OpenMed/multicare-articles huggingface dataset:
Acute Ulcerative Enterocolitis With Severe Protein Loss Due to Mucosal Invasion With Enterococcus spp. in a Dog With Exocrine Pancreatic Insufficiency: A Case Report
Authors: Jennifer A Cartwright, Jorge Pérez-Accino, Clare Timothy, Kenneth W Simpson, Silke Salavati Schmitz
Journal: Front Vet Sci (2020)
Keywords: adherent-invasive, fluorescent in-situ hybridization, hemorrhagic gastroenteritis, protein-losing enteropathy, ulcerative colitis
MeSH terms: Case Reports

We describe an unusual case of severe acute protein-losing enteropathy in a dog, which presented with a systemic inflammatory response syndrome. This dog's condition could not be categorized as any well-known canine intestinal condition. Instead, components of several enteropathies like acute hemorrhagic diarrhea syndrome (AHDS), chronic inflammatory enteropathy (CIE), and ulcerative and granulomatous colitis were present. Thorough investigations identified concurrent exocrine pancreatic insufficiency (EPI) and hypocobalaminemia. On histopathology, marked diffuse chronic-active ileitis and ulcerative colitis with fibroplasia and neovascularization were present. Intestinal biopsy cultures identified E.coli and multiresistant Enterococcus spp. The latter was identified as mucosally invasive using fluorescent in situ hybridization (FISH). Protracted clinical signs following the acute presentation required intensive care including enteral and parenteral feeding for a successful outcome, but eventually stabilized with antibiotics and immunosuppressive doses of glucocorticoids. This case highlights a potentially previously unrecognized condition, suspected to be a form of CIE manifesting acutely after bacterial mucosal invasion. In this case, this might have been facilitated by EPI-induced dysbiosis. The use of FISH and mucosal culture in this context provided important clinical information and should be considered more frequently in CIE and non-responsive AHDS.
Neurobiology of KB220Z-Glutaminergic-Dopaminergic Optimization Complex [GDOC] as a Liquid Nano: Clinical Activation of Brain in a Highly Functional Clinician Improving Focus, Motivation and Overall Sensory Input Following Chronic Intake
Authors: Lucien L Duquette, Frank Mattiace, Kenneth Blum, Roger L Waite, Teresa Boland, Thomas McLaughlin, Kristina Dushaj, Marcelo Febo, Rajendra D Badgaiyan
Journal: Clin Med Rev Case Rep (2016)
Keywords: dopaminergic, focus, glutaminergic, kb220z-nano-liquid variant, motivation, reward deficiency syndrome (rds), sensory input

Background:
With neurogenetic and epigenetic tools utilized in research and neuroimaging, we are unraveling the mysteries of brain function, especially as it relates to Reward Deficiency (RDS). We encourage the development of pharmaceuticals or nutraceuticals that promote a reduction in dopamine resistance and balance brain neurochemistry, leading to dopamine homeostasis. We disclose self-assessment of a highly functional professional under work-related stress following KB220Z use, a liquid (aqua) nano glutaminergic-dopaminergic optimization complex (GDOC).
Case presentation:
Subject took GDOC for one month. Subject self-administered GDOC using one-half-ounce twice a day. During first three days, unique brain activation occurred; resembling white noise after 30 minutes and sensation was strong for 45 minutes and then dissipated. He described effect as if his eyesight improved slightly and pointed out that his sense of smell and sleep greatly improved. Subject experienced a calming effect similar to meditation that could be linked to dopamine release. He also reported control of going over the edge after a hard day's work, which was coupled with a slight increase in energy, increased motivation to work, increased focus and multi-tasking, with clearer purpose of task at hand. Subject felt less inhibited in a social setting and suggested Syndrome that GDOC increased his Behavior Activating System (reward), while having a decrease in the Behavior Inhibition System (caution).
Conclusion:
These results and other related studies reveal an improved mood, work-related focus, and sleep. These effects as a subjective feeling of brain activation maybe due to direct or indirect dopaminergic interaction. While this case is encouraging, we must await more research in a larger randomized placebo-controlled study to map the role of GDOC, especially in a nano-sized product, to determine the possible effects on circuit inhibitory control and memory banks and the induction of dopamine homeostasis independent of either hypo- or hyper-dopaminergic traits/states.
Systemic Inflammation-Related Bradycardia in COVID-19
Authors: Aswin Srinivasan, Tusharkumar Pansuriya, Branden Wilson, Siva T Sarva, Turuvekere Jayaram, Salman Alim, Ramesh Kesavan, Syed Raza
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Systemic inflammation-related sinus bradycardia in COVID-19 infection has not been well described yet. This six-patient case series excludes common causes of bradycardia. As bradycardia may be a sequela of COVID-19 infection, we recommend closely monitoring hemodynamics and stopping medications that can exacerbate bradycardia in these patients.
Papillary meningioma: a rare but distinct variant of malignant meningioma
Authors: Singh Avninder, Sarvjot Vermani, Sharma Shruti, Karam Chand
Journal: Diagn Pathol (2007)

Background:
Papillary meningiomas are rare meningeal tumors and are associated with aggressive clinical behavior as compared with other meningiomas. Because of their rare occurrence, they may pose a diagnostic dilemma to the unwary pathologist. We report a case of papillary meningioma in a 16-year-old boy.
Case presentation:
A 16-year-old boy presented with complaints of headache, progressively diminishing vision and more recently generalized seizures. MRI revealed a large bifrontal meningioma which showed presence of a predominantly papillary pattern with areas of focal necrosis, frequent mitoses and bone invasion. He underwent radical excision of the tumor and is free from recurrence or metastasis at 15 months follow-up.
Conclusion:
Papillary meningiomas are rare but well recognized variants of meningioma. They need to be differentiated from other intracranial tumors with a papillary pattern. They are malignant, frequently show bone and parenchymatous invasion and have the potential for extracranial metastasis. Their timely recognition could prevent local and distant metastasis and the mortality or morbidity associated with it.
Fibrous dysplasia of the middle nasal turbinate: imaging and clinical significance
Authors: Venkatraman Bhat, Kanav Kansal, Shri Harsha Krishna, Rekha Pobbysetty, Suhel Hassan
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Two cases of fibrous dysplasia involving the middle nasal turbinate are presented. Fibrous dysplasia is a common benign fibro-osseous disease involving the flat bones, often affecting the bony structures of the skull and facial skeleton. Primary occurrence or secondary involvement of the nasal turbinate is not a common manifestation of the disease. Involvement of the inferior turbinate generally does not have specific management-related issues; however, involvement of the middle turbinate, especially the lateral lamella, can predispose to surgical morbidity during endoscopic surgical management. Clinical presentation, management and features of the disease on CT imaging are presented.
Neglected isolated plantar dislocation of middle cuneiform: a case report
Authors: Ashu Verma, Vinod Kumar Sharma, Sumit Batra, Mahender Singh Rohria
Journal: BMC Musculoskelet Disord (2007)
MeSH terms: Foot Joints / pathology, Joint Dislocations / surgery, Tarsal Bones, Case Reports, Foot Deformities / diagnosis, Foot Deformities / pathology, Foot Deformities / surgery, Foot Joints / surgery, Humans, Joint Dislocations / diagnosis, Joint Dislocations / pathology, Male, Middle Aged, Weight-Bearing

Background:
Four cases of plantar dislocation of middle cuneiform have been reported in the english literature. All of them were fresh cases and treated with open reduction. We are reporting a case of neglected plantar dislocation of middle cuneiform which was treated with excision.
Case presentation:
A farmer presented with a painful plantar dislocation of middle cuneiform bone after 9 months of injury. The bone was deformed and was excised by a plantar incision. It resulted in painless foot with no disability.
Conclusion:
The neglected plantar dislocated middle cuneiform bone becomes deformed due to repeated weight bearing. The gap gets filled with Fibrous tissue. Excision of the cuneiform gives good results.
Delayed-Onset Neuropathic Pain after Septoplasty
Authors: Foteini-Stefania Koumpa, Mark Ferguson, Hesham Saleh
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

Postoperative pain following a septoplasty is expected to be mild and limited to a few days after the operation. Chronic pain following the procedure is rare. No cases of delayed-onset neuropathic pain or allodynia have been described in the literature. This paper presents a case of delayed-onset neuropathic pain after septoplasty in a previously pain-free asthmatic patient that was successfully managed by administration of intranasal local anaesthesia. Physical examination and imaging excluded any other cause of neuralgia. A literature review revealed reports of chronic pain in patients following septoplasty if there were nasal contact or compression points or nasal tumours. Separately, acute postseptoplasty allodynia is documented in iatrogenic maxillary nerve damage. However, delayed-onset neuralgic pain, exacerbated by certain environmental triggers, has not been previously described. Facial pain can be debilitating; successfully managing this neuralgic pain with administration of intranasal local anaesthetic had a substantial effect on the patient's quality of life.
Case report: dual primary malignancies treated by laparoscopic multiorgan resection with natural orifice specimen extraction surgery
Authors: Kunpeng Hu, Yifan Ke, Qin Chen, Jiezhong Wu, Yingping Ke, Qiuxian Xie, Bo Liu, Jiajia Chen
Journal: Front Oncol (2022)
Keywords: case report, dual primary malignancies, endometrial cancer, intrahepatic cholangiocarcinoma (icc), laparoscopic multiorgan resection, natural orifice specimen extraction surgery (noses)
MeSH terms: Case Reports

With microtrauma becoming a consensus, in order to improve surgical treatment capability, the clinical application of laparoscopic multiorgan resection is becoming more and more complicated and diversified. Recently, we successfully presented a case of transvaginal specimen extraction surgery that included laparoscopic anatomical left hemihepatectomy combined with laparoscopic total hysterectomy and bilateral adnexectomy and the pelvic and para-aortic lymphadenectomy. The patient, a 75-year-old woman, was hospitalized with abnormal vaginal discharge and bleeding. The pathologic diagnosis of uterine curettage was endometrioid adenocarcinoma. After completing examinations such as color Doppler ultrasound, CEUS, MRCP and thoracoabdominal enhanced spiral CT, preoperative diagnosis was considered as endometrial cancer and a space-occupying lesion in the liver (primary or secondary site)?. No lymphatic or distant metastasis had been found. We also excluded Lynch syndrome by digestive endoscopy and gene sequencing. After a multidisciplinary consultation, the patient underwent surgery under general anesthesia on 24 September 2021. The operation was completed uneventfully in 6 hours, then the patient was transferred to the ICU for follow-up monitoring. The patient began to eat and was able to leave bed on the 4th postoperative day. According to immunohistochemistry, the patient's postoperative diagnosis was intrahepatic cholangiocarcinoma (ICC) and endometrial cancer. Compared with open surgery, laparoscopic multiorgan resection with natural orifice specimen extraction surgery (NOSES) has many advantages such as fewer traumas, shorter recovery time, and better postoperative quality of life. However, combined large-scale laparoscopic surgeries of different organs can be challenging for surgeons and anesthesiologists. No similar cases have been searched.
A Calcium Enterolith in a Patient with Crohn's Disease and Its In Vitro Dissolubility in Citric Acid
Authors: Masaya Iwamuro, Haruo Urata, Sakiko Hiraoka, Masayasu Ohmori, Yoshitaka Kondo, Yoshiro Kawahara, Hiroyuki Okada
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

The microstructure and dissolubility of a calcified enterolith and enterolith pieces removed from a 26-year-old Japanese woman with Crohn's disease were analyzed using scanning electron microscopy and energy dispersive X-ray spectroscopy. The enterolith showed a multilayered structure with fatty acid calcium and magnesium phosphate. The amount of calcium, magnesium, and phosphate decreased after they were immersed in a citric acid solution, suggesting a potential contribution of acidic aqueous solution to elute inorganic substances contained in calcified enteroliths. This is the first study to investigate the in vitro dissolubility of calcified enteroliths induced by citric acid solution.
Non-Invasive Pulse Wave Analysis in a Thrombus-Free Abdominal Aortic Aneurysm after Implantation of a Nitinol Aortic Endograft
Authors: Efstratios Georgakarakos, Christos Argyriou, George S Georgiadis, Miltos K Lazarides
Journal: Front Surg (2016)
Keywords: abdominal aortic aneurysm, arterial stiffness, augmentation index, endovascular aneurysm repair, hemodynamics, pulse wave analysis, pulse wave velocity
MeSH terms: Case Reports

Endovascular aneurysm repair has been associated with changes in arterial stiffness, as estimated by pulse wave velocity (PWV). This marker is influenced by the medical status of the patient, the elastic characteristics of the aneurysm wall, and the presence of intraluminal thrombus. Therefore, in order to delineate the influence of the endograft implantation in the early post-operative period, we conducted non-invasively pulse wave analysis in a male patient with an abdominal aortic aneurysm containing no intraluminal thrombus, unremarkable past medical history, and absence of peripheral arterial disease. The estimated parameters were the systolic and diastolic pressure calculated at the aortic level (central pressures), PWV, augmentation pressure (AP) and augmentation index (AI), pressure wave reflection magnitude (RM), and peripheral resistance. Central systolic and diastolic pressure decreased post-operatively. PWV showed subtle changes from 11.6 to 10.6 and 10.9 m/s at 1-week and 1-month, respectively. Accordingly, the AI decreased from 28 to 14% and continued to drop to 25%. The AP decreased gradually from 15 to 6 and 4 mmHg. The wave RM dropped from 68 to 52% at 1-month. Finally, the peripheral resistance dropped from 1.41 to 0.99 and 0.85 dyn × s × cm(-5). Our example shows that the implantation of an aortic endograft can modify the pressure wave reflection over the aortic bifurcation without causing significant alterations in PWV.
Anomalies of radial and ulnar arteries
Authors: Rajani Singh, Rashmi Malhotra, Munish Wadhawan
Journal: J Vasc Bras (2017)
Keywords: brachial artery, median nerve, radial artery, ulnar artery, variation
MeSH terms: Case Reports

During dissection conducted in an anatomy department of the right upper limb of the cadaver of a 70-year-old male, both origin and course of the radial and ulnar arteries were found to be anomalous. After descending 5.5 cm from the lower border of the teres major, the brachial artery anomalously bifurcated into a radial artery medially and an ulnar artery laterally. In the arm, the ulnar artery lay lateral to the median nerve. It followed a normal course in the forearm. The radial artery was medial to the median nerve in the arm and then, at the level of the medial epicondyle, it crossed from the medial to the lateral side of the forearm, superficial to the flexor muscles. The course of the radial artery was superficial and tortuous throughout the arm and forearm. The variations of radial and ulnar arteries described above were associated with anomalous formation and course of the median nerve in the arm. Knowledge of neurovascular anomalies are important for vascular surgeons and radiologists.
Causal relationship between acute pancreatitis and methylprednisolone pulse therapy for fulminant autoimmune hepatitis: a case report and review of literature
Authors: Daisuke Nango, Hiroki Nakashima, Yukifumi Hirose, Masaaki Shiina, Hirotoshi Echizen
Journal: J Pharm Health Care Sci (2018)
Keywords: acute pancreatitis, autoimmune hepatitis, short-term tapering, steroid pulse therapy
MeSH terms: Case Reports

Background:
A causal relationship between acute pancreatitis and administration of glucocorticoids remains a matter of debate, since most of the reported cases were diagnosed with systemic vascular diseases (including systemic lupus erythematosus and polyarteritis nodosa) that may be responsible for the pancreatitis.
Case presentation:
We report a case of a 51-year-old woman who developed acute pancreatitis after receiving methylprednisolone pulse therapy for the treatment of fulminant autoimmune hepatitis (AIH). She was admitted to our hospital because of overt jaundice and back pain. Since her liver dysfunction deteriorated progressively, a liver biopsy was performed and a diagnosis of AIH was established. She was given intravenous methylprednisolone pulse therapy at 1000 mg/day for 3 days, and oral prednisolone at 40 mg/day thereafter. While her liver function improved rapidly, she started complaining of mild back pain and serum amylase and lipase levels were elevated from 5 days after the initiation of steroid therapy. A CT scan revealed mildly edematous changes around the pancreas, leading to a diagnosis of acute pancreatitis. After tapering off prednisolone, back pain disappeared, and elevated serum amylase was normalized without exacerbation of AIH. A systematic literature review identified 8 cases of acute pancreatitis developing after administration of corticosteroid pulse therapy with a median latent period of 5 days.
Conclusions:
The present case and reports in the literature suggest that steroid pulse therapy may cause acute pancreatitis in patients having no signs of systemic vasculitis.
Intussusception in an Infant With SARS-CoV-2 Infection: A Case Report and a Review of the Literature
Authors: Massimo Luca Castellazzi, Antonio Corsello, Lucia Cerrato, Alessandra Carnevali, Anna Morandi, Ernesto Leva, Carlo Virginio Agostoni, Paola Marchisio
Journal: Front Pediatr (2021)
Keywords: covid-19, sars-cov-2, gastrointestinal symptoms, infants, intussusception
MeSH terms: Case Reports

Coronavirus disease 2019 (COVID-19) is caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even if predominantly considered a respiratory pathogen, it could be associated with gastrointestinal involvement, generally in mild forms. Recent reports highlight the association between SARS-CoV-2 and intussusception in infants. A case of intussusception is hereby described in a previously healthy infant in whom the diagnosis of SARS-CoV-2 was made after the analysis of bronchoalveolar lavage and intraoperative specimens following surgical procedures. Accordingly, a review of infant cases with intussusception and SARS-CoV-2 infection is also reported.
Diagnosis of Vitreoretinal Aspergillosis with Transvitreal Retinochoroidal Biopsy
Authors: Krishi Peddada, Nida M Khan, Jascha Rubin, Haykanush Zakaryan, Yaobin Liu, Nikolay Popnikolov, Roshun Sangani, Weiye Li
Journal: Case Rep Ophthalmol Med (2018)
MeSH terms: Case Reports

Diagnosing culture-proven endophthalmitis is complicated by the insufficient yield of intraocular samples and the variety of etiologies which mimic true endophthalmitis. In cases of impending vision loss where vitreous biopsy cannot provide a definitive diagnosis, transvitreal retinochoroidal biopsy can be an effective next step. Our case is a 48-year-old male with B-cell acute lymphoblastic leukemia that presented with counting fingers vision, redness, and tearing of the left eye. Exam showed cell and flare with hypopyon as well as dense vitritis. The patient underwent diagnostic pars plana vitrectomy and vitreous culture was negative at the time. Flow cytometry demonstrated no malignant cells. However, the patient's vision and mental status continued to clinically decline despite being started on intravitreal and systemic antibiotic and antifungal therapy. Neuroimaging revealed rim-enhancing brain lesions. Transvitreal retinochoroidal biopsy was performed in an elevated area of the retina. The biopsy helped rule out malignancy and showed acute-angle, septate, branching hyphae characteristic of Aspergillus fumigatus. Ultimately, the vitreous biopsy, cultures, and a biopsy from the left frontal lobe brain abscess all confirmed this diagnosis as well. Transvitreal retinochoroidal biopsy can play a role in the diagnosis of a case of posterior uveitis and can be particularly effective in diagnosing a fungal endophthalmitis.
The first use of laparoscopy to treat pelvic ring fractures: A case report
Authors: Rémi Di Francia, Jean-Loup Tanner, Julien Marolleau
Journal: Int J Surg Case Rep (2020)
Keywords: laparoscopy, pelvic ring fracture, plate fixation
MeSH terms: Case Reports

Introduction:
Pelvic ring injuries pose major challenges for the trauma surgeon. Given the complications of open surgeries, percutaneous techniques have become increasingly popular, but laparoscopy has never been employed for internal osteosynthesis of the pelvic ring.
Presentation of case:
We describe a 34-year-old male with a pelvic ring fracture (grade AO/OTA 61B2.1b). The anterior pelvic arch was successfully plate-fixed using a laparoscopic technique. This is the first report of such an approach to treat pelvic ring fractures.
Discussion:
Our principal point is that "laparoscopic internal fixation" delivered an in situ result as good as that of open surgery, but we required only four trocar portals.
Conclusion:
We describe a novel laparoscopic approach to treatment of pelvic ring fractures.
Topical Treatment of Truncal Acne with Tretinoin Lotion 0.05% and Azelaic Acid Foam
Authors: Sharleen St Surin-Lord, Judi Miller
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

Truncal acne is present in approximately half of all patients with facial acne but is also occasionally seen in isolation. Important considerations when selecting treatment options for adult female acne, whether on the face, back, chest, or shoulders, include patient compliance, treatment response time, tolerability of the treatment, and psychosocial impact of the disease. Oral antibiotics are widely prescribed for truncal acne due to the challenges of applying topical therapy to such an extensive body surface area. In cases of severe inflammatory and nodular acne vulgaris, this may be a reasonable consideration; however, oral antibiotics should only be used for short durations. Overprescription contributes to microbial resistance and may cause disruption of the gastrointestinal microbiome. In many cases of mild, moderate, or even severe truncal acne, combinations of topical therapies may be valid alternatives. The introduction of foam formulations with enhanced percutaneous absorption and tretinoin lotion formulations that incorporate moisturizing/hydrating agents challenges the previously held idea that effective and tolerable treatment of truncal acne requires oral treatment. This case series describes four female African-American patients with truncal acne successfully treated with a combination of tretinoin lotion 0.05% and azelaic acid 15% foam.