OpenMed/multicare-articles huggingface dataset:
Human Interleukin-1 β Profile and Self-Reported Pain Monitoring Using Clear Aligners with or without Acceleration Techniques: A Case Report and Investigational Study
Authors: Selma Pascoal, Aline Gonçalves, Andreia Brandão, Duarte Rocha, Sofia Oliveira, Francisca Monteiro, Óscar Carvalho, Susana Coimbra, Teresa Pinho
Journal: Int J Dent (2022)

Introduction:
There is a growing demand for more aesthetic, comfortable, and faster orthodontic treatments, and clear aligners emerged as a solution to fulfill this need. However, the effectiveness of clear aligners to treat complex malocclusions is yet contentious. The use of acceleration methods could improve the efficacy of clear aligners by stimulating cells' mechanobiology through numerous pathways, but this hypothesis is still poorly explored.
Objective:
We aimed to monitor the release profile of an inflammatory marker-the interleukin-1β-and to evaluate its relationship with self-reported pain scores with and without the use of acceleration techniques during an orthodontic treatment requiring difficult tooth movements with clear aligners. Case Report. Here, we report a case of a 46-year-old female patient who presented functional and aesthetic complaints. Intraoral examination revealed a diminished overjet and overbite, rotation of teeth 45 and 24, absence of teeth 25, 35, and 36, buccolingual dislocation of tooth 21, a tendency to a Class III malocclusion, and a 2 mm left deviation of the lower midline. This study is divided into three stimulation phases: no stimulation, mechanical vibration stimulation, and photobiomodulation. Interleukin-1β levels in gingival crevicular fluid samples from the pressure side of six selected teeth were evaluated at four time points after the orthodontic treatment onset. Pain monitoring in those teeth was performed using a visual analogue scale at the same time points.
Results:
Interleukin-1β protein production peaked 24 h after treatment onset. Complex movements were associated with increased self-reported pain.
Conclusion:
Clear aligners show limitations in solving complex tooth movements, even when combined with acceleration. The development of customized and programmable stimulation microdevices integrated into "smart aligners," which could be designed to specifically stimulate the direction of movement and stimulation parameters and could constitute a solution to optimize the orthodontic tooth movement with clear aligners.
A novel acquired inv(2)(p23.3q24.3) with concurrent submicroscopic deletions at 2p23.3, 2p22.1, 2q24.3 and 1p13.2 in a patient with chronic thrombocytopenia and anemia
Authors: Eigil Kjeldsen
Journal: Mol Cytogenet (2015)
Keywords: anemia, chromosome 2, inversion, microdeletion, thrombocytopenia, acgh

Background:
Thrombocytopenia can result from a wide range of conditions and may be determined by multiple mechanisms. It can be due to a reduced platelet production or an increased destruction of platelets. Increased destruction is seen in conditions such as disseminated intravascular coagulation (DIC) and thrombotic microangiopathies, whereas decreased production is seen in bone marrow (BM) failure syndromes such as aplastic anemia, myelodysplastic syndromes, and chemotherapy-induced thrombocytopenia. In BM failure syndromes thrombocytopenia is often accompanied by anemia and/or leucopenia. Recognition of the cause of thrombocytopenia is often crucial for correct management of patients.
Case presentation:
Here, we report on a 71 year-old male caucasian with thrombocytopenia since six years, and a recent development of anemia. At the time of progression with anemia a bone marrow sampling was done to examine for a possible causative myeloid malignancy. The morphological examination was normal whereas immunophenotyping by flowcytometry could not exclude myelodysplasia. Cytogenetic analysis by G-banding revealed a pericentric inversion of chromosome 2 in 23 out of 25 analyzed metaphases. The inversion was further characterized by molecular cytogenetics and high-resolution oligo-based array-CGH analysis. Together the analyses demonstrated a 141.8 Mb pericentric inversion, inv(2)(p23.3q24.3), and concurrent submicroscopic deletions in 2p23.3, 2p22.1, 2q24.3 and 1p13.2 between 0.6-1.9 Mb in size. Locus-specific FISH analyses confirmed all deletions and the pericentric inversion of chromosome 2. The chromosomal abnormalities were present in 87% of the bone marrow cells whereas analysis of a skin biopsy revealed a normal male karyotype as well as a normal array-CGH result. These findings demonstrate that the identified abnormalities were acquired.
Conclusion:
To the best of our knowledge, this is the first report of chronic thrombocytopenia and anemia associated with acquired inv(2)(p23.3q24.3) as a sole cytogenetic abnormality together with concurrent submicroscopic deletions at 2p23.3, 2p22.1, 2q24.3 and 1p13.2.
Placental site trophoblastic tumor: a case report and review of the literature
Authors: Jean Bouquet de la Jolinière, F Khomsi, Anis Fadhlaoui, Nordine Ben Ali, Jean-Bernard Dubuisson, Anis Feki
Journal: Front Surg (2014)
Keywords: immunochemistry, chemotherapy, placental site, pregnancy, trophoblastic tumor

Placental site trophoblastic tumor is rare. They represent a rare form of gestational trophoblastic disease. They occur mainly in women who have a history of miscarriage, termination of pregnancy, or even a normal or pathological ongoing pregnancy. The clinical course is unpredictable. This malignancy has different characteristics from other gestational trophoblastic tumors. Following a clinical case that we encountered and treated, we conducted a literary research and review, focusing primarily on prognostic factors and treatment.
ANCA-Negative Granulomatosis with Polyangiitis Presenting with Hypertrophic Cranial Pachymeningitis, Abducens Nerve Palsy, and Stenosis of the Internal Carotid Artery
Authors: Shohei Harabuchi, Nobuyuki Bandoh, Rika Yasukawa, Michihisa Kono, Takashi Goto, Yasuaki Harabuchi, Hidetoshi Ikeda, Hajime Kamada, Hiroshi Nishihara
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

We report a rare case of granulomatosis with polyangiitis (GPA) presenting with hypertrophic cranial pachymeningitis (HCP), abducens nerve palsy, and stenosis of the internal carotid artery (ICA). A 59-year-old Japanese man presented with a year history of nasal obstruction and a 2-month history of slight headache. Histopathological examination of the granulomatous mucosa in the ethmoid sinuses resected by endoscopic sinus surgery revealed necrotizing vasculitis with multinucleated giant cells. The patient was diagnosed with the limited form of GPA as a result of the systemic examination. He declined immunosuppressive treatment. Eighteen months after the diagnosis of GPA, he presented with diplopia and severe headache. Though nasal findings indicating GPA were not observed in the nasal cavity, CT scan revealed a lesion of the right sphenoid sinus eroding the bone of the clivus. Gadolinium-enhanced MRI of the brain showed thickening of the dura mater around the right cavernous sinus and clivus. Magnetic resonance angiography and cerebral angiography revealed narrowing at the C5 portion of the ICA. Intravenous methylprednisolone pulse therapy followed by oral prednisolone and cyclophosphamide resolved headache and dramatically improved HCP and stenosis of the ICA.
Macroprolactinemia and Empty Sella Syndrome
Authors: Ach Taieb, Kacem Njah Maha, Yosra Hasni El Abed, Amel Maaroufi Beizig, Molka Chaieb Chadli, Koussay Ach
Journal: Pan Afr Med J (2017)
Keywords: empty sella syndrome, hyperprolactinemia, macroprolactinemia, pregnancy
MeSH terms: Empty Sella Syndrome / diagnosis, Hyperprolactinemia / etiology, Prolactin / blood, Case Reports, Bromocriptine / administration & dosage, Dopamine Agonists / administration & dosage, Empty Sella Syndrome / complications, Female, Humans, Middle Aged, Dopamine Agonists, prolactin, polymeric, Bromocriptine, Prolactin

Macroprolactinemia is a polymeric form of prolactin-release, causing mildly symptomatic clinical pictures. The former can be isolated or associated with other causes of hyperprolactinemia. The association with an empty sella syndrome is rare. We report a case of a female patient discovered with this association. It's about a female patient 47 years old, followed up since the age of 31 years for bilateral galactorrhea and a spaniomenorrhea. There has been no associated drug intake. Her exploration has showed a serum prolactin level of 635 mIU/L. Thyroid test results were normal T4 = 10,2ng/L and TSH = 1.76 mIU/L. A brain scan has showed an empty sella turcica. Despite the unchanged levels of prolactinemia, the evolution under dopaminergic 5 mg /D has been marked by the occurrence of a pregnancy with persistent moderate hyperprolactinemia in the postpartum. Chromatography has showed a predominance of the macroprolactin form with: Prolactin monomer at 4.8%, Big Prolactin at 5% and Big Big Prolactin at 83%, thus stopping bromocriptine. Our observation suggests that macroprolactinemia can be associated with conventional etiologies of moderate hyperprolactinemia as the empty sella syndrome. Its detection would prevent the use of dopaminergic therapy which seems not useful.
Anesthesia management in a patient with anomalous origin of left pulmonary artery from the descending aorta: A case report and literature review
Authors: Lu Wang, Yaru Li, Xinrui Yin, Qiaoyu Han, Yi Feng, Yi Shi, Gang Liu, Liang Sun
Journal: Front Surg (2023)
Keywords: adolescent, anesthesia management, anomalous origin of the left pulmonary artery, pulmonary arterial hypertension, surgical repair
MeSH terms: Case Reports

Anomalous origin of the left pulmonary artery from the descending aorta is an extremely rare congenital malformation. There were merely four case reports of such malformation in previous literature, and all four cases underwent surgical repair in their first year of life. Actually, long-term pulmonary arterial hypertension and irreversible pulmonary vascular changes make anesthesia management quite a challenge, while anesthesia for managing these cases has not been discussed before. We present a 15-year-old boy undergoing corrective surgery and try to provide some tips on anesthesia management for this surgical procedure. Through optimal perioperative management, successful outcomes can be achieved for this malformation.
Teledermatology in Low-Resource Settings: The MSF Experience with a Multilingual Tele-Expertise Platform
Authors: Sophie Delaigue, Jean-Jacques Morand, David Olson, Richard Wootton, Laurent Bonnardot
Journal: Front Public Health (2014)
Keywords: lmics, dermatology, low-resource settings, telehealth, telemedicine

Introduction:
In 2010, Médecins Sans Frontières (MSF) launched a tele-expertise system to improve the access to specialized clinical support for its field health workers. Among medical specialties, dermatology is the second most commonly requested type of tele-expertise. The aim of the present study was to review all MSF teledermatology cases in the first 4 years of operation. Our hypothesis was that the review would enable the identification of key areas for improvement in the current MSF teledermatology system.
Methods:
We carried out a retrospective analysis of all dermatology cases referred by MSF field doctors through the MSF platform from April 2010 until February 2014. We conducted a quantitative and qualitative analysis based on a survey sent to all referrers and specialists involved in these cases.
Results:
A total of 65 clinical cases were recorded by the system and 26 experts were involved in case management. The median delay in providing the first specialist response was 10.2 h (IQR 3.7-21.1). The median delay in allocating a new case was 0.96 h (IQR 0.26-3.05). The three main countries of case origin were South Sudan (29%), Ethiopia (12%), and Democratic Republic of Congo (10%). The most common topics treated were infectious diseases (46%), inflammatory diseases (25%), and genetic diseases (14%). One-third of users completed the survey. The two main issues raised by specialists and/or referrers were the lack of feedback about patient follow-up and the insufficient quality of clinical details and information supplied by referrers.
Discussion:
The system clearly delivered a useful service to referrers because the workload rose steadily during the 4-year study period. Nonetheless, user surveys and retrospective analysis suggest that the MSF teledermatology system can be improved by providing guidance on best practice, using pre-filled referral forms, following-up the cases after teleconsultation, and establishing standards for clinical photography.
Case report: Hybrid approach in the management of a complete persistent sciatic artery aneurysm
Authors: Andrew Yang, Ammar Hashmi, Anton Androsov, Gregory Salzler, Evan Ryer
Journal: Int J Surg Case Rep (2020)
Keywords: aneurysm, bypass, endovascular, hybrid, persistent sciatic artery
MeSH terms: Case Reports

Introduction:
Persistent sciatic artery (PSA) is a rare embryological vascular anomaly with a prevalence between 0.025-0.06%. PSA is frequently associated with aneurysmal degeneration and can result in neuropathy, thrombosis, or rupture, threatening limb and life.
Case presentation:
We present a case of a 72-year-old man with an incidental finding of a right sided 4 cm PSA aneurysm with limited symptoms. The aneurysm was treated successfully with endovascular exclusion and a femoral-popliteal bypass was performed to revascularize the leg.
Discussion:
Treatment of PSA aneurysms involve excluding the aneurysm and revascularizing the involved leg. Improvements in endovascular embolization techniques now offer new solutions in the management of these aneurysms.
Conclusion:
A high degree of clinical suspicion is required to properly diagnose and treat PSA aneurysms. Referral to a center with expertise in both open and endovascular techniques is vital to ensure good outcomes.
Case report: A double pathogenic mutation in a patient with late-onset MELAS/PEO overlap syndrome
Authors: Qiu Yan Zhao, Wen Zhao Zhang, Xue Lian Zhu, Fei Qiao, Li Yuan Jia, Bi Li, Yong Xiao, Han Chen, Yu Zhang, Yun Guo Chen, Yong Liang Wang
Journal: Front Neurol (2022)
Keywords: chinese, melas, peo, gene, mutation
MeSH terms: Case Reports

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and progressive external ophthalmoplegia (PEO) are established phenotypes of mitochondrial disorders. They are maternally-inherited, multisystem disorder that is characterized by variable clinical, biochemical, and imaging features. We described the clinical and genetic features of a Chinese patient with late-onset MELAS/PEO overlap syndrome, which has rarely been reported. The patient was a 48-year-old woman who presented with recurrent ischemic strokes associated with characteristic brain imaging and bilateral ptosis. We assessed her clinical characteristics and performed mutation analyses. The main manifestations of the patient were stroke-like episodes and seizures. A laboratory examination revealed an increased level of plasma lactic acid and a brain MRI showed multiple lesions in the cortex. A muscle biopsy demonstrated ragged red fibers. Genetic analysis from a muscle sample identified two mutations: TL1 m.3243A>G and POLG c.3560C>T, with mutation loads of 83 and 43%, respectively. This suggested that mitochondrial disorders are associated with various clinical presentations and an overlap between the syndromes and whole exome sequencing is important, as patients may carry multiple mutations.
Membranoproliferative Glomerulonephritis Associated with Nivolumab Therapy
Authors: Jessica Cruz-Whitley, Nolan Giehl, Kuang-Yu Jen, Brian Young
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

Nivolumab is an immune checkpoint inhibitor that targets programmed death-1 on T cells and is designed to amplify an immunologic reaction against cancer cells. However, upregulation of the immune system with checkpoint inhibition is nonspecific, and it can be associated with certain renal side effects, the best documented of which is acute tubulointerstitial nephritis. We present a unique case of a patient with acute kidney injury associated with nephrotic syndrome shortly after starting nivolumab therapy for metastatic anal carcinoma. Subsequent renal biopsy revealed membranoproliferative glomerulonephritis (MPGN). We believe this represents the first reported direct case of nivolumab-associated MPGN. As immunotherapy becomes more widely used in cancer treatment, particular attention must be paid to possible consequences of immune checkpoint inhibitors.
Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Strongyloides Hyperinfection Syndrome
Authors: Muhammad Farhan Khaliq, Rayan E Ihle, James Perry
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Strongyloides stercoralis is an endemic parasitic infection that can remain asymptomatic for years, but it can cause death in immunosuppressed individuals. Here, we present a case of Strongyloides hyperinfection in a 75-year-old male secondary to sepsis and chronic immunosuppression due to TNF-α inhibitors. Despite aggressive treatment including broad-spectrum antibiotics and antihelminths, his respiratory failure worsened and he died after palliative extubation. S. stercoralis infection remains a diagnostic challenge. Presentation with Strongyloides is often nonspecific, and eosinophilia is absent in hyperinfection. Diagnosis can be delayed, especially in low-prevalence areas where suspicion is low. Strongyloides should be considered in the differential diagnosis in the presence of risk factors including immunosuppressive therapy, and a travel history should be carefully obtained. Patients with recurrent enterobacterial sepsis or respiratory failure with diffuse infiltrates in the setting of eosinophilia should undergo testing for Strongyloides. A multidisciplinary approach can result in earlier diagnosis and favorable outcomes.
Subtrochanteric femur fracture after slipped capital femoral epiphysis pinning: a novel treatment
Authors: Michael Paloski, Benjamin C Taylor, Mark Willits
Journal: Adv Orthop (2011)
MeSH terms: Case Reports

Slipped capital femoral epiphysis is a common injury suffered by adolescents worldwide. Treatment of most slips can be accomplished by percutaneous screw fixation, as this is an accepted and proven method associated with minimal morbidity. Complications, although limited, can be problematic for both the patient and treating physician. These include avascular necrosis, chondrolysis, infection, and fracture. We report a case of an individual who sustained a subtrochanteric femure fracture three weeks after in situ pinning of his left hip treated with a reconstruction intramedullary nail. This option allowed both the subtrochanteric fracture and SCFE to be treated concomitantly with minimized morbidity.
Primary vitreous cysts
Authors: Pieter Robben, Rita Van Ginderdeuren, Daphne Thoma, Catherine Deghislage, Joachim Van Calster, Johan Blanckaert, Ingele Casteels
Journal: GMS Ophthalmol Cases (2020)
MeSH terms: Case Reports

Objective: To report two cases of vitreous cysts with discussion of their pathophysiology and management. Methods: Clinical examination with fundus photography, ultrasound and optical coherence tomography. Histopathology was performed in the first case. Results: The first case illustrates a pigmented, free-floating cyst, which was removed during a 27-gauge vitrectomy. The histopathology shows a single layer of pigmented epithelium and confirms the previously reported presence of a PAS-positive basement membrane. The second case shows a sessile, non-pigmented cyst associated with significant anisometropia. Conclusion: Primary vitreous cysts are rare and can have a wide range in their clinical aspect. This likely reflects whether they originate either from the pigment epithelium or the primary hyaloidal system. The management of vitreous cysts is mostly conservative, but pars plana vitrectomy can be used safely if the symptoms are debilitating.
LASH in Severely Enlarged Uterine Leiomyoma: Removal of a Uterus of 4065 g
Authors: Garri Tchartchian, Harald Krentel, Bernd Bojahr, Rudy L De Wilde
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Today, even though minimally invasive approaches have become standard worldwide, large uteri are still mainly removed by means of open abdominal approaches. The present case describes the successful removal of the largest uterus ever reported (4065 g) by means of laparoscopy-assisted supracervical hysterectomy (LASH). We combined LASH with the changeover technique which allows a better access and view. We further explain how this approach allows for the safe minimally invasive removal of uteri of any size.
A Rare Case of Oral Papillomatosis in a Goat Kid
Authors: Mohammed Naji Ahmed Odhah, Bashiru Garba, Chan Xin Wen, Mohd Farhan Hanif Reduan
Journal: Case Rep Vet Med (2022)
MeSH terms: Case Reports

The clinical management and outcome of a case of caprine papillomatosis in a 2-week-old kid goat was reported. Based on the PCR result, contagious ecthyma (CE) was ruled out. Based on the history and physical examination findings, the case was diagnosed as severe clinical case of papillomatosis in a goat's kid. The treatment procedure was administrated with flunixin meglumine (5%) 1.1 mg/kg, 0.5 ml, IM, SID, 3 days, and Penstrep (procaine penicillin, dihydrostreptomycin sulphate) 2 ml and a topical preparation for 5 days to prevent secondary bacterial infection. Also, Vitavet (multivitamin-vitamins A, D3, and B12), 1 ml/10 kg, 1 ml, IM, SID, was administered for 3 days to boost the immune system.
A Case of Progressive Stroke on Posterior Circulation with Transient Bilateral Oculomotor Palsy
Authors: Chiaki Takahashi
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Infarction located in the midbrain and pons presents various ophthalmic symptoms, because of the damage of the nuclei that control the movement of internal and external ocular and palpebral muscles. We experienced a case which presented with rare ocular symptoms and course. A 61-year-old man presented with left hemiparesis and dysarthria, bilateral ptosis, and bilateral impaired eyeball movement: right eyeball movement was totally impaired and left could only perform slight adduction. MRI showed fresh stroke in the right thalamus, cerebral crus, and posterior lobe and cuneate lesion on bilateral paramedian portion of the midbrain. MRA showed occlusion in the P1 area of the posterior cerebral artery (PCA). Transesophageal echocardiography (TEE) showed findings of a patent foramen ovale (PFO). These findings suggested cardioembolic stroke as a cause of PCA occlusion and we prescribed rivaroxaban. The patient's eyeball and eyelid movement, only on the left side, was improved imperfectly 2 weeks later. We thought that neurological findings and course of this case may have arisen from dysfunction of the oculomotor nucleus and oculomotor fascicles, and MLF results from the presence of the lesion in paramedian midbrain and pons.
Case report: Dual atrioventricular nodal non-reentrant tachycardia with six types of ECG patterns leading to tachycardia-induced cardiomyopathy in a 51-year-old man
Authors: Man-Yi Ren, Yong Zhang, Yu-Jiao Zhang, Mei Gao, Cai-Hua Sang, Yong-Mei Cha, Ying-Long Hou
Journal: Front Cardiovasc Med (2022)
Keywords: cardiomyopathy, catheter ablation, dual atrioventricular nodal non-reentrant tachycardia, electrocardiogram, slow pathway
MeSH terms: Case Reports

More than three types of ECG manifestations in one patient with dual atrioventricular nodal non-reentrant tachycardia (DAVNNT) are rare. We report a 51-year-old male patient with DAVNNT consisting of six types of ECG patterns leading to tachycardia-induced cardiomyopathy. After radiofrequency ablation of the slow pathway, DAVNNT was eliminated and cardiac function was restored.