OpenMed/multicare-articles huggingface dataset:
On the origin of rhythmic contractile activity of the esophagus in early achalasia, a clinical case study
Authors: Ji-Hong Chen, Xuan-Yu Wang, Louis W C Liu, Wenzhen Yu, Yuanjie Yu, Liang Zhao, Jan D Huizinga
Journal: Front Neurosci (2013)
Keywords: pdgfralpha, achalasia, enteric nervous system, esophagus, interstitial cells of cajal, nitrergic neurons, pacemaker, vagus nerve
MeSH terms: Case Reports

A patient with early achalasia presented spontaneous strong rhythmic non-propulsive contractions at ~7/min, independent of swallows. Our aim was to evaluate characteristics of the rhythmic contractions, provide data on the structure of pacemaker cells in the esophagus and discuss a potential role for interstitial cells of Cajal (ICC) in the origin of rhythmicity. We hypothesize that intramuscular ICC (ICC-IM) are the primary pacemaker cells. The frequency but not the amplitude of the rhythmic contractions was inhibited by the phosphodiesterase inhibitor drotaverine consistent with cAMP inhibiting pacemaker currents in ICC-IM. The frequency increased by wet swallows but not dry swallows, consistent with stretch causing increase in slow wave frequency in ICC-IM. New studies on archival material showed that ICC-IM were present throughout the human esophageal musculature and were not diminished in early achalasia. Although ICC-IM exhibited a low density, they were connected to PDGFRα-positive fibroblast-like cells with whom they formed a dense gap junction coupled network. Nitrergic innervation of ICC was strongly diminished in early achalasia because of the loss of nitrergic nerves. It therefore appears possibly that ICC-IM function as pacemaker cells in the esophagus and that the network of ICC and PDGFRα-positive cells allows for coupling and propagation of the pacemaker activity. Loss of nitrergic innervation to ICC in achalasia may render them more excitable such that its pacemaker activity is more easily expressed. Loss of propagation in achalasia may be due to loss of contraction-induced aboral nitrergic inhibition.
A Case of Primary Intraosseous Adenoid Cystic Carcinoma of the Mandible
Authors: Erika Sasaki, Kenji Yamagata, Takayuki Hagiwara, Ryo Takasaki, Satoshi Fukuzawa, Fumihiko Uchida, Naomi Ishibashi-Kanno, Hiroki Bukawa
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Primary intraosseous adenoid cystic carcinoma (PIACC) of the jaw is rare. To our knowledge, only 51 cases have been reported in the English literature. We present a rare case of PIACC arising in the mandible with multiple bone metastases and review the previous articles. A 70-year-old woman presented with paresthesia of the right chin and lower gingiva for 4 months. Radiography revealed an irregular radiolucent region on the right side of the ramus, infiltrating to the mandibular canal. Biopsy revealed a pathological diagnosis of adenoid cystic carcinoma. Multiple bone metastases were present in the sternum, scapula, and thighs. The treatment effect was progressive disease for chemotherapy; therefore, best supportive care was provided for 3 years.
Enhanced Mental Health with Virtual Reality Mental Hygiene by a Veteran Suffering from PTSD
Authors: Bo Søndergaard Jensen, Niels Andersen, Jes Petersen, Lene Nyboe
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

This paper describes the application and feasibility of the use of Virtual Reality Mental Hygiene (VRMH) as a mean to reduce anxiety and stress in a Danish veteran suffering from posttraumatic stress disorder (PTSD) and enduring personality change after a catastrophic experience. The results from this case study provide preliminary evidence that VRMH can be used as a mean to reduce arousal in patients with severe PTSD.
Feeling without localizing: exploring tactile misperception in a patient with uncommon parietal left brain damage
Authors: Laurence Have, François Quesque, Anne-Emmanuelle Priot, Véronique Chastres, Patrice Revol, Ludovic Delporte, Eric Chabanat, Nathalie Obadia, François Cotton, Karen T Reilly, Yves Rossetti
Journal: Front Hum Neurosci (2023)
Keywords: multisensory, parietal lesion, somatosensory processing, tactile localizing, visuo-tactile integration

Introduction:
We report a very unique clinical presentation of a patient who complained, after a left parietal brain damage, about feeling tactile stimulations on his right upper limb without being able to localize them.
Methods:
Using a single case study approach, we report three experiments relying on several custom-made tasks to explore the different levels of somatosensory information processing, ranging from somato-sensation to somato-representation.
Results:
Our results showed a preserved ability to localize tactile stimuli applied on the right upper limb when using pointing responses while the ability to localize was less efficient when having to name the stimulated part (akin Numbsense). When the stimuli were applied on more distal locations (i.e., on the hand and on fingers), the number of correct responses decreased significantly independently of the modality of response. Finally, when visually presented with a stimulus delivered on the hand of an examiner in synchrony with the stimulation on the hidden hand of the patient, responses were largely influenced by the visual information available. Altogether, the convergence of these different customized tasks revealed an absence of autotopagnosia for motor responses for the right upper limb, associated with altered abilities to discriminate stimulus applied on distal and restricted/closer zones in the hand.
Discussion:
The somato-representation of our patient seemed to significantly rely on visual information, leading to striking deficits to localize tactile stimuli when vision and somesthesic afferences are discordant. This case report offers a clinical illustration of pathological imbalance between vision and somesthesia. Implications of these troubles in somato-representation on higher cognitive level processes are discussed.
Chiari 1 Malformation Presenting as Central Sleep Apnea during Pregnancy: A Case Report, Treatment Considerations, and Review of the Literature
Authors: Erik K St Louis, Praveen Jinnur, Stuart J McCarter, Ethan J Duwell, Eduardo E Benarroch, Kejal Kantarci, Mark A Pichelmann, Michael H Silber, Bradley F Boeve, Eric J Olson, Timothy I Morgenthaler, Virend K Somers
Journal: Front Neurol (2014)
Keywords: chiari malformation, adaptive servoventilation, central sleep apnea, pregnancy, presentation

Purpose:
Chiari malformation (CM) type-1 frequently causes obstructive or central sleep-disordered breathing (SDB) in both adults and children, although SDB is relatively rare as a presenting manifestation in the absence of other neurological symptoms. The definitive treatment of symptomatic CM is surgical decompression. We report a case that is, to our knowledge, a novel manifestation of central sleep apnea (CSA) due to CM type-1 with severe exacerbation and initial clinical presentation during pregnancy.
Methods:
Case report from tertiary care comprehensive sleep medicine center with literature review of SDB manifestations associated with CM type-1. PubMed search was conducted between January 1982 and October 2013.
Results:
We report a 25-year-old woman with severe CSA initially presenting during her first pregnancy that eventually proved to be caused by CM type-1. The patient was successfully treated preoperatively by adaptive servoventilation (ASV), with effective resolution of SDB following surgical decompression, and without recurrence in a subsequent pregnancy. Our literature review found that 58% of CM patients with SDB had OSA alone, 28% had CSA alone, 8 (10%) had mixed OSA/CSA, and 6 (8%) had hypoventilation. Of CM patients presenting with SDB, 50% had OSA, 42% had CSA, 8% had mixed OSA/CSA, and 10.4% had hypoventilation. We speculate that CSA may develop in CM patients in whom brainstem compression results in excessive central chemoreflex sensitivity with consequent hypocapnic CSA.
Conclusion:
Chiari malformation type-1 may present with a diversity of SDB manifestations, and timely recognition and surgical referral are necessary to prevent further neurological deficits. ASV therapy can effectively manage CSA caused by CM type-1, which may initially present during pregnancy.
Reversal of vision after bleomycin injection in orbital lymphangioma
Authors: Pratheeba Devi Nivean, Nivean Madhivanan
Journal: GMS Ophthalmol Cases (2022)
Keywords: bleomycin injection, orbital lymphangioma, reversal of vision
MeSH terms: Case Reports

Lymphangiomas are benign hemartomatous tumors that can occur in all parts of the body, but most frequently in the neck (75%), as well as in the axilla and inguinal areas. Surgical removal is very difficult, as it is very fragile and tumor dissection is very difficult. Ultrasound-guided bleomycin injection directly into the cyst collapses the cyst and shrinks the tumor. It reduces proptosis, discomfort, and cosmetic blemish. We present this case who had gross defective vision and relative afferent pupillary defect in her right eye for 10 days which tremendously improved after injection.
Renal Cell Carcinoma Metastasis to the Breast: A Rare Presentation
Authors: Heba O E Ali, Tamer Ghorab, Iain R Cameron, Ahmed M S M Marzouk
Journal: Case Rep Radiol (2021)
MeSH terms: Case Reports

Worldwide breast malignancy is the most common cancer in women; however, metastases to the breast from extramammary malignancies are very rare and only a few sporadic cases are reported in the international literature. In this article, the authors report a case of a 73-year-old woman, who underwent nephrectomy for clear cell renal cell carcinoma and 3 years later presented with a breast metastasis from renal cell carcinoma (clear cell type).
Pemphigus Vulgaris Possibly Associated with COVID-19 Infection
Authors: Yul Hee Kim, Hee Young Kang
Journal: Cureus (2023)
Keywords: autoimmune bullous disease, covid-19, keratinocyte, pemphigus vulgaris, sars-cov-2 spike protein
MeSH terms: Case Reports

Pemphigus vulgaris (PV) represents damage to epidermal keratinocytes, resulting in acantholysis due to the production of autoantibodies against desmoglein-1 and desmoglein-3. Autoimmune blistering disorders such as pemphigus vulgaris or bullous pemphigoid that develop following coronavirus disease 2019 (COVID-19) have been reported in several studies. Herein, we report a case of PV onset following COVID-19 infection in a 17-year-old female, demonstrating --the potential pathogenic capacity of SARS-CoV-2 to develop PV.
Simultaneous Association of Pulmonary Tuberculosis and Kaposi's Sarcoma in an Immunocompetent Subject: A Case Report and Literature Review
Authors: Sofia Baina, Jihane Achrane, Jouda Benamor, Jamal Eddine Bourkadi
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

Kaposi's Sarcoma (KS) occurs as a pathological entity that may be classified into four different types: classic, endemic, epidemic, and iatrogenic. It can arise among HIV-positive subjects or within immunosuppression, yet exceptionally of tuberculous origin. We describe a new case report of an HIV-negative patient, manifesting Kaposi's disease in the course of tuberculosis, with the aim to assess this uncommon disorder and to outline this rare atypical association.
Open fracture of the acromion associated with a supraspinatus tendon rupture: an exceptional case report
Authors: Abdelhak Mardy, Atif Mechchat, Amine El Ghazi, Mohammed El Idrissi, Mohammed Shimi, Abdelhalim El Ibrahimi, Abdelmajid El Mrini
Journal: Pan Afr Med J (2014)
Keywords: acromion, open fracture, supraspinatus
MeSH terms: Acromion / pathology, Fractures, Open / pathology, Shoulder Joint / pathology, Tendon Injuries / pathology, Case Reports, Acromion / surgery, Fractures, Open / surgery, Humans, Male, Rupture / pathology, Rupture / surgery, Suture Techniques, Tendon Injuries / surgery, Young Adult

The combination of the acromion Open fracture to a section of the supraspinatus tendon is an exceptional situation. The author reports the case of a young patient with a wound of the posterolateral side of the right shoulder. Screwing was done for the fracture of the acromion after supraspinatus tendon suture with good clinical and radiological outcome after an appropriate rehabilitation.
An Adverse Reaction in the Pediatric Sleep Laboratory
Authors: Diana Reppucci, Debra Medin, Suhail Al-Saleh, Mary Jane Smith, Jill Barter, Reshma Amin
Journal: Can Respir J (2016)
MeSH terms: Anti-Infective Agents, Local / adverse effects, Dermatitis, Allergic Contact / etiology, Facial Dermatoses / chemically induced, Masks, Povidone-Iodine / adverse effects, Sleep Apnea, Central / therapy, Case Reports, Humans, Infant, Male, Polysomnography, Positive-Pressure Respiration / instrumentation, Severity of Illness Index, Anti-Infective Agents, Local, Povidone-Iodine

We present a case of a 15-month-old boy with Cornelia de Lange Syndrome (NIPBL gene mutation). On a PSG, central sleep apnea (central apnea-hypopnea index of 19/hour) and nocturnal hypoventilation (transcutaneous CO2 > 50 mmHg for 53% of the night) were found. A positive pressure initiation study was aborted because the patient developed a serious adverse reaction. The differential diagnosis included a skin fragility condition versus an allergic contact dermatitis to the interface; this could be from the povidone-iodine solution used to clean the NiPPV interface or from the plastic of the interface itself. A skin biopsy was performed which was normal. The reaction was likely secondary to an allergic contact dermatitis from the povidone-iodine solution used to clean the NiPPV interface. The patient is currently tolerating NiPPV.
Rare Clinical Course of Immunoglobulin G4-Related Inflammatory Abdominal Aortic Aneurysm with Multiple Rare Complications
Authors: Yuji Naito, Tsukasa Miyatake, Manami Iwasaki, Atsushi Okuyama, Akio Takada, Koji Chiba, Masahiko Obata, Junichi Oba
Journal: Case Rep Vasc Med (2019)
MeSH terms: Case Reports

Immunoglobulin G4- (IgG4-) related inflammatory abdominal aortic aneurysm (AAA) has been recognized as a manifestation of IgG4-related disease (IgG4-RD). We experienced one patient with multiple consecutive manifestations before and after endovascular stent grafting for IgG4-related inflammatory AAA (IAAA). A 71-year-old man was diagnosed with IgG4-RD due to increased IgG4 serum concentration, typical findings of parotid gland biopsy, and periaortitis in another hospital 2 years and 7 months before visiting our hospital. He came to our hospital because of abdominal pain and IAAA. He developed paraplegia after hospitalization and underwent endovascular stent grafting for the IAAA. About one month after stent grafting, he developed perforation of the sigmoid colon due to enteritis. He also had myocardial infarction. Finally, he died of intestinal bleeding. Here, we describe this case with rare, multiple, consecutive manifestations of IgG4-RD, some of which might be caused by IgG4-related IAAA or side effects of treatments rather than by IgG4-RD itself. We report this case because the clinical course seemed rare for IgG4-RD or IgG4-related IAAA. For treating IgG4-RD with IgG4-related IAAA, we should consider factors causing the symptoms and carefully select the proper treatment.
The Use of Etoposide, Ara-Cytarabine, and Melphalan (EAM) Conditioning Chemotherapy in Autologous Stem Cell Transplantation (ASCT) for a Patient with Relapsed Hodgkin's Lymphoma
Authors: Eko A Pangarsa, Ridho M Naibaho, Vina Yunarvika, Budi Setiawan, Damai Santosa, Catharina Suharti
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

Up to 20-40% of patients with Hodgkin's lymphoma will eventually relapse after treatment, among which early relapse confers a poor outcome. With salvage chemotherapy followed by autologous stem cell transplantation (ASCT), the long-term remission rate is 30%. We report our experience of using a modified-BEAM conditioning regimen without BCNU consisting of etoposide, cytarabine, and melphalan (EAM) in a patient with relapsed Hodgkin's lymphoma. Before transplantation, the patient achieved second complete remission (CR2) using brentuximab vedotin and ESHAP (BR-ESHAP) chemotherapy. The ASCT went well without significant complications. This case demonstrated the considerable efficacy of EAM protocol as a conditioning regimen in terms of sufficient ablative capabilities, and the patient showed a successful hematopoietic engraftment. Although durability of the disease-free survival needs further observation, it had nearly 18 months of complete remission and the patient was in good performance status at the time of writing this manuscript.
Treatment of Tourette Syndrome With Attention Training Technique-A Case Series
Authors: Anja Schaich, Valerie Brandt, Alena Senft, Christian Schiemenz, Jan-Philipp Klein, Eva Faßbinder, Alexander Münchau, Daniel Alvarez-Fischer
Journal: Front Psychiatry (2020)
Keywords: gilles de la tourette syndrome, attention training technique, metacognitive therapy, psychotherapy, tic

The existing therapeutic strategies of Tourette syndrome (TS) do not lead to sufficient improvement in a significant number of patients. Recently published studies show that paying attention to tics increases whereas directing attention away decreases tic frequency. The aim of the present case series in three patients with TS was to investigate the effect of attention training technique (ATT) on TS symptoms. ATT is a technique derived from metacognitive therapy that aims on training patients to consciously (re-)focus their attention away from themselves. Friedman's chi-square test indicated a trend regarding the reduction of tic frequency and tic severity and a significant reduction of positive metacognitions from pre-baseline to follow-up. Reliable Change Indices (RCIs) are given for each measure and patient. Given the small number of patients, further studies including randomized controlled trials appear warranted.
Oral Candidiasis: Aiding in the Diagnosis of HIV-A Case Report
Authors: Arvind Shetti, Ishita Gupta, Shivyogi M Charantimath
Journal: Case Rep Dent (2011)
MeSH terms: Case Reports

Opportunistic fungal infections account for a significant amount of morbidity associated with HIV disease. Candidiasis is the most common oral opportunistic infection affecting people with HIV infection or AIDS. It is considered as an important marker of immune suppression and may be the initial manifestation of the disease in about 10% of HIV-infected adults. We report a case of an apparently healthy 45-year-old male with oral candidiasis which proved to be the first indicator of HIV infection.
A unique case of miliary pulmonary tuberculosis induced by bacillus Calmette-Guérin intravesical instillation with COVID-19 superinfection
Authors: Nicolò Brandi, Laura Bartalena, Cristina Mosconi, Rita Golfieri
Journal: SA J Radiol (2021)
Keywords: bcg, covid-19, ct, sars-cov-2, tuberculosis
MeSH terms: Case Reports

Intravesical instillation of Bacillus Calmette-Guérin (BCG) is used as an adjuvant treatment of bladder cancer. Systemic BCG infection occurs in less than 1% of cases, and pulmonary involvement is even rarer (0.3% - 0.7%), with a favourable prognosis. A 78-year-old male developed miliary tuberculosis (TB) secondary to intravesical BCG treatment and subsequent coronavirus disease 2019 (COVID-19) superinfection that led to patient death. High awareness amongst clinicians is needed to proceed with immediate appropriate therapy in these patients, especially during the COVID-19 pandemic.
Cariprazine Use in Early Psychosis: Three Case Reports
Authors: Ricardo Coentre, Rodrigo Saraiva, Carolina Sereijo, Pedro Levy
Journal: Front Psychiatry (2021)
Keywords: cariprazine, case report, early intervention, early psychosis, first-episode psychosis, schizophrenia
MeSH terms: Case Reports

Objective: Cariprazine is a new atypical antipsychotic approved for the acute and maintenance treatment of schizophrenia (1, 2) and for the treatment of manic or mixed episodes associated with bipolar I disorder (1). Recently, cariprazine also got extended FDA-approval for the treatment of depressive episodes in adults with bipolar I disorder (3). The use of low doses of atypical antipsychotics is an essential component of early intervention in psychosis. For its particular performance and tolerability, cariprazine is becoming an important option for the treatment of first-episode psychosis. Method: Three patients experiencing first-episode psychosis (FEP) were successfully treated with cariprazine. Two patients were in their first months of the disease, and the third patient was in his third year after the FEP. Results: The three patients had a diagnosis of non-affective FEP, which includes schizophrenia, delusional disorder, and schizoaffective disorder. One of them was in their third year after the FEP with a predominance of negative symptoms at this stage of the disorder. All the patients were treated with cariprazine with a target dose of 3-4.5 mg/day. The three patients showed improvements in their psychosis, including a decrease in negative symptoms. No significant side effects were reported. Conclusion: Our three case reports indicate that cariprazine is an atypical antipsychotic beneficial in the treatment of early psychosis. Treatment with low doses of cariprazine could be effective and tolerable in this phase of the disorder. Future studies with longer follow-up of FEP patients are recommended to confirm these positive results of cariprazine in the early phases of psychosis.
Blue toe syndrome caused by emboli from anomalous left atrial septal pouch thrombus: a case report
Authors: Snehasis Pradhan, Kciku Gresa, Jan-Peter Röing Genannt Nölke, Hans-Joachim Trappe
Journal: Thromb J (2020)
Keywords: atrial fibrillation, blue toe syndrome (bts), ct angiography, case report, interatrial septum, left atrial septal pouch (lasp), transesophageal echocardiography
MeSH terms: Case Reports

Background:
Left atrial septal pouches (LASPs) are a relatively newly described but common anatomical cardiac variant thought to be associated with atrial fibrillation (AF) and cardio-embolic stroke. Blue toe syndrome (BTS) describes ischemic changes in the toes due to microembolisation of the digital arteries. Establishing the etiology of BTS is vital so that the underlying cause can be treated. Here we describe the first case of BTS arising due to emboli from LASP thrombus arising on a background of new-onset AF.
Case presentation:
A 65-year-old man presented with a two-day history of progressive painful swelling and bluish-purple discoloration of the second and fourth toes of his left foot and new-onset AF. Tests for hypercoagulability disorders were negative. Duplex ultrasound and CT angiography excluded deep venous thrombosis and an absence of embolus, thrombus, or occlusion in the arterial tree in the lower extremities bilaterally, so BTS was diagnosed. While transthoracic echocardiography and chest CT initially showed no cardiac abnormalities or mural thrombus, subsequent transesophageal echocardiography revealed a LASP with an associated pedunculated thrombus. The affected toes were amputated due to wet gangrene, but the patient recovered well with thrombus resolution after anticoagulation.
Conclusion:
The presence of a LASP in the absence of any other identifiable cause of BTS should trigger careful investigation of the interatrial septum, preferably using a multimodality imaging approach. The possibility that LASPs may not merely be an innocent bystander but a causative mechanism for peripheral ischemia must be considered.