OpenMed/multicare-articles huggingface dataset:
Transplantation of a free fillet flap from discarded fingers for repair of a finger pulp skin defect: a case report
Authors: Xianting Zhou, Chenxi Zhang, Xuekai Fan, Xiaoming Cai, Xin Wang, Jiadong Pan
Journal: Front Surg (2024)
Keywords: finger pulp defect, finger pulp reconstruction, hand trauma, spare-parts, surgical skills
MeSH terms: Case Reports

Background:
Replantation represents a treatment option for patients with severed finger pulps. However, in some cases, replantation is a challenging task.
Case presentation:
We report a successful case of finger pulp reconstruction of the ring finger using free flaps from a nonreplantable index finger in a spare-parts procedure. A 43-year-old worker accidentally injured the index, middle and ring fingers of his left hand on a machine turntable. The severed index and middle fingers and the distal pulp of the ring finger could not be replanted in situ due to extensive contusion of blood vessels and soft tissues. After vascular and nerve anastomosis, a free skin flap isolated from the nonreplantable index finger was transplanted to the wound of the distal pulpal defect of the ring finger. The flap survived completely postoperatively. Six months after the operation, only a slight deformity of the ring finger was observed. Moreover, sensation of the digit recovered well.
Conclusions:
Spare-part surgery is a surgical approach that effectively saves and utilizes tissue that would otherwise be discarded in cases of severe limb trauma. This idea may be applied to treatment of severe injuries to multiple fingers. Additionally, in the process of tissue transplantation and repair, attention should be given to protecting the tissue in the recipient area to avoid damage to the original undamaged tissue structure, which can adversely affect healing and recovery of the tissue.
Cryptosporidiosis diagnosed using metagenomic next-generation sequencing in a healthy child admitted to pediatric intensive care unit: a case report
Authors: Xiaoyi Liu, Jing Wang, Jun Liu, Xuming Li, Yuanlin Guan, Suyun Qian, Xinlei Jia
Journal: Front Cell Infect Microbiol (2023)
Keywords: cryptosporidium parvum, picu, healthy boy, mngs, pancreatitis
MeSH terms: Cryptosporidiosis / epidemiology, Cryptosporidium / genetics, Case Reports, Research Support, Non-U.S. Gov't, Child, Diarrhea / diagnosis, Diarrhea / epidemiology, High-Throughput Nucleotide Sequencing, Humans, Intensive Care Units, Pediatric, Male

Background:

Cryptosporidium infections in humans typically result in symptoms such as abdominal pain and diarrhea. When the diarrhea is severe, it can cause serious complications and even be life-threatening, especially in patients with compromised immune systems.
Case presentation:
Here, we reported the use of metagenomic next-generation sequencing (mNGS) to assist in the diagnosis and treatment of a 10-year-old boy with severe Cryptosporidium infection. Despite the absence of any history of immunocompromise, the infection still resulted in severe symptoms, including shock, as well as damage to his pancreas and kidneys. The mNGS tests detected the presence of Cryptosporidium parvum when conventional methods failed. The patient received anti-parasite treatment along with supportive care to manage the condition. With disease surveillance based on regular clinical tests and sequential mNGS tests, the child recovered from the severe conditions.
Conclusion:
Our study emphasized the importance of recognizing the potential severity of Cryptosporidium infection, even among individuals with normal immune systems. Timely diagnosis and ongoing monitoring are essential for patient prognosis.
Case report: Disitamab vedotin combined with immunotherapy demonstrated excellent efficacy in scrotal Paget's disease with Her-2 overexpression
Authors: Jia-Ling Wang, Wen-Jun Meng, Nian Hu, Ji-Yan Liu
Journal: Front Immunol (2024)
Keywords: case report, disitamab vedotin, extramammary paget’s disease, human epidermal growth factor receptor 2, scrotal cancer
MeSH terms: Paget Disease, Extramammary / drug therapy, Paget Disease, Extramammary / therapy, Receptor, ErbB-2 / genetics, Receptor, ErbB-2 / metabolism, Case Reports, Antineoplastic Combined Chemotherapy Protocols / adverse effects, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Humans, Immunoconjugates / therapeutic use, Immunotherapy / methods, Male, Middle Aged, Scrotum / pathology, Treatment Outcome, Receptor, ErbB-2, ERBB2 protein, human, Immunoconjugates

Background:
Extramammary Paget's disease (EMPD) is a rare epithelial malignancy, and approximately 30%-40% of EMPD patients overexpress human epidermal growth factor receptor 2 (Her-2). Currently, there are no established standard treatments for advanced EMPD while anti-Her-2 therapy is recommended for Her-2-positive cases.
Case presentation:
Here, we report a 51-year-old male diagnosed with advanced Her-2-positive EMPD, presenting with numerous lymph node metastases. This patient received disitamab vedotin (an antibody-drug conjugate, targeting Her-2) combined with serplulimab as first-line treatment. After seven cycles of combination therapy, the patient tolerated the treatment well and the lymph node lesions continued to shrink. However, the patient developed immunotherapy-related pneumonia following the eighth treatment. Hormone therapy was administered while all the anti-tumor therapies were halted. After the pneumonia improved, the patient underwent positron emission tomography-computed tomography, revealing a complete response to his tumor. To consolidate the effect, he received another five cycles of disitamab vedotin monotherapy as maintenance therapy, without experiencing any adverse events. To date, the patient has remained in good health without any recurrence 10 months after drug discontinuance.
Conclusion:
Disitamab vedotin combined with immunotherapy demonstrated a long-term clinical benefit in advanced Her-2-positive EMPD. For rare solid tumors with Her-2 overexpression, disitamab vedotin combined with immunotherapy might offer a viable therapeutic choice.
Super super obesity with a BMI of 98 kg/m2: a case report
Authors: Ragad I Al Jazzar, Nayef Alzahrani, Mustafa M Eltayeb, Ahmed K Satti, Hussain Omar, Arief Arrowaili
Journal: J Surg Case Rep (2024)
Keywords: laparoscopy, sleeve gastrectomy, super super obesity
MeSH terms: Case Reports

Standards of care in regards to super-super obese patients are yet to be evolving due to the sparsity of this weight category along with the high morbidity and mortality rates attributed to it. We report a successful case of laparoscopic sleeve gastrectomy for a 35 years old lady with a body mass index (BMI) of 98 kg/m2.
ERBB2 (HER2) amplifications and co-occurring KRAS alterations in the circulating cell-free DNA of pancreatic ductal adenocarcinoma patients and response to HER2 inhibition
Authors: Afsaneh Barzi, Caroline M Weipert, Carin R Espenschied, Victoria M Raymond, Andrea Wang-Gillam, Mohammad Amin Nezami, Eva J Gordon, Daruka Mahadevan, Kabir Mody
Journal: Front Oncol (2024)
Keywords: erbb2, her2 amplification, ctdna, liquid biopsy, pancreatic cancer

Purpose:
Despite accumulating data regarding the genomic landscape of pancreatic ductal adenocarcinoma (PDAC), olaparib is the only biomarker-driven FDA-approved targeted therapy with a PDAC-specific approval. Treating ERBB2(HER2)-amplified PDAC with anti-HER2 therapy has been reported with mixed results. Most pancreatic adenocarcinomas have KRAS alterations, which have been shown to be a marker of resistance to HER2-targeted therapies in other malignancies, though the impact of these alterations in pancreatic cancer is unknown. We describe two cases of ERBB2-amplified pancreatic cancer patients treated with anti-HER2 therapy and provide data on the frequency of ERBB2 amplifications and KRAS alterations identified by clinical circulating cell-free DNA testing.
Methods:
De-identified molecular test results for all patients with pancreatic cancer who received clinical cell-free circulating DNA analysis (Guardant360) between 06/2014 and 01/2018 were analyzed. Cell-free circulating DNA analysis included next-generation sequencing of up to 73 genes, including select small insertion/deletions, copy number amplifications, and fusions.
Results:
Of 1,791 patients with pancreatic adenocarcinoma, 36 (2.0%) had an ERBB2 amplification, 26 (72.2%) of whom had a KRAS alteration. Treatment data were available for seven patients. Two were treated with anti-HER2 therapy after their cell-free circulating DNA result, with both benefiting from therapy, including one with a durable response to trastuzumab and no KRAS alteration detected until progression.
Conclusion:
Our case series illustrates that certain patients with ERBB2-amplified pancreatic adenocarcinoma may respond to anti-HER2 therapy and gain several months of prolonged survival. Our data suggests KRAS mutations as a possible mechanism of primary and acquired resistance to anti-HER2 therapy in pancreatic cancer. Additional studies are needed to clarify the role of KRAS in resistance to anti-HER2 therapy.
Severe thyrotoxicosis induced by tislelizumab: a case report and literature review
Authors: Liman Huo, Chao Wang, Haixia Ding, Xuelian Shi, Bin Shan, Ruoying Zhou, Ping Liang, Juan Hou
Journal: Front Oncol (2023)
Keywords: hyperthyroidism, hypothyroidism, immune-related adverse events, thyroiditis, tislelizumab
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) have made significant breakthroughs in the treatment of a variety of malignancies. As its use increases, the unique immune-mediated toxicity profile of ICls are becoming apparent. We report a case of immune-related endocrine adverse events (irAE) in a patient with hepatocellular carcinoma treated with anti-programmed cell death protein 1 (PD-1) (tislelizumab). Although many irAEs have been reported, few cases of severe thyrotoxicosis have been described after immunotherapy in the literature. We present the case of a 49-year-old male who experienced a Grade 3 tislelizumab-related adverse reaction according to Common Terminology Criteria for Adverse Events (CTCAE5.0) and received methylprednisolone, thiamazole, and levothyroxine sodium tablets. Early identification of irAEs, risk factors, regular monitoring, use of steroids and/or immunoglobulins, and adjuvant supportive care are critical to the clinical prognosis of patients. It should be underlined that the tumor benefits of ICI therapy outweigh the risks associated with ICI-induced endocrine disorders, and ICI treatment should not be stopped or delayed except in rare cases (adrenal crisis, severe thyrotoxicosis). The familiarity of healthcare professionals with irAEs of the thyroid when thyrotoxicosis occurs is important to facilitate an effective diagnosis and appropriate treatment of this increasingly common thyroid disorder.
Retained arterial catheter following patient self-discontinuation-a case report
Authors: Alexandria Byskosh, Kevin Olsen
Journal: J Surg Case Rep (2024)
Keywords: arterial line, retained line, vascular surgery
MeSH terms: Case Reports

A patient self-discontinues arterial line resulting in retention of arterial catheter. The retained catheter was identified on bedside ultrasound and the patient required radial artery exploration and removal of catheter under general anesthesia. We describe potential contributing factors and solutions to catheter design and placement as well as next steps once a retained catheter has been identified.
Development of IgE-mediated food allergies in children with history of food protein-induced allergic proctocolitis: a series of five cases
Authors: Kim L Tran, Elizabeth L Wisner, George M Jeha, Luke A Wall
Journal: Front Allergy (2024)
Keywords: fpiap, ige, anaphylaxis, atopy, case report, food allergy

Food protein-induced allergic proctocolitis (FPIAP) is a non-IgE-mediated allergic condition that presents with hematochezia in otherwise healthy infants. It is most commonly induced by cow's milk protein via breast milk or formula. The prognosis for FPIAP is generally considered favorable with most infants achieving symptomatic resolution after diet modification. Most infants go on to tolerate the offending foods by 1-3 years of age. Over 8 years at our institution, five patients were identified and noted to have FPIAP to cow's milk during infancy with subsequent development of IgE-mediated allergic reaction to cow's milk and other foods. All five cases developed other atopic disorders (atopic dermatitis in four cases). IgE-mediated cow's milk allergy has persisted beyond the preschool years in at least two patients (currently 8 and 16 years old). For three of the patients, the IgE-mediated reaction to cow's milk was severe with development of anaphylaxis or angioedema. In addition, three patients experienced anaphylaxis or angioedema to allergens other than milk. While FPIAP is a non-IgE-mediated process traditionally thought not to progress past the first year of life, some infants with FPIAP develop severe, persistent IgE-mediated cow's milk allergy. To our knowledge, this is the first detailed clinical description of such patients.
Case report: Transition from anti-CD20 therapy to inebilizumab for 14 cases of neuromyelitis optica spectrum disorder
Authors: Benjamin Osborne, Gabriela Romanow, J Michael Hemphill, Myassar Zarif, Tracy DeAngelis, Tyler Kaplan, Unsong Oh, Johnathan Pinkhasov, Kristina Patterson, Michael Levy
Journal: Front Neurol (2024)
Keywords: aquaporin-4 antibody, case report, clinical outcome, inebilizumab, neuromyelitis optica spectrum disorder, rituximab, treatment transition
MeSH terms: Case Reports

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disorder of the central nervous system characterized by recurrent, disabling attacks that affect the optic nerve, spinal cord, and brain/brainstem. While rituximab, targeting CD20-positive B-cells, is used as an off-label therapy for NMOSD, some patients continue to exhibit breakthrough attacks and/or adverse reactions. Inebilizumab, a humanized and glycoengineered monoclonal antibody targeting CD19-positive B-cells, has been FDA approved for the treatment of NMOSD in adult patients who are anti-aquaporin-4 (AQP4) antibody positive. Given the limited real-world data on the efficacy and safety of inebilizumab, especially in those transitioning from rituximab, a retrospective chart review was conducted on 14 NMOSD patients from seven centers. Of these, 71.4% (n = 10) experienced a combined 17 attacks during rituximab treatment, attributed to either breakthrough disease (n = 10) or treatment delay (n = 7). The mean duration of rituximab treatment was 38.4 months (3.2 years). Notably, no subsequent attacks were observed during inebilizumab treatment [mean duration of inebilizumab treatment was 19.3 months (1.6 years)], underscoring its potential as an effective treatment for NMOSD. Our data suggest that inebilizumab provides clinical benefit with effective disease control and a favorable safety profile for patients transitioning from rituximab.
Case report: Successful treatment of recurrent E. coli infection with bacteriophage therapy for patient suffering from chronic bacterial prostatitis
Authors: Apurva Virmani Johri, Pranav Johri, Naomi Hoyle, Lia Nadareishvili, Levan Pipia, Dea Nizharadze
Journal: Front Pharmacol (2023)
Keywords: e coli, antibiotic resistance, bacteriophage, biofilms, chronic bacterial prostatitis, phage therapy, successful treatment
MeSH terms: Case Reports

Background: Chronic Bacterial Prostatitis (CBP) is inflammation of the prostate caused by bacterial infection. An estimated 8.2% of men have prostatitis, most commonly under the age of 50. Antibiotics often fail to treat CBP due to presence of bacterial biofilms and rising antibiotic resistance of pathogenic bacterial strains. The multidrug resistant (MDR) bacterial strains often implicated in cases of CBP include Extended Spectrum Beta Lactam resistant Escherichia coli, Vancomycin resistant Enterococci, Gram-positive bacterial strains like Staphylococci and Streptococci, Enterobacteriaceae like Klebsiella and Proteus, and Pseudomonas aeruginosa. CBP patients experience significant deterioration in quality of life, with impact on mental health comparable with patients of diabetes mellitus and chronic heart failure, leading patients to explore alternatives like phage therapy. Case presentation: We present the case of a patient diagnosed with and exhibiting typical symptoms of CBP. Tests of the prostatic and seminal fluids identified E. coli as the causative pathogen. The patient did not experience favourable long-term treatment outcomes despite repeated antibiotic courses administered over 5 years. This led him to seek phage therapy for treatment of his condition. Methods and outcome: The cultured strain of E. coli was tested against bacteriophage preparations developed by the Eliava Institute, Georgia. Preparations showing lytic activity against the strain were used for the patient's treatment at the Eliava Phage Therapy Center (EPTC). The patient underwent two courses of treatment with the EPTC. The first treatment course resulted in significant symptomatic improvement, followed by complete resolution of symptoms post the second course of phage therapy. Samples tested during treatment showed declining bacterial growth, corresponding with symptomatic improvement. Post-treatment cultures had no growth of pathogenic bacteria. Discussion: This case illustrates the efficacy of bacteriophages in treating CBP, a condition that is often resistant to antibiotic therapies. Antibiotics such as ofloxacin, Fosfomycin, trimethoprim, nitrofurantoin and ceftriaxone were administered in multiple courses over 5 years, but the infection recurred after each course. After two courses of phage therapy, the patient experienced long-term symptom resolution and substantial reduction in bacterial load. Increasing numbers of such cases globally warrant further research into the potential for bacteriophages for treating MDR and chronic infections.
Case Report: Extraction of a stylet-driven lead for left bundle branch area pacing >2 years after implantation
Authors: Ivana Grgic Romic, Ana Lanca Bastiancic, David Zidan, Mate Mavric, Sandro Brusich
Journal: Front Cardiovasc Med (2024)
Keywords: conduction system pacing, left bundle branch area pacing, stylet-driven lead, transvenous lead extraction, venoplasty
MeSH terms: Case Reports

Left bundle branch pacing has recently emerged as a significant alternative to right ventricular pacing. The rate of implanted stylet-driven septal leads is expected to increase substantially in the coming years, along with the need to manage long-term complications. Experience in extracting these leads is currently very limited; however, the number of complex extractions is anticipated to increase in the future. We report a complex case involving the extraction of a long-dwelling Solia lead used for left bundle branch pacing in a 21-year-old man. The lead was extracted through the implant vein 27 months after implantation, using a methodology that involved a locking stylet and compression coil. The new lead insertion was challenging due to venous occlusion but after successful venoplasty, the His lead was successfully implanted. The postoperative course was uneventful, demonstrating the feasibility of extraction without complications.
First case report of diagnosis of extrapancreatic solid pseudopapillary tumor with SMA invasion in a 47-year-old man: a case report and literature review
Authors: Aijing Zhang, Kaibin Wang, Xiaohan Tian, Shuhai Chen, Jianwei Xu, Han Liu, Lei Wang, Feng Li
Journal: Front Surg (2024)
Keywords: ectopic spt, extrapancreatic tumor, pancreatic cancer, solid pseudopapillary tumor of the pancreas (spt), vascular invasion
MeSH terms: Case Reports

Background:
Solid pseudopapillary tumor of the pancreas (SPT) is a rare low-grade malignant tumor predominantly observed in young women without significant clinical symptoms. While most SPTs occur in the pancreatic region, rare cases have occurred in the retroperitoneum, making the diagnosis of ectopic SPTs difficult.
Case presentation:
Herein, we report a rare case of an extrapancreatic solid SPT with superior mesenteric artery (SMA) involvement in a 47-year-old man together with a literature review to provide context with clinical information, CT and a literature review.
Conclusions:
This case may provide a practical approach for the diagnosis of ectopic SPT, especially for patients with vascular invasion.
Staphylococcus schleiferi: An Uncommon Pathogen in an Immunocompetent Adolescent with Chronic Osteomyelitis
Authors: Maria Celeste Ruiz Holgado, Joanna Iris Depasupil, Michael Stracher, Esra Fakioglu, Lily Q Lew
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Staphylococcus schleiferi represents an uncommon pathogen in human infections. As a veterinary pathogen, S. schleiferi causes canine ear and skin infections. Chronic osteomyelitis is a progressive process characterized by bone destruction and the formation of sequestrum. It may be a sequela of untreated or undertreated acute osteomyelitis or septic arthritis. Descriptions detailing the pathogenicity and virulence of S. schleiferi osteomyelitis were limited to a few case reports. Among the three reported cases of S. schleiferi osteomyelitis, immunosuppression, malignancy, and recent surgical procedures were comorbidities. Compared to those who are immunosuppressed, immunocompetent individuals are generally not susceptible to uncommon microorganisms. Early detection of osteomyelitis, aggressive appropriate prolonged antimicrobial treatment and a multidisciplinary approach contribute to optimal recovery. We report the first case of S. schleiferi chronic osteomyelitis in an immunocompetent adolescent.
Tibial Lateral Condyle Fracture After Cementless Oxford Unicompartmental Knee Arthroplasty (UKA): A Report of Four Cases
Authors: Atsuki Tanaka, Takafumi Hiranaka, Takaaki Fujishiro, Motoki Koide, Koji Okamoto
Journal: Cureus (2024)
Keywords: cementless, lateral tibial fracture, magnetic resonance imaging (mri), pinhole, unicompartmental knee arthroplasty (uka)
MeSH terms: Case Reports

Cementless unicompartmental knee arthroplasty (UKA) has a lower rate of radiolucency in postoperative follow-up than cemented UKA. However, the rate of tibial plateau fracture, one of the complications, has been reported to be higher in cementless UKA than in cemented UKA. We report four cases of postoperative tibial lateral condyle fractures after cementless Oxford UKA. Four patients underwent cementless Oxford UKA. Immediate postoperative radiography and CT showed no fracture lines. At five to six weeks postoperatively, MRI showed a fracture line from the intersection of the longitudinal and transverse tibial osteotomies through the lateral pinhole to the end of the lateral tibial diaphysis. At three months, bone union was observed without surgical treatments. Lateral tibial fracture after cementless Oxford UKA has a good clinical course without the need for surgical intervention. Medial fractures should thus be more actively prevented. MRI is useful for less symptomatic tibial lateral condyle fractures.