OpenMed/multicare-articles huggingface dataset:
Case report: Complete response after transcatheter arterial chemoembolization combined with donafenib plus tislelizumab therapy for hepatocellular carcinoma with main trunk portal vein tumor thrombus in a patient coinfected with HIV and HBV
Authors: Xuhua Xiao, Haixiao Fu, Huixia Qin, Longkuan Xu, Jing Gu, Zhan Zhang, Houxiang Ya, Kaiwen Jiang, Zhiyuan Jian, Shuqun Li
Journal: Front Immunol (2024)
Keywords: hiv, complete response, donafenib, hepatocellular carcinoma, main trunk portal vein thrombus, tislelizumab
MeSH terms: Antibodies, Monoclonal, Humanized / administration & dosage, Antibodies, Monoclonal, Humanized / therapeutic use, Carcinoma, Hepatocellular / complications, Carcinoma, Hepatocellular / therapy, Chemoembolization, Therapeutic / methods, Coinfection, HIV Infections / complications, Liver Neoplasms / complications, Liver Neoplasms / therapy, Portal Vein, Case Reports, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Female, Hepatitis B / complications, Humans, Male, Middle Aged, Treatment Outcome, Antibodies, Monoclonal, Humanized, tislelizumab

Background:
Coinfection with the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV) occurs in 5-67% of patients with HIV. HIV weakens the human immune system and leads to various tumors. Patients with unresectable hepatocellular carcinoma (HCC) and HIV experience poor treatment efficacy and have a short survival period. Approximately 70% of cases of HCC are diagnosed at advanced stages due to the subtle onset of the disease. As a result, most cases are not suits for curative therapy. Transcatheter arterial chemoembolization (TACE) is the first-line treatment for intermediate-stage HCC and is commonly used to treat unresectable HCC in China. Recent advancements in systemic treatments have significantly enhanced the effectiveness of unresectable HCC treatment. Several previous study showed that combination treatment combination therapy can enhance the efficacy. Notably, studies proposed that TACE combined targeted drugs with immune checkpoint inhibitors results in a high objective response rate and overall survival. However, the novelty of this study lies in its report of a complete response using a triple combination in patients with HIV and HCC with main trunk portal vein tumor thrombus.
Case presentation:
A 57-year-old woman was diagnosed with HCC with a main trunk portal vein tumor thrombus combined with HIV infection, cirrhosis, and chronic viral hepatitis. She underwent TACE and was administered donafenib and tislelizumab. This triple therapy treatment regimen resulted in a clinical complete response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) based on contrast-enhanced computed tomography.
Conclusion:
We first used TACE combined with donafenib and tislelizumab for HCC patients with main trunk portal vein tumor thrombus and HIV-HBV coinfection and achieved complete response.
Expert assessment of the impact of ship-strikes on cetacean welfare using the Welfare Assessment Tool for Wild Cetaceans
Authors: Francesca Rae, Christine Nicol, Mark P Simmonds
Journal: Anim Welf (2023)
Keywords: watwc, animal welfare, five domains model, humpback whale, ship-strike, wild animal welfare

Human activities are increasingly impacting our oceans and the focus tends to be on their environmental impacts, rather than consequences for animal welfare. Global shipping density has quadrupled since 1992. Unsurprisingly, increased levels of vessel collisions with cetaceans have followed this global expansion of shipping. This paper is the first to attempt to consider the severity of ship-strike on individual whale welfare. The methodology of the 'Welfare Assessment Tool for Wild Cetaceans' (WATWC) was used, which is itself based upon the Five Domains model. Expert opinion was sought on six hypothetical but realistic case studies involving humpback whales (Megaptera novaeangliae) struck by ships. Twenty-nine experts in the cetacean and welfare sector took part. They were split into two groups; Group 1 first assessed a case we judged to be the least severe and Group 2 first assessed the most severe. Both groups then additionally assessed the same four further cases. This was to investigate whether the severity of the first case influenced judgements regarding subsequent cases (i.e. expert judgements were relative) or not (i.e. judgements were absolute). No significant difference between the two groups of assessors was found; therefore, the hypothesis of relative scoring was rejected. Experts judged whales may suffer some level (>1) of overall (Domain 5) harm for the rest of their lives following a ship-strike incident. Health, closely followed by Behaviour were found to be the welfare aspects most affected by ship-strikes. Overall, the WATWC shows a robust potential to aid decision-making on wild cetacean welfare.
Case report: Noonan syndrome with protein-losing enteropathy
Authors: Yang Ou, Jun-Chao Yuan, Yao Zheng, Jin-Man Zhang, Tian He, Zhi Liang, Yi-Kun Zhou
Journal: Front Genet (2023)
Keywords: noonan syndrome, ptpn11, intestinal lymphatic vessels, lymphatic abnormalities, protein-losing enteropathy
MeSH terms: Case Reports

Background: Noonan syndrome (NS) is characterized by typical facial features, short stature, congenital heart defects and other comorbidities. Lymphedema and chylous pleural effusions are also common in NS, but protein-losing enteropathy (PLE) is rarely reported. Case presentation: We present the case of a 19-year-old Chinese woman presenting with PLE. Small intestine biopsy showed obvious expansion of lymphatic vessels. The gene mutation results of the patient indicated a c.184T>G missense mutation (p.Tyr62Asp) in the PTPN11 gene (NM_002834.3). Conclusion: NS accompanied by PLE is not common, but hypoproteinemia attributable to PLE may be more common in patients with NS than previously thought. It remains uncertain whether mutation of the PTPN11 gene is related to PLE, indicating that further research is needed.
Even a worm will turn: An atypical presentation of hydatid disease
Authors: Piero Saieva, Tamsin Lovelock, Thabiet Jardine
Journal: S Afr J Infect Dis (2024)
Keywords: echinococcus, cyst, cystic echinococcosis, hydatid, hydatid disease
MeSH terms: Case Reports

Hydatid disease (cystic echinococcosis) is a neglected zoonosis, often incidentally detected in its late stages. The clinical manifestations depend on the location and dimensions of the cysts, with the liver and lungs frequently affected. This case report describes thrombocytopenia, an unusual haematological complication of hydatid disease. We use this case to highlight the role that platelets play in various parasitic infections and to advocate for further research into the role of platelets in hydatid disease.
Contribution:
We draw attention to a less well-known complication of hydatid disease.
Oral Rehabilitation for a Patient with Cocaine-Induced Midline Destructive Lesions
Authors: Antoine Berberi, Elie Azar
Journal: Case Rep Otolaryngol (2024)
MeSH terms: Case Reports

Background:
Cocaine is the second most consumed drug worldwide, more than 0.4% of the global population, and has become a real public health problem in recent years. Its inhalation causes significant centrofacial lesions, grouped under the name cocaine-induced midline destructive lesion (CIMDL). These destructions are due to the conjunction of the vasoconstrictor, local prothrombogenic effects, and cytotoxic effects of cocaine. The ischemia produced by this substance is due to vasoconstriction that leads to nasal tissue necrosis and perforation of the nasal septum secondary to chondral necrosis. Case Presentation. A 36-year-old man, previously grappling with cocaine addiction, was hospitalized to undergo comprehensive clinical, microbiological, and radiological examinations because he was suffering from the emergence of crusts and ulceration in the nasal mucosa, accompanied by a palate perforation, a 39°C fever, and chills. Standard bacteriological culture was positive for coagulase-negative staphylococci and Escherichia coli, while mycological culture was positive for Candida tropicalis. The CT scan images of the sinuses confirmed the presence of palatal perforation and total destruction of the nasal septum, cartilaginous portion, maxillary sinus medial wall, lower and middle turbinates, and middle meatus. Nasal endoscopy revealed an exposition of the bony wall and displayed the exposition of the occipital bone's clivus. A diagnosis of CIMDL was confirmed. Antibiotic therapy was decided based on antibiogram results by the consulting microbiologist. Debridement of necrotic tissue was done by nasal endoscopy with local cleaning and was repetitive during the first week to maintain the best cleanliness possible. The patient was discharged with oro-nasal hygiene instructions and referred for prosthetic rehabilation. As for the cocaine addiction, the patient was in follow-up with a psychologist in a specialized centre.
Conclusion:
The care is multidisciplinary. Psychological help and assistance are essential to guide patients to become cocaine free and to avoid a relapse. Weaning is a prerequisite for surgery. Rehabilitation of speech and swallowing is necessary. Many local flaps or micro-anastomoses are possible.
An Infected Dog Bite With Neisseria canis: A Case Report and Review of the Literature
Authors: Richard Giovane, Luis Pernia, Traci Guy, Hannah Blevins
Journal: Cureus (2024)
Keywords: dog bites, drug allergy recording, infectious cellulitis, neisseria spp, site of infection
MeSH terms: Case Reports

Neisseria is a common bacteria that colonizes in humans. Of the 11 species, only two, N. meningitidis and N. gonorrhea, are pathogenic. Although sparse, there are case reports of other Neisseria species causing infections in humans. Neisseria canis, which is a part of normal flora in the mouths of dogs and cats, has been shown to have potential to be pathogenic in humans. The standard treatment for dog and cat bites is oral amoxicillin/clavulanic acid (Augmentin) or IV ampicillin/sulbactam (Unasyn). However, in cases where the patient has multiple antibiotic allergies, careful antibiotic selection must be made to ensure resolution of infection.
Simultaneous, Dual Continuous Venovenous Haemodiafiltration as Salvage Therapy for Severe Sodium Valproate Intoxication
Authors: Aminah Hussan, Ifrah Hasan, Reem El-Hayani, Moustafa Shebl Zahra
Journal: Case Rep Crit Care (2024)
MeSH terms: Case Reports

Sodium valproate overdose leads to CNS depression, cerebral oedema, and severe metabolic acidosis in cases of severe toxicity. Extracorporeal removal, specifically through intermittent haemodialysis, is recommended, though not always tolerated by or accessible to haemodynamically unstable patients in intensive care units. We present a case of a male in his mid-twenties presenting following a massive, intentional overdose of 13 g of sodium valproate over 7 hours, with an initial valproate blood concentration of 975 μg/ml (normal 50-100 μg/ml). He was hypoxic and severely acidotic on arrival and was given fluids and L-carnitine according to TOXBASE guidelines. This resulted in only marginal improvement to his acidosis. Once transferred to our intensive care unit, the patient was started on inotropic support followed by continuous venovenous hemofiltration (CVVHDF) at the maximum effluent rate of 60 ml/kg/hr. Due to his persisting metabolic acidosis and worsening hyperlacataemia, dual CVVHDF was started by adding another filter in series after 26 hours, increasing the maximum effluent rate to 96 ml/kg/hr. The patient remained on dual CVVHDF for 31 hours, during which his acidosis and lactate showed considerable improvement, and he was subsequently stepped down to single-filter CVVHDF for a further 20 hours until complete resolution of his acidosis. This case report recognises dual CVVHDF as a viable salvage therapy for severe sodium valproate overdose by facilitating the achievement of a higher effluent flow rate compared to what can be accomplished with single-filter CVVHDF.
"You Sleep, You Die": A Rare Clinical Case of Ondine's Curse after Posterior Fossa Surgery
Authors: Mitesh Karn, Basant Kumar Mahato, Ranjan Sah, Dipendra Kandel, Shabal Sapkota
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Ondine's curse is a rare condition in which breathing is preserved while awake, but there is absence of autonomic control of ventilation. It is a potentially fatal complication that may result rarely from surgery in posterior fossa in area close to respiratory centers. We describe a patient with posterior fossa hemangioblastoma who underwent subtotal resection via telovelar approach and developed acquired Ondine's curse postoperatively. The patient's presentation and management are described. Besides that, Ondine's is a great example of how modern medicine is linked to ancient literature, and thus, its anecdotal history is also described.
Small Bowel Obstruction Caused by Type IV Hiatal Hernia
Authors: Katsudai Shirakabe, Naoya Ozawa, Yoshihiro Mochizuki, Ken Mizokami
Journal: Case Rep Surg (2024)
MeSH terms: Case Reports

Type IV hiatal hernia of the esophagus is characterized by herniation of the stomach and associated organs, such as the spleen, large and small bowel, and pancreas, through the esophageal hiatus. It is a relatively rare form of hiatal hernia that sometimes requires emergency surgery due to gastric incarceration, volvulus, and strangulation. Of these, small bowel obstruction is extremely rare and requires surgery. We report the case of an 83-year-old woman who was admitted to the hospital for small bowel obstruction caused by an ileum that had incarcerated the esophageal hiatus; emergency laparoscopic surgery was performed.
Progressive Strategy for Congenitally Missing Anteriors in Binder Syndrome: A Case Report
Authors: Lovely Bharti, Sunita Shrivastav, Ranjit H Kamble, Aksha Bhargava
Journal: Cureus (2024)
Keywords: binder syndrome, cleft lip and palate, emotional trauma, maxillonasal dysplasia, psychological trauma, riding pontic
MeSH terms: Case Reports

Binder syndrome (maxillonasal dysplasia) is an uncommon congenital craniofacial condition. It is marked by distinctive facial characteristics including a flat, vertically oriented nose, maxillary underdevelopment, malocclusion, and nasal bone irregularities. This case study introduces an inventive strategy for addressing congenitally absent anterior teeth in a patient diagnosed with Binder syndrome. Our treatment approach combined orthodontic interventions and prosthetic restorations to enhance both aesthetics and function. This report explores the diagnostic and therapeutic aspects of the case, underscoring the encountered challenges and the ultimately successful outcome. This approach provides valuable insights into managing dental anomalies linked to Binder syndrome, emphasizing the necessity of a multidisciplinary approach for comprehensive patient care. A suitable strategy for adult patients might be slow maxillary expansion. This case report is about a rare case of maxillonasal dysplasia managed with the esthetic replacement of anterior teeth.
Case report: Gastric carcinoma with SMARCA4 deficient: two cases report and literature review
Authors: Zeyang Lin, Qian Li, Yujie He, Shujing Guo, Yuhan Ye, Zhengjin Liu
Journal: Front Oncol (2024)
Keywords: smarca4, case, category, gastric carcinoma, therapy
MeSH terms: Case Reports

SMARCA4-deficient gastric carcinoma has been reported sporadically since 2016. Only 29 patients have been reported; nevertheless, it is aggressive and highly malignant with poor outcomes. It has an immunohistochemical phenotype showing loss of SMARCA4 expression and can be accompanied by codeletion of other switch/sucrose non-fermentable chromatin-remodeling complex subunits. Microscopically, it displays high-grade undifferentiated histological morphology with rhabdoid cell differentiation. Rarely does the tumor contain a purely or partly adenocarcinoma component. Here, we report two cases to demonstrate these unusual morphologies analyzed using morphological and immunohistochemical techniques. In addition, there is a lack of research on the classification of these morphologies. Therefore, our report will aid the diagnosis and classification of SMARCA4-deficient gastric carcinoma.
Case Report: Refractory macrophage activation syndrome requiring high-dose anakinra, emapalumab, and etoposide therapy in early-onset systemic juvenile idiopathic arthritis associated with adenoviremia
Authors: Elizabeth D Slaney, Renee Modica, Leandra Woolnough, Dina Kafisheh, Denise Heather Bell-Brunson, Melissa Elder
Journal: Front Pediatr (2024)
Keywords: anakinra, emapalumab, etoposide, macrophage activation syndrome, systemic arthritis
MeSH terms: Case Reports

Macrophage activation syndrome (MAS) is a life-threatening condition characterized by the excessive stimulation of macrophages and T lymphocytes, provoked by infections, malignancy, and autoimmune or autoinflammatory conditions such as systemic juvenile idiopathic arthritis (sJIA). Clinical signs of sJIA may include high-spiking, quotidian fevers, lymphadenopathy, hepatosplenomegaly, and a salmon-colored migratory, evanescent rash. By contrast, MAS is characterized by unremitting fevers and diffuse, fixed, maculopapular rashes. In addition to hepatosplenomegaly and lymphadenopathy, patients with MAS may also have clinical signs of coagulopathy, as well as cardiac, lung, renal, and central nervous system dysfunction. The empiric treatment for MAS is initially high-dose IV corticosteroids, but usually requires addition of immunomodulators such as tacrolimus or a biologic such as Anakinra to control. The addition of immunotherapies for MAS has improved patient outcomes. We present a 2-year-old male patient with a history of early-onset sJIA, who presented with MAS refractory to corticosteroids and anakinra triggered by adenoviremia that required addition of emapalumab to control. We believe this is the first reported case of a combination of immunosuppressive therapy of emapalumab, etoposide, anakinra, tacrolimus, and corticosteroids used in the successful treatment of infection-induced MAS in early-onset sJIA. Given the lack of treatment guidelines and approved therapies for MAS, alternative strategies should be considered for patients with an intractable course.
Acute Abdomen in Pregnancy due to Idiopathic Chylous Ascites
Authors: Claudia Epelde, Fátima Saravia, Mónica Aguinaga, Ane Toledo, Arantza Lekuona, Mikel Gorostidi
Journal: Case Rep Obstet Gynecol (2024)
MeSH terms: Case Reports

Chylous ascites results from the leakage of lymph rich in lipids into the peritoneal cavity and represents an exceedingly rare event in the course of pregnancy. While there are numerous documented instances of this pathology manifesting with hypogastric or diffuse abdominal pain, our report highlights a unique presentation involving a 35-week pregnant woman experiencing severe epigastric pain unrelated to pregnancy-induced hypertension or other gastrointestinal disorders. Major acute obstetric pathologies were ruled out, and there was no evidence of fetal distress. Due to uncontrolled pain with an unidentified etiology and an unfavorable Bishop score, an urgent cesarean section was performed. A copious amount of milky fluid was observed during the surgery, subsequently confirmed as chylous in nature. Both the newborn and the mother had positive outcomes postsurgery. Although it is usually a benign condition, it is important for healthcare professionals to be aware of this entity in order to provide timely medical care and administer appropriate treatment.
Paraneoplastic neuromyelitis optica spectrum disorder associated with ovarian dysgerminoma: a case report and literature review
Authors: Pan Liu, Shuangying Wang, Chunhua Zhang, Yanfang Li
Journal: Front Immunol (2024)
Keywords: aqp4, ivmp, immunosuppression, ovarian dysgerminoma, paraneoplastic nmosd
MeSH terms: Neuromyelitis Optica / complications, Neuromyelitis Optica / diagnosis, Neuromyelitis Optica / etiology, Neuromyelitis Optica / immunology, Ovarian Neoplasms / complications, Ovarian Neoplasms / diagnosis, Case Reports, Review, Aquaporin 4 / immunology, Autoantibodies / blood, Autoantibodies / immunology, Dysgerminoma / complications, Dysgerminoma / diagnosis, Dysgerminoma / pathology, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Aquaporin 4, Autoantibodies, AQP4 protein, human

Neuromyelitis optica spectrum disorder (NMOSD) is a clinical syndrome characterized by attacks of acute optic neuritis and transverse myelitis. We report a case with paraneoplastic NMOSD that improved after immunosuppressive therapy, surgical resection, and chemotherapy. A 48-year-old woman initially presented with gradual binocular visual loss over the course of one week. The patient was evaluated using magnetic resonance imaging (MRI), computed tomography (CT), visual evoked potential (VEP), pathological biopsy, immunohistochemistry, and autoimmune antibody testing. The brain MRI findings were normal. The VEP revealed prolonged P100 latencies in the right eye and an absence of significant waves in the left eye. Positive serum AQP4-IgG antibodies were found. The patient was diagnosed as NMOSD. Then the patient responded well to treatment with methylprednisolone. An ovarian tumor was found in the patient using abdominal MRI and CT. The tumor was surgically resected, and a pathological biopsy revealed that it was ovarian dysgerminoma. The patient received four rounds of chemotherapy after surgery. One month after the final chemotherapy treatment, a positron emission tomography (PET) scan revealed no tumor. The vision of the patient gradually recovered and serum AQP4 was negative. Furthermore, we summarized the characteristics of patients diagnosed with paraneoplastic NMOSD associated with ovarian neoplasms in previous studies. This is a characteristic case of overlapping NMOSD and ovarian dysgerminoma, demonstrating the importance of tumor therapy in cases of paraneoplastic NMOSD.
Incidental Detection of a Rare Pediatric High-Grade Fibrosarcoma in a Post-traumatic Setting: The Conundrum of Intra-Abdominal Hematoma versus Neoplasia
Authors: Kamand Khalaj, Nikoo Fattahi, Allen C Omo-Ogboi, Jaiyeola O Thomas-Ogunniyi, Olanrewaju A Ogunleye, Ashish Khanal, Larry A Kramer
Journal: Case Rep Radiol (2023)
MeSH terms: Case Reports

Infantile fibrosarcoma (IF) is a rare malignant fibroblastic tumor that affects infants and young children, occurring most commonly in the extremities. Here, we present a 14-year-old patient with an abdominal mass incidentally detected after a blunt injury to the abdomen. The initial trauma protocol CT revealed a high attenuation mesenteric lesion in the left central abdomen suggestive of mesenteric hematoma. However, the possibility of a solid neoplastic mass lesion could not be excluded. Further evaluation with dynamic contrast-enhanced serial MRI showed a progressive enhancing mass and excluded a hyperacute hematoma with active bleeding. The mass was resected, and histopathological examination and molecular analysis of tumor cells were consistent with a high-grade fibrosarcoma with KMT2D : BCOR fusion.