OpenMed/multicare-articles huggingface dataset:
Painful and recurring injection site reaction to alirocumab and evolocumab in a young woman with familial hypercholesterolemia and effective therapeutic alternative based on inclisiran: a case report
Authors: Massimiliano Allevi, Silvia Sarnari, Federico Giulietti, Francesco Spannella, Chiara Di Pentima, Riccardo Sarzani
Journal: Front Cardiovasc Med (2023)
Keywords: pcsk9-inhibitor, familial hypercholesterolemia, inclisiran, injection site reaction, polygenic hypercholesterolemia
MeSH terms: Case Reports

A 28-year-old woman with autosomal dominant familial hypercholesterolemia (FH) with a probable coexistent polygenic contribution causing very high low-density lipoprotein-cholesterol (LDL-C) levels, started therapy with the proprotein convertase subtilisin/kexin type 9-inhibitor (PCSK9i) alirocumab, in addition to high-intensity statin plus ezetimibe. Forty-eight hours after the second injection of alirocumab, the patient developed a painful palpable injection site reaction (ISR) that recurred after the third administration of the drug. Treatment was then switched to evolocumab, another PCSK9i, but the patient had an ISR with similar features. The most conceivable cause of the ISR was a cell-mediated hypersensitivity reaction to polysorbate, an excipient contained in both drugs. Although ISR after PCSK9i administration is usually transient and does not compromise the continuation of treatment, in this case the recurrence of such side effect in an exacerbated way led to treatment withdrawal, with a subsequent re-exposure to increased cardiovascular (CV) risk. As soon as it became available in clinical practice, the patient started treatment with inclisiran, a small interfering RNA targeting hepatic PCSK9 synthesis. No adverse events were reported after inclisiran administration and LDL-C levels decreased significantly, confirming the evidence that this innovative approach to hypercholesterolemia is a safe and effective resource in patients at high CV risk who cannot achieve LDL-C goal with conventional lipid-lowering therapies and antibody-based PCSK9i.
The Use of Lausanne Trilogue Play in Three Cases of Gastroschisis Diagnosed during Pregnancy
Authors: Sandra Pellizzoni, Antonella Tripani, Marina Miscioscia, Rosella Giuliani, Andrea Clarici
Journal: Front Psychol (2017)
Keywords: lausanne trilogue play, fetal malformations, gastroschisis, parents, prenatal diagnosis

From pregnancy to the 1st years of a child's life, families develop and increase representations and interactive competences toward the child. Prenatal diagnosis of a severe fetus' defect could profoundly alter the parental perception and development of these representations. The aim of the study was to evaluate triadic interactions in families, whose baby was prenatally diagnosed with severe gastroschisis. Three families took part in the preliminary case study, which was carried out when the babies were 6 months old. The Lausanne Trilogue Play shows that prenatal diagnosis of fetal malformation may affect family triadic interactions as follows: (a) parents, especially mothers, tend to be intrusive during the play; (b) parents presents maladjustments in the child stimulations, especially during the third part, when both parents have to simultaneously interact with the baby; (c) parents experience difficulties in creating a space that allows them to communicate directly with each other, leaving the child in a peripheral position. Observational data and clinical implications are discussed.
EGFR T790M-Positive Lung Adenocarcinoma Metastases to the Pituitary Gland Causing Adrenal Insufficiency: A Case Report
Authors: Michael L Adashek, Kenneth Miller, Arit A Silpasuvan
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

A 64-year-old man, with history of micropapillary thyroid cancer and epidermal growth factor receptor-positive lung adenocarcinoma with no evidence of active disease for 3 years after chemotherapy and radiation on erlotinib, presented with fatigue, nausea, lack of appetite, and xeroderma. A screening magnetic resonance image of the patient's head demonstrated a new bilateral pituitary mass. Initial evaluation revealed low morning cortisol, and the patient was diagnosed with adrenal insufficiency. His symptoms rapidly improved with maintenance glucocorticoids. Soon thereafter, the patient developed an acute visual deficit secondary to enlargement of the pituitary mass, and biopsy revealed EGFR T790M positive metastatic lung adenocarcinoma. Hence, we present a rare case of metastatic lung adenocarcinoma to the pituitary causing secondary adrenal insufficiency.
Topical ophthalmic cyclosporine in the treatment of toxic epidermal necrolysis
Authors: Zafer Onaran, Gülşah Usta, Mukadder Koçak, Kemal Ornek, Unase Büyükkoçak
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Aim. To describe a case of toxic epidermal necrolysis (TEN) with ocular involvement treated with topical ophthalmic cyclosporine. Case Presentation. A 20-year-old woman developed TEN following administration of carbamazepine that was prescribed for epilepsy. Ophthalmic examination revealed bilateral pseudomembranous conjunctivitis. She was hospitalized in the intensive care unit and treated with intravenous corticosteroid and immunoglobulin. Topical cyclosporine was used in combination with topical corticosteroids for ocular surface disease. Following two months of ocular treatment, she recovered without any severe ocular complication. Ocular examination at the four-month followup showed a 2 mm of symblepharon in the lower fornix as the sole pathologic finding. Conclusion. Topical ophthalmic cyclosporine may contribute to decrease the ophthalmic complications of TEN and should be considered in the acute stage of the disease.
MAML2-Rearranged Primary Central Mucoepidermoid Carcinoma of the Mandible as an Incidental Finding: A Case Report and Review of the Literature of Molecularly Confirmed Cases
Authors: Sarah E Aguirre, Donald Tyler Jr, Adepitan A Owosho
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

This report presents an extremely rare case of MAML2-rearranged primary central mucoepidermoid carcinoma (MEC) of the mandible that was discovered as an incidental finding. Our review of the literature identified 36 cases of MAML2-rearranged intraosseous lesions of the jaw (30 central MECs, 5 odontogenic cysts with mucous prosoplasia, and 1 glandular odontogenic cyst). Given the therapeutic indications for a diagnosis of MEC (a malignant neoplasm), MAML2 rearrangement should be confirmed in suspected cases of central MEC.
Hepatic involvement in Wegener's granulomatosis: a case report
Authors: Constantin Goritsas, Nicolas P Paissios, Rodoula Trigidou, Joanna Delladetsima
Journal: J Med Case Rep (2010)

Introduction:
We report the case of a 58-year-old Caucasian Greek man who presented with dry cough, fever, bilateral alveolar infiltrates and acute hepatitis.
Case presentation:
After a lung biopsy, the patient was diagnosed with Wegener's granulomatosis. The diagnosis was supported by the presence of anti-proteinase-3 anti-neutrophil cytoplasmic antibodies. A liver biopsy demonstrated the presence of mild non-specific lobular hepatitis and periodic acid-Schiff positive Lafora-like inclusions in a large number of his liver cells. The patient was treated with prednisone and cyclophosphamide, which was followed by subsequent remissions of chest X-ray findings and liver function studies.
Conclusion:
What makes this case worth reporting is the coexistence of liver inflammation with a biochemical profile of severe anicteric non-viral, non-drug induced hepatitis coinciding with the diagnosis of Wegener's granulomatosis. Our paper may be the first report of hepatic involvement in a patient diagnosed with Wegener's granulomatosis. The aetiological link between the two diseases is supported by the reversion of hepatitis after the immunosuppression of Wegener's granulomatosis. We favor the hypothesis that hepatic vasculitis may be the cause of acute hepatocellular necrosis.
Transient Global Amnesia as the Sole Presentation of an Acute Stroke in the Left Cingulate Gyrus
Authors: Lawrence Chau, Antonio Liu
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

We discuss a patient who presented to our hospital with signs, symptoms, and clinical course consistent with transient global amnesia (TGA). Her hospital work-up was overall unremarkable except for the presence of a diffusion weighted imaging (DWI) abnormality on MRI suggestive of acute infarction in the left cingulate gyrus. Symptoms quickly resolved, and she was discharged home in stable condition. While the etiology of TGA remains controversial, in discussing this case and the current literature we hope to provide further data supporting the possibility of an underlying ischemic process, as well as help better illustrate the neurologic structures involved.
Case report: Treatment of psychiatric symptoms for an acromegalic patient with pituitary adenoma
Authors: Zhongyong Shi, Enzhao Cong, Yan Wu, Xinchun Mei, Yun Wang, Daihui Peng
Journal: Front Psychiatry (2022)
Keywords: aripiprazole, acromegaly, case report, mental disorders, pituitary tumor
MeSH terms: Case Reports

Acromegalic patients always demonstrate a wide range of clinic manifestations, including typical physical changes such as acral and facial features, as well as untypical neuropsychiatric and psychological disturbances. However, there is still a lack of clinical guidance on the treatment for acromegalic patients with psychiatric comorbidities. We therefore share this case to provide a reference for clinicians to manage the acromegalic patients with psychiatric symptoms. This case report describes a 41-year-old male with an 8-year history of acromegaly due to growth hormone-secreting pituitary adenoma, the maximum cross-sectional area of which was 42 mm × 37 mm demonstrated by pituitary magnetic resonance imaging (MRI). The patient received conservative medicine treatment by regularly injecting with Sandostatin LAR 10 mg per month. Two days before admission, he suddenly presented with an acute psychotic episode. In addition to the typical acromegaly-associated changes, his main clinical presentations were olfactory/auditory hallucinations, reference/persecutory delusions, instable emotion and impulsive behavior. Considering the schizophrenic-like psychoses and course features, he was diagnosed with Brief Psychotic Disorder according to Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) after a multidisciplinary consultation and evaluation. He was prescribed Aripiprazole, which had less extrapyramidal symptoms and minimal influence on prolactin elevation, with the dose of 5 mg per day to control the psychiatric symptoms and he responded quite well. At the time of discharge and the follow-up 2 month later, the patient was stable without recurrence of any psychotic symptoms. The levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) 1 week after discharge were 2.22 ng/mL [normal range (0-2.47 ng/mL)] and 381 μg/L [normal range (94-284 μg/L)], respectively, which were similar to those before the psychotic episode. Results from this report further supported that small dose of Aripiprazole had little influence on hormonal levels and the development of pituitary macroadenoma. This particular case emphasizes the importance for the clinician to master and carefully identify the possible symptoms of mental disorders associated with acromegaly, and also highlights the need for further investigation in more efficient treatment strategies for acromegalic cases with psychiatric comorbidities.
Interrupted time series analysis of children's blood lead levels: A case study of lead hazard control program in Syracuse, New York
Authors: Liyang Shao, Lianjun Zhang, Zhen Zhen
Journal: PLoS One (2017)
MeSH terms: Environmental Monitoring / methods, Interrupted Time Series Analysis, Lead / blood, Lead Poisoning / blood, Safety Management / methods, Child, Environmental Exposure / analysis, Female, Humans, Lead Poisoning / epidemiology, Male, Models, Theoretical, New York / epidemiology, Seasons, Lead

Children's blood lead concentrations have been closely monitored over the last two decades in the United States. The bio-monitoring surveillance data collected in local agencies reflected the local temporal trends of children's blood lead levels (BLLs). However, the analysis and modeling of the long-term time series of BLLs have rarely been reported. We attempted to quantify the long-term trends of children's BLLs in the city of Syracuse, New York and evaluate the impacts of local lead poisoning prevention programs and Lead Hazard Control Program on reducing the children's BLLs. We applied interrupted time series analysis on the monthly time series of BLLs surveillance data and used ARMA (autoregressive and moving average) models to measure the average children's blood lead level shift and detect the seasonal pattern change. Our results showed that there were three intervention stages over the past 20 years to reduce children's BLLs in the city of Syracuse, NY. The average of children's BLLs was significantly decreased after the interventions, declining from 8.77μg/dL to 3.94μg/dL during1992 to 2011. The seasonal variation diminished over the past decade, but more short term influences were in the variation. The lead hazard control treatment intervention proved effective in reducing the children's blood lead levels in Syracuse, NY. Also, the reduction of the seasonal variation of children's BLLs reflected the impacts of the local lead-based paint mitigation program. The replacement of window and door was the major cost of lead house abatement. However, soil lead was not considered a major source of lead hazard in our analysis.
WITHDRAWN: An anatomic aberration and a surgical challenge: Mediastinal parathyroid adenoma anterior the pericardium. A case report
Authors: Antonios Patrinos, Maria Zarokosta, Theodoros Piperos, Dimosthenis Chrysikos, Dimosthenis Kakaviatos, Panagiotis Theodoropoulos, Vasileios Kalles, John Tsiaoussis, George Noussios, Theodoros Mariolis-Sapsako
Journal: Int J Surg Case Rep (2019)
Keywords: aberrant location, case report, hypercalcemia, phpt, single parathyroid adenoma
MeSH terms: Retracted Publication

The Publisher regrets that this article is an accidental duplication of an article that has already been published in “International Journal of Surgery Case Reports, 57C (2019) 106–109”, https://doi.org/10.1016/j.ijscr.2019.03.014. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
Cerebellar Medulloblastoma in Middle-to-Late Adulthood
Authors: Majid Aljoghaiman, Mahmoud S Taha, Marwah M Abdulkader
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Medulloblastoma is a malignant brain tumor that is typically seen in children. It is classified as an embryonal tumor, classically located within the posterior fossa. When it involves the fourth ventricle, the patient commonly presents with signs and symptoms of raised intracranial pressure secondary to obstructive hydrocephalus. It is exceedingly rare for Medulloblastoma to occur in middle and late adulthood. In this paper, we present a case of a 51-year-old man who presented with a posterior fossa mass that was diagnosed later as Medulloblastoma.
Arcobacter butzleri is an opportunistic pathogen: recurrent bacteraemia in an immunocompromised patient without diarrhoea
Authors: Kerstin K Soelberg, Trille K L Danielsen, Raquel Martin-Iguacel, Ulrik S Justesen
Journal: Access Microbiol (2020)
Keywords: arcobacter butzleri, bacteraemia, immunosuppression, pathogen
MeSH terms: Case Reports

Introduction:

Arcobacter butzleri is attracting increasing interest due to its possible pathogenic properties. Researchers have described cases in which A. butzleri is isolated in stool samples from patients with gastrointestinal symptoms, mostly diarrhoea. The relevance of adding our case to the literature lies in its description of recurrent A. butzleri bacteraemia in a patient without diarrhoea.
Case presentation:
An immunocompromised patient was hospitalized three times within 12 months due to A. butzleri-induced bacteraemia. At no time did the patient experience diarrhoea even though examination of stool samples showed growth of A. butzleri . The isolate was susceptible to gentamicin, colistin and tetracyclines. The patient was successfully treated with doxycycline.
Conclusion:
For the first time in the literature we describe recurrent A. butzleri bacteraemia in a patient without diarrhoea. This case supports the classification of A. butzleri as an opportunistic pathogenic species, which clinical microbiology laboratories should be able to identify.
Adverse events of acupuncture: a systematic review of case reports
Authors: Shifen Xu, Lizhen Wang, Emily Cooper, Ming Zhang, Eric Manheimer, Brian Berman, Xueyong Shen, Lixing Lao
Journal: Evid Based Complement Alternat Med (2013)

Acupuncture, moxibustion, and cupping, important in traditional Eastern medicine, are increasingly used in the West. Their widening acceptance demands continual safety assessment. This review, a sequel to one our team published 10 years ago, is an evaluation of the frequency and severity of adverse events (AEs) reported for acupuncture, moxibustion, and cupping between 2000 and 2011. Relevant English-language reports in six databases were identified and assessed by two reviewers. During this 12-year period, 117 reports of 308 AEs from 25 countries and regions were associated with acupuncture (294 cases), moxibustion (4 cases), or cupping (10 cases). Country of occurrence, patient's sex and age, and outcome were extracted. Infections, mycobacterial, staphylococcal, and others, were the main complication of acupuncture. In the previous review, we found the main source of infection to be hepatitis, caused by reusable needles. In this review, we found the majority of infections to be bacterial, caused by skin contact at acupoint sites; we found no cases of hepatitis. Although the route of infection had changed, infections were still the major complication of acupuncture. Clearly, guidelines such as Clean Needle Technique must be followed in order to minimize acupuncture AEs.
Case Report First-in-Man Method Description: Left Ventricular Unloading With iVAC2L During Veno-Arterial Extracorporeal Membrane Oxygenation: From Veno-Arterial Extracorporeal Membrane Oxygenation to ECMELLA to EC-iVAC®
Authors: Carsten Tschöpe, Alessio Alogna, Alessandro Faragli, Karin Klingel, Gunther Schmidt, Torsten Wolfgang Heilmann, Marcelo B Bastos, Frank Spillmann
Journal: Front Cardiovasc Med (2020)
Keywords: ecmo, ivac, impella, heart failure, mechanical circulatory support, mechanical unloading
MeSH terms: Case Reports

Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is increasingly used in bi-ventricular failure with cardiogenic shock to maintain systemic perfusion. Nonetheless, it tends to increase left ventricular (LV) afterload and myocardial oxygen demand. In order to mitigate these negative effects on the myocardium, an Impella CP® (3.5 L/min Cardiac Output) can be used in conjunction with V-A ECMO (ECMELLA approach). We implemented this strategy in a patient with severe acute myocarditis complicated by cardiogenic shock. Due to a hemolysis crisis, Impella CP® had to be substituted with PulseCath iVAC2L®, which applies pulsatile flow to unload the LV. A subsequent improvement in LV systolic function was noted, with increased LV ejection fraction (LVEF), LV end-diastolic diameter (LVEDD) reduction, and a reduction in plasma free hemoglobin. This case documents the efficacy of iVAC2L in replacing Impella CP as a LV vent during V-A ECMO, with less hemolysis.
Use of Hyaluronic Acid-Based Biological Bilaminar Matrix in Wound Bed Preparation: A Case Series
Authors: Richard Simman, Walid Mari, Sara Younes, Michael Wilson
Journal: Eplasty (2018)
Keywords: hyalomatrix, extracellular matrix, healing, hyaluronic acid, wound

Objective: Hyalomatrix, a matrix that consists of esterified hyaluronic acid, covered with a removable, semipermeable silicone top layer, was used to generate granulation tissue in a series of 12 serious, surgical wounds of different etiologies. Methods: Many defects showed exposed muscle, tendons, and/or bone. After thorough debridement, the matrix was applied, in a number of cases, combined with negative pressure wound therapy. Results: All wounds developed granulation tissue in and on top of the matrix. Nine wounds were then closed with a split skin autograft. There was no graft failure, and all wounds showed complete reepithelialization. Three wounds healed by secondary intention and also reached complete healing. Conclusion: This case series shows a strong trend for Hyalomatrix to play an important role in supporting wound healing in complex, surgical wounds.
Cardiac arrest associated with non-toxigenic corynebacterium diphtheria strain: A case report
Authors: George V Alvarez, Deborah D Rupert, Samantha Sinclair, Santiago J Miyara, Sara Guevara, Peter Shih, Cynthia Hoey
Journal: Front Med (Lausanne) (2023)
Keywords: c diphtheria, corynebacterium diphtheriae, corynebacterium diphtheriae infection, critical care medicine, non-toxigenic corynebacterium diphtheriae, prolonged qt syndrome
MeSH terms: Case Reports

Here we document a rare, acute, infection caused by non-toxigenic Corynebacterium diphtheriae and the resulting unique and severe clinical sequelae. Our patient was a young man with no known pre-existing conditions that presented in cardiopulmonary arrest. We contrast this case with prior instances of non-toxigenic C. diphtheriae strain infection in the United States and summarize the literature that suggests systemic infection can result in cardiogenic toxicity. We speculate on a possible missed, pre-existing condition that could have increased this patient's susceptibility to poor clinical outcome.
Subjective Positive and Negative Sleep Variables Differentially Affect Cellular Immune Activity in a Breast Cancer Survivor: A Time-series Analysis Approach
Authors: Magdalena Singer, Christina Burbaum, Kurt Fritzsche, Sylvia Peterlini, Harald R Bliem, Francisco M Ocaña-Peinado, Dietmar Fuchs, Christian Schubert
Journal: Front Neurol (2018)
Keywords: cancer, neopterin, single-case design, sleep, time-series analysis
MeSH terms: Case Reports

This study on a breast cancer survivor suffering from cancer-related fatigue (CaRF) and depression investigated the bidirectional relationship between cellular immune activity and subjective sleep. The 49-year-old patient (breast cancer diagnosis 5 years before the study, currently in remission) collected her full urine output for 28 days in 12-h intervals (8:00 p.m. to 8:00 a.m. and 8:00 a.m. to 8:00 p.m.). These urine samples were used to determine urinary neopterin (cellular immune activation marker) and creatinine concentrations via high-pressure liquid chromatography (HPLC). Each morning, the patient answered questions on five sleep variables: sleep quality (SQ), sleep recreational value (SRV), total sleep time (TST), total wake time (TWT), and awakenings during sleep period (ADS). For the purpose of this study, the time series of the nighttime urinary neopterin levels and the five sleep variables were determined. Using centered moving average (CMA) smoothing and cross-correlational analysis, this study showed that increases in the positive sleep variables SQ and SRV were followed by urinary neopterin concentration decreases after 96-120 h (SQ, lag 4: r = -0.411; p = 0.044; SRV: lag 4: r = -0.472; p = 0.021) and 120-144 h (SRV, lag 5: r = -0.464; p = 0.026). Increases in the negative sleep variable TWT, by contrast, were followed by increases in urinary neopterin concentrations 72-96 h later (lag 3: r = 0.522; p = 0.009). No systematic effects in the other direction, i.e., from urinary neopterin levels to sleep, were observed in this study. Although preliminary, the findings of this study highlight the benefit of carefully investigating temporal delays and directions of effects when studying the dynamic relationship between sleep and immune variables in the natural context of everyday life.