OpenMed/multicare-articles huggingface dataset:
Abemaciclib plus fulvestrant for the treatment of hormone receptor-positive/human epidermal growth factor receptor 2-negative breast cancer with cystic brain metastases: A case report and literature review
Authors: Zhaohui Chu
Journal: Front Oncol (2022)
Keywords: abemaciclib, breast cancer, cystic brain metastases, fulvestrant, radiotherapy
MeSH terms: Case Reports

Cystic brain metastases (CBM) in patients with breast cancer are rare. They have a worse prognosis than solid brain metastases, and they are less sensitive to radiotherapy. We report a case of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer with CBM. The patient underwent treatment with docetaxel combined with capecitabine for 5 months, followed by anastrozole maintenance therapy for 10 months, and palbociclib combined with exemestane for 22 months. CBM emerged and bone metastases increased in number. A missense mutation in PIK3CA (exon 10, c.1633G>A [p.Glu545Lys]) was detected by whole-exome next-generation sequencing from peripheral blood samples. After whole-brain radiotherapy (40 Gy/20 fx) combined with 3 months of treatment with everolimus and fulvestrant, CBM demonstrated partial remission (PR), but extracranial bone metastases continued to increase in number. Thus, the patient underwent fourth-line treatment with abemaciclib (100 mg bid) combined with fulvestrant (500 mg). Three months later, CBM significantly demonstrated PR and extracranial bone metastases were stable. At present, the patient has above 9 months of progression-free survival time without obvious adverse effects. This is the first report of abemaciclib combined with fulvestrant in the treatment of CBM in a patient with HR+/HER2- breast cancer.
A Case of Intrathoracic Gastric Duplication Cyst Detected on Prenatal Ultrasound Examination
Authors: Hisako Yagi, Yoshino Kinjyo, Yukiko Chinen, Hayase Nitta, Tadatsugu Kinjo, Keiko Mekaru, Hitoshi Masamoto, Hideki Goya, Tomohide Yoshida, Naoya Sanabe, Yoichi Aoki
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

A 37-year-old (G4P3) woman was referred to our hospital at 32 weeks of gestation for the evaluation of a fetus with an intrathoracic cystic lesion. Ultrasonography and magnetic resonance imaging revealed that a fetal cystic lesion without a mucosal layer was located in the posterior mediastinum. These findings were consistent with a bronchogenic cyst. At 38 3/7 weeks of gestation, an elective cesarean section was performed because of her previous cesarean section. A female neonate without any external anomalies, weighing 2,442 g, with Apgar scores of 8 and 9, and requiring no resuscitation was born. Four weeks after delivery, the neonate was admitted because of respiratory distress due to mass effect. At right lateral thoracotomy, a 105 × 65 mm of solitary smooth-walled cyst containing serosanguineous fluid was found in the posterior mediastinum, which was excised completely. Histologic examination revealed the diagnosis of the mediastinal gastric duplication cyst. The neonate made an uneventful recovery. Accurate diagnosis is not necessary, but detection and continuous observation are logical. Although gastric duplication, particularly intrathoracic, is a rare pathology, it should be considered in the differential diagnosis of any intrathoracic cyst.
FAST CBT for pediatric OCD: A multiple-baseline controlled pilot trial of parent training in exposure and response prevention delivered via telehealth
Authors: Lara J Farrell, Natalja A Nabinger de Diaz, Sharna Mathieu, Matthew L McKenzie, Taka Miyamoto, Caroline L Donovan, Allison M Waters, Sonja March, Nicole Bothma, Rianca Kroon, Gabrielle Simcock, Robert S Ware, Robert R Selles, Eric A Storch, Thomas Ollendick
Journal: Front Psychol (2022)
Keywords: cbt, erp, ocd, adolescent, child, parent, telethealth

Objective:
The current study utilized a single case series, non-concurrent multiple baseline design to examine the efficacy of training parents via telehealth videoconferencing in exposure and response prevention (ERP) for home delivery of the treatment for their children and adolescents with obsessive compulsive disorder (OCD).
Method:
There were nine participants aged 8 to 14 years who had received a primary diagnosis of OCD. The design involved a series of AB replications, whereby following pre-treatment assessments participants were randomly assigned to either a 2-week (n = 4) or 3-week (n = 5) baseline condition with weekly monitoring of their child's OCD symptoms. Following baseline, parents participated four weekly telehealth parent-training modules in delivering FAST (Families Accessing Skills Training) cognitive behavior therapy (CBT) with ERP (CBT-ERP) to children with OCD via videoconferencing with the clinician. Primary outcome measures were OCD symptom severity, diagnostic severity, and global functioning, which were assessed post-treatment and at 2 month follow-up.
Results:
The stability of the baseline period from pre-treatment to week 2 (for the 2-week condition) or to week 3 (for the 3-week condition) was established as there were no significant differences across baseline scores for parent target obsessions or parent target compulsions ratings. Significant improvements on the primary outcomes of clinician assessed symptom severity, diagnostic ratings, and global functioning were observed from baseline to post-treatment, and continued to 2 months follow-up.
Conclusion:
These data suggest that brief, parent training in FAST CBT-ERP via telehealth provides an overall effective intervention that is likely to be of most benefit to children and youth who are mild to moderate in severity.
Genital tuberculosis as the cause of tuboovarian abscess in an immunosuppressed patient
Authors: M Ilmer, F Bergauer, K Friese, I Mylonas
Journal: Infect Dis Obstet Gynecol (2009)
MeSH terms: Abdominal Abscess / microbiology, Fallopian Tube Diseases / microbiology, HIV Infections / complications, Ovarian Diseases / microbiology, Tuberculosis, Female Genital / complications, Case Reports, Abdominal Abscess / diagnostic imaging, Abdominal Abscess / drug therapy, Abdominal Abscess / immunology, Antibiotics, Antitubercular / therapeutic use, Fallopian Tube Diseases / diagnostic imaging, Fallopian Tube Diseases / immunology, Fallopian Tube Diseases / pathology, Female, HIV Infections / immunology, HIV Infections / microbiology, HIV Infections / pathology, Histocytochemistry, Humans, Mycobacterium tuberculosis / genetics, Mycobacterium tuberculosis / isolation & purification, Ovarian Diseases / diagnostic imaging, Ovarian Diseases / pathology, Polymerase Chain Reaction, Tuberculosis, Female Genital / diagnostic imaging, Tuberculosis, Female Genital / drug therapy, Tuberculosis, Female Genital / immunology, Ultrasonography, Antibiotics, Antitubercular

Background:
Although tuberculosis (TB) is a major health problem worldwide, primary extrapulmonary tuberculosis (EPTB), and in particular female genital tract infection, remains a rare event.
Case report:
A 35-year-old human immunodeficiency virus (HIV) seropositive woman of African descent with lower abdominal pain and fever of two days duration underwent surgery due to left adnexal mass suggesting pelvic inflammatory disease. The surgical situs showed a four quadrant peritonitis, consistent with the clinical symptoms of the patient, provoked by a tuboovarian abscess (TOA) on the left side. All routine diagnostic procedures failed to determine the causative organism/pathogen of the infection. Histopathological evaluation identified a necrotic granulomatous salpingitis and specific PCR analysis corroborated Mycobacterium tuberculosis (M. Tb). Consequently, antituberculotic therapy was provided.
Conclusion:
In the differential diagnosis of pelvic inflammatory disease, internal genital tuberculosis should be considered. Moreover, physicians should consider tuberculous infections early in the work-up of patients when immunosuppressive conditions are present.
Panscleritis masquerading as an attack of primary acute angle closure glaucoma
Authors: Hafsa Bashir, Uma Sridhar, Shahana Mazumdar, Koushik Tripathy
Journal: GMS Ophthalmol Cases (2019)
Keywords: anterior rotation of ciliary body, congestive glaucoma, pupillary block glaucoma, secondary glaucoma
MeSH terms: Case Reports

Purpose: To report a female who presented with acute angle closure glaucoma and was found to have panscleritis on further evaluation. Method: Case report. Case description: A 50-year-old female was referred to us as a case of primary acute angle closure attack in the right eye and for laser peripheral iridotomy. She had severe pain, redness, a very shallow anterior chamber, and an intraocular pressure of 38 mmHg in the right eye. However, the fellow eye had a deep anterior chamber and the right eye also had severe chemosis, lid edema, scleral tenderness, choroidal folds, and pain during ocular movements which was limited. Ultrasound biomicroscopy showed a ciliochoroidal effusion with anterior rotation of the ciliary body. The ultrasound of the eye revealed an increased thickness of the ocular coats and subtenon fluid. A diagnosis of panscleritis causing secondary angle closure glaucoma was made. She responded well to topical atropine, and topical with systemic steroids. Conclusions: Secondary angle closure glaucoma due to panscleritis may mimic primary acute angle closure attack in a clinical setting. It is important to differentiate the two as treatment is opposite and may worsen the condition if misdiagnosed.
Typhlocolitis associated with Clostridium difficile ribotypes 078 and 110 in neonatal piglets from a commercial Irish pig herd
Authors: Máire C McElroy, Martin Hill, Geraldine Moloney, Micheál Mac Aogáin, Shane McGettrick, Áine O'Doherty, Thomas R Rogers
Journal: Ir Vet J (2016)
Keywords: clostridium difficile, pcr ribotyping, pigs, typhlocolitis

Background:
Clostridium difficile is a recognised cause of typhlocolitis and diarrhoea in neonatal pigs but has never been confirmed in association with pathology and disease in Irish pigs.
Case presentation:
Four neonatal piglets, with a history of diarrhoea were referred to the Central Veterinary Research Laboratory, Backweston for necropsy. They were from a fully integrated, commercial pig farm with approximately 1000 sows. Three piglets had acute, superficial, erosive and suppurative typhlocolitis and the other had mild suppurative mesocolitis. Clostridium difficile (C. difficile) toxins A/B were detected using ELISA in the colonic contents from each piglet. C. difficile isolates from two of the piglets were PCR-ribotyped as 078 and an isolate from a third pig was ribotyped as 110.
Conclusions:
This is the first report confirming C. difficile in association with typhlocolitis in Irish pigs.
Ventral Stabilization of a T2-T3 Vertebral Luxation via Median Sternotomy in a Dog
Authors: Sarah Klatzkow, Matthew D Johnson, Michele James, Sheila Carrera-Justiz
Journal: Case Rep Vet Med (2018)
MeSH terms: Case Reports

An 8-year-old neutered male miniature Poodle presented for evaluation of a suspected T3-L3 lesion with cervical component following vehicular trauma. Magnetic resonance imaging and computed tomography revealed a T2-T3 luxation with right displacement of T3. A T2 caudal endplate fracture was present as well as multifocal noncompressive bulges of cervical intervertebral discs. Conservative management failed and ventral stabilization of C7-T4 was performed via a median sternotomy. Paired String-of-Pearls plates were placed on the ventral aspect of vertebrae. Eight weeks postoperatively, the dog was ambulatory with moderate pelvic limb paraparesis. A luxation of T2-T3 is uncommon in small animals and surgical stabilization is poorly described in literature. This case report demonstrates the use of a ventral approach to cranial thoracic vertebral stabilization with a successful outcome.
Two Cases of Helicobacter pylori-Negative Gastric Outlet Obstruction in Children
Authors: Raza A Patel, Susan S Baker, Wael N Sayej, Robert D Baker
Journal: Case Rep Gastrointest Med (2011)
MeSH terms: Case Reports

Gastric outlet obstruction (GOO) in children is most commonly caused by idiopathic hypertrophic pyloric stenosis. Prior to proton pump inhibitors and H2 blockers, peptic ulcer disease (PUD) secondary to H. pylori was a cause of GOO. Both patients presented with a history of weight loss, vomiting, and abdominal pain. Their diagnosis of PUD and GOO was made by EGD and UGI. H. pylori testing was negative for both on multiple occasions but still received H. pylori eradication therapy. Patient 1 after failing pharmaceutical management underwent surgery for definitive treatment. Patient 2 underwent six therapeutic pyloric dilations before undergoing surgery as definitive treatment. These cases suggest that GOO secondary to PUD occurs in the absence of H. pylori infection and surgical management can provide definitive therapy.
Response to Ipilimumab/Nivolumab Rechallenge and BRAF Inhibitor/MEK Inhibitor Rechallenge in a Patient with Advanced Metastatic Melanoma Previously Treated with BRAF Targeted Therapy and Immunotherapy
Authors: Caitlyn N Myrdal, Srinath Sundararajan
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Little is known about the optimal sequencing of targeted therapy and immunotherapy in the treatment of patients with BRAFV600-mutated metastatic melanoma. BRAF/MEK inhibition often has the benefit of rapid disease regression; however, resistance is frequently seen with long-term use. Treatment with immune checkpoint inhibitors offers the potential for long-term response but displays a lower rate of objective response. The benefit of synergy between therapies is apparent; however, there is limited data regarding optimal sequencing in the treatment of advanced melanoma. We present the case of a 62-year-old gentleman with advanced BRAFV600-mutated melanoma who followed an unconventional treatment path. After progressing on single-agent vemurafenib, he had response to multiple modalities of immunotherapy before progression. After, he had a substantial response to multiple BRAF/MEK inhibitor rechallenges before developing resistance. The patient is now stable after a retrial of combination immunotherapy. Our case illustrates that with the right sequencing of therapy, meaningful clinical responses can be elicited with rechallenging of targeted therapy and immunotherapy in metastatic melanoma.
Recurrent Breast Abscesses due to Corynebacterium kroppenstedtii, a Human Pathogen Uncommon in Caucasian Women
Authors: Anne Le Flèche-Matéos, Nicolas Berthet, Fabienne Lomprez, Yolande Arnoux, Anne-Sophie Le Guern, India Leclercq, Ana Maria Burguière, Jean-Claude Manuguerra
Journal: Case Rep Infect Dis (2012)

Background. Corynebacterium kroppenstedtii (Ck) was first described in 1998 from human sputum. Contrary to what is observed in ethnic groups such as Maori, Ck is rarely isolated from breast abscesses and granulomatous mastitis in Caucasian women. Case Presentation. We herein report a case of recurrent breast abscesses in a 46-year-old Caucasian woman. Conclusion. In the case of recurrent breast abscesses, even in Caucasian women, the possible involvement of Ck should be investigated. The current lack of such investigations, probably due to the difficulty to detect Ck, may cause the underestimation of such an aetiology.
Insulin Edema Syndrome due to Rapid Glucose Correction in a Diabetic Patient
Authors: Siham M Hussien, Hasan Imanli, Dena H Tran, Robert D Chow, Aseem Sood
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Edema resulting from the initiation of insulin therapy or intensification of glycemic control is a rare and under-recognized complication. In this report, we present a case of a 46-year-old patient with insulin-dependent diabetes mellitus (IDDM) who avoided insulin treatment due to associated peripheral edema. Though rare, this phenomenon is typically seen in patients with elevated glucose levels who are initiated on insulin treatment, resulting in rapid correction and tight control of glucose levels. The diagnosis of insulin-induced edema is made after other causes of acute edema are ruled out. Furthermore, in this case report, we will also discuss the postulated mechanisms for the edema-causing property of insulin.
Symptomatic Neovaginal Candidiasis in Transgender Women After Penile Inversion Vaginoplasty: A Clinical Case Series of Five Consecutive Patients
Authors: Kristin B de Haseth, Marlon E Buncamper, Müjde Özer, Lian Elfering, Jan Maerten Smit, Mark-Bram Bouman, Wouter B van der Sluis
Journal: Transgend Health (2018)
Keywords: candida, candidiasis, gender dysphoria, transgender, vaginoplasty

Background: Vaginoplasty is performed as gender-affirming surgery in transgender women. While multiple surgical techniques exist for this goal, penile inversion vaginoplasty is performed most frequently. Neovaginal symptoms may impede sexual functioning after surgery. Methods: A total of five consecutive patients with symptoms and positive swabs for neovaginal candida infection were described. Results: All patients presented with white-colored neovaginal discharge and some with neovaginal itching and/or malodor. All were topically treated with miconazole, which resulted in symptom clearance. Follow-up swabs were negative for candida. Conclusions: To our knowledge, this is the first report on (symptomatic) candidiasis of the penile-inverted neovagina.
Maternal Bradycardia Associated with Betamethasone Administration During Pregnancy
Authors: Mojirayo A Sarumi, James W Hole, Robert B Gherman
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Maternal risks of betamethasone have been rarely reported.
Case:
At 36 weeks' gestation, a previously healthy 23-year-old gravida with fetal intrauterine growth restriction was admitted to the hospital for steroid administration. Twenty-six hours after the first dose of betamethasone, a maternal bradycardia was initially noted and eventually nadired at 41 beats per minute. Consultation with the cardio-electrophysiology service revealed no other apparent etiologies for the sinus bradycardia. Due to the asymptomatic nature of the maternal bradycardia, pharmacologic interventions were not recommended. With observation alone, a normal maternal heart rate returned by forty-nine hours after the original betamethasone injection. The patient subsequently had an uneventful intrapartum course.
Conclusion:
Maternal bradycardia can be associated with antenatal betamethasone administration. Due to the transient nature of this side effect, expectant management is recommended as the treatment option for asymptomatic patients.
A Case of Early Stage Bladder Carcinosarcoma in Late Recurrence of Urothelial Carcinoma after Transurethral Resection
Authors: Daisaku Hirano, Toshiyuki Yoshida, Daigo Funakoshi, Fuminori Sakurai, Shou Ohno, Yoshiaki Kusumi
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Carcinosarcomas of the urinary bladder are rare biphasic neoplasms, consisting of both malignant epithelial and malignant mesenchymal components, and the prognosis of this tumor is unfavorable in most patients with even possibility of resection of disease. A 77-year-old male with a history of transurethral resection (TUR) of urothelial carcinoma (UC) of the bladder and adjuvant intravesical chemotherapy with pirarubicin 10 years ago revisited our department with a gross hematuria. Cystoscopy demonstrated an approximately 2.5 cm nonpapillary tumor on the right wall of the bladder. Pelvic MRI showed the tumor without extending the base of the bladder wall. The tumor could be completely removed with TUR. The malignant epithelial elements consisted of high-grade UC and the majority of mesenchymal components were fibrosarcomatous differentiation based on immunohistochemical studies. The tumor could be pathologically also suspected to be an early stage on TUR specimens. Although he has received no additional intervention due to the occurrence of myocardial infarction at three weeks after the TUR, he has been alive with no evidence of recurrence of the disease 27 months after the TUR. Some early stages of bladder carcinosarcoma might have a favorable prognosis without aggressive treatments.
Distinguishing Dependent-Stage Secondary Epileptogenesis in a Complex Case of Giant Hypothalamic Hamartoma With Assistance of a Computational Method
Authors: Zhao Liu, Guoming Luan, Chuanzuo Yang, Yuguang Guan, Changqing Liu, Jing Wang, Mengyang Wang, Qingyun Wang
Journal: Front Neurol (2020)
Keywords: coupled neuronal population model, epileptogenic networks, epileptogenic zone localization, hypothalamic hamartoma, refractory focal epilepsy, stereo-electroencephalography
MeSH terms: Case Reports

Besides gelastic seizures, hypothalamic hamartoma (HH) is also noted for its susceptibility to remote secondary epileptogenesis. Although clinical observations have demonstrated its existence, and a three-stage theory has been proposed, how to determine whether a remote symptom is spontaneous or dependent on epileptic activities of HH is difficult in some cases. Herein, we report a case of new non-gelastic seizures in a 9-year-old female associated with a postoperatively remaining HH. Electrophysiological examinations and stereo-electroencephalography (SEEG) demonstrated seizure onsets with slow-wave and fast activities on the outside of the HH. By using computational methodologies to calculate the network dynamic effective connectivities, the importance of HH in the epileptic network was revealed. After SEEG-guided thermal coagulation of the remaining HH, the patient finally was seizure-free at the 2-year follow-up. This case showed the ability of computational methods to reveal information underlying complex SEEG signals, and further demonstrated the dependent-stage secondary epileptogenesis, which has been rarely reported.
Spontaneous Intracerebral Hemorrhage Due to Delta Storage Pool Disease in a Patient on a Serotonin-Norepinephrine Reuptake Inhibitor
Authors: Annette Leibetseder, Judith Wagner, Josef Tomasits, Hans-Peter Haring, Markus Hutterer, Johannes Trenkler, Tim J von Oertzen
Journal: Front Neurol (2019)
Keywords: snri, ssri, delta storage pool disease, intracerebral hemorrhage, stroke, thrombocytopathy
MeSH terms: Case Reports

We report a case of spontaneous intracerebral hemorrhage (sICH) due to delta storage pool disease in a 60-year-old female on a serotonin-norepinephrine reuptake inhibitor (SNRI). Increased susceptibility to SNRI-effects on hemostasis was due to a genetic disposition mediated by a polymorphism of the SLC6A4 gene coding for the human serotonin transporter (SERT). Pathophysiological and clinical implications of these findings are discussed.