scholarly journals A Rare Medullary Carcinoma of Jejunum

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S69-S69
Author(s):  
S Fathima ◽  
A Bredeweg
Keyword(s):  
Celiac Disease ◽  
Clinical Manifestations ◽  
Collagenous Colitis ◽  
Rare Condition ◽  
Medullary Carcinoma ◽  
Treatment Modalities ◽  
Chronic Anemia ◽  
Nuclear Expression ◽  
Appropriate Treatment

Abstract Introduction/Objective Medullary carcinoma of jejunum is an extremely rare condition. These tumors account for less than 0.04% of all colorectal cancers and less than 3 cases to date has been reported in the small intestine Methods/Case Report We present a case of 78-year-old woman with a celiac disease and collagenous colitis, chronic diarrhea, chronic anemia and 2.1 cm apple core lesion on mid to distal jejunum on CT leading to partial obstruction. Results (if a Case Study enter NA) Histologically tumor showed invasive carcinoma in a solid growth pattern with pushing border. The tumor cells were uniform, enlarged with prominent nucleoli and brisk mitotic activity. There was prominent inflammatory response within and around the tumor. Immunohistochemical stains were positive for CK7, CDX2 CK19, CKAE1-3 and negative for CD45, CK20, Chromogranin Synaptophysin, PAX-8. MLH1 &PMS2 showed loss of nuclear expression and MSH2 & MSH6 with Intact nuclear expression. Microsatellite instability was High (MSI- H) with instability in two or more microsatellite markers. Diagnosis of medullary carcinoma of jejunum was made. Conclusion Although the clinical manifestations can be consistent with signs of intestinal obstruction, often these rare tumors are discovered incidentally. Conditions such as celiac disease, Crohn’s disease, and other chronic inflammatory illnesses have been linked to contributing risk factors. Imaging and appropriate tumor markers have less role in diagnosis; however, biopsy is needed for definitive diagnosis. Even though the development of these tumors in the small bowel is rare, further enhancement of awareness can aid in the appropriate early detection and appropriate treatment modalities.

Enhancing Fidelity to Cancer Treatment Guidelines

2018 ◽  
Author(s):  
Kathy J. Helzlsouer ◽  
Arti Patel Varanasi
Keyword(s):  
Cancer Treatment ◽  
Treatment Guidelines ◽  
Treatment Plan ◽  
Rapid Development ◽  
Treatment Modalities ◽  
Appropriate Treatment ◽  
Complex Process ◽  
Navigation Program ◽  
Race Ethnicity

Cancer treatment has become increasingly complex with the rapid development of new therapies and treatment modalities. Guidelines for optimum cancer treatment are produced by several organizations, but ensuring that the patient receives the treatment requires both provider awareness and patient support to follow a complex treatment plan. An individual diagnosed with cancer must simultaneously come to terms with the diagnosis, make difficult shared decisions about treatment with his or her provider, and commence treatment in a matter of a few days or weeks. Ensuring optimum treatment is an increasingly complex process that involves multiple people and steps. Well-documented disparities exist in the receipt of and adherence to appropriate treatment by demographic and social factors, such as age, race, ethnicity, socioeconomic status, and geography. This case study provides an example of how the process of providing optimum cancer treatment may be improved through a technology-enhanced navigation program.

scholarly journals Collagenous colitis presenting with bloody diarrhea and rectal erosions in a patient with celiac disease: a case report

2013 ◽  
pp. 254-258
Author(s):  
Antonio Carroccio ◽  
Tiziana Catalano ◽  
Marilena Fiorino ◽  
Accursia Bongiovì ◽  
Giuseppe Napoli ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Case Report ◽  
Oral Prednisone ◽  
Collagenous Colitis ◽  
Rare Condition ◽  
Bloody Diarrhea ◽  
Watery Diarrhea ◽  
Strict Adherence ◽  
Bowel Diseases ◽  
One Year

Introduction: Collagenous colitis (CC) is a rare condition that is known to complicate inflammatory bowel diseases, but its relationship with celiac disease (CD) is more controversial. Aims: To report a case of CC that developed in a patient with CD and was manifested by rectal erosions at onset. Case report: A 46-year-old woman was diagnosed with CD and placed on a gluten-free diet. After an initial phase of improvement, her diarrhea resumed, and she began to lose weight. Despite strict adherence to the diet, the patient's diarrhea worsened. One year after diagnosis, colonoscopy was performed and mucosal biopsies were collected, but the findings were inconclusive. Two months later, the previously watery diarrhea became bloody, and a second colonoscopy was performed. Histological examination of the biopsy specimens revealed rectal erosions and CC. The patient was treated with oral prednisone plus mesalazine for 6 weeks, and her symptoms immediately disappeared. Mesalazine was continued, and the prednisone was then gradually replaced with budesonide. Six months after the CC diagnosis, the patient was asymptomatic, and a second colonoscopy revealed no macroscopic or microscopic signs of CC. She continues to take mesalazine and budesonide. An attempt to taper the dosage of the latter drug from 6 to 3 mg/day caused the reappearance of the diarrhea. Conclusion: CC is rarely associated to CD and can cause bloody diarrhea. Excellent results were obtained in this case with prednisone plus mesalazine followed by maintenance therapy with budesonide plus mesalazine.

scholarly journals Spontaneous jejunoileal perforation as a manifestation of celiac disease—a rare entity: a case report

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Alex Paul Guachilema Ribadeneira ◽  
Naysi Cristina Zambrano Martinez ◽  
Silvana Alexandra Valencia Valverde ◽  
Raúl Ernesto Villacis Peñaherrera ◽  
Fabian Medardo Romero Chacón ◽  
...  
Keyword(s):  
Small Intestine ◽  
Celiac Disease ◽  
Clinical Manifestations ◽  
Human Leukocyte ◽  
Rare Condition ◽  
Autoimmune Response ◽  
Classical Type ◽  
High Morbidity ◽  
Gluten Sensitive Enteropathy ◽  
Hla Dq2

Abstract Celiac disease or gluten-sensitive enteropathy is characterized by an autoimmune response in the small intestine triggered by the ingestion of gluten in the diet. It has a prevalence of 0.62% worldwide with considerable variation in incidence among countries. The clinical manifestations of celiac disease differ according to type: the classical type presents with intestinal symptoms, the non-classical type with intestinal or extraintestinal symptoms and the silent type is asymptomatic. Human leukocyte antigens (HLA)-DQ2 (DQA1_05/DQB1_02) are expressed in >90% of patients with celiac disease, and the presence of HLA-DQ2 or HLA-DQ8 (DQA1_ 0301/DQB1_0302) is necessary for its development. One complication of this disease is ulcerative jejunoileitis, a rare condition characterized by chronic idiopathic ulceration affecting the small intestine that can cause intestinal perforation resulting in high morbidity.

scholarly journals Role of Vamana and Padhabhayanga in the Management of Vipakdika With special reference to Plantopalmar Psoriasis

2020 ◽  
Vol 11 (1) ◽  
pp. 131-135
Author(s):  
Padma Priya Nakka ◽  
Praveen Kumar Madikonda ◽  
Johar B
Keyword(s):  
Skin Diseases ◽  
Symptomatic Relief ◽  
Clinical Manifestations ◽  
Modern Science ◽  
Treatment Modalities ◽  
Immune Disease ◽  
Short Period ◽  
Present Case Study

Ayurveda described various skin diseases under the single heading Kushta. In Charaka Samhita, Acharya Charaka explained Ashtadasha Kushtas in two main categories namely ‘Maha Kushta’ and ‘Kshudra Kushta’. Kushta is tridoshaja vyadi, however, the symptoms appear according to the dosha predominance. Vipadika is one of the Kshudra Kushta with predominance of vata kapha doshas and it is charactrised by Pani Pada sputana (fissures in palms and soles) and Teevra vedana (severe pain). According to clinical manifestations, Vipadika is more similar to ‘Planto Palmar Psoriasis’ which is long lasting Auto Immune disease. It is found to be 3-4% of all Psoriasis cases. In modern science, many treatment modalities are available to treat the disease. They may cause many side effects and recurrence after subside is also very common which gave a big scope to alternative system of medicines to treat Vipadika. In the present case study, the line of management followed was mentioned by Acharya Charaka, according to dosha Predominance. The patient, initially administered sneha pana with Maha Tiktaka gritha for 7 days which was beneficial to pacify pitta dosha and kapha dosha utkleshana before Vamana. Later on, Vamana therapy was conducted to eliminate kapha dosha which gave good symptomatic relief to the patient. However, in view of the severity, chronicity and recurrence of the disease, Mridu Lavana jala Avagaha Sweda followed by Padhabyanga with pinda taila was also performed which resulted in excellent improvement in very short period of time.

scholarly journals Multicentric Castleman's Disease in a 21 Years Old Female : A Rare But Important Condition

2017 ◽  
Vol 16 (1) ◽  
pp. 57-59
Author(s):  
Shahed Ahmad Chowdhury ◽  
Samira Taufiq Reshma ◽  
Shanjana Islam
Keyword(s):  
Treatment Options ◽  
Castleman’S Disease ◽  
Clinical Manifestations ◽  
Rare Condition ◽  
Treatment Modalities ◽  
Unknown Etiology ◽  
Castleman's Disease ◽  
Multicentric Castleman’S Disease ◽  
Angiofollicular Lymph Node Hyperplasia ◽  
Multicentric Castleman's Disease

Castleman’s disease, also known as angiofollicular lymph node hyperplasia, is a rare disease with two known expansion types, unicentric and multicentric, which plays a major role in determining therapy. The rare multicentric type is a lymphoproliferative disorder of unknown etiology and is characterized by various clinical manifestations and multiple organ involvement. This disease runs a more aggressive course and a poor prognosis. Optimal therapies have not been well established till now. We here report a case of rare Multicentric Castleman's Disease (MCD) in a 21yrs old female. She presented with slowly enlarging lymph nodes in cervical and inguinal regions which lead to a histological diagnosis of this rare condition. Its clinical features, types, relevant investigations and current treatment modalities are discussed. Though rare, early suspicion of this condition may relieve the suffering, avoid unnecessary investigations, give opportunity to choose treatment options and can save lives.Chatt Maa Shi Hosp Med Coll J; Vol.16 (1); Jan 2017; Page 57-59

scholarly journals Analysis of the etiologies, treatments and prognoses in children and adolescent vitreous hemorrhage

2021 ◽  
Vol 14 (2) ◽  
pp. 299-305
Author(s):  
Zheng-Wei Liu ◽  
◽  
Chun-Li Chen ◽  
Xue-Hao Cui ◽  
Pei-Quan Zhao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Traffic Accidents ◽  
Clinical Manifestations ◽  
Vitreous Hemorrhage ◽  
Treatment Modalities ◽  
Children And Adolescent ◽  
Appropriate Treatment ◽  
Common Etiology ◽  
Management Modality ◽  
Systemic Examination

AIM: To determine the etiologies, treatment modalities and visual outcomes of vitreous hemorrhage (VH; range from birth to 18y). METHODS: A total of 262 eyes from 210 patients between January 2010 and September 2016 were included. All children underwent an appropriate ocular and systemic examination. Data collected included demographics, clinical manifestations, details of the ocular and systemic examination, management details, final fundus anatomy and visual acuity (VA). RESULTS: The most common etiologies were non-traumatic VH (64.89%), most of which were due to retinopathy of prematurity (ROP; 37.10%); while traffic accidents, including 16 (21.00%) eyes, was the most common ocular traumas. Surgery, performed in 143 (54.58%) eyes, was the most common management modality. The initial mean baseline visual acuity was 2.77±0.21 logarithm of the minimal angle of resolution (logMAR) in children and adolescent with traumatic VH, which was significantly improved to 2.15±1.31 logMAR (P<0.05). CONCLUSION: VH in children and adolescent has a complicated and diverse etiology. ROP is the primary cause of non-traumatic VH, which is the most common etiology. Appropriate treatment of traumatic VH is associated with obvious improvement in visual acuity. The initial VA is one of most important predictors of outcome.

scholarly journals Pharmacological approach in the Management of Katishula (Low back ache) - A case study

2020 ◽  
Vol 11 (1) ◽  
pp. 124-129
Author(s):  
Narahari B R
Keyword(s):  
Treatment Modalities ◽  
Daily Routine ◽  
Low Back ◽  
Major Health ◽  
Oral Medications ◽  
Appropriate Treatment ◽  
Back Ache ◽  
History Of ◽  
The Right

Katishula (low back ache) is one of the major health problems now a days which affects approximately 60 – 85% of adults during some point of their life causing trouble to their daily routine. It is shosha (degeneration), sthamba (stiffness), and shula (pain) predominant vyadhi (disease). It is clearly stated in the classics that the pain is produced due to stiffness which is produced by sama or nirama vayu movement in the kati (low back) region. Ayurvedic classics have mentioned appropriate treatment modalities for kati shula. A 24 year old female patient with katishula was treated conservatively with internal medicine and panchakarma (treatment procedure). Patient presented with low back ache for 1 year with aggravated symptoms like shooting pain, pain while standing and pain in the left leg. SLR was positive being 20 degree on the left leg and was negative in the right leg. There was no history of any kind of trauma. Management was done in 2 rounds where the first part included  matra basti and oral medications, through which the symptoms got reduced around 40 – 50% and in the second part of the treatment patient was managed only with the oral medications which gave very good results where the patient was almost completely relieved.

Endogenous Tongue Thrust – Myth?

2021 ◽  
Vol 14 (1) ◽  
pp. 8-12
Author(s):  
Yung Lam ◽  
Andrew Shelton ◽  
Jonathan Sandler
Keyword(s):  
Clinical Relevance ◽  
Open Bite ◽  
Treatment Modalities ◽  
Anterior Open Bite ◽  
Appropriate Treatment ◽  
Clinical Considerations ◽  
Tongue Thrust

Anterior open bite cases are very challenging to manage due to the high relapse potential associated with this feature of malocclusion. It is helpful if the aetiology is established before embarking on treatment to ensure that the appropriate treatment modalities are carried out. Determining whether the aetiology of an anterior open bite is caused by an ‘endogenous tongue thrust’ is extremely difficult. In particular, differentiating between an adaptive and endogenous tongue thrust can be extremely challenging. The case study presented explores the clinical considerations when diagnosing and treating anterior open bites. CPD/Clinical Relevance: This report raises the question: is it possible to diagnose an endogenous tongue thrust?

Site specific agricultural soil management with the use of new technologies

2013 ◽  
Vol 16 (1) ◽  
pp. 59-67
Keyword(s):  
New Technologies ◽  
Digital Interface ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Soil Variation ◽  
Soil Information ◽  
Remote Sensing Techniques ◽  
Agricultural Areas

<p>The Soil Science Institute of Thessaloniki produces new digitized Soil Maps that provide a useful electronic database for the spatial representation of the soil variation within a region, based on in situ soil sampling, laboratory analyses, GIS techniques and plant nutrition mathematical models, coupled with the local land cadastre. The novelty of these studies is that local agronomists have immediate access to a wide range of soil information by clicking on a field parcel shown in this digital interface and, therefore, can suggest an appropriate treatment (e.g. liming, manure incorporation, desalination, application of proper type and quantity of fertilizer) depending on the field conditions and cultivated crops. A specific case study is presented in the current work with regards to the construction of the digitized Soil Map of the regional unit of Kastoria. The potential of this map can easily be realized by the fact that the mapping of the physicochemical properties of the soils in this region provided delineation zones for differential fertilization management. An experiment was also conducted using remote sensing techniques for the enhancement of the fertilization advisory software database, which is a component of the digitized map, and the optimization of nitrogen management in agricultural areas.</p>

Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

2020 ◽  
Vol 16 (3) ◽  
pp. 241-247
Author(s):  
Atifete Ramosaj-Morina ◽  
Alije Keka-Sylaj ◽  
Arbana Baloku Zejnullahu ◽  
Lidvana Spahiu ◽  
Virgjina Hasbahta ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Dominant Mode ◽  
Primary School Children ◽  
Cross Sectional ◽  
Classical Form ◽  
Wide Range ◽  
The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

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