OpenMed/multicare-articles huggingface dataset:
Emotion Processing and the Role of Compassion in Psychotherapy from the Perspective of Multiple Selves and the Compassionate Self
Authors: Kenichi Asano
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Emotion processing is an important factor for successful psychotherapy. Clients tend to suffer from maladaptive emotions, which contribute to states of confusion, rumination, and stagnation. The therapist should demonstrate adequate empathy and understanding of the client's complaints to help the client to recognize and respect their own emotions and desires. In most cases, there is more than one desire, and each desire should be confronted. The compassionate self exercises are helpful to distinguish and integrate confused states. In this report, the author introduces a case in which the therapist helped a client to process emotional experiences by leading the client to pay attention to her own emotional responses. The client accessed multiple desires for each emotion and recognized the context for each. To integrate multiple desires and contexts, the therapist used multiple selves exercises from Compassion Focused Therapy. The compassionate self exercises play a role in integrating complicated emotions and in directing the client toward making an adequate choice independently. On its own, processing emotional experiences can induce adaptive and healthy desires; however, using compassionate self exercises helps the client to integrate complicated emotions and to approach their own values in a more direct way.
A Case of Successful Treatment with Unilateral Oophorectomy in a Patient with Resistant Polycystic Ovary Syndrome
Authors: S Pathmanathan, I Ranathunga, N P Somasundaram
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Background:
Polycystic ovary syndrome (PCOS) is a common endocrine disorder with heterogeneous etiology. Typical features consist of oligo/anovulation, polycystic ovaries, and features of hyperandrogenism. Pathogenesis is multifactorial, and positive family history may have a predisposition for disease development. The syndrome is associated with multiple metabolic and nonmetabolic entities. As the disease is involved with multiple adverse outcomes, the successful treatment is pivotal. Among the more advanced options, the unilateral oophorectomy is considered as a last resort to alleviate the symptoms. Case Presentation. A 29-year-old female presented to us with oligomenorrhea, severe hirsutism, androgenic pattern hair loss, acne, increased skin pigmentation, and secondary subfertility. On examination, she was obese with a body mass index (BMI) of 29.6 kg/m2. She had evidence of acanthosis nigricans, androgenic pattern balding, acne, dorsal, supraclavicular fat deposition, and moderate-severe hirsutism. Investigations confirmed excess right ovarian testosterone secretion which led to the ultimate management with right oophorectomy with successful alleviation of clinical features.
Conclusions:
The multifaceted medical treatment comprises the first-line therapy in PCOS. Surgery is considered as a second-line option in resistant PCOS following failure of initial therapeutic options. We report a case of resistant polycystic ovary syndrome with secondary subfertility and moderate-to-severe hirsutism who was successfully treated with unilateral oophorectomy with favorable results.
Ketogenic Diet Therapy for the Treatment of Post-encephalitic and Autoimmune-Associated Epilepsies
Authors: Khalil S Husari, Mackenzie C Cervenka
Journal: Front Neurol (2021)
Keywords: se, autoimmune epilepsy, drug-resistant, encephalitis, modified atkins diet, status epilepticus

Introduction: Acute Encephalitis is associated with a high risk of acute symptomatic seizures, status epilepticus, and remote symptomatic epilepsy. Ketogenic diet therapies (KDT) have been established as a feasible and safe adjunctive management of refractory- and super-refractory status epilepticus. However, the role of KDT in the chronic management of Post-encephalitic epilepsy (PE) and autoimmune-associated epilepsy (AE) is unknown. This study aims to investigate the use of KDT in patients with PE and AE. Methods: A retrospective single-center case series examining adult patients with PE and AE treated with the modified Atkins diet (MAD), a KDT commonly used by adults with drug-resistant epilepsy. Results: Ten patients with PE and AE who were treated with adjunctive MAD were included. Four patients had either confirmed or presumed viral encephalitis, five patients had seronegative AE, and one patient had GAD65 AE. The median latency between starting MAD and onset of encephalitis was 6 years (IQR: 1-10). The median duration of MAD was 10 months (IQR: 3.75-36). Three patients (30%) became seizure-free, one patient (10%) achieved 90% seizure freedom, and three patients (30%) achieved a 50-75% reduction in their baseline seizure frequency, while three patients (30%) had no significant benefit. Overall, seven patients (70%) achieved ≥50% seizure reduction. Conclusion: In addition to its established role in the treatment of RSE, KDT may be a safe and feasible option for the treatment of chronic PE and AE, particularly in those with prior history of SE. Prospective studies are warranted to explore the efficacy of KDT in management of patients with PE and AE.
Case Report: Gastrointestinal PEComa With TFE3 Rearrangement Treated With Anti-VEGFR TKI Apatinib
Authors: Jiaming Xu, Xiao-Lei Gong, Huanwen Wu, Lin Zhao
Journal: Front Oncol (2020)
Keywords: tfe3, anti-vegfr, apatinib, mammalian target of rapamycin inhibitor, perivascular epithelioid cell tumors, tyrosine kinase inhibitor
MeSH terms: Case Reports

Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors. Unresectable malignant PEComas with TFE3 rearrangement have no recommended therapy to date. Here, we report the first case of malignant gastrointestinal PEComa with TFE3 rearrangement which has a response to the targeted therapy of an anti-VEGFR tyrosine kinase inhibitor (TKI), apatinib. A 31-year-old female was diagnosed with malignant gastrointestinal PEComa with TFE3 rearrangement and hepatic metastases. A resection of the giant retroperitoneal mass was performed. The patient received the anti-VEGFR TKI apatinib to treat the hepatic metastasis. The tumor remained stable during apatinib treatment and the progression-free survival (PFS) lasted about 7 months. This case suggests that targeting the VEGF/VEGFR signaling pathway may be an essential new therapeutic choice for TFE3-associated malignant PEComas.
E. coli Sepsis: Red Flag for Colon Carcinoma-A Case Report and Review of the Literature
Authors: Hiren G Patel, Seme Tabassum, Sohail Shaikh
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

We present an atypical case of newly diagnosed colon cancer and provide insight into the infectious predispositions of E. coli bacteremia to the development of colon adenocarcinoma. A 66-year-old female was admitted to the hospital with one-week symptoms of subjective fevers, chills, and lower back pain. Upon initial evaluation, her temperature was 101 degrees Fahrenheit with a white count of 12,000 K/mm3. Initial septic workup was positive for E. coli bacteremia. The patient was started on Aztreonam. Repeat blood culture 48 hours later was negative for any growth. However, later during hospital stay blood culture was repeated due to SIRS, which was positive again for E. coli. CT scan of the chest/abdomen/pelvis with contrast revealed no signs of colitis. Without clear etiology for recurrent E. coli bacteremia ultimately colonoscopy was performed which showed an ulcerated mass in the cecum. Biopsy showed moderately differentiated adenocarcinoma. E. coli strains B2 and D produce cyclomodulin toxins as part of their virulence, which interferes with the cell cycle regulation, promoting chromosomal instability, and increasing susceptibility to cancer. In patients with recurrent E. coli bacteremia with an unknown source, colonoscopy should be done to look for colon cancer.
Periostitis Ossificans: Report of Two Cases Resolved with Endodontic Treatment
Authors: Hana Bougatef, Eya Moussaoui, Ines Kallel, Mahmoud Smaoui, Lamia Oualha, Nabiha Douki
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Periostitis ossificans is a chronic disease characterized by an ossifying periostitis, occurring in children and young adults, commonly as a reaction to a mild infection or irritation. It is also characterized by the presence of lamellae of newly formed periosteal bone outside the cortex, giving the characteristic radiographic appearance of "onion skin." Aim. The aim of this paper was to present the clinical and radiographic findings, as well as the postoperative follow-up of two cases diagnosed with periostitis ossificans of dental origin, and to discuss the differential diagnosis and treatment modalities. Case Reports. In the first case, a 16-year-old adolescent was referred for a persistent mandibular swelling. Intraoral examination showed two sinus tracts in relation to the carious necrotic left mandibular first molar. The periapical radiograph showed a periapical lesion in relation to the two root canals of the left mandibular first molar. Occlusal radiographs revealed the "onion skin" bone formation aspect. In the second case, a 10-year-old girl presented to our department with a slightly painful mandibular swelling. The periapical radiograph showed a periapical lesion in relation to both the mesial and distal roots of the carious necrotic right mandibular first molar. Cone beam computed tomography (CBCT) showed a subperiosteal bone formation with an "onion skin" aspect. Diagnosis of periostitis ossificans in the two cases was confirmed and the lesion was resolved by simply an endodontic treatment. Conclusion. Specific attention should be given to clinical and radiographic exploration in case of children with mandibular swelling. As osteosarcoma can be misdiagnosed, additional examinations, such as computed tomography, can be useful in differential diagnosis and in searching malignancy signs.
Prostate Cancer Presenting with Parietal Bone Metastasis
Authors: Brahima Kirakoya, Abdoul Karim Pare, Babagana Mustapha Abubakar, Moussa Kabore
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

Bone metastases from prostate cancer are very common. They are usually located on the axial skeleton. However, cranial bone metastases especially to the parietal bone are rare. We report a case of metastatic prostate cancer presenting with left parietal bone metastasis in a patient with no urological symptoms or signs. We should consider prostate cancer in any man above 60 years presenting unusual bone lesions.
Case report: Anti-IgLON5 disease and anti-LGI1 encephalitis following COVID-19
Authors: Yanfei Li, Yanjie Jia
Journal: Front Immunol (2023)
Keywords: covid-19, iglon5, lgi1, autoimmune encephalitis, case report
MeSH terms: Autoimmune Diseases of the Nervous System, COVID-19 / complications, Disorders of Excessive Somnolence, Encephalitis / diagnosis, Encephalitis / drug therapy, Encephalitis / etiology, Glioma, Sleep Apnea, Obstructive, Sleep Wake Disorders, Case Reports, Adult, Humans, Male, Hashimoto's encephalitis

Anti-IgLON family member 5 (IgLON5) disease is a rare autoimmune encephalitis, characterized by sleep problems, cognitive decline, gait abnormalities, and bulbar dysfunction. Anti-leucine-rich glioma-inactivated 1 (LGI1) autoimmune encephalitis is characterized by cognitive dysfunction, mental disorders, faciobrachial dystonic seizures (FBDS), and hyponatremia. Various studies report that coronavirus disease 2019 (COVID-19) have an effect on the nervous system and induce a wide range of neurological symptoms. Autoimmune encephalitis is one of the neurological complications in severe acute respiratory syndrome coronavirus 2 infection. Until now, autoimmune encephalitis with both anti-IgLON5 and anti-LGI1 receptor antibodies following COVID-19 is rarely reported. The case report described a 40-year-old man who presented with sleep behavior disorder, daytime sleepiness, paramnesia, cognitive decline, FBDS, and anxiety following COVID-19. Anti-IgLON5 and anti-LGI1 receptor antibodies were positive in serum, and anti-LGI1 receptor antibodies were positive in cerebrospinal fluid. The patient presented with typical symptoms of anti-IgLON5 disease such as sleep behavior disorder, obstructive sleep apnea, and daytime sleepiness. Moreover, he presented with FBDS, which is common in anti-LGI1 encephalitis. Therefore, the patient was diagnosed with anti-IgLON5 disease and anti-LGI1 autoimmune encephalitis. The patient turned better after high-dose steroid and mycophenolate mofetil therapy. The case serves to increase the awareness of rare autoimmune encephalitis after COVID-19.
Short-Term Efficacy and Safety Outcomes of Brolucizumab in the Real-Life Clinical Practice
Authors: Andrea Montesel, Claudio Bucolo, Ferenc B Sallo, Chiara M Eandi
Journal: Front Pharmacol (2021)
Keywords: anti-vascular endothelial growth factor, brolucizumab, choroid, intravitreal route, neovascular age-related macular degeneration, retina

To report the early efficacy and safety outcomes of treatment with intravitreal injections of brolucizumab (IVT-B) in patients presenting neovascular age-related macular degeneration (nAMD) in a tertiary clinical setting. A retrospective case series of patients that received IVT-B with a minimum of two injections performed and at least 4 weeks of follow-up after last injection. Nineteen eyes of 19 patients were included. The number of IVT-B performed for the whole cohort was 58 injections; the mean number of IVT-B per patient was 3.0 ± 1.0 (range 2-6); the mean follow-up time was 14.4 ± 9.0 weeks. Mean baseline best-corrected visual acuity was 0.4 ± 0.4 logMAR and at the last follow-up was 0.4 ± 0.6 logMAR (p = 0.778). All eyes showed a reduction in retinal thickness, with the central macular thickness being 470 ± 151 μm at baseline and 360 ± 144 μm at the last follow-up (p = 0.001). Intra-retinal fluid was present at baseline in 12 eyes (63%) and in three eyes (16%) at the last follow-up (p = 0.065). Sub-retinal fluid was present at baseline in 17 eyes (89%) and at the last follow-up in three eyes (16%, p = 0.011). Pigment epithelium detachment was apparent in the 16 eyes (84%) at baseline and was still present in 14 eyes (73%, p = 0.811). One adverse event of intraocular inflammation was reported. In conclusion, our short-term experience showed that brolucizumab was highly effective in restoring the anatomy and in stabilizing the visual acuity of eyes with nAMD. Its safety profile should be evaluated carefully and needs further investigations.
Rare Type Cranial Postauricular Pilonidal Sinus: A Case Report and Brief Review of Literature
Authors: Sebahattin Destek, Vahit Onur Gul, Serkan Ahioglu
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

A pilonidal sinus is a chronic inflammatory process, the etiology of which is still not fully elucidated. It frequently presents at the sacrococcygeal region (typical) and rarely at extrasacrococcygeal (atypical) locations, including the interdigital, axillary, inguinal, and umbilical regions, as well as the neck, face, and scalp. A 46-year-old man presented with a thirty-year history of a slowly growing nodule on the postauricular area of the scalp. The lesion was excised and diagnosed as a pilonidal sinus based on the clinical and histological findings. The purpose of this review is to report the unusual occurrence of a pilonidal sinus on the scalp and to review the literature regarding this particular location of occurrence.
Sweet syndrome: a rare feature of ANCA-associated vasculitis or unusual consequence of azathioprine-induced treatment
Authors: A U Arun Kumar, Mohamed E Elsayed, Ahmed Alghali, Alaa A Ali, Husham Mohamed, Wael Hussein, Catriona Hackett, Niamh Leonard, Austin G Stack
Journal: Allergy Asthma Clin Immunol (2018)
MeSH terms: Case Reports

Background:
Sweet syndrome is a rare skin condition characterised by fever, neutrophilia, and tender erythematous skin lesions and has been reported to occur in association with anti-neutrophil cytoplasmic antibodies (ANCA) as well as complicate treatment with azathioprine therapy. Azathioprine, a relatively safe immunosuppressive, is frequently used to maintain disease remission in the treatment of ANCA-associated vasculitis. The occurrence of Sweet syndrome in a patient with ANCA-positive vasculitis and following treatment with azathioprine prompted us to present this clinical case and share this unusually rare occurrence. In doing so, we also wish to discuss current understanding of the disease and plausible associations.
Case presentation:
Herein, we discuss the case of a 54-year old white male, who presented with features of ANCA vasculitis with haemoptysis, arthralgia, abnormal kidney function with active urine sediment and a positive p-ANCA titre. Standard immunosuppressive treatment with corticosteroids and intravenous rituximab resulted in disease remission. Due to significant steroid side effects, his steroid treatment was gradually tapered and switched to azathioprine over a 6-month period. Two weeks following initiation of azathioprine, he developed a painful maculo-papular erythematous skin rash and fever. A skin biopsy confirmed classical features consistent with Sweet syndrome. Withdrawal of azathioprine and treatment with oral corticosteroids and colchicine therapy resulted in complete resolution of the rash, although he continued to have high titres of MPO positive ANCA.
Conclusion:
Sweet syndrome is a rare adverse reaction to azathioprine but has also been reported to occur in association with ANCA vasculitis. The temporal association with azathioprine in our case and the relatively rapid resolution of the skin vasculitis upon its withdrawal suggested a primarily drug-induced reaction rather than an associated feature of ANCA vasculitis.
T-cell/histiocyte-rich large B-cell lymphoma of the thyroid
Authors: Satoshi Ichikawa, Yasuaki Watanabe, Kei Saito, Jun Kimura, Ryo Ichinohasama, Hideo Harigae
Journal: Exp Hematol Oncol (2013)

T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare subtype of diffuse large B-cell lymphoma, and has been reported to mainly affect lymph nodes with advanced Ann Arbor stage. We present a 69-year-old woman with a past history of chronic thyroiditis, who had suffered from rapidly-growing thyroid tumor. No other lymph nodes swelling or extranodal lesions were detected. She promptly underwent surgery with resection of the thyroid tumor, and the diagnosis of THRLBCL was established pathologically. She was successfully treated by standard rituximab-containing chemotherapy. To our knowledge, this is the first case report of THRLBCL exclusively arising in the thyroid.
Case report: Surgical removal of an intradural and intramedullary brainstem foreign body in a young German Shepherd
Authors: Oscar Thamar-Torres, Andy Shores
Journal: Front Vet Sci (2023)
Keywords: 3d printing, brainstem, brainstem foreign body, intradural, intramedullary, tetraparesis, ventral craniectomy
MeSH terms: Case Reports

A young, female German Shepherd was presented for evaluation of a progressive, mildly ambulatory tetraparesis with severe neck pain. All segmental reflexes were intact, and the paresis was more severe on the right thoracic and pelvic limbs. Diagnostic imaging (radiographs and computed tomography) revealed 2 metallic linear foreign bodies lodged at the right side of the cervicomedullary junction. A modification of the previously described ventral craniectomy approach was performed and after removal of a portion of the basioccipital bone using a nitrogen powered drill, the foreign bodies were removed. Over a period of 3 months, the patient made a full recovery.
Primary Myeloid Sarcoma of the Prostate: A Case Report and Literature Review
Authors: Ryan Nguyen, Hamid Sayar
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

We report the case of a 73-year-old male with primary myeloid sarcoma (MS) of the prostate. He underwent remission-induction chemotherapy followed by conventional consolidation for acute myeloid leukemia (AML). One year after initial diagnosis, he was without evidence of AML, the longest reported period of time in the literature for a case of primary MS of the prostate. From 1985 to 2017, fifteen other cases of MS of the prostate have been reported and are reviewed here. Five cases occurred as primary MS, without evidence of AML on bone marrow examination or prior history of hematologic disorders, and progressed to AML within a range of three weeks to seven months. None of these cases were started on conventional chemotherapy for AML prior to progression. Due to its rarity, primary MS of the prostate is often diagnosed incidentally, but prompt AML-targeted treatment is crucial to delaying the progression to AML.
Case Report: Novel pathogenic variant in NFIX in two sisters with Malan syndrome due to germline mosaicism
Authors: Elizabeth Langley, Laura S Farach, Kate Mowrey
Journal: Front Genet (2022)
Keywords: nfix, genetic counseling, germline mosaicism, intellectual disability, malan syndrome, overgrowth, recurrence risk
MeSH terms: Case Reports

Malan syndrome is an autosomal dominant disorder caused by pathogenic variants in NFIX with less than 100 cases reported thus far. NFIX is important for stem cell proliferation, quiescence, and differentiation during development and its protein plays a role in replication, signal transduction, and transcription. As a result of pathogenic variants, symptoms of Malan syndrome include overgrowth, intellectual disability, speech delay, and dysmorphic features. Currently, the recurrence risk for this disorder is indicated at less than 1%, standard for de novo autosomal dominant disorders. Herein, we report an additional set of sisters with the same novel pathogenic variant in NFIX and clinical features consistent with Malan syndrome providing evidence of germline mosaicism. Considering the rarity of this condition in conjunction with three previous reports of germline mosaicism, it is worthwhile to investigate and re-evaluate the proper recurrence risk for this condition. This discovery would be paramount for family planning and genetic counseling practices in families with affected individuals.
A Case of John Cunningham Virus Induced Rhombencephalitis after Rituximab Therapy for Idiopathic Thrombocytopenic Purpura
Authors: Silpita Katragadda, Varshaa Koneru, Genevieve Devany, Aaron S DeWitt, Vasudev H Tati
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Background:
John Cunningham virus (JCV) is known to cause progressive multifocal leukoencephalopathy (PML) in immuno-compromised patients due to lytic infection of oligodendrocytes and astrocytes. Rarely, it may also present as granule cell neuronopathy (GCN), leading to degeneration of cerebellar granule cell neurons. It is described in patients with underlying conditions or medication contributing to immune compromise. Case Presentation. A 73-year-old man presented with ataxia and difficulty in speech which began 3 months after initiation of treatment for idiopathic thrombocytopenic purpura with rituximab. Neurological examination was significant for torsional nystagmus, motor aphasia, right-sided dysmetria, and dysdiadochokinesia with gait ataxia. Magnetic resonance imaging (MRI) showed right cerebellar lesion and cerebrospinal fluid (CSF) polymerase chain reaction (PCR) was positive for JC virus.
Conclusion:
The diagnosis of JC virus-related cerebellar disease can be missed, due to the subacute to chronic onset and challenges in detection. Clinicians should have a high degree of suspicion for development of these symptoms, even a few months after initiation of immune-modulatory therapy because the progression and outcomes can be disastrous.