Medicine
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Racial differences exist in the severity of systemic sclerosis (SSc). To enhance our knowledge about SSc in African Americans, we established a comprehensive clinical database from the largest multicenter cohort of African American SSc patients assembled to date (the Genome Research in African American Scleroderma Patients (GRASP) cohort). African American SSc patients were enrolled retrospectively and prospectively over a 30-year period (1987-2016), from 18 academic centers throughout the United States. ⋯ A significant association was noted between longer disease duration and higher odds of pulmonary hypertension, telangiectasia, and calcinosis. The prevalence of potentially fatal scleroderma renal crisis was 7%, 3.5 times higher than the 2% prevalence reported in the European League Against Rheumatism Scleroderma Trials and Research (EUSTAR) cohort. Our study emphasizes the unique and severe disease burden of SSc in African Americans compared to those of European ancestry.
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Review Case Reports
Treatment-related acute granulocyte-monocytic leukemia from multiple myeloma: A case report and literature review.
To investigate the clinical features of treatment-related acute granulocyte-monocytic leukemia (t-AML) from multiple myeloma (MM) thereby improving the understanding of this disease. ⋯ The reported case was a rare t-AML, which is resistant to currently available treatments and has a poor prognosis.
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Review Case Reports
Brain metastasis in a patient with melanoma receiving Pembrolizumab therapy: A case report and review of the literature.
Melanoma with brain metastasis is associated with a poor prognosis and high mortality rate. As patients with this condition have been excluded from most clinical trials, data on the use of anti-programmed death 1 therapy for these patients are limited. ⋯ In the case reported here, a delayed and mixed response was observed after Pembrolizumab was used. Because of causing severe pulmonary infection, the use of steroids should be considered carefully when treating immunorelated adverse events. It seemed that the Pembrolizumab has a positive effect on melanoma brain metastases especially combined with other treatments. However, there are still some challenges including patient selection, predictors of response, drug tolerance, optimizing combination strategies and control of adverse effects. More carefully designed clinical trials are urgently needed.
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Endometriosis-associated malignant transformation in abdominal surgical scar (EAMTAS) is a very rare and aggressive phenomenon. Our current article aims to provide a clinical overview, focusing on risk factors affecting survival. ⋯ EAMTAS is a rare and aggressive disease. It is mostly related to cesarean section scars and is diagnosed many years postsurgery. Clear-cell histology tends to endure from the worse prognosis. The treatment is mainly extensive surgery and adjuvant chemotherapy and/or radiotherapy.
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Review Case Reports
An intracardiac accessory thyroid gland mimicking cardiac tumor: A case report and literature review.
An accessory thyroid gland (ATG) in the right ventricle is an extremely rare condition. Described herein are histological findings of ATG in the right ventricle found in a patient with a normal cervical thyroid gland. ⋯ After review and analysis of the case, we found that plain and contrast-enhanced computed tomography scans showed that the mass had a similar intensity and enhancement to a cervical thyroid gland, which we think may be a useful clue for making a preoperative diagnosis of ATG.