OpenMed/multicare-articles huggingface dataset:
Diagnosis of bilateral pharyngoesophageal diverticula with using swallow contrast-enhanced ultrasound: a case report
Authors: Xue Wan, Hongyan Liu, Juxian Liu, Yulan Peng
Journal: Front Oncol (2024)
Keywords: case report, contrast-enhanced ultrasound, diagnosis, pharyngoesophageal diverticula, thyroid nodule
MeSH terms: Case Reports

Pharyngoesophageal diverticulum (PED) is a rare disease of the esophagus that is usually asymptomatic and often found incidentally during a thyroid ultrasound examination. Due to its anatomical location close to the thyroid, it is easily misdiagnosed as a thyroid nodule, which leads to unnecessary thyroid biopsies and surgical treatment. The occurrence of a single esophageal diverticula is common, while the existence of multiple diverticula is rare. Left side diverticula are more common than right sided ones, while bilateral occurrences are rarely reported. We report an extremely rare case of bilateral pharyngeal esophageal diverticula. The patient was a 55-year-old asymptomatic man who came to our hospital after thyroid nodules were identified in another hospital. Due to the extensive clinical experience of the ultrasound physician at our facility, the patient was suspected to have bilateral esophageal diverticula, which was confirmed by using swallow contrast-enhanced ultrasound (CEUS). Consequently, unnecessary thyroid treatments were avoided in this patient. This study shows that although bilateral pharyngeal diverticula are unusual, the possibility of their existence should be considered if nodules are located posterior to the bilateral thyroid glands and have suspicious imaging characteristics. Particular attention should be given to nodules located on the right side of the thyroid, which are sometimes overlooked easily due to their very low incidence. If real-time ultrasound cannot be used in making the diagnosis, PED can be further identified using swallowing CEUS to avoid unnecessary thyroid fine needle aspiration (FNA) and surgical treatment.
Acupuncture therapy for Parkinson's disease: a case report demonstrating symptomatic improvement without medication
Authors: Suying Lei, Qing Liu, IanI Leong, Jingqi Fan, YauKeung Tsang, Xin Liu, Xiaoyan Xu, Lixing Zhuang
Journal: Front Neurol (2024)
Keywords: parkinson’s disease, acupuncture therapy, alternative treatment, case report, symptomatic improvement
MeSH terms: Case Reports

Background:
Parkinson's disease (PD) often necessitates immediate medical intervention following diagnosis. In recent years, there has been a noticeable increase in clinical investigations assessing the efficacy of acupuncture in PD, with many studies reporting positive outcomes. Ethical guidelines commonly endorse pharmaceutical therapies for PD, leading ongoing research to combine acupuncture with standard drug-based treatments. At present, there is a conspicuous absence of dedicated clinical research exclusively examining the independent impact of acupuncture on PD treatment.
Case:
In a clinical observation, we documented a case involving a 75-year-old male displaying progressive, characteristic PD symptoms, including evident limb tremors, rigidity, bradykinesia, fatigue, and additional non-motor symptoms. The patient received a confirmed diagnosis of PD. Due to the refusal of the patient to take medication, we exclusively administered acupuncture therapy. The outcomes indicated a noteworthy enhancement in the clinical symptoms of the patient solely through acupuncture intervention.
Conclusion:
This case affirms that using acupuncture in isolation significantly improved both the motor and non-motor symptoms in the patient. Acupuncture could potentially serve as an alternative therapy for patients who decline or are intolerant to anti-Parkinson drugs. However, further studies are needed to assess its long-term efficacy. This case report obtained approval from the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine (Ethics number: K-2023-127).
Case report: Isolated oligometastatic disease of the prostate from a primary lung adenocarcinoma
Authors: Josette M Kamel, Simran Arjani, Kateryna Fedorov, Fnu Sapna, Jinrong Cheng, Ioannis Mantzaris
Journal: Front Oncol (2024)
Keywords: lung adenocarcinoma, lung adenocarcinoma with oligometastatic disease, prostate cancer, secondary prostate cancer, tumor to tumor metastasis
MeSH terms: Case Reports

Secondary prostate cancer typically occurs from direct seeding of a renal or bladder tumor. Metastasis via hematogenous spread is exceedingly rare and is typically identified incidentally at autopsy. This report describes a 72-year-old male with lung adenocarcinoma initially staged as Stage IA2 who developed oligometastatic disease of the prostate. He was initially treated with radiation therapy and was found to have a hypermetabolic focus in the prostate gland during surveillance PET/CT imaging 6 months following treatment. Subsequent biopsy revealed metastatic lung adenocarcinoma in 6/6 core samples, leading to diagnosis of oligometastatic disease of the prostate. To our knowledge, this is the first report of isolated oligometastatic disease to the prostate from a primary lung adenocarcinoma.
Efgartigimod as a promising add-on therapy for myasthenic crisis: a prospective case series
Authors: Jie Song, Haiyan Wang, Xiao Huan, Qilong Jiang, Zongtai Wu, Chong Yan, Jianying Xi, Chongbo Zhao, Huiyu Feng, Sushan Luo
Journal: Front Immunol (2024)
Keywords: antibody, efgartigimod, immunoglobulin g, myasthenic crisis, respiratory muscle, ventilation
MeSH terms: Myasthenia Gravis / drug therapy, Myasthenia Gravis / immunology, Observational Study, Multicenter Study, Adult, Aged, Autoantibodies / blood, Autoantibodies / immunology, CD4-Positive T-Lymphocytes / drug effects, CD4-Positive T-Lymphocytes / immunology, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Prospective Studies, Receptors, Cholinergic / immunology, Treatment Outcome, Autoantibodies, Receptors, Cholinergic

Introduction:
Efgartigimod is effective and well-tolerated in patients with anti-acetylcholine receptor (AChR) antibody-positive generalized myasthenia gravis (MG). However, the therapeutic potential and the safety profile of efgartigimod in myasthenic crisis (MC) remained largely unknown.
Methods:
This is an observational, prospective, multicenter, real-world study to follow 2 MC patients who initiated efgartigimod as a first-line rescue therapy and 8 cases who used it as an add-on therapy. Baseline demographic features and immunotherapies were collected, and the MG-activities of daily living (MG-ADL) scale was evaluated every week since efgartigimod treatment for 8 weeks. Additionally, serum IgG and anti-AChR antibody levels and the peripheral CD4+ T lymphocytes were measured before and after one cycle of treatment.
Results:
Ten patients with MC were enrolled in the study, including 9 anti-AChR antibody positive and 1 anti-muscle-specific kinase (MuSK) positive. All patients were successfully weaned from the ventilation after receiving efgartigimod treatment, with a length of 10.44 ± 4.30 days. After one cycle of infusions, the MG-ADL score reduced from 15.6 ± 4.4 at the baseline to 3.4 ± 2.2, while the corticosteroid dose was tapered from 55.0 ± 20.7 mg to 26.0 ± 14.1 mg. The proportions of regulatory T cells and naïve T cells (% in CD4+ T) significantly decreased post-efgartigimod treatment (5.48 ± 1.23 vs. 6.90 ± 1.80, P=0.0313, and 34.98 ± 6.47 vs. 43.68 ± 6.54, P=0.0313, respectively).
Conclusion:
These findings validated the rapid action of efgartigimod in facilitating the weaning process with a good safety profile in patients with MC.
Case report: Uterine perforation caused by migration of intrauterine devices
Authors: Qi Li, Desheng Qi, Tingting Bi, Xinyi Guo, Huan Chen
Journal: Front Med (Lausanne) (2024)
Keywords: hysteroscopy, laparoscopy, migration of intrauterine devices, three-dimensional computed tomography, uterine perforation
MeSH terms: Case Reports

Intrauterine devices (IUDs) are often considered a form of contraception by women of reproductive age because of their reversible, effective, safe, and convenient nature. However, its complications include bleeding, infection, displacement, and uterine perforation. As most patients do not exhibit any obvious symptoms, they ignore their complications and are unaware of the necessity of regular evaluation. Therefore, they are unable to implement timely interventions for the complications that can result in serious consequences. Although, three-dimensional (3D) ultrasound has demonstrated greater sensitivity in detecting subtle IUD malposition issues, particularly with side-arm embedment. Computed tomography (CT) scanning followed by multi-planar reformatting, maximum intensity projection, and volume rendering can precisely and intuitively display the morphology and location of the IUD, accurately exhibit the anatomical relationship between the IUD and the pelvis, and allow for a more accurate assessment of the degree of perforation and presence and absence of bowel perforation, thereby enabling us to select a more suitable surgical procedure with less damage to the patient. In this study, we reported an asymptomatic case of uterine perforation of the IUD into the serosal layer of the bladder, which developed 6 years post-IUD placement. A preoperative 3D reconstruction was made using the CT images of the IUD; then, the IUD was successfully removed with the assistance of a hysteroscope and laparoscope.
Case report: when art is faced with brain surgery: acute change in creative style in a painter after glioma resection
Authors: Hugues Duffau
Journal: Front Oncol (2024)
Keywords: art, brain surgery, case report, creativity, glioma
MeSH terms: Case Reports

Background:
Strong interactions between art and health are well-known. While advances in brain surgery resulted in an improved preservation of sensorimotor, visuospatial, language and cognitive functions, creative abilities received less attention. However, creativity may represent a critical issue to resume an optimal quality of life, especially in artists. Here, a unique case of sudden change in creative style in a painter who underwent glioma resection is described. This prompts to explore further creative thinking and its clinical implications in routine practice.
Methods:
A 36-year-old right-handed woman experienced inaugural seizures, allowing the discovery of a right frontal lesion. The patient was a professional painter and did not complain about any decline in her creativity. The preoperative neurological examination was normal.
Results:
Surgery was achieved with a maximal tumor resection through a frontal lobectomy. A WHO grade II oligodendroglioma was diagnosed. A regular surveillance was performed without adjuvant oncological treatment. The patient did not exhibit postoperative functional deterioration and she returned to normal activities including painting during 15 years. Remarkably, even though her creative activity was judged by the patient herself to be rich and satisfying, her style drastically changed from surrealism and mysticism to cubism whereas she was not able to explain why.
Conclusion:
This is the first report of acute modification of the painting style following frontal lobectomy for a low-grade glioma, supporting that brain resective surgery may impact creativity. While neglected for many decades, this complex human ability should be evaluated more regularly in neurosurgical practice, particularly in artists.
Case report: A rare case of isolated sigmoid Rosai-Dorfman disease on contrast-enhanced CT and 18F-FDG PET/CT
Authors: Wanling Qi, Zhehuang Luo, Mingyan Shao, Min Chen, Fengxiang Liao, Linfeng Hu
Journal: Front Med (Lausanne) (2024)
Keywords: 18f-fdg, ct, pet/ct, rosai-dorfman disease, histiocytosis
MeSH terms: Case Reports

Rosai-Dorfman disease (RDD) is an uncommon histiocytic disorder that occurs in nodal and/or extranodal sites. Extranodal RDD exhibits a wide range of clinical and radiological presentations, frequently leading to misdiagnoses. Involvement of the gastrointestinal (GI) system is uncommon, accounting for less than 1% of the reported cases. Here we present a case of a 54-year-old male who complained of abdominal distention and was diagnosed with RDD affecting the sigmoid colon, manifesting as a sigmoid mass. The patient had a past medical history of liver transplantation due to hepatocellular carcinoma (HC). This report details the multiphase contrast-enhanced computed tomography (CT) and fluorodeoxyglucose (18F-FDG) positron emission tomography (PET-CT) imaging findings of RDD involving the sigmoid colon without lymphadenopathy, and a review of the relevant literature is provided.
Multimodal Imaging in Unusual Alport Retinopathy
Authors: William Evans, James Richardson-May, Rashi Arora
Journal: Cureus (2024)
Keywords: alport retinopathy, alport syndrome, autofluorescence, fundus photo, multimodal imaging, oct
MeSH terms: Case Reports

Alport syndrome, a rare genetic condition, can manifest various ocular abnormalities. This case report presents a unique instance of Alport syndrome where bilateral reduced visual acuity led to cataract surgery and subsequent central serous chorioretinopathy due to steroid treatment. By utilizing multiple imaging modalities, we aim to illustrate classical and atypical findings, addressing a literature gap and sharing our experience for educational purposes.
Case Report: New presentation of CLIFAHDD syndrome with a novel variant in the NALCN gene and a literature review
Authors: Yi Chen, Xiaotong Xia, Yiwen Zhang, Li Gao, Chenyiyi He, Jianguo Cao
Journal: Front Pediatr (2024)
Keywords: clifahdd syndrome, nalcn gene, developmental delay, genetic testing, hypotonia, missense variant
MeSH terms: Case Reports

Background:
Congenital contractures of the limbs and face, hypotonia, and developmental delay (CLIFAHDD) syndrome (OMIM #616266) is an autosomal dominant hereditary disease that can lead to the congenital contracture of the limbs and face, hypotonia, and developmental delay. In addition, it may result in growth retardation and present various clinical symptoms, such as brain atrophy, a small pituitary gland, musculoskeletal abnormalities, abnormal breathing, abdominal hernia, and abnormal facial features. Herein, we describe a novel de novo missense genetic variant in the sodium leak channel, non-selective (NALCN) gene that is associated with CLIFAHDD syndrome.
Case description:
This study describes a patient with varus deformities in both feet, deviation of the ulnar side of the fingers, and severe hypotonia. This patient was subsequently confirmed to have CLIFAHDD syndrome through genetic testing, which also revealed a novel missense de novo genetic variant in the NALCN gene (c.3553G > A, p.Ala1185Thr).
Conclusions:
Our findings further enrich the known variant spectrum of the NALCN gene and may expand the range of clinical options for treating NALCN-related disorders.
Behaviours and psychological symptoms of childhood dementia: two cases of psychosocial interventions
Authors: Mustafa Atee, Ineka Whiteman, Rebecca Lloyd, Thomas Morris
Journal: Palliat Care Soc Pract (2024)
Keywords: batten disease, sanfilippo syndrome, behaviours and psychological symptoms of dementia, case report, childhood dementia, dementia behaviour support programs, neuropsychiatric symptoms, psychosocial interventions
MeSH terms: Case Reports

Childhood dementias are a group of rare, fatal neurodegenerative disorders, characterised by global cognitive decline, loss of previously acquired developmental skills and behaviours and psychological symptoms of dementia (BPSD). Batten disease, or neuronal ceroid lipofuscinosis, and Sanfilippo syndrome, or mucopolysaccharidosis type III, are two of the more common forms of childhood dementia disorders worldwide. While psychosocial interventions are the best available therapeutic approach for BPSD management in adult-onset dementia, there is very limited literature or clinical experience in the context of childhood dementia. To address this gap, we conducted a descriptive case analysis of BPSD profiles, associated contributing factors and targeted psychosocial interventions in two cases with childhood dementia disorders (Sanfilippo syndrome and CLN3 (juvenile onset) Batten disease) who were referred to Dementia Support Australia, a national dementia behaviour support service in Australia. Primary BPSD identified in these disorders included physical and verbal aggression and irritability/lability. In these cases, contributing factors to the development of BPSD were not monolithic, encompassing pain, caregiver's approach and over or under-stimulation. Improvement in BPSD were observed using the Neuropsychiatric Inventory-Quesionnaire and globally noted as per the qualitative feedback reported by family and caregivers. Person-centred, multimodal psychosocial interventions were recognised as effective therapies in resolving BPSD in these cases. In conclusion, the case studies described the nature and presentation of BPSD in two common forms of childhood dementia and demonstrated the potential benefits of person-centred psychosocial interventions (delivered through national dementia-specific support programs) in alleviating BPSD such as irritability and aggression in these disorders.
Case Report: Callosal disconnection syndrome manifesting as mixed frontal-callosal-posterior alien hand syndrome following extensive corpus callosum infarct
Authors: Muhamad Faizal Zainudin, Kar Chuan Soo, Khin Nyein Yin
Journal: F1000Res (2024)
Keywords: alien hand syndrome, brain infarction, case report, corpus callosum, middle cerebral artery stroke, rehabilitation outcome
MeSH terms: Case Reports

Alien hand syndrome (AHS) is a rare neurological phenomenon first described by Van Vleuten over a century ago. The most widely recognized variants in literature are frontal, callosal, and posterior AHS. AHS due to the corpus callosum lesion can occur alone or as part of callosal disconnection syndrome (CDS). This report presents a unique CDS case manifesting clinical features from all three AHS variants, resulting from an extensive corpus callosum infarct. Our patient exhibited various clinical features from the three AHS variants, which include grasping, groping, and difficulty releasing objects from the hand (anterior); intermanual conflict (callosal); arm levitation, mild hemiparesis, and hemisensory loss (posterior). Additionally, the extensive disruption of the corpus callosal fibers produced neurological manifestations of CDS, such as cognitive impairment, ideomotor and constructional apraxia, behavioral disorder, and transcortical motor aphasia. We employed a range of rehabilitation interventions, such as mirror box therapy, limb restraint strategy, verbal cue training, cognitive behavioral therapy, bimanual hand training, speech and language therapy, and pharmacological treatment with clonazepam. The patient showed almost complete resolution of CDS and AHS features by nine months post-stroke Our case report highlights distinctive clinical variations of AHS and the challenging correlation between clinical manifestations and neuroanatomical substrates. Future studies are necessary to explore the intricate neural connections and the precise function of the corpus callosum. This can be achieved by combining comprehensive neuropsychological testing with diffusion tensor tractography studies. It is also essential to develop a validated tool to standardize AHS assessment. Finally, the scarcity of evidence in rehabilitation interventions necessitates further studies to address the wide knowledge gap in AHS and CDS management.
A Smile Reimagined: Gummy Smile Resolution with Cutting Edge Method Using Chu's Gauge and Polymethylmethacrylate (PMMA) Bone Cement
Authors: Shalini Mundra, Neetha J Shetty
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Excessive gingival display (EGD) is one of the most common aesthetic concerns, and its correction often presents a challenge to periodontists. It has a multifactorial etiology, and this article describes a case involving hypermobile upper lip (HUL), altered passive eruption (APE), and vertical maxillary excess (VME). Upon investigation, a positive collum angle and marked subnasal skeletal depression were observed. In this context, it is noted that during a spontaneous smile, the upper lip retracts and gets lodged in this depression. The rehabilitation plan includes included aesthetic crown lengthening via gingivectomy using Chu's proportional gauge for altered passive eruption and filling the subnasal depression by PMMA (polymethylmethacrylate) bone cement. The entire treatment plan was digitalised using cutting edge methods such as computed tomography (CT), cone beam computed tomography (CBCT), and 3D printers for virtual planning of the defect's position, size, and shape. No postoperative complications were reported. After six months, the patient exhibited a harmonious smile with reduced exposed gingiva.
Canine Descemet Stripping Endothelial Keratoplasty with a Tissue Insertion Device: Technique and Long-Term Outcome
Authors: Conan Y Chen, Steven J Solar, Daniel S Lewis, Kali Barnes, Batya G Wiener, Satya Baliga, Eric Chiang, Tim E Askew, Allen O Eghrari, Micki D Armour
Journal: Case Rep Vet Med (2023)
MeSH terms: Case Reports

Introduction. We describe a case of canine Descemet's stripping endothelial keratoplasty (DSEK) using an open-source canine tissue delivery device. Case Presentation. We follow the four-year outcomes of a 1.5-year-old Tibetan Terrier who presented with difficulty seeing, diffuse corneal edema, and central corneal thickness of 1400 microns in the left eye. To perform DSEK, a polycarbonate carrier and insertion device was designed for canine corneas that measure up to 15 mm in diameter. The tissue was loaded into the inserter prior to surgery with the endothelium facing inwards and the stroma facing the cartridge wall. From the cartridge, the graft was pulled into the eye using microforceps and an anterior chamber maintainer. We assessed preoperative endothelial cell count, postoperative corneal clearance, and graft adhesion. The donor was a two-year-old Airedale Terrier who died one day prior to surgery, with endothelial cell density of 3149 cells/mm2. One week after DSEK, the cornea began to clear, and pachymetry of the donor and graft total was 1410 microns. This improved to 800 microns at 4 months and continued improving in its clarity at the last postoperative visit 4 years after surgery. Discussion. We demonstrate the feasibility of conducting canine endothelial keratoplasty with a specially designed tissue delivery device and the potential of long-term corneal clearance after DSEK in canine eyes.
Pleuroparenchymal Fibroelastosis as a Late-Onset Pulmonary Toxicity after Treatment with Anticancer Chemotherapy for High-Risk Neuroblastoma
Authors: Satoshi Yokoyama, Risa Kanai, Daisuke Fukao, Keigo Hamahata
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

Pleuroparenchymal fibroelastosis (PPFE) is a rare, progressive, restrictive lung disease characterized by hypercarbic respiratory failure. In pediatrics, it has been described in patients with a history of malignancy who have received a bone marrow transplant, chemotherapy, or radiotherapy. It is characterized by pleural thickening, fibrosis, subpleural elastosis, and intraalveolar collagen deposits. Survival is poor, and the only therapy is lung transplantation. Here, we report a patient who developed PPFE as a late-onset pulmonary toxicity after treatment with anticancer chemotherapy for high-risk neuroblastoma (NB).