OpenMed/multicare-articles huggingface dataset:
Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy
Authors: Harmeet Dhani, Juan Pablo Hinestrosa, Jesus Izaguirre-Carbonell, Heath I Balcer, Razelle Kurzrock, Paul R Billings
Journal: Front Oncol (2023)
Keywords: ipmn, clinical utility, early cancer detection, early diagnosis, exosomes, extracellular vesicles, pancreatic ductal adenocarcinoma
MeSH terms: Case Reports

Background:
The detection of pancreatic ductal adenocarcinoma (PDAC) lesions at pre-cancerous or early-stages is critical to improving patient survival. We have developed a liquid biopsy test (ExoVita®) based on the measurement of protein biomarkers in cancer-derived exosomes. The high sensitivity and specificity of the test for early-stage PDAC has the potential to improve a patient's diagnostic journey in hopes to impact patient outcomes.
Methods:
Exosome isolation was performed using alternating current electric (ACE) field applied to the patient plasma sample. Following a wash to eliminate unbound particles, the exosomes were eluted from the cartridge. A downstream multiplex immunoassay was performed to measure proteins of interest on the exosomes, and a proprietary algorithm provided a score for probability of PDAC.
Results:
We describe the case of a 60-year-old healthy non-Hispanic white male with acute pancreatitis who underwent numerous invasive diagnostic procedures that failed to detect radiographic evidence of pancreatic lesions. Following the results of our exosome-based liquid biopsy test showing "High Likelihood of PDAC", in addition to KRAS and TP53 mutations, the patient decided to undergo a robotic pancreaticoduodenectomy (Whipple) procedure. Surgical pathology confirmed the diagnosis of high-grade intraductal papillary mucinous neoplasm (IPMN), which was consistent with the results of our ExoVita® test. The patient's post-operative course was unremarkable. At five-month follow-up, the patient continued to recover well without complications, in addition to a repeat ExoVita test which demonstrated "Low Likelihood of PDAC".
Conclusion:
This case report highlights how a novel liquid biopsy diagnostic test based on the detection of exosome protein biomarkers allowed early diagnosis of a high-grade precancerous lesion for PDAC and improved patient outcome.
Squamous cell carcinoma arising from an unknown primary site metastasizing to the stomach: A case report
Authors: Guangyao Wang, Ping Chen, Lei Shi, Wei Zhao
Journal: Oncol Lett (2014)
Keywords: gastric carcinoma, metastasis, squamous cell carcinoma

Primary squamous cell carcinoma (SCC) may originate elsewhere in the body, including the head, neck, lung, bronchus, cervix uteri, esophagus and cardia, and metastasize to the stomach. In the present report, a case is presented of an SCC, which arose from an unknown primary site and metastasized to the stomach of a 59-year-old male. The tumor was located in the interspace between the liver and the stomach. It involved the placenta percreta, lamina muscularis and submucosa, however, had already metastasized to a regional lymph node at the time of surgery. No SCC was observed in other organs on physical examination, which included positron emission tomography-computed tomography. In the follow-up period, there was no evidence of additional malignant tumors in the patient; therefore, the origin of the tumor was speculative. To the best of our knowledge, this is the first case report regarding a tumor of this type.
Case report: Osteitis/osteomyelitis pubis simulating acute appendicitis
Authors: James G Glasser
Journal: Int J Surg Case Rep (2018)
Keywords: acute appendicitis’ differential diagnosis, athletic (sports) hernia, osteitis pubis, osteomyelitis pubis

There is a continuum between Athletic (Sports) Hernia, Osteitis Pubis, and Osteomyelitis Pubis. The pubis is the site of attachment of many "core" muscles. A lay term used to describe a hernia is "rupture". Athletic hernia denotes a tear. Chronic musculotendinous strain may cause inflammation (osteitis pubis). An inflammatory focus may become a nidus for infection (osteomyelitis pubis). The symptoms caused by these three entities blur one with the other and with those characterizing acute appendicitis. This is an important association for clinicians to know.
Pneumonia due to a Rare Pathogen: Achromobacter xylosoxidans, Subspecies denitrificans
Authors: Hesham Awadh, Munthir Mansour, Obadah Aqtash, Yousef Shweihat
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Achromobacter xylosoxidans, subspecies denitrificans, is a gram-negative rod recently implicated as an emerging cause of infection in both immunosuppressed and immunocompetent populations. Few cases are reported in literature involving multiple body systems. Diagnosis depends on cultures of appropriate specimens, and management usually is by administration of appropriate antibiotics (usually agents with antipseudomonal activity). We report a rare case of pneumonia due to infection with this organism, in a patient with preexisting bronchiectasis secondary to chronic aspiration.
A novel approach to treat peri implantitis with the help of PRF
Authors: Rashmi Shah, Hemal Shah, Omkar Shetty, Gaurang Mistry
Journal: Pan Afr Med J (2017)
Keywords: prf, peri implantitis, keratinsed mucosa
MeSH terms: Dental Implants / adverse effects, Peri-Implantitis / therapy, Platelet-Rich Fibrin, Case Reports, Female, Humans, Middle Aged, Stomatitis / therapy, Tissue Engineering / methods, Dental Implants

A new field of biomédical science, known as tissue engineering, applies the principles of biology and engineering to the development of functional substitutes for tissues and organs. Little is known about the influence of Keratinised Mucosa dimension around implants on the soft and hard tissue health The purpose of this case report is to understand the importance of healthy tissue around the implants for long term success and how biomimetic materials like PRF Membrane can be incorporated in treatment plan as an important modality in selected cases.
Case report of a 65-year-old man with biatrial metastatic localisation from poorly differentiated cutaneous squamous cell carcinoma
Authors: Lorenzo Dottorini, Italo Sarno, Pasquale Scopelliti, Gianluca Cotroneo, Maribel Duluc, Alessandro Iaculli, Nicola Giuntini, Federica Brena, Giuseppe Nastasi
Journal: Ecancermedicalscience (2019)
Keywords: atrial metastases, biatrial, cancer, carcinoma, cutaneous, heart, skin
MeSH terms: Case Reports

We report the case of an immunocompetent 65-year-old man affected by cutaneous squamous cell carcinoma (cSCC) with lung and biatrial metastatic localisation. In May 2018, the patient underwent lower limb amputation due to the finding of a large ulceration which upon biopsy was found to be a poorly differentiated squamous cell carcinoma (SCC), ulcerated, full-thickness infiltrating from the skin to the underlying bone tissue. After 1 month, a radiological restaging found multiple pulmonary localisations and a right-atrial metastatic localisation. The patient was then studied in-depth and a transesophageal echocardiogram found that the patient had two 2 and 5 cm metastatic localisations in the left atrium and a 3-cm metastatic localisation in the right atrium. Informed about the clinical situation and about the risks of a chemotherapeutic treatment, the patient decided not to start any treatment. This case represents, to our knowledge, the only case of a biatrial metastatic localisation from cSCC and is representative of how cardiac symptoms and signs in patients affected by this disease must be evaluated.
Hepatitis B viremia manifesting as polyarteritis nodosa and secondary membranous nephropathy
Authors: Manish Rameshlal Balwani, Vivek B Kute, Pankaj R Shah, Maulin Shah, Saiprasad G Shinde, Jay Shah, Hargovind L Trivedi
Journal: J Nephropharmacol (2016)
Keywords: hepatitis b, membranous nephropathy, plasmapheresis, polyarteritis nodosa
MeSH terms: Case Reports

Renal involvement in hepatitis B-polyarteritis nodosa (HBV-PAN) usually occurs in the form of hypertension, microscopic hematuria, proteinuria but nephrotic range proteinuria or renal failure is very uncommon. A 60-year-old man had abdominal pain for 15 days which was followed by bilateral pedal edema in a day and in next three days he had sudden onset bilateral foot drop with numbness. He had weight loss of 10 kg in last 20 days. Pedal edema was pitting, bilateral. Macular skin rashes around both ankles were present. Serum creatinine was 2.4 mg/dl and blood urea nitrogen was 102 mg/dl.24 hour proteinuria was 3.4 g/day. Serum HBsAg, HBeAg and anti-HBc IgM were positive. Serum HBV-DNA level (PCR) was 582917 copies/ml. The nerve conduction study showed axonal and demyelinating polyneuropathy in bilateral lower limbs. A kidney biopsy revealed membranous nephropathy (MN). Doppler for renal vessels was normal. Prednisolone (60 mg/day), plasmapheresis (5 courses) and entecavir (0.5 mg/ every second day) were started. At 2 months follow up, patient improved in the form of grade 3/5 power in both lower limbs with sensory improvement. Twenty-four hours proteinuria decreased to 800 mg/day and serum creatinine reached to 1.5 mg/dl. Polyarteritis nodosa was due to HBV infection, but the etiology of MN was uncertain, as it has rarely been described in PAN. Proteinuria responded to nucleoside analogue therapy. So patient was considered to have an association of classic PAN and MN, both related to HBV. Patient responded to combined treatment of steroid, plasmapheresis and nucleoside analogue.
Mechanism of Action and Clinical Efficacy of CDK4/6 Inhibitors in BRCA-Mutated, Estrogen Receptor-Positive Breast Cancers: Case Report and Literature Review
Authors: Anna Maria Militello, Teresa Zielli, Daniela Boggiani, Maria Michiara, Nadia Naldi, Beatrice Bortesi, Paola Zanelli, Vera Uliana, Sara Giuliotti, Antonino Musolino
Journal: Front Oncol (2019)
Keywords: brca, cdk4/6 inhibitor, breast cancer, cyclin d1, endocrine therapy, estrogen receptor, homologous recombination
MeSH terms: Case Reports

Sensitivity to endocrine therapy of patients with estrogen receptor (ER)-positive metastatic breast cancer and germline BRCA1/2 mutations is not yet fully elucidated. Furthermore, the registration trials of CDK 4/6 inhibitors in combination with endocrine therapy lacked of a pre-specified subgroup analysis in BRCA1/2 mutation carriers. We report clinical history of two patients with BRCA-mutated, ER-positive metastatic breast cancer treated with letrozole plus the CDK 4/6 inhibitor palbociclib. Biological and clinical implications of the treatment outcome observed in the two cases are discussed with the knowledge of scientific evidence to date available. Overall, biological rationale, preclinical, and clinical data support the prominent role of CDK 4/6 inhibitors plus endocrine therapy, even in combination with PARP inhibitors, in the treatment of BRCA-mutated, ER-positive breast cancers. However, the interaction between Cyclin/CDK pathway, ER and BRCA is complex and evidences reported so far, albeit reliable, await confirmation in the context of future randomized clinical trials.
Successful pregnancies in post-kidney transplant couples: four case reports
Authors: Hao Huang, Xinyu Liu, Xiaoli Lin, Xiaoying Wu, Yingyin Qiu, Hongfeng Huang
Journal: Front Immunol (2023)
Keywords: couple, immunity, kidney transplantation, pre-eclampsia, pregnancy
MeSH terms: Kidney Transplantation / adverse effects, Pre-Eclampsia, Case Reports, Research Support, Non-U.S. Gov't, Adult, Cesarean Section / adverse effects, Female, Humans, Infant, Newborn, Infant, Premature, Pregnancy, Pregnancy Outcome

Background:
The fertility of female kidney transplant recipients is increasing with the progression of transplant management. This article aims to evaluate the clinical prognosis of mothers and newborns for post-kidney transplant couples.
Methods:
From January 2019 to April 2022, a total of four couples, all kidney transplant recipients, were successfully prepared for pregnancy after a rigorous preconception evaluation, including three cases of natural conception and one case of in vitro fertilization. Data regarding the mother and newborn, including general clinical condition and laboratory results, were recorded and assessed throughout the pregnancy and up until 12 months after delivery.
Results:
The mean conception age of the mothers was 34.8 years (30-38 years), and the mean interval between renal transplantation and pregnancy was 6.6 years (3.7-8.7 years). All deliveries were by cesarean section and took place without incident. There were three premature births (<37 weeks; average 35.1 weeks). In case 1 (in vitro fertilization), pre-eclampsia occurred during maternity, and this was the only case in which the fetal weight was less than 2,500 g (average 2,576.7 g). The mean Apgar score (1 min) was 7.8 (6-9) and reached 9 in all cases at 5 min. The mothers' eGFR rose during mid-gestation, decreased in late pregnancy, and was largely restored along with proteinuria 1 year postpartum. Postnatal evaluation at 6 months showed normal neurological development. In addition, NK cell and IFN-γ levels increased and Treg cell and IL-10 levels decreased along with the onset of pre-eclampsia.
Conclusions:
Pregnancies can succeed in couples who are both kidney transplant recipients. However, there might be higher risks of infertility, prematurity, and low birth weight.
Case report: A de novo Non-sense SOX9 mutation (p.Q417*) located in transactivation domain is Responsible for Campomelic Dysplasia
Authors: Xingxing Qiao, Liping Wu, Jianjun Tang, Rong Xiang, Liangliang Fan, Hao Huang, Yaqin Chen
Journal: Front Pediatr (2023)
Keywords: sox9, campomelic dysplasia, non-sense, terminated mutation, transactivation
MeSH terms: Case Reports

Background:
Campomelic dysplasia (CD) is an autosomal dominant skeletal dysplasia syndrome characterized by shortness and bowing of lower extremities, and often accompanied by XY sex reversal. Heterozygous pathogenic variants of SOX9 or rearrangement involving the long arm of chromosome 17 are the causes of disease. However, evidence for pathogenesis of SOX9 haploinsufficiency is insufficient.
Methods:
We enrolled a Chinese family where the fetus was diagnosed with CD. The affected fetus was selected for whole-exome sequencing to identify the pathogenic mutations in this family.
Results:
After data filtering, a novel non-sense SOX9 variant (NM_000346.3; c.1249C > T; p.Q417*) was identified as the pathogenic lesion in the fetus. Further co-segregation analysis using Sanger sequencing confirmed that this novel SOX9 mutation (c.1249C > T; p.Q417*) was a de novo mutation in the affected fetus. This terminated codon mutation identified by bioinformatics was located at an evolutionarily conserved site of SOX9. The bioinformatics-based analysis predicted this variant was pathogenic and affected SOX9 transactivation activity.
Conclusion:
CD is a rare condition, which connected with SOX9 tightly. We identified a novel heterozygous SOX9 variant (p.Q417*) in a Chinese CD family. Our study supports the putative reduced transactivation of SOX9 variants in the pathogenicity of CD.
Tuberculous aortitis as a rare cause of aortobronchial fistula with massive haemoptysis: A case report
Authors: Joseph Motshedi Sekgololo, Chauke Risenga Frank, Vally Moinuddeen, Dehghan-Dehnavi Alireza, Khaba Moshawa Calvin
Journal: Int J Surg Case Rep (2020)
Keywords: aortobronchial, aortobronchopulmonary, aortopulmonary, fistula
MeSH terms: Case Reports

Background:
Aortobronchial fistula is a rare condition, which is difficult to diagnose. It is fatal if misdiagnosed or not well treated. Massive haemoptysis is usually the first common symptom. Computed tomography angiogram (CTA) is the best non-invasive diagnostic modality. Treatment options include open repair procedure or Transthoracic Endovascular Aortic Repair (TEVAR) and resection of the destroyed lung tissue. The recurrent rate is high.
Case presentation:
This report is a case of a 26-year-old African female patient who presented with massive haemoptysis. She had been treated for pulmonary tuberculosis two years before. The patient was diagnosed with retroviral disease and had been on treatment for two years. She underwent a 2-stage repair procedure. The initial treatment was TEVAR, which was followed by lung resection after two weeks. Both operations were uneventful. Histopathology analysis confirmed tuberculous aortitis as aetiology. The patient had been followed up for a year, with no recurrence.
Discussion:
Aortobronchial is divided into primary and secondary subtypes. Primary aortobronchial fistula is commonly caused by inflammatory disease and atherosclerosis. Secondary aortobronchial fistula is a complication of surgery for thoracic aorta and congenital cardiac disease. Tuberculous fistula is an uncommon cause of aortobronchial fistula. Surgery for aortobronchial fistula should include controlling both aortic and pulmonary fistula sites. A healthy tissue or muscle flap should be used between the repaired sites to prevent refistulisation. Recurrence is common; hence, long-term follow up is important.
Conclusion:
Early diagnosis and adequate treatment are important. A high index of suspicion is important for diagnosis, because the diagnosis is difficult.
Gastrointestinal neoplasia associated with bowel parasitosis: real or imaginary?
Authors: Michael R Peterson, Noel Weidner
Journal: J Trop Med (2011)

Several parasitic species are well known to have carcinogenic properties, namely; Schistosoma hematobium (squamous cell carcinoma of the bladder) and the liver flukes Opisthorchis and Chlonorchis (cholangiocarcinoma). A large number of parasites are known to colonize the gastrointestinal tract. We sought to review the evidence that implicates these parasites in gastrointestinal neoplasia. Schistosoma japonicum, which is endemic primarily in east Asia, has been shown in multiple studies to convey a mildly increased risk of colorectal adenocarcinoma. The data supporting a causative role for Schistosoma mansoni in colorectal or other neoplastic processes are less convincing, limited primarily to small case-control studies and case series. Reports of possible associations between other gastrointestinal parasites (e.g., E. histolytica and A. lumbricoides) and neoplasia may be found in the literature but are limited to individual cases. We conclude that, other than S. japonicum and to a lesser extent S. mansoni, there is little evidence of an association between gastrointestinal parasites and neoplasia.
When to Start and Stop Bone-Protecting Medication for Preventing Glucocorticoid-Induced Osteoporosis
Authors: Kaleen N Hayes, Ulrike Baschant, Barbara Hauser, Andrea M Burden, Elizabeth M Winter
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: anti-resorptive treatment, bisphosphonates, bone density, bone density conservation agents, bone fractures, glucocorticoid-induced osteoporosis, glucocorticoids, teriparatide
MeSH terms: Bone Density / drug effects, Bone Density Conservation Agents / administration & dosage, Glucocorticoids / adverse effects, Osteoporosis / chemically induced, Osteoporosis / drug therapy, Withholding Treatment, Case Reports, Review, Bone Density / physiology, Female, Fractures, Bone / diagnostic imaging, Fractures, Bone / prevention & control, Glucocorticoids / administration & dosage, Humans, Lupus Erythematosus, Systemic / diagnostic imaging, Lupus Erythematosus, Systemic / drug therapy, Middle Aged, Osteoporosis / diagnostic imaging, Time-to-Treatment, Bone Density Conservation Agents, Glucocorticoids

Glucocorticoid-induced osteoporosis (GIOP) leads to fractures in up to 40% of patients with chronic glucocorticoid (GC) therapy when left untreated. GCs rapidly increase fracture risk, and thus many patients with anticipated chronic GC exposures should start anti-osteoporosis pharmacotherapy to prevent fractures. In addition to low awareness of the need for anti-osteoporosis therapy among clinicians treating patients with GCs, a major barrier to prevention of fractures from GIOP is a lack of clear guideline recommendations on when to start and stop anti-osteoporosis treatment in patients with GC use. The aim of this narrative review is to summarize current evidence and provide considerations for the duration of anti-osteoporosis treatment in patients taking GCs based on pre-clinical, clinical, epidemiologic, and pharmacologic evidence. We review the pathophysiology of GIOP, outline current guideline recommendations on initiating and stopping anti-osteoporosis therapy for GIOP, and present considerations for the duration of anti-osteoporosis treatment based on existing evidence. In each section, we illustrate major points through a patient case example. Finally, we conclude with proposed areas for future research and emerging areas of interest related to GIOP clinical management.
Veillonella montpellierensis endocarditis
Authors: Clarisse Rovery, Anne Etienne, Cédric Foucault, Pierre Berger, Philippe Brouqui
Journal: Emerg Infect Dis (2005)
MeSH terms: Endocarditis, Bacterial / microbiology, Gram-Negative Bacterial Infections / microbiology, Veillonella / isolation & purification, Case Reports, Review, Aged, Anti-Bacterial Agents / therapeutic use, Female, Gram-Negative Bacterial Infections / diagnosis, Gram-Negative Bacterial Infections / drug therapy, Humans, Anti-Bacterial Agents

Veillonella spp. rarely cause infections in humans. We report a case of Veillonella endocarditis documented by isolating a slow-growing, gram-negative microbe in blood cultures. This microbe was identified as the newly recognized species Veillonella montpellierensis (100% homology) by 16S RNA gene sequence analysis.
3D Reconstruction and Prediction of Sialolith Surgery
Authors: Jamyson Oliveira Santos, Brunna da Silva Firmino, Matheus Santos Carvalho, Jean de Pinho Mendes, Lucas Novaes Teixeira, Sérgio Lúcio Pereira de Castro Lopes, André Luiz Ferreira Costa, Antonione Santos Bezerra Pinto
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Imaging examinations play an important role in the diagnosis of sialolithiasis, whose symptoms are initially confounded with other diseases. The objective of the present case report is to highlight imaging and processing techniques as well as image analysis for the preoperative assessment and planning of surgical interventions and adequate treatment of massive sialoliths. A 35-year-old male patient presented complaining of pain in the submandibular region and purulent secretions from a lingual caruncle with slightly increased volume in the region. Imaging examinations were ordered as follows: cone beam computed tomography, ultrasonography, and three-dimensional reconstruction, including clinical evaluation. A final diagnosis of sialolithiasis was established. Surgery was indicated and carried out by using a lateral transcervical approach for complete resection of the gland, which was based on the calculation of the total volume of the sialolith, thus increasing the surgery's success.