Young Caucasian Man Research Articles

Clinical encounter with three cancer patients affected by groundwater contamination at Camp Lejeune: a case series and review of the literature

BackgroundAdvanced understanding of tumor biology has recently revealed the complexity of cancer genetics, intra/inter-tumor heterogeneity, and diverse mechanisms of resistance to cancer treatment. In turn, there has been a growing interest in cancer prevention and minimizing exposure to potential environmental carcinogens that surround us. In the 1980s, several chemical carcinogens, including perchloroethylene (PCE), trichloroethylene (TCE), and benzene, were detected in water systems supplying Camp Lejeune, a US Marine Corps Base Camp located in North Carolina.Case presentationThis article presents three cases of cancer patients who have lived at Camp Lejeune, and, decades later, came to our clinic located 1000 miles from the original exposure site. The first patient is a young Caucasian man who was diagnosed with T cell acute lymphoblastic leukemia at the age of 37, and the second patient is a Caucasian man who had multiple types of cancer in the prostate, lung, and colon as well as chronic lymphocytic leukemia in his 60s and 70s. The third patient is another Caucasian man who had recurrent skin cancers of different histology, namely basal cell carcinomas, squamous cell carcinomas, and melanoma, from his 50s to 70s.ConclusionsThe US Congress passed the Honoring America’s Veterans and Caring for Camp Lejeune Families Act in 2012, which covers appropriate medical care for the people affected by the contamination. We hope that this article raises awareness about the history of Camp Lejeune’s water contamination among cancer care providers, so the affected patients can receive appropriate medical coverage and cancer screening across the country.

Severe Plasmodium ovale malaria complicated by acute respiratory distress syndrome in a young Caucasian man

BackgroundAlthough Plasmodium ovale is considered the cause of only mild malaria, a case of severe malaria due to P. ovale with acute respiratory distress syndrome is reported.Case presentationA 37-year old Caucasian man returning home from Angola was admitted for ovale malaria to the National Institute for Infectious Diseases Lazzaro Spallanzani in Rome, Italy. Two days after initiation of oral chloroquine treatment, an acute respiratory distress syndrome was diagnosed through chest X-ray and chest CT scan with intravenous contrast. Intravenous artesunate and oral doxycycline were started and he made a full recovery.ConclusionOvale malaria is usually considered a tropical infectious disease associated with low morbidity and mortality. However, severe disease and death have occasionally been reported. In this case clinical failure of oral chloroquine treatment with clinical progression towards acute respiratory distress syndrome is described.

Incidental late diagnosis of cystic fibrosis following AH1N1 influenza virus pneumonia: a case report

BackgroundCystic fibrosis is an autosomal recessive disorder characterized by chronic progressive multisystem involvement. AH1N1 virus infections caused classic influenza symptoms in the majority of cystic fibrosis patients while others experienced severe outcomes.Case presentationWe report a case of late incidental cystic fibrosis diagnosis in a young Caucasian man suffering from respiratory failure following infection due to AH1N1 influenza virus. The patient was admitted to our department with fever, cough, and dyspnea at rest unresponsive to antibioticsConclusionsLate diagnosis of cystic fibrosis in uncommon. This report highlights the importance of early cystic fibrosis diagnosis to minimize risk of occurrence of potential life-threatening complications.

Primary care physicians are under-testing for celiac disease in patients with iron deficiency anemia: Results of a national survey.

BackgroundIron deficiency anemia (IDA) is a common extra-intestinal manifestation of celiac disease (CD). Little is known about the frequency with which primary care physicians (PCPs) test for CD in patients with IDA. We aimed to describe how PCPs approach testing for CD in asymptomatic patients with IDA.MethodsWe electronically distributed a survey to PCPs who are members of the American College of Physicians. Respondents were asked whether they would test for CD (serologic testing, refer for esophagogastroduodenoscopy [EGD], or refer to GI) in hypothetical patients with new IDA, including: (1) a young Caucasian man, (2) a premenopausal Caucasian woman, (3) an elderly Caucasian man, and (4) a young African American man. These scenarios were chosen to assess for differences in testing for CD based on age, gender, and race. Multivariable logistic regression was used to identify independent predictors of testing.ResultsTesting for CD varied significantly according to patient characteristics, with young Caucasian men being the most frequently tested (61% of respondents reporting they would perform serologic testing in this subgroup (p<0.001)). Contrary to guideline recommendations, 80% of respondents reported they would definitely or probably start a patient with positive serologies for CD on a gluten free diet prior to confirmatory upper endoscopy.ConclusionsPCPs are under-testing for CD in patients with IDA, regardless of age, gender, race, or post-menopausal status. The majority of PCPs surveyed reported they do not strictly adhere to established guidelines regarding a confirmatory duodenal biopsy in a patient with positive serology for CD.

21-Year-old male with severe coronary atherosclerosis

Coronary heart disease (CHD) is not limited to middle-aged and elderly individuals; when premature CHD develops in the younger population, it has distinct characteristics in terms of lipid profile, risk factors, and clinical presentation. The following describes a 21-year-old male who presented with stable angina, underwent a full cardiac workup, and was ultimately found to have multivessel CHD. In summary, the presence of mild dyslipidemia, high blood pressure, cigarette smoking, obesity, and a family history was sufficient to induce ischemic heart disease at such a young age.<Learning objective: This case report reveals an exceptionally young Caucasian man presenting with stable angina and found to have multivessel coronary disease. The patient received a coronary artery bypass surgery at just 21 years of age. He exhibits traditional risk factors of CHD; hypertension, dyslipidemia, cigarette smoking, and obesity. CHD may be more prevalent in the younger population than once was thought, and it is important that risk factor reduction starts in early in life.>

Personal familiarity influences the processing of upright and inverted faces in infants.

Infant face processing becomes more selective during the first year of life as a function of varying experience with distinct face categories defined by species, race, and age. Given that any individual face belongs to many such categories (e.g. A young Caucasian man's face) we asked how the neural selectivity for one aspect of facial appearance was affected by category membership along another dimension of variability. 6-month-old infants were shown upright and inverted pictures of either their own mother or a stranger while event-related potentials (ERPs) were recorded. We found that the amplitude of the P400 (a face-sensitive ERP component) was only sensitive to the orientation of the mother's face, suggesting that “tuning” of the neural response to faces is realized jointly across multiple dimensions of face appearance.

Eyelid Sebaceous Gland Carcinoma in a Young Caucasian Man

Eyelid sebaceous gland carcinoma is rarely observed in young Caucasian men. A 28-year-old man was referred for a recurring chalazion of the eyelid that had been operated four times in the past two years. The chalazion-like lesion of the external third of the upper left eyelid was associated with a cystic lesion. Cytology of the fluid in the cyst and histology of the lesion were compatible with a sebaceous cell carcinoma. Magnetic resonance imaging revealed that the cystic lesion associated with the eyelid tumour was extending into the orbit. According to current clinical practice and experience, to increase the chance of survival of the patient, an orbital exenteration was conducted to remove the sebaceous cell carcinoma in total. Although rare, one should be aware that an eyelid sebaceous cell carcinoma can occur in a young Caucasian man and this diagnosis should be evoked in case of a recurrent chalazion.

Budd-Chiari syndrome caused by membranous obstruction of the inferior vena cava associated with coeliac disease

Ten cases of Budd-Chiari syndrome associated with coeliac disease have been reported in the literature, most of them in North African subjects. Supporting this association, we report a new case in a young Spanish Caucasian man in whom the cause of the syndrome was the membranous obstruction of the inferior vena cava, an infrequent cause of Budd-Chiari syndrome in Western countries. A percutaneous balloon angioplasty was performed, with satisfactory outcome.

Fibrinogen bellingham: a gamma-chain R275C substitution and a beta-promoter polymorphism in a thrombotic member of an asymptomatic family.

Congenital dysfibrinogenemia is a rare cause of unexplained thrombosis. However, most individuals with dysfibrinogenemia are asymptomatic, suggesting that co-morbid factors contribute to thrombo-embolic events. The potential roles of additional genetic or acquired prothrombotic risk factors are poorly understood because detailed family studies are lacking. Herein, we describe a family whose propositus was a young Caucasian man with recurrent venous thrombo-emboli and dysfibrinogenemia due to heterozygosity for an Arg-->Cys substitution at residue 275 in the gamma-chain. The only additional thrombophilic abnormality found in the proband was heterozygosity for a G/A transition at position -455 in the fibrinogen beta-chain promoter; a genotype associated with high acute phase levels of fibrinogen. The proband's father, who died of a cerebral artery thrombosis, carried the gammaR275C substitution but not the beta-promoter -455 variant. Among 14 living relatives, eight were heterozygous for one or the other mutation and only one, a 21-year-old niece, was dually affected. None had suffered bleeding or thrombosis. In vitro studies of the proband's purified fibrinogen revealed markedly abnormal thrombin-catalyzed polymerization and delayed fibrin clot lysis by tPA-activated plasmin. We hypothesize that the gammaR275C substitution predisposes to thrombosis by generating clots that are relatively resistant to fibrinolysis. The clinical risk is low, however, in the absence of an additional thrombophilic mutation. The beta-promoter variant could, theoretically, contribute to this risk by augmenting expression of the dysfibrinogen under conditions of stress. Like the common hereditary thrombophilias, heterozygous familial dysfibrinogenemia induces thrombosis in the setting of multiple prothrombotic influences.

Disseminated mycobacterium kansasii infection: Successful treatment of a patient with pancytopenia

A young adult Caucasian man with fever and pancytopenia but without parenchymal pulmonary lesions had disseminated Mycobacterium kansasii infection, proved by sputum cultures, scalene lymph node and bone marrow biopsies and cultures. Unlike the fatal termination in other reported cases of this disease, our patient responded completely to isoniazid, para-aminosalicylic acid, streptomycin and ethambutol therapy, despite in vitro resistance to three of the antibiotics used.