OpenMed/multicare-articles huggingface dataset:
Case report: Evaluation of cutaneous squamous cell carcinoma metastasized to lymph nodes using 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in a dog
Authors: Jin Seok, Sungin Lee
Journal: Front Vet Sci (2024)
Keywords: 18f-fluorodeoxyglucose, cutaneous squamous cell carcinoma, flank, lymph node, positron emission tomography
MeSH terms: Case Reports

Introduction:
18F-fluorodeoxy-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is used with high sensitivity in human medicine for initial staging and treatment planning of cutaneous squamous cell carcinoma (SCC). To the best of our knowledge, 18F-FDG PET/computed tomography (CT) has not been used for canine cutaneous SCC with lymph node metastasis.
Case presentation:
A 13 year-old spayed female Maltese had rapidly growing flank SCC, which had previously recurred twice. Radiography revealed no metastases. On PET/CT imaging, increased FDG uptake was observed not only in the flank but also in the left axillary lymph node and left inguinal lymph node (standardized uptake value max [SUVmax]: 8.602, 5.354, and 1.96, respectively). Despite the evidence of metastasis, palliative skin mass resection with a 3-cm margin and lymph node dissection were performed. Histopathological examination confirmed the presence of metastases in both lymph nodes.
Discussion:
18F-FDG PET/CT is valuable for the detection of metastatic tumors in various organs. Cutaneous SCC can accumulate 18F-FDG, making it detectable on PET/CT. In this dog with flank SCC, 18F-FDG-PET/CT showed high SUVmax values, indicating its potential for tumor assessment. In veterinary medicine, SUVmax values of 2.5-3.5 are commonly used to identify metastatic lymph nodes in other cancers. Therefore, the interpretation of an SUVmax of 1.96 in an inguinal lymph node for metastatic involvement may be uncertain. Owing to the partial volume effect, 18F-FDG PET/CT has limited sensitivity in identifying LN metastases, particularly in cases of small lesions. Lower SUVmax values adjusted for smaller sizes may better distinguish between benign and malignant lymph nodes. Hence, combining differentiated SUVmax cut-offs based on lymph node size with CT assessment could enhance lymph node evaluation and assist in surgical planning.
Distinguishing 'dual' from 'duplicated' right coronary artery: Revisiting the nomenclature
Authors: Niraj Nirmal Pandey, Aprateem Mukherjee, Nitish Naik, Priya Jagia
Journal: J Cardiovasc Thorac Res (2023)
Keywords: cardiac-gated imaging techniques, computed tomography angiography, coronary artery disease
MeSH terms: Case Reports

We report a case of a 53-year-old man with a "short RCA" seen coursing within the proximal part of the right atrioventricular (AV) groove and terminating in the mid-portion of the right AV groove and a "long RCA" seen to have a proximal course outside the right AV groove, over the free wall of the right ventricle, where it gave rise to the right ventricular and acute marginal branches before returning to the right AV groove in its distal course. The discussion highlights the need for revisiting the nomenclature of "dual RCA and drawing a distinction between "dual" and "duplicated" RCA.
Ceftazidime/avibactam combined with colistimethate sodium successfully cures carbapenem-resistant Pseudomonas aeruginosa-induced brain abscess in a child post-craniotomy: a case report
Authors: Minglu Yuan, Miao Zong, Cong Ren, Wenjing Zong, Zhongdong Li
Journal: Front Oncol (2024)
Keywords: brain abscess, carbapenem-resistant pseudomonas aeruginosa, ceftazidime/avibactam, central nervous system infections, colistimethate sodium
MeSH terms: Case Reports

The treatment of brain abscess induced by carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a clinical challenge around the world. Apart from novel β-lactam/β-lactamase inhibitors and polymyxins, there are few sufficiently powerful antibiotics that are effective against CRPA-induced infections. Considering the blood-brain barrier factor, there are even fewer drugs that can be used to treat intracranial CRPA-induced infections. In this article, we reported a case of CRPA-induced brain abscess that was successfully treated with intravenous ceftazidime/avibactam and intrathecal colistimethate sodium in a child after intracranial tumor resection.
A case report of Vancomycin in the treatment of Q fever endocarditis
Authors: Xuan Wang, Guangmei Zou, Qianli Wang, Jiao Li
Journal: Front Cell Infect Microbiol (2024)
Keywords: coxiella burnetii, q fever, infective endocarditis, liver injury, vancomycin
MeSH terms: Coxiella burnetii, Endocarditis, Bacterial / diagnosis, Endocarditis, Bacterial / drug therapy, Q Fever / diagnosis, Q Fever / drug therapy, Case Reports, Adult, Doxycycline / therapeutic use, Humans, Hydroxychloroquine, Male, Vancomycin / therapeutic use, Vancomycin, Doxycycline, Hydroxychloroquine

The patient, a 43-year-old male, was admitted to the hospital with gradually aggravated exertional palpitations and chest tightness over a 2-day period. Upon hospital admission, a cardiac ultrasound revealed aortic valve redundancy, however multiple blood culture investigations came back negative. Blood mNGS was perfected, revealing Coxiella burnetii, and the diagnosis of Q fever (query fever) was established. The temperature and inflammatory indices of the patient were all normal with the treatment of vancomycin before cardiac surgery. But for the potential liver damage of and the Coxiella burnetii was still positive in the anti-phase II IgG titer, the doxycycline and hydroxychloroquine instead of vancomycin were applied for the patient. Despite receiving standardized anti-infective therapy of doxycycline combined with hydroxychloroquine, this patient had fever and increased leukocytes following surgery. After the addition of vancomycin as an anti-infective treatment, the temperature and leukocytes improved quickly. During the treatment of vancomycin, a discovery of liver injury may have resulted. These findings provide new therapy options for future professionals.
Case report: Regression after low-dose glucocorticoid therapy in a case of acute immune myocarditis induced by anti-PD-1 therapy for NSCLC
Authors: Liqianqi Chen, Suihao Zhang, Long Gong, Yucong Zhang
Journal: Front Oncol (2024)
Keywords: pd-1 inhibitor, immune myocarditis, low-dose glucocorticoid, methylprednisolone, non-small cell lung cancer
MeSH terms: Case Reports

Background:
PD-1 inhibitors exhibit efficacy in managing unresectable/metastatic driver gene-negative NSCLC, albeit with potential immune-related adverse events (irAEs). Among these, immune checkpoint inhibitor-associated myocarditis (ICI-M) is rare yet lethal. This study presents the initial successful instance of ICI-M in a lung cancer patient, rescued by low-dose glucocorticoids post-deterioration during treatment.
Case summary:
A 78-year-old male with a medical history of stage IV pT3N2M1 NSCLC underwent four cycles of palliative chemotherapy, resulting in stable disease (SD). Subsequent to declining further chemotherapy, the patient was transitioned to a targeted therapy regimen comprising Anlotinib in conjunction with PD-1 inhibitor immunotherapy. On the 26th day post-administration of the PD-1 inhibitor, the patient manifested Grade 2 immune-mediated myocarditis. Treatment encompassing 1mg/kg methylprednisolone combined with immunoglobulin shock therapy was initiated for 3 days, achieving symptomatic control. Nonetheless, upon tapering methylprednisolone dosage to 4-8mg/3-4d, the condition deteriorated, necessitating transfer to the intensive care unit. Methylprednisolone dosage was escalated to 80mg/day for 3 days, followed by gradual reduction by one-third to two-thirds weekly, culminating in the patient's safe discharge from the hospital.
Conclusion:
Immune-related myocarditis linked to checkpoint inhibitors is often managed effectively with high-dose glucocorticoid therapy. However, in Asian populations, low-dose glucocorticoids are increasingly utilized for salvage therapy, yielding favorable outcomes and improving prognosis compared to European populations.
Tendency of Semaglutide to Induce Gastroparesis: A Case Report
Authors: Ahtshamullah Chaudhry, Buluku Gabriel, Jawad Noor, Saima Jawad, Suryanarayana R Challa
Journal: Cureus (2024)
Keywords: gastroparesis, nausea and vomiting, semaglutide, upper endoscopy, weight loss and obesity
MeSH terms: Case Reports

Semaglutide, an agonist of the glucagon-like peptide-1 receptor, is frequently used in the treatment of diabetes mellitus type 2, although, lately, weight loss has additionally become a reason for its use. However, if a patient is already experiencing bloating, nausea, abdominal pain, and discomfort in the abdomen, it is not recommended to use it due to concern about aggravating these symptoms. Although it is often well tolerated, there are occasions when it can have several gastrointestinal side effects. Therefore, we report a case of a patient who started taking semaglutide and later developed gastroparoresis.
A case report and literature review on reactive cutaneous capillary endothelial proliferation induced by camrelizumab in a nasopharyngeal carcinoma patient
Authors: Yao Lin, Yuxin Lin, Xiaoping Zhong, Qingshan Chen, Shijie Tang, Jiasheng Chen
Journal: Front Oncol (2023)
Keywords: camrelizumab, case report, literature review, nasopharyngeal carcinoma, reactive cutaneous capillary endothelial proliferation
MeSH terms: Case Reports

Camrelizumab, a monoclonal antibody, blocks programmed cell death protein-1 from binding to T cells and programmed cell death ligand 1 on tumor cells, thereby ensuring sustained T cell activation and blocking immune escape of various types of cancer, including nasopharyngeal carcinoma. Reactive cutaneous capillary endothelial hyperplasia (RCCEP) is the most common immune-related adverse event in patients treated with camrelizumab. We report a case nasopharyngeal carcinoma in a patient with camrelizumab-induced RCCEP. A 68-year-old man diagnosed with nasopharyngeal carcinoma developed RCCEP at multiple locations after 3 months of camrelizumab treatment. RCCEP of the right lower eyelid affected closure of the right eye. In this report, we also reviewed previous literature on camrelizumab-induced RCCEP. In summary, the mechanism underlying camrelizumab-induced RCCEP remains unclear. RCCEP typically gradually subsides after discontinuing camrelizumab treatment. Larger nodules can be treated with lasers, ligation, or surgery. Although surgical excision is effective, RCCEP may recur in patients undergoing camrelizumab treatment. RCCEP management may not be required in the absence of adverse effects on the patient's daily life.
5-MeO-DMT for post-traumatic stress disorder: a real-world longitudinal case study
Authors: Anya Ragnhildstveit, Ryan Khan, Paul Seli, Lisa Claire Bass, River Jude August, Miriam Kaiyo, Nathaniel Barr, Laura Kate Jackson, Michael Santo Gaffrey, Joseph Peter Barsuglia, Lynnette Astrid Averill
Journal: Front Psychiatry (2023)
Keywords: 5-meo-dmt, 5-methoxy-n, n-dimethyltryptamine, ptsd, case report, post-traumatic stress disorder, psychedelic therapy, trauma
MeSH terms: Case Reports

Psychedelic therapy is, arguably, the next frontier in psychiatry. It offers a radical alternative to longstanding, mainstays of treatment, while exciting a paradigm shift in translational science and drug discovery. There is particular interest in 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT)-a serotonergic psychedelic-as a novel, fast-acting therapeutic. Yet, few studies have directly examined 5-MeO-DMT for trauma- or stress-related psychopathology, including post-traumatic stress disorder (PTSD). Herein, we present the first longitudinal case study on 5-MeO-DMT for chronic refractory PTSD, in a 23-year-old female. A single dose of vaporized bufotoxin of the Sonoran Desert Toad (Incilius alvarius), containing an estimated 10-15 mg of 5-MeO-DMT, led to clinically significant improvements in PTSD, with next-day effects. This was accompanied by marked reductions in hopelessness and related suicide risk. Improvements, across all constructs, were sustained at 1-, 3-, 6-, and 12-months follow-up, as monitored by a supporting clinician. The subject further endorsed a complete mystical experience, hypothesized to underly 5-MeO-DMT's therapeutic activity. No drug-related, serious adverse events occurred. Together, results showed that 5-MeO-DMT was generally tolerable, safe to administer, and effective for PTSD; however, this was not without risk. The subject reported acute nausea, overwhelming subjective effects, and late onset of night terrors. Further research is warranted to replicate and extend these findings, which are inherently limited, non-generalizable, and rely on methods not clinically accepted.
Successful Preoperative Radiotherapy for Neglected Shoulder Liposarcoma: A Retrospective Case Report
Authors: Camilla Linhart, Craig MacLeod
Journal: Case Rep Oncol Med (2024)
Keywords: liposarcoma, radiotherapy, shoulder
MeSH terms: Case Reports

This study examines a unique case of a 61-year-old male with a 5-year history of a progressively growing mass above his right shoulder, diagnosed as a dedifferentiated pleomorphic liposarcoma. Using computerized tomography-guided core needle biopsy, the tumour was identified as intermediate to high grade. Surgical removal required preoperative radiotherapy to reduce the size of the tumour. Several unique characteristics set apart this particular case of liposarcoma: its substantial size, its unpredictable growth pattern, its absence of metastasis, and notably, its prolonged period of being untreated. This case report outlines the clinical background, diagnostic procedures, and treatment modalities employed in managing this condition, emphasizing a localized dual therapy approach combining radiotherapy and surgery. Emphasis is placed on distinguishing liposarcoma from lipoblastoma, a benign adipocyte tumour, to facilitate accurate diagnosis and appropriate treatment selection. The positive result achieved in this case could provide valuable insights for the future treatment and management of similarly sized aggressive tumours.
Giant Lipoma: A Case Report
Authors: Chinmay Kher, Swarupa Chakole
Journal: Cureus (2024)
Keywords: adipose tissue, benign tumor, deformity, giant lipoma, lipoma, liposarcoma, liposuction, recurrent lipoma
MeSH terms: Case Reports

Lipomas are one of the most common, benign, slow-growing tumours composed of adipose (fat) tissue. These soft, rubbery lumps are usually painless and move easily when touched. Lipomas are generally small, ranging from less than an inch to a few inches in diameter. However, when a lipoma grows to a size larger than 10 cm (about 4 in), it is referred to as a giant lipoma. Only about 1% of all lipomas can be called "giant". Though usually they are benign, in the case of a very large lipoma it is essential to rule out the possibility of malignancy before embarking on its surgical treatment. Lipomas can occur anywhere in the body, but they are most commonly found on the neck, shoulders, back, abdomen, arms, or thighs. Here, we present a case of a 42-year-old woman with a giant lipoma over her left scapula.
Successful closure of a refractory giant (15 sq mm) macular hole with amniotic membrane graft
Authors: Kakarla Venkata Chalam, Marib Akanda, Meenakshi Subramanian
Journal: J Surg Case Rep (2024)
Keywords: amniotic membrane graft, large macular hole, pars plana vitrectomy, surgery, treatment, visual recovery
MeSH terms: Case Reports

The management of macular hole defects has undergone a significant transformation with the advent of advanced diagnostic tools and surgical techniques. These developments have enabled the effective treatment of macular holes that were previously considered untreatable. Although the majority of patients exhibit a positive response to initial treatment, a subset of patients may develop refractory macular holes that necessitate multiple surgeries for closure. In these instances, the utilization of amniotic membrane grafts to aid in the closure of large retinal holes presents a promising alternative. This report details the successful closure of a refractory giant macular hole (15 sq. mm) in a patient using an amniotic membrane graft, with improvement in visual acuity.
Case report: Beneficial effects of visual cortex tDCS stimulation combined with visual training in patients with visual field defects
Authors: Yanhua Lian, Xiaoping Cheng, Qunlin Chen, Libin Huang, Lili Xie, Wenzong Wang, Jun Ni, Xinyuan Chen
Journal: Front Neurol (2024)
Keywords: case report, perceptual training, transcranial direct current stimulation, visual field defect, visual recovery strategies
MeSH terms: Case Reports

Background:
Visual field defect (VFD) refers to the phenomenon that the eye is unable to see a certain area within the normal range of vision, which may be caused by eye diseases, neurological diseases and other reasons. Transcranial direct current stimulation (tDCS) is expected to be an effective treatment for the recovery or partial recovery of VFD. This paper describes the potential for tDCS in combination with visual retraining strategies to have a positive impact on vision recovery, and the potential for neuroplasticity to play a key role in vision recovery.
Methods:
This case report includes two patients. Patient 1 was diagnosed with a right occipital hemorrhage and homonymous hemianopia. Patient 2 had multiple facial fractures, a contusion of the right eye, and damage to the optic nerve of the right eye, which was diagnosed as a peripheral nerve injury (optic nerve injury). We administered a series of treatments to two patients, including transcranial direct current stimulation; visual field restoration rehabilitation: paracentric gaze training, upper and lower visual field training, VR rehabilitation, and perceptual training. One time per day, 5 days per week, total 6 weeks.
Results:
After 6 weeks of visual rehabilitation and tDCS treatment, Patient 1 Humphrey visual field examination showed a significant improvement compared to the initial visit, with a reduction in the extent of visual field defects, increased visual acuity, and improvement in most visual functions. Patient 2 had an expanded visual field, improved visual sensitivity, and substantial improvement in visual function.
Conclusion:
Our case reports support the feasibility and effectiveness of tDCS combined with visual rehabilitation training in the treatment of occipital stroke and optic nerve injury settings.
Case Report: A novel RRM2B variant in a Chinese infant with mitochondrial DNA depletion syndrome and collective analyses of RRM2B variants for disease etiology
Authors: Yanjun Wang, Ling Hang, Weihua Shou, Cuifen Li, Fangling Dong, Xingxing Feng, Ruohong Jin, Bin Li, Shufang Xiao
Journal: Front Pediatr (2024)
Keywords: rrm2b, disease etiology, disease spectrum, mitochondrial dna depletion syndrome, whole-exome sequencing
MeSH terms: Case Reports

Background:
There are few reports of infantile mitochondrial DNA depletion syndrome (MDDS) caused by variants in RRM2B and the correlation between genotype and phenotype has rarely been analyzed in detail. This study investigated an infantile patient with MDDS, from clinical characteristics to genetic causes.
Methods:
Routine physical examinations, laboratory assays, which included gas chromatography-mass spectrometry of blood and urine, and MRI scans were performed to obtain an exact diagnosis. Whole-exome sequencing was used to pinpoint the abnormal gene and bioinformatic analyses were performed on the identified variant.
Results:
The case presented with progressive neurologic deterioration, failure to thrive, respiratory distress and lactic acidosis. Sequencing revealed that the patient had a homozygous novel missense variant, c.155T>C (p.Ile52Thr), in exon 2 of the RRM2B gene. Multiple lines of bioinformatic evidence suggested that this was a likely detrimental variant. In addition, reported RRM2B variants were compiled from the relevant literature to analyze disease etiology. We found a distinctive distribution of genotypes across disease manifestations of different severity. Pathogenic alleles of RRM2B were significantly enriched in MDDS cases.
Conclusion:
The novel variant is a likely genetic cause of MDDS. It expands our understanding of the pathogenic variant spectrum and the contribution of the RRM2B gene to the disease spectrum of MDDS.
Hypothyroidism After Use of Immune Checkpoint Inhibitor Therapy in Patient With Graves' Disease: Cure?
Authors: Rajeev Sharma
Journal: JCEM Case Rep (2022)
Keywords: graves' disease, antithyroid drug (atd), hypothyroidism, immune checkpoint inhibitors, programmed cell death protein-1 (pd-1) inhibitor, thyroid-stimulating hormone, thyroiditis
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) are frequently used as treatment for many malignancies. Immune-related adverse events (irAEs) due to use of ICIs are common. Thyroid involvement is the most common endocrine irAE. Here, we present an unusual case of Graves' disease potentially cured due to destructive thyroiditis caused by inflammation due to ICIs. Thyroid irAEs are more common with programmed cell death protein-1 (PD-1) inhibitor or programmed cell death-ligand 1 (PD-L1) inhibitors than cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors. Baseline and serial monitoring of thyroid function tests is recommended.
Robot-Assisted Repair of Bladder Rupture following Penile Ring Entrapment
Authors: Matthew Skalak, Rami Jirjis, Barrett G Anderson, Brandi D Miller
Journal: Case Rep Urol (2023)
MeSH terms: Case Reports

Penile rings have been used to help sustain erection and enhance sexual pleasure for centuries. Constriction of the penis reduces the outflow of blood from the cavernosal tissue. However, if left for an extended time period, a condition called penile ring entrapment can occur. This may result in severe edema, gangrene, necrosis, and even penile amputation. Penile ring entrapment is a very rare condition; complete urinary obstruction with concomitant bladder rupture as a result renders this case even more extraordinary. We discuss our experience in the management of a 64-year-old man, who presented with altered mental status and inability to urinate, found to have penile ring entrapment and intraperitoneal bladder rupture. Removal of the constricting ring was performed in the ED, and bladder injury and penile necrosis were subsequently repaired with robot-assisted laparoscopic cystorrhaphy, penectomy, and perineal urethrostomy.
Management of perioperative anticoagulation in patients with mechanical heart valve replacement undergoing laparoscopic cholecystectomy: a case report of postoperative cerebral embolism
Authors: Wei He, Panli Tang
Journal: Front Surg (2024)
Keywords: abdominal surgery, mechanical heart valve replacement, perioperative anticoagulation, postoperative cerebral embolism, warfarin bridging therapy
MeSH terms: Case Reports

Patients with mechanical heart valve replacement require lifelong anticoagulation therapy, and additional surgeries can pose a risk of bleeding and thromboembolic events due to the need for perioperative anticoagulation management. Here, we present a case report of a patient who underwent laparoscopic cholecystectomy (LC) and endoscopic retrograde cholangiopancreatography (ERCP) after mechanical heart valve replacement and experienced postoperative cerebral embolism. The management of perioperative anticoagulation in these patients is discussed, including strategies for minimizing the risks of bleeding and thromboembolic events during and after surgery.