OpenMed/multicare-articles huggingface dataset:
Case study of cervical cancer prevention in two sub-Saharan African countries: Rwanda and Sierra Leone
Authors: Mohamed S Bangura, Yuqian Zhao, Maria Jose Gonzalez Mendez, Yixuan Wang, Salah Didier Sama, Kunpeng Xu, Ran Ren, Li Ma, You-Lin Qiao
Journal: Front Med (Lausanne) (2022)
Keywords: rwanda, sierra leone, cervical cancer, screening, vaccination

Background:
Cervical cancer is a public health issue of global concern. It is a preventable disease but continues to threaten the lives of women, especially in developing countries in sub-Saharan Africa.
Methods:
We selected two African countries in sub-Saharan Africa (the Republic of Rwanda and the Republic of Sierra Leone) to show a good example of cervical cancer prevention and constrains hindering countries from effectively implementing cervical cancer programs. Secondary data were collected from the World Health Organization (WHO), the International Agency for Research on Cancer (IARC), the Global Burden of Cancer (GLOBOCAN), the United Nations Development Programme (UNDP), and the World Bank and from official websites of the selected countries. A descriptive analysis method was used to source data and compare variables such as the associated factors, disease burden, prevention programs, health workforce, success factors, and challenges.
Results:
Rwanda achieved 93.3% human papillomavirus (HPV) vaccination of the three doses vaccinating girls in class 6, as a result of effective school-based platform delivery system and community partnership to identify girls who are out of school. Rwanda reduced the historical two-decade gap in vaccine introduction between high- and low-income countries. The country also introduced a nationwide cervical cancer screening and treatment program. An impressive decreased cervical cancer incidence rate in Rwanda in recent years was observed. Sierra Leone lags behind in terms of almost all cervical cancer prevention programs. Therefore, Sierra Leone needs more efforts to implement cervical cancer intervention programs at the national level, including HPV vaccination, and train and increase the number of health professionals, treatment, and palliative care services to accelerate cervical cancer activities.
Conclusion:
The disease burden of cervical cancer for Rwanda and Sierra Leone is heavy. There remains huge room for improvement in preventing and controlling cervical cancer in these countries. The goal of cervical cancer elimination would not be feasible in countries without the awareness and will of the policymakers and the public, the compliance to fund cervical cancer programs, the prioritization of cervical cancer activities, the availability of resources, the adequate health workforce and infrastructure, the cross-sectional collaboration and planning, inter-sectorial, national, regional, and international partnerships.
A cardiac hydatid cyst underlying pulmonary embolism: a case report
Authors: Abid Leila, Lobna Laroussi, Med Abdennadher, Sameh Msaad, Imed Frikha, Samir Kammoun
Journal: Pan Afr Med J (2011)
Keywords: echinococcosis, hydatidosis, pulmonary embolism, cardiac, hydatid cyst
MeSH terms: Atrial Septum / parasitology, Echinococcosis / complications, Heart Diseases / parasitology, Pulmonary Embolism / parasitology, Case Reports, Acute Disease, Adolescent, Atrial Septum / surgery, Echinococcosis / surgery, Follow-Up Studies, Heart Diseases / surgery, Humans, Male, Pulmonary Embolism / surgery, Sternotomy, Treatment Outcome

Hydatid cysts located in the interatrial septum are especially rare but when they occur, they might cause intracavity rupture. We report on a patient with acute pulmonary embolism caused by an isolated, ruptured hydatid cyst on the right side of the interatrial septum. A 16-year-old-boy with an uneventful history was hospitalized for exercise-induced dyspnea and blood expectorations. Multiple and bilateral opacities were visualized on standard chest x-ray. Signs of right-sided hypertrophy were seen on ECG. Imaging findings led to the diagnosis of pulmonary embolism complicating cardiac hydatid cysts. An operation was performed through median sternotomy to remove the cardiac cyst. The pleural cavity was entered through the fifth intercostal space to withdraw lung hydatid cysts. Operative recovery was uneventful and the patient resumed his normal activities 19 months later. Prompt diagnosis and an appropriate surgical treatment prevented a potentially fatal outcome.
An Adolescent Patient With Idiopathic Pulmonary Arterial Hypertension Weaned Off Intravenous Epoprostenol Following Treatment With Selexipag: A Case Report
Authors: Ayako Chida-Nagai, Takao Tsujioka, Daisuke Sasaki, Gaku Izumi, Hirokuni Yamazawa, Atsuhito Takeda
Journal: Front Pediatr (2022)
Keywords: adolescence, drug transition, epoprostenol, pulmonary arterial hypertension, selexipag
MeSH terms: Case Reports

Idiopathic pulmonary arterial hypertension (PAH) is a rare, progressive disease affecting the pulmonary arteries. Epoprostenol, a synthetic prostaglandin analog, is the most potent pharmacological treatment modality used in patients with PAH. However, it requires continuous intravenous infusion, which negatively impacts the patient's quality of life and frequently results in complications, such as catheter-related bloodstream infection. We weaned an adolescent female patient off epoprostenol by gradually introducing oral selexipag over a sustained period, following many years of continuous intravenous epoprostenol use alone. Oral selexipag might have an efficacy comparable to epoprostenol in young patients with PAH.
Case report: Novel compound heterozygous missense mutations in the DDHD2 gene in a Chinese patient associated with spastic paraplegia type 54
Authors: Xin Xu, Fen Lu, Senjie Du, Xiaoke Zhao, Hongying Li, Li Zhang, Jian Tang
Journal: Front Pediatr (2022)
Keywords: ddhd2, children, compound heterozygous mutations, intellectual disability, spastic paraplegia
MeSH terms: Case Reports

Background:
Spastic paraplegia type 54 (SPG54) is a rare inherited autosomal recessive disorder, and a complex hereditary spastic paraplegia (HSP) caused by mutations in the phospholipase DDHD2 gene. SPG54 is characterized by early onset of spastic paraplegia, intellectual disability and dysplasia of corpus callosum.
Case presentation:
We report a 9 years and 5 months old Chinese girl with progressive spasm of the lower limbs, muscle weakness and intellectual disability. Brain magnetic resonance imaging (MRI) showed periventricular leukomalacia and thinning of the corpus callosum. According to the Wechsler Intelligence Scale, her IQ is 42. By whole exome sequencing, novel compound heterozygous missense mutations in the DDHD2 gene [c.168G>C, p.(Trp56Cys) and c.1505T>C, p.(Phe502Ser)] were identified in the proband. Comparative amino acid sequence alignment across different species revealed that Trp56 and Phe502 in the DDHD2 protein were highly conserved during evolution. And multiple in silico prediction tools suggested that both mutations were deleterious.
Conclusions:
Our study reports a very rare case of complicated HSP caused by two novel compound heterozygous mutations in the DDHD2 gene. Our findings expand the genetic spectrum of SPG54.
CDK 4/6 inhibitor induced lung injury: a case report and review of literature
Authors: Namrata Mathew, Anjana Joel, Anand George Andrews, Ajoy Oommen John, Ashish Singh
Journal: Ecancermedicalscience (2021)
Keywords: cdk 4/6 inhibitors, drug induced pneumonitis, palbociclib
MeSH terms: Case Reports

Palbociclib is a cyclin dependent kinase (CDK) 4/6 inhibitor that is indicated in combination with an aromatase inhibitor for first-line treatment of hormone receptor-positive, human epidermal growth factor receptor 2 -negative advanced or metastatic breast cancer. The commonly described side effects of palbociclib are neutropenia, anaemia, thrombocytopenia, fatigue, nausea, stomatitis, alopecia, diarrhoea, decreased appetite, vomiting, asthenia, peripheral neuropathy and epistaxis. However, post approval, increasing use of this drug has revealed another potentially fatal complication, in the form of pneumonitis, especially in the Asian population. The PALOMA 3 trial showed that rates of grade 3 and grade 4 adverse events were modestly higher in Asians than non-Asians, though palbociclib exposure was similar in both races. From this, we could infer that adverse effects of this drug must be monitored more specifically in individual racial populations. We report a patient who developed pneumonitis while on palbociclib and discuss the possible mechanisms and management of CDK 4/6 inhibitor-related lung injury.
Case Report: A Case of Myeloproliferative Neoplasm Complicated by Alopecia Areata
Authors: Yotaro Tamai, Shinichi Teshima, Shun Tsunoda, Wataru Kamata, Shuku Sato
Journal: Front Med (Lausanne) (2022)
Keywords: jak, alopecia areata, essential thrombocytosis, myeloproliferative neoplasm, ruxolitinib
MeSH terms: Case Reports

Myeloproliferative neoplasms (MPNs) are caused by genetic abnormalities in the stem cells and manifest with various systemic symptoms. Here, we describe a case of MPN complicated by alopecia areata. A 51-year-old woman visited our hematology department for further evaluation of a slight platelet elevation. Her recent medical history included 3 years of concurrent severe alopecia, mild fatigue, and hot flashes but no fever and weight loss. Physical examination revealed unilateral hair loss on the entire body but no hepatosplenomegaly. Laboratory analysis revealed a normal hemoglobin level, normal white blood cell count, and platelet count of 377,000/μL. Genetic testing confirmed the presence of the JAK2 V617F mutation. Bone marrow examination revealed no morphologic dysplasia in any stem cell lineage and no fibrotic change. Skin biopsy revealed lymphocyte infiltration around the hair follicles. We diagnosed MPN, unclassifiable, which was believed to be the cause of alopecia. About 6 months after treatment with ruxolitinib began, the patient's hair growth dramatically improved. The differential diagnosis of MPNs should include hematological diseases when affected patients have alopecia areata.
Acetabular Reconstruction Using Multiple Porous Tantalum Augments: Three-Quarter Football Augment
Authors: C H Ansorge, M Ohlmeier, T M Ballhause, T Gehrke, M Citak, M Lee
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

Reconstruction of a large acetabular bone defect is a complex problem in revision hip arthroplasty. The authors report a novel method of reconstructing an uncontained acetabular defect (Paprosky type IIIb) using multiple tantalum augments. A 73-year-old female patient presented to our institution with a chronically dislocated primary left total hip arthroplasty with radiographs demonstrating migration of acetabular component and formation of pseudoarthrosis within the left ilium. Extensive arthrolysis and anatomic reconstruction of the acetabular bone defect were performed using the novel method of multiple tantalum augments. Postoperatively, recovery was initially complicated by multiple dislocations requiring an exchange to an elevated liner, however subsequently achieved good function.
Clinical course and management of insidious adrenal crisis manifested initially as hyperpyrexia secondary to pembrolizumab: Case reports and literature review
Authors: Dandan Geng, Yingnan Wang, Xin Zhang, Chenguang Zhao, Yao Fan, Chang Liu, Jinmei Wei, Bingjie Huo, Yang Zhao, Fengbin Zhang, Ruixing Zhang
Journal: Front Oncol (2022)
Keywords: adrenal crisis, hyperpyrexia, immune checkpoint inhibitors (icis), immune-related adverse events (iraes), pembrolizumab
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) are novel drugs with a dramatic survival benefit in patients with advanced malignancies. With the widespread use, several immune-related adverse events (irAEs) have emerged, which may be life-threatening. Herein we report two patients with adrenal crisis who received anti-programmed cell death protein 1 (PD-1) (pembrolizumab) therapy. Several reports of secondary adrenal insufficiency caused by pembrolizumab exist, including during treatment or late onset. Severe adrenal insufficiency according to the Common Terminology Criteria for Adverse Events (CTCAE) has rarely been described in the literature, since it initially manifests as high-grade fever. The two male patients developed adrenal crisis that was first characterized by hyperpyrexia accompanied by abdominal symptoms. These initial manifestations confused the clinicians who misdiagnosed them as infection. Timely identification, hydrocortisone pulse therapy, and fluid resuscitation improved the patients' condition. Compliance with the standardized treatment approach and course can prevent or relieve the crisis as soon as possible. Assessment of relevant laboratory test results and patient education, including when to use stress-dose hydrocortisone and guidance on route of administration, can reduce the incidence of adrenal crisis. We report these two cases and have evaluated the literature on previously reported cases to improve our understanding of this condition and offer a more scientific approach to diagnosis and treatment options.
Rectal prolapse associated with anorexia nervosa: a case report and review of the literature
Authors: Nadine Mitchell, Mark L Norris
Journal: J Eat Disord (2013)
Keywords: anorexia nervosa, bulimia nervosa, constipation, rectal prolapse
MeSH terms: Case Reports

Anorexia nervosa is one of a few mental health diagnoses that affects every organ system. Patients with AN often present with multiple secondary effects of starvation at the time of first assessment, including gastrointestinal (GI) complaints. In extreme cases, severe GI complications such as rectal prolapse may be encountered as a consequence of the illness although formal studies investigating the frequency of such occurrences are lacking. We present the case of a 16 year old female previously diagnosed with anorexia nervosa that developed a rectal prolapse as a consequence of her disease as well as a detailed literature review investigating the frequency and prevalence of such occurrences in this population.
Case report: JAK inhibition as promising treatment option of fatal RVCLS due to TREX1 mutation (pVAL235Glyfs*6)
Authors: Friederike Ufer, Susanne M Ziegler, Marcus Altfeld, Manuel A Friese
Journal: Front Neurol (2023)
Keywords: cxcl10, jak inhibition, trex1, brain vascular disorder, hereditary autoinflammatory diseases, immunosuppression
MeSH terms: Case Reports

Introduction:
Autosomal dominant mutations in the C-terminal part of TREX1 (pVAL235Glyfs*6) result in fatal retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCLS) without any treatment options. Here, we report on a treatment of a RVCLS patient with anti-retroviral drugs and the janus kinase (JAK) inhibitor ruxolitinib.
Methods:
We collected clinical data of an extended family with RVCLS (TREX1 pVAL235Glyfs*6). Within this family we identified a 45-year-old woman as index patient that we treated experimentally for 5 years and prospectively collected clinical, laboratory and imaging data.
Results:
We report clinical details from 29 family members with 17 of them showing RVCLS symptoms. Treatment of the index patient with ruxolitinib for >4 years was well-tolerated and clinically stabilized RVCLS activity. Moreover, we noticed normalization of initially elevated CXCL10 mRNA in peripheral blood monocular cells (PBMCs) and a reduction of antinuclear autoantibodies.
Discussion:
We provide evidence that JAK inhibition as RVCLS treatment appears safe and could slow clinical worsening in symptomatic adults. These results encourage further use of JAK inhibitors in affected individuals together with monitoring of CXCL10 transcripts in PBMCs as useful biomarker of disease activity.
Opportunities, challenges, and contextual supports to promote enacting maturing during adolescence
Authors: Parissa J Ballard, Lindsay Till Hoyt, Jasmine Johnson
Journal: Front Psychol (2022)
Keywords: adolescence, development, development in context, developmental needs, enacting maturity
MeSH terms: Review

Conceptions of adolescent "storm and stress" may be tied to a developmental mismatch that exists between young people's need for meaningful roles and autonomy - which we refer to as a need for enacting maturity - and the lack of such opportunities in most adolescents' contexts. First, we summarize our previous work on enacting maturity, including a review of the key components, links to wellbeing, and the nuances and limitations of this construct. Next, we extend this work by considering how the ecological contexts (e.g., family, school, community) young people are embedded in and their various intersecting social positions and identities (e.g., race/ethnicity, gender, immigrant origin) influence their experiences with enacting maturity. In this section, we pose several key questions for developmental scientists around: (a) identifying a young person's desire for, and phenomenological processing of, their adult-like roles, (b) understanding how complex and unequal responses to physical maturation shape opportunities for enacting maturity, and (c) attending to disparities in curricular and extracurricular pathways to leadership, responsibility, and autonomy. Finally, we discuss spaces with high potential to support enacting maturity, including both specially designed programs (e.g., youth participatory action research, leadership programs) as well as routine, everyday opportunities (e.g., interactions with teachers, training for companies that employ youth). We offer two levers for supporting enacting maturity across both types of spaces: adult allies and responsive organizations. Looking to exemplary programs, innovative leaders, social media, and case studies, we re-imagine how adults and organizations can promote young people enacting maturing in ways that are safe, worthwhile, and equitable.
Platypnea-orthodeoxia associated with a fenestrated atrial septal aneurysm: case report
Authors: William J van Gaal, Majo Joseph, Elizabeth Jones, George Matalanis, Mark Horrigan
Journal: Cardiovasc Ultrasound (2005)
MeSH terms: Dyspnea / diagnostic imaging, Heart Aneurysm / diagnostic imaging, Heart Aneurysm / surgery, Heart Septal Defects, Atrial / diagnostic imaging, Heart Septal Defects, Atrial / surgery, Hypoxia / diagnostic imaging, Case Reports, Aged, Dyspnea / prevention & control, Female, Humans, Hypoxia / prevention & control, Syndrome, Ultrasonography

Background:
Platypnea-orthodeoxia describes the condition of combined dyspnea and hypoxia respectively, whilst in the upright position, which improves in the recumbent position.
Case report:
We present a case of platypnea-orthodeoxia due to a fenestrated atrial septal defect associated with an atrial septal aneurysm. Due to the fenestrated nature of the atrial septal defect, surgical rather than percutaneous correction was performed.
Conclusion:
A high index of suspicion is required to diagnose the syndrome of platypnea-orthodeoxia. Careful echocardiographic evaluation is required to identify the syndrome, and to determine suitability for percutaneous repair.
A Case Report and Literature Review of Mesalazine-Induced Kidney Injury in a Pediatric Patient With Ulcerative Colitis
Authors: Shuo Wang, Pengxiang Zhou, Zailing Li
Journal: Front Pediatr (2022)
Keywords: 5-aminosalicylic acid, inflammatory bowel disease, mesalazine, nephrotoxicity, renal injury
MeSH terms: Case Reports

Background:
Mesalazine, a preparation of 5-aminosalicylic acid, is a medication widely used in clinical practice as a first-line therapy in the treatment of mild and moderate inflammatory bowel disease. However, mesalazine has nephrotoxicity and can cause adverse events in the kidney system. While these adverse reactions are very rare, they may have serious consequences.
Case presentation:
The patient was a 14-year-old boy who had a 5-year history of ulcerative colitis (UC). He received mesalazine due to relapse. Abnormal urinary protein content and sterile leukocyturia were observed 2 months after the initiation of the mesalazine treatment. The urine analysis returned to normal after discontinuation of mesalazine. However, the patients' renal function worsened again after restarting mesalazine therapy. Ten cases of mesalazine-induced renal injury were identified using a systematic literature review. We found that: (1) mesalazine-induced kidney injury was more common in boys with UC; (2) all cases had proteinuria or leukocyturia; (3) kidney injury might progress to end-stage renal disease; and (4) timely withdrawal of the drug and steroid therapy might contribute to improved renal function.
Conclusion:
Urinalysis results and renal function should be monitored regularly in pediatric patients receiving mesalazine therapy to avoid renal insufficiency and renal failure.
Case report: Back pseudocyst of unknown origin
Authors: Moustafa Moussally, Joanna Khalifeh, Imad Mokalled, Walid Faraj, Mohamad J Khalife
Journal: Int J Surg Case Rep (2020)
Keywords: back tumor, case report, pseudocyst, soft tissue mass, traumatic cyst
MeSH terms: Case Reports

Introduction:
Soft tissue masses are fairly encountered clinical entities. Among the rare forms of soft tissues masses are non-pancreatic pseudocysts which are defined as encapsulated fluid collections not lined by epithelium. We are presenting a rare case of a pseudocyst of the back located within the paravertebral muscles at a tertiary care center.
Case description:
Patient presented with a progressively enlarging painless back mass. CT scan was done which showed a 10 × 10 cm cystic lesion along the paravertebral muscles of the back. Surgical excision of the mass was performed revealing an irregularly shaped multilocular cyst. Final pathology showed the lesion to be a pseudocyst.
Discussion:
Pseudocysts can arise in a variety of locations such as omentum, adrenal glands, spleen or lungs. The etiology of these pseudocysts is highly variable and can be related to trauma, inflammation, or surgery. The diagnosis of these entities requires proper imaging and histopathologic examination.
Conclusion:
Pseudocysts arise due to a myriad of conditions and their diagnosis remains a challenge. Our case comprises the first reported case of idiopathic pseudocyst of the back. Although rare, pseudocysts should be considered in the differential of unexplained masses.
Relapsed Acute Lymphoblastic Leukemia Presenting as Acute Renal Failure
Authors: Ashley Rose, Samuel Slone, Eric Padron
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults. It is an aggressive hematologic neoplasm, with a bimodal age distribution typically presenting in childhood and the 6th decade of life (Terwilliger and Abdul-Hay, 2017). Renal injury in ALL is common and can occur through many different mechanisms, such as prerenal acute kidney injury, acute tubular necrosis, renovascular disease, obstruction, glomerulonephritis, and parenchymal infiltration of tumor cells (Luciano and Brewster, 2014). Infiltration of kidneys by leukemia cells is common; however a resultant injury only occurs in about 1% of patients, and renal failure is even more rare (Luciano and Brewster, 2014). Renal failure due to bilateral infiltration of tumor cells has been reported in only a few cases and is thought to be a poor prognostic indicator (Luciano and Brewster, 2014; Sherief et al., 2015). Biopsy is essential to the diagnosis of renal infiltration of leukemia. We present a case of acute renal failure secondary to bilateral renal infiltration of ALL presenting as the first sign of relapse in a young man.