OpenMed/multicare-articles huggingface dataset:
Radiation and Checkpoint Inhibitor Immunotherapy Lead to Long Term Disease Control in a Metastatic RCC patient With Brain Metastases
Authors: Maria Levitin, Joel Ofori, Woo Jae Shin, Jiayi Huang, Mackenzie Daly, Dengfeng Cao, Russell Pachynski
Journal: Front Oncol (2020)
Keywords: sbrt (stereotactic body radiation therapy), abscopal, brain metastases (bms), immunotherapy, renal cell carcinoma (rcc)
MeSH terms: Case Reports

Renal cell carcinoma (RCC) comprises 4.2% of all new cancer cases in the United States and 30% of cases are metastatic (mRCC) at diagnosis. Brain metastatic RCC historically has poor prognosis, but the development of immune checkpoint inhibitors has revolutionized their care and may be successfully combined with SBRT to improve prognosis. Here, we present a case of a patient with mRCC who had brain metastases treated with concurrent immune checkpoint inhibitors and SBRT. He continues to survive with good functional status years following his initial diagnosis. We discuss the relevant history regarding treatment approach in patients with brain metastatic RCC, ongoing trials focusing on the combination of immunotherapy and radiation, and the potential and promise of the abscopal effect.
Cytomegalovirus Associated Duodenal Ulcer and Duodenitis in a Malnourished Pediatric Patient
Authors: Rachel Bernard, Ghanim Aljomah, Emily Klepper, Elizabeth McDonough
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Cytomegalovirus (CMV) duodenitis is a rare occurrence, especially in pediatric patients. A thirteen-month-old female presented to the Emergency Department for a febrile seizure. She was incidentally admitted for severe malnutrition with an initial workup remarkable for only a slight elevation in her ALT at 48. The patient was found to have an oral aversion requiring nasogastric tube feeds for adequate caloric intake. She continued to fail to gain weight and underwent an EGD that demonstrated a duodenal ulcer. She was consequently started on sucralfate and omeprazole. Post-EGD lab work demonstrated a pronounced increase in AST and ALT. Pathology from the EGD biopsies later demonstrated viral inclusion bodies consistent with CMV duodenitis. Apart from malnutrition, other causes of immune deficiency were eliminated from the differential diagnosis due to negative HIV PCR and normal immunoglobulins. While on antiviral treatment, her viral load of 1080 IU/mL trended to resolution and her liver enzymes normalized. The patient was ultimately discharged home demonstrating adequate weight gain via gastrostomy tube feeds. This case advocates for pediatricians to include immunodeficiency and infectious etiologies in their differential for malnourished patients in order to lead to earlier diagnosis and management of this treatable condition.
Bilateral petrous apex cephaloceles: Is surgical intervention indicated?
Authors: Ali Alkhaibary, Fahd Musawnaq, Makki Almuntashri, Abdulaziz Alarifi
Journal: Int J Surg Case Rep (2020)
Keywords: bilateral, case report, cephalocele, headache, petrous, sella
MeSH terms: Case Reports

Introdcution:
Petrous apex cephaloceles are characterized by herniation of Meckel's cave into the petrous apex. An extensive review of the literature reveals 20 cases of bilateral petrous apex cephaloceles. This article reports an additional case of bilateral petrous apex cephaloceles and reviews the pertinent literature.
Presentation of case:
A 64-year-old female was referred from a primary care clinic due to longstanding headache. A non-enhanced CT scan of the brain revealed osteolytic bony lesions at the petrous apices and an empty sella. A brain MRI with contrast showed CSF-containing lesions in the petrous apices, communicating with Meckel's cave bilaterally. The patient was managed conservatively and is currently followed up in the neurosurgery clinic.
Discussion:
While the exact etiology remains uncertain, petrous apex cephaloceles are postulated to originate from sustained, chronic elevation of intracranial pressure. On MRI, petrous apex cephaloceles display signal intensities resembling CSF throughout all sequences. They demonstrate well-defined margins continuous with Meckel's cave. CT scans allow further characterization, i.e. invasive erosions, of the osseous structures in patients with petrous apex cephaloceles.
Conclusion:
A thorough understanding of the petrous apex anatomy and its pathological lesions is paramount. A brain MRI remains the diagnostic imaging of choice to characterize petrous apex cephaloceles.
Multiple paraneoplastic syndromes revealing non-small cell lung carcinoma
Authors: Monia Youssef, Melek Kechida, Saoussen Cheikhmohamed, Adnene Moussa, Jameleddine
Journal: Pan Afr Med J (2014)
Keywords: carcinoma, ige, paraneoplastic dermatoses
MeSH terms: Lung Neoplasms / diagnosis, Paraneoplastic Syndromes / diagnosis, Small Cell Lung Carcinoma / diagnosis, Case Reports, Humans, Lung Neoplasms / pathology, Male, Middle Aged, Paraneoplastic Syndromes / pathology, Pneumonectomy, Prognosis, Small Cell Lung Carcinoma / pathology, Tomography, X-Ray Computed

A broad spectrum of paraneoplastic dermatoses is associated with lung cancer. We report herein a 56-year-old man who presented an association of erythroderma, acquired ichthyosis, palmo-plantar keratoderma, hypereosinophilia and hyper IgE. In light of these clinical and biological assessments an underlying malignancy had been suspected. A thoracic, abdominal and pelvic computed tomography showed a left hilar mass. The patient underwent a left pneumonectomy and the histological study had confirmed a non-small cell lung cancer. Recognition of cutaneous paraneoplastic syndromes is important since it leads to prompt diagnosis of an underlying malignancy and consequently a better management and prognosis of the disease.
Integration of Fetal Middle Cerebral Arterial (MCA) Ultrasonography in Acute Fetal-Maternal Hemorrhage
Authors: Jessian L Munoz, Maria Schleicher, Natalie Bowersox
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Here we present a case of maternal-fetal hemorrhage characterized by intermittently reassuring fetal testing. Additional testing performed with ultrasound, including middle cerebral artery (MCA) doppler waveforms, confirmed fetal hemorrhage followed by emergent cesarean section. This report highlights the acute usage of MCA dopplers in obstetric decision making. The Newborn required transfusion but otherwise recovered well. MCA may be a useful tool for fetal assessment in Labor and Delivery units.
Case report: Bilateral damage to the immature optic radiation and secondary massive loss of retinal ganglion cells causing tunnel vision
Authors: Maria Nilsson, Finn Lennartsson, Hanna Maria Öhnell, Lotta Gränse, Lena Jacobson
Journal: Front Neurosci (2023)
Keywords: cerebral visual impairment, optical coherence tomography, retrograde trans-synaptic degeneration, tunnel vision, white matter damage of immaturity
MeSH terms: Case Reports

We describe the case of a 30-year-old woman, who needed a formal report on her visual impairment to seek support from society. She was born preterm, and during her neonatal period, she suffered from bilateral intraventricular hemorrhage (IVH) grade 3, a condition that can cause cerebral visual impairment (CVI) due to damage to the retro-geniculate visual pathways. Individuals with such brain damage of this severity are often restricted by cerebral palsy (CP) and intellectual disability, and thus have a limited ability to cooperate in the assessment of visual function. However, our patient was capable of providing reliable test results, and she manifested only a small island of central vision in each eye, with additional reduced visual acuities. She cooperated well in examinations involving MRI of the brain, optical coherence tomography (OCT) of retinal ganglion cells, and multi-focal visual evoked potentials, with each test providing information about potential limitations in the structural prerequisites for visual function. What distinguishes our case is the severity of the damage to the optic radiations and the massive secondary loss of most of her retinal ganglion cells (GCs). However, there is some measurable visual function, which may be due to developmental neuroplasticity during early development, when surviving GCs prioritize the central visual field. Despite her visual difficulties, she is a keen portrait painter. Our patient may be representative of, and a spokesperson for, other individuals with extensive brain damage of the same etiology, who are unable to perform perimetric tests and therefore run the risk of not being recognized as severely visually impaired, and consequently, not being given the best conditions for habilitation. OCT may serve as a helpful diagnostic tool. Aim: This study aims to describe visual behavior and practical applications of visual function in relation to structural prerequisites for visual function.
The role of 3-dimensional power Doppler imaging in the assessment of ovarian teratoma in pregnancy: a case report
Authors: Konstantinos Kalmantis, Christos Iavazzo, Vasiliki Anastasiadou, Aris Antsaklis
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Background. Conventional sonography is the primary imaging tool for these pregnant women who present with an ovarian teratoma. In some cases, however, sonography diagnosis is difficult. We report a case of ovarian teratoma during pregnancy diagnosed by three-dimensional Power Doppler. The cyst was removed via laparotomy without fetal or maternal complications. Three-dimensional ultrasound with multiplanar view can better discriminate a benign ovarian teratoma from complex ovarian lesions or malignant tumors. Its role is significant especially during pregnancy as it may assist in determining which patients are requiring surgery and which are not. The results of three-dimensional sonography and magnetic resonance (MR) were equal but the role of MR imaging is limited in early pregnancy. Conclusions. Three-dimensional technique is a reliable diagnostic modality for preoperative assessment of an ovarian teratoma as it can be performed during the first trimester of pregnancy.
Very delayed liver metastasis from small bowel gastrointestinal stromal tumor (32 years after resection of the small bowel GIST): Report of a case
Authors: Masahiro Ishizaki, Futoshi Uno, Ryosuke Yoshida, Shunsaku Miyauchi, Osamu Honda
Journal: Int J Surg Case Rep (2020)
Keywords: follow up, gist, late liver metastasis
MeSH terms: Case Reports

Introduction:
Recurrent forms of gastrointestinal stromal tumor (GIST) include liver metastases and peritoneal dissemination. Recurrence often occurs within 2 years. We report a case of liver metastasis, which was detected 30 years after resection of a primary lesion in the small intestine and was resected 32 years later.
Presentation of case:
The patient was a 72-year-old woman and was being followed up for ureteral stones at the department of urology of our hospital. Computed tomography (CT) showed a small mass in segment 7 of the liver, 2 years ago. As the tumor gradually increased, a biopsy was performed, and a mesenchymal tumor was diagnosed. The tumor continued to increase in size and partial hepatectomy was performed. GIST was suspected from the sample extracted during hepatectomy. The patient had undergone a resection of the small intestine for a tumor 32 years ago. On tracing her medical records, it was confirmed that resection of the small intestine was performed for the diagnosis of leiomyosarcoma.
Discussion:
Based on the block specimen from 32 years ago, the tumor of the intestine was confirmed to be GIST, and the liver mass was finally diagnosed as liver metastasis of the GIST that had occurred 32 years ago.
Conclusion:
We experienced a case of liver metastasis 32 years after surgery for the first small intestinal GIST. To the best of our knowledge, this case had the longest disease-free interval before metastasis to the liver.
Hyperthermic intraperitoneal chemotherapy in management of malignant intraductal papillary mucinous neoplasm with peritoneal dissemination: Case report
Authors: Chayanit Sirisai, Yutaka Yonemura, Haruaki Ishibashi, Satoshi Wakama, Akiyoshi Mizumoto
Journal: Int J Surg Case Rep (2019)
Keywords: cytoreductive surgery, hipec, intraductal papillary mucinous neoplasm, pancreatic cystic tumor, peritoneal dissemination, pseudomyxoma peritonei

Introduction:
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are treatment to deal with peritoneal dissemination that has excellent result for various cancer especially pseudomyxoma peritonei (PMP), mesothelioma. For now, this combination of treatment is still running for pancreatic adenocarcinoma but no description for pancreatic cystic tumor like malignant Intraductal papillary mucinous neoplasm (IPMN).
Presentation of cases:
We report 3 cases of malignant IPMN with peritoneal dissemination that treated with CRS and HIPEC. Two cases have atypical presentation of malignant IPMN with PMP. HIPEC was performed using cisplatin-based regimen. The longest survival in this study is 93 months, compared to the median survival of 44.3 months without HIPEC.
Discussion:
CRS and HIPEC have not proven to treat in patient with pancreatic cystic tumor with peritoneal dissemination. But these treatments can be improved survival outcome in selected patient.
Conclusion:
CRS and HIPEC trend to improve survival. More studies need, not only to evaluate the role of HIPEC on malignant IPMN, but also prognosis and outcome.
Breastfeeding selfies as relational practice: becoming a maternal subject in the digital age: a single case study
Authors: Sharon Tugwell
Journal: Int Breastfeed J (2019)
Keywords: breastfeeding, breastfeeding selfies, maternal subjectivity, online support groups, recognition
MeSH terms: Breast Feeding, Mothers, Parenting / trends, Social Media, Case Reports, Research Support, Non-U.S. Gov't, Adult, Female, Humans, Infant, Newborn, Pregnancy

Background:
In 2015, the popular online parenting forum, Netmums, named breastfeeding selfies as the number one parenting trend in the UK for that year. Public reaction to the rise in popularity of this practice is polarised, much like breastfeeding in public. The unspoken rule that breastfeeding should be discreet is challenged by the ostentatious presence of breastfeeding selfies.
The case study:
This paper focuses on a detailed case study with a white, working class, single mother of two children who has taken and shared breastfeeding selfies online. The analysis employs psychoanalytic and phenomenological methods in order to consider the interrelation of both the internal processes and external forces at work in the practice of taking and sharing breastfeeding selfies. The focus is on how her practice might function in relation to the development of a maternal subject position and the ways in which any cultural capital associated with breastfeeding is perceived and mobilised. The analysis reveals how the relational dimension of selfie taking and participation in online breastfeeding and mothers' groups helps develop an embodied sense of cultural capital which has ramifications in the everyday, although not without its own contradictions. Whilst breastfeeding may take up a particular place in contemporary discourses around parenting and 'good mothering', the capital it affords women is inherently wrapped up in their subject position and material conditions. Online spaces allow for manoeuvre and the mobilisation of this capital in a way which is precluded in the outside world. The practice of sharing and consuming breastfeeding selfies critically contributes to the actualisation of this capital in an embodied sense.
Conclusions:
The key theme which emerges is the crucial need for recognition at both the micro and macro level and how this need for recognition is informed by both psychic and social pressures. The visibility, or self-exposure, associated with selfie sharing contributes to the surety of taking up a maternal subject position, from which the participant was better placed to work through some of the cultural ambivalences she too had internalised toward breastfeeding.
Recurrent Syncope, a Clue in Amyloid Cardiomyopathy
Authors: Julian A Marin-Acevedo, Catalina Sanchez-Alvarez, Ali A Alsaad, Ricardo J Pagán
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Infiltrative cardiomyopathies include a variety of disorders that lead to myocardial thickening resulting in a constellation of clinical manifestations and eventually heart failure that could be the first clue to reach the diagnosis. Among the more described infiltrative diseases of the heart is amyloid cardiomyopathy. The disease usually presents with subtle, nonspecific symptoms. Herein, we illustrate a case of recurrent syncope as the initial presenting symptom for systemic amyloid with polyneuropathy and cardiomyopathy as a cause of syncope. The article illustrates the role of advanced cardiac imaging in the diagnosis of the disease with a focused literature review. We also highlight the role of early, shared decision-making between patient, family, and medical team in the management of cardiac amyloidosis.
Neuroplasticity and Epilepsy Surgery in Brain Eloquent Areas: Case Report
Authors: Pedro Jesus Serrano-Castro, Bienvenido Ros-López, Victoria Eugenia Fernández-Sánchez, Natalia García-Casares, Luis Muñoz-Becerra, Pablo Cabezudo-Garcia, Maria José Aguilar-Castillo, Maria Vidal-Denis, Esperanza Cruz-Andreotti, Maria Jose Postigo-Pozo, Guillermo Estivill-Torrús, Guillermo Ibañez-Botella
Journal: Front Neurol (2020)
Keywords: boston test, eloquent area surgery, epilepsy surgery, language functional mri, language prehabilitation, neuropshycological measures
MeSH terms: Case Reports

Introduction: Neuronal plasticity includes changes in any component of the central nervous system in response to intrinsic or extrinsic stimuli. Brain functions that depend on the epileptogenic cortex pose a challenge in epilepsy surgery because many patients are excluded from pre-surgical evaluation for fear of the possible sequelae. Some of these patients may be rescued by enhancing neuronal plasticity with brain neuromodulation techniques. Case Report: We describe a 6-year-old child with refractory focal motor seizures symptomatic to a neuroepithelial dysembryoblastic tumor in the left temporo-parietal region. He underwent limited resection of the lesion in order to avoid sequelae in his language function. A functional study at age of 17 years revealed an overlap of Wernicke's area with the tumor and areas of incipient language reorganization in the contralateral hemisphere. An invasive neuromodulation procedure was designed to enhance neuroplasticity. After craniotomy, he underwent language training and simultaneous electrical inhibition of language using an electrode grid placed over the lesion. The intensity of the language inhibitory stimulus was increased every day to force the use of accessory language areas in the right hemisphere by neuroplasticity. Results: The language of the patient improved for six consecutive days until he was able to speak and understand while undergoing maximum electrical inhibition. The tumor was resected using a cortical mapping guide. Discussion: Application of direct cortical stimulation techniques and language pre-habilitation before epilepsy surgery can be useful to rescue patients excluded from resective surgery, especially young patients with long-term lesions.
Assessing embodied interpersonal emotion regulation in somatic symptom disorders: a case study
Authors: Zeynep Okur Güney, Heribert Sattel, Daniela Cardone, Arcangelo Merla
Journal: Front Psychol (2015)
Keywords: anger, embodiment, emotion regulation, interpersonal interactions, relaxation, somatic symptom disorders

The aim of the present study was to examine the intra- and interpersonal emotion regulation of patients with somatic symptom disorders (SSDs) during interactions with significant others (i.e., romantic partners). We presented two case couples for analysis. The first couple consisted of a patient with SSD and his healthy partner, whereas the second couple consisted of two healthy partners. The couples underwent an interpersonal experiment that involved baseline, anger and relaxation tasks. During each task, partners' cutaneous facial temperature, heart rate and skin conductance levels were measured simultaneously. Participants' trait-emotion regulation, state-affect reports for self and other, and attachment styles were also examined. The experimental phases were successful in creating variations in physiological processes and affective experience. As expected, emotion regulation difficulties predicted higher increase in the course of temperature at each phase. Besides, the patient showed restricted awareness and reflection to emotions despite his higher autonomic activity compared to healthy controls. Both partners of the first couple revealed limited ability in understanding the other's emotions, whereas the second couple performed relatively better in that domain. The temperature variations between the patient and his partner were significantly correlated while the correlations of temperature changes between the second couple were negligible except anger task. The study supported the merits of an embodied interpersonal approach in clinical studies. The tentative results of the cases were discussed in the light of findings in emotion regulation and attachment research.
A Persons-Centered Approach for Prevention of COVID-19 Disease and Its Impacts in Persons With Disabilities
Authors: Suraj Singh Senjam
Journal: Front Public Health (2021)
Keywords: impact on persons with disabilities, international classification for functioning health and disability, person-centered analysis/approach, preventive strategies, the covid-19
MeSH terms: COVID-19 / prevention & control, Disabled Persons, Quarantine, Social Work, Case Reports, Adolescent, Communicable Disease Control / methods, Humans, Male

The World Health Organization (WHO) considers COVID-19 a great threat to humanity and, thus, declared the COVID-19 outbreak a pandemic on March 11, 2020. To limit its transmission, governments announced lockdowns in their respective nations, and recommended control measures, including behavior change. Persons with disabilities (PwDs) are among the population that may be at a higher risk of becoming infected and may suffer serious illness due to COVID-19. Additionally, lockdowns pose immense challenges and have tremendous impacts on PwDs in terms of receiving their daily support. To mitigate these challenges, their impact, and to reduce the risk of infection, it is important to design strategies that can improve the overall outcome for PwDs. This study therefore intends to provide a uniform strategy or guideline using the person-centered approach principles which is perhaps the most feasible and implementable approach to circumvent the challenges faced by PwDs during emergency lockdowns. Two case studies are used as examples. This pandemic also provides an opportunity for health care planners and policymakers in the health sector to implement reforms to ensure disability inclusiveness in potential future emergency lockdowns.
Iron depletion: an ameliorating factor for sickle cell disease?
Authors: P C Giordano, W Huisman, C L Harteveld
Journal: ISRN Hematol (2011)
MeSH terms: Case Reports

We report some observations from our laboratory practice that might be important for the treatment of sickle cell disease (SCD). We describe data from two cases indicating that iron depletion might have a beneficial effect diminishing the formation of HbS in favor of HbF, possibly reducing the severity of the disease. We believe that it would be worthwhile to monitor the course of the disease comparing cases with identical genotypes with and without iron depletion, and we advise to consider chelation therapy to reduce iron overload in patients with SCD.