Complex presentation of Bouveret syndrome: Gastric outlet obstruction and septic complications by Mena Louis, DO, Bolaji Ayinde, MD, Nathaniel Grabill, MD, Brian Gibson, MD

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Complex Presentation of Multicentric Castleman Disease with Coexisting HIV, HHV-8, and Other Opportunistic Infections by Yehya Tlaiss, Hadi Farhat, Firas Hasan, Rami Yazbek, Noura Shakaroun, Nizar Bitar

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Tuberous Sclerosis Complex Presenting as Periungual Fibromas: A Rare Case Report and Literature Review by Li Y, Wang Z, Yang Y, Xu X

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Psychotherapies for adults with complex presentations of PTSD: a clinical guideline and five systematic reviews with meta-analyses by Ole Jakob Storebø, Sophie Juul, Stephen Fitzgerald Austin, Maria Quistgaard, Julie Perrine Schaug, Lise Møller, Nina Reinholt, Dyveke Bové Illum, Frida Lau Græbe, Line Bang Mikkelsen, Nina Nørrelykke Paulsen, Adrian Maria Tremel Porsing, Oliver Rumle Hovmand, Mie Sedoc Jørgensen, Ida-Marie Terese Pereira Arendt, Magnus Tang Kristensen, Sidsel Christine Buskbjerg Døssing, Bent Rosenbaum, Nicole Gremaud Rosenberg, Sidse Marie Arnfred

“…Objective To develop a clinician-guided, research-based guideline for adult outpatient psychotherapy for complex presentations of post-traumatic stress disorder (PTSD).Methods We used state-of-the-art methods to develop clinical guideline recommendations and conduct systematic reviews with meta-analyses for five research questions: (Q1) When treating adults with PTSD, should trauma-focused psychotherapy include exposure? …”
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A Complex Presentation of Multiple Myeloma With Renal Complications in a Young Female: Diagnostic Challenges and Treatment Approach by Hem Prajapati, Yash M. Patel, Ajay C. Parmar, Sahaj Y. Patel, Tasin Mohammedyakub Shaikhjiwala

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Computational metal-flavonoids complexes presentation of greenly synthesized silver nanoparticles combined flavonoids from Lens culinaris L. as anticancer agents using BcL-2 and IspC proteins by Heba W. Alhamdi, Fatma Alzahraa Mokhtar, Fouad Lamghari Ridouane, Ali A. Shati, Serag Eldin I. Elbehairi, Lamiaa I. Fahmy, Mohammad Y. Alfaifi, Nada K. Sedky, Heba A. Fahmy

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Rare Association of Ureteral Atresia in a Horseshoe Kidney: A Case Report and Review of Literature by Deepak Kumar Garnaik, Rajat Piplani, Prashant Kothari, Sarita Syal, Akash Dhiman

“…The report aims to contribute to the existing literature on pediatric renal anomalies by detailing the diagnostic process, surgical intervention, and subsequent outcomes in the context of this complex presentation.…”
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Unusual Cause of Mitral Regurgitation by Kader Muneer, Sajeer Kalathingathodika, Madurai Shanmugasundaram Shivendrran, Vipin Das

“…The LCA arose from the nonfacing sinus of the PA, a rare and complex presentation, which makes surgery challenging. ALCAPA is a life-threatening condition, and early diagnosis and surgery are crucial. …”
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Zollinger-Ellison Syndrome Unmasked during Hiatal Hernia Evaluation: A Case Report by Ramya Vasireddy, Greeshma Gaddipati, Mariah Malak Bilalaga, Ayushi Garg, Pranav Chalasani, Dongmei Xing, Abhinav Sankineni, Hashroop Gurm

“…This case highlights a complex presentation and underscores the importance of thorough evaluation, multidisciplinary management, and including rare diagnosis in the differential. …”
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An Unusual Presentation of Catatonia-Like Behavior: Differentiating Malingering from Catatonia by Andy Y. Wang, Urrooj H. Rehman

“…Here, we describe a 45-year-old female who was admitted to an acute psychiatric hospital with a complex presentation of catatonia-like signs that was ultimately thought to be volitional behavior, resulting in a diagnosis of malingering. …”
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The Use of Percutaneous Lumbar Fixation Screws for Bilateral Pedicle Fractures with an Associated Dislocation of a Lumbar Disc Prosthesis by William D. Harrison, David J. Harrison

“…This case describes a successful method of fixation for this complex presentation. Methods and Results. A 48-year-old male with lumbar degenerative disc disease and no comorbidities. …”
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Case Report: 2-PAM or not 2-PAM by Madelyn Huttner, Kahra Nix, Caitlyn Blair, Matthew Eisenstat

“…Conclusion: Acute OP exposure is a rare but complex presentation in the United States. In the United States there are bans on several organophosphate varieties, which have reduced the number and severity of OP toxicities. …”
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Attachment-based Phase-oriented Intervention Framework for Complex Trauma: A Psychotherapy Case Study and Reflections by Cathy Roshini, Sakhardande Kasturi Atmaram, Naveen Achyuta Yedavally, Harshini Manohar

“…Early exposure to multiple trauma has a cumulative and pervasive effect, often resulting in complex symptomatology that includes Post Traumatic Stress Disorder (PTSD), as well as a variable group of symptoms, including self-regulatory disturbances, dissociative experiences, negative view of self, and difficulties in the relational context referred to as complex-PTSD. The complex presentation calls for a nuanced understanding of the interdependent impact of trauma on neurobiology and healthy development to formulate and implement specific psychotherapeutic interventions. …”
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Taiwanese Dermatological Association consensus for the diagnosis and management of prurigo nodularis by Cheng-Che E. Lan, Wen-Hung Chung, Yang-Yi Chen, Pa-Fan Hsiao, Yu-Ping Hsiao, Chih-Hung Lee, Tzu-Kai Lin, Hsing-San Yang

“…Prurigo nodularis (PN) is a chronic neuroinflammatory skin disease that, while considered rare, is likely underestimated. Due to its complex presentation, misdiagnosis is not uncommon, highlighting the need for greater awareness among healthcare professionals to ensure the accurate diagnosis and appropriate management. …”
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Reactive Attachment Disorder in the General Population: A Hidden ESSENCE Disorder by Rachel Pritchett, Jennifer Pritchett, Emma Marshall, Claire Davidson, Helen Minnis

“…We found that children with RAD are more likely to have multiple comorbidities with other disorders, lower IQs than population norms, more disorganised attachment, more problem behaviours, and poorer social skills than would be found in the general population and therefore have a complex presentation than can be described as ESSENCE. We discuss the clinical and educational implications.…”
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Simple and Complex Phonic Tics in Tourette Syndrome by José Fidel Baizabal-Carvallo, Joseph Jankovic

“…Conclusions: Complex phonic tics seem to be part of a more widely distributed, severe, and complex presentation of TS, likely representing a continuum within the spectrum of motor and phonic tics.…”
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McCune–Albright syndrome with multiple hyperfunctional endocrinopathies: diagnosis, treatment, and long-term follow-up: a case report by Mariam J. Zainab, Labibah L. Khamies, Joudi Baladi, Nawal Almutairi, Abdulhameed Alsaheel

“…This case report presents the long-term follow-up of an eight-year-old girl diagnosed with MAS, who first presented at 22 months of age with skin pigmentation, hyperthyroidism, and precocious puberty, later developing additional features such as fibrous dysplasia and growth hormone excess. This complex presentation of MAS—featuring more than two hyperfunctioning endocrinopathies along with fibrous dysplasia—has rarely been described in the literature. …”
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Multidisciplinary Vulvar Cancer Management: The Dermatologist’s Perspective by Marta Cebolla-Verdugo, Victor Alfredo Cassini-Gómez de Cádiz, Juan Pablo Velasco-Amador, María Zulaika-Lloret, Francisco Manuel Almazán-Fernández, Ricardo Ruiz-Villaverde

“…Vulvar cancer, particularly squamous cell carcinoma (SCC) and melanoma, poses significant diagnostic and therapeutic challenges due to its complex presentation and high rates of postoperative complications. …”
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The Fake Diary of a Historical Figure: Klementyna Tańska-Hoffmanowa’s Journal of Countess Françoise Krasińska (1825) by Magdalena Ożarska

“…Hoffmanowa’s novel, begun as a project aimed to educate young girls in modesty and other traditional feminine virtues, soon became a tour-de-force of fake diarising, the first ever psychologically complex presentation of the workings of a young girl’s mind in Polish literature. …”
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Secondary Angle Closure Glaucoma in Weill–Marchesani Syndrome by Valeria Coviltir, Miruna Gabriela Burcel, Maria Cristina Marinescu, Bianca Maria Urse, Ciprian Danielescu

“…Weill–Marchesani syndrome has a complex presentation, with ophthalmological, musculoskeletal, cardiac and psychiatric manifestations. …”
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