S3465 Biliary Cystadenoma: A Case Review

This case review discusses the importance of providing a holistic approach to the care of a patient with two stomas and an enterocutaneous fistula. In this case, the stomas and fistula significantly affected the patient; not just physically but emotionally and socially. The different challenges that arose in pouching a high-output ileostomy, enterocutaneous fistula and ileal conduit with Foley catheter in situ are explored. It also delves into the various options for discharging a patient with complex ostomy complications requiring different needs and resources. Finally, it aims to highlight the therapeutic comprehensive care the stomal therapy nurse provided to the patient and their family.

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Case Review of lgG4-Related Disease Patient with Combined Tubulointerstitial Nephritis and Membranous Nephropathy Coexisting with Cholangiocarcinoma: Case Report

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.11.10685 ◽

2020 ◽

Vol 103 (11) ◽

pp. 1230-1235

Keyword(s):

Renal Failure ◽

Membranous Nephropathy ◽

Tubulointerstitial Nephritis ◽

Disease Patient ◽

Case Review ◽

Related Disease ◽

Phospholipase A2 Receptor ◽

Wide Range ◽

Serum Igg4 ◽

Secondary Membranous Nephropathy

Immunoglobulin G4-related disease (IgG4-RD) has recently been recognized as an autoimmune disorder involving multiple organs. The kidney is a represented organ with a wide range of renal manifestations. The authors report a case of an 83-year-old Thai male with combined IgG4 tubulointerstitial nephritis and membranous nephropathy coexisting with cholangiocarcinoma. The patient presented with proteinuria, acute renal failure, eosinophilia, hypocomplementemia, and high serum IgG4 concentration. The diagnosis was IgG 4-related tubulointerstitial nephritis and membranous nephropathy on renal biopsy, with negative immunohistochemistry for anti-phospholipase A2 receptor antibodies. Magnetic resonance imaging (MRI) abdomen showed two wedge shaped arterial enhancing lesions of liver. Liver biopsy revealed adenocarcinoma, compatible with cholangiocarcinoma. Proteinuria and renal failure were resolved with initial steroid treatment. Meanwhile, IgG4-related membranous nephropathy should be considered in the differential diagnosis for patients with proteinuria. Potentially, IgG4-RD may be rarely associated with carcinoma development. However, further studies are recommended to ratify and confirm the association between IgG4-RD and incidence of malignancies. Keywords: IgG4-related disease, Membranous nephropathy, Secondary membranous nephropathy, Tubulointerstitial nephritis, Cholangiocarcinoma

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Biliary cystadenoma and cystadenocarcinoma.

American Journal of Roentgenology ◽

10.2214/ajr.156.5.2017944 ◽

1991 ◽

Vol 156 (5) ◽

pp. 1113-1113 ◽

Cited By ~ 8

Author(s):

A M Agildere ◽

M Haliloglu ◽

O Akhan

Keyword(s):

Biliary Cystadenoma

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Video is better: why aren’t we using it? A mixed-methods study of the barriers to routine procedural video recording and case review

Surgical Endoscopy ◽

10.1007/s00464-021-08375-4 ◽

2021 ◽

Author(s):

Laura Mazer ◽

Oliver Varban ◽

John R. Montgomery ◽

Michael M. Awad ◽

Allison Schulman

Keyword(s):

Mixed Methods ◽

Video Recording ◽

Mixed Methods Study ◽

Case Review

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Assessment of vitamin B12 deficiency and B12 screening trends for patients on metformin: a retrospective cohort case review

BMJ Nutrition, Prevention & Health ◽

10.1136/bmjnph-2020-000193 ◽

2021 ◽

pp. bmjnph-2020-000193

Author(s):

Darby Martin ◽

Jeet Thaker ◽

Maria Shreve ◽

Lois Lamerato ◽

Kartazyna Budzynska

Keyword(s):

Retrospective Cohort ◽

Protective Factor ◽

Vitamin B12 Deficiency ◽

Older Age ◽

Secondary Outcome ◽

Vitamin B ◽

Case Review ◽

Large Hospital ◽

Hospital System ◽

B12 Deficiency

ObjectivesOur study investigated the use of vitamin B12 testing in a large cohort of patients on metformin and assesses appropriateness and benefits of screening recommendations for vitamin B12 deficiency.DesignThis retrospective cohort study included insured adult patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin to establish compliance. The comparison group was not exposed to metformin. Primary outcome was incidence of B12 deficiency diagnosed in patients on metformin. Secondary outcome was occurrence of B12 testing in the patient population on metformin. Records dated through 31 December 2018 were analysed.SettingLarge hospital system consisting of inpatient and outpatient data base.ParticipantsA diverse, adult, insured population of patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin.ResultsOf 13 489 patients on metformin, 6051 (44.9%) were tested for vitamin B12 deficiency, of which 202 (3.3%) tested positive (vs 2.2% of comparisons). Average time to test was 990 days. Average time to test positive for deficiency was 1926 days. Factors associated with testing were linked to sex (female, 47.8%), older age (62.79% in patients over 80 years old), race (48.98% white) and causes of malabsorption (7.11%). Multivariable logistic regression showed older age as the only factor associated with vitamin B12 deficiency, whereas African-American ethnicity approached significance as a protective factor.ConclusionsBased on our study’s findings of vitamin B12 deficiency in patients on metformin who are greater than 65 years old and have been using it for over 5 years, we recommend that physicians consider screening in these populations.

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