Humans ; Lymphoma, Primary Effusion ; Lymphoma ; Fatal Outcome

Fatal Outcome ; Female ; Hepatic Encephalopathy/genetics* ; Humans ; Infant ; Male ; Metabolism, Inborn Errors/genetics* ; Mitochondrial Proteins/genetics* ; Mutation ; Peptide Elongation Factor G/genetics* ; Whole Exome Sequencing

Immune checkpoint blockade targeting PD-1 and PD-L1 has resulted in unprecedented clinical benefit for cancer patients. Anti-PD-1/PD-L1 therapy has become the standard treatment for diverse cancer types as monotherapy or in combination with other anti-cancer therapies, and its indications are expanding. However, many patients do not benefit from anti-PD-1/PD-L1 therapy due to primary and/or acquired resistance, which is a major obstacle to broadening the clinical applicability of anti-PD-1/PD-L1 therapy. In addition, hyperprogressive disease, an acceleration of tumor growth following anti-PD-1/PD-L1 therapy, has been proposed as a new response pattern associated with deleterious prognosis. Anti-PD-1/PD-L1 therapy can also cause a unique pattern of adverse events termed immune-related adverse events, sometimes leading to treatment discontinuation and fatal outcomes. Investigations have been carried out to predict and monitor treatment outcomes using peripheral blood as an alternative to tissue biopsy. This review summarizes recent studies utilizing peripheral blood immune cells to predict various outcomes in cancer patients treated with anti-PD-1/PD-L1 therapy.
Acceleration ; Antigens, CD274 ; Biomarkers ; Biopsy ; Drug-Related Side Effects and Adverse Reactions ; Fatal Outcome ; Humans ; Prognosis ; Programmed Cell Death 1 Receptor

Objective: To analyse the clinical history, laboratory tests and pathological data of a patient who suffered from novel coronavirus pneumonia(COVID-19) and provide reference for the clinical treatment of similar cases. Methods: Data of clinical manifestation, laboratory examination, bronchoscopy, echocardiography and cardiopulmonary pathological results were retrospectively reviewed in a case of COVID-19 with rapid exacerbation from mild to critical condition. Results: This patient hospitalized at day 9 post 2019 novel coronavirus(2019-nCoV) infection, experienced progressive deterioration from mild to severe at day 12, severe to critical at day 18 and underwent extracorporeal membrane oxygenation(ECMO) and continuous renal replacement therapy(CRRT) as well as heart lung transplantation during day 28-45 post infection, and died at the second day post heart and lung transplantation. The patient had suffered from hypertension for 8 years. At the early stage of the disease, his symptoms were mild and the inflammatory indices increased and the lymphocyte count decreased continuously. The patient's condition exacerbated rapidly with multi-organ infections, and eventually developed pulmonary hemorrhage and consolidation, pulmonary hypertension, right heart failure, malignant ventricular arrhythmias, liver dysfunction, etc. His clinical manifestations could not be improved despite viral RNAs test results became negative. The patient underwent lung and heart transplantation and finally died of multi organ failure at the second day post lung and heart transplantation. Pathological examination indicated massive mucus, dark red secretions and blood clots in bronchus. The pathological changes were mainly diffused pulmonary hemorrhagic injuries and necrosis, fibrosis, small vessel disease with cardiac edema and lymphocyte infiltration. Conclusions: The clinical course of severe COVID-19 can exacerbate rapidly from mild to critical with lung, liver and heart injuries.
Betacoronavirus ; COVID-19 ; Coronavirus Infections/pathology* ; Fatal Outcome ; Hemorrhage/virology* ; Humans ; Lung/pathology* ; Myocardium/pathology* ; Pandemics ; Pneumonia, Viral/pathology* ; Retrospective Studies ; SARS-CoV-2

A 70-year-old male presenting with a mass in the right inguinal area was treated with surgery, and was diagnosed pathologically as spermatic cord metastasis of pancreatic cancer. He was given systemic chemotherapy. Unfortunately, he died of ascites and cachexia three months later.
Aged ; Fatal Outcome ; Genital Diseases, Male/surgery* ; Humans ; Male ; Pancreatic Neoplasms/diagnostic imaging* ; Spermatic Cord/surgery* ; Tomography, X-Ray Computed/methods*

The incidence of telbivudine-related adverse reactions has been gradually increased. The increased levels of muscle enzymes and blood lactate are common. In this case, a 23-year-old male patient with long-term oral telbivudine had a rare serious adverse reaction. The main clinical manifestations were progressive myalgia, gradually progressed to mental disorder, and together with multiple organ dysfunction, in which the level of blood lactate was increased significantly and metabolic acidosis was extremely severe. Blood purification and sodium bicarbonate were given to correct acidosis, while ceftazidime was used to prevent infection. Telbivudine was discontinued, and tenofovir disoproxil fumarate and liver protective drug were used. The patient was discharged with a better health condition. Such patients are easily misdiagnosed as neuromuscular diseases in the early stage, which might delay the treatment and worsen medical conditions. Clinicians need to be cautious and obtain an early identification to avoid misdiagnosis.
Acidosis, Lactic ; chemically induced ; Fatal Outcome ; Humans ; Male ; Multiple Organ Failure ; Telbivudine ; adverse effects ; Young Adult

BACKGROUND: Tick anaphylaxis is a potentially fatal outcome of improper tick removal and management. OBJECTIVE: To investigate whether killing ticks in-situ with ether-containing sprays or permethrin cream, before careful removal by the mouthparts could reduce this risk. METHODS: This was a prospective study at Mona Vale Hospital Emergency Department (ED) in Sydney, New South Wales, over a 6-month period during the peak tick season of 2016. Tick removal methods, allergic/anaphylactic reactions were recorded for patients presenting with ticks in situ or having already removed the ticks themselves. Primary endpoint was allergic/anaphylactic reaction after tick killing/removal. RESULTS: One hundred twenty-one patients met study inclusion criteria. Sixty-one patients (28 known tick-hypersensitive) had ticks killed with Wart-Off Freeze or Lyclear Scabies Cream (5% w/w permethrin) before removal with fine-tipped forceps or Tick Twister. Three patients (2 known tick-hypersensitive) had allergic reactions (5%), none anaphylactic. The 2 known hypersensitive patients suffered reactions during the killing process and the third patient had a particularly embedded tick meaning it could not be removed solely by mouthparts. Fifty patients presented to the ED posttick removal by various methods, none using either fine-tipped forceps or Tick Twister, of which 43 (86%) experienced allergic reactions – 2 anaphylactic. Five patients suffered allergic reactions before presentation despite no attempt at kill or removal, but ticks had likely been disturbed by some other method. Five patients had live ticks removed in ED – 3 refused killing and had no reaction despite 1 having known hypersensitivity; 2 had ticks on eyelids contraindicating killing, 1 with known hypersensitivity but both had allergic reactions post removal. CONCLUSION: Results support killing ticks in-situ before careful removal by mouthparts to reduce allergic/anaphylactic reactions although further research is still required.
Anaphylaxis ; Cross-Sectional Studies ; Emergency Service, Hospital ; Eyelids ; Fatal Outcome ; Homicide ; Humans ; Hypersensitivity ; Methods ; New South Wales ; Permethrin ; Prospective Studies ; Scabies ; Seasons ; Surgical Instruments ; Tick Bites ; Tick Toxicoses ; Ticks

Tyrosine kinase inhibitor (TKI) have been proved to be effective in the treatment of advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) sensitive mutation, which is superior to chemotherapy. However, there are still some patients with sensitive mutations have primary drug resistance. It may be related to the coexistence of susceptible and resistant mutations of EGFR gene, downstream mutations of EGFR pathway, MET amplification and BIM deletion polymorphism. We present 2 cases of primary drug resistance and analyze the reasons.
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Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; drug therapy ; genetics ; Disease Progression ; Drug Resistance, Neoplasm ; drug effects ; genetics ; ErbB Receptors ; antagonists & inhibitors ; genetics ; Fatal Outcome ; Humans ; Lung Neoplasms ; diagnostic imaging ; drug therapy ; genetics ; Male ; Middle Aged ; Mutation ; Protein Kinase Inhibitors ; therapeutic use ; Treatment Outcome

Aged ; Carcinoma, Hepatocellular ; complications ; diagnosis ; diagnostic imaging ; Fatal Outcome ; Humans ; Liver Neoplasms ; complications ; diagnosis ; diagnostic imaging ; Male ; Skin Neoplasms ; diagnosis ; diagnostic imaging ; secondary

In malaria, splenic rupture is a serious complication potentially leading to death. Subcapsular hemorrhage of spleen is thought to be an impending sign of splenic rupture; however, the characteristics of subcapsular hemorrhage are not well known. We report 3 cases of subcapsular hemorrhage of the spleen in vivax malaria, with varying degrees of severity. Case 1 showed subcapsular hemorrhage without splenic rupture, was treated by antimalarial drug without any procedure. The healing process of the patient's spleen was monitored through 6 computed tomography follow-up examinations, over 118 days. Case 2 presented subcapsular hemorrhage with splenic rupture, treated only with an antimalarial drug. Case 3 showed subcapsular hemorrhage with splenic rupture and hypotension, treated using splenic artery embolization. They all recovered from subcapsular hemorrhage without any other complications. These 3 cases reveal the process of subcapsular hemorrhage leading to rupture and a potentially fatal outcome. The treatment plan of subcapsular hemorrhage should be determined carefully considering the vital signs, changes in hemoglobin, and bleeding tendency.
Fatal Outcome ; Follow-Up Studies ; Hemorrhage ; Hypotension ; Malaria ; Malaria, Vivax ; Plasmodium vivax ; Rupture ; Spleen ; Splenic Artery ; Splenic Rupture ; Vital Signs