OpenMed/multicare-articles huggingface dataset:
The Utility of MRI in the Diagnosis of Takayasu Arteritis
Authors: Marian Gaballah, Rachelle Goldfisher, John B Amodio
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Takayasu Arteritis (TA) is an inflammatory disorder involving the thoracoabdominal aorta and its branches and the pulmonary arteries, with eventual vascular stenosis, occlusion, or aneurysm formation. Conventional angiography has been the reference imaging standard for diagnosis of TA. The purpose of this case report is to demonstrate the utility of MR imaging and MR angiography in the diagnosis of Takayasu Arteritis in a pediatric patient. The patient is a 15-year-old female patient presenting with anemia, hypertension, and acute kidney injury. Initial chest CT demonstrated ectasia of the ascending and focal stenosis of the descending thoracic aorta, prompting further evaluation with MRI and MRA. MRI/MRA demonstrated mural thickening with luminal stenosis of the aorta and aortic branch vessels. These imaging findings were suggestive of a large vessel arteritis and along with the clinical presentation and laboratory abnormalities the diagnosis of Takayasu Arteritis was suggested. Several case series in adults have described the cross-sectional findings of TA. However, this case report demonstrates the utility of MRI/MRA in the evaluation of TA in children and in the course of follow-up, as it provides a noninvasive method for evaluating a child without ionizing radiation or iodinated contrast.
Paratesticular liposarcoma: a case report
Authors: Karima Mouden, Soukaina Wakrim, Afaf Semmar
Journal: Pan Afr Med J (2019)
Keywords: paratesticular liposarcoma, giant liposarcoma, pelvic tumor, well-differentiated liposarcoma
MeSH terms: Genital Neoplasms, Male / diagnosis, Liposarcoma / diagnosis, Spermatic Cord / pathology, Testicular Neoplasms / diagnosis, Case Reports, Genital Neoplasms, Male / pathology, Genital Neoplasms, Male / surgery, Humans, Liposarcoma / pathology, Liposarcoma / surgery, Male, Margins of Excision, Middle Aged, Orchiectomy, Testicular Neoplasms / pathology, Testicular Neoplasms / surgery

Paratesticular liposarcomas (PLS) is a very uncommon pathology type of paratesticular sarcomas, with less 200 similar cases reported to date in the English literature. There are a few cases regarding giant paratesticular liposarcoma measuring over 10 cm. We present an unusual case with a giant well differentiated PLS of the left testis extended to the pelvic cavity. We report the case of a 55-year-old man who presented with large left groin mass. The patient underwent left orchiectomy following a cure of a scrotal hernia. Histological and immunohistochemical findings were suggestive of a well-differentiated liposarcoma of spermatic cord. The surgical margins were positive. Metastatic work-up, which included CT of the thorax, abdomen and pelvis, did not reveal any distant metastasis in thorax but there is a left pathological external iliac lymph nodes and a left lateroplevic lipomatous mass extended to the iliac fossa and left parietocolic gutter up to the umbilicus measuring 15x7x17 cm. Our patient refused treatment. A review of the literature revealed that there are fewer cases of giant well differentiated paratesticular liposarcoma extended to the pelvic cavity were reported. This study focuses on the clinical characteristics and treatment of this rare type of tumours.
Successful Utilization of Mechanical Thrombectomy in a Presentation of Pediatric Acute Ischemic Stroke
Authors: Esther S Kim, Erica K Mason, Andrew Koons, Shawn M Quinn, Robert L Williams
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Guidelines regarding the management of acute ischemic stroke (AIS) in the pediatric population using mechanical recanalization procedures are lacking. We present a case of a 14-year-old male diagnosed in the Emergency Department with an acute onset stroke who underwent successful mechanical clot removal by interventional radiology.
Quantitative effects on proximal joints of botulinum toxin treatment for gastrocnemius spasticity: a 4-year-old case study
Authors: Veronica Cimolin, Manuela Galli, Marcello Crivellini, Giorgio Albertini
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Botulinum toxin A (BTA) is a recognized treatment for the early management of spasticity in children with Cerebral Palsy. This study quantified with Gait Analysis (GA) the gait pattern of a 4-year-old diplegic child with calf contracture before, 5 days, and 3 months after BTA injections into gastrocnemius. Kinematic and kinetic data of main lower limb joints were investigated. After only 5 days, ankle dorsi-plantarflexion and knee flex-extension improved, but hip joint worsened, increasing its excessive flexion, to compensate the improvement in knee position of the treated limb and to obtain better stability. A worsening of hip power happened. After 3 months, all joints generally improved their position during gait cycle. Hip and knee joints increased their range of movement and improvements occurred at ankle kinematics and kinetisc, too; a better ankle position and an increase of its capacity of propulsion during terminal stance were evident.
Severe rhabdomyolysis in homozygote carnitine palmitoyltransferase II deficiency
Authors: Wolfgang J Schnedl, Michael Schenk, Dietmar Enko, Harald Mangge
Journal: EXCLI J (2020)
Keywords: carnitine palmitoyltransferase ii deficiency, myalgia, rhabdomyolysis, urosepsis
MeSH terms: Case Reports

Carnitine palmitoyltransferase II (CPT II) deficiency represents an inherited defect in mitochondrial long-chain fatty acid oxidation. Rhabdomyolysis with necrosis of muscle is caused by the destruction of skeletal muscle and leads to systemic, multiorgan complications due to the release of intracellular muscle components. Severe rhabdomyolysis may be triggered by combination of a genetic predisposition, including CPT II deficiency, with additionally acting causes. Generally, patients with CPT II deficiency are rarely clinical recognized and reported. We describe a patient presenting severe rhabdomyolysis due to urosepsis, who, in genetic testing, demonstrated the homozygous CPT II deficiency (c.338C>T, p.Ser113Leu) mutation. The diagnosis of CPT II deficiency helped this patient to put the symptoms into context, and this reduced myopathy and the risk of recurring rhabdomyolysis. We report on this patient to increase awareness of diagnostic and medical management in CPT II deficiency.
Intraductal papilloma: atypical presentation
Authors: P Ramaswamy, Tanya Khaitan, A Anuradha, B Praveen Kumar, S Sudhakar
Journal: Case Rep Dent (2013)

Ductal papillomas have unique papillary features arising from the salivary gland duct system. They comprise three rare benign adenomas, namely, inverted ductal papilloma, sialadenoma papilliferum, and intraductal papilloma. Intraductal papilloma is an extremely rare benign salivary gland tumor that occurs most commonly in the minor salivary glands. Here, we are presenting a case report of intraductal papilloma in an 18-year-old patient.
Introducing a drift and diffusion framework for childhood growth research
Authors: Fraser I Lewis, Godfrey Guga, Paschal Mdoe, Esto Mduma, Cloupas Mahopo, Pascal Bessong, Stephanie A Richard, Benjamin J J McCormick
Journal: Gates Open Res (2020)
Keywords: mal-ed, child growth, dynamic modelling, stochastic differential equations

Background: Growth trajectories are highly variable between children, making epidemiological analyses challenging both to the identification of malnutrition interventions at the population level and also risk assessment at individual level. We introduce stochastic differential equation (SDE) models into child growth research. SDEs describe flexible dynamic processes comprising: drift - gradual smooth changes - such as physiology or gut microbiome, and diffusion - sudden perturbations, such as illness or infection. Methods: We present a case study applying SDE models to child growth trajectory data from the Haydom, Tanzania and Venda, South Africa sites within the MAL-ED cohort. These data comprise n=460 children aged 0-24 months. A comparison with classical curve fitting (linear mixed models) is also presented. Results: The SDE models offered a wide range of new flexible shapes and parameterizations compared to classical additive models, with performance as good or better than standard approaches. The predictions from the SDE models suggest distinct longitudinal clusters that form distinct 'streams' hidden by the large between-child variability. Conclusions: Using SDE models to predict future growth trajectories revealed new insights in the observed data, where trajectories appear to cluster together in bands, which may have a future risk assessment application. SDEs offer an attractive approach for child growth modelling and potentially offer new insights.
Apexification Management of Mandibular Second Premolar with a Blunderbuss Apex and Periapical Lesion of an Adult Patient
Authors: Chenshuang Li, Zhong Zheng, Xiaohong Deng, Lan Zhang, Baoyan Wang, Qingyu Guo, Min Zou
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Apexification is widely applied in teenager patients but rarely used in the adult population. Instead, artificial apical barrier with mineral trioxide aggregate (MTA) is clinically accepted, and spontaneous apical closure in nonvital immature teeth of adult patients has rarely been encountered while only apexification of the maxillary incisors in adult patients has been reported. The aim of this case report is to share a successful apexification application in the mandibular premolar with a blunderbuss apex and periapical lesion of an adult patient by using calcium hydroxide: radiographically, spontaneous hard tissue barrier has been established, and narrowing canal space and decreasing area of periapical shadow were documented without complications. Taken together, our study indicates that patient's age and tooth position may not be the critical limitation for apexification.
Coexistence of anti-SOX1 and anti-GABAB receptor antibodies with paraneoplastic limbic encephalitis presenting with seizures and memory impairment in small cell lung cancer: A case report
Authors: Sizhu Gong, Yue Han, Enling He, Min Liu, Xiyao Fu, Fang Deng
Journal: Front Immunol (2022)
Keywords: anti-gabab receptor antibody, anti-sox1 antibody, autoimmune encephalitis, paraneoplastic limbic encephalitis, small cell lung cancer
MeSH terms: Limbic Encephalitis / diagnosis, Limbic Encephalitis / drug therapy, Lung Neoplasms / complications, Lung Neoplasms / diagnosis, Paraneoplastic Syndromes / complications, Small Cell Lung Carcinoma / complications, Small Cell Lung Carcinoma / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Anticonvulsants, Humans, Male, Memory Disorders, Middle Aged, Positron Emission Tomography Computed Tomography, Seizures / complications, Anticonvulsants

Purpose:
Paraneoplastic neurological syndromes associated with autoantibodies are rare diseases that cause abnormal manifestations of the nervous system. Early diagnosis of paraneoplastic neurological syndromes paves the way for prompt and efficient therapy.
Case report:
we reported a 56-year-old man presenting with seizures and rapidly progressive cognitive impairment diagnosed as paraneoplastic limbic encephalitis (PLE) with anti-SRY-like high-mobility group box-1 (SOX-1) and anti-γ-aminobutyric acid B (GABAB) receptor antibodies and finally confirmed by biopsy as small cell lung cancer (SCLC). At the first admission, brain magnetic resonance imaging (MRI) showed no abnormal signal in bilateral hippocampal regions and no abnormal enhancement of enhanced scan. The serum anti-GABAB receptor antibody was 1:100 and was diagnosed as autoimmune encephalitis (AE). The computed tomography (CT) scans of the chest showed no obvious tumor signs for the first time. Although positron emission tomography-computed tomography (PET-CT) revealed hypermetabolism in the para mid-esophageal, the patient and his family declined to undertake a biopsy. The patient improved after receiving immunoglobulin, antiepileptic therapy, and intravenous methylprednisolone (IVMP) pulse treatment. However, after 4 months, the symptoms reappeared. Brain MRI revealed abnormal signals in the hippocampal regions. Reexamination of the cerebral fluid revealed anti-GABAB receptor and anti-SOX-1 antibodies, which contributed to the diagnosis of PLE. SCLC was found in a para mid-esophageal pathological biopsy. Antiepileptic medications and immunoglobulin were used to treat the patient, and the symptoms were under control.
Conclusion:
Our findings increase the awareness that patients with limbic encephalitis with cognitive dysfunction and epileptic seizures should be enhanced to detect latent malignancy. Our case also highlights the importance of anti-SOX1 antibodies in the detection of underlying neoplasm, particularly SCLC. Our findings raise awareness of the cognitive impairment seen by patients with limbic encephalitis.
Minimally Invasive Bilateral Lung Resections and CABG through 5 Ports
Authors: N Asemota, M J Rouhani, L Harling, H Raubenheimer, A C De Souza, E Lim
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Minimal access surgery is increasingly popular to reduce postoperative morbidity and enhance recovery. We present a case of a patient who underwent bilateral minimally invasive thoracic and cardiac surgery. An 81-year-old woman was diagnosed with T1aN0M0 left upper lobe small-cell lung cancer and underwent single-port left video-assisted thoracoscopic surgery (VATS) upper lobectomy in 2016. She developed a contralateral right lower lobe nodule and underwent a single-port right VATS wedge resection of the lower lobe nodule, subsequently confirmed as necrotising granulomatous inflammation with acid-fast bacilli, consistent with previous tuberculosis (TB) infection. On postoperative day 1, she had an episode of self-reverting ventricular tachycardia and bradycardia. Subsequent myocardial perfusion scan and coronary angiogram showed significant LV dysfunction and severe coronary artery disease with a left main stem (LMS) lesion. After agreement at MDT, an Endo-ACAB (endoscopic atraumatic coronary artery bypass grafting) was performed, via 3 ports, with the left internal mammary artery anastomosed to left anterior descending artery. She recovered well postoperatively and was discharged. Multiple sequential minimally invasive procedures are now routine and can be performed safely in patients with a complex combination of pathologies. In this case, bilateral single-port (anatomic and nonanatomic) lung resections were undertaken followed by coronary revascularisation with a total of 5 minimal access ports.
Benign familial neonatal convulsions: A family with a rare disorder
Authors: Harbag Singh, Rajnish Raj
Journal: Ann Indian Acad Neurol (2008)
Keywords: benign familial neonatal convulsions, computed tomography, electroencephalograph
MeSH terms: Case Reports

The authors report a family from Punjab (India) with 10 members having benign familial neonatal convulsions (also known as benign familial neonatal seizures) in two generations. This disorder is quite rare. The clinical presentation of index case along with the findings of computed tomography of the brain and electroencephalograph is described. Important features of all the family members along with a brief review of the literature are also given.
Multiple osteochondromas of the cervical spine, a potential cause of radiculopathy in the elderly: A case report and review of literature
Authors: Andhika Yudistira, Yasushi Fujiwara, William Putera Sukmajaya, Ray Asaf Hexa Pandiangan, Muhammad Abduh
Journal: Int J Surg Case Rep (2020)
Keywords: case report, cervical spine, elderly, osteochondroma, radiculopathy
MeSH terms: Case Reports

Introduction:
Osteochondroma is the most prevalent type of bone tumour, often arising in the long bones. Most are found in the third decade of life, and rarely in the axial skeleton of elderly patients. This case report aims to highlight the possibility of this differential diagnosis in an elderly patient with symptoms of radiculopathy, aside from degenerative cause.
Presentation of case:
A 76-years-old woman presented to the authors' hospital with complaints of pain and numbness of the left suboccipital and preauricular region. There was hypoesthesia of left C2 and C3 dermatome without any signs of myelopathy. CT-scan and MRI showed an expansile bone lesion from the posterior arch of C1 and lamina of C2. The patient underwent laminectomy of C1 and hemilaminectomy of C2. Postoperative histopathologic examination showed the features of osteochondroma. Radiologic follow-up after nine months showed no sign of recurrence. After eighteen months, the patient was ambulatory with complaints of fingers numbness and moderate neck pain.
Discussion:
Osteochondroma usually arises in long bone metaphysis. This lesion normally ceases to grow with growth plate closure, but other findings suggest it may continue to grow beyond skeletal maturity. About 29.5% of all osteochondroma of the spine would cause radiculopathy, and 27% would cause myelopathy. The cervical spine osteochondroma is usually treated by en bloc resection through posterior approach.
Conclusion:
Osteochondroma of the cervical spine in the elderly is rare. However, this diagnosis could be considered as a possible cause of radiculopathy in this age group aside from other degenerative causes.
Heparin-induced thrombocytopenia in a non-heparin-naive patient: a case report
Authors: Marion Wiegele, Dieter Adelmann, Johannes Gratz, Eva Schaden
Journal: Springerplus (2015)
Keywords: argatroban, hit ii, heparin induced thrombocytopenia, lmwh, low molecular heparin

Introduction:
Administration of low molecular weight heparin (LMWH) is recommended for prophylaxis of venous thromboembolism in patients undergoing hip surgery. In this context, heparin-induced thrombocytopenia (HIT) type II is a complication of rare incidence but sometimes fatal outcome.
Case description:
A 52-year old obese patient undergoing antithrombotic therapy with Enoxaparin after hip surgery presented with a painful, swollen leg and thrombocytopenia on day eight after surgery. Medical history showed previous administration of Enoxaparin without complications 2 years ago. Further diagnostic investigation supplied evidence of multiple thromboembolic events and concomitant compartment syndrome. Administration of Enoxaparin was stopped immediately and treatment with Argatroban was initiated. Diagnosis of HIT was confirmed according to current guidelines. Despite interventional thrombectomy and fasciotomy, amputation of both lower limbs had to be performed due to ongoing necroses. After a 30-days-stay at the intensive care unit because of sepsis, respiratory and renal failure, clinical condition improved and the patient could be transferred for rehabilitation.
Discussion and evaluation:
HIT II is known as complication of administration of LMWH in the perioperative setting. Diagnosis results from clinical findings and platelet count. Argatroban is recommended as an alternative therapeutic anticoagulant in HIT II. Inflammation and surgical trauma are discussed as priming factors to increase risk of HIT II.
Conclusions:
Administration of LMWH may result in HIT II despite prior uneventful drug exposure. Except for immediate diagnosis, only consequent anticoagulation can stop the course of disease. Hence, interdisciplinary awareness is inevitable for early diagnosis and accurate therapy to prevent from a catastrophic clinical course.
Bilateral adrenal incidentalomas: a case report and review of diagnostic challenges
Authors: Anders L Carlson, Annis M Marney, Scott R Anderson, Matthew P Gilbert
Journal: Case Rep Endocrinol (2013)

Incidentally discovered adrenal masses (incidentalomas) are common and present challenges both in diagnosis and management. When incidentally discovered adrenal masses are bilateral, a refined diagnostic approach is warranted since bilateral disease is more likely to be pathologic. We review a case of a 34-year-old man with incidentally discovered bilateral adrenal nodules. A comprehensive diagnostic strategy led to the diagnosis of bilateral pheochromocytoma caused by von Hippel-Lindau syndrome. He was successfully treated with bilateral laparoscopic adrenalectomy and has recovered well. While the initial diagnostic approach is similar to the unilateral incidentaloma, additional testing and/or genetic testing should be considered in the case of the bilateral adrenal mass.
A case of pacemaker implantation in the patient with duplication of the left innominate vein: a case report
Authors: Iwanari Kawamura, Rintaro Hojo, Seiji Fukamizu
Journal: Springerplus (2016)
Keywords: duplication of the left innominate vein, pacemaker, retroaortic innominate vein

Introduction:
Duplication of the left innominate vein is a rare systemic venous anomaly defined as the coexistence of a retroaortic innominate vein and a normally positioned left innominate vein. We describe a successful case of pacemaker implantation in a patient with duplication of the left innominate vein via a retroaortic innominate vein.
Case description:
A 70-year-old mentally challenged man was admitted to our hospital because of bradycardia and an altered state of consciousness. Electrocardiogram indicated sinus arrest and junctional escape rhythm with a heart rate of 40 beats/min; hence, a pacemaker was implanted. Left subclavian venography showed two vessels that were connected to the superior vena cava: a narrow, normal positioned left innominate vein and a tortuous vein. The normally positioned left innominate vein was too narrow to pass through with a guide wire. Therefore, we chose the tortuous vein for implantation. However, the procedure was difficult because of the vein's tortuosity. Finally, leads at the right atrium and ventricle were successfully implanted using a steerable stylet. After the procedure, computed tomography showed two innominate veins: a retroaortic innominate vein and narrow left innominate vein that was a duplication of the left innominate vein.
Discussion and evaluation:
The exact embryogenesis of retroaortic innominate vein remains unknown and incidence of retroaortic innominate vein is very rare. But for cardiologists performing transvenous pacemaker insertion, the anomalous brachiocephalic vein may cause technical difficulty during a left arm approach.
Conclusions:
In cases in which subclavian venography shows a tortuous vein, cardiologists should consider the presence of a retroaortic innominate vein.