OpenMed/multicare-articles huggingface dataset:
Rituximab as First-Line Therapy in Severe Lupus Erythematosus with Neuropsychiatric and Renal Involvement: A Case-Report and Review of the Literature
Authors: Andrea Angeletti, Olga Baraldi, Anna Laura Chiocchini, Giorgia Comai, Paolo Cravedi, Gaetano La Manna
Journal: J Clin Case Rep (2017)
Keywords: b cell, first-line therapy, immunosuppression, systemic lupus

Neuropsychiatric and renal involvement are common in systemic lupus erythematosus with negative impact on patient survival. Glucocorticoids, antiproliferative and cytotoxic agents represent first-line therapies, but are often ineffective and are burdened by significant toxicities. Despite the negative results of two randomized controlled trials, rituximab is still widely used as second- or third-line therapy in similar cases. No case has been reported so far where rituximab has been used as first-line therapy. We report the case of a 60-year-old cCaucasian woman with concurrent neuropsychiatric and renal lupus erythematous treated with one cycle of rituximab therapy at disease onset. Treatment was well tolerated and at 24 months the patient is in complete remission and free of immunosuppression. To the best of our knowledge, this is the first case of neuropsychiatric and renal lupus erythematosus successfully treated with rituximab as first-line therapy.
Three-dimensional evaluation using CBCT of the mandibular asymmetry and the compensation mechanism in a growing patient: A case report
Authors: Monica Macrì, Felice Festa
Journal: Front Public Health (2022)
Keywords: cbct, fränkel-iii, dental midline deviation, facial asymmetry, orthodontic therapy, orthopedic therapy, rapid palatal expander
MeSH terms: Facial Asymmetry / diagnostic imaging, Spiral Cone-Beam Computed Tomography, Case Reports, Cephalometry / methods, Cone-Beam Computed Tomography / methods, Humans, Male, Mandible / diagnostic imaging

Background:
This case report aims to evaluate the development and the compensation mechanisms of the mandibular asymmetry in a growing male patient using cone beam computed tomography (CBCT). In this case, the menton deviated on the right, a sporadic condition, which may be the consequence of a disorder in the mandibular growth.
Case presentation:
The young male patient was treated with rapid palatal expander (RPE) and Fränkel functional regulator III (FR-3). The initial CBCT was acquired at the beginning of therapy when the patient was 8 years old, and the final CBCT was developed at the end of the treatment when the patient was 12 years old. The patient's CBCT was performed with the head oriented according to the Natural Head Position (NHP); the NHP is a physiological and reproducible posture defined for morphological analysis. The 3D image of the cranium was oriented in the Dolphin software according to NHP posture, and cephalometric measurements were taken in the software's frontal, laterolateral right and left, posteroanterior, and submentovertex views. The therapy lasted 3.8 years and ended with significant regression of the mandibular asymmetry from moderate grade (4.2 mm) to slight grade (1.3 mm).
Conclusion:
The literature shows that the left hemi-mandible has grown more than the right side, which affirms that in case of deviation of the menton >4 mm, the bone volume increases on the non-deviated side.
Endovascular Treatment of Aortic Stump Rupture After Extra-anatomic Aortoduodenal Fistula Repair is not a Definitive Treatment: A Case Report and Literature Review
Authors: Elise Beijer, Vincent P W Scholtes, J Hillian Nederhoed, Rutger J Lely, Arjan W J Hoksbergen
Journal: EJVES Vasc Forum (2022)
Keywords: abfb, axillo-bifemoral bypass, adf, aortoduodenal fistula, avp, amplatzer® vascular plug, amplatzer® vascular plug, aortic stump blow-out, aortic stump rupture, aortoduodenal fistula, endovascular treatment, fdg, fluor-18-glucose, icu, intensive care unit, pet, positron emission tomography
MeSH terms: Case Reports

Introduction:
Endovascular treatment of an aortic stump rupture is technically feasible. Whether this is a definitive treatment or a bridge to further surgery is unknown.
Report:
Previously a Case of an aortic stump rupture following extra-anatomic repair of a recurrent aortoduodenal fistula (ADF), which was successfully treated endovascularly by placement of an Amplatzer® Vascular Plug was described. The patient survived this acute procedure, but four years later was admitted with fever and back pain. Imaging revealed progressive enlargement of the aortic stump. A re-exploration was performed with removal of the infected aortic stump including the Amplatzer plug. A new aortic stump was created together with resection of an adherent part of the duodenum. The patient was discharged after five months and was able to survive for two more years without any recurring vascular complications.
Discussion:
This Case demonstrates that after four years, endovascular treatment was not a definitive treatment for aortic stump rupture. Endovascular treatment should be followed by definitive treatment when the patient is fit for surgery, especially in cases of ADF. If the patient is unfit for surgery, conservative treatment with culture based antibiotics is a reasonable alternative. Positive obstinacy lengthened the survival of this patient with eight years of reasonably good quality life.
Worsening psychosis associated with administrations of buspirone and concerns for intranasal administration: A case report
Authors: Samuel Apeldoorn, Rebecca Chavez, Freshta Haschemi, Kareem Elsherif, David Weinstein, Tyler Torrico
Journal: Front Psychiatry (2023)
Keywords: adverse reaction, anxiolytic, drug abuse, methamphetamine, nasal inhalation, nasal insufflation, psychopharmacology
MeSH terms: Case Reports

Buspirone is commonly used to treat generalized anxiety disorder and demonstrates a limited side-effect profile compared to other anxiolytics. Buspirone is considered generally safe, and neuropsychiatric adverse reactions are uncommon. There are rare clinical case reports that suggest buspirone-induced psychosis. We present a case of buspirone worsening psychosis for a patient psychiatrically hospitalized for an episode of decompensated schizoaffective disorder. The patient had a primary diagnosis of schizoaffective disorder and was treated with antipsychotics during this hospitalization, but his symptoms worsened when buspirone was administered on two separate occasions. During the first trial of buspirone, the patient exhibited traits of increased aggression, odd behaviors, and paranoia. The buspirone was discontinued after the patient admitted to hiding his pills to later consume through nasal ingestion. The second trial resulted in repeated exacerbated symptoms of paranoia related to food and substantially decreased oral intake. Considering its complex mechanism of action, buspirone is suggested to derive its neuropharmacological effects through 5-HT1A receptors. However, the drug also has been found to mediate dopamine neurotransmission. Buspirone acts as an antagonist at presynaptic dopamine D2, D3, and D4 receptors. Yet, contrary to expected outcomes, it was unable to produce antipsychotic effects and instead resulted in a substantial increase in dopaminergic metabolites. The route of administration may also play a role in the enhancement of the buspirone's effects, particularly considering that after first-pass metabolism, buspirone has approximately 4% oral bioavailability. Intranasal administration of buspirone leads to faster drug absorption by direct transport from the nasal mucosa to the brain and increased bioavailability.
Klippel-Trenaunay Syndrome Causing Life-Threatening GI Bleeding: A Case Report and Review of the Literature
Authors: Salih Samo, Muhammed Sherid, Husein Husein, Samian Sulaiman, Margaret Yungbluth, John A Vainder
Journal: Case Rep Gastrointest Med (2013)

Klippel-Trenaunay syndrome (KTS) is a rare congenital syndrome of vascular malformations and soft tissue and bone hypertrophy. Vascular malformations can affect multiple organ systems. Involvement of the gastrointestinal (GI) tract is uncommon in KTS, but it can be a source of life-threatening bleeding. We report a case of a 32-year-old male with a known diagnosis of KTS who presented with a life-threatening rectal bleeding and was treated with proctosigmoidectomy and massive blood products transfusion. He expired after a long hospitalization. We then review the literature on KTS and management of some of its complications.
Head and Neck Myxoma Presenting as Isolated Laryngeal Polyp
Authors: Smriti Panda, Rajeev Kumar, Vikram Raj Gopinath, Prem Sagar
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Myxoma is a benign tumour with a propensity for local infiltration and recurrence. Laryngeal myxoma presents as a submucosal polyp. Being an uncommon tumour and mimicking vocal cord polyp, only anecdotal evidence is available in the literature. The literature was reviewed from 1986 onwards using the keywords "myxoma" and "larynx." The databases used were PubMed, Google Scholar, Scopus, and Web of Science. Along with this, we also report our case of vocal fold myxoma. We found a total of 19 studies reporting laryngeal myxoma. Laryngeal myxoma typically affects males in the 6th decade with a history of smoking. Unlike myxomas originating outside the larynx, recurrence is not widely described, and microlaryngeal surgery will usually suffice. Laryngeal myxomas should definitely be kept in the list of differential diagnosis when dealing with a benign-looking vocal fold lesion.
Complete Urogenital and Anorectal Duplication in a Dog
Authors: Jonathan M Coffman, Marina McConkey, Gary Ellison, Elizabeth Huynh, Michael J Dark
Journal: Case Rep Vet Med (2019)
MeSH terms: Case Reports

A 10-week-old sexually intact female golden retriever was evaluated for two functional anal openings and a bipartite vulva. Examination revealed haired skin between two separate anatomically smaller anal openings. On rectal palpation, a soft tissue septum (5 cm) with a mucosal surface between the two anal openings was palpated. In addition, circumferential rectal musculature was not appreciated on the ventral aspect. Urogenital evaluation revealed duplication of the vestibule and vagina with a complete centrally located septum extending dorsoventrally. Computed tomography (CT) of the abdomen and pelvis, vaginocystourethrogram, and colonogram were performed. Complete bifurcation of the urinary bladder with duplication of the urethra, cervix, and vaginal canal was noted. Approximately 2 cm from the rectum, there was a similar bifurcation that converged the colon into two rectal portions and separate anal openings. The owner was counseled on the severity of congenital malformations and a high likelihood of aging-related developmental complications in the future. The owner elected humane euthanasia and a necropsy was performed to confirm the malformations.
Dialysis Disequilibrium Syndrome and Cerebellar Herniation with Successful Reversal Using Mannitol
Authors: Anna Curtis, Christian Lamb, Hussain Rao, Andrew Williams, Amit Patel
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

Dialysis disequilibrium syndrome (DDS) is a morbid but rare complication of dialysis. Feared sequalae of this diagnosis are brain herniation and death. This report presents a patient who was diagnosed with DDS with subsequent tonsillar herniation shown on imaging with complete resolution of clinical signs and symptoms, as well as imaging findings of herniation after prompt initiation of intravenous mannitol. This is the first known case of reversal and survival of DDS-induced tonsillar herniation using mannitol.
Brain, Behavior, and Cognitive Interplay in Disorders of Consciousness: A Multiple Case Study
Authors: Charlène Aubinet, Lesley Murphy, Mohamed A Bahri, Stephen K Larroque, Helena Cassol, Jitka Annen, Manon Carrière, Sarah Wannez, Aurore Thibaut, Steven Laureys, Olivia Gosseries
Journal: Front Neurol (2018)
Keywords: (emergence from) minimally conscious state, behavior, cognitive functions, neural correlates, neuropsychological assessment, positron emission tomography, structural magnetic resonance imaging

Patients with prolonged disorders of consciousness (DoC) after severe brain injury may present residual behavioral and cognitive functions. Yet the bedside assessment of these functions is compromised by patients' multiple impairments. Standardized behavioral scales such as the Coma Recovery Scale-Revised (CRS-R) have been developed to diagnose DoC, but there is also a need for neuropsychological measurement in these patients. The Cognitive Assessment by Visual Election (CAVE) was therefore recently created. In this study, we describe five patients in minimally conscious state (MCS) or emerging from the MCS (EMCS). Their cognitive profiles, derived from the CRS-R and CAVE, are presented alongside their neuroimaging results using structural magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET). Scores on the CAVE decreased along with the CRS-R total score, establishing a consistent behavioral/cognitive profile for each patient. Out of these five cases, the one with highest CRS-R and CAVE performance had the least extended cerebral hypometabolism. All patients showed structural and functional brain impairments that were consistent with their behavioral/cognitive profile as based on previous literature. For instance, the presence of visual and motor residual functions was respectively associated with a relative preservation of occipital and motor cortex/cerebellum metabolism. Moreover, residual language comprehension skills were found in the presence of preserved temporal and angular cortex metabolism. Some patients also presented structural impairment of hippocampus, suggesting the presence of memory impairments. Our results suggest that brain-behavior relationships might be observed even in severely brain-injured patients and they highlight the importance of developing new tools to assess residual cognition and language in MCS and EMCS patients. Indeed, a better characterization of their cognitive profile will be helpful in preparation of rehabilitation programs and daily routines.
Case Report: Case report: Non-invasive mechanical ventilation in combination with bronchoscopy in the treatment of respiratory failure of lung cancer patient
Authors: Katarzyna Guziejko, Łukasz Minarowski, Robert Mróz
Journal: F1000Res (2022)
Keywords: cancer, flexible bronchoscopy, non-invasive ventilation, palliative care, respiratory failure
MeSH terms: Lung Neoplasms / complications, Lung Neoplasms / therapy, Pulmonary Disease, Chronic Obstructive / complications, Pulmonary Disease, Chronic Obstructive / therapy, Respiratory Insufficiency / etiology, Respiratory Insufficiency / therapy, Case Reports, Bronchoscopy, Humans, Quality of Life, Respiration, Artificial

Background: Respiratory failure (RF) is a common medical problem among cancer patients. Particularly active or ex-smokers diagnosed with chronic obstructive pulmonary disease (COPD) or lung cancer may develop severe hypoxemic and hypercapnic respiratory failure. Moreover, pneumonitis as a complication of the currently widely used immunotherapy of various cancers, may cause respiratory disorders requiring ventilation support. Non-invasive ventilation (NIV) is recommended as the first-line treatment for this type of respiratory failure and reduces the need for endotracheal intubation. Case presentation: We present a case report of lung cancer patient, who received NIV in the treatment of RF due to an infectious exacerbation of COPD. In addition, NIV enabled assisted flexible bronchoscopy (NIV-FB) to be performed. During the procedure tumor samples were collected for further molecular diagnosis of lung cancer. Improvement of the patient general condition and quality of life was also achieved. Conclusions: NIV can be used at any stage of oncological management in patients with lung cancer. It can also be implemented during endoscopic procedures of the respiratory system, as well as support in palliative care of patients with lung cancer at the end of life. Further studies should evaluate the use of NIV in conjunction with various oncological treatments and identify the exact contradictions for BF with NIV support in advanced cancer patients with RF.
Diogenes syndrome: a case report
Authors: Projna Biswas, Anusree Ganguly, Sanchaita Bala, Falguni Nag, Nidhi Choudhary, Sumit Sen
Journal: Case Rep Dermatol Med (2013)

Cessation of normal skin cleansing seen in geriatric or self-neglected patients can cause accumulation of keratinous crusts on the skin. In the extreme end of this spectrum is a condition known as Diogenes syndrome (DS). These patients may have psychiatric disorders like paranoid disorders, mood affection, or temporofrontal dementia. Subjects are mainly the elderly but few cases in younger age group of patients have also been reported. Lesions of DS are usually found over upper central chest, back, and groin. In the young, lesions are mainly found over scalp, face, or arms. Absence of normal skin cleaning causes keratin and dirty debris to accumulate and with time form a thick shell. These debris can be secondarily infected by bacteria, fungus, and so forth. These skin lesions are not usually seen in individual with proper hygiene. We report a case of Diogenes syndrome in a 34-year-old young male patient who had associated schizophrenia.
Acute Hemolytic Transfusion Reaction in Group B Recipient Associated with Group A Apheresis Platelet Donor: Case Report and Literature Review
Authors: Tracy R Shachner, Christopher T Clark
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Acute hemolytic transfusion reaction is a known but rare potential adverse event related to platelet transfusion. Most reported cases of platelet-related hemolytic transfusion reaction have resulted from transfusion of platelets from group O donor to group A recipient. We identified only one prior case report in the literature of hemolytic transfusion reactions resulting from transfusion of apheresis platelets from group A donor to group B recipient. In that case report, two platelet units were obtained from a single donation and transfused into two separate patients. Both patients exhibited acute hemolytic reactions. The donor is reported to have high anti-B titers, as well as report of probiotic use. We report a case of acute hemolytic reaction in group B recipient following transfusion of apheresis platelets from group A donor with high-titer anti-B but unknown status of probiotic use. This case demonstrates that while low, there still exists potential risk for hemolysis from out-of-group A plasma transfusion.
A Tool to Guide Creation of Products for Risk Communications and Community Engagement (RCCE)
Authors: Wai Jia Tam, Nina Gobat, Divya Hemavathi, Dale Fisher
Journal: Front Public Health (2022)
Keywords: covid-19, risk communication and community engagement (rcce), creation tool, vaccination, vaccine hesitancy
MeSH terms: Communication, Health Literacy, Public Health, Singapore

Using best practices to produce creative, relatable, contextualized health messaging contributes to effective risk communication. During emergency disasters, the landscape of mis- and dis-information demands strategic, collaborative approaches across all stakeholders particularly government and the media to ensure effective public messaging. However, tools for new RCCE practitioners and media agencies such as television producers and advertising firms to rapidly create effective RCCE products are currently not readily available. In response to concerns that vaccine hesitancy may become more evident once a significant proportion of the population had been reached, the Ministry of Communications and Information (MCI) in Singapore launched a public health music video on 2 May 2021, making headlines globally and garnering more than 5 million views worldwide. The video aimed to dispel myths and concerns about vaccinations and encouraged citizens to get their vaccination quickly rather than wait. We aimed to evaluate this video as a case study and articulate why it is an example of good practice in risk communications. Working inductively to identify emergent principles of product creation in this case study and analyzing them against existing RCCE frameworks and recommendations helped develop a practical tool to guide the rapid creation of RCCE products by those who may be unfamiliar to RCCE principles. This tool can help new RCCE practitioners and media agencies to produce effective products in times of crisis. The easy-to-use tool provides a brief checklist that guides rapid creation of RCCE products, including criteria for understanding the target audience, message comprehension, development, reach and impact measurement. Given its derivation from existing RCCE frameworks and health literacy concepts, these can potentially be applied across different modalities and diverse cultures. Future work would include validation of these criteria and evaluation of its utility to strengthen RCCE as core in an emergency response.
Primary Segmental Small Bowel Volvulus in an Adolescent Female
Authors: Friederike Heidtmann, Felicitas Eckoldt, Hans-Joachim Mentzel, Ilmi Alhussami
Journal: European J Pediatr Surg Rep (2021)
Keywords: abdominal pain, segmental small bowel volvulus, small bowel obstruction
MeSH terms: Case Reports

Small bowel volvulus is a rare but important cause of abdominal pain and small bowel obstruction in children and adults. In the neonate, small bowel volvulus is a well-known complication of malrotation. Segmental small bowel volvulus is a lesser-known condition, which occurs in children and adults alike and can rapidly progress to bowel ischemia. Primary segmental small bowel volvulus occurs in the absence of rotational anomalies or other intraabdominal lesions and is rare in Europe and North America. Clinical presentation can be misleading, causing a delay in diagnosis and treatment, in which case the resection of necrotic bowel may become necessary. We report on a 14-year-old girl who presented with severe colicky abdominal pain but showed no other signs of peritoneal irritation or bowel obstruction. An emergency magnetic resonance imaging was highly suspicious for small bowel volvulus. Emergency laparotomy revealed a 115 cm segment of strangulated distal ileum with no underlying pathology. We performed a detorsion of the affected bowel segment. Despite the initial markedly ischemic appearance of the affected bowel segment, the patient achieved full recovery without resection of bowel becoming necessary.