OpenMed/multicare-articles huggingface dataset:
Beta-human chorionic gonadotropin producing osteosarcoma of the sacrum in a 26-year-old woman: a case report and review of the literature
Authors: Ryan Glass, Jaya Ruth Asirvatham, Leonard Kahn, Mohamed Aziz
Journal: Case Rep Pathol (2015)

Ectopic secretion of beta-human chorionic gonadotropin is considered a poor prognostic marker in epithelial tumors. However, very few cases have been reported in sarcomas. We present the case of a 26-year-old female who presented with a metastatic osteosarcoma. She underwent usual testing prior to starting treatment and was found to have elevated levels of beta-human chorionic gonadotropin. As the patient was not pregnant, another source of beta-human chorionic gonadotropin secretion had to be considered. The tumor cells demonstrated positive staining for beta-human chorionic gonadotropin by immunohistochemistry, and serum levels of beta-human chorionic gonadotropin were used to monitor tumor progression and response to chemotherapy. We review the literature and discuss a potential role of beta-human chorionic gonadotropin in the treatment of such patients.
Nonparametric percentile curve estimation for a nonnegative marker with excessive zeros
Authors: Oke Gerke, Robyn L McClelland
Journal: MethodsX (2022)
Keywords: centile, non-normal, non-parametric, norm-curve, overdispersion, smoothing

Norm curves for the head circumference, height, and weight of newborns and infants are widely known examples of percentile curves over age, and early accounts date back 50 years. The advent of the Agatston score for coronary calcification based on coronary computed tomography in 1990 heralded the era of a new marker in preventive medicine, in addition to well-known cardiovascular risk factors. A peculiarity of the nonnegative Agatston score in populations that are free of coronary artery disease is the overexpression of zeros. In a case study, we have demonstrated a nonparametric approach for percentile curve estimation using markers such as the Agatston score. This method is based on lowess smoothing of marker-positive scores on age, and the resulting percentile curves are subsequently transposed according to the estimated proportions of zeros. The approach does not involve any parametric assumptions, is robust against outliers, and fulfills the noncrossing property for percentile curves. A simulation study using samples of N=1,000, 2,000, 5,000, and 10,000 subjects illuminates the closeness of the estimated 50th, 75th, and 90th percentile curves to the respective true curves, assuming an exponentially distributed marker and a proportion of zero scores that increase with age.•The method is applicable to highly skewed data and exemplified here with subgroup data of the referenced procedure.•The consistency and general performance of the method is shown by means of simulation.•The method is an explicit, transferable, and reproducible procedure that is applicable to a wide spectrum of markers and scores across various scientific disciplines, far beyond cardiovascular medicine.
5p13.3p13.2 duplication associated with developmental delay, congenital malformations and chromosome instability manifested as low-level aneuploidy
Authors: Ivan Y Iourov, Svetlana G Vorsanova, Irina A Demidova, Galina A Aliamovskaia, Elena S Keshishian, Yuri B Yurov
Journal: Springerplus (2015)
Keywords: 5p13 duplication, aneuploidy, bioinformatics, chromosome instability, mosaicism

Recent developments in molecular cytogenetics allow the detection of genomic rearrangements at an unprecedented level leading to discoveries of previously unknown chromosomal imbalances (zygotic and post-zygotic/mosaic). These can be accompanied by a different kind of pathological genome variations, i.e. chromosome instability (CIN) manifested as structural chromosomal rearrangements and low-level mosaic aneuploidy. Fortunately, combining whole-genome and single-cell molecular cytogenetic techniques with bioinformatics offers an opportunity to link genomic changes to specific molecular or cellular pathology. High-resolution chromosomal SNP microarray analysis was performed to study the genome of a 15-month-aged boy presented with developmental delay, congenital malformations, feeding problems, deafness, epileptiform activity, and eye pathology. In addition, somatic chromosomal mutations (CIN) were analyzed by fluorescence in situ hybridization (FISH). Interstitial 5p13.3p13.2 duplication was revealed in the index patient. Moreover, CIN manifested almost exclusively as chromosome losses and gains (aneuploidy) was detected. Using bioinformatic analysis of SNP array data and FISH results, CIN association with the genomic imbalance resulted from the duplication was proposed. The duplication was demonstrated to encompass genes implicated in cell cycle, programmed cell death, chromosome segregation and genome stability maintenance pathways as shown by an interactomic analysis. Genotype-phenotype correlations were observed, as well. To the best our knowledge, identical duplications have not been reported in the available literature. Apart from genotype-phenotype correlations, it was possible to propose a link between the duplication and CIN (aneuploidy). This case study demonstrates that combining SNP array genomic analysis, bioinformatics and molecular cytogenetic evaluation of somatic genome variations is able to provide a view on cellular and molecular pathology in a personalized manner. Therefore, one can speculate that similar approaches targeting both interindividual and intercellular genomic variations could be useful for a better understanding of disease mechanisms and disease-related biological processes.
Oncoplastic surgery in Japanese patients with breast cancer close to the areola: partial mastectomy using periareolar mammoplasty: a case report
Authors: Yuko Kijima, Heiji Yoshinaka, Munetsugu Hirata, Tadao Mizoguchi, Sumiya Ishigami, Akihiro Nakajo, Hideo Arima, Shinichi Ueno, Shoji Natsugoe
Journal: Case Rep Surg (2011)
MeSH terms: Case Reports

We report the results of oncoplastic surgery in two Japanese patients with early breast cancer. Their breasts were large and ptotic, and their lesions, which were close to the areola, were considered to be suitable for breast conservative surgery. Oncoplastic surgery involving partial resection of the gland and a periareolar mammoplasty were performed. The technique was easy to perform, and the cosmetic outcome was excellent.
Avatar Therapy for Persistent Auditory Verbal Hallucinations in an Ultra-Resistant Schizophrenia Patient: A Case Report
Authors: Laura Dellazizzo, Stéphane Potvin, Kingsada Phraxayavong, Pierre Lalonde, Alexandre Dumais
Journal: Front Psychiatry (2018)
Keywords: auditory verbal hallucinations, avatar therapy, case report, cognitive-behavioral therapy, psychological treatment, treatment-resistant schizophrenia, virtual reality
MeSH terms: Case Reports

Effective treatment strategies for schizophrenia remain very challenging and many treatment-resistant patients will suffer from persistent auditory verbal hallucinations (AVH). While clozapine is the gold-standard medication for this complex population, many will not respond to this molecule. For these ultra-resistant patients, limited options are available. Cognitive-behavioral therapy (CBT) is the most widely used psychological intervention, though it offers modest effects. With the interpersonal dimension of AVH being recognized, Avatar Therapy (AT), a novel experiential treatment enabling patients to create an avatar of their persecutor and allowing them to gain control over their symptoms, was developed and tested. Results have shown significant improvements in AVH symptomatology. This paper details a case report showcasing the beneficial results of AT for even the most severe and symptomatic cases of schizophrenia. Mr. Smith has been afflicted with the persistency of all his voices for almost 20 years. To our knowledge, this patient tried almost all possible treatments with little efficacy. This case highlights the difficulty of finding an adequate treatment for ultra-resistant patients. Mr. Smith first followed CBT before initiating AT. With AT, he significantly improved in a way that was not observed with any other intervention and these improvements remained afterward. The severity of his positive symptoms as well as his depressive symptoms diminished, and his most distressing persecutory voice disappeared. He was able to regain a life. The effects of AT went well beyond the patient, the morale of the entire family improved. This ultra-resistant case suggests that AT may be a promising intervention for refractory AVH in schizophrenia.
Posttraumatic displacement management: lateral luxation and alveolar bone fracture in young permanent teeth with 5 years of follow-up
Authors: Heitor Marques Honório, Catarina Ribeiro Barros de Alencar, Edmer Silvestre Pereira Júnior, Daniela Silva Barroso de Oliveira, Gabriela Cristina de Oliveira, Daniela Rios
Journal: Case Rep Dent (2015)

Dental trauma is an important public health problem due to high prevalence and associated limitations. The external impact accounting for trauma may result in different injury types to teeth and supporting structures. This paper describes a clinical case of tooth trauma in an 8-year-old patient exhibiting the displacement of three permanent teeth with open root apexes. Although the traumatic impact resulted in two injury types to teeth and supporting tissues (lateral luxation and alveolar bone fracture), the therapeutic approach was the same in both situations. The bone and teeth were repositioned by digital pressure, stabilized by semirigid splint, and followed up at every week. After six weeks, the splint was removed. At that moment, the clinical and radiographic findings indicated normal soft/hard tissues and absence of pulp/periodontal pathologies. At the fifth year of follow-up, the treatment success of the case was confirmed, although it has been observed that all lower incisors exhibited pulp obliteration as a consequence of the dental trauma.
Case Report: Neuroendocrine Tumor With Cardiac Metastasis
Authors: Rachel E Kinney, Robert Decker, Deborah Sundlof, Muhammad A Rizvi, Kelly Schadler
Journal: Front Cardiovasc Med (2020)
Keywords: 177lu dotatate, ileal neuroendocrine tumor, infiltrative myocardial metastasis, intracardiac metastases, neuroendocrine tumor
MeSH terms: Case Reports

Neuroendocrine tumors (NETs), also known as carcinoid tumors, are a heterogeneous group of neoplasms that arise from cells throughout the neuroendocrine system, most commonly arising from the gastrointestinal (GI) tract, lungs, and bronchi. Myocardial carcinoid metastasis is rare with an incidence among metastatic carcinoid patients of 4%. They are generally asymptomatic and detected incidentally. Infiltrative myocardial metastasis secondary to carcinoid tumor is exceedingly rare with only single-digit cases reported in the literature. We report the case of a 65-years-old female with a newly diagnosed ileal neuroendocrine tumor as well as heart failure due to infiltrative myocardial metastasis.
Tension Pneumocephalus Induced by Nasal Cannula
Authors: Hao Xiao, Tony Chen, Andrew Tagg
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Tension pneumocephalus is a rare medical emergency. Spontaneous atraumatic tension pneumocephalus is reported in cases of neoplasm, Valsalva manoeuvres, and air cell hyperpneumatization. For the first time, we describe a case of atraumatic tension pneumocephalus induced by nasal cannula in a patient with ventriculoperitoneal shunt. Our case report discusses the possible mechanisms of the tension pneumocephalus in this case.
Resolution of Severe Neurologic Signs Following Intravenous Lipid Emulsion Therapy in a Young Dog With a Portosystemic Shunt: Case Report
Authors: Amanda M Spillane, Jenica L Haraschak, Maureen A McMichael
Journal: Front Vet Sci (2021)
Keywords: ammonia, case report, hepatic encephalopathy, intralipid, intravenous fat emulsion
MeSH terms: Case Reports

A 5-month-old male intact Great Pyrenees was presented for an acute onset of severe neurologic signs (stupor, absent menace, intermittent head turn to the left). The patient's history included possible naproxen ingestion with a maximum ingested dose of 59 mg/kg, exceeding the reported dose of >50 mg/kg known to cause neurologic signs. Blood sampling for baseline bloodwork was performed, and intravenous lipid emulsion (ILE) was subsequently administered, for treatment of the suspected toxicosis. Due to severe and life-threatening neurologic signs, other methods of decontamination were contraindicated and unlikely to be effective; extracorporeal therapy was also unavailable. Complete resolution of neurologic signs occurred 30 min after completion of ILE therapy. At this time, the owners found the missing naproxen tablets after returning home and the bloodwork results returned revealing findings consistent with hepatic encephalopathy. The fasted blood ammonia concentration immediately prior to ILE administration was 702.1 μg/dL (reference interval, RI: 24-36 μg/dL) and decreased to 194.1 μg/dL 24 h later. In the first 24 h, the patient also received three doses of lactulose, N-acetylcysteine, and intravenous fluids. The patient was subsequently diagnosed with a single, large intrahepatic portosystemic shunt via computed tomography and underwent an endovascular coil embolization procedure. Given the rapid and dramatic improvement in severe neurologic signs after ILE therapy alone, it is strongly suspected that this treatment resulted in improvement of hepatic encephalopathy.
Celiac Disease in Patients with Cystic Fibrosis-Related Bone Disease
Authors: Melissa S Putman, Alexandra Haagensen, Isabel Neuringer, Leonard Sicilian
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Both cystic fibrosis (CF) and celiac disease can cause low bone mineral density (BMD) and fractures. Celiac disease may occur at a higher frequency in patients with CF than the general population, and symptoms of these conditions may overlap. We report on two patients presenting with CF-related bone disease in the past year who were subsequently found to have concurrent celiac disease. Because adherence to a gluten-free diet may improve BMD in patients with celiac disease, this could have important implications for treatment. Clinicians should consider screening for celiac disease in patients with CF who have low BMD, worsening BMD in the absence of other risk factors, and/or difficult to treat vitamin D deficiency.
Gemcitabine-induced progressive and sustained tumour response in a patient with multi-drug resistant uterine leiomyosarcoma
Authors: T De Pas, G Spitaleri, P D Vigna, F Toffalorio, G Curigliano, A Gambino, S Boselli, C Catania, F de Braud
Journal: Ecancermedicalscience (2008)
Keywords: gemcitabine, refractory uterine leiomyosarcoma, second-line chemotherapy
MeSH terms: Case Reports

Background:
despite the fact that the combination of gemcitabine (GCB) and docetaxel shows an increased benefit for disease-free survival and overall survival compared to GCB alone in patients with soft-tissue sarcoma, GCB mono-chemotherapy should be considered as a preferable option with respect to the combination because of its lower toxicity profile and the possibility of it being administered continuously for a long time period.
Case report:
we report a clinical case of a woman with advanced high-grade uterine leiomyosarcoma, refractory to ifosfamide, doxorubicin and trabectedin, who experienced a sustained and progressive response to GCB alone.
Conclusions:
GCB given as mono-chemotherapy can obtain long-lasting tumour control in patients heavily pre-treated with various chemotherapeutic regimes for uterine LMS and should be considered as a possible option for this subset of patients.
Huge toxic goiter extending to the posterior mediastinum; Case report with literature review
Authors: Abdullah Saeed Abdullah, Alaa S Bahjat, Ayad Ahmad Mohammed
Journal: Int J Surg Case Rep (2019)
Keywords: goiter, manubriotomy, retrosternal goiter, sternotomy, thyroidectomy

Introduction:
Retrosternal goiter may occur in up to 7% of the cases, most of them extend to the anterior mediastinum, extension to the posterior mediastinum is very rare. It causes compression on mediastinal structures such as the trachea, the bronchi, the esophagus, and great vessels. The diagnosis is done mostly by CT scan. Most cases need surgery which is done by the combined cervical and the thoracic incisions.
Case presentation:
A 70-year-old man had history of thyroid enlargement for 10 years which was hyper-functioning and controlled with medical therapy. For the last 2 months the patient was complaining from dyspnea especially during supine posture and dysphagia. CT-scan showed huge extension of the thyroid gland to the posterior mediastinum causing compression over the tracheal and the esophagus. Surgery done through both cervical incision and manubriotomy and the huge thyroid gland extracted. The patient had uneventful recovery with no postoperative complications.
Conclusion:
Retrosternal goiter causes airway compromise in most patients. Surgery for such cases is a challenging procedure with higher rate of complications, CT-scan is the most single valuable tool in selecting patients for sternotomy before surgery but the final decision for sternotomy is best done during surgery. A team work between a thyroid surgeon and a thoracic surgeon has better results.
A neglected cervicovesical fistula diagnosed and repaired by combined hysteroscopy and laparoscopy: A case report and review of literature
Authors: Dongjing Sun, Wenzhi Xu, Yicheng Chen, Xueyuan Chen, Xiaona Lin
Journal: Front Surg (2022)
Keywords: bladder, cervicovesical fistula, hysteroscopy, intrauterine adhesions, uterus
MeSH terms: Case Reports

Objective:
To analyze a case of neglected cervicovesical fistula with intrauterine adhesions caused by cesarean section.
Methods:
A 36-year-old female patient with a history of two previous cesarean sections complained of the absence of menstruation for the last 18 months. The diagnosis of the cervicovesical fistula was made through hysteroscopy and cystoscopy. The reconstruction of the uterus and bladder was achieved by a laparoscopic repair technique.
Results:
The patient resumed normal menstruation postoperatively without complaining of any complications. Uterine continuity and cavity had been restored to normal at the second look of hysteroscopy.
Conclusions:
Cervicovesical fistula with intrauterine adhesions is very rare in our clinical work. Hysteroscopy might play an essential role in diagnosing cervicovesical fistula and IUA. In our literature review, a surgical approach was the mainstay and definitive management of the cervicovesical fistula following a cesarean section.
Intraoral adult rhabdomyoma: a case report
Authors: Ana Amelia Souza, Vera Cavalcanti de Araújo, Fabricio Passador Santos, Elizabeth Ferreira Martinez, Jose Ferreira de Menezes Filho, Ney Soares de Araujo, Andresa Borges Soares
Journal: Case Rep Dent (2013)

A case of adult rhabdomyoma is reported. The lesion is a rare benign tumor of skeletal muscle origin which occurs predominantly in the head and neck region. In the present case, the clinical diagnosis favored a benign salivary gland tumor. Histologically, the tumor was composed of large round, oval, and polygonal cells of varying size with abundant pale, eosinophilic, fine, granular cytoplasm with peripherally located nuclei. Immunohistochemically, the lesion was positive for muscle-specific actin, smooth muscle actin, desmin, S100 protein, and Masson's trichrome. Electron microscopic examination confirmed the presence of numerous myofibrils. The lesion was treated by surgical resection. The clinical, histological, immunohistochemical, and ultrastructural features are discussed in this study.
Efficacy of Combination Chemo-Immunotherapy as a First-Line Treatment for Advanced Non-Small-Cell Lung Cancer Patients With HER2 Alterations: A Case Series
Authors: Shuang Zhao, Xinghong Xian, Panwen Tian, Weimin Li, Ke Wang, Yalun Li
Journal: Front Oncol (2021)
Keywords: chemotherapy, human epidermal growth factor receptor2, immunotherapy, non-small-cell lung cancer, prognosis

Objective:
Although the treatment of non-small-cell lung cancer (NSCLC) patients with human epidermal growth factor receptor 2 (HER2) alterations has been studied for years, the overall response rate (ORR) of these patients is still unsatisfactory, and more therapeutic strategies are needed. Little is known about the combination of chemo- and immunotherapy in HER2-altered lung cancer treatment.
Materials and methods:
We report five cases of advanced NSCLC with HER2 insertion mutation or amplification treated with immunotherapy combined with chemotherapy as the first-line treatment. The HER2 alteration type, duration of treatment and survival were also analyzed.
Results:
The five advanced NSCLC patients, three with HER2 mutations and two with HER2 amplifications, received chemo-immunotherapy as the first-line treatment. The average patient age was 54.6 years. Three patients were females, and two were males. Among all the patients, only one had a smoking history. The immunotherapies used were as follows: two patients were treated with sintilimab, and three patients were treated with pembrolizumab. Only one patient had squamous carcinoma, and she was also the only patient with a complete response (CR). The progression-free survival (PFS) ranged from 2-12 months, with a median PFS of 8.0 months.
Conclusions:
Chemo-immunotherapy may be a promising first-line treatment option for NSCLC patients with HER2 alterations. Further clinical trials are required to confirm this therapeutic option.
Pulmonary Mucormycosis in Chronic Lymphocytic Leukemia and Neutropenia
Authors: Izza Mir, Sijan Basnet, David Ellsworth, Elan Mohanty
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Pulmonary mucormycosis is a rare life-threatening fungal infection associated with high mortality. We present the case of a 61-year-old man with history of chronic lymphocytic leukemia who presented with fever and cough, eventually diagnosed with pulmonary mucormycosis after right lung video-assisted thoracoscopic surgery. The patient was successfully treated with amphotericin B and right lung pneumonectomy; however, he later died from left lung pneumonia.