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Corticosteroid-Induced Adrenal Insufficiency in Africa: Report of Nine Cases at the internal medicine/endocrinology-diabetology department of Pikine NHC

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Open Journal of Endocrine and Metabolic Diseases 2020年第12期10卷 155-163页

作者： Nafy Ndiaye Ngone Diaba Diack Yakham Mohamed Leye Abdou Dieng Mamadou Ba Abdoulaye Leye internal medicine/endocrinology-diabetology department Teaching Hospital of Pikine Dakar Senegal

Introduction: Prolonged corticosteroid therapy is labeled as the main cause of corticotropic adrenal insufficiency. However, the current frequency of this complication remains unknown. The objective of our study was to assess its epidemiologic, diagnostic, therapeutic, and evolutionary aspects of our practice. Methodology: A 60-month retrospective study was performed from May 2014 to April 2020 in the Pikine National Hospital Centre. Data were obtained from the medical records of patients with corticosteroid-induced adrenal insufficiency. Epidemiologic, diagnostic, therapeutic, and evolutionary parameters, and data related to corticotherapy were recorded. Patients with basal plasma cortisol levels Results: Medical records were obtained from nine patients, comprising six women and three men. The mean age of the patients was 48 years. Long-term corticosteroid therapy was used for self-medication in six patients and artificial bleaching in the remaining three patients. Betamethasone was the most commonly used drug in four patients, followed by clobetasol in three patients. Corticotropic insufficiency was revealed as a result of acute decompensation in five patients. All patients presented with a pseudo-cushingoid pattern. Diagnosis of corticotropic adrenal insufficiency was confirmed by measuring basal plasma cortisol levels of <50 ng/ml in seven patients. A standard Synachtene test was performed on two patients. All patients benefited from hydrocortisone supplementation. In the short-term, the outcome was unremarkable for all patients. Medium and long-term progression could be assessed in only three patients. Two patients showed persistent suppression with a 6- and 9-month follow-up. One patient was readmitted after one month due to an adrenal cris

关键词： Adrenal Insufficiency Corticotherapy Artificial Depigmentation Self-Medication

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Fanlian Huazhuo formula:A promising therapeutic approach for metabolic associated steatotic liver disease

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World Journal of Gastroenterology 2025年第1期31卷 167-171页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305Taiwan Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei 23561Taiwan Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002Taiwan department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328Taiwan

This article reviews the study,“Fanlian huazhuo formula alleviates high-fat-dietinduced nonalcoholic fatty liver disease by modulating autophagy and lipid synthesis signaling pathway”published in the World Journal of *** study explores the therapeutic potential of Fanlian Huazhuo formula(FLHZF)in treating metabolic-associated steatotic liver disease(MASLD),demonstrating that FLHZF reduces lipid accumulation,oxidative stress,and liver injury in MASLD models by modulating key signaling pathways involved in lipid metabolism and *** editorial emphasizes the potential of FLHZF as a treatment for MASLD and calls for further research to verify its clinical efficacy.

关键词： Fanlian Huazhuo formula Metabolic associated steatotic liver disease Autophagy Lipid metabolism Oxidative stress

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Elafibranor:A promising therapeutic approach for liver fibrosis and gut barrier dysfunction in alcohol-associated liver disease

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World Journal of Gastroenterology 2025年第3期31卷 123-126页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305Taiwan Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei City 23561Taiwan Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002Taiwan department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328Taiwan

This article discusses the recent study written by Koizumi et ***-associated liver disease(ALD)is a major cause of liver-related morbidity and mortality,which is driven by complex mechanisms,including lipid accumulation,apoptosis,and inflammatory responses exacerbated by gut barrier *** study explored the therapeutic potential of elafibranor,a dual peroxisome proliferatoractivated receptor alpha/delta *** clinical trials,elafibranor has shown promise for the treatment of other liver conditions;however,its effects on ALD remain *** authors’findings indicate that elafibranor significantly reduced liver fibrosis and enhanced gut barrier integrity in patients with *** positive effects of elafibranor are mediated through multiple *** promotes lipid metabolism,reduces oxidative stress,and inhibits inflammatory responses by restoring gut barrier ***,it improves hepatocyte function by enhancing autophagic and antioxidant capacity,and it mitigates inflammation by suppressing the lipopolysaccharide/toll-like receptor 4/nuclear factor kappa B signaling *** findings indicate that elafibranor has promising clinical *** addition,the study highlights elafibranor’s potential as a therapeutic agent for liver diseases,particularly *** article underscores the importance of understanding the mechanistic pathways underlying ALD and suggests directions for future research aimed at elucidating the benefits and limitations of elafibranor.

关键词： Elafibranor Liver fibrosis Gut barrier function Alcohol-associated liver disease Peroxisome proliferatoractivated receptor agonists

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Advancing treatment strategies:Insights from network meta-analysis of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 252-255页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan City 33305TaiwanChina Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei City 23561TaiwanChina Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002TaiwanChina department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung City 404328TaiwanChina

This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard *** article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced ***,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.

关键词： Hepatic arterial infusion chemotherapy Advanced hepatocellular carcinoma Combination therapy Network meta-analysis Treatment efficacy

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Septic shock due to cytomegalovirus colitis associated with rituximab use:A case report

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World Journal of Virology 2025年第1期14卷 118-123页

作者： Siddharth Patel Jordan Jay Prutha Pathak Mc Anto Antony Mrudula Thiriveedi department of internal medicine Decatur Morgan HospitalDecaturAL 35601United States department of medicine Alabama College of Osteopathic MedicineDothanAL 36303United States department of internal medicine North Alabama Medical CenterFlorenceAL 35630United States department of endocrinology Diabetes and MetabolismMedical University of South Carolina/AnMed CampusAndersonSC 29621United States

BACKGROUND Cytomegalovirus(CMV)infections can cause significant morbidity and mortality in immunocompromised *** targets dysfunctional *** rituximab(RTX)therapy can cause B-lymphocyte dysfunction,increasing CMV ***,CMV infections present with critical illness such as septic *** SUMMARY A 64-year-old African American woman presented with generalized weakness and non-bloody watery diarrhea of 4-6 weeks *** did not have nausea,vomiting or,abdominal *** had been on monthly RTX infusions for neuromyelitis *** was admitted for septic shock due to *** investigations suggested pancytopenia and serology detected significantly elevated CMV *** treatment led to disease *** This case illustrates an extremely rare case of CMV colitis associated with RTX use presenting with septic *** suspicion for rare opportunistic infections is imperative in individuals with long-term RTX use.

关键词： Cytomegalovirus colitis Rituximab use Immunocompromised status Septic shock Pancytopenia Case report

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Role of pancreatic juice cytology in diagnosis of high-grade pancreatic intraepithelial neoplasia

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World Journal of Clinical Cases 2025年第10期13卷 59-61页

作者： Hussein Hassan Okasha Mohammed Tag-Adeen Hossam Eldin Shaaban Division of Gastroenterology and Hepatology Department of Internal MedicineKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt Division of Gastroenterology and Hepatology Department of Internal MedicineQena Faculty of MedicineSouth Valley UniversityQena 83523Egypt department of internal medicine and Gastroenterology National Hepatology and Tropical Medicine Research InstituteCairo 11796Egypt

High-grade pancreatic intraepithelial neoplasia is a challenging diagnosis and itdoes not exhibit mass lesions. It is suspected based on changes in the mainpancreatic duct in magnetic resonance cholangiopancreatography. Sometimesonly an unclear duct shows in magnetic resonance cholangiopancreatographywith no focal strictures and upstream dilatation of the main pancreatic duct. Serialpancreatic juice cytology is valuable in diagnosis of those patients.

关键词： High-grade pancreatic intraepithelial neoplasia Pancreatic cancer Magnetic resonance cholangiopancreatography Endoscopic retrograde pancreatography Pancreatic juice cytology Pancreatic ductal adenocarcinoma

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Red cell distribution width/platelet ratio predicts decompensation of metabolic dysfunction-associated steatotic liver disease-related compensated advanced chronic liver disease

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World Journal of Gastroenterology 2025年第3期31卷 1-10页

作者： Ming-Hua Zheng Amedeo Lonardo department of Hepatology MAFLD Research CenterThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina department of internal medicine Azienda Ospedaliero-Universitaria of Modena(2023)Modena 41126Italy

Prognostication of compensated advanced chronic liver disease(cACLD)is of paramount importance for the physician-and-patient communication and for rational clinical *** paper published by Dallio et al reports on red cell distribution width(RDW)/platelet ratio(RPR)as a non-invasive biomarker in predicting decompensation of metabolic dysfunction-associated steatotic liver disease(MASLD)-related *** from other biomarkers and algorithms,RPR is inexpensive and widely available,based on parameters which are included in a complete blood *** is computed on the grounds of two different items,one of which,RDW,mirrors the host’s response to a variety of disease stimuli and is *** second parameter involved in RPR,platelet count,is more specific and has been used in the hepatological clinic to discriminate cirrhotic from non-cirrhotic chronic liver disease for *** disease is the primary cause of mortality among MASLD subjects,followed by extra-hepatic cancers and liver-related ***,MASLD biomarkers should be validated not only in terms of liver-related events but also in the prediction of major adverse cardiovascular events and cardiovascular mortality and extra-hepatic *** sized multi-ethnic confirmatory investigation is required to define the role and significance of RPR in the stratification of MASLD-cACLD.

关键词： Cirrhosis Liver fibrosis Natural course Prognostication Stratification

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Prediabetes and atrial fibrillation risk stratification,phenotyping,and possible reversal to normoglycemia

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World Journal of Diabetes 2025年第1期16卷 7-11页

作者： Hyder O Mirghani department of internal medicine University of TabukTabuk 51941TabukSaudi Arabia

Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding *** shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high *** of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various ***,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is *** roles lifestyle and metformin play in prediabetes are well ***,the role of glucagon-like peptide agonists and metabolic surgery is less *** is considered an intermediate between normoglycemia and diabetes along the blood glucose *** billion people are expected to suffer from prediabetes by the year ***,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.

关键词： Major adverse cardiac or cerebrovascular event Prediabetes Risk stratification Phenotype Stress hyperglycemia Reversal to normoglycemia

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Ulcerative colitis and bullous pemphigoid:Direct association or a medication side effect:A case report

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World Journal of Clinical Cases 2025年第9期13卷 47-52页

作者： Gaelle-Christie Haddad Anthony El Dada Sergio Sbeih Tony Kazzi Karam Karam Louis A Chaptini department of internal medicine University of BalamandBeirut 100Lebanon department of medicine GastroenterologyUniversity of BalamandBalamand 100Lebanon department of medicine Digestive DiseasesYale School of MedicineNew HavenCT 06510United States

BACKGROUND Bullous pemphigoid(BP)is an autoimmune blistering skin *** is associated with other autoimmune disorders and the use of certain *** describe a case of BP in a patient with ulcerative colitis(UC)treated with *** SUMMARY A 38-year-old male patient with UC and a history of multiple flares was maintained on mesalamine with good clinical *** year after starting mesalamine,he sought medical care following the onset of a severe itchy rash of several weeks’duration with a recent appearance of skin bullae.A biopsy of the skin revealed subepidermal blistering dermatitis with focal eosinophilic *** immunofluorescence studies revealed linear IgG and C3 immune reactant deposits at the dermoepidermal junction,consistent with the diagnosis of *** therapy alleviated his ***,tapering prednisone led to re-eruption of the *** BP should be considered when patients with UC develop skin *** BP is not one of the extraintestinal manifestations of UC,there may be an association between these two *** treatment with mesalamine or other therapeutic agents plays a role in the development of BP remains unclear.

关键词： Bullous pemphigoid Ulcerative colitis Autoimmune disorders Skin manifestations in inflammatory bowel diseases Mesalamine Case report

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Patients admitted in the intensive care unit after solid organ or bone marrow transplantation:Retrospective cohort study

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World Journal of Transplantation 2025年第1期15卷 95-104页

作者： Ana Vujaklija Brajkovic Iva Kosuta Lucija Batur Sara Sundalic Marijana Medic Andro Vujevic Luka Bielen Jaksa Babel department of internal medicine University Hospital Centre ZagrebZagreb 10000Croatia School of medicine University of ZagrebZagreb 10000Croatia

BACKGROUND Solid organ transplantation(SOT)and hematopoietic stem cell transplantation(HSCT)revolutionized the survival and quality of life of patients with malignant diseases,various immunologic,and metabolic disorders or those associated with a significant impairment in a patient's quality of *** To investigate admission causes and treatment outcomes of patients after SOT or HSCT treated in a medical intensive care unit(ICU).METHODS We conducted a single-center,retrospective epidemiological study in the medical ICU at the University Hospital Centre Zagreb,Croatia covering the period from January 1,2018 to December 31,*** The study included 91 patients with either SOT[28 patients(30.8%)]or HSCT[63 patients(69.2%)].The median age was 56(43.2-64.7)years,and 60.4%of the patients were *** with SOT had more comorbidities than patients after HSCT[χ^(2)(5,n=141)=18.513,P<0.001].Sepsis and septic shock were the most frequent reasons for admission,followed by acute respiratory insufficiency in patients following *** rate significantly differed between SOT and HSCT[χ^(2)(1,n=91)=21.767,P<0.001].ICU survival was 57%in the SOT and 12.7%in the HSCT *** need for mechanical ventilation[χ^(2)(1,n=91)=17.081,P<0.001]and vasopressor therapy[χ^(2)(1,n=91)=36.803,P<0.001]was associated with *** necessity for acute renal replacement therapy did not influence patients'survival[χ^(2)(1,n=91)=0.376,P=0.54].In the subgroup of patients with infection,90%had septic shock,and the majority had positive microbiological samples,mostly Gram-negative *** ICU survival of patients with sepsis/septic shock cumulatively was 15%.The survival of SOT patients with sepsis/shock was 45%.CONCLUSION Patients with SOT or HSCT are frequently admitted to the ICU due to sepsis and septic *** advancements in critical care,the mortality rate of patients with refractory septic shock and multiorgan failure in this patient population is extremely hig

关键词： Liver transplantation Kidney transplantation Hematopoietic stem cell transplantation Critical care Sepsis Septic shock Mortality

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