OpenMed/multicare-articles huggingface dataset:
An Atypical Case of a Common Pregnancy Issue: Appendicitis-Like Hyperemesis Gravidarum
Authors: Janice Chung, Ryan P Berryman
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Hyperemesis gravidarum (HG) is a severe subtype of nausea and vomiting in pregnancy (NVP) that typically affects women in their first trimester of pregnancy. Because HG is a diagnosis of exclusion, a thorough work-up ruling out organic causes must be performed. Herein, we describe a case of a pregnant woman with HG who presented with intractable pain mimicking appendicitis. While her clinical picture and ultrasound findings were only mildly consistent with appendicitis, the only therapy that provided pain relief was empiric antibiotic treatment that was prescribed due to a mildly elevated procalcitonin of 0.61. Thereby, the detection and treatment of concurrent organic causes is important as it may provide significant symptomatic relief in cases of concurrent HG.
PD-1 blockade induces remissions in relapsed classical Hodgkin lymphoma following allogeneic hematopoietic stem cell transplantation
Authors: James Godfrey, Michael R Bishop, Sahr Syed, Elizabeth Hyjek, Justin Kline
Journal: J Immunother Cancer (2017)
Keywords: allogeneic transplant, checkpoint blockade, hodgkin lymphoma, pd-1
MeSH terms: Antibodies, Monoclonal / therapeutic use, Antineoplastic Agents / therapeutic use, Hodgkin Disease / drug therapy, Hodgkin Disease / therapy, Programmed Cell Death 1 Receptor / antagonists & inhibitors, Case Reports, Adult, Antibodies, Monoclonal / adverse effects, Antineoplastic Agents / adverse effects, Hematopoietic Stem Cell Transplantation, Humans, Male, Middle Aged, Nivolumab, Recurrence, Remission Induction, Transplantation, Homologous, Antibodies, Monoclonal, Antineoplastic Agents, PDCD1 protein, human, Programmed Cell Death 1 Receptor, Nivolumab

Background:
Allogeneic hematopoietic stem cell transplantation and checkpoint blockade therapy are immune-based therapies that have activity in selected refractory hematologic malignancies. Interest has developed in combining these treatments for high-risk hematologic diseases. However, there is concern that checkpoint blockade could augment graft-versus-host disease, and very few studies have evaluated the safety of checkpoint blockade in the post-allogeneic setting. Here, we report the outcomes of three patients with relapsed classical Hodgkin's lymphoma following allogeneic transplant that were treated with the anti-PD-1 antibody, nivolumab.
Case presentations:
Three patients with Hodgkin's lymphoma relapsed following allogeneic transplant received nivolumab therapy at our institution. All patients were free of graft-versus-host disease and were off of all systemic immunosuppressive medications at the time of nivolumab treatment. Nivolumab was well-tolerated in two of the patients. However, nivolumab had to be discontinued in one patient due to development of immune-related polyarthritis requiring treatment with systemic corticosteroids and methotrexate. Objective responses were observed in all three patients.
Conclusions:
Our case series demonstrates that anti-PD-1 therapy with nivolumab can be highly effective following allogeneic transplant for Hodgkin's lymphoma, but serious immune-related adverse events can occur, requiring very close monitoring and interruption of therapy.
Ethmoidal osteoid osteoma with orbital and intracranial extension - a case report
Authors: S Balaji Pai, K Harish, M S Venkatesh, Udayshankar, Deepthi Jermely
Journal: BMC Ear Nose Throat Disord (2005)

Background:
Osteoid osteoma is a benign bone neoplasm which is seen in the long bones of appendicular skeleton. It is rarely seen in the cranium. Skull base osteoid osteoma is extremely rare and has been anecdotally reported.
Case presentation:
The authors report a case of a large osteoid osteoma of the ethmoid with intraorbital and intracranial extension in a 33 year old male patient. He presented with loss of vision in the left eye. The intra-cranial extension was excised through a single burr-hole fronto-orbitotomy. The ethmoid and orbital portions were approached and excised through a Weber-Ferguson incision and inferior orbitotomy. Radical excision of the tumor could thus be achieved through a craniofacial approach.
Conclusion:
Although benign and rare, skull base osteoid osteoma can present with neurological deficit due to its mass effect and involvement of vital structures. A multispeciality team approach is advisable in such cases if radical excision is to be achieved. A craniofacial approach made radical single stage excision of this multicompartmental osteoid osteoma possible with an uneventful postoperative period.
Amyloid-Beta related angiitis of the central nervous system: case report and topic review
Authors: Amre Nouh, Ewa Borys, Angelica K Gierut, José Biller
Journal: Front Neurol (2014)
Keywords: amyloid-beta related angiitis, cerebral amyloid angiopathy, cerebral amyloid angiopathy-related inflammation, leptomeningeal enhancement, primary angiitis of the central nervous system

Amyloid-beta related angiitis (ABRA) of the central nervous system (CNS) is a rare disorder with overlapping features of primary angiitis of the CNS and cerebral amyloid angiopathy. We evaluated a 74-year-old man with intermittent left sided weakness and MRI findings of leptomeningeal enhancement, vasogenic edema, and subcortical white matter disease proven to have ABRA. We discuss clinicopathological features and review the topic of ABRA.
Valproic acid induced necrohemorragic pancreatitis: Case report and diagnostic approach in uncommon pancreatitis
Authors: Silvia Carolina Barbosa, Paulo Cabrera, Bayron Guerra, Carlos F Roman
Journal: Int J Surg Case Rep (2019)
Keywords: acute pancreatitis, algorithm, medication induced pancreatitis, necrotizing pancreatitis, valproic acid

Background:
Acute pancreatitis (AP) is one of the most frequent gastrointestinal alterations in the United States. Medication induced AP has been undervalued in the surgical environment as etiologic entity of necrohemorragic pancreatitis (NHP). A case of NHP induced by valproic acid (VA) is presented, and an exclusion diagnostic algorithm is proposed.
Case report:
A 29-year-old female with past medical history of migraine controlled with VA was admitted to our institute for acute abdominal pain and peritoneal irritation. An exploratory laparotomy was performed, finding pancreatic necrosis and a diagnosis of NHP was determined. The most frequent etiologies for AP were discarded. An exclusion diagnostic algorithm was performed reaching VA as etiologic gent. The treatment consisted on medication withdrawal, oral restriction, parenteral nutrition, hydration, analgesia and peritoneal wash-outs with a positive outcome.
Conclusion:
Is convenient to consider a medication induced AP in patients without clear causative agent, such as the VA case presented. An etiological diagnosis algorithm of exclusion is proposed, for an adequate therapeutic approach in medication induced PNH. Algorithm validation is required.
Intra-articular synovial lipoma of the knee joint
Authors: L Poorteman, H Declercq, P Natens, K Wetzels, F Vanhoenacker
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

We present a rare case of an intra-articular synovial lipoma, which was diagnosed in a patient after a knee trauma. MRI is the imaging modality of choice to suggest the diagnosis preoperatively, by demonstrating a well-delineated fat-containing lesion. The differential diagnosis of an intra-articular lipomatous lesion consists of lipoma arborescens and synovial lipoma.
Nerve root metastasis of gastric adenocarcinoma: A case report and review of the literature
Authors: Alessandra Di Sibio, Lucia Romano, Antonio Giuliani, Marco Varrassi, Maria Carmela De Donato, Antonio Iacopino, Marco Perri, Mario Schietroma, Francesco Carlei, Ernesto Di Cesare, Carlo Masciocchi
Journal: Int J Surg Case Rep (2019)
Keywords: metastasis, metastatic gastric cancer, radiation therapy, spinal nerve root ganglion neoplasm

Introduction:
Nerve root metastasis without extension from an adjacent process has been seldom reported in case of solid tumors. We describe a case of solitary nerve root metastasis of gastric adenocarcinoma, likely due to hematogenous spread.
Case presentation:
A 75-year-old man presented with radiculopathy refractory to medical treatment. MRI and CT demonstrated a right-sided S1 nerve root mass involving the spinal ganglion in its intra-foraminal region with avid enhancement, initial erosive bone changes on sacral foramina and focal hyperaccumulation on 18F - FDG CT-PET, suspicious for metastasis. The histopathological examination confirmed a metastasis of gastric adenocarcinoma.
Discussion:
A review of the current literature revealed only ten cases of hematogenous metastases to spinal nerve root ganglia; the primary lesions in those cases were an oat cell carcinoma of the lung, two cases of colonic adenocarcinoma, a case of uterine adenocarcinoma, a ductal breast carcinoma, a Ewing's sarcoma, a Renal Cell Carcinoma, a gastro-intestinal stromal tumor, a follicular thyroid carcinoma, a pulmonary adenocarcinoma.
Conclusion:
In the setting of a known malignancy, a nerve root metastasis should be considered in the differential diagnosis of a nerve root mass, although it occurs very rarely.
French Language Online Cognitive Behavioral Therapy for Insomnia Disorder: A Randomized Controlled Trial
Authors: Régis Lopez, Elisa Evangelista, Lucie Barateau, Sofiene Chenini, Adriana Bosco, Michel Billiard, Anne-Dominique Bonte, Séverine Béziat, Isabelle Jaussent, Yves Dauvilliers
Journal: Front Neurol (2019)
Keywords: adults, cognitive-behavioral therapy, insomnia, internet-based intervention, randomized controlled trial
MeSH terms: Case Reports

Background: Despite cognitive-behavioral therapy for insomnia (CBT-I) being the recommended treatment for insomnia disorder, its access remains very limited. Automated Internet-delivered CBT-I (eCBT-I) is an emerging cost-effective strategy for adults with insomnia, however no such program is currently available in French Language. We evaluated a French-speaking, eCBT-I intervention to improve insomnia disorder in comparison to minimal psychoeducation therapy (mPT). Methods: Forty-six adults with insomnia disorder were randomly allocated to eCBT-I or mPT. The eCBT-I program consisted of seven sessions that delivered the typical components of CBT-I during 12 weeks. The mPT provided structured and non-tailored information about sleep and insomnia during a 1 h session. Insomnia severity Index (ISI, primary outcome), measures of fatigue, sleepiness, anxiety, depressive symptoms and quality of life were collected at baseline and endpoint. Electronic sleep diaries were completed over 2 week periods pre- and post-intervention. Results: Compared to mPT, eCBT-I resulted in greater decrease in ISI scores between baseline and endpoint. Sleep diaries parameters improved in both groups, with a greater improvement in the eCBT-I group. Patients allocated to eCBT-I group also improved depressive, fatigue, anxiety symptoms, and quality of life. Among patients with CNS-active drug at baseline, 91.7% reduced or stopped their hypnotic medication, and 16.7% in the mPT group. Conclusions: The present eCBT-I program seems feasible, acceptable and effective in reducing insomnia severity and insomnia-related functional outcomes in this small clinically-derived population. Given the high prevalence of insomnia, our data are supportive of the use of such program as an effective alternative to treat insomnia in daily clinical practice in French speaking countries.
Technical Note on Root Coverage of Lower Anterior Teeth Using a Partially Deepithelialized Connective Tissue Graft (PE-CTG) Aided by a High-Speed Handpiece
Authors: Kyeong-Ok Lim, Byung-Ock Kim, Won-Pyo Lee
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Root coverage in the mandibular anterior region is challenging because of a thin gingival biotype, shallow vestibule, and high frenum attachment. Several methods have been introduced to predict the root coverage in this area. Stimmelmayr proposed a method of performing root coverage using a combination epithelialized-subepithelial connective tissue graft (CTG). However, it is difficult to precisely acquire connective tissue according to this method. Therefore, in this case report, we would like to introduce a technique to harvest a partially deepithelialized CTG (PE-CTG) aided by a high-speed handpiece, which helps in procuring the graft easily and quickly. This method could lower the patient's morbidity at donor sites and enhance the healing process. Additionally, it could increase the amount of keratinized gingiva in the mandibular anterior region without reducing the vestibular depth. Therefore, PE-CTG using a high-speed handpiece can be a promising treatment option for the root coverage of the mandibular anterior teeth.
Osseointegrated supported prosthesis and interdisciplinary approach for prosthodontic rehabilitation of a young patient with ectodermal dysplasia
Authors: Karthik M Sadashiva, N Sridhar Shetty, Rakshith Hegde, Mallika M Karthik
Journal: Case Rep Med (2013)

Anhidrotic ectodermal dysplasia is a triad of hypodontia or anodontia, hypotrichosis, and hypohydrosis, associated with other problems that result from the defective development of structures of ectodermal origin (Freire-Maia, Pinheiro (1988)). Early and extensive dental treatment is needed keeping in mind the effect on the craniofacial growth. Due to rapid growth of the jaws, the patients are rehabilitated using removable prostheses (Tarjan et al. (2005)). Hence for a young patient in this case report, the placement of endosseous osseointegrated implants was delayed till adulthood. Finally a definitive fixed tooth-supported and osseointegrated implant supported fixed partial denture therapy was used to rehabilitate the patient satisfactorily after she had completed her growth (Sweeney et al. (2005)). A review of the current literature relevant to several aspects of syndromic hypodontia, patient selection, and implant planning is discussed.
The potential utility of pharmacogenetic testing in psychiatry
Authors: Kathryn R Gardner, Francis X Brennan, Rachel Scott, Jay Lombard
Journal: Psychiatry J (2014)
MeSH terms: Review

Over the last decade, pharmacogenetics has become increasingly significant to clinical practice. Psychiatric patients, in particular, may benefit from pharmacogenetic testing as many of the psychotropic medications prescribed in practice lead to varied response rates and a wide range of side effects. The use of pharmacogenetic testing can help tailor psychotropic treatment and inform personalized treatment plans with the highest likelihood of success. Recently, many studies have been published demonstrating improved patient outcomes and decreased healthcare costs for psychiatric patients who utilize genetic testing. This review will describe evidence supporting the clinical utility of genetic testing in psychiatry, present several case studies to demonstrate use in everyday practice, and explore current patient and clinician opinions of genetic testing.
Case Report: Identification of likely recurrent CEP290 mutation in a child with Joubert syndrome and cerebello-retinal-renal features
Authors: Lidvana Spahiu, John A Sayer, Emir Behluli, Thomas Liehr, Gazmend Temaj
Journal: F1000Res (2023)
Keywords: cep290, joubert syndrome, ciliopathy, molecular genetics, retinal dystrophy
MeSH terms: Abnormalities, Multiple / genetics, Ciliopathies, Eye Abnormalities / diagnostic imaging, Eye Abnormalities / genetics, Kidney Diseases, Cystic / diagnostic imaging, Kidney Diseases, Cystic / genetics, Case Reports, Research Support, Non-U.S. Gov't, Antigens, Neoplasm / genetics, Cell Cycle Proteins / genetics, Cerebellum / diagnostic imaging, Child, Preschool, Cytoskeletal Proteins / genetics, Female, Humans, Kidney, Retina / diagnostic imaging, Antigens, Neoplasm, Cell Cycle Proteins, Cep290 protein, human, Cytoskeletal Proteins, Agenesis of Cerebellar Vermis

Background. Joubert syndrome (JS) is a rare autosomal recessive ciliopathy with an estimated prevalence of 1 in 100,000. JS is characterized by hyperpnoea, hypotonia, ataxia, developmental delay and various neuropathological abnormalities in the brain including cerebellar hypoplasia and cerebellar vermis aplasia. JS can also have variable multi-organ involvement, including the retina, kidneys, liver, and musculoskeletal system. Methods and Results. Here we report a clinical description of two-year-old girl presenting with breathing difficulties, hyperechoic kidneys with loss of corticomedullary differentiation. Brain magnetic resonance imaging revealed the typical molar tooth sign consistent with a clinical diagnosis of JS and retinal examination showed severe retinal dystrophy leading to blindness. Molecular genetic analysis using whole exome sequencing and Sanger sequence confirmation demonstrated a homozygous mutation (c.5493delA, p.(A1832fs*19) in CEP290 which segregated from either parent and was consistent with the multisystem ciliopathy phenotype. This precise variant has been described previously in 2 families from the Kosovar-Albanian region suggesting this allele is a recurrent mutation in this population. Conclusions. Mutations in CEP290 lead to multisystem ciliopathy syndromes and molecular genetic diagnostics of such cases allows precise diagnosis, screening of at risk relatives and appropriate management.
Abdominal Tuberculosis: A Diagnostic Dilemma
Authors: Arun Joyati Tarafder, Mamun-Al Mahtab, Sisir Ranjan Das, Rezaul Karim, Habibur Rahaman, Salimur Rahman
Journal: Euroasian J Hepatogastroenterol (2015)
Keywords: abdominal tuberculosis, diagnosis, tuberculosis
MeSH terms: Case Reports

According to the World Health Organization, more than 2 billion people are estimated to be infected with tuberculosis (TB) and approximately 95% of tuberculosis cases occur in developing countries. Extrapulmonary forms of tuberculosis constitute approximately one-sixth of all cases and the prevalence of extrapulmonary tuberculosis (TB) seems to be rising, particularly due to increasing prevalence of acquired immunodeficiency syndrome (AIDS). In patients with extrapulmonary TB, abdomen is involved in 12% of patients. Gastrointestinal involvement is found in 66 to 75% of abdominal cases, with the terminal ileum and the ileocecal region being the most common sites of involvement. Here, we report a case of abdominal TB.
How to cite this article:
Tarafder AJ, Al-Mahtab M, Das SR, Karim R, Rahaman H, Rahman S. Abdominal Tuberculosis: A Diagnostic Dilemma. Euroasian J Hepato-Gastroenterol 2015;5(1):57-59.
Acquired Factor VIII Inhibitor Presenting as Occult GI Bleeding
Authors: Carlos I Pacheco Cano, Marilyn A Arosemena, Roumen B Iordanov, Ankitha Lingamaneni, Ankur Aneja
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

An acquired coagulation factor deficiency is characterized by acquired autoantibodies against specific clotting factors in those without diagnosed hemophilia. It is a relatively rare condition with an incidence of approximately one case per million per year. We present a case report of an elderly male who initially presented with an occult GI bleed that was identified with a positive fecal occult blood test result. This is the first case reported to our knowledge of an acquired factor inhibitor deficiency presenting in this manner. We postulate the importance of acquired factor inhibitors in the setting of unexplained anemia given absence of overt clinical symptoms that could contribute to aggravate an established GI bleed, especially in the elderly population.
Case report: Meningioma associated with meningioangiomatosis mimicking invasive meningioma
Authors: Rong Ge, Jun Yang, Xiangang Yin, Jingya Wang
Journal: Front Neurol (2023)
Keywords: invasive meningioma, meningioangiomatosis, meningioma, neurology, pathology
MeSH terms: Case Reports

Meningioangiomatosis (MA) is a rare malformation or hamartomatous lesion in the central nervous system, characterized by a plaque-like mass within the leptomeninges and cerebral cortex. An even rarer condition is MA complicated with meningiomas. We herein report a case of meningioma associated with MA that might be erroneously interpreted as a higher-grade lesion or an invasion by preoperative radiologic and postoperative histological examinations.
First Case Report of Sinusitis with Lophomonas blattarum from Iran
Authors: Fariba Berenji, Mahmoud Parian, Abdolmajid Fata, Mahdi Bakhshaee, Fereshte Fattahi
Journal: Case Rep Infect Dis (2016)

Introduction. Lophomonas blattarum is a rare cause of bronchopulmonary and sinus infection. This paper presents a rare case of Lophomonas sinusitis. Case Presentation. The patient was a 31-year-old woman who was admitted because of a history of upper respiratory infection and sinusitis. Direct microscopic examination of the sputum and nasal discharge showed large numbers of living Lophomonas blattarum with irregular movement of flagella. The patient was successfully treated by Metronidazole 750 mg t.i.d. for 30 days. Conclusions. This is the first case report of Lophomonas blattarum sinusitis from Iran.
MODIFIED SALTER PELVIC OSTEOTOMY FOR THE DDH TREATMENT
Authors: Suvorov Vasyl, Filipchuk Viktor
Journal: Acta Ortop Bras (2023)
Keywords: developmental dysplasia of the hip, evaluation of results of therapeutic interventions, osteotomy, pelvic region

Objectives:
Three pelvic osteotomies (Salter, Dega, Pemberton) are widely used in walking patients under seven years old for DDH treatment. We've proposed a modified Salter Pelvic Osteotomy (SPO), which has the advantages of the abovementioned osteotomies.
Methods:
Short- and mid-term results were assessed in 19 patients after the modified SPO application. Patients were examined before and after the surgery, at 6 months postoperatively, and at follow-up.
Results:
Acetabular Index (AI) before the surgery was 39.5 ± 7 °; after the surgery - 24.4 ± 5.5 °, at 6 months - 20.4 ± 5 ° (9-28), at follow-up - 14.5 ± 4 °; AI correction - 14.9 ± 5.5 °. Lateral Centre-Edge Angle at follow-up - 22.7 ± 4.7 °. Clinical results at follow-up were I / II McKay grade in 18 patients (94.7%); radiological results were I / II Severin class in 18 patients (94.7%).
Conclusion:
Modified SPO improves the FH coverage in any direction; results after modified SPO are excellent and good in most patients. Level of Evidence IV; Case Series .
Fatal Type B Lactic Acidosis Associated With Metastatic Colorectal Cancer: A Case Report With Review of Literature, Pathogenesis, and Treatment
Authors: Bharatsinh Gharia, Karan Seegobin, Hetavi Mahida, Marwan Shaikh, Trevanne Matthews Hew, Dat Pham
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: colorectal cancer, lactic acidosis, literature review

Type B lactic acidosis associated with malignancy is a life-threatening complication and mostly seen in hematological malignancies but can also be seen in solid tumors. We report a rare case of a 64-year-old female diagnosed with metastatic adenocarcinoma of the colon with liver metastasis associated with severe type B lactic acidosis. We discuss pathophysiology, previously reported cases, and their outcomes. The most widely used therapies are bicarbonate infusion, thiamine supplementation, chemotherapy, and supportive care but is associated with poor outcomes, and no standard treatment recommendations are available. Early chemotherapy administration remains the only intervention that has shown some survival benefit. Physicians should be aware and proactive for early diagnosis and management of this condition with further research needed to guide optimal therapy.