OpenMed/multicare-articles huggingface dataset:
Cannabidiol enhances cerebral glucose utilization and ameliorates psychopathology and cognition: A case report in a clinically high-risk mental state
Authors: Dagmar Koethe, Cathrin Rohleder, Lutz Kracht, F Markus Leweke
Journal: Front Psychiatry (2023)
Keywords: cbd, cognitive function, fdg-pet (f-18-fluorodeoxyglucose-positron emission tomography), at-risk mental state (arms), cannabinoids, clinical high at-risk mental state (charms), psychopathological symptoms, ultra-high risk (uhr) for psychosis
MeSH terms: Case Reports

Adolescent individuals often present with subtle, sub-threshold psychiatric syndromes that fluctuate or persist for years. These symptoms have been classified as Clinically High-Risk mental states (CHR), negatively affecting these individuals' psychosocial development and integration by reducing performance and affecting interpersonal relations. The pathophysiological underpinnings have not been studied in detail, contributing to the current lack of appropriate intervention strategies. This case report sheds new light on potential pathophysiological mechanisms of this condition, which may be addressed by novel treatment approaches such as cannabidiol. A 19-year-old student presented to our early intervention center with a marked cognitive decline within 6 months, anhedonia, ambivalence, social withdrawal, poverty of speech, and brief intermittent psychotic symptoms (delusions and hallucinations). He was diagnosed with CHR state, and we decided to treat him with the non-psychotomimetic phytocannabinoid cannabidiol. Cannabidiol is a promising compound carrying an orphan drug approval for rare certain childhood epilepsy types and is under investigation as an antipsychotic compound with a new mechanism of action compared to existing antipsychotics. We investigated the effect of oral cannabidiol (600 mg per day) over 4 weeks on psychopathology and cerebral glucose utilization. We observed no relevant side effects but a significant clinical improvement. In addition, positron emission tomography (PET) showed a considerable increase in cerebral [18F]fluoro-2-deoxyglucose (FDG) uptake in various brain regions. This finding suggests that cannabidiol may enhance cerebral glucose utilization, possibly via activation of peroxisome proliferator-activated receptor-gamma (PPAR-γ) by its endogenous ligand anandamide or related N-acylethanolamines. This mechanism may represent a new innovative treatment approach for CHR, especially given that many individuals with CHR and early psychosis do not substantially benefit from current psychopharmacological interventions.
Choroidal Vascular Changes in Acute Idiopathic Maculopathy as Demonstrated by Multimodal Imaging including Optical Coherence Tomography Angiography
Authors: Tahsin Khundkar, Syed R Hasan, Mark P Breazzano, Constance Mei, Brandon B Johnson
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Purpose. To present a case of acute idiopathic maculopathy (AIM) and illustrate primary choroidal perfusion defect using multimodal imaging. Case Description. We report a case of a 24-year-old man with a paracentral scotoma of the right eye and recent flu-like illness. The patient was found to have a unilateral ovoid-shaped, placoid lesion just inferior to the fovea. Multimodal imaging confirmed findings most consistent with a diagnosis of acute idiopathic maculopathy (AIM). Serologic studies confirmed a strongly positive immunoglobulin G (IgG) titer for coxsackievirus A. Spectral-domain optical coherence tomography angiography (SD-OCTA) showed bilateral areas of vascular reduction at the level of the choriocapillaris and choroid, sparing the retinal circulation. Conclusions and Importance. The changes in outer retina and retinal pigment epithelium, classically described in AIM, are likely secondary to choroidal hypoperfusion.
Serial Femoral Fractures in An Amputation Stump: A Case Report
Authors: M Nannaparaju, K Annavaram, R Anwar, W S Khan, J Hambidge
Journal: Open Orthop J (2017)
Keywords: above-knee amputation, complications, dynamic hip screw, fracture, open reduction and internal fixation, rehabilitation
MeSH terms: Case Reports

We report a case of an above-knee amputee who underwent dynamic hip screw fixation for a proximal femoral fracture and then open reduction and internal fixation a few years later for a further femoral fracture in the same stump. The patient had a good outcome. We aim to discuss the challenges in decision making, surgical technique and potential complications for the patient.
Paradoxical Reaction to Alprazolam in an Elderly Woman with a History of Anxiety, Mood Disorders, and Hypothyroidism
Authors: Daniel Kirkpatrick, Tyler Smith, Mitchell Kerfeld, Taylor Ramsdell, Hasnain Sadiq, Arun Sharma
Journal: Case Rep Psychiatry (2016)

With less than 1% of patients who use benzodiazepines being affected, paradoxical responses to benzodiazepines are rare. In this case report, we outline the course of an 80-year-old female who developed a paradoxical response to benzodiazepines. Significant medical and psychiatric history includes anxiety, mood disorder, hypothyroidism, bilateral mastectomy, goiter removal, and triple bypass. The patient presented with mental status changes, anxiety, motor restlessness, and paranoia. Over time, a temporal relationship between the severity of the patient's motor agitation and intake of alprazolam was observed. As doses of alprazolam were decreased, her motor agitation became less severe. In addition to motor agitation, the patient also demonstrated increased aggressiveness, a subjective feeling of restlessness, and increased talkativeness. As her dose of alprazolam decreased, many of the patient's symptoms were observed to decrease. This case report also discusses theories regarding the pathophysiology of paradoxical reactions to benzodiazepines, known risk factors, and appropriate treatment.
Intrathoracic Kidney after Blunt Abdominal Trauma: A Case Report and Review of the Literature
Authors: Fikret Halis, Akin Soner Amasyali, Aysel Yucak, Turan Yildiz, Ahmet Gokce
Journal: Case Rep Urol (2015)

Abdominal trauma is responsible for most genitourinary injuries. The incidence of renal artery injury and intrathoracic kidney is quite low in patients who present with blunt trauma experiencing damage. There are four defined etiologies for intrathoracic kidney, which include real intrathoracic ectopic kidney, eventration of the diaphragm, congenital diaphragmatic herniation, and traumatic diaphragmatic rupture. The traumatic intrathoracic kidney is an extremely rare case. We presented intrathoracic kidney case after traumatic posterior diaphragmatic rupture.
A Nonsense Mitochondrial DNA Mutation Associates with Dysfunction of HIF1 α in a Von Hippel-Lindau Renal Oncocytoma
Authors: Monica De Luise, Vito Guarnieri, Claudio Ceccarelli, Leonardo D'Agruma, Anna Maria Porcelli, Giuseppe Gasparre
Journal: Oxid Med Cell Longev (2019)
MeSH terms: Adenoma, Oxyphilic / genetics, Codon, Nonsense / genetics, DNA, Mitochondrial / genetics, Kidney Neoplasms / genetics, von Hippel-Lindau Disease / genetics, Case Reports, Adenoma, Oxyphilic / pathology, Adult, Humans, Hypoxia-Inducible Factor 1, alpha Subunit / genetics, Kidney Neoplasms / pathology, Male, Mutation, von Hippel-Lindau Disease / pathology, Codon, Nonsense, DNA, Mitochondrial, Hypoxia-Inducible Factor 1, alpha Subunit, Oncocytoma, renal

The Von Hippel-Lindau (VHL) syndrome has been rarely associated with renal oncocytomas, and tumors usually show HIF1α chronic stabilization. By contrast, oncocytomas mainly associated with respiratory chain (RC) defects due to severe mitochondrial DNA (mtDNA) mutations are incapable of stabilizing HIF1α, since oxygen consumption by the RC is dramatically diminished and prolylhydroxylase activity is increased by α-ketoglutarate accumulation following Krebs cycle slowdown. Here, we investigate the cooccurrence of a pseudohypoxic condition with oncocytic transformation in a case of VHL-associated renal oncocytoma. While HIF1α was abundant in nuclei concordantly with defects in VHL, negative staining of its targets carbonic anhydrase IX (CAIX) and glucose transporter GLUT1, usually overexpressed in VHL-associated neoplasms, suggested HIF1α to be present in its inactive (hydroxylated) form. MtDNA sequencing and immunohistochemistry analyses revealed a MT-CO1 stop-gain mutation and cytochrome c oxidase loss. We suggest that a mitochondrial respiration impairment may lead to hyperhydroxylation of the transcription factor, which we confirmed by specific staining of hydroxylated HIF1α. Such inactive form hence accumulated in the VHL-deficient tumor, where it may contribute to the benign nature of the neoplasm. We propose that the protumorigenic role of HIF1α in VHL cancers may be blunted through drugs inhibiting mitochondrial respiratory complexes, such as metformin.
MRI AI Use Case: Synthetic CT Images for Fracture Evaluation
Authors: Thiebault Saveyn, Lennart Jans, Frederiek Laloo
Journal: J Belg Soc Radiol (2022)
Keywords: mri, artificial intelligence, bone imaging, fracture, synthetic ct
MeSH terms: Case Reports

Teaching Point: Synthetic CT images can improve evaluation of bony lesions on MRI and show potential for fracture evaluation, but validation is needed.
Case Report: Bilateral Renal Cell Carcinoma With Different Histological and Morphological Features, Clear Cell and Cystic Thyroid-Like Follicular Subtype
Authors: Jinsong Ni, Ni Cui, Yanfang Wang, Jixuan Liu
Journal: Front Oncol (2021)
Keywords: bilateral renal cancer, cyst, imaging diagnosis, pathological diagnosis, surgical treatment, thyroid-like follicular carcinoma of kidney
MeSH terms: Case Reports

Thyroid-like follicular renal cell carcinoma is a rare subtype of renal cell carcinoma that has only been recently recognized, as most cases involve a solid tumor in one kidney. In this study, we report a rare case of bilateral renal cell carcinoma wherein the tumor in the left kidney was diagnosed as clear cell carcinoma, while the tumor in right kidney as thyroid-like follicular renal cell carcinoma. The difference between this case and the ones described in previous reports is that thyroid-like follicular renal cell carcinoma showed cystic changes on imaging. This suggests that when renal cystic lesions are encountered, we should consider the possibility of such rare tumors.
Cytological diagnosis of adult-type fibrosarcoma of the neck in an elderly patient. Report of one case and review of the literature
Authors: Immacolata Cozzolino, Alessia Caleo, Vincenzo Di Crescenzo, Mariapia Cinelli, Chiara Carlomagno, Alfredo Garzi, Mario Vitale
Journal: BMC Surg (2013)
MeSH terms: Fibrosarcoma / pathology, Head and Neck Neoplasms / pathology, Case Reports, Review, Aged, Humans, Male

Background:
Fibrosarcoma (FS) accounts for about 3% of all soft tissue sarcomas. It may arise in any area of the body, but it is relative rare in the head and neck district. Fine-needle cytology (FNC) is widely used in the diagnosis of neoplastic and non-neoplastic lesions of soft tissue. This article describes a case of FS of the neck diagnosed by FNC.
Methods:
FNC was performed in a sub-fascial supraclavicular mass of an elderly patient under ultrasound (US) control. FNC was used to prepare cytological smears that were conventionally and immunocytochemically (ICC) stained.
Results:
Smears showed a monomorphous spindle cell population and were positive at ICC for Vimentin and negative for CKAE1AE3, Actin, S-100, CD68, CT and PAX-8. The cytological diagnosis was confirmed by histological diagnosis. The patient underwent surgical resection and subsequent radiotherapy.
Conclusions:
FNC diagnosis of FS is reliable and accurate and may be conveniently used in the scheduling of surgical procedures, when needed, avoiding the treatment of benign nodules.
Case Report: Successful Use of Biliary Stent for Iatrogenic Esophageal Perforation Following Balloon Dilation in a 7-Month-Old Infant
Authors: Meng-Chuan Liu, Yao-Sheng Wang, Yao-Jong Yang, Fu-Ping Lai
Journal: Front Pediatr (2020)
Keywords: biliary stent, endoscopic balloon dilation, endoscopic therapy, esophageal perforation, esophageal stent, pediatrics—infants
MeSH terms: Case Reports

Esophageal perforation is a rare but critical emergency that requires early detection and prompt management. In the pediatric population, iatrogenic injury is the most common etiology of esophageal perforation, and the majority of cases come from stricture dilation. Treatment options include medical management, endoscopic therapy, and surgery. Usually, conservative treatment is appropriate in most carefully selected patients, especially in the setting of early diagnosis and with the absence of severe sepsis. A surgical approach is reserved for a large tear with mediastinum contamination, or clinical deterioration after unsuccessful conservative management. With the advancement of the endoscopy technique, endoscopy therapy using esophageal stents is an available choice for adult populations who have a complicated protracted healing course or comorbidities precluding surgical attempts. However, this procedure is seldom implemented in children, especially in young infants, owing to unavailable equipment and experts. We report our successful use of a fully-covered self-expandable metal biliary stent in managing esophageal perforation in a seven-month-old infant. In light of this encouraging achievement, this model can be applied to more children who have the same problem.
Meningococcal Pneumonia in a Young Healthy Male
Authors: Abdullah M Al Alawi
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

A 23-year-old male presented to the emergency department with one-day history of right-sided pleuritic chest pain, haemoptysis, and fever. In the emergency department, the blood pressure was 140/60 mmHg, heart rate 89/min, body temperature 40°C, respiratory rates 20 breaths/min, and oxygen saturation 98% in room air. Physical examination revealed rales and bronchial breathing in the right infrascapular region. Laboratory analysis showed raised white blood cell counts and elevated inflammation markers. Chest X-ray showed right lower lobe consolidation. Intravenous(IV) ceftriaxone and doxycycline were started for the management of community-acquired pneumonia as per the local guideline. Later, on admission, blood culture was positive for Neisseria meningitidis (N. meningitidis). Ceftriaxone was continued for 4 days, and the patient was discharged while being on oral amoxicillin (1 gm TDS) for another 3 days. He remained well during the outpatient follow-up.
Episodic angioedema with eosinophilia (Gleich's syndrome) associated with urticarial vasculitis: a coincidence or a novel clinical entity?
Authors: J R Basso, L G Z Bizinoto, G A Limone, M M S S Enokihara, K do Espirito-Santo Filho, A R Fonseca, R C Agondi, A F T de Gois, L L Cunha
Journal: Braz J Med Biol Res (2021)
MeSH terms: Angioedema / complications, Angioedema / diagnosis, Eosinophilia / complications, Urticaria / complications, Vasculitis, Case Reports, Adult, Female, Humans, Skin

Episodic angioedema with eosinophilia (EAE) is a rare condition characterized by recurrent attacks of angioedema and urticaria accompanied by a marked elevation of peripheral eosinophil count. We report the case of a young female patient diagnosed with EAE associated with urticarial vasculitis. A 40-year-old female patient was admitted to our institution due to recurrent episodes of cheek and eyelid angioedema in the previous year. Episodes of facial angioedema lasted for two months with spontaneous remission afterwards. In addition, she presented pruritic and painful skin eruptions of erythematous circles, which persisted for longer than 24 h, that were palpable, somewhat purplish, and more pronounced on the face, arms, and trunk. Laboratory investigation showed a sustained elevation of white cell counts with marked eosinophilia. Serum IgM, IgE, and IgA were normal; IgG was slightly elevated. C1-esterase inhibitor and tryptase test were normal. Reverse transcriptase-polymerase chain reaction was performed for detection of FIP1L1-PDGFRA and BCR-ABL rearrangements. None of these alterations were found. Skin biopsies were suggestive of urticarial vasculitis. The patient was submitted to esophagogastroduodenoscopy, which showed mild chronic gastritis, with no eosinophilic infiltration. Cardiac dimensions and function were normal. Abdominal ultrasound and total body CT-scan failed to show lymphadenopathy, organomegaly, and tumors. We report the first case of association between episodic angioedema with eosinophilia and urticarial vasculitis. It is possible that both conditions share a physiopathological mechanism, suggesting that it is not just a chance association.
Dyspnoea at term in an obese mother
Authors: Vicky O'Dwyer, Yvonne O'Brien, Nadine Farah, Michael J Turner
Journal: Case Rep Obstet Gynecol (2011)
MeSH terms: Case Reports

Peripartum cardiomyopathy is a serious, potentially life-threatening heart disease of uncertain aetiology in previously healthy women. We report a morbidly obese woman who presented with peripartum shortness of breath. We discuss the differential diagnosis of dyspnoea in pregnancy and highlight the complexity of care of the morbidly obese woman.
The First Clinical Use of Augmented Reality to Treat Salivary Stones
Authors: Anna Lysenko, Alexandra Razumova, Andrey Yaremenko, Rustam Mirzakhmedov, Anna Zubareva, Marina Chibisova
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

In this study, we report our first experience of applying the concretion visualization method using augmented reality technology. A clinical case of a new surgical intervention on the parotid salivary gland with the localization of salivary stone in its parenchyma is considered. During additional diagnostics, it was found that the size of the concretion exceeds 5 mm which did not allow us to use the endoscopic technologies. That was the reason for the choice of surgical intervention external access using salivary stone visualization with the help of augmented reality. The preoperative procedures included making the upper jaw cast model, fitting the model and individual mouthguard with an X-ray contrast marker and marker slot. In addition to this, computed tomography of the head and neck using a mouthguard was made. During surgery under general anesthesia with nasal intubation, the mouthguard together with the marker is installed in the patient's mouth and the surgeon puts on the glasses to visualize the stone image in place of its localization. This method enables to visualize the salivary stone on all surgery stages no matter what type of approach is used or performing hydropreparation. That is why using the augmented reality appears promising and is to be studied further.
Fat Embolism Syndrome Mimicking a COVID-19 Infection
Authors: Alexandru Leonard Alexa, Adela Hilda Onutu
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Fat embolism syndrome (FES) is a multiple organ disorder that can appear after pelvic and long bone fractures. The most common clinical finding is hypoxia, accompanied by diffuse petechiae, alveolar infiltrates, altered mental status, fever, polypnea, and tachycardia. We present a mild FES case on a 32-year-old man with no medical history admitted for an orthopedic procedure, following both tibia and fibulae fractures. Thirty hours postoperatively, he developed respiratory failure with altered mental status and needed admission in the intensive care unit. The chest radiography and later chest tomography raised the suspicion of a COVID-19 disease, even if our first suspicion was FES. After being carefully investigated in a dedicated COVID-19 ward and three negative RT-PCR SARS-CoV-2 tests, he returned to continue supportive treatment in the orthopedic intensive care ward. His evolution was favorable with discharge at ten days, without sequelae. In the context of the SARS CoV-2 pandemic, differential diagnosis has become an increasingly challenging process. Added to the variety of preexisting respiratory diseases and disorders, the COVID-19 infection, with its symptomatology so similar to multiple other pulmonary diseases, must not cloud our clinical judgement.
Nasolabial cyst
Authors: Caner Sahin
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Nasolabial cyst is a rare nonodontogenics, soft-tissue cyst occurring in the sublabial area and anterior maxillary region. The patient usually presents with a slowly enlarging asymptomatic swelling. They are usually diagnosed in early stages because of cosmetic problems. In our paper we report a nasolabial cyst of a 53-year-old man and discuss the diagnosis, differential diagnosis, and treatment in the light of the literature.
Atypical perioperative management for duodenal obstruction in an infant with heterotaxy syndrome: a case report
Authors: Hirofumi Obinata, Shinichi Nishibe, Yoko Ishihara
Journal: JA Clin Rep (2018)
Keywords: duodenal obstruction, heterotaxy, intestinal malrotation, preduodenal portal vein, total anomalous pulmonary venous connection

Background:
Heterotaxy syndrome (HS) is characterized by a wide variety of cardiac and extra-cardiac malformations, including pulmonary valve stenosis, interruption of the inferior vena cava, total anomalous pulmonary venous connection (TAPVC), asplenia, polysplenia, intestinal malrotation, and preduodenal portal vein (PDPV). We report the case of a heterotaxic infant with an infracardiac TAPVC and preduodenal portal vein who experienced repetitive hemodynamic instability during urgent laparotomy for duodenal obstruction.
Case presentation:
A 3-day-old boy with HS was planned to undergo urgent laparotomy for duodenal atresia. Echocardiogram showed an interrupted inferior vena cava, single right ventricle, pulmonary valve stenosis, and infracardiac TAPVC. On exploratory laparotomy, intestinal malrotation characterized by Ladd's band was found. During further exploration, repetitive severe hypotension and hypoxia occurred. Thorough examination revealed a greatly dilated PDPV crossing over and compressing the proximal duodenum externally. Finally, we considered the possibility that surgical manipulation directly compressed the dilated PDPV into which the TAPVC had pulmonary venous drainage, leading to repetitive pulmonary venous obstruction (PVO). Computed tomography, which was examined after laparotomy, indicated that the vertical vein from pulmonary venous confluence drained into the portal vein.
Conclusion:
PDPV is a rare anomaly associated with HS. In case of intestinal malrotation and duodenal obstruction in HS with infracardiac TAPVC, both the presence of PDPV and the possibility of pulmonary venous drainage into the PDPV should be considered by pediatric surgeons and anesthesiologists performing laparotomy to avoid catastrophic PVO.
Interference of Monoclonal Gammopathy with Fibrinogen Assay Producing Spurious Dysfibrinogenemia
Authors: Francesca Martini, Nadia Cecconi, Aldo Paolicchi, Sara Galimberti, Giulia Cervetti, Gabriele Buda, Mario Petrini
Journal: TH Open (2019)
Keywords: coagulation factors, fibrin, fibrinogen, inhibitor
MeSH terms: Case Reports

Abnormal coagulation properties indicative of a dysfibrinogenemia were found in the plasma of an asymptomatic 65-year-old male. An immunoglobulin k light chain was found to interfere with Fg functional assay and coagulation tests (activated partial thromboplastin time, prothrombin time, and thrombin time). Steroid therapy reduced the inhibitory effect (after dexamethasone treatment coagulation test and functional Fg value normalized). Spurious dysfibrinogenemia associated with light chain monoclonal gammopathy of undetermined significance was diagnosed.