OpenMed/multicare-articles huggingface dataset:
Healing and Spontaneous Realignment of Displaced Roots With Periapical Granuloma After Microsurgical Endodontic Treatment (Three Years' Follow-up): A Case Report
Authors: Omar Alzahrani, Hisham Komo, Mohammed Howait
Journal: Cureus (2024)
Keywords: apical microsurgery, apicoectomy, dental healing, mineral trioxide aggregate, root canal treatment
MeSH terms: Case Reports

Endodontic therapy aims to treat or prevent apical periodontitis, a condition characterized by inflammation of the periapical tissues at the apex of the tooth root. This case study demonstrates the successful nonsurgical and surgical management of a large periapical lesion involving the lower central incisors with root displacement induced by a periapical granuloma. A patient was referred from the maxillofacial department for endodontic treatment due to persistent pain and swelling in the lower anterior region started two months ago. Upon arrival, a clinical examination and radiographic assessment were performed using cone-beam computed tomography (CBCT). The CBCT scan revealed a significant radiolucent area measuring (10x8) mm extending from the lower left lateral incisor to the right central incisor. The lower left central incisor was necrotic and tender to palpation and percussion. A nonsurgical root canal was performed followed by an apicectomy using mineral trioxide aggregate (MTA) to facilitate healing of the periapical lesion. Histopathological examination of the lesion confirmed the diagnosis of periapical granuloma. At follow-up 1, 2, and 3 years' visits, the periodontal assessment was performed and found to be free of pain upon percussion or palpation. No other clinical or radiological signs or symptoms were identified except for a small radiolucent area mesially adjacent to the root of the lower left central incisor. The development of materials such as MTA has significantly improved the prognosis of cases with large periapical lesions. In this case, healing and spontaneous realignment of the root were observed after three years.
Electroconvulsive Therapy in Transgender and Gender Diverse Population: A Case Report and Review of Literature
Authors: Lachlan Draper, Ashis Vikas, Subhash Das, Suresh Yadav, Frances Walker, Ivona Bandilovska
Journal: Case Rep Psychiatry (2024)
MeSH terms: Case Reports

Objective:
Present a case of a transgender and gender diverse (TGD) individual receiving gender affirming hormone therapy (GAHT) who presented with first episode bipolar mania and received electroconvulsive therapy (ECT). To understand the safety and efficacy of ECT in the TGD population including those receiving GAHT through literature review.
Materials and methods:
Case report using informed consent from an individual TGD patient who received ECT. A review of the literature was conducted using PubMed, Embase, and Medline.
Results:
The case illustrated safe and effective ECT use in a TGD individual receiving GAHT. Eight studies were reviewed. GAHT has been reported to interfere with certain anaesthetic agents used in ECT. ECT appeared to be a safe and effective treatment in the TGD samples in those studies.
Conclusion:
There is limited literature on the safety and efficacy of ECT for TGD individuals receiving GAHT. More research is required to address mental health inequalities in this population and to support safe and effective gender affirming treatment modalities.
Breast and cervical cancer in transgender men: literature review and a case report
Authors: Francesca Sofia Di Lisa, Alice Villa, Lorena Filomeno, Teresa Arcuri, Benito Chiofalo, Giuseppe Sanguineti, Laura Pizzuti, Eriseld Krasniqi, Maddalena Barba, Domenico Sergi, Francesco Lombardo, Francesco Romanelli, Claudio Botti, Giovanni Zoccali, Gennaro Ciliberto, Patrizia Vici
Journal: Ther Adv Med Oncol (2024)
Keywords: breast and cervical cancer, case report, screening, testosterone therapy, transgender men
MeSH terms: Case Reports

Transgender individuals exhibit a higher prevalence of cancer-related risk factors, such as substance abuse and sexually transmitted infections. These factors, coupled with suboptimal adherence to cancer screening recommendations, may lead to a higher incidence of cancers, such as breast and cervical cancer, and contribute to delayed diagnoses in transgender patients. Herein, we report a unique case of a transgender man with a history of alcohol and drug abuse, undergoing gender-affirming exogenous testosterone therapy, who developed synchronous locally advanced breast cancer and human papilloma virus (HPV)-related cervical cancer. He underwent concurrent chemoradiation for cervical cancer and surgery followed by endocrine therapy for breast cancer. The treatments were suboptimals due to patient's comorbidities, among them liver cirrhosis leading to an early death. Additionally, we have conducted a review of existing literature, including case reports, clinical studies, and review articles investigating the role of potential risk factors specifically related to breast and cervical tumors in transgender men. Gender-affirming testosterone therapy is common among transgender men to induce gender affirmation, but its link to breast cancer risk remains ambiguous, with studies being limited and sometimes contradictory. Conversely, HPV is a well-established cause of up to 99% of cervical cancers. Despite persistent risk for cervical cancer in transgender men who retain their cervix, several studies indicate notable disparities in screening adherence, due to personal and structural barriers. Moreover, alcohol and drug use disorders, commonly encountered in transgender population, may negatively influence the adherence to screening programs. Current cancer screening guidelines for this population are somewhat unclear, and specific programs based on more robust data are urgently required along with further tailored studies.
Report of Giardia duodenalis in a non-captive chital Axis axis (Erxleben 1777) in Santa Catarina, South of Brazil
Authors: Jackson Fábio Preuss, Clóvis Junior Chimin Chafes, Andréia Buzatti
Journal: Braz J Vet Med (2024)
Keywords: exotic deer, giardiasis, parasitological diagnosis, public health, zoonotic agent
MeSH terms: Case Reports

Giardiasis is an infection of the small intestine by protozoa of the genus Giardia, which has a wide range of susceptible hosts, including domestic and wild animals and humans. Giardia is a zoonotic agent and represents one of the main human parasites, with high prevalence and great importance in public health. This report aims to describe the parasitism of a non-captive Chital deer (Axis axis) by Giardia duodenalis. The animal, after being rescued by soldiers from the 2nd Platoon of the 2nd Company of the 2nd Battalion of the Environmental Military Police of the State of Santa Catarina, was sent to the Wildlife Studies Center (NEVS) of the University of Western Santa Catarina (UNOESC). During clinical care, an exposed fracture in the left pelvic limb and signs of acute respiratory failure were found. Fecal samples were collected for later parasitological diagnosis. Two techniques were applied: centrifugal flotation with zinc sulfate, to diagnose parasites of the gastrointestinal system, and Baermann, to search for parasitism in the respiratory tract. The investigation revealed the presence of Giardia duodenalis. The animal died on the same day of its arrival due to a cardiorespiratory arrest. The presence of this parasite in an invasive exotic deer species highlights its epidemiological importance, as it can act as a source of infection and spread the disease to humans and other animals.
Case report: Surgical treatment and long-term successful outcome of a spinal intramedullary vascular malformation in a dog
Authors: Koen M Santifort, Marta Plonek, Guy C M Grinwis, Ines Carrera, Simon Platt
Journal: Front Vet Sci (2023)
Keywords: hamartoma, hemorrhage, intramedullary, outcome, prognosis, spinal cord, vascular malformation
MeSH terms: Case Reports

A 3.5-year-old male intact Staffordshire terrier crossbreed dog was presented with a one-week history of progressive paraparesis with fecal and urinary incontinence. Neurological examination was consistent with a T3-L3 myelopathy. A magnetic resonance imaging study revealed the presence of a well-circumscribed hemorrhagic space-occupying lesion at the level of T12, suspected to be a vascular malformation, such as cavernoma or arteriovenous fistula, primary hematoma or hamartoma; less likely considerations included hemorrhagic inflammation or hemorrhagic primary or secondary neoplasia. A dorsal laminectomy, durotomy, and midline dorsal myelotomy were performed with a surgical microscope, and the vascular lesion was identified and removed. Histological examination of surgical samples yielded fibrin, hemorrhage, hematoidin pigment, and some neural tissue. Although a lining wall was visualized during surgery consistent with a vascular malformation, there was no histological confirmation of such a structure, hampering definitive classification of the lesion. There was no gross or histopathological evidence that would support a diagnosis of a hamartoma or benign neoplasia. The dog was paraplegic with intact nociception the day following surgery. Ambulation was recovered within 2 weeks. Progressive and complete recovery of neurological function was seen over the next 12 weeks. No recurrence of neurological dysfunction was seen over a 12-month follow-up period. Surgical treatment should be considered in dogs with spinal intramedullary vascular lesions which can have a successful long-term outcome.
Case Report: sintilimab-induced Stevens-Johnson Syndrome in a patient with advanced lung adenocarcinoma
Authors: Xueqin Li, Guanghui Li, Diangang Chen, Linxi Su, Ru-Peng Wang, Yi Zhou
Journal: Front Oncol (2023)
Keywords: stevens-johnson syndrome, adverse events, case report, immunotherapy, sintilimab
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) have been widely applicated in clinical therapy in recent years. Skin-related adverse reaction is one of the most common adverse events for ICIs. Stevens-Johnson syndrome (SJS) is one of the serious cutaneous reactions threatening the life. Here, we reported a case of 76-year-old male patient with poorly differentiated metastatic lung adenocarcinoma, after 9 weeks exposure of sintilimab (3 doses) combined with paclitaxel liposome after concurrent chemotherapy/radiotherapy, experienced Stevens-Johnson syndrome involving limbs, trunk, lip and the oral mucosa. Biopsy of the skin tissue showed infiltration of CD4 and CD8 positive T lymphocytes. We also found PD-L1 expression in the glands and the basal layer of the skin. This finding is distinct from the previously reported expression of PD-L1 on the surface of epidermal keratinocytes in patients with SJS due to immunotherapy.
Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report
Authors: Zhoujun Liu, Yueting Zhao, Xue Han, Xin Hu, Yuzhi Zhang, Lan Xu, Guofang Chen, Chao Liu, Shuhang Xu
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: case report, microwave ablation, multiple endocrine neoplasia, primary hyperparathyroidism, recurrence
MeSH terms: Hyperparathyroidism, Primary / complications, Hyperparathyroidism, Primary / diagnostic imaging, Hyperparathyroidism, Primary / surgery, Multiple Endocrine Neoplasia Type 1 / complications, Multiple Endocrine Neoplasia Type 1 / genetics, Multiple Endocrine Neoplasia Type 1 / surgery, Case Reports, Research Support, Non-U.S. Gov't, Adult, Female, Humans, Microwaves / therapeutic use, Parathyroid Glands / diagnostic imaging, Parathyroid Glands / pathology, Parathyroid Glands / surgery, Ultrasonography, Interventional

Background:
Multiple endocrine neoplasia type 1 (MEN1) is an inherited endocrine syndrome caused by the mutation in the tumor suppressor gene MEN1. The recurrence rate of primary hyperparathyroidism (PHPT) in patients with MEN1 after parathyroidectomy remains high, and the management of recurrent hyperparathyroidism is still challenging.
Case presentation:
We reported a 44-year-old woman with MEN1 combined with PHPT who was diagnosed through genetic screening of the patient and her family members. After parathyroidectomy to remove one parathyroid gland, the patient suffered from persistent high levels of serum calcium and parathyroid hormone, which returned to normal at up to 8 months after ultrasound-guided microwave ablation (MWA) for bilateral parathyroid glands, suggesting an acceptable short-term prognosis.
Conclusion:
Ultrasound-guided MWA for parathyroid nodules may be an effective therapeutic strategy for recurrent PHPT in MEN1 patients.
Case report: Successful treatment of acute generalized pustular psoriasis with multiple comorbidities with oral tacrolimus
Authors: Mingdan Zhao, Fujun Huang, Lei Tang, Xun Zhou, Miao Zhang, Mengxue Liao, Lirong Liu, Mengya Huang
Journal: Front Immunol (2024)
Keywords: acute generalized pustular psoriasis, case report, oral, tacrolimus, treatment
MeSH terms: Diabetes Mellitus, Type 2 / complications, Diabetes Mellitus, Type 2 / drug therapy, Psoriasis / complications, Psoriasis / diagnosis, Psoriasis / drug therapy, Renal Insufficiency, Chronic / complications, Case Reports, Research Support, Non-U.S. Gov't, Acute Disease, Aged, Chronic Disease, Female, Humans, Interleukins, Tacrolimus / therapeutic use, Tacrolimus, Interleukins

Acute generalized pustular psoriasis (GPP) is a serious illness. Despite various treatment methods, there is still lack of effective treatment plans for refractory cases with multiple comorbidities. This case report presents a 67-year-old woman with acute GPP, stage 4 chronic kidney disease (CKD), type 2 diabetes, and cardiovascular disease, in whom skin symptom disappearance and kidney function improvement were observed after the use of oral tacrolimus as the sole therapy. This is the first report on the application of tacrolimus in the treatment of acute GPP, especially refractory acute GPP. The successful treatment indicates that there are shared immune pathways between acute GPP and CKD, and the pathways can be interdicted by tacrolimus. Further studies are needed to optimize the therapy to maximize efficacy and minimize toxicity.
Case report: Pemigatinib-induced retinopathy: a serial examination of subretinal fluid secondary to an FGFR inhibitor
Authors: Daniel Barmas-Alamdari, George Jiao, Ronni Lieberman
Journal: Front Ophthalmol (Lausanne) (2024)
Keywords: fgfr (fibroblast growth factor receptor), fgfr inhibitor, oct, pemazyre, pemigatinib, pigment epithelial detachment, subretinal fluid
MeSH terms: Case Reports

Background:
Modern chemotherapeutic agents continue to evolve as modern monoclonal antibody treatments are designed to directly target proteins, enzymes, and focal loci. A particular class of these medications, fibroblast growth factor (FGFR) inhibitors, specifically pemigatinib (Pemazyre®; Incyte), has been approved by the US Food and Drug Administration since April 2020 for the treatment of advanced or metastatic cholangiocarcinoma. As it is a relatively new medication, its side-effect profile is manifesting in active clinical practice. The presence of FGFR receptors in the retinal pigment epithelium makes the retina susceptible to potential adverse effects secondary to pemigatinib use.
Case presentation:
A 69-year-old African-American male with a tumor mutation burden 3 (TMB-3) metastatic adenocarcinoma of the liver from primary cholangiocarcinoma, who was undergoing chemotherapy with pemigatinib, was found to have asymptomatic bilateral subretinal fluid accumulation. Serial monitoring with optical coherence tomography (OCT) demonstrated complete resolution of the subretinal fluid while off-cycle and asymptomatic re-accumulation of subretinal fluid while on-cycle, with no significant changes in visual acuity.
Conclusions:
Subretinal fluid accumulation secondary to pemigatinib may develop during the active treatment cycles without causing any significant visual symptoms for the patient. Serial monitoring demonstrates fluctuations of subretinal fluid during the patient's on- and off-cycles. This case strengthens the current guidelines for continuing pemigatinib in asymptomatic patients found to have subretinal fluid. Further studies are warranted to identify patients who may be at higher risk for developing subretinal fluid.
Use of transcranial magnetic stimulation in the treatment of nonfluent primary progressive aphasia: a case report
Authors: Natália Maria Lins Martins, Tathiana Baczynski, Larissa Sena, Romário de Macedo Espíndola, Natia Horato, Antonio Egidio Nardi, Valeska Marinho
Journal: Dement Neuropsychol (2023)
Keywords: dorsolateral prefrontal cortex, primary progressive aphasias, transcranial magnetic stimulation
MeSH terms: Case Reports

Primary progressive aphasia comprises a group of neurodegenerative diseases characterized by progressive speech and language dysfunction. Neuroimaging (structural and functional), biomarkers, and neuropsychological assessments allow for early diagnosis. However, there is no pharmacological treatment for the disease. Speech and language therapy is the main rehabilitation strategy. In this case report, we describe a female patient diagnosed with nonfluent primary progressive aphasia who underwent sessions of high-frequency transcranial magnetic stimulation in the left dorsolateral prefrontal cortex and showed improvement in depression scores, naming tasks in oral and written speech, and comprehension tasks in oral and written discourse.
Case report: Effective treatment of rituximab-resistant minimal change disease with obinutuzumab in an adult
Authors: Qiang Wang, Lin Lin, Junhui Zhen, Bei Jiang, Guangyi Liu
Journal: Front Immunol (2024)
Keywords: minimal change disease, obinutuzumab, refractory, rituximab-resistant, steroid-dependent
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Nephrosis, Lipoid / drug therapy, Rituximab / therapeutic use, Case Reports, Adult, Drug Resistance, Female, Humans, Recurrence, Remission Induction, Treatment Outcome, Rituximab, obinutuzumab, Antibodies, Monoclonal, Humanized

Background:
Minimal change disease (MCD) is a common cause of adult nephrotic syndrome. Most adults with MCD achieve complete remission (CR) after initial steroid therapy. However, approximately 30% of adults who respond to steroids experience frequent relapses, becoming steroid-dependent and potentially developing refractory MCD. Treating refractory MCD in adults poses a significant challenge.
Main body:
A 37-year-old woman presented to the nephrology department with a 6-year history of MCD. The diagnosis of MCD was confirmed via renal biopsy. She initially achieved CR with steroid treatment but experienced relapse during steroid tapering. Subsequent CR was achieved with a regimen of steroids and tacrolimus although multiple relapses occurred. Rituximab led to another CR, but its maintenance lasted only 6 months. The response to subsequent rituximab treatments was unsatisfactory. Ultimately, obinutuzumab was selected, resulting in the induction and maintenance of CR for 12 months.
Conclusions:
This case demonstrates the successful treatment of frequently relapsed, steroid-dependent, and rituximab-resistant MCD with obinutuzumab. Obinutuzumab is a promising therapeutic option for rituximab-resistant MCD.
Case Report: Scleral hyperpigmentation associated with oral hydroxychloroquine use
Authors: Caroline Maretz, Felix Omoruyi, Rachel A F Wozniak
Journal: Front Ophthalmol (Lausanne) (2023)
Keywords: drug reaction, hydroxychloroquine, hyperpigmentation, sclera, skin pigmentation
MeSH terms: Case Reports

Hydroxychloroquine (HCQ) is a commonly used medication for its immunosuppressive and dermatologic effects. It has known ocular side effects, which include retinopathy, corneal deposits, and choroidal thinning. Herein, we report the first known case of HCQ-induced hyperpigmentation of the sclera. A 75-year-old female presented after 10 months of gradual progression of painless blue-gray discoloration of the bilateral sclera, fingernails, and lower extremities secondary to oral HCQ therapy. Cessation of the drug led to a partial reversal of the hyperpigmentation at 5 months, further supporting HCQ as the causative agent. Hyperpigmentation reactions can be distressing to patients and lead to decreased medication adherence; given the widespread use of HCQ, it is important to increase awareness of this potential drug reaction.
Between the personal and the political: life experiences during the covid-19 pandemic in Tucumán, Argentina, 2020-2022
Authors: María Laura Cordero, Eric D Carter
Journal: Hist Cienc Saude Manguinhos (2023)
MeSH terms: COVID-19 / epidemiology, Pandemics, Argentina / epidemiology, Humans, Life Change Events, Politics

This article analyzes feelings, experiences, practices, and actions that underlie the meanings attributed to the covid-19 pandemic. Based on a case study located in the province of Tucumán (Argentina), a mixed-methods investigation was developed, interested in capturing life experiences. Discourse analysis show the resignification of life itself, the valorization of close ties, community social capital, the State and politics. From the personal to the political, the interpretive frames people use to signify life experiences during the covid-19 pandemic exhibit differentiated feelings, experiences, practices, and actions.
Vara Deformity and Subluxed Humeral Heads: An Unusual Sign in Pseudohypoparathyroidism
Authors: Mason A Williams, Kharina Guruvadoo, Lena Naffaa
Journal: Cureus (2024)
Keywords: bone resorption, humeral head, parathyroid hormone (pth), pseudohypoparathyroidism, slipped capital femoral epiphysis, vara deformity
MeSH terms: Case Reports

Pseudohypoparathyroidism is a rare disorder characterized by end-organ resistance to intact parathyroid hormone (PTH) and concomitant laboratory findings of hypocalcemia and hyperphosphatemia. Radiologic evidence of the disease may manifest as a variety of bone abnormalities. This case describes an 11-year-old female with a history of repaired bilateral slipped capital femoral epiphysis who presented with a limited range of motion of the bilateral upper extremities. Laboratory findings were consistent with pseudohypoparathyroidism. Radiographs revealed subchondral resorption of bilateral clavicular heads and multiple ribs and band lucencies of proximal humeral metaphyses, along with vara deformity and inferior subluxation of the humeral heads. This presentation adds to the spectrum of potential radiographic manifestations of pseudohypoparathyroidism.