OpenMed/multicare-articles huggingface dataset:
Prefabricated Zirconia Crowns and Preformed Metal Crowns in the Treatment of Severely Childhood Caries and Anterior Crossbite in a Child with Autistic Spectrum Disorder
Authors: Shuman Deng, Qi Gao, Li Zhang, Jing Xie, Ying Chen, Xuezhen Peng
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Crowns have been recommended to treat decayed teeth and rebuild teeth function. The dental management of children with autism is a tremendous challenge for pediatric dentists due to the impaired behaviors and communication disorders. In this context, a 5-year-old boy with autism was treated to solve carious lesions under the assistance of general anesthesia. The posterior occlusal function was restored, and the crossbite existing in the primary anterior teeth was approached merely by NuSmile® zirconia crowns (ZCs) rather than orthodontic intervention. We conducted an 18-month period. Throughout the long-term follow-up, the boy's masticatory efficiency was remarkably improved and the anterior teeth had transferred into the correct position with adequate overbite to maintain the new relationship, thus ameliorating the appearance of tissue on the labial surface and enhancing his quality of life and oral health.
Renal Embolism Associated with Foramen Ovale Coexisting Acute Pulmonary Embolism
Authors: Yanling He, Yi Xiao, Yanping Chen, Zhidong Li
Journal: Case Rep Pulmonol (2023)
MeSH terms: Case Reports

We report a singular case of renal embolism in a hitherto healthy 46-year-old female. The patient initially presented with symptoms of exertional distress and chest discomfort. Following an extensive diagnostic workup, she was subsequently diagnosed with acute pulmonary embolism. On the day succeeding her admission, the patient manifested sustained abdominal discomfort. Abdominal computed tomography angiography (CTA) subsequently revealed the presence of renal artery embolisms and infarctions. Concurrently, an echocardiographic evaluation disclosed a patent foramen ovale (PFO) and pulmonary hypertension. In this specific case, we hypothesize that the embolic event traversed through the PFO, ultimately localizing in the renal artery and culminating in renal embolism.
Case report: Scapulohumeral arthrodesis in a reindeer
Authors: Kimery L Hankins, Shannon K Reed, Keila K Ida, Jeffrey P Watkins, Sarah A White
Journal: Front Vet Sci (2023)
Keywords: arthrodesis, locking compression plate™, reindeer, scapulohumeral joint, subluxation
MeSH terms: Case Reports

This case report describes the anesthetic, surgical, and postoperative management of scapulohumeral arthrodesis in a juvenile reindeer with severe lameness due to a chronic proximal humeral fracture and scapulohumeral luxation. The reindeer was managed with prolonged stall confinement and physical therapy and 9 months postoperatively was walking and bearing weight equally when standing. This case demonstrates that comparative techniques from other veterinary species coupled with considerations for reindeer anesthesia can be successful in restoring functional soundness after scapulohumeral arthrodesis.
Case report: Rapid clinical improvement in acute exacerbation of MuSK-MG with efgartigimod
Authors: Geke Zhu, Yongbo Ma, Han Zhou, Xiangtao Nie, Wenjing Qi, Lei Hao, Xiuming Guo
Journal: Front Immunol (2024)
Keywords: musk, efgartigimod, exacerbation, lymphoplasmapheresis, myasthenia gravis
MeSH terms: Myasthenia Gravis / drug therapy, Receptors, Cholinergic / immunology, Case Reports, Aged, Autoantibodies / blood, Autoantibodies / immunology, Female, Humans, Male, Receptor Protein-Tyrosine Kinases / antagonists & inhibitors, Receptor Protein-Tyrosine Kinases / immunology, Treatment Outcome, Receptors, Cholinergic, MUSK protein, human, Receptor Protein-Tyrosine Kinases, Autoantibodies

Myasthenia gravis with positive MuSK antibody often involves the bulbar muscles and is usually refractory to acetylcholinesterase inhibitors. For MuSK-MG patients who experience acute exacerbations and do not respond to conventional treatments, there is an urgent need to find more suitable treatment options. With the advent of biologic agents, efgartigimod has shown promising results in the treatment of MG. We report a 65-year-old MuSK-MG patient who presented with impaired eye movements initially, and the symptoms rapidly worsened within a week, affecting the limbs and neck muscles, and had difficulties in chewing and swallowing. Lymphoplasmapheresis did not achieve satisfactory results, but after a cycle of efgartigimod treatment, the patient's symptoms gradually improved and remained in a good clinical state for several months.
Immune-related intestinal pseudo-obstruction caused by immune checkpoint inhibitors: case report
Authors: Yimeng Qian, Zheng Zhi, Jing Ai, Lin Kang, Gang Qiu, Xin Huang, Jing Zhao
Journal: Front Oncol (2024)
Keywords: adverse effects, bloating, constipation, immune checkpoint inhibitor, immune-related pseudo-obstruction
MeSH terms: Case Reports

Intestinal obstruction, a rare manifestation of immunotherapy-related gastrointestinal adverse events, can be severe and even life-threatening with intestinal perforation. We present a 64-year-old man with HCC and currently under the therapy with Pembrolizumab, who was admitted in our hospital with abdominal distension. Radiologic findings were consistent with small bowel ileus. After conservative treatment, the patient underwent colonoscopy where no cause of ileus was discovered. The patient received high-dose prednisone due to the side effects of immune checkpoint inhibitor therapy. This resulted in a gradual improvement of symptoms.
Case report: Interstitial implantation radiotherapy combined with immunotherapy and GM-CSF in oligometastatic platinum-resistant ovarian cancer
Authors: Yi Qin, Shangke Huang, Junli Tang, Yu Fan, Xiangyu Deng, Ping Guan, Zhenhua Zhang, Qinglian Wen, Dan Li
Journal: Front Immunol (2024)
Keywords: gm-csf, prag therapy, case report, immunotherapy, interstitial implantation radiotherapy, platinum-resistant ovarian cancer
MeSH terms: Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use, Ovarian Neoplasms / pathology, Ovarian Neoplasms / therapy, Case Reports, Bevacizumab / therapeutic use, Female, Humans, Immunotherapy, Prognosis, Granulocyte-Macrophage Colony-Stimulating Factor, Bevacizumab

Background:
Treatment for platinum-resistant ovarian cancer is challenging. Currently, platinum-resistant ovarian cancer is typically treated with non-platinum single-agent chemotherapy ± bevacizumab, but the prognosis is often extremely poor. In the treatment of platinum-resistant ovarian cancer patients, reports of triple therapy with interstitial implantation radiotherapy combined with immunotherapy and granulocyte-macrophage colony-stimulating factor (GM-CSF) (PRaG for short) are relatively rare.
Case description:
Here, we report a patient with oligometastatic platinum-resistant ovarian cancer. The patient achieved partial response (PR) of the lesion and sustained benefit for more than six months after receiving interstitial implantation radiotherapy combined with immunotherapy along with GM-CSF.
Conclusion:
This triple therapy may provide additional options for these patients.
Discovery of metastases in thyroid cancer and "benign metastasizing goiter": a historical note
Authors: Sergiy Kushchayev, Yevgeniya Kushchayeva, Tetiana Glushko, Iryna Pestun, Oleg Teytelboym
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: cancer, goiter, history, malignancies, metastases, thyroid
MeSH terms: Goiter / history, Goiter / pathology, Thyroid Neoplasms / history, Thyroid Neoplasms / pathology, Historical Article, Review, History, 18th Century, History, 19th Century, History, 20th Century, Humans, Neoplasm Metastasis

At the beginning of the eighteenth century, most physicians recognized cancer as an aggressive process that gradually spreads, leading to cachexia and death. Thyroid malignancies had long been underestimated because the majority of the population of West Europe suffered from diffuse goiters that masked malignant processes in the neck. Moreover, the life expectancy at that time was very low (about 37-40 years), so the majority of people died of other causes before metastatic thyroid cancer could develop and manifest. Nevertheless, in 1817, French dermatologist Jean Louis Alibert described the first case of a malignant tumor involving the thyroid gland. From the 1820s the number of case reports describing thyroid cancer increased. Even though Jean Claude Recamier described metastases in 1829, secondary lesions on various organs in patients with thyroid malignancies were not themselves considered malignant until 1876.
The multiple faces of autoimmune Addison's disease in children
Authors: Donatella Capalbo, Andrea Esposito, Valeria Gaeta, Paola Lorello, Sara Vasaturo, Raffaella Di Mase, Mariacarolina Salerno
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: adrenal crises, autoimmune addison’s disease, autoimmune polyendocrine syndromes, pediatric age, primary adrenal insufficiency
MeSH terms: Addison Disease / diagnosis, Addison Disease / epidemiology, Addison Disease / immunology, Autoimmune Diseases / diagnosis, Autoimmune Diseases / epidemiology, Autoimmune Diseases / immunology, Review, Adrenal Hyperplasia, Congenital / diagnosis, Adrenal Hyperplasia, Congenital / epidemiology, Autoimmunity, Child, Humans

Primary adrenal insufficiency (PAI) is a rare medical condition, characterized by a deficiency in adrenal hormones. Although rare, PAI is a life-threatening disease requiring prompt recognition and treatment. However, symptoms of PAI are often non-specific and diagnosis can be challenging, causing frequent diagnostic delays. In adults, autoimmunity is the most common cause of PAI in industrialized countries, whereas in children, the most frequent etiology is represented by congenital defects of steroidogenesis and, in particular, by congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. A few recent case series from different countries have reported that autoimmunity is the second most common etiology of PAI in the pediatric age group. However, data on autoimmune PAI in children are still scant and the exact epidemiology, clinical manifestations, and long-term outcomes of this condition have yet to be defined. The scope of this review is to summarize the current knowledge on the etiology, presentation, and treatment of autoimmune PAI in childhood and to increase physicians' awareness of the signs that should raise an early suspicion of this condition.
High-grade transformation of a polymorphous adenocarcinoma of the salivary gland: a case report and review of the literature
Authors: Giacomo Miserocchi, Massimo Bassi, Giovanni De Luca, Sebastiano Calpona, Francesco De Rosa, Alberto Bongiovanni, Elisabetta Parisi, Giandomenico Di Menna, Alessandro De Vita, Chiara Liverani, Chiara Spadazzi, Claudia Cocchi, Silvia Vanni, Laura Capelli, Massimo Magnani, Giuseppe Meccariello, Claudio Vicini, Angelo Campobassi, Laura Mercatali, Toni Ibrahim
Journal: Front Oncol (2023)
Keywords: gene expression profiling, high-grade transformation, minor salivary gland, oral floor, polymorphous adenocarcinoma
MeSH terms: Case Reports

Background:
Polymorphous adenocarcinoma (PAC) represents the second most widespread neoplasm of the minor salivary glands. These tumors rarely develop a histological progression from low-grade to high-grade malignancy, named "high-grade transformation" (HGT). Only nine cases are described in literature.
Case description:
Here, we describe the case of a 76-year-old male patient with a PAC recurrence of the oral floor displaying HGT, and we explore the tumor cytomorphological features, genomic profiling, and the patient's clinical management. The tumor mass was characterized by poorly atypical cellular elements with vesicular nuclei and comedonecrosis foci. The growth pattern was predominantly solid, tubular, and cribriform. The lesion did not show microsatellite instability or targeted molecular alterations. The case was successfully treated with radical surgery followed by radiotherapy.
Conclusion:
We report for the first time the recurrence of a PAC with HGT arising in the oral floor after 20 years from the primary lesion. These preliminary data and the literature analysis enhance the knowledge of this extremely rare disease.
Approaching "highly sensitive person" as a cultural concept of distress: a case-study using the cultural formulation interview in patients with bipolar disorder
Authors: Michael Ioannou, Sofia Olsson, Ane Bakken Wold, Marzia Dellepiane, Steinn Steingrímsson
Journal: Front Psychiatry (2023)
Keywords: dsm-5, bipolar disorder, cultural concept of distress, cultural formulation interview, cultural psychiatry, highly sensitive person

Background:
Psychiatric patients may refer to concepts neither medically accepted nor easily understood to describe their experiences when seeking medical care. These concepts may lie outside the clinician's cultural references and consequently hinder the diagnostic consultation. In the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the clinical instrument Cultural Formulation Interview (CFI) was included. The CFI aims to facilitate the gathering and synthesis of culturally relevant clinical information. The notion of Cultural Concepts of Distress (CCD) was also introduced in DSM-5. The CCD include the subterms of the cultural syndrome, cultural explanation, and cultural idiom of distress. No previous study has used CFI for conceptualizing a cultural notion as a CCD. This study aimed to approach the cultural notion of being a highly sensitive person (HSP) in patients with bipolar disorder (BD) by applying the CFI. The cultural notion of HSP has garnered great interest globally, although scientific evidence is limited. No direct correlation between BD and HSP was hypothesized before or during the study process.
Methods:
In this case study, three patients with BD who reported being HSP were interviewed using the CFI. Furthermore, the applicability of the CCD was examined based on the outcomes of the CFI using an interpretive approach.
Results:
All three patients reported that the CFI facilitated the clinical consultation, and in one of the cases, it may also have increased the treatment engagement. Based on the synthesis of the CFI outcomes in these illustrative cases, HSP could be understood as a cultural syndrome, a cultural explanation, and a cultural idiom of distress.
Conclusion:
By applying a person-centered perspective, CFI was used for the conceptualization of a cultural notion as a CCD (i.e., HSP in our study). Moreover, the cases highlight the complexity of illness insight in BD as a medical phenomenon when patients' illness perspectives are taken into consideration. Future studies need to further examine the clinical relevance of the CFI in the management of BD.
Combination of a bronchogenic cyst in the thoracic spinal canal with chronic myelocytic leukemia
Authors: Hao Zhang, Hai-Feng Li, Hai-Feng Duan, Ke-Feng Huang, Zhi-Hua Tian
Journal: Open Life Sci (2023)
Keywords: bronchogenic cyst, case report, chronic myelocytic leukemia, intramedullary, surgical resection
MeSH terms: Case Reports

The presented case report describes an incredibly rare instance of an intramedullary bronchial cyst located in the thoracic spinal canal on the dorsal side of the spinal cord, which was observed in a patient with chronic myelogenous leukemia. A 29-year-old man presented with back pain for half a month, along with numbness and pain below the chest and ribs for 1 week. Hypersensitivity was present in the inferior plane of the long xiphoid process in the nervous system. Magnetic resonance imaging (MRI) showed intramedullary cystic lesions in the vertebral body plane of the third to the fourth thoracic vertebra. There was no recurrence during the 6-month postoperative follow-up period. The histopathological findings were consistent with bronchogenic cysts. Cystic lesions were eliminated through the posterior median approach. After the cyst ruptured during surgery, gel liquid was seen, and the majority of the cyst walls were removed. One week after the surgery, the hypersensitivity fully subsided. Six months following surgery, an updated MRI revealed no recurrence. Intramedullary bronchogenic cysts on the dorsal side of the thoracic spine are extremely uncommon. Diagnosis requires histopathological evidence, and it is challenging to diagnose before surgery. Prompt surgical resection is recommended in case of positive diagnosis.
Long-Lasting SARS-CoV-2 Infection With Post-COVID-19 Chronic Interstitial Pneumonia in a Patient With Chronic Lymphocytic Leukemia Treated Successfully With Intravenous Immunoglobulin
Authors: Ahmad Haddad, Qusai Al-Maharmeh, Mohammad N Kloub, Elrazi A Ali, Hamid Shaaban
Journal: Cureus (2024)
Keywords: chronic lymphocytic leukemia (cll), covid-19 in cancer patients, intravenous immunoglobulin, non-specific interstitial pneumonia, sars-cov-2 and covid-19
MeSH terms: Case Reports

Post-coronavirus disease 2019 (post-COVID-19) condition is a post-acute syndrome characterized by non-specific symptoms that remain for at least two months and typically appear three months after the start of the acute phase. Individuals with chronic lymphocytic leukemia (CLL) are considered to be at high risk of contracting COVID-19. It is also becoming increasingly evident that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine response is frequently lacking or insufficient. We present a 77-year-old male patient with CLL who had multiple hospitalizations for the management of pneumonia related to persistent COVID-19 infection due to hypogammaglobulinemia. He was subsequently treated with intravenous immunoglobulin (IVIG). This case emphasizes the importance of the early detection of hypogammaglobulinemia in patients with CLL and long COVID because of the potential therapeutic benefit of IVIG therapy. We also provide a literature review on COVID-19 infection in CLL patients, focusing mainly on the subset population of patients with hypergammaglobulinemia.
Case Report: Epithelioid angiosarcoma of the pleura
Authors: Niels Michael Dörr-Jerat, Claus May, Jürgen Knolle, Sylke Schmidt, Marcus Krüger
Journal: Front Surg (2024)
Keywords: angiosarcoma, pleura, rare disease (rd), sarcoma, thoracic surgery
MeSH terms: Case Reports

Introduction:
We present the case of a patient with recurrent bilateral hemothorax. After misdiagnosis despite several histological samples, a pleural manifestation of epithelioid angiosarcoma was diagnosed by further immunohistological staining. Based on this situation, we aim to sensitize the reader to this rare disease.
Main concerns and important clinical findings:
A 73-year-old fully conscious woman presented with dyspnea for 3 days. She was in stable general condition, pain was denied, she had a history of cigarette smoking, she had no cardiopulmonary events, and she was not receiving any anticoagulation medication. Physical examination revealed decreased breath sounds on the left side, and her hemoglobin level was 7.0 mmol/L.
Primary diagnoses interventions and outcomes:
The initial chest x-ray showed a left-sided effusion. Hemothorax was then diagnosed. Further investigation revealed no evidence of malignancy (CT, EBUS, cytology, etc.). VATS was performed, and biopsies of pleural lesions did not reveal congruent findings for the hemothorax. Due to recurrent bilateral hemothorax with the need for erythrocyte transfusion, the patient underwent several operations, including histological sampling, without evidence of malignancy. After further processing, an additional pathological report revealed an epithelioid angiosarcoma defined by massively proliferating epithelioid cells strongly positive for ERG and CD31 and negative for CD34. The neoplastic cells coexpressed D2-40 (podoplanin). Finally, due to multiple cerebral metastases, palliative therapy was indicated.
Conclusion:
Physicians and pathologists treating spontaneous hemothorax need to have broad knowledge of the possible, sometimes rare, etiologies. If the clinical course and intraoperative findings do not agree with the histopathological results, this finding must be questioned, and further immunohistochemical staining is mandatory. Thus, in the case of recurrent hemothorax, angiosarcoma of the pleura should also be considered for differential diagnosis.
Combined surgery and sclerotherapy for 13 years: a case report of a patient with CLOVES
Authors: Shiqi Wang, Siming Yuan
Journal: Front Pediatr (2024)
Keywords: cloves syndrome, overgrowth syndrome, sclerotherapy, truncal mass, vascular malformation
MeSH terms: Case Reports

Congenital lipomatous overgrowth, vascular malformations, epidermal nevi, and skeletal anomalies (CLOVES) constitute a rare overgrowth disorder resulting from a mosaic function-acquiring mutation in the PIK3CA gene. Targeted drugs for the PI3K-AKT signaling pathway remain under clinical trial and surgery is commonly used to meet both aesthetic and functional requirements for CLOVES patients. We report here the course and experience of a male patient treated at our institution for up to 13 years. The course of treatment consisted of nine anhydrous ethanol sclerotherapy procedures and two segmental trunk mass resections. After undergoing sequential treatment, the patient experienced improved thoracic deformity and scoliosis, enabling him to grow and develop normally.
Conjunctival Melanoma: A Case Presentation
Authors: Fatemeh Montazer, Seyed Mohammad Heshmati, Salar Asgari, Shabnam Mollazadehghomi
Journal: Iran J Pathol (2023)
Keywords: conjunctiva, melanoma, neoplasms, nevus
MeSH terms: Case Reports

Conjunctival melanoma is an uncommon tumor that is likely to recur and carries an overall mortality rate of approximately 30%. Melanoma arises from melanocytes, most often in sun-exposed skin. Less commonly, melanoma originates from other tissues such as the uvea, rectum, mouth, respiratory tract, and conjunctiva. Conjunctival melanoma represents only 1.6% of all noncutaneous melanoma. Herein, we reported a case of conjunctival melanoma followed by reviewing the literature to provide an optimal diagnostic approach.
Calcium Blood Level Elevation After Atorvastatin Initiation in a Patient With Hyperparathyroidism
Authors: Michael Rechter, Michael Hauzer
Journal: Cureus (2024)
Keywords: atorvastatin, drug-related adverse event, hypercalcemia, hyperparathyroidism, prevention in primary care
MeSH terms: Case Reports

Atorvastatin is a very common medication used for lowering blood cholesterol levels. The drug has known adverse effects, but an elevation in calcium levels is not listed as one of them. We report a 52-year-old man with hyperparathyroidism and hypercholesterolemia, who, under treatment with atorvastatin, developed an additional rise in calcium levels. He was asymptomatic, and during the investigation of his hypercalcemia, a drug adverse effect was suspected. Therefore, atorvastatin therapy was stopped, and calcium levels dropped as a result. Subsequent readministration of atorvastatin and its cessation produced similar results. While hypercalcemia is not listed as a common adverse effect of atorvastatin, we introduce such a phenomenon along with possible underlying mechanisms. Although our patient was asymptomatic, hypercalcemia can be a dangerous condition, especially in a population where the initial calcium levels are already elevated.