OpenMed/multicare-articles huggingface dataset:
Successful treatment of human herpesvirus 6 encephalomyelitis in immunocompetent patient
Authors: Eric Denes, Laurent Magy, Karine Pradeau, Sophie Alain, Pierre Weinbreck, Sylvie Ranger-Rogez
Journal: Emerg Infect Dis (2004)
MeSH terms: Antiviral Agents / administration & dosage, Cytosine / administration & dosage, Cytosine / analogs & derivatives, Encephalomyelitis / drug therapy, Ganciclovir / administration & dosage, Herpesvirus 6, Human, Organophosphonates, Organophosphorus Compounds / administration & dosage, Roseolovirus Infections / drug therapy, Case Reports, Adult, Cidofovir, Drug Therapy, Combination, Female, Humans, Immunocompetence, Antiviral Agents, Organophosphonates, Organophosphorus Compounds, Cytosine, Cidofovir, Ganciclovir

We report a case of human herpesvirus 6 (HHV-6) encephalomyelitis in an immunocompetent patient, which was confirmed by viral amplification from cerebrospinal fluid. Cidofovir was used, followed by ganciclovir, because of an adverse effect to probenecid. The patient recovered. HHV-6 should be recognized as one of the causes of encephalomyelitis.
Occupational traumatic amputation of distal part of thumb caused by constriction effect of nylon rope: a case report with review of literature
Authors: M Kalra, A Mahmood, M Patralekh
Journal: Case Rep Orthop (2011)
MeSH terms: Case Reports

A 60-year-old farmer came to the accident and emergency department complaining of traumatic amputation of distal part of right thumb. On examination, there was a circumferential wound located at the base of right thumbnail with injury to both neurovascular bundles and fracture of distal part of distal phalanx with the distal part hanging by volar skin only. The wound was irrigated and the distal part terminalised with direct loose skin closure. Discussion with the patient about the scenario of trauma revealed a mechanism of injury which may appear unique.
Recombinant chromosome with partial 14 q trisomy due to maternal pericentric inversion
Authors: Hande Küçük Kurtulgan, Leyla Özer, Malik Ejder Yıldırım, Evrim Ünsal, Süleyman Aktuna, Volkan Baltacı, Nejmiye Akkuş, İlhan Sezgin
Journal: Mol Cytogenet (2015)
Keywords: 14q duplication, cardiac defects, microcephaly, pericentric inversion of chromosome 14
MeSH terms: Case Reports

Background:
14q duplications caused by parental pericentric inversion of chromosome 14 are rarely reported and no clear genotype-phenotype correlation has been determined yet.
Case presentation:
Here we reported a 7 years old female patient with recombinant chromosome characterized by 14 q duplication and originated from maternal pericentric inversion of chromosome 14. Principal clinical findings of the child include developmental delay, microcephaly, hypertelorism, low set ears, clinodactyly of fifth fingers, hypotonia, telecanthus and cardiac malformation.
Conclusions:
Her final karyotype was 46,XX,rec(14)dup(14q)inv(14)(p11.2q24)mat,arr14q24.1-qter(64,800,000-108,350,000 bp)x3.
Fulvestrant May Falsely Increase 17β-Estradiol Levels in Immunoassays: A Case Report of a 57-Year-Old Postmenopausal Patient With Recurrent Estrogen Receptor-Positive Breast Cancer
Authors: Jingxian Ding, Yali Cao, Yonghong Guo
Journal: Front Oncol (2022)
Keywords: 17β-estradiol (e2), antihormonal therapy, breast cancer, fulvestrant, reirradiation (re-rt)
MeSH terms: Case Reports

The prognosis for female patients with locoregionally recurrent breast cancer has improved with the concurrent local and systemic treatment under multiple disciplinary teams. Radiotherapy is a valuable local treatment measure for unresectable locoregional recurrent breast cancer; however, reirradiation in previously irradiated areas is still a matter of debate. Antihormonal therapy achieves an overall survival benefit for most of these patients with estrogen receptor-positive (ER+) breast cancer in both adjuvant and metastatic settings. Fulvestrant is an ER antagonist and selective ER downregulator widely used in antihormonal therapy, especially in recurrent postmenopausal ER+ breast cancers. However, fulvestrant closely resembles 17β-estradiol in its molecular structure which may result in false increases in serum 17β-estradiol levels in commercially available immunoassays leading to incorrect medical decisions. Herein, we report a case of a 57-year-old postmenopausal patient with recurrent ER+ breast cancer treated with concurrent fulvestrant and reirradiation. There was a good clinical response, and the combination treatment was well tolerable. During the quarterly follow-up, we monitored a gradual increase of the serum 17β-estradiol level in immunoassays, unexpectedly, because the patient underwent natural menopause 8 years ago. To rule out the suspected fulvestrant cross-reactivity with 17β-estradiol in immunoassay, the patient's serum 17β-estradiol levels were subsequently tested with the more sensitive and specific liquid chromatography-mass spectrometry (LC-MS) method, which confirmed 17β-estradiol levels at the postmenopausal level. Concomitant fulvestrant with reirradiation seems to be a safe and effective therapy for locoregionally recurrent ER+ breast cancer. However, a falsely increased 17β-estradiol may result from cross-reactivity between 17β-estradiol and its molecular analog compounds, for example, fulvestrant. Therefore, it is important for the clinicians with the knowledge of this interaction to prevent unnecessary erroneous interpretation of results and avoid wrong medical decisions.
Complexity Thinking as a Tool to Understand the Didactics of Psychology
Authors: László Harmat, Anna Herbert
Journal: Front Psychol (2020)
Keywords: complexity theory, complexity thinking, didactics of psychology, education, learning, psychology teaching

The need to establish a research field within psychology didactics at secondary level has recently been voiced by several researchers internationally. An analysis of a Swedish case coming out of secondary level education in psychology presented here provides an illustration that complexity thinking-derived from complexity theory-is uniquely placed to consider and indicate possible solutions to challenges, described by researchers as central to the foundation of a new field. Subject matter didactics is defined for the purpose of this paper as a combination of general didactics and subject matter content, and considering the international nature of research traditions coming out of psychology, the implications of the results presented here cannot be regarded as limited solely to national concerns. An online survey was sent to secondary schools in Sweden. Discussions and lectures along with teaching to the book-alternatively used as inspiration-emerged as central from the thematic analysis of the results, providing the first mapping of teaching practices secondary level psychology in Sweden. An analysis, founded on complexity thinking-combined with a model enabling a delimitation of the scope of study-focused on time use and the importance placed on self-knowledge, along with the transformation of theory into practice. The former pointed to a teacher-centered nested subsystem (e.g., asymmetric relations between teachers and students), whereas the latter pointed to student-centered nested subsystems coming out of embodied knowledge (e.g., students as node) where psychological perspectives are learnt through self-reflection, case studies, and everyday life experiences (turning theory to practice), implying a holistic approach. The analysis applied to the Swedish case provides an illustration of how complexity theory has the potential to address challenges at the micro and the macro levels to the establishment of a new research field in psychology didactics and to indicate possible solutions (drawing among other things upon teaching experiences coming out of the Swedish case study). Psychology's high relevance to everyday life, multi-causality, perspective pluralism, dynamic systems character, and scientific character make complexity thinking a relevant approach in the consideration of challenges to the establishment of a research field in didactics of psychology.
Idiopathic Membranous Glomerulonephritis Leading to Secondary Polycythemia: A Rare Association
Authors: Prabhakar Yadav, Saurabh Pathak, Makkapalem S Malik
Journal: Cureus (2023)
Keywords: erythropoietin, membranous glomerulonephritis, nephrotic syndrome, polycythemia, receptor mutations
MeSH terms: Case Reports

Primary polycythemia is caused due to mutations in erythropoietin (EPO) receptor or Janus Kinase 2 (JAK2). Secondary polycythemia is seldom associated with renal diseases, such as adult polycystic kidney disease, kidney tumors (like renal cell carcinoma and reninoma), renal artery stenosis, and kidney transplant due to increased EPO production. Polycythemia associated with nephrotic syndrome (NS) is very rare. Here, we report a case with membranous nephropathy, the patient had polycythemia at presentation. Nephrotic range proteinuria causes nephrosarca leading to renal hypoxia which causes increased EPO and IL-8 production, this is proposed to cause secondary polycythemia in NS. The reduction of polycythemia following remission in proteinuria further suggests the correlation. The exact mechanism remains to be found out.
Massive deposition and accumulation of hydroxyapatite crystal after total hip arthroplasty: a case report
Authors: Shin Yamada, Koji Nozaka, Hidetomo Saito, Hiroaki Kijima, Hiroshi Tazawa, Yasusi Takasaki, Yoichi Shimada
Journal: Case Rep Orthop (2013)

We presented a case in which massive hydroxyapatite accumulation was observed around the artificial hip joint. A 66-year-old female showed a massive accumulation of fluid in and around the hip joint, and milk-like aspirate was obtained. Her aspirate culture was negative, and sediment analysis by X-ray diffraction showed that its component was hydroxyapatite. Since pain was mild, the patient was treated conservatively. To our knowledge, this is the first case in which liquid hydroxyapatite (milk of calcium) was accumulated around the artificial hip joint.
IgA pemphigus following COVID-19 vaccination: A case report
Authors: Rafael Paolo Lansang, Esiahas Amdemichael, Dusan Sajic
Journal: SAGE Open Med Case Rep (2023)
Keywords: covid-19, covid-19 vaccination, iga pemphigus, moderna vaccine, pemphigus, adverse effects
MeSH terms: Case Reports

A patient presented with pruritic lesions on their back and leg after COVID-19 vaccination. Biopsy and direct immunofluorescence were consistent with IgA pemphigus-likely caused by the COVID-19 vaccine.
Axillary accessory breast cancer with persistent leftsuperior vena cava: A case report and treatment controversy
Authors: Jun Zhang, Weidong Zhang, Meilin Min, Yunbo Pan
Journal: Int J Surg Case Rep (2020)
Keywords: accessory breast cancer, case report, persistent left superior vena cava, treatment controversy
MeSH terms: Case Reports

Introduction:
Axillary accessory breast cancer and persistent left superior vena cava (PLSVC) are rare clinically. Many controversial treatments for accessory breast cancer are worth discussing and learning.
Presentation of the case:
A 48-year-old woman presented with biopsy histopathology confirmed. Right axillary mass biopsy pathology showed mucinous adenocarcinoma of accessory breast. She concerned that the axillary accessory breast cancer was more likely to metastasize and unsure about whether to remove the breast. She accepted extended right axillary accessory breast resection plus ipsilateral axillary lymph node dissection (ALND) and received chemotherapy. She was found to have a PLSVC before chemotherapy.
Discussion:
Is there a need to remove the breast and perform ALND during axillary accessory breast cancer surgery? Is sentinel lymph node biopsy (SLNB) appropriate for axillary accessory breast cancer surgery? Can negative SLNB for axillary accessory breast cancer avoid ALND? Does accessory breast cancer without axillary lymph node metastasis require local radiotherapy? Does PLSVC impact the use of peripherally inserted central catheters (PICC) tubes during chemotherapy? Patients with accessory breast cancer without breast invasion should undergo local extended resection and ALND. SLNB for accessory breast cancer cannot instead of ALND. We recommend routine axillary radiotherapy after accessory breast cancer surgery. If it is determined that the tip of PICC is not in the coronary sinus of PLSVC, PLSVC does not affect chemotherapy.
Conclusion:
Many treatment strategies for accessory breast cancer require more evidence from evidence-based medicine. It is imperative to conduct multi-center accessory breast cancer research.
A Rare Cause of Small Bowel Obstruction: A Case Report
Authors: Piaopiao Chen, Qiang Hu, Jinfeng Wu, Yuanshui Sun
Journal: Front Surg (2022)
Keywords: bezoar, case report, phytobezoar, small bowel obstruction, surgery
MeSH terms: Case Reports

Introduction:
Small bowel obstruction is a common surgical emergency abdominal condition in clinical practice. Fecalith is one of the rare causative factors, especially phytobezoars.
Case report:
We report the case of a 66-year-old man admitted with "abdominal pain with vomiting for 1 day." Enhanced CT of the abdomen suggested incomplete small bowel obstruction. The symptomatic treatment with fasting, fluid replacement, gastrointestinal decompression, and antibiotics was conducted after the patient was admitted to the hospital. After 2 days of treatment, the patient's abdominal pain was not significantly relieved, so a decision was made to perform laparoscopic examination surgery. During surgery, a columnar foreign body was found embedded in the lumen of the small intestine about 10 cm away from the ileocecal region. Combined with the patient's preoperative history of consuming a large number of persimmons, the primary diagnosis of small intestinal fecalith obstruction was considered. We performed an enterotomy to remove the foreign body, and the procedure was uneventful. On postoperative day 7, the patient was successfully discharged.
Conclusion:
When we encounter a patient with intestinal obstruction without a history of surgery in our clinical work, we should take a careful history, especially about the consumption of foods that can cause phytoliths. When a patient has consumed a large amount of food that can cause phytobezoars before the abdominal pain, we should diagnostically consider it as phytobezoars intestinal obstruction, which helps to reduce the incidence of misdiagnosis and allows the patient to receive treatment timely and effectively.
COVID-19 in a Child With Transposition of the Great Arteries S/P Fontan Palliation: A Case Report and Literature Review
Authors: Chen Wen, Guocheng Shi, Wei Liu, Hao Zhang, Gangxi Lin, Huiwen Chen
Journal: Front Cardiovasc Med (2022)
Keywords: covid-19, fontan procedure, sars-cov-2, case report, congenital heart disease
MeSH terms: Case Reports

Background:
Although adult patients with cardiovascular disease are at higher risk of adverse outcomes such as death or severe infection, limited data exist regarding pediatric patients with congenital heart disease. We would like to report our experience with COVID-19 in a pediatric patient with Fontan circulation. Furthermore, we present a review of patients with Fontan palliation and COVID-19 previously reported in the literature to summarize the clinical characteristics of this population.
Case presentation:
A 9-year-old boy with dextro-transposition of the great arteries, ventricular septal defect, pulmonary stenosis, patent foramen ovale, and borderline left ventricle post bidirectional Glenn shunt and Fontan palliation presented with paroxysmal cough in the context of COVID-19. The coagulation profile was beyond the normal limits, and the patient began to receive anticoagulant aspirin. On the 5th day, the patient presented with fever, sore throat, and fatigue. The oxygen saturations dropped to 93%, and he received nasal catheter oxygen inhalation. On the 7th day, computed tomography of the chest revealed little emerging flaky exudation in the posterior basal segment of the left lower lobe. Nasal cannula was removed on the 12th day, and the coagulation profile returned to normal on the 16th day. After two consecutively negative SARS-CoV-2 viral RNA tests (on the 18th and 19th days, interval ≥ 24 h), he was discharged from the hospital on the 21st day. Literature review indicated that COVID-19 with Fontan palliation seemed to be more common in male adults. Disease presentation varied from mild upper respiratory tract infection to severe pneumonia. Complications were not uncommon in this population. The treatments varied depending on the specific factors. Fortunately, most patients reported a favorable prognosis.
Conclusion:
Although patients with COVID-19 and Fontan circulation might have the risk of adverse outcomes due to multiple mechanisms, most patients have a favorable prognosis.
A Rare Adrenal Mass in a 3-Month-Old: A Case Report and Literature Review
Authors: Ashish Garg, Elza Pollak-Christian, Navneetha Unnikrishnan
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

A three-month-old female infant presented with abdominal distention for 2 months. A large palpable mass in right upper quadrant was noted on physical exam. Abdominal ultrasound revealed a large heterogeneous mass with multiple cystic components. Mass was surgically excised and pathology was consistent with mature adrenal teratoma. Teratoma is a germ cell tumor mainly found in gonadal tissues. Occurrence of adrenal gland teratoma in children is very rare with less than 10 pediatric case reports in English literature. We present a rare case of primary adrenal tumor in an infant and a review of the literature.
Iatrogenic Teratoma Rupture during TVOR Complicated with Peritonitis, Pleuritis, and Septic Shock
Authors: Pei-Yi Wang, Yi-En Chang, Yu-Chieh Lee, Chii Ruey Tzeng
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Objective:
To obtain a better understanding of the clinical course and the subsequent complications of teratoma rupture.
Case:
We report a rare case of chemical peritonitis and pleuritis caused by teratoma rupture during ultrasonographically guided transvaginal oocyte retrieval (TVOR). The patient initially presented with nonspecific and digestive symptoms after TVOR, but the condition deteriorated rapidly after three weeks with peritonitis and septic shock. Thus, exploratory laparoscopy was performed with the findings of a ruptured teratoma at left adnexa, severe adhesions, and purulent fluid in her peritoneal cavity. Bilateral pleuritis was also noted after the operation, which was suspected to be caused by chemical irritation of the spilled contents of the teratoma. The patient's condition improved after surgical treatment and was discharged 28 days after admission.
Conclusion:
Our case showed that the timing of peritoneal irritation caused by teratoma rupture converting to severe chemical peritonitis was approximately 3 weeks. Physicians should avoid cyst puncture during TVOR and closely observe or even perform surgical treatment when iatrogenic teratoma ruptures are suspected.
Avian influenza (H7N9) virus infection in Chinese tourist in Malaysia, 2014
Authors: Timothy William, Bharathan Thevarajah, Shiu Fee Lee, Maria Suleiman, Mohamad Saffree Jeffree, Jayaram Menon, Zainah Saat, Ravindran Thayan, Paul Anantharajah Tambyah, Tsin Wen Yeo
Journal: Emerg Infect Dis (2015)
MeSH terms: Influenza A Virus, H7N9 Subtype / genetics, Influenza, Human / diagnosis, Case Reports, Aged, China / ethnology, Epidemiological Monitoring, Female, Humans, Influenza, Human / virology, Malaysia, Multilocus Sequence Typing, Travel

Of the ≈400 cases of avian influenza (H7N9) diagnosed in China since 2003, the only travel-related cases have been in Hong Kong and Taiwan. Detection of a case in a Chinese tourist in Sabah, Malaysia, highlights the ease with which emerging viral respiratory infections can travel globally.
Scoliosis treatment using spinal manipulation and the Pettibon Weighting System: a summary of 3 atypical presentations
Authors: Mark W Morningstar, Timothy Joy
Journal: Chiropr Osteopat (2006)

Background:
Given the relative lack of treatment options for mild to moderate scoliosis, when the Cobb angle measurements fall below the 25-30 degrees range, conservative manual therapies for scoliosis treatment have been increasingly investigated in recent years. In this case series, we present 3 specific cases of scoliosis.
Case presentation:
Patient presentation, examination, intervention and outcomes are detailed for each case. The types of scoliosis presented here are left thoracic, idiopathic scoliosis after Harrington rod instrumentation, and a left thoracic scoliosis secondary to Scheuermann's Kyphosis. Each case carries its own clinical significance, in relation to clinical presentation. The first patient presented for chiropractic treatment with a 35 degrees thoracic dextroscoliosis 18 years following Harrington Rod instrumentation and fusion. The second patient presented with a 22 degrees thoracic levoscoliosis and concomitant Scheuermann's Disease. Finally, the third case summarizes the treatment of a patient with a primary 37 degrees idiopathic thoracic levoscoliosis. Each patient was treated with a novel active rehabilitation program for varying lengths of time, including spinal manipulation and a patented external head and body weighting system. Following a course of treatment, consisting of clinic and home care treatments, post-treatment radiographs and examinations were conducted. Improvement in symptoms and daily function was obtained in all 3 cases. Concerning Cobb angle measurements, there was an apparent reduction in Cobb angle of 13 degrees , 8 degrees , and 16 degrees over a maximum of 12 weeks of treatment.
Conclusion:
Although mild to moderate reductions in Cobb angle measurements were achieved in these cases, these improvements may not be related to the symptomatic and functional improvements. The lack of a control also includes the possibility of a placebo effect. However, this study adds to the growing body of literature investigating methods by which mild to moderate cases of scoliosis can be treated conservatively. Further investigation is necessary to determine whether curve reduction and/or manipulation and/or placebo was responsible for the symptomatic and functional improvements noted in these cases.
Olecranon Apophyseal Nonunion in Adolescent Judo Players: A Report of Two Cases
Authors: Kohei Yamaura, Yutaka Mifune, Atsuyuki Inui, Hanako Nishimoto, Yasuhiro Ueda, Takeshi Kataoka, Takashi Kurosawa, Shintaro Mukohara, Takeshi Kokubu, Ryosuke Kuroda
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated. One suffered from unilateral and the other from bilateral chronic posterior elbow pain. They were diagnosed with olecranon apophyseal nonunion, which was treated using internal fixation and bone grafting. Radiographic evidence of the apophyseal union was observed four months postsurgery. Two elbows were treated with tension band wiring, then they underwent hardware removal six months postsurgery. Both patients returned to their previous levels of activities six months postsurgery. Internal fixation using autologous bone grafting was a useful treatment for these Judo athletes with olecranon apophyseal nonunion.