OpenMed/multicare-articles huggingface dataset:
Case report: catamenial hyperglycemia: the trigger of recurrent DKA in a female patient with three-year follow-up
Authors: Sumita Cholekho, Zuli Fan, Huiwen Tan
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: catamenial hyperglycemia, diabetes mellitus, diabetic ketoacidosis, luteal phase, menstrual cycle
MeSH terms: Diabetes Mellitus, Type 1 / complications, Diabetic Ketoacidosis / complications, Hyperglycemia / complications, Case Reports, Adult, Blood Glucose, Blood Glucose Self-Monitoring, Female, Follow-Up Studies, Humans, Young Adult, Blood Glucose

Background:
Catamenial hyperglycemia is a rare type of spontaneous, recurring Diabetic Ketoacidosis(DKA) in females during the luteal phase, most commonly observed in type 1 diabetes mellitus. Even with controlled serum glucose levels, adherence to a diabetic diet, medications, and in the absence of other common influencing factors such as infection, glucose levels tend to increase during the premenstrual period. This uncommon issue related to the menstrual cycle phase has not been extensively researched. Therefore, this study aims to diagnose catamenial hyperglycemia promptly and initiate early treatment to prevent complications.
Case report:
We presented a case of a 19-year-old girl who experienced recurrent DKA during the premenstrual period, without an apparent cause. She was admitted multiple times to various hospitals and sought consultations, undergoing numerous laboratory and imaging examinations, yet the etiology remained elusive. Ultimately, she received a diagnosis of catamenial diabetic hyperglycemia. To prevent recurrence of complications associated with catamenial hyperglycemia, we initiated a comprehensive approach which included continuous glucose monitoring, adherence to a strict diabetic diet, diabetic health education, regular exercise, timely medication administration, and increase in insulin dosage during the premenstrual period based on glucose levels.
Conclusions:
Although catamenial hyperglycemia is rare, it should be considered a cause of recurrent hyperglycemia in any postpubertal female to prevent complications. The specific underlying mechanisms responsible for catamenial hyperglycemia or DKA remain unidentified.
Cushing's syndrome caused by ACTH precursors secreted from a pancreatic yolk sac tumor in an adult-a case report and literature review
Authors: Johnny Yau Cheung Chang, Chariene Shao Lin Woo, Wing Sun Chow, Anne White, Ka Chung Wong, Po Tsui, Alan Chun Hong Lee, Eunice Ka Hong Leung, Yu Cho Woo, Kathryn Choon Beng Tan, Karen Siu Ling Lam, Chi Ho Lee, David Tak Wai Lui
Journal: Front Med (Lausanne) (2023)
Keywords: acth precursor, cushing’s syndrome, ectopic acth syndrome, pancreatic tumor, yolk sac tumor
MeSH terms: Case Reports

Here, we report the first adult case of pancreatic yolk sac tumor with ectopic adrenocorticotropic hormone (ACTH) syndrome. The patient was a 27-year-old woman presenting with abdominal distension, Cushingoid features, and hyperpigmentation. Endogenous Cushing's syndrome was biochemically confirmed. The ACTH level was in the normal range, which raised the suspicion of ACTH precursor-dependent disease. Elevated ACTH precursors were detected, supporting the diagnosis of ectopic ACTH syndrome. Functional imaging followed by tissue sampling revealed a pancreatic yolk sac tumor. The final diagnosis was Cushing's syndrome due to a yolk sac tumor. The patient received a steroidogenesis inhibitor and subsequent bilateral adrenalectomy for control of hypercortisolism. Her yolk sac tumor was treated with chemotherapy and targeted therapy. Cushing's syndrome secondary to a yolk sac tumor is extremely rare. This case illustrated the utility of ACTH precursor measurement in confirming an ACTH-related pathology and distinguishing an ectopic from a pituitary source for Cushing's syndrome.
Bilateral high origin and superficial trajectory of the deep femoral artery: clinical and applied anatomy
Authors: Gabriel Deveaux, William P Mayer
Journal: Autops Case Rep (2024)
Keywords: anatomic variation, anatomy, regional, case reports, dissection, femoral artery
MeSH terms: Case Reports

The anatomy of the femoral triangle is explored in various approaches, ranging from pulse verification to invasive catheterization procedures. Within the femoral triangle, the deep femoral artery is one of the vessels reported to present several anatomical variations that must be considered before clinical or surgical interventions. Here, we are reporting a unique bilateral variation of the deep femoral artery for medical education purposes and reflecting on its applied, surgical, and clinical anatomy. During the dissection of the femoral triangle, we observed that the deep femoral artery originated in the vicinity of the inguinal ligament and ran in parallel with the femoral artery in a superficial trajectory on both sides of the donor. On the right side, the DFA continued superficial for 8.8 cm, with an origin of 1.2 cm inferior to the inguinal ligament. On the left side, it presented a similar anatomical arrangement, though with an origin of 1.6cm inferior to the inguinal ligament and a superficial course of 5cm. The position of the lateral circumflex femoral vein posterior to the deep femoral artery played a role in this distinctive, lengthy, and superficial presentation of the deep femoral artery. This anatomical variation directly affects surgical procedures, diagnostics, and endovascular interventions. A deep femoral artery with such a lengthy superficial trajectory can be mistakenly used for catheterization instead of the femoral artery or be injured, disrupting the main blood supply of the thigh muscles.
Case report: A 53-year-old woman with synchronous WHO classification II and IV gliomas
Authors: Fang Jia, Yin Kang, Zhanxiang Wang
Journal: Front Oncol (2024)
Keywords: idh, who grade, astrocytoma, case report, glioblastoma, synchronous
MeSH terms: Case Reports

Introduction:
Glioma is the most common primary intracranial neoplasm with a relatively poor prognosis.
Case presentation:
Here, we present a unique case of a 53-year-old woman with two histopathologically distinct gliomas at the initial diagnosis. She presented with headaches and left limb weakness before admission, and magnetic resonance imaging (MRI) showed right frontal and basal ganglia area involvement combined with hemorrhage. The patient underwent a navigation-guided craniotomy for tumor removal. Pathological examination revealed the right frontal lobe lesion as a WHO grade II IDH-NOS astrocytoma, but the right parietal lobe lesion was a WHO grade IV IDH-mutant diffuse astrocytoma. Molecular detection of the parietal lesion revealed a point mutation at the R132 locus of the IDH1 gene, no mutation in the TERT promoter, amplification of the epidermal growth factor receptor, and a non-homozygous CDKN2A/B deletion.
Discussion:
In-depth epigenomic analysis and molecular examination revealed that one patient had two different brain tumors, underscoring the importance of performing a comprehensive brain tumor workup.
Conclusion:
This unique case confirms that adjacent astrocytomas may have different molecular pathogenesis and provides novel insights into the development of gliomas.
Iliacus Myositis and Bacteremia Caused by Non-typhoidal Salmonella in a Healthy Adult: A Case Report
Authors: Yu Miyazaki, Takuya Adachi
Journal: Cureus (2024)
Keywords: abscess, bacteremia, extra-intestinal focal infection, iliacus myositis, immunocompetent, non-typhoidal salmonella
MeSH terms: Case Reports

Typically, non-typhoidal Salmonella (NTS) causes gastroenteritis; however, NTS can also lead to extraintestinal manifestations like bacteremia, meningitis, and abscess in vulnerable populations such as children, elderly, and immunocompromised individuals. Extraintestinal manifestations in an immunocompetent patient are uncommon. Here, we report a case of iliacus myositis and bacteremia caused by NTS in a healthy adult. A previously healthy 23-year-old Japanese woman presented to the emergency room due to a one-day history of vomiting, abdominal pain, and diarrhea. She had a fever, and her blood test showed leukocytosis. Computed tomography (CT) of the abdomen and pelvis revealed a thickening of the ascending colon. She was diagnosed with gastroenteritis and treated with antibiotics. Blood culture at that time was negative, but Salmonella serogroup 09 was detected in stool culture. Subsequently, her symptoms improved; however, on day 13, she returned to our hospital complaining of pain in her left thigh. CT scan of the abdomen and pelvis revealed no abscess or muscle inflammation, but due to persistent symptoms, the patient was admitted to the hospital, and antibiotics were initiated. Salmonella serogroup 09 was detected from the blood culture obtained at the time of admission. Magnetic resonance imaging of the hip joint and CT of the abdomen and pelvis after admission revealed inflammation in the left iliacus muscle and an abscess near the left ilium. The patient was treated successfully with antibiotics. This case highlights two findings. First, NTS can cause bacteremia even in a healthy adult with no risk factors for bacteremia. Second, NTS bacteremia can cause complications in an immunocompetent adult. This case implies that even in the case of NTS infection in otherwise healthy individuals, if there are signs of bacteremia or complications, it is essential to conduct blood culture and additional tests.
Assessing the spatial equity of the aged care institutions based on the improved potential model: a case study in Shanghai, China
Authors: Chenyang Wang, Xiuli Geng
Journal: Front Public Health (2024)
Keywords: aged care institutions, improved potential model, spatial configuration, spatial distribution, spatial equity
MeSH terms: Spatial Analysis, Aged, China, Health Services Accessibility / statistics & numerical data, Homes for the Aged / standards, Homes for the Aged / statistics & numerical data, Humans, Nursing Homes / statistics & numerical data

With the spread of an aging society, the demand for aged care institutions among older adults is increasing. The inadequate supply and distribution of aged care institutions have led to an increasing concern about spatial equity in aged care institutions. Most studies have utilized accessibility to assess spatial equity from the supply perspective, while the demand perspective has received little attention. In addition, few studies have evaluated the spatial equity of aged care institutions at grid resolution. Therefore, this study takes Shanghai as an example to analyze aged care institutions from both the supply and demand perspectives. By proposing an improved potential model, at a network resolution of 500 × 500, the spatial equity of aged care institutions is more refined. The results show that aged care institutions and the older population in Shanghai are predominantly concentrated in the downtown area and surrounding regions. However, the results obtained from the Lorenz curve and Gini coefficient indicate the allocation of pension beds based on population size is proportional across different districts of Shanghai. When considering the quality indicators of aged care institutions and introducing the improved potential energy model to calculate spatial accessibility, an imbalance between regions in Shanghai still exists and needs further optimization.
Case report: Clinical and neuroradiological longitudinal follow-up in Leukoencephalopathy with Calcifications and Cysts during treatment with bevacizumab
Authors: Elena Scaffei, Bianca Buchignani, Rosa Pasquariello, Paola Cristofani, Raffaello Canapicchi, Laura Biagi, Flavio Giordano, Emanuela De Marco, Yanick J Crow, Roberta Battini
Journal: Front Neurol (2023)
Keywords: lcc, labrune syndrome, mri, bevacizumab, calcifications, cysts, inherited white matter disease, leukoencephalopathy
MeSH terms: Case Reports

Leukoencephalopathy with Calcifications and Cysts (LCC) is a rare genetic microangiopathy exclusively affecting the central nervous system caused by biallelic mutations in SNORD118. Brain magnetic resonance imaging (MRI) is often diagnostic due to the highly characteristic triad of leukoencephalopathy, intracranial calcifications, and brain cysts. Age at onset, presentation and disease evolution can all vary, ranging from pauci-symptomatic disease to rapid evolution of signs with loss of motor and cognitive abilities. No specific therapies for LCC are currently licensed. According to the literature, bevacizumab might represent an effective modality to improve the clinical and MRI features of the disease. However, uncertainty remains as to the true efficacy of this approach, when to begin therapy, appropriate dosing, and the consequences of drug withdrawal. According to CARE guidelines, we describe the long-term clinical and neuro-radiological follow-up of a 10-year-old child with LCC. We report disease evolution following repeated cycles of treatment with bevacizumab. Our case report suggests that repeated cycles of bevacizumab might effectively modify disease progression, possibly indicating a time-dependent effect.
Treatment of type 2 diabetes and stress using neuro-emotional technique: case report
Authors: Peter Bablis, Ryan R Day, Henry Pollard
Journal: Front Endocrinol (Lausanne) (2024)
Keywords: adverse childhood experiences (aces), allostatic load, neuro-emotional technique (net), psycho-immune-neuroendocrine (pine) network, stress, type 2 diabetes (t2d)
MeSH terms: Diabetes Mellitus, Type 2 / psychology, Diabetes Mellitus, Type 2 / therapy, Stress, Psychological / therapy, Case Reports, Blood Glucose / analysis, Blood Glucose / metabolism, Humans, Male, Middle Aged, Mind-Body Therapies / methods, Blood Glucose

This case report presents a novel, non-pharmacological treatment of Type 2 Diabetes in a 46-year-old male, demonstrating improvements in blood chemistry and psychometric markers after 8 treatments using a Mind-Body Intervention (MBI) called Neuro-Emotional Technique (NET). The patient presented with a diagnosis of Type 2 Diabetes (T2D), pain, psychosocial indicators of stress and anxiety, and a score of 4 on the ACE-Q (Adverse Childhood Experiences Questionnaire) that is consistent with a predisposition to chronic disease and autoimmune disorders. Glucose levels for this patient were above normal levels (typically between 10-15mmol/L where optimal range is between 4-10mmol/L) for at least two months prior to the 4-week NET intervention period, despite the standard use of conventional antidiabetic medications (insulin injections). The patient exhibited numerous indictors of chronic stress that were hypothesised to be underlying his medical diagnosis and a series of 8 NET treatments over a period of 4 weeks was recommended. Psychometric tests and glucose measurements were recorded at baseline (prior to treatment), 4 weeks (at the conclusion of treatment) and at 8 weeks (4 weeks following the conclusion of treatment). Results show that glucose levels were reduced, and self-reported measures of depression, anxiety, stress, distress and pain all decreased from high and extreme levels to within normal ranges after 4 weeks, with ongoing improvement at 8 weeks. McEwen described the concept of allostatic load and the disruptive effects that cumulative stress can have on both mental and physical health. It is hypothesized that NET reduces allostatic load thereby fortifying homeostasis and the salutogenic stress response mechanisms involved in recovery from chronic illness, possibly via the Psycho-Immune-Neuroendocrine (PINE) network. Further studies with larger sample sizes are required to establish whether these results could be extrapolated to a wider population, however the results of this case suggest that it may be beneficial to consider co-management of T2D with an MBI such as NET.
Incidental Petrous Apex Cephalocele Presenting With Transient Global Amnesia: A Case Report and Rapid Literature Review
Authors: Alexandros Brotis, Mariana Vlychou, Ioannis Ioannidis
Journal: Cureus (2024)
Keywords: asymptomatic, empty sella, magnetic resonance imaging, petrous apex cephalocele, transient global amnesia
MeSH terms: Case Reports

Transient global amnesia (TGA) constitutes a rare clinical entity that manifests with temporary memory without any other neurological manifestation. Several pathogenetic mechanisms have been implicated, including temporal hypoperfusion, venous congestion, and cortical spreading potentials. Accordingly, the only relevant imaging findings are hippocampal CA1 areas of restricted diffusion on diffusion-weighted images. In the current case report, we present the rare case of a patient with TGA associated with bilateral petrous apex cephalocele (PAC). A 63-year-old female presented with a single episode of transient memory. The brain MRI showed a bilateral PAC and an empty sella. The patient was neurologically intact upon examination and was conservatively managed. There was no symptom recurrence during the six months of follow-up. We hypothesize that the presence of the meningocele could be associated with the pathogenesis of TGA. To the best of our knowledge, this is the first case of a petrous apex meningocele presenting with TGA. Most previously reported patients were females in their fourth decade of life, usually presenting with headaches or incidentally. Almost half of the cases were bilateral, with an empty sella. Surgical treatment was reserved for symptomatic patients with cerebrospinal fluid leaks and excruciating trigeminal neuralgia. Patients with TGA may be associated with temporal lesions, including PAC. Likewise, PAC is an extremely rare clinical entity that could occasionally present with TGA.
Cranial Conundrum: An Unusual Case of an Epidermoid Cyst in the Prepontine Cistern
Authors: Joseph Russo, Bradley Thompson, Nida Ansari, Malina Mohtadi, Sacide S Ozgur, Patrick Michael
Journal: Cureus (2024)
Keywords: cerebello-pontine angle tumour, cp angle, ct and mri brain, cystic brain tumor, epidermoid cysts, transphenoidal surgery
MeSH terms: Case Reports

We present a fascinating case of a patient who suffered from persistent headaches for three months due to an epidermoid cyst located in the prepontine cistern. Epidermoid cysts are a very uncommon type of intracranial tumor, known for their slow growth and gradual onset of neurological symptoms. In this particular case, our patient, a 35-year-old, experienced a headache that was accompanied by dizziness, photophobia, and pain when moving their eyes. Further imaging revealed a cystic lesion in the prepontine cistern, which had a mass effect on the pons. After confirming the lesion was likely an epidermoid cyst through an MRI, the patient underwent surgery to have it removed. We hope to highlight the rarity of this type of tumor and its unique features when viewed through imaging.
Renal cell oncocytoma tumor evolutions: a case report
Authors: Alaa Khalid Alduraibi, Noora Bin Essa, Jamshed Bomanji
Journal: Front Oncol (2024)
Keywords: fdg pet/ct, i123 scan, renal cancer, renal cell oncocytoma, thyroid cancer
MeSH terms: Case Reports

This report delineates the clinical progression of a renal oncocytoma in a 38-year-old female, initially asymptomatic, over a three-year follow-up period following her treatment for papillary thyroid cancer. The timeline of this case is as follows: In 2016, the patient was treated with total thyroidectomy and I131 for thyroid cancer. During an annual follow-up, an incidental renal mass was detected via FDG PET/CT, initially characterized as a benign, non-FDG-avid renal oncocytoma. Over two years, this lesion demonstrated a remarkable increase in FDG uptake and a slight growth in size, coupled with new I131 uptake in subsequent scans. These findings led to a reassessment of the diagnosis, initially suggesting a potential small renal cell carcinoma (RCC). Histopathological analysis eventually confirmed the diagnosis of oncocytoma. This case is notable for the tumor's unusual metabolic evolution and the challenges it posed in differential diagnosis.
Demethylating agents in combination with CD7-targeted CAR-T for the successful treatment of a case with mixed-phenotype acute leukemia relapsed after allogeneic hematopoietic stem cell transplantation: A Case Report
Authors: Ying Han, Hao Yao, Guang-Cui He, Si-Han Lai, Yan Deng, Shan Zhang, Ying He, Yi-Song Xiong, Alex H Chang, Yi Su, Hai Yi
Journal: Front Immunol (2023)
Keywords: cd7-targeted, allogeneic hematopoietic stem cell transplantation, chimeric antigen receptor-t cell therapy, demethylate, demethylating agent, mixed-phenotype acute leukemia
MeSH terms: Hematopoietic Stem Cell Transplantation, Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy, Receptors, Chimeric Antigen / genetics, Case Reports, Research Support, Non-U.S. Gov't, Acute Disease, Chronic Disease, Humans, Male, Neoplasm, Residual, Phenotype, Recurrence, Receptors, Chimeric Antigen

Background:
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has cured many patients with malignant hematologic diseases such as mixed phenotype acute leukemia (MPAL), while those relapsing after allo-HSCT still exhibit high mortality, poor prognosis, and no standard treatment modalities. It is necessary to explore more therapeutic modalities for patients with post-transplant relapse to obtain a better prognosis.
Case presentation:
In this case report, a young male with MPAL received allo-HSCT after reaching complete remission (CR) by induction chemotherapy. Unfortunately, relapse of both myeloid and T lineages occurred nine months later. After receiving demethylating chemotherapy, myeloid lineage measurable residual disease (MRD) turned negative. T-lineage MRD turned negative after CD7-targeted chimeric antigen receptor (CAR)-T cell therapy. The bone marrow remained MRD-negative for 4 months. This case preliminarily demonstrated a long-lasting CR with CD7-targeted CAR-T cell therapy, allowing a better prognosis.
Conclusion:
Demethylating drugs combined with CD7-targeted CAR-T cell therapy is feasible in treating MPAL patients with relapse after transplantation, with good efficacy and safety, which will be a promising treatment option for MPAL.
Case report: Sodium-glucose cotransporter 2 inhibitors induce left ventricular reverse remodeling in anthracycline-related cardiac dysfunction-a case series
Authors: Francesco Giangiacomi, Andrea Faggiano, Daniela Cardinale, Francesca Gaia Rossi, Alberto Pollina, Elisa Gherbesi, Eleonora Gnan, Stefano Carugo, Marco Vicenzi
Journal: Front Cardiovasc Med (2023)
Keywords: anthracycline-related cardiac dysfunction, cardiotoxicity, heart faillure, left ventricular remodeling, sodium-glucose cotransporter 2 inhibitors
MeSH terms: Case Reports

Purpose:
To describe the efficacy and safety of sodium-glucose cotransporter 2 inhibitors as a specific treatment for anthracycline-related cardiac dysfunction in a small real-world population.
Methods:
Seven patients with anthracycline-related cardiac dysfunction were clinically and echocardiographically evaluated before and after the introduction of sodium-glucose cotransporter 2 inhibitors.
Results:
After a median period of 24 weeks with uninterrupted sodium-glucose cotransporter 2 inhibitors treatment, a significant clinical improvement was observed with at least one New York Heart Association Functional Class (NHYA FC) improvement in all patients (median NYHA FC: I vs. III, p < 0.010). A noteworthy left ventricular reserve remodeling (median left ventricular end diastolic volume indexed: 53 vs. 82.5 ml/m2, p = 0.018; median left ventricular ejection fraction: 50% vs. 40%, p = 0.17) was also observed. Sodium-glucose cotransporter 2 inhibitors therapy was well tolerated by every patients; no cases of discontinuation or relevant side effects were observed.
Conclusion:
Sodium-glucose cotransporter 2 inhibitors induce a significant clinical improvement and left ventricular reserve remodeling in patients affected by anthracycline-related cardiac dysfunction.