OpenMed/multicare-articles huggingface dataset:
Analysis of polypharmacy effects in older patients using Japanese Adverse Drug Event Report database
Authors: Junko Abe, Ryogo Umetsu, Hiroaki Uranishi, Honami Suzuki, Yuri Nishibata, Yamato Kato, Natsumi Ueda, Sayaka Sasaoka, Haruna Hatahira, Yumi Motooka, Mayuko Masuta, Mitsuhiro Nakamura
Journal: PLoS One (2017)
MeSH terms: Adverse Drug Reaction Reporting Systems, Polypharmacy, Research Support, Non-U.S. Gov't, Aged, Female, Humans, Japan, Male

Population aging is a global phenomenon, and choosing appropriate medical care for the elderly is critical. Polypharmacy is suspected to increase the risk of adverse events (AEs) in older patients. We examined the AE profiles associated with polypharmacy and aging using the Japanese Adverse Drug Event Report (JADER) database. We attempted to mitigate the effect of patient-related factors using a multiple-logistic regression technique and data subsetting. We selected case reports for AEs as specified in the Medical Dictionary for Regulatory Activities (MedDRA). The association between polypharmacy and "renal disorder" or "hepatic disorder" was evaluated using reporting odds ratio (ROR) and adjusted for covariates using multiple-logistic regression. For renal disorder, advanced polypharmacy showed higher adjusted RORs, because the value of administered drugs group [1.82 (1.76-1.88), ≥ 10] was higher than that of the number of administered drugs group [1.27 (1.24-1.31), 5-9]. The lower limit of the 95% confidence interval (CI) of adjusted ROR for age (≥ 60 years) was > 1 for renal disorder. For hepatic disorder, the adjusted RORs were as follows: 1.17 (1.14-1.20) for the number of administered drugs group (5-9) and 1.14 (1.11-1.18) for the number of administered drugs group (≥ 10). The adjusted RORs of hepatic disorder compared to those of renal disorder had lower adjusted RORs related to the increase in the number of administered drugs. Therefore, elderly individuals should be closely monitored for the occurrence of renal disorder when they are subjected to polypharmacy. This approach might apply to the simultaneous evaluation of the AE risk of polypharmacy and aging.
Histological and Immunohistochemical Characterization of a Case of Endometriosis in a Guinea Pig (Cavia tschudii)
Authors: Alfonso Baldi, Andrea Lanza, Francesco Menicagli, Pietro G Signorile, Enrico P Spugnini
Journal: Case Rep Vet Med (2017)
MeSH terms: Case Reports

Endometriosis is a chronic gynecological disease characterized by the ectopic proliferation of endometrial tissue outside of the uterine cavity. The pathogenesis of this disease is still obscure, and Sampson's theory of retrograde menstruation is still the most widely accepted explanation. Endometriosis in animals has been so far described not only in baboons and a rhesus macaque but also in dogs and horses that are nonmenstruating animals. In this article, we report the histological and immunohistochemical characterization of the first case of ovarian cystic endometriosis and adenomyosis in a guinea pig. The case presented supports the hypothesis that endometriosis is a disease not at all related to the phenomenon of retrograde menstruation but is a consequence of some alterations in the morphogenesis of the female genital system and therefore it could be found in any mammal. We suggest considering endometriosis among the other pathological phenotypes in animals displaying ovarian and uterine alterations and having a history of difficulties in conceiving.
Case Report: Functional Investigation of an Undescribed Missense Variant Affecting Splicing in a Patient With Dravet Syndrome
Authors: Peter Sparber, Svetlana Mikhaylova, Varvara Galkina, Yulia Itkis, Mikhail Skoblov
Journal: Front Neurol (2021)
Keywords: dravet syndrome, epilepsy, functional analysis, medical genetics, molecular pathogenesis, splicing
MeSH terms: Case Reports

Pathogenic variants in the SCN1A gene are associated with a spectrum of epileptic disorders ranging in severity from familial febrile seizures to Dravet syndrome. Large proportions of reported pathogenic variants in SCN1A are annotated as missense variants and are often classified as variants of uncertain significance when no functional data are available. Although loss-of-function variants are associated with a more severe phenotype in SCN1A, the molecular mechanism of single nucleotide variants is often not clear, and genotype-phenotype correlations in SCN1A-related epilepsy remain uncertain. Coding variants can affect splicing by creating novel cryptic splicing sites in exons or by disrupting exonic cis-regulation elements crucial for proper pre-mRNA splicing. Here, we report a novel case of Dravet syndrome caused by an undescribed missense variant, c.4852G>A (p.(Gly1618Ser)). By midigene splicing assay, we demonstrated that the identified variant is in fact splice-affecting. To our knowledge, this is the first report on the functional investigation of a missense variant affecting splicing in Dravet syndrome.
'We're passengers sailing in the same ship, but we have our own berths to sleep in': Evaluating patient and public involvement within a regional research programme: An action research project informed by Normalisation Process Theory
Authors: Julia Keenan, Fiona Poland, Jonathan Boote, Amanda Howe, Helena Wythe, Anna Varley, Penny Vicary, Lisa Irvine, Amander Wellings
Journal: PLoS One (2019)
MeSH terms: Health Services Research, Patient Participation / statistics & numerical data, Stakeholder Participation, Research Support, Non-U.S. Gov't, Humans

Background:
Patient and public involvement (PPI) is a requirement for UK health and social care research funding. Evidence for how best to implement PPI in research programmes, such as National Institute for Health Research (NIHR) Collaborations for Applied Health Research and Care (CLAHRCs), remains limited. This paper reports findings from an action research (AR) project called IMPRESS, which aims to strengthen PPI within CLAHRC East of England (EoE). IMPRESS combines AR with Normalisation Process Theory (NPT) to explore PPI within diverse case study projects, identifying actions to implement, test and refine to further embed PPI.
Methods:
We purposively selected CLAHRC EoE case study projects for in-depth analysis of PPI using NPT. Data were generated from project PPI documentation, semi-structured qualitative interviews with researchers and PPI contributors and focus groups. Transcripts and documents were subjected to abductive thematic analysis and triangulation within case. Systematic across case comparison of themes was undertaken with findings and implications refined through stakeholder consultation.
Results:
We interviewed 24 researchers and 13 PPI contributors and analysed 28 documents from 10 case studies. Three focus groups were held: two with researchers (n = 4 and n = 6) and one with PPI contributors (n = 5). Findings detail to what extent projects made sense of PPI, bought in to PPI, operationalised PPI and appraised it, thus identifying barriers and enablers to fully embedded PPI.
Conclusion:
Combining NPT with AR allows us to assess the embeddedness of PPI within projects and programme, to inform specific local action and report broader conceptual lessons for PPI knowledge and practice informing the development of an action framework for embedding PPI in research programmes. To embed PPI within similar programmes teams, professionals, disciplines and institutions should be recognised as variably networked into existing PPI support. Further focus and research is needed on sharing PPI learning and supporting innovation in PPI.
Consecutive Case Series of Healed Single-Molar Sites Immediately Restored with Wide-Diameter Implants: A 1-Year Evaluation
Authors: Hadi Antoun, Pierre Cherfane, Bouchra Sojod
Journal: Int J Dent (2016)

Introduction. To evaluate outcomes of wide-diameter (6 mm) implants immediately provisionalized with cement-retained single crowns in posterior molar sites. Materials and Methods. Forty-eight consecutive patients received a total of 53 moderately rough-surface, 6 mm diameter implants in healed sites. All implants were immediately provisionalized with a cement-retained provisional crown. Final prosthesis with cement-retained porcelain fused to metal crowns was delivered 3-6 months later. Patients were followed up for 1 year. Outcome measures were implant failures and success rate, complications, marginal bone levels, bone level changes, papilla index, bleeding on probing, and inflammation. Results. One patient was lost to follow-up. At one year, the implant survival and success rate were 98.1%. The mean marginal bone loss after 1 year was -0.17 ± 1.84 mm. Ideal papilla score was recorded at 83.8% of the sites. More than 95.6% of the sites showed no bleeding or inflammation. No procedure-related or device-related adverse events were reported. Conclusion. Wide-diameter (6 mm) implants can safely and successfully replace single posterior molars. Longer follow-up studies are necessary to evaluate the long-term success of these implants.
A Rare Cervical Dystonia Mimic in Adults: Congenital Muscular Torticollis (Fibromatosis colli), a Follow-up
Authors: Mehmet C Uluer, Branko Bojovic
Journal: Front Neurol (2016)
Keywords: congenital muscular torticollis, fibromatosis colli, muscular torticollis, operative, sternocleidomastoid muscle, surgical procedures
MeSH terms: Case Reports

Neglected or undiagnosed congenital muscular torticollis in adults is quite rare, although it is the third most common congenital deformity in the newborn (1). When left untreated at an early age, deficits in lateral and rotational range of motion can occur along with irreversible facial and skeletal deformities that develop over time. Subtle cases can go unnoticed until early adulthood, with predominant fibrotic replacement in the sternocleidomastoid (SCM) making physical therapy and chemodenervation mostly ineffective. Surgical intervention, in these cases, can prove effective in alleviating pain, improving function and cosmesis (2). We report an update on a previously reported case, misdiagnosed as cervical dystonia, which had undergone partial myectomy of the anterior belly of the SCM with some relief of symptoms but without total resolution after the correct diagnosis of fibromatosis colli (3).
An Uncommon Case of Peripheral Osteoma of the Maxilla: A Case Report
Authors: Akanksha Shiradhonkar, Motilal Jangid, Vino Tito V Kurien, Ruchita Humne, Saleem Khan
Journal: Cureus (2023)
Keywords: benign, electrocautery, maxilla, osteoma, peripheral type
MeSH terms: Case Reports

Facial bone osteomas are uncommon, with only a few cases reported in the literature. Osteomas are benign neoplasms that are composed of well-differentiated, mature bones. There are three types of osteomas: central osteomas that develop from the endosteum, peripheral osteomas (PO) that develop from the periosteum, and extra-skeletal soft tissue osteomas that develop from the muscle. Both central and peripheral osteomas of the facial bones have been described. Peripheral osteomas have been reported in the frontal, ethmoid, and maxillary sinuses, but they are uncommon in the jawbone. It occurs at a younger age but is most prevalent in the sixth decade, with a female-to-male ratio of 1:2. The purpose of this case report was to examine the clinical manifestation and management protocol of such lesions using electrocautery.
Unusual case of simultaneous presentation of plasma cell myeloma, chronic myelogenous leukemia, and a jak2 positive myeloproliferative disorder
Authors: J Maerki, G Katava, D Siegel, J Silberberg, P K Bhattacharyya
Journal: Case Rep Hematol (2014)

Background. Multiple articles discuss the rare incidence and potential causes of second hematologic disorders arising after treatment of Chronic Myelogenous Leukemia (CML), leading to the theory of imatinib, the current treatment regimen for CML, as a possible trigger for the development of secondary neoplasms. Our case eliminates the possibility of imatinib as the sole cause since our patient received a diagnosis of simultaneous plasma cell myeloma, CML, and a Jak2 mutation positive myeloproliferative disorder (MPD) arising de novo, prior to any treatment. We will further investigate into alternative theories as potential causes for multiple hematopathologic disorders. Case Report. There are currently no reported cases with the diagnosis of simultaneous plasma cell myeloma, chronic myelogenous leukemia, and Jak2 positive myeloproliferative disorder. We present a case of a 77-year-old male who was discovered to have these three concurring hematopathologic diagnoses. Our review of the literature includes a look at potential associations linking the three coexisting hematologic entities. Conclusion. The mechanism resulting in simultaneous malignancies is most likely multifactorial and potentially includes factors specific to the host, continuous stimulation of the immune system, previous chemotherapy or radiation, a potential common pluripotent stem cell, or, lastly, preexisting myeloma which may increase the susceptibility of additional malignancies.
Noninvasive Positive-Pressure Ventilation for Preeclampsia-Induced Pulmonary Edema: 3 Case Reports and a Literature Review
Authors: Kohei Hamada, Yoshitsugu Chigusa, Eiji Kondoh, Yusuke Ueda, Shunsuke Kawahara, Haruta Mogami, Akihito Horie, Tsukasa Baba, Masaki Mandai
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Pulmonary edema caused by severe preeclampsia can be an indication for pregnancy termination. We aimed to investigate whether noninvasive positive-pressure ventilation (NPPV) was useful for preeclampsia-induced pulmonary edema. Three cases of preeclampsia-induced pulmonary edema managed with NPPV in our institute were reviewed retrospectively. A literature review was conducted regarding NPPV usage during pregnancy. NPPV was initiated at 30, 20, and 24 weeks of gestation in the 3 cases. In all cases, NPPV slowed the progression of pulmonary edema and succeeded in delaying pregnancy termination by 17 days on average. Maternal outcomes were positive, and no intubation was required. Between 1994 and 2017, there were 11 articles describing 12 cases in which NPPV was applied for pulmonary edema during pregnancy. However, there has been no case of NPPV management of preeclampsia-induced pulmonary edema thus far. Maternal and fetal outcomes were positive in these 12 cases. NPPV may contribute to prolonging pregnancy in patients with poor oxygenation due to preeclampsia-induced pulmonary edema. However, patients should be closely monitored, and the decision to intubate or terminate the pregnancy should be made without delay when the maternal or fetal condition worsens.
Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases
Authors: Ahmed F Alkandari, Abrar Alawadhi, Fatma A Alawadhi, Waleed M Renno
Journal: Cureus (2023)
Keywords: camper's chiasma, case report, flexor digitorum profundus, flexor digitorum superficialis, flexor zone ii, isolated fdp injury, no man's land, tendon cut, the critical zone, traumatic hand injury
MeSH terms: Case Reports

Injuries of the hand's flexor tendons carry a poor prognosis, mainly if they are in zone II (also called 'the critical zone' or 'no man's land'). The superficial tendon in this zone ends by bifurcating and attaching to the sides of the middle phalanx, exposing the deep tendon that attaches to the distal phalanx. Thus, trauma to this zone may result in a complete cut to the deep tendon while the superficial one remains intact. The lacerated tendon, in turn, would be retracted proximally to the palm making it difficult to be found during wound exploration. The complex anatomy of the hand, particularly that of the flexor zones, may contribute to the misdiagnosis of a tendon injury. We report five cases of an isolated cut of the flexor digitorum profundus (FDP) tendon after traumatic injury to the flexor zone II of the hand. The mechanism of injury of each case is reported together with a clinical approach that guides ED physicians toward diagnosing flexor tendon injuries in hand. In cut wounds involving the flexor zone II of the hand, it should be not surprising to find that the deep tendon (FDP) is completely lacerated without an injury to the superficial one (FDS). Therefore, we conclude that a systematic examination approach for traumatic hand injuries is essential to ensure the proper assessment. Understanding the mechanism of injury, performing a systemic examination approach, and having basic anatomical knowledge of flexor tendons of the hand are essential to identifying tendon injuries, anticipating complications, and providing adequate healthcare.
Verrucous Carcinoma of the Vulva: A Case Report and Review of the Literature
Authors: Jean Bouquet de Jolinière, F Khomsi, J M Gothuey, L Guillou, A Fadhlaoui, J B Dubuisson, A Feki
Journal: Front Surg (2016)
Keywords: hpv, condyloma, verrucous carcinoma, vulva carcinoma, vulva surgery
MeSH terms: Case Reports

Verrucous carcinoma of the vulva is a rare lesion (1). Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in vulval carcinoma classification and its scalability is uncertain and unpredictable. Here, we present a case concerning a 48-year-old patient, without follow-up after a condyloma acuminate of the vulva (large left lip). The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows the rarity of this lesion of the female genital tract.
Acute rhabdomyolysis in a young woman with moderate COVID-19
Authors: Kohei Fujita, Osamu Kanai, Kazutaka Nanba, Naoki Esaka, Hiroaki Hata, Koichi Seta, Takao Odagaki
Journal: IDCases (2021)
Keywords: covid-19, exercise, muscle training, rhabdomyolysis, sars-cov-2
MeSH terms: Case Reports

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is having serious medical, social, and economic impacts worldwide. COVID-19 may lead to a variety of complications, including rhabdomyolysis. Although rhabdomyolysis is a rare complication, it can lead to severe kidney damage. Recent studies suggest that rhabdomyolysis caused by SARS-CoV-2 is more common in middle-aged and older men with severe COVID-19. Herein we report a case of rhabdomyolysis in a young woman with moderate COVID-19. She had a habit of muscle training. She presented with moderate COVID-19 and acute rhabdomyolysis that required a large volume of fluid infusion in addition to dexamethasone and remdesivir. Clinicians should pay attention to the development of rhabdomyolysis in patients with COVID-19, especially those with a habit of strenuous exercise or muscle training, even if they are young and have moderate COVID-19.
Anti-PD-1 sintilimab-induced bilateral optic neuropathy in non-small cell lung cancer: A case report and literature review
Authors: Jian Wang, Xiaoyue Xiao, Xiaorong Dong, Gang Wu, Xinghua Wang, Ruiguang Zhang
Journal: Front Oncol (2022)
Keywords: pd-1, immune-related adverse events, non-small cell lung cancer, optic neuropathy, sintilimab
MeSH terms: Case Reports

Anti-PD-1/PD-L1 immunotherapy reactivates T-cell activity to boost the antitumor effect and may trigger autoimmune toxicity in various organ systems involving eyeball and periocular structures at the same time. The rarity of ocular immune-related adverse events should not prevent us from paying attention to this issue because of the bad consequences of visual impairment. This is the first case report of anti-PD-1 sintilimab-induced bilateral optic neuropathy in a 76-year-old man with squamous non-small cell lung cancer (NSCLC). The patient presented with sudden vision blurring without pain in both eyes after three therapeutic cycles of sintilimab plus chemotherapy. Based on the ophthalmic examination, laboratory, and radiological results, our patient was diagnosed with optic neuropathy complication secondary to anti-PD-1 sintilimab treatment. Consequently, sintilimab was held and systemic steroids were administered. The follow-up review showed that the vision recovered and the size of the primary tumor continued to decrease with the response assessment as the partial response. In conclusion, this case report suggested that patients with NSCLC undergoing anti-PD-1/PD-L1 therapy should be closely monitored for ophthalmic assessment and alert to the occurrence of sintilimab-induced optic neuropathy.
Long-term multimodal imaging in acute posterior multifocal placoid pigment epitheliopathy and association with coxsackievirus exposure
Authors: Alexa L Li, Neal V Palejwala, Jessica G Shantha, Ghazala O'Keefe, Cecilia S Lee, Thomas Albini, Steven Yeh
Journal: PLoS One (2020)
MeSH terms: Enterovirus / physiology, Environmental Exposure / adverse effects, Multifocal Choroiditis / diagnostic imaging, Multifocal Choroiditis / virology, Multimodal Imaging, Retinal Diseases / diagnostic imaging, Retinal Diseases / virology, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Acute Disease, Adolescent, Adult, Aged, Angiography, Female, Humans, Male, Middle Aged, Optical Imaging, Retrospective Studies, Tomography, Optical Coherence, Young Adult

The purpose of this study was to evaluate potential insights into the pathogenesis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) using multimodal diagnostic imaging and laboratory evaluation in long-term follow-up. A retrospective, single-center case series was conducted on seven consecutive patients (14 eyes) who were given a diagnosis of APMPPE from March 1, 2011, through June 30, 2019 with at least three months of follow-up. Clinical characteristics (age, symptoms, visual acuity [VA]), laboratory testing including coxsackievirus titers, and multimodal imaging from fundus photography, spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), fluorescein angiography (FA), and indocyanine green angiography (ICG) were analyzed for each patient. The initial median VA was 20/71 and final median VA was 20/22. Coxsackievirus B (CVB) titers were elevated (≥ 1:80) in six of seven patients, with a four-fold increase in convalescent titers seen in two patients suggestive of recent infection. All patients were treated with oral corticosteroids, and five patients underwent corticosteroid-sparing immunomodulatory therapy. Initially, multifocal deep choroidal lesions were observed in the posterior pole corresponding to patches of hypocyanescence on ICG. Overlying retinal pigment epithelium (RPE) disease was observed on FAF, although this finding was not universally observed, suggesting that RPE disease may occur as a sequelae to unchecked choroidal inflammation. SD-OCT architectural changes confirmed outer retina and ellipsoid zone disruption. FA of active lesions showed early hypofluorescence and late hyperfluorescence with surrounding leakage while inactive disease showed areas of staining. Long-term follow-up of multimodal diagnostic imaging in APMPPE revealed that choroidal inflammation likely precedes RPE change and photoreceptor damage. Elevation of coxsackievirus titers with seroconversion may be associated with an infectious trigger in concert with immune-mediated disease in this posterior uveitis syndrome.