OpenMed/multicare-articles huggingface dataset:
Case Report: Emergency High-Risk Percutaneous Coronary Intervention Following Transcatheter Aortic Valve Implantation in Bicuspid Anatomy
Authors: Ahmed El-Medany, Gemina Doolub, Amardeep Dastidar, Nikhil Joshi, Thomas Johnson, Stephen Dorman
Journal: Front Cardiovasc Med (2021)
Keywords: aortic stenosis, case report, coronary angiography, percutaneous intervention, transcatheter aortic valve implantation
MeSH terms: Case Reports

Background: Transcatheter aortic valve implantation (TAVR) continues to develop as a valuable alternative to surgical aortic valve replacement (SAVR) in an increasingly wide spectrum of patients with severe symptomatic aortic stenosis (AS). AS frequently coexists with coronary artery disease, and performing technically challenging percutaneous coronary intervention (PCI) following TAVR will become more frequent with increased use of TAVR. Case Summary: We herein report the case of a 53-years-old man with complex medical history including type 1 diabetes and dialysis-dependent renal failure and prior Evolut-R TAVR for critical bicuspid aortic valve stenosis who underwent intravascular ultrasound study (IVUS)-guided PCI to a critical distal left main stem (LMS) and proximal left anterior descending (LAD) lesion after presenting with ventricular fibrillation (VF) secondary to an acute coronary syndrome (ACS). Discussion: Selective engagement of coronary ostia through the side cells of TAVR prosthesis can be challenging, especially in an emergency setting. The particular challenges associated with this case are described, as well as an up-to-date literature search on strategies and equipment that can help in this situation.
A Thymic Hyperplasia Case without Suppressing on Chemical Shift Magnetic Resonance Imaging
Authors: Tuan Phung, Thach Nguyen, Dung Tran, Nga Phan, Hung Nguyen
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

A 22-year-old woman with myasthenia gravis (MG) presented with ptosis and mild muscle weakness symptoms for one year. Computed tomography (CT) presented a diffuse bilobulate enlargement gland with a high density of soft tissue. Magnetic resonance imaging (MRI) showed the gland with no suppression on the opposed-phase chemical shift. After the thymic tumor diagnosis, she underwent thoracoscopic surgery for tumor resection. The postoperative histopathological finding was thymic lymphoid hyperplasia. This case suggests chemical shift MRI is not enough in distinguishing, and supplementary examination is essential to avoid unnecessary thymic biopsy and surgery.
Small bowel Gastrointestinal Stromal Tumors can physiologically alter gut motility before causing mechanical obstruction
Authors: Manish S Kothari, Vasilis Kosmoliaptsis, John Meyrick-Thomas
Journal: Int Semin Surg Oncol (2005)

Background:
Gastro Intestinal Stromal Tumors (GISTs) are rare stromal neoplasms that represent the most common mesenchymal tumor of the G.I. tract, accounting for 5% of all sarcomas. Originating from interstitial cells of Cajal, which are regulators of gut peristalsis, they are preferentially located in the stomach and the small intestine and clinical presentation is variable, ranging from vague complaints to major G.I. bleeding. Surgical resection is the mainstay of treatment for patients with resectable GIST and 5-year survival ranges from 21% to 88% in different series depending on risk grading and completeness of surgical resection. Imatinib mesylate, a tyrosine kinase inhibitor, provides an encouraging option for treating high risk GISTs.
Case presentation:
We report the case of a 62-year-old lady who had been diagnosed and being treated unsuccessfully for Irritable bowel syndrome for 11 years and eventually found to have an obstructing small bowel GIST.
Conclusion:
The symptoms from GIST may mimic those of irritable bowel syndrome. A physiological alteration in gut peristalsis resulting from neoplastic transformation of the interstitial cells of Cajal, is a hypothesis that could explain this presentation. An alternative diagnosis should be considered when treating patients with irritable bowel syndrome who fail to respond for a prolonged period.
Identification of a balanced complex chromosomal rearrangement involving chromosomes 3, 18 and 21 with recurrent abortion: case report
Authors: Yaping Liao, Liqun Wang, Ding Zhang, Changqing Liu
Journal: Mol Cytogenet (2014)
Keywords: complex chromosomal rearrangements (ccrs), fluorescence in situ hybridization, genetic counseling, recurrent spontaneous abortions
MeSH terms: Case Reports

Background:
Complex chromosome rearrangements (CCRs) are constitutional structural rearrangements involve more than two breakpoints on two or more chromosomes. Balanced CCR carriers are often phenotypically normal but associated with high risk of spontaneous abortion and having abnormal offspring with unbalanced karyotype. Here, we report a new familial case of complex chromosome structural aberrations involving chromosomes 3, 18 and 21 and four breakpoints.
Results:
Cytogenetic investigations showed a complex chromosomal chromosome rearrangement involving chromosomes 3, 18 and 21 with four breakpoints. 2 of 4 breakpoints were within the long arm of chromosome 18. Three-color fluorescence in situ hybridization (FISH) confirmed the complexity of the rearrangement and showed the derivative 21 to be composed of 3 distinct segments derived from chromosomes 21, 18, and 3. The karyotype of CCR carrier was determined as 46,XX,t(3;21;18)(3pter → 3q12::18q23 → 18qter;21pter → 21q22.1::18q21.1 → 18q23::3q12 → 3qter; 18pter → 18q21.1::21q22.1 → 21qter).
Discussion:
A new complex balanced CCR was characterized using conventional high resolution banding and molecular cytogenetic analysis. The results provided an explanation of recurrent abortion and abnormal child for balanced CCR carriers. Genetic counselling and prenatal diagnosis for couples with a balanced CCR is necessary since they have a high risk of having a child with unbalanced karyotype. Additional studies to reveal the molecular mechanism of CCRs would help reveal the rule of inherited CCRs in offspring.
High-Intensity Focused Ultrasound (HIFU) Focal Therapy for Localized Prostate Cancer with MRI-US Fusion Platform
Authors: Chi-Hang Yee, Peter Ka-Fung Chiu, Jeremy Yuen-Chun Teoh, Chi-Fai Ng, Chi-Kwok Chan, See-Ming Hou
Journal: Adv Urol (2021)

Objective:
The study aimed at investigating the outcome of prostate HIFU focal therapy using the MRI-US fusion platform for treatment localization and delivery.
Methods:
It is a prospectively designed case series of HIFU focal therapy for localized prostate cancer. The inclusion criteria include clinical tumor stage ≤T2, visible index lesion on multiparametric MRI less than 20 mm in diameter, absence of Gleason 5 pattern on prostate biopsy, and PSA ≤ 20 ng/ml. HIFU focal therapy was performed in the conventional manner in the beginning 50% of the series, whereas the subsequent cases were performed with MRI-US fusion platform. The primary outcome was treatment failure rate which is defined by the need of salvage therapy. Secondary outcomes included tumor recurrence in follow-up biopsy, PSA change, perioperative complications, and postoperative functional outcomes.
Results:
Twenty patients underwent HIFU focal ablation. HIFU on an MRI-US fusion platform had a trend of a longer total operative time than the conventional counterpart (124.2 min vs. 107.1 min, p=0.066). There was no difference in the mean ablation volume to lesion volume ratio between the two. The mean PSA percentage change from baseline to 6-month is more significant in the conventional group (63.3% vs. 44.6%, p=0.035). No suspicious lesion was seen at 6-month mpMRI in all 20 patients. Two patients, one from each group, eventually underwent radical treatment because of the presence of clinically significant prostate cancer in the form of out-of-field recurrences during follow-up biopsy. No significant difference was observed before and after HIFU concerning uroflowmetry, SF-12 score, and EPIC-26 score. It was observed that energy used per volume was positively correlated with PSA density of the patient (r = 0.6364, p=0.014).
Conclusion:
In conclusion, HIFU with conventional or MRI-US fusion platform provided similar oncological and functional outcomes.
Bradycardia Leading to Asystole Following Dexmedetomidine Infusion during Cataract Surgery: Dexmedetomidine-Induced Asystole for Cataract Surgery
Authors: Amaniti Aikaterini, Dalakakis Ioannis, Gkinas Dimitrios, Sapalidis Konstantinos, Grosomanidis Vasilios, Papazisis George
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports

Dexmedetomidine is an elective alpha-2 adrenergic agonist, being used in anesthesia practice. It offers sedative, anxiolytic, analgesic, muscle relaxant, and sympathetic lytic properties. While respiratory effects are considered minor, there are important cardiovascular side effects with bradycardia and hypotension being the most common. This article presents a case of a patient, with significant comorbidities and polypharmacy, who was scheduled for cataract surgery under dexmedetomidine sedation. During the administration, severe hemodynamic deterioration was observed with bradycardia and hypotension leading to asystole. Cardiac arrest was successfully managed in accordance with the guidelines of the European Resuscitation Council. Despite the promising role of dexmedetomidine in anesthesia practice, the associated adverse effects cannot be ignored. For this reason it is obligatory to have the minimum mandatory monitoring in accordance with the safety and quality guidelines.
T-cell/Natural killer-cell neoplasms presenting as leukemia- Case series from single tertiary care center
Authors: Shano Naseem, Maninderbir Kaur, Manupdesh Singh Sachdeva, Jasmina Ahluwalia, Reena Das, Neelam Varma, Subhash Varma
Journal: Int J Hematol Oncol Stem Cell Res (2016)
Keywords: immunophenotyping, morphology, nk-lineage leukemia, t-lineage leukemia

Background:
Mature T/ NK-cell neoplasms are a rare group of disorders and their presentation as leukemia is even rarer. Most of the previous studies have focused on mature B-cell lineage leukemias and there is a paucity of data on mature T/NK-cell lineage leukemias. We, therefore, planned this study to analyze their spectrum, frequency, morphology and immunophenotypic features.
Subjects and methods:
All cases of lymphomas presenting as leukemia over a period of two and a half years were evaluated. Detailed analysis of cases with T/NK-cell lineage was done for their clinical, hematological and immunophenotypic features.
Results:
A total of 262 cases of mature lymphoid neoplasms presented as leukemia during the study period. Of whom, only 8 (3.1%) cases were of T /NK-cell lineage and the remaining (96.9%) were of B-cell lineage. Of 8 cases, 4 (50%) had T-prolymphocytic leukemia, 2 (25%) had chronic lymphoproliferative disorder- natural killer cell and 1 (12.5%) case of each T-large granular lymphocytic leukemia and hepatosplenic γ/δ T-NHL.
Conclusion:
T/NK-cell leukemias are rare. Along with clinical and morphological features, pattern of immunophenotypic markers is vital for their diagnosis and subcategorization.
Chronic idiopathic neutrophilia in two twins
Authors: Roberto Miniero, Giuseppe Antonio Mazza, Federica Altomare, Carla Fusaro
Journal: Case Rep Hematol (2014)

Neutrophilia in adults refers to an alteration in the total number of blood neutrophils that is in excess of about 7500 cells/μL. This definition is restrictive in childhood as neutrophil count is age-dependent. Chronic Idiopathic Neutrophilia (CIN) refers to a condition that persists for many years in individuals who appear otherwise healthy. CIN is rarely mentioned in scientific literature and in academic books of hematology; only few words are dedicated to this topic. We report a case study of two twins with CIN followed from the first year of life to 24 years of age. To the best of our knowledge this is the first case report of two twins with CIN followed through a long period of time. We believe that our observation may contribute to better understand and characterize this hematologic abnormality.
Superior vena cava syndrome in a patient with polycytemia vera: diagnosis and treatment
Authors: Salvatore Lentini, Mario Barone, Filippo Benedetto, Francesco Spinelli
Journal: Cardiol Res Pract (2010)
MeSH terms: Case Reports

Polycythemia vera is a myeloproliferative disorder characterized by thrombotic complications both in the arterial and venous systems. We report the case of a 55-year-old patient affected by polycythemia vera, presenting with acute superior vena cava syndrome due to thrombosis of the upper part of the superior vena cava. Diagnosis was done clinically and by computed tomography scan and showed an unusual finding: an air bubble trapped in the brachiocephalic venous trunk. The patient underwent emergency surgery. Diagnosis and treatment of the case are discussed.
Catastrophic Antiphospholipid Syndrome Presenting as a Stroke in an 11-Year-Old with Lupus
Authors: Brooke Senken, Anne Whitehead
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Catastrophic antiphospholipid syndrome (CAPS) is an infrequent but feared life-threatening complication of antiphospholipid syndrome (APS). CAPS is characterized by the rapid development of numerous thromboses across multiple organs resulting in multiorgan failure. It is rare but well-documented in the adult population. In contrast, it is exceedingly uncommon in pediatric patients and therefore not yet well described in the pediatric literature. Early recognition of APS is of the utmost importance to provide timely and effective management for a positive outcome. We present the case of an 11-year-old girl with history of systemic lupus erythematosus (SLE) and hypertension (HTN) who presented with acute onset altered mental status, found to have a large ischemic middle cerebral artery (MCA) and anterior cerebral artery (ACA) stroke as well as multiple, diffuse, and smaller ischemic lesions in the frontal lobe and cerebellum. Her presentation was further complicated by thrombocytopenia and renal and splenic infarction, as well as thrombosis of the right brachial vein consistent with a diagnosis of CAPS.
Breastfeeding grief after chest masculinisation mastectomy and detransition: A case report with lessons about unanticipated harm
Authors: Karleen D Gribble, Susan Bewley, Hannah G Dahlen
Journal: Front Glob Womens Health (2023)
Keywords: breastfeeding, case report, detransition, grief, mastectomy, milk banking, transgender
MeSH terms: Case Reports

An increasing number of young females are undergoing chest masculinsation mastectomy to affirm a gender identity and/or to relieve gender dysphoria. Some desist in their transgender identification and/or become reconciled with their sex, and then revert (or detransition). To the best of our knowledge, this report presents the first published case of a woman who had chest masculinisation surgery to affirm a gender identity as a trans man, but who later detransitioned, became pregnant and grieved her inability to breastfeed. She described a lack of understanding by maternity health providers of her experience and the importance she placed on breastfeeding. Subsequent poor maternity care contributed to her distress. The absence of breast function as a consideration in transgender surgical literature is highlighted. That breastfeeding is missing in counselling and consent guidelines for chest masculinisation mastectomy is also described as is the poor quality of existing research on detransition rates and benefit or otherwise of chest masculinising mastectomy. Recommendations are made for improving maternity care for detransitioned women. Increasing numbers of chest masculinsation mastectomies will likely be followed by more new mothers without functioning breasts who will require honest, knowledgeable, and compassionate support.
Blunt renal trauma in children: the experience of Mohammed VI University Hospital of Oujda in Morocco between 2015 and 2021
Authors: Abdelouhab Ammor, Kamal El Haissoufi, Mariame Karrouchi, Siham Nasri, Imane Skiker, Houssain Benhaddou
Journal: Pan Afr Med J (2022)
Keywords: american association for the surgery of trauma (aast), blunt renal trauma, kidney injury scale, children, conservative management
MeSH terms: Abdominal Injuries / complications, Abdominal Injuries / epidemiology, Abdominal Injuries / therapy, Wounds, Nonpenetrating / complications, Wounds, Nonpenetrating / epidemiology, Wounds, Nonpenetrating / therapy, Case Reports, Child, Female, Hospitals, University, Humans, Injury Severity Score, Kidney / pathology, Male, Morocco / epidemiology, Retrospective Studies, Trauma Centers

Introduction:
blunt renal traumas in children are rare and their management is not suited to a very clear consensus. We sought to report our experience in managing renal injuries in children presented after blunt abdominal trauma.
Methods:
data of children aged less than 16 years with blunt renal injuries between January 2015 and April 2021 were retrospectively reviewed. Demographic characteristics, clinical course, biological results, radiological findings, associated injuries, management and follow up of included patients were described. Renal lesions were classified according to the American Association for the Surgery of Trauma (AAST).
Results:
we included a total of 20 children, of whom 70% (n=14) were males. The mean of age was 8.50 ± 3.42 years. Falls in 65% (n=13) and motor-vehicle accidents in 35% (n=7) were the two main mechanisms of injuries. Abdominal pain was the most common symptom and macroscopic hematuria was assessed in 55% of patients (n=11). Low-grade injuries (I-III) represented 40% of the cases (n=8), 60% of injuries were AAST grade IV (n=12) and none with AAST grade V was diagnosed. Spleen injuries in 25% (n=5) as well as traumatic brain injuries in 25% (n=5) were the most identified concomitant injuries followed by liver lesions in 15% (n=3). 75% of renal injuries (n=15) were managed conservatively and all cases that required an operative management were with AAST grade IV. No nephrectomy in our series was performed and the follow up was favorable with a median of 3 years.
Conclusion:
our data suggest that the majority of children with blunt renal injuries can be managed conservatively regardless the grade of lesions as long as no hemodynamic instability or symptomatic urinoma are identified.
IMRT and HDR-ICBT for Locally Advanced Clear Cell Adenocarcinoma of the Cervix in Uterus Didelphys Associated With Unilateral Renal Agenesis
Authors: Chengzhi Lei, Manni Huang, Ning Li, Jusheng An, Suiyang Xiong, Xiaoguang Li, Lingying Wu
Journal: Front Oncol (2020)
Keywords: cervical adenocarcinoma, clear cell adenocarcinoma, genitourinary malformation, unilateral renal agenesis, uterus didelphys
MeSH terms: Case Reports

Clear cell adenocarcinoma of the cervix (CCAC) with genitourinary malformations is rare. Here, we report a case of CCAC in uterus didelphys (UD) associated with unilateral renal agenesis (URA) that was treated with intensity-modulated radiotherapy (IMRT) and high-dose rate intracavitary brachytherapy (HDR-ICBT). We also retrospectively reviewed the medical records of CCAC cases with genitourinary malformations treated at the National Cancer Center/Cancer Hospital (Beijing, China) between December 2006 and June 2017. Eight cases of this rare condition were identified by pathologic diagnosis. Seven patients received surgical treatment including radical hysterectomy (n = 4), modified radical hysterectomy (n = 1), and total hysterectomy (n = 2). Five patients received adjuvant radiotherapy and chemotherapy after surgery. One patient with CCAC in UD associated with URA was treated with radical IMRT and adjuvant chemotherapy. The eight patients were followed up for an average of 7.9 years; in seven cases, there was no evidence of disease recurrence, while one patient relapsed and died after 1.5 years of treatment. On the basis of these findings, locally advanced CCAC in UD associated with URA can be effectively treated with radical IMRT.
Sarcoidosis with Both Plaques and Subcutaneous Nodules Associated with Combination Therapy with Peginterferon α-2a and Ribavirin
Authors: M Kondo, M Nishii
Journal: Case Rep Dermatol Med (2011)
MeSH terms: Case Reports

A 64-year-old woman with hepatitis C was treated using combination therapy with peginterferon α-2a and ribavirin. After 3 months, she presented with raised nodules on her knees and elbows. After 8 months, she developed painful subcutaneous nodules on her forearms. We diagnosed sarcoidosis with both plaques and subcutaneous nodules associated with combination therapy with peginterferon α-2a and ribavirin. Sarcoidosis with both plaques and subcutaneous nodules is very rare. The patient had a sustained Th2 response in the liver. And a sustained Th1 response occurred only in the skin. It is likely that, for this reason, sarcoidosis was localized to the skin, and the patient developed sarcoidosis with both plaques and subcutaneous nodules.
Sinus lift and transantral approach to root fragment removal
Authors: Andrea Enrico Borgonovo, Federica Rizza, Adele Dudaite, Rachele Censi, Dino Re
Journal: Case Rep Dent (2013)

The aim of this case report is to present a case of root fragment removal during planned sinus lift procedure. After failed molar tooth extraction, we chose to retrieve the residual root apex with transantral approach not to damage excessively bone volume. Without changing primary implant rehabilitation purpose, the fragment removal procedure was performed prior to implant placement during necessary sinus lift surgery. Higher visibility of surgical field was achieved. The root fragment residual was removed without an additional surgery appointment avoiding postoperative discomfort. The goal is to underline the importance of being able to change planning during intrasurgical complications. It is most appropriate to operate with safe and simple procedures to reduce surgical discomfort for the patient.
A Case of Congenital Syphilis Presenting with Unusual Skin Eruptions
Authors: Alexander K C Leung, Kin Fon Leong, Joseph M Lam
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Once believed to be a rare disease in developed countries, recent data suggest that there is a surge in incidence of congenital syphilis in many developed countries. Diagnosis of congenital syphilis can be difficult because more than two-thirds of affected infants are asymptomatic at birth, and signs of symptomatic infants may be nonspecific or subtle. On top of this, some affected infants may have atypical presentations. Familiarity with the diverse presentations is essential to diagnosis. We report a 2-week-old male infant with congenital syphilis whose cutaneous manifestations included diffuse, erythematous keratoderma with desquamation and fissures on his hands and feet, multiple linear scaly fissures at the angles of his mouth, and onychauxis of the fingernails and toenails To our knowledge, diffuse, erythematous keratoderma of the hands and feet and thick nails have not been reported previously in congenital syphilis.