Summary
Post‐transplant erythrocytosis (PTE) can occur in up to 10–16% after kidney transplant (KT). However, the post‐transplant outcomes of recipients with PTE in the literature were conflicting. ...We performed systematic review and meta‐analysis of published studies to evaluate risk factors of PTE as well as outcomes of recipients who developed PTE compared with controls. A literature search was conducted evaluating all literature from existence through February 2, 2021, using MEDLINE and EMBASE. Data from each study were combined using the random‐effects model. (PROSPERO: CRD42021230377). Thirty‐nine studies from July 1982 to January 2021 were included (7,099 KT recipients). The following factors were associated with PTE development: male gender (pooled RR = 1.62 1.38, 1.91, I2 = 39%), deceased‐donor KT (pooled RR = 1.18 1.03, 1.35, I2 = 32%), history of smoking (pooled RR = 1.36 1.11, 1.67, I2 = 13%), underlying polycystic kidney disease (PKD) (pooled RR=1.56 1.21, 2.01, I2=44%), and pretransplant dialysis (pooled RR=1.6 1.02, 2.51, I2=46%). However, PTE was not associated with outcomes of interest, including overall mortality, death‐censored graft failure, and thromboembolism. Our meta‐analysis demonstrates that male gender, deceased‐donor KT, history of smoking, underlying PKD, and pretransplant dialysis were significantly associated with developing PTE. However, with proper management, PTE has no impact on prognosis of KT patients.
Male gender, deceased‐donor KT, history of smoking, underlying PKD, and pretransplant dialysis were significantly associated with developing PTE. However, with proper management, PTE has no impact on the prognosis of KT patients.
Ischaemic colitis is a rare complication of rheumatoid vasculitis.1 2 Tumor necrosis factor (TNF)-α inhibitors, commonly used biological agents in RA, are also reported to cause ischaemic colitis, ...through an unknown mechanism.3 Such widespread localisation of the lesions, rather than watershed zones, goes against hypoperfusion as a cause of ischaemic colitis. Since she lacked other symptoms of RA flare and had only mildly elevated non-specific inflammatory markers, ischaemic colitis from rheumatoid vasculitis complication was unlikely. Ischaemic colitis in rheumatoid arthritis patients receiving tumour necrosis factor-α inhibitors: an analysis of reports to the US FDA adverse event reporting system.
COVID toes following vaccination Cavazos, Annia; Deb, Anasua; Sharma, Upama ...
Proceedings - Baylor University. Medical Center,
2022, Letnik:
35, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Cutaneous manifestations of COVID-19 infections include "COVID toes." These are pernio-like, pale purple, painful, ill-defined cyanotic lesions that have inflammatory infiltrates on histologic ...studies. COVID toes can also develop following COVID vaccination. COVID toes was reported by 29 individuals to the Vaccine Adverse Event Reporting System maintained by the Centers for Disease Control and Prevention through May 25, 2021. The mean age of these individuals was 52 ± 18 years; 23 (79%) were women. They had received both mRNA vaccines and the adenovirus vector-based vaccine. This discoloration developed 4.5 ± 9.8 days following vaccination, usually after the first dose. Four individuals required hospitalization for systemic symptoms, and one died. This information indicates that some individuals develop important clinical syndromes following vaccination and suggests that some of the manifestations of COVID-19 infection represent immune responses and not necessarily active tissue infection.
A 78-year-old man presented with upper gastrointestinal bleeding, which was biopsy proven to be from a gastric neuroendocrine tumor. By the time of diagnosis, he developed liver metastasis and died 2 ...months later. Upper gastrointestinal bleeding is an uncommon feature in gastroenteropancreatic neuroendocrine tumor.
Correspondence to Dr Anasua Deb; anasua.deb@gmail.com Description Worldwide, testicular cancer contributes to 1%–2% of all cancers in men1 and is also the most common malignancy in young adult men.2 ...Review of the Surveillance, Epidemiology, and End Results programme database from 1975 to 2015 revealed that in the USA, the incidence of testicular cancer has been increasing.3 Germ cell tumour (GCT) is the most common type, accounting for 95% of testicular cancer cases.4 Seminomas account for 60.2% of GCT and have a varied initial presentation.5 Gastrointestinal (GI) presentation of GCT is unusual as they rarely metastasise to the GI tract.6 Less than 5% of all testicular GCT metastasise to the GI tract, whereas the incidence of GI metastasis for seminomas is less than 1%.7 Upper GI tumour bleeding that leads to the first diagnosis of cancer accounts for 2.4% of all acute upper GI bleeding cases.8 We report a case of a male patient who presented with acute upper GI bleeding caused by a duodenal lesion invaded by retroperitoneal metastasis from a testicular GCT. To rule out duodenal perforation, contrast-enhanced CT was performed, which revealed a 5.8×5 cm midline retroperitoneal soft tissue mass that displaced the third portion of the duodenum anteriorly (figure 2). Contrast-enhanced CT revealed a midline retroperitoneal soft tissue mass that displaced the third portion of the duodenum anteriorly (arrow).
Idiopathic spontaneous pneumoperitoneum Deb, Anasua; Ghosh, Binita; Cavazos, Annia ...
Proceedings - Baylor University. Medical Center,
2022, Letnik:
35, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Spontaneous pneumoperitoneum is the presence of free air in the peritoneum without evidence of any perforation of hollow viscera. The usual presentation includes acute abdominal pain with ...leukocytosis and elevated inflammatory markers. Here we present a case of spontaneous pneumoperitoneum occurring recurrently in a 58-year-old man with inclusion body myositis and hypertension who presented with cellulitis of both legs. Abdominal computed tomography demonstrated retroperitoneal free air; however, colonoscopy, esophagogastroduodenoscopy, and a prior laparoscopy did not demonstrate any perforation of hollow viscera. Conservative management with antibiotics and symptom control with antiemetics and pain medicines led to clinical improvement, and the patient was discharged home in stable condition.
A 75-year-old woman presented with recurrent abdominal pain and vomiting for 1 year and was later found to have splenomegaly and pancytopenia. This case report depicts a clinical picture of ...intestinal angioedema, a challenging diagnosis, and an underlying rare syndrome of acquired C1 esterase inhibitor deficiency associated with splenic marginal zone lymphoma.
Colon cancer generally presents with lower gastrointestinal symptoms, such as diarrhea, constipation, and general abdominal discomfort; it is rare for the primary presentation to have upper ...gastrointestinal symptoms. We report a patient with coloduodenal fistula secondary to colon malignancy who presented with incessant vomiting and dramatic weight loss as the chief complaint. It is important to consider colon cancer as part of the differential in patients with atypical presentations of upper gastrointestinal symptoms who have known colon cancer risk factors.
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