OpenMed/multicare-articles huggingface dataset:
Life-Threatening Rupture of an Idiopathic Left Hepatic Artery Pseudoaneurysm Successfully Treated with Endovascular Coil Embolization
Authors: Jorge E Sandelis-Pérez, Andrés Córdova-Toro, Steven García-Santiago, Erica G Otero-Cárdenas, Pedro Gil de Rubio-Cruz, Suheiry Márquez-Márquez, Mary J Rodríguez-Malavé, Arelis Febles-Negrón, José A Colon-Márquez, Alejandro Hidalgo-Ríos
Journal: Case Rep Vasc Med (2020)
MeSH terms: Case Reports

Hepatic artery pseudoaneurysm is a rare condition; they are multifactorial, most of them locating in the extrahepatic vasculature and the mortality associated to its rupture may reach up to 70%. We report a 77 years old female who was admitted due to headache and uncontrolled hypertension and that on her second hospital day developed sudden hemodynamic instability, abdominal pain, fatigue, skin-mucosa pallor, and anemia. Abdominal CT scan with contrast showed a left hepatic artery pseudoaneurysm associated with extensive hemoperitoneum. Patient required emergent hemodynamic stabilization and finally was treated successfully with a superselective endovascular coil embolization. Our patient represents an atypical case of a spontaneous rupture of an idiopathic hepatic artery pseudoaneurysm. Hence, the importance of having a high index of clinical suspicion. Endovascular coil embolization has become the first-line treatment.
Fatal Case of Pulmonary Invasive Aspergillus after Heart Transplant with a Rapidly Progressive Course
Authors: B Shakerian, N Razavi, M H Mandegar
Journal: Int J Organ Transplant Med (2018)
Keywords: aspergillus, fungal infection, heart transplant
MeSH terms: Case Reports

The incidence of invasive fungal infections is lower than that of bacterial infections in heart transplant recipients. However, they are always life-threatening. Clinical manifestations may range from asymptomatic colonization to disseminated infection. This complication is responsible for significant morbidity and mortality, particularly in heart transplant recipients. Herein, we present on a cardiac transplant recipient who presented with invasive pulmonary aspergillosis quickly leading to death, in spite of early diagnosis and aggressive therapy. It just took 10 hours from the diagnosis to death. In other reports, this period was at least 12 days.
Complications during the Management of Dislocated Tracheostomy Cannula
Authors: Kristian Krogh, Anette Marianne Fedder
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

We describe an acute complication to a tracheostomy cannula in the form of a dislocated cannula after a surgical tracheostomy in a 65-year-old male patient. The case illustrates the development of progressing subcutaneous emphysema resulting in a cannot intubate, cannot oxygenate (CICO) situation and the airway management of the patient with respiratory distress. Early recognition and situational awareness are essential in the management of patients with acute airway complications. Consequently, deliberate practice and continuing professional development should be encouraged so that we can best manage acute situations when they occur.
Hodgkin Lymphoma and Castleman Disease: When One Blood Disease Can Hide Another
Authors: L Filliatre-Clement, H Busby-Venner, C Moulin, G Roth-Guepin, A Perrot
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

We describe a rare case of Castleman disease associated de novo with Hodgkin lymphoma. The incidence of Castleman disease is rare; only a few studies have described it in de novo association with Hodgkin lymphoma. The patient described here complained of unique evolutionary axillary adenopathy. A positron-emission tomography/computed tomography scan revealed hypermetabolic activity in this area. Diagnosis was based on a total excision biopsy of the adenopathy. The patient underwent complete remission with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy for treating Hodgkin lymphoma after surgical excision of the unicentric Castleman disease lesion.
Endocrine-responsive breast cancer: a 28-year Odyssey
Authors: A West, Kp Friedman, F Muggia
Journal: Ecancermedicalscience (2011)
MeSH terms: Case Reports

Details on the 28-year treatment history of a patient with an endocrine-responsive breast cancer are provided. She was originally diagnosed as having a T1N0M0 cancer after a modified radical mastectomy at age 41. Fifteen years later, in 1998, she presented with hemoptysis and pleuritic chest pain: a 10 cm right atrial tumor and estrogen receptor (ER) positive endobronchial and adjacent lung parenchyma adenocarcinoma were documented. Epithelial markers normalized as she manifested a partial response (PR) lasting 3 years with tamoxifen treatment. From 2001 to 2007 she benefitted from exemestane treatment. Upon progression in the previous lung area and left adrenal, exemestane withdrawal led to transient decrease in markers. Six months later (in July 2008), with growth in her adrenal tumor, laparoscopic adrenalectomy was performed: in addition to ER positivity, the tumor showed Her2 overexpression and amplification. She has subsequently had some control of disease with fulvestrant, letrozole + trastuzumab, and subsequently letrozole + lapatinib. In addition to the chronicity of disease, this history illustrates the expanding range of treatments available for endocrine-responsive breast cancer commensurate to our greater understanding of tumor biology.
A case report of three children with secondary hypertension caused by Liddle syndrome
Authors: Zheyi Teoh, Siddharth Shah
Journal: Clin Nephrol Case Stud (2020)
Keywords: liddle syndrome, monogenetic hypertension, secondary hypertension
MeSH terms: Case Reports

Background:
Liddle syndrome is a monogenetic cause of early-onset hypertension that is associated with hypokalemia and metabolic alkalosis that is inherited in an autosomal dominant fashion with variable penetrance.
Case presentation:
We present a case report of three children seen at a tertiary children's hospital with varying severity of hypertension and electrolyte disturbances, who had genetic testing performed due to strong family history of hypertension. They were each subsequently found with the same genetic mutation of SCNN1B consistent with Liddle syndrome and started on epithelial sodium channel inhibitors with improvement in their blood pressure.
Conclusion:
Due to its variable penetrance, Liddle syndrome can have varying severity of blood pressure and electrolyte disturbances. Prompt recognition of Liddle syndrome is important to prevent cardiovascular complications from uncontrolled hypertension.
Inpatient Specialist Palliative Care in Patients With Left Ventricular Assist Devices (LVAD): A Retrospective Case Series
Authors: Theresa Tenge, David Santer, Daniel Schlieper, Manuela Schallenburger, Jacqueline Schwartz, Stefan Meier, Payam Akhyari, Otmar Pfister, Silke Walter, Sandra Eckstein, Friedrich Eckstein, Martin Siegemund, Jan Gaertner, Martin Neukirchen
Journal: Front Cardiovasc Med (2022)
Keywords: cardiac surgery, end of life care, heart assist devices, heart failure, left ventricular assist devices, palliative care, quality of life

Background:
Repeat hospitalizations, complications, and psychosocial burdens are common in patients with left ventricular assist devices (LVAD). Specialist palliative care (sPC) involvement supports patients during decision-making until end-of-life. In the United States, guidelines recommend early specialist palliative care (esPC) involvement prior to implantation. Yet, data about sPC and esPC involvement in Europe are scarce.
Materials and methods:
This is a retrospective descriptive study of deceased LVAD patients who had received sPC during their LVAD-related admissions to two university hospitals in Duesseldorf, Germany and Basel, Switzerland from 2010 to 2021. The main objectives were to assess: To which extent have LVAD patients received sPC, how early is sPC involved? What are the characteristics of those, how did sPC take place and what are key challenges in end-of-life care?
Results:
In total, 288 patients were implanted with a LVAD, including 31 who received sPC (11%). Twenty-two deceased LVAD patients (19 male) with sPC were included. Mean patient age at the time of implantation was 67 (range 49-79) years. Thirteen patients (59%) received LVAD as destination therapy, eight patients (36%) were implanted as bridge to transplantation (BTT), and one as an emergency LVAD after cardiogenic shock (5%). None of the eight BTT patients received a heart transplantation before dying. Most (n = 13) patients lived with their family and mean Eastern Cooperative Oncology Group (ECOG) performance status was three. Mean time between LVAD implantation and first sPC contact was 1.71 years, with a range of first sPC contact from 49 days prior to implantation to more than 6 years after. Two patients received esPC before implantation. In Duesseldorf, mean time between first sPC contact and in-hospital death was 10.2 (1-42) days. In Basel, patients died 16 (0.7-44) months after first sPC contact, only one died on the external sPC unit. Based on thorough examination of two case reports, we describe key challenges of sPC in LVAD patients including the necessity for sPC expertise, ethical and communicative issues as well as the available resources in this setting.
Conclusion:
Despite unequivocal recommendations for sPC in LVAD patients, the integration of sPC for these patients is yet not well established.
Safety of pegfilgrastim (neulasta) in patients with sickle cell trait/anemia
Authors: Pashtoon Murtaza Kasi, Mrinal M Patnaik, Prema P Peethambaram
Journal: Case Rep Hematol (2013)

Pegfilgrastim (Neulasta) is a recombinant filgrastim (human granulocyte colony-stimulating factor (G-CSF)) attached to a polyethylene glycol (PEG) molecule and is given as part of chemotherapy regimens that are associated with significant myelosuppression and risk for febrile neutropenia. Prescribing information available on manufacturer's website for the drug warns us about possible severe sickle cell crises related to the medication but does not report the actual incidence or the use in patients with sickle cell trait. Caution is advised when using it in patients with sickle cell disease. Here we present a case of a Caucasian female with known sickle cell trait (SCT) with no prior complications who developed a presumed sickle cell crisis after getting Neulasta, as a part of the chemotherapy regimen used to treat her breast cancer. Based on our literature review, this appears to be the first case report of a patient with SCT developing a sickle cell crisis with the pegylated form of recombinant filgrastim. Given the dearth of literature regarding the use of G-CSF and its related pegylated forms in patients with sickle cell anemia and sickle cell trait, a discussion of potential mechanisms and review of current literature and guidelines is also presented.
Intravascular Lymphoma with Progressive CNS Hemorrhage and Multiple Dissections
Authors: Ricky Chen, Gurjeet Singh, J Scott McNally, Cheryl A Palmer, Adam de Havenon
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Introduction:
Intravascular lymphoma (IVL) is an uncommon and often fatal disease characterized by intraluminal proliferation of lymphomatous cells within blood vessels. Because of a heterogeneous clinical presentation and lack of sensitive diagnostic protocols, diagnosis of IVL is most often made at autopsy. However, with early diagnosis and appropriate chemotherapy, the prognosis is greatly improved and complete remission is possible. In order to broaden the possible presentations of IVL, we present a patient with an atypical manifestation of biopsy-proven intravascular large B-cell lymphoma who suffered dissections of both intracranial and extracranial arteries in addition to progressive intracranial hemorrhages. Case Report. A 47-year-old woman presented with unilateral paresthesias. She developed progressive multifocal infarcts and hemorrhage with dissections of both intracranial and extracranial arteries, resulting in coma. Brain biopsy revealed IVL. She received aggressive chemotherapy and remains in complete remission with good neurologic recovery.
Conclusion:
IVL is known to exert its pathology on small arteries and capillaries, but is not known to cause dissections of large vessels. The diagnosis should be considered in cases with unexplained arterial dissections and progressive strokes. Early diagnosis with appropriate laboratory screening and tissue confirmation by biopsy can lead to greatly improved outcomes.
Scleroderma renal crisis in tropical region: two senegalese cases
Authors: Mouhamadou Moustapha Cisse, Sidy Mohamed Seck, Daher Abdoul Karim Oumar, Khodia Fall, Ahmed Tall Lemrabott, Moussa Diallo, Maria Faye, Moustapha Faye, Abdou Niang, Boucar Diouf
Journal: Pan Afr Med J (2015)
Keywords: dakar, scleroderma renal crisis, corticosteroids, thrombotic microangiopathy
MeSH terms: Hypertension, Malignant / etiology, Hypertension, Renal / etiology, Renal Insufficiency / etiology, Scleroderma, Systemic / complications, Case Reports, Adult, Angiotensin-Converting Enzyme Inhibitors / therapeutic use, Disease Progression, Fatal Outcome, Female, Humans, Hypertension, Malignant / drug therapy, Hypertension, Renal / drug therapy, Middle Aged, Renal Dialysis, Renal Insufficiency / drug therapy, Senegal, Angiotensin-Converting Enzyme Inhibitors

Scleroderma renal crisis (SRC) is defined as the new onset of accelerated arterial hypertension and /or rapidly progressive oliguric renal failure during the course of systemic sclerosis. It is a rare but life-threatening complication. This formerly serious complication has got a considerable brighter outlook since the introduction of angiotensin converting enzyme inhibitors (ACE) however the mortality is still remaining high. We report two cases of SRC which to our knowledge are the firsts described in Dakar. They were two women aged 45 and 32 years, one of them was previously following for systemic sclerosis. Both of them had malignant hypertension associated with rapidly progressive renal failure, the other was put under corticosteroid therapy four months before SRC occurrence. The histological and laboratory finding showed thrombotic microangiopathy. The height blood pressure returned to normal value after treatment with ACE inhibitors. The final outcome was undesirable with the death of one after two months due to the hemodialysis discontinuation and persistence of renal failure in the other.
Spontaneous Adrenal Hematoma in a Pregnant Woman; a Case Report
Authors: Mahshid Ghasemi, Ali Akbar Beigi, Faranak Behnaz, Farhad Fathi, Elham Memary
Journal: Emerg (Tehran) (2017)
Keywords: adrenal glands, adrenal gland diseases, case reports, hematoma, hemorrhage, rare diseases
MeSH terms: Case Reports

Spontaneous adrenal hematoma is a very rare condition and its prevalence has been reported to be about 1% in previous studies. Although various causes have been proposed to explain its incidence in existing case reports, the etiology and pathology of this condition is still not known. The present study presents a case of spontaneous adrenal hematoma in a pregnant 31 year old womanwithout history of trauma or other probable risk factors of hemorrhage, presenting to the emergency department with chief complaint of pain in the right flank.Diagnostic measures, imaging and laparotomy,confirmed the diagnosis of spontaneous adrenal hematomafor her.
Conservative treatment for well-differentiated endometrial cancer: when and why it should be considered in young women
Authors: Michele Peiretti, Francesca Congiu, Enzo Ricciardi, Paolo Maniglio, Valerio Mais, Stefano Angioni
Journal: Ecancermedicalscience (2019)
Keywords: conservative treatment, endometrial cancer, fertility-sparing treatment, hysteroscopic resection
MeSH terms: Review

The aim of this review was to update current knowledge on the conservative treatment of endometrial cancer (EC) based on a literature review. A web-based search in the MEDLINE database was carried out on EC management and treatment. All relevant information has been collected and analysed. Case series were mainly found in the literature search. Conservative treatments were offered to young patients with stage I low-grade endometrioid carcinomas of the endometrium. Different options included high/low dose progestin treatments, hysteroscopic resection of the disease, a levonorgestrel intrauterine device or a combination of various strategies. The overall complete response rate was near 76.5% with a recurrence rate of up to 33.8%. Pregnancy outcomes reached rates of 64.8% for live births. The current clinical outcomes show that conservative treatment aimed at preserving fertility is feasible for stage I endometrial well-differentiated adenocarcinomas in motivated patients under close monitoring.
Oral Lichenoid Lesion Manifesting as Desquamative Gingivitis: Unlikely Association? Case Report
Authors: Lívia Maria Lopes de Oliveira, Luiz Henrique Carvalho Batista, Alexandrino Pereira Dos Santos Neto, Luciano Barreto Silva, Renata Cimões, Jair Carneiro Leão, Maria Leticia Cintra, Camila Maria Béder Ribeiro
Journal: Open Dent J (2018)
Keywords: dental amalgam, gingivitis diseases, lichenoid lesions, delayed hypersensitivity, heterogeneous clinical manifestations, oral lichen planus
MeSH terms: Case Reports

Introduction:
The aim of this report is to present a clinical case of oral lichenoid lesions associated with amalgam restorations with the presence of desquamative gingivitis for a nine months follow up period.
Case report:
The histopathologic characteristics and direct immunofluorescence were compatible with Oral Lichenoid Lesion (LLO). Diagnosis was based on a synthesis of all available information, including medical history, clinical examination, histopathology and the results of specific tests, such as the patch test, which confirmed allergy to thimerosal, an organic compound of mercury.
Discussion:
The replacement of amalgam restorations has brought improvements to the instrument, as evidenced by the disappearance of desquamative gingivitis, aspect erythematosus and erosive lesions. The fading does not complete the same, however, indicates the need to continue has been under continuous observation, the patient, having in view the possibility of the existence of an underlying lichen planus.
Extensive Intracardiac and Deep Venous Thromboses in a Young Woman with Heparin-Induced Thrombocytopenia and May-Thurner Syndrome
Authors: Yekaterina Kim, Daniel C Choi, Ali N Zaidi
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

A 38-year-old woman with a history of recurrent deep venous thromboses (DVTs) on chronic anticoagulation presented with acute left leg swelling. The patient was diagnosed with an acute left lower extremity (LLE) DVT in the setting of May-Thurner syndrome for which treatment with unfractionated heparin was started. Her hospital course was complicated by a new diagnosis of heparin-induced thrombocytopenia (HIT), with an incidental discovery of a large tricuspid valve mobile mass on a transthoracic echocardiogram (TTE). Subsequent imaging confirmed multiple right atrial thrombi along with LLE venous stent thrombosis and a new right LE acute DVT. Anticoagulation with argatroban for HIT thrombosis was started. She underwent a right atrial percutaneous thrombectomy and bilateral lower extremity thrombectomy with directed angioplasty and stent placement. This presentation is a rare manifestation of HIT with extensive intracardiac and deep venous thrombi, with successful staged interventions.
Traumatic Closed Proximal Muscle Rupture of the Biceps Brachii in Military Paratrooper
Authors: Georgios Kalinterakis, Emmanouil Antonogiannakis, Ioannis Rampakakis, Evangelos Tsialogiannis, Athanasios Syllaios, Miltiadis Ziogas
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Traumatic closed proximal muscle rupture of the biceps brachii has been infrequently cited in the medical bibliography. Early reports of this injury derived from US military during parachute jumps, and it may compromise >4% of injuries at altitude. The mechanism is a direct blow to the upper extremity by static lines. We report a case of traumatic closed proximal rupture of the biceps brachii in a healthy 25 years of age military paratrooper. He was managed with primary surgical repair, and after three years of follow-up, the patient has excellent functional results.
Prenatal screening tests may be a warning for the partial molar pregnancy? case report
Authors: Mehmet Akif Sargin, Niyazi Tug, Murat Yassa, Arzu Yavuz
Journal: Pan Afr Med J (2015)
Keywords: partial hydatidiform mole, complet hydatidiform, prenatal screening
MeSH terms: Hydatidiform Mole / diagnosis, Prenatal Diagnosis / methods, Case Reports, Adult, Diagnostic Errors, Female, Humans, Hydatidiform Mole / pathology, Pregnancy, Pregnancy Trimester, First

Prenatal screening tests are frequently requested for chromosomal abnormalities. Placental pathologies in early pregnancy may be overlooked, especially in partial molar pregnancy. We are reporting an incorrect preliminary diagnosed case with an increased risk of Down syndrome in her first-trimester screening test due to partial molar pregnancy.
Robotic Subtotal Cholecystectomy in a Geriatric Acute Care Surgery Patient with Super Obesity
Authors: Diane Bronikowski, Dominic Lombardo, Connie DeLa'O, Nova Szoka
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Introduction. Unique challenges exist with conventional laparoscopic operations in patients with super obesity (BMI > 50). Limited literature is available regarding use of the robotic platform to treat patients with super obesity or acute care surgery patients. This case describes an interval robotic subtotal cholecystectomy in an elderly patient with super obesity and multiple comorbidities. Case Description. A 74-year-old male with a BMI of 59.9 developed acute cholecystitis. He was deemed excessively high risk for operative intervention due to concurrent comorbid conditions and underwent percutaneous cholecystostomy. After a few months, a cholangiogram demonstrated persistent cystic duct occlusion. The patient expressed interest in tube removal and elective interval cholecystectomy. After preoperative risk stratification and optimization, he underwent a robotic subtotal cholecystectomy with near infrared fluorescence cholangiography. The patient was discharged on postoperative day one and recovered without complications. Discussion. Obesity is a risk factor for acute cholecystitis, which is most commonly treated with conventional laparoscopy (CL). CL is technically restraining and difficult to perform in patients with super obesity. The body habitus of patients with super obesity can impair proper instrumentation and increase perioperative morbidity. In this case, robotic assisted cholecystectomy console improved surgeon ergonomics and provided support for proper instrumentation. Robotic, minimally invasive cholecystectomy approaches may reduce perioperative morbidity in patients with super obesity. Further studies are necessary to address the role of robotic surgery in acute care surgery patients with super obesity.