OpenMed/multicare-articles huggingface dataset:
Primary Health Care in transitional care of people with stroke
Authors: Adriana Bitencourt Magagnin, Kenia Lara da Silva, Giane Zupellari Dos Santos Melo, Ivonete Teresinha Schulter Buss Heidemann
Journal: Rev Bras Enferm (2024)
MeSH terms: Primary Health Care / standards, Qualitative Research, Stroke / therapy, Transitional Care / standards, Transitional Care / trends, Continuity of Patient Care / standards, Female, Humans, Male, Middle Aged

Objectives:
to understand the role of Primary Health Care teams in caring for people with stroke after hospital discharge.
Methods:
single case study, with integrated units of analysis, with a qualitative approach. Data triangulation occurred through interviews with professionals and family caregivers involved in transition of care, in addition to direct observations in rounds and document analysis. For the analyses, the analytical strategies of theoretical propositions and construction of explanations were used, with the help of ATLAS.ti®.
Results:
the importance of counter-referral, the role of community health workers and the multidisciplinary team, health promotion, secondary prevention, home visits as a visceral attribute and nurses as care managers are evident.
Final considerations:
the high demand on teams and the Social Determinants of Health interfere with adequate continuity of care. Transitional care programs that enable continuity of care are recommended.
Wandering spleen combined with pedicle torsion and splenic infarction: a rare case report and literature review
Authors: Qian Cui, Xiaoyan Xu, Chang Li, Lihao Tang
Journal: Front Pediatr (2024)
Keywords: acute, contrast-enhanced computed tomography, infarction, torsion, wandering spleen
MeSH terms: Case Reports

Wandering spleen (WS) concurrent with splenic pedicle torsion and infarction has been described rarely. We reported our experience in diagnosing and treating such a condition in a 16-year-old girl with acute abdominal pain. A plain CT scan showed the wandering of the spleen from the left upper quadrant. Contrast-enhanced CT indicated dilatation and distortion in the splenic vein, a counterclockwise "whirl sign" in the splenic pedicle, pancreatic tail torsion, and splenic infarction. The patient was diagnosed with WS combined with splenic pedicle torsion and splenic infarction and underwent splenectomy for treatment. She showed a satisfactory outcome during the follow-up. To enhance our understanding of it, we performed a comprehensive literature research to summarize the clinical manifestations, treatment options, and outcomes among adolescent patients.
Metastasis from small cell lung cancer to ovary: A case report
Authors: Benzheng Zhao, Weixin Zhao, Yang Xia, Jian Liu, Yuan Wang, Tianjiao Song, Wenxi Tan, Shuhua Zhao
Journal: Open Life Sci (2023)
Keywords: case report, hypercalcemic type, metastatic ovarian tumor, pulmonary type, small cell cancer
MeSH terms: Case Reports

Small cell lung cancer (SCLC) rarely metastasizes to the ovary, and is difficult to diagnose given its overlapping clinical features and histological characteristics with primary ovarian cancer. Since therapies for SCLC and primary ovarian cancer differ, it is important to determine the original site of ovarian lesions. This report describes the differential diagnosis of metastatic from primary ovarian cancer. A 46-year-old Chinese woman with a history of SCLC, confirmed by transbronchial lung biopsy in August 2018, presented with abdominal distension in December 2018. Ultrasound examination and whole abdomen computed tomography showed one mass in each ovary. A provisional diagnosis of ovarian tumor was given. A palliative total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed; and three postoperative courses of chemotherapies. The patient died from multiple organ failure in May 2019. Metastatic ovarian cancer from SCLC was determined based on characteristic histological and immunohistochemical staining.
Extrapulmonary Tuberculosis Leading to Abdominal Wall Mass in Young Patient
Authors: Mohadeseh Karimi, Ali AtashAbParvar
Journal: Case Rep Infect Dis (2024)
MeSH terms: Case Reports

Background:
Tuberculosis is a bacterial infection that is caused by Mycobacterium tuberculosis. Tuberculosis has arguably been the largest killer of humans historically, and it remains one of the most important infectious causes of death in the world. Tuberculosis can be classified into different forms and it manifests as pulmonary and out pulmonary, respectively, in 85% and 15% of cases. Only a few cases of tuberculosis with abdominal wall involvement have been reported. Case Presentation. Herein, we present a 27-year-old Persian woman, presented with asymmetric abdominal bulging in the right side of the periumbilical area since 6 months before admission that has no pain or secretion. The patient was oriented and not ill or toxic in general appearance. Vital signs were within normal ranges. An abdominal physical examination revealed a mobile, well-bordered, nontender mass 3 × 3 centimeter (cm) in diameter palpated in the right periumbilical area. The patient underwent surgery which revealed a cystic lesion that was carefully resected. In histopathology examination of the specimen resection, tuberculosis was confirmed.
Conclusion:
We report a rare case of extrapulmonary tuberculosis that was identified at the abdominal wall. Due to the high number of cases of TB and the development of extrapulmonary forms that can present in an unusual location as an abdominal wall which are difficult to diagnose, it is very important to keep in mind the differential diagnosis of tuberculosis.
Exercise-induced venous thrombosis of the upper extremity: A case report
Authors: Kathleen Trinh, Antonio M Pessegueiro
Journal: SAGE Open Med Case Rep (2024)
Keywords: paget-schroetter syndrome, deep vein thrombosis, thoracic outlet syndrome
MeSH terms: Case Reports

Paget-Schroetter syndrome, the venous variant of thoracic outlet syndrome, is an uncommon presentation of deep vein thrombosis. In patients with Paget-Schroetter syndrome, the subclavian vein is compressed within the thoracic outlet as a result of repetitive and vigorous arm motions. Repeated endothelial injury leads to stasis in flow and eventual thrombus formation in the subclavian vein and its tributaries. This report highlights the case of an active and otherwise healthy 46-year-old patient who presented with swelling and pain of his right upper extremity after a run and was found to have multiple, effort-induced thrombi involving the right subclavian, axillary, brachial, and basilic veins. The unusual clinical picture of Paget-Schroetter syndrome and its presentation commonly in the demographic of young, healthy individuals make it a diagnosis likely overlooked and unfamiliar to many in the clinical setting.
The sFlt-1/PlGF Ratio Trend Is Useful in Predicting Preeclampsia Severity in Hyperreactio Luteinalis Complicated with Preeclampsia
Authors: Risa Miyatake, Tatsuya Fujii, Keiichi Kumasawa, Mari Ichinose, Masatake Toshimitsu, Seisuke Sayama, Takahiro Seyama, Takayuki Iriyama, Takeshi Nagamatsu, Yutaka Osuga
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Hyperreactio luteinalis (HL) is a rare condition that presents as bilateral ovarian enlargement during pregnancy. Typically, it is thought to be caused by increased production of human chorionic gonadotropin (hCG) associated with gestational trophoblastic diseases or multiple pregnancies. The prognosis is relatively good, with many cases resulting in term birth. However, some obstetric complications, such as preeclampsia (PE) and preterm births, have been reported. We present a serious case of HL with subsequent PE that resulted in preterm delivery at 31 weeks of gestation. The soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio was very high at the onset of PE at 24 weeks of gestation, followed by a modest decline, which then increased in proportion to the exacerbation of symptoms. Since HL cases have also been reported to be associated with PE, repeated measurement of the sFlt-1/PlGF ratio proved useful for better pregnancy management.
Squamous cell carcinoma and Crohn's disease: a sometimes-challenging diagnosis
Authors: Mona Boudabbous, Baha Barkia, Wiem Feki, Héla Gdoura, Lassad Chtourou, Manel Moalla, Leila Mnif, Ali Amouri, Zeinab Mnif, Nabil Tahri
Journal: Future Sci OA (2024)
Keywords: combination therapy, inflammatory bowel disease, squamous cell carcinoma, thiopurines
MeSH terms: Case Reports

Aim: Non-melanoma skin cancers are more common in people with inflammatory bowel disease. However, these tumors can rarely mimic a cutaneous manifestation of the disease, which delays diagnosis and clouds prognosis. Observation: A 35-year-old man with stenosing and fistulizing ileocolic Crohn's disease developed squamous cell carcinoma mimicking a groin fold abscess. After surgical drainage of the abscess, despite antibiotics and therapy combining azathioprine with infliximab, the abscess has recurred. Biopsies revealed a cutaneous squamous cell carcinoma. Palliative radiotherapy-chemotherapy was initiated, but the patient died after 3 months. Conclusion: This observation illustrates the increased risk of non-melanoma skin cancers in inflammatory bowel disease patients, particularly those exposed to thiopurines, and the value of diagnosing them at an early stage.
Bevacizumab-induced immune thrombocytopenia in an ovarian cancer patient with mixed connective tissue disease: case report and literature review
Authors: Yunting Zhang, Fanchun Yang, Jining Wang, Hui Fu, Fuming Shen, Jie Liu, Dongjie Li
Journal: Front Immunol (2024)
Keywords: autoimmune diseases, bevacizumab, case report, drug-induced immune thrombocytopenia, mixed connective tissue disease, ovarian cancer
MeSH terms: Bevacizumab / adverse effects, Mixed Connective Tissue Disease / complications, Mixed Connective Tissue Disease / drug therapy, Mixed Connective Tissue Disease / immunology, Ovarian Neoplasms / complications, Ovarian Neoplasms / drug therapy, Purpura, Thrombocytopenic, Idiopathic / chemically induced, Purpura, Thrombocytopenic, Idiopathic / diagnosis, Purpura, Thrombocytopenic, Idiopathic / drug therapy, Purpura, Thrombocytopenic, Idiopathic / immunology, Case Reports, Review, Antineoplastic Agents, Immunological / adverse effects, Antineoplastic Combined Chemotherapy Protocols / adverse effects, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Female, Humans, Antineoplastic Agents, Immunological, Bevacizumab

Drug-induced immune thrombocytopenia is an adverse reaction marked by accelerated destruction of blood platelets. In cancer therapy, thrombocytopenia has many other causes including bone marrow suppression induced by chemotherapeutic agents, infection, and progression of cancer; drug-induced thrombocytopenia can easily be misdiagnosed or overlooked. Here, we present a case of an ovarian cancer patient with a history of mixed connective tissue disease who underwent surgery followed by treatment with paclitaxel, cisplatin, and bevacizumab. The patient developed acute isolated thrombocytopenia after the sixth cycle. Serum antiplatelet antibody testing revealed antibodies against glycoprotein IIb. After we analyzed the whole therapeutic process of this patient, drug-induced immune thrombocytopenia was assumed, and bevacizumab was conjectured as the most probable drug. Thrombocytopenia was ultimately successfully managed using recombinant human thrombopoietin, prednisone, and recombinant human interleukin-11. We provide a summary of existing literature on immune thrombocytopenia induced by bevacizumab and discuss related mechanisms and triggers for drug-induced immune thrombocytopenia. The present case underscores the potential of bevacizumab to induce immune-mediated thrombocytopenia, emphasizing the need for heightened vigilance towards autoimmune diseases or an autoimmune-activated state as plausible triggers for rare drug-induced immune thrombocytopenia in cancer therapy.
Inferior Vena Cava Thrombosis in a Patient with Factor V Leiden Syndrome Presenting with Scrotal Pain
Authors: Helmy Elhag, Fadl Al-Tairy, Mohammed Shakeeb Dahdaha, Ahmed Shaeshaa, Yavuz Yigit
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

Thrombosis in the inferior vena cava (IVC) is a rare but serious condition that can lead to significant morbidity and mortality. We present a case report of a 39-year-old male who presented to the emergency department with right flank pain that had progressed to severe back pain, bilateral flank pain, scrotal pain, and leg pain over the course of two days. The pain was severe enough to affect his daily activities. Laboratory investigations revealed a D-dimer level of 17 ng/mL, creatinine level of 110 µmol/L, and a white blood cell count of 10 × 109/L with a CRP level of 5 mg/L. Urine analysis was positive for blood. Doppler ultrasound of both legs showed deep vein thrombosis extending from the external iliac veins to the distal veins of both legs. Further investigation with computed tomography of the abdomen revealed a large thrombus in the distal vena cava extending to the renal artery and both external and internal iliac veins. The patient was diagnosed with Factor V Leiden syndrome based on genetic testing, which revealed a heterozygous mutation in the F5 gene. He was successfully treated with low molecular weight heparin and warfarin, and after five days of hospitalization, he was discharged with warfarin for long-term anticoagulation. This case report emphasizes the importance of considering IVC thrombosis in patients with a constellation of symptoms, including scrotal pain, and the role of genetic testing in identifying underlying hypercoagulable states.
Case Report: Right aortic arch with isolation of left brachiocephalic artery and ventricular septal defect
Authors: Gang Wang, Jieqiong Wang, Hongjie Zhang, Hui Wang, Qiang Meng, Linhong Song, Gengxu Zhou
Journal: Front Cardiovasc Med (2024)
Keywords: aortic arch anomaly, congenital heart defect, isolation of left brachiocephalic artery, right aortic arch, subclavian steal syndrome
MeSH terms: Case Reports

Right aortic arch with isolation of left brachiocephalic artery is a rare congenital aortic arch anomaly. Herein, we reported a case of this rare anomaly with ventricular septal defect in a 9-month-old infant. We successfully reconstructed the islolated left brachiocephalic artery and repaired the ventricular septal defect in one stage.
A case of bleeding shock induced by injury of the intercostal artery following percutaneous nephrolithotripsy
Authors: Hiroaki Kakinoki, Yukako Yamaguchi, Minika Yukimoto, Yuka Kakinoki, Kazuma Udo, Shohei Tobu, Go Takeshita, Yoshiaki Egashira, Ken Yamaguchi, Mitsuru Noguchi
Journal: IJU Case Rep (2023)
Keywords: bleeding shock, embolization, intercostal artery, percutaneous nephrolithotripsy
MeSH terms: Case Reports

Introduction:
The risk of postoperative bleeding complications should be concerned to perform percutaneous nephrolithotripsy. Most of the vascular injuries occurred at the peripheral renal artery in the previous reports. We experienced a case of bleeding shock induced by the injury of the intercostal artery in the abdominal wall following percutaneous nephrolithotripsy.
Case presentation:
A 56-year-old woman had been in the bleeding shock status on the 2nd day after percutaneous nephrolithotoripsy. Emergently, contrast-enhanced computed tomography was performed and extravasation of contrast agents was seen in the abdominal wall. Injuries of the intercostal artery were identified in the angiography and controlled by transcatheter arterial embolization.
Conclusion:
The intercostal arteries could be injured in the anterolateral zone of the abdominal wall over the end of the ribs. Contrast-enhanced computed tomography was useful to detect the bleeding point. Transcatheter arterial embolization was an effective and safe method to control bleedings from them.
Infantile orbital abscess caused by methicillin-resistant Staphylococcus aureus: a case report and literature review
Authors: Yanran Qin, Junming Huo, Chengjun Liu, Yueqiang Fu, Jing Li
Journal: Front Pediatr (2023)
Keywords: mrsa, corticosteroids, infant, orbital abscess, vancomycin
MeSH terms: Case Reports

Objective:
To report and review infantile orbital abscess caused by methicillin-resistant Staphylococcus aureus (MRSA).
Methods:
We report a case of MRSA-induced infantile orbital abscess accompanied by sepsis, pneumonia, and purulent meningitis. We systematically review cases of MRSA-induced infantile orbital abscess published in PubMed, Web of Science and ScienceDirect until April 2023.
Results:
We reviewed 14 patients [our patient + 13 patients (10 papers) identified via literature searches]. There were nine boys and five girls; nine neonates and five older infants; and 8 full-term births and 1 preterm birth. The gestational age at birth was unknown for five infants. The right and left orbits were affected in 10 and 4 patients, respectively. The clinical presentation included periorbital soft-tissue edema or redness (11 patients), fever (7 patients), exophthalmos (10 patients), limited eye movement (4 patients), purulent eye secretions (2 patients), and skin abscess and convulsion (1 patient each). The source of infection was sinusitis (8 patients), vertical transmission, gingivitis, dacryocystitis, upper respiratory tract infection (1 patient each), and unknown (2 patients). MRSA was detected in blood (6 patients) or pus culture (8 patients). Vancomycin or linezolid were used for 11 patients; corticosteroids were administered to only 1 patient. Surgical drainage was performed for 13 infants (external drainage, 11 patients; endoscopic drainage, 2 patients). Two patients initially had pulmonary and intracranial infections. Except for one patient with neurological dysfunction at discharge, all other infants had no sequelae or complications.
Conclusion:
Early aggressive anti-infective treatment and timely drainage are essential for managing MRSA-induced infantile orbital abscess.
Individualized neoantigen peptide immunization of a metastatic pancreatic cancer patient: a case report of combined tumor and liquid biopsy
Authors: Tim Roehnisch, Mari Carmen Martos-Contreras, Mehdi Manoochehri, Mauro Nogueira, Franziska Bremm, Jan Dörrie, Jan Christoph, Meik Kunz, Wolfgang Schönharting
Journal: Front Immunol (2024)
Keywords: case report, immunotherapy, neoantigen, pancreatic ductal adenocarcinoma, peptide immunization
MeSH terms: Antigens, Neoplasm / immunology, Pancreatic Neoplasms / immunology, Pancreatic Neoplasms / pathology, Pancreatic Neoplasms / therapy, Precision Medicine, Case Reports, Biomarkers, Tumor, Cancer Vaccines / administration & dosage, Cancer Vaccines / immunology, Cancer Vaccines / therapeutic use, Female, Humans, Immunization, Liquid Biopsy / methods, Liver Neoplasms / immunology, Liver Neoplasms / secondary, Liver Neoplasms / therapy, Male, Middle Aged, Peptides / administration & dosage, Peptides / immunology, Vaccines, Subunit / administration & dosage, Antigens, Neoplasm, Cancer Vaccines, Peptides, Vaccines, Subunit, Biomarkers, Tumor

This report details a case of pancreatic cancer with liver metastasis that exhibited a positive immune response to personalized immunization therapy. Our study involved the identification of neoantigens and their corresponding immunogenic peptides using an in-house bioinformatic pipeline. This process included the identification of somatic mutations through DNA/RNA sequencing of solid tumor tissue and blood liquid biopsy. Computational prediction techniques were then employed to identify novel epitopes, followed by the design and manufacture of patient-specific immunization peptides. In combination with standard-of-care chemotherapy, the patient received a sequence of 5 biweekly prime injections followed by 2 boost injections 2 and 5 months later. The peptides were emulsified in Montanide and the injection-site was conditioned with nivolumab and imiquimod. The combined regimen of peptide immunization and chemotherapy resulted in a notable decline in CA19-9 tumor marker levels following both prime and boost applications. Subsequent MRI assessments revealed a reduction in the size of liver metastases several months post-immunization initiation. Importantly, the patient showed and improved overall survival and reported an improved quality of life without experiencing significant treatment-related adverse effects. This case underscores the potential benefits of personalized peptide-based immunization as an adjunctive therapy in the treatment of advanced pancreatic cancer, showcasing promising outcomes in tumor marker reduction, tumor shrinkage, and enhanced patient well-being.
Changes in Corticospinal Tract Consistency after Dry Needling in a Stroke Patient
Authors: Masoome Ebrahimzadeh, Noureddin Nakhostin Ansari, Iraj Abdollahi, Behnam Akhbari, Jan Dommerholt
Journal: Case Rep Neurol Med (2024)
MeSH terms: Case Reports

Background:
Dry needling (DN) is a technique employed to mitigate spasticity and enhance functionality in stroke patients. We report the impact of DN on both corticospinal tract (CST) consistency and wrist flexors spasticity of an individual affected by stroke.
Case:
The participant was a 57-year-old male who had experienced an ischemic stroke 9 months prior. The primary outcome measures included fractional anisotropy (FA), asymmetry FA (aFA), ratio FA (rFA), and Modified Modified Ashworth Scale (MMAS). Additionally, secondary outcomes encompassed wrist extension range of motion (ROM) and performance in the box and block test (BBT). These measurements were taken both before and after the administration of DN treatment.
Results:
After the application of DN, the mean FA of the ipsilesional CST increased from 0.35 to 0.39, concomitantly with a decline in aFA from 0.18 to 0.13. Notably, the rFA exhibited a pre-DN value of 0.69, which subsequently rose to 0.76 post-DN. Moreover, a significant reduction in MMAS scores was detected, from a score of "3" prior to DN application to a post-DN score of "1". In terms of wrist mobility, both active and passive extension ROM exhibited favorable improvements, with an increase of 12° for active extension and 16° for passive extension. Furthermore, there was a substantial improvement in the BBT score, an indicator of manual dexterity, ascending from 12 to 24.
Conclusion:
Enhancements in CST consistency suggest it as a potential mechanism contributing to the observed improvements following DN in this stroke case.
Anti-HMGCR myopathy mimicking facioscapulohumeral muscular dystrophy
Authors: Andreas Albert Braun, Monika Atiya, Katja Göhner, Tibor Hortobagyi, Tobias Burkhardt, Bettina Schreiner
Journal: Open Med (Wars) (2024)
Keywords: fshd, anti-hmg-coa reductase antibodies, case report, facioscapulohumeral muscular dystrophy, immune-mediated necrotizing myopathy
MeSH terms: Case Reports

Introduction:
Statin use can lead to various muscle-related issues, including benign creatine kinase (CK) elevations, myalgias, toxic myopathies, rhabdomyolysis, and immune-mediated necrotizing myositis (IMNM), which primarily affects older males. IMNM presents with proximal muscle weakness, elevated CK levels, and specific antibodies.
Case presentation:
We describe a 72-year-old patient with muscle weakness persisting for over 3 years after statin therapy. Initially suspected to have a genetic disorder, further testing revealed elevated anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) antibodies, indicating immune-mediated myopathy. Despite the absence of inflammatory changes on biopsy, the patient responded positively to immune therapy.
Conclusion:
This case highlights challenges in diagnosing immune-mediated myopathy, especially in older patients with atypical presentations. Testing for HMGCR antibodies can aid in diagnosis, particularly when inflammatory markers are absent. Awareness of red flags, such as delayed symptom onset and response to prednisone, is crucial for accurate diagnosis and management.