OpenMed/multicare-articles huggingface dataset:
Haemosiderotic Synovitis Secondary to Anticoagulant Use: An Unusual Mechanism of Failure of a Unicompartmental Knee Replacement
Authors: Jonathan Bartlett, Surjit S Lidder, Andrew T Bucknill
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Haemosiderotic synovitis is a rare condition caused by recurrent or chronic haemarthroses. This may lead to intra-articular destruction, a painful joint, and, if untreated, ankylosis of the joint. We highlight a case of an elderly lady who presented to an orthopaedic clinic with left knee pain, following recurrent left knee atraumatic haemarthroses secondary to oral anticoagulant use. At her presentation, she had a left medial unicompartmental knee prosthesis in situ. Weight bearing radiographs of the left knee showed marked loss of lateral joint space with valgus alignment. These radiographic findings were not present on the radiographs taken at her first presentation with haemarthrosis nine months previously. A left revision total knee arthroplasty was performed, and a diagnosis of haemosiderotic synovitis was made following histological analysis of intraoperative tissue samples. This case highlights an unusual mechanism of failure of a unicompartmental knee replacement. Though haemosiderotic synovitis is an exceedingly rare condition, it must be considered following recurrent haemarthrosis as, due to its destructive nature, prompt recognition and treatment is paramount.
Classification of Rhinoentomophthoromycosis into Atypical, Early, Intermediate, and Late Disease: A Proposal
Authors: Christian G Blumentrath, Martin P Grobusch, Pierre-Blaise Matsiégui, Friedrich Pahlke, Rella Zoleko-Manego, Solange Nzenze-Aféne, Barthélemy Mabicka, Maurizio Sanguinetti, Peter G Kremsner, Frieder Schaumburg
Journal: PLoS Negl Trop Dis (2015)
MeSH terms: Entomophthorales / isolation & purification, Rhinitis / classification, Zygomycosis / classification, Case Reports, Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Zygomycosis / diagnosis, Zygomycosis / drug therapy

Background:
Rhinoentomophthoromycosis, or rhino-facial conidiobolomycosis, is a rare, grossly disfiguring disease due to an infection with entomophthoralean fungi. We report a case of rhinoentomophthoromycosis from Gabon and suggest a staging system, which provides information on the prognosis and duration of antifungal therapy.
Methods:
We present a case of rhinoentomophthoromycosis including the histopathology, mycology, and course of disease. For the suggested staging system, all cases on confirmed rhinoentomophthoromycosis published in the literature without language restriction were eligible. Exclusion criteria were missing data on (i) duration of disease before correct diagnosis, (ii) outcome, and (iii) confirmation of entomophthoralean fungus infection by histopathology and/or mycology. We classified cases into atypical (orbital cellulitis, severe pain, fever, dissemination), early, intermediate, and late disease based on the duration of symptoms before diagnosis. The outcome was evaluated for each stage of disease.
Findings:
The literature search of the Medpilot database was conducted on January 13, 2014, (updated on January 18, 2015). The search yielded 8,333 results including 198 cases from 117 papers; of these, 145 met our inclusion criteria and were included in the final analysis. Median duration of treatment was 4, 3, 4, and 5 months in atypical, early, intermediate, and late disease, respectively. Cure rates were clearly associated with stage of disease and were 57%, 100%, 82%, and 43% in atypical, early, intermediate, and late disease, respectively.
Conclusion:
We suggest a clinical staging system that underlines the benefit of early case detection and may guide the duration of antifungal treatment. The scientific value of this classification is its capacity to structure and harmonize the clinical and research approach towards rhinoentomophthoromycosis.
Adjuvant Use of Ivabradine in Acute Heart Failure due to Myocarditis
Authors: Jennifer Franke, Dorothee Schmahl, Stephanie Lehrke, Regina Pribe, Raffi Bekeredjian, Andreas O Doesch, Philipp Ehlermann, Philipp Schnabel, Hugo A Katus, Christian Zugck
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We report two cases of young men in whom acute heart failure due to myocarditis was diagnosed. The patients had been transferred to the intensive care unit (ICU) with commencing symptoms of acute heart failure and consecutive multiorgan failure for further treatment and to evaluate the indication for implantation of a ventricular assist device or for high urgent orthotopic heart transplantation. In both patients, the I(f)-channel inhibitor ivabradine was administered off-label to provide selective heart rate reduction, and thus support hemodynamic stabilization. Though currently considered off-label use in patients suffering from severe hypotension and acute heart failure, the use of ivabradine may beneficially influence outcome by allowing optimization of the patient's heart rate concomitant to initial measures of clinical stabilization.
A Multi-Disciplinary Approach in the Management of Endo-Perio Lesions: A 4-year Follow-Up Case Report
Authors: Stephani Dwiyanti
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Summary. This case report discusses the multi-disciplinary approach and long-term follow-up of a 66-year-old male who suffered a combined endodontic-periodontal lesion (EPL). As EPL is uncommon in daily practice and dentists' knowledge and awareness of EPL is quite low, this case becomes of high interest and value to document and research. The objective of this study is to present the diagnosis, multi-disciplinary approach, and long-term follow-up of compromised teeth with EPL. It highlights the importance of the identification and elimination of all causative factors as well as the correct treatment sequence to achieve a predictable outcome. The patient was referred to the periodontist after multiple unsuccessful attempts by his previous dentist. He complained of recurrent dull pain and abscess on his upper left tooth (tooth #26) that had been present for the past three years. A diagnosis of combined EPL was obtained after thorough anamnesis, clinical evaluation, and radiographic examination. The clinician identified several predisposing factors, such as plaque, trauma from occlusion, and excessive force on tooth #26 due to incorrect denture design. Treatment involved multiple dental specialties. At the periodontist, the patient underwent scaling, root planning, and removal of overhanging part of the restoration. At the endodontist, root canal treatment (RCT) was completed. Two months after RCT, a periodontal regenerative procedure was done. The defect was filled with a combination of allograft/alloplastic bone graft and covered with a barrier membrane. Upon healing, the prosthodontist did the final restoration of fiber post with a metal crown on tooth #26 and constructed a new denture with a periodontal-friendly design. A follow-up at five months and four years showed excellent results. The patient was symptom-free, and tooth #26 showed no periodontal inflammation. Radiographic examination showed a good bone fill at the defect. Supportive periodontal therapy should be emphasized to achieve the long-term success of EPL.
Case Report: Anti-flotillin 1/2 Autoantibody-Associated Atypical Dementia
Authors: Niels Hansen, Claudia Bartels, Winfried Stöcker, Jens Wiltfang, Charles Timäus
Journal: Front Psychiatry (2021)
Keywords: autoantibodies, autoimmunity, dementia, flotillin 1/2, phosphorylated tau protein
MeSH terms: Case Reports

Flotillin proteins are involved in neurodegeneration and T-cell immunity. Here, we report the case of 65-year-old woman who presented with dementia, depressive symptoms, and a patient history involving speech problems. As diagnostics methods we applied magnetic resonance imaging, clinical examination, extensive neuropsychological testing, and cerebrospinal fluid analysis. Neuropsychological testing revealed major cognitive decline in attentional, executive, and memory functions together with impaired activities of daily living. The cerebrospinal fluid showed elevated phosphorylated tau protein 181. We identified serum autoantibodies against the flotillin 1/2 complex. Immunotherapy entailing four cycles of high-dose steroids resulted in less cognitive dysfunction along with reduced depressive symptoms in the second follow-up after starting steroids. In conclusion: probable autoimmune-mediated dementia associated with anti-flotillin 1/2 complex autoantibodies expands the phenotypic spectrum of anti-flotillin 1/2 antibody disease.
Pigmented villonodular synovitis of the cervical spine: case report and review of the literature
Authors: Nicholas A Koontz, Edward P Quigley, Benjamin L Witt, R Kent Sanders, Lubdha M Shah
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Pigmented villonodular synovitis (PVNS) is an uncommon, benign, but locally aggressive lesion characterized most commonly by synovial proliferation of the appendicular large joints, but occasionally involving a bursa or the tendon sheath. PVNS of the spine is rare, typically involving the posterior elements. The lytic radiographic appearance and fludeoxyglucose avidity of PVNS may mimic malignant bone lesions, including metastatic disease or myeloma. On T 1 and T 2 weighted, and gradient recalled echo MRI sequences, the low signal intensity may mimic giant cell tumour of the bone, gout or synovial amyloid deposits, thus posing a diagnostic dilemma for the imagers and the treating clinicians. We present a pathologically confirmed case of PVNS of the cervical spine in a 49-year-old female, detailing her imaging work-up, describing histopathological correlation and highlighting the lesion location and involvement of the joint space as useful imaging discriminators for diagnosing PVNS of the cervical spine.
Asymptomatic wide complex tachycardia: a case report
Authors: Siddharth Mukerji, Feras Aloka, Atul Khasnis
Journal: Cases J (2009)

Wide complex tachycardias are a commonly encountered entity in coronary care units, intensive care units and emergency departments. Though, these arrhythmias are potentially fatal, they need to recognized first and treated appropriately. Associated physical signs are helpful in this. We present a case of a 54-year-old-female who recently underwent placement of an implantable cardioverter-defibrillator for cardiomyopathy and developed tachycardia.
Case Report: Acute Onset Fear of Falling and Treatment With "Cognitive Physical Therapy"
Authors: Patricia Castro, Shree Vadera, Matthew James Bancroft, Joseph Buttell, Diego Kaski
Journal: Front Neurol (2021)
Keywords: cognitive behavioural therapy, cognitive physical therapy, falls, fear of falling, postural anxiety
MeSH terms: Case Reports

Fear of falling (FoF) is prevalent in older adults, especially those with previous falls, and typically starts insidiously. We present a 78-year-old woman with an abrupt onset FoF and no history of falls, balance problems, vertigo, oscillopsia, psychiatric or psychological issues to account for this. These cognitive changes led to a behavioural alteration of her gait that became slow and wide-based, with her gaze fixed on the floor. She began a tailored program of "Cognitive Physical Therapy (CPT)" combining cognitive behavioural therapy (CBT) and physical rehabilitation. 1 month later her 6 m walk time and steps were reduced by a 25 and 35%, respectively, and the stride length increased by 34%, with further improvement 2 months later. We postulate that the abrupt onset of symptoms triggered a central shift toward postural hypervigilance and anxiety, suppression of anticipatory (feed forward) postural adjustments (APA) leading to FoF. CPT improved objective gait parameters related to FoF and reduced postural anxiety suggesting that early diagnosis and prompt treatment may avoid chronic symptoms and social isolation.
Life-Threatening Coronary Vasospasm Treated by Implantable Cardioverter Defibrillator: The Warning Signs
Authors: Deborah Adepoju, Jamie A L Smith, Stephen J Leslie
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Coronary artery vasospasm is the sudden narrowing of an artery caused by rapid prolonged contraction. It reduces blood supply to the heart and can present with typical cardiac chest pain symptoms. Vasospasm can lead to fatal arrhythmic complications such as ventricular fibrillation. Our case report describes an example of this occurring in a 53-year-old female, and the management plan that ensued. We look at the importance of accurate and prompt diagnosis of vasospasm and how this can have implications for treatment options. One of the available treatments for vasospasm is placement of an implantable cardioverter defibrillator (ICD). This delivers a shock in the event of future life-threatening arrhythmia, with the aim of preventing cardiac arrest. ICD placement, however, is not always a suitable option. This case report discusses the various challenges that arose while making the decision for ICD placement and gives insight into the best available treatment options for coronary artery vasospasm. We also highlight early warning signs that predict life-threatening vasospastic events and how this can be diagnosed and treated appropriately.
Coupling treatment planning with navigation system: a new technological approach in treatment of head and neck tumors by electrochemotherapy
Authors: Ales Groselj, Bor Kos, Maja Cemazar, Jure Urbancic, Grega Kragelj, Masa Bosnjak, Biserka Veberic, Primoz Strojan, Damijan Miklavcic, Gregor Sersa
Journal: Biomed Eng Online (2015)
MeSH terms: Electrochemotherapy / methods, Head and Neck Neoplasms / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Aged, 80 and over, Electrochemotherapy / instrumentation, Electrodes, Feasibility Studies, Head and Neck Neoplasms / pathology, Humans, Lymphatic Metastasis, Male, Needles, Treatment Outcome

Background:
Electrochemotherapy provides highly effective local treatment for a variety of tumors. In deep-seated tumors of the head and neck, due to complex anatomy of the region or inability to cover the whole tumor with standard electrodes, the use of long single needle electrodes is mandatory. In such cases, a treatment plan provides the information on the optimal configuration of the electrodes to adequately cover the tumor with electric field, while the accurate placement of the electrodes in the surgical room in patients can remain a problem. Therefore, during electrochemotherapy of two head and neck lymph-node metastases of squamous cell carcinoma origin, a navigation system for placement of electrodes was used.
Patient and methods:
Electrochemotherapy of two lymph-node metastases of cutaneous squamous cell carcinoma, one in the left parotid gland and the other in the neck just behind the left mandibular angle, was performed using intravenous administration of bleomycin and long single needle electrodes. The tumors were treated according to the prepared treatment plan, and executed with the use of navigation system.
Results:
Coupling of treatment plan with the navigation system aided to an accurate placement of the electrodes. The navigation system helped the surgeon to identify the exact location of the tumors, and helped with the positioning of the long needle electrodes during their insertion, according to treatment plan. Five electrodes were inserted for each metastasis, one centrally in the tumor and four in the periphery of the tumor. Five weeks after electrochemotherapy, computed tomography images demonstrated partial response of the first metastasis and complete response of the second one. Six weeks after electrochemotherapy, fine-needle aspiration biopsy specimen obtained from the treated lesions revealed necrosis and inflammatory cells, without any viable tumor cells.
Conclusion:
We describe a new technological approach for electrochemotherapy of deep-seated head and neck tumors, coupling of the treatment planning with navigation system for accurate placement of the single long needle electrodes into and around the tumors, according to the treatment plan. Evidence of its effectiveness on two lymph-node metastases of cutaneous squamous cell carcinoma origin in neck lymph is provided.
The wanderlust of a gallstone: a case report of intrathoracic migration of a gallstone post complicated cholecystectomy mimicking lung cancer
Authors: Alya Saeed Binmahfouz, Karin Steinke
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Gallstones migrating into the right hemithorax post complicated cholecystectomy may be misdiagnosed for lung cancer, especially in the context of a distant history of cholecystectomy, poor recall of medical history and incomplete patient data. We present a case of a female patient with heavy smoking history who presented to our emergency department with haemoptysis and mild weight loss. Imaging workup showed an 18F-fludeoxyglucose positron emission tomography-positive heterogeneous nodule with central calcification in the right lower lobe, carrying lung cancer as a differential diagnosis. The resected specimen revealed an inflammatory pseudomass formed around a gallstone. This case illustrates the importance of knowing the spectrum of clinical and radiological presentation of a gallstone migrating into the right hemithorax, in order to prompt appropriate management and prevent misdiagnosis and mistreatment.
A Delayed Anatomic Diagnosis and Management Challenge in an Initially Asymptomatic Infant With Type II Pulmonary Artery Sling: A Case Report
Authors: Xiaoqing Shi, Chuan Wang, Yimin Hua, Xiaoliang Liu, Hongyu Duan
Journal: Front Cardiovasc Med (2021)
Keywords: bronchoscopy, delayed diagnosis, management, pulmonary artery sling, tracheal stenosis
MeSH terms: Case Reports

Pulmonary artery sling (PAS) is a rare but fatal malformation. Patients with PAS tend to develop obstructive symptoms in few weeks of life. Conversely, some patients may be otherwise mild or asymptomatic in their early life. Currently, no consensus on the intervention timing and treatment strategy for asymptomatic and mild cases has been reached. Moreover, the extent of tracheal stenosis is another determining factor for the choice of intervention timing since clinical symptoms might not correspond well with the degree of stenosis. Lack of comprehensive assessment of entire airways confer underestimation of disease severity and in turn improper choice of treatment regimens and poor outcomes. Herein, we described an infantile case of PAS, who was scheduled initially for periodic outpatient follow-up on account of the absence of symptoms and inadequate imaging assessment at diagnosis. The patient developed recurrent wheezing and progressive respiratory distress at 7 months of age. After left pulmonary artery (LPA) reimplantation without tracheal intervention, bronchoscopy was performed due to failure to wean from mechanical ventilation, which demonstrated complete tracheal cartilage rings, a long segment tracheal stenosis, a low tracheal bifurcation at T6, and the absence of a separate right middle lobe bronchus. The patient was finally diagnosed with type IIb PAS and extubated successfully following conservative treatment. Miserably, neurological sequelae were devastating, leading to poor outcomes. Comprehensive airway evaluation using bronchoscopy is substantial to early identification of all components responsible for airway compromise in PAS anatomic subtypes. Considering severe concomitant maldevelopment of the bronchial tree in children with type IIb PAS, early and complete correction by surgery might decrease perioperative morbidities and mortalities of these patients.
Case report: Primary Ewing sarcoma of the ureter, an exceptional finding of unique manifestation of disease
Authors: Marina Valeri, Leocadia Dore, Noemi Rudini, Miriam Cieri, Grazia Maria Elefante, Alberto Saita, Alexia Bertuzzi, Piergiuseppe Colombo
Journal: Front Oncol (2023)
Keywords: ewsr1–fli1, ewing sarcoma, case report, extraskeletal es, rare tumor, ureter
MeSH terms: Case Reports

Ewing sarcoma (ES) is the second most common malignant bone tumor in children and has also been described in adults with highly aggressive behavior. ES belongs to the small round blue cell tumor family and presents the distinctive translocation of FET-ETS family genes (85% with EWSR1), generating gene fusions. Extraskeletal ES mainly occurs in soft tissues; the urogenital tract is rarely affected, and ureteral localization is an exceptional event with only 4 cases described in the literature. Here we report the first Italian case of primary ES of the ureter, a 24-year-old young man with lower back pain and a narrowed left ureteral lumen on CT scan. ES of the urogenital tract is an almost unique condition with a nonspecific clinical presentation and a challenging diagnosis for pathologists. We encourage awareness of these exceptional events in the differential diagnosis of ureteral lesions in young patients.
Primary B cell lymphoma of the tongue base: a case report
Authors: Achour Bechir, Achour Asma, Regaieg Haifa, Abdessayed Nesrine, Ben Youssef Yosra, Sriha Badreddine, Khelif Abderrahim
Journal: Pan Afr Med J (2016)
Keywords: b-cell neoplasms, non hodgkin lymphoma, tongue
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Lymphoma, Large B-Cell, Diffuse / diagnosis, Tongue Neoplasms / diagnosis, Case Reports, Aged, Cyclophosphamide / therapeutic use, Epirubicin / therapeutic use, Humans, Lymphoma, Large B-Cell, Diffuse / drug therapy, Lymphoma, Large B-Cell, Diffuse / pathology, Male, Prednisone / therapeutic use, Rituximab / administration & dosage, Tongue Neoplasms / drug therapy, Tongue Neoplasms / pathology, Vincristine / therapeutic use, Epirubicin, Rituximab, Vincristine, Cyclophosphamide, Prednisone, CEOP protocol 1

Primary non-Hodgkin's lymphoma's of the tongue is very rare and accounts for 1% of all malignant tumor of the oral cavity. Clinical features are non-specific ulcerative lesions that do not heal. In the literature, the majority of cases are diffuse large B cell type however, T cell phenotype also may occur. We describe a 77 years old man, who presented with an ulcerative mass in the left margin of the tongue the diagnosis diffuse large B cell lymphoma was confirmed. The patient is actually on treatment R-mini CEOP and has favorable evolution.
Ovarian vein thrombosis
Authors: Amel Achour Jenayah, Sarra Saoudi, Fethia Boudaya, Ines Bouriel, Ezzeddine Sfar, Dalenda Chelli
Journal: Pan Afr Med J (2015)
Keywords: ovarian vein thrombosis, postpartum, pregnancy
MeSH terms: Abdominal Pain / etiology, Ovary / blood supply, Puerperal Disorders / diagnosis, Venous Thrombosis / diagnosis, Case Reports, Adult, Female, Humans, Magnetic Resonance Imaging / methods, Postoperative Complications / diagnosis, Postoperative Complications / pathology, Pregnancy, Puerperal Disorders / pathology, Tomography, X-Ray Computed / methods, Venous Thrombosis / pathology

Ovarian vein thrombosis (OVT) is a rare cause of abdominal pain that may mimic a surgical abdomen. It is most often diagnosed during the postpartum period. In this report, we present four cases of postoperative ovarian vein thrombosis. The complications of OVT can be significant, and the diagnosis relies on a careful examination of the radiographic findings. It can occur with lower quadrant abdominal pain, especially in the setting of recent pregnancy, abdominal surgery, pelvic inflammatory disease, or malignancy. Diagnosis can be made with confidence using ultrasound, computed tomography or magnetic resonance imaging. Treatment of ovarian vein thrombosis is particularly important in the post-partum patients, with anticoagulation therapy being the current recommendation.