OpenMed/multicare-articles huggingface dataset:
Case report and literature review: autonomous robotic system assisted palatal implantation at an anterior teeth site compromised by periapical cyst
Authors: Xiuyu Liu, Huixin Lv, Meiqing Chen, Siyu Chen, Kewen Jia, Sezhen Quni, Lu Zhang, Yanmin Zhou
Journal: Front Med (Lausanne) (2024)
Keywords: aesthetic area, case report, dynamic navigation, immediate implant, static navigation
MeSH terms: Case Reports

Background:
Immediate implant placement (IIP), which preserves gingival height and papilla shape while simultaneously accelerating the implant treatment period, has become a popular method due to its commendable clinical outcomes. Nonetheless, deploying immediate implants demands specific preconditions concerning the remaining alveolar bone. This poses a challenge to the accuracy of implant surgery.
Case presentation:
In this report, we present the case of a 60-year-old woman with a left upper anterior tooth crown dislodged for over a month. Cone beam computed tomography (CBCT) revealed the absence of a labial bone wall on tooth 22, a remaining 1 mm bone wall on the labial side of the root apex, and a 17.2 mm*8.9 mm*4.7 mm shadow in the periapical region of the root apices of teeth 21 and 22, with the narrowest width on the sagittal plane being approximately 5 mm. After the surgeon removed the cyst, they completed the subsequent implantation surgery using an autonomous robot in a challenging aesthetic area. This method circumvented the potential exposure of the screw thread on the labial implant surface, assured initial implant stability.
Conclusion:
Five months after the operation, the dental crown was restored. The implant remained stable, with yielding notable clinical results. To the best of our knowledge, this clinical case is the first to report the feasibility and precision of immediate implantation in anterior teeth site with periapical cyst removal, performed by an autonomous robotic surgical system. Autonomous robots exhibit exceptional accuracy by accurately controlling axial and angular errors. It can improve the accuracy of implant surgery, which may become a key technology for changing implant surgery. However, further clinical trials are still needed to provide a basis for the rapid development of robotic surgery field.
Concomitant Lymphocytic Colitis With Recurrent Clostridium difficile Infection
Authors: Noor M Suleiman, Maya Baiyasi, Tala Al-Saghir, Bryan Daines, Falgun Patel
Journal: Cureus (2024)
Keywords: chronic watery diarrhea, concomitant infection, lymphocytic colitis, microscopic colitis, recurrent clostridium difficile infection
MeSH terms: Case Reports

Microscopic colitis is a clinicopathological diagnosis that is characterized by chronic microscopic inflammation of the colon and presents with chronic watery diarrhea. There are following two subtypes of microscopic colitis: lymphocytic colitis and collagenous colitis. This is a case of a 70-year-old female with a history of Clostridium difficile infections who presented with persistent watery diarrhea and was diagnosed with lymphocytic colitis in the setting of a concomitant C. difficile infection. Given her clinical presentation, the patient was initiated on empiric treatment for C. difficile infection and showed a lack of clinical improvement with persistent watery diarrhea and elevated white blood cell count. The patient's symptoms resolved upon the confirmatory diagnosis and treatment of lymphocytic colitis. This study illustrates the importance of assessing for, diagnosing, and treating lymphocytic colitis in patients with chronic non-resolving watery diarrhea, especially in the setting of concomitant or recurrent C. difficile infections. Additionally, it emphasizes the need for further characterization of the relationship between C. difficile infection and microscopic colitis.
Left ventricle pedunculated thrombi risks and outcomes: a case report and literature review
Authors: Ahmed Ali Ali, Eman Elsayed Sakr
Journal: J Vasc Bras (2024)
Keywords: emboli, left ventricle, myocardial infarction, outcomes, risks, thrombosis
MeSH terms: Case Reports

A 42-year-old male with ischemic cardiomyopathy presented with acute bilateral femoral artery embolization. After management with embolectomy and fasciotomy in both femoral arteries, transthoracic echocardiography revealed two pedunculated highly mobile left ventricle (LV) thrombi. Given the procedural risk, anticoagulation therapy was recommended over surgery. However, the bleeding risk impeded the continuation of anticoagulation, which increased the thrombus size. Multiorgan failure and disseminated intravascular coagulopathy followed and the patient died. We also systematically reviewed the PubMed and Scopus databases for pedunculated LV thrombi cases and retrieved 74 and 63 reports respectively. Of these, 37 relevant reports (45 cases) plus 11 reports from the manual search were included for data extraction, a total of 56 cases besides our case. Based on the etiologies and risks, LV thrombi are predictable and preventable, especially after ischemic events. A clear diagnostic algorithm and vigilant follow-up are needed as well as multidisciplinary management once a diagnosis is confirmed.
Concurrent remission of lymphoma and Sjögren's disease following anti-CD19 chimeric antigen receptor-T cell therapy for diffuse large B-cell lymphoma: a case report
Authors: Lingshuang Sheng, Yilun Zhang, Qi Song, Xufeng Jiang, Weiguo Cao, Lei Li, Hongmei Yi, Xiangqin Weng, Sheng Chen, Zhongmin Wang, Wen Wu, Li Wang, Weili Zhao, Zixun Yan
Journal: Front Immunol (2023)
Keywords: car-t cell therapy, sjögren’s disease, autoimmune diseases, chimeric t cell receptors, immunotherapy
MeSH terms: Lymphoma, Large B-Cell, Diffuse / therapy, Receptors, Chimeric Antigen, Sjogren's Syndrome / complications, Sjogren's Syndrome / therapy, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antigens, CD19, Cell- and Tissue-Based Therapy, Female, Humans, Immunotherapy, Adoptive, Receptors, Chimeric Antigen, Antigens, CD19

Anti-CD19 chimeric antigen receptor (CAR)-T cells not only target CD19-positive malignant lymphoma cells but also normal B cells. The utility of CAR-T cell therapy has been reported in rheumatoid arthritis and systemic lupus erythematosus; however, its use in Sjögren's disease (SjD) remains unknown. In this study, we describe the case of a 76-year-old woman with active SjD for 10 years who was diagnosed with diffuse large B-cell lymphoma. After receiving anti-CD19 CAR-T cell therapy, she achieved complete remission (CR) on day 28. Since the onset of her 10-year history with SjD, she was negative for antinuclear antibodies and anti-Ro-52 for the first time on day 90 after CAR-T cell therapy. Six months after CAR-T cell therapy, the CR status was maintained, serum cytokine levels returned to their normal levels, and dry mouth symptoms improved. The EULAR Sjögren's Syndrome Disease Activity Index score decreased from 5 to 2, indicating a partial remission of SjD activity compared with that before CAR-T cell treatment. In the early stage of treatment, she presented with grade 2 cytokine release syndrome and grade 1 neurotoxicity, which were completely controlled after an active intervention. This case highlights the potential application of CAR-T cells in treating autoimmune diseases, such as SjD.
Sagliker Syndrome in a Patient With Secondary Hyperparathyroidism and Chronic Kidney Disease: A Case Report From Palestine
Authors: Ibtihal Ahmad, Saja Alkomi, Rula Sharaha, Shaheera Manasrah, Osama N Dukmak
Journal: Cureus (2024)
Keywords: case report, chronic kidney disease, renal osteodystrophy, sagliker syndrome, secondary hyperparathyroidism
MeSH terms: Case Reports

Sagliker syndrome (SS) is a rare complication in patients with chronic kidney disease (CKD) on prolonged dialysis due to uncontrolled secondary hyperparathyroidism (SHPT). SS manifests with a constellation of clinical manifestations, including short stature, craniomaxillofacial abnormalities, hearing loss, and neuropsychiatric disorders. This article reports a 33-year-old male patient with CKD who complained of progressive disfiguring facial changes, multiple recurrent fractures, and shortened height. The condition affects his quality of life. On workup, his lab results showed highly elevated serum levels of parathyroid hormone, alkaline phosphatase (ALP), calcium, and phosphate. His comorbidities and poor health status limit his ability to do parathyroidectomy (Ptx). A reliable diagnostic approach must be considered, enabling physicians to make earlier interventions and get better outcomes.
Alpha-fetoprotein-elevated postpubertal testicular teratoma with retroperitoneal metastasis on 18F-FDG PET/CT: case report and literature review
Authors: Hao Jiao, Yongkang Qiu, Wenpeng Huang, Yongbai Zhang, Zhao Chen, Aixiang Wang, Lei Kang
Journal: Front Med (Lausanne) (2023)
Keywords: 18f-fdg, pet/ct, alpha-fetoprotein, postpubertal testicular teratoma, retroperitoneal metastasis
MeSH terms: Case Reports

Postpubertal testicular teratoma exhibits malignant biological behavior and has metastatic potential. We report a case of a 17-year-old patient diagnosed with postpubertal testicular teratoma with massive retroperitoneal metastasis. The pathological examination revealed a mature teratoma without any other components. However, the patient had a significantly increased level of AFP, and 18F-FDG PET/CT showed the retroperitoneal metastasis had increased FDG uptake, with a SUVmax of 15.6, suggesting the coexistence of other germ cell tumor components, and the patient might have a poor prognosis. After resection of the retroperitoneal tumor, PET/CT further revealed multiple abdominal and pelvic metastases, with a SUVmax of 22.5. Therefore, the patient received a cycle of chemotherapy and follow-up PET/CT imaging showed the achievement of complete metabolic response after the treatment. In this case, PET/CT played a crucial role in detecting metastasis, compensating for the limitations of pathological sampling, thus establishing a definitive diagnosis and predicting prognosis. And it was evident that PET/CT also has the advantage of evaluating therapeutic efficacy.
Case report: tracheobronchial diverticulum, a potential risk for diving?
Authors: Long Qing, Yan Wang, Meng Zhang, Qinqin Pu, Wanwan Cai, Yaping Pan, Delin Xia
Journal: Front Med (Lausanne) (2024)
Keywords: barotrauma, computed tomography, decompression, diving, fitness to dive, tracheobronchial diverticulum
MeSH terms: Case Reports

Tracheobronchial diverticulum (TBD) is an asymptomatic, benign cystic lesion outside the lumen of the trachea and bronchus. This is the first report case of a SCUBA (self contained underwater breathing apparatus) diver diagnosed with TBD, which is a potential risk to diving. No literature or guideline is available so far on the diving fitness for patients with congenital or acquired TBD condition. A healthy 26-year-old male professional diver has records of SCUBA diving up to a depth of 40 meters sea water. He did not have any diving-related injuries or symptoms during his career and had no history of smoking, drinking, or other special illnesses except for a COVID-19 infection. A tracheal diverticulum was found accidentally by computed tomography (CT), but its communication with the trachea was not clear initially. Therefore, high-resolution CT and electronic bronchoscopy were done to clarify the situation of the diverticulum and identify the diving risk. High-resolution CT showed a possible opening in the diverticulum, but this was not seen under electronic bronchoscopy. Although a potential opening was shown in high-resolution CT, the lack of visual bronchoscopic evidence made it likely to be a dead cavity. As there is a higher theoretical risk of barotrauma during decompression, leading to pneumomediastinum, hemorrhage, or arterial gas embolism, the current clinical consensus is that air-containing tissue should be regarded as a relative contraindication for diving. Overall, it is recommended that the diver should dive carefully and avoid ascending too rapidly.
Neuromyelitis optica spectrum disorder safely and successfully treated with satralizumab during pregnancy and breastfeeding: a case report
Authors: Takashi Yoshida, Osamu Watanabe, Miwa Nomura, Yusuke Yoshimoto, Yoshimitsu Maki, Hiroshi Takashima
Journal: Front Neurol (2023)
Keywords: il-6, breastfeeding, neuromyelitis optica, pregnancy, satralizumab
MeSH terms: Case Reports

Background:
Satralizumab, a monoclonal antibody that recognizes interleukin-6 receptors, is known to reduce the relapse rate in neuromyelitis optica spectrum disorder (NMOSD), but its safety during pregnancy has not been established. We present the case of an NMOSD patient who safely completed pregnancy, parturition, and breastfeeding under satralizumab treatment. Importantly, satralizumab transfer to umbilical cord blood, infant serum, or breast milk was not observed.
Case presentation:
A 37-year-old Japanese female developed anti-aquaporin 4 antibody-positive NMOSD with left optic neuritis. Despite responding to steroid and azathioprine therapy, she experienced moon face and weight gain and desired the prompt reduction of the steroid dosage. She also wanted to conceive a child with a safe and preferably early pregnancy and parturition. Because pregnancy and parturition after the onset of NMOSD elevate the risk of relapse and miscarriage, treatment with satralizumab was initiated with the patient's consent. She experienced normal parturition and continued with satralizumab, steroid, and azathioprine treatments while breastfeeding without experiencing any relapses. Concentrations of satralizumab in the umbilical cord blood, infant serum, and breast milk were below the detection sensitivity.
Conclusion:
These findings suggest that satralizumab may be safe and effective for the perinatal management of NMOSD, especially when there are concerns about continuing pregnancy and the risk of relapse after parturition.
Ichthyosis Skin Changes in a Patient With Hereditary Hemochromatosis
Authors: Neha Arora, Kaycee Nguyen, Andrew Hudson, Lindsay Bicknell
Journal: Cureus (2024)
Keywords: cutaneous manifestation, hereditary hemochromatosis, ichthyosis, ichthyosis vulgaris, imbalance in iron homeostasis
MeSH terms: Case Reports

Hereditary hemochromatosis (HH) is characterized by elevated iron absorption in the body, leading to iron accumulation with subsequent dysfunction and end-organ damage. While the progression of the disease can result in arthralgias, hepatomegaly, cardiomyopathies, and diabetes, over a third of HH patients present with cutaneous manifestations. We present the case of a 56-year-old male with HH who presented to dermatology with a rash and diffuse scaling. The patient exhibited brown plate-like scales clinically consistent with diffuse ichthyosis vulgaris. While ichthyosis has been seen in patients with idiopathic hemochromatosis, its association with HH is not well reported. Due to the high prevalence of cutaneous involvement in hereditary hemochromatosis, physicians should familiarize themselves with ichthyosis and the other dermatologic manifestations of this disease.
Neurological manifestations of nontuberculous mycobacteria in adults: case series and review of the literature
Authors: Yair Mina, Ahnika Kline, Maura Manion, Dima A Hammoud, Tianxia Wu, Julie Hogan, Irini Sereti, Bryan R Smith, Christa S Zerbe, Steven M Holland, Avindra Nath
Journal: Front Neurol (2024)
Keywords: infections, magnetic resonance imaging, neuroimaging, neuroinfectious diseases, nontuberculous mycobacteria

Introduction:
Nontuberculous mycobacteria (NTM) mediated infections are important to consider in cases with neuroinflammatory presentations. We aimed to characterize cases of NTM with neurological manifestations at the National Institutes of Health (NIH) Clinical Center and review the relevant literature.
Materials and methods:
Between January 1995 and December 2020, six cases were identified. Records were reviewed for demographic, clinical, and radiological characteristics. A MEDLINE search found previously reported cases. Data were extracted, followed by statistical analysis to compare two groups [cases with slow-growing mycobacteria (SGM) vs. those with rapidly growing mycobacteria (RGM)] and evaluate for predictors of survival. NIH cases were evaluated for clinical and radiological characteristics. Cases from the literature were reviewed to determine the differences between SGM and RGM cases and to identify predictors of survival.
Results:
Six cases from NIH were identified (age 41 ± 13, 83% male). Five cases were caused by SGM [Mycobacterium avium complex (MAC) n = 4; Mycobacterium haemophilum n = 1] and one due to RGM (Mycobacterium abscessus). Underlying immune disorders were identified only in the SGM cases [genetic (n = 2), HIV (n = 1), sarcoidosis (n = 1), and anti-interferon-gamma antibodies (n = 1)]. All cases were diagnosed using tissue analysis. A literature review found 81 reports on 125 cases (SGM n = 85, RGM n = 38, non-identified n = 2). No immune disorder was reported in 26 cases (21%). Within SGM cases, the most common underlying disease was HIV infection (n = 55, 65%), and seizures and focal lesions were more common. In RGM cases, the most common underlying condition was neurosurgical intervention or implants (55%), and headaches and meningeal signs were common. Tissue-based diagnosis was used more for SGM than RGM (39% vs. 13%, p = 0.04). Survival rates were similar in both groups (48% SGM and 55% in RGM). Factors associated with better survival were a solitary CNS lesion (OR 5.9, p = 0.01) and a diagnosis made by CSF sampling only (OR 9.9, p = 0.04).
Discussion:
NTM infections cause diverse neurological manifestations, with some distinctions between SGM and RGM infections. Tissue sampling may be necessary to establish the diagnosis, and an effort should be made to identify an underlying immune disorder.
Coexistence of hereditary spherocytosis with SPTB P.Trp1150 gene variant and Gilbert syndrome: A case report and literature review
Authors: Changwei Chi, Shenghao Wu, Wenjin Zhou, Yingying Hu, Yanwei Lu, Shanshan Weng
Journal: Open Life Sci (2024)
Keywords: gilbert syndrome, hereditary spherocytosis, jaundice
MeSH terms: Case Reports

A congenital protein anomaly in the erythrocyte membrane skeleton causes a hereditary haemolytic illness known as hereditary spherocytosis (HS). The primary characteristic of HS is an increase in the number of tiny spherical red blood cells in the peripheral blood. The chief clinical features of HS include anaemia, jaundice, splenomegaly, spherical erythrocytosis in the blood, chronic anaemia with haemolysis, and recurrent acute attacks. Most patients have a family history; some have autosomal recessive inheritance, whereas most have autosomal dominant inheritance. In cases of severe hyperbilirubinemia disproportionate to haemolysis, other causes of hyperbilirubinemia should be considered. Gilbert syndrome (GS) is an autosomal dominant illness caused by the reduced activity of uridine diphosphate-glucuronosyl transferase lAl and is characterised by intermittent hyperbilirubinemia without any other signs or symptoms of liver disease. The possibility of the coexistence of HS and GS is very limited. Here we present the case of an elderly man with yellow skin and sclera recurring anaemia, and a final diagnosis of coexisting HS and GS.
Metacognition in musical practices: two studies with beginner and expert Brazilian musicians
Authors: Rosane Cardoso de Araújo, Rafael Stefanichen Ferronato, Flávio Denis Dias Veloso
Journal: Front Psychol (2024)
Keywords: beginners musicians, expert musicians, metacognition, metacognitive process, musical practices

Metacognition is essential in the musical learning process as it involves understanding the purpose of each task, its planning, execution and evaluation. Considering the relevance of metacognitive processes, our objective in this study was to investigate how expert and beginner musicians manifest and verbalize their metacognitive processes in the context of preparing repertoire for a performance. The method used was a multi-case study carried out in two different contexts: with the five members of a brass quintet made up of professional musicians and with three beginner university violin students. The results obtained indicated that even at different levels of expertise, metacognitive processes were present in the musical practices of participants in the two contexts investigated. It was found that in both cases time management is a component of the preparation process in metacognitive regulation, however, for the beginner violinists in our sample it was a significantly more complex task than for the professional brass players. Regarding the learning monitoring and evaluation processes, it was possible to verify that beginner instrumentalists as well as professional musicians used declarative, conditional and procedural knowledge to carry out and reflect on their musical practices. These results have implications for both the individual and collective study process and for teaching processes. It is also observed that reflective thinking must accompany the processes of individual and collective interpretative-musical practices, considering that the musical results desired by musicians are related to the quality of cognitive, behavioral, affective and motivational undertakings pertinent to control and regulation of metacognitive processes.
The Approach to Dental Caries Prevention in a Case of Agenesis of the Major Salivary Glands: A Case Report
Authors: Akram F Qutob
Journal: Cureus (2024)
Keywords: caries, dental, prevention, salivary, xerostomia
MeSH terms: Case Reports

Xerostomia leads to great challenges for patients and dentists in managing and maintaining oral health due to the high risk of developing dental caries. We discuss a case of a 10-year-old male patient who presented with complaints of decayed teeth and difficulty chewing and swallowing food. He had bilateral congenital stenosis and stricture of lacrimal ducts and a family history of lacrimal gland agenesis and Hashimoto's disease. The diagnosis reached was agenesis of all major salivary glands confirmed by saliva testing and ultrasound examination of the glands. Comprehensive preventative, restorative, and maintenance protocols based on caries management by risk assessment (CAMBRA) were implemented, including fissure sealants, amalgam and composite resin restorations, professional and home-applied fluoride, chlorhexidine mouthwash, frequent water consumption, and two-monthly recalls. We were able to stabilize the patient's risk of dental caries for over three years. The implementation of stringent restorative, preventive, and maintenance protocols is key to improving and maintaining oral health in severe cases of xerostomia.