OpenMed/multicare-articles huggingface dataset:
Liquid Levothyroxine Formulation Taken during Lunch in Italy: A Case Report and Review of the Literature
Authors: Carlo Cappelli, Ilenia Pirola, Maurizio Castellano
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Levothyroxine (L-T4) is among the most widely prescribed medications in the world, and it is considered by the World Health Organization an essential medicine for basic health care. Replacement therapy has always been considered straightforward although different factors may interfere with intestinal absorption of L-T4, including food, dietary fibre, coffee, drugs, and gastrointestinal diseases. For these reasons, current guidelines recommend that L-T4 should be taken in a fasting state because its absorption is maximised when it is taken on an empty stomach, reflecting the importance of gastric acidity in the absorption process. In addition to sodium L-T4 in tablet form, various formulations (soft-gel capsules and liquid solutions) have become available for clinical use in the last years promising improved absorption. We described a 31-year-old Italian man who took liquid levothyroxine formulation during lunch. He was under replacement therapy with liquid levothyroxine 75 mcg daily for hypothyroidism due to Hashimoto thyroiditis for three years. During confirmation of the L-T4 replacement therapy, the patient stated that he was going to continue to "take liquid levothyroxine during (his) lunch every day." We recommended taking the medication correctly in the morning at least thirty minutes before breakfast and repeating TSH, fT4, and fT3 after three months. The thyroid hormonal profiles taken after 3 and 6 months were comparable to those when the patient was taking the medication during lunch. In conclusion, liquid levothyroxine formulation should be preferred in case of malabsorption or potential malabsorption. Liquid formulation should be preferred due to the possibility of taking it during breakfast, which significantly improves the compliance of patients. Further studies are needed to evaluate the possibility of taking liquid L-T4 during lunch.
Silane Heat Treatment Could Eliminate the Hydrofluoric Acid Etching of Lithium Disilicate Overlays: A Four-Year Follow-Up
Authors: Spartak Spasov Yanakiev, Mirela Borislavova Marinova-Takorova
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

A four-year follow-up of a novel silane heat treatment method for bonding lithium disilicate overlays to tooth structures without hydrofluoric acid etching of the ceramic surface is presented in this case report. Silane heat treatment modifies the silane layer and thus enhances resin ceramic bond strength without hydrofluoric acid etching. The standard ceramic preparation technique prior to bonding silicate ceramics to tooth structure is hydrofluoric acid etching and applying a silane coupling agent, followed by dental adhesive. In this case, the micromechanical roughening of the ceramic surface was performed by air abrasion with Al2O3. Silane heat treatment with constant 120°C airflow, applied for 60 sec, followed by dental adhesive application enhanced the resin-ceramic bond strength. After a four-year follow-up, the restorations' clinical appearance could be defined as excellent/very good according to the FDI clinical criteria for the evaluation of direct and indirect restorations. This clinical result supports many in vitro studies regarding the resin-ceramic bond strength and durability obtained through postsilanization heat treatment.
Two Atypical Cases of Nodular Gastritis: A Poorly Differentiated Gastric Adenocarcinoma and a Pseudo-Low Grade Gastric MALT Lymphoma
Authors: Hye Jin Choi, Sun-Young Lee, Jung Hyun Lee, Dong Choon Seol, So Young Kim, Hae Jin Choi, Hyun Sik Park, Sung Noh Hong, Hye Seung Han
Journal: Gastroenterology Res (2010)
Keywords: gastric cancer, gastric mucosa associated lymphoid tumor, helicobacter pylori, nodular gastritis
MeSH terms: Case Reports

Nodular gastritis is a Helicobacter pylori-related gastritis with endoscopically proven gooseflesh skin-like nodularity in the gastric antrum. Although an association between nodular gastritis and gastric malignancies has been suggested, there is neither a treatment strategy nor a treatment guideline for this condition because of its relative rarity. We have recently experienced two cases of diffuse-type nodular gastritis invading both the antrum and corpus of the stomach with atypical findings that required specific treatments in two young females. The first patient was diagnosed with a suspicious low grade gastric mucosa associated lymphoid tissue (MALT) lymphoma lesion on a diffuse-type nodular gastritis, and was cured by H. pylori eradication. The second patient was diagnosed with a signet cell type gastric cancer on a diffuse-type nodular gastritis, and was cured by surgical resection. When considering the nature and significance of these gastric lesions, a link between nodular gastritis and gastric malignancy should be considered, especially in young women who have diffuse-type nodular gastritis involving both the antrum and corpus of the stomach.
Malign recurrence of primary chest wall hemangiopericytoma in the lung after four years: a case report and review of the literature
Authors: Tulay Akman, Ahmet Alacacioglu, Devrim Dolek, Tugba Unek, Duygu Gurel, Ahmet Ugur Yilmaz, Ahmet Onen
Journal: Case Rep Oncol Med (2014)

Hemangiopericytoma (HPC) may develop in every site where the endothelial tissue exits and primarily develops in the skeletal-muscular system or the skin. Adult cases of HPC generally exhibit a benign course. 20-30% of the cases may show a malign course. The tumors that show more than four mitoses, a focal area of necrosis, and increased cellularity on a magnification ×10 are considered as malign. In our paper, we presented our case who showed a lung metastasis at the end of 4 years and who developed a pathological fracture of the right humerus at the end of approximately 2 years, because hemangiopericytoma is rarely seen in the chest wall as a primary tumor.
Intradural prepontine chordoma in an 11-year-old boy. A case report
Authors: R Saman Vinke, Elise Charlotte Lamers, Benno Kusters, Erik J van Lindert
Journal: Childs Nerv Syst (2016)
Keywords: chordoma, intradural, paediatric, prepontine
MeSH terms: Brain Neoplasms / diagnosis, Brain Neoplasms / therapy, Chordoma / diagnosis, Chordoma / therapy, Ventriculoperitoneal Shunt / methods, Case Reports, Brain Neoplasms / complications, Child, Chordoma / complications, Humans, Magnetic Resonance Imaging, Male, Tomography, X-Ray Computed

Case report:
The authors report a case of an 11-year-old boy that presented with headache and vomiting that was present for several months. CT and MR imaging revealed a large prepontine mass and an obstructive hydrocephalus. A ventriculoperitoneal shunt was inserted, and in a second operation, a radiologically proven total resection was performed, using a left frontotemporal transsylvian approach. The tumour showed no involvement of the dura or clivus. Histological examination showed the characteristics of a chordoma. No further adjuvant treatment was given. The patient remained disease or tumour free after a 6-year follow-up.
Discussion:
Intradural chordomas are extremely rare tumours that originate from notochordal remnants. Only three other cases have been reported in the paediatric population. Ecchordosis physaliphora (EP) is an ectopic notochordal remnant that has a similar biological behaviour and is difficult to distinguish from intradural chordomas. They might exist in a continuum from benign notochordal tumour to malignant chordoma. A surgical resection without adjuvant radiation therapy is suggested to be the treatment of choice in the paediatric population.
Conclusion:
The authors describe a rare case of an intradural prepontine chordoma in an 11-year-old boy that stayed disease free after a 6-year follow-up.
Economic attributes and childhood stunting in Rwanda: case study of the City of Kigali
Authors: Manassé Nzayirambaho, Aimable Nsabimana, Vincent Manirakiza, Pierre Claver Rutayisire, Kato Njunwa
Journal: Pan Afr Med J (2022)
Keywords: economic attributes, kigali, rwanda, stunting, under five children
MeSH terms: Growth Disorders / epidemiology, Growth Disorders / etiology, Income, Child, Cross-Sectional Studies, Humans, Retrospective Studies, Rwanda / epidemiology

Introduction:
stunting in under five children is a great concern in low and middle-income countries including Rwanda. While over the past decades different developing countries have made remarkable efforts improving their economic growth, there is mixed evidence and lack of consensus on the impact of economic development on nutrition improvement. The objective of this study was to assess the relationship between economic attributes and childhood stunting in the City of Kigali.
Methods:
this was a retrospective cross-sectional and comparative study documenting the period 2010-2017. Stunting in under five children was analyzed in relation to the economic attributes which include the household consumption per capita, annual household income and level of poverty. The analysis was done at the level of district. Official reports from the National Institute of Statistics of Rwanda provided data on both economic attributes and stunting.
Results:
in some situations, the improvements in economic attributes such as increase in average household consumption per capita and increase in annual household income are followed by the reduction of stunting in under five children. However, in some other situations, the reduction of the level of poverty and the increase of annual household income was not translated into the reduction of stunting.
Conclusion:
improvements in some economic attributes do not necessarily translate into reduction of stunting in under five children. Further studies are needed to understand possible lead forces underlying this situation including establishing the proportion of household income spent on children´s nutrition as well as possible inequity and inequality in wealth distribution.
Former mucinous bronchioloalveolar carcinoma revisited
Authors: Mohammed H Alshati, Mohammed M Yaktien, Kenneth C Katchy
Journal: Case Rep Med (2013)

This is a brief case report of invasive multicentric mucinous adenocarcinoma presented at a rather young age with bronchorrhea and persistent consolidation that ended up with the patient demise; nevertheless, we demonstrate relevant radiological and pathological features with emphasis on the new classification of bronchioloalveolar carcinoma, a term that should no longer be in use.
Cutaneous squamous cell carcinoma in vertically acquired HIV and epidermodysplasia verruciformis
Authors: Linda A Mandikiyana Chirimuta, Francis J Ndowa, Margaret J Pascoe
Journal: South Afr J HIV Med (2022)
Keywords: hiv infection, epidermodysplasia verruciformis, human papillomavirus, squamous cell carcinoma, verruca plana
MeSH terms: Case Reports

Introduction:
Acquired epidermodysplasia verruciformis (EV) is a skin disorder that has been described in individuals with perinatally acquired HIV. Many cases have been identified in sub-Saharan Africa in keeping with the epidemiology of HIV infection compared to the rest of the world, where cases are rare. Epidermodysplasia verruciformis skin lesions may undergo malignant transformation. There are few documented cases of malignant transformation of these skin lesions. We describe a patient with an EV-like skin rash who developed cutaneous squamous cell carcinoma (SCC).
Patient presentation:
A 25-year-old man, on antiretroviral treatment for 12 years, presented with a generalised skin rash since the age of 11 years, and a 7-month history of a persistent scalp ulcer. He had no history of trauma, radiation or other chronic conditions. Despite an undetectable HIV viral load, he had failed to immune reconstitute (CD4 42 cells/µL). Physical examination revealed a generalised hypopigmented, papular skin rash resembling verruca plana and a 3 cm × 3 cm ulcer with rolled edges on the right parietal region of the scalp. There were no palpable lymph nodes in the head and neck areas. Biopsy of the ulcer revealed moderately differentiated SCC.
Management and outcome:
Wide local excision of the lesion was done under local anaesthesia and histological analysis confirmed completely excised moderately differentiated SCC. Further examination four weeks later revealed two, smaller, histologically similar scalp lesions which were completely excised.
Conclusion:
Patients with acquired EV require thorough, frequent examination for skin lesions with possible malignant transformation. Early identification of malignant transformation and treatment with surgical intervention is curative.
Mycotic Aneurysm after Bacillus Calmette-Guérin Treatment: Case Report and Review of the Literature
Authors: Nathaniel D Coddington, Jesse K Sandberg, Chen Yang, Jennifer K Sehn, Eric H Kim, Seth A Strope
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

Background. Intravesicular Bacillus Calmette-Guérin (BCG) is an effective adjunctive therapy for superficial bladder cancer that has been shown to delay recurrence and progression of disease. Serious side effects are relatively rare but are difficult to diagnosis and commonly overlooked. Case Presentation. We report the case of a patient who was found to have mycotic aortic aneurysms secondary to treatment with BCG after a prolonged course with multiple intervening hospitalizations. Conclusion. Through this report, we discuss our present understanding of BCG infection following treatment and review the literature regarding this particular rare manifestation.
Giant Ectopic Parathyroid Adenoma Arising in the Posterior Mediastinum. Report of Case and a Review
Authors: Yousef S Amr, Mousa M Saleh, Samir S Amr
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

We present a case of a greatly enlarged giant ectopic parathyroid adenoma that weighed 43 grams, which was located in the posterior mediastinum of a 74-year-old man. The patient presented with generalized weakness and decreased level of consciousness. He was found to have elevated level of serum calcium (19.9 mg/dl), and a subsequent assay of parathyroid hormone (PTH) was greatly elevated (2234 pg/ml). We report the course of management and outcome of the patient and present a review of the literature on giant ectopic parathyroid adenomas in the posterior mediastinum.
Inspection of Ureteral Orifices: The Pearl of Flexible Cystoscopy
Authors: Seshikanth Middela, Charmaine Matthews, Hamid Bushra, Sanjay Das, Bo Pettersson
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

Cystoscopy is most common diagnostic investigation. The examination technique and the findings, both normal and pathological, were well described described a hundred years ago. With technological advances, there has been over-emphasis on imaging modalities for diagnostic purposes. A basic maneuver of examining the ureteral orifices is sometimes rushed through when in fact careful examination can clinch the diagnosis. The importance is exemplified by two cases, one of which is a rare case of Xanthoma of the ureter.
Weight Loss Effects of Glucagon-Like Peptide-One Receptor Analog Treatment in a Severely Obese Patient During Hospital Admission
Authors: Yaiseli Figueredo, Claudia Cottone, Tanira Ferreira, Jesus Gonzalez, Gianluca Iacobellis
Journal: Cureus (2023)
Keywords: extreme obesity, glp-1 receptor agonist, nutrition and metabolism, weight disorders, weight loss
MeSH terms: Case Reports

Obesity is considered an independent risk factor for increased hospital length of stay and can be an obstacle to a safe discharge. Although typically prescribed in the outpatient setting, initiating glucagon-like peptide-one receptor agonists (GLP-1RAs) in the inpatient setting can be efficacious in reducing weight and increasing functional status. We report the use of GLP-1RA therapy with liraglutide and subsequent transition to subcutaneous semaglutide weekly in a 37-year-old female with severe obesity, weighing 694 lbs (314 kg) with a body mass index (BMI) of 108 kg/m2. Multiple medical and socioeconomic factors impaired the patient from being safely discharged and ultimately led to prolonged hospitalization. The patient received 31 consecutive weeks of GLP-1RA therapy in the inpatient setting along with a very low-calorie diet (800 kcal/day). Initiation and up-titration doses were completed using liraglutide for a total of five weeks. Subsequently, the patient was transitioned to receive weekly semaglutide and completed 26 weeks of therapy. At the end of week 31, the patient's weight decreased by 174 lbs (79 kg), or 25% of baseline weight, and BMI decreased from 108 to 81 kg/m2. GLP-1RAs offer a promising avenue for weight loss interventions in patients with severe obesity in addition to lifestyle modifications. The weight loss observed in our patient at the halfway point of the total treatment duration is a milestone in the pathway to gaining functional independence and meeting the criteria for future bariatric surgery. Semaglutide, a GLP-1RA, can be an effective intervention for severely obese patients with BMI greater than 100 kg/m2.
A Marked Response to Immunosuppressive Intervention for Abruptly Occurring Cardiac Complications in a Case of Juvenile Systemic Sclerosis Overlapped with Dermatomyositis
Authors: Tsunehisa Nagamori, Yoichiro Yoshida, Hironori Takahashi, Hideharu Oka, Aya Kajihama, Koichi Nakau, Masaya Sugimoto, Masako Minami-Hori, Hiroshi Azuma
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Juvenile-onset systemic sclerosis (jSSc) is a rare condition, having unique characteristic features compared to adult-onset SSc. Although cardiac involvement (CI) is known as a leading cause of mortality overall in SSc, the importance of CI in jSSc has not been emphasized. Here we present a 13-year-old female with jSSc overlapped with dermatomyositis (DM) complicated CI. She developed skin thickness and induration, Raynaud's phenomenon, digital pitting scars in fingertips, and skeletal myositis. Oral prednisolone and pulse methotrexate treatment led to the improvement of skin findings; however two weeks after the initiation she suddenly presented with muscle pain and dyspnea within a few days. Cardiac investigations then showed pericardiac effusion and diastolic dysfunction due to significant biventricular hypertrophy causing heart failure. As pericardiac effusion and exacerbation of skeletal myositis were evident, steroid pulse therapy was initiated. Unexpectedly, not only the myositis but also the CI including diastolic dysfunction was improved. She thereafter followed a favorable clinical course without reactivation of the CI or cardiac fibrosis. As a conclusion, close attention to CI must be paid in jSSc patients, especially when skeletal muscle involvement is evident and immunosuppressive therapy may be effective for CI in jSSc in cases where it occurs abruptly.
A Novel De Novo Mutation of the DHX30 Gene in a Patient With Neurodevelopmental Disorder, Severe Motor Impairment, and Absent Language (NEDMIAL)
Authors: Mohammad M Alomaim, Aziza M Mushiba
Journal: Cureus (2023)
Keywords: atp-dependent rna helicase, dhx30, nedmial, pro796leu, whole exome sequence
MeSH terms: Case Reports

Introduction:
DExH-Box Helicase 30 (DHX30) is a gene that codes for proteins. It belongs to the class of RNA secondary structure unwinding helicases known as DExH-boxes. There have been numerous reports of pathogenic DHX30 variants. Most mutations, but not all, result in severe phenotypic abnormalities. The most common symptoms are severe motor developmental delay, intellectual disability, sleep disturbances, autism spectrum disorder, seizures, and gait abnormalities.
Objective:
The objectives of reporting this case are: To report a novel mutation giving rise to NEDMIAL and to update the literature regarding the manifestation of the case of a rare condition (NEDMIAL).
Case presentation:
We report the case of a 12-year-old female who presented with similar complaints of severe motor impairment, seizures, intellectual disability, and absent language and was later diagnosed on Next-Generation Sequencing (NGS) with an autosomal dominant neurodevelopmental disorder (NEDMIAL).
Conclusion:
We report a case of neurodevelopmental disorder with severe motor impairment and absent language (NEDMIAL) with a De novo novel DHX30 mutation (p.Pro796Leu) detected by whole exome sequence. We suggest upgrading the variant classification of DHX30:p.Pro796Leu to likely pathogenic, according to the evidence found in our patient. To the best of our knowledge, this is the first reported case of this mutation and disorder in the Middle East.
Case Report: Extensive Dermatitis Secondary to Severe Malnutrition, Zinc and Vitamin Deficiencies After Malabsorptive Bariatric Surgery
Authors: Aura D Herrera-Martínez, Sonia Junquera-Bañares, Lucía Turrión-Merino, Francisco Arrieta-Blanco, José Botella-Carretero, Clotilde Vázquez-Martínez, Alfonso Calañas-Continente
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: bariatric surgery complications, biliopancreatic diversion, dermatitis, severe malnutrition, zinc deficiency
MeSH terms: Avitaminosis / etiology, Bariatric Surgery / adverse effects, Dermatitis / etiology, Malnutrition / etiology, Zinc / deficiency, Case Reports, Research Support, Non-U.S. Gov't, Adult, Female, Humans, Obesity, Morbid / surgery, Zinc

Bariatric surgery is one of the most effective treatments currently available for obesity and its derived comorbidities. However, complications may occur, especially when malabsorptive surgeries like a biliopancreatic diversion is performed. We present the case of a female patient whose obesity was treated with this technique, and in the 9th year of follow-up developed an extensive dermatitis secondary to zinc deficiency and malnutrition, precipitated by therapeutic non-compliance. A close surveillance of early symptoms and signs of nutritional deficiencies as well as chronic supplementation of vitamins and trace elements is required; this case illustrates the relevance of periodical, lifelong visits to a medical physician with special training and experience in the management of post bariatric surgery patients in order to prevent, diagnosis and early treat related complications.