OpenMed/multicare-articles huggingface dataset:
Left Main Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement in a Young Male with Rheumatic Heart Disease and Porcelain Aorta
Authors: Vinod Chainani, Osman Perez, Ram Hanno, Patrick Hourani, Pablo Rengifo-Moreno, Pedro Martinez-Clark, Carlos E Alfonso
Journal: Case Rep Cardiol (2016)

We highlight the presence of a calcified mass in the left main coronary artery without significant atherosclerosis seen in the other coronary arteries or in the peripheral large arteries. In our view, the calcified character of the obstruction and the calcification of the aortic valve are characteristic of a variant type of coronary artery disease (CAD) not associated with the same risk factors as diffuse coronary atherosclerosis, but, in this case, with rheumatic heart disease. This case report also emphasizes the interventional approach for patients with aortic valve stenosis secondary to rheumatic heart disease.
Pull-Up Palms (PUP): A Case of Exercise-Associated Palmar Callosities and Review of Sports-Related Hand-Associated Skin Conditions in Athletes
Authors: David W Hoyt, Philip R Cohen
Journal: Cureus (2023)
Keywords: athletes, callosities, calluses, dermatosis, exercise, hand, palms, pull-up, skin, sports
MeSH terms: Case Reports

Sports dermatology describes skin conditions occurring in athletes. We describe a man with callosities on his palmar hands and fingers secondary to pull-ups and review sports-related dermatoses involving the hands. A 42-year-old man presented with a several-year history of calluses on his palmar hands. The lesions correspond to areas of contact on his ventral hand with the pull-up bar; therefore, the condition is referred to as pull-up palms (PUP). Sports-related dermatoses affecting the hands include contact dermatitis, infections, lacerations, and mechanical trauma. Several of the sports-associated conditions of the hand are unique to a specific sport. Hand-associated sports dermatoses are reviewed.
Sho-Based Kampo Medicine Combined With Assisted Reproductive Technology Is Effective for Refractory Infertility and Early Recurrent Miscarriage: A Case Report
Authors: Hiromi Yoshida-Komiya, Masafumi Ami, Ryota Suganuma, Tadamichi Mitsuma
Journal: Front Nutr (2021)
Keywords: kampo, sho, assisted reproductive technology, early recurrent miscarriage, infertility
MeSH terms: Case Reports

Assisted reproductive technology (ART) is an effective treatment developed for infertile couples in the world. As a result, women suffering from infertility benefit from ART treatment. However, even when ART treatment is successfully performed, there are cases where conception is not achieved or maintained. Kampo medicine was originally developed in Japan, and Sho is the central part of Kampo concept. Although it is thought that Kampo medicine is useful for various women-specific symptoms in modern Japan, evidence is still lacking regarding the effectiveness of combination of Sho-based Kampo and Western medicine such as ART. In this article, we report a case of a patient with refractory infertility and early recurrent miscarriage (ERM) of unknown cause who successfully became pregnant with combination therapy of Kampo based on Sho and ART. The patient was a 34 year-old Japanese woman and had been treated with ART in a nearby clinic. In a 3 year period, she had undergone oocyte retrieval twice, frozen embryo transfer (FET) seven times and conceived twice. Since both conceptions ended in miscarriages and pregnancy could not be established thereafter, her clinic referred her to our hospital for Kampo treatment. As result of the diagnosis of her Sho-pattern, we chose Kampo medicine. Finally, she succeeded in conception 1.5 years after beginning treatment and was able to carry the fetus to term successfully. The current case showed that although our patient had been unable to give a birth after undergoing various western medical treatments for infertility, pregnancy was established and kept to term after addition of Sho-based Kampo treatment. Kampo medicine chosen by the Sho-patterns is useful for refractory infertility and ERM. It is important to note that examinations for evaluting the Sho-patterns are essential for selecting appropriate Kampo medicine. Sho-based Kampo leads to an increase in the effectiveness of ART treatment, and accumulation of evidence that clarifies Sho-pattern is required.
Use of Cidofovir for Safe Transplantation in a Toddler with Acute Liver Failure and Adenovirus Viremia
Authors: Vikram J Christian, Raiya Sarwar, Joseph C Resch, Sarah Lim, Arif Somani, Catherine Larson-Nath, Shane McAllister, Beth K Thielen, Oyedele Adeyi, Srinath Chinnakotla, Heli Bhatt
Journal: Case Rep Transplant (2022)
MeSH terms: Case Reports

Background:
Since October 2021, there have been more than 500 cases of severe hepatitis of unknown origin in children reported worldwide, including 180 cases in the U.S. The most frequently detected potential pathogen to date has been adenovirus, typically serotype 41. Adenovirus is known to cause a self-limited infection in the immunocompetent host. However, in immunosuppressed individuals, severe or disseminated infections may occur.
Method:
We present the case of a two-year-old female who presented with cholestatic hepatitis and acute liver failure (ALF). Work up for etiologies of ALF was significant for adenovirus viremia, but liver biopsy was consistently negative for the virus. The risk for severe adenoviral infection in the setting of anticipated immunosuppression prompted us to initiate cidofovir to decrease viral load prior to undergoing liver transplantation.
Result:
Our patient received a successful liver transplant, cleared the viremia after 5 doses of cidofovir, and continues to maintain allograft function without signs of infection at the time of this report, 5 months posttransplant.
Conclusion:
Recent reports of pediatric hepatitis cases may be associated with adenoviral infection although the exact relationship is unclear. There is the possibility of the ongoing SARS-CoV-2 environment, or other immunologic modifying factors. All patients presenting with hepatitis or acute liver failure should be screened for adenovirus and reported to state health departments. Cidofovir may be used to decrease viral load prior to liver transplantation, to decrease risk of severe adenoviral infection.
Chronic Dialysis Dependent Renal Failure Resulting from a Massive Bladder Containing Inguinal Hernia
Authors: Michael M Herskowitz, Jamel Reid, Robert F Leonardo
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

Bladder involvement in inguinal hernia is relatively rare, 1-4%, although the incidence is increased to 10% with advancing age or obesity. There are several previously reported cases presenting with obstructive uropathy and renal failure, but all reversed with urinary diversion and hernia repair. We believe this to be the first reported case of bladder hernia leading to dialysis dependent chronic renal failure.
Rapidly Progressive Paraneoplastic Neuropathy Associated with Renal Cell Carcinoma: A Case Report
Authors: Divya Shah, Jaya Trivedi, Steven Vernino, Shaida Khan
Journal: J Cancer Sci Clin Ther (2022)
Keywords: case report, neuropathy, paraneoplastic, plasmapheresis, renal cancer

Background:
Paraneoplastic neurological disorders are rare syndromes that occur with various malignancies including renal cell carcinoma. Symptoms of paraneoplastic neurological disorders are diverse and involve either the central nervous system, peripheral nervous system, or both.
Case presentation:
We present a patient with diffuse limb pain, rapidly progressive asymmetric motor and sensory symptoms and distal upper limb atrophy. Electrodiagnostic testing was suggestive of mononeuritis multiplex. Initial empiric treatment with corticosteroids did not lead to improvement. Further diagnostic studies revealed bilateral clear cell renal carcinoma. Treatment with plasmapheresis led to significant and rapid improvement in pain and limb strength.
Conclusions:
This case highlights the rare occurrence of paraneoplastic neuropathy in renal cancer and emphasizes the importance of screening for malignancy in patients presenting with rapidly progressive multifocal neuropathy.
Case Report: Malacoplakia Due to E. coli With Cryptococcus albidus Infection of a Transplanted Kidney in a Patient With Recurrent Urinary Tract Infection
Authors: Ziyan Yan, Wenfeng Deng, Yuchen Wang, Yanna Liu, Hengbiao Sun, Renfei Xia, Wenli Zeng, Jian Geng, Gui Chen, Xiaolong He, Jian Xu, Chin-Lee Wu, Yun Miao
Journal: Front Med (Lausanne) (2021)
Keywords: cryptococcus albidus, escherichia coli 09-02e, cryptococcoma, malacoplakia, metagenome sequencing, transplanted kidney
MeSH terms: Case Reports

Background: Colonization of Cryptococcus rarely occurs in a graft. This study reports a case of malacoplakia and cryptococcoma caused by E. coli and Cryptococcus albidus in a transplanted kidney, with detailed pathology and metagenome sequencing analysis. Case Presentation: We presented a case of cryptococcoma and malacoplakia in the genitourinary system including the transplant kidney, bladder, prostate, and seminal vesicles caused by Cryptococcus albidus and Escherichia coli in a renal-transplant recipient. Metagenome sequencing was conducted on a series of samples obtained from the patient at three different time points, which we termed Phase I (at the diagnosis of cryptococcoma), Phase II (during perioperative period of graftectomy, 3 months after the diagnosis), and Phase III (2 months after graftectomy). Sequencing study in the Phase I detected two and four sequences of C. albidus respectively in cerebrospinal fluid (CSF) and feces, with resistant Escherichia coli 09-02E presented in urine and renal mass. A 3-month antibiotic treatment yielded a smaller bladder lesion but an enlarged allograft lesion, leading to a nephrectomy. In the Phase II, two sequences of C. albidus were detected in CSF, while the E. coli 09-02E continued as before. In the Phase III, the lesions were generally reduced, with one C. albidus sequence in feces only. Conclusions: The existence and clearance of Cryptococcus sequences in CSF without central nervous system symptoms may be related to the distribution of infection foci in vivo, the microbial load, and the body's immunity. Overall, this study highlights the need for enhanced vigilance against uncommon types of Cryptococcus infections in immunocompromised populations and increased concern about the potential correlation between E. coli and Cryptococcus infections.
Gigantic GIST: A Case of the Largest Gastrointestinal Stromal Tumor Found to Date
Authors: Abdalla Mohamed, Youssef Botros, Paul Hanna, Sang Lee, Walid Baddoura, Jamshed Zuberi, Tanuja Damani
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Gastrointestinal stromal tumors are uncommon when compared to all gastrointestinal neoplasms but are the most common mesenchymal tumors of the gastrointestinal tract. The largest gastrointestinal stromal tumor ever recorded in literature weighed approximately 6.1 kg and measured 39 cm × 27 cm × 14 cm. About two-thirds of GISTs are malignant. The tumor size, mitotic rate, cellularity, and nuclear pleomorphism are the most important parameters when considering prognosis and recurrence. The definitive treatment for these tumors is resection. In the year 2000, the first patient was treated with the tyrosine kinase inhibitor imatinib and since then, gastrointestinal stromal tumors with high-risk features have been treated successfully with tyrosine kinase inhibitors. We present the largest gastrointestinal stromal tumor recorded in medical literature measuring 42.0 cm × 31.0 cm × 23.0 cm in maximum dimensions and weighing in at approximately 18.5 kg in a 65-year-old African-American male who presented with increased abdominal distention. The mass was successfully excised, and the patient was treated with imatinib without local or distant recurrence 1.5 years postoperatively.
Osteosynthesis of bilateral Vancouver B2 periprosthetic femoral fracture after a bilateral RM® total hip arthroplasty at 24 and 21-years follow-up: A case report
Authors: Isabel Dinis Ferreira, João Cura Mariano, Francisco M Lucas, Fernando M Judas
Journal: Int J Surg Case Rep (2019)
Keywords: bilateral periprosthetic fractures, femoral stem loosening, isoelastic total hip arthroplasty, locking compression plate, vancouver b2

Introduction:
The management of periprosthetic femoral fractures following hip arthroplasty is challenging, and the choice between osteosynthesis of the fracture and the revision of the prosthesis is still matter of discussion.
Case report:
In a 81-year-old male patient, a bilateral Vancouver type-B2 periprosthetic femoral fracture with stem loosening occurred after an accidental fall. The patient had severe medical comorbidities. The radiographic study showed a bilateral Robert Mathys cementless total hip arthroplasty at 24 and 21-years follow-up. The fractures were treated with open reduction and fixation with locking compression plates. Bicortical fixation of the loose stem was obtained by the screws of the locking plate, due to the polymeric composition of the isoelastic femoral stem. Both fractures sites were augmented with bone allografts. At follow-up period of 12 months, the X-rays showed bone union of both fractures and bilateral stable stem fixation. The patient expressed high degree of satisfaction with surgery result.
Discussion:
The standard treatment for Vancouver type-B2 periprosthetic femoral fractures is the removal of the loose implant, fixation of the fracture, and implantation of a new revision femoral stem. However, the implantation of two long revision hip prostheses is a major operation for an older patient with precarious health condition, which can contribute to higher risk of medical and prosthetic complications.
Conclusion:
In older patients with multiple comorbidities, the use of locking plates can be a valid treatment of bilateral Vancouver B2-periprosthetic femoral fractures following RM® cementless isoelastic stem, as an alternative surgical option to femoral stem revision.
High-Grade Transformation (Dedifferentiation) of Acinic Cell Carcinoma of the Parotid Gland: Report of an Unusual Variant
Authors: Sarah S Al-Otaibi, Faiza Alotaibi, Yaseer Al Zaher, Nabil Al Zaher, M A Dababo
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Acinic cell carcinoma with high-grade transformation of the salivary gland is an unusual variant with less than fifty cases being reported in the literature. It is characterized by a low- and high-grade component juxtaposed with one another and tends to take on a more aggressive clinical course than its low-grade counterpart, suggesting a poor clinical outcome. We, hereby, report a case of acinic cell carcinoma in a 48-year-old woman with a 6-month history of a right parotid facial swelling rapidly increasing in size. The tumor was initially resected; however, residual focal tissue subsequently revealed areas typical of low-grade acinic cell carcinoma as well as high-grade transformation/dedifferentiation via histopathology.
What Lies behind the Ischemic Stroke: Aortic Dissection?
Authors: Turgut Deniz, Ersel Dag, Murat Tulmac, Burcu Azapoglu, Caglar Alp
Journal: Case Rep Emerg Med (2014)

Introduction. Some cases with aortic dissection (AD) could present with various complaints other than pain, especially neurological and cardiovascular manifestations. AD involving the carotid arteries could be associated with many clinical presentations, ranging from stroke to nonspecific headache. Case Report. A 71-year-old woman was admitted to emergency department with vertigo which started within the previous one hour and progressed with deterioration of consciousness following speech disorder. On arrival, she was disoriented and uncooperative. Diffusion magnetic resonance imaging (MRI) of brain was consistent with acute ischemia in the cerebral hemisphere. Fibrinolytic treatment has been planned since symptoms started within two hours. Echocardiography has shown the dilatation of ascending aorta with a suspicion of flap. Computed tomography (CT) angiography has been applied and intimal flap has been detected which was consistent with aortic dissection, intramural hematoma of which was reaching from aortic arch to bilateral common carotid artery. Thereafter, treatment strategy has completely changed and surgical invention has been done. Conclusion. In patients who are admitted to the emergency department with the loss of consciousness and stroke, inadequacy of anamnesis and carotid artery involvement of aortic dissection should be kept in mind.
A Manualized Behavioral Therapy Intervention for Youth with Autism Spectrum Disorder and Substance Use Disorder
Authors: James McKowen, Amy Berger, Joshua Towbin, Amy M Yule, Diana Woodward, Lisa Nowinski, Gina Forchelli, Robert J Meyers, Gagan Joshi, Timothy E Wilens
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Research highlights the increasing overlap of autism spectrum disorder and substance use disorders in young people. However, no behavioral treatments exist addressing this comorbidity despite great need. A team of clinicians developed an integrated behavioral protocol addressing substance use in youth with autism spectrum disorder. The multidisciplinary team developed 12 youth, 7 parent, and 3 joint modules based on established evidence-based therapies shown to have effectiveness separately addressing autism spectrum and substance use. Two cases are discussed to illuminate this integrated intervention. Adaptations to the protocol were made during feedback from patients and their parents. Further research is needed to determine the effectiveness of this preliminary protocol.
Leukocytosis of unknown origin: gangrenous cholecystitis
Authors: Amara Jyothi Nidimusili, M Chadi Alraies, Naseem Eisa, Abdul Hamid Alraiyes, Khaldoon Shaheen
Journal: Case Rep Med (2013)

There have been case reports where patients admitted with acute cholecystitis, who were managed conservatively, had subsequently developed GC (gangrenous cholecystitis). The current case is unique, since our patient denied any prior episodes of abdominal pain and the only tip off was leukocytosis. A high index of suspicion is essential for the early diagnosis and treatment of GC. GC has a mortality rate of up to 22% and a complication rate of 16-25%. Complications associated with GC include perforation, which has been reported to occur in as many as 10% of cases of acute cholecystitis. The radiological investigations may not be conclusive. Ultrasonography usually serves as the first-line imaging modality for the evaluation of patients with clinically suspected acute cholecystitis. However, CT can play an important role in the evaluation of these patients if sonography is inconclusive. There is a need for an early (if not urgent) surgical intervention in acute cholecystitis (whether laparoscopic or open surgery) in order to decrease the time elapsed from the start of symptoms to admission and treatment.
Case Report: Novel TRPM6 Mutations Cause Hereditary Hypomagnesemia With Secondary Hypocalcemia in a Chinese Family and a Literature Review
Authors: Yiran Han, Yajuan Zhao, Hua Wang, Liang Huo
Journal: Front Pediatr (2022)
Keywords: chinese pedigree, hsh, trpm6, autosomal recessive inheritance, febrile convulsions, novel mutation
MeSH terms: Case Reports

Background:
Hereditary hypomagnesemia with secondary hypocalcemia (HSH) is a rare autosomal recessive disease due to biallelic TRPM6 mutations. Although the reports of HSH caused by TRPM6 mutations are not very rare, the age of onset in previously reported HSH cases were <1 year.
Methods:
We collected and analyzed the clinical data of twin brothers with onset age over 1 year old and performed whole exome sequencing in the patients and their parents. Confirmed by Sanger sequencing, missense mutation was analyzed in silico. We also searched Pubmed, and extracted clinical data from case reports and case series with full text in English, reporting original data of patients with TRPM6 mutations.
Results:
The twin patients had canonical HSH phenotype with compound novel TRPM6 mutations, p.T87K and c.705dupT, inherited from their father and mother, respectively. T87 is a highly conserved site and T87K is predicted to cause hydrogen bond disruption. We identified 26 articles published between May 28, 2002 to December 31, 2021 which reported a total of 88 patients with TRPM6 mutation. We found that the most common clinical phenotypes were hypomagnesemia, hypocalcemia, and convulsions. However, the age of onset in HSH patients almost always occurred under 12 months old, the twin patients of our study were 18 and 26 months old at onset.
Conclusion:
We identified two novel TRPM6 mutations in a Chinses family with HSH, and showed that the age of onset with c.704c-c.705(exon7)insT and c.260(exon4)C>A mutation in TRPM6 was much later than other mutations and would be much less serious.
Immune Reconstitution Inflammatory Syndrome and Cytomegalovirus Pneumonia Case Report: Highlights and Missing Links in Classification Criteria and Standardized Treatment
Authors: Stefania Petarra-Del Río, Adrian Rodriguez-Hernandez, Luis Anguiano-Landa, Georgina Aguilar-Portillo, Isidro Zavala-Trujillo, Arnulfo Hernan Nava-Zavala, Maria G Zavala-Cerna
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Background:
Cytomegalovirus (CMV) pulmonary involvement is rarely associated with IRIS; therefore, limited information is available.
Case presentation:
Here, we describe the case of a 43-year-old HIV-infected male who developed an unusual case of IRIS after cytomegalovirus (CMV) pneumonia. Clinically there was a progressive and paradoxical worsening of respiratory distress, despite being treated for CMV after initiation with antiretroviral therapy. Chest X-ray revealed disseminated infiltrates in both lungs; chest CT-scan showed generalized lung involvement and mediastinal adenopathy. Pulmonary biopsy confirmed CMV pneumonia with the observation of typical viral inclusions on pneumocytes.
Conclusions:
CMV pneumonia can be associated with the development of IRIS requiring treatment with immunosuppressant's and immunomodulatory drugs.
Multiple Phantom Tumor of the Lung: A Complex Appearance Resolving with Appropriate Intervention
Authors: Haleh Mikaeili, Jafar Mehdizadeh Baghbani
Journal: Tanaffos (2016)
Keywords: congestive heart failure, diagnosis, pleural effusion
MeSH terms: Case Reports

The term phantom tumor may be used to describe a well-demarcated opacity resulted from pleural effusion. Phantom tumors are commonly associated with congestive heart failure causing transudative pleural effusion within pulmonary fissures. The figure may bring about inaccurate invasive diagnostic interventions. We report a heavy smoker patient with multiple phantom tumors in the right lung resolved with medical management. This case report provides records for a timely management of similar patients.
Reversible cerebral vasoconstriction syndrome presenting as an isolated primary intraventricular hemorrhage
Authors: Katarina Dakay, Ryan A McTaggart, Mahesh V Jayaraman, Shadi Yaghi, Linda C Wendell
Journal: Chin Neurosurg J (2018)
Keywords: primary intraventricular hemorrhage, pseudoephedrine, reversible cerebral vasoconstriction syndrome
MeSH terms: Case Reports

Background:
Primary intraventricular hemorrhage is an uncommon cause of stroke and is often associated with longstanding, uncontrolled hypertension. Reversible cerebral vasoconstriction is also an uncommon condition characterized by reversible constriction of intracerebral vessels, which can lead to ischemic or hemorrhagic strokes.
Case presentation:
We describe a case of isolated primary intraventricular hemorrhage secondary to reversible cerebral vasoconstriction syndrome triggered by pseudoephedrine.
Conclusions:
Reversible cerebral vasoconstriction syndrome is a rare cause of primary intraventricular hemorrhage and should be considered in the differential in angiography-negative IVH when there is a history of vasoactive substance use.