OpenMed/multicare-articles huggingface dataset:
Cystic lung tuberculosis in children: A series of five cases
Authors: Chetna Mishra, Pooja Abbey, Rama Anand, Varinder Singh, Ravinder Kaur
Journal: SA J Radiol (2023)
Keywords: tb, cystic lung disease, pneumothorax, pulmonary tuberculosis, pulmonary tuberculosis in children
MeSH terms: Case Reports

Frequent imaging manifestations of pulmonary tuberculosis are airspace or interstitial nodules with or without tree-in-bud nodules, consolidation, cavitation, ground glass opacity, miliary nodules, lymphadenopathy and pleural effusion. It is unusual to encounter cystic changes in patients with pulmonary tuberculosis, and these findings should be differentiated from other cystic lung diseases. This case series describes five cases of cystic lung disease in children with tuberculosis (TB) with illustrative chest radiography and CT findings.
Contribution:
The manuscript highlights the need to consider tuberculosis as a possible cause of acquired cystic lung disease in appropriate clinical settings, particularly in endemic regions.
Clinicopathological Analysis of Bronchiolar Adenoma Lined Purely by Mucinous Luminal Cells
Authors: Guangjie Liao, Xinke Zhang
Journal: Case Rep Pathol (2023)
MeSH terms: Case Reports

Bronchiolar adenoma (BA) is a rare lung tumor that has recently been clearly named, including the previous ciliated muconodular papillary tumor (CMPT) and the so-called nonclassical CMPT. The most prominent histological feature of BA is a double-layer cell structure composed of a continuous basal cell layer and a luminal cell layer. BA lined purely by mucinous luminal cells is very rare, and only one case has been reported in the English literature. This type of BA can easily be misdiagnosed as early mucinous adenocarcinoma. This article analyzes the clinicopathological characteristics of a newly discovered case of BA lined purely by mucinous luminal cells and fully integrated with the literatures.
Refractory Cytomegalovirus Colitis in Common Variable Immunodeficiency Requiring Total Colectomy
Authors: Sulaiman Almushir, Faisal Aljohani, Abdulrahman Qatomah
Journal: Case Rep Gastrointest Med (2023)
MeSH terms: Case Reports

Cytomegalovirus (CMV) colitis is an uncommon infection in immunocompetent hosts, usually occurring in the presence of an underlying immunodeficiency condition that allows for the reactivation of latent CMV infection. CMV colitis typically presents with persistent diarrhea, sometimes accompanied by bloody stools and nonspecific abdominal pain. We present the case of a 76-year-old woman known to have chronic CMV colitis, which was diagnosed in the context of underlying common variable immunodeficiency (CVID). Despite multiple attempts at managing CMV colitis, her symptoms persisted over the years. Ultimately, the patient required a pan colectomy due to refractory CMV colitis.
Chronic Lithium Intoxication: A Challenging Diagnosis
Authors: Sofia Ferreira, Sara Santos, Sérgio Gomes Ferreira, Luís Fernandes, Penélope Almeida
Journal: Cureus (2024)
Keywords: bipolar disorder, chronic renal insufficiency, diabetes insipidus nephrogenic, lithium carbonate, toxicity
MeSH terms: Case Reports

Lithium has been used in clinical practice since the 1970s. This medication is commonly used to treat and prevent bipolar disorder, but it has a narrow therapeutic index, making toxicity a frequent occurrence. Chronic lithium intoxication can arise due to progressive accumulation, particularly in contexts of dehydration. The effects of chronic lithium intoxication on the nervous, renal, and cardiac systems, as well as on the thyroid and parathyroid glands, are well documented in the literature. The authors present the case of a 66-year-old woman with schizoaffective psychosis and chronic kidney disease, admitted due to altered mental status and dysarthria. Notwithstanding an earlier clinical recommendation to cease lithium administration more than a year ago, the patient continued its usage, culminating in neurological, cardiac, renal, and endocrine manifestations. Although the diagnosis was delayed, her clinical progression was favorable, obviating the need for renal replacement therapy. This case highlights the importance of a detailed medical history and the diagnostic challenges in clinical practice. The use of this drug without proper monitoring can lead to multisystem dysfunction.
Creatures Great and Small: Horse and Dog Allergy Cross-Reactivity
Authors: Graey Wolfley, Brittanie Neaves, Christopher Coop
Journal: Cureus (2024)
Keywords: cross-reactivity, dog, horse, immunotherapy, military
MeSH terms: Case Reports

Cat, dog, and horse aeroallergens can cause allergic disease in susceptible individuals. Allergy cross-reactivity occurs when the body recognizes the protein of one allergen as being similar to a different protein, leading to an allergic response. Cross-reactivity has been demonstrated among animal species such as cat, dog, and horse. These allergens fall into the same protein families, with the lipocalin family predominating. We present a case demonstrating cross-reactivity among cat, dog, and horse allergens. Additionally, our case highlights the difficulty of managing and receiving allergen immunotherapy within the military health system due to the disruption of therapy due to frequent moves and temporary duty assignments.
Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series
Authors: Taofan Taofan, Iwan Dakota, Achmad Hafiedz Azis Kartamihardja, Jonathan Edbert Afandy, Suci Indriani, Suko Adiarto
Journal: F1000Res (2024)
Keywords: below the knee, complication, endovenous laser ablation, laser power, outcome, venous leg ulcer
MeSH terms: Laser Therapy / methods, Saphenous Vein / surgery, Case Reports, Comment, Aged, Endovascular Procedures / methods, Female, Humans, Leg Ulcer / surgery, Male, Middle Aged, Treatment Outcome, Varicose Ulcer / surgery

Background:
Active venous leg ulcer (VLU) is the most severe manifestation of chronic venous disease which not only affects patients' health, but also decreases the quality of life, and delivers economic burdens. Treatment of superficial venous reflux with early endovenous laser ablation (EVLA) has been associated with reducing ulcer recurrence levels and promoting faster VLU healing. We reported three cases of patients with active VLU undergoing EVLA with different approaches.
Case illustration:
Three patients came with complaint of leg ulcer, diagnosed with C6sEpAsdPr, with venous clinical severity scores (VCSS) of 15, 23, and 22 respectively. Severe great saphenous veins (GSV) reflux was found in all patients by duplex ultrasound examination. The second patient had undergone above-the-knee EVLA. All patients underwent EVLA using 1470-nano meter wavelength laser device and ELVeS radial fiber (Biolitec, Bonn, Germany). The laser energy protocol used was 6 W linear endovenous energy density (LEED) 50 J/cm for proximal until media ATK GSV ablation, 5 W LEED 40 J/cm for media ATK until proximal below-the-knee (BTK) GSV, and 2 W LEED 20 J/cm for proximal until distal BTK GSV. The third patient was also treated with EVLA for small saphenous vein severe reflux. Follow-up until 6 months post-EVLA showed significant healing of the ulcer with 14, 16, and 17 VCSS reduction consecutively without any complication.
Conclusion:
We've reported three cases of patients with active VLU undergoing EVLA until BTK with significant results. The EVLA of GSV until BTK where there is still significant reflux is safe and provides satisfactory results in patients with VLU.
Case report: Early use of whole exome sequencing unveils HNRNPU-related neurodevelopmental disorder and answers additional clinical questions through reanalysis
Authors: Erika Nicole Dreikorn, Christine Munro, Natasha Robin Berman, Amina Kunovac, Daniel Bellissimo, Mylynda B Massart
Journal: Front Genet (2024)
Keywords: hnrnpu gene mutation, clinical utility, diagnostic odyssey, genome sequencing technologies, interdisciplinary collaboration, neurodevelopmental disorder (ndd), precision medicine, whole exome sequencing (wes)
MeSH terms: Case Reports

This case report chronicles the diagnostic odyssey and resolution of a 27-year-old female with a complex neurodevelopmental disorder (NDD) using Whole Exome Sequencing (WES). The patient presented to a precision medicine clinic with multiple diagnoses including intellectual disability, autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), tics, seizures, and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Although this patient previously had chromosomal microarray and several single-gene tests, the underlying cause of this patient's symptoms remained elusive. WES revealed a pathogenic missense mutation in the HNRNPU gene, associated with HNRNPU-related neurodevelopmental disorder (HNRNPU-NDD) and developmental and epileptic encephalopathy-54 (DEE54, OMIM: # 617391). Following this diagnoses, other treating clinicians identified additional indications for genetic testing, however, as the WES data was readily available, the clinical team was able to re-analyze the WES data to address their inquiries without requiring additional tests. This emphasizes the pivotal role of WES in expediting diagnoses, reducing costs, and providing ongoing clinical utility throughout a patient's life. Accessible WES data in primary care settings can enhance patient care by informing future genetic inquiries, enhancing coordination of care, and facilitating precision medicine interventions, thereby mitigating the burden on families and the healthcare system.
Electrical burn-induced vocal cord injury: insights from a case report and literature review
Authors: José Fonseca, Jorge Garza, Mauricio García, Karen Aguirre, Haya Alotaibi, Hatan Mortada
Journal: Case Reports Plast Surg Hand Surg (2024)
Keywords: electrical injuries, burn, electrical burn injury, high voltage, vocal cord complications
MeSH terms: Case Reports

We report a rare case of vocal cord injury from an electrical burn, managed successfully with conservative, non-invasive treatment. This unique case illustrates potential complications of electrical trauma and underscores the need for vigilance and consideration of conservative management approaches.
Ischial Tuberosity Avulsion Fracture Mimicking Calcified Mass on Plain Films: A Case Report
Authors: Mason A Williams, Lena Naffaa
Journal: Cureus (2024)
Keywords: avulsion, avulsion fracture, calcified mass, ischial tuberosity, mri pelvis, pediatric radiology, sports related injuries
MeSH terms: Case Reports

Ischial tuberosity avulsion fractures are overall uncommon but are known injuries in the adolescent population. They are the result of sudden, forceful contraction of the hamstring muscle groups. The characteristic radiographic appearance of an ischial tuberosity avulsion fracture is of an irregular ischial margin and a nearby avulsed bone fragment. Callous formation may ensue and appears as a calcific density in the region of injury. Awareness of the spectrum of radiographic presentations can help ensure correct diagnosis and minimize concern for alternative underlying diagnoses. This case report describes a 14-year-old boy with a chronic ischial tuberosity avulsion fracture which demonstrated an unusual presentation on radiographs and required MRI to confirm the diagnosis and rule out other potentially ominous pathology.
Radiologic-pathologic autopsy correlation of an internal watershed infarct, a case report
Authors: Thomas Dimitrios Zaikos, David M Yousem, Juan C Troncoso, James Stephen Nix
Journal: Autops Case Rep (2023)
Keywords: internal watershed, autopsy, infarction, neuropathology
MeSH terms: Case Reports

Internal watershed infarcts (IWIs) occur at the junction of the deep and superficial perforating arterial branches of the cerebrum. Despite documentation in the radiology literature, IWIs are rarely encountered at the time of autopsy. Here, we report the case of a 59-year-old incarcerated male who was brought to the emergency department after being found unresponsive on the floor of his jail cell. Initial examination and imaging demonstrated right-sided hemiplegia, aphasia, right facial droop, and severe stenosis of the left middle cerebral artery, respectively. Repeat imaging 4 days after admission and 26 days before death demonstrated advanced stenosis of the intracranial, communicating segment of the right internal carotid artery, a large acute infarct in the right posterior cerebral artery territory, and bilateral deep white matter ischemic changes with a right-sided "rosary-like" pattern of injury that is typical of IWIs. Postmortem gross examination showed that the right deep white matter lesion had progressed to a confluent, "cigar-shaped" subacute IWI involving the right corona radiata. This is the first well-documented case of an IWI with radiologic imaging and photographic gross pathology correlation. This case uniquely highlights a rarely encountered lesion at the time of autopsy and provides an excellent visual representation of internal watershed neuroanatomy.
Hidden family rules: perspective on a dysfunctional paternalistic system and the persistence of pain
Authors: Matt Hudson, Mark I Johnson
Journal: Front Pain Res (Lausanne) (2023)
Keywords: split-second unlearning, dysfunctional paternalistic system, emotional memory image (emi), family, family rule, folie à deux, pain, painogenicity

This article explores how paternalistic control and power reside within the family system and how this may influence pain and its persistence. Drawing upon clinical case studies and existing literature, this exploration emphasises the role of paternal dysfunction in creating emotional memory images and delves into how this may influence the chronification and treatment resistance of pain (i.e., making pain "sticky"). We argue that a dysfunctional paternalistic family system, often characterised by authoritarian dynamics, emotional neglect, and abuse, results in adverse experiences and emotional memory images that create a fertile ground for the entrenchment and propagation of psychosomatic symptoms, including pain. Further, the paper emphasizes the potential intergenerational effects of such a scenario, where inherited "Family Rules" drive maladaptive coping mechanisms, which contribute to the persistence of psychological and physiological distress across generations. Understanding these complexities offers new perspectives on treating psychological disorders and their physiological ramifications. It also highlights the urgency of addressing dysfunctional familial dynamics in psychotherapeutic interventions for both immediate and long-term psychophysiological health outcomes.
Simultaneous Intrusion and Retraction of Maxillary Anterior Teeth in Class II Malocclusion Using the Kalra Simultaneous Intrusion and Retraction (K-SIR) Loop: A Case Report
Authors: Shefali Singh, Rizwan Gilani, Shruti Rathi
Journal: Cureus (2024)
Keywords: intrusion, k-sir loop, loops, retraction, space closure
MeSH terms: Case Reports

The straight-wire device offers the best finishing potential and control. This case study focuses on the treatment of severe deep bite and Class II malocclusion involving first premolar extraction of the upper arch using a Kalra Simultaneous Intrusion and Retraction loop. Using minimal force and creating enough space for anterior teeth to retract while maintaining the Class II molar relationship was the aim of the therapy. Due to the unsightly excessive maxillary incisor showing at rest, the decision was made to intrude anterior teeth to treat a deep overbite. Good and consistent changes occurred post-treatment.
Successful perioperative preparation of a child with autism spectrum disorder in collaboration with his school for special needs education: a case report
Authors: Yuto Arai, Tohru Okanishi, Yuko Nakamura, Yoshihiro Maegaki
Journal: Front Psychiatry (2024)
Keywords: autism spectrum disorder, parents, perioperative management, school cooperation, school for special need education, school information, unique behavior
MeSH terms: Case Reports

Introduction:
The incidence of autism spectrum disorder (ASD) in children is greater than 1%. Children with ASD show an increased rate of hospital contact for several reasons. Perioperative preparation for children with ASD can be challenging; therefore, obtaining information from patients' families prior to surgery is important. However, no previous reports have described the collection of information from educational facilities.
Case report:
A 12 years-old male patient with ASD was referred for surgery for traumatic dislocation of the left knee joint. Before admission, we obtained valuable information from his parents regarding expected behavioral problems and coping strategies during hospitalization and from his teachers at his school for special needs education. In particular, the information obtained from teachers was specific and practical. Consequently, we could effectively conduct perioperative management based on his specific autistic characteristics.
Conclusion:
We report a pediatric case of ASD in which favorable perioperative management was successfully achieved by collecting information before admission from family members as well as teachers at the patient's school for special needs education. This management may help in future hospital admissions for children with autism.
Medication-Related Osteonecrosis of the Jaw: A Case Report of an Unusual Side Effect of Adalimumab
Authors: Laura Sisalli, Francesco Giordano, Andrea Chiacchio, Alfonso Acerra, Mario Caggiano
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Background:
Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse drug reaction characterized by progressive bone destruction and necrosis of mandibular and/or maxillary jaw bone that occurs in patients undergoing treatments with antiresorptive drugs such as bisphosphonates or denosumab, antiangiogenic agents such as bevacizumab, or other kinds of monoclonal antibodies such as rituximab and ipilimumab, for different oncologic and nononcologic diseases. The aim of this study was to report a case of MRONJ in a patient affected by rheumatoid arthritis disease in treatment with adalimumab. Case Presentation. A 70-year-old female patient affected by rheumatoid arthritis (RA), who had been undergoing adalimumab (40 mg subcutaneous injection) every two weeks for 5 years, with no history of antiresorptive or antiangiogenic agent administration, came to our attention for intraoral necrotic bone exposures of the anterior mandible. After drug withdrawal and antibiotic cycles, the patient underwent surgical treatment with bone resection and debridement of necrotic tissues. After an observation period of 8 months, a complete healing without signs of recurrence was detected.
Conclusions:
Based on this study, a correlation between adalimumab and MRONJ is possible. Therefore, we believe that an oral cavity examination should be done in every patients, before starting therapy with adalimumab, to possibly avoid MRONJ onset. Further studies are required to confirm the role of adalimumab in MRONJ.
Case Report: A rare case of recurrent ascites after anti-Claudin18.2 antibody therapy for metastatic gastric cancer while responding sustainingly
Authors: Jinlu Liu, Dan Jiang, Qingqiang Lei, Qing Zhu, Hong Zhu
Journal: Front Oncol (2023)
Keywords: claudin182, adverse effect, gastric cancer, monoclonal antibody, targeted therapy
MeSH terms: Case Reports

Background:
Gastric cancer remains one of the deadliest malignancies in the world, thus urgently requiring effective and safe therapeutics. Claudin18.2 is a member of the tight junction protein family specifically expressed in gastric cancer cells. Monoclonal antibodies targeting Claudin18.2 have been receiving increasing attention recently. ASKB589 is a humanized monoclonal antibody targeting Claudin18.2.
Case presentation:
This case described a 65-year-old Chinese man diagnosed with gastric cancer metastasizing to the liver and multiple lymph nodes. The biomarker examination revealed that he had proficient mismatch repair (pMMR), human epidermal growth factor receptor 2 (HER2) was negative, and the combined proportion score (CPS) of PD-L1 (22C3) was 1. After being proven to be moderately positive for Claudin18.2 expression, he received ASKB589 and CAPOX (oxaliplatin and capecitabine) chemotherapy. After a six-cycle therapy (from 14 July 2022 to 29 November 2022), the target tumor was evaluated for partial response (PR) by the investigator based on the enhanced CT scan according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. However, this patient also suffered from intolerable ascites that gradually aggravated during the therapy, which was not controlled well by the supporting therapy. Therefore, the patient stopped receiving the combined therapy in our hospital and did not receive any other anti-tumor treatment. After 4 months of discontinuation of the drug, the patient's ascites almost disappeared, while the tumor continued to reduce and almost achieved clinically complete relapse (cCR). His progression-free survival (PFS) reached at least 10 months.
Conclusion:
This is the first case of severe ascites reported after anti-Claudin18.2 monoclonal antibody treatment for advanced gastric cancer. At the same time, the patient still benefited significantly from this incomplete treatment even after discontinuation of the drug and the PFS reached at least 10 months. The ascites might be an immune adverse effect related to the monoclonal antibody-induced antibody-dependent cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC). Further mechanisms remain to be investigated.
Female vs. male relative fatality risk in fatal motor vehicle crashes in the US, 1975-2020
Authors: Mitchell Z Abrams, Cameron R Bass
Journal: PLoS One (2024)
MeSH terms: Accidents, Traffic, Automobiles, Case Reports, Adolescent, Adult, Female, Humans, Male, Motor Vehicles, Risk, Seat Belts, Sex Characteristics, United States / epidemiology, Young Adult

Motor vehicle accidents are the leading cause of death for young adults 18-29 years old worldwide, resulting in nearly 1 million years of life lost annually in the United States. Despite improvements in vehicle safety technologies, young women are at higher risk of dying in car crashes compared with men in matched scenarios. Vehicle crash testing primarily revolves around test dummies representative of the 50th percentile adult male, potentially resulting in these differences in fatality risk for female occupants compared to males. Vehicle occupants involved in fatal car crashes were matched using seating location, vehicle type, airbag deployment, seatbelt usage, and age. The relative risk for fatality (R) between males and females was calculated using a Double Pair Comparison. Young women (20s-40s) are at approximately 20% higher risk of dying in car crashes compared with men of the same age in matched scenarios. In passenger cars, 25-year-old female occupants in passenger car crashes from 1975-2020 exhibit R = 1.201 (95% CI 1.160-1.250) compared to 25-year-old males, and R-1.117 (95% CI 1.040-1.207) for passenger car crashes from 2010-2020. This trend persists across vehicle type, airbag deployment, seatbelt use, and number of vehicles involved in a crash. Known sex-based differences do not explain this large risk differential, suggesting a need for expanded test methodologies and research strategies to address as-yet unexplored sex differences in crash fatalities. These differences should be further investigated to ensure equitable crash protection.