OpenMed/multicare-articles huggingface dataset:
A Case of Femoral Neck Insufficiency Fracture due to Tumor-Induced Osteomalacia
Authors: Yu Inoue, Tomoaki Fukui, Keisuke Oe, Shinya Hayashi, Teruya Kawamoto, Ryosuke Kuroda, Takahiro Niikura
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Tumor-induced osteomalacia (TIO) is a rare skeletal disease caused by hypersecretion of fibroblast growth factor 23 (FGF-23) from neoplasms of mesenchymal origin; patients with TIO present with insufficiency fractures, progressive bone pain, and delayed fracture unions. Herein, we report the case of a 48-year-old man with an insufficiency fracture in his left femoral neck associated with TIO. The causative tumor located in the patient's maxillary sinus had been resected; however, complete resection was impossible due to the location of the tumor. Therefore, the patient's osteomalacia persisted, and he experienced a left femoral neck fracture in the absence of severe trauma. Because delayed fracture union was anticipated in this patient, we performed an internal fixation using an implant with a lateral plate for angular stability and multiple screws for rotational stability. Although fracture union took 15 months, the patient's postoperative course was uneventful, and he could walk without any symptoms or assistance at his most recent follow-up 30 months after surgery. In TIO, hypersecretion of FGF-23 leads to increased renal excretion of phosphorus, increased bone resorption of calcium and phosphorus, decreased osteoblastic bone mineralization, and decreased gastrointestinal absorption of calcium and phosphorus, leading to insufficiency fractures and delayed fracture unions. Diagnosis of TIO is often delayed due to its rarity and vague symptoms. Total resection of the causative tumor is the optimal treatment; however, in cases wherein complete tumor resection is impossible, drug therapy may be insufficient, and the underlying TIO pathology, including bone fragility, may persist. Early diagnosis of TIO is important for preventing insufficiency fractures; however, when fractures are unavoidable, the surgical treatment of femoral neck fractures in patients with osteomalacia should account for a longer time frame for complete fracture union and therefore utilize implants with sufficient stability.
Music as an Element of Tourism Innovation: Types of Nightlife Premises in Ibiza (Spain)
Authors: José Ramón-Cardona, María Dolores Sánchez-Fernández, Amador Durán-Sánchez, José Álvarez-García
Journal: Front Psychol (2022)
Keywords: ibiza, entrepreneur, establishment, nightlife, offer, types

The island of Ibiza is a western Mediterranean destination known internationally for its nightlife. The aim of this paper is to make a proposal to classify the different types of premises in the Ibiza nightlife offer. This involves making a first definition that allows to delimit which businesses are parts of the sector. The methodology used is based on the case study and specifically, on the review of the promotional actions and activities carried out, completed with the visit to the premises. The classification has been made based on the offer marketed and not only on the legal forms used, as innovation goes ahead of the existing legal classifications. Although it is a particular application, due to the international importance of Ibiza, it is a good starting point to classify the nightlife offer of many other tourist destinations. The resulting typology divides the sector into two large groups: nightclubs and other premises. While nightclubs have musical parties as their main activity declared, the other premises have accommodation or catering as their main activity, with music being an element of differentiation. Nightclubs are divided into several subgroups, depending on their size and relevance. The other premises are subdivided into Beach Clubs, Hotel Clubs, Party Boats, Lounge Clubs, Disco Pubs, among others.
Unusual localization of bleeding under acenocoumarol: Spinal subdural hematoma
Authors: Ismail Aissa, Abdelghafour Elkoundi, Rabi Andalousi, Aziz Benakrout, Abdelatif Chlouchi, Mohamed Moutaoukil, Jawad Laaguili, Mustapha Bensghir, Hicham Balkhi, Salim Jaafar Lalaoui
Journal: Int J Surg Case Rep (2019)
Keywords: acenocoumarol, spinal cord compression, spinal subdural hematoma

Background:
The spinal subdural hematoma (SSH) is an extremely rare entity which represents only 4.1% of all spinal hematomas. It needs accurate diagnosis and rapid intervention because of the major neurological risk induced by spinal compression. Several etiologies have been reported: anticoagulant treatments, haematological disorders, arterio-venous malformation, repeated attempts at lumbar punctures and tumors. We report the case of an 82-year-old patient under acenocoumarol for atrial fibrillation who presented with paraplegia secondary to SSH.
Case report:
An 82-year-old patient with a history of ischemic heart disease and atrial fibrillation under acenocoumarol was admitted to emergency department with sudden onset of paraplegia and intense back pain associated with urinary incontinence and anal sphincter disorder. On examination his lower limb power was MRC grade 0 out of 5 in all ranges of movement bilaterally and a complete bilateral anesthesia reaching the T12 dermatome was noted. Biological test results showed an International Normalized Ratio at 10. Magnetic resonance imaging revealed a posteriorly located spinal hematoma at T12 level, measuring 36 mm with spinal cord compression. After correction of hemostasis disorders the patient was admitted to the operating room for a T11-L1 laminectomy with evacuation of the subdural hematoma. Muscle power showed a gradual improvement in the lower limbs estimated at 3/5 with regression of sphincter disorders but unfortunately a sequellar sensory impairment persisted.
Conclusion:
SSH is a rare situation of acenocoumarol bleeding incident, it should be evoked in any patient treated by this molecule with signs of spinal cord compression.
An unusual cause of haemoptysis in childhood: A case report and literature review
Authors: S Chaya, R de Decker, M Zampoli, A Vanker
Journal: Afr J Thorac Crit Care Med (2018)
Keywords: broncho-oesophageal fistula, haemoptysis
MeSH terms: Case Reports

Haemoptysis is uncommon in children and the diagnosis is challenging. We describe a 14-year-old child who presented with haemoptysis secondary to a suspected congenital broncho-oesophageal fistula. This is a rare condition and the symptoms are insidious, occasionally beginning in childhood but may present only in adulthood. The case report describes the presentation, diagnosis and management of broncho-oesophageal fistulas, with a review of the current literature.
A Delicate Surgical Resection to Treat a Proximal Pulmonary Adenoid Cystic Carcinoma
Authors: N Belloumi, H Baili, M Abdennadher, C Habbouria, I Bachouch, I Bouassida, S Zairi, F Chermiti Ben Abdallah, S Fenniche, H Zribi, A Marghli
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Pulmonary adenoid cystic carcinoma (PACC) is an exceedingly rare tumor of low-grade malignancy. Diagnosis is often late, so the tumoral process may be huge at presentation. Surgical resection could be challenging, and the recurrence rate would be greater. We report, hereby, a case of proximal PACC with involvement of the carina in a young male adult, without respiratory distress. Surgical resection was performed through a left pneumonectomy followed by a complex trachea-bronchoplastic procedure. During the operative time, the assisted ventilatory mode was carefully chosen. No adjuvant treatment was needed. Our patient is still under clinicoradiological surveillance and remains disease-free.
Malignant Transformation of Mature Cystic Teratoma Diagnosed after a 10-Year Interval
Authors: Mariko Jitsumori, Satoru Munakata, Toshiya Yamamoto
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

A 67-year-old uniparous woman had undergone surgery for acute perforated gastric ulcer 10 years prior to the current presentation. Although abdominal computed tomography (CT) performed at that point had revealed a mature cystic teratoma measuring 6 cm in diameter in the right ovary, it was left untreated. She visited the department of surgery at our hospital with chief complaints of appetite loss, nausea, and vomiting that had persisted for the prior two weeks. She was admitted with a diagnosis of ileus attributed to an abdominal incisional hernia. CT performed on admission revealed a tumor measuring 21 cm in diameter with mural nodules in the right ovary. Thus, surgery was performed under suspicion of malignant transformation of the previously detected ovarian mature cystic teratoma. While neither lymphadenopathy nor distant metastasis was detected by imaging studies, bilateral adnexectomy and repair of the abdominal incisional hernia were performed. Cytology of ascites was negative. The postoperative pathological diagnosis was squamous cell carcinoma arising from teratoma, and the postoperative clinical diagnosis was stage IA ovarian cancer. It was assumed that the mature cystic teratoma which had been detected in the right ovary 10 years earlier had undergone malignant transformation.
Posterior reversible encephalopathy syndrome in the setting of trauma: A case report
Authors: Joshua Braganza, Abimbola Pratt
Journal: Int J Surg Case Rep (2020)
Keywords: intracranial hypertension, neuroimaging, posterior reversible encephalopathy syndrome (pres), trauma, traumatic brain injury
MeSH terms: Case Reports

Reports of posterior reversible encephalopathy syndrome (PRES) in the setting of trauma and acute care surgery are scarce. PRES presents rapidly with a variety of symptoms including headaches, visual disturbances, altered consciousness, and seizures. It is associated with acute hypertensive episodes. PRES is diagnosed with a specific neuroimaging pattern and a constellation of clinical symptoms. This case report presents two traumatically injured patients with one confirmed case of PRES and the other with a potential case of PRES. The diagnosis was made through neuroimaging showing patchy T2 and diffusion hyperintensity in the periphery of both occipital lobes and adjacent cerebellar hemispheres on MRI in one case. The other case highlights extensive stable white matter disease without evidence of acute infarct on MRI, as well as diminished attenuation within the cerebral white matter in the occipital lobes on CT scan. There was resolution of visual symptoms in one patient while the other patient's neurologic status did not allow for evaluation of symptom resolution. This report aims to emphasize the possibility of PRES in trauma patients with a specific pattern of neuroimaging and clinical symptoms, and to increase the index of suspicion in acute care providers.
Dramatic Response to First Line Single Agent Pembrolizumab in Anaplastic Thyroid Carcinoma
Authors: Valérie Spalart, Barbara Legius, Kurt Segers, Johan Coolen, Brigitte Maes, Lynn Decoster
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Anaplastic thyroid carcinoma (ATC) is a deadly disease with very limited therapeutic options. There is an urgent need for new and efficacious drugs. Unfortunately accrual in clinical trials is problematic because of the rarity of the disease and often poor performance status at diagnosis. Recently some data have emerged suggesting a role for immunotherapy in the treatment of ATC. We describe the case of a 75-year-old patient with poor performance status and compromised airway and oesophagus at diagnosis, showing a rapid and dramatic response to first line single agent pembrolizumab. Disease progression in the brain occurred 16 months after initial diagnosis. At that time there was ongoing extracranial disease control.
Catastrophic Antiphospholipid Syndrome after Orthotopic Liver Transplant
Authors: R Okeke, J Lok, R Wells, M Wycoff, A Engelhardt, J Bettag, C O'Leary, T Hallcox, M Nazzal
Journal: Case Rep Transplant (2022)
MeSH terms: Case Reports

Background:
Catastrophic antiphospholipid syndrome (CAPS) is an autoimmune thrombogenic disorder of small and large vessels caused by autoantibodies against phospholipids and phospholipid-binding proteins. This severe form of antiphospholipid syndrome (APS) presents clinically with simultaneous life-threatening multiorgan thrombosis and the presence of two or more persistent antiphospholipid antibodies (APL) confirmed on testing 12 weeks apart. Case Presentation. We describe a case report of a 66-year-old woman with detected antinuclear antibodies (ANA) pretransplant diagnosed with CAPS following orthotopic liver transplant. The patient had acute respiratory failure; Doppler ultrasound and CT angiogram confirmed thrombosis in the hepatic artery, subsequent occlusion of the jump graft, and a splenic infarct. Hypercoagulability workup showed elevated levels of anticardiolipin IgG and beta-2-glycoprotein IgG/IgM and positive lupus anticoagulant, treated with steroids and anticoagulation. The patient was discharged after one month and was transitioned from heparin to life-long warfarin.
Conclusion:
Our patient provided a standard presentation of CAPS with abnormal pretransplant levels of antinuclear antibodies (ANA). Although there have been studies investigating the relationship between anticardiolipin antibodies and lupus anticoagulants and APS, the relationship between pretransplant positive ANA or antimitochondrial antibodies (AMA) and CAPS has yet to be explored. Further studies will be needed to determine the significance of these antibodies. We recommend preoperative APL testing for patients with positive ANA and AMA at preliver transplant presentation.
Detection of t(14;16)(q32;q22) and Monosomy 13 by FISH Analysis in a Patient with Multiple Myeloma Associated with Sjögren's Syndrome: The First Case Report from India
Authors: Rupesh R Sanap, Arundhati S Athalye, Prochi F Madon, Boman N Dhabhar, Mahendra B Sute, Amit A Mahabale, Dhanashree J Warang, Firuza R Parikh
Journal: Case Rep Genet (2013)

Sjögren's syndrome (SS) is a chronic slowly progressive autoimmune disorder characterized by symptoms of oral and ocular dryness, exocrine dysfunction, and lymphocytic infiltration of exocrine glands. Multiple myeloma (MM) is a bone-marrow-based malignant neoplasm of plasma cells associated with serum/urine monoclonal paraproteins and lytic skeletal lesions. There have been very few reported cases of MM, who had SS as the first presentation. We report a case of a woman diagnosed with Sjögren's syndrome, who was later suspected to have multiple myeloma on serum protein electrophoresis. Fluorescence in situ hybridization (FISH) was carried out to check for deletions of loci 13q14.3, ATM, p53, and IGH (14q32) rearrangements on a bone marrow aspirate. Monosomy 13 was observed in 49% of cells, and a rearrangement at the IGH locus was seen in 42% of cells. To determine the partner chromosome associated with the IGH rearrangement, further FISH tests were set up for t(4;14)(p16;q32) followed by t(14;16)(q32;q22) on fresh slides. The test was negative for t(4;14) but positive for t(14;16) in 27% of cells. This confirmed the diagnosis of MM. We report the first case from India, having an association of Sjögren's syndrome with multiple myeloma, which showed t(14;16) and monosomy 13 by FISH analysis.
Fibrinogen A Alpha-Chain Amyloidosis in Two Chinese Patients
Authors: Zhen-Yu Li, Shuang Wang, Dan-Yang Li, Dan Liu, Su-Xia Wang, Xiao-Juan Yu, Gang Liu, Fu-De Zhou, Ming-Hui Zhao
Journal: Front Med (Lausanne) (2022)
Keywords: china, lect2, amyloidosis, fibrinogen, gene mutation, kidney, mass spectrometry
MeSH terms: Case Reports

Objectives:
Fibrinogen A alpha-chain amyloidosis (AFib amyloidosis) is the most common form of hereditary renal amyloidosis in the United Kingdom and Europe, but has rarely been reported in Asia. In this study, we reported two AFib amyloidosis patients in China, reviewing the literature and summarizing main characteristics of AFib amyloidosis in Asia.
Methods:
Two unrelated Chinese patients were diagnosed with AFib amyloidosis by clinical presentation, renal biopsy, mass spectrometry and DNA sequencing in Peking University First Hospital of China from 2014 to 2016.
Results:
Both of the patients presented with proteinuria, edema and hypertension. Renal biopsies of two patients showed extensive amyloid deposits (Congo red positive) in glomeruli, and focal tubulointerstitial amyloid deposits was also found in patient 1. Besides, hepatic involvement of amyloidosis has been detected by liver biopsy in patient 1. By electron microscopy, randomly arranged fibrils in a diameter of 8-12 nm was identified in mesangial matrix and subendothelial area of glomeruli. Immunohistochemistry demonstrated amyloid deposits were strongly positive for fibrinogen Aα in glomeruli and positive for LECT2 in the interstitium of renal medulla and the liver in Patient 1. Unevenly positive staining for both fibrinogen Aα and ApoA-I were found in Patient 2. Fibrinogen Aα was the most abundant amyloidogenic protein in both patients identified by laser microdissection and mass spectrometry-based proteomic analysis. Genetic analysis revealed the fibrinogen A a-chain gene (FGA) mutation in both patients, including a new deletion mutation [c.1639delA (p.Arg547Glyfs*21; NM_000508)] in Patient 2. Genetic analysis of the LECT2 gene in patient 1 revealed a codon change from ATC to GTC at position 172 [c.172A>G (p.Ile58Val; NM_002302)], which is a common polymorphism (SNP rs31517) in all ALECT2 amyloidosis patients.
Conclusions:
We reported two AFib amyloidosis patients in China, one of them coexisted with ALECT2 amyloidosis simultaneously.
Acute cholestatic hepatitis a virus infection presenting with hemolytic anemia and renal failure: a case report
Authors: Robert T Lapp, Fedja Rochling
Journal: Case Reports Hepatol (2013)

Hepatitis A virus is the most common acute viral hepatitis worldwide with approximately 1.5 million cases annually. Hepatitis A virus infection in general is self-limited. In rare cases, hepatitis A virus infection may cause renal failure, hemolytic anemia, and/or cholestasis. We report the first case of acute cholestatic hepatitis A virus infection complicated by hemolytic anemia, and renal failure in one patient. A 42-year-old Caucasian male presented with cholestasis, hemolytic anemia and renal failure after consuming street tacos in Central and South America while on a business trip. His protracted course required corticosteroid therapy, multiple sessions of plasma exchange, and numerous units of packed red blood cells. This case demonstrates the importance of vaccination in high-risk adults. A prompt diagnosis of acute hepatitis A virus infection is essential, as uncommon presentations may delay diagnosis leading to permanent morbidity and potentially death in fulminant cases. We also demonstrate the efficacy of treatment of cholestatic hepatitis A virus infection, hemolytic anemia, and renal failure with corticosteroids and plasma exchange.
Agenesis of the Gallbladder in Monozygotic Twin Sisters
Authors: Koki Hoshi, Atsushi Irisawa, Goro Shibukawa, Akane Yamabe, Mariko Fujisawa, Ryo Igarashi, Ai Sato, Takumi Maki
Journal: Case Rep Gastrointest Med (2016)

Agenesis of the gallbladder, a rare anomaly, is generally regarded as an organogenic failure. Several reports suggest that this congenital defect is inherited but that supposition remains controversial. We described agenesis of the gallbladder in identical twins. A 21-year-old female presented with a history of acute pain in the epigastrium and right hypochondrium. Various imaging modalities showed "gallbladder agenesis." Moreover, her older identical twin sister had also no visualized gallbladder in imaging modalities. This case report strongly suggested that agenesis of the gallbladder would be caused by a genetic abnormality.
High altitude area - A risk factor for gastric perforation? : A case series
Authors: Aditya Pawar, Vikas Sinha, Pawan Sharma, Deependra Kumar Sinha
Journal: Int J Surg Case Rep (2018)
Keywords: gastric antrum, high altitude, intra-luminal pressure, mucosal atrophy, perforations

Introduction:
This is an original case series on soldiers evacuated from HAA(High Altitude Area) over last one year(Sept 2017-Aug 2018), of which 100% cases were found to have gastric antrum perforation. This is a deviation from the usual trend that is being noted in Indian subcontinent where duodenal perforations are commonest.
Discussion:
High altitude associated dyspepsia is a common phenomenon and some studies done in high altitude population have recorded high incidence of antral gastritis and mucosal atrophy on histo-pathological evaluation. This is also supported by high incidence of H. pylori infection. The presence of atrophic gastric mucosa associated with antral gastritis, when exposed to hypobaric hypoxemic conditions faced by soldiers posted to heights above 15,000 ft, may leads to increased intra-luminal pressure and ischemia which probably predisposes individuals for gastric antrum perforations.
Conclusion:
This is a relatively untouched topic as we have not found studies onhigh altitude related gastric perforations and probably this is the first case series of its kind. The acknowledgement of this phenomenon may pave way for further studies for defining the role of high altitude in gastric perforations.
Full Recovery From Cocaine-Induced Toxic Leukoencephalopathy: Emphasizing the Role of Neuroinflammation and Brain Edema
Authors: Edward C Mader Jr, Alexander B Ramos, Roberto A Cruz, Lionel A Branch
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: eeg, mri, cocaine, edema, inflammation, leukoencephalopathy, toxic, white matter
MeSH terms: Brain Edema / chemically induced, Cocaine / toxicity, Cocaine-Related Disorders / complications, Leukoencephalopathies / chemically induced, Case Reports, Brain Edema / diagnostic imaging, Electroencephalography, Humans, Leukoencephalopathies / diagnostic imaging, Magnetic Resonance Imaging, Male, Middle Aged, Neuroimaging, Cocaine

Toxic leukoencephalopathy (TL) is characterized by white matter disease on magnetic resonance imaging (MRI) and evidence of exposure to a neurotoxic agent. We describe a case of cocaine-induced TL in which extensive white matter disease did not preclude full recovery. A 57-year-old man with substance abuse disorder presented with a 5-day history of strange behavior. On admission, he was alert but had difficulty concentrating, psychomotor retardation, and diffuse hyperreflexia. Brain MRI revealed confluent subcortical white matter hyperintensities with restricted diffusion in some but not in other areas. Electroencephalography (EEG) showed mild diffuse slowing. Blood tests were normal except for mild hyperammonemia. Urine screen was positive for cocaine and benzodiazepine but quantitative analysis was significant only for cocaine. Prednisone 60-mg qd was initiated on day 4, tapered over a 5-day period, and discontinued on day 9. He was discharged after 3 weeks. Cognitive function returned to normal 2 weeks after discharge. Five months later, neurologic exam and EEG were normal and MRI showed near-100% resolution of white matter lesions. TL has been attributed to white matter ischemia/hypoxia resulting in demyelination/axonal injury. The clinical, EEG, and MRI findings and time course of recovery of our patient suggest that cocaine-induced inflammation/edema resulted in TL but not in ischemic/hypoxic injury. While inflammation/edema may have regressed when cocaine was discontinued, we cannot exclude a role for prednisone in protecting the patient from the ischemic/hypoxic sequelae of inflammation/edema. MRI is indispensable for diagnosing TL but EEG may provide additional useful diagnostic and prognostic information.