OpenMed/multicare-articles huggingface dataset:
Case Report: CBD Cigarettes for Harm Reduction and Adjunctive Therapy in a Patient With Schizophrenia and Substance Use Disorder
Authors: Maximilian Meyer, Marc Walter, Stefan Borgwardt, Alexandra Scheidegger, Elisabeth Lang, Patrick Köck
Journal: Front Psychiatry (2021)
Keywords: cannabidiol, case report, psychosis, schizophrenia, substance use disorder
MeSH terms: Case Reports

The treatment of patients with schizophrenia and substance use disorder poses a challenge for clinicians. Continued use of cannabis and cocaine can exacerbate psychotic symptoms and worsen the course of disease. To date, no pharmacotherapy is available for patients with cannabis use disorder (CUD). Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) are the main active constituents in Cannabis sativa, with the latter being linked to an increased risk of psychosis. We describe a clinical case of a male patient diagnosed with schizophrenia, combined personality disorder, CUD and cocaine use disorder. Over the course of 8 years, he was hospitalized 30 times due to psychotic relapses and continued substance use. Consequently, CBD cigarettes with a low THC content (<1%) were used as adjunctive therapy. Additionally, we established off-label treatment with methylphenidate to support abstinence. The patient reported to feel significantly less need to consume illegal cannabis with a high THC content. He stopped to use cocaine, for the time being, and has not been hospitalized since. This case report demonstrates the potential of smoked CBD as a substitute for severe and chronic CUD.
Diagnosis of Langerhans cell histiocytosis on fine needle aspiration cytology: a case report and review of the cytology literature
Authors: Neeta Kumar, Shahin Sayed, Sudhir Vinayak
Journal: Patholog Res Int (2011)
MeSH terms: Case Reports

A case of multifocal Langerhans cell histiocytosis in a two-year-old child is presented where fine needle aspiration was helpful in achieving a rapid and accurate diagnosis in an appropriate clinical and radiological setting. This can avoid unnecessary biopsy and guide the management especially where access to histopathology is limited. The highly characteristic common and rare cytological features are highlighted with focus on differential diagnoses and causes of pitfalls.
Raloxifene Has No Efficacy in Reducing the High Bone Turnover and the Risk of Spontaneous Vertebral Fractures after Denosumab Discontinuation
Authors: Elena Gonzalez-Rodriguez, Delphine Stoll, Olivier Lamy
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

At denosumab discontinuation, an antiresorptive agent is prescribed to reduce the high bone turnover, the rapid bone loss, and the risk of spontaneous vertebral fractures. We report the case of a woman treated with aromatase inhibitors and denosumab for 5 years. Raloxifene was then prescribed to prevent the rebound effect. Raloxifene was ineffective to reduce the high bone turnover and to avoid spontaneous clinical vertebral fractures. We believe that among the antiresorptive treatments, the most powerful bisphosphonates should be favored, and their administration adapted according to the serial follow-up of bone markers.
When the Room Is Spinning: Experience of Vestibular Neuritis by a Neurotologist
Authors: Ji-Soo Kim
Journal: Front Neurol (2020)
Keywords: dizziness, head impulse tests, imbalance, nystagmus, vertigo, vestibular neuritis
MeSH terms: Case Reports

Vestibular neuritis (VN) is the most common cause of acute prolonged spontaneous vertigo, and is characterized by acute unilateral vestibular hypofunction, probably due to inflammation of the vestibular nerve. VN is diagnosed at the bedside when there is spontaneous horizontal-torsional nystagmus beating away from the side of the lesion, abnormal head impulse tests for the semicircular canals involved on the lesion side, and when other neurological symptoms and signs are absent. Here, as a neuro-otologist, I describe my experience during an attack of VN and discuss how it may help physicians to better understand why and what a patient feels during attacks of vertigo.
A Small Glomus Tympanicum Tumor Resected by Minimally Invasive Transcanal Endoscopic Approach
Authors: Masafumi Ohki, Shigeru Kikuchi
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

We present a case of the transcanal endoscopic resection of a glomus tympanicum tumor. A 51-year-old woman presented with pulsatile tinnitus of the right ear persisting for 6 months. A reddish mass was observed through her tympanic membrane. A computed tomography scan revealed a small mass in the mesotympanum. She was diagnosed with a right-sided glomus tympanicum tumor. The glomus tympanicum tumor was classified as type 1 using the Glasscock-Jackson classification, class A using the Fisch classification, and class A1 using the modified Fisch and Mattox classification. The tumor was transcanally and completely resected by endoscopy without any complication. Before and after the surgery, pure-tone audiometry showed a normal hearing level. Preoperative right-sided pulsatile tinnitus resolved after the surgery. Transcanal endoscopic ear surgery is a favorable surgical method for small localized glomus tympanicum tumors.
Case report: Double-chambered right ventricle diagnosed in a middle-aged female with hypertrophic cardiomyopathy and atrial flutter: A rare case
Authors: Junye Ge, Tong Hu, Yan Liu, Qian Wang, Guanqi Fan, Chuanzhen Liu, Jun Zhang, Shiming Chen, Kellina Maduray, Yun Zhang, Tongshuai Chen, Jingquan Zhong
Journal: Front Cardiovasc Med (2022)
Keywords: atrial flutter, cardiac magnetic resonance, double-chambered right ventricle, echocardiography, hypertrophic cardiomyopathy
MeSH terms: Case Reports

Double-chambered right ventricle (DCRV) is a rare congenital heart defect in adults, manifesting with progressive right ventricular outflow tract obstruction. We describe the first case of DCRV coexisting with hypertrophic cardiomyopathy, which is complicated by atrial flutter. A middle-aged woman with recurrent symptomatic atrial flutter who had previously been diagnosed with biventricular hypertrophic cardiomyopathy was admitted to our department. Echocardiography and cardiac magnetic resonance revealed asymmetrical interventricular septal hypertrophy, and abnormal muscle bundles within the right ventricle, generating an obstructive gradient. Genetic testing detected a hypertrophic cardiomyopathy-associated mutation: MYH7, c.4135G > A, p. Ala1379Thr. A diagnosis of DCRV complicated by hypertrophic cardiomyopathy and atrial flutter was made. Surgical intervention was performed, which included radiofrequency ablation, removal of abnormal muscle bundles, and ventricular septal defect repair. Intraoperative transesophageal echocardiography demonstrated the well-corrected right ventricular outflow tract. Free of early postoperative complications, the patient was discharged in sinus rhythm on the 11th day after the surgery. Unfortunately, the patient died from a sudden death 38 days following the surgery. In conclusion, the coexistence of DCRV with hypertrophic cardiomyopathy in patients is an uncommon condition. The present case highlights the importance of diagnostic imaging in the management of this disorder.
Leiomyoma of the Vulva: A Diagnostic Challenge Case Report
Authors: Saad Kurdi, Abdullah S Arafat, Maysan Almegbel, Mayson Aladham
Journal: Case Rep Obstet Gynecol (2016)

Uterine leiomyomas are common and can affect up to 30% of women older than 35 years. Despite this, leiomyomas of the vulva are rare, masquerading, and usually misdiagnosed as Bartholin cyst preoperatively. These smooth muscle tumors are typically painless, solitary, and well circumscribed and can affect female of any age group. We present a case of a 46-year-old female that presented to the clinic with 2-year history of right labial mass and was diagnosed as Bartholin cyst initially. The patient underwent elective excision under spinal anaesthesia and the mass was removed. The final diagnosis after microscopy result showed benign vulvar leiomyoma.
Hybrid fixation in the bilateral sagittal split osteotomy for lower jaw advancement
Authors: Felipe Ladeira Pereira, Marcos Janson, Eduardo Sant'Ana
Journal: J Appl Oral Sci (2010)
MeSH terms: Bone Plates, Bone Screws, Mandible / surgery, Mandibular Advancement / methods, Orthognathic Surgical Procedures / methods, Case Reports, Adult, Female, Follow-Up Studies, Humans, Mandibular Advancement / instrumentation, Mandibular Nerve / physiopathology, Maxilla / surgery, Orthognathic Surgical Procedures / instrumentation, Osteotomy, Le Fort, Paresthesia / etiology, Patient Satisfaction, Postoperative Complications, Range of Motion, Articular / physiology, Rotation, Treatment Outcome

Miniplate and screw fixation has been widely used in bilateral sagittal split osteotomy, but some issues remain unclear concerning its lack of rigidity when compared to Spiessl's bicortical technique. This paper demonstrates the hybrid fixation technique in a case report. A 34-year-old female patient underwent a double jaw surgery with counter-clockwise rotation of the mandible fixed using the hybrid fixation technique. The patient evolved well in the postoperative period and is still under follow up after 14 months, reporting satisfaction with the results and no significant deviation from the treatment plan up to now. No damage to tooth roots was done, maxillomandibular range of motion was within normality and regression of the inferior alveolar nerve paresthesia was observed bilaterally. The hybrid mandibular fixation is clearly visible in the panoramic and cephalometric control radiographs. It seems that the hybrid fixation can sum the advantages of both monocortical and bicortical techniques in lower jaw advancement, increasing fixation stability without significant damage to the mandibular articulation and the inferior alveolar nerve. A statistical investigation seems necessary to prove its efficacy.
Gastric Linitis Plastica and Peritoneal Carcinomatosis as First Manifestations of Occult Breast Carcinoma: A Case Report and Literature Review
Authors: Mara Mantiero, Giovanni Faggioni, Alice Menichetti, Matteo Fassan, Valentina Guarneri, Pierfranco Conte
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Gastric linitis plastica is a diffuse involvement of the stomach walls by neoplastic cells. It represents about 3-19% of primitive gastric adenocarcinomas, but it can also be the manifestation of a metastatic disease. Breast cancer is the most frequent malignancy in women, and the metastatic spread to the stomach occurs in less than 10% of the cases. We present an unusual case of gastric linitis plastica and peritoneal carcinomatosis as manifestations of an occult breast cancer in a 53-year-old woman. Imaging and endoscopic evaluation were not able to discriminate a primary from a secondary gastric lesion. The histological evaluation excluded the diagnosis of a primary gastric neoplasia. The IHC profile was consistent with the diagnosis of metastases from the breast cancer. Due to the hormonal receptors' positivity, we started therapy with fulvestrant (500 mg, day 0, 14, and 28 and every 28 days thereafter by intramuscular injection). After 20 months, the same therapy is still ongoing and well tolerated, while the patient is in good condition with improvement of the dysphagia. Almost 2 years after the diagnosis of linitis plastica, the primitive breast lesion is still occult.
Combination Treatment of Perioperative Rehabilitation and Psychoeducation Undergoing Thoracic Surgery
Authors: Kazuhiro Hayashi, Takayuki Inoue, Motoki Nagaya, Satoru Ito, Hiroki Nakajima, Keiko Hattori, Izumi Kadono, Kohei Yokoi, Yoshihiro Nishida
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Postoperative pulmonary complications are a risk associated with thoracic surgery. However, there have been few reports on cases at high risk of postoperative complications. Cancer patients often have negative automatic thoughts about illness, and these negative automatic thoughts are associated with reduced health behavior and physical activity. This case series demonstrates the successful combination treatment of perioperative rehabilitation and psychoeducation for negative automatic thoughts in two cancer patients who underwent thoracic surgery. One patient underwent pneumonectomy with laryngeal recurrent nerve paralysis; the other patient, who had a history of recurrent hepatic encephalopathy and dialysis, underwent S6 segmentectomy. Both patients had negative automatic thoughts about cancer-related stress and postoperative pain. The physical therapists conducted a perioperative rehabilitation program in which the patients were educated to replace their maladaptive thoughts with more adaptive thoughts. After rehabilitation, the patients had improved adaptive thoughts, increased physical activity, and favorable recovery without pulmonary complications. This indicates that the combination treatment of perioperative rehabilitation and psychoeducation was useful in two thoracic cancer surgery patients. The psychoeducational approach should be expanded to perioperative rehabilitation of patients with cancer.
Right Hydronephrosis as a Complication of Acute Appendicitis
Authors: Selahattin Koray Okur, Yavuz Savaş Koca, İhsan Yıldız, İbrahim Barut
Journal: Case Rep Emerg Med (2016)

Introduction. Acute appendicitis is the most common cause of acute abdomen, but atypical appendicitis may lead to delayed diagnosis and related complications. In this report, we present a very rare case of acute appendicitis causing right hydronephrosis. Case Report. A 54-year-old male patient who had been receiving antibiotic therapy due to the diagnosis of urinary tract infection for the last one week but had no clinical improvement was admitted to the emergency service. Abdominal computed tomography (CT) showed right hydronephrosis and a pelvic abscess. After appendectomy and abscess drainage had been performed, hydronephrosis was completely recovered. Discussion. The use of appendicitis scoring systems, abdominal ultrasonography (USG), abdominal CT, and diagnostic laparoscopy can be useful for the diagnostic process in patients presenting with acute abdomen. In our patient, we considered that the surgical treatment was delayed since the symptoms of acute appendicitis were suppressed by the antibiotic therapy that was being administered due to the complaints including symptoms of urinary tract infections. Conclusion. Atypical appendicitis may cause a delay in the diagnosis of acute appendicitis and thus may lead to serious complications such as right hydronephrosis, prolonged hospital stay, increased morbidity and mortality, and increased antibiotic resistance.
A Novel HNF4A Mutation Causing Three Phenotypic Forms of Glucose Dysregulation in a Family
Authors: Suresh Chandran, Victor Samuel Rajadurai, Wai Han Hoi, Sarah E Flanagan, Khalid Hussain, Fabian Yap
Journal: Front Pediatr (2020)
Keywords: congenital hyperinsulinism, diazoxide, hepatocyte nuclear factor 4-alpha, hepatocyte nuclear factor−1- alpha, hyperinsulinemic hypoglycemia of infancy, maturity-onset diabetes mellitus
MeSH terms: Case Reports

Maturity-onset diabetes of the young (MODY) classically describes dominantly inherited forms of monogenic diabetes diagnosed before 25 years of age due to pancreatic β-cell dysfunction. In contrast, mutations in certain MODY genes can also present with transient or persistent hyperinsulinemic hypoglycemia in newborn infants, reflecting instead β-cell dysregulation. Of the MODY genes described to date, only hepatocyte nuclear factor-4-alpha (HNF4A; MODY1) and hepatocyte nuclear factor-1-alpha (HNF1A; MODY3) mutations may result in a biphasic phenotype of hypoglycemia in early life and hyperglycemia in later life. We report a family with a novel HNF4A mutation with diverse phenotypic presentations of glucose dysregulation. The proband was a term, appropriate-for-gestational age male infant with symptomatic hypoglycemia on day 3 of life needing high glucose infusion rate to maintain normoglycemia. He was born to a non-obese and non-diabetic mother. Glucose regulation was optimized using diazoxide upon confirmation of hyperinsulinism. Cascade genetic screening identified the same mutation in his father and elder sister, but mother was negative. Father was diagnosed with Type 1 diabetes at 15 years of age that required insulin therapy. Proband's elder sister, born at term appropriate for gestational age, presented with transient neonatal hypoglycemia needing parenteral glucose infusion for a week followed by spontaneous resolution. The paternal grandparents were negative for this mutation, confirming a paternal de novo mutation and autosomal dominant inheritance in this family. This pedigree suggests that the presence of early-onset paternal diabetes should prompt molecular testing in infants presenting in the newborn period with diazoxide-responsive hyperinsulinemic hypoglycemia, even in the absence of maternal diabetes and macrosomia.
Successful Extracorporeal Membrane Oxygenation After Incidental Azygos Vein Cannulation in a Neonate With Right-Sided Congenital Diaphragmatic Hernia Interruption of the Inferior Vena Cava and Azygos Continuation
Authors: Alessandra Mayer, Genny Raffaeli, Federico Schena, Valeria Parente, Gabriele Sorrentino, Francesco Macchini, Anna Maria Colli, Lucia Mauri, Simona Neri, Irene Borzani, Ernesto Leva, Fabio Mosca, Giacomo Cavallaro
Journal: Front Pediatr (2019)
Keywords: cdh, ecmo, azygos, free hemoglobin, inferior vena cava
MeSH terms: Case Reports

Incidental azygos vein cannulation has been reported in a few cases of neonatal extracorporeal membrane oxygenation (ECMO). This complication is described in the literature mainly in pathological conditions wherein increased central venous pressure dilates the superior vena cava (SVC), i.e., right congenital diaphragmatic hernia (CDH) or pulmonary hypertension. Azygos vein cannulation should always be suspected in cases of impaired venous return and circuit failure. Although rare, it hinders proper venous aspiration of the ECMO circuit and generally requires repositioning or replacement of the venous cannula or conversion to central cannulation. In this report, we describe a newborn with severe right CDH who required ECMO assistance, wherein incidental cannulation of the azygos vein resulted in successful functioning of the circuit because of the concomitant presence of isolated interruption of the inferior vena cava and azygos continuation. To the best of our knowledge, this is the first report of successful neonatal ECMO despite azygos vein cannulation in a patient with such rare physiology.
Large Uterine Fibroids in Pregnancy with Successful Caesarean Myomectomy
Authors: Edu Eyong, Okon A Okon
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Uterine fibroid is the commonest benign tumour of the female reproductive tract. It occurs in 20-40% of women, whereas the estimated incidence in pregnancy is 0.1-3.9%. Uterine fibroid in pregnancy is usually asymptomatic with complications occurring in 10-30% of cases. The first line of management is conservative with counselling for myomectomy after delivery. However, in the presence of intractable symptoms, both antepartum myomectomy and caesarean myomectomy have been reported to be successfully performed in carefully selected cases. We report a case of large subserous uterine fibroid in pregnancy that was referred to our centre at 14 weeks of gestation. She developed generalized body weakness, backache, and breathlessness at 27 weeks gestation. Thus, she was admitted and managed conservatively for eight weeks with significant relief of symptoms. She eventually had a caesarean myomectomy at 35 weeks of gestation; the outcome was a live female baby with a birth weight of 2.3 kg and a large subserous fibroid weighing 9.5 kg. We can therefore say that caesarean myomectomy can be safely performed in carefully selected cases.
Antimony to Cure Visceral Leishmaniasis Unresponsive to Liposomal Amphotericin B
Authors: Gloria Morizot, Romain Jouffroy, Albert Faye, Paul Chabert, Katia Belhouari, Ruxandra Calin, Caroline Charlier, Patrick Miailhes, Jean-Yves Siriez, Oussama Mouri, Hélène Yera, Jacques Gilquin, Roland Tubiana, Fanny Lanternier, Marie-France Mamzer, Christophe Legendre, Dominique Peyramond, Eric Caumes, Olivier Lortholary, Pierre Buffet
Journal: PLoS Negl Trop Dis (2016)
MeSH terms: Amphotericin B / therapeutic use, Antimony / therapeutic use, Antiprotozoal Agents / therapeutic use, Leishmania donovani / drug effects, Leishmaniasis, Visceral / drug therapy, Case Reports, Adult, Aged, Female, Humans, Infant, Male, Middle Aged, Treatment Outcome, Antiprotozoal Agents, liposomal amphotericin B, Amphotericin B, Antimony

We report on 4 patients (1 immunocompetent, 3 immunosuppressed) in whom visceral leishmaniasis had become unresponsive to (or had relapsed after) treatment with appropriate doses of liposomal amphotericin B. Under close follow-up, full courses of pentavalent antimony were administered without life-threatening adverse events and resulted in rapid and sustained clinical and parasitological cure.
Case Report: A Deletion Variant in the DCAF17 Gene Underlying Woodhouse-Sakati Syndrome in a Chinese Consanguineous Family
Authors: Guangmin Chen, Ling Zhou, Qimou Chen, Juan Wang, Peng Jiang, Rufei Shen, Min Long, Houdi Zhou
Journal: Front Genet (2021)
Keywords: dcaf17, alopecia, deletion mutation, diabetes mellitus, hypogonadism, woodhouse-sakati syndrome
MeSH terms: Case Reports

Woodhouse-Sakati syndrome (WSS, MIM 241080) is a rare neuroendocrine disease characterized by hair loss, hypogonadism, diabetes, hearing loss, and extrapyramidal syndrome, and is usually caused by mutations in the DCAF17 gene as an inherited disease. DCAF17 plays an important role in mammalian gonadal development and infertility. So far, there have been no WSS reports in China. The patient introduced in this case is from a consanguineous family. The main symptoms of the patient were alopecia and gonadal agenesis. Other symptoms such as hearing loss, intellectual disability, and hyperglycemia were remarkable, and these symptoms are often observed in WSS patients. We found a nonsense mutation in the 11th exon of the gene DCAF17 (Refseq: NM_025000) in the patient and her younger brother, which confirmed the diagnosis of WSS. The genetic results also showed that the mutation was inherited from their healthy first-cousin parents.