Iguratimod promotes transformation of mononuclear macrophages in elderly patients with rheumatoid arthritis by nuclear factor-κB pathway

paythelady.612 shared this article with you from Inoreader Iguratimod promotes transformation of mononuclear macrophages in elderly patients with rheumatoid arthritis by nuclear factor-κB pathway Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 6;9(10):2181-2191. doi: 10.12998/wjcc.v9.i10.2181. ABSTRACT BACKGROUND: The role of macrophages in rheumatoid arthritis (RA) and its mechanism have attracted much attention in RA pathogenesis. Macrophages accumulate in the synoviums of RA, and the proportion of M1 type pro-inflammatory macrophages is higher than that of M2 type anti-inflammatory macrophages, leading to the secretion of inflammatory molecules and the aggravation of inflammatory reaction, which has made macrophages a potential target of RA drugs. Iguratimod is a kind of cyclo-oxygenase-2 inhibitor that affects macrophage polarity. It is speculated that its anti-inflammatory and anti-rheumatic effects may be related to the regulation of macrophage M1/M2 ratio. AIM: To investigate the effects of Iguratimod on the polarity of mononuclear macrophages in elderly patients with RA. METHODS: Elderly patients with RA and joint effusion wer e selected, including 10 men and 25 women, with an average age of 66.37 ± 4.42 years. Patients were treated with oral administration of 25 mg Iguratimod (Iremod, State Food and Drug Administration Approval No. H20110084) twice daily for 12 wk. Disease Activity Score 28 and Health Assessment Questionnaire score were collected according to the disease severity before and after treatment. Venous blood and joint effusion fluid were collected, mononuclear macrophages were extracted and expression of cell surface markers CD86, CD64, CD163, and CD206 was analyzed by flow cytometry. The concentration of inflammatory factors interleukin (IL)-6, IL-1β, transforming growth factor-β, and IL-4 in the joint effusion fluid was analyzed by enzyme-linked immunosorbent assay. Expression of mononuclear cells inhibitor of nuclear factor-κB (IκB) and phosphorylated IκB in peripheral blood was analyzed by western blotting. RESULTS: Disease Activity Score 28 score and Health Assessment Questio nnaire score of patients treated with Iguratimod decreased significantly. The percentage of cell surface markers CD86 and CD64 decreased significantly, and the percentage of CD163 and CD206 increased significantly (P < 0.05). The inflammatory factors IL-6 and IL-1β decreased significantly, and transforming growth factor-β and IL-4 increased significantly. Western blot analysis showed that mononuclear cell inhibitor of nuclear factor-κB in peripheral blood was significantly increased after treatment, and its phosphorylation level was significantly decreased (P < 0.05). CONCLUSION: Iguratimod can promote the transformation of mononuclear macrophages from M1 to M2 in elderly patients with RA by inhibiting the nuclear factor-κB pathway, thus improving symptoms of RA. PMID:33869594 | PMC:PMC8026846 | DOI:10.12998/wjcc.v9.i10.2181 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two-stage transcrestal sinus floor elevation-insight into replantation: Six case reports

paythelady.612 shared this article with you from Inoreader Two-stage transcrestal sinus floor elevation-insight into replantation: Six case reports Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 6;9(10):2386-2393. doi: 10.12998/wjcc.v9.i10.2386. ABSTRACT BACKGROUND: Transcrestal sinus floor elevation (TSFE) has been widely used in the oral clinic when the residual bone height (RBH) exceeds 5 mm. However, when there is insufficient RBH in the posterior maxilla, two-stage TSFE may be an option. CASE SUMMARY: This article introduces the concept of two-stage TSFE. Six patients had osseointegration failure after TSFE. For the first-stage surgery, we restricted the vertical bone augmentation as much as possible. At the second-stage surgery, the increased RBH was 3.28 ± 1.55 mm, which was beneficial for surgery. Five implants functioned successfully on schedule, but one implant failed again during the healing period. A third surgery was performed, and the implant functioned successfully. CONCLUSION: When RBH was less than 5 mm, two or more procedures of TSFE might result in a higher RBH. < p>PMID:33869618 | PMC:PMC8026825 | DOI:10.12998/wjcc.v9.i10.2386 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mechanical thrombectomy for acute occlusion of the posterior inferior cerebellar artery: A case report

paythelady.612 shared this article with you from Inoreader Mechanical thrombectomy for acute occlusion of the posterior inferior cerebellar artery: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 6;9(10):2268-2273. doi: 10.12998/wjcc.v9.i10.2268. ABSTRACT BACKGROUND: Mechanical thrombectomy (MT) has been demonstrated to be useful for the treatment of ischemic stroke in patients with large vessel occlusions. However, recanalization by MT is not recommended for distal vessels such as second-order branches of the middle cerebral artery and posterior inferior cerebellar artery (PICA). Because of the small size and tortuosity of these arteries, the risks of using the available endovascular devices outweigh the benefits of treatment. However, MT appears to be effective in patients with primary distal vessel occlusion in eloquent areas, those with a high National Institutes of Health Stroke Scale score, and those ineligible for recombinant tissue plasminogen activator therapy. Here, we report the use of MT for treating acute occlusion of the PICA using a direct-aspiration first-pass technique (ADAPT). < p>CASE SUMMARY: In this case, the patient received acute occlusion of the PICA with ADAPT when right internal carotid artery stenting was performed. CONCLUSION: With the introduction of advanced endovascular devices, MT may now be a feasible treatment for acute occlusion of the PICA. PMID:33869602 | PMC:PMC8026849 | DOI:10.12998/wjcc.v9.i10.2268 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Programmed cell death protein-1 inhibitor combined with chimeric antigen receptor T cells in the treatment of relapsed refractory non-Hodgkin lymphoma: A case report

paythelady.612 shared this article with you from Inoreader Programmed cell death protein-1 inhibitor combined with chimeric antigen receptor T cells in the treatment of relapsed refractory non-Hodgkin lymphoma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 6;9(10):2394-2399. doi: 10.12998/wjcc.v9.i10.2394. ABSTRACT BACKGROUND: Chimeric antigen receptor T cell (CART) therapy has benefited many refractory lymphoma patients, but some patients experience poor effects. Previous studies have shown that programmed cell death protein-1 (PD-1) inhibitors can improve and prolong the therapeutic effect of CAR-T cell treatment. CASE SUMMARY: A 61-year-old male presented with 15-d history of diarrhea and lower-limb edema. A large mass was detected in the pelvis, and pathology indicated non-Hodgkin diffuse large B-cell lymphoma. After three cycles of the R-CHOP chemotherapeutic regimen, the patient showed three subcutaneous nodules under the left armpit and both sides of the cervical spine. Pathological examination of the nodules indicated DLBCL again. The patient was diagnosed with relapsed and refractory diffuse large B-cell lymphoma. We recommended CAR-T cell trea tment. Before treatment, the patient's T cell function and expression of immune detection points were tested. Expression of PD-1 was obviously increased (52.7%) on cluster of differentiation (CD)3+ T cells. The PD-1 inhibitor (3 mg/kg) was infused prior to lymphodepleting chemotherapy with fludarabine and cyclophosphamide. CAR-CD19 T cells of 3 × 106/kg and CAR-CD22 T cells 1 × 106/kg were infused, respectively. The therapeutic effect was significant, and the deoxyribonucleic acid copy numbers of CAR-CD19 T cells and CAR-CD22 T cells were stable. Presently, the patient has been disease-free for more than 12 mo. CONCLUSION: This case suggests that the combination of PD-1 inhibitors and CAR-T cells improved therapeutic efficacy in B-cell lymphoma. PMID:33869619 | PMC:PMC8026848 | DOI:10.12998/wjcc.v9.i10.2394 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Distribution and drug resistance of pathogens in burn patients in China from 2006 to 2019

paythelady.612 shared this article with you from Inoreader Distribution and drug resistance of pathogens in burn patients in China from 2006 to 2019 Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 6;9(10):2228-2237. doi: 10.12998/wjcc.v9.i10.2228. ABSTRACT BACKGROUND: In this study, recent trends in the distribution and drug resistance of pathogenic bacteria isolated from patients treated at a burn ward between 2006 and 2019 were investigated. AIM: To develop more effective clinical strategies and techniques for the prevention and treatment of bacterial infections in burn patients. METHODS: Clinical samples with positive bacteria were collected from patients at the burn ward in Beijing Jishuitan Hospital in China between January 2006 and December 2019. The samples were retrospectively analyzed, the distribution of pathogenic bacteria was determined, and the trends and changes in bacterial drug resistance during different period were assessed. Drug resistance in several main pathogenic bacteria from 2006 to 2011 and from 2012 to 2019 was comparatively summarized and analyzed. RESULTS : Samples from 17119 patients were collected and analyzed from 2006 to 2019. Surprisingly, a total of 7960 strains of different pathogenic bacteria were isolated at this hospital. Among these bacteria, 87.98% (7003/7960) of the strains were isolated from burn wounds, and only 1.34% (107/7960) were isolated from the blood of patients. In addition, 49.70% (3956/7960) were identified as Gram-positive bacteria, 48.13% (3831/7960) were Gram-negative bacteria, and the remaining 2.17% (173/7960) were classified as fungi or other pathogens. Importantly, Staphylococcus aureus (21.68%), Pseudomonas aeruginosa (14.23%), and Staphylococcus epidermidis (9.61%) were the top three pathogens most frequently isolated from patients. CONCLUSION: In patients treated at the burn ward in this hospital from 2006 to 2019, Staphylococcus aureus and Pseudomonas aeruginosa were the predominant clinical pathogens responsible for bacterial infections. The circumstantial detection and detailed monitoring of the intensity and growth of different pathogenic bacteria in clinical patients as well as tests of drug sensitivity during burn recovery are particularly important to provide guidelines for the application of antibiotics and other related drugs. Careful collection and correct, standard culture of bacterial specimens are also crucial to improve the efficiency of bacterial infection detection. Effective monitoring and timely clinical treatment in patients may help reduce the possibility and rate of infection as well as alleviate the effects of drug resistance among patients in burn centers. PMID:33869598 | PMC:PMC8026851 | DOI:10.12998/wjcc.v9.i10.2228 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pancreatic cancer secondary to intraductal papillary mucinous neoplasm with collision between gastric cancer and B-cell lymphoma: A case report

paythelady.612 shared this article with you from Inoreader Pancreatic cancer secondary to intraductal papillary mucinous neoplasm with collision between gastric cancer and B-cell lymphoma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 6;9(10):2400-2408. doi: 10.12998/wjcc.v9.i10.2400. ABSTRACT BACKGROUND: Patients with intraductal papillary mucinous neoplasm (IPMN) have an increased risk of pancreatic and extrapancreatic malignancies. Lymphomas are rare extrapancreatic malignancies, and in situ collisions of early gastric cancer and diffuse large B-cell lymphoma (DLBCL) are even rarer. Here, we report the first case of pancreatic cancer comorbid with in situ collision of extrapancreatic malignancies (early gastric cancer and DLBCL) in a follow-up IPMN patient. Furthermore, we have made innovations in the treatment of such cases. CASE SUMMARY: An 81-year-old Japanese female diagnosed with IPMN developed elevated carbohydrate antigen (CA) 19-9 levels during follow-up. Because her CA19-9 levels continued to rise, endoscopic ultrasound (EUS) was performed and revealed a suspicious lesion at the pancreatic tail. However, l esions in the pancreas were not found by computed tomography, magnetic resonance imaging, or endoscopic retrograde cholangiopancreatography. To make an exact patho-logical diagnosis, EUS-guided fine needle aspiration was performed. To our supprise, early gastric cancer was found in preoperative gastroscopy. The gastric cancer was completely resected through endoscopic submucosal dissection before postoperative pathology identified early adenocarcinoma collided with DLBCL. Subsequent EUS-guided fine needle aspiration provided pathological support for the pancreatic cancer diagnosis, and then laparoscopic distal pancreatectomy and splenectomy were performed. CA19-9 levels returned to normal postoperatively. CONCLUSION: Endoscopic submucosal dissection is appropriate for submucosal lymphomas in patients intoleratant of chemotherapy. EUS can detect small IPMN-related pancreatic tumors. PMID:33869620 | PMC:PMC8026844 | DOI:10.12998/wjcc.v9.i10.2400 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Salvage of vascular graft infections via vacuum sealing drainage and rectus femoris muscle flap transposition: A case report

paythelady.612 shared this article with you from Inoreader Salvage of vascular graft infections <em>via</em> vacuum sealing drainage and rectus femoris muscle flap transposition: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 6;9(10):2296-2301. doi: 10.12998/wjcc.v9.i10.2296. ABSTRACT BACKGROUND: The management of vascular graft infections continues to be a significant challenge in a clinical situation. The aim of this report is to illustrate the novel vacuum sealing drainage (VSD) technique and rectus femoris muscle flap transposition for vascular graft infections, and to evaluate the prospective of future testing of this surgical procedure. CASE SUMMARY: We report the case of a 32-year-old male patient, who presented a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure. Using the VSD and muscle flap trans-position, the groin wound and vascular graft infection were finally treated successfully. CONCLUSION: Our case report highlights that VSD technique and rectus femoris muscle flap transposition could be considered in patients pre senting with a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure, especially in consideration of treatable conditions. PMID:33869606 | PMC:PMC8026842 | DOI:10.12998/wjcc.v9.i10.2296 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasal Dermoids in Children: Factors Influencing the Distant Result

xlomafota13 shared this article with you from Inoreader Nasal Dermoids in Children: Factors Influencing the Distant Result Via Otolaryngology Indian Abstract The aim of the study was to present a single institution's treatment strategy for nasal dermoids and to identify factors influencing distant results. The study covered 24 surgically treated pediatric patients with nasal dermoids (NDs). The medical data concerning demographics, preoperative local inflammations and surgical procedures, form of the abnormality, imaging, surgical techniques, and a role of osteotomies and reconstructions were analyzed. The recurrence rates and distant aesthetic outcomes were assessed. The surgical approach included vertical incision in 21 patients, the external rhinoplasty approach in 2 cases, and bicoronal incision in 1 child. The intracranial extension was confirmed in 6 patients. Seven out of 8 cases with preoperative local inflammations and 3 out of 4 with secondary fistulization were < 4 years old. Nine patients required osteotomies. Three children required reconstruction of the nasal skeleton. None of the distant c osmetic results was described as hideous or unsatisfactory. The incidence of local inflammatory complications is unrelated to the age of the patients. The distant aesthetic result depends on both the initial extent of the disease and preoperative local conditions or interventions. Prompt surgical intervention is highly recommended. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Title of the Article: Paranasal Mucormycosis in COVID-19 Patient

xlomafota13 shared this article with you from Inoreader Title of the Article: Paranasal Mucormycosis in COVID-19 Patient Via Otolaryngology Indian Abstract There have been a variety of complications reported during and post- COVID infection. Recently, there has been an increase in sporadic cases of paranasal sinus mucormycosis in COVID- 19 patients. We report a case of COVID- 19 patient diagnosed to have orbital apex syndrome secondary to mucormycosis of nose and paranasal sinus requiring emergency endoscopic sinus surgery. Appropriate use of personal protective equipment and safety precautions taken by health care workers prevented the spread of the virus during surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stigmatic Impact of COVID-19 Pandemic on Head & Neck Cancers Survivors

xlomafota13 shared this article with you from Inoreader Stigmatic Impact of COVID-19 Pandemic on Head & Neck Cancers Survivors Via Otolaryngology Indian Abstract Social stigma is the spoilation of the social image of an individual, which leads to the social disapproval of the individual by the community. Patients of many diseases like HIV, deafness, and reproductive disorders often face social disproval. Head & neck cancer survivors perceived stigma due to the mutilation that occurred after surgical treatment procedures. The novel coronavirus is a recently emerged zoonotic viral agent that affects the respiratory system of humans. Following its outbreak from the Wuhan city of China, the COVID-19 spreaded fiercely around the globe, forming a pandemic. Since COVID-19 is a contagious disease with no available treatment, social distancing is considered as the best strategy to prevent the geometric spread of infection. With the social distancing model, the head & neck cancer survivors along with the various other stakeholders perceived stigma being a high-risk group for COVID-19 infection. As the pool of caregivers is diminished due to pandemic, head & neck cancer survivors face increased social isolation and perceived stigma in asking for help from relatives. At the time of the pandemic, social support is critical to fighting against the disease. Social distancing should be maintained along with communication with the patients through calls, text, and online social platforms. It is not wise to stigmatize disease as, in that case, patients who are infected with the disease will try to hide it and avoid seeking medical care. With the promotion of social distancing, it is crucial to convey awareness regarding not to stigmatize the disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Case Report of Unilateral Maxillary Mass from Adrenal Neuroblastoma

xlomafota13 shared this article with you from Inoreader A Rare Case Report of Unilateral Maxillary Mass from Adrenal Neuroblastoma Via Otolaryngology Indian Abstract Neuroblastoma is the most common extracranial neoplasm among paediatric patients, which arises from ectodermal neural crest cells. The most frequent primary site of neuroblastoma arises from retroperitoneum, specifically in the adrenal medulla. We present a rare case of adrenal neuroblastoma metastasis to maxillary sinus in a 20 month-old boy presenting with right maxillary swelling for the past 2 months. Computed tomography (CT) scan of paranasal sinus demonstrated right maxillary mass. A biopsy performed via a sublabial approach, surprisingly revealed neuroblastoma. Subsequent further workup depicted a huge right adrenal tumour. He was diagnosed with adrenal neuroblastoma stage 4 and treated with chemotherapy and surgical resection. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.