OpenMed/multicare-articles huggingface dataset:
A Population-Based Systematic Clinical Analysis With a Single-Center Case Series of Patients With Pulmonary Large Cell Neuroendocrine Carcinoma
Authors: Xu Sun, Yijun Wu, Jing Shen, Chang Han, Kai Kang, Zhikai Liu, Fuquan Zhang
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: incidence, mortality, pulmonary large cell neuroendocrine carcinoma, survival, treatment
MeSH terms: Carcinoma, Neuroendocrine / mortality, Lung Neoplasms / mortality, Research Support, Non-U.S. Gov't, Aged, Carcinoma, Neuroendocrine / therapy, China / epidemiology, Female, Humans, Incidence, Lung Neoplasms / therapy, Male, Middle Aged, Nomograms, Retrospective Studies, SEER Program

Background and objectives:
This study aims to conduct an updated systematic analysis of patients with pulmonary large cell neuroendocrine carcinoma (PLCNC) in recent decades, concerning incidence and mortality trends, demographics, treatments, survival and death causes.
Methods:
Patients who were diagnosed with PLCNC at the Peking Union Medical College Hospital (PUMCH) between 2000 to 2020 were retrospectively analyzed. The population-based Surveillance, Epidemiology, and End Results (SEER) database were also retrieved. Frequencies and average annual age-adjusted rates (AAR) of PLCNC patients were calculated and analyzed by Joint-point regression. Univariate and multivariate Cox regression were used for identifying prognostic factors. Predictive nomograms for overall survival (OS) and cancer-specific survival (CSS) were developed and then validated by calculating C-index values and drawing calibration curves. Survival curves were plotted using the Kaplan-Meier method and compared by log-rank test. Causes of death were also analyzed by time latency.
Results:
A total of 56 PLCNC patients of the PUMCH cohort were included. Additionally, the PLCNC patients in the SEER database were also identified from different subsets. The AAR from 2001 to 2017 were 3.21 (95%CI: 3.12-3.30) per million. Its incidence and mortality rates in PLCNC patients increased at first but seemed to decline in recent years. Besides TNM stage and treatments, older age and male gender were independently associated with poorer survival, while marital status only affected CSS other than OS. The nomograms for OS and CSS presented great predictive ability and calibration performance. Surgery gave significantly more survival benefits to PLCNC patients, and chemotherapy might add survival benefits to stage II-IV. However, radiation therapy seemed to only improve stage III patients' survival.
Conclusions:
This study supported some previous studies in terms of incidence, survival, and treatment options. The mortality rates seemed to decline recently, after an earlier increase. Among PLCNC patients, most of the deaths occurred within the first five years, while other non-PLCNC diseases increased after that. Thus, careful management and follow-up of other comorbidities are of equal importance. Our study may partly solve the dilemma caused by PLCNC's rarity and inspire more insights in future researches.
Maternal deaths associated with hypertension in South Africa: lessons to learn from the Saving Mothers report, 2005-2007
Authors: J Moodley, National Committee on Confidential Enquiries into Maternal Deaths, National Department ofHealth, South Africa
Journal: Cardiovasc J Afr (2011)
MeSH terms: Cause of Death, Hypertension, Pregnancy-Induced / mortality, Maternal Mortality, Pregnancy Complications, Cardiovascular / mortality, Quality of Health Care, Case Reports, Adult, Attitude of Health Personnel, Communication Barriers, Female, Health Knowledge, Attitudes, Practice, Health Services Accessibility, Humans, Maternal Health Services, Middle Aged, Patient Acceptance of Health Care, Patient Education as Topic, Pregnancy, Referral and Consultation, South Africa, Time Factors, Young Adult

From 2005-2007, there were 622 deaths associated with hypertensive disorders of pregnancy. Eclampsia was the major cause of death (n = 344; 55.3%). There were 173 (28.3%) deaths due to pre-eclampsia, and 38 (6.1%) associated with chronic hypertension. Cerebral complications were the final cause of death in 283 (45.5%), while cardiac failure and respiratory failure were the final causes in 142 (22.8%) and 158 (25.4%), respectively. Major problems were identified in all areas of assessment. Non-attendance for antenatal care (n = 106; 19.4%) and delay in seeking help (n = 106; 19.4%) were major patient-related factors. Communication problems (n = 63; 10.8%) and lack of facilities (n = 50; 8.5%) were health administration issues. Health worker-avoidable factors included problem recognition, delay in referral and management at an inappropriate level of healthcare. Compared to the previous report of 2002-2004, there was a reduction in deaths due to hypertension.
Systemic Lupus Erythematosus Presented with Bilateral Orbital Edema and Negative Serology
Authors: Manal Al-Khaldi, Manal Alsabbagh
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Isolated bilateral periorbital edema with negative serology is an extremely rare presentation of cutaneous lupus erythematosus that may lead to eyelid scarring, infection, or even corneal involvement. The treatment usually comprises a combination of hydroxychloroquine and a tapering dose of systemic steroids. Patients require long-term follow-up as they may develop systemic lupus erythematosus with positive serology later in life. We report a case of a 32-year-old female who presented with chronic bilateral periorbital edema, and the histopathology confirmed cutaneous lupus erythematosus.
Hashimoto's encephalopathy - presenting with epilepsia partialis continua and a frontal lobe lesion
Authors: Lokesh A Rukmangadachar, Sudeepta Dandapat, Esther N Bit-Ivan, Yen-Yi Peng
Journal: Clin Case Rep (2017)
Keywords: epilepsia partialis continua, hashimoto's encephalopathy, thyroglobulin antibody, thyroperoxidase antibody
MeSH terms: Case Reports

We report a case of Hashimoto's encephalopathy (HE), who presented with epilepsia partialis continua (EPC) and a frontal lobe lesion. The diagnosis of HE remained elusive until the serum thyroid antibodies became positive 7 months after the onset of EPC. The histopathology of this frontal lesion showed nonvasculitic inflammation.
Successful hematopoietic stem cell transplantation for two patients with relapse of intrachromosomal amplification of chromosome 21-positive B-cell precursor acute lymphoblastic leukemia
Authors: Tomoya Harada, Hidemi Toyoda, Naoki Tsuboya, Ryo Hanaki, Keishiro Amano, Masahiro Hirayama
Journal: Front Pediatr (2022)
Keywords: b-cell precursor acute lymphoblastic leukemia, hematopoietic stem cell transplantation, iamp21, late bone marrow relapse, minimal residual disease, relapsed acute lymphoblastic leukemia
MeSH terms: Case Reports

In children with relapsed acute lymphoblastic leukemia (ALL), it is essential to identify patients in need of treatment intensification. Minimal residual disease (MRD)-based treatment stratification resulted in excellent survival in children with late relapsed B-cell precursor (BCP)-ALL. Chemotherapy alone produced a favorable outcome in patients with negative MRD after induction. The genetic abnormality also plays an important role in determining the prognosis and stratification for treatment. Intrachromosomal amplification of chromosome 21 (iAMP21) is associated with a poor outcome and a high risk for relapse, and there is no standard treatment after relapse. Herein, we present two patients with relapsed iAMP21-positive ALL who were successfully treated by cord blood transplantation (CBT). Although both patients had late bone marrow relapse and favorable MRD response, CBT was performed due to iAMP21 positive. Patients 1 and 2 have been in remission post-CBT for 15 and 45 months, respectively. Patients with relapsed iAMP21-positive ALL may be considered for stem cell transplantation even in late relapses and favorable MRD response.
Emergency surgery for tubo-ovarian abscess identified extended-spectrum beta-lactamase-producing Escherichia coli: the first case presentation revealing causative bacteria
Authors: Teppei Tokumaru, Yasuo Shima, Takehiro Okabayashi, Kazutoshi Hayashi, Yorito Yamamoto, Kazuhide Ozaki, Jun Iwata
Journal: Surg Case Rep (2015)
Keywords: emergency surgery, extended-spectrum beta-lactamase, surgery, tubo-ovarian abscess

We report herein a 41-year-old female with a tubo-ovarian abscess (TOA), which microbial cultures showed to contain extended-spectrum beta-lactamase (ESBL)-producing E. coli, a causative agent of community-acquired infection. The patient initially presented with acute abdominal pain and back pain. Pelvic computed tomography and transvaginal ultrasonography revealed multiple cystic lesions in the bilateral ovaries that suggested TOA. An emergency laparotomy was therefore performed due to the potential for life-threatening septic shock from the TOA-associated pelvic inflammatory disease. Microbial cultures of postoperative fluid discharge from the placed intra-abdominal catheter, vaginal secretions, urine, blood, and feces detected ESBL-producing E.coli. In summary, we successfully performed emergency surgery for life-threatening septic TOA caused by ESBL-producing E. coli infection.
Unexpected long-term survival of Stage IV pancreatic cancer patient with synchronic liver metastases after multimodal therapy including upfront surgery
Authors: Aiman Obed, Mahmoud Siyam, Amr Anwar Jarrad, Ody Abdelhadi, Muaweih Ababneh, Hassan Annab, Laszlo Füzesi, Abdalla Bashir, Anwar Jarrad
Journal: J Surg Case Rep (2023)
MeSH terms: Case Reports

We report the case of a 56-year-old male with pancreatic cancer and 25 liver metastases. The patient underwent a distal pancreatectomy with 11 metastasectomies in the left liver lobe. Histological examination demonstrated a moderately differentiated ductal adenocarcinoma with pT3N0M1, Stage IVb. Three weeks later, we performed transarterial chemoembolization for the right lobe of the liver, and after 6 weeks we started systemic chemotherapy with FOLFIRINOX. After 31 months, computer tomography examination showed increases in size of the remaining lesions at segment VII/VIII of the right lobe. All liver metastases were surgically removed and a new chemotherapy was initiated. Nevertheless, after 40 months the patient developed two brain metastases. One was surgically resected and the smaller lesion was treated by gamma knife. Unfortunately, the patient died 42 months after the first presentation. Conclusively, in very selected patients with synchronic liver metastasis, multimodal treatment including repeated surgery, TACE and chemotherapy may prolong survival.
Pellucid-like keratoconus
Authors: Mazen M Sinjab, Lara N Youssef
Journal: F1000Res (2012)

Purpose:
To study the tomographic features of pellucid-like keratoconus (PLK), and to report a new sign on the pachymetry map (PM) in pellucid marginal degeneration (PMD).
Patients and methods:
A retrospective descriptive case series was performed in Damascus University in 2011. Clinical and tomographic findings of 15 eyes (9 patients) that had the claw pattern of the anterior sagital map (ASM) were reviewed. Patients were distributed into two groups: (1) 4 eyes were considered PMD since they had inferior corneal thinning on both slitlamp biomicroscopy and PM; (2) 11 eyes were considered as PLK since they did not show inferior corneal thinning. Patients were studied using slitlamp biomicroscopy and Scheimpflug-based tomography (Pentacam HR). The ASM, anterior elevation map (AEM) and PM were analyzed and compared to study the "kissing birds" sign, the "bell" sign, and cone location.
Results:
Patients' average age was 25.93±8.05 (16-44 years). In total, 60% of patients were male. In group 1, the AEM in the best fit sphere (BFS) mode revealed no kissing birds sign, and the cone was central in 1 eye (25%) and paracentral in 3 eyes (75%). PM showed the bell sign in 4 eyes (100%). In group 2, the AEM in the BFS mode revealed the kissing birds sign in 2 eyes (18.2%), and the cone was central in 1 eye (9.1%), paracentral in 8 eyes (72.7%) and peripheral in 2 eyes (18.2%). PM didn't show the bell sign in any eye.
Conclusion:
The claw pattern on the ASM is not a hallmark of PMD; it can be seen in PLK. Cone location does not relate to diagnosis. The "bell" sign on the PM is a deferential diagnostic sign in PMD.
Rare and Underestimated Association of Pulmonary Embolism and Olanzapine Therapy; Report of Two Cases
Authors: Hammam Rasras, Mustapha Beghi, Maryem Samti, Nabila Ismaili, Noha El Ouafi
Journal: Arch Acad Emerg Med (2021)
Keywords: pulmonary embolism, antipsychotic agents, olanzapine, risk factors, venous thromboembolism
MeSH terms: Case Reports

Venous thromboembolic disease (VTD) is a very common and severe pathological condition in which there are many predisposing factors. Olanzapine is a drug frequently used in psychiatric practises; it is thought to increase the risk of VTD. Here, we report two cases, a young man and a woman, with a medical history of schizophrenia treated by olanzapine who developed pulmonary embolism and we did not find any aetiologies of VTD in them. Due to the link between olanzapine and pulmonary embolism, which has been previously described, olanzapine is considered responsible for this problem. Two mechanisms have been reported in the literature in this regard; significant weight gain and lethargy, which are very common side effects of olanzapine. So far, no direct effect of olanzapine on platelet aggregation or coagulation has been found. In patients developing VTD while being treated with olanzapine, discontinuation of olanzapine as a treatment option must be done with an adjustment of antipsychotic treatment and regular monitoring of psychic symptoms. Since the diagnosis of pulmonary embolism is not easy to make in a schizophrenic patient, clinicians should take that in consideration when prescribing these drugs and when facing clinical situations where VTD is suspected.
Multisystem Inflammatory Syndrome with Features of Atypical Kawasaki Disease during the COVID-19 Pandemic
Authors: Reza Shahriarirad, Anahita Sanaei Dashti, Shabnam Hajiani Ghotbabadi
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Background:
Although Kawasaki disease (KD) is the most common self-limited systemic vasculitis in pediatrics, the exact etiology of the disease, its association with other diseases, and pathogens is still unknown. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating KD during the COVID-19 pandemic. Here, we present a case of an atypical case of KD presenting as multisystem inflammatory syndrome (MIS) during the COVID-19 pandemic. Case Presentation. The patient is a 7-year-old girl who developed fever (39°C) and erythematous multiform rash on the abdomen and along with erythema and edema on the extremities. Laboratory evaluation revealed neutrophilia and lymphopenia along with elevated C-reactive protein, erythrocyte sedimentation rate, troponin, lactate dehydrogenase, ferritin, and D-dimer. Although the patient did not fulfill the KD criteria, based on approved guidelines and approaches regarding atypical KD and multisystem inflammatory syndrome in children (MIS-C) during the COVID-19 pandemic, intravenous immunoglobulin along with aspirin was administered for the patients. The patient's symptoms resolved with an uneventful postdischarge course.
Conclusion:
Early diagnosis and treatment of patients meeting full or partial criteria for KD are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.
Resistance to thyroid hormone due to a novel mutation in the thyroid beta receptor ( THRβ) gene coexisting with autoimmune thyroid disease-A case report
Authors: Elżbieta Skowrońska-Jóźwiak, Agnieszka Gach, Anna Cyniak-Magierska, Anna Nykel, Monika Jurkowska, Andrzej Lewiński
Journal: Front Genet (2023)
Keywords: mutation in thrβ gene, resistance to thyroid hormone, thyroglobulin antibodies, thyroid autoimmunity, thyroperoxidase antibodies
MeSH terms: Case Reports

Resistance to thyroid hormone (RTH) is a syndrome characterized by impaired responsiveness of target tissues to thyroid hormones. The relationship between RTHβ and thyroid autoimmunity has been under research. In this study, we demonstrate a case report of a woman with a novel mutation in THRβ gene coexisting with autoimmune thyroid disease (AITD). The 36-year-old woman has been treated since childhood for a thyroid disease. Based on high levels of thyroid hormones (THs) and elevated concentrations of thyroperoxidase and thyroglobulin antibodies (TPOAb and TgAb, respectively), she received unnecessary long-term treatment with methimazole and finally underwent subtotal thyroidectomy. After the surgery, her TSH level remained significantly elevated, despite the treatment with 150 + 15 µg of thyroxine and triiodothyronine. A sequence analysis of the THRβ gene revealed a novel dinucleotide substitution affecting codon 453, resulting in the replacement of the normal proline with an asparagine (c.1357_1358delinsAA, p.(Pro453Asn)). The mutation has not been described in the literature yet; however, THRβ codon 453 represents a mutational hot spot, frequently altered in the TH receptor ß gene. After establishing the diagnosis of RTH, the patient was treated with 300 µg of thyroxine, which showed clinical improvement and normalization of TSH. The coexistence of RTHβ and AITD may additionally impede establishment of a proper diagnosis, leading to unnecessary therapy and delayed correct treatment. The presented case encourages a closer cooperation between clinical endocrinologists and geneticists.
A Case Report of Isolated Bilateral Cerebral Peduncular Infarction
Authors: Chenguang Zhou, Yuanhong He, Xiaorui Tian, Zhiwen Chao, Yinghui Zhu, Du Cheng, Kui Li
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Isolated bilateral cerebral peduncular infarctions (BCPI) presenting as acute pseudobulbar palsy are rarely reported and, to the best of our knowledge, most of the previous reports of BCPI were related to locked-in syndrome and disturbance of consciousness. Herein, we described a case of a 55-year-old man who presented with acute pseudobulbar palsy and mild tetraparesis, but preserved eye movements, with no consciousness disturbance. DWI revealed an acute infarction involving the central portion of the cerebral peduncle with a characteristic "traditional Chinese eight character" sign. The relationship between the infarcted range in the cerebral peduncle and the clinical manifestation was discussed in our report.
Case Report: A Case of Encephalopathy Presenting the Lentiform Fork Sign on MRI in a Diabetic Dialysis Patient
Authors: Yuri Ishizaki, Ryuzoh Nishizono, Masao Kikuchi, Hiroko Inagaki, Yuji Sato, Shouichi Fujimoto
Journal: F1000Res (2020)
Keywords: basal ganglia lesion, consciousness disturbance, diabetic uremic syndrome, lentiform fork sign, metformin
MeSH terms: Brain Diseases, Diabetes Mellitus, Diabetic Nephropathies / complications, Diabetic Nephropathies / therapy, Uremia / complications, Uremia / therapy, Case Reports, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Renal Dialysis

Basal ganglia lesions showing an expansile high signal intensity on T2-weighted MRI are termed the lentiform fork sign. This specific finding is mainly observed in diabetic patients with uremic encephalopathy with metabolic acidosis, although there are also reports in patients with ketoacidosis, dialysis disequilibrium syndrome, intoxication, and following drug treatment (e.g., metformin). A 57-year-old Japanese man on chronic hemodialysis for 4 years because of diabetic nephropathy was admitted to our hospital for relatively rapid-onset gait disturbance, severe dysarthria, and consciousness disturbance. Brain T2-weighted MRI showed the lentiform fork sign. Hemodialysis was performed the day before admission, and laboratory tests showed mild metabolic (lactic) acidosis, but no uremia. Surprisingly, metformin, which is contraindicated for patients with end-stage kidney disease, had been prescribed for 6 months in his medication record, and his sluggish speaking and dysarthria appeared gradually after metformin treatment was started. Thus, the encephalopathy was considered to be related to metformin treatment. He received hemodialysis treatment for 6 consecutive days, and his consciousness disturbance and dysarthria improved in 1 week. At the 8-month follow-up, the size of the hyperintensity area on MRI had decreased, while the mild gait disturbance remained. Considering the rapid onset of gait and consciousness disturbance immediately before admission, diabetic uremic syndrome may also have occurred with metformin-related encephalopathy, and resulted in the lentiform fork sign, despite the patient showing no evidence of severe uremia on laboratory data.
Acute pancreatitis and obstructive jaundice as initial complaints of hepatocellular carcinoma: case report
Authors: Guo-Qing Jiang, Jian-Jun Qian, Jie Yao, Sheng-Jie Jin, Dou-Sheng Bai
Journal: World J Surg Oncol (2014)
MeSH terms: Carcinoma, Hepatocellular / complications, Cholestasis / etiology, Common Bile Duct / pathology, Embolism / complications, Jaundice, Obstructive / etiology, Liver Neoplasms / complications, Pancreatitis / etiology, Case Reports, Carcinoma, Hepatocellular / diagnosis, Carcinoma, Hepatocellular / therapy, Cholecystectomy, Cholestasis / pathology, Cholestasis / surgery, Common Bile Duct / surgery, Humans, Jaundice, Obstructive / pathology, Jaundice, Obstructive / surgery, Liver Neoplasms / diagnosis, Liver Neoplasms / therapy, Male, Middle Aged, Pancreatitis / pathology, Pancreatitis / surgery, Prognosis

Background:
Patients with cirrhosis-associated hepatocellular carcinoma (HCC) rarely present with acute pancreatitis (AP) and obstructive jaundice as the main clinical features. AP with obstructive jaundice caused by common bile duct embolism (CBDE) is very rare.
Case presentation:
A 54-year-old man with CBDE was misdiagnosed with common bile duct stones three times over a 7-month period. Investigations during this time did not identify CBDE. Surgical exploration was performed because of AP, obstructive jaundice, and a tumor in the left lobe of the liver. CBDE from the hepatic tumor was diagnosed by intraoperative biopsy and frozen section examination. The patient underwent left hemihepatectomy, cholecystectomy, and bile duct exploration.
Conclusion:
Preoperative diagnosis of CBDE is difficult because of the rarity of the condition, lack of physician awareness, and easy misdiagnosis on imaging examinations. Early and accurate diagnosis of this condition is important.