OpenMed/multicare-articles huggingface dataset:
Integrative treatment program for the treatment of children with autism spectrum disorder: A prospective observational case series
Authors: Boram Lee, Serin Park, Hyun Jeong Kwon, Gwi Seo Hwang, Moonju Kim
Journal: Front Neurol (2023)
Keywords: floortime, autism spectrum disorder, case series, herbal medicine, integrative medicine, sensory enrichment therapy

Background:
In a situation where conventional treatments for autism spectrum disorder (ASD) are labor-intensive and there are concerns about the side effects of conventional medications, a 6-month integrative treatment program, including herbal medicine (HM), Floortime, and sensory enrichment therapy (SET) has been used on children with ASD in Korean medicine clinical settings.
Methods:
We observed the treatment responses of 18 children with ASD (66.7% male, mean age 3.9 ± 0.9 years) to the integrative treatment program as part of a prospective, single-center, observational case series. Individualized HMs were administered according to the patient's symptoms, and parents were instructed to perform Floortime and SET with their children at home for 2 h and 20 min a day, 5 days a week, respectively. The Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) were used to evaluate the core symptoms of ASD. A linear mixed model for repeated measures was used for analyzing the effect of the program over time, and logistic regression used to explore the predictors of treatment response.
Results:
The CARS and ABC scores were significantly improved from 34.58 ± 6.27 and 69.28 ± 15.73 at baseline to 28.56 ± 6.05 and 39.67 ± 20.36 after 6 months (p < 0.0001, respectively). No serious adverse events (AEs) were reported, and compliance with HM, Floortime, and SET was high at >90%.
Conclusion:
This 6-month integrative treatment program appears to be a potentially effective, safe, and feasible option for children with ASD. Low baseline CARS scores may be predictors of higher treatment response.
Magnetic resonance imaging findings in a patient with seropositive neuromyelitis optica
Authors: Siviwe S Mpateni, Naye C Sihlali, Emma C Gardiner, Nkululo Gigi
Journal: SA J Radiol (2018)
MeSH terms: Case Reports

We present the case of a 23-year-old female with a subacute history of complex additive neurology which consisted of progressive unilateral visual impairment and subsequent blindness of the right eye, in conjunction with distal lower motor neuron symptoms of weakness and sensory loss from T4 level down. Special investigations performed, included serology and an urgent magnetic resonance imaging (MRI) of the brain and spinal cord, which exhibited a diffuse demyelinating disease of the brain and spinal cord without the typical features of multiple sclerosis (MS) and laboratory findings, which were positive for the AQP-4 antibody, confirming the diagnosis of neuromyelitis optica (NMO). Pulsed methylprednisolone was initiated urgently with good effect and immunosuppression with cyclophosphamide was added after the exclusion of additional pathology. She experienced a complete resolution of her weakness and sensory impairment upon discharge; however, her unilateral visual loss remained. The recent advances in the identification of autoimmune biomarkers and the widening spectrum of imaging findings in NMO necessitate that the clinician and radiologist keep abreast of the current diagnostic tools and criteria that distinguish NMO from other demyelinating conditions.
Long-term survival in a patient with multiple brain metastases from small-cell lung cancer treated with gamma knife radiosurgery on four occasions: a case report
Authors: Ameer L Elaimy, Sudheer R Thumma, Andrew F Lamm, Alexander R Mackay, Wayne T Lamoreaux, Robert K Fairbanks, John J Demakas, Barton S Cooke, Christopher M Lee
Journal: Case Rep Neurol Med (2012)

Brain metastases are the most common cancerous neoplasm in the brain. The treatment of these lesions is challenging and often includes a multimodality management approach with whole-brain radiation therapy, stereotactic radiosurgery, and neurosurgery options. Although advances in biomedical imaging technologies and the treatment of extracranial cancer have led to the overall increase in the survival of brain metastases patients, the finding that select patients survive several years remains puzzling. For this reason, we present the case of a 70-year-old patient who was diagnosed with multiple brain metastases from small-cell lung cancer five years ago and is currently alive following treatment with chemotherapy for the primary cancer and whole-brain radiation therapy and Gamma Knife radiosurgery on four separate occasions for the neurological cancer. Since the diagnosis of brain metastases five years ago, the patient's primary cancer has remained controlled. Furthermore, multiple repeat GKRS procedures provided this patient with high levels of local tumor control, which in combination with a stable primary cancer led to an extended period of survival and a highly functional life. Further analysis and clinical research will be valuable in assessing the durability of multiple GKRS for brain metastases patients who experience long-term survival.
Progressive macular hypomelanosis: a rarely diagnosed hypopigmentation in Caucasians
Authors: Sven Neynaber, Christina Kirschner, Stefanie Kamann, Gerd Plewig, Michael J Flaig
Journal: Dermatol Res Pract (2009)
MeSH terms: Case Reports

A 35-year-old woman who developed whitish macules on trunk and limbs at 12 years of age and observed a remarkable increase of the hypopigmentated lesions after her pregnancies at ages 29 and 32 years. Because of the highly characteristic clinical aspect and the light- and electron-microscopic histopathologic findings, we diagnosed progressive macular hypomelanosis (PMH). It is a nonscaly disorder with hypopigmented macules mainly on the trunk and is more often seen in young women. In contrast to some authors assuming the presence of Propionibacterium spp. as a matter of principle in PMH, we report a case with no evidence for Propionibacterium spp.
Recovering of Dizziness of a Patient with Sinusitis after Root Canal Therapy for Upper Second Molar
Authors: Ibrahem Amro, Lyana Shawar, Raed Abu Hantash, Basem Abuquba, Akram Amro
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

This case report illustrates the recovery of dizziness of a young healthy patient after root canal therapy of upper second molar. The patient developed dizziness and unbalanced walking four months ago. After cardiac, ENT, neurological, physiotherapy and medical investigations, his entire checkup showed no abnormalities. The patient visited a dental clinic for a routine checkup; after dental clinical and radiographical examination, a chronic abscess infection in an upper second molar region close to the sinus was diagnosed. Root canal therapy was performed that resulted in a disappearance of the dizziness and full recovery was achieved. Conclusion. Infected upper teeth with periapical lesion are associated with dizziness as a complication of odontogenic-related sinusitis. Dental and medical cooperation contributes to a better management diagnosis of the dizziness.
Complicated COVID-19 in pregnancy, maternal and neonatal outcomes: a case report
Authors: Mouna Gara, Eya Sahraoui, Wafa Dhouib, Dhekra Toumi, Olfa Zoukar, Meriem Mehdi, Ali Jlali, Raja Faleh, Lotfi Grati
Journal: Pan Afr Med J (2022)
Keywords: covid-19, case report, coagulopathy, pregnancy, respiratory distress syndrome
MeSH terms: COVID-19 / complications, COVID-19 / diagnosis, COVID-19 / therapy, Pregnancy Complications, Infectious / diagnosis, Respiratory Distress Syndrome, Case Reports, Family, Female, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Intensive Care Units, Neonatal, Pregnancy, Pregnancy Outcome, SARS-CoV-2

The novel coronavirus disease 2019 (COVID-19) has exposed vulnerable populations, including pregnant women, to an unprecedented public health crisis. According to recent data, pregnancy in COVID-19 patients is associated with increased hospitalization, admission to the intensive care unit (ICU) and intubation. It has been suggested that pregnancy induced immune responses and cardiorespiratory changes can exaggerate the course of the COVID-19. The present is a case of a pregnant woman who presented with critical respiratory failure secondary to COVID-19 resulted in her admission to the ICU and mechanical ventilator support. After childbirth, maternal outcomes were marked by disseminated intravascular coagulopathy and cardiopulmonary arrest on day thirty-four of admission. As to the neonatal outcome, a preterm female baby was transferred to the neonatal intensive care unit (NICU) and intubated immediately due to progressive respiratory distress. She was diagnosed with bacterial pneumonia with no evidence of COVID-19 and recovered after twenty-one days after NICU stay. This case showed that the maternal COVID-19 may lead to acute respiratory distress syndrome, coagulation dysfunction and preterm delivery. The risk of vertical transmission by SARS-CoV-2 is probably very low.
Case report: Treatment-resistant depression with acute psychosis in an adolescent girl with Cushing's syndrome
Authors: Xiaowen Yin, Song Chen, Xuan Ju, Xiwen Hu
Journal: Front Psychiatry (2023)
Keywords: cushing's syndrome (cs), acute psychosis, adolescent girl, adrenal adenoma (aa), treatment-resistant depression
MeSH terms: Case Reports

Cushing's syndrome (CS) is a rare disease with multiple somatic signs and a high prevalence of co-occurring depression. However, the characteristics of depression secondary to CS and the differences from major depression have not been described in detail. In this case, we report a 17-year-old girl with treatment-resistant depression with a series of atypical features and acute psychotic episodes, which is a rare condition secondary to CS. This case showed a more detailed profile of depression secondary to CS and highlighted the differences with major depression in clinical features, and it will improve insight into the differential diagnosis especially when the symptoms are not typical.
Unusual Etiology of Chronic Posterior Leg Pain in a Running Athlete: Could It Be a Schwannoma? A Case Report and Review of the Literature
Authors: Naoufal Elghoul, Omar Zaddoug, Mohammed Tbouda, Mohammed Benchakroun, Abdeloihab Jaafar
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Schwannomas represent only 5% of all soft tissue tumors. As a variant of this tumor, the plexiform schwannoma is rare accounting for less than 5% of all schwannomas. Herein, we report a rare case of a 49-year-old athlete who suffered from a pain in the posterior aspect of the right leg one year before his presentation. Initially, a radiograph of his right leg showed no abnormality, and so, the emergency physician discharged him on analgesics and anti-inflammatory medications, and rest was advised. The persistent pain obliged the patient to consult our orthopedic department. On examination, we found a firm mass in the proximal medial aspect of his right leg. The neurovascular exam was normal. Sonography of the leg was not conclusive. Therefore, magnetic resonance imaging was performed, and a hemangioma or schwannoma was suspected. The patient underwent surgery in which the entire tumor mass was shelled out in one piece with no damage. The histopathological finding was concomitant with a plexiform schwannoma. Follow-up evaluation, sixteen months later, showed no evidence of recurrence, and the patient has regained his previous level of sportive activities. So, given the case described here, despite the rarity of the schwannoma, it should be taken into consideration as a possible diagnosis in such situation to promote early diagnosis and appropriate treatment.
Diagnostic challenges in systemic amyloidosis: a case report with clinical and laboratorial pitfalls
Authors: Angelina Maria Martins Lino, Jussara Bianchi Castelli, Roberta Shcolnik Szor, Fabio Fernandes, Vera Demarchi Aiello
Journal: Autops Case Rep (2021)
Keywords: amyloidosis, familial, diagnostic errors, light chain immunoglobulin amyloidosis, paraproteinemias, polyradiculoneuropathy, chronic inflammatory demyelinating
MeSH terms: Case Reports

Currently, there is growing evidence in the literature warning of misdiagnosis involving amyloidosis and chronic inflammatory demyelinating polyneuropathy (CIDP). Although inducing clinical manifestations outside the peripheral nervous system, light chain and transthyretin amyloidosis may initially present with peripheral neuropathy, which can be indistinguishable from CIDP, leading to a delay in the correct diagnosis. Besides, the precise identification of the amyloid subtype is often challenging. This case report exemplifies clinical and laboratory pitfalls in diagnosing amyloidosis and subtyping amyloid, exposing the patient to potentially harmful procedures.
Multisystemic Sarcoidosis Presenting With Leg Ulcers, Pancytopenia, and Polyserositis Was Successfully Treated With Glucocorticoids: A Case Report and Literature Review
Authors: Xin Qiao, Shan He, Abdullah Altawil, Qiu-Yue Wang, Jian Kang, Wen-Yang Li, Yan Yin
Journal: Front Med (Lausanne) (2022)
Keywords: case report, glucocorticoid, pancytopenia, sarcoidosis, splenomegaly
MeSH terms: Case Reports

Introduction:
Sarcoidosis is a chronic granulomatous disease of unknown etiology. A variety of studies have pointed out that almost every part of the body can be affected, but it most often affected the lungs and intrathoracic lymph nodes. However, cases of sarcoidosis involving multiple organs in one patient are rarely reported. We describe a unique case of sarcoidosis, which was characterized by multiorgan involvement, including leg ulcers, splenomegaly, pancytopenia, and polyserositis. Glucocorticoids were effective during the treatment of the above lesions. This case highlights the diversity of clinical manifestations of sarcoidosis and emphasizes the importance of its differential diagnosis and the periodical follow-up. These are crucial to physicians in the diagnosis and treatment of sarcoidosis.
Main symptoms and important clinical findings:
A 30-year-old male complained about intermittent fever 3 years ago. A computed tomographic scan of the chest showed lymphadenopathy in the mediastinum and hilar regions. Routine blood tests showed leukopenia and mild anemia. The pathologic result of mediastinal lymph node biopsy was granulomatous lesions; thus, the patient was diagnosed with type II sarcoidosis without glucocorticoid therapy. In the following 2 years, the patient suffered from intermittent fever accompanied by dyspnea, fatigue, occasional cough, less sputum, and apparent weight loss. Abnormal physical examinations included leg ulcers and splenomegaly. Laboratory and physical tests revealed pancytopenia, polyserositis, and enlargement of lymph nodes. The pathological findings of leg ulceration, pleura, and left supraclavicular lymph node all suggested granulomas.
Diagnosis interventions and outcomes:
It strongly suggested sarcoidosis since tuberculosis, lymphoma, and connective tissue disease were all excluded. Due to severe conditions and multiorgan involvement, we tried to provide methylprednisolone for this patient. After 9 months of oral glucocorticoids therapy, his subjective symptoms as well as hematological and radiological findings were all improved. His leg skin ulceration and scab were also completely disappeared.
Conclusion:
Sarcoidosis has diverse clinical presentations, and many patients present with atypical symptoms. It needs to be timely identified by the clinician and carefully differentiated from other diseases with similar findings so as to make an accurate diagnosis. In this case, the patient had a poor clinical response to glucocorticoids in the early stage of treatment due to the severe condition and multi-organ involvement. It is worth noting that the patient had improved significantly after 9 months of treatment of corticosteroids, which suggested that follow-up is critical.
The pathophysiology of rapid fluctuations in mental status associated with olanzapine: A case report
Authors: Tyler J Torrico
Journal: Front Psychiatry (2022)
Keywords: (h1)
MeSH terms: Case Reports

Background:
Olanzapine toxicity is reported to be a rare but specific phenomenon characterized by rapid fluctuations between somnolence and agitation, which has been referred to as "agitation despite sedation." A similar phenomenon is observed as an adverse reaction of the long-acting injectable olanzapine formulation, which has been referred to as "delirium/sedation syndrome."
Case presentation:
This case report describes a 48-year-old man diagnosed with schizophrenia who experienced rapid fluctuations between somnolence and agitation during a cross-titration of olanzapine to clozapine. The patient had normal serum levels of both medications and the symptoms resolved with the discontinuation of olanzapine.
Conclusion:
Rapid fluctuations in mental status between somnolence and agitation are not clearly described among other antipsychotics, and it is possible that this phenomenon may be specific to olanzapine. The findings of this case report suggested that this phenomenon was likely the result of the oversaturation of (H1) and (M1) receptors.
B-cell lymphoblastic lymphoma following intravenous BNT162b2 mRNA booster in a BALB/c mouse: A case report
Authors: Sander Eens, Manon Van Hecke, Kasper Favere, Thomas Tousseyn, Pieter-Jan Guns, Tania Roskams, Hein Heidbuchel
Journal: Front Oncol (2023)
Keywords: b-cell, balb/c, bnt162b2, covid-19, lymphoblastic, lymphoma, mrna vaccine, mouse
MeSH terms: Case Reports

Unprecedented immunization campaigns have been rolled out worldwide in an attempt to contain the ongoing COVID-19 pandemic. Multiple vaccines were brought to the market, among two utilizing novel messenger ribonucleic acid technology. Despite their undisputed success in decreasing COVID-19-associated hospitalizations and mortality, various adverse events have been reported. The emergence of malignant lymphoma is one of such rare adverse events that has raised concern, although an understanding of the mechanisms potentially involved remains lacking. Herein, we present the first case of B-cell lymphoblastic lymphoma following intravenous high-dose mRNA COVID-19 vaccination (BNT162b2) in a BALB/c mouse. Two days following booster vaccination (i.e., 16 days after prime), at only 14 weeks of age, our animal suffered spontaneous death with marked organomegaly and diffuse malignant infiltration of multiple extranodal organs (heart, lung, liver, kidney, spleen) by lymphoid neoplasm. Immunohistochemical examination revealed organ sections positive for CD19, terminal deoxynucleotidyl transferase, and c-MYC, compatible with a B-cell lymphoblastic lymphoma immunophenotype. Our murine case adds to previous clinical reports on malignant lymphoma development following novel mRNA COVID-19 vaccination, although a demonstration of direct causality remains difficult. Extra vigilance is required, with conscientious reporting of similar cases and a further investigation of the mechanisms of action explaining the aforementioned association.
Free tissue transfer for trophic ulcer complicating leprosy
Authors: Yogesh C Bhatt, Nikhil S Panse, Kinnari A Vyas, Gunjan A Patel
Journal: Indian J Plast Surg (2009)
MeSH terms: Case Reports

Plantar ulceration is the commonest disability in leprosy and occurs in about 10 to 20% of leprosy patients. Various loco-regional flaps have been described for reconstruction of trophic ulcers; however, very large defects are not amenable to local flaps and free flaps form one of the important treatment options. We present a case of a post Hansen's trophic ulcer over the forefoot managed using a radial artery forearm free flap. Debridement of the osteomyelitic bone, removal of the bony prominences, coverage by a well-vascularised tissue, end-to-side arterial anastomosis, use of anterior tibial as the recipient vessel and good postoperative compliance in foot care on the part of the patient gave us good results.
Recurrence of Postoperative Stress-Induced Cardiomyopathy Resulting from Status Epilepticus
Authors: Grant A Miller, Yousef M Ahmed, Nicki S Tarant
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Introduction. Classically, stress-induced cardiomyopathy (SIC), also known as takotsubo cardiomyopathy, displays the pathognomonic feature of reversible left ventricular apical ballooning without coronary artery stenosis following stressful event(s). Temporary reduction in ejection fraction (EF) resolves spontaneously. Variants of SIC exhibiting mid-ventricular regional wall motion abnormalities have been identified. Recent case series present SIC as a finding in association with sudden unexplained death in epilepsy (SUDEP). This case presents a patient who develops recurrence of nonapical cardiomyopathy secondary to status epilepticus. Case Report. Involving a postoperative, postmenopausal woman having two distinct episodes of status epilepticus (SE) preceding two incidents of SIC. Preoperative transthoracic echocardiogram (TTE) confirms the patient's baseline EF of 60% prior to the second event. Postoperatively, SE occurs, and the initial electrocardiogram exhibits T-wave inversions with subsequent elevation of troponin I. Postoperative TTE shows an EF of 30% with mid-ventricular wall akinesia restoring baseline EF rapidly. Conclusion. This case identifies the need to understand SIC and its diagnostic criteria, especially when cardiac catheterization is neither indicated nor available. Sudden cardiac death should be considered as a possible complication of refractory status epilepticus. The pathophysiology in SUDEP is currently unknown; yet a correlation between SUDEP and SIC is hypothesized to exist.
Digital Record for Removable Denture Patients
Authors: G Krishna Teja, B L Rao, Tsv Satyanarayana, Tlg Sravanthi, D Padmini, C D Saikumar
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Denture marking is required for forensic and social reasons in the event that patients must be identified individually. The majority of surface marking and inclusion techniques are costly and time-consuming, and do not allow for the incorporation of large amounts of data. Near-field communication (NFC) is a popular wireless technology that allows you to transfer data between two devices that are in close proximity to each other. This tag features an internal memory that can be used to store patient information. Incorporating this tag into a denture can make things handy for storage of information digitally.