OpenMed/multicare-articles huggingface dataset:
The Doppelgänger phenomenon and death: a peculiar case of homicide by a subject with first-episode psychosis
Authors: Cristiano Barbieri, Gabriele Rocca, Caterina Bosco, Lucia Tattoli, Ignazio Grattagliano, Giancarlo Di Vella
Journal: Forensic Sci Res (2022)
Keywords: doppelgänger, forensic sciences, criminal responsibility, delusional disorder, first-episode psychosis, forensic psychiatry, homicide
MeSH terms: Case Reports

The Doppelgänger phenomenon refers to the experience of a direct encounter with one's self, characteriswed by: (i) the perception of a figure with one's own identical physical features; or (ii) the apprehension that the perceived figure shares the same personality and identity. The Doppelgänger does not only look like the same person, it is his/her double. The perceptual element is usually a hallucination, although occasionally a false perception of an actual figure may be involved. This phenomenon has been described in individuals suffering from overwhelming fear, severe anxiety or intoxication, epilepsy, as well as in the sleep-wakefulness transition. It has also been reported in major psychoses. The fear of imminent death often precedes the Doppelgänger experience. This report presents the case of a 30-year-old man, Mr. Y, who was stabbed to death by Mr. X, his "double". The aggressor and his victim, although not related, were truly doubles; remarkably, they shared the same name and surname, age, professional activity and place of work. Moreover, they attended the same sports center but barely knew each other. The forensic psychiatric evaluations in Mr. X, subsequent to the crime committed, were suggestive of a psychotic condition. This case is unique in the scientific literature. In the most serious psychotic forms, the issue of the "double" calls into question not only the dissociative processes involved in the etiopathogenesis of the disorder, but also bio-psycho-social elements, as well as personal data in this case, which made the victim and the aggressor "identical". In the context of psychopathological functioning, the delusional mood (Wahnstimmung) that precedes the development of delirium is a sort of gateway to an impending psychotic illness, involving delusional awareness or mood (atmosphere). In psychosis, splitting is the main issue and this influence is seen as an evil, foreign, apocalyptic and unknown side no longer recognised as belonging to the self even in a physical sense. In such a situation, it is felt that the only way to survive is by suppressing one's double as a defense against disorganisation of the self.
Case report: Local bleomycin injection: A possible treatment option for primitive myxoid mesenchymal tumor of infancy
Authors: Binbin Yang, Qingjiang Chen, Yueling Zhu, Jianbing Wang, Ao Dong, Yi Chen, Xue He, Weizhong Gu, Zhigang Gao, Yunzhong Qian
Journal: Front Pediatr (2022)
Keywords: bleomycin injection therapy, necrosis response, primitive myxoid mesenchymal tumor of infancy, surgical prognosis, tumor necrosis
MeSH terms: Case Reports

In recent years, it has been determined that primitive myxoid mesenchymal tumors of infancy (PMMTI) are solid tumors. To date, very few cases of PMMTI have been reported, and there is no consensus regarding treatment. To provide additional references, it is necessary to collect and report the diagnoses and treatment outcomes of related cases. We report the case of a 38-day-old girl who presented with a 5-cm purple tumor in the right shoulder. Upon hospital admission, the patient received an intratumoral injection of bleomycin after diagnosis of a possible lymphangioma. 10 days after the treatment, the tumor began to develop inflammation and necrosis, resulting in a clear demarcation between the tumor and surrounding tissue. Hence, during the second hospitalization, we performed a successful tumor resection. Postoperatively, the tumor was pathologically diagnosed as PMMTI. 3 months after excision, the patient showed no local recurrence on re-examination. To the best of our knowledge, this is the first report of a PMMTI in which bleomycin, or other similar chemotherapeutic drugs, have been injected into tumors. This result offers novel insights into the treatment of PMMTI. Injection therapy with bleomycin and similar chemotherapeutics may result in specific responses to PMMTI, which may help in developing better surgical conditions or improving outcomes in non-surgical patients.
Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU
Authors: Nicolas Barbarot, Emmanuelle Nourry, Nicolas Massart, François Legay, Matthieu Debarre, Pierre Fillatre, Eric Magalhaes, Arnaud Mari, Julien Wallois, Eric Briens, Stéphane Jouneau
Journal: Case Rep Pulmonol (2022)
MeSH terms: Case Reports

Introduction:
About 10% of the 300 million people worldwide who suffer from asthma have a severe disease that is uncontrolled despite treatment with inhaled corticosteroids and long-acting beta agonists. The eosinophilic inflammation pathway in the respiratory tract and blood is involved and interleukin-5 (IL-5) has recently been identified as a major promotor of this pathway. The anti-IL-5 antibodies reduce the incidence of exacerbation and allowed steroid sparing in severe asthma patients but only two case reports have been published on their use in critical care. Case Presentation. This report describes the extraordinary clinical improvement of a young patient with steroid-refractory eosinophilic acute severe asthma who required mechanical ventilation, VV-ECMO followed by treatment with mepolizumab. The salient point in this case is the use of an anti-IL-5 monoclonal antibody for a critically ill patient whose condition was deteriorating despite mechanical ventilation and VV-ECMO. The usual steroid treatment failed to control the increase in blood eosinophils or his bronchial inflammation and constriction.
Conclusion:
Anti-IL-5 antibodies are now a standard treatment for severe eosinophilic asthma that can also be useful in an emergency to treat steroid-refractory eosinophilic acute severe asthma.
Thickening of the pulmonary artery wall in acute intramural hematoma of the ascending aorta
Authors: Martín Munín, María S Goerner, Martín Lombardero, Gustavo Sanchez, Juan C Pereira Redondo, Fernando Spernanzoni, Héctor Lardani, Víctor Torres
Journal: Cardiovasc Ultrasound (2007)
MeSH terms: Aortic Diseases / diagnostic imaging, Echocardiography, Transesophageal, Hematoma / complications, Hematoma / diagnostic imaging, Pulmonary Valve Stenosis / diagnostic imaging, Pulmonary Valve Stenosis / etiology, Case Reports, Acute Disease, Aged, 80 and over, Aorta / diagnostic imaging, Aortic Diseases / complications, Female, Humans

Background:
The occurrence of pulmonary artery obstruction in the course of acute aortic dissection is an unusual complication. The mechanism implicated is the rupture of the outer layer of the aorta and the subsequent hemorrhage into the adventitia of the pulmonary artery that causes its wall thickening and, at times, produces extrinsic obstruction of the vessel. There are no reports of this complication in acute intramural hematoma.
Case presentation:
An 87-year-old woman was admitted to the hospital in shock after having had severe chest pain followed by syncope. An urgent transesophageal echocardiogram revealed the presence of acute intramural hematoma, no evidence of aortic dissection, severe pericardial effusion with cardiac tamponade, and periaortic hematoma that involved the pulmonary artery generating circumferential wall thickening of its trunk and right branch with no evidence of flow obstruction. Urgent surgery was performed but the patient died in the operating room. The post mortem examination, in the operating room, confirmed that there was an extensive hematoma around the aorta and beneath the adventitial layer of the pulmonary artery, with no evidence of flow obstruction.
Conclusion:
This is the first time that this rare complication is reported in the scenario of acute intramural hematoma and with the transesophageal echocardiogram as the diagnostic tool.
Possibility of Using Flexible Dentures over Iliac Bone Graft in Adolescent Patients with Ameloblastoma: A 9-Month Follow-Up Clinical Report
Authors: Ammar Belal, Bassil Monther, Wael Alzarif
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Introduction:
The use of bone grafts is a common procedure after excision and reconstruction of the mandible, although it is rare in children and adolescents due to incomplete growth, which means a long transition period until reaching an appropriate age for implants or more predictable outcomes. Case Report. This article describes a 9-month follow-up of the use of a flexible denture above a bone graft taken from the anterior iliac crest for adolescent patients with resected mandible due to ameloblastoma. Taking into account prosthetic considerations, radiography, and clinical observation, no complications were seen with the graft.
Conclusion:
It is safe to use a flexible denture as a prosthetic over an iliac bone graft block during the healing period.
Peri- and Postoperative Treatment with the Interleukin-1 Receptor Antagonist Anakinra Is Safe in Patients Undergoing Renal Transplantation: Case Series and Review of the Literature
Authors: Catharina M Mulders-Manders, Marije C Baas, Femke M Molenaar, Anna Simon
Journal: Front Pharmacol (2017)
Keywords: anakinra, immunosuppressive drugs, interleukin 1, organ transplantation, renal transplantation

In patients undergoing solid organ transplantation, the presence of an interleukin-1 (IL-1) driven disease may require the addition of IL-1 inhibiting drugs to the standard immunosuppressive regimen to protect against inflammation and negative graft outcome. Three patients undergoing renal transplantation were treated perioperatively with the interleukin-1 receptor antagonist anakinra. Kidney function increased rapidly in all three and the only complications seen were minor infections. In vitro studies report associations between serum and urinary levels of IL-1β and IL-1 receptor antagonist and negative graft outcome, and studies in animals and two small human trials illustrate a possible protective effect of anti-IL-1 therapy after solid organ transplantation. Peri- and postoperative use of anakinra is safe and effective in patients undergoing renal transplantation.
Synchronous tuberculosis, Epstein-Barr virus-associated lymphoproliferative disorder and cytomegalovirus infection in an allogeneic transplant recipient: a case report
Authors: Benjamin Nils Ostendorf, Christian Friedrich Jehn, Lam Giang Vuong, Hendrik Nogai, Philipp Guido Hemmati, Bernhard Gebauer, Olaf Penack, Igor Wolfgang Blau, Ioannis Anagnostopoulos, Renate Arnold
Journal: Springerplus (2014)
Keywords: allogeneic stem cell transplantation, cytomegalovirus, epstein-barr virus, post-transplant lymphoproliferative disorder, tuberculosis

Background:
Allogeneic stem cell transplant recipients are prone to infections by various organisms. Tuberculosis (TB) represents a rare infectious complication, especially in countries non-endemic for TB.
Case report:
Here, we report the case of a German patient with exposure to TB decades before he was diagnosed with disseminated TB as well as synchronous Epstein-Barr virus associated lymphoproliferative disorder and cytomegalovirus infection after allogeneic stem cell transplantation for refractory acute myeloid leukemia. Tuberculostatic and virostatic therapy was administered and the patient could be discharged with no apparent signs of infection two weeks after initiation of therapy.
Conclusion:
This case illustrates the need for awareness of mycobacterial infections in patients from non-endemic regions undergoing stem cell transplantation even if other reasons for fever are present.
Recombinant chromosome 4 in two fetuses - case report and literature review
Authors: Yi Wu, Yanlin Wang, Shi Wu Wen, Xinrong Zhao, Wenjing Hu, Chunmin Liu, Li Gao, Yan Zhang, Shan Wang, Xingyu Yang, Biwei He, Weiwei Cheng
Journal: Mol Cytogenet (2018)
Keywords: congenital heart disease, prenatal diagnosis, rare genetic disorder, recombinant (4) syndrome
MeSH terms: Review

Background:
Recombinant chromosome 4 syndrome (rec 4 syndrome) is a rare genetic disorder, predominately resulting from a parental pericentric inversion of chromosome 4. To date, a total of 18 cases of rec (4) syndrome were published in literature. We report the first kindred of rec (4) syndrome analyzed using copy number variation sequencing (CNV-seq).
Results:
A woman with two adverse fetal outcomes was described in the present study. The first fetus presented with severe intrauterine growth restriction, hyposarca, hydrothorax and ascites. The CNV-seq revealed a dup 4q and del 4p. The second fetus presented with cardiovascular disease of ventricular septal defect, overriding aorta and persistent trunk. The CNV-seq revealed a dup 4p and del 4q. We collected 18 rec (4) cases through literature review. Genotype-phenotype correlation analysis was also performed.
Conclusion:
Recombinant 4 syndrome is a rare genetic disorder. It should be divided into two categories according to the alternative recombinant types. The clinical manifestations of rec (4) cases with dup 4q and del 4p are consistent with the Wolf-Hirschhorn syndrome. For cases harboring dup 4p and del 4q, the high incidence of congenital heart disease is prominent.
Merkel cell carcinoma with lymphoepithelioma-like pattern: a case report of an exceedingly rare variant of merkel cell carcinoma with lymph node metastases at presentation
Authors: Soumaya Ben Abdelkrim, Abdelmajid Dhouibi, Adnène Moussa, Rim Hadhri, Leila Njim, Khalifa Mighri, Abdelfatteh Zakhama
Journal: Case Rep Pathol (2011)
MeSH terms: Case Reports

Merkel cell carcinoma (MCC) or primary neuroendocrine carcinoma of the skin is a rare neoplasm with aggressive behavior. Primary lymphoepithelioma-like (LEL) carcinoma of the skin is a recently described exceptional tumor, with a relatively good prognosis, and is characterized by a neoplastic epithelial component associated with a dense lymphoid stroma. Rarely, MCC shows a marked lymphocytic host response or can even mimic a LEL carcinoma. We report a new case of MCC mimicking an LEL carcinoma in a 72-year-old male; the diagnosis of MCC was made on the basis of the morphology and immunohistochemical findings. We present through this case an exceptional pattern of MCC which can be misleading, and we insist on differential diagnoses.
Penile gangrene: an unusual complication of malignant priapism in a patient with renal cell carcinoma
Authors: Mohammed Aynaou, Amine Elhoumaidi, Tarik Mhanna, Paapa Dua Boateng, Mehdi Chennoufi, Ali Barki
Journal: Pan Afr Med J (2019)
Keywords: penile gangrene, malignant priapism, renal cell carcinoma
MeSH terms: Carcinoma, Renal Cell / diagnosis, Kidney Neoplasms / diagnosis, Penile Diseases / diagnosis, Priapism / diagnosis, Case Reports, Aged, Biopsy, Carcinoma, Renal Cell / pathology, Gangrene / diagnosis, Gangrene / etiology, Humans, Kidney Neoplasms / pathology, Male, Penile Diseases / etiology, Penile Diseases / pathology, Priapism / complications, Tomography, X-Ray Computed, Ultrasonography, Interventional

A 68-year-old man presented with priapism and penile gangrene. The patient had no history of penis trauma or medications for erectile dysfunction. Corpus cavernosa aspiration cytology were positive for malignant cells. Total penectomy was performed. Enhanced chest and abdominal computed tomography showed a left renal tumor with pulmonary and hepatic metastases. Ultrasound-guided renal biopsy showed clear cell renal cell carcinoma.
Perforated neonatal appendicitis with pneumoperitoneum
Authors: Yousuf Aziz Khan, Kanwal Zia, Nasir Salim Saddal
Journal: APSP J Case Rep (2013)
Keywords: mortality, neonatal appendicitis, pneumoperitoneum
MeSH terms: Case Reports

Acute appendicitis is a rare condition in neonates, with a high mortality. If perforated, it seldom presents with radiologically significant pneumoperitoneum. An 11-day-old newborn presented with abdominal distension and reluctance to feeds. X-ray abdomen revealed significant pneumoperitoneum. After optimization of his condition, exploratory laparotomy was performed. Perforated appendix was found and appendicectomy done. Post operative course was stormy that lead to demise of the baby.
Neuralgia of the glossopharyngeal nerve in a patient with posttonsillectomy scarring: recovery after local infiltration of procaine-case report and pathophysiologic discussion
Authors: L Fischer, S M Ludin, K Puente de la Vega, M Sturzenegger
Journal: Case Rep Neurol Med (2015)

We describe a patient with a three-year history of severe progressive left-sided glossopharyngeal neuralgia (GPN) that failed to adequately respond to various drug therapies. The application of lidocaine spray to the posterior pharyngeal wall provided no more than short-term relief. Apart from a large hypertrophic tonsillectomy scar on the left side all clinical and radiologic findings were normal. In terms of therapeutic local anaesthesia, the hypertrophic tonsillectomy scar tissue was completely infiltrated with the local anaesthetic (LA) procaine 1%. The patient has been almost completely pain-free ever since, and the lidocaine spray is no longer needed. Six weeks after the first treatment a repeat infiltration of the tonsillectomy scar led to the complete resolution of all symptoms. The patient has become totally symptom-free without the need to take any medication now for two and a half years. This is the first report of a successful therapeutic infiltration of a tonsillectomy scar using an LA in a patient with GPN that has been refractory to medical treatment for several years. A possible explanation may be that the positive feedback loop maintaining neurogenic inflammation is disrupted and "sympathetically maintained pain" resolved by LA infiltration.
Laser thermal ablation to treat a recurrent soft-tissue sarcoma of the leg: a case report
Authors: Chiara De Angelis, Paolo Della Vigna, Gianluca Maria Varano, Giovanni Mauri
Journal: Ecancermedicalscience (2019)
Keywords: amputation, interventional radiology, laser ablation, sarcoma
MeSH terms: Case Reports

We present the case of a 52-year-old male patient with recurrence of a soft-tissue sarcoma of the left leg treated with percutaneous laser ablation. The patient received the diagnosis of sarcoma for the first time in 2011; further local recurrences and a pulmonary metastatic spread occurred during follow-up, so the patient has been treated several times with chemotherapy, limb-sparing surgery and radiotherapy. In September 2017, a new local recurrence of sarcoma occurred, for which limb amputation was proposed but refused by the patient. Laser ablation with ultrasound guidance was performed, with complete ablation at 6 months and limb salvage.
Revitalizing quality of life: a case report on the beneficial impact of comprehensive rehabilitation therapy in treating upper-limb lymphedema following breast cancer surgery
Authors: Yan-Fang Sui, Lang-Qian Tong, Xia-Fei Lin, Hai-Xia Wu, Jing-Qin Shi, Shan-Shan Wang, Bu-He Tang, Zhen-Hua Song
Journal: Front Oncol (2023)
Keywords: breast cancer, comprehensive rehabilitation, functional brace, lymphedema, seven-step decongestion therapy
MeSH terms: Case Reports

Objective:
To underscore the paramount significance of incorporating comprehensive rehabilitation therapy as a crucial aspect of managing lymphedema caused by breast cancer surgery, and to illuminate our first-hand experience and insights gained in utilizing this approach.
Methods:
We present a case report of a breast cancer survivor who had been suffering from persistent left upper-limb edema for over 15 years, who was effectively treated with a combination of conventional rehabilitation (seven-step decongestion therapy) and a comprehensive rehabilitation program (seven-step decongestion therapy, along with core and respiratory function training, as well as functional brace wearing). The efficacy of the rehabilitation therapy was evaluated through a comprehensive assessment.
Results:
Although the patient underwent the conventional rehabilitation program for one month, only limited improvement was observed. However, after an additional month of comprehensive rehabilitation treatment, the patient exhibited significant improvement in both lymphedema and the overall function of the left upper limb. The patient's progress was quantified by measuring the reduction in arm circumference, which demonstrated a notable decrease. Furthermore, improvements in joint range of motion were observed, with forward flexion of the shoulder enhancing by 10°, forward flexion improving by 15°, and elbow flexion increasing by 10°. In addition, manual muscular strength tests revealed an increase in strength from Grade 4 to Grade 5. The patient's quality of life was also significantly improved, as evidenced by the increase in the Activities of Daily Living score from 95 to 100 points, the increase in the the Functional Assessment of Cancer Therapy: Breast score from 53 to 79 points, and the decrease in the Kessler Psychological Distress Scale score from 24 to 17 points.
Conclusion:
While seven-step decongestion therapy has been shown to be effective in reducing upper-limb lymphedema caused by breast cancer surgery, it has limitations in treating more chronic cases of the condition. However, when combined with core and respiratory function training and functional brace wearing, seven-step decongestion therapy has been shown to be even more effective in reducing lymphedema and improving limb function, ultimately leading to significant improvements in quality of life.
Comprehensive Molecular Profiling for Relapsed/Refractory Pediatric Burkitt Lymphomas-Retrospective Analysis of Three Real-Life Clinical Cases-Addressing Issues on Randomization and Customization at the Bedside
Authors: Kristyna Polaskova, Tomas Merta, Alexandra Martincekova, Danica Zapletalova, Michal Kyr, Pavel Mazanek, Zdenka Krenova, Peter Mudry, Marta Jezova, Jiri Tuma, Jarmila Skotakova, Ivana Cervinkova, Dalibor Valik, Lenka Zdrazilova-Dubska, Hana Noskova, Karol Pal, Ondrej Slaby, Pavel Fabian, Sarka Kozakova, Jakub Neradil, Renata Veselska, Veronika Kanderova, Ondrej Hrusak, Tomas Freiberger, Giannoula Lakka Klement, Jaroslav Sterba
Journal: Front Oncol (2020)
Keywords: burkitt lymphoma, pediatric oncology, precision medicine, targeted therapy, theranostics

In order to identify reasons for treatment failures when using targeted therapies, we have analyzed the comprehensive molecular profiles of three relapsed, poor-prognosis Burkitt lymphoma cases. All three cases had resembling clinical presentation and histology and all three patients relapsed, but their outcomes differed significantly. The samples of their tumor tissue were analyzed using whole-exome sequencing, gene expression profiling, phosphoproteomic assays, and single-cell phosphoflow cytometry. These results explain different treatment responses of the three histologically identical but molecularly different tumors. Our findings support a personalized approach for patient with high risk, refractory, and rare diseases and may contribute to personalized and customized treatment efforts for patients with limited treatment options like relapsed/refractory Burkitt lymphoma.
Summary:
The main aim of this study is to analyze three relapsed Burkitt lymphoma patients using a comprehensive molecular profiling, in order to explain their different outcomes and to propose a biomarker-based targeted treatment. In cases 1 and 3, the tumor tissue and the host were analyzed prospectively and appropriate target for the treatment was successfully implemented; however, in case 2, analyses become available only retrospectively and his empirically based rescue treatment did not hit the right target of his disease.