OpenMed/multicare-articles huggingface dataset:
Improvement in Clinical Symptoms and Fecal Microbiome After Fecal Microbiota Transplantation in a Dog with Inflammatory Bowel Disease
Authors: Ayaka Niina, Ryoko Kibe, Ryohei Suzuki, Yunosuke Yuchi, Takahiro Teshima, Hirotaka Matsumoto, Yasushi Kataoka, Hidekazu Koyama
Journal: Vet Med (Auckl) (2019)
Keywords: canine, diversity, dysbiosis, fecal microbiota transplantation, inflammatory bowel disease, microbiome
MeSH terms: Case Reports

Purpose:
Recently, fecal microbiota transplantation (FMT) has been tested in veterinary medicine as a treatment option for multiple gastrointestinal (GI) diseases, such as inflammatory bowel disease (IBD). However, there are no reports of changes in the microbial diversity of fecal microbiome after treatment with FMT in canine IBD cases. Moreover, little is known about the long-term efficacy and safety of FMT treatment for dogs. Herein, we present a case of canine intractable IBD treated with repeated, long-term FMT.
Patients and methods:
The patient was a 10-year-old, neutered, male, 4-kg Toy Poodle with a prolonged history of vomiting and diarrhea. Fecal examination for pathogens was negative. Despite treatment with multiple antibacterial and antidiarrheal agents, the patient showed no improvement. Endoscopic mucus sampling diagnosed a case of lymphocytic-plasmacytic duodenitis, ie, idiopathic IBD. Eventually, we performed periodic, long-term fecal microbiota transplantation of fresh donor feces collected from a 4-year-old, 32.8-kg, neutered male Golden Retriever by rectal enema. Additionally, we performed 16S rRNA sequence analysis, before and after FMT, to evaluate the microbiome diversity.
Results:
Fecal microbiome diversity after FMT resembled that of the healthy donor dog's fecal microbiome, before FMT, which led us to conclude that the fecal microbiome in our patient normalized with FMT. Moreover, the clinical symptoms improved remarkably with regard to the changes in the fecal microbiome. Additionally, we noted no observable side effects during FMT treatment.
Conclusion:
This report indicates the efficacy and safety of long-term, periodic FMT for a case of canine IBD based on attenuation of clinical symptoms and changes in fecal microbiome diversity. Therefore, FMT could be chosen as a treatment option for IBD in canines in the future.
Severe thrombocytopenia in primary EBV- Infection with no signs of infectious mononucleosis. A case report
Authors: Maria Pishmisheva-Peleva, Stanislav Kotsev, Djahide Emin, Naum Simonoski, Martina Shopova, Radka Argirova
Journal: IDCases (2022)
Keywords: ebv dna, ebv-infection, haemorrhagic diathesis, infectious mononucleosis, thrombocytopenia
MeSH terms: Case Reports

Epstein-Barr virus is a widely spread Herpesvirus. Primary EBV infection affects children and young people, inducing haematological changes, with lymphocytosis being the most common. Moderate symptomless thrombocytopenia is found in 50% of the patients, however, severe thrombocytopenia is exceptionally rare. We present a case report of a 20-year-old man with an acute EBV infection, severe thrombocytopenia, and no signs of infectious mononucleosis.
Explaining predictive factors in patient pathways using autoencoders
Authors: Hugo De Oliveira, Prodel Martin, Lamarsalle Ludovic, Augusto Vincent, Xie Xiaolan
Journal: PLoS One (2022)
MeSH terms: Defibrillators, Implantable, Humans

This paper introduces an end-to-end methodology to predict a pathway-related outcome and identifying predictive factors using autoencoders. A formal description of autoencoders for explainable binary predictions is presented, along with two objective functions that allows for filtering and inverting negative examples during training. A methodology to model and transform complex medical event logs is also proposed, which keeps the pathway information in terms of events and time, as well as the hierarchy information carried in medical codes. A case study is presented, in which the short-term mortality after the implementation of an Implantable Cardioverter-Defibrillator is predicted. Proposed methodologies have been tested and compared to other predictive methods, both explainable and not explainable. Results show the competitiveness of the method in terms of performances, particularly the use of a Variational Auto Encoder with an inverse objective function. Finally, the explainability of the method has been demonstrated, allowing for the identification of interesting predictive factors validated using relative risks.
Polymicrobial Transjugular Intrahepatic Portosystemic Shunt Infection in the Setting of a Prior Hepaticojejunostomy Anastomosis: A Case Report
Authors: Prerna Gupta, Timothy R Donahue
Journal: Case Rep Pancreat Cancer (2016)
Keywords: tips, biliary tree infections, endotipsitis, hepaticojejunostomy, neuroendocrine pancreatic tumor
MeSH terms: Case Reports

Background: Vegetative transjugular intrahepatic portosystemic shunt (TIPS) infections are a rare complication of TIPS placement. Cases have been reported in the literature and one study estimated incidence to be 1%.1 The vast majority of cases were reported in the setting of cirrhosis. Here, we report a case of vegetative polymicrobial TIPS infection refractory to broad spectrum antibiotics in a patient with a prior hepaticojejunostomy anastomosis as part of a Whipple procedure for a pancreatic neuroendocrine tumor. Case Presentation: A 40-year-old gentleman with pancreatic neuroendocrine tumor underwent neoadjuvant chemoradiation therapy and became eligible for tumor resection. A pancreaticoduodenectomy (Whipple resection) with en bloc superior mesenteric vein (SMV) and portal vein-splenic vein confluence resection was performed. The patient developed SMV stenosis, and a TIPS was placed to access the SMV for stent placement. The patient eventually developed recurrent fevers because of Escherichia coli and Enterococcal bacteremia that did not resolve with extended courses of various antibiotics, including meropenem, vancomycin, daptomycin, ertapenem, caspofungin, and piperacillin-tazobactam. The TIPS was eventually removed with an interventional radiology procedure; however, the patient ultimately succumbed to sepsis from antibiotic-resistant bacteria. Conclusion: Here we present a case of endotipsitis in a patient with a biliary enteric anastomosis who did not respond to antibiotic therapy. We caution the use of TIPS in patients with this anatomy, as the biliary tree is inevitably colonized with enteric bacteria and in contact with the intraparenchymal hardware of the TIPS.
Nonischemic central retinal vein occlusion in an adolescent patient with ulcerative colitis
Authors: Deepak Vayalambrone, Tsveta Ivanova, Aseema Misra
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

Inflammatory bowel disease (IBD) can present with extraintestinal manifestations occasionally involving the eye. Retinal vein occlusions are rarely seen and have never been reported in the pediatric population though vascular thrombosis can be associated with IBD. Here, we present a case of what we believe is the youngest reported patient with nonischemic central retinal vein occlusion (CRVO).
A brief online mindful parenting program: Feasibility and initial effects pilot in a community sample
Authors: Ashra Sherwood, Jessica Paynter, Lisa-Marie Emerson
Journal: J Child Fam Stud (2023)
Keywords: mindful parenting, online mbi, parenting, parenting stress

Mindful parenting programs are effective in reducing parenting stress. More efficient offerings may increase accessibility. The current single case study aimed to determine the feasibility, acceptability and initial effects of a brief, online mindful parenting program. Six parents, recruited from the community, completed a 4-week online mindful parenting program (Two Hearts). Feasibility and acceptability were assessed by participant program evaluation, retention, engagement with program materials (i.e., videos), and home practice. Parents completed primary outcome measurements of parenting stress, and general distress, at pre- and post-intervention, and 4-week follow-up. Individual level reliable change index and clinically significant change were calculated for outcome measures. All parents were retained through the study; all participants reported obtaining something of lasting value from the training. Program adherence varied over time. At post-intervention, four parents reported 40-50 minutes practice per week; two parents reported 10-15 minutes practice per week. At follow-up, 50% of parents reported 30-50 minutes practice per week. Three parents showed a reliable reduction in parenting stress; two of these parents demonstrated clinically significant change. Improvements in parent general distress were indicated in half the sample. Two parents experienced a clinically significant increase in parenting stress and/or general distress. In conclusion, the Two Hearts program demonstrated good acceptability, and may be a feasible and effective program for some parents. Program adherence and dosage require further investigation. The role of acute stressors (e.g., COVID-19) must be also considered.
Vaginal Cuff Dehiscence Presenting with Free Air 60 Days after Robotic-Assisted Hysterectomy
Authors: D Munger, M Iannamorelli, C Galvez, C Service
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Introduction:
The vast majority of patients presenting with pneumoperitoneum have visceral organ perforation and require urgent diagnostic laparoscopy. Nonsurgical causes are relatively rare and may be attributed to multiple etiologies.
Case presentation:
Here we describe the case of a 38-year-old Caucasian female who presented to the emergency department with three days of cramping, epigastric abdominal pain. Her physical exam was notable for tenderness to palpation in the epigastric area and abdominal and chest X-rays showed free air under the diaphragm. Free air around the porta hepatis was verified on CT scan. Approximately 90% of pneumoperitoneum cases are due to perforation of visceral organs and therefore require operative management. An urgent exploratory laparoscopy revealed no clear source of free air, but postoperatively the patient developed a large volume of watery discharge from her vagina. Subsequent workup revealed a 1 cm vaginal cuff dehiscence which was later repaired with no postoperative complications.
Conclusion:
Although the majority of patients with pneumoperitoneum require urgent exploratory laparoscopy, a careful diagnostic workup may reveal sources of free air that are not related to hollow viscous perforation. Vaginal cuff dehiscence represents a rare yet nonurgent source of pneumoperitoneum. This differential should be considered in light of the possible intra- and postoperative complications of surgery.
Multifocal metachronous giant cell tumor: case report and review of the literature
Authors: B Ghostine, A Sebaaly, I Ghanem
Journal: Case Rep Med (2014)

Introduction. Giant cell tumors (GCTs) of bone are known for their local aggressiveness and high recurrence rate. There are rare cases of multicentric GCT and most are synchronous. We herein review metachronous multicentric GCT reported in the literature. Material and Methods. A MEDLINE, Cochrane, and Google Scholar search was done to collect all cases of multicentric metachronous GCT specifying the clinical, radiological, and histological characteristics of each location and its treatment. Results. A total of 37 multifocal giant cell tumors were found in the literature. 68% of cases of multicentric giant cell tumors occur in less than 4 years following treatment of the first lesion. Thirty-seven cases of multifocal metachronous GCT were identified in the literature until 2012. Patients with multicentric GCT tend to be younger averaging 23. There is a slight female predominance in metachronous GCT. The most common site of the primary GCT is around the knee followed by wrist and hand and feet. Recurrence rate of multicentric GCT is 28.5%. Conclusion. Multicentric giant cell tumor is rare. The correct diagnosis relies on correlation of clinical and radiographic findings with confirmation of the diagnosis by histopathologic examination.
Juvenile polyposis syndrome: A case report
Authors: Edwin Mogere, Elijah Mwaura, Mark Waithaka, Victor Mutua, Maurice Mugao, Chris von Csefalvay, Dennis Mukamati
Journal: Clin Case Rep (2023)
Keywords: colon cancer, gastroenterology, juvenile polyposis syndrome
MeSH terms: Case Reports

Juvenile polyposis syndrome (JPS) is an autosomal dominant disease that is characterized by multiple hamartomatous polyps. Patients with JPS are at increased risk for developing colorectal and gastric cancer. JPS was diagnosed by endoscopy and histology, and the patient underwent surgery, total proctocolectomy and ileal pouch-anal anastomosis.
Pure Red Cell Aplasia Associated with Thymolipoma: Complete Anaemia Resolution following Thymectomy
Authors: David Ferreira, Royston Ponraj, Adrian Yeung, Jillian de Malmanche
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Pure red cell aplasia is an uncommon cause of anaemia rarely associated with thymoma. A combination of immunosuppressive therapy and thymectomy offers a potential cure. Thymectomy alone rarely results in anaemia resolution. A seventy-three-year-old male with Klinefelter syndrome presented with progressively increasing shortness of breath and anaemia. Serological testing supported primary bone marrow pathology, and a bone marrow biopsy was performed. A pure red cell aplasia was seen on bone marrow examination, and computed tomography of the chest demonstrated a thymoma. Thymectomy was performed, and histology revealed a thymolipoma. Complete anaemia resolution was achieved following thymectomy alone. This suggests that thymomas may directly mediate immune dysregulation resulting in erythroid precursor destruction.
COVID-19: is it just a lung disease? A case-based review
Authors: Valerio Spuntarelli, M Luciani, E Bentivegna, V Marini, F Falangone, G Conforti, E S Rachele, P Martelletti
Journal: SN Compr Clin Med (2020)
Keywords: “covid-19” “or” “sars” “or” “sars – cov 2” “and” “systemic disease”, “cardiac pathology”, “central nervous system”, “nephropathy”
MeSH terms: Review

Due to its extreme virulence, COVID-19 virus has rapidly spread, developing a severe pandemic. SARS-COV-2 mostly affected the respiratory tract, causing a severe acute lung failure. Although the infection of airways, COVID-19 can be associated with chronic and systemic damages still not so much known. The purpose of this research is to collect recent evidence in literature about systemic diseases caused by COVID-19. The format of the present article has features of a systematic case-based review (level of evidence), and it is structured as a case series report (patients of our COVID-19 Medicine Ward have been selected as cases). Data for this review have been selected systematically, taking evidence only from indexed journals and databases: PubMed, Scopus, MEDLINE, and Cochrane systems. Papers chosen included systematic reviews, case series, clinical cases, meta-analysis studies, and RCTs. We start collecting studies since 2003. The main keywords used were "COVID-19" "OR" "SARS" "OR" "SARS - COV 2" "AND" "systemic disease" / "nephropathy" / "cardiac pathology" / "central nervous system." Clinical cases belong to our COVID-19 Medicine Ward. One of the most severe COVID-19 clinical presentations includes cardiovascular problems, like myocarditis, pericarditis, and acute hearth failure. Cytokine release syndrome caused by COVID-19 develops severe acute kidney failure. It is still unknown the way coronavirus damages the liver, brain, and reproductive system. Considering the majority of the new studies about this pathology, it issues that COVID-19 is considered to be a multi-organ disease.
Primary hairy cell leukemia/lymphoma of the breast: a case report and review of the literature
Authors: Monika Pilichowska, Ahmad Shariftabrizi, Ian Mukand-Cerro, Kenneth Miller
Journal: Case Rep Pathol (2014)

Hairy cell leukemia/lymphoma (HCL) is a rare B-cell neoplasm primarily involving spleen, bone marrow, and blood. However, other sites of primary involvement do occur and can present a diagnostic and therapeutic challenge. We present an unusual case of HCL involving predominantly the breast that was diagnosed as an incidental finding during an elective reduction mammoplasty in an otherwise healthy asymptomatic woman. Bone marrow performed for staging revealed limited involvement by HCL. Notably, there was no splenomegaly and/or involvement of other extramedullary sites. The peripheral blood revealed minimal involvement detected by flow cytometry. Extensive immunohistochemical studies supported by positive BRAF V600E mutational status confirmed the diagnosis of HCL. The patient remains asymptomatic without treatment one year following the diagnosis. This is the first case of a well-documented HCL presenting primarily in the breast in an asymptomatic patient. We review the literature on extramedullary, extrasplenic involvement by HCL and discuss the diagnostic challenges as well as the utility of immunohistochemistry and molecular studies in the diagnosis of atypical presentations of HCL.
An Atypical Presentation of Chronic Atrophic Gastritis: Hemolytic Anemia and Mesenteric Panniculitis
Authors: Zurab Azmaiparashvili, Vinicius M Jorge, Catiele Antunes
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Microangiopathic hemolytic anemia (MAHA) requires an aggressive approach since primary thrombotic microangiopathy syndromes such as thrombotic thrombocytopenic purpura (TTP) can progress rapidly to a fatal outcome. Differential diagnosis can be challenging even for an experienced hematologist. We present a case of a 52-year-old male who presented with symptoms of mesenteric panniculitis and showed signs of MAHA. His condition was attributed to severe vitamin B12 deficiency secondary to chronic atrophic gastritis and initiation of appropriate therapy was met with complete resolution of symptoms and normalization of hematologic parameters.
Chondroblastoma of mandibular condyle: Case report and literature review
Authors: Xiaoqin Yang, Manyi Wang, Wenfeng Gao, Di Wan, Junfa Zheng, Zhaoqiang Zhang
Journal: Open Med (Wars) (2021)
Keywords: chondroblastoma, mandibular condyle, treatment
MeSH terms: Case Reports

Chondroblastoma is one of the uncommon benign bone tumors, particularly when located in the mandibular condyle. Such a location makes its diagnosis difficult when based on only its clinical presentation and radiographic features. Herein the current report presents a case of chondroblastoma of the mandibular condyle: its clinical presentation, radiographic features, and immediate condylar reconstruction after resection. Additionally, the relevant literature is discussed to provide clinical recommendations for its diagnosis and treatment. Chondroblastoma has been reported so infrequently in the temporomandibular joint (TMJ), more common entities should first be considered in the differential diagnosis of masses in this location. Osteochondroma is the most frequent bone neoplasm in the TMJ. Since a correct diagnosis is difficult, additional tools, such as magnetic resonance imaging (MRI) and immunohistochemical analyses, should be used for diagnostics and surgical planning.
Infrarenal Infected Aortic Aneurysm Caused by Streptococcus pyogenes
Authors: Floryn Cherbanyk, Markus Menth, Bernhard Egger, Véronique Erard
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Infectious aneurysm is a rare entity associated with significant morbidity and mortality. Current knowledge on pathogenesis, outcome, diagnosis, management, and follow-up remains debatable. We report the case of a patient with Streptococcus pyogenes aneurysm who was successfully treated with a homograft implant and discuss microbiological characteristics, diagnostic methods, and treatment options currently available for this serious disease.
Deep Brain Stimulation of the H Fields of Forel Alleviates Tics in Tourette Syndrome
Authors: Clemens Neudorfer, Faycal El Majdoub, Stefan Hunsche, Klaus Richter, Volker Sturm, Mohammad Maarouf
Journal: Front Hum Neurosci (2017)
Keywords: cstc, tourette syndrome, deep brain stimulation, fields of forel, pallidothalamic fibers, subthalamus
MeSH terms: Case Reports

The current rationale for target selection in Tourette syndrome revolves around the notion of cortico-basal ganglia circuit involvement in the pathophysiology of the disease. However, despite extensive research, the ideal target for deep brain stimulation (DBS) is still under debate, with many structures being neglected and underexplored. Based on clinical observations and taking into account the prevailing hypotheses of network processing in Tourette syndrome, we chose the fields of Forel, namely field H1, as a target for DBS. The fields of Forel constitute the main link between the striatopallidal system and the thalamocortical network, relaying pallidothalamic projections from core anatomical structures to the thalamic ventral nuclear group. In a retrospective study we investigated two patients suffering from chronic, medically intractable Tourette syndrome who underwent bilateral lead implantation in field H1 of Forel. Clinical scales revealed significant alleviation of tics and comorbid symptoms, namely depression and anxiety, in the postoperative course in both patients.
Solitary fibrous tumor arising from the sphenoid sinus
Authors: Kenji Takasaki, Takeshi Watanabe, Tomayoshi Hayashi, Naoe Kinoshita, Hidetaka Kumagami, Haruo Takahashi
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. To our knowledge, only 30 cases of SFTs in the nasal cavity and paranasal sinuses have been reported in the literature. We describe an SFT that arose from the right sphenoid sinus and extended to the nasal cavity and epipharynx. The tumor was completely removed by endoscopic sinus surgery without complication. The patient is taking an uneventful course without any evidence of recurrence of the disease 8 months after surgery now.
Increased Intracranial Pressure in the Setting of Enterovirus and Other Viral Meningitides
Authors: Jules C Beal
Journal: Neurol Res Int (2017)

Increased intracranial pressure due to viral meningitis has not been widely discussed in the literature, although associations with Varicella and rarely Enterovirus have been described. Patients with increased intracranial pressure and cerebrospinal fluid analysis suggestive of a viral process are sometimes classified as having atypical idiopathic intracranial hypertension (IIH). However, a diagnosis of IIH requires normal cerebrospinal fluid, and therefore in these cases an infection with secondary intracranial hypertension may be a more likely diagnosis. Here seven patients are presented with elevated intracranial pressure and cerebrospinal fluid suggestive of viral or aseptic meningitis. Of these, 1 had Enterovirus and the remainder were diagnosed with nonspecific viral meningitis. These data suggest that viral meningitis may be associated with elevated intracranial pressure more often than is commonly recognized. Enterovirus has previously been associated with increased intracranial pressure only in rare case reports.