OpenMed/multicare-articles huggingface dataset:
Students' Consumption of Beverages and Snacks at School and Away from School: A Case Study in the North East of Italy
Authors: Carmen Losasso, Veronica Cappa, Marian L Neuhouser, Valerio Giaccone, Igino Andrighetto, Antonia Ricci
Journal: Front Nutr (2015)
Keywords: bsq, beverages and snacks consumption, food habits, healthy eating

In North-East Italy (the Veneto region), several public school nutrition policies have been developed to reduce the consumption of high-caloric snacks and beverages. However, little is known about whether the policies actually influence students' dietary behaviors. In order to address this point, a multi-center cross-sectional survey of 691 Italian students was conducted. Students completed the Beverage and Snack Questionnaire, which assesses the consumption of beverages and snacks at school and out of school. Three-level Poisson Models with random intercept with students (level 1 units) nested into classroom (level 2 units), and nested into schools (level 3 units), were used to examine the influence of the school setting vs. the out of school environment (independent variable) on students' consumption of sweet beverages, snacks, milk-based beverages, low-carbohydrate drinks, fruit, and vegetables (dependent variable) (p ≤ 0.05). The results showed a significantly higher consumption of sweet beverages, snacks, milk-based beverages, low-carbohydrate drinks, fruit, and vegetables out-of-the school, suggesting a school-protective association Thus, the policies aimed to limit or deny access to unhealthy foods in the school environment may play an important role in promoting more healthful dietary patterns for school children. Additional studies should be conducted to compare students' dietary behaviors between schools with nutrition policies to those without nutrition policies.
Case report: Fluctuating tumor markers in a boy with gonadotropin-releasing hormone-independent precocious puberty induced by a pineal germ cell tumor
Authors: Alessandro Cattoni, Assunta Albanese
Journal: Front Pediatr (2022)
Keywords: anastrozole, aromatase inhibitors, bicalutamide, chorionic gonadotropin, germ cell and embryonal neoplasms, pineal cyst, precocious puberty
MeSH terms: Case Reports

GnRH-independent precocious puberty (GIPP) can be the presenting clinical picture experienced by patients with secreting germ cell tumor (GCT). Indeed, as luteinizing hormone (LH) and human chorionic gonadotropin (hCG) share identical α-subunits and similar β-subunits, an increased secretion of β-hCG may result in a precocious activation of Leydig cells. Though the co-occurrence of raised β-hCG levels and signs of precocious virilization usually prompts a complete oncological work-up, the diagnostic and therapeutic management of GCT-induced GIPP may be challenging. We report the case of a 6.2 year-old boy presenting with clinical and biochemical findings consistent with GIPP (discrepancy between overt virilization and pre-pubertal testicular volume, suppressed gonadotropins and remarkably raised testosterone). Brain imaging detected a bilobed cyst of the pineal gland, while serum and cerebrospinal baseline assessment initially ruled out raised alpha-fetoprotein or β-hCG levels. Nevertheless, a strict biochemical follow-up highlighted a fluctuant trend of tumor markers, with a more aggressive behavior and recurrent erections occurring as a result of unpredictable phases of raised testosterone and serum/cerebrospinal β-hCG, followed by sudden spontaneous decrease. Accordingly, a secreting pineal GCT was suspected. Given the fluctuating trend of tumor markers, surgery was initially kept on hold and a combined treatment with bicalutamide (androgen receptor blocker) and anastrozole (aromatase inhibitor) was undertaken in order to prevent the patient from experiencing further virilization and excessive bone age maturation. Subsequently, a progression in the size of the pineal tumor prompted surgical resection and a diagnosis of secreting GCT was histologically confirmed. Accordingly, the patient was started on adjuvant chemo- and radiotherapy. Antineoplastic treatment was followed by persistent and remarkable decrease of tumor markers and by a complete pubertal arrest. We reported the challenging diagnosis of a secreting pineal GCT in a patient with GIPP and a fluctuating trend of tumor markers, testosterone levels and associated clinical signs, hence prompting the indication for a systematic assessment and a strict monitoring whenever a patient with GnRH-independent precocious puberty shows clinical or radiological markers potentially consistent with a GCT.
Heart Failure after Laboratory Confirmed Influenza Infection (FLU-HF)
Authors: Phyllis Sin, Muhammad Siddiqui, Rashell Wozniak, Idris Bare, Jessica Minion, Stephen Sanche, Jacob Udell, Andrea Lavoie, Payam Dehghani
Journal: Glob Heart (2022)
Keywords: influenza, heart failure, hospitalization, respiratory infection
MeSH terms: Heart Failure / diagnosis, Heart Failure / epidemiology, Heart Failure / etiology, Influenza, Human / complications, Influenza, Human / epidemiology, Multicenter Study, Research Support, Non-U.S. Gov't, Hospitalization, Humans, Incidence, Retrospective Studies

Background:
Influenza has been shown to exacerbate heart failure (HF). Importantly, no study to date has examined the relationship between HF hospitalizations (HFH) with laboratory confirmed influenza infections. This study evaluated the association between laboratory confirmed influenza infection and HFH in the two largest hospitals in Saskatchewan, Canada.
Methods:
We used a retrospective self-controlled case series design to evaluate the association between laboratory-confirmed influenza infection and HFH. We compared the incidence ratio for HFH during the influenza risk interval with the control interval. We defined the influenza risk interval as the seven days after a laboratory confirmed influenza result and the control interval as one year before and after the risk interval.
Results:
We identified 114 HFH that occurred within one year before and after a positive test result for influenza between April 1, 2010, and April 30, 2018. Of these, 28 (28 admissions per week) occurred during the risk interval and 86 (0.853 admissions per week) occurred during the control interval. The incidence ratio of a HFH during the risk interval as compared with the control interval was 33.53 (95% confidence interval [CI], 21.89 to 51.36). A decline in incidence was observed after day seven; between days 8 to 14 and 14 to 28 incidence ratios was 0.91 (95% CI, 0.13 to 6.52) and 0.91 (95% CI, 0.22 to 3.68) respectively.
Conclusion:
We have observed a significant association between acute influenza infection and HFH. However, further research with a larger sample size and involving a multicenter setting is warranted.
Highlights:
Influenza may contribute and exacerbate heart failure events especially during annual influenza season.Early identification of influenza among patients with heart failure, could lead to earlier treatment with antiviral medication, reduce unnecessary antibiotic use, and tail off the morbidity and mortality.In this study, despite our efficient study design, our sample size was limited to only the two largest hospitals in the province, possibly excluding a significant population in remote areas.
Preoperative diagnosis of hydatid cyst of the breast: a case report
Authors: Ali Alamer, Asim Aldhilan, Dorothy Makanjuola, Abdulmohsen Alkushi
Journal: Pan Afr Med J (2013)
Keywords: ct, hydatid cyst, hydatid disease, breast lump, mammography, ultrasound
MeSH terms: Breast Diseases / diagnosis, Breast Diseases / parasitology, Echinococcosis / diagnosis, Case Reports, Aged, Breast Diseases / surgery, Echinococcosis / surgery, Female, Humans, Preoperative Care

Hydatid cyst of the breast is endemic in some areas like sheep-raising countries. The location of the disease is mostly in the liver and lungs. We presents a case of 66-year-old female with hydatid cyst of the breast diagnosed pre-operatively by core needle biopsy. Complete radiology workup are also provided which includes mammography, ultrasound, and computed tomography images. Hydatid cyst of the breast is extremely rare even in endemic areas, its only accounts for 0.27% of all cases. Only few reports are published in the literatures about breast hydatid cyst and majority of cases have been diagnosed post-operatively with no complete radiology workup.
A novel familial mutation in the PCSK1 gene that alters the oxyanion hole residue of proprotein convertase 1/3 and impairs its enzymatic activity
Authors: Michael Wilschanski, Montaser Abbasi, Elias Blanco, Iris Lindberg, Michael Yourshaw, David Zangen, Itai Berger, Eyal Shteyer, Orit Pappo, Benjamin Bar-Oz, Martin G Martín, Orly Elpeleg
Journal: PLoS One (2014)
MeSH terms: Diarrhea / congenital, Diarrhea / genetics, Mutation, Proprotein Convertase 1 / genetics, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Child, Diarrhea / metabolism, Endocrine System Diseases / genetics, Endocrine System Diseases / metabolism, Exome, Female, Humans, Infant, Infant, Newborn, Male, Pedigree, Proprotein Convertase 1 / metabolism, PCSK1 protein, human, Proprotein Convertase 1

Four siblings presented with congenital diarrhea and various endocrinopathies. Exome sequencing and homozygosity mapping identified five regions, comprising 337 protein-coding genes that were shared by three affected siblings. Exome sequencing identified a novel homozygous N309K mutation in the proprotein convertase subtilisin/kexin type 1 (PCSK1) gene, encoding the neuroendocrine convertase 1 precursor (PC1/3) which was recently reported as a cause of Congenital Diarrhea Disorder (CDD). The PCSK1 mutation affected the oxyanion hole transition state-stabilizing amino acid within the active site, which is critical for appropriate proprotein maturation and enzyme activity. Unexpectedly, the N309K mutant protein exhibited normal, though slowed, prodomain removal and was secreted from both HEK293 and Neuro2A cells. However, the secreted enzyme showed no catalytic activity, and was not processed into the 66 kDa form. We conclude that the N309K enzyme is able to cleave its own propeptide but is catalytically inert against in trans substrates, and that this variant accounts for the enteric and systemic endocrinopathies seen in this large consanguineous kindred.
Constipation, the sole presentation of primary renal carcinoid tumor: A case report
Authors: Mehdi Salehipour, Amir Ahmad Mostaghni, Bita Geramizadeh, Alireza Makarem, Alireza Rezvani
Journal: Rare Tumors (2019)
Keywords: carcinoid tumor, constipation, renal carcinoid tumor, renal mass
MeSH terms: Case Reports

Primary renal carcinoid tumors are quite rare. The pathogenesis of these tumors is unknown due to lack of enterochromaffin cells in the kidney. Because of nonspecific clinical manifestations and radiologic features, they are commonly misdiagnosed. Hence, Primary renal carcinoid tumors should be considered in differential diagnosis of any renal mass. In the present case, a 26-year-old woman was presented with a renal mass and constipation. After partial nephrectomy, diagnosis of carcinoid tumor was confirmed.
Case Report: Anesthetic Management of Cesarean Section in a Patient With Paraplegia
Authors: Yongchun Su, Xiaofeng Lei, Jin Yu
Journal: Front Med (Lausanne) (2022)
Keywords: anesthesia, autonomic hyperreflexia, cesarean section, paraplegia, spinal cord injury
MeSH terms: Case Reports

Background:
With the advancement of medical science and rehabilitative care, more women with spinal cord injury (SCI) can conceive. However, autonomic hyperreflexia due to SCI complicates anesthesia management during cesarean sections.
Case presentation:
This study reports the anesthesia management in a woman with paraplegia with a T6 SCI lesion who underwent a cesarean section. It also reviews the anesthesia strategies used in other studies. Spinal anesthesia with a low concentration of ropivacaine was administered along with dexmedetomidine for sedation. Stable hemodynamics were achieved without complications.
Conclusions:
Based on the reported case and literature review, we conclude that the intrathecal block is the preferred choice for women with paraplegia who require cesarean section if the lumbar bone structure allows puncture attempts.
Myasthenia gravis masquerading as acute stroke: a case report
Authors: Sarath Menon Ramachandra Menon, Namith Ranjith Mokkath
Journal: Pan Afr Med J (2020)
Keywords: myasthenia gravis, acetyl choline receptor antibody, acute stroke, case report, reversible tongue atrophy
MeSH terms: Ischemic Stroke / diagnosis, Myasthenia Gravis / diagnosis, Case Reports, Diagnosis, Differential, Diagnostic Errors, Drug Therapy, Combination, Humans, Male, Middle Aged, Myasthenia Gravis / drug therapy, Myasthenia Gravis / physiopathology, Neostigmine / administration & dosage, Prednisolone / administration & dosage, Pyridostigmine Bromide / administration & dosage, Neostigmine, Prednisolone, Pyridostigmine Bromide

Among non-iatrogenic neuromuscular disorders, myasthenia gravis remains the most prevalent. Diagnosing this disorder may become challenging in certain cases such as in patients with coexisting comorbid illnesses and non-specific clinical symptoms. This is a case of atypical myasthenia gravis in a middle-aged hypertensive male, who initially presented symptoms suggestive of an acute ischemic stroke. Upon later investigation, prompted by persistent symptoms, the patient was found to have AchR antibodies and had the rare finding of a fissured and atrophied tongue (reversible on treatment). It is a well-known fact that brainstem strokes can present with bulbar weakness resulting in aspiration pneumonitis, as was with the clinical presentation in the below mentioned report. Due to the initial misdiagnosis, he had received medical therapy aimed towards stroke management and prevention. Further investigation leading to a definitive diagnosis, was followed by medical therapy with neostigmine, pyridostigmine and oral prednisolone, leading to significant improvement in symptoms. Hence as a mandatory measure, while dealing with a case of a new onset of weakness, especially in cranial musculature, myasthenia gravis must not be excluded from the list of differential diagnosis. Myasthenia gravis (MG) is a potential "stroke mimic" especially in the elderly. However, due to recent change in trends of stroke statistics, this disease should be considered a possibility even in younger patients.
Differentiation between Angiomatous Meningioma and Solitary Fibrous Tumors
Authors: Martijn Verdam, Gert-Jan Allemeersch, Frans Van den Bergh
Journal: J Belg Soc Radiol (2022)
Keywords: angiomatous meningioma, hemangiopericytoma, solitary fibrous tumor, early draining veins, intralesional calcifications
MeSH terms: Case Reports

Teaching point: The presence of intralesional calcifications, a dural tail sign, adjacent hyperostosis, and early draining veins can help distinguish angiomatous meningiomas (AM) from solitary fibrous tumors (SFT).
Severe Neonatal Epileptic Encephalopathy and KCNQ2 Mutation: Neuropathological Substrate?
Authors: Charlotte Dalen Meurs-van der Schoor, Mirjam van Weissenbruch, Marjan van Kempen, Marianna Bugiani, Eleonora Aronica, Hanneke Ronner, R Jeroen Vermeulen
Journal: Front Pediatr (2014)
Keywords: kcnq2 mutation, mri, cortical dysplasia, ion channel gene defect, neonatal, neonatal seizures

Background:
Neonatal convulsions are clinical manifestations in a heterogeneous group of disorders with different etiology and outcome. They are attributed to several genetic causes.
Methods:
We describe a patient with intractable neonatal seizures who died from respiratory compromise during a status epilepticus.
Results:
This case report provides electroencephalogram (EEG), MRI, genetic analysis, and neuropathological data. Genetic analysis revealed a de novo heterozygous missense mutation in the KCNQ2 gene, which encodes a subunit of a voltage-gated potassium channel. KCNQ2 gene mutation is associated with intractable neonatal seizures. EEG, MRI, data as well as mutation analysis have been described in other KCNQ2 cases. Post-mortem neuropathological investigation revealed mild malformation of cortical development with increased heterotopic neurons in the deep white matter compared to an age-matched control subject. The new finding of this study is the combination of a KCNQ2 mutation and the cortical abnormalities.
Conclusion:
KCNQ2 mutations should be considered in neonates with refractory epilepsy of unknown cause. The mild cortical malformation is an important new finding, though it remains unknown whether these cortical abnormalities are due to the KCNQ2 mutation or are secondary to the refractory seizures.
Dysexecutive mild cognitive impairment associated to frontal atrophy: Case report
Authors: Marcio Luiz Figueredo Balthazar, Benito Pereira Damasceno
Journal: Dement Neuropsychol (2008)
Keywords: alzheimer’s disease, executive function, frontotemporal dementia, mild cognitive impairment
MeSH terms: Case Reports

Non-amnestic mild cognitive impairment (MCI) evolving to neurodegenerative diseases other than Alzheimer's disease (AD) is rarely well documented. We report a case of a 49 year-old woman who presented a slowly progressive attentional/dysexecutive syndrome sparing other cognitive domains and without significant impairment of daily life activities. Her mother had Parkinsonism and her brother, a psychotic syndrome. Brain CT/MRI showed frontal atrophy while brain SPECT showed moderate cortical hypoperfusion, mainly in the frontal lobes. Our case is an example of non-memory MCI whose neuropsychological data and brain imaging indicating high likelihood of progression to a non-AD dementia.
Case report of a prostatic abscess with a review of the literature
Authors: Michael T Flannery, Deborah Humphrey
Journal: Case Rep Med (2012)

A middle age male with type 2 diabetes mellitus presented with urinary symptoms. Blood and urine cultures were consistent with Methicillin Resistant Staphylcoccal Aureus (MRSA). A computed tomography demonstrated mutiple prostatic microabscessess. No other hematogenous source was identified. Transurethral prostatic drainage and intravenous Vancomycin followed by oral doxcycline led to clinical success for this likely Community acquired case of MRSA (CA-MRSA). We discuss our case report and discuss the current literature on the trends, causation, diagnosis and treatment of MRSA induced prostatic abscess.
Dermoscopic Features of CD8-Positive Solitary Pagetoid Reticulosis on the Left Leg
Authors: Reiko Suzaki, Ken Kobayashi, Sumiko Ishizaki, Mariko Fujibayashi, Masaru Tanaka
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

Solitary pagetoid reticulosis, also known as Woringer-Kolopp disease, is a rare subtype of cutaneous T-cell lymphoma. The typical clinical presentation is a solitary, localized psoriasiform or hyperkeratotic plaque or tumor located on the extremities. It primarily affects middle-aged males. Because the clinical features of pagetoid reticulosis are indistinctive, pagetoid reticulosis may progress for years before accurate diagnosis. We reported a 57-year-old Japanese woman who presented with a 1-year history of a solitary erythematous plaque on the left leg. Dermoscopic features simulated Bowen's disease showing dotted and glomerular vessels, whitish scaly areas, and a broad negative network. Dermoscopic features of pagetoid reticulosis have never been reported. We have discussed the diagnostic significance of the observed dermoscopic findings.
Retrosternal mass: An interesting allergic reaction to intravenous thrombolytic therapy for acute ischemic stroke
Authors: Masoud Mehrpour, Mohammad Reza Motamed, Mahboubeh Aghaei, Zahra Badi
Journal: Iran J Neurol (2013)
Keywords: acute ischemic stroke, allergic reaction, thrombolytic therapy
MeSH terms: Case Reports

Stroke is an important cause of disability and death worldwide, with the majority of strokes occurring in older people. Thrombolysis with recombinant tissue plasminogen activator (r-TPA) is the approved treatment for acute ischemic stroke. A major concern of physicians, who treat acute ischemic stroke with recombinant tissue plasminogen activator (r-TPA,) is the risk of intracerebral hemorrhage. However, other adverse reactions, including anaphylaxis and angioedema, can also occur. Here we report an interesting soft tissue reaction to intravenous r-TPA in an 80 year-old male who was treated for acute ischemic stroke.
Antiphospholipid Syndrome Associated with Nonradiographic Axial Spondyloarthritis
Authors: Jozélio Freire De Carvalho, Antoniella Fernanda Mendanha Sousa
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

Herein, we describe a patient with antiphospholipid syndrome (APS) associated with nonradiographic axial spondyloarthritis (NRAS). A 31-year-old woman with a past medical history of uveitis experienced a pulmonary thromboembolism in March 2014 and was treated with rivaroxaban (20 mg/day). Five months later, she started complaining of low back pain. The results on contrast-enhanced sacroiliac magnetic resonance imaging were normal. Laboratory tests revealed positive HLA-B27 and the presence of lupus anticoagulant and IgM anticardiolipin. The diagnoses of APS and NRAS were made. The patient was treated with rivaroxaban for APS and sulfasalazine (2 g/day), respectively. As she showed the presence of lupus anticoagulant antibodies in blood, she did not receive nonsteroidal anti-inflammatory drugs. After 6 months, the patient was asymptomatic, without lumbar pain; she also showed normalization of the erythrocyte sedimentation rate and the C-reactive protein and vitamin D levels, good control of lumbar pain, and no new uveitis episodes. The APS was also stable. To the best of our knowledge, this is the first reported case of NRAS associated with APS.