OpenMed/multicare-articles huggingface dataset:
Longitudinal Neuropsychological Assessment in Two Elderly Adults With Attention-Deficit/Hyperactivity Disorder: Case Report
Authors: Margarete Klein, Maria Aparecida Silva, Gabriel Okawa Belizario, Cristiana Castanho de Almeida Rocca, Antonio De Padua Serafim, Mario R Louzã
Journal: Front Psychol (2019)
Keywords: attention-deficit/hyperactivity disorder, cognitive decline, elderly, longitudinal evaluation, neuropsychological assessment

The neuropsychological deficits in attention-deficit/hyperactivity disorder (ADHD) may present clinical features similar to mild and/or major neurocognitive disorder and may act as a confounding factor, making it difficult to detect cognitive decline. In this paper, we present the results of longitudinal neuropsychological evaluations in two elderly women with ADHD. Three neuropsychological assessments were performed in two women with ADHD (60 and 77 years old) between 2010 and 2013 at intervals varying from 12 to 15 months. We used structural magnetic resonance imaging to rule out significant abnormalities that could account for cognitive impairment. The results showed two different cognitive profiles with fluctuations in performance over these 2 years, sometimes with improvement and sometimes with decline of some functions such as attention, memory, inhibitory control, and reaction time. To minimize confounding aspects of these fluctuations in clinical practice, we used a longer follow-up with the application of a reliable change index and a minimum of three spaced assessments to provide a more consistent baseline cognitive profile. Our findings did not indicate a consistent cognitive decline, suggesting a less pessimistic perspective about cognitive impairments that could be a prodrome of ADHD-related dementia.
Immune myocarditis related to sintilimab treatment in a patient with advanced lung adenocarcinoma: A case report
Authors: Yunling Lin, Xun Yuan, Lianglong Chen
Journal: Front Cardiovasc Med (2022)
Keywords: pd-1, cardio-oncology, immune-related adverse events, lung adenocarcinoma, myocarditis, sintilimab
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICI) have improved clinical outcomes of patients with advanced lung cancer, but may lead to fatal cardiac injury. We describe a 66-year-old man with advanced lung adenocarcinoma who presented with chest pain and dyspnea 3 weeks after the first dose of sintilimab. The initial electrocardiogram (ECG) demonstrated ST-elevation in leads V5-V9, and a high-sensitivity troponin level was significantly elevated. However, coronary angiography did not reveal any significant stenosis. The patient was successfully treated with methylprednisolone and immunoglobulin. Cardiac MRI was carried out before discharge and late gadolinium enhancement (LGE) was found to be in the mid layer of the septal segment and the subepicardial layer of the inferolateral wall. Due to the high fatality, ICI-related myocarditis requires close surveillance, prompt management and long-term follow-up.
Management of Venous Thromboembolism in Patients with Hereditary Antithrombin Deficiency and Pregnancy: Case Report and Review of the Literature
Authors: Mohammad Refaei, Lydia Xing, Wendy Lim, Mark Crowther, Kochawan Boonyawat
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Background. Hereditary antithrombin deficiency is a thrombogenic disorder associated with a 50-90% lifetime risk of venous thromboembolism (VTE), which is increased during pregnancy and the puerperium in these patients. We present a case of a woman with antithrombin (AT) deficiency who presented with a VTE despite therapeutic low molecular weight heparin (LMWH). Though the pregnancy was deemed unviable, further maternal complications were mitigated through the combined use of therapeutic anticoagulation and plasma-derived antithrombin concentrate infusions to normalize her functional antithrombin levels. Methods. A review of the literature was conducted for studies on prophylaxis and management of VTE in pregnant patients with hereditary AT deficiency. The search involved a number of electronic databases, using combinations of keywords as described in the text. Only English language studies between 1946 and 2015 were included. Conclusion. Antithrombin concentrate is indicated in pregnant women with hereditary AT deficiency who develop VTE despite being on therapeutic dose anticoagulation. Expert opinion suggests AT concentrate should be used concomitantly with therapeutic dose anticoagulation. However, further high-quality studies on the dose and duration of treatment in the postpartum period are required. Use of AT concentrate for prophylaxis is controversial and should be based on individual VTE risk stratification.
Successful rescue therapy with tenofovir in a patient with hepatic decompensation and adefovir resistant HBV mutant
Authors: Vlad Ratziu, Vincent Thibault, Yves Benhamou, Thierry Poynard
Journal: Comp Hepatol (2006)

Background:
Prolonged adefovir therapy exposes to the emergence of adefovir resistant hepatitis B virus mutants. Initial reports of the rtN236T mutation showed preserved sensitivity to lamivudine; however, complex mutations are emerging with reduced susceptibility to lamivudine.
Case presentation:
After 2 years of therapy, a cirrhotic patient developed the rtN236T and rtA181T adefovir resistant mutations. He had been previously treated with lamivudine, developed lamivudine resistance and, despite good compliance, had an incomplete response to adefovir. Adefovir resistance resulted in viral breakthrough with hepatitis flare-up and liver decompensation. Tenofovir had an excellent antiviral effect allowing sustained control of viral replication and reversal of hepatic failure.
Conclusion:
In patients with cirrhosis, adefovir resistance can lead to severe hepatitis. Tenofovir appears to be an effective treatment of adefovir resistant mutants. Incomplete control of viral replication with adefovir requires monitoring for viral resistance and should prompt a change in antiviral treatment.
Squamous cell carcinoma of the external auditory canal: a case report
Authors: Harry Boamah, Glenn Knight, Joseph Taylor, Kevin Palka, Billy Ballard
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

Squamous cell carcinoma of the temporal bone and external auditory canal is a rare tumor with a reported incidence of between 1 to 6 cases per million population per year. Because squamous cell carcinoma of the temporal bone and auditory canal is so rare, developing an adequate tumor staging system and treatment has been difficult. We present a case of squamous cell carcinoma of the external auditory canal in 65-year-old Hispanic female who presented with a 6-month history of right ear pain, 3-month history of serosanguineous right ear drainage, and symptoms of facial paralysis. Due to the extensive spread of her tumor into the middle ear at the time of diagnosis, her tumor was deemed unresectable and she received palliative chemotherapy and radiation therapy and was sent to Alice Hospice and died several weeks later.
Primary hydatid cyst of kidney and ureter with gross hydatiduria: A case report and evaluation of radiological features
Authors: Ritesh Mongha, Shrinivas Narayan, Anup K Kundu
Journal: Indian J Urol (2008)
Keywords: hydatid, hydatiduria, renal
MeSH terms: Case Reports

We report a rare case of echinococcosis, primarily involving the right kidney and ureter, presenting with gross hydatiduria. We also present the salient diagnostic features of renal hydatid.
Bioprosthetic valve thrombosis after transcatheter aortic valve replacement and pulmonary embolism due to heparin-induced thrombocytopenia: a case report
Authors: Loïc Faucher, Benjamin Marchandot, Adrien Carmona, Mickael Ohana, Antonin Trimaille, Olivier Morel
Journal: Front Cardiovasc Med (2023)
Keywords: tavr—transcatheter aortic valve replacement, argatroban, bioprosthetic valve dysfunction, heparin-induced thrombocytopenia, intensive unit care, pulmonary embolism, thrombosis—etiology
MeSH terms: Case Reports

Background:
Bioprosthetic valve thrombosis is a complication of transcatheter aortic valve replacement (TAVR). It is believed to be platelet independent, mainly driven by contact phase activation, and more likely to be targeted by oral anticoagulant (OAC).
Case summary:
We report case of an 86-year-old man with history of TAVR, who presented an early TAVR aortic valve thrombosis occurring in the context of heparin-induced thrombocytopenia (HIT) and pulmonary embolism. The patient rapidly recovered and was discharged 17 days after readmission. OAC by Coumadin was administered for 3 months. Chest tomography after 3 months showed the disappearance of the hypoattenuated leaflet thickening.
Discussion:
Although HIT has been fully described and is known for being a prothrombotic disorder, this is the first case report of aortic valve thrombosis after TAVR due to HIT. HIT is rare but possibly lethal. Diagnosis is based on pre-test probability evaluation with the 4T clinical score and confirmation with laboratory evidence of anti-PF4/heparin complexes and positivity of a functional test. Management of HIT is based on heparin discontinuation, and treatment of thrombotic complication with direct anti-IIa inhibitor or anti-Xa inhibitor. According to our knowledge, this case represents the first report of bioprosthetic valve thrombosis after TAVR due to HIT.
Use of botulinum toxin injections to treat peripheral stimulator induced facial muscle twitching: a case report
Authors: Terrence L Trentman, Jillian A Maloney, Christopher S Wie, Alanna M Rebecca, David M Rosenfeld
Journal: Springerplus (2015)

Background:
Facial pain can be a management challenge. Peripheral nerve/field stimulation may be an effective option for refractory cases, but direct muscle stimulation with facial twitching may result. Botulinum toxin injections have been used for blepharospasm and may be effective when facial stimulation results in unacceptable facial muscle twitching due to peripheral stimulation.
Case presentation:
A 53-year old female suffered with chronic, refractory facial pain and migraines. Her facial pain began after a root canal of a left upper molar. She was trialed and then permanently implanted with a 1 × 8 sub-compact percutaneous stimulator lead, resulting in improved pain control and reduced medication use. However, she experienced blepharospasm whenever the amplitude was above 2.75 A. Therefore, she was treated with botulinum toxin injections into her bilateral cheek, face, temple and occiput. This treatment provided excellent relief of the facial spasms, allowing her to use her stimulator at high amplitudes, and thereby maximizing her pain relief. She received two subsequent treatments of botulinum toxin injections at 5-month intervals with similar results.
Conclusion:
Peripheral nerve/field stimulation is being used for headaches and facial pain. An undesirable side effect of this emerging therapy is direct muscle stimulation. Botulinum toxin injections may be an effective treatment modality when stimulation techniques provide pain relief but also causes muscle twitching.
Oral administration of injectable vitamin K1 in brodifacoum intoxication
Authors: Yen-Jung Chu, Jing-Hua Lin, Dong-Zong Hung
Journal: Biomedicine (Taipei) (2022)
Keywords: brodifacoum, oral administration, rodenticide, vitamin k1
MeSH terms: Case Reports

Brodifacoum is a highly potent and long-acting anticoagulant rodenticide (LAAR). LAAR poisoning possibly leads to long term bleeding problems and needs vitamin K1 treatment for several months. Due to economic concern, tablet preparation of vitamin K1 was not available in most of the countries, including Taiwan. In literature, few reports had pointed out that injectable form of vitamin K could be used orally in patients on anticoagulant therapy with supratherapeutic state. Here, we reported a family with 3 members suffering from brodifacoum poisoning with severe coagulopathy needed to prolong hospitalization for intravenous vitamin K1 therapy, and successfully managed with injectable formula orally for about 5 months. Oral administration of injectable vitamin K1 might be a suitable substitute for intravenous route in long-term treatment for LAAR poisonings.
Large Retroperitoneal Haemorrhage Following Cyst Rupture in a Patient with Autosomal Dominant Polycystic Kidney Disease
Authors: Holly Mabillard, Shalabh Srivastava, Philip Haslam, Maciej Karasek, John A Sayer
Journal: Case Rep Nephrol (2017)
MeSH terms: Case Reports

The complications of autosomal dominant polycystic kidney disease (ADPKD) include cyst rupture and haemorrhage leading to loin pain and frank haematuria. Risk factors include large kidney volume, hypertension, and renal impairment. We present a case of a young male who, following trauma to the kidney, had a life threatening bleed from his polycystic kidney. The case was initially treated with fluid resuscitation and blood transfusion but necessitated radiological embolization of bleeding source to control the blood loss. We review the risk factors and management of cyst haemorrhage in patients with ADPKD. Contact sports should be avoided as cyst rupture can lead to severe life threatening haemorrhage.
Breast-milk substitutes: a new old-threat for breastfeeding policy in developing countries. A case study in a traditionally high breastfeeding country
Authors: Hubert Barennes, Gwenaelle Empis, Thao Duong Quang, Khouanheuan Sengkhamyong, Phonethepa Phasavath, Aina Harimanana, Emercia M Sambany, Paulin N Koffi
Journal: PLoS One (2012)
MeSH terms: Breast Feeding / statistics & numerical data, Milk Substitutes / statistics & numerical data, Research Support, Non-U.S. Gov't, Adult, Developing Countries, Female, Humans, Infant, Laos, Mothers, Social Class, Socioeconomic Factors, Surveys and Questionnaires

Background:
Developing countries with traditionally breastfeeding are now experiencing the increasing pressure of formula milk marketing. This may endanger lives and undermine the efforts of national policies in achieving the objectives of the Millennium Development Goals. We examined the use of, and factors for use, of all available breast-milk substitutes (BMS) in a country with a traditionally high rate of breastfeeding.
Methods:
Randomised multi-stage sampling surveys in 90 villages in 12/17 provinces in Laos.
Participants:
1057 mothers with infants under 24 months of age.
Tools:
50-query questionnaire and a poster of 22 BMS (8 canned or powdered milk; 6 non-dairy; 6 formulas; 2 non-formulas). OUTCOME MEASURES INCLUDED: prevalence of use and age of starting BMS in relation to socio-demographic characteristics and information sources, by univariate and multivariate analyses.
Results:
Of 1057 mothers: 72.5% currently breastfed; 25.4% gave BMS (10.6% infant formula); 19.6% gave BMS before 6 months of age (of them: 83% non-dairy or cereals; mean age: 2.9 months; 95% Confidence interval: 2.6-3.2). One formula and one non-formula product accounted for 85% of BMS. BMS were considered as milk by the majority of mothers. Thai TV was the main source of information on BMS for mothers. Lao Loum mothers (the main ethnic group) living in concrete houses with good sanitary conditions, were more likely than others to use BMS before 6 months (OR: 1.79, (1.15-2.78), p<0.009). Mothers who fed their infants colostrum at birth were less likely to use BMS before 6 months of age (OR: 0.63, (0.41-0.99), p = 0.04). Unemployed mothers living in rural areas were less likely to consider BMS better than breast milk.
Conclusion:
In Laos, mothers with the highest socio-economic status are showing a tendency to give up breastfeeding. Successful educational strategies and advocacy measures should be urgently developed to promote and sustain breastfeeding in developing countries.
Supporting Young Dads' Journeys through Fatherhood
Authors: Jessica Cundy
Journal: Soc Policy Soc (2016)
Keywords: young fathers, children, family support, policy, voluntary sector

While the recent Coalition government committed to some initiatives supporting the role of parents, relationships and the early years, there remains a lack of focus on fathers as a distinct policy area. This is reflected at local government level, as lead professionals for young fathers are rare and data on the number of young fathers in each local area are not routinely collected. Barnardo's was funded by the Department for Education in 2012, as part of the Family Strategic Partnership, to highlight the needs and experiences of young fathers in England, and the joint role of statutory and voluntary services in supporting them (fully reported by Barnardo's in Cundy, 2012). Based on selected case studies drawn from research and a range of practice organisations, this article presents the journeys of five young fathers and their experience of maternity services, children's centres, schools, housing services and the secure estate.
Evans Syndrome Complicated by Intratubular Hemoglobin Cast Nephropathy
Authors: Iván González, Rehan Rais, Joseph P Gaut, Louis P Dehner
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Evans syndrome (ES) is a rare autoimmune disorder whose exact pathophysiology is unknown. It is characterized by the simultaneous or subsequent development of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Intravascular hemolysis, with hemoglobinemia, is known to produce acute kidney injury; however, the development of intratubular hemoglobin casts (hemoglobin cast nephropathy) in the setting of acute hemolysis is uncommon. Likewise, the association of ES and acute renal failure is equally uncommon. We present a case of a 7-year-old girl with ES who developed acute kidney injury in the setting of intravascular hemolysis and had widespread intratubular hemoglobin casts.
Coronary artery ectasia presenting with thrombus embolization and acute myocardial infarction: A case report
Authors: Yongle Li, Chengcheng Wu, Wennan Liu
Journal: Medicine (Baltimore) (2017)
MeSH terms: Coronary Disease / complications, Myocardial Infarction / etiology, Case Reports, Dilatation, Pathologic, Humans, Male, Young Adult

Rationale:
Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. CAE is often associated with the presence of slow coronary flow and may lead to acute myocardial infarction (AMI), even without total occlusion.
Patient concerns and diagnosis:
We report a case of a 24-year-old male patient with CAE suffering from AMI.
Interventions:
Percutaneous coronary intervention with aspiration thrombectomy failed to restore adequate blood flow. Heparin and antiplatelet treatment were provided for pharmacological management, but follow-up angiography 15 days later still revealed a poor result. This patient was ultimately treated with antiplatelet therapy in combination with warfarin treatment.
Outcomes:
Follow-up coronary angiography 15 months later showed a restored normal Thrombolysis In Myocardial Infarction grade (TIMI) 3 flow.
Lessons:
CAE-related infarct is often associated with high-burden thrombus formation. Long-term warfarin in combination with antiplatelet therapy may be a good alternative intervention to decrease thrombus burden and enhance blood flow.
Case report: Leukemia cutis as the first manifestation of chronic neutrophilic leukemia in a 6-year-old girl
Authors: Ya Bin Zhou, Jia Feng Yao, Zi Gang Xu, Rui Hui Wu
Journal: Front Pediatr (2022)
Keywords: csf3r, child, chronic neutrophilic leukemia, leukemia cutis, skin
MeSH terms: Case Reports

Chronic neutrophilic leukemia (CNL) is a rare BCR-ABL negative myeloproliferative neoplasm that usually affects older adults with a poor prognosis. Leukemia cutis is an extramedullary manifestation of leukemia and may be misdiagnosed by dermatologists. Here, we describe a case of CNL in a 6-year-old Chinese girl with leukemia cutis as the first manifestation. Her skin rashes failed to attract the attention of dermatologists in early stages. The diagnosis was confirmed by peripheral smear, bone marrow studies, genomic analysis and skin biopsy.
Morphological and Molecular Characterization of Human Gingival Tissue Overlying Multiple Oral Exostoses
Authors: Luca Francetti, Claudia Dellavia, Stefano Corbella, Nicolò Cavalli, Claudia Moscheni, Elena Canciani, Nicoletta Gagliano
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Gingival and osseous augmentations are reported as hypertrophic or hyperplastic reactions to different factors including chronic traumatisms and surgeries such as free gingival graft (FGG) that induce an abnormal growth of both hard and soft tissues in genetically predisposed subjects. Since an imbalance in collagen turnover plays a key role in the development of gingival overgrowth leading to an accumulation of collagen in gingival connective tissue, in this study we described the histological and molecular features of three oral overgrowths obtained from a 34-year-old woman previously operated for FGG in order to evaluate a possible relationship between exostoses and overgrown tissue. Healthy and overgrown gingiva were analyzed by histological methods, and the expression of genes and proteins involved in collagen synthesis, maturation, and degradation was assessed in cultured fibroblasts obtained from gingival fragments at the molecular level. Our results show that general morphology and collagen content were similar in healthy and overgrown gingivae. However, fibroblasts obtained from the overgrown gingiva revealed an anabolic phenotype characterized by an increased collagen turnover and maturation. These findings indicate that an exostosis could act as a mechanical stimulus stretching the overlying connective tissue and triggering an anabolic phenotype of gingival fibroblasts and suggest to use minimally invasive surgical techniques to avoid traumatizing the periosteal tissues for the eradication of the exostosis with minimal relapses.
ACTH-Independent Cushing's Syndrome Associated with Left Adrenocortical Oncocytoma of Uncertain Malignant Potential
Authors: Giuseppe S Sica, Leandro Siragusa, Bruno Sensi, Vittoria Bellato, Pierangela Floris, Valentina Rovella, Alessandro Mauriello, Monia Di Prete, Rossana Telesca, Valerio Ciavoni, Carmine Cardillo, Nicola Di Daniele, Manfredi Tesauro
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Adrenocortical oncocytomas are rare and mostly nonfunctioning neoplasms. We report the case of a 27-year-old woman diagnosed with an ACTH-independent Cushing's syndrome due to left adrenal oncocytoma. She underwent laparoscopic adrenalectomy. Histopathological examination revealed an oncocytoma of uncertain malignant potential with a low Ki-67 proliferation index, inhibin A positivity, and chromogranin A negativity. Electron micrographs confirmed adrenal oncocytoma cells, characterized by the presence of a large amount of mitochondria. The postoperative course was uneventful, and the patient experienced a progressive regression of Cushing-related symptoms. Periodical follow-ups with MRI and cortisol dosage are required due to the neoplasm's uncertain malignant potential. Considerations on the diagnosis, pathology findings, clinical remarks, and interventions are made.
Differentiating tics from functional (psychogenic) movements with electrophysiological tools
Authors: Felipe Vial, Sanaz Attaripour, Mark Hallett
Journal: Clin Neurophysiol Pract (2019)
Keywords: bereitschaftspotential, functional movement, psychogenic movement, tic
MeSH terms: Case Reports

Objective:
We report on two patients that presented to our clinic with the differential diagnosis of functional movement disorder vs tic disorder.
Case reports:
The first patient is a 23-year-old woman with a 3-year history of repetitive involuntary neck flexion movements. The second patient is a 59-year-old man with a 10-month history of involuntary trunk jerks. In both cases, the polyelectromyographic study and the observation of Bereitschaftspotential helped us in making the final diagnosis.
Significance:
The use of electrophysiological tools can be helpful in making the distinction between functional movement disorders and tic disorders.