OpenMed/multicare-articles huggingface dataset:
Asymmetric Extraction Treatment in a Middle-Aged Patient with Dental Crowding and Protrusion using Clear Aligners
Authors: Xiujin Xing, Hanglin Qin, Jing Sun, Kun Li
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Frequently, orthodontic treatment involves symmetrically extracting premolars to correct severe crowding or protrusion. Nevertheless, in some cases, a more reasonable alternative may be to remove teeth with poor prognoses to improve protrusion and relieve crowding. A middle-aged woman sought treatment for dental protrusion and crowding. Her mandibular right first molar had been treated with root canal therapy due to pulpitis, but she still felt uncomfortable. In addition, her maxillary left second premolar had become carious. Extractions of the maxillary right first premolar and left second premolar, as well as mandibular right first molar and left first premolar were chosen to resolve the occlusion problems. The patient opted for clear aligners on the demands of esthetics as well as comfort. Following orthodontic treatment, the patient attained properly aligned teeth, a pleasing smile, and a facial profile that exhibited greater harmony. This case report demonstrates that, under proper planning, clear aligners are capable of handling challenging cases, including those involving middle-aged individuals and molar extractions.
ACTH-producing small cell neuroendocrine carcinoma from the gallbladder: a case report and literature review
Authors: Xiaofang Zhang, Dihua Huang, Xiaojie Pan, Qiya Si, Qiaoying You
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: cushing syndrome, case report, ectopic adrenocorticotropic hormone syndrome, gallbladder, neuroendocrine tumor
MeSH terms: Case Reports

Ectopic adrenocorticotropic hormone syndrome (EAS) is a condition of hypercortisolism caused by non-pituitary tumors that secrete adrenocorticotropic hormone (ACTH). A rare occurrence of this syndrome is due to an ACTH-producing neuroendocrine tumor that originates from the gallbladder. One patient with severe hypokalemia and alkalosis was admitted to our hospital. Clinical presentations and radiographic findings confirmed the diagnosis of an aggressive ACTH-producing gallbladder malignancy with multiple liver metastases. The diagnosis was verified by pathological and immunohistochemical measurements from a biopsy of the hepatic metastasis. A literature review identified only four similar cases had been reported. Despite being rare and having a poor prognosis, hormone-producing neuroendocrine tumors that derive from the gallbladder should be considered in the differential diagnosis of ectopic ACTH syndrome.
Is thyroid dysfunction a cause or a trigger of bipolar disorder? a case report
Authors: Jiashu Yao, Jiating Xu, Rong Yan, Ruihuan Ye, Yuedi Shen, Ning Dai, Wei Chen
Journal: Front Psychiatry (2024)
Keywords: bipolar disorder, bipolar disorder due to another medical condition, comorbidity, hyperthyroidism, psychosomatic disorders
MeSH terms: Case Reports

Here we report on a case of a 40-year-old female patient who presented with hypomanic episode after hyperthyroidism and major depressive episode after hypothyroidism, which was initially misdiagnosed as bipolar disorder due to another medical condition, and was found to be a co-morbid bipolar disorder of hyperthyroidism after treatment and follow-up. The course of diagnosis and treatment in this case suggests a close temporal relationship does not necessarily mean that there is a causal relationship on a physiologic level. User's Guide for the SCID-5-CV Structured Clinical Interview for DSM-5 Disorders elaborate that the diagnosis of "……due to another medical condition" is relatively rare, and co-morbidity between psychiatric disorders and somatic diseases is much more common. Therefore, the relationship between somatic diseases and psychiatric disorders requires careful study of symptom correlation and more time for observational follow-up. When in doubt, the examiner's default assumption should be that the somatic disease is not the cause (i.e., the psychiatric disorder is primary).
Using human-centered design to develop a nurse-to-family telehealth intervention for pediatric transfers
Authors: Jennifer L Rosenthal, Audriana Ketchersid, Elva Horath, April Sanders, Thomas A Harper, Adrienne E Hoyt-Austin, Sarah C Haynes
Journal: Digit Health (2023)
Keywords: pediatrics, emergency medicine, human-centered design, nurses, patient transfer, telemedicine

Objective:
To develop a nurse-to-family telehealth intervention for pediatric inter-facility transfers using the human-centered design approach.
Methods:
We conducted the inspiration and ideation phases of a human-centered design process from July 2022 to December 2022. For the inspiration phase, we conducted a qualitative cross-sectional case study design over 3 months. We used thematic analysis with the framework approach of parent and provider interviews. Five team members individually coded transcripts and then met to discuss memos, update a construct summary sheet, and identify emerging themes. The team adapted themes into "How Might We" statements. For the ideation phase, multidisciplinary stakeholders brainstormed solutions to the "How Might We" statements in a design workshop. Workshop findings informed the design of a nurse-to-family telehealth intervention, which was iteratively revised over 2 months based on stakeholder feedback sessions.
Results:
We conducted interviews with nine parents, 11 nurses, and 13 physicians. Four themes emerged supporting the promise of a nurse-to-family telehealth intervention, the need to effectively communicate the intervention purpose, the value of a user-friendly workflow, and the essentiality of ensuring that diverse populations equitably benefit from the intervention. "How Might We" statements were discussed among 22 total workshop participants. Iterative adaptations were made to the intervention until feedback from workshop participants and 67 other stakeholders supported no further improvements were needed.
Conclusion:
Human-centered design phases facilitated stakeholder engagement in developing a nurse-to-family telehealth intervention. This intervention will be tested in an implementation phase as a feasibility and pilot trial.
Case Report: HAVCR2 mutation-associated Hemophagocytic lymphohistiocytosis
Authors: Deli Song, Jingshi Wang, Jia Zhang, Junxia Hu, Chaofan Wu, Zhao Wang
Journal: Front Immunol (2023)
Keywords: havcr2 mutation, cytokine, hemophagocytic lymphohistiocytosis, immunodeficiency, subcutaneous panniculitis-like t-cell lymphoma
MeSH terms: Lymphohistiocytosis, Hemophagocytic / complications, Lymphohistiocytosis, Hemophagocytic / diagnosis, Lymphohistiocytosis, Hemophagocytic / genetics, Lymphoma, T-Cell / pathology, Panniculitis / pathology, Case Reports, Research Support, Non-U.S. Gov't, Germ-Line Mutation, Hepatitis A Virus Cellular Receptor 2 / genetics, Humans, Mutation, HAVCR2 protein, human, Hepatitis A Virus Cellular Receptor 2

Germline HAVCR2 mutation has been reported to be associated with subcutaneous panniculitis-like T-cell lymphoma (SPTCL) leading to Hemophagocytic lymphohistiocytosis (HLH). Several studies have indicated that HAVCR2 mutation can cause HLH even in the absence of lymphoma, though the exact mechanism remains unclear. In this article, we reported five cases of HAVCR2 mutation-associated HLH. Our analysis revealed an elevated level of IL-1RA in the serum of these patients. Furthermore, we investigated the potential mechanisms underlying HLH associated with HAVCR2 mutation based on changes in cytokine levels. Our findings suggest that HAVCR2 mutation may represent a distinct genetic defect underlying HLH, differing from traditional primary HLH.
Epidemiology, treatment outcome and resistance profile of pulmonary tuberculosis cases at the Niamey national anti-tuberculosis center in Niger: a retrospective study
Authors: Mamane Djika, Charles Hornel Koudokpon, Victorien Tamègnon Dougnon, N'dira Sanoussi, Soumana Alphazazi, Boubacar Ballé, Hassane Daouda, Phénix Assogba, Honoré Bankole, Clément Agbangla
Journal: Pan Afr Med J (2024)
Keywords: tuberculosis, diagnosis, resistance, treatment
MeSH terms: Antitubercular Agents / administration & dosage, Antitubercular Agents / pharmacology, Mycobacterium tuberculosis / drug effects, Mycobacterium tuberculosis / isolation & purification, Tuberculosis, Pulmonary / diagnosis, Tuberculosis, Pulmonary / drug therapy, Tuberculosis, Pulmonary / epidemiology, Adolescent, Adult, Aged, Child, Child, Preschool, Coinfection / drug therapy, Coinfection / epidemiology, Female, HIV Infections / drug therapy, HIV Infections / epidemiology, Humans, Incidence, Infant, Male, Middle Aged, Niger / epidemiology, Prevalence, Retrospective Studies, Sputum / microbiology, Treatment Outcome, Tuberculosis, Multidrug-Resistant / diagnosis, Tuberculosis, Multidrug-Resistant / drug therapy, Tuberculosis, Multidrug-Resistant / epidemiology, Young Adult, Antitubercular Agents

Introduction:
tuberculosis remains a major public health problem, with continuing high levels of prevalence, and mortality. In Niger, the incidence of tuberculosis remains high. This study aims to investigate the epidemiology of pulmonary tuberculosis at the National Anti-Tuberculosis Center of Niamey in Niger.
Methods:
this study used a quantitative approach with a retrospective and descriptive design. Data were obtained from positive pulmonary tuberculosis cases detected by microscopy on Ziehl-Neelsen stained sputum at the National Anti-Tuberculosis Center (NATC) in Niamey, Niger covered the period between June 2017 and January 2020. 955 pulmonary TB patients were recorded whose diagnosis was based either on clinical-radiological arguments (thus negative microscopy) or positive microscopy. This form was used to collect data recorded in the clinical case registers, registers, and Excel files of the GeneXpert platform of the NATC laboratory.
Results:
eighty-nine-point eleven percent (89.11%) of the patients were microscopy-positive. Among the study population, men were the most affected by tuberculosis with 80.03%. The 25-34 age group, representing 23.77%, was the most affected. 6.93% of patients were co-infected with tuberculosis and HIV. All patients were put on treatment, with a therapeutic success rate of 72.38% and a therapeutic failure rate of 10.95%. Among the cases of therapeutic failure, 80.90% had Mycobacterium tuberculosis complex detected and 27.14% were resistant to Rifampicin.
Conclusion:
Niger continues to have a tuberculosis epidemic which requires monitoring. Improving the diagnostic system for more effective management of the disease is important for appropriate diagnosis and treatment.
Severe haemorrhagic diathesis due to acquired hypofibrinogenemia in a patient with early T-cell precursor acute lymphoblastic leukaemia/lymphoma: a case report
Authors: Luca Spiezia, Marcello Riva, Carmela Gurrieri, Elena Campello, Paolo Simioni
Journal: Front Cardiovasc Med (2024)
Keywords: acquired hypofibrinogenemia, case report, consumptive coagulopathy, early t-cell precursor acute lymphoblastic leukaemia/lymphoma, haemorrhagic diathesis
MeSH terms: Case Reports

The most frequent haematological malignancy associated with acquired hypo/dysfibrinogenemia is multiple myeloma. We present an unusual case of severe haemorrhagic diathesis due to acquired hypofibrinogenemia in a patient with early T-cell precursor acute lymphoblastic leukaemia/lymphoma (ETP-ALL/LBL). A 57-year-old male was admitted to the General Internal Medicine Department of Padova University Hospital for acute massive haematomas of the left lower extremity associated with macrohaematuria. Coagulation tests showed prolonged prothrombin time, activated partial thromboplastin time and thrombin time due to isolated severe hypofibrinogenemia (antigen 0.70 g/L and activity 26%). The radiological workup showed a bulky lesion located in the anterior mediastinum, and a biopsy led to the diagnosis of ETP-ALL/LBL. Fibrinogen replacement therapy failed to correct the bleeding diathesis and we were able to exclude other frequent causes of acquired hypofibrinogenemia (i.e., liver dysfunction, fibrinogen-specific antibody or drug toxicity); therefore, we hypothesised that hypofibrinogenemia might stem either from enhanced removal of fibrinogen from the circulation or consumptive coagulopathy. Notably, only after initiating a specific chemotherapy treatment did the patient start showing improvement in bleeding symptoms and achieve normal fibrinogen levels.
A Rare Case of Submandibular Gland Squamous Cell Carcinoma: Diagnostic Challenges and Surgical Management
Authors: Nikhil Thatipalli, Anup Zade, Darshana Tote
Journal: Cureus (2024)
Keywords: fine needle aspiration cytology (fnac), multidisciplinary approach, salivary glands, squamous cell carcinoma, submandibular gland, surgical excision
MeSH terms: Case Reports

Squamous cell carcinoma (SCC) in salivary glands is rare, often posing diagnostic challenges. This case report presents a 75-year-old male with progressively increasing swelling and pain in the right submandibular gland, eventually diagnosed as moderately differentiated SCC. The diagnostic journey involved fine needle aspiration cytology, imaging studies, and histopathological examination. The patient underwent surgical intervention, including submandibular gland excision and selective neck dissection, which successfully achieved local control. Subsequent postoperative follow-up indicated a favorable outcome, with no significant complaints. This report contributes insights into the multidisciplinary diagnostic approach and underscores the importance of imaging modalities in managing salivary gland SCC. This rare case emphasizes the need for ongoing research to refine management strategies for salivary gland SCC. By presenting a comprehensive diagnostic and therapeutic approach, this report contributes to the limited literature on this malignancy, emphasizing its rarity and the necessity for continued exploration of long-term outcomes. In conclusion, our case provides valuable insights into the medical knowledge surrounding SCC in salivary glands, warranting attention and further investigation.
A Rare Pediatric Neurological Case: Dyke-Davidoff-Masson Syndrome Unprecedented at 10 Months
Authors: Rahul Khandelwal, Jayant D Vagha, Revat J Meshram, Ankita Patel, Sri Sita Naga Sai Priya K
Journal: Cureus (2024)
Keywords: cerebral hemiatrophy, dyke-davidoff-masson syndrome, pediatric neurology, seizures, ventricular enlargement
MeSH terms: Case Reports

This case report presents a rare occurrence of Dyke-Davidoff-Masson Syndrome (DDMS) in a 10-month-old male child, highlighting the atypical presentation of this neurological disorder in early infancy. The child initially presented with irritability, loss of appetite, and right-sided weakness following episodes of fever. A comprehensive medical history revealed the sudden onset of generalized tonic-clonic seizures, prompting further investigation. Diagnostic imaging, including CT and MRI, confirmed features consistent with DDMS, including cerebral hemiatrophy, ventricular enlargement, and calvarial thickening. Notably, the child's seizures were successfully managed with antiepileptic medication, leading to stabilized vital signs. This case emphasizes the importance of considering rare neurological disorders in pediatric patients with unusual presentations and underscores the challenges in diagnosing and managing DDMS in infancy. Further research is warranted to elucidate the underlying mechanisms, contributing factors, and optimal management strategies for DDMS in this age group.
Case Report: Challenges in the etiology of left ventricular aneurysm
Authors: El Mehdi Channan, Georgiana Pintea Bentea, Brahim Berdaoui, Nasroolla Damry, Marielle Morissens, José Castro Rodriguez
Journal: F1000Res (2023)
Keywords: left ventricular non-compaction cardiomyopathy, ventricular aneurysm
MeSH terms: Echocardiography, Heart Aneurysm / complications, Heart Aneurysm / diagnostic imaging, Heart Aneurysm / etiology, Heart Ventricles / pathology, Case Reports, Adult, Humans, Male

Left ventricular aneurysms are outpouchings delineated by a thin myocardial wall, more frequently encountered at the apex of the left ventricle, which is seldom dyskinetic or akinetic. Apart from coronary artery disease, the etiology can be challenging. We report the case of a 30-year-old man with an isolated apical left ventricular aneurysm associated with prominent trabeculations on echocardiography.
Demand for emergency services during the COVID-19 pandemic and disease burden: a case study in Portugal
Authors: Alcina Nunes, Catarina Costa, João P Martins, Pedro L Ferreira, Rui Pimenta
Journal: Front Public Health (2024)
Keywords: disease burden, emergency service, pandemic (covid-19), panel (longitudinal) data analysis, user profile
MeSH terms: COVID-19 / epidemiology, Observational Study, Research Support, Non-U.S. Gov't, Adolescent, Adult, Communicable Disease Control, Cost of Illness, Cross-Sectional Studies, Humans, Pandemics / prevention & control, Portugal / epidemiology, SARS-CoV-2

Background:
The COVID-19 pandemic brought changes in the pattern of care use. A significant increase in the volume of emergencies was expected. However, a significant decrease was observed worldwide.
Methods:
An observational, analytical and cross-sectional study of all records of emergency episodes of patients aged 18 years or older admitted to the emergency services of the University of Porto Hospital Centre (2018-2022) were analysed.
Results:
During the pandemic, a significant reduction in emergency episode admissions (up to 40% during lockdowns), an increase in pre-emergency services, and discharges from Infectious Diseases and Internal Medicine was observed. The discharges from General Practice and General Practice and Family Medicine were residual.
Conclusion:
The lower use and type of use of emergency services during the COVID-19 pandemic had a negative impact on the disease burden. This could be prevented in future pandemics through the development of strategies to promote confidence in the use of health resources and establishing contingency plans for virtual assistance.
ST-Segment Elevation Myocardial Infarction Caused by 5-Fluorouracil-Related Cardiotoxicity
Authors: Nivedha Balaji, Priyadarshini Dixit, Alex M Adams, Fardeen Faiz, Daisy Ngwainmbi, Glen Henry, Nima Ghasemzadeh
Journal: Cureus (2024)
Keywords: #cardio-oncology, 5fu, chemotherapy-related toxicity, interventional cardiologist, st-elevation myocardial infarction (stemi)
MeSH terms: Case Reports

5-Fluorouracil (5-FU) and its prodrug, capecitabine, are commonly used chemotherapeutic agents for solid tumor management. While these agents can present with adverse side effects such as nausea, vomiting, diarrhea, and myelosuppression, they can also, less commonly, cause cardiovascular toxicity. This toxicity may manifest as cardiac arrhythmias, myocarditis, heart failure, myocardial infarction, and even death. The management of 5-FU-related cardiotoxicity includes early recognition of symptom manifestation so that medication can be discontinued promptly and symptoms can be addressed appropriately. Here, we describe the case of a 72-year-old male who developed coronary vasospasm and ST-segment elevation myocardial infarction shortly after the initiation of chemotherapy with 5-FU.
Benign proliferating pilar tumor excised with Slow Mohs surgery: A case report
Authors: Krystal Stewart, Doha Itani, Andrew Mulherin, Robert Hayes
Journal: SAGE Open Med Case Rep (2023)
Keywords: mohs micrographic surgery, proliferating pilar tumor, slow mohs, benign, proliferating trichilemmal tumor
MeSH terms: Case Reports

Proliferating pilar tumors are rare, benign, exophytic neoplasms, which can closely resemble a squamous cell carcinoma. We describe a patient with a large benign exophytic tumor on the scalp that had been slowly growing over 10 years. While this class of benign follicular tumors is rare, the standard of care is typically excision with clear histologic margins. In this case, this large scalp tumor was surgically excised with clear margins/permanent section margin control using "Slow Mohs" technique, with subsequent repair using a skin substitute dressing, followed by a delayed skin graft.
Two-Stage Cervical and Thoracic-Lumbar-Sacral Circumferential Fixation for Pyogenic Spondylitis: A Case Report
Authors: Yoshinori Maki, Kenji Fukaya
Journal: Cureus (2024)
Keywords: anterior cervical discectomy and fusion, oblique lumbar intervertebral fixation, percutaneous pedicle screw, posterior cervical fixation, pyogenic spondylitis
MeSH terms: Case Reports

Pyogenic spondylitis is a rare life-threatening condition. Conservative treatment with antibiotics is indicated; however, surgery can be considered in refractory cases. The surgical strategy varies, as pyogenic spondylosis can occur from the cervical to sacral regions. To our knowledge, although there is less invasiveness as an advantage in the following management, cervical and thoracic-lumbar-sacral circumferential fixations in two sessions for pyogenic spondylitis have not been previously described. An 84-year-old man complained of ambulation disturbances and pain in the neck and upper and lower extremities (the Japan Orthopaedic Association cervical myelopathy evaluation questionnaire score of 5/17). Magnetic resonance imaging revealed pyogenic spondylitis of the cervical, thoracic, and lumbar regions. Epidural abscesses and spondylodiscitis were concurrently diagnosed with multi-level skipping lesions from the cervical to the sacral regions. As these lesions were resistant to antibiotic treatment and the neurological symptoms worsened, surgical treatment was planned. Anterior cervical discectomy and fusion, and posterior cervical fixation were followed by oblique and posterior lumbar intervertebral fusions with long-level fixation from T12 to the ilium using percutaneous pedicle screws. The surgeries were performed in two sessions to avoid the invasiveness of surgeries in a single session. The patient's condition improved after a second surgery. The patient was discharged on postoperative day 116. No recurrence was observed for six months, and the patient was able to ambulate independently. Two-stage cervical and thoracic-lumbar-sacral circumferential fixation for pyogenic spondylitis contributed to a favorable outcome (the Japan Orthopaedic Association cervical myelopathy evaluation questionnaire score of 13/17).
Cluster Headache Presenting As Sinonasal Pathology in a Young Adult: A Diagnostic Odyssey
Authors: Sanya Gupta, Ashish Anjankar, Chirag Sathe
Journal: Cureus (2024)
Keywords: chronic cluster headache, cluster headache, headache disorders, neurology and systemic disease, woman health in neurology
MeSH terms: Case Reports

Cluster headache is a debilitating primary headache disorder marked by severe, unilateral pain often accompanied by autonomic symptoms. We describe the case of a 20-year-old student who presented with excruciating peri-orbital pain localized to the right side, accompanied by ipsilateral nasal obstruction, a nasal spur, and a deviated nasal septum (DNS). The initial clinical picture strongly suggested sinonasal pathology, leading to investigations and treatments aimed at this presumed diagnosis. However, as the patient's symptoms persisted and evolved over time, with episodes of recurrent and intense pain associated with ipsilateral tearing, rhinorrhea, and ptosis, further evaluation was pursued. A comprehensive assessment, including detailed headache characteristics, neurological examination, and neuroimaging, ultimately revealed the diagnosis of cluster headache. This case emphasizes the diagnostic challenges associated with atypical presentations of cluster headaches, the importance of a meticulous clinical evaluation, and the need for early recognition to provide timely and effective interventions for these severely affected individuals.