OpenMed/multicare-articles huggingface dataset:
Pulmonary arterial hypertension post COVID-19: A sequala of SARS-CoV-2 infection?
Authors: Abdul Wali Khan, Irfan Ullah, Kiran Shafiq Khan, Muhammad Junaid Tahir, Sri Masyeni, Harapan Harapan
Journal: Respir Med Case Rep (2021)
Keywords: covid-19, complication, pah, pulmonary arterial hypertension, sequala
MeSH terms: Case Reports

It has been suggested that pulmonary arterial hypertension (PAH) could be a potential sequela of coronavirus disease 2019 (COVID-19) in particular in those with hypertension; however, development of PAH after the course of COVID-19 in normotensive individuals are rarely reported. Here, we report a patient who developed PAH two months post-COVID-19. The patient was a 55-year-old female and normotensive, tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), developed mild respiratory distress syndrome and necessitated continuous positive airway pressure during the treatment in the hospital. After two months discharged from the hospital with RT-PCR negative for SARS-CoV-2, the patient presented with exertional dyspnea, dry cough, fatigue and episodes of syncope during exertion. Based on clinical presentation, electrocardiography, computed tomography, and transthoracic echocardiography assessment, PAH diagnosis was made. To our knowledge, this is a rare PAH case and this highlights the possible of PAH as sequala that might present in post COVID-19 patients.
Colloid Carcinoma of the Pancreas: Case Report and Review of the Literature
Authors: Sonia T Orcutt, Domenico Coppola, Pamela J Hodul
Journal: Case Rep Pancreat Cancer (2016)
Keywords: ipmn, colloid carcinomas, pancreatic cancer
MeSH terms: Case Reports

Background: Colloid carcinoma of the pancreas is a rare type of pancreatic cancer that has a more indolent course and superior long-term survival compared to ductal adenocarcinoma. There is a dearth of literature describing this diagnosis due to its rarity and its only recent recognition as a distinct clinical entity. We present two cases of patients with colloid carcinoma and discuss the presentation and management of this disease. Case Presentation: A 58-year-old man with repeated bouts of pancreatitis and a 72-year-old woman with symptoms of pancreatic exocrine and endocrine insufficiency were both found to have cystic masses in the head of the pancreas. Both were identified as having at least mixed main duct/side branch intraductal papillary mucinous neoplasms (IPMNs) on appropriate workup with additional imaging and endoscopy. Pancreaticoduodenectomy was recommended. Both patients, however, were noted to have high-grade dysplasia at the resection margin intraoperatively on frozen section, and thus, total pancreatectomies were performed. Final pathology in each case demonstrated colloid carcinoma with no nodal spread of disease. The patients recovered well. Adjuvant chemotherapy was recommended. Conclusion: Colloid carcinoma of the pancreas is a rare pathologic diagnosis and is frequently associated with IPMN. Colloid carcinomas tend to present at earlier stages than do ductal adenocarcinomas and are known to have improved long-term survival. Surgical and systemic options for treatment parallel that of ductal adenocarcinoma due to the rarity of the diagnosis and the lack of trials assessing therapy for this specific diagnosis.
Persistent Atraumatic Knee Pain in a Teenage Female with Bony Protuberance Secondary to Hook-Shaped Osteochrondroma
Authors: Adityanarayan Rao, Joshua Pryor, Jaclyn Otero, Molly Posa
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

A 13-year-old female presented at her pediatrician's office with a complaint of sharp, intermittent, right-sided knee pain that had been present for the previous three days without any known trauma and no association with activity. Her medical history was significant for fractures, and on physical exam, there was a hard mass palpated on the medial aspect of her distal thigh that was nontender, nonmobile, and without overlying skin changes. The plain radiograph findings were consistent with a hook-shaped osteochondroma of the right medial distal metaphysis. Orthopedics recommended conservative management with continued ibuprofen for pain and six-week follow-up with repeat radiograph to evaluate for progression. The follow-up radiograph showed no interval growth. However, due to continued pain, the patient had surgical excision of the osteochondroma six months after initial presentation, allowing her to finish her current soccer season. The surgery was successful, and the patient did well after operation with no residual pain.
Bariatric surgery in a patient with cystinuria
Authors: Melissa R Nemati, Peter C Harris, Andrea G Cogal, David S Goldfarb
Journal: Clin Nephrol Case Stud (2021)
Keywords: autosomal recessive, bariatric surgery, cystinuria, gastric sleeve, genetic disease, kidney calculi, kidney/abnormalities, nephrocalcinosis
MeSH terms: Case Reports

We recently encountered concern about the safety of bariatric surgery for a patient with cystinuria. Bariatric surgery procedures include those that cause malabsorption, like the Roux-en-Y gastric bypass procedure, and restrictive operations, such as the sleeve gastrectomy. These procedures produce beneficial effects on health and life expectancy, though whether kidney stones are prevented, as well as promoted, is not established. Although the importance of body weight to metabolic stone activity in patients with cystinuria is not established, the patient's physicians were concerned about whether any bariatric surgery procedure would affect her ability to drink sufficient quantities of water in order to reduce stone activity. Here we report the experience of a genetically defined patient with cystinuria who underwent a gastric sleeve procedure. In the months after the procedure, she lost 45 kg, though with time she regained 23 kg of that loss. She was able to maintain a urine volume of 4.0 L per day and has had no stone recurrence.
Combining market and nonmarket food sources provides rural households with more options to achieve better diets in Southern Benin
Authors: Mauricio R Bellon, Gervais Ntandou-Bouzitou, Janet E Lauderdale, Francesco Caracciolo
Journal: Food Secur (2023)
Keywords: benin, dietary diversity, market participation, production diversity, west africa

This study examines the relative contributions to dietary diversity of the diversity of plant and domesticated animal species which rural households produce or collect, i.e., nonmarket food sources, versus the diversity of foods purchased in markets. Although opinions differ in the literature as to their relative importance, clarifying how different sources of food contribute to the dietary diversity of rural households in the developing world is important to inform policies and interventions to improve their food security and dietary quality. This case study was carried out among a random sample of 654 rural households in southern Benin during two seasons: when food is plentiful after harvest; and when food is scarcer between harvests. We collected data on crops, wild plants, and domesticated animals utilized by households, the number of markets they visited, and the diet of a mother in the household, with a structured 24-hour food frequency questionnaire. We hypothesize that the number of markets visited is an indicator of the diversity of foods available in the markets they have access to, and thus shows the contribution of markets as food sources. Results support this hypothesis and show that households that produced more plant and domesticated animal species and those that visited more markets had more diversified diets. Obtaining diverse foods from multiple sources provides households with more options to achieve better diets. These results suggest a need for a more holistic approach that recognizes the complementarities between market and nonmarket sources of foods. This approach should build on the diversity of species rural households already utilize, and on the ways they interact with markets.
Supplementary information:
The online version contains supplementary material available at 10.1007/s12571-022-01320-w.
Case report: Three-dimensional printing as an educational tool for optimal lead positioning to left bundle branch pacing
Authors: Hui-Qiang Wei, Yumei Xue, Shulin Wu, Xianhong Fang
Journal: Front Cardiovasc Med (2022)
Keywords: 3-dimensional printing, interventricular septum, left bundle branch area, pacing lead, physiological pacing
MeSH terms: Case Reports

Left bundle branch pacing (LBBP) has been widely adopted as a physiological pacing approach. However, LBBP fails to achieve in some cases because it is difficult to maintain the orientation of the lead tip perpendicular to the interventricular septum (IVS). Three-dimensional (3D) printing technology has emerged as a promising tool for modeling and teaching cardiovascular interventions. Seeking confirmation of optimal lead placement relative to the IVS, we used 3D printing technology to generate a 3D printed heart from a selected patient with successful and proven LBBP. Our model successfully illustrated that the lead tip was perpendicular to the IVS. Application of the 3D technology has potential to help the early-operator understand the optimal lead placement relative to IVS and diminish the learning-curve.
Successful Renal Transplantation between Identical Twins with Very Brief Immunosuppression
Authors: Idris Yakubu, Abdolreza Haririan, Stephen Bartlett, Tracy Sparkes
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

Renal transplantation between monozygous identical twins provides an opportunity to utilize minimal immunosuppression to maintain stable allograft function, thereby alleviating the toxicities of immunosuppressive therapy. Despite monozygosity, there is a possibility of discordant protein presentation in identical twins that could trigger alloimmune response and lead to graft injury. Therefore, the optimal immunosuppression regimen in this patient population is unknown, and the safety of immunosuppression withdrawal remains controversial. Herein, we describe two patients who underwent successful renal transplantation from monozygotic identical twin donors. Monozygosity was determined using short tandem repeat (STR) analysis. All immunosuppression was successfully discontinued at 2 days and 3 weeks, respectively, after transplantation. Both patients are alive with functioning renal grafts at 1 year and 5 years after transplant, respectively. These two cases suggest that immunosuppression can be withdrawn safely and rapidly in select monozygous identical twin renal transplant recipients.
Intracranial Migration of Hardware 16 Years Following Craniosynostosis Repair
Authors: Haripriya S Ayyala, Ian C Hoppe, Allison M Rathmann, Frank S Ciminello
Journal: Eplasty (2018)
Keywords: craniosynostosis, hardware, surgical complication, transcranial migration
MeSH terms: Case Reports

Introduction: The techniques used to fixate osteotomized segments of bone have evolved alongside the treatment of craniosynostosis. The use of nonresorbable metal plates and screws offered a method of rigidly stabilizing repositioned segments of bone. Several reports specify the tendency for these fixation systems to "migrate" transcranially. Methods: We present a unique case of a patient who initially underwent treatment of multisuture craniosynostosis utilizing titanium miniplates at 6 months of age. At 16 years of age, the patient was returned to the operating room with complaints of pain and contour irregularities, and intracranial migration of the screws and plates was observed. Results: The hardware was extracted and the cranium reconstructed. Symptoms resolved and bony contour was improved. Conclusion: The craniofacial surgeon considering metal plate fixation in the pediatric population should be aware of the possibility for transcranial plate and screw migration.
Pediatric Ovarian Growing Teratoma Syndrome
Authors: Rebecca M Rentea, Aaron Varghese, Atif Ahmed, Alexander Kats, Michelle Manalang, Tazim Dowlut-McElroy, Richard J Hendrickson
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Ovarian immature teratoma is a germ cell tumor that comprises less than 1% of ovarian cancers and is treated with surgical debulking and chemotherapy depending on stage. Growing teratoma syndrome (GTS) is the phenomenon of the growth of mature teratoma elements with normal tumor markers during or following chemotherapy for treatment of a malignant germ cell tumor. These tumors are associated with significant morbidity and mortality due to invasive and compressive growth as well as potential for malignant transformation. Current treatment modality is surgical resection. We discuss a 12-year-old female who presented following resection of a pure ovarian immature teratoma (grade 3, FIGO stage IIIC). Following chemotherapy and resection of a pelvic/liver recurrence demonstrating mature teratoma, she underwent molecular genetics based chemotherapeutic treatment. No standardized management protocol has been established for the treatment of GTS. The effect of chemotherapeutic agents for decreasing the volume of and prevention of expansion is unknown. We review in detail the history, diagnostic algorithm, and previous reported pediatric cases as well as treatment options for pediatric patients with GTS.
Use of Diagnostic Laparoscopy for Identification of Bilateral Noncommunicating Hydroceles in an Infant with Right-Sided Abdominoscrotal Mass and Left-Sided Scrotal Mass
Authors: Kian Asanad, Pooya Banapour, Monica Metzdorf
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

Infantile abdominoscrotal hydrocele (ASH) is a rare condition characterized by a dumbbell-shaped cystic mass extending from the scrotum to the abdomen. We present the case of a 4-month-old infant who presented with progressively enlarging bilateral scrotal swelling and a tense, ballotable right-sided abdominal mass with extension into the scrotum. Scrotal ultrasound revealed bilateral hydroceles but exam and ultrasound could not rule out communication. At the time of planned hydrocelectomy, initial diagnostic laparoscopy was used to identify a massive right-sided ASH extending from the internal ring to the umbilicus and a large noncommunicating left-sided hydrocele that was visible with application of pressure to the left side of the scrotum. Following confirmation of anatomy with diagnostic laparoscopy, a scrotal approach to hydrocelectomy was performed as well as bilateral orchidopexy.
Case report: desensitization of hypersensitivity against the antisense oligonucleotide volanesorsen
Authors: Rafael H Isaac, Deyanira Gonzalez-Devia, Carlos O Mendivil, Edgardo Chapman
Journal: Front Allergy (2023)
Keywords: adverse reactions, familial chylomicronemia syndrome, pancreatitis, triglycerides, urticaria, volanesorsen
MeSH terms: Case Reports

Familial chylomicronemia syndrome (FCS) is a rare autosomal recessive metabolic disorder that causes extremely elevated plasma triglyceride levels, with limited therapeutic options. Volanesorsen is an antisense oligonucleotide approved for its treatment. A 24-year-old woman with genetically diagnosed FCS secondary to a pathogenic variant in APOA5 and a history of recurrent hypertriglyceridemia-induced pancreatitis episodes was being treated with volanesorsen, 285 mg every 2 weeks. Treatment with volanesorsen achieved normalization of triglycerides to <200 mg/dl. However, after the fifth dose of the medication, the patient developed urticaria and volanesorsen was discontinued. In the absence of alternative pharmacological treatments, the patient received a novel desensitization protocol for volanesorsen that allowed continuation of therapy, without evidence of hypersensitivity reactions after subsequent administrations. FCS requires aggressive multimodal therapy and close follow-up. Volanesorsen has shown great efficacy, but a significant rate of discontinuation due to side effects has been observed. Here, the patient presented an immediate hypersensitivity reaction to volanesorsen, but the provision of a desensitization protocol was effective, facilitating continued treatment and impacting the survival and quality of life of the patient.
A Case of an Incidentally Removed Lingual Osseous Choristoma
Authors: Tomotaka Hemmi, Jun Suzuki, Satoko Sato, Masumi Tabata, Kojiro Watanabe, Mitsuru Sugawara, Yukio Katori
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

Lingual osseous choristoma is a rare benign tumor consisting of normal matured bone tissue. It was first reported in 1913, and less than 100 cases of lingual osseous choristomas, mainly in their twenties and thirties, have been reported in the English literature until now. Here, we report an additional case of lingual osseous choristoma, in an elderly patient, that was incidentally removed by coughing and cured without additional interventions. An 89-year-old male patient was referred to our department for an evaluation of chronic cough. When we examined his oral cavity and pharynx, he expectorated a 10 -mm mass which was histologically diagnosed as an osseous choristoma. We confirmed the well-defined, rounded, high-density mass with a tiny pedicle on the base of the tongue in previous cervical spine CT images. No signs of recurrence were found during the 15-month follow-up examination. Our case serves as a reminder of this rare entity in the diagnosis of tongue masses of the elderly.
Drug-induced lung disease adverse effect with Ledipasvir Acetonate/Sofosbuvir
Authors: Sachiko Omotani, Toshihiko Ishizaka, Miki Inoue, Koji Nishida, Yukako Yasui, Yasutoshi Hatsuda, Junji Mukai, Michiaki Myotoku
Journal: J Pharm Health Care Sci (2020)
Keywords: chronic hepatitis c, direct acting antivirals (daas), drug-induced lung disease, interstitial lung disease
MeSH terms: Case Reports

Background:
Interferon and ribavirin have been used as therapeutic agents for chronic hepatitis C infection or C-compensated cirrhosis in the conventional treatment. Hepatitis C virus (HCV) -specific direct-acting antiviral agents that directly inhibit the growth process of HCV have been approved since 2011. However, in the early post-marketing vigilance phase of ledipasvir acetonate/sofosbuvir (LDV/SOF), there were reports of interstitial lung disease in 4 out of 32,700 cases with death in 1 case; the onset mechanism is unknown.
Case presentation:
Treatment for hepatitis C was deemed to be necessary, and the patient was referred to our hospital. Oral administration of LDV/SOF was started. On day 8 of administration, a fever of 38-39 °C and coughing were observed followed by the gradual appearance of shortness of breath. As there was no improvement, the patient visited her primary care physician on day 16 of administration and the patient was brought urgently to our hospital on the same day. Blood tests and imaging tests were conducted at our hospital on the day of emergency transport; inflammatory response markers showed abnormal values, and sialylated carbohydrate antigen Krebs von den Lungen-6 was within the normal value range at 303 U/mL. Because the possibility of infection was low based on results of imaging and bronchoalveolar lavage, drug-induced lung disease was suspected, LDV/SOF administration was discontinued, and steroid administration was started. Following steroid pulse therapy, treatment with oral prednisolone tablets was gradually tapered. The patient's symptoms were relieved and she was discharged.
Conclusions:
The patient's medication history in this case indicated that there were no drugs taken before or after administration of LDV/SOF until the adverse reaction occurred, and there were no supplements or dietary supplements taken. Therefore, LDV/SOF has been proposed as the cause of the suspected adverse effect. Pharmacists should try to collect adverse effect reports to identify adverse effects early.
A Case of Cephalic Tetanus in an Elderly Patient with Trismus
Authors: Marilia Bernardes, Saberio Lo Presti, Kenneth Ratzan
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

We report a case of a 77-year-old woman who presented to the Emergency Room with a three-day history of oral lesions and jaw tightness. Her physical examination was remarkable for the presence of trismus and white ulcers on the visible portion of the tongue. CT head and neck was unremarkable, and she was discharged with empiric treatment for oral candidiasis. She returned two days later with worsening symptoms and subsequently developed tonic-clonic seizures. MRI of the brain and temporomandibular joints were noncontributory. Psychiatry was consulted, and the patient was prescribed olanzapine and mirtazapine for suspected depression with somatization symptoms. She continued to deteriorate despite therapy and developed right lid ptosis and ophthalmoparesis, which led to a presumptive diagnosis of cephalic tetanus. On the 14th day of illness, tetanus immune globulin, metronidazole, and tetanus toxoid vaccine were administered. Despite treatment, the patient died after 24 days of hospitalization. This case illustrates the importance of early recognition of tetanus since successful treatment depends on timely administration of immune globulin.
Raised intraocular pressure as a potential risk factor for visual loss in Leber Hereditary Optic Neuropathy
Authors: Anais Thouin, Philip G Griffiths, Gavin Hudson, Patrick F Chinnery, Patrick Yu-Wai-Man
Journal: PLoS One (2013)
MeSH terms: Blindness / complications, Blindness / physiopathology, Intraocular Pressure / physiology, Optic Atrophy, Hereditary, Leber / complications, Optic Atrophy, Hereditary, Leber / physiopathology, Research Support, Non-U.S. Gov't, Aged, Humans, Male, Middle Aged, Optic Disk / pathology, Optic Disk / physiopathology, Risk Factors, Visual Fields / physiology

Leber Hereditary Optic Neuropathy (LHON) is an important cause of inherited mitochondrial blindness among young adults. The majority of patients carry one of three mitochondrial DNA (mtDNA) point mutations: m.3460G>A, m.11778G>A and m.14484T>C, all of which affect critical complex I subunits of the mitochondrial respiratory chain. LHON is characterised by marked incomplete penetrance, clearly implying that the mtDNA mutation is insufficient on its own to trigger retinal ganglion cell dysfunction and visual loss. In this case series of three affected patients harbouring the m.11778G>A mutation, we provide evidence suggesting that raised intraocular pressure could be a risk factor triggering visual loss in at-risk LHON carriers.
Systemic Lupus Erythematosus with Multiple Autoimmune Disease Presented with Extensive Peripheral Gangrene
Authors: Tareq Z Alzughayyar, Jihad Samer Zalloum, Mohammad N Elqadi, Sadi A Abukhalaf, Fawzy M Abunejma, Mohammed M Y Alkhanafsa, Motasem H M Haif, Firas Alqarajeh, Mo'min R Mesk, Rami A Misk
Journal: Case Rep Rheumatol (2020)
MeSH terms: Case Reports

Systemic lupus erythematosus (SLE) is an autoimmune disease and can be associated with other autoimmune diseases. SLE usually presents with skin change and rarely presents with gangrene. SLE gangrene usually involves the digits of upper extremities. We report the first case of SLE associated with an extremely rare constellation of neuromyelitis Optica (NMO) and diabetes mellitus type 1, presented with a rare form of the SLE gangrene which involves bilateral lower extremities up to midlegs, a case that has not yet been reported in the literature. Although SLE gangrene may respond to immunosuppressants, it has a high risk of complications that can end up with amputations.