OpenMed/multicare-articles huggingface dataset:
Treating verbal working memory in a boy with intellectual disability
Authors: Margherita Orsolini, Sergio Melogno, Nausica Latini, Roberta Penge, Sara Conforti
Journal: Front Psychol (2015)
Keywords: attention, inhibition, intellectual disability, switching, training, verbal working memory
MeSH terms: Case Reports

The present case study investigates the effects of a cognitive training of verbal working memory that was proposed for Davide, a 14-year-old boy diagnosed with mild intellectual disability. The program stimulated attention, inhibition, switching, and the ability to engage either in verbal dual tasks or in producing inferences after the content of a short passage had been encoded in episodic memory. Key elements in our program included (1) core training of target cognitive mechanisms; (2) guided practice emphasizing concrete strategies to engage in exercises; and (3) a variable amount of adult support. The study explored whether such a complex program produced "near transfer" effects on an untrained dual task assessing verbal working memory and whether effects on this and other target cognitive mechanisms (i.e., attention, inhibition, and switching) were long-lasting and produced "far transfer" effects on cognitive flexibility. The effects of the intervention program were investigated with a research design consisting of four subsequent phases lasting 8 or 10 weeks, each preceded and followed by testing. There was a control condition (phase 1) in which the boy received, at home, a stimulation focused on the visuospatial domain. Subsequently, there were three experimental training phases, in which stimulation in the verbal domain was first focused on attention and inhibition (phase 2a), then on switching and simple working memory tasks (phase 2b), then on complex working memory tasks (phase 3). A battery of neuropsychological tests was administered before and after each training phase and 7 months after the conclusion of the intervention. The main finding was that Davide changed from being incapable of addressing the dual task request of the listening span test in the initial assessment to performing close to the normal limits of a 13-year-old boy in the follow-up assessment with this test, when he was 15 years old.
Mass-forming renal Crohn's disease: a case report with multimodality imaging
Authors: Frans van Tonder, Melanie Seale, Eric Yong, Prue Hill, Jonathan Darby, Tom Sutherland
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

The most common extraintestinal manifestations of Crohn's disease involve the eyes, skin, hepatobiliary tract, and the musculoskeletal and respiratory systems. Mass-forming granulomatous inflammation in extraintestinal organs is extremely rare and there are only a few reports of patients with Crohn's disease presenting with inflammatory pseudotumours of the liver, pancreas and kidneys. We present a case of a mass-forming renal granulomatous inflammation in an adult female with Crohn's disease. The clinical, pathological and imaging features of this case illustrate that renal inflammatory pseudotumour is a rare but important differential diagnosis of a renal mass in patients with Crohn's disease and that radiologists should be aware of its existence when considering other more common pathologies, such as focal pyelonephritis and renal tumours. Renal inflammatory pseudotumour may have relatively non-specific imaging features and a biopsy may be required to make the diagnosis.
Whole-Exome Sequencing Revealed Mutations of MED12 and EFNB1 in Fetal Agenesis of the Corpus Callosum
Authors: Ying Jiang, Ye-Qing Qian, Meng-Meng Yang, Qi-Tao Zhan, Yuan Chen, Fang-Fang Xi, Matthew Sagnelli, Min-Yue Dong, Bai-Hui Zhao, Qiong Luo
Journal: Front Genet (2019)
Keywords: sanger sequencing, de novo mutation, fetal agenesis of the corpus callosum, prenatal diagnosis, whole-exome sequencing
MeSH terms: Case Reports

Agenesis of the corpus callosum (ACC) is a birth defect in which the corpus callosum is either partially or completely missing. With recent advances in prenatal ultrasound, detection of ACC in obstetric practices is becoming more common. Etiologies of ACC include chromosome errors, genetic factors, prenatal infections, and other factors related to the prenatal environment. In an effort to elucidate more about the genetic influence in the pathogenesis of ACC, we identified, through whole-exome sequencing (WES), two gene mutations in two families with complete agenesis of the corpus callosum. These two mutations are located on chromosome X: one is a hemizygous missense mutation c.3746T>C (p. L1249P) in the gene mediator complex subunit 12 (MED12); the other one is a heterozygous missense mutation c.128+5G>C in gene ephrin B1 (EFNB1). Historically, early diagnosis of complete ACC during pregnancy has been difficult; however, WES has provided us with a creative avenue of diagnosis, combining identification of genetic mutations with prenatal imaging.
A Case of Psychosis and Renal Failure Associated with Excessive Energy Drink Consumption
Authors: D Kelsey, A J Berry, R A Swain, S Lorenz
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Energy drinks are nonalcoholic beverages that are widely consumed in the general population, and worldwide usage is increasing. The main stimulant component of energy drinks is typically caffeine. Few case reports exist that link energy drink consumption to psychosis, and similarly few reports exist that associate energy drink consumption with acute renal failure. We present a patient who simultaneously developed psychosis and acute renal failure associated with excessive energy drink consumption. The patient required haemodialysis, and his psychosis resolved on cessation of energy drinks and a brief course of antipsychotic medication. We perform a review of similar cases where excessive caffeinated energy drink consumption has been linked to psychosis or acute renal failure. To our knowledge, this is the first case report describing both renal failure and psychosis occurring simultaneously in a patient. Recognising the spectrum of disorders associated with excessive energy drink consumption is vital for both physicians and psychiatrists, as this has important implications for both prognosis and treatment.
Orthodontically Induced External Apical Root Resorption in Class II Malocclusion
Authors: Praveen Kumar Reddy Karnati, Priyank Seth, Ahmad Termizi Bin Zamzuri, Payal Tharwani
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Orthodontic-induced external apical root resorption is one of the idiopathic phenomena as an effect, with force generated through mechanotherapy as the cause and the biological tissues with their diversified variations as witness. It is also classified as iatrogenic as a result of indeterminate application of orthodontic forces with subconscious appreciation of the existing underlying conditions. Numerous factors were identified to relate to this irreversible pathologic condition, but none were proven scientifically. Genetics and salivary markers have proved the reliability with time, but the application became insignificant limiting mostly to the research field. Different assessment methods were also identified to clinically diagnose it both subjectively and objectively. Mostly, it is identified through routine radiographic stage records like orthopantomogram or certain prediction radiographs for root resorption probability assessment like in this case. This case report discusses one such encounter which was experienced after stage 1 and 2 mechanics involving quite a few teeth. Considering the biotype of the individual and tooth morphology, the ongoing treatment was terminated and recovery measures were briefed to uplift the self-esteem of the individual. Furthermore, the prognosis is compromised to be very poor with unpredictability to any other treatment modalities.
Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications
Authors: Melvyn W Zhang, Keith M Harris, Roger C Ho
Journal: BMC Med Ethics (2016)
MeSH terms: Antidepressive Agents / therapeutic use, Depression / drug therapy, Depressive Disorder / drug therapy, Ketamine / therapeutic use, Off-Label Use / ethics, Off-Label Use / legislation & jurisprudence, Safety, Case Reports, Adult, Antidepressive Agents / adverse effects, Female, Humans, Ketamine / adverse effects, Male, Middle Aged, Antidepressive Agents, Ketamine

Background:
Depressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen (phencyclidine). Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.
Discussion:
The use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.
Conclusion:
We urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine.
Ciprofloxacin and Clozapine: A Potentially Fatal but Underappreciated Interaction
Authors: Jonathan M Meyer, George Proctor, Michael A Cummings, Laura J Dardashti, Stephen M Stahl
Journal: Case Rep Psychiatry (2016)

Objective. Clozapine provides a 50%-60% response rate in refractory schizophrenia but has a narrow therapeutic index and is susceptible to pharmacokinetic interactions, particularly with strong inhibitors or inducers of cytochrome P450 (CYP) 1A2. Case Report. We report the case of a 28-year-old nonsmoking female with intellectual disability who was maintained for 3 years on clozapine 100 mg orally twice daily. The patient was treated for presumptive urinary tract infection with ciprofloxacin 500 mg orally twice daily and two days later collapsed and died despite resuscitation efforts. The postmortem femoral clozapine plasma level was dramatically elevated at 2900 ng/mL, and the cause of death was listed as acute clozapine toxicity. Conclusion. Given the potentially fatal pharmacokinetic interaction between clozapine and ciprofloxacin, clinicians are advised to monitor baseline clozapine levels prior to adding strong CYP450 1A2 inhibitors, reduce the clozapine dose by at least two-thirds if adding a 1A2 inhibitor such as ciprofloxacin, check subsequent steady state clozapine levels, and adjust the clozapine dose to maintain levels close to those obtained at baseline.
Canal complexity of a mandibular first molar
Authors: S Poorni, Ra Kumar, R Indira
Journal: J Conserv Dent (2009)
Keywords: canal complexity, mandibular first molar, middle mesial canal
MeSH terms: Case Reports

The endodontic treatment of a mandibular molar with aberrant canal configuration can be diagnostically and technically challenging. This case report presents the treatment of a mandibular first molar with five root canals, of which three were located in the mesial root. A third canal was found between the mesiobuccal and mesiolingual root canals. The morphological pattern of separate apical terminations of three mesial root canals with separate orifices, as manifested in this case, is a rare one.
A Traumatic Direct Inguinal Hernia from Pelvic Ring Disruption
Authors: Kevin L Chow, Eduardo Smith-Singares, James Doherty
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Pelvic fractures usually involve a high-energy traumatic mechanism and account for approximately 3% of all blunt traumatic skeletal injuries. Additional musculoskeletal injuries are found in over 80% of unstable pelvic fractures. Traumatic abdominal wall hernias (TAWHs) are a rare entity, and traumatic inguinal hernias (TIHs) associated with open-book pelvic fractures have not been described previously.
Case presentation:
We present the case of a 45-year-old male motorcyclist involved in a collision resulting in a traumatic direct inguinal hernia due to abdominal wall disruption from an open-book pelvic fracture. He underwent a combined operation with an open reduction and internal fixation (ORIF) of his pelvic fracture and an abdominal wall reconstruction with a modified Stoppa technique utilizing mesh for his hernia.
Discussion:
This is a unique presentation of a TIH due to an open-book pelvic fracture after blunt abdominal trauma. The formation of TAWH is typically from a combination of local tangential shearing forces and a sudden rise in intraabdominal pressures damaging the muscle, fascia, and peritoneum while the skin remains intact. In patients without hollow viscous injuries and gross contamination, these hernias can be repaired safely with mesh in the acute setting simultaneously with pelvic reduction.
The first case of human autochtonous subconjunctival dirofilariosis in Poland and MALT lymphoma as possible consequence of this parasitosis
Authors: Piotr K Borkowski, Grzegorz Rymkiewicz, Joanna Golebiewska, Nestor Nestoros, Joanna Romejko-Jarosinska, Hanna Zarnowska-Prymek, Aleksander Masny, Jakub Palucki, Danuta Cielecka
Journal: Infect Agent Cancer (2015)
Keywords: autochtonous species, dirofilaria repens, human, malt lymphoma, poland, wolbachia
MeSH terms: Case Reports

The first case of human dirofilarosis in Poland was recorded in 2007. Until that time our country was free of Dirofilaria repens. Recent studies show that 21,4- 60% of dogs in Warsaw region harbour microfilariae, therefore it is becoming a growing problem in Central Europe. In April 2013 a subconjunctival D. repens was removed from the eye of 61-year-old woman. It was the twenty first case of this disease in Poland, the third case of eye dirofilaria and the fourth autochtonous case. The patient had never been abroad, so it was the first case of autochtonous human ocular dirofilariosis in Poland. Nine months after the D. repens had been removed, a MALT lymphoma was discovered. In the article we discuss whether a MALT lymphoma of the lacrimal gland of the eye, previously affected by the parasite, may be the consequence of the invasion.
Case Report: Bilateral Biportal Endoscopic Open-Door Laminoplasty With the Use of Suture Anchors: A Technical Report and Literature Review
Authors: Chengyue Zhu, Jing Wang, Wei Cheng, Dong Wang, Hao Pan, Wei Zhang
Journal: Front Surg (2022)
Keywords: bilateral biportal endoscopy, cervical laminoplasty, cervical stenosis, endoscopic spine surgery, suture anchor
MeSH terms: Case Reports

Background:
Unilateral biportal endoscopy (UBE) is a newly developed technique for spine surgery. Owing to the convenience of nerve decompression and compatibility with open surgical instruments under endoscopic guidance, this technique has seen widespread global use. In this study, we first used modified UBE with suture anchor fixation for cervical laminoplasty in a 65-year-old female patient with good clinical outcomes.
Methods:
We used bilateral biportal endoscopy (BBE) for cervical laminoplasty with suture anchor fixation in a patient with cervical stenosis. Under endoscopic guidance, a bilateral approach was used to make the gutter and lift the lamina door. After the lamina doors were opened, sutures were tied tightly using facia cannula and knot pusher. After confirming the solidarity of the open-door status, the drainage tube was inserted and the incisions were closed. The patient's pre- and postoperative radiological and clinical results were evaluated.
Results:
Postoperative Japanese Orthopaedic Association (JOA) and Neck Disability Index (NDI) scores were improved clinically, and cervical canal was decompressed radiologically.
Conclusions:
BBE laminoplasty combined with suture anchor fixation showed a favorable clinical and radiological result and appears to be a safe and effective technique for cervical stenosis.
Intramuscular Hemangioma of the Forearm with Flexion Contracture
Authors: Sunyarn Niempoog, Waroot Pholsawatchai
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Intramuscular hemangiomas can be an infrequent but important cause of musculoskeletal pain. This report describes a 25-year-old male who presented with pain in the right forearm and contracture of the right hand for 4 years. Physical examination revealed severe tenderness of the midforearm with contracture of the flexor tendons in the index, middle, ring, and little fingers. Conventional radiography of the forearm revealed a soft tissue phlebolith. Magnetic resonance imaging showed a well-defined lobulated mass partially involving the FDP tendon. An intramuscular hemangioma within the deep anterior compartment of the forearm was suspected. Following surgical excision of the hemangioma, the patient's symptoms resolved completely. In conclusion, intramuscular hemangioma can be a rare cause of flexion contracture of the hands and should be considered as a cause of a flexion contracture that fails to respond to conservative treatment.
Primary Osteosarcoma of the Breast Arising in an Intraductal Papilloma
Authors: Khalefa Ali Alghofaily, Musab Hamoud Almushayqih, Muhannad Faleh Alanazi, Abdullah Abdulrahman Bin Salamah, Halldor Benediktsson
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

Introduction:
Primary osteosarcoma of the breast is extremely rare, and an osteosarcoma arising from an intraductal papilloma is exceptional.
Case presentation:
A 72-year-old Saudi Arabian woman presented with a solid, bone-containing breast mass that was diagnosed as primary osteosarcoma of the breast on biopsy. She had a history of untreated intraductal papilloma. Treatment was completed with a modified mastectomy after excluding extramammary metastases. However, she subsequently developed multiple recurrent lesions at the same site.
Conclusion:
Primary osteogenic sarcomas of the breast are very rare. Although the main treatment is resection the optimal management remains uncertain and prognosis is poor.
Spontaneous Pneumothorax in an Allogeneic Cell Transplant Recipient with Invasive Pulmonary Aspergillosis and Antecedent RSV Pneumonitis
Authors: Liang-Piu Koh, Michelle Li-Mei Poon, John Kit-Chung Tam, Lynette Teo, Li-Yang Hsu
Journal: Mediterr J Hematol Infect Dis (2011)
MeSH terms: Case Reports

We report a case of invasive pulmonary aspergillosis (IPA) following respiratory syncytial virus infection in an allogeneic hematopoietic stem cell transplant (HSCT) recipient with chronic graft-versus-host disease. Delayed diagnosis of IPA resulted in the development of a pneumothorax, a rare consequence of fungal pneumonia. Respiratory virus infections are often harbingers of other infective organisms in HSCT recipients. More aggressive diagnostic investigations such as computed tomography scans of the thorax and bronchoscopy with bronchoalveolar lavage should be considered early in any HSCT patient presenting with respiratory virus pneumonia, particularly if atypical features are present or recovery is delayed.
Late cholestatic syndrome due to previous perforating trauma: Case report
Authors: Frank Pinheiro Pessoa Coelho De Macedo, Carolina Augusta Dorgam Maués, Otávio Mendes Filho, Ketlen Gomes da Costa, Juan Eduardo Rios Rodriguez, Irma Csasznik, João José Corrêa Bergamasco, Rubem Alves da Silva Neto, Rubem Alves da Silva Júnior
Journal: Int J Surg Case Rep (2019)
Keywords: cholangitis, cholestasis, foreign bodies, foreign-body migration, gunshot wound, obstructive jaundice

Introduction:
The presence of a foreign body obstructing the bile duct may appear through a typical picture of cholangitis, usually caused by the presence of gallstones.
Presentation of case:
Male patient, 31 years old, involved an in accident with gunshot in 2006, injured in the abdominal region. Evolved to a picture of intense pain in the right hypochondrium, mainly after fat meals, without irradiation 12 years after being injured. Presented jaundice episode associated to fecal acholia, choluria, pruritus and sporadic fever. It was diagnosed cholangitis due to the foreign body like a bullet, located in the hepatic duct after tomography performed for investigation. The conduction of the case is described next.
Discussion:
Cholestatic syndrome caused by gun bullet in a prior event to the symptoms is a rare event in the literature. Total, there are 8 case reports of bullets found in bile ducts with distinct evolution time among themselves. The first exam will not necessarily identify the bullet, but it simplifies the visualization of the bile ducts dilation, characterizing obstruction.
Conclusion:
The presence of a foreign body in the bile ducts is well reported in literature, and it is directly dependent on previous history. We should always avoid using cholangioresonance in dubious cases. To keep the ERCP as initial treatment is recommended due to the advances on the procedure quality, but in more severe cases or lack of resources, the surgical exploration is still indicated.