OpenMed/multicare-articles huggingface dataset:
Case report: Cheek acupuncture exhibits an immediate effect in relieving severe pain associated with nerve compression or damage of central nervous system and its potential mechanism of action
Authors: Yongzhou Wang, Lu Yang, Yongzheng Wu
Journal: Front Neurosci (2023)
Keywords: central nerve system, cheek acupuncture, mechanism of action, nerve compression, pain
MeSH terms: Case Reports

Peripheral nerve compression or permanent damage of central nervous system (CNS) can trigger severe neuralgia to patients. Analgesic medicine or even surgery to remove nerve compression is commonly used for pain relief. But these treatments either are ineffective, have side-effect or can cause subsequent complications. Acupuncture, a technique that has been widely used in China and other Asian countries for thousands of years, is an alternative to relieve pain, although the mechanism of action is not fully understood. In this study, two patients who had symptoms of severe neuralgia associated with peripheral nerve compression or permanent damage/dysfunction of CNS and analgesic medicines are ineffective, underwent cheek acupuncture, a new technique established recent years by the author with the features of painless, standardization, simplicity, and precision. An immediate analgesic effect of the cheek acupuncture was observed without any side effects, and clinical remission was achieved after several sessions of treatments. It suggests that this new approach is an efficient alternative for pain relief induced by nerve impairment. The authors proposed a biological holographic model of triplet homunculi existing at the level of the local cheek, spinal cord, and cerebral cortex, to explain the immediate and accurate analgesic effect of the cheek acupuncture. These homunculi have the same structure, and synchronized sensations and actions that are mediated by afferent and efferent neurons, as the integrated human body. Therefore, the nociception and needling signals are sensed, transmitted, analyzed, and manipulated cooperatively and simultaneously among these homunculi with the subsequent pain relief in the body.
An outbreak of type π vaccine-derived poliovirus in Sichuan province, China: emergence and circulation in an under-immunized population
Authors: Hai-Bo Wang, Gang Fang, Wen-Zhou Yu, Fei Du, Chun-Xiang Fan, Qing-Lian Liu, Li-Xin Hao, Yu Liu, Jing-Shan Zheng, Zhi-Ying Qin, Wei Xia, Shi-Yue Zhang, Zun-Dong Yin, Qiong Jing, Yan-Xia Zhang, Rong-Na Huang, Ru-Pei Yang, Wen-Bin Tong, Qi Qi, Xu-Jing Guan, Yu-Lin Jing, Qian-Li Ma, Jin Wang, Xiao-Zhen Ma, Na Chen, Hong-Ru Zheng, Yin-Qiao Li, Chao Ma, Qi-Ru Su, Kathleen H Reilly, Hui-Ming Luo, Xian-Ping Wu, Ning Wen, Wei-Zhong Yang
Journal: PLoS One (2014)
MeSH terms: Disease Outbreaks / prevention & control, Immunization / statistics & numerical data, Poliomyelitis / epidemiology, Poliomyelitis / prevention & control, Poliovirus / immunology, Poliovirus Vaccines / immunology, Case Reports, Adolescent, Child, Child, Preschool, China / epidemiology, Female, Humans, Infant, Male, Paralysis / epidemiology, Poliomyelitis / transmission, Poliovirus / physiology, Poliovirus Vaccines

Background:
During August 2011-February 2012, an outbreak of type Π circulating vaccine-derived poliovirus (cVDPVs) occurred in Sichuan Province, China.
Methods:
A field investigation of the outbreak was conducted to characterize outbreak isolates and to guide emergency response. Sequence analysis of poliovirus capsid protein VP1 was performed to determine the viral propagation, and a coverage survey was carried out for risk assessment.
Results:
One clinical compatible polio case and three VDPV cases were determined in Ngawa County, Ngawa Tibetan and Qiang Autonomous Prefecture, Sichuan Province. Case patients were unimmunized children, 0.8-1 years old. Genetic sequencing showed that the isolates diverged from the VP1 region of the type Π Sabin strain by 5-12 nucleotides (nt) and shared the same 5 nt VP1 substitutions, which indicate single lineage of cVDPVs. Of the 7 acute flaccid paralysis cases (all>6 months) reported in Ngawa Prefecture in 2011, 4 (57.1%) cases (including 2 polio cases) did not receive oral attenuated poliovirus vaccine. Supplementary immunization activities (SIAs) were conducted in February-May, 2012, and the strain has not been isolated since.
Conclusion:
High coverage of routine immunization should be maintained among children until WPV transmission is globally eradicated. Risk assessments should be conducted regularly to pinpoint high risk areas or subpopulations, with SIAs developed if necessary.
Qat use and esophageal cancer in Ethiopia: A pilot case-control study
Authors: Maria E Leon, Mathewos Assefa, Endale Kassa, Abate Bane, Tufa Gemechu, Yared Tilahun, Nigatu Endalafer, Gilles Ferro, Kurt Straif, Elizabeth Ward, Abraham Aseffa, Joachim Schüz, Ahmedin Jemal
Journal: PLoS One (2017)
MeSH terms: Catha / adverse effects, Esophageal Neoplasms / metabolism, Mouth Neoplasms / etiology, Adult, Alcohol Drinking / adverse effects, Case-Control Studies, Education, Esophageal Neoplasms / genetics, Ethiopia / epidemiology, Feeding Behavior, Female, Humans, Logistic Models, Male, Middle Aged, Mouth Neoplasms / chemically induced, Mouth Neoplasms / epidemiology, Risk Factors, Surveys and Questionnaires

Background:
Qat (Catha edulis) chewing is reported to induce lesions in the buccal mucosa, irritation of the esophagus, and esophageal reflux. Case series suggest a possible etiological role in oral and esophageal cancers. This pilot study aimed to generate preliminary estimates of the magnitude and direction of the association between qat use and esophageal cancer (EC) risk and to inform the logistics required to conduct a multi-center case-control study.
Methods:
Between May 2012 and May 2013, 73 EC cases (including 12 gastro-esophageal junction cases) and 133 controls matched individually on sex, age, and residence were enrolled at two endoscopy clinics and a cancer treatment hospital in Addis Ababa. A face-to-face structured questionnaire was administered. Qat use was defined as ever having chewed qat once a week or more frequently for at least one year. Odds ratios were calculated using conditional logistic regression.
Results:
Only 8% of cases resided in Addis Ababa. Qat use was more frequent in cases (36%) than in controls (26%). A 2-fold elevation in EC risk was observed in ever qat chewers compared with never users in unadjusted conditional logistic regression (OR = 2.12; 95% CI = 0.94, 4.74), an association that disappeared after adjusting for differences in tobacco use, consumption of alcohol and green vegetables, education level, and religion (OR = 0.95; 0.22, 4.22). Among never tobacco users, however, a non-significant increase in EC risk was suggested in ever qat users also after adjustment. Increases in EC risk were observed with ever tobacco use, alcohol consumption, low consumption of green vegetables, a salty diet, illiteracy, and among Muslims; the four latter associations were significant.
Conclusions:
This pilot study generated EC risk estimates in association with a habit practiced by millions of people and never before studied in a case-control design. Results must be interpreted cautiously in light of possible selection bias, with some demographics such as education level and religion differing between cases and controls. A large case-control study with enrolment of EC cases and carefully matched controls at health facilities from high-risk areas in the countryside, where the majority of cases occur, is needed to further investigate the association between qat use and EC.
Unilateral anterior uveitis complicating zoledronic acid therapy in breast cancer
Authors: Nagi S El Saghir, Zaher K Otrock, Jamal H Bleik
Journal: BMC Cancer (2005)
MeSH terms: Bone Density Conservation Agents / adverse effects, Breast Neoplasms / complications, Diphosphonates / adverse effects, Imidazoles / adverse effects, Uveitis, Anterior / chemically induced, Case Reports, Bone Density Conservation Agents / therapeutic use, Diphosphonates / therapeutic use, Female, Humans, Imidazoles / therapeutic use, Middle Aged, Osteoporosis / drug therapy, Osteoporosis / etiology, Zoledronic Acid, Bone Density Conservation Agents, Diphosphonates, Imidazoles, Zoledronic Acid

Background:
Zoledronic acid is very widely used in patients with metastatic bone disease and osteoporosis. Only one case of bilateral uveitis was recently reported related to its use.
Case presentation:
We report the first case of severe unilateral anterior uveitis in a patient with breast cancer and an intraocular lens. Following zoledronic acid infusion, the patient developed severe and dramatic right eye pain with decreased visual acuity within 24 hours and was found to have a fibrinous anterior uveitis of moderate severity The patient was treated with topical prednisone and atropine eyedrops and recovered slowly over several months.
Conclusion:
Internists, oncologists, endocrinologists, and ophtalmologists should be aware of uveitis as a possible complication of zoledronic acid therapy. Patients should be instructed to report immediately to their physicians and treatment with topical prednisone and atropine eyedrops should be instituted immediately at the onset of symptoms. This report documents anterior uveitis as a complication of zoledronic acid therapy. This reaction could be an idiosyncratic one but further research may shed more light on the etiology.
Defining disease phenotypes using national linked electronic health records: a case study of atrial fibrillation
Authors: Katherine I Morley, Joshua Wallace, Spiros C Denaxas, Ross J Hunter, Riyaz S Patel, Pablo Perel, Anoop D Shah, Adam D Timmis, Richard J Schilling, Harry Hemingway
Journal: PLoS One (2014)
MeSH terms: Atrial Fibrillation / diagnosis, Electronic Health Records, Research Support, Non-U.S. Gov't, Adult, Aged, Aged, 80 and over, Algorithms, Atrial Fibrillation / epidemiology, Atrial Fibrillation / pathology, Cohort Studies, Hospitals, Humans, Incidence, Middle Aged, Phenotype, Proportional Hazards Models, Risk Factors

Background:
National electronic health records (EHR) are increasingly used for research but identifying disease cases is challenging due to differences in information captured between sources (e.g. primary and secondary care). Our objective was to provide a transparent, reproducible model for integrating these data using atrial fibrillation (AF), a chronic condition diagnosed and managed in multiple ways in different healthcare settings, as a case study.
Methods:
Potentially relevant codes for AF screening, diagnosis, and management were identified in four coding systems: Read (primary care diagnoses and procedures), British National Formulary (BNF; primary care prescriptions), ICD-10 (secondary care diagnoses) and OPCS-4 (secondary care procedures). From these we developed a phenotype algorithm via expert review and analysis of linked EHR data from 1998 to 2010 for a cohort of 2.14 million UK patients aged ≥ 30 years. The cohort was also used to evaluate the phenotype by examining associations between incident AF and known risk factors.
Results:
The phenotype algorithm incorporated 286 codes: 201 Read, 63 BNF, 18 ICD-10, and four OPCS-4. Incident AF diagnoses were recorded for 72,793 patients, but only 39.6% (N = 28,795) were recorded in primary care and secondary care. An additional 7,468 potential cases were inferred from data on treatment and pre-existing conditions. The proportion of cases identified from each source differed by diagnosis age; inferred diagnoses contributed a greater proportion of younger cases (≤ 60 years), while older patients (≥ 80 years) were mainly diagnosed in SC. Associations of risk factors (hypertension, myocardial infarction, heart failure) with incident AF defined using different EHR sources were comparable in magnitude to those from traditional consented cohorts.
Conclusions:
A single EHR source is not sufficient to identify all patients, nor will it provide a representative sample. Combining multiple data sources and integrating information on treatment and comorbid conditions can substantially improve case identification.
Risk Factors Associated with Fatal Dengue Hemorrhagic Fever in Adults: A Case Control Study
Authors: Arjuna Medagama, Chamara Dalugama, Gukes Meiyalakan, Darshani Lakmali
Journal: Can J Infect Dis Med Microbiol (2020)

Background:
Dengue is endemic in most parts of the tropics with a significant mortality of 1-5%. Although individual case reports and case series have been published, large-scale case controls studies are few. The objective of this study was to find clinical and laboratory predictors of mortality in dengue.
Methods:
Hospital case record based case control study was performed.
Results:
Twenty fatalities with 80 controls were analyzed. Clinical parameters of postural dizziness (OR 3.2; 95% CI 1.1-8.9), bleeding (OR 31.9; 95% CI 6.08-167.34), presence of plasma leakage (OR 64.6; 95% CI 7.45-560.5), abdominal tenderness (OR 2.24; 95% CI 0.79-6.38), and signs of cardiorespiratory instability at admission increased the risk of dying from dengue. Altered consciousness was exclusively seen in 20% of cases. Laboratory parameters of elevated CRP (OR 1.652; 95% CI 1.28-2.14), AST, or ALT > 500 IU/L (OR 52.5; 95% CI 12.52-220.1) and acute kidney injury (AKI) (OR 103.5; 95% CI 13.26-807.78) during hospital stay increased the odds of dying. Need for assisted ventilation and multiorgan dysfunction (MOD) were exclusively seen in the cases. Multivariate logistic regression revealed bleeding at admission, AKI, and elevated hepatic transaminase >500 IU/L to be independent predictors of mortality.
Conclusions:
This case control study revealed that mortality from dengue could be predicted using clinical parameters at admission and low cost routine laboratory investigations.
Coin-shaped epithelial lesions following an acute attack of erythema multiforme minor with confocal microscopy findings
Authors: Kalpana Babu, Vinay R Murthy, Veeresh P Akki, Venkatesh C Prabhakaran, K R Murthy
Journal: Indian J Ophthalmol (2010)
MeSH terms: Cornea / pathology, Corneal Diseases / pathology, Microscopy, Confocal / methods, Stevens-Johnson Syndrome / complications, Case Reports, Acute Disease, Adult, Antiviral Agents / therapeutic use, Corneal Diseases / drug therapy, Corneal Diseases / etiology, Diagnosis, Differential, Drug Therapy, Combination, Follow-Up Studies, Glucocorticoids / therapeutic use, Humans, Male, Stevens-Johnson Syndrome / diagnosis, Stevens-Johnson Syndrome / drug therapy, Antiviral Agents, Glucocorticoids

We report an interesting ocular finding of bilateral multiple coin-shaped epithelial lesions along with the confocal microscopy findings in a patient following an acute attack of erythema multiforme (EM) minor. A 30-year-old male presented with a history of watering and irritation in both eyes of three days duration. He was diagnosed to have EM minor and was on oral acyclovir. Slit-lamp examination revealed multiple coin-shaped epithelial lesions. Confocal microscopy showed a corresponding conglomerate of hyper-reflective epithelial lesions. The corneal lesions resolved over six weeks with oral steroids and acyclovir. An immunological mechanism is suspected.
Oral and vulvo-vaginal lichenoid reactions due to mitotane (Lysodren): A case report
Authors: Arthur Schmouchkovitch, Héloïse Herry, Philippe Thuillier, Véronique Kerlan, Camille Fleuret, Guy Le Toux, Sylvie Boisramé
Journal: Medicine (Baltimore) (2017)
MeSH terms: Antineoplastic Agents, Hormonal / adverse effects, Lichenoid Eruptions / chemically induced, Mitotane / adverse effects, Mouth Diseases / chemically induced, Vulvar Diseases / chemically induced, Case Reports, Adrenal Cortex Neoplasms / drug therapy, Carcinoma / drug therapy, Female, Humans, Middle Aged, Antineoplastic Agents, Hormonal, Mitotane

Background:
The purpose of pharmacovigilance (drug safety) is collection, detection, assessment, monitoring, and prevention of adverse effects with pharmaceutical products. It is meant to identify, characterize, prevent, or minimize actual or potential risks relating to medicinal products. To prevent these adverse effects and improve our practice, health professionals have a duty to report side effects to assess this risk and evaluate the benefit/risk requirements. Mitotane (Lysodren) is used for treating adrenocortical carcinoma. Currently, no side effects concerning oral and genital mucosa have been reported.
Case summary:
This case report is about a 50 years old woman. Six months after the initiation on mitotane treatment, she developed erosive lesions located on the oral and vaginal mucosa. These drug reactions were diagnosed as erosive lichen planus by the biopsy. This lichenoid lesions were resistant to the usual treatments, mitotane being at the time not replaceable.
Conclusion:
This case describes an unreported adverse effect of mitotane, it is - to our knowledge - the 1st description of erosive lichenoid drug reaction due to Mitotane.
Cox-2 gene overexpression in ureteral stump urothelial carcinoma following nephrectomy for renal cell carcinoma: a case report
Authors: Wei-Pin Chang, Tsu-Ming Chien, Yu-Shiuan Wang, Siou-Jin Chiu, Mei-Hui Lee, Wei-Chiao Chang, Yii-Her Chou, Ming-Feng Hou
Journal: J Med Case Rep (2012)

Introduction:
A primary ureteral stump tumor after a nephrectomy is rare; urothelial carcinoma of the ureteral stump after a nephrectomy for renal cell carcinoma is even rarer. A thorough review of the literature indicated that only seven cases have previously been reported. In this study, we report the first Taiwanese case of urothelial carcinoma of the ureteral stump after a nephrectomy. It is also the first female case in the literature. The relationship between inflammatory genes, medication history and ureteral stump carcinoma after a nephrectomy for renal cell carcinoma has not been reported.
Case presentation:
A 72-year-old Asian Taiwanese women with chronic hepatitis C, liver cirrhosis and chronic kidney disease underwent a hand-assisted laparoscopic radical nephrectomy in 2001 due to renal cell carcinoma. Nine years later, she was diagnosed with ureteral stump urothelial carcinoma. Genetic and medication surveys were performed. Importantly, our patient had taken Chinese herbal drugs for more than 10 years and the inflammatory gene, Cox-2, was highly expressed in this patient. This is the first report to study the relationship between the Cox-2 gene and ureteral stump carcinoma after a nephrectomy for renal cell carcinoma.
Conclusion:
Long-term multiple use of Chinese herbal drugs could be one of the important risk factors for developing urothelial cancer. Close functional coupling between Chinese herbal drugs, Cox-2 gene activation and urothelial cancer should be further investigated.
Sagging Eye Syndrome or Nemaline Rod Myopathy? Divergence Insufficiency with Levator Dehiscence as an Overlapping Symptom between Two Diagnoses
Authors: Stephanie S L Cheung, Larissa K Ghadiali, Thomas H Brannagan Iii, Gul Moonis, Phyllis L Faust, Jeffrey G Odel
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

A 78-year-old woman complained of gradual, painless onset of horizontal binocular diplopia associated with progressive axial weakness. Physical examination revealed esotropia that was greater at distance than at near vision, bilateral levator dehiscence, and normal abducting saccadic speeds. Given the age of the patient and compatible clinical findings, the diagnosis of Sagging Eye Syndrome (SES) was made. However, further work-up with a muscle biopsy suggested Sporadic Late-Onset Nemaline Myopathy (SLONM) as the cause of her progressive muscle weakness. Although rare, external ophthalmoplegia has been described in the literature as a presenting symptom in SLONM. To elucidate the pathological mechanism for the patient's diplopia, an MRI of the orbits was performed, which revealed findings consistent with SES. This case aims to highlight the importance of integrating clinical findings during the diagnostic process and serves as a reminder that diplopia can be a common symptom for an uncommon diagnosis.
A Rare Case of Cavitary Lesion of the Lung Caused by Mycoplasma pneumoniae in an Immunocompetent Patient
Authors: Muhammad Kashif, Rizwan Ahmed Dudekula, Misbahuddin Khaja
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Mycoplasma pneumoniae is an atypical bacterium that most commonly causes upper respiratory tract infections, but it can also cause pneumonia, referred to as "walking pneumonia." Although cavitary lesions are present in a wide variety of infectious and noninfectious processes, those attributable to M. pneumoniae are extremely uncommon; thus, to date, epidemiological studies are lacking. Here, we present a rare case of a 20-year-old male, referred to us from a psychiatric facility for evaluation of a cough, who was found to have a cavitary lesion in the right upper lobe. An extensive workup for cavitary lesion was negative, but his mycoplasma IgM level was high. A computed tomography (CT) of the chest confirmed the presence of a cavitary lesion. After treatment with levofloxacin antibiotics, a follow-up CT showed complete resolution of the lesion. Our case is a rare presentation of mycoplasma pneumonia as a cavitary lesion in a patient without any known risk factors predisposing to mycoplasma infection. Early recognition and treatment with an appropriate antibiotic may lead to complete resolution of the cavitary lesion.
Candida guilliermondii as an agent of postpartum subacute mastitis in Rio de Janeiro, Brazil: Case report
Authors: Tatiane Nobre Pinto, Alana Kohn, Gisela Lara da Costa, Laura M A Oliveira, Tatiana C A Pinto, Manoel M E Oliveira
Journal: Front Microbiol (2022)
Keywords: candida guilliermondii, breastfeeding, candidiasis, mammary infections, mastitis, yeasts

Candida spp. can cause mild-to-severe human infections. Certain species have been described as the etiologic agent of human mastitis, inflammation of the breast tissue. Mastitis affects millions of lactating women and can be a source of disease transmission to the infant. In this work, we report the detection of the unusual etiologic agent of human mastitis, Candida guilliermondii, isolated from the milk of a puerperal woman with subacute mastitis in Rio de Janeiro, Brazil. Species identification was performed by MALDI-TOF MS and genetic sequencing. The patient had a full recovery after antifungal therapy.
Choledochoplasty with Gallbladder Wall Free Flap: A Novel Technique for Large Bile Duct Defects from Mirizzi Syndrome in High-Risk Patients-A Case Report and Literature Review
Authors: Louis F Chai, Gary S Xiao
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Background:
Cholecystectomies are almost universally performed laparoscopically with complication rates similar to open surgery. Possible complications include bleeding and damage to surrounding structures. These often require intervention to repair the damage immediately when recognized intraoperatively or postoperatively. These injuries can cause significant morbidity and mortality, and additional interventions further compound this, especially for high-risk patients. All attempts should be made to a lower risk while performing the safest operation and addressing complications appropriately. We present a case of a surgically high-risk patient who underwent an attempted laparoscopic, converted to open, cholecystectomy for Mirizzi syndrome, during which a biliary defect was found and repaired with a novel technique of choledochoplasty with a gallbladder wall free flap.
Case:
An 82-year-old female with abdominal pain was diagnosed with a cholecystocholedochal fistula from chronic cholecystitis and Mirizzi syndrome. During cholecystectomy, a large common bile duct defect was noted, and given intraoperative instability, the repair was completed using a gallbladder wall free flap. Postoperatively, the patient recovered well through a 4.5-year follow-up.
Conclusion:
Complications from laparoscopic cholecystectomy are rare but may result in additional interventions. For patients who are high-risk surgical candidates, gallbladder wall free flap choledochoplasty should be considered to avoid additional morbidity and mortality.