OpenMed/multicare-articles huggingface dataset:
Muscle Coactivation during Stability Exercises in Rhythmic Gymnastics: A Two-Case Study
Authors: Alicja Rutkowska-Kucharska, Agnieszka Szpala, Sebastian Jaroszczuk, Małgorzata Sobera
Journal: Appl Bionics Biomech (2018)

Balance exercises in rhythmic gymnastics are performed on tiptoes, which causes overload of foot joints. This study aimed to evaluate the engagement of muscles stabilizing ankle and knee joints in balance exercises and determine exercises which may lead to ankle and knee joint injuries. It was hypothesized that long-term training has an influence on balance control and efficient use of muscles in their stabilizing function. Two rhythmic gymnasts (8 and 21 years old) performed balances on tiptoes (side split with hand support, ring with hand support) and on a flat foot (back split without hand support exercise). Surface electromyography, ground reaction forces, and kinematic parameters of movement were measured. The measuring systems applied were synchronized with the BTS SMART system. The results show the necessity to limit balance exercises on tiptoes in children because gastrocnemius medialis (GM) and gastrocnemius lateralis (GL) activity significantly exceeds their activity. Ankle joint stabilizing activity of GM and GL muscles in the younger gymnast was more important than in the older one. Performing this exercise, the younger gymnast distributed load on the anterior side of the foot while the older one did so on its posterior. Gymnastics coaches should be advised to exclude ring with hand support exercise from the training of young gymnasts.
Percutaneous snare-retrieval of intracardiac thrombus under fluoroscopic and transesophageal echocardiography guidance: case report and systematic review
Authors: Huaji Zhou, Bing Wang, Jun Pan, Chenyang Qiu, Xinyu Yu, Yangyan He, Qianqian Zhu, Lei Yu, Ziheng Wu, Donglin Li, Hongkun Zhang
Journal: Front Cardiovasc Med (2023)
Keywords: intracardiac foreign body, percutaneous retrieval, snare retrieval, thrombus, transesophageal echocardiography
MeSH terms: Review

Intracardiac foreign bodies (IFB) are rare clinical conditions. There are now several reports on the percutaneous retrieval of IFB under fluoroscopy. However, some IFB are not radiopaque, and retrieval requires combined fluoroscopic and ultrasound guidance. We report the case of a bedridden 23-year-old male patient with T-lymphoblastic lymphoma treated with long-term chemotherapy. Ultrasound examination diagnosed a huge thrombus in the right atrium near the opening of the inferior vena cava which affected the patency of his PICC line. Ten days of anticoagulant therapy did not modify the thrombus size. Open heart surgery was not feasible because of the patient clinical condition. Snare-capture of the non-opaque thrombus was done from the femoral vein under fluoroscopic and ultrasound guidance with excellent outcomes. We also present a systematic review of IFB. We found out that percutaneous removal of IFBs is a safe and effective procedure. The youngest patient who received percutaneous IFB retrieval was 10 days old and weighed only 800 g, while the oldest patient was 70 years old. Port catheters (43.5%) and PICC lines (42.3%) were the most commonly found IFBs. Snare catheters and forceps were the most commonly used instruments.
Case Report: Clinical and Pharmacokinetic Profile of Lithium Monotherapy in Exclusive Breastfeeding. A Follow-Up Case Series
Authors: Maria Luisa Imaz, Dolors Soy, Mercé Torra, Llüisa García-Esteve, Cristina Soler, Rocio Martin-Santos
Journal: Front Pharmacol (2021)
Keywords: bipolar disorder, case report, delivery, exclusive maternal breastfeeding, lactation, lithium, nursing infant, pharmacokinetics
MeSH terms: Case Reports

Background: Most guidelines advise that women taking lithium should not breastfeed. The variation in transfer is just one reason behind this advice. Objectives: To present clinical and pharmacokinetic data of nine mother-infant pairs exposed to lithium monotherapy during late pregnancy and exclusive breastfeeding at the Perinatal Psychiatric Unit (2006-2018). Methods: We obtained sociodemographic data, medical risk factors, obstetric variables, and family and personal psychiatric history by semi-structured interview, and assessed maternal psychopathology with the Hamilton Depression Rating Scale and Young Mania Rating Scale. A senior neonatologist reviewed neonatal outcomes at birth using the Peripartum Events Scale. Paired maternal and cord blood and infant venous blood samples were collected. During the breastfeeding period, we monitored serum lithium and creatinine concentrations in mother-infant pairs at delivery, and at days 1-5, 7-11, 30, and 60 postpartum, and monthly until 6-months. Results: Lithium equilibrated completely across the placenta [1.13 (0.10), range (1.02-1.30)]. No women presented symptoms of postpartum lithium intoxication, two of the neonates presented transient hypotonia (22%). Lithium exposure was significantly less during breastfeeding than during late pregnancy, and serum lithium concentrations decreased up to 44% overtime from delivery to the first-month, and up to 60% to the third-month postpartum. There was no growth or developmental delay in the follow-up period. One woman had a manic episode with psychotic features at 45 days postpartum. Conclusions: In carefully selected women with bipolar disorder, lithium therapy when breastfeeding can be an appropriate option if coupled with close monitoring of the mother-infant pair.
Proximal-type epithelioid sarcoma of the perineum: A case report and literature review
Authors: Shijun Xia, Wenjiang Wu, Lijuan Ma
Journal: Front Oncol (2023)
Keywords: diagnosis, epithelioid sarcoma, perineum, proximal-type, resect
MeSH terms: Case Reports

Proximal-type epithelioid sarcoma of the perineum is a rare soft-tissue malignancy, and only 55 cases have been reported in the English literature to date. This tumor has an indetectable early symptom and frequent recurrences. Here, we present the case of a 31-year-old man with proximal-type epithelioid sarcoma of the perineum who underwent wide excision. Further, we reviewed the current literature regarding differential diagnosis and management of this disease.
Scrotal Lipomatosis Mimicking Varicocele: A Case Report and Review of the Literature
Authors: Sadi Turkan, Mehmet Kalkan, Coşkun Şahin
Journal: Case Rep Urol (2015)

Scrotal lipomatosis is a rarely seen disease with an etiology that is not fully understood. Some information suggests that this disease may be associated with infertility. It is characterized by pain-free scrotal swelling. In this study, we reported a scrotal lipomatosis case presenting due to infertility and pain-free scrotal swelling. It was operated on with the initial diagnosis of varicocele, but once fatty tissue was observed in the scrotum, the case was diagnosed as scrotal lipomatosis. Here, we present this rare case with a literature review.
Postoperative Adjuvant Chemotherapy Regimen of CAPOX Combined With Ninjin'yoeito in an Elderly Patient With Stage III Colon Cancer: A Case Report
Authors: Naoki Aomatsu, Yasutake Uchima, Gen Tsujio, Yoshinari Miyamoto, Takuma Okada, Shigeaki Kurihara, Shinji Matsutani, Toshiki Hirakawa, Takehiko Iwauchi, Junya Morimoto, Shigehito Yamagata, Kazunori Nakazawa, Takafumi Nishii, Akiko Tachimori, Kiyoshi Maeda, Katsumi Ikeda, Kazuhiro Takeuchi
Journal: Front Nutr (2020)
Keywords: capox, adjuvant chemotherapy, colon cancer, kampo medicine, ninjin'yoeito
MeSH terms: Case Reports

We report the successful management of stage III colon cancer in an elderly patient who received an adjuvant chemotherapy regimen of capecitabine plus oxaliplatin (CAPOX) with the Japanese kampo medicine ninjin'yoeito (NYT). A 75-year-old woman with a medical history of hypertension presented at another institution with fecal occult blood, and a colonoscopy that showed a type II tumor in the sigmoid colon. She was referred to our hospital for tumor resection, where colonoscopy confirmed the location of the type II tumor in the sigmoid colon. Histopathology of the biopsy specimen indicated a moderately differentiated tubular adenocarcinoma. Enhanced computed tomography of the thorax and abdomen indicated thickening of the sigmoid colon wall. Regional lymph node metastasis was suspected, but distant metastasis was not indicated. A blood examination revealed an elevated carcinoembryonic antigen (CEA) concentration (32.7 ng/ml). Following a diagnosis of cancer of the sigmoid colon, clinical stage IIIb [cT4a, N1b, M0], a laparoscopic sigmoid colectomy was performed without complications. The postoperative histopathological examination revealed a moderately differentiated to mucinous adenocarcinoma. Three of 16 retrieved lymph nodes contained malignant cells. The final tumor classification was Stage IIIb [pT4a, pN1b, M0]. The patient recovered uneventfully, and was discharged 10 days after surgery with a recommendation for adjuvant chemotherapy with CAPOX starting 4 weeks after surgery. The patient also received 7.5 g of NYT daily throughout the adjuvant chemotherapy course. She did not report any loss of appetite, general fatigue, peripheral neuropathy, neutropenia, or febrile neutropenia. During a 1-year postoperative follow-up, she has not experienced any recurrence. We conclude that NYT might be useful for reducing the adverse effects of anticancer therapy, particularly in elderly patients.
Peeled Guidewire Coating with Debulked Plaque Obtained by Directional Coronary Atherectomy
Authors: Rikuta Hamaya, Taishi Yonetsu, Sadamitsu Ichijo, Makoto Araki, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Junji Matsuda, Masahiro Hoshino, Masahiro Hada, Takayuki Niida, Yoshinori Kanno, Tsunekazu Kakuta
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Percutaneous directional coronary atherectomy (DCA) is a plaque debulking method performed in Japan, and recently a renewed DCA device has been launched. We present a case with a tight left anterior descending lesion undergoing percutaneous coronary intervention with application of DCA. After several sessions of DCA, white plaques accompanied by green, stringed materials were obtained from the device; some materials were considerably long (approximately 15 mm in length). A drug-eluting stent was subsequently implanted, and the procedure was completed successfully without any complications. The extracted plaques and artificial materials were pathologically examined, and no inflammatory changes were detected on plaques adjacent to the material. Assessing pathological findings and structure of the DCA catheter, the obtained artificial materials were considered as peeled guidewire, possibly resulting from the friction between the guidewire and metallic bearing in the housing of DCA catheter. Of note, this phenomenon has been recognized even in other DCA cases in which guidewires of the other kind are used. We report this phenomenon for the first time, warning of theoretically possible distal embolization of artificial materials caused by any debulking devices.
Celiac Axis Resection with Distal Pancreatectomy (Modified Appleby Procedure) Allows for R0 Resection of Pancreatic Body and Tail Mass Following Neoadjuvant Therapy: Case Report and Literature Review
Authors: Mackenzie Morris, Thea Price, Zachary Callahan, Charles J Yeo
Journal: Case Rep Pancreat Cancer (2016)
Keywords: celiac axis resection, chemotherapy, distal pancreatectomy, pancreatic cancer
MeSH terms: Case Reports

Background: The modified Appleby procedure has been developed for cancer of the pancreatic body or tail with celiac axis invasion, historically classified as unresectable disease. Post-Appleby resection, the source of arterial blood to the liver is the superior mesenteric artery, which supplies the gastroduodenal artery and ultimately feeds the proper hepatic artery. In cases of inadequate collateralization, preoperative coiling of the common hepatic artery (CHA) or intraoperative reconstruction via an aorto-hepatic bypass has been described. Method: We describe a 74-year-old female with a pancreatic mass that was initially determined to be unresectable. She underwent extensive combination neoadjuvant chemotherapy. A favorable response was evidenced by a decrease in serum CA 19-9 levels. After 7 months, she was restaged and offered a distal pancreatectomy (DP) with the possibility of a modified Appleby procedure due to potential tumor involvement of the proximal CHA. Results: Intraoperatively, tumor was identified along the CHA traveling proximally to the celiac axis. Therefore, a modified Appleby procedure with DP and splenectomy was performed without the need for reconstruction of the CHA. Postoperative specimen pathology showed residual pancreatic ductal adenocarcinoma with marked treatment effects. The pathology confirmed an R0 resection. The patient followed our postpancreatic surgery care pathway. She remains well 7 months postoperatively. Conclusion: A pancreatic body or tail mass encasing the celiac vessels should not be an immediate referral for palliative care. Recent evidence shows that successful R0 resection can be achieved following neoadjuvant therapy. In fact, patients who have undergone a successful modified Appleby procedure show survival outcomes similar to patients with less advanced cancer who underwent standard DP. The modified Appleby procedure used in conjunction with neoadjuvant therapy can achieve complete resection in select patients previously thought to be unresectable.
A Rare Paraneoplastic Syndrome of Lung Cancer
Authors: R Azzeddine, L Herrak, A Rhanim, A Jniene, M Elftouh, L Achachi
Journal: Case Rep Pulmonol (2020)
MeSH terms: Case Reports

Achalasia is a neurodegenerative motor disease of the esophagus resulting mainly from a loss of function of the lower esophageal sphincter, the pathophysiology of which is still poorly understood. Its incidence is rare-it is 1.6 per 100,000-and its occurrence in the context of paraneoplastic syndrome has been rarely described in the literature. We report a rare case of paraneoplastic achalasia associated with lung cancer.
Health in conflict and post-conflict settings: reproductive, maternal and child health in Colombia
Authors: Sara Milena Ramos Jaraba, Natalia Quiceno Toro, María Ochoa Sierra, Laura Ruiz Sánchez, Marlly Andrea García Jiménez, Mary Y Salazar-Barrientos, Edison Bedoya Bedoya, Gladis Adriana Vélez Álvarez, Ana Langer, Jewel Gausman, Isabel C Garcés-Palacio
Journal: Confl Health (2020)

Background:
In conflict-afflicted areas, pregnant women and newborns often have higher rates of adverse health outcomes.
Objective:
To describe maternal and child health indicators and interventions between 1998 and 2016 comparing high and low conflict areas in Colombia.
Methods:
Mixed study of convergent triangulation. In the quantitative component, 16 indicators were calculated using official, secondary data sources. The victimization rate resulting from armed conflict was calculated by municipality and grouped into quintiles. In the qualitative component, a comparative case study was carried out in two municipalities of Antioquia: one with high rates of armed conflict and another with low rates. A total of 41 interviews and 8 focus groups were held with local and national government officials, health professionals, community informants, UN agencies and NGOs.
Results:
All of the indicators show improvement, however, four show statistically significant differences between municipalities with high victimization rates versus low ones. The maternal mortality ratio was higher in the municipalities with greater victimization in the periods 1998-2004, 2005-2011 and 2012-2016. The percentage of cesarean births and women who received four or more antenatal visits was lower among women who experienced the highest levels of victimization for the period 1998-2000, while the fertility rate for women between 15 and 19 years was higher in these municipalities between 2012 and 2016. In the context of the armed conflict in Colombia, maternal and child health was affected by the limited availability of interventions given the lack of human resources in health, supplies, geographical access difficulties and insecurity. The national government was the one that mostly provided the programs, with difficulties in continuity and quality. UN Agencies and NGOs accessed more easily remote and intense armed conflict areas. Few specific health interventions were identified in the post-conflict context.
Conclusions:
In Colombia, maternal and child health indicators have improved since the conflict, however a pattern of inequality is observed in the municipalities most affected by the armed conflict.
Combination of Anti-EGFR and Anti-VEGF Drugs for the Treatment of Previously Treated Metastatic Colorectal Cancer: A Case Report and Literature Review
Authors: Yong Li, Xian Chen, Wenzhu Li, Yongsong Ye, Xiaohua Du, Shaodan Sun, Lirong Liu, Haibo Zhang
Journal: Front Oncol (2021)
Keywords: cetuximab, chemotherapy, fruquintinib, metastatic colorectal cancer, resistance
MeSH terms: Review

The standard third-line treatment of metastatic colorectal cancer (mCRC) includes the small-molecule anti-vascular drugs (Regofenib and Fruquintinib) and the chemotherapy drug trifluridine and tipiracil hydrochloride (TAS-102). There is no standard treatment for mCRC if the third-line treatment failed. Therefore, it is a pressing need to develop new therapeutic approaches to improve the survival of patients who developed drug resistance to the third-line treatment. In this study, we report a case of mCRC with RAS/BRAF wild-type, who was successfully treated using cetuximab in combination with fruquintinib after resistance to chemotherapy, bevacizumab, cetuximab and regorafenib. This patient responded to this combination regimen. Then, we discuss the mechanisms of action of this combination. Furthermore, we introduce the clinical trials on the combination regimens of anti-EGFR with anti-vascular monoclonal antibodies. Finally, we discuss the clinical explorations of using combination of anti-EGFR with small-molecule anti-VEGF drugs and their potential benefits. The clinical effects of small-molecule anti-vascular drugs in combination with anti-EGFR in the treatment of CRC warrant further explored.
Pneumocystis Pneumonia in Non-HIV Pregnant Women Receiving Chemotherapy for Malignant Lymphoma: Two Case Reports
Authors: Yuki Fukutani, Yoshitsugu Chigusa, Eiji Kondoh, Kaoru Kawasaki, Shingo Io, Noriomi Matsumura
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Pneumocystis pneumonia (PCP) is a life-threatening opportunistic infection that sometimes occurs in immunocompromised patients with human immunodeficiency virus (HIV). Here, we report two extremely rare cases of PCP in non-HIV pregnant women who underwent chemotherapy for malignant lymphoma. Case 1 is a 34-year-old primigravida who was diagnosed with Hodgkin's lymphoma. She received ABVD chemotherapy and developed PCP at 37 weeks of gestation. After the onset of PCP, emergent cesarean section was performed due to a nonreassuring fetal status. Case 2 is a 31-year-old multigravida with diffuse large B-cell lymphoma who was administered R-CHOP chemotherapy. At 34 weeks of gestation, she complained of dyspnea and developed PCP. She delivered her baby vaginally immediately after the onset of symptoms. Both patients were treated with sulfamethoxazole-trimethoprim (ST) and recovered shortly thereafter. The babies' courses were also uneventful. PCP remains a serious cause of death, especially in non-HIV patients, and, therefore, appropriate prophylaxis and a prompt diagnosis are imperative.
A Rare Case of Intermittent Claudication Associated with Impaired Arterial Vasodilation
Authors: J J Posthuma, K D Reesink, M Schütten, C Ghossein, M E Spaanderman, H Ten Cate, G Schep
Journal: Case Rep Vasc Med (2017)
MeSH terms: Case Reports

Exercise-related intermittent claudication is marked by reduced blood flow to extremities caused by either stenosis or impaired vascular function. Although intermittent claudication is common in the elderly, it rarely occurs in the young and middle-aged individuals. Here, we report a case of exercise-related claudication in a 41-year-old woman, in the absence of overt vascular pathology. Using a series of imaging and functional tests, we established that her complaints were due to impaired arterial vasodilation, possibly due to a defect in nitrous oxide-mediated dilation. The symptoms were reversible upon administration of a calcium antagonist, showing reversibility of the vascular impairment. Identification of reversible vascular "stiffness" merits consideration in young and otherwise healthy subjects with claudication of unknown origin.
Aldosterone-producing adrenocortical carcinoma with prominent hepatic metastasis diagnosed by liver biopsy: a case report
Authors: Kennosuke Ohashi, Takeshi Hayashi, Masaya Sakamoto, Hiroyuki Iuchi, Hirofumi Suzuki, Takanori Ebisawa, Katsuyoshi Tojo, Hironobu Sasano, Kazunori Utsunomiya
Journal: BMC Endocr Disord (2016)
MeSH terms: Adrenal Cortex Neoplasms / pathology, Adrenocortical Carcinoma / pathology, Aldosterone / metabolism, Liver / pathology, Liver Neoplasms / secondary, Case Reports, Adrenal Cortex Neoplasms / metabolism, Adrenocortical Carcinoma / metabolism, Aged, Biopsy, Female, Humans, Tumor Burden, Aldosterone

Background:
Aldosterone-producing adrenocortical carcinoma is a rare malignancy, which is usually diagnosed by histopathological examination of the excised tumor. In inoperable cases, aldosterone-producing ACC diagnosed by immunohistochemical staining of the metastatic tumor for Cytochrome P450 (CYP) 11β has not previously been reported and even in that case staining for adrenocortical-specific adrenal 4 binding protein/steroidogenic factor1 (Ad4BP/SF1) and steroidogenic enzymes has not been reported.
Case presentation:
We report the case of a 67-year-old Japanese woman with aldosterone-producing adrenocortical carcinoma. Laboratory findings showed severe hypopotassemia. Endocrinological examination revealed an increased plasma aldosterone concentration and suppressed plasma renin activity. Plasma dehydroepiandrosterone sulfate (DHEA-S) was elevated. Diurnal variation in serum cortisol was lost and administration of 1 mg and 8 mg dexamethasone did not suppress serum cortisol levels. From the 24-h urine collection sample, urine aldosterone and urine cortisol levels were greatly increased. Therefore, autonomous excess production was observed for the three adrenal cortex hormones. Abdominal computed tomography and magnetic resonance imaging showed a right adrenal tumor and a huge liver tumor. Adrenocortical carcinoma with metastatic liver cancer was strongly suggested, however surgery could not be considered due to stage IV disease: the liver tumor was too large and cardiac ultrasonography indicated that her cardiac function was poor. Therefore, a liver biopsy was taken to properly determine the diagnosis. Immunohistochemical stains for Ad4BP/SF1 and steroidogenic enzymes were positive. Ad4BP/SF-1 was originally identified as a steroidogenic, tissue-specific transcription factor implicated in the expression of the steroidogenic CYP gene encoding cytochrome P450s. Hence we could diagnose the patient as having adrenocortical carcinoma with metastatic liver cancer.
Conclusion:
This rare case had severe hypopotassemia accompanied with not only increased cortisol and DHEA-S but also aldosterone. We reached the diagnosis of adrenocortical carcinoma with metastatic liver cancer based on positive immunohistochemical staining of Ad4BP/SF1 in the liver biopsy specimen. We have reported the first case of aldosterone-producing adrenocortical carcinoma diagnosed solely by immunohistochemical staining for adrenocortical-specific Ad4BP/SF1 and steroidogenic enzymes in a metastatic liver tumor.