I. A. Vacaroiu, F. Calangiu, G. Tănase, Sebastian Isac, D. Georgescu, D. Dragoș, C. Cobilinschi, L. V. Chiperi, D. Ionescu, Andra-Elena Balcangiu-Stroescu, A. Călinoiu, R. Tulin, D. Balan
Abstract Introduction. Chronic kidney disease (CKD) is one of the most prevalent public health problems of the elderly population. End-Stage Renal Disease (ESRD)’s most common treatment is dialysis. There are some dissimilarities between the sexes that are apparent in the status and the possible outcomes of CKD. This study aims to shed some light on these somewhat overlooked wwwvariations and their implications. Materials and methods. We conducted an observational study on subjects with CKD, undergoing hemodialysis for at least 2 years. For participation, we selected an equal number of men and women, which were divided into 2 groups according to gender. Plasma levels of the following parameters were monitored: creatinine, urea, bicarbonate, phosphorus, calcium, alkaline phosphatase, vitamin D, FGF-23 and TNF-alpha. The differences of the variables between the two groups were evaluated using TTEST and CORREL test. Results. A significant correlation was between the plasma levels of FGF-23 and gender (p =0.02). Regarding the plasmatic levels of urea, besides the expected difference in pre- and post- dialysis levels, we obtained a significant correlation between its post-dialysis value and gender (p =0.045). In regard to the plasmatic levels of the alkaline phosphatase, there was a significant correlation between its value and gender (p =0.01). Conclusions. There is a significant correlation between the plasmatic levels of creatinine, urea, alkaline phosphatase, vitamin D, FGF-23 and gender. Women present lower levels of creatinine and urea, while men present lower plasmatic levels of vitamin D, alkaline phosphatase and FGF-23.
{"title":"Biomarkers Involved in the Mineral-Bone Disorders Secondary to Chronic Hemodialysis","authors":"I. A. Vacaroiu, F. Calangiu, G. Tănase, Sebastian Isac, D. Georgescu, D. Dragoș, C. Cobilinschi, L. V. Chiperi, D. Ionescu, Andra-Elena Balcangiu-Stroescu, A. Călinoiu, R. Tulin, D. Balan","doi":"10.2478/inmed-2022-0225","DOIUrl":"https://doi.org/10.2478/inmed-2022-0225","url":null,"abstract":"Abstract Introduction. Chronic kidney disease (CKD) is one of the most prevalent public health problems of the elderly population. End-Stage Renal Disease (ESRD)’s most common treatment is dialysis. There are some dissimilarities between the sexes that are apparent in the status and the possible outcomes of CKD. This study aims to shed some light on these somewhat overlooked wwwvariations and their implications. Materials and methods. We conducted an observational study on subjects with CKD, undergoing hemodialysis for at least 2 years. For participation, we selected an equal number of men and women, which were divided into 2 groups according to gender. Plasma levels of the following parameters were monitored: creatinine, urea, bicarbonate, phosphorus, calcium, alkaline phosphatase, vitamin D, FGF-23 and TNF-alpha. The differences of the variables between the two groups were evaluated using TTEST and CORREL test. Results. A significant correlation was between the plasma levels of FGF-23 and gender (p =0.02). Regarding the plasmatic levels of urea, besides the expected difference in pre- and post- dialysis levels, we obtained a significant correlation between its post-dialysis value and gender (p =0.045). In regard to the plasmatic levels of the alkaline phosphatase, there was a significant correlation between its value and gender (p =0.01). Conclusions. There is a significant correlation between the plasmatic levels of creatinine, urea, alkaline phosphatase, vitamin D, FGF-23 and gender. Women present lower levels of creatinine and urea, while men present lower plasmatic levels of vitamin D, alkaline phosphatase and FGF-23.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"17 - 25"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45747259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Myocardial infarction (MI) - represents cardiomyocytes necrosis due to prolonged myocardial ischemia, occurring in the context of an imbalance between myocardial oxygen supply and consumption. According to the National Bureau of Statistics, in 2017, mortality from cardiovascular diseases made up 58.4% of all deaths, of which ischemic heart disease (IHD) constituted 52.5% and 8.5% were due to acute myocardial infarction. Cardiovascular rehabilitation is used to optimize the physical, psychological and social functioning of the patient who suffered a myocardial infarction. The session includes 3 phases: the warm-up, the actual training and the recovery (relaxation) phase. The program is individualized, so it is necessary to correctly select the type, intensity, duration and frequency for maximum therapeutic effect. Exercise-based medical rehabilitation is a supplement to drug therapy and post-infarction interventional surgery, as it improves cardiopulmonary function, optimizes drug therapy, decreases risk factors, increases exercise tolerance, improves mental status, reduces the risk of repeated heart attack and cardiac mortality. There are fewer complications due to bed rest and increased performance as a result of improved hemodynamic and metabolic function. As part of a cardiac rehabilitation program, physical activity helps with psychological adaptation and contributes to a successful return to work.
{"title":"Cardiac Rehabilitation of Patients Following Myocardial Infarction","authors":"Maxim Badan, L. Mazur-Nicorici","doi":"10.2478/inmed-2022-0230","DOIUrl":"https://doi.org/10.2478/inmed-2022-0230","url":null,"abstract":"Abstract Myocardial infarction (MI) - represents cardiomyocytes necrosis due to prolonged myocardial ischemia, occurring in the context of an imbalance between myocardial oxygen supply and consumption. According to the National Bureau of Statistics, in 2017, mortality from cardiovascular diseases made up 58.4% of all deaths, of which ischemic heart disease (IHD) constituted 52.5% and 8.5% were due to acute myocardial infarction. Cardiovascular rehabilitation is used to optimize the physical, psychological and social functioning of the patient who suffered a myocardial infarction. The session includes 3 phases: the warm-up, the actual training and the recovery (relaxation) phase. The program is individualized, so it is necessary to correctly select the type, intensity, duration and frequency for maximum therapeutic effect. Exercise-based medical rehabilitation is a supplement to drug therapy and post-infarction interventional surgery, as it improves cardiopulmonary function, optimizes drug therapy, decreases risk factors, increases exercise tolerance, improves mental status, reduces the risk of repeated heart attack and cardiac mortality. There are fewer complications due to bed rest and increased performance as a result of improved hemodynamic and metabolic function. As part of a cardiac rehabilitation program, physical activity helps with psychological adaptation and contributes to a successful return to work.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"71 - 75"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42377683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Heterotopic Pancreas, A Rare Cause of Dyspepsia","authors":"R. Călin","doi":"10.2478/inmed-2022-0233","DOIUrl":"https://doi.org/10.2478/inmed-2022-0233","url":null,"abstract":"","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"98 - 99"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44145694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The SARS-CoV-2 pandemic and its specific respiratory pathology has generated extensive research that has highlighted the specific nature of the disease (COVID-19). Thrombotic processes in the macrocirculation and microcirculation were among the first reported, accompanying respiratory (pulmonary) manifestations. Of the COVID-19 complications, thrombosis in the venous system (venous thrombosis and pulmonary embolism) and the atrial system (stroke) are the most numerous and severe in terms of evolution and prognosis. The prophylaxis of thrombotic processes in COVID-19, initially empirical, has gained a scientific basis based on research and experience of clinicians. The current paper presents general data on macro- and microcirculatory thrombosis and the rationale for thromboprophylaxis. Thromboprophylaxis in non-hospitalized COVID-19 patients, “non-critical” and “critical” hospitalized patients and possible post-hospital thromboprophylaxis are presented. Heparins (HGMM and HNF) are the most commonly indicated and used antithrombotic agents. Other antithrombotic agents - antiplatelets and direct anticoagulants (oral - DOAC) have a very limited and possibly negative role in thromboprophylaxis in COVID-19.
{"title":"Thromboprophylaxis in COVID-19","authors":"A. Vlădăreanu, R. Nistor","doi":"10.2478/inmed-2022-0229","DOIUrl":"https://doi.org/10.2478/inmed-2022-0229","url":null,"abstract":"Abstract The SARS-CoV-2 pandemic and its specific respiratory pathology has generated extensive research that has highlighted the specific nature of the disease (COVID-19). Thrombotic processes in the macrocirculation and microcirculation were among the first reported, accompanying respiratory (pulmonary) manifestations. Of the COVID-19 complications, thrombosis in the venous system (venous thrombosis and pulmonary embolism) and the atrial system (stroke) are the most numerous and severe in terms of evolution and prognosis. The prophylaxis of thrombotic processes in COVID-19, initially empirical, has gained a scientific basis based on research and experience of clinicians. The current paper presents general data on macro- and microcirculatory thrombosis and the rationale for thromboprophylaxis. Thromboprophylaxis in non-hospitalized COVID-19 patients, “non-critical” and “critical” hospitalized patients and possible post-hospital thromboprophylaxis are presented. Heparins (HGMM and HNF) are the most commonly indicated and used antithrombotic agents. Other antithrombotic agents - antiplatelets and direct anticoagulants (oral - DOAC) have a very limited and possibly negative role in thromboprophylaxis in COVID-19.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"59 - 69"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44307335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cosmin-Viorel Bogu, R. Siliște, Mădălina Cîrlan, D. Spătaru, A. Gurghean, I. Săvulescu-Fiedler, Umar Shamim, G. Constantinescu
Abstract Portal vein thrombosis, in the clinical setting of liver cirrhosis, is a complication which increases mortality rate by leading to specific complications. Its presence also serves as a negative prognostic factor for these patients. Specialized literature, although rich in papers on this subject, presents loose and sometimes contradictory information regarding its prognosis and specific treatment. This paper brings into discussion the issue of recent portal vein thrombosis in cirrhotic patients, with emphasis on indications for initiation of anticoagulant therapy and the optimal drug of choice. It also highlights the utility of using correct terminology for facilitating clinical approach of guideline recommendations as well as increasing the quality of published scientific papers. The coagulation homeostasis of the cirrhotic patient presents many particularities that can make the optimal therapeutic choice extremely difficult when portal vein thrombosis is established. Absence of randomized clinical trials and lack of consensus regarding anticoagulant treatment in these patients leaves it up to the clinician to decide when and what anticoagulant to use. Analysis of the newest guidelines and recent meta-analysis made it possible to identify the right context for initiating therapy with the most used anticoagulants currently: low molecular weight heparin, vitamin K antagonists and direct oral anticoagulants.
{"title":"Beyond the Guidelines: Anticoagulant Treatment of Patients with Recent Portal Vein Thrombosis in the Setting of Liver Cirrhosis","authors":"Cosmin-Viorel Bogu, R. Siliște, Mădălina Cîrlan, D. Spătaru, A. Gurghean, I. Săvulescu-Fiedler, Umar Shamim, G. Constantinescu","doi":"10.2478/inmed-2022-0227","DOIUrl":"https://doi.org/10.2478/inmed-2022-0227","url":null,"abstract":"Abstract Portal vein thrombosis, in the clinical setting of liver cirrhosis, is a complication which increases mortality rate by leading to specific complications. Its presence also serves as a negative prognostic factor for these patients. Specialized literature, although rich in papers on this subject, presents loose and sometimes contradictory information regarding its prognosis and specific treatment. This paper brings into discussion the issue of recent portal vein thrombosis in cirrhotic patients, with emphasis on indications for initiation of anticoagulant therapy and the optimal drug of choice. It also highlights the utility of using correct terminology for facilitating clinical approach of guideline recommendations as well as increasing the quality of published scientific papers. The coagulation homeostasis of the cirrhotic patient presents many particularities that can make the optimal therapeutic choice extremely difficult when portal vein thrombosis is established. Absence of randomized clinical trials and lack of consensus regarding anticoagulant treatment in these patients leaves it up to the clinician to decide when and what anticoagulant to use. Analysis of the newest guidelines and recent meta-analysis made it possible to identify the right context for initiating therapy with the most used anticoagulants currently: low molecular weight heparin, vitamin K antagonists and direct oral anticoagulants.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"37 - 45"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48642538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Balan, A. Avino, D. Mutu, Alexandra Gaube, A. Neagu, R. Tulin, Sebastian Isac, D. Georgescu, D. Dragoș, C. Cobilinschi, L. V. Chiperi, D. Ionescu, Andra-Elena Balcangiu-Stroescu, A. Călinoiu, I. A. Vacaroiu
Abstract Introduction. Because of the increasing interest in the study of saliva, many methods have become available that can allow us to perform multiple and rapid analyzes of the composition of salivary secretion using advanced techniques of nanotechnology and fluid micro- engineering. The objectives of our study were to identify immunoglobulin levels variations with age. Materials and methods. We conducted an analysis to check the correlation between saliva and plasma parameters on 24 patients. The study population was divided into 2 groups based on age, with a cut-off at 35 years. The differences on the variables between two groups were evaluated by TTEST and CORREL. Results. Total plasma calcium, as well as ionic calcium have increased values in group 2, the increase being statistically significant (p =0.04) only for ionic calcium. Significant correlation of plasma and salivary values in the case of IgA / IgG ratio, and also a significant correlation of salivary and plasma concentrations for IgG were identified in our study. Conclusions. The correlation between plasma and salivary parameters is closely related to age and these can be used as markers for diagnosis and evaluation of various pathologies. Also, regarding women, salivary calcium and phosphate concentrations increase with age showing peak values around menopause.
{"title":"Correlation Depending on Age Between Saliva and Plasma Parameters","authors":"D. Balan, A. Avino, D. Mutu, Alexandra Gaube, A. Neagu, R. Tulin, Sebastian Isac, D. Georgescu, D. Dragoș, C. Cobilinschi, L. V. Chiperi, D. Ionescu, Andra-Elena Balcangiu-Stroescu, A. Călinoiu, I. A. Vacaroiu","doi":"10.2478/inmed-2022-0226","DOIUrl":"https://doi.org/10.2478/inmed-2022-0226","url":null,"abstract":"Abstract Introduction. Because of the increasing interest in the study of saliva, many methods have become available that can allow us to perform multiple and rapid analyzes of the composition of salivary secretion using advanced techniques of nanotechnology and fluid micro- engineering. The objectives of our study were to identify immunoglobulin levels variations with age. Materials and methods. We conducted an analysis to check the correlation between saliva and plasma parameters on 24 patients. The study population was divided into 2 groups based on age, with a cut-off at 35 years. The differences on the variables between two groups were evaluated by TTEST and CORREL. Results. Total plasma calcium, as well as ionic calcium have increased values in group 2, the increase being statistically significant (p =0.04) only for ionic calcium. Significant correlation of plasma and salivary values in the case of IgA / IgG ratio, and also a significant correlation of salivary and plasma concentrations for IgG were identified in our study. Conclusions. The correlation between plasma and salivary parameters is closely related to age and these can be used as markers for diagnosis and evaluation of various pathologies. Also, regarding women, salivary calcium and phosphate concentrations increase with age showing peak values around menopause.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"27 - 35"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42504572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luiza Cristina Dumitrof, I. Nedelciuc, M. Roca, D. Boișteanu, R. Crișan-Dabija, T. Mihăescu, G. Tinică, F. Mitu
Abstract Aortic stenosis is one of the most common valve diseases in patients over 60 years of age. Lack of prompt surgical correction by conventional valve replacement or interventional transcatheter aortic valve implantation (TAVI) increases the risk of morbidity and mortality, in the context of worsening clinical picture. Since the first interventional transcatheter valve implantation procedure in 2012 and to date, the evolution of technology and refinement of medical techniques has led to the refinement of the treatment method and thus to the improvement of the prognosis of patients with aortic stenosis undergoing TAVI after only one month.
{"title":"Evolution of Biological Parameters in Patients with Severe Aortic Stenosis Undergoing TAVI - Results at One Month","authors":"Luiza Cristina Dumitrof, I. Nedelciuc, M. Roca, D. Boișteanu, R. Crișan-Dabija, T. Mihăescu, G. Tinică, F. Mitu","doi":"10.2478/inmed-2022-0228","DOIUrl":"https://doi.org/10.2478/inmed-2022-0228","url":null,"abstract":"Abstract Aortic stenosis is one of the most common valve diseases in patients over 60 years of age. Lack of prompt surgical correction by conventional valve replacement or interventional transcatheter aortic valve implantation (TAVI) increases the risk of morbidity and mortality, in the context of worsening clinical picture. Since the first interventional transcatheter valve implantation procedure in 2012 and to date, the evolution of technology and refinement of medical techniques has led to the refinement of the treatment method and thus to the improvement of the prognosis of patients with aortic stenosis undergoing TAVI after only one month.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"90 ","pages":"47 - 58"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41278890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Primary Sjögren's syndrome (pSS) has multi-dimensional manifestations, including neutropenia and polyneuropathy. We herein report a 76-year-old woman with pSS initially presenting as severe granulocyte-colony-stimulating factor (G-CSF)-refractory neutropenia and axonal sensorimotor polyneuropathies (SMP). Systemic glucocorticoid administration had reduced neutrophil-associated immunoglobulin G (NAIgG) on the neutrophil surface as detected using flow cytometry, resulting in the development of neutropenia. A patient with pSS concomitant with axonal SMP might show severe neutropenia as aggressive autoimmune disease. Neutropenia can be treated with systemic glucocorticoids based on the assessment of NAIgG on the neutrophil surface.
{"title":"Granulocyte-colony-stimulating Factor-resistant Neutropenia and Polyneuropathy Presenting as Severe Complications of Sjögren's Syndrome.","authors":"Katsuyuki Tomita, Shinnosuke Tokugawa, Genki Inui, Shotaro Moriyasu, Tomoyuki Ikeuchi, Hirokazu Touge, Fuminari Tajima","doi":"10.2169/internalmedicine.9092-21","DOIUrl":"10.2169/internalmedicine.9092-21","url":null,"abstract":"<p><p>Primary Sjögren's syndrome (pSS) has multi-dimensional manifestations, including neutropenia and polyneuropathy. We herein report a 76-year-old woman with pSS initially presenting as severe granulocyte-colony-stimulating factor (G-CSF)-refractory neutropenia and axonal sensorimotor polyneuropathies (SMP). Systemic glucocorticoid administration had reduced neutrophil-associated immunoglobulin G (NAIgG) on the neutrophil surface as detected using flow cytometry, resulting in the development of neutropenia. A patient with pSS concomitant with axonal SMP might show severe neutropenia as aggressive autoimmune disease. Neutropenia can be treated with systemic glucocorticoids based on the assessment of NAIgG on the neutrophil surface.</p>","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"3287-3291"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46317692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01Epub Date: 2022-05-31DOI: 10.2169/internalmedicine.9218-21
Kai Korekawa, Atsushi Kunimitsu, Rento Morishima
An 80-year-old woman was referred to our hospital for a thorough examination of enlarged lymph nodes on the lesser curvature of the stomach. Upon suspicion of malignant lymphoma, the patient underwent open lymphadenectomy and was diagnosed with lymph node metastasis of poorly differentiated adenocarcinoma. The patient was subsequently diagnosed with microsatellite instability-high cancer of unknown primary origin. Surgical removal of the affected lymph nodes achieved full remission. Chemotherapy was considered in case of recurrence or identification of the primary site. Recurrence has not occurred in three years since the surgery. However, a long-term survival without chemotherapy is rare.
{"title":"Microsatellite Instability-high-positive Cancer of Unknown Primary Origin with a Long-term Survival after Surgery Alone.","authors":"Kai Korekawa, Atsushi Kunimitsu, Rento Morishima","doi":"10.2169/internalmedicine.9218-21","DOIUrl":"10.2169/internalmedicine.9218-21","url":null,"abstract":"<p><p>An 80-year-old woman was referred to our hospital for a thorough examination of enlarged lymph nodes on the lesser curvature of the stomach. Upon suspicion of malignant lymphoma, the patient underwent open lymphadenectomy and was diagnosed with lymph node metastasis of poorly differentiated adenocarcinoma. The patient was subsequently diagnosed with microsatellite instability-high cancer of unknown primary origin. Surgical removal of the affected lymph nodes achieved full remission. Chemotherapy was considered in case of recurrence or identification of the primary site. Recurrence has not occurred in three years since the surgery. However, a long-term survival without chemotherapy is rare.</p>","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"3301-3308"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48159741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Stoian, Gabriel Scarlat, S. Seitan, Bianca Procopiescu
Abstract Glomerulonephritis is a major cause of morbidity in systemic lupus erythematosus (SLE). In fact, immune complex formation and deposition in the kidney results in intraglomerular inflammation with recruitment of leukocytes and activation and proliferation of resident renal cells. Intense injury may destroy resident renal cells by necrosis or apoptosis resulting in fibrinoid necrosis. When injury is less intense, endocapillary cells respond by proliferating and production of extracellular matrix (proliferative lesions). Renal biopsy, examination of urine sediment and measurement of C3 levels (and to less anti-DNA titers) are essential for the management of lupus nephritis. Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombotic episodes in the arterial or venous circulation, in the presence of antiphospholipid antibodies (aPL), namely lupus anticoagulant (LA), anticardiolipin antibodies, and anti-β2glycoprotein-I antibodies (anti-β2GPI). Catastrophic APS (CAPS) is a very rare (---lt---1%) and extremely severe variant of APS. It is characterized by multiple systems and thrombotic organ involvement that occurs in a very short period (days to weeks). Renal involvement is a common feature in CAPS, the most frequent finding is thrombotic microangiopathy (TMA), but other chronic lesions of APSN can also be found.
{"title":"A Clinical Approach of Lupus Nephritis Associated with Catastrophic Antiphospholipid - Antibody Syndrome - Review and Case Report","authors":"M. Stoian, Gabriel Scarlat, S. Seitan, Bianca Procopiescu","doi":"10.31579/2690-4861/233","DOIUrl":"https://doi.org/10.31579/2690-4861/233","url":null,"abstract":"Abstract Glomerulonephritis is a major cause of morbidity in systemic lupus erythematosus (SLE). In fact, immune complex formation and deposition in the kidney results in intraglomerular inflammation with recruitment of leukocytes and activation and proliferation of resident renal cells. Intense injury may destroy resident renal cells by necrosis or apoptosis resulting in fibrinoid necrosis. When injury is less intense, endocapillary cells respond by proliferating and production of extracellular matrix (proliferative lesions). Renal biopsy, examination of urine sediment and measurement of C3 levels (and to less anti-DNA titers) are essential for the management of lupus nephritis. Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombotic episodes in the arterial or venous circulation, in the presence of antiphospholipid antibodies (aPL), namely lupus anticoagulant (LA), anticardiolipin antibodies, and anti-β2glycoprotein-I antibodies (anti-β2GPI). Catastrophic APS (CAPS) is a very rare (---lt---1%) and extremely severe variant of APS. It is characterized by multiple systems and thrombotic organ involvement that occurs in a very short period (days to weeks). Renal involvement is a common feature in CAPS, the most frequent finding is thrombotic microangiopathy (TMA), but other chronic lesions of APSN can also be found.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"77 - 87"},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46632121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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