OpenMed/multicare-articles huggingface dataset:
A case of bone metastasis of colon cancer that markedly responded to S-1/CPT-11 combination chemotherapy and became curable by resection
Authors: Kazunari Mado, Yukimoto Ishii, Takero Mazaki, Masaya Ushio, Hideki Masuda, Tadatoshi Takayama
Journal: World J Surg Oncol (2006)

Background:
An oral combined fluoropyrimidine anticancer drug, tegafur/gimeracil/oteracil potassium (S-1), has recently been used alone or in combination for colon cancer.
Case presentation:
The patient was a 42-year-old man with sigmoid colon cancer with direct invasion of the urinary bladder and multiple costal metastases. A diagnosis of T4, M1, stage IV sigmoid colon cancer was made, and curative resection was considered impossible. S-1 at 50 mg/m2 was administered by oral route from day 1 to day 14. Irinotecan (CPT-11) at 40 mg/m2 was administered by intravenous day 1 and 15. This treatment was followed by 2 weeks absent period, and repeated every 4 weeks. Six cycles of administration were performed in total. Following this treatment, the multiple costal metastases resolved. Down-staging to T3, M0, stage IIA was achieved, and curative resection was judged to be possible.
Conclusion:
Occasional cases in which S-1/CPT-11 therapy was effective have been recently reported. The patient's tumor became resectable despite the discovery of colon cancer associated with bone metastasis at the initial examination, offering hope for cancer patients.
Leiomyosarcoma Ex Pleomorphic Adenoma of the Parotid Gland: A Case Report and Literature Review
Authors: Michael Coulter, Jingxuan Liu, Mark Marzouk
Journal: Case Rep Otolaryngol (2016)

There is only one previously reported incident in the English literature of sarcoma ex pleomorphic adenoma of the parotid and there are only 8 cases of primary parotid leiomyosarcoma. In our case, a 79-year-old female patient presented to our care with left preauricular pain, swelling, and facial weakness. After CT imaging, she underwent left total parotidectomy. A spindle cell lesion was identified intraoperatively and the facial nerve was sacrificed. Subsequent analysis of the lesion yielded a diagnosis of leiomyosarcoma ex pleomorphic adenoma. After 30 fractions of radiation therapy, scans were negative for tumor. However, 18 months after first experiencing symptoms, she was found to have metastases to the brainstem and lung. When diagnosing sarcoma ex pleomorphic adenoma of the parotid gland, it is important to perform thorough immunohistochemical staining and exclude a previous history of sarcoma or other sources of metastases. Complete resection is critical due to the tumor's local aggressiveness and metastatic potential. Although these tumors are not very responsive to chemotherapy or radiation, adjuvant treatment is commonly used when margins are unclear.
Spontaneous aching pain and peculiar involuntary movements: a case report of painful legs and moving toes and review of the literature
Authors: Yang-Yi Fan, Yan Xu, Xu-Guang Gao
Journal: Case Rep Med (2014)

Painful legs and moving toes (PLMT) is a rare syndrome characterized by spontaneous neuropathic pain and peculiar involuntary movements in the lower limbs, especially the toes and feet. As it is a relatively rare disorder worldwide, the exact pathophysiology still remains a mystery. Until recently, numerous methods of clinical treatments have been tried; however, the success rate of the therapies is still very low. Here, we report a case of PLMT and also summarize the recent clinical and research literatures regarding clinical presentation, electrophysiological features, etiology, treatment methods, and prognosis of this disorder. Doctors should be aware of this rare syndrome in a patient with painful and/or restless legs. On the other hand, multiple clinical treatments should be tried, even those which usually produce a poor outcome.
Case Report: Catatonia Associated With Post-traumatic Stress Disorder
Authors: Gellan K Ahmed, Khaled Elbeh, Ahmed A Karim, Eman M Khedr
Journal: Front Psychiatry (2021)
Keywords: asylum seeking, catatonia, children, post-traumatic stress disorder, resignation syndrome
MeSH terms: Case Reports

We report here about a 12-year-old female patient who had two life-threatening accidents that led to post-traumatic stress disorder associated with catatonia. She had closed eyes, had urinary and fecal incontinence, and had been in an abnormal position for one and half month. Moreover, she had complications such as dehydration, malunion of the fractured arm, and deformities in hand and foot. After detailed psychiatric examination, neurological assessment, and laboratory investigation, the patient received successful treatment in the form of benzodiazepine injections, intravenous fluid, oral antidepressants, and six sessions of electroconvulsive therapy (ECT). We discuss the pathophysiology of catatonia, which remains elusive, and recommend evaluating catatonic children for any possible trauma during psychiatry assessment.
Adverse Events Associated with Immune Checkpoint Blockade in Patients with Cancer: A Systematic Review of Case Reports
Authors: Noha Abdel-Wahab, Mohsin Shah, Maria E Suarez-Almazor
Journal: PLoS One (2016)
MeSH terms: Antineoplastic Agents / adverse effects, Cell Cycle Checkpoints / drug effects, Neoplasms / drug therapy, Review, Systematic Review, Adult, Aged, Aged, 80 and over, Cell Cycle Checkpoints / immunology, Female, Humans, Male, Middle Aged, Neoplasms / immunology, Antineoplastic Agents

Background:
Three checkpoint inhibitor drugs have been approved by the US Food and Drug Administration for use in specific types of cancers. While the results are promising, severe immunotherapy-related adverse events (irAEs) have been reported.
Objectives:
To conduct a systematic review of case reports describing the occurrence of irAEs in patients with cancer following checkpoint blockade therapy, primarily to identify potentially unrecognized or unusual clinical findings and toxicity.
Data sources:
We searched Medline, EMBASE, Web of Science, PubMed ePubs, and Cochrane CENTRAL with no restriction through August 2015.
Study selection:
Studies reporting cases of cancer develop irAEs following treatment with anti CTLA-4 (ipilimumab) or anti PD-1 (nivolumab or pembrolizumab) antibodies were included.
Data extraction:
We extracted data on patient characteristics, irAEs characteristics, how irAEs were managed, and their outcomes.
Data synthesis:
191 publications met inclusion criteria, reporting on 251 cases. Most patients had metastatic melanoma (95.6%), and the majority were treated with ipilimumab (93.2%). Autoimmune colitis, hepatitis, endocrinopathies, and cutaneous irAEs were the most frequently reported irAEs in ipilimumab treated patients. A broad spectrum of toxicities were reported for almost every body system. Moreover, well-defined diseases such as sarcoidosis, polyarthritis, polymyalgia rheumatica/arteritis, lupus, celiac disease, dermatomyositis, and Vogt-Koyanagi-like syndrome were reported. The most frequent irAEs reported with anti-PD1 agents were dermatitis for pembrolizumab, and thyroid disease and pneumonitis for nivolumab. Complete resolution of adverse events occurred in most cases. However, persistent irAEs and death were reported, mainly in patients treated with ipilimumab.
Limitations:
Our study is limited by information available in the original reports.
Conclusions:
Evidence from case reports shows that cancer patients develop irAEs following checkpoint blockade therapy, and can occasionally develop clearly defined autoimmune systemic diseases. While discontinuation of therapy and/or treatment can result in resolution of irAEs, long-term sequelae and death have been reported.
Abdominoplasty for male truncal obesity: case report
Authors: Ugochukwu Uzodimma Nnadozie, Gabriel Maduwuike Okorie, Charles Chidiebele Maduba, Njoku Isaac Omoke, Amaechi Ugbala, Emmanuel Uchendu, Collins Nwachi Ugwu
Journal: Pan Afr Med J (2020)
Keywords: abdominoplasty, elderly male, quality of life, truncal obesity
MeSH terms: Abdominoplasty / methods, Obesity, Abdominal / surgery, Quality of Life, Case Reports, Abdominal Wall / surgery, Aged, Humans, Male, Postoperative Complications / epidemiology

Truncal obesity and its associated health risk is an enormous burden. The traditional surgical treatment modality is liposuction or lipoabdominoplasty. An uncommon mode of the treatment is the use of abdominoplasty alone or as a surgical component. The aim of this report is to show a satisfactory outcome of abdominoplasty as the only surgical component in the management of severe truncal obesity in elderly male patient. We report a 75 year old Nigerian trader who had truncal obesity with gross abdominal asymmetry and cardiovascular and diabetes mellitus co-morbidities as well as bilateral knee osteoarthritis and social isolation due to truncal disfigurement. He was offered abdominoplasty as a sole surgical option for correction of anterior abdominal wall asymmetry. Apart from post operative wound complications and blood transfusion reactions, the patient had a good recovery and improved quality of life. Abdominoplasty is a rewarding treatment when used as a sole surgical option in centrally obese patients with anterior abdominal wall asymmetry and significant subcutaneous fat thickness.
Anorexia Nervosa Complicating Pediatric Crohn Disease-Case Report and Literature Review
Authors: Aedin Collins, Elizabeth Nolan, Michelle Hurley, Antoinette D'Alton, Séamus Hussey
Journal: Front Pediatr (2018)
Keywords: bmi, crohn disease, adolescent, anorexia nervosa, weight loss
MeSH terms: Case Reports

Crohn disease and anorexia nervosa share common symptoms of weight loss and reduced oral intake. The prevalence of both disorders has increased over time. Symptoms of Crohn disease and anorexia nervosa can mimic each other leading to a delayed diagnosis and requiring complex, multidisciplinary management. Here we present a case of a 15 year old girl with Crohn disease who subsequently developed anorexia nervosa, and review the published literature on the occurrence of both diagnoses.
Protracted Hiccups Induced by Aripiprazole and Regressed after Administration of Gabapentin
Authors: Manuel Glauco Carbone, Claudia Tagliarini, Filippo Della Rocca, Walter Flamini, Giovanni Pagni, Beniamino Tripodi, Donatella Marazziti, Icro Maremmani
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Hiccups are sudden, repeated, and involuntary contractions of the diaphragm muscle (myoclonic contraction). It involves a reflex arc that, once activated, causes a strong contraction of the diaphragm immediately followed by the closure of the glottis translating into the classic "hic" sound. Hiccups can be short, persistent, and intractable depending on the duration. The most disabling hiccups often represent the epiphenomenon of a medical condition such as gastrointestinal and cardiovascular disorders; central nervous system (CNS) abnormalities; ear, nose, and throat (ENT) conditions or pneumological problems; metabolic/endocrine disorders; infections; and psychogenic disorders. Some drugs, such as aripiprazole, a second-generation antipsychotic, can induce the onset of variable hiccups. We describe herein the cases of three hospitalized patients who developed insistent hiccups after taking aripiprazole and who positively responded to low doses of gabapentin. It is probable that aripiprazole, prescribed at a low dosage (<7.5 mg/day), would act as a dopamine agonist by stimulating D2 and D3 receptors at the "hiccup center" level-located in the brain stem-thus triggering the hiccup. On the other hand, gabapentin led to a complete regression of the hiccup probably by reducing the nerve impulse transmission and modulating the diaphragmatic activity. The present case series suggests the use of low doses of gabapentin as an effective treatment for aripiprazole-induced hiccups. However, our knowledge of the neurotransmitter functioning of the hiccup reflex arc is still limited, and further research is needed to characterize the neurotransmitters involved in hiccups for potential novel therapeutic targets.
"Don't stop believing!" From health religiosity to an equality-enhancing hermeneutic of health promotion
Authors: Britta Pelters, Åsa Roxberg
Journal: Int J Qual Stud Health Well-being (2018)
Keywords: health beliefs, health disparities, health promotion, hermeneutics, religiosity
MeSH terms: Comprehension, Health Behavior, Health Knowledge, Attitudes, Practice, Health Promotion, Hermeneutics, Religion, Spirituality, Case Reports, Culture, Health Status Disparities, Humans

Purpose:
Health beliefs are usually regarded as subjective understandings of one's health. They can, however, be re-interpreted by drawing on the understanding that the structural features of the health discourse resemble the characteristics of a religion and on the spiritual dimension of health with its possibly salutogenic influence. The applicability of the notion of "health religiosity" and its consequences for individual health promotion are explored.
Method:
Data consist of already existent semi-structured interviews. These have been reanalyzed in a deductive-hermeneutical way by using a five-dimensional concept of religiosity as deductive template.
Results:
The concept of religiosity proved to be productive and revealed that all health dimensions in the case are infused with spiritually ennobled ideas.
Conclusion:
We conclude that, irrespective of their factual accuracy, the salutogenic potential of ennobled ideas may best be utilized by understanding them hermeneutically. An exploration of a narrative hermeneutic approach to individual health promotion is suggested as the merging of meaning horizons in a hermeneutic dialogue is expected to increase awareness of spiritualized aspects of health beliefs. This may mitigate healthism and health disparities. Moreover, three challenges for individual health promotion are anticipated: realizing the situation, recognizing its complexity and resisting a simplistic practical approach.
Minimally Invasive Management of Hemorrhagic Pheochromocytoma-A Rare Case Report
Authors: Ajay H Bhandarwar, Amarjeet E Tandur, Keerthika Reddy Rachapalli, Amol Wagh, Abhijit Shah, Nikhil Dhimole
Journal: Surg J (N Y) (2023)
Keywords: case report, hemorrhagic pheochromocytoma, minimally invasive surgery, rare complication
MeSH terms: Case Reports

Pheochromocytoma is a rare catecholamine-secreting tumor derived from chromaffin cells. The diagnosis is usually suggested by its classic history, presence of a strong family history, or discovery of an incidental mass on imaging in an asymptomatic patient. Hemorrhage into an occult pheochromocytoma is a rare complication with ∼1 to 2 per 100,000 individuals diagnosed annually. We report a case of a 29-year-old woman, who presented with abdominal pain (with no other significant history) due to a right hemorrhagic pheochromocytoma. Computed tomographic imaging and magnetic resonance imaging revealed the source of retroperitoneal hemorrhage as the right adrenal mass. They lacked the typical features of a pheochromocytoma which was eventually proven by the biochemical tests. The patient underwent preoperative stabilization with α and β adrenergic receptor blockers for 7 days following which laparoscopic adrenalectomy was performed successfully with an uneventful postoperative period. This is the eighth reported case in literature managed laparoscopically. Histopathology confirmed it as pheochromocytoma. The treacherous and deceptive nature of pheochromocytomas and its hemorrhage make it crucial to detect and treat it promptly; otherwise, it will almost certainly be fatal from cardiovascular complications or metastasis.
Adult diagnosis of Swyer-James-MacLeod syndrome: a case report
Authors: Carlos Capela, Paulo Gouveia, Marco Sousa, Maria J Regadas
Journal: J Med Case Rep (2011)

Introduction:
Swyer-James-MacLeod syndrome or unilateral hyperlucent lung syndrome is a rare entity associated with postinfectious bronchiolitis obliterans occurring in childhood. It is characterized by hypoplasia and/or agenesis of the pulmonary arteries resulting in pulmonary parenchyma hypoperfusion.
Case presentation:
Here we report the case of a 53-year-old Caucasian woman with Swyer-James-MacLeod syndrome found in the differential diagnosis workup for a new onset of heart failure, secondary to pulmonary arterial hypertension complicated by a patent ductus arteriosus.
Conclusion:
Typically, this disorder is diagnosed in childhood after evaluation for recurrent respiratory infections, but sometimes an indolent course means diagnosis is not made until adulthood.
Case Report: Exacerbation of Relapses Following mRNA COVID-19 Vaccination in Multiple Sclerosis: A Case Series
Authors: Carlos Quintanilla-Bordás, Francisco Gascón-Gimenez, Carmen Alcalá, María Payá, Javier Mallada, Raquel Silla, Sara Carratalà-Boscà, Raquel Gasque-Rubio, Jessica Castillo, Bonaventura Casanova
Journal: Front Neurol (2022)
Keywords: exacerbation (symptom flare up), mrna covid-19 vaccine, multiple sclerosis, relapses, vaccination
MeSH terms: Case Reports

Introduction:
mRNA coronavirus disease 2019 (COVID-19) vaccination has been widely used to arrest the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Rarely, autoimmune events such as relapses in patients with multiple sclerosis (MS) have been reported after vaccination. However, the possible effects of vaccination in a patient already experiencing the symptoms of a relapse represent an unusual scenario that has not been described.
Patients and methods:
This is a retrospective case series of four patients from three major tertiary referral centers that received mRNA COVID-19 vaccination after starting with symptoms of acute demyelination of the central nervous system due to non-recognized MS. A detailed description of each case, including MRI studies, serum light-neurofilament levels, and cerebrospinal fluid (CSF) cytokine profile, is provided.
Case description:
All patients presented exacerbation of ongoing symptoms after vaccination (range 14-112 days first dose). All patients presented MRI features suggestive of highly active MS and fulfilled McDonald 2017 criteria at the time of presentation. All patients presented high serum light-neurofilament levels and oligoclonal G bands restricted to the CSF. Higher levels of interleukin-6 in the CSF were present in the more severe cases.
Discussion:
We describe exacerbation of relapses after mRNA COVID-19 vaccination. We hypothesize RNA sensors such as Toll-like receptor 7 may be activated and contribute to amplify the inflammatory response during a relapse.
Conclusion:
Patients should seek medical attention if experiencing acute neurological symptoms, especially before vaccination. Fast diagnostic procedures and prompt treatment should be performed in these patients. Pharmacovigilance and further study are warranted to confirm causality.
Low-Grade Endometrial Stromal Sarcoma with a Nodule-in-Nodule Appearance in Preoperative Magnetic Resonance Images
Authors: Mitsuhiro Nakamura, Ryusuke Murakami, Kaoru Abiko, Taito Miyamoto, Yoshimi Kitawaki, Ken Yamaguchi, Akihito Horie, Junzo Hamanishi, Eiji Kodoh, Tsukasa Baba, Aki Kido, Sachiko Minamiguchi, Noriomi Matsumura, Masaki Mandai
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Low-grade endometrial stromal sarcoma (LG-ESS) is a rare malignant disease and demonstrates various patterns in preoperative imaging. Therefore, accurate diagnosis is important. Given its unique form, we report a case of LG-ESS with a nodule-in-nodule appearance on preoperative imaging. A 41-year-old woman was referred to our department for further examination of a 45 mm diameter uterine corpus mass. Preoperative magnetic resonance imaging (MRI) revealed several small nodules within a larger nodule. T2-weighted images showed moderate-to-high signal intensity with focal bands of low signal intensity in the small nodules. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological findings of the small nodules showed densely concentrated endometrial stromal cells reminiscent of a proliferative phase endometrium with a concentric arrangement of small spiral arteriole-like vessels. The small nodules exhibited an expansile growth pattern and were surrounded by less densely concentrated endometrial stromal cells intermingled with the normal uterine myometrium. LG-ESS with smooth muscle differentiation and sex cord-like elements was partially observed. In summary, LG-ESS demonstrating a unique nodule-in-nodule appearance on preoperative imaging histopathologically comprised tumor cells of varying densities. Our current case suggests that preoperative diagnostic imaging with MRI may be useful.
Is Ceftriaxone-Induced Biliary Pseudolithiasis Influenced by UDP-Glucuronosyltransferase 1A1 Gene Polymorphisms?
Authors: Andrew Fretzayas, Olga Liapi, Anna Papadopoulou, Polyxeni Nicolaidou, Alexandra Stamoulakatou
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Ceftriaxone (cfx), a third-generation cephalosporin antibiotic, leads to transient cholelithiasis in some children, also known as pseudolithiasis. However, the underlying pathogenetic mechanism of this adverse effect has not yet been elucidated. We describe 3 children with ceftriaxone-induced pseudolithiasis, who were also carriers of the A(TA)(7)TAA polymorphism of the UGT1A1 gene, implying that a cause and effect relation may exist.
General theory for integrated analysis of growth, gene, and protein expression in biofilms
Authors: Tianyu Zhang, Breana Pabst, Isaac Klapper, Philip S Stewart
Journal: PLoS One (2013)
MeSH terms: Bacterial Proteins / genetics, Bacterial Proteins / metabolism, Biofilms / growth & development, Gene Expression Regulation, Bacterial / drug effects, Models, Biological, Pseudomonas aeruginosa / genetics, Pseudomonas aeruginosa / physiology, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S., Biofilms / drug effects, Oxygen / pharmacology, Pseudomonas aeruginosa / cytology, Pseudomonas aeruginosa / drug effects, Quorum Sensing / drug effects, Quorum Sensing / genetics, Stress, Physiological / drug effects, Bacterial Proteins, Oxygen

A theory for analysis and prediction of spatial and temporal patterns of gene and protein expression within microbial biofilms is derived. The theory integrates phenomena of solute reaction and diffusion, microbial growth, mRNA or protein synthesis, biomass advection, and gene transcript or protein turnover. Case studies illustrate the capacity of the theory to simulate heterogeneous spatial patterns and predict microbial activities in biofilms that are qualitatively different from those of planktonic cells. Specific scenarios analyzed include an inducible GFP or fluorescent protein reporter, a denitrification gene repressed by oxygen, an acid stress response gene, and a quorum sensing circuit. It is shown that the patterns of activity revealed by inducible stable fluorescent proteins or reporter unstable proteins overestimate the region of activity. This is due to advective spreading and finite protein turnover rates. In the cases of a gene induced by either limitation for a metabolic substrate or accumulation of a metabolic product, maximal expression is predicted in an internal stratum of the biofilm. A quorum sensing system that includes an oxygen-responsive negative regulator exhibits behavior that is distinct from any stage of a batch planktonic culture. Though here the analyses have been limited to simultaneous interactions of up to two substrates and two genes, the framework applies to arbitrarily large networks of genes and metabolites. Extension of reaction-diffusion modeling in biofilms to the analysis of individual genes and gene networks is an important advance that dovetails with the growing toolkit of molecular and genetic experimental techniques.