OpenMed/multicare-articles huggingface dataset:
Dye Laser to Treat an Arteriovenous Malformation of the Tongue: 40-Month Follow-Up
Authors: Niccolò Giuseppe Armogida, Luigi Esposito, Elena Calabria, Mariangela Cernera, Gianrico Spagnuolo, Flavia Iaculli
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Arteriovenous malformations (AVMs) are abnormal connections between blood vessels that bypass the normal capillary bed. To avoid the invasiveness of the gold standard surgical excision, the use of dye laser has been suggested as an alternative. A 53-year-old man in good overall health presented with a large bluish-red nodular growth covered by intact mucosa on the left side of his tongue. The growth had a hard-elastic consistency and was not painful to touch. Imaging investigations revealed a capsulated growth consistent with a diagnosis of AVM. The patient underwent two sessions of rhodamine dye laser treatment using the following parameters: fluence of 12 J/cm2, 6 mm laser spot, a single pulse with repetition up to 1.0 Hz, and a pulse duration of 3.0 ms. Follow-up examinations were conducted at 12, 24, 36, and 40 months after the treatment. At the 40-month follow-up, the lesion had reduced in size, with a more organized vascular network, and was not clinically detectable. Considering the limitations of this case report, the application of dye laser appears to be a potentially successful treatment option for AVMs.
A Case of Successful Rehabilitation for Controlling Chronic Pain Following Osteonecrosis of the Femoral Head in a Young Adult Cancer Survivor
Authors: Tomoki Aoyama, Mari Matsuoka
Journal: Cureus (2024)
Keywords: adolescent and young adult, cancer survivor, chronic pain, mindset, osteonecrosis of the femoral head, physical medicine and rehabilitation, self-efficacy
MeSH terms: Case Reports

A 26-year-old woman previously treated for acute lymphoblastic leukemia (ALL) 14 years ago faced challenges in managing chronic pain resulting from right femoral head necrosis, a complication of her earlier ALL treatment. Ultimately, the persistent chronic pain was successfully treated via a comprehensive rehabilitation approach. The patient presented with hip contractures, muscle weakness, and reduced endurance without evident arthropathic changes or inflammatory findings in the femoral head. Active physiotherapy was implemented with the primary objective of increasing her social activity. This therapeutic intervention effectively managed the severe pain without the necessity for analgesic drugs, leading to a significant improvement in the patient's social activity. Recognizing the adolescent and young adult age group as a critical phase of physical, psychological, and social development, cancer survivors within this age group require multimodal care. This study highlights the role of stepwise rehabilitation treatments involving stretching, muscle strengthening, and endurance training, particularly in challenging cases of chronic pain. Post-treatment interviews revealed that successful experiences in each movement contributed to increased self-efficacy and promoted not only the control of chronic pain but also fostered improvements in social activities.
Multidrug-Resistant Tuberculosis of the Spine With Bilateral Psoas and Pre- and Paravertebral Abscesses in an Immunocompetent Indian Female With Multiple Adverse Drug Reactions: The World's First Report
Authors: Sankalp Yadav
Journal: Cureus (2024)
Keywords: cbnaat/ xpert/ rif assay, line probe assays (lpa), multi-drug resistant tb (mdr tb), paravertebral abscess, pott's spine, prevertebral abscess, psoas abcess
MeSH terms: Case Reports

Tuberculosis is prevalent in high-burden countries. Extrapulmonary drug-resistant tuberculosis is exceedingly rare. Simultaneous involvement of the spine with psoas muscles in the absence of pulmonary seeding with a drug-resistant strain of Mycobacterium tuberculosis in an adult female is never reported. A 33-year-old Indian female presented with complaints of chronic back pain for eight months. She was on antituberculous treatment for Pott's spine for six months. The diagnosis was challenging due to the paucibacillary nature of the disease, and it required a high index of suspicion backed by radiometric investigations, liquid culture, a line probe assay, and cartridge-based nucleic acid amplification of the pus. Further, her treatment was associated with multiple adverse drug reactions like a rise of QTcF (QT corrected for heart rate by Fridericia's cube root formula) on the electrocardiogram, peripheral neuropathy, and abnormal behavior (decreased awareness and anger outbursts with restlessness), which were addressed by a team of experts including a cardiologist, a psychiatrist, a neurologist, and an infectious disease expert. She was managed conservatively, with an 18-month-long antituberculous treatment, which was stopped after consultation with an orthopedist at a nodal drug-resistant tuberculosis center with the advice to consult the orthopedic outpatient department; however, she was lost to follow-up.
Managing intraoperative rupture of internal carotid pseudoaneurysms during endoscopic transnasal optic canal decompression: a case report
Authors: Zeran Yu, Junhui Qi, Lei Wang, Xiang Yang, Zhengqiao Liu, Xu Chen, Hongling Xu, Yajie Li, Yuyun Chen, Chengguo Dai, Zhen Gu
Journal: Front Neurol (2024)
Keywords: endoscopic transnasal optic canal decompression, endovascular embolization, intraoperative hemorrhage, pseudoaneurysm, traumatic optic neuropathy
MeSH terms: Case Reports

Background:
Endoscopic transnasal optic canal decompression is widely used in the treatment of traumatic optic neuropathy (TON) following head and craniofacial trauma. Intraoperative hemorrhage is a catastrophic surgical complication during optic canal decompression.
Case description:
We present two cases of patients with TON who suffered unexpected intra-operative massive bleeding during endoscopic transnasal optic canal decompression. After intraoperative hemostasis was achieved, emergent cerebral angiograms demonstrated the formation of internal carotid pseudoaneurysms, which were immediately embolized with coils combined with or without Onyx with balloon assistance. One of these cases was also complicated by a postoperative cerebrospinal fluid leak, which failed to be treated with lumbar drainage but was successfully repaired with endoscopic transnasal surgery.
Conclusion:
The intra-operative rupture of ICA pseudoaneurysm is a rare but catastrophic complication in TON patients. Intraoperative massive bleeding indicates rupture of ICA pseudoaneurysm. Postoperative emergency angiography and endovascular therapy should be arranged to evaluate and repair the cerebral vascular injury. Endoscopic trans-nasal surgery repairing CSF leaks resistant to lumbar drainage could be efficient and safe following pseudoaneurysm embolization.
Identification of a novel METTL23 gene variant in a patient with an intellectual development disorder: a literature review and case report
Authors: Jian Zha, Yong Chen, Fangfang Cao, Yanghong Yu, Ruiyan Wang, Jianmin Zhong
Journal: Front Pediatr (2024)
Keywords: mettl23, developmental delay, gene variant, intellectual disability, magnetic resonance imaging
MeSH terms: Case Reports

METTL23 belongs to a family of protein lysine methyltransferases that methylate non-histone proteins. Recently, the METTL23 gene has been reported to be related to an intellectual developmental disorder, autosomal recessive 44. Patients present with developmental delay, intellectual disability (ID), and variable dysmorphic features. Here, we report on a Chinese girl who presented with global developmental delay, abnormal brain structure, and multiple facial deformities, including a short/upturned nose with a sunken bridge, thin lips, and flat occiput. Whole-exome sequencing identified a novel variant (NM_001080510.5: c.322+1del) on the METTL23 gene. This variant was not collected on public human variants databases such as gnomAD, predicted to influence the splicing as a classical splicing variant, and classified as Pathogenic according to the American College of Medical Genetics and Genomics (ACMG) guidelines. Since patients with METTL23-related ID are rare, we summarize and compare the clinical phenotype of reported patients with METTL23 variants. Our report further expands the METTL23 variants and provides new evidence for clinical diagnosis of METTL23-related ID.
Case Report: Application of 18F-FDG PET/CT in identifying plasmacytoma in monoclonal gammopathy associated peripheral neuropathy
Authors: Jiequn Weng, Jie Lin, Chong Sun
Journal: Front Nucl Med (2024)
Keywords: 18f-fdg pet/ct, chronic inflammatory demyelinating polyneuropathy, monoclonal gammopathy associated peripheral neuropathy, monoclonal gammopathy of undetermined significance, multiple myeloma
MeSH terms: Case Reports

Peripheral neuropathy is a prevalent complication in plasma cell disorders, posing significant diagnostic and therapeutic challenges. This study presents three cases initially diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Despite initial symptom regression post-immunomodulatory treatment, the patients exhibited progressive neurological deficits. Advanced laboratory evaluation confirmed monoclonal protein presence, yet traditional diagnostic methods, including bone marrow biopsy and flow cytometry, yielded normal results. Utilizing 18F-FDG PET/CT, we identified multiple hypermetabolic vertebral lesions, which upon biopsy, confirmed the diagnosis of plasmacytoma. Our findings underscore the utility of PET/CT as a reliable diagnostic tool for monoclonal gammopathy associated neuropathy, advocating for its consideration in cases with equivocal diagnosis. When the diagnosis is in doubt, biopsy of a lesion may facilitate early and accurate diagnosis, potentially influencing treatment strategies and patient outcomes.
A case of a rare type of cancer: Anal squamous cell carcinoma in a patient without significant risk factors
Authors: Kevan English, Mercedes Erpelding, Sandra Kaldas, Sabrine Semoin
Journal: Qatar Med J (2024)
Keywords: anal cancer, adenocarcinoma, anal canal, human papillomavirus, squamous cell cancer
MeSH terms: Case Reports

Introduction:
Anal carcinoma is a relatively uncommon tumor that accounts for less than 2% of large bowel malignancies and approximately 1-6% of anorectal tumors. Most anal cancers originate in the mucosa between the anorectal junction and the anal verge. Risk factors for anal carcinoma include human papillomavirus (HPV), immunosuppression, older age, female gender, and smoking. Approximately 85% of anal cancers are squamous cell carcinoma, and the pathophysiology is believed to be linked to HPV-related inflammation, leading to dysplasia and progression to cancer.
Case presentation:
We present the case of a 65-year-old woman who sought medical attention at the emergency department (ED) due to rectal pain and concurrent rectal lesions persisting for the past three months. Before admission, she reported abdominal discomfort and constipation for 2-3 months, during which she took laxatives for relief. Laboratory findings in the ED were significant for anemia and leukocytosis, with all other values within normal limits. Blood tests, including antibodies for HPV and human immunodeficiency virus, were negative. A computed tomography scan of the abdomen and pelvis was largely unremarkable. On physical examination, perianal lesions with heaped-up edges were observed. A punch biopsy was subsequently performed, revealing squamous cell carcinoma (SCC). About three weeks following discharge, after one week of admission to the general medicine ward, the patient started chemoradiation therapy and reported some improvement in her symptoms. Seven weeks later, she was in remission.
Discussion:
Squamous cell carcinoma (SCC) of the anus, a rare disease entity, is often a slow and progressive malignancy. The length of time for patients to become symptomatic, in combination with its mimicking clinical presentation to common gastrointestinal tract diseases and its rarity, makes diagnosis challenging. Additionally, a patient lacking traditional risk factors for anal cancer, such as HPV and smoking, may further complicate diagnosis, treatment, and quality of life.
Conclusion:
This case report emphasizes the pathogenesis and the similarities in clinical presentation of anal cancer to mild diseases, which may lead to a delay in diagnosis. Patients with anal carcinoma often delay seeking medical care, which is anecdotal in relation to the considerable overlap in symptoms of benign diseases such as hemorrhoids. Therefore, patients with "hemorrhoid" complaints, rectal bleeding, or rectal mass should warrant further physical examination and prompt referral to a gastroenterologist or a colorectal surgeon for additional evaluation.
Abstracts From the First Annual Research Day Hosted by the Michigan State University College of Osteopathic Medicine, Novi, Michigan, May 15, 2023
Authors: Andrea Amalfitano, Patricia Obando, Rana Ismail, Francis Akenami
Journal: Spartan Med Res J (2024)
Keywords: abstracts, college of osteopathic medicine, first annual research day in 2023, michigan state university, novi-michigan, spartan medical research journal

The Spartan Medical Research Journal (SMRJ) is pleased to publish abstracts from the First Annual Research Day hosted by the Michigan State University College of Osteopathic Medicine (MSUCOM), held in Novi, Michigan, on May 15, 2023. Sponsored by MSUCOM, the Statewide Campus System (SCS), and Research, Innovation, and Scholarly Engagement (RISE), this event showcased a total of 139 selected research abstracts following a meticulous blinded review by the MSUCOM Research Day Planning Committee and SMRJ editorial staff. These abstracts were subsequently presented at the MSUCOM First Annual Research Day in 2023, with awards for exceptional oral and poster presentations conferred on May 15, 2023. Of the 139 presentations that were ultimately chosen, 45 authors consented and elected to have their abstracts published in SMRJ. The abstracts from 2023 encompass a wide array of contemporary medical and clinical subjects, incorporating a variety of research designs that cover basic science, clinical research, case reports, medical education, and quality improvement. While abstracts offer concise overview of research projects or presentations, they do not permit a comprehensive evaluation of the scientific rigor employed in the respective works. Although these abstracts offer preliminary results that may necessitate further refinement and validation, they serve a vital function in disseminating novel research concepts and advancements in the discipline of medicine. This knowledge-sharing promotes meaningful dialogue among researchers, clinicians, and educators, thereby making a valuable contribution to the collective body of knowledge in the fields of medical sciences and osteopathic medicine. Andrea Amalfitano, DO, PhD Osteopathic Heritage Foundation Professor of Pediatrics, Microbiology and Molecular Genetics Professor, BioMolecular Science Gateway Editor-in-Chief, Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System C. Patricia Obando S., PhD Associate Dean and DIO, Graduate Medical Education Associate Professor- MSU College of Osteopathic Medicine- Statewide Campus System Rana Ismail, PhD, MSc, CPHQ Director of Research Editor, Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System Francis Akenami, BMLS, PhD, MSc, FIMLS Managing Editor Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System.
Application of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) on a Teratozoospermic Patient and Its Effect on the In-Vitro Fertilization (IVF) Outcome
Authors: Gauri Gajabe, Akash More, Jarul Shrivastava, Namrata Choudhary, Shilpa Dutta, Krushnali S Kadu, Ritesh Jadhav
Journal: Cureus (2024)
Keywords: infertility female, intracytoplasmatic morphologically selected sperm injection (imsi), introcytoplasmic sperm injection (icsi), poor ovarian reserve, teratozoospermia
MeSH terms: Case Reports

Infertility, defined as the inability to conceive after 12 months of unprotected sexual activity, affects millions globally. Approximately 80% of cases have identifiable causes, including endometriosis, tubal obstruction, ovulatory dysfunction, and male sperm abnormalities. Lifestyle factors, such as smoking and obesity, also impact fertility. Sperm morphology, a key factor in male infertility, often presents as teratozoospermia, with defects in the head, midpiece, or tail. Poor ovarian reserve, indicated by low anti-mullerine hormone (AMH) and antra-follicular count (AFC) values, contributes to female infertility, often exacerbated by age-related factors. Elevated follicle-stimulating hormone (FSH) levels further diminish oocyte quantity and quality. Intracytoplasmic Sperm Injection (ICSI), a micromanipulation technique aiding infertile couples, may face challenges in detecting subtle sperm morphology defects. Advanced methods like Motile Sperm Organelle Morphological Examination (MSOME) and Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) under high magnification enhance sperm selection accuracy. We present the case of a 36-year-old woman and her 42-year-old husband who sought assistance after seven years of infertility. Previous Intrauterine injection (IUI) and ICSI attempts failed due to the wife's low ovarian reserve and elevated FSH, compounded by the husband's teratozoospermia. Their earlier In-Vitro Fertilization (IVF) experience yielded a single poor-quality oocyte, hindering blastocyst formation. Investigations revealed the wife's poor AFC, AMH of 0.033ng/ml, and FSH at 24IU/L. Her medical history included hypertension and gallbladder removal. The husband exhibited 98% defective sperm, devoid of a substance abuse history. The wife's family had a polycystic ovarian syndrome (PCOS) history, and her low AMH and AFC yielded only three poor-quality oocytes during the current assessment. Oocytes were retrieved, and sperm were selected with the help of IMSI. After ICSI, the patient successfully conceived.
EBV-Positive Classic Hodgkin Lymphoma and Primary Nodal T-Cell/NK-Cell Lymphoma Arising in the Background of Follicular Lymphoma
Authors: Suravi Raychaudhuri, Zhao Ming Dong, Scott Knowles, Solomon Graf
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

EBV-positive primary nodal T-cell/NK cell lymphoma (TNKL) is a rare diagnosis with a poor prognosis. No relationship with follicular lymphoma (FL), classic Hodgkin lymphoma (cHL), or other non-Hodgkin lymphomas is established. We describe a case of Epstein-Barr virus (EBV)-positive cHL and EBV-positive primary nodal TNKL in the background of an antecedent FL, with all 3 subtypes identified in a single lymph node biopsy from an immunocompetent patient. Intensive frontline therapy achieved only a temporary response, with subsequent rapid progression associated with hemophagocytic lymphohistiocytosis (HLH). We discuss the relationship of the three lymphoma subtypes and the potential roles of EBV and immune dysregulation as contributing factors to this previously undescribed composite lymphoma.
Encephalitozoon hellem infection after haploidentical allogeneic hematopoietic stem cell transplantation in children: a case report
Authors: Yue Shang, Yuanyuan Ren, Lipeng Liu, Xia Chen, Fang Liu, Xiaolan Li, Yang Wan, Wenbin An, Wenyu Yang, Xiaofan Zhu, Ye Guo
Journal: Front Immunol (2024)
Keywords: encephalitozoon hellem, gvhd, hsct, child, mngs
MeSH terms: Hematopoietic Stem Cell Transplantation / adverse effects, Transplantation, Haploidentical / adverse effects, Case Reports, Albendazole / therapeutic use, Anemia, Aplastic / therapy, Child, Graft vs Host Disease / etiology, Humans, Male, Transplantation, Homologous / adverse effects, Albendazole

Background:
Encephalitozoon hellem (E. hellem) infection is a zoonotic disease, rarely observed in individuals, causing various clinical manifestations including diarrhea, keratoconjunctivitis, cystitis, etc. E. hellem infection after hematopoietic stem-cell transplantation (HSCT) is a rare, serious complication.
Case presentation:
Herein, we present a case of E. hellem infection developing during HLA-haploidentical HSCT in a 9-year-old boy who suffered from aplastic anemia. On 15 days after HSCT, the patient developed recurrent and prolonged fever, diarrhea and hematuria. It is challenging to differentiate whether the symptoms mentioned in this case are caused by graft-versus-host disease (GVHD) or a specific infection. Based on the result of metagenomic next-generation sequencing (mNGS) and clinical observation, the patient was diagnosed as E. hellem infection, and received albendazole and decreased the immunosuppressive treatment. Finally, he had recovered.
Conclusion:
We should pay attention to the uncommon disease caused by the E. hellem infection after HSCT, especially in cases with immune reconstitution unrecovered. Among those rare infection, mNGS can be performed for better understanding the source of infection and targeted therapy, which can benefit the patients.
Pleomorphic hyalinizing angiectatic tumour of the lower back - a rare case and review of the literature
Authors: Carlos Neblett, Kenneth Appiah, Tahjeme Lawrence, Malik Graham, Daynalee Wilson, Rory Thompson
Journal: J Surg Case Rep (2024)
Keywords: back, pleomorphic hyalinizing angiectatic tumour, soft tissue, trunk
MeSH terms: Case Reports

Pleomorphic hyalinizing angiectatic tumour (PHAT) is a very rare low-grade indeterminate neoplasm of connective and other soft tissue, which is not known to metastasize though local recurrence has been documented. It most commonly presents in the lower extremities, but other anatomical locations have been described. This is the second known case of PHAT from the Caribbean region and adds to the limited reported cases of the condition in the literature.
Pulmonary infection with Aeromonas dhakensis in a patient with acute T lymphoblastic leukemia: a case report and review of the literature
Authors: Chaoyang Wang, Nan Wei, Moyuan Zhang, Xiaoju Zhang
Journal: Front Med (Lausanne) (2024)
Keywords: aeromonas, aeromonas dhakensis, antibiotic, mngs, pulmonary infection
MeSH terms: Case Reports

Background:

Aeromonas dhakensis is a gram-negative bacterium. In recent years, Aeromonas dhakensis has gradually attracted increasing attention due to its strong virulence and poor prognosis. Clinical reports of pulmonary infection caused by Aeromonas dhakensis are rare.
Case presentation:
A patient with acute T lymphoblastic leukemia experienced myelosuppression after chemotherapy, developed a secondary pulmonary infection with Aeromonas dhakensis and was hospitalized due to fever. The patient underwent testing for inflammatory markers, chest imaging, blood culture, bronchoalveolar lavage, pleural drainage, and metagenomic next-generation sequencing of alveolar lavage fluid and pleural fluid to obtain evidence of Aeromonas dhakensis infection, and was treated with four generations of cephalosporin combined with fluoroquinolone antibiotics. The patient's condition significantly improved.
Discussion:
Among pulmonary infectious pathogens, Aeromonas dhakensis is relatively rare. Once an Aeromonas strain is cultured in the clinical work, pathogenic sequencing should be performed on the detected samples for early accurate diagnosis and effective anti-infection treatment.