A 64 -year-old woman was referred to our hospital with a diagnosis of advanced rectal cancer with metastases to the left supraclavicular lymph nodes and paraaortic lymph nodes. Alow anterior resection was performed because of the symptoms of ileus. Subsequently, chemotherapy consisting of XELOX with bevacizumab was initiated as the first-line regimen, over 6 courses. Asecond -line regimen of FOLFIRI with bevacizumab was selected due to multiple lung metastases and the progression to both left supraclavicular and paraaortic lymph nodes. During the first 3 courses, the patient had no harmful side effects. Although the patient received adequate prophylactic antiemetic therapy and supportive treatment, grade 4 delayed emesis induced by irinotecan (CPT-11) occurred at 7 days after the fourth course of FOLFIRI chemotherapy. The patient was given total parenteral nutrition, after which she recovered substantially from the emesis. Delayed emesis is occasionally seen with irinotecan therapy and can be efficiently managed with adequate prophylactic antiemetic therapy. However, delayed emesis occurring one week after administration is rarely observed. Delayed emesis and subsequent therapy affect the quality of life (QOL) of the patient and subsequent therapy therefore, adequate attention and prompt management are required for delayed emesis.
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Cureus
December 2024
Cardiothoracic Surgery, Moscow Regional Research and Clinical Institute, Moscow, RUS.
Introduction Preoperative fasting is essential in surgical care to reduce the risk of pulmonary aspiration during anesthesia. International guidelines, such as those from the American Society of Anesthesiologists (ASA) and the European Society of Anaesthesiology (ESA), recommend fasting durations of six hours for solids and two hours for clear liquids. However, adherence to these guidelines often varies in clinical practice, leading to prolonged fasting times that can negatively impact patient outcomes, including dehydration, hypoglycemia, discomfort, and delayed recovery.
View Article and Find Full Text PDFFront Psychiatry
December 2024
Translational Genomic Department, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Background: Pathogenic variants in are associated with pyridoxine-dependent epilepsy (PDE), a rare autosomal recessive disorder characterized by epileptic seizures, unresponsiveness to standard antiseizure medications (ASM), and a response only to pyridoxine. Here, we report two patients (from a consanguineous family) with neonatal seizures and developmental delay.
Case Presentation: Patient 1 (a 13-year-old girl) was born normally at term.
Unlabelled: Transmesenteric hernia is an internal hernia without a sac caused by a congenital defect of the mesentery. It is a rare cause of intestinal atresia, usually diagnosed intraoperatively, therefore, its prognosis is variable and may be associated with high morbidity and mortality.
Objective: To report a case of transmesenteric hernia with multiple intestinal atresia of late diagnosis.
Am J Case Rep
January 2025
Medical School, University of Western Australia, Fremantle, Western Australia, Australia.
BACKGROUND Although hypomagnesemia is common in type 2 diabetes, clinical presentations with severe hypomagnesemia are rare. A number of oral blood glucose-lowering medications can reduce serum magnesium concentrations, and several severe cases have been reported in the presence of marked glucagon-like peptide-1 receptor agonist (GLP-1RA)-associated gastrointestinal adverse effects. In the present case, an acute presentation with severe hypomagnesemia was likely due to polypharmacy including semaglutide, albeit with a delayed relationship to discontinuation of this GLP-1RA, due to nausea and vomiting.
View Article and Find Full Text PDFCancer Biol Med
January 2025
Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
Objective: The role of intraoperative radiation therapy (IORT) in the management of resectable pancreatic cancer (RPC) remains unclear. To date, the application of IORT using a low-energy X-ray source has not been extensively investigated. Therefore, this study was conducted to evaluate the safety and efficacy of IORT using a 50 kV X-ray source in treating RPC.
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