scholarly journals Interleukin-8 Producing Hepatocellular Carcinoma with Pyrexia

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Norifumi Harimoto ◽  
Ken Shirabe ◽  
Tomoyuki Abe ◽  
Kiyoshi Kajiyama ◽  
Takashi Nagaie ◽  
...  
Keyword(s):  
Proinflammatory Cytokine ◽  
Preoperative Diagnosis ◽  
Poor Prognosis ◽  
Tumor Thrombus ◽  
Laboratory Data ◽  
Chief Complaint ◽  
Interleukin 8 ◽  
Immunohistochemical Stain ◽  
History Of ◽  
Poorly Differentiated

We discuss a patient who had poorly differentiated HCC with pyrexia and high CRP in laboratory data, which are not commonly observed in the usual HCC. A 50-year-old man with a history of liver dysfunction was admitted with a chief complaint of a prolonged fever and general fatigue. Preoperative diagnosis was HCC with portal vein tumor thrombus. Posterior segmentectomy of the liver and thrombectomy was performed. Rapid tumor recurrence occurred after surgery, and he died 79 days after the operation. Immunohistochemical stain of HCC in this patient revealed the production of proinflammatory cytokine, interleukin-8 (IL-8). IL-8 production may have contributed to the high fever, high inflammatory reaction, and poor prognosis in this case.

scholarly journals Tuberculous Pyomyositis: A Rare but Serious Diagnosis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Vikram Krishnasamy ◽  
Matthew Joseph
Keyword(s):  
Lower Extremity ◽  
Poor Prognosis ◽  
Multiorgan Failure ◽  
Laboratory Data ◽  
The United States ◽  
Past Medical History ◽  
Blood Cell Count ◽  
Large Area ◽  
Left Lower Extremity ◽  
History Of

Tuberculous pyomyositis is a rare clinical entity with serious consequences if a diagnosis is not established early. A 53-year-old female with a past medical history of sarcoidosis and pulmonary fibrosis presented from an outside hospital with persistent fevers and a rash. She had been hospitalized multiple times at an outside hospital without any improvement in her symptoms. On examination, she was noted to have a large area of left upper lower extremity (LUE) tenderness with superimposed erythema. Laboratory data revealed a white blood cell count of 22,300. Computed tomography (CT) scans of the LUE, chest, and left lower extremity (LLE) showed multiple intramuscular abscesses in those regions without evidence of osteomyelitis. Subsequent drainage of the abscesses and resulting cultures revealedMycobacterium tuberculosis. The patient was started on therapy with rifampin, isoniazid, pyrazinamide, and ethambutol. However, the patient developed hepatitis on these agents and subsequently went into septic shock with multiorgan failure. Care was eventually withdrawn as a result of a poor prognosis. This case illustrates the severe consequences of TB pyomyositis if not diagnosed promptly. While tuberculosis is uncommon in the United States, it should be an important consideration in the differential diagnosis of immunocompromised patients.

Budd-Chiari syndrome due to segmental obstruction of the inferior vena cava successfully managed with endovascular stenting

MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 22-26
Author(s):  
Uyen Vo ◽  
Duc Quach ◽  
Luan Dang ◽  
Thao Luu ◽  
Luan Nguyen
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Laboratory Data ◽  
Transaminase Level ◽  
Vena Cava ◽  
Budd Chiari Syndrome ◽  
Endovascular Stenting ◽  
Massive Ascites ◽  
Chiari Syndrome ◽  
History Of

Budd–Chiari syndrome (BCS), a rare and life-threatening disorder due to hepatic venous outflow obstruction, is occasionally associated with hypoproteinemia. We herein report the first case of BCS with segmental obstruction of the intrahepatic portion of inferior vena cava (IVC) and hepatic veins (HVs) successfully treated by endovascular stenting in Vietnam. A 32-year-old female patient presented with a 2-month history of massive ascites and leg swelling. She refused history of oral contraceptives use. Hepatosplenomegaly without tenderness was noted. Laboratory data showed polycythemia, mild hypoalbuminemia and hypoproteinemia, slightly high total bilirubin and normal transaminase level. The serum ascites albumin gradient was 1.9 g/dL and ascitic protein level was 1.1 g/dL. The other data were normal. BCS was suspected because of the discrepancy between mild liver failure and massive ascites; and the presence of hepatosplenomegaly and polycythemia. On abdominal magnetic resonance imaging, the segmental obstruction of three HVs and IVC was 2-3 cm long without thrombus. Cavogram revealed the severe segmental stenosis of intrahepatic portion of IVC with no visualized HV and extensive collateral veins. A Protégé stent was deployed to IVC. Leg swelling and ascites were completely resolved within 3 days after stenting. During 1-year follow-up, edema was not recurred and repeated laboratory results were all normal.

Glucose Levels and Outcome After Primary Intraventricular Hemorrhage

2019 ◽  
Vol 16 (1) ◽  
pp. 40-46
Author(s):  
Rui Guo ◽  
Ruiqi Chen ◽  
Chao You ◽  
Lu Ma ◽  
Hao Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Incidence Rate ◽  
Glucose Level ◽  
Intraventricular Hemorrhage ◽  
Laboratory Data ◽  
History Of ◽  
Poor Outcomes ◽  
The Impact

Background and Purpose: Hyperglycemia is reported to be associated with poor outcome in patients with spontaneous Intracerebral Hemorrhage (ICH), but the association between blood glucose level and outcomes in Primary Intraventricular Hemorrhage (PIVH) remains unclear. We sought to identify the parameters associated with admission hyperglycemia and analyze the impact of hyperglycemia on clinical outcome in patients with PIVH. Methods: Patients admitted to Department of Neurosurgery, West China Hospital with PIVH between 2010 and 2016 were retrospectively included in our study. Clinical, radiographic, and laboratory data were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of poor outcomes. Results: One hundred and seventy patients were included in the analysis. Mean admission blood glucose level was 7.78±2.73 mmol/L and 10 patients (5.9%) had a history of diabetes mellitus. History of diabetes mellitus (P = 0.01; Odds Ratio [OR], 9.10; 95% Confidence Interval [CI], 1.64 to 50.54) was independent predictor of admission critical hyperglycemia defined at 8.17 mmol/L. Patients with admission critical hyperglycemia poorer outcome at discharge (P < 0.001) and 90 days (P < 0.001). After adjustment, admission blood glucose was significantly associated with discharge (P = 0.01; OR, 1.30; 95% CI, 1.06 to 1.59) and 90-day poor outcomes (P = 0.03; OR, 1.27; 95% CI, 1.03 to 1.58), as well as mortality at 90 days (P = 0.005; OR, 1.41; 95% CI, 1.11 to 1.78). In addition, admission critical hyperglycemia showed significantly increased the incidence rate of pneumonia in PIVH (P = 0.02; OR, 6.04; 95% CI 1.27 to 28.80) even after adjusting for the confounders. Conclusion: Admission blood glucose after PIVH is associated with discharge and 90-day poor outcomes, as well as mortality at 90 days. Admission hyperglycemia significantly increases the incidence rate of pneumonia in PIVH.

scholarly journals Gastric cancer with repeated metastasis in the colonic lumen: a case report and multi-surgical experience

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110184
Author(s):  
Yi Wang ◽  
Peiqing Ma ◽  
Kan Liu ◽  
Dongkui Xu ◽  
Qian Liu
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Poor Prognosis ◽  
Partial Gastrectomy ◽  
Radical Resection ◽  
Surgical Experience ◽  
Colonic Lumen ◽  
Poorly Differentiated ◽  
Gastric Stump Carcinoma ◽  
Peritoneal Spread

Poorly differentiated gastric adenocarcinoma is commonly associated with lymph node metastasis, peritoneal spread, and liver metastasis but rarely with intraintestinal metastasis. Most patients with metastatic gastric carcinoma are unable to undergo surgical treatment and have a poor prognosis. A 42-year-old man with hunger-related abdominal pain was diagnosed as having gastric cancer. After the first surgery (distal partial gastrectomy) and the second surgery (gastric stump carcinoma (GSC) resection), the patient suffered repeated multiple intracolonic metastases and underwent three additional resection operations. The patient survived for 154 months after the first operation. In patients with gastric carcinoma that metastasizes to the colonic lumen, radical resection, if possible, can extend survival. Once patients develop extensive extraintestinal metastasis, radical resection cannot be performed, and patients often exhibit a poor prognosis.

Syphilis among men who have sex with men attending a large HIV clinic in Trinidad

2021 ◽  
pp. 095646242199719
Author(s):  
Robert Jeffrey Edwards ◽  
Isshad John ◽  
Selena Todd ◽  
Leon-Omari Lavia ◽  
David Musa ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Chart Review ◽  
Laboratory Data ◽  
Previous History ◽  
History Of ◽  
Review Study ◽  
Sex With Men ◽  
Associated Risk Factors ◽  
Living With Hiv ◽  
Age Range

A chart review study was conducted to determine the prevalence of syphilis and explore the associated risk factors among men who have sex with men (MSM) who attended a large HIV clinic in Trinidad during the period January–December 2019. Patients were routinely screened for syphilis annually, and demographic, clinical, and laboratory data were extracted from the medical records. Descriptive and bivariate analyses were performed, and factors significantly associated with a syphilis diagnosis were assessed using multivariate logistic regression. During the period, 218 MSM were seen, age range 19–67 years, and median age 34.0 years. The prevalence of syphilis was 41.3% (90/218), and 71.1% (64//90) of these infections were asymptomatic. Multivariate analysis using logistic regression showed that MSM living with HIV in the 30–34 years old-age group (OR, 4.32; 95% CI, 1.04–18.02), and those with a previous history of treated syphilis (OR, 10.18; 95% CI, 4.60–22.53) were more likely to be diagnosed with syphilis. The prevalence of syphilis is high among MSM attending the HIV clinic in Trinidad, and most of these infections were asymptomatic; hence, targeted and sustained interventions to reduce syphilis transmission are urgently required. Repeat episodes of syphilis may play a role in the transmission dynamics of syphilis in MSM.

scholarly journals Predictive factors of epilepsy outcome in a sample of Egyptian pre-elderly and elderly population

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Steven Emil Gerges ◽  
Mahmoud Hemeda El Rakawy ◽  
Naglaa Mohammed El Khayat ◽  
Yousry Abo Elnaga Abdelhamid ◽  
Ahmed Mohammed Hazzou ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Elderly Population ◽  
Laboratory Data ◽  
The Elderly ◽  
Medical Comorbidities ◽  
Mri Brain ◽  
Group Data ◽  
History Of ◽  
Eeg Changes ◽  
International League

Abstract Background Elderly people with epilepsy are large, but neglected group. Data on the predictive factors for recurrent seizures in the elderly population are inconclusive or are not known for the majority of patients. This is especially true for the Egyptian population as no specific study was concluded to address this issue before. Objectives The aim of this study was to detect the predictive factors of epilepsy outcome in a sample of Egyptian aged population. Materials and methods A total of 100 patients aged 50 years or older with epilepsy diagnosed according to International League Against Epilepsy (ILAE) latest definition were included in the study and followed up for 6 months as regards seizure control. All participants were prospectively evaluated for epidemiological, clinical, radiological, electrodiagnostic, and laboratory data. Results The outcome was statistically significant affected in relation to absence of medical comorbidities (P = 0.037), seizure etiology (P = 0.007), history of status epilepticus (P <  0.001), MRI brain findings (P = 0.005), EEG changes (P <  0.001), Ca (P = 0.01), and Mg level (P = 0.046). Conclusion We conclude that aged Egyptian epileptic population with no medical comorbidities, normal MRI brain, or normal EEG can be predicted to have good outcome of their epilepsy while patients with post stroke epilepsy, abnormal MRI brain, and abnormal EEG, with low serum Ca or Mg level can be predicted to have poor outcome.

scholarly journals Endometriosis Mimicking a Cecum Mass with Complete Bowel Obstruction: An Infrequent Cause of Acute Abdomen

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Gabriel A. Molina ◽  
Darwin R. Ramos ◽  
Alberto Yu ◽  
Patricio A. Paute ◽  
Paul S. Llerena ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Preoperative Diagnosis ◽  
Malignant Tumors ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Intestinal Involvement ◽  
History Of ◽  
Ovarian Abscess ◽  
Fertile Women

Endometriosis is a common entity among fertile women which unfortunately manifests through variable symptomatology. Intestinal involvement in endometriosis is quite common and can simulate several diseases such as Crohn’s disease, appendicitis, tubo-ovarian abscess, or malignant tumors. Intestinal obstruction due to endometriosis is rare, and preoperative diagnosis is difficult because the signs and symptoms are nonspecific and can be easily confused. In the case of patients without a history of endometriosis, diagnosis is further complicated. We present a case of a 41-year-old female patient. She presented to the emergency room with complete bowel obstruction and a mass in the cecum. Surgery was decided, and the patient underwent full recovery. Endometriosis was the final diagnosis for the observed condition.

Prognosis of patients in prolonged coma after severe carbon monoxide poisoning

2021 ◽  
pp. 096032712199799
Author(s):  
Y Gao ◽  
H Gu ◽  
J Yang ◽  
L Yang ◽  
Z Li ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Poor Prognosis ◽  
Vegetative State ◽  
Carbon Monoxide Poisoning ◽  
Demographic Data ◽  
Laboratory Data ◽  
Persistent Vegetative State ◽  
Chronic Phase ◽  
Imaging Features ◽  
Prolonged Coma

Background: Late recovery in patients following prolonged coma from carbon monoxide poisoning have been reported, but the probability is unclear. The purpose of this research was to assess the prognosis of patients in prolonged coma after severe carbon monoxide poisoning and related clinical and imaging features. Methods: There were 13 patients who had been in a state of coma for >7 days after acute carbon monoxide poisoning in the retrospective observational study, and demographic data, clinical data, laboratory data, complications, and image data were collected. Outcome was assessed by means of the Glasgow outcome scale after 1 year. The relationship between complications and imaging manifestations and prognosis was also analyzed. Results: One year after severe carbon monoxide poisoning, two patients (15.4%) had died (GOS 1), nine (69.2%) were in a persistent vegetative state (GOS 2), one (7.7%) was moderately disabled (GOS 4), and one (7.7%) achieved a good recovery (GOS 5) with minimal disability. Conclusions: Most patients with prolonged coma after severe carbon monoxide poisoning had a poor prognosis, although the younger patients had a better prognosis. Respiratory failure, hypotension and renal failure during the course of the disease were associated with a poor prognosis. The prognosis of patients with injuries in two sites in early CT was poor. Multiple lesions (≥3) and extensive white matter damage (Fazekas grade (PVH or DWMH) = 3) on MRI of chronic phase were also associated with a poor prognosis.

A STUDY OF ETIOPATHOGENESIS OF MIDDLE EAR GRANULATIONS IN CHRONIC OTITIS MEDIAAND THEIR MANAGEMENT

2021 ◽  
pp. 33-35
Author(s):  
Shambhu Sharan Gupta ◽  
Satish Kumar ◽  
Debarshi Jana
Keyword(s):  
Middle Ear ◽  
Laboratory Data ◽  
Topical Steroid ◽  
Chronic Otitis Media ◽  
Urban Background ◽  
Male Preponderance ◽  
History Of ◽  
Chemical Cautery ◽  
Rural Patients ◽  
Complete History

Objective: The purpose of this study was to evaluate the etiopathogenesis of middle ear granulations in cases of Chronic Otitis Media (COM) and their management. Materials and Methods:Aprospective study was conducted on 100 patients over a period of 12 months. Patients clinically diagnosed as COM and operated, with the ndings of granulations in middle ear were included in this study. Each of these patients was subjected to complete history and thorough ENT examination after taking proper written informed consent. Clinical and laboratory data from the study was recorded as per the proforma. Results:Analysis of data revealed that maximum cases were found in the second or third decade of life with a male preponderance. Rural patients were 75% as compared to those from urban background 25%. Mucosal type of COM was found in 69% patients and squamous type in 31% patients. Maximum patients presented with history of discharge since 5-10 years, mostly mucopurulent type of discharge. Granulations were found to be present at more that one site in middle ear in most of the patients. Incus was the most commonly involved ossicle. Conservative management included chemical cautery and aural toilet followed with antibiotics with topical steroid.

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