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https://www.readbyqxmd.com/read/29334337/durable-responses-in-refractory-autoimmune-hemolytic-anemia-with-alemtuzumab
#1
Renee K McAlister, Mahsa S Talbott, Nishitha M Reddy
Autoimmune hemolytic anemia occurs due to an interaction of IgG antibodies with protein antigens expressed on red blood corpuscles. Glucocorticoids are the mainstay of treatment for autoimmune hemolytic anemia. For patients not responding to initial therapy, other agents such as rituximab, immunosuppressive therapy, or splenectomy are considered. When refractory to these treatment options, alemtuzumab is an alternative agent. However, long-term outcomes of patients supporting its use are lacking. We present three patients with refractory autoimmune hemolytic anemia treated with alemtuzumab...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29332223/long-term-efficacy-of-partial-splenic-embolization-for-the-treatment-of-steroid-resistant-chronic-immune-thrombocytopenia
#2
Emi Togasaki, Naomi Shimizu, Yuhei Nagao, Chika Kawajiri-Manako, Ryoh Shimizu, Nagisa Oshima-Hasegawa, Tomoya Muto, Shokichi Tsukamoto, Shio Mitsukawa, Yusuke Takeda, Naoya Mimura, Chikako Ohwada, Masahiro Takeuchi, Emiko Sakaida, Tohru Iseki, Hideyuki Yoshitomi, Masayuki Ohtsuka, Masaru Miyazaki, Chiaki Nakaseko
Thrombopoietin-receptor agonists have been recently introduced for a second-line treatment of immune thrombocytopenia (ITP). Splenectomy has tended to be avoided because of its complications, but the response rate of splenectomy is 60-80% and it has still been considered for steroid-refractory ITP. We performed partial splenic embolization (PSE) as an alternative to splenectomy. Between 1988 and 2013, 91 patients with steroid-resistant ITP underwent PSE at our hospital, and we retrospectively analyzed the efficacy and long-term outcomes of PSE...
January 13, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29331883/curative-distal-pancreatectomy-in-patients-with-acinar-cell-carcinoma-of-pancreas-diagnosed-by-endoscopic-aspiration-via-esophago-jejunostomy-a-successful-case-report
#3
Takeomi Hamada, Atsushi Nanashima, Masahide Hiyoshi, Makoto Ikenoue, Naoya Imamura, Koichi Yano, Yoshiro Fujii, Yoshimasa Kubota, Tesshin Ban, Hiroshi Kawakami, Yuichiro Sato
INTRODUCTION: This is a case report on the advances in preoperative endoscopic-guided fine-needle-aspiration (FNA) diagnosis for pancreatic carcinoma to achieve a curative operation even in patients who have a history of total gastrectomy. CASE PRESENTATION: A 65-year-old man, who underwent total gastrectomy for gastric cancer 13 years ago, had discomfort in the left lateral abdomen. A 3-cm hypovascular mass accompanying a large distal pseudocyst in the pancreatic tail was observed on computed tomography...
January 8, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29324540/metastatic-involvement-of-lesser-sac-in-advanced-epithelial-ovarian-cancer
#4
Asima Mukhopadhyay, Nicolò Bizzarri, Melissa Bradbury, Subir Sinha, Jaydip Bhaumik, C William Helm
OBJECTIVES: In advanced epithelial ovarian cancer (AOC), lesser sac (LS) metastasis particularly to the supragastric LS (SGLS) may be overlooked, resulting in unrecognized residual disease. We aimed to identify the frequency, distribution, and predictors of LS metastasis using laparoscopic evaluation at laparotomy and perioperative surgical complications associated with evaluation and resection/ablation. METHODS: Prospective observational study in consecutive patients with AOC undergoing laparotomy for primary or interval cytoreductive surgery in 2 centers between November 2013 and December 2016...
January 10, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29318024/congenital-cranial-ventral-abdominal-hernia-peritoneopericardial-diaphragmatic-hernia-and-sternal-cleft-in-a-4-year-old-multiparous-pregnant-queen
#5
Camille Bismuth, Claire Deroy
Case summary: Cranial ventral midline hernias, most often congenital, can be associated with other congenital abnormalities, such as sternal, diaphragmatic or cardiac malformations. A 4-year-old multiparous queen with a substernal hernia was admitted for evaluation of a mammary mass. During CT examination, a bifid sternum, the abdominal hernia containing the intestines, spleen, omentum, three fetuses, a mammary mass and an incidental peritoneopericardial diaphragmatic hernia were identified...
July 2017: JFMS Open Reports
https://www.readbyqxmd.com/read/29316173/usefulness-of-fluorescence-vascular-imaging-for-evaluating-splenic-perfusion
#6
Yota Kawasaki, Kosei Maemura, Hiroshi Kurahara, Yuko Mataki, Satoshi Iino, Masahiko Sakoda, Hiroyuki Shinchi, Shoji Natsugoe
BACKGROUND: The aim of this study was to confirm whether intraoperative fluorescence vascular imaging using indocyanine green (FVI-ICG) is useful for evaluating splenic perfusion after spleen-preserving distal pancreatectomy (SPDP) performed with the Warshaw technique (SPDP-W). METHODS: We evaluated the blood perfusion of the spleen with an intraoperative FVI-ICG system after SPDP-W. All of the patients underwent dynamic computed tomography (CT) scans at one post-operative week and one post-operative month to evaluate the post-operative blood perfusion of the spleen...
January 8, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29313164/treatment-of-nonocclusive-mesenteric-ischemia-with-type-b-aortic-dissection-using-intra-arterial-catheterization-after-trauma-surgery-case-report
#7
Sho Fujiwara, Yuki Sekine, Ryuichi Nishimura, Kazuya Tadasa, Shukichi Miyazaki
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) is a mesenteric arterial spasm and intestinal ischemia. This disease is a highly lethal disease because diagnosis and decision of appropriate treatments are often difficult. Operations cannot resolve the spasms and may worsen the situation. However, the safety and effectiveness of catheterization for NOMI with aortic dissection (AD) have not yet been elucidated. Here, we report a successful case of early diagnosis and treatment of NOMI with type B AD involving the superior mesenteric artery (SMA) using the intra-arterial infusion of a vasodilator via the SMA...
January 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29309376/a-case-with-pyruvate-kinase-deficiency-remarkably-sensitive-to-heat
#8
Tekin Aksu, Neşe Yarali, Elisa Fermo, Anna Marcello, Şadan Hacisalihoğlu, Paola Bianchi, Namik Y Özbek
Pyruvate kinase (PK) deficiency is the most common defect of the glycolytic pathway leading to congenital hemolytic anemia. We present the case of an 18-year-old boy with chronic nonspherocytic hemolytic anemia, who had remarkable sensitivity to heat. Moreover, the patient showed clinical impairment in the last year. For this reason, we excluded the immunologic or infectious nature (malaria, babesia), which may play a role in the worsening of anemia. Red blood cell enzyme assay showed the presence of a significant increase in other enzyme activities, except for PK, suggesting a PK deficiency in the patient...
January 5, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29306859/a-case-of-shewanella-algae-endocarditis-an-emerging-pathogen-with-a-diverse-clinical-spectrum
#9
Natalie Lousie Davidson, Shradha Subedi, Kathryn Wilks, Joanna Morgan
Shewanella algae is a rare pathogen related to water exposure in temperate climates. It is commonly associated with skin and soft tissue infections, peritonitis and bacteraemia. We report the first-ever case of S. algae infective endocarditis in a patient with previous splenectomy and explore the difficulties in treatment as well as highlight the importance of this organism as an emerging pathogen.
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29300242/klf1-e325k-associated-congenital-dyserythropoietic-anemia-type-iv-insights-into-the-variable-clinical-severity
#10
Yaddanapudi Ravindranath, Robert M Johnson, Gerard Goyette, Steven Buck, Manisha Gadgeel, Patrick G Gallagher
We identified a child with KLF1-E325K congenital dyserythropoietic anemia type IV who experienced a severe clinical course, fetal anemia, hydrops fetalis, and postnatal transfusion dependence only partially responsive to splenectomy. The child also had complete sex reversal, the cause which remains undetermined. To gain insights into our patient's severe hematologic phenotype, detailed analyses were performed. Erythrocytes from the patient and parents demonstrated functional abnormalities of the erythrocyte membrane, attributed to variants in the α-spectrin gene...
January 3, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29297977/the-association-between-idiopathic-thrombocytopenic-purpura-and-cardiovascular-disease-a-retrospective-cohort-study
#11
Joht Singh Chandan, Tom Thomas, Sophie Lee, Tom Marshall, Brian Willis, Krishnarajah Nirantharakumar
BACKGROUND: Idiopathic Thrombocytopenic Purpura (ITP) is classically characterized by a transient or persistent decrease of platelet count. Mortality is higher in the ITP population than the general population, with a possible association to increased cardiovascular disease (CVD). OBJECTIVES: The objective was to assess the strength of the association between ITP and CVD, with a secondary aim to assess the impact of splenectomy on CVD. METHODS: A population-based retrospective, open cohort study using clinical codes was performed using data from 6,591 patients with ITP and 24,275 randomly matched controls (up to 1:4 ratio matched by age, sex, body mass index and smoking status)...
January 3, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29295846/splenectomy-for-immune-thrombocytopenia-down-but-not-out
#12
Shruti Chaturvedi, Donald M/ Arnold, Keith R McCrae
Splenectomy is an effective therapy for steroid-refractory or dependent immune thrombocytopenia (ITP). With the advent of medical alternatives such as rituximab and thrombopoietin receptor antagonists (TPO-RA), the use of splenectomy has declined and is generally reserved for patients that fail multiple medical therapies. Splenectomy removes the primary site of platelet clearance and autoantibody production, and offers the highest rate of durable response (50-70%) compared to other ITP therapies. However, there are no reliable predictors of splenectomy response, and long-term risks of infection and cardiovascular complications must be considered...
January 2, 2018: Blood
https://www.readbyqxmd.com/read/29291540/open-splenectomy-for-varicella-zoster-induced-spontaneous-splenic-rupture
#13
Mark Christopher Sykes, Bilal Azhar, Laurence John, Salman Bokhari
INTRODUCTION: Here we present a case of atraumatic splenic rupture secondary to varicella infection requiring emergency splenectomy. The presentation was as would be expected for epstein barr virus (EBV) related splenic injury, which is well documented in the literature. Dermatological findings however suggested varicella zoster, and viral serology subsequently confirmed the diagnosis. PRESENTATION OF CASE: A young Romanian male presented to the emergency department with peritonism without preceding trauma...
December 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29288421/first-line-treatment-with-bendamustine-and-rituximab-in-patients-with-intermediate-high-risk-splenic-marginal-zone-lymphomas
#14
Roberto Castelli, Luigi Bergamaschini, Giorgio Lambertenghi Deliliers
Splenic marginal zone lymphomas (SMZLs) are rare indolent B cell neoplasms that affect the spleen, bone marrow, and blood. Although they have an indolent course in the majority of patients, who have a median survival of 8-10 years, ∼ 30% may experience a worse outcome. The prognostic criteria of progression are lymph node and extra-nodal involvement, high lymphocyte counts, anaemia, and thrombocytopenia. The treatment of SMZLs include a "wait and watch strategy", splenectomy, and alkylating agents ± rituximab...
December 29, 2017: Medical Oncology
https://www.readbyqxmd.com/read/29286028/-isolated-pancreatic-metastases-of-renal-cell-carcinoma
#15
G A Shatveryan, N K Chardarov, N N Bagmet, N P Ratnikova, A L Bedzhanyan, K N Petrenko, L O Polishchuk, G A Karagyozyan
AIM: To present own experience of surgical treatment of isolated pancreatic metastases of renal cell carcinoma. MATERIAL AND METHODS: There are 3 cases of pancreatic metastases of renal cell carcinoma. They were diagnosed in women aged 55, 66 and 67 years in 9, 11 and 23 years after nephrectomy respectively. RESULTS: The tumors were placed in head (60 mm), body (10 and 5 mm) and tail (30 mm) of the pancreas. There were 2 distal pancreatectomy with splenectomy and 1 pancreatoduodenectomy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29284415/streptococcus-agalactiae-infective-endocarditis-complicated-by-multiple-mycotic-hepatic-aneurysms-and-massive-splenic-infarction-a-case-report
#16
Pietro Achilli, Angelo Guttadauro, Paolo Bonfanti, Sabina Terragni, Luca Fumagalli, Ugo Cioffi, Francesco Gabrielli, Matilde De Simone, Marco Chiarelli
BACKGROUND: The burden of disease caused by Streptococcus agalactiae has increased significantly among older adults in the last decades. Group B streptococcus infection can be associated with invasive disease and severe clinical syndromes, such as meningitis and endocarditis. CASE PRESENTATION: We present the case of a 56-year-old man who developed multiple mycotic aneurysms of the right hepatic artery and massive splenic infarction as rare complications of Streptococcus agalactiae infective endocarditis...
December 29, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29283968/transfer-and-non-transfer-patients-in-isolated-low-grade-blunt-pediatric-solid-organ-injury-implications-for-regionalized-trauma-systems
#17
Robert A Tessler, Vivian H Lyons, Judith C Hagedorn, Monica S Vavilala, Adam Goldin, Saman Arbabi, Frederick P Rivara
BACKGROUND: Regionalization of trauma care is a national priority and hospitalization for blunt abdominal trauma, that may include transfer, is common among children. The objective of this study was to determine whether there were differences in mortality, treatment, or length of stay between patients treated at or transferred to a higher level trauma center and those not transferred and admitted to a lower level trauma center. METHODS: Cohort from Washington state trauma registry from 2000-2014 of patients 16 years or younger with isolated Grade I-III spleen, liver, or kidney injury...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29275312/prognostic-impact-of-splenectomy-in-patients-with-esophagogastric-junction-carcinoma
#18
Minoru Fukuchi, Erito Mochiki, Toru Ishiguro, Kana Saito, Hiroshi Naitoh, Youichi Kumagai, Keiichiro Ishibashi, Hideyuki Ishida
BACKGROUND/AIM: We evaluated the survival benefit of splenectomy in patients with esophagogastric junction (ECJ) carcinoma. PATIENTS AND METHODS: We retrospectively examined clinicopathological and survival data for 60 surgically-treated patients with ECJ carcinoma. RESULTS: The 5-year overall survival (OS) rate was 47%. Splenectomy was performed in 20 patients (30%). Multivariate Cox regression analysis revealed splenectomy (odds ratio (OR), 2...
January 2018: In Vivo
https://www.readbyqxmd.com/read/29274795/-splenic-sarcoidosis-diagnosed-by-us-guided-biopsy-about-a-case
#19
A Gaudemer, G Sauvet, A Hij, R Stanciu, D Farge-Bancel, J-P Algayres
INTRODUCTION: Splenic localisation of sarcoidosis is common but rare as unique location. We report a case diagnosed by US-guided biopsy. OBSERVATION: A 42-year-old woman presented atypic and recidivant epigastric pain. Abdominal ultrasound showed splenic hypoechoic nodules not characterizable with CT or MRI. PET-CT revealed hypermetabolism without any other abnormal metabolic activity. US-guided biopsy with small needle achieved diagnosis of isolated splenic sarcoidosis...
December 20, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29273875/robotic-total-pancreatectomy-with-splenectomy-technique-and-outcomes
#20
Ioannis T Konstantinidis, Zeljka Jutric, Oliver S Eng, Susanne G Warner, Laleh G Melstrom, Yuman Fong, Byrne Lee, Gagandeep Singh
BACKGROUND: Robotic total pancreatectomy (TP) represents a minimally invasive approach to a major intra-abdominal operation. Its utility, technique, and outcomes are evolving. METHODS: In this video, we describe a systematic approach to a robotic total pancreatectomy performed for multifocal intraductal papillary mucinous neoplasm (IPMN). Additionally, we reviewed the National Cancer Database (NCDB) to examine the outcomes of robotic TP compared to laparoscopic and open TP between 2010 and 2014...
December 22, 2017: Surgical Endoscopy
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