BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardiac monitoring.CASE SUMMARY Two patients with non-small cell lung cancer developed SSS after 15 months and 5 months of anlotinib treatment,respectively,presenting with syncope and palpit-ations.Electrocardiogram confirmed SSS,and different treatment approaches were taken for each patient.One patient received a dual-chamber permanent pacemaker,while the other discontinued the medication and experienced symptom resolution.CONCLUSION Anlotinib can induce SSS,suggesting that cardiac monitoring is crucial during anlotinib treatment.Individualized management strategies are necessary for affected individuals.
Cheng-Feng FuLi-Fen YangLei TianSong DengQi ZhangBiao Yao
BACKGROUND Wilson's disease(WD)is a rare metabolic disorder of copper accumulation in organs such as liver,brain,and cornea.Diagnoses and treatments are challenging in settings,where advanced diagnostic tests are unavailable,copper chelating agents are frequently scarce,healthcare professionals lack disease awareness,and medical follow-ups are limited.Prompt diagnoses and treatments help prevent complications,improve patients’quality of life,and ensure a normal life expectancy.The clinical presentations and outcomes of WD can vary within a single family.CASE SUMMARY We present the cases of two siblings(19 and 27 years)from a consanguineous family in rural Ecuador,diagnosed as having WD during a family screening.The male patient,diagnosed at age 19 after his brother’s death from acute liver failure,presented with compensated cirrhosis,neurological symptoms,and bilateral Kayser-Fleischer rings.He developed progressive neurological deterioration during an irregular treatment with D-penicillamine due to medication shortages.His condition improved upon switching to trientine tetrahydrochloride,and his neurological symptoms improved over an 8-year period of follow-ups.The female patient,diagnosed at age 10,exhibited only biochemical alterations.Her treatment history was similar;however,she remained asymptomatic without disease progression over the same follow-up period.We discuss the potential influence of epigenetic mechanisms and modifier genes on the various phenotypes,emphasizing the need for research in these areas to optimize therapeutic strategies.CONCLUSION Our patients’medical histories show how early diagnosis and treatment can prevent disease progression;and,how suboptimal treatments impact disease outcomes.
This article explores the ethical considerations surrounding the reporting of offlabel and experimental treatments in medical case reports,with a focus on fields such as oncology,psychiatry,and pediatrics.It emphasizes the balance between innovation and evidence-based medicine,highlighting the critical role of case reports in disseminating clinical experiences and advancing medical knowledge.The discussion delves into the ethical framework guiding case reporting,including principles of patient autonomy,informed consent,non-maleficence,beneficence,justice,and transparency.Challenges such as negative outcome reporting,commercial interests,and the balance between innovation and caution are examined.Recommendations for ethical vigilance,the development of comprehensive guidelines,and the role of regulatory bodies are proposed to ensure patient safety and uphold scientific integrity.The article concludes by underscoring the importance of a collaborative effort among clinicians,researchers,ethicists,and regulatory bodies to foster the responsible advancement of medical science while adhering to the highest ethical standards.
BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyces boulardii(S.boulardii),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered FPIES.In this report,we describe a new clinical FPIES in which S.boulardii was the sole triggering factor of acute FPIES adverse reaction in seven healthy infants.CASE SUMMARY Seven FPIES cases triggered by only S.boulardii were gathered from 2011 to the present.None of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary food.The age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of S.boulardii,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated diarrhea.All patients experienced severe repetitive vomiting 1-3 hours after S.boulardii ingestion.Extreme lethargy,marked pallor,and cyanosis were also observed.No IgE-mediated hypersensitivity developed in any patient.Diarrhea was followed by initial intense vomiting in approximately 5-10 hours after S.boulardii ingestion,and only one case showed bloody,purulent,and foul-smelling diarrhea.The patients stabilized quickly,mostly within 6 hours.Symptoms got all improved within 24 hours after discontinuation of S.boulardii.CONCLUSION S.boulardii can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.
BACKGROUND Small cell lung cancer(SCLC)is the most malignant type of lung cancer.Even in the latent period and early stage of the tumor,SCLC is prone to produce distant metastases with complex and diverse clinical manifestations.SCLC is most closely related to paraneoplastic syndrome,and some cases present as paraneoplastic peripheral neuropathy(PPN).PPN in SCLC appears early,lacks specificity,and often occurs before diagnosis of the primary tumor.It is easy to be misdiagnosed as a primary disease of the nervous system,leading to missed diagnosis and delayed diagnosis and treatment.CASE SUMMARY This paper reports two cases of SCLC with limb weakness as the first symptom.The first symptoms of one patient were rash,limb weakness,and abnormal electromyography.The patient was repeatedly referred to the hospital for limb weakness and rash for>1 year,during which time,treatment with hormones and immunosuppressants did not lead to significant improvement,and the condition gradually aggravated.The patient was later diagnosed with SCLC,and the dyskinesia did not worsen as the dermatomyositis improved after antineoplastic and hormone therapy.The second case presented with limb numbness and weakness as the first symptom,but the patient did not pay attention to it.Later,the patient was diagnosed with SCLC after facial edema caused by tumor thrombus invading the vein.However,he was diagnosed with extensive SCLC and died 1 year after diagnosis.CONCLUSION The two cases had PPN and abnormal electromyography,highlighting its correlation with early clinical indicators of SCLC.
《海关医报(Customs Medical Reports)》是19世纪70年代至20世纪初有关沿海、沿江以及沿边通商口岸的医疗卫生报告,为认识当时商埠城市的环境、卫生和传染病提供了珍贵的文献资料。本文追溯西方列强控制的卫生检疫,在阐述《海关医报》的历史、内容和有限作用的基础上,讨论对我国社会主义现代化海关卫生检疫的启示,指出坚持党的领导是实现海关主权和保护人民健康的必然,开展传染病防控研究是海关促进人民健康使命的必然,强化传染病防控顶层设计是海关卫生检疫发展的必然,强化国际医学交流与合作是海关增强履职能力的必然,提升专业人员的技术能力是卫生检疫执法需要的必然,促进社会公众广泛参与是海关彰显社会文明的必然,融入国家大卫生及联防联控是海关行使检疫主权的必然,推进构建人类卫生健康共同体是新时代海关奋进的必然。
The development of a knowledge management system for the National Hydro Data Center of Thailand was described in this paper. The system was created after the major flood event in 2011 to improve water resource management. It addresses the need for easy access to water situation reports, which are crucial for informed decision-making on water usage, allocation, and reservoir management. The system utilizes Optical Character Recognition technique to convert scanned water situation reports into searchable text. It applied FastText and ElasticSearch for advanced search functionalities. FastText identified the documents related to the search query, even with typos or misspelled words. ElasticSearch allows for efficient searching of text data based on relevance. The system also integrates Google Search for additional information access. Therefore, this knowledge management system provides an efficient way to access and analyze water situation data in Thailand.
The original online version of this article (Kamenarova, K., Cherninkova, S., Mihova, K., Georgiev, R., Nikolaeva, Y. and Kaneva, R. (2022) Identification of Novel Nonsense RPGR Variant Causing Mild X-Linked Cone-Rod Dystrophy and Myopia. Case Reports in Clinical Medicine, 11, 422-434. DOI: 10.4236/crcm.2022.1110059) unfortunately contains a mistake. The authors need to replace Figure 1.
