OpenMed/multicare-articles huggingface dataset:
Abdominal unicentric Castleman's disease: a case report
Authors: Samir Bradai, Amal Khsiba, Abdelwaheb Nakhli, Moufida Mahmoudi, Asma Ben Mohamed, Abir Chaabane, Emna Chelbi, Medhioub Mona, Lamine Hamzaoui, Mousadek Azouz
Journal: Pan Afr Med J (2021)
Keywords: castleman’s disease, abdominal localization, case report, surgery
MeSH terms: Abdominal Pain / etiology, Castleman Disease / diagnosis, Retroperitoneal Neoplasms / diagnosis, Case Reports, Aged, Castleman Disease / surgery, Diagnosis, Differential, Female, Humans, Retroperitoneal Neoplasms / pathology

Castleman's disease is a rare disease characterized by benign lymphoepithelial proliferation. There are two forms: unicentric and multicentric Castleman's disease. Mediastinal location is the most frequent. Intra-abdominal Castleman's disease is a rare presentation. We report a case of 65-year-old female who presented with epigastric pain. Investigations revealed a retroperitoneal mass which was surgically resected. Histopathological examination showed hyaline-vascular type Castleman's disease. In conclusion, Castelman´s disease is a diagnostic challenge and it must be included in the differential diagnosis of retroperitoneal tumors.
A rare tumour of the vulva: a case report of a vulva angioneurofibroma hamartoma in a Cameroonian woman
Authors: Florent Fouelifack Ymele, Efuetnkeng Bechem, Philip Nana Njotang, Charlette Nangue, Jeanne Hortence Fouedjio, Sadjoli Damtheou, Robinson Mbu Enoh
Journal: Pan Afr Med J (2013)
Keywords: tumour, ngioneurofibroma hamartoma, vulva
MeSH terms: Hamartoma / diagnosis, Neoplasms, Vascular Tissue / diagnosis, Neurofibroma / diagnosis, Vulvar Neoplasms / diagnosis, Case Reports, Adult, Cameroon, Female, Humans, Neoplasms, Complex and Mixed / diagnosis, Rare Diseases

We present the case of a rare vulva tumour, in a 33 years Cameroonian old woman and managed in Obstetrics and Gynecology Unit of Yaoundé Central Hospital in Cameroon. It was a painless pedunculated vulva tumour which developed over a period of six months. This gigantic rapidly growing tumour, was treated with simple surgical resection. After surgical resection, histology confirmed an angioneurofibroma hamartoma. There has been no recurrence and presently the patient is symptom-free.
Rehabilitation of an irradiated marginal mandibulectomy patient using immediately loaded basal implant-supported fixed prostheses and hyperbaric oxygen therapy: A 2-year follow-up
Authors: Fadia Awadalkreem, Nadia Khalifa, Abdelnasir G Ahmad, Ahmed Mohamed Suliman, Motaz Osman
Journal: Int J Surg Case Rep (2020)
Keywords: basal implant-supported prostheses, hyperbaric oxygen, immediately loaded fixed prostheses, mandibular resection
MeSH terms: Case Reports

Introduction:
The prosthetic rehabilitation of mandibular defects owing to tumor resection is challenging, especially when the patient has undergone subsequent radiotherapy.
Presentation of case:
A 46-year old male presented with a marginal mandibular resection. Following surgery, the patient received adjunctive radiation therapy with a total dose of 70 grays. On clinical examination, the patient presented with severely resorbed edentulous jaws, with an anterior marginal mandibular resection and an obliterated vestibular sulcus. The panoramic radiograph showed a hypocellularity of the maxillary and mandibular bones. A multidisciplinary team was formed, and a treatment plan was formulated which involved the construction of a vestibuloplast stent, and the application of 20 hyperbaric oxygen sessions before implant treatment and 10 more sessions after implant insertion. A total of 16 basal cortical screw implants were inserted to support the fixed prostheses, and a vestibuloplasty was performed to improve esthetics. No complications were observed, and at the 2-year follow-up, the patient presented with excellent peri-implant soft tissue health; increased bone-implant contact; and stable, well-functioning prostheses.
Discussion:
The construction of a stable, retentive, well-supported removable prosthesis may be complicated in cases of comprehensive mandibular resection. Basal implants can eliminate the need for bone grafting, and reduce the treatment period required for providing a fixed prosthesis.
Conclusion:
To our knowledge this is the first evidence reporting the use of fixed basal implant-supported prostheses in irradiated bone, in conjunction with hyperbaric oxygen therapy. A treatment modality that significantly improves the peri-implant tissue health, and ensures an excellent implant-bone contact.
Case report: A case of novel treatment for retrograde cricopharyngeal dysfunction
Authors: Mengshu Xie, Hongmei Wen, Zulin Dou
Journal: Front Neurol (2022)
Keywords: botulinum toxin, electromyography, flatulence, inability to belch, retrograde cricopharyngeal dysfunction
MeSH terms: Case Reports

Retrograde cricopharyngeal dysfunction (R-CPD) is a recently described disorder characterized by an inability to belch, excessive flatulence, unpleasant gurgling noises, and discomfort in the lower neck, chest, and abdomen. Herein, we describe a case of R-CPD in a 19-year-old man. The patient suffered from flatulence and was unable to belch since birth; auxiliary examination of his digestive system was normal. He was diagnosed with R-CPD based on clinical manifestations and laboratory results. He received an injection of botulinum toxin to the cricopharyngeal muscle under ultrasound, catheter balloon, and electromyographic guidance. His symptoms completely resolved 1 week after the injection.
Ureteroscopic Stone Extraction in Cross-Fused Renal Ectopia
Authors: Amir Toussi, Timothy Boswell, Aaron Potretzke
Journal: J Endourol Case Rep (2018)
Keywords: cross-fused renal ectopia, ureteral stone, ureteroscopy
MeSH terms: Case Reports

Background: Urinary stone disease in cross-fused renal ectopia is rare and the aberrant anatomy poses challenges to treatment options. The available literature on treatment modalities remains limited. In this study, we present a case of ureteral stone in a cross-fused renal ectopia managed through retrograde approach. Case Presentation: We present a case of a 69-year-old woman with an obstructing ureteral stone in a cross-fused renal ectopia managed with ureteroscopic stone extraction. With the use of a ureteral access sheath, holmium laser, and Nitonol basket, the stone was fragmented and removed through retrograde access. The stone composition was 100% calcium oxalate monohydrate and her 24-hour urine collection was only significant for low volume. Conclusion: With special modifications and attention to the individual patient's anatomy, retrograde approach with the use of an access sheath is safe and effective for treatment of ureteral stones in patients with cross-fused renal ectopia.
Extension for Community Healthcare Outcomes Based Telementoring of Physicians for Dementia-Effectiveness in India
Authors: Shruti Nair, Preeti Sinha, Prabhat Chand, Prashant Sahu, Naga Vss Gorthi, Mathew Varghese, P T Sivakumar
Journal: Front Psychiatry (2022)
Keywords: echo, dementia, primary care, telementoring, training

Objective:
The study aimed to evaluate the effectiveness of a program based on the telementoring model [Extension for Community Healthcare Outcomes (ECHO)] for primary care physicians in diagnosing and treating patients with dementia.
Method:
The ECHO model was adapted through 12 live sessions of 2 h every 2 weeks consisting of a didactic presentation by the expert, peer-led new case discussions, and follow-up discussions. In addition, there were 10 h of self-paced e-learning and interim assignments. The impact was examined by noting participation, session ratings, monthly clinical reports, and comparing knowledge and competency scores before and after the course.
Results:
Among the 63 participants, 39.7% attended at least 80% of the sessions; completing the program successfully. The ratings for all sessions ranged from "good" to "excellent." The paired sample t-test revealed a statistically significant improvement (p < 0.001) in self-rated skills and confidence in diagnosing and treating dementia with an effect size of 1.25 and 1.37, respectively. No change in the knowledge score was observed throughout the course. A considerable increase in dementia-related clinical practice was observed during four monthly summary of clinical cases. Due to the limited data of monthly reports during the COVID pandemic, no statistical analysis was attempted.
Conclusion:
The ECHO model appears to have a positive immediate impact on the clinical ability of primary care physicians to diagnose and treat dementia. Its direct impact on patient health and at the community level should be aimed at in future studies.
Neonatal Diabetes: Case Report of a 9-Week-Old Presenting Diabetic Ketoacidosis Due to an Activating ABCC8 Gene Mutation
Authors: Shawn Sood, Hannah Landreth, Jessee Bustinza, Laura Chalmers, Roopa Thukaram
Journal: J Investig Med High Impact Case Rep (2017)
Keywords: abcc8, katp, kcnj11, kir62, diabetic ketoacidosis, neonatal diabetes mellitus, pediatric intensive care unit, sulfonylurea

Context: Neonatal diabetes mellitus, a rare condition occurring in approximately 1 in 500 000 live births, is defined as insulin-requiring hyperglycemia presenting in the first months of life. Neonatal diabetes can be transient or permanent, with studies characterizing the condition as a monogenic disorder. Case Report: We describe a case of a 9-week-old infant with neonatal diabetes who presented in diabetic ketoacidosis due to a mutation affecting the ABCC8 gene that encodes the SUR1 subunit of the potassium ATP channel. Conclusion: This genetic diagnosis has therapeutic implications regarding the initiation of sulfonylurea administration as 85% of patients with neonatal diabetes due to ABCC8 gene mutations can be successfully treated with oral sulfonylurea treatment.
Cat-scratch disease: unusual perivascular chorioretinal lesions
Authors: Ozlem Sahin
Journal: Med Hypothesis Discov Innov Ophthalmol (2014)
Keywords: bartonellahenselae, cat-scratch disease, chorioretinal lesions, retinal vascular lesions
MeSH terms: Case Reports

This study is a case report of bilateral perivascular chorioretinal lesions associated with Bartonella henselae. A 37-year-old woman presented with headache and blurred vision in both eyes aggravating occasionally during five years. She was otherwise healthy, with best-corrected visual acuities were 20/20 in both eyes. History of close contact with cats was more than merely eye-catching upon examination of her fundus. In both eyes, fundi were coated with yellow-brown pigmented perivenous chorioretinal lesions along the superotemporal and inferotemporal vascular arcades and their branches. The perivenous lesions were associated with vascular fibrous bands and corresponding changes in vascular calibers. There were no associated intraocular inflammatory signs in both eyes. The serologic tests confirmed the diagnosis of cat-scratch disease. The patient received no treatment, and she was followed for three years without any signs of ocular inflammation.
Fatal Retroperitoneal Hematoma in a Patient Receiving Enoxaparin for Bilateral Pulmonary Emboli
Authors: Jordan Sexe, Robin McCarthy, Navid Dara, Lyon Brown, Gaurav Dutta
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

Venous thromboembolism occurs when a deep vein thrombosis travels to the lungs and forms a pulmonary embolism. Low-molecular-weight heparins are a mainstay in the treatment and prevention of venous thromboembolism and should be initiated promptly due to substantial morbidity and mortality. A rare side effect of low-molecular-weight heparins is major bleeding, which also carries a significant morbidity and mortality rate. Here, we present a case of a fatal retroperitoneal hematoma in a patient being treated with enoxaparin for bilateral pulmonary emboli.
Severe Hair Loss of the Scalp due to a Hair Dye Containing Para phenylenediamine
Authors: Waka Ishida, Teruhiko Makino, Tadamichi Shimizu
Journal: ISRN Dermatol (2011)
MeSH terms: Case Reports

We report the case of a 41-year-old female showing severe hair loss approximately 90% after the use of a hair dye. These symptoms developed six days after the use of a hair dye containing PPD. A patch test showed a (++) reaction at 48 h to 1% PPD in petrolatum, whereas all metals and white petrolatum were negative. She was therefore diagnosed with contact dermatitis due to PPD, resulting in hair loss. The skin lesions gradually improved after starting treatment with the systemic corticosteroids. The possibility that allergic contact dermatitis from hair dyes may be responsible for telogen effluvium should always be considered in a patient with increased hair loss.
Persistent pain and numbness in the extremities of an adult due to paraneoplastic peripheral neuropathy caused by olfactory neuroblastoma: A case report
Authors: Wenwen Liang, Yanyan Wang, Wenzhe Sun, Dongrui Li, Xiaoping Zhang, Pengcheng Zhu, Zhou Zhu, Yongkang Fang
Journal: Front Neurol (2023)
Keywords: fdg-pet/ct, anti-hu antibody, case report, olfactory neuroblastoma, paraneoplastic peripheral neuropathy
MeSH terms: Case Reports

Background:
Paraneoplastic peripheral neuropathy (PPN) caused by olfactory neuroblastoma (ONB) has not yet been reported.
Case report:
We present a rare case of an adult who hospitalized repeatedly over the past 9 months for persistent pain and numbness in the limbs. This patient was initially diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP) and treated accordingly, but neurological symptoms did not improve significantly. After this admission, FDG-PET/CT showed focal hypermetabolism of a soft-tissue mass in the nasal cavity, and further lesion biopsy suggested ONB. Combined with positive serum anti-Hu antibody, the diagnosis of PPN associated with ONB was eventually made. Furthermore, the patient's neurological symptoms were relieved after removal of the primary tumor, confirming the accuracy of the diagnosis.
Conclusion:
Our case not only expanded the clinical characteristics of ONB but also highlighted the importance of early and comprehensive tumor screening for the diagnosis of PPN.
Obscure gastrointestinal bleeding localization using preoperative super-selective mesenteric angiography and intraoperative methylene blue injection: A case report and literature review
Authors: Sidra B Bhuller, Mark Lieser, Naveed Ismail, Bradley Woods
Journal: Int J Surg Case Rep (2019)
Keywords: angiodysplasia, arteriovenous malformation, methylene blue, obscure gastrointestinal bleeding, superselective angiography

Introduction:
Currently available diagnostic tests for localizing the source of gastrointestinal bleeding include esophagogastroduodenoscopy, colonoscopy, push enteroscopy, video capsule endoscopy, deep enteroscopy, nuclear scan, angiography, radiographic contrast studies of the small bowel, intraoperative enteroscopy, and computed tomography scanning. Despite these diagnostic modalities obscure gastrointestinal bleeding (OGIB) can be difficult to localize, making surgical intervention challenging.
Presentation of case:
We report the case of a 78-year-old patient who presented with OGIB, melena and passing bright red blood per rectum, with a hemoglobin of 4.8 g/dl requiring multiple blood transfusions. Initially the source of the bleeding was difficult to identify. Eventually, a preoperative superior mesenteric angiogram was performed, identifying an arteriovenous malformation (AVM) within the small bowel as the source of OGIB. Intraoperative methylene blue was then injected through the previously placed angiogram catheter to further localize the bowel segment with the lesion.
Discussion:
Despite multiple diagnostic modalities, OGIB, especially originating in the small bowel, is challenging to localize, making surgical intervention difficult. Methylene blue is frequently used intraoperatively to properly identify anatomic landmarks.
Conclusion:
In cases of OGIB, superselective mesenteric angiography (SSMA) with intraoperative methylene blue injection can be used as an adjunct to routine diagnostic modalities to guide surgical interventions for controlling hemorrhage and for limiting the extent of bowel resection.
Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study
Authors: Pattaraporn Khongboon, Sathirakorn Pongpanich
Journal: J Aging Res (2018)

Background:
Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand.
Methods:
The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs.
Results:
The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation.
Conclusions:
Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.
Asymptomatic Infant With Atypical SCID and Novel Hypomorphic RAG Variant Identified by Newborn Screening: A Diagnostic and Treatment Dilemma
Authors: Maria Chitty-Lopez, Emma Westermann-Clark, Irina Dawson, Boglarka Ujhazi, Krisztian Csomos, Kerry Dobbs, Khuong Le, Yasuhiro Yamazaki, Amir A Sadighi Akha, Deepak Chellapandian, Ben Oshrine, Luigi D Notarangelo, Gauri Sunkersett, Jennifer W Leiding, Jolan E Walter
Journal: Front Immunol (2020)
Keywords: hsct, scid, asymptomatic infant, immunodeficiency, newborn screening, recombinase activating gene (rag)
MeSH terms: Genetic Variation, Hematopoietic Stem Cell Transplantation, Homeodomain Proteins / genetics, Neonatal Screening, Severe Combined Immunodeficiency / diagnosis, Severe Combined Immunodeficiency / surgery, Case Reports, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't, Asymptomatic Diseases, Genetic Predisposition to Disease, Humans, Infant, Newborn, Male, Phenotype, Predictive Value of Tests, Severe Combined Immunodeficiency / genetics, Severe Combined Immunodeficiency / immunology, Treatment Outcome, Homeodomain Proteins, RAG-1 protein

The T-cell receptor excision circle (TREC) assay detects T-cell lymphopenia (TCL) in newborns and is especially important to identify severe combined immunodeficiency (SCID). A spectrum of SCID variants and non-SCID conditions that present with TCL are being discovered with increasing frequency by newborn screening (NBS). Recombination-activating gene (RAG) deficiency is one the most common causes of classical and atypical SCID and other conditions with immune dysregulation. We present the case of an asymptomatic male with undetectable TRECs on NBS at 1 week of age. The asymptomatic newborn was found to have severe TCL, but normal B cell quantities and lymphocyte proliferation upon mitogen stimulation. Next generation sequencing revealed compound heterozygous hypomorphic RAG variants, one of which was novel. The moderately decreased recombinase activity of the RAG variants (16 and 40%) resulted in abnormal T and B-cell receptor repertoires, decreased fraction of CD3+ TCRVα7.2+ T cells and an immune phenotype consistent with the RAG hypomorphic variants. The patient underwent successful treatment with hematopoietic stem cell transplantation (HSCT) at 5 months of age. This case illustrates how after identification of a novel RAG variant, in vitro studies are important to confirm the pathogenicity of the variant. This confirmation allows the clinician to expedite definitive treatment with HSCT in an asymptomatic phase, mitigating the risk of serious infectious and non-infectious complications.
Sacubitril/Valsartanstive Heart Failure: Cardiogenic Shock
Authors: H A Rawal, A G Kocheril
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Sacubitril/valsartan is a combination drug described as a new class of dual-acting angiotensin receptor-neprilysin inhibitor (ARNi) for heart failure. We present a case of a patient with NYHA class IV systolic heart failure who was refractory to all other classes of heart failure medications and was started on this new medication. On sacubitril/valsartan, he developed cardiogenic shock. This led us to reevaluate the use and risks of this medication in the class IV heart failure population.
Retained Products of Conception: An Atypical Presentation Diagnosed Immediately with Bedside Emergency Ultrasound
Authors: Kristin Adkins, Joseph Minardi, Erin Setzer, Debra Williams
Journal: Case Rep Emerg Med (2016)

Background. Retained products of conception is an important diagnosis to consider in patients presenting with postpartum complaints. Bedside ultrasound is a rapid, accurate, noninvasive modality to evaluate these patients. Objective. To report an atypical case of retained products of conception diagnosed with bedside ultrasound in the emergency department. Case Report. A 27-year-old female who was 1-month postpartum presented with vaginal bleeding, pelvic pain, and no fever. At the time of initial H&P, bedside ultrasound revealed echogenic material within the endometrial cavity with blood flow seen by color Doppler consistent with retained products of conception. The bedside ultrasound rapidly narrowed the differential and allowed a definitive diagnosis immediately. Ob/Gyn was consulted and dilation and curettage was performed in the operating room. Conclusions. Retained products of conception is an important diagnosis for the emergency physician to consider in at-risk patients. The sonographic findings are easily obtained and interpreted by emergency physicians. Earlier diagnosis of this disease process should lead to more focused patient evaluations and management.
Oncological resection, myasthenia gravis and staging as prognostic factors in thymic tumours: a Chilean case series
Authors: Patricio Salas, Maria Eliana Solovera, Felipe Bannura, Matias Muñoz-Medel, Miguel Cordova-Delgado, Cesar Sanchez, Carolina Ibañez, Marcelo Garrido, Erica Koch, Francisco Acevedo, Sebastian Mondaca, Bruno Nervi, Jorge Madrid, Jose Peña, Mauricio P Pinto, José Valbuena, Hector Galindo
Journal: Ecancermedicalscience (2021)
Keywords: myasthenia gravis, staging, thymic tumour, thymoma

Background:
Thymic epithelial tumours are rare and highly heterogeneous. Reports from the United States suggest an overall incidence of 0.15 per 100,000/year. In contrast, the incidence of these tumours in Latin America is largely unknown and reports are scarce, somewhat limited to case reports.
Methods:
Herein, we report a series of 38 thymic tumours from a single institution, retrospectively incorporated into this study. Patient characteristics and outcomes including age, sex, stage, paraneoplastic syndromes, treatment regimens and the date of decease were obtained from medical records.
Results:
Most cases in our series were females and young age (<50 years old) and early stage by Masaoka-Koga or the Moran staging systems. Also, a 34% of patients had myasthenia gravis (MG). Next, we analysed overall survival rates in our series and found that the quality of surgery (R0, R1 or R2), MG status and staging (Masaoka-Koga, Moran or TNM) were prognostic factors. Finally, we compared our data to larger thymic tumour series.
Conclusions:
Overall, our study confirms complete surgical resection as the standard, most effective treatment for thymic epithelial tumours. Also, the Masaoka-Koga staging system remains as a reliable prognostic factor but also the Moran staging system should be considered for thymomas.