OpenMed/multicare-articles huggingface dataset:
A rare case report of waldenström macroglobulinemia converted to serum low IgM
Authors: Yuan Xiang, Shi-Qiang Fang, Yi-Wen Liu, Hui Wang, Zhong-Xin Lu
Journal: Front Genet (2023)
Keywords: abnormal increase of igm, mutation, rare chronic lymphoproliferative, waldenström macroglobulinemia, waldenström macroglobulinemia/lymphoplasmacytoid lymphoma
MeSH terms: Case Reports

Waldenström Macroglobulinemia (WM) is a rare chronic lymphoproliferative disease, accounting for less than 2% of hematological malignancies. It is characterized by plasma cytoid lymphocyte infiltration in bone marrow and abnormal increase of monoclonal IgM in peripheral blood. Only 5%-10% of cases of WM secrete monoclonal IgG and IgA components or do not secrete monoclonal long immunoglobulin. This case is the first to report of serum protein recombination from lgM and Igkappa band mutation to abnormal lgG and Igkappa band after 6 years of treatment in a male patient with WM.
Immunodeficiency-Associated Lymphoid Hyperplasia As a Cause of Intussusception in a Case of Activated PI3K-δ Syndrome
Authors: Daniel Mettman, Isabelle Thiffault, Chitra Dinakar, Carol Saunders
Journal: Front Pediatr (2017)
Keywords: b-cell lymphomas, pik3cd, lymphoid hyperplasia, primary immunodeficiency, sinopulmonary infections
MeSH terms: Case Reports

Activated PI3K-δ syndrome refers to a recently described primary immunodeficiency syndrome consisting of recurrent sinopulmonary infections, lymphadenopathy, mucosal lymphoid aggregates, increased susceptibility to Epstein-Barr virus and cytomegalovirus, and increased incidence of B-cell lymphomas. Variants in PIK3CD, which encodes the phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit delta isoform, enhance membrane association and kinase activity, resulting in increased signal transduction through the PI3K-Akt pathway. Whole-exome sequencing revealed a pathogenic PIK3CD variant in a patient with history of immunologic impairment, recurrent sinopulmonary infections, and lymphoid hyperplasia presenting as intussusception. This case illustrates that while lymphoid hyperplasia secondary to immunodeficiency is most often unsurprising and non-threatening, it can present as an emergency-like intussusception.
Fibrous tumor of the stomach causing abdominal pain and melena: Case report with review of literature
Authors: Wan Aldohuky, Ayad Ahmad Mohammed
Journal: Int J Surg Case Rep (2019)
Keywords: abdominal pain, dystrophic calcifications, endoscopy, fibrous tumors, gastric tumors

Introduction:
Fibrous tumor of the stomach is a rare mesenchymal tumor composed of hyalinized fibrous tissue with spindle shaped fibroblasts. This type of tumor usually occurs in the subcutaneous tissues and the deep soft tissues. Its occurrence in stomach is extremely a rare finding and only few cases have been reported worldwide, the exact etiology is still unclear.
Presentation of case:
A 68-year-old female was complaining from epigastric and right hypochondrial pain for few months. It was associated with attacks of non-bilious vomiting and early satiety, with attacks of melena. During abdominal examination there was a palpable mass in the epigastric region which was oval in shape, soft, mobile in the vertical direction, and was non-pulsatile. The hemoglobin was 9 gm/liter. Ultrasound and CT-scan of the abdomen showed a well-defined non-enhancing, multi-loculated mass related to the body of the stomach. Gastroscopy showed soft tissue mass with intact mucosa in the anterior gastric wall, multiple biopsies were taken which revealed fatty tissue with no evidence of malignancy. Laparotomy was done and a soft, mobile mass was found in the anterior gastric wall in the pre-pyloric region, the serosa was intact, complete excision of the mass was performed. The histopathological result showed fibrous tumors of the stomach.
Conclusion:
The treatment of this tumor is mainly through surgical intervention. Which should be done at the time of diagnosis. The prognosis after successful resection is excellent, few cases are reported with local recurrence.
Use of Cone Beam Computed Tomography for Identification of a Distant Causative Tooth: An Unusual Case of an Apical Lesion from a Maxillary Premolar Mimicking That from Maxillary Incisors
Authors: Shu Abe, Takashi Muramatsu
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

The article describes an unusual case of an apical lesion at the first premolar with spontaneous pain and swelling around the root and tooth mobility at the maxillary right central and lateral incisors. The patient was a 45-year-old man with a chief complaint of discomfort at the maxillary right central and lateral incisors for one year. Oral examination showed spontaneous pain, swelling, and tooth mobility of the maxillary right central and lateral incisors. Intraoral and panoramic radiographs showed clear apical radiolucency at these sites, although there were no carious incisors. Neither tooth had periodontal pockets, and there was no bleeding on probing sites. A cold thermal examination revealed normal responses of the vital dental pulp. Initial panoramic radiography showed an apical lesion of the maxillary right first premolar, which was root filled and without inflammatory symptoms. A cone beam computed tomography (CBCT) revealed that the apical lesion of the premolar had extensively spread to the anterior through the palatal side, circumventing the palatal side of the adjacent canine, and reached the apical areas of the central and lateral incisors. We treated the apical lesion of the first premolar, and the radiolucent regions had almost disappeared after three years with regard to not only the apical lesion in the first premolar and incisors but also the primary symptoms on the incisors without endodontic treatment. This case shows that CBCT is an effective alternative that allows appropriate treatment to be selected more reliably.
InferBERT: A Transformer-Based Causal Inference Framework for Enhancing Pharmacovigilance
Authors: Xingqiao Wang, Xiaowei Xu, Weida Tong, Ruth Roberts, Zhichao Liu
Journal: Front Artif Intell (2021)
Keywords: artificial intelligence, causal inference, language models, natural language processing, pharmacovigilance

Background: T ransformer-based language models have delivered clear improvements in a wide range of natural language processing (NLP) tasks. However, those models have a significant limitation; specifically, they cannot infer causality, a prerequisite for deployment in pharmacovigilance, and health care. Therefore, these transformer-based language models should be developed to infer causality to address the key question of the cause of a clinical outcome. Results: In this study, we propose an innovative causal inference model-InferBERT, by integrating the A Lite Bidirectional Encoder Representations from Transformers (ALBERT) and Judea Pearl's Do-calculus to establish potential causality in pharmacovigilance. Two FDA Adverse Event Reporting System case studies, including Analgesics-related acute liver failure and Tramadol-related mortalities, were employed to evaluate the proposed InferBERT model. The InferBERT model yielded accuracies of 0.78 and 0.95 for identifying Analgesics-related acute liver failure and Tramadol-related death cases, respectively. Meanwhile, the inferred causes of the two clinical outcomes, (i.e. acute liver failure and death) were highly consistent with clinical knowledge. Furthermore, inferred causes were organized into a causal tree using the proposed recursive do-calculus algorithm to improve the model's understanding of causality. Moreover, the high reproducibility of the proposed InferBERT model was demonstrated by a robustness assessment. Conclusion: The empirical results demonstrated that the proposed InferBERT approach is able to both predict clinical events and to infer their causes. Overall, the proposed InferBERT model is a promising approach to establish causal effects behind text-based observational data to enhance our understanding of intrinsic causality. Availability and implementation: The InferBERT model and preprocessed FAERS data sets are available on GitHub at https://github.com/XingqiaoWang/DeepCausalPV-master.
Why live recording sounds better: a case study of Schumann's Träumerei
Authors: Haruka Shoda, Mayumi Adachi
Journal: Front Psychol (2015)
Keywords: acoustical analysis, functional principal components analysis, listeners' evaluation, live recording, multi-group path analysis, music, social facilitation

We explore the concept that artists perform best in front of an audience. The negative effects of performance anxiety are much better known than their related cousin on the other shoulder: the positive effects of "social facilitation." The present study, however, reveals a listener's preference for performances recorded in front of an audience. In Study 1, we prepared two types of recordings of Träumerei performed by 13 pianists: recordings in front of an audience and those with no audience. According to the evaluation by 153 listeners, the recordings performed in front of an audience sounded better, suggesting that the presence of an audience enhanced or facilitated the performance. In Study 2, we analyzed pianists' durational and dynamic expressions. According to the functional principal components analyses, we found that the expression of "Träumerei" consisted of three components: the overall quantity, the cross-sectional contrast between the final and the remaining sections, and the control of the expressive variability. Pianists' expressions were targeted more to the "average" of the cross-sectional variation in the audience-present than in the audience-absent recordings. In Study 3, we explored a model that explained listeners' responses induced by pianists' acoustical expressions, using path analyses. The final model indicated that the cross-sectional variation of the duration and that of the dynamics determined listeners' evaluations of the quality and the emotionally moving experience, respectively. In line with human's preferences for commonality, the more "average" the durational expressions were in live recording, the better the listeners' evaluations were regardless of their musical experiences. Only the well-experienced listeners (at least 16 years of musical training) were moved more by the "deviated" dynamic expressions in live recording, suggesting a link between the experienced listener's emotional experience and the unique dynamics in music.
Coxarthritis as the presenting symptom of Gaucher disease type 1
Authors: Giacomo Brisca, Maja Di Rocco, Paolo Picco, Maria Beatrice Damasio, Alberto Martini
Journal: Arthritis (2011)
MeSH terms: Case Reports

Gaucher disease (GD) type 1 is the most common lysosomal storage disorder due to beta glucocerebrosidase deficiency leading to an abnormal accumulation of its substrate, glucocerebroside, in the mononuclear phagocyte system. The disease presentation is usually characterized by signs and symptoms related to hypersplenism, such as splenomegaly, anaemia, thrombocytopenia and leucopenia. Skeletal disease may occur later for the infiltration of bone marrow by macrophages infiltration and bone resorption: bone involvement may be heterogeneously manifested by symptoms ranging from bone crisis to avascular necrosis, osteoporosis and defect in remodeling of long bones. Herein, we report a patient in whom the osteoarticular involvement has been the only symptom of the disease stressing that this unusual presentation of GD has prompted a wide differential diagnosis with more common forms of coxitis.
Postpartum invasive group A streptococcal disease in the modern era
Authors: David M Aronoff, Zuber D Mulla
Journal: Infect Dis Obstet Gynecol (2008)
MeSH terms: Postpartum Period, Pregnancy Complications, Infectious / epidemiology, Streptococcal Infections / epidemiology, Streptococcus pyogenes / isolation & purification, Case Reports, Adult, Anti-Bacterial Agents / therapeutic use, Female, Florida / epidemiology, Hospitalization / statistics & numerical data, Humans, Length of Stay, Male, Pregnancy, Pregnancy Complications, Infectious / drug therapy, Pregnancy Complications, Infectious / microbiology, Prevalence, Retrospective Studies, Risk Factors, Statistics, Nonparametric, Streptococcal Infections / drug therapy, Streptococcal Infections / microbiology, Anti-Bacterial Agents

To describe the clinical features of individuals hospitalized for postpartum invasive group A Streptococcus (GAS) infection, a retrospective, population-based study of hospitalized patients in the state of Florida was conducted. Cases of postpartum invasive GAS infection (occurring within 42 days of delivery) were compared to women with other manifestations of invasive GAS disease with respect to their age at the time of admission. Four cases of postpartum invasive GAS infection were detected in this population, yielding a prevalence of 1.6% (4/257) of postpartum disease in this invasive GAS infection database. Patients presented a median of 4 days (mean of 9 days) after delivery with signs and symptoms of infection. Three cases were complicated by bacteremia and one patient had streptococcal toxic shock syndrome. Each patient received multiple antibiotics and survived. No patients received intravenous immunoglobulin. For comparison, a secondary retrospective investigation of a large hospital discharge dataset obtained from the Florida Agency for Health Care Administration was assessed for patients with puerperal GAS infections. This method yielded an additional three cases, whose clinical and demographic characteristics were summarized. These data highlight that postpartum invasive GAS infection continues to complicate pregnancy, though the frequency has decreased markedly over the past century.
Acute hepatitis and myositis associated with Erythema infectiosum by Parvovirus B19 in an adolescent
Authors: Maria Koliou, Evaggelia Karaoli, Elpidoforos S Soteriades, Sylvie Pavlides, Stavros Bashiardes, Christina Christodoulou
Journal: BMC Pediatr (2014)
MeSH terms: Erythema Infectiosum, Hepatitis / virology, Myositis / virology, Case Reports, Acute Disease, Adolescent, Hepatitis / complications, Humans, Male, Myositis / complications, Parvovirus B19, Human

Background:
Erythema infectiosum is the most common clinical manifestation of Parvovirus B19 infection although it has also been associated with rheumatologic diseases and various types of systemic vasculitides. Acute hepatitis and benign myositis however are rarely reported in association with Parvovirus B19 infection.
Case presentation:
Here we report a 14-year old male, who developed acute hepatitis and benign myositis associated with erythema infectiosum following Parvovirus B19 infection.
Conclusion:
Parvovirus B19 infection has rarely been associated with acute hepatitis and exceptionally rarely with benign myositis. Parvovirus B19 should be considered in the differential diagnosis of acute non-A to E hepatitis and in the case of acute benign myositis presenting with a rash especially in children.
Acute Symptomatic Calcific Discitis Mimicking a Septic Spondylodiscitis
Authors: Magda Choueiri, Florent Eymard, Sandra Guignard, Frédéric Pigneur, Xavier Chevalier
Journal: Case Rep Rheumatol (2020)
MeSH terms: Case Reports

Acute symptomatic calcific discitis is a poorly understood condition that has been mostly reported in children. Cases in adults have been scarcely reported and may mimic an infectious process. Imaging, including computed tomography, can show the disc calcification but might fail to show it because its resorption can occur early after the onset of symptoms. We report the case of an adult patient presenting with severe cervical-dorsal junction pain, fever, high C-reactive protein (CRP) levels, and imaging findings mimicking an infectious spondylodiscitis, including an erosion of the anterior part of the vertebral endplate. However, the patient improved spontaneously and rapidly, with pain and fever disappearing and C-reactive protein (CRP) returning to normal within a week.
Severe Type B Lactic Acidosis in a Rare and Aggressive HIV-Related Lymphoma
Authors: John Harwood Scott, Ashish P S Bains, Timothy D Lindsay, Xiaofeng Zhao, Michael E Bromberg
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

We describe the prognostic implication and aggressive clinical course of lymphoma-related lactic acidosis in a rare HIV-related lymphoma. Patient was diagnosed with plasmablastic lymphoma and developed severe lactic acidosis, and was treated on the medical floor and in the medical intensive care unit. Her lactic acidosis was considered to be type B, secondary to her underlying lymphoma since she never had an infectious source, hypovolemic state, or low/high cardiac-output state. The mechanism of the lymphoma-related lactic acidosis is from altered cellular metabolism, thought to aid in lymphoma proliferation, rather than tissue hypoperfusion. It is a rare complication of aggressive lymphomas and signifies a poor prognosis. Patients having this complication should be considered for close monitoring and management in an intensive care unit until definitive treatment (i.e., chemotherapy) can be implemented.
Collaborating with interventional pulmonology in managing a massive tracheoesophageal fistula that extends from cricoid to carina: a case report
Authors: Luis E Tollinche, Mohit Chawla, Eunice W Lee, A Rolando Peralta
Journal: JA Clin Rep (2017)
Keywords: bronchoscopy, esophageal stent, jet ventilation, tracheal stent, tracheoesophageal fistula

Tracheoesophageal fistulas (TEF) present a perioperative management challenge. A 62 year-old man with esophageal carcinoma presented with a large tracheoesophageal fistula extending most of the trachea. Previously, the patient had two overlapping esophageal and one tracheal stent placed, but he developed progressive tracheal disruption due to esophageal stent perforation near the level of the cricoid. This case describes the anesthetic management of tracheal stent placement for an expanding TEF. Management included a spontaneous breathing inhalation induction followed by ventilation through a supraglottic device-laryngeal mask airway (LMA). Finally, during rigid bronchoscopy, a combination of bag ventilation and jet ventilation was utilized.
Case report: Spontaneous remission of synchronous endometrial and ovarian cancers following pregnancy
Authors: Diandra Daley, Malcolm Padwick, Sabina Mistry, Vivek Malhotra, Radhika Selvi Vikram, Paul Stanciu
Journal: Front Oncol (2022)
Keywords: endometrial, endometrioid, ovarian, pregnancy, remission, synchronous
MeSH terms: Case Reports

Introduction:
Endometrial cancer is one of the most common malignancies affecting women. It is uncommonly diagnosed in young women, particularly in the absence of abnormal vaginal bleeding symptoms.
Case presentation:
A 28-year-old woman was referred to our department with lower abdominal pain. Transvaginal ultrasound showed a complex right adnexal mass with mixed echogenicity. Magnetic resonance imaging (MRI) identified a right-sided, torted, cystic solid ovarian mass, and a polypoid lesion in the uterine cavity.
Diagnosis:
Following multidisciplinary team advice, hysteroscopic transcervical resection of endometrial polypoid mass and laparoscopic right salpingo-oophorectomy was performed. Histopathologic assessment of the endometrial tissue showed changes consistent with grade 1 endometrioid endometrial carcinoma, while the right ovarian mass showed a well-differentiated endometrioid carcinoma.
Intervention:
The patient underwent hormonal treatment and surveillance whilst making a final decision regarding further surgical management. However, the patient stopped hormonal treatment after 2 weeks, went abroad and absconded from treatment for 8 months. On her return, she had conceived naturally and was in the first trimester of pregnancy. Further management was postponed until the patient was 7 weeks postnatal. The patient was not keen on any further surgical management and opted for close surveillance with ultrasound scans and hysteroscopies with endometrial biopsies. All subsequent endometrial biopsies showed normal endometrium, with no evidence of hyperplasia or malignancy.
Outcome:
To date, the patient remains on a 6-monthly surveillance plan and is considered to have had complete natural remission of her endometrial and ovarian cancers following pregnancy.
Conclusion:
This unique case demonstrates a natural phenomenon, in which the complete, natural remission of endometrial and ovarian cancers occurred following pregnancy and childbirth. The aetiology may be related to the high progesterone levels occurring in pregnancy.
Thumbs up: Needle marker technique for preoperative localisation of radiolucent foreign bodies with ultrasonography
Authors: Valliappan Muthukumar, David Bodansky, Ravindra Badge
Journal: Int J Surg Case Rep (2020)
Keywords: case report, foreign bodies, needle, new technique, radio- lucent, ultrasonography
MeSH terms: Case Reports

Background:
A 26-year-old man presented with pain and swelling after pricking his right thumb pulp with a thorn, gardening three-weeks previously.
Technique:
After a thumb digital ring block with local anesthetic, a linear array ultrasound (US) transducer (frequency XX) identified a foreign body (FB) in both longitudinal and transverse planes. This was a hyperechoic FB, 5mm in length with surrounding hypoechoic shadow, denoting granulation tissue and fluid collection. Two 20G needles were passed orthogonally, in-line with the US transducer, from the fingertip and ulnar aspect. The needle tips were placed touching, just deep to the FB, preventing displacement. A longitudinal incision was made over the intersection, revealing the FB.
Discussion:
Here, we describe peri-operative localization of radiolucent FBs with ultrasonography needle placement in superficial or deep planes as an adjunct to necessary surgical exploration. This method has a small learning curve, reduces the required incision and helps prevent pushing the FB deeper during dissection.
An Unusual Case of Francisella tularensis
Authors: Samantha Huang, Bradley Kaptur, Julius Manu, Elias Woldegabriel
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

A 67-year-old male presented with complaints of weakness, fatigue, and shortness of breath in the context of a recent hospitalization for the same unresolved symptoms. After a largely nonspecific clinical presentation, a chest X-ray revealed a loculated pleural effusion. Culture of the postthoracentesis exudate revealed the culprit to be the aerobic Gram-negative bacterium Francisella tularensis. Amidst reports of potential resurgence, clinicians should be aware of the possible presentations of tularemia and consider it in the case of an ostensibly contributory patient history.
Pleuroperitoneal leak: an unusual cause of acute shortness of breath in a peritoneal dialysis patient
Authors: D P Ramaema, P Mpikashe
Journal: Case Rep Radiol (2014)

Introduction. Pleuroperitoneal leak is an uncommon complication of continuous ambulatory peritoneal dialysis (CAPD), with an estimated incidence of 1.6%. It should be suspected in these patients when they present with recurrent unilateral pleural effusions and/or acute shortness of breath following dialysate infusion. Case Presentation. We present the case of a 25-year-old female patient who had acute hydrothorax as a result of pleuroperitoneal leak complicating continuous ambulatory peritoneal dialysis (CAPD), which was confirmed on peritoneal scintigraphy. Conclusion. Continuous ambulatory peritoneal dialysis patients presenting with acute shortness of breath and/or recurrent unilateral pleural effusion should be investigated with peritoneal scintigraphy to exclude pleuroperitoneal leak.