OpenMed/multicare-articles huggingface dataset:
Urethral Polyembolokoilamania: An Unusual Manifestation of Behavioral and Psychological Symptoms of Dementia (BPSD)
Authors: Reem M A Shafi, Laura Suarez, Maria I Lapid
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

Behavioral and psychological symptoms of dementia (BPSD) have varied presentations and frequently occur throughout the trajectory of dementia. Hypersexuality and general disinhibition of societal and cultural norms are commonly documented in all types of dementia. However, sparse literature exists on polyembolokoilamania (insertion of foreign objects in bodily orifices) without a sexual component as a dementia-related symptom. We review an unusual case of a 94-year-old man who presented with urethral polyembolokoilamania without hypersexuality or other behavioral disinhibition. We highlight clinical considerations of managing urethral polyembolokoilamania in an elderly patient without a previous neurocognitive disorder diagnosis. A multidisciplinary team approach with input from Internal Medicine, Urology, Psychiatry, and Neurology lead to a comprehensive assessment of a patient that could have been managed solely as a surgical case. This spearheaded a formal diagnosis of neurocognitive disorder-guiding successful management, follow-up, caregiver education, and reduction of further harm.
Anesthetic Management of Laparoscopic Adrenalectomy for a Patient with Concomitant Pheochromocytoma and Bilateral Carotid Artery Stenosis
Authors: Kristina L Michaud, Robert H Thiele, Katherine T Forkin
Journal: Case Rep Anesthesiol (2023)
MeSH terms: Case Reports

Symptomatic carotid stenosis and pheochromocytoma both require timely surgical intervention. Following a transient ischemic attack (TIA), a 46-year-old man was diagnosed with bilateral carotid artery stenosis and scheduled for carotid endarterectomy. He was a poor candidate for minimally invasive options due to prior neck radiation. Simultaneously, he began experiencing difficulty with diabetes management and elevated blood pressures and was ultimately diagnosed with pheochromocytoma. This unique situation required coordination to determine the appropriate timing of the two interventions. This case highlights the importance of communication and coordination amongst medical specialists and consideration for anesthetic management of patients with concomitant pheochromocytoma and carotid stenosis.
Dural and Multiple Brain Metastases From Basaloid Nasopharyngeal Carcinoma: Case Report and Literature Review
Authors: Xiaotao Geng, Furong Hao, Guiyan Han, Yaping Zhang, Peiyan Qin
Journal: Front Oncol (2021)
Keywords: basaloid nasopharyngeal carcinoma, basaloid squamous cell carcinoma, brain metastasis, chemotherapy, dural metastasis, immunotherapy, nasopharyngeal carcinoma, radiotherapy
MeSH terms: Case Reports

Background:
Nasopharyngeal carcinoma is an endemic head and neck cancer in Southern China. The common metastases organs involve bone, lung, and liver. Metastases in the dura and at multiple locations in the brain after a diagnosis of nasopharyngeal carcinoma are extremely rare.
Case presentation:
We present a case of a 66-year-old man who initially complained of nasal congestion, epistaxis, and hearing impairment. The biopsy of the nasopharynx lesion showed basaloid squamous cell carcinoma. Eight months after conventional therapy, the patient was admitted to our hospital again with the complaint of a headache. A PET/CT scan was performed, revealing multiple metastases. A biopsy of subcutaneous soft tissue from the right upper arm was consistent with the previous biopsy. Palliative chemotherapy was administered. Thereafter, the patient had sudden dysfunction of the right side of the body. MRI demonstrated dural and multiple brain metastases. The therapeutic regimen then consisted of whole-brain radiotherapy, anti-angiogenesis therapy, and immunotherapy.
Conclusions:
This case highlights the diagnosis and treatment of uncommon metastases of nasopharyngeal carcinoma. Clinicians should remain vigilant for metastases during the treatment and follow-up periods.
Spontaneous hemispheric ventricular collapse and subarachnoid haemorrhages in a dog with congenital hydrocephalus internus
Authors: Agnieszka Olszewska, Daniela Farke, Martin Jürgen Schmidt
Journal: Ir Vet J (2020)
Keywords: brain herniation, canine, internal hydrocephalus, intracranial bleeding, magnetic resonance imaging
MeSH terms: Case Reports

Background:
Overdrainage and collapse of the hemispheres is a potential severe complication after surgical treatment of internal hydrocephalus using ventriculoperitoneal shunts. Here we describe a case of a spontaneous hemispheric ventricular collapse in an untreated dog with congenital hydrocephalus internus.
Case presentation:
A twelve-week-old, male, intact Golden Retriever was presented with a history of peracute obtundation, impaired vision, and progressive gait abnormalities of all limbs for three days. Neurological examination revealed a dome shaped skull, a broad-based stance and a moderate cerebellar ataxia. The postural responses were markedly delayed in all limbs. Moderate ventro-lateral strabismus, vertical nystagmus and absent menace response were observed bilaterally. Clinical signs indicated multifocal localisation (forebrain, cerebellum). Magnetic resonance imaging (MRI) showed dilation of all cerebral ventricles, irregular thinning of the periventricular white and grey matter, consistent with internal hydrocephalus. In addition, the hemispheres were collapsed at the right temporal and left frontal lobe with haemorrhage filling the adjacent subarachnoid space. The dog underwent left frontal and right temporal craniotomy for removal of the haemorrhage. The dog improved on all neurological signs and was discharged after seven days. A repeat MRI three months postsurgical intervention showed reexpansion of the cerebral hemispheres. Subarachnoid haemorrhages were markedly reduced.
Conclusions:
Collapse of the hemispheres can occur spontaneously in dogs with hydrocephalus internus. Removal of the haemorrhage can improve clinical signs.
Oral malignant melanoma: a rare case with unusual clinical presentation
Authors: Elneel Ahmed Mohamed Ali, Musadak Ali Karrar, Abeer Abdalla El-Siddig, Azza Zulfu
Journal: Pan Afr Med J (2015)
Keywords: sudan, epithelial neoplasm, oral malignant melanoma, unusual presentation
MeSH terms: Mandibular Neoplasms / diagnosis, Melanoma / diagnosis, Case Reports, Female, Humans, Mandibular Neoplasms / pathology, Melanoma / pathology, Middle Aged, Prognosis, Sudan

Primary Oral malignant melanoma is a rare tumor with an indigent prognosis. This is a case report of 47-year-old Sudanese female diagnosed as Oral malignant melanoma of the mandible with an unusual pattern of growth and clinical presentation. Furthermore, a possibility of intraosseous origin is suggested.
Gas gangrene as a result of femoral traction pin placement
Authors: Benjamin C Taylor, Thomas J Bramwell, Nathan Formaini
Journal: Case Rep Orthop (2011)
MeSH terms: Case Reports

Treatment of adult femoral shaft fractures typically involves operative stabilization with intramedullary implants, external fixation, or a plate and screw construct. However, when stabilization is delayed for any reason, use of a traction pin is recommended to stabilize the fracture, prevent significant shortening, as well as to help with pain control. In this paper, we present the rare complication of a severe gas gangrene infection caused by Clostridium perfringens that led to several amputations and ultimately death. We also discuss risks of temporary skeletal traction and techniques to overcome the morbidity of such a procedure.
Multiple coil closure of isolated aortopulmonary collateral
Authors: Sumanta S Padhi, Kinjal D Bakshi, Ram K Shastri
Journal: Ann Pediatr Cardiol (2010)
Keywords: congestive heart failure, isolated aortopulmonary collateral, multiple coil closure, structurally normal heart
MeSH terms: Case Reports

A 7-month-old girl was diagnosed to have large aortopulmonary collateral during evaluation for congestive heart failure. There was no other evidence of cardiopulmonary disease. The collateral was successfully closed with multiple coils delivered sequentially. We describe the issues associated during closure of the aortopulmonary collateral in this case. To the best of our knowledge, this is the first reported case of large aortopulmonary collateral presenting with heart failure in an otherwise structurally normal heart that was closed successfully with multiple coils delivered sequentially.
A Novel PKD1 Mutation Associated With Autosomal Dominant Kidney Disease and Cerebral Cavernous Malformation
Authors: Christian Thomas, Andrea Zühlsdorf, Konstanze Hörtnagel, Lejla Mulahasanovic, Oliver M Grauer, Philipp Kümpers, Heinz Wiendl, Sven G Meuth
Journal: Front Neurol (2018)
Keywords: adpkd, ccm, familial, mutation, sequencing
MeSH terms: Case Reports

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by the presence of renal cysts and specific extrarenal abnormalities. ADPKD is caused by mutations in either PKD1 or PKD2 genes that encode for integral membrane proteins Polycystin-1 (PC1) and Polycystin-2 (PC2), respectively. Extrarenal involvement includes noncystic manifestations such as dilatation of the aortic root, artery dissection and intracranial aneurysms. Cerebral cavernous malformation (CCM) is a rare vascular malformation disorder characterized by closely clustered and irregularly dilated capillaries that can be asymptomatic or cause variable neurological manifestations, such as seizures, non-specific headaches, progressive or transient focal neurologic deficits, and cerebral hemorrhages. Familial CCM is typically associated with mutations in KRIT1 (CCM1), CCM2, and PDCD10 (CCM3). The co-occurrence of ADPKD and CCM has been previously described in a single patient, although genetic analysis was not performed in this study. We report here a family with ADPKD associated with CCM in two sisters. Direct sequencing of the index patient revealed a single novel heterozygous frameshift mutation in PKD1, and lack of mutations in genes usually related to CCM. This suggests that CCM represents an additional phenotype of ADPKD.
Conservative management of an infected laparoscopic hernia mesh: A case study
Authors: Duncan Alston, Stephanie Parnell, Bhupinder Hoonjan, Arun Sebastian, Adam Howard
Journal: Int J Surg Case Rep (2013)
Keywords: hernia, infection, irrigation, laparoscopic, mesh

Introduction:
A dreaded complication of laparoscopic hernia repair is infection of the mesh. Traditionally mesh infection is managed by surgical removal of the mesh, an extensive procedure resulting in high re-herniation rates. A technique to treat such infections whilst salvaging the mesh is sorely needed. We describe a case in which a laparoscopic mesh infection was treated solely with drainage, parenteral antibiotics and antibiotic irrigation of the mesh.
Presentation of case:
A 65 year old gentleman presented 11 months post laparoscopic repair of an inguinal hernia with malaise and an uncomfortable groin swelling. Computed tomography scanning revealed a collection surrounding the mesh which was drained and cultured to show heavy growth of Staphylococcus aureus. A pigtail drain on continuous drainage was inserted and kept in situ for 7 weeks. The patient received one week of intravenous flucloxacillin and two gentamycin irrigations through the drain as an inpatient. He then received 6 weeks of oral flucloxacillin and bi-weekly saline flushes through the drain in the community. By 12 weeks an ultrasound scan showed resolution of the collection. At 7 months he remains clinically free from recurrence.
Discussion:
Here we report a novel conservative method used to treat a hernia mesh infection, preserve the mesh and avoid major surgery. Other reports exist suggesting variations in conservative methods to treat mesh infections, however ours is by far the most conservative.
Conclusion:
Clearly, further research is required to identify which method is most effective and in which patients it is likely to be successful.
Folie à deux
Authors: P N Suresh Kumar, N Subramanyam, Biju Thomas, Abu Abraham, Kishore Kumar
Journal: Indian J Psychiatry (2005)
Keywords: folie à deux, folie imposé, induced delusional disorder, shared psychotic disorder

Folie à deux is defined as an identical or similar mental disorder affecting two or more individuals, usually the members of a close family. Two case reports of this condition are presented with a brief review of the literature. Prompt recognition of this condition is an essential step in the management. The majority of patients with folie à deux require multiple treatments including separation, antipsychotics, individual and group psychotherapy, and family therapy.
A Case of a Pregnant Woman with Thrombosis in an Artificial Aortic Valve Resulting in Severe Cerebral Hemorrhage in the Newborn
Authors: Hidetake Kamei, Yu Wakimoto, Yumi Murakami, Maya Omote, Kayoko Harada, Atsushi Fukui, Hiroyuki Tanaka, Hideaki Sawai, Hiroaki Shibahara
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Many patients, after artificial valve replacement surgery, receive warfarin anticoagulant therapy. However, it has been reported that warfarin administration during pregnancy can cause fetal teratogenicity. With reference to this case, we will discuss how warfarin administration in mid-pregnancy caused severe cerebral hemorrhage in the newborn child. The 36-year-old patient in this case underwent aortic valve replacement surgery when she was 11 years old; this requires the continued use of warfarin after surgery. Although she was advised otherwise, the patient became pregnant. The warfarin treatment was discontinued at 5 weeks of gestation and she began self-injection of heparin; however, her health quickly deteriorated requiring an emergency, warfarin treatment. On gestation week 21, she was admitted to our hospital with a high likelihood of a spontaneous abortion. A week later, transesophageal ultrasonography revealed a thrombus in the patient's aortic valve. Because of this finding, we re-started warfarin administration. At 32 weeks of gestation, cardiotocography showed decreased fetal heart rate; thus, an emergency Cesarean section was performed. A baby was delivered, weighing 1,702 g with an Apgar Score of 1 at 1 minute and 4 at 5 minutes. Cranial computed tomography of the infant showed bilateral intraventricular hemorrhage and ventricular dilation. In order to protect the mother and prevent hemorrhage in the newborn, it is recommended that a continuous heparin infusion should be administered to the pregnant woman after the 36th week of gestation. Regarding the impact on the infant, it is considered that continuous intravenous administration of heparin is safer during the third trimester of pregnancy. However, administration of heparin alone makes the preventive effect of thrombosis uncertain. When warfarin is administered in pregnancy, pregnancy management should be performed bearing the risk of fetal cerebral hemorrhage in mind.
Interprofessional education day 2019 - a qualitative participant evaluation
Authors: Stefan Gysin, Marion Huber, Emanuel Feusi, Andreas Gerber-Grote, Claudia M Witt
Journal: GMS J Med Educ (2022)
Keywords: health professions, interprofessional collaboration, interprofessional competencies, interprofessional education, interprofessionality, medicine
MeSH terms: Students, Health Occupations, Curriculum, Health Occupations / education, Humans, Interprofessional Education, Interprofessional Relations

Objective:
Interprofessional education (IPE) is when two or more students from different professions learn with, from, and about each other to improve collaboration and quality of healthcare. In October 2019, a first interprofessional education (IPE) day was held in the canton of Zurich with the aim of teaching interprofessional skills to participating students.
Methodology:
The IPE day was developed by an interprofessional team of students. After a short introduction, the roles and tasks of the professional groups involved were discussed. This was followed by two case studies with simulation persons and reflection rounds. For the evaluation of the day, 15 semi-structured interviews with students and lecturers were conducted and qualitatively evaluated by means of thematic analysis.
Results:
The students and lecturers had a very positive experience of the IPE day. Especially the participation of medical and pharmacy students, the practical case studies with simulation persons and the informal exchange during the breaks were appreciated. There was room for improvement in the development of role models. Through an open attitude and good communication, the students learned to know and appreciate the competencies of the other professional groups. All those interviewed wished for more interprofessional teaching opportunities and the students felt encouraged to apply what they had learned in their later professional practice.
Conclusion:
The IPE day could be carried out successfully and the didactic concept worked largely well. The evaluation provided subjective evidence that the students were able to improve the interprofessional competencies of teamwork, communication, openness, appreciation and reflectiveness. In the future, the IPE day should be anchored in the curricula.
Therapeutic dilemma in the management of a patient with the clinical picture of TTP and severe B12 deficiency
Authors: Kara Walter, Jennifer Vaughn, Daniel Martin
Journal: BMC Hematol (2015)
Keywords: anemia, cobalamin, pernicious anemia, schistocytes, ttp, pseudo-ttp
MeSH terms: Case Reports

Background:
Idiopathic thrombotic thrombocytopenic purpura (TTP) is a rare hematological emergency characterized by the pentad of microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, renal injury, and fever that is invariably fatal if left untreated. Prompt intervention with plasma exchange minimizes mortality and is the cornerstone of therapy. Rare reports have described "pseudo-TTP" driven by extreme hematologic abnormalities resulting from deficiency of vitamin B12. Distinguishing between these entities can pose a diagnostic and therapeutic challenge.
Case presentation:
A 77 year old female presented with altered mental status, renal insufficiency, thrombocytopenia and evidence of microangiopathic hemolytic anemia, suggesting TTP. Workup demonstrated macrocytosis and reticulocytopenia, and B12 level was unmeasurably low. Other elements of her clinical presentation, including volume loss and bleeding suggested a multifactorial pathogenesis could be contributing to her laboratory abnormalities, reducing the likelihood that she had TTP. The risks and benefits of treating aggressively with therapeutic plasma exchange (TPE) for TTP were considered given the diagnostic possibilities. The patient received TPE initially, with rapid de-escalation after her clinical response suggested "pseudo-TTP" from B12 deficiency was the driving the process. B12 supplementation corrected her hematologic abnormalities and she remains well two years after presenting.
Conclusions:
TTP is a rare condition with fatal consequences if left untreated. Guidelines recommend TPE even if there is uncertainty about the diagnosis of TTP. B12 deficiency is common, though not typically associated with severe hematologic abnormalities. We compare the presenting characteristics of all thirteen cases of pseudo-TTP reported in the literature with those from patients in case series of TTP to suggest a set of parameters that can help clinicians distinguish between pseudo-TTP and TTP and guide decision making regarding intervention. Evaluation of all TTP cases should include a B12, methylmalonic acid level and reticulocyte count. Reticulocytopenia suggests B12 deficiency. Finally an LDH level above 2500 IU/L is relatively uncommon in TTP and should suggest consideration of B12 deficiency.
Acute abdomen caused by rupture of a torted intra-abdominal testicular mass: Case report
Authors: Ahmed Ghobashy, Doaa Hasan, Ahmed AbdElsalam, Aboubakr Ahmed, Ahmed Arafat, Mahmoud Tarek, Moutaz Ragab
Journal: Int J Surg Case Rep (2020)
Keywords: cryptorchidism, germ cell tumor, intra-abdominal mass, testicular cancer, undescended testis
MeSH terms: Case Reports

Introduction:
Cryptorchidism is defined as the absence of one or both testicles from the scrotum, which is considered one of the most common birth defects of male genitalia. Mostly the undescended testes are in the inguinal region, while the intra-abdominal location accounts for only 10 % of the cases. The potential risk of malignant transformation in an undescended testis is approximately 2.5-8 times higher than in scrotal position. Torsion of the cryptorchid testis is a very rare cause of acute abdominal pain with few cases published in literature.
Case presentation:
A 44-year-old male patient presented to the emergency room with acute abdominal pain. General examination revealed relevant tachycardia. Upon abdominal examination there was tenderness and rebound tenderness all over the abdomen, more evident in the lower abdomen. Interestingly, routine examination of the inguino-scrotal region revealed empty right hemi-scrotum despite the patient not being aware. Routine blood tests showed marked anemia Hb: 7.4 g/dl. Urgent pelvi-abdominal U/S showed moderate free intra-abdominal collection in addition to a pelvic mass. CT of the abdomen showed a well-defined heterogenous hypodense mass measuring about 8.5 × 5.5 cm in the pelvis. Urgent exploratory laparotomy was done, and a mass was found to be torted and ruptured. Excision was done and histo-pathological examination revealed testicular mixed germ cell tumor.
Conclusion:
Undescended testis is associated with an increased risk of infertility, testicular cancer and torsion. In any male with undescended testis and intra-abdominal mass; the risk of intra-abdominal testicular tumor should be considered.
Ingestion of Partial Denture after General Anesthesia Induction and Ventılation: A Rare Case Report
Authors: Hakan Akelma, Fikret Salik, Ömer Başol, Hüseyin Bilge, Akif Yıldırım, Şule Özgün
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

The swallowing of dentures during general anaesthesia is a significant problem for anesthesiologists. It is seen more often in patients with psychiatric disorders, mental retardation, alcoholism, or poor quality dentures. It has become an important issue for anesthesiologists preoperatively due to the increase in the proportion of dentures associated with prolongation of life. In elderly, the use of partial fixed prosthesis increases and the risk of swallowing dentures is increased. In this case report, it was presented that the denture was swallowed spontaneously before intubation while the patient was ventilated preoperatively.