OpenMed/multicare-articles huggingface dataset:
Whole-genome sequencing of matched primary and metastatic hepatocellular carcinomas
Authors: Limei Ouyang, Jeeyun Lee, Cheol-Keun Park, Mao Mao, Yujian Shi, Zhuolin Gong, Hancheng Zheng, Yingrui Li, Yonggang Zhao, Guangbiao Wang, Huiling Fu, Jhingook Kim, Ho Yeong Lim
Journal: BMC Med Genomics (2014)
MeSH terms: Carcinoma, Hepatocellular / genetics, Carcinoma, Hepatocellular / pathology, Genome, Human / genetics, Liver Neoplasms / genetics, Liver Neoplasms / pathology, Sequence Analysis, DNA, Case Reports, Research Support, Non-U.S. Gov't, Adult, DNA Copy Number Variations / genetics, DNA Mutational Analysis, Disease Progression, Fatal Outcome, Gene Frequency / genetics, Humans, Male, Middle Aged, Mutation / genetics, Neoplasm Metastasis, RNA Splice Sites / genetics, Signal Transduction / genetics, RNA Splice Sites

Background:
To gain biological insights into lung metastases from hepatocellular carcinoma (HCC), we compared the whole-genome sequencing profiles of primary HCC and paired lung metastases.
Methods:
We used whole-genome sequencing at 33X-43X coverage to profile somatic mutations in primary HCC (HBV+) and metachronous lung metastases (> 2 years interval).
Results:
In total, 5,027-13,961 and 5,275-12,624 somatic single-nucleotide variants (SNVs) were detected in primary HCC and lung metastases, respectively. Generally, 38.88-78.49% of SNVs detected in metastases were present in primary tumors. We identified 65-221 structural variations (SVs) in primary tumors and 60-232 SVs in metastases. Comparison of these SVs shows very similar and largely overlapped mutated segments between primary and metastatic tumors. Copy number alterations between primary and metastatic pairs were also found to be closely related. Together, these preservations in genomic profiles from liver primary tumors to metachronous lung metastases indicate that the genomic features during tumorigenesis may be retained during metastasis.
Conclusions:
We found very similar genomic alterations between primary and metastatic tumors, with a few mutations found specifically in lung metastases, which may explain the clinical observation that both primary and metastatic tumors are usually sensitive or resistant to the same systemic treatments.
How to communicate climate change 'impact and solutions' to vulnerable population of Indian Sundarbans? From theory to practice
Authors: Abhiroop Chowdhury, Subodh Kumar Maiti, Santanu Bhattacharyya
Journal: Springerplus (2016)
Keywords: aila, alternative income generation activity, climate change adaptation strategies, communication, community mobilization, disaster management, endemic knowledge, mangrove conservation, micro-finance institution (mfi), non-governmental organization (ngo), social work, wealth rank tool

Introduction:
Global consciousness on climate change problems and adaptation revolves around the disparity of information sharing and communication gap between theoretical scientific knowledge at academic end and practical implications of these at the vulnerable populations' end. Coastal communities facing socio-economic stress, like densely populated Sundarbans, are the most affected part of the world, exposed to climate change problems and uncertainties. This article explores the successes of a socio-environmental project implemented at Indian Sundarbans targeted towards economic improvement and aims at communicating environmental conservation through organized community participation.
Case description:
Participatory rural appraisal (PRA) and the wealth rank tool (WRT) were used to form a "group based organization" with 2100 vulnerable families to give them knowledge about capacity building, disaster management, resource conservation and sustainable agriculture practices. Training was conducted with the selected group members on resource conservation, institution building, alternative income generation activities (AIGA) like, Poultry, Small business, Tricycle van, Organic farming and disaster management in a participatory mode. The climate change 'problems-solutions' were communicated to this socio-economically marginalized and ostracized community through participatory educational theater (PET).
Discussion and evaluation:
WRT revealed that 45 % of the population was under economic stress. Out of 2100 beneficiaries', 1015 beneficiaries' started organic farming, 133 beneficiaries' adopted poultry instead of resource exploitive livelihood and 71 beneficiaries' engaged themselves with small business, which was the success stories of this project. To mitigate disaster, 10-committees were formed and the endemic knowledge about climate change was recorded by participatory method validated through survey by structured questionnaire. As a part of this project 87 ha of naked deforested mudflat was reclaimed with endangered mangroves involving target community members aimed to sequester CO2, control soil erosion and act as a barrier during natural disasters.
Conclusion:
This case study concluded that participatory method of communication, aiming not only to communicate theoretical knowledge, but also to devise adaptation strategies through conservation of endemic knowledge, popularizing sustainability through Micro Finance Institutions and promoting AIGA along with motivating vulnerable community to restore degraded forest lands, could be a effective solution to practically combat climate change problems.
Intestinal Haemorrhage and Colitis Induced by Treatment With Osimertinib for Non-Small-Cell Lung Carcinoma: A Case Report
Authors: Wang Shujun, Lou Lili, Yang Lei, Wang Feng, Zhan Hefeng
Journal: Front Pharmacol (2022)
Keywords: non-small-cell lung carcinoma (nsclc), aumolertinib, drug-induced colitis, epidermal growth factor receptor tyrosine kinase inhibitor, intestinal haemorrhage, osimertinib
MeSH terms: Case Reports

Background: Osimertinib is recommended either as the first-line therapy for sensitizing EGFR-mutations (FLAURA trial) or at progression to first-/second-generation EGFR inhibitors in the presence of resistance mutation T790M (AURA 3 study). It can effectively improve the prognosis of patients with NSCLC with manageable adverse reactions. Among adverse events, intestinal haemorrhage is rare and requires extensive study on its potential lethality. Case presentation: A 59-year-old female, diagnosed with relapsed stage IV (cT4N2M1c) NSCLC with T790M mutation of the EGFR gene, received osimertinib treatment. Eight months after osimertinib treatment, she complained of lower abdominal pain and haematochezia without haemorrhoids. Potential causes of intestinal haemorrhage other than osimertinib toxicity were ruled out. Colonoscopy examination showed severe colitis with grade 3 CTCAE. Osimertinib was discontinued, and prednisone 0.5 mg/kg was administered. Follow-up endoscopy showed no pathological findings. A novel third-generation EGFR-TKI, aumolertinib, was administrated. Five months after aumolertinib initiation, CT evaluation showed stable disease (SD), and this patient was free of colitis recurrence. Conclusion: To our knowledge, this is the first case report of severe colitis as an adverse event associated with osimertinib. Although osimertinib is the standard treatment for NSCLC in patients with T790M mutation and has fewer side effects, colitis may occur after months of treatment. Aumolertinib, a novel third-generation EGFR-TKI, might be an effective alternative for the treatment of patients with NSCLC experiencing colitis from osimertinib.
Case report: Successful use of mepolizumab for immune checkpoint inhibitors-induced hypereosinophilic syndrome in two patients with solid malignancies
Authors: Chiara Lazzari, Mona Rita Yacoub, Corrado Campochiaro, Alessandra Bulotta, Diego Palumbo, Francesca Rita Ogliari, Lorenzo Dagna, Silvia Marchesi, Maurilio Ponzoni, Vanesa Gregorc
Journal: Front Oncol (2023)
Keywords: hes, nsclc, immune checkpoint inhibitor, mepolizumab, mesothelioma
MeSH terms: Case Reports

Hypereosinophilic syndrome (HES) represents a group of blood disorders characterized by an absolute eosinophil count (AEC) > 1.5 × 103/μl in the peripheral blood, which eventually extravasate and cause organ damage. It can be primary or secondary to infections or tumors. The infiltration of eosinophils in tissue and organs is associated with different disorders and, in some cases, with life-threatening manifestations. Albeit the pathogenesis of HES in patients with solid tumo\rs is not yet clarified; recently, HES has also been described as an immune-related adverse event in patients with solid tumors receiving immune checkpoint inhibitors. Treatment of HES is still debated, especially in patients with concomitant solid tumors, and different drugs including imatinib, hydroxyurea, interferon-ɑ, glucocorticoids, and the monoclonal antibody targeting circulating IL-5 mepolizumab have been proposed according to the underlying cause and the severity of HES. Herein, we describe, for the first time, the successful use of mepolizumab for the treatment of immune checkpoint-induced HES in two patients with metastatic solid tumor.
Case Reports on Metaplastic Squamous Cell Carcinoma of the Breast and Treatment Dilemma
Authors: Anita Pandey, Kishor Joshi, Harry Moussouris, Gardith Joseph
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Metaplastic squamous cell carcinoma of the breast is a very rare form of breast cancer that consists of both glandular and nonglandular components mixed with epithelial and mesenchymal tissues. Worldwide, the incidence of this tumor is between 0.1 and 2%. Because of the rarity of this tumor and heterogeneous behavior of the tumor cells, it is difficult to establish the standard therapeutic approach. We report 2 cases of metaplastic squamous cell carcinoma of the breast in young patients with different responses to treatment strategies. The first case is a premenopausal female with metaplastic squamous cell carcinoma treated with surgery, chemotherapy, and radiotherapy, and the second case is perimenopausal metaplastic squamous cell carcinoma with sarcomatoid subtype and osteoid matrix production which progressed on chemotherapy and was treated with surgery and radiation.
Case report: High-resolution, intra-operative µDoppler-imaging of spinal cord hemangioblastoma
Authors: Sadaf Soloukey, Luuk Verhoef, Bastian S Generowicz, Chris I De Zeeuw, Sebastiaan K E Koekkoek, Arnaud J P E Vincent, Clemens M F Dirven, Biswadjiet S Harhangi, Pieter Kruizinga
Journal: Front Surg (2023)
Keywords: case report, functional ultrasound, hemangioblastoma, intramedullary tumor, spinal cord, µdoppler

Surgical resection of spinal cord hemangioblastomas remains a challenging endeavor: the neurosurgeon's aim to reach total tumor resections directly endangers their aim to minimize post-operative neurological deficits. The currently available tools to guide the neurosurgeon's intra-operative decision-making consist mostly of pre-operative imaging techniques such as MRI or MRA, which cannot cater to intra-operative changes in field of view. For a while now, spinal cord surgeons have adopted ultrasound and its submodalities such as Doppler and CEUS as intra-operative techniques, given their many benefits such as real-time feedback, mobility and ease of use. However, for highly vascularized lesions such as hemangioblastomas, which contain up to capillary-level microvasculature, having access to higher-resolution intra-operative vascular imaging could potentially be highly beneficial. µDoppler-imaging is a new imaging modality especially fit for high-resolution hemodynamic imaging. Over the last decade, µDoppler-imaging has emerged as a high-resolution, contrast-free sonography-based technique which relies on High-Frame-Rate (HFR)-ultrasound and subsequent Doppler processing. In contrast to conventional millimeter-scale (Doppler) ultrasound, the µDoppler technique has a higher sensitivity to detect slow flow in the entire field-of-view which allows for unprecedented visualization of blood flow down to sub-millimeter resolution. In contrast to CEUS, µDoppler is able to image high-resolution details continuously, without being contrast bolus-dependent. Previously, our team has demonstrated the use of this technique in the context of functional brain mapping during awake brain tumor resections and surgical resections of cerebral arteriovenous malformations (AVM). However, the application of µDoppler-imaging in the context of the spinal cord has remained restricted to a handful of mostly pre-clinical animal studies. Here we describe the first application of µDoppler-imaging in the case of a patient with two thoracic spinal hemangioblastomas. We demonstrate how µDoppler is able to identify intra-operatively and with high-resolution, hemodynamic features of the lesion. In contrast to pre-operative MRA, µDoppler could identify intralesional vascular details, in real-time during the surgical procedure. Additionally, we show highly detailed post-resection images of physiological human spinal cord anatomy. Finally, we discuss the necessary future steps to push µDoppler to reach actual clinical maturity.
Silvopastoral systems for offsetting livestock emissions in the tropics: a case study of a dairy farm in Costa Rica
Authors: Robert Brook, Eilidh Forster, David Styles, André Mancebo Mazzetto, Claudia Arndt, M Jimena Esquivel, David Chadwick
Journal: Agron Sustain Dev (2022)
Keywords: agroforestry, carbon sequestration, life cycle assessment, live fences, milk, trees

Ways are being sought to reduce the environmental impact of ruminant livestock farming. Integration of trees into farming systems has been advocated as a measure to deliver ecosystem services, inter alia climate regulation and adaptation, water quality regulation, provisioning of fibre, fuel and habitats to support biodiversity. Despite the rapid expansion of cattle farming in the tropics, notably in Latin America, there is little robust evidence on the extent to which trees are able to mitigate the effects of cattle farming in this ecological zone. This article describes a case study conducted on a large, specialised dairy farm in Costa Rica, where two-thirds of the field boundaries are live tree fences. For the first time, this study quantifies the offset potential of trees by estimating rate of carbon sequestration in a silvopastoral system (SPS) in the tropics. It was found that over a 30-month interval, trees sequestered 1.43 Mg C ha-1 year-1 above and below ground. Attributional life cycle assessment (LCA) (cradle to farm gate) was applied to calculate the carbon footprint of milk produced on the farm for the years 2016 to 2018. Trees in live fences offset 21-37% of milk footprints, resulting in residual net footprints of 0.75±0.25 to 0.84±0.26 kg CO2 eq. kg-1 milk. Exclusion of life cycle emissions that may not fall within national emission inventory accounting (e.g. fertiliser manufacture and feed production) increased the mean offset from 27 to 34% of gross milk footprint. Although based on temporally limited data (30 months), our findings indicate that a live fence SPS could play an important role in short- to medium-term climate mitigation from livestock production, buying time for deployment of long-term mitigation and adaptation planning.
Supplementary information:
The online version contains supplementary material available at 10.1007/s13593-022-00834-z.
Case report: Common clonal origin of concurrent langerhans cell histiocytosis and acute myeloid leukemia
Authors: Shintaro Kazama, Kazuaki Yokoyama, Toshimitsu Ueki, Hiroko Kazumoto, Hidetoshi Satomi, Masahiko Sumi, Ichiro Ito, Nozomi Yusa, Rika Kasajima, Eigo Shimizu, Rui Yamaguchi, Seiya Imoto, Satoru Miyano, Yukihisa Tanaka, Tamami Denda, Yasunori Ota, Arinobu Tojo, Hikaru Kobayashi
Journal: Front Oncol (2022)
Keywords: braf v600e, mapk pathway, nras, acute myeloid leukemia, dendritic cells, histiocytic disorders, inflammatory myeloid neoplasm, langerhans cell histiocytosis
MeSH terms: Case Reports

Langerhans cell histiocytosis (LCH) and acute myeloid leukemia (AML) are distinct entities of blood neoplasms, and the exact developmental origin of both neoplasms are considered be heterogenous among patients. However, reports of concurrent LCH and AML are rare. Herein we report a novel case of concurrent LCH and AML which shared same the driver mutations, strongly suggesting a common clonal origin.An 84-year-old female presented with cervical lymphadenopathy and pruritic skin rash on the face and scalp. Laboratory tests revealed pancytopenia with 13% of blasts, elevated LDH and liver enzymes, in addition to generalised lymphadenopathy and splenomegaly by computed tomography. Bone marrow specimens showed massive infiltration of MPO-positive myeloblasts, whereas S-100 and CD1a positive atypical dendritic cell-like cells accounted for 10% of the atypical cells on bone marrow pathology, suggesting a mixture of LCH and AML. A biopsy specimen from a cervical lymph node and the skin demonstrated the accumulation of atypical cells which were positive for S-100 and CD1a. LCH was found in lymph nodes, skin and bone marrow; AML was found in peripheral blood and bone marrow (AML was predominant compared with LCH in the bone marrow). Next generation sequencing revealed four somatic driver mutations (NRAS-G13D, IDH2-R140Q, and DNMT3A-F640fs/-I715fs), equally shared by both the lymph node and bone marrow, suggesting a common clonal origin for the concurrent LCH and AML. Prednisolone and vinblastine were initially given with partial response in LCH; peripheral blood blasts also disappeared for 3 months. Salvage chemotherapy with low dose cytarabine and aclarubicin were given for relapse, with partial response in both LCH and AML. She died from pneumonia and septicemia on day 384. Our case demonstrates a common cell of origin for LCH and AML with a common genetic mutation, providing evidence to support the proposal to classify histiocytosis, including LCH, as a myeloid/myeloproliferative malignancy.
Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients
Authors: Samshol Sukahri, Lily Diana Zainudin, Mohd Firdaus Hadi, Mohd Al-Baqlish Mohd Firdaus, Muhammad Imran Abdul Hafidz
Journal: Case Rep Pulmonol (2020)
MeSH terms: Case Reports

Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.
Case Report: Wound Closure Acceleration in a Patient With Toxic Epidermal Necrolysis Using a Lyophilised Amniotic Membrane
Authors: Bretislav Lipový, Martin Hladík, Petr Štourač, Serhiy Forostyak
Journal: Front Bioeng Biotechnol (2021)
Keywords: amniotic membrane, infection control, lyophilised amniotic membrane, reepithelization, toxic epidermal necrolysis
MeSH terms: Case Reports

Background: Toxic epidermal necrolysis (TEN) is a rare life-threatening disease that mainly affects the skin and mucous membranes, resulting from a toxic delayed-type hypersensitivity (DTH) reaction (type IV reaction) to the presence of foreign antigens such as drugs. The clinical symptoms are caused by pathophysiological processes leading to massive apoptosis of keratinocytes in the dermo-epidermal junction. This results in the formation of a bulla and subsequent separation of the entire epidermis with the exposure of the dermis. The current approach in the local therapy of TEN prefers the use of biological dressings, which helps provide several critical requirements for defect healing; in particular, it helps in the acceleration of the spontaneous wound closure (re-epithelialization) of the skin defect and the reduction of the risk of development of various complications and infections, such as the risk of pathological scar maturation. This paper is a case report of the use of a lyophilized amniotic membrane (AM) for accelerating wound healing in a patient with TEN. Case Presentation: We report a case of an 8-year-old girl transferred to our center with a histologically confirmed diagnosis of TEN. Despite the application of immunosuppressive therapy consisting of corticosteroids and intravenous immunoglobulins, we have observed disease progression and exfoliation of up to 60% of the total body surface area (TBSA). In the facial area, which is cosmetically privileged, we decided to use the lyophilized amniotic membrane (Amnioderm®) to cover up approximately 2% of the TBSA. Within 2 days after the application, we observed accelerated reepithelialisation, with rapid wound closure. We have not observed any side effects nor infections during the subsequent phases of wound healing. Skin defects in non-facial areas of the body were treated with synthetic dressings. When compared to the areas covered with the lyophilized AM, the healing process was prolonged. Conclusions: To our knowledge, this is the first case study using a lyophilized amniotic membrane in the treatment of a patient with TEN. The AM application in the cosmetically-privileged area (face), proved to be very efficient in the treatment of TEN patients. The use of this allogeneic material demonstrated excellent biocompatibility and caused a unique acceleration of epithelialization and wound healing, yielding also excellent long-term results. The current study opens broad possibilities for clinical application of the used material, the improvement of current therapy of patients with TEN and better outcomes and recovery of patients.
Case Report: QT Prolongation and Abortive Sudden Death Observed in an 85-Year-Old Female Patient With Advanced Lung Cancer Treated With Tyrosine Kinase Inhibitor Osimertinib
Authors: Moë Kondo, Megumi Kisanuki, Yosuke Kokawa, Seiichiro Gohara, Osamu Kawano, Shuntaro Kagiyama, Toru Maruyama, Keita Odashiro, Yoshihiko Maehara
Journal: Front Cardiovasc Med (2021)
Keywords: qt prolongation, cancer, cardiooncology, herbal drug, osimertinib
MeSH terms: Case Reports

Cardiac arrest occurred in an 85-year-old female administered osimertinib for advanced lung cancer expressing epidermal growth factor receptor (EGFR) mutations. Electrocardiogram (ECG) recorded at recurrence of spontaneous circulation showed sinus rhythm associated with mild QT prolongation (QTc = 455 ms) to which silent myocardial ischemia and coadministration of itraconazole and herbal drug causing hypokalemia (2.1 mEq/L) may have contributed. Discontinuation of osimertinib, itraconazole and herbal drug, potassium supplementation and percutaneous coronary intervention alleviated QT prolongation (QTc = 432 ms). Osimertinib is the third-generation tyrosine kinase inhibitor lengthening QT interval, and careful monitoring of ECG, serum potassium and drugs coadministered during chemotherapy including osimertinib are highly required.