OpenMed/multicare-articles huggingface dataset:
Renal angiomyolipoma associated with inferior vena cava thrombus
Authors: Xavier Durand, Raphaelle Renard-Penna, Eva Comperat, Marc-Olivier Bitker, Francois Richard
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

A 57-year-old woman was found to have an inferior vena cava involvement of a known sinusal angiomyolipoma incompletely resected three years beforehand. Intravascular extension into the IVC of angiomyolipoma has rarely been reported. We present a new case and reconsider the literature about this uncommon complication of a benign renal tumor.
Developing the public health workforce: training and recognizing specialists in public health from backgrounds other than medicine: experience in the UK
Authors: Selena F Gray, David Evans
Journal: Public Health Rev (2018)
Keywords: capacity development, professional regulation, public health workforce

Background:
There is increasing recognition that improving health and tackling inequalities requires a strong public health workforce capable of delivering key public health functions across systems. The World Health Organization in Europe has identified securing the delivery of the Essential Public Health Operations and strengthening public health capacities within this as a priority.It is acknowledged that current public health capacities and arrangements of public health services vary considerably across the World Health Organization in European Region, and investment in multidisciplinary workforce with new skills is essential if public health services are to be delivered.
Case presentation:
This paper describes the current situation in the UK where there are nationally funded multidisciplinary programmes for training senior public health specialists. Uniquely, the UK provides public health registration for multidisciplinary as well as medical public health specialists.
Conclusion:
The transition from a predominantly medical to a multidisciplinary public health specialist workforce over a relatively short timescale is unprecedented globally and was the product of a sustained period of grass roots activism aligned with national policy innovation. the UK experience might provide a model for other countries seeking to develop public health specialist workforce capacity in line with the Essential Public Health Operations.
A rare form of heteropagus twinning: three-armed infant with spinal dysraphism
Authors: Aynur Solak, Sonnaz Ergün, Ipek Polat, Neslın Sahin, Berhan Genç
Journal: Case Rep Pediatr (2012)

An ectopic or accessory limb attached to the back is an extremely rare and strange condition, and there are only a few documented cases in the worldwide literature. The first case was described by Jones and Larkin (1889). There are several theories regarding the origin of this condition. Asymmetric conjoined twinning which is located dorsally in the vertebral column (rachipagus) is the most probable diagnosis of our patient. Conjoined twinning is very rare and the incidence is 1 per 50 000 live births. Rachipagus is even rarer, with no more than 30 case reports so far (Chadha et al. (1993, 2006)). In this report, we present a patient who underwent successful surgical excision of a third arm attached to the back in the midline over the low-dorsal region. Differential diagnoses including teratoma and fetus in fetu are discussed.
Case Report: CMV-Associated Congenital Nephrotic Syndrome
Authors: Anju Jacob, Shameer M Habeeb, Leal Herlitz, Eva Simkova, Jwan F Shekhy, Alan Taylor, Walid Abuhammour, Ahmad Abou Tayoun, Martin Bitzan
Journal: Front Pediatr (2020)
Keywords: finnish-type nephrotic syndrome, nphs1, streptococcus pneumoniae, case report, cytomegalovirus, glomerulonephritis, infantile nephrotic syndrome
MeSH terms: Case Reports

Background: Congenital nephrotic syndrome, historically defined by the onset of large proteinuria during the first 3 months of life, is a rare clinical disorder, generally with poor outcome. It is caused by pathogenic variants in genes associated with this syndrome or by fetal infections disrupting podocyte and/or glomerular basement membrane integrity. Here we describe an infant with congenital CMV infection and nephrotic syndrome that failed to respond to targeted antiviral therapy. Case and literature survey highlight the importance of the "tetrad" of clinical, virologic, histologic, and genetic workup to better understand the pathogenesis of CMV-associated congenital and infantile nephrotic syndromes. Case Presentation: A male infant was referred at 9 weeks of life with progressive abdominal distention, scrotal edema, and vomiting. Pregnancy was complicated by oligohydramnios and pre-maturity (34 weeks). He was found to have nephrotic syndrome and anemia, normal platelet and white blood cell count, no splenomegaly, and no syndromic features. Diagnostic workup revealed active CMV infection (positive CMV IgM/PCR in plasma) and decreased C3 and C4. Maternal anti-CMV IgG was positive, IgM negative. Kidney biopsy demonstrated focal mesangial proliferative and sclerosing glomerulonephritis with few fibrocellular crescents, interstitial T- and B-lymphocyte infiltrates, and fibrosis/tubular atrophy. Immunofluorescence was negative. Electron microscopy showed diffuse podocyte effacement, but no cytomegalic inclusions or endothelial tubuloreticular arrays. After 4 weeks of treatment with valganciclovir, plasma and urine CMV PCR were negative, without improvement of the proteinuria. Unfortunately, the patient succumbed to fulminant pneumococcal infection at 7 months of age. Whole exome sequencing and targeted gene analysis identified a novel homozygous, pathogenic variant (2071+1G>T) in NPHS1. Literature Review and Discussion: The role of CMV infection in isolated congenital nephrotic syndrome and the corresponding pathological changes are still debated. A search of the literature identified only three previous reports of infants with congenital nephrotic syndrome and evidence of CMV infection, who also underwent kidney biopsy and genetic studies. Conclusion: Complete workup of congenital infections associated with nephrotic syndrome is warranted for a better understanding of their pathogenesis ("diagnostic triad" of viral, biopsy, and genetic studies). Molecular testing is essential for acute and long-term prognosis and treatment plan.
Disseminated Cryptococcosis in a Non-HIV Patient in Singapore
Authors: Jonathan See, Kok Choon Raymond Fong, Humaira Shafi
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

We present a case of disseminated cryptococcosis (DC) in a 71-year-old gentleman with systemic lupus erythematosus (SLE) on long-term corticosteroids. He initially presented with right arm cellulitis in a tertiary hospital in Singapore and was subsequently diagnosed with DC involving skin, meninges, blood, and possibly pulmonary involvement. He eventually succumbed to the disease despite prolonged antifungal therapy. Through this case, we wish to highlight an atypical clinical presentation of an uncommon infection and hope to share the importance of considering DC in the differential diagnosis of nonresolving cellulitis among immunocompromised individuals. Mortality and morbidity rates for this condition remain high despite appropriate treatment. Early diagnosis and treatment are crucial for improved outcomes. More research is needed to improve the therapeutic modalities for treatment of DC and to improve the clinical outcomes for this life-threatening condition.
Fatal multiorgan failure associated with disseminated herpes simplex virus-1 infection: a case report
Authors: Michael Glas, Sigrun Smola, Thorsten Pfuhl, Juliane Pokorny, Rainer M Bohle, Arno Bücker, Jörn Kamradt, Thomas Volk
Journal: Case Rep Crit Care (2012)

Herpes simplex virus type 1 (HSV-1) infections cause typical dermal and mucosal lesions in children and adults. Also complications to the peripheral and central nervous system, pneumonia or hepatitis are well known. However, dissemination to viscera in adults is rare and predominantly observed in immunocompromised patients. Here we describe the case of a 70-year-old male admitted with macrohematuria and signs of acute infection and finally deceasing in a septic shock with multi organ failure 17 days after admission to intensive care unit. No bacterial or fungal infection could be detected during his stay, but only two days before death the patient showed signs of rectal, orolabial and genital herpes infection. The presence of HSV-1 was detected in swabs taken from the lesions, oropharyngeal fluid as well as in plasma. Post-mortem polymerase chain reaction analyses confirmed a disseminated infection with HSV-1 involving various organs and tissues but excluding the central nervous system. Autopsy revealed a predominantly retroperitoneal diffuse large B-cell lymphoma as the suspected origin of immunosuppression underlying herpes simplex dissemination.
Psoas abscess formation in suboptimally controlled diabetes mellitus
Authors: A J Lansdown, A Downing, A W Roberts, D Martin
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Psoas abscess formation is a rare entity for which diabetes mellitus remains a major predisposing factor. Diabetes has long been associated with a predisposition to unusual and more serious infections. Here we present two cases that demonstrate that chronically suboptimally controlled diabetes remains an important marker for the development of primary psoas abscess. It is important to include psoas abscess in the differential in such patients to ensure early diagnosis and treatment.
Idiopathic Scrotal Calcinosis: A Case Report of a Rare Entity
Authors: Umesh Jayarajah, Lalani de Silva, Chandu de Silva, Sanjeewa Seneviratne
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Scrotal calcinosis is a benign condition where multiple calcified nodules are found within the dermis of the scrotal skin. It is a rare condition which is usually asymptomatic and has no clear aetiology although several theories have been proposed in the aetiopathogenesis. We report a 55-year-old man with extensive scrotal calcinosis. Surgical excision of the affected scrotal skin was curative.
A case report on parvovirus b19 associated myositis
Authors: Nathan D Oliver, Auleen Millar, Adrian Pendleton
Journal: Case Rep Rheumatol (2012)

Introduction. Whilst there are reports of viral myopathies affecting children and the immunocompromised, infective myositis is a relatively rare inflammatory myopathy in adults. The clinical spectrum can range from benign myalgias to more serious complications in certain risk groups. Case Presentation. We present two cases of myositis as a result of parvovirus B19 infection. Conclusion. Viral myositis and parvovirus B19 associated myositis should be considered in adults presenting with significant myalgia.
Behavioral Activation (BA) in the Management of Depression in an Adolescent with Down Syndrome in Dubai
Authors: Sidra Shadan, Sarah Almarzooqi, Meshal A Sultan
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Depression has been commonly treated with psychotherapy and/or pharmacotherapy for several decades. Ongoing research in the field has suggested promise for behavioral activation (BA), a form of psychotherapeutic intervention, as a means of increasing engagement in adaptive activities and developing skills to counter avoidance in individuals suffering from depression. In this case report, we present the treatment course of BA for an adolescent with Down syndrome (DS), presenting with depression. A multidisciplinary approach was utilized in developing a personalized management plan for the patient since the initial presentation. Sessions at the outpatient psychiatry clinic alternated between in-person visits and virtual ones, due to circumstances associated with physical distancing with the COVID-19 pandemic. Parents were included as integral parts of the management plan, and education, strategic implementation of BA, and barriers to care were discussed extensively to support the adolescent through the course of her treatment. Within 6 weeks of introducing BA, positive outcomes were noted in the patient, with the resolution of her clinical depression. In this report, we discuss BA further as a potentially effective therapeutic approach to the treatment of depressive symptoms in children and adolescents with DS and intellectual disabilities.
Solid pseudopapillary tumor of the pancreas: E-cadherin, β-catenin, CD99 new useful markers with characteristic expression (about two case reports)
Authors: Nechi Salwa, Dhouib Rym, Doghri Raoudha, Charfi Lamia, Abbes Imen, Driss Maha, Mrad Karima
Journal: Pan Afr Med J (2021)
Keywords: cd99, e-cadherin, solid pseudo-papillary tumor of the pancreas, case report, β-catenin
MeSH terms: Carcinoma, Papillary / diagnosis, Carcinoma, Papillary / surgery, Pancreatic Neoplasms / diagnosis, Case Reports, 12E7 Antigen, Adult, Biomarkers, Tumor, Cadherins, Female, Humans, Neoplasm Recurrence, Local, Pancreas, beta Catenin, 12E7 Antigen, Biomarkers, Tumor, CD99 protein, human, Cadherins, beta Catenin

Solid pseudopapillary neoplasm of the pancreas is a rare tumor that has favorable prognosis. It poses frequently diagnostic challenges. We describe two cases of solid pseudopapillary tumor of the pancreas managed in our department between 2007 and 2011. Two females have mean age of 36.5 years. Clinical presentation include: abdominal pain, bloating and palpable abdominal mass. Tumor is localized in the head of the pancreas in one case and in the tail in the other case. The mean size of the mass was 6 cm (range: 5 to 7 cm). Surgical treatment was performed in two cases. Histological examination confirms the diagnosis of solid pseudopapillary tumor of the pancreas. Immunohistochemical analysis was concordant to the literature data especially concerning CD99 which positivity was in dot, loss of positivity of E-cadherin and nuclear staining of β-catenin. CD10 and α-1-antitrypsin were also positive. One patient was dead 3 days postoperative and neither cancer recurrence nor distant metastases were detected on the follow up of the other. However, solid pseudo-papillary tumor of the pancreas has a distinctive histological appearance; some cases are problematic requiring the use of immunohistochemistry to distinguish it from other pancreatic neoplasm which prognosis is different.
Epidemiology of severe acute respiratory infections from hospital-based surveillance in Madagascar, November 2010 to July 2013
Authors: Norosoa Harline Razanajatovo, Julia Guillebaud, Aina Harimanana, Soatiana Rajatonirina, Elisoa Hariniaina Ratsima, Zo Zafitsara Andrianirina, Hervé Rakotoariniaina, Todisoa Andriatahina, Arnaud Orelle, Rila Ratovoson, Judickaelle Irinantenaina, Dina Arinalina Rakotonanahary, Lovasoa Ramparany, Frédérique Randrianirina, Vincent Richard, Jean-Michel Heraud
Journal: PLoS One (2018)
MeSH terms: Epidemiological Monitoring, Hospitals, Respiratory Tract Infections / epidemiology, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Hospitalization, Humans, Infant, Infant, Newborn, Logistic Models, Madagascar / epidemiology, Male, Prevalence, Respiratory Tract Infections / microbiology, Respiratory Tract Infections / virology, Young Adult

Background:
Few comprehensive data exist regarding the epidemiology of severe acute respiratory infections (SARI) in low income countries. This study aimed at identifying etiologies and describing clinical features of SARI-associated hospitalization in Madagascar.
Methods:
It is a prospective surveillance of SARI in 2 hospitals for 3 years. Nasopharyngeal swabs, sputum, and blood were collected from SARI patients enrolled and tested for viruses and bacteria. Epidemiological and clinical information were obtained from case report forms.
Results:
Overall, 876 patients were enrolled in the study, of which 83.1% (728/876) were tested positive for at least one pathogen. Viral and bacterial infections occurred in 76.1% (667/876) and 35.8% (314/876) of tested samples, respectively. Among all detected viruses, respiratory syncytial virus (RSV) was the most common (37.7%; 348/924) followed by influenza virus A (FLUA, 18.4%; 170/924), rhinovirus (RV, 13.5%; 125/924), and adenovirus (ADV, 8.3%; 77/924). Among bacteria, Streptococcus pneumoniae (S. pneumoniae, 50.3%, 189/370) was the most detected followed by Haemophilus influenzae type b (Hib, 21.4%; 79/370), and Klebsiella (4.6%; 17/370). Other Streptococcus species were found in 8.1% (30/370) of samples. Compared to patients aged less than 5 years, older age groups were significantly less infected with RSV. On the other hand, patients aged more than 64 years (OR = 3.66) were at higher risk to be infected with FLUA, while those aged 15-29 years (OR = 3.22) and 30-64 years (OR = 2.39) were more likely to be infected with FLUB (influenza virus B).
Conclusion:
The frequency of influenza viruses detected among SARI patients aged 65 years and more highlights the need for health authorities to develop strategies to reduce morbidity amongst at-risk population through vaccine recommendation. Amongst young children, the demonstrated burden of RSV should guide clinicians for a better case management of children. These findings reveal the need to develop point-of-care tests to avoid overuse of antibiotics and to promote vaccine that could reduce drastically the RSV hospitalizations.
Autotransplantation of mandibular third molar: a case report
Authors: Pabbati Ravi Kumar, Mandava Jyothi, Kantheti Sirisha, Khushboo Racca, Chalasani Uma
Journal: Case Rep Dent (2012)

Autogenous transplantation is a feasible, fast, and economical option for the treatment of nonsalvageable teeth when a suitable donor tooth is available. This paper presents successful autotransplantation of a mature mandibular left third molar (38) without anatomical variances is used to replace a mandibular left second molar (37). The mandibular second molar was nonrestorable due to extensive root caries and resorption of distal root. After extraction of mandibular second and third molars, root canal therapy was done for the third molar extraorally, and the tooth was reimplanted into the extracted socket of second molar site. After one year, clinical and radiographic examination revealed satisfactory outcome with no signs or symptoms suggestive of pathology. In selected cases, autogenous tooth transplantation, even after complete root formation of the donor tooth, may be considered as a practical treatment alternative to conventional prosthetic rehabilitation or implant treatment.
A Case Report of Perceptual Disturbances with Incidental Calcifications in the Cerebellum
Authors: Sarah Manzoor, Lillian Sangha, Pavandeep Badh, Heela Azizi, Ayodeji Jolayemi
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Background:
The cerebellum has extensive connections with motor and nonmotor areas of the nervous system. These nonmotor areas include the cognitive, affective, and perceptual areas of the central nervous system. Extensive literature has emerged cognitive documents and mood disorders in patients with cerebellar dysfunction. Perceptual disturbances consistent with cerebellar connections with perceptual areas have not been as widely documented. Case Presentation. We present the case of a 58-year-old female presenting with new onset isolated auditory hallucinations and incidental findings of cerebellar calcifications.
Conclusion:
In light of this case, we discuss an expanding body of evidence that suggests the likely role of the cerebellum in perceptual functioning.
Laparoscopy treatment of liver abscess secondary to an unusual foreign body (rosemary twig)
Authors: André Thá Nassif, Victor Hugo Granella, Tulio Rucinski, Bruno Landal Cavassin, Alesandra Bassani, Lucas Thá Nassif
Journal: Autops Case Rep (2021)
Keywords: foreign-body migration, general surgery, laparoscopy, liver abscess
MeSH terms: Case Reports

A hepatic abscess caused by a swallowed foreign body is a rare and challenging diagnosis. Most patients have nonspecific symptoms, and more than 90% of patients do not remember having swallowed it, which occurred accidentally. In this setting, fish bones, chicken bones, and toothpicks are the most found foreign bodies. We reported the case of a 54-year-old male patient admitted with abdominal pain and intermittent fever. He was diagnosed with liver abscess and treated successfully with antibiotics and a laparoscopic procedure; a rosemary twig was found during the abscess drainage procedure. Furthermore, a literature review of 22 cases of laparoscopic treated liver abscesses associated with a foreign body was made.
Pembrolizumab in a Patient with Treatment-Naïve Unresectable BRAF-Mutation Negative Anaplastic Thyroid Cancer
Authors: Fadi Nabhan, Elizabeth Kander, Rulong Shen, Amit Agrawal, Vineeth Sukrithan, Ye Zhou, Ashima Goyal, Katie Roll, Manisha Shah, Bhavana Konda
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Immune check point inhibitor (ICI) therapy can be a potentially effective salvage treatment for anaplastic thyroid cancer (ATC) with progression despite standard of care therapies. We report a case of unresectable treatment-naïve ATC showing a dramatic and durable response to first-line pembrolizumab therapy. A 69-year-old male presented with a large, right-sided neck mass associated with compressive symptoms. A neck ultrasound showed a large, right-sided, and highly suspicious thyroid nodule. A fine needle aspiration (FNA) biopsy revealed tumor cells consistent with ATC that were positive for PD-L1, with an expression score of >95% and negative for the BRAF V600E mutation. Imaging studies were negative for distant metastases. The disease was declared surgically inoperable, and the patient declined chemotherapy/radiation therapy (XRT), but agreed to ICI therapy with intravenous pembrolizumab 200 mg every three weeks. The patient has received 25 doses of pembrolizumab to date, with rapid resolution of symptoms and a significant reduction in tumor size. He remains alive without disease progression 18 months since initial diagnosis.
Enoxaparin Effect on Pregnancy Outcomes in a Patient with Elevated Plasminogen Activator Inhibitor-1
Authors: Kathleen Minor, Heidi Leftwich
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Background:
Plasminogen activator inhibitor-1 (PAI-1) inhibits tPA and creates a prothrombotic state. Gene polymorphisms of PAI-1 are associated with elevated levels and adverse pregnancy outcomes.
Case:
A 36-year-old gravida 6, para 1-1-3-1 with elevated prepregnancy PAI-1 levels, a history of early-onset preeclampsia with severe features superimposed on chronic hypertension, intrauterine growth restriction (IUGR), and recurrent pregnancy loss (RPL), presented with a dichorionic-diamniotic twin gestation. She was managed with aspirin and enoxaparin and delivered appropriately grown twins at 36 weeks and 3 days, due to the development of preeclampsia superimposed on chronic hypertension. She was discharged not on enoxaparin and represented with pulmonary edema on postoperative day 8.
Conclusion:
It is reasonable to consider testing certain patients with recurrent pregnancy loss and/or early preeclampsia with severe features for PAI-1. If levels are elevated, treatment with prophylactic enoxaparin may be beneficial. Further research is needed to determine the effect of this therapy in patients with exceedingly poor perinatal outcomes to better assess for any impact on improved outcomes.