Archives of medical case reports最新文献

{"title":"Safety and Efficacy of s-MOX Regimen in Patients with Colorectal Cancer Who Developed Cardiotoxicity Following Fluoropyrimidine Administration: A Case Series.","authors":"Matthew I Ehrlich,&nbsp;Kristin Kaley,&nbsp;Melissa Smith,&nbsp;M Wasif Saif","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Fluoropyrimidines compose the backbone of regimens to treat many common solid tumors, including gastrointestinal (GI), breast and head/neck. As we continue to use these agents routinely, recognition of rare but real toxicities, such as cardiotoxicity, has also improved. The treatment options for patients who have encountered fluoropyrimidine-induced cardiotoxicity are limited as many anti-angiogenic drugs also pose a cardiac risk.</p><p><strong>Patients and methods: </strong>We present a case series of three patients who developed cardiotoxicity in the form of anginal-like symptoms, EKG changes and elevated cardiac enzymes on infusional 5-FU or capecitabine and were subsequently treated with the s-MOX (simplified-mitomycin-oxaliplatin) regimen for their metastatic colorectal cancer (mCRC). All three patients were tested for polymorphic abnormality of <i>DYPD</i> and <i>TYMS</i>.</p><p><strong>Results: </strong>All three patients were treated with s-MOX consisting of mitomycin-C 7 mg/m² on day 1 and oxaliplatin 85 mg/m² on days 1 and 15 (1 cycle = 28 days) after they encountered cardiotoxicity to 5-FU and/or capecitabine. None of these patients developed any cardiotoxicity on s-MOX. Overall, the MOX regimen was well tolerated. The most common toxicities included ≤ 2 grade peripheral neuropathy, nausea, vomiting, thrombocytopenia, and anemia. Grade ≥ 3 toxicities included neutropenia (10%), thrombocytopenia (33%), vomiting (8%), and peripheral neuropathy (30%). <i>DYPD</i> gene was normal in all patients and <i>TYMS</i> was abnormal (2R/2R) in one patient.</p><p><strong>Conclusion: </strong>This is the first case series that reports the safety and feasibility of s-MOX in patients with mCRC who developed cardiac toxicity to 5-FU or capecitabine. The s-MOX regimen may provide an alternative treatment option for patients who either develop fluoropyrimidine-related cardiotoxicity or who have abnormalities in the <i>DYPD</i> gene.</p>","PeriodicalId":93075,"journal":{"name":"Archives of medical case reports","volume":"2 1","pages":"23-29"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38409943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thymoma as an Incidental Finding in a Myocardial Perfusion Study with 99mTc-MIBI","authors":"J. Yepes, I. F. V. González, Nikolai Strusberg Fernández, Juan Carlos Ramirez Fontalvo, Óscar Alejandro Osorio Echeverry, Luz Kelly Anzola Fuentes","doi":"10.33696/casereports.1.001","DOIUrl":"https://doi.org/10.33696/casereports.1.001","url":null,"abstract":"Juan Carlos Ramirez Yepes1, Iván Fabricio Vega González2, Nikolai Strusberg Fernández1, Juan Carlos Ramirez Fontalvo2, Óscar Alejandro Osorio Echeverry2, Luz Kelly Anzola Fuentes3* 1Post Graduate Program in Nuclear Medicine, Fundación Universitaria Sanitas, Bogota, Colombia 2Nuclear Medicine Department, Clinica Las AmericasMedellín, Colombia 3Director of Post Graduate Program in Nuclear Medicine, Fundación Universitaria Sanitas, Bogota, Colombia","PeriodicalId":93075,"journal":{"name":"Archives of medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69669687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Global Rise of Chronic Diseases: Why Broaden the Paradigm to Include Tick-borne Illness and Environmental Toxin Exposure?","authors":"R. Horowitz","doi":"10.33696/casereports.1.003","DOIUrl":"https://doi.org/10.33696/casereports.1.003","url":null,"abstract":"7 The incidence of chronic diseases is rapidly increasing worldwide. It has been calculated that, in 2001, chronic diseases contributed to approximately 46% of the global burden of disease and 60% of the total reported deaths with that number expected to increase to 57% by 2020, when chronic diseases will account for almost 75% of all deaths worldwide [1,2]. The role of obesity, poor nutrition, physical inactivity, tobacco use, the harmful use of alcohol, as well as elevated blood pressure and blood glucose levels have all been validated as important variables in chronic disease [3]. These risk factors account, in part, for the top ten causes of disability and death worldwide, including non-communicable diseases (ischemic heart disease, strokes, chronic obstructive pulmonary disease), cancer, Alzheimer’s disease and dementia as well as communicable diseases including infections like tuberculosis [4].","PeriodicalId":93075,"journal":{"name":"Archives of medical case reports","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69669701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}