OpenMed/multicare-articles huggingface dataset:
Case report: KETOLAND the psychoeducation program for ketogenic diet
Authors: Martina Paola Zanaboni, Ludovica Pasca, Maria Angela Geraci, Costanza Varesio, Monica Guglielmetti, Anna Tagliabue, Serena Grumi, Valentina De Giorgis
Journal: Front Psychiatry (2023)
Keywords: cognitive behavioral play therapy, chronic disease, glut1 deficiency syndrome (glut1ds), ketogenic diet therapy, psychoeducation, therapeutic storytelling
MeSH terms: Case Reports

Glucose transporter type 1 deficiency syndrome (GLUT1DS) is a rare neurological disorder characterized by a wide spectrum of symptoms: epilepsy, movement disorders and neurocognitive impairment. The gold standard treatment for GLUT1DS are ketogenic dietary therapies (KDTs), specifically classical ketogenic diet (CKD). Despite the benefits, CKD often represents a challenge for patients and their families since meal preparation is extremely demanding and deviates a lot from normal diet. To assure an optimal compliance to CKD a psychological support for parents and patients with GLUT1DS is highly recommended. Specifically, a psychoeducational intervention that ameliorates the knowledge about the illness and its therapy improves treatment' s adherence and efficacy. The aim of this case report is to investigate the effectiveness of a psychoeducational program, partially implemented through telepsychology, based on the theoretical model of Cognitive Behavioral Play Therapy (CBPT) to support KDT knowledge and adherence in a patient with GLUT1DS who presented a worsening of her clinical picture due to a sparse knowledge of KDTs principles which determined a low adherence. Thus, with this case report we propose a model of intervention with psychoeducation in a patient with a complex chronic disease.
Time Course of Antispike Antibody Titer after Administration of BNT162b2 mRNA COVID-19 Vaccine in a Patient with Rheumatoid Arthritis on Methotrexate
Authors: Satoshi Shinohara, Yasuhiro Hirose
Journal: Case Rep Rheumatol (2023)
MeSH terms: Case Reports

Methotrexate, an anchor drug for rheumatoid arthritis, hinders the immunogenicity of mRNA COVID-19 vaccines. Therefore, an optimal vaccine strategy for patients with rheumatoid arthritis receiving methotrexate is vital. We monitored antispike antibody titers after BNT162b2 mRNA COVID-19 vaccination in seven healthcare workers and one methotrexate-treated rheumatoid arthritis patient. The antispike antibody titers of healthcare workers significantly increased immediately after primary vaccination and then continued to decrease, whereas those of the rheumatoid arthritis patient were significantly lower immediately after primary vaccination and then increased. The titers in all participants dramatically increased 1-month postbooster. These changes over time may suggest that in the methotrexate-treated rheumatoid arthritis patient, the generation of short-lived plasma cells was strongly suppressed; in contrast, the generation of long-lived plasma cells and memory B cells was intact. For methotrexate-treated rheumatoid arthritis patients, it is important to complete the primary and booster vaccination series to ensure sufficient immunity against COVID-19.
Lung abscess by Fusobacterium nucleatum and Streptococcus spp. co-infection by mNGS: A case series
Authors: Na Wang, Zhichao Gao, Shuai He, Mengzhen Han, Wenjie Han, Xiaolin Liu, Hui Cao, Mingxi Jing, Tao Sun, Junnan Xu
Journal: Open Life Sci (2023)
Keywords: fusobacterium nucleatum, streptococcus spp, co-infection, lung abscess, shotgun metagenome next-generation sequencing
MeSH terms: Case Reports

A lung abscess is a necrotizing infection caused by microbiomes that lead to the loss of healthy lung tissue. The routine culture is a waste of time and yields false-negative results, and clinicians could only choose empiric therapy or use broad-spectrum antibiotics, which could significantly contribute to the problem of resistance or aggravate the condition. We report three patients with a routine-culture-negative lung abscess. The presenting symptoms included fever, cough, dyspnea, and chest pain, and a computed tomography scan revealed a lesion in the lungs. The bronchoalveolar lavage fluid and pleural fluid were tested for pathogens using metagenome next-generation sequencing (mNGS), and the results revealed Fusobacterium nucleatum and Streptococcus spp. (S. constellatus, S. intermedius) as the most represented microbial pathogens. Our data demonstrated that mNGS could be a promising alternative diagnostic tool for pathogen detection, and the pathogen lists indicate that it will be important to focus on the Streptococcus genus rather than the dominant Streptococcus spp. in terms of co-infection of pathogen determined by shotgun mNGS.
Management of Psychosis Associated with Graves' Disease: A Rare Case Report
Authors: Ozge Ceren Amuk Williams, Mouad Abdulrahim, Victoria Davis, Charles Jenson, Ayush Anand, Anil Krishna Bachu
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Graves' disease is an autoimmune disease in which patients can rarely present with psychiatric symptoms. In these patients, detailed history with psychiatric evaluation using a mental status examination is crucial for the early identification of psychiatric manifestations. Early intervention with medical and surgical therapy can help effectively treat the condition and prevent adverse outcomes such as catatonia. We reported the case of a 25-year-old African American female with Graves' disease who had significant stressors and presented with auditory hallucinations. She was diagnosed with psychosis secondary to Graves' disease and was managed medically using antithyroid drugs and beta-blockers. On failure of medical therapy, a surgical approach was employed. The patient was managed successfully, and her condition improved. Our case highlights that the importance of early intervention in these cases can lead to successful outcomes in patients with Graves' disease-induced psychosis.
An unusual occurrence of multiple dental anomalies in a single nonsyndromic patient: a case report
Authors: N B Nagaveni
Journal: Case Rep Dent (2012)
MeSH terms: Case Reports

Dental anomalies are the formative defects caused by genetic disturbances or environmental factors during tooth morphogenesis. Simultaneous occurrence of various multiple anomalies has been reported previously, particularly in cases of chromosomal abnormalities that often manifest with multisystem involvement. Very few cases of multiple anomalies have been documented in patients with no known generalized abnormalities. The present paper shows an unusual occurrence of a combination of dental anomalies like mandibular canine transmigration, taurodontism in permanent mandibular molars, congenital agenesis of 14 numbers of permanent teeth excluding third molars, canine impaction, primary molars with pyramidal roots, midline diastema and generalized microdontia in an apparently normal 13-year-old Indian girl.
Hair-thread tourniquet syndrome: a case report and literature review
Authors: Niroshan Sivathasan, Lavnya Vijayarajan
Journal: Case Rep Med (2012)

Though widely reported, Hair-thread Tourniquet Syndrome (HTTS) is poorly recognized. It refers to external, mechanical, circumferential constriction of an appendage, typically with an end-artery such as a digit, resulting in a "compartment syndrome-like" situation. HTTS is illustrated using the case of an infant. Children presenting with irritability should have their digits examined for signs of strangulation, with the awareness that numerous strands may be involved, with some buried in the skin. Early surgical-release must be performed if unwinding or simple cutting is unsuccessful.
Bilateral tubal gestation associated with schistosomiasis in an african woman
Authors: K H Odubamowo, O M Akinpelu, O O Lawal, C A Okolo, A A Odukogbe, A O Adekunle
Journal: Case Rep Obstet Gynecol (2014)

Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3(+0) (3 alive) woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days' duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide). Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation.
A 5-year-old with new-onset diabetes presenting with ketoacidosis, acute pancreatitis, and renal failure
Authors: Seth M Alexander, Vivek Shenoy, Margaret Kihlstrom, Amy Levenson
Journal: SAGE Open Med Case Rep (2022)
Keywords: diabetes, critical care, diabetic ketoacidosis, emergency medicine, endocrinology, gastroenterology, pancreatitis, renal failure, shock
MeSH terms: Case Reports

A 5-year-old girl presented to the emergency room with altered mental status secondary to severe diabetic ketoacidosis due to new-onset GAD65 antibody positive, type 1 diabetes mellitus. On hospital day 0, she developed anuria, shock, and hypertriglyceridemia-associated acute pancreatitis. Following intravenous insulin therapy, the patient's ketoacidosis improved. Her other complications persisted for several days and improved only with significant fluid resuscitation and supportive interventions, including intubation, thoracostomy, and vasopressors. This case underscores the importance of recognizing the early warning signs of diabetic ketoacidosis and reviews how to appropriately manage its associated life-threatening complications.
Managing Drawbacks in Unconventional Successful Glaucoma Surgery: A Case Report of Stent Exposure
Authors: Antonio Fea, Paola Maria Loredana Cannizzo, Giulia Consolandi, Carlo Alessandro Lavia, Giulia Pignata, Federico M Grignolo
Journal: Case Rep Ophthalmol Med (2015)

Traditional options in managing failed trabeculectomy (bleb needling, revision, additional incisional surgery and tube surgery) have a relatively high failure and complication rate. The use of microinvasive glaucoma surgery (MIGS) has generally been reserved to mild to moderate glaucoma cases, proving good safety profiles but significant limitations in terms of efficacy. We describe a patient who underwent MIGS (XEN Aquesys subconjunctival shunt implantation) after a prior failed trabeculectomy. After the surgery, the IOP was well controlled but as the stent was close to an area of scarred conjunctiva of the previous trabeculectomy, it became partially exposed. As a complete success was achieved, we decided to remove the conjunctiva over the exposed area and replace it by an amniotic membrane transplantation and a conjunctiva autograft. Six months after surgery, the unmedicated IOP is still well controlled with complete visual acuity recovery.
A malignant granular cell tumor excised with mohs micrographic surgery
Authors: David Crowe, Elias E Ayli, Hugh M Gloster Jr
Journal: Case Rep Oncol Med (2012)
MeSH terms: Case Reports

Malignant granular cell tumors are extremely rare, aggressive neoplasms displaying rapid growth and frequent associated metastatic disease. Excision and evaluation for metastatic disease are mandatory. We present a 54-year-old patient with a malignant granular cell tumor, treated with Mohs micrographic surgery. Cutaneous granular cell tumors are uncommon neoplasms, likely of perineural origin. Most follow a benign and uneventful course, with wide local excision being the treatment of choice (Enzinger, 1988). The malignant granular cell tumor is an extremely rare, aggressive variant, which provides a diagnostic challenge and management dilemma, especially with early presentation when it may be mistaken for other entities. There is also controversy regarding surgical management and follow-up of both benign and malignant granular cell tumors.
A Unique Case of Midvariant Reverse Takotsubo Cardiomyopathy
Authors: Carmel Moazez, Vicken Zeitjian, Azar Mehdizadeh
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is known to have 4 variants: apical, midventricular, basal, and focal. Here, we report the 2nd case of reverse midvariant (midventricular) stress cardiomyopathy and the 1st case of reverse midvariant takotsubo cardiomyopathy with apical thrombus.
Chemotherapy-Related Encephalopathy With Super-Refractory Status Epilepticus in a Child With Osteosarcoma: A Case Report With a Review of Literature
Authors: Lorenza Di Genova, Katia Perruccio, Maria Grazia Celani, Elena Mastrodicasa, Teresa Anna Cantisani, Susanna Esposito, Maurizio Caniglia
Journal: Front Pharmacol (2019)
Keywords: cisplatin, encephalopathy, methotrexate, osteosarcoma, psychosis, seizures, status epilepticus
MeSH terms: Case Reports

Osteosarcoma is the most frequent primary cancer of the bones, and a combination of primary chemotherapy, surgery, and adjuvant chemotherapy is its current treatment. In adults, some authors have reported problems with memory and concentration following chemotherapy, but in children, severe neurologic dysfunction has been rarely reported. This report describes a 13-year-old patient with primary high-grade nonmetastatic osteosarcoma of the tibia who developed encephalopathy with super-refractory status epilepticus related to chemotherapy. He received methotrexate (MTX) and cisplatin (CDDP)-containing polychemotherapy, and after the first course of drug administration, he developed fever, confusion, a state of psychomotor agitation, and super-refractory status epilepticus with normal laboratory and imaging findings. The causal relationship between the administration of the first polychemotherapy course and his neurological manifestations may be supported by the evaluation and exclusion of other causes. The administration of antiepileptic drugs and off-label atypical antipsychotics was necessary to treat his neurological complications and behavioral changes. This patient represents the first known example of super-refractory status epilepticus in a child treated with MTX and CDDP-containing chemotherapy. Physicians should be aware that encephalopathy and seizures are possible consequences of CDDP therapy when administered alone or in combination with other chemotherapeutic agents. Further studies are needed to better define this relationship in children.
SPECT/CT-Guided Surgical Removal of a Positive External Iliac Sentinel Node in Primary Umbilical Melanoma: Report of a Case, and Up-to-Date Review of the Literature
Authors: Franco Picciotto, Adriana Lesca, Luca Mastorino, Elena Califaretti, Luca Conti, Pietro Quaglino, Simone Ribero, Virginia Caliendo, Désirée Deandreis
Journal: Front Oncol (2022)
Keywords: spect/ct, lymphoscintigraphy, navel melanoma, sentinel node, sentinel node biopsy, thick melanoma, umbilical melanoma
MeSH terms: Case Reports

Primary umbilical melanoma is rare tumor, representing about 5% of all umbilical malignancies.The lymphatic drainage from the tumor is challenging and can be to inguinal, axillary and retroperitoneal nodes. Dynamic and static lymphoscintigraphy with single-photon emission tomography/computed tomography (SPECT/CT) and sentinel lymph node biopsy (SLNB) is a widely validated technique in patients with clinically localized melanoma to search for and quantify nodal spread of cutaneous melanoma. Moreover, it offers the surgeon the preoperative information about the number and location of the sentinel lymph nodes (SLNs), which makes SLNB easier and quicker. This is the first report of an ulcerated thick melanoma of the umbilicus metastasizing only to an external iliac lymph-node without involvement of superficial inguinal SLNs. The preoperative high-resolution ultrasound (HR-US) examination of the regional lymph node field had been normal. This case-report shows how addition of SPECT/CT to planar imaging in a patient with clinically localized umbilical melanoma can help avoid incomplete SLNB when a deep SLN is not removed. A literature review of umbilical melanoma is also provided.
Case Report: Simultaneous Hyperprogression and Fulminant Myocarditis in a Patient With Advanced Melanoma Following Treatment With Immune Checkpoint Inhibitor Therapy
Authors: Whitney Barham, Ruifeng Guo, Sean S Park, Joerg Herrmann, Haidong Dong, Yiyi Yan
Journal: Front Immunol (2021)
Keywords: case report, cytolytic t lymphocytes, hyperprogression, immune checkpoint inhibitors, melanoma, myocarditis
MeSH terms: Immune Checkpoint Inhibitors / adverse effects, Melanoma / complications, Myocarditis / diagnosis, Myocarditis / etiology, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Aged, Biomarkers, Biomarkers, Tumor, Biopsy, Disease Management, Disease Progression, Disease Susceptibility, Female, Humans, Immune Checkpoint Inhibitors / therapeutic use, Melanoma / diagnosis, Melanoma / drug therapy, Melanoma / etiology, Multimodal Imaging, Myocarditis / therapy, T-Lymphocyte Subsets / immunology, T-Lymphocyte Subsets / metabolism, T-Lymphocyte Subsets / pathology, Biomarkers, Biomarkers, Tumor, Immune Checkpoint Inhibitors

We report here a patient with stage IV mucosal melanoma treated with dual immune checkpoint inhibitor (ICI) therapy (Nivolumab/Ipilimumab) who experienced rapid disease progression and metastatic spread within three weeks of first infusion. Surprisingly, this patient also developed fulminant myocarditis within the same time frame. Immunohistochemical staining of the primary tumor and a metastatic omental lesion revealed robust CD8+ PD-1+ T cell infiltration after ICI treatment, as would be expected following immune activation. However, the CD8+ T cell infiltrate was largely negative for both Granzyme B and TIA-1, suggesting these T cells were not capable of effective tumor lysis. We discuss the possibility that heightened pro-inflammatory T cell activity (rather than tumor-directed cytolytic activity) was induced by anti-PD-1 and anti-CTLA-4, which could have provoked both rapid tumor resistance mechanisms and myocarditis. This case highlights the fact that the mere presence of tumor infiltrating lymphocytes (TILs) does not necessarily correlate to ICI response and that additional functional markers are necessary to differentiate between inflammatory and cytolytic CD8+ TILs.
Myoepithelioma of the Parotid Gland: A Case Report with Review of the Literature and Classic Histopathology
Authors: Mark Weitzel, Jason E Cohn, Harvey Spector
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Myoepithelioma is a rare salivary gland neoplasm. They most commonly affect the major and minor salivary glands with the parotid gland being the most common, approximately 40%. Only 1% of all salivary gland neoplasms are myoepitheliomas. Myoepithelioma is usually a benign tumor arising from neoplastic myoepithelial or basket cells which are found between the basement membrane and the basal plasma membrane of acinar cells. They also contain multiple cellular elements. We present a case of a 73-year-old female with myoepithelioma of the parotid gland, an extremely rare neoplasm. There have been approximately 42 cases reported through 1985 and fewer than 100 cases through 1993. We will discuss the clinical presentation, pathophysiology, diagnosis, and treatment of such neoplasms.
Gastric Outlet Obstruction as the Initial Presentation of Upper Tract Urothelial Carcinoma
Authors: Karl Andersen, Sarah Burroughs, Assad Munis, Ryan T Hoff, Alan Shapiro
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

GOO is often the first sign of advanced upper gastrointestinal neoplasms. The most common neoplasms associated with GOO include gastric, pancreatic, and biliary tract cancers. Urinary tract urothelial carcinoma has been a rarely documented cause of GOO.
Gastric Metastasis of Primary Lung Cancer: Case Report and Systematic Review With Pooled Analysis
Authors: Dong Tang, Jianjian Lv, Zhijing Liu, Shuhui Zhan, Yuqiang Gao
Journal: Front Oncol (2022)
Keywords: egfr mutation, clinicopathological features, gastric metastasis, primary lung cancer, prognosis
MeSH terms: Systematic Review

Background:
Gastric metastasis from lung cancer (GMLC) is a rare occurrence. The clinicopathological characteristics, outcomes, and prognostic factors remain largely elusive.
Methods:
We conducted a systematic review on case reports and case series of GMLC by scanning MEDLINE, Embase, and ISI Web of Knowledge. Data involving the clinicopathological features, treatment, and outcomes were extracted and analyzed. Survival analysis was performed using Kaplan-Meier method. The Cox proportional hazards regression model was used to identify potential prognostic factors associated with survival. Furthermore, a case of metastatic gastric adenocarcinoma of pulmonary origin with epidermal growth factor receptor (EGFR) L858R+T790M mutation was also described and included.
Results:
Seventy-eight records involving 114 cases (including ours) were finally included. The median age on admission was 65 years with a male predominance of 79.8%. Lung adenocarcinoma (42.1%), located in the right upper lobe (30.3%), was the most frequent primary tumor. Bleeding (36.7%) and abdominal pain (35.8%) were the two most common symptoms. Endoscopically, gastric lesions were typically presented as elevated lesions with or without volcano-like ulceration, or ulcerative lesions, mostly involving the gastric corpus. The median overall survival time and survival time after diagnosis of metastatic cancer were 11 months [95% confidence interval (CI): 7-14] and 4.5 months (95% CI: 3-9), respectively. The survival analyses revealed that surgical interventions (including lung surgery and/or abdominal surgery) and systemic therapy (including chemotherapy, radiotherapy, and/or targeted therapy) seemed to be positive prognostic factors for both overall survival and survival after diagnosis of metastatic cancer.
Conclusions:
Clinicians should be alerted to the occurrence of gastric metastasis in lung cancer patients. Comprehensive evaluation and appropriate treatment for specific patients may improve the survival rate of GMLC patients.
Case Report: Concurrent Resistance and Aerobic Training Regulate Adiponectin Expression and Disease Severity in Multiple Sclerosis: A Case Study
Authors: Elisa Grazioli, Ersilia Nigro, Claudia Cerulli, Giovanna Borriello, Annamaria Mancini, Eliana Tranchita, Rita Polito, Attilio Parisi, Pasqualina Buono, Aurora Daniele
Journal: Front Neurosci (2020)
Keywords: edss, hmw oligomers, adiponectin, multiple sclerosis, training
MeSH terms: Case Reports

Adapted exercise is an effective non-pharmacological tool to improve functional, cognitive, and psychological parameters in multiple sclerosis (MS), in association with increased quality of life (QoL) and decreased disease severity. Adipose tissue, through the production of different adipokines, is involved in regulating energy metabolism and inflammation. Adiponectin, increased in MS, circulates as oligomers of low (LMW), medium (MMW), and high molecular weight (HMW), the latter mediating the main biological effects. The aim of study was to evaluate the effects of 4 months training at moderate intensity [65% heart rate reserve (HRR)] on BMI, adiponectin, and QoL in a volunteer with secondary progressive MS. The parameters were evaluated before (T0), after 4 months training (T1), and 6 months after the end of training (T2); total serum adiponectin and its oligomeric profile were evaluated. We found a reduction in BMI (-0.9%) and FAT (-2.6%), an improvement in perceived QoL and a reduced expression of total adiponectin and HMW oligomers together with decreased MS disability level at T1 measured by EDSS. Despite the limitations of a case study, this represent a starting point to understand the influence of exercise in MS and the relationship with adiponectin expression.