OpenMed/multicare-articles huggingface dataset:
Doing Contrariness: Therapeutic Talk-In-Interaction in a Single Therapy Session With a Traumatized Child
Authors: Michael B Buchholz, Timo Buchholz, Barbara Wülfing
Journal: Front Psychol (2021)
Keywords: adoptive children, children in treatment, conversation analysis, doing contrariness, psychotherapy, trauma

Conversation analysis (CA) of children-adult-interaction in various contexts has become an established field of research. However, child therapy has received limited attention in CA. In child therapy, the general psychotherapeutic practice of achieving empathy faces particular challenges. In relation to this, our contribution sets out three issues for investigation and analysis: the first one is that practices of achieving empathy must be preceded by efforts aiming to establish which kind of individualized conversation works with this child (Midgley, 2006). Psychotherapy process researchers in adult therapy (Stiles et al., 2015) have found that therapists "invent" a new therapy for each patient (Norcross and Wampold, 2018). The second issue is that it can be difficult for adults to understand the ways in which children express their conflicts and issues. In particular, play activities in therapy, e.g., with dolls, can open up additional scenarios of interaction. The play scenario can be used to disclose unformulated problems masked in everyday and family interactions. The third issue is how to respect the child's higher degree of vulnerability, compared with adult patients. How is it communicated and dealt with in therapy? We present an interaction analysis of a single case study of the first 20 min of a child therapy session with an adopted girl aged 4 years brought to treatment because of "unexplainable rage." The session was videotaped; parents granted permission. We analyze this session using an applied version of CA. In our analysis, we describe "doing contrariness," as a conversational practice producing epistemic and affiliative disruptions, while "avoiding doing contrariness" and "remedying contrariness" are strategies for preserving or restoring the affiliative dimension of a relationship (in child therapy). We show how these practices operate in various modes and how they are used by both parties in our case study to variously aid and impedethe achievement of empathy and understanding.
Long QT interval and syncope after a single dose of COVID-19 vaccination: a case report
Authors: Nahid Azdaki, Marjan Farzad
Journal: Pan Afr Med J (2021)
Keywords: covid-19, case report, long qt interval
MeSH terms: COVID-19 Vaccines / adverse effects, Long QT Syndrome / etiology, Syncope / etiology, Case Reports, Aged, Arrhythmias, Cardiac / diagnosis, Arrhythmias, Cardiac / etiology, COVID-19 / prevention & control, COVID-19 Vaccines / administration & dosage, Electrocardiography, Humans, Long QT Syndrome / diagnosis, Long QT Syndrome / drug therapy, Magnesium / administration & dosage, Male, Myocarditis / diagnosis, Myocarditis / etiology, Syncope / diagnosis, Vaccination / adverse effects, Vaccination / methods, COVID-19 Vaccines, Magnesium

Adverse consequences of the coronavirus disease 2019 (COVID-19) vaccination which have been reported in scientific papers are varied. One possible but rare consequence is myocarditis, which may have a diversity of clinical manifestations. We report a case of a 70-year-old man who presented to the hospital for some syncope, 3 days after his first COVID-19 AstraZeneca Vaccination. Initial electrocardiogram (ECG) showed a long QT interval (QTc = 600 milliseconds). Laboratory tests revealed elevated troponin and lack of evidence of viral infection. Further investigations revealed the vaccine-induced myocarditis and arrhythmias linked to it. Within one week of magnesium treatment, the QT interval was completely corrected, and the patient discharged with no typical syncope attacks. This case like the previous reported one confirms that myocarditis is a complication of COVID-19 vaccine, but implies its clinical manifestations may be varied and even may happen after the single dose of vaccination.
Supraglottic stenosis as a late complication of radiotherapy: a case report
Authors: Claudiney Cândido Costa, Sarah Vidal da Silva, Mateus Capuzzo Gonçalves, Hugo Valter Lisboa Ramos
Journal: Einstein (Sao Paulo) (2022)
MeSH terms: Nasopharyngeal Neoplasms / pathology, Nasopharyngeal Neoplasms / radiotherapy, Quality of Life, Case Reports, Constriction, Pathologic / etiology, Humans, Male, Nasopharyngeal Carcinoma / complications, Nasopharyngeal Carcinoma / radiotherapy

Nasopharyngeal carcinoma is rare and affect mainly men between the fourth and sixth decades of life. The clinic is characterized to be nonspecific and the main complaints or findings related to this disease are: cervical mass, aural dysfunction, and headache. The basis of treatment is radiotherapy that involves a wide field of irradiation of normal tissues, which usually generates sequelae with direct implications for quality of life. We report a case of a nasopharyngeal carcinoma treated with radiotherapy and chemotherapy that evolved, after 8 years, into supraglottic stenosis. We emphasize the relevance of clinical follow-up after radiotherapy, particularly due to the late sequelae and the relevance of using radiotherapy devices with a more focal cancer field, in order to minimize complications.
Case report: Immediate revascularization for symptomatic hepatic artery pseudoaneurysm after orthotopic liver transplantation? A case series and literature review
Authors: An Verena Lerut, Jacques Pirenne, Mauricio Sainz-Barriga, Joris Blondeel, Geert Maleux, Diethard Monbaliu
Journal: Front Surg (2023)
Keywords: arterial reconstruction, case series, endovascular treatment, hepatic artery pseudoaneurysm, orthotopic liver transplantation
MeSH terms: Case Reports

Introduction:
Hepatic artery pseudoaneurysm (HAPA), a rare vascular complication that can develop after liver transplantation, is associated with a high mortality rate and graft loss. To salvage the liver graft, immediate revascularization, either through surgical or endovascular intervention, is required. However, currently there is no consensus on the optimal strategy. Here, we report three cases of liver transplant recipients diagnosed with HAPA and treated with immediate revascularization. In addition, we present an overview of HAPA cases described in the literature and make recommendations on how to treat this rare complication.
Methods:
All adults transplanted in our center between 2005 and 2021 were retrospectively reviewed. Literature search was done in PubMed for original studies between 1980 and 2021 reporting early hepatic artery (pseudo) aneurysm after liver transplantation requiring either surgical or endovascular intervention.
Results:
From a total of 1,172, 3 liver transplant patients were identified with a symptomatic HAPA and treated with immediate revascularization. HAPA occurred 73, 27, and 8 days after liver transplantation and was treated with immediate revascularization (two surgical and one endovascular intervention). Literature review identified 127 cases of HAPA. HAPA was managed with endovascular therapy in 20 cases and by surgical intervention in 89 cases. Overall reported mortality rate was 39.6%, whereas overall graft survival was 45.2%.
Conclusion:
Immediate surgical or radiological interventional excision and prompt revascularization to salvage liver grafts is feasible but still associated with a high mortality.
Case report: Long-term voluntary Tyrosine Kinase Inhibitor (TKI) discontinuation in chronic myeloid leukemia (CML): Molecular evidence of an immune surveillance
Authors: Jusuf Imeri, Christophe Desterke, Paul Marcoux, Diana Chaker, Noufissa Oudrhiri, Xavier Fund, Jamila Faivre, Annelise Bennaceur-Griscelli, Ali G Turhan
Journal: Front Oncol (2023)
Keywords: cml, nkg7, tfr, chronic myelogenous leukemia, natural killer cells
MeSH terms: Case Reports

The classical natural history of chronic myeloid leukemia (CML) has been drastically modified by the introduction of tyrosine kinase inhibitor (TKI) therapies. TKI discontinuation is currently possible in patients in deep molecular responses, using strict recommendations of molecular follow-up due to risk of molecular relapse, especially during the first 6 months. We report here the case of a patient who voluntarily interrupted her TKI therapy. She remained in deep molecular remission (MR4) for 18 months followed by detection of a molecular relapse at +20 months. Despite this relapse, she declined therapy until the occurrence of the hematological relapse (+ 4 years and 10 months). Retrospective sequential transcriptome experiments and a single-cell transcriptome RNA-seq analysis were performed. They revealed a molecular network focusing on several genes involved in both activation and inhibition of NK-T cell activity. Interestingly, the single-cell transcriptome analysis showed the presence of cells expressing NKG7, a gene involved in granule exocytosis and highly involved in anti-tumor immunity. Single cells expressing as granzyme H, cathepsin-W, and granulysin were also identified. The study of this case suggests that CML was controlled for a long period of time, potentially via an immune surveillance phenomenon. The role of NKG7 expression in the occurrence of treatment-free remissions (TFR) should be evaluated in future studies.
Rare Recurrent EWSR1-PLAGL1 Rearranged Intracranial Tumor With Biphasic Epithelioid Differentiation: One Case Report With Literature Review
Authors: Ai-Yan Xing, Wen-Wei Yang, Yu-Lu Liu, Nan-Nan Sun, Xiao-Meng Hao, Su-Xia Wang, Kun Mu
Journal: Front Oncol (2022)
Keywords: ewsr1-plagl1 fusion, tert, biphasic differentiation, intracranial tumors, recurrence
MeSH terms: Case Reports

EWSR1-rearranged tumors encompass a rare and heterogeneous group of entities with features of the central nervous system (CNS) mesenchymal and primary glial/neuronal tumors. EWSR1-PLAGL1 gene fusion is a particularly rare form of rearrangement. We presented a recurrent intracranial EWSR1-PLAGL1 rearranged tumor and reviewed the relevant literature. In this case, histopathology and immunohistochemistry (IHC) were evaluated for both the primary and relapsed tumors. Fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS) were performed for the relapsed tumor. We compared the morphology, IHC results and molecular features with the previously reported EWSR1-PLAGL1 rearranged CNS tumors. Our case exhibited a unique feature with a variable biphasic pattern of epithelioid differentiation, which differed from the two reported groups. The primary and relapsed tumors both expressed cytokeratin of the focal area with epithelioid differentiation. The recurrent tumor showed an increased proliferation index (average Ki-67 index of 15%) compared with the primary tumor (average Ki-67 index of 5%). NGS showed that TERT promoter mutation was the only molecular change besides EWSR1-PLAGL1 fusion. Our study provides further insight into intracranial tumors with EWSR1-PLAGL1 fusion, representing a distinct CNS tumor with no-reported histological and immunohistochemical features. Future studies, particularly for the biphasic differentiation and the role of TERT promoter mutation were needed to clarify this unusual chromosomal rearrangement in the CNS tumor.
First confirmed case of nasal pythiosis in a horse in Thailand
Authors: Walaiporn Tonpitak, Watcharapol Pathomsakulwong, Chulabha Sornklien, Theerapong Krajaejun, Suppathat Wutthiwithayaphong
Journal: JMM Case Rep (2018)
Keywords: pythium insidiosum, thailand, horse, pythiosis
MeSH terms: Case Reports

Introduction:
Pythiosis is caused by Pythium insidiosum, a fungus-like organism in the class Oomycetes. It can infect humans and a variety of animal species in tropical, subtropical and some temperate regions. Cases of animal pythiosis have occurred predominantly in horses in the skin and subcutaneous tissue at the limbs and in the ventral portion of thoracoabdominal wall - lesions in the nasal region are rarely reported. Moreover, although many human pythiosis cases have been reported in Thailand, no cases of animal pythiosis in Thailand have been reported.
Case presentation:
We report a case of pythiosis in a horse infected at the nasal cavity. Diagnosis was performed by zoospore formation by bait technique, immunohistochemical stain, immunochromatography and sequence analysis.
Conclusion:
The sequences of rDNA were 99 % and 96 to 99 % identical to GenBank isolates of Pythium insidiosum from two Thai human patients and horses from various countries, respectively. This represents the first confirmed report of nasal equine pythiosis in Thailand.
Myxedema Crisis Presenting with Seizures: A Rare Life-Threatening Presentation-A Case Report and Review of the Literature
Authors: Sonali Sihindi Chapa Gunatilake, Uditha Bulugahapitiya
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Myxedema crisis is a life-threatening extreme form of hypothyroidism with a high mortality rate if left untreated. Myxedema crisis is commonly seen in older patients, especially in women, and is associated with signs of hypothyroidism, hypothermia, hyponatraemia, hypercarbia, and hypoxemia. Patients might present with different organ specific symptoms. Seizures are a recognized but rare manifestation of myxedema with a very high mortality rate. Prompt diagnosis and appropriate management may improve the prognosis. Many contributory factors may involve development of seizures in a patient with myxedema. Hyponatraemia is one such cause, which is seen in moderate-severe form in the background of myxedema. We report an elderly male who presented with generalized tonic clonic seizure preceded by memory impairment and drowsiness. He had moderate hyponatraemia and very high thyroid stimulatory hormone levels in association with low free thyroxin levels. Diagnosis of myxedema crisis was made and patient was successfully treated with sodium correction and thyroid hormone replacement.
Phenazopyridine-Induced Methemoglobinemia: A Case Report
Authors: Alexis A Koch, Laurence Stolzenberg, Prutha R Pathak, Alexis R Penot
Journal: Cureus (2023)
Keywords: acquired methemoglobinemia, arterial blood gas, case report, methylene blue, phenazopyridine, toxicology, urinary tract infection
MeSH terms: Case Reports

Methemoglobinemia is a condition caused by increased methemoglobin, a reduced form of hemoglobin, in the blood. This causes the molecules to bind oxygen more tightly and decreases their ability to release that oxygen to tissue. Most cases of methemoglobinemia are acquired and occur either in pediatric populations or in individuals with predisposing conditions. This report illustrates a case of an otherwise healthy 31-year-old patient presenting to the emergency department with cyanosis of the hands and mouth and an O2 saturation of 78% after taking increased doses of the over-the-counter medication phenazopyridine. A "chocolate-brown" color of her arterial blood, and increased methemoglobin levels of 20.2%, confirmed the diagnosis of methemoglobinemia. She was treated with both methylene blue and ascorbic acid, and her oxygen saturation and serum chemistry returned to normal levels within a few hours. The case highlights the importance of discussing the dosage of all over-the-counter medications with patients and recognizing the signs and symptoms of methemoglobinemia.
Complex functional and epithetic rehabilitation after ablation of recurrent retroauricular basal cell carcinoma - a case study
Authors: Waldemar Reich, Anika Exner, Eileen Winter, Bilal Al-Nawas, Alexander Walter Eckert
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2017)
Keywords: auricular, basal cell carcinoma, concha, craniofacial, epithesis, implant, insertion side, mastoid, radiotherapy, tumor resection
MeSH terms: Case Reports

The reconstruction of extended defects of the concha poses a complex challenge for plastic surgeons. In cases of subtotal ablation, an alternative method designed especially for elderly oncological patients consists of epithetic rehabilitation. However, inserting an implant-retained concha epithesis proves challenging in patients with antecedents of deep resections involving the mastoid process. In the present case study, we report on the long-term treatment course (2009-2017) of a 79-year-old male patient suffering from a recurrent basal cell carcinoma of the retroauricular region. Following tumor resection, along with lateral mastoidectomy, reconstruction, and adjuvant radiotherapy, functional and esthetic deficits primarily due to peripheral facial nerve palsy were successfully managed using a multistep procedure. The procedure was completed by inserting an implant-retained concha epithesis, resulting in improved quality of life. Due to prior lateral mastoidectomy, ultra-short implants (4 mm) were inserted, partially at atypical positions. For maintaining healthy periimplant soft tissue, aftercare comprised cold plasma treatment. This oncologic case demonstrates the therapeutic necessity of using a broad spectrum of reconstructive procedures, along with their limitations, in a critical anatomic region. Specific features include the presentation of a workflow using ultra-short implants in a compromised mastoid region. Surgeons should consider alternative implant positions in the event of any compromised mastoid process. A particular emphasis has been put on meticulous aftercare to preserve healthy periimplant soft tissues.
Successful Complete Response of Tumor Thrombus after Combined with Chemotherapy and Irradiation for Ewing Sarcoma
Authors: Yusuke Minami, Seiichi Matsumoto, Keisuke Ae, Taisuke Tanizawa, Keiko Hayakawa, Yuki Funauchi, Sakae Okumura, Yutaka Takazawa
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Pelvic Ewing sarcoma is associated with a worse prognosis. Thromboembolic events are relatively common in pediatric patients with cancers including sarcomas. We have presented a case of Ewing sarcoma arising from the left iliac bone with tumor thrombus of inferior vena cava (IVC) which was obtained complete response by both chemotherapy and irradiation. Magnetic resonance imaging (MRI) scan demonstrated that the tumor arising from the left iliac bone extended into the left side of sacral bone, suggesting the difficulty of surgical resection. Computed tomography (CT) revealed the existence of the tumor thrombus of IVC. We performed irradiation (31.2 Gy) and chemotherapy (combination of VCR, Act-D, IFM, and ADR). The tumor was controlled successfully, and the tumor thrombus of IVC has completely vanished. Four years after the treatment, coin lesion in the left upper lung appeared. Suspected of metastasis, segmental resection of the left upper lung was performed. Fourteen years after the surgery, the patient has been remained free of recurrence. It is clinically significant for surgeons to treat pelvic Ewing sarcoma with tumor thrombus.
Gossypiboma posing as a diagnostic dilemma: a case report and review of the literature
Authors: K N Srivastava, Amit Agarwal
Journal: Case Rep Surg (2014)

The term gossypiboma is used to describe a retained surgical sponge after operation. It is a rare but serious complication which is seldom reported because of the medicolegal implications. Gossypiboma usually has varied and vague presentation and is also difficult to detect on radiological investigations. It can even remain silent and present years after the operation. We report a case of a 38-year-old lady who presented with vague pain and chronic lump in the right iliac fossa region. She had a history of cesarean section 4 years ago. Radiological investigations were inconclusive in detecting the retained sponge. A working diagnosis of mesenteric cyst was made and an exploratory laparotomy was done where she was found to have a large gossypiboma densely adhered to the small bowel and surrounding structures. Though rare, gossypiboma should be kept in mind as a differential diagnosis in postoperative cases presenting as vague pain or chronic lump even years after the operation.
Rhinogenic Optic Neuritis Caused by Sphenoid Mucocele with Sinusitis
Authors: Sasitorn Siritho, Weerachai Tantinikorn, Paithoon Wichiwaniwate, Krit Pongpirul
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

A 59-year-old male who presented with a nonspecific headache at the vertex, resembling retrobulbar optic neuritis, was treated as such but did not show any improvement. Although optic nerve compression from sphenoid mucocele was finally discovered, the delayed diagnosis and improper treatment led to a permanent visual loss. Optic neuritis could be caused by a common problem, "mucocele/sinusitis," but might be easily overlooked in general practice. Rhinogenic optic neuropathy should, therefore, be considered in every case of optic neuritis whenever atypical presentation occurs or is unresponsive to high-dose steroid treatment.
A case report of eosinophilic esophagitis accompanying hypereosinophilic syndrome
Authors: Mahreema Jawairia, Ghulamullah Shahzad, Jaspreet Singh, Kaleem Rizvon, Paul Mustacchia
Journal: Case Rep Gastrointest Med (2012)

Hypereosinophilic syndrome is a blood disorder characterized by the overproduction of eosinophils in the bone marrow with persistent peripheral eosinophilia, associated with organ damage by the release of eosinophilic mediators. Although HES can involve multiple organ systems, GI tract involvement is very rare. Few cases of HES presenting with gastritis or enteritis have been reported worldwide. To date, HES presenting with esophagus involvement has only been reported once. Here, we present a 39-year-old Hispanic female patient with history of HES presenting with complaints of dysphagia and generalized pruritus.
Case report: A case report and literature review of extrapancreatic solid pseudopapillary neoplasm
Authors: Hang Liu, Zhiquan Xu, Yaxu Wang, Haitao Gu, Yunhao Tang, Dabin Wu, Jijian Wang, Jianbo Zhang
Journal: Front Surg (2022)
Keywords: diagnosis, extrapancreatic solid pseudopapillary neoplasm, ileum, origin, treatment
MeSH terms: Case Reports

Background:
Solid pseudopapillary neoplasm (SPN) is a rare tumor with low malignant potential, which typically occurs in the pancreas. Extrapancreatic SPN is also extremely rare worldwide.
Case presentation:
We report a case of a 70-year-old woman hospitalized with abdominal pain and bloating. The patient did not have any underlying diseases, such as diabetes, coronary heart disease, or hypertension. More than 30 years ago, the patient underwent surgery for "ectopic pregnancy". The patient had no family history of hereditary disease, nor did any immediate family members have a history of cancer. Laboratory tests showed that her hemoglobin and albumin levels were low and she had a high level of cancer antigen 125 (CA125). Enhanced computed tomography (CT) showed a large tumor in the abdomen and pelvis. The patient subsequently underwent surgery, and it was found that the tumor was attached to the terminal ileum. Pathological findings suggested that the tumor was an extrapancreatic SPN, with an ectopic pancreas found in the tumor tissue. The patient did not receive chemotherapy or radiotherapy after surgery. After 13 months of follow-up, the patient was admitted again with abdominal pain. CT showed tumor recurrence with extensive systemic metastases. The patient and her family refused reoperation and biopsy, and the patient was discharged after the abdominal pain and anemia resolved.
Conclusion:
We report a rare case of extrapancreatic SPN of ileal origin, which could be the first report worldwide. It had aggressive biological features, with recurrence and metastasis 13 months after surgery. For extrapancreatic SPN, the risk of recurrence should be assessed, and for tumors suspected of malignant behavior, a longer follow-up after discharge may be needed. Although SPN generally has a good prognosis after surgery, there is no consensus on whether postoperative chemotherapy and other treatments are needed for patients with high recurrence risk.