OpenMed/multicare-articles huggingface dataset:
Pharmacogenomic Testing to Guide Personalized Cancer Medicine Decisions in Private Oncology Practice: A Case Study
Authors: George Astras, Christos I Papagiannopoulos, Konstantinos A Kyritsis, Constantina Markitani, Ioannis S Vizirianakis
Journal: Front Oncol (2020)
Keywords: next generation sequencing, oncology, personal cancer genome sequencing, pharmacogenomic testing, precision medicine, routine clinical practice, targeted therapeutics

Innovative tumor profiling methodologies are utilized to elucidate the pharmacogenomic landscape of tumor cells in order to support the molecularly guided delivery of therapeutics. Indeed, improved clinical outcomes are achieved in oncology practice by providing the physicians with expert-guided, standardized, and easily interpretable knowledge, translated from molecular profiling analysis to support clinical decision-making. However, there is still limited utilization of the technology especially in small private oncology practices. In this work, we analyzed how molecularly guided interventions in 17 consented cancer patients led to an overall improvement of disease response rates in a private oncology center. The precision medicine strategy was based on the OncoDEEP™ profiling solutions and focused on finding clinically actionable relationships between tumor biomarkers and drug responses. The obtained data support the notion that (a) following the pharmacogenomic-derived recommendations favorably impacted cancer therapy progression, and (b) the earlier profiling followed by the delivery of molecularly targeted therapy led to more durable and improved pharmacological response rates. Moreover, we report the example of a patient with metastatic gastric adenocarcinoma who, based on the molecular profiling data, received an off-label therapy that resulted in a complete response and a current cancer-free maintenance status. Overall, our data provide a paradigm on how molecular tumor profiling can improve decision-making in the routine private oncology practice.
Myocardial infarction in a young female with palindromic rheumatism: a consequence of negative remodeling
Authors: Timothy R Larsen, Sachin Kumar Amruthlal Jain, Jamal Zarghami, Shukri David
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Palindromic rheumatism is a rare disease associated with systemic inflammation. Negative or constrictive coronary artery remodeling is typically not seen until the 7th or 8th decade of life. We report a case of a young female with palindromic rheumatism who suffered a non-ST segment elevation myocardial infarction secondary to a flow-limiting lesion that demonstrated negative remodeling by intravascular ultrasound (IVUS).
Pacemaker related infective endocarditis from Staphylococcus lugdunensis: a case report
Authors: Michael Ward, Kevin M Boehm
Journal: Case Rep Crit Care (2013)

Staphylococcus lugdunensis is a common skin flora not typically associated with infection. There are, however, several cases reported in the literature of Staphylococcus lugdunensis as a causative bacterium of various infections. This paper reports an additional case of pacemaker associated endocarditis with Staphylococcus lugdunensis as the causative bacterium.
Fetal Sirenomelia Associated with an Abdominal Cyst Originating from a Saccular Cloaca
Authors: Yui Kinjo, Hitoshi Masamoto, Hayase Nitta, Tadatsugu Kinjo, Tomoko Tamaki, Naoki Yoshimi, Yoichi Aoki
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

A 40-year-old pregnant woman presented with a fetal abdominal cyst and oligohydramnios. Color Doppler scan revealed a single blood vessel from the fetal aorta into a single umbilical artery. Severe oligohydramnios limited ultrasonographic evaluation of the fetal lower limbs, kidneys, or bladder. The pregnancy was terminated; the fetus showed fused lower limbs, bulging abdomen, and absent external genitalia and was diagnosed with type III sirenomelia. On autopsy, no normal bladder was observed, but duodenal atresia, anorectal atresia, and right renal agenesis were found. An intra-abdominal cyst, diagnosed histologically as a saccular cloaca, occupied the abdominal cavity. Ultrasonographic diagnosis of fetal sirenomelia is difficult due to poor depiction of the lower limbs. A vitelline artery leading to a single umbilical artery and a fetal abdominal cyst occupying most of the abdominal cavity are considered fetal sirenomelia associated with large defects of the gastrointestinal and genitourinary tracts.
Idiopathic Calcinosis Cutis in a Child: Report of a Rare Case
Authors: Muhannad Al Wadany, Feras Al Wadany, Abdulelah Almousa, Farah Almoussa, Ahlam Alharbi
Journal: Cureus (2023)
Keywords: calcification, calcinosis cutis, case report, idiopathic, knee lesion
MeSH terms: Case Reports

Calcinosis cutis is characterized by the deposition of calcium salts in the skin and subcutaneous tissue. Calcinosis cutis has different types, but the idiopathic type is considered the rarest type. We present the case of a 10-year-old boy who presented with a skin lesion on his right knee. No other similar nodules were noted elsewhere in the body. The lesion was first noted one year ago, and it slightly increased in size. The lesion was not pruritic and did not ulcerate. No history of previous trauma was provided. On physical examination, a nontender, firm, immobile, reddish, solitary nodule of 2 cm in diameter was observed on the extensor surface of the right knee. The patient underwent complete laboratory investigations that included hematological, biochemical, and immunological parameters, which yielded normal results. Excisional biopsy was performed, and histopathological examination revealed well-circumscribed deposits of basophilic materials in the subcutaneous tissue that is consistent with calcium deposits of calcinosis cutis. Idiopathic calcinosis cutis is a rare condition in children, particularly if it has a unilateral distribution. Proper evaluation should be performed to rule out any associated metabolic or systemic disorders that may alter the management pathway.
Postoperative gastric dilatation causing abdominal compartment syndrome
Authors: Ahmad Mahajna, Sharon Mitkal, Michael M Krausz
Journal: World J Emerg Surg (2008)

Objective:
To study the effect of postoperative gastric dilatation on intra-abdominal pressure (IAP).
Design and setting:
Single case report from a primary teaching hospital.
Patients and methods:
A 72-year-old woman demonstrated a sudden respiratory and cardiovascular collapse following resection of a retroperitoneal sarcoma. This collapse was caused by abdominal compartment syndrome due to gastric dilatation.
Results:
The patient was re-explored, an enormously distended stomach was found with the nasogastric tube situated in a small sliding hernia which prevented drainage of the distended stomach. Re-positioning of the nasogastric tube, allowed the decompression of the stomach and the patient's condition immediately improved.
Conclusion:
Acute abdominal distention following major abdominal surgery may result from acute gastric dilatation, leading to oliguria and increased airway pressures. Untreated gastric dilatation can cause abdominal compartment syndrome.
Combining Mental Training and Physical Training With Goal-Oriented Protocols in Stroke Rehabilitation: A Feasibility Case Study
Authors: Xin Zhang, Ahmed M Elnady, Bubblepreet K Randhawa, Lara A Boyd, Carlo Menon
Journal: Front Hum Neurosci (2018)
Keywords: bci, fes, exoskeleton, mental training, physical training, stroke rehabilitation

Stroke is one of the leading causes of permanent disability in adults. The literature suggests that rehabilitation is key to early motor recovery. However, conventional therapy is labor and cost intensive. Robotic and functional electrical stimulation (FES) devices can provide a high dose of repetitions and as such may provide an alternative, or an adjunct, to conventional rehabilitation therapy. Brain-computer interfaces (BCI) could augment neuroplasticity by introducing mental training. However, mental training alone is not enough; but combining mental with physical training could boost outcomes. In the current case study, a portable rehabilitative platform and goal-oriented supporting training protocols were introduced and tested with a chronic stroke participant. A novel training method was introduced with the proposed rehabilitative platform. A 37-year old individual with chronic stroke participated in 6-weeks of training (18 sessions in total, 3 sessions a week, and 1 h per session). In this case study, we show that an individual with chronic stroke can tolerate a 6-week training bout with our system and protocol. The participant was actively engaged throughout the training. Changes in the Wolf Motor Function Test (WMFT) suggest that the training positively affected arm motor function (12% improvement in WMFT score).
Nodular Scleritis Associated with Herpes Zoster Virus: An Infectious and Immune-Mediated Process
Authors: Mónica Loureiro, Renata Rothwell, Sofia Fonseca
Journal: Case Rep Ophthalmol Med (2016)

Purpose. To describe a case of anterior nodular scleritis, preceded by an anterior hypertensive uveitis, which was primarily caused by varicella zoster virus (VZV). Case Report. A 54-year-old woman presented with anterior uveitis of the right eye presumably caused by herpetic viral disease and was successfully treated. Two months later, she developed a nodular scleritis and started oral nonsteroidal anti-inflammatory without effect. A complete laboratory workup revealed positivity for HLA-B27; the infectious workup was negative. Therapy was changed to oral prednisolone and an incomplete improvement occurred. Therefore, a diagnostic anterior paracentesis was performed and the polymerase chain reaction (PCR) analysis revealed VZV. She was treated with valacyclovir and the oral prednisolone began to decrease; however, a marked worsening of the scleritis occurred with the reduction of the daily dose; subsequently, methotrexate was introduced allowing the suspension of the prednisolone and led to clinical resolution of the scleritis. Conclusion. This report of anterior nodular scleritis caused by VZV argues in favor of an underlying immune-mediated component, requiring immunosuppressive therapy for clinical resolution. The PCR analysis of the aqueous humor was revealed to be a valuable technique and should be considered in cases of scleritis with poor response to treatment.
Hand-Assisted Laparoscopic Donor Nephrectomy in Complete Situs Inversus
Authors: John V Gahagan, Matthew D Whealon, Uttam Reddy, Clarence E Foster 3rd, Hirohito Ichii
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Complete situs inversus is a rare congenital anomaly characterized by transposition of organs. We report a case of renal transplantation using a kidney from a living complete situs inversus donor. The recipient was a 59-year-old female with end-stage renal disease because of type 2 diabetes mellitus. The donor was the 56-year-old sister of the recipient with complete situs inversus. CT angiogram of the abdomen and pelvis showed complete situs inversus and an otherwise normal appearance of the bilateral kidneys with patent bilateral single renal arteries and longer renal vein in the right kidney. The patient was taken to the operating room for a hand-assisted laparoscopic right donor nephrectomy. The patient tolerated the procedure well and was discharged home in good condition on postoperative day 1. The recipient experienced no episodes of acute rejection or infection, with serum creatinine levels of 0.8-1.2 mg/dL. Laparoscopic donor nephrectomy in a patient with complete situs inversus remains a technically feasible operation and the presence of situs inversus should not preclude consideration for living kidney donation.
One for two, ipsilateral reduction and contralateral reconstruction mammoplasty: A case report
Authors: Abdulwahid M Salih, Zuhair D Hammood, Fahmi H Kakamad, Karzan M Salih, Hiwa O Baba, Hunar A Hassan, Shvan H Mohammed, Goran A Qadir, Hemn A Hassan, Ismael Y Abdullah
Journal: Int J Surg Case Rep (2020)
Keywords: case report, flap, mammoplasty, reduction
MeSH terms: Case Reports

Introduction:
The aim of this paper is to introduce a novel procedure for concomitant contralateral reduction and ipsilateral reconstruction mammoplasty by dividing the contralateral breast and creating a pectoralis myocutaneous flap for reconstruction.
Presentation of case:
A 34-year-old female, with a history of left side mastectomy presented for reconstruction. Under general anesthesia, the scar of the previous operation was resected in an elliptical shaped incision, the right breast was divided in middle, leaving the flap (pectoralis myocutaneous flap) with pectoralis branch of thoracoacromial artery. The superiomedial part of right breast (the flap) was rotated under the bridge of intermammary skin into the left incision. Ten days after the operation, the flap was viable and healthy.
Discussion:
The aim of breast reconstruction is to provide psychosocial support and improve quality of life in the long term by restoring the shape of the breast surgically. New techniques have emerged constantly, and each comes with its list of advantages and risks. The benefits of reconstruction are clear, yet often it is not found as a part of breast cancer treatment routinely.
Conclusion:
In single session reduction mammoplasty in one breast and using the resected piece as a flap to reconstruct the contralateral breast is possible whenever indication.
Encouraging Early Outcomes of Treatment With Arsenic Trioxide Combined With Chemotherapy for Alveolar Rhabdomyosarcoma in Children: 4 Case Reports
Authors: Xiaomin Peng, Xilin Xiong, Yang Li, Chuchu Feng, Hongyan Liu, Pingping Wu, Chunmou Li, Wenjun Weng
Journal: Front Oncol (2021)
Keywords: ato, alveolar rhabdomyosarcoma, arsenic trioxide, chemotherapy, children

Background:
Alveolar rhabdomyosarcoma (ARMS) is a subtype of rhabdomyosarcoma characterized by its aggressive behavior and poor prognosis, highlighting the need for novel treatment options. Arsenic trioxide (ATO) has been shown to specifically inhibit tumor growth and the metastasis of ARMS in vitro by acting on the hedgehog pathway. Here we report on a pilot clinical study to evaluate the activity of an ATO-combined chemotherapy approach for the treatment of ARMS patients.
Methods:
We designed a therapeutic schedule of an ATO-combined chemotherapy, incorporating comprehensive management according to the Intergroup Rhabdomyosarcoma Study Group protocol. ATO was administered at 0.16 mg/kg per day over 8 h via an IV for 10 days combined with a chemotherapeutic regimen of vincristine, actinomycin, and cyclophosphamide (VAC regimen) on the third day, which was repeated every 21 days. A total of eight cycles of ATO-combined chemotherapy were applied throughout the entire scheme.
Results:
A total of three refractory/recurrent and one untreated ARMS patient, three male and one female, with a median age of 5.8 years (range, 5.1 to 12.5 years), were enrolled in the present study. All patients were sensitive to combined chemotherapy with ATO and achieved partial or complete remission during treatment. Except for reversible gastrointestinal reaction and myelosuppression, no other adverse events were observed during the process of treatment.
Conclusions:
The combined chemotherapy of ATO and the VAC regimen exhibited beneficial activities against ARMS in pediatrics and was well tolerated, but prospective large-scale clinical trials are warranted to determine the long-term efficacy, optimal courses, and late toxicity in this population.
Bilateral Hypertrophy of the m. Tensor Fascia Latae
Authors: Cedric De Clercq, Lennart Jans, Koenraad Verstraete
Journal: J Belg Soc Radiol (2022)
Keywords: mri, tfl, hypertrophy, pseudotumor, tensor fascia latae
MeSH terms: Case Reports

Teaching point: Hypertrophy of the m. tensor fascia lata mimics a soft tissue tumor, but understanding of its presentation on MRI prevents unnecessary biopsy.
Primary Sjogren's Syndrome Associated With Treatment-Resistant Obsessive-Compulsive Disorder
Authors: Lawrence T C Ong, Gary Galambos, David A Brown
Journal: Front Psychiatry (2017)
Keywords: sjogren’s syndrome, autoimmune serology, major depressive disorder, obsessive–compulsive disorder, treatment resistance
MeSH terms: Case Reports

There is an increasing awareness that autoimmune diseases can present with neuropsychiatric manifestations. We present the case of a 17-year-old female requiring psychiatric hospitalization for obsessive-compulsive disorder and major depressive disorder with mixed affective features, who was subsequently diagnosed with primary Sjogren's syndrome. Treatment with potent immunosuppression resulted in remission of psychiatric illness. Due to a lack of awareness and/or the lack of specific biomarkers, clinicians may not associate psychiatric symptoms with autoimmune disease, including primary Sjogren's syndrome. This case demonstrates that Sjogren's syndrome may be a causative or aggravating factor in mental disorders and that autoimmune diseases should be carefully considered in the differential diagnosis of psychiatric illness especially in cases of concurrent physical symptomatology and severity or treatment resistance of psychiatric disease.
Azacitidine-induced cryptogenic organizing pneumonia: a case report and review of the literature
Authors: Yanal Alnimer, Samer Salah, Bashar Abuqayas, Kamal Alrabi
Journal: J Med Case Rep (2016)
MeSH terms: Adrenal Cortex Hormones / therapeutic use, Antimetabolites, Antineoplastic / adverse effects, Azacitidine / adverse effects, Cryptogenic Organizing Pneumonia / chemically induced, Lung / pathology, Myelodysplastic Syndromes / drug therapy, Case Reports, Review, Antimetabolites, Antineoplastic / administration & dosage, Azacitidine / administration & dosage, Bronchoscopy / methods, Cough / etiology, Cryptogenic Organizing Pneumonia / complications, Cryptogenic Organizing Pneumonia / physiopathology, Cryptogenic Organizing Pneumonia / therapy, Home Care Services, Humans, Lung / diagnostic imaging, Lung / drug effects, Male, Middle Aged, Oxygen Inhalation Therapy, Radiography, Treatment Outcome, Adrenal Cortex Hormones, Antimetabolites, Antineoplastic, Azacitidine

Background:
Myelodysplasia syndrome is a heterogeneous group of hematological disorders that are characterized by abnormal morphology and cytopenias of bone marrow elements. Azacitidine is a hypomethylating agent that is commonly used in treatment of myelodysplasia syndrome. We present an extremely rare case of cryptogenic organizing pneumonia following therapy with azacitidine and a review of the relevant literature. This is the fifth case of azacitidine-induced interstitial lung disease and the sixth one due to hypomethylating drugs; of interest, this is the first reported case that has occurred after the second cycle. Our case report highlights an important, potentially treatable and rare side effect of azacitidine and hypomethylating agents in general that might be overlooked by oncologists. Furthermore, our review of the literature showed heterogeneity in the clinical outcome which might, in part, be due to delay in initiating corticosteroids treatment.
Case presentation:
A 67-year-old white man presented with worsening shortness of breath and mild productive cough that started 1 week prior to his presentation. An initial chest X-ray showed infiltration of both lung fields. Radiographic findings of computed axial tomography, results of bronchoscopy and a lung biopsy were consistent with cryptogenic organizing pneumonia. The patient showed variable clinical response to steroids and he remained dependent on home oxygen.
Conclusions:
We concluded that there is a recognizable potentially life-threatening toxicity due to organizing pneumonia secondary to azacitidine in the setting of myelodysplasia syndrome treatment. This toxicity is not limited to the first cycle as in previous cases; furthermore, pleural effusion can be associated with this toxicity. Health care professionals should be aware of this recognizable side effect. Early recognition and timely management are critical to prevent permanent lung fibrosis.
Unilateral Head Impulses Training in Uncompensated Vestibular Hypofunction
Authors: Ana Carolina Binetti, Andrea Ximena Varela, Dana Lucila Lucarelli, Daniel Héctor Verdecchia
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

The aim of this paper is to report a case of a young woman with unilateral vestibular chronic failure with a poorly compensated vestibuloocular reflex during rapid head rotation. Additionally, she developed migraine symptoms during the treatment with associated chronic dizzy sensations and blurred vision. Her report of blurred vision only improved after she completed a rehabilitation program using fast head impulse rotations towards the affected side for 5 consecutive days. We discuss why we elected this form of treatment and how this method may be useful for different patients.
Case Report: Avelumab and ruxolitinib to manage polycythemia vera and secondary metastatic Merkel cell carcinoma: a possible successful combination
Authors: Chiara Masucci, Mauro Passucci, Emilia Scalzulli, Ida Carmosino, Marcello Capriata, Alessandro Costa, Claudia Ielo, Maurizio Martelli, Massimo Breccia
Journal: Front Oncol (2023)
Keywords: merkel cell carcinoma, avelumab, polycytemia vera, ruxolitinib, second malignancies
MeSH terms: Case Reports

We describe a case of second primary malignancy in a 65-year-old patient affected by polycythemia vera treated with the JAK 1/2 inhibitor ruxolitinib. The latter is recognized as a risk factor for the onset of non-melanoma skin cancers in many retrospective and perspective studies, but the concomitant use of ruxolitinib with new immunotherapies is very rarely reported, and the safety of this association is still not clear. In our case, ruxolitinib combined with the anti-PD-L1 avelumab demonstrated both safety and efficacy for hematological disease control and underlying carcinoma remission.
Combined Tumors in Hematolymphoid Neoplasms: Case Series of Histiocytic and Langerhans Cell Sarcomas Arising From Low-Grade B-Cell Lymphoma
Authors: Stephanie L Skala, Jing C Ye, Jennifer Stumph, William R Macon, Frances R Quinones, Vadim Khachaturov, Rhett P Ketterling, Rajan Dewar
Journal: Clin Pathol (2019)
Keywords: langerhans cell sarcoma, transdifferentiation, chronic lymphocytic leukemia, histiocytic sarcoma
MeSH terms: Case Reports

We report an index case of histiocytic sarcoma arising in a 70-year-old patient with long-standing chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The patient presented in 2017 with painful, enlarging swelling of the left neck. He had remote history of cutaneous squamous cell carcinoma with no sign of recurrence, and his CLL/SLL was thought to be in remission. Computed tomography showed mild splenomegaly and multifocal lymphadenopathy including a 3-cm left neck mass. Biopsy of the left neck mass showed CLL/SLL with associated histiocytic sarcoma. Flow cytometry demonstrated a B cell neoplasm with CLL/SLL phenotype. Despite radiation therapy, he expired 3 months after presentation. Two similar cases (CLL/SLL and histiocytic sarcoma, follicular lymphoma and Langerhans cell sarcoma) from another institution are also illustrated. The pathological features of combined tumors in lymphoid neoplasms, a general framework to the work-up to determine interrelatedness of tumor components, and the clinical relevance are discussed.