OpenMed/multicare-articles huggingface dataset:
Understanding gender inequity in brain health outcomes: missed stroke as a case study for intersectionality
Authors: Suze G Berkhout, Syeda Hashmi, Aleksandra Pikula
Journal: Front Glob Womens Health (2024)
Keywords: brain health gap, gender, implicit bias, intersectionality, misdiagnosis, stroke

Recent attention into sex and gender-based inequities surrounding outcomes for brain health disorders has generated momentum toward addressing what has been called the "brain health gap." Importantly though, "women" are not uniform demographic group. In this perspective piece, we discuss misdiagnosis in stroke as an aspect of access and quality of care within brain health. Drawing on narrative data from a mixed methods study of young stroke survivors we suggest that while missed stroke isn't only an issue of gender, if we are going to understand gender-based gaps in access and navigation through stroke care, we have to understand how intersections of gender with age, ethnoracial identity, nationality, language, (dis)ability, and other aspects of social identity come together to create affordances as well as biases that contribute to stroke outcomes.
Incidental finding of cardiac hydatid cyst during autopsy
Authors: Nishant Purbey, Amit Patil, Shreekant Bharti, Keshav Chandra, Shashank Ranjan
Journal: Autops Case Rep (2024)
Keywords: autopsy, echinococcus, electric injuries, forensic pathology, parasitic diseases
MeSH terms: Case Reports

Hydatidosis or echinococcosis is an endemic parasitic disease caused by the ingestion of eggs of echinococcal species worldwide. In India, the annual incidence varies from 1 to 200 per one 100,000 hab., with the highest prevalence reported in the Indian states of Andhra Pradesh and Tamil Nadu. The dog is the definitive host, while humans, sheep, and cattle are intermediate hosts. The disease usually involves the liver and lungs, with the kidney and other organs rare involvement. Cardiac hydatidosis is still further rare, seen in 0.2% to 2% of the patients who remain asymptomatic until the development of its complications. Sudden deaths in cardiac echinococcosis are mostly attributed to cardiac arrhythmias, coronary artery diseases, valvular diseases, cardiomyopathies, pericarditis, and cardiac tamponade. We, herein, report a rare case of cardiac hydatid cyst incidentally found during the autopsy of a 26-year-old male who died due to electrical injuries. A single greyish-white cystic mass measuring 1.5cm X 1.2cm was detected on the left anterior ventricular wall 4 cm above the apex and was confirmed microscopically as a hydatid cyst. The cause of death was attributed to external injury.
Primary cervical malignant melanoma that was successfully treated with pembrolizumab: a case report and literature review
Authors: Mengpei Zhang, Rutie Yin, Liang Song, Lan Zhong, Ruiyu Wang
Journal: Front Oncol (2024)
Keywords: case report, cervical cancer, immunotherapy, pembrolizumab, primary cervical malignant melanoma
MeSH terms: Case Reports

Primary malignant melanoma (MM) arising from the cervix is an exceedingly rare occurrence, and patients diagnosed with this condition often face a dismal clinical prognosis. Here, we present a case study of a postmenopausal woman presenting with vaginal bleeding and a conspicuous 5-centimeter black mass on the cervix. Based on the staging criteria established by the International Federation of Gynecology and Obstetrics, she was diagnosed with stage IIB primary cervical MM. The patient underwent neoadjuvant therapy prior to a radical hysterectomy and a bilateral salpingo-oophorectomy. Subsequently, she completed 18 cycles of pembrolizumab therapy, achieving clinical complete remission. Notably, at the 31-month follow-up, there were no signs of recurrence. This successful treatment outcome serves as a valuable clinical reference for the management of primary cervical MM.
FLNC Associated Restrictive Cardiomyopathy and Hypertrabeculation, a Rare Association
Authors: Ana M Aristizabal, Carlos Alberto Guzmán-Serrano, María Isabel Lizcano, Walter Mosquera, Juliana Lores, Harry Pachajoa, Cesar Cely
Journal: Arq Bras Cardiol (2024)
MeSH terms: Cardiomyopathy, Restrictive / genetics, Mutation, Missense, Case Reports, Child, Exome Sequencing, Female, Humans, Pedigree

A six-year-old girl with restrictive cardiomyopathy and hypertrabeculation, due to the early onset of her disease, whole exome sequencing was conducted, revealing the presence of a novel heterozygous missense variant in the FLNC gene. The same gene variant was also identified in her father, who, at an adult age, displayed normal imaging results and was symptom-free. This variant has not been reported in population databases or current medical literature and is classified as likely pathogenic.
Outcome of eight working dogs with fibrotic myopathy following extracorporeal shockwave and rehabilitation therapy: a case series
Authors: Frank C Tsai, Leilani X Alvarez
Journal: Front Vet Sci (2024)
Keywords: german shepherd, extracorporeal shockwave therapy, fibrotic myopathy, gracilis, muscle contracture, semitendinosus, working dogs

Introduction:
Fibrotic myopathy of the gracilis, semitendinosus, and semimembranosus is described primarily in working German Shepherd dogs. The purpose of this case series is to describe the rehabilitation modalities and treatments utilized in working dogs with fibrotic myopathy and the time frame they were able to continue working.
Methods:
Medical records of patients with hindlimb lameness that were presented to the Schwarzman Animal Medical Center in New York City from 2012 to 2023 were retrospectively searched. Signalment, history, clinical evaluation, gait analysis, goniometry of stifles, and follow-up evaluation were compared among patients. Ten male working dogs met inclusion criteria. Extracorporeal Shockwave Therapy (ECSWT) was administered under sedation or general anesthesia. Rehabilitation therapy (RT), including massage, hamstring stretch, photobiomodulation, pulsed electromagnetic field therapy, warm compress, therapeutic ultrasound, underwater treadmill, and therapeutic exercises, were performed once every one to 3 weeks with varying protocols according to patient assessments. Follow-up phone calls and emails were conducted to determine long-term outcome.
Results:
On average, dogs were able to work full-time for 32.1 months (range 6-82; SD 23.6) from the time of diagnosis. No activity limitation was reported by the owners/handlers.
Discussion:
This report is the first to describe non-invasive medical treatments that may extend the working ability of dogs diagnosed with fibrotic myopathy. Further prospective randomized controlled studies are needed to demonstrate the efficacy of ECSWT and RT for treating fibrotic myopathy.
Conclusion:
The results of this retrospective study suggest that the combination of ECSWT and RT may allow working dogs with fibrotic myopathy to continue their working capacity for an extended period of time.
Case Report: Surgical management of idiopathic pulmonary aneurysms and review surgical approaches
Authors: Kui Wu, Xuan Fan, Xuanyi Hu, Xuejun Li, Siyuan Yang
Journal: Front Cardiovasc Med (2023)
Keywords: case report, idiopathic, procedure, pulmonary aneurysms, vascular replacement
MeSH terms: Case Reports

Idiopathic pulmonary aneurysm is a clinically rare condition characterized by an unknown etiology and episodic occurrence. Despite its rarity, idiopathic pulmonary artery aneurysm poses potential risks to patients. Currently, there is a lack of established clinical guidelines and consensus regarding its management, leading to ongoing controversies in treatment strategies. Particularly, the optimal approach for addressing the main pulmonary artery, its branches, and the pulmonary artery valve remains uncertain. A 57-year-old female patient presented with chest pain and tightness, leading to the diagnosis of idiopathic pulmonary artery aneurysm after excluding other potential causes. Subsequently, she underwent surgical treatment. However, during the surgery, the pulmonary artery wall was found to be extremely weak, prompting us to employ a surgical approach involving the utilization of autologous vessel wrapping with artificial grafts. By summarizing almost all surgical treatment strategies reported in recent years, including the management of pulmonary artery vessels and the pulmonary valve, we have developed a treatment flow chart. This flowchart serves as a valuable guide for the management of future cases presenting similar challenges, offering clinicians valuable insights and evidence-based recommendations.
Diffuse Idiopathic Skeletal Hyperostosis Causing Progressive Dysphagia: A Case Report and Review
Authors: Farzin Davoodi, Narges Bazgir, Reza Naseri
Journal: Case Rep Radiol (2023)
MeSH terms: Case Reports

Background:
Diffuse idiopathic skeletal hyperostosis (DISH) is a rare noninflammatory disorder impacting spinal longitudinal ligament and enthesis. The majority of DISH cases are asymptomatic or have few manifestations. Manifestations include neck pain and stiffness, stridor, breathing disturbances, and dysphagia. Case Presentation. A mid-aged man with progressive dysphagia to solid food was admitted to Loghman Hakim Hospital. In cervical X-ray, a huge ossification in the anterior longitudinal ligament was evident. Eventually, he was diagnosed with DISH. Because of coronary artery disease, conservative treatment was considered for him.
Conclusion:
DISH is a rare disorder usually asymptomatic. In this case report, we present a DISH case with progressive dysphagia to solid foods.
Case report and review of literature: IgG4-gastroduodenitis in upper GI Crohn's disease: two separate entities or just a marker of disease severity?
Authors: Valérie Desmedt, Jeroen Geldof, Anne Hoorens, Triana Lobaton
Journal: Front Med (Lausanne) (2024)
Keywords: crohn’s disease, igg4-related disease, anti-tnf, gastritis, granulomatous disease, upper gi tract
MeSH terms: Case Reports

A 20-year-old man was presented with ulcerative gastritis and duodenitis complicated by pyloric stenosis. Helicobacter pylori infection was excluded, and the lesions did not respond to treatment with proton pump inhibitors. No other parts of the intestinal tract showed signs of inflammation. Histopathological review showed signs of chronic inflammation with granuloma formation. A tentative diagnosis of isolated upper gastrointestinal (UGI) Crohn's disease was performed. However, additional work-up revealed significantly positive IgG4 staining as well as elevated IgG4 serum levels. Since granulomatous disease is unlikely in IgG4-related disease, an eventual diagnosis of overlapping IgG4-related disease and Crohn's disease (CD) was performed. Treatment with systemic steroids and anti-TNF in combination with azathioprine led to rapid symptomatic improvement. In this article, we review the available literature on IgG4-related gastroduodenitis, granulomatous gastritis, and upper GI CD. We suggest the possibility that IgG4-infiltration may be a marker of severely active inflammatory bowel disease rather than a separate disease entity.
Successful Treatment of Noninflammatory CaHA Nodules Using Focused Mechanical Vibration
Authors: Alec D McCarthy, Shoham Berkowitz, William Gregory Chernoff
Journal: Aesthet Surg J Open Forum (2024)
MeSH terms: Case Reports

Noninflammatory nodules arising from the injection of biostimulatory fillers persist as an unwanted complication. Pathologically, noninflammatory nodules may arise from superficial injection, accidental boluses, or incorrect concentration of microparticles contained within the filler. This case report introduces a method for reversing calcium hydroxylapatite (CaHA) using focused mechanical vibration. An in situ hyperdilution was created by injecting saline into the nodule core to prepare it for resuspension. Topical microneedling was subsequently applied to generate vibrations, aiming to disperse the accumulated CaHA particles. The outcome demonstrated a significant reduction in the size and visibility of the nodule. This combined saline-microneedling approach offers a potential noninvasive, nonpharmacologic solution for managing superficial CaHA nodules.
Case report: A rare case of malacoplakia resembling a malignant tumor of the cervix: a case report and review of the literature
Authors: Jiaorong Li, Jiaying Mi, Juanjuan Wang, Zhihong Zhuo
Journal: Front Med (Lausanne) (2024)
Keywords: case report, malacoplakia, malignant tumor of the cervix, pathology, vaginal bleeding
MeSH terms: Case Reports

Malacoplakia is a rare chronic granulomatous disease that mostly affects the gastrointestinal tract and urinary tract of immunocompromised patients; malacoplakia rarely effects the female reproductive tract. Here, we report a 56-year-old patient who underwent thymectomy for thymoma and myasthenia gravis prior to developing cervical and vaginal malacoplakia. The patient presented with recurrent vaginal bleeding. We discovered that there were alterations in the cervical cauliflower pattern during colposcopy, which is suggestive of cervical cancer. Pathological examination of the lesion tissue showed that a large number of macrophages aggregated, and M-G bodies with concentric circles and refractive properties were observed between cells. Immunostaining for CD68 and CD163 was positive, and special staining for D-PAS and PAS was positive. The discovery of Escherichia coli in bacterial culture can aid in the diagnosis of malacoplakia. Following surgery, we performed vaginal lavage with antibiotics in addition to resection of local cervical and vaginal lesions. This study provides a fresh perspective on the management of genital malacoplakia.
Congenital Internal Jugular Phlebectasia: An Anomaly Still Poorly Recognized
Authors: Alessandro Raffaele, Marta Gazzaneo, Piero Romano, Maria Sole Prevedoni Gorone, Luigi Avolio
Journal: European J Pediatr Surg Rep (2023)
Keywords: jugular vein, neck mass, phlebectasia
MeSH terms: Case Reports

Congenital internal jugular phlebectasia (CIJP) is a rare condition characterized by congenital dilatation of the vein without tortuosity that becomes more evident during straining as a lateral neck mass. CIJP often remains undiagnosed from a few months to several years after the onset of the swelling. It is frequently asymptomatic although symptomatic cases have been occasionally reported. We present the case of a healthy 7-year-old boy with a lateral neck mass, triggered by the Valsalva maneuver. Neck ultrasound (US) showed right internal jugular axial ectasia, increasing during the Valsalva maneuver; contrast computed tomography (CT) scan confirmed a fusiform dilatation of the right internal jugular vein. Due to the lack of symptoms, we treated our patient conservatively. At 5 years of follow-up, the patient is still asymptomatic, with no evidence of complications or thrombosis. Due to its self-limiting nature, treatment for asymptomatic cases of CIJP should be conservative, providing a follow-up with both clinical and US annual evaluations.
Intravascular Leiomyoma Considered Preoperatively as Uterine Sarcoma: A Rare Case
Authors: Yingyao Wang, Song Xu, Caibo Wang, Wenjuan Li, Jianhao Xu, Zhiwei Zhu, Qin Liu, Lixia Zhu
Journal: Womens Health Rep (New Rochelle) (2024)
Keywords: intravascular leiomyoma, pathology, uterine sarcoma
MeSH terms: Case Reports

Intravascular leiomyoma (IVL) is usually defined as a histologically benign leiomyoma that originates in a uterine fibroid or the intrauterine vein wall and grows and expands intravenously. We report a case in which pelvic IVL was detected early and discuss the early diagnosis of and best treatment for this tumor.
Allogeneic hematopoietic stem cell transplant for familial hemophagocytic lymphohistiocytosis: a case report and literature review
Authors: Liu Bingjie, Zhang Linlin, Ma Futian, Xuan Fan, Du Huan, Xiaoli Wu, Lixia Zhou, Wang Fuxu, Zhang Xuejun, Wang Ying
Journal: Front Immunol (2024)
Keywords: unc13d gene, cytokine storm, familial hemophagocytic lymphohistiocytosis (fhl), hematopoietic stem cell transplant (hsct), white matter damage
MeSH terms: Hematopoietic Stem Cell Transplantation, Lymphohistiocytosis, Hemophagocytic / diagnosis, Lymphohistiocytosis, Hemophagocytic / etiology, Lymphohistiocytosis, Hemophagocytic / genetics, Lymphohistiocytosis, Hemophagocytic / therapy, Transplantation, Homologous, Case Reports, Review, Child, Female, Humans, Membrane Proteins / genetics, Mutation, Treatment Outcome, UNC13D protein, human, Membrane Proteins

Objectives:
This study aims to discuss the clinical manifestations and treatment of Familial hemophagocytic lymphohistiocytosis (FHL) caused by a mutation in the UNC13D gene.
Methods:
A 6-year-old female child presented with unexplained febricity, splenomegaly, pancytopenia, hemophagocytic lymphohistiocytosis in bone marrow, decreased NK cell activity, soluble CD25 levels > 44000ng/ml. Genetic sequencing revealed a mutation in the UNC13D gene. Additionally, the patient experienced intermittent fever with seizures characterized by involuntary twitching of the left upper limb. Head magnetic resonance imaging (MRI) showed white matter lesions.
Results:
According to the HLH-2004 diagnostic criteria revised by the International Society of Histiocytosis the patient was diagnosed with FHL. Despite receiving HLH-2004 treatment, the disease relapsed. However, after a salvage allogeneic Hematopoietic Stem Cell Transplant (HSCT), febricity, abnormal blood cells, and neurological symptoms significantly improved.
Conclusions:
Prompt performance of allogeneic HSCT is crucial upon diagnosis of FHL, especially when neurological involvement is present.
Case report: Cytokine and miRNA profiling in multisystem inflammatory syndrome in children
Authors: Yun-Hao Tsai, Jun-Jie Hong, Chao-Min Cheng, Mei-Hsiu Cheng, Cheng-Han Chen, Min-Ling Hsieh, Kai-Sheng Hsieh, Ching-Fen Shen
Journal: Front Med (Lausanne) (2024)
Keywords: covid-19, il-1β, il-6, mis-c, case report, cytokines, mirna
MeSH terms: Case Reports

Multisystem inflammatory syndrome in children (MIS-C) is an imperative pediatric inflammatory condition closely linked to COVID-19, which garners substantial attention since the onset of the pandemic. Like Kawasaki illness, this condition is characterized by an overactive immune response, leading to symptoms including pyrexia, cardiac and renal complications. To elucidate the pathogenesis of MIS-C and identify potential biomarkers, we conducted an extensive examination of specific cytokines (IL-6, IL-1β, IL-6R, IL-10, and TNF-α) and microRNA (miRNA) expression profiles at various intervals (ranging from 3 to 20 days) in the peripheral blood sample of a severely affected MIS-C patient. Our investigation revealed a gradual decline in circulating levels of IL-6, IL-1β, IL-10, and TNF-α following intravenous immune globulin (IVIG) therapy. Notably, IL-6 exhibited a significant reduction from 74.30 to 1.49 pg./mL, while IL-6R levels remained consistently stable throughout the disease course. Furthermore, we observed an inverse correlation between the expression of hsa-miR-596 and hsa-miR-224-5p and the aforementioned cytokines. Our findings underscore a robust association between blood cytokine and miRNA concentrations and the severity of MIS-C. These insights enhance our understanding of the genetic regulatory mechanisms implicated in MIS-C pathogenesis, offering potential avenues for early biomarker detection and therapy monitoring through miRNA analysis.
Adapting food environment frameworks to recognize a wild-cultivated continuum
Authors: Lilly Zeitler, Shauna Downs, Bronwen Powell
Journal: Front Nutr (2024)
Keywords: swidden, diet, diet quality, dietary diversity, indigenous, natural food environment, niche construction theory, wild foods

Food environments, or interfaces between consumers and their food systems, are a useful lens for assessing global dietary change. Growing inclusivity of nature-dependent societies in lower-and middle-income countries is driving recent developments in food environment frameworks. Downs et al. (2020) propose a food environment typology that includes: wild, cultivated, informal and formal market environments, where wild and cultivated are "natural food environments." Drawing from transdisciplinary perspectives, this paper argues that wild and cultivated food environments are not dichotomous, but rather exist across diverse landscapes under varying levels of human management and alteration. The adapted typology is applied to a case study of Indigenous Pgaz K'Nyau food environments in San Din Daeng village, Thailand, using the Gallup Poll's Thailand-adapted Diet Quality Questionnaire with additional food source questions. Wild-cultivated food environments, as classified by local participants, were the source of more food items than any other type of food environment (37% of reported food items). The case of Indigenous Pgaz K'Nyau food environments demonstrates the importance of understanding natural food environments along a continuum from wild to cultivated.
Multiple verrucous squamous cell carcinomas developing on chronic hidradenitis suppurativa lesions-a rare case report from Romania
Authors: Gyula László Fekete, László Fekete, László Barna Iantovics, Júlia E Fekete, Ilarie Brihan
Journal: Front Med (Lausanne) (2024)
Keywords: comorbidities, hidradenitis suppurativa, inflammatory lesions, squamous cell carcinoma, verrucous carcinoma
MeSH terms: Case Reports

Hidradenitis suppurativa (HS) is an uncommon, recurrent, inflammatory skin illness of the apocrine glands, with a questionable etiology. The disease is associated with a multitude of comorbidities, of which the appearance of malignancy is the most important. Squamous cell carcinoma is considered the most frequent malignancy that can appear in HS. A case report of a 72 years-old male is presented, who suffered over 40 years from persistent, extensive hidradenitis suppurativa in stage Hurley III, on the buttocks and perianal region, who recently presented two verrucous semi-consistent, skin-colored tumors on the right buttock. The biopsy and histopathological exam confirmed a verrucous type of squamous cell carcinoma. There are about 100 reported clinical cases of squamous cell carcinoma complicating hidradenitis suppurativa in the literature, but only a few describe a verrucous carcinoma as a clinical form. The particularity of the case is the rare appearance of multiple verrucous types of squamous cell carcinomas in a male patient, in Hurley Stage III, with a long HS disease duration, appearing on the perianal/gluteal region, being the first case report in our country. We suggest that a tumor screening should be done for all the patients with HS who have these risks.