OpenMed/multicare-articles huggingface dataset:
Case Report: Abnormal ECG and Pantalgia in a Patient With Guillain-Barré Syndrome
Authors: Xiangqi Cao, Manyun Tang, Hui Liu, Xin Yue, Guogang Luo, Yang Yan
Journal: Front Cardiovasc Med (2021)
Keywords: guillain-barré syndrome, acute coronary syndrome, electrocardiogram, pantalgia, transitional t-wave inversion
MeSH terms: Case Reports

Background: Guillain-Barré syndrome (GBS) is an acute immune-mediated disorder in the peripheral nervous system (PNS) characterized by symmetrical limb weakness, sensory disturbances, and clinically absent or decreased reflexes. Pantalgia and dysautonomia, including cardiovascular abnormalities, are common findings in the spectrum of GBS. It is usually challenging to distinguish GBS-related electrocardiogram (ECG) abnormities and chest pain from acute coronary syndrome (ACS) in patients with GBS due to the similar clinical symptom and ECG characteristics. Here, we present a case of GBS complicating ACS. Case Summary: A 37-year-old woman with a 2-month history of GBS presented to the emergency department due to pantalgia. The ECG showed a pattern of transitional T-wave inversion in the leads I, aVL, and V2 through V4 and shortly returned to normal, which appeared several times in a short time, but lab testing was unremarkable. Then, a further coronary computed tomography angiography (CTA) revealed the presence of critical stenosis of the left anterior descending artery, leading to the diagnosis of ACS. During the follow-up, she suffered from a non-ST-elevation myocardial infarction and accepted revascularization of the left anterior descending artery in the second week after discharge. Conclusion: Guillain-Barré syndrome could accompany chest pain and abnormalities on ECG. Meanwhile, it is essential to bear in mind that "GBS-related ECG abnormalities and chest pain" is a diagnosis of exclusion that can only be considered after excluding coronary artery disease, especially when concomitant chest pain, despite being a common presentation of pantalgia, occurs.
Durable Remission with Immunotherapy in a Patient with Sarcomatoid Renal Cell Carcinoma
Authors: Anusim Nwabundo, Gbadebo Damilola, Afolayan-Oloye Olabisi, Jaiyesimi Ishmael
Journal: J Kidney Cancer VHL (2021)
Keywords: case study, immunotherapy, renal cell carcinoma, sarcomatoid differentiation
MeSH terms: Case Reports

Sarcomatoid differentiation is a rare and aggressive histologic subtype with poor prognosis, seen in several malignancies. In sarcomatoid renal cell carcinoma (RCC), the degree of sarcomatoid differentiation and the stage at presentation determines the prognosis. Despite resection, chemotherapy and targeted therapy response is modest, with relapse usually occurring within a few months. We present a case of a gentleman with sarcomatoid RCC managed with pembrolizumab, who has had no evidence of recurrence for over 4 years since the last dose of immunotherapy. RCCs with sarcomatoid differentiation have a high presence of programmed cell death protein 1 and programmed cell death ligand 1 in T cells and tumor cells, respectively, making immunotherapy an attractive option in this setting. Clinical trials are ongoing to further define the benefit of immunotherapy in sarcomatoid RCC.
Case Report: Successful Concomitant Pulmonary Thromboendarterectomy and Carotid Endarterectomy
Authors: Zhan Liu, Xiaopeng Liu, Xia Zheng, Fan Lin, Guang Sun, Zhidong Ye, Yanan Zhen, Peng Liu
Journal: Front Cardiovasc Med (2022)
Keywords: carotid endarterectomy (cea), carotid stenosis, cerebral protection, chronic thromboembolic pulmonary hypertension (cteph), pulmonary thromboendarterectomy (pte)
MeSH terms: Case Reports

Pulmonary thromboendarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension. Pulmonary thromboendarterectomy concomitant with additional cardiac procedures was reported as safe and feasible. However, the treatment strategy for chronic thromboembolic pulmonary hypertension patients with severe carotid stenosis is still not clear. We describe a case of successful concomitant pulmonary thromboendarterectomy and carotid endarterectomy.
Streptococcal Toxic Shock Syndrome Caused by Group G Streptococcus, United Kingdom
Authors: Melissa Baxter, Marina Morgan
Journal: Emerg Infect Dis (2017)
Keywords: ivig, stss, bacteria, bacterial infections, group g streptococcus, intravenous immunoglobulin, streptococcal toxic shock syndrome, streptococci, streptococcus
MeSH terms: Anti-Bacterial Agents / therapeutic use, Immunoglobulins, Intravenous / therapeutic use, Shock, Septic / drug therapy, Streptococcal Infections / drug therapy, Streptococcus / classification, Case Reports, Aged, Female, Humans, Male, Middle Aged, Serotyping, Shock, Septic / microbiology, Shock, Septic / pathology, Shock, Septic / surgery, Streptococcal Infections / microbiology, Streptococcal Infections / pathology, Streptococcal Infections / surgery, Streptococcus / drug effects, Streptococcus / genetics, Streptococcus / pathogenicity, Treatment Outcome, United Kingdom, Anti-Bacterial Agents, Immunoglobulins, Intravenous

We describe successful management of 3 patients with streptococcal toxic shock syndrome (STSS) attributable to group G Streptococcus infection. This small series supports recognition of group G Streptococcus in the etiology of STSS. We propose intravenous immunoglobulin be used in treatment as it is for STSS caused by group A Streptococcus.
Cardiac Metastasis in a Patient with Head and Neck Cancer: A Case Report and Review of the Literature
Authors: Joseph K Kim, Kunal Sindhu, Richard L Bakst
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Cardiac metastasis from a primary head and neck cancer is a rare finding. Most patients with cardiac metastases have nonspecific symptoms that may vary depending on the severity and location of the lesion. Due to the infrequency of reported cases, there are no clear guidelines for the diagnosis or management of cardiac metastasis in head and neck cancer patients. In this report, we discuss the case of a patient with a primary diagnosis of oral tongue cancer who developed a cardiac metastasis that was detected antemortem.
Postsurgical Prosthetic Rehabilitation after Mandibular Ameloblastoma Resection: A 7-Year Follow-Up Case Report
Authors: C Moreno-Soriano, A Estrugo-Devesa, P Castañeda-Vega, E Jané-Salas, J López-López
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Ameloblastomas are benign but locally invasive odontogenic tumors most frequently located in the mandible. The gold standard of treatment is the surgical resection of the tumor with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. This case report describes the prosthetic rehabilitation of a 42-year-old male after resection of a mandibular ameloblastoma. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis fabricated using computer-aided design-computer-aided manufacturing. During a 7-year and 5-month follow-up, some clinical complications were observed.
Herb-Induced Liver Injury in the Berlin Case-Control Surveillance Study
Authors: Antonios Douros, Elisabeth Bronder, Frank Andersohn, Andreas Klimpel, Reinhold Kreutz, Edeltraut Garbe, Juliane Bolbrinker
Journal: Int J Mol Sci (2016)
Keywords: hepatotoxicity, pharmacovigilance, phytotherapeutics
MeSH terms: Chemical and Drug Induced Liver Injury / epidemiology, Plant Preparations / adverse effects, Adult, Aged, Case-Control Studies, Female, Germany, Humans, Male, Middle Aged, Plant Preparations / toxicity, Plant Preparations

Herb-induced liver injury (HILI) has recently attracted attention due to increasing reports of hepatotoxicity associated with use of phytotherapeutics. Here, we present data on HILI from the Berlin Case-Control Surveillance Study. The study was initiated in 2000 to investigate the serious toxicity of drugs including herbal medicines. Potential cases of liver injury were ascertained in more than 180 Departments of all 51 Berlin hospitals from October 2002 to December 2011. Drug or herb intake was assessed through a standardized face-to-face interview. Drug or herbal aetiology was assessed based on the updated Council for International Organizations of Medical Sciences scale. In ten of all 198 cases of hepatotoxicity included in the study, herbal aetiology was assessed as probable (once ayurvedic herb) or possible (Valeriana five times, Mentha piperita once, Pelargonium sidoides once, Hypericum perforatum once, Eucalyptus globulus once). Mean age was 56.4 ± 9.7 years, and the predominant pattern of liver injury was hepatocellular. No cases of acute liver failure or death were observed. This case series corroborates known risks for ayurvedic herbs, supports the suspected association between Valeriana use and liver injury, and indicates a hepatotoxic potential for herbs such as Pelargonium sidoides, Hypericum perforatum or Mentha piperita that were rarely associated with liver injury before. However, given that possible causality does not prove clinical significance, further studies in this field are needed.
Spontaneous Pneumothorax in a Patient with Systemic Lupus Erythematosus and Recent Infection with Coronavirus
Authors: Nicholas Graves, Julia Flint, Amol Sagdeo, Ayman Askari, Patrick Ball, Hana Morrissey
Journal: Case Rep Pulmonol (2022)
MeSH terms: Case Reports

A 50-year-old woman with a history of systemic lupus erythematosus and a recent infection with COVID-19 presented to the emergency department with acute shortness of breath twice in 10 days. She was diagnosed with myopericarditis attributed to COVID-19 infection (first admission), and chest X-ray revealed a small left-sided pneumothorax, pericardial effusion (second admission), with no mediastinal shift or other signs of tension. Computed tomography confirmed these results and revealed a few small cysts in the right lung. An echocardiogram demonstrated normal heart anatomy and filling dynamics. The patient was diagnosed with simple pneumothorax and ongoing myopericarditis managed with colchicine, ibuprofen, and low-dose prednisolone. The patient responded to treatment and was discharged. Pneumothorax association with COVID-19 is reported in a small number of publications, but the association is less clear with SLE. Our patient may have been predisposed to developing pneumothorax after COVID-19 infection due to her existing connective tissue disorder.
Case Report: Transcatheter Arterial Embolization for the Initial Management of Intra-Abdominal Hemorrhage From a Hepatic Tumor in a Cat
Authors: Yuta Kawamura, Hiroki Itou, Akitomo Kida, Hiroki Sunkawa, Kenji Kawamura
Journal: Front Vet Sci (2021)
Keywords: feline, hemostasis, hepatic mass, intra-abdominal hemorrhage, transcatheter arterial embolization
MeSH terms: Case Reports

An 8-year-old Ragdoll cat was admitted to our hospital after its owner noticed sudden lethargy. Abdominal ultrasonography showed a large amount of blood in the abdominal cavity, and the cat was diagnosed as having hemorrhagic shock caused by the rupture of an intra-abdominal mass. Blood transfusion was performed on the 1st day of hospitalization. On the 2nd day, contrast-enhanced computed tomography (CT) was performed, and hemorrhage from a mass originating in the caudate lobe of the liver was noted. Transcatheter arterial embolization (TAE) was performed to stop the bleeding from the mass using Gelpart to embolize the feeding artery. The following day, fever and elevation of liver enzyme levels were observed, but these subsided within a few days. At discharge 5 days after TAE, no fluid was found in the peritoneal cavity, and no further intra-abdominal bleeding occurred. Sixty-six days after TAE, we were able to perform resection surgery with the cat in good condition. A partial response was observed on CT performed before surgery. Histopathology revealed cholangiocellular adenoma. The cat was doing well as of postoperative day 549. This case indicates that TAE may be effective for initial hemostasis and stabilization of conditions in animals with tumor-induced hemorrhage.
Near complete response after single dose of nivolumab in patient with advanced heavily pre-treated KRAS mutant pulmonary adenocarcinoma
Authors: Diwakar Davar, Mark A Socinski, Sanja Dacic, Timothy F Burns
Journal: Exp Hematol Oncol (2015)
Keywords: adenocarcinoma, kras mutant, lung cancer, nivolumab, programmed death receptor-1 (pd-1)
MeSH terms: Case Reports

The programmed death 1 (PD-1) receptor is expressed by activated T-cells and engaged by ligands PD-L1 and PD-L2 normally expressed by infiltrating immune cells in response to viral infection. The PD-1/PD-L1 axis is a negative inhibitory pathway that down-regulates T-cells but is also used by tumors to evade anti-tumor immunity. Antibodies targeting PD-1/PD-L1 axis are capable of restoring functional anti-tumor immunity and have demonstrated efficacy in a broad range of tumor types including non-small cell lung cancer in both squamous and adenocarcinoma histologies. Ongoing issues affecting clinical development of these agents include assessment of response, optimal duration of therapy in excellent responders, predictive biomarkers and mechanisms of resistance. In this report, we describe a patient with advanced KRAS mutant heavily pretreated pulmonary adenocarcinoma who developed an excellent response after a single-dose of nivolumab. Pre-treatment tumor was found to have moderate CD3 and PD-L1 positivity by immunohistochemical staining. Evaluation of exceptional responders and non-responders are critical to furthering our understanding of the mechanisms of action (and resistance) to these agents.
About a rare cause of calf pain in an athlete: the popliteal artery entrapment syndrome (a case report)
Authors: Ameni Ammar, Mahmoud Smida, Mohamed Samir Daghfous
Journal: Pan Afr Med J (2021)
Keywords: popliteal artery entrapment syndrome, anterior cruciate ligament injuries, asymptomatic diseases, case report
MeSH terms: Joint Instability / complications, Knee Injuries / complications, Popliteal Artery Entrapment Syndrome / diagnostic imaging, Case Reports, Adult, Athletes, Athletic Injuries / complications, Computed Tomography Angiography, Humans, Male, Pain / etiology, Popliteal Artery Entrapment Syndrome / surgery

Claudication of the young patient is a very rare symptom for orthopaedic surgeons and it is often overlooked. We report a rare case of popliteal artery entrapment syndrome (PAES), discovered during a vascular claudication following post-traumatic anterior instability of the knee. The diagnosis was confirmed by CT angiography which showed a PAES, with a pathway in the inter-condylar notch. The patient had a releasing of the trapped vessel by myomectomy, with disappearance of vascular symptoms six months later. Through this case, we wanted to draw the attention of orthopaedic surgeons to the fact that the PAES can be asymptomatic. Its symptomatology can be triggered by a traumatic instability of the knee. Its presence represents a risk of lesion of the popliteal artery during arthroscopic ACL reconstruction. Therefore, it is important to think about this disease if a calf pain occurring after a ligament injury of the knee.
Scombroid Poisoning with Concurrent Brevundimonas Septicemia: A Unique Case Report and Brief Literature Review
Authors: Caroline C Eskind, Cassandra A Doucet, Bryan D Harris
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Scombroid poisoning is a predominantly self-limited illness associated with ingestion of poorly handled fish. It is not frequently associated with bacteremia and has never been described with Brevundimonas septicemia. We describe a case of a man who presented in shock with histamine poisoning after ingesting sushi. Blood cultures grew an uncommon pathogen, Brevundimonas vesicularis. This case demonstrates systemic bacterial infection in the setting of histamine poisoning, which is an atypical presentation for a well-known foodborne illness.
Case Report: Hereditary Alpha Tryptasemia in Children: A Pediatric Case Series and a Brief Overview of Literature
Authors: Daniele Zama, Edoardo Muratore, Arianna Giannetti, Iria Neri, Francesca Conti, Pamela Magini, Simona Ferrari, Andrea Pession
Journal: Front Pediatr (2021)
Keywords: genetic disorder, hereditary alpha tryptasemia, mast cell activation syndrome, mastocytosis, pediatric allergology
MeSH terms: Case Reports

Hereditary alpha tryptasemia (HαT) is a recently described autosomal dominant genetic trait caused by an increased copy number of the TPSAB1 gene. It commonly leads to elevated basal serum tryptase levels, and it is associated with heterogeneous clinical manifestations. Some individuals report few to no symptoms, while others present with a spectrum of debilitating features. Most symptoms related to HαT may be explained by mast cell activation and mediator release, namely multiple allergies, anaphylaxis, and skin rash. However, the genotype-phenotype correlation has not yet been clearly understood. In particular, the characterization of the clinical spectrum lacks in children, where differential diagnosis could be challenging. Systemic mastocytosis, HαT, and mast cell activation syndrome are all associated with overlapping pathophysiology and symptoms, making the distinction between these conditions a difficult task. We herein describe two pediatric cases of HαT and their respective families at our tertiary care teaching hospital, highlighting the diagnostic workup and differential diagnosis. We also provide a brief review of the literature to underline the peculiar features of this condition in children.
Targeting the glutamatergic system to treat pathological gambling: current evidence and future perspectives
Authors: Mauro Pettorruso, Luisa De Risio, Giovanni Martinotti, Marco Di Nicola, Filippo Ruggeri, Gianluigi Conte, Massimo Di Giannantonio, Luigi Janiri
Journal: Biomed Res Int (2014)
MeSH terms: Behavior, Addictive / drug therapy, Dopamine / metabolism, Excitatory Amino Acid Agents / therapeutic use, Gambling / drug therapy, Glutamic Acid / metabolism, Review, Behavior, Addictive / metabolism, Behavior, Addictive / pathology, Gambling / metabolism, Gambling / pathology, Humans, Male, Molecular Targeted Therapy, N-Methylaspartate / metabolism, Synaptic Transmission / drug effects, Excitatory Amino Acid Agents, Glutamic Acid, N-Methylaspartate, Dopamine

Pathological gambling or gambling disorder has been defined by the DSM-5 as a behavioral addiction. To date, its pathophysiology is not completely understood and there is no FDA-approved treatment for gambling disorders. Glutamate is the principal excitatory neurotransmitter in the nervous system and it has been recently involved in the pathophysiology of addictive behaviors. In this paper, we review the current literature on a class of drugs that act as modulating glutamate system in PG. A total of 19 studies have been included, according to inclusion and exclusion criteria. Clinical trial and case series using glutamatergic drugs (N-acetylcysteine, memantine, amantadine, topiramate, acamprosate, baclofen, gabapentin, pregabalin, and modafinil) will be presented to elucidate the effectiveness on gambling behaviors and on the related clinical dimensions (craving, withdrawal, and cognitive symptoms) in PG patients. The results have been discussed to gain more insight in the pathophysiology and treatment of PG. In conclusion, manipulation of glutamatergic neurotransmission appears to be promising in developing improved therapeutic agents for the treatment of gambling disorders. Further studies are required. Finally, we propose future directions and challenges in this research area.
Radiation recall reaction induced by adjuvant trastuzumab (herceptin)
Authors: Caroline Chung, David Stuart, Mira Keyes
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Although concerns of radiation sensitization have been raised with concurrent trastuzumab (Herceptin) administration, there has been no published case of radiation recall reaction associated with trastuzumab. This case describes a clinical presentation consistent with a radiation recall reaction following administration of adjuvant trastuzumab after neoadjuvant FEC-D chemotherapy and locoregional radiotherapy for HER2-positive, locally advanced breast cancer in a premenopausal woman. Although the mechanism and etiology of radiation recall dermatitis remain unclear, this case raises further hypotheses regarding a possible drug dose-dependence and possible predisposing risk factor for the development of radiation recall reactions.
Case report: Eighteen nails gun shots in the head, thorax and abdomen but still conscious at admission: A challenging patient for the cardiac surgeon!
Authors: Ahmed Ouda, Anna Maria Schürner, Martin Oliver Schmiady, Gerrolt Nico Jukema, Paul Robert Vogt, Thierry Carrel
Journal: Front Cardiovasc Med (2023)
Keywords: anticoagulation, cerebral bleeding, head injury, penetrating cardiac trauma, surgical treatment
MeSH terms: Case Reports

We report an unusual case of multiple penetrating cerebral, cardiac and abdominal injuries following a suicidal attempt using a nail gun. Successful treatment required several emergency procedures and resulted from a wise interdisciplinary management and timing of surgery.
Phenibut ( β-Phenyl- γ-aminobutyric Acid) Dependence and Management of Withdrawal: Emerging Nootropics of Abuse
Authors: Tania Ahuja, Ofole Mgbako, Caroline Katzman, Allison Grossman
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

This case report describes the development of withdrawal from phenibut, a gamma-aminobutyric acid-receptor type B agonist. Although phenibut is not an FDA-approved medication, it is available through online retailers as a nootropic supplement. There are reports of dependence in patients that misuse phenibut. We report a case in which a patient experienced withdrawal symptoms from phenibut and was successfully treated with a baclofen taper. This case report highlights the development of phenibut use disorder with coingestion of alcohol and potential management for phenibut withdrawal. We believe clinicians must be aware of how phenibut dependence may present and how to manage the withdrawal syndrome.
Case report: A novel mutation in RTEL1 gene in dyskeratosis congenita
Authors: Haider Nisar, Memoona Khan, Qamar Un Nisa Chaudhry, Raheel Iftikhar, Tariq Ghafoor
Journal: Front Oncol (2023)
Keywords: rtel1, dyskeratosis congenita, heterozygous, mutation, telomere biology disorders
MeSH terms: Case Reports

Dyskeratosis congenita (DKC), also known as Zinsser-Cole-Engman syndrome, is a telomeropathy typically presenting as a triad of leukoplakia, nail dystrophy, and reticular hyperpigmentation. Reported genetic mutations linked to DKC include DKC1, TINF2, TERC, TERT, C16orf57, NOLA2, NOLA3, WRAP53/TCAB1, and RTEL1. Homozygous, compound heterozygous, and heterozygous mutations in RTEL1 (RTEL1, regulator of telomere elongation helicase 1) gene on chromosome 20q13 are known to cause autosomal dominant as well as recessive DKC. Pathogenic variants of RTEL1 gene in DKC patients include c.2288G>T (p. Gly763Val), c.3791G>A (p. Arg1264His), and RTEL p. Arg981Trp. We report a novel homozygous variant of RTEL1, transcript ID: ENST00000360203.11, exon 24, c.2060C>T (p.Ala687Val), in a patient of DKC presenting with leukoplakia, dystrophic nails, reticulate pigmentation, and positive family history of a similar phenotype. The novel variant, reported as a variant of uncertain significance, may therefore be considered diagnostic for DKC in a Pakistani population.