OpenMed/multicare-articles huggingface dataset:
First-episode olfactory hallucination in a patient with anxiety disorder: A case report
Authors: Xingmei Jiang, Yiwen Yuan, Zhixiong Li, Ying Ou, Zhe Li
Journal: Front Psychiatry (2022)
Keywords: anti-anxiety treatment, anxiety disorder, case report, first-episode, olfactory hallucination
MeSH terms: Case Reports

Background:
Olfactory hallucination refers to olfactory perception in the absence of chemical stimuli. Although it has been associated with many neurological and psychotic disorders, it has rarely been reported as the first and only symptom in patients with anxiety disorder, and its treatment remains inadequate.
Case summary:
A 66-year-old woman who had been experiencing gradually worsening olfactory hallucinations for almost 4 years was diagnosed with generalized anxiety disorder. Olfactory hallucination disappeared after treatment with anti-anxiety drugs.
Conclusion:
Olfactory hallucination can be the first and only symptom in patients with anxiety disorder and may be effectively treated with anti-anxiety medication. In fact, it can precede the diagnosis of anxiety disorder by several years.
Late Onset Descemet Membrane Detachment after Radial Keratotomy Resolved with Medical Therapy
Authors: P Rosetta, E F Legrottaglie, R Vinciguerra, P Vinciguerra
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Purpose:
To report a case of a Descemet membrane's (DM) detachment after radial keratotomy (RK).
Methods:
A patient (male) underwent RK (16 cuts) 20 years before referring to the Eye Center of Humanitas (Milan) for a progressive visual loss. The slit-lamp examination showed severe corneal stromal edema and a large DM detachment in the lower half of the cornea. Anterior segment optical coherence tomography (AS-OCT) and endothelial cells count confirmed DM detachment and endothelial cells damage. Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) was planned and topical hypertonic therapy was prescribed before the surgery.
Results:
Eight months later, the patient mentioned a spontaneous increase in visual acuity; the slit-lamp examination and the AS-OCT displayed a recovery of corneal transparency with a resolution of DM detachment.
Conclusions:
This is the first report of spontaneous DM detachment with severe corneal edema after RK. We suggest that hypertonic therapy may reduce DM detachment and restore corneal transparency.
Delirium and High Creatine Kinase and Myoglobin Levels Related to Synthetic Cannabinoid Withdrawal
Authors: Ahmet Bulent Yazici, Esra Yazici, Atila Erol
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Synthetic cannabinoids (SCs) are included in a group of drugs called new psychoactive substances. Effects of SCs on the central nervous system are similar to other cannabinoids, but 2-100 times more potent than marijuana. Thus, addiction and withdrawal symptoms are more severe than natural cannabinoids. Withdrawal symptoms of SCs were reported in the literature previously. But there is no report about SC withdrawal delirium and its treatment. Several studies reported that agonists of CB1 receptors play a role in GABA and glutamatergic neurotransmission, which is similar to the effects of alcohol on GABA and glutamatergic receptors. Previous studies on alcohol delirium cases suggested that elevated creatine kinase (CK) can be a marker of progress. This study reports delirium and high serum CK levels related to SC withdrawal and offers a treatment with benzodiazepine for them. We described two cases treated in our inpatient clinic about SC withdrawal with increase of serum CK level and other laboratory parameters. One of them demonstrated delirium symptoms and the other did not with early rapid treatment.
Sex Differences and Bone Metastases of Breast, Lung, and Prostate Cancers: Do Bone Homing Cancers Favor Feminized Bone Marrow?
Authors: Mary C Farach-Carson, Sue-Hwa Lin, Theresa Nalty, Robert L Satcher
Journal: Front Oncol (2017)
Keywords: bone marrow, bone metastasis, breast cancer, lung cancer, prostate cancer, sex differences, sex hormones
MeSH terms: Review

Sex-associated differences in bone metastasis formation from breast, lung, and prostate cancer exist in clinical studies, but have not been systematically reviewed. Differences in the bone marrow niche can be attributed to sexual dimorphism, to genetic variations that affect sex hormone levels, or to the direct effects of sex hormones, natural or exogenously delivered. This review describes the present understanding of sex-associated and sex hormone level differences in the marrow niche and in formation of bone metastasis during the transition of these three cancers from treatable disease to an often untreatable, lethal metastatic one. Our purpose is to provide insight into some underlying molecular mechanisms for hormonal influence in bone metastasis formation, and to the potential influence of sexual dimorphism, genetic differences affecting sex assignment, and sex hormone level differences on the bone niche and its favorability for metastasis formation. We reviewed publications in PubMed and EMBASE, including full length manuscripts, case reports, and clinical studies of relevance to our topic. We focused on bone metastasis formation in breast, lung, and prostate cancer because all three commonly present with bone metastases. Several clear observations emerged. For breast cancer bone metastasis formation, estrogen receptor (ER) signaling pathways indicate a role for ER beta (ERβ). Estrogen influences the bone microenvironment, creating and conditioning a favorable niche for colonization and breast cancer progression. For lung cancer, studies support the hypothesis that females have a more favorable bone microenvironment for metastasis formation. For prostate cancer, a decrease in the relative androgen to estrogen balance or a "feminization" of bone marrow favors bone metastasis formation, with a potentially important role for ERβ that may be similar to that in breast cancer. Long-term estrogen administration or androgen blockade in males may feminize the bone marrow niche to one more favorable for bone metastases in prostate cancer. Administration of androgens in females, especially combined with mastectomy, may reduce risk of developing bone metastatic breast cancer. We conclude that it should be considered that females, those with female-leaning genetic variations, or hormonal states that feminize the bone marrow, may offer favorable sites for bone metastases.
Case Report: The Carotid Body in COVID-19: Histopathological and Virological Analyses of an Autopsy Case Series
Authors: Andrea Porzionato, Aron Emmi, Martina Contran, Elena Stocco, Silvia Riccetti, Alessandro Sinigaglia, Veronica Macchi, Luisa Barzon, Raffaele De Caro
Journal: Front Immunol (2021)
Keywords: covid-19, carotid body, chemosensitivity, nervous system, peripheral arterial chemoreceptors, silent hypoxia
MeSH terms: COVID-19 / pathology, COVID-19 / virology, Carotid Body / pathology, Carotid Body / virology, SARS-CoV-2 / genetics, Case Reports, Research Support, Non-U.S. Gov't, Aged, Autopsy, Coronavirus Nucleocapsid Proteins / metabolism, Female, Humans, Male, Phosphoproteins / metabolism, RNA, Viral / analysis, Spike Glycoprotein, Coronavirus / metabolism, Coronavirus Nucleocapsid Proteins, Phosphoproteins, RNA, Viral, Spike Glycoprotein, Coronavirus, nucleocapsid phosphoprotein, SARS-CoV-2, spike protein, SARS-CoV-2

Various authors have hypothesized carotid body (CB) involvement in Coronavirus Disease 2019 (COVID-19), through direct invasion or indirect effects by systemic stimuli ('cytokine storm', angiotensin-converting enzyme [ACE]1/ACE2 imbalance). However, empirical evidence is limited or partial. Here, we present an integrated histopathological and virological analysis of CBs sampled at autopsy from four subjects (2 males and 2 females; age: >70 years old) who died of COVID-19. Histopathological, immunohistochemical and molecular investigation techniques were employed to characterize Severe Acute Respiratory Syndrome - Coronavirus 2 (SARS-CoV2) viral invasion and inflammatory reaction. SARS-CoV2 RNA was detected in the CBs of three cases through Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR). In these cases, positive immunostaining for Nucleocapsid and Spike protein were also demonstrated, mainly at the level of large roundish cells consistent with type I cells, confirming direct CB invasion. In these cases, T lymphocytes showed focal aggregations in the CBs, suggestive of local inflammatory reaction. Blood congestion and microthrombosis were also found in one of the positive cases. Intriguingly, microthrombosis, blood congestion and microhaemorrages were also bilaterally detected in the CBs of the negative case, supporting the possibility of COVID-19 effects on the CB even in the absence of its direct invasion. SARS-CoV-2 direct invasion of the CB is confirmed through both immunohistochemistry and RT-PCR, with likely involvement of different cell types. We also reported histopathological findings which could be ascribed to local and/or systemic actions of SARS-CoV-2 and which could potentially affect chemoreception.
Clinical Utility of Fluid Volume Assessment in Heart Failure Patients Using Bioimpedance Spectroscopy
Authors: Andrew J Accardi, Bradley S Matsubara, Richelle L Gaw, Anne Daleiden-Burns, James Thomas Heywood
Journal: Front Cardiovasc Med (2021)
Keywords: bioimpedance spectroscopy, case study, extracellular fluid, heart failure, total body water
MeSH terms: Case Reports

Background: Bioimpedance spectroscopy (BIS) is a non-invasive method used to measure fluid volumes. In this report, we compare BIS measurements from patients with heart failure (HF) to those from healthy adults, and describe how these point-of-care fluid volume assessments may be applied to HF management. Methods and results: Fluid volumes were measured in 64 patients with NYHA class II or III HF and 69 healthy control subjects. BIS parameters including extracellular fluid (ECF), intracellular fluid (ICF), total body water (TBW), and ECF as a percentage of TBW (ECF%TBW) were analyzed. ECF%TBW values for the HF and control populations differed significantly (49.2 ± 3.2% vs. 45.2 ± 2.1%, respectively; p < 0.001); both distributions satisfied criteria for normality. Interquartile ranges did not overlap (46.7-51.0% vs. 43.8-46.4%, respectively; p < 0.001). Subgroup analyses of HF patients who underwent transthoracic echocardiography showed that impedance measurements correlated with inferior vena cava size (Pearson correlation -0.73, p < 0.0001). A case study is presented for illustrative purposes. Conclusions: BIS-measured ECF%TBW values were significantly higher in HF patients as compared to adults without HF. We describe three strata of ECF%TBW (normal, elevated, fluid overload) that may aid in clinical risk stratification and fluid volume monitoring of HF patients. Clinical Trial Registration: COMPARE - www.ClinicalTrials.gov; IMPEL - www.ClinicalTrials.gov; Heart Failure at Home - www.ClinicalTrials.gov, identifier: NCT02939053; NCT02857231; NCT04013373.
Metastasis to the pancreas: a rare site for secondary malignancy of breast cancer (a case report)
Authors: Fadila Kouhen, Meriem Chihabeddine, Mohammed Squali, Mohammed Allaoui, Abderrahmane Al Bouzidi, Nadia Errafiy, Nabil Ismaili
Journal: Pan Afr Med J (2020)
Keywords: breast cancer, case report, pancreatic metastases, prognosis
MeSH terms: Breast Neoplasms / pathology, Pancreatic Neoplasms / secondary, Case Reports, Female, Humans, Middle Aged, Pancreatic Neoplasms / pathology

Breast cancer is the most frequent invasive cancer in women and the second cause of death by cancer in women after lung cancer. It causes metastases especially to bones, liver and lungs. Pancreatic metastases from a primary breast neoplasm are rare and unusual, occurring in less than 3% of the cases. There have been only 28 cases described in the literature. This paper adds one more case to the published literature. We present a case of pancreatic metastasis of the breast in a 64-year-old female and a discussion based on a review of the literature.
A new endoscopic submucosal resection -ligation technique for gastric tumors
Authors: Hamid Asadzadeh Aghdaei, Amir Sadeghi, Ahmad Ghorbanpour Nouri, Gholam Reza Nouri, Arash Dooghaie Moghadam, Mohammad Reza Azizi, Pegah Eslami
Journal: Gastroenterol Hepatol Bed Bench (2020)
Keywords: endoscopic mucosal resection, subepithelial tumor
MeSH terms: Case Reports

Although most subepithelial lesions are benign, the malignant forms could present as serious life-threating cancers. Their accurate diagnosis depends on complete surgical resection. Different endoscopic methods have been recommended for the resection. Recently, the EMR has been considered as a safe and effective technique, while various revised EMR techniques have been introduced. In this study, a new version of EMR has been evaluated in two patients. Two middle-aged cases with gastric subepithelial tumors were admitted to Taleghani gastrointestinal department. The polyps were resected via our new Endoscopic Mucosal Resection (EMR) technique. In this technique, the needle knife was used for un-roofing the mucosal surface. Then, the polyps were resected with hot snares. The hemoclips were applied for ligation too. We found no early or delayed complications. Furthermore, the microscopic margins of the lesions were free. Our study represented a safe and cost-beneficial technique for subepithelial lesions and no complications was found and the margins were free. However, further investigations are required for confirming the validity of this new EMR technique.
Undiagnosed Behçet's Disease Presenting as Fournier's Gangrene in a Young Male
Authors: Jasmine C Winyard, Anton Wong, Hala Rashed, John K Mellon
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Behçet's disease is rare, especially in the paediatric population. In this case, a healthy 16-year-old made presented with discrete scrotal ulcers and systemic illness. He was found to have Fournier's gangrene and with subsequent investigation was diagnosed with Behçet's disease as an underlying cause. A PubMed search reveals no similar case reports. His only risk factors for Fournier's gangrene was his raised body mass index. His only risk factor for Behçet's disease was his ethnic origin. An understanding of risk factors and epidemiology can raise suspicion of these rare pathologies.
Mycoplasma pneumoniae Infection Associated C3 Glomerulopathy Presenting as Severe Crescentic Glomerulonephritis
Authors: Lalani De Silva, Dinesha Jayasinghe, Priyani Amarathunga
Journal: Case Rep Nephrol (2021)
MeSH terms: Case Reports

C3 glomerulopathy (C3GP) is a group of diseases caused by a deregulated complement system, which encompasses both dense deposit disease and C3 glomerulonephritis. Renal manifestations of C3GP are primarily of proliferative glomerulonephritis, and only a few case reports of crescentic glomerulonephritis (CGN) in association with C3GP are available. Here is a case of an adult South-Asian female, who was diagnosed as seropositive acute Mycoplasma pneumoniae infection, with associated systemic manifestations, including immune-type extravascular haemolysis and nephrotic range proteinuria. Subsequent renal biopsy revealed CGN with disrupted Bowman's capsules and necrotizing lesions. Immunofluorescence showed coarse granular mesangial C3 deposits with negative IgM, IgG, IgA, and C1q. The immunomorphological phenotype raised two possibilities including C3GP and infection-related glomerulonephritis (IRGN). Persistent proteinuria with no evidence of resolution even after 6 months of follow-up favoured C3GP over IRGN. The patient proceeded to end-stage renal failure requiring renal replacement despite aggressive immunosuppression. This case illustrates the rare association of CGN with C3GP induced by Mycoplasma pneumoniae infection, highlighting the importance of correct diagnosis as well as timely identification of triggering factors in CGN on patient outcome.
Severe Hypokalemia Causing Ventricular Tachycardia: A Case Report
Authors: Katharine Pula, Kedar N Patel, Robert P Briggs, Kevin R Weaver
Journal: Cureus (2023)
Keywords: electrolyte abnormality, hyperosmolar hyperglycemic syndrome, hypokalemia, neurological deficits, torsade de pointes, ventricular tachycardia, wide-complex tachycardia
MeSH terms: Case Reports

Hypokalemia and hyperosmolar hyperglycemic syndrome (HHS) are two reversible but potentially fatal disorders that are important to identify and treat urgently. A 43-year-old patient presented to the ED with altered mental status and slurred speech, difficulty communicating, left-sided facial droop, and stool incontinence according to emergency medical services. This was preceded by 1.5 weeks of nausea, vomiting, polydipsia, and weight loss. On presentation, the patient was found tachycardic and tachypneic, with uncertain neurological deficits on physical exam, hyperglycemia, and electrocardiogram (EKG) abnormalities. Lab data were consistent with hyperosmolar hyperglycemic nonketotic coma. This case provides two important clinical scenarios in which cardiac EKG abnormalities and focal neurological deficits are the product of hyperosmolality and electrolyte abnormalities. Hypokalemia with EKG abnormalities consistent with a potential ischemic disease can progress into wide complex tachycardia and ventricular fibrillation. Hyperosmolar hyperglycemia may manifest with focal neurological deficits and without the classical presentation of a coma. Careful consideration of EKG and lab values in the context of clinical presentation may provide clues to resolvable etiologies. We report a case of a patient who presented to the ED with hypokalemia and HHS, both reversible but potentially fatal disorders that are important to identify and urgently treat.
Case report: Misdiagnosis of accessory spleen in the left adrenal region as an adrenal tumour after splenectomy
Authors: Yuhua Zou, Xiaojuan Xie, Sheng Yan, Gengqing Wu, Quanliang Liu
Journal: Front Surg (2022)
Keywords: accessory spleen, adrenal tumour, case report, image diagnosis, misdiagnosis, splenectomy

Background:
Adrenal tumours are common in urology and endocrinology, and the diagnosis of adrenal tumours were mainly depends on imaging diagnosis. Howerver, misdiagnosis can still occur for some adrenal space-occupying lesions without specific manifestations or abnormal biochemical indexes.
Methods:
We report the case of a 55-year-old patient with a soft-tissue mass in the left adrenal region, and have no specific manifestations or abnormalities in biochemical indexes. The patient had undergone open splenectomy 20 years ago for splenic rupture caused by traffic-accident trauma, and had a 10-year special history of hypertension. Because of the uncertain nature of the mass, surgical treatment was recommended.
Results:
The surgeon managed to remove the left adrenal region mass. During the surgery, the adrenal source was excluded. In the histological examination, the splenic corpuscle and splenic medullary structure were seen under the microscope, and an accessory spleen was diagnosed.
Conclusions:
The accessory spleen was located in the adrenal region rarely, and can easily be misdiagnosed as an adrenal tumour. When the cases show abnormal adrenal space-occupying lesions in imaging examinations, non-adrenal diseases should be considered. we need to combine different imaging techniques for analysis, and think more about it, avoid misdiagnosis leading to unnecessary surgery.
Long-Term Persistence of Serum-Specific Anti-Chikungunya IgM Antibody - A Case Series of Brazilian Patients
Authors: Denise Maria do Nascimento Costa, Maria Rosângela Cunha Duarte Coêlho, Pedro Alves da Cruz Gouveia, Luan Araújo Bezerra, Claudia Diniz Lopes Marques, Angela Luzia Branco Pinto Duarte, Lucila Maria Valente, Vera Magalhães
Journal: Rev Soc Bras Med Trop (2021)
MeSH terms: Chikungunya Fever / diagnosis, Chikungunya virus, Case Reports, Antibodies, Viral, Brazil, Humans, Immunoglobulin M, Antibodies, Viral, Immunoglobulin M

The persistence of serum-specific anti-chikungunya IgM antibodies (CHIKV-IgM) can vary after chikungunya fever (CHIK) infection. However, the factors related to its production are not yet known. We described a case series drawn up from data collected from 57 patients between 12 and 36 months after the acute phase of CHIK infection in Northeastern Brazil. CHIKV-IgM was detectable in 7/57 (12.3%) patients after 28.3 months of infection. No frequency differences in chronic musculoskeletal manifestations and underlying conditions were detected between patients with or without CHIKV-IgM. CHIKV-IgM was detected for up to 35 months in Brazilian patients after CHIK infection.
Pancreatic Duct Obstruction in a Middle-Aged Woman: A Case Report
Authors: Mustafa Suker, Michael Doukas, Casper van Eijck, Katharina Biermann
Journal: J Pancreat Cancer (2017)
Keywords: granular cell tumor, pancreatic duct dilatation, pancreatic neoplasms
MeSH terms: Case Reports

Background: Granular cell tumors (GCTs) are rare benign neoplasms of Schwann cells. These tumors have been described in almost every human organ. Although GCT has been described in the pancreas previously, we present a case report about GCTs in multiple organs at a simultaneous time. Case Presentation: A 51-year-old Caucasian female known with epilepsy and COPD presented with recurrent abdominal pain. Previously, endoscopic mucosal resection in the esophagus and lumpectomy of the right breast were performed for what proved to be GCTs. Computed tomography showed a hypodense unclearly demarcated tumor of the pancreas tail-body with the impression of infiltrative growth and pancreatic duct dilation. The patient underwent an uncomplicated distal pancreatectomy with the pathological examination showing a fibrotic area of 6 mm consisting of diffusely spread nests of large cells embedded in a collagenous stroma of the pancreatic tail. The tumor nuclei were not atypical and the cytoplasm was granular and eosinophilic. The cell clusters stained positive for S-100 and CD68 in the cell cytoplasm. The diagnosis, GCT of the pancreas, was made and the postoperative course was uneventful for our patient, and a year after surgery, there have been no new tumorous lesions detected. Conclusion: We present a rare case of multiple GCTs affecting the breast, esophagus, and pancreas. Although GCT of the pancreas is a rare disease, the diagnosis should be considered if there is GCT in the medical history of the patient.