OpenMed/multicare-articles huggingface dataset:
Chronic Lymphocytic Leukemia as an Unusual Cause of Rapid Airway Compromise
Authors: Adrian R Bersabe, Joshua T Romain, Erin E Ezzell, John S Renshaw
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Chronic Lymphocytic Leukemia (CLL) is the most prevalent form of non-Hodgkin's lymphoma (NHL) in Western countries predominantly affecting adults over the age of 65. CLL is commonly indolent in nature but can present locally and aggressively at extranodal sites. Although CLL may commonly present with cervical lymphadenopathy, manifestation in nonlymphoid regions of the head and neck is not well described. CLL causing upper airway obstruction is even more uncommon. We describe a case of a patient with known history of CLL and stable lymphocytosis that developed an enlarging lymphoid base of tongue (BOT) mass resulting in rapid airway compromise.
HIV testing and linkage to services for youth
Authors: Ann E Kurth, Michelle A Lally, Augustine T Choko, Irene W Inwani, J Dennis Fortenberry
Journal: J Int AIDS Soc (2015)
Keywords: hiv continuum of care, hiv testing, adolescents, development, key populations, youth
MeSH terms: HIV Infections / diagnosis, Adolescent, Adult, Child, Female, HIV Infections / prevention & control, Health Services, Humans, Kenya, Male, Young Adult

Introduction:
HIV testing is the portal to serostatus knowledge that can empower linkage to care for HIV treatment and HIV prevention. However, young people's access to HIV testing is uneven worldwide. The objective of this paper is to review the context and concerns faced by youth around HIV testing in low- as well as high-income country settings.
Discussion:
HIV testing is a critical entry point for primary and secondary prevention as well as care and treatment for young people including key populations of vulnerable youth. We provide a framework for thinking about the role of testing in the continuum of prevention and care for young people. Brief case study examples from Kenya and the US illustrate some of the common barriers and issues involved for young people.
Conclusions:
Young people worldwide need more routine access to HIV testing services that effectively address the developmental, socio-political and other issues faced by young women and men.
Spectrum of HIV-associated infectious diseases: A case series through the eyes of the histopathologist
Authors: Reena Mohanlal, Denasha L Reddy
Journal: South Afr J HIV Med (2020)
Keywords: hiv, diagnosis, histology, infectious diseases, opportunistic infections

Background:
Human immunodeficiency virus (HIV) infection increases the risk of infection by a host of other opportunistic pathogens. The clinical presentations of these co-infections in immunocompromised patients are often atypical; therefore diagnosis is delayed in the absence of investigations such as tissue biopsy. Infection may involve sites that are difficult to access for biopsy and, as a consequence, there is limited diagnostic tissue available for analysis. The histopathologist, aided by ancillary tests, is relied upon to make a timeous and accurate diagnosis.
Objectives:
To illustrate key histological features of HIV-associated infectious diseases encountered in a histopathology laboratory and to highlight, with the aid of literature, the relevance of histopathology in diagnosis.
Method:
A retrospective descriptive case series of biopsies histologically diagnosed with HIV-associated infectious diseases over four years (2015-2019) was performed at the Chris Hani Baragwanath Academic Hospital National Health Laboratory Services Histopathology department. These cases have been photographed to illustrate microscopic aspects and will be accompanied by a literature review of opportunistic infections in the context of HIV infection.
Results:
This article highlights aspects of fungal, parasitic, viral and selected bacterial infections of people living with HIV for whom the histopathological examination of tissue was an essential component of the clinical diagnosis. Histological features are noted on routine slides and accompanied by diagnostic features revealed with histochemical and immunohistochemical stains.
Conclusion:
Medical practitioners working in areas of high HIV endemicity should be familiar with the variety of infectious diseases that are encountered and with the diagnostic importance of the histopathologist in clinical management.
Adapting Metacognitive Therapy to Children with Generalised Anxiety Disorder: Suggestions for a Manual
Authors: Barbara Hoff Esbjørn, Nicoline Normann, Marie Louise Reinholdt-Dunne
Journal: J Contemp Psychother (2015)
Keywords: children, disorder-specific treatment, generalised anxiety disorder, metacognitive therapy

The metacognitive model and therapy has proven to be a promising theory and intervention for emotional disorders in adults. The model has also received empirical support in normal and clinical child samples. The purpose of the present study was to adapt metacognitive therapy to children (MCT-c) with generalised anxiety disorder (GAD) and create suggestions for an adapted manual. The adaptation was based on the structure and techniques used in MCT for adults with GAD. However, the developmental limitations of children were taken into account. For instance, therapy was aided with worksheets, practical exercises and delivered in a group format. Overall, the intervention relied heavily on practising MCT techniques in vivo with therapist assistance. A detailed description of how the manual was adapted for this age group is given, and examples from a group of four children are presented in a case series. Findings indicate that the adapted version of the metacognitive techniques and manual for children is feasible.
Abdominal cocoon secondary to meconium peritonitis in a neonate: a case report
Authors: Safwan Ahmad, Kanchan Kayastha, Sana Javed, Arsalan Wasti
Journal: J Neonatal Surg (2013)
Keywords: abdominal cocoon, meconium peritonitis, neonatal intestinal obstruction
MeSH terms: Case Reports

Abdominal cocoon is a complete or partial encasement of intestines and rarely viscera by a fibrocollagenous sac which is usually formed by a nonspecific chronic inflammatory reaction. We report a case of abdominal cocoon in a 2-day-old neonate presenting with intestinal obstruction.
Utility of serum immunoglobulin A antibody against glycopeptidolipid core antigen in the diagnosis and management of hypersensitivity pneumonitis associated with Mycobacterium avium complex: A case report
Authors: Yuta Mori, Harunori Nakashima, Takashi Funasaka, Sho Hori, Michiko Kagajo, Takashi Abe, Morihide Ando, Joe Shindoh
Journal: Respir Med Case Rep (2022)
Keywords: bal, bronchoalveolar lavage, crp, c-reactive protein, dlco, diffusing capacity of the lung for carbon monoxide, elisa, enzyme-linked immunosorbent assay, enzyme-linked immunosorbent assay, fvc, forced vital capacity, gpl, glycopeptidolipid, hp, hypersensitivity pneumonitis, hrct, high-resolution computed tomography, hot-tub lung, hypersensitivity pneumonitis, mac, mycobacterium avium complex, mycobacterium avium complex, pao2, partial pressure of oxygen, wbc, white blood cell
MeSH terms: Case Reports

Measurement of the levels of serum immunoglobulin A antibody against glycopeptidolipid (GPL) core antigen, a cell surface antigen found in Mycobacterium avium complex (MAC), has been reported to be useful in the diagnosis and management of pulmonary MAC infection. However, evidence on its utility in hypersensitivity pneumonitis (HP) associated with MAC (i.e., "hot-tub lung") is limited. We herein report a case of HP associated with MAC in which the GPL core antibody levels were serially measured from diagnosis to treatment and thereafter. A 61-year-old man was suspected to have non-fibrotic HP based on the clinical course, laboratory findings, imaging pattern, bronchoalveolar lavage (BAL) lymphocytosis, and histopathological findings. Based on the history of whirlpool bath use, inhalation of aerosolized MAC was suspected as the cause of HP. The GPL core antibody level, measured using an enzyme-linked immunosorbent assay kit, was elevated, suggesting an immunological sensitization to MAC. A provocation test using the patient's whirlpool bath was positive. An identical MAC strain was isolated from the BAL fluid and bathtub. Accordingly, the patient was diagnosed with HP caused by the inhalation of aerosolized MAC from the whirlpool bath. The patient recovered after steroid treatment and discontinuation of the whirlpool bath. The GPL core antibody levels decreased with disease improvement. In conclusion, GPL core antibody levels could be elevated in HP associated with MAC and decrease with disease improvement. Thus, measurement of the GPL core antibody level may be useful for the diagnosis and management of HP associated with MAC.
Palliative Radiotherapy for Disfiguring Mycosis Fungoides Lesion: A Key Treatment to Reduce Psychological and Social Impact
Authors: Axel Egal, Caroline Ram-Wolf, Laurent Quero, Martine Bagot, Marie-Dominique Vignon-Pennamen, Christophe Hennequin, Basma M'Barek
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Mycosis Fungoides (MF) is a rare disease with a relatively good prognosis at early stage. However, skin lesions can impair quality of life due to extensive skin lesions. In some cases, skin lesions, and especially those of the face, become visible and change the physical appearance of the patients. This aspect can deeply affect patients psychologically and can impact their social life. Here, we report the case of a patient with multiple lesions including a disfiguring lesion arising from the nose. The extent of his skin lesions gave a palliative intent to his treatment project. The patient underwent several lines of chemotherapy and immunotherapy with poor results. He was then referred to our radiotherapy and received localized radiotherapy. Lesions disappeared completely within a few weeks. The patient reported a psychological relief. This case highlights the fact that radiotherapy can be done in a "palliative" intent in order to improve esthetic aspects of lesions that can dramatically impact the psychosocial side of patient's life. Clinicians can consider radiotherapy as treatment of some MF lesions as far as they impair the patient's comfort from a psychological and social point of view.
Streptococcus milleri and Recurrent Intra-Abdominal Abscesses: A Case Report and Literature Review
Authors: Tabitha M Gana, Olugbenga Awolaran, Sobia Akhtar
Journal: Case Rep Surg (2016)

We report a case of recurrent intra-abdominal abscesses as a postoperative complication following diverticular perforation in which Streptococcus milleri (SM) was isolated. SM is evaluated here as a potent pyogenic organism commonly associated with intra-abdominal abscess especially in the postoperative setting. With the commonly adopted conservative management, the challenges of recurrence and prolonged hospital stay experienced in the indexed case as well as many other previous reports are highlighted. We also present a recommendation of the need for a more intensive approach of SM-related abscess drainage along with areas that would benefit further research.
Squamous Cell Carcinoma Originating from a Crohn's Enterocutaneous Fistula
Authors: Bogdan Protyniak, Travis Shutt, Russell Farmer
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Purpose. Squamous cell carcinoma (SCC) developing within fistulae and chronic wounds in patients with Crohn's disease is a rare phenomenon with few reported studies in the literature. Clinical suspicion for SCC in Crohn's disease patients with chronic painful fistulae is low, leading to delayed diagnosis and treatment. We present a patient with long-standing Crohn's disease complicated by malignant degeneration of an enterocutaneous fistula tract. Methods. Workup with MRI, CT, and fistulogram revealed a 7 × 3 cm fistulous connection between a loop of small intestine and the patient's perineum. Biopsies of the fistula tract confirmed the diagnosis of SCC. Results. The patient underwent an abdominoperineal resection with positive margins and is currently awaiting radiation therapy. Conclusions. This is the second case reported within the English literature of SCC arising from an enterocutaneous fistula in the setting of Crohn's disease. Based on the findings in this case report and others presented in the literature, a high degree of suspicion of malignancy should be present in patients with chronic painful, poor-healing fistulae, especially in the absence of infection.
A series of patients with purging type anorexia nervosa who do "tube vomiting"
Authors: Takeshi Horie, Saki Harashima, Ryo Yoneda, Maiko Hiraide, Shuji Inada, Makoto Otani, Kazuhiro Yoshiuchi
Journal: Biopsychosoc Med (2016)
Keywords: anorexia nervosa, purging, tube vomiting
MeSH terms: Case Reports

Background:
It is important for clinicians to assess their patients' purging behavior. Various methods of purging, such as self-induced vomiting are well-known. Because patients do not always report their purging behavior, knowing the clinical signs that indicate the behavior is useful. However, we have experienced patients who did not have the reported physical signs of self-induced vomiting because they used hoses instead of their fingers to purge their stomach contents, which they call "tube vomiting". No other previous studies have reported the use of hoses as a purging tool.
Case presentation:
We present as our main case a 20-year-old Japanese woman with anorexia nervosa who engaged in "tube vomiting." Although she recovered well under medical treatment in our hospital, she began to lose weight and blood potassium soon after discharge. We found that she used a garden hose instead of her fingers to perform self-induced vomiting,. She inserted the hose into her stomach and evacuated the stomach contents through it, without pain. She learned this technique through a blog about eating disorders. We also present two other similar cases. In fact, many patients discuss "tube vomiting" on the internet.
Conclusion:
Our experience suggests that a sudden decrease in the weight and blood potassium level could indicate "tube vomiting". In addition, because many information resources are available on the internet, medical practitioners should be aware of these sites.
Unilateral optic disc edema in a paediatric patient: diagnostic dilemmas and management
Authors: Evgenia Kanonidou, Irini Chatziralli, Christina Kanonidou, Maria Parava, Nikolas Ziakas
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Introduction. We report a case of unilateral optic disc edema in a paediatric patient and discuss the concerns involved in diagnosis and management of similar cases. Materials and Methods. Female aged 10 years was referred to our clinic due to progressive visual loss of the LE over a few days. Her visual acuities (VA) were RE 10/10, LE 3/10, and she had a relative afferent pupillary defect and decreased colour vision in her LE and normal and painless eye movements. Fundoscopy showed a remarkably swollen disc of the LE, and visual field (VF) examination revealed enlargement of the blind spot and presence of horizontal inferior papillomacular scotoma. Neurological examination, CT of brain and orbits and blood tests were normal. Visual evoked potentials revealed an obstacle in the myelin substance before the optic chiasma of the LE. Results. The patient was treated with intravenous methylprednoslone for 3 days and with oral methylprednizole for 15 days in progressively diminished daily doses. This led to gradual improvement of VA, colour vision, and visual field and resolution of optic disc oedema. Discussion. Concerns that have to be taken into account regarding diagnosis and management of similar cases are related to lumbar puncture indications, treatment with corticosteroids, and appropriate followup.
Multidisciplinary Approach to Cover an Apex-Exposed Tooth: A Case Report after 6-Year Follow-Up
Authors: Jamila Kissa, Wafa El Kholti, Khadija Sekak, Sihame Chemlali
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Introduction:
The prognosis for a successful treatment of gingival recessions (GRs) is one of the main criteria for deciding whether or not and how to perform root coverage surgery. The defect-related factors are the most important to predict root coverage outcomes. Thus, severe GR could make the root coverage (RC) challenging especially in cases with advanced interdental clinical attachment loss (ICAL).
Case presentation:
This case report demonstrates a challenging management of a deep localized Miller Class III GR with root apex exposure associated with ICAL. After initial therapy, the treatment had consisted of a multidisciplinary approach involving endodontic treatment, periodontal plastic surgery including a laterally positioned flap, and orthodontic treatment. The 6-year follow-up showed improvement in clinical outcomes (recession reduction (RR) and keratinized tissue (KT) augmentation) and a higher patient satisfaction.
Conclusions:
This case report demonstrates the role of the multidisciplinary approach in the management of deep GRs associated with ICAL. A rational choice of the RC technique was critical to achieve good clinical outcomes.
Glaucomatocyclitic Crises May Occur in Patients with Narrow or Closed Angles
Authors: Pei-Kang Liu, Han-Yi Tseng, Min-Yu Huang, Kwou-Yeung Wu
Journal: J Ophthalmol (2017)

Purpose:
To report cases of glaucomatocyclitic crises and discuss the possibility of occurrence in patients with narrow or closed angles.
Background:
The prevalence of angle closure is much higher among Asians than among the Western population. Currently, there is no evidence for a direct relationship between the etiology and angle structure.
Design:
A retrospective and observational case series.
Methods:
We retrospectively collected data from nine adult patients (three males and six females) who were diagnosed with a glaucomatocyclitic crisis and a shallow anterior chamber over a 21-year period, from 1995 to 2016, at the Kaohsiung Medical University Hospital. A narrow angle was defined as a grade less than the Shaffer system grade II. Ophthalmic examinations, including anterior segment biomicroscopy, direct ophthalmoscopy, intraocular pressure measurements, anterior chamber reaction, visual field tests, and the grade of the anterior chamber angle according to the Shaffer system, were reviewed.
Results:
These patients experienced at least one typical unilateral ocular hypertensive episode that fulfilled the criteria of a glaucomatocyclitic crisis without the angle feature. All patients had gonioscopically narrow or closed angles with or without peripheral anterior synechiae.
Conclusions:
The coexistence of narrow or closed angles and a glaucomatocyclitic crisis is possible, especially in patients of Asian descent. In patients with shallow anterior chambers, a glaucomatocyclitic crisis may be a cause of acute glaucoma episodes.
Adult Primary Spinal Epidural Extraosseous Ewing's Sarcoma: A Case Report and Review of the Literature
Authors: Mark Bustoros, Cheddhi Thomas, Joshua Frenster, Aram S Modrek, N Sumru Bayin, Matija Snuderl, Gerald Rosen, Peter B Schiff, Dimitris G Placantonakis
Journal: Case Rep Neurol Med (2016)

Background. Extraosseous Ewing's sarcoma in the spinal epidural space is a rare malignancy, especially in adults. Case Presentation. A 40-year-old male presented with back pain and urinary hesitancy. MRI revealed a thoracic extradural mass with no osseous involvement. He underwent surgery for gross total resection of the mass, which was diagnosed as Ewing's sarcoma. He was subsequently treated with chemoradiotherapy. He remains disease-free 1 year after surgery. Review of the literature indicated only 45 previously reported cases of spinal epidural extraosseous Ewing's sarcoma in adults. Conclusions. Extraosseous Ewing's sarcoma in the spinal epidural space is a rare clinical entity that should be included in the differential for spinal epidural masses. Its treatment is multidisciplinary but frequently requires surgical intervention due to compressive neurologic symptoms. Gross total resection appears to correlate with improved outcomes.
Case Report: Unable to Jump Like a Kangaroo Due to Myositis Ossificans Circumscripta
Authors: Enrice I Huenerfauth, Viktor Molnár, Marco Rosati, Malgorzata Ciurkiewicz, Franz J Söbbeler, Oliver Harms, Robert Hildebrandt, Wolfgang Baumgärtner, Andrea Tipold, Holger A Volk, Jasmin Nessler
Journal: Front Vet Sci (2022)
Keywords: calcification, lameness, macropod, myopathy, traumatic
MeSH terms: Case Reports

A male 10-year-old captive red kangaroo (Macropus rufus) was presented with a chronic progressive pelvic limb lameness and reluctance to jump. The general examination revealed a palpable induration of the lumbar epaxial muscles. Magnetic resonance imaging performed under general anesthesia revealed bilateral almost symmetric, well-circumscribed mass lesions in superficial erector spinae muscles. The lesions had irregular to multilobulated appearance with hyper-, hypo-, and isointense areas in T2- and T1-weighted (w) sequences without contrast enhancement. On computed tomography, a peripheral rim of mineralization was apparent. Histopathological analysis of a muscle biopsy showed osseous trabeculae with rare clusters of chondrocytes indicating metaplasia of muscle tissue to bone. No indications of inflammation or malignancy were visible. The clinical, histopathological, and imaging workup of this case was consistent with myositis ossificans circumscripta. This disorder is particularly well-known among human professional athletes such as basketball players, where excessive, chronic-repetitive force or blunt trauma causes microtrauma to the musculature. Metaplasia of muscle tissue due to abnormal regeneration processes causes heterotopic ossification. The kangaroo's clinical signs improved with cyto-reductive surgery, cage rest, weight reduction, and meloxicam without further relapse.
Seronegative Coeliac Disease in Children: A Case Report and Review of the Literature
Authors: Vinod Kolimarala, Ekta Vasita, Hany Banoub, Sonny K F Chong
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Serology is frequently used for the diagnosis of coeliac disease in children; however, a small proportion of children are seronegative. We present a case of seronegative coeliac disease along with literature review to include diagnostic and management dilemmas.
Phantom Sensations Following Brachial Plexus Nerve Block: A Case Report
Authors: Hannah G Russell, Jack W Tsao
Journal: Front Neurol (2018)
Keywords: amputation, brachial plexus anesthesia, brachial plexus injury, cortical remapping, cortical reorganization, frozen limb, phantom limb pain, phantom limb sensation
MeSH terms: Case Reports

Following the administration of brachial plexus anesthesia for right thumb carpometacarpal arthroplasty with ligament reconstruction, a 54-year-old woman with all limbs intact developed phantom limb sensations, including the misperception of the placement of her right arm and frozen limb sensations in her fingers. Immobility of her fingers in a stacked position was experienced for ~3.5 days after surgery, and she described her phantom sensations as the hand experiencing "tingling" and feeling "heavy." While the onset of these phantom sensations occurred almost immediately after administration of brachial plexus anesthesia, they lasted for ~69 h after anesthesia wear off, suggesting that cortical effects from denervation resolves much more slowly than initial remapping, giving insight into the mechanisms behind phantom limb sensations that are often experienced by amputees.