OpenMed/multicare-articles huggingface dataset:
What Drives Embryo Development? Chromosomal Normality or Mitochondria?
Authors: A Bayram, I Elkhatib, A Arnanz, A Linan, F Ruiz, B Lawrenz, H M Fatemi
Journal: Case Rep Genet (2017)
MeSH terms: Case Reports

Objective:
To report the arrest of euploid embryos with high mtDNA content.
Design:
A report of 2 cases.
Setting:
Private fertility clinic.
Patients:
2 patients, 45 and 40 years old undergoing IVF treatment.
Interventions:
Mature oocytes were collected and vitrified from two ovarian stimulations. Postthaw, survived mature oocytes underwent fertilization by intracytoplasmic sperm injection (ICSI). Preimplantation genetic screening (PGS) and mitochondrial DNA (mtDNA) copy number were done using next generation sequencing (NGS). The only normal embryo among the all-biopsied embryos had the highest "Mitoscore" value and was the only arrested embryo in both cases. Therefore, the embryo transfer was cancelled.
Main outcome measures:
Postthaw survival and fertilization rate, embryo euploidy, mtDNA copy number, and embryo development.
Results:
In both patients, after PGS only 1 embryo was euploid. Both embryos had the highest mtDNA copy number from all tested embryos and both embryos were arrested on further development.
Conclusions:
These cases clearly demonstrate the lack of correlation between mtDNA value (Mitoscore) and chromosomal status of embryo.
Fournier gangrene: rare complication of rectal cancer
Authors: Pierlesky Elion Ossibi, Tarik Souiki, Karim Ibn Majdoub, Imane Toughrai, Said Ait Laalim, Khalid Mazaz, Somuah Tenkorang, My Hassan Farih
Journal: Pan Afr Med J (2015)
Keywords: fournier's gangrene, complication, rectal cancer
MeSH terms: Adenocarcinoma / complications, Fournier Gangrene / etiology, Rectal Neoplasms / complications, Case Reports, Anti-Bacterial Agents / therapeutic use, Colectomy, Colon, Sigmoid / surgery, Debridement, Early Diagnosis, Emergencies, Fournier Gangrene / diagnosis, Fournier Gangrene / drug therapy, Fournier Gangrene / surgery, Humans, Male, Middle Aged, Necrosis, Perineum / pathology, Scrotum / pathology, Anti-Bacterial Agents

Fournier's Gangrene is a rare complication of rectal cancer. Its discovery is often delayed. It's incidence is about 0.3/100,000 populations in Western countries. We report a patient with peritoneal perforation of rectal cancer revealed by scrotal and perineal necrotizing fasciitis.
Endometrial Cytology as a Method to Improve the Accuracy of Diagnosis of Endometrial Cancer: Case Report and Meta-Analysis
Authors: Qing Wang, Qi Wang, Lanbo Zhao, Lu Han, Chao Sun, Sijia Ma, Huilian Hou, Qing Song, Qiling Li
Journal: Front Oncol (2019)
Keywords: atypical hyperplasia, cytology, diagnosis, endometrial cancer, histology

More and more researchers have reported that dilatation and curettage (D&C) or Pipelle had low accuracy, high misdiagnosis, and insufficient rate. Endometrial cytology is often compared with histology and seems to be an efficient method for the diagnosis of endometrial disorders, especially endometrial cancer. We report a case of misdiagnosed endometrial cancer by D&C, but with a positive cytopathological finding. Following that, a meta-analysis including 4,179 patients of endometrial diseases with cyto-histopathological results was performed to assess the value of the endometrial cytological method in endometrial cancer diagnosis. The pooled sensitivity and specificity of the cytological method in detecting endometrial atypical hyperplasia or cancer was 0.91[95% confidence interval (CI) 0.74-0.97] and 0.96 (95% CI 0.90-0.99), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 25.4 (95% CI 8.1-80.1) and 0.10 (95% CI 0.00-0.30), respectively. The diagnostic odds ratio which was usually used to evaluate the diagnostic test performance reached 260 (95% CI 36-1905). So we recommend that D&C and Pipelle are still practical procedures to evaluate the endometrium, cytological examinations should be utilized as an additional endometrial assessment method.
Psychogenic or neurogenic origin of agrammatism and foreign accent syndrome in a bipolar patient: a case report
Authors: Stéphane Poulin, Joël Macoir, Nancy Paquet, Marion Fossard, Louis Gagnon
Journal: Ann Gen Psychiatry (2007)

Background:
Foreign accent syndrome (FAS) is a rare speech disorder characterized by the appearance of a new accent, different from the speaker's native language and perceived as foreign by the speaker and the listener. In most of the reported cases, FAS follows stroke but has also been found following traumatic brain injury, cerebral haemorrhage and multiple sclerosis. In very few cases, FAS was reported in patients presenting with psychiatric disorders but the link between this condition and FAS was confirmed in only one case.
Case presentation:
In this report, we present the case of FG, a bipolar patient presenting with language disorders characterized by a foreign accent and agrammatism, initially categorized as being of psychogenic origin. The patient had an extensive neuropsychological and language evaluation as well as brain imaging exams. In addition to FAS and agrammatism, FG also showed a working memory deficit and executive dysfunction. Moreover, these clinical signs were related to altered cerebral activity on an FDG-PET scan that showed diffuse hypometabolism in the frontal, parietal and temporal lobes bilaterally as well as a focal deficit in the area of the anterior left temporal lobe. When compared to the MRI, these deficits were related to asymmetric atrophy, which was retrospectively seen in the left temporal and frontal opercular/insular region without a focal lesion.
Discussion:
To our knowledge, FG is the first case of FAS imaged with an 18F-FDG-PET scan. The nature and type of neuropsychological and linguistic deficits, supported by neuroimaging data, exclude a neurotoxic or neurodegenerative origin for this patient's clinical manifestations. For similar reasons, a psychogenic etiology is also highly improbable.
Conclusion:
To account for the FAS and agrammatism in FG, various explanations have been ruled out. Because of the focal deficit seen on the brain imaging, involving the left insular and anterior temporal cortex, two brain regions frequently involved in aphasic syndrome but also in FAS, a cerebrovascular origin must be considered the best explanation to account for FG's language deficits.
Congenital Adrenal Hyperplasia with Salt Wasting Crisis: A Case Report
Authors: Deepa Khanal, Deependra Mandal, Rajan Phuyal, Uttara Adhikari
Journal: JNMA J Nepal Med Assoc (2020)
MeSH terms: Adrenal Hyperplasia, Congenital / blood, Adrenal Hyperplasia, Congenital / diagnosis, Adrenal Hyperplasia, Congenital / physiopathology, Adrenal Hyperplasia, Congenital / therapy, Fludrocortisone / analogs & derivatives, Prednisolone / administration & dosage, Steroid 21-Hydroxylase / blood, Case Reports, 17-alpha-Hydroxyprogesterone / blood, Diagnosis, Differential, Fludrocortisone / administration & dosage, Humans, Infant, Long-Term Care / methods, Male, Steroids / administration & dosage, Water-Electrolyte Imbalance / diagnosis, Water-Electrolyte Imbalance / etiology, Steroids, 17-alpha-Hydroxyprogesterone, Prednisolone, Steroid 21-Hydroxylase, Fludrocortisone, fludrocortisone acetate

Congenital Adrenal Hyperplasia is a group of autosomal recessive disorders due to deficiencies of enzymes involved in steroidogenesis. The most common form is a 21-hydroxylase deficiency which can be classical or non-classical. The severe form also called Classical Congenital Adrenal Hyperplasia is usually detected after birth to infant period. If Congenital Adrenal Hyperplasia is not diagnosed and treated early, neonates are susceptible to sudden death in the early weeks of life. We report a case of thirty-five days male with a salt-wasting variant of congenital adrenal hyperplasia. The diagnosis was based on an elevated level of 17-hydroxyprogesterone. He was managed and life long oral Prednisolone and Fludrocortisone were prescribed. Keywords: 21-hydroxylase, congenital adrenal hyperplasia, case report.
A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis
Authors: Pinky Jha, Kurtis Swanson, Jeremiah Stromich, Basia M Michalski, Edit Olasz
Journal: Case Rep Dermatol Med (2017)
MeSH terms: Case Reports

Linear IgA bullous dermatosis (LABD) is an autoimmune vesiculobullous disease, which is typically idiopathic but can also rarely be caused by medications or infections. Vancomycin is the most common drug associated with LABD. Lesions typically appear 24 hours to 15 days after the first dose of vancomycin. It is best characterized pathologically by subepidermal bulla (blister) formation with linear IgA deposition at the dermoepidermal junction. Here we report an 86-year-old male with a history of left knee osteoarthritis who underwent a left knee arthroplasty and subsequently developed a prosthetic joint infection. This infection was treated with intravenous vancomycin as well as placement of a vancomycin impregnated joint spacer. Five days following initiation of antibiotic therapy, he presented with a vesiculobullous eruption on an erythematous base over his trunk, extremities, and oral mucosa. The eruption resolved completely when intravenous vancomycin was discontinued and colchicine treatment was begun. Curiously, complete resolution occurred despite the presence of the vancomycin containing joint spacer. The diagnosis of vancomycin-induced linear IgA bullous dermatosis was made based on characteristic clinical and histopathologic presentations.
Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor: A Case Report and Review of the Literature
Authors: Anoopa A Koshy, Ilyssa O Gordon, Thuong G Van Ha, Edwin L Kaplan, Louis H Philipson
Journal: J Investig Med High Impact Case Rep (2013)
Keywords: metastatic insulinoma, nonfunctioning pancreatic endocrine tumor, pancreatic endocrine neoplasm, recurrent hypoglycemia

A 56-year-old woman presented to our clinic for recurrent hypoglycemia after undergoing resection of an incidentally discovered nonfunctional pancreatic endocrine tumor 6 years ago. She underwent a distal pancreatectomy and splenectomy, after which she developed diabetes and was placed on an insulin pump. Pathology showed a pancreatic endocrine neoplasm with negative islet hormone immunostains. Two years later, computed tomography scan of the abdomen showed multiple liver lesions. Biopsy of a liver lesion showed a well-differentiated neuroendocrine neoplasm, consistent with pancreatic origin. Six years later, she presented to clinic with 1.5 years of recurrent hypoglycemia. Laboratory results showed elevated proinsulin, insulin levels, and c-peptide levels during a hypoglycemic episode. Computed tomography scan of the abdomen redemonstrated multiple liver lesions. Repeated transarterial catheter chemoembolization and microwave thermal ablation controlled hypoglycemia. The unusual features of interest of this case include the transformation of nonfunctioning pancreatic endocrine tumor to a metastatic insulinoma and the occurrence of atrial flutter after octreotide for treatment.
An unusual case of primary choriocarcinoma of the lung
Authors: Vincenzo Di Crescenzo, Paolo Laperuta, Filomena Napolitano, Chiara Carlomagno, Alfredo Garzi, Mario Vitale
Journal: BMC Surg (2013)
MeSH terms: Choriocarcinoma / diagnosis, Choriocarcinoma / surgery, Lung Neoplasms / diagnosis, Lung Neoplasms / surgery, Case Reports, Adult, Female, Humans

Choriocarcinoma is a germ cell tumor containing syncytiotrophoblastic cells and secreting human Beta-HCG. Primary choriocarcinoma of the lung is extremely uncommon. The prognosis of this tumor is extremely poor, despite surgical and chemotherapeutic treatment. We report a surgically treated case of choriocarcinoma in a 37-year-old woman who came to our attention because of a isolated lung lesion. The tumor was successfully resected. Chemotherapy was started 2 months after thoracic surgery and consisted of bleomycin, etoposide, and cisplatin. At 1-year follow-up the patient is alive in good condition. The hCG level is actually normal.
Recurrent desmoid tumor of the abdominal wall
Authors: Imane Toughrai, Aya Oufkir, Said Ait Laalim, Karim Ibn Majdoub, Khalid Mazaz
Journal: Pan Afr Med J (2012)
Keywords: desmoid tumor, abdominal wall, reconstruction, recurrent tumor
MeSH terms: Abdominal Neoplasms / surgery, Fibromatosis, Aggressive / surgery, Neoplasm Recurrence, Local / surgery, Case Reports, Abdominal Neoplasms / diagnosis, Abdominal Wall / pathology, Abdominal Wall / surgery, Adult, Digestive System Surgical Procedures, Female, Fibromatosis, Aggressive / diagnosis, Fibromatosis, Aggressive / pathology, Humans, Neoplasm Recurrence, Local / diagnosis, Plastic Surgery Procedures

Desmoid tumors most often occur in abdominal wall. Their tendency to recur lead to repeated operations which can make the abdominal wall reconstruction difficult. We report a 28-year-old female history. The patient was referred to our hospital for a recurrent desmoid tumor of the abdominal wall. The tumor was totally removed. The reconstruction was successful and the patient recovery was uneventful. Radical surgery still the mainstay of the desmoid tumors treatement. In abdominal wall location, the reconstruction can be a real challenge. Many procedures are discussed in literature. We used a double layer mesh covered by a fascial bepedicled flap. Taking into account their unpredictable behaviour and treatment complications, recurrent abdominal desmoid tumors can be managed simply and efficiently.
Candida Glabrata Lymphadenitis Following Infliximab Therapy for Inflammatory Bowel Disease in a Patient With Chronic Granulomatous Disease: Case Report and Literature Review
Authors: Heather Kristin Lehman, Rahool Davé
Journal: Front Pediatr (2021)
Keywords: cgd colitis, candida glabrata, tnf - α, chronic granulomatous disease (cgd), infliximab
MeSH terms: Case Reports

Chronic granulomatous disease (CGD) is an inborn error of immunity caused by inactivating genetic mutations in any one of the components of the phagocyte nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex. Phagocytic cell reactive oxygen species generation is impaired in the absence of a functional NADPH oxidase complex. As a result, patients with CGD are at high risk of developing deep-seated infections with certain bacteria and fungi. Additionally, aberrant inflammation and granuloma formation may occur in multiple organs including the bowels, with inflammatory bowel disease seen as a common inflammatory complication of CGD. Traditionally, TNF-α inhibitors are considered effective biological therapies for moderate-to-severe inflammatory bowel disease. While limited case series and reports of patients with CGD have shown improvement in fistula healing with use of TNF-α inhibitors, several patients have developed severe, even fatal, infections with CGD-related pathogens while on TNF-inhibitor therapy. In this case report, we describe an adolescent male with X-linked CGD and steroid-refractory colitis with perirectal fistula and abscesses, who was initiated on treatment with infliximab, a TNF-α inhibitor. Following his first two infliximab doses, the patient developed a Candida glabrata lymphadenitis and associated ulcerating oropharyngeal lesions, requiring hospitalization and therapy with amphotericin B for resolution. We compare our patient's case to prior reports of infliximab use in CGD-related inflammatory bowel disease.
Mandibular talon cusp in primary lateral incisor: a rare case report
Authors: Swaminathan Kavitha, Haridoss Selvakumar, Rajendran Barathan
Journal: Case Rep Dent (2012)

A talon cusp is a dental anomaly commonly occurring in the permanent dentition compared to the primary dentition. It commonly affects the maxillary anterior teeth. In primary dentition, the most commonly affected tooth is the maxillary central incisors. This is a rare case report of a 5-year-old male patient with a talon cusp affecting the mandibular primary lateral incisor. Recognition and treatment of this anomaly at early stages is important to avoid complications.
Interstitial ectopic pregnancy: a case report
Authors: Olayemi Atinuke Alagbe, Tinuola Omolade Adeniyi, Olawale Ayobami Abayomi, Emmanuel Olugbenga Onifade
Journal: Pan Afr Med J (2017)
Keywords: interstitial, ectopic pregnancy, ultrasonography
MeSH terms: Methotrexate / administration & dosage, Pregnancy, Interstitial / diagnostic imaging, Ultrasonography, Prenatal / methods, Case Reports, Abortifacient Agents, Nonsteroidal / administration & dosage, Adult, Female, Humans, Pregnancy, Pregnancy Trimester, First, Abortifacient Agents, Nonsteroidal, Methotrexate

Interstitial ectopic pregnancy is a rare type of tubal pregnancy that poses diagnostic challenge. It is associated with the highest risk of massive, uncontrollable bleeding and can result in uterine rupture in the second trimester. This is a rare case of unruptured interstitial ectopic diagnosed in the first trimester by ultrasonography and managed medically with systemic methrotrexate and serial ultrasound monitoring.`.
Atrial myxoma: a rare cause of hemiplegia in children
Authors: Uchenna Onubogu, Boma West, Boma Orupabo-Oyan
Journal: Cardiovasc J Afr (2017)
MeSH terms: Heart Atria / diagnostic imaging, Heart Neoplasms / complications, Hemiplegia / diagnostic imaging, Myxoma / complications, Case Reports, Child, Diagnosis, Differential, Echocardiography / methods, Female, Heart Atria / pathology, Heart Neoplasms / diagnostic imaging, Hemiplegia / etiology, Hemiplegia / physiopathology, Humans, Magnetic Resonance Imaging / methods, Myxoma / diagnostic imaging, Thrombosis / diagnosis

Background:
Atrial myxoma is an uncommon cause of hemiplegia in children. However hemiplegia is the commonest manifestation of atrial myxoma in the paediatric age group.
Case report:
An 11-year-old girl presented with left hemiplegia and palpitations. Three months later she had a deepvein thrombosis of the right common iliac vein. MRI of the brain showed a subacute right thalamic infarct, and an ECG showed left atrial and left ventricular hypertrophy. Transthoracic echocardiography revealed a left atrial myxoma impinging on the mitral valve. A diagnosis of left atrial myxoma with multiple thromboembolic events was made. She was placed on anticoagulants until she died while awaiting surgical tumour resection.
Conclusion:
Echocardiography should be done early in children presenting with ischaemic thromboembolic diseases in order to reduce morbidity and mortality rates resulting from cardiac pathology.
Pancreatico-gastric fistula arising from IPMN associated with ductal adenocarcinoma of the pancreas: a case report and a literature review
Authors: M AbuDalu, Y Munz, G Ohana
Journal: Front Surg (2023)
Keywords: ipmn, adenocarcinoma, case report, pancreatico-gastric fistula, total pancreatectomy
MeSH terms: Case Reports

Introduction:
An intraductal papillary mucinous neoplasm (IPMN) is a potentially malignant cystic tumor that is characterized by an excessive papillary proliferation of mucin-producing epithelial cells. The IPMN usually exhibits different degrees of dysplasia and is accompanied by cystic dilation of the main pancreatic duct (MPD) or side branch. We report a case of an IPMN that has penetrated the stomach and has differentiated into an adenocarcinoma.
Case presentation:
A 69-year-old female, suffering from chronic pancreatitis of unknown etiology, visited our outpatient clinic with complaints of sudden weight loss, diarrhea, and abdominal pain. She underwent several examinations to evaluate the reasons for her sudden onset of symptoms. A gastroscopy showed an ulcerated lesion covered with mucus. CT and magnetic resonance cholangiopancreatography images revealed that the MPD was dilated to 1.3 cm with a fistula formation between the MPD and the stomach. After a multidisciplinary discussion of this case, a total pancreatectomy was proposed. An en bloc total pancreatectomy with gastric wedge resection including the fistula together with splenectomy was carried out. A Roux-en-Y choledochojejunostomy and gastrojejunostomy were performed. Histology results revealed the association of IPMN with invasive carcinoma.
Discussion:
Many reports on IPMN of the pancreas have been published recently. Fistula formation between IPMN and adjacent organs is possible. Given the CT and endoscopic ultrasonography findings, it shows that in our case a main duct IPMN (MD-IPMN) formed a pancreatico-gastric fistula. We point out that the adherence of invasive cancer cells contributed to the fistula formation between the pancreas and the stomach.
Conclusion:
This case report provides evidence for the possibility of IPMN becoming complicated with pancreatico-gastric fistula. Thus, we suggest that surgical resection should be considered in the case of MD-IPMN because of its high propensity for malignant transformation.
The Functional Psychotherapy Approach: A Process-Outcome Multiple Case Study
Authors: Diego Rocco, Luca Rizzi, Gaia Dell'Arciprete, Raffaella Perrella
Journal: Front Psychol (2022)
Keywords: functional psychotherapy, multiple case study, process-outcome, psychotherapy outcome, psychotherapy process

Objective: The present work aims to conduct the first naturalistic empirical investigation of the process and outcome assessment of functional psychotherapy (FP) treatment. The FP model of psychotherapy is rooted in psychoanalysis and integrates the verbal communication approach founded on transference and countertransference dynamics with the analysis of bodily processes. Method: The study sample included ten patients recruited on a voluntary basis and treated by clinicians in their private practices. Each patient received FP with an average duration of 40 h (min 35 and max 42). Therapies had weekly sessions, were audio-recorded with the patient's written consent, and lasted for an average of 10 months (min 9 and max 12). Outcome and process tools included the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Luborsky's the Core Conflictual Relationship Theme (CCRT), used to assess therapeutic benefit, and the Metacognition Assessment Scale (MAS) and the Italian Discourse Attributes Analysis Program (IDAAP) system, used to evaluate therapeutic benefit and process. The MMPI-2 was used also in the follow-up assessment. Results: Results show that FP had a positive therapeutic outcome on the patients assessed in this study, and that the therapeutic benefits were maintained over time. Some specific features of the FP approach were found to contribute more than others to the observed therapeutic benefits. Conclusion: The current investigation constitutes a first step toward assessment of the therapeutic effectiveness of FP. Future developments should apply the methodology to a larger sample, possibly introducing different methodologies to enable detection of specific bodily oriented processes and techniques.