OpenMed/multicare-articles huggingface dataset:
Primary Pituitary Lymphoma in Immunocompetent Patients: A Report on Two Case Studies and the Review of Literature
Authors: Lian Duan, Jie Liu, Yan Zhang, Lijia Cui, Xiao Zhai, Boju Pan, Lin Lu, Hui Pan, Yong Yao, Huijuan Zhu
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: chemotherapy, large b-cell lymphoma, primary cns lymphoma, primary pituitary lymphoma, radiotherapy, sellar mass
MeSH terms: Adenoma / diagnostic imaging, Immunocompetence / physiology, Lymphoma / diagnostic imaging, Pituitary Neoplasms / diagnostic imaging, Case Reports, Research Support, Non-U.S. Gov't, Systematic Review, Adenoma / immunology, Adenoma / metabolism, Aged, Female, Humans, Lymphoma / immunology, Lymphoma / metabolism, Magnetic Resonance Imaging / methods, Male, Middle Aged, Pituitary Neoplasms / immunology, Pituitary Neoplasms / metabolism, Positron Emission Tomography Computed Tomography / methods

Primary pituitary lymphoma (PPL) represents an extremely rare entity. Here, we have reported two recently identified cases of immunocompetent PPL having diffuse large B-cell lymphoma by surgical biopsy. Both patients had hypopituitarism, with one patient developing right ptosis. In both patients, MRI and FDG-PET/CT depicted sellar mass that extended into the cavernous sinus with the right sphenoid also present in one of the patients. No systemic disease was found in these two patients. Surprisingly, we found that both patients had infiltrative lesions in sphenoid sinus mucosa pathologically, but the sphenoid bones that composed the sellar base were visually intact during the biopsy procedure. Chemotherapy was administered to both patients, where one patient achieved remission at the recent follow-up, whereas the other one did not respond to the treatment. The diagnosis of PPL is usually difficult if solely dependent on history, clinical presentation, biochemical indexes, and radiographic findings. We have also updated and reviewed the epidemiologic features, clinical presentations, pathological characteristics, potential mechanisms, therapeutic orientation, and prognostic advances of PPL. A total of 40 cases (including ours and four pediatric patients), histologically diagnosed, were analyzed in terms of clinical presentation, endocrine abnormality, radiological features, pathology, treatment, and follow-up. Hypopituitarism and headache were the most common presentation of PPL, while diabetes insipidus was reported in 13 patients (43.3%). B cell lymphoma was the most common type of pathology, followed by T-cell and NK/T cell. PPL was more invasive in nature at the suprasellar region (72.5%), cavernous sinus (52.5%), and sphenoidal sinus (27.5%) in 29, 21, and 11 patients, respectively. Pediatric patients with PPL seem to be different compared to their adult counterparts in terms of pathogenesis, clinical presentation, and radiological features. The management of PPL usually follows the treatment protocols for PCNSL but has a poor prognosis compared to the pituitary involvement of systemic lymphoma.
Paratesticular liposarcoma: a case report and review of the literature
Authors: Haider Alyousef, Elsawi M Osman, Mohamed A Gomha
Journal: Case Rep Urol (2013)

Introduction. Liposarcoma is a rare pathological entity. By far it is the most common histological subtype of genitourinary sarcomas in adults. Approximately two hundred cases were reported in the literature. We are hereby presenting a case with a typical clinical scenario of paratesticular liposarcoma. Case report. A 75-year-old gentleman presented with a painless right hemiscrotal swelling that was progressively increasing in size over the last 6 years. Testicular tumour markers were negative. Imaging showed a heterogenous mass with fat component. Subsequently he underwent wide local excision that included the paratesticular mass along with the right testicle and all right inguinal canal contents up to the deep inguinal ring with the sparing of right illioinguinal nerve. Histopathological examination showed a well differentiated liposarcoma of the spermatic cord. He remained recurrence-free so far after 18 months of followup. Conclusion. Radical orchidectomy with wide local excision comprises the cornerstone of treatment of paratesticular liposarcoma. Due to the rarity of the disease there is no definite universal consensus of opinion as regards the role of radiotherapy and chemotherapy.
Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease and Varicella Zoster Virus Infection - Frequency of an Association
Authors: Franziska Di Pauli, Paul Morschewsky, Klaus Berek, Michael Auer, Angelika Bauer, Thomas Berger, Gabriel Bsteh, Paul Rhomberg, Kathrin Schanda, Anne Zinganell, Florian Deisenhammer, Markus Reindl, Harald Hegen
Journal: Front Immunol (2021)
Keywords: aqp-4-igg, mog antibody associated diseases, mog-igg, longitudinally extensive transverse myelitis, neuromyelitis optica spectrum disorder, varicella zoster virus infection
MeSH terms: Autoantibodies / immunology, Herpesvirus 3, Human / immunology, Myelin-Oligodendrocyte Glycoprotein / immunology, Myelitis, Transverse / immunology, Varicella Zoster Virus Infection / immunology, Case Reports, Research Support, Non-U.S. Gov't, Adult, Aged, Aquaporin 4 / immunology, Encephalitis / diagnosis, Encephalitis / immunology, Female, Herpesvirus 3, Human / genetics, Herpesvirus 3, Human / physiology, Humans, Immunoglobulin G / immunology, Male, Middle Aged, Myelitis, Transverse / diagnosis, Retrospective Studies, Review Literature as Topic, Varicella Zoster Virus Infection / diagnosis, Varicella Zoster Virus Infection / virology, Aquaporin 4, Autoantibodies, Immunoglobulin G, Myelin-Oligodendrocyte Glycoprotein

To determine whether there is a correlation between myelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases and varicella zoster virus (VZV) infection. We provide a case report and performed a study to determine the frequency of MOG antibodies (MOG-IgG) in neurological VZV infections. Patients admitted to the Medical University of Innsbruck from 2008-2020 with a diagnosis of a neurological manifestation of VZV infection (n=59) were included in this study; patients with neuroborreliosis (n=34) served as control group. MOG-IgG was detected using live cell-based assays. In addition, we performed a literature review focusing on MOG and aquaporin-4 (AQP4) antibodies and their association with VZV infection. Our case presented with VZV-associated longitudinally extensive transverse myelitis and had MOG-IgG at a titer of 1:1280. In the study, we did not detect MOG-IgG in any other patient neither in the VZV group (including 15 with VZV encephalitis/myelitis) nor in the neuroborreliosis group. In the review of the literature, 3 cases with MOG-IgG and additional 9 cases with AQP4 IgG associated disorders in association with a VZV infection were identified. MOG-IgG are rarely detected in patients with VZV infections associated with neurological diseases.
Concomitant cryptococcosis and burkholderia infection in an asymptomatic lung transplant patient with cystic fibrosis
Authors: S Shafaghi, M Pour Abdollah, P Tabarsi, F Ghorbani, S S M Makki, H R Khoddami Vishteh, J Faeghi, K Najafizadeh
Journal: Int J Organ Transplant Med (2010)
Keywords: burkholderia infection, cryptococcosis, cystic fibrosis, double lung transplantation
MeSH terms: Case Reports

Concomitant pulmonary infections with Cryptococcus neoformans and Burkholderia cepacia in lung transplant recipients are very rare and create unique diagnostic and therapeutic dilemmas. Herein, we present a double lung transplant patient with cystic fibrosis who was found to have coinfection with these two rare organisms, though he was completely asymptomatic.
Rare case of Alstrom syndrome with empty sella and interfamilial presence of Bardet-Biedl phenotype
Authors: D Catrinoiu, C M Mihai, L Tuta, R Stoicescu, A Simpetru
Journal: J Med Life (2009)
MeSH terms: Alstrom Syndrome / genetics, Bardet-Biedl Syndrome / genetics, Empty Sella Syndrome / genetics, Case Reports, Blindness / genetics, Cardiomyopathy, Dilated / genetics, Cilia / physiology, Diabetes Mellitus, Type 2 / genetics, Hearing Loss, Sensorineural / genetics, Human Growth Hormone / deficiency, Humans, Hypertension / genetics, Male, Obesity / genetics, Pedigree, Phenotype, Young Adult, Human Growth Hormone

Alstrom syndrome is an extremely rare, autosomal recessive genetic disorder characterized by a group of signs and symptoms including infantile onset dilated cardiomyopathy, blindness, hearing impairment/loss, obesity, diabetes, hepatic and renal dysfunction. Since the first description of the syndrome in 1959, there have never been reported cases of Alstrom syndrome with the occurrence of the Bardet-Biedl syndrome in their relatives, this case suggesting a close genetic link between these two ciliopathies. The presence of empty sella seems to be a rare morphologic finding in Alstrom syndrome although it has been documented in few Bardet-Biedl cases.
Case presentation:
We report a case of a 20 -year-old caucasian male with hearing and visual loss, short stature, insulin resistant diabetes, dilated cardiomyopathy, hepatic and renal dysfunction, hypertension, and alopecia. By studying his family medical records we identified two relatives with suggestive clinical findings for Bardet Biedl syndrome.
Conclusion:
Analyzing the clinical traits of these patients we found that retinopathy, nephropathy and central obesity were present in all patients, suggesting a main anomaly in ciliary function controlling photoreception, renal and metabolic processes. The occurrence of similar clinical cases within a family further demonstrates the existence of a common pathologic cilliary mechanism, a genetic basis of phenotypic variability in seemingly monogenic disease and a functional link between rare disorders and common traits with overlapping clinical manifestations. Genetic studies in such patients may provide new data regarding the consequences of defective cilia and a possible identification of new gene mutations.
A Case Report of Histoplasma-Associated Empyema Treated With Intravenous Injection and Local Thoracic Irrigation of Amphotericin B Plus Medical Thoracoscopy
Authors: Ning Cui, Lijun Wang, Jingming Zhao
Journal: Front Public Health (2022)
Keywords: histoplasma, amphotericin b, empyema, medical thoracoscopy, thoracic irrigation
MeSH terms: Empyema, Pleural / drug therapy, Empyema, Pleural / etiology, Histoplasmosis / complications, Histoplasmosis / drug therapy, Pleural Effusion / complications, Pleural Effusion / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Amphotericin B / therapeutic use, Female, Histoplasma, Humans, Injections, Intravenous, Middle Aged, Therapeutic Irrigation / adverse effects, Thoracoscopy / adverse effects, Thoracoscopy / methods, Amphotericin B

Cases of empyema associated with Histoplasma infection are rarely reported. Here, we discuss a case of Histoplasma-associated empyema successfully treated with amphotericin B intravenous and pleural infusion therapy and multiple medical thoracoscopies. A 57-year-old Chinese woman with preexisting diabetes mellitus and gastric cancer had massive left-sided pleural effusion diagnosed by chest computed tomography. Her pleural effusion was purulent through pleural catheter drainage, and the culture of the pleural fluid showed Escherichia coli and Streptococcus constellation. Histopathology of the thoracoscopic pleural biopsy after hexamine silver and PAS staining supported Histoplasma infection. The patient was treated with intravenous injection and local thoracic irrigation of amphotericin B and continuous oral administration of itraconazole. At the same time, the patient received thoracic cannulation, daily thoracic lavage and thoracoscopy for purulent and necrotic tissue removal three times during hospitalization. The patient's pleural effusion and necrotic tissue in the pleural cavity were significantly reduced in a short time, and the clinical symptoms were significantly improved. After discharge, the patient recovered well and had no obvious complications or sequelae. Intravenous injection and local thoracic irrigation of amphotericin B are safe and effective drug therapies to treat fungal-associated empyema such as Histoplasma. Medical thoracoscopy effectively shortens the recovery time of empyema, improving the prognosis and reducing complications.
"Hallucinations" Following Acute Cannabis Dosing: A Case Report and Comparison to Other Hallucinogenic Drugs
Authors: Frederick S Barrett, Nicolas J Schlienz, Natalie Lembeck, Muhammad Waqas, Ryan Vandrey
Journal: Cannabis Cannabinoid Res (2018)
Keywords: adverse event, cannabis, comparative pharmacology, hallucination, vaporization

Introduction: Cannabis has been historically classified as a hallucinogen. However, subjective cannabis effects do not typically include hallucinogen-like effects. Empirical reports of hallucinogen-like effects produced by cannabis in controlled settings, particularly among healthy research volunteers, are rare and have mostly occurred after administration of purified Δ-9 tetrahydrocannabinol (THC) rather than whole plant cannabis. Methods: The case of a healthy 30-year-old male who experienced auditory and visual hallucinations in a controlled laboratory study after inhaling vaporized cannabis that contained 25 mg THC (case dose) is presented. Ratings on the Hallucinogen Rating Scale (HRS) following the case dose are compared with HRS ratings obtained from the participant after other doses of cannabis and with archival HRS data from laboratory studies involving acute doses of cannabis, psilocybin, dextromethorphan (DXM), and salvinorin A. Results: Scores on the Volition subscale of the HRS were greater for the case dose than for the maximum dose administered in any other comparison study. Scores on the Intensity and Perception subscales were greater for the case dose than for the maximum dose of cannabis, psilocybin, or salvinorin A. Scores on the Somaesthesia subscale were greater for the case dose than for the maximum dose of DXM, salvinorin A, or cannabis. Scores on the Affect and Cognition subscales for the case dose were significantly lower than for the maximum doses of psilocybin and DXM. Conclusion: Acute cannabis exposure in a healthy adult male resulted in self-reported hallucinations that rated high in magnitude on several subscales of the HRS. However, the hallucinatory experience in this case was qualitatively different than that typically experienced by participants receiving classic and atypical hallucinogens, suggesting that the hallucinatory effects of cannabis may have a unique pharmacological mechanism of action. This type of adverse event needs to be considered in the clinical use of cannabis.
Case report: First case report of an Emirati child with a novel gene variant causing aromatic L-amino acid decarboxylase deficiency
Authors: Mohamed O E Babiker, Manju A Kurian, Jehan Suleiman
Journal: Front Pediatr (2022)
Keywords: aadc deficiency, uae, case report, delayed diagnosis, developmental delay, dystonia, hypotonia, oculogyric crises
MeSH terms: Case Reports

Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare, neurometabolic disorder resulting from biallelic mutations in the dopa decarboxylase (DDC) gene. This is the first reported case of AADC deficiency in the United Arab Emirates (UAE) and describes an Emirati male patient who presented in the first few months of life with a severe phenotype of global hypotonia, developmental delay and oculogyric crisis. Following whole exome sequencing, a novel homozygous mutation in the DDC gene (c.1144G>T, p.Val382Phe) was reported and the patient underwent further testing, after which a diagnosis of AADC deficiency was confirmed. This mutation has not been previously described, but the clinical phenotype and corresponding biochemical profile confirmed that it is a pathogenic variant. The patient is currently managed at a tertiary referral center in the UAE and is treated in accordance with published guidance on AADC deficiency, including the recommended medical therapy combined with multidisciplinary care from a team of specialists. Some symptomatic improvements have been reported but at 5 years of age the patient continues to exhibit profound developmental delay, oculogyric crisis and is prone to recurrent respiratory infections. In order to improve outcomes for patients with AADC deficiency in the Middle Eastern region, there is an urgent need to raise the index of clinical suspicion, particularly among primary care physicians, pediatricians, and pediatric neurologists, and to improve access to diagnostic testing. This is particularly relevant at the current time, given the ongoing development of potentially disease-modifying gene therapy for AADC deficiency.
Improved strategy for post-traumatic hydrocephalus following decompressive craniectomy: Experience of a single center
Authors: Kun Wang, Hongbin Guo, Yinxin Zhu, Jinjian Li, Huanjiang Niu, Yirong Wang, Xiujun Cai
Journal: Front Surg (2023)
Keywords: complication, cranioplasty, post-traumatic hydrocephalus, procedure, ventriculoperitoneal shunt

Background:
Patients with head trauma may develop hydrocephalus after decompressive craniectomy. Many studies have referred one-stage cranioplasty (CP) and ventriculoperitoneal shunt (VPS) was applied to treat cranial defect with post-traumatic hydrocephalus (PTH), but the safety and efficiency of the procedure remain controversial.
Methods:
This is a retrospective cohort study including 70 patients of PTH following decompressive craniectomy who underwent simultaneous (50) and separated (20) procedures of cranioplasty and VPS from March 2014 to March 2021 at the authors' institution with at least 30 days of follow-up. Patient characteristics, clinical findings, and complications were collected and analyzed.
Results:
Fifty patients with PTH underwent improved simultaneous procedures and 20 patients underwent staged surgeries. Among the cases, the overall complication rate was 22.86%. Complications suffered by patients who underwent one-stage procedure of CP and VPS did not differ significantly, compared with patients in the group of staged procedures (22% vs. 25%, p = 0.763). The significant difference was not observed in the two groups, regarding the complications of subdural/epidural fluid collection (4%/6% vs. 0/2%, p = 1.000/1.000), epidural hemorrhage (6% vs. 4%, p = 0.942), dysfunction of shunting system (0 vs. 2%, p = 0.286), postoperative seizure (8% vs. 4%, p = 1.000), and reoperation case (0 vs. 2%, p = 0.286). No case of subdural hemorrhage, incision/intracranial/abdominal infection, shunting system dysfunction, or reoperation was observed in the group of simultaneous procedure. Complications including subdural/epidural fluid collection, subdural hemorrhage, and incision/intracranial infection were not shown in the case series of the staged procedure group.
Conclusion:
The improved simultaneous procedure of cranioplasty and VPS is effective and safe to treat cranial defect and post-traumatic hydrocephalus with low risk of complications.
Connected: Recommendations and Techniques in Order to Employ Internet Tools for the Enhancement of Online Therapeutic Relationships. Experiences from Italy
Authors: Gianmarco Manfrida, Valentina Albertini, Erica Eisenberg
Journal: Contemp Fam Ther (2017)
Keywords: advantages and risks of communication technologies, group chats interventions, online psychotherapy, online sessions, psychotherapeutic emails, therapeutic relationship online

The article explores the different types of therapeutic relationship that can evolve both on- and offline, thanks to the use of tools, such as software and applications, which enable therapists and patients contact outside of the traditional setting. Given the premise that it is practically impossible today to maintain a relationship without the use of internet and telephones, it becomes necessary to question the ways in which the online space can become a useful extension of the therapeutic setting. The authors, starting from a consideration regarding the specificity of the online therapeutic relationship, analyze the best ways to use text and email messaging with patients. Furthermore, specific interactions via group chats are presented, for example, to coordinate a therapeutic team involving several professionals. Further, video chat settings are discussed through a clinical case presentation. Lastly, the therapist's management of social networks is debated, underscoring the importance for the therapists that his or her online identity be consistent with the offline image which patients are introduced to in the traditional setting of the therapy room.
Transanal Drainage of Coloanal Anastomotic Leaks
Authors: Bradley Sherman, Mark Arnold, Syed Husain
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

The conventional operative intervention for leaks following coloanal anastomoses has been proximal fecal diversion with or without take-down of anastomosis. A few of these cases are also amenable to percutaneous drainage. Ostomies created in this situation are often permanent, specifically in cases where coloanal anastomoses are taken down at the time of reoperation. We present two patients who developed perianastomotic pelvic abscesses that were treated with transanal large bore catheter drainage resulting in successful salvage of coloanal anastomoses without the need for a laparotomy or ostomy creation. We propose this to be an effective therapeutic approach to leaks involving low coloanal anastomoses in the absence of generalized peritonitis.
Towards real-time metabolic profiling of a biopsy specimen during a surgical operation by 1H high resolution magic angle spinning nuclear magnetic resonance: a case report
Authors: Martial Piotto, François-Marie Moussallieh, Agnès Neuville, Jean-Pierre Bellocq, Karim Elbayed, Izzie Jacques Namer
Journal: J Med Case Rep (2012)

Introduction:
Providing information on cancerous tissue samples during a surgical operation can help surgeons delineate the limits of a tumoral invasion more reliably. Here, we describe the use of metabolic profiling of a colon biopsy specimen by high resolution magic angle spinning nuclear magnetic resonance spectroscopy to evaluate tumoral invasion during a simulated surgical operation.
Case presentation:
Biopsy specimens (n = 9) originating from the excised right colon of a 66-year-old Caucasian women with an adenocarcinoma were automatically analyzed using a previously built statistical model.
Conclusions:
Metabolic profiling results were in full agreement with those of a histopathological analysis. The time-response of the technique is sufficiently fast for it to be used effectively during a real operation (17 min/sample). Metabolic profiling has the potential to become a method to rapidly characterize cancerous biopsies in the operation theater.