OpenMed/multicare-articles huggingface dataset:
Cognitive therapy for moral injury in post-traumatic stress disorder
Authors: Hannah Murray, Anke Ehlers
Journal: Cogn Behav Therap (2021)
Keywords: ptsd, betrayal, cognitive therapy, moral injury, trauma
MeSH terms: Review

Moral injury is the profound psychological distress that can arise following participating in, or witnessing, events that transgress an individual's morals and include harming, betraying, or failure to help others, or being subjected to such events, e.g. being betrayed by leaders. It has been primarily researched in the military, but it also found in other professionals such as healthcare workers coping with the COVID-19 pandemic and civilians following a wide range of traumas. In this article, we describe how to use cognitive therapy for post-traumatic stress disorder (CT-PTSD) to treat patients presenting with moral injury-related PTSD. We outline the key techniques involved in CT-PTSD and describe their application to treating patients with moral injury-related PTSD. A case study of a healthcare worker is presented to illustrate the treatment interventions.
Key learning aims:
(1)To recognise moral injury where it arises alongside PTSD.(2)To understand how Ehlers and Clark's cognitive model of PTSD can be applied to moral injury.(3)To be able to apply cognitive therapy for PTSD to patients with moral injury-related PTSD.
Posterior hip dislocation associated with posterior wall acetabular fracture and ipsilateral intertrochantric fracture: a very rare case report
Authors: Ahmad Yousefi, Hami Ashraf, Ali Mashhadinezhad, Ali Birjandinejad
Journal: Trauma Mon (2013)
Keywords: fracture, hip dislocation, posterior, sciatic nerve
MeSH terms: Case Reports

Traumatic hip dislocations are common in high-energy motor vehicle accidents. We present a case of a 43-year old man who sustained posterior hip dislocation with posterior wall acetabular fracture and ipsilateral intertrochantric fracture following a motorcycle accident. Urgent open reduction and internal fixation of the hip fracture-dislocation and fixation of intertrochantric fracture with a dynamic hip screw were done. To our knowledge, such an injury has been rarely reported in the literature. Possible mechanisms of injury and operative procedures are discussed. Radiographic follow-up after eight months showed union. No major complications were observed in our patient.
Case Report: Is It Premature Ovarian Insufficiency or Swyer Syndrome After Bone Marrow Transplantation?
Authors: Hui Li, Jin Li, Xiaohong Li, Hong Yi, Qixiu Ren, Xiaoyan Chen
Journal: Front Pediatr (2022)
Keywords: 46, xy karyotype, bone marrow transplantation, premature ovarian insufficiency (poi), primary amenorrhea, thalassemia major
MeSH terms: Case Reports

Introduction: Iatrogenic factor is one of the recognized causes for premature ovarian insufficiency. The aim of this case report was to present a rare case with premature ovarian insufficiency and 46, XY karyotype after bone marrow transplant (BMT) for thalassaemia major at childhood. We also reviewed some relevant literature in this report. Case Presentation: A 17-year-old girl was presented with primary amenorrhea and premature ovarian insufficiency after receiving chemotherapy and BMT from her brother due to thalassaemia major at childhood. She had poor secondary sex characteristics, assessed as stage I for the development of breasts and external genitalia based on the Tanner scale. Transabdominal ultrasound showed small uterus with visible endometrial lining and small ovaries. Laboratory data showed hypergonadotropic hypogonadism profile with low level of estrogen and high level of follicular-stimulating hormone (FSH). Patient's peripheral lymphocytes karyotype was 46, XY. Conclusions: This case was diagnosed as a chemotherapy induced premature ovarian insufficiency. Patient's peripheral lymphocytes karyotype (46, XY) after she received BMT from a male donor was a misleading finding, and the case could be easily misdiagnosed as Swyer syndrome. A correct diagnosis in such cases should depend not only on the recent clinical findings, but also on the detailed medical history. To prevent premature ovarian insufficiency in similar cases, fertility preservation should be offered to girls before they receive chemotherapy, total body irradiation and BMT.
Ischiospinal Dysostosis in a Child with Pierre-Robin Syndrome
Authors: Mahmoud Almasri, Waleed Kishta, Fahad H Abduljabbar, Vincent Arlet, Neil Saran, Jean Oullet
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Ischiospinal Dysostosis (ISD) is a complex and very rare medical entity. It is associated with kyphoscoliosis, dysplasia or aplasia of the ischial rami, segmental anomalies of the bony vertebrae, and peculiar facial morphologies. In this case report, we present a child with Ischiospinal Dysostosis and Pierre-Robin Syndrome. This case report is unique as we followed the patient for 13 years in which he had multiple spinal procedures to treat his kyphoscoliosis. In this paper, we elucidated the number of case reports with documented follow-up regarding spinal cord injury or other complications of ISD and its management.
Henoch-Schönlein purpura nephritis associated with monoclonal gammopathy of renal significance: a case report
Authors: Hui Zhao, Wen-Hui Huang, Jun-Yue Huang, Shou-Yan Lu, Ya-Hong Yang, Zhi-Gang Ma
Journal: Braz J Med Biol Res (2019)
MeSH terms: IgA Vasculitis / complications, Nephritis / complications, Paraproteinemias / etiology, Case Reports, Glucocorticoids / administration & dosage, Humans, IgA Vasculitis / drug therapy, IgA Vasculitis / pathology, Immunosuppressive Agents / administration & dosage, Male, Middle Aged, Nephritis / drug therapy, Nephritis / pathology, Paraproteinemias / drug therapy, Paraproteinemias / pathology, Glucocorticoids, Immunosuppressive Agents

Monoclonal gammopathy of renal significance (MGRS) can present with different morphologic features and lead to kidney failure. The Henoch-Schönlein purpura nephritis (HSPN) that cannot be relieved by treatment with glucocorticoid and immunosuppressive agents suggests the presence of monoclonal gammopathy in adult patients. The present study reports on a single case of HSPN associated with IgA-κMGRS. The patient who suffered from recurrent skin purpura for 6 months and nephrotic syndrome for 2 months was admitted to our hospital. Bone marrow biopsy showed monoclonal gammopathy of undetermined significance. Kidney biopsy indicated a Henoch-Schönlein purpura nephritis (HSPN, ISKDC classified as type III) with positive staining with κ-light chain in the glomeruli and renal tubular epithelial cells. Furthermore, skin biopsy showed leukocytoclastic vasculitis and negative staining for Congo red and light chain. Given both the renal and cutaneous involvement, the patient was considered to have HSPN associated with IgA-κMGRS. The patient experienced an exacerbation in his purpura-like lesions and clinical status after treatment with glucocorticoid and immunosuppressive agents. Consequently, the patient was put on a regimen that included dexamethasone (20 mg on the 1st, 4th, 8th, and 11th days of each month, iv) and bortezomib (2.4 mg on the 1st, 4th, 8th, and 11th days of each month, iv). Eight weeks after treatment, he had complete resolution of his cutaneous purpura and his biochemical parameters improved. The latent presence of MGRS in cases of HSPN should be considered in adult patients. Increased cognizance and correct treatment options could improve patient outcomes.
May salivary alpha-amylase level be a useful tool for assessment of the severity of schizophrenia and evaluation of therapy? A case report
Authors: Masa Ieda, Tsuyoshi Miyaoka, Kiminori Kawano, Rei Wake, Takuji Inagaki, Jun Horiguchi
Journal: Case Rep Psychiatry (2012)

Background. Previous studies suggested dysfunction of the autonomic nervous system (ANS) in schizophrenia patients, but the mechanism remains unclear. Recently, the measurement of salivary alpha-amylase (sAA) has been considered a useful tool for evaluating ANS, especially the sympathoadrenal medullary system. Furthermore, there was a report that patients with schizophrenia showed much higher sAA level than normal controls. Methods. We present the case of a 51-year-old female with catatonic schizophrenia. She needed the treatment of electroconvulsive therapy (ECT). We evaluated her sAA level and her psychiatric symptoms during the treatment. Results. Before ECT treatment, she showed high sAA level. Her sAA level decreased during the course of ECT, and this attenuation was accompanied by improvement of schizophrenic symptoms. Conclusion. We consider that measurement of the sAA level may be one of the useful biological markers for assessment of psychotic state and efficacy of treatment in patients with schizophrenia.
Merkel cell carcinoma of left groin: a case report and literature review
Authors: Ahmed Abu-Zaid, Ayman Azzam, Ahmed Al-Wusaibie, Maraei Bin Makhashen, Abdulaziz Jarman, Tarek Amin
Journal: Case Rep Oncol Med (2013)

Merkel cell carcinoma (MCC) is an uncommon highly aggressive skin malignancy with an increased tendency to recur locally, invade regional lymph nodes, and metastasize distally to lung, liver, brain, bone, and skin. The sun-exposed skin of head and neck is the most frequent site of involvement (55%). We report the case of a 63-year-old Caucasian male patient who presented with a recurrent left inguinal mass for the third time after surgical resection with safe margins and no postoperative radio- or chemotherapy. The presented mass was excised, and pathological diagnosis revealed recurrent MCC. The patient underwent postoperative radiation therapy, and 6 months later, he developed a right groin mass which was resected and pathological diagnosis confirmed metastatic MCC. Six months later, patient developed an oropharyngeal mass which was unresectable, and pathological biopsy confirmed metastatic MCC. Patient was offered palliative radio- and chemotherapy. In this paper, we also present a brief literature review on MCC.
Acute Coronary Syndrome in Acute Myeloid Leukemia with Maturation Accompanying Megakaryocytic Differentiation
Authors: Kentaro Odani, Junya Abe, Yoshiaki Tsuyuki, Soshi Yanagita, Kazuya Shiogama, Mitsuhiro Tachibana, Yutaka Tsutsumi
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

An autopsy case (85-year-old Japanese male) of myeloperoxidase- (MPO-) positive acute myeloid leukemia with maturation (M1) accompanying megakaryocytic differentiation is presented. The patient manifested acute coronary syndrome. Even after emergent percutaneous coronary intervention, his performance status remained poor, so no chemotherapy against leukemia was given. The final white blood cell count reached 291,700/μL, and the platelet count was elevated to 510,000/μL. No cytogenetic studies were performed. He died at the 25th day of hospitalization. Autopsy revealed marked leukemic infiltration to the endocardium and subendocardial myocardium. Subendocardial myonecrosis was surrounded or replaced by the leukemic blasts, and neither granulation tissue reaction nor fibrosis was observed. In the cardiovascular lumen, lard-like blood clots were formed and microscopically consisted of leukemic blasts and platelets (leukemic thrombi). Infiltration of leukemic blasts was seen in the body cavities and systemic organs including the lung. The MPO-positive blasts lacked azurophilic granules and expressed the stem cell markers, CD34 and CD117 (c-kit). No features of myelofibrosis were seen in the 100% cellular marrow. In the endocardium, liver, lymph nodes, and bone marrow, megakaryocytic cells (CD42b/CD61+, MPO-) were distributed, while the small-sized blastic cells in the blood and tissues predominantly expressed MPO. The blasts lacked expression of CD42b/CD61. Megakaryocytic differentiation might be stimulated by certain tissue factors. AML accompanying megakaryocytic differentiation in certain tissues and organs should be distinguished from acute megakaryoblastic leukemia. The mechanisms provoking acute coronary syndrome in acute myeloid leukemia are discussed.
Usable comprehensive-factor authentication for a secure time attendance system
Authors: Chalee Vorakulpipat, Sasakorn Pichetjamroen, Ekkachan Rattanalerdnusorn
Journal: PeerJ Comput Sci (2021)
Keywords: access control, information security, mobile device, multi-factor authentication, time attendance, usability

In information security, it is widely accepted that the more authentication factors are used, the higher the security level. However, more factors cannot guarantee usability in real usage because human and other non-technical factors are involved. This paper proposes the use of all possible authentication factors, called comprehensive-factor authentication, which can maintain the required security level and usability in real-world implementation. A case study of an implementation of a secure time attendance system that applies this approach is presented. The contribution of this paper is therefore to provide a security scheme seamlessly integrating all classical authentication factors plus a location factor into one single system in a real environment with a security and usability focus. Usability factors emerging from the study are related to a seamless process including the least number of actions required, the lowest amount of time taken, health safety during the pandemic, and data privacy compliance.
Autonomic Neuropathy and Albuminocytologic Dissociation in Cerebrospinal Fluid As the Presenting Features of Primary Amyloidosis: A Case Report
Authors: Jingjing Li, Yi Li, Hongbing Chen, Shihui Xing, Huiyu Feng, Dawei Liu, Dilong Wang, Jinsheng Zeng, Yuhua Fan
Journal: Front Neurol (2017)
Keywords: albuminocytologic dissociation, autonomic neuropathy, biopsy, orthostatic hypotension, primary amyloidosis
MeSH terms: Case Reports

Objective:
Primary amyloidosis is a disease with a poor prognosis and multi-organ involvement. Here, we report the clinical and pathological features of a patient with primary amyloidosis featuring autonomic neuropathy as the initial symptom and albuminocytologic dissociation in the cerebrospinal fluid (CSF).
Methods:
The patient was a 60-year-old Chinese male with numbness, orthostatic hypotension, and gastrointestinal symptoms. For diagnosis, we performed an electromyogram (EMG), lumbar puncture, Bence Jones protein urine test, serum electrophoresis blood test, sural nerve and rectal membrane biopsies, transthyretin (TTR) gene sequencing, and bone marrow puncture.
Results:
Congo red staining of sural nerve and rectal membrane biopsies showed amyloid deposition and apple-green birefringence was visualized under polarized light microscopy. TTR gene sequencing showed no causative mutation. Following lumbar puncture, normal CSF cell counts and elevated CSF protein concentration (1,680 mg/L) were detected. Bone marrow puncture showed that out of the total number of whole blood cells, 0.56% were abnormal plasma cells and that 87.4% of the total number of plasma cells were abnormal. EMG results showed mixed peripheral nerve damage predominately in the sensory nerve fibers.
Conclusion:
Obvious symptoms of neuropathy, particularly autonomic neuropathy, albuminocytologic dissociation, and organ function damage suggested a diagnosis of amyloidosis. In such patients, neurologists should use caution to differentiate between chronic inflammatory demyelinating polyneuropathy, primary amyloidosis, and familial amyloid neuropathy.
Case report: Malignant vasovagal reflex syndrome during percutaneous transcatheter closure of patent foramen ovale
Authors: Zhiyang Li, Qian Dong, Lun Huang, Qiutang Zeng, Kunwu Yu
Journal: Front Cardiovasc Med (2023)
Keywords: cardiac arrest, malignant arrhythmia, percutaneous transcatheter closure of patent foramen ovale, vasovagal reflex syndrome, ventricular tachycardia
MeSH terms: Case Reports

Malignant vasovagal reflex syndrome can be induced by pulling of cardiac tissue during percutaneous transcatheter closure of patent foramen ovale. In this case, a patient presented with a malignant vasovagal reflex syndrome characterized by decreased heart rate, cardiac arrest, and ventricular tachycardia. Therefore, it's particularly important to observe patients' heart rate and timely deal with vasovagal reflex syndrome during the operation.
Carbon-Fiber-Reinforced PEEK Intramedullary Nails Defining the Niche
Authors: Georges F Vles, Maximillian H Brodermann, Mark A Roussot, James Youngman
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Background:
Carbon-fiber-reinforced Polyetheretherketone (CFR-PEEK) nails are gaining interest as they have biomechanical properties potentially capable of overcoming disadvantages of conventional metal nails.
Case summary:
Three cases are illustrated which required superior mechanical toughness, compatibility with radiotherapy, and postoperative advanced imaging.
Conclusion:
CFR-PEEK nails seem to have a niche role in distinct groups of patients.
Systemic p-ANCA vasculitis with fatal outcome, arising in the setting of methimazole use
Authors: Sean Hacking, Nupur N Uppal, Neelofar Khan, Marina Ionescu, Vanesa Bijol
Journal: Clin Nephrol Case Stud (2019)
Keywords: anca, drug-induced vasculitis, methimazole, vasculitis
MeSH terms: Case Reports

Here we report a fatal case of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) due to methimazole use in a 64-year-old woman. She was initially hospitalized for abdominal pain and possible colitis, and subsequently developed hematuria, renal failure, and hemoptysis. The serologic work-up revealed positive antinuclear antibody (ANA) and perinuclear-antineutrophilic cytoplasm antibodies (p-ANCA), with positive antimyeloperoxidase. Three weeks following admission, the patient was found to be pulseless, and expired. At autopsy, microscopic review included widespread transmural necrotizing vasculitis and crescentic glomerulonephritis in the kidney, and diffuse pulmonary alveolar hemorrhage; focal coronary artery intimal vasculitis and necrotizing pericarditis were also noted. Several drugs have been associated with the development of ANCA-positive diseases, including propylthiouracil, hydralazine, allopurinol, penicillamine, and levamisole in cocaine. Association of ANCA vasculitis with methimazole exposure is less known, and severe presentation with fatal outcome, as seen in our patient, is exceedingly rare. We reviewed clinical and histopathologic features of drug-induced ANCA vasculitis associated with methimazole to raise awareness of this potentially life-threatening complication associated with this agent.
Long-Term Follow-Up following Condylotomy in a Case of Traumatic Unilateral Anterosuperior Mandibular Condyle Dislocation
Authors: Syed Nabil, Elavarasi Kuppusamy, Rifqah Nordin, Abdul Jabar Nazimi, Roszalina Ramli
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Anterosuperior temporomandibular joint dislocation is rare. Manual reduction of such dislocation is difficult especially when treatment is delayed. Therefore, it has an increased likelihood of needing surgical intervention to achieve reduction. The authors report a case of an anterosuperior temporomandibular dislocation in a 19-year-old male following a motor vehicle accident. Difficulties were encountered in reducing the dislocation necessitating surgically assisted reduction. The long-term outcome following management by condylotomy is reported. This present report also reviews the literature regarding the classification and management of this uncommon dislocation.
Pulmonary Neuroendocrine Cell Hyperplasia Associated with Surfactant Protein C Gene Mutation
Authors: Norlalak Jiramethee, David Erasmus, Lawrence Nogee, Andras Khoor
Journal: Case Rep Pulmonol (2017)
MeSH terms: Case Reports

Familial interstitial lung disease (ILD) is defined as presence of ILD in 2 or more family members. Surfactant protein C (SFTPC) gene mutations are rare, but well-known cause of familial ILD. We reported a 20-year-old male, who was referred for lung transplantation. He was symptomatic at age 3 and underwent surgical lung biopsy at age 6, which revealed a nonspecific interstitial pneumonia (NSIP) pattern. Genetic workup revealed a novel SFTPC mutation in the first intron with a C to A transversion. At age 21, he underwent bilateral lung transplantation. Explanted lung histology suggested NSIP. In addition there was pulmonary neuroendocrine cell (PNEC) hyperplasia and carcinoid tumorlets. His mother had undergone lung transplantation several years earlier, and her explanted lung showed similar pathology. SFTPC mutations are inherited in an autosomal dominant pattern. Various types of ILD have been associated with SFTPC mutation including NSIP, usual interstitial pneumonia (UIP), and desquamative interstitial pneumonia (DIP). PNEC hyperplasia has been described to occur in association with lung inflammation but has not been previously described with familial ILD associated with SFTPC mutation.
Ureteral Obstruction Secondary to an Appendiceal Mucocele: A Case Report and Literature Review
Authors: Melody Djuimo, Liane S Feldman, Sero Andonian
Journal: J Endourol Case Rep (2018)
Keywords: appendix, management, mucocele, ureteral calculi, ureteral obstruction
MeSH terms: Case Reports

Background: Ureteral obstruction is rarely caused by extrinsic compression from the appendix. In addition, mucinous neoplasms of the appendix are rare, found incidentally in 0.2%-0.7% of appendectomy specimens. Case Presentation: We present an unusual case of ureteral obstruction caused by a large appendiceal mucocele. An asymptomatic 53-year-old caucasian male patient, known for recurrent nephrolithiasis, was referred for management of bilateral nephrolithiasis. A noncontrast CT scan found an atrophic kidney with an obstructive 1.8 cm right midureteral stone above a 9 × 4.3 cm appendiceal mucocele compressing the right midureter. Although the impacted ureteral stone was extracted with retrograde ureteroscopy and holmium laser lithotripsy, the appendiceal mucocele was resected by laparoscopic appendectomy. Final pathology analysis revealed an unperforated low-grade appendiceal mucinous neoplasm of 13 cm without lymphovascular invasion. Since the whole mucocele was completely excised, it did not require any further follow-up. Postoperative CT scan demonstrated stone-free status on the right side with residual mild right hydroureteronephrosis. A diuretic renal scintigraphy showed a nonobstructed right kidney with a chronically dilated pelvicaliceal system and a 34% differential function in the right kidney. Follow-up for up to 2 years postoperatively demonstrated that his diuretic renal scan did not show deterioration of the differential renal function, indicating that there was no significant obstruction. Conclusion: This is the fourth reported case of appendiceal mucocele causing extrinsic ureteral obstruction, and the secondary urinary stasis contributed to formation of a large midureteral stone and cortical renal atrophy. This case demonstrates the importance of the work-up and management of obstructive ureteral stones before definitive management of appendiceal mucoceles.
Primary osteosarcoma of the breast: a case report
Authors: Anna Rizzi, Alberto Soregaroli, Claudia Zambelli, Fausto Zorzi, Stefano Mutti, Claudio Codignola, Paola Bertocchi, Alberto Zaniboni
Journal: Case Rep Oncol Med (2013)

Introduction. Primary osteosarcoma of the breast is a rare soft-tissue form of osteosarcoma without involvement of the skeletal system. Due to the rarity of the disease, its clinical features and optimal treatment remain unclear. Case Presentation. This case report deals with a 62-year-old woman with pure osteosarcoma of the breast. Conclusions. The prognosis of primary osteosarcoma of the breast is poor. Recurrence is frequent, and it is often associated with haematogenous spread of the disease to the lung. Treatment follows the model of sarcomas affecting other locations and must be planned in a multidisciplinary fashion. Adjuvant chemotherapy should be considered for patients with tumors showing aggressive features.