OpenMed/multicare-articles huggingface dataset:
Multimodal Retinal Imaging of Intravascular Lipid in Severe/Extreme Hypertriglyceridemia
Authors: Christos Christakopoulos
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

Retinal intravascular lipid aggregates were detected in the left eye in a patient with uncontrolled diabetes and very high blood triglycerides. The patient suffered visual loss in the left eye due to retinal ischemia. Optical coherence tomography, fluorescein angiography, infrared fundus photography, and autofluorescence studies of the retina demonstrated unique findings. Slowed choroidal and retinal flow was detected on fluorescein angiography, and a prominent middle layer membrane sign was present on OCT. Intravascular lipid reflectivity was manifest on retinal infrared and autofluorescence imaging. Eventually, insulin and statin therapy proved effective in reversing the vascular lesions, although retinal atrophy finally ensued. This report of a very rare clinical condition provides unique findings on multimodal retinal imaging and confirms the need for prompt insulin and statin therapy in severe/extreme hypertriglyceridemia and dysregulated diabetes. One similar case was reported in the past when multimodal imaging studies of the retina were not available. The lesions described herein should be differentiated from the more frequently encountered lipemia retinalis as they may confer worse prognosis.
Case Report: Identification of a novel LYN::LINC01900 transcript with promyelocytic phenotype and TP53 mutation in acute myeloid leukemia
Authors: Chengjun Hu, Qiuxin Dai, Ruiyi Zhang, Huanping Yang, Man Wang, Kaili Gu, Jiangang Yang, Wenjun Meng, Ping Chen, Maozhong Xu
Journal: Front Oncol (2023)
Keywords: lyn
MeSH terms: Case Reports

Acute myeloid leukemia (AML) is a malignant disease of myeloid hematopoietic stem/progenitor cells characterized by the abnormal proliferation of primitive and naive random cells in the bone marrow and peripheral blood. Acute promyelocytic leukemia (APL) is a type (AML-M3) of AML. Most patients with APL have the characteristic chromosomal translocation t(15; 17)(q22; q12), forming PML::RARA fusion. The occurrence and progression of AML are often accompanied by the emergence of gene fusions such as PML::RARA, CBFβ::MYH11, and RUNX1::RUNX1T1, among others. Gene fusions are the main molecular biological abnormalities in acute leukemia, and all fusion genes act as crucial oncogenic factors in leukemia. Herein, we report the first case of LYN::LINC01900 fusion transcript in AML with a promyelocytic phenotype and TP53 mutation. Further studies should address whether new protein products may result from this fusion, as well as the biological function of these new products in disease occurrence and progression.
Giant uterine tumor and miscarriage: how to proceed?
Authors: E A Hase, L L Iervolino, H A Antico, N Bozzini, R P V Francisco
Journal: Braz J Med Biol Res (2024)
MeSH terms: Abortion, Spontaneous, Uterine Neoplasms / diagnostic imaging, Uterine Neoplasms / pathology, Uterine Neoplasms / surgery, Case Reports, Adult, Female, Humans, Leiomyoma / diagnostic imaging, Leiomyoma / pathology, Leiomyoma / surgery, Pregnancy, Pregnancy Complications, Neoplastic / diagnostic imaging, Pregnancy Complications, Neoplastic / pathology, Pregnancy Complications, Neoplastic / surgery, Ultrasonography

Expanding uterine masses can be the cause of pregnancy loss and add technical difficulties to uterus evacuation due to the intense anatomical distortion of the endocervical canal and uterine cavity. The literature is scarce in the peculiarities of the management of missed abortions in uterus with important distorted anatomies. We report a case of a primigravida patient who presented a rapid and expressive increase of abdominal volume due to a giant uterine mass, evolving to miscarriage. Ultrasound can be a useful tool, allowing visualization of the endocervical path and uterine cavity, helping to perform uterine evacuation in the presence of anatomical distortion without compromising the reproductive future. To the best of our knowledge, no such case has been previously reported.
SARS-CoV-2 shedding, infectivity, and evolution in an immunocompromised adult patient
Authors: Maria Cassia Mendes-Correa, Fábio de Rose Ghilardi, Matias Chiarastelli Salomão, Lucy Santos Villas-Boas, Anderson Vicente de Paula, Heuder Gustavo Oliveira Paiao, Antonio Charlys da Costa, Tânia Regina Tozetto-Mendoza, Wilton Freire, Flavia Cristina Silva Sales, Ingra Morales Claro, Ester Cerdeira Sabino, Nuno Rodrigues Faria, Steven Sol Witkin
Journal: Rev Inst Med Trop Sao Paulo (2024)
MeSH terms: COVID-19 / immunology, Immunocompromised Host, SARS-CoV-2 / genetics, SARS-CoV-2 / immunology, Virus Shedding, Case Reports, Adult, Hematopoietic Stem Cell Transplantation, Humans, Lymphoma, Large B-Cell, Diffuse / immunology, Lymphoma, Large B-Cell, Diffuse / virology, Male, Whole Genome Sequencing

This study aimed to provide further insight into the evolutionary dynamics of SARS-CoV-2 by analyzing the case of a 40-year-old man who had previously undergone autologous hematopoietic stem cell transplantation due to a diffuse large B-cell lymphoma. He developed a persistent SARS-CoV-2 infection lasting at least 218 days and did not manifest a humoral immune response to the virus during this follow-up period. Whole-genome sequencing and viral cultures confirmed a persistent infection with a replication-positive virus that had undergone genetic variation for at least 196 days after symptom onset.
Effect of Recombinant Human Growth Hormone Treatment in a Patient with Short Stature Associated with the Ring Chromosome 17 Syndrome
Authors: Gustavo Tempone Cardoso Penna, Gabriela de Rezende Lelot, Ana Luiza de Rezende Lelot, Juliana Greghi Hernandez, Carolina Costa Figueiredo, Nara Michelle de Araujo Evangelista, Vania de Fatima Tonetto Fernandes, Guido de Paula Colares Neto
Journal: Case Rep Pediatr (2023)
MeSH terms: Case Reports

Background:
Ring chromosome 17 syndrome is a rare hereditary disorder whose prevalence is less than 1 : 1.000.000. We present a ten-year-old patient with ring chromosome 17 syndrome who had short stature and was treated with recombinant human growth hormone (rhGH). Case Report. A ten-year-old male scholar had moderate left conductive deafness, left kidney hypoplasia with hypertension, epilepsy, malformations in hands, feet, and abdomen, and disproportionately short stature. Despite no evidence of growth hormone deficiency, rhGH treatment was indicated as a therapeutic test due to his decelerated growth velocity and severe short stature. As a result, his growth velocity increased by 4.2 cm per year and his stature Z-score increased (from -5.87 to -5.23).
Conclusion:
The patient's severe short stature may be related to genetic, environmental, and hormonal factors and the positive response to rhGH may indicate abnormalities in the somatotropic axis that were mitigated with the treatment. Although rhGH associated with adequate comorbidities controls improved his growth velocity and height Z-score, its effects in the long term are still unclear.
Patisiran exposure in early pregnancy: a case report
Authors: Valentin Loser, Thomas Baumgartner, Hélène Legardeur, Alice Panchaud, Marie Théaudin
Journal: Ther Adv Neurol Disord (2024)
Keywords: patisiran, amyloidosis, case report, hattr, pregnancy, sirna
MeSH terms: Case Reports

We describe here the first case of exposure to patisiran treatment, a small interfering RNA molecule, during early pregnancy of a 36-year-old woman with symptomatic hereditary transthyretin-related amyloidosis. There were no major complications during pregnancy and delivery, except for a postpartum hemorrhage due to uterine atony. Vitamin A levels had to be closely monitored during pregnancy, and vitamin A substitution adapted accordingly. There was no sign of minor or major congenital abnormalities of the baby. One month after delivery, the patient showed slight clinical and electrophysiological signs of neuropathy progression due to patisiran treatment withdrawal. Patisiran infusions were resumed 3 months after delivery. Due to the unknown teratogenic potential of patisiran, the risk of neuropathy worsening associated with withholding treatment must of course be weighed against a potential teratogenic risk of treatment during pregnancy. Vitamin A levels need to be closely assessed, and substitution must be adapted accordingly, to avoid embryofetal adverse outcome due to vitamin A deficiency or toxicity.
Measuring and shaping the nutritional environment via food sales logs: case studies of campus-wide food choice and a call to action
Authors: Kristina Gligorić, Robin Zbinden, Arnaud Chiolero, Emre Kıcıman, Ryen W White, Eric Horvitz, Robert West
Journal: Front Nutr (2024)
Keywords: determinants, digital traces, food choice, health, measurement, monitoring, policy, sustainability

Although diets influence health and the environment, measuring and changing nutrition is challenging. Traditional measurement methods face challenges, and designing and conducting behavior-changing interventions is conceptually and logistically complicated. Situated local communities such as university campuses offer unique opportunities to shape the nutritional environment and promote health and sustainability. The present study investigates how passively sensed food purchase logs typically collected as part of regular business operations can be used to monitor and measure on-campus food consumption and understand food choice determinants. First, based on 38 million sales logs collected on a large university campus over eight years, we perform statistical analyses to quantify spatio-temporal determinants of food choice and characterize harmful patterns in dietary behaviors, in a case study of food purchasing at EPFL campus. We identify spatial proximity, food item pairing, and academic schedules (yearly and daily) as important determinants driving the on-campus food choice. The case studies demonstrate the potential of food sales logs for measuring nutrition and highlight the breadth and depth of future possibilities to study individual food-choice determinants. We describe how these insights provide an opportunity for stakeholders, such as campus offices responsible for managing food services, to shape the nutritional environment and improve health and sustainability by designing policies and behavioral interventions. Finally, based on the insights derived through the case study of food purchases at EPFL campus, we identify five future opportunities and offer a call to action for the nutrition research community to contribute to ensuring the health and sustainability of on-campus populations-the very communities to which many researchers belong.
Complex Presentation of Multicentric Castleman Disease with Coexisting HIV, HHV-8, and Other Opportunistic Infections
Authors: Yehya Tlaiss, Hadi Farhat, Firas Hasan, Rami Yazbek, Noura Shakaroun, Nizar Bitar
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

Castleman disease (CD) is a rare lymphoproliferative disorder characterized by benign lymph node enlargement. We present the case of a 43-year-old male with a complex medical history, including Crohn's disease treated with Adalimumab and later complicated with tuberculosis (TB) infection. Subsequently, in May 2021, he was diagnosed with human immunodeficiency virus (HIV) and started on antiretroviral therapy (efavirez, emricitabine, and tenofovir). Despite stropping adalimumab, anti-Tb, and antiviral therapy, he experienced persistent fever, neurological symptoms, and lymphadenopathy. Toxoplasmosis, Cytomegalovirus (CMV), and Human Herpesvirus-8 (HHV-8) were diagnosed and then treated. Furthermore, the patient displayed intermittent febrile episodes, pancytopenia, altered coagulation parameters, hypoalbuminemia, edema, and generalized abdominal pain, as well as radiological evidence of hepatosplenomegaly and pulmonary infiltrates. Left axillary lymph node biopsy (ALNB) was done and confirmed multicentric castleman disease (MCD). Moreover, the bone marrow aspirate showed plasmocytes. His treatment included chemotherapy with doxorubicin and rituximab while continuing his anti-Tb and antiretroviral therapy. This complex case highlights the diagnostic challenges of managing CD in the presence of multiple coexisting conditions, emphasizing the need for comprehensive evaluation in complex clinical presentations.
Analysis of demand and influencing factors for smart senior care among older adults in underdeveloped regions of western China: a case study of Lanzhou
Authors: Yunhua Wang, Hongyu Zeng, Fengli Lv, Jiancheng Wang
Journal: Front Public Health (2024)
Keywords: lanzhou, demand, influencing factors, older adults, smart senior care
MeSH terms: Health Services Needs and Demand / statistics & numerical data, Aged, Aged, 80 and over, China, Cross-Sectional Studies, Female, Health Services for the Aged / statistics & numerical data, Humans, Male, Middle Aged, Surveys and Questionnaires

Introduction:
With the rapid development of artificial intelligence and Internet-of-Things technology, internal support systems among families are gradually weakening, which can no longer satisfy the current demands of older adults. In this context, smart senior care has become a new development direction. However, existing studies on the demand for smart senior care are primarily concentrated in economically developed provinces and mega-cities in eastern China; their research results or conclusions may not apply to underdeveloped areas in the Western region. Therefore, our study selects Lanzhou as a representative city in an underdeveloped western region to investigate the demand of older adults for smart senior care and analyze the influencing factors.
Methods:
This cross-sectional study included 4,815 older adults from Lanzhou, China. A structured questionnaire was designed to investigate the demands of the older adults for smart senior care and analyze thie influencing factors. The Chi-square test was used for single factor analysis of each variable. The logistic regression model included the statistically significant variables to analyze factors influencing older adults' demand for smart senior care. A significance level of p < 0.05 was considered statistically significant.
Results:
Among the surveyed older adults, 1,625 (33.75%) expressed a demand for smart senior care. The finding indicated that participants' age, level of education, marital status, monthly income, number of children, type of endowment insurance, and knowledge of smart senior care were significantly associated with their demands for smart senior care (p < 0.05). Notably, medical care emerged as the smart senior care service with the highest demand rate (79.45%).
Conclusion:
In Lanzhou, older adults show a low level of knowledge but a high demand for smart senior care. Their demand is influenced by personal, family, health conditions, senior care security, and other factors. To advance smart senior care, government departments should accelerate the improvement of the laws and regulations on smart senior care while vigorously enhancing the service's publicity to raise knowledge about it. Additionally, the service contents for smart senior care should be expanded to meet the diversified demands of older adults.
Case Report: A challenging diagnosis of an apocrine sweat gland carcinoma
Authors: Adeel Ahmad, Sajjaad Samat, Yaohong Tan, Harvey Bumpers
Journal: Front Surg (2024)
Keywords: apocrine, apocrine carcinoma, eccrine, eccrine carcinoma, sweat gland carcinoma
MeSH terms: Case Reports

The differential diagnosis for an axillary mass in a patient with a previously treated malignancy is broad and definitive tissue diagnosis is required to guide treatment and surveillance strategies. We present the case of a 76-year-old African American male with a history of prostate cancer who presented with a left axillary mass two years after achieving remission from his prostate malignancy. Due to the diagnostic challenge, this excisional biopsy was reviewed at four different academic centers. Although no universal consensus among these institutions' pathologists, but in the context of clinical presentation and anatomic location, the overall clinical findings are consistent with apocrine sweat gland carcinoma. The mass was treated with complete local surgical excision, though regional lymph node metastasis occurred 2 years later. Multimodal treatment with surgery and radiation was done with removal of regional metastasis and no distant disease was identified. Primary apocrine carcinoma is a rare cutaneous neoplasm with less than 100 reported cases in the literature. A combination of clinical history and presentation, histomorphology, anatomical location, and immunohistochemistry is used to support the diagnosis and ultimately drive management.
Strangulated penis in a prison inmate: Complete penile degloving and full-thickness skin graft
Authors: Abdulla Uthman, Shahad Al-Mashhadani, Naomi Blower, Muhammed Iqbal
Journal: IJU Case Rep (2023)
Keywords: penile necrosis, skin graft, strangulated penis
MeSH terms: Case Reports

Introduction:
Penile strangulation is a rare urological emergency that necessitates urgent management. The reasoning behind it may include sexual pleasure, erection reinforcement, or a psychiatric disorder.
Case presentation:
Despite being an uncommon complication of penile strangulation, we report a 45-year-old prison inmate who presented with penile shaft necrosis secondary to using a non-metallic constriction object. The patient reported a 5-day history of progressive penile pain, edema, and skin injury but no urinary symptoms. The patient underwent complete penile skin degloving, circumcision, and insertion of a suprapubic catheter. Postoperatively, the penile tissue appeared healthy, and the wound was granulating. On the eleventh day following degloving, a full-thickness skin graft was taken from the groin area. The patient remained in the hospital for 20 days, during which he was clinically stable with clean, healing wounds.
Conclusion:
Early management of penile strangulation is vital in order to prevent vascular and mechanical complications.
A True Human Tail In A Neonate Born In Saudi Arabia: A Case Report
Authors: Sarah A Algallaf, Majed A Alobaid, Shahad G Alghamdi, Kholoud S Alanazi
Journal: Cureus (2024)
Keywords: case report pediatric, kingdom of saudi arabia (ksa), magnetic resonance imaging, neonate, spinal dysraphism, tail
MeSH terms: Case Reports

A caudal cutaneous appendage known as the true human tail is a rare and benign condition. Different classification systems have been established, mostly based on the presence of associated spinal dysraphism. Imaging studies play an important role in detecting the prognosis and developing a management plan. Here, we present a rare case of a true human tail with no underlying spinal dysraphism in a preterm neonate.
Case report: 'Atypical Richter transformation from CLL-type monoclonal B-cell lymphocytosis into Burkitt lymphoma in a treatment naïve patient'
Authors: Annaïse J Jauch, Ilaria Alborelli, Andreas Reusser, Albert Baschong, Cyrill Rütsche, Olivier Bignucolo, Jakob Passweg, Stefan Dirnhofer, Fatime Krasniqi
Journal: Front Oncol (2024)
Keywords: burkitt lymphoma, mbl, richter transformation, sll/cll, state sequencing
MeSH terms: Case Reports

Background:
Richter transformation refers to the progression of an initially slow-growing small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) into an aggressive lymphoma, typically diffuse large B-cell lymphoma (DLBCL) or Hodgkin lymphoma.
Case presentation:
The patient presented with a rapid onset of localized cervical swelling, accompanied by monoclonal B-cell lymphocytosis displaying a CLL immunophenotype. The histopathological analysis identified a Burkitt lymphoma (BL) located in the submandibular gland and adjacent lymph node. The patient's bone marrow displayed a minor infiltration of monoclonal B-cells with a CLL immunophenotype (< 10%). Molecular analysis demonstrated the presence of the same monoclonal rearrangement in the framework region (FR3 region) of the immunoglobulin heavy chain (IGH) locus. High-throughput sequencing of the immunoglobulin heavy and light chains also confirmed the presence of the same rearrangement in SLL/CLL and in the Burkitt lymphoma sample, but also highlighted the presence of a second rearrangement in the Burkitt lymphoma cells, not shared with the SLL/CLL cells in the bone marrow. The patient was treated with DA-EPOCH-R, which lead to a complete metabolic response.
Conclusion:
This report provides an exceptionally rare description of a CLL-type monoclonal B-cell lymphocytosis transforming into a very aggressive Burkitt lymphoma in a treatment naïve patient.
Super-refractory status epilepticus in a woman with Aeromonas caviae meningitis: a rare case report and review of the literature
Authors: Yanlang He, Jia Liu, Sheng Wei, Jianyong Chen
Journal: Front Med (Lausanne) (2024)
Keywords: aeromonas caviae, anesthetic drug, meningitis, multi-drug combination, non-anesthetic anti-epileptic drugs, super-refractory status epilepticus
MeSH terms: Case Reports

Currently, there is a lack of knowledge regarding Aeromonas caviae meningitis. We report the first case of super-refractory status epilepticus (SRSE) in a woman with Aeromonas caviae meningitis. The case report demonstrates that this condition can lead to severe SRSE. Effective treatment for epilepsy is crucial for improving the prognosis for similar patients. According to Gomes et al.'s consensus protocol for SRSE, using a combination of up to one anesthetic drug and three non-anesthetic anti-epileptic drugs may be helpful and important in managing SRSE that is caused by Aeromonas caviae meningitis.
Severe influenza A virus pneumonia complicated with Curvularia lunata infection: Case Report
Authors: Yanqing Zhang, Haixia Li, Ling Chen, Fei Feng, Liping Liu, Qinghong Guo
Journal: Front Cell Infect Microbiol (2023)
Keywords: curvularia lunata, influenza a virus infection, invasive fungal infection, severe pneumonia, treatment
MeSH terms: Influenza A virus, Mycoses / complications, Mycoses / diagnosis, Mycoses / drug therapy, Pneumonia, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antifungal Agents / therapeutic use, Curvularia, Female, Humans, Young Adult, Antifungal Agents, Curvularia lunata

Human infection with Curvularia lunata (C. lunata) is exceptionally rare. A 23-year-old female patient contracted both bacterial and Curvularia lunata infections during influenza A virus infection. Multiple etiological tests were performed repeatedly during hospitalization due to fluctuations in condition. On the 17th day after hospital admission, mold hyphae were discovered in the pathogen culture of the patient's bronchoalveolar lavage fluid during one of these examinations. The patient was suspected to have a filamentous fungal infection. Consequently, we further obtained sputum samples for fungal culture, which confirmed the diagnosis of Curvularia infection. The patient, in this case, was in a critical condition, experiencing complications of lung abscess, pneumothorax, sepsis, and multiorgan failure. Despite prompt initiation of antifungal therapy including amphotericin B cholesteryl sulfate complex and isavuconazole upon detection of the fungal infection and concurrent administration of active organ function support treatment, the patient's condition rapidly deteriorated due to compromised immune function. Ultimately, on the 27th day of treatment, the patient succumbed to septic shock and multiple organ dysfunction syndrome. This is the first case of Curvularia lunata infection in our hospital. In this paper, we aim to raise awareness of Curvularia lunata infection and to emphasize that the possibility of this fungal infection should be considered in patients with severe pneumonia caused by influenza A virus and that empirical antifungal therapy should be given promptly when the patient has invasive lung damage.