Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease
Poor outcomes of hepatocellular carcinomas (HCC) in chronic kidney disease (CKD) patients are well described. Transarterial therapy is the standard treatment for HCC, following which regular contrast-enhanced imaging for residual disease is recommended. CKD is considered a relative contraindication for transarterial therapy owing to renal failure. This retrospective study investigated the outcomes of transarterial therapy in HCC patients with CKD. In total, 132 HCC patients who received transarterial therapy were enrolled, of whom 36 had CKD. Most CKD patients were elderly, with mean age of diagnosis of 69.7 ± 11.4 years. Hypertension (odds ratio [OR]; 5.06; 95% confidence interval [Cl]; 1.83–13.94), hepatitis C virus carrier rate (OR; 4.12, 95% CI; 1.13–14.99) and diabetes (OR; 3.62, 95% CI; 1.22–10.72) were significant predictors for CKD in HCC patients. Post therapy, the estimated glomerular filtration rate significantly decreased 13.7% from baseline in the CKD patients (P = .03). There were more post-therapy complications than in the non-CKD group, e.g. acute renal failure and sepsis (P
Publication date: Available online 31 March 2020Source: Materials Today: ProceedingsAuthor(s): K. Senthil Kannan, S. Gayathri Devi, Prithiviraj Nagarajan, G. Flora, R. Ranadevan
Authors: Kamimura MA, Nerbass FB PMID: 32227070 [PubMed - as supplied by publisher]
In this report, we describe two patients with anticentriole antibodies-positive SSc-PAH who were treated with pulmonary vasodilators. Both cases were elderly women with poor physical conditions and clinical findings of SSc. Case 1 was resistant to combination therapy with pulmonary vasodilators; in Case 2, hemodynamic improvement was obtained by upfront combination therapy at an early stage. Because anticentriole antibodies-positive SSc-PAH rapidly deteriorates, careful hemodynamic observation and timely aggressive use of pulmonary vasodilators should be considered. PMID: 32224603 [PubMed - in process]
Authors: Sugimoto K, Yoshihisa A, Nakazato K, Yokokawa T, Misaka T, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Ishida T, Takeishi Y Abstract Pulmonary hypertension (PH) caused by left-sided heart disease (LHD-PH) is classified into 2 types: isolated post-capillary PH (Ipc-PH) and combined pre- and post-capillary PH (Cpc-PH). However, the impact of pulmonary vascular resistance (PVR) or diastolic pressure gradient (DPG) on the prognosis of LHD-PH has varied among previous studies. Thus, we verified the significance of PVR or DPG on the prognosis of LHD-PH in our series.We analyzed 243 consecutive LHD-PH patients. The...
We present a case of synchronous bilateral renal cell carcinoma and prostate carcinoma in a 62 year old man. In a fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scan, the left renal mass showed intense 18F-FDG uptake with maximum standardized uptake volume (SUVmax) of 8.12, while uptake in the right renal mass was minimal with SUVmax of 2.99. Fluorine-18-FDG uptake in the prostate gland lesion was moderate with SUVmax of 4.19. Histopathologically, both renal tumors were clear cell renal cell carcinoma with International Society of Urological Pathology (ISUP) Grade 2 and 3 for the right and left k...
We presented a rare case of primary pleural squamous cell carcinoma (SCC) on fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). It manifested as multiple pleural nodules with moderate 18F-FDG uptake and massive pleural effusion on PET/CT. The pathology result supported the primary squamous cell carcinoma. Our case highlighted the SCC should be included as differential diagnosis of the multiple pleural lesions and other differential diagnosis consisted of mesothelioma, solitary fibrous tumor, metastases. PMID: 32222735 [PubMed - as supplied by publisher]
We present a case of a 79 year old patient with a medical history of unilateral nerve-sparing radical prostatectomy due to a pT3aN0 (Gleason score 7) prostate carcinoma. Because of slightly elevated prostate specific antigen (PSA) level (0.35ng/dL), a fluorine-18-prostate specific membrane antigen (18F-PSMA)-1007 positron emission tomography/computed tomography (PET/CT) scan was performed, showing no signs of malignant recurrence. However, a moderately PSMA-avid nodular lesion was observed in the left occipital region with homogeneous contrast enhancement, suggestive for a meningioma, which was confirmed on magnetic resona...
CONCLUSION: A lower SUA level in HD patients was associated with a higher risk of all-cause mortality and CV mortality. Moreover, higher SUA concentrations may be cardioprotective in HD patients. PMID: 32223483 [PubMed - in process]
Authors: PMID: 32223372 [PubMed - in process]
Authors: Fülöp T PMID: 32223363 [PubMed - in process]