Gastroesophageal varices in a patient presenting with essential thrombocythemia: A case report

paythelady.612 shared this article with you from Inoreader Gastroesophageal varices in a patient presenting with essential thrombocythemia: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1871-1876. doi: 10.12998/wjcc.v9.i8.1871. ABSTRACT BACKGROUND: Gastroesophageal varices are a rare complication of essential thrombocythemia (ET). ET is a chronic myeloproliferative neoplasm (MPN) characterized by an increased number of blood platelets. CASE SUMMARY: A 46-year-old woman, who denied a history of liver disease, was admitted to our hospital on presentation of hematemesis. Laboratory examination revealed a hemoglobin level of 83 g/L, and a platelet count of 397 × 109/L. The appearance of gastric and esophageal varices with red colored signs as displayed by an urgent endoscopy was followed by endoscopic variceal ligation and endoscopic tissue adhesive. Abdominal computed tomography revealed cirrhosis, marked splenomegaly, portal vein thrombosis and portal hypertension. In addition, bone marrow biopsy and evidence of mutated Janus kinase 2, substantiated the onset of ET. The patient was asymptomatic with regular routine blood testing during the 6-mo follow-up period. Therefore, in this case, gastroesophageal varices were induced by ET. CONCLUSION: MPN should be given considerable attention when performing differential diagnoses in patients with gastroesophageal varices. An integrated approach such as laboratory tests, radiological examination, and pathological biopsy, should be included to allow optimal decisions and management. PMID:33748236 | PMC:PMC7953392 | DOI:10.12998/wjcc.v9.i8.1871 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inadvertent globe penetration during retrobulbar anesthesia: A case report

paythelady.612 shared this article with you from Inoreader Inadvertent globe penetration during retrobulbar anesthesia: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):2001-2007. doi: 10.12998/wjcc.v9.i8.2001. ABSTRACT BACKGROUND: To report the possible reasons for needle perforation and complications related to perforation, as well as the clinical management of subretinal hemorrhage (SRH) during retrobulbar injection. CASE SUMMARY: A 65-year-old female was scheduled to undergo pars plana vitrectomy (PPV) in her left eye for rhegmatogenous retinal detachment (RRD). During retrobulbar anesthesia, needle perforation of the globe occurred. Massive SRH in the inferotemporal quadrant together with vitreous hemorrhage were observed. The patient underwent PPV combined with retinotomy for removal of the massive SRH. After earlier surgical intervention, successful reattachment of the retina was achieved. CONCLUSION: Inadvertent globe penetration during retrobulbar anesthesia is associated with a poor prognosis and may result in blindness. Timely detection and e arlier intervention may be beneficial. PMID:33748253 | PMC:PMC7953384 | DOI:10.12998/wjcc.v9.i8.2001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Conservative endodontic management using a calcium silicate bioceramic sealer for delayed root fracture: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Conservative endodontic management using a calcium silicate bioceramic sealer for delayed root fracture: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1835-1843. doi: 10.12998/wjcc.v9.i8.1835. ABSTRACT BACKGROUND: The success rate of conservative endodontic management for root fracture varies greatly based on different methods used. It has been rarely reported that calcium silicate-based materials are applied in root fracture treatment. CASE SUMMARY: A 38-year-old male patient presented with spontaneous pain from the upper left anterior teeth for 1 wk. The spontaneous pain was subsequently relieved, but pain on mastication persisted for 3 d. The patient had a dental trauma from a boxing match 15 years ago. Cone beam computed tomography showed that the maxillary left central incisor had oblique fracture lines and a radiolucent lesion around the fracture line. The tooth was diagnosed with an oblique root fracture with no healing and symptomatic apical periodontitis. In the following conservative endodontic management, the coronal and apical fr agments of the canal both were chemo-mechanically prepared and obturated using a single cone gutta-percha with iRoot SP (Innovative BioCreamix Inc, Vancouver, Canada), a new calcium silicate-based bioceramic root canal sealer. At follow-ups at 1, 6, 12, and 24 mo, the patient was asymptomatic and the radiolucency around the fracture line was healing radiographically. CONCLUSION: Conservative root canal treatment is an alternative treatment in some cases of oblique root fracture with no healing. The application of bioceramic sealers and single core obturation techniques may also be essential to obtain an excellent outcome. PMID:33748232 | PMC:PMC7953412 | DOI:10.12998/wjcc.v9.i8.1835 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Systemic lupus erythematosus combined with primary hyperfibrinolysis and protein C and protein S deficiency: A case report

paythelady.612 shared this article with you from Inoreader Systemic lupus erythematosus combined with primary hyperfibrinolysis and protein C and protein S deficiency: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):2008-2014. doi: 10.12998/wjcc.v9.i8.2008. ABSTRACT BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by systemic involvement and multiple autoantibodies in the serum. Patients with protein C (PC) and protein S (PS) deficiency are prone to thrombosis. In contrast, patients with primary hyperfibrino-lysis tend to bleed. CASE SUMMARY: A 52-year-old female patient with bilateral pleural effusion was diagnosed with "tuberculous pleurisy" and treated with anti-tuberculosis drugs and prednisone. The coagulation-related laboratory results showed decreased fibrinogen, PC activity, PS activity, and antithrombin Ш activity. The immune-related laboratory results showed positive antinuclear antibody, anti-Smith antibody, anticardiolipin antibody (ACL), anti-β2-glycoprotein I antibody (aβ2GPI) and direct Coomb's test and decreased complement 3 and complement 4. Thoraco scopy was performed and bloody pleural fluid was drained. Pathology of the pleural biopsy showed lymphocytes, plasma cells, and a few eosinophils in adipose and fibrous connective tissue. Results of whole exome sequencing of blood showed no genetic mutations suggesting the presence of hereditary hematological diseases. The patient was finally diagnosed with SLE and primary hyperfibrinolysis, and was treated with prednisolone, hydroxychloroquine, and compound cyclophosphamide. CONCLUSION: PC and PS deficiency in SLE might be related to ACL and aβ2GPI. SLE and primary hyperfibrinolysis can coexist in one patient, with both a risk of thrombosis and a risk of bleeding. PMID:33748254 | PMC:PMC7953391 | DOI:10.12998/wjcc.v9.i8.2008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Severe community-acquired pneumonia caused by Leptospira interrogans: A case report and review of literature

paythelady.612 shared this article with you from Inoreader Severe community-acquired pneumonia caused by <em>Leptospira interrogans</em>: A case report and review of literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1901-1908. doi: 10.12998/wjcc.v9.i8.1901. ABSTRACT BACKGROUND: Leptospira is an uncommon pathogen for adult severe community-acquired pneumonia and its nonspecific manifestations and limited diagnostic tests make it difficult to identify. Although conventional penicillin remains efficacious to treat leptospirosis, failure in early diagnosis and treatment can lead to progression into a deadly syndrome with multiple organ dysfunction. Next generation sequencing is of great value to understand cases with infection of unknown cause, which could help in the diagnosis of uncertain Leptospira infection. CASE SUMMARY: We recently managed a patient with fever, cough and dyspnea on admission that progressed into persistent adult respiratory distress syndrome, hemoptysis and hematuria after admission. In this case, the rare Leptospira infection was clouded by the positive influenza t ests at admission, delaying early Leptospira-targeted antibiotics administration. Next generation sequencing, a novel molecular diagnostic tool, provided a key hint to uncover the crucial pathogen, Leptospira interrogans, further supported by the possible occupational exposure history. Subsequent conventional penicillin and mechanical respiratory support were administrated to cure the patient successfully without any sequela. CONCLUSION: Clinicians must pay attention to possible exposure history and keep uncommon Leptospira in mind when managing pneumonia with unknown causes. PMID:33748240 | PMC:PMC7953396 | DOI:10.12998/wjcc.v9.i8.1901 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of Visual and Brainstem Auditory Evoked Potentials in Patients with Hashimoto's Thyroiditis

xlomafota13 shared this article with you from Inoreader Assessment of Visual and Brainstem Auditory Evoked Potentials in Patients with Hashimoto's Thyroiditis Via cortical auditory J Immunol Res. 2021 Mar 3;2021:3258942. doi: 10.1155/2021/3258942. eCollection 2021. ABSTRACT BACKGROUND: The present study was aimed to evaluate parameters of visual and brainstem auditory evoked potentials (VEP, BAEP) in euthyreotic Hashimoto's thyroiditis (HT) patients without central nervous system involvement. METHODS: 100 HT patients (92 women, 8 men), mean age 46.9 years, and 50 healthy controls. They underwent a neurological examination, thyroid hormone levels, thyroid autoantibody titers, and brain imaging. Latencies and amplitudes of the N75, P100, and N145 component of VEP and the I-V components of BAEP were analyzed. RESULTS: The neurological examination revealed in 31 patients signs of increased neurovegetative excitability. Brain resonance imaging showed no abnormalities in HT patients. The mean P100, relative P100, and N145 VEP latencies were significantly longer, and P100 amplitude significantly higher in HT patien ts than the controls. HT patients also had a longer mean wave BAEP V latency and mean wave III-V and I-V interpeak latencies, and significantly lower mean wave I and V amplitudes. Abnormal VEP and BAEP were recorded in 34% of the patients. There were no statistically significant correlations between the mean VEP parameters and thyroid profile and the applied dose of L-thyroxine. There was a relationship between the level of TSH and the wave BAEP III-V interpeak latency. CONCLUSIONS: There were changes in the brain's bioelectrical activity in one-third of the patients with HT without nervous system involvement. The increased amplitude of the VEP may indicate increased cerebral cortex activity. Disorders of the brain's bioelectrical activity in the course of HT may be associated with an autoimmune process. PMID:33763490 | PMC:PMC7946475 | DOI:10.1155/2021/3258942 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identification of miR-145 as a regulator of the cardiomyocyte inflammatory response and oxidative stress under hyperglycemia

xlomafota13 shared this article with you from Inoreader Identification of miR-145 as a regulator of the cardiomyocyte inflammatory response and oxidative stress under hyperglycemia Via Experimental and therapeutic medicine Exp Ther Med. 2021 May;21(5):467. doi: 10.3892/etm.2021.9898. Epub 2021 Mar 8. ABSTRACT The current study aimed to explore the effects of microRNA (miR)-145 on the inflammatory response and oxidative stress (OS) in high glucose (HG)-induced cardiomyocytes, as well as the specific mechanism underlying this action. H9c2 cells were treated with 33 mmol/l glucose (HG group) or cotreated with 24.5 mmol/l mannitol and 5.5 mmol/l glucose (hypertonic group), and the expression levels of miR-145 and ADP ribosylation factor 6 (ARF6) were detected. The cells were transfected with pcDNA3.1-ARF6, miR-145 mimics or corresponding negative controls prior to the assessment of cell survival rate. Levels of lactate dehydrogenase (LDH), reactive oxygen species (ROS) and malondialdehyde (MDA), as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), and the levels of IL-6, TNF-α and monocyte chemoattractant protein-1 (MCP-1) were subsequently determined. The apoptotic rate of H9c2 cells was examined by flow cytometry. The interaction between miR-145-ARF6 was predicted and confirmed by luciferase reporter assays. In the HG group, miR-145 expression was significantly decreased and ARF6 expression significantly increased compared with controls. Furthermore, the levels of inflammatory factors (IL-6, TNF-α and MCP-1), LDH, ROS and MDA were significantly elevated in the HG group compared with controls. Significantly decreased SOD, CAT and GPx activities and significantly increased numbers of apoptotic cells were observed in the HG group compared with controls. The cells transfected with miR-145 mimics exhibited significantly decreased LDH, ROS and MDA levels, significantly increased antioxidant enzyme activities and significantly decreased apoptotic rates compared with controls, while the opposite results were observed in cells transfected with pcDNA3.1-ARF6. Moreover, co-transfection with miR-145 mimics and pcDNA3.1-ARF6 exacerbated the inflammatory response and OS injury in HG-induced cardiomyocytes compared with cells transfected with miR-145 mimics alone. Furthermore, miR-145 negatively targeted ARF6. miR-145 attenuated the HG-induced inflammatory response and OS injury in cardiomyocytes by negatively regulating ARF6, which may contribute to providing a theoretical basis for the treatment of diabetic cardiomyopathy. PMID:33763154 | PMC:PMC7983182 | DOI:10.3892/etm.2021.9898 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.