OpenMed/multicare-articles huggingface dataset:
Ultrasound-detected lateral band snapping syndrome in proximal interphalangeal joint of small finger-A rare case report
Authors: Tyng-Shiuan Hsieh, Yi-Jie Kuo, Yu-Pin Chen
Journal: Int J Surg Case Rep (2019)
Keywords: case report, lateral band snapping syndrome, ultrasound

Background:
Snapping fingers resulting from flexor tendon tenosynovitis at the metacarpophalangeal (MCP) joint, is common. However lateral band snapping syndrome (LPSS) in the proximal interphalangeal joint (PIPJ) are extremely rare.
Case presentation:
A 43-year-old female was diagnosed with LPSS in the PIPJ of fifth finger which was confirmed by dynamic evaluation upon ultrasound. Repair of retinacular ligament of the extensor tendon was performed. At the six-month follow up, the patient had regained full ROM with no discomfort, without evidence of recurrence.
Discussion:
The diagnosis of LPSS at the PIPJ is challenging. Dynamic evaluation of the extensor tendon over PIPJ is necessary to diagnose LBSS. Ultrasound was used to assess the movement of the lateral band of the extensor tendon when the fingers flexed and to demonstrate dynamically the snapping and subluxation of the lateral band, so as to facilitate confirming the diagnosis of LBSS.
Conclusion:
Given clinical suspicion of LBSS, we recommend ultrasonography as a feasible tool to confirm the diagnosis. Patients with LBSS may thus benefit from prompt repair of the retinacular ligament without sequela.
Incipient Melanonychia: Benign Finding or Occult Malignancy? A Case Report of Subungual Melanoma
Authors: Alejandro J Quiroz Alfaro, Juliana Greiffenstein, Andrés Felipe Herrera Ortiz, Catalina A Dussan Tovar, Sara Saldarriaga Santamaría, Jaqueline Cifuentes Burbano, Nataly García, Maria C Rodríguez Díaz, Susana M Sierra Molina, Guillermo Jiménez Calfat
Journal: Cureus (2023)
Keywords: dermatology, histopathologic diagnosis, immunohistochemistry, internal medicine, melanonychia, mohs surgery, nail matrix tumor, onychoscopy, skin neoplasm, subungual melanoma
MeSH terms: Case Reports

Subungual melanomas are rare neoplasms that tend to debut as longitudinal melanonychia. They are primarily found in patients over 60 years of age and are usually diagnosed late, representing a diagnostic challenge. We present a case report of a 59-year-old female Hispanic patient who initially presented with melanonychia and was eventually diagnosed with subungual melanoma in situ. She was surgically treated and, after three months, remained healthy. Relevant risk factors, clinical and onychoscopic findings, diagnostic criteria, and treatment options are also discussed. Since many benign entities present similarly, high clinical suspicion is critical for diagnosing this entity.
Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament Hysteropexy
Authors: Ali Azadi, Alexandra Wolfe, Greg J Marchand
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Nonpuerperal uterine inversions are rare. Typically occurring in older women, they are most commonly due to transcervical mass expulsion. Diagnosis is often difficult because of vague symptomatology, presentation, and unknown course of the pathology. Surgical correction is often necessary in the presence of active bleeding or prolapse severity causing urinary retention. This case of nonpuerperal inversion presented to the emergency department with vaginal bleeding and mass protrusion. The examination was consistent with POPQ stage IV prolapse and uterine inversion secondary to cervical expulsion of multiple uterine fibroids. Because of full cervical dilation and concerns of ureteral injury with an extirpative procedure, vaginal myomectomy was performed with concomitant robotic uterosacral ligament hysteropexy. The operative procedure and postoperative course were uncomplicated, and discharge occurred on post-op day 1. She remained asymptomatic at the 6-month follow-up encounter. Though uterine preservation has been performed in cases of uterine inversion to maintain fertility, there are no reported cases of concomitant hysteropexy being completed for correction of POPQ stage IV prolapse simultaneously encountered. Additionally, the novel robotic approach has not been documented. This case illustrates the short-term success of robotic uterosacral hysteropexy as an additional option of care with potentially less morbidity when compared to hysterectomy for advanced stage uterine prolapse with nonpuerperal uterine inversion.
Basilar impression presenting as intermittent mechanical neck pain: a rare case report
Authors: Firas Mourad, Giuseppe Giovannico, Filippo Maselli, Francesca Bonetti, César Fernández de las Peñas, James Dunning
Journal: BMC Musculoskelet Disord (2016)
MeSH terms: Neck Pain / diagnostic imaging, Neck Pain / etiology, Platybasia / complications, Platybasia / diagnostic imaging, Case Reports, Adult, Diagnosis, Differential, Humans, Male, Radiography

Background:
Neck pain is one of the most common musculoskeletal disorders in clinical practice. However neck pain may mask more serious pathology. Although uncommon in most musculoskeletal physiotherapy practices, it is possible to encounter rare and extremely life-threatening conditions, such as craniovertebral congenital anomalies. Basilar invagination is an abnormality where the odontoid peg projects above the foramen magnum and is the commonest malformation of the craniocervical junction. Its prevalence in the general population is estimated to be 1%. Furthermore, it is a well-recognised cause of neck pain insomuch as it can be easily overlooked and mistaken for a musculoskeletal disorder. Diagnosis is based on the patient's symptoms in conjunction with magnetic resonance imaging (MRI). If life-threatening symptoms, or pressure on the spinal cord are present, the recommended treatment is typically surgical correction.
Case presentation:
This case report describes the history, relevant examination findings, and clinical reasoning used for a 37 year old male who had the chief complaint of neck pain and occipital headache. After the history and the physical examination, there were several key indicators in the patient's presentation that appeared to warrant further investigation with diagnostic imaging: (1) the drop attack after a triggering event (i.e., heading a football), (2) several episodes of facial numbness immediately and shortly after the trauma, (3) the poorly defined muscle upper extremity muscle weakness, and (4) the modification of symptoms during the modified Sharp-Purser test. Therefore, the decision was made to contact the referring neurosurgeon to discuss the patient's history and his physical examination. The physician requested immediate cervical spine MRI, which revealed a "basilar impression".
Conclusion:
This case report highlights the need for more research into a number of issues surrounding the prevalence, diagnosis, and the central role of primary care clinicians such as physiotherapists. Furthermore it underlines the importance of including Basilar invagination in the differential diagnosis. Physiotherapists working within a direct access environment must take a comprehensive history and be capable of screening for non-musculoskeletal medical conditions (on a systems, not diagnosis level) in order to avoid providing potentially harmful musculoskeletal treatments (e.g., cervical mobilization or manipulation, stretching, exercise) to patients with sinister medical pathologies, not benign musculoskeletal disorders.
Hybrid Percutaneous Brachiofemoral Shunt and Open Abdominal Aortic Aneurysm Repair in a Kidney Transplant Recipient
Authors: Javad Salimi, Sayed Alimohammad Sadat, Mohammad Javad Yavari Barhaghtalab, Hormat Rahimzadeh
Journal: Case Rep Vasc Med (2021)
MeSH terms: Case Reports

Abdominal aortic aneurysm (AAA) repair in kidney transplant recipients may cause ischemia in the transplanted kidney. As a result, various techniques have been described for protection of the renal allograft during AAA repair including temporary shunt, extracorporeal bypass, cold renal perfusion, endovascular aortic aneurysm repair (EVAR), and operation without renal allograft protection. We successfully treated a 56-year-old man, a case of kidney transplantation with AAA, using a temporary hybrid percutaneous brachiofemoral shunt using vascular prosthesis with a long 7-French (Fr) catheter sheath introducer (CSI) in the aortic arch via the right brachial artery and 8 Fr CSI in the right femoral artery that were connected together with a 7 Fr guiding catheter, before aortic cross-clamping and repair of AAA using a Dacron tube graft. The patient recovered well from the surgery without any complication and was discharged on the 6th postoperative day. To our knowledge, this is the first report of using a temporary hybrid percutaneous brachiofemoral shunt for renal allograft protection in AAA repair surgery in a patient with kidney transplantation, and we think that this temporary shunt is an easy, safe, and rapid method for renal allograft protection from ischemia.
Human neurobrucellosis with intracerebral granuloma caused by a marine mammal Brucella spp
Authors: Annette H Sohn, Will S Probert, Carol A Glaser, Nalin Gupta, Andrew W Bollen, Jane D Wong, Elizabeth M Grace, William C McDonald
Journal: Emerg Infect Dis (2003)
MeSH terms: Brucella / isolation & purification, Community-Acquired Infections / physiopathology, Granuloma / pathology, Case Reports, Adolescent, Adult, Brucella / classification, Brucella / pathogenicity, Brucellosis / drug therapy, Brucellosis / physiopathology, Community-Acquired Infections / drug therapy, Humans, Male, Peru

We present the first report of community-acquired human infections with marine mammal-associated Brucella spp. and describe the identification of these strains in two patients with neurobrucellosis and intracerebral granulomas. The identification of these isolates as marine mammal strains was based on omp2a sequence and amplification of the region flanking bp26.
Gastric small-cell carcinoma found on esophagogastroduodenoscopy: a case report and literature review
Authors: Natassja Frances, Simon B Zeichner, Michael Francavilla, Mike Cusnir
Journal: Case Rep Oncol Med (2013)

Introduction. Characterized as an undifferentiated, neuroendocrine tumor arising from totipotent stem cells, small-cell carcinoma (SCC) most commonly arises from the lung. Extrapulmonary small-cell carcinomas (ESCC) are rare and account for only four percent of SCC. Gastric ESCC, more commonly seen in Japanese male patients in their seventh decade of life, accounts for approximately 0.1 percent of ESCC. Case Presentation. A 75-year-old Hispanic male presented with a several week history of worsening epigastric pain with nausea and vomiting. Computer tomography (CT) of the abdomen and pelvis showed a large heterogeneous mass involving the posterior gastric wall with diffuse extension into the gastric cardia. Esophagogastroduodenoscopy (EGD) revealed a large fungating mass in the lesser curvature of the stomach. Biopsy of the mass revealed small-cell carcinoma of the stomach. The patient was diagnosed with extensive/stage 4 disease and started on chemoradiation. Discussion. Our case, of a very rare condition highlights, the importance of recognizing atypical pathologic diagnoses. More research will need to be conducted with GSCC patients in order to better characterize disease pathogenesis, genetic mutations, and optimal disease management. The hope is to identify biomarkers that will identify patients earlier in their disease course when cure is possible.
Forestier's disease presenting with dysphagia and disphonia
Authors: Jaafar Najib, Stephane Goutagny, Mathieu Peyre, Thierry Faillot, Michel Kalamarides
Journal: Pan Afr Med J (2014)
Keywords: forestier's disease, disphonia, dysphagia
MeSH terms: Deglutition Disorders / complications, Dysphonia / complications, Hyperostosis, Diffuse Idiopathic Skeletal / complications, Case Reports, Aged, Deglutition Disorders / diagnosis, Dysphonia / diagnosis, Humans, Hyperostosis, Diffuse Idiopathic Skeletal / diagnosis, Male

Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis (DISH), is a pathology of vertebral bodies characterised by exuberant osteophytis formation. Forestier's disease is usually managed conservatively. Surgical resection of the osteophytes is reported to be an effective treatment for severe cases and/ or cases with airway obstruction. We report a 55-year-old man presenting with 6 months' progressive dysphagia and dysphonia. He was managed successfully with an anterior cervical osteophytectomy without fusion. A literature review is included.
Design for learning - a case study of blended learning in a science unit
Authors: Roslyn Gleadow, Barbara Macfarlan, Melissa Honeydew
Journal: F1000Res (2015)
Keywords: blended learning, moodle, educational design, higher education, on-line learning, science communication

Making material available through learning management systems is standard practice in most universities, but this is generally seen as an adjunct to the 'real' teaching, that takes place in face-to-face classes. Lecture attendance is poor, and it is becoming increasingly difficult to engage students, both in the material being taught and campus life. This paper describes the redevelopment of a large course in scientific practice and communication that is compulsory for all science students studying at our Melbourne and Malaysian campuses, or by distance education. Working with an educational designer, a blended learning methodology was developed, converting the environment provided by the learning management system into a teaching space, rather than a filing system. To ensure focus, topics are clustered into themes with a 'question of the week', a pre-class stimulus and follow up activities. The content of the course did not change, but by restructuring the delivery using educationally relevant design techniques, the content was contextualised resulting in an integrated learning experience. Students are more engaged intellectually, and lecture attendance has improved. The approach we describe here is a simple and effective approach to bringing this university's teaching and learning into the 21 (st) century.
Isolated Vastus Lateralis Rupture and Repair Using Suture Anchor Technique
Authors: Pierce Johnson, Ryan Digiovanni, Tony Nguyen
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Introduction:
This is a case report of an isolated vastus lateralis rupture identified by MRI and treated successfully with surgical repair. Case Presentation. A 50-year-old male recreational weightlifter who sustained an isolated vastus lateralis rupture while dead lifting and underwent surgical repair using a suture anchor fixation.
Conclusion:
An isolated vastus lateralis rupture is a rare injury that may be successfully treated with surgical repair allowing return to preinjury activities.
Case Report: Surgery to remove adrenocortical oncocytic carcinoma from an Asian male
Authors: Hongtao Liu, Kai Huang, Dan Liu, Yehua Wang
Journal: Front Surg (2023)
Keywords: adrenocortical carcinoma, case report, oncocytic, scoliosis, surgery
MeSH terms: Case Reports

Adrenocortical oncocytic carcinoma is a rare type of adrenocortical tumor. Its clinical characteristics and biological behavior need to be further evaluated after the accumulation of cases. Here we report a case of adrenocortical oncocytic carcinoma in an Asian male with scoliosis. We performed an operation on this patient. Because the patient's scoliosis was limited during the operation and the tumor protruded into the chest, we decided to adopt open surgery in the supine position. During the operation, we found a tumor about 8 cm in diameter in the right adrenal region and successfully removed it. The patient recovered well after surgery, and there was no tumor recurrence after one year of follow-up. Pathological results confirmed the diagnosis of adrenocortical oncocytic carcinoma. Pathological features showed tumor cell invasion of adipose tissue, with atypical mitosis and abundant esinophilic cytoplasm. Immunohistochemistry showed that nucleus related antigen (Ki67) index was more than 15% and the positive pathological staining of Synaptophysin (Syn), Melanoma A (Melan A), Inhibin and calretinin. The incidence rate of adrenocortical oncocytic carcinoma is extremely rare. Abdominal Computed tomography (CT) scans and other imaging examination methods are not specific. For larger adrenal tumors, the diagnosis of this disease should be considered. For patients with adrenocortical oncocytic carcinoma who have not yet metastasized, we may achieve sound treatment effects and reduce recurrence by removing the tumor, retroperitoneal fat around the tumor and locoregional lymph nodes.
Penile Glans Necrosis following Prostatic Artery Embolization for the Treatment of Benign Prostatic Hyperplasia: A Rare but Serious Complication
Authors: Eric Chung
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Background:
Prostate artery embolization (PAE) is a novel endovascular procedure to treat men with benign prostatic hyperplasia (BPH) symptoms who wish to maintain sexual potency postoperatively. However, serious treatment-related adverse events (TRAEs) of PAE such as penile glans necrosis (PGN) can be devastating and require urgent attention. Case presentation. Mr GM is a 65-year-old sexually active Anglo-Saxon man who have long-standing BPH symptoms unresponsive to medical therapy. While he had an uneventful bilateral superselective PAE using gel foam, there were signs to suggest of PGN, and this was treated conservatively. The patient presented to the emergency department 5 days later with a painful, dark penile glans and accompanying urinary dysuria and hematuria. Clinical examination confirmed evolving PGN. He received 10 courses of hyperbaric oxygen therapy (HBOT) with complete resolution of his PGN.
Conclusion:
While superselective embolization is usually always performed, nontarget embolization may occur, as intravascular particles may reflux into adjacent vessels. In this unique and extremely rare case report of PGN following PAE, complete resolution was achieved with HBOT. Proposed benefits of HBOT include anti-inflammation, promotion of neovascularization, and induced rate of collagen deposition, resulting in a faster and more effective resolution of PGN.
Successful Vaginal Delivery of Naturally Conceived Dicavitary Twin in Didelphys Uterus: A Rare Reported Case
Authors: Houda Nasser Al Yaqoubi, Nishat Fatema
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Didelphys uterus, or double uterus, is an embryological developmental malformation of the müllerian ducts with the incidence of approximately 8.3% of all müllerian duct abnormalities (MDAs). Didelphys uterus accompanying dicavitary twin gestation is encountered as a very rare entity with overall incidence of about 1 in 1,000,000. We report a rare case of didelphys uterus, diagnosed since her first pregnancy, and during her fourth pregnancy she conceived dicavitary twin naturally without any infertility treatment. Though, the pregnancy course was complicated by preterm labour at 34-week gestation and she delivered simultaneously both fetuses with the cephalic presentation by spontaneous vaginal delivery with good maternal and neonatal outcomes.
Multivalvular involvement associated with Libman-Sacks endocarditis detected by multimodality imaging: A case report
Authors: Son Tran Thanh Bui, Phuong Hoang Nguyen, Trang Ngoc Nguyen, James N Kirkpatrick, Viet Khoi Nguyen, Hoai Thi Thu Nguyen
Journal: Front Cardiovasc Med (2023)
Keywords: libman-sacks endocarditis, cardiac computed tomography, cardiac magnetic resonance, multimodality imaging, nonbacterial thrombotic endocarditis, three-dimensional echocardiography, white matter hyperintensity
MeSH terms: Case Reports

Libman-Sacks endocarditis accounts for 6-11 percent of systemic lupus erythematosus patients and is associated with varying degrees of valvular dysfunction, increased risk for stroke and transient ischemic attacks, and increased mortality. In previous studies, left-sided valvular Libman-Sacks vegetations were more frequently detected than right sided vegetations; reported cases of bilateral involvement is very rare. A comprehensive clinical assessment and the multimodality imaging is of utmost importance in the management of systemic lupus erythematosus. In this case report, we describe a 31-year-old female patient with uncontrolled systemic lupus erythematosus initially presented with gastrointestinal symptoms but eventually had a vegetation-like structure on the posterior leaflet of the mitral valve which was revealed during routine echocardiography. Two-dimensional/three-dimensional transthoracic and transesophageal echocardiography, cardiac magnetic resonance, and cardiac computed tomography further characterized the mitral valve vegetation and revealed an additional vegetation of the pulmonary valve. Echocardiography remains the cornerstone for the detection of Libman-Sacks vegetations. Cardiac MRI and cardiac CT are useful in characterizing lesion size and effects and may prove particularly helpful in the assessment of right-sided or multivalvular endocarditis. The presence of focal brain lesions on brain MRI prompted antithrombotic therapy.
Massive Hematochezia from a Large Bleeding Duodenal Diverticulum
Authors: Marcus Juan Esteban, Amit Sureen, Daniel Herlihy, Sherif Elhanafi, Marc J Zuckerman
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Background:
Duodenal diverticula are a rare cause of gastrointestinal (GI) bleeding despite being a common finding in the GI tract. We present a case of a patient who had massive hematochezia due to a complex duodenal diverticulum. Case Presentation. A 74-year-old Hispanic female presented initially with generalized weakness. During admission, the patient had an episode of a large amount of hematochezia and had to be transferred to the intensive care unit (ICU). Upper endoscopy was done using a forward-viewing endoscope which revealed a bleeding complex duodenal diverticulum. Successful hemostasis was achieved through epinephrine injection followed by placement of hemostatic clips.
Conclusion:
Although rare, gastroenterologists need to be aware of duodenal diverticulum as a possible cause of gastrointestinal bleed. It could be life-threatening, and thus, prompt diagnosis and management is necessary.
Case Report: A Chinese Family of Type A Insulin Resistance Syndrome With Diabetes Mellitus, With a Novel Heterozygous Missense Mutation of the Insulin Receptor Gene
Authors: Wei You, Jianming Yang, Lu Wang, Yanqun Liu, Wen Wang, Li Zhu, Wei Wang, Jun Yang, Fangyuan Chen
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: chinese family, diabetes, heterozygous missense mutation, insulin receptor gene, type a insulin resistance syndrome
MeSH terms: Diabetes Mellitus / genetics, Hyperinsulinism, Insulin Resistance / genetics, Case Reports, C-Peptide, Humans, Insulin / genetics, Mutation, Missense, Receptor, Insulin / genetics, C-Peptide, Insulin, Receptor, Insulin

Type A Insulin resistance syndrome (TAIRS) is an autosomal dominant or recessive genetic disorder caused by insulin dysfunction resulting from insulin receptor (INSR) gene mutation. The main features of TAIRS include hyperinsulinemia, abnormal glucose metabolism, and changes in acanthosis nigricans. We identified, in China, a TAIRS family with a novel heterozygous missense gene mutation type. One patient from the Chinese Han family exhibited signs and symptoms of TAIRS and was presented for evaluation. Whole-exome sequencing revealed a heterozygous mutation. Both the patient proband and his father were identified with insulin receptor exon 19c.3472C>T(p.Arg1158Trp), which resulted in a missense mutation that led to replace by a base in the amino acid codon. We found that the patient proband and his father exhibited high insulin and C-peptide release after glucose stimulation by insulin and C-peptide release tests. At the same time, we also ruled out the possibility of islet βcell tumor through relevant examinations. These findings indicate that the INSR gene mutation may cause pancreatic β cell functional impairment and contribute to the development of diabetes.