OpenMed/multicare-articles huggingface dataset:
Repurposing Drugs in Controlling Recurrent Platinum-Resistant Clear-Cell Ovarian Cancer
Authors: Woraporn Sinsuwan, Phawit Norchai
Journal: Case Rep Oncol Med (2023)
MeSH terms: Case Reports

Background:
Recurrent platinum-resistant clear-cell ovarian cancer has a low overall survival duration of 7-8 months, making it a fatal disease. Currently, chemotherapy is the major kind of treatment, but it offers little advantage. Repurposed conventional drugs have recently been found to offer the ability to control cancer with few side effects and at a reasonable cost to healthcare organizations. Case Presentation. In this case report, we present the case of a 41-year-old Thai female patient diagnosed with recurrent platinum-resistant clear-cell ovarian cancer (PRCCC) in the year 2020. After undergoing chemotherapy for two courses and failing to respond to treatment, she began alternative medicine with repurposing drugs in November 2020. Simvastatin, metformin, niclosamide, mebendazole, itraconazole, loratadine, and chloroquine were also administered. Two months after therapy, a computerized tomography (CT) scan revealed a conflict between a decline in tumor marker levels (CA 125, CA 19-9) and an increase in the number of lymph nodes. However, after continuing all medications for 4 months, the CA 125 level decreased from 303.6 to 54 U/ml, and the CA 19-9 level decreased from 1210.3 to 386.10 U/ml. The patient's EQ-5D-5L score increased from 0.631 to 0.829 (abdominal pain and depression), indicating improved quality of life. Overall survival was 8.5 months, and progression-free survival was 2 months.
Conclusion:
The response to drug repurposing is demonstrated by a four-month-long improvement in symptoms. This work introduces a novel strategy for the management of recurrent platinum-resistant clear-cell ovarian cancer that needs further evaluation in large-scale studies.
Case Report: Diabetic urinary auto-brewery and review of literature
Authors: Abdulrahman A Alduraywish
Journal: F1000Res (2021)
Keywords: amphotericin b, blood ethanol, candiduria, type 2 diabetes mellitus, urinary auto-brewery
MeSH terms: Alcoholic Intoxication / diagnosis, Alcoholic Intoxication / metabolism, Diabetes Mellitus, Kidney Diseases, Urinary Tract Infections, Case Reports, Review, Aged, Amphotericin B, Ethanol / metabolism, Humans, Insulin, Male, Insulin, Ethanol, Amphotericin B

Background: Although candiduria is an expected encounter and should not be surprising in uncontrolled diabetes with glucose-enriched urine, urinary auto-brewery is rarely thought of by diabetologists. Moreover, endogenous ethanol production in humans from gut microbiome, urinary tract fungi and bacteria, and intermediary metabolism, has been reported for a long time, particularly in diabetics. Case description: To alert physicians to the overlooked implication of endogenously produced ethanol both as a biomarker for poor control of diabetes and as a complicating factor, we report this case of an elderly male smoker alcohol-abstinent insulin-dependent Type 2 diabetic patient. Because of circumstantial treatment and incompliance for one week, he developed endogenously produced alcohol intoxication. We proposed candidal urinary auto-brewery evidence sourced from the case history, urinalysis, and culture/identification tests - without excluding other sources. Fortunately, his diet and glycemic control were fairly controlled and, liver and kidney functions were almost normal. Amphotericin B I/V for five days, insulin, and a fluid therapy regimen greatly improved the case and cleared both the candiduria and ethanol from the urine and blood and the patient regained his base-line normal life. Conclusion: Symptoms of alcohol intoxication should be expected in patients with uncontrolled diabetes that most often correlates with candiduria and/or constipation. These symptoms can be exaggerated in those already suffering a degree of dementia and/or comorbid psychiatric/neurologic affections. Direct wet mount examination of urine under phase contrast microscopy would show the budding yeast cells. Appropriate antifungal, insulin and fluid therapies regained the base-line norms.
Oral Isotretinoin Therapy in Recalcitrant Molluscum Contagiosum in an Immunocompromised Patient
Authors: Vikash Paudel, Deepa Chudal
Journal: Case Rep Dermatol Med (2021)
MeSH terms: Case Reports

Molluscum contagiosum is a viral infection caused by the Poxvirus characterized by multiple umbilicated papules. It is common in children and can be present at any body site. Severe molluscum is common in immunocompromised patients. We report a 20-year-old HIV-positive individual with widespread molluscum contagiosum, recalcitrant to topical therapy, under antiretroviral therapy, who was treated with oral isotretinoin and had a dramatic outcome. Although studies are needed to confirm the effectiveness of oral isotretinoin therapy in molluscum contagiosum, its easy availability, cost, and excellent safety profile appear to offer a promising therapeutic option.
Transcatheter Tricuspid Valve-in-Valve Replacement Using a J-Valve System for a Failed Tricuspid Bioprosthesis
Authors: Mingkui Zhang, Hui Xue, Lifu Miao, Xiujie Tang, Yanbin Shao
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Background:
Redo operation for failed tricuspid bioprosthetic valves is associated with high morbidity and mortality. Transcatheter tricuspid valve-in-valve implantation has become an acceptable option for high-risk patients with a failed tricuspid bioprosthesis. We present a case of successful tricuspid valve-in-valve implantation using a J-valve in a failed tricuspid bioprosthesis position. Case Summary. A 48-year-old male, who had a failed tricuspid bioprosthesis, presented with right-side heart failure, right-to-left shunting at the atrial level, severe dyspnea, cyanosis, peripheral edema, hepatauxe, and ascites. After the interdisciplinary assessment, we successfully performed transcatheter tricuspid valve-in-valve implantation with the J-valve system. At 34-month postoperative follow-up, the patient had no symptoms of heart failure and the echocardiogram showed good valve position and well hemodynamic status.
Conclusions:
This case demonstrated that the J-valve system may be a new option for high-risk patients with a failed tricuspid bioprosthetic valve.
Unusual Presentation of Hemophagocytic Lymphohistiocytosis in a Kidney Transplant Patient
Authors: Danwen Yang, Natanong Thamcharoen, Chelsea Marcus, Andreas Varkaris, William Aird, Eliyahu V Khankin, Francesca Cardarelli
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

We are presenting a case of a middle-aged woman with history of remote kidney transplantation who had multiple admissions for septic shock-like picture, recurrent fever, and hypotension. Her shock manifestation would resolve after stress dose steroid administration and less than 24 hours of vasopressor administration. Initially, extensive workup was performed without revealing etiology. Eventually, a bone marrow biopsy was carried out leading to the diagnosis of hemophagocytic lymphohistiocytosis, most likely related to recent cytomegalovirus infection.
Transcatheter heart valve in valve implantation with Edwards SAPIEN bioprosthetic valve for different degenerated bioprosthetic valve positions (First Iranian ViV report with mid-term follow up)
Authors: Ali Mohammad Haji Zeinali, Kyomars Abbasi, Mohammad Saheb Jam, Shahrooz Yazdani, Seyedeh Hamideh Mortazavi
Journal: J Cardiovasc Thorac Res (2017)
Keywords: bioprosthetic valve, edwards sapein valve, transcatheter valve, valve-in-valve

Introduction: After early successful experience with transcatheter aortic valve replacement (TAVR), concept of transcatheter implantation of a new valve within a failing bioprosthetic valve emerged. Valve-in-valve (ViV) implantation seems to be a simpler option for high risk surgical patients. Methods: We performed five ViV procedures in different valve positions. We included patients with failing bioprosthetic valves with high surgical risk due to concomitant comorbidities. We performed 2 transapical ViV procedures for failing mitral bioprosthetic valves, 1 transfemoral procedure for failing pulmonary valve and 2 transfemoral ViV implantation for failing tricuspid bioprosthetic valves. Results: The procedures were successfully completed in all 5 cases with initial excellent fluoroscopic and echocardiographic verification. There was no valve embolization or paravalvular leakage in any of the cases. Transcatheter valve function was appropriate with echocardiography. Post procedural clinical adverse events like pleural effusion and transient ischemic attack were managed successfully. In midterm follow up all cases remained in appropriate functional class except from the transcatheter pulmonary valve which became moderately stenotic and regurgitant. Conclusion: As the first Iranian all-comers case series with midterm follow up for ViV implantation, we had no mortality. Interestingly none of our patients had neurologic sequelae after the procedure. Midterm follow up for our patients was acceptable with good functional class and appropriate echocardiographic findings. Due to high surgical risk of the redo procedure after failing of a bioprosthetic valve especially in elderly patients with comorbidities, ViV implantation would be a good alternative to surgery for this high risk group.
Type 1 diabetes complicated with uncontrollable adult cyclic vomiting syndrome: a case report
Authors: Kazuma Ogiso, Nobuyuki Koriyama, Ayako Akao, Mayumi Otsuji, Takahiko Goto, Natsuko Fujisaki, Machiko Minobe, Mayumi Kinowaki, Shigeru Matsuki
Journal: J Diabetes Metab Disord (2015)
Keywords: continuous subcutaneous insulin infusion therapy (csii), cyclic vomiting syndrome (cvs), hypnotherapy, sandplay therapy, type 1 diabetes mellitus
MeSH terms: Case Reports

We herein describe the case of a 29-year-old woman with type 1 diabetes from 10 years of age who developed adult cyclic vomiting syndrome. Beginning at 25 years of age, she was frequently hospitalized for stress-induced vomiting. Her vomiting episodes developed acutely and remitted after severe vomiting of more than 30 times a day for a few days. The vomiting periods were accompanied by leukocytosis with a predominance of neutrophils, high blood pressure and fever. In addition, it was noted that her levels of both adrenocorticotropic hormone and antidiuretic hormone during the vomiting attacks increased and subsequently dramatically decreased immediately after symptom improvement; therefore, she was diagnosed with adult-type cyclic vomiting syndrome in accordance with the diagnostic criteria of Rome III, a system developed to classify functional gastrointestinal disorders. Though glycemic control had improved with continuous subcutaneous insulin infusion therapy, the vomiting frequency increased due to the failure of drug treatments and general psychotherapy to terminate the vomiting attacks, making discharge difficult and greatly interfering with everyday life. Eventually, hypnotherapy and miniature garden therapy were prescribed, which significantly reduced the vomiting frequency, making it possible to discharge her from inpatient medical care. In the treatment of this patient with type 1 diabetes and adult-type cyclic vomiting syndrome, continuous subcutaneous insulin infusion therapy and comprehensive psychotherapy were effective.
Case report: Primary pleural squamous cell carcinoma in a 68-year-old male
Authors: Chuan Zhong, Haining Zhou, Ramón Rami-Porta, Yunfei Zhao
Journal: Front Surg (2022)
Keywords: a promising therapeutic approach, primary pleural squamous cell carcinoma, pulmonary bullae, radiotherapy, surgical resection
MeSH terms: Case Reports

Introduction:
Primary pleural squamous cell carcinoma (PPSCC) is a sporadic disease that is rarely reported in the literature. Due to its low incidence, the pathogenesis of PPSCC is unknown.
Case summary:
We report a case of a 68-year-old male with PPSCC and sizable pulmonary bullae. Two months after complete resection of both lesions, a total dose of 50 Gy radiotherapy was administered over the operative field. After more than a year of follow-up, the patient is in steady condition without any sign of recurrence.
Conclusion:
Since PPSCC is rarely reported, our case proposed that complete surgical resection combined with radiotherapy may be a promising therapeutic approach.
Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome
Authors: Sz-Jiun Shiu, Ting-Ting Li, Bor-Jen Lee, Pin-Kuei Fu, Chen-Yu Wang, Sz-Iuan Shiu
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Acute respiratory distress syndrome (ARDS) and hemophagocytic lymphohistiocytosis (HLH) are accompanied with poor outcome and high mortality when miliary tuberculosis is a causative pathogen for both of them. A patient complicated with ARDS and HLH is unusual in critical care, and few case reports are present in PudMed. Besides, the relationship between HLH and ARDS is still unknown and has not been reviewed in the literature. In this report, we present the case of a 74-year-old Taiwanese woman suffering from pulmonary tuberculosis and miliary tuberculosis, and she developed ARDS and HLH on the 3rd day after admission. We arranged serial laboratory examination, various serum markers, bone marrow aspiration, and bronchoscopy with alveolar lavage for survey; we prescribed empirical antibiotics and antituberculosis medication soon after alveolar lavage showing positive acid-fast stain. She was extubated on hospital day 31 and discharged on hospital day 73. In conclusion, early diagnosis and intervention for underlying disease and intensive bundle care for multiorgan failure are crucial for both ARDS and HLH.
Case Report: Cerebral venous thrombosis revealing celiac disease
Authors: Romdhane Wiem, Arfa Sondess, Chelly Jihene, Jomaa Olfa, Hammami Sonia, Hmida Karima, El Arbi Fatma, Berriche Olfa
Journal: F1000Res (2021)
Keywords: celiac disease, venous thromboembolic disease, malabsorption syndrome, hypercoagulability
MeSH terms: Celiac Disease / complications, Celiac Disease / diagnosis, Venous Thrombosis, Case Reports, Adult, Autoantibodies, Female, Glutens, Humans, Transglutaminases, Autoantibodies, Glutens, Transglutaminases

Celiac disease (CD) is an autoimmune enteropathy resulting from intolerance of an individual genetically predisposed to gluten. It has a large clinical polymorphism ranging from a classic digestive clinical presentation due to the malabsorption syndrome to extra-intestinal symptoms. Among the hematologic abnormalities, venous thromboembolic disease (VTE) has been reported, and they are most often located in the abdomen or lower limbs, but the cerebral localization was exceptionally described. We report a case of CD revealed by cerebral thrombophlebitis. A 44-year-old patient with no medical history and no drug intake, presented with hemiplegia followed by a status epilepticus in a context of apyrexia, initially hospitalized in intensive care. Magnetic imaging resonance displayed a cerebral venous thrombosis of the sigmoid sinus requiring anticoagulant treatment, then transferred to our department for the etiological investigation. On questioning, the patient reported chronic diarrhea and weight loss with no other associated symptoms. The examination revealed an underweight patient with pale conjunctiva, improvement of her deficit symptoms, and no other abnormalities. Laboratory tests noted biological signs of malabsorption. The thrombophilia assessment revealed a protein C deficiency with a slight increase in anticardiolipin antibodies and anti-Beta 2 glycoprotein 1 antibodies. Immunological tests noted positives anti-transglutaminase and IgA anti-endomysium antibodies. Duodenal biopsy demonstrated villous atrophy. After ruling out the other causes of VTE, the diagnosis of cerebral venous thrombosis secondary to CD was retained. Early diagnosis and treatment of CD improves the quality-of-life for patients and may spare them various long-term or even fatal complications.
Suspected anemia caused by maternal anti-Jra antibodies: a case report
Authors: Yasufumi Endo, Shoichi Ito, Yoshiko Ogiyama
Journal: Biomark Res (2015)
Keywords: atp-binding cassette, atp-binding cassette g2 [abcg2(cd338)], anti-jra, irregular antibodies, transporter
MeSH terms: Case Reports

Most cases of hemolytic disease of the newborn associated with anti-Jra are mild. However, rare cases of hydrops fetalis and severe anemia have been reported. We treated a neonate with anemia who was born with maternal anti-Jra, which were detected in the umbilical cord plasma. The Jra antigens in the neonate core blood red blood cells (RBCs) exhibited extremely weak reactivity to PEG-IAT, an anti-Jra reagent. However, upon re-examination of Jra antigen using PEG-IAT at 3 months postpartum, positivity was observed. Thereafter, upon performing PCR-SSP analysis of blood relatives targeting ABCG2 at positions 376 and 421, we found that the mother was Jr(a-) with 376 T homozygosity, whereas the father was Jr(a+) with 376 C homozygosity and a carrier of a 421 C > A mutation. The first sibling, like the propositus, was Jr(a+), exhibiting 376 CT heterozygosity. However, the first sibling carried a 421 C > A mutation, whereas the propositus had no mutation at position 421. Setting the normal Jra (a+) type (376 C, 421 C) to 100 %, we identified the amount of Jra in RBC using FCM to be 82 % in the father, 31 % in the first sibling, and 69 % in the propositus. Furthermore, upon comparing peripheral blood and myelograms of the neonate at the time of birth, we found a low myeloid cells/erythroid cells ratio, undifferentiated erythroblasts, and reduced megakaryocytes. On the basis of these findings, we suggest that cell surface antigen is involved in the HDN caused by anti-Jra, and that a cytodifferentiation abnormality is present in the hematopoietic system.
Malignant Transformation of Giant Cell Tumor of Bone and the Association with Denosumab Treatment: A Radiology and Pathology Perspective
Authors: K van Langevelde, A H G Cleven, A Navas Cañete, L van der Heijden, M A J van de Sande, H Gelderblom, J V M G Bovée
Journal: Sarcoma (2022)

Objective:
Malignancy in giant cell tumor of bone (mGCTB) is categorized as primary (concomitantly with conventional GCTB) or secondary (after radiotherapy or other treatment). Denosumab therapy has been suggested to play a role in the etiology of secondary mGCTB. In this case series from a tertiary referral sarcoma center, we aimed to find distinctive features for malignant transformation in GCTB on different imaging modalities. Furthermore, we assessed the duration of denosumab treatment and lag time to the development of malignancy.
Methods:
From a histopathology database search, 6 patients were pathologically confirmed as having initial conventional GCTB and subsequently with secondary mGCTB.
Results:
At the time of mGCTB diagnosis, 2 cases were treated with denosumab only, 2 with denosumab and surgery, 1 with multiple curettages and radiotherapy, and 1 with surgery only. In the 4 denosumab treated patients, the mean lag time to malignant transformation was 7 months (range 2-11 months). Imaging findings suspicious of malignant transformation related to denosumab therapy are the absence of fibro-osseous matrix formation and absent neocortex formation on CT, and stable or even increased size of the soft tissue component.
Conclusion:
In 4 patients treated with denosumab, secondary mGCTB occurred within the first year after initiation of treatment. Radiotherapy-associated mGCTB has a longer lag time than denosumab-associated mGCTB. Close clinical and imaging follow-up during the first months of denosumab therapy is key, as mGCTB tends to have rapid aggressive behavior, similar to other high-grade sarcomas. Nonresponders should be (re) evaluated for their primary diagnosis of conventional GCTB.
Surgical Management of Nephrolithiasis in the Bottlenose Dolphin: Collaborations Between the Urologist and Veterinarian
Authors: Roger L Sur, Jenny M Meegan, Cynthia R Smith, Todd Schmitt, James L'Esperance, Dean Hendrikson, Jason R Woo
Journal: J Endourol Case Rep (2018)
Keywords: tursiops truncatus, bottlenose dolphin, laparoscopy, nephrolithiasis, ureteroscopy, urolithiasis, veterinary medicine
MeSH terms: Case Reports

Background: Cohorts of bottlenose (Tursiops truncatus) dolphins are at significant risk for nephrolithiasis development. However, effective surgical treatment has been limited due to absence of literature and also familiarity by both veterinarians and urologists. Recently a joint veterinarian and urology team were called to treat local bottlenose dolphins in San Diego, CA, and they performed several cases. The fund of knowledge from these cases is presented for future providers who may be asked to surgically treat these animals. Case Presentation: Two surgical kidney stone cases were performed by a joint veterinarian and physician team. An effective ureteroscopic stone removal was performed on a 39-year-old female bottlenose dolphin with 9.7 mm distal ureteral calculus. The second case involved laparoscopic ureterolithotomy on a 31-year-old male bottlenose dolphin with a 6-mm right distal ureteral calculus that previously failed retrograde ureteroscopic removal. The stone was not effectively removed laparoscopically as well due to failure to progress associated with operative machinery malfunction. The dolphin was ultimately euthanized. Conclusion: Despite suboptimal outcome in one case, extremely valuable lessons were learned during both cases. We present our surgical experiences, as well as pertinent anatomical differences, in these animals with the hope that this discussion will facilitate future surgical kidney stone treatment of dolphins.
Serious Complications of EUS-Guided Hepaticoesophagostomy due to Transmural Stent Migration
Authors: Mateusz Jagielski, Michał Zieliński, Jacek Piątkowski, Marek Jackowski
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Thoracic complications, such as biliopleural fistula and bile leaking into the right pleural cavity, are serious adverse events of transmural endoscopic ultrasound- (EUS-) guided biliary drainage involving EUS-guided hepaticoesophagostomy (EUS-HES). In this article, the authors present endoscopic treatment of biliopleural fistula as a serious thoracic complication of EUS-HES. The authors highlight key components of EUS-guided transmural biliary drainage and their experience with particular emphasis on endoscopic treatment of thoracic complications.
A 49-year-old woman presenting with hepatoid adenocarcinoma of the urinary bladder: a case report
Authors: Yohei Sekino, Hideki Mochizuki, Hiroki Kuniyasu
Journal: J Med Case Rep (2013)

Introduction:
Adenocarcinomas represent less than 2 percent of all urothelial neoplasms. Hepatoid adenocarcinoma is rare in the urinary bladder. Pathological diagnosis is based on a combination of histological features resembling hepatocellular carcinoma and positive immunostaining for α-fetoprotein.
Case presentation:
We report a case of hepatoid adenocarcinoma of the urinary bladder. A 49-year-old Japanese woman underwent a total mastectomy, and post-operatively abdominal computed tomography revealed a tumor of the urinary bladder. Trans-urethral resection of the bladder tumor was performed, and pathological examination revealed a hepatoid adenocarcinoma of the urinary bladder. Our patient has had no evidence of recurrence 20 months after surgery to remove the tumor.
Conclusions:
Hepatoid adenocarcinoma seems to be an aggressive malignant neoplasm that is rare in the urinary bladder. This case report is only the ninth case of hepatoid adenocarcinoma in the urinary bladder to appear in the literature. It is important to be aware of atypical cancer localizations in order to reach a correct diagnosis.