OpenMed/multicare-articles huggingface dataset:
Clopidogrel-induced neutropenia after coronary stenting: is cilostazol a good alternative?
Authors: Massimo Montalto, Italo Porto, Antonella Gallo, Claudia Camaioni, Roberta Della Bona, Antonio Grieco, Filippo Crea, Raffaele Landolfi
Journal: Int J Vasc Med (2011)
MeSH terms: Case Reports

Dual antiplatelet therapy with aspirin plus thienopyridines has become the standard treatment of patients undergoing coronary stenting. Clopidogrel has mostly replaced the use of ticlopidine due to its more favourable adverse event profile. However, also the use of clopidogrel is not without side effects. Clopidogrel major adverse events are represented by marrow suppression, manifesting with aplastic anaemia, thrombocytopenia and neutropenia. When clopidogrel toxicity occurs, there are few and unsubstantiated alternative treatments and thus, in these cases, medical decisions may be very difficult. We report a case of clopidogrel-induced bone marrow toxicity manifesting with severe neutropenia in a patient treated with multiple coronary stents and provide suggestions for an alternative treatment.
Combined Endoscopic and Percutaneous Retrieval of a Retained 4-Wire Ureteral Stone Basket
Authors: Adam G Kaplan, Glenn M Preminger, Michael E Lipkin
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

Complex endourologic procedures may require the use of a combined ureteroscopic and percutaneous approach. Endoscopic removal of a retained 4-wire ureteral stone basket is particularly complex, as broken tines can potentially injure the ureter if the basket is removed in a retrograde manner. The patient in this case presented with a ureteral stone basket embedded within the urothelium of the upper pole of the kidney. Holmium laser incision of the overlying urothelium allowed retrieval of the basket, although the tines were broken. Endoscopically guided percutaneous access to the kidney was obtained to allow for direct passage of the retained basket out of a nephrostomy sheath, thereby protecting the kidney.
Effectiveness of Combined Immunoglobulin and Glucocorticoid Treatments in a Patient With Stiff Limb Syndrome: Case Report and Review of the Literature
Authors: Juan Huang, Huan-Yu Meng, Xian Duan, Wen-Wen Li, Hong-Wei Xu, Ya-Fang Zhou, Lin Zhou
Journal: Front Neurol (2020)
Keywords: anti–glutamic acid decarboxylase (anti-gad) antibody, diazepam, glucocorticoid, intravenous immunoglobulin, stiff limb syndrome
MeSH terms: Case Reports

Stiff limb syndrome (SLS) is a rare autoimmune-related central nervous system disorder, resulting in stiffness and spasms of limbs since onset with rare involvement of the truncal muscles. However, SLS patients will gain notable effects by appropriate therapy focusing on symptomatic treatment and immunotherapy. We reported on a 55-year-old female who showed typical painful spasms in both lower limbs and abduction of the right eyeball that partially responded to low-dose diazepam and had high-titer anti-glutamic acid decarboxylase (anti-GAD) antibody. Electromyography (EMG) only showed continuous motor unit activity (CMUA) in the anterior tibialis and right triceps. Eventually, our patient was diagnosed with SLS and treated with intravenous immunoglobulin (IVIG) and glucocorticoid combined simultaneously. She obtained notable effects. We also review and summarize the current literature on clinical characteristics, coexisting disease, treatment, and outcome of 40 patients with SLS. We hope that this report will provide a basis for further understanding of SLS and promote the formation of more advanced diagnosis and treatment processes.
Community-Acquired Methicillin-Resistant Staphylococcus aureus Prostatic Abscess Presenting as Acute Urinary Retention: A Case Report and Review of the Literature
Authors: Ali Naboush, Ali Abou Yassine, Mohamad Yasmin, Neville Mobarakai
Journal: Case Rep Infect Dis (2013)

Background. Community-associated MRSA (CA-MRSA) strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system. Prostatic abscess is an uncommon disease. To date, there are only 6 published reports of a prostatic abscess secondary to CA-MRSA. Case Description. A 52-year-old diabetic Caucasian presented to the emergency department with severe lower abdominal pain of few hours duration, urinary frequency, and dribbling over the last 3 weeks. Physical examination was remarkable for an enlarged nontender prostate. A urine analysis showed pyuria while urine cultures grew CA-MRSA. Computed tomography of the abdomen and pelvis showed multiple prostate abscesses and a thickened urinary bladder wall. A TURP was performed by the urology team and pathology showed severe acute and chronic prostatitis with abscess formation and necrotic tissue. Our treatment regimen included IV vancomycin followed by oral trimethoprim/sulfamethoxazole and rifampin. Eradication of CA-MRSA was confirmed by follow-up cultures 2 months following discharge. Conclusion. This case illustrates the successful identification, diagnosis, and prompt treatment of a prostatic abscess secondary to CA-MRSA in a diabetic patient without recent hospitalization. Early treatment with antibiotics and transurethral resection of the prostate abscess led to a shortened hospital stay and decreased morbidity.
Molecular, Histologic, and Radiologic Findings of High-Grade Invasive Adenocarcinoma Arising in Oncocytic Subtype of Intraductal Papillary Mucinous Neoplasm: A Case Report and Review of Literature
Authors: Jared Shows, Christan Bartsch, Heather Carmichael, Irfan Qureshi, Barish Edil, Hubert Fenton
Journal: J Pancreat Cancer (2017)
Keywords: kras, intraductal, intraductal papillary mucinous neoplasm, oncocytic, oncocytic papillary neoplasm
MeSH terms: Case Reports

Background: We present a case of adenocarcinoma arising in the oncocytic subtype of intraductal papillary mucinous neoplasm (O-IPMN), with emphasis on the molecular findings in the adenocarcinoma component. Tissue microdissection and next-generation sequencing were performed using a 26 gene panel (AKT1, ALK, APC, BRAF, CDH1, CTNNB1, EGFR, ERBB2, FBXW7, FGFR2, FOXL2, GNAQ, GNAS, KIT, KRAS, MAP2K1, MET, MSH6, NRAS, PDGFRA, PIK3CA, PTEN, SMAD4, SRC, STK11, TP53) of cancer-related genes. Case Presentation: A 69-year-old Caucasian female presented with chest pain and was found to have findings consistent with acute pancreatitis. During her work-up, computed tomography scan revealed a large cystic and solid mass in the tail of the pancreas. She recovered from her acute pancreatitis and was discharged home. She later returned for resection of her mass. Results: Evaluation of three microdissected regions of tumor demonstrated no identifiable nonsynonymous alterations in any of the three regions, within the targeted genes. Conclusion: This case demonstrates that the O-IPMN is a molecularly distinct subtype, and we conclude that adenocarcinoma arising in these neoplasms shows molecularly distinct tumorigenesis from traditional pancreatic ductal adenocarcinoma. These differences may help explain the improved survival with invasive adenocarcinoma arising from these lesions compared with traditional ductal adenocarcinoma.
A Human Intestinal Infection Caused by a Novel Non-O1/O139 Vibrio cholerae Genotype and Its Dissemination Along the River
Authors: Songzhe Fu, Jingwei Hao, Shibo Jin, Kui Wu, Yi Wang, Shigen Ye, Ying Liu, Ruijun Li
Journal: Front Public Health (2019)
Keywords: vibrio cholerae, core genomic typing, genomic surveillance, mollusc, movement of water
MeSH terms: Case Reports

Non-O1/O139 Vibrio cholerae is increasingly reported in the clinical settings. However, intestinal infections via the consumption of non-O1/O139 V. cholerae-carrying seafood are rarely documented in China. In this study, we reported a case of mild watery diarrhea in a young male, caused by non-O1/O139 V. cholerae in the downstream of Liaohe River. Epidemiological investigation showed that this intestinal infection potentially associated with the raw consumption of mollusc. Prior to this finding, we conducted a 6-month pathogen surveillance of three locations along the Liaohe River and identified three environmental non-O1/O139 V. cholerae strains. To confirm the epidemiological links between clinical and environmental strains, high-resolution genomic typing was employed and revealed that V. cholerae isolated from human stool sample was genomically related to the one found in local mollusc and shared a common ancestor with other environmental strains obtained in the upstream sites of the Liaohe River. This fact suggests that the river is a natural reservoir for non-O1/O139 V. cholerae which poses a potential threat to the public health. In summary, our results deepened the insights on the transmission of non-pandemic V. cholerae strains and underscored the significance of genomic surveillance for drinking water along the river sites.
Durable Clinical Response to Pyrotinib After Resistance to Prior Anti-HER2 Therapy for HER2-Positive Advanced Gastric Cancer: A Case Report
Authors: Le-Tian Huang, Jie-Tao Ma, Shu-Ling Zhang, Xiao-Han Li, Li Sun, Wei Jing, Jian-Zhu Zhao, Yan-Ru Wang, Cheng-Bo Han
Journal: Front Oncol (2019)
Keywords: her2, apatinib, gastric cancer, nivolumab, pyrotinib
MeSH terms: Case Reports

Background: Patients with advanced gastric cancer, especially the HER2-positive type, have a poor prognosis; there is a paucity of effective anti-HER2 drug therapies in patients who develop resistance to trastuzumab. Case presentation: We report the case of a 36-year-old male with HER2-positive gastric cancer with lung and liver metastases. The patient responded after treatment with trastuzumab combined with chemotherapy and attained a progression-free survival (PFS) of 17 months. Subsequently, the patient received apatinib that selectively inhibits the VEGFR2 and obtained an evident tumor response and a PFS of 8 months. When the disease progressed again, the regimen containing lapatinib failed. Then, the patient received treatment with nivolumab. However, he presented with hyper-progressive disease (HPD). Finally, he received a combination of capecitabine and pyrotinib, an irreversible dual TKI, acting on HER2 and EGFR. The tumor shrank markedly with this combination therapy. The mechanism of both HPD due to immunotherapy and the resistance to trastuzumab and lapatinib were investigated in this case. Loss of phosphatase and tensin homolog (PTEN) and new mutations of BRCA1 and KRAS were detected after resistance to trastuzumab and lapatinib. Conclusions: For patients with HER2-positive advanced gastric cancer who have developed resistance to trastuzumab, pyrotinib is a promising new agent, which can be used as salvage therapy.
Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR) Imaging Studies
Authors: Geraldine H Chang, Eric Y Chang, Christine B Chung, Donald L Resnick
Journal: Case Rep Med (2014)

Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR) imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications.
Cardiogenic Shock due to Kounis Syndrome following Cobra Bite
Authors: W D D Priyankara, E M Manoj, A Gunapala, A G R M A Ranaweera, K S Vithanage, M Sivasubramanium, E Snajeeva
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

Kounis syndrome is associated with mast cell activation resulting in acute coronary syndrome secondary to an allergic insult. Various drugs such as antibiotics, analgesics, and environmental exposures such as bee, wasp sting, and poison ivy are known to induce Kounis syndrome. A 68-year-old man admitted with a cobra bite on both hands to emergency care unit and sustained cardiorespiratory arrest. Electrocardiogram, taken 6 hours after the cardiac arrest, showed ST elevations in leads V2 to V5 suggestive of anterior ST elevation myocardial Infarction (STEMI). Serum Troponin was 10 ng/ml (control= <0.5). Serum IgE levels were significantly high (19155IU/ml, baseline 100). 2-Dimensional echocardiogram showed anterior and apical-septal hypokinesia with left ventricular ejection fraction of 30-35%. Coronary angiogram was normal. He remained hypotensive requiring inotropic and vasopressor support during ICU stay. This was a case of Kounis syndrome leading to cardiogenic shock secondary to Cobra (naja naja) bite. This is the only reported case of cobra bite causing Kounis syndrome and cardiogenic shock. Identification of the cause of myocardial infarction in snake envenomation is useful in the management as some of the drugs like adrenaline, morphine, and beta blockers may worsen the clinical syndrome if it is due to Kounis syndrome.
Case report: Ventriculoperitoneal shunt disconnection resulting in migration of the distal catheter entirely into the abdominal cavity due to seizure
Authors: Xiang Yang, Chaohua Yang, Yuekang Zhang
Journal: Front Surg (2022)
Keywords: catheter, disconnection, seizure, valve, ventriculoperitoneal (vp)
MeSH terms: Case Reports

Ventriculoperitoneal (VP) shunt disconnection, a VP shunt complication, can be caused by several factors. We report the case of a young man who suffered VP shunt disconnection, and whose entire distal catheter migrated into the abdominal cavity due to a seizure. To our knowledge, risk factors for seizures related to shunt disconnection have not been previously evaluated. We report this rare case to highlight the fact that seizures are not negligible in increasing the probability of disconnection and migration of the entire distal catheter into the abdominal cavity, and the standardized treatment of traumatic seizures is extremely important.
A Case of Postpartum Anogenital Mammary-Like Gland Tumor with Focal Lactational Features: A Nomenclature Issue
Authors: Sakinah A Thiryayi, Marjan Rouzbahman, Danny Ghazarian
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Mammary-like glands (MLG) are considered to be a normal constituent of the anogenital region and can give rise to tumors with variable morphology that may be difficult to classify. We present a case of an anogenital mammary-like gland tumor in a breastfeeding woman showing morphological variation with lactational change, an unusual finding. We discuss the differing terminology used to report these tumors and the variation in assignment of their origin to MLG or ectopic breast tissue.
New Directions in 3D Medical Modeling: 3D-Printing Anatomy and Functions in Neurosurgical Planning
Authors: Paolo Gargiulo, Íris Árnadóttir, Magnús Gíslason, Kyle Edmunds, Ingvar Ólafsson
Journal: J Healthc Eng (2017)
MeSH terms: Brain Neoplasms / surgery, Glioma / surgery, Imaging, Three-Dimensional, Models, Anatomic, Printing, Three-Dimensional, Case Reports, Research Support, Non-U.S. Gov't, Adult, Brain Neoplasms / diagnostic imaging, Corpus Callosum / diagnostic imaging, Female, Glioma / diagnostic imaging, Humans, Magnetic Resonance Imaging, Neurosurgical Procedures, Tomography, X-Ray Computed

This paper illustrates the feasibility and utility of combining cranial anatomy and brain function on the same 3D-printed model, as evidenced by a neurosurgical planning case study of a 29-year-old female patient with a low-grade frontal-lobe glioma. We herein report the rapid prototyping methodology utilized in conjunction with surgical navigation to prepare and plan a complex neurosurgery. The method introduced here combines CT and MRI images with DTI tractography, while using various image segmentation protocols to 3D model the skull base, tumor, and five eloquent fiber tracts. This 3D model is rapid-prototyped and coregistered with patient images and a reported surgical navigation system, establishing a clear link between the printed model and surgical navigation. This methodology highlights the potential for advanced neurosurgical preparation, which can begin before the patient enters the operation theatre. Moreover, the work presented here demonstrates the workflow developed at the National University Hospital of Iceland, Landspitali, focusing on the processes of anatomy segmentation, fiber tract extrapolation, MRI/CT registration, and 3D printing. Furthermore, we present a qualitative and quantitative assessment for fiber tract generation in a case study where these processes are applied in the preparation of brain tumor resection surgery.
The Effect of Exercise Intervention Based Upon the Selective Functional Movement Assessment in an Athlete With Non-specific Low Back Pain: A Case Report and Pilot Study
Authors: Li Huang, Haowei Liu, Li Zhao, Li Peng
Journal: Front Psychol (2020)
Keywords: selective functional movement assessment, chronic non-specific low back pain, exercise intervention, mobility, musculoskeletal disorders, stability

Objectives:
To illustrate the effectiveness of the Selective Functional Movement Assessment (SFMA) as a guide to exercise intervention on chronic non-specific low back pain (CNLBP).
Methods:
A 23-year-old male volleyball athlete with CNLBP was evaluated using the SFMA to assess the degree of physical dysfunctions. And then two-stage exercise protocol was designed based on the results of SFMA. The athlete conducted the exercise intervention for 8 weeks, 1 h each time, three times a week. Transverse abdominal muscles and multifidus muscle thickness, the degree of low back pain, and the degree of physical dysfunctions were measured at pre-intervention, midintervention, and post-intervention.
Results:
Based on the results of SFMA, the exercise protocol in the first 4-week session was designed mainly to develop the mobility of ankle, hip, and chest and the stability of lumbar, hip, and knee, in order to improve core strength and gluteal muscle strength. The second 4-week session was an advanced stage with the increase of exercise load on the basis of flexibility and stability; its main purpose was to loosen the hamstring muscles and continue strengthening the core stability and finally help the participant to establish the correct movement pattern and solve the problems of dysfunctions. After 8-week exercise intervention, all movement patterns became functional/non-painful except the deep squat pattern; the Quebec Back Pain Disability Scale score decreased from 11 to 2; visual analog scale score decreased from 4 to 2; the thicknesses of the transverse abdominis muscles (right side: 0.2 vs. 0.31 cm, left side: 0.22 vs. 0.33 cm) and multifidus muscles (right side: 2.09 vs. 2.26 cm, left side: 2.15 vs. 2.29 cm) were both increased.
Conclusion:
In this case, the SFMA helped to recognize problems related to mobility and stability on the hip joint, thoracic spine, and even areas far away from the lumbar spine in an athlete with CNLBP that were not seen with more conventional examination procedures. The improvements of physical function, the increase in deep core muscles thickness, and the released pain after exercise intervention all verified the effectiveness of SFMA to qualitatively analyze movement patterns at examination and to direct subsequent exercise intervention.
Severe paraneoplastic hypoglycemia in a patient with a gastrointestinal stromal tumor with an exon 9 mutation: a case report
Authors: Guillermo A Escobar, William A Robinson, Trevor L Nydam, Drew C Heiple, Glen J Weiss, Linda Buckley, Rene Gonzalez, Martin D McCarter
Journal: BMC Cancer (2007)
MeSH terms: Gastrointestinal Stromal Tumors / complications, Gastrointestinal Stromal Tumors / genetics, Mutation, Paraneoplastic Syndromes / genetics, Proto-Oncogene Proteins c-kit / genetics, Case Reports, Adult, Exons / genetics, Gastrointestinal Stromal Tumors / diagnosis, Gastrointestinal Stromal Tumors / pathology, Gastrointestinal Stromal Tumors / surgery, Glucose / therapeutic use, Humans, Hypoglycemia / diagnosis, Hypoglycemia / therapy, Intestine, Small / pathology, Intestine, Small / surgery, Laparotomy / methods, Male, Neoplasm Staging, Paraneoplastic Syndromes / pathology, Paraneoplastic Syndromes / surgery, Tomography, X-Ray Computed, Treatment Outcome, Proto-Oncogene Proteins c-kit, Glucose

Background:
Non-islet cell tumor induced hypoglycemia (NICTH) is a very rare phenomenon, but even more so in gastrointestinal stromal tumors. It tends to present in large or metastatic tumors, and can appear at any time in the progression of the disease. We present herein a case of NICTH in a GIST tumor and report an exon 9 mutation associated to it.
Case presentation:
A thirty nine year-old man with a recurrent, metastatic gastrointestinal stromal tumor presented to the hospital with nausea, dizziness, loss of consciousness, and profound hypoglycemia (20 mg/dL). There was no evidence of factitious hypoglycemia. He was stabilized with a continuous glucose infusion and following selective vascular embolization, the patient underwent debulking of a multicentric 40 cm x 25 cm x 10 cm gastrointestinal stromal tumor. After resection, the patient became euglycemic and returned to his normal activities. Tumor analysis confirmed excessive production of insulin-like growth factor II m-RNA and the precursor protein, "big" insulin-like growth factor II. Mutational analysis also identified a rare, 6 bp tandem repeat insert (gcctat) at position 1530 in exon 9 of KIT.
Conclusion:
Optimal management of gastrointestinal stromal tumor-induced hypoglycemia requires a multidisciplinary approach, and surgical debulking is the treatment of choice to obtain immediate symptom relief. Imatinib or combinations of glucocorticoids and growth hormone are alternative palliative strategies for symptomatic hypoglycemia. In addition, mutations in exon 9 of the tyrosine kinase receptor KIT occur in 11-20% of GIST and are often associated with poor patient outcomes. The association of this KIT mutation with non-islet cell tumor induced hypoglycemia has yet to be established.
Child with a tail
Authors: Naeem Liaqat, Asif Iqbal Sandhu, Feeroz Alam Khan, Ejaz Ehmed, Sajid Hameed Dar
Journal: APSP J Case Rep (2013)
Keywords: congenital tail, spina bifida, spinal dysraphism, tethered spinal cord
MeSH terms: Case Reports

Spina Bifida occulta usually presents with some cutaneous stigmata e.g. hair patch, sinus, lipoma, hyperpigmented skin and very rarely a congenital tail. A congenital tail may and may not be associated with spina bifida occulta and tethered cord. A four month old male child presented with congenital tail which was associated with spinal dysraphism and caused tethering of the cord itself. The tail and tethering lesion were excised successfully.
Anti-Yo Mediated Paraneoplastic Cerebellar Degeneration Associated with Pseudobulbar Affect in a Patient with Breast Cancer
Authors: Allison N Martin, Patrick M Dillon, David E Jones, David R Brenin, David A Lapides
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Paraneoplastic cerebellar degeneration (PCD) is a rare anti-Yo mediated paraneoplastic syndromes rarely that is infrequently associated with breast cancer. We present a case of a 52-year-old female presenting with diplopia, gait instability, dysarthria, dysphagia, nystagmus, and, most notably, new onset paroxysmal episodes of uncontrollable crying concerning for pseudobulbar affect (PBA). Serologic testing showed anti-Yo antibodies. The patient was found to have stage IIIA breast cancer as the inciting cause of the paraneoplastic syndrome. The patient was treated with neoadjuvant chemotherapy, modified radical mastectomy, adjuvant Herceptin, and pertuzumab. She was given IVIG for paraneoplastic syndrome, antidepressants, and dextromethorphan-quinidine (Nuedexta), the first FDA-approved therapy for PBA. With multimodality therapy, she demonstrated significant improvement in neurologic and mood symptoms associated with PCD and PBA.