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The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which triggered the ongoing pandemic, was first discovered in China in late 2019. SARS-CoV-2 is a respiratory virus responsible for coronavirus disease 2019 (COVID-19) that often manifests as a pneumonic syndrome. In the context of the pandemic, there are mixed views on the data provided by epidemiologists and the information collected by hospital clinicians about their patients. In addition, the literature reports a large proportion of patients free of pneumonia vs a small percentage of patients with severe pneumonia among confirmed COVID-19 cases. This raises the issue of the complexity of the work required to control or contain the pandemic. We believe that an integrative and pluralistic approach will help to put the analyses into perspective and reinforce collaboration and creativity in the fight against this major scourge. This paper proposes a comprehensive and integrative approach to COVID-19 research, prevention, control, and treatment to better address the pandemic. Thus, this literature review applies a pluralistic approach to fight the pandemic.Patients with heart failure (HF) may be at a higher risk of coronavirus disease 2019 (COVID-19) infection and may have a worse outcome due to their comorbid conditions and advanced age. In this narrative review, we aim to study the interaction between COVID-19 and HF from a critical care perspective. We performed a systematic search for studies that reported HF and critical care-related outcomes in COVID-19 patients in the PubMed and Medline databases. From a total of 1050 papers, we identified 26 that satisfied the eligibility criteria for our review. Data such as patient demographics, HF, intensive care unit (ICU) admission, management, and outcome were extracted from these studies and analyzed. We reported outcomes in heart-transplant patients with COVID-19 separately. In hospitalized patients with COVID-19, the prevalence of HF varied between 4% and 21%. The requirement for ICU admission was between 8% and 33%. HF patients with COVID-19 had an overall mortality rate between 20% and 40%. We identified that HF is an independent predictor of mortality in hospitalized COVID-19 patients, and patients with HF were more likely to require ventilation, ICU admission and develop complications. Patients with HF with reduced ejection fraction did worse than those with HF with midrange ejection fraction, and HF with preserved ejection fraction. COVID-19 patients with HF should be identified early and managed aggressively in an attempt to improve outcomes in this cohort of patients.Pulmonary inflammatory myofibroblastic tumors (IMTs) are rarely reported in adult males. Given the low incidence of IMT and the lack of imaging references and pathological guidance, the misdiagnosis rate of IMT is high. In this article, we describe two cases of IMTs in the lungs. Both patients were adult males with lesions in the right lobe, a history of pulmonary tuberculosis, and a long period of refractory intermittent pulmonary inflammation. Our two male patients both experienced intermittent cough symptoms, but pulmonary IMTs were not suspected for a long time. Both patients were diagnosed with pulmonary tuberculosis before IMT was confirmed and treated with isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E) (HRZE) or isoniazid (H), levofloxacin (L), pyrazinamide (Z), and ethambutol (E) (HLZE) for months. In Case 2, we observed multiple subpleural cord signs in the left lung, soft tissue mass shadows at the apex of the right upper lobe, a thickened interlobular interval, and scattered patches and nodules in the upper right lung. These features are novel in the identification of IMTs. Both of the pathological findings revealed a great deal of myofibroblasts, fibroblasts and collagen fibers in the lower right lung lesion, accompanied by a large number of plasma cells and foam cell infiltration, which were consistent with the features of IMT. The two patients displayed exceedingly different symptoms, computed tomography (CT) imaging features, and pathological results from those reported in traditional records. These findings provide novel references that will extend understandings of this rare disease.We report the case of a 23-year-old man with a medical history of idiopathic thrombocytopenic purpura (ITP) and newly diagnosed with the Epstein-Barr virus (EBV)-positive multiple-site extramedullary plasmacytoma (EMP), which involves the respiratory system. The patient was referred to our hospital because of progressive nasal congestion and nasal mass. Nasopharyngoscopy and bronchoscopy were performed. The biopsy pathological hematoxylin and eosin (HE) staining indicated plasma cell myeloma, and further immunohistochemistry CD99(+), CD79a(+), CD38(+), MUM-1(+), and Lambda(+) confirmed the diagnosis. The patient’s bone marrow was normal, and hypercalcemia, renal insufficiency, anemia, evident bone lesions were not observed. Serum immunoglobulin quantification, serum protein electrophoresis, and blood and urine light chain quantification were all within the normal range. The serum immunofixation electrophoresis was negative, and the serum-free light chain was normal. THZ1 price These results could rule out multiple myeloma (MM) and prove to be EMP involving the nasal cavity, main bronchus, lung, and left hip. No desired effect was achieved after receiving PAD (bortezomib, adriamycin, and dexamethasone) and VRD (bortezomib, lenalidomide, and dexamethasone) treatments. Even if the tumor was remarkably relieved after receiving the 2-course CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimen, secondary resistance to CHOP unfortunately occurred in this case. We attempted to apply epigenetic therapy in the treatment of refractory multiple EMP. Although no complete remission (CR) was achieved, the maximum standard uptake value (SUVmax) in tumor lesions was significantly lower than before, and the patient’s symptoms significantly improved. The patient tolerated decitabine and chidamide. We speculated that epigenetic drugs have potential effect in the treatment of multiple-site EMP.Mixed epithelial and stromal tumor of the kidney (MESTK) is rare renal neoplasm, which usually behaves benignly, while very rarely malignancies have also been reported. Histologically, MESTK is composed of both mesenchymal and epithelial components, where the epithelial components are arranged in a tubular or tubule-cystic pattern against a background of ovarian-like stromal proliferation. MESTK is more commonly seen in perimenopausal women or in patients on long-term estrogen replacement therapy. Given the popularity of routine health screening, patients main present asymptomatically. We report one rare case of MESTK, which was diagnosed in a 30-year-old woman. A computed tomography (CT) scan revealed one well-defined, uneven mass in the left kidney. The tissue obtained by fine-needle aspiration showed relatively homogeneous cells. Renal cell carcinoma could not be excluded, and left complete nephrectomy was performed, according to the patient’s wishes. Another case of MESTK we present here was diagnosed in an 18-year-old male adolescent, who did not have a history of estrogen treatment, with estrogen treatment seen rarely in the clinical setting. Renal cell carcinoma was suspected, and a left partial nephrectomy was performed. Based on histopathological examination, the diagnosis was MESTK for both cases. Both patients were periodically monitored for one year following surgery and showed no imaging findings of recurrence or metastases. MESTK is benign tumor, and hence preoperative diagnosis is crucial to avoid overtreatment. To improve the current understanding of this disease, comprehensive studies on their pathogenesis and preoperative diagnosis are needed.Radiation therapy (RT) for localized prostate cancer yields oncological outcomes similar to those following radical prostatectomy, but is associated with more anorectal toxicity. An endorectal balloon (ERB) has been utilized to decrease the incidental dose to the rectal wall. However, few studies analyzed whether the ERB can further spare the rectum in helical tomotherapy (HT), which by itself can be used to treat prostate cancer while minimizing irradiation of surrounding critical tissues. Here, we report a 64-year-old man with pathologically proven prostate adenocarcinoma (stage T2cN0M0). He underwent definitive RT using HT with a hypofractionated scheme of 70 Gy in 28 fractions. Simulation CT was performed twice with and without ERB application. The ERB was filled with 70 mL of air. Two intensity-modulated RT (IMRT) plans were generated for each CT image set (with and without ERB) and compared about the dose to the anorectum. The rectal volume receiving ≥40 Gy (V40Gy) was reduced from 43.4% to 34.6% with ERB use (20.3% reduction). This reduction rate increased continuously up to V70Gy (48.2% reduction). The anal volume reduction was approximately 50% from V5Gy to V15Gy. The patient tolerated all ERB insertions well and there were no severe acute toxicities. ERB had a further anorectal-sparing effect in this case of prostate cancer treated by highly conformal HT, beyond the generally recommended dose-volume constraints of hypofractionated IMRT.Primary mucinous adenocarcinoma of renal pelvis is an extremely uncommon malignant tumor without typical clinical manifestations and imaging characteristics. A definite diagnosis often depends on postoperative pathological results. Operation is the preferred choice of treatment, but prognosis is unsatisfactory. We describe a 42-year-old male patient who was admitted for repeated and intermittent pain of left abdominal flank for more than 5 years and aggravation of the symptom for more than 1 month. In the course of disease, he was misdiagnosed twice as a renal cyst in other hospitals. However, mild percussive pain was discovered in the left kidney area during this hospitalization. Moreover, abdominal computed tomography (CT) scan of our hospital demonstrated that a huge mixed-density mass derived from left kidney, along with congenital variation of the inferior vena cava and filling defect area in the left renal vein and the adjacent inferior vena cava. After adequate preoperative preparation, he was treated with radical resection of the left kidney and artificial vascular replacement of the inferior vena cava segment containing the emboli. The mass was verified to be mucinous adenocarcinoma by postoperative pathological result. In the end, he was diagnosed as primary mucinous adenocarcinoma of the left renal pelvis with ectopic inferior vena cava and invasion of the left renal vein and the adjacent inferior vena cava. Two weeks after operation, he recovered and was discharged. There was no evidence of recurrence after more than 4 years of follow-up. Blood oncogenic biomarkers were valuable in diagnosis by reviewing literature. In conclusion, Primary mucinous adenocarcinoma of the kidney is easy to be misdiagnosed as renal cyst. Preoperative CT and blood oncogenic biomarkers are extremely important for preliminary diagnosis. Postoperative pathological result is the gold standard for final diagnosis. Although prognosis is generally unfavourable, radical resection of the tumor can benefit patients.