OpenMed/multicare-articles huggingface dataset:
Case report: Central alveolar hypoventilation in a survivor of cardiopulmonary arrest
Authors: Fajun Wang, Joseph Darby
Journal: Front Neurol (2023)
Keywords: ondine’s curse, cardiac arrest and brain injuries, central alveolar hypoventilation, dysautonomia, nucleus tracti solitarii
MeSH terms: Case Reports

Introduction:
Ondine's curse is a rare respiratory disorder that is characterized by central alveolar hypoventilation (CAH) during sleep. It is most commonly congenital. However, it can also be acquired very rarely. Herein, we report a young survivor who developed CAH following cardiopulmonary arrest.
Case presentation:
A 35-year-old man was admitted to the Intensive Care Unit following unwitnessed cardiopulmonary arrest. Following resuscitative interventions, he remained comatose. Early diagnostic testing showed elevated neuronal specific enolase (28.7 ng/ml), absent cortical responses on evoked potential testing and MRI evidence of restricted diffusion in the cerebellum, hippocampi, juxtacortical white matter, superior cerebellar peduncles, dorsal pons, dorsolateral medulla, and upper cervical spinal cord. Ten days following admission, the patient remained comatose and underwent tracheostomy. He subsequently began to emerge from coma but had persistent unexplained hypotension and bradypnea necessitating ongoing vasopressor and respiratory support. Repeat MRI on hospital day 40 revealed residual FLAIR hyperintensities in the medulla within the nucleus tractus solitarius (NTS). After being discharged to long-term acute care facility, he was successfully liberated from mechanical ventilation 70 days post arrest.
Conclusion:
We report the first survivor of cardiopulmonary arrest who was complicated by CAH and hypotension with MRI verified ischemic injury to the bilateral NTS regions. Despite this injury, ventilator and vasopressor dependency resolved over a period of 10 weeks. Our case highlighted the essential functions of NTS in regulating the respiratory and cardiovascular systems.
Recurrent lung atelectasis from fibrin plugs as a very early complication of bronchial thermoplasty: a case report
Authors: Nicola Facciolongo, Francesco Menzella, Mirco Lusuardi, Roberto Piro, Carla Galeone, Claudia Castagnetti, Alberto Cavazza, Cristiano Carbonelli, Luigi Zucchi, Pier Paolo Salsi
Journal: Multidiscip Respir Med (2015)
Keywords: asthma, bronchial thermoplasty, bronchoscopy
MeSH terms: Case Reports

Background:
Bronchial thermoplasty (BT) is a new therapeutic option for severe refractory asthma not controlled despite high dose inhaled corticosteroids plus long-acting bronchodilators and omalizumab in selected cases. Risk of pulmonary atelectasis after BT in severe asthma has been described in literature, but no details have been reported on the possible mechanisms of the complication.
Case presentation:
A 49-year-old male with severe uncontrolled asthma was referred to BT. One hour after the first procedure, acute respiratory failure occurred with PaO2/FiO2 < 300. A CT scan showed atelectasis of the right lower and middle lobes. A new bronchoscopy was performed under non-invasive ventilation; the right lower and middle lobe bronchus were occluded by bronchus-shaped plugs, that were very difficult to remove despite repeated saline washings and fragmentation with forceps. The patient had a rapid resolution of respiratory failure. Four weeks later, 6 hours after the second session of BT, severe bronchospasm occurred with respiratory failure. Chest X-Ray showed atelectasis of the left lower lobe, prompting to perform a new flexible bronchoscopy on non-invasive ventilation. The exam showed again a plug occluding the left lower lobar bronchus, removed with forceps and washings. The histological analysis of the plugs demonstrated the massive presence of fibrin with mucus debris, rare Charcot-Leyden crystals, scattered macrophages, neutrophils, eosinophils and bronchial epithelial cells.
Conclusion:
The originality of our case report is related to the recurrence of bronchial plugging with lobar atelectasis within one and five hours respectively, after two sequential BT procedures. At the histological evaluation the bronchial plugs appeared very different from the typical mucoid asthma plugs, being composed prevalently by fibrin. It can be hypothesized that intense thermal stimulation of the bronchial mucosa may represent a strong boost for inflammation in susceptible patients, with microvascular alteration induced directly by heat or through the release of mediators. Although in severe asthma a risk of atelectasis from the classical asthma mucoid plugs may be expected, the peculiarity of our case resides in the formation of fibrin plugs whose direct correlation with BT should be considered.
A Rare Case of Bilateral Patellar Tendon Ruptures: A Case Report and Literature Review
Authors: Nadim Tarazi, Padhraig O'loughlin, Amin Amin, Peter Keogh
Journal: Case Rep Orthop (2016)

Bilateral patellar tendon ruptures are rare. The majority of case reports describing bilateral patellar tendon ruptures have occurred in patients with predisposing factors to tendinopathy. We describe a case of bilateral patellar tendon rupture sustained following minimal trauma by a patient with no systemic disease or history of steroid use. Due to the rarity of this injury, clinical suspicion is low. It is reported that 38% of patellar tendon ruptures are misdiagnosed initially. Therefore careful history taking and physical examination is integral in ensuring a diagnosis is achieved for early primary repair. We discuss the aetiology of spontaneous tendon rupture and report a literature review of bilateral patellar tendon ruptures.
Case report: Primary chronic calcaneal bursitis treated with subtotal bursectomy in a cat
Authors: YoungJin Jeon, Haebeom Lee, Yoonho Roh, Daehyun Kim, Seong Mok Jeong, Jaemin Jeong
Journal: Front Vet Sci (2022)
Keywords: calcaneal bursitis, cat, cyst-like mass, recurrent lameness, subtotal calcaneal bursectomy
MeSH terms: Case Reports

A 6-year-old, female spayed Bengal cat with a bodyweight of 6.4 kg was presented with swelling of the bilateral calcaneal region and weight-bearing hindlimb lameness with a 4-month history of unsuccessful conservative therapy. On orthopedic examination, a cyst-like mass around the calcaneal tendon was palpated. Palpating the mass and flexing the tarsal joint triggered pain. Through ultrasonography and magnetic resonance imaging, an inflamed or fluid-accumulated lesion was suspected around the calcaneal tendon, but there was no evidence of calcaneal tendonitis. Swollen calcaneal bursae were removed surgically. Histopathologic examination revealed fibrosis and an edematous feature. The cat was diagnosed with bilateral chronic primary calcaneal bursitis based on history, clinical signs, and diagnostic results. Hence, subtotal bursectomy was performed. At 4 weeks postoperatively, the cat had no pain around the tarsal joints and was ambulating normally. Radiographic and ultrasonographic exams revealed no recurrence of swelling or inflammation in the calcaneal region. Thirteen-month follow-up confirmed acceptable function and no relapse of clinical signs. The inflammation of calcaneal bursa alone can be the primary cause of hindlimb lameness in cats. A cat with hindlimb lameness and swelling on the calcaneal region should be assessed with the possibility of primary calcaneal bursitis. Subtotal calcaneal bursectomy can be considered as an effective treatment for primary chronic bursitis.
Expertise in clinical psychology. The effects of university training and practical experience on expertise in clinical psychology
Authors: Sabine Vollmer, Hans Spada, Franz Caspar, Salome Burri
Journal: Front Psychol (2013)
Keywords: behavior therapy, clinical competencies, clinical knowledge, experience, expertise

How do university training and subsequent practical experience affect expertise in clinical psychology? To answer this question we developed methods to assess psychological knowledge and the competence to diagnose, construct case conceptualizations, and plan psychotherapeutic treatment: a knowledge test and short case studies in a first study, and a complex, dynamically evolving case study in the second study. In our cross-sectional studies, psychology students, trainees in a certified postgraduate psychotherapist curriculum, and behavior therapists with more than 10 years of experience were tested (100 in total: 20 each of novice, intermediate, and advanced university students, postgraduate trainees, and therapists). Clinical knowledge and competence increased up to the level of trainees but unexpectedly decreased at the level of experienced therapists. We discuss the results against the background of expertise research and the training of clinical psychologists (in Germany). Important factors for the continuing professional development of psychotherapists are proposed.
Laparoscopic pancreaticoduodenectomy in A-92-older Chinese patient for cancer of head of the pancreas: A Case report
Authors: Jiayu Zhou, Chang Xin, Tao Xia, Yiping Mou, Xiaowu Xu, Renchao Zhang, Yucheng Zhou, Weiwei Jin, Chao Lu
Journal: Medicine (Baltimore) (2017)
MeSH terms: Carcinoma, Pancreatic Ductal / surgery, Pancreatic Neoplasms / surgery, Pancreaticoduodenectomy / methods, Case Reports, Aged, 80 and over, Female, Humans, Laparoscopy

Introduction:
Laparoscopic pancreaticoduodenectomy (LPD) is one of the most complex gastrointestinal procedures performed in laparoscopic abdominal surgery. However, the concern for elderly undergoing LPD remains. To the best of our knowledge, there are no reports describing LPD for A-92-older patient. This study aimed to share the experience of a tertiary pancreatic center and confirm the safety, feasibility of LPD for the elderly.
Method:
The patient had complained of 6-months history of abdominal discomfort and progressive jaundice. Abdominal computed tomography CT/MR imaging revealed a 3 × 3 cm solid hypovascular mass in the head of the pancreas. LPD was successfully performed after multidisciplinary team (MDT). Operation time was 450 minutes, and blood loss was 120 mL. Histological examination of the resected specimen confirmed the diagnosis of pancreatic ductal adenocarcinoma (PDAC).
Outcomes:
The patient was discharged on POD13 following an uneventful postoperative period. She was followed up 4 months without any sign of recurrence.
Conclusion:
LPD can be performed safely in patients of any age who are fit for surgery in specialist centers.
The Treatment of Cleidocranial Dysostosis (Scheuthauer-Marie-Sainton Syndrome), a Rare Form of Skeletal Dysplasia, Accompanied by Spinal Deformities: A Review of the Literature and Two Case Reports
Authors: Mehmet Bülent Balioğlu, Deniz Kargın, Akif Albayrak, Yunus Atıcı
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Cleidocranial dysostosis is a skeletal dysplasia inherited in an autosomal dominant manner and may lead to complications such as scoliosis and kyphosis, concurrent with various orthopedic involvements. Since concurrent spinal deformities are of progressive nature, surgical treatment may be necessary. In addition to other orthopedic problems, possible accompanying complications such as atlanto-axial subluxation, myelopathy, syringomyelia, congenital spine deformities, spondylosis, and spondylolisthesis should be kept in mind while planning for the treatment of scoliosis and kyphosis. Lengthening the use of growth-friendly systems (growing rod) in patients, like ours, with an early onset of symptoms, and performing posterior instrumentation and fusion once the spinal growth is complete will yield successful results with no complications in the middle and the long term. Further multicenter studies with more comprehensive assessments are required to find solutions to spinal problems related to this rare skeletal dysplasia.
ALK-R3HDM1 and EML4-ALK fusion as a mechanism of acquired resistance to gefitinib: A case report and literature review
Authors: Zhu Zeng, Tao Wang, Junjun He, Yuehong Wang
Journal: Front Oncol (2022)
Keywords: alk fusion, egfr-tki resistance, alectinib, lung cancer, non-reciprocal/reciprocal alk
MeSH terms: Case Reports

We report a case with a novel ALK-R3HDM1 and EML4-ALK dual fusion that might be a delicate mechanism for the acquired resistance of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI). A patient with EGFR L858R lung adenocarcinoma developed disease progression after 72.7 months of gefitinib therapy; rebiopsy was done, and next-generation sequencing showed the disappearance of the previous EGFR mutations. In addition, two new ALK fusions emerged, indicating that the emergence of dual ALK rearrangement may be the underlying mechanism of gefitinib resistance. The patient exhibits an excellent response to second-line alectinib treatment with a significant clinical benefit and a high quality of life. Finally, we summarized previous studies in which ALK fusion is a required resistance mechanism to EGFR-TKI.
Unusual malignant transformation of recurrent sebaceoma. A case report
Authors: Heba Al-Khashnam, Hisham Burezq, Ibrahim Al-Aradi, Humoud Al-Sabah, Khalid Al-Abdulhadi
Journal: Clin Med Oncol (2008)
Keywords: malignancy, recurrence, sebaceoma
MeSH terms: Case Reports

Sebaceoma is a benign tumor composed of incompletely differentiated sebaceous cells of varying degrees of maturity. Sebaceomas was never reported as a known premalignant lesion.This is a report of a sixteen year old boy who presented with a malignant transformation of a recurrent sebaceoma which was excised twice by Moh's surgery. Excision was done with a free margin of 1 cm down to the parotid fascia. Reconstruction was performed on the same set by using cervicofascial flap extending down to the supra-clavicular area. The patient had an uneventful postoperative period apart from distal marginal necrosis of the flap, which healed nicely with conservative measures and daily dressing and was sent to our cancer centre to start his adjuvant radiotherapy.Previous literature stated that sebaceoma is a distinctive benign tumor. We have presented a case of an unusual malignant transformation of a preauricular recurrent sebaceoma. This indicates that sebaceoma does have a potential risk of malignant transformation. We believe that managing recurrent sebaceoma more aggressively with wide local excision and postoperative adjuvant radiotherapy would provide better prognosis.
Ovarian Pregnancy following Intracytoplasmic Sperm Injection and Embryo Transfer: A Case Report
Authors: Amar Ramachandran, Swati Sharma, Kumar Pratap, Bhakta Rajesh, Vasudeva Akhila, Akhila Ramayapally, Manna Valiathan
Journal: Case Rep Obstet Gynecol (2012)

Ovarian pregnancy is a rare form of ectopic pregnancy following ICSI-ET, and the diagnosis depends on the physicians suspicion and experience. Preservation of ovarian tissue during surgery is of utmost importance to preserve fertility. We present a case of ovarian pregnancy who had a successful treatment preserving the ovary.
Mitral Valve Endocarditis due to Lactobacillus
Authors: Patrick Groga-Bada, Iris I Mueller, Federico Foschi, Meinrad Gawaz, Christian Eick
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Lactobacillus species are Gram-positive, facultative anaerobic, rod-shaped bacteria. They belong to the lactic acid bacteria group and are also known as a usual part of the normal flora of the gastrointestinal tract as well as of the urinary and genital tracts. They are an infrequent human pathogen but can induce several infections such as bacteremia and infectious endocarditis. We report the case of an 81-year-old woman with Lactobacillus bacteremia and mitral valve endocarditis as well as splenic abscesses.
The diagnosis and treatment strategy of occipital skull mass in hemophilic patients: a rare case report and literature review
Authors: Qingyuan Liu, Jun Wu, Chunde Li, Shuo Wang
Journal: Chin Neurosurg J (2019)
Keywords: diagnosis strategy, hemophilic pseudotumor, one-stage cranioplasty, perioperative management, replacement treatment
MeSH terms: Case Reports

Background:
Cranial hemophilic pseudotumor (cHPT) is a very rare disease, which is easy to misdiagnose. It is also difficult to manage such patients. We reported the first case of occipital cHPT.
Case presentation:
Here, we presented a rare case of an occipital bone mass in a 3-year-old boy who was diagnosed with hemophilia A. The mass was misdiagnosed as an aneurysmal bone cyst by pathological examination. After resection, the patient underwent one-stage cranioplasty. However, the patient was admitted again for hematoma caused by an invasive procedure. A second surgery and one-stage cranioplasty were performed at the same time. A follow-up 3 months after discharging showed the patient was uneventful, and the titanium mesh was well fixed.
Conclusion:
The diagnosis of cHPT requires the combining of history, radiological examination, and pathological examination. Resection is the best choice for symptomatic cHPT. Replacement treatment and less invasive treatment can make perioperative management safer. One-stage cranioplasty for resection of an occipital cHPT can improve the quality of life.
Necrotizing fasciitis from an iliopsoas muscle abscess caused by a toothpick: A case report and literature review
Authors: Wei-Quen Tee, Yin-Lun Chang, Pao-Jen Kuo, Chih-Hsiung Kang
Journal: Int J Surg Case Rep (2020)
Keywords: case report, iliopsoas muscle abscess, ingested toothpicks, necrotizing fasciitis, sepsis
MeSH terms: Case Reports

Introduction:
Psoas muscle abscess is rare and can become more complicated to treat after they have progressed to necrotizing fasciitis. The data of secondary psoas muscle abscess cause by ingested toothpick are limited in the literature. We have done an extensive literature review and found a number of 8 cases (including our new case) of ingested toothpicks causing iliopsoas muscle abscess.
Presentation of case:
We present a 70-year-old man with unremarkable medical history experienced left flank pain for several days with radiated to left thigh and unable to walk. He initially exhibited drowsiness at emergency department with fever and chillness. Computed tomography showed iliopsoas abscess and necrotizing fasciitis. This patient received emergent surgical debridement and a toothpick was found lodged in the deep portion of the left psoas muscle. He was tolerated to the treatment and discharged on 58 days after the operation.
Discussion:
A review of the literature revealed only eight reported cases since 1946 (including ours) of ingested toothpicks migrating into the iliopsoas muscle and causing abscess formation or necrotizing fasciitis. Three of the cases did not exhibit gut perforation, possibly because of self-healing of the wound. Gastrointestinal symptoms are not always apparent when the perforation site is over the retroperitoneal space. Thorough debridement is essential if the origin of infection is unknown.
Conclusion:
Ingestion of a foreign body may be asymptomatic, the present case and a review of the literature indicated that ingested toothpicks can cause severe morbidity or even mortality. The diagnosis of psoas abscesses associated with toothpicks is difficult, and such cases should not be overlooked. Appropriate early surgical intervention is recommended.
Lymphangitic carcinomatosis as a cause of malignant transient pleural transudate
Authors: Raquel Garcia Sevila, Encarnacion Barroso, Concepcion Martin, Ignacio Aranda, Santiago Romero
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Although it is generally accepted that a malignant transient pleural transudate may appear during the early stages of lymphatic obstruction, cases demonstrating such probability are rare in literature. A 67-year-old woman was admitted to hospital because a lymphangitic carcinomatosis and a transudative infrapulmonary pleural effusion with a cytology positive for adenocarcinoma. One month later the effusion keeps being positive for adenocarcinoma but exudative in character. Lymphatic obstruction appears as the cause of the initial transudative characteristics of the pleural effusion.
Rasburicase-Induced Falsely Low Measurement of Uric Acid in Tumor Lysis Syndrome: A Report of Two Cases
Authors: Lian Yu, Yinjing Xie, Jiangtao Ma, Guoqiang Li, Xiaopeng Yuan
Journal: Cureus (2023)
Keywords: case report, hyperuricemia, rasburicase, tumor lysis syndrome, uric acid
MeSH terms: Case Reports

Rasburicase, a recombinant urate-oxidase enzyme, can significantly catalyze the oxidation of uric acid to allantoin. It was approved by the US Food and Drug Administration (FDA) to control blood uric acid levels in both pediatric and adult patients especially those with tumor lysis syndrome. It is quite important to realize that rasburicase can continue to be effective ex vivo and cause falsely low results if the blood sample is not contained and transported in ice water immediately. We presented two cases of falsely low measurement of blood uric acid caused by rasburicase and elaborated the proper method for collecting and transporting blood samples from patients using rasburicase.
Perioperative Identification of an Accessory Fissure of the Right Lung
Authors: Yannick Taverne, Gert-Jan Kleinrensink, Peter de Rooij
Journal: Case Rep Pulmonol (2015)

Anatomical variations of lungs are common in clinical practice; however, they are sometimes overlooked in routine imaging. Surgical anatomy of the lung is complex and many variations are known to occur. A defective pulmonary development gives rise to variations in lobes and fissures. Morphological presentation is of clinical importance and profound knowledge of the organogenesis and functional anatomy is imperative for the interpretation and evaluation of lung pathophysiology and subsequent surgical intervention. However, appreciating them on radiographs and CT scans is difficult and they are therefore often either not identified or completely misinterpreted. As presented in this case report, an accessory fissure separating the superior segment of the right lower lobe from its native lobe was seen perioperatively and could only retrospectively be defined on X-rays and CT scan. It is imperative to keep in mind that accessory fissures can be missed on imaging studies and thus can make the surgical procedure more challenging.
Minimally Invasive Abdominal Repair of a Giant Paraesophageal Hiatal Hernia with Occupation of the Right Thorax in a 53-Year-Old Man
Authors: Francisco Navarro, Eduardo Pizarro, Marco Ceroni
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Paraesophageal giant hiatal hernia is a rare condition associated with serious complications if not treated surgically. There are no reports of the minimally invasive abdominal repair of a giant hiatal hernia of the stomach almost entirely occupying the right thoracic cavity. The most common clinical presentation includes pathological gastroesophageal reflux, dysphagia, chest pain, or respiratory symptoms such as chronic cough or dyspnoea. Chest computed tomography, upper gastrointestinal endoscopy, and high-resolution oesophageal manometry are used to indicate the best treatment. This article reports the minimally invasive abdominal repair of a case of paraesophageal giant hiatal hernia occupying the right thoracic cavity.