OpenMed/multicare-articles huggingface dataset:
Addressing Mood Disorder Diagnosis' Stigma With an Honest, Open, Proud (HOP)-Based Intervention: A Randomized Controlled Trial
Authors: Arlete Modelli, Viviane P Candal Setti, Martinus Theodorus van de Bilt, Wagner Farid Gattaz, Alexandre Andrade Loch, Wulf Rössler
Journal: Front Psychiatry (2021)
Keywords: honest, open, proud, disclosure, mental illness, self-conscience, self-stigma, stigma stress
MeSH terms: Case Reports

Introduction: The public stigma and self-stigma contribute to the dilemma of disclosing or not one's own mental illness diagnosis. Studies suggest that revealing it diminishes stress, besides helping with self-esteem. Honest, Open, Proud (HOP) is a group program that aids in the process of deciding on it, reducing its impact. Considering the relevance of this issue, the present study aimed to apply a HOP-based intervention in a group of patients diagnosed with mood disorders. Methods: A randomized controlled clinical trial was used, including 61 patients with mood disorders, of whom 31 were diagnosed with depression and 30 were diagnosed with bipolar disorder. They were randomly placed on the intervention (HOP) or the control group (unstructured psychoeducation). The evaluations occurred before (T0) and after (T1) the sessions. We administered eight scales, from which three presented relevant results: Coming Out with Mental Illness Scale (COMIS), Cognitive Appraisal of Stigma as a Stressor (CogApp), and Authenticity Scale. Results: The intervention groups (depression and bipolar) did not present a significant change regarding the decision to disclose their diagnostics. However, the depression group showed a decrease on the perception of stigma as a stressor (T0 = 0.50 vs. T1 = -1.45; p = 0.058). Improvements in post-intervention results were seen for both groups (depression and bipolar) on the Authenticity Scale-self-alienation subscale (T0 = 10.40 vs. T1 = 12.37, p = 0.058). Conclusion: Our HOP-based intervention appeared to be an important program to aid patients in facing stigma stress, showing positive effects, whether helping to diminish stress or to improve self-conscience, both of which have indirect effects on self-stigma. As it is a compact program, it can bring benefits when applying to public health institutions.
Technical Feasibility of Acoustic Coordinated Reset Therapy for Tinnitus Delivered via Hearing Aids: A Case Study
Authors: Christian Hauptmann, Mark Williams, Federica Vinciati, Markus Haller
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Primary tinnitus has a severe negative influence on the quality of life of a substantial portion of the general population. When acoustic coordinated reset (CR) neuromodulation stimuli are delivered for several hours per day over several weeks a clinically significant symptom reduction in patients with primary tonal tinnitus has been reported by several clinical sites. Here, we reported the first case where CR neuromodulation was delivered through a hearing aid. A 52-year-old man with chronic primary tonal tinnitus was previously considered untreatable with sound therapy. He initially received the classic CR treatment protocol with signals delivered with the separate proprietary device with his hearing aids removed during treatment. He was subsequently treated with the therapy being deployed through a set of contemporary hearing aids. After 5 months of classic CR treatment with the separate custom device, the THI and VASL/A scores worsened by 57% and 13%/14%, respectively. Using the hearing aid without CR treatment for 5 months no change in tinnitus symptoms was observed. However, after three months of CR treatment delivered through the hearing aids, the THI and VASL/A scores were reduced by 70% and 32%/32%, respectively.
Coexisting Thyroglossal Duct Cyst with Papillary Thyroid Cancer: A Case Report and Literature Review
Authors: Abdullah A Alarfaj, Ahmed Zekri, Ibrahim Alyaeesh, Ahmed Alomairin, Abdulrahman Al Naim
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

Thyroglossal duct cysts (TGDCs) are common developmental anomalies in which the thyroglossal duct is not obliterated. Coexisting papillary thyroid cancer and TGDC are uncommon and should be investigated thoroughly to rule out TGDC carcinoma. We report a rare case of coexisting papillary thyroid cancer and TGDC in a 48-year-old man, who presented with a history of recurrent mild painful midline neck swelling, and ultrasound (US) revealed a TGDC that was subsequently managed conservatively. On follow-up after 1.6 years, a thyroid US and a fine-needle aspiration (FNA) biopsy were performed, which showed malignant papillary thyroid carcinoma. Total thyroidectomy, the Sistrunk procedure, and central neck dissection were implemented. After three days, the patient was discharged on 150 mg of levothyroxine. Follow-up was unremarkable with no complications. The authors would like to stress the importance of regular TGDC and thyroid gland follow-ups for early detection and diagnosis of thyroid malignancy via clinical examination and US.
Atypical Presentation of Anti-Phospholipid Antibody Syndrome with Seizure and Atrial Mass
Authors: Rajish Sanjit Kumar Shil, Amal Abdallah Al Dhuhoori, Vipin Mughilassery Thomachan, Jamal Ali Teir, Renganathan Radhakrishnan
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Anti-phospholipid antibody syndrome (APS) has a broad spectrum of thrombotic and nonthrombotic clinical manifestations. The diagnosis requires a set of clinical criteria of thrombosis along with persistently positive anti-phospholipid antibody tests. In this report, we are presenting a case of APS, who is a 38-year-old male, presented with complains of seizures and found to have stroke, which on further investigation revealed to have been caused possibly from a left atrial mass. Therefore, high index of suspicion is required for the diagnosis of APS in young patients, who present with various neurological and cardiovascular manifestations, mostly secondary to thrombosis.
Chronic Central Serous Chorioretinopathy in a Patient with Pigment Dispersion Syndrome: A Possible Correlation
Authors: Dimitrios Kourkoutas, George Tsakonas, Aristotelis Karamaounas, Nikolaos Karamaounas
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Chronic central serous chorioretinopathy (CSCR) is a progressive chorioretinopathy with widespread atrophic RPE abnormalities and serous retinal detachments (SRDs) present for 6 months or longer. We report a case of CSCR in a 38-year-old patient with Pigment Dispersion Syndrome (PDS). In the presented case of CSCR, the chronic course of the disease may in part be associated with an underlying generalized degenerative dysfunction of the pigmented cells of the eye on grounds of PDS. We suggest that a chronic course of disease may be suspected in the setting of CSCR with concurrent RPE pathology, such as what is found in PDS.
How Successful is Combined Superior and Inferior Oblique Muscle Surgery in Young Children with Superior Oblique Underaction Presenting in Infancy with a Severe Head Tilt?
Authors: Revelle A Littlewood, John P Burke
Journal: Br Ir Orthopt J (2021)
Keywords: congenital superior oblique palsy, torticollis, vertical diplopia

Background/objective:
To evaluate the success of combining ipsilateral inferior and superior oblique muscle surgery in young children with congenital unilateral superior oblique under action who present in infancy with a large socially noticeable head-tilt.
Methods:
A consecutive retrospective case series of young children was analysed. The success of surgery in eliminating the head-tilt was evaluated by pre- and post-operative ocular motility assessment focusing on the vertical misalignment in primary position and downgaze, the magnitude of the head-tilt in degrees and the status of the superior oblique tendon.
Results:
Five children had a mean age at first surgery of 41 (range 25-63) months, a mean primary position vertical deviation of 26 (25-30) prism dioptres, a head-tilt of 30 (20-35) degrees and a mean post-operative follow up of 24 (8-43) months. While there was a uniform surgical plan, nonetheless each operation required individualisation based on a spectrum of per-operative superior oblique tendon findings. The head tilt was eliminated in 40% and reduced in the remainder, to a mean of 7 (0-18) degrees and with a mean post-operative primary position vertical misalignment of 3 (range 0-10) and of 10 (range 0-40) prism dioptres in downgaze.
Conclusion:
Combined, ipsilateral oblique muscle surgery reduced the severe head tilt and primary position alignment to a psychosocially and functionally acceptable level. For the majority, the outcome was stable or associated with further decremental improvement. A persistent downgaze vertical tropia occurred in children with macroscopically abnormal superior oblique tendons but these cases were not identifiable clinically pre-operatively.
Advanced HCC Patient Benefit From Neoantigen Reactive T Cells Based Immunotherapy: A Case Report
Authors: Chenxi Liu, Jie Shao, Yanbing Dong, Qiuping Xu, Zhengyun Zou, Fangjun Chen, Jing Yan, Juan Liu, Shuangshuang Li, Baorui Liu, Jie Shen
Journal: Front Immunol (2021)
Keywords: benefit, hepatocellular carcinoma, immunotherapy, neoantigen reactive t cells, tomotherapy
MeSH terms: Antigens, Neoplasm / immunology, Carcinoma, Hepatocellular / therapy, Liver Neoplasms / therapy, T-Lymphocytes / immunology, Case Reports, Research Support, Non-U.S. Gov't, Aged, Carcinoma, Hepatocellular / immunology, Humans, Immunotherapy, Liver Neoplasms / immunology, Male, Prognosis, Antigens, Neoplasm

Advanced hepatocellular carcinoma (HCC) is a highly lethal disease, mainly due to the late stage at diagnosis and its rapid progression. Although patients with advanced HCC can choose targeted therapy or chemotherapy, overall, the treatment response rate is extremely low and the average survival time is one year more or less. But the application of immunotherapy have led to a paradigm shift in the treatment of HCC,such as TILs (tumor infiltrating lymphocytes),Checkpoint blockade (immune Checkpoint blockade), CAR-T(chimeric antigen receptor T cells) and TCR-T (engineered t-cell receptor T cells). And recent data indicate neoantigens generated when tumors mutate are the main target of tumor-specific TILs, and they are also the main antigens mediating tumor regression in TILs treatment. Moreover, numerous evidences have revealed that radiotherapy lead to massive release of tumor antigens, which may increase the effectiveness of immunotherapy. Based on the above theory, we used neoantigen reactive T cells combined with tomotherapy to treat a patient with advanced HCC (Clinical Trial Study Registration Number: NCT03199807), who reached a long time progress free survival.
Injection-Site Sarcoma in a Dog: Clinical and Pathological Findings
Authors: Terry M Jacobs, Cathy E Poehlmann, Matti Kiupel
Journal: Case Rep Vet Med (2017)
MeSH terms: Case Reports

This case report documents the clinical and pathological findings in a dog that rapidly developed a high-grade sarcoma at the site of multiple vaccinations and follows the response to surgery and adjunct treatment with toceranib. An 11-year-old female spayed Labrador Retriever presented with dorsocervical subcutaneous masses at the injection site three weeks after receiving DA2PP-Lepto, Rabies, and Bordetella vaccinations. A high-grade soft tissue sarcoma was diagnosed microscopically and immunohistochemistry revealed positive expression of VEGFr, PDGFr, SCF, and EGFR. Repeat surgical resections and targeted treatment with toceranib resulted in a stable remission for nearly two years.
Cardiogenic Shock Secondary to Dynamic Left Ventricular Outflow Tract Obstruction and Apical Ballooning after Nonmitral Cardiovascular Surgery
Authors: Hoang Bac Nguyen, Hoang Dinh Nguyen, Thi Thanh Thuy Tran, Minh Khoi Le
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Background:
The dynamic obstruction of the left ventricular outflow tract (LVOT) is a well-known complication in mitral annuloplasty but rarely seen in nonmitral cardiovascular surgery. The dynamic LVOT obstruction can lead to hemodynamic instability, even shock and the treatment is significantly different from the standard approach. Case Presentation. We reported a case of low cardiac output syndrome (LCOS) with severe mitral regurgitation (MR), dramatically reduced left ventricular ejection fraction (LVEF) after coronary artery bypass grafting in a 72-year-old female requiring an escalation of inotropic support, volume restriction, and mechanical support. The detailed echocardiography combined with lung ultrasound revealed a dynamic systolic anterior movement of the anterior mitral leaflet (SAM), apical ballooning, and no significant lung congestion. Intravenous fluids were given, diuretics withdrawn, inotrope discontinued, and vasopressors uptitrated. The dynamic SAM was rapidly relieved, the hemodynamics was stabilized, and the LVEF was improving. The patient was discharged in good condition without residual LVOT obstruction and trace MR.
Conclusion:
We strongly suggest that a detailed echocardiography should be performed in any patient who presents in shock to rule out a dynamic LVOT obstruction. Lung ultrasound should be a routine examination in addition to echocardiography. Once SAM is detected, treatment should be based on volume expansion, inotrope discontinuation, and a careful afterload increasing.
Effect of intravitreal aflibercept on recalcitrant diabetic macular edema
Authors: Kendra A Klein, Tina S Cleary, Elias Reichel
Journal: Int J Retina Vitreous (2017)
Keywords: aflibercept, anti-vegf, chronic, diabetic macular edema

Background:
Despite anti-VEGF therapy, some patients develop chronic diabetic macular edema. The objective of this study was to evaluate anatomic and visual outcomes of switching patients with chronic DME from intravitreal bevacizumab or ranibizumab to intravitreal aflibercept injection.
Methods:
In this retrospective observational case series, 11 eyes with recalcitrant diabetic macular edema (DME) were evaluated 6 months prior to and 6 months following initial intravitreal aflibercept injection (IAI). Recalcitrant DME was defined as having a thickened retina (≥350 μm) on spectral domain optical coherence tomography (SD-OCT) with persistent cystic changes (less than a 15% reduction in central retinal thickness) over 6 months prior to intravitreal aflibercept switch despite aggressive treatment for DME during this time.
Results:
One hundred and forty-seven patients in total were treated with IAI during this time, and of these, 31 patients were treated with IAI for DME. 18 eyes had less than 4 treatments within the 6 months prior to switch to IAI, 6 patients had a central retinal thickness (CRT) on SD-OCT of less than 350 μm at time of switch to IAI, and 2 patients had a greater than 15% decline in CRT on SD-OCT over the 6 months prior to switch to IAI. A total of 11 patients were included in the study. Over the 6 months prior to switch, the mean change in central retinal thickness was +18.6% and over the 6 months following switch to aflibercept the mean change in central retinal thickness was -27.1%. Switching to a regimen of at least 3 intravitreal aflibercept injections over 6 months resulted in some anatomic improvement and improvement or stabilization of Snellen visual acuity in all eligible patients.
Conclusions:
In patients with recalcitrant diabetic macular edema, switching to intravitreal aflibercept resulted in improved a 25% or more decrease in central retinal thickness in 81% (9/11) patients at 6-month follow-up. Sixty-three percent (7/11) had improvement in Snellen visual acuity after switching to intravitreal aflibercept injection, suggesting some reversibility of functional damage.
Papillary Thyroid Cancer and Lung Adenocarcinoma Presenting as Two Primary Malignancies in a Patient with Symptomatic Goiter
Authors: Deepu Daniel, Leah Delumpa, Natasha Bray
Journal: Case Rep Med (2015)

In rare instances, patients may be diagnosed with two different primary malignancies. Though such synchronous malignancies have been documented in sporadic case reports, the overwhelming majority of malignancies involving multiple organs can be attributed to a primary source. Papillary thyroid carcinoma and lung adenocarcinoma are rarely diagnosed within the same year. Our case report presents a patient who was diagnosed with these two malignancies during her same hospital visit. Biopsies results proved that the two malignancies were in fact separate entities and not a consequence of metastasis from a primary source.
Use of Humidified High Flow Nasal Oxygen in Community Palliative Care: A Case Report
Authors: Stephen Bode, Graham Grove
Journal: Palliat Med Rep (2020)
Keywords: airvo, community palliative care, humidified high-flow nasal oxygen
MeSH terms: Case Reports

Breathlessness is a distressing symptom that is often seen in palliative care patients with respiratory failure and it can make care in the home setting difficult. Humidified High Flow Nasal Oxygen is a relatively new intervention for respiratory failure, but it has not been researched greatly in a palliative care setting. One device with the capacity to deliver high flow humidified oxygen to spontaneously breathing patients is the myAIRVO2 humidifier.1 The myAIRVO2 is a humidifier with an integrated flow generator that delivers warmed and humidified respiratory gases to a spontaneously breathing patient.1 The following case report describes how the technology was used at home for symptom control in a 76 year old patient with severe chronic obstructive pulmonary disease with associated pulmonary hypertension. The patient was successfully discharged from hospital and managed at home using high-flow nasal oxygen for approximately one month up until his death. In this last month of life, he reported that he was more comfortable on high-flow nasal oxygen than on traditionally-administered oxygen. Humidified High Flow Nasal Oxygen is potentially beneficial to aid in symptom control for palliative care patients in an inpatient and community setting.
Acute Myeloid Leukaemia With Translocation (8;21) Masquerading as Peripheral Blood Eosinophilia Having Dysplastic Features: A Diagnostic Challenge
Authors: Anurag Singh, Tanya Tripathi, Akanksha Singh, Sanjay Mishra, Shailendra P Verma
Journal: Cureus (2023)
Keywords: acute myeloid leukaemia, bone marrow examination, cytogenetic studies, eosinophilia, immunophenotyping
MeSH terms: Case Reports

Eosinophilia with a modest number of blasts (<20%) in the peripheral blood and bone marrow smears raises suspicion for myeloproliferative neoplasms (MPNs) and acute myeloid leukaemia (AML). Here, we present a case of AML in a 16-year-old boy who presented with high-grade fever, respiratory distress, and generalised weakness. Marked eosinophilia with dysplastic features and occasional blasts were found in the peripheral blood. In view of dysplastic eosinophils and occasional blasts in peripheral blood, a bone marrow examination was requested which revealed increased eosinophils and their progenitors with dysplasia and a modest number of blast cells (<20%). The bone marrow findings suggest MPNs, which were eventually identified as AML having translocation (8;21) with the aid of immunophenotyping and cytogenetic studies. Eosinophilia and its phenotypic anomalies are rarely found in peripheral blood smears of AML patients with translocation (8;21) which may have been related to the leukaemic process.
Malignant Pleural Effusion in Pediatrics: A Rare Presentation
Authors: Lubna Almogarry, Alzahra Y Alradhi, Abdullah Alshamrani
Journal: Cureus (2023)
Keywords: effusion, lymphoma, malignancy, parapneumonic effusion, pneumonia
MeSH terms: Case Reports

Pleural effusion is the most common presentation of pleural diseases. It is relatively common in children with two predominant types: exudative and transudative effusions. In children, exudative types are the most common with bacterial infection being the most prevalent cause. In some cases, effusion could be difficult to confirm. We describe two patients with a similar age group who presented with respiratory distress in the form of fever, cough, and shortness of breath. They were managed clinically and radiologically as cases of parapneumonic effusion. Both were started on antibiotics with no improvement. After reviewing the cases, it was discovered that some crucial aspects of the history and physical examination that were essential to reach the correct diagnosis had not been taken into consideration. Parapneumonic effusion should be taken with caution, meticulous history and examination are warranted, and lymphocytic-predominant effusion is very alarming for potential malignancy in the absence of tuberculosis infection. If the antibiotic medication yields no significant improvement, earlier referral should be considered.
Case report: A case of corneal epithelial injury associated with Pthiriasis palpebrarum
Authors: Da-Hu Wang, Xin-Quan Liu
Journal: Front Med (Lausanne) (2022)
Keywords: pthiriasis palpebrarum, pthirus pubis, blepharitis, case report, corneal epithelial injury, dry eye disease
MeSH terms: Case Reports

Significance:

Phthiriasis palpebrarum is an uncommon infection due to Phthirus pubis inoculating the eyelashes and surrounding tissues of the eye. Because of its rarity, it may be misdiagnosed as blepharitis or conjunctivitis clinically.
Purpose:
This report described a rare case of corneal epithelial injury associated with Phthiriasis palpebrarum.
Case report:
A 59-year-old woman presented with 1 month history of repeated episodes of itching and irritation symptoms in both eyes. A slit-lamp examination was performed, which revealed mild conjunctival hyperemia and corneal epithelial defects in both eyes. On closer examination, crab-like lice, nits, and red pinpoint excretions were seen on her eyelashes and eyelids bilaterally. Corneal fluorescein staining in both eyes was observed, and tear film break-up time (BUT) in each eye was 2 s. Numerous lice were also found attached to the scalp hair. Therefore, a clinical diagnosis of corneal epithelial injury associated with Pthiriasis palpebrarum was made. For treatment, eyelashes with nits and/or lice were removed mechanically with a fine tweezers. Then, 0.01% Hypochlorous Acid eye wash was used to clean the eyelid margin twice daily. Also, she was prescribed a combination of Vitamin A Palmitate eye gel three times a day and Tobradex® eye ointment once daily. Meanwhile, the patient was provided with suggestions on how to improve personal hygiene and environmental hygiene, including cutting of the scalp hair and the application of 0.01% permethrin rinse. One week later, no evidence of lice and nits of the eyelashes and scalp hair was found, and the patient's symptoms and signs also improved significantly.
Conclusion:
This rare case suggested that the eyelashes of patients presenting with itching and irritation symptoms should be carefully examined with a slit-lamp. Besides removal of the parasites, attention should be paid to the treatment of corneal epithelial injury associated with Pthiriasis palpebrarum.