeneity and I 2 showed heterogeneity. Chi-square (I 2) tests were used to quantify the extent of heterogeneity (P < 0.0 1 was considered statistically significant). The efficacy of topical TXA in reducing blood loss and promoting wound healing in bone surgery was compared with intravenous TXA and placebo. RESULTS: According to the research design, 1360 potentially important research abstracts and titles were discovered in our electronic searches, and 18 papers remained in agreement with our inclusion criteria. It was found that TXA reduced 277.51 mL of blood loss compared to placebo, and there was no significant difference between topical TXA and IV TXA in reducing blood loss in bone surgery. Our analyses also showed that TXA significantly reduced blood transfusion compared to placebo and there was no significant difference between topical TXA and IV TXA. CONCLUSION: The use of both topical and intravenous TXA are equally effective in reducing blood loss in bone surgery, which might be beneficial for wound healing after surgery. PMID:34141783 | PMC:PMC8173404 | DOI:10.12998/wjcc.v9.i17.4210 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Advances in the Diagnosis and Treatment of Primary Ciliary Dyskinesia

xlomafota13 shared this article with you from Inoreader Advances in the Diagnosis and Treatment of Primary Ciliary Dyskinesia Via JAMA Otolaryngology–Head & Neck Surgery Online First This review discusses the diagnostic testing for primary ciliary dyskinesia and its potential novel molecular therapeutic targets, with a focus on the otolaryngological manifestations of the disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Early Intervention for the Treatment of Acute Laryngeal Injury After Intubation—Excellent Outcomes With Low Risk?—Reply

xlomafota13 shared this article with you from Inoreader Early Intervention for the Treatment of Acute Laryngeal Injury After Intubation—Excellent Outcomes With Low Risk?—Reply Via JAMA Otolaryngology–Head & Neck Surgery Online First In Reply Aretha et al offer support for our recent observations detailing the importance of early intervention for the treatment of acute laryngeal injury after prolonged mechanical ventilation. In addition, the authors raise several good points that will shape future questions surrounding laryngeal functional recovery after critical illness. Their letter also highlights the inherent limitations involved in a retrospective cohort study. These limitations are salient, as evidenced by their mention and thorough discussion in our initial manuscript. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Early Intervention for the Treatment of Acute Laryngeal Injury After Intubation

xlomafota13 shared this article with you from Inoreader Early Intervention for the Treatment of Acute Laryngeal Injury After Intubation Via JAMA Otolaryngology–Head & Neck Surgery Online First To the Editor We read with great interest the recently published article by Lowery AS et al in JAMA Otolaryngology–Head & Neck Surgery, where it was shown that early intervention for patients with postintubation laryngeal injury was associated with a decreased duration of tracheostomy dependence, a higher rate of decannulation, and fewer surgical procedures compared with late intervention. Patients who underwent early intervention also avoided open reconstruction. We appreciate the important information presented in this study and we wish to comment on some associated issues. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasal Mass in a Middle-aged Woman With Multiple Myeloma and Recurrent Fungal Sinusitis

xlomafota13 shared this article with you from Inoreader Nasal Mass in a Middle-aged Woman With Multiple Myeloma and Recurrent Fungal Sinusitis Via JAMA Otolaryngology–Head & Neck Surgery Online First A woman in her 50s with multiple myeloma and persistent sinus mucormycosis is admitted with new left-sided nasal congestion, facial pain, and cheek numbness, and a nasal mass is found. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perineural Spread of Melanoma Into the Orbit With Inflammatory Response and Nonsurgical Treatment

xlomafota13 shared this article with you from Inoreader Perineural Spread of Melanoma Into the Orbit With Inflammatory Response and Nonsurgical Treatment Via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a patient with glabellar melanoma who was previously treated with immune-therapy and presented with perineural spread recurrence with inflammatory features associated with prior immune-therapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.