OpenMed/multicare-articles huggingface dataset:
AB thymoma revealed by a huge intraparenchymal lung mass: a case report
Authors: Btissame Es-Sabbahi, Mounia Serraj, Baderdine Alami, Mohammed Elbiaze, Mohammed Chakib Benjelloun, Bouchra Amara
Journal: Pan Afr Med J (2021)
Keywords: thymoma, case report, ectopics locations, primary intrapulmonary thymoma
MeSH terms: Lung Neoplasms / diagnostic imaging, Thymoma / diagnostic imaging, Thymus Neoplasms / diagnostic imaging, Case Reports, Female, Humans, Lung Neoplasms / secondary, Lung Neoplasms / therapy, Middle Aged, Neoadjuvant Therapy / methods, Thorax / diagnostic imaging, Thymoma / therapy, Thymus Neoplasms / therapy, Tomography, X-Ray Computed

Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior mediastinum. Unusually it can be found in other locations as well. Ectopic thymoma rarely presents as an intrathoracic tumor. We report a case of ectopic thymoma presenting as a giant right intrathoracic tumor, the patient was 51-year-old, and who was presented with heaviness in chest and breathlessness. Detailed investigation including chest computed tomography scan revealed a well-defined large solid tumor in the right thoracic cavity, in this case, immunohistochemical analysis demonstrated a thymome AB. The tumor was metastatic to the lung. Patient received a neoadjuvant chemotherapy, with favorable evolution.
Laparoscopic total extraperitoneal (TEP) mesh repair for femoral hernia in a patient of child B liver cirrhosis with ascites. A case report
Authors: Aditya Kumar, Manjunath Maruti Pol
Journal: Int J Surg Case Rep (2020)
Keywords: child b cirrhosis, femoral hernia, laparoscopic tep
MeSH terms: Case Reports

Introduction:
Femoral hernia is infrequently encountered in surgical practice and is even rare in patients with liver cirrhosis. Recurrent pain adds to the existing morbidity and affects the quality of life of these patients. Management of such cases had rather high rates of morbidity and mortality owing to hepatic decompensation. However, more recent studies have shown a significant improvement of the quality of life and improved rates of morbidity in cirrhotic patients with inguinal hernias post repair. These studies all included open hernia repair with preperitoneal approach with improved results in terms of morbidity and lower rates of recurrence postoperatively. However, when compared to laparoscopic repairs these have more postoperative complications, complication related re-operations, pain and recurrence rates. Keeping these in mind, the laparoscopic approach was considered in our patient which has not been described yet in literature for femoral hernia. The report is in line with the SCARE criteria. (Agha et al. (2018) [1]) The case report is registered with research registry (UID researchregistry5467).
Presentation of case:
A 40 year old female patient with Child B cirrhosis of liver with ascites was operated for a symptomatic left uncomplicated femoral hernia using standard three port laparoscopic total extraperitoneal repair with prolene mesh. She was discharged on postoperative day 2. She developed ascitic leak from the hypogastric port site in the late postoperative period which was managed conservatively. The patient has remained stable without recurrence at one year follow up.
Conclusion:
Laparoscopic TEP may be a safe option with no major adverse events in symptomatic femoral hernias. Further studies are needed to ascertain its role.
CD19 chimeric antigen receptor T-cell therapy following autologous stem cell transplantation against relapsed or refractory Burkitt lymphoma/leukemia: A case report and literature review
Authors: Mingyu Ye, Lei Gao, Tao Wang, Jiechen Yu, Jiaping Gui, Jianmin Yang
Journal: Front Oncol (2022)
Keywords: burkitt lymphoma, cd19, autologous stem cell transplantation, chimeric antigen receptor t-cell, leukemia
MeSH terms: Case Reports

Burkitt lymphoma or leukemia (BL) is a highly aggressive non-Hodgkin lymphoma. Older age (over 60 years old) and the presence of high-risk factors (such as abdominal mass, high levels of the serum lactic dehydrogenase, Ann Arbor stage II-IV and so on) usually predict a poorer outcome. Chimeric antigen receptor T cells (CART) have achieved remarkable success in the treatment of B-cell leukemia and lymphoma. Here, for the first time, we report a 61-year-old, high-risk BL patient with autologous stem cell transplantation (ASCT) bridging therapy prior to CART as consolidation therapy. Our findings demonstrate that the combination of ASCT and CART for BL is safe and feasible.
New Onset Insomnia in a Pediatric Patient: A Case of Anti-NMDA Receptor Encephalitis
Authors: Tamar N Goldberg, Michael F Cellucci
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Anti-NMDAR encephalitis is becoming more widely recognized as a cause of encephalopathy in both adults and children. Certain clinical features such as mood lability, movement disorders, speech dysfunction, seizures, and autonomic instability in a pediatric patient should prompt immediate concern and evaluation for autoimmune encephalitis among providers. We present the case of a pediatric patient with anti-NMDAR encephalitis in which the symptom prompting medical evaluation was insomnia. Insomnia has not previously been emphasized in the literature as a presenting feature of this disease in children and has a broad differential. Recognition of the symptoms of anti-NMDAR encephalitis and its variable presentation are key to early diagnosis and prompt initiation of treatment which may help to improve outcomes.
Adenoid Cystic Carcinoma of the Breast in a Male Patient: A Case Report and Literature Review
Authors: Dan Wan, Hongyuan Zhou, Yutao Zhang
Journal: Front Oncol (2022)
Keywords: myb, adenoid cystic carcinoma, differential diagnosis, immunohistochemistry, male breast cancer
MeSH terms: Case Reports

Adenoid cystic carcinoma (ACC) of the breast (breast ACC) is a rare tumor, especially in men, with only 17 cases reported in the literature. Owing to this rarity, male breast ACC is susceptible to missed or incorrect diagnoses, and data on treatment options and prognosis is also scarce. Herein, we report a case of a male patient with primary breast ACC and performed a detailed clinicopathological analysis of the 17 cases reported in the literature. A 38-year-old Chinese man patient developed right-sided breast nipple retraction in 2013 and presented to our hospital in 2015 with a palpable mass in the right breast for four days. B-scan ultrasound indicated the presence of a solid space-occupying lesion in the right breast. Breast Imaging Reporting and Data System (BI-RADS) classified the lesion as category 4B, and mammography showed a right breast nodule classified as BI-RADS 4C. Modified radical mastectomy for breast cancer was performed on the right breast. Microscopic examination of the excised tissue revealed diffuse tumor invasion of the subcutaneous fibers and adipose tissue, with tumor cells arranged in cribriform, tubular, and microcystic patterns. Immunohistochemical staining indicated that the glandular epithelial cells were positive for CD117, CK7, and Ki67 (approximately 30%) and negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, while the myoepithelial/basal cells were positive for P63, CK5/6 and S-100. Moreover, basement membrane materials were positive for collagen type IV. Molecular pathology analysis by fluorescence in situ hybridization revealed that the tumor was negative for MYB rearrangements. The patient was followed up for 82 months with no tumor recurrence or metastasis. According to the current literature, mastectomies have a better prognosis than lumpectomy. Accurately identifying the diagnosis of male breast ACC and considering the surgery of mastectomy may be the key factors for patients to obtain a good prognosis based on the microscopic characteristics of the tumor.
Epidemiology and prediction model of patients with carcinosarcoma in the United States
Authors: Mingjing Chen, Xiandong He, Qiao Yang, Jia Zhang, Jiayi Peng, Danni Wang, Kexin Tong, Wenxiang Huang
Journal: Front Public Health (2022)
Keywords: seer database, carcinosarcoma, epidemiology, initial treatment, nomogram
MeSH terms: Carcinosarcoma / epidemiology, Patients, Aged, Female, Humans, Multivariate Analysis, Nomograms, ROC Curve, United States / epidemiology

Background:
Carcinosarcoma is a rare biphasic tumor composed of both carcinoma and sarcoma elements, which occurs at various sites. Most studies are case reports or small population-based studies for a single disease site, so comprehensive evaluations of epidemiology and prognostic factors for carcinosarcoma are needed.
Methods:
Surveillance, Epidemiology, and End Results (SEER)-8 (1975-2019) provided data for the epidemiological analysis. SEER-17 (2000-2019) provided data on the primary tumor sites, initial treatment, construction, and validation of the nomogram.
Results:
The age-adjusted incidence per 100,000 persons of carcinosarcoma increased significantly from 0.46 to 0.91 [1975-2019; average annual percent change (AAPC): 1.3%, P = 0.006], with localized stage increasing from 0.14 to 0.26 [2005-2015; annual percent change (APC): 4.2%]. The 20-year limited-duration prevalence per 100,000 increased from 0.47 to 3.36 (1999-2018). The mortality per 100,000 increased significantly from 0.16 to 0.51 (1975-2019; AAPC: 1.9%, P < 0.001). The 5-year relative survival was 32.8%. The greatest number of carcinosarcomas were from the uterus (68.7%), ovary (17.8%), lung and bronchus (2.3%). The main treatment is comprehensive treatment based on surgery; however, surgery alone is preferred in older patients. In multivariate analysis (N = 11,424), age, sex, race, year of diagnosis, disease stage, tumor site, and treatment were associated with survival. A nomogram was established to predict 1-, 3-, and 5-year survival, and the C-indexes were 0.732 and 0.748 for the training and testing sets, respectively. The receiver operating characteristic curve demonstrated that the nomogram provided a comprehensive and accurate prediction [1-year area under the curve (AUC): 0.782 vs. 0.796; 3-year AUC: 0.771 vs. 0.798; 5-year AUC: 0.777 vs. 0.810].
Conclusions:
In this study, the incidence, prevalence, and mortality of carcinosarcoma have increased over the past decades. There was a rapid rise in the incidence of localized stage in recent years, which reflected improved early detection. The prognosis of carcinosarcoma remains poor, signifying the urgency of exploring targeted cancer control treatments. Explicating distribution and gender disparities of carcinosarcoma may facilitate disease screening and medical surveillance. The nomogram demonstrated good predictive capacity and facilitated clinical decision-making.
An unusual case of abdominal mycobacterial infection: Case report and literature review
Authors: Pieter Ekermans, Rene de Gama, Celeste Kock, Ebrahim Hoosien, Tomas Slavik, Terry Marshall, Craig Corcoran, Jakko van Ingen
Journal: South Afr J HIV Med (2019)
Keywords: 16s rrna sequence analysis, fastidious, line-probe assay, mycobacterium genavense, non-tuberculous mycobacterium, retractile mesenteritis

This article presents a case of an HIV-infected paediatric patient with an unusual Mycobacterium genavense infection with predominantly abdominal organ involvement.
Case report: Sevelamer-associated colitis-a cause of pseudotumor formation with colon perforation and life-threatening bleeding
Authors: Margareta Fistrek Prlic, Mislav Jelakovic, Marko Brinar, Dora Grgic, Ivan Romic, Zlatko Marusic, Ema Ivandic, Bojan Jelakovic, Ivana Vukovic Brinar, Zeljko Krznaric
Journal: Front Med (Lausanne) (2023)
Keywords: case report, chronic kidney disease, colon rupture, gastrointestinal bleeding, gastrointestinal lesion, sevelamer carbonate
MeSH terms: Case Reports

Chronic kidney disease (CKD) is a very common chronic non-communicable disease. Phosphate and calcium metabolism disorders are one of the most common features of CKD. Sevelamer carbonate is the most widely used non-calcium phosphate binder. Gastrointestinal (GI) injury associated with sevelamer use is a documented adverse effect but is underrecognized as a cause of gastrointestinal symptoms in patients with CKD. We report a case of a 74-year-old woman taking low-dose sevelamer with serious gastrointestinal adverse effects causing colon rupture and severe gastrointestinal bleeding.
National Partnership to Improve Dementia Care in Nursing Homes Campaign: State and Facility Strategies, Impact, and Antipsychotic Reduction Outcomes
Authors: Stephen Crystal, Olga F Jarrín, Marsha Rosenthal, Richard Hermida, Beth Angell
Journal: Innov Aging (2020)
Keywords: alzheimer’s disease and related dementias, antipsychotics, chemical restraints, sedative-hypnotics

Background and objectives:
Antipsychotic medications have been widely used in nursing homes to manage behavioral and psychological symptoms of dementia, despite significantly increased mortality risk. Use grew rapidly during the 2000s, reaching 23.9% of residents by 2011. A national campaign for safer dementia care in U.S. nursing homes was launched in 2012, with public reporting of quality measures, increased regulatory scrutiny, and accompanying state and facility initiatives. By the second quarter of 2019, use had declined by 40.1% to 14.3%. We assessed the impact of state and facility initiatives during the Campaign aimed at encouraging more-judicious prescribing of antipsychotic medications.
Research design and methods:
Our mixed-methods strategy integrated administrative and clinical data analyses with state and facility case studies.
Results:
Results suggest that substantial change in prescribing is achievable through sustained, data-informed quality improvement initiatives integrating educational and regulatory interventions, supported by public quality reporting. Adequate staffing, particularly of registered nurses, is key to support individualized management of symptoms through nonpharmacological strategies. Case study results suggest that state and facility initiatives during the campaign achieved considerable buy-in for the goal of more conservative prescribing, through a social process of normalization. Reporting and reduction of antipsychotic use was not followed by increases in sedative-hypnotic medication use. Rather, sedative-hypnotic use declined in tandem with antipsychotic reduction, suggesting that increased attention to prescribing patterns led to more cautious use of other risky psychotropic medications.
Discussion and implications:
Quality improvement initiatives to change entrenched but problematic clinical practices face many barriers to success, including provider-level inertia; perceptions that alternatives are not available; and family and staff resistance. Nevertheless, systemic change is possible through concerted, collaborative efforts that touch prescribing practices at multiple points; integrate educational and regulatory influences; activate local and state champions for improvement; foster reputational influences through public reporting and benchmarking; and support a social process of normalization of preferred care processes as a best practice that is in the interest of patients.
Extensor Tendon Dislocation at the Metacarpophalangeal Joint of Both Ring Fingers Caused by a Specific Hand Posture in a Shiatsu Therapist
Authors: Mariko Kamiya, Gen Sasaki, Kensuke Ikuta, Hideaki Miyamoto, Michio Kimura, Hirotaka Kawano
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

A 43-year-old female shiatsu therapist complained of sudden snapping of the metacarpophalangeal joints (MCPjs) of both ring fingers during a specific hand posture. The extensor tendon of the ring finger was dislocated ulnarly when the MCPj of the ring finger was flexed and deviated ulnarly and the MCPj of the middle finger was extended. Surgical exploration revealed an attenuated radial sagittal band. We plicated the juncturae tendinum of the extensor digitorum communis between the middle and ring fingers and released the ulnar sagittal band partially to centralise the extensor tendon excursion. Twenty-six months postoperatively, the patient regained full active and passive range of motion of all fingers without extensor tendon dislocation or snapping in either hand during work.
Preeclampsia, HELLP Syndrome, and Postpartum Renal Failure with Thin Basement Membrane Nephropathy: Case Report and a Brief Review of Postpartum Renal Failure
Authors: K C Janga, Pavani Chitamanni, Shraddha Raghavan, Kamlesh Kumar, Sheldon Greenberg, Kundan Jana
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

A 36-year-old primigravida female from a birthing center was referred for elevated blood pressure to the hospital two days after normal spontaneous vaginal delivery with nausea, vomiting, and diarrhea. During this two-day period, she was experiencing persistent vaginal bleeding and lower abdominal pains for which she took six doses of 600 mg ibuprofen. Further laboratory evaluation reflected leukocytosis, anemia, thrombocytopenia, elevation of liver enzymes, and renal failure with hyperkalemia requiring emergent hemodialysis once in the Medical Intensive Care Unit (MICU). She was diagnosed with HELLP syndrome with underlying preeclampsia. A week later, due to hypertension controlled with medications and nonoliguric renal failure with no active urine sediments, a renal biopsy was indicated to direct management. The renal biopsy supported the diagnosis of diffuse severe acute tubulointerstitial nephritis with hypereosinophilia and thin basement membrane nephropathy (see figures). She was subsequently treated with high-dose steroids which resulted in the normalization of blood pressures and renal function returning to baseline. We report the first case of acute tubulointerstitial nephritis in an individual with thin basement membrane nephropathy secondary to postpartum complications.
Macular edema is a rare finding in untreated vitreoretinal lymphoma: small case series and review of the literature
Authors: Elisa Carreras, Diva R Salomão, Jeroni Nadal, Sejal R Amin, Harish Raja, Thomas J Grube, Ryan L Geraets, Patrick B Johnston, Brian P O'Neill, Jose S Pulido
Journal: Int J Retina Vitreous (2017)
MeSH terms: Review

Background:
To determine the occurrence of macular edema (ME) in vitreoretinal lymphoma (VRL).
Methods:
Retrospective analysis of 17 patients (31 eyes) with VRL. A review of the literature was done as well.
Results:
Nine patients (15 eyes) had fluorescein angiography and/or optical coherence tomography at presentation. In the ME group (six eyes of four patients), three patients (five eyes) had prior chemotherapy and radiation. Excluding eyes with radiation retinopathy (three eyes), rate of ME was 25% (3/12). When two unirradiated fellow eyes of eyes with radiation retinopathy were also excluded, ME rate was 10% (1/10). Excluding the eyes with intraocular surgery, the rate of ME was 0%. In the group without ME (nine eyes of six patients), one patient (one eye) was treated with chemotherapy and radiation and three patients (five eyes) with chemotherapy. Review of the literature showed that the ME was found between 2 and 60% of cases, but most of the cases with ME had prior interventions.
Conclusions:
Macular edema in VRL is not uncommon but usually related to prior interventions. Macular edema as an initial presentation of VRL is rare.
Novel Homozygous TTI2 Variant Causing Autosomal Recessive Syndromic Intellectual Disability and Primary Microcephaly from Pakistan: A Case Report (Exome Report)
Authors: Zul Qarnain, Fatima Khan, Fizza Akbar, Salman Kirmani
Journal: Case Rep Genet (2022)
MeSH terms: Case Reports

We describe a male patient with a novel TTI2 variant, which has not been previously associated with a human phenotype. His features include intellectual disability, primary microcephaly, delayed psychomotor development, speech delay, short stature, dysmorphic facial features, esotropia, kyphoscoliosis, and behavior abnormalities (Figure). Next generation sequencing revealed autosomal recessive TTI2 variant with uncertain significance, denoted as c.21_22insAAGCGCTCTG (p.Glu8Lysfs × 12). TTI2 encodes a regulator of DNA damage response and helps maintain steady levels of the PIKK family of protein kinases. No disease-causing variants in other genes potentially linked to his clinical presentation were identified. We report a novel loss-of-function homozygous variant in TTI2 that leads to syndromic intellectual disability and primary microcephaly.
Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature
Authors: Aayush Adhikari, Surendra Khanal, Sagar Rana Magar, Srijana Thapa, Srijana Khati, Rajan Lamichhane, Kundan Marasini
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Aspergilloma (a saprophytic infection) typically colonizes lung cavities due to underlying diseases such as tuberculosis, bronchiectasis, cavitary lung cancer, sarcoidosis, and pulmonary infarctions. Rarely, aspergilloma has been noted within a hydatid cyst. Even if this was the case, it is more common to find the coexistence of aspergilloma and pulmonary echinococcal cysts in immunocompromised individuals. It is, however, very uncommon to find this coinfection in normal immune status individuals. Here, we report on the successfully treated case of a 30-year-old immunocompetent female from Western Nepal with histologically proven coinfection by these two pathogens. She had a prolonged history of exposure to domesticated dogs. She suffered from hemoptysis from time to time for 3 years with increased frequency in the last 30 days. She was misdiagnosed clinically during a past medical visit at a local health center. Her computed tomography (CT) scans showed well-defined nonenhancing cystic lesions in the anterior basal segment of the right lower lobe adjacent to the major fissure. She underwent enucleation of the cyst via right posterolateral thoracotomy. On further histopathological evaluation, laminated membranes of the ectocyst along with fungal elements were found, and periodic acid-Schiff (PAS) staining revealed Aspergillus in the form of septate hyphae and acute angle branching. Owing to patient's economic constraints and unavailability in our center, DNA testing and molecular characterization could not be performed which further highlights the essence of diagnosing and managing such cases in resource poor settings. Eventually, we reviewed 12 confirmed cases of this coinfection in immunocompetent individuals during a period of 7 years (2015-2022) comparing them to a systematic review of 22 confirmed cases of the same coinfection from 1995 to 2014.
Acute Kidney Injury Secondary to Rhabdomyolysis: A Case of Child Physical Abuse
Authors: Abdulaziz S Alrafiaah, Manal Alsaiari, Khamisa Almokali, Abdullah T Al Qahtani
Journal: Cureus (2023)
Keywords: acute kidney injury, child abuse, childhood maltreatment, non-accidental trauma, rhabdomyolysis
MeSH terms: Case Reports

Child abuse is a challenging problem that any healthcare worker might encounter. It can lead to multiple physical and psychological effects on the child. We report a case of an eight-year-old boy who presented to the emergency department with history of decreased level of consciousness and change in urine color. On examination, he was found to be jaundiced, pale, and hypertensive (160/90 mmHg) with multiple skin abrasions all over the body, suggestive of physical abuse. Laboratory investigations were consistent with acute kidney injury and significant muscle damage. The patient was admitted to intensive care unit (ICU) as a case of acute renal failure secondary to rhabdomyolysis, and subsequently required temporary hemodialysis during his stay in the ICU. The child protective team was involved in the case throughout his hospital admission. Rhabdomyolysis with acute kidney injury secondary to child abuse is an unusual presentation in children, and reporting such cases may lead to early diagnosis and initiation of prompt interventions.