OpenMed/multicare-articles huggingface dataset:
Endovascular repair of infected carotid pseudoaneurysm: A case report
Authors: Mohsen Bannazadeh, Ali Reza Sattari, Edvard Skripochnik, Gergios Tzavellas, Apostolos Tassiopoulos
Journal: Int J Surg Case Rep (2020)
Keywords: carotid endarterectomy, case report, endovascular, infection, pseudoaneurysm
MeSH terms: Case Reports

Background:
Pseudoaneurysm (PA) of the carotid artery is a rare but life-threatening complication following carotid endarterectomy (CEA). Management of carotid PAs is challenging due to the increased risk of stroke and nerve injury in an infected and re-operative field. Open surgery has been the mainstay for this complicated pathology however some patients have characteristics which make an endovascular approach more advantageous. Yet endovascular intervention for infected fields is scrutinized and used as a last option.
History and treatment plan:
72 year old female with history of basilar artery aneurysm embolization and right internal carotid artery occlusion presented with a left carotid pseudoaneurysm after a CEA 6 months prior. She presented with 2 days of increasing left neck swelling, erythema, and a small ulcerated area with bloody discharge from incision site. A Computed Tomagraphy scan (CTA) showed hematoma surrounding the left ICA concerning for PA. Wound cultures were obtained which grew coagulase (-) staphylococcus. We elected to perform an endovascular procedure to temporize the bleeding by placing a stent graft (7 mm × 7.5 cm Gore Viabahn) across the left ICA. She remains asymptomatic with no recurrent symptoms 6 months postoperatively.
Conclusion:
Our experience in this patient indicates that endovascular stenting could be feasible and potentially effective intervention for infection-associated post-CEA PA in patients with an excessively high risk for stroke and nerve injury. We suggest each patient should be evaluated individually and all pertinent characteristics should be considered to make the best decision.
An 82-year-old Caucasian man with a ductal prostate adenocarcinoma with unusual cystoscopic appearance: a case report
Authors: Stavros Sfoungaristos, Ioannis S Katafigiotis, Stavros I Tyritzis, Adamantios Kavouras, Panagiotis Kanatas, Anastasios Petas
Journal: J Med Case Rep (2011)

Introduction:
Ductal adenocarcinoma is a rare variety of the common acinar adenocarcinoma. It usually presents with refractory symptoms, and during cystoscopy, it is seen as an exophytic lesion at the area of the verumontanum.
Case presentation:
An 82-year-old Caucasian man was diagnosed with ductal adenocarcinoma of the prostate after undergoing transurethral resection of the prostate for urinary retention. Immunohistochemistry confirmed the nature of the tumor. The patient was treated with triptorelin, 3.75 mg once/month, and bicalutamide, 50 mg 1 × 1. The serum prostate-specific antigen at three, six and 12 months after transurethral resection of the prostate was 0.1 ng/ml. The patient remains asymptomatic, and he entered a six-month follow-up protocol.
Conclusion:
Ductal adenocarcinoma often involves the central ducts of the gland and may present as an exophytic papillary lesion in the prostatic urethra. This is why it usually presents with refractory symptoms. The outcome for men with prostatic ductal adenocarcinoma is, in most studies, worse than the outcome for men with prostatic acinar adenocarcinoma. Aggressive management is indicated, even with low-volume metastatic disease.
Resolution of macular edema in Coats' disease with intravitreal bevacizumab
Authors: Morteza Entezari, Alireza Ramezani, Ladan Safavizadeh, Nader Bassirnia
Journal: Indian J Ophthalmol (2010)
MeSH terms: Angiogenesis Inhibitors / administration & dosage, Antibodies, Monoclonal / administration & dosage, Macular Edema / drug therapy, Retinal Vessels / pathology, Telangiectasis / complications, Case Reports, Adolescent, Antibodies, Monoclonal, Humanized, Bevacizumab, Diagnosis, Differential, Follow-Up Studies, Humans, Injections, Macular Edema / complications, Macular Edema / diagnosis, Male, Microscopy, Acoustic, Ophthalmoscopy, Retinal Diseases / complications, Retinal Diseases / diagnosis, Retinal Diseases / drug therapy, Telangiectasis / diagnosis, Telangiectasis / drug therapy, Vascular Endothelial Growth Factor A / antagonists & inhibitors, Visual Acuity, Vitreous Body, Angiogenesis Inhibitors, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Vascular Endothelial Growth Factor A, Bevacizumab

A 13-year-old boy was referred because of visual deterioration in his right eye. The visual acuity was two meters of counting fingers. Indirect ophthalmoscopy and biomicroscopy revealed exudative macular edema as well as tumor-like telangiectatic vessels and exudation in temporal periphery. With diagnosis of Coats' disease (stage II) confirmed by fluorescein angiography, three intravitreal injections of bevacizumab were performed at 6-week intervals. One year after the last injection, there was a significant resolution of macular edema as well as visual acuity improvement to 20/20. This is the first case report in which a distinct improvement in macular edema was observed with intravitreal bevacizumab in Coats' disease.
Unexpected discovery of multiple myeloma following cardiomyopathy
Authors: Souhail Dahraoui, Jean Uwingabiye, Badia Belarj, Asmae Biaz, Achraf Rachid, Abdellah Dami, Sanae Bouhsain, Zohra Ouzzif, Samira Elmachatni Idrissi
Journal: Clin Case Rep (2017)
Keywords: anemia, cardiorenal syndrome, multiple myeloma
MeSH terms: Case Reports

We report the case of multiple myeloma of unexpected discovery in an old patient admitted to the emergency department of cardiomyopathy. This observation emphasizes the need for exploring any anemia before linking it to heart failure or kidney disease. Serum protein electrophoresis remains crucial especially in the elderly patients.
Pneumocystis jirovecii pneumonia associated with immune checkpoint inhibitors: A systematic literature review of published case reports and disproportionality analysis based on the FAERS database
Authors: Shuang Xia, Hui Gong, Yi-Kun Wang, Ling Liu, Yi-Chang Zhao, Lin Guo, Bi-Kui Zhang, Mayur Sarangdhar, Yoshihiro Noguchi, Miao Yan
Journal: Front Pharmacol (2023)
Keywords: faers, immune checkpoint inhibitors, pharmacovigilance, pneumocystis jirovecii pneumonia, systematic literature review

Background: Pneumocystis jirovecii pneumonia (PJP) has been reported with ICIs but limited to case reports. The clinical features of PJP with ICIs remain mostly unknown. This study aims to investigate the association of PJP with ICIs and describe clinical features. Methods: Reports of PJP recorded in FAERS (January 2004-December 2022) were identified through the preferred term "Pneumocystis jirovecii pneumonia". Demographic and clinical features were described, and disproportionality signals were assessed through the Reporting Odds Ratio (ROR) and Information Component (IC), using traditional chemotherapy and targeted therapy as comparators, and adjusting signals by excluding contaminant immunosuppressive drugs and pre-existing diseases. A systematic literature review was conducted to describe clinical features of published PJP reports with ICIs. Bradford Hill criteria was adopted for global assessment of the evidence. Results: We identified 677 reports of PJP associated with ICIs, in which 300 (44.3%) PJP cases with fatal outcome. Nivolumab (IC025 2.05), pembrolizumab (IC025 1.88), ipilimumab (IC025 1.43), atezolizumab (IC025 0.36), durvalumab (IC025 1.65), nivolumab plus ipilimumab (IC025 1.59) have significant signals compared to other drugs in FAERS database. After excluding pre-existing diseases and immunosuppressive agents which may increase susceptibility of PJP, the signals for PJP associated with nivolumab, pembrolizumab, durvalumab, nivolumab plus ipilimumab remained robust (IC025 > 0). When compared to other anticancer regimens, although all ICIs showed a lower disproportionate signal for PJP than chemotherapy, nivolumab (IC025 0.33, p < 0.001), pembrolizumab (IC025 0.16, p < 0.001), both PD-1 inhibitors, presented a higher signal for PJP than targeted therapy. Male gender (IC025 0.26, p < 0.001) and age >65 years (IC025 0.38, p < 0.001) were predominant in PJP cases associated with across all ICIs. In literature, 15 PJP cases associated with ICIs were reported in 10 published case reports. 12 of 15 (80.0%) of cases received PD-1 inhibitors before PJP was diagnosed. Conclusion: By the combined analysis of post-marketing data from FAERS and published case reports, we identified ICIs may be associated with PJP, especially in males aged >65years. After accounting for confounders, PD-1 inhibitors emerged with a robust disproportionality signal when compared to PD-L1/CTLA-4 inhibitors as well as targeted therapy. Further research is warranted to validate our findings.
Within Patient Radiological Comparative Analysis of the Performance of Two Bone Graft Extenders Utilized in Posterolateral Lumbar Fusion: A Retrospective Case Series
Authors: Geoffrey Stewart, Gary B Gage, Gary Neidert, Huston Davis Adkisson 4th
Journal: Front Surg (2016)
Keywords: biomaterial scaffold, bone graft extender, bone marrow aspirate, endochondral ossification, hyaluronic acid, spine fusion

Two bone graft extenders differing in chemical composition were implanted contralaterally in 27 consecutive patients undergoing instrumented posterolateral lumbar fusion as standard-of-care. Bone marrow aspirate and autogenous bone graft were equally combined either with β-tricalcium phosphate (β-TCP) or a hybrid biomaterial [containing hyaluronic acid (HyA) but lacking a calcium salt] and implanted between the transverse processes. Fusion status on each side of the vertebrae was retrospectively graded (1-5 scale) on AP planar X-ray at multiple visits as available, through approximately 12 months. Additionally, consolidation or resorption since prior visit for each treatment was recorded. Sides receiving β-TCP extender showed marked resorption prior to bone consolidation during the first 6 months. By contrast, sides receiving the hybrid biomaterial containing integrated HyA showed rapid bone consolidation by week 6-8, with maintenance of initial bone volume through 12 months. Fusion grade was superior for the hybrid biomaterial, differing significantly from β-TCP at day 109 and beyond. Fusion success at >12 months was 92.9 vs. 67.9% for the hybrid biomaterial and β-TCP-treated sides, respectively. The hybrid biomaterial extender demonstrated a shortened time-to-fusion compared to the calcium-based graft. Mode of action has been demonstrated in the literature to differ between these compositions. Therefore, choice of synthetic biomaterial composition may significantly influence the mode of action of cellular events regulating appositional bone growth.
Hyoid Elongation May Be a Rare Cause of Recurrent Ischemic Stroke in Youth-A Case Report and Literature Review
Authors: Gang Liu, Yuan Wang, Changbiao Chu, Yi Ren, Yang Hua, Xunming Ji, Haiqing Song
Journal: Front Neurol (2021)
Keywords: carotid artery diseases, hyoid bone, imaging diagnosis, recurrent stroke, young adults
MeSH terms: Case Reports

The investigation for etiology of ischemic stroke in young adults remains a diagnostic challenge. Hyoid bone-related carotid injury is a rare and under-recognized cause of ischemic stroke, without established guidelines. We describe a case of recurrent ischemic stroke in a young patient presumably attributed to an impingement of the carotid artery by an elongated hyoid bone, and present other cases reported in the literature. Based on the imaging study as well as the lack of other findings, we attributed recurrent neurovascular events to the repetitive mechanical stimulation by the elongated hyoid bone that caused a vessel wall injury with subsequent thrombus and embolus. Given repeated recurrence under antiplatelet treatment, anticoagulation was added. The following 2-year follow-up showed no new neurologic events or any other complaints. Among the young, a broad spectrum of possibilities should be considered and we call attention to this infrequent etiology of ischemic stroke.
Primary lung sebaceous carcinoma successfully treated with radiotherapy and pembrolizumab: A case report
Authors: Yasumiko Jodai, Shohei Hamada, Mikiko Yamada, Yuiko Masuda, Moriyasu Anai, Takayuki Jodai, Yusuke Tomita, Sho Saeki, Hidenori Ichiyasu, Takuro Sakagami
Journal: Thorac Cancer (2023)
Keywords: pembrolizumab, primary lung sebaceous carcinoma, radiotherapy
MeSH terms: Carcinoma, Lung Neoplasms / secondary, Sebaceous Gland Neoplasms / pathology, Skin Neoplasms, Case Reports, Aged, Humans, Lung / pathology, Male, pembrolizumab

Sebaceous carcinoma is a rare cutaneous malignant tumor, usually occurring on the eyelids, head, neck, and trunk. There have been few reports about sebaceous carcinoma with primary lung cancer, for which optimal therapy has not yet been established. A 70-year-old man presented with a mass in the left iliac bone and tumor of the lower left lung. The morphological characteristics of the iliac bone biopsy pathology and immunostaining results showed sebaceous gland differentiation. After systemic examination, we diagnosed a primary lung sebaceous carcinoma with intrapulmonary and bone metastases. PD-L1 was positive in 1%-24% of tumor cells, and microsatellites were stable. We detected protein kinase B (AKT1) mutations using the Oncomine Dx target test. Palliative radiotherapy (RT) of a total of 45 Gy was provided in 15 fractions to the left iliac region, which resulted in a 25% reduction in the tumor size. Subsequently, four courses of first-line pembrolizumab led to a 30% reduction in the total tumor count. RT and pembrolizumab may be treatment options for certain rare primary sebaceous carcinomas of the lungs. A synergistic effect from RT and subsequent administration of immune checkpoint inhibitors may have contributed to tumor reduction.
The labyrinth of pyrexia of unknown origin: a case of intravascular diffuse B cell lymphoma
Authors: Sujith V Cherian, Subhraleena Das, Bandita Das Basu, Robert E Hutchison
Journal: Mediterr J Hematol Infect Dis (2013)
MeSH terms: Case Reports

Intravascular large B cell lymphoma (IVLBCL) is a rare, aggressive extranodal B cell lymphoma, classified as a subset of diffuse B cell lymphoma. IVLBCL typically occurs in elderly persons and the clinical heterogeneity of the condition makes the diagnosis elusive in most cases. Most of the reported cases have been in the Asian population with the majority of the cases being diagnosed postmortem. We present a unique case of IVLBCL in a 65-year-old Caucasian male who presented with fever of unknown origin.
Concurrent cemento-osseous dysplasia and osteogenic sarcoma: report of two cases
Authors: A A Olusanya, B F Adeyemi, A O Adisa
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Aim. Cemento-osseous dysplasia (COD) represents a rare group of benign fibroosseous disorders, while osteogenic sarcoma (OS) on the hand, is a malignant tumour of ominous prognosis. A combination of COD and OS is rare and sparsely reported in literature. There are only four reported cases known to the authors. The aim of this paper is to report additional cases of COD occurring concurrently with OS. Materials and Methods. The clinicoradiologic findings and histological analysis of mandibular lesions in two patients who reported at the Dental Centre of the University College Hospital, Ibadan, Nigeria, are presented. Results. The two patients were diagnosed of mandible osteosarcoma occurring concurrently with bilateral mandibular focal cemento-osseous dysplasia. Conclusion. The simultaneous occurrence of osteosarcoma and cemento-osseous dysplasia raises the question of whether COD has transformed into OS or a collision tumour has occurred and their simultaneous occurrence is just a coincidence.
Laparoscopic-assisted excision of a huge polycystic omental lymphangioma in a 3 year old patient presenting with acute abdomen: case report and review
Authors: Maria Tsopozidi, Chrysostomos Kepertis, Dimitrios Godosis, Vasilios Mouravas, Charikleia Demiri, Ioannis Spyridakis
Journal: Pan Afr Med J (2021)
Keywords: lymphangioma, acute abdomen, case report, greater omentum, laparoscopic management
MeSH terms: Abdomen, Acute / etiology, Lymphangioma, Cystic / surgery, Omentum / surgery, Peritoneal Neoplasms / surgery, Case Reports, Review, Child, Preschool, Female, Humans, Laparoscopy, Lymphangioma, Cystic / diagnosis, Omentum / pathology, Peritoneal Neoplasms / diagnosis

Lymphangioma is a rare benign neoplasm affecting mainly children. In this report we present a complicated case of polycystic omental lymphangioma in a 3 year old female presenting with acute abdomen. The patient underwent a laparoscopic-assisted excision of the lesion and had an excellent postoperative course. We discuss the effectiveness and advantages of this laparoscopic surgical approach in children and elaborate on the current literature.
Case report: Pathological complete response to perioperative treatment of radiotherapy combined with angiogenesis inhibitor in a patient with pleomorphic liposarcoma
Authors: Chenlu Zhang, Wenshuai Liu, Binliang Wang, Na Zhu, Xi Guo, Zhiming Wang, Rongyuan Zhuang, Yang You, Yong Zhang, Hanxing Tong, Weiqi Lu, Yuhong Zhou
Journal: Front Oncol (2023)
Keywords: angiogenesis inhibitor, case report, pathological complete response, pleomorphic liposarcoma, preoperative radiotherapy
MeSH terms: Case Reports

Background:
Liposarcomas (LPS) are mesenchymal malignancies with four principal subtypes presenting distinct molecular and clinical features. Pleomorphic liposarcoma (PLPS) is one of the rarest and most aggressive subtypes of LPS. Surgical resection is currently a preferred curative approach for localized PLPS. However, the prognosis of unresectable PLPS is extremely poor, and there is no standard treatment.
Case presentation:
A 59-year-old Chinese woman was diagnosed with unresectable PLPS. The case was discussed and managed by specialists from a multidisciplinary team at Fudan Zhongshan Hospital. Preoperative radiotherapy (RT) of intensity-modulated radiation therapy (IMRT) at 50 Gy/25 Fx concurrently with the angiogenesis inhibitor anlotinib (8 mg, days 1-14, every 3 weeks) was prescribed to the patient. The dosage of anlotinib was increased to 10 mg after RT. After 6 months of treatment, the tumor had significantly shrunk and was successfully resected. Examination of the surgical specimens showed a pathological complete response (pCR). Until the latest follow-up (April 2022), no recurrence was observed, and disease-free survival has exceeded 14 months.
Conclusion:
This case sheds light on the probability that perioperative RT combined with an angiogenesis inhibitor can be effectively used in PLPS, which is resistant to chemotherapy and usually considered to have a poor prognosis. Further studies with randomized controlled clinical trials will improve our knowledge of this preoperative treatment strategy.
Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care
Authors: Salomé Azevedo, Federico Guede-Fernández, Francisco von Hafe, Pedro Dias, Inês Lopes, Nuno Cardoso, Pedro Coelho, Jorge Santos, José Fragata, Clara Vital, Helena Semedo, Ana Gualdino, Ana Londral
Journal: Front Digit Health (2022)
Keywords: collaboration, follow-up care, implementation, participatory action research, remote patient monitoring

Background:
COVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability and rapid implementation of RPM services require social change and active collaboration between stakeholders. Therefore, a participatory action research (PAR) approach is needed to support the collaborative development of the technological component while simultaneously implementing and evaluating the RPM service through critical action-reflection cycles.
Objective:
This study aims to demonstrate how PAR can be used to guide the scalability design of RPM pilot initiatives and the implementation of RPM-based follow-up services.
Methods:
Using a case study strategy, we described the PAR team's (nurses, physicians, developers, and researchers) activities within and across the four phases of the research process (problem definition, planning, action, and reflection). Team meetings were analyzed through content analysis and descriptive statistics. The PAR team selected ex-ante pilot initiatives to reflect upon features feedback and participatory level assessment. Pilot initiatives were investigated using semi-structured interviews transcribed and coded into themes following the principles of grounded theory and pilot meetings minutes and reports through content analysis. The PAR team used the MoSCoW prioritization method to define the set of features and descriptive statistics to reflect on the performance of the PAR approach.
Results:
The approach involved two action-reflection cycles. From the 15 features identified, the team classified 11 as must-haves in the scaled-up version. The participation was similar among researchers (52.9%), developers (47.5%), and physicians (46.7%), who focused on suggesting and planning actions. Nurses with the lowest participation (5.8%) focused on knowledge sharing and generation. The top three meeting outcomes were: improved research and development system (35.0%), socio-technical-economic constraints characterization (25.2%), and understanding of end-user technology utilization (22.0%).
Conclusion:
The scalability and implementation of RPM services must consider contextual factors, such as individuals' and organizations' interests and needs. The PAR approach supports simultaneously designing, developing, testing, and evaluating the RPM technological features, in a real-world context, with the participation of healthcare professionals, developers, and researchers.
Femoral artery thrombosis after internal fixation of a transverse acetabular fracture in a patient with osteogenesis imperfecta type I
Authors: Navid M Ziran, Jeffrey L Johnson, Steven J Morgan, Wade R Smith
Journal: Patient Saf Surg (2008)

Osteogenesis imperfecta is a genetic disorder characterized by increased susceptibility to fractures and vascular injuries due to connective tissue fragility. In this case report, we present a patient with osteogenesis imperfecta type I who sustained a transverse fracture of the right acetabulum while transferring from bed to chair. The fracture was repaired through an ilioinguinal approach. During the surgery, an iatrogenic injury to the femoral artery and vein occurred. This intraoperative complication was salvaged by immediate vascular repair. We discuss the possible causes of iatrogenic vascular injuries in patients with osteogenesis imperfecta. Orthopaedic surgeons should be aware of this potentially devastating complication in this particular patient cohort.