OpenMed/multicare-articles huggingface dataset:
The gut-brain axis: historical reflections
Authors: Ian Miller
Journal: Microb Ecol Health Dis (2018)
Keywords: history of gut, history of emotions, history of gut–brain axis, history of microbiome, history of stomach

The gut-brain axis and the microbiome have recently acquired an important position in explaining a wide range of human behaviours and emotions. Researchers have typically presented developments in understandings of the microbiome as radical and new, offering huge potential for better understandings of our bodies and what it means to be human. Without refuting the value of this research, this article insists that, traditionally, doctors and patients acknowledged the complex interactions between their guts and emotions, although using alternative models often based on nerves or psychology. For example, nineteenth-century doctors and patients would have been well acquainted with the idea that their stomachs and minds were somehow connected, and that this interaction could produce positive or negative physical and mental health impacts. To demonstrate this, this article offers a snapshot of medical and public thought on (what we currently call) the gut-brain axis in the nineteenth and twentieth centuries, using Britain as a key case study due to the prevalence of gastric problems in that country. It commences by exploring how nineteenth-century doctors and patients took for granted the intimate relations between gut and mind and used their ideas on this to debate personal health, medical theory and social and political discourse. The article then moves on to argue that various medical sub-disciplines emerged (anatomy, physiology, surgery) that threatened to reduce the stomach to a physiologically complex organ but, in doing so, inadvertently began to erase ideas of a gut-mind connection. However, these new models proved unsatisfactory, allowing more holistic ideas of the body-mind relationship to continue to carry currency in twentieth-century psychological and medical thought. In the late century, pharmacological developments once again threatened to minimise the gut-brain axis, before it once again became popular in the early twenty-first century, now debated through a new language of microbiology.
Delayed diagnosis of lung cancer after missed vertebral metastasis on CT
Authors: M P H Hawkesford, S Kalogrianitis
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

A 71-year-old man presented with a 4-month history of severe atraumatic monolateral hip pain. Radiographs were normal, and MRI had to be aborted owing to heating up of a remnant of an old spinal cord stimulator. CT revealed squamous cell lung carcinoma with widespread metastases of the spine and pelvis, causing L1 nerve root compression. In retrospect, a lytic lesion consistent with spinal metastasis was found on CT taken 5 months previously, soon after the onset of hip pain, but this was missed by the reporting radiologist at that time. This case highlights that errors in radiology reporting are inevitable, but can be minimized by using a systematic approach to carefully review all available images to avoid missing unexpected pathology.
Large bowel obstruction in a young woman simulating a malignant neoplasm: a case report of actinomyces infection
Authors: R Nissi, R B Blanco Sequeiros, E Lappi-Blanco, H Karjula, A Talvensaari-Mattila
Journal: Case Rep Obstet Gynecol (2013)

Pelvic and intra-abdominal Actinomycosis can be difficult to diagnose preoperatively and it may also mimic many other diseases, including malignancies. We present a patient with pelvic Actinomycosis probably caused by a long-standing intrauterine device (IUD). We emphasize the challenges in diagnostic process and stress that though a rare disease, intra-abdominal Actinomycosis should be suspected in cases with intra-abdominal mass of uncertain etiology. The early recognition may spare the patient from extensive surgical operation.
Tracheostomal myiasis: a case report and review of the literature
Authors: S Prasanna Kumar, A Ravikumar, L Somu, P Vijaya Prabhu, Rajavel Mundakannan Subbaiya Periyasamy Subbaraj
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

"Myiasis" is considered in Hindu mythology as "God's punishment for sinners." It is known to infest live human or animal tissue. Literature abounds with reports of myiasis affecting the nasal cavity, ear, nonhealing ulcers, exophytic malignant growth, and cutaneous tissue. But report of myiasis of the tracheal stoma is rare. Only a few cases of tracheal myiasis have been reported in literature. We report a case of tracheostomal myiasis in an elderly male. The species which had infested the stoma was identified as Chrysomya bezziana, an obligate parasite. This is to our knowledge the first case report of an obligate parasite (Chrysomya bezziana) infestation of the tracheostoma from India.
Adenolipoleiomyoma Polyp of the Uterus: A Case Report and Review of the Literature
Authors: Xavier Catteau, Vincent Anaf, Jean-Christophe Noël
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Adenolipoleiomyoma is a very rare lesion of the uterus. Only four cases were reported. We describe one case of adenolipoleiomyoma presenting as a polyp in a postmenopausal woman with menorrhagia. Adenolipoleiomyoma is a very rare lesion and the histogenesis remains unclear. We discuss the origin and the differential diagnosis of this lesion.
Home-based functional walking program for advanced cancer patients receiving palliative care: a case series
Authors: Sonya S Lowe, Sharon M Watanabe, Vickie E Baracos, Kerry S Courneya
Journal: BMC Palliat Care (2013)
Keywords: cancer, palliative care, physical activity, quality of life, walking

Background:
Although meta-analyses have demonstrated that physical activity can positively impact quality of life outcomes in early stage cancer patients, it is not yet known whether these benefits can be extended to patients with advanced cancer. In a previous pilot survey of patients with advanced cancer with a median survival of 104 days, participants felt willing and able to participate in a physical activity intervention, and reported a strong preference for walking and home-based programming. Here, we report on the initial development and feasibility of a home-based functional walking program in patients with advanced cancer receiving palliative care.
Methods:
Nine adult patients were recruited from outpatient palliative care clinics and palliative home care. A pilot intervention trial was conducted over a 6-week period. The McGill Quality of Life Questionnaire (MQOL), Late Life Function and Disability Instrument (LLFDI), Edmonton Symptom Assessment System (ESAS), Seniors Fitness Test, four-test balance scale, and grip strength, were performed pre- and post-intervention. Participants wore activPAL™ accelerometers to monitor ambulatory activity levels.
Results:
Of the nine recruited participants, three participants dropped out prior to baseline testing due to hospital admission and feeling overwhelmed, and three participants dropped out during the intervention due to severe symptoms. Only three participants completed the intervention program, pre- and post-intervention assessments: two reported improvements in total MQOL scores, yet all three shared an overall trend towards worsening symptom and total fatigue scores post-intervention. Two participants passed away within 90 days of completing the intervention.
Conclusions:
This case series demonstrates the challenges of a physical activity intervention in patients with advanced cancer receiving palliative care. Further feasibility research is required in this patient population.
Trial registration:
This study is registered under ClinicalTrials.gov as NCT00438620.
Spectrum of surgical presentation of eosinophilic enteritis
Authors: Spoorthy Sudhakar Shetty, Charan Kishor Shetty
Journal: Case Rep Surg (2015)

Eosinophilic enteritis is a rare disorder presenting mostly with diarrhea, malabsorption, abdominal pain, weight loss, and hypersensitivity. Surgical manifestation of eosinophilic gastrointestinal disorders depends on the site and extent of involvement. In our case series of four patients two of them had ileocaecal masses with recurrent subacute intestinal obstruction with past history of intake of antitubercular drugs for 9 months. On histopathological examination both of them proved to have eosinophilic enterocolitis. Thus it is a clinical dilemma to differentiate between these two conditions. The other two patients presented as acute abdomen with perforation and intussusception. All four patients were treated surgically. Postoperatively they recovered well with no symptoms on one year follow-up. In Indian setup tuberculosis being rampant there may be under reporting or wrongly diagnosed cases of eosinophilic enteritis. Thus a strong clinical suspicion and awareness of this clinical entity are essential among surgical community.
Intermediate Autosomal Recessive Osteopetrosis With an Unusual Absence of Fractures
Authors: Ali Ishaque, Eisha Farid, Sharmeen Nasir, Laila Tul Qadar, Ammarah Jamal
Journal: Ochsner J (2022)
Keywords: genetic diseases–inborn, osteomyelitis, osteopetrosis
MeSH terms: Case Reports

Background: Osteopetrosis includes a variety of rare inherited skeletal disorders characterized by increased bone density and thickness. It has different clinical forms, including infantile autosomal recessive, intermediate autosomal recessive, and late-onset autosomal dominant forms. Intermediate autosomal recessive osteopetrosis (IARO) displays high variability. Case Report: A 10-year-old male presented to our pediatrics emergency department with abdominal distension, low-grade fever, and swelling of the right maxilla with associated discharge. His local physician had treated the lesion with drainage and aspiration of pus without improvement. Examination revealed pallor, hepatosplenomegaly, poor dentition, and dental caries. Eye examination showed reduced visual acuity, absent color vision, nystagmus, and bilateral optic nerve atrophy. Laboratory investigations showed anemia and thrombocytopenia. Radiography yielded classic features of osteopetrosis. Detailed intraoral examination revealed an area of exposed necrotic bone in the alveolar region of the right maxilla, leading to a diagnosis of IARO with underlying osteomyelitis. The intraoral wound was treated with bismuth iodoform paraffin paste dressing, and the infection was treated with antibiotics. Anemia and thrombocytopenia were managed supportively by transfusion of packed red blood cells and platelets. Conclusion: IARO commonly presents with multiple fractures, so the absence of fractures in our patient was unusual. Studies evaluating the intermediate variant are meager; hence, documenting its various presentations is essential to aid physicians in making early diagnoses. Osteomyelitis of the jaws is a feared complication in these patients. Therefore, practitioners need to be cautious of infections of dental origin.
Acute Intermittent Porphyria in a Man with Dual Enzyme Deficiencies
Authors: G N Cerbino, L Abou Assali, L S Varela, L Tomassi, A Batlle, V E Parera, M V Rossetti
Journal: Case Rep Genet (2020)
MeSH terms: Case Reports

Porphyrias are a heterogeneous group of metabolic disorders that result from the altered activity of specific enzymes of the heme biosynthetic pathway and are characterized by accumulation of pathway intermediates. Porphyria cutanea tarda (PCT) is the most common porphyria and is due to deficient activity of uroporphyrinogen decarboxylase (UROD). Acute intermittent porphyria (AIP) is the most common of the acute hepatic porphyrias, caused by decreased activity of hydroxymethylbilane synthase (HMBS). An Argentinean man with a family history of PCT who carried the UROD variant c.10_11insA suffered severe abdominal pain. Biochemical testing was consistent with AIP, and molecular analysis of HMBS revealed a de novo variant: c.344 + 2_ + 5delTAAG. This is one of the few cases of porphyria identified with both UROD and HMBS mutations and the first confirmed case of porphyria with dual enzyme deficiencies in Argentina.
Vertical root fracture: preservation of the alveolar ridge using immediate implants
Authors: Edmar de Oliveira Oya, Debora Pallos, Humberto Osvaldo Schwartz-Filho, William Cunha Brandt, Wilson Roberto Sendyk, Caio Vinicius Gonçalves Roman-Torres
Journal: Case Rep Dent (2014)

Teeth with vertical root fracture (VRF) have complete or incomplete fractures that begin in the root and extend toward the occlusal surface. The most frequent causes of VRF originate from physical trauma, occlusal prematurity, inadequate endodontic treatment, and iatrogenic causes. Diagnose is difficult and delay can cause stomatognathic system problem. The purpose of this case report was to evaluate immediate implant placement after extraction of teeth with vertical root fracture. For the 1st case, the VRF in 1st left lower molar was confirmed during surgical flap and at the same time, the tooth was removed and immediate implant was placed. For the 2nd case, the VRF 1st left lower molar was confirmed during endodontic access and at the same appointment, the tooth was removed and the immediate implant is placed. Several studies have shown that immediate implants have similar success rates when compared with late implants. Consider that this approach is a safe procedure with favorable prognosis. In cases of VRF, the main factor to be considered is the presence of adequate bone support and immediate implants can preserve the vertical bone height, adding the fact that good patient compliance reduces the number of surgical interventions and promotes the functionality of stomatognathic system.
Liposarcoma arising in the foot: a case report
Authors: Toshihiro Matsuo, Takashi Sugita, Shoji Shimose, Tadahiko Kubo, Yuji Yasunaga, Mitsuo Ochi
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Liposarcoma is categorized as a soft tissue sarcoma and most commonly appears in the lower extremities and rarely in the foot during adulthood. We present a very rare case report of a primary well-differentiated liposarcoma arising in the foot on a 60-year-old female. Marginal resection of the tumor with metatarsal ray amputation was eventually performed. The patient's postoperative course was uneventful without recurrence 5 years after the original operation. The authors review the literature and also report on the low incidence of this tumor arising in the foot.
Targeted next-generation sequencing approach for molecular genetic diagnosis of hereditary colorectal cancer: Identification of a novel single nucleotide germline insertion in adenomatous polyposis coli gene causes familial adenomatous polyposis
Authors: Dan Wang, Shengyun Liang, Xipeng Zhang, Subrata Kumar Dey, Yuwei Li, Chen Xu, Yongjun Yu, Mingsen Li, Guoru Zhao, Zhao Zhang
Journal: Mol Genet Genomic Med (2019)
Keywords: apc gene, chinese population, colorectal cancer, familial adenomatous polyposis, single nucleotide deletion, targeted next-generation sequencing
MeSH terms: Adenomatous Polyposis Coli / genetics, Adenomatous Polyposis Coli Protein / genetics, Germ-Line Mutation, Polymorphism, Single Nucleotide, Case Reports, Research Support, Non-U.S. Gov't, Adenomatous Polyposis Coli / pathology, Adult, Female, Genetic Testing / methods, Humans, Loss of Function Mutation, Male, Middle Aged, Pedigree, Sequence Analysis, DNA / methods, APC protein, human, Adenomatous Polyposis Coli Protein

Background:
Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited disease which primarily manifested with developing adenomas or polyps in colon or rectum. It is caused by the germline mutations in adenomatous polyposis coli (APC) gene. Patients with FAP are usually manifested with "hundreds or even thousands" adenomas or polyps in colon or rectum. However, without proper clinical diagnosis and timely surgical interventions, colorectal adenomas, or polyps gradually increase in size and in numbers which finally leads to colorectal cancer (CRC) at the mean age of 36 years of the patient.
Methods:
In this study, we identified a family with FAP. In this family, FAP has been diagnosed clinically based on symptoms, medical test reports, and positive family history for three generations. In order to unveil the molecular genetic consequences underlying the disease phenotype, we performed next-generation sequencing with a customized and designed panel of genes reported to be associated with hereditary CRC. The variant identified by next-generation sequencing has been validated by Sanger sequencing.
Results:
A heterozygous novel insertion [c.3992_3993insA; p.Thr1332Asnfs*10] in exon 16 of APC gene has been identified. This novel insertion is cosegregated well with the FAP phenotype among all the affected members of this family. This mutation causes a frameshift by the formation of a premature stop codon which finally results in the formation of a truncated APC protein of 1,342 amino acids instead of the wild type APC protein of 2,843 amino acids. Hence, this is a loss-of-function mutation. This mutation was not found in unaffected family members or in normal control individuals.
Conclusion:
Our present study emphasizes the importance of a novel approach of the gene panel-based high-throughput sequencing technology for easy and rapid screening for patients with FAP or CRC which will help the clinician for follow-up and management.
Case report: Drainage tube penetrating anastomosis as a rare cause for long-term nonunion of esophagogastric anastomosis in neck
Authors: Yaochen Huang, Xiangning Fu, Shengling Fu
Journal: Front Surg (2023)
Keywords: mckeown esophagectomy, anastomotic leakage, case report, cervical drainage, esophageal cancer
MeSH terms: Case Reports

Anastomotic leakage is a life-threatening complication for esophageal cancer patients who received McKeown esophagectomy. Cervical drainage tube penetrating anastomosis is a rare but noteworthy cause of long-term nonunion of esophagogastric anastomosis. Here we reported two cases of esophageal cancer patients who received McKeown esophagectomy. The first case acquired the anastomotic leakage on postoperative day (POD) 7, and lasted for 56 days. The cervical drainage tube was removed at POD 38, and the leakage healed in 25 days. The second case acquired the anastomotic leakage on POD 8 and lasted for 95 days. The cervical drainage tube was removed at POD 57, and the leakage healed in 46 days. The two cases demonstrated the duration-prolonging effect of drainage tube penetrating anastomosis, which should not be overlooked in clinical practice. We suggested paying attention to the duration of leakage, the drainage fluids amounts and characteristics, and the imaging manifestations to help diagnose. If the cervical drainage tube penetrated the anastomosis, the tube should be eliminated as soon.
Homicide and associated steroid acute psychosis: a case report
Authors: G Airagnes, C Rouge-Maillart, J-B Garre, B Gohier
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We report the case of an old man treated with methylprednisolone for chronic lymphoid leukemia. After two months of treatment, he declared an acute steroid psychosis and beat his wife to death. Steroids were stopped and the psychotic symptoms subsided, but his condition declined very quickly. The clinical course was complicated by a major depressive disorder with suicidal ideas, due to the steroid stoppage, the leukemia progressed, and by a sudden onset of a fatal pulmonary embolism. This clinical case highlights the importance of early detection of steroid psychosis and proposes, should treatment not be stopped, a strategy of dose reduction combined with a mood stabilizer or antipsychotic treatment. In addition have been revised the risks of the adverse psychiatric effects of steroids.
Surgical Intervention for Penile Methamphetamine Injections
Authors: Thomas W Gaither, E Charles Osterberg, Mohannad A Awad, Benjamin N Breyer
Journal: Case Rep Urol (2015)

Methamphetamine is a central nervous system stimulant and is the second most commonly used illicit drug after cannabis. Methamphetamine use for sexual pleasure is well documented. In this case report, we describe two cases presenting to our urban county hospital associated with complications related to penile injection of methamphetamine. Both patients developed penile abscesses and required urgent surgical incision and drainage. Penile abscesses represent a rare complication associated with IV drug administration into the penile corpora. Resultant penile abscesses require broad-spectrum antibiotics and surgical drainage. Further understanding of methamphetamine abuse along with the role it plays in sexual enhancement would be an invaluable addition to understanding of the rationale behind this self-administered stimulant. Drainage of penile abscesses associated with IV drug users may be hazardous to healthcare providers who are at risk from a needle stick injury.
Secondary SUNCT syndrome caused by dorsolateral medullary infarction
Authors: Di Jin, Ya-Jun Lian, Hai-Feng Zhang
Journal: J Headache Pain (2016)
Keywords: dorsolateral medullary infarction, sunct syndrome
MeSH terms: Lateral Medullary Syndrome / complications, SUNCT Syndrome / etiology, Case Reports, Research Support, Non-U.S. Gov't, Humans, Lateral Medullary Syndrome / diagnosis, Male, Middle Aged, SUNCT Syndrome / diagnosis

Short-lasting unilateral neuralgiform headaches with conjunctival injection and tearing (SUNCT) is a rare headache syndrome which belongs to trigeminal autonomic cephalalgias. Though the majority of SUNCT syndrome is idiopathic, more and more cases of secondary SUNCT syndrome have been reported recently. In this study, we present a case of symptomatic SUNCT syndrome caused by acute dorsolateral medullary infarction which was verified by brain MRI(magnetic resonance imaging). Up to now, there is not absolutely effective treatment for SUNCT syndrome. However, in our case, SUNCT was completely resolved after conventional treatment for cerebral infarction without specific drug intervention.
Case report: 18F-FDG PET confirmed pupil-sparing third nerve palsy heralding aseptic cavernous sinus embolism in patient with chest malignancy
Authors: Jianmei Xiong, Huanbo Liu, Jianyong Li, Jiajia Hou, Fang Cui
Journal: Front Surg (2022)
Keywords: 18f-fdg pet, cancer embolus, cavernous sinus embolism, diplopia, lung
MeSH terms: Case Reports

Classical cavernous sinus embolism is a rare clinical finding, presented most commonly by complaints of headache, diplopia, visual field defects, facial pain, and progressive neurological deficits. Many patients exhibit symptoms of III, IV, and VI nerve palsies. We hereby report a rare case of aseptic cavernous sinus embolism developed in a 75-year-old male with primary lung cancer who presented with binocular diplopia due to unilateral third and sixth cranial nerve palsies with pupil-sparing. The possibility of cavernous sinus cancer embolus should be considered if the routine examination excluded metastases, infiltration, carcinomatous meningitis, or the paraneoplastic process. 18F-FDG PET imaging may provide a promising diagnostic modality for the diagnosis of cancer embolus.