OpenMed/multicare-articles huggingface dataset:
Primary Pure Squamous Cell Carcinoma of the Duodenum: A Case Report
Authors: Tadashi Terada
Journal: Gastroenterology Res (2010)
Keywords: duodenum, histopathology, squamous cell carcinoma
MeSH terms: Case Reports

Only two cases of squamous cell carcinoma of the duodenum have been reported in the literature. The author herein reports a case of squamous cell carcinoma of the duodenum. A 75-year-old man was admitted to our hospital because of nausea, vomiting, and weakness. An endoscopic examination revealed a duodenal tumor. The tumor was circumferential elevated one with duodenal obstruction, and located in the descending part near and distal to the ampulla of Vater. Imaging modalities also detected the duodenal tumor, but did not show tumors of other locations including the pancreas. The duodenal tumor was different from ampullary tumor and pancreatic tumor. Six biopsies were obtained from the duodenal tumor. All the six biopsies showed malignant cells arranged in a medullary pattern. The malignant cells showed hyperchromatic nuclei, and mitotic figures were scattered. Keratinization and intercellular bridges were recognized. The pathologic features were interpreted as a squamous cell carcinoma of the duodenum. The carcinoma was pure squamous cell carcinoma without differentiation into adenocarcinoma or endocrine carcinoma. Operation was not possible because of the patient's age and weakness. The patient was treated by chemotherapy and radiation, but he showed a downhill course. Metastases emerged, and he died of systemic metastasis 17 months after the first presentation. Autopsy was not performed.
Lipomatous lesions around the shoulder: Recent experience in a Nigerian hospital
Authors: Ganiyu A, Rahman, Adekunle Y Abdulkadir, I F Yusuf
Journal: Int J Shoulder Surg (2009)
Keywords: lipoma, shoulder functions, shoulder joint
MeSH terms: Case Reports

We present four cases of shoulder lipomas in two females and two males in their fourth to fifth decades of life. All four lipomas were big. Three were subcutaneous and one was intermuscular. None of them were associated with any functional limitation of the affected shoulder. Subcutaneous or intermuscular lipomas around the shoulder do not appear to affect shoulder functions. Complete surgical excision is rewarding and was achieved under local anesthesia in all our patients with no incidence of recurrence.
Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data
Authors: J S Vieira, E M Brandão-Filho, F R Deliberador, J C Zielak, A F Giovanini, T M Deliberador
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14), the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.
Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder
Authors: Madhu Chhanda Mohanty, Manisha Ranjan Madkaikar, Mukesh Desai, Jahnavi Aluri, Swapnil Yashwant Varose, Prasad Taur, Deepa Kailash Sharma, Uma Prajwal Nalavade, Sneha Vijay Rane, Maya Gupta, Snehal Shabarish, Aparna Dalvi, Jagadish Mohanrao Deshpande
Journal: Front Immunol (2019)
Keywords: inflammatory cytokines, leaky scid, oral polio vaccine, primary immunodeficiency disorder, severe combined immune-deficiency, vaccine-derived polioviruses
MeSH terms: Poliovirus Vaccine, Oral / adverse effects, Primary Immunodeficiency Diseases / diagnosis, Primary Immunodeficiency Diseases / etiology, Case Reports, Research Support, Non-U.S. Gov't, Age Factors, Antibodies, Neutralizing / blood, Antibodies, Neutralizing / immunology, Antibodies, Viral / blood, Antibodies, Viral / immunology, B-Lymphocytes / immunology, B-Lymphocytes / metabolism, Child, Preschool, Cytokines / blood, Humans, Immunoglobulins / blood, Male, Poliovirus / genetics, Poliovirus / immunology, Poliovirus Vaccine, Oral / immunology, Primary Immunodeficiency Diseases / blood, Primary Immunodeficiency Diseases / therapy, Serologic Tests, Symptom Assessment, T-Lymphocytes / immunology, T-Lymphocytes / metabolism, Vaccination / adverse effects, Antibodies, Neutralizing, Antibodies, Viral, Cytokines, Immunoglobulins, Poliovirus Vaccine, Oral

The emergence of immunodeficiency-associated vaccine-derived polioviruses (iVDPV) from children with primary immunodeficiency disorders poses a threat to the eradication program. Herein, we report a patient with severe combined immunodeficiency (SCID), identified as a prolonged serotype 3 iVDPV (iVDPV3) excreter with 13 VDPV3 isolates and a maximum of 10.33% nucleotide divergence, who abruptly cleared infection after a period of 2 years. Occurrence of an episode of norovirus diarrhea associated with increased activated oligoclonal cytotoxic T cells, inverse CD4:CD8 ratio, significantly elevated pro-inflammatory cytokines, and subsequent clearance of the poliovirus suggests a possible link between inflammatory diarrheal illness and clearance of iVDPV. Our findings suggest that in the absence of B cells and sufficiently activated T/NK cells, macrophages and other T cells may produce auto-inflammatory conditions by TLR/RLR ligands expressed by previous/ongoing bacterial or viral infections to clear VDPV infection. The study highlights the need to screen all the patients with combined immunodeficiency for poliovirus excretion and intermittent follow-up of their immune parameters if found positive, in order to manage the risk of iVDPV excretion in the polio eradication endgame strategy.
Improving Criminal Responsibility Determinations Using Structured Professional Judgment
Authors: Marvin W Acklin, Joseph P Velasquez
Journal: Front Psychol (2021)
Keywords: actuarial prediction, criminal responsibility, forensic assessment, methamphetamine psychosis, structured professional judgment

Forensic psychologists commonly utilize unstructured clinical judgment in aggregating clinical and forensic information in forming opinions. Unstructured clinical judgment is prone to evaluator bias and suboptimal levels of inter-rater reliability. This article proposes Structured Professional Judgment (SPJ) methods as a potential remedy. Following a review of canonical forensic assessment models, the prevalence of bias in forensic judgments, and inter-rater agreement in criminal responsibility (CR) determinations, this article presents a SPJ model for CR evaluations translated from violence risk assessment methodology. A systematic user-friendly methodology is described, applying procedural checklists, application of a mental state at time of the offense (MSO) model using structured data collection methods, aggregation of empirical evidence guidelines, and post-hoc hypothesis testing using the Analysis of Competing Hypotheses (ACH). A case study describes application of the procedural and CR decision model in a complex homicide case. The model demonstrates the power and efficacy of the application of SPJ to forensic decision-making and is relevant to other types of forensic assessment (e.g., competency to stand trial, post-acquittal release decision-making).
Spontaneous iliac vein rupture showed by femoral contrast bolus: A case report
Authors: Alexander A J Grüter, Sytse F Oudkerk
Journal: Radiol Case Rep (2022)
Keywords: ct venography, ct, computed tomography, case report, endovascular repair, femoral contrast bolus, sivr, spontaneous iliac vein rupture, spontaneous iliac vein rupture
MeSH terms: Case Reports

Introduction: Spontaneous iliac vein rupture (SIVR) is an uncommon disease with less than sixty cases reported before. This disease often requires surgical intervention. SIVR has never been imaged in the literature. This report shows how to image this diagnosis. Case report: A 71-year-old female was diagnosed with SIVR with the use of CT venography. Endovascular repair with 2 endografts and a sinus XL stent was performed. Postoperatively, the patient developed abdominal compartment syndrome and a large part of the intestines had to be removed because of ischemia. Discussion: This is the first report that shows SIVR before and after endovascular treatment with the use of CT venography by injecting a contrast bolus in the femoral vein. This information is of high interest for a broad range of clinicians to show or exclude a venous abdominal bleeding in an early stage.
Hyperbaric oxygen therapy for digital ulcers due to Raynaud's disease
Authors: Tomoya Sato, Kiyohito Arai, Shigeru Ichioka
Journal: Case Reports Plast Surg Hand Surg (2018)
Keywords: addiction, alcohol, knowledge, media, qualitative interviews, trust
MeSH terms: Case Reports

We present a case of Raynaud's disease with digital ulcers that was successfully treated with hyperbaric oxygen therapy. Hyperbaric oxygen therapy can be considered as a safe and useful adjunct treatment for intractable digital ulcers in patients with Raynaud's disease.
Effects of the Attention Training Technique on Auditory Hallucinations in Schizo-Affective Disorder: A Single Case Study
Authors: Karin E P Carter, Adrian Wells
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

A 41-year-old female with schizo-affective disorder presenting with an eight-year history of auditory hallucinations participated in a single case treatment study (A-B-A-B-A-C-B) of the effects of the Attention Training Technique (ATT). No antipsychotic medication was prescribed in this case following a serious adverse reaction in the past. The aim of the study was to test the impact of ATT on the frequency and duration of hallucinations using a repeated return to baseline followed by an alternating treatment design. The alternative intervention consisted of autogenic relaxation instructions. The patient monitored the frequency, duration, and her distress over the voices on a daily basis during baseline and intervention phases across a study period of 80 weeks. Visual analysis of the data showed that ATT when introduced at three phases following baselines or control conditions was associated with a reduction in auditory hallucination frequency and duration compared to the other phases. This contrasted with the autogenic relaxation intervention that was associated with an increase in duration and frequency of voices. The perceived benefits of ATT were maintained for varying periods of time.
A Potential Novel Treatment for Chronic Cough in Long COVID Patients: Clearance of Epipharyngeal Residual SARS-CoV-2 Spike RNA by Epipharyngeal Abrasive Therapy
Authors: Kensuke Nishi, Shohei Yoshimoto, Takayuki Tanaka, Shoichi Kimura, Yudai Shinchi, Takafumi Yamano
Journal: Cureus (2023)
Keywords: chronic cough, chronic epipharyngitis, epipharyngeal abrasive therapy, il-6, long covid, sars-cov-2 spike rna, tnf-α
MeSH terms: Case Reports

A major target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the epipharyngeal mucosa. Epipharyngeal abrasive therapy (EAT) is a Japanese treatment for chronic epipharyngitis. EAT is a treatment for chronic epipharyngitis in Japan that involves applying zinc chloride as an anti-inflammatory agent to the epipharyngeal mucosa. Here, we present a case of a 21-year-old man with chronic coughing that persisted for four months after a diagnosis of mild coronavirus disease 2019 (COVID-19), who was treated by EAT. We diagnosed chronic epipharyngitis as the cause of the chronic cough after the SARS-CoV-2 infection. SARS-CoV-2 spike RNA had persisted in the epipharyngeal mucosa of this Long COVID patient. EAT was performed once a week for three months, which eliminated residual SARS-CoV-2 RNA and reduced epipharyngeal inflammation. Moreover, a reduction in the expression of proinflammatory cytokines was found by histopathological examination. We speculate that the virus was excreted with the drainage induced by EAT, which stopped the secretion of proinflammatory cytokines. This case study suggests that EAT is a useful treatment for chronic epipharyngitis involving long COVID.
Nodular regenerative hyperplasia and portal hypertension in a patient with coeliac disease
Authors: Erwin Biecker, Hans-Peter Fischer, Michael Schepke
Journal: Case Rep Gastrointest Med (2011)
MeSH terms: Case Reports

Nodular regenerative hyperplasia (NRH) of the liver is often associated with rheumatologic or lymphoproliferative disorders and a cause of portal hypertension in some patients. We report the case of a 71-year-old patient with celiac disease and unexplained portal hypertension. Biopsy of the liver revealed NRH as the underlying cause. The patient did not suffer from an autoimmune, rheumatologic or lymphoproliferative disease. A thrombophilic disorder that might cause NRH was ruled out. Celiac disease is often associated with mild elevation of liver enzymes and steatosis of the liver, but the association with NRH was described in only a few patients. We discuss the possible relationship of celiac disease and NRH.
Homozygous delta-beta Thalassemia in a Child: a Rare Cause of Elevated Fetal Hemoglobin
Authors: S Verma, M Bhargava, Sk Mittal, R Gupta
Journal: Iran J Ped Hematol Oncol (2013)
Keywords: chromatography, delta-beta thalassemia, high pressure liquid, homozygote
MeSH terms: Case Reports

Background:
Delta beta (δβ) thalassemia is an unusual variant of thalassemia with elevated level of fetal hemoglobin (HbF). Homozygous patients of this disorder, unlike β-thalassemia, show mild anemia. Only few cases of δβ-thalassemia have been reported from India in the available indexed English literature.
Case presentation:
A four-year old male child was evaluated for recent-onset jaundice. Hematological investigations showed mild anemia with microcytic hypochromic red cells. A comprehensive analysis of hemoglobin by high-performance liquid chromatography (HPLC) showed complete absence of HbA and HbA2 with HbF constituting 100% of the hemoglobin. Hemoglobin analysis of both parents showed elevated level of HbF with normal HbA2. A final diagnosis of δβ-thalassemia in the child with both parents being carriers was rendered.
Conclusion:
Delta beta-thalassemia is an uncommon cause of markedly elevated fetal hemoglobin beyond fetal period. Clinical and haematological parameters should be evaluated to render an accurate diagnosis.
Spinal Accessory Nerve Duplication: A Case Report and Literature Review
Authors: Eleni Papagianni, Panagiota Kosmidou, Sotiria Fergadaki, Athanasios Pallantzas, Panagiotis Skandalakis, Dimitrios Filippou
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Aim of the present study is to expand our knowledge of the anatomy of the 11th cranial nerve and discuss the clinical importance and literature pertaining to accessory nerve duplication. We present one case of duplicated spinal accessory nerve in a patient undergoing neck dissection for oral cavity cancer. The literature review confirms the extremely rare diagnosis of a duplicated accessory nerve. Its clinical implication is of great importance. From this finding, a further extension to our knowledge of the existing anatomy is proposed.
A Modular Adjustable Transhumeral Prosthetic Socket for Evaluating Myoelectric Control
Authors: Ben W Hallworth, James A Austin, Heather E Williams, Mayank Rehani, Ahmed W Shehata, Jacqueline S Hebert
Journal: IEEE J Transl Eng Health Med (2020)
Keywords: electromyography (emg), additive manufacturing, linear discriminant analysis, pattern recognition, prosthetics

Novel myoelectric control strategies may yield more robust, capable prostheses which improve quality of life for those affected by upper-limb loss; however, the development and translation of such strategies from an experimental setting towards daily use by persons with limb loss is a slow and costly process. Since prosthesis functionality is highly dependent on the physical interface between the user's prosthetic socket and residual limb, assessment of such controllers under realistic (noisy) environmental conditions, integrated into prosthetic sockets, and with participants with amputation is essential for obtaining representative results. Unfortunately, this step is particularly difficult as participant- and control strategy-specific prosthetic sockets must be custom-designed and manufactured. There is thus a need for a system to reduce these burdens and facilitate this crucial phase of the development pipeline. This study aims to address this gap through the design and assessment of an inexpensive and easy-to-use 3D-printed Modular-Adjustable transhumeral Prosthetic Socket (MAPS). This 3D-printed, open-source socket was developed in consultation with prosthetists and compared with a participant-specific suction socket in a single-participant case-study. We conducted mechanical and functional assessments to ensure that the developed socket enabled similar performance compared to participant-specific sockets. Both socket systems yielded similar results in mechanical and functional assessments, as well as in self-reported user feedback. The MAPS system shows promise as a research tool which catalyzes the development and deployment of novel myoelectric control strategies by better-enabling comprehensive assessment involving participants with amputations.
Two cases of possible transmitted drug-resistant HIV: likely HIV superinfection and unmasking of pre-existing resistance
Authors: Fabiola Martin, John Lee, Emma Thomson, Nick Tarrant, Antony Hale, Charles J Lacey
Journal: Int J STD AIDS (2016)
Keywords: aids, hiv, transmitted drug resistance, antiviral, dual infection, hepatitis c, high-risk behaviour, highly active antiretroviral therapy, minority species, superinfection, syphilis (treponema pallidum), viral disease
MeSH terms: Anti-HIV Agents / therapeutic use, Drug Resistance, Viral / genetics, HIV Infections / drug therapy, HIV-1 / drug effects, Superinfection / complications, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antiretroviral Therapy, Highly Active, Coinfection / drug therapy, Coinfection / virology, Genotype, Homosexuality, Male, Humans, Male, RNA, Viral / analysis, Superinfection / drug therapy, Treatment Outcome, Viral Load / drug effects, Anti-HIV Agents, RNA, Viral

In the UK, patients undergo HIV viral load and genotype testing before they are prescribed antiretroviral therapy. The genotype test guides clinicians in prescribing antiretroviral therapy with maximum efficacy against the patient's specific viral strain. HIV viral load escape under antiretroviral drug therapy, to which the virus was thought to be genotypically susceptible, is commonly observed in patients with poor adherence. We observed early viral escapes in two-newly diagnosed patients, during antiretroviral treatment, with different sequences compared to their original viral resistance test and who reported excellent adherence to and tolerance of their therapy. HIV superinfection with a new viral strain was identified in a patient with multiple risk factors and co-infections with sexually transmitted infections. The second patient was a case of the emergence of primary resistant virus under drug pressure. Both suppressed their virus promptly after treatment switch.
Paradoxical markers of conscious levels: Effects of propofol on patients in disorders of consciousness
Authors: Charlotte Maschke, Catherine Duclos, Stefanie Blain-Moraes
Journal: Front Hum Neurosci (2022)
Keywords: anesthesia, complexity, disorders of consciousness, electroencephalography, functional connectivity

Human consciousness is widely understood to be underpinned by rich and diverse functional networks, whose breakdown results in unconsciousness. Candidate neural correlates of anesthetic-induced unconsciousness include: (1) disrupted frontoparietal functional connectivity; (2) disrupted brain network hubs; and (3) reduced spatiotemporal complexity. However, emerging counterexamples have revealed that these markers may appear outside of the state they are associated with, challenging both their inclusion as markers of conscious level, and the theories of consciousness that rely on their evidence. In this study, we present a case series of three individuals in disorders of consciousness (DOC) who exhibit paradoxical brain responses to exposure to anesthesia. High-density electroencephalographic data were recorded from three patients with unresponsive wakefulness syndrome (UWS) while they underwent a protocol of propofol anesthesia with a targeted effect site concentration of 2 μg/ml. Network hubs and directionality of functional connectivity in the alpha frequency band (8-13 Hz), were estimated using the weighted phase lag index (wPLI) and directed phase lag index (dPLI). The spatiotemporal signal complexity was estimated using three types of Lempel-Ziv complexity (LZC). Our results illustrate that exposure to propofol anesthesia can paradoxically result in: (1) increased frontoparietal feedback-dominant connectivity; (2) posterior network hubs; and (3) increased spatiotemporal complexity. The case examples presented in this paper challenge the role of functional connectivity and spatiotemporal complexity in theories of consciousness and for the clinical evaluation of levels of human consciousness.
Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan
Authors: Elizabeth G Zolper, Alan H Kim, Kevin G Kim, Paige K Dekker, Jenna C Bekeny, David H Song, Kenneth L Fan
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

Sugammadex hypersensitivity is an uncommon event that typically occurs at higher doses. We report a case of suspected sugammadex hypersensitivity in a patient who developed hypoxia and bronchospasm following three administrations of the standard 2 mg/kg doses of sugammadex within 26 hours due to flap takebacks. Hypersensitivity to sugammadex was not initially suspected given that the patient had previous exposures. Diagnoses of pneumothorax, hemothorax, mucus plug, and tracheal tube malposition were immediately ruled out. Furthermore, the onset of hypoxia with sudden loss of tidal volume, development of high peak airway pressures, and temporal correlation with sugammadex administration all supported bronchospasm secondary to a hypersensitivity reaction. Sugammadex is a useful agent for neuromuscular blockade reversal; however, it is critical to carefully examine all adverse reactions. This case report highlights the importance of considering hypersensitivity reactions in the setting of repeat sugammadex administrations in a limited timeframe, such as in free flap reconstruction requiring multiple takebacks to the operating room in the setting of flap compromise.