OpenMed/multicare-articles huggingface dataset:
After the Storm: Inter-disciplinary Dialogic Discourses With a Post-Fishing Community
Authors: Carol Stephenson, Fiona MacPherson
Journal: Front Sociol (2020)
Keywords: applied theater, dialogic discourses, inter-disciplinary, post-industrial, public sociology

This paper is a critical evaluation of a unique approach to working with disadvantaged communities, which involves inter-disciplinary collaboration between an Applied Theater (AT) director and a sociologist. The application of the approach, in a community disadvantaged by the loss of industry, provides the case study basis for the evaluation. Between 2014 and 2017 community participants from Eyemouth, southeast Scotland, worked with an artistic team led by director Fiona MacPherson, and a sociologist, Carol Stephenson, to develop a creative performance of the town's fishing disaster of 1881. This inter-disciplinary project was facilitated through dialogic discourses between community participants, AT director and sociologist in which the equalization of relationships, meaning-making and active listening were established as shared values and processes. The paper makes four claims. Firstly, sociological observation of the negotiation of the creative process revealed previously hidden and nuanced social interactions, which could later be examined in greater detail with the AT director and in focus group discussions with community participants. Second, the use of dialogic discourses in the critical appraisal of AT practice by the sociologist ultimately enabled the inter-disciplinary sharing of practice, ideas and theories that were mutually beneficial. Third, the creative process revealed insights into the lived experience of post-industrial communities and enabled public sociology discourse, which ultimately prompted social activism within the case study community. Last, while the inter-disciplinary approach is labor intensive and demands high levels of commitment to the shared values associated with dialogic discourses, it provides a new and innovative way of working with, and for, disadvantaged communities.
Severe hyperlipidemia pancreatitis induced by taking tamoxifen after breast cancer surgery-Case report
Authors: Chao Zhai, Xiang Li, Dong Xiao, Liang Chen, Chaoyang Wang, MingHua Zheng
Journal: Front Oncol (2023)
Keywords: breast cancer, endocrine therapy, hyperlipidemia, severe pancreatitis, tamoxifen
MeSH terms: Case Reports

Introduction:
The research investigates the mechanism, diagnosis, treatment, and subsequent endocrine therapy of severe pancreatitis induced by tamoxifen treatment in patients who have undergone breast cancer surgery.
Case presentation:
We studied two cases of breast cancer in whom severe acute pancreatitis developed after taking tamoxifen for endocrine therapy in our hospital. A brief literature review was provided to analyze the causes, clinical manifestations, treatment process, and prognosis of severe acute pancreatitis. Both cases involved patients with severe hyperlipidemic pancreatitis. After conservative treatment, none of them died. Pancreatitis did not recur after changing endocrine therapy drugs.
Discussion/conclusion:
Endocrine therapy with tamoxifen in breast cancer patients can induce hyperlipidemia, which can subsequently cause severe pancreatitis. The treatment of severe pancreatitis should strengthen the regulation of blood lipids. The application of low-molecular-weight heparin combined with insulin therapy can rapidly lower blood lipids. Involved treatments, including acid suppression, enzyme suppression, and peritoneal dialysis, can accelerate the recovery of pancreatitis and reduce the occurrence of serious complications. Patients with severe pancreatitis should not continue to use tamoxifen for endocrine therapy. To complete follow-up endocrine therapy, switching to a steroidal aromatase inhibitor is better if the situation allows it.
A primary mediastinal germ cell tumor of yolk sac type: case report
Authors: Khadija Darif, Zineb Benbrahim, Nisrine Acharfi, Anass Khacha, Mustapha Maaroufi, Lamiae Amaadour, Karima Oualla, Samia Arifi, Nawfel Mellas
Journal: Pan Afr Med J (2021)
Keywords: germ cell tumors, case report, mediastinum, yolk sac tumor
MeSH terms: Chest Pain / etiology, Endodermal Sinus Tumor / diagnosis, Mediastinal Neoplasms / diagnosis, Case Reports, Antineoplastic Combined Chemotherapy Protocols / administration & dosage, Biopsy, Combined Modality Therapy, Endodermal Sinus Tumor / pathology, Endodermal Sinus Tumor / therapy, Etoposide / administration & dosage, Humans, Ifosfamide / administration & dosage, Mediastinal Neoplasms / pathology, Mediastinal Neoplasms / therapy, Platinum Compounds / administration & dosage, Tomography, X-Ray Computed, Young Adult, Platinum Compounds, Etoposide, Ifosfamide

The mediastinal malignant germ cells tumor represents less than 0.5% of thoracic tumors, although the mediastinum is one of the main extragonadic locations of these tumors. In the majority of cases, young people are those most affected. The prognosis of mediastinal malignant germ cells tumors is poor, especially non-seminomatous germ tumors. In this article, we report a rare case of a young 19-years-old patient treated for a mediastinal germ cell tumor of yolk sac. The patient presented a chest pain; the chest computed tomography (CT) showed a right paramedian mediastinal mass with a pleural effusion associated with supraclavicular and cervical lymph nodes. Biopsy revealed a non-seminomatousgerm cell tumor of yolk sac. The exams showed elevated alpha-fetoprotein (AFP), without any meaningful elevation of other serictumor markers. The patient received 4 cycles of chemotherapy based on etoposide, ifosfamide and platinum salts then a complete excision of the mass.
Case report: 17α- hydroxylase deficiency due to a hotspot variant and a novel compound heterozygous variant in the CYP 17 A 1 gene of five Chinese patients
Authors: Jinying Li, Qiang Zhang, Jing Chen, Xingjiao Fu, Jingpin Yang, Lijun Liu
Journal: Front Pediatr (2022)
Keywords: 17α-hydroxylase deficiency, children, hypertension, hypokalemia, novel variant, twin
MeSH terms: Case Reports

17α-Hydroxylase deficiency (17OHD) is a rare form of congenital adrenal hyperplasia caused by mutations in the CYP17A1 gene. It is characterized by impaired adrenal and gonad steroid biosynthesis. Affected patients present with hypertension, hypokalemia, and disorders of sexual development. Here, we describe the genotypes and phenotypes of five patients from three families with this rare disease. Most patients had the hotspot variant, c.985_987delTACinsAA, in CYP17A1, which may be caused by a founder effect. However, the patients in our study were younger than the typical age of onset of 17OHD, and there was a pair of twins with the karyotypes 46, XX and 46, XY, but they both had a female phenotype. Meanwhile, we identified a novel compound heterozygous variant, c.1243+6T>G (p.Y329fs/splicing) in the CYP17A1 gene.
An Unusual Location of Subungual Warty Dyskeratoma: A Case Report and Review of the Literature
Authors: Elena Vargas-Laguna, Adrián Imbernón-Moya, Antonio Aguilar-Martínez, Fernando Burgos
Journal: Case Rep Dermatol Med (2017)
MeSH terms: Case Reports

Warty dyskeratoma is an uncommon entity characterized by a solitary keratotic papule or nodule usually located in the head and neck of young adults. The histopathology shows a pattern of acantholytic dyskeratosis. We report a 32-year-old man who presented pain, serous exudation, a distal onycholysis with subungual hyperkeratosis, and roundish erythronychia in the nail plate of his left first toe 2 years ago. A histopathologic diagnosis of subungual warty dyskeratoma was made. When dealing with focal acantholytic dyskeratosis several differential diagnoses should be considered including Darier's disease, transient focal acantholytic dyskeratosis or Grover disease, and Hailey-Hailey disease. We present an unusual location of warty dyskeratoma in the nail bed using a clinicohistopathological correlation for the diagnosis.
Neuropsychiatric Symptoms as The First Manifestation of Juvenile Systemic Lupus Erythematosus: A Complicated Case with Klinefelter's Syndrome
Authors: Reza Shiari, Mehrnoush Hassase Yegane, Shirin Farivar, Vadood Javadi Parvaneh, Seyed Alireza Mirjavadi
Journal: Iran J Child Neurol (2014)
Keywords: cognitive dysfunction, juvenile systemic lupus erythematosus, klinefelter’s syndrome, neuropsychiatric
MeSH terms: Case Reports

Systemic Lupus Erythematosus (SLE) is an autoimmune, multisystem disorder with various manifestations. There are limited reports on the neuropsychiatric findings as the first manifestation of SLE in children. Herein, we report a 14-year-old Iranian boy with a two-year history of cognitive dysfunction and behavioural problems as well as a recent history of epistaxis. The patient workup ended with a diagnosis of Klinefelter's syndrome associated with juvenile SLE. Patients with Klinefelter's syndrome may exhibit behavioural problems and psychological disease. These psychiatric disorders could be complicated with lupus in children. In fact, psychiatric symptoms may occur as the first manifestation of juvenile SLE. Specially, if accompanied with Klinefelter's syndrome. We suggest the diagnosis of SLE must be considered in all children with neuropsychiatric manifestations.
Treatment of Recurrent Wide Neck Bifurcation Aneurysm With the Barrel Vascular Reconstruction Device
Authors: Stanimir Sirakov, Adriana Panayotova, Alexander Sirakov, Karsimir Minkin, Kirstian Ninov, Radoslav Raychev
Journal: Front Neurol (2019)
Keywords: brain aneurysm, retreatment, stent-assisted coil embolization, subarachanoid hemorrhage, wide neck aneurysm
MeSH terms: Case Reports

We present a case of successful embolization of a recurrent wide neck bifurcation aneurysm with a Barrel vascular reconstruction device (VRD). The unique properties of this novel device allowed optimal aneurysm neck coverage during third consecutive re-treatment, ultimately resulting in complete aneurysm obliteration. The parent vessel anatomy and the neck morphology of the aneurysm, in combination with a presence of a large pre-existing coil mass, were ideal for Barrel stent placement. The expanded portion of the device conformed perfectly to the recanalized aneurysm neck, providing optimal support for additional coil embolization. This case illustrates the advantages of Barrel VRD for definitive embolization of large, recurrent, and previously coiled wide-neck bifurcation aneurysm as a reasonable alternative to other traditional treatment modalities, such as flow diversion or Y and X stenting.
A giant right atrial myxoma with pulmonary arterial hypertension
Authors: Ihsen Zairi, Khadija Mzoughi, Zouhayer Jnifene, Sana Fennira, Fathia Ben Moussa, Sofiene Kammoun, Mohamed Mounir Dhiab, Sondos Kraiem
Journal: Pan Afr Med J (2015)
Keywords: atrial myxoma, cardiac tumors, surgery
MeSH terms: Heart Atria / pathology, Heart Neoplasms / diagnosis, Hypertension, Pulmonary / etiology, Myxoma / diagnosis, Case Reports, Adult, Female, Heart Neoplasms / pathology, Heart Neoplasms / surgery, Humans, Myxoma / pathology, Myxoma / surgery

Here we report a case of a right atrial mass that morphology mimicking myxoma, in a young patient with no past medical history. The mass was pathologically confirmed to be symptomatic and surgical removal was successfully done.
Case Report: A Rare Case of Pembrolizumab-Induced Bullous Pemphigoid
Authors: Xiaoyan Zhang, Dongjiang Sui, Dong Wang, Lina Zhang, Ruiyan Wang
Journal: Front Immunol (2021)
Keywords: bullous pemphigoid, glucocorticoid, immunotherapy, pembrolizumab, programmed cell death protein 1
MeSH terms: Antibodies, Monoclonal, Humanized / adverse effects, Drug Eruptions / etiology, Immune Checkpoint Inhibitors / adverse effects, Pemphigoid, Bullous / chemically induced, Skin / drug effects, Case Reports, Aged, Drug Eruptions / diagnosis, Drug Eruptions / drug therapy, Glucocorticoids / therapeutic use, Humans, Male, Methylprednisolone / therapeutic use, Pemphigoid, Bullous / diagnosis, Pemphigoid, Bullous / drug therapy, Skin / pathology, Treatment Outcome, Antibodies, Monoclonal, Humanized, Glucocorticoids, Immune Checkpoint Inhibitors, pembrolizumab, Methylprednisolone

The programmed cell death protein 1 inhibitor pembrolizumab, an immune checkpoint inhibitor, has subsequently been approved for the treatment of a wide variety of malignant tumors. Compared with conventional chemotherapy, immunotherapy is associated with a unique set of immune reactions, known collectively as immune-related adverse events. Although often mild, dermatologic toxicity can occasionally be high grade and potentially life-threatening. Here we describe a rare case of bullous pemphigoid (BP) associated with pembrolizumab. A 79-year-old male patient presented with scattered erythema, papules, blisters, and pruritus after pembrolizumab treatment. Then, the rash gradually aggravated and spread to the whole body. The extensive edematous erythema, blisters, bullae, and blood blisters were loose and easy to rupture, forming an erosive surface and with pruritus and obvious pain. The hemidesmosomal protein BP180 (type XVII collagen) was detectable in the serum, and the histological examination diagnosis was bullous pemphigoid. After 10 days of glucocorticoid (methylprednisolone, iv, 80 mg/day) treatment, new blister formation ceased. We need to increase the awareness on and facilitate the earlier identification of the cutaneous adverse effects of BP with immunotherapy so that treat can begin early in order to limit the duration and severity of toxicity.
Accelerating translational research by clinically driven development of an informatics platform--a case study
Authors: Imad Abugessaisa, Saedis Saevarsdottir, Giorgos Tsipras, Staffan Lindblad, Charlotta Sandin, Pernilla Nikamo, Mona Ståhle, Vivianne Malmström, Lars Klareskog, Jesper Tegnér
Journal: PLoS One (2014)
MeSH terms: Medical Informatics / methods, Translational Research, Biomedical / methods, Research Support, Non-U.S. Gov't, Arthritis, Rheumatoid / genetics, Arthritis, Rheumatoid / immunology, Arthritis, Rheumatoid / metabolism, Arthritis, Rheumatoid / therapy, Autoantibodies / blood, Biomarkers / blood, Cohort Studies, Databases, Factual, Decision Support Systems, Clinical, Gene Frequency, Genotype, Humans, Internet, Metabolome, Polymorphism, Single Nucleotide, Psoriasis / genetics, Psoriasis / immunology, Psoriasis / metabolism, Psoriasis / therapy, Serology, Time Factors, Treatment Outcome, User-Computer Interface, Autoantibodies, Biomarkers

Translational medicine is becoming increasingly dependent upon data generated from health care, clinical research, and molecular investigations. This increasing rate of production and diversity in data has brought about several challenges, including the need to integrate fragmented databases, enable secondary use of patient clinical data from health care in clinical research, and to create information systems that clinicians and biomedical researchers can readily use. Our case study effectively integrates requirements from the clinical and biomedical researcher perspectives in a translational medicine setting. Our three principal achievements are (a) a design of a user-friendly web-based system for management and integration of clinical and molecular databases, while adhering to proper de-identification and security measures; (b) providing a real-world test of the system functionalities using clinical cohorts; and (c) system integration with a clinical decision support system to demonstrate system interoperability. We engaged two active clinical cohorts, 747 psoriasis patients and 2001 rheumatoid arthritis patients, to demonstrate efficient query possibilities across the data sources, enable cohort stratification, extract variation in antibody patterns, study biomarker predictors of treatment response in RA patients, and to explore metabolic profiles of psoriasis patients. Finally, we demonstrated system interoperability by enabling integration with an established clinical decision support system in health care. To assure the usefulness and usability of the system, we followed two approaches. First, we created a graphical user interface supporting all user interactions. Secondly we carried out a system performance evaluation study where we measured the average response time in seconds for active users, http errors, and kilobits per second received and sent. The maximum response time was found to be 0.12 seconds; no server or client errors of any kind were detected. In conclusion, the system can readily be used by clinicians and biomedical researchers in a translational medicine setting.
A Case Series of Bowen's Disease Treated with the Combination of Cryosurgery and Ingenol Mebutate and Followed Up with Optical Coherence Tomography
Authors: Georgios Gaitanis, Theodora Tsironi, Panagiota Spyridonos, Ioannis D Bassukas
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Bowen's disease (BD) is a relatively rare in situ squamous cell carcinoma (SCC) with a limited potential of becoming invasive. Ingenol mebutate (IM) was relatively successful for the treatment of BD lesions in small case series. Optical coherence tomography (OCT) is a promising method for the diagnosis of cutaneous keratinocytic carcinomas, including BD. Herein we report the treatment of BD with the combination of cryosurgery and IM and the application of OCT imagining in treatment monitoring. Patients treated within a period of 12 months are retrospectively compiled. Treatment consisted of a mild cryosurgery session (liquid N2, open spray, and 2 freeze-thaw cycles of 15 sec each) of a field including the BD lesion and a 0.5cm rim and IM application for 4 consecutive days starting at the cryosurgery day. Four patients (3 females; average age: 76.5 years) with 4 lesions (20-70mm maximal diameter; average 36.2mm) were included. Healing was excellent and no relapse was observed at 12 months' follow-up. Baseline OCT revealed a disarranged, thickened epidermis, while a normally layered epidermis overlying a hyperreflective dermis was present after treatment. Conclusively, the combination of cryosurgery followed by IM is a feasible, effective treatment for BD that should be evaluated in further studies.
Successful management of invasive pulmonary nocardiosis and aspergillosis in a patient with T-cell lymphoma: a case report
Authors: Khalid A Al-Anazi, Mahmoud D Aljurf, Fahad I Al-Mohareb, Laila Al-Dabal, Mohammed Zaitoni, Majed Halim
Journal: Clin Med Case Rep (2008)
Keywords: aspergillus niger, nocardia asteroides, angioimmunoblastic t-cell lymphoma, invasive pulmonary infections
MeSH terms: Case Reports

In patients with malignant hematological disorders receiving immunosuppressive therapy, invasive pulmonary infections are serious complications that are associated with high morbidity and mortality. In immunocompromised hosts with impaired cellular immunity, two or more organisms may coexist leading to a wide range of clinical and radiological manifestations. Reported here is an old man who was diagnosed to have angioimmunoblastic T-cell lymphoma at King Faisal Specialist Hospital and Research Centre in Riyadh in December 2004. The lymphoma was treated with various immunosuppressive agents including alemtuzumab. In October 2006, the patient was admitted with severe bronchopneumonia caused by Nocardia asteroides and Aspergillus niger that was complicated by septic shock. The invasive pulmonary infections were successfully treated with trimethoprim-sulphamethoxazole, amikacin and liposomal amphotericin-B (amBisome).
Nephrogenic diabetes insipidus after esophagectomy in a patient with remote history of lithium treatment: A case report
Authors: Dania Shakaroun, Hassan Nasser, Semeret Munie, Sandeep Soman
Journal: Int J Surg Case Rep (2019)
Keywords: case report, esophageal cancer, esophagectomy, hypernatremia, lithium, nephrogenic diabetes insipidus

Introduction:
Nephrogenic diabetes insipidus occurs in patients on chronic lithium treatment even after lithium discontinuation. Patients affected by this disorder are highly vulnerable to hypernatremia when they cannot respond to their thirst mechanism. We report a rare case of hypernatremia due to undiagnosed nephrogenic diabetes insipidus post esophagectomy in a patient with remote history of lithium use.
Presentation of case:
A 70-year-old female with past medical history of bipolar disorder, chronic kidney disease and pheochromocytoma underwent an elective esophagectomy for esophageal adenocarcinoma. Lithium was discontinued 10 years prior to her presentation. She was kept nil per os post operatively and subsequently developed altered mental status necessitating intubation. Her sodium level was found to be 156 mmol/L. A water deprivation test and desmopressin trial confirmed nephrogenic diabetes insipidus. Days after dextrose 5% in water infusion, free water flushes through the jejunostomy tube and hydrochlorothiazide, her hypernatremia improved slowly with subsequent improvement in her mental status.
Discussion:
Several mechanisms have been described in literature to explain the persistent damage caused by lithium on the kidneys. When patients lose access to a source of free water and are resuscitated with normal saline post operatively, they are at risk of developing life-threatening hypernatremia. This can be avoided by aggressive hydration with appropriate fluid replacement.
Conclusion:
Surgeons should be aware of the persistent renal defects caused by long term lithium use and development of nephrogenic diabetes insipidus even years after medication cessation.
Atypical craniosynostosis with torticollis and neurological symptoms: a rhombencephalosynapsis sequence
Authors: Virve Koljonen, Junnu Leikola, Leena Valanne, Jyri Hukki
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Purpose. We describe a case of 3-year-old girl with rhombencephalosynapsis, a rare cerebellar anomaly. Patient. A 3-year-old girl was admitted to our hospital due to congenital torticollis and asymmetry of face, skull and trunk. Craniosynostosis was suspected due to abnormal head shape. 3D-CT revealed closure of the sagittal suture without scaphocephalic skull. Due to atypical craniosynostosis with neurological symptoms, brain-MRI was performed revealing rhombencephalosynapsis. Results. Our patient presented with atypical craniosynostosis and balance problems, not typical for scaphocephaly. Operative treatment for craniosynotosis was not carried out because the cause of the problems was the cerebellum instead of the brain. Conclusions. Therefore, we conclude that patients with atypical craniosynostosis should be examined with brain-MRI to exclude the intracranial malformations, which 3D-CT does not reveal. Without brain-MRI, decision (not) to perform surgery could have been different.