OpenMed/multicare-articles huggingface dataset:
Case Report: Migraine-Like Headache With Visual Aura Initiated by Endovascular Coiling Treatment for a Posterior Cerebral Artery Aneurysm
Authors: Xin Chen, Juan Zhang, Han-Li Li, Zi-Ru Deng, Long Wang, Li Cao, Cheng-Juan Xie, Yu Wang
Journal: Front Neurol (2021)
Keywords: case report, endovascular therapy, migraine, posterior cerebral artery aneurysm, visual aura
MeSH terms: Case Reports

Cervical, anterior, and middle cerebral artery aneurysm is a causative factor for migraine, and endovascular treatment usually improves migraine headache. Posterior cerebral artery (PCA) aneurysm is a rare condition, and its association with migraine is very rarely reported. In addition, endovascular coiling treatment causing migraine-like headache has never been reported. Here, we describe a newly developed migraine-like headache with visual aura after endovascular coiling treatment for PCA aneurysm in a 31-year-old female patient. One month after the endovascular therapy, the patient stopped using the antiplatelet agents clopidogrel and aspirin and presented with an episodic headache attack twice a month with typical migraine features, including visual aura, right-sided temporal throbbing pain accompanied with nausea, vomiting, and photophobia. The recurrence of migraine-like headache with visual aura was terminated by clopidogrel administration. The generation of the migraine-like headache with visual aura is probably associated with microemboli due to endovascular coiling. This case supports the hypothesis that migraine with aura can be associated with microemboli of variant origins.
An Adult Case of Adenovirus-Associated Acute Disseminated Encephalomyelitis
Authors: Dewayne Campbell, Gordon S Wong, Hyun Park, Gavin McLeod
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Acute disseminated encephalomyelitis (ADEM) is an autoimmune neurological disease that predominately affects pediatric population. Only a single fatal adult case of adenovirus-associated ADEM has previously been published by Qamar et al. in 2021. Here, we present an adult case of adenovirus-associated ADEM, which was diagnosed early in her clinical course. The patient was treated with the prompt initiation of steroids, intravenous immune globulin (IVIG), and plasmapheresis (PLEX), and the patient recovered fully. This case highlights the importance of early accurate diagnosis for other clinicians to treat adenovirus-associated ADEM in a timely fashion to prevent a potentially fatal outcome.
Psychiatric disorders in the acoustic neuroma: about a case
Authors: Samira Younes, Sabria Khouadja, Samia Younes, Rim Ben Soussia, Walid Bouali, Ahmed Haj Mohamed, Lazhar Zarrouk
Journal: Pan Afr Med J (2019)
Keywords: neurofibromatosis type 2, acoustic neuroma, hearing loss, psychiatry, psychosis, vestibular schwannoma
MeSH terms: Mental Disorders / diagnosis, Neurofibromatosis 2 / diagnosis, Neuroma, Acoustic / diagnosis, Case Reports, Hearing Loss / etiology, Humans, Male, Mental Disorders / etiology, Neurofibromatosis 2 / complications, Neuroma, Acoustic / etiology, Young Adult

Neurofibromatosis type 2 (NF2) is a rare autosomal dominant disorder characterized by formation of central nervous system tumors. They are associated to significant morbidity due to multiple problems such as hearing loss that can lead to many psychiatric disorders.
Machine learning in predicting respiratory failure in patients with COVID-19 pneumonia-Challenges, strengths, and opportunities in a global health emergency
Authors: Davide Ferrari, Jovana Milic, Roberto Tonelli, Francesco Ghinelli, Marianna Meschiari, Sara Volpi, Matteo Faltoni, Giacomo Franceschi, Vittorio Iadisernia, Dina Yaacoub, Giacomo Ciusa, Erica Bacca, Carlotta Rogati, Marco Tutone, Giulia Burastero, Alessandro Raimondi, Marianna Menozzi, Erica Franceschini, Gianluca Cuomo, Luca Corradi, Gabriella Orlando, Antonella Santoro, Margherita Digaetano, Cinzia Puzzolante, Federica Carli, Vanni Borghi, Andrea Bedini, Riccardo Fantini, Luca Tabbì, Ivana Castaniere, Stefano Busani, Enrico Clini, Massimo Girardis, Mario Sarti, Andrea Cossarizza, Cristina Mussini, Federica Mandreoli, Paolo Missier, Giovanni Guaraldi
Journal: PLoS One (2020)
MeSH terms: Computer Simulation, Coronavirus Infections / complications, Machine Learning, Pneumonia, Viral / complications, Respiratory Insufficiency / diagnosis, Observational Study, Aged, Betacoronavirus, Blood Gas Analysis, COVID-19, Female, Humans, Italy, Male, Middle Aged, Models, Statistical, Pandemics, Prospective Studies, Respiration, Artificial, Respiratory Insufficiency / etiology, SARS-CoV-2

Aims:
The aim of this study was to estimate a 48 hour prediction of moderate to severe respiratory failure, requiring mechanical ventilation, in hospitalized patients with COVID-19 pneumonia.
Methods:
This was an observational prospective study that comprised consecutive patients with COVID-19 pneumonia admitted to hospital from 21 February to 6 April 2020. The patients' medical history, demographic, epidemiologic and clinical data were collected in an electronic patient chart. The dataset was used to train predictive models using an established machine learning framework leveraging a hybrid approach where clinical expertise is applied alongside a data-driven analysis. The study outcome was the onset of moderate to severe respiratory failure defined as PaO2/FiO2 ratio <150 mmHg in at least one of two consecutive arterial blood gas analyses in the following 48 hours. Shapley Additive exPlanations values were used to quantify the positive or negative impact of each variable included in each model on the predicted outcome.
Results:
A total of 198 patients contributed to generate 1068 usable observations which allowed to build 3 predictive models based respectively on 31-variables signs and symptoms, 39-variables laboratory biomarkers and 91-variables as a composition of the two. A fourth "boosted mixed model" included 20 variables was selected from the model 3, achieved the best predictive performance (AUC = 0.84) without worsening the FN rate. Its clinical performance was applied in a narrative case report as an example.
Conclusion:
This study developed a machine model with 84% prediction accuracy, which is able to assist clinicians in decision making process and contribute to develop new analytics to improve care at high technology readiness levels.
Art Therapy With Jewish Ultra-Orthodox Children: Unique Characteristics, Benefits, and Conflicts
Authors: Einat Doron
Journal: Front Psychol (2020)
Keywords: art therapy, children, inter-cultural therapy, secular therapist, ultra-orthodox jews
MeSH terms: Case Reports

The paper presents the potential benefits and conflicts of the encounter between Jewish ultra-orthodox (UO) children - belonging to a closed and segregated group - and art therapy - with its cultural, Western, secular, and professional characteristics. The paper describes the complex interface between the therapeutic use of art as a form of free expression and religious commandments and restrictions. The dialogue between art, therapy, and cultural religious boundaries is described through a case study of an 8-year-old UO boy and a secular female art therapist. Issues such as self-expression, gender roles, and identity exploration are discussed, emphasizing the unique characteristics, benefits, and conflicts of such an encounter.
The Treatment of Clozapine-Withdrawal Delirium with Electroconvulsive Therapy
Authors: Anish Modak, Arne Åhlin
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

Clozapine, a commonly used atypical antipsychotic, can precipitate a severe withdrawal syndrome. In this report, we describe a case of delirium with catatonic features emerging after the immediate cessation of clozapine subsequent to concerns of developing neuroleptic malignant syndrome. After multiple treatments were found to be inefficacious, electroconvulsive therapy (ECT) was initiated, resulting in significant improvement. A literature search revealed six previous cases of clozapine-withdrawal syndromes of varied symptomatology treated with ECT. To our knowledge, the present case represents the first reported clozapine-withdrawal delirium treated successfully with ECT.
Lung sarcoidosis in etanercept treated rheumatoid arthritis patient: a case report and review of the literature
Authors: Supat Thongpooswan, Adriana Abrudescu
Journal: Case Rep Rheumatol (2014)

We report a 55-year-old female with seropositive rheumatoid arthritis for 10 years who developed large mediastinal and hilar adenopathy while receiving etanercept therapy. Chest high resolution computed tomography (HRCT) showed mediastinal lymph nodes with size of 2.3 × 3.1 centimeters. Right paratracheal lymph node biopsy showed nonnecrotizing epithelioid granulomata. All infectious studies of pulmonary lymph node tissues were negative. Etanercept was discontinued. Follow-up HRCT 6 months later showed resolution of mediastinal lymph nodes. This report should increase awareness of pulmonary sarcoidosis development in patient treated with tumor necrosis factor-alpha blocking agent, etanercept.
A Huge Mesenteric Lymphangioma Presenting as a Small Bowel Volvulus in a Paediatric Patient: A Case Report
Authors: Sushma Thapa, Abhinav Sharma, Dipesh Upreti, Om Bahadur Karki, Sudeep Regmi, Dilasma Ghartimagar, Arnab Ghosh
Journal: Case Rep Pathol (2022)
MeSH terms: Case Reports

Lymphangioma is a benign tumor characterized by proliferation of thin-walled lymphatic spaces. Lymphangioma of the small-bowel mesentery is rare, with an incidence of 1 : 250,000, representing less than 1% of all lymphangiomas. The predilection of the tumor is in the head and neck (70%), axillary (20%), and internal organs (10%). They are usually asymptomatic but can cause acute abdominal symptoms due to complications such as volvulus, bleeding, or lymphangioma rupture that require emergent surgery. Here, we report a case of mesenteric lymphangioma (ML) of a small bowel in a paediatric patient who presented with pain abdomen on and off which increased in severity and later had features of subacute intestinal obstruction. He underwent explorative laparotomy, and the mass was excised completely along with the part of small intestine. Pathological analysis of the surgical specimen confirmed the diagnosis of ML of the small intestine. The postoperative recovery was uneventful, and the patient was discharged after ten days of hospital stay. Though benign in nature, ML may cause acute abdominal symptoms that require emergent surgery. Therefore, it has to be kept in differential diagnosis of the acute abdominal condition.
Case Report: Heparin-induced thrombocytopenia in a patient with COVID-19
Authors: Ragia Aly, Sachin Gupta, Sorab Gupta, Balraj Singh, Abhinav Goyal, Sheila Kalathil
Journal: F1000Res (2020)
Keywords: covid- 19, heparin-induced thrombocytopenia
MeSH terms: COVID-19, Thrombocytopenia / chemically induced, Case Reports, Aged, Anticoagulants / adverse effects, Female, Humans, Pandemics, SARS-CoV-2, Anticoagulants

With the spread of the novel coronavirus disease of 2019 (COVID-19) worldwide and associated high incidence of thromboembolic complications, the use of heparin is on the rise. It therefore is crucial to identify patients with contraindications for heparin. Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of exposure to heparin. We report a 66-year-old woman, who was admitted to the hospital with COVID-19 infection. Her course was complicated by pulmonary embolism and dialysis catheter thrombosis. Our patient had a known history of HIT. Treatment of this patient with heparin would have been catastrophic. The COVID-19 pandemic has overwhelmed healthcare systems and is causing a global health crisis. Nevertheless, this case serves as a reminder of the importance of making every effort to obtain thorough history and review of records of every patient.
Complete androgen insensitivity syndrome or testicular feminization: review of literature based on a case report
Authors: Regragui Souhail, Slaoui Amine, Abounouh Nadia, Karmouni Tarik, El Khader Khalid, Koutani Abdellatif, Ibn Attya Ahmed
Journal: Pan Afr Med J (2016)
Keywords: testicular, androgen, feminization, insensitivity, laparoscopy
MeSH terms: Amenorrhea / etiology, Androgen-Insensitivity Syndrome / diagnosis, Case Reports, Review, Adult, Female, Humans, Male, Phenotype

Testicular feminization, or the androgen insensitivity syndrome, is a rare disease. Because of various abnormalities of the X chromosome, a male, genetically XY, has some physical characteristics of a woman or a full female phenotype. Indeed the androgen insensitivity syndrome occurs because of a resistance to the actions of the androgen hormones, which in turn switches the development towards the aspect of a woman. We report a case of complete androgen insensitivity syndrome in a 30 years old woman who presented primary amenorrhea. We aim to improve our knowledge of this illness from the data that provides us this study, and a review of the literature.
A papilloma in a large cyst of the breast: A case report
Authors: Hwan Soo Kim, Yang Hei Kim, Sung Bae Park
Journal: Int J Surg Case Rep (2019)
Keywords: breast, intracystic lesions, large cyst, papilloma

Introduction:
Intracystic lesions of the breast prove to be benign more often than malignancy, most intracystic lesions are benign papillomas. Generally sizes of cysts that contain papilloma are small. Relatively cysts that contain papillary carcinoma are large. A papilloma in a large cyst of the Breast is rare.
Presentation of case:
We report a rare case of a papilloma in a large cyst of the breast that presented a painless palpable mass. A 53-yr-old woman noticed palpable mass in her right breast. Ultrasonography indicated a 7 × 7 cm sized large cyst. There is a 2 × 2.5 cm sized hyper-echoic, polypoid mass in the cyst. On fine-needle aspiration was not obtained malignant cells. Excisional biopsy was done. Pathologic finding was papilloma.
Discussion:
Tumors in a large cyst of the breast is difficult in distinguish benign from malignancy by preoperative imaging, cytological and histological study.
Conclusion:
Excisional biopsy should be performed before cancer surgery such as mastectomy to manage the cysts with intracystic growths.
Endovascular Repair of Aortobronchial Fistula due to Saccular Aneurysm of Thoracic Aorta
Authors: Konstantinos Tigkiropoulos, Kyriakos Stavridis, Ioannis Lazaridis, Nikolaos Saratzis
Journal: Case Rep Vasc Med (2017)
MeSH terms: Case Reports

Aortobronchial fistula (ABF) is a rare condition which can be lethal if left untreated. Open surgical treatment carries high morbidity and mortality. Recent advances in endovascular technology have made thoracic endovascular aortic repair (TEVAR) the treatment of choice. We present a successful endovascular repair of aortobronchial fistula due to a saccular aneurysm of descending thoracic aorta.
Myocardial Infarction as an Early Presentation in Thrombotic Thrombocytopenic Purpura: A Rare Case Series
Authors: Sumit Dahal, Dipesh K C Ghimire, Saroj Sapkota, Suyash Dahal, Paritosh Kafle, Manjul Bhandari
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: cardiac involvement, myocardial infarction, thrombotic thrombocytopenic purpura

Renal and neurological involvements are frequently seen in thrombotic thrombocytopenic purpura (TTP). Cardiac involvement, however, has been rarely reported. In this article, we present 2 cases of myocardial infarction in patients with TTP. In the first case, a young man presented with non-ST-segment elevation myocardial infarction that resolved promptly with plasmapheresis. The second patient developed ST-segment elevation myocardial infarction early in the course of the disease and died before plasmapheresis could be initiated. Hence, a high degree of suspicion with prompt diagnosis and treatment is needed to prevent mortality associated with cardiac involvement in TTP.
Floppy Closing Door Epiglottis Treated Successfully with an Mhealth Application Based on Myofunctional Therapy: A Case Report
Authors: Carlos O'Connor Reina, Guillermo Plaza Mayor, Jose Maria Ignacio-Garcia, Peter Baptista Jardin, Maria Teresa Garcia-Iriarte, Juan Carlos Casado-Morente
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

We introduce the first case reported to date of a floppy closing door epiglottis in an OSA (obstructive sleep apnea) patient treated successfully with an Mhealth smartphone application based on myofunctional therapy.
The use of intravitreal ranibizumab for choroidal neovascularization associated with vogt-koyanagi-harada syndrome
Authors: A M Kolomeyer, M S Roy, D S Chu
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Purpose. To describe the use of intravitreal ranibizumab for choroidal neovascular membrane (CNVM) secondary to Vogt-Koyanagi-Harada (VKH) syndrome. Methods. Interventional case report. Results. A 50-year-old woman presented with conjunctival injection and bilateral eye pain. Vision was 20/400 and 20/80 in the right and left eyes, respectively. Bilateral iritis, vitritis, and choroidal thickening were evident. Exudative retinal detachment was present in the left eye. Corticosteroid treatment improved vision to 20/40 bilaterally. Methotrexate (MTX) was initiated and vision remained stable for 3 months. After a 5-month loss to follow-up, vision in the left eye decreased to finger counting (CF) and a parafoveal CNVM was identified. After 3 intravitreal ranibizumab injections, vision improved to 20/40. Twelve months later, despite inflammation control, vision decrease to CF due to recurrent CNVM. A fourth ranibizumab injection was given. Twenty months later, best-corrected vision was 20/400, and an inactive CNVM was present in the left eye. Conclusion. After initial CNVM regression and visual acuity improvement due to ranibizumab, the CNVM recurred and became refractory to treatment. Despite control of inflammation and neovascularization, VKH chronicity lead to permanent vision loss in our patient. A combinational treatment approach may be required in such patients.
Pheochromocytoma-related cardiomyopathy presenting as broken heart syndrome: Case report and literature review
Authors: Brandon Diaz, Adel Elkbuli, John D Ehrhardt Jr, Mark McKenney, Dessy Boneva, Shaikh Hai
Journal: Int J Surg Case Rep (2019)
Keywords: acute coronary syndrome, cardiac catheterization, catecholamine-induced heart failure, pheochromocytoma, surgical management, takotsubo cardiomyopathy

Introduction:
Pheochromocytoma are neuroendocrine tumors that arise from sympathetic chromaffin cells within the adrenal medulla. They principally secrete catecholamines, potentially causing life-threatening cardiovascular complications. A myriad of symptomatology and clinical findings are associated with pheochromocytoma, including a catecholamine-induced dilated cardiomyopathy.
Presentation of case:
A 50-year-old woman presented with retrosternal chest pain and underwent diagnostic evaluation for acute coronary syndrome. Cardiac catheterization demonstrated patent coronary arteries and a pattern of ventricular hypokinesis consistent with takotsubo cardiomyopathy, also known as broken heart syndrome. Further imaging with abdominal CT revealed an adrenal mass. Laboratory markers supported the clinical picture of pheochromocytoma. Right adrenalectomy was performed and our patient was symptom-free at discharge on post-operative day three.
Discussion:
Alpha and beta adrenergic blockade are used in a critical care setting to prevent perioperative hemodynamic instability as well as catecholamine-induced heart failure in the setting of pheochromocytoma. Patients commonly require vasopressors in the postoperative period due to the rapid reduction in circulating catecholamines following resection. Discharge planning should include recommendations for genetic counseling to screen for syndromic causes of pheochromocytoma that increase the risk for other neoplasms.
Conclusion:
We present a case report of a rare adrenal tumor in a middle-aged woman that manifested as acute coronary syndrome. A presumptive diagnosis of takotsubo cardiomyopathy on cardiac catheterization led to further investigation. Abdominal imaging located an adrenal mass that correlated with laboratory studies positive for high levels of catecholamines and their metabolites. The tumor was excised and the patient recovered without complications.
The Effect of Mineral Trioxide Aggregate on the Periapical Tissues after Unintentional Extrusion beyond the Apical Foramen
Authors: Pradnya S Nagmode, Archana B Satpute, Ankit V Patel, Pushpak L Ladhe
Journal: Case Rep Dent (2016)

Introduction. Single-step apexification procedures using mineral trioxide aggregate (MTA) have been reported as favorable treatment options for teeth with an open apex, posing greater benefits compared to the other available medicaments. However, controlled apical placement of MTA is a challenging procedure to perform using orthograde approach. This case series describes the outcome of the unintentional extrusion of MTA into periradicular tissues during apexification, in three separate cases. Methods. Three adult patients reported to the Department of Conservative Dentistry and Endodontics for the management of maxillary incisors with open apices. After isolation, conventional access, and cleaning and shaping procedures, one-step MTA apexification was performed. On subsequent radiographs, a considerable amount of MTA was seen to be extruded in all the three cases. Results. During follow-up examination the teeth were seen to be asymptomatic in all cases and radiographically demonstrated repair of the periapical lesion. Conclusion. The results of these cases suggest that extrusion of MTA into the periapical tissues does not cause any detrimental effect, which could be attributed to the biologic properties of MTA.