OpenMed/multicare-articles huggingface dataset:
Pembrolizumab plus lenvatinib in advanced endometrial cancer: case report and systematic review of lung toxicity
Authors: Nicoletta Staropoli, Angela Salvino, Federica Falcone, Valentina Farenza, Martina Costa, Giacomo Rossini, Francesco Manti, Antonella Crispino, Caterina Riillo, Domenico Ciliberto, Mariamena Arbitrio, Pierfrancesco Tassone, Pierosandro Tagliaferri
Journal: Front Oncol (2023)
Keywords: advanced endometrial cancer, immunotherapy, lenvatinib, lung toxicity, pembrolizumab, targeted therapy
MeSH terms: Case Reports

Background:
The optimal strategy for the treatment of recurrent and/or advanced endometrial cancer is still undefined. Recently, despite the lack of any predictive biomarker, the combination of pembrolizumab with lenvatinib has improved survival outcomes. We here report the long-term management of lung toxicity in a patient with endometrial cancer, and we critically review the current therapeutic options for this disease.
Results:
A patient with heavily pretreated endometrial cancer took pembrolizumab plus lenvatinib for 1 year, achieving a persistent partial response with a time to treatment failure of 18 months, despite relevant lung toxicity that did not affect the remarkable overall clinical benefit. A systematic review of this combination underlines the efficacy outcome despite toxicity. Interestingly, the literature review on lung toxicity suggested the role of anti-angiogenetic agents in the pathogenesis of lung cavitation, probably related to direct treatment activity, and disclosed a potential radiological sign predictive of the activity of anti-angiogenetic agents.
Conclusion:
We underline the efficacy of pembrolizumab plus lenvatinib in the current treatment landscape of endometrial cancer, underscoring the relevance of a correct management of toxicity.
Pyogenic Liver Abscess with No Predisposing Risk Factors
Authors: Matthew Chadwick, Leonid Shamban, Michael Neumann
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Pyogenic liver abscesses (PLA) are an uncommon cause of hospitalization in the United States. The majority of such cases are polymicrobial and are most commonly caused by seeding of infection from the biliary system. PLA is frequently associated with specific comorbidities such as diabetes mellitus, history of liver transplant, underlying hepatobiliary, or pancreatic disease. Herein, we describe a 47-year-old healthy male with no known risk factors associated with PLA who presented to the hospital with acute fever, abdominal pain, and dark colored urine. Initially the patient had a negative right upper quadrant ultrasound. However, the patient continued to have persistent fevers and abnormal liver biochemistries with negative liver serology that led to checking a magnetic resonance cholangiopancreatography which suggested multiple liver abscesses. Computer tomography guided aspiration revealed a monobacterial Streptococcus species within the abscess, which is commonly associated with arterial bacteremia as a source of PLA. Arterial bacteremia is one of most rare causes of PLA. The patient's septic workup was negative for any source of infection. This case demonstrates a patient with no risk factors who was diagnosed with PLA caused by apparent arterial bacteremia with no clear source of infection.
Successful recovery without any neurological complication after intraoperative cardiopulmonary resuscitation for an extended period of time in the lateral position: a case report
Authors: Kazuma Yunoki, Ryo Sasaki, Akihisa Taguchi, Shun Maekawa, Hiroshi Ueta, Kazuo Yamazaki
Journal: JA Clin Rep (2016)
Keywords: cardiopulmonary resuscitation, chest compression, end-tidal co2, lateral position

No successful resuscitation has ever been reported about intraoperative cardiopulmonary resuscitation (CPR) for an extended period of time in the lateral position. Here we report a case of successful resuscitation without any neurological complication after cardiac arrest due to massive hemorrhage and 25 min of CPR in the lateral position. The patient was a 65-year-old man. During open hemostasis for the postoperative hemorrhage, the patient's rhythm changed sinus to ventricular fibrillation (VF), followed by asystole. We started CPR immediately with the patient in the left lateral position. Chest compression was performed by two practitioners, one pressing patient's sternum and the other pressing simultaneously patient's mid-thoracic spine from his back. During CPR, though the value of end-tidal CO2 (EtCO2) was significantly low (around 5-20 mmHg), the value of systolic arterial pressure was kept about 35-50 mmHg, and diastolic pressure about 20-30 mmHg. After the 25 min of lateral CPR, he achieved the return of spontaneous circulation (ROSC). He was hemodynamically stable after ROSC. He regained his consciousness at the next postoperative day. He was discharged from our hospital on the 60th day of operation without any cardiac and neurological complication. Successful neurological outcome suggests that we may expect satisfactory neurological outcome even in the case of lateral position and prolonged CPR if we perform effective CPR with the feedback of arterial blood pressure and EtCO2 and with the immediate intervention to culprit injuries.
Investigation of Channel Selection for Gesture Classification for Prosthesis Control Using Force Myography: A Case Study
Authors: Chakaveh Ahmadizadeh, Brittany Pousett, Carlo Menon
Journal: Front Bioeng Biotechnol (2019)
Keywords: channel selection, force myography, gesture classification, high density fmg, prosthesis control, robotic hand, upper limb prosthesis

Background: Various human machine interfaces (HMIs) are used to control prostheses, such as robotic hands. One of the promising HMIs is Force Myography (FMG). Previous research has shown the potential for the use of high density FMG (HD-FMG) that can lead to higher accuracy of prosthesis control. Motivation: The more sensors used in an FMG controlled system, the more complicated and costlier the system becomes. This study proposes a design method that can produce powered prostheses with performance comparable to that of HD-FMG controlled systems using a fewer number of sensors. An HD-FMG apparatus would be used to collect information from the user only in the design phase. Channel selection would then be applied to the collected data to determine the number and location of sensors that are vital to performance of the device. This study assessed the use of multiple channel selection (CS) methods for this purpose. Methods: In this case study, three datasets were used. These datasets were collected from force sensitive resistors embedded in the inner socket of a subject with transradial amputation. Sensor data were collected as the subject carried out five repetitions of six gestures. Collected data were then used to asses five CS methods: Sequential forward selection (SFS) with two different stopping criteria, minimum redundancy-maximum relevance (mRMR), genetic algorithm (GA), and Boruta. Results: Three out of the five methods (mRMR, GA, and Boruta) were able to decrease channel numbers significantly while maintaining classification accuracy in all datasets. Neither of them outperformed the other two in all datasets. However, GA resulted in the smallest channel subset in all three of the datasets. The three selected methods were also compared in terms of stability [i.e., consistency of the channel subset chosen by the method as new training data were introduced or some training data were removed (Chandrashekar and Sahin, 2014)]. Boruta and mRMR resulted in less instability compared to GA when applied to the datasets of this study. Conclusion: This study shows feasibility of using the proposed design method that can produce prosthetic systems that are simpler than HD-FMG systems but have performance comparable to theirs.
The Role of Lingual Bone Grafting in the Treatment of Displaced Edentulous Mandibular Fracture with Severe Atrophy
Authors: Amin Rahpeyma, Saeedeh Khajehahmadi
Journal: Iran J Otorhinolaryngol (2018)
Keywords: bone graft, edentulous mandible, fracture
MeSH terms: Case Reports

Introduction:
Treatment of edentulous atrophic mandible with severe atrophy is a challenge based on local conditions and systemic diseases confronted by the age group affected. If bone grafting is indicated, it is often used in lateral or inferior aspects of the mandible.
Case report:
A 70-year-old male with a unilateral fracture of the atrophied left mandibular body was managed by lingual bone grafting and inferior border miniplate fixation to prevent two common problems after fracture healing; the need for plate removal before denture fabrication and facial asymmetry in the unilateral body fracture.
Conclusion:
If bone grafting is indicated in the management of displaced edentulous mandibular fracture with severe atrophy, a combination of plating at the inferior border of the mandible and lingual corticocancellous bone grafting should be considered in treatment planning.
Human Encephalitis Complicated With Ocular Symptoms Associated With Pseudorabies Virus Infection: A Case Report
Authors: Liu Yue, Li Yi, Tong Fei, Tian MengWu, Li Man, Wang LiQing, Zou YueLi, Duan JiaLiang, Bu Hui, He JunYing
Journal: Front Neurol (2022)
Keywords: antiviral therapy, case report, next-generation sequencing, severe visual impairment, viral encephalitis
MeSH terms: Case Reports

Pseudorabies virus (PRV) is an alpha herpesvirus found in many wild and domestic animals, and causes neurological diseases in humans. Several cases of PRV-induced human encephalitis accompanied with severe visual impairment have been reported. There is currently no effective treatment for severe visual impairment caused by PRV. We report a case of PRV encephalitis with severe visual impairment. The diagnosis and treatment experience of this patient is summarized to improve the awareness of clinicians. We present a 42-year-old man with PRV infection who was admitted due to intermittent fever for 5 days and unconsciousness for 1 day. He subsequently developed severe visual impairment during hospital stay. Empirical antiviral treatment with ganciclovir and sodium foscarnet was started on the day of admission and continued for > 50 days, which had significant treatment effect. Eye complications caused by PRV infection have been frequently reported in patients with PRV encephalitis. In this patient, based on the patient's condition, antiviral therapy was initiated on admission day, and according to the results of the next-generation sequencing of the cerebrospinal fluid, the duration of antiviral therapy was prolonged, which improved treatment efficacy and alleviated neurological symptoms and eye vision damage. To the best of our knowledge, this is the first report that describes partial restoration of acute vision loss associated with PRV infection after aggressive treatment. Our experience suggests that although prompt treatment cannot prevent the acute vision loss associated with PRV infection, timely anti-viral and anti-inflammatory treatment can alleviate ocular complications.
Transient remission of hyperparathyroidism after fine-needle aspiration biopsy
Authors: Ana Rita Elvas, Andreia Martins Fernandes, Sara Reis, Joana Couto, Raquel G Martins, Jacinta Santos, Teresa Martins, Bernardo Marques, Joana Guimarães, Fernando J C Rodrigues
Journal: Endocr Oncol (2022)
MeSH terms: Case Reports

Primary hyperparathyroidism (PHPT) is the unregulated overproduction of parathyroid hormone (PTH), resulting in abnormal calcium homeostasis. PHPT is most commonly caused by a single adenoma of the parathyroid gland, which can have an intrathyroid location in rare cases. The measurement of intact PTH in the washout fluid obtained by ultrasound (US)-guided fineneedle aspiration (FNA) can be useful in clarifying the aetiology of these lesions. This study presented a 48-year-old man with a background history of symptomatic renal stone disease who was diagnosed with PHPT and referred to our Endocrinology department. A neck US revealed a thyroid nodule with a size of 21 mm in the right lobe. The patient underwent US-guided FNA of the lesion. The measurement of PTH in the washout fluid was significantly elevated. Following the procedure, he reported neck pain and noticed distal paraesthesias in the upper limbs. Blood test results showed significant hypocalcaemia and supplementation with calcium and calcitriol was started. The patient was closely monitored. Recurrence of hypercalcaemia was later observed, and the patient was submitted to surgery. We present a case of FNAinduced transitory remission of PHPT in a patient with an intrathyroid parathyroid adenoma. We conjecture that intra-nodular haemorrhage might have occurred, which temporarily affected the viability of the autonomous parathyroid tissue. A few similar cases of spontaneous or induced remission of PHPT after FNA have been previously described in the literature. This remission can be transitory or permanent, depending on the degree of cellular damage thus follow-up of these patients is recommended.
Rare Site of Ectopic Pregnancy in a Patient with Bicornuate Uterus
Authors: Ayman Shehata, Mohamed El Namoury, Mostafa Heider
Journal: Case Rep Obstet Gynecol (2016)

Ectopic pregnancy occurs in about 1-2% in normal cycles but in IVF cycles the rate jumps to 4%. No definite cause for ectopic pregnancy was detected, but many risk factors were described as abnormal tube, pelvic infection, or surgery. In this case report we found 2 abnormalities in eight-year infertile woman; the first abnormality was bicornuate uterus and the second abnormality was the site of ectopic pregnancy which was in between the two horns of uterus. ‎This is the only case reported with primary abdominal pregnancy with bicornuate uterus and both healthy ovaries and tubes.‎ The case was unstable and managed by laparotomy and repair of ectopic site after enucleation of sac using Vicryl 2/0. The case was discharged 24 hours after operation in good health.
Where is the pain? A qualitative analysis of Ghana's opioid (tramadol) 'crisis' and youth perspectives
Authors: Jacob Albin Korem Alhassan
Journal: PLOS Glob Public Health (2022)

Over the last five years, media reports in West African countries have suggested a tramadol abuse 'crisis' characterised by a precipitous rise in use by youth in the region. This discourse is connected to evidence of an emerging global opioid crisis. While the reported increase in tramadol abuse in West Africa is likely true, few studies have critically interrogated structural explanations for tramadol use by youth. Nascent academic literature has sought to explain the rise in drug use as a function of moral weakness among youth. This Ghanaian case study draws on primary and secondary data sources to explore the pain that precedes tramadol abuse. Through a discourse analysis of 295 media articles and 15 interviews (11 with youth who currently use tramadol and 4 with health system stakeholders), this study draws on structural violence and moral panic theories to contribute to the emerging literature on tramadol (ab)use in West Africa. The evidence parsed from multiple sources reveals that government responses to tramadol abuse among Ghanaian youth have focused on arrests and victim blaming often informed by a moralising discourse. Interviews with those who use tramadol on their lived experiences reveal however that although some youth use the opioid for pleasure, many use tramadol for reasons related to work and feelings of dislocation. A more complex way to understand tramadol use among young people in Ghana is to explore the pain that leads to consumption. Two kinds of pain; physical (related to strenuous work) and non-physical (related to anxiety and the condition of youth itself) explain tramadol use requiring a harm reduction and social determinants of health approach rather than the moralising 'war on drugs' approach that has been favoured by policy makers.
A Patency Capsule Remained Intact in the Colon over 210 Hours
Authors: Yu Hihara, Satoru Joshita, Toshiharu Takahashi, Shinji Okaniwa, Yoshiki Mizukami, Yoshiyuki Nakamura
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

We present an unusual case of a 35-year-old male patient whom a patency capsule stayed in his gut without breaking. He has a history of Peutz-Jeghers syndrome and multiple abdominal surgeries. Prestudy was performed for abdominal searching, but a patency capsule remained in the colon over 9 days. He displayed neither abdominal nor obstructive symptoms in that period. We collected the patency capsule using colonoscopy after dilating a postoperative stricture at an anastomotic site of the rectum. Clinicians should bear in mind that patency capsules may become retained as distally as the colon in patients with a surgical history of the large intestine.
Combined endoscopic transethmoid and transconjunctival en bloc resection of optic nerve tumors in patients lacking functional vision
Authors: Jieliang Shi, Yunhai Tu, Mingna Xu, Wencan Wu
Journal: Front Oncol (2022)
Keywords: novel surgical technique for optic nerve tumors resection optic nerve tumor, en bloc resection, endoscopic endonasal surgery, optic glioma, optic nerve sheath meningioma

Background:
Surgical treatment of optic nerve tumors is challenging. The study's objective was to evaluate the efficacy of a combined endoscopic transethmoid and transconjunctival approach in patients without functional vision.
Design:
A retrospective, noncomparative case series.
Methods:
Retrospective data were collected from all patients who had undergone tumor resection using this approach at the authors' institution between 2015 and 2021. Preoperative assessments included magnetic resonance imaging and ophthalmological examinations, and re-assessments were conducted three months after surgery and regularly during the follow-up period.
Results:
Seventeen patients, mean age 35 ± 19.0 years, were enrolled. Of these, 64.7% presented with visual acuity (VA) of light perception or no light perception. Gross total resection was realized in all patients. The average decline in exophthalmos was 3.63 ± 1.93 mm. Tumor histopathological analysis identified 12 optic nerve sheath meningiomas and 5 optic gliomas. The mean follow-up time was 30 months during which there was no local recurrence in any of the patients.
Conclusions:
The combined endoscopic transethmoid and transconjunctival approach offers an additional choice for accessing optic nerve tumors. The procedure is both safe and effective and provides an alternative transcranial route to the orbit.
Congenital giant fibroepithelial polyp of the scrotum in an infant: the first case report from China
Authors: Chenghao Zhanghuang, Yu Hang, Fengming Ji, Na Long, Zhigang Yao, Li Li, Zhen Yang, Haoyu Tang, Kun Zhang, Chengchuang Wu, Yucheng Xie, Bing Yan
Journal: Front Pediatr (2023)
Keywords: case report, childhood, fibroepithelial, male, pathology, scrotum
MeSH terms: Case Reports

Giant fibroepithelial polyp (FP) of the scrotum in infants is a rare disease. We reported the first case of FP in China. The child was only 9 months and 12 days old and was admitted to the hospital due to rapid growth and rupture of the scrotal mass. The patient underwent scrotal exploration under general anesthesia, and the mass was cystic-solid with clear boundaries. The tumor did not invade the sarcolemma of the scrotum and testicular tissue. The intraoperative pathological frozen section tended to be benign, and the scrotum's tumor and subcutaneous pedicle tissue were removed entirely after 0.5 cm from the boundary of the mass. The operation was successful. The mass was confirmed as FP by postoperative pathology. 6 months after the operation, the incision healed well without recurrence. This case report has a detailed diagnosis and treatment process and adequate examination results. It can provide a reference for diagnosing and treating FP in infants and reduce the risk of misdiagnosis and mistreatment.
Systemic lupus erythematosus presenting as thrombotic thrombocytopenia purpura: how close is close enough?
Authors: Cesar A Perez, Nabil Abdo, Anuj Shrestha, Edgardo S Santos
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Thrombotic thrombocytopenic purpura (TTP) is an uncommon life-threatening disease characterized by microangiopathic hemolytic anemia and thrombocytopenia, commonly associated with infections, malignancy, drugs, and autoimmune diseases. We report a case of 19-year-old previously healthy female that presents with anemia and thrombocytopenia diagnosed with thrombotic thrombocytopenic purpura that was treated successfully with plasmapheresis and corticosteroids. Laboratory findings also revealed antinuclear antibodies and antibodies to double-stranded DNA. Two weeks after presentation developed inflammatory arthritis, fulfilling diagnostic criteria for systemic lupus erythematosus (SLE). Prompt diagnosis and treatment with plasma exchange and corticosteroids should be instituted as soon as the diagnosis of TTP is suspected, even if other diagnoses, including lupus, are possible. When present, the coexistence of these two etiologies can have a higher mortality than either disease alone. An underlying diagnosis of SLE should be considered in all patients presenting TTP and the study of this association may provide a better understanding of their immune-mediated pathophysiology.
A Rare Case of Multifocal Asynchronous Benign Granular Cell Tumors with PIK3CA Subclonal Mutation Identified in One Tumor by Next-Generation Sequencing
Authors: Tiago Palmisano, Tina Bocker Edmonston, Thomas Holdbrook, Shuyue Ren
Journal: Case Rep Pathol (2023)
MeSH terms: Case Reports

Granular cell tumor (GCT) is a benign neuroectodermal tumor typically in the dermis or subcutis, although deep soft tissues and organs are occasionally involved. Multifocal GCTs are estimated to occur as many as 10% of patients. A 40-year-old female presented with multiple GCTs asynchronously involving various body sites including gastrointestinal, gynecologic, breast, urinary, and soft tissue systems. Pathologic examinations suggested benign GCTs. TruSight Tumor 170 next-generation sequencing (NGS) analysis performed on four resected tumors revealed subclonal mutation of PIK3CA p.H1047R identified in the esophageal GCT but not in the right vulva or the two cecal GCTs, suggesting that each is a primary tumor with a distinct genetic profile, rather than metastasis. PIK3CA p.H1047R is a common mutation in many cancers. Our benign GCT case demonstrates PIK3CA mutation with a low mutant allele frequency of 7%, which may represent an evolving subclone and might confer a more aggressive behavior.
Unpredictable nature of tolvaptan in treatment of hypervolemic hyponatremia: case review on role of vaptans
Authors: Ishan Malhotra, Shilpa Gopinath, Kalyana C Janga, Sheldon Greenberg, Shree K Sharma, Regina Tarkovsky
Journal: Case Rep Endocrinol (2014)

Hyponatremia is one of the most commonly encountered electrolyte abnormalities occurring in up to 22% of hospitalized patients. Hyponatremia usually reflects excess water retention relative to sodium rather than sodium deficiency. Volume status and serum osmolality are essential to determine etiology. Treatment depends on several factors, including the cause, overall volume status of the patient, severity of hyponatremic symptoms, and duration of hyponatremia at presentation. Vasopressin antagonists like tolvaptan seem promising for the treatment of euvolemic and hypervolemic hyponatremia in heart failure. Low sodium concentrations cause cerebral edema, but the overly rapid sodium correction can also lead to iatrogenic cerebral osmotic demyelination syndrome. Demyelination may occur days after sodium correction or initial neurologic recovery from hyponatremia. The following case report analyzes the role of vasopressin antagonists in the treatment of hyponatremia and the need for daily dosing of tolvaptan and the monitoring of serum sodium levels to avoid rapid overcorrection which can result in osmotic demyelination syndrome (ODS).