OpenMed/multicare-articles huggingface dataset:
Recurrent Plunging Ranula Due to a Sublingual Ectopic Gland: A Rare Clinical Entity
Authors: Cristina Rodrigues Barros, Frederico Caeiro Dos Santos Portugal Guerreiro, Joaquim Seixas-Martins, Maria do Céu Machado
Journal: Cureus (2024)
Keywords: ectopic gland, mouth floor, plunging ranula, salivary gland, tail sign, transoral surgical approach
MeSH terms: Case Reports

Ranula is a benign cystic lesion caused by the escape and collection of salivary mucus. Classically, it is divided into simple ranulas, a cystic mass in the floor of the mouth, and diving/plunging/cervical ranulas, a submandibular mass without apparent intraoral involvement. Although plunging ranula is a well-documented cause of neck swelling, its association with the presence of ectopic sublingual glands is extremely rare, with less than five cases reported. Other cervical cystic lesions may have the same clinical aspect; therefore, advanced diagnostic techniques like a CT scan or MRI play a critical role in early diagnosis. Different approaches have been used to treat ranulas, including non-invasive, minimally invasive, and surgical techniques. The purpose of this paper is to highlight a case report of a giant plunging ranula due to an anatomical aberration of the right sublingual gland, along with a significant literature review.
Methodological procedure based on quantitizing/liquefying: a case study to assess work climate in an emergency department
Authors: Salvador Chacón-Moscoso, M Teresa Anguera, Susana Sanduvete-Chaves, José A Lozano-Lozano
Journal: Front Psychol (2023)
Keywords: emergency department, hospital, in-depth interview, indirect observational methodology, mixed methods, polar coordinate analysis, single-case study, work climate

Introduction:
In the assessment of health organizations, results-based indicators are mainly used, with no consideration of internal work dynamics. This type of assessment forfeits much of the rich, useful information needed to make decisions on improving the organization. In order to address this, a rigorous procedure based on mixed methods is laid out here on gathering, analyzing, and interpreting data associated with the implementation process.
Methods:
A 55-year-old doctor was selected at random from among the staff who volunteered to be interviewed at the emergency department at a public hospital located in southern Spain for an interview. Qualitative data obtained from the in-depth interview (indirect observation) were progressively systematized (liquefied and quantitized) based on a theoretical framework until a code matrix was obtained, without losing or distorting any information. Afterwards, data quality was controlled using Cohen's kappa (κ) coefficient. A quantitative polar coordinate analysis was then carried out using the free software HOISAN (v. 1.6.3.3) to obtain robust results, vectorizing the relationships between codes and specifying whenever such relationships were statistically significant (and if they resulted in behavior activation or inhibition). Finally, a supplementary quantitative and qualitative assessment was carried out.
Results and discussion:
The proposed method was applied to the needs assessment of teams in order to evaluate that work climate in the hospital's emergency department Health Services of a hospital. Data quality control yielded an adequate result (κ = 0.82). Significant activation and inhibition of behaviors occurred, both prospectively and retrospectively. For instance, We seek to understand the needs of our clients and We readily adapt to new circumstances showed a significant activation (vector length = 3.43, p < 0.01) both prospectively (Zsum = 0.48) and retrospectively (Zsum = 3.4).An adequate method to obtain detailed information about group dynamics in a work environment is presented, based on an in-depth interview. Practical applications for implementations to improve the functioning of organizations are presented.
Hyaline cartilage at the portal plate and gallbladder in biliary atresia
Authors: Sangamitra Rajasekaran, Hari Neupane, Monika Bawa, Uma Nahar Saikia, Sadhna Lal, Suvradeep Mitra
Journal: Autops Case Rep (2024)
Keywords: biliary atresia, gallbladder, hyaline cartilage, metaplasia, portal plate
MeSH terms: Case Reports

Biliary atresia (BA) is a fibro-obliterative cholestatic disease of infancy. The presence of cartilage in the resected tissue is an uncommon finding. We documented the presence of both mature and immature hyaline cartilage in the portal plate and the wall of the gallbladder in a 2-month-old girl infant with BA who had undergone Kasai portoenterostomy. The presence of cartilage could be part of a heterotopia or an uncommon connective tissue metaplasia. The presence of immature cartilage with the merging of the perichondrium with the soft tissue highlights a metaplastic etiology in the index case.
Case report: Light-chain amyloidosis responsive to selinexor in combination with daratumumab and dexamethasone (SDd) therapy
Authors: Xiaolu Long, Ning An, Chunhui Li, Hui Zhu, Haojie Li, Qiuxia Yu, Yimei Que, Menglei Xu, Zhe Li, Wei Chen, Shuai Wang, Di Wang, Chunrui Li
Journal: Front Med (Lausanne) (2024)
Keywords: sdd therapy, daratumumab, light-chain amyloidosis, organ response, selinexor
MeSH terms: Case Reports

The outcome of AL amyloidosis remains poor, particularly in patients with advanced organ involvement which takes long time to recovery. We conducted an observational study of two patients with AL amyloidosis treated with SDd regimen. Both patients successfully achieved significant hematological and organ responses without severe adverse events, and the time to organ response was remarkably shorter than previously reported. Notably, an over 15% reduction in interventricular septal thickness (IVST) was observed in patient#2 within 6 months. Up to now, SDd therapy has not been previously reported in AL amyloidosis and may be a promising option for these patients.
Bacteroides fragilis Acute Hematogenous Osteomyelitis in a Young Female with Sickle Cell Disease
Authors: Nada Bassam Hamieh, Hiba Abdul Hamid Abou Layla, Rola Ali Ali, Zeina Bayram, Abdul Rahman Bizri
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Patients with sickle cell disease are at increased risk for multiple infections including osteomyelitis. The most reported causative organisms are Salmonella spp. and Staphylococcus aureus. Anaerobic infections including Bacteroides fragilis are not commonly seen. Here, we report the first case of a 28-year-old female patient with sickle cell disease and acute hematogenous Bacteroides fragilis tibial osteomyelitis. Diagnosis was made by isolating the organism from blood and tibial fluid cultures. The patient was successfully managed with a course of intravenous followed by oral antibiotics and percutaneous drainage of collection and responded well. This case report will shed light on the importance of Bacteroides fragilis as a causative organism for osteomyelitis in sickle cell disease patients, thereby affecting the management of these patients.
Old woman with Sheehan's syndrome suffered severe hyponatremia following percutaneous coronary intervention: a case report and review of literature
Authors: Jie Gao, Yuehai Wang, Anqi Zhang, Huihui Pang, Fei Wang
Journal: Front Cardiovasc Med (2024)
Keywords: sheehan’s syndrome, contrast agent, coronary atherosclerotic disease, glucocorticoid deficiency, percutaneous coronary intervention, severe hyponatremia, stress
MeSH terms: Case Reports

Glucocorticoid deficiency can lead to hypoglycemia, hypotension, and electrolyte disorders. Acute glucocorticoid deficiency under stress is very dangerous. Here, we present a case study of an elderly patient diagnosed with Sheehan's syndrome, manifesting secondary adrenal insufficiency and secondary hypothyroidism, managed with daily prednisone and levothyroxine therapy. She was admitted to our hospital due to acute non-ST segment elevation myocardial infarction. The patient developed nausea and limb twitching post-percutaneous coronary intervention, with subsequent diagnosis of hyponatremia. Despite initial intravenous sodium supplementation failed to rectify the condition, and consciousness disturbances ensued. However, administration of 50 mg hydrocortisone alongside 6.25 mg sodium chloride rapidly ameliorated symptoms and elevated blood sodium levels. Glucocorticoid deficiency emerged as the primary etiology of hyponatremia in this context, exacerbated by procedural stress during percutaneous coronary intervention. Contrast agent contributed to blood sodium dilution. Consequently, glucocorticoid supplementation emerges as imperative, emphasizing the necessity of stress-dose administration of glucocorticoid before the procedure. Consideration of shorter intervention durations and reduced contrast agent dosages may mitigate severe hyponatremia risks. Moreover, it is crucial for this patient to receive interdisciplinary endocrinologist management. In addition, Sheehan's syndrome may pose a risk for coronary atherosclerotic disease.
Hepatic arterial infusion chemotherapy with implantable arterial access port for advanced-stage hepatocellular carcinoma: a case report
Authors: Xin Jiang, Afaf Aljbri, Jiaxuan Liu, Liqi Shang, Yulong Tian, Haibo Shao
Journal: Front Oncol (2024)
Keywords: folfox-haic, anti-angiogenic therapy, case report, hepatocellular carcinoma, immune checkpoint inhibitors
MeSH terms: Case Reports

Background:
Hepatocellular carcinoma (HCC) is a common gastrointestinal malignancy characterized by high incidence rates and a poor prognosis. Common treatment modalities include surgery, ablation, and transarterial chemoembolization (TACE). Hepatic arterial infusion chemotherapy (HAIC) has long been used in the treatment of unresectable liver cancer. In recent years, the combination of anti-angiogenesis therapy and immune checkpoint inhibitors has shown significant advances in the treatment of middle- and advanced-stage liver cancer. This report presents a case of HCC in which sustained benefits are achieved through a combination of HAIC of infusional oxaliplatin, leucovorin, and fluorouracil (FOLFOX), targeted therapy, and immunotherapy.
Main body:
A 64-year-old male patient was diagnosed with a parenchymal mass in the liver by a three-dimensional color ultrasound one month before admission, prompting consideration of liver cancer. Subsequently, computed tomography (CT) imaging performed at our hospital identified mass shadows in the right lobe of the liver and diffuse nodules throughout the liver, suggesting malignant lesions. Upon admission, the patient presented poor general health and baseline indicators. Following symptomatic treatment, the patient underwent a therapeutic regimen that combined transarterial infusion port FOLFOX-HAIC with Lenvatinib and Sintilimab. This combined treatment resulted in significant liver tumor necrosis and effectively managed the patient's condition.
Conclusion:
The combined approach of using FOLFO-HAIC transarterial infusion alongside anti-angiogenesis therapy and immune checkpoint inhibitors has shown promising results that provide substantial benefits. This combined regimen has demonstrated the potential to improve treatment compliance among certain patients. Given these encouraging outcomes, further investigation into this combination therapy regimen is warranted to understand better its efficacy and potential broader applications in clinical settings.
Case report: A case of recurrent cervical cancer with bronchial and esophageal metastases presenting with hemoptysis and dysphagia
Authors: Xiao Yu, Shixiang Dong, Wenjie Wang, Xin Sun, Yankui Wang, Fengsheng Yu
Journal: Front Oncol (2024)
Keywords: bronchial metastasis, esophageal metastasis, immune checkpoint inhibitor, recurrent cervical cancer, tumor-associated dermatomyositis
MeSH terms: Case Reports

Background:
The treatment outcomes and prognosis for recurrent cervical cancer are generally poor, with a 5-year survival rate of only 10%-20%.
Case presentation:
In this case, the patient is a young woman who experienced a recurrence 5 years after the initial treatment of cervical cancer. Her primary symptoms were hemoptysis and dysphagia, indicative of hilar and mediastinal lymph node metastases, with further involvement of the bronchus and esophagus. Additionally, the patient also presented with tumor-associated dermatomyositis. Following combined treatment with albumin-bound paclitaxel, carboplatin, bevacizumab, and cadonilimab, the patient's tumor was effectively controlled.
Small bowel volvulus with chylous ascites: a case report
Authors: Shun Nakamura, Masaaki Tajima, Naoki Yokoyama, Nobuyuki Kikuchi
Journal: J Surg Case Rep (2024)
Keywords: adults, chylous ascites, small bowel volvulus
MeSH terms: Case Reports

Here, we report a rare case of small bowel volvulus with chylous ascites. A 93-year-old man with a medical history of angina pectoris presented to the emergency department with abdominal pain. Computed tomography revealed a whirl sign of the mesenteric vessels with the axis of the superior mesenteric artery. A diagnosis of small bowel volvulus was made, and emergency surgery was performed. Laparoscopic examination revealed chylous ascites. Due to severe intestinal edema and difficulty in manipulating the forceps, surgery was transferred to a laparotomy. The entire small bowel was twisted 360° counterclockwise, requiring manual untwisting. Examination of the intestinal tract after untwisting revealed no evidence of ischemia or necrosis. However, because a diverticulum was observed on the mesenteric side of the upper jejunum and considering the influence of secondary small bowel volvulus, partial small bowel resection was performed. The patient had a favorable postoperative course.
Auricular acupuncture for persistent insomnia and anxiety associated with COVID-19: a case report
Authors: Hantong Hu, YingYing Cheng, Lianqiang Fang, Liping Yang, Xingling Li
Journal: Front Neurol (2023)
Keywords: covid-19, anxiety, auricular acupuncture, insomnia, sleep disorders
MeSH terms: Case Reports

The coronavirus disease 2019 (COVID-19) has been associated with various psychological symptoms. We report a case of a female patient who was diagnosed with persistent insomnia and anxiety associated with COVID-19, which was successfully treated with nine treatment sessions of auricular acupuncture. This case report provides preliminary evidence to support further research into auricular acupuncture as a potential therapy for persistent insomnia and anxiety associated with COVID-19.
Left Main Coronary Artery Spasm During Cryoballoon Ablation for Atrial Fibrillation: A Case Report and Literature Review
Authors: Amith Reddy Seri, Fahimeh Talaei, Mahmoud Ibrahim, Mustafa Hassan
Journal: Cureus (2024)
Keywords: atrial fibrillation, case report, coronary artery spasm, cryoballoon ablation, st segment elevation
MeSH terms: Case Reports

Although phrenic nerve and esophageal injury are commonly known risks associated with cryoablation, there is limited literature regarding coronary artery spasm (CAS), a serious and potentially fatal complication of cryoablation. We report the case of a 68-year-old Caucasian female who developed a left main CAS with a significant hemodynamic compromise during cryoablation. The patient, with a history of hyperlipidemia, hypertension, and symptomatic persistent atrial fibrillation, was admitted for elective catheter ablation for atrial fibrillation. During the ablation of the left superior pulmonary vein (LSPV), the patient developed severe hypotension and bradycardia. The patient's monitor revealed ST elevation, confirmed by a 12-lead ECG. Immediate coronary angiography revealed the left main coronary spasm, which improved with nitroglycerine administration with resolution of ST elevation and return of the patient's hemodynamics to stability. The patient's left main CAS was induced by cryoablation of LSPV. Literature on atrial fibrillation ablation-induced CAS is scant, but a Japanese study has shown that it occurs more commonly in cryoablation than in radiofrequency, hot balloon, or laser ablation. The study showed LSPV as the most common site of ablation right before the spasms happened. Further studies about this topic are needed to delineate further the risk factors and the precautions that could prevent CAS. In the meantime, prompt recognition and appropriate intervention are critical for a good patient outcome.
Renal and cardiac biopsy findings in an adolescent patient with the 3243A>G mitochondrial DNA mutation: Favorable renal prognosis post renal transplantation from the mother
Authors: Hisashi Kamido, Shigekazu Kurihara, Yuki Oba, Masayuki Yamanouchi, Tatsuya Suwabe, Katsuyuki Miki, Yuki Nakamura, Yasuo Ishi, Kei Kono, Kenichi Ohashi, Naoki Sawa, Yoshifumi Ubara
Journal: Clin Nephrol Case Stud (2024)
Keywords: mitochondrial dna mutation 3243a>g, mitochondrial cardiomyopathy, mitochondrial encephalopathy, mitochondrial nephropathy, renal transplantation
MeSH terms: Case Reports

We investigated the pathogenesis of a perihilar variant of focal segmental glomerulosclerosis detected by kidney biopsy in a 16-year-old male. The disease was refractory to steroid therapy, and at the second kidney biopsy, abnormal mitochondrial proliferation was newly observed in the podocytes. The patient also developed late-onset hearing loss and had a family history of diabetes, and genetic testing confirmed the mitochondrial DNA mutation 3243A>G (48%). Eight months after hemodialysis was started, encephalopathy occurred presumably due to rapid dehydration. After changing dialysis into continuous ambulatory peritoneal dialysis, encephalopathy was resolved, but the patient developed myocardial hypertrophy, probably because of the myocardial overreaction to congestion. A myocardial biopsy showed mitochondrial proliferation in the myocardium. After renal transplantation from his mother with a heteroplasmy of 4%, the cardiomyopathy improved, and the renal function has remained stable for 4 years. We speculated that the abnormal mitochondrial morphology in the kidney and heart may be characteristic of mitochondrial genetic disease, and renal transplantation from the mother with a low heteroplasmy was considered desirable for mitochondrial nephropathy with poor prognosis.
Libman-Sacks endocarditis in a child with systemic lupus erythematosus: a case report and literature review
Authors: Jingyi Lu, Shengfang Bao, Xuemei Xu, Yingying Jin, Chenxi Liu, Yuqi Zhang, Qian Wang, Yanliang Jin
Journal: Front Pediatr (2024)
Keywords: libman-sacks endocarditis, case report, children, immunosuppressive therapy, systemic lupus erythematosus
MeSH terms: Case Reports

Libman-Sacks endocarditis (LSE) is a cardiac condition characterized by the growth of verrucous vegetation. Although relatively rare in children, LSE is nevertheless a known cardiac manifestation of autoimmune diseases, including systemic lupus erythematosus (SLE). The mitral valve is the most commonly affected region, followed by the aortic valve, while the tricuspid and pulmonary valves are rarely affected. The management of established Libman-Sacks vegetation poses significant challenges, often necessitating surgical interventions, although surgery is not the primary treatment modality. Herein, we present the case of a 14-year-old Chinese female patient whose initial lupus manifestation included LSE, among other symptoms and signs that provided insights into the final diagnosis of SLE. After early comprehensive pharmacological treatment, tricuspid regurgitation and vegetation disappeared within 28 days without necessitating cardiac surgery, indicating that the resolution of LSE vegetation in this patient was achieved through a combination of immunosuppressive and anticoagulant therapy. These findings suggest the potential of this treatment approach as a viable model for the management of LSE in young patients.
Malignant glomus tumor of the breast: a case report
Authors: Qian Mou, Zhenpeng Jiang, Jiaojiao Zhou
Journal: Front Oncol (2024)
Keywords: breast, case report, glomus tumor, imaging, malignant
MeSH terms: Case Reports

Malignant glomus tumor (MGT) is a rare mesenchymal neoplasm. It is rarely located in the breast. We present a case of a 57-year-old female patient presenting with complaints of a progressively growing mass found in her left breast. Though multiple imaging examinations have been performed, especially multimodal ultrasound examinations, an accurate diagnosis still cannot be determined. Finally, the lesion was confirmed to be a MGT of the breast by postoperative pathological diagnosis. In conclusion, MGT originating from breast is extremely rare. No such case has ever been described before. This study demonstrates the imaging characteristics of a patient with MGT of the breast in order to provide more extensive insights to consider the differential diagnosis of breast lesions.
Case report: Fatal traumatic coronary artery dissection-an overlooked complication of chest fracture
Authors: Tao Jiang, Cheng Qian, Gang Wei, Ling Cheng, Wenwu Zheng, Gong Chen
Journal: Front Cardiovasc Med (2023)
Keywords: oct, chest, coronary artery dissection, fracture, trauma
MeSH terms: Case Reports

Coronary artery dissection caused by trauma is a rare occurrence that can be life-threatening. Accordingly, its rapid identification and treatment are essential to improve patient outcomes. Here, we present a case of a patient who suffered multiple rib and femur fractures after falling from a height of eighteen meters and subsequently experienced persistent chest pain. After the initial diagnostic workup, the medical team diagnosed the patient's chest pain as rib fractures and failed to consider the potential of a cardiac injury as the underlying cause. No emphasis was placed on monitoring changes in myocardial enzymes and ECG, which could have indicated coronary artery dissection. The dissection was confirmed and treated with a stent only after the subsequent coronary angiography (CAG) and optical coherence tomography (OCT) examinations, gradually relieving the patient's chest pain. In this case report, we discuss the management of fractures complicated by traumatic coronary artery dissection and highlight the benefits of OCT in diagnosing and treating this condition. The case also emphasizes the importance of considering coronary artery injury in patients with chest pain due to trauma.
Hypoattenuated Leaflet Thickening-Associated Myocardial Infarction: A Rare Case Report and Literature Review
Authors: Shubam Trehan, Ankur Singla, Gaurav Bector, Nadish Garg
Journal: Cureus (2024)
Keywords: cad
MeSH terms: Case Reports

Hypoattenuated leaflet thickening (HALT), a potential aftereffect of transcatheter aortic valve replacement (TAVR) procedure, may affect valve performance and clinical outcomes. At this moment we describe an elderly patient who, despite being on prophylactic antiplatelet medication for previous percutaneous intervention (PCI) for coronary artery disease (CAD) and a self-expanding valve in-situ for aortic stenosis (TAVR), presented to the emergency room with non-ST-segment elevation myocardial infarction (NSTEMI), probably as a result of a thromboembolic event from HALT. The case highlights the significance of considering HALT-associated thromboembolism as a potential cause of myocardial infarction (MI) in post-TAVR patients.