OpenMed/multicare-articles huggingface dataset:
Pulmonary aspiration of gastric contents in two patients taking semaglutide for weight loss
Authors: S A Avraham, J Hossein, F Somri, N Hawash, O Hochman
Journal: Anaesth Rep (2024)
Keywords: glp‐1 agonist, aspiration, gastric emptying
MeSH terms: Case Reports

Semaglutide is a new weight loss treatment that has received substantial media attention in recent years. Anaesthetists must be aware of a potentially dangerous side effect of the drug: decreased gastric emptying. This is caused by effects on gastric smooth muscle, mediated by the vagal afferent nerves. This is especially relevant in the peri-operative setting where pulmonary aspiration of gastric contents is a recognised complication. Here, we report two cases of peri-operative regurgitation of gastric contents in patients taking semaglutide. A patient taking semaglutide may have a full stomach despite compliance with routine pre-operative fasting guidelines. We consider how to manage patients receiving glucagon-like peptide-1 agonist therapy in the peri-operative period, including identifying those at high risk of regurgitation. Precautions such as rapid sequence induction and tracheal intubation can be used, but gastric ultrasound may also be useful in the pre-operative environment to help identify patients at high risk of aspiration.
Beyond Words: A Case of Pure Alexia Following Posterior Cerebral Artery Occlusion
Authors: João Romano, Sara Silva, Nuno Oliveira, Fausto Carvalheira, João Paulo Sousa
Journal: Cureus (2024)
Keywords: hemianopsia, homonymous quadrantanopia, ischemic stroke, posterior cerebral artery, pure alexia
MeSH terms: Case Reports

Alexia is an acquired reading disorder known as pure alexia or alexia without agraphia when unaccompanied by other higher-level deficits. We present the case of a 40-year-old man experiencing a sudden-onset headache and blurred vision. Despite an absence of known medical history, the patient exhibited a distinctive difficulty in reading without impairing other language aspects accompanied by a right superior homonymous quadrantanopia. Through comprehensive ophthalmological and neurological evaluations, a diagnosis of pure alexia was established. An imaging scan uncovered a left posterior cerebral artery occlusion as the underlying cause. Meticulous assessments of visual acuity, perimetry, and non-visual functions played a pivotal role in decisively diagnosing this condition. This case emphasizes the indispensable role of ophthalmologists in recognizing urgent clinical conditions that extend beyond ophthalmic concerns.
Ossifying renal tumor of infancy: a case report
Authors: Yu Qu, Guoqiang Du, Feng Guo, Rongde Wu, Wei Liu
Journal: Front Oncol (2023)
Keywords: diagnosis, ossifying renal tumor of infancy, partial nephrectomy, pathology, prognosis
MeSH terms: Case Reports

Ossifying renal tumor of infancy (ORTI) is an extremely rare benign renal solid tumor with typical clinical and pathological features. Most cases are diagnosed in infants that are less than 12 months of age and is more common in males. The first symptom in most patients is painless gross hematuria. Microscopically, the tumor has three main components: an osteoid core, osteoblast-like cells, and spindle cells. We reported a case of a 21-day-old patient diagnosed with ORTI who underwent partial nephrectomy and had good follow-up. The unique features of this case are the strong expression of Wilms Tumor-1 (WT-1) and a high Ki-67 index in the hot spot area. ORTI is considered to have a favorable prognosis. Due to the rarity of WT-1 positivity and high Ki-67 index, we should be highly aware that this patient needs to be followed closely. In addition, we reviewed the available literature on ORTI, with the aim of summarizing the diagnostic and therapeutic experience. The diagnosis needs to be given cautiously on the basis of clinical symptoms, imaging, and pathologic examination. Depending on the location and extent of the tumor, surgery can be performed by partial nephrectomy or nephrectomy to avoid overtreatment.
Case report: Manual carbon hemoperfusion for the treatment of meloxicam toxicity in a cat and suspected ibuprofen toxicity in a dog
Authors: Lauren E Haire, Amber D Vitalo, Ronald P Gonçalves, Travis M Lanaux
Journal: Front Vet Sci (2024)
Keywords: cats, dogs, extracorporeal blood purification, hemoperfusion, non-steroidal anti-inflammatory drug
MeSH terms: Case Reports

Extracorporeal blood purification (ECBP) has become a popular treatment option for non-steroidal anti-inflammatory drug (NSAID) toxicity in small animals. However, challenges arise when using ECBP for small dogs and cats because the priming volume required by most machine-based ECBP platforms might be excessive, leading to cardiovascular instability if a blood prime is not used. This report describes the successful use of manual carbon hemoperfusion (MCHP) to reduce plasma meloxicam levels in a cat following an inadvertent overdose and its use in a dog following suspected ibuprofen ingestion. In both animals, MCHP reduced the circuit volume needed for ECBP from 125 mL with a machine-based therapeutic plasma exchange or 104 mL with an in-series carbon hemoperfusion on an intermittent hemodialysis platform to just 40-50 mL. In the cat, MCHP reduced plasma meloxicam levels by 44%, and in both animals, the use of MCHP in these pets was well-tolerated and safe. Due to pre-existing anemia, the cat required a blood transfusion but the dog did not. MCHP is technically simple and can be performed at any hospital with access to carbon filters and blood bank resources. This technique may represent a reasonable alternative to treat NSAID toxicities in animals that are too small for conventional extracorporeal decontamination methods using either machine-based platforms without using a blood prime or in locations where these machines are unavailable.
Primary prostate lymphoma: a rare presentation of lower urinary tract symptoms in young aged patient
Authors: Mohammed Ali Alhamadani, Aleksandr Pecherkin, Terrence Doyle
Journal: J Surg Case Rep (2024)
Keywords: diffuse large b cell lymphoma, non-hodgkin lymphoma, prostate lymphoma, prostate neoplasm, prostatic specific antigen
MeSH terms: Case Reports

Primary prostatic lymphoma is a rare prostate malignancy that accounts for 0.09% of prostate cancer and 0.1% of lymphoma. Clinical misdiagnosis is common as majority of cases present with non-specific urinary symptoms like other prostatic diseases or prostatic cancer. Early diagnosis is of significant paramount as prognosis is dependent on histological type and tumour staging at the time of diagnosis. Urologists should remain aware of rare histological types of prostate cancer as delayed diagnosis of primary prostate lymphoma can be detrimental and lead to advanced disease causing serious sequelae i.e renal failure in addition to the primary pathology.
Diagnostic Delay of Spinal Tuberculosis Causing Medullary Compression
Authors: Krestine Corydon, Matilde Bjørn Ørum, Kristoffer Backman Nøhr, Kristina Öbrink-Hansen
Journal: Case Rep Infect Dis (2024)
MeSH terms: Case Reports

We present a case of a Philippine woman in her late twenties, diagnosed with spinal tuberculosis after surgical intervention due to medullary compression. The diagnosis was preceded by four months of unexplained back pain. Differential diagnoses included ulcer, liver-gallbladder disease, musculoskeletal causes, and cancer. This case highlights the importance of considering tuberculosis as a differential diagnosis in patients from high-endemic areas to avoid diagnostic delay and the risk of disease progression.
Case report: Innovative treatment for one metastatic thyroid-like follicular carcinoma of the kidney with ATM and POLE mutations
Authors: Jin-Ju Lei, Jie Rao, Hong-Yan Feng, De-Dong Cao, Hong-Lin Yan, Jing-Ping Yuan, Zhen-Min Jiang, Yi-Qiao Zhang
Journal: Front Oncol (2024)
Keywords: atm and pole mutations, metastatic thyroid-like follicular carcinoma of the kidney, pazopanib, programmed death 1 receptor inhibitor, radiotherapy
MeSH terms: Case Reports

Thyroid-like follicular renal cell carcinoma (TLFRCC), also known as thyroid-like follicular carcinoma of the kidney or thyroid follicular carcinoma like renal tumor, is an exceedingly rare variant of renal cell carcinoma that has only recently been acknowledged. This neoplasm exhibits a distinct follicular morphology resembling that of the thyroid gland. Immunohistochemical analysis reveals positive expression of PAX8, Vimentin, and EMA, while thyroid-specific markers TG and TTF1 are consistently absent. Furthermore, there is a notable absence of any concurrent thyroid pathology on clinical evaluation. Previous reports have suggested that TLFRCC is an indolent, slow-growing malignancy with infrequent metastatic potential. In this report, we present a case of TLFRCC characterized by remarkable ossification and widespread metastasis, including multifocal pulmonary lesions, involvement of the abdominal wall, and infiltration into the psoas muscle. To our knowledge, this represents only the third documented instance of distant metastasis in thyroid follicular renal carcinoma. The current case demonstrates a therapeutic approach that combines radiotherapy with the utilization of toripalimab, a programmed cell death 1 (PD-1) receptor inhibitor, and pazopanib. This treatment regimen was tailored based on comprehensive genomic profiling, which identified mutations in the POLE (catalytic subunit of DNA polymerase epsilon) and ATM (ataxia-telangiectasia mutated) genes, both of which have been implicated in the pathogenesis of various malignant tumors. These findings represent a novel discovery, as such mutations have never been reported in association with TLFRCC. Thus far, this therapeutic approach has proven to be the most efficacious option for treating metastatic TLFRCC among previously reported, and it also marks the first mention of the potential benefits of radiotherapy in managing this particular subtype of renal cell carcinoma.
Case report: Chronic Candida albicans meningitis: a rare entity diagnosed by metagenomic next-generation sequencing
Authors: Andrea B Kuenzli, Mandy D Müller, Werner J Z Graggen, Laura N Walti, Yonas Martin, Vladimir Lazarevic, Jacques Schrenzel, Alexander Oberli
Journal: Front Cell Infect Microbiol (2024)
Keywords: (1,3)-beta-d-glucan, candida albicans, cerebrospinal fluid, chronic meningitis, metagenomic next-generation sequencing, ventriculitis
MeSH terms: Candida albicans / genetics, Candida albicans / isolation & purification, High-Throughput Nucleotide Sequencing, Meningitis, Fungal / diagnosis, Meningitis, Fungal / drug therapy, Meningitis, Fungal / microbiology, Metagenomics / methods, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antifungal Agents / therapeutic use, Candidiasis / cerebrospinal fluid, Candidiasis / diagnosis, Candidiasis / microbiology, Chronic Disease, Humans, Male, Meningitis, Aseptic / diagnosis, Antifungal Agents

The aetiology of chronic aseptic meningitis is difficult to establish. Candida meningitis in particular is often diagnosed late, as cerebrospinal fluid (CSF) work-up and imaging findings are nonspecific. A 35-year-old patient with chronic aseptic meningitis, for which repeated microbiological testing of CSF was unrevealing, was finally diagnosed with Candida albicans (C. albicans) meningitis with cauda equina involvement using metagenomic next-generation sequencing (mNGS). This report highlights the diagnostic challenges and the difficulties of treating shunt-associated fungal meningitis.
Organ-specific immune-mediated reactions to polyethylene glycol and polysorbate excipients: three case reports
Authors: Olga Rogozina, Carmen Ruiz-Fernández, Susana Martín-López, Ibtissam Akatbach-Bousaid, Miguel González-Muñoz, Elena Ramírez
Journal: Front Pharmacol (2024)
Keywords: cd69 upregulation, adverse drug reactions, case report, causality algorithms, delayed hypersensitivity reactions, excipients, lymphocyte transformation test
MeSH terms: Case Reports

Drug-related acute pancreatitis (AP), acute interstitial nephritis (AIN) and drug-induced liver injury (DILI) are rare but serious adverse drug reactions (ADRs) that can have life-threatening consequences. Although the diagnosis of these ADRs can be challenging, causality algorithms and the lymphocyte transformation test (LTT) can be employed to help with the diagnosis. In this report, we present 3 cases of drug-related AP, AIN and DILI. The first case involved a patient with AP to lacosamide and to the excipient polysorbate 80 in pantoprazole. The second case involved a patient with DILI secondary to polyethylene glycol (PEG) excipients and amoxicillin-clavulanate. In case 3, AIN was considered to be the result of sensitization to excipients. Diagnoses were made using causality algorithms and the LTT. The LTT is a useful tool for helping diagnose drug-related AP and DILI, and it can be used to identify the specific drug or excipient causing the ADR. These cases highlight the importance of considering PEG and polysorbate excipients in the causality diagnosis of ADRs.
Prepubertal Female Bartholin's Gland Abscess: A Comprehensive Case Report Study
Authors: Ahmed Salh Alsayed, Tarek Talaat Harb Elkadi, Mohammed Suliman Alshamari, Azza Tawfik Attallah
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

Introduction:
Bartholin's gland abscesses are rare in pediatric patients, with limited documented cases. This case report aims to contribute valuable insights into managing this uncommon condition in children.
Methods:
A thorough examination and diagnostic workup were conducted on a 4-month-old female infant presenting with labial swelling. Clinical assessment strongly suggested the presence of a Bartholin's gland abscess. A culture of purulent discharge revealed the presence of Escherichia coli and Gram-negative Klebsiella pneumoniae. Antibiotic susceptibility testing guided the choice of treatment. Case Presentation. Despite initial treatment with oral antibiotics and sitz baths, there was limited therapeutic response. Close surveillance under the guidance of a pediatric surgeon continued for two months. Subsequently, surgical excision of the Bartholin gland was performed, and the specimen was sent for pathological examination.
Results:
Pathological analysis revealed signs of ulceration and granulation tissue, indicative of a mixed inflammatory response. An eight-month follow-up demonstrated marked improvement and overall well-being in the patient.
Conclusion:
This case report underscores the importance of considering Bartholin's gland abscess in diagnosing labial swelling in pediatric patients. The successful outcome achieved through surgical excision and appropriate antibiotic therapy provides valuable insights for potential treatment approaches in similar cases. Continued research and comprehensive studies are essential for establishing optimal treatment protocols for this patient demographic.
Brief psychotic disorder related to areca nut use: a case report
Authors: Sixun Li, Zhixiong Li, Juan Chen, Feng Wang, Ying Ou, Yi Huang, Zhe Li
Journal: Front Psychiatry (2024)
Keywords: areca nut, arecoline, betel nut, brief psychotic disorder, case report
MeSH terms: Case Reports

Background:
Areca Nut (AN) is the fourth most commonly abused drug after nicotine, ethanol, and caffeine, due to its psychoactive properties provided by bioactive substances. Although previous studies have demonstrated AN's anxiolytic-like activity and potential benefits in ameliorating symptoms of depression and schizophrenia, there remains limited awareness regarding its association with brief psychotic disorder.
Case presentation:
This case report presents the clinical profile of a 30-year-old male patient with a history of betel nut chewing for the past 2 years, who exhibited sudden onset delusions, hallucinations, and disorganized speech and behavior upon increasing the dosage of betel nut consumption. The patient displayed a positive response to antipsychotic treatment, and symptoms resolved upon discontinuation of betel nut consumption. However, one month after discharge, the patient experienced a recurrence of auditory hallucinations upon resuming betel nut chewing. Through counseling and support, the importance of abstaining from betel nut use and maintaining medication compliance was emphasized, resulting in no recurrence of psychotic symptoms during the six-month follow-up.
Conclusions:
This case report highlights the related role of betel nut with brief psychotic disorder, especially when the chewing dosage is abruptly increased. It underscores the importance of considering betel nut as a potential precipitant related to acute psychiatric disorders in clinical settings.
LONG-TERM REPEATED BOTULINUM TOXIN A TREATMENT OVER 12 YEARS GRADUALLY CHANGES GAIT CHARACTERISTICS: SINGLE-CASE STUDY
Authors: Hiroki Tanikawa, Hitoshi Kagaya, Shota Itoh, Kento Katagiri, Hikaru Kondoh, Kenta Fujimura, Satoshi Hirano, Toshio Teranishi
Journal: J Rehabil Med Clin Commun (2024)
Keywords: botulinum toxins, gait analysis, gait disorders, long-term treatment, muscle spasticity
MeSH terms: Case Reports

Objective:
To demonstrate the long-term efficacy of repeated botulinum toxin A injections into the same muscles for ameliorating lower limb spasticity and gait function.
Design:
Single-case study.
Patient:
A 36-year-old woman with right cerebral haemorrhage received her first botulinum toxin A injection 1,296 days after onset. The patient underwent 30 treatments over 12 years after the first injection to improve upper and lower limb spasticity and abnormal gait patterns. The mean duration between injections was 147 days.
Methods:
The Modified Ashworth Scale, passive range of motion, gait velocity, and degree of abnormal gait patterns during treadmill gait were evaluated pre-injection and at 2, 6, and 12 weeks after every injection.
Results:
The follow-up period showed no injection-related adverse events. Comfortable overground gait velocity gradually improved over 30 injections. The Modified Ashworth Scale and passive range of motion improved after each injection. Pre-injection values of the degree of pes varus, circumduction, hip hiking, and knee extensor thrust improved gradually. However, the degree of contralateral vaulting, excessive lateral shift of the trunk, and insufficient knee flexion did not improve after 30 injections.
Conclusion:
Repeated botulinum toxin A injections effectively improve abnormal gait patterns, even when a single injection cannot change these values.
Post-Traumatic Radial Artery Pseudoaneurysm at the Wrist Level: A Case Report
Authors: Shreosi Sarkar, Ansarul Haq, Veena K Singh, Varun H Kashyap
Journal: Cureus (2024)
Keywords: post-traumatic, pseudoaneurysm, radial artery, surgical repair, vena comitantes graft, wrist level
MeSH terms: Case Reports

A pseudoaneurysm is a collection of blood outside the arterial lumen but remains in continuity with the lumen and lined by fibrous tissue. Radial artery pseudoaneurysm is a rare entity mostly occurring due to iatrogenic reasons. Traumatic causes are rare. In this case report, we report a post-traumatic left radial artery pseudoaneurysm at the wrist level in a 20-year-old male patient. The patient was treated with end-to-end repair of excised pseudoaneurysm with a vein graft taken from the radial artery vena comitantes through the same incision.
Metastatic gastric adenocarcinoma to the cutaneous neck and chest wall
Authors: Christina M Murphy, Kevin Wang, Christopher Wachuku, Aman Prasad, Ishita Dhawan, Eric E Morgan, Katherine K Brown, Leo Wang
Journal: SAGE Open Med Case Rep (2024)
Keywords: cancer, dermatology
MeSH terms: Case Reports

This case describes an atypical cutaneous presentation of metastatic gastric carcinoma in a patient initially presenting with dysphagia and a sclerotic red plaque overlying the anterior neck and chest. Skin biopsy revealed metastatic adenocarcinoma from the upper gastrointestinal tract. Esophagogastroduodenoscopy revealed stage IV metastatic gastric adenocarcinoma. Treatment with chemotherapy was initiated.
The psychosocial aid response after the 22/03/2016 attacks in Belgium: a community case study
Authors: Emilie Muysewinkel, Lara Vesentini, Helena Van Deynse, Lise Eilin Stene, Johan Bilsen, Roel Van Overmeire
Journal: Front Public Health (2024)
Keywords: mental health, mental healthcare, posttraumatic stress disorder, registration data, terrorism
MeSH terms: Terrorism / psychology, Research Support, Non-U.S. Gov't, Belgium, Female, Humans, Survivors / psychology

Introduction:
After the terrorist attacks, early psychosocial care is provided to people considered at risk of developing mental health issues due to the attacks. Despite the clear importance of such early intervention, there is very few data on how this is registered, who is targeted, and whether target-recipients accept such aid.
Methods:
Using registry data from the Centre General Wellbeingwork (CAW), a collection of centers in the regions Brussels and Flanders that provide psychosocial care, we examined the early psychosocial care response after the terrorist attacks of 22/03/2016 in Belgium.
Results:
In total, 327 people were listed to be contacted by the CAW, while only 205 were reached out to (62.7%). Most were contacted within a month (84.9%), and were victims of the attacks (69.8%). Overall, the majority was female (55.6%).
Conclusion:
Overall, target recipients were witnesses and survivors of the attacks, though a large proportion of people were not reached by the early outreach.
Neonatal Testicular Torsion with Hydrocele: A Case Report Underscoring the Need for Early Recognition and Management
Authors: Kareem Omran, Sameh Ali Ali, Ehsan Ahmad, Hilal Matta, Wissam Jamal Al Tamr
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

Neonatal testicular torsion (NTT) is a rare but significant condition occurring within the first 30-day postbirth, leading to vascular compromise and potential testicular loss. This paper presents a case of NTT detected incidentally in a neonate with bilateral hydrocele, emphasizing the challenge of early diagnosis and management complexities. The infant underwent surgical intervention involving detorsion and bilateral orchiopexy but eventually required right orchiectomy due to necrosis. The paper highlights the prevalence of NTT in conjunction with hydrocele and stresses the importance of parent education and vigilant follow-up. Various diagnostic methods, primarily ultrasonography, and a range of management strategies are discussed, considering factors such as salvage potential, risk to the contralateral testicle, and surgical intervention's risks and benefits. The paper argues for individualized management, taking into account specific neonate conditions and parental preferences, underlining the essential role of informed and empathetic consultation. The case reinforces the urgent need for increased awareness, early detection, and carefully considered therapeutic approaches to prevent devastating outcomes like infertility and the necessity for lifelong hormone supplementation.