OpenMed/multicare-articles huggingface dataset:
Obstacles and facilitators of cancer-related dyadic efficacy experienced by couples coping with non-metastatic cancers
Authors: Danielle C Brosseau, Sandra Peláez, Bethsheba Ananng, Annett Körner
Journal: Front Psychol (2023)
Keywords: cancer, couples, dyadic efficacy, focus groups, psychosocial, qualitative research methods, reflexive thematic analysis

Introduction:
Cancer-related dyadic efficacy is an individual's confidence to work together with a partner to conjointly manage the effects of cancer and its treatment. In other health contexts, higher levels of dyadic efficacy have been associated with fewer symptoms of psychological distress and higher ratings of relationship satisfaction. The aim of the current study was to explore patient and partner perspectives on what obstructs and facilitates cancer-related dyadic efficacy.
Methods:
These aims were accomplished through a secondary analysis of data collected as a part of a collective qualitative case study. Participants (N = 17 participants) were patients undergoing treatment or recently completed treatment (within 6 months) for a non-metastatic cancer and their partners. To enable in-depth discussions among participants, data was collected through five focus groups. Participants described obstacles and facilitators of dyadic efficacy as dimensions of a common influence. Consistent with these descriptions, reflexive thematic analysis was used to identify influences on cancer-related dyadic efficacy and their subsequent obstructive and facilitative dimensions.
Results:
Four main categories of influence with the potential to obstruct or facilitate cancer-related dyadic efficacy were identified along with their subthemes: appraisals of the couple relationship (quality and togetherness), communication (pattern and interest in information), coping (strategy and evaluation), and responses to change (in tasks and roles and sex life). Eight obstructive and seven facilitative dimensions of these subthemes were described.Discussion: This first analysis of obstacles and facilitators of couples' cancer-related dyadic efficacy capitalized on the experiential expertise of individuals with cancer and their partners. These thematic results are instructive for the design of dyadic efficacy-enhancing interventions for couples coping with cancer.
Implementing guidelines on physical health in the acute mental health setting: a quality improvement approach
Authors: Stuart Green, Ed Beveridge, Liz Evans, Jenny Trite, Sandra Jayacodi, Rachel Evered, Caroline Parker, Luca Polledri, Emily Tabb, John Green, Anton Manickam, Joanna Williams, Rebecca Deere, Bill Tiplady
Journal: Int J Ment Health Syst (2018)
Keywords: clinical practice guideline, healthcare inequalities, mental health services, quality improvement

Background:
In the UK, life expectancy for people living with a serious mental illness, such as schizophrenia and bipolar disorder, is reduced by 15-20 years compared with the general population. In recent years, evidence based guidelines/policies designed to improve their physical health have been published, yet a gap remains between recommendations and practice. This case study describes how guidelines to support physical health were implemented using a quality improvement approach.
Case presentation:
A quasi-experimental study explored systems and processes for assessing the physical health of patients admitted to an acute mental health unit. The multi-disciplinary team of healthcare professionals, service users and experts in quality improvement methods developed solutions to improve the assessment of physical health, drawing on existing guidelines/policies as well as professional and lived experience. Three key interventions were developed: a comprehensive physical health assessment; a patient-held physical health booklet; and education and training for staff and patients. Interventions were co-designed by front-line healthcare staff and service users with iterative development and implementation through Plan-Do-Study-Act cycles. Real-time weekly data were reported on five measures over a 15-month implementation period (318 patients) and compared to a 10-month baseline period (247 patients) to gauge the success of the implementation of the physical health assessment. Improvements were seen in the numbers of patients receiving a physical health assessment: 81.3% (201/247) vs 96.9% (308/318), recording of body mass index: 21.55% (53/247) vs 58.6% (204/318) and systolic blood pressure: 22.35% (55/247) vs 75.9% (239/318) but a reduction in the recording of smoking status: 80.1% (198/247) vs 70.9% (225/318). However, 31.7% (118/318) patients had a cardiovascular risk-score documented in the implementation phase, compared to none in the baseline.
Conclusion:
This study demonstrates the use of a quality improvement approach to support teams to implement guidelines on physical health in the acute mental health setting. Reflections of the team have identified the need for resources, training, support and leadership to support changes to the way care is delivered. Furthermore, collaborations between service users and frontline clinical staff can co-design interventions to support improvements and raise awareness of the physical health needs of this population.
Human Herpesvirus-6 Encephalitis
Authors: Stijn Marcelis, Stephanie Vanden Bossche, Sven Dekeyzer
Journal: J Belg Soc Radiol (2022)
Keywords: hhv-6, hse, mri, encephalitis, stem cell transplantation
MeSH terms: Case Reports

Teaching point: HHV6 encephalitis is a specific complication to be considered in a patient with neurological symptoms after hematopoietic stem cell transplantation and typically shows symmetrical involvement of the limbic system.
Subglottic Metastatic Rectal Adenocarcinoma: A Specialist Multidisciplinary Airway Team Approach for Optimized Voice and Airway Outcome
Authors: Richard Heyes, Ramkishan Balakumar, Krishan Ramdoo, Taran Tatla
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

A 56-year-old female with a background of metastatic rectal adenocarcinoma presented with a subglottic mass causing biphasic stridor. Transoral laser microsurgery and the use of fibrin glue prevented the need for tracheostomy. Six months postoperatively there was no evidence of recurrence. Laryngeal metastasis of colorectal adenocarcinoma, although remarkably rare, is perhaps more prevalent than commonly perceived and the presence of laryngeal symptoms in a patient with colorectal adenocarcinoma should raise concern. This case is presented to aid physicians should they encounter a similar presentation of metastasis to the subglottis.
Response to apatinib and camrelizumab combined treatment in a radioiodine refractory differentiated thyroid cancer patient resistant to prior anti-angiogenic therapy: A case report and literature review
Authors: Jiayi Li, Xin Zhang, Zhuanzhuan Mu, Di Sun, Yuqing Sun, Yansong Lin
Journal: Front Immunol (2022)
Keywords: apatinib plus camrelizumab treatment, combination immunotherapy, differentiated thyroid cancer, multitargeted kinase inhibitors plus pd-1/pd-l1 inhibitors therapy, radioactive iodine refractory
MeSH terms: Adenocarcinoma / drug therapy, Thyroid Neoplasms / drug therapy, Thyroid Neoplasms / pathology, Case Reports, Review, Research Support, Non-U.S. Gov't, Adult, Antibodies, Monoclonal, Humanized, Humans, Immunotherapy, Iodine Radioisotopes / therapeutic use, Male, Pyridines, Antibodies, Monoclonal, Humanized, Iodine Radioisotopes, Pyridines, apatinib, camrelizumab

Background:
Patients with radioactive iodine refractory progressive (RAIR) differentiated thyroid cancer (DTC) often developed resistance after first-line therapy. Apatinib plus camrelizumab is a therapy with promising efficacy in patients with other malignant cancers. Herein, we presented a case of progressive RAIR DTC treated with apatinib plus camrelizumab.
Case presentation:
We reported a 43-year-old man diagnosed as DTC with metastases in the lungs, the 7th cervical vertebra, and malignant lymph nodes mainly in the mediastinum. While initially showing disease stabilization after giving the first-line multitargeted kinase inhibitor (MKI) therapy, the patient developed progressive disease and was enrolled into a combined therapy with both apatinib and camrelizumab on November 10, 2020. Upon the first 6 months, the combination therapy showed disease control in terms of both stable structural lesions and biochemical thyroglobulin (Tg) level. Six months later, a decrease over the targeted lesions was observed and a partial response (PR) according to RECIST 1.1 criteria was finally achieved upon 12 months' assessment, followed by the decline in serum Tg level. The main adverse event was occasional diarrhea without treatment interruption.
Conclusion:
We reported a case with RAIR DTC that benefited from combination immunotherapy, apatinib plus camrelizumab, after resistance from donafenib. We observed a gradually getting better efficacy and a mild and long duration of this combination therapy and hoped to provide a therapeutic choice for these patients.
Syphilitic Hepatitis: A Rare Cause of Elevated Liver Function Tests
Authors: Shaharyar Salim, Rabeea Farhan, Asif Surani
Journal: Cureus (2023)
Keywords: deranged liver function test, hepatic enzymes, hepatic manifestations, infectious hepatitis, liver function test (lft), sexual transmitted diseases, sexually transmitted infection (sti), syphilis, treponema pallidum
MeSH terms: Case Reports

Syphilitic hepatitis is a rare manifestation of syphilis with an incidence of 0.2-38%. We describe a case of a healthy, immunocompetent male patient with elevated liver function tests (LFTs) who was found to have syphilitic hepatitis. A 28-year-old male with no past medical history presented with abdominal pain for two to three weeks. He also reported diminished appetite, intermittent chills, weight loss, and fatigue. His history was positive for high-risk sexual behavior including multiple partners and absence of using protection. His physical examination was remarkable for right-sided abdominal tenderness and a painless chancre on his penile shaft. His workup revealed elevated aspartate aminotransferase (AST: 169 U/L), alanine transaminase (ALT: 271 U/L), and alkaline phosphatase (ALP: 377 U/L). His abdominal CT scan was unremarkable except for the abdominal and pelvic lymphadenopathy. A thorough serology panel revealed negative hepatitis A, B, C, human immunodeficiency virus (HIV) (including HIV RNA), Epstein-Barr virus (EBV), and cytomegalovirus (CMV). His immunological workup was negative as well. His rapid plasma reagin (RPR) was reactive with positive IgG/IgM treponemal antibodies. He was managed as secondary syphilis and received 2.4 million units of benzathine penicillin. Upon follow-up after one week, he reported a complete resolution of his symptoms, and his LFTs were normalized on a repeat checkup. Given the significant morbidity associated with a missed diagnosis, syphilitic hepatitis should be considered an essential part of the workup for evaluating elevated LFTs in an appropriate clinical setting. This case also highlights the importance of obtaining a comprehensive sexual history and performing a thorough genital examination.
A Case of Quadricuspid Aortic Valve Regurgitation: The Cardiac Clover
Authors: John S Dayco, Shaun Cardozo
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

A quadricuspid aortic valve is a very rare congenital heart condition that can present as aortic regurgitation in the 5th and 6th decade of life. The following case report will describe a patient who presented with symptoms of severe aortic regurgitation and was found to have a quadricuspid aortic valve on echocardiography. The case will describe the clinical manifestations in which the patient presented and the subsequent diagnosis of the quadricuspid aortic valve. The rationale for the surgical approach will also be discussed, along with the patient's clinical response.
Rectosigmoid-Junction Squamous Cell Carcinoma With pMMR/MSS Achieved a Partial Response Following PD-1 Blockade Combined With Chemotherapy: A Case Report
Authors: Yanxin He, Lunqing Wang, Xiao Li, Tongsong Zhang, Tingting Song, Junling Zhang, Yangyang Yu, Shiqing Chen, Haiping Song
Journal: Front Oncol (2021)
Keywords: proficient mismatch repair/microsatellite stability, programmed death ligand-1 blockade, programmed death ligand-1 expression, rectosigmoid-junction squamous cell carcinoma, tumor mutation burden
MeSH terms: Case Reports

Colorectal squamous cell carcinoma (SCC) is extremely rare and associated with a poor prognosis. And the pMMR/MSS colorectal cancer is related to a limited response to programmed death ligand-1 (PD-1) blockade monotherapy. However, the clinical activity of PD-1 blockade monotherapy or combination therapy in colorectal SCC is unknown. One patient with rectosigmoid-junction SCC was treated with PD-1 blockade combined with chemotherapy. After 3 months of PD-1 blockade and chemotherapy, the computed tomography imaging showed that this patient achieved a partial response. The next generation sequencing and immunohistochemistry analysis showed that the patient had tumors with proficient mismatch repair (pMMR) and microsatellite stability (MSS), strong PD-L1 expression, and tumor mutational burden-high (TMB-High), respectively. This case suggests that PD-1 blockade combined with chemotherapy might be an effective therapy for colorectal SCC with pMMR/MSS status. Moreover, the PD-L1 expression and TMB might be the potential predictors of PD-1 blockade response for colorectal SCC patients.
Acute Kidney Injury due to Anticoagulant-Related Nephropathy : A Suggestion for Therapy
Authors: Letizia Zeni, Chiara Manenti, Simona Fisogni, Vincenzo Terlizzi, Federica Verzeletti, Mario Gaggiotti, Giovanni Cancarini
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

The relationship between kidneys and anticoagulation is complex, especially after introduction of the direct oral anticoagulants (DOAC). It is recently growing evidence of an anticoagulant-related nephropathy (ARN), a form of acute kidney injury caused by excessive anticoagulation. The pathogenesis of kidney damage in this setting is multifactorial, and nowadays, there is no established treatment. We describe a case of ARN, admitted to our Nephrology Unit with a strong suspicion of ANCA-associated vasculitis due to gross haematuria and haemoptysis; the patient was being given dabigatran. Renal biopsy excluded ANCA-associated vasculitis and diagnosed a red blood cell cast nephropathy superimposed to an underlying IgA nephropathy. Several mechanisms are possibly responsible for kidney injury in ARN: tubular obstruction, cytotoxicity of heme-containing molecules and free iron, and activation of proinflammatory/proﬁbrotic cytokines. Therefore, the patient was given a multilevel strategy of treatment. A combination of reversal of coagulopathy (i.e., withdrawal of dabigatran and infusion of its specific antidote) along with administration of fluids, sodium bicarbonate, steroids, and mannitol resulted in conservative management of AKI and fast recovery of renal function. This observation could suggest a prospective study aiming to find the best therapy of ARN.
Human infection with M- strain of Brucella canis
Authors: Jorge C Wallach, Guillermo H Giambartolomei, Pablo C Baldi, Carlos A Fossati
Journal: Emerg Infect Dis (2004)
MeSH terms: Brucella canis / pathogenicity, Brucellosis / physiopathology, Case Reports, Research Support, Non-U.S. Gov't, Adult, Brucella canis / immunology, Brucellosis / etiology, Brucellosis / immunology, Humans, Male, Occupational Exposure

The less mucoid strain of Brucella canis or M- strain is used for the serologic diagnosis of canine brucellosis. While this strain is avirulent in dogs, we report the case of clinical brucellosis that developed in a laboratory worker a few days after handling live M- cells for antigen production.
A COVID-19 Patient Presenting with Pneumothorax
Authors: Seyyedeh Narjes Abootalebi, Eslam Shorafa, Alireza Abbaspour, Seyed Sina Dehghani, Mehdi Forooghi
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus that has affected millions of individuals across the world. It was officially declared as a pandemic on March 11, 2020. Although most patients with COVID-19 manifest as viral pneumonia characterized by symptoms such as fever, dyspnea, and cough, atypical presentations such as acute respiratory distress syndrome (ARDS) and acute kidney or cardiac injury have been reported amongst COVID-19 patients. Bilateral and peripheral ground-glass and opacities are the hallmarks of COVID-19 infection on imaging exams. Herein, we aim to describe a COVID-19 patient who presented with shortness of breath, neck pain, chest pain, and bilateral pneumothorax in his imaging exam.
An isolated congenital absence of nasal columella: A case report and review of literature
Authors: Bareqa Salah, Isam Bsisu, Osama Sarhan, Zayed Al-Zu'bi, Ahmad Suleihat
Journal: Int J Surg Case Rep (2019)
Keywords: absence, congenital, columella

Introduction:
The nasal columella is an important aesthetic and functional entity of the midface. Congenital absence of the nasal columella as an isolated anomaly is extremely rare.
Presentation of case:
We present a case of total congenital aplasia of the nasal columella in a 3-month-old female infant. The deformity was not associated with any other anomalies and with no obvious underlying cause.
Discussion:
Isolated congenital absence of the nasal columella is an extremely rare anomaly and its etiology is still unknown. Surgical reconstruction of absent nasal columella is challenging as a result of its complex anatomy, and different surgical techniques have been described in the literature to reconstruct the nasal columella with varying advantages and disadvantages.
Conclusion:
The variety in available surgical techniques for the reconstruction of nasal columella necessitates a thorough preoperative evaluation in order to choose the most suitable surgical technique and achieve the best outcome, both functionally and esthetically.
Intra-radicular reinforcement using a modified fiber post customization technique: a case report
Authors: Usman Anwer Bhatti, Muhammad Qasim Javed, Mustafa Hussein Al Attas
Journal: Pan Afr Med J (2021)
Keywords: adhesive cement, case report, esthetics, fiberglass, post and core technique
MeSH terms: Post and Core Technique, Case Reports, Adolescent, Humans, Incisor / injuries

Trauma sustained by developing anterior teeth can lead to an arrested root development and loss of structure which can complicate the endodontic and restorative management. The preservation of the anterior tooth has a definite esthetic and biologic advantage especially during the developmental years of adolescence. However, restorative treatment of such cases is met with serious biomechanical and adhesive challenges in the form of thin dentinal walls, a high configuration factor etc. This case report describes a fiber post customization technique for the intraradicular reinforcement of a maxillary central incisor in a 14-year-old patient.
Complicated Urinary Tract Tuberculosis in a 13-Year-Old Adolescent with Chronic Kidney Disease and Antituberculous Drug-Induced Hepatotoxicity
Authors: Heda Melinda Nataprawira, Adhitya Agung Pratama, Ahmedz Widiasta, Jupiter Sibarani, Dany Hilmanto, Nanan Sekarwana, Dedi Rachmadi
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Urinary tract tuberculosis (TB) is a rare extrapulmonary manifestation of TB in children. The disease is potentially underdiagnosed because it clinically resembles other urinary tract infections. A 13-year-old adolescent girl presented with pain, difficulty in micturition, and gross hematuria for almost two years before admission, and she had left flank pain since one year ago and significant loss of body weight during the illness. The close TB contact was her grandmother who was on TB treatment. Acid-fast bacilli yielded positive result, Mantoux test was positive (17 mm), urine GeneXpert MTB/Rif was positive; tuberculoma was identified on kidney histopathology, and a diuretic renogram revealed an uncorrected glomerular filtration rate (GFR) of the right and left kidney to be 32.5 mL/min/1.73 m2 and 5 mL/min/1.73 m2, respectively. During the treatment, oral anti-TB drug-induced hepatotoxicity (ADIH) occurred to the patient. This problem was solved with management according to the British Thoracic Society (BTS) guidelines. Screening TB in children is very important for a better outcome. If children complain of some complicated urinary tract infection, TB should be suspected. Optimaly treating children with urinary tract TB exagerrated with ADIH and CKD is very challenging.
Placental Findings in Lysosomal Storage Disease Diagnosis: A Case Report of Galactosialidosis
Authors: Sasha Libbrecht, Francois Eyskens, Sabine Declercq, Cecile Colpaert
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Introduction. Lysosomal storage disorders (LSDs) are rare diseases with more than 50 different entities described today. The spectrum of phenotypes varies from severe to lethal and early-onset disease to mild and late onset. Recognition of the clinical signs and diagnostic workup is challenging and requires expertise. Diagnosis relies on finding abnormal metabolites in urine and serum followed by further enzymatic or molecular analysis. Routine histological examination of the foetal and placental tissues frequently shows vacuolisation, providing a readily available important clue to the diagnosis. Case Report. A third child of consanguineal parents showed several dysmorphic features and a complicated neonatal period with eventual demise in the early postneonatal period due to respiratory failure. An LSD was suspected based on clinical presentation, urine metabolite excretion, skeletal radiograph, and vacuolisation in lymphocytes and placental tissues on, respectively, blood smear and routine histological examination. Homozygosity mapping favoured galactosialidosis. The diagnosis was confirmed by massive parallel sequencing, revealing a single nucleotide variation in the CTSA gene (c.265A>C, p.Ser89Arg). Discussion. Histological placental examination may be either the first clue or complimentary evidence in recognizing LSDs. It is important to recognize these clues as it may prompt further investigation and facilitate earlier recognition of the disease.