Anti-tumor effect of statin on pancreatic adenocarcinoma: From concept to precision medicine

paythelady.612 shared this article with you from Inoreader Anti-tumor effect of statin on pancreatic adenocarcinoma: From concept to precision medicine Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4500-4505. doi: 10.12998/wjcc.v9.i18.4500. ABSTRACT A statin is a cholesterol-lowering agent, which inhibits HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase and subsequently reduces the cholesterol precursor, and was first used commercially in 1987. The concept of cholesterol restriction leading to cancer cell dysfunction was proposed in 1992. The interruption of different signaling pathways has been proved in preclinical experiments to elucidate the anti-tumor mechanism of statins in pancreatic adenocarcinoma. Observational studies have shown that the clinical use of statins is beneficial in patients with pancreatic adenocarcinoma, including a chemoprevention effect, post-surgical resection follow-up and therapeutic prognosis of advanced cancer stage. Arrest of the cancer cell cycle by the combined use of gemcitabine and statin was observed in a cell line study. The effect of microbiota on the tumor microenvironment of pancreatic adenocarcinoma is a new therapeutic approach as statins can modulate the gut microbiota. Hence, further randomized trials of statins in pancreatic adenocarcinoma treatment will be warranted with application of precision medicine from microbiota-derived, cell cycle-based and signaling pathway-targeted research. PMID:34222418 | PMC:PMC8223840 | DOI:10.12998/wjcc.v9.i18.4500 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of combination of localized closure, ethacridine lactate dressing, and phototherapy in treatment of severe extravasation injuries: A case series

paythelady.612 shared this article with you from Inoreader Efficacy of combination of localized closure, ethacridine lactate dressing, and phototherapy in treatment of severe extravasation injuries: A case series Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4599-4606. doi: 10.12998/wjcc.v9.i18.4599. ABSTRACT BACKGROUND: The management of severe extravasation injuries is still controversial. Extravasation injuries can be treated in many ways. AIM: To present a series of patients with severe extravasation injuries due to infusion who were managed with ethacridine lactate dressing combined with localized closure and phototherapy. METHODS: In this study, we evaluated the data of eight patients, including six from the Department of Burn, one (with colorectal carcinoma) from the Veteran Cadre Department, and one (with leukemia) from the Hematology Department. Of these, three patients were male and five were female. Age of the patients ranged from 10 mo to 72 years, including two children (10 and 19 mo of age). In this study, the infusion was stopped immediately when the extravasation was identified. The extravasation event was managed routinely using a blocking solution. A ring-shaped localized closure was performed using the blocking agents. Moreover, ethacridine lactate dressing and phototherapy were applied for 3-5 d. RESULTS: In this study, the drugs contained in the infusates were iodixanol, norepinephrine, alprostadil, amino acids, fat emulsion, cefoselis, cefoxitin, and potassium chloride + concentrated sodium chloride. All of the patients achieved complete healing after treatment and no obvious adverse reactions were observed. CONCLUSION: The treatment of severe extravasation injuries using a combination of localized closure, ethacridine lactate dressing, and phototherapy resulted in satisfactory outcomes in patients. PMID:34222426 | PMC:PMC8223846 | DOI:10.12998/wjcc.v9.i18.4599 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Central pontine myelinolysis mimicking glioma in diabetes: A case report

paythelady.612 shared this article with you from Inoreader Central pontine myelinolysis mimicking glioma in diabetes: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4837-4843. doi: 10.12998/wjcc.v9.i18.4837. ABSTRACT BACKGROUND: Central pontine myelinolysis (CPM) usually occurs during rapid correction of serum osmolality, typically with brainstem lesions presenting uniform signals following enhancement on magnetic resonance imaging (MRI). We report a case of CPM caused by diabetes, which was characterized by glioma-like imaging features and the patient responded well to corticosteroids. CASE SUMMARY: A 49-year-old man with type 2 diabetes was admitted due to numbness and weakness for 6 mo with progressive aggravation for 2 wk. His complete blood count, serum electrolytes, renal and liver function parameters were within the normal range. MRI showed mass lesions in the brainstem, with unusually inhomogeneous signal intensity after contrast-enhanced scans. His symptoms worsened after hypoglycemic therapy. Due to his clinical history and examination results, CPM was considered the most likely diagnosis. Treatment with corticosteroids was administered with a methylprednisolone pulse in the acute phase followed by dose tapering. During the 8-mo follow-up period, his clinical symptoms and imaging features significantly improved. CONCLUSION: Diabetes could rarely be accompanied by CPM, and patients who experience this neurological complication could benefit from corticosteroid treatment. Clinicians should recognize the special relationship between diabetes and CPM, and improve awareness of early identification and appropriate treatment. PMID:34222456 | PMC:PMC8223854 | DOI:10.12998/wjcc.v9.i18.4837 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Microscopic transduodenal excision of an ampullary adenoma: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Microscopic transduodenal excision of an ampullary adenoma: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4844-4851. doi: 10.12998/wjcc.v9.i18.4844. ABSTRACT BACKGROUND: Transduodenal local excision is an alternative treatment approach for benign ampullary tumors. However, this procedure has technical difficulties, especially during reconstruction of the pancreaticobiliary ducts. An operating microscope has been widely used by surgeons for delicate surgery due to its major advantages of magnification, illumination, and stereoscopic view. The application of an operating microscope in transduodenal excision of ampullary tumors has not been reported. CASE SUMMARY: A 55-year-old woman was admitted for investigation of recurrent upper abdominal pain. Physical examination and laboratory tests found no abnormalities. Imaging identified a large mass in the descending part of the duodenum. Esophagogastroduodenoscopy revealed a 3.5-cm-sized villous growth over the major duodenal papilla. Pathology of the e ndoscopic biopsy indicated a villous adenoma with low-grade dysplasia. Microscopic transduodenal excision of the ampullary tumor was performed. The final pathological diagnosis was villous-tubular adenoma with low-grade dysplasia. The patient was discharged on postoperative day 12 after an uneventful recovery. Endoscopic retrograde cholangiopancreatography was performed 3 mo postoperatively and showed no bile duct or pancreatic duct strictures and no tumor recurrence. The patient is continuing follow-up at our clinic and remains well. CONCLUSION: Operating microscope-assisted transduodenal local excision is a feasible and effective option for benign ampullary tumors. PMID:34222457 | PMC:PMC8223850 | DOI:10.12998/wjcc.v9.i18.4844 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical outcomes and 5-year follow-up results of keratosis pilaris treated by a high concentration of glycolic acid

paythelady.612 shared this article with you from Inoreader Clinical outcomes and 5-year follow-up results of keratosis pilaris treated by a high concentration of glycolic acid Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4681-4689. doi: 10.12998/wjcc.v9.i18.4681. ABSTRACT BACKGROUND: Keratosis pilaris is a hereditary abnormal keratosis of the hair follicle orifice. Gray-brown keratotic plugs in the pores and dark red keratotic papules at the openings of hair follicles can be seen, which contain coiled hair and are often accompanied by perifollicular erythema and pigmentation. Glycolic acid can correct the abnormalities of hair follicular duct keratosis and eliminate excessive accumulation of keratinocytes. It also promotes skin metabolism and accelerates the melanin metabolism. The therapeutic effect is related to the glycolic acid concentration. AIM: To evaluate the efficacy and safety of a high concentration of glycolic acid in the treatment of keratosis pilaris, and to observe the outcomes at 5-year of follow-up. METHODS: Twenty-five participants were recruited and areas with typical keratosis pilari s were selected as testing sites. High concentrations of glycolic acid (50% or 70%) were applied to a circular area (d = 8 cm, S = 50 cm2) and repeated four times, on days 0, 20, 40 and 60. Before each treatment and 20 d after the last treatment, on days 0, 20, 40, 60, and 80 and at a 5-year follow-up, The number of follicular keratotic papules were counted and the extent of perifollicular erythema and pigmentation was determined. At the same time, the participants provided subjective evaluations of treatment efficacy and safety. RESULTS: Treatment effectiveness was indicated by the percentage of keratotic papules in the test site, on days 20, 40, 60 and 80, which were 8%, 12%, 36%, and 60%, respectively. Compared with day 0, each difference was significant (P < 0.05). Compared with day 0, differences in melanin content (M) in the skin and skin lightness (L) on days 40, 60 and 80, the were statistically significant (P < 0.05); skin hemoglobin con tent (E) on days 60 and 80 was statistically different as compared with before treatment (P < 0.05). There were no significant differences in the number of keratotic papules, M, L, and E in 9 participants at the 5-year follow-up compared with before treatment (P > 0.05%). CONCLUSION: A high concentration of glycolic acid significantly improved skin roughness as well as follicular hyperpigmentation of patients with keratosis pilaris. The treatment was relatively safe, but there was no significant difference at the 5-year follow-up compared to before treatment. PMID:34222434 | PMC:PMC8223817 | DOI:10.12998/wjcc.v9.i18.4681 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Growth hormone cocktail improves hepatopulmonary syndrome secondary to hypopituitarism: A case report

paythelady.612 shared this article with you from Inoreader Growth hormone cocktail improves hepatopulmonary syndrome secondary to hypopituitarism: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4852-4858. doi: 10.12998/wjcc.v9.i18.4852. ABSTRACT BACKGROUND: Metabolic associated fatty liver disease frequently occurs in patients with hypopituitarism and growth hormone (GH) deficiency. Some patients may develop to hepatopulmonary syndrome (HPS). HPS has a poor prognosis and liver transplantation is regarded as the only approach to cure it. CASE SUMMARY: A 29-year-old man presented with progressive dyspnea for 1 mo. At the age of 10 years, he was diagnosed with panhypopituitarism associated with pituitary stalk interruption syndrome. Levothyroxine and hydrocortisone were given since then. To achieve ideal height, he received GH treatment for 5 years. The patient had an oxygen saturation of 78% and a partial pressure of arterial oxygen of 37 mmHg with an alveolar-arterial oxygen gradient of 70.2 mmHg. Abdominal ultrasonography showed liver cirrhosis and an enlarged spleen. Perfusion lung scan demonstrated intrapulmonary arteriovenous right-to-left shunt. HPS (very severe) was our primary consideration. His hormonal evaluation revealed GH deficiency and hypogonadotropic hypogonadism when thyroid hormone, cortisol, and desmopressin were administrated. After adding with long-acting recombinant human GH and testosterone for 14 mo, his liver function and hypoxemia were improved and his progressive liver fibrosis was stabilized. He was off the waiting list of liver transplantation. CONCLUSION: Clinicians should screen HPS patients' anterior pituitary function as early as possible and treat them primarily with GH cocktail accordingly. PMID:34222458 | PMC:PMC8223853 | DOI:10.12998/wjcc.v9.i18.4852 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Significance of highly phosphorylated insulin-like growth factor binding protein-1 and cervical length for prediction of preterm delivery in twin pregnancies

paythelady.612 shared this article with you from Inoreader Significance of highly phosphorylated insulin-like growth factor binding protein-1 and cervical length for prediction of preterm delivery in twin pregnancies Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4553-4558. doi: 10.12998/wjcc.v9.i18.4553. ABSTRACT BACKGROUND: A twin pregnancy can carry greater risks than singleton pregnancies. About 60 in 100 twin pregnancies result in spontaneous birth before 37 wk, which is associated with several complications in the premature babies. Clinical detection of biomarkers may help to predict the possibility of premature birth so that corresponding interventions can be given to the pregnant women in a timely manner, in order to reduce the risk of preterm birth and improve the outcomes of the newborn infants. AIM: To explore the clinical value of transvaginal ultrasound measurement of cervical length combined with insulin-like growth factor binding protein-1 (IGFBP-1) hyperphosphorylation in cervical secretions as predictors of preterm delivery in twin pregnancies. METHODS: A total of 254 pregnant women with twin pregnancies, who were admitted to Ha inan General Hospital and underwent maternity examination, were selected as the study subjects from January 2015 to December 2018. All participants received transvaginal ultrasound measurement of cervical length and phosphorylated IGFBP-1 (phIGFBP-1) test between 24 and 34 wk gestation. The pregnancy outcomes were analyzed. RESULTS: Of the women with a positive phIGFBP-1 test result, preterm birth rate was higher in those with a cervical length ≤ 25 mm than those with a cervical length > 25 mm (all P < 0.05). Similarly, in women with a negative phIGFBP-1 test result, preterm birth rate was higher in those with a cervical length ≤ 25 mm than those with a cervical length > 25 mm (all P < 0.05). The sensitivity, specificity, and positive and negative predictive values of the phIGFBP-1 test combined with the cervical length test were 95.71%, 91.21%, 95.12% and 92.22%, respectively, for the prediction of preterm birth. CONCLUSION: Cervical length combined with phIGFBP-1 tests is of value for the prediction of outcomes of preterm delivery in twin pregnancies. PMID:34222422 | PMC:PMC8223815 | DOI:10.12998/wjcc.v9.i18.4553 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Low symptomatic COVID-19 in an elderly patient with follicular lymphoma treated with rituximab-based immunotherapy: A case report

paythelady.612 shared this article with you from Inoreader Low symptomatic COVID-19 in an elderly patient with follicular lymphoma treated with rituximab-based immunotherapy: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4859-4865. doi: 10.12998/wjcc.v9.i18.4859. ABSTRACT BACKGROUND: Follicular lymphoma is an indolent lymphoma that may progress to a highly aggressive form requiring immunochemotherapy. Most regimens utilize rituximab, an anti-CD20 monoclonal antibody, which may affect the clinical course of novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections [coronavirus disease 2019 (COVID-19)]. Here we describe the first case of mild COVID-19 during ongoing oncological treatment without significant deterioration after rituximab administration. CASE SUMMARY: A 74-year-old female with an enlargement of her right palatine tonsil was diagnosed with follicular lymphoma following tonsillectomy and started immunochemotherapy according to the rituximab, cyclophosphamide, vincristine, prednisone regimen. At home before the fourth cycle, she developed nonspecific symptoms (excess ive fatigue, loss of appetite and nausea), misdiagnosed as adverse effects of chemotherapy. Unexpectedly, interim positron emission tomography-computed tomography scan, performed shortly before rituximab administration, revealed previously nonexistent pulmonary changes, potentially of infectious etiology. SARS-CoV-2 infection was confirmed by a nasopharyngeal swab (with reverse transcriptase polymerase chain reaction test) performed the following day. Despite rituximab infusion, the patient remained oligosymptomatic and was discharged home for self-isolation. Having reached a negative SARS-CoV-2 status before the subsequently scheduled regimen, the patient successfully received six cycles of rituximab, cyclophosphamide, vincristine, prednisone and obtained complete remission by positron emission tomography-computed tomography. CONCLUSION: Our case shows that rituximab-based immunotherapy due to follicular lymphoma may have no evident negative effect on the COVID-19 clinical co urse. PMID:34222459 | PMC:PMC8223830 | DOI:10.12998/wjcc.v9.i18.4859 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgery for pancreatic tumors in the midst of COVID-19 pandemic

paythelady.612 shared this article with you from Inoreader Surgery for pancreatic tumors in the midst of COVID-19 pandemic Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4460-4466. doi: 10.12998/wjcc.v9.i18.4460. ABSTRACT The spread of the new coronavirus (COVID-19) infection in 2020 has had a significant impact on the treatment of cancer worldwide. During the COVID-19 pandemic, the biggest challenge for pancreatic surgeons is the difficulty in providing oncological care. In this review article, from the standpoint of surgeons, we explain the concept of triaging of patients with pancreatic tumors under the COVID-19 pandemic, and the actual impact of COVID-19 on the treatment of patients with pancreatic tumors. The most vital points in selecting the best therapeutic approach for patients with pancreatic tumors during this pandemic are (1) Oncologists need to tailor the treatment plan based on the COVID-19 phase, tumor malignant potential, and patients' comorbidities; and (2) Optimal treatment for pancreatic cancer should be planned according to the condition of each patient and tumor resectability based on national comprehensive cancer network resectability criteria. To choose the best therapeutic approach for patients with pancreatic tumors during this pandemic, we need to tailor the treatment plan based on elective surgery acuity scale (ESAS). Newly established ESAS for pancreatic tumor and flowchart indicating the treatment strategy of pancreatic cancer, are feasible to overcome this situation. PMID:34222414 | PMC:PMC8223860 | DOI:10.12998/wjcc.v9.i18.4460 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adult rhabdomyosarcoma originating in the temporal muscle, invading the skull and meninges: A case report

paythelady.612 shared this article with you from Inoreader Adult rhabdomyosarcoma originating in the temporal muscle, invading the skull and meninges: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Jun 26;9(18):4866-4872. doi: 10.12998/wjcc.v9.i18.4866. ABSTRACT BACKGROUND: Rhabdomyosarcoma (RMS) is a rare malignant tumor of mesenchymal origin that mainly affects children. Spindle cell/sclerosing RMS (SSRMS) is even rarer. It is a new subtype that was added to the World Health Organization disease classification in 2013. To the best of our knowledge, this is the first reported case of adult SSRMS disease classification originating in the temporal muscle. CASE SUMMARY: SSRMS originating in the temporal muscle of a male adult enlarged rapidly, destroyed the skull, and invaded the meninges. The tumor was completely removed, and the postoperative pathological diagnosis was SSRMS. Postoperative recovery was good and chemotherapy and radiotherapy were given after the operation. Followed up for 3 mo, no tumor recurred. CONCLUSION: RMS is one of the differential diagnoses for head soft tissue tumors w ith short-term enlargement and skull infiltration. Preoperative computed tomography or magnetic resonance imaging is necessary for early detection of tumor invasion of the skull and brain tissue. PMID:34222460 | PMC:PMC8223841 | DOI:10.12998/wjcc.v9.i18.4866 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.