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https://www.readbyqxmd.com/read/28527173/gaucher-disease-presenting-in-an-adult-with-intracerebral-bleed
#1
Sandeep Nemani, Bhumi Agrawal, Sumita Danda, Biju George
Gaucher disease (GD) is the most common lysosomal storage disorder, caused by deficiency of acid beta glucosidase. GD usually presents in children but occasional cases can present in adulthood. Here we report a case of type I GD in a 37 year old female who presented with intracerebral bleed due to long standing thrombocytopenia. She underwent splenectomy in view of limited resources for enzyme replacement therapy. With splenectomy her platelet counts normalised and neurological status also improved.
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28525829/epidemiology-and-management-of-primary-immune-thrombocytopenia-a-nationwide-population-based-study-in-korea
#2
Ji Yun Lee, Ju-Hyun Lee, Heeyoung Lee, Beodeul Kang, Ji-Won Kim, Se Hyun Kim, Jeong-Ok Lee, Jin Won Kim, Yu Jung Kim, Keun-Wook Lee, Jee Hyun Kim, Hyoung Soo Choi, Jong Seok Lee, Soo-Mee Bang
INTRODUCTION: The epidemiology of immune thrombocytopenia (ITP) is not well characterized in an Asian population. MATERIALS AND METHODS: From July 2010 to June 2014, ITP patients were identified using the Korean Health Insurance Review and Assessment Service database. RESULTS: The overall incidence rate of ITP was 5.3 per 100,000 person-years (95% CI: 5.1-5.5). The overall incidence rate ratios of children under 15years old to adults and females to males were 3...
May 11, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28522787/surgical-treatment-of-pancreatic-cystic-tumors
#3
Beata Jabłońska, Łukasz Braszczok, Weronika Szczęsny-Karczewska, Beata Dubiel-Braszczok, Paweł Lampe
The aim of this study was to assess short-term outcomes of surgical treatment of pancreatic cystic tumors (PCTs). MATERIAL AND METHODS: We retrospectively reviewed medical records of 46 patients (31 women and 15 men) who had undergone surgery for pancreatic cystic tumors in our department. RESULTS: Pancreatic cystic tumors were located within the pancreatic head (21), body (11), tail (13), and whole pancreas (1). The following surgical procedures were performed: pancreatoduodenectomy (20), central pancreatectomy (9), distal pancreatectomy (3), distal pancreatectomy with splenectomy (3), distal extended pancreatectomy with splenectomy (2), total pancreatectomy (1), duodenum preserving pancreatic head resection (1), local tumor resection (4), and other procedures (2)...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28522785/infeasibility-of-endoscopic-transmural-drainage-due-to-pancreatic-pseudocyst-wall-calcifications-case-report
#4
Andrzej Krajewski, Gustaw Lech, Marcin Makiewicz, Andrzej Kluciński, Monika Wojtasik, Sławomir Kozieł, Maciej Słodkowski
Postinflammatory pancreatic pseudocysts are one of the most common complications of acute pancreatitis. In most cases, pseudocysts self-absorb in the course of treatment of pancreatitis. In some patients, pancreatic pseudocysts are symptomatic and cause pain, problems with gastrointestinal transit, and other complications. In such cases, drainage or resection should be performed. Among the invasive methods, mini invasive procedures like endoscopic transmural drainage through the wall of the stomach or duodenum play an important role...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28522783/splenic-abcesses-as-infectious-complication-following-127-implantation-of-left-ventricular-asssist-device-case-report
#5
Sławomir Gajda, Anna M Szczepanik, Grzegorz Religa, Andrzej Misiak, Andrzej B Szczepanik
Left ventricular assist device (LVAD) is one of the modern management therapies in patients with advanced heart failure, and it serves as a bridge to heart transplantation or even as destination therapy. However, it is burdened with a high risk of thromboembolic, hemorrhagic, and infectious complications despite prophylactic management. Splenic abscesses, as septic complications following implantation of mechanical ventricular support, have not yet been described in the literature. We report of a patient with severe left ventricular insufficiency (NYHA II/III), pulmonary hypertension, and arrhythmia who underwent implantation of the Heart Ware® pump for left ventricular support with simultaneous tricuspidvalvoplasty, as a bridge therapy to heart transplantation...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28513529/total-gastric-necrosis-a-case-report-and-literature-review
#6
G Huang, Y Jin
Total gastric necrosis is a rare disease and easy to misdiagnose. Here we report a rare case of total gastric necrosis. The patient, an 89-year-old male, had epigastric pain for 5 days. He was transferred to our hospital because of intraperitoneal hemorrhage and hypovolemic shock. We performed an emergency laparotomy. During the surgery, we found a total of 3500ml unclotted blood in the abdomen, splenic infarction and gastric necrosis. Total gastrectomy with Roux-en-Y esophagojejunostromy and splenectomy was performed...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28512755/evaluation-of-safety-of-concomitant-splenectomy-in-living-donor-liver-transplantation
#7
Amr Badawy, Yuhei Hamaguchi, Satoru Seo, Tochimi Kaido, Hideaki Okajima, Shinji Uemoto
In Asian countries, concomitant splenectomy in living donor liver transplantation (LDLT) is indicated to modulate the portal vein pressure in the small sized graft to protect against small for size syndrome. While concomitant splenectomy in deceased donor liver transplantation is almost contraindicated based on western reports of increased mortality and morbidity rate due to septic complications, there are few studies about that in LDLT. So, we retrospectively investigated the clinical outcome of adult LDLT at Kyoto University Hospital from July 2010 to July 2016...
May 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28512414/an-intra-abdominal-desmoid-tumor-embedded-in-the-pancreas-preoperatively-diagnosed-as-an-extragastric-growing-gastrointestinal-stromal-tumor
#8
Mari Mizuno, Yoshiaki Kawaguchi, Aya Kawanishi, Yohei Kawashima, Atsuko Maruno, Masami Ogawa, Mifuji Tomioku, Daisuke Furukawa, Kazuhito Nabeshima, Kenji Nakamura, Kenichi Hirabayashi, Tetsuya Mine
A 45-year-old woman was found to have a pancreatic tumor by abdominal ultrasound performed for a medical check-up. Abdominal contrast-enhanced computed tomography showed a hypovascular tumor measuring 30 mm in diameter in the pancreatic tail. Endoscopic ultrasound-guided fine needle aspiration was performed. An extragastric growing gastrointestinal stromal tumor was thereby diagnosed preoperatively, and surgical resection was planned. Laparoscopic surgery was attempted but conversion to open surgery was necessitated by extensive adhesions, and distal pancreatectomy, splenectomy, and partial gastrectomy were performed...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28508873/mutant-kras-promotes-malignant-pleural-effusion-formation
#9
Theodora Αgalioti, Anastasios D Giannou, Anthi C Krontira, Nikolaos I Kanellakis, Danai Kati, Malamati Vreka, Mario Pepe, Μagda Spella, Ioannis Lilis, Dimitra E Zazara, Eirini Nikolouli, Nikolitsa Spiropoulou, Andreas Papadakis, Konstantina Papadia, Apostolos Voulgaridis, Vaggelis Harokopos, Panagiota Stamou, Silke Meiners, Oliver Eickelberg, Linda A Snyder, Sophia G Antimisiaris, Dimitrios Kardamakis, Ioannis Psallidas, Antonia Μarazioti, Georgios T Stathopoulos
Malignant pleural effusion (MPE) is the lethal consequence of various human cancers metastatic to the pleural cavity. However, the mechanisms responsible for the development of MPE are still obscure. Here we show that mutant KRAS is important for MPE induction in mice. Pleural disseminated, mutant KRAS bearing tumour cells upregulate and systemically release chemokine ligand 2 (CCL2) into the bloodstream to mobilize myeloid cells from the host bone marrow to the pleural space via the spleen. These cells promote MPE formation, as indicated by splenectomy and splenocyte restoration experiments...
May 16, 2017: Nature Communications
https://www.readbyqxmd.com/read/28504685/spleen-derived-lipocalin-2-in-the-portal-vein-regulates-kupffer-cells-activation-and-attenuates-the-development-of-liver-fibrosis-in-mice
#10
Tomonori Aoyama, Kyoko Kuwahara-Arai, Akira Uchiyama, Kazuyoshi Kon, Hironao Okubo, Shunhei Yamashina, Kenichi Ikejima, Shigehiro Kokubu, Akihisa Miyazaki, Sumio Watanabe
The liver has an immune tolerance against gut-derived products from the portal vein (PV). A disruption of the gut-liver axis leads to liver injury and fibrosis. The spleen is connected to the PV and regulates immune functions. However, possible splenic effects on liver fibrosis development are unclear. Lipocalin-2 (Lcn2) is an antimicrobial protein that regulates macrophage activation. To clarify the role of the spleen in liver fibrosis development, we induced liver fibrosis in mice after splenectomy, and investigated liver fibrosis development...
May 15, 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/28498097/the-asplenic-patient-post-insult-immunocompetence-infection-and-vaccination
#11
Brandon Dionne, Walter Dehority, Meghan Brett, Thomas R Howdieshell
BACKGROUND: Splenic injury can occur through multiple mechanisms and may result in various degrees of residual immunocompetence. Functionally or anatomically asplenic patients are at higher risk for infection, particularly with encapsulated bacteria. Vaccination is recommended to prevent infection with these organisms; however, the recommendations are routinely updated, and vaccine selection and timing are complex. METHODS: Review of the pertinent English-language literature, including the recommendations of the U...
May 12, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28496360/epidural-anesthesia-for-labor-and-delivery-in-a-patient-with-may-hegglin-anomaly-a-case-report
#12
Annas Muhammad Muzannar, Mohammed Al Harbi, Raza Rathore, Nasser Tawfeeq, Freddie Wambi, Nasir Mahmood, Sonia Albrechtova, Vassilios Dimitriou
We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28491197/traumatic-rupture-of-a-giant-congenital-splenic-cyst-presenting-as-peritonitis
#13
Alexander Tassopoulos, Melissa Wein, Annette Segura
Splenic cysts are uncommon, with large cysts and complications being rare. We describe a 6-year-old patient who initially presented 1 day after falling onto her abdomen at the playground with worsening abdominal pain and distention. An ultrasound of the abdomen demonstrated free abdominal fluid in all four quadrants. A subsequent contrast-enhanced computed tomography scan of the abdomen and pelvis was performed which showed a large splenic cyst with open communication to the peritoneal cavity. A congenital primary cyst was confirmed on pathology after partial splenectomy was performed...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28490219/recruitment-of-macrophages-from-the-spleen-contributes-to-myocardial-fibrosis-and-hypertension-induced-by-angiotensin-ii
#14
Ning-Ping Wang, James Erskine, Wei-Wei Zhang, Rong-Hua Zheng, Li-Hui Zhang, Garret Duron, Julian Gendreau, Zhi-Qing Zhao
INTRODUCTION: The purpose of this study was to determine whether macrophages migrated from the spleen are associated with angiotensin II-induced cardiac fibrosis and hypertension. METHODS: Sprague-Dawley rats were subjected to angiotensin II infusion in vehicle (500 ng/kg/min) for up to four weeks. In splenectomy, the spleen was removed before angiotensin II infusion. In the angiotensin II AT1 receptor blockade, telmisartan was administered by gastric gavage (10 mg/kg/day) during angiotensin II infusion...
April 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/28488145/anti-pneumococcal-vaccine-induced-cellular-immune-responses-in-post-traumatic-splenectomized-individuals
#15
Djursun Karasartova, Umut Gazi, Ozgur Tosun, Ayse S Gureser, Ibrahim T Sahiner, Mete Dolapci, Aysegul T Ozkan
PURPOSE: Splenectomy is associated with increased risk of overwhelming post-splenectomy infections despite proper anti-pneumococcal vaccination. As most studies concentrated on vaccination-induced humoral immunity, the cellular immune responses triggered in splenectomized patients are not yet well studied. The present study aims to investigate this area as it can contribute to the development of more effective vaccination strategies. METHODS: Five healthy and 14 splenectomized patients were vaccinated with pneumococcal conjugate polysaccharide vaccine (PCV) followed by pneumococcal polysaccharide vaccine according to the guidelines established by Advisory Committee on Immunization Practices...
May 2017: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28486174/subtotal-splenectomy-preserving-the-inferior-splenic-pole-for-the-treatment-of-hodgkin-s-lymphoma
#16
Andy Petroianu
INTRODUCTION: Splenectomy is helpful in the management of selected patients with Hodgkin's lymphoma (HL), but in some cases this procedure is accompanied by a greater morbidity and mortality mainly due to sepsis. This is the first published case of subtotal splenectomy preserving the inferior splenic pole without the maintenance of the splenic vascular pedicle. PRESENTATION OF CASE: A 53-year-old man with HL refractory to chemo and radiotherapy associated to a very large spleen was successfully treated with subtotal splenectomy, preserving the inferior splenic pole supplied only by the left gastroepiploic and inferior splenic pole vessels...
April 25, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28486007/concomitant-laparoscopic-perisplenic-artery-ligation-facilitates-surgery-for-hepatobiliary-disease-coexisting-with-portal-hypertension
#17
Youlong Wang, Fei Chen, Yajuan Chu, Xiaofang Tan, Jingwang Tan, Wenbin Ji
BACKGROUND: Although liver cirrhosis with portal hypertension (PH) contributes significantly to morbidity and mortality in abdominal surgery, many authors still consider this disease as an indication for surgery. In many reports, however, numerous treatment modalities focus on hypersplenism secondary to PH, irrespective of splenomegaly and PH. The proven benefits of laparoscopy seem especially applicable to patients with this complex disease. This study evaluates the safety and efficacy of laparoscopic perisplenic artery ligation (SAL) in patients with hepatobiliary disease and PH...
May 9, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28484163/progress-in-diagnosis-and-treatment-of-autoimmune-hemolytic-disorders
#18
Toyomi Kamesaki
Discovery of the Coombs' test was an epoch-making event in the history of managing autoimmune hemolytic anemia (AIHA). The Coombs' test allows immune-related hemolytic anemia to be distinguished from nonimmune acquired hemolytic anemia, but also creates a complicated category; Coombs-negative AIHA. To resolve this problem, several trials have been conducted to detect immunoglobulin (Ig) G molecules on erythrocytes (RBC-IgG) that the Coombs' test cannot detect. In Japan, RBC-IgG can be quantitated using a radioimmunoassay, but this procedure is time-consuming and expensive...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28473904/from-chronic-immune-thrombocytopenia-to-severe-aplastic-anemia-recent-insights-into-the-evolution-of-eltrombopag
#19
REVIEW
Harinder Gill, Raymond S M Wong, Yok-Lam Kwong
Thrombopoietin (TPO) is the most potent cytokine stimulating thrombopoiesis. Therapy with exogenous TPO is limited by the formation of antibodies cross-reacting with endogenous TPO. Mimetics of TPO are compounds with no antigenic similarity to TPO. Eltrombopag is an orally-active nonpeptide small molecule that binds to the transmembrane portion of the TPO receptor MPL. Initial trials of eltrombopag have centered on immune thrombocytopenia (ITP), which is due to both increased destruction and decreased production of platelets...
May 2017: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/28473360/emergency-splenectomy-postelective-colonoscopy
#20
Carolyn Cullinane, Jaroslaw Gudyma, Gerarde McArdle
Colonoscopy is the gold standard for investigation of colorectal carcinoma and inflammatory bowel disease. Splenic injury is a rare but potentially fatal complication of colonoscopy. The present case study outlines the early clinical presentation and rapid deterioration of a patient with a splenic injury after an elective colonoscopy. A 70-year-old female underwent a colonoscopy for investigation of altered bowel habit. The procedure was documented as difficult due to the presence of 'stiff loopy colon'. In recovery, patient's condition deteriorated and she was moved to the ward for further assessment...
May 3, 2017: BMJ Case Reports
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