OpenMed/multicare-articles huggingface dataset:
Bilateral simultaneous heterotopic ossification of the reflected head of rectus femoris muscle: a case report and review of the literature
Authors: Murat Tonbul, Seyma Ozen, Ayse Tuba Tonbul
Journal: Case Rep Orthop (2014)

Lamellar bone formation in an abnormal location is defined as heterotopic ossification. It commonly occurs around the hip joint and most often involves the abductor muscles. It is a benign condition; however, its etiology remains largely unknown. Most previously reported cases have been due to trauma or intramuscular hemorrhage. In this paper, we present a case of bilateral heterotopic ossification of the reflected head of rectus femoris muscle without antecedent trauma or any other known cause, as the first and unique case in the literature. She was treated by excision of the right symptomatic bony mass via a modified Smith-Petersen approach. Postoperatively, she received 75 mg indomethacin daily for six weeks. She was pain-free and obtained full range of motion 3 weeks after the first intervention.
Environmental perceptions of global business travel by Swiss companies in the Zurich airport region
Authors: Ignacio Echeverria Arrondo, Bert Wolfs
Journal: F1000Res (2021)
Keywords: switzerland business travel covid-19 environmental awareness mobility corporate culture leadership
MeSH terms: Airports, COVID-19 / epidemiology, Commerce, Humans, Switzerland / epidemiology, Travel

Background: This article presents findings from research conducted before the coronavirus disease 2019 (COVID-19) pandemic on companies located in the Zurich airport region of Switzerland, regarding the needs for global business travel and its impacts. Methods: The study involved a mixed methods approach. Five hypotheses were tested using inferential statistics on data obtained from pre-tested closed questions in a web-based survey. Deeper context was explored through an interview-based case-study conducted at a Swiss pharma company. Results: Supporting alternative hypothesis 3 (Ha(3)), a significant positive relationship was found between travel frequency and business growth, F(1, 100) = 11.31, p = 0.0011. Supporting Ha(4), corporate culture had a significant positive relationship with business travel frequency (F(1, 100) = 15.50, p = 0.0002) and average trip length (F(1, 100) = 6.39, p = 0.01). And thirdly supporting Ha(5), corporate social responsibility had a significant relationship with global business travel (91%). Ho(2) and Ho(3) were accepted. The case study found that smart corporate travel policies and regulations should be instantiated to enhance our environment, which would also benefit employee wellbeing. Travel can be reduced significantly despite being demonstrated that physical co-presence is important for building trust. The case study suggests tools to support the monitoring and management of global business travel by organizations. Conclusions: COVID-19 has impacted travel for business significantly, and future research will be necessary to assess its impact. The article explores the ongoing research in this area, and several relevant implications are proposed for future leaders. The case study found willingness to pay both corporate and individual green taxes, and a deficiency in corporate communication around the environment. Business travel is needed to build trust; however, it can be reduced.
The Dynamics of SARS-CoV-2 (RT-PCR) Testing
Authors: Nicole Joyce, Lynsey Seim, Michael Smerina
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is estimated to have affected 6.2 million people in the United States and 27.5 million people worldwide as of September 9, 2020. On February 2, 2020, the Secretary of the Department of Health and Human Services (HHS) determined that the public health emergency justified the development and emergency use of "in vitro diagnostics for the detection and/or diagnosis of the virus that causes COVID-19" by activating the Emergency Use Authorization (EUA) authority under section 564 of the Federal Food, Drug, and Cosmetic Act. Unfortunately, effective mitigation efforts were thwarted early in the outbreak resulting in an expansion of the initial EUA on February 29, 2020, to improve accessibility to in vitro diagnostic testing. Expectantly, the development and deployment of SARS-CoV-2 testing including RT-PCR expanded rapidly in the weeks following the EUA expansion. These newly developed and approved SARS-CoV-2 RT-PCR tests boast impressive positive and negative agreement rates nearing 100%. Despite the exceptionally high rates of agreement, caution is advised as the RT-PCR tests approved under the COVID-19 EUA are in vitro analyses developed with samples artificially doped with SARS-CoV-2 RNA. These tests therefore do not have clinically applicable sensitivity and specificity because they lack a "gold standard" for diagnosis. Here we present three challenging cases requiring cautious interpretation of the newest generation of RT-PCR molecular detection assays, highlighting the major challenges faced by providers treating patients potentially infected with SARS-CoV-2.
Analyzing the EU Migration Crisis as Reflected on Twitter
Authors: Sagnik Mukherjee, Eva Hauthal, Dirk Burghardt
Journal: KN J Cartogr Geogr Inf (2022)
Keywords: eu migration crisis, geospatial visualization, social media, twitter, user generated data

The proliferation of social media has resulted in its extensive use as a valuable source of information for researchers. This paper aims to use Twitter data to analyze and visualize tweets about the migration crisis in the European Union from 2016 to 2021. The paper uses a methodology to structure data for better understanding of complex social media data. The methods and metrics include the facet model of location based social media, the HyperLogLog data structure and novel uses of the metric typicality. The authors have also developed a web based interactive application closely following the methodology used to organize the dataset. Additionally the work also includes maps using spatial typicality which could be utilized for studying spatial phenomenon. The case study selected also provides unique insights and sets a template for working with multi-lingual geo-social media data. The authors believe that these methods and metrics could be reproduced for other case studies and aid in understanding and communication geo-social media data.
Supplementary information:
The online version contains supplementary material available at 10.1007/s42489-022-00114-6.
Congenital Chloride Diarrhea: Diagnosis by Easy-Accessible Chloride Measurement in Feces
Authors: C Gils, M-C Eckhardt, P E Nielsen, M Nybo
Journal: Case Rep Pediatr (2016)

Background. Congenital chloride diarrhea (CCD) is an autosomal recessive disorder caused by mutations in the genes encoding the intestinal Cl(-)/HCO3 (-) exchanger and is clinically characterized by watery, profound diarrhea, electrolyte disturbances, and metabolic alkalosis. The CCD diagnosis is based on the clinical symptoms and measurement of high chloride concentration in feces (>90 mmol/L) and is confirmed by DNA testing. Untreated CCD is lethal, while long-term clinical outcome improves when treated correctly. Case Presentation. A 27-year-old woman had an emergency caesarian due to pain and discomfort in gestational week 36 + 4. The newborn boy had abdominal distension and yellow fluid per rectum. Therapy with intravenous glucose and sodium chloride decreased his stool frequency and improved his clinical condition. A suspicion of congenital chloride diarrhea was strongly supported using blood gas analyzer to measure an increased chloride concentration in the feces; the diagnosis was confirmed by DNA testing. Discussion. Measurement of chloride in feces using an ordinary blood gas analyzer can serve as a preliminary analysis when congenital chloride diarrhea is suspected. This measurement can be easily performed with a watery feces composition. An easy-accessible chloride measurement available will facilitate the diagnostics and support the initial treatment if CCD is suspected.
Palmar-plantar erythrodysesthesia associated with capecitabine chemotherapy: a case report
Authors: Gabriel Kigen, Naftali Busakhala, Evangeline Njiru, Fredrick Chite, Patrick Loehrer
Journal: Pan Afr Med J (2015)
Keywords: kenya, palmar-plantar erythrodysesthesia, capecitabine
MeSH terms: Antimetabolites, Antineoplastic / adverse effects, Capecitabine / adverse effects, Hand-Foot Syndrome / etiology, Case Reports, Adenocarcinoma / drug therapy, Adenocarcinoma / pathology, Antimetabolites, Antineoplastic / therapeutic use, Capecitabine / therapeutic use, Colonic Neoplasms / drug therapy, Colonic Neoplasms / pathology, Female, Hand-Foot Syndrome / pathology, Humans, Middle Aged, Antimetabolites, Antineoplastic, Capecitabine

We report a case of a 62 year-old patient who developed Palmar-plantar erythrodysesthesia upon receiving four cycles of capacitabine-based chemotherapy. She was on post surgical adjuvant treatment for invasive well differentiated adenocarcinoma of the colon. The clinical and therapeutic aspects of this chemotherapeutic adverse effect are discussed.
Orbital apex syndrome in herpes zoster ophthalmicus
Authors: Hatice Arda, Ertugrul Mirza, Koray Gumus, Ayse Oner, Sarper Karakucuk, Ender Sırakaya
Journal: Case Rep Ophthalmol Med (2012)
MeSH terms: Case Reports

Orbital apex syndrome is a rare manifestation of Herpes Zoster Ophthalmicus. Herein we report on a case of orbital apex syndrome secondary to Herpes Zoster Ophthalmicus. A 75 year-old male complained of vision loss, conjunctival hyperemia and proptosis on the left eye, was referred to our clinic. Visual acuity was 5/10 Snellen lines and he had conjunctival hyperemia, chemosis, minimal nuclear cataract and proptosis on the left eye. A diagnosis of orbital pseudotumor was demonstrated firstly. The patient received oral and topical corticosteroids, antiinflammatory and antibiotic agents. On day 2, vesiculopustular lesions were observed, Herpes Zoster Ophthalmicus was diagnosed and corticosteroid treatment stopped, oral acyclovir treatment initiated. Two days later, total ophthalmoplegia, ptosis and significant visual loss were observed on the left. The diagnosis of orbital apex syndrome was considered and the patient commenced on an intravenous acyclovir treatment. After the improvement of acute symptoms, a tapering dose of oral cortisone treatment initiated to accelarate the recovery of ophthalmoplegia. At 5-month follow-up, ptosis and ocular motility showed improvement. VA did not significantly improve because of cataract and choroidal detachment on the left. We conclude that ophthalmoplegia secondary to Herpes Zoster Ophthalmicus responds favourably to intravenous acyclovir and steroids.
Ewing's Sarcoma Mimicking an Avulsion Fracture
Authors: Charlotte Vanhoenacker, Jan Myncke, Filip Vanhoenacker
Journal: J Belg Soc Radiol (2021)
Keywords: ct, ewing’s sarcoma, mri, avulsion fracture of the lesser trochanter, radiography
MeSH terms: Case Reports

Teaching Point: In the absence of a clear history of trauma, avulsion of the lesser trochanter should raise a high index of suspicion of an underlying malignancy.
Fulminant hepatic failure secondary to primary hepatic angiosarcoma
Authors: Ayokunle T Abegunde, Efe Aisien, Benjamin Mba, Rohini Chennuri, Marin Sekosan
Journal: Case Rep Gastrointest Med (2015)

Background. Hepatic angiosarcoma is a rare and aggressive tumor that often presents at an advanced stage with nonspecific symptoms. Objective. To report a case of primary hepatic angiosarcoma in an otherwise healthy man with normal liver function tests two months prior to presenting with a short period of jaundice that progressed to fulminant hepatic failure. Methods. Case report and review of literature. Conclusion. This case illustrates the rapidity of progression to death after the onset of symptoms in a patient with hepatic angiosarcoma. Research on early diagnostic strategies and newer therapies are needed to improve prognosis in this rare and poorly understood malignancy with limited treatment options.
A rare case of unrecognized and uncommon bladder perforation after transobturator tape procedure
Authors: Ercüment Kılınç, Yaşam Kemal Akpak
Journal: Case Rep Med (2015)

The transobturator tape (TOT) procedure has become practically widespread worldwide. Complications seem to be rare, but recognizing them intraoperatively is the most significant step because some of the complications which may appear in postoperative period can be challenging for both physicians and patients. The purpose of this case, with this patient who was operated on with open surgery, is to evaluate this rarely seen unrecognized and uncommon bladder perforation after TOT procedure and thus make some contribution to the literature. Here, we present a case report about the treatment of a 48-year-old woman patient with unrecognized and uncommon bladder perforation after TOT procedure, 5 months postoperatively. Cystoscopic evaluation is not recommended routinely, but it must be performed if the patient is complicated enough to create doubt and also the surgeon's skill and ability are not sufficient enough to operate decently.
Parkinson disease in Gaucher disease
Authors: Federico Rodriguez-Porcel, Alberto J Espay, Miryam Carecchio
Journal: J Clin Mov Disord (2017)
Keywords: gaucher disease, glucocerebrosidase, parkinson disease
MeSH terms: Case Reports

Background:
Gaucher disease (GD) is an inborn error of metabolism caused by mutations in the gene (GBA) coding for glucocerebrosidase (GCase), inherited in an autosomal recessive pattern. GD patients have up to 9% risk of developing PD.
Case presentation:
We report two patients with GD that developed PD at different disease stages.
Conclusion:
We reviewed the literature on the coexistence of PD and GD and speculate that the severity of symptoms may be related to the type of GBA mutation inherited.
False Elevation of Troponin in a Case of Multiple Myeloma
Authors: Omer Bajwa, Gashaw Hassen, Jacob Fishbein, Unamba Uchenna, Hussam Ammar
Journal: Cureus (2023)
Keywords: clinical reasoning, false high troponin, macrotroponin, myeloma, troponin
MeSH terms: Case Reports

Falsely elevated troponin has been reported in the literature. The authors present a case of a 51-year-old man who was admitted with nausea, vomiting, and chest discomfort. He was found to have elevated troponin with no electrocardiographic changes. He has normal coronaries on angiogram and normal echocardiogram. A diagnostic time-out and second look at the laboratory values captured abnormalities that triggered a workup that ruled in a multiple myeloma diagnosis. We suspected falsely elevated troponin levels secondary to macrotroponin, a complex of elevated immunoglobulin levels and troponin, which has been rarely reported to cause elevated troponin levels in patients with multiple myeloma.
Case Report: The Sexual Experiences of Forensic Mental Health Patients
Authors: Elnike Brand, Angela Ratsch, Edward Heffernan
Journal: Front Psychiatry (2021)
Keywords: forensic mental health, forensic psychiatry, sexual health, sexual rehabilitation, sexuality
MeSH terms: Case Reports

The recovery-based approach to forensic mental health rehabilitation is to support the patient to achieve a fulfilling life-a principle which should include achieving a fulfilling sexual life. This paper presents four vignettes from forensic mental health patients. The four cases demonstrate the omission, avoidance and then judgement by forensic mental health clinicians around the intimate and sensitive, yet important domain of the patient's sexual life. The cases illustrate that gap in the clinical domain and demonstrate the requirement for forensic mental health clinicians to have a greater awareness, acknowledgment, and assessment of their patient's sexuality and sexual health needs. Incorporating sexual health into standard clinical assessments will contribute to improved patient management in addition to supporting the principles of holistic forensic mental health recovery and rehabilitation.
Craniodentofacial Manifestations in a Rare Syndrome: Orofaciodigital Type IV (Mohr-Majewski Syndrome)
Authors: Meltem Ozdemir-Karatas, Didem Ozdemir-Ozenen, P Suzanne Hart, Thomas C Hart
Journal: Case Rep Dent (2014)

Background. The orofaciodigital syndromes (OFDS) are a heterogeneous group of syndromes that affect the face, oral cavity, and the digits. OFDS type IV (OMIM %258860) is rare and characterized by broad nasal root and tip, orbital hypertelorism or telecanthus, micrognathia, hypoplastic mandible, and low-set ears. Oral symptoms may include cleft lip, cleft or highly arched palate, bifid uvula, cleft or hypoplastic maxillary and mandibular alveolar ridge, oral frenula, lingual hamartoma, and absent or hypoplastic epiglottis. Dental anomalies are common and generally include disturbances in the number of teeth. Case Report. This report presents a six-year-old girl, referred with the chief complaint of missing teeth. She was diagnosed as having OFDS type IV based on clinical findings. Her parents reported three deceased children and two fetuses that had the same phenotype. She was the seventh child of consanguineous parents who were first cousins. Conclusion. This is a very rare syndrome. Many reported OFDS type IV cases have consanguineous parents, consistent with an autosomal recessive trait. Manifestation of cleft palate in the healthy sibling may be mild expression of the disorder or an unrelated isolated cleft.
A Case of Asymptomatic Pulmonary Artery Aneurysm with Review of Management Strategies
Authors: Muhammad Talha Ayub, Allison Zimmerman, Wajeeha Rasool, Dinesh Kalra, Melissa Tracy, Anupama K Rao
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Pulmonary artery aneurysm (PAA) is defined as pulmonary artery diameter greater than 4 cm. With advances in cardiac imaging, the detection rate has increased but the natural history remains unknown. We present the case of a large, incidentally identified PAA in a patient with a history of congenital pulmonic stenosis.
Phenomenology and Physiology of Tacrolimus Induced Tremor
Authors: Aparna Wagle Shukla, Caroline Lunny, Ibrahim Hisham, Jackson Cagle, Joyce Malea, Alfonso Santos, Ashutosh M Shukla
Journal: Tremor Other Hyperkinet Mov (N Y) (2023)
Keywords: adaptive device, cooling, drug induced tremor, limb cooling, physiology, tacrolimus, tacrolimus induced tremor, tremor
MeSH terms: Tacrolimus / adverse effects, Tremor, Case Reports, Forearm / physiology, Humans, Immunosuppressive Agents / adverse effects, Upper Extremity, Tacrolimus, Immunosuppressive Agents

Background:
Tacrolimus is a potent immunosuppressant drug commonly used after solid organ transplant surgery. The use of this drug is frequently associated with the emergence of tremors. There is little information on the clinical and physiological characteristics of tacrolimus-induced tremors. Characterizing these tremors is essential as they can promote the development of specific therapies.
Methods:
We describe four patients placed on tacrolimus immunosuppressant therapy following kidney transplant surgery and who developed tremors impacting their daily functional activities. We describe the clinical and physiological characteristics of the tremor and the response generated after a limb cooling test.
Results:
A postural and kinetic tremor mainly involving the distal hands was observed in our cohort. In the accelerometer-based assessment, the tremor amplitude was noted to be mild to moderate, and the frequency was 5-6 Hz. Cooling the forearm and the hand led to a temporary albeit significant reduction of tremor amplitude (p = 0.03). Limb cooling lowered the tremor frequency by 1 Hz in two patients with no change in the other two patients, and the statistical comparison was not significant (p > 0.05).
Conclusions:
Limb cooling may be pursued as a therapeutic option for addressing tacrolimus-induced tremor, as the patients in our cohort benefitted from temporary tremor suppression.
A case report of esophageal heterotopic pancreas presenting as recurrent mediastinal abscess, treated by minimally invasive esophagectomy
Authors: Edno Tales Bianchi, Francisco Tustumi, André Fonseca Duarte, Evelin Sánchez Ortiz, Sérgio Szachnowicz, Francisco Carlos Bernal da Costa Seguro, Rubens Antônio Aissar Sallum, Ivan Cecconello
Journal: Int J Surg Case Rep (2019)
Keywords: accessory pancreas, esophageal neoplasms, esophagectomy, pancreatitis

Introduction:
Heterotopic pancreas is a rare congenital anomaly. We report a case of esophageal heterotopic pancreas complicated by recurrent mediastinal abscess and treated by minimally invasive resection.
Presentation of case:
A 31-year-old woman was admitted with a history of recurrent chest pain, dysphagia, and heartburn. CT scan revealed focal confined collection in the lower mediastinum surrounding esophagus. Endoscopic ultrasound revealed a subepithelial lesion. The patient was treated by minimally invasive esophagectomy and made an uneventful postoperative recovery.
Discussion:
The management of subepithelial lesions would depend on their size, ability to exclude other etiologies and their associated symptoms. The patient, in this case, was obviously symptomatic and accurate differentiation from malignant etiologies could not be accurately made.
Conclusion:
Although pancreatic heterotopia is rare, it should be remembered in the differential diagnosis of various gastrointestinal lesions.
A complete duplication of X chromosome resulting in a tricentric isochromosome originated by centromere repositioning
Authors: N Villa, D Conconi, D Gambel Benussi, G Tornese, F Crosti, E Sala, L Dalprà, V Pecile
Journal: Mol Cytogenet (2017)
Keywords: chromosome complex rearrangement, telomeric-centromeric x rearrangement
MeSH terms: Case Reports

Background:
Neocentromeres are rare and considered chromosomal aberrations, because a non-centromeric region evolves in an active centromere by mutation. The literature reported several structural anomalies of X chromosome and they influence the female reproductive capacity or are associated to Turner syndrome in the presence of monosomy X cell line.
Case presentation:
We report a case of chromosome X complex rearrangement found in a prenatal diagnosis. The fetal karyotype showed a mosaicism with a 45,X cell line and a 46 chromosomes second line with a big marker, instead of a sex chromosome. The marker morphology and fluorescence in situ hybridization (FISH) characterization allowed us to identify a tricentric X chromosome constituted by two complete X chromosome fused at the p arms telomere and an active neocentromere in the middle, at the union of the two Xp arms, where usually are the telomeric regions. FISH also showed the presence of a paracentric inversion of both Xp arms. Furthermore, fragility figures were found in 56% of metaphases from peripheral blood lymphocytes culture at birth: a shorter marker chromosome and an apparently acentric fragment frequently lost.
Conclusions:
At our knowledge, this is the first isochromosome of an entire non-acrocentric chromosome. The neocentromere is constituted by canonical sequences but localized in an unusual position and the original centromeres are inactivated. We speculated that marker chromosome was the result of a double rearrangement: firstly, a paracentric inversion which involved the Xp arm, shifting a part of the centromere at the p end and subsequently a duplication of the entire X chromosome, which gave rise to an isochromosome. It is possible to suppose that the first event could be a result of a non-allelic homologous recombination mediated by inverted low-copy repeats. As expected, our case shows a Turner phenotype with mild facial features and no major skeletal deformity, normal psychomotor development and a spontaneous development of puberty and menarche, although with irregular menses since the last follow-up.