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  1. Article ; Online: Massive Ischemic Strokes in a Young Patient With Severe Coronavirus Disease 2019 Pneumonia.

    Achebe, Ikechukwu / Nagubadi, Swamy / Pierre-Louis, Serge J C

    Journal of investigative medicine high impact case reports

    2021  Volume 9, Page(s) 23247096211028389

    Abstract: Stroke is an identified sequela of severe coronavirus disease 2019 (COVID-19) infection. While the pathophysiology remains poorly understood, endothelial dysfunction and intravascular thrombosis secondary to sepsis-induced hypercoagulability likely ... ...

    Abstract Stroke is an identified sequela of severe coronavirus disease 2019 (COVID-19) infection. While the pathophysiology remains poorly understood, endothelial dysfunction and intravascular thrombosis secondary to sepsis-induced hypercoagulability likely increase the risk of stroke. This report describes the rare case of an otherwise healthy 42-year-old male who developed large bilateral ischemic infarcts during admission for severe hypoxemic respiratory failure secondary to COVID pneumonia. This report adds to scarce literature describing massive cerebrovascular injury in COVID patients and emphasizes the importance of increased clinical suspicion for stroke in patients who exhibit acute change in mental status or motor function, as well as rapid clinical deterioration.
    Language English
    Publishing date 2021-06-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2710326-2
    ISSN 2324-7096 ; 2324-7096
    ISSN (online) 2324-7096
    ISSN 2324-7096
    DOI 10.1177/23247096211028389
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Left-Sided Prosthetic Valve Dysfunction and Gastrointestinal Bleeding.

    Hussain, Kifah / Kattoor, Ajoe J / Liu, Bolun / Parfieniuk, Agata / Achebe, Ikechukwu / Doukky, Rami

    Cureus

    2023  Volume 15, Issue 4, Page(s) e37042

    Abstract: Introduction We sought to investigate the association between left-sided prosthetic valve dysfunction and gastrointestinal (GI) bleeding. Methods In a retrospective cohort of patients with left-sided prostheses, we identified those who experienced one or ...

    Abstract Introduction We sought to investigate the association between left-sided prosthetic valve dysfunction and gastrointestinal (GI) bleeding. Methods In a retrospective cohort of patients with left-sided prostheses, we identified those who experienced one or more GI bleeds. The latest or chronologically closest echocardiogram to the GI bleed was analyzed by a blinded investigator for prosthetic valve dysfunction. Results Among 334 unique patients, 166 had aortic prostheses, 127 had mitral prostheses, and 41 had both. A total of 58 (17.4%) subjects had GI bleeding events. Patients in the
    Language English
    Publishing date 2023-04-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.37042
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Catheter-based deployment of vascular plugs for the management of challenging gastric fistulae.

    Rau, Prashanth / McNamara, Philip / Achebe, Ikechukwu / Belkin, Dimitri / Zadeh, Odel / Marya, Neil B

    VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy

    2023  Volume 8, Issue 12, Page(s) 497–499

    Abstract: Video 1Case demonstrations of endoscopic vascular plug placement for challenging gastrointestinal fistulae. ...

    Abstract Video 1Case demonstrations of endoscopic vascular plug placement for challenging gastrointestinal fistulae.
    Language English
    Publishing date 2023-08-19
    Publishing country United States
    Document type Journal Article
    ISSN 2468-4481
    ISSN (online) 2468-4481
    DOI 10.1016/j.vgie.2023.08.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: An Unusual Cause of Intermittent Abdominal Pain.

    Achebe, Ikechukwu / Gandhi, Seema / Attar, Bashar

    Gastroenterology

    2020  Volume 160, Issue 5, Page(s) e9–e10

    MeSH term(s) Abdominal Pain/etiology ; Angioedema/complications ; Angioedema/diagnosis ; Biopsy ; Enteritis/diagnosis ; Enteritis/etiology ; Humans ; Male ; Middle Aged ; Recurrence ; Tomography, X-Ray Computed
    Language English
    Publishing date 2020-08-21
    Publishing country United States
    Document type Case Reports
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2020.08.035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Superior Divisional Palsy of the Oculomotor Nerve as a Presenting Sign of SARS-CoV-2 (COVID-19)

    Shrestha Prajwal MD / Achebe Ikechukwu MD / Sharma Bharosa MD / Mba Benjamin MD, MRCP (UK), CHCQM, FACP

    Journal of Investigative Medicine High Impact Case Reports, Vol

    2022  Volume 10

    Abstract: Although COVID is a predominantly respiratory disease, recent studies demonstrate variable and atypical presentations with multiorgan involvement. Neurological manifestations involving cranial nerves and the peripheral nervous system are more frequently ... ...

    Abstract Although COVID is a predominantly respiratory disease, recent studies demonstrate variable and atypical presentations with multiorgan involvement. Neurological manifestations involving cranial nerves and the peripheral nervous system are more frequently being described. Although mechanisms are still under investigation, several studies demonstrate the neuroinvasive potential of COVID via angiotensin-converting enzyme 2 (ACE2) receptor interactions and postulate this mechanism to be the route of COVID central nervous system (CNS) infection. We present the rare case of a purely superior divisional palsy of the left oculomotor nerve in a 46-year-old woman with no medical history in the setting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, confirmed by magnetic resonance imaging (MRI) findings of asymmetrical thickening and enhancement of the left oculomotor nerve. With this report, we hope to increase clinical suspicion for oculomotor nerve palsies as a manifestation of SARS-CoV-2 infection and also to inspire further studies investigating neurological manifestations of COVID.
    Keywords Medicine (General) ; R5-920 ; Pathology ; RB1-214
    Subject code 610
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: Dystrophic Calcinosis Cutis in Systemic Lupus Erythematosus.

    Achebe, Ikechukwu / Mbachi, Chimezie / Asotibe, Jennifer C / Paintsil, Isaac

    Cureus

    2020  Volume 12, Issue 6, Page(s) e8727

    Abstract: Calcinosis cutis is a disorder of pathologic calcium deposition in the cutaneous and subcutaneous layers of skin. While common in dermatomyositis and scleroderma, calcinosis cutis less frequently occurs in systemic lupus erythematosus (SLE) and is ... ...

    Abstract Calcinosis cutis is a disorder of pathologic calcium deposition in the cutaneous and subcutaneous layers of skin. While common in dermatomyositis and scleroderma, calcinosis cutis less frequently occurs in systemic lupus erythematosus (SLE) and is infrequently described in literature. In this report, we discuss the case of a 36-year-old patient with SLE, presenting with vascular compromise, ulceration, and superimposed infection of her left hand as a consequence of severe calcinosis cutis. This report includes a review of the current literature, and highlights the importance of early detection and intervention in preventing disease complications.
    Language English
    Publishing date 2020-06-20
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.8727
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Higher Inpatient Morbidity and Mortality in Biliary Pancreatitis Compared to Hypertriglyceridemia-Induced Pancreatitis: A Nationwide Retrospective Study.

    Shaka, Hafeez / Asotibe, Jennifer C / Achebe, Ikechukwu / Pudasaini, Garima

    Cureus

    2020  Volume 12, Issue 9, Page(s) e10351

    Abstract: Introduction Hypertriglyceridemia (HTG)-induced pancreatitis is the third most common cause of acute pancreatitis after gallstone disease and alcohol. We analyzed data from the National (Nationwide) Inpatient Sample (NIS) with the aim of evaluating the ... ...

    Abstract Introduction Hypertriglyceridemia (HTG)-induced pancreatitis is the third most common cause of acute pancreatitis after gallstone disease and alcohol. We analyzed data from the National (Nationwide) Inpatient Sample (NIS) with the aim of evaluating the outcomes of patients with HTG-induced pancreatitis when compared to those with biliary-induced pancreatitis. Methods The NIS database was sourced for data involving adult hospitalizations for HTG-induced pancreatitis in the United States between January 1, 2016 and December 31, 2017. The main outcome was mortality in patients with biliary pancreatitis vs HTG pancreatitis. Secondary outcomes were the incidence of sepsis, septic shock, non-ST-elevation myocardial infarction (NSTEMI), blood transfusion requirements, acute kidney failure, acute respiratory distress syndrome (ARDS), and length of hospital stay. Results A total of 575,230 patients were admitted with a diagnosis of acute pancreatitis, 18.2% of which were classified as having HTG pancreatitis. The in-hospital mortality for pancreatitis was 0.59%. Patients with HTG pancreatitis had lower odds of in-hospital mortality (adjusted odds ratio [aOR]: 0.74, 95% CI 0.582-0.934, p=0.012) compared to those with biliary pancreatitis. Patients with HTG pancreatitis had less odds of developing comorbid sepsis (aOR: 0.52, 95% CI 0.441-0.612, p<0.001), septic shock (aOR: 0.64, 95% CI 0.482-0.851, p<0.001), and NSTEMI (aOR: 0.70, 95% CI 0.535-0.926, p<0.001) and had less odds of requiring transfusion of blood products (aOR: 0.57, 95% CI 0.478-0.678, p<0.001) when compared to those with biliary pancreatitis. Patients with HTG pancreatitis also had a lower average length of hospital stay and lower total hospital charges compared to those with biliary pancreatitis. There was no statistical difference, however, in acute kidney failure and ARDS between the two groups. Conclusion Patients with HTG-induced pancreatitis possibly have better inpatient outcomes including mortality when compared to those with biliary-induced pancreatitis.
    Language English
    Publishing date 2020-09-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.10351
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  8. Article: Application of artificial intelligence in diagnosis of pancreatic malignancies by endoscopic ultrasound: a systemic review.

    Goyal, Hemant / Sherazi, Syed Ali Amir / Gupta, Shweta / Perisetti, Abhilash / Achebe, Ikechukwu / Ali, Aman / Tharian, Benjamin / Thosani, Nirav / Sharma, Neil R

    Therapeutic advances in gastroenterology

    2022  Volume 15, Page(s) 17562848221093873

    Abstract: Background: Pancreatic cancer (PC) is a highly fatal malignancy with a global overall 5-year survival of under 10%. Screening of PC is not recommended outside of clinical trials. Endoscopic ultrasonography (EUS) is a very sensitive test to identify PC ... ...

    Abstract Background: Pancreatic cancer (PC) is a highly fatal malignancy with a global overall 5-year survival of under 10%. Screening of PC is not recommended outside of clinical trials. Endoscopic ultrasonography (EUS) is a very sensitive test to identify PC but lacks specificity and is operator-dependent, especially in the presence of chronic pancreatitis (CP). Artificial Intelligence (AI) is a growing field with a wide range of applications to augment the currently available modalities. This study was undertaken to study the effectiveness of AI with EUS in the diagnosis of PC.
    Methods: Studies from MEDLINE and EMBASE databases reporting the AI performance applied to EUS imaging for recognizing PC. Data were analyzed using descriptive statistics. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of the included studies.
    Results: A total of 11 articles reported the role of EUS in the diagnosis of PC. The overall accuracy, sensitivity, and specificity of AI in recognizing PC were 80-97.5%, 83-100%, and 50-99%, respectively, with corresponding positive predictive value (PPV) and negative predictive value (NPV) of 75-99% and 57-100%, respectively. Types of AI studied were artificial neural networks (ANNs), convolutional neural networks (CNN), and support vector machine (SVM). Seven studies using other than basic ANN reported a sensitivity and specificity of 88-96% and 83-94% to differentiate PC from CP. Two studies using SVM reported a 94-96% sensitivity, 93%-99% specificity, and 94-98% accuracy to diagnose PC from CP. The reported sensitivity and specificity of detection of malignant from benign Intraductal Papillary Mucinous Neoplasms (IPMNs) was 96% and 92%, respectively.
    Conclusion: AI reported a high sensitivity with high specificity and accuracy to diagnose PC, differentiate PC from CP, and differentiate benign from malignant IPMN when used with EUS.
    Language English
    Publishing date 2022-04-29
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2440710-0
    ISSN 1756-2848 ; 1756-283X
    ISSN (online) 1756-2848
    ISSN 1756-283X
    DOI 10.1177/17562848221093873
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Acute Rheumatic Fever Presenting as a Mimicker of Septic Arthritis.

    Achebe, Ikechukwu / Hussain, Kifah / Abraham, Annette / Asotibe, Jennifer C / Shaka, Hafeez

    Cureus

    2020  Volume 12, Issue 7, Page(s) e9431

    Abstract: Acute rheumatic fever (ARF) describes the non-suppurative and autoimmune inflammation of joint, muscle, and fibrous tissue that occurs after group A streptococcal (GAS) pharyngitis. This report describes a rare case of a 39-year-old male with migratory ... ...

    Abstract Acute rheumatic fever (ARF) describes the non-suppurative and autoimmune inflammation of joint, muscle, and fibrous tissue that occurs after group A streptococcal (GAS) pharyngitis. This report describes a rare case of a 39-year-old male with migratory arthralgias as a presenting sign of ARF. Through this case, we review the current literature on ARF and highlight clinical and objective findings that differentiate ARF from similar presenting arthralgias, specifically post-streptococcal reactive arthritis (PSRA). With this report, we hope to increase clinical suspicion for ARF in patients with acute joint pain, as differentiating ARF from other arthritides, PSRA specifically, determines management strategy and need for secondary prophylaxis against rheumatic heart disease.
    Language English
    Publishing date 2020-07-27
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.9431
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Wound Myiasis in Severe Venous Stasis Ulcer.

    Asotibe, Jennifer C / Achebe, Ikechukwu / Mbachi, Chimezie / Igwilo, Rita / Paintsil, Isaac

    Cureus

    2020  Volume 12, Issue 6, Page(s) e8585

    Abstract: Although myiasis infestation of wounds presents with significant psychological discomfort to patients, studies have shown that it can be beneficial in the management of recalcitrant ulcers resistant to standard management. Here we report a patient with ... ...

    Abstract Although myiasis infestation of wounds presents with significant psychological discomfort to patients, studies have shown that it can be beneficial in the management of recalcitrant ulcers resistant to standard management. Here we report a patient with persistent ulcers unresponsive to standard management who was lost to follow-up for five months and presented with ''maggots in his wound''. This however proved beneficial to the patient as the ulcer showed healthy granulation tissue on presentation and improved healing on follow-up. Our case presents the beneficial effect of myiasis infestation in the 21st century and helps to highlight a time-tested therapy with further encouragement of the use of biotherapy (sterile maggots) for the management of recalcitrant ulcers.
    Language English
    Publishing date 2020-06-12
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.8585
    Database MEDical Literature Analysis and Retrieval System OnLINE

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