OpenMed/multicare-articles huggingface dataset:
Bilateral adrenalectomy in the context of primary adrenal insufficiency due to colorectal cancer metastasis
Authors: Joaquin Fernandez Alberti, Walter S Nardi, Maricel Recalde, Sergio D Quildrian
Journal: Ecancermedicalscience (2022)
Keywords: adrenal insufficiency, adrenalectomy, bilateral metastasis, colorectal cancer, surgical oncology
MeSH terms: Case Reports

Introduction:
Adrenal glands are a common site of metastasis for several types of malignancies. Nevertheless, bilateral metastasis leading to adrenal insufficiency is a very rare presentation.
Presentation of case:
We present a 62-year-old woman with previous history of colorectal cancer and bilateral adrenal metastasis associated with primary adrenal insufficiency. The patient underwent bilateral open adrenalectomy after a multidisciplinary tumour board evaluation.
Conclusion:
The incidence of adrenal insufficiency may be underestimated in patients with a history of cancer. Adrenal function must be evaluated in those patients presenting with bilateral adrenal masses and hormonal replacement therapy should be considered, if appropriate. In selected cases, bilateral adrenalectomy can give a possible therapeutic option for patients with confined disease to the adrenal glands.
Anterograde bile duct drainage for intractable bile leakage after hepatectomy in a patient with previous pancreatoduodenectomy: A case report
Authors: Ryohei Murata, Yo Kamiizumi, Chihiro Ishizuka, Sayuri Kashiwakura, Takeshi Tsuji, Hironori Kasai, Yasuhiro Tani, Tsutomu Haneda, Tadashi Yoshida, Koji Ito
Journal: Int J Surg Case Rep (2019)
Keywords: anterograde drainage, bile leakage, choledochojejunostomy, hepatectomy, pancreatoduodenectomy

Introduction:
Endoscopic retrograde drainage is effective for managing bile leakage, which is relatively common after hepatectomy without bile duct reconstruction. However, the procedure is difficult to perform after pancreatoduodenectomy with choledochojejunostomy. We present a case of anterograde bile duct drainage for intractable bile leakage after hepatectomy in a patient with previous pancreatoduodenectomy.
Presentation of case:
An 80-year-old woman with a history of pancreatoduodenectomy for distal biliary cancer and adjuvant chemotherapy presented with bile leakage. Six years after the pancreatoduodenectomy, she underwent partial hepatectomy for suspected metastasis or intrahepatic cholangiocarcinoma. On the 9th postoperative day, bile leaked from her drainage tube forming an abscess cavity; this continued until the 28th postoperative day. We attempted selective anterograde drainage from the cut surface of the liver under fluoroscopic guidance using a guidewire and Cobra-type catheter. We selectively cannulated the entrance hole of the bile duct. Twenty days after the drainage, the abscess cavity disappeared. After 41 days, the tube was removed, and the patient was discharged. We suggest this procedure as a possible treatment option for difficult bile leakage cases.
Discussion:
A case of intractable bile leakage after hepatectomy in a patient with a previous history of pancreatoduodenectomy is difficult to manage, and usually needs surgical intervention. The effect of selective cannulation of the entrance hole of the bile duct has not been studied.
Conclusion:
Selective anterograde bile duct drainage for intractable bile leakage after hepatectomy in a patient with a previous history of pancreatoduodenectomy successfully resolved bile duct leakage in our patient.
Maternal Death in Rural Ghana: A Case Study in the Upper East Region of Ghana
Authors: Paschal Awingura Apanga, John Koku Awoonor-Williams
Journal: Front Public Health (2018)
Keywords: antenatal care, healthcare, maternal mortality, rural, strengthening
MeSH terms: Case Reports

Maternal mortality remains a challenge in providing quality maternal and other reproductive healthcare services in Ghana. This is a case investigation of a maternal death in rural Ghana that seeks to unravel the circumstances that lead to her death. We conducted three in-depth interviews with healthcare staff as well as a focused group discussion comprising of six relatives of the deceased, including her husband. The investigation revealed that lack of logistics, medical, and laboratory equipment, inadequate knowledge about the benefits of antenatal care services as well as non-adherence of healthcare workers to treatment protocols and standard operating procedures were found as major setbacks to the provision of effective and quality maternal healthcare services in Ghana. It is, therefore, imperative for the Government of Ghana and other Non-Governmental Organizations to invest in strengthening the healthcare delivery system especially in rural Ghana by making available basic logistics, medical, and laboratory equipment, as well as improving upon maternal health education, and consistently organizing capacity building training programs for healthcare workers.
Severe Cytomegalovirus Reactivation in Patient with Low-Grade Non-Hodgkin's Lymphoma after Standard Chemotherapy
Authors: Lena Modvig, Ciaran Boyle, Katie Randall, Anton Borg
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Clinically significant cytomegalovirus (CMV) reactivation is not uncommon in patients with severe immunodeficiency secondary to underlying medical disorders or following aggressive immunosuppressive therapy. However, it is less frequently found in patients with low-grade haematological malignancies after nonintensive chemotherapy. We treated a patient at our centre for stage IVB follicular lymphoma with standard chemotherapy who successively developed CMV colitis associated with a CMV viral load of >3 million copies/ml. Four lines of antiviral treatment were necessary to obtain biochemical remission with undetectable CMV levels, with an initially insufficient response to valganciclovir despite therapeutic pre- and posttreatment levels. Subsequently, our patient also developed an infection with Pneumocystis jirovecii pneumonia (PJP) as further evidence of severe immune compromise. This case report demonstrates the importance of including investigations for less common sources of infection when confronted with a patient with a low-grade haematological malignancy and a pyrexia of unknown origin.
Tranexamic Acid as a Successful Therapy in Turner Syndrome With Recurrent Overt Gastrointestinal Bleeding due to Small Intestinal Venous Anomalies
Authors: Pongtawat Lertwilaiwittaya, Frederick H Weber Jr
Journal: ACG Case Rep J (2023)
Keywords: gi bleed, turner syndrome, female, small intestine
MeSH terms: Case Reports

Small intestinal venous abnormalities are an underrecognized condition as an etiology of overt gastrointestinal (GI) bleeding in patients with Turner syndrome. Evidence-based therapeutic options for these lesions are lacking in the published literature. A 47-year-old woman with Turner syndrome with a 30-year course of recurrent GI bleeding was found to harbor diffuse small intestinal venous ectasias through endoscopic imaging. Achievement of a 21-month clinical remission (elimination of hospitalizations for overt GI bleeding and normalization of hemoglobin concentration) was reached after initiation of tranexamic acid titrated to 2,600 mg daily.
Case Report: Extreme Levels of Serum S-100B in a Patient with Chronic Subdural Hematoma
Authors: Malin Elisabet Persson, Eric Peter Thelin, Bo-Michael Bellander
Journal: Front Neurol (2012)
Keywords: s-100b, biomarkers, human, malignant melanoma, neurosurgery

The protein S-100B is a biomarker increasingly used within neurosurgery and neurointensive care. As a relatively sensitive, yet unspecific, indicator of CNS pathology, potential sources of error must be clearly understood when interpreting serum S-100B levels. This case report studied the course of a 46-year-old gentleman with a chronic subdural hemorrhage, serum S-100B levels of 22 μg/l, and a history of malignant melanoma. Both intra- and extra-cranial sources of S-100B are evaluated and imply an unclear contribution of several sources to the total serum concentration. Potential sources of error when interpreting serum concentrations of S-100B are discussed.
Annexin A2 Expression in the Aerogenous Spread of Pulmonary Invasive Mucinous Adenocarcinoma with Gastric Lineage
Authors: Kazumori Arai, Tomohiro Iwasaki, Chinatsu Tsuchiya, Akihiro Sonoda
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Spread through air spaces (STAS) is a unique form of lung cancer progression associated with a worse prognosis. However, the mechanisms underlying STAS and the associated proteins remain unclear. Annexin A2 (ANX A2), which is a membrane-binding protein involved in cell adhesion, is known to promote cancer invasion. In this report, we describe the immunohistochemical analysis of ANX A2 expression in an invasive mucinous adenocarcinoma (IMAC) resected from a 63-year-old man in whom the tumor cells had detached from the alveolar wall and exhibited STAS. At the detachment site, we observed cytoplasmic ANX A2 positivity on the basal side and in the exfoliative gap, as well as reduced collagen IV positivity expression. This biomarker pattern suggested an IMAC with gastric lineage. We hypothesize that ANX A2 is secreted from the basal sides of tumor cells and induces tumor cell detachment by degrading the basement membrane. A further comparison of this case with an IMAC with nongastric lineage suggested the following probabilities: (1) ANX A2 likely contributes to STAS in a manner that is dependent on its subcellular localization. (2) Both the subcellular localization of ANX A2 and the detachment site depend on tumor cell characteristics, including the biomarker immunophenotype.
Point of Care Ultrasound in Monitoring of Post-Renal Biopsy Bleeding
Authors: Natalie N McCall, Anna Burgner
Journal: POCUS J (2022)
Keywords: pocus, renal biopsy, renal ultrasound
MeSH terms: Case Reports

A 32-year-old male presented with hypertensive emergency and features of thrombotic microangiopathy. He underwent a kidney biopsy after renal dysfunction persisted despite clinical improvement otherwise. The kidney biopsy was performed with direct ultrasound guidance. The procedure was complicated by hematoma formation and persistent turbulent flow on color Doppler concerning for ongoing bleeding. Serial point of care ultrasounds of the kidney with color flow Doppler were used to monitor the size of the hematoma and determine if there was evidence of ongoing bleeding. These serial ultrasounds showed stable hematoma size, resolution of biopsy-associated Doppler signal and prevented further invasive interventions.
Two case reports and a systematic review of the literature on adult cerebral cortical encephalitis with anti-myelin oligodendrocyte glycoprotein antibody
Authors: Meihui Xu, Chi Ma, Ming Dong, Chunjie Guo, Simin Yang, Yue Liu, Xu Wang
Journal: Front Immunol (2023)
Keywords: mri, adult, cerebral cortical encephalitis, myelin oligodendrocyte glycoprotein antibody, myelin oligodendrocyte glycoprotein antibody-associated disease
MeSH terms: Autoantibodies, Encephalitis / diagnosis, Encephalitis / drug therapy, Systematic Review, Case Reports, Research Support, Non-U.S. Gov't, Female, Humans, Immunoglobulin G / therapeutic use, Male, Myelin-Oligodendrocyte Glycoprotein, Oligodendroglia, Seizures, Myelin-Oligodendrocyte Glycoprotein, Autoantibodies, Immunoglobulin G

Background and purpose:
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has gained recognition in recent years as an immune-mediated inflammatory demyelinating disease of the central nervous system. The clinical features and prognosis of MOGAD adult cerebral cortical encephalitis (adult CCE) have not been fully elucidated. This study aims to further characterize the clinical symptoms, magnetic resonance imaging (MRI) findings, and prognosis of CCE with anti-MOG antibody.
Methods:
We present two adult cases of CCE with anti-MOG antibody and summarize the clinical symptoms, magnetic resonance imaging (MRI) findings, and prognosis of this phenotype as per a completed systematic review of the literature.
Results:
We found a total of 39 cases of MOGAD adult CCE (36% females; average age of onset of 29 years). Among them, 85% had seizure, 82% had headache, 64% had cortical symptoms, 64% had fever, 54% had changes of consciousness, and 38% had ocular symptoms. All cases demonstrated cerebral cortical T2 fluid-attenuated inversion recovery (FLAIR) lesions on MRI. Of the 25 patients (with seizure or not) who had EEG reports, 76% of patients showed abnormal EEG. Cerebrospinal fluid (CSF) white blood cell count of 90% of patients and CSF total protein of 67% of patients were elevated. In 16 patients with available CSF cytology data, 11 (69%) had abnormal cytology findings with monocytic predominance. In the 15 cases for which MOG antibody IgG was tested in both serum and CSF, 14 (93%) demonstrated a higher positive MOG IgG titer in serum than CSF. The majority of patients were treated with immunosuppressive therapy (97% corticosteroids, 15% mycophenolate mofetil, 13% IVIg, 5% azathioprine, and 5% other). The majority of patients had a favorable prognosis after treatment, as exemplified by improved clinical symptoms and imaging. Two patients relapsed.
Conclusions:
The clinical presentation and prognosis of adult CCE remain less understood in comparison to more common MOGAD phenotypes. It is important to consider MOGAD as an underlying etiology for adult CCE, as early detection and immunotherapy may improve outcomes.
Flow Diverter-Assisted Coil Embolization of Blood Blister-Like Aneurysm Using Semi-deploying Technique
Authors: Ping Zhang, Weiying Zhong, Tao Li, Xianjun Tan, Chao Chen, Mingxin Li, Zhonggang Li, Gang Li, Yunyan Wang
Journal: Front Neurol (2021)
Keywords: blood blister aneurysm, coil embolization, efficacy and safety, flow diversion, semi-deploying technique
MeSH terms: Case Reports

Despite many therapeutic methods were utilized to treat blood blister-like aneurysms (BBAs), the optimal treatment approach has not yet been defined. This study presents the single center experience with BBAs treated with flow diverter-assisted coiling using semi-deploying technique, and discusses the efficacy and safety of the method. The patients with subarachnoid hemorrhages (SAH) due to BBAs and treated with Pipeline Flex Embolization Device (PED) between November 2015 and February 2019 in our hospital were retrospectively reviewed. Patient demographic data, timing of treatment, angiographic details, treatment techniques, clinical outcomes and follow-up results were recorded. Ten cases (6 women and 4 men) were enrolled. The mean age of patients was 50.7 years (range 40-61 years). The aneurysm size ranged from 2 × 1.7 mm to 4.5 × 3.8 mm. Seven patients were treated with PED assisted coil embolization using semi-deploying technique, and all of the aneurysms were totally obliterated at the follow up. One patient treated with PED assisted coil embolization suffered from parenchymal hemorrhage 3 days after the treatment, and another one patient also treated with PED and coil died of severe vasospasm 10 days after the treatment. There was no reruptured cases during the follow-up. Here we showed that PED assisted coil embolization using semi-deploying technique could be a technically safe and effective treatment for BBAs.
A case of worsening deep cerebral venous sinus thrombosis managed by intrasinus thrombolysis
Authors: Nidhi Sood, Nikhil Sood, Arun Talkad
Journal: Case Rep Neurol Med (2011)
MeSH terms: Case Reports

Cerebral venous sinus thrombosis (CVST) is an uncommon condition with severe consequences. Although we do not know the exact incidence and prevalence of CVST, it is an important diagnosis. Over the past decade, it has been diagnosed more frequently due to greater awareness and availability of noninvasive diagnostic techniques. Furthermore, routine diagnostic neuroimaging has been used to monitor the clinical progress of these patients, especially in deteriorating cases. In order to decrease morbidity and mortality, an understanding of CVST treatment options is important. Treatment of extensive intracranial venous sinus thrombosis with intrasinus infusion of recombinant tissue plasminogen activator (rt-PA) is relatively controversial as there are no clear guidelines in regards to appropriate therapeutic management. We report a case of successful intrasinus thrombolysis of deep cerebral sinus thrombosis (DCST) resulting in rapid radiographic improvement associated with complete clinical recovery.
Abdominoplasty in the Presence of a Stoma for Functional and Aesthetic Indications
Authors: Joseph M Firriolo, Ashley K Truong, Heath J Charvet
Journal: Aesthet Surg J Open Forum (2023)
MeSH terms: Case Reports

Background:
Abdominoplasty is widely available; however, patients with abdominal stomas appear to be relatively undertreated. Apprehension to offer abdominoplasty in the presence of a stoma may be secondary to the fear of surgical site infection and stoma compromise.
Objectives:
To demonstrate the feasibility and safety of abdominoplasty in the presence of an abdominal stoma for both functional and aesthetic indications and to define perioperative protocols to reduce the risk of surgical site infection in this patient population.
Methods:
The authors present 2 patients with stomas who underwent abdominoplasty. Patient 1 was a 62-year-old female with a history of urostomy formation and weight loss. She had a fold of skin overhanging her ostomy site, making it difficult to maintain a seal on her urostomy bag. She underwent fleur-de-lis abdominoplasty and urostomy revision. Patient 2 was a 43-year-old female with a history of end ileostomy formation, who requested cosmetic abdominoplasty to address postpartum abdominal changes; she had no functional stoma-related complaints. Abdominoplasty, flank liposuction, and ileostomy revision were performed.
Results:
Both patients were satisfied with their aesthetic and functional outcomes. There were no complications and no instances of stoma compromise. At follow-up, Patient 1 reported a complete amelioration of her urosotomy appliance issues.
Conclusions:
Abdominoplasty may confer both functional and aesthetic benefits to patients with abdominal stomas. The authors present peri- and intraoperative protocols, both to prevent stoma compromise and to reduce the risk of surgical site infection. The presence of a stoma does not appear to be an absolute contraindication to cosmetic abdominoplasty.
Sympathetic, Metabolic Adaptations, and Oxidative Stress in Autism Spectrum Disorders: How Far From Physiology?
Authors: Antonietta Messina, Vincenzo Monda, Francesco Sessa, Anna Valenzano, Monica Salerno, Ilaria Bitetti, Francesco Precenzano, Rosa Marotta, Francesco Lavano, Serena M Lavano, Margherita Salerno, Agata Maltese, Michele Roccella, Lucia Parisi, Roberta I Ferrentino, Gabriele Tripi, Beatrice Gallai, Giuseppe Cibelli, Marcellino Monda, Giovanni Messina, Marco Carotenuto
Journal: Front Physiol (2018)
Keywords: orexin-a, autism spectrum disorders (asd), heart rate (hr), heart rate variability (hrv), oxidative stress
MeSH terms: Case Reports

Autism spectrum disorders (ASD) is a complex and multifaceted neurobehavioral syndrome with no specific cause still identified, despite the worldwide increasing (prevalence for 1,000 children from 6.7 to 14.6, between 2000 and 2012). Many biological and instrumental markers have been suggested as potential predictive factors for the precocious diagnosis during infancy and/or pediatric age. Many studies reported structural and functional abnormalities in the autonomic system in subjects with ASD. Sleep problems in ASD are a prominent feature, having an impact on the social interaction of the patient. Considering the role of orexins (A and B) in wake-sleep circadian rhythm, we could speculate that ASD subjects may present a dysregulation in orexinergic neurotransmission. Conversely, oxidative stress is implicated in the pathophysiology of many neurological disorders. Nonetheless, little is known about the linkage between oxidative stress and the occurrence or the progress of autism and autonomic functioning; some markers, such as heart rate (HR), heart rate variability (HRV), body temperature, and galvanic skin response (GSR), may be altered in the patient with this so complex disorder. In the present paper, we analyzed an autism case report, focusing on the rule of the sympathetic activity with the aim to suggest that it may be considered an important tool in ASD evaluation. The results of this case confirm our hypothesis even if further studies needed.
Scrotal Swelling and Testicular Atrophy due to Schistosomiasis in a 9-Year-Old Boy: A Case Report
Authors: Peter F Rambau, Alphonce Chandika, Philipo L Chalya, Kahima Jackson
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

Schistosomiasis is a communicable disease which commonly involves urinary bladder causing hematuria, or large bowel causing bloody stool. The common species encountered in this lake region surrounding Lake Victoria in Tanzania are Schistosoma haematobium and Schistosoma mansoni. Complications can lead to portal hypertension due portal fibrosis in liver, and fibrosis in lung can lead to pulmonary hypertension; this commonly seen with S. mansoni. Major complications of S. maeametobium are chronic cystitis with squamous metaplasia with subsequent development of squamous cell carcinoma. Involvement of spinal cord causing paraplegia has been observed in S. haematobium. Other unusual pathology of schistosomiasis has been described, such as involvement of the appendix, ovary, prostate, and cervix. Here, we present a case of schistosomiasis in a 9-year-old boy who presented with left scrotal pain for one year which was accompanied by scrotal swelling; surgical exploration was done, and the finding was hydrocele and atrophic testes with nodules on the surface. Histological examination reveals atrophic testis and heavy active granulomatous inflammation with schistosoma eggs consistent with Schistosoma haematobium in the tunica vaginalis.