OpenMed/multicare-articles huggingface dataset:
A Report of Two Cases of Hazards Associated with High Flow Arteriovenous Fistula in ESRD Patients
Authors: Vipuj Shah, Rakesh Navuluri, Yolanda Becker, Mary Hammes
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

High flow arteriovenous fistulas are a common clinical entity affecting patients with end-stage renal failure receiving hemodialysis. Given the difficulty in predicting who will develop a high flow arteriovenous fistula the exact prevalence is unclear. We present two cases of patients with high flow arteriovenous fistula that developed clinical cardiac failure at a time point after the fistula was placed with findings of significant cephalic arch stenosis. Both patients required treatment of cephalic arch stenosis with balloon angioplasty with subsequent surgical aneurism resection. Accurate and timely diagnosis of high flow arteriovenous hemodynamics by prospective monitoring of volumetric flow and cardiac function is required to halt this process prior to cardiac compromise.
Management of anterior abdominal wall defect using a pedicled tensor fascia lata flap: a case report
Authors: K D Ojuka, F Nangole, M Ngugi
Journal: Case Rep Med (2012)

Degloving injuries to anterior abdominal wall are rare due to the mechanism of injury. Pedicled tensor fascia lata is known to be a versatile flap with ability to reach the lower anterior abdomen. A 34-year-old man who was involved in a road traffic accident presented with degloving injury and defect at the left inguinal region, sigmoid colon injury, and scrotal bruises. At investigation, he was found to have pelvic fracture. The management consisted of colostomy and tensor fascia lata to cover the defect at reversal. Though he developed burst abdomen on fifth postoperative day, the flap healed with no complications.
Myelin Oligodendrocyte Glycoprotein Antibody Associated Cerebral Cortical Encephalitis: Case Reports and Review of Literature
Authors: Hang Shu, Manqiu Ding, Pei Shang, Jia Song, Yue Lang, Li Cui
Journal: Front Hum Neurosci (2022)
Keywords: mog, autoimmune, cortical, encephalitis, seizures

Myelin oligodendrocyte glycoprotein antibody-associated disease is an immune-mediated demyelinating disease of the central nervous system that is present in both adults and children. The most common clinical manifestations are optic neuritis, myelitis, acute disseminated encephalomyelitis, and brainstem syndrome. Cerebral cortical encephalitis (CCE) is a rare clinical phenotype of myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD), which usually begins with seizures, headaches, and fever, and may be misdiagnosed as viral encephalitis in the early stages. Herein, we report two typical MOG antibody (MOG-Ab)-positive patients presenting with CCE, both of whom presented with headache, fever, seizures, and who recovered completely after immunotherapy. In addition, we performed a systematic review of the present literature from the perspectives of population characteristics, clinical symptoms, MRI abnormalities, treatments, and prognosis. Among the patients reported in 25 articles, 33 met our inclusion criteria, with the age of onset ranging from 4 to 52 years. Most of the patients had seizures, headache, fever, and unilateral cortical lesions on brain MRI. For acute CCE, 30 patients were treated with high-dose intravenous methylprednisolone, and the symptoms of most patients were completely relieved after immunotherapy. This study reported our experience and lessons learned in the diagnosis and treatment of MOG-Ab-positive CCE and provides a systematic review of the literature to analyse this rare clinical phenotype.
Capnocytophaga Induced Acute Necrotizing and Exudative Pericarditis with Abscess Formation
Authors: Alexa Bello, Alejandro Castaneda, Abhay Vakil, Joseph Varon, Salim Surani
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

We present the case of a 55-year-old gentleman, with bilateral pulmonary embolism and a large pericardial effusion that lead to a pericardial window with evacuation of creamy pus. Gram stains were negative, with culture growing Capnocytophaga. Pathology revealed acute necrotizing and exudative changes, including frank abscess formation. In developed countries, pericardial abscess and acute pericarditis are uncommon due to availability of broad-spectrum antibiotics. Pericardial abscess due to Capnocytophaga is even more uncommon.
Case Report: Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Application in Intraperitoneally Disseminated Inflammatory Myofibroblastic Tumor and in the Youngest Patient in the World: New Indication and Modification of Technique
Authors: Hanna Garnier, Maciej Murawski, Tomasz Jastrzebski, Katarzyna Pawinska-Wasikowska, Walentyna Balwierz, Katarzyna Sinacka, Wojciech Gorecki, Ewa Izycka-Swieszewska, Piotr Czauderna
Journal: Front Surg (2021)
Keywords: hipec (heated intraperitoneal chemotherapy), cytoreductive surgery, inflammatory myofibroblastic tumor, oncological surgical treatment, pediatric oncology
MeSH terms: Case Reports

Introduction: Peritoneal metastases occur in cancers that spread to the peritoneal cavity and indicate the advanced stage of the disease. In children they are mainly seen in sarcomas, Gastrointestinal Stromal Tumors and primary disseminated ovarian tumors. Inflammatory Myofibroblastic Tumor (IMT) is a very rare lesion, characterized by an unpredictable clinical course. The absorption of chemotherapeutic agents through the peritoneal-plasma barrier (PPB) is minimized, thus HIPEC procedure limits the systemic exposure to chemotherapy and permits the administration of its higher doses. The main purpose of HIPEC is to remove the visible macroscopic disease in order to achieve complete cytoreduction (CRS). HIPEC Procedure in Children: Several papers deal with the CRS and HIPEC in children and adolescents, however pediatric experience is still limited. Thus far, the HIPEC procedure has been carried out on patients over 2 years old. The most common indication for the surgery and the best outcome was experienced by patients with desmoplastic small round cell tumor (DSRCT). Most patients received intraperitoneal cisplatin. HIPEC Modification: A 5-month-old infant was admitted to the Department of Pediatric Oncology due to the abdominal distention and blood in the stool. The Computed Tomography (CT) revealed a solid-cystic mass in the right abdominal area. The primary tumor and numerous peritoneal metastasis were removed and the Inflammatory Myofibroblastic Tumor (IMT) was diagnosed. The patient underwent subsequently CRS and modified HIPEC procedure. To avoid overheating of the infant, the intraperitoneal normothermic chemoperfusion was performed. Due to the low body weight a modified dosage of intraperitoneal doxorubicin was used. The child underwent standard postoperative chemotherapy and received crizotinib therapy. At 12 months follow-up since treatment completion the patient remains in complete remission. To our knowledge this is the youngest patient, the only infant and the first pediatric patient with IMT who underwent the modified HIPEC procedure in the world. Conclusions: CRS and HIPEC is technically possible also in infants. For its safe course patients selection and technique modification are necessary. Use of HIPEC should be also considered in intraperitoneally disseminated IMT. A complete cytoreductive surgery as the first HIPEC step seems to be the key factor in survival.
Cases report: MRI findings of asymptomatically familial subependymal heterotopia with filamin A gene abnormality
Authors: Bin Lv, Yushan Zhou, Jianguang Zeng, Ling Wang, Fumin Zhao, Huizhu Chen, Xuesheng Li, Yu Song, Mei Xiao, Zhiyong Ding, Bochao Cheng
Journal: Front Neurosci (2022)
Keywords: asymptomatic, case report, filamin a, magnetic resonance imaging, subependymal heterotopia
MeSH terms: Case Reports

Subependymal heterotopia (SEH) is a rare neuronal migration disorder consisting of gray matter nodules along the lateral ventricular walls and is often associated with other brain malformations. Despite most SEH cases showing epilepsy during their lifetimes, very few patients with asymptomatically familial SEH tend to cause misdiagnosis or missed diagnosis. We present four familial SEH cases without any positive symptoms and medical history, including two fetuses, who were diagnosed by MRI and confirmed by genetic testing with mutation of filamin A. This report emphasizes the role of MRI in the recognition of SEH at an early age of gestation and in asymptomatically familial SEH. MRI provides a fast, repeatable, reliable, and cheap choice for detecting and screening familial SEH.
Novel Treatment of Small-Cell Neuroendocrine of the Vagina
Authors: Kathryn Kostamo, Mishka Peart, Nathalie McKenzie, Conisha Holloman, S J Carlan, Li Ge, John Maksem
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Background:
Primary vaginal small-cell neuroendocrine carcinoma is an extremely rare and highly aggressive malignancy. Eighty-five percent of patients die within one year of diagnosis from metastatic disease despite multimodal therapy. Gene expression profiling of tumor tissue may be useful for treatment options for various malignancies.
Case:
A 34-year-old nulliparous woman was diagnosed with primary vaginal small-cell neuroendocrine carcinoma. Twenty weeks after the initial visit, she was diagnosed with recurrence and started on chemoradiation based on the results of gene expression profile of tumor tissue. She died 34 months after the initial visit and had a 14-month progression-free survival (PFS).
Conclusion:
Gene expression profile of tumor tissue in the management of primary vaginal small-cell neuroendocrine carcinoma may be helpful in extending progression-free survival.
Upper-Extremity Deep Venous Thrombosis following a Fracture of the Proximal Humerus: An Orthopaedic Case Report
Authors: John Strony, Gerard Chang, James C Krieg
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Deep venous thrombosis of the lower extremities following orthopaedic surgery is well-documented. Though less common than its lower extremity counterpart, upper extremity deep venous thrombosis (UEDVT) has been documented in the literature as well, largely in the context of arthroscopic shoulder surgery. However, there is a paucity of literature documenting UEDVT following surgical fixation of upper extremity fractures, specifically fractures involving the proximal humerus. We present a case of UEDVT following a fracture to the proximal humerus and subsequent surgery. Though UEDVT is considered a rare complication following this type of surgery based on a lack of documentation within the literature, we believe a high-index of suspicion is required to prevent potentially life-threatening sequelae, such as pulmonary embolism (PE) and post-thrombotic syndrome.
Focal form of congenital hyperinsulinism clearly detectable by contrast-enhanced computed tomography imaging
Authors: Yukiko Hashimoto, Azumi Sakakibara, Rie Kawakita, Yuki Hosokawa, Rika Fujimaru, Tetsuro Nakamura, Hiroko Fukushima, Aiko Igarashi, Michiya Masue, Hironori Nishibori, Nobuyoshi Tamagawa, Akiko Murakami, Kazue Hatake, Tohru Yorifuji
Journal: Int J Pediatr Endocrinol (2015)
MeSH terms: Case Reports

The focal form of congenital hyperinsulinism (CHI) is characterized by a cluster of abnormal insulin-oversecreting β cells within a restricted area of the pancreas. Although identification of the focal lesion is very important in the management of CHI, it has been reported that imaging studies, including computed tomography (CT), magnetic resonance imaging (MRI) scans, or angiography, are not helpful in identifying the focal lesion. Currently, fluorine-18-L-dihydroxyphenylalanine positron emission tomography ((18)F-DOPA PET) is believed to be the only imaging modality that can identify the focal lesions. In this report, however, we present a case of a 7-month-old girl with the focal form of CHI, caused by a loss-of-function mutation in the ABCC8 gene, whose lesion was clearly visible as a hyperenhancing nodule on contrast-enhanced CT and dynamic MRI imaging.
Apocrine Adenoma of the External Auditory Canal with Pseudoepitheliomatous Hyperplasia
Authors: Masafumi Ohki, Shigeru Kikuchi
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

The tumors derived of the ceruminous gland in the external auditory canal are rare. Here, we report a case of a ceruminous adenoma (apocrine adenoma) with refractory chronic inflammation in the external auditory canal. A 46-year-old man presented with otorrhea, itching, and a foreign body sensation in his right ear. A soft reddish protruding lesion was revealed at the posterosuperior portion of the entry to the right external auditory canal by otoscopy. The skin lesion was endaurally resected; histopathology showed luminal structures in the middle to deep layer of the epidermis and inflammatory granulation below pseudoepitheliomatous hyperplasia. The walls of the luminal structures consisted of inner luminal secretory cells featuring apical decapitation secretion and outer myoepithelial cells. The patient was diagnosed with an apocrine adenoma. Three years after surgery, there has been no evidence of recurrence. Complete resection, including the deep layer of the epidermis, is necessary.
Suspected Spontaneous Aqueous Humor Misdirection Syndrome in a Boston Terrier
Authors: Ashley E Zibura, Michael G Davidson, Hans D Westermeyer
Journal: Case Rep Vet Med (2020)
MeSH terms: Case Reports

An eight-year-old female spayed Boston Terrier presented to the North Carolina Veterinary Hospital with glaucoma in the left eye (OS). Initial ophthalmic examination revealed moderate ocular hypertension, a diffusely and markedly shallow anterior chamber with anteriorly displaced iris and lens, vitreal prolapse, and a normal iridocorneal angle (ICA) morphology. The patient displayed a paradoxical response to topical latanoprost with an increase in intraocular pressure. These examination findings led to a putative diagnosis of spontaneous aqueous humor misdirection syndrome (AHMS). The patient was successfully managed with topical carbonic anhydrase inhibitors (CAIs) and apraclonidine for eight months until progressive ulcerative keratitis necessitated enucleation of the affected globe. Histopathology and high-field magnetic resonance imaging (MRI) of the enucleated globe did not identify an underlying cause for the glaucoma. This case suggests that AHMS should be considered in dogs presenting with a shallow anterior chamber, vitreal prolapse, increased intraocular pressure, and no other causes of glaucoma.
Bilateral Visual Loss as Presenting Symptom of Posterior Reversible Encephalopathy Syndrome in a Patient with HIV/Tuberculosis Coinfection: A Case Report
Authors: S Guerriero, L Ciracì, T Centoducati, F Pignatelli, V Lamargese, A Salvati, F Dicuonzo
Journal: Case Rep Ophthalmol Med (2012)

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state accompanied by a unique brain imaging pattern. This cliniconeuroradiological entity usually presents with visual disturbances (cortical blindness, homonymous hemianopia, visual neglect, and blurred vision) along with neurotoxic manifestations. Only a few cases of PRES have previously been reported in patients with advanced HIV disease. The authors describe a case of posterior reversible encephalopathy syndrome (PRES) in a patient with advanced HIV/TBC infection who developed a neurotoxic state following TB and ART therapy initiation. They present a comprehensive review of the literature and discuss the pathogenetic hypotheses.
Case Report: Successful Long-Term Management of a Low-Birth Weight Preterm Infant With Compound Heterozygous Protein C Deficiency With Subcutaneous Protein C Concentrate Up to Adolescence
Authors: Johannes Pöschl, Wolfgang Behnisch, Bernd Beedgen, Navina Kuss
Journal: Front Pediatr (2021)
Keywords: congenital protein c deficiency, preterm infant, protein c concentrate, replacement therapy, subcutaneous infusion
MeSH terms: Case Reports

Homozygous/compound heterozygous forms of congenital protein C deficiency are often associated with severe antenatal and postnatal thrombotic or hemorrhagic complications. Protein C deficiency frequently leads to severe adverse outcomes like blindness and neurodevelopmental delay in children and may even lead to death. The most widely used long-term postnatal treatment consists of oral anticoagulation with vitamin K antagonists (e.g., warfarin), which is supplemented with protein C concentrate in acute phases. Subcutaneous infusions have been described in infants mostly from 2 months of age after severe postnatal thrombosis, but not in newborns or premature infants without thromboembolism. We report the first case of a compound heterozygous protein C-deficient preterm infant, born at 31+5 weeks of gestation to parents with heterozygous protein C deficiency (protein C activity 0.9% at birth). We focus on both prenatal and perinatal management including antithrombotic treatment during pregnancy, the cesarean section, and continuous postnatal intravenous and consecutive subcutaneous therapy with protein C concentrate followed by a change of therapy to direct oral anticoagulants (DOACs) (apixaban). We report successful home treatment with subcutaneous protein C concentrate substitution overnight (target protein C activity >25%) without complication up to 12.5 years of age. We propose that early planned cesarean section at 32 or preferably 34 weeks of gestation limits potential maternal side effects of anticoagulation with vitamin K antagonists and reduces fetal thromboembolic complications during late pregnancy. Intravenously administered protein C and early switch to subcutaneous infusions (reaching about 3 kg body weight) resulted in sufficient protein C activity and has guaranteed an excellent quality of life without any history of thrombosis for 13 years now. In older children with protein C deficiency, as in our case, DOACs could be a new therapeutic option.
Case Report: Portal cavernoma related to multiple liver hydatidosis: A rare case of fatal cataclysmic haemorrhage
Authors: Alia Zouaghi, Nawel Bellil, Khalaf Ben Abdallah, Dhafer Hadded, Haithem Zaafouri, Mona Cherif, Anis Ben Maamer
Journal: F1000Res (2021)
Keywords: case report, hydatidosis, portal cavernoma, variceal bleeding
MeSH terms: Echinococcosis, Hepatic / complications, Esophageal and Gastric Varices, Hypertension, Portal / complications, Case Reports, Adult, Gastrointestinal Hemorrhage / etiology, Humans, Male

Clinical presentation of liver hydatidosis can vary from asymptomatic forms to lethal complications. We report herein a rare case of a 27-year-old male from a rural Tunisian region who presented with large-abundance haematemesis, haemodynamic instability, and marked biological data of hypersplenism. Endoscopy showed bleeding esophageal varicose veins that were ligated. Abdominal ultrasound concluded the presence of three type CE2 hydatic liver cysts causing portal cavernoma with signs of portal hypertension. Despite resuscitation, the patient died of massive rebleeding leading to haemorrhagic shock. Hepatic hydatid cyst should be considered as an indirect cause of gastrointestinal bleeding in endemic countries. Early abdominal ultrasound in varicose haemorrhage is essential in orienting the diagnosis.
Transverse vs. median laparotomy in peritonitis and staged lavage: a single center case series
Authors: Sven Petersen, Alice Deder, Axel Prause, Christopher Pohland, Dominik Richter, Thomas Mansfeld, Gero Puhl
Journal: Ger Med Sci (2020)
Keywords: peritonitis, staged lavage, wound healing
MeSH terms: Abdominal Wound Closure Techniques / adverse effects, Laparotomy / adverse effects, Laparotomy / methods, Laparotomy / statistics & numerical data, Peritoneal Lavage / adverse effects, Peritoneal Lavage / methods, Peritonitis / diagnosis, Peritonitis / etiology, Peritonitis / mortality, Peritonitis / surgery, Sepsis / complications, Surgical Wound Dehiscence / etiology, Surgical Wound Dehiscence / prevention & control, Abdominal Cavity / surgery, Aged, Critical Care / methods, Female, Germany / epidemiology, Humans, Male, Outcome and Process Assessment, Health Care, Patient Acuity, Surgical Wound / complications, Wound Healing

Background: Staged lavage was first introduced in the 1970s and now serves as a therapeutic option for septic patients with peritonitis. A central aspect of this treatment concept is leaving the abdomen open after a wide incision. To evaluate the influence of transverse vs. median access to the abdomen in staged lavage, data from the authors' patients were analyzed. Methods: To evaluate patients with peritonitis, prospective intensive care data were examined together with data on the surgical details. The main aspects covered here were the surgical details of the lavage (namely, transverse vs. median laparotomy), number of lavages, fascia closure, wound-healing disorders, and observed lethality, in combination with the preoperatively evaluated SAPS-II score, expected hospital lethality, patient age, and the Mannheim Peritonitis Index. Results: Between January 2008 and December 2018, 522 patients were treated with open abdomen and staged lavage. The mean age of the patients was 66.0 years (standard deviation (SD) 15.9 years). A median incision was used in 140 cases, and transverse laparotomy was performed in 382. The mean SAPS-II score was 46.5 (SD 15.7), expected lethality was 39.6% (SD 26.3%), and observed lethality was 19.9%. On average, two lavages were performed after the index operation. Transverse incision was significantly less likely to cause wound-healing disorder (p=0.03), and fascial dehiscence was observed less frequently in the transverse laparotomies group than in median incisions in the statistical trend (p=0.06). Conclusion: In summary, staged lavage reduced expected lethality in patients with peritonitis. Transverse incision caused wound-healing disorders and fascial dehiscence less often. Therefore, the indication for transverse laparotomy should be generous, as this form of treatment is advantageous in case of peritonitis.
Transmucosal Buprenorphine in the Treatment of Dyspnea: Case Series and Review of the Literature
Authors: François Blumenfeld-Kouchner, Lisa Bullis, Kathy Koch
Journal: Palliat Med Rep (2021)
Keywords: breathlessness, buprenorphine, case series, dyspnea, opioid analgesics

Full μ-opioid agonists are commonly employed in advanced disease to relieve dyspnea of various etiologies. Although there are ongoing debates and studies regarding the relative efficacy of different agents, a factor limiting more general use is a concern about side effects, in particular respiratory depression. Buprenorphine is a partial μ receptor agonist and a κ-opioid receptor antagonist, with a better safety profile than full μ receptor agonists. We conducted a literature search, which did not reveal any studies looking at the use of buprenorphine to treat dyspnea. We also report a case series of three patients with dyspnea of various etiologies treated with buprenorphine, with an apparent excellent response of dyspnea to treatment, without any significant side effects. Given those results, as well as the potential impact of κ-opioid receptor antagonism on dyspnea-associated anxiety, we conclude that there is a need for controlled studies of buprenorphine against full μ-opioid agonists for the symptomatic treatment of dyspnea in palliative care.