OpenMed/multicare-articles huggingface dataset:
Continuous false positive results by SARS-CoV-2 rapid antigen testing: a case report
Authors: Yannick Galipeau, Abishek Xavier, Aaron Dyks, Curtis Cooper, Marc-André Langlois
Journal: Front Public Health (2023)
Keywords: covid-19, sars-cov-2, case report, false positive, rapid antigen test (rat)
MeSH terms: COVID-19 / diagnosis, SARS-CoV-2, Case Reports, Research Support, Non-U.S. Gov't, Adult, COVID-19 Testing, Female, Humans

Efficient and rapid identification of active SARS-CoV-2 infections has been key to monitoring and mitigating the spread of the virus. The implementation of nucleic acid testing (e.g., RT-PCR) was broadly adopted by most public health organizations at the national and community levels across the globe, which was followed by more accessible means of home testing including lateral flow immunochromatographic assay (LFA), also known as a rapid antigen test. Here we report the case of an adult female who repeatedly and consecutively tested positive by RAT (BTNX inc). This sustained false positive was not linked with an active SARS-CoV-2 infection, which was ruled out by RT-PCR and serological analyses. SARS-CoV-2 serology revealed no detectable levels of antibodies against the nucleocapsid suggesting no recent prior infection by SARS-CoV-2. This continuous false positive was limited to BTNX testing devices. This case report aims to describe that such continuous false positives can occur and describes alternative testing approaches that can be performed to confirm RAT results. In addition, broader awareness of such occurrences is warranted in the healthcare and public health community to avoid unnecessary negative impacts on individual's day to day life.
Case report: Suspicious laryngeal mass: a case of laryngeal lymphoma misdiagnosed as chronic inflammation
Authors: Juanjuan Hu, Baoai Han, Ranran Ding, Yue Qiu, Haiying Sun, Yun Zhu
Journal: Front Oncol (2024)
Keywords: cervical lymphadenopathy, chronic tonsillitis, differential diagnosis, laryngeal lymphoma, tongue base
MeSH terms: Case Reports

This case report aims to highlight the importance of considering lymphoma as a potential differential diagnosis in patients presenting with laryngeal mass and associated cervical lymphadenopathy, particularly those with a history of chronic tonsillitis. A case of a 63-year-old male patient who underwent bilateral tonsillectomy for tumor in the left tonsil was presented. Two months after the procedure, he developed throat discomfort, dysphagia, neck swelling, and other symptoms. The patient was initially diagnosed with "tongue base mass" and chronic lymphadenitis. Partial excision of the tongue base mass was performed twice in another hospital, revealing chronic inflammation of the epithelial mucosa. Further evaluations, including electron laryngoscopy and imaging studies, were conducted to investigate the condition. A computed tomography (CT) scan showed irregular soft tissue density in the oropharyngeal region, along with multiple lymph nodes in the neck. Subsequent histopathological examination of the lingual base biopsy revealed peripheral T-cell lymphoma with a follicular T-helper cell phenotype. Immunohistochemical staining confirmed specific markers while ruling out other markers. In situ hybridization testing demonstrated positivity for Epstein-Barr virus-encoded RNA, and TCRG clonality was confirmed. The duration from symptom onset to diagnosis was 2 months. This case emphasizes the importance of considering lymphoma in patients with laryngeal mass and associated cervical lymphadenopathy, especially when a history of chronic tonsillitis is present. Accurate diagnosis and early intervention are crucial for effective management and improved patient outcomes.
Case report: Reversible splenial lesion syndrome caused by diquat poisoning
Authors: Ping Dai, Jin Sun, Zhongkai Yu, Tongyue Zhang, Zixin Wen, Tianzi Jian, Lanlan Guo, Aerbusili Genjiafu, Baotian Kan, Binbin Zhang, Xiangdong Jian
Journal: Front Neurol (2023)
Keywords: mri, acute kidney injury, diquat, reversible splenial lesion syndrome, toxic encephalopathy
MeSH terms: Case Reports

Diquat (DQ), chemically known as 1,1 '-ethylene-2,2' -bipyridine, is a non-selective herbicide for leaf removal and drying. It has toxic effects on central nervous system cells, and toxic neurological lesions include axonal degeneration and pontine myelolysis. At the same time, DQ can also affect the activity of dopaminergic nerve cells through oxidative stress, causing degeneration and reducing dopamine uptake. With the increasing application of DQ in agricultural production, the clinical reports of neurotoxicity caused by acute DQ poisoning are also increasing. At present, DQ rapid-phase-related toxic encephalopathy mainly involves the pons, midbrain, basal ganglia, thalamus and other brain regions. However, this case is unusual in that the lesion mainly involved the splenium of the corpus callosum. It is also the first time to be reported.
Nicotine or marijuana vaping exposure during pregnancy and altered immune responses in offspring
Authors: Jonas M Ndeke, James E Klaunig, Sarah Commodore
Journal: J Environ Expo Assess (2024)
Keywords: cancer risk, e-cigarette, electronic nicotine delivery systems, marijuana vaping, offspring, pregnancy

Electronic nicotine delivery systems (ENDS) - which include electronic cigarettes or e-cigarettes, or simply e-cigs, and marijuana vaping have become increasingly popular. ENDS devices have been established as one of the tobacco quit methods and promoted to be safer compared to traditional tobacco cigarettes. Emerging evidence demonstrates that e-cigarette and marijuana vape use can be harmful, with potential associations with cancer. Herein, we summarize the level of evidence to date for altered immune response, with a focus on cancer risks in the offspring after maternal use of, or aerosol exposures from, ENDS or marijuana vape during pregnancy. From 27 published articles retrieved from PubMed, we sought to find out identified carcinogens in ENDS aerosols and marijuana vapor, which cross the placental barrier and can increase cancer risk in the offspring. Carcinogens in vaping aerosols include aldehydes, metals, tobacco-specific nitrosamines, tobacco alkaloids, polycyclic aromatic hydrocarbons, and volatile organic compounds. Additionally, there was only one passive vaping exposure case study on a human fetus, which noted that glycerol, aluminum, chromium, nickel, copper, zinc, selenium, and lead crossed from the mother to the offspring's cord blood. The carcinogens (metals) in that study were at lower concentrations compared to the mother's biological matrices. Lastly, we observed that in utero exposures to ENDS-associated chemicals can occur in vital organs such as the lungs, kidneys, brain, bladder, and heart. Any resulting DNA damage increases the risk of tumorigenesis. Future epidemiological studies are needed to examine the effects of passive aerosol exposures from existing and emerging electronic nicotine and marijuana products on developing offspring to cancer.
Spontaneous pregnancy after thread-embedding therapy treatment with premature ovarian insufficiency after unilateral oophorectomy: a case report
Authors: Ziniu Zhang, Jingxue Yuan, Jingjing Zhao, Yue Song, Jinxia Ni
Journal: Front Med (Lausanne) (2024)
Keywords: acupuncture, case report, pregnancy, premature ovarian insufficiency, thread-embedding therapy, unilateral oophorectomy
MeSH terms: Case Reports

Premature ovarian insufficiency (POI) is a condition characterized by menstrual disturbance, subfertility, and estrogen deficiency symptoms. Women with POI have a small chance of natural conception, which may be even smaller when complicated with unilateral ovarian due to reduction of the ovarian follicular reserve. In China, acupuncture has been widely used to treat POI and POI-induced infertility, and studies have shown that acupuncture is helpful for improving ovarian function. Thread-embedding therapy is a method of acupuncture treatment development and extension, which can make the acupuncture effect last. In this article, we report a patient diagnosed with POI after unilateral oophorectomy (UO) who spontaneously conceived after thread-embedding therapy. Thread-embedding therapy may improve ovarian function in patients with POI, thereby providing a treatment strategy for infertility in patients with POI. This case report was written in accordance with the CARE guidelines.
Clozapine Withdrawal Catatonia: A Case Report
Authors: Amit Jagtiani, Tarika Nagi, Raghu Gandhi, Abid Rizvi
Journal: Cureus (2024)
Keywords: catatonia, clozapine, schizoaffective, schizophrenia, withdrawal
MeSH terms: Case Reports

Catatonia, which is associated with gamma-aminobutyric acid (GABA) hypoactivity, often responds robustly to benzodiazepines. It has been reported to be a consequence of abrupt discontinuation of clozapine, an antipsychotic used for treatment-resistant schizophrenia. Clozapine discontinuation, sometimes necessitated by medical concerns, can carry the risk of adverse outcomes, including catatonia. We present the case of a 66-year-old African-American male with schizoaffective disorder (depressive subtype) and a complex medical history. He discontinued clozapine abruptly due to medication unavailability, and, seven days later, presented with catatonic symptoms, initially unrecognized by emergency room clinicians. His symptoms included self-neglect, auditory hallucinations, isolation, psychomotor retardation, fixed gaze, and thought blocking. An attempt to reinstate clozapine led to orthostatic hypotension, prompting admission to an inpatient psychiatry unit. Attempt to initiate risperidone for psychosis worsened the catatonia, which then responded rapidly to intravenous lorazepam challenge. This facilitated the re-introduction of clozapine with slow re-titration.
Donor-Derived Cell-Free DNA as a Companion Biomarker for AMR Treatment With Daratumumab: Case Series
Authors: Bilgin Osmanodja, Aylin Akifova, Klemens Budde, Michael Oellerich, Julia Beck, Kirsten Bornemann-Kolatzki, Ekkehard Schütz, Joachim Velden, Claudia Lehmann, Bastian Malte Krüger, Anette Bachmann, Jan Kowald
Journal: Transpl Int (2024)
Keywords: antibody-mediated rejection, biomarker, daratumumab, donor-derived cell-free dna, kidney transplantation
MeSH terms: Antibodies, Monoclonal / therapeutic use, Biomarkers / blood, Cell-Free Nucleic Acids / blood, Graft Rejection / drug therapy, Kidney Transplantation, Case Reports, ADP-ribosyl Cyclase 1, Adult, Female, Humans, Male, Middle Aged, Tissue Donors, daratumumab, Cell-Free Nucleic Acids, Antibodies, Monoclonal, Biomarkers, ADP-ribosyl Cyclase 1

Antibody-mediated rejection (AMR) is among the most frequent causes for graft loss after kidney transplantation. While there are no approved therapies, several case reports with daratumumab and the very recent phase 2 trial of felzartamab in AMR have indicated the potential efficacy of therapeutic interventions targeting CD38. Donor-derived cell-free DNA (dd-cfDNA) is an emerging biomarker with injury-specific release and a short half-life, which could facilitate early diagnosis of AMR and monitoring of treatment response. We describe two cases of patients with chronic active AMR, who were treated with monthly daratumumab infusions, and in whom donor-derived cell-free DNA (dd-cfDNA) was measured longitudinally to monitor treatment response. In both patients, daratumumab treatment led to stabilization of kidney function parameters, a strong decline of dd-cfDNA below the previously established threshold for rejection, and partial or complete histologic resolution of AMR activity. Our case series suggests that dd-cfDNA may be a useful companion biomarker for longitudinal monitoring of anti-CD38 treatment in patients with AMR.
Pediatric acute respiratory distress syndrome in a Moroccan intensive care unit: a retrospective observational study of 23 cases
Authors: Said Benlamkaddem, Fatima Bouyerman, Mohamed Adnane Berdai, Mustapha Harandou
Journal: Pan Afr Med J (2023)
Keywords: pediatric acute respiratory distress syndrome, lung protective ventilation, prone position
MeSH terms: Respiratory Distress Syndrome / epidemiology, Observational Study, Case Reports, Adult, Child, Child, Preschool, Female, Humans, Intensive Care Units, Pediatric, Lung, Male, Respiration, Artificial, Retrospective Studies

Acute respiratory distress syndrome (ARDS) is a life-threatening condition despite medical development. Unlike adult, ARDS, in pediatric population, has been recently defined in the Pediatric Acute Lung Injury Consensus Conference (PALICC), 2015. We conduct a retrospective descriptive study, in pediatric intensive care unit (PICU) of Hassan II University Hospital during a period of 2 years (2019 to 2021) in which we included 23 pediatric cases of ARDS defined using 2012 Berlin criteria. They represent 2.7% of all patients admitted in our unit (23 patients of 850 admissions), with a male predominance 17 males/6 females, the median of age was 4.6 years-old (2 months to 14 years-old). Pediatric acute respiratory distress syndrome (PARDS) cases were stratified as mild in 13% (n=3), moderate in 52% (n=12), and severe in 35% (n=8). The etiologies were of pulmonary origin (pneumonia, aspiration, pulmonary contusion, and foreign body) in 79% of cases (n=18), and extra-pulmonary origin (sepsis, burn and major trauma) in 21% (n=5). The management was based on lung protective invasive mechanical ventilation (95%, n=22), Prone positioning was applied (26%, n=6), inhaled nitric oxide (iNO) was used in (35%, n=8), recruitment maneuvers (56%, n=13), neuromuscular blockade (NMB) (74%, n=17) and extracorporeal membrane oxygenation (ECMO) in 1 case. The outcome was favorable in 65% (n=15) with a mean PICU-stay of 20 days (SD=16 days). Overall mortality rate was 35% (n=8), and 100% (n=5) in case of extrapulmonary (indirect) etiologies. It was proportional to the disease severity, 50% (4 of 8 cases), 33% (4 of 12 cases), and no death respectively in severe, moderate, and mild PARDS. PARDS in our context is a serious problem as it is more frequent in children < 5 years, a population considered as fragile, with a high mortality rate especially in indirect lung etiologies of PARDS.
Syncope: Atypical Presentation of Diaphragmatic Hernia
Authors: Hazem AlHazmi, Ammar Y Bahadur, Khalid AlAhmadi, Ola Y Bahadur
Journal: Cureus (2024)
Keywords: congenital diaphragmatic hernia (cdh), diaphragmatic hernias, emergency, pediatrics, syncope
MeSH terms: Case Reports

In this case report, we describe a rare presentation of diaphragmatic hernia in a pediatric patient presenting with syncope. Congenital diaphragmatic hernia (CDH) is a developmental discontinuity of the diaphragm that causes the abdominal viscera to herniate into the thoracic cavity. It is usually diagnosed shortly after birth and is often associated with pulmonary hypoplasia and pulmonary hypertension, causing life-threatening conditions, or it could be completely asymptomatic. Syncope is induced by various conditions such as cerebrovascular disease, arrhythmia, hypoglycemia, anemia, epilepsy, and autonomic nervous disorder.
Adverse reactions of piperacillin: A literature review of case reports
Authors: Hongru Zhang, Liping Yang
Journal: Open Med (Wars) (2024)
Keywords: adverse drug reactions, anaphylactic shock, case reports, piperacillin, toxic epidermal necrolysis
MeSH terms: Review

Aim:
This study aimed to summarize case reports of adverse drug reactions (ADRs) caused by piperacillin and explore their effects on human organs in real-world settings.
Method:
Case reports of piperacillin ADRs were collected by searching databases such as PubMed, Embase, Web of Science, CNKI, WanFang, and VIP from inception to December 2022.
Results:
A total of 170 patients were ultimately included. The results revealed that ADRs caused by piperacillin were primarily associated with the entire body, followed by the blood system, skin and soft tissues, and the nervous system. The most frequently reported cases included anaphylactic shock, drug fever, rash, and thrombocytopenia. The most severe ADRs were identified as anaphylactic shock and bullous epidermal necrolysis. Furthermore, a comparison was made between systemic adverse reactions caused by piperacillin as a single drug and two composite preparations of piperacillin/β-lactamase inhibitor. ADRs not mentioned in the instructions included convulsions or hallucinations and Kounis syndrome (KS).
Conclusion:
This review suggests that the most severe ADRs associated with piperacillin are toxic epidermal necrolysis and anaphylactic shock. Rare ADRs caused by piperacillin, such as myoclonic jerks, hallucinations, and KS, were identified. The most common symptom with domestic preparations of piperacillin/sulbactam and piperacillin sodium was dyspnea.
Antepartum Rupture of the Posterior Uterine Wall in a Woman With Two Previous Cesarean Deliveries
Authors: Marina Gato, Catarina Castro, Luísa Pinto
Journal: Cureus (2024)
Keywords: cesarean section, hysterectomy, neonatal outcomes, pregnancy, uterine rupture
MeSH terms: Case Reports

Uterine rupture is a rare pregnancy complication. In patients with a previous cesarean delivery, it usually involves the scarred area. Uterine rupture of the posterior wall is even rarer and mostly described during labor. Conditions that confer fragility to the posterior uterine wall have been associated with an increased risk of uterine rupture. There are very few cases of spontaneous posterior uterine wall rupture in a non-labor setting in pregnant women without risk factors. We report the case of a pregnant woman admitted to the hospital due to placental abruption at 26 weeks' gestation. Once fetal and maternal stability were assured, expectant management was maintained. At 29 weeks, an emergent cesarean delivery due to fetal bradycardia was performed, and a large rupture of the posterior uterine wall was diagnosed. Subsequently, a hysterectomy was performed. The patient was discharged nine days after the procedure and the newborn on the 64th day of life.
Case report: Adult with bipolar disorder and autism treated with ketamine assisted psychotherapy
Authors: Christopher P Harris, Becky Jones, Kathryn Walker, Meredith S Berry
Journal: Front Psychiatry (2024)
Keywords: autism spectrum disorder, bipolar disorder, case report, ketamine, ketamine assisted psychotherapy, psychopharmacology
MeSH terms: Case Reports

Background:
Evidence has increased in recent years regarding the potential for ketamine to serve as a novel treatment option for a range of conditions, particularly depression (unipolar and bipolar). However, research regarding ketamine as a potential therapeutic for Autism Spectrum Disorder (ASD) is lacking, despite high overlap with bipolar depression and theoretical foundations for its use.
Case presentation:
A 29-year-old man with bipolar disorder and Autism Spectrum Disorder, type 2 diabetes, presented with mood swings and suicidal thoughts, and anger outbursts occurring daily. The patient was referred by a psychiatrist due to irritability and outbursts during the previous 5 months. These outbursts were unable to be controlled by the medications prescribed, included yelling and screaming, and the patient was unable to speak with the psychiatrist. The patient underwent ketamine assisted psychotherapy with 6 initial IV infusions of ketamine over a 1 month period followed by 2 booster IV ketamine infusions. Following ketamine treatment, dramatic reductions in outbursts were observed as well as reductions in anxiety, suicidality, and depression scores.
Conclusion:
This case study adds to the scant literature regarding ketamine treatment for individuals with bipolar disorder and ASD. We did not find ASD to be a contraindication for IV ketamine and ketamine assisted psychotherapy. Reductions in anger outbursts, anxiety, suicidality, and depression suggest ketamine treatment might be tailored to individuals with bipolar disorder and ASD, and additional systematized research is warranted. Although potential mechanisms of action are not clear, these data add to the discussion regarding clinical practice considerations and the potential for ketamine to improve quality of life and associated metrics.
Papillary renal cell carcinoma with extensive spindle cell foci: mimicker of mucinous tubular and spindle cell carcinoma
Authors: Fareed Rajack, Shawn Medford, Tammey Naab
Journal: Autops Case Rep (2024)
Keywords: carcinoma, papillary, hippo signaling pathway, immunohistochemistry, kidney neoplasms, nephrectomy
MeSH terms: Case Reports

Papillary renal cell carcinoma (PRCC) is the second most common renal cell carcinoma (RCC), accounting for 10-15% of cases. Mucinous tubular and spindle cell carcinoma (MTSCC), on the other hand, accounts for only 1% of renal tumors and has a more favorable prognosis compared to PRCC. We report a 75-year-old female with a left upper pole solid renal mass displaying features of both papillary renal cell carcinoma (PRCC) and mucinous tubular and spindle cell carcinoma (MTSC). In this case, a shaggy luminal surface, multiple papillations, and psammoma bodies, absence of E-cadherin expression, and strong CD10 expression favored PRCC. Both immunohistochemistry and genomic analysis are critical to diagnose and differentiate tumors that may have overlapping features accurately.
Case report: Early-onset Parkinson's disease with lower limb spasticity in a new DJ-1/PARK7 patient
Authors: Masako Fujita, Haruo Nishijima, Atsuko Katagai, Chieko Suzuki, Nobutaka Hattori, Masahiko Tomiyama
Journal: Front Neurosci (2024)
Keywords: dj-1 variant, parkinson’s disease, cognitive dysfunction, limb spasticity, parkinsonism
MeSH terms: Case Reports

Rare autosomal recessive variants in DJ-1, a causative gene for early-onset Parkinson's disease, have been associated with a variety of clinical syndromes in a limited number of patients. Here, we report a case of a novel DJ-1 variant in a 39-year-old man with a 4-year history of parkinsonism, cognitive dysfunction, and lower limb spasticity. He was diagnosed with Parkinson's disease. Genetic testing of the patient revealed compound heterozygous variants in the DJ-1 gene (exon 6 deletion + c.242dup), of which exon 6 deletion was a novel variant. We conclude that variants in DJ-1 should be considered possible causes of early-onset parkinsonism with spasticity and cognitive impairment, as in this case.
The essential role of thoracic duct embolization in management of traumatic iatrogenic chylothorax
Authors: Bruno Pagnin Schmid, Guilherme Moratti Gilberto, Marcela Juliano Silva Cunha, Leonardo Guedes Moreira Valle, Gustavo Foronda, Santiago Raul Arrieta, Felipe Nasser, Rodrigo Gobbo Garcia
Journal: J Vasc Bras (2023)
Keywords: chylothorax, embolization, therapeutic, interventional radiology, lymphangiography, lymphatic diseases, thoracic duct
MeSH terms: Case Reports

This study aims to describe a case series of patients who underwent thoracic duct embolization (TDE) to treat traumatic iatrogenic chylothorax (TIC). Three patients were included: Case #1, a 49-year-old woman with follicular lymphoma developed a TIC following video-assisted thoracoscopic surgery to resect a solid right paravertebral mass and was treated with TDE using microcoils and N-butyl cyanoacrylate (NBCA) glue. Case #2, a 68-year-old man with cardiac amyloidosis developed a TIC following heart transplantation and was treated with TDE using microcoils and ethylene vinyl alcohol copolymer. Case#3: A 6-year-old patient with congenital heart disease developed a TIC following a Fontan procedure and was treated with TDE using NBCA glue. All lesions were identified during lymphangiography and TDE was successfully performed in all cases. TDE is a safe and valuable technique that provides minimally invasive treatment for TCI.