OpenMed/multicare-articles huggingface dataset:
The Correlation between Chronic Periodontitis and Oral Cancer
Authors: Maximilian Krüger, Torsten Hansen, Adrian Kasaj, Maximilian Moergel
Journal: Case Rep Dent (2013)

Infections are increasingly considered as potential trigger for carcinogenesis apart from risk factors like alcohol and tobacco. The discussion about human papilloma virus (HPV) in oral squamous cell carcinoma (OSCC) points at a general role of infection for the development of oral carcinomas. Furthermore, first studies describe a correlation between chronic periodontitis and OSCC, thus, characterizing chronic inflammation as being a possible trigger for OSCC. In front of this background, we present four well-documented clinical cases. All patients showed a significant anatomical relation between OSCC and clinical signs of chronic periodontitis. The interindividual differences of the clinical findings lead to different theoretical concepts: two with coincidental appearance of OSCC and chronic periodontitis and two with possible de novo development of OSCC triggered by chronic inflammation. We conclude that the activation of different inflammatory cascades by chronic periodontitis negatively affects mucosa and bone. Furthermore, the inflammatory response has the potential to activate carcinogenesis. Apart from a mere coincidental occurrence, two out of four patients give first clinical hints for a model wherein chronic periodontitis represents a potential risk factor for the development of OSCC.
Case report: An unusual case of small bowel bleeding and common iliac artery pseudoaneurysm caused by an unnoticed swallowed toothpick
Authors: Yao Xiong, Jing Yan, Gaowu Yan, Lei Feng, Yong Li, Suyu He, Ruyi Li, Gangcheng Tan, Bo Feng
Journal: Front Med (Lausanne) (2023)
Keywords: foreign bodies, gastrointestinal bleeding, gastrointestinal perforation, iliac artery, pseudoaneurysm, small intestine, toothpick
MeSH terms: Case Reports

Gastrointestinal (GI) bleeding is a common clinical condition that can be caused by a variety of reasons. Bleeding can occur anywhere in the GI tract, and it usually presents as vomiting of blood, melena or black stools. We herein present a case of a 48-year-old man who was ultimately diagnosed with perforation of the lower ileum, pseudoaneurysm of the right common iliac artery, lower ileum-right common iliac artery fistula, and pelvic abscess caused by accidental ingestion of a toothpick. This case suggests that accidental ingestion of a toothpick may also be the cause of GI bleeding in some patients. For patients with unexplained GI bleeding, especially those with small bowel bleeding, a rational and combined use of gastroduodenoscopy, colonoscopy, unenhanced and contrast-enhanced abdominal CT can help detect the causes of GI bleeding and improve diagnostic accuracy.
Case Study in Youth Flexible Assertive Community Treatment: An Illustration of the Need for Integrated Care
Authors: Marieke Broersen, Nynke Frieswijk, Rob Coolen, Daan H M Creemers, Hans Kroon
Journal: Front Psychiatry (2022)
Keywords: flexible assertive community treatment, adolescents, early intervention, family centred, fragmented care, integrated care approach, intensive case management, mental healthcare model

Youth Flexible Assertive Community Treatment (Youth Flexible ACT) is a client- and family-centered service delivery model for young people up to 24 years of age who have interrelated psychiatric- and social problems across multiple life domains and do not readily engage with office-based mental health services. Youth Flexible ACT teams were set up to meet the multifaceted needs of this subgroup in an integrated manner. In this paper, we present a case study to (1) describe the core principles of Youth Flexible ACT and (2) illustrate the application of the mental healthcare model. Subsequently, we describe the contribution of model elements to a positive care process and discuss the challenges of the team in working with the model. The case study displays the importance of integrated flexible and personalized care services to enable adolescents to remain engaged in care.
Successful Treatment of Advanced Intrahepatic Cholangiocarcinoma With a High Tumor Mutational Burden and PD-L1 Expression by PD-1 Blockade Combined With Tyrosine Kinase Inhibitors: A Case Report
Authors: Ze Zhang, Wenwen Zhang, Hongguang Wang, Bingyang Hu, Zhanbo Wang, Shichun Lu
Journal: Front Immunol (2021)
Keywords: pd-l1, tmb, conversion therapy, immunotherapy, intrahepatic cholangiocarcinoma
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Bile Duct Neoplasms / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antibodies, Monoclonal, Humanized / administration & dosage, B7-H1 Antigen / biosynthesis, Bile Duct Neoplasms / genetics, Bile Duct Neoplasms / surgery, Chemotherapy, Adjuvant / methods, Cholangiocarcinoma / drug therapy, Cholangiocarcinoma / genetics, Cholangiocarcinoma / surgery, Female, Hepatitis B, Chronic / complications, Humans, Immune Checkpoint Inhibitors / administration & dosage, Neoadjuvant Therapy / methods, Phenylurea Compounds / administration & dosage, Protein Kinase Inhibitors / administration & dosage, Quinolines / administration & dosage, Antibodies, Monoclonal, Humanized, B7-H1 Antigen, CD274 protein, human, Immune Checkpoint Inhibitors, Phenylurea Compounds, Protein Kinase Inhibitors, Quinolines, sintilimab, lenvatinib

Advanced intrahepatic cholangiocarcinoma (iCCA) is not suitable for surgical treatment. Guided by the concept of precision medicine, preoperative systematic treatment may reshape the clinical outcomes of advanced intrahepatic cholangiocarcinoma patients. We describe the case of a 38-year-old female who has been diagnosed with stage IV intrahepatic cholangiocarcinoma with a high tumor mutational burden and positively programmed death-ligand 1 (PD-L1) expression. The patient was treated with programmed cell death 1 (PD-1) inhibitors combined with tyrosine kinase inhibitors (TKIs). After 7 cycles of combination therapy, she underwent radical resection and no tumor cells were found in the postoperative histopathological examination. In addition, the patient's survival time had reached 25 months, as of August 2021. To date, this is the first case of successful radical resection after combined immunotherapy with TKIs for advanced PD-L1-positive intrahepatic cholangiocarcinoma with a high tumor mutational burden (TMB). The case provides a new approach to the treatment of advanced intrahepatic cholangiocarcinoma.
Neuroblastoma Soft Tissue Metastasis in a 10-Month-Old Infant with a Right Thigh Mass
Authors: Shokouh Taghipour Zahir, Fateme Salemi
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Background:
Neuroblastoma is a solid tumor that occurs more frequently in pediatric populations. It may originate from any part of the sympathetic nervous system, but it most commonly arises from the paraspinal sympathetic ganglia in the abdomen or mediastinum. Local lymphadenopathy and distant metastasis to the central nervous system, orbit, and liver might be detected; however, it rarely includes soft tissue or musculoskeletal involvement. Case Report. Here, we report a 10-month-old infant presented with a right thigh mass with an otherwise benign physical exam and medical history. MRI of the lower extremities suggested tumoral infiltration in the soft tissue of both thighs, predominantly on the right side. Surgical pathology of the lesion confirmed neuroblastoma. A large subhepatic mass and paraaortic lymphadenopathy in the abdominal CT scan and metaiodobenzylguanidine scan findings favored primary abdominal neuroblastoma that had spread to lower extremities. The patient has been in remission since the completion of chemotherapy.
Conclusion:
Neuroblastoma should be considered in infants with an abnormal mass in extremities. Due to its aggressive nature, most patients struggle with distant and local tumor spread at diagnosis. Therefore, any abnormal signs and symptoms, especially in younger pediatrics, warrant immediate evaluation to avoid tumor expansion.
Failed Switching off in the MIBI-Parathyroid Scintigraphy in a Dialyzed Patient with Secondary Hyperparathyroidism Responsive to Cinacalcet Therapy
Authors: Piergiorgio Bolasco, Alessandra Serra, Maurizio Loi, Andrea Galfré, Mario Piga
Journal: Int J Endocrinol (2010)
MeSH terms: Case Reports

The aims of your case report is to show the predictivity of (99m)Tc-sestamibi (MIBI) scintigraphy and doppler ultrasound imaging on secondary hyperparathyroidism (SHPT) in a patient responsive to calcimimetic treatment. Moreover, it has been reported that calcimimetic has great potential in reducing the volume of the parathyroid gland. On the other hand, the MIBI scintigraphy is considered a crucial diagnostic procedure to monitor the response to therapy in terms of turnover and cellular metabolism; whereas, ultrasound to monitor the volume variation in response to treatment. It is described the case of a 73-year-old man on hemodialysis from 1995 for ESRD. Within 2 years the patient gradually developed SHPT with progressively increased iPTH up to 1,000 rhog/ml. The ultrasound, highlighted the presence of two parathyroid hyperplasia, confirmed by scintigraphy, showing focal increase uptake of sestamibi in the same anatomical areas. As a result of the patient's refusal to perform a parathyroidectomy, cinacalcet, was administered (65 mg overage daily dose). After a year of treatment, there was a striking decrease of iPTH (from 1300 to 57 rhog/ml, -95%); but, on the contrary to expectations, this positive metabolic outcome, was not followed by parathyroid changes in ultrasound and scintigraphic findings.
Case Report: Sacral Nerve Root Pelvic Neural Retraining, With Long-Term Sustainability After the Device Explantation
Authors: Panteleimon Vassiliu, Filippos Patoulis, Leon Naar, Georgios Dendias, Nikolaos Arkadopoulos
Journal: Front Rehabil Sci (2021)
Keywords: snm, bladder detrusor muscle, fecal incontinence, neuronal remodeling, neuroplasticity, rehabilitation, spina bifida, urinary incontinence
MeSH terms: Case Reports

Introduction: Sacral-Nerve-Neuromodulation (SNM) is an effective treatment increasingly used in patients with urinary (UI) and fecal incontinence (FI). The way it acts in the body at its full potential have not yet been elucidated. The authors review the literature on SNM and the way it possibly works, relating it to a case with an unusually favorable outcome. Case Presentation: A female presented with UI and FI. Operated for meningocele as a neonate. It the age of 5 bilateral Cohen ureter reimplantation performed for persistent urinary infections due to vesicourethral reflux. At the age of 13, she started complaining about UI associated with a hyper functional detrusor muscle. After a diary incontinence evaluation with a standardized questionnaire, SNM was applied at the age of 18 and was retained for 4 years. She was re-evaluated with a yearly follow-up. Results: The patient retained the positive effect of SNM even after its removal and in addition showed signs of improvement. The patient developed the sensation of fillingness of the bladder and the rectum, which she never had before the SNM implantation, sensation which she retained 29 months after (last follow-up) device removal, allowing her to control her voids. Discussion: The modern literature hypothesis that SNM contributes to the plasticity of the nerves through the stimulated area is supported by the present case, in which the SNM effect remained and led to improvements even after its removal. Device settings are presented as they may correlate with the result. This reinforces and expands the frontiers of SNM application and research.
Axillobifemoral bypass for total abdominal occlusion secondary to Takayasu's arteritis: A case report
Authors: Omar Jiménez-Zarazúa, Lourdes Noemí Vélez-Ramírez, María Andrea Martínez-Rivera, Abraham Hernández-Ramírez, Pascual Palomares-Anda, María Alcocer-León, Angélica Monserrat Becerra-Baeza, Jaime D Mondragón
Journal: Int J Surg Case Rep (2019)
Keywords: axillobifemoral bypass, case report, takayasu’s arteritis, total abdominal occlusion

Introduction:
Takayasu's arteritis (TA) is a rare disease that mainly affects large arteries. Approximately 20% of TA patients will require surgical intervention secondary to arterial complications such as intermittent claudication, persistent hypertension refractory to treatment, and heart failure.
Presentation of case:
The case of a 22-year-old female with TA of five years of evolution is presented. The patient deteriorated clinically after five years of corticosteroid and immunosuppressant management requiring surgical intervention with an axillobifemoral bypass for a total abdominal occlusion. Onset, pre-surgical and post-surgical Doppler ultrasonography as well as abdominal angiotomographies document and corroborate the patient's clinical and hemodynamic improvement.
Discussion:
Very limited literature exists regarding surgical interventions for TA patients. While most reported cases present an endovascular surgical management. Open surgical procedures have lower rates of restenosis than endovascular management. Although endovascular management is less invasive than extra-anatomical axillobifemoral bypass, the patient was not a candidate for endovascular stent graft placement due to the increased risk for vascular injury and subsequent perforation. Approximately a fifth of TA patients are candidates for surgical intervention over time.
Conclusion:
Vascular surgery in TA cases becomes an option when the patient does not improve clinically after administration of medical treatment. Although endovascular management has fewer complications, the rate of restenosis is higher. Patients at risk of restenosis and who have increased perioperative vascular risk can benefit from open surgical procedures. Surgical management should be tailored to the patient's needs.
DISTAL NEUROTIZATION OF THE ANTERIOR INTEROSSEOUS NERVE TO RECOVER HAND GRASPING
Authors: Álvaro Baik Cho, Carlos Henrique Vieira Ferreira, Renan Martins Fontana, Gary Alan Ângulo Montano, Leandro Yoshinobu Kiyohara, Luiz Sorrenti
Journal: Acta Ortop Bras (2023)
Keywords: microsurgery, nerve lesion, nerve transfer

Lower trunk lesions are uncommon, representing about 3 to 5% of brachial plexus lesions in adults. One of the functions lost by patients who suffer this type of injury is the flexion of the fingers, with important harming of palmar grip. This series of cases proposes the transfer of a branch of the radial nerve to the anterior interosseous nerve (AIN), presenting a new alternative for the treatment of these lesions with highly satisfactory results.
Objective:
To demonstrate our strategy, technique, and results in the reinnervation of the AIN in lesions isolated from the lower trunk of the brachial plexus in four cases of high lesion of the median nerve.
Method:
Prospective cohort study in which four patients underwent neurotizations. The treatment was directed to the recovery of the fingers' flexors of the hand and the grip.
Results:
All patients presented reinnervation of the flexor pollicis longus (FPL) and deep flexors of the 2nd, 3rd, and 4th fingers. The deep flexor of the 5th finger also showed reinnervation but with reduced strength (M3/4) comparing to the others (M4+).
Conclusion:
Despite the limited number of cases in this and other studies, the results are uniformly good, allowing to consider this treatment predictable. Level of Evidence IV, Case Series.
Internal Iliac Aneurysm Causing Hydroureteronephrosis
Authors: Tawfeeq Sangey, Sibtain Moledina
Journal: Case Rep Radiol (2020)
MeSH terms: Case Reports

A 63-year-old presented with right lumbar pain and increased frequency of urination. Imaging revealed right internal iliac artery aneurysm causing hydroureteronephrosis and compressing the urinary bladder.
A case of multiple myeloma in a poultry worker
Authors: Pil Kyun Jung, Inah Kim, Inhyo Park, Chinyon Kim, Eun-A Kim, Jaehoon Roh
Journal: Ann Occup Environ Med (2014)
Keywords: formaldehyde, hematologic neoplasm, multiple myeloma, pesticides, poultry, solvents
MeSH terms: Case Reports

Background:
Livestock breeders including poultry workers are exposed to various agricultural chemicals including pesticides and/or organic solvents. Multiple myeloma is a rare disease in Korea, and few reports have investigated the influence of occupational exposures on multiple myeloma occurrence.
Case presentation:
A 61-year-old male poultry farm worker presented with bone pain and generalized weakness. A bone marrow biopsy was performed, and he was diagnosed with multiple myeloma. The patient had worked in a poultry farm for 16 years and was exposed to various pesticides and organic solvents such as formaldehyde without any proper personal protective equipment. Results of the work reenactment revealed that the concentration of formaldehyde (17.53 ppm) greatly exceeded the time-weighted average (0.5 ppm) and short-term exposure limit (1.0 ppm) suggested in the Korean Industrial Safety and Health Act.
Conclusions:
This case report suggests that poultry workers may be exposed to high levels of various hazardous chemicals including pesticides and/or organic solvents. Numerous previous studies have suggested an association between multiple myeloma and exposure to agricultural chemicals; thus, multiple myeloma in this patient might have resulted from the prolonged, high exposure to these chemicals.
Obstructive Jaundice due to Pancreatic Involvement as an Initial Presentation of Adult Acute Lymphoblastic Leukemia
Authors: Oreoluwa Oladiran, Ifeanyi Nwosu
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Acute lymphoblastic leukemia (ALL) is a heterogeneous group of lymphoid disorders characterized by monoclonal proliferation and expansion of immature lymphoid cells in the bone marrow, blood, and other organs. It commonly presents with nonspecific symptoms such as lethargy, easy bruising, and weight loss. In this article, we present the case of a 48-year-old male who presented to the hospital with painless jaundice resulting from pancreatic infiltration, initially thought to be due to pancreatic or hepatobiliary malignancy. He was later diagnosed with ALL by lymph node biopsy and peripheral blood flow cytometry immunophenotyping and was transferred to a cancer treatment centre for unilateral bone marrow biopsy and further management. Our case highlights the rare occurrence of pancreatic infiltration in ALL.
Surgical Resection of Anastomotic Stenosis after Rectal Cancer Surgery Using a Circular Stapler and Colostomy with Double Orifice
Authors: Toru Imagami, Satoru Takayama, Yohei Maeda, Taku Hattori, Ryohei Matsui, Masaki Sakamoto, Hisanori Kani
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

The double stapling technique has greatly facilitated intestinal reconstruction, particularly for anastomosis after anterior resection. However, anastomotic stenosis may occur, which sometimes requires surgical treatment. Redo surgery with reresection and reanastomosis presents a high risk of complications. Treatment methods need to be selected depending on the degree and location of stenosis. In an effort to propose a new resolution, reporting new cases and sharing valid experiences are necessary. An 82-year-old man diagnosed with rectal cancer had undergone laparoscopic anterior resection. Endoscopic balloon dilation performed for anastomotic stenosis had failed. Therefore, colostomy with double orifice was constructed on the oral side at 10 cm from the stenosis. Approaching from the anal and stoma side, the anastomotic stenosis was resected using a circular stapler. The colostomy was closed 1 month after surgery. Stenosis resection using a circular stapler requires the following steps: (1) passing the center shaft through the stenosis, (2) inserting the anvil head into the oral side of the stenosis, and (3) attaching the anvil head to the center shaft. This method can resect the stenosis using a circular stapler without being affected by postoperative adhesion in the pelvis. Compared to endoscopic balloon dilation, resection of the stricture by the circular stapler is thought to be reliable. This technique is particularly effective for localized stenosis, including anastomotic stenosis. It is considered that this method is minimally invasive and is low risk for complications. This method can contribute to the useful surgical option for refractory anastomotic stenosis after anterior resection.
Longitudinal Improvement of Neurocognition after Electroconvulsive Therapy in Bipolar Depression
Authors: Tomosuke Nakano, Eishi Motomura, Toshiki Hasegawa, Yasuhiro Kawano, Motohiro Okada
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Electroconvulsive therapy (ECT) is applied to treatment-resistant mood disorders. Its therapeutic effect on neurocognition remains unclear. We report the case of a 55-year-old man with treatment-resistant bipolar depression who underwent ECT series. We longitudinally monitored his neurocognition with the Brief Assessment of Cognition in Schizophrenia-Japanese version (BACS-J). The patient's scores on all of the BACS-J domains except working memory recovered after the ECT series. Interestingly, his verbal memory, motor speed, and executive function recovered 1 month after ECT, whereas his verbal fluency and attention scores recovered approx. 1 year after ECT. The BACS can be useful for monitoring ECT's longitudinal effects on individuals' cognitive recovery. Further studies with a large sample size are needed to confirm our present findings.
Metastatic Malignant Ovarian Steroid Cell Tumor: A Case Report and Review of the Literature
Authors: Jessica Lee, Veena S John, Sharon X Liang, Catherine A D'Agostino, Andrew W Menzin
Journal: Case Rep Obstet Gynecol (2016)

We report a case of malignant ovarian steroid cell tumor not otherwise specified (NOS) in a 47-year-old female who presented with hirsutism, virilization, and amenorrhea. At the time of laparotomy, the tumor had already spread to the pelvic cul-de-sac. She underwent a total hysterectomy, bilateral salpingo-oophorectomy, and tumor resection with no residual disease. She received three cycles of bleomycin, etoposide, and cisplatin (BEP) and is now free of disease 24 months after surgery. Literature review of ovarian steroid cell tumors NOS including clinicopathological features and clinical management was performed.
Isolated spontaneous biceps abscess causing septic shock in a diabetic patient: A rare case report
Authors: M Masood Sidiqi, Benjamin Witte
Journal: Int J Surg Case Rep (2020)
Keywords: abscess, biceps, brachii, sepsis
MeSH terms: Case Reports

Introduction:
Intramuscular abscesses, particularly in the biceps brachii, are an extremely rare phenomenon. When present they are usually secondary to trauma, intramuscular injections, or systemic disease.
Presentation of case:
A 56 year old diabetic woman presented to our emergency department with a 3 day history of fever, cough, and a painful left shoulder. Although she had a mechanical fall 2 weeks prior, she denied any pain in her shoulder immediately after the fall. She also denied any history of drug abuse or recent intramuscular injection. On examination she looked acutely unwell and was in acute septic shock requiring inotropic support. Computed tomography of her shoulder showed a large intramuscular abscess in her left biceps brachii muscle. She was immediately taken to the operating theatre for open exploration and washout of the abscess. The multiloculated abscess was tracking into the glenohumeral joint. Post operatively she showed significant clinical improvement and after a 2 week course of intravenous antibiotics recovered well and was discharged from hospital.
Discussion:
Intramuscular abscesses are usually seen in patients who are immunocompromised. Intramuscular needle injections and haematomas secondary to trauma are also risk factors. To the best of our knowledge, there have only been 4 published reports in the English literature of intramuscular abscess formation in the biceps brachii.
Conclusion:
We report a case of a seemingly spontaneous intramuscular biceps abscess in a diabetic patient presenting with septic shock.