OpenMed/multicare-articles huggingface dataset:
Pyogenic Granuloma in the Mandibular Anterior Gingiva: A Case Study
Authors: Prasanna R Sonar, Aarati S Panchbhai
Journal: Cureus (2024)
Keywords: benign lesion, gingiva, gingival pyogenic granuloma, pyogenic granuloma, soft tissue enlargement
MeSH terms: Case Reports

The oral cavity is frequently affected by gingival pyogenic granuloma (PG), a benign tumor that is known for its quick growth and tendency to hemorrhage. The clinical presentation, diagnostic procedure, and treatment of a patient with gingival pyogenic granuloma are all detailed in this case study. A female individual aged 25 years in otherwise good condition arrived with a sessile gingival tumor in the anterior mandibular region that was expanding quickly. During dental hygiene procedures, there was intermittent bleeding and discomfort related to the lesion. Based on histology analysis and clinical examination, PG was diagnosed. The course of treatment included surgical excision followed by a histological analysis to ensure total eradication. Appointments for follow-up revealed adequate healing and no indications of recurrence. This case study aims to demonstrate the need for prompt diagnosis, appropriate treatment, and diligent follow-up to effectively manage gingival pyogenic granuloma. Dental professionals can better treat patients and achieve better results with a thorough understanding of this common oral lesion and its management.
Case report: Report of a case of female adnexal malignant tumor of Wolffian origin
Authors: Shujun Ji, Xiao Yu, Yufang Xia, Yifan Yin, Tingting Ge, Lihua Cheng, Cui Tian, Yanhui Lou
Journal: Front Oncol (2024)
Keywords: wolffian tumors, female adnexal tumors, immunotherapy, targeted therapy, tubal malignancies
MeSH terms: Case Reports

A 33-year-old young woman with a rare female appendage tumor of suspected Wolffian origin was initially diagnosed with a benign lesion after the resection of a tubal lesion due to the benign cytomorphology of the tumor tissue. However, 1 year after surgery, she was diagnosed with stage IV fallopian tube cancer due to a recurrence, which presented with substantial ascites and invasion of multiple organs, including the bilateral ovaries, intestines, pelvic peritoneum, greater omentum, and appendix. After tumor cytoreduction, the patient responded well to treatment, which included a regimen of platinum-based drugs combined with docetaxel, aromatase inhibitors such as letrozole, antihormonal therapy, and targeted therapy with bevacizumab.
Perioperative Rehabilitation in Collaboration with the Department of Occupational Medicine for Patients with Cholangiocarcinoma: A Case Report
Authors: Hiroaki Teramatsu, Akiko Hachisuka, Masako Nagata, Shiro Kohi, Manabu Hamada, Satoshi Kuhara, Akio Takemoto, Hideaki Itoh, Satoru Saeki
Journal: Phys Ther Res (2024)
Keywords: cholangiocarcinoma, department of occupational medicine, perioperative rehabilitation, return to work
MeSH terms: Case Reports

Introduction:
Although the number of cancer survivors has increased, the role of physical therapy in return to work (RTW) for employed patients with cancer remains unclear.
Case presentation:
The patient is a 50-year-old man diagnosed with cholangiocarcinoma who worked as a liquefied petroleum gas station filler. He started perioperative rehabilitation and underwent pancreaticoduodenectomy for cholangiocarcinoma. He developed a postoperative pancreatic fistula, which improved with conservative treatment over 40 days. Although he achieved independence regarding day-to-day activities, his physical condition and workability worsened, as his skeletal muscle index decreased from 8.7 to 7.7, 6-min walk distance from 518 to 460 m, and work ability index (WAI) from 37 to 20 points. His physical therapist was concerned about his RTW and recommended that he receive RTW support from the Department of Occupational Medicine (DOM). The DOM employed a team approach for the RTW strategy, and the primary physician, occupational physician, and company collaborated to support the patient. After the outpatient treatment protocol and RTW support plans were formulated, the patient was discharged. The physical therapist reported declining physical performance and WAI at the DOM's multidisciplinary conference. After consulting with multiple professionals, the team recommended work resumption in stages: part-time for three months and full-time for four months after surgery while undergoing oral adjuvant chemotherapy. The WAI improved to 35 points after RTW.
Conclusion:
This case report suggests that physical therapists are vital in providing continuous patient support, from perioperative rehabilitation to DOM intervention, to build physical strength for return to work.
Hydroxychloroquine-induced hyperpigmentation of the skin and bull's-eye maculopathy in rheumatic patients: a case report and literature review
Authors: Ji-Peng Peng, Xiao-Yu Yang, Feng Luo, Xue-Mei Yuan, Hong Xiong, Wu-Kai Ma, Xue-Ming Yao
Journal: Front Immunol (2024)
Keywords: adverse drug reaction, autoimmune disease, bull’s-eye maculopathy, hydroxychloroquine, hyperpigmentation of the skin, literature review
MeSH terms: Antirheumatic Agents / adverse effects, Antirheumatic Agents / therapeutic use, Arthritis, Rheumatoid / drug therapy, Hydroxychloroquine / adverse effects, Hydroxychloroquine / therapeutic use, Hyperpigmentation / chemically induced, Hyperpigmentation / diagnosis, Case Reports, Review, Research Support, Non-U.S. Gov't, Aged, Female, Humans, Skin / drug effects, Skin / pathology, Hydroxychloroquine, Antirheumatic Agents

Hydroxychloroquine (HCQ) is used as a traditional disease-modifying antirheumatic drugs (DMARDs), for the treatment of autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, it can cause serious adverse reactions, including hyperpigmentation of the skin and bull's-eye macular lesions. Here, we present a case of HCQ-induced hyperpigmentation of the skin and bull's-eye macular lesions in a patient who received HCQ for RA. A 65-year-old female patient developed blurred vision and hyperpigmentation of multiple areas of skin over the body for one month after 3 years of HCQ treatment for RA. Based on clinical presentation, ophthalmological examination and dermatopathological biopsy, a diagnosis of drug-induced cutaneous hyperpigmentation and bullous maculopathy of the right eye was made. After discontinuation of HCQ and treatment with iguratimod tablets, the hyperpigmentation of the patient 's skin was gradually reduced, and the symptoms of blurred vision were not significantly improved. We also reviewed the available literature on HCQ-induced cutaneous hyperpigmentation and bull's-eye macular lesions and described the clinical features of HCQ-induced cutaneous hyperpigmentation and bull's-eye macular lesions. In conclusion, clinicians should be aware of early cutaneous symptoms and HCQ-associated ophthalmotoxicity in patients with rheumatic diseases on HCQ sulphate and should actively monitor patients, have them undergo regular ophthalmological examinations and give appropriate treatment to prevent exacerbation of symptoms.
Spurious Presentation of Pulmonary Kaposi Sarcoma as Unresolved Pneumonia Led to Fatal Outcome
Authors: Baldeep Kaur Mann, Carlos D'Assumpcao, Lawrence Okumoto, Shatha Aboaid, Ayham Abooed, Everardo Cobos, Arash Heidari
Journal: J Investig Med High Impact Case Rep (2023)
Keywords: aids associated ks, disseminated ks, hhv-8, kaposi sarcoma
MeSH terms: Acquired Immunodeficiency Syndrome, HIV Infections / complications, HIV Infections / drug therapy, Herpesvirus 8, Human, Lung Neoplasms / pathology, Pneumonia / complications, Sarcoma, Kaposi / complications, Sarcoma, Kaposi / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Adult, Fatal Outcome, Humans, Male

Acquired immunodeficiency syndrome (AIDS)-associated Kaposi sarcoma (KS) is an angioproliferative neoplasia caused by infection with human herpesvirus 8 (HHV-8). It typically presents with mucocutaneous involvement, but it can be disseminated. Initial presentation with primarily pulmonary KS is rare. We present a case of a 32-year-old male with untreated human immunodeficiency virus (HIV) diagnosed 1 year before presentation who developed progressively worsening cough and shortness of breath for 6 months. He was hospitalized twice and treated for unresolved pneumonia in an outside hospital. The patient concomitantly developed purplish nodules on his face, then the upper trunk, back, chest, and thighs bilaterally that gradually increased in size and number. Histopathology findings from skin lesions were consistent for KS. Bronchoscopy found multiple erythematous plaques throughout the tracheobronchial tree with telangiectasias and inflammation suggestive of pulmonary KS. His imaging findings and positive serum HHV-8 polymerase chain reaction (PCR) were consistent with disseminated KS. He started antiretroviral therapy (ART) to treat his HIV infection, followed by liposomal doxorubicin chemotherapy. But both ART and chemotherapy were interrupted due to adherence and insurance issues. The patient was readmitted with acute respiratory failure requiring mechanical ventilation with multiple vasopressors that led to the patient's demise. The late recognition of KS diagnosis and delayed treatment can lead to worse outcomes.
Balloon dilation of the eustachian tube using endovascular balloon under local anesthesia-a case series and systematic literature review
Authors: Omer J Ungar, Münir Demir Bajin, Valerie Dahm, Vincent Y W Lin, Joseph M Chen, Trung N Le
Journal: Front Surg (2024)
Keywords: balloon dilation, endovascular balloon, endovascular catheter, eustachian tube, eustachian tube dysfunction, eustachian tuboplasty

Objective:
To report a novel technique in Balloon Dilation of Eustachian Tube (BDET) using an endovascular balloon (EVB), in a prospective cohort. The results are compared with reported outcomes using standard balloons.
Methods:
Demographic information and clinical parameters were collected prospectively fora series of patients with obstructive eustachian tube dysfunction (OETD). Balloon dilation Eustachian tuboplasty was performed under local anesthesia in a tertiary referral center, using the EVB. Systematic literature review was used for comparison, using Medline via "PubMed", "Embase", and "Web of Science".
Results:
Eight OETD candidates (12 ears) were enrolled; 5 males and 3 females. Average age was 48 (range -23 to 63) years. The most common presenting symptom was aural fullness (9/12), followed by ear pressure (7/12), hearing loss (5/12) and tinnitus (4/12). Otoscopically, tympanic membrane retraction was evident in 10/12 ears, the majority of which was class II-Sade classification. Pre-operative tympanogram was type B and C in 7 and 5 ears, respectively. All BDETs were performed without complications. Post-operative tympanometry was A in 8/12 ears. Post-operatively, Eustachian Tube Dysfunction Questionnaire-7 results reduced to within normal limits (average score ≤3) in 11/12 ears (p = 0.0014). The systematic literature review included 6 papers (193 patients, 262 ETs) with comparable results, most also with little adverse effects.
Conclusion:
BDET using an EVB is a safe and effective option for OETD. It is well tolerated under local anesthesia in properly selected individuals. The reduced procedural cost may be an important factor in certain healthcare jurisdictions.
Extensive Intracranial Meningioma With Dehiscences: A Case Report
Authors: Corneliu Toader, Luca-Andrei Glavan, Razvan-Adrian Covache-Busuioc, Bogdan-Gabriel Bratu, Horia-Petre Costin, Antonio-Daniel Corlatescu, Alexandru Vladimir Ciurea
Journal: Cureus (2024)
Keywords: frontotemporal neurosurgery, gender incidence disparity, genetic predisposition, interdisciplinary treatment approach, meningioma pathophysiology, monoclonal origins, postoperative cerebrospinal fluid leak, radiosurgical outcomes, sars-cov-2 neurological impact
MeSH terms: Case Reports

This case report elucidates the clinical and surgical journey of a 62-year-old patient with a history of multiple comorbidities including a severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection, presenting with temporospatial disorientation, bradypsychia, and bradyphasia, without motor deficits, diagnosed with sarcomatous meningioma and skull lysis. Amidst the complexities of managing primary brain tumors, this report underscores the significance of thorough morphopathological examination, while considering patient demographics and tumor localization in assessing the nature of the neoplasm. It highlights meningiomas as predominantly benign yet stemming from monoclonal proliferation, with their occurrence influenced by genetic predispositions and environmental factors such as ionizing radiation exposure. The intricate case details multiple surgical interventions necessitated by complications such as wound dehiscence and cerebrospinal fluid leaks, managed successfully through a tailored neurosurgical approach and meticulous postoperative care. This narrative reinforces the pivotal role of interdisciplinary collaboration, with substantial contributions from radiology, anesthesiology, intensive care, cardiology, infectious disease, and rehabilitation medicine in achieving favorable outcomes. The discussion contextualizes the patient's condition within the broader neurosurgical literature, reflecting on the prognostic factors associated with giant meningiomas and the impact of factors like age and tumor location on resection outcomes. The case also delves into the efficacy of Gamma Knife radiosurgery in long-term tumor control, drawing on retrospective analyses. In conclusion, the case report advocates for a nuanced, individualized treatment, where the integration of multiple disciplines and responsive management of postoperative complications is critical to patient recovery. The successful resolution of this patient's condition exemplifies the quintessential nature of interdisciplinary collaboration and highlights the potential for optimizing neurosurgical protocols in the context of complex patient profiles.
Online public health promotion at the local level: An evaluation of four local authority-led marketing campaigns
Authors: Kristin Hanson, Anna-Marie Degas, Daniel Green, Antoine Al-Hosri, Tushna Vandrevala
Journal: Digit Health (2024)
Keywords: com-b, public health, behaviour change, ethnicity, health promotion, local authority, online advertising, programmatic marketing, search engine marketing, social media marketing

Objective:
Local authority-led online campaigns offer the possibility of targeted health promotion to connect local services and residents. This study assesses the evidence for medium (e.g., click-trhoughs) and high (off-line behaviour change) levels of public engagement with four local authority-led campaigns across a variety of public health promotions (sexual health, weight loss, and vaccination), online marketing approaches (social media marketing, search engine marketing, and programmatic marketing) and target demographics (language, gender, age, income, ethnicity) undertaken by a London borough local authority.
Methods:
Employing quasi-experimental and observational study designs, engagement with local health services during the course of the campaigns was evaluated. The first three campaigns were evaluated based on an interrupted time series model of intervention assessment comparing outcome variables of interest during the campaign to periods before and after the campaign period. The results of the fourth campaign, an observational case-study, are discussed using descriptive statistics only.
Results:
The analyses of the high engagement data for two of the three campaigns statistically assessed clearly supported the effectiveness of the campaigns. While the effect of high engagement could not be determined in the other two campaigns, they provide data that may be useful in online campaign design.
Conclusions:
The evidence assessed in this study across a variety of platforms, health promotion initiatives, and population targets suggests that local authority-led online marketing campaigns for health promotion may be useful for increasing participation in public health programmes.
Case report: Management and long-term ophthalmic sequelae of monogenean ocular infestation in cownose rays (Rhinoptera bonasus)
Authors: April Beatty, Anne Gemensky-Metzler, Georgina Newbold, Andrea C Aplasca, Kathryn E Seeley
Journal: Front Vet Sci (2024)
Keywords: capsalid monogenean, case report, cownose ray, elasmobranch, veterinary ophthalmology
MeSH terms: Case Reports

Monogenean ectoparasitic flatworm infestations, particularly in closely confined populations, can result in severe epizootic disease that is often devastating and occasionally fatal. This case series describes a population of cownose rays (Rhinoptera bonasus) (n = 52) housed in an aquarium touch-tank exhibit that presented with severe ocular disease due to infestation with monogeneans, presumably Benedeniella posterocolpa of the Capsilidae family. The most severely affected individuals (n = 9), including several cases with bilaterally ruptured corneas, underwent serial examinations prior to and following treatment with praziquantel, systemic antibiotics, and corticosteroids. The entire population underwent frequent therapeutic water changes with a scheduled decrease in salinity, increase in temperature, and a series of seven praziquantel tank treatments. At the last follow up examination (3.75 years), the most common ocular findings were corneal fibrosis (18/18 eyes; 100%), cataract formation (13/18 eyes; 72.2%), synechia (8/18 eyes; 44.4%), and dyscoria (5/18 eyes; 27.8%). Despite severe corneal disease, including corneal rupture, all examined eyes (18/18; 100%) showed remarkable corneal remodeling and a largely clear visual axis. There are very few reports describing corneal disease in aquarium housed elasmobranchs, and no reports describe ophthalmic implications of monogenean infestation in these animals. This further underscores the importance of this case series in demonstrating the capacity for healing of elasmobranch eyes and can provide further guidance regarding prognosis and treatment in cases of severe corneal disease.
Use of allogeneic platelet-rich plasma for the treatment of autoimmune ocular surface disorders: case series
Authors: Maura Mancini, Elisa Imelde Postorino, Ludovica Gargiulo, Pasquale Aragona
Journal: Front Ophthalmol (Lausanne) (2023)
Keywords: sjogren’s syndrome, allogeneic platelet rich plasma, autoimmune ocular surface disorders, dry eye disease (ded), growth factors

Purpose:
To assess the effectiveness of topical allogeneic platelet-rich plasma (PRP) eye drops for the treatment of symptoms and clinical signs in patients with severe dry eye disease as a secondary condition caused by Sjögren's syndrome (SS).
Design:
Case series and literature review.
Methods:
Six eyes from three consecutive patients with severe dry eye from SS were evaluated. The eyes were treated with allogeneic topical PRP eye drops, with one drop applied six times daily for 3 months. A post-treatment follow-up evaluation was conducted 3 months after treatment suspension. We evaluated subjective symptoms, visual acuity, tear breakup time, the results of Schirmer's I test, fluorescein corneal and conjunctival staining, and corneal sensitivity.
Results:
The symptoms and visual acuity improved significantly in all patients. There was a significant improvement in corneal sensitivity and a decrease or disappearance of fluorescein corneal staining.
Conclusion:
The treatment with allogenic PRP eye drops of patients with SS-related severe dry eye disease has proven to be very effective, with an improvement in symptoms and main clinical signs.
Case report: Primary pulmonary low grade fibromyxoid sarcoma progressing to dedifferentiation: probably due to TP53 driver mutation
Authors: Jiawen Zhang, Haisheng Fang, Xiaomei Zhu, Chenchen Yao, Qinhe Fan, Qixing Gong
Journal: Front Oncol (2024)
Keywords: lgfms, tp53, dedifferentiated, lung, next-generation sequencing
MeSH terms: Case Reports

Low Grade Fibromyxoid Sarcoma (LGFMS), a rare entity characterized by bland histologic features, typically affects deep soft tissues of the trunk and lower extremities. Rare cases have been reported arising from the viscera and few demonstrating morphology of high-grade dedifferentiation. Here we report a 39-year-old Chinese woman presenting with primary lung LGFMS, which metastasized to the pancreas five years after diagnosis and then relapsed ten years later as a mediastinum mass. Microscopically, the lung and pancreatic lumps shared similar classical features of LGFMS, composed of bland spindle-shaped cells with low mitotic activity. However, the mediastinal mass had dedifferentiated morphology of dense sheets of round and epithelioid cells with high degree of nuclear pleomorphism and brisk mitosis. Molecular studies showed both classical and dedifferentiated areas had FUS::CREB3L2 rearrangement. However, the mediastinal dedifferentiated area presented with extra H193Y mutation of the TP53. Moreover, the mediastinal tumor displayed a strong and diffuse pattern of p53 expression immunohistochemically, but the primary lung and secondary pancreatic masses did not. Thus, we diagnosed the mediastinal mass as dedifferentiated LGFMS and proposed that TP53 mutation was probably the driver gene alteration in the process, which, to the best of our knowledge, has not been reported in the existing literature.
A case series of the twiddler syndrome
Authors: Roberta Montisci, Cinzia Soro, Roberta Demelas, Elena Agus, Alessio Follesa, Gesualdo Siragusa, Vincenzo Nissardi
Journal: Eur Heart J Case Rep (2024)
Keywords: case series, leadless pacemaker, submuscular pacemaker implant, twiddler syndrome
MeSH terms: Case Reports

Background:
Twiddler syndrome (TS) is a complication of cardiac implantable electronic device (CIED) implantation, caused by the deliberate or unconscious manipulation of the device by the patient himself, which results in dislocation of the leads by retraction towards the subcutaneous pocket.
Case summary:
This report describes two clinical cases that occurred in our centre, for which two different solutions were successfully implemented. In the first case, a complete removal of the stimulation system was performed, and a leadless pacemaker (PM; Medtronic Micra VR) was implanted. In the second case, the patient underwent a revision procedure. The PM was disconnected, and the electrodes were debrided, a submuscular pocket for the PM was created, and at the end of the procedure, the PM was anchored to the pectoralis major.
Discussion:
Twiddler syndrome is a not so rare and serious complication of CIED implantation, leading to device malfunctioning and higher risk of infection of the pocket due to multiple re-interventions. In these two cases, different surgical solutions were performed, both resulting to be effective to solve the effects of TS.