OpenMed/multicare-articles huggingface dataset:
Fahr's syndrome as a manifestation of autoimmune polyendocrine syndrome-1 and its unusual association with neuromyelitis optica spectrum disorder
Authors: Ahmad Nawaz, Azba Ahmad, Ayesha Aslam, Safia Bano, Ahsan Numan, Eisham Sarmad
Journal: Front Neurosci (2023)
Keywords: fahr’s syndrome, autoimmune polyendocrine syndrome type-1 (aps-1), hypoparathyroidism, mucocutaneous candidiasis, neuromyelitis optica spectrum disorder (nmo-sd)
MeSH terms: Review

Fahr's syndrome, also known as bilateral striopallidodendate calcinosis, is a rare inherited neurodegenerative illness characterized by abnormal calcium deposition in several areas of the brain, resulting in a wide range of neuropsychological symptoms. Fahr's syndrome, secondary to autoimmune polyendocrine syndrome type 1, which includes adrenal insufficiency and mucocutaneous candidiasis in addition to hypoparathyroidism, is exceedingly rare. No case report has been documented to date to show the co-occurrence of Fahr's syndrome and neuromyelitis optica spectrum disorder. Here, we discuss the case of a 30-year-old man with a previous history of seizures and symptoms of ectodermal dystrophy presented with seizures, left-sided hemiparesis, dysarthria, and other characteristics indicative of severe hypocalcemia. The neuroimaging findings strongly suggested Fahr's syndrome, with radiographic evidence of Neuromyelitis optica spectrum disorder as longitudinal extensive transverse myelitis in the cervical spinal cord, high titers of serum aquaporin-4 antibodies, and demyelinating neuropathy on nerve conduction studies. This distinct neuropsychological presentation and neuroimaging findings led to the diagnosis of Fahr's syndrome as a result of hypoparathyroidism caused by autoimmune polyendocrine syndrome type 1 with cooccurrence of neuromyelitis optica spectrum disorder. The patient's clinical symptoms improved considerably after he was treated based on a provisional diagnosis. The clinical importance of our case is significant for both neuropsychiatrists and endocrinologists, as autoimmune polyendocrine syndrome should be considered as the etiology of Fahr's syndrome. This case report also aims to report this unusual association of Neuromyelitis optica spectrum disorder with Fahr's syndrome to give the future prospective to know whether this association is incidental or there is a missing link between these two different disorders.
Giant Cell Urothelial Carcinoma of Bladder
Authors: Harshima Disvini Wijesinghe, Ajith Malalasekera
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Giant cell urothelial carcinoma is a rare variant of bladder cancer recognized by the current World Health Organization classification of urologic tumours. It is an aggressive tumour with a poor prognosis that usually presents at an advanced stage. It is characterized histologically by pleomorphic giant cells. We discuss a case of giant cell urothelial carcinoma presenting at an early stage in a previously well 62-year-old woman. Histology showed a tumour comprising pancytokeratin positive bizarre mononuclear and multi-nuclear giant cells admixed with areas of conventional urothelial carcinoma and carcinoma in situ. Three-month follow-up cystoscopy and magnetic resonance imaging showed no evidence of recurrence or pelvic lymphadenopathy.
Full Mouth Rehabilitation Using Telescopic Removable Prosthesis
Authors: Sara Hussain Alhammadi
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

A female, aged 55 years, was presented to the clinic concerned with her inability to function properly due to missing teeth and collapse of her vertical dimension. On examination, remaining tooth position of the upper arch was favorable for telescopic denture and remaining tooth position of the lower arch was favorable for removable prosthesis. The patient requested an aesthetic maxillary and mandibular denture with no visible metal clasps on smiling. Therefore, upper telescopic removable complete denture and lower chrome cobalt removable prostheses were suggested to the patient as conservative treatment to reestablish her occlusal vertical dimension and restore her aesthetics and function.
Case Report: Cannabidiol-Induced Skin Rash: A Case Series and Key Recommendations
Authors: José Diogo S Souza, Maíra Fassoni-Ribeiro, Rayssa Miranda Batista, Juliana Mayumi Ushirohira, Antonio W Zuardi, Francisco S Guimarães, Alline C Campos, Flávia de Lima Osório, Daniel Elias, Cacilda S Souza, AndRea A Fassoni, Jaime E C Hallak, José Alexandre S Crippa
Journal: Front Pharmacol (2022)
Keywords: cannabidiol, case report, case series, drug interaction, side effects, skin rash
MeSH terms: Case Reports

Cannabidiol (CBD) is a non-psychotomimetic constituent of the Cannabis plant, with potential therapeutic properties for many physical and neuropsychiatric conditions. Isolated CBD has been suggested to have favorable safety and tolerability. Although CBD-related rash is described, few case reports are well documented in the literature, and usually, CBD was used concomitantly with other medications. Thus, we report four women who presented a skin rash after ongoing CBD use. Other causes of these skin rashes were ruled out after conducting an extensive viral and serological detection panel, and three patients had their lesions biopsied. Two patients were re-exposed to the vehicle (MCT) without developing a new skin rash. Therefore, clinicians must be aware of this potential adverse effect of CBD use.
A case of recto-sigmoid endometriosis mimicking carcinoma
Authors: Ritu Rana, Sandeep Sharma, Harjeet Narula, Brijesh Madhok
Journal: Springerplus (2016)

Introduction:
Although endometriosis with sigmoid serosal involvement is not uncommon in women of childbearing age, the mucosal and lymph node involvement is rare and differential diagnosis from colon cancer and diverticulitis may be difficult due to poor diagnostic accuracy of colonoscopy and colonic biopsies.
Case presentation:
We present a case of a nulliparous woman presenting with large bowel obstruction. She underwent emergency sigmoid colectomy based on clinical and radiological findings. At operation, the pathology was thought to be primary sigmoid tumour. However, histopathological examination of the sigmoid colon led to the final diagnosis of large intestinal endometriosis.
Conclusion:
Rectosigmoid endometriosis is often difficult to diagnose but should be considered in differential diagnosis of child bearing aged women with lower gastrointestinal tract obstruction.
Massive Pulmonary Embolism at the Onset of Acute Promyelocytic Leukemia
Authors: Federica Sorà, Patrizia Chiusolo, Luca Laurenti, Francesco Autore, Sabrina Giammarco, Simona Sica
Journal: Mediterr J Hematol Infect Dis (2016)
MeSH terms: Case Reports

Life-threatening bleeding is a major and early complication of acute promyelocytic leukemia (APL), but in the last years there is a growing evidence of thromboses in APL. We report the first case of a young woman with dyspnea as the first symptom of APL due to massive pulmonary embolism (PE) successfully treated with thrombolysis for PE and heparin. APL has been processed with a combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) obtaining complete remission.
Three-dimensional printing as an aid to airway evaluation after tracheotomy in a patient with laryngeal carcinoma
Authors: Bin Han, Yajie Liu, Xiaoqing Zhang, Jun Wang
Journal: BMC Anesthesiol (2016)
MeSH terms: Intubation, Intratracheal / methods, Laryngeal Neoplasms / diagnostic imaging, Models, Anatomic, Printing, Three-Dimensional, Tracheotomy / adverse effects, Case Reports, Aged, Humans, Intubation, Intratracheal / instrumentation, Laryngeal Neoplasms / surgery, Male, Radiography

Background:
Difficult airway may result in significant morbidity and mortality. Proficient airway evaluation, therefore, is one of the key elements in the safe conduct of anesthesia. A three-dimensional (3D) printing model was recently introduced for medical application. 3D printing is a fast, convenient, and relatively affordable technique. We present a case in which a 3D-printed airway model was successfully used for airway evaluation.
Case presentation:
A 77-year-old man who had previously undergone total laryngectomy was scheduled for resection of a pelvic mass. The condition of his airway, however, complicated the procedure. Routine methods to evaluate his airway were not suitable. Therefore, the patient's computed tomography imaging data were used to generate stereolithography files and then to print out 3D models of his trachea. These 3D models enhanced our understanding of his tracheal morphology. They helped us devise a preanesthesia plan and effectively execute it without complications.
Conclusion:
3D printing models allow better understanding of morphological changes in the airway and aid preanesthesia planning. The successful outcome of our case suggests 3D printing is a potent tool for evaluating difficult and more widespread use is encouraged.
Adverse Events of the BCG (Bacillus Calmette-Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity
Authors: Suleiman Al-Hammadi, Najla S Alkuwaiti, Ghassan A Ghatasheh, Huda Al Dhanhani, Hiba M Shendi, Abdulghani S Elomami, Farida Almarzooqi, Abdul-Kader Souid
Journal: Case Reports Immunol (2020)
MeSH terms: Case Reports

Background:
The Bacillus Calmette-Guérin (BCG) and rotavirus vaccines are live-attenuated preparations. In the United Arab Emirates, these products are universally administered to the young infants. This unguided practice does not account for the children with immunodeficiency, which frequently manifests after the administration of these vaccines. We present here a young infant with immunodeficiency that developed disseminated tuberculosis infection and severe diarrhea due to these improper immunizations. Case Presentation. This young infant was diagnosed at six months of age with "immunodeficiency type 19" (MIM#615617) due to homozygous nonsense variant, NM_000732.4 (CD3D):c.128G > A, p.Trp43∗ (variation ClinVar#VCV000643120.1; pathogenic). This variant creates premature stop-gain in CD3D (CD3 antigen, delta subunit, autosomal recessive; MIM#186790), resulting in loss-of-function. He also had "X-linked agammaglobulinemia" (MIM#300755) due to hemizygous missense variant, NM_001287344.1 (BTK):c.80G > A, p.Gly27Asp (novel). He had a sibling who passed away in infancy of unknown disease and family members with autoimmune disorders. Despite these clear clues, he was immunized with BCG at birth and rotavirus at 2 and 4 months. He was well in the first four months. He then developed high-fever, lymphadenopathy, and refractory diarrhea. Stool was positive for rotavirus, and lymph node biopsy showed acid-fast bacilli, consistent with tuberculosis lymphadenitis. These infections were serious and markedly complicated his clinical course, which included bone marrow transplantation from a matched sibling.
Conclusions:
These unfortunate events could have been avoided by compiling the available clinical information. This patient underscores the importance of implementing proper policies for BCG and rotavirus vaccinations. International registries of adverse events of universally administered vaccines are crucial.
Occipital Neuralgia Treated With Acupuncture: A Case Report
Authors: Molly Mallory, Brent Bauer, Tony Chon
Journal: Glob Adv Health Med (2019)
Keywords: acupuncture, integrative medicine, occipital neuralgia, pain
MeSH terms: Case Reports

We present a case report of a patient whose occipital neuralgia symptoms were substantially improved after a single acupuncture treatment with complete resolution after only a short course of care. The patient, a 78-year-old woman, presented to our institution's neurology department with symptoms of posterior neck pain and electrical sensations in her head which had been present for more than 1 year. With a desire to avoid pharmacologic intervention or invasive procedures, the patient requested acupuncture treatment. The patient received 5 acupuncture treatments over the course of 8 days with substantial resolution of her head pain after a single treatment. This case is suggestive that acupuncture may be a beneficial treatment for patients with occipital neuralgia.
Adaptation of the curriculum for the inclusion of learners with special education needs in selected primary schools in the Fort Beaufort District
Authors: Toyin M Adewumi, Symphorosa Rembe, Jenny Shumba, Adeola Akinyemi
Journal: Afr J Disabil (2017)

Background:
There is need for 'high-quality' teachers who are equipped to meet the needs of all learners through provision of education for an inclusive society according to equal opportunities to all.
Objective:
This paper investigates pockets of good practice in the adaptation of the curriculum for the inclusion of learners with special education needs (SEN) in selected primary schools in the Fort Beaufort District.
Method:
The study adopted a qualitative research approach and employed a case study design. Eight teachers and 10 principals from 10 selected primary schools, 4 education district officials and 1 provincial official were interviewed. Purposive sampling was used to select the participants. Data were collected using document analysis and semi-structured interviews and were analysed thematically.
Result:
The study established that teachers use methods relating to different teaching strategies, individual work, group work and extra work.
Conclusion:
It was concluded that there are pockets of good practice of inclusion policy such as the use of different teaching strategies, individual work, group work and extra work for inclusion of learners with SEN in some of the selected primary schools in the poor rural context. The paper recommends adequate training for teachers in curriculum adaptation in order for all teachers to accommodate learners with SEN.
Another Case of De Novo 3q26.33q27.3 Microdeletion and Its Medicolegal Sequel
Authors: Ugo Indraccolo, Salvatore Renato Indraccolo, Piergiorgio Fedeli
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

A new case of a de novo 3q26.33q27.3 microdeletion is reported. The fetus had a sonographically undiagnosable polymalformative syndrome. The case highlights the difficulties of echographic diagnosis of such syndromes and leads to reflection on the difficulties of appropriate counselling in cases of uncertainty.
Treatment of postoperative jejunal intussusception in adult with oral gastrografin after laparoscopic low rectal resection. A case report
Authors: Mafalda Romano, Ernesto Tartaglia, Ferdinando Amodio, Angelo Gragnaniello, Sara Bortone, Massimiliano Fabozzi
Journal: Int J Surg Case Rep (2020)
Keywords: contrast material, gastrografin, intestinal obstruction, intussusception, postoperative bowel intussusception
MeSH terms: Case Reports

Introduction:
Postoperative intussusception is a rare cause of intestinal obstruction in adults. Intussusception refers to a condition in which a segment of the intestine invaginates into the lumen of an adjacent segment of the intestine.
Presentation of case:
We report a case of postoperative jejunojejunal intussusception in a 42-year-old male following a laparoscopic low anterior resection for rectal cancer. In post-operative day (POD) 2 the patient showed intermittent bowel obstruction and fever. Diagnosis was established with abdominal computed tomography (CT) and enteroclysis, which led to a spontaneous reduction of the invagination.
Discussion:
The incidence of intussusception in adults is rare condition. It represents less than 5% of all cases. In adults, transient asymptomatic enteric intussusception often resolves spontaneously without any treatment. When bowel obstruction is complete and persistent, surgery is need. Intussusception as cause of intestinal obstruction should be kept in mind in a post operative patient who develops obstructive symptoms. Early diagnosis makes the difference between surgical and others treatment. The pathogenesis and diagnosis of postoperative intussusception in the adult is discussed in the case report.
Conclusion:
The authors presented a rare cause of postoperative small bowel obstruction treated without surgery. The peculiarity of this case report is that the authors have successfully used, in an adult, conservative treatment with gastrografin, which is the treatment of choice used in children. The use of gastrografin was decisive and there were no recurrences in the follow up.
Spontaneous pneumomediastinum from running sprints
Authors: Joseph W Turban
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Spontaneous pneumomediastinum (SPM) is a fairly rare condition, caused by increased intrathoracic pressure, leading to free air in the mediastinal structures. Underlying lung conditions are associated with increased incidence of SPM, including asthma, interstitial lung disease, pneumonia, bullous lung, and radiation therapy for lung cancer. It is often preceded by Valsalva maneuvers, vomiting, coughing, asthma exacerbation, sneezing, childbirth, or intense physical activity. A case of SPM is presented in a 15-year-old male, who complained of throat pain and dyspnea while running sprints at football practice. Workup revealed SPM, and he was subsequently admitted and treated conservatively. His symptoms resolved in 2 days and he was discharged and suffered no further recurrences. In contrast to secondary pneumomediastinum, SPM is usually a benign condition although life-threatening conditions can rarely arise. Differentiating between these two conditions has important prognostic indications. There is a paucity of prospectively collected data regarding SPM, and considerable variation in recommendations concerning the extent of workup.
Coping Ability and Promotion Countermeasures of Medical and Health Institutions Reputation Crisis: A Case Study in Hubei Province
Authors: Yang Liu, Xiaofang Li, Rui Ding, Tianrun He, Xian-Jia Wang
Journal: Front Public Health (2022)
Keywords: coping ability, medical and health institutions, promotion countermeasures, reputation crisis, situational crisis communication theory
MeSH terms: Adaptation, Psychological, Hospitals, Research Support, Non-U.S. Gov't, Child, Family, Humans, Universities

At present, the doctor-patient relationships in Chinese medical and health institutions (MHI) are increasingly tense, and the reputation crisis challenges are being faced by MHI more frequently. However, the reputation crisis management level of the MHI is directly related to the future development and construction of the MHI and is an important management link that cannot be ignored. Therefore, how to quantify the impact of the relevant crisis on hospitals has become a major problem. First of all, this paper uses the situational crisis communication theory (SCCT) to combine the characteristics of hospital reputation crisis with the theory and classification of MHI reputation crisis from three perspectives: victim crisis, accidental crisis, and preventable crisis. Second, a more comprehensive analysis of MHI reputation crisis management model is conducted in the research cases, based on the relevant data of Union Hospital, Tongji Medical College Huazhong University of Science and Technology (UH), Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology (TJ), Zhongnan Hospital of Wuhan University (ZN), Renmin Hospital of Wuhan University (RM), and Maternal and Child Hospital of Hubei Province (MC). Third, we divide MHI reputation positioning into four types, namely robust, growth, fragile, and sensitive, and innovate SCCT to build a new MHI crisis classification type. Finally, this paper provides appropriate crisis management strategies for sample MHI based on the above examples and theories. Furthermore, we realize the lifecycle management of MHI reputation by identifying, evaluating and responding to reputation issues. This study provides a theoretical reference for the MHI reputation crisis management level and the adjustment of future management strategies.
Nivolumab and Ipilimumab in the Treatment of Metastatic Uveal Melanoma: A Single-Center Experience
Authors: Vidhya Karivedu, Ihab Eldessouki, Ahmad Taftaf, Zheng Zhu, Abouelmagd Makramalla, Nagla Abdel Karim
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Background:
Metastatic uveal melanoma (MUM) is associated with a poor prognosis, with a median overall survival (OS) of 4-15 months. Despite new insights into the genetic and molecular background of MUM, satisfactory systemic treatment approaches are currently lacking. The study results of innovative treatment strategies are urgently needed.
Patients and methods:
This was a retrospective case series of 8 patients with MUM managed at the University of Cincinnati between January 2015 and January 2018. The immune-related Response Evaluation Criteria in Solid Tumors (irRECIST) 1.1 criteria were used for patient evaluation, and magnetic resonance imaging was used for evaluation at treatment checkpoints.
Objective:
To assess the clinical outcome of patients with MUM treated with a combination of checkpoint inhibitors.
Results:
The series included eight patients, six men and two women, with MUM. Their median age at MUM diagnosis was 69 (range, 55-77) years. All patients were treated with ipilimumab and nivolumab combination along with transarterial chemoembolization (TACE), followed by nivolumab maintenance and monthly TACE procedures. The majority of patients had a partial response or stable disease. Two of the patients had partial response, while four others had stable disease. Two other patients experienced disease progression.
Conclusion:
We report the outcomes of eight patients with MUM treated with the combination of ipilimumab and nivolumab. We report the clinical outcome and toxicity associated with this treatment approach. Further studies are warranted to explore immunotherapy in MUM. These findings support the consideration of immunotherapy in MUM.
Biopsy with the new essen biopsy forceps
Authors: Peter G Traine, Katharina J E Schedler, Mariuccia G S Brusa, Eduardo B Rodrigues
Journal: Case Rep Ophthalmol Med (2013)

Purpose. To present initial experience with a novel biopsy method, the Essen biopsy forceps. Therefore, two patients with diagnostic suspicion of uveal melanoma underwent biopsy for histopathological confirmation. Case Presentation. Two patients presented with painless unilateral vision reduction. Ultrasound revealed the diagnostic suspicion of uveal melanoma. Therefore, biopsy with the Essen biopsy forceps using a sutureless 23-gauge three-port vitrectomy system was performed. The specimens were then submitted to a pathologist and processed. Histopathology of the obtained specimen confirmed the diagnostic suspicion of choroid melanoma in both patients. Conclusion. Essen biopsy forceps is a very practicable alternative method to the FNAB, allowing a combined histopathological and immunohistochemical examination for achieving high diagnostic accuracy at minimal risk.