OpenMed/multicare-articles huggingface dataset:
Ten-Year Follow-Up of Collision Tumors Composed of Craniopharyngioma and Pituitary Adenoma: A Case Report and Literature Review
Authors: Takeshi Miyazaki, Kentaro Kowari, Hirotake Eda, Mizuki Kambara, Riruke Maruyama, Yasuhiko Akiyama
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Although craniopharyngioma (CP) and pituitary adenoma (PA) are common tumors of the parasellar lesions, the coexistence of CP and PA is very rare. A 48-year-old male visited our hospital because of consciousness disturbance. The neuroimaging revealed a sellar tumor contact with a massive suprasellar cyst including calcification. Preoperative diagnosis was CP, and the patient underwent craniotomy to resolve the suprasellar mass effect. The histological examination disclosed adamantinomatous CP, and subsequently a transsphenoidal approach was chosen for the residual intrasellar tumor. Against expectations, the histological diagnosis was not CP but PA. The patient underwent gamma knife surgery for the residual tumor, and the postoperative course was good. After a 10-year follow-up, both lesions were still completely controlled. If we had suspected and diagnosed the tumor involved as not only CP but also PA at the first operation, the second operation could have been avoided because we would have chosen gamma knife surgery for the residual tumor. We should draw attention to this rare situation for differential diagnosis of parasellar tumor to avoid unnecessary surgery and to decide the best strategy for treatment. In addition, the biological behavior of collision tumors composed of CP and PA is probably the same as solitary CP or PA based on a long-term follow-up of our case.
Autism Case Report: Cause and Treatment of "High Opioid Tone" Autism
Authors: Vishal Anugu, John Ringhisen, Brian Johnson
Journal: Front Psychol (2021)
Keywords: autism, case report, cold pressor test, neurobiological systems engineering, opioid tone
MeSH terms: Case Reports

Introduction: Neurobiological systems engineering models are useful for treating patients. We show a model of "high opioid tone" autism and present a hypothesis about how autism is caused by administration of opioids during childbirth. Main Symptoms: Clinical diagnosis of autism in a 25 year old man was confirmed by a Social Responsiveness Scale (SRS) self-rating of 79, severe, and a Social Communications Questionnaire (SCQ-2) by the patient's father scoring 27. Cold pressor time (CPT) was 190 seconds-unusually long, consonant with the high pain tolerance of autism. Therapeutic Intervention and Outcomes: At naltrexone 50 mg/day SRS fell to 54 and SCQ--2-9; both non-significant. CPT fell to 28, repeat 39 s. Improved relatedness was experienced ambivalently, understood as feelings never before experienced-causing pain. Non-compliance with naltrexone was followed by cutting open his palm and drinking alcoholically. Transference focused psychotherapy has helped him remain naltrexone-compliant while he works on issues of identity and relatedness. Conclusion: The model suggests studies that could be conducted to both prevent and treat this form of autism.
A Case Report of Umbilical Vein Varix with Thrombosis: Prenatal Ultrasonographic Diagnosis and Management
Authors: Yuuki Matsumoto, Akihiro Yanai, Saori Kamei, Ayaka Yamaguchi, Hirokazu Nakamine, Kohei Fujita
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Umbilical vein varix (UVV) is a very rare cord anomaly associated with intrauterine fetal death and fetal anomaly. We describe a case of extra-abdominal UVV with thrombosis. UVV was diagnosed at 23 weeks of gestation for the first time by ultrasonographic screening. Peak systolic velocity (PSV) near the UVV was partially increased up to about 100 cm/s, and blood flow was not detected in one of the umbilical arteries at 28 weeks of gestation. Therefore, the mother was hospitalized to monitor alterations of the PSV of the UVV frequently. Because the PSV of the UVV showed a sudden rapid increase up to about 150 cm/s at 32 weeks of gestation, she underwent emergent cesarean section on the same day to avoid sudden umbilical cord occlusion. The infant's birth weight was 1,744 g, and the Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. The pathological examination showed UVV with thrombosis and an occlusion in one of the umbilical arteries. The neonatal laboratory data showed no coagulopathy. Based on our experience with this case, frequent ultrasonographic examination should be performed to detect the acute thrombosis in the case of extra-abdominal UVV, especially during the preterm period.
Bilateral septic arthritis of the temporo mandibular joint: case report
Authors: Samia Ayachi, Zouha Mziou, Ramzi Moatemri, Habib Khochtali
Journal: Pan Afr Med J (2016)
Keywords: septic arthritis, adult, infection, temporo-mandibular joint
MeSH terms: Arthritis, Infectious / diagnosis, Temporomandibular Joint / microbiology, Temporomandibular Joint Disorders / diagnosis, Case Reports, Adult, Arthritis, Infectious / microbiology, Female, Fever / etiology, Fever / microbiology, Humans, Pain / etiology, Pain / microbiology, Temporomandibular Joint / pathology, Temporomandibular Joint Disorders / microbiology, Trismus / etiology, Trismus / microbiology

Septic arthritis of the temporo-mandibular joint (TMJ) is a rare disease that has been reported infrequently. To the best of the authors' knowledge, only one case of bilateral TMJ septic arthritis has been reported. The contamination may result from direct extension of adjacent infection (dental or ENT), from hematogenous spread of blood-borne organisms or from direct inoculation. The most common presenting are trismus and pain, although swelling, tenderness and erythema have also been described. In addition, patients may develop fever, regional lymphadenopathy and malocclusion. Through a successively bilateral case of TMJ arthritis, without obvious portal of entry of the bacteria, we will analyze characteristics and treatment of this disease.
A high complex karyotype involving eleven chromosomes including three novel chromosomal aberrations and monoallelic loss of TP53 in case of follicular lymphoma transformed into B-cell lymphoblastic leukemia
Authors: Abdulsamad Wafa, Faten Moassass, Thomas Liehr, Samarth Bhatt, Abdulmunim Aljapawe, Walid Al Achkar
Journal: Mol Cytogenet (2016)
Keywords: chromosomal aberration, clonal evolution, fish, follicular lymphoma (fl), prognostic factors, t(14, 18)(q32, q21)
MeSH terms: Case Reports

Background:
Follicular lymphoma (FL) is one of the most common B-cell non-Hodgkin's lymphoma (NHL). A subset of FL cases transform into more aggressive malignancies, most often to diffuse large B-cell lymphoma (DLBCL); in addition, lymphoblastic lymphoma and acute lymphoblastic leukemia (ALL) have also been rarely reported. The most common cytogenetic abnormalities associated with FL are translocation t(14;18)(q32;q21) with BCL2 rearrangements, present in 80-90% of all FL. However, that translocation alone is insufficient to cause FL and additional genomic events specifically leading to this kind of disease are still to be determined. The most frequently reported secondary changes are gains of chromosomes 7p or 7q, Xp, 12q and 18q, as well as losses on 6q and mutations within BCL2 and/or BCL6 genes. The presence of additional genomic aberrations, in particular 17p and 6q deletions is more frequent in grade 2 and 3 FL patients and correlated with shorter survival and a higher rate of transformation into DLBCL.
Case presentation:
We describe here, an adult FL grade 2 patient that had transformed to B-ALL at diagnosis. Banding cytogenetics, refined by multi-color fluorescence in situ hybridization including array-proven multicolor banding revealed a unique complex karyotype involving eleven chromosomes, translocation t(X;20)(p21.3;q11.2), translocation t(3;20)(q26.2;q12), and a dicentric dic(17;18). Interestingly, the dicentric chromosome led to monosomy of the tumor suppressor gene TP53. The case had an immunophenotype consistent with follicular center cell lymphoma according to the World Health Organization (WHO) recommendations.
Conclusions:
To the best of our knowledge, a comparable adult FL grade 2 case that transformed to B-ALL associated with such a complex karyotype and loss of TP53 was not previously reported. Most of complex aberrations were found simultaneously in approximately 85% of studied malignant cells and the remained cells studied were non-clonal; mechanisms explaining this may be either multiple-step mechanisms or single step in sense of chromothripsis.
Trial registration:
Identifying number: 3842. Registered 09 July 2012.
Successful Combination Therapy of Trazodone and Fluvoxamine for Pica in Alzheimer's Disease: A Case Report
Authors: Tadashi Kanamori, Yoshiyuki Kaneko, Kouju Yamada, Masahiro Suzuki
Journal: Front Psychiatry (2021)
Keywords: alzheimer's disease, klüver–bucy syndrome, case report, fluvoxamine, pica, trazodone
MeSH terms: Case Reports

Pica in Alzheimer's disease (AD) makes it difficult for caregivers to provide care. However, few effective medications have been reported for pica in AD. We report a case of AD with pica that was successfully improved by trazodone and fluvoxamine. An 80-year-old woman with AD was admitted to our hospital due to aggravated pica, including eating weeds in the facility's garden and eating a dishwashing sponge. Her pica was accompanied by oral tendency, prosopagnosia, and placidity. She took rivastigmine and memantine, but these were ineffective for her pica. She was given olanzapine and perospirone, but both were discontinued due to over-sedation and severe extrapyramidal symptoms, respectively. We then administered trazodone and fluvoxamine, both of which have demonstrated effectiveness for pica in frontotemporal dementia (FTD). Her pica behaviors then disappeared without daytime sleepiness. In this case, pica with oral tendency, which was accompanied by prosopagnosia and placidity, may be interpreted as a partial symptom of Klüver-Bucy syndrome (KBS). KBS is often seen in FTD, but also occurs in late-stage AD. Our case together with previous reports showing that trazodone and fluvoxamine were effective for pica in FTD suggest that the same common drug therapy may be successful in pica with oral tendency, regardless of the subtype of dementia.
Combining Minimally Invasive Techniques in Managing a Frail Patient with Postpneumonectomy Bronchopleural Fistula
Authors: Kostas Kostopanagiotou, Dimitrios Filippiadis, Efthimios Bakas, Costas Thomas, Andreas Kostroglou, Santaitidis Elias, Tatiana Sidiropoulou, Sotirios Tsiodras, Periklis Tomos
Journal: Case Rep Pulmonol (2021)
MeSH terms: Case Reports

A postpneumonectomy bronchopleural fistula is a life-threatening complication requiring aggressive treatment and early repair. Reoperations are common due to initial treatment failure. Advanced bronchoscopic techniques are rapidly evolving, but permanent results are questionable. We report the minimally invasive management of a frail 79-year-old patient with postpneumonectomy fistula in respiratory failure due to repeated infections. Previous bronchoscopic closure attempts with fibrin failed. The multistep interdisciplinary management included airway surveillance by virtual bronchoscopy, percutaneous fibrin glue instillation under computed tomography, and awake thoracoscopic surgery to achieve temporary closure. This provided an acceptable long period of symptomatic and physical improvement. The bronchial stump failed again four months later, and the patient succumbed to pneumonia. Pneumonectomy has to be avoided unless strongly indicated. Complications are best managed with surgery for definite treatment. We emphasize our approach only when a patient declines surgery or is medically unfit as a temporary time-buying strategy in view of definite surgery in a high-volume center.
Hemoadsorption in a Case of Severe Septic Shock and Necrotizing Fasciitis Caused by Nontraumatic Renal Rupture due to Pyelonephritis with Obstructive Uropathy
Authors: Lampros Kousoulas, Uwe Wittel, Stefan Fichtner-Feigl, Stefan Utzolino
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Background:
Nontraumatic renal rupture due to pyelonephritis with obstructive uropathy is an uncommon but life-threatening situation.
Case presentation:
A 25-year-old female presented to the emergency department with acute worsening of abdominal pain that began four weeks earlier. She was found to have peritonitis, leukocytosis, severe lactic acidosis, and a pronounced anemia and imaging was consistent with nontraumatic renal rupture with retroperitoneal abscess, perforation of the colon, and severe necrotizing fasciitis of the right lower limb. She underwent a right nephrectomy, a right hemicolectomy, surgical debridement of the retroperitoneum, and an upper thigh amputation. Due to severe septic shock and rhabdomyolysis with acute renal failure we performed a combined treatment of hemoadsorption using a Cytosorb hemoadsorber and continuous venovenous hemodialysis (CVVHD). Subsequently the patient recovered and was discharged home with no signs of infections and with normal renal function.
Conclusion:
We present a case of pyelonephritis with nontraumatic renal rupture leading to necrotizing fasciitis with osteomyelitis of the lower limb. The early treatment of the patient with a Cytosorb hemoadsorber led to a rapid hemodynamic and metabolic stabilization and preservation of the renal function, suggesting that hemoadsorption might be a rescue therapy in patients with severe septic shock and traumatic rhabdomyolysis.
Successful Treatment With Omalizumab in a Child With Asthma and Urticaria: A Clinical Case Report
Authors: Maria Maddalena Sirufo, Lia Ginaldi, Massimo De Martinis
Journal: Front Pediatr (2019)
Keywords: allergy, asthma, child, chronic spontaneous urticaria, hypersensitivity, omalizumab, precision medicine, translational medical research
MeSH terms: Case Reports

Childhood urticaria is not rare, although its persistence is less frequent. In children, chronic spontaneous urticaria (CSU) is associated with comorbidities, including asthma, allergic rhinitis, or atopic dermatitis, and many children with CSU have a family history of atopy. The therapeutic approach to CSU in children is the same one recommended by international guidelines for treatment of chronic urticaria in adults. In the European Union, according to the European Medicine Agency, omalizumab is the add-on drug of choice for the management of CSU in adult and adolescent patients (from 12 years of age) with inadequate response to H1 antihistamine therapy. In addition, in children (6 to <12 years of age), it is the add-on therapy of choice to improve asthma control. The management of children with urticaria under 12 is a therapeutic area with few certainties, where omalizumab can be administered only "off-label."
Endoscopic findings in loin pain hematuria syndrome: concentric clot in calyceal fornices
Authors: Benjamin K Canales, Andrew Windsperger, Stephen Lukasewycz, Manoj Monga
Journal: Diagn Ther Endosc (2008)
MeSH terms: Case Reports

The loin pain hematuria syndrome (LPHS) creates a considerable burden, both for patients afflicted with the disease and for those involved in medical management and diagnosis. To date, the diagnosis of LPHS remains one of exclusion, with some speculation regarding the extent of actual pathology. We report ureteroscopic findings in 2 cases of LPHS. These findings provide objective confirmation of underlying pathology in a difficult-to-manage disease process.
Case Report: A case of radioactive iodine-refractory thyroid cancer accompanying cervical lymph node metastasis treated with US-guided RFA combined with 125I seed implantation
Authors: Yuanpeng Zhai, Yu Shao, Qian Li
Journal: Front Oncol (2022)
Keywords: 125i seed implantation, cervical lymph node metastasis, radioactive iodine-refractory (rair) thyroid cancer, radiofrequency ablation (rfa), ultrasound- (us) guided
MeSH terms: Case Reports

Background:
Local control of metastases is critical to improving the life quality of patients with radioactive iodine-refractory (RAIR) thyroid cancer accompanying regional lymph node metastasis.
Case report:
The reported patient suffered from RAIR thyroid cancer accompanying poorly controlled cervical lymph node metastasis. The patient's lesions were controlled through 125I seed implantation combined with ultrasound-guided radio-frequency ablation (US-guided RFA). Such a combination therapy has not been reported to date.
Conclusion:
This study found US-guided RFA combined with 125I seed implantation to be safe and effective for the control of cervical local metastases in patients with RAIR thyroid cancer.
Aortic dissection induced by vascular endothelial growth factor inhibitors
Authors: Shuqi Dai, Yu Zhong, Hongxia Cui, Jin Zhao, Su Li
Journal: Front Pharmacol (2023)
Keywords: adverse reaction, aortic dissection, drug safety, hypertension, vascular endothelial growth factor inhibitors
MeSH terms: Review

Vascular endothelial growth factor (VEGF) contributes to angiogenesis and vasculogenesis. The occurrence and progression of tumors are accompanied by angiogenesis. Vascular endothelial growth factor inhibitors (VEGFI) have been used in anti-tumor treatment. However, aortic dissection (AD) is one of the VEGFI-associated adverse reactions with cute onset, rapid progression, and high case fatality rate. We collected case reports of VEGFI related to aortic dissection in PubMed and CNKI (China National Knowledge Infrastructure) from inception to 28 April 2022. Seventeen case reports were selected. The medication included sunitinib, sorafenib, pazopanib, axitinib, apatinib, anlotinib, bevacizumab, and ramucirumab. This review discusses the pathology, risk factors, diagnosis, and treatment of AD. Vascular endothelial growth factor inhibitors are related to aortic dissection. Although current literature lacks clear statistical evidence on the population, we offer points to encourage further confirmation of the best methods of care for these patients.
Case report: Clinical and virological characteristics of aseptic meningitis caused by a recombinant echovirus 18 in an immunocompetent adult
Authors: Chunmei Jiang, Zhixiang Xu, Jin Li, Jiaqi Zhang, Xingkui Xue, Jingxia Jiang, Guihua Jiang, Xisheng Wang, Yun Peng, Tian Chen, Zhenzhen Liu, Liu Xie, Haibin Gao, Yingxia Liu, Yang Yang
Journal: Front Med (Lausanne) (2023)
Keywords: aseptic meningitis, case report, echovirus 18, immunocompetent adult, recombination < evolution
MeSH terms: Case Reports

Echovirus 18 has been recognized as an important causative pathogen of aseptic meningitis in young children worldwide, and echovirus 18-induced meningitis is rarely found in adults with immunocompetence. In this case study, we report the clinical and virological characteristics of aseptic meningitis caused by recombinant echovirus 18 in an adult with immunocompetence. A 31-year-old woman with immunocompetence was admitted to our hospital with fever, dizziness, severe headache, nausea, and vomiting for the past 1 day and was diagnosed with viral meningitis based on the clinical manifestations and laboratory results from cerebrospinal fluid (CSF). The patient received antiviral treatment with ribavirin and interferon as soon as the enterovirus infection was identified using qRT-PCR and was cured after 4 days. From the oropharyngeal swab and CSF samples, two echovirus 18 strains were isolated with a single nucleotide difference located at the 5' UTR. Phylogenetic analyses based on the VP1 gene showed that the two strains belonged to the subgenotype C2 and were clustered with sequences obtained from China after 2015, while the results from the 3D polymerase region showed that the two strains were closely related to the E30 strains. Bootscanning results using the 5' UTR to 2A region and the 2B to 3' UTR region showed that potential intertypic recombination had occurred in the 2B gene. Recombination analyses further confirmed that the two strains (echovirus 18) presented genome recombination with echovirus 30 in the nucleotide regions of the 2B gene. To the best of our knowledge, this is the first report of echovirus 18-induced meningitis in an adult with immunocompetence from mainland China, highlighting the need for close surveillance of echovirus 18 both in children and adults in the future.
When treatment success is not as black and white as a radiograph: the bio/psycho/social impact of chronic osteomyelitis
Authors: Freya Jane Yoward, Sarah Lucy Bury
Journal: Pan Afr Med J (2014)
Keywords: malawi, osteomyelitis, bone deformity, disability
MeSH terms: Disability Evaluation, Osteomyelitis / physiopathology, Practice Guidelines as Topic, Case Reports, Child, Chronic Disease, Humans, Malawi, Male, Osteomyelitis / psychology, Osteomyelitis / therapy, Treatment Outcome

This case report is from Malawi Beit CURE international Hospital (BCIH), a center of excellence for the management of chronic osteomyelitis (COM) in children. Currently minimal evidence based data exists on the long term outcomes for treatment of bone defects following COM. Few studies evaluating outcomes are based solely on clinical parameters. This case study highlights the often-debilitating outcome after treatment and hence the need for further research to find the most effective treatment to create treatment guidelines. It particularly demonstrates the importance of the bio/psycho/social impact of long-term morbidity and disability, which must be considered alongside clinical outcomes in evaluation.
Rituximab-induced coronary vasospasm
Authors: Linda Lee, Vishal Kukreti
Journal: Case Rep Hematol (2012)
MeSH terms: Case Reports

Rituximab has improved the treatment of B-cell non-Hodgkin lymphomas. While it is generally well tolerated, serious adverse effects including infusion reactions with hemodynamic compromise and cardiac arrhythmias or ischemia are possible. We report a case of coronary vasospasm occurring during a rituximab infusion in a patient with minimal tumour burden and who had no cardiac risk factors. This case highlights that determination of the cause of ischemia is important and may identify some patients who can be successfully rechallenged.
Recurrent Huge Left Bartholin's Gland Abscess for One Year in a Teenager
Authors: Athanase Lilungulu, Bonaventura C T Mpondo, Abdallah Mlwati, Dismas Matovelo, Albert Kihunrwa, Balthazar Gumodoka
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Bartholin's gland abscess is the commonest worldwide reported abscess in gynaecological outpatient clinics; it has also been reported that Bartholin's gland abscess is three times more common in occurrences compared to Bartholin's gland cyst. It is more common in women who are at risk of acquiring sexually transmitted infections; however, other causes of infection should be investigated to exclude other causes of disease. We present the case of an 18-year-old female patient, a teenager of the reproductive age group, with the recurrent development of huge Bartholin's gland abscess in a period of one year. The marsupialization surgical technique of repair was performed successfully. She was discharged home and she was scheduled to visit STI's clinic where she was receiving regular screening for STI's and she was also given health education regarding preventive measures for STI's.