OpenMed/multicare-articles huggingface dataset:
ChatGPT is not ready yet for use in providing mental health assessment and interventions
Authors: Ismail Dergaa, Feten Fekih-Romdhane, Souheil Hallit, Alexandre Andrade Loch, Jordan M Glenn, Mohamed Saifeddin Fessi, Mohamed Ben Aissa, Nizar Souissi, Noomen Guelmami, Sarya Swed, Abdelfatteh El Omri, Nicola Luigi Bragazzi, Helmi Ben Saad
Journal: Front Psychiatry (2024)
Keywords: anxiety, chatbots, depression, insomnia, language models, mental health, patient care, psychiatric disorders

Background:
Psychiatry is a specialized field of medicine that focuses on the diagnosis, treatment, and prevention of mental health disorders. With advancements in technology and the rise of artificial intelligence (AI), there has been a growing interest in exploring the potential of AI language models systems, such as Chat Generative Pre-training Transformer (ChatGPT), to assist in the field of psychiatry.
Objective:
Our study aimed to evaluates the effectiveness, reliability and safeness of ChatGPT in assisting patients with mental health problems, and to assess its potential as a collaborative tool for mental health professionals through a simulated interaction with three distinct imaginary patients.
Methods:
Three imaginary patient scenarios (cases A, B, and C) were created, representing different mental health problems. All three patients present with, and seek to eliminate, the same chief complaint (i.e., difficulty falling asleep and waking up frequently during the night in the last 2°weeks). ChatGPT was engaged as a virtual psychiatric assistant to provide responses and treatment recommendations.
Results:
In case A, the recommendations were relatively appropriate (albeit non-specific), and could potentially be beneficial for both users and clinicians. However, as complexity of clinical cases increased (cases B and C), the information and recommendations generated by ChatGPT became inappropriate, even dangerous; and the limitations of the program became more glaring. The main strengths of ChatGPT lie in its ability to provide quick responses to user queries and to simulate empathy. One notable limitation is ChatGPT inability to interact with users to collect further information relevant to the diagnosis and management of a patient's clinical condition. Another serious limitation is ChatGPT inability to use critical thinking and clinical judgment to drive patient's management.
Conclusion:
As for July 2023, ChatGPT failed to give the simple medical advice given certain clinical scenarios. This supports that the quality of ChatGPT-generated content is still far from being a guide for users and professionals to provide accurate mental health information. It remains, therefore, premature to conclude on the usefulness and safety of ChatGPT in mental health practice.
VKH-like uveitis during donafenib therapy for hepatocellular carcinoma: a case report and review of the literature
Authors: Rui Liu, Guina Liu, Fang Lu
Journal: Front Pharmacol (2024)
Keywords: vkh-like uveitis, donafenib-induced uveitis, hepatocellular carcinoma, ocular side effects of cancer therapy, targeted therapy
MeSH terms: Case Reports

Background:
The incidence of uveitis has risen with the use of targeted therapies, particularly prevalent in the administration of immune checkpoint inhibitors and MAP-kinase pathway inhibitors. We report the first case of VKH-like uveitis linked to Donafenib employed for the primary hepatocellular carcinoma, highlighting the necessity of ophthalmological follow-up in patients undergoing treatment with Donafenib.
Case presentation:
A 55-year-old man developed VKH-like symptoms, including sporadic white patches, tinnitus, headache, and mild bilateral vision reduction, after 18 months of treatment with Donafenib and Sintilimab for hepatocellular carcinoma. Based on ophthalmological examinations that fundus fluorescein angiography images demonstrating multiple focal areas of pinpoint hyperfluorescence, along with pooling indicative of neurosensory detachment and disc leakage in both eyes, choroid thickening in swept-source optical coherence tomography, and "sunset-glow" fundus appearance, a tentative diagnosis of VKH-like uveitis was made. Initially, his best-corrected visual acuity (BCVA) was 20/200 in the right eye and 20/80 in the left eye. Upon discontinuing Donafenib and starting a 3-month course of oral glucocorticoids, his BCVA improved to 20/30 in the right eye and 20/40 in the left eye.
Conclusion:
Targeted drugs have been commonly used for cancer treatment in recent years, but challenges of ocular side effects emerged gradually. To optimize patient outcomes, regular ophthalmological follow-ups are essential for those undergoing treatment with targeted therapies like Donafenib.
Case report: Chronic disseminated intravascular coagulopathy with concurrent paraneoplastic secondary hyperfibrinolysis in a dog with metastatic nasal adenocarcinoma
Authors: Kyle L Granger Jr, Trish Paulos, Mary-Keara Boss, Liz Guieu, Sarah Shropshire
Journal: Front Vet Sci (2024)
Keywords: dic, adenocarcinoma, dog, paraneoplastic, secondary hyperfibrinolysis
MeSH terms: Case Reports

In human medicine, hemostatic disorders such as thrombocytopenia, hyperfibrinolysis, and disseminated intravascular coagulopathy (DIC) have been associated with many cancers. Acute hemorrhage secondary to hyperfibrinolysis has been predominantly reported with prostatic adenocarcinoma in human patients. To the author's knowledge, severe bleeding due to paraneoplastic hyperfibrinolysis has not yet been reported in veterinary medicine. The case involves an 8-year-old neutered male Border Collie who was evaluated for progressive and recurrent epistaxis, having a history of 1 year of treatment for metastatic nasal adenocarcinoma. A progressive and severe coagulopathy thought to be related to the known cancer was diagnosed. Advanced coagulation testing was consistent with a chronic DIC and secondary hyperfibrinolysis. Throughout 1 week of hospitalization, the dog was treated with multiple blood products, vitamin K1, and anti-fibrinolytic medications. While the dog was initially discharged home, the dog re-presented the following day and was humanely euthanized due to a perceived poor quality of life. Post-mortem analysis revealed a histopathologic diagnosis of disseminated adenocarcinoma. In dogs with disseminated nasal adenocarcinoma that are experiencing severe bleeding, paraneoplastic secondary hyperfibrinolysis should be considered as a differential. Knowing this association could help guide treatment recommendations for optimal patient management.
Hemoptysis Secondary to Anomalous Origin of Right Pulmonary Artery From Ascending Aorta in a Young Male: A Case Report
Authors: Simran Nimal, Gowrishankar Palaniswamy, Navya Pillikunte Doddareddy, Sahithi Talacheru, Shraddha Jadhav, Tanmayee Mareedu, Mihirkumar P Parmar, Anup Banur
Journal: Cureus (2024)
Keywords: anomalous origin, congenital, dyspnea, hemoptysis, pda
MeSH terms: Case Reports

We report a rare case of a 24-year-old male with a rare anatomic variant of patent ductus arteriosus (PDA). The patient presented with symptoms of productive cough with recurrent and severe bouts of hemoptysis and grade I dyspnea. There were no prior episodes reported. The patient was vitally stable with bilateral clubbing. On cardiopulmonary auscultation, a prominent parasternal heave, loud P2, and right lung crepitus were noted. A complete blood count revealed an elevated hemoglobin and RBC count. An ECG revealed sinus tachycardia and right ventricle (RV) strain. ECHO confirmed these findings, as dilated right atrium (RA) and RV, mild tricuspid valve regurgitation (TR), and severe pulmonary hypertension were noted. CT of the chest demonstrated multiple ground glass opacities, right lung consolidation, and volume loss suggestive of right-sided pneumonia with atelectasis. CT also proved the presence of PDA and an anomalous origin of the right pulmonary artery from the right ascending aorta, causing compression of the right main bronchus. We show the clinical and radiological findings and discuss the implications and approach to this rare congenital cardiovascular malformation, as well as how a patient-centered approach is necessary for its management.
Combined treatment for a rare malignant glomus tumor of the esophagus with pulmonary and liver metastases: a case report and review of literature
Authors: Yanan Liu, Jingjing Mao, Dongfeng Shen, Baoli Jin, Xueqin Wu, Congcong Song, Wenjing Du
Journal: Front Oncol (2024)
Keywords: anlotinib, case report, esophageal, immunotherapy, malignant glomus tumor
MeSH terms: Case Reports

Background:
Glomus tumors are typically benign soft tissue tumors that occur at the extremities; malignant and viscerally occurring cases are extremely rare.
Case presentation:
We report a 49-year old male patient with a malignant esophageal glomus tumor that was complicated by lung and liver metastases. Genetic test results guided the patient's individualized treatment. Consequently, treatment with Anlotinib combined with Tislelizumab achieved significant clinical benefits.
Conclusion:
Our case report demonstrates that immunotherapy combined with anti-angiogenic therapy in patients with malignant esophageal glomus tumors can achieve significant efficacy and suggests the potential value of next-generation sequencing (NGS) detection in guiding personalized treatments in patients with malignant esophageal glomus tumors.
Incomplete vascular ring of the aortic arch presenting with dysphagia in an adult: case report
Authors: Ndubueze Ezemba, Augustine Chukwudi Onuh, Uchenna Simon Onoh
Journal: Pan Afr Med J (2023)
Keywords: vascular ring, aberrant right subclavian artery, aortic arch anomaly, case report, dysphagia lusoria
MeSH terms: Cardiovascular Abnormalities / complications, Cardiovascular Abnormalities / diagnosis, Cardiovascular Abnormalities / surgery, Deglutition Disorders / diagnosis, Deglutition Disorders / etiology, Vascular Ring / complications, Case Reports, Adult, Aorta, Thoracic / surgery, Humans, Male, Subclavian Artery / abnormalities, Aberrant subclavian artery

Anomalies of the arterial branches of the arch of the aorta are rare, with the aberrant right subclavian artery being the most common of this anomaly. Majority of the anomalies are asymptomatic and often discovered as incidental findings. In the great majority of the symptomatic cases, the presentation may be either with breathlessness or dysphagia or both. This is in addition to the nature of the intrinsic arterial disease of the aberrant vessel, especially in adult patients; and unless borne in mind, the diagnosis is often missed leading to delays and wrong treatment. In this report we present a case of dysphagia in an adult male Nigerian initially diagnosed as œsophageal stricture from herbal potion ingestion but review of his imaging investigations gave a final diagnosis of dysphagia lusoria from an aberrant right subclavian artery. The difficulty in making a diagnosis and the need for a multidisciplinary review of the imaging investigations are highlighted. The patient was successfully treated by a combined trans-thoracic and cervical approach with division and re-implantation of the aberrant vessel unto the right common carotid artery. He has remained symptom-free for 2 years after surgery. Although the great majority of these anomalies are often asymptomatic, it is important they are borne in mind both in imaging investigations as well as in procedures involving structures in the upper visceral mediastinum. Various surgical approaches have been documented in the management of symptomatic ones; it is however recommended that options that ensure revascularization of the affected limb be selected.
Case report: A case report of co-morbidity of cervical intraepithelial neoplasia III and urethral cancer associated with HPV16
Authors: San Zhu, Yuhao Liu, Ce Bian, Yan Luo, Manman Zhu, Lingyun Yang
Journal: Front Oncol (2024)
Keywords: cancer diagnosis, cervical intraepithelial neoplasia iii, human papillomavirus, lymph nodes metastasis, urethral squamous cell carcinoma
MeSH terms: Case Reports

In this report, we present a case of a woman with concurrent cervical intraepithelial neoplasia grade III (CIN III) and urethral cancer, both associated with HPV16 infection. This unique case was initially brought to attention due to postmenopausal vaginal bleeding, despite the absence of urological symptoms and negative tumor markers. An unexpected discovery of pelvic lymph node metastasis during a hysterectomy intended for CIN III highlighted the rare coexistence of these conditions, with urethral cancer also linked to HPV-16 within the urethral lesion. This case emphasizes the diagnostic challenges faced by HPV-related cervical lesions and the critical need for increased vigilance, even when urological symptoms are not apparent. The findings underline the potential complexity of HPV-associated lesions and advocate for comprehensive screening strategies to ensure the timely detection and management of such intricate cases.
Unveiling the Metabolic Maze: FDG PET/CT Findings in Peritoneal Carcinomatosis - A Case Series
Authors: Vijay Singh, Dinesh Srivastava, Neha Kotarya, Manish Ora, Prasanta Kumar Pradhan
Journal: Asia Ocean J Nucl Med Biol (2024)
MeSH terms: Case Reports

Peritoneal carcinomatosis (PC), the spread of cancer cells in the peritoneum, is a significant concern in advanced gastrointestinal and gynecological cancers. This case series includes findings on the appearance and pattern of PC on 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT). The primary sources of peritoneal dissemination are direct invasion from abdominal or pelvic tumors and metastatic spread from distant tumors. The accurate preoperative diagnosis and quantification of PC play a vital role in determining the appropriate treatment approach, with a particular emphasis on surgical planning. Several imaging modalities have been employed in preoperative evaluation, such as computed tomography (CT), magnetic resonance imaging (MRI), and 18F-FDG PET/CT. Among these modalities, 18F-FDG PET/CT has demonstrated improved anatomical localization and accurate information about the nature of pathological findings. The case series showcases four cases that illustrate the imaging characteristics of PC on FDG PET/CT. FDG PET/CT plays a vital role in diagnosing and assessing PC, aiding in its detection, staging, and treatment planning. It surpasses conventional imaging techniques in identifying and characterizing lesions and detecting the primary tumor site in cases where its location is unknown. Furthermore, FDG PET/CT additionally assists in evaluating treatment response and monitoring disease progression, providing insights into treatment effectiveness and guiding patient management decisions.
Case Report: Post-traumatic splenosis and potential pitfall for PSMA-PET
Authors: Marina Nearchou, Elizabeth Georgiou, Alexis Vrachimis, Konstantinos Ferentinos, Iosif Strouthos
Journal: Front Nucl Med (2023)
Keywords: 18f-psma pet/ct, 99mtc-sulphur colloid spect, ectopic splenic tissue, false positive, prostate cancer, splenosis
MeSH terms: Case Reports

Background:
18F-prostate specific membrane antigen (PSMA) PET is fast becoming the gold-standard in prostate cancer, both in staging of intermediate-/high-risk patients and in re-staging patients with biochemical failure. Several pitfalls of 18F-PSMA PET have been reported, and we report, to our best of knowledge, for the first time, a case which could have been falsely diagnosed as peritoneal spread.
Case presentation:
A 67-year-old patient with high-risk prostate cancer underwent staging with 18F-PSMA-1007 PET/CT (PSMA-PET/CT). PSMA-PET/CT revealed a histologically confirmed prostatic malignancy in the peripheral left zone. Unexpectedly, additional multiple highly PSMA-expressing intraabdominal formations were discovered. Based on apparent anatomic asplenia and a history of traumatic splenic rapture during childhood, a suspicion of post-traumatic splenosis was raised. For further non-invasive evaluation, a C-99 sulphur colloid scintigraphy with SPECT was conducted, confirming the presence of multiple functional ectopic splenic tissues. This is, to our best of knowledge, the first case utilising 18F-PSMA-1007-PET/CT and 99mTc-sulphur colloid SPECT to detect intraabdominal splenosis, highlighting the high potential of nuclear medicine in such trivial cases.
Viral Myositis Secondary to Influenza A in a Preschool Child in Saudi Arabia: A Case Report
Authors: Rawia F Albar, Rahaf A Hubayni, Raghad A Aldahhas, Elaf I Khshwry
Journal: Cureus (2024)
Keywords: ck, influenza a virus, pediatric, upper respiratory tract infection, viral myositis
MeSH terms: Case Reports

Infective myositis is a rare complication of viral infection, occurring most commonly in children. Here, we present the first case report in Saudi Arabia that describes a four-year-old healthy female who presented to the emergency department with a history of fever associated with coryzal symptoms for four days and a one-day history of bilateral lower limb pain and an inability to walk without assistance. Lower limb pain was not associated with joint pain, swelling, or skin rashes. The respiratory virus panel was positive for influenza A, and she was found to have increased levels of creatine kinase (CK). The patient was diagnosed with viral myositis secondary to influenza type A infection and was admitted for dehydration. She was treated successfully with supportive measures and oseltamivir. The patient's condition improved three days after the initial presentation and was discharged and followed up to ensure resolution. Extensive laboratory assessment and hospitalization can often be deemed unnecessary, given that the majority of cases of viral myositis carry a positive prognosis and are self-limiting. Therefore, it is important to consider viral myositis as a potential diagnosis for a child presenting with difficulties walking, particularly if these symptoms arise following a respiratory infection.
Long-term follow-up of complete remission in a patient with advanced hepatocellular carcinoma treated with sorafenib: a case report
Authors: Gordan Adžić, Juraj Prejac, Stjepko Pleština
Journal: Front Oncol (2023)
Keywords: case report, complete response, hepatocellular carcinoma, sorafenib, tyrosine-kinase inhibitor
MeSH terms: Case Reports

Introduction:
Hepatocellular carcinoma (HCC) accounts for approximately 90% of primary liver cancer and can be caused by well-known risk factors, including infection with hepatitis B and C viruses, alcohol intake, and metabolic syndrome. The overall prognosis remains poor with a median survival of 1 year for symptomatic advanced-stage cases treated with systemic therapies.
Case description:
In July 2020, a 73-year-old male patient presented at our institution with mild abdominal pain and an attack of intense cold. After a radiological workup, the diagnosis of HCC located in the caudate lobe was established. The patient underwent atypical caudate lobe resection, and pathology confirmed the diagnosis of grade 3 HCC. Postoperative MRI showed a new metastasis in the 6th liver segment 1.3 cm in diameter, and a PVT progression which now affected the whole right lobe. The patient was started on sorafenib and demonstrated a complete response which still lasts for more than two years.
Conclusion:
We present a rare case of a patient who demonstrated a complete response to sorafenib treatment in advanced HCC with unfavorable prognostic factors.
Case report: Recurrence of primary hepatic neuroendocrine tumors after resection of liver segments IV in 8 years follow-up
Authors: Chunli Li, Li Bian, Guangtao Fan, Yilong Huang, Jiang Li, Bo He
Journal: Front Med (Lausanne) (2024)
Keywords: case report, follow-up, liver, neuroendocrine tumors, recurrence
MeSH terms: Case Reports

Background:
Primary hepatic neuroendocrine tumors (PHNETs) are an utterly rare entity. The diagnosis of PHNETs could legitimize when an extrahepatic primary NET must always be excluded. PHNETs can achieve a high survival rate after complete surgical resection, however, most patients still have an 18% risk of recurrence within 5 years after surgery. In our case, the recurrence occurred 8 years after the first hepatectomy, which is relatively rare in the current literature. Therefore, rigorous postoperative follow-up is necessary for early detection and timely treatment of recurrent PHNETs.
Case information:
We report a case of PHNET in a 24-year-old previously healthy female patient who relapsed 8 years after hepatectomy. This case focuses on the importance of diagnosis of primary and recurrent PHNETS in young patients, rare pathological types, and post-operative follow-up.
Conclusion:
This case report detailed the rare pathological morphology and characteristic immunohistochemical markers in our case for PHNETS, which enhanced the new understanding of the diagnosis of this entity. In addition, we also highlighted the variable duration of recurrence after treatment of PHNETs. The 8-year recurrent period in our case suggests the importance of regular examination in patients with PHNETs by following the doctor's instructions.
Navigating P2Y12 inhibition in the labyrinth of cardio-oncology care: cangrelor bridging in patients with cancer
Authors: Abdelrahman Ali, Poonam Jewani, Max Bourdillon, Efstratios Koutroumpakis, Shaden Khalaf, Konstantinos Charitakis, Kara Thompson, Konstantinos Marmagkiolis, Anita Deswal, Cezar Iliescu
Journal: Front Cardiovasc Med (2024)
Keywords: p2y12 inhibitors, bridging, cangrelor, coronary artery disease, thrombocytopenia
MeSH terms: Case Reports

Cangrelor, a potent intravenous P2Y12 platelet inhibitor, has demonstrated effectiveness in reducing ischemic events without a corresponding increase in severe bleeding during percutaneous coronary intervention, as evidenced by the CHAMPION-PHOENIX trial. Its off-label role as a bridging antiplatelet agent for patients facing high thrombotic risks who must temporarily stop oral P2Y12 inhibitor therapy further underscores its clinical utility. This is the first case series to shed light on the application of cangrelor in cancer patients needing to pause dual antiplatelet therapy for a range of medical interventions, marking it as a pioneering effort in this domain. The inclusion of patients with a variety of cancer types and cardiovascular conditions in this series underlines the adaptability and critical role of cangrelor in managing the dual challenges of bleeding risk and the need for uninterrupted antiplatelet protection. By offering a bridge for high-risk cancer patients who have recently undergone percutaneous coronary intervention and need to halt oral P2Y12 inhibitors temporarily, cangrelor presents a practical solution. Early findings indicate it can be discontinued safely 2-4 h before medical procedures, allowing for the effective reintroduction of oral P2Y12 inhibitors without adverse effects. This evidence calls for expanded research to validate and extend these preliminary observations, emphasizing the importance of further investigation into cangrelor's applications in complex patient care scenarios.