Arthroscopic treatment of iliopsoas tendinitis after total hip arthroplasty with acetabular cup malposition: Two case reports.

paythelady.612 shared this article with you from Inoreader Arthroscopic treatment of iliopsoas tendinitis after total hip arthroplasty with acetabular cup malposition: Two case reports. Μέσω pubmed: "world j clin cases"... Related Articles Arthroscopic treatment of iliopsoas tendinitis after total hip arthroplasty with acetabular cup malposition: Two case reports. World J Clin Cases. 2020 Nov 06;8(21):5326-5333 Authors: Won H, Kim KH, Jung JW, Kim SY, Baek SH Abstract BACKGROUND: Optimal treatment for iliopsoas tendinitis after total hip arthroplasty (THA) with cup malposition, iliopsoas release alone or with cup revision, is controversial, particularly in young, active patients. Moreover, arthroscopic iliopsoas tendon (IPT) release in these patients has been rarely described, and midterm effects of this procedure on THA longevity and groin pain recurrence remain unclear. We performed arthroscopic IPT release after THA and report midterm outcomes in two young patients with acetabular cup malposition. CASE SUMMARY: In the two patients, groin pain started early after THA. Physical examination revealed nonspecific findings, and laboratory tests showed no evidence of infection. Radiography and computed tomography showed reduced acetabular component anteversion angle and anterior cup prominence of more than 16 mm. For therapeutic diagnosis, ultrasonography-guided lidocaine with steroid was injected into the IPT sheath. In both patients, groin pain improved initially but worsened after a few months. Therefore, the patients underwent arthroscopic IPT release under spinal anesthesia. Arthroscopy revealed synovitis with fibrous tissues around the IPT and various lesions related to the implants after THA. IPT tenotomy and debridement with biopsy were performed; histopathologic studies showed chronic inflammation with synovial hyperplasia. Both patients were encouraged to start walking immediately after surgery, and they returned to complete daily function early after surgery. They experienced no recurrence of groin pain or any implant-related problems 5 years postoperatively. CONCLUSION: Arthroscopic IPT release for cup malposition produced excellent midterm outcomes without recurrence of groin pain and implant-related problems. PMID: 33269266 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Successful treatment of a high-risk nonseminomatous germ cell tumor using etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine: A case report.

paythelady.612 shared this article with you from Inoreader Successful treatment of a high-risk nonseminomatous germ cell tumor using etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine: A case report. Μέσω pubmed: "world j clin cases"... Related Articles Successful treatment of a high-risk nonseminomatous germ cell tumor using etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine: A case report. World J Clin Cases. 2020 Nov 06;8(21):5334-5340 Authors: Yun J, Lee SW, Lim SH, Kim SH, Kim CK, Park SK Abstract BACKGROUND: Choriocarcinoma is an infrequent entity and the most aggressive subtype of germ-cell tumors. Because of early metastatic spread and rapid disease progression, choriocarcinoma patients display poor prognosis. Although etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA-CO) regimen is widely used to treat gestational trophoblastic tumors in females, its role in treating male choriocarcinoma is seldom reported. CASE SUMMARY: A 32-year-old man was diagnosed with burned-out primary germ cell tumors (GCT) with retroperitoneum, liver and lung metastases. Biopsy of the liver revealed pure choriocarcinoma. The patient received bleomycin, etoposide, and cisplatin chemotherapy. After two cycles of treatment, response evaluation revealed the mixed response. EMA-CO regimen was used in the second-line therapy. After eight cycles, the patient showed a potentially resectable state and thus, all residual masses were surgically removed. The patient was completely cured, and 10 years later, he is leading a healthy life without complications. CONCLUSION: This paper is the first case of high-risk nonseminomatous GCT in a male patient to be successfully treated with the EMA-CO regimen. The EMA-CO regimen can be used actively in patients with high-risk nonseminomatous GCT. PMID: 33269267 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Donepezil-related inadequate neuromuscular blockade during laparoscopic surgery: A case report.

paythelady.612 shared this article with you from Inoreader Donepezil-related inadequate neuromuscular blockade during laparoscopic surgery: A case report. Μέσω pubmed: "world j clin cases"... Related Articles Donepezil-related inadequate neuromuscular blockade during laparoscopic surgery: A case report. World J Clin Cases. 2020 Nov 06;8(21):5341-5346 Authors: Jang EA, Kim TY, Jung EG, Jeong S, Bae HB, Lee S Abstract BACKGROUND: Donepezil is an acetylcholinesterase inhibitor used to improve cognition and delay disease progression in dementia patients by increasing acetylcholine levels. This drug may potentially interact with neuromuscular blocking agents (NMBAs) that act on muscular acetylcholine receptors during general anesthesia. Herein, we present a case of inadequate neuromuscular blockade with rocuronium, a nondepolarizing NMBA, in a dementia patient who had taken donepezil. CASE SUMMARY: A 71-year-old man was scheduled for laparoscopic gastrectomy. He had been taking donepezil 5 mg for dementia. General anesthesia was induced with propofol and remifentanil. The depth of neuromuscular blockade was monitored by train-of-four (TOF) stimulation. After the administration of rocuronium, the TOF ratio decreased at an unusually slow rate, and a TOF count of 0 was detected 7 min later. After intubation, a TOF count of 1 was detected within 1 min, and a TOF ratio of 12% was detected within 2 min. The TOF count remained at 4 even with an additional bolus and continuous infusion of rocuronium, suggesting resistance to this NMBA. Instead of propofol, an inhalation anesthetic was administered alongside another NMBA (cisatracurium). Then, the quality of neuromuscular blockade improved, and the TOF count remained at 0-1 for the next 70 min. No further problems were encountered with respect to surgery or anesthesia. CONCLUSION: Donepezil may be responsible for inadequate neuromuscular blockade during anesthesia, especially when total intravenous anesthesia is used. PMID: 33269268 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Successful treatment of relapsed acute promyelocytic leukemia with arsenic trioxide in a hemodialysis-dependent patient: A case report.

paythelady.612 shared this article with you from Inoreader Successful treatment of relapsed acute promyelocytic leukemia with arsenic trioxide in a hemodialysis-dependent patient: A case report. Μέσω pubmed: "world j clin cases"... Related Articles Successful treatment of relapsed acute promyelocytic leukemia with arsenic trioxide in a hemodialysis-dependent patient: A case report. World J Clin Cases. 2020 Nov 06;8(21):5347-5352 Authors: Lee HJ, Park SG Abstract BACKGROUND: Arsenic trioxide (ATO) is recommended for patients who do not achieve molecular remission or who have molecular or morphologic relapse. However, there are no guidelines for adjusting ATO dosage in patients with severe renal failure or on dialysis. Herein, we report the successful treatment of relapsed acute promyelocytic leukemia (APL) in a patient on hemodialysis with ATO single agent and review the cases in literature. CASE SUMMARY: A 46-year-old woman who has been on hemodialysis to chronic glomerulone-phritis for 15 years visited our hospital for pancytopenia. She had been seen for pancytopenia 3 years ago and had been diagnosed with APL. She also received chemotherapy for APL but unfortunately was lost to follow-up after her second consolidation chemotherapy. She was noted to have pancytopenia by her nephrologist during hemodialysis 1 mo ago. Bone marrow biopsy and reverse transcriptase-polymerase chain reaction (RT-PCR) tests revealed a diagnosis of relapsed APL. Treatment for relapsed APL with ATO single agent was started and she achieved molecular remission after administering 24 doses of ATO. Thus far, four consolidation therapies have been performed with the ATO single agent, and, to date, the molecular remission has been maintained as negative promyelocytic leukemia/retinoic acid receptor-α fusion gene as confirmed by RT-PCR testing for two years. CONCLUSION: This is a rare case of relapsed APL successfully treated with the single agent ATO in a patient on hemodialysis. PMID: 33269269 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment of afferent loop syndrome using fluoroscopic-guided nasointestinal tube placement: Two case reports.

paythelady.612 shared this article with you from Inoreader Treatment of afferent loop syndrome using fluoroscopic-guided nasointestinal tube placement: Two case reports. Μέσω pubmed: "world j clin cases"... Related Articles Treatment of afferent loop syndrome using fluoroscopic-guided nasointestinal tube placement: Two case reports. World J Clin Cases. 2020 Nov 06;8(21):5353-5360 Authors: Hu HT, Ma FH, Wu ZM, Qi XH, Zhong YX, Xie YB, Tian YT Abstract BACKGROUND: Afferent loop syndrome (ALS) is a rare mechanical complication that occurs after reconstruction of the stomach or esophagus to the jejunum, such as Billroth II gastrojejunostomy, Roux-en-Y gastrojejunostomy, or Roux-en-Y esophagoje-junostomy. Traditionally, an operation is the first choice for benign causes. However, for patients in poor physical condition who experience ALS soon after R0 resection, the type of treatment remains controversial. Here, we present an efficient conservative method to treat ALS. CASE SUMMARY: Case 1 was a 69-year-old male patient who underwent total gastrectomy with Roux-en-Y jejunojejunostomy. On postoperative day (POD) 10 he developed symptoms of ALS that persisted and increased over 1 wk. Case 2 was a 59-year-old male patient who underwent distal gastrectomy with Billroth II gastrojejunostomy. On postoperative day POD 9 he developed symptoms of ALS that persisted for 2 wk. Both patients underwent fluoroscopic-guided nasointestinal tube placement with maintenance of continuous negative pressure suction. Approximately 20 d after the procedure, both patients had recovered well and were discharged from hospital after removal of the tube. At 3-mo follow-up, there were no signs of ALS in these two patients. CONCLUSION: This is the first report of treating postoperative ALS by fluoroscopic-guided nasointestinal tube placement. Our cases demonstrate that this procedure is an effective and safe method to treat ALS that relieves patients' symptoms and avoids complications caused by other invasive procedures. PMID: 33269270 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emergency surgical workflow and experience of suspected cases of COVID-19: A case report.

paythelady.612 shared this article with you from Inoreader Emergency surgical workflow and experience of suspected cases of COVID-19: A case report. Μέσω pubmed: "world j clin cases"... Related Articles Emergency surgical workflow and experience of suspected cases of COVID-19: A case report. World J Clin Cases. 2020 Nov 06;8(21):5361-5370 Authors: Wu D, Xie TY, Sun XH, Wang XX Abstract BACKGROUND: Severe acute respiratory syndrome coronavirus 2 has been confirmed to be a newly discovered zoonotic pathogen that causes highly contagious viral pneumonia, which the World Health Organization has named novel coronavirus pneumonia. Since its outbreak, it has become a global pandemic. During the outbreak of coronavirus disease 2019 (COVID-19), however, there is no mature experience or guidance on how to carry out emergency surgery for suspected cases requiring emergency surgical intervention and perioperative safety protection against virus. CASE SUMMARY: A 41-year-old man was admitted to the hospital for emergency treatment due to "3-d abdominal pain aggravated with cessation of exhaust and defecation". After improving inspections and laboratory tests, the patient was assessed and diagnosed by the multiple discipline team as "strangulation obstruction, pulmonary infection". His body temperature was 38.8 °C, and the chest computed tomography showed pulmonary infection. Given fever and pneumonia, we could not rule out COVID-19 after consultation by fever clinicians and respiratory experts. Hence, we performed emergency surgery under three-level protection for the suspected case. After surgery, his nucleic acid test for COVID-19 was negative, meaning COVID-19 was excluded, and routine postoperative treatment and nursing was followed. The patient was treated with symptomatic support after the operation. The stomach tube and urinary tube were removed on the 1st d after the operation. The clearing diet was started on the 3rd d after the operation, and the body temperature returned to normal. Flatus and bowel movements were noted on 5th postoperative day. He was discharged after 8 d of hospitalization. The patient was followed up for 4 mo after discharge, no serious complications occurred. A 71-year-old woman was admitted to our emergency room due to "abdominal distention, fatigue for 6 d and fever for 13 h". After the multiple discipline team evaluation, the patient was diagnosed as "intestinal obstruction, abdominal mass, peritonitis and pulmonary infection". At that time, the patient's body temperature was 39.6 °C, and chest computed tomography indicated pulmonary infection. COVID-19 could not be completely excluded after consultation in the fever outpatient department and respiratory department. Therefore, the patient was treated as a suspected case, and an urgent operation was performed under three-level medical protection. Postoperative nucleic acid test was negative, COVID-19 was exclude d, and routine postoperative treatment and nursing were followed. After the operation, the patient received symptomatic and supportive treatment. The gastric tube was removed on the 1st d after the operation, and the urinary tube was removed on the 3rd d after the operation. Enteral nutrition began on the 3rd d after the operation. To date, no serious complications have been found during follow-up after discharge. CONCLUSION: Based on the previous treatment experience, we reviewed the procedures of two cases of suspected COVID-19 emergency surgery and extracted the perioperative protection experience. By referring to the literature and following the regulations on prevention and management of infectious diseases, we have developed a relatively mature and complete emergency surgical workflow for suspected COVID-19 cases and shared perioperative protection and management experience and measures. PMID: 33269271 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The nonsurgical expansion of maxillary and mandibular arches in a young adult:

paythelady.612 shared this article with you from Inoreader Seven-year follow-up of the nonsurgical expansion of maxillary and mandibular arches in a young adult: A case report. Μέσω pubmed: "world j clin cases"... Related Articles Seven-year follow-up of the nonsurgical expansion of maxillary and mandibular arches in a young adult: A case report. World J Clin Cases. 2020 Nov 06;8(21):5371-5379 Authors: Yu TT, Li J, Liu DW Abstract BACKGROUND: Palatal expansion treatment has been used to expand the constricted maxillary arch and has become a routine procedure in orthodontic practice over the past decades. However, the long-term stability of expansion in the permanent dentition without a surgical approach is uncertain. CASE SUMMARY: We present the case of a 15-year-old boy with Class II malocclusion and constricted arches. The patient was treated with rapid palatal expansion (RPE) followed by a fixed orthodontic appliance. A 7-year follow-up evaluation was performed by analyzing cephalometric radiographs, plaster models, and photographs. The patient's constricted maxillary and mandibular arches were relived after the expansion treatment. A Class I occlusion and normal arch form were established and maintained in the long-term. CONCLUSION: RPE treatment is successful in solving constricted dental arch in the permanent dentition without a surgical approach. Permanent retention and even occlusal contact help prevent long-term relapse. PMID: 33269272 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.