OpenMed/multicare-articles huggingface dataset:
A retrospective case-series of influence of chronic hepatitis B on synchronous liver metastasis of colorectal cancer
Authors: Lin Zhu, Piqing Gong, Ye Liu, Yunjie Shi, Wenqiang Wang, Wei Zhang, Zhiqian Hu, Xinxing Li
Journal: Front Oncol (2023)
Keywords: hbv, chronic hepatitis b, colorectal cancer, liver cirrhosis, synchronous liver metastasis

Main point:
Our retrospective analysis of a large number of cases found in patients with primary colorectal cancer (CRC) carrying positive HBsAg inhibited the occurrence of synchronous liver metastases (SLM). However, liver cirrhosis caused by non-HBV factors promoted the occurrence of SLM.
Objectives:
This study aimed to investigate the effect of HBV on the occurrence of synchronous liver metastases (SLM) of colorectal cancer (CRC).
Methods:
Univariate and multivariate analyses were used to analyze the influence of clinical parameters on the occurrence of SLM.
Results:
A total of 6, 020 patients with primary CRC were included in our study, of which 449 patients carrying HBsAg(+) accounted for 7.46%. 44 cases of SLM occurred in the HBsAg(+) group, accounting for 9.80%, which was much lower than 13.6% (758/5571) in the HBsAg(-) group (X=5.214, P=0.022). Among CRC patients with HBsAg(-), the incidence of SLM was 24.9% and 14.9% in the group with high APRI and FIB-4 levels, respectively, which were significantly higher than that in the compared groups (12.3% and 12.5%, all P<0.05). Compared with the control group, female patients, late-onset patients, and HBV-infective patients had lower risks of SLM (HR=0.737, 95%CI: 0.614-0.883, P<0.001; HR=0.752, 95%CI: 0.603-0.943, P=0.013; HR=0.682, 95%CI: 0.473-0.961, P=0.034).
Conclusions:
The carriage of HBsAg(+) status inhibited the occurrence of SLM from CRC. HBV-causing liver cirrhosis did not further influence the occurrence of SLM, whereas non-HBV-factor cirrhosis promoted the occurrence of SLM. Nevertheless, this still required prospective data validation.
Misdiagnosis of Psychosis and Obsessive-Compulsive Disorder in a Young Patient with Autism Spectrum Disorder
Authors: Jiangbo Ying, Melvyn Weibin Zhang, Sreedharan Geetha Sajith, Giles Ming-Yee Tan, Ker-Chiah Wei
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction and the presence of restricted and repetitive patterns of behavior. Making a first diagnosis of ASD in adults has certain difficulties, including inaccurate recall of developmental history and overlapping behaviors with other psychiatric conditions. This case study presents a young man who was assessed to have no major mental illness during his first visit to emergency services in a psychiatric hospital. During his second visit, he was initially assessed to have first episode psychosis, due to his possible delusional beliefs related to the insurance payout, social withdrawal, and strange behaviors, and then later he was assessed to have obsessive-compulsive disorder (OCD) instead of psychosis, because of his recurrent and intrusive thoughts. Eventually, his diagnosis was revised to ASD during outpatient follow-up after more comprehensive assessment. It is not easy to differentiate ASD from psychosis among some adult patients, even for expert psychiatrists. Cognitive rigidity in ASD may be similar to delusions in psychosis. Unusual behaviors in ASD can be confused with disorganized behaviors in psychosis. Differentiating ASD from OCD can be a complicated task as well, due to similarities between ASD and OCD. Restricted interests and repetitive behaviors in ASD may be perceived as obsessions and compulsions in OCD. Overall, diagnosis of ASD in adults requires comprehensive evaluation. Distinguishing symptoms of OCD and psychosis from autistic traits is critical for accurate diagnosis and optimal treatment. Although research in adult ASD has expanded alongside increased prevalence statistics over the past few years, more efforts to enhance the diagnostic processes in adult ASD are needed to reduce the challenges in this field.
Craniopharyngioma involving the anterior, middle, and posterior cranial fossa in adults: A case report
Authors: Bin Tian, Ming Li, Xiaolin Du, Hui Zhou, Kun Zhou, Shiguang Li
Journal: Front Neurol (2023)
Keywords: ct, mri, adult, craniopharyngioma, multiple cystic masses
MeSH terms: Case Reports

Craniopharyngioma (CP) is a rare benign tumor that develops from the residual epithelial cells of the craniopharynx, accounting for < 5% of intracranial tumors. It is common for CPs to grow in the sellar/parasellar region and extend suprasellar. The pathology classifies CPs into adamantinomatous craniopharyngiomas (ACP) and papillary craniopharyngiomas (PCP). The PCP is mainly solid and occurs only in adults. ACP is predominantly cystic and more common in childhood and adolescent. Multilocular cystic ACP involving the anterior, middle, and posterior cranial fossa is rare in adults. Here, we report a case of a 46-year-old adult male patient who presented with recurrent headaches for 1 year with choking and hoarseness. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed multiple cystic masses in the anterior, middle, and posterior cranial fossa. Initial hypotheses included the following: CP, colloid cyst, enterogenous cyst, epidermoid cyst, and dermoid cyst. Subsequently, the patient underwent surgery and postoperative histopathology diagnosed ACP. Adults with ACP involving the anterior, middle, and posterior cranial fossae are uncommon. This is a rare condition that radiologists should be aware of.
En bloc kidney transplant from an 18-month-old donor to an adult recipient: Case report and literature review
Authors: B Patrice Mwipatayi, Chee Weng Leong, Pradeep Subramanian, Alarick Picardo
Journal: Int J Surg Case Rep (2013)
Keywords: en bloc kidney transplant, paediatric kidney donor, single kidney transplantation

Introduction:
There is an ever-increasing need for organ donations globally. Paediatric kidney transplantation into adult recipients is a well-recognised technique to expand the donor pool. The transplantation can be done either via en bloc kidney transplant (EBKT) or as single kidney transplantation (SKT).
Presentation of case:
An EKBT from a 18-month-old (15kg) male patient was transplanted in a 35-year old, 85kg male with end stage renal failure (ESRF), secondary to Focal Segmental Glomerulosclerosis (FSGS) on haemodialysis. Post-operative recovery was uneventful. Immuno-suppressant drugs used were tacrolimus, basiliximab and prednisolone. Doppler ultrasound scans performed post-operatively showed normal renal resistive indices in both kidneys. Serum creatinine decreased from 1200 to 170μmol/L 57 with eGFR improving from 4 to 38mL/min/1.73m(2) at four weeks post-transplant.
Discussion:
Given the low incidence of paediatric donors, EBKTs are relatively uncommon and subsequently published series tend to be centre specific with small numbers. The graft survival rates tell us that paediatric kidney donors should not be considered as marginal transplants. The difficulty is in determining when it is more appropriate to perform a paediatric EBKT as opposed to splitting and performing two SKT. Unfortunately there are no widely accepted guidelines to direct clinicians.
Conclusion:
This case report highlights the first EKBT performed at our institution. The current literature demonstrates that paediatric donors are excellent resources that should be procured whenever available.
Solitary Fibrous Tumor of the Prostate Which Was Initially Misdiagnosed as Prostate Cancer
Authors: Soma Osamu, Hiromi Murasawa, Atsushi Imai, Shingo Hatakeyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Chikara Ohyama
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

Solitary fibrous tumor (SFT) of the prostate is a very rare tumor. We report a case of 65-year-old man with SFT of the prostate which was initially misdiagnosed as prostate cancer. Finally, we performed total prostatectomy and the tumor was histologically diagnosed as SFT of the prostate. The patient's clinical course has progressed favorably with no obvious recurrence 18 months postoperatively.
Cryptococcus: A Rare Cause of Parotid Abscess in Liver Cirrhosis
Authors: Takeshi Okamoto, Katsuyuki Fukuda
Journal: Case Reports Hepatol (2020)
MeSH terms: Case Reports

A 61-year-old man with decompensated liver cirrhosis presented with a parotid mass. Fine-needle aspiration of the parotid gland revealed Cryptococcus neoformans. Lumbar puncture confirmed cryptococcal meningitis. Multiple splenic lesions with radiographic features consistent with cryptococcal splenic abscesses were also seen. Despite antifungal therapy, the patient died 17 days after infection was confirmed. This is the first report of a cryptococcal parotid abscess in a patient with liver cirrhosis.
Cardiac Sarcoidosis as an Uncommon Etiology for Posterior Circulation Stroke Presenting with Alexia without Agraphia
Authors: Mohankumar Kurukumbi, Lauren Gardiner, Shevani Sahai, John W Cochran
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Sarcoidosis is a systemic disease with cardiac involvement occurring in 20-50% of cases. Cardiogenic stroke caused by cardiac sarcoidosis, especially PCA infarction, is a rare clinical presentation that necessitates timely diagnosis and may warrant treatment prophylaxis against CVA. In this case report, we describe a 54-year-old Caucasian male presenting with left PCA stroke in the setting of cardiac and pulmonary sarcoidosis, and hypertension. His presenting symptoms included right partial hemianopia, difficulty with naming, memory, and recall, and alexia without agraphia. Cardiogenic stroke is an uncommon manifestation of cardiac sarcoidosis, and given the disabling nature of these sequelae, the importance of early diagnosis and prevention with anticoagulation is crucial to prevent morbidity and mortality.
Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders
Authors: Rohan Ameratunga
Journal: Allergy Asthma Clin Immunol (2017)
Keywords: bariatric surgery, cvid, ivig, scig
MeSH terms: Case Reports

Background:
Immunoglobulin therapy plays a critical role in the treatment of immunodeficiency disorders as well as autoimmune and inflammatory conditions. In immunodeficient patients, there has been controversy whether initial loading doses of intravenous (IVIG) should be based on actual body weight or a calculated parameter such as adjusted body weight in obese patients.
Case presentation:
I describe a patient with Common Variable Immunodeficiency disorder (CVID) who underwent bariatric surgery for morbid obesity. Her weight decreased by 50% to below her calculated ideal body weight (IBW) while her immunoglobulin requirement fell by approximately 20%. Her steady state serum IgG increased from approximately 7 g/l to 11.7 g/l concomitant with weight loss.
Conclusions:
I present this observation as support for the recommendation that initial loading doses of SCIG/IVIG in immunodeficiency should be based on adjusted body weight (AjBW) and not actual body weight in obese patients. This has important fiscal implications for treating obese patients with immunodeficiency disorders.
COVID-19 Like Findings in a Fatal Case of Idiopathic Desquamative Interstitial Pneumonia Associated With IgA Glomerulonephritis in a 13-Month-Old Child
Authors: Simona Gurzu, Catalin Bogdan Satala, Lorena Elena Melit, Adrian Streinu-Cercel, Dan Otelea, Brandusa Capalna, Claudiu Ioan Puiac, Janos Szederjesi, Ioan Jung
Journal: Front Pediatr (2020)
Keywords: berger, covid, iga, sars, autopsy, glomerulopathy, infant, interstitial pneumonia
MeSH terms: Case Reports

In the COVID-19 era, patients with severe acute respiratory syndrome (SARS) are suspected to be associated with SARS-CoV-2 infection. The aim of this paper is to present a case with COVID-like pneumonia, with fatal evolution. The clinical aspects were correlated with the autopsy findings and discussed on the background of the most recent data from the medical literature. A 13-month-old girl was admitted to the emergency room with acute severe shortness of breath and pulmonary bilateral ground-glass opacities and an almost complete opacified left lung. The patient suddenly deteriorated, and death was confirmed 3 h after admission. At autopsy, severe desquamative interstitial pneumonia was diagnosed and was associated with an unusual IgA glomerulonephritis. No SARS-CoV-2 infection was detected in the lung parenchyma by RT- PCR. This is a very unusual case of rapid deterioration of an infant with idiopathic desquamative interstitial pneumonia (IDP) and multiorgan involvement. Based on immunohistochemical stains, we hypothesize that, in IDP, the hyaline membranes arise from necrotizing desquamated pneumocytes. In the COVID-19 era, such cases are extremely difficult to diagnose; they can mimic SARS-CoV-2-induced lung injuries. This pattern of hyaline membrane formation might explain the poor response to oxygen therapy. The present case highlights the importance of autopsy in such challenging cases.
First in human neochordae retensioning for recurrence of mitral regurgitation after neochord procedure
Authors: Alessandro Fiocco, Demetrio Pittarello, Augusto D'Onofrio, Florinda Mastro, Gino Gerosa, Andrea Colli
Journal: Front Cardiovasc Med (2023)
Keywords: neochord procedure, microinvasive, mitral valve, mitral valve repair, retensioning

The Neochord procedure is a viable option to treat degenerative mitral valve regurgitation in selected patients. Left ventricle reverse remodeling can cause neochord-relative elongation and reprolapse of the treated leaflet, leading to failure. We present a clinical case of extensive ventricle reverse remodeling after neochord implantation and the first-in-man off-pump surgical retensioning of the previously implanted artificial chords.
Bronchoesophageal Fistula due to Esophageal Tuberculosis
Authors: Pathik Desai, Prachi Mayenkar, Thomas F Northrup, Vijaya Mallela
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

This is a case report regarding a patient who presented with 6 months of dysphagia and subsequent 40-pound weight loss. The patient underwent imaging, suggestive of pulmonary TB. Further workup of his dysphagia with esophagogastroduodenoscopy and bronchoscopy revealed two bronchoesophageal fistulas. Tuberculosis is an important differential diagnosis of prolonged dysphagia in immunocompetent patients.
Delayed primary closure in open abdomen with stoma using dynamic closure system
Authors: Juan Manuel Suarez-Grau, Juan Francisco Guadalajara Jurado, Julio Gómez Menchero, Juan Antonio Bellido Luque
Journal: Springerplus (2015)
Keywords: abra, abdominal wall, closure, compartimental syndrome, open abdomen, surgery, vac

Background:
The situation of abdominal sepsis secondary to colonic perforation sometimes forces treat the patient with multiple interventions in the open abdomen (OA) context. Correct management of OA is important to restore the patient's clinical situation and to avoid further complications of the abdominal wall. Delayed primary closure of the abdomen using a dynamic and progressive traction is a relatively new technique for treating the OA.
Case presentation:
We report the case of a 50 year old woman with history of malnutrition and chronic obstructive pulmonary disease, affects for an OA after several surgical interventions. Two previous interventions (right colectomy, ileostomy and laparotomy with Bogotá bag) for disseminated peritonitis and abdominal compartment syndrome were performed. Six days after the Bogota bag the of the dynamic closure system ABRA(®) system was placed to delayed primary closure of the abdomen with excellent result results of the contingency of the abdominal wall.
Discussion:
The most common technique in the current management of OA is the placement of vacuum-assisted closure or the use of a mesh. These systems generally require several operations to restore the integrity of the abdominal wall. However, the dynamic closure of the abdominal wall makes it possible to restore it into the same process.
Conclusions:
ABRA system allows delayed primary closure of the abdominal wall in an OA by sepsis secondary to colonic perforation. The stoma was not a problem with this technique. The final closure of the abdomen was at 16 days after the ABRA placement. The abdominal wall has not alterations in the follow up after 3 years.
Beneficial Effects of Palmitoylethanolamide on Expressive Language, Cognition, and Behaviors in Autism: A Report of Two Cases
Authors: Nicola Antonucci, Alessandra Cirillo, Dario Siniscalco
Journal: Case Rep Psychiatry (2015)

Introduction. Autism spectrum disorders are defined by behavioral and language atypias. Growing body of evidence indicates inflammatory mediators may contribute to the condition. Palmitoylethanolamide (PEA) is naturally occurring and has been available as a nonprescription medical food supplement in Europe since 2008. PEA has been tested in thousands of human subjects without any noted significant side effects. Here we report the first cases of the administration of PEA to two children with autism. Case Presentations. The first 13-year-old male child (Subject 1) presented with a total IgE of 572 IU/mL (nl < 200) and with low mature CD57(+) natural killer cell counts (32 cells/µL; nl = 60-300 cells/µL) and with significant eczema and allergic stigmata. Expressive language, as measured by mean length of utterance, and overall autism severity as measured by the Childhood Autism Rating Scale, Second Edition, improved significantly. Atopic symptoms diminished. No side effects were reported. The second male child, age 15 (Subject 2), also displayed noticeable and rapid improvements in cognitive, behaviors, and sociability. Conclusion. Currently, there is no definitive treatment for autism condition. Palmitoylethanolamide could be an effective treatment for autism syndrome. We propose appropriate double-blind clinical trials to further explore palmitoylethanolamide efficacy and safety.
A "Rash" Decision in Anesthetic Management: Benzyl Alcohol Allergy in the Perioperative Period
Authors: Michael Tripp, Matthew Ribeiro, Susanna Kmiecik, Ramon Go
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

Here, we present the case of a 54-year-old female presenting for outpatient ankle hardware removal who experienced severe total body pruritus along with a maculopapular rash persisting four days after the procedure. Patch testing demonstrated a sensitivity to benzyl alcohol, a preservative in propofol and several other anesthetics. The patient returned for left ankle arthroscopy a year later, and during that procedure, the anesthetic team avoided medications containing benzyl alcohol. This resulted in no pruritus or rash. Hypersensitivity reactions, ranging from contact dermatitis to anaphylaxis, are critical events in the perioperative period. Induction of general anesthesia has been implicated as the inciting event for perioperative hypersensitivity reactions. Benzyl alcohol is among a few excipients found in common anesthetic agents known to cause hypersensitivity reactions in susceptible patients. While reports of adult death are rare, infantile death due to benzyl alcohol has been described.
Postmortem demonstration of the source of pulmonary thromboembolism: the importance of the autopsy
Authors: Gina Elhammady, Andrew T Schubeck, Vicky El-Najjar, Morton J Robinson
Journal: Case Rep Vasc Med (2011)
MeSH terms: Case Reports

Periprostatic or paravaginal venous thromboses are rarely considered clinically as sites of clot origin in patients with pulmonary thromboembolism. The majority of emboli have been demonstrated to originate in the veins of the legs. This report raises awareness of pelvic vein thrombosis as a potential source of pulmonary embolism that is rarely considered or detected clinically, and which usually requires postmortem examination for recognition. It also reviews the possible routes emboli may take to reach the lungs.
Rheopheresis for Digital Ulcers and Raynaud's Phenomenon in Systemic Sclerosis Refractory to Conventional Treatments
Authors: Peter Korsten, Gerhard A Müller, Jan-Gerd Rademacher, Michael Zeisberg, Björn Tampe
Journal: Front Med (Lausanne) (2019)
Keywords: extracorporeal circulation, plasmapheresis, raynaud phenomenon, skin ulcers, systemic sclerosis
MeSH terms: Case Reports

Raynaud's phenomenon (RP) is almost universally present in patients with Systemic Sclerosis (SSc). RP represents a generalized vasculopathy and potentially lead to digital ulcers (DU), which may be complicated by superinfection, tissue necrosis, and limb loss. We report the analysis of an extracorporeal procedure in a 36-year-old female patient with diffuse SSc with refractory RP and DU despite treatment with diltiazem, candesartan, sildenafil, and intravenous iloprost. We performed rheopheresis (RheoP), a variant of double-filtration plasmapheresis, as a potential new treatment option for refractory patients despite optimal medical therapy. We performed two RheoP per week every 4 weeks for a total of 3 months. Clinical improvement in DU healing occurred with no adverse events directly related to the treatment. While there was no reduction in the number of Raynaud attacks with RheoP, a significant reduction of the duration of attacks from a median of 15 (5-45, 95% CI 10-15) to 7 (3-30, 95% CI 6-10) minutes with an improvement of the Raynaud Condition Score (RCS) improved from 4 to 2. In conclusion, RheoP is a feasible and potentially beneficial treatment modality in patients with refractory RP and DU. We propose that RheoP should be investigated in a larger number of patients in a clinical trial setting.
Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports
Authors: Thalitta Mendes Cavalcante, Vanessa Terezinha Gubert, Carolina de Deus Lima, Larissa Anjos Luciano, Mariana Garcia Croda, James Venturini, Antonio Luiz Dal Bello Gasparoto, Wellyngton Matheus Souza Santiago, Ana Rita Coimbra Motta-Castro, Fernanda Paes Reis, Ana Paula da Costa Marques, Aline Pedroso Lorenz, Wellington Santos Fava, Marina Castilhos Souza Umaki Zardin, Cláudia Elizabeth Volpe Chaves, Gabriel Pereira Braga, Anamaria Mello Miranda Paniago, Sandra Maria do Valle Leone de Oliveira
Journal: J Venom Anim Toxins Incl Trop Dis (2022)
Keywords: neurological manifestation, peripheral facial paralysis, post-covid, sars-cov-2 infection
MeSH terms: Review

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.