OpenMed/multicare-articles huggingface dataset:
Lupus podocytopathy and antiphospholipid syndrome in a child with SLE: A case report and literature review
Authors: Guo-Min Li, Yi-Fan Li, Qiao-Qian Zeng, Xiao-Mei Zhang, Hai-Mei Liu, Jia-Yan Feng, Yu Shi, Bing-Bing Wu, Hong Xu, Li Sun
Journal: Front Pediatr (2022)
Keywords: apl antibodies, antiphospholipid syndrome, foot process effacement, lupus podocytopathy, systemic lupus erythematosus
MeSH terms: Case Reports

Lupus podocytopathy is a glomerular lesion in systemic lupus erythematosus (SLE) characterized by diffuse podocyte foot process effacement (FPE) without immune complex (IC) deposition or with only mesangial IC deposition. It is rarely seen in children with SLE. A 13-year-old girl met the 2019 European League Against Rheumatism (EULAR)/ American College of Rheumatology (ACR) Classification Criteria for SLE based on positive ANA; facial rash; thrombocytopenia; proteinuria; and positive antiphospholipid (aPL) antibodies, including lupus anticoagulant (LAC), anti-β2 glycoprotein-I antibody (anti-β2GPI), and anti-cardiolipin antibody (aCL). The renal lesion was characterized by 3+ proteinuria, a 4.2 mg/mg spot (random) urine protein to creatinine ratio, and hypoalbuminemia (26.2 g/l) at the beginning of the disease. Kidney biopsy findings displayed negative immunofluorescence (IF) for immunoglobulin A (IgA), IgM, fibrinogen (Fb), C3, and C1q, except faint IgG; a normal glomerular appearance under a light microscope; and diffuse podocyte foot process effacement (FPE) in the absence of subepithelial or subendothelial deposition by electron microscopy (EM). Histopathology of the epidermis and dermis of the pinna revealed a hyaline thrombus in small vessels. The patient met the APS classification criteria based on microvascular thrombogenesis and persistently positive aPL antibodies. She responded to a combination of glucocorticoids and immunosuppressive agents. Our study reinforces the need to consider the potential cooccurrence of LP and APS. Clinicians should be aware of the potential presence of APS in patients with a diagnosis of LP presenting with NS and positivity for aPL antibodies, especially triple aPL antibodies (LCA, anti-β2GPI, and aCL).
Decomposition of Near-Infrared Spectroscopy Signals Using Oblique Subspace Projections: Applications in Brain Hemodynamic Monitoring
Authors: Alexander Caicedo, Carolina Varon, Borbala Hunyadi, Maria Papademetriou, Ilias Tachtsidis, Sabine Van Huffel
Journal: Front Physiol (2016)
Keywords: nirs, tikhonov regularization, biomedical signal processing, brain hemodynamics, oblique subspace projections

Clinical data is comprised by a large number of synchronously collected biomedical signals that are measured at different locations. Deciphering the interrelationships of these signals can yield important information about their dependence providing some useful clinical diagnostic data. For instance, by computing the coupling between Near-Infrared Spectroscopy signals (NIRS) and systemic variables the status of the hemodynamic regulation mechanisms can be assessed. In this paper we introduce an algorithm for the decomposition of NIRS signals into additive components. The algorithm, SIgnal DEcomposition base on Obliques Subspace Projections (SIDE-ObSP), assumes that the measured NIRS signal is a linear combination of the systemic measurements, following the linear regression model y = Ax + ϵ. SIDE-ObSP decomposes the output such that, each component in the decomposition represents the sole linear influence of one corresponding regressor variable. This decomposition scheme aims at providing a better understanding of the relation between NIRS and systemic variables, and to provide a framework for the clinical interpretation of regression algorithms, thereby, facilitating their introduction into clinical practice. SIDE-ObSP combines oblique subspace projections (ObSP) with the structure of a mean average system in order to define adequate signal subspaces. To guarantee smoothness in the estimated regression parameters, as observed in normal physiological processes, we impose a Tikhonov regularization using a matrix differential operator. We evaluate the performance of SIDE-ObSP by using a synthetic dataset, and present two case studies in the field of cerebral hemodynamics monitoring using NIRS. In addition, we compare the performance of this method with other system identification techniques. In the first case study data from 20 neonates during the first 3 days of life was used, here SIDE-ObSP decoupled the influence of changes in arterial oxygen saturation from the NIRS measurements, facilitating the use of NIRS as a surrogate measure for cerebral blood flow (CBF). The second case study used data from a 3-years old infant under Extra Corporeal Membrane Oxygenation (ECMO), here SIDE-ObSP decomposed cerebral/peripheral tissue oxygenation, as a sum of the partial contributions from different systemic variables, facilitating the comparison between the effects of each systemic variable on the cerebral/peripheral hemodynamics.
Case report: Pathological and genetic features of pancreatic undifferentiated carcinoma with osteoclast-like giant cells
Authors: Ni Zhao, Nan Mei, Ye Yi, Hongyan Wang, Yajian Wang, Yu Yao, Chunli Li
Journal: Pathol Oncol Res (2023)
Keywords: osteoclast-like giant cells, pancreatic carcinoma, pathological features, prognosis, undifferentiated carcinoma
MeSH terms: Adenocarcinoma / pathology, Carcinoma / pathology, Pancreatic Neoplasms / pathology, Case Reports, Giant Cells / pathology, Humans, Osteoclasts / pathology, Pancreatic Ducts / pathology, Retrospective Studies, Pancreatic Carcinoma

Objectives: Pancreatic undifferentiated carcinoma accounts for 2%-7% of pancreatic carcinomas. We aimed to investigate the pathological and genetic characteristics of pancreatic undifferentiated carcinoma with osteoclast-like giant cells and the key points of treatment. Methods: The clinical data and follow-up results of four patients diagnosed with pancreatic undifferentiated carcinoma with osteoclast-like giant cells between May 2015 and May 2020 at the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively analyzed. Results: Chief complaints included "pain and discomfort in the upper abdomen" (2/4), "nausea and vomiting" (1/4) or no symptoms (1/4). Preoperative mildly elevated tumor markers included carcinoembryonic antigen (1/4) and CA19-9 (1/4). The tumors were located in the tail of the pancreas in three patients and the head and neck in one patient. Tumor metastasis was found in pancreatic adipose tissue in two patients and lymph node metastasis in one patient, with microscopic heterogeneous mononuclear cells and scattered osteoclast-like giant cells of various sizes. One patient (1/4) had a mucinous cystic tumor of the pancreas, and two patients (2/4) had adenocarcinoma of the pancreatic duct. Only one patient received postoperative gemcitabine combined with albumin-bound paclitaxel chemotherapy. Conclusion: Currently, treatment guidelines are lacking for PUC-OGC, and prognosis varies markedly. More cases must be reported to clarify its origination. The long-term follow-up of diagnosed patients and genetic mutation testing can also contribute to improving treatment and prognosis of this disease.
Canalicular adenoma of the tongue: report of a unique case
Authors: Neetu Yadav, Manisha Khorate, Nigel Figueiredo
Journal: Pan Afr Med J (2021)
Keywords: canalicular adenoma, case report, salivary gland neoplasm, tongue
MeSH terms: Adenoma / diagnosis, Tongue Neoplasms / diagnosis, Case Reports, Adenoma / pathology, Adenoma / surgery, Adult, Humans, Male, Tongue Neoplasms / pathology, Tongue Neoplasms / surgery

Canalicular adenoma (CA) is a rare, unique benign salivary gland neoplasm, which usually involves the minor salivary glands of the upper lip, buccal mucosa and palate. It is usually seen in middle-aged or older individuals, has a female predilection, and commonly presents as a painless, slow-growing, non-ulcerated nodule or swelling. Its treatment involves surgical excision or enucleation. This case report describes a case of CA of the ventrum of the tongue diagnosed in a 41-year-old male patient, which could possibly be the first reported case of this lesion involving the tongue.
Rudimentary Meningocele of the Scalp: A Pitfall in the Diagnosis of Vascular Neoplasms
Authors: Subramaniam Ramkumar
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

We present a case of sequestrated meningocele in a 1-year-old girl, who presented with a 1x1cm occipital swelling since birth. CT brain revealed the soft tissue swelling to be extracranial. She underwent surgical excision of the specimen and the excised mass was sent for histopathological examination. The specimen consisted of skin and subcutaneous tissue measuring 2 x 1 x 1 cm. The entire tissue was paraffin processed. Multiple sections studied from the lesion showed an ill circumscribed locally infiltrative dermal lesion. The lesion was composed of whorled proliferations of meningothelial cells enclosing pseudovascular spaces. Immunohistochemically the lesion was positive for EMA, Desmin, and negative for endothelial markers. The present case was documented as a rare case of a rudimentary meningocele.
A Rare Case of Synchronous Primary Gallbladder and Sigmoid Colon Neoplasms
Authors: Ilias Galanis, Ioannis Lintzeris, Magdalini Simou, Georgios Stylianidis
Journal: Cureus (2023)
Keywords: biliary tract cancer, colonic cancer, gallbladder cancer, sigmoid cancer, synchronous cancers
MeSH terms: Case Reports

Colorectal cancer is considered the third most common cancer worldwide. On the other hand, gallbladder cancer is rare. Synchronous tumors in both the colon and the gallbladder are extremely infrequent. Herein, we report the case of a female patient with sigmoid colon cancer and incidental detection of synchronous gallbladder cancer on histopathological examination of the surgical specimen. As synchronous gallbladder and colonic carcinomas are rare, physicians should be aware of these so that an optimal course of treatment can be chosen.
De novo mosaic and partial monosomy of chromosome 21 in a case with superior vena cava duplication
Authors: Abul Kalam Azad, Lindsay Yanakakis, Samantha Issleb, Jessica Turina, Kelli Drabik, Christina Bonner, Eve Simi, Andrew Wagner, Morry Fiddler, Rizwan Naeem
Journal: Mol Cytogenet (2020)
Keywords: chromosome 21, mosaicism, partial monosomy, superior vena cava duplication
MeSH terms: Case Reports

Background:
Full or partial monosomy of chromosome (chr) 21 is a very rare abnormal cytogenetic finding. It is characterized by variable sizes and deletion breakpoints on the long arm (q) of chr 21 that lead to a broad spectrum of phenotypes that include an increased risk of birth defects, developmental delay and intellectual deficit.
Case presentation:
We report a 37-year-old G1P0 woman initially screened by non-invasive prenatal testing with no positive findings that was followed by an 18-week anatomy scan with a fetal finding of duplication of the superior vena cava (SVC). The medical and family history was otherwise uneventful. After appropriate genetic counseling, amniocentesis was performed to evaluate suspected chromosomal anomalies.
Conclusions:
Interphase fluorescent in situ hybridization revealed loss of one chr 21 signal that was further delineated by chromosomal microarray analysis on uncultured amniocytes as a terminal 10 Mb deletion on chr 21q. Karyotype and microarrays on cultured amniocytes showed two cell lines for a mosaic 21q terminal deletion and monosomy 21. The combined molecular cytogenetics results reported following the ISCN 2016 guideline as mos 46,XX,del(21)(q22)dn[20]/45,XX,-21dn[10].nuc ish(D21S342/D21S341/D21S259x1)[100].arr[GRCh37] 21q11.2q22.12(15412676_36272993)x1~2,21q22.12q22.3(36431283_47612400)x1. Parental chromosomal analysis revealed normal karyotypes. Thus, this was a de novo mosaic full and partial monosomy of chr 21 in a case with SVC duplication. Despite the association of congenital heart disease with monsomy 21 we could not find any published literature or online databases for this cytogenetic abnormality. The patient terminated the pregnancy following the abnormal molecular cytogenetic results due to the possible challenges the baby would face if carried to term.
An Unexpected Cause of Bradycardia in a Patient with Bacterial Meningitis
Authors: Petros Ioannou, Magdalini Velegraki, Stella Soundoulounaki, Achilleas Gikas, Diamantis P Kofteridis
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Sinus bradycardia which is a sinus rhythm with a resting heart rate of less than 60 bpm is caused by intrinsic cardiac disorders like sick sinus syndrome or inferior myocardial infarction, metabolic and environmental causes (such as hypothyroidism and electrolyte disorders), medications (such as beta-blockers and amiodarone), infection (such as myocarditis), increased intracranial pressure, and toxic exposure, while it can sometimes be a normal phenomenon, especially during sleep, in athletes, and during pregnancy. Symptomatic sinus bradycardia should warrant a thorough work-up in order to identify any reversible causes; otherwise, placement of a permanent pacemaker could be needed. We present the case of a patient who was admitted due to confusion and fever and was found to have pneumococcal meningitis and bacteremia, and during his hospital stay he developed symptomatic sinus bradycardia that was of intractable cause and persistent. Placement of a permanent pacemaker was chosen until the night staff of the hospital discovered by chance the neglected cause of his bradycardia.
Early tangential excision debulking after free latissimus dorsi flap reconstruction for soft tissue defects: presentation of three cases
Authors: Hiroko Murakami, Kazuo Sato, Yuta Izawa, Tatsuhiko Muraoka, Yoshihiko Tsuchida
Journal: Case Reports Plast Surg Hand Surg (2022)
Keywords: debulking surgical procedures, esthetics, free tissue flaps, tangential excision
MeSH terms: Case Reports

Bulkiness is patients' major complaint after free latissimus dorsi (LD) flap. We performed tangential excision debulking at 6-13 days following free LD flap in three patients. No flap necrosis or major complications occurred. Tangential excision debulking during the early phase after free LD flap might be safe and reliable.
Preaugmentation Soft Tissue Expansion: A Report of Four Pilot Cases
Authors: Farah Asa'ad, Gionata Bellucci, Luca Ferrantino, Davide Trisciuoglio, Silvio Taschieri, Massimo Del Fabbro
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

This pilot study aimed at investigating the safety and feasibility of pre-augmentation soft tissue expansion (STE). Tissue expanders of different sizes (from 240 to 1300 mm3) were implanted subperiosteally in four patients requiring vertical and/or horizontal bone augmentation, and left in situ for 20-60 days, according to the expander size. Guided bone regeneration was carried out after STE completion. Horizontal and vertical bone gains were analyzed through CBCT. Optical scanning and superimposition of cast models were used for volumetric analysis. The mean soft tissue volume increase was 483.8 ± 251.7 mm3. Horizontal bone gain averaged 3 mm in two successfully expanded sites while one case had a vertical bone gain of 8 mm. Despite promising outcomes in bone and soft tissue gain, the present technique needs improvement before being applied routinely in everyday dental practice.
Case report: Safety and efficacy of adalimumab in treating difficult-to-treat rheumatoid arthritis in a human immunodeficiency virus-positive patient, one year follow-up
Authors: Jing-Wen Chen, Guo-Shu Deng, Wen-Shuang Zhang, Ming-Ying Zhang, Tong Guan, Qiang Xu
Journal: Front Immunol (2022)
Keywords: aids, tnf, adalimumab, human immunodeficiency virus, rheumatoid arthritis
MeSH terms: Acquired Immunodeficiency Syndrome / complications, Antirheumatic Agents / adverse effects, Arthritis, Rheumatoid / complications, Arthritis, Rheumatoid / diagnosis, Arthritis, Rheumatoid / drug therapy, HIV Infections / complications, HIV Infections / drug therapy, HIV Seropositivity / drug therapy, Case Reports, Adalimumab / adverse effects, Arthralgia, Fatigue / complications, Female, Follow-Up Studies, HIV, Humans, Middle Aged, Antirheumatic Agents, Adalimumab

Rheumatoid arthritis (RA) is a joint-disabling inflammatory disease associated with the pathology of synovitis. Some patients with RA are difficult to treat, using disease-modifying anti-rheumatic drugs (DMARDs). Biology and targeted synthetic DMARDs (b/tsDMARDs) are options for patients with RA. Acquired immunodeficiency syndrome (AIDS) is an infectious disease caused by the human immunodeficiency virus (HIV). Adalimumab is an anti-tumor necrosis factor therapy commonly used in patients with RA. However, there are no reports or related data on patients with RA-HIV/AIDS treated with adalimumab are available. In this report, we described the first successful case of a 60-year-old HIV-positive woman with difficult-to-treat RA treated with ADA after being screened for hepatitis virus, latent tuberculosis (LTBI), and other infections. She contracted HIV from sexual exposure while on adalimumab therapy. As the patient was resistant to first-line DMARDs, she continued adalimumab along with the initiation of highly active antiretroviral therapy (HAART). The patient was treated with adalimumab therapy for a year; her CD4+ lymphocyte count was normal, HIV-1 RNA decreased, and no new infections were triggered. The patient achieved clinical remission of RA. In conclusion, adalimumab is a safe option for patients with RA-HIV and may slow the progression of HIV infection. Furthermore, HAART has the potential to reduce joint pain and fatigue in patients with difficult-to-treat RA.
Conclusions:
Adalimumab is a safe option for patients with RA-HIV, and may slow down the progression of HIV infection. The HAART therapy has the potential to reduce joint pain and fatigue in patients with difficult-to-treat RA.
Case Report: Unexplained Fever and Chest Pain in a 5-Year-Old
Authors: Paulina Lubocka, Robert Sabiniewicz
Journal: Front Pediatr (2021)
Keywords: case report, chest pain, pericarditis, prednisone, thoracic injuries
MeSH terms: Case Reports

Pericarditis is a rare, but severe cause of chest pain in children that can easily be overlooked during routine diagnostics. Fibrinous pericarditis was recognized in a 5-year old patient who presented with fever and chest pain. Despite thorough diagnostics, no evident etiological factor was found. Furthermore, the disease was unresponsive to broad-spectrum antibiotics and NSAIDs, however oral prednisone was found to cause rapid improvement in the patients' condition. It was presumed that the patient's condition was caused by a blunt trauma to the chest experienced 3 days prior to the onset of symptoms. In an 8-month follow-up the patient remains in good overall condition and no recurrences were observed.
Sinoorbital Mucormycosis Associated with Corticosteroid Therapy in COVID-19 Infection
Authors: Zeinab Mehrabi, Maryam Salimi, Kianoush Niknam, Farzaneh Mohammadi, Hesan Jelodari Mamaghani, Mohammad Reza Sasani, Mohammad Javad Ashraf, Amirhossein Salimi, Mohammad Hassan Zahedroozegar, Zohreh Erfani
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Background:
Mucormycosis is a rare and invasive fungal infection, affecting almost exclusively immunocompromised individuals. Immunosuppressive effects of corticosteroids which are widely prescribed in COVID-19 patients might be a predisposing factor for opportunistic infections even though the other factors should also be considered. Case Presentation. A middle-aged man without any significant past medical history was admitted to the hospital due to a severe COVID-19 infection. He received a high dose of corticosteroids as a part of the treatment. Five days after discharge, he presents with a headache and fever. Eventually, orbital mucormycosis was diagnosed for him and he was treated with antifungal medications.
Conclusion:
Opportunistic infections should be considered during the current pandemic of COVID-19, during which corticosteroids are widely prescribed.
The challenge of concomitant infections in the coronavirus disease 2019 pandemic era: Severe acute respiratory syndrome coronavirus 2 infection in a patient with chronic Chagas disease and dimorphic leprosy
Authors: Patricia Shu Kurizky, Selma Regina Penha Silva Cerqueira, Débora Vilela Cunha, Cleandro Pires de Albuquerque, Rodrigo Barbosa Aires, Licia Maria Henrique da Mota, Ciro Martins Gomes
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: Chagas Disease / complications, Coronavirus Infections / complications, Leprosy, Borderline / complications, Pneumonia, Viral / complications, Case Reports, BCG Vaccine / administration & dosage, Betacoronavirus, Brazil, COVID-19, Family Characteristics, Humans, Pandemics, SARS-CoV-2, BCG Vaccine

Coronavirus disease 2019 (COVID-19) was first officially described in Brazil on February 26th, 2020. The accumulation of reports of concomitant infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pathogens that cause diseases endemic to tropical countries, such as dengue and chikungunya fever, has started to draw attention. Chagas disease and leprosy remain public health problems in many developing countries, such as Brazil. In this manuscript, we describe a case of concomitant leprosy, Chagas disease, and COVID-19, highlighting the cutaneous manifestations of SARS-CoV-2 infection and the clinical behavior of household contacts who previously received prophylactic Bacillus Calmette-Guérin vaccines.
Kawasaki disease shock syndrome complicated by coronary aneurysms: a case report
Authors: Ahmed Rassas, Rihab Guizani, Amina Werdani, Nesrine Jammeli, Bahri Mahjoub
Journal: Pan Afr Med J (2021)
Keywords: kawasaki disease, case report, coronary aneurysm, shock
MeSH terms: Coronary Aneurysm / diagnostic imaging, Mucocutaneous Lymph Node Syndrome / diagnosis, Shock / diagnosis, Case Reports, Adolescent, Coronary Aneurysm / etiology, Delayed Diagnosis, Echocardiography, Humans, Male, Mucocutaneous Lymph Node Syndrome / complications, Shock / etiology

Kawasaki disease is a generalized systemic vasculitis, which primarily affects medium-sized arteries. Kawasaki disease shock syndrome is a rare but severe presentation of this disease. This report describes a case of delayed diagnosis of Kawasaki disease shock syndrome in a 13-year-old boy who presented with cervical adenophlegmon, persistent fever, injected conjunctiva, rash, and hypotension. Echocardiography revealed the presence of bilateral coronary aneurysms. Early recognition of Kawasaki disease shock syndrome can be difficult; however, delay in diagnosis and treatment can increase the risk of coronary artery disease.