OpenMed/multicare-articles huggingface dataset:
Case report: Senescence as mechanism of resistance to Pembrolizumab in a Lymphoma patient who failed CD19-Targeted CAR-T cell therapy
Authors: Serena De Matteis, Beatrice Casadei, Ginevra Lolli, Michele Dicataldo, Francesco Barbato, Elisa Dan, Andrea Paccagnella, Barbara Sinigaglia, Clara Bertuzzi, Annalisa Arcari, Luca Zazzeroni, Patrizia Bernuzzi, Noemi Laprovitera, Gianluca Storci, Salvatore Nicola Bertuccio, Manuela Ferracin, Massimiliano Bonafè, Pier Luigi Zinzani, Francesca Bonifazi
Journal: Front Immunol (2022)
Keywords: chimeric antigen receptor (car t), exhaustion, lymphoma, pembrolizumab, resistance, senescence
MeSH terms: Lymphoma, Large B-Cell, Diffuse / drug therapy, Receptors, Chimeric Antigen / genetics, Receptors, Chimeric Antigen / metabolism, Case Reports, Research Support, Non-U.S. Gov't, Antigens, CD19, CD8-Positive T-Lymphocytes, Cell- and Tissue-Based Therapy, Humans, Immunotherapy, Adoptive, Receptors, Antigen, T-Cell, Antigens, CD19, Receptors, Chimeric Antigen, pembrolizumab, Receptors, Antigen, T-Cell

Background:
T cells engineered to target CD19 antigen on neoplastic B cells represent the most striking example of CAR-T cell therapy. The success rate of this therapy is affected by several limitations: target antigen loss, and/or acquisition of a senescent/exhausted phenotype by CAR and non-CAR T cells.
Case presentation:
We report on a patient affected by refractory Diffuse Large B-cell Lymphoma who was resistant to CAR T-cell therapy and to two cycles post CAR-T of pembrolizumab (PBZ) due to the evolution into a B-cell Hodgkin-like lymphoma. Owing to the CD30 expression and the Hodgkin-like phenotype, the patient was ultimately treated with Brentuximab-Vedotin and finally underwent remission. Upon PBZ treatment, 100% of circulating CAR-T+ cells showed a persistent CD8+ senescent/exhausted phenotype, while an increase in the percentage of senescent cells was found in the non-CAR CD8+ T cells compartment.
Conclusions:
PBZ is not able to reinvigorate exhausted CAR+ T cells and to confer durable clinical response. We hypothesize that the phenomenon is due to the senescent phenotype of CAR+ T cells, which did not allow PBZ-induced reactivation and proliferative rescue. The phenomenon, together with the loss of CAR-T target CD19 and the shift of non-CAR CD8+ T cells towards a senescent phenotype likely contributed to set up an immune landscape with poor antitumor capacity.
Case Report: A Case of Leukocyte Adhesion Deficiency, Type III Presenting With Impaired Platelet Function, Lymphocytosis and Granulocytosis
Authors: Amal M Yahya, Asia A AlMulla, Haydar J AlRufaye, Ahmed Al Dhaheri, Abdulghani S Elomami, Suleiman Al-Hammadi, Lalitha Kailas, Ranjit Vijayan, Abdul-Kader Souid
Journal: Front Pediatr (2021)
Keywords: bcg vaccine, fermt3, glanzmann thrombasthenia, epistaxis, inborn error of immunity, kindlin-3, leukocytosis, platelet dysfunction
MeSH terms: Case Reports

Fermitin family homolog 3 (FERMT3), alternatively kindlin-3 (KIND3), is an integrin binding protein (of 667 residues) encoded by the FERMT3 gene. The molecule is essential for activating integrin αIIbβ3 (the fibrinogen receptor) on platelets and for the integrin-mediated hematopoietic cell (including platelets, T lymphocytes, B lymphocytes, and granulocytes) adhesion. Its defects are associated with impaired primary hemostasis, described as "Glanzmann's thrombasthenia (MIM#273800)-like bleeding problem." The defects are also associated with infections, designated as "LAD1 (leukocyte adhesion deficiency, type I; MIM#116920)-like immune deficiency." The entity that joins the impaired primary hemostasis with the leukocyte malfunction has been termed "leukocyte adhesion deficiency, type III" (LAD3, autosomal recessive, MIM#612840), representing a defective activation of the integrins β1, β2, and β3 on leukocytes and platelets. Here, we report a male toddler with novel compound heterozygous variants, NM_178443.2(FERMT3):c.1800G>A, p.Trp600* (a non-sense variant) and NM_178443.2(FERMT3):c.2001del p.*668Glufs*106 (a non-stop variant). His umbilical cord separated at about 3 weeks of age. A skin rash (mainly petechiae and purpura) and recurrent episodes of severe epistaxis required blood transfusions in early infancy. His hemostatic work-up was remarkable for a normal platelet count, but abnormal platelet function screen with markedly prolonged collagen-epinephrine and collagen-ADP closure times. The impaired platelet function was associated with reduced platelet aggregation with all agonists. The expression of platelet receptors was normal. Other remarkable findings were persistent lymphocytosis and granulocytosis, representing defects in diapedesis due to the integrin dysfunction. The natural history of his condition, structure and sequence analysis of the variations, and comparison with other LAD3 cases reported in the literature are presented.
A Calcifying Odontogenic Cyst Associated with Compound Odontoma Mimicking a Tooth Germ
Authors: Eduardo Morato Oliveira, Lucas Alves da Mota Santana, Erika Rezende Silva, Leandro Napier Souza
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Calcifying odontogenic cyst (COC) is a rare cyst that affects mainly the anterior region of the jaws. Generally, it appears as a unilocular radiolucent lesion containing peripheral foci of calcification, but with radiographic variations depending on the type of presentation. Here, we report an atypical case of COC associated with odontoma, initially diagnosed as a tooth germ, in the posterior region of the mandible of a 10-year-old male patient. Interestingly, the radiographic aspect appeared as a unilocular radiolucent lesion without peripheral foci of calcification in the edentulous region, having its size increased after traction of the impacted tooth adjacent to that area. Thus, the case presented in this study is aimed at calling dentists' attention to its developmental changes and related pathologies.
A Journey toward Immediate Denture: Overcoming Bitter Reality with Psychotherapy
Authors: R Varsha, P S Manoharan, Vigneshvar Chandrasekaran, K Savitha
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

The loss of teeth affects the aesthetics, function (mastication and speech), confidence, mental state, and the overall quality of life of an individual. Aggressive periodontitis is a destructive condition leading to loss of teeth at early stages of the disease. Individuals facing this inevitable condition of losing the teeth and replacement at a younger age experience formidable psychological distress. The prosthodontic procedure when supported with psychotherapeutic interventions can support the patient in accepting the prognosis and treatment. We report the scenario where psychological intervention was provided in a systematic manner adopting the SPIKES protocol for a 42-year-old man presenting with aggressive periodontitis.
Tumor-Induced Osteomalacia and the Importance of Plasma Fibroblast Growth Factor 23 as an Indicator: Diagnostic Delay Leads to a Suicide Attempt
Authors: LaRae Seemann, Sandeep Anand Padala, Azeem Mohammed, Nardos Belayneh
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: fgf23, fibroblast growth factor 23, hypophosphatemia, octreotide scintigraphy, osteomalacia, paraneoplastic syndromes, phosphaturic mesenchymal tumor, renal phosphate wasting, tumor-induced osteomalacia
MeSH terms: Fibroblast Growth Factors / blood, Neoplasms, Connective Tissue / diagnosis, Paraneoplastic Syndromes / diagnosis, Suicide, Attempted / psychology, Case Reports, Delayed Diagnosis / psychology, Female, Fibroblast Growth Factor-23, Fibromyalgia / etiology, Humans, Hypophosphatemia / etiology, Magnetic Resonance Imaging, Middle Aged, Neoplasms, Connective Tissue / blood, Neoplasms, Connective Tissue / complications, Osteomalacia, Pain / etiology, Paraneoplastic Syndromes / blood, Paraneoplastic Syndromes / complications, Phosphates / blood, Radionuclide Imaging, Rickets, Hypophosphatemic / etiology, FGF23 protein, human, Phosphates, Fibroblast Growth Factors, Fibroblast Growth Factor-23, Oncogenic osteomalacia

Tumor-induced osteomalacia is a rare hypophosphatemic disease caused by unregulated production of fibroblast growth factor 23 by a tumor, thereby inducing renal phosphate wasting and inhibiting appropriate increase of calcitriol production. Symptoms of tumor-induced osteomalacia, including muscle weakness, bone pain, and pathologic fractures, are nonspecific and warrant further workup. We report the case of a 50-year-old African American female with no known psychiatric illness who was admitted after a failed suicide attempt provoked by severe bone pain. She had been treated for fibromyalgia and hypophosphatemic rickets at other facilities with no improvement. The findings of profound renal phosphate wasting initiated further evaluation, which revealed an elevated fibroblast growth factor 23 level and a right proximal fibular mesenchymal tumor on octreotide scintigraphy. Magnetic resonance imaging confirmed the findings of a solid intramuscular tumor corresponding to the octreotide avid lesion. After wide excision of the tumor, serum phosphate and parathyroid hormone levels began to normalize. This case highlights the importance of extensively investigating the cause of bone pain, weakness, and fatigue in patients without a family history of hypophosphatemia or bone disorders. The aforementioned symptoms may precede recurrent pathological fractures, and a thorough workup ensures that a diagnosis of tumor is not delayed or overlooked, as tumor resection confers a favorable prognosis and dramatic increase in the quality of life for patients.
EUS-guided FNA of a portal vein thrombus in hepatocellular carcinoma
Authors: Yusuf Kayar, Kenan Ahmet Turkdogan, Birol Baysal, Nurcan Unver, Ahmet Danalioglu, Hakan Senturk
Journal: Pan Afr Med J (2015)
Keywords: endoscopic ultrasonography, hepatocellular carcinoma, portal vein thrombosis
MeSH terms: Carcinoma, Hepatocellular / diagnosis, Liver Neoplasms / diagnosis, Venous Thrombosis / diagnosis, Case Reports, Aged, Carcinoma, Hepatocellular / pathology, Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods, Humans, Liver Cirrhosis / diagnosis, Liver Cirrhosis / pathology, Liver Neoplasms / pathology, Male, Middle Aged, Portal Vein / pathology, Venous Thrombosis / pathology

Portal vein thrombosis is a relatively rare but well-known complication of cirrhosis that has a prevalence of between 1% and 5.7%. On the contrary, in case of hepatocellular carcinoma (HCC), it is a much more frequent complication. In this paper, we presented three cases that had liver cirrhosis, mass and portal vein thrombosis in liver. We were not able to diagnose the cases through imaging methods, laboratory results or histopathologically, however, they were diagnosed with endoscopic ultrasonography- fine needle aspiration EUS-FNA from portal vein thrombus.
Fine needle aspiration cytology of cysticercosis-a case report
Authors: S Suchitha, K Vani, R Sunila, G V Manjunath
Journal: Case Rep Infect Dis (2012)

Cysticercosis, caused by cysticercus cellulosae, the larval form of Taenia solium, is potentially a dangerous systemic disease with variable clinical manifestations. The disease most commonly involves subcutaneous and muscle tissues, followed by the eye and brain. Cysticercosis can be diagnosed by various radiologic means or by serology, both of which, however, are not definitive. Biopsy and histologic examination containing the cysticerci is the most definitive method of diagnosis. We report a case of cysticercosis in a 27-year-old male patient, who presented with a subcutaneous swelling in the back which was diagnosed on fine needle aspiration cytology (FNAC).
Preeclampsia Induced Liver Dysfunction Complicated by Disseminated Intravascular Coagulopathy and Placental Abruption: A Case Report and Review of the Literature
Authors: Jordan Myers, Gary Wu, Robert E Shapiro, Manuel C Vallejo
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

A 33-year-old primigravida at 32-week gestation was admitted to labor and delivery complaining of severe right upper quadrant pain and worsening coagulopathy. We report the anesthetic and obstetrical management of a complex case of a parturient with a mixed picture of hemolysis, elevated liver enzymes and low platelets who was delivered under general anesthesia further complicated by Disseminated Intravascular Coagulopathy (DIC) and placental abruption.
COVID-19 complicated by infective endocarditis or concomitant infection? a case report
Authors: Chaymae Miri, Falmata Laouan Brem, Hammam Rasras, Noha El Ouafi, Bazid Zakaria
Journal: Pan Afr Med J (2022)
Keywords: covid-19, sars-cov-2, case report, complication, infective endocarditis
MeSH terms: COVID-19 / complications, COVID-19 / diagnosis, Endocarditis / complications, Endocarditis / diagnosis, Endocarditis, Bacterial / complications, Endocarditis, Bacterial / diagnosis, Endocarditis, Bacterial / drug therapy, Case Reports, Female, Humans, Middle Aged, Mitral Valve, Pandemics

Coronavirus disease 2019 (COVID-19) is a global pandemic and public health emergency. With a high infectivity and dissemination rate, cardiovascular complications have been observed and associated with a poorer prognosis. COVID-19 appears to be both a risk and prognosis factor for infective endocarditis. In this report, we present the case of a 53-year-old woman with a non-productive cough, progressive dyspnea and fatigue, diagnosed with COVID-19 four weeks earlier. The patient was referred to our department displaying the same symptoms. She was diagnosed with infective endocarditis of the mitral valve based on clinical symptoms, as well as radiological and analytical investigations. The patient was given appropriate medical treatment before admission based on azithromycin, corticosteroids for two weeks, during the hospitalization, she underwent treatment with antibiotics based on Teicoplanin and gentamicin. Outcome was good; the disappearance of the vegetative lesion on the weekly transthoracic echocardiogram (TTE). This rare case highlights questions about considering other coexisting diagnoses as well as possible complications a long with COVID-19.
A rare case of horse shoe shaped lipoma of the upper extremity
Authors: Nikhil Panse, Parag Sahasrabudhe, Ajay Chandanwale, Namrata Joshi
Journal: World J Plast Surg (2013)
Keywords: horse shoe shaped lipoma, upper extremity
MeSH terms: Case Reports

Horse shoe shaped lipoma of the upper extremity is a very rare entity. We present a case of 45 years old female who presented with painless progressive swelling over the distal forearm and tingling and numbness over the ulnar nerve territory. MRI and surgical exploration showed a horse shoe shaped multilobulated lipoma encasing the distal ulna. The mass was excised in toto, and the sensory alterations were completely relieved at three months follow up. We would like to highlight this rare occurrence of a horse shoe lipoma and present a detailed history of this case to increase awareness amongst clinicians regarding this condition.
Dissecting pseudoaneurysm of the proper hepatic artery repaired by primary anastomosis: a case report
Authors: Roshan Razik, Aria Fallah, Charbel Sandroussi, Alice C Wei, Ian D McGilvray
Journal: Case Rep Surg (2012)

Background. Although rare, visceral artery pseudoaneurysms often present as surgical emergencies with a specific mortality rate as high as 35% related to aneurysmal rupture. Risk factors for the development of iatrogenic pseudoaneurysms include anticoagulation, female gender, obesity, and vessel calcification. Case Report. We present a case of an elderly female who developed a dissecting pseudoaneurysm of the proper hepatic artery after undergoing routine surgery to resect a large duodenal adenoma. Surgical repair comprised of resection and primary anastomosis was employed resulting in a favourable outcome. Discussion/Conclusion. Surgical management reduces the risk of hepatic ischemia, biliary complications, and abscess formation. Although stenting, coil embolization, and thrombin injection are all plausible options for management, we propose that surgical reconstruction be considered seriously as a treatment for such spontaneous pseudoaneurysms.
A multidisciplinary effort to increase COVID-19 vaccination among the older adults
Authors: Aminath S Moosa, Yi M S Wee, Meng H Jaw, Qifan F Tan, Wan L D Tse, Chui Y Loke, Guan L A Ee, Chee C D Ng, Wai K Aau, Yi L E Koh, Ngiap C Tan
Journal: Front Public Health (2022)
Keywords: covid-19, covid-19 vaccination, multidisciplinary team, older adult, vaccination program, vaccine promotion
MeSH terms: COVID-19 Vaccines, COVID-19 / prevention & control, Research Support, Non-U.S. Gov't, Aged, Aged, 80 and over, Health Personnel, Humans, Intention, Vaccination, COVID-19 Vaccines

Background:
COVID-19 vaccination significantly reduces the risk of infection and its associated morbidity and mortality. However, poor uptake of the COVID-19 vaccination was reported among the high-risk group of older people amidst emerging variants of concern. This community case study reports an outreach program in Singapore, COVE (COVID-19 Vaccination for the Elderly) initiated by healthcare workers in a cluster of primary care clinics. They assessed the vaccine hesitancy among these older persons, addressed their concerns and facilitated their vaccination appointment during a brief phone conversation.
Method:
Twenty one thousand six hundred and sixty three unvaccinated adults aged ≥60 years were contacted by healthcare worker volunteers over two phases from June to October 2021. In phase I, they contacted adults aged above 70 years over 2 weeks. Adults who were uncontactable in phase I and those aged 60-69 years were sent SMS in phase II. Data were analyzed via descriptive data analysis.
Results:
After phase 1, 65.5% (n = 5,646/8,617) of older adults had received at least one dose of the COVID-19 vaccine. The respondents expressed intention to vaccinate (39%, n = 3,390), requested to seek further information (25%, n = 2,138), reported access barrier (8%, n = 715), or were concerned of the vaccine adverse effects (3%, n = 288). Vaccination was refused by 24% (n = 2,086) of the respondents. Eventually 60.4% (n = 13,082/21,663) of them were vaccinated 3 months after COVE implementation.
Conclusion:
The COVE program increased the COVID-19 vaccination uptake of older adults from 84.6 to 96.3%. A person-centric proactive approach by healthcare workers addressed vaccine hesitancy and optimized vaccination. The outreach scheduling of vaccination appointments is key in promoting vaccination uptake among older adults.
Case Report: Intramammary lymph node metastasis of an unknown primary, probably occult breast, undifferentiated carcinoma
Authors: Zacharoula Sidiropoulou, Félix Adélia, Isabela Gil, Tobias Teles, Claudia Santos, Lucilia Monteiro
Journal: F1000Res (2017)
Keywords: breast cancer, intramammary lymph node metastasis, multidisciplinary approach, occult breast cancer

Little is known about the clinical importance of intramammary lymph node metastasis of breast cancer, even though it is not rare. In the present paper, the authors present an unusual, rare case of an intramammary lymph node metastasis of an unknown primary, probably occult breast cancer, and its management. The patient was submitted to various staging exams and surgical procedures and a definitive diagnosis was not established. From a multidisciplinary context, it was assumed that the patient had a breast triple negative primary with axillary involvement. This decision lead to adjuvant chemo and radiotherapy. Challenging cases like the one described here, should always be managed within the multidisciplinary team context and recorded in the institution's database.
Case of IV Stage Juvenile Nasopharyngeal Angiofibroma Presurgically Treated with a Single ECA Stop-Flow Embolization Technique Using Onyx 18
Authors: Eliodoro Faiella, Domiziana Santucci, Davide Fior, Federica Riva, Chiara Tagliaferri, Laura Demelas, Giovanni D' Aniello, Rosa Maria Muraca, Maurizio Bignami, Lorenzo Paolo Moramarco
Journal: Case Rep Otolaryngol (2023)
MeSH terms: Case Reports

Background:
Juvenile nasopharyngeal angiofibroma (JNA) is a rare tumor that mainly affects young boys. Its intervention may be complex due to its high vascularity, location, and extension. Preoperative embolization is used to prevent intrasurgical and postsurgical bleeding. Two main kinds of embolization are described in literature: intratumoral and transarterial, and numerous embolic materials are used. Case Presentation. We want to present a case of presurgical embolization of a stage IV JNA, performed using a single stop-flow balloon assisted technique with the balloon cuffed exclusively in the external carotid artery and using Onyx 18 as an embolic agent.
Conclusions:
The embolization with an exclusive external carotid artery single stop-flow technique using Onyx 18 is a safe, effective, and a definitive approach.
Ileal duplication cyst causing recurrent abdominal pain and melena
Authors: Muhammad Ali Sheikh, Tariq Latif, Masoom Ali Shah, Imran Hashim, Akhtar Jameel
Journal: APSP J Case Rep (2010)
Keywords: alimentary tract duplications, melena, pain abdomen
MeSH terms: Case Reports

Alimentary tract duplications are rare congenital anomalies. The presentation depends on their anatomical location, size and other characteristics. The most common variety is small bowel cystic duplication. We report a case of an eight years old girl who presented with recurrent abdominal pain and melena. Radioisotope technetium scan showed increased uptake of tracer in right lower abdomen and a diagnosis of Meckel's diverticulum made. At surgery a cystic, communicating, ileal duplication found which was resected along with adjacent gut. It is thus reiterated that while investigating children with recurrent abdominal pain and melena, gut duplications must be included in the differential diagnosis.
Effect of Cathodal Transcranial Direct Current Stimulation on a Child with Involuntary Movement after Hypoxic Encephalopathy
Authors: Mayumi Nagai, Naofumi Tanaka, Yutaka Oouchida, Shin-Ichi Izumi
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

The aim of the study was to investigate the effect of cathodal transcranial direct current stimulation to the supplementary motor area to inhibit involuntary movements of a child. An 8-year-old boy who developed hypoxic encephalopathy after asphyxia at the age of 2 had difficulty in remaining standing without support because of involuntary movements. He was instructed to remain standing with his plastic ankle-foot orthosis for 10 s at three time points by leaning forward with his forearms on a desk. He received cathodal or sham transcranial direct current stimulation to the supplementary motor area at 1 mA for 10 min. Involuntary movements during standing were measured using an accelerometer attached to his forehead. The low-frequency power of involuntary movements during cathodal transcranial direct current stimulation significantly decreased compared with that during sham stimulation. No adverse effects were observed. Involuntary movement reduction by cathodal stimulation to supplementary motor areas suggests that stimulations modulated the corticobasal ganglia motor circuit. Cathodal stimulation to supplementary motor areas may be effective for reducing involuntary movements and may be safely applied to children with movement disorders.