OpenMed/multicare-articles huggingface dataset:
Prevention of Periodontal Pocket Formation after Mandibular Third Molar Extraction Using Dentin Autologous Graft: A Split Mouth Case Report
Authors: Alberto De Biase, Giulia Mazzucchi, Dario Di Nardo, Marco Lollobrigida, Giorgio Serafini, Luca Testarelli
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Surgical extraction of the third molar can often result in the development of a periodontal pocket distal to the second molar that could delay the healing, and the socket could be colonized by bacteria and lead to secondary abscesses, or it may cause mobility or hypersensitivity. The aim of this case report is to assess the efficacy of a dentin autograft in the prevention of periodontal dehiscences after the surgical extraction of the third molar, obtained by the immediate grinding of the extracted tooth. A healthy 18-year-old male patient underwent surgery of both impacted mandibular molars: right postextractive socket was filled with grinded dentin; then, the left one was filled with fibrin sponge. The patient was followed up for six months, and clinical and radiographic assessment were performed: measurements of plaque index (PI), bleeding on probing (BOP), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) were done before surgery and repeated at 90 and 180 days after the extractions. Measurements made at six months after the surgery revealed that the grafted site was characterized by a minor depth of the pocket if compared with the nongrafted site, with no clinical/radiographic signs of complications.
Case Report: Diagnosis of Human Alveolar Echinococcosis via Next-Generation Sequencing Analysis
Authors: Ke Li, Yubao Ma, Rui Ban, Qiang Shi
Journal: Front Genet (2021)
Keywords: echinococcus multilocularis, adrenal gland, alveolar echinococcosis, diagnose, next-generation sequencing
MeSH terms: Case Reports

Introduction: Alveolar echinococcosis (AE) is a rare parasitic disease caused by the infection of Echinococcus multilocularis. AE may mimic malignancy both in clinical presentation and radiological imaging, which is often misdiagnosed as metastatic tumor. Recently, next-generation sequencing (NGS) technologies are increasingly being used to address a diverse range of biological questions. Here, we describe a rare case of alveolar echinococcosis diagnosed by pan-pathogen screening, using next-generation sequencing. To the best of our knowledge, this is the first reported case of AE which was definitely diagnosed relying NGS of cerebrospinal fluid (CSF). Case Presentation: A 33-year-old man presented with repeat seizure and progressive headache for six months. Head magnetic resonance imaging (MRI) showed multiple masses with edema. Lung and abdominal computer tomography (CT) revealed multiple masses in bilateral lung, liver and the right adrenal gland. Bacterial, tuberculosis and fungal infection were excluded by CSF examination. Repeated target biopsy on the masses in the lung and liver showed as fibrous connective tissue without positive findings. NGS of CSF was performed and detected nucleic acid sequences of E. multilocularis. Consequently, the patient has accepted 1-year albendazole therapy. His case was followed up through imaging procedures. Conclusion: The next-generation sequencing of CSF is a reliable and sensitive diagnostic method for the detection of pathogenic microorganisms, and may allow the accurate diagnosis of alveolar echinococcosis. In view of this case, we recommend NGS as a potential tool for diagnosis of cerebral AE, especially if repeated biopsies are negative.
Dysbiosis-Associated Polyposis of the Colon-Cap Polyposis
Authors: Kazuki Okamoto, Tomohiro Watanabe, Yoriaki Komeda, Ayana Okamoto, Kosuke Minaga, Ken Kamata, Kentaro Yamao, Mamoru Takenaka, Satoru Hagiwara, Toshiharu Sakurai, Tomonori Tanaka, Hiroki Sakamoto, Kiyoshige Fujimoto, Naoshi Nishida, Masatoshi Kudo
Journal: Front Immunol (2018)
Keywords: antibiotics, cap polyposis, inflammation, intestinal microbiota, next-generation sequencing
MeSH terms: Anti-Bacterial Agents / therapeutic use, Bacteria / drug effects, Colonic Polyps / drug therapy, Dysbiosis / complications, Gastrointestinal Diseases / drug therapy, Gastrointestinal Microbiome / drug effects, Case Reports, Research Support, Non-U.S. Gov't, Ampicillin / therapeutic use, Asymptomatic Diseases, Bacteria / classification, Colon / drug effects, Colon / pathology, Colonic Polyps / microbiology, Dysbiosis / drug therapy, Feces / microbiology, Gastrointestinal Diseases / etiology, High-Throughput Nucleotide Sequencing, Humans, Inflammation, Male, Metronidazole / therapeutic use, Middle Aged, Anti-Bacterial Agents, Metronidazole, Ampicillin

Cap polyposis is a rare gastrointestinal disease characterized by multiple inflammatory polyps located between the distal colon and the rectum. Despite the lack of clarity regarding its pathogenesis, mucosal prolapse, chronic inflammatory responses, and Helicobacter pylori infection are considered key contributors to the development of this disease entity. Although it is now generally accepted that dysbiosis of gut microbiota is associated with intestinal and extra-intestinal diseases, alterations of intestinal microbiota have been poorly defined in cap polyposis. Here, we report a patient with H. pylori-negative cap polyposis who was successfully treated with antibiotics and exhibited dramatic alterations in intestinal microbiota composition after antibiotic treatment. The patient was treated with oral administration of ampicillin and metronidazole and showed regression of cap polyposis 6 months after antibiotic treatment. Fecal microbiota analysis using the next-generation sequencing technology revealed a significant alteration in the intestinal microbiota composition following antibiotic treatment-a marked reduction of Blautia, Dorea, and Sutterella was observed concomitant with a marked increase in Fusobacterium. These data suggest that cap polyposis may originate from dysbiosis and that microbiome-targeted therapy may be useful in this disorder.
Lymphoma and metastatic breast cancer presenting with palpable axillary and inguinal lymphadenopathy in a 40-year-old man with rheumatoid arthritis on anti-tumor necrosis factor α therapy: a case report
Authors: Gourab Datta, Dorendra Maisnam
Journal: J Med Case Rep (2013)

Introduction:
We present the case of a 40-year-old man with severe rheumatoid arthritis being treated with high-dose anti-tumor necrosis factor α therapy (adalimumab), who developed simultaneous lymphoma and breast cancer with lymph node metastases. We describe strategies for investigations and management of this presentation.
Case presentation:
A 40-year-old Caucasian man with severe rheumatoid arthritis being treated with high-dose adalimumab presented to our facility with a swollen leg and palpable left groin and left axillary lumps and a left nipple lesion. Left lower limb ultrasound, computed tomography and positron emission tomography scans showed extensive lymphadenopathy. Core biopsies of the left groin, axilla and nipple lesion showed this to be concurrent diffuse B-cell lymphoma and locally metastatic invasive ductal carcinoma of the breast. He underwent a left mastectomy with axillary clearance, and adjuvant fluorouracil, epirubicin and cyclophosphamide chemotherapy with rituximab, and the adalimumab was stopped.
Conclusions:
The findings from our patient's case should increase awareness that patients with severe rheumatoid arthritis, especially if they are on high-dose biological treatments, have the potential to develop lymphoma, which in turn increases the risk of developing other primary tumors, so that in rare cases a patient may have concurrent tumors. Assessment and management of these patients is challenging and should include computed tomography scans of the of neck, thorax, abdomen and pelvis, including a fludeoxyglucose positron emission tomography/computed tomography scan, bone marrow testing and appropriate core biopsies and discussion at multidisciplinary team meetings about treatment of the separate tumors in the presence of hematologists, oncologists, surgeons and rheumatologists.
A Case of Severe Mitral Valve Regurgitation in a Patient with Leadless Pacemaker
Authors: Srikala R Gumireddy, Minako Katayama, Hari P Chaliki
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

An 85-year-old man with cardiac history notable for atrial fibrillation diagnosed 10 years ago which was being treated with atenolol and warfarin presented to our institution with persistent atrial fibrillation. His echocardiogram showed ejection fraction (EF) of 56%, no regional wall motion abnormalities, mild mitral and pulmonary regurgitation, and trivial tricuspid regurgitation. Despite this treatment, he had recurrent episodes of paroxysmal symptomatic atrial fibrillation with a rapid rate requiring multiple emergency department visits and hospital admissions. Given difficulty to control the rate, he underwent atrioventricular (AV) nodal ablation and leadless pacemaker insertion. Fifteen days after the procedure, he was found to have a severe mitral regurgitation murmur.
Case Report: Next-Generation Sequencing Reveals Tumor Origin in a Female Patient With Brain Metastases
Authors: Qun Li, Xiaoyan Zhang, Jiao Feng, Dezhi Cheng, Lin Cai, Zhang'an Dai, Shuyu Zhao, Jianmin Li, Jingjing Huang, Yu Fang, Honglin Zhu, Danhua Wang, Sizhen Wang, Tonghui Ma, Xianghe Lu
Journal: Front Oncol (2021)
Keywords: ret fusion, tert promoter mutation, anlotinib, next-generation sequencing, tumor origin, undifferential thyroid cancer
MeSH terms: Case Reports

Background:
Brain metastasis mainly originates from lung cancer. Napsin A and TTF-1 factors have frequently been detected in lung adenocarcinoma cases. Brain metastasis tumors with napsin A and TTF-1 positive are easily classified as lung adenocarcinoma origin. However, some thyroid cancers also exhibit these clinical features. Besides, lung is the most common metastasis of undifferential thyroid cancer. Therefore, it requires development of novel diagnostic tools to aid in distinguishing between pulmonary and thyroid origin.
Patient findings:
We reported a case that was initially diagnosed as brain metastatic lung cancer based on immunohistochemistry results. Analysis of next-generation sequencing (NGS) data from the brain lesion revealed that the cancer may have originated from the thyroid. We detected combo mutations in TERT promoter mutation, RET fusion and TP53, which are common in undifferential thyroid cancer (UTC), but rare for lung cancer. These results, coupled with identification of PAX8, indicated that this patient had UTC. Additionally, her three sons, despite being asymptomatic, were all diagnosed with papillary thyroid carcinoma.
Summary:
The patient received anlotinib treatment and showed good clinical outcomes. One month after anlotinib treatment, the pulmonary nodules were found to be controlled, and the thyroid tumor drastically reduced, and tracheal compression relieved. She continued anlotinib treatment for the following two months, but died one month later because the treatment stopped owing to financial reasons. All her sons underwent total thyroidectomy with lymph node dissection.
Conclusions:
Although NGS has been reported to assist in diagnosis of the origin of some tumors, this is the first evidence of NGS for the determination of the origin of thyroid tumors. To our knowledge, this is the first time that a combination of multiple mutations has been used to help determine the origin of a tumor, compared with the previous single mutant gene. Moreover, this is the first evidence on the use of anlotinib for treatment of UTC with distant metastasis. Besides, all three sons of the patient had thyroid carcinoma in subsequent examinations, indicating high-risk for familial non-medullary thyroid cancer in UTC patients and necessity for performing thyroid ultrasound testing in other family members.
Ulcerative colitis complicated by primary sclerosing cholangitis and autoimmune hepatitis overlap syndrome: a case report and literature review
Authors: Xinhe Zhang, Xuyong Lin, Xuedan Li, Lin Guan, Yiling Li, Ningning Wang
Journal: Front Immunol (2023)
Keywords: udca, autoimmune hepatitis, overlap syndrome, primary sclerosing cholangitis, ulcerative colitis
MeSH terms: Cholangitis, Sclerosing / complications, Cholangitis, Sclerosing / diagnosis, Cholangitis, Sclerosing / drug therapy, Colitis, Ulcerative / complications, Colitis, Ulcerative / diagnosis, Colitis, Ulcerative / drug therapy, Connective Tissue Diseases, Hepatitis, Autoimmune / complications, Hepatitis, Autoimmune / diagnosis, Hepatitis, Autoimmune / drug therapy, Liver Diseases / drug therapy, Review, Case Reports, Adult, Humans, Male, Syndrome, Ursodeoxycholic Acid / therapeutic use, Ursodeoxycholic Acid

Primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), and ulcerative colitis (UC) are immune diseases of the digestive system. Some patients develop overlap syndrome, the presentation of two or more of the clinical, biochemical, immunological, and histological features of these conditions simultaneously or sequentially. The incidence of UC in PSC-AIH overlap syndrome is as high as 50%. In contrast, PSC-AIH overlap syndrome is rare in UC patients. However, because it has a low prevalence and has been studied in less detail, PSC is often misdiagnosed as primary biliary cholangitis (PBC) in its early stage. Herein, we reported a case of a 38-year-old male patient who presented to a clinician in 2014 with irregular bowel habits. A colonoscopy suggested UC. In 2016, the patient was found to have abnormal liver function and was diagnosed with PBC by pathology. He was treated with ursodeoxycholic acid (UDCA) but this had no effect on his liver function. Additional liver biopsies in 2018 indicated PBC-AIH overlap syndrome. The patient refused hormone therapy for personal reasons. Following UDCA monotherapy, his liver function remained abnormal. The patient was reexamined after repeated abnormal liver function tests and bowel symptoms. Systematic laboratory testing, imaging diagnosis, colonoscopy, liver biopsy, and various pathological examinations conducted in 2021 were used to diagnose the patient with PSC-AIH-UC overlap syndrome. He was treated with various drugs, including UDCA, methylprednisolone, mycophenolate mofetil, and mesalazine. His liver function improved significantly after treatment and follow-up is ongoing. Our case report highlights the need to raise awareness about rare and difficult-to-diagnose clinical disorders.
The never-ending patient journey of chronically ill patients: A qualitative case study on touchpoints in relation to patient-centered care
Authors: Vera K Maas, Frederik H Dibbets, Vincent J T Peters, Bert R Meijboom, Daniëlle van Bijnen
Journal: PLoS One (2023)
MeSH terms: Patient-Centered Care / methods, Patients, Humans, Qualitative Research

Background:
Healthcare professionals caring for chronically ill patients increasingly want to provide patient-centered care (PCC). By understanding each individual patient journey, they can significantly improve the quality of PCC. A patient journey consists of patient interactions, so-called touchpoints, with healthcare professionals distributed over three periods: pre-service, service, and post-service period. The aim of this study was to ascertain chronically ill patients' needs for digital alternatives for touchpoints. Specifically, we aimed to explore which digital alternatives patients would like to see implemented into their patient journey to help healthcare professionals providing PCC.
Methods:
Eight semi-structured interviews were conducted either face-to-face or via Zoom. Participants were included if they had visited the department of internal medicine and had received treatment for either arteriosclerosis, diabetes, HIV, or kidney failure. The interviews were analyzed utilizing a thematic analysis approach.
Results:
The results suggest that the patient journey of chronically ill patients is a continuous cycle. Furthermore, the results showed that chronically ill patients would like to see digital alternatives for touchpoints implemented into their patient journey. These digital alternatives consisted of video calls, digitally checking in before a physical appointment, digitally self-monitoring one's medical condition and personally uploading monitoring results into the patient portal, and viewing their own medical status in a digital format. Particularly, patients who were familiar with their healthcare professional(s) and were in a stable condition mostly opted for digital alternatives.
Conclusion:
In the cyclical patient journey, digitalization can help put the wishes and needs of the chronically ill patients at the center of care. It is recommended that healthcare professionals implement digital alternatives for touchpoints. Most chronically ill patients consider digital alternatives to lead to more efficient interactions with their healthcare professionals. Furthermore, digital alternatives support patients to be better informed about the progress of their chronical illness.
Congenital partial pericardial defect confirmed based on spontaneous pneumothorax: A case report and literature review
Authors: Naoki Date, Teruya Komatsu, Takuji Fujinaga
Journal: Int J Surg Case Rep (2020)
Keywords: case report, pericardial defect, pneumothorax, video-assisted thoracoscopic surgery
MeSH terms: Case Reports

Introduction:
Congenital pericardial defects are rare but can cause fatal complications. Most cases are asymptomatic and incidentally detected during a thoracic surgery or autopsy. We report a case of a partial pericardial defect confirmed based on spontaneous pneumothorax.
Presentation of case:
A 16-year-old boy with left spontaneous pneumothorax showed pneumopericardium on chest X-ray. Chest computed tomography revealed a partial pericardial defect. Video-assisted thoracoscopic surgery was performed, and a small pericardial defect was confirmed at the level of the upper pulmonary hilum. We did not reconstruct the defect because of the improbability of cardiac herniation.
Discussion:
Pneumopericardium combined with pneumothorax suggests the existence of a pericardial foramen. Partial pericardial defects could cause cardiac herniation or strangulation, and pneumothorax may worsen the protruding of the heart. Video-assisted thoracic surgery is an effective method to prevent the recurrence of pneumothorax and determine whether reconstruction of the defect is required.
Conclusion:
Video-assisted thoracic surgery should be performed in the case of a pericardial defect combined with pneumothorax.
Occipitosacral Fusion for Multiple Vertebral Fractures with Kyphotic Deformity in a Patient with Mutilating Rheumatoid Arthritis: A Case Report
Authors: Tetsu Tanouchi, Takachika Shimizu, Masatake Ino, Naofumi Toda, Nodoka Manabe, Kanako Itoh, Keisuke Fueki
Journal: Surg J (N Y) (2017)
Keywords: kyphosis, osteoporosis, rheumatoid arthritis, thoracolumbar spine, vertebral compression fracture
MeSH terms: Case Reports

Osteoporotic vertebral fractures are well-known complications of rheumatoid arthritis. The management of multiple vertebral fractures with kyphotic deformity is controversial. We present a case of a patient with mutilating rheumatoid arthritis who had multiple vertebral fractures with kyphotic deformity after occipitothoracic fusion for rheumatoid cervical disorder. Occipitosacral fusion was effective to create stable spine with better sagittal alignment in this case, but careful clinical assessment for early detection and management of postoperative insufficient pelvic fracture were required.
A journey without maps-Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru
Authors: Rosie Mayston, Peter Lloyd-Sherlock, Sara Gallardo, Hong Wang, Yueqin Huang, Veronica Montes de Oca, Peter Ezeah, Mariella Guerra, Ana Luisa Sosa, Zhaourui Liu, Richard Uwakwe, Maëlenn M Guerchet, Martin Prince
Journal: PLoS One (2017)
MeSH terms: Caregivers / economics, Caregivers / statistics & numerical data, Costs and Cost Analysis, Aged, Aging, China, Cross-Sectional Studies, Female, Health Services / economics, Housing, Humans, Insurance, Health / economics, Male, Mexico, Nigeria, Pensions / statistics & numerical data, Peru, Rural Population / statistics & numerical data, Socioeconomic Factors, Urban Population / statistics & numerical data

Purpose of the study:
Populations in Latin America, Asia and sub-Saharan Africa are rapidly ageing. The extent to which traditional systems of family support and security can manage the care of increased numbers of older people with chronic health problems is unclear. Our aim was to explore the social and economic effects of caring for an older dependent person, including insight into pathways to economic vulnerability.
Design & methods:
We carried out a series of household case studies across urban and rural sites in Peru, Mexico, China and Nigeria (n = 24), as part of a cross-sectional study, nested within the 10/66 Dementia Research Group cohort. Case studies consisted of in-depth narrative style interviews (n = 60) with multiple family members, including the older dependent person.
Results:
Governments were largely uninvolved in the care and support of older dependent people, leaving families to negotiate a 'journey without maps'. Women were de facto caregivers but the traditional role of female relative as caregiver was beginning to be contested. Household composition was flexible and responsive to changing needs of multiple generations but family finances were stretched.
Implications:
Governments are lagging behind sociodemographic and social change. There is an urgent need for policy frameworks to support and supplement inputs from families. These should include community-based and residential care services, disability benefits and carers allowances. Further enhancement of health insurance schemes and scale-up of social pensions are an important component of bolstering the security of dependent older people and supporting their continued social and economic participation.
Sustainability of food production support services offered by Sustainable Agriculture Trust to subsistence farmers in Bikita District, Zimbabwe
Authors: Norman Chivasa
Journal: Jamba (2019)
Keywords: food production, food security, subsistence farming, sustainability, conventional farming

In developing countries, food production challenges continue to persist, despite interventions at household levels such as input provision to address farmers' resource constraints and training in conservation farming to improve land use and management by farmers. In Bikita District of Zimbabwe, concerns over the viability of conservation farming and input support services in helping out subsistence farmers to mitigate food production challenges remain unresolved. This research, therefore, evaluated the sustainability of support services offered by the Sustainable Agriculture Trust to subsistence farmers taking Ward 13 of Bikita District as a case study. Data collection involved two qualitative methods, namely structured interviews and focus group discussions, with 32 household heads comprising 18 women and 14 men. Results showed that the capacity by subsistence farmers to continue practising conservation farming using retained maize, sorghum and cowpea seed varieties and still produce better yields even after the Sustainable Agriculture Trust's exit justify the hypothesis that conservation farming is a sustainable food production intervention. This study therefore concludes that the proficiency by subsistence farmers in Ward 13 of Bikita District carries the implication that training household heads in conservation farming means developing more subsistence farmers capable of producing their own food even amidst unpredictable rains, heat waves and shortening rainfall seasons.
Keywords:
food production; food security; subsistence farming; sustainability; conventional farming.