OpenMed/multicare-articles huggingface dataset:
The Novel Ulnar Nerve Coverage Method Which Has the Potential to Prevent the Postoperative Ulnar Neuropathy after Plate Fixation of Distal Humerus Fractures: Three Case Reports
Authors: Hiroki Shibayama, Shintaro Yamaga, Yutaro Sugawara, Tsuyoshi Asano, Norimasa Iwasaki
Journal: Case Rep Orthop (2023)
MeSH terms: Case Reports

Introduction:
Postoperative ulnar neuropathy is still an unresolved complication in patients undergoing plate fixation of distal humerus fractures. We hypothesized that decreased blood flow to the ulnar nerve due to intraoperative procedures is an important factor in the development of postoperative ulnar neuropathy. We herein report three cases of distal humerus fractures in which the soft tissues surrounding the ulnar nerve were preserved as much as possible and finally not transferred anteriorly. Case Presentation. A 76-year-old woman, 82-year-old woman, and 34-year-old woman underwent plate fixation for distal humerus fractures. None of the patients developed postoperative ulnar neuropathy, and there were no complaints of numbness after postoperative day 1. Nerve conduction studies were performed after 3 months postoperatively and revealed that the motor nerve conduction velocities and compound motor nerve action potentials of the ulnar nerve in two of the three patients were higher than those of the noninjured side. In one of the three patients, these values were slightly lower than those of the noninjured side. All three patients achieved bony union after several months postoperatively.
Conclusions:
We obtained good outcomes with the ulnar nerve coverage method for preventing postoperative ulnar neuropathy in patients with distal humerus fractures. Preservation of blood flow to the ulnar nerve was considered important, and anatomical repositioning of the ulnar nerve after plate fixation has the potential to prevent adhesion between the ulnar nerve and the plate.
An Incidental Diagnosis of Herlyn-Werner-Wunderlich Syndrome in a Young Female: A Case Report of a Rare Entity
Authors: Sravya Gudapati, Kamlesh Chaudhari, Apoorva Dave, Dhanajay Shinde
Journal: Cureus (2024)
Keywords: hematocolpos, herlyn–werner–wunderlich syndrome, ohivra syndrome, renal agenesis, uterus didelphys
MeSH terms: Case Reports

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome, a rare genetic condition of the urogenital system, is characterized by distinctive features such as ipsilateral renal agenesis, obstructed hemivagina, and uterus didelphys. It is also referred to as Herlyn-Werner-Wunderlich (HWW) syndrome. Its clinical manifestations include dysmenorrhea, consistent abdominal pain, and infrequent periods. It is typically diagnosed after menarche. We report a case of a 20-year-old female who was admitted to the casualty ward following a road accident. She was Incidentally found to have uterine didelphys with hemorrhagic cystic lesion and left renal agenesis on ultrasonography (USG). She also had gallbladder stones, along with the findings mentioned above. Clinicians should exclude HWW syndrome in cases where uterine didelphys and unilateral renal agenesis coexist. Prompt identification and treatment of the condition can help avoid potential untoward pregnancy-related issues in the future.
A novel balloon-assisted technique to secure visceral catheterization during a chimney endovascular repair of a ruptured abdominal aortic aneurysm in a centenarian patient
Authors: Francisco Leonardo Galastri, Leonardo Guedes Moreira Valle, Marcela Juliano Silva Cunha, Bruno Pagnin Schmid, Rodrigo Gobbo Garcia, David Salomão Lewi, Breno Boueri Affonso, Felipe Nasser
Journal: J Vasc Bras (2023)
Keywords: abdominal aortic aneurysm, aged, 80 and over, aneurysm, ruptured, case report, endoleak, endovascular procedure

A 100-year-old male patient was admitted with a ruptured abdominal aortic aneurysm due to type IA endoleak. Given the proximity of the ruptured site to the superior mesenteric artery (SMA) and renal arteries, a ChEVAR was indicated. Catheterization of the target visceral vessels was a challenging procedural step because of an intensely tortuous thoracic aorta. This hostile aortic anatomy also inhibited exchange for a super stiff guide-wire and selective cannulation with the diagnostic catheter was repeatedly lost when guidewire exchange was attempted. To overcome this issue, a 5 x 40 mm balloon catheter was placed 3cm into the target arteries. The balloon was then inflated below the nominal pressure limit enabling safe exchange for a super stiff guidewire and placement of three 90-cm long 7Fr guiding sheaths. The procedure was thus safely performed with deployment of an aortic extension and the bridging stents.
Public mental health through social media in the post COVID-19 era
Authors: Deepika Sharma, Jaiteg Singh, Babar Shah, Farman Ali, Ahmad Ali AlZubi, Mallak Ahmad AlZubi
Journal: Front Public Health (2023)
Keywords: cnn, covid-19, individual behavior, micro-expressions, public mental health, social media
MeSH terms: COVID-19 / psychology, Social Media, Research Support, Non-U.S. Gov't, Emotions, Humans, Mental Health, Public Health

Social media is a powerful communication tool and a reflection of our digital environment. Social media acted as an augmenter and influencer during and after COVID-19. Many of the people sharing social media posts were not actually aware of their mental health status. This situation warrants to automate the detection of mental disorders. This paper presents a methodology for the detection of mental disorders using micro facial expressions. Micro-expressions are momentary, involuntary facial expressions that can be indicative of deeper feelings and mental states. Nevertheless, manually detecting and interpreting micro-expressions can be rather challenging. A deep learning HybridMicroNet model, based on convolution neural networks, is proposed for emotion recognition from micro-expressions. Further, a case study for the detection of mental health has been undertaken. The findings demonstrated that the proposed model achieved a high accuracy when attempting to diagnose mental health disorders based on micro-expressions. The attained accuracy on the CASME dataset was 99.08%, whereas the accuracy that was achieved on SAMM dataset was 97.62%. Based on these findings, deep learning may prove to be an effective method for diagnosing mental health conditions by analyzing micro-expressions.
Case report: Timing of eculizumab treatment in catastrophic antiphospholipid syndrome
Authors: Camillo Carrara, Blerina Mataj, Sara Gastoldi, Piero Ruggenenti, Savino Sciascia, Dario Roccatello
Journal: Front Immunol (2024)
Keywords: c5b-9, antiphospholipid syndrome, catastrophic antiphospholipid antibody syndrome (caps), complement system, eculizumab, kidney failure, timing
MeSH terms: Antibodies, Monoclonal, Humanized / administration & dosage, Antibodies, Monoclonal, Humanized / therapeutic use, Antiphospholipid Syndrome / drug therapy, Case Reports, Adult, Catastrophic Illness, Complement Inactivating Agents / therapeutic use, Complement Membrane Attack Complex / metabolism, Female, Humans, Male, Thrombotic Microangiopathies / diagnosis, Thrombotic Microangiopathies / drug therapy, Thrombotic Microangiopathies / etiology, Treatment Outcome, eculizumab, Antibodies, Monoclonal, Humanized, Complement Inactivating Agents, Complement Membrane Attack Complex

Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening condition of small-vessel thrombosis with acute multiple-organ involvement and visceral damage. In this report, we present a case of a patient with CAPS who is refractory to conventional therapy. For the first time in a patient with CAPS, marked C5b-9 formation was demonstrated on microvascular endothelial cells, suggesting the usefulness of therapeutic complement inhibition in this setting. Eculizumab, a C5-blocking monoclonal antibody, is remarkably effective in the treatment of different forms of thrombotic microangiopathy by controlling complement system hyperactivation. It halted the "thrombotic storm" and promptly achieved full recovery of thrombocytopenia. However, kidney function did not recover, possibly because eculizumab was administered too late. Conceivably, the timing of treatment is crucial to achieving disease remission before irreversible structural damage occurs in target organs, thereby preventing their complete functional recovery.
Case report: Robotically visualized and biopsy-confirmed peritoneal carcinomatosis as initial identification of metastatic prostate adenocarcinoma in a patient with a history of prostatic urethral lift
Authors: Qateeb Khan, Bryn Myers, Breann Bowar, Maryam Khan, Henry Mullaney, Jordan Gainey, Robert Schneider, Laila Dahmoush, Kenneth G Nepple, James D Byrne
Journal: Front Oncol (2024)
Keywords: ralp, metastatic prostate cancer (mpca), peritoneal metastases, prostate cancer, robot-assisted laparoscopic radical prostatectomy
MeSH terms: Case Reports

Background:
Peritoneal carcinomatosis is a particularly rare presentation of prostate cancer. Here we report a rare clinical case of surgically identified peritoneal carcinomatosis at the time of a planned robotic prostatectomy in a patient with a history of prostatic urethral lift procedure.
Case presentation:
A 72-year-old man, with a history of urinary retention managed with tamsulosin, presented to his local urologist. Prostatic urethral lift procedures were performed for symptom management. After a definitive uptrend in his prostate-specific antigen (PSA) values, a biopsy was obtained, which demonstrated prostate adenocarcinoma. On presurgical multidisciplinary review, it was presumed that he had very high-risk localized prostate cancer. However, upon initiation of robotically assisted laparoscopic radical prostatectomy (RALP), he was noted to have numerous punctate white plaques on the peritoneum; biopsy of these lesions confirmed metastatic disease-for which the patient was starting on triple therapy per the PEACE-1 trial. The PSA level responded appropriately, decreasing from 16.8 to 0.08. Genetic testing was performed and returned negative for any clinically significant mutations.
Conclusion:
Our patient, diagnosed with peritoneal carcinomatosis during a planned RALP, highlights the importance of vigilant laparoscopic exam prior to this prostatectomy. Multidisciplinary discussion is crucial for individualized and optimal treatment planning.
Case report: Rare pulmonary fungal infection caused by Penicillium digitatum: the first clinical report in China
Authors: Xiaojuan Shi, Jiaqing Ye, Peiling Liu, Weili Gao, Zhongjun Feng, Cuiying Zheng, Yinqi Huang, Yumei Guo, Lijie Zhang
Journal: Front Med (Lausanne) (2024)
Keywords: penicillium digitatum, fungal infection, invasive pulmonary fungal infection, mngs, pulmonary infection
MeSH terms: Case Reports

Penicillium digitatum is a common plant pathogen that causes citrus rot, which is extremely rare in humans. We report a case of a 66-year-old man with a history of consuming large amounts of citrus fruits, smoking for 30 years, and a history of emphysema. He had experienced intermittent coughing with sputum for more than 10 years and was admitted to the hospital due to worsening of symptoms over the past month. Despite antibiotic treatment, his condition did not improve. Subsequently, bronchoalveolar lavage fluid (BALF) was detected by metagenomic next-generation sequencing (mNGS), which showed the presence of P. digitatum. The fungal culture of BALF also indicated the presence of the Penicillium genus. The diagnosis was lung infection caused by P. digitatum, and the patient was treated with itraconazole. The lung infection was controlled. This is the third reported case of invasive pulmonary fungal infection caused by P. digitatum worldwide at the genus level, and the first reported case in China. Although human infections caused by P. digitatum are rare, as an emerging opportunistic pathogen, the detection of this fungus in immunocompromised patients should still be clinically important.
High PEEP extubation as guided by esophageal manometry
Authors: Kathryn M Pendleton, Jacob Fiocchi, Julia Meyer, Alexandra Fuher, Sarah Green, William M LeTourneau, Ronald A Reilkoff
Journal: Respir Med Case Rep (2024)
Keywords: esophageal manometry, morbid obesity, obese, positive end expiratory pressure (peep), spontaneous breathing trials (sbt), ventilator weaning
MeSH terms: Case Reports

The ventilatory management of morbidly obese patients presents an ongoing challenge in the Intensive Care Unit (ICU) as multiple physiologic changes in the respiratory system complicate weaning efforts and make extubation more difficult, often leading to increased time on the ventilator. We report the case of a young adult male who presented to our ICU on two separate occasions with hypoxemic respiratory failure requiring intubation. Esophageal manometry (EM) guided positive end expiratory pressure (PEEP) titration was utilized during both ICU admissions to improve oxygenation and aid in extubation with spontaneous breathing trials performed on higher-than-normal PEEP settings and successful liberation on both occasions.
A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI Test
Authors: Hirozumi Mori, Masashi Tamura, Ryo Ogawa, Yuta Kimata, Sho Endo, Katsutoshi Sekine, Sayuri Kodama, Hiromi Hisazumi Watanabe, Kiyoshi Ookuma, Masahiro Jinzaki
Journal: Case Rep Endocrinol (2024)
MeSH terms: Case Reports

Objective:
ACTH-producing pancreatic NETs have a propensity to metastasize, and in patients with metastases, there is no established method yet to precisely determine if the excess ACTH is produced by the primary or the metastatic tumors. Localizing the source of production of ACTH in such cases is important for devising suitable treatment strategies and evaluating the benefit of local therapies from the viewpoint of control of Cushing's syndrome.
Methods:
We performed the selective arterial calcium injection (SACI) test combined with selective portal and hepatic venous sampling in a 32-year-old female patient with ectopic ACTH-producing pancreatic NET and liver metastases.
Results:
The blood level of ACTH after Ca loading was significantly elevated only in the vessels thought to be directly feeding the pancreatic tumor, and Ca loading from any artery did not significantly increase ACTH concentrations in the hepatic veins compared to the main trunk of the portal vein.
Conclusions:
The present case demonstrates that there might be an ACTH-producing p-NET that responds to Ca loading. Further in vitro studies are required to validate this possibility.
Middle ear neuroendocrine tumor with multiple brain metastases: a case report and literature review
Authors: Yesheng Sun, Ying Zhang, Dongpeng Cai, Wei Zhang, Zhiqian Yang
Journal: Front Oncol (2024)
Keywords: menet, brain metastases, carcinoid, chemotherapy, middle ear neuroendocrine tumor, operation, radiotherapy
MeSH terms: Review

Middle ear neuroendocrine tumor (MeNET) is a low-grade tumor with rare recurrence or metastasis. Here, we describe the case of a 29-year-old man who suffered from MeNET that recurred 3 times over 10 years and eventually metastasized to the brain. The patient was treated with surgical resection, radiotherapy, and chemotherapy. However, the tumor was not entirely removed as the brain metastatic tumor adhered tightly to the brainstem. Due to tumor rupture and bleeding after multiple brain tumor removal, profound coma developed. Finally, the patient died 10 months after the last surgery. To our knowledge, this is the first report of a MeNET case with multiple brain metastases. Characteristics of the present case indicate that CK, SYN, increased Ki67 index, and ATRX may be potential biomarkers of invasive MeNET. The survival of patients with brain metastatic MeNET may be extended by surgical resection, radiotherapy, and chemotherapy. Close follow-up of distinctive metastases and biomarkers related to recurrence is also suggested.
Primary cervicothoracic melanoma of spinal cord: a case report and literature review
Authors: Ying Dang, Aichao Du, Wenyuan Wei, Jungang Xue
Journal: Front Oncol (2024)
Keywords: csep, dsep, cervicothoracic, electromyogram, primary, spinal cord
MeSH terms: Case Reports

A 53-year-old male patient presented progressive numbness and weakness in the right limbs for a 2-year duration. Magnetic resonance imaging scans revealed an intramedullary lesion crossed over cervical and thoracic levels accompanied by syringomyelia at the proximal end of the lesion. The patient underwent subtotal resection of the neoplasm. The histological findings of the tumor were consistent with primary intramedullary malignant melanoma and not initial ependymoma after careful dermatologic and ophthalmologic re-examination. Primary melanoma of the spinal cord, particularly cervicothoracic localization with syringomyelia, is seldom reported in the literature. We report a case of this uncommon tumor and also discuss the clinical course, diagnosis, and treatment.
Left Ventricular Pseudoaneurysm: A Rare but Fatal Complication of Myocardial Infarction
Authors: Sehajpreet Singh, Jasveen Kaur, Arjun Basnet, Ravi Jayanti, Bilal A Malik
Journal: Cureus (2024)
Keywords: cardiac surgical procedures, cardiology imaging, left ventricular pseudoaneurysm, myocardial infarction, myocardial rupture
MeSH terms: Case Reports

Left ventricular pseudoaneurysm is a ventricular free wall rupture contained within the adjacent adherent pericardium or scar tissue. Myocardial infarction (MI), cardiac surgery, and chest trauma are the common causes. The most common presenting symptoms of pseudoaneurysms are congestive heart failure, chest pain, and dyspnea, but a small percentage of patients may be asymptomatic. Early diagnosis and treatment are of prime importance because of the tendency of pseudoaneurysms to expand and rupture, with a high mortality rate, especially if left untreated. We present a case of a 65-year-old man who was found to have left ventricular pseudoaneurysm on a follow-up echocardiography within three weeks of an MI. He subsequently underwent patch repair and was discharged after medical optimization. Our case highlights the importance of maintaining a high clinical suspicion of pseudoaneurysm in a patient post-MI, as delayed diagnosis and treatment can be fatal.
Case report: The evolving phenotype of ESCO2 spectrum disorder in a 15-year-old Malaysian child
Authors: Sok-Kun Tae, Mazlan Ra, Meow-Keong Thong
Journal: Front Genet (2024)
Keywords: esco2 gene, esco2 spectrum disorders, malaysia, roberts syndrome, cohesinopathy
MeSH terms: Case Reports

ESCO2 spectrum disorder is an autosomal recessive developmental disorder characterized by growth retardation, symmetrical mesomelic limb malformation, and distinctive facies with microcephaly, with a wide phenotypic continuum that ranges from Roberts syndrome (MIM #268300) at the severe end to SC phocomelia (MIM #269000) at the milder end. ESCO2 encodes a 601-amino acid protein belonging to the Eco1/Ctf7 family of acetyltransferases that is involved in the establishment of sister chromatid cohesion, which is essential for accurate chromosome segregation and genomic stability and thus belongs to a group of disorders called "cohesinopathies". We describe a 15-year-old Malaysian female who presented with the characteristic triad of ESCO2 spectrum disorder, with an equivocal chromosomal breakage study and normal karyotyping findings. She was initially suspected to have mosaic Fanconi anemia but whole exome sequencing (WES) showed a likely pathogenic homozygous splice variant c.955 + 2_955+5del in the ESCO2 gene. During the 15-year diagnostic odyssey, she developed type 2 diabetes mellitus, primary ovarian insufficiency, increased optic cup-to-disc ratio with tortuous vessels bilaterally, and an evolving but distinct facial and skin hypopigmentation phenotype. Of note, there was an absence of learning disabilities. Our findings provide further evidence for ESCO2 spectrum disorder in an Asian child and contribute to defining the clinical and radiographic spectrum.
Autoreactive Antibodies Associated with Castleman Disease Triad
Authors: Jacqueline A Turner, Ali Hakimi, Hannah Lee, Jeffrey T Schowinsky, Jeffrey M Sippel, Bradford J Siegele, Raul M Torres, William A Robinson
Journal: Case Reports Immunol (2024)
MeSH terms: Case Reports

The Castleman triad has been described in a select few patients presenting with a retroperitoneal mass, mucocutaneous pemphigus vulgaris, and bronchiolitis obliterans. Here, we describe the Castleman triad in a 19-year-old male with unicentric hyaline vascular type Castleman disease (HV-CD). This patient presented with an array of positive antibodies, including anti-cyclic citrullinated peptide, anti-double-stranded DNA, and Sjogren's IgG. Interestingly, the patient's rheumatologic symptoms resolved after tumor resection, while his antibody profile remained relatively unchanged. HV-CD, with a triad presentation, was thought to be from a paraneoplastic syndrome secondary to an underlying lymphoproliferative disorder. The findings presented here identify multiple autoantibodies potentially contributing to this patient's presentation with HV-CD.
Gradenigo Syndrome: A Case Report of a Rare Complication of Otitis Media
Authors: Zainab Ali, Sajdah Alhantoosh, Zaynab Albaqal, Rawan Alkhudaimi, Ahlam S Alharbi, Tareq A Hamad
Journal: Cureus (2024)
Keywords: gradenigo syndrome, magnetic resonance imaging, meckel's cave, otitis media, unilateral abducens nerve palsy
MeSH terms: Case Reports

Otitis media, a common inflammation of the middle ear, frequently complicates upper respiratory infections. Gradenigo's syndrome, a rare complication, manifests as suppurative otitis media, abducens nerve palsy, and severe trigeminal nerve pain. Prompt recognition is vital because of the proximity of the infection to critical neurovascular structures. We present the case of a 38-year-old female who presented with facial pain, otalgia, and diplopia following an upper respiratory infection. Examination revealed facial weakness and abducens nerve palsy. Laboratory results showed elevated inflammatory markers. Imaging confirmed middle ear involvement. Antibiotics were initiated, and myringotomy was performed, resulting in a successful outcome. This case report contributes to understanding Gradenigo's syndrome's clinical nuances, emphasizing the necessity of a structured diagnostic and therapeutic approach. Ongoing research is crucial for refining diagnostic criteria, optimizing treatment, and enhancing pathophysiological understanding. Increased medical education is imperative to ensure early detection and improved patient outcomes.
Acute primary chylous peritonitis mimicking acute abdomen: a case report and literature review
Authors: Hanen Zenati, Maissa Jallali, Asma Korbi, Amina Chaka, Sadok Ben Jabra, Ibtissem Korbi, Faouzi Noomen
Journal: Pan Afr Med J (2024)
Keywords: acute, abdomen, case report, chylous peritonitis, laparotomy, lymphatic fluid
MeSH terms: Abdomen, Acute / diagnosis, Abdomen, Acute / etiology, Chylous Ascites / diagnosis, Laparotomy / methods, Case Reports, Review, Acute Disease, Diagnosis, Differential, Humans

Acute chylous peritonitis is an uncommon medical condition that can occur suddenly, resulting in the buildup of chylous fluid in the peritoneal cavity. It is considered idiopathic because the exact cause is often unknown. The symptoms of acute chylous idiopathic peritonitis can mimic other abdominal emergencies, making it challenging to diagnose and manage, requiring a multidisciplinary approach. We present a case report of acute idiopathic chylous peritonitis miming acute abdomen, how was successfully treated with surgery, and provide a comprehensive review of the available literature on this topic. Chylous peritonitis is a rare condition whose clinical presentation mimics an acute abdomen. It is necessary to undertake careful exploration. An emergent laparotomy is indicated to treat the peritonitis and search for and treat the underlying cause.