OpenMed/multicare-articles huggingface dataset:
Hypercalcemia, an Important Puzzle Piece in Uncommon Onset Pediatric Sarcoidosis-A Case Report and a Review of the Literature
Authors: Cristina Oana Mărginean, Lorena Elena Meliţ, Gabriel Grigorescu, Claudiu Puiac, Iunius Simu
Journal: Front Pediatr (2020)
Keywords: children, hypercalcemia, renal failure, sarcoidosis, uncommon onset
MeSH terms: Case Reports

Sarcoidosis (SD) is a systemic granulomatous condition that is especially encountered in young adults and rarely in children, affecting predominantly the lungs and lymph nodes. We report the case of a 14-year-old teenage boy admitted to our clinic for nausea, vomiting, and weight loss. Clinical examination at the time of admission revealed malaise, pallor, and abdominal tenderness in the epigastric area at palpation. Laboratory tests revealed an elevated level of hemoglobin, mild thrombocytosis, increased erythrocyte sedimentation rate, and a mild increase in creatinine and urea levels along with hypercalcemia. An abdominal ultrasound revealed a right ectopic kidney, whereas the upper digestive endoscopy showed intense hyperemia and edema of the gastric mucosa. Thoracic computed tomography scan revealed giant hilar and mediastinal lymphadenopathy, along with multiple micronodules within the lung parenchyma and ground-glass aspect. The level of angiotensin-converting enzyme was high, parathormone was normal, and vitamin D level was low. Pathological examination of the bronchial, mediastinal, and lung biopsies established the diagnosis of SD. We administered oral corticosteroids for 2 months with outstandingly favorable outcome and no signs of recurrence 6 months after the cessation of the therapy.
Successful Pregnancy in a Case of Behçet's Disease after Treatment with Prednisolone
Authors: Shogo Nishii, Koushi Yamaguchi, Mitsuyoshi Amita, Takakazu Saito, Hidekazu Saito, Akihiko Sekizawa
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

A 34-year-old woman (gravida 1, para 0) visited the Division of Reproductive Medicine/National Center for Child Health and Development due to infertility; she had also been suffering from incompletely treated genital ulcers and stomatitis for 10 years. This case was diagnosed as an incomplete-type Behçet's disease (BD) at the Department of Maternal-Fetal Biology/National Center for Child Health and Development. Since no apparent abnormality was found in the general infertility test, artificial insemination with the husband's semen (AIH) was performed for the patient with unexplained infertility, which failed. However, after treating BD with prednisolone, chronic inflammation (stomatitis and genital ulcer) and immunological abnormalities (Th2 and NK cell activity) improved, and conception was possible by AIH. Thus, prednisolone administration may have induced immune tolerance in the patient with BD, which may have contributed to the success of AIH.
Moving in musicking: the evolving pedagogical practice of the artist-facilitator within asylum seeker centers
Authors: Georgia Nicolaou, Luc Nijs, Peter van Petegem
Journal: Front Psychol (2023)
Keywords: artist-facilitator, asylum seekers, children, movement, music, participatory workshops, pedagogical practice

The field of community music has been continuously expanding during the last years alongside the need for experienced musicians who can carry out music activities for culturally diverse groups. Based on previous studies, we identified a need for research-based practices for training musicians and music teachers who wish to facilitate community music projects. We believe that it is important to incorporate reflexive practice in order to inform the planning of the workshops, but also to support the needs of the participants. The article examines the evolution of the pedagogical practice of the artist-facilitator in active music making with children, during a series of movement-based musical workshops at an asylum seeker center in Netherlands. We used an exploratory case study integrating Action Research, in order to focus on the artist-facilitator's pedagogical practice, the participatory role of the children and the content of this type of workshops. The researchers describe the adopted pedagogical approach based on a set of guiding principles and key components that supported the design and content of the workshops. Based on a cyclical process (plan-act-observe-evaluate), the findings from every cycle were incorporated in the next one by analyzing the video footage of the workshops and the immediate reflections of the artist-facilitator. Data analysis revealed a set of recurring themes that reflect crucial aspects of the artist-facilitator's practice. Furthermore, a set of pedagogical implications are proposed that can be directly implemented within the practice of artists-facilitators who wish to engage in activities with children at asylum seeker centers.
Unilateral lateral rectus palsy: an unusual presentation of pineal epidermoid cyst
Authors: Koushik Handattu, Ramesh Bhat Yellanthoor, Sandesh Kini
Journal: Pan Afr Med J (2020)
Keywords: pineal gland cyst, child, sixth nerve palsy
MeSH terms: Abducens Nerve Diseases / etiology, Epidermal Cyst / diagnosis, Pineal Gland / pathology, Case Reports, Child, Diplopia / etiology, Epidermal Cyst / pathology, Epidermal Cyst / surgery, Headache / etiology, Humans, Magnetic Resonance Imaging, Male, Neck Pain / etiology, Papilledema / etiology, Pineal Gland / surgery, Pseudotumor Cerebri / diagnosis

An 11-year-old boy presenting with sudden onset double vision, headache and neck pain was found to have left lateral rectus palsy, papilledema and neck rigidity. An initial diagnosis of benign intracranial hypertension was considered. However, magnetic resonance imaging (MRI) of the brain surprisingly discovered the pineal gland cyst. He underwent Krause´s procedure for the excision biopsy of the cyst. Histopathological examination confirmed epidermoid cyst. Postoperatively, he had transient ataxia and upgaze palsy but recovered well. He was asymptomatic during the first and third-month follow-ups. The case highlights the unusual presentation of a rare intracranial tumor, pineal epidermoid cyst. Neuroimaging and timely surgery lead to a good outcome.
A Case of Lithium Encephalopathy with Therapeutic Lithium Levels: The Diagnostic Role of EEG
Authors: Claudia Carmassi, Benedetta Nardi, Simone Battaglini, Chiara Bonelli, Miriam Violi, Enrica Bonanni, Liliana Dell'Osso
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Introduction. Lithium is considered a first-line therapy for both the acute phase and the maintenance of bipolar disorder. Many studies highlighted its neuroprotective and neuroplastic capacity suggesting a potential usefulness in the treatment of neurodegenerative diseases. Despite the undeniable efficacy, lithium clearly presents several adverse effects including neurotoxicity, also known as lithium encephalopathy, regarding both neurological, psychiatric, and cognitive side effects. In this case, adverse reactions are not always related to its serum levels, possibly appearing within the therapeutic range. Case Presentation. We analyzed the case of a bipolar patient who has been uncontinuosly treated with lithium salts since the onset of the psychopathological picture. Over the years, the average values of lithemia always remained around 0.60-0.70 mEq/L, but in 2019, the patient begun to manifest distal tremors and in the mandibular district accompanied, in the following months, by psychomotor slowdown, generalized tremors, reduced alertness, spatiotemporal disorientation, and aphasia. While alterations referable to neurodegenerative diseases were excluded, EEG maintained rhythm alteration 1 year after the probable intoxication. Discussion. This case confirms the central role of EEG for lithium neurotoxicity, while its dosages are in therapeutic range, being plasma levels are not always indicative of liquoral and neuronal lithium's levels. We highlight the importance of an early diagnosis of lithium encephalopathy proposing EEG as an indispensable tool for assessing lithium neurotoxicity both in acute and chronic intoxication.
Case report: A novel STXBP1 splice variant and the landscape of splicing-involved STXBP1-related disorders
Authors: Haiping Wang, Xiuli Chen, Zhanli Liu, Chen Chen, Xin Liu, Mingwei Huang, Zhuying Zhou
Journal: Front Neurol (2023)
Keywords: ohtahara syndrome, rt-pcr, stxbp1-related disorder, epilepsy, functional study, genotype-phenotype relationship, intron retention, splice variant
MeSH terms: Case Reports

STXBP1 variants are one of the most common genetic causes of neurodevelopmental disorders and epilepsy, wherein STXBP1-related disorders are characterized by neurodevelopmental abnormalities in 95% and seizures in 89% of affected patients. However, the spectrums of both genotype and phenotype are quite wide and diverse, with a high baseline variability even for recurrent STXBP1 variants. Until now, no clear genotype-phenotype correlations have been established and multiple disease mechanisms have been proposed for STXBP1-related disorders. Without an ascertained disease cause for many cases of STXBP1 variants, it is challenging to manage this disease in an effective manner and current symptom-based treatments are focused on seizure control only, which has a minimal impact on global development. A novel STXBP1 canonical splice variant, NM_001032221.4:c.578+2T>C, was reported in this study, together with detailed documentation of disease manifestations and treatment management. Further RNA expression analysis revealed abnormal intron retention and possible production of truncated STXBP1 proteins as a likely pathogenic mechanism. More importantly, the landscape of previously understudied STXBP1 splice variants and functional investigations was assessed for the first time to provide a context for the discussion of the complicated genotype-phenotype relationship of STXBP1-related disorders. Future cases of this disorder and a deeper mechanism-based understanding of its pathogenic cause are required for precision medicine and better disease management.
Subcutaneous soft tissue metastases from esophageal squamous cell carcinoma with neuroendocrine differentiation: Case report and literature review
Authors: Xiaotao Geng, Jie Liu, Huimin Sun, Zhenguo Song, Shaoyong Qin, Yang Li, Yanan Zhang, Furong Hao, Yuanyuan Cai
Journal: Front Oncol (2022)
Keywords: chemotherapy, esophageal carcinoma, esophagus, immunotherapy, radiotherapy, soft tissue metastasis, squamous cell carcinoma, subcutaneous soft tissue metastasis
MeSH terms: Case Reports

Background:
Esophageal squamous cell carcinoma is the predominant subtype of esophageal cancer in China and so differs from presentations in Western countries. Common metastatic locations of esophageal cancer include the liver, lung, bone, and brain. In contrast, metastases in subcutaneous soft tissue are exceedingly rare.
Case presentation:
We present the experience of a 57-year-old man with a complaint of hand and leg dysfunction on the right side. He had a past medical history of esophageal squamous cell carcinoma. Further imaging workup revealed a solitary brain metastasis, thickening of the esophageal wall, swollen lymph nodes in the mediastinum, and right adrenal gland metastasis. Gamma knife radiosurgery of the brain metastasis and intensity-modulated radiotherapy of the esophagus and lymph nodes were administered. After 1.5 months, he was admitted to our hospital again, and nodules were identified in the anterior abdominal wall and left posterior chest wall. Ultrasound, CT, and radical excision of the abdominal wall mass were undertaken and revealed metastatic squamous cell carcinoma with neuroendocrine differentiation. We administered immunotherapy followed by targeted therapy. A PET/CT scan was performed to identify other organ metastases; the scan revealed multiple areas of fluorodeoxyglucose uptake and foci in the esophagus, lung, liver, bone, and right adrenal gland; and in various lymph nodes. In addition, an intensely hypermetabolic lesion was localized in the left posterior thorax.
Conclusion:
This case highlights the diagnosis and treatment of uncommon metastases of esophageal squamous cell carcinoma. We hope that our clinical experience provides insights into these uncommon metastases.
Chronic fungal osteomyelitis of the tibia due to Acremonium curvulum: a rare case
Authors: Sadia Khan, Anil Kumar, Vadakekoottu Bhaskaran, Sabthami Chandran, Kavitha Dinesh
Journal: Pan Afr Med J (2019)
Keywords: acremonium curvulum, acremonium spp, fungal osteomyelitis, tibial osteomyelitis, voriconazole for fungal osteomyelitis
MeSH terms: Mycoses / diagnosis, Osteomyelitis / diagnosis, Tibia / pathology, Case Reports, Acremonium / isolation & purification, Antifungal Agents / administration & dosage, Chronic Disease, Humans, Immunocompetence, Male, Middle Aged, Mycoses / drug therapy, Osteomyelitis / drug therapy, Tibia / microbiology, Treatment Outcome, Voriconazole / administration & dosage, Antifungal Agents, Voriconazole

Fungal osteomyelitis is a rare disease which usually presents in an indolent manner. Opportunistic infections due to other non-aspergillus moulds are an emerging entity. We report a case of fungal osteomyelitis due to Acremonium spp in an immunocompetent adult which showed a chronic, indolent course but responded well to treatment with voriconazole. This case highlights the importance of diagnosing the causative agent in fungal osteomyelitis as species specific susceptibility can aid in the treatment of fungal osteomyelitis.
Suprascapular Nerve Entrapment Caused by Protrusion of an Intraosseous Ganglion of the Glenoid into the Spinoglenoid Notch: A Rare Cause of Posterior Shoulder Pain
Authors: Daichi Ishimaru, Akihito Nagano, Nobuo Terabayashi, Yutaka Nishimoto, Haruhiko Akiyama
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

We describe a case of suprascapular nerve entrapment caused by protrusion of an intraosseous ganglion of the glenoid into the spinoglenoid notch. A 47-year-old man with left shoulder pain developed an intraosseous cyst in the left glenoid, which came into contact with the suprascapular nerve. The area at which the patient experienced spontaneous shoulder pain was innervated by the suprascapular nerve, and 1% xylocaine injection into the spinoglenoid notch under ultrasonographic guidance relieved the pain. Therefore, we concluded that the protrusion of an intraosseous cyst of the glenoid into the spinoglenoid notch was a cause of the pain, and performed curettage. Consequently, the shoulder pain was resolved promptly without suprascapular nerve complications, and the cyst was histologically diagnosed as an intraosseous ganglion. This case demonstrated that the intraosseous ganglion of the glenoid was a benign lesion but could be a cause of suprascapular nerve entrapment syndrome. Curettage is a useful treatment option for a ganglion inside bone and very close to the suprascapular nerve.
Perihepatic Abscess due to a Liver Suture with Pledgets Used to Treat a Penetrating Liver Injury
Authors: Hazuki Koguchi, Kimihiko Kusashio, Akihiro Fujita, Nao Yamamoto
Journal: Case Rep Emerg Med (2021)
MeSH terms: Case Reports

Background:
Selective nonoperative management has become the standard for liver injuries. Accordingly, we cannot perform surgery for liver injuries as frequently as in the past. This report is aimed at sharing a valuable experience of postoperative complications after surgery for a liver injury. Case Presentation. A 40-year-old man was stabbed in his abdomen and underwent an emergency laparotomy for a severe liver injury. Five months after the operation, he developed fever, and purulent discharge was observed from an abdominal fistula. He was diagnosed with a perihepatic abscess and duodenal perforation due to the pledgets used for the operation. He underwent a second surgery to remove the pledgets and the abscess cavity for infection control and was discharged in good condition.
Conclusion:
The intra-abdominal environment should be considered contaminated due to bile leakage in surgeries following liver injury. Furthermore, nonabsorbable agents should not be used in these contaminated areas.
Internal replacement of a vertebral body in pseudarthrosis-Armed kyphoplasty with bone graft-filled stents: Case report
Authors: Diogo Lino Moura, Ana Rita Cavaca
Journal: Front Surg (2023)
Keywords: armed kyphoplasty, bone graft, pseudarthrosis, stents, vertebral necrosis
MeSH terms: Case Reports

Background:
Post-traumatic vertebral necrosis and pseudarthrosis represents one of the most concerning and unpredictable challenges in spinal traumatology. The evolution of this disease at the thoracolumbar transition usually courses with progressive bone resorption and necrosis, leading to vertebral collapse, retropulsion of the posterior wall and neurological injury. As such, the therapeutic goal is the interruption of this cascade, seeking to stabilize the vertebral body and avoid the negative consequences of its collapse.
Case description:
We present a clinical case of a pseudarthrosis of T12 vertebral body with severe posterior wall collapse, treated with removal of intravertebral pseudarthrosis focus by transpedicular access, T12 armed kyphoplasty with VBS® stents filled with cancellous bone autograft, laminectomy and stabilization with T10-T11-L1-L2 pedicle screws. We present clinical and imaging detailed results at 2-year follow-up and discuss our option for this biological minimally invasive treatment for vertebral pseudarthrosis that mimics the general principles of atrophic pseudarthrosis therapeutic and allows to perform an internal replacement of the necrotic vertebral body, avoiding the aggression of a total corpectomy.
Conclusions:
This clinical case demonstrates a successful outcome of the surgical treatment of pseudarthrosis of vertebral body (mobile nonunion vertebral body) in which expandable intravertebral stents allow to perform an internal replacement of the necrotic vertebral body by creating intrasomatic cavities and filling them with bone graft, obtaining a totally bony vertebra with a metallic endoskeleton, which is biomechanically and physiologically more similar to the original one. This biological internal replacement of the necrotic vertebral body technique can be a safe and effective alternative over cementoplasty procedures or total vertebral body corpectomy and replacement for vertebral pseudarthrosis and may have several advantages over them, however long-term prospective studies are needed in order to prove the effectiveness and advantages of this surgical option in this rare and difficult pathological entity.
Long-term positive severe acute respiratory syndrome coronavirus 2 ribonucleic acid and therapeutic effect of antivirals in patients with coronavirus disease: Case reports
Authors: Bo Wei, Xiaofeng Hang, Ying Xie, Yuanjing Zhang, Jianrong Wang, Xinghao Cao, Jinzi J Wu, Junxue Wang
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: Antiviral Agents / therapeutic use, Coronavirus Infections / drug therapy, Coronavirus Infections / virology, Coronavirus, Pandemics, Pneumonia, Viral / drug therapy, Pneumonia, Viral / virology, RNA, Viral / blood, Case Reports, Adult, Aged, Betacoronavirus, COVID-19, COVID-19 Drug Treatment, Humans, Male, Middle Aged, SARS-CoV-2, Antiviral Agents, RNA, Viral

Coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared a pandemic. We herein report four COVID-19 cases with long-term positive viral ribonucleic acid (RNA) for about 61 days. Despite treatment with recombinant human interferon, convalescent plasma from COVID-19 patients, arbidol, etc., nucleic acid results were still positive for SARS-CoV-2. After treatment with ritonavir-boosted danoprevir (DNVr, 100/100 mg, once daily), all four patients showed two to three consecutive negative SARS-CoV-2 RNA and were thus discharged from hospital. Therefore, DNVr may be a potentially effective antiviral for COVID-19 patients with long-term positive SARS-CoV-2 RNA.
Rhabdomyolysis-induced acute renal failure following fenofibrate therapy: a case report and literature review
Authors: Ramazan Danis, Sami Akbulut, Sehmus Ozmen, Senay Arikan
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Fenofibrate, a fibric acid derivative, is used to treat diabetic dyslipidemia, hypertriglyceridemia, and combined hyperlipidemia, administered alone or in combination with statins. Rhabdomyolysis is defined as a pathological condition involving skeletal muscle cell damage leading to the release of toxic intracellular material into circulation. Its major causes include muscle compression or overexertion; trauma; ischemia; toxins; cocaine, alcohol, and drug use; metabolic disorders; infections. However, rhabdomyolysis associated with fenofibrate is extremely rare. Herein we report a 45-year-old female patient who was referred to our department because of generalized muscle pain, fatigue, weakness, and oliguria over the preceding 3 weeks. On the basis of the pathogenesis and clinical and laboratory examinations, a diagnosis of acute renal failure secondary to fenofibrate-induced rhabdomyolysis was made. Weekly followups for patients who are administered fenofibrate are the most important way to prevent possible complications.
A qualitative analysis of the nurturing care environment of families participating in Brazil's Criança Feliz early childhood program
Authors: Laura Mendes Toledo Dal'Ava Dos Santos, Lidia Godoi, Beatriz de Andrade E Guimarães, Isabela Mendes Coutinho, Nathalia Pizato, Vivian S S Gonçalves, Gabriela Buccini
Journal: PLoS One (2023)
MeSH terms: Family, Nutritional Status, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Brazil, Child, Child Health, Child, Preschool, Humans, Poverty

Investing in early childhood programs such as Brazil's Criança Feliz Program (PCF) to support low-income families in providing a nurturing care environment is critical to ensure that children reach their full developmental potential. We aimed to analyze the influence of the PCF on the nurturing care environment provided by families enrolled in the program in the Federal District, Brazil. A qualitative case study was conducted based on in-depth interviews with a purposive sampling of 22 caregivers enrolled in the PCF for at least six months. Eighteen subthemes emerged from the thematic analysis following the five components of the Nurturing Care Framework (i.e., good health, adequate nutrition, responsive care, early learning, and security and safety). Caregivers recognized the benefits of the PCF on children's mental health (good health) and reported challenges in providing adequate nutrition due to food insecurity (adequate nutrition). A bond between the home visitor and families was identified as critical to promote responsive parenting practices (responsive care). Caregivers appreciated the early stimulation activities provided during PCF home visits (opportunities for early learning). Access to social welfare programs, such as conditional cash transfer and food assistance, were facilitated through PCF multisectoral actions (safety and security). On the other hand, families reported not receiving support from PCF for issues such as breastfeeding, maternal mental health, and disciplinary practices. In summary, PCF enhanced the components of the nurturing care environment provided by families. However, their vulnerabilities and contextual implementation barriers may prevent families from fully benefiting from PCF activities.