OpenMed/multicare-articles huggingface dataset:
Sclerosing Angiomatoid Nodular Transformation of the Spleen: An uncommon Cause of Abdominal Pain
Authors: Hakan Atas, Hakan Bulus, Göhan Akkurt
Journal: Euroasian J Hepatogastroenterol (2017)
Keywords: abdominal pain, sclerosing angiomatoid nodular transformation, spleen, splenectomy
MeSH terms: Case Reports

Sclerosing angiomatoid nodular transformation (SANT) is a rare and benign lesion arising from the red pulp of the spleen, with an unknown etiopathogenesis. These tumors are usually asymptomatic or cause nonspecific abdominal pain. Most SANTs are found incidentally on radiographic examination, or during surgery for an unrelated condition. Therefore, high clinical suspicion is of great importance for the diagnosis. Splenectomy provides complete cure, and no recurrence and/or malignant transformation was reported to date. In this study, a rare case of SANT was reported in a young adult male, and was discussed with the relevant literature. How to cite this article: Atas H, Bulus H, Akkurt G. Sclerosing Angiomatoid Nodular Transformation of the Spleen: An uncommon Cause of Abdominal Pain. Euroasian J Hepato-Gastroenterol 2017;7(1):89-91.
Endoscopic meatotomy in the treatment of ureterocele: results in adult patients
Authors: Amine Oueslati, Ahmed Saadi, Marouene Chakroun, Selim Zaghbib, Abderrazak Bouzouita, Amine Derouiche, Mohamed Riadh Ben Slama, Haroun Ayed, Mohamed Chebil
Journal: Pan Afr Med J (2020)
Keywords: ureterocele, adult, endoscopy, meatotomy
MeSH terms: Endoscopy / methods, Postoperative Complications / epidemiology, Ureterocele / surgery, Urologic Surgical Procedures / methods, Case Reports, Adult, Aged, Female, Follow-Up Studies, Humans, Length of Stay, Male, Middle Aged, Operative Time, Retrospective Studies, Vesico-Ureteral Reflux / etiology, Young Adult

To evaluate the efficacy of endoscopic meatotomy in the treatment of ureterocele in adults. A retrospective study of adult patients with ureterocele, treated between January 1987 and December 2014. In 47 patients, 55 intravesical ureteroceles were diagnosed and classified as 18 right, 21 left and eight bilateral (38%, 44% and 17% respectively). According to the Bruézière classification, 41 (75%) ureteroceles were type A and 14 (25%) others were type C. These ureteroceles were complicated by calculus formation in 22 cases, moderately dilated excretory pathways in 16 cases and both complications in a total of 9 cases. Four patients had a complicated ureterocele with pyelonephritis, one of which was emphysematous. The endoscopic treatment was performed in cases of complicated and/or symptomatic ureteroceles. Fifty one cases were treated by a "smiling mouth" meatotomy consisting in a transverse horizontal incision, with the treatment of any associated complication. The mean operative time was 35 minutes (10-90). The operative follow-up was uneventful in 42 patients and complications occurred in 5 patients (2 urinary retentions, 2 infectious complications and one hematuria). The mean duration of postoperative stay was 1-2 days. The mean follow-up was 15 months. Four patients developed vesicoureteral reflux and no stenosis was noted. The endoscopic incision of the ureteroceles seems today, after reviewing the results, to be a good treatment of adult ureterocele. It is a simple, minimally invasive and has a low morbidity rate.
Case report: Anti- N-methyl-D-aspartate receptor antibody-associated autoimmunity triggered by primary central nervous system B-cell lymphoma
Authors: Yuki Yokota, Makoto Hara, Natsuki Oshita, Tomotaka Mizoguchi, Haruna Nishimaki, Hiroyuki Hao, Hideto Nakajima
Journal: Front Neurol (2023)
Keywords: anti-nmdar antibody, diagnostic criteria, encephalitis, primary central nervous system lymphoma, syndrome
MeSH terms: Case Reports

Background:
We herein detail our experience with a unique patient with a primary central nervous system (PCNS) B-cell lymphoma concomitant with anti-N-methyl-d-aspartate receptor (NMDAR) antibodies that satisfied the criteria of "probable anti-NMDAR encephalitis (ProNMDARE)" based on the Graus criteria 2016.
Case presentation:
A 73-year-old Japanese woman presented with acute pyrexia, agitation, and disturbance of consciousness. She gradually developed a reduction in speech frequency and truncal dystonia causing abnormal posture. Brain magnetic resonance imaging (MRI) demonstrated high-intensity lesions in the bilateral frontal lobes, and her cerebrospinal fluid revealed mild pleocytosis. She was diagnosed with acute encephalitis and treated with acyclovir and intravenous dexamethasone; however, no improvement was observed. She was transferred to our hospital 6 weeks after the onset of her symptoms, and anti-NMDAR antibodies were identified in her cerebrospinal fluid through indirect immunolabeling with rat brain frozen sections and cell-based assays with NR1/NR2 transfected HEK cells. Follow-up MRI showed enlargement of the lesions in the right frontal lobe with gadolinium enhancement, suggesting a brain tumor. Stereotactic surgery was implemented, with subsequent pathological examination revealing that the tumor was consistent with diffuse large B-cell lymphoma (DLBCL) without evidence of systemic satellite lesions. Stereotactic irradiative therapies were then added to her treatment regimen, which partly improved her neurological symptoms with only mild cognitive dysfunction still remaining. A decrease in anti-NMDAR antibody titer was also confirmed after immunotherapy and tumor removal.
Conclusions:
We herein report our experience with a novel case of PCNS-DLBCL masquerading as anti-NMDAR encephalitis that satisfied the diagnostic criteria of "proNMDARE." Treatment, including tumor removal, ameliorated disease severity and antibody titers of the patient. Our findings suggest that anti-NMDAR antibody-associated autoimmunity can be triggered by PCNS B-cell tumors, although primary brain tumors need to be excluded before establishing a diagnosis of autoimmune encephalitis.
Ipilimumab-induced thrombotic thrombocytopenic purpura (TTP)
Authors: Jeanelle King, Javier de la Cruz, Jose Lutzky
Journal: J Immunother Cancer (2017)
MeSH terms: CTLA-4 Antigen / antagonists & inhibitors, Ipilimumab / adverse effects, Melanoma / drug therapy, Purpura, Thrombotic Thrombocytopenic / pathology, Case Reports, Aged, CTLA-4 Antigen / immunology, CTLA-4 Antigen / therapeutic use, Drug-Related Side Effects and Adverse Reactions / immunology, Drug-Related Side Effects and Adverse Reactions / pathology, Female, Humans, Immune System Diseases / chemically induced, Immune System Diseases / pathology, Ipilimumab / administration & dosage, Melanoma / complications, Melanoma / immunology, Melanoma / pathology, Purpura, Thrombotic Thrombocytopenic / chemically induced, Purpura, Thrombotic Thrombocytopenic / diagnosis, T-Lymphocytes / drug effects, T-Lymphocytes / immunology, T-Lymphocytes, Cytotoxic / drug effects, CTLA-4 Antigen, Ipilimumab

Background:
CTLA-4 (Cytotoxic T-lymphocyte-associated protein 4) was the first immune checkpoint receptor clinically targeted for use in cancer treatment. It is expressed exclusively on T-cells where its primary role is to regulate the amplitude of the early stages of T-cell activation.1 Ipilimumab, a CTLA-4 blocking antibody, has been widely used for the treatment of patients with high risk and metastatic melanoma. Given its mechanism of action and consequent immune activation, the side effect profile of this drug greatly differs from that of standard cytotoxic chemotherapy. Adverse events are from the most part immune-mediated, ranging from the more common, such as rash and fatigue, to the less common, such as immune endocrinopathy and colitis.
Case presentation:
We describe a case of immune-mediated thrombotic thrombocytopenic purpura (TTP) in a 68 year-old woman with high risk, stage III melanoma occurring after 3 cycles of adjuvant treatment with ipilimumab as part of a clinical trial.
Conclusion:
The range of immune-mediated adverse events during treatment with ipilimumab is wide and varied and clinicians should have a high degree of suspicion when managing these patients.
Drug-resistant Salmonella Typhi induced kidney injury with rhabdomyolysis: A case report, and literature review
Authors: Fateen Ata, Sandy Kamil Kamal Marzouk, Ammara Bint I Bilal, Adeel Ahmed Khan, Ezzedin Ibrahim, Mohammed Taha Mahmood Almadani
Journal: IDCases (2021)
Keywords: acute kidney injury, enteric fever, rhabdomyolysis, salmonella
MeSH terms: Case Reports

Salmonella Typhi (ST) is a rod-shaped gram-negative bacterium that infects humans via contaminated food or water. Humans are the only reservoirs for the bacteria. Infection usually manifests as fever, abdominal pain, and diarrhea. However, complications such as intestinal perforation, hepatosplenomegaly, and renal injury can occasionally occur. Acute kidney injury (AKI) is associated more commonly with ST than other bacteria causing gastrointestinal (GI) infections. The exact pathophysiology of AKI in ST infection is unknown. One of the rarely reported mechanisms is rhabdomyolysis. We present a similar case of resistant ST infection leading to AKI with rhabdomyolysis. This article also contains an extensive literature reviews of all reported ST bacteremia cases with AKI secondary to rhabdomyolysis.
Patients who achieved long-term clinical complete response and subsequently terminated multidisciplinary and anti-HER2 therapy for metastatic breast cancer: A case series
Authors: Haruko Takuwa, Wakako Tsuji, Fumiaki Yotsumoto
Journal: Int J Surg Case Rep (2018)
Keywords: anti-her2 therapy, clinical complete response, metastatic breast cancer, multidisciplinary therapy, termination of therapy

Background:
Human epidermal growth factor receptor 2 (HER2) -positive breast cancers tend to be more aggressive and more likely to recur than HER2-negative breast cancers. However, novel anti-HER2 therapies have dramatically improved the prognosis of patients with HER2-positive breast cancer.
Case report:
We review the cases of 4 women with metastatic breast cancer who achieved clinical complete response (cCR) and terminated their systemic therapy. Two patients had de novo metastatic disease and two patients experienced relapse after adjuvant therapy. All patients achieved cCR using multidisciplinary therapy, experienced prolonged complete remission, and subsequently terminated their systemic therapy without experiencing secondary recurrence.
Conclusion:
There is no evidence that systemic therapy can be safely terminated after a specific time period, although adverse events (e.g., cardiotoxicity) and unnecessary treatment should be avoided. Thus, it is possible that select patients may be suitable for termination of systemic therapy after they have achieved a prolonged period of cCR.
A solitary hemangioblastoma of the posterior brain fossa: the role of radiotherapy
Authors: Fatima Zahra Abboud, Moulay Ali Youssoufi, Touria Bouhafa, Khalid Hassouni
Journal: Pan Afr Med J (2020)
Keywords: hemangioblastoma, posterior brain fossa, radiotherapy, surgical excision
MeSH terms: Hemangioblastoma / diagnosis, Infratentorial Neoplasms / diagnosis, Case Reports, Adolescent, Combined Modality Therapy, Headache / etiology, Hemangioblastoma / pathology, Hemangioblastoma / therapy, Humans, Infratentorial Neoplasms / pathology, Infratentorial Neoplasms / therapy, Male, Tomography, X-Ray Computed, Vomiting / etiology

We report here the case of a patient admitted for management of posterior fossa cerebral hemangioblastoma. A 16-year-old male patient with a history of intracranial hypertension syndrome consisting of progressively worsening headache, vomiting, especially morning and jet vomiting, and decreased visual acuity. The patient's symptomatology worsened a few days later with the appearance of a disturbance of balance with enlargement of the sustentation polygon. The patient initially benefited from a brain computed tomography (CT) scan that objectified a solidocystic process of the posterior brain fossa. The patient then underwent a surgical excision that was considered partial and the diagnosis of hemangioblastoma was made on the surgical specimen. Since the surgical removal was partial the patient was referred to our training where he received external radiotherapy on his hemangioblastoma of the posterior brain fossa. The patient was examined one month after the end of irradiation; he presented a spectacular improvement in his neurological symptomatology with a clear regression of balance disorders. The standard treatment for cerebellar hemangioblastoma is complete microsurgical removal, but our results show a high level of efficacy for fractional photon radiotherapy after partial surgery of this benign tumour.
Laparoscopic Repair of Morgagni Hernia Combined with Right Hemicolectomy for Bleeding Ascending Colon Carcinoma Lodged within the Chest: A Case Report and Review of the Literature
Authors: Oluwatobi O Onafowokan, Kiran Khosa, Hugo Bonatti
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Background:
Morgagni hernias are rare in adults and may be asymptomatic but, nevertheless, require surgical repair, with laparoscopy offering an excellent option. The colon dislodged into the chest through diaphragmatic hernias may be affected by various disorders, including malignancies. Case Report. A 70-year-old obese male presented with fatigue and shortness of breath. CT scan showed the right colon lodged in the chest through a Morgagni hernia. He was anaemic, and colonoscopy revealed a colon cancer. He underwent combined laparoscopic hernia repair with bioabsorbable mesh and right hemicolectomy. Recovery was uneventful, but the patient died 5 months later from chemotherapy-associated cardiac failure. Literature review revealed eight similar published cases, and including ours, there were seven Morgagni hernias, one traumatic hernia, and one Bochdalek hernia. Median age of the five men and four women was 66 (range 49-85) years. Surgical approach was thoracotomy (2), laparotomy (5), and laparoscopy (2).
Conclusion:
Outcome of the rare condition is determined by the course of the colon cancer. Hernia repair was successful in ours and all other published cases. A combined laparoscopic approach can be safely done.
Territory, neglected diseases and the action of community and endemic combat agents
Authors: Gabriela Soledad Márdero García, Eliana Amorim de Souza, Vigna Maria de Araújo, Mariana Sousa Santos Macedo, Rosélly Mascarenhas Amaral de Andrade, Paulo Rogers da Silva Ferreira, Maria Cristina Soares Guimarães, José Alexandre Menezes da Silva, Alberto Novaes Ramos Júnior
Journal: Rev Saude Publica (2022)
MeSH terms: Chagas Disease / epidemiology, Chagas Disease / prevention & control, Leprosy / drug therapy, Leprosy / epidemiology, Leprosy / prevention & control, Brazil / epidemiology, Endemic Diseases, Humans, Neglected Diseases / epidemiology, Neglected Diseases / prevention & control

Objective:
To characterize knowledge, practices, and professional experience of community health agents (ACS) and endemic combat agents (ACE) on leprosy and Chagas disease (DC), during participation in an integrated training workshop in the IntegraDTNs-Bahia project.
Methods:
Descriptive and exploratory case study, involving health agents and endemic combat agents participating in a training workshop on the shared role of these professionals in health care and surveillance processes. The project was developed in the municipalities of Anagé, Tremedal and Vitória da Conquista, in the southwestern State of Bahia, 2019-2020. A specific instrument was applied, with questions related to knowledge and practices of surveillance and care for leprosy and Chagas disease. Descriptive analysis of the data, in addition to consolidation of the lexical analysis, was performed.
Results:
Out of a total of 135 participants (107 ACS and 28 ACE), 80.7% of them have been working for at least 12 years, without previous participation in joint training processes. Only 17.9% of endemic combat agentes reported having participated in training on leprosy and none reported developing specific actions to control the disease. For Chagas disease, 36.4% of community health agents participated in training more than a decade before, while for 60.7% of endemic combat agents the last training was carried out in the last five years. The development of educational actions for Chagas disease was more frequent for endemic combat agents (64.3%). When asked about ways of recognizing diseases, the term "skin spots" was the most reported (38 times) for leprosy and, for Chagas disease, the term "I don't know" (17 times).
Conclusion:
Processes of health agents and endemic combat agents action in realities endemic for leprosy and Chagas disease in the interior of Bahia proved to be fragmented in the territories. For these diseases, the distance between surveillance and health care actions is reinforced, including in training processes. The importance of innovative permanent and integrated education actions is reiterated to actually promote changes in practices.
Arresting rampant dental caries with silver diamine fluoride in a young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report
Authors: Chun-Hung Chu, Angeline Hui-Cheng Lee, Liwu Zheng, May Lei Mei, Godfrey Chi-Fung Chan
Journal: BMC Res Notes (2014)
MeSH terms: Bone Marrow Transplantation / adverse effects, Dental Caries / drug therapy, Fluorides, Topical / therapeutic use, Graft vs Host Disease / complications, Quaternary Ammonium Compounds / therapeutic use, Case Reports, Adolescent, Chewing Gum, Chronic Disease, Crowns, Dental Caries / etiology, Dental Caries / prevention & control, Gingivitis / complications, Humans, Immunocompromised Host, Immunosuppressive Agents / adverse effects, Immunosuppressive Agents / therapeutic use, Male, Malnutrition / complications, Oral Hygiene, Postoperative Complications, Silver Compounds, Xerostomia / complications, Xerostomia / therapy, beta-Thalassemia / surgery, Chewing Gum, Fluorides, Topical, Immunosuppressive Agents, Quaternary Ammonium Compounds, Silver Compounds, silver diamine fluoride

Background:
Rampant caries is an advanced and severe dental disease that affects multiple teeth. This case describes the management of rampant caries in a young teenager suffering from chronic oral graft versus host disease after allogeneic bone marrow transplantation.
Case presentation:
A 14-year-old Chinese boy suffering from β-thalassemia major was referred to the dental clinic for the management of rampant dental caries. An oral examination revealed pale conjunctiva, bruising of lips, and depapillation of tongue indicating an underlying condition of anemia. The poor oral condition due to topical and systemic immunosuppressants was seriously aggravated, and rampant caries developed rapidly, affecting all newly erupted, permanent teeth. The teeth were hypersensitive and halitosis was apparent. Strategies for oral health education and diet modification were given to the patient. Xylitol chewing gum was used to stimulate saliva flow to promote remineralization of teeth. Silver diamine fluoride was topically applied to arrest rampant caries and to relieve pain from hypersensitivity. Carious teeth with pulpal involvement were endodontically treated. Stainless steel crowns were provided on molars to restore chewing function, and polycarbonate crowns were placed on premolars, upper canines and incisors.
Conclusion:
This case report demonstrates success in treating a young teenager with severe rampant dental decay by contemporary caries control and preventive strategy.
Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study
Authors: Andrew Harnish, William Dieter, Albert Crawford, Tiffany E Shubert
Journal: Front Public Health (2016)
Keywords: evidence-based, falls, group-based exercise, stratification, wellness

Background:
Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care.
Objectives:
The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing.
Methods:
Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency.
Results:
Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s (p = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 (p = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s (p < 0.0001). Participants did not experience any falls or hospitalizations, and two participants required physical therapy episodes of care.
Conclusion:
Implementing an evidence-based fall reduction program into a senior living program has a positive effect on strength, balance, fall risk, gait speed, fall rate, hospitalizations, and amount of physical therapy intervention.
Seronegative Autoimmune Hepatitis A Clinically Challenging Difficult Diagnosis
Authors: Jagannath M Sherigar, Arefiev Yavgeniy, Debra Guss, Nhu Ngo, Smruti Mohanty
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Autoimmune hepatitis (AIH) is a complex liver disease of unknown cause which results in immune-mediated liver injury with varied clinical presentations. Seronegative AIH follows a similar course to autoantibody-positive disease and diagnosis may be challenging. There are no single serologic tests of sufficient diagnostic specificity, and delay in appropriate treatment may lead to progression of the liver disease and liver failure. The revised conventional diagnostic criteria (RDC) scoring for AIH is complex and not routinely used in the clinical practice. The more recent simplified diagnostic criteria (SDC) scoring proposed by International Autoimmune Hepatitis Group in 2008 has wider application in routine practice facilitating the diagnosis of AIH with a specificity and sensitivity of ~90%. In this report, we describe a case of seronegative autoimmune hepatitis diagnosed using RDC. SDC score calculated in our case was 4 and was not diagnostic for AIH. We subsequently used the complex revised diagnostic criteria for definitive diagnosis. Some of the patients previously diagnosed as cryptogenic active hepatitis of unknown etiology probably had an unrecognized diagnosis of seronegative autoimmune hepatitis. SDC scoring may not be applicable in patients with seronegative autoimmune hepatitis. These patients should be reassessed by using RDC.