OpenMed/multicare-articles huggingface dataset:
Whipple's Disease: A Challenging Diagnosis
Authors: Beatriz Porteiro, Ana Rita Freitas, Filipa Nunes, Marinela Major, Frederico Batista
Journal: Cureus (2024)
Keywords: deep vein thrombosis (dvt), polyarthralgia, reactive lymphadenitis, tropheryma whipplei, whipple's disease
MeSH terms: Case Reports

Whipple's disease (WD) is a chronic multisystemic infection caused by Tropheryma whipplei. It is a rare condition with a wide spectrum of clinical presentations, necessitating a high clinical suspicion to arrive at the diagnosis. We present the case of a 65-year-old woman who experienced chronic, intermittent, and migratory polyarthralgia, weight loss, anorexia, and pyrosis. She was admitted due to bilateral deep vein thrombosis (DVT). She exhibited lymphadenopathy without hepatosplenomegaly, and lymph node biopsy revealed reactive lymphadenitis with intrahistiocytic bacilli that reacted positively to periodic acid-Schiff staining. This led to the suspicion of WD, which was subsequently confirmed through small bowel biopsies. She initiated treatment with ceftriaxone and experienced rapid clinical improvement. WD poses a diagnostic challenge. The signs and symptoms are often nonspecific and can result in misdiagnosis as a rheumatic or neoplastic disease. The presentation with DVT, while unusual, has been reported as a manifestation of WD.
A study on the spatial distribution characteristics and driving factors of traditional villages in the southeast coast of China: A case study of Puxian, Fujian
Authors: Xiaoxue Lu, Zhuo Peng, Yuchen Zhou, Yanqiu Xie, Zujian Chen
Journal: PLoS One (2024)
MeSH terms: Urbanization, China, Conservation of Natural Resources, Humans, Rural Population, Spatial Analysis

Traditional villages are the common historical and cultural heritage of all mankind. With the intensification of urbanization, the continuation of traditional villages and the inheritance of historical and cultural heritage are facing risks. The research on the driving factors affecting the spatial distribution characteristics, heterogeneity and human land interaction of traditional villages provides a new idea for the protection of traditional villages. This study takes 137 traditional villages in Puxian area, a typical cultural area in the southeast coast, as the research object, analyzes the spatial distribution pattern of traditional villages by using spatial analysis method, and selects 13 factors to analyze the main driving forces and interaction mechanisms through geographical detectors. The results show that: (1) Puxian traditional villages are clustered and distributed, and the distribution among counties is uneven, mainly in the state of "one cluster and many scattered points" with more coastal areas and less mountainous areas. (2) Puxian traditional villages are mainly affected by many factors such as nature, space, society and culture. They are more densely distributed in areas with rich cultural heritage, fertile land, flat terrain, suitable climate, close to water systems, developed transportation, backward economy and dense population. (3) Cultural factors are the primary factors affecting the spatial distribution of traditional villages, the order of driving factors' explanatory power is: intangible cultural heritage (0.5160) > protected cultural relic units (0.3591) > distance from railway (0.3255) > night light remote sensing (0.3179) > elevation (0.3012) > population density (0.2671) > slope (0.2032) > soil type (0.1804) > precipitation (0.1750) > temperature (0.1744) > land use (0.1492) > distance from river (0.0691)>distance from highway (0.0530). The interaction of intangible cultural heritage, protected cultural relic units and distance from the railway is the dominant factor for the spatial differentiation of traditional villages. Among them, the interaction of intangible cultural heritage∩distance from the railway is the strongest, and the q-value is 0.79, which proves that the interpretation ability of the two factor model is much higher than that of the single factor model. The results of this study reflect that traditional villages and nature, space, society and culture are interdependent, so the protection of traditional villages should be adapted to local conditions.
The effects of icon design features on user perception and preference: A case study of icons for Covid-19
Authors: Deng Lujie, Chunhua Lin, Qiong Liao, Shuicai Qiu
Journal: PLoS One (2024)
MeSH terms: COVID-19 / epidemiology, COVID-19 / prevention & control, COVID-19 / psychology, Cartoons as Topic, Humans, Perception, SARS-CoV-2 / isolation & purification, Semantics

The objective of this study is to evaluate users' perceptions and preferences on the design features of the COVID-19 prevention promotion icon from the perspective of users' aesthetic and perceptual needs. In this study, 120 officially published icons from 24 countries and regions were collected from online platforms for ranking tests, and then the top-ranked icons were subjectively rated by the semantic differential method. By evaluating the quality of users' perceptions of multiple semantic dimensions of icons, we extracted the perceptual semantic words that users valued as the main icon design features. Spearmen correlations were applied to derive possible correlations between user rankings and semantic scales, and a Friedman test was also conducted to determine the true differences in user perceptions and preferences for different styles of icons. Factor analysis was conducted to extract six perceptual words that influence the design features of the COVID-19 prevention promotion icon. The methodology adopted in this study facilitated the screening of design features related to icon effectiveness, and the findings show that "Interesting," "Simple," "Familiar, "Recognizable," "Concrete," and "Close(semantic distance)" are the key features that influence users' perception and preference of COVID-19 icon design. The results of this study can be used as the basis for designing and improving publicity icons for preventive measures in COVID-19, and the methods adopted in this study can be applied to evaluate other types of icon design.
Case Report: Taxifolin for neurosurgery-associated early-onset cerebral amyloid angiopathy
Authors: Maxwell C Y Choi, Tiffany H P Law, Sirong Chen, William S K Cheung, Carmen Yim, Oliver K S Ng, Lisa W C Au, Vincent C T Mok, Peter Y M Woo
Journal: Front Neurol (2024)
Keywords: 11c-pittsburgh compound b positron emission tomography, amyloid-beta, early-onset cerebral amyloid angiopathy, intracerebral hemorrhage, taxifolin
MeSH terms: Case Reports

Cases of iatrogenic cerebral amyloid angiopathy (CAA) have been increasingly reported recently, particularly those associated with neurosurgery. Preclinical studies have shown taxifolin to be promising for treating CAA. We describe a young 42-year-old man with a history of childhood traumatic brain injury that required a craniotomy for hematoma evacuation. He later presented with recurrent lobar intracerebral hemorrhage (ICH) decades later, which was histologically confirmed to be CAA. Serial 11C-Pittsburgh compound B positron emission tomography (11C-PiB-PET) imaging showed a 24% decrease in global standardized uptake value ratio (SUVR) at 10 months after taxifolin use. During this period, the patient experienced clinical improvement with improved consciousness and reduced recurrent ICH frequency, which may be partly attributable to the potential amyloid-β (Aβ) clearing the effect of taxifolin. However, this effect seemed to have diminished at 15 months, CAA should be considered in young patients presenting with recurrent lobar ICH with a history of childhood neurosurgery, and serial 11C-PiB-PET scans warrant further validation as a strategy for monitoring treatment response in CAA for candidate Aβ-clearing therapeutic agents such as taxifolin.
An Uncommon Presentation of Aortic Endarteritis
Authors: Sofia Rito, Joao Oliveira Dias, Dina Rodrigues, Paula Martins, António Pires
Journal: Cureus (2024)
Keywords: berry syndrome, congenital heart disease, endarteritis, endocarditis, haemorrhagic stroke, paediatric cardiology
MeSH terms: Case Reports

Endocarditis is an uncommon infectious complication of congenital heart disease (CHD), typically presenting with fever as its primary symptom; however, its occurrence may not always be accompanied by fever. This paper elaborates on a case involving a patient with surgically corrected Berry syndrome and residual aortic coarctation. The clinical presentation of aortic endarteritis in this case manifested as seizures attributed to a hemorrhagic stroke. In this paper, we aim to raise awareness of this infrequent complication of aortic coarctation, as it may present itself with cerebral hemorrhage due to septic microemboli, even in the absence of fever at its initial presentation.
Multiple cystic echinococcosis in abdominal and pelvic cavity treated by surgery with a 4-year follow-up: a case report
Authors: Lerong Yan, Zhiqiang Chu, Jian Yang, Yongguo Zhang, Guisheng Liu, Zhen Lei, Qian Chen, Jiang Li, Jing Yang, Meifeng Zhao, Shijie Zhang, Xiangwei Wu, Xinyu Peng, Hongwei Zhang
Journal: Front Med (Lausanne) (2024)
Keywords: ascites, bile leakage, endocystectomy, hepatic cystic echinococcosis, negative pressure drainage, pericystectomy
MeSH terms: Case Reports

We report a case of a male patient who presented with multiple abdominal and pelvic echinococcosis. The patient had been diagnosed with hepatic echinococcosis for 7 years and developed intermittent distension and discomfort in the upper abdomen after an accidental fall. In recent years, the patient's abdominal distention increased gradually. Computed tomography revealed multiple hydatid cysts in the liver, spleen, abdominal cavity, and pelvic cavity. Abdominal organs were severely compressed, such that he could not eat normally except for a liquid diet. The patient underwent radical surgical resection based on the multi-disciplinary treatment (MDT) and the operation lasted 10 h, nearly 100 hydatid cysts were excised, about 18 liters of cyst fluid and cyst contents were removed, and the patient lost 20 kg of weight after surgery. The operation was successful, but there were still some postoperative complications such as hypovolemic shock, postoperative ascites, postoperative bile leakage. Treatment measures for the patient were anti-infection, antishock, clamping the abdominal drainage tube, and negative pressure abdominal puncture drainage. At follow up the patient's quality of life had been significantly improved with 15 kg weight gain compared to before.
Catastrophic Case of West Nile Virus Rhombencephalitis in AIDS
Authors: Rupam Sharma, Elika Salimi, Carlos D'Assumpcao, Michael Valdez, Akriti Chaudhry, Arash Heidari, Rasha Kuran, Janpreet Bhandohal
Journal: J Investig Med High Impact Case Rep (2024)
Keywords: west nile virus in an aids patient, west nile virus rhombencephalitis, and west nile virus, neurosyphilis
MeSH terms: Acquired Immunodeficiency Syndrome / complications, West Nile Fever / complications, West Nile Fever / diagnosis, West Nile virus / isolation & purification, Case Reports, Adult, Fatal Outcome, Humans, Magnetic Resonance Imaging, Male, Rhombencephalon / diagnostic imaging

West Nile Virus (WNV) belongs to the Flaviviridae family of viruses. It was first isolated and identified in 1937. Patients typically present with flu-like symptoms or are asymptomatic; however, neuroinvasive West Nile can lead to significant neurological impairment. Herein presented is a catastrophic case of WNV rhombencephalitis in a male patient newly diagnosed with AIDS. This report sheds light on the potential for severe neurological complications in co-infected patients and emphasizes the importance of early recognition.
Case report: Long-term management of occlusion after surgical-orthodontic treatment for a patient with drug-induced open bite developed after the onset of schizophrenia
Authors: Jun-Ichi Takada, Norihisa Higashihori, Chiho Kadota-Watanabe, Tatsuo Kawamoto, Akira Toyofuku, Keiji Moriyama
Journal: Front Psychiatry (2023)
Keywords: drug-induced open bite, extra pyramidal symptoms, jaw deformity, schizophrenia, surgical-orthodontic treatment
MeSH terms: Case Reports

Background:
Schizophrenia is a major mental disorder, with an estimated incidence of 1%. Since they are sensitive to sensory changes, orthodontic treatment to move teeth should be avoided as aggressively as possible in these patients because of strong concerns about the possibility of causing adverse psychological effects, thus there are few reports on orthodontic treatment for schizophrenia patients. We report a case of severe open bite caused by medication after the onset of schizophrenia, even though the patient's occlusion had been stable for a long time after surgical orthodontic treatment. Medication control and the use of a minimally invasive orthodontic appliance improved the occlusion without adversely affecting the patient's mental health.
Case:
A 22-year-old woman presented to the clinic with a chief complaint of an anterior open bite. Intraoral findings showed an overbite (vertical overlap of the incisor teeth) of -3.0 mm and an overjet (horizontal overlap of the incisor teeth) of -0.5 mm. The preoperative orthodontic treatment included bilateral extraction of the maxillary first premolars. Subsequently, orthognathic surgery was performed to achieve a harmonized skeletal relationship and occlusion. Occlusion was stable for 3 years after surgery. However, 10 years after surgery, the patient returned to the clinic complaining of an anterior open bite (overbite = -4.0 mm). Six years prior to the return, the patient was diagnosed with schizophrenia. We thought that ignoring the patient's strong desire to treat her open bite might also cause psychological problems; therefore, in addition to medication control, we treated her using a minimally invasive removable orthodontic appliance (retainer with tongue crib). Her anterior open bite improved (overbite, +1.0 mm) to within the normal range.
Conclusion:
In this case, medication control was thought to be essential to improve her drug-induced open bite. However, minimally invasive orthodontic treatment, such as the use of a removable appliance, might be helpful in promoting her mental stability as well as for improving occlusion. Careful support is required to obtain information about the patient's mental state and medications through close cooperation with psychiatrists.
Case report: Clinicopathological characteristic of two cases of primary endometrial squamous cell carcinoma and review of the literature
Authors: Hui-Bin Zhang, Li-Hua Lin, Qiu-Ping Lin, Yuan-Qing Lin, Dan Luo, Shu-Xia Xu
Journal: Front Oncol (2024)
Keywords: clinicopathological feature, endometrial squamous cell carcinoma, pathogenesis, pathology, primary
MeSH terms: Case Reports

Primary endometrial squamous cell carcinoma (PESCC) is a rare malignant tumor. To investigate the clinical and pathological features of PESCC, two cases of PESCC in Fujian Maternal and Child Health Hospital were retrospectively studied and the literatures were reviewed. Both of the two cases were menopausal women aged 57-62 years, clinically presenting with "vaginal discharge". Case 1 was a non-keratinising squamous cell carcinoma with high-risk HPV infection. Tumor infiltrated in deep myometrium with multifocal intravascular thrombus and macro metastases to one pelvic lymph node (1/15) and abdominal aortic lymph node (1/1). Lung metastasis occurred 36 months after the surgery. After surgical resection and without postoperative supplemental therapy, the patient remained tumor-free for 110 months to date. Case 2 had a history of breast cancer for 5 years and long-term intake of aromatase inhibitor drugs without HPV infection. It was a keratinized squamous cell carcinoma. Tumor also infiltrated in deep myometrium with multifocal intravascular thrombus and one pelvic lymph node metastasis (1/18), However, no metastasis was seen elsewhere. To date, the patient survived for 16 months without tumor after surgery. Both of the two cases expressed squamous epithelial markers P40, P63, and CK5/6, but neither expressed PAX8 or PR. Case 1 had diffuse expression of P16, wild-type P53, and ER-negative. Case 2 had negative P16, mutant P53, and focal positive ER. PESCC is often associated with HPV infection and low estrogen levels. However, studies in the literatures have found that P16 expression is not always consistent with HPV infection, indicating that PESCC cannot be easily classified as HPV-associated or non-dependent like cervical cancer. There are two main patterns of P16 and P53 expression, P16-positive/P53 wild-type and P16-negative/P53-mutant, but no positive expression of both has been seen so far. It is worth noting that we reported the second case of PESCC with a history of breast cancer, where the patient had been taking the oral aromatase inhibitor drug (exemestane) for a long period of time to reduce the estrogen level, indicating the low estrogen level may be also a key factor in the pathogenesis of PESCC.
Case report: Iatrogenic tattoos caused by skin marking pen in a postoperative patient
Authors: Hanxing Zhao, Xingru Wu, Yue Yu, Chang Cao
Journal: Front Med (Lausanne) (2024)
Keywords: dermatosurgery, iatrogenic accident, pigmentation and colour, surgical complication, tattoo
MeSH terms: Case Reports

In this report, a female patient suffering from pigment retention caused by a skin marking pen was elucidated. The patient underwent blepharoplasty 6 months ago and presented with blue-black linear marks at the upper eyelid incision 2 weeks after surgery. Under dermoscopy, scattered pigments were observed to accumulate in the epidermis of the upper eyelid. The patient was diagnosed with iatrogenic tattoo by a surgical marking pen. We chose surgical excision of the skin with the pigmentation. Previous studies have established that the risk of bacterial contamination, contact dermatitis, and allergies may increase with the surgical marking pens, while pigment retention has not yet been mentioned yet. Here, we present a case with a pigment retention in the incision. The selection of the surgical labelling methods and the management of the pigmentation were also addressed. According to our clinical findings, the risk of pigment retention by marking pens needs to be mentioned in the patient's informed consent. Therefore, the practitioner should ensure that the ink is cleaned by the end of each invasive procedure.
Maculopapular rash with multiple drug hypersensitivity to cotrimoxazole, amikacin, piperacillin/tazobactam, and meropenem in a patient with hairy cell leukemia
Authors: Katie Townsend, Claire Leck, Thippeswamy Billahalli, Elizabeth Barachina, Timothy J Watts
Journal: Allergol Select (2024)
Keywords: delayed hypersensitivity, drug allergy, multiple drug hypersensitivity, type iv hypersensitivity
MeSH terms: Case Reports

We describe a rare case of a 54-year-old female with hairy cell leukemia, who following treatment for neutropenic sepsis, developed an extensive severe maculopapular exanthema with perifollicular hemorrhage. Cladribine, cotrimoxazole, allopurinol, domperidone, amikacin, piperacillin/tazobactam, and meropenem had all been given in the 9 days prior to eruption onset. Three months later, drug patch testing/delayed intradermal testing was positive to cotrimoxazole, trimethoprim, amikacin, piperacillin/tazobactam, and meropenem, with additional evidence of penicillin cross-reactivity. Drug challenge tests were negative to allopurinol and domperidone. She was diagnosed with multiple drug hypersensitivity to cotrimoxazole, amikacin, piperacillin/tazobactam, and meropenem. Multiple drug hypersensitivity is a novel syndrome mainly seen with severe delayed type IV drug eruptions, involving long-lasting strong T-cell reactivity to two or more structurally unrelated drugs.
A rare case report: co-occurrence of two types of lung cancer with hamartoma and pulmonary tuberculosis
Authors: Jianxiong Kang, Mu Wang, Peiyan Hua, Bin Wang
Journal: Front Oncol (2023)
Keywords: case report, lung adenocarcinoma, lung squamous cell carcinoma, pulmonary hamartoma, pulmonary tuberculosis
MeSH terms: Case Reports

With the widespread use of low-dose chest Computed Tomography (CT), lung nodules are being increasingly detected. Common pulmonary conditions such as lung adenocarcinoma, lung squamous cell carcinoma, and tuberculosis are typically diagnosable through imaging examinations. Nevertheless, when multiple types of lung cancer are combined with other benign tumors, how can an accurate diagnosis be made? In this report, we present a rare case of a patient with the simultaneous occurrence of lung adenocarcinoma, lung squamous cell carcinoma, pulmonary tuberculosis, and pulmonary hamartoma, which has not been previously reported. This patient underwent surgical intervention in the Department of Thoracic Surgery at the Second Hospital of Jilin University and has now fully recovered and been discharged. The patient's preoperative positron emission tomography-CT(PET-CT)results did not align with the postoperative pathological diagnosis. The imaging findings were atypical, and the pathological diagnosis was exceptionally rare. We share this case report to contribute to the accumulation of clinical experience.
Silent spinal epidural abscess due to facet joint arthritis
Authors: Yuta Nakamura, Takahiro Namba, Momoko Sakurai, Masato Yasui
Journal: IDCases (2023)
Keywords: d-dimer, facet joint arthritis, fibrinogen, magnetic resonance imaging, pediatric, spinal epidural abscess
MeSH terms: Case Reports

Spinal epidural abscess (SEA) is an abscess that forms between the dura mater and vertebrae. SEA is characterized by back pain and neuropathy associated with fever, of which early diagnosis and treatment are necessary to avoid irreversible neurological sequelae. However, its diagnosis is often difficult because specific symptoms are rarely present in the early stages of the disease. A 25-month-old boy, healthy by nature and free of risk factors, was referred and admitted for fever symptoms only, without back pain or neurological symptoms. We focused on the residual activation of the coagulation-fibrinolytic system, which was contrary to the response to therapy, and were able to establish a diagnosis of SEA. After the initiation of antibiotics, the patient responded well to treatment and made a mild recovery without the need for surgical intervention. To date, there are no reported cases of SEA with only febrile symptoms without localized spinal cord tenderness. SEA is easily overlooked and should be considered in the differential diagnosis of pediatric fever of unknown origin. Although imaging studies have drawbacks, such as radiation exposure and sedation, they should be immediately performed if SEA is suspected.
Relapsing Plasmodium vivax malaria in a 12-year-old Brazilian girl: A case report
Authors: Ezequias B Martins, Anielle de Pina-Costa, Roxana F Mamani, Otilia Lupi, Guilherme A Calvet, Clarisse S Bressan, Michele F B Silva, André M Siqueira, Sidnei da Silva, Graziela Maria Zanini, Maria de Fátima Ferreira-da-Cruz, Cláudio Tadeu Daniel-Ribeiro, Patrícia Brasil
Journal: Malariaworld J (2024)
MeSH terms: Case Reports

Plasmodium vivax causes the vast majority of malaria cases in Brazil. The lifecycle of this parasite includes a latent stage in the liver, the hypnozoite. Reactivation of hypnozoites induces repeated relapses. We report a case of two relapses of vivax malaria in a teenage girl after conventional treatment with chloroquine and primaquine. Chloroquine prophylactic treatment for three months was prescribed with a favourable outcome of the case.