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Diagnostics (Basel, Switzerland) Apr 2024Achalasia is an esophageal motor disorder characterized by aperistalsis and the failure of the relaxation of the lower esophageal sphincter. We want to find out whether...
BACKGROUND
Achalasia is an esophageal motor disorder characterized by aperistalsis and the failure of the relaxation of the lower esophageal sphincter. We want to find out whether external compression or recurrent micro-aspiration of undigested food has a functional effect on the airway.
METHODS
The aim of this research was to analyze the influence of achalasia on the peak expiratory flow and flow-volume curve. All of the 110 patients performed spirometry.
RESULTS
The mean diameter of the esophagus was 5.4 ± 2.1 cm, and nine of the patients had mega-esophagus. Seven patients had a plateau in the inspiratory part of the flow-volume curve, which coincides with the patients who had mega-esophagus. The rest of the patients had a plateau in the expiration part of the curve. The existence of a plateau in the diameter of the esophagus of more than 5 cm was significant ( 0.003). Statistical significance between the existence of a plateau and a lowered PEF (PEF < 80) has been proven ( 0.001). Also, a statistical significance between the subtype and diameter of more than 4 cm has been proved. There was no significant improvement in the PEF values after operation. In total, 20.9% of patients had a spirometry abnormality finding. The frequency of the improvement in the spirometry values after surgery did not differ significantly by achalasia subtype. The improvement in FEV1 was statistically significant compared to the FVC values.
CONCLUSIONS
Awareness of the influence of achalasia on the pulmonary parameters is important because low values of PEF with a plateau on the spirometry loop can lead to misdiagnosis. The recognition of various patterns of the spirometry loop may help in identifying airway obstruction caused by another non-pulmonary disease such as achalasia.
PubMed: 38732346
DOI: 10.3390/diagnostics14090933 -
Animals : An Open Access Journal From... Apr 2024Ovarian tumors in mares are uncommon in comparison to other neoplasms and are classified into three categories: gonadal stromal tumors, coelomic epithelium surface...
Ovarian tumors in mares are uncommon in comparison to other neoplasms and are classified into three categories: gonadal stromal tumors, coelomic epithelium surface tumors, and germinal cell tumors. Some ovarian neoplasms histologically show a mixture of multiple cell types in the same tumor, such as fibrothecoma; therefore, the differentiation between fibroma and thecoma is often difficult. According to the World Health Organization, fibrothecomas are classified as sex-cord stromal tumors (pure stromal tumors). Neoplasms such as fibrothecoma present with limited morphological, clinical, ultrasonographic, and endocrine profile characteristics. To diagnose this type of tumor, a broad clinical examination is needed, but histopathology remains the most accurate. Herein, we report a case of incidentally found ovarian fibrothecoma during a diagnostic laparotomy in a 6-year-old Dutch Warmblood (KWPN) mare who presented to the clinic with colic symptoms. After a unilateral ovariectomy, the altered right ovary was diagnosed as fibrothecoma based on histopathological features.
PubMed: 38731310
DOI: 10.3390/ani14091307 -
International Journal of Surgery Case... Jun 2024Paraduodenal hernias are difficult to diagnose due to their unusual presentation. Herein, five new cases are added to the literature.
INTRODUCTION AND IMPORTANCE
Paraduodenal hernias are difficult to diagnose due to their unusual presentation. Herein, five new cases are added to the literature.
CASE PRESENTATION
Four male and one female child complained of paraduodenal hernias, two on the right side and three on the left side. The intestinal part that herniated inside the hernia sac was also malrotated in four patients. One patient had Meckel's diverticulum with a herniated intestine. One infant had extrahepatic biliary disease, a single atrium, polysplenia, intestinal malrotation, and a left paraduodenal hernia. Exploratory labarotomy was done for reduction of the intestine, reorientation, and repair of hernia orifices.
CLINICAL DISCUSSION
Paraduodenal hernia is a component of malrotation. Cautious dissection of the hernia orifice is required to keep away from injuries to the inferior mesenteric vein or left colic artery in the course of the restoration of the left paraduodenal hernia. Also, the superior mesenteric vessels may be injured in the course of the restoration of the right paraduodenal hernia.
CONCLUSION
There is a correlation between the occurrence of PDH with malrotation. The diagnosis of malrotation can be made with an ultrasound abdomen; however, it is true that ultrasound cannot make a confirmed diagnosis in all patients. Once the diagnosis of a mesocolic hernia has occurred, surgical repair is mandatory by closure of the defect.
PubMed: 38714067
DOI: 10.1016/j.ijscr.2024.109696 -
Journal of Education & Teaching in... Apr 2024Intussusception is a familiar diagnosis among the pediatric population; however, it is rarely considered among the adult population due to a myriad of life-threatening...
UNLABELLED
Intussusception is a familiar diagnosis among the pediatric population; however, it is rarely considered among the adult population due to a myriad of life-threatening pathologies within the abdomen. We present an adult female who presented to the emergency department (ED) with abdominal pain and constipation. Laboratory testing and a computed tomography (CT) scan of the abdomen were ordered. Laboratory test results were notable for an elevated lymphocyte count as well as leukocyte esterase, white blood cells (WBC), and bacteria seen on urinalysis. The computed tomography scan detected a colo-colic intussusception secondary to a benign mass within the bowel lumen. The mass was surgically resected and the patient had an uneventful postoperative course. This unique case represents the occurrence of a pathology to which the adult population is not immune, and therefore should not be overlooked when evaluating a non-specific case of abdominal pain.
TOPICS
Intussusception, colo-colic, obstruction, abdominal pain, constipation, female, mass, bowel, lymphocyte, ultrasound, computed tomography.
PubMed: 38707945
DOI: 10.21980/J8Q06C -
Annals of Medicine and Surgery (2012) May 2024Gastric leiomyosarcoma is a rare malignant tumor among the primary gastric carcinomas. Among the different common presentations, dysphagia is an uncommon presentation of...
INTRODUCTION AND IMPORTANCE
Gastric leiomyosarcoma is a rare malignant tumor among the primary gastric carcinomas. Among the different common presentations, dysphagia is an uncommon presentation of gastric leiomyosarcoma.
CASE PRESENTATION
A 29-year-old female presented with complaints of progressive dysphagia for 1 year associated with vomiting, significant weight loss, and anorexia for 6 months. On blood investigations, she had anemia, hypokalemia, prerenal acute kidney injury, and unconjugated hyperbilirubinemia. Upper gastrointestinal endoscopy and contrast-enhanced computed tomography (CECT) were initially suggestive of carcinoma of stomach. Immunohistochemistry was diagnostic of leiomyosarcoma of stomach extending to the gastroesophageal junction and distal esophagus. She underwent total gastrectomy with distal esophagectomy with lateral segmentectomy of liver (nonanatomical) with Roux-en-Y esophago-jejunal anastomosis (end-to-side and retro-colic) through thoracoabdominal approach. After 6 weeks, she received four cycles of doxorubicin therapy. Follow-up at 18 months after surgery revealed no recurrence of malignancy.
CLINICAL DISCUSSION
Leiomyosarcoma, a rare malignant tumor arising from stomach involves commonly gastric body followed by antrum and fundus. Imaging including CECT and tissue diagnosis including immunohistochemistry (positive for α-SMA, desmin, calponin, h-caldesmon, or smoothelin) have been mainstay for definitive diagnosis. The standard treatment for leiomyosarcoma of stomach is complete surgical resection of tumor because it has malignant potential and does not respond to targeted treatment with a tyrosine kinase inhibitor. The type of surgery depends on the size and localization of the tumor.
CONCLUSIONS
Early diagnosis with proper imaging, immunohistochemistry, and biopsy play important role in differentiating gastric leiomyosarcoma from gastrointestinal stromal tumor. Surgical resection is the mainstay of treatment.
PubMed: 38694323
DOI: 10.1097/MS9.0000000000001980 -
Cureus Mar 2024As our understanding of the intricate interaction between gut bacteria and human health continues to expand, so too has interest in the ability of probiotics to manage... (Review)
Review
As our understanding of the intricate interaction between gut bacteria and human health continues to expand, so too has interest in the ability of probiotics to manage gut microbiota and confer multiple health benefits to the host. The mini literature review focuses on the expanding potential of the use of probiotics in GI health, with a focus on probiotics' potential therapeutic advantages in a variety of gastrointestinal (GI) illnesses. Probiotics play a significant role in managing diarrhea and symptoms of irritable bowel syndrome with diarrhea (IBS-D) by modulating gut microbial communities. Specific probiotic strains have been found to reduce the abundance of harmful bacteria, regulate inflammatory markers like interleukin 6, and improve GI symptoms such as abdominal discomfort and stool consistency. Additionally, probiotic blends have shown potential for preventing GI infections and alleviating GI pain in IBS-D patients. Studies have demonstrated that certain multi-strain probiotics, including and species, can significantly increase the frequency of bowel movements and reduce the proportion of individuals experiencing constipation. It has also been found that probiotic supplementation may reduce the incidence of postoperative complications and mortality, particularly in patients undergoing colorectal adenocarcinoma surgery. Additionally, probiotics have been associated with decreased levels of pro-inflammatory cytokines and improved clinical outcomes in patients with colorectal cancer. Furthermore, probiotics have been associated with enhanced digestive tolerance, reduced GI inflammation, and prolonged clinical remission in certain UC patients. Studies have also shown that probiotics, administered either directly to infants or pregnant women during the perinatal stage, can alleviate symptoms such as inconsolable crying and irritation associated with infant colic, improve bowel movement frequency in cases of functional constipation, and enhance overall conditions in premature infants, including reducing regurgitation and improving feeding tolerance. The review addresses both encouraging results and challenges with probiotic therapy, while also arguing for more studies to elucidate underlying mechanisms and enhance therapeutic techniques. As we traverse the complex field of probiotic therapy in the treatment of GI illnesses, researchers, physicians, and other healthcare professionals can benefit from the informative information provided by this study.
PubMed: 38681263
DOI: 10.7759/cureus.57055 -
Nature Communications Apr 2024Genetic interactions mediate the emergence of phenotype from genotype, but technologies for combinatorial genetic perturbation in mammalian cells are challenging to...
Genetic interactions mediate the emergence of phenotype from genotype, but technologies for combinatorial genetic perturbation in mammalian cells are challenging to scale. Here, we identify background-independent paralog synthetic lethals from previous CRISPR genetic interaction screens, and find that the Cas12a platform provides superior sensitivity and assay replicability. We develop the in4mer Cas12a platform that uses arrays of four independent guide RNAs targeting the same or different genes. We construct a genome-scale library, Inzolia, that is ~30% smaller than a typical CRISPR/Cas9 library while also targeting ~4000 paralog pairs. Screens in cancer cells demonstrate discrimination of core and context-dependent essential genes similar to that of CRISPR/Cas9 libraries, as well as detection of synthetic lethal and masking/buffering genetic interactions between paralogs of various family sizes. Importantly, the in4mer platform offers a fivefold reduction in library size compared to other genetic interaction methods, substantially reducing the cost and effort required for these assays.
Topics: CRISPR-Cas Systems; Humans; Gene Knockout Techniques; RNA, Guide, CRISPR-Cas Systems; Gene Library; Cell Line, Tumor; Genes, Essential; HEK293 Cells; Epistasis, Genetic; CRISPR-Associated Proteins; Bacterial Proteins; Endodeoxyribonucleases
PubMed: 38678031
DOI: 10.1038/s41467-024-47795-3 -
Medicina (Kaunas, Lithuania) Apr 2024Lung cancer is the second most common form of cancer in the world for both men and women as well as the most common cause of cancer-related deaths worldwide. The aim of...
Lung cancer is the second most common form of cancer in the world for both men and women as well as the most common cause of cancer-related deaths worldwide. The aim of this study is to summarize the radiological characteristics between primary lung adenocarcinoma subtypes and to correlate them with FDG uptake on PET-CT. This retrospective study included 102 patients with pathohistologically confirmed lung adenocarcinoma. A PET-CT examination was performed on some of the patients and the values of SUVmax were also correlated with the histological and morphological characteristics of the masses in the lungs. The results of this analysis showed that the mean size of AIS-MIA (adenocarcinoma in situ and minimally invasive adenocarcinoma) cancer was significantly lower than for all other cancer types, while the mean size of the acinar cancer was smaller than in the solid type of cancer. Metastases were significantly more frequent in solid adenocarcinoma than in acinar, lepidic, and AIS-MIA cancer subtypes. The maximum standardized FDG uptake was significantly lower in AIS-MIA than in all other cancer types and in the acinar predominant subtype compared to solid cancer. Papillary predominant adenocarcinoma had higher odds of developing contralateral lymph node involvement compared to other types. Solid adenocarcinoma was associated with higher odds of having metastases and with higher SUVmax. AIS-MIA was associated with lower odds of one unit increase in tumor size and ipsilateral lymph node involvement. The correlation between histopathological and radiological findings is crucial for accurate diagnosis and staging. By integrating both sets of data, clinicians can enhance diagnostic accuracy and determine the optimal treatment plan.
Topics: Humans; Male; Female; Retrospective Studies; Positron Emission Tomography Computed Tomography; Middle Aged; Aged; Adenocarcinoma of Lung; Lung Neoplasms; Adenocarcinoma; Fluorodeoxyglucose F18; Adult; Aged, 80 and over
PubMed: 38674262
DOI: 10.3390/medicina60040617 -
Children (Basel, Switzerland) Apr 2024The WHO and UNICEF recommend that only breastmilk, vitamin drops, oral rehydration solution, and prescribed medicine can go through the infant's mouth. Non-prescribed...
UNLABELLED
The WHO and UNICEF recommend that only breastmilk, vitamin drops, oral rehydration solution, and prescribed medicine can go through the infant's mouth. Non-prescribed medications (NPM) include over-the-counter medications and traditional medicine and are contraindicated during infancy. Furthermore, the updated exclusive breastfeeding (EBF) indicator details that herbal fluids and similar traditional medicines are counted as fluids, and infants who consume these are not exclusively breastfed. However, the use of these items is common among caregivers for various reasons, including religious reasons, cultural beliefs, prevention of diseases, and the treatment of diseases. The practice of administering NPM before six months of age undermines exclusive breastfeeding and can result in undesirable health outcomes.
METHODS
The purpose of this study was to determine the prevalence of NPM, describe the types of medications used, and explain why caregivers use NMP in infants younger than six months of age. A quantitative approach and a facility-based cross-sectional survey were used to conduct this study. Convenience sampling was used to select clinics, and proportionality and simple random sampling were used to select 146 participants. Data were analyzed using SPSS (29). A -value of < 0.05 was considered significant.
RESULTS
In this study, the prevalence of NPM was 75.3%. Of the 146 participants, most were 25-35 years old (54%) and first-time mothers (36.3%). More caregivers had high school and matric (67.1%), and 84.2% of caregivers delivered in public health facilities. Almost three-quarters are unemployed (66.7%) and on a child support grant (56.4%). About 43.6% of infants received NPM within the first month of life. The main source of advice to give NPM was family members (86.4%). The main reasons for administering NPM were the treatment of the umbilical cord (57.3%) and the prevention of colic (32.7%). The results show a statistically significant association between the administration of medication and the age of the infant, < 0.005.
CONCLUSIONS
Non-prescribed medications are highly prevalent in the rural areas of Polokwane and are practiced by caregivers between the ages of 25-35 years advised by the families. Access to self-medication should be controlled, especially in the first month of life. Interventions to reduce the use of NPM should be targeted at young mothers and their families.
PubMed: 38671651
DOI: 10.3390/children11040434