OpenMed/multicare-articles huggingface dataset:
Beyond the School Walls: Keeping Interactive Learning Environments Alive in Confinement for Students in Special Education
Authors: Garazi Álvarez-Guerrero, Ane López de Aguileta, Sandra Racionero-Plaza, Lirio Gissela Flores-Moncada
Journal: Front Psychol (2021)
Keywords: dialogic gatherings, distance learning, interactive learning environments, special education needs, successful educational actions

The COVID-19 pandemic and the accompanying safety measures, including confinement, has meant an unprecedented challenge for the world population today. However, it has entailed additional difficulties for specific populations, including children and people with disabilities. Being out of school for months has reduced the learning opportunities for many children, such as those with less academic resources at home or with poorer technological connectivity. For students with disabilities, it has entailed losing the quality of the special attention they often need, in addition to a more limited understanding of the situation. In this context, a case study was conducted in a special education classroom of a secondary education school. This class started implementing Dialogic Literary Gatherings with their special education students before the COVID-19 confinement and continued online during the confinement. Qualitative data was collected after a period of implementation of the gatherings showing positive impacts on the participants. The case study shows that interactive learning environments such as the Dialogic Literary Gatherings can provide quality distance learning for students with disabilities, contributing to overcome some of the barriers that the pandemic context creates for the education of these students.
Treatment of Atypical Ulnar Fractures Associated with Long-Term Bisphosphonate Therapy for Osteoporosis: Autogenous Bone Graft with Internal Fixation
Authors: Yohei Shimada, Tetsuhiro Ishikawa, Jun Endo, Jo Katsuragi, Toshiaki Kotani, Hitoshi Kiuchi, Kazuki Kuniyoshi, Seiji Ohtori
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Long-term bisphosphonate use has been suggested to result in decreased bone remodelling and an increased risk of atypical fractures. Fractures of this nature commonly occur in the femur, and relatively few reports exist to show that they occur in other bones. Among eight previous reports of atypical ulnar fractures associated with bisphosphonate use, one report described nonunion in a patient who was treated with cast immobilization and another described ulna nonunion in one of three patients, all of whom were treated surgically with a locking plate. The remaining two surgical patients achieved bone union uneventfully following resection of the osteosclerotic lesion and iliac bone grafting before rigid fixation. We hypothesized that the discontinuation of bisphosphonate therapy, the use of teriparatide treatment, and low-intensity pulsed ultrasound (LIPUS) might have been associated with fracture healing.
Urothelial carcinoma of donor origin in a kidney transplant patient
Authors: Rosa M Michel Ortega, Daynna J Wolff, Cynthia A Schandl, Harry A Drabkin
Journal: J Immunother Cancer (2016)
Keywords: immunosuppression, post-transplant malignancy, solid organ transplantation, urothelial carcinoma
MeSH terms: Kidney Transplantation / adverse effects, Tissue Donors, Urologic Neoplasms / diagnosis, Urologic Neoplasms / etiology, Case Reports, Aged, BK Virus, Chromosome Aberrations, Humans, Immunosuppression Therapy, Immunosuppressive Agents / adverse effects, In Situ Hybridization, Fluorescence, Magnetic Resonance Imaging, Male, Polyomavirus Infections / complications, Polyomavirus Infections / virology, Tomography, X-Ray Computed, Transplantation, Homologous, Tumor Virus Infections / complications, Tumor Virus Infections / virology, Urologic Neoplasms / genetics, Urologic Neoplasms / therapy, Immunosuppressive Agents

Background:
Malignancy after transplantation is an uncommon multifactorial occurrence. Immunosuppression to prevent graft rejection is described as a major risk factor in malignancy development in the post-transplant state. Donor-derived malignancy is a rare reported complication. Herein, we review our patient history and discuss diagnostic strategies and the implications of immunosuppression for donor-derived malignancy.
Case presentation:
This is a 69-year-old man with post-renal-transplant urothelial carcinoma determined to be of donor origin. His course was complicated by BK virus at six years post-transplant; urothelial carcinoma was identified nine years post-transplant. Cystectomy was performed, but because of immunosuppression and underlying chronic kidney disease, the patient was considered ineligible for adjuvant chemotherapy. Two years after resection, screening MRI demonstrated retroperitoneal lymphadenopathy and a right upper pole mass in the transplanted kidney. Urine cytology confirmed the presence of malignant cells; FISH showed 2-8 copies of the X chromosome and no Y chromosome consistent with female origin of the malignant cells. CT-guided renal mass and paraaortic lymph node biopsies demonstrated that about 50 % of cells had an XY complement, while the remainder showed a XX genotype by chromosomal SNP microarray analysis. Immunosuppression was discontinued and the donor kidney removed. X/Y FISH of the urothelial carcinoma identified in the explanted kidney confirmed that the malignant cells were of female donor origin. Follow-up at 3, 6 and 12 months after discontinuation of immunosuppression and surgery demonstrated normalization of the lymphadenopathy and absence of new lesions.
Conclusions:
Immunosuppression is a major risk factor for development of malignancy in transplant recipients. Donor-derived malignancy can arise and current molecular studies allow an accurate diagnosis. Withdrawal of immunosuppression and surgical resection of the transplant kidney proved an effective treatment in our case.
Cardiopulmonary Resuscitation With Mechanical Chest Compression Device During Percutaneous Coronary Intervention. A Case Report
Authors: Dóra Ujvárosy, Veronika Sebestyén, Tamás Ötvös, Balázs Ratku, István Lorincz, Tibor Szuk, Zoltán Csanádi, Ervin Berényi, Zoltán Szabó
Journal: Front Cardiovasc Med (2021)
Keywords: cardiopulmonary resuscitation, case report, coronary intervention, mechanical chest compression device, sudden cardiac death
MeSH terms: Case Reports

Sudden cardiac death is a leading cause of death worldwide, whereby myocardial infarction is considered the most frequent underlying condition. Percutaneous coronary intervention (PCI) is an important component of post-resuscitation care, while uninterrupted high-quality chest compressions are key determinants in cardiopulmonary resuscitation (CPR). In our paper, we evaluate a case of a female patient who suffered aborted cardiac arrest due to myocardial infarction. The ambulance crew providing prehospital care for sudden cardiac arrest used a mechanical chest compression device during advanced CPR, which enabled them to deliver ongoing resuscitation during transfer to the PCI laboratory located 20 km away from the scene. Mechanical chest compressions were continued during the primary coronary intervention. The resuscitation, carried out for 2 h and 35 min, and the coronary intervention were successful, as evidenced by the return of spontaneous circulation and by the fact that, after a short rehabilitation, the patient was discharged home with a favorable neurological outcome. Our case can serve as an example for the effective and safe use of a mechanical compression device during primary coronary intervention.
Isolated transverse sacrum fracture: a case report
Authors: Cemil Kavalci, Gökhan Akdur, Mustafa Burak Sayhan, Ozgur Sogut, Mehmet Tahir Gökdemir
Journal: Emerg Med Int (2011)
MeSH terms: Case Reports

Sacral fracture commonly results from high-energy trauma. Most insufficiency fractures of the sacrum are seen in women after the age of 70. Fractures of the sacrum are rare and generally combined with a concomitant pelvic fracture. Transverse sacral fractures are even less frequent which constitute only 3-5% of all sacral fractures. This type of fractures provide a diagnostic challenge. We report a unique case of isolated transverse fracture of sacrum in a young man sustained low-energy trauma. The patient presented to our emergency department after several hours of injury, and diagnosed by clinical features and roentgenogram findings.
A Case of Acute Eosinophilic Leukemia with a Novel PHF 6 Mutation
Authors: J J Lipof, E J Huselton, C S Zent, A Evans, B Zhang, P G Rothberg, J M Bennett
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

Acute eosinophilic leukemia (AEL) is a rare form of acute myeloid leukemia (AML) that requires prompt exclusion of reactive etiologies of eosinophilia and identification of an underlying acute myeloid neoplasm. Myeloid neoplasms with prominent eosinophilia often have rearrangements in the platelet-derived growth factor receptor α (PDGFRA) or β (PDGFRB) or are associated with core-binding factor AML. In this report, we describe a 35-year-old male presenting with chest discomfort and altered mental status, found to have marked leukocytosis with eosinophilic predominance and an elevated blast count. Bone marrow aspirate and biopsy findings were morphologically consistent with AEL. Fluorescence in situ hybridization (FISH) and standard karyotype analysis did not reveal any abnormalities, and mutation analysis using next generation sequencing (NGS) revealed a pathogenic mutation in PHF6. Cardiac work-up revealed findings suggestive of eosinophilic myocarditis. High-dose glucocorticoid therapy was initiated followed by standard intensive induction chemotherapy with cytarabine and idarubicin. He experienced a rapid reduction in peripheral blood eosinophil and blast count and was found to be in a complete remission at the time of his postinduction bone marrow examination. He underwent allogeneic stem cell transplantation with a matched sibling donor after consolidative high-dose cytarabine and remains in remission at the time of this report, 6 months following his initial diagnosis. The rarity of this condition has resulted in a paucity of data to guide management. Additional studies are needed to better characterize this entity and inform optimal management strategies to attain a long-term sustained remission in these patients.
Case report: Balloon compression for cervical chyle leakage post neck dissection
Authors: Zhaoming Ding, Mengshi Chen, Rui Pang, Ruinan Sheng, Xuesong Zhao, Chunlei Nie
Journal: Front Surg (2022)
Keywords: balloon compression, case report, chyle leakage, neck dissection, thyroid cancer
MeSH terms: Case Reports

Postoperative chyle leakage (CL) is a rare but severe complication after neck dissection, and most patients with this complication can be treated conservatively. However, in patients with high-flow leakage, efficient and well-tolerated conservative treatment options are still lacking, and the treatments can be complicated. In this study, we report a case with CL of 1100 ml/day after neck dissection that was successfully treated by balloon compression.
Composite tumor of metanephric adenoma and Wilms' tumor of the kidney: A case report and review of the literature
Authors: Pengcheng Zhu, Fei Yan, Zixuan Yang, Li Meng, Qilin Ao
Journal: Oncol Lett (2013)
Keywords: wilms’ tumor, composite tumor, differential diagnosis, metanephric adenoma

Metanephric adenoma (MA) and Wilms' tumor (WT) are two distinct types of renal tumors. Composite MA and WT of the kidney are extremely rare. Here, a rare case of composite MA and WT of the kidney in a 36-year-old male is described. MA and WT each have their own histopathological features, respectively, and they focally share morphological similarities, which can be a diagnostic challenge. Immunohistochemistry is useful in the differential diagnosis of MA and WT. The histopathological features and differential diagnosis of the composite tumor are emphasized here to promote a better and broader understanding of this less understood subject.
Successful Antiviral Treatment with Direct-Acting Antivirals for Hepatitis C Virus Infection during Peritransplant Period in a Kidney Transplant Recipient
Authors: Giovanni Varotti, Ferdinando Dodi, Ernesto Paoletti, Andrea Bruno, Iris Fontana
Journal: Case Rep Transplant (2021)
MeSH terms: Case Reports

Introduction. Hepatitis C virus (HCV) infection continues to represent a poor prognostic factor in kidney transplant (KTx) patients. New direct-acting antiviral agents (DAA) have dramatically changed the therapy management for HCV, showing promising results in terms of sustained virologic response. Timing for DAA therapy in HCV positive kidney waitlist patients continues to be controversial, and caution is recommended due to the potential difficult immunosuppressant dose adjustments, particularly in the early posttransplant period. We report a case of a KTx performed during antiviral DAA therapy. Report of Case. Patient was a 44-year-old man suffering from chronic HCV hepatitis associated with end-stage kidney disease (ESRD), waitlisted for a second KTx as a sensitized patient (panel-reactive antibody peak 85%) in March 2019. Four months later, antiviral DAA therapy was started (glecaprevir/pibrentasvir 300 mg/120 mg daily, for 8 weeks). After 30 days, a left kidney was offered and, given the good compatibility, we decided to proceed with KTx without discontinuing the DAA therapy. A standard straightforward kidney transplant was performed. Immunosuppression included thymoglobulin and prednisone for induction and tacrolimus and mycophenolate for maintenance. After a transient delay graft function, creatinine levels progressively decreased. From postoperative day 3, tacrolimus reached target levels and remained stable. No episodes of acute rejection occurred. The 8-week DAA therapy was carried out without interruption. All HCV-RNA level controls resulted undetectable. On postoperative day 15, the patient was discharged and remains in healthy condition with normal renal function and HCV negative after 18 months of follow-up. Discussion. In this case, DAA therapy during the perioperative KTx period was well tolerated and effective. If confirmed, patients should not necessarily be suspended from the waiting list during DAA therapy for HCV eradication.
A clinical case study of the use of ecological momentary assessment in obsessive compulsive disorder
Authors: P J Matt Tilley, Clare S Rees
Journal: Front Psychol (2014)
Keywords: anxiety disorders, assessment, ecological momentary assessment, ecological momentary assessment data, obsessive-compulsive disorder (ocd)
MeSH terms: Case Reports

Accurate assessment of obsessions and compulsions is a crucial step in treatment planning for Obsessive-Compulsive Disorder (OCD). In this clinical case study, we sought to determine if the use of Ecological Momentary Assessment (EMA) could provide additional symptom information beyond that captured during standard assessment of OCD. We studied three adults diagnosed with OCD and compared the number and types of obsessions and compulsions captured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) compared to EMA. Following completion of the Y-BOCS interview, participants then recorded their OCD symptoms into a digital voice recorder across a 12-h period in reply to randomly sent mobile phone SMS prompts. The EMA approach yielded a lower number of symptoms of obsessions and compulsions than the Y-BOCS but produced additional types of obsessions and compulsions not previously identified by the Y-BOCS. We conclude that the EMA-OCD procedure may represent a worthy addition to the suite of assessment tools used when working with clients who have OCD. Further research with larger samples is required to strengthen this conclusion.
Giant cell angiofibroma in unusual localization: a case report
Authors: Emel Ebru Pala, Rafet Beyhan, Umit Bayol, Suheyla Cumurcu, Ulku Kucuk
Journal: Case Rep Pathol (2012)
MeSH terms: Case Reports

Giant cell angiofibroma (GCA) was initially described as a potentially recurrent tumor in the orbit of adults. However, it is now recognized that it can also present in other locations. The morphological hallmark is a richly vascularized patternless spindle cell proliferation containing pseudovascular spaces and floret like multinucleate giant cells. Our case was a 32-years-old female complaining of painless solitary nodule arising on the occipital region of the scalp, which was diagnosed as giant cell angiofibroma. We report the case because of its extremely rare localization.
Low Spigelian hernia in a 6-year-old boy presenting as an incarcerated inguinal hernia: a case report
Authors: Efstratios Christianakis, Nikolaos Paschalidis, Georgios Filippou, Spiros Rizos, Dimitrios Smailis, Dimitrios Filippou
Journal: J Med Case Rep (2009)

Introduction:
Lower Spigelian hernia is a very rare entity. The clinical findings are similar to those of inguinal hernias and in many cases may be misdiagnosed. In the literature, only a few references to this entity have been reported in children. To the best of our knowledge, this is the first case report of a lower Spigelian hernia in a child who presented with an acute painful scrotum.
Case presentation:
We discuss the case of a 6-year-old Greek boy who presented to our emergency department complaining of severe pain in the left inguinal area and scrotum. The acute painful swelling started suddenly, without any obvious cause. The initial diagnosis was incarcerated inguinal hernia which was reduced with difficulty. Five days later, the patient still experienced mild pain during palpation and he was operated on. During the operation, a large lower Spigelian hernia was revealed and reconstructed.
Conclusion:
Although Spigelian hernias are rare in children and difficult to diagnose, physicians should be aware of them and include them in the differential diagnosis.
Pericarditis with cardiac tamponade - A misleading complication of appendicitis: A rare case report
Authors: Agnieszka Wójcik, Paweł Skorek, Dorota Palczewska, Piotr Weryński
Journal: Int J Surg Case Rep (2020)
Keywords: appendicitis, case report, heart tamponade, pericardectomy, pericardial effusion, pericarditis
MeSH terms: Case Reports

Introduction:
As severe complication of appendicitis as effusive pericarditis is a rare phenomenon. Taking into consideration open access data in a 50-year period we perceived three pediatric cases with pericarditis as a complication of appendicitis.
Presentation of case:
We report a 15-year-old boy who presented cardiac tamponade, bilateral pleural effusions, liver enlargement and ascites as a presentation of atypical appendicitis.
Discussion:
Even nowadays appendicitis could be difficult to diagnose in children. A delayed diagnosis could be responsible for severe morbidity and mortality.
Conclusion:
This report is aimed to be a reminder of serious life-threatening complications after a common abdomen condition - appendicitis.
A Novel Mutation of GFAP Causing Adult-Onset Alexander Disease
Authors: Andrea Ciammola, Davide Sangalli, Jenny Sassone, Barbara Poletti, Laura Carelli, Paolo Banfi, Gabriele Pappacoda, Isabella Ceccherini, Alice Grossi, Luca Maderna, Monica Pingue, Floriano Girotti, Vincenzo Silani
Journal: Front Neurol (2019)
Keywords: alexander disease, gfap-glial fibrillary acidic protein, adult onset, gene mutation, leukodystrophy
MeSH terms: Case Reports

Alexander disease (AxD) is a rare, autosomal dominant neurological disorder. Three clinical subtypes are distinguished based on age at onset: infantile (0-2 years), juvenile (2-13 years), and adult (>13 years). The three forms differ in symptoms and prognosis. Rapid neurological decline with a fatal course characterizes the early-onset forms, while symptoms are milder and survival is longer in the adult forms. Currently, the sole known cause of AxD is mutations in the GFAP gene, which encodes a type III intermediate filament protein that is predominantly expressed in astrocytes. A wide spectrum of GFAP mutations comprising point mutations, small insertions, and deletions is associated with the disease. The genotype-phenotype correlation remains unclear. The considerable heterogeneity in severity of disease among individuals carrying identical mutations suggests that other genetic or environmental factors probably modify age at onset or progression of AxD. Describing new cases is therefore important for establishing reliable genotype-phenotype correlations and revealing environmental factors able to modify age at onset or progression of AxD. We report the case of a 54-year-old Caucasian woman, previously diagnosed with ovarian cancer and treated with surgery and chemotherapy, who developed dysarthria, ataxia, and spastic tetraparesis involving mainly the left side. Cerebral and spinal magnetic resonance imaging (MRI) revealed a peculiar tadpole-like atrophy of the brainstem. Genetic analysis of the GFAP gene detected a heterozygous mutation in exon 1 (c.219G>C), resulting in an amino acid exchange from methionine to isoleucine at codon 73 (p.M73I). The expression of this mutant in vitro affected the formation of the intermediate filament network. Thus, we have identified a new GFAP mutation in a patient with an adult form of AxD.
Small-Cell Type, Poorly Differentiated Neuroendocrine Carcinoma of the Gallbladder: A Case Report and Review of the Literature
Authors: Kishore Kumar, Hassan Tariq, Rafeeq Ahmed, Chime Chukwunonso, Masooma Niazi, Ariyo Ihimoyan
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

The poorly differentiated small-cell type, neuroendocrine carcinoma (NEC) of the gallbladder is a very uncommon subtype of a neuroendocrine tumor of the gastrointestinal tract. Nonsecretory NEC by virtue of its nonspecific and subtle clinical presentation of the tumor is usually diagnosed at an advance stage with presenting symptoms related to either locally advance disease or from metastatic disease. Though the radiologic imaging does identify the gall bladder cancer, the tumor lacks a specific diagnostic test; therefore, the diagnosis is almost always confirmed on histopathologic and immunohistochemical staining. We present a case of a poorly differentiated, small-cell neuroendocrine tumor of the gallbladder. The patient died within 3 months after the definitive diagnosis was made. Survival from this deadly malignancy can be improved with aggressive surgical treatment followed by chemotherapy and radiotherapy on a case-by-case scenario. The systemic chemotherapy remained the treatment of choice for an unresectable tumor (Chen et al., 2014).