OpenMed/multicare-articles huggingface dataset:
Saliva secretion disorder in a schizophrenic patient - a problem in dental and psychiatric treatment: a case report
Authors: Danuta Maria Moś
Journal: Ann Gen Psychiatry (2015)
Keywords: dental plaque, neuroleptic, saliva secretion, schizophrenia
MeSH terms: Case Reports

Objective:
Saliva secretion disorder may appear in patients at any age and represents a serious problem in interdisciplinary treatment. It is manifested by hyposecretion or hypersecretion of saliva. One of the major groups of patients who have been diagnosed with saliva secretion disorder includes those treated with neuroleptics. Among patients taking neuroleptics, schizophrenic patients represent the least cooperative group in terms of doctor-patient relationship. Schizophrenia is a mental disorder exacerbated by uncontrolled neuroleptic dose reduction or regardless of applied pharmacotherapy.
Method:
This paper presents a clinical case of a 30-year-old schizophrenic patient with saliva secretion problems.
Results:
In schizophrenia, thought disorders (TD) and social functioning impairment have a negative impact on patients' somatic health care. Saliva hyposecretion and its health consequences, such as parodontitis and caries, are the reasons why the patients decide to have a dental appointment.
Conclusion:
This paper contains important information for dentists, psychiatrists, and psychologists, as it raises an issue of a proper interdisciplinary care approach provided to schizophrenic patients. It emphasises the importance of psychoeducation and draws attention to social functioning of mentally ill patients.
A Painless Restricted Motion of the Thumb: What Etiology? About An Uncommon Tumor in Uncommon Localization
Authors: Naoufal Elghoul, Mohammed Benchakroun, Azzelarab Bennis, Omar Zaddoug, Ali Zine, Mansour Tanane, Abdeloihab Jaafar
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Lipomas in fingers are rare and account for less than 1% of all cases. As a type of lipoma, the spindle cell lipoma is exceptional and it presents 1.5% of total adipocyte tumors. Moreover, its localization in the thumb is extremely rare. Only three cases have already been reported in adults; our case constitutes the fourth case, which is about a 61-year-old female who presented since 18 months a mass on the ulnar lateral aspect of the thumb. After clinical and radiological assessments, an entire excisional biopsy of the mass was performed. The histopathological analysis confirmed the spindle cell lipoma of the thumb. At the last follow-up of two years, the patient did well with no recurrence and no restricted motion of the thumb. So, although lipomas of the digit are rare, they should be considered a possible etiology of either painful or mechanic restricted motion of the digit.
Rare type I CBFβ/MYH11 fusion transcript in primary acute myeloid leukemia with inv(16)(p13.1q22): a case report
Authors: Wenyi Zhang, Hainan Wang, Peilei Zhang, Hongliang Li, Xiaoli Ma, Hongxing Liu
Journal: Braz J Med Biol Res (2021)
MeSH terms: Chromosome Inversion / genetics, Leukemia, Myeloid, Acute / genetics, Case Reports, Humans, Myosin Heavy Chains / genetics, Oncogene Proteins, Fusion / genetics, MYH11 protein, human, Oncogene Proteins, Fusion, Myosin Heavy Chains

Inv(16)(p13.1q22) in acute myeloid leukemia (AML) is a common chromosomal abnormality. It leads to the core-binding factor ß-subunit (CBFβ)/smooth muscle myosin heavy chain 11 (MYH11) fusion gene. Different breakpoints were observed in the CBFβ gene at 16q22 and the MYH11 gene at 16p13.1. For this reason, different CBFβ/MYH11 fusion genes are generated, with more than 13 types having been reported to date. Type I CBFβ/MYH11 fusion transcripts are very rare, with only 10 cases being reported to date. This case report describes a primary AML patient with inv(16)(p13.1q22) and a rare type I CBFβ/MYH11 fusion gene. The morphological analysis did not conform to the typical M4eo. Abnormal eosinophils were less than 5%, and there was obvious dysgranulopoiesis. The patient was in hematological and genetic remission for 487 days after the initial chemotherapy cycles. However, the CBFβ/MYH11 fusion had been constantly positive. Moreover, the presence of non-type A fusions may affect its biology and clinical prognosis. Therefore, further studies on understanding its biological and prognostic significance are essential.
Brooke-spiegler syndrome with multiple scalp cylindromas and bilateral parotid gland adenomas
Authors: Peter Kalina, Rokea El-Azhary
Journal: Case Rep Radiol (2012)
MeSH terms: Case Reports

A 62-year-old female presented with numerous soft tissue lesions of her scalp and bilateral preauricular region. Several of these have been biopsied or removed with a diagnosis of cylindromas. Cylindromas are benign tumors with a differentiation towards apocrine sweat glands that increase in number and size throughout life. Multiple scalp cylindromas may coalesce and cover the entire scalp, resulting in the "turban tumor." These are often associated with the autosomal dominant Brooke-Spiegler syndrome with coexistent facial trichoepitheliomas and spiradenomas. There is a very rare association between cylindromas and basal cell adenoma and adenocarcinoma of the parotid gland, with only 17 reported cases. Ours is the first CT demonstration of both the scalp and parotid gland findings in this uncommon situation.
Total uterine prolapse: a rare cause of chronic obstructive uropathy associated with renal dysfunction (a case report)
Authors: Anna Thanasa, Efthymia Thanasa, Ioannis Paraoulakis, Evangelos Kamaretsos, Apostolos Ziogas, Gerasimos Kontogeorgis, Vasiliki Grapsidi, Evangelos-Ektoras Gerokostas, Elisavet Mylona, Ioannis Thanasas
Journal: Pan Afr Med J (2023)
Keywords: total uterine prolapse, case report, hydronephrosis, imaging examination, renal dysfunction
MeSH terms: Cystocele / complications, Hydronephrosis / etiology, Pelvic Organ Prolapse / pathology, Uterine Prolapse / complications, Uterine Prolapse / surgery, Case Reports, Female, Humans, Pregnancy, Quality of Life

Pelvic organ prolapse is rarely associated with severe bilateral ureteral hydronephrosis and renal dysfunction. The etiopathogenetic mechanism has not been fully elucidated. Contemporary imaging methods of the urinary tract play a decisive role in assessing the morphological function of the kidneys. In cases of moderate and severe pelvic organ prolapse, surgery appears to be the main choice of treatment. Our case concerns a post-menopausal patient with three vaginal deliveries in her obstetric history and with a history of bilateral hydronephrosis and impaired renal function who was referred to the outpatient clinic for a gynecological examination due to complete uterine prolapse. Bilateral hydroureteronephrosis due to prolapse was assessed as the main cause of renal dysfunction. A surgical intervention was decided to the pelvic floor and a vaginal hysterectomy was performed with simultaneous correction of the cystocele and rectocele. The postoperative course was uneventful. Three months later, re-examination of the urinary tract showed complete remediation of kidney morphology and function. The present case report emphasizes the significant degree of bilateral hydroureteronephrosis and deterioration of renal function rarely seen in patients with complete uterine prolapse. At the same time, it is pointed out that the exclusion of renal dysfunction related to complete uterine prolapse should be the main concern of the modern gynecologist even for complex cases with coexisting etiological factors for renal disease, in order to avoid permanent renal parenchymal damage and ensure the best health and quality of life of these patients.
Implant loosening following THA with S-ROM prosthesis and subtrochanteric osteotomy: Three case reports
Authors: Yingkai Ma, Xinnan Ma, Shi Cheng, Songcen Lv, Xin Qi
Journal: Front Surg (2023)
Keywords: ddh, osteotomy under the lesser, prosthesis loosening, revision, s-rom
MeSH terms: Case Reports

Prosthesis loosening after THA is a rather common complication. For DDH patients with Crowe IV, the surgical risk and complexity is significant. THA with S-ROM prosthesis combined with subtrochanteric osteotomy is a common treatment. However, loosening of a modular femoral prosthesis (S-rom) is uncommon in THA and has a very low incidence. With modular prostheses distal prosthesis looseness are rarely reported. Non-union osteotomy is a common complication of subtrochanteric osteotomy. We report three patients with Crowe IV DDH who developed prosthesis loosening following THA with an S-ROM prosthesis and subtrochanteric osteotomy. We addressed the management of these patients and prosthesis loosening as likely underlying causes.
Reexpansion Pulmonary Edema following Tube Thoracostomy in a Pediatric Patient with Anterior Mediastinal Mass
Authors: Sung-Wook Choi, Deborah A Romeo, David A Gutman, Jennifer V Smith
Journal: Case Rep Anesthesiol (2022)
MeSH terms: Case Reports

Reexpansion pulmonary edema (RPE) is an exceedingly rare and potentially fatal complication of a rapidly reexpanded lung following evacuation of air or fluid from the pleural space secondary to conditions such as a mediastinal mass, pleural effusion, or pneumothorax. Clinical presentations can range from mild radiographic changes to acute respiratory failure and hemodynamic instability. The rapidly progressive nature of the disease makes it important for clinicians to appropriately diagnose and manage patients who develop RPE. We present a case of a child with a large malignant pleural effusion who developed severe RPE after tube thoracostomy and ultimately required venoarterial extracorporeal membrane oxygenation (VA-ECMO). The patient was 7-year-old Caucasian male with newly diagnosed ambiguous T cell myeloid leukemia. A chest computerized tomography (CT) demonstrated a large pleural effusion causing tracheal shift and left bronchus compression as well as an anterior mediastinal mass causing compression of the right atria and right ventricle. Tube thoracostomy was performed in the operating room (OR) with deep sedation. The procedure was complicated with hypoxemia, bradycardia, and pulseless cardiac arrest. After return of spontaneous circulation, the child continued to have refractory hypoxemia, profound hypotension, and frothy secretions. Endotracheal intubation was performed with a size 5.0 cuffed endotracheal tube. Chest radiograph demonstrated opacification of the left hemithorax with chest infiltrates. Patient required VA-ECMO for circulatory support. Supportive therapy of RPE was continued and decannulation was done on day three. Tracheal extubation was performed on day five.
Clinical and Immunohistochemical Features of Oral Angioleiomyoma: A Comprehensive Review of the Literature and Report of a Case in a Young Patient
Authors: Amerigo Giudice, Francesco Bennardo, Caterina Buffone, Ylenia Brancaccio, Francesca Maria Plutino, Leonzio Fortunato
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Angioleiomyoma (AL) is an uncommon benign soft tissue neoplasia arising from the tunica media of the smooth muscle cells. AL appears as a solitary and slow-growing mass and seldom is observed in oral tissues. We reported a rare case of AL involving the cheek of a 17-year-old young woman. A review of the English-language literature was performed entering the keywords "angioleiomyoma" and "oral" in the search fields of PubMed. 70 results were identified. Excluded were cases that were not in the oral cavity or not compatible with the AL diagnosis or report lacking immunohistochemical analysis. According to the exclusion criteria, we selected 30 studies that included 63 cases of AL. The results of the review showed an average age of 42.97 years with a prevalence between the fourth and fifth decade of life with a male-to-female ratio of 1.95 : 1. The most affected sites were palate, buccal mucosa of the cheek, lip, tongue, and gingiva. Surgical excision was the treatment of choice, and diagnosis was possible through histopathological and immunohistochemical analysis. SMA, vimentin, CD34, desmin, and S-100 were the most common markers to guide the histopathological diagnosis of oral AL. In conclusion, oral AL is a rare entity, especially in adolescence as in the reported case of AL of the cheek in a 17-year-old woman. The clinical aspects of AL did not allow clinicians to make a correct presumptive diagnosis. A scrupulous histopathological analysis and immunohistochemical examinations are fundamental to differentiate AL from other lesions.
Hemophagocytic Lymphohistiocytosis Following COVID-19 Infection
Authors: Guarina Molina, Rafael Contreras, Kyle Coombes, Thilini Walgamage, Maria A Perozo, Martha T DesBiens
Journal: Cureus (2023)
Keywords: covid 19, disseminated intravascular coagulation (dic), hemophagocytic lymphohistiocytosis (hlh), inflammatory mediators, pancytopenia, soluble interleukin receptors
MeSH terms: Case Reports

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been associated with multiple inflammatory symptoms involving several organ systems, including hematologic manifestations. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome caused by excessive inflammation in the absence of immune regulation. We present the case of a patient with HLH secondary to dysregulated inflammatory response following COVID-19; we also describe the diagnostic and management challenges associated with the condition.
Barriers to knowledge sharing in Chinese healthcare referral services: an emergent theoretical model
Authors: Lihong Zhou, Miguel Baptista Nunes
Journal: Glob Health Action (2016)
Keywords: chinese healthcare systems, healthcare referral services, knowledge sharing, knowledge sharing barriers
MeSH terms: Attitude of Health Personnel, Communication Barriers, Health Services, Interprofessional Relations, Referral and Consultation, Research Support, Non-U.S. Gov't, China, Humans, Leadership, Models, Theoretical, Qualitative Research

Background:
This paper reports on a research study that aims to identify and explain barriers to knowledge sharing (KS) in the provision of healthcare referral services in Chinese healthcare organisations.
Design:
An inductive case study approach was employed, in which 24 healthcare professionals and workers from four healthcare organisations in the province of Hubei, Central China, were interviewed using semi-structured scripts.
Results:
Through data analysis, 14 KS barriers emerged in four main themes: interpersonal trust barriers, communication barriers, management and leadership barriers, and inter-institutional barriers. A cause-consequence analysis of the identified barriers revealed that three of them are at the core of the majority of problems, namely, the absence of national and local policies for inter-hospital KS, lack of a specific hospital KS requirement, and lack of mutual acquaintance.
Conclusions:
To resolve KS problems, it is of great importance that healthcare governance agencies, both at the national and regional levels, take leadership in the process of KS implementation by establishing specific and strong policies for inter-institutional KS in the referral process. This paper raises important issues that exceed academic interests and are important to healthcare professionals, hospital managers, and Information communication technology (ICT) managers in hospitals, as well as healthcare politicians and policy makers.
Adverse Effects of Proton Pump Inhibitors on Platelet Count: A Case Report and Review of the Literature
Authors: Subhajit Mukherjee, Tanima Jana, Jen-Jung Pan
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Proton pump inhibitors (PPIs) are the most effective and preferred class of drugs used to treat peptic ulcer disease, gastroesophageal reflux disease, and other diseases associated with increased production of gastric acid. PPIs in general have an excellent long-term safety profile and are well-tolerated. However, studies have shown some adverse reactions (e.g., osteoporosis, Clostridium difficile-associated diarrhea, Vitamin B12 and iron deficiency, and acute interstitial nephritis) on long-term PPI use. Thrombocytopenia attributed to use of PPIs has been described in a few case reports and a retrospective study. In this case report, we describe a case of PPI-induced thrombocytopenia. In our patient, thrombocytopenia immediately developed after the initiation of PPI on two separate occasions and resolved after its discontinuation. The strong association found in our case implies the potential role of PPI in causing this rare but serious adverse reaction. Based on this case report and the observation from other studies, a PPI-induced adverse event should be considered as a possible etiology for new-onset idiopathic thrombocytopenia.
Pembrolizumab-Induced Thyroiditis Shows PD-L1Expressing Histiocytes and Infiltrating T Cells in Thyroid Tissue - A Case Report
Authors: Jörg Jabkowski, Almute Loidl, Barbara Auinger, Helmut Kehrer, Norbert Sepp, Robert Pichler
Journal: Front Immunol (2021)
Keywords: fdg, pet, melanoma, pembrolizumab, thyroiditis
MeSH terms: Antibodies, Monoclonal, Humanized / adverse effects, B7-H1 Antigen / metabolism, CD4-Positive T-Lymphocytes / immunology, Drug-Related Side Effects and Adverse Reactions / diagnosis, Histiocytes / immunology, Immune Checkpoint Inhibitors / adverse effects, Immunotherapy / methods, Melanoma / drug therapy, Skin Neoplasms / drug therapy, Thyroid Gland / pathology, Thyroiditis / diagnosis, Case Reports, Antibodies, Monoclonal, Humanized / therapeutic use, Cell Movement, Humans, Immune Checkpoint Inhibitors / therapeutic use, Male, Melanoma / complications, Melanoma / diagnosis, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Skin Neoplasms / complications, Skin Neoplasms / diagnosis, Thyroid Gland / immunology, Thyroidectomy, Thyroiditis / etiology, Antibodies, Monoclonal, Humanized, B7-H1 Antigen, CD274 protein, human, Immune Checkpoint Inhibitors, pembrolizumab

Context:
Immune-related adverse events frequently take place after initiation of immune checkpoint inhibitors (ICI) therapy. The thyroid gland is the endocrine organ most commonly affected by ICI therapy, the pathological mechanism is still poorly understood.
Case description:
A 60-year old Upper Austrian male melanoma patient under pembrolizumab therapy received thyroidectomy because of a suspicious FDG avid thyroid nodule. Histopathology showed a pattern comparable with thyroiditis de Quervain. The inflammatory process consisted predominantly of T lymphocytes with a dominance of CD4+ T helper cells. In addition CD68+ histiocytes co-expressing PD-L1 were observed.
Conclusion:
Clusters of perifollicular histiocytes expressing PD-L1 were observed in this case of pembrolizumab induced thyroiditis - probably induced by the former ICI therapy. This finding might indicate the initial target for the breakdown of self tolerance. In context with other data the immunological process seems to be driven by CD3+ lymphocytes infiltrating the thyroid.
Nonfunctioning Pituitary Adenoma That Changed to a Functional Gonadotropinoma
Authors: Gerson Geovany Andino-Ríos, Lesly Portocarrero-Ortiz, Carlos Rojas-Guerrero, Alejandro Terrones-Lozano, Alma Ortiz-Plata, Alfredo Adolfo Reza-Albarrán
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Objective:
Pituitary adenomas can be classified as clinically functional or silent. Depending on the reviewed literature, these are the first or second place in frequency of the total pituitary adenomas. Even rarer is the presence of a functional gonadotropinoma since only very few case reports exist to date. The conversion of a clinically silent to functional pituitary adenoma is extraordinarily rare; the mechanisms that explain these phenomena are unknown or not fully understood.
Methods:
We report the case of a woman who initially had a nonfunctional gonadotropinoma and in the course of her medical condition showed biochemical changes in her hormonal pituitary profile compatible with a functional gonadotropinoma.
Results:
We considered that the patient had a functional gonadotropinoma due to the hyperestrogenemia in the context of secondary amenorrhea, resolving the hyperestrogenemia after almost complete resection of the tumor.
Conclusion:
It is necessary to point out from a clinical and/or biochemical point of view the change in functionality that a nonfunctional pituitary adenoma may have. In the case of our patient, the suspicion of this change in functionality became evident when we found an increase in the FSH/LH ratio and a progressive increase in serum estradiol concentrations when the patient had amenorrhea.
Pregnancy Outcome after Exposure to Migalastat for Fabry Disease: A Clinical Report
Authors: Natalja Haninger-Vacariu, Sarah El-Hadi, Udo Pauler, Marina Foretnik, Renate Kain, Zoltán Prohászka, Alice Schmidt, Nina Skuban, Jay A Barth, Gere Sunder-Plassmann
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Our patient was a 37-year-old woman with Fabry disease (GLA p.R112H) with a medical history of recurrent headache, nausea, vomiting, vertigo, and tobacco use (20 cigarettes/day). Fabry disease was diagnosed in 2005 when she experienced proteinuria, preeclampsia, and hypertension (201/130 mm Hg) during pregnancy (delivered 50 cm, 3.4 kg healthy boy; GLA wild type [WT]). Enzyme replacement therapy was initiated in 2009. The patient enrolled in the phase 3 ATTRACT trial (ClinicalTrials.gov; NCT01218659) and started migalastat in May 2012 while taking hormonal contraceptives. Two years after initiating migalastat, the patient had proteinuria (2166 mg/24 h) without hypertension (131/68 mm Hg), which persisted (788 mg/24 h a month later). Kidney biopsy results were consistent with existing Fabry disease. A serum pregnancy test and ultrasound confirmed pregnancy (18 weeks' gestation). Migalastat and hormonal contraceptives were stopped; the patient continued to smoke. Fetal MRI was normal at ~29 weeks' gestation. In October 2014, at 37+ weeks' gestation, the patient delivered a 45-cm, 2.29-kg healthy girl (GLA WT). Excepting low birth weight, which may be related to the patient's smoking, pregnancy outcome was normal despite exposure to migalastat for 18 weeks. Migalastat therapy during pregnancy is not advised.