World Journal of Clinical Cases最新文献

{"title":"Dystrophic epidermolysis bullosa caused by novel frameshift mutation in the <i>COL7A1</i> gene: A case report.","authors":"Yan Yang, Zhi-Wei Guan, Qin-Feng Li","doi":"10.12998/wjcc.v13.i11.99256","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.99256","url":null,"abstract":"<p><strong>Background: </strong>Dystrophic epidermolysis bullosa is characterized by fragile ulcerations of the skin caused by mutations in specific genes. However, genetic typing of this condition is rare.</p><p><strong>Case summary: </strong>An 11-year-old female suffered from recurrent fever, visible ulcerations of the entire skin, and severe malnutrition. Genetic testing revealed a frameshift mutation in the coding region 4047 of the 35^th intron region of <i>COL7A1</i>, and she was diagnosed as malnutrition-type epidermolysis bullosa. Drug therapy (immunoglobulin, fresh frozen plasma), topical therapy (silver ion dressing), fever reduction, cough relief, and promotion of gastrointestinal peristalsis are mainly used for respiratory and gastrointestinal complications. The patient's condition improved after treatment.</p><p><strong>Conclusion: </strong>Dystrophic epidermolysis bullosa caused by a new framework shift mutation in <i>COL7A1</i> should be taken seriously.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"99256"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021701","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":"Hepatic hemangiomas mimicking gastrointestinal stromal tumors: A case report.","authors":"Ji-Ze Wang, Hao Chen","doi":"10.12998/wjcc.v13.i11.101668","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.101668","url":null,"abstract":"<p><strong>Background: </strong>Hepatic hemangiomas can be challenging to diagnose, particularly when they present with atypical features that mimic other conditions, such as gastrointestinal stromal tumors (GISTs). This case highlights the diagnostic difficulties encountered when imaging subepithelial lesions, especially when conventional methods such as computed tomography (CT) and endoscopic ultrasound (EUS) are used.</p><p><strong>Case summary: </strong>A 44-year-old woman presented with intermittent abdominal distension and heartburn for three months. Her medical history included iron deficiency anemia, menorrhagia, and previous cholecystectomy. One week prior to admission, an endoscopy suggested a bulging gastric fundus, which was likely a GIST, along with chronic nonatrophic gastritis and bile reflux. CT and EUS revealed nodules in the gastric fundus, which were initially considered benign tumors with a differential diagnosis of stromal tumor or leiomyoma. During surgery, unexpected lesions were found in the liver pressing against the gastric fundus, leading to laparoscopic liver resection. Postoperative pathology confirmed the diagnosis of hepatic cavernous hemangiomas. The patient recovered well and was discharged five days later, with normal follow-up results at three months.</p><p><strong>Conclusion: </strong>This case underscores the challenges in the preoperative diagnosis of GISTs, particularly the limitations of the use of CT and EUS for the evaluation of subepithelial lesions. While CT is the primary tool for visualizing abdominal tumors, it is difficult to detect smaller lesions and assess the layers of the gastrointestinal wall on CT. EUS is recommended for the evaluation of nodules smaller than 2 cm and is useful for distinguishing GISTs from other lesions; however, its accuracy with regard to the differential diagnosis is relatively low. In this case, the gastric distension observed on imaging led to the compression of a liver tumor against the stomach, resulting in the misinterpretation of the tumor as a gastric wall lesion.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"101668"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029958","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":"Parietal peritoneal hernia after abdominal hysterectomy for forty years: A case report.","authors":"Ya-Chen Chou","doi":"10.12998/wjcc.v13.i11.98570","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.98570","url":null,"abstract":"<p><strong>Background: </strong>Internal hernia is a rare complication following abdominal surgery, primarily resulting from structural defects caused by anastomosis. We report a unique case of a late abdominal wall internal hernia highly suspected as resulting from insufficient peritoneal closure.</p><p><strong>Case summary: </strong>A 72-year-old woman presented with symptoms of intestinal obstruction 40 years after undergoing an abdominal hysterectomy. Abdominal computed tomography revealed a suspicious closed loop of intestine; then, a laparotomy was performed for suspected internal hernia. During the procedure, herniation of intestine into the preperitoneal space through a parietal peritoneal defect between rectus abdominis and sigmoid colon was identified. Intestinal reduction, resection of the ischemic segment and closure of the peritoneal defect were performed. The patient recovered well.</p><p><strong>Conclusion: </strong>Non-closure of peritoneum might lead to late internal hernias. Meticulous peritoneal closure should be considered to prevent this potentially lethal complication.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"98570"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026921","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":"Nipah virus: Preventing the next outbreak.","authors":"Satvik Tyagi, Shalini Upadhyay, Tanisha Bharara, Sanjeev Sahai","doi":"10.12998/wjcc.v13.i11.99748","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.99748","url":null,"abstract":"<p><p>Nipah is a deadly viral infection which has come to the news highlight recently, due to its fresh onslaught in Southern India. As the world continues to recover from coronavirus disease 2019, the World Health Organization has identified a list of high-priority pathogens with the potential to cause future pandemics. Among them is the Nipah virus (NiV), which poses a significant threat. Even a small outbreak could trigger widespread panic among the public. The emergence and re-emergence of NiV among other zoonotic infections is a stern reminder of the importance of One health concept.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"99748"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038448","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":"High-grade pancreatic intraepithelial neoplasia: A commentary of magnetic resonance cholangiopancreatography findings.","authors":"Alessandro Posa, Enza Genco","doi":"10.12998/wjcc.v13.i11.98854","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.98854","url":null,"abstract":"<p><p>Commentary on the role of magnetic resonance cholangiopancreatography findings in diagnosing high grade pancreatic intraepithelial neoplasms.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"98854"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049513","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":"Rapid improvement in postpartum pulmonary hypertension associated with hereditary hemorrhagic telangiectasia: A case report and review of literature.","authors":"Sheng-Yu Hao, Yaxiaerjiang Muhetaer, Xin Zheng, Yu-Liang Long, Jie-Qiong Song, Ming Zhong","doi":"10.12998/wjcc.v13.i11.98128","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.98128","url":null,"abstract":"<p><strong>Background: </strong>Postpartum pulmonary arterial hypertension (PAH) complicated with hereditary hemorrhagic telangiectasia (HHT) is a rare condition. Diagnosing and treating PAH in patients with HHT can be challenging. To the best of our knowledge, no previous reports have investigated the efficacy of pulmonary vasodilators in improving hemodynamics in postpartum patients with this disease.</p><p><strong>Case summary: </strong>In this paper, we report a postpartum case of HHT combined with PAH, presenting with worsening dyspnea. Genetic testing revealed that the patient carried a heterozygous variant of activin receptor-like kinase 1. The patient received various treatments, including diuretics, anticoagulants, sildenafil, macitentan, inhalation of nitric oxide, and iloprost. Changes in PaO₂/FiO₂, pulmonary artery systolic pressure as assessed by echocardiography, and N-terminus pro-brain natriuretic peptide levels suggested that, except for iloprost inhalation, the other treatments appeared to have limited efficacy.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first report on efficacy of pulmonary vasodilators in postpartum patients with HHT and PAH.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"98128"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030584","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":"Predicting outcomes using neural networks in the intensive care unit.","authors":"Gumpeny R Sridhar, Venkat Yarabati, Lakshmi Gumpeny","doi":"10.12998/wjcc.v13.i11.100966","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.100966","url":null,"abstract":"<p><p>Patients in intensive care units (ICUs) require rapid critical decision making. Modern ICUs are data rich, where information streams from diverse sources. Machine learning (ML) and neural networks (NN) can leverage the rich data for prognostication and clinical care. They can handle complex nonlinear relationships in medical data and have advantages over traditional predictive methods. A number of models are used: (1) Feedforward networks; and (2) Recurrent NN and convolutional NN to predict key outcomes such as mortality, length of stay in the ICU and the likelihood of complications. Current NN models exist in silos; their integration into clinical workflow requires greater transparency on data that are analyzed. Most models that are accurate enough for use in clinical care operate as 'black-boxes' in which the logic behind their decision making is opaque. Advances have occurred to see through the opacity and peer into the processing of the black-box. In the near future ML is positioned to help in clinical decision making far beyond what is currently possible. Transparency is the first step toward validation which is followed by clinical trust and adoption. In summary, NNs have the transformative ability to enhance predictive accuracy and improve patient management in ICUs. The concept should soon be turning into reality.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"100966"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002538","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":"Exercise rehabilitation on patients with non-small cell lung cancer: A meta-analysis of randomized controlled trials.","authors":"Sheng-Hui Xu, Hong Xu, Kai-Wen Xiao, Su-Jie Mao","doi":"10.12998/wjcc.v13.i11.100161","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.100161","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is one of the most common and deadly cancers worldwide. As the disease progresses and due to the side effects of treatment, patients' physical activity significantly decreases.</p><p><strong>Aim: </strong>To systematically review and conduct a meta-analysis on the effects of exercise rehabilitation on the physical activity of lung cancer patients and determine the best implementation methods to provide clinical guidance.</p><p><strong>Methods: </strong>Literature was searched through multiple electronic databases. A random effects model was used to combine effect sizes through standardized mean difference (SMD). The Cochrane risk of bias tool was used to assess the quality of the literature, sensitivity analysis was used to ensure the robustness of the results, and Egger's test was used to detect publication bias and asymmetry.</p><p><strong>Results: </strong>A total of 11 studies involving 541 patients were included in this study. The physical endurance, muscle function and cardiopulmonary function of non-small cell lung cancer (NSCLC) patients were evaluated. The overall effect size of the six-minute walk test (6MWT) was not statistically significant. However, subgroup analysis found that endurance significantly improved when exercise duration exceeded 0.5 hours (<i>P ≤</i> 0.05). In terms of muscle function, the overall effect size was SMD = 0.619. Subgroup analysis showed that strength training, respiratory training, and cross-training (XT) significantly improved muscle function. Exercise rehabilitation significantly enhanced cardiopulmonary endurance (SMD = 0.856, <i>P =</i> 0.002), and the effect was better when the single exercise duration was more than 1 hour, age was over 65 years, and the intervention period was more than 3 months.</p><p><strong>Conclusion: </strong>Exercise rehabilitation effectively improved muscle function in NSCLC patients, especially strength training, respiratory training, and cross-training. Cardiopulmonary function also showed improvement, particularly when exercise duration exceeded 1 hour, age was ≥ 65 years, and the intervention period was more than 3 months. A single exercise duration of more than 0.5 hours can enhance patients' physical endurance. Appropriately increasing exercise duration and selecting suitable exercise forms can effectively improve the physical activity of NSCLC patients.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"100161"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050675","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":"Treatment of thymoma with low-dose glucocorticoids before surgery for significant tumor shrinkage: A case report.","authors":"Jin-Kun Yao, Zi-Yi He, Zheng Zhu, Hai-Tao Huang","doi":"10.12998/wjcc.v13.i11.98979","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.98979","url":null,"abstract":"<p><strong>Background: </strong>Thymic epithelial neoplasms are rare malignant neoplasms originating in the thymus gland. There have been case reports of patients with advanced thymomas treated with a methylprednisolone pulse or with glucocorticoid (GCs) shock before surgery, followed by surgical treatment, all of whom achieved good results. The effect of GCs on thymomas is related mainly to the action on GC receptors in thymic lymphocytes and epithelial cells. GC receptor expression has been associated with a better prognosis in patients with thymomas, including those with surgically removed thymomas.</p><p><strong>Case summary: </strong>We report a case of a patient with thymoma who had a significant response to preoperative low-dose GC therapy. A mediastinal tumor was detected in the patient <i>via</i> computerized tomography upon admission. The tumor was initially suspected to be a thymic tumor, but lymphoma could not be ruled out. The tumor shrank significantly after low-dose (5 mg/day) GC therapy. Thoracoscopic thymoma resection was performed after puncture pathology was confirmed. The patient recovered well after the operation and is currently performing well with no recurrence of the tumor.</p><p><strong>Conclusion: </strong>This case highlights that low-dose GCs are effective in the treatment of thymomas, and we believe that GCs should be applied more frequently and studied more thoroughly in the treatment of thymomas.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"98979"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043254","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":"Utilizing complementary therapy to enhance quality of life and reduce stress and fatigue in pediatric cancer patients.","authors":"Luis Carlos Lopes-Júnior, Regina Aparecida Garcia de Lima","doi":"10.12998/wjcc.v13.i11.98013","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i11.98013","url":null,"abstract":"<p><p>The international scientific literature presents still incipient results regarding the management of cancer symptom clusters by oncology nursing, especially in pediatric oncology. This is a promising field of investigation for clinical nurses and researchers, and when it is subsidized by medium-range theories, they corroborate the diagnoses and interventions of nursing in oncology, enhancing the science of nursing care. This minireview article aims to discuss the utilizing the hospital clowns as a complementary therapy, to enhance quality of life and reduce stress and fatigue in pediatric cancer patients. Overall, the evidence presented so far pointed out that complementary therapy might help improve the quality of life of pediatric cancer patients, and that complementary therapy usage should be part of a health comprehensive care model, delivering therapeutic approaches that might enhance the mind-body during a pediatric cancer patients' life span. The results of scientific investigations by nurses, particularly those linked to the basic sciences, play a critical role in advancing personalized care in pediatric integrative oncology.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 11","pages":"98013"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026923","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}