scholarly journals Resección de adenoma velloso gigante causante del síndrome de Mckittrick-Wheelock

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Marcos Leites ◽  
Adrián Canavesi ◽  
Diana Valencia ◽  
Rodrigo Dorelo ◽  
Iván Trostchansky ◽  
...  
Keyword(s):  
Chronic Diarrhea ◽  
Kidney Injury ◽  
Lateral Spreading ◽  
Low Grade ◽  
Electrolyte Disorders ◽  
Symptomatic Management ◽  
Lateral Spreading Tumor ◽  
Pull Through ◽  
Rectal Obstruction ◽  
Villous Adenomas

Large colorectal villous adenomas are unusual. They can cause a rectal bleeding, a chronic diarrhea and less frequently a rectal obstruction and a prolapse. In addition, they can secrete a mucinous material rich in electrolytes, causing hydroelectrolyte disturbances, dehydration and acute kidney injury. In most cases, the management of these adenomas due to their size has been surgical, but endoscopic treatment has been reported with promising results, reducing the morbidity. We report and discuss the case of a 73-year-old man, who presented with syncope, with chronic diarrhea and a hydroelectrolytic alteration. Colonoscopy revealed a granular lateral spreading tumor of the rectum, and pathology confirmed a villous adenoma with a low-grade dysplasia. An initial symptomatic management of diarrhea and electrolyte disorders was performed with a subsequent surgical treatment using pull through technique with coloanal anastomosis.

scholarly journals Renal Complications Related to Checkpoint Inhibitors: Diagnostic and Therapeutic Strategies

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1187
Author(s):  
Julie Belliere ◽  
Julien Mazieres ◽  
Nicolas Meyer ◽  
Leila Chebane ◽  
Fabien Despas
Keyword(s):  
Checkpoint Inhibitors ◽  
Treatment Strategies ◽  
Kidney Injury ◽  
Immunosuppressive Drugs ◽  
Peripheral Tolerance ◽  
Electrolyte Disorders ◽  
Glomerular Diseases ◽  
Renal Complications ◽  
Lower Baseline ◽  
Low Incidence

Immune checkpoint inhibitors (ICI) targeting CTLA-4 and the PD-1/PD-L1 axis have unprecedentedly improved global prognosis in several types of cancers. However, they are associated with the occurrence of immune-related adverse events. Despite their low incidence, renal complications can interfere with the oncologic strategy. The breaking of peripheral tolerance and the emergence of auto- or drug-reactive T-cells are the main pathophysiological hypotheses to explain renal complications after ICI exposure. ICIs can induce a large spectrum of renal symptoms with variable severity (from isolated electrolyte disorders to dialysis-dependent acute kidney injury (AKI)) and presentation (acute tubule-interstitial nephritis in >90% of cases and a minority of glomerular diseases). In this review, the current trends in diagnosis and treatment strategies are summarized. The diagnosis of ICI-related renal complications requires special steps to avoid confounding factors, identify known risk factors (lower baseline estimated glomerular filtration rate, proton pump inhibitor use, and combination ICI therapy), and prove ICI causality, even after long-term exposure (weeks to months). A kidney biopsy should be performed as soon as possible. The treatment strategies rely on ICI discontinuation as well as co-medications, corticosteroids for 2 months, and tailored immunosuppressive drugs when renal response is not achieved.

scholarly journals How to trick artificial intelligence: rectal heterotopic gastric lateral spreading tumor

VideoGIE ◽  
2021 ◽  
Author(s):  
Matteo Badalamenti ◽  
Roberta Maselli ◽  
Marco Spadaccini ◽  
Piera Alessia Galtieri ◽  
Antonio Capogreco ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Lateral Spreading ◽  
Lateral Spreading Tumor

scholarly journals Assessment of a Modified Antibiotic Prophylaxis Open Fracture Protocol

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S93-S93
Author(s):  
Brandon Hill ◽  
Kamla Sanasi-Bhola ◽  
Stella Okoye ◽  
Margaret Madera ◽  
Janie Ferren ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Open Fracture ◽  
Kidney Injury ◽  
Fracture Site ◽  
Adherence Rate ◽  
Low Grade ◽  
Infection Rates ◽  
National Guidelines ◽  
Gram Negative ◽  
Clinical Endpoints

Abstract Background National guidelines support antibiotic prophylaxis for open fracture with cefazolin +/− aminoglycoside based on fracture grade and contamination. The purpose of this study was to assess a modified adult antibiotic prophylaxis open fracture protocol (AOFP) which recommended weight-based cefazolin for low-grade fractures or ciprofloxacin plus vancomycin for high-grade fractures. Methods Adult patients with open fractures admitted to Palmetto Health Richland between January 2012 and December 2016 were screened for study inclusion. Exclusion criteria were receipt of antibiotics for reasons other than open fracture, death prior to wound closure, and local admission time >48 hours after time of injury. Compliance to all elements of AOFP was assessed. Clinical endpoints including open fracture infection rates, epidemiology, and drug-related adverse events were compared between pre-implementation (January 2012 – December 2012) and post-implementation period (November 2015 – December 2016). χ 2 and t-tests as appropriate were used to compare outcomes between groups. Results Following exclusions 189 patients were included in the analysis (90 pre- vs. 99 post-AOFP, respectively). Post-AOFP, a 17% (16/93) adherence rate to all AOFP elements was found. Appropriate agents were selected in 82.8% (77/93). The most common reasons for non-adherence were incorrect dosing and prolonged antibiotic duration. Fracture site infection rates were 23.3% (21/90) and 7.1% (7/99) in pre- and post-AOFP groups, respectively (P = 0.001). Infections primary caused by Gram-negative pathogens in pre-AOFP and Gram-negative organisms comprised 62 and 40% of open fracture site infections in pre- and post-AOFP groups, respectively. Incidence of acute kidney injury, Clostridium difficile-associated diarrhea, and other antibiotic-associated AEs were rare and comparable between groups. Change in median days to infection (55.6 days vs. 56.55 days, P = 0.71) and median duration of antibiotics in hours (48.0 vs. 54.7, P = 0.59) was not significantly different post implementation. Conclusion Local adherence to all elements of the modified AOFP was low, yet the appropriate agent(s) was used in majority of cases. The modified AOFP was associated with a numerical decrease in infection rates post-open fracture and comparable AEs. Disclosures P. B. Bookstaver, Rock Pointe: Content Developer, Consulting fee

scholarly journals Fatal Outcome Consequent to an Endoscopic Full Thickness Resection of a Colonic Lateral Spreading Tumor: A Case Report

2020 ◽  
Vol 21 ◽  
Author(s):  
Giovanni Oliviero ◽  
Mario Gagliardi ◽  
Marco Napoli ◽  
Orazio Labianca ◽  
Antonio D\'Antonio ◽  
...  
Keyword(s):  
Case Report ◽  
Fatal Outcome ◽  
Lateral Spreading ◽  
Full Thickness ◽  
Lateral Spreading Tumor ◽  
Endoscopic Full Thickness Resection

Kidney Disease in the Cancer Patient

2014 ◽  
Author(s):  
Colm Magee ◽  
Lynn Redahan
Keyword(s):  
Kidney Disease ◽  
Cancer Patient ◽  
Tumor Lysis Syndrome ◽  
Interleukin 2 ◽  
Kidney Injury ◽  
Vascular Diseases ◽  
Electrolyte Disorders ◽  
Laboratory Findings ◽  
Hematopoietic Stem ◽  
Electrolyte Disturbances

The spectrum of kidney disease in the cancer patient is wide. Kidney dysfunction can result from the cancer itself or its treatment. The presentation in this population is varied and may manifest as acute kidney injury (AKI) or chronic kidney disease. In addition, other manifestations of kidney disease can include proteinuria, hypertension, and electrolyte disturbances. As new cancer treatments emerge, the range of therapy-associated renal syndromes increases. This chapter deals predominantly with causes and management of renal dysfunction that are specific to the cancer patient, including those caused by hypercalcemia; hepatorenal syndrome; the use of interleukin-2 (IL-2) and bisphosphonate; glomerular, tubular, interstitial, and vascular diseases; multiple myeloma (MM); and tumor infiltration. The chapter also examines postrenal causes of AKI, electrolyte disorders, and hematopoietic stem cell transplantation (HSCT). Tables provide the features of kidney disease in the cancer patient, the pathogenesis of hypercalcemia, strategies for preventing and managing AKI with IL-2 therapy, laboratory findings with hemolytic-uremic syndrome/thrombocytopenic purpura, the causes of acute tubular necrosis in MM, a summary of electrolyte disturbances in the cancer patient, indications for HSCT, and a summary of the management of patients with post-HSCT AKI. The chapter is also enhanced by ultrasound and computed tomographic scans, histology images, and an illustration of tumor lysis syndrome. This chapter contains 105 references, 8 tables, 4 highly rendered figures, and 5 MCQs.

Acute kidney injury (AKI)

2021 ◽  
pp. 490-525
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Function ◽  
Low Income ◽  
Urine Output ◽  
Incidental Finding ◽  
Hospital Setting ◽  
Kidney Injury ◽  
Electrolyte Disorders ◽  
Severe Condition ◽  
Renal Replacement Therapies

Acute kidney injury (AKI) can generally be considered as sudden reduction in kidney function occurring over hours to days, and is commonly but not always associated with a reduction in urine output. Its definition was based on rises in serum creatinine and reductions in urine output criteria. Its incidence, prevalence, and aetiology vary according to the country/region profile (low income, high income, tropical, etc.), age (children, adult, or elderly), and clinical setting (outpatients versus inpatient, hospital versus intensive care unit). The incidence of AKI is increasing in the hospital setting, and is more common with increasing age, male sex, pre-existing CKD, and comorbidity (congestive cardiac failure, diabetes, hypertension). The majority of cases result from multiple insults: dehydration, drugs in conjunction with inflammation and/or sepsis. AKI may have a spectrum of being an incidental finding with no signs or symptoms to a moderate to severe condition with increased morbidity and mortality due to accumulation of nitrogenous waste products and fluid–electrolyte disorders. The aetiologies of AKI are numerous and can broadly be classified as pre-renal, intrinsic renal, and post-renal (obstructive). A thorough evaluation of the patients with AKI for diagnosis and treatment are required. There are no specific treatments, but eliminating aetiological reasons and protection from further kidney function loss are crucial. A balanced haemodynamic management along with a balanced fluid–electrolyte replacement and arranging drug dosages are important. Various modes of renal replacement therapies may be used for treating severe cases.

scholarly journals Lateral Spreading Tumor Arising in an Interposed Colonic Segment

2019 ◽  
Vol 6 (10) ◽  
pp. e00245
Author(s):  
Carolina Simões ◽  
Miguel Moura ◽  
Carlos Noronha Ferreira ◽  
Rosario Rosa ◽  
José Paulo Freire ◽  
...  
Keyword(s):  
Lateral Spreading ◽  
Colonic Segment ◽  
Lateral Spreading Tumor

scholarly journals A young adult with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)-like illness: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aaron D. Kofman ◽  
Emma K. Sizemore ◽  
Joshua F. Detelich ◽  
Benjamin Albrecht ◽  
Anne L. Piantadosi
Keyword(s):  
Cardiac Dysfunction ◽  
Clinical Characteristics ◽  
Kidney Injury ◽  
Clinical Findings ◽  
Low Grade ◽  
Rare Form ◽  
Case Presentation ◽  
Lymph Node Swelling ◽  
Inflammatory Syndrome

Abstract Background A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age. Case presentation The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5. Conclusion MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.

Acute kidney injury and electrolyte disorders in the critically ill patient with cancer

2017 ◽  
Vol 23 (6) ◽  
pp. 475-483 ◽  
Author(s):  
Mitchell H. Rosner ◽  
Giovambattista Capasso ◽  
Mark A. Perazella
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Kidney Injury ◽  
Critically Ill Patient ◽  
Electrolyte Disorders

Large Duodenal Tumor with Positive K‐ras Mutation Mimicking Lateral Spreading Tumor of the Colon — a Case Report

1999 ◽  
Vol 11 (1) ◽  
pp. 70-75
Author(s):  
Hironi TAGA ◽  
Hiroyuki WATANABE ◽  
Yasushi YAMAGUCHI ◽  
Kohshiro OHTSUBO ◽  
Aiguli HA ◽  
...  
Keyword(s):  
Case Report ◽  
Lateral Spreading ◽  
Ras Mutation ◽  
Duodenal Tumor ◽  
Lateral Spreading Tumor
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