OpenMed/multicare-articles huggingface dataset:
Social networking sites and educational adaptation in higher education: a case study of Chinese international students in New Zealand
Authors: Ling Cao, Tingting Zhang
Journal: ScientificWorldJournal (2012)
MeSH terms: Education, Social Networking, Students, Research Support, Non-U.S. Gov't, China / ethnology, Humans, Internationality, New Zealand

This study aims to find out the relationship between the use of SNSs and educational adaptation process of Chinese international students (from China) in New Zealand. Based on interview data, this paper addressed how Chinese international students use SNSs (RenRen, Facebook, etc.) to expand and manage their online social networks to help their adaptation to new educational environment. As a case study of Chinese international students in New Zealand and from the narrative of students, we examined the relationship among educational difficulties, life satisfaction, and the use of SNSs. This study would help in further understanding how and why SNSs can be adopted in higher education to support effective overseas learning experiences.
Combined three-part humeral anterior fracture-dislocation and humeral shaft fracture treated with one-stage long stem shoulder hemiarthroplasty in an active elderly patient - A case report and review of literature
Authors: Guillaume Herzberg, Eloise Tebaa
Journal: SICOT J (2017)

Introduction:
Injuries combining a humeral head fracture-dislocation and a shaft fracture of the ipsilateral humerus are very rare. They should be separated from extended fractures of the humeral head to the shaft [1].
Case report:
We present the case of an active 84-year-old man who sustained a three-part fracture-dislocation of the proximal humerus combined with a long spiral humeral middle third diaphyseal fracture, after a ski fall. We were unable to find a similar case in the literature. He was treated with a long stem hemiarthroplasty, associated with screw osteosynthesis of the long spiral shaft fracture. The result after 30 months of follow-up was excellent, with good shoulder range of motion, good bone integration of the prosthesis and uneventful healing of the fracture.
Conclusion:
This treatment allowed this intrepid elderly patient to recover a normal quality of life, including driving his car and to return to skiing.
Complete non-puerperal uterine inversion caused by uterine hemangioma: about a case report
Authors: Skander Abid, Ghassen Ben Dhaou, Ghada Abdelmoula, Ahmed Ben Smida, Mohamed Raouf Ben Abdesslem, Ons Mrad, Mouna Derouiche, Latifa Lassoued
Journal: Pan Afr Med J (2022)
Keywords: non-puerperal uterine inversion, angioleiomyoma, case report, surgical interventions
MeSH terms: Abdomen, Acute, Angiomyoma, Hemangioma, Obstetric Labor Complications, Uterine Inversion / diagnosis, Uterine Inversion / etiology, Uterine Inversion / surgery, Uterine Neoplasms / complications, Uterine Neoplasms / diagnosis, Uterine Neoplasms / surgery, Case Reports, Child, Preschool, Female, Humans, Pregnancy, Uterus / surgery, Vagina

Uterine inversion is a rare postpartum complication. It is a rare condition in which the internal surface of the uterus protrudes through the vagina. Non-puerperal uterine inversion (NPUI) is extremely rare. In most instances, it is linked to uterine tumors. Among these tumors, leiomyoma is the most frequent cause reported in data. This condition may not be noticed until time of surgery. Malignancy is suspected in most cases. Nevertheless, uterine inversion can be diagnosed preoperatively using radiology. Difficulties in diagnosing NPUI makes this clinical case a challenge in gynaecology and not commonly reported in literature. We report our experience in the diagnosis and treatment of a complete non-puerperal uterine inversion associated with uterine angioleiomyoma. The patient's age was 44, gravida 2 para 1 presented with intermittent vaginal bleeding for four months and an acute abdominal cramping pain. On examination, a large mass lesion was observed which occupies the vaginal cavity and the contour of the uterine cervix could not be reached. Biopsies and Immunohistochemistry matched with an angioleiomyoma. She underwent a transvaginal surgical reposition technique: Spinelli's. It is important to diagnose accurate non-puerperal uterine inversion. Surgery provides good prognosis and it is necessary. We report a case of NPUI caused by angioleiomyoma. Nevertheless, malignancy must be eliminated in first place.
Orthodontic Treatment for a Patient with Root Resorption of All Four Maxillary Incisors due to Bilaterally Impacted Canines
Authors: Makoto Yanoshita, Naoto Hirose, Azusa Onishi, Sayuri Nishiyama, Naoki Kubo, Daiki Kita, Kotaro Tanimoto
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Maxillary canines require the longest period from the generation of the tooth germ to the completion of eruption, and they have more difficulties in eruption than other teeth. The incisor roots are often resorbed due to malpositioned canines. An 11-year-old girl presented with an extremely rare case of root resorption of four maxillary incisors due to bilaterally impacted maxillary canines, which were located excessively mesially. The case was managed through oral surgery and orthodontic treatment over five years. After extracting the maxillary deciduous canines, the maxillary bilateral canines were surgically exposed. The bimaxillary lateral incisors were extracted, and the canines were orthodontically tracted over 8 months. All teeth were then aligned using edgewise brackets. No further root resorption of the central incisors was observed for 5 years after canine traction. This case demonstrates the importance of early detection of abnormally positioned canines.
Delayed diagnosis of gastric outlet obstruction from bouveret syndrome in a young woman
Authors: Zachary Smith, Jodie Totten, Adrienne Hughes, Jared Strote
Journal: West J Emerg Med (2015)
MeSH terms: Delayed Diagnosis, Duodenal Obstruction / diagnosis, Gallstones / complications, Gastric Outlet Obstruction / diagnosis, Case Reports, Adult, Duodenal Obstruction / etiology, Female, Gallstones / diagnosis, Gastric Outlet Obstruction / etiology, Humans, Syndrome

Bouveret syndrome is a rare presentation of gastric outlet obstruction caused by a gallstone in the proximal duodenum via a bilioenteric fistula. This is an infrequent although clinically significant cause of abdominal pain, almost exclusively in the elderly. The clinical presentation is similar to that of a small bowel obstruction with abdominal pain, nausea and vomiting. Surgery or endoscopy is often required for definitive diagnosis and therapy. We describe the case of a young woman with this condition who had a delayed diagnosis in part because of her age and the rarity of the condition.
"Pulmonary Actinomycosis attributable to Actinomyces meyeri presenting as cardiac tamponade: a case report"
Authors: Saori Nishizawa, Keisuke Anan, Kazunori Tobino, Masanobu Okahisa, Yuki Goto, Kojin Murakami, Takuto Sueyasu, Miyuki Munechika, Kohei Yoshimine, Mai Yoshino
Journal: Multidiscip Respir Med (2018)
Keywords: actinomyces meyeri, actinomycosis, cardiac tamponade, lung abscess
MeSH terms: Case Reports

Background:
Recently, it is reported that Actinomyces meyeri is the most common species causing actinomycosis. However, to our knowledge, there was no report about pulmonary actinomycosis attributable to A. meyeri presenting as cardiac tamponade.
Case presentation:
Hereby we describe a case of pulmonary actinomycosis attributable to A. meyeri presenting as cardiac tamponade. At first, the patient was diagnosed with bacterial pericarditis with lung abscess in the left lower lung lobe and underwent pericardial drainage. Three days after the removal of the drainage tube, atrial fibrillation followed by cardiac arrest with asystole occurred and immediate cardiopulmonary resuscitation restored his circulation. Thereafter, he underwent pneumocentesis of the lung abscess and the culture grew A. meyeri. He was successfully treated with penicillin G.
Conclusion:
This is the first case of pulmonary actinomycosis attributable to A. meyeri presenting as cardiac tamponade. We believe that an increased awareness of the disease is necessary to expedite diagnosis therefore minimizing morbidity and mortality.
Exceptional response to oral metronomic chemotherapy in a rare case of sinonasal mucosal melanoma
Authors: Anukul Karn, Satvik Khaddar, Amit Agrawal, Akhil Kapoor
Journal: Ecancermedicalscience (2021)
Keywords: nasal cavity, oral metronomic therapy, sinonasal melanoma
MeSH terms: Case Reports

Sinonasal mucosal melanoma is a rare malignancy with limited treatment options and a poor prognosis. They are usually diagnosed at an advanced stage owing to their late and nonspecific clinical presentation. Here we present a case of relapsed refractory unresectable malignant melanoma involving the right nasal cavity managed with Oral Metronomic Chemotherapy (OMCT). A 75-year-old male patient was diagnosed with unresectable malignant melanoma involving the right nasal cavity and showed radiological progression after initial management with four cycles of Dacarbazine. He was then shifted to OMCT (Cyclophosphamide, Celecoxib and Tamoxifen), as immunotherapy could not be given due to financial constraints, on which he showed approximately 40% reduction in tumour size after 6 months. This result can have important clinical implications in resource constrained settings, where the use of immunotherapy is limited by great financial burden.
Motor Neuron Syndrome as a New Phenotypic Manifestation of Mutation 9185T>C in Gene MTATP6
Authors: Marisa Brum, Cristina Semedo, Rui Guerreiro, José Pinto Marques
Journal: Case Rep Neurol Med (2014)

Background. The mutation 9185T>C in ATP6 gene, associated with Leigh syndrome, was reported in only few families. Motor neuron disease (MND), both clinically and electrophysiologically, was not previously described in association with this mutation. Case Report. 33-year-old male, with family history of mitochondrial disease, presented with cognitive impairment, exercise intolerance, and progressive muscle weakness. Examination revealed global hypotonia, and proximal tetraparesis, without atrophy or fasciculation, pyramidal signs, or sensory symptoms. The laboratory findings revealed an increase of lactate and lactate/pyruvate ratio; electromyogram showed chronic neurogenic compromise; muscle biopsy was suggestive of spinal muscular atrophy and mitochondriopathy; genetic study of SMN1 was negative but detected a homoplasmic mutation 9185T>C in ATP6 gene. His younger sister, with the same mutation, had cognitive impairment, ataxia, and muscle weakness. EMG showed axonal peripheral neuropathy. Conclusion. This case is unique because of the benignity and the coexistence of clinical, neurophysiological, and pathological findings suggestive of MND that, although described in mitochondrial disease, have not yet been reported in association with 9185T>C mutation. The present case contributes to the expansion of the phenotypic expressions of this particular mutation.
An Unusual Neurological Form of Acute Intussusception in an Infant: Late Diagnosis and Management
Authors: Ouidad Louachama, Noureddine Rada, Ghizlane Draiss, Karima Fouraiji, Mohamed Ouled Saiad, Mohamed Bouskraoui
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Acute intussusception is one of the most common causes of intestinal obstruction in infants and small children and involves the invagination of one bowel segment into another. The clinical signs can be deceptively misleading when there is only one symptom or when an unusual symptom is in the foreground, especially in infants less than 1-year-old. We report a case of an infant with an acute intussusception where the neurological symptoms are predominant. The neurological form is the expression of major vascular narrowing of the collar of the intestinal intussusception; this form is rare and misleading and can be responsible for a delayed diagnosis.
Retrospondyloptosis of the Spine Secondary to Nonaccidental Trauma
Authors: T S Duffin, S W Thomas
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Spinal fracture rates from NAT have been reported in <1-3% of spinal injury cases. We present a 13-month-old female who presented with signs of spinal cord injury and was found to have complete retrospondylolisthesis of T12 vertebra and multiple rib fractures in various stages of healing due to NAT. This case reports an extremely severe spinal injury due to NAT of which there are few in the literature and highlights the importance of suspicion of NAT when pediatric patients present with neurologic symptoms and spinal trauma without plausible mechanism of injury.
Severe diltiazem poisoning treated with hyperinsulinaemia-euglycaemia and lipid emulsion
Authors: Nadine Monteiro, Joana Silvestre, João Gonçalves-Pereira, Camila Tapadinhas, Vitor Mendes, Pedro Póvoa
Journal: Case Rep Crit Care (2013)

Introduction. Calcium channel blockers (CCBs) drugs are widely used in the treatment of cardiovascular diseases. CCB poisoning is associated with significant cardiovascular toxicity and is potentially fatal. Currently, there is no specific antidote and the treatment of CCB poisoning is supportive; however, this supportive therapy is often insufficient. We present a clinical case of severe diltiazem poisoning and the therapeutic approaches that were used. Case Report. A 55-year-old male was admitted to the intensive care unit (ICU) after voluntary multiple drug intake, including extended release diltiazem (7200 mg). The patient developed symptoms of refractory shock to conventional therapy and required mechanical ventilation, a temporary pacemaker, and renal replacement therapy. Approximately 17 hours after drug intake, hyperinsulinaemia-euglycaemia with lipid emulsion therapy was initiated, followed by progressive haemodynamic recovery within approximately 30 minutes. The toxicological serum analysis 12 h after drug ingestion revealed a diltiazem serum level of 4778 ng/mL (therapeutic level: 40-200 ng/mL). Conclusions. This case report supports the therapeutic efficacy of hyperinsulinaemia-euglycaemia and lipid emulsion in the treatment of severe diltiazem poisoning.
Apexification with Calcium Hydroxide vs. Revascularization
Authors: H Boufdil, M Mtalsi, S El Arabi, B Bousfiha
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Treatment of necrotic immature teeth has always been a real challenge for the clinician due to the open apex and weak root structure, which does not allow a conventional endodontic treatment. Several therapeutic options are possible to treat those teeth. Calcium hydroxide apexification is the oldest and most studied therapeutic option, but it has some disadvantages, including the long term of treatment, the possibility of reinfection, and the weakness of the wall. To solve these problems, several authors recommend the revascularization technique. This therapy allows the continuation of root edification with apical closure and thickening of the walls. The aim of our work is to compare the two therapeutic procedures, apexification with calcium hydroxide and revascularization, through a clinical case treated and followed up for 24 months at the pediatric dentistry department in Casablanca, Morocco.
Improvement of Restless Legs Syndrome Under Treatment of Cancer Pain With Morphine and Fentanyl
Authors: Jan Gärtner, Karin Jaroslawski, Gerhild Becker, Christopher Boehlke
Journal: Front Neurol (2019)
Keywords: willis-ekbom disease, morphine, oxycodone, restless-legs-syndrome, transdermal fentanyl, treatment
MeSH terms: Case Reports

Restless-Legs-Syndrome (RLS), also known as Willis-Ekbom disease, is a sleep- and rest related disorder characterized by the unpleasant urge to move the legs. Pharmacological therapy is mainly based on dopamine-agonists and delta-2-alpha calcium channel ligands. Also, randomized-controlled-trials (RCTs) reported effectiveness of oral oxycodone (in combination with naloxone), and intrathecal opioids have also been administered for this indication. In the case reported here, a patient with advanced pancreatic cancer was referred to an acute palliative care unit for the treatment of cancer-related pain. Yet, in thorough exploration of her symptom burden, the patient reported that she felt her quality of life had been predominantly limited by symptoms other than cancer pain. Her medical history and neurological examination revealed that these symptoms were most obviously caused by severe RLS. In the years before, pharmacological therapies with dopamine-agonists and delta-2-alpha calcium channel ligands were initiated, but failed to relieve the RLS. In the palliative care ward, intravenous morphine was successfully titrated to treat her cancer pain. Concurrently, the patient also experienced almost complete relief from her RLS-symptoms and an increase in quality of life. The amelioration of her RLS-symptoms continued after morphine therapy was switched from intravenous to oral administration. Even after the patient was dismissed to home care and opioid rotation to transdermal fentanyl, symptom control of RLS remained excellent. To our knowledge, this is the first report of successfully treating RLS with intravenous and oral morphine. Since morphine is more easily available worldwide and the cost of morphine therapy is substantially lower compared to oxycodone/naloxone, comparisons to morphine may be an intriguing option for future RCTs.
Weaning from long-term mechanical ventilation utilizing closed-loop ventilation mode (IntelliVent®-ASV®) in a patient with spinal cord injury
Authors: Satoru Shimizu, Masashi Nakajima, Masayuki Yamazaki, Takashi Nagayama, Ryuta Suzuki
Journal: Spinal Cord Ser Cases (2018)

Introduction:
Cervical spinal cord injury with the C3 neurological level may cause respiratory failure and require long-term mechanical ventilation. Conventional weaning of spontaneous breathing trials is difficult to perform outside of intensive care or spinal cord units.
Case presentation:
An 80-year-old man presented with total tetraplegia and restrictive respiratory failure that required assisted ventilation after a falling accident. Cervical spine magnetic resonance imaging showed cervical cord compression that was worst at the C3-C4 intervertebral level. He experienced unexpected cardiac arrest during the conventional weaning process of trials of intermittent spontaneous breathing in the intensive care unit. The automated weaning protocol utilizing a closed-loop ventilation mode (IntelliVent®-ASV ® ) was introduced 131 days after injury in our ward for chronically ill patients. The patient was successfully weaned 39 days after the introduction of the weaning protocol.
Discussion:
An automated weaning protocol utilizing a closed-loop ventilation mode could be an optional procedure in patients with cervical cord injury on long-term mechanical ventilation, even in a ward for chronically ill patients where sufficient staff is not available. The efficacy and safety, and the cost-effectiveness of the procedure should be examined in larger spinal cord units.
Graves' Disease Presenting as a Unilateral Breast Mass
Authors: Neeka N Akhavan, Edlira Maska
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Introduction:
Graves' disease is an autoimmune thyroid disorder that is the most common cause of hyperthyroidism. Common manifestations of Graves' disease include weight loss, palpitations, heat intolerance, fatigue, tremors, and exophthalmos, occurring in more than 50% of patients. In rare cases, findings may predominate in one organ system; isolated findings of diarrhea, anxiety, or gynecomastia (as in our case) may occur, distracting from the correct diagnosis. Case Report. We report on a 37-year-old male who presented to the primary care clinic with the chief complaint of a tender right-sided breast mass and with an associated loss of appetite and forty-pound weight loss. Laboratory evaluation revealed suppressed TSH and elevated free T4. A bilateral diagnostic mammogram revealed bilateral gynecomastia. A nuclear medicine thyroid uptake scan was subsequently ordered, which showed the diffusely enlarged thyroid gland with homogenous increased uptake throughout, consistent with Graves' disease.
Conclusion:
It is important to keep a high index of suspicion for thyroid disease as hyperthyroid states may be deceiving in presenting with single organ system involvement. Although it is rare, gynecomastia is a known finding in Graves' disease and can be the presenting sign. Patients with unexplained gynecomastia or breast masses should be screened for thyrotoxicosis.
Spontaneous Hepatic Hemorrhage: An Unexpected Complication From Enoxaparin
Authors: Abhishrut Jog, Vijil Rajan, Charbel Ishak, Maryam Soliman
Journal: Cureus (2023)
Keywords: acute pancreatitis, anticoagulation, ct guided drainage, hepatic congestion, spontaneous hepatic hemorrhage
MeSH terms: Case Reports

Spontaneous hepatic hemorrhage (SHH) is a rare condition that occurs due to a breach in the liver parenchyma in the absence of an external cause, most commonly from hepatocellular cancer. If a solid liver lesion is absent, then it has been linked with diffuse hepatic diseases or systemic diseases. Although SHH has been linked with the use of warfarin, it has not been thus far linked with enoxaparin. SHH can present with non-specific symptoms, and lab parameters can reveal substantial drops in hemoglobin. It is diagnosed most commonly with computed tomography (CT) imaging and conservative treatment is effective in the majority of cases. We present one such rare case of SHH.
Leber's Hereditary Optic Neuropathy - Case Discussion
Authors: Cristina Culea, Bogdana Tăbăcaru, Simona Stanca, Horia Tudor Stanca
Journal: Rom J Ophthalmol (2019)
Keywords: absence of relative afferent pupillary defect, idebenone, maternal inheritance, pattern of nerve fiber damage, selective vulnerability of the optic nerve and the retinal ganglion cells
MeSH terms: Optic Atrophy, Hereditary, Leber / diagnosis, Optic Nerve / pathology, Retinal Ganglion Cells / pathology, Visual Acuity, Visual Fields / physiology, Case Reports, Fluorescein Angiography, Fundus Oculi, Humans, Male, Nerve Fibers / pathology, Tomography, Optical Coherence, Young Adult

Purpose. To report a case of a young patient with a clinical condition suggestive of Leber's hereditary optic neuropathy (LHON) confirmed by genetic testing. Material and methods. We present a case of a 21-year-old Caucasian male with bilateral visual loss. The patient complained of visual loss, initially in the right eye and two weeks thereafter in the left eye. Ophthalmological examination revealed visual acuity of 20/ 400 in both eyes, anterior segment of normal appearance, normal direct and consensual pupillary light reflexes, and absence of a relative afferent pupillary defect. Fundus examination demonstrated bilateral protruding, hyperemic, with blurred margins in the nasal quadrant papilla and reduced excavation, tortuous vessels, peripapillary telangiectasias. The optical coherence tomography (OCT) revealed bilateral increase of the retinal nerve fiber layer (RNFL) thickness and ganglion cell layer - inner plexiform layer complex (GCL-IPL complex) severely thinned. Results. The clinical suspicion of Leber's hereditary optic neuropathy was confirmed by the 3460 mutation, which was identified on blood mitochondrial analysis. Meantime, the visual acuity decreased to CF in both eyes. We initiated treatment with idebenone (300 mg T.I.D.). After three months of follow-up, visual acuity was CF in both eyes, bilateral pupillary light reflexes within normal limits and optic disc pallor was noticed in both eyes. Conclusion. No visual recovery was noticed after one year. We recommended that the idebenone treatment was continued and the patient was followed-up further.