OpenMed/multicare-articles huggingface dataset:
Conservative Management of Dental Erosion in Adolescents with Medical Conditions
Authors: Hikmah Mohd Nor, Nor Asilah Harun
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

The prevalence of dental erosion among children and adolescents is trending higher in recent decades and is becoming a major concern. Dental erosion can be caused by either extrinsic or intrinsic acids or both. One of the established aetiological factors for dental erosion by intrinsic acid is the gastrooesophageal reflux disease. The degree of dental erosions may be influenced by any medical conditions that cause a reduction in salivary flow such as the salivary gland excision, autoimmune disease, radiation to the head and neck regions, and medications. If left untreated, the dental erosion can cause dentine hypersensitivity, loss of occlusal vertical height, and aesthetic problems. For effective management of dental erosion, the aetiology of each case must be determined, and its detection at an early stage is of prime importance. This case report illustrates the conservative management of dental erosion in two adolescent patients presented with their medical conditions and behaviour issues. The aim of the treatments was to preserve the vitality of the affected teeth. The treatments were successfully completed using a conservative approach, with the patients' medical conditions taken into consideration.
Unusual Case of Anaplastic Large Cell Lymphoma Presenting as a Breast Mass in a Patient with no History of Breast Implants
Authors: Yana Ivashkevich, Yaroslav Chernov, Denis Chinenov, Evgeniy Shpot, Alexander A Bessonov, Arthy Yoga, Kirill A Lyapichev, Sergej Konoplev
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Adenocarcinoma is the most common malignant neoplasm involving breast tissue. In contrast to carcinomas, the other types of malignant neoplasms involving the breast are relatively uncommon. One of the examples of this rare entity is lymphoma. Traditionally, non-Hodgkin lymphomas (NHL) involving the breast are divided into primary lymphoma of the breast and systemic lymphoma, although the distinction could be challenging. Most of NHL involving breast tissue have B cell origin; T cell NHL represents less than 20% of all lymphoma cases. Anaplastic large cell lymphomas (ALCL) involving the breast accounts for even lower percentage of cases. Similar to ALCL involving other sites, there are several main types of ALCL identified: primary cutaneous ALCL and systemic ALCL, which is subdivided into ALK positive and ALK negative subtypes. Relatively recently, an additional distinct subtype of ALK-negative ALCL was described, which is associated with textured breast implants and needs to be considered as a differential diagnosis if patient has a history of breast implants. Here, we report a case of ALCL presented as a breast mass without history of breast implant and discuss similar cases published in the literature.
Case Report: Anlotinib Reverses Nivolumab Resistance in Advanced Primary Pulmonary Lymphoepithelioma-Like Carcinoma With FGFR3 Gene Amplification
Authors: Yanyang Liu, Lang Long, Jiewei Liu, Lingling Zhu, Feng Luo
Journal: Front Oncol (2021)
Keywords: fgfr3, anlotinib, anti-pd-1 resistance, nivolumab, pulmonary lymphoepithelioma-like carcinoma
MeSH terms: Case Reports

Background:
Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare type of non-small cell lung cancer (NSCLC). Currently, anti-programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) has become an important treatment for NSCLC. Anti-human PD-1 monoclonal antibodies, such as nivolumab, significantly prolong the survival time of patients with advanced lung adenocarcinoma and lung squamous cell carcinoma. However, there are few reports on the therapeutic effect, drug resistance mechanism, and strategies to overcome resistance to anti-PD-1/PD-L1 treatment in advanced pulmonary LELC. We report the case of a patient with advanced pulmonary LELC harboring fibroblast growth factor receptor (FGFR)3 gene amplification that showed resistance to nivolumab. After treatment with anlotinib, a multi-targeted small-molecule tyrosine kinase inhibitor, the patient's resistance to nivolumab was reversed. She achieved long-term disease remission with a combination of anlotinib and nivolumab treatment.
Case presentation:
A 68-year-old woman was diagnosed with stage IVA pulmonary LELC. After multiple-line chemotherapy, her disease progressed. Since the PD-L1 expression rate of the patient was 90%, nivolumab was administered. However, the therapeutic effect of nivolumab was not ideal; the disease continued to progress, and a new cervical lymph node metastasis appeared. FGFR3 gene amplification was detected in lymph node metastasis. Based on this gene abnormality, we added anlotinib to the treatment. After two cycles of anlotinib and nivolumab, the metastatic focus of the patient was significantly reduced. The patient continued to receive this combined treatment and achieved remission for more than 15 months.
Conclusion:
Pulmonary LELC with FGFR3 gene amplification may not respond well to nivolumab monotherapy. The combination of anlotinib and nivolumab can reverse the resistance to nivolumab in pulmonary LELC with FGFR3 gene amplification.
Aortocaval Fistula in a Behcet's Disease Patient
Authors: Yusuf Ata, Tamer Turk, Mihriban Demir, Filiz Ata, Senol Yavuz
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Behcet's disease (BD) is a chronic, recurrent, systemic disease that is characterized by oral and genital ulcers and oculocutaneous inflammatory lesions. Cardiovascular involvement especially large artery involvement is a serious and vital complication of BD. Pseudoaneurysms in the major arteries may be the cause of sudden death in BD. In our case a pulsatile abdominal mass was determined to be an aortic pseudoaneurysm associated with BD and an aortocaval fistula. Here we report this case and a short review of literature because this is the first reported aortocaval fistula in a BD patient in English literature.
Drug-Induced Thrombotic Microangiopathy due to Cumulative Toxicity of Ixazomib
Authors: Suheil Albert Atallah-Yunes, Myat Han Soe
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Drug-induced thrombotic microangiopathies (DTMAs) are increasingly being recognized as an important category of thrombotic microangiopathies (TMAs). Cancer therapeutic agents including proteasome inhibitors (PIs) are among the most common medications reported to cause DTMA. PIs could cause DTMA either by an immune mechanism or dose-dependent/cumulative toxicity. Eleven cases of DTMA have been reported with bortezomib and carfilzomib. To the best of our knowledge, only one case of DTMA has been reported with ixazomib due to an immune-mediated mechanism. Here, we report the first case of ixazomib-induced DTMA due to cumulative toxicity rather than immune-mediated mechanism. In this article, we discuss the precipitating factors for cumulative toxicity of ixazomib, resulting in DTMA, diagnostic workup, and management of DTMA. We also discuss clinical reasoning based analysis of DTMA versus cancer-associated TMA as well as DTMA versus cyclic thrombocytopenia seen in PI use.
Bayesian Profile Regression to Deal With Multiple Highly Correlated Exposures and a Censored Survival Outcome. First Application in Ionizing Radiation Epidemiology
Authors: Marion Belloni, Olivier Laurent, Chantal Guihenneuc, Sophie Ancelet
Journal: Front Public Health (2020)
Keywords: bayesian inference, ionizing radiation, lung cancer, multicollinearity, profile regression, survival data, truncated dirichlet process mixture
MeSH terms: Environmental Exposure / adverse effects, Models, Statistical, Research Support, Non-U.S. Gov't, Bayes Theorem, Cohort Studies, Humans, Radiation, Ionizing

As multifactorial and chronic diseases, cancers are among these pathologies for which the exposome concept is essential to gain more insight into the associated etiology and, ultimately, lead to better primary prevention strategies for public health. Indeed, cancers result from the combined influence of many genetic, environmental and behavioral stressors that may occur simultaneously and interact. It is thus important to properly account for multifactorial exposure patterns when estimating specific cancer risks at individual or population level. Nevertheless, the risk factors, especially environmental, are still too often considered in isolation in epidemiological studies. Moreover, major statistical difficulties occur when exposures to several factors are highly correlated due, for instance, to common sources shared by several pollutants. Suitable statistical methods must then be used to deal with these multicollinearity issues. In this work, we focused on the specific problem of estimating a disease risk from highly correlated environmental exposure covariates and a censored survival outcome. We extended Bayesian profile regression mixture (PRM) models to this context by assuming an instantaneous excess hazard ratio disease sub-model. The proposed hierarchical model incorporates an underlying truncated Dirichlet process mixture as an attribution sub-model. A specific adaptive Metropolis-Within-Gibbs algorithm-including label switching moves-was implemented to infer the model. This allows simultaneously clustering individuals with similar risks and similar exposure characteristics and estimating the associated risk for each group. Our Bayesian PRM model was applied to the estimation of the risk of death by lung cancer in a cohort of French uranium miners who were chronically and occupationally exposed to multiple and correlated sources of ionizing radiation. Several groups of uranium miners with high risk and low risk of death by lung cancer were identified and characterized by specific exposure profiles. Interestingly, our case study illustrates a limit of MCMC algorithms to fit full Bayesian PRM models even if the updating schemes for the cluster labels incorporate label-switching moves. Then, although this paper shows that Bayesian PRM models are promising tools for exposome research, it also opens new avenues for methodological research in this class of probabilistic models.
Partial Mandibulectomy Rehabilitation of Keratocystic Odontogenic Tumour Case in Neutral Zone
Authors: Mohamad Syahrizal Halim, Tengku Fazrina Tengku Mohd Ariff
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Restoring the patient's missing dentition secondary to partial mandibulectomy of KCOT is important to improve function and aesthetics. The patient presented with a significant loss of alveolar bone which makes the fabrication of rehabilitation prosthesis a significant challenge. A neutral-zone impression technique is helpful in determining the exact space to be restored without compromising aesthetics and it avoids functional muscle displacement that may displace the prosthesis. This article describes the neutral zone impression technique to record a patient's functional muscular movement in guiding the setting of acrylic teeth and denture flange in the neutral zone area. This technique is very useful for postsurgical cases with significant loss of alveolar bone.
Successful Treatment of Necrotizing Fasciitis and Streptococcal Toxic Shock Syndrome with the Addition of Linezolid
Authors: Hana Rac, Karine D Bojikian, Jose Lucar, Katie E Barber
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Necrotizing fasciitis is a deep-seated subcutaneous tissue infection that is commonly associated with streptococcal toxic shock syndrome (TSS). Surgical debridement plus penicillin and clindamycin are the current standard of care. We report a case of necrotizing fasciitis and streptococcal TSS where linezolid was added after a failure to improve with standard therapy. Briefly after isolation of Streptococcus pyogenes from tissue cultures, the patient underwent two surgical debridement procedures and was changed to standard of care therapy. While the patient was hemodynamically stable, the patient's wounds, leukocytosis, and thrombocytopenia all progressively worsened. After initiation of linezolid, the patient slowly improved clinically. The present report is the first to highlight the role of linezolid in streptococcal necrotizing fasciitis and TSS not improving with standard therapy.
Integrating a Sport-Based Trauma-Sensitive Program in a National Youth-Serving Organization
Authors: M Shaikh, C Bean, L Bergholz, M Rojas, M Ali, T Forneris
Journal: Child Adolesc Social Work J (2021)
Keywords: child, community-engaged, evaluation, knowledge translation, scale-out

There is a pressing need to equip youth-serving community organizations to respond to the unique needs of trauma-exposed children. Early prevention measures can be an effective means of redirecting children to self-regulatory healing, while facilitating their transition toward strength-based thriving. Sport can offer a powerful opportunity to reach these children; however there remains little information on how to effectively develop, deliver, evaluate, and sustain trauma-sensitive sport programs in a community context. The purpose of this paper is to outline a case study of integrating sport-based trauma-sensitive practices with BGC Canada's national Bounce Back League program. An interdisciplinary partnership of academic, community, and practice experts used a community-based participatory action research approach, paired with a knowledge translational approach, to guide the process of program development. Mixed methods (e.g., surveys, logbooks, interviews, focus groups, online communications) were used to generate ongoing insights of staff's training experiences, successes and challenges of program implementation, and potential impact of program on club members. Several stages of program development are described, including: (a) collaboratively planning the program; (b) piloting the program to three clubs; (c) adapting the program using pilot insights; (d) expanding the adapted program to ten clubs; and (e) creating opportunities to maintain, sustain, and scale-out practices throughout grant duration and beyond. Lessons learned regarding the leadership team's experiences in terms of developing, adapting, and integrating trauma-sensitive practices in this community context are shared.
Supplementary information:
The online version contains supplementary material available at 10.1007/s10560-021-00776-7.
Secondary renal amyloidosis in a patient of pulmonary tuberculosis and common variable immunodeficiency
Authors: Manish R Balwani, Vivek B Kute, Pankaj R Shah, Pawan Wakhare, Hargovind L Trivedi
Journal: J Nephropharmacol (2015)
Keywords: immunodeficiency, proteinuria, secondary amyloidosis, tuberculosis
MeSH terms: Case Reports

Common variable immunodeficiency (CVID) usually manifests in the second or third decade of life with recurrent bacterial infections and hypoglobulinemia. Secondary renal amyloidosis with history of pulmonary tuberculosis is rare in CVID, although T cell dysfunction has been reported in few CVID patients. A 40-year-old male was admitted to our hospital with a 3-month history of recurrent respiratory infections and persistent pitting pedal edema. His past history revealed 3 to 5 episodes of recurrent respiratory tract infections and diarrhoea each year since last 20 years. He had been successfully treated for sputum positive pulmonary tuberculosis 8 years back. Laboratory studies disclosed high erythrocyte sedimentation rate (ESR), hypoalbuminemia and nephrotic range proteinuria. Serum immunoglobulin levels were low. CD4/CD8 ratio and CD3 level was normal. C3 and C4 complement levels were normal. Biopsy revealed amyloid A (AA) positive secondary renal amyloidosis. Glomeruli showed variable widening of mesangial regions with deposition of periodic schiff stain (PAS) pale positive of pink matrix showing apple green birefringence on Congo-red staining. Immunohistochemistry was AA stain positive. Immunofluorescence microscopy revealed no staining with anti-human IgG, IgM, IgA, C3, C1q, kappa and lambda light chains antisera. Patient was treated symptomatically for respiratory tract infection and was discharged with low dose angiotensin receptor blocker. An old treated tuberculosis and chronic inflammation due to recurrent respiratory tract infections were thought to be responsible for AA amyloidosis. Thus pulmonary tuberculosis should be considered in differential diagnosis of secondary causes of AA renal amyloidosis in patients of CVID especially in endemic settings.
Spontaneous supraceliac isolated abdominal aortic dissection sparing major visceral and renal vessels and presenting as chronic limb ischemia
Authors: Sean O Z Bello, Ilias Kouerinis, Woolagasen Pillay
Journal: Int J Vasc Med (2011)
MeSH terms: Case Reports

Aortic dissections that originate from isolated tears in the abdominal aorta are uncommon. Rarer still are cases of isolated abdominal aortic dissections arising in suprarenal locations, as most appear from infrarenal intimal defects. We present a quite unusual case of a spontaneous supraceliac isolated abdominal aortic dissection sparing the renal and mesenteric arteries and manifesting as chronic rather than acute limb ischemia. The atypical presentation of this case led to repeated misdiagnosis with consequent loss of part of the patient's limb. Better illustration of the natural history of this ill-defined pathology is needed to aid understanding and improve patient care.
Anti-U1RNP-70kD-positive case of neonatal lupus presenting with seizure and incomplete heart block: a case report and literature review
Authors: Maryam Alfalasi, Gehad ElGhazali, Waseem Fathalla, Khulood Khawaja
Journal: Front Pediatr (2023)
Keywords: case report, heart block, neonatal lupus, seizure, systemic lupus erythematosus
MeSH terms: Case Reports

Neonatal lupus erythematosus (NLE) is an autoimmune disease caused by the transplacental passage of anti-Ro/SS-A and anti-La/SS-B. This can be less commonly seen with U1-ribonucleoprotein (U1RNP). Our patient is a 7-day-old male, who first presented with seizures. In addition, during an electroencephalogram, he was found to have an irregular heart rhythm. Looking further into the history, we found that the mother was aware that she had systemic lupus erythematosus (SLE). However, she had not been followed up with a rheumatologist. The workup for NLE found a negative anti-Ro/SS-A and anti-La/SS-B, with a positive U1RNP-70kD. U1RNP-70kD is a diagnostic test for mixed connective tissue disease in adults, but no research has been done on its significance in NLE. Despite having SLE, the infant's mother did not receive surveillance during her pregnancy, as the current guidelines are tailored for mothers with anti-Ro/SS-A and anti-La/SS-B. As a result, this calls for the extension of these guidelines to include the U1RNP-70kD antibody. In this case, the 70kD subtype of U1RNP was positive, which may have had a role to play in this unusual presentation. However, further research is needed to improve the care of mothers and babies with U1RNP-70kD.
Nursing Care Coordination in Primary Healthcare for Patients with Complex Needs: A Comparative Case Study
Authors: Marlène Karam, Maud-Christine Chouinard, Yves Couturier, Isabelle Vedel, Catherine Hudon
Journal: Int J Integr Care (2023)
Keywords: care coordination, case study, complex needs, continuing education, integrated care, nurses

Introduction:
Despite nurses' substantial role in care coordination, few education programs exist to better support them in this role. Identification of a set of core care coordination activities across heterogeneous care coordination programs would facilitate the development of a standard of practice. We sought to examine care coordination activities across two care coordination programs in Family Medicine Groups in Quebec, and their relationship to the program design.
Methods:
We performed a comparative case study of two care coordination programs in primary care targeting frequent users of healthcare services and people with Alzheimer's disease and related disorders. Data collection included documents and semi-structured interviews with key informants.
Results:
Several activities were common to both programs, such as patient identification; assessment, development of an individualized service plan; and linking patients and caregivers with professionals and services. However, their components were different due to the impact of the integrated care program design, policy environment, and the target patient populations' complex needs.
Discussion:
The homogeneity or heterogeneity of patients' complex needs shapes their care trajectory and the intensity of their care coordination needs. As the complexity of these needs grows, so does the necessity to build the care coordinators' capacity for integrated care.
Case report: Psychedelic-induced seizures captured by intracranial electrocorticography
Authors: Benjamin N Blond, Emmanuelle A D Schindler
Journal: Front Neurol (2023)
Keywords: case report, epilepsy, psilocybin, psychedelics, seizures
MeSH terms: Case Reports

Classic psychedelics are currently re-emerging as therapeutic agents with unique clinical benefits; however, it is also important to recognize the adverse effects of this drug class. While the risk of seizures with this drug class is known, the literature is lacking in detail. We present a case of psychedelic mushroom-induced seizures in a person with refractory right temporal lobe epilepsy implanted with a responsive neurostimulation (RNS) system. A large increase in typical seizure frequency coincided with the ingestion of a large dose of the mushrooms. This is the first reported case of electrographically confirmed seizures associated with classic psychedelic drug use. With the surge of research and movements toward the clinical application of classic psychedelic compounds, the risk for drug-induced seizures should be considered, including factors such as a history of epilepsy and drug doses and regimens.
Successful Treatment of Rhabdomyolysis-Associated Acute Kidney Injury with Haemoadsorption and Continuous Renal Replacement Therapy
Authors: Wun Fung Hui, Kam Lun Hon, Kin Shing Lun, Karen Ka Yan Leung, Wing Lum Cheung, Alexander K C Leung
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

We report two children with rhabdomyolysis-associated acute kidney injury who were successfully treated with a haemoadsorption column CytoSorb® in addition to continuous renal replacement therapy (CRRT). A 14-year-old girl with multiorgan failure requiring extracorporeal membrane oxygenation developed rhabdomyolysis due to reperfusion injury. Her creatine kinase (CK) and lactate levels continued to escalate despite high-dose CRRT. A haemoadsorption column was therefore added post-CRRT filter, which brought down the CK level from 264,500 IU/L to 97,436 IU/L after 8 hours of therapy. Another 4-year-old boy with epilepsy and cerebral palsy who was admitted for gastroenteritis with dehydration developed acute kidney injury and rhabdomyolysis with a peak CK level of 946,060 IU/L. He was initially treated with CRRT for 40 hours, which reduced his CK level to 147,580 IU/L. Two sessions of haemoadsorption were then performed in addition to the CRRT, which further lowered his CK level to 32,306 IU/L in 48 hours. Both patients demonstrated enhanced reduction of CK levels when the haemoadsorption column was used in addition to the CRRT, and no specific complication related to the haemoadsorption therapy was reported. Our cases showed that haemoadsorption can be considered as an adjunctive therapy for children with severe rhabdomyolysis-associated acute kidney injury.