World Journal of Clinical Cases最新文献

{"title":"Incidental renal cell carcinoma post bilateral nephrectomy in autosomal dominant polycystic kidney disease.","authors":"Min-Ho Shin, Nam-Kyu Choi","doi":"10.12998/wjcc.v12.i28.6187","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6187","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) is more common in patients with autosomal dominant polycystic kidney disease (ADPKD) than in the general population. Diagnosing RCC in ADPKD is challenging due to the presence of multiple renal cysts, often leading to delays and difficulties in distinguishing RCC from cyst infection or hemorrhage.</p><p><strong>Aim: </strong>To analyze the prevalence and characterize the clinical features of RCC in patients with ADPKD undergoing simultaneous bilateral native nephrectomy.</p><p><strong>Methods: </strong>Between May 2017 and April 2024, 19 ADPKD patients undergoing hemodialysis and awaiting kidney transplantation due to end-stage renal disease (ESRD) underwent bilateral nephrectomies in a single center. Parameters such as patient characteristics, intraoperative blood loss, blood transfusion volume, length of hospital stay, and postoperative complications were documented. Pathological findings for RCC were reviewed.</p><p><strong>Results: </strong>A total of 38 kidneys were excised from 19 patients, with a mean age of 56.8 years and an average hemodialysis duration of 84.2 months. Eight patients underwent open nephrectomies, and 11 underwent hand-assisted laparoscopic nephrectomies. RCC was detected in 15.8% of kidneys, affecting 21.1% of patients. Two patients had multifocal RCC in both kidneys. All RCC cases were pT1 stage, with the largest lesion averaging 16.5 mm in diameter. The average operative duration was 120 minutes, with intraoperative blood loss averaging 184.2 mL. Five patients required blood transfusions. Postoperative complications occurred in five patients, with a mean hospital stay of 17.1 days. The mean follow-up period was 28.1 months.</p><p><strong>Conclusion: </strong>The prevalence of RCC is higher in patients with ADPKD with ESRD than in those with ESRD alone. Thus, clinicians should be cautious and implement surveillance programs to monitor the development of RCC in patients with ADPKD, particularly those on dialysis.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent multisystem Langerhans cell histiocytosis involving the female genitalia: A case report.","authors":"Chun-Yan Yuan, Zhi-Rong Zhang, Ming-Fang Guo, Na Zhang","doi":"10.12998/wjcc.v12.i28.6222","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6222","url":null,"abstract":"<p><strong>Background: </strong>Langerhans cell histiocytosis (LCH) is a histiocytic proliferative disease caused by clonal proliferation of Langerhans cells, which is currently defined as an inflammatory myeloid tumor. It is rare in adults, with an incidence of 1-2 per million, and is highly heterogeneous in clinical presentation, with unpredictable disease progression and outcome.</p><p><strong>Case summary: </strong>A 52-year-old postmenopausal female patient presented to the gynecology department in July 2023 with bilateral vulvar masses. She was diagnosed with recurrent multisystem LCH. The patient had previously been diagnosed with a single-system and single-focal LCH in October 2021 due to a right maxillofacial mass, which resolved after surgical treatment. A chemotherapy regimen was developed after multidisciplinary consultation. Six cycles of chemotherapy resulted in partial remission, and maintenance chemotherapy is currently being administered.</p><p><strong>Conclusion: </strong>Recurrent LCH involving the bilateral vulva has been poorly reported. Comprehensive imaging and pathological evaluation is important for diagnosis. The model of joint multidisciplinary specialist diagnosis and treatment is worthy of clinical application.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-expanding metal stent for relieving the stricture after endoscopic injection for esophageal varices.","authors":"Fu-Long Zhang, Jing Xu, Yu-Hong Jiang, Yuan-Dong Zhu, Yan Shi, Xiao Li, Hai Wang, Chao-Jun Huang, Chun-Hua Zhou, Qun Zhu, Jing-Wen Chen","doi":"10.12998/wjcc.v12.i28.6180","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6180","url":null,"abstract":"<p><strong>Background: </strong>Esophageal stricture is one of the complications after esophageal varices sclerotherapy injection (ESI), and the incidence rate is between 2%-10%.</p><p><strong>Aim: </strong>To explore the efficacy of self-expanding metal stent (SEMS) for the stricture after endoscopic injection with cyanoacrylate (CYA) and sclerotherapy for esophageal varices.</p><p><strong>Methods: </strong>We retrospectively analyzed the efficacy of SEMS to improve the stricture after endoscopic injection with CYA and sclerotherapy for esophageal varices in 4 patients from February 2023 to June 2023.</p><p><strong>Results: </strong>The strictures were improved in four patients after stenting. The stent was removed after two weeks because of chest pain with embedding into esophageal mucosa in one patient. The stent was removed after one month, however, the stent was reinserted because of the strictures happening again in two patients. The stent was removed after three months, however, the stent was reinserted because of the strictures happening again in one patient. The stent embedded into esophageal mucosa in three patients. There were 3 patients suffered reflux esophagitis, and the acid reflux was relieved by taking hydrotalcite. There was no other complication of esophageal perforation, bleeding from varices or infection.</p><p><strong>Conclusion: </strong>SEMS may relieve the stricture which happened after endoscopic injection with CYA and sclerotherapy for esophageal varices. However, when we should remove the stent still needs to be explored.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluating the necessity of routine laboratory monitoring during isotretinoin therapy for acne.","authors":"Yun-Xia Zhu, Liang Wu, Sheng-Cai Zhu, Xiu-Ping Wang, Deng Zhang, Yan-Ping Tan, Xiao-Liang Ouyang, Chun-Ming Li","doi":"10.12998/wjcc.v12.i28.6237","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6237","url":null,"abstract":"<p><p>In this letter, we discuss the topic of necessity of routine laboratory monitoring during isotretinoin treatment for acne. According to Park and colleagues, it is advisable to monitor the levels of triglycerides, alanine aminotransferase, and aspartate aminotransferase every 5 to 6 months. Additionally, the levels of total cholesterol and low-density lipoprotein should be checked within the first two months of treatment. Isotretinoin is a commonly prescribed agent mainly used to treat acne. Despite its high effectiveness, it necessitates regular monitoring of laboratory parameters due to its side effect profile. Currently, there remains a lack of consensus on the appropriate frequency for monitoring these parameters during treatment with isotretinoin. This letter will provide insight into this complex and controversial topic. Based on existing literature, we concluded that the incidence of changes in lipid and liver aminotransferase levels during isotretinoin treatment for acne was low and likely clinically insignificant. For generally healthy people, we recommend testing lipid and liver profiles once at baseline and a second time at the peak dosage. However, frequent testing might still be beneficial in certain populations of patients.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversion therapy for hepatocellular carcinoma to improve treatment strategies for intermediate and advanced stages.","authors":"Antonio Giorgio, Massimo De Luca","doi":"10.12998/wjcc.v12.i28.6241","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6241","url":null,"abstract":"<p><p>This manuscript is based on a case reported by Song <i>et al</i> published in the <i>World Journal of Clinical Cases</i>. Several challenges remain in the field of hepatocellular carcinoma (HCC) conversion therapy. Consequently, only a limited number of patients with HCC accompanied by portal vein tumor thrombosis (PVTT) and hepatic vein tumor thrombosis (HVTT) are eligible for resection. This clinical case demonstrates that considering the complexity of the disease, a multimodal and multidisciplinary approach is essential for managing HCC accompanied by PVTT and HVTT. However, the outcomes of such surgeries remain controversial. In conclusion, research on HCC conversion therapy is extremely useful for improving treatment strategies for intermediate and advanced HCC, which currently have disappointing clinical outcomes.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke: Evolution of newer treatment modalities for acute ischemic stroke.","authors":"Deb Sanjay Nag, Amlan Swain, Seelora Sahu, Biswajit Sen, Vatsala, Sadiya Parween","doi":"10.12998/wjcc.v12.i28.6137","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6137","url":null,"abstract":"<p><p>Acute ischemic stroke is one of the leading causes of morbidity and mortality worldwide. Restoration of cerebral blood flow to affected ischemic areas has been the cornerstone of therapy for patients for eligible patients as early diagnosis and treatment have shown improved outcomes. However, there has been a paradigm shift in the management approach over the last decade, and with the emphasis currently directed toward including newer modalities such as neuroprotection, stem cell treatment, magnetic stimulation, anti-apoptotic drugs, delayed recanalization, and utilization of artificial intelligence for early diagnosis and suggesting algorithm-based management protocols.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden army within: Harnessing the microbiome to improve cancer treatment outcomes.","authors":"Ippokratis Messaritakis, Georgios Vougiouklakis, Asimina Koulouridi, Aris P Agouridis, Nikolaos Spernovasilis","doi":"10.12998/wjcc.v12.i28.6159","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6159","url":null,"abstract":"<p><p>The gut microbiome has emerged as a critical player in cancer pathogenesis and treatment response. Dysbiosis, an imbalance in the gut microbial community, impacts tumor initiation, progression, and therapy outcomes. Specific bacterial species have been associated with either promoting or inhibiting tumor growth, offering potential targets for therapeutic intervention. The gut microbiome influences the efficacy and toxicity of conventional treatments and cutting-edge immunotherapies, highlighting its potential as a therapeutic target in cancer care. However, translating microbiome research into clinical practice requires addressing challenges such as standardizing methodologies, validating microbial biomarkers, and ensuring ethical considerations. Here, we provide a comprehensive overview of the gut microbiome's role in cancer highlighting the need for ongoing research, collaboration, and innovation to harness its full potential for improving patient outcomes in oncology. The current editorial aims to explore these insights and emphasizes the need for standardized methodologies, validation of microbial biomarkers, and interdisciplinary collaboration to translate microbiome research into clinical applications. Furthermore, it underscores ethical considerations and regulatory challenges surrounding the use of microbiome-based therapies. Together, this article advocates for ongoing research, collaboration, and innovation to realize the full potential of microbiome-guided oncology in improving patient care and outcomes.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pituitary metastasis from lung adenocarcinoma.","authors":"Xue-Jian Wang","doi":"10.12998/wjcc.v12.i28.6155","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6155","url":null,"abstract":"<p><p>Pituitary tumor is a common neuroendocrine tumor, but there are also rare clinical metastases at this site, which are generally transferred from extrabellar tumors. Although the clinical incidence is low, the prognosis is poor. The purpose of this editorial is to discuss further the relevant knowledge of pituitary metastases and remind clinicians to prevent missed diagnosis and improve the prognosis of these patients.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.","authors":"Hong-Zhuan Chen, Yi Gao, Ke-Ke Li, Li An, Jing Yan, Hong Li, Jin Zhang","doi":"10.12998/wjcc.v12.i28.6195","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6195","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Following cesarean section, a significant number of women encounter moderate to severe pain. Inadequate management of acute pain post-cesarean section can have far-reaching implications, adversely impacting maternal emotional well-being, daily activities, breastfeeding, and neonatal care. It may also impede maternal organ function recovery, leading to escalated opioid usage, heightened risk of postpartum depression, and the development of chronic postoperative pain. Both the Chinese Enhanced Recovery After Surgery (ERAS) guidelines and the American ERAS Society guidelines consistently advocate for the adoption of multimodal analgesia protocols in post-cesarean section pain management. Esketamine, functioning as an antagonist of the N-Methyl-D-Aspartate receptor, has been validated for pain management in surgical patients and has exhibited effectiveness in depression treatment. Research has suggested that incorporating esketamine into postoperative pain management &lt;i&gt;via&lt;/i&gt; pain pumps can lead to improvements in short-term depression and pain outcomes. This study aims to assess the efficacy and safety of administering a single dose of esketamine during cesarean section.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 315 women undergoing elective cesarean section under combined spinal-epidural anesthesia were randomized into three groups: low-dose esketamine (0.15 mg/kg), high-dose esketamine (0.25 mg/kg), and control (saline). Postoperative Visual Analog Scale (VAS) scores were recorded at 6 hours, 12 hours, 24 hours, and 48 hours. Edinburgh Postnatal Depression Scale (EPDS) scores were noted on 2 days, 7 days and 42 days. Ramsay sedation scores were assessed at specified intervals post-injection. Postoperative adverse reactions were also recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Low-dose group and high-dose group compared to control group, had significantly lower postoperative VAS pain scores at 6 hours 12 hours, and 24 hours (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), with reduced analgesic usage (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). EPDS scores and postpartum depression rates were significantly lower on 2 days and 7 days (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). No significant differences in first exhaust and defecation times were observed (&lt;i&gt;P&lt;/i&gt; &gt; 0.05), but ambulation times were shorter (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Ramsay scores were higher at 5 minutes, 15 minutes, and upon room exit (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Low-dose group and high-dose group had higher incidences of hallucination, lethargy, and diplopia within 2 hours (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), and with low-dose group had lower incidences of hallucination, lethargy, and diplopia than high-dose group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Esketamine enhances analgesia and postpartum recovery; a 0.15 mg/kg dose is optimal for cesarean sections, balancing effi","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early pirfenidone treatment enhances lung function in idiopathic pulmonary fibrosis patients.","authors":"Jin-Wei Zhang","doi":"10.12998/wjcc.v12.i28.6247","DOIUrl":"https://doi.org/10.12998/wjcc.v12.i28.6247","url":null,"abstract":"<p><p>This editorial comments on the study by Lei <i>et al</i> investigating the efficacy of early treatment with pirfenidone on the lung function of patients with idiopathic pulmonary fibrosis (IPF) published. This study evaluates the efficacy of early treatment with pirfenidone on lung function in patients with IPF. The early and advanced stages of IPF are defined, highlighting the drug's benefits. While prior research indicates pirfenidone's effectiveness in advanced IPF, this study focuses on its advantages in early stages. The study emphasizes the importance of computed tomography imaging alongside biochemical data and lung function tests for a comprehensive analysis of symptom relief. Results show that early intervention with pirfenidone significantly reduces disease progression and preserves lung function, underscoring its potential as a critical treatment strategy in early IPF.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}