OpenMed/multicare-articles huggingface dataset:
Turning conceptual systems maps into dynamic simulation models: An Australian case study for diabetes in pregnancy
Authors: Louise Freebairn, Jo-An Atkinson, Nathaniel D Osgood, Paul M Kelly, Geoff McDonnell, Lucie Rychetnik
Journal: PLoS One (2019)
MeSH terms: Pregnancy in Diabetics / etiology, Research Support, Non-U.S. Gov't, Australia, Computer Simulation, Decision Making, Evidence-Based Practice, Female, Health Policy, Humans, Models, Biological, Policy Making, Pregnancy, Public Health, Risk Factors, Systems Analysis

Background:
System science approaches are increasingly used to explore complex public health problems. Quantitative methods, such as participatory dynamic simulation modelling, can mobilise knowledge to inform health policy decisions. However, the analytic and practical steps required to turn collaboratively developed, qualitative system maps into rigorous and policy-relevant quantified dynamic simulation models are not well described. This paper reports on the processes, interactions and decisions that occurred at the interface between modellers and end-user participants in an applied health sector case study focusing on diabetes in pregnancy.
Methods:
An analysis was conducted using qualitative data from a participatory dynamic simulation modelling case study in an Australian health policy setting. Recordings of participatory model development workshops and subsequent meetings were analysed and triangulated with field notes and other written records of discussions and decisions. Case study vignettes were collated to illustrate the deliberations and decisions made throughout the model development process.
Results:
The key analytic objectives and decision-making processes included: defining the model scope; analysing and refining the model structure to maximise local relevance and utility; reviewing and incorporating evidence to inform model parameters and assumptions; focusing the model on priority policy questions; communicating results and applying the models to policy processes. These stages did not occur sequentially; the model development was cyclical and iterative with decisions being re-visited and refined throughout the process. Storytelling was an effective strategy to both communicate and resolve concerns about the model logic and structure, and to communicate the outputs of the model to a broader audience.
Conclusion:
The in-depth analysis reported here examined the application of participatory modelling methods to move beyond qualitative conceptual mapping to the development of a rigorously quantified and policy relevant, complex dynamic simulation model. The analytic objectives and decision-making themes identified provide guidance for interpreting, understanding and reporting future participatory modelling projects and methods.
Two Rare Complications in One Patient: Acquired von Willebrand Syndrome Associated with Intracranial Plasmacytoma
Authors: H Auge, C Yguel, E Schmitt, B Frotscher, H Busby-Venner, R Morizot, C Moulin, P Feugier, A Perrot, L Filliatre-Clement
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Here, we describe a rare case of acquired von Willebrand syndrome (VWS) associated with intracranial plasmacytoma. The literature includes reports of a few cases of plasmacytoma with central nervous involvement, but none of them with acquired VWS. Diagnosis was made based on a stereotaxic intracerebral biopsy. During this biopsy, a ventriculoperitoneal shunt was established, which was complicated with abnormal bleeding. Subsequent hemostasis assessment related to hemopathy revealed acquired von Willebrand disease. The patient received induction therapy with bortezomib, thalidomide, and dexamethasone (VTD), followed by high-dose melphalan chemotherapy and autologous stem cell transplantation, and then VTD consolidation, and finally maintenance with lenalidomide. Our patient currently remains in very good partial response without neurological symptoms after 4 months of maintenance. The patient is free of progression 14 months after their original presentation.
Clinical Observation of Computer Vision Technology Combined with Music Therapy in the Treatment of Alzheimer's Disease
Authors: Anshuang Zhang, Yunpeng Yang, Ming Xu
Journal: Emerg Med Int (2022)

With the world's population aging, Alzheimer's disease has attracted more and more attention as a common elderly disease. The clinical manifestations of cognitive function decline in Alzheimer's disease are mainly memory decline, which will seriously damage the patient's sense of self-worth. The purpose is to use the method of song recall to conduct individual music therapy intervention for Alzheimer's disease patients, to help Alzheimer's disease patients activate autobiographical memory, trigger positive emotions, improve behavioral symptoms, and delay the development of the disease. This paper proposes to combine computer vision technology with music therapy to obtain relevant data before and after intervention through the literature method, measurement method, case study method and experimental method. It helps AD patients to improve and slow down the forgetting and confusion of autobiographical memory, thereby enhancing the mood and cognition of AD patients. It observes the changes of AD patients before and after intervention by song recall and provides new ideas and practical basis for the application of music therapy in the field of Alzheimer's disease research. The experimental results showed that the subjects' autobiographical memory test (AMT) after 16 sessions of music therapy, from 12 points before the test to 14 points after the test. The scores were significantly positively correlated, and the improvement of autobiographical memory could improve the patient's orientation and memory.
Early Clinical Diagnosis and Treatment of Traumatic Aortic Injury Caused by Thoracic and Abdominal Injuries: A Series of Four Cases with Literature Review
Authors: Qiqi Wu, Shanshan Sun, Jie Xie, Tianyu Li, Hui Li, Xiangjun Bai, Zhanfei Li, Wei Wang
Journal: Biomed Res Int (2021)
MeSH terms: Aorta / diagnostic imaging, Aorta / injuries, Thoracic Injuries / complications, Thoracic Injuries / diagnosis, Thoracic Injuries / surgery, Vascular System Injuries / diagnosis, Vascular System Injuries / etiology, Vascular System Injuries / surgery, Case Reports, Review, Abdominal Injuries / complications, Abdominal Injuries / diagnosis, Abdominal Injuries / surgery, Adult, Aortic Dissection, Early Diagnosis, Female, Hematoma, Humans, Male, Middle Aged

Aortic injury, particularly traumatic aortic dissection caused by thoracic and abdominal injuries, is extremely rare. The diagnosis rate of blunt aortic injury caused by chest and abdominal injuries is often low, and its clinical manifestations are atypical. Once missed or misdiagnosed, the consequences are serious. Early diagnosis of traumatic aortic injury in complex thoracic and abdominal injuries is a key factor in reducing the mortality of trauma patients. Among all trauma patients treated in our department from December 2018 to December 2020, we diagnosed four cases of aortic injury, including three cases of aortic dissection and one case of intramural hematoma. Successful surgical treatment and clinical outcome were achieved in all four patients. We found that early diagnosis and surgical treatment can help to reduce the mortality of patients with traumatic aortic injury and improve the prognosis.
Silicone-Induced Granulomatous Reaction Causing Severe Hypercalcemia: Case Report and Literature Review
Authors: Gulshan Man Singh Dangol, Hilmer Negrete
Journal: Case Rep Nephrol (2019)
MeSH terms: Case Reports

A 67-year-old woman presented to the hospital with complaints of abdominal pain. Physical exam was significant for signs of severe dehydration, mild epigastric tenderness and multiple non-tender hard nodules over her arms and thighs. Incidental finding of severe hypercalcemia led to negative workups for hyperparathyroidism, vitamin D intoxication, and malignancy. However, elevated levels of 1,25-hydroxy vitamin D raised the possibility of granulomatous diseases. Imaging and patient report revealed silicone-induced foreign body granulomatous reaction as the cause of hypercalcemia. Use of silicone for cosmetic enhancement of body contours can result in siliconomas, severe hypercalcemia, and complications. Treatment is unestablished for this condition. Increasing prevalence of cosmetic enhancement should prompt vigilance for this rare disease entity. Providers should counsel and educate individuals undergoing such procedures.
Salvage with a Secondary Infrahepatic Cavocavostomy of the Occluded Modified Piggyback Anastomosis during Split Liver Transplantation: A Case Report
Authors: Erdem Kinaci, Cuneyt Kayaalp, Sezai Yilmaz, Emrah Otan
Journal: Case Rep Transplant (2014)

Hepatic venous outflow obstruction following liver transplantation is rare but disastrous. Here we described a 14-year-old boy who underwent a split right lobe liver transplantation with modified (side-to-side) piggyback technique which resulted in hepatic venous outflow obstruction. When the liver graft was lifted up, the outflow drainage returned to normal but when it was placed back into the abdomen, the outflow obstruction recurred. Because reanastomosis would have resulted in hepatic reischemia, alternatively, a second infrahepatic cavocavostomy was planned without requiring hepatic reischemia. During this procedure, the first assistant hung the liver up to provide sufficient outflow and the portal inflow of the graft continued as well. We only clamped the recipient's infrahepatic vena cava and the caudal cuff of the graft cava. After the second end-to-side cavocaval anastomosis, the graft was placed in its orthotopic position and there was no outflow problem anymore. The patient tolerated the procedure well and there were no problems after three months of follow-up. A second cavocavostomy can provide an extra bypass for some hepatic venous outflow problems after piggyback anastomosis by avoiding hepatic reischemia.
Topiramate-Induced Persistent Eyelid Myokymia
Authors: Mohammadrasoul Khalkhali
Journal: Case Rep Psychiatry (2016)

Background. Topiramate (TPM) is a psychotropic drug, which is used mainly as an antiepileptic drug and now over the years is used for a wider range of indications, including migraine prophylaxis and binge eating disorders. Although ocular side effects of Topiramate have been frequently reported, neuroophthalmologic manifestations such as myokymia are rarely reported. Case Presentation. This case report presents a case of a 47-year-old woman who had begun TPM for binge eating problem. She developed unilateral long standing lower eyelid twitching, which progressed to upper eyelid and eyebrow at the same side. The patient was not a smoker or excessive alcohol or caffeine abuser. Increasing the resting time and changing life style made no significant changes in her eyelid twitching. There was no definite evidence by neuroimaging and clinical or laboratory evaluations causing eyelid myokymia. The symptoms resolved with discontinuation of TPM. Conclusion. Although eyelid myokymia is a benign and self-limited condition, it sometimes becomes a source of distress in chronic long standing cases. Physicians should be aware of the neuroophthalmologic side effects of this drug.
Osteopetrosis in two siblings: two case reports
Authors: Satish Yadav, Shiv Chalise, Shipra Chaudhary, Gauri Shankar Shah, Mukesh Kumar Gupta, Om Prakash Mishra
Journal: BMC Res Notes (2016)
MeSH terms: Osteopetrosis / pathology, Siblings, Case Reports, Bone Density, Humans, Osteopetrosis / diagnostic imaging, Radiography, Sclerosis, Skull / diagnostic imaging, Skull / pathology, Spine / diagnostic imaging, Spine / pathology

Background:
Osteopetrosis is a rare inherited metabolic bone disorder characterized by extensive sclerosis of skeletons, visual and hearing impairment, hepatosplenomegaly and anemia. It has two major clinical forms: the autosomal dominant adult (benign) form is associated with milder symptoms often appearing in later childhood and adulthood whereas the autosomal recessive infantile (malignant) form has severe presentations appearing in very early childhood, if untreated, is typically fatal during infancy or early childhood. A rare autosomal recessive (intermediate) form is present during childhood with some signs and symptoms of malignant osteopetrosis. Diagnosis is mainly based on clinical and typical generalized increase in bone density.
Case presentation:
The two siblings of Indo-Aryan ethnicity, aged five and 8 years, were admitted with irregular low grade fever and gradually increasing abdominal mass for last 3 years. They also had history of hearing loss. On examination, the patients were found pale with poor nutritional status, short stature, frontal bossing and splenomegaly. We made a clinical diagnosis of hemolytic anemia and investigated accordingly. Peripheral Blood Smear was suggestive of leucoerythroblastic picture in both the siblings. We extended our investigations and radiological survey revealed generalized increase in bone density which was consistent with osteopetrosis.
Conclusion:
Osteopetrosis is a rare disease transmitted by autosomal dominant or recessive inheritance having variable penetrance. We report here milder form of disease in the two siblings having typical clinical features in the form of anemia, hepatosplenomegaly and hearing loss. Diagnosis was confirmed by typical generalized increase in bone density in both the patients.
Case report: CD19-directed CAR-T cell therapy combined with BTK inhibitor and PD-1 antibody against secondary central nervous system lymphoma
Authors: Wenqi Zhang, Chen Huang, Ruixia Liu, Huichao Zhang, Weijing Li, Shaoning Yin, Lianjing Wang, Wei Liu, Lihong Liu
Journal: Front Immunol (2022)
Keywords: btk inhibitor, cd19 car-t cell therapy, pd-1 antibody, scnsl, tislelizumab, zanubrutinib
MeSH terms: Central Nervous System Neoplasms / pathology, Central Nervous System Neoplasms / therapy, Lymphoma, Large B-Cell, Diffuse / pathology, Neoplasms, Second Primary, Receptors, Chimeric Antigen, Case Reports, Research Support, Non-U.S. Gov't, Antigens, CD19, Cell- and Tissue-Based Therapy, Central Nervous System, Clinical Trials as Topic, Female, Humans, Neoplasm Recurrence, Local / drug therapy, Programmed Cell Death 1 Receptor, Protein Kinase Inhibitors / therapeutic use, Antigens, CD19, Programmed Cell Death 1 Receptor, Protein Kinase Inhibitors, Receptors, Chimeric Antigen

Current therapeutic strategies for central nervous system (CNS) relapse of diffuse large B-cell lymphoma (DLBCL) are extremely limited. Secondary central nervous system lymphoma (SCNSL) also shows a grave prognosis and high mortality. This report describes a young female patient with DLBCL and CNS relapse who received low-dose CD19-directed chimeric antigen receptor T (CAR-T) cell therapy followed with Bruton's tyrosine kinase inhibitor and programmed cell death protein 1 antibody after several lines of chemotherapy. However, limited reports on CAR-T cell therapy are applied for SCNSL, particularly those in combination with targeted agents. The current treatment combination for this case provides a new regimen for CNS relapse from DLBCL.
Clinical trial registration:
ClinicalTrials.gov number, NCT04666168.
Extensive Arterial and Venous Thrombosis in a Female With a Known Untreated Polycystic Ovarian Syndrome: A Case Report
Authors: Salim A Al Busaidi, Muzna Al-Farsi, Juhaina S Al-Maqbali, Masoud Salim Kashoob, Hatem Farhan, Bader Al Rawahi, Abdullah M Al Alawi
Journal: Cureus (2023)
Keywords: atrial septal defect, case report, deep venous thrombosis, polycystic ovarian syndrome, pulmonary embolism
MeSH terms: Case Reports

Polycystic ovarian syndrome (PCOS) is a common heterogeneous endocrine disease associated with a twofold higher risk of stroke and venous thromboembolism (VTE). An 18-year-old female presented to the emergency department (ED) with a one-hour history of right-side body weakness, facial asymmetry, and altered mental status. The patient had poor mentation and was unable to protect her airway. She was intubated and admitted to the intensive care unit (ICU). She was diagnosed with polycystic ovarian syndrome three years ago; however, she was not on active treatment at the time of presentation. She received two doses of the BNT162b2 mRNA COVID-19 vaccine, and her last dose was six months before the current presentation. A workup showed that she had extensive arterial and venous thrombosis. Later during investigations, she was found to have a complex atrial septal defect (ASD) with a left-to-right shunt. This case reports a management approach for a young female with untreated polycystic ovarian syndrome that predisposed her to develop deep vein thrombosis (DVT), pulmonary embolism (PE), and ischemic stroke due to atrial septal defect with possible transient shunt reversal.
Neoadjuvant famitinib and camrelizumab, a new combined therapy allowing surgical resection of the primary site for anaplastic thyroid carcinoma
Authors: Shuwen Yang, Dongmei Ji, Fen Xue, Tongzhen Chen, Yu Wang, Qinhai Ji
Journal: Cancer Rep (Hoboken) (2023)
Keywords: anaplastic thyroid cancer, camrelizumab, famitinib, radiation therapy, surgery
MeSH terms: Thyroid Carcinoma, Anaplastic / diagnosis, Thyroid Carcinoma, Anaplastic / drug therapy, Thyroid Carcinoma, Anaplastic / genetics, Thyroid Neoplasms / drug therapy, Thyroid Neoplasms / genetics, Thyroid Neoplasms / surgery, Clinical Trial, Phase II, Case Reports, Humans, Neoadjuvant Therapy, Protein Kinase Inhibitors / therapeutic use, Proto-Oncogene Proteins B-raf / genetics, Proto-Oncogene Proteins B-raf / therapeutic use, camrelizumab, famitinib, Proto-Oncogene Proteins B-raf, Protein Kinase Inhibitors

Background:
Anaplastic thyroid cancer (ATC) is considered the most lethal thyroid cancer, with an overall 5-year survival rate below 10%. The FDA approved a BRAF/MEK inhibitor combination for the treatment of patients with BRAF-mutated ATC. However, effective therapeutic options for patients with wild-type BRAF are lacking.
Case:
In our phase II study, patients having advanced/metastatic solid ATCs were treated with famitinib and camrelizumab, a combination therapy involving a multi-targeted kinase inhibitor and an anti-PD-1 antibody. We report a case of a patient with locally advanced unresectable ATC who underwent this combination therapy, allowing us to perform complete surgical resection followed by post-operative radiation therapy.
Conclision:
To the best of our knowledge, this is the first report describing the use of famitinib and camrelizumab as a neoadjuvant treatment for ATC with wild-type BRAF. Clinical trial for a novel neoadjuvant approach for ATC are currently open for enrollment.
How to misuse echo contrast
Authors: Magnus Dencker, Anna Missios
Journal: Cardiovasc Ultrasound (2009)
MeSH terms: Diagnostic Errors, Echocardiography, Heart Neoplasms / diagnostic imaging, Hernia, Hiatal / diagnostic imaging, Case Reports, Aged, 80 and over, Diagnosis, Differential, Dyspnea / diagnostic imaging, Female, Gastroscopy, Humans

Background:
Primary intracardiac tumours are rare, there are however several entities that can mimic tumours. Contrast echocardiography has been suggested to aid the differentiation of various suspected masses. We present a case where transthoracic echocardiography completely misdiagnosed a left atrial mass, partly due to use of echo contrast.
Case presentation:
An 80 year-old woman was referred for transthoracic echocardiography because of one-month duration of worsening of dyspnoea. Transthoracic echocardiography displayed a large echodense mass in the left atrium. Intravenous injection of contrast (SonoVue, Bracco Inc., It) indicated contrast-enhancement of the structure, suggesting tumour. Transesophageal echocardiography revealed, however, a completely normal finding in the left atrium. Subsequent gastroscopy examination showed a hiatal hernia.
Conclusion:
It is noteworthy that the transthoracic echocardiographic exam completely misdiagnosed what seemed like a left atrial mass, which in part was an effect of the use of echo contrast. This example highlights that liberal use of transoesophageal echocardiography is often warranted if optimal display of cardiac structures is desired.
Refractory Heparin-Induced Thrombocytopenia With Cerebral Venous Sinus Thrombosis Treated With IVIg, Steroids, and a Combination of Anticoagulants: A Case Report
Authors: Mia Gonzales, Amrish Pipalia, Andrew Weil
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: ivig, autoimmune hit, cerebral venous sinus thrombosis, heparin-induced thrombocytopenia, refractory hit
MeSH terms: Anticoagulants / administration & dosage, Immunoglobulins, Intravenous / administration & dosage, Purpura, Thrombocytopenic, Idiopathic / drug therapy, Sinus Thrombosis, Intracranial / drug therapy, Steroids / administration & dosage, Case Reports, Anticoagulants / adverse effects, Anticoagulants / immunology, Autoantibodies / blood, Blood Platelets / drug effects, Blood Platelets / immunology, Female, Heparin / adverse effects, Heparin / immunology, Humans, Middle Aged, Purpura, Thrombocytopenic, Idiopathic / blood, Purpura, Thrombocytopenic, Idiopathic / chemically induced, Purpura, Thrombocytopenic, Idiopathic / immunology, Recurrence, Sinus Thrombosis, Intracranial / chemically induced, Anticoagulants, Autoantibodies, Immunoglobulins, Intravenous, Steroids, Heparin

Heparin-induced thrombocytopenia (HIT) type II is caused by antibody production that bind complexes between heparin and platelet factor 4 leading to platelet consumption and thrombosis. In a small subset of cases referred to as autoimmune HIT, the antibodies activate platelets even in the absence of heparin. Refractory HIT is a type of autoimmune HIT in which thrombocytopenia persists for weeks after heparin discontinuation and carries increased risk for thrombosis and more severe thrombocytopenia. We present a case of refractory HIT with cerebral venous sinus thrombosis (CVST) that was successfully treated with a change in anticoagulant alongside steroids and a second trial of intravenous immunoglobulin (IVIg).
Expanding our Understanding of Atypical Antipsychotics: Acute Urinary Retention Secondary to Olanzapine
Authors: Hannah Mirzakhani, Mariam Rahim, Jacob Mathew Jr
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

Antipsychotics are considered the most efficacious drugs in the treatment of schizophrenia and other psychotic disorders. While clinicians monitor for the onset of extrapyramidal symptoms (EPSs), many do not consider the antimuscarinic and histaminergic side effects that can occur with second generation antipsychotics. We present the case of a 62-year-old male who presented with acute urinary retention that was found to be due to the recent initiation of olanzapine. Gradual cessation of the medication and follow-up with urology revealed resolution of his symptoms. With the increasing demand for psychiatric care but limited psychiatric resources, more and more primary care physicians find themselves dealing with the complex challenges of mental illness and managing antipsychotic medications. As a result, coordinating care among multiple specialties and understanding the full profile of side effects that are associated with psychiatric medications can yield quicker diagnoses and improve patient care.