OpenMed/multicare-articles huggingface dataset:
Suicidal behavior and depression in smoking cessation treatments
Authors: Thomas J Moore, Curt D Furberg, Joseph Glenmullen, John T Maltsberger, Sonal Singh
Journal: PLoS One (2011)
MeSH terms: Benzazepines / adverse effects, Bupropion / adverse effects, Depression / chemically induced, Nicotine / adverse effects, Quinoxalines / adverse effects, Smoking Cessation / methods, Suicide / psychology, Research Support, U.S. Gov't, Non-P.H.S., Adult, Depression / psychology, Female, Humans, Male, Middle Aged, Nicotinic Agonists / adverse effects, Varenicline, Benzazepines, Nicotinic Agonists, Quinoxalines, Bupropion, Nicotine, Varenicline

Background:
Two treatments for smoking cessation--varenicline and bupropion--carry Boxed Warnings from the U.S. Food and Drug Administration (FDA) about suicidal/self-injurious behavior and depression. However, some epidemiological studies report an increased risk in smoking or smoking cessation independent of treatment, and differences between drugs are unknown.
Methodology:
From the FDA's Adverse Event Reporting System (AERS) database from 1998 through September 2010 we selected domestic, serious case reports for varenicline (n = 9,575), bupropion for smoking cessation (n = 1,751), and nicotine replacement products (n = 1,917). A composite endpoint of suicidal/self-injurious behavior or depression was defined as a case with one or more Preferred Terms in Standardized MedDRA Query (SMQ) for those adverse effects. The main outcome measure was the ratio of reported suicide/self-injury or depression cases for each drug compared to all other serious events for that drug.
Results:
Overall we identified 3,249 reported cases of suicidal/self-injurious behavior or depression, 2,925 (90%) for varenicline, 229 (7%) for bupropion, and 95 (3%) for nicotine replacement. Compared to nicotine replacement, the disproportionality results (OR (95% CI)) were varenicline 8.4 (6.8-10.4), and bupropion 2.9 (2.3-3.7). The disproportionality persisted after excluding reports indicating concomitant therapy with any of 58 drugs with suicidal behavior warnings or precautions in the prescribing information. An additional antibiotic comparison group showed that adverse event reports of suicidal/self-injurious behavior or depression were otherwise rare in a healthy population receiving short-term drug treatment.
Conclusions:
Varenicline shows a substantial, statistically significant increased risk of reported depression and suicidal/self-injurious behavior. Bupropion for smoking cessation had smaller increased risks. The findings for varenicline, combined with other problems with its safety profile, render it unsuitable for first-line use in smoking cessation.
A First Case Report of Subependymoma in PTPN11 Mutation-Associated Noonan Syndrome
Authors: Boonchai Boonyawat, Mongkon Charoenpitakchai, Piradee Suwanpakdee
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

Noonan syndrome (NS) is an autosomal dominant disorder in some cases caused by PTPN11 mutations. Since somatic mutations in PTPN11 are seen in several tumor types, NS which causes germline PTPN11 mutations are also increase the risk of hematologic malignancies and brain solid tumors. However, the report of brain tumors in Noonan syndrome remains rather rare. Here, we report the first case of an 11-year-old Thai boy with Noonan syndrome who presented with symptoms related to hydrocephalus secondary to subependymoma in the fourth ventricle, and PTPN11 mutation was identified in this patient.
Bupropion Induced Hyponatremia in an Elderly Patient: A Case Report and Review of the Literature
Authors: Sahil Munjal, Yvette Smolin
Journal: Case Rep Psychiatry (2016)

We present the case of a 72-year-old female with a major depressive episode who developed hyponatremia associated with bupropion. In reviewing the literature, there are only a few case reports which pertain to this topic. The clinical symptoms of hyponatremia can be misinterpreted as a worsening of the primary psychiatric illness and can lead to potentially serious consequences if not fully evaluated. We recommend that clinicians should be well aware of this side effect and that sodium levels should be checked within the first 2 weeks after initiating treatment in patients, especially those with additional risk factors for hyponatremia, such as older age, female sex, diuretic use, low BMI, and unexplained mental status changes at any time during treatment with antidepressants. The risk for hyponatremia associated with mirtazapine appears to be low and its use can be helpful in patients who have developed hyponatremia induced by other antidepressants and who experienced symptoms of weight loss and insomnia.
Aldosterone Response in Severe Hypokalemia and Volume Depletion: A Case Report and Review of the Recent Research
Authors: Keiko Kai, Naoto Tominaga, Daisuke Uchida, Nanae Fukai, Yumie Matsuura, Susumu Uda, Akio Yokochi
Journal: Case Rep Nephrol (2016)

We report a case of severe hypokalemia and volume depletion complicated by chronic watery diarrhea resulting from chronic alcoholism in a 57-year-old man. Prompt replacement of normal saline with potassium chloride and cessation of alcohol intake resulted in a favorable outcome. We discuss the pathophysiology of the case, emphasizing the response of aldosterone in both hypokalemia and volume depletion, and provide a review of recent research.
Massive Ovarian Edema in a Girl with Hemoglobin SC Disease
Authors: Eric Johannesen, Van Nguyen
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Massive ovarian edema is a benign tumor like lesion of the ovary. The widely accepted mechanism is disruption of vascular drainage resulting in accumulation of fluid within the stroma and enlargement of the ovary. We report a case of massive ovarian edema in a teenage girl with hemoglobin SC disease. A 16-year-old female with hemoglobin SC disease was admitted with right lower quadrant pain. An ultrasound and CT scan showed a large, heterogeneous solid, and cystic pelvic mass. Due to the size and the possibility of malignancy, the patient underwent a salpingo-oophorectomy. The mass was an 8.3 cm hemorrhagic cyst with some solid areas. Histologic exam showed diffuse edema with scattered entrapped follicles and a narrow rim of normal appearing ovarian stroma. Dilated and occluded capillaries were seen along with hemorrhage and sickled red blood cells but no necrosis was identified. These histologic features were consistent with massive ovarian edema. Massive ovarian edema is thought to be caused by disturbance of the vascular outflow resulting in fluid buildup in the stroma. It is most often attributed to intermittent ovarian torsion that disrupts capillary and venous flow, but arterial flow is maintained. Rare cases of massive ovarian edema caused by tumor emboli or external compression by tumors have been reported, but this is the first case of a patient with hemoglobin SC disease developing vasoocclusions resulting in this lesion.
Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review
Authors: Ibrahim Abdulmomen, Eman Satti, Basem Awadh
Journal: Case Rep Rheumatol (2023)
MeSH terms: Case Reports

Objective:
To describe four peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response mimicking infection.
Methods:
Between 2017 and 2019, four patients with the final diagnosis of peripheral spondyloarthritis had atypical presentation of fever and severe systemic inflammatory response requiring hospital admission and extensive workup.
Results:
We reported four patients who were admitted to the hospital for fever and arthritis. They all had laboratory tests of the severe systemic inflammatory response (leukocytosis, thrombocytosis, high ESR, and high CRP) concerning infection. They underwent extensive workup for infectious causes, including septic arthritis, which came back negative. Other rheumatic diseases that are known to present with fever such as adult-onset Still's disease, reactive arthritis, and crystal arthritis were all excluded. The final diagnosis of spondyloarthritis was made during their follow-up: three patients with peripheral spondyloarthritis and one with psoriatic arthritis. All patients received conventional DMARDs (methotrexate and sulfasalazine) and two patients received tumor necrosis factor inhibitors in addition to conventional DMARDs to control their disease.
Conclusion:
We observed a subgroup of peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response requiring hospitalization. Recognition of this subgroup is important and should be considered once an infection is ruled out.
PAX8 Distinguishes Diffuse Large B-Cell Lymphoma Mimicking Sarcoma
Authors: Michelle S Hirsch, Alessandra F Nascimento
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

PAX8 is important for embryogenesis of the thyroid, Müllerian system, and upper urinary/renal tract, and expression of PAX8 has been described in carcinomas from each of these sites. The sensitivity and specificity of the polyclonal PAX8 antibody in a large cohort of epithelial tumors as well as lymphomas have been previously determined, the latter because polyclonal PAX8 is known to be immunoreactive in nonneoplastic B-cell lymphocytes which are often used as the positive internal control for immunohistochemistry. In this case report, PAX8 was a diagnostic clue for revising a previous diagnosis of unclassified high grade sarcoma to diffuse large B-cell lymphoma. This case report demonstrates a pitfall for PAX8 immunoreactivity and acts as a reminder that lymphoma should be included in the differential diagnosis of a PAX8 positive, epithelial cell marker negative tumor of unknown primary origin.
Surgical treatment of chronic thromboembolic pulmonary hypertension in combination with a left anterior descending artery myocardial bridge: A case report
Authors: Ilkhom K Zugurov, Aleksei M Osadchii, Maria A Simakova, Olga M Moiseeva, Mikhail L Gordeev
Journal: Front Cardiovasc Med (2022)
Keywords: chronic thromboembolic pulmonary hypertension, deep hypothermic circulatory arrest, left anterior descending artery myocardial bridge, pulmonary thromboendarterectomy, supracoronary myotomy
MeSH terms: Case Reports

Pulmonary thromboendarterectomy is a potentially curative option for most patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, a special group of patients with CTEPH requires simultaneous cardiac procedures. We report a rare case of successful surgical treatment of a CTEPH patient with a left anterior descending artery myocardial bridge. Despite the complexity of performing pulmonary thromboendarterectomy (PTE), the issue concerning the method of revascularization of the artery in the case of the left anterior descending artery myocardial bridge is controversial. PTE and supracoronary myotomy were performed. In our case, the optimal surgery method for the left anterior descending artery myocardial bridge was chosen intraoperatively based on the depth and length of the myocardial bridge. The patient's significant functional improvement after surgery and hemodynamic normalization were confirmed at the follow-up assessment. This case demonstrates rare but potentially dangerous pathologies that can be treated with minimal adverse effects.
Multiple extra-ischemic hemorrhages following intravenous thrombolysis in a patient with Trousseau syndrome: case study
Authors: Hiroyuki Ikeda, Rei Enatsu, Norikazu Yamana, Masaki Nishimura, Masaaki Saiki
Journal: Springerplus (2015)
Keywords: cerebral infarction, intracerebral hemorrhage, intravenous thrombolysis, trousseau syndrome, vascular disorders

Background:
Intracerebral hemorrhage is the most feared complication of intravenous thrombolysis for acute ischemic stroke. Such hemorrhage usually occurs within or at the margin of ischemic or manifestly infarcted brain tissue. A patient with Trousseau syndrome who developed multiple extra-ischemic hemorrhages following intravenous thrombolysis is described.
Case description:
An 80-year-old Japanese man with no other underlying disease was diagnosed with unresectable advanced lung cancer (stage IV) without brain metastasis and had not yet been treated. The patient suddenly presented with disturbance of consciousness, right hemiplegia, and total aphasia, and was admitted to our hospital. Magnetic resonance imaging revealed acute cerebral infarction extending from the basal ganglia to the corona radiata of the left cerebrum and multiple small areas of bilateral cerebral cortices. Cardiogenic cerebral embolism was considered among the differential diagnoses, but the brain natriuretic peptide level was within the normal range, and no arrhythmias such as atrial fibrillation were observed. With no other causes, the patient was diagnosed with Trousseau syndrome due to hypercoagulability associated with the advanced lung cancer. The patient received intravenous tissue plasminogen activator (t-PA) at 96 minutes after onset of symptoms. His symptoms partially improved, but they suddenly deteriorated at 84 minutes after the thrombolysis. A computed tomography (CT) scan immediately after the neurological deterioration revealed a subcortical hemorrhage in the left occipital lobe. A repeat CT scan the day after onset showed enlargement of the left occipital hemorrhage and two new subcortical hemorrhages in the right frontal and right temporal lobes. These hemorrhages were located in areas remote from the acute ischemic lesions.
Conclusion:
To the best of our knowledge, this is the first reported case of multiple extra-ischemic hemorrhages following intravenous thrombolysis in a patient with Trousseau syndrome. The course of this case suggests that intravenous t-PA administration for acute ischemic stroke with Trousseau syndrome may be associated with a higher risk of intracranial hemorrhage.
Primary Intraosseous Synovial Sarcoma in the Mandible
Authors: Lucas Novaes Teixeira, Eduardo Zambaldi da Cruz, Ana Cláudia Garcia Rosa, Anderson Abdo Rodrigues, Fabrício Passador-Santos, Vera Cavalcanti de Araújo, Andresa Borges Soares
Journal: Case Rep Oncol Med (2021)
MeSH terms: Case Reports

Synovial sarcoma (SS) is a rare malignant mesenchymal tumor that mainly occurs in body extremities, being uncommon in the head and neck region. In the present study, we described a case of primary intraosseous SS arising in the mandible of a 22-year-old young male. The patient reported a painful swelling on the left side of the mandible for the last 7 months. Imaging exams showed the presence of an expansive and multilocular radiolucent lesion, extending from the left condyle to the mandibular body. The clinic diagnostic hypotheses were ameloblastoma or malignant neoplasm. Histologically, the lesion was characterized by a proliferation of spindle cells exhibiting vesicular nuclei and evident nucleolus. Neoplastic cells were positive for AE1/AE3, cytokeratin 7, vimentin, CD-99, and TLE-1 and negative for CD-34, S-100, SMA, and HHF-35. A combination of clinical, histologic, and immunohistochemical characteristics supported the diagnosis of SS. The patient was referred for treatment, and preoperative exams did not reveal any other tumor foci in the body of the patient. The final diagnosis was of a primary intraosseous SS of the mandible.
Norwegian Scabies management after prolonged disease course: A case report
Authors: William Aukerman, Karleigh Curfman, Daniel Urias, Kamran Shayesteh
Journal: Int J Surg Case Rep (2019)
Keywords: debridement, hand, norwegian scabies, scabies

Introduction:
Scabies is a well - known, commonly recognized, and frequently diagnosed pathology especially in children, close quarters, living facilities, and immunocompromised patients. An accelerated severe infestation of traditional scabies with limited treatment options is known as the rare entity of Norwegian or Crusted Scabies.
Case presentation:
We present the history, clinical manifestations, medical treatments and surgical interventions of a patient with Norwegian Scabies of his hands, which rendered them nonfunctional prior to intervention. The patient was initially misdiagnosed and underwent inappropriate treatments for several years prior to our assessment, and ultimately required surgical intervention that was therapeutic.
Discussion:
Norwegian, or Crusted, Scabies is a severe infestation of S. scabiei in which the mite load is extreme in comparison to traditional scabies. This manifests as scaly plaques that are often misdiagnosed for other hyperkeratotic skin lesions. With this misdiagnosis, improper treatments are often recommended, and can even accelerate the manifestation. Traditional scabies therapies can be effective, however often due significant disease progression due to diagnostic delay, invasive measures, such as surgical debridement like presented here, are the only option.
Conclusion:
The patient presented in this case harbored a rare infection, known as Norwegian Scabies, for several years, with inappropriate medical therapy. Due to his prolonged inadequate treatments, his disease became so pronounced that the recommended medical treatments were no longer adequate, thus he required surgical debridements which ultimately allowed him to regain function in his hands.
Case report: Transcatheter pulmonary valve-in-valve implantation in a deteriorated self-expandable valve caused by infective endocarditis
Authors: Yan-Jie Li, Xin Pan, Cheng Wang, Ben He
Journal: Front Cardiovasc Med (2022)
Keywords: degenerated bioprosthesis, infective endocarditis, tetralogy of fallot, transcatheter pulmonary valve implantation, valve-in-valve (viv)
MeSH terms: Case Reports

Background:
Infective endocarditis is a complication with high mortality in patients with congenital heart disease, particularly for those with bioprosthetic valve.
Case summary:
We report a case of a 54-year-old female with a history of tetralogy of Fallot who had been surgically repaired using a transannular patch due to severe pulmonary insufficiency with right heart enlargement and presented with worsening dyspnea. She had received transcatheter pulmonary valve implantation (TPVI) 5 years ago. Unfortunately, bioprosthesis-associated infective endocarditis occurred due to dental caries. Given persistent antibiotic medication, she became clinically stable with prosthesis functional recovery. However, dysfunctional bioprosthesis was still detected 3 years later, which was successfully treated by valve-in-valve TPVI with the help of modified buddy wire technique. At a 12-month follow-up after valve-in-valve TPVI, she was completely recovered with improved symptoms of heart failure.
Conclusion:
This is the first report of valve-in-valve TPVI of a self-expandable valve in a degenerated self-expandable valve. The case highlights increased surveillance for infective endocarditis of transcatheter pulmonary valve should be emphasized. Subsequent valve-in-valve TPVI is an effective treatment for valve failure in defined conditions improving the hemodynamics.
Myositis ossificans in a child athlete: a case study
Authors: R Sapire, R Nenova, P Gounder, A Rampersad, V Maboho, N Nhlapo, K Tibatshi, S Rampurtab, A I Ranchod, R T Saggers, J Patricios
Journal: S Afr J Sports Med (2022)
Keywords: benign, extracorporeal shock-wave therapy, malignant, osteosarcoma, traumatic
MeSH terms: Case Reports

Background:
A 13-year-old female athlete presented with a painful lesion in her right buttock for which she had been receiving physiotherapy. It was keeping her from participating in sports.
Aim:
To report on a case of traumatic myositis ossificans in a child athlete - including the presentation, investigations, management, and outcome.
Findings:
Palpation of the right buttock indicated a tender mass. Investigation by musculoskeletal ultrasound detected a large hypoechoic lesion. An MRI revealed patterns of calcification that were inconclusive in differentiating between a malignant or benign lesion. Macroscopic and microscopic histological examination, as well as immunohistochemistry, were consistent with myositis ossificans (MO), a non-malignant condition. The patient improved remarkably within three months of treatment with rest, non-steroidal anti-inflammatory drugs (NSAIDs) and extracorporeal shock wave therapy (ESWT).
Implications:
Accurate differentiation of myositis ossificans from other benign and malignant soft tissue lesions may require histological evaluation in addition to a comprehensive radiological workup. Successful treatment with the patient being able to return to a pain-free and active state is achievable. Extracorporeal shock-wave therapy can play an important role in the management of this condition and should be considered when presented with a case of MO.
Germination Ecology and Seed Dispersal of a Critically Endangered Plant: A Case Study of Pomaderris vacciniifolia (Round-Leaf Pomaderris)
Authors: John Patykowski, Matthew Dell, Maria Gibson
Journal: PLoS One (2016)
MeSH terms: Ecology, Endangered Species, Germination, Rhamnaceae, Seed Dispersal, Seeds, Ecosystem, Humans, Permeability

Change in ecosystem disturbance regimes from human land-use poses a worldwide problem for management of rare species. Two important types of disturbance influencing the persistence of species in Australian ecosystems are habitat fragmentation and fire. In this study, seed dispersal and the germination ecology of Pomaderris vacciniifolia-a critically endangered, rare endemic Australian shrub-were examined to identify likely influences of fire and fragmentation on the decline of populations. The response of seed germination to simulated effects of wildfire and canopy openings was investigated, as was the unaided dispersal capability of seeds from parent plants. A significant increase in germination rate was observed following 100°C heat treatment to seeds, while smoke and light exposure had little influence. Seed imbibition was strongly influenced by heat treatment. The findings indicate a likely positive post-fire germination response, with implications for recruitment success determined by moisture availability following fire. Unaided seed dispersal was limited, which partly explains the apparent decline of populations. Understanding disturbance requirements for threatened species, and subsequent management of landscapes for disturbance, will aid conservation of rare species throughout the world.