OpenMed/multicare-articles huggingface dataset:
Anabolic Steroid Use for Weight and Strength Gain in Critically Ill Patients: A Case Series and Review of the Literature
Authors: Matthew Anstey, Shilpa Desai, Luke Torre, Bradley Wibrow, Jason Seet, Emma Osnain
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Background:
An important long-term complication of critical illness is significant weakness and its resulting functional impairment. Recent advances have aimed to prevent critical illness weakness via early mobilisation of patients, minimising sedation, and optimising nutrition. One other potential treatment may be to provide anabolic support in the recovery phase, especially as patients have decreased levels of anabolic hormones.
Case presentation:
We describe a case series of 4 patients who had either (1) profound critical illness myopathy and (2) profound weight loss. All patients were already receiving appropriate nutritional support and physiotherapy. All patients had functional improvements in their muscle strength.
Conclusions:
For patients in the recovery phase of critical illness, we provide examples of when anabolic steroid supplementation may assist the treating clinicians in rehabilitating their patients who are still in the Intensive Care Unit. We discuss patient selection and the current supporting literature for anabolic supplementation in critically ill patients.
Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with 2019 Novel Coronavirus (SARS-CoV-2) Infection
Authors: Helen Kest, Ashlesha Kaushik, William DeBruin, Mario Colletti, David Goldberg
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

We report three critically ill pediatric patients (aged 6-10 years), presenting with features of multisystem inflammatory syndrome in children (MIS-C) from April 4 to May 10, 2020, to a tertiary-care center in New Jersey, United States. All patients tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and were previously healthy. Clinical presentations were similar with fever, abdominal pain, gastrointestinal complaints, and/or rash. One patient had altered mental status with cerebrospinal fluid (CSF) findings consistent with aseptic meningitis. Laboratory values were remarkable for high levels of C-reactive protein, D-dimers, B-type natriuretic peptide (BNP), and troponin in all patients. All had low albumin levels. Evaluation for other infectious etiologies was negative. All of the patients were critically ill, requiring admission to the intensive care unit. All had circulatory shock and needed inotropes. Two patients had respiratory failure requiring advanced respiratory support and one had cardiac dysfunction. All patients received steroids, and two received intravenous immunoglobulin (IVIG). One patient received tocilizumab. None of the children died. MIS-C is a recently recognized pediatric illness spectrum in association with SARS-CoV-2 infection, and clinical characterization is essential for understanding disease mechanisms to inform clinical practice.
Small-Cell Lung Cancer with Positive Anti-NMDAR and Anti-AMPAR Antibodies Paraneoplastic Limbic Encephalitis
Authors: Sabina Boangher, Pascal Mespouille, Corina-Mihaela Filip, Sophie Goffette
Journal: Case Rep Neurol Med (2016)
MeSH terms: Case Reports

We report the case of a 66-year-old woman, with paraneoplastic limbic encephalitis, treated 6 months earlier for bladder neoplasia. The patient presented to the emergency room with rapidly increasing symptoms, noninfectious cerebral spinal fluid associated with positive anti-NMDAR (as well as in serum) and positive AMPAR antibodies in the serum. Four months later, the patient was diagnosed with a small-cell lung cancer for which chemotherapy and radiotherapy was commenced. Simultaneously, endoscopic surgical treatment was undertaken for an in situ relapse of the bladder neoplasm. After the completion of 3 cycles of chemotherapy her neurological status temporarily worsened. The cerebral MRI did not show signs of encephalitis such as increased T2/FLAIR signal intensity in the mesial temporal lobes and limbic systems. No specific treatment was prescribed. Limbic encephalitis can be associated with malignant tumors such as lung carcinoma. Several cases reported in the literature have shown cognitive improvement after tumoral therapy. Regarding our experience, significant progress was achieved through immuno-modulatory treatment. A transitory deterioration of the cognitive process was perceived during the chemotherapy sessions.
Maxillary Swelling as the First Evidence of Multiple Myeloma
Authors: Atsushi Kasamatsu, Yasushi Kimura, Hideki Tsujimura, Harusachi Kanazawa, Nao Koide, Isao Miyamoto, Yosuke Endo-Sakamoto, Masashi Shiiba, Hideki Tanzawa, Katsuhiro Uzawa
Journal: Case Rep Dent (2015)

Multiple myeloma is a malignant neoplasm of plasma cells characterized by proliferation of a single clone of abnormal immunoglobulin-secreting plasma cells. Since the amount of hemopoietic bone marrow is decreased in the maxilla, oral manifestations of multiple myeloma are less common in the maxilla than in the mandible. We report the case of 33-year-old Japanese man who presented with a mass in the right maxillary alveolar region. Computed tomography and magnetic resonance images showed a soft tissue mass in the right maxilla eroding the anterior and lateral walls of the maxillary sinus and extending into the buccal space. The biopsy results, imaging, and laboratory investigations led to the diagnosis of multiple myeloma. This case report suggests that oral surgeons and dentists should properly address oral manifestations as first indications of multiple myeloma.
Shewanella putrefaciens: a rare cause of purulent otorrhoea
Authors: Elmostafa Benaissa, Adil Maleb, Mostafa Elouennass
Journal: Access Microbiol (2022)
Keywords: shewanella putrefaciens, otorrhoea, purulent
MeSH terms: Case Reports

Shewanella putrefaciens is a Gram-negative, non-fermenting, motile and oxidase-positive bacillus. Its incrimination in human pathology is very rare, although there has been a resurgence in Shewanella infections in recent years. We report the first case in Morocco of a purulent otorrhoea caused by S. putrefaciens , resistant to conventional treatment, occurring in a 25-year-old female, afebrile, without deterioration of the general state and possibly acquired during sea bathing. We also describe the bacteriological characteristics of and antibiotic susceptibility results for the isolate.
Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech
Authors: Xiaolin Deng, Paulo J Negro Jr, Patrick L Jung, Christopher M Marano, Stephanie Knight, Seshagiri R Doddi, Nana Y A Nimo, Rachel M LeMalefant, Drew A Myers, Andrea K Haake, Rebecca Chandler
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Our patient Mr. A is a mentally and physically disabled gentleman. He was first diagnosed with bipolar disorder as a teenager. He incurred a lumbar spinal injury due to a motor vehicle incident in his 20s which led to weakness, numbness, and frequent infection over both of his lower extremities. He also developed alcohol addiction over the course of his life. Mr. A presented to our facility with complicated neuropsychiatric symptoms. By adopting various clinical strategies, we were able to control his symptoms of agitation, self-harm, mood swings, and stereotyped behavior. However, we were not able to improve his neurocognitive functioning or speech impairment which seemed to become severe and irreversible in a period of a few months. We felt disappointed and perplexed by the mixed treatment responses. To understand Mr. A's clinical presentation, various laboratory tests and imaging studies were performed. Different psychotropic medications were used to manage his symptoms. Gradually, we felt that we were able to understand this case better clinically and etiologically. His bipolar disorder, alcohol addiction, and physical injury had likely all contributed to his neuropsychiatric symptoms, directly or indirectly. It is highly possible that an alcohol-related progressive dementia along with his chronic bipolar disorder played a key role in the progression of his brain neurodegeneration. Also, Wernicke-Korsakoff syndrome could reasonably be considered having developed during his clinical course. Moreover, the fluctuation of the patient's neuropsychiatric symptoms we observed during his hospitalization reflects the increased vulnerability of the human brain under sustained neurodegeneration.
Concurrence of multiple sclerosis and primary biliary cholangitis: Report of 3 cases
Authors: Mozhgan Sattar, Maryam Poursadeghfard
Journal: Caspian J Intern Med (2020)
Keywords: autoimmune disorders, multiple sclerosis, primary biliary cholangitis
MeSH terms: Case Reports

Background:
Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system which damages the myelin and axon. Primary biliary cholangitis (PBC) is a slow progressive liver disease with autoimmune feature in which non-purulent destructive cholangitis and interlobular bile duct destruction occur. Involvement of each of PBC and MS is thought to be related to environmental exposure in genetically susceptible persons.
Case presentation:
Here, we aim to report 3 women 52, 27 and 51 years old with MS and PBC.
Conclusion:
Although MS seems to have an association with some autoimmune gastrointestinal disorders such as ulcerative colitis, the concurrence of MS and PBC has been rarely reported.
Surgical Management of an Aspergillus Empyema in a 3-Year-Old Child
Authors: Meletios A Kanakis, Konstantinos Th Petsios, Nicholas M Giannopoulos, Dimitrios Bobos, Sofia Hatzianastasiou, Lida C Sianidou, Achilleas Lioulias
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Aspergillus empyema in nonimmunocompromised children is rare. A case of surgical management of invasive aspergillosis in a previously healthy 3-year-old child is presented. The patient was initially admitted to a hospital with severe respiratory deterioration and clinical instability, originally attributed to sepsis. After surgical intervention and the diagnosis of invasive aspergillosis, intravenous therapy with voriconazole was initiated. During postoperative care, the patient's condition remained stable with mild functional respiratory deficits. The diagnosis and treatment of Aspergillus empyema remains challenging, especially in cases that the recognition of aspergillosis is delayed and urgent surgical management of the empyema is required due to rapid clinical deterioration of the patient. The early initiation, prolonged administration, and close monitoring of high-dose antifungal treatment are highly recommended.
A CASE REPORT: RESPIRATORY MANIFESTATIONS OF COVID-19 STARTING WITH A GASTROINTESTINAL COMPLAINT: A COINCIDENCE OR A CORRELATION?
Authors: Anna Surgean Veterini, Lucky Andriyanto, Hamzah Hamzah
Journal: Afr J Infect Dis (2021)
Keywords: abdominal pain, covid-19, gastrointestinal complaints

Background:
SARS COV-2 is the cause of the current outbreak of COVID-19. The infection of SARS COV-2 causes changes in the gut-lung axis and the intestinal microbiota pro-inflammatory cytokines interaction which leads to the injury of the gastrointestinal tract. One of the symptoms of COVID-19 outside the respiratory system is a complaint in the GIT.
Materials and methods:
We present a COVID-19 case report that begins with a complaint of abdominal pain.
Results:
There was no previous suspicion of COVID-19, but after a radiological examination and SARS-COV2 positive PCR result, the patient was proven to be suffering from COVID-19.
Conclusion:
After hospitalization in the ICU for about 14 days, a recovery occurred and the patient was able to go home in a very good clinical condition.
A rare case of hepatosplenic gamma-delta T-cell lymphoma and secondary hemophagocytic lymphohistiocytosis
Authors: Philip H Brandt, Leena T Rahmat, Syed S Ali
Journal: Clin Case Rep (2018)
Keywords: hemophagocytic lymphohistiocytosis, hepatosplenic t‐cell lymphoma
MeSH terms: Case Reports

Hepatosplenic gamma-delta T-cell lymphoma with concurrent hemophogocytic lymphohistiocytosis is a rare but well-recognized clinical scenario, associated with a grim prognosis. Clinicians must be aware of this aggressive type of lymphoma so that a prompt diagnosis can be made with timely initiation of systemic therapy and referral for bone marrow transplant.
Idiopathic hypertrophic pyloric stenosis in an adult, a potential mimic of gastric carcinoma
Authors: Alireza Zarineh, Marino E Leon, Reda S Saad, Jan F Silverman
Journal: Patholog Res Int (2010)
MeSH terms: Case Reports

Primary or idiopathic hypertrophy of the pyloric muscle (IHPM) is a rare entity with uncertain pathogenesis which both clinically and pathologically mimics gastric cancer. We present a rare late-occurring case of IHPM in a 71-year-old Caucasian man with no apparent predisposing factor. Imaging studies demonstrated gastric distension with air fluid levels and no evidence of extrinsic compression. At upper endoscopy, massive gastric distension and no evidence of any ulcer or other mucosal defects were observed. Microscopically, marked hypertrophy of muscularis mucosa with smooth muscle cells arranged in whorls and fascicles was present which gradually transitioned to normal areas. The muscle fibers stained with smooth muscle actin and trichrome stain highlighted fibrosis between the muscle fibers. Although uncommon, IHPM can clinically and histologically mimic other proliferations in the gastric wall, such as gastrointestinal stromal tumor or a spindle cell neoplasm. The recent advances in understanding the pathogenesis of IHPM are discussed.
A Case of Metastatic Uterine Tumor Originating from Small-Cell Lung Cancer (SCLC) Mimicking Uterine Sarcoma
Authors: Mariko Fujima, Yoichi Kobayashi, Momoe Watanabe, Hiromi Shibuya, Hironori Matsumoto, Yoshiko Nishigaya, Mai Momomura, Shinya Yoshiike, Kiyotaka Nagahama, Junji Shibahara, Atsushi Suzuki
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Metastatic uterine tumors originating from extragenital cancers are a rare clinical occurrence. We report a case of metastatic uterine cancer derived from small-cell lung cancer (SCLC) that necessitated surgical treatment. The patient was a 59 y/o female who had undergone chemotherapy for stage IIIB SCLC. A 15 cm uterine tumor lesion was initially detected on CT scans. The patient had previously been diagnosed with uterine fibroids, but compared to the most recent CT scans taken one and a half months earlier, imaging diagnosis revealed a sudden increase in the size of the tumor when compared to the 8 cm myoma fibroid noted previously. Additional work-up with MRI scans revealed T2-enhanced images of a tumor that had almost completely invaded the myometrium; the tumor presented with marked diffusion-weighted enhancement, and a flow void was noted within the tumor. A differential diagnosis of uterine sarcoma was considered, but due to the lack of focal hemorrhage or necrosis findings on MRI imaging, the possibility of differential diagnosis of metastatic SCLC was also noted. As the patient was experiencing abdominal symptoms including abdominal distension and tenderness due the tumor, a simple hysterectomy and bilateral salpingo-oophorectomy were performed to palliate the symptoms. During the surgical procedures, intra-abdominal findings noted peritoneal dissemination while intraoperative cell cytology diagnosis of ascites revealed small-cell cancer. The final histopathological diagnosis likewise revealed metastatic small-cell cancer from the primary lung cancer. The clinical status of the lung cancer was evaluated as progressive disease (PD), and a change in chemotherapy regimen was necessitated. Further disease progression was noted on CT scans at 2 and a half months after surgery, and with gradual systemic disease progression, the patient died of disease at 3 months postsurgery. Initial evaluation of rapidly enlarging uterine tumors should include a differential diagnosis of uterine sarcoma; additionally, it is necessary to also consider the rare possibility of metastatic disease as in the present case with a clinical history of extragenital malignancy.
Meaning and Significance of "Alkalization Therapy for Cancer"
Authors: Hiromi Wada, Reo Hamaguchi, Ryoko Narui, Hiromasa Morikawa
Journal: Front Oncol (2022)
Keywords: alkalization therapy, bicarbonate, cancer, metabolism, tumor microenvironment, urine ph

Objectives of the study:
Our research aims to answer the following questions. Can cancer progression be stopped by changing the body condition of person with cancer? Can cancer be cured?If cancer progression can be stopped, what is the underlying mechanism?
Theoretical rationale for alkalization therapy:
Almost 70 years ago, Goldblatt H. & Cameron G. reported on the idea of alkalization therapy. Before that, Otto Warburg had been studying the metabolism of cancer and had discovered the essential nature of cancer. He published a review in Science in 1956 under the title "On the origin of cancer cells". From his phenomena described above, we established the theoretical rationale for alkalization therapy, based on the question of "How does cancer form and what is its nature"?
Limitations of deductive methods and inductive approaches:
In this paper, we describe a method to reconstruct the limitations and weaknesses of modern cancer medicine as Science-based Medicine using an inductive method, and to present a new vision of cancer therapy. How should we treat cancer? (Case presentation): Using a specific clinical case, we present patients in whom were successfully treated with no or few anticancer drugs.
Summary:
The biggest weakness of current cancer treatments is that they only treat the cancer and not the actual patient. The "alkalization therapy" that we advocate does not compete with any of the current standard treatments, but improves the effectiveness of standard treatments, reduces side effects, and lowers medical costs.
Spontaneous Intraperitoneal Rupture of Bladder Diverticulum: A Rare Cause of Peritonitis
Authors: Ahmed Ibrahimi, Adil Kallat, Idriss Ziani, Hachem El Sayegh, Lounis Benslimane, Yassine Nouini
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Spontaneous rupture of acquired bladder diverticulum in an adult patient is an extremely rare pathological entity with only 15 cases reported in the available literature. Etiologies are dominated by bladder outlet obstruction, represented mainly by benign prostatic hypertrophy (BPH) in elderly men. Clinical presentation is nonspecific, leading to delayed diagnosis and treatment. Surgical management is the standard approach for intraperitoneal rupture of bladder diverticulum. The prognosis depends on the earliness of treatment, associated comorbidity, and the nature of underlying diseases. Herein, we report a rare case of a 65-year-old male patient, who presented a spontaneous rupture of a large acquired bladder diverticulum, secondary to acute urinary retention complicating benign prostatic hypertrophy. The diagnosis was suspected in the presence of generalized peritonitis associated with lower urinary tract symptoms (LUTS) and was confirmed accurately and promptly by a computed tomography (CT) of the abdomen and pelvis. The patient underwent a successful surgical excision of the diverticulum and bladder repair without delay. The postoperative course was uneventful, and he was discharged from the hospital without any complication.
Acute mesenteric ischemia following lancehead snakebite: an unusual case report in the Northernmost Brazilian Amazon
Authors: Luis E B Galan, Vitória Souza Silva, Vitória Santos Silva, Rommel C Monte, Sewbert R Jati, Isadora S Oliveira, Felipe A Cerni, Wuelton M Monteiro, Jacqueline Sachett, Domingos S M Dantas, Roberto C C Carbonell, Manuela B Pucca
Journal: Front Med (Lausanne) (2023)
Keywords: amazon, bothrops, roraima, yanomami, ischemia, snakebite envenoming (sbe)
MeSH terms: Case Reports

Snakebites have a great impact in the Brazilian Amazon, being the lancehead Bothrops atrox the species responsible for most accidents, disabilities, and deaths. This study shows a case report of an indigenous patient from the Yanomami ethnicity, male, 33 years-old, envenomed by a B. atrox snake. Envenoming caused by B. atrox are characterized by local manifestations (e.g., pain and edema) and systemic manifestations, mainly coagulation disorders. The indigenous victim was admitted in the main hospital of Roraima and evolved with an unusual complication, an ischemia and necrosis of the proximal ileum, requiring segmental enterectomy with posterior side-to-side anastomosis. The victim was discharge after 27 days of hospitalization with no complaints. Snakebite envenomations may evolve with life-threatening complications, which can be treated by the antivenom following access to a healthcare unit, often late in indigenous population. This clinical case shows the need of strategies that aim improvement in the access to the healthcare by indigenous people, as well as demonstrates an unusual complication that may result from lancehead snakebites. The article also discusses the decentralization of snakebites clinical management to indigenous community healthcare centers to mitigate complications.
Ductal aneurysm masquerading as nonresolving pneumonia: A challenging differential!
Authors: Maitri Chodhary, Munesh Tomar, Sitaraman Radhakrishnan
Journal: Ann Pediatr Cardiol (2010)
Keywords: ductal aneurysm, pda, pneumonia
MeSH terms: Case Reports

We report here, the case of a six-and-a-half-month-old boy investigated for persistent respiratory distress and homogeneous opacity in the left upper lobe. Echocardiography revealed a giant ductal aneurysm compressing the left pulmonary artery and upper lobe division of the left bronchus. Computerized tomography angiogram delineated the exact anatomy and prompt surgical resection provided a successful cure to this lesser known entity.
'Two-step' percutaneous procedure for repairing the atrial septal defect with severe pulmonary hypertension: a case report
Authors: Liang Fu, Ruoxin Wang, Jinlong Zhao, Yinkai Ni, Zonghui Chen, Feng Li
Journal: J Surg Case Rep (2023)
MeSH terms: Case Reports

Atrial septal defect is the most common type of congenital heart disease. Interventional closure is currently the best treatment for the atrial septal defect. However, the repair strategy for atrial septal defect accompanies by severe pulmonary hypertension remains controversial. We report a case of an atrial septal defect with severe pulmonary hypertension in which we applied a perforated occlude for atrial septal defect percutaneously at first. After 6 months, when the pulmonary pressure gradually went down, we completely blocked the reserved hole with a closure device percutaneously. We suggest that the stepwise procedure is an important treatment option for select patients with atrial septal defect accompanied by severe pulmonary hypertension.