Key clinical message
A suspicious malignant lung nodule with cutaneous reaction is not always cancer, especially in low risk for malignancy patients. A lung biopsy should be taken into consideration. ...The associated cause of Sweet's syndrome directs the treatment in each patient.
Key Clinical Message
Statins can commonly cause myopathy. Most of the time, stopping the culprit drug should solve the problem. However, if the drug has been discontinued but muscle weakness ...continues to worsen, immune‐mediated myopathy should be taken into consideration.
Pancreatic duct (PD) stent migration is among the recognized complications of endoscopic retrograde cholangiopancreatography (ERCP) with PD stent placement. Proximal stent migration poses a challenge ...for removal due to risks of PD damage, smaller caliber, and possible stricture. Here, we present a case of SpyGlass DS system‐assisted PD stent repositioning after failure with traditional tools.
Pancreatic duct (PD) stent migration is among the recognized complications of endoscopic retrograde cholangiopancreatography (ERCP) with PD stent placement. Proximal stent migration poses a challenge for removal due to risks of PD damage, smaller caliber, and possible stricture. Here, we present a case of SpyGlass DS system‐assisted PD stent repositioning after failure with traditional tools. With literature review, SpyGlass DS system demonstrated to be highly successful, cost effective and carry fewer complications due to direct visualization.
Key Clinical Message
Neuroendocrine tumors, rare and slow‐growing, primarily affect the gastrointestinal tract, causing symptoms due to hormone secretion or mass effect. This case image described ...postprandial abdominal pain as an atypical initial presentation of abdominal neuroendocrine tumor recurrence in a middle‐aged male.
Neuroendocrine tumors are a group of rare, slow‐growing neoplasms, most commonly affecting the gastrointestinal tract. Clinical presentations include symptoms related to the mass or hypersecretion of hormones, such as flushing, diarrhea, or bronchoconstriction. Postprandial abdominal pain is most commonly related to chronic mesenteric ischemia from atherosclerotic changes but is rarely linked to external mass compression, including gastrointestinal tumors. Hereby, the authors highlight an uncommon presentation of NET, which is very challenging to diagnose and demands a high index of suspicion.
Key Clinical Message
This case image describes the complex proposed etiologies of a case of superior vena cava syndrome. Hence, different diagnostic and therapeutic modalities are needed in a ...multidisciplinary team approach.
Background:
The clinical presentations in patients with SARS-CoV-2 (COVID-19) infections range from asymptomatic upper respiratory infections to acute respiratory failure with bilateral pulmonary ...infiltrates requiring mechanical ventilation. Clinicians often measured inflammatory markers in hospitalized patients to characterize the severity of the infection. Multiple studies published in 2020 reported information on the frequency of elevated inflammatory markers in hospitalized patients in various categories of disease severity.
Methods:
The PubMed database was searched using the terms “Inflammatory markers in COVID-19 patients” and “Clinical features of patients infected with COVID-19.” Thirty-three publications were analyzed in detail to determine which inflammatory markers were increased and the frequency of these increases in various clinical classifications, including patients requiring hospitalization, patients with pneumonia, patients with severe infection, patients requiring intensive care unit admission, and patients who died.
Results:
C-reactive protein (CRP) was the most frequently elevated inflammatory marker in all categories. Ferritin, D-dimer, and erythrocyte sedimentation rate levels were also frequently elevated. In general, frequencies were higher in patients with more severe infections. For example, 24 out of 24 patients who died had an elevated CRP level.
Conclusion:
This review provides concrete information about the frequency of various inflammatory markers in patients with COVID-19 infection who required hospitalization. It also provides us some insight into the approach clinicians took in the early phase of this pandemic in their efforts to characterize these patients and perhaps understand the disease process better. However, these results might suggest that clinicians and laboratory directors should develop protocols to optimize laboratory testing.
Objective
To comprehensively investigate the association between obesity/high body mass index (BMI) and risk of
Clostridioides difficile
infection (CDI) using systematic review and meta-analysis.
...Methods
Potentially eligible studies were identified from Medline and EMBASE databases from inception to February 2021 using search strategy consisting of terms for “Body Mass Index” and “
Clostridioides Difficile
”. We only included studies that consist of a group of individuals with CDI and another group without CDI. Then, the studies must report their BMI or history of obesity. Odds ratio (OR) and 95% CIs of the association between BMI status and CDI were retrieved from each study and combined using the generic inverse variance method. Funnel plot was used to assess publication bias.
Results
A total of 4609 articles were identified. After two rounds of systematic review, 17 studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed that individuals with high BMI had a significantly decreased odds of CDI with the pooled OR of 0.88 (95% CI 0.80–0.97). This meta-analysis had high statistical heterogeneity with
I
2
of 74%. Funnel plot was symmetric, which was not suggestive of presence of publication bias.
Conclusion
This meta-analysis revealed a significant negative association between BMI and CDI.
Purpose
This study aimed to investigate the association between asthma and risk of myasthenia gravis (MG) using the method of systematic review and meta-analysis.
Methods
Potentially eligible studies ...were identified from Medline and EMBASE databases from inception to July 2020 using search strategy that comprised terms for “Asthma” and “Myasthenia Gravis”. Eligible cohort study must consist of one cohort of individuals with asthma and another cohort of individuals without asthma. Then, the study must report relative risk (RR) with 95% confidence intervals (95% CIs) of incident MG between the groups. Eligible case–control studies must include cases with MG and controls without MG. Then, the study must explore their history of asthma. Odds ratio (OR) with 95% CIs of the association between asthma status and MG must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method.
Results
A total of 6,835 articles were identified. After two rounds of independent review by five investigators, two cohort studies and three case–control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed that asthma was significantly associated with risk of MG with the pooled risk ratio of 1.38 (95% CI 1.02–1.86). Funnel plot was symmetric, which was not suggestive of publication bias.
Conclusion
The current study found a significant association between asthma and increased risk of MG.
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