OpenMed/multicare-articles huggingface dataset:
Pheochromocytoma-induced myocardial infarction: A case report
Authors: Haixia Tang, Jichun Liu, Bangsheng Hu, Yuwen Yang, Xiangrong Xie, Youquan Wei
Journal: Open Life Sci (2024)
Keywords: acute myocardial infarction, case report, chest pain, neuroendocrine tumor, pheochromocytoma
MeSH terms: Case Reports

The pheochromocytoma is an uncommon endocrine neoplasm that originates from chromaffin cells and causes significant cardiovascular effects through the intermittent or sustained release of catecholamines. In this report, we present a rare case of myocardial infarction (MI) induced by pheochromocytoma. A 53-year-old female presented to the emergency department with a history of intermittent palpitations, back pain, and sweating for over 10 years, which had worsened over the past 2 days. The patient's cardiac enzymes and troponin levels were significantly elevated, and the electrocardiogram (ECG) showed ST-segment elevation, leading to an initial diagnosis of acute myocardial infarction. Echocardiography revealed apical ballooning, indicative of stress cardiomyopathy. Emergency coronary angiography revealed no significant stenosis, and the patient's blood pressure was fluctuating. Computerized tomography (CT) scan of the adrenal gland revealed a bilateral adrenal mass, with the left adrenal mass being larger in size after contrast-enhanced CT scan. The patient's left adrenal gland was successfully removed through laparoscopic adrenalectomy, and histopathology results confirmed the presence of adrenal pheochromocytoma. Follow-up for 3 months after discharge showed the patient had no symptoms and good prognosis. The abnormal findings on echocardiography and ECG resolved. Prompt diagnosis and management of pheochromocytoma are crucial for a favorable prognosis.
Fulminant Myocarditis with SARS-CoV-2 Infection: A Narrative Review from the Case Studies
Authors: Ryohei Ono, Togo Iwahana, Kaoruko Aoki, Hirotoshi Kato, Sho Okada, Yoshio Kobayashi
Journal: Can J Infect Dis Med Microbiol (2024)
MeSH terms: Review

One of the severe complications of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is myocarditis. However, the characteristics of fulminant myocarditis with SARS-CoV-2 infection are still unclear. We systematically reviewed the previously reported cases of fulminant myocarditis associated with SARS-CoV-2 infection from January 2020 to December 2022, identifying 108 cases. Of those, 67 were male and 41 female. The average age was 34.8 years; 30 patients (27.8%) were ≤20 years old, whereas 10 (9.3%) were ≥60. Major comorbidities included hypertension, obesity, diabetes mellitus, asthma, heart disease, gynecologic disease, hyperlipidemia, and connective tissue disorders. Regarding left ventricular ejection fraction (LVEF) at admission, 93% of the patients with fulminant myocarditis were classified as having heart failure with reduced ejection fraction (LVEF ≤ 40%). Most of the cases were administered catecholamines (97.8%), and mechanical circulatory support (MCS) was required in 67 cases (62.0%). The type of MCS was extracorporeal membrane oxygenation (n = 56, 83.6%), percutaneous ventricular assist device (Impella®) (n = 19, 28.4%), intra-aortic balloon pumping (n = 12, 12.9%), or right ventricular assist device (n = 2, 3.0%); combination of these devices occurred in 20 cases (29.9%). The average duration of MCS was 7.7 ± 3.8 days. Of the 76 surviving patients whose cardiac function was available for follow-up, 65 (85.5%) recovered normally. The overall mortality rate was 22.4%, and the recovery rate was 77.6% (alive: 83 patients, dead: 24 patients; outcome not described: 1 patient).
Osteomyelitis Masquerading as Cellulitis: A Case Report
Authors: Sanjiya Arora, Vikramaditya Rai, Devendra Tripathi, Sachin M Chaudhary, Ajay Singh, Mohitha Chowdary
Journal: Cureus (2024)
Keywords: antimicrobial therapy, cellulitis, debridement, osteomyelitis, osteopenia
MeSH terms: Case Reports

Osteomyelitis, a significant global healthcare issue, often results from infections related to open fractures, surgery, or conditions like diabetic foot ulcers. This report describes a case of osteomyelitis in a 62-year-old female with various pre-existing health conditions. The patient initially presented with swelling, pain, and difficulty walking in the right lower extremity, accompanied by systemic symptoms. Despite an initial diagnosis of cellulitis and treatment with ceftriaxone, a subsequent CT scan revealed a pretibial abscess and confirmed osteomyelitis caused by pan-sensitive Escherichia coli. Surgical debridement was performed, and the patient received six weeks of intravenous antibiotics. Hence, a heightened level of suspicion is essential to facilitate a timely diagnosis of osteomyelitis and enhance long-term prognosis. The case underscores the importance of a multidisciplinary approach, including meticulous surgical intervention and tailored antimicrobial therapy, in achieving positive outcomes for osteomyelitis patients.
A New and Effective Procedure for Advanced Oral Cancer Therapy: The Potential of a Cancer Stem Cell Assay in Guiding Chemotherapy
Authors: Francesca Spirito, Pier Paolo Claudio, Candace M Howard, Jagan Valluri, Krista L Denning, Lorenzo Lo Muzio, Antonio Cortese
Journal: Transl Med UniSa (2023)
Keywords: chemoid, chemotherapy, head & neck cancer, individualized therapy, oral cancer, oral squamous cell carcinoma, personalized medicine

Introduction:
Ineffective anticancer therapy can result in unnecessary toxicity and the development of resistant clones. Many types of solid tumors, including head and neck squamous cell carcinoma, have been found to contain a small population of cancer stem cells (CSCs) that contribute to tumor propagation, maintenance, and treatment resistance.
Materials and methods:
Selectively enriched CSCs from primary cancer cell cultures can be used in a chemosensitivity assay for a functional test (ChemoID) that uses patients' live tumor cells to indicate which chemotherapy agent (or "combinations") will kill not only the bulk of tumor cells but also the CSCs that are known to cause cancer to recur. This study aimed to show the potential of testing the sensitivity of CSCs enriched from oral cancer patients' biopsies to conventional chemotherapies. A case series of eleven patients affected by advanced oral squamous cell carcinoma (OSCC) have been included in this study. We compared the results of the CSC assay among all the patients and found that there was variability in the chemotherapy response predicted by the assay.
Results:
Variability in chemotherapy response was found by the CSC assay in advanced OSCC patients suggesting more precise and personalized therapies to the Oncologist.
Conclusions:
Variability in chemosensitivity for OSCC warrants the need to investigate further the use of the assay in larger cohorts to gain a broader understanding of the utility of the clinical test.
Uncertainty Quantification and Interpretability for Clinical Trial Approval Prediction
Authors: Yingzhou Lu, Tianyi Chen, Nan Hao, Capucine Van Rechem, Jintai Chen, Tianfan Fu
Journal: Health Data Sci (2024)

Background: Clinical trial is a crucial step in the development of a new therapy (e.g., medication) and is remarkably expensive and time-consuming. Forecasting the approval of clinical trials accurately would enable us to circumvent trials destined to fail, thereby allowing us to allocate more resources to therapies with better chances. However, existing approval prediction algorithms did not quantify the uncertainty and provide interpretability, limiting their usage in real-world clinical trial management. Methods: This paper quantifies uncertainty and improves interpretability in clinical trial approval predictions. We devised a selective classification approach and integrated it with the Hierarchical Interaction Network, the state-of-the-art clinical trial prediction model. Selective classification, encompassing a spectrum of methods for uncertainty quantification, empowers the model to withhold decision-making in the face of samples marked by ambiguity or low confidence. This approach not only amplifies the accuracy of predictions for the instances it chooses to classify but also notably enhances the model's interpretability. Results: Comprehensive experiments demonstrate that incorporating uncertainty markedly enhances the model's performance. Specifically, the proposed method achieved 32.37%, 21.43%, and 13.27% relative improvement on area under the precision-recall curve over the base model (Hierarchical Interaction Network) in phase I, II, and III trial approval predictions, respectively. For phase III trials, our method reaches 0.9022 area under the precision-recall curve scores. In addition, we show a case study of interpretability that helps domain experts to understand model's outcome. The code is publicly available at https://github.com/Vincent-1125/Uncertainty-Quantification-on-Clinical-Trial-Outcome-Prediction. Conclusion: Our approach not only measures model uncertainty but also greatly improves interpretability and performance for clinical trial approval prediction.
Retrograde Migration of a Percutaneous Endoscopic Gastro-Jejunal Tube Into the Esophagus
Authors: Binyamin R Abramowitz, Jude Noel, Sushil Ahlawat
Journal: Cureus (2024)
Keywords: aspiration pneumonia, enteral nutrition, gastrojejunostomy, percutaneous endoscopic gastro-jejunostomy, percutaneous endoscopic gastrostomy, tube feeds, tube migration
MeSH terms: Case Reports

Percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic gastro-jejunal (PEG-J) tube placement are both common procedures regularly performed on patients requiring nutritional support. These procedures may be complicated by infection, hemorrhage, fistulization, or tube migration. We present an extremely rare case of a patient with a PEG-J tube that migrated into the esophagus.
A public health study on the participation mechanism of social capital in the governance of public sports space in dilapidated urban communities - a case study of Changsha City, Hunan Province
Authors: Li Xinze, Zhang Xiaoyi, He Qiao
Journal: Front Public Health (2023)
Keywords: community governance, dilapidated communities, public sports spaces, social capital, sustainable development
MeSH terms: Public Health, Social Capital, Aged, Aging, Environment, Humans, Quality of Life

Introduction:
China's aging population, mobile population, low-income families, and other vulnerable groups congregate in dilapidated urban communities serving as public health spaces. As a result, managing public sports spaces in aging urban areas is a significant public health project in China, an essential strategy for raising residents' quality of life, and a significant effort to support the active aging of the older adult.
Methods:
The study used mathematical and statistical techniques, questionnaires, and logical deduction to conduct a public health study on the participation mechanism of social capital in the governance of public sports spaces in dilapidated urban communities. It chose 11 old Changsha, Hunan Province, communities as the research objects.
Results:
Personal social capital was found to boost the availability of public sports spaces in older populations through social connections. Collective social capital improves the availability of public sports spaces in aging populations through social trust and stabilizes the order of public sports spaces in aging communities through social involvement.
Discussion:
To improve the governance efficiency of public sports spaces in aging urban communities, the study aims to actively mobilize and accumulate social capital through cultivating the public spirit, reshaping the concept of sports governance, appropriately decentralizing and empowering, strengthening sports governance structures, enhancing communication and collaboration, and building sports governance. This is essential for China to fully implement the policies of active aging, a healthy China, and creating a community for global public health.
A case report and literature review on TP53 gene mutation in a bladder rhabdomyosarcoma patient
Authors: Yixuan Li, Tianci Yang, Zhouhang Zheng, Zhong Wang, Shahzard Muhammad Umar, Ning Fan, Shenbao He, Wei Chang, Wei Wang
Journal: Front Oncol (2024)
Keywords: tp53, bladder tumor, case report, gene mutation, rhabdomyosarcoma
MeSH terms: Case Reports

Background:
Rhabdomyosarcoma of the bladder is an infrequent neoplastic condition characterized by a pronounced malignant situation with challenges in treatment due to the lack of standardized guidelines and large-scale of clinical studies. The patient in this case is tested TP53 mutation that may provide new diagnostic and therapeutic options.
Case presentation:
Here, we reported a 34-year-old male who received bladder tumor resection, and diagnosed as bladder rhabdomyosarcoma with TP53 mutation after the pathology test. This patient underwent 6 rounds of chemotherapy. However, the pelvic tumor recurred 11 months after the first surgery. So, the patient accepted the pelvic tumor resection. Only 3 months after the surgical intervention, the patient underwent abdominal massive metastasis and ultimately succumbed to the illness six months following the second surgery. The course of the illness was 22 months.
Conclusion:
Bladder rhabdomyosarcoma is a disease with an extremely poor prognosis. Genetic testing holds significant value in the diagnosis and treatment. Perhaps targeted therapy against TP53 is potential valuable for such rare diseases.
Case report: Durable complete response of a mucosal melanoma of the rectum after neoadjuvant immunotherapy with ipilimumab plus nivolumab
Authors: Oskar Krueger, Robin Eisenburger, Alpaslan Tasdogan, Lisa Zimmer, Elisabeth Livingstone, Eva Hadaschik, Sarah Theurer, Berthold Brodin, Dirk Schadendorf, Selma Ugurel
Journal: Front Immunol (2024)
Keywords: checkpoint inhibitors, complete response, immunotherapy, mucosal melanoma, neoadjuvant
MeSH terms: Ipilimumab / administration & dosage, Ipilimumab / therapeutic use, Melanoma / drug therapy, Melanoma / therapy, Neoadjuvant Therapy / methods, Nivolumab / administration & dosage, Nivolumab / therapeutic use, Rectal Neoplasms / drug therapy, Rectal Neoplasms / immunology, Rectal Neoplasms / pathology, Rectal Neoplasms / therapy, Case Reports, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Humans, Immune Checkpoint Inhibitors / administration & dosage, Immune Checkpoint Inhibitors / therapeutic use, Immunotherapy / methods, Male, Middle Aged, Treatment Outcome, Ipilimumab, Nivolumab, Immune Checkpoint Inhibitors

Melanoma causes the majority of skin cancer-related deaths. Despite novel therapy options, metastatic melanoma still has a poor prognosis. Immune checkpoint inhibition (ICI) therapy has been shown to prolong overall survival in patients with advanced melanoma, but mucosal melanomas respond less favorably compared to melanomas of cutaneous origin. We report on a patient with a mucosal melanoma of the rectum diagnosed in June 2020. Since a surgical intervention in order to achieve a tumor-free situation would have required an amputation of the rectum, a neo-adjuvant systemic immunotherapy with ipilimumab and nivolumab was initiated. As restaging and colonoscopy after four doses of this combination immunotherapy showed a partial response, the patient decided against the pre-planned surgery and a maintenance therapy with nivolumab was started. Repeated colonoscopy showed a complete response after four doses of nivolumab. After ongoing ICI therapy with nivolumab and no evidence of tumor relapse, immunotherapy was stopped in July 2022 after nearly 2 years of continuous treatment. The patient remained tumor-free during further follow-up. Neo-adjuvant immunotherapy is getting more explored in advanced melanoma. By administering ICI therapy before surgical resection of an essentially operable tumor, a stronger and more diverse immunological response is supposed to be achieved. Our reported case demonstrates that this approach could also be effective in mucosal melanoma despite of its generally lower response to immunotherapy.
Optimal age-specific vaccination control for COVID-19: An Irish case study
Authors: Eleni Zavrakli, Andrew Parnell, David Malone, Ken Duffy, Subhrakanti Dey
Journal: PLoS One (2023)
MeSH terms: COVID-19, Research Support, Non-U.S. Gov't, Age Factors, Communicable Disease Control, Humans, SARS-CoV-2, Vaccination

The outbreak of a novel coronavirus causing severe acute respiratory syndrome in December 2019 has escalated into a worldwide pandemic. In this work, we propose a compartmental model to describe the dynamics of transmission of infection and use it to obtain the optimal vaccination control. The model accounts for the various stages of the vaccination, and the optimisation is focused on minimising the infections to protect the population and relieve the healthcare system. As a case study, we selected the Republic of Ireland. We use data provided by Ireland's COVID-19 Data-Hub and simulate the evolution of the pandemic with and without the vaccination in place for two different scenarios, one representative of a national lockdown situation and the other indicating looser restrictions in place. One of the main findings of our work is that the optimal approach would involve a vaccination programme where the older population is vaccinated in larger numbers earlier while simultaneously part of the younger population also gets vaccinated to lower the risk of transmission between groups. We compare our simulated results with those of the vaccination policy taken by the Irish government to explore the advantages of our optimisation method. Our comparison suggests that a similar reduction in cases may have been possible even with a reduced set of vaccinations available for use.
Severe community-acquired pneumonia caused by Chlamydia abortus in China: a case report
Authors: Qiong-Fang Yang, Cai-Min Shu
Journal: Front Med (Lausanne) (2024)
Keywords: chlamydia abortus, case report, community-acquired pneumonia, metagenomic next-generation sequencing, severe
MeSH terms: Case Reports

Background:

Chlamydia abortus causes abortions in ruminants; it can also cause miscarriages and stillbirths in pregnant women. However, it rarely causes pneumonia in humans. Here, we report a case of severe community-acquired pneumonia caused by C. abortus.
Case presentation:
On admission to our hospital, a 74-year-old woman reported that she had had a fever, cough, phlegm in her throat, and shortness of breath for 10 days. In the local hospital, she was initially diagnosed with community-acquired pneumonia and treated with piperacillin-tazobactam for 4 days. However, her condition worsened, and she was therefore transferred to our hospital. On arrival at our emergency department, she was diagnosed with severe community-acquired pneumonia and treated with a high-flow nasal cannula and meropenem; she was then transferred to the Department of Respiratory Medicine. There, her condition continued to worsen despite continued treatment with the high-flow nasal cannula and omadacycline. After 24 h and emergency tracheal intubation, the patient was sent to the intensive care unit (ICU) for further treatment. The doctors in the ICU again adjusted the treatment, this time to meropenem along with mechanical ventilation; they also instituted methylprednisolone, ulinastatin, nadroparin calcium, and human immunoglobulin. In addition, bronchoalveolar lavage fluid was sent for metagenomic next-generation sequencing (mNGS). Subsequent mNGS suggested the presence of C. abortus, sequence number 5072; we therefore discontinued the meropenem and implemented a combination of doxycycline and moxifloxacin. After 8 days of treatment in the ICU, the patient's condition improved; she was then extubated and, 3 days later, transferred back to the respiratory medicine department. The respiratory physician continued to administer doxycycline and moxifloxacin for 4 days, after which the patient was discharged with medication. A month later, a repeat computed tomography (CT) scan of the chest suggested that the lesions in both lungs had been largely absorbed.
Conclusion:

C. abortus can occasionally cause pneumonia in humans and, rarely, severe, life-threatening pneumonia. mNGS is uniquely suited for the early detection of this unusual infection. The combination of doxycycline and quinolones has been shown to be effective in severe pneumonia caused by C. abortus.
A Case of Steroid-Responsive Acute Tubular Injury of Unknown Trigger: A Case Report
Authors: Ali Alqaraishi, Mohammed Tawhari, Nawaf M Alyahya, Alanoud Alotaibi, Alanoud Ghoulah, Abdulrahman Aledrees, Abdulrahman Alabdulsalam
Journal: Cureus (2024)
Keywords: acute kidney injury care, acute tubular necrosis (atn), kidney biopsy, pulse steroids, role of steroids
MeSH terms: Case Reports

Acute tubular necrosis (ATN) is a serious medical condition characterized by the rapid destruction of renal tubular epithelial cells, resulting in acute kidney injury, given its multifactorial etiologies, which can include nephrotoxic agents, ischemic insults, hypovolemia, and sepsis. We report the case of a young male patient who presented with recurrent worsening kidney function with bland sediment that was confirmed with multiple kidney biopsies as recurrent attacks of ATN of unclear etiology, which did not respond to supportive measures but did respond to steroids.
From Unipolar to Bipolar: The Diagnostic Evolution in an Elderly Man
Authors: Vincent John Magat Lu, Melvyn Weibin Zhang, Giles Ming-Yee Tan, Jiangbo Ying
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

A pivotal concept in the field of mood disorders is the dichotomy between unipolar depression and bipolar disorder. Due to the unique treatment in older age bipolar disorder and the scarcity of research in this area, it is clinically important to raise the awareness of the diagnostic conversion of unipolar depression to bipolar disorder in the elderly population. We present a case of a 71-year-old Chinese man whose diagnosis was revised to bipolar disorder after 9 years of treatment for unipolar depression. Organic workup, including blood tests and brain imaging, was performed to rule out organic causes. This patient eventually responded well to the combined treatment of an antipsychotic and a mood stabilizer. This case report adds to the growing literature of challenges in identifying and managing bipolar disorder in the elderly. As unipolar depression and bipolar disorder have different disease courses and different treatment strategies, it is essential for clinicians to be aware of diagnostic conversion. Further research is needed to delineate bipolar disorder from unipolar depression in the elderly population.