OpenMed/multicare-articles huggingface dataset:
Carbimazole induced pleural effusion: a case report
Authors: Gautam Das, Stephen E R S Stanaway, Liz Brohan
Journal: Case Rep Endocrinol (2012)
MeSH terms: Case Reports

Objective. To describe a patient with unilateral exudative pleural effusion that developed after commencement of carbimazole. Methods. We describe the presentation and clinical journey of an elderly woman who presented to the chest physicians initially with pleural effusion but was followed up by the endocrinology team. Result. The patient was a 77-year-old Caucasian woman who presented with symptoms of breathlessness and a confirmed unilateral pleural effusion while being on treatment for thyrotoxicosis. Her symptoms needed recurrent hospital admission for investigations and drainage, but no potential cause was identified after extensive investigations. A drug-induced exudative effusion consequent to carbimazole intake was diagnosed as discontinuation of the drug lead to complete resolution of the effusion with no recurrence. Conclusion. Physicians and Endocrinologist must bear in mind that this potentially rare complication of carbimazole while treating patients of thyrotoxicosis as appearance of similar features in their patients while being on carbimazole should lead to the discontinuation of the drug, and alternative treatment strategy should be considered.
False-Positive Phencyclidine (PCP) Result on 11-Panel Urine Drug Screen (UDS) in a 17-Year-Old Adolescent with Long-Term Venlafaxine Use
Authors: Hyun Sue Kim, Aakash Jain, Anita S Kablinger
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Venlafaxine is an antidepressant belonging to the class of serotonin-norepinephrine reuptake inhibitors that are US Food and Drug Administration-approved to treat and manage symptoms of depression, anxiety, and other mood disorders in adults. We describe an adolescent patient who likely had a false-positive phencyclidine result detected with an 11-panel urine drug screen in an outpatient setting of long-term use of therapeutic venlafaxine extended release for the treatment of recurrent major depressive disorder and generalized anxiety disorder. We believe that this may be the first published case report to characterize this phenomenon in a young patient in the absence of an acute overdose.
Large Spontaneous Right Catamenial Pneumothorax with Diaphragmatic Defect and Liver Herniation
Authors: Venkata Kishore Mukku, Emily Cassidy, Catalina Negulescu, Tonya Jagneaux, John Godke
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

Catamenial pneumothorax is a spontaneous pneumothorax that occurs predominantly women of child bearing age. We describe a case of a 40-year-old nulliparous woman with medical history significant for endometriosis who presented with severe chest tightness of one-day duration. Chest radiography (CXR) showed a large right spontaneous pneumothorax, what was thought to be a 5.6 cm pleural mass at the right lung base. Following pneumothorax diagnosis, the patient underwent emergent right thoracostomy with pigtail catheter placement. A repeat CXR revealed marked re-expansion of the lung but persistence of a right pleural mass. Follow up computed tomography scan of the chest showed a 33 mm diaphragmatic defect with 5.8 x 4.6 x 3.9 cm area of herniated liver corresponding to the presumed pleural mass. Following complete thoracic imaging, patient underwent video-assisted thoracoscopic surgery, mechanical pleurodesis, and open repair of the right diaphragmatic defect. Intraoperatively, an endometrial implant was noted on the chest wall. On postoperative day three, she began her menstrual cycle and was evaluated by gynecologist who recommended hormonal therapy to reduce risk of recurrent pneumothorax. Due to a persistent air leak, the chest tube was transitioned to a Heimlich valve to facilitate home discharge. The patient was discharged on postoperative day eight, seen as outpatient with resolution of air leak and removal of chest tube.
A New Case of de novo Variant c.892C>T (p.Arg298Trp) in NACC1: A First Case Report From China
Authors: Baiyu Lyu, Yan Dong, Juan Kang
Journal: Front Pediatr (2021)
Keywords: nacc1, congenital cataract, feeding difficulties, infantile epilepsy, intellectual disability
MeSH terms: Case Reports

Background: The nucleus accumbens associated 1 (NACC1) gene is a transcription factor member of the BTB/POZ family. A de novo heterozygous c.892C>T (p.Arg298Trp) variant in the NACC1 may define a syndrome characterized by intellectual disability, infantile epilepsy, congenital cataract, and feeding difficulties. Case Presentation: We report a new case with a neurodevelopmental disorder characterized by severe intellectual disability, infantile epilepsy, congenital cataract, and feeding difficulties. Brain MRI reveals brain dysplasia. We observe a de novo heterozygous c.892C>T (p.Arg298Trp) variant in the NACC1 gene in this case. Now, the child regularly goes to the hospital for rehabilitation training (once a month). Sodium Valproate (10 mg/kg/day) and Clobazam (10 mg/kg/day) are used in the treatment of epilepsy. A total of three articles were screened, and two papers were excluded. The search revealed one article related to a syndrome caused by a de novo heterozygous c.892C>T (p.Arg298Trp) variant in the NACC1; they screened the main clinical features of eight cases of a syndrome, which were summarized and analyzed. Conclusions: The NACC1 gene is a member of the BTB/POZ family of transcription factors. A de novo heterozygous c.892C>T (p.Arg298Trp) variant in the NACC1 may define a syndrome characterized by intellectual disability, infantile epilepsy, congenital cataract, and feeding difficulties. At present, there is no effective cure. In the future, we need more cases to determine the phenotype-genotype correlation of NACC1 variants. Many questions remain to be answered, and many challenges remain to be faced. Future transcriptional studies may further clarify this rare, recurrent variant, and could potentially lead to targeted therapies.
A weighted quantile sum regression with penalized weights and two indices
Authors: Stefano Renzetti, Chris Gennings, Stefano Calza
Journal: Front Public Health (2023)
Keywords: environmental mixture, nutrients, obesity, penalized weights, two indices, weighted quantile sum regression
MeSH terms: Environmental Exposure, Obesity, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Humans, Nutrition Surveys

Background:
New statistical methodologies were developed in the last decade to face the challenges of estimating the effects of exposure to multiple chemicals. Weighted Quantile Sum (WQS) regression is a recent statistical method that allows estimating a mixture effect associated with a specific health effect and identifying the components that characterize the mixture effect.
Objectives:
In this study, we propose an extension of WQS regression that estimates two mixture effects of chemicals on a health outcome in the same model through the inclusion of two indices, one in the positive direction and one in the negative direction, with the introduction of a penalization term.
Methods:
To evaluate the performance of this new model we performed both a simulation study and a real case study where we assessed the effects of nutrients on obesity among adults using the National Health and Nutrition Examination Survey (NHANES) data.
Results:
The method showed good performance in estimating both the regression parameter and the weights associated with the single elements when the penalized term was set equal to the magnitude of the Akaike information criterion of the unpenalized WQS regression. The two indices further helped to give a better estimate of the parameters [Positive direction Median Error (PME): 0.022; Negative direction Median Error (NME): -0.044] compared to the standard WQS without the penalization term (PME: -0.227; NME: 0.215). In the case study, WQS with two indices was able to find a significant effect of nutrients on obesity in both directions identifying sodium and magnesium as the main actors in the positive and negative association, respectively.
Discussion:
Through this work, we introduced an extension of WQS regression that improved the accuracy of the parameter estimates when considering a mixture of elements that can have both a protective and a harmful effect on the outcome; and the advantage of adding a penalization term when estimating the weights.
Establishing undergraduate public health education: process, challenges, and achievements in a case study in Israel
Authors: Osnat Bashkin, Theodore Herzl Tulchinsky
Journal: Public Health Rev (2017)
Keywords: curricula, democratization of public health career entry, education, undergraduate public health

Background:
In this paper, we describe the development process of the first undergraduate public health baccalaureate program, in the Ashkelon Academic College in Israel. Expansion of degree-granting colleges in Israel is part of the democratization of higher education providing access to and increasing educational opportunities for groups underrepresented in universities. The main objectives of the program at Ashkelon Academic College have been to open accessible and affordable career opportunities for current workers in the health system and for new entries to health careers for academic advancement in a peripheral and relatively poor region of the country.
Case presentation:
The program focuses on well-established and literature-based learning goals of public health education but also includes basic medical sciences, incorporation of arts and sciences into public health, development of critical thinking and quantitative skills, experiential field learning, and integrative learning for facing global health challenges. The curricula of the program is composed of seven modules including introductory courses, methodology courses, health organization courses, epidemiology courses, courses related to core content of public health, elective courses and practicum. The first class will graduate in 2017; this will allow for final approval of the Council of Higher Education of Israel and possible revision of curriculum. A second BA program is now seeking approval in Israel and cooperation with post-graduate schools of public health is developing.
Conclusion﻿s﻿:
Our program is in keeping with trends in Europe and the USA to broaden public health education, to reduce inequality of career opportunity, to expand the workforce, and to promote public health.
Repeated mapping of cortical language sites by preoperative navigated transcranial magnetic stimulation compared to repeated intraoperative DCS mapping in awake craniotomy
Authors: Sandro M Krieg, Nico Sollmann, Theresa Hauck, Sebastian Ille, Bernhard Meyer, Florian Ringel
Journal: BMC Neurosci (2014)
MeSH terms: Brain Neoplasms / physiopathology, Brain Neoplasms / surgery, Cerebral Cortex / physiopathology, Cerebral Cortex / surgery, Intraoperative Neurophysiological Monitoring / methods, Language Disorders / physiopathology, Transcranial Magnetic Stimulation / methods, Case Reports, Adult, Brain Mapping / methods, Brain Neoplasms / diagnosis, Craniotomy / methods, Humans, Language, Language Disorders / diagnosis, Language Disorders / surgery, Middle Aged, Nerve Net / physiopathology, Nerve Net / surgery, Surgery, Computer-Assisted / methods, Treatment Outcome, Wakefulness

Background:
Repetitive navigated transcranial magnetic stimulation (rTMS) was recently described for mapping of human language areas. However, its capability of detecting language plasticity in brain tumor patients was not proven up to now. Thus, this study was designed to evaluate such data in order to compare rTMS language mapping to language mapping during repeated awake surgery during follow-up in patients suffering from language-eloquent gliomas.
Methods:
Three right-handed patients with left-sided gliomas (2 opercular glioblastomas, 1 astrocytoma WHO grade III of the angular gyrus) underwent preoperative language mapping by rTMS as well as intraoperative language mapping provided via direct cortical stimulation (DCS) for initial as well as for repeated Resection 7, 10, and 15 months later.
Results:
Overall, preoperative rTMS was able to elicit clear language errors in all mappings. A good correlation between initial rTMS and DCS results was observed. As a consequence of brain plasticity, initial DCS and rTMS findings only corresponded with the results obtained during the second examination in one out of three patients thus suggesting changes of language organization in two of our three patients.
Conclusions:
This report points out the usefulness but also the limitations of preoperative rTMS language mapping to detect plastic changes in language function or for long-term follow-up prior to DCS even in recurrent gliomas. However, DCS still has to be regarded as gold standard.
Acute Pulmonary Embolism Associated with Low-Dose Olanzapine in a Patient without Risk Factors for Venous Thromboembolism
Authors: Vu Hoang Vu, Nguyen Duong Khang, Mai Thanh Thao, Le Minh Khoi
Journal: Case Rep Vasc Med (2021)
MeSH terms: Case Reports

Background:
Olanzapine is a second-generation antipsychotic drug commonly prescribed for certain mental/mood conditions such as schizophrenia and bipolar disorders. This agent has been considered a precipitating factor for venous thromboembolism formation. Most of the cases previously reported were associated with high-dose olanzapine therapy or in patients with high-risk factors for the development of thromboembolism. Case Presentation. We report a patient who developed pulmonary embolism after a long course of low-dose olanzapine. A 66-year-old female patient suffering from insomnia had been prescribed olanzapine 2.5 mg and paroxetine 10 mg for two years. The patient suddenly developed a syncopal episode at home and was immediately brought to the hospital. The diagnosis of pulmonary embolism was made by chance during the computerized tomography of coronary arteries. The patient made a full recovery under conventional treatment and was discharged in stable condition. The thoracic computed tomography taken two months after discharge showed a completely normal pulmonary arterial tree.
Conclusion:
Olanzapine-associated pulmonary embolism is a rare entity and might be missed if the physician in charge is not vigilant and well informed. Even low-dose olanzapine can be associated with pulmonary embolism in patients with low classic risk factors if the treatment is prolonged. Pulmonary embolism should be sought in patients taking olanzapine even though the presenting manifestations are nonspecific.
COVID-19 infection in known epileptic and non-epileptic children: what is the place of chloroquine sulfate? (a case report)
Authors: Hugues Ghislain Atakla, Aïtchéou Cadnel Wilfried Houedenou Noudohounsi, Lounceny Fatoumata Barry, Mahugnon Maurel Ulrich Dénis Noudohounsi, Lauréano Déo-Gratias Legba, Ibrahima Sory Souare, Fatoumata Kaba, Dismand Stephan Houinato
Journal: Pan Afr Med J (2020)
Keywords: epileptic seizures, chloroquine sulfate, coronavirus, epileptic malaise
MeSH terms: COVID-19 / complications, Chloroquine / adverse effects, Epilepsy / virology, Seizures, Febrile / etiology, Case Reports, Adolescent, COVID-19 / diagnosis, COVID-19 Drug Treatment, Child, Chloroquine / administration & dosage, Electroencephalography, Epilepsy / physiopathology, Humans, Male, Seizures, Febrile / virology, Chloroquine

The coronavirus 19 (COVID-19) disease, which was declared in China in December 2019, very early on became a pandemic, claiming more than 28 million victims worldwide to date. Its impact on the central nervous system is still poorly understood. The objective of this work is to assess the involvement of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the aggravation of seizures in children known to have epilepsy and in the epileptogenesis of children hitherto seizure-free. Prior to conducting this work, we had obtained informed consent from patients and parents. We report the cases of three (3) patients, one known epileptic and the other two apparently healthy, who presented a febrile seizure in a context of COVID-19 infection. The aggravation of the epileptic seizure was indicative of a SARS-CoV-2 infection in the first patient, while the seizure occurred after induction of chloroquine sulfate treatment in the 2 other patients. Although our current concern is to limit the spread of the disease to COVID-19, it is crucial to address its possible complications. Notably, the worsening of seizures in children with epilepsy and the occurrence of first seizures in children without epilepsy following drug treatment. Equipping our COVID-19 patient management facilities with electroencephalogram (EEG) equipment could facilitate continuous electroencephalographic monitoring of children for proper management.
Large ossifying fibroma of jaw bone: a rare case report
Authors: Vinay Kharsan, Ramnik Singh Madan, Pankaj Rathod, Abhishek Balani, Sumit Tiwari, Saurabh Sharma
Journal: Pan Afr Med J (2018)
Keywords: ossifying fibroma, cemento-fying fibroma, fibro-osseous lesion
MeSH terms: Fibroma, Ossifying / diagnosis, Mandibular Neoplasms / diagnosis, Case Reports, Adolescent, Female, Fibroma, Ossifying / pathology, Fibroma, Ossifying / surgery, Humans, Mandibular Neoplasms / pathology, Mandibular Neoplasms / surgery

Ossifying fibroma (OF) is classified as, and behaves like, a benign bone neoplasm. It is often considered to be a type of fibro-osseous lesion (FOL). It can affect both mandible and the maxilla, particularly the mandible. This bone tumour consists of highly cellular, fibrous tissue that contains varied amounts of bone or cementum resembling calcified tissue. Present case is an unusual report of central ossifying fibroma involving the left side of mandible in an 18 year old female patient, who presented to the department with a painless hard swelling. The lesion was treated by surgical resection and reconstruction.
Atypical presentation of classic Kaposi sarcoma in circumcised penis presenting as an ulcerative nodule with human herpesvirus 8 (HHV8) positivity and successfully treated with only local excision
Authors: Abdulaziz Alamri, B K Adiga
Journal: Infect Agent Cancer (2019)
Keywords: hhv-8, kaposi sarcoma, penile nodule

Introduction:
Although the Kaposi sarcoma (KS) is one of the AIDS defining entity and seen in almost one third of HIV infected patients with low CD4 cell counts, it is not uncommon in HIV seronegative persons, but genital KS is rare, particularly in people without risk factors for HIV infection. Isolated penile KS is an unusual manifestation, especially as solitary nodule with ulceration, in HIV seronegative patient.
Case presentation:
We report such a case of Kaposi sarcoma showing HHV-8 positivity in an elderly male Arabian patient with a delay in prompt diagnosis, but treated successfully with 3 3 years follow-up after limited local surgical excision.
Conclusion:
The general practitioners, venereologists and urologists should think of KS as a possibility in such lesion and consider early biopsy.
Intravenous Lobular Capillary Haemangioma (Pyogenic Granuloma) of the Superior Vena Cava: Case Report and Literature Review
Authors: Elisabeth Blaya, Vincenzo Vento, Salomé Kuntz, Laurence Bruyns, Mickael Ohana, Noelle Weingertner, Anne Lejay, Nabil Chakfé
Journal: EJVES Vasc Forum (2020)
MeSH terms: Case Reports

Introduction:
Intravascular lobular capillary haemangioma is a rare benign intravascular tumour, especially in large vessels. This is the report of a case and associated literature review.
Report and literature review:
This is the report of the first case of an intravenous lobular capillary haemangioma (ILCH) of the superior vena cava (SVC). A 30 year old female presented with a collateral thoraco-abdominal venous circulation. Chest computed tomography angiography, thoracic magnetic resonance imaging, and positron emission tomography revealed an intraluminal SVC tumour extending from the left brachiocephalic venous trunk to the distal third of the SVC. No pre-operative biopsy was indicated. An en bloc tumour excision was performed, followed by reconstruction of the SVC with an L shaped, ringed polytetrafluoroethylene (PTFE) prosthesis. Histopathology revealed the presence of an ILCH with free margins. A review of the literature identified 64 cases of ILCH to date, all of which underwent total resection. When reported, no recurrences were found during follow up.
Discussion:
In this case, the ePTFE reconstruction of the SVC must be checked regularly for any adverse events. Although ILCH is a benign tumour with no risk of recurrence, regular surveillance is advised.
Unusually aggressive immature neo-intimal hyperplasia causing in-stent restenosis
Authors: Keir McCutcheon, Andreas S Triantafyllis, Johan Bennett, Tom Adriaenssens
Journal: Cardiovasc J Afr (2017)
MeSH terms: Angina, Unstable / etiology, Coronary Artery Disease / therapy, Coronary Restenosis / etiology, Coronary Vessels / pathology, Drug-Eluting Stents, Neointima, Percutaneous Coronary Intervention / adverse effects, Percutaneous Coronary Intervention / instrumentation, Case Reports, Angina, Unstable / diagnostic imaging, Angina, Unstable / pathology, Coronary Angiography, Coronary Restenosis / diagnostic imaging, Coronary Restenosis / pathology, Coronary Vessels / diagnostic imaging, Humans, Hyperplasia, Male, Middle Aged, Time Factors, Tomography, Optical Coherence, Treatment Outcome

This image illustrates a very unusual pattern of early and aggressive immature neo-intimal hyperplasia in a 52-year-old man with unstable angina, two months after deployment of a drug-eluting stent in the proximal left anterior descending artery.
Fusion or Gemination? Diagnosis and Management in Primary Teeth: A Report of Two Cases
Authors: Mouna Ben Salem, Farah Chouchene, Fatma Masmoudi, Ahlem Baaziz, Fethi Maatouk, Hichem Ghedira
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Primary double teeth (PDT), referring to either gemination or fusion, are one of the most important and frequent developmental dental anomalies that can affect children's oral health. Many clinical complications are correlated with these anomalies, such as dental caries, malocclusions, periodontal problems, and dental anomalies in permanent dentition. The aim of this report was to describe, through two cases, a case of gemination and another of fusion, the clinical management, the consequent effects, and the possible repercussions of these two developmental abnormalities on permanent successors. The first case involved gemination of the primary maxillary left central incisor (#61) in a 6-year-old boy. The patient presented with dental caries in the geminated tooth and its contiguous primary left lateral incisor (#62). The radiological examination revealed a slight developmental delay in the permanent left lateral incisor (#22). The treatment plan involved performing a pulpotomy and restoring the dental crowns of the affected teeth. The second clinical case describes a 6-year-old girl with unilateral fusion between a primary mandibular lateral incisor (#72) and a supernumerary tooth (#72'). The treatment included restoration of the deep grooves of the fused teeth using flowable composite and coronal restoration of the contiguous left primary canine (#73). Clinical and radiological follow-ups were performed every 3 months to monitor the development of teeth. No clinical and radiological symptoms were noted during the follow-up visits. PDT may require a multidisciplinary treatment. They should be diagnosed early to avoid and treat any possible complications in both the primary teeth and their permanent successors.