OpenMed/multicare-articles huggingface dataset:
Suicide versus Accidental Death by Autoerotic Asphyxiation in a Patient Receiving Intravenous Ketamine for Depression
Authors: Jeremy Weleff, Kelly Bryant, Alexsandra Kovacevich, Brian S Barnett
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Background:
Clinical trials have demonstrated that subanesthetic intravenous ketamine exerts antidepressant effects lasting a week or longer postinfusion, as well as antisuicidal effects starting approximately 4 hours postinfusion and lasting 72 hours or longer. These findings have generated considerable enthusiasm within psychiatry. However, reports of treatment-emergent suicide attempts and completed suicides in some patients receiving ketamine or the ketamine enantiomer esketamine have begun to emerge. Here, we contribute to the small literature on suicide-related adverse events and ketamine with an unusual case of a patient who died either by suicide or accidental death via autoerotic asphyxiation approximately four days after a ketamine infusion. Case Presentation. The patient was a 28-year-old man with major depressive disorder, generalized anxiety disorder, panic disorder, obsessive compulsive disorder, autism spectrum disorder without intellectual disability, attention deficit hyperactivity disorder, hypothyroidism, low testosterone, and sleep apnea referred for management of treatment resistant depression. His depression briefly remitted with ketamine, and suicidality briefly disappeared. However, these improvements were short-lived. Four days after his seventh and final scheduled ketamine infusion, the patient was found dead, presumably due to autoerotic asphyxiation. Interestingly, ketamine use has been reported in association with autoerotic asphyxiation. However, given our patient's recent severe suicidality, methods of his past suicide attempts, and family history of suicide, death from suicide seems more likely. Discussion. Here we consider the possibility of whether ketamine may have contributed to the patient's possible suicide, either via a direct worsening of his suicidality or psychological withdrawal following cessation of treatment, given recent concerns about psychological withdrawal's potential role insuicides following esketamine treatment.
Conclusions:
Though we are uncertain about the patient's cause of death, this case provides an opportunity to highlight important gaps in our understanding of the suicide-related risks of subanesthetic intravenous ketamine treatment for mood disorders and suicidality.
Probable Enalapril Hepatotoxicity in a 13-Year-Old Male Western Lowland Gorilla: Pharmacologic Risks and Vigilance
Authors: Kathryn C Gamble, Jessica N Lovstad, Kate A Gustavsen
Journal: Front Vet Sci (2019)
Keywords: adverse drug reaction, angiotensin converting enzyme inhibitors, browse, liver, pharmaceutical
MeSH terms: Case Reports

A 13-year-old male Western lowland gorilla presented acutely with a precipitous decline in health status from liver disease. Through diagnostic assessment, including serum chemistries and advanced imaging, it was diagnosed with probable hepatotoxicity resulting from its prescribed medication, enalapril. As one of several angiotensin converting enzyme inhibitors (ACE-I) available to zoo veterinarians, enalapril had been administered for treatment of mild ventricular hypertrophy diagnosed during routine examination 2.5 years prior to the presentation. The gorilla made a complete recovery with discontinuation of this medication, and provision of hepatoprotectants. Hepatotoxicity has been documented in humans receiving this product as an adverse drug reaction and is considered both rare and unpredictable in occurrence. In this event, an association was suspected with indulgent consumption of mulberry browse (Morus sp.) offered as nutritional enrichment immediately prior to clinical presentation and had potential impact on hepatic cytochrome P450 metabolism of the enalapril. Although ACE-I are important medications in this taxon due to its predisposition to cardiac disease, this event underscores the need for vigilance on the part of veterinarians and managers whenever pharmaceuticals are administered. Most drugs are modeled in a limited number of species but utilized in a wide variety, and unintended results are possible.
Surgical and oncological management of renal medullary carcinoma in a young patient: a case report
Authors: Jean Courcier, Alexandre De La Taille, Riccardo Bertolo, Daniele Amparore, Selcuk Erdem, Onder Kara, Michele Marchioni, Nicola Pavan, Eduard Roussel, Maria Mamodaly, Riccardo Campi, Alexandre Ingels
Journal: Front Oncol (2023)
Keywords: smarcb1, chemotherapy, non-clear cell rcc, onco-urological management, renal medullary carcinoma
MeSH terms: Case Reports

Renal medullary carcinoma (RMC) is a rare form of renal cell carcinoma that has a poor prognosis. It is known to be associated with sickle cell trait or disease, although the exact underlying mechanisms are still unclear. The diagnosis is made through immunochemical staining for SMARCB1 (INI1). In this report, we present a case of a 31-year-old male patient with sickle cell trait who was diagnosed with stage III right RMC. Despite the poor prognosis, the patient survived for a remarkable duration of 37 months. Radiological assessment and follow-up were primarily performed using 18F-FDG PET/MRI. The patient underwent upfront cisplatin-based cytotoxic chemotherapy before surgical removal of the right kidney and retroperitoneal lymph node dissection. Identical adjuvant chemotherapy was administered post-surgery. Disease relapses were detected in the retroperitoneal lymph nodes; these were managed with chemotherapy and surgical rechallenges. We also discuss the oncological and surgical management of RMC, which currently relies on perioperative cytotoxic chemotherapy strategies, as there are no known alternative therapies that have been shown to be superior to date.
Autoinfarction of Giant Parathyroid Adenoma after Preoperative Withdrawal of Anticoagulants
Authors: Raoul Verzijl, Pim J Bongers, Geetha Mukerji, Ozgur Mete, Karen M Devon, Jesse D Pasternak
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

A 71-year-old man with known history of atrial fibrillation (treated with routine rivaroxaban therapy) was found to have incidental biochemical elevated calcium and parathyroid hormone (PTH) levels. His physical examination demonstrated the presence of a palpable right neck mass. Subsequent imaging studies revealed a large parathyroid mass as well as multiple bone lesions, raising the suspicion of parathyroid carcinoma. The anticoagulant therapy was stopped 5 days prior to his elective surgery. The night before his elective surgery, he presented to the emergency room with profound hypocalcemia. The surgery was postponed and rescheduled after calcium correction. Intraoperative findings and detailed histopathological examination revealed an infarcted 4.0 cm parathyroid adenoma with cystic change. His bony changes were related to brown tumors associated with long-standing hyperparathyroidism. Autoinfarction of a large parathyroid adenoma causing severe hypocalcemia is a rare phenomenon and may be considered in patients with large parathyroid adenomas after withdrawal of anticoagulants.
Case Series: Managing Severe Mental Illness in Disaster Situation: the Croatian Experience After 2020 Earthquake
Authors: Sara Medved, Azijada Srkalović Imširagić, Igor Salopek, Dragan Puljić, Hrvoje Handl, Marina Kovač, Alma Mihaljević Peleš, Danijela Štimac Grbic, Luka Romančuk, Roberto MuŽić, Laura Shields Zeeman, Martina Rojnić Kuzman
Journal: Front Psychiatry (2022)
Keywords: cmht, community mental health team, crisis, earthquake, severe mental illness
MeSH terms: Case Reports

On the 29th of December 2020, amidst the COVID-19 pandemic, Petrinja in the Croatian Sisak-Moslavina County experienced a strong earthquake, resulting in a severe disruption in mental health service delivery. Specialized care community mental health teams were introduced days within the event with the aim to bridge the gap in psychiatric care that was severely disturbed in the region affected by the earthquake. Through a case series of patients with SMI, we describe how care was quickly deployed and delivered after a natural disaster and during a pandemic resulting in their functional recovery. Community mental health teams have the potential to provide feasible, comprehensive, and accessible mental health services, and their continued implementation in the post-disaster period in Croatia could be beneficial for care management of people with severe mental illness.
Ultrasonographic and endoscopic guidance in diagnosis of Helicobacter gastritis presenting as a mass lesion in a dog: A case report
Authors: Thomas Gomes, Cecelia Harmon, Michael Nappier
Journal: Front Vet Sci (2022)
Keywords: helicobacter, antibiotics, dog, endoscopy, fundus, gastric mass, lymphocytic-plasmacytic gastritis, ultrasound
MeSH terms: Case Reports

This case documents a previously undescribed presentation of Helicobacter spp. gastritis. An 8-year-old female spayed golden retriever with chronic vomiting was found to have a cluster of multiple, round, well-defined, hypoechoic foci of varying sizes surrounded by gas within the lumen of the stomach on ultrasonographic examination. Further endoscopic examination revealed multiple raised mass-like lesions in the fundus on endoscopic examination. Histopathological findings were consistent with Helicobacter spp. infection. The dog was treated with both amoxicillin 400 mg and clarithromycin 180 mg BID for 21 days and omeprazole 20 mg SID for 34 days. After the treatment, the vomiting and fundic lesions were resolved on ultrasonographic examination. This case represents a novel gross morphologic presentation for Helicobacter spp. gastritis that responded to appropriate therapy and highlights how early intervention with advanced imaging can aid in diagnosis and treatment.
Pernicious Effects of Toe Sucking Habit in Children
Authors: Deepika Pai, Saurabh Kumar, Abhay T Kamath, Vipin Bhaskar
Journal: Case Rep Dent (2016)

Digit sucking is common nonnutritive sucking habit in childhood. However it is unusual to find toe sucking habit in children. We report a case of a seven-year-old child sucking great toe of the left foot. The child was referred by her paediatrician for dental evaluation due to her complaint of recurrent episodes of pyrexia. A dental evaluation was warranted as no particular system contributed to such recurrent episodes of fever in this child. Although dental examination did not reveal any cause for recurrent episodes of pyrexia, as a part of routine history taking we discovered that this child indulges frequently in sucking the great toe of her left foot since infancy. Any nonnutritive sucking habit is considered deleterious; this habit also caused significant effect on the child's dentofacial structures, sucked toe, and her general health. Hence the treatment plan was formulated for immediate cessation of habit. Appropriate interception of habit and timely orthodontic intervention led to not only early interception of cross-bite but also decrease in pyrexial episodes. This case report describes the pernicious effects of toe sucking habit and its relevance to recurrent pyrexia in children.
Case Report: Predicting the Range of Lamotrigine Concentration Using Pharmacokinetic Models Based on Monte Carlo Simulation: A Case Study of Antiepileptic Drug-Related Leukopenia
Authors: Xiuqing Zhu, Tao Xiao, Shanqing Huang, Shujing Liu, Xiaolin Li, Dewei Shang, Yuguan Wen
Journal: Front Pharmacol (2021)
Keywords: monte carlo simulation, adolescence, antiepileptic drug, case report, lamotrigine, leukopenia, pharmacokinetic models, steady-state serum concentrations
MeSH terms: Case Reports

Lamotrigine (LTG), a wide-spectrum antiepileptic drug, is frequently associated with cutaneous side-effects, whereas hematological side-effects such as leukopenia have rarely been reported for it. We report the case of a 15-year-old Chinese female epileptic patient weighing 60 kg who developed combined asymptomatic leukopenia after receiving concomitant therapy with LTG and valproate acid (VPA). In this case report, antiepileptic drug-related leukopenia may have occurred in definite relation to an increase in LTG concentration and reversed with the discontinuation of VPA. Monte Carlo (MC) simulations were performed to estimate the steady-state serum concentrations (C ss ) of LTG for different dosing regimens in adolescent Chinese epileptic patients weighing the same as the patient considered in the case study, based on pharmacokinetic (PK) models published in past research. Adjustments to the dosage of LTG for the patient were analyzed to illustrate the application of MC simulations and verify the results. The predicted LTG concentrations within a prediction interval between the 10th and 90th percentiles that represented 80% of the simulated populations, could adequately capture the measured LTG concentrations of the patient, indicating that MC simulations are a useful tool for estimating drug concentrations. Clinicians may benefit from the timely probabilistic predictions of the range of drug concentration based on an MC simulation that considers a large sample of virtual patients. The case considered here highlights the importance of therapeutic drug monitoring (TDM) and implementing model-informed precision dosing in the course of a patient's individualized treatment to minimize adverse reactions.
Case Report: Review of CT Findings and Histopathological Characteristics of Primary Liver Carcinosarcoma
Authors: Lu Huang, Lijian Lu
Journal: Front Genet (2021)
Keywords: diagnosis, liver, tomography, tumora, x-ray computed
MeSH terms: Case Reports

Objectives: The aim of the present study was to describe the computed tomography (CT) characteristics of primary liver carcinosarcoma (PLCS) and to explore the pathological basis for the diagnosis of primary hepatocellular carcinoma sarcoma. Methods: Three male patients with PLCS were included in the present retrospective research, and the age was ranged from 52 to 63 years. The plain CT scan and third-stage enhancement scan were performed on patients. The pathological characteristics were analyzed. Stomachache was the main clinical symptoms of the three patients. Cirrhosis background was confirmed in one patients, and chronic Hepatitis B background was confirmed in other two patients. Results: According to the results of CT, the inner diameter of the tumors ranged from 8.6 to 27.0 cm. The fibrous pseudocapsule around the tumor tissues was observed in two patients. Tumor tissues from all three patients were composed of sarcomatous and carcinomatous components. For carcinomatous components, hepatocellular carcinoma was observed in one patient and cholangiocarcinoma was observed in the other two patients. For sarcomatous components, angiosarcoma was observed in two patients and malignant fibrous histiocytoma was observed in another one patient. The tumor tissues were visualized as heterogeneous low density with large sheets of necrotic cystic lesions or thick-walled areas of multilocular cystic lesions using the plain CT scan. Edge-to-center filling and strengthening lesions, mild to moderate enhanced parenchyma at the arterial phase, and isodensity between the tumor parenchyma and the surrounding liver parenchyma at the portal vein phase or delayed phase were observed using the third-stage enhancement scan. Conclusions: CT characteristics observed in the present study were of great benefit for the diagnosis of PLCS.
Congenital medulloblastoma in two brothers with SUFU-mutated Gorlin-Goltz syndrome: Case reports and literature review
Authors: Yufan Chen, Haibo Zhang, Yang Zhao, Jie Ma
Journal: Front Oncol (2022)
Keywords: gorlin-goltz syndrome, congenital medulloblastoma, infantile, stem cell transplantation, sufu
MeSH terms: Case Reports

Background:
Congenital medulloblastoma is very rare, and many cases involve germline mutations that can lead to inherited syndromes. Here, we first report two brothers with congenital medulloblastoma who were diagnosed with Gorlin-Goltz syndrome caused by SUFU mutation.
Clinical presentation:
Medulloblastoma was detected in two brothers at 2 and 3 months of age, with very similar imaging features. Genetic testing revealed that both children and their mother carried SUFU gene germline mutations, and both brothers were diagnosed with Gorlin-Goltz syndrome.
Conclusion:
Gorlin-Goltz syndrome-associated congenital medulloblastoma with SUFU germline mutation is very rare. Pathological types mostly involve desmoplastic/nodular or extensive nodularity; chemotherapy is the main treatment, and studies revealing prognostic data are scarce.
Bisphosphonates and atypical fractures of femur
Authors: Tero Yli-Kyyny
Journal: J Osteoporos (2011)

Bisphosphonates are the most widely prescribed medicines for the treatment of osteoporosis and have generally been regarded as well-tolerated and safe drugs. Since 2005, there have been numerous case reports about atypical fractures of the femur linked to long-term treatment of osteoporosis with bisphosphonates. Some attempts to characterize pathophysiology and epidemiology of these fractures have been published as well. However, as the American Society for Bone and Mineral Research (ASBMR) concluded in their task force report, the subject warrants further studies.
Case report: Myocarditis in congenital STAT1 gain-of function
Authors: Frederik Staels, Willem Roosens, Simone Giovannozzi, Leen Moens, Jan Bogaert, Cecilia Iglesias-Herrero, Rik Gijsbers, Xavier Bossuyt, Glynis Frans, Adrian Liston, Stephanie Humblet-Baron, Isabelle Meyts, Lucas Van Aelst, Rik Schrijvers
Journal: Front Immunol (2023)
Keywords: stat1 gof, chronic mucocutaneous candidiasis, infectious susceptibility, myocarditis, primary immunodeficiencies
MeSH terms: Autoimmune Diseases, Candidiasis, Chronic Mucocutaneous / genetics, Myocarditis, Case Reports, Research Support, Non-U.S. Gov't, Gain of Function Mutation, Humans, STAT1 Transcription Factor / metabolism, STAT1 protein, human, STAT1 Transcription Factor

Autosomal dominant Signal transducer and activator of transcription 1 (STAT1) gain-of-function (GOF) mutations result in an inborn error of immunity characterized by chronic mucocutaneous candidiasis, recurrent viral and bacterial infections, and diverse autoimmune manifestations. Current treatment consists of chronic antifungal therapy, antibiotics for concomitant infections, and immunosuppressive therapy in case of autoimmune diseases. More recently, treatment with Janus kinases 1 and 2 (JAK1/2) inhibitors have shown promising yet variable results. We describe a STAT1 GOF patient with an incidental finding of elevated cardiac troponins, leading to a diagnosis of a longstanding, slowly progressive idiopathic myocarditis, attributed to STAT1 GOF. Treatment with a JAK-inhibitor (baricitinib) mitigated cardiac inflammation on MRI but was unable to alter fibrosis, possibly due to the diagnostic and therapeutic delay, which finally led to fatal arrhythmia. Our case illustrates that myocarditis could be part of the heterogeneous disease spectrum of STAT1 GOF. Given the insidious presentation in our case, a low threshold for cardiac evaluation in STAT1 GOF patients seems warranted.
Atypical SARS in geriatric patient
Authors: Augustine K H Tee, Helen M L Oh, Christopher T C Lien, K Narendran, B H Heng, A E Ling
Journal: Emerg Infect Dis (2004)
MeSH terms: Severe Acute Respiratory Syndrome / diagnosis, Case Reports, Aged, Aged, 80 and over, Contact Tracing, Disease Outbreaks, Female, Humans, Male, Radiography, Thoracic, Severe Acute Respiratory Syndrome / diagnostic imaging, Severe Acute Respiratory Syndrome / epidemiology, Severe Acute Respiratory Syndrome / transmission, Singapore

We describe an atypical presentation of severe acute respiratory syndrome (SARS) in a geriatric patient with multiple coexisting conditions. Interpretation of radiographic changes was confounded by cardiac failure, with resolution of fever causing delayed diagnosis and a cluster of cases. SARS should be considered even if a contact history is unavailable, during an ongoing outbreak.
A giant cell fibroma and focal fibrous hyperplasia in a young child: a case report
Authors: Rodney J Vergotine
Journal: Case Rep Dent (2012)
MeSH terms: Case Reports

A case of two fibrotic lesions of the oral mucosa in a 17-month-old African-American female is reported. Both lesions occurred on the anterior maxilla, one lesion pedunculated on the buccal attached gingiva and the other lesion sessile on the palate. Histological examination characterized the buccal lesion as focal fibrous hyperplasia (FFH) and the palatal lesion as a giant cell fibroma (GCF). A case is made for continuing the consideration of GCF as a histologically distinct entity from FFH but that no difference in clinical impact between the two lesions exists.
Hemodynamic Signal Changes Accompanying Execution and Imagery of Swallowing in Patients with Dysphagia: A Multiple Single-Case Near-Infrared Spectroscopy Study
Authors: Silvia Erika Kober, Günther Bauernfeind, Carina Woller, Magdalena Sampl, Peter Grieshofer, Christa Neuper, Guilherme Wood
Journal: Front Neurol (2015)
Keywords: dysphagia, motor execution, motor imagery, near-infrared spectroscopy, stroke, swallowing

In the present multiple case study, we examined hemodynamic changes in the brain in response to motor execution (ME) and motor imagery (MI) of swallowing in dysphagia patients compared to healthy matched controls using near-infrared spectroscopy (NIRS). Two stroke patients with cerebral lesions in the right hemisphere, two stroke patients with lesions in the brainstem, and two neurologically healthy control subjects actively swallowed saliva (ME) and mentally imagined to swallow saliva (MI) in a randomized order while changes in concentration of oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) were assessed. In line with recent findings in healthy young adults, MI and ME of swallowing led to the strongest NIRS signal change in the inferior frontal gyrus in stroke patients as well as in healthy elderly. We found differences in the topographical distribution and time course of the hemodynamic response in dependence on lesion location. Dysphagia patients with lesions in the brainstem showed bilateral hemodynamic signal changes in the inferior frontal gyrus during active swallowing comparable to healthy controls. In contrast, dysphagia patients with cerebral lesions in the right hemisphere showed more unilateral activation patterns during swallowing. Furthermore, patients with cerebral lesions showed a prolonged time course of the hemodynamic response during MI and ME of swallowing compared to healthy controls and patients with brainstem lesions. Brain activation patterns associated with ME and MI of swallowing were largely comparable, especially for changes in deoxy-Hb. Hence, the present results provide new evidence regarding timing and topographical distribution of the hemodynamic response during ME and MI of swallowing in dysphagia patients and may have practical impact on future dysphagia treatment.