OpenMed/multicare-articles huggingface dataset:
Asymptomatic severe hypocalcemia secondary to vitamin d deficiency in an elderly patient
Authors: Saleh Aldasouqi, Crystal M Glassy, Matthew S Glassy, Anxhela Treska, Molly Caldwell-McMillan, Ved Gossain
Journal: Case Rep Endocrinol (2011)
MeSH terms: Case Reports

Objective. To describe an asymptomatic presentation of severe hypocalcemia secondary to vitamin D deficiency in an elderly patient. Methods. We describe the presentation and clinical course of an elderly woman with asymptomatic severe hypocalcemia referred to an endocrinology clinic for hyperparathyroidism. Results. The patient is an 83-year-old Caucasian woman who presented to an endocrinology clinic for evaluation of hyperparathyroidism, with an intact PTH of 462 pg/mL (normal range 14-72 pg/mL). The same lab report included a serum calcium of 5.2 mg/dL (normal range 8-10.5 mg/dL). She displayed no signs or symptoms of hypocalcemia. Given the extreme severity of hypocalcemia and her age, she was hospitalized. Vitamin D deficiency was suspected and was subsequently confirmed with undetectable serum levels. The patient remained asymptomatic throughout her hospital stay. Total and ionized calcium levels at discharge were 7.2 mg/dL and 1.03 mmol/L (normal range 1.1-1.4 mmol/L), respectively. Conclusion. Physicians should exercise prudent management with respect to the vitamin D status of the elderly patient, as certain patients may exhibit severe hypovitaminosis D and hypocalcemia without apparent clinical symptoms.
" Then and Now," Mapping the 25 Year Evolution and Impact of North American Vascular Biology Organization Science Through Publications of its Founding and Current Members
Authors: Zorina S Galis, Bruce W Herr 2nd, Santoshmurti S Daptardar, Medina Sydykanova, Katy Börner
Journal: Front Res Metr Anal (2020)
Keywords: bibliometrics, impact assessment, network science, research assessment, science maps, science of science, scientometrics

Scholarly organizations bring together experts to move forward specific areas of scientific endeavor. More than 5,000 scholarly societies exist world-wide yet little is known about the composition, evolution, and collaboration of experts within these organizations. This study presents general methods to study the evolution of a biomedical organization and its impact over time. Methods are illustrated in a case study that aims to capture the "Then and Now" science of the North American Vascular Biology Organization (NAVBO). Publications authored by the founding members who came together to create NAVBO in 1994 are compared with publications by those representing the society 25 years later. Google Scholar data was compiled for NAVBO members registered in 1994 (n = 70) and in 2019 (n = 465), some members being present in both data sets (n = 22). The 501 unique NAVBO members had more than 76,000 papers cited over 4,400,000 times. Several characteristics associated with the NAVBO members' output were revealed, including their high productivity, the high impact of their publications, and the predominant contribution of relatively small laboratories, as suggested by a low average number of authors per publication. To understand how NAVBO fostered scientific collaborations and exchanges of expertize, data was analyzed and visualized to show the evolution of member co-author networks. The UCSD Map of Science was used to communicate the evolution of scientific topics covered by NAVBO members helping to create a global picture of NAVBO's science "then and now." All workflows are available online in case other scholarly organizations would want to use them to map their own evolution and impact; and meta studies that communicate the inner workings of these important scholarly efforts can be conducted.
A gallbladder tumor revealing metastatic clear cell renal carcinoma: report of case and review of literature
Authors: Merieme Ghaouti, Kaoutar Znati, Ahmed Jahid, Fouad Zouaidia, Zakiya Bernoussi, Youssef El Fakir, Najat Mahassini
Journal: Diagn Pathol (2013)
MeSH terms: Carcinoma, Renal Cell / secondary, Gallbladder Neoplasms / secondary, Kidney Neoplasms / pathology, Case Reports, Review, Biomarkers, Tumor / analysis, Carcinoma, Renal Cell / chemistry, Carcinoma, Renal Cell / surgery, Cholecystectomy, Diagnosis, Differential, Female, Gallbladder Neoplasms / chemistry, Gallbladder Neoplasms / surgery, Humans, Immunohistochemistry, Kidney Neoplasms / chemistry, Kidney Neoplasms / surgery, Middle Aged, Nephrectomy, Predictive Value of Tests, Tomography, X-Ray Computed, Biomarkers, Tumor

Metastatic renal cell carcinoma in the gallbladder is extremely rare, with reported frequencies of less than 0.6% in large autopsy reviews. Only 40 cases were reported in the literature. We report a first case of gallbladder polypoid tumor revealing metastatic clear cell renal cell carcinoma, which demonstrates the importance of radiological tests, histology and immunohistochemistry when making a definitive diagnosis. These examinations also allow differentiating metastatic clear cell renal cell carcinoma from other polypoid lesions in the gallbladder with clear cell morphology. Cholecystectomy should be performed to obtain a definitive diagnosis and to improve survival in case of solitary metastatic renal cell carcinoma.
Virtual slides:
The virtual slides' for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8956897238238989
Early Treatment of Acute Complex Regional Pain Syndrome after Fracture or Injury with Prednisone: Why Is There a Failure to Treat? A Case Series
Authors: Paul Winston
Journal: Pain Res Manag (2016)
MeSH terms: Anti-Inflammatory Agents / therapeutic use, Complex Regional Pain Syndromes / drug therapy, Complex Regional Pain Syndromes / etiology, Fractures, Bone / complications, Prednisone / therapeutic use, Case Reports, Aged, Female, Humans, Male, Middle Aged, Anti-Inflammatory Agents, Prednisone

Background. Complex regional pain syndrome (CRPS) after fracture is a cause of pain, dysfunction, and potentially permanent disability. The evidence for treatment with oral corticosteroids is growing and supported by several international guidelines; however, treatment is not widely offered. Objective. Rapid recognition and treatment of complex regional pain in the upper extremity after acute injury as a disease modifying and potentially curative treatment. Methods. The present study was a case series involving three patients who developed CRPS after a trauma to the neck and/or upper limb. Patients were screened by clinical examination and bone scan and met the Budapest criteria. Results. Resolution of pain, swelling, and disability in all three patients. Discussion. There is increasing support, based on the existing evidence and clinical outcomes, for the use of prednisone to treat the acute phase of CRPS and as a promising treatment to halt the progression of the phenomenon and potentially cure the condition; however, widespread use of prednisone likely remains low, potentially resulting in long-term pain, joint contracture, and disability. A large-scale randomized control trial has not been performed. Conclusion. Corticosteroids can be an effective treatment option for CRPS after fracture.
Omega-3 Fatty Acids Improve Functionality of High-Density Lipoprotein in Individuals With High Cardiovascular Risk: A Randomized, Parallel, Controlled and Double-Blind Clinical Trial
Authors: Flávia De Conti Cartolano, Gabriela Duarte Dias, Sayuri Miyamoto, Nágila Raquel Teixeira Damasceno
Journal: Front Nutr (2022)
Keywords: hdl subfractions, clinical trial, high density lipoprotein, human, omega-3
MeSH terms: Case Reports

Omega-3 (ω-3) fatty acids have been extensively studied for primary and secondary prevention of cardiovascular health, but their ability to modulate HDL functionality remains unclear. The purpose of this study was to investigate the role of ω-3, rich in eicosapentaenoic (EPA) and docosahexaenoic (DHA), on HDL functionality. For that, 147 individuals with high cardiovascular risk were randomized in ω-3 (1 g of fish oil each - 370 mg of EPA and 230 mg of DHA, 3 times per day total EPA+DHA = 1,800 mg) or ω-6 groups (1 g of sunflower oil each - 760 mg of linoleic acid, 3 times per day; total linoleic acid = 2,280 mg). Fasting blood samples were collected at baseline time and after 8 weeks of follow-up and, and the lipid profile and glucose metabolism were evaluated from plasma. From HDL, the fatty acid profile, apolipoproteins (Apo AI, CII and CIII), paraoxonase-1 (PON1), cholesteryl ester transfer protein (CETP), subfractions and antioxidant activity were investigated. Omega-3 improved large HDL (HDL = 28.7%) and reduced small HDL (HDL10 = -10.6%) and the non-esterified fatty acids in HDL (NEFAs-HDL) level (-16.2%). A significant reduction in CETP activity was observed in the ω-3group (Δ ω-6 = 3.60 pmol/ul/h and Δ ω-3 = -1.99 pmol/ul/h; p = 0.044). The antioxidant capacity estimated by Lag time analysis did not change after the ω-3intervention. Changes in PON1 and Apo AI were inversely associated with increased incorporation of EPA (AOR = 0.446; IC = 0.200-0.994) and DHA (AOR = 0.351; IC = 0.150-0.821) in HDL, respectively. Cardioprotective profile obtained by pooled fatty acids analysis was related to a decrease in Apo CIII (r = -0.638; p = 0.002) and CETP (r = -0.341; p = 0.012) and an increase in Apo CII (r = 0.448; p = 0.042) and PON1 (r = 0.388; p = 0.003). In conclusion, omega-3 was effective in the reduction of cardiovascular risk associated with HDL functionality by size improvement and changes in its lipid, antioxidant and enzyme composition.
Clinical Characteristics of Pediatric Cases of COVID-19 in Hunan, China: A Retrospective, Multi-Center Case Series
Authors: Lei Wu, Xiao-Fo Zhang, Yong Yang, Xiu-Ying Yi, Xin-Ping Jiang, Hai-Ying Han, Xiao-Ying Cao, Tuan-Mei Wang, Man-Zhi Wang
Journal: Front Pediatr (2021)
Keywords: covid-19, epidemiology, laboratory characteristics, pediatric infection, symptoms

Objective: Aimed to investigate the epidemiological characteristics, clinical features, treatment, and short-term prognosis of COVID-19 in children. Methods: Retrospective analysis was conducted in 48 children with COVID-19 admitted to 12 hospitals in eight cities in Hunan province, China, from January 26, 2020 to June 30, 2020. Results: Of the 48 cases, Familial clusters were confirmed for 46 children (96%). 16 (33%) were imported from other provinces. There were 11 (23%) asymptomatic cases. only 2 cases (4%) were severe. The most common symptom was fever (n = 20, 42%). Other symptoms included cough (n = 19, 40%), fatigue (n = 8, 17%), and diarrhea (n = 5, 10%). In the early stage, the total peripheral blood leukocytes count increased in 3(6%) cases and the lymphocytes count decreased in 5 (10%) cases. C-reactive protein and procalcitonin were elevated respectively in 3 (6%) cases and 2 (4%) cases. There were abnormal chest CT changes in 22 (46%) children, including 15 (68%) with patchy ground glass opacity, 5 (22%) with consolidation, and 2 (10%) with mixed shadowing. In addition to supportive treatment, antiviral therapy was received by 41 (85%) children, 11 (23%) patients were treated with antibiotics, and 2 (4%) were treated with methylprednisolone and intravenous immunoglobulin. Compared to 2 weeks follow-up, one child developed low fever and headache during the 4 weeks follow-up, 3 (6%) children had runny noses, one of them got mild cough, and 4 (12%) children had elevated white blood cells and lymphocytes. However, LDH and CK increased at 2 weeks and 4 weeks follow-up. 2 weeks follow-up identified normal chest radiographs in 33 (69%) pediatric patients. RT-PCR detection of SARS-CoV-2 was negative in all follow-up patients at 2 and 4 weeks follow-up. All 48 pediatric patients were visited by calling after 1 year of discharge. Conclusions: Most cases of COVID-19 in children in Hunan province were asymptomatic, mild, or moderate. Close family contact was the main route of infection. It appeared that the younger the patient, the less obvious their symptoms. Epidemiological history, nucleic acid test, and chest imaging were important tools for diagnosis in children.
Case Report: First Confirmed Case of Coinfection of SARS-CoV-2 With Choclo orthohantavirus
Authors: Susana Hesse, Heydy Nuñez, Jacqueline R Salazar, Tybbysay P Salinas, Erika Barrera, Ricardo Chong, Saúl Torres, Amarellys Cumbrera, Idiamín Olivares, Aimee Junco, Christian Matteo, Claudia González, Oris Chavarría, Ambar Moreno, Jessica Góndola, Leyda Ábrego, Yamilka Díaz, Yaneth Pitti, Danilo Franco, Mabel Martínez-Montero, Juan Miguel Pascale, Sandra López-Vergès, Alexander A Martínez, Blas Armién
Journal: Front Trop Dis (2021)
Keywords: covid-19, choclo orthohantavirus, sars-cov-2, case report, coinfection, hantavirus pulmonary syndrome
MeSH terms: Case Reports

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a major international public health concern. The World Health Organization (WHO) declared the pandemic of coronavirus disease 2019 (COVID-19) on March 11, 2020. In Panama, the first SARS-CoV-2 infection was confirmed on March 9, 2020, and the first fatal case associated to COVID-19 was reported on March 10. This report presents the case of a 44-year-old female who arrived at the hospital with a respiratory failure, five days after the first fatal COVID-19 case, and who was living in a region where hantavirus pulmonary syndrome cases caused by Choclo orthohantavirus (CHOV), are prevalent. Thus, the clinical personnel set a differential diagnosis to determine a respiratory disease caused by the endemic CHOV or the new pandemic SARS-CoV-2. This case investigation describes the first coinfection by SARS-CoV-2 and CHOV worldwide. PCR detected both viruses during early stages of the disease and the genomic sequences were obtained. The presence of antibodies was determined during the patient's hospitalization. After 23 days at the intensive care unit, the patient survived with no sequelae, and antibodies against CHOV and SARS-CoV-2 were still detectable 12 months after the disease. The detection of the coinfection in this patient highlights the importance, during a pandemic, of complementing the testing and diagnosis of the emergent agent, SARS-CoV-2, with other common endemic respiratory pathogens and other zoonotic pathogens, like CHOV, in regions where they are of public health concern.
Duloxetine-Induced Hyponatremia in an Elderly Male Patient with Treatment-Refractory Major Depressive Disorder
Authors: Ching-Fang Sun, Yeo-Lin Chen, Ying-Hsuan Li, Monika Kumaraswamy, Ying-Chih Lo, Yi-Ting Chen
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Several classes of antidepressants can induce syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH), thereby causing hyponatremia. Initial symptoms of hyponatremia include neuropsychiatric and gastrointestinal manifestations can mimic depression, especially in elderly people with multiple somatic complaints. Here we present a case of a 68-year-old man with treatment-refractory depression and general anxiety disorder who developed duloxetine-induced hyponatremia. His symptoms of hyponatremia including unsteady gait, dizziness, nausea, general malaise, and poor appetite subsided after discontinuing the offending medication. Our case illustrates that drug-induced SIADH and potential drug-drug interactions should be considered in elderly patients who develop hyponatremia following the initiation of antidepressants.
Case report: A novel heterozygous frameshift mutation of ACAN in a Chinese family with short stature and advanced bone age
Authors: Hao Huang, Jieyuan Jin, Rong Xiang, Xia Wang
Journal: Front Genet (2023)
Keywords: acan, case report, frameshift, novel mutation, short stature, whole-exome sequencing
MeSH terms: Case Reports

Short stature (OMIM: 165800) is a common pediatric disorder. Any abnormality in the cartilage formation of the growth plate can cause short stature. Aggrecan, encoded by ACAN, is an important component of the extracellular matrix. Mutations in ACAN have been reported to cause short stature. In the present study, we enrolled a Chinese family with short stature and advanced bone age across three generations. Whole-exome sequencing (WES) was performed on the proband to detect the candidate genes causing short stature in family. A novel heterozygous frameshift mutation (NM_013227.3:c.7230delT; NP_001356197.1: p. Phe2410Leufs*9) of the ACAN gene was confirmed to be a genetic lesion in this family. This variant, which was located in a functional site globular 3 (G3) domain of ACAN and predicted to be deleterious by informatics programs, was co-segregated with the affected family members by performing Sanger sequencing. Literatures review of growth hormone (GH) treatment outcome of all previously reported ACAN patients suggesting that the G3 domain of ACAN may be critical in the development of short stature and growth hormone treatment. These findings not only contribute to the genetic diagnosis and counseling of the family, but will also expand the mutation spectrum of ACAN.
Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation
Authors: Christos Sidiropoulos, Susan M Bowyer, Andrew Zillgitt, Peter A LeWitt, Hassan Bagher-Ebadian, Esmaeil Davoodi-Bojd, Jason M Schwalb, Richard Rammo, Ellen Air, Hamid Soltanian-Zadeh
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Background:
Dystonia is a syndrome with varied phenomenology but our understanding of its mechanisms is deficient. With neuroimaging techniques, such as fiber tractography (FT) and magnetoencephalography (MEG), pathway connectivity can be studied to that end. We present a hemidystonia patient treated with deep brain stimulation (DBS).
Methods:
After 10 years of left axial hemidystonia, a 45-year-old male underwent unilateral right globus pallidus internus (GPi) DBS. Whole brain MEG before and after anticholinergic medication was performed prior to surgery. 26-direction diffusion tensor imaging (DTI) was obtained in a 3 T MRI machine along with FT. The patient was assessed before and one year after surgery by using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS).
Results:
In the eyes-closed MEG study there was an increase in brain coherence in the gamma band after medication in the middle and inferior frontal region. FT demonstrated over 50% more intense ipsilateral connectivity in the right hemisphere compared to the left. After DBS, BFMDRS motor and disability scores both dropped by 71%.
Conclusion:
Multimodal neuroimaging techniques can offer insights into the pathophysiology of dystonia and can direct choices for developing therapeutics. Unilateral pallidal DBS can provide significant symptom control in axial hemidystonia poorly responsive to medication.
Traumatic pseudoaneurysm of the brachiocephalic artery obstructing the airways
Authors: Bader M Tahlawi, Amirah Hassan, Mohamed Regal
Journal: Int J Surg Case Rep (2020)
Keywords: airway obstruction, brachiocephalic artery, innominate artery, mediastinal tumor, pseudoaneurysm
MeSH terms: Case Reports

This is a case report of a young patient referred to our ER as a case of mediastinal tumor compressing the airways. On presentation, the patient had severe stridor and tachypnea, with oxygen saturation less than 60%. As the patient presented alone to the ER, obtaining any history was not possible. Chest x-ray showed a huge right paratracheal mediastinal mass compressing the airway. The patient was not able to lie supine and was taken to the OR for intubation under fiberoptic bronchoscopy guidance. Bronchoscopic evaluation showed significant compression of the trachea from the right side. A small endotracheal tube (size 5) was successfully inserted. Then, the patient was taken for a chest CT with IV contrast. Chest CT showed a huge vascular mass compressing the trachea, the right mainstem bronchus, and the superior vena cava. The study showed the proximal innominate artery, followed by a pseudoaneurysm. There was an interruption of the right subclavian artery at its origin. Collaterals were seen supplying the right upper limb. Surgical resection was done. Postoperatively the patient gave a history of chest-penetrating injury in the right infraclavicular area, 15 years prior to presentation. The pseudoaneurysm of the innominate artery is a rare delayed complication of chest trauma.
Treatment of periscapular tendinopathy with radiofrequency coblation: A case report
Authors: Alexander Tham, Michael McLean, Caroline Atherton, Neal L Millar
Journal: SAGE Open Med Case Rep (2020)
Keywords: tendinopathy, coblation, inflammation, tendon, therapy
MeSH terms: Case Reports

Overuse injuries of the tendon - 'tendinopathy' - account for 30%-50% of all sporting injuries and a high proportion of orthopaedic referrals from primary care physicians. Tendinopathies often have a multifactorial aetiology and injury can be due to a combination of both acute and chronic trauma which contributes to loss of tissue integrity and eventual rupture. Our incomplete understanding of the mechanisms surrounding tendon pathophysiology continues to cause difficulties in treatments beyond loading regimes which can be unsuccessful in up to 30% of cases. We describe an uncommon case of tendinopathy affecting the periscapular muscle/tendon unit in a 35-year-old female with persistent pain around the inferior posterior pole of her right scapula. Magnetic resonance imaging findings confirmed oedema of the muscles around the inferior scapular margin in keeping with enthesopathy/tendinopathy and she was treated with radiofrequency coblation to the area. This case highlights radiofrequency ablation as a surgical option should non-operative treatments fail in the rare diagnosis of periscapular tendinopathy.
Improvements in dizziness and imbalance results from using a multi disciplinary and multi sensory approach to Vestibular Physical Therapy - a case study
Authors: Kim R Gottshall, Pinata H Sessoms
Journal: Front Syst Neurosci (2015)
Keywords: caren, tbi, traumatic brain injury, treadmill, vestibular physical therapy, virtual reality

This paper discusses a case study of a 41-year-old active duty male service member who sustained head trauma from a motorcycle accident and underwent multidisciplinary vestibular physical therapy rehabilitation. He was initially treated with traditional physical therapy applications of treadmill walking and standing balance with some symptom improvements, but was not able to maintain a running speed that would allow him to return to full active duty status. Further treatment utilizing a Computer Assisted Rehabilitation Environment was performed in order to increase level of difficulty and further enhance function. This treatment is able to elicit vestibular deficits seen in the community as it requires subjects to walk and balance while performing tasks within a virtual scenario incorporating platform motion, visual surround and flow, and cognitive processing. After 6 weeks of therapy, twice weekly, improvements in clinical vestibular measures were observed as well as walking speed and patient confidence. The patient was able to return to full duty after treatment. This case study provides supportive evidence that multidimensional tasking in a virtual environment provides a safe but demanding form of vestibular therapy for patients needing more challenging tasks than those provided with traditional therapy techniques. Those persons requiring higher levels of performance before returning to full duty (e.g., pilots, special operators, etc.) may find this type of therapy beneficial.