OpenMed/multicare-articles huggingface dataset:
Neo Left Main Channel Creation Using Double Stenting Alongside a Sapien 3 Aortic Valve Bioprosthesis for Left Main Coronary Obstruction Following Valve-in-Valve Transcatheter Aortic Valve Replacement: A Case Report With Review of Literature
Authors: Apurva D Patel, Thomas Haldis, Kais Al Balbissi, Timir Paul
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: aortic stenosis, left main coronary obstruction, transcatheter aortic valve replacement, valve-in-valve

Transcatheter aortic valve replacement in the setting of failed surgical bioprosthesis (valve-in-valve) is a valuable option for patients with bioprosthetic aortic stenosis or regurgitation who are deemed high risk for repeat open heart surgery. Although the procedure is successful with proper preprocedural assessment, instances of left main (LM) coronary artery ostium obstruction have been documented. We present a case of LM coronary obstruction in the immediate postoperative period following implantation of a 20-mm Edwards Sapien 3 valve inside the degenerated 21-mm Mitroflow bioprosthesis stenosis, which was treated with double stenting alongside the Edwards Sapien 3 valve creating a channel ("neo left main") that extended from mid-LM to the upper margin of the Edwards Sapien 3 valve. Although valve-in-valve in a Mitroflow degenerated bioprosthesis is a relatively safe procedure, 2 or more stents may be necessary to scaffold a channel to the coronary arteries between Edwards Sapien 3 prosthesis and aorta in the event of a coronary obstruction.
Post-Mortem Toxicology: A Systematic Review of Death Cases Involving Synthetic Cannabinoid Receptor Agonists
Authors: Arianna Giorgetti, Francesco Paolo Busardò, Roberta Tittarelli, Volker Auwärter, Raffaele Giorgetti
Journal: Front Psychiatry (2020)
Keywords: forensic toxicology, novel psychoactive substances, post-mortem examination, synthetic cannabinoids, toxicological significance score
MeSH terms: Systematic Review

Background:
Synthetic cannabinoid receptor agonists (SCRAs) have become the largest group of new psychoactive substances monitored by the European Union Early Warning System. Despite the wide diffusion on the market, data regarding effects, toxicities, and mechanisms as well as toxic/lethal doses are still scarce.
Methods:
A comprehensive literature search for articles published up to January 2019 was performed in multiple electronic databases. Only cases of death in which toxicological analyses revealed the presence of SCRAs in blood or urine and at least an external examination was performed, including those occurred in emergency departments, were included.
Results:
Of 380 studies identified, 354 were excluded, while 8 additional manuscripts were included through the screening of relevant references cited in the selected articles. A total number of 34 manuscripts (8 case series and 26 case reports) were included.
Conclusions:
Typical toxic ranges for SCRAs have not been so far identified, and the results of toxicological analyses should be interpreted with caution. In death cases involving SCRAs, a thorough post-mortem examination is a prerequisite to assess the role of the substance use in the deceased and to identify a probable mechanism of death. Even after a comprehensive analysis of clinical, circumstantial, toxicological, and autoptic data, the cause and manner of death remain unclear in some cases.
Homonymous Retinal Ganglion Cell Layer Atrophy With Asymptomatic Optic Tract Glioma in Neurofibromatosis Type I
Authors: Amirah I Momen, Ryan T Muir, Carolina Barnett, Arun N E Sundaram
Journal: Front Neurol (2020)
Keywords: ganglion cell layer, neurofibromatosis, optic chiasm, optic pathway glioma, optic tract, optical coherence tomography
MeSH terms: Case Reports

Approximately 20% of patients with Neurofibromatosis type 1 (NF1) develop optic pathway gliomas (OPGs). Not all OPGs in NF1 necessarily become vision compromising and predicting which patients might develop visual decline is difficult at present time. Optical coherence tomography (OCT) has emerged as a useful tool able to directly assess the morphology and thickness of individual retinal layers. The ganglion cell layer (GCL) is composed of the retinal ganglion cells which receive information from photoreceptors via interneurons, while the retinal nerve fiber layer (RNFL) contains the retinal ganglion cell unmyelinated axons that merge to form the optic nerve. Lesions of the anterior visual pathway result in retrograde axonal degeneration from ganglion cell death and ultimately manifest as thinning of the RNFL and/or GCL. In this report we highlight a case of a 38 year-old woman with an NF1 associated left chiasmal and optic tract glioma who had normal visual fields and visual acuity. However, using OCT we demonstrate a homonymous pattern of GCL atrophy that corresponds with her left optic tract glioma. Given this homonymous pattern of atrophy in the GCL and the left optic tract lesion, one would expect a right homonymous hemianopia. To our knowledge this is the first reported case of a homonymous pattern of GCL-IPL atrophy in an adult with an NF1 related OPG involving the optic chiasm and optic tract, but without objective visual field or acuity deficits. This case is important because, mechanistically, it suggests that a necessary threshold of GCL atrophy may be needed before visual concerns can be detected and, secondly, it invites future studies to evaluate whether OCT may serve as a potential screening tool for those with NF1 related OPGs.
Tiger-Striped PASH: Recognition of a Unique Morphology Allows for a Zippered-Up Diagnosis of Pseudoangiomatous Stromal Hyperplasia of Breast
Authors: Mohamad Sakibuzzaman, Ryan W Kendziora, Toshi Ghosh, Malvika H Solanki, Amy Lynn Conners, Lisa J Ahlberg, Charles D Sturgis
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is histologically characterized by anastomosing and slit-like spaces invested by collagenous stroma and lined by flattened, spindle cells. These clear spaces that may mimic microscopic vascular channels do not contain red blood cells. Immunohistochemistry (IHC) studies may also help to confirm a diagnosis of PASH, with the spindled cells marking positively with CD34 and PR while demonstrating no reactivity with more specific endothelial antigens such as CD31 and ERG. In the current case, a 39-year-old female was diagnosed with cellular PASH of the right breast with unique histological patterns showing "tiger-striped" and "zippered" histologies. To our knowledge, this is the first report of these unique variant PASH morphologies.
A geriatric patient: age is not a factor
Authors: Lisa Klodnitskaya, Michele M Harutunian, Santiago Mareque Buenos, Denise Estafan, Mark S Wolff
Journal: Int J Dent (2011)
MeSH terms: Case Reports

Objective. A patient presented to the dental office expressing dissatisfaction with the appearance of his teeth, and as a result, of his smile. Our objective was to satisfy his initial chief complaint: "I don't like how my teeth look when I smile." Methodology. Upon completing all initial exams and consultations, an esthetic dental treatment plan was formulated and agreed upon by both the practitioners and the patient. Results. The patient received periodontal treatment first to create esthetic gingival margins. Anterior ceramic crowns followed. Conclusion. The results surpassed all patient's expectations.
Primary neonatal diaphragmatic abscess
Authors: Mohamed Zouari, Mohamed Jallouli, Afef Ben Thabet, Mahdi Ben Dhaou, Abdellatif Gargouri, Riadh Mhiri
Journal: J Neonatal Surg (2015)
Keywords: abscess, diaphragm, liver, neonate
MeSH terms: Case Reports

Neonatal diaphragmatic abscesses are extremely rare and they usually develop by direct extension from a liver abscess. The first case of primary diaphragmatic abscess in a neonate is reported and the difficulties of diagnosing this rare entity are discussed.
Postoperative Radiotherapy for the Treatment of Solitary Fibrous Tumor With Malignant Transformation of the Pelvic: A Rare Case Report With Literature Review
Authors: Chao Gao, Yong Zhang, Ming Jing, Wei Qu, Jia Li, Xiang-Rong Zhao, Yong-Hua Yu
Journal: Medicine (Baltimore) (2016)
MeSH terms: Cell Transformation, Neoplastic / pathology, Neoplasm Recurrence, Local / pathology, Solitary Fibrous Tumors / pathology, Solitary Fibrous Tumors / radiotherapy, Case Reports, Research Support, Non-U.S. Gov't, Review, Biopsy, Needle, Follow-Up Studies, Humans, Immunohistochemistry, Male, Middle Aged, Neoplasm Recurrence, Local / radiotherapy, Pelvis, Radiotherapy, Adjuvant, Radiotherapy, Intensity-Modulated / methods, Rare Diseases, Risk Assessment, Solitary Fibrous Tumors / surgery, Tomography, X-Ray Computed / methods, Treatment Outcome, Ultrasonography, Doppler

Solitary fibrous tumor of the pelvic is an uncommon neoplasm with nonspecific symptoms. Reports of malignant transformation are especially rare. We report a case of solitary fibrous tumor in pelvic. A unique feature of our case compared with previously reported is that this patient relapsed with malignant transformation and had significant response to radiotherapy. The patient was initially treated with surgery, followed by postoperative dimensional conformal intensity modulated radiation therapy (dynamic MLC VRIAN 23EX Linac, inversely optimized by the Eclipse system) to provide a radical cure for residual tumor.In this case, there were no signs of recurrence after six and a half years of further follow-up, indicating that postoperation radiotherapy may be an effective treatment for SFT with malignant transformation in pelvic.
Surgical Management of Thoracic Osteomyelitis due to Escherichia Coli Sepsis
Authors: Mark K Lyons, Maziyar Kalani, Matthew T Neal, Naresh P Patel
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Case Report. Escherichia coli is a rare cause of vertebral osteomyelitis. It is more common in adults and males. We present a case of an immunocompetent adult male presenting with a several month history of progressive systemic symptoms and subsequent neurologic compromise. We discuss the neurosurgical evaluation of a patient with a progressive vertebral osteomyelitis and treatment options. Surgical debridement and spinal stabilization were performed and confirmed the diagnosis. The patient successfully completed a prolonged antimicrobial therapy course. The patient made a complete neurologic recovery. We discuss the presentation of a patient with Escherichia coli vertebral osteomyelitis and the successful surgical management.
Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient
Authors: Minjiang Chen, Lei Zhang, Wei Zhong, Ke Zheng, Wei Ye, Mengzhao Wang
Journal: Front Immunol (2021)
Keywords: thsd7a (thrombospondin type 1 domain-containing protein 7a), immune checkpoint inhibitors, immune related adverse event, membranous nephropathy, non-small cell lung cancer
MeSH terms: Antibodies, Monoclonal, Humanized / adverse effects, Glomerulonephritis, Membranous / diagnosis, Glomerulonephritis, Membranous / etiology, Immune Checkpoint Inhibitors / adverse effects, Lung Neoplasms / complications, Lung Neoplasms / immunology, Thrombospondins / immunology, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antibodies, Monoclonal, Humanized / therapeutic use, Autoantibodies / immunology, Biomarkers, Carcinoma, Non-Small-Cell Lung / complications, Carcinoma, Non-Small-Cell Lung / diagnosis, Carcinoma, Non-Small-Cell Lung / drug therapy, Carcinoma, Non-Small-Cell Lung / immunology, Disease Susceptibility, Fluorescent Antibody Technique, Humans, Immune Checkpoint Inhibitors / therapeutic use, Immunohistochemistry, Lung Neoplasms / diagnosis, Lung Neoplasms / drug therapy, Male, Tomography, X-Ray Computed, Antibodies, Monoclonal, Humanized, Autoantibodies, Biomarkers, Immune Checkpoint Inhibitors, THSD7A protein, human, Thrombospondins, tislelizumab

Immune checkpoint inhibitors (ICIs) became the standard treatment for many different kinds of cancers and can result in a variety of immune-related adverse events (irAEs). IrAEs of kidney are uncommon and consists of different pathology types. Among the different types, membranous nephropathy (MN) is rare and have not been well-described. Since MN can also be associated with malignancies, differential diagnosis in patients receiving ICIs who develop MN can be very difficult. We present the case of a 74-year-old man with metastatic non-small cell lung cancer who developed MN after ICIs therapy. The patient tested positive for thrombospondin type-1 domain-containing 7A antibodies (THSD7A) when diagnosed with MN. Supplementary examinations revealed the predisposing antigen in the primary tumor and present of the antibody after immunotherapy, which corresponded to the patient's clinical course of nephropathy. Treatment consisting of systemic glucocorticoids and rituximab resulted in a good clinical response, and the THSD7A antibodies were no longer detected. In this case, we first discuss the potential mechanism of immunotherapy related MN, in which the activation of humoral immunity may play an important role.
Advanced extrauterine pregnancy at 33 weeks with a healthy newborn
Authors: Tajudeen Dabiri, Guillermo A Marroquin, Boleslaw Bendek, Enyonam Agamasu, Magdy Mikhail
Journal: Biomed Res Int (2014)
MeSH terms: Pregnancy, Abdominal / physiopathology, Pregnancy, Ectopic / physiopathology, Case Reports, Adult, Cesarean Section, Female, Fetus, Humans, Hysterectomy, Infant, Newborn, Pregnancy, Pregnancy Trimester, Third, Pregnancy, Abdominal / diagnosis, Pregnancy, Ectopic / diagnosis, Ultrasonography, Prenatal

Abdominal pregnancy is a very rare form of ectopic pregnancy, associated with high morbidity and mortality for both fetus and mother. It is, and often, seen in poor resource nations, where early diagnosis is often a major challenge due to poor prenatal care and lack of medical resources. An advanced abdominal pregnancy with a good fetal and maternal outcome is therefore a more extraordinary occurrence in the modern developed world. We present a case of an abdominal pregnancy at 33.4 weeks in an individual with no documented prenatal care, who arrived in a hospital in the Bronx, in June 25th 2014, with symptoms of generalized, severe lower abdominal pain. Upon examination it was found that due to category III fetal tracing an emergent cesarean section was performed. At the time of laparotomy the fetus was located in the pelvis covered by the uterine serosa, with distortion of the entire right adnexa and invasion to the right parametrium. The placenta invaded the pouch of Douglas and the lower part of the sigmoid colon. A massive hemorrhage followed, followed by a supracervical hysterectomy. A viable infant was delivered and mother discharged on postoperative day 4.
Case report: A novel 5'-UTR-exon1-intron1 deletion in MLYCD in an IVF child with malonyl coenzyme A decarboxylase deficiency and literature review
Authors: Fang Xu, Yangyang Wu, Jiyi Huang, Yunguo Zhou, Fei Xu, Junkai Duan, Hong Li
Journal: Front Med (Lausanne) (2023)
Keywords: mlycd, cardiomyopathy, malonyl coenzyme a decarboxylase deficiency, metabolic disease, novel mutation
MeSH terms: Case Reports

The subject of the study is an 11-month old IVF baby girl with the typical clinical manifestation of malonyl coenzyme A decarboxylase deficiency, including developmental delay, limb weakness, cardiomyopathy, and excessive excretion of malonic acid and methylmalonic acid. Whole genome sequencing (WGS) revealed a novel heterozygous nonsense mutation (c.672delG, p.Trp224Ter) in the MLYCD gene of the proband and her father and a novel heterozygous deletion in 5'-UTR-exon1-intron1 of the MLYCD gene of the proband and her mother. The patient's cardiac function and limb weakness improved considerably after 3 months of a low-fat diet supplemented with L-carnitine. Furthermore, mapping of gene mutations and clinical manifestations was done by case collection.
Nontraumatic Acute Elevation of Pancreatic Enzymes following Percutaneous Nephrolithotomy: A Rare Complication
Authors: Nikolaos Ferakis, Antonios Katsimantas, Georgios Zervopoulos, Vasileios Klapsis, Spyridon Paparidis, Filippos Venetsanos, Konstantinos Bouropoulos
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

Herein, we report the case of a 48-year-old female who developed nontraumatic acute pancreatitis following left supracostal Percutaneous Nephrolithotomy. Three hours postoperatively, the patient developed fever with signs and symptoms consistent with hydrothorax, which was confirmed radiologically and was managed conservatively. The following days, the patient developed manifestations of Systemic Inflammatory Response Syndrome with epigastric pain, nausea, and vomiting. Blood, urine, and sputum cultures were negative. Serum amylase and lipase levels were elevated 3 and 13 times above the normal level, respectively. Imaging studies revealed no pathologic findings from pancreas. These findings were consistent with the diagnosis of acute pancreatitis.
Adolescent catatonia successfully treated with Lorazepam and aripiprazole
Authors: Aaron J Roberto, Subhash Pinnaka, Abhishek Mohan, Hiejin Yoon, Kyle A B Lapidus
Journal: Case Rep Psychiatry (2014)

Catatonia is especially concerning in children and adolescents. It leads to significant impairment, including emotional distress, difficulty communicating, and other debilitating symptoms. In this case report, we discuss a patient with no previous history of neuroleptic medication or psychotic symptoms, presenting with first-episode catatonia in the presence of disorganized, psychotic thoughts. We then review the catatonia syndrome, citing examples in the literature supporting its underdiagnosis in children and adolescents, and discuss successful treatment modalities. It is important to diagnose and treat catatonia as efficiently as possible, to limit functional and emotional distress to the patient.
Contralateral Ovarian Metastasis of Clear-Cell Renal Carcinoma: A Rare Case Report and Review of the Literature
Authors: Fatih Uruc, Serkan Akan, Aytaç Sahin, Caglar Yildirim, Ahmet Urkmez
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Renal cell carcinoma (RCC) constitutes 2-3% of all types of cancers. RCCs metastasize into lungs (50-60%), lymph nodes (36%), bones (30-40%), liver (30-40%), and brain (5%) in respective percentages. RCC rarely metastasizes into ovary. Only 25 cases of ovarian tumor, which metastasized into kidneys, have been presented. In the literature, a kidney-ovary axis has been defined, and its interrelationship begins with embryological life. With this case report, we aimed both to present a very rarely seen metastasis of RCC into contralateral ovary and also to review the literature.
Renal Mucormycosis: Post-COVID-19 Infection Presenting as Unilateral Hydronephrosis in a Young Immunocompetent Male
Authors: Rabin Nepali, Shreya Shrivastav, Dibya Singh Shah
Journal: Case Rep Nephrol (2022)
MeSH terms: Case Reports

Mucormycosis is a rare invasive fungal infection with a high mortality rate caused by members of the family Mucoraceae. It mainly affects immunocompromised hosts such as poorly controlled diabetes mellitus, previous solid organ transplant, high-dose steroids, and hematologic malignancy. The most common sites of the disease are rhinocerebral, the skin, the lungs, and the gastrointestinal tract. In this era of COVID-19 infection, there has been a significant rise in invasive mucormycosis predominantly reported from southeast. We present a case of isolated renal mucormycosis in an apparently healthy individual with post-COVID-19 infection presenting as unilateral hydronephrosis. Timely identifying at-risk populations and having a high degree of suspicion with involvement of multidisciplinary teams are of utmost importance to diagnose and treat a rare and fatal infection. Even if there is a long history, antifungal drugs and removal of the source can result in a good outcome.
Giant J (Osborn) Wave due to Bonsai Abuse: Comments on Clinical Practice
Authors: Murat Yalçın, Mustafa Aparcı, Murat Eroğlu, Zafer Işılak, Namık Özmen
Journal: Balkan Med J (2017)
Keywords: osborn, arrhythmia, cannabis
MeSH terms: Arrhythmias, Cardiac / etiology, Cannabinoids / adverse effects, Case Reports, Electrocardiography / methods, Humans, Male, Young Adult, Cannabinoids

Background:
Osborn wave, typically associated with hypothermia, is currently referred to as one of the J wave syndromes due to its clinical potential to develop lethal cardiac arrhythmia; it may rarely be observed in a non-hypothermic setting such as cannabis abuse.
Case report:
In this paper, we presented two young cases who presented to the emergency services with unconsciousness, drowsiness, and hypoxia, and also J wave on electrocardiography (ECG) due to Bonsai abuse.
Conclusion:
Osborn wave may be a significant criterion to initiate close monitoring in a coronary care unit, with supportive treatment and mechanical ventilation as necessary in those patients who abuse Bonsai.
Quantification of lean and fat tissue repletion following critical illness: a case report
Authors: Clare L Reid, Peter R Murgatroyd, Antony Wright, David K Menon
Journal: Crit Care (2008)
MeSH terms: Body Composition / physiology, Body Mass Index, Myelinolysis, Central Pontine / physiopathology, Case Reports, Research Support, Non-U.S. Gov't, Addison Disease / physiopathology, Addison Disease / therapy, Adult, Critical Illness, Fatigue / physiopathology, Female, Follow-Up Studies, Hand Strength / physiology, Humans, Intensive Care Units, Muscular Atrophy / diagnostic imaging, Myelinolysis, Central Pontine / therapy, Quality of Life, Respiratory Muscles / physiology, Ultrasonography

Introduction:
Muscle wasting is a recognised feature of critical illness and has obvious implications for patient rehabilitation and recovery. Whilst many clinicians believe lean tissue repletion to be a slow process following critical illness, and a probable explanation for poor functional recovery of patients many months after resolution of the illness, we have found no studies quantifying body composition changes during patient recovery.
Methods:
A combination of assessment techniques were used to monitor changes in body composition (that is, fat, water, protein and mineral), following intensive care unit (ICU) discharge, in a 38-year-old female recovering from extrapontine myelinolysis. Assessments were made at discharge from the ICU and then again 1 month, 3 months, 6 months and 12 months later. Functional recovery (respiratory muscle and hand-grip strength) and quality of life (36-item Short-form Health Survey) were assessed at these same timepoints.
Results:
Twelve months after discharge from the ICU, and despite an extensive rehabilitation programme and improvements in respiratory muscle and hand-grip muscle strength, our patient was unable to return to full-time employment and continued to complain of fatigue. She had successfully regained weight and was back to her pre-illness body weight. Body composition measurements showed that an incredible 73% of the weight gained was due to an increase in body fat.
Conclusion:
It is difficult to extrapolate the results of a single case to the wider ICU population, not least because the present patient sustained a significant neurological injury, but our data are the first to support the long-held belief that patient weight gain following critical illness is largely attributable to a gain in fat mass. The magnitude of body composition changes in the present patient are startling and support the need for longitudinal body composition data in a wider ICU population.