scholarly journals Symptomatic Effects of Smoking in Ulcertive Colitis: A Clinical Dilemma

2018 ◽  
Vol 03 (02) ◽  
Author(s):  
Yashi Jain ◽  
Anjali Singh
Keyword(s):  
Clinical Dilemma

scholarly journals Significance of indeterminate pulmonary nodules in resectable pancreatic adenocarcinoma—a review

2021 ◽  
Author(s):  
Li Lian Kuan ◽  
Ashley R. Dennison ◽  
Giuseppe Garcea
Keyword(s):  
Overall Survival ◽  
Pancreatic Adenocarcinoma ◽  
Median Overall Survival ◽  
Current Knowledge ◽  
Pulmonary Nodules ◽  
Preoperative Imaging ◽  
Significant Finding ◽  
Comprehensive Overview ◽  
Significant Difference ◽  
Clinical Dilemma

Abstract Background The clinical significance of indeterminate pulmonary nodules (IPN) in patients with resectable pancreatic adenocarcinoma (PDAC) is unknown. The rate of detection on IPN has risen due to enhanced staging investigations to determine resectability. IPNs detected on preoperative imaging represent a clinical dilemma and complicate decision-making. Currently, there are no recommendations on the management of IPN. This review provides a comprehensive overview of the current knowledge on the natural history of IPN detected among patients with resectable PDAC. Methods A systematic review based on a search in Medline and Embase databases was performed. All clinical studies evaluating the significance of IPN in patients with resectable PDAC were included. PRISMA guidelines were followed. Results Five studies met the inclusion criteria. The total patient population was 761. The prevalence of IPN reported ranged from 18 to 71%. The median follow-up duration was 17 months. The median overall survival was 19 months. Patients with pre-operative IPN which subsequently progressed to clinically recognizable pulmonary metastases, ranged from 1.5 to 16%. Four studies found that there was no significant difference in median overall survival in patients with or without IPNs. Conclusion This is a first review on the significance of IPN in patients with resectable PDAC. The preoperative presence of IPN does not demonstrate an association with overall survival after surgery. The identification of IPN is a significant finding however it should not preclude patients with resectable PDAC from undergoing curative resection.

scholarly journals Leptomeningeal Carcinomatosis: A Clinical Dilemma in Neuroendocrine Neoplasms

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 277
Author(s):  
Leonidas Apostolidis ◽  
Jörg Schrader ◽  
Henning Jann ◽  
Anja Rinke ◽  
Sebastian Krug
Keyword(s):  
Brain Metastases ◽  
Median Overall Survival ◽  
Case Reports ◽  
Individual Case ◽  
Leptomeningeal Carcinomatosis ◽  
Neuroendocrine Neoplasms ◽  
Cns Involvement ◽  
Ki 67 ◽  
Sensory Deficits ◽  
Clinical Dilemma

Central nervous system (CNS) involvement by paraneoplastic syndromes, brain metastases, or leptomeningeal carcinomatosis (LC) in patients with neuroendocrine neoplasms (NEN) has only been described in individual case reports. We evaluated patients with LC in four neuroendocrine tumor (NET) centers (Halle/Saale, Hamburg, Heidelberg, and Marburg) and characterized them clinically. In the study, 17 patients with a LC were defined with respect to diagnosis, clinic, and therapy. The prognosis of a LC is very poor, with 10 months in median overall survival (mOS). This is reflected by an even worse course in neuroendocrine carcinoma (NEC) G3 Ki-67 >55%, with a mOS of 2 months. Motor and sensory deficits together with vigilance abnormalities were common symptoms. In most cases, targeted radiation or temozolomide therapy was used against the LC. LC appears to be similarly devastating to brain metastases in NEN patients. Therefore, the indication for CNS imaging should be discussed in certain cases.

scholarly journals Covid-19 vaccine- induced thrombosis and thrombocytopenia-a commentary on an important and practical clinical dilemma

2021 ◽  
Author(s):  
Aashish Gupta ◽  
Partha Sardar ◽  
Michael E. Cash ◽  
Richard V. Milani ◽  
Carl J. Lavie
Keyword(s):  
Clinical Dilemma

Testing of Helicobacter pylori by Endoscopic Biopsy: The Clinical Dilemma of Suppressive Conditions

Digestion ◽  
2019 ◽  
Vol 101 (5) ◽  
pp. 552-556
Author(s):  
Richard F. Knoop ◽  
Golo Petzold ◽  
Ahmad Amanzada ◽  
Sebastian C.B. Bremer ◽  
Thomas M. Gress ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Endoscopic Biopsy ◽  
Clinical Dilemma

scholarly journals Uterine Necrosis after Uterine Artery Embolization for Symptomatic Fibroids

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Steve Kyende Mutiso ◽  
Felix Mwembi Oindi ◽  
Nigel Hacking ◽  
Timona Obura
Keyword(s):  
Abdominal Pain ◽  
Surgical Management ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
The Body ◽  
Poly Vinyl Alcohol ◽  
Artery Embolization ◽  
Body Of Knowledge ◽  
Clinical Dilemma ◽  
Postembolization Syndrome

Introduction. Uterine artery embolization (UAE) is a minimally invasive intervention that is used in the treatment of fibroids. UAE can lead to complications including postembolization syndrome, postprocedure pain, infection, endometrial atrophy leading to secondary amenorrhea, and uterine necrosis. Uterine necrosis after UAE is very rare and hence poses a clinical dilemma for any clinician in its identification and management. We document a case of uterine necrosis after UAE and conduct a literature review on its causation, clinical features, and management principles. Case. A patient presented one month after UAE with abdominal pain and abdominal vaginal discharge. Her work-up revealed features of possible uterine necrosis with sepsis and she was scheduled for a laparotomy and a subtotal hysterectomy was performed. She was subsequently managed with broad spectrum antibiotic and recovered well. Conclusion. Uterine necrosis after UAE is a rare occurrence and we hope the documentation of this case will add to the body of knowledge around it. Theories that explain its occurrence include the use of small particles at embolization, the use of Contour-SE a spherical poly-vinyl alcohol, and lack of collateral supply to the uterus. Its symptoms may be nonspecific but unremitting abdominal pain is invariably present. Finally although conservative management may be successful at times, surgical management with hysterectomy will be required in some cases. The prognosis is good after diagnosis and surgical management.

Infantile colic in exclusive breast feed babies: A clinical dilemma

2021 ◽  
Vol 2 (2) ◽  
pp. 32
Author(s):  
Sudip Bhattacharya ◽  
Nishantadeb Ghatak ◽  
SheikhMohd Saleem
Keyword(s):  
Infantile Colic ◽  
Breast Feed ◽  
Clinical Dilemma
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