OpenMed/multicare-articles huggingface dataset:
Case Report: Adrenal Epithelial Cyst in an 11-Year-Old Leptailurus Serval
Authors: Sacha L Devereux, Wendy I Baltzer, Susan A Piripi, Mark C Owen
Journal: Front Vet Sci (2022)
Keywords: adrenal, adrenal cyst, case report, epithelial cyst, serval
MeSH terms: Case Reports

Case description:
A serval (Leptailurus serval) presented for progressive enlargement of the right adrenal gland, which had been found incidentally on abdominal ultrasound 2 years previously and upon subsequent ultrasound examinations enlarged progressively from 1.26 to 1.43 cm.
Clinical findings:
Clinical signs had not been recorded by the zookeeper, however, progressive weight gain and lethargy were reported. Computed tomography (CT) confirmed the presence of a right caudal pole adrenal mass measuring 1.8 cm.
Treatment and outcome:
The right adrenal with associated mass was surgically resected via a ventral midline laparotomy that included the resection of the right phrenicoabdominal vein in association with the mass. Histopathological examination identified the mass as an epithelial cyst. Chromogranin A staining for a possible pheochromocytoma was performed but was negative. The serval recovered at the zoo without complication and has been on display for 18 months.
Clinical relevance:
Epithelial adrenal cysts have not been previously reported in felids. An adrenal cyst should be included on the differential list for any animal with an enlarged, slowly growing adrenal gland mass with non-specific clinical signs.
Methaemoglobinemia Induced by MDMA?
Authors: L L W Verhaert
Journal: Case Rep Pulmonol (2011)
MeSH terms: Case Reports

Case. A 45-year-old man with a blank medical history presented at the emergency room with dizziness and cyanosis. Physical examination showed cyanosis with a peripheral saturation (SpO(2)) of 85%, he did not respond to supplemental oxygen. Arterial blood gas analysis showed a striking chocolate brown colour. Based on these data, we determined the arterial methaemoglobin concentration. This was 32%. We gave 100% oxygen and observed the patient in a medium care unit. The next day, patient could be discharged in good condition. Further inquiry about exhibitions and extensive history revealed that the patient used MDMA (3,4- methylenedioxymethamphetamine, the active ingredient of ecstasy). Conclusion. Acquired methaemoglobinemia is a condition that occurs infrequently, but is potentially life threatening. Different nutrients, medications, and chemicals can induce methaemoglobinemia by oxidation of haemoglobin. The clinical presentation of a patient with methaemoglobinemia is due to the impossibility of O(2) binding and transport, resulting in tissue hypoxia. Important is to think about methaemoglobin in a patient who presents with cyanosis, a peripheral saturation of 85% that fails to respond properly to the administration of O(2). Because methaemoglobin can be reduced physiologically, it is usually sufficient to remove the causative agent, to give O(2), and to observe the patient.
COVID-19 pandemic and the judicialization of health care: an explanatory case study
Authors: Eloá Carneiro Carvalho, Pedro Hugo Dantas de Oliveira Souza, Thereza Christina Mó Y Mó Loureiro Varella, Norma Valéria Dantas de Oliveira Souza, Sheila Nascimento Pereira de Farias, Samira Silva Santos Soares
Journal: Rev Lat Am Enfermagem (2020)
MeSH terms: Coronavirus Infections / epidemiology, Delivery of Health Care / legislation & jurisprudence, Pandemics / legislation & jurisprudence, Pneumonia, Viral / epidemiology, Betacoronavirus, Brazil / epidemiology, COVID-19, Humans, Right to Health, SARS-CoV-2

Objective to identify the reasons that led to the judicialization of health care in the context of the COVID-19 pandemic; describe the outcomes of lawsuits concerning health care involving the COVID-19; and analyze the cases of health care judicialization intended to ensure the population's right to health. Method qualitative, explanatory case study. Data were collected from the websites of the Federal Prosecution Service, Regional Labor Court (1st Region), and the Court of Justice of Rio de Janeiro. The inclusion criterion was public civil actions that concerned health care and situations involving the COVID-19 pandemic. Two categories emerged from data analysis. Results four cases were identified. Conclusion the judicialization of health care consists of obtaining assets and rights in the courts. These assets and rights are essential to ensure the health of citizens but have been denied in various instances, often due to the omission of the executive and legislative powers. Analyzing the judicialization of health care amidst the pandemic brings focus and highlights the importance of giving voice and visibility to the enormous contingent of the Brazilian society unassisted by public authorities.
Case Report: A Novel GNB1 Mutation Causes Global Developmental Delay With Intellectual Disability and Behavioral Disorders
Authors: Jorge Diogo Da Silva, Marta Daniela Costa, Bruno Almeida, Fátima Lopes, Patrícia Maciel, Andreia Teixeira-Castro
Journal: Front Neurol (2021)
Keywords: g proteins, gnb1, intellectual disability, neurodevelopment, neurogenetics
MeSH terms: Case Reports

Diseases of neurodevelopment mostly exhibit neurological and psychiatric symptoms that go from very mild to extremely severe. While the etiology of most cases of neurodevelopmental disease is still unknown, the discovery of underlying genetic causes is rapidly increasing, with hundreds of genes being currently implicated as disease-causing. Here, we report a clinical case of a patient with a previously undiagnosed syndrome comprising severe global developmental delay, intellectual disability, and behavioral disorders (such as attention-deficit/hyperactivity disorder, autism spectrum disorder and recurrent bouts of aggressive behavior). After genetic testing, a pathogenic variant was detected in the GNB1 gene, which codes for the G-protein subunit β1. The detected variant (c.217G>A, p.A73T) has not been previously reported in any of the 58 published cases of GNB1 encephalopathy. However, it localizes to the mutational hotspot in exons 6 and 7 in which 88% of all missense mutations occur. An in silico model predicts that this mutation is likely to disrupt the WD40 domain of the GNB1 protein, which is required for its interaction with other G-proteins and, consequently, for downstream signal transduction. In conclusion, we reported an additional GNB1 encephalopathy patient, bearing a novel mutation, taking another step toward a better understanding of its clinical presentation and prospective development of treatments for the disease.
Fatal sickling-associated microvascular occlusive crisis in a young with sickle cell trait
Authors: Deepti Mutreja, Benjith Paul K, Tilak Tvsvgk
Journal: Autops Case Rep (2021)
Keywords: autopsy, military personnel, physical exertion, sickle cell trait
MeSH terms: Case Reports

Sickle cell trait (SCT), a heterozygous state characterized by hemoglobin AS, occurs commonly in sub-Saharan Africa, South America, Central America, India, and the Mediterranean countries. SCT is compatible with a normal lifespan and is not commonly regarded as a cause of morbid illness or death compared to its homozygous counterpart. We describe a case of fatal sickling-associated microvascular crisis, identified on post mortem evaluation in a previously undiagnosed 21-year-old military recruit with sickle cell trait. The individual presented with repeated syncope episodes during his training and was autopsied in the pursuit of cardiac anomalies and heat syncope. During the terminal episode, he collapsed and died of severe metabolic complications as he struggled to complete an organized run during routine training activities. To our knowledge, this is the first report of fatal sickling-associated crisis in a military recruit with sickle cell trait from India. This case serves to remind all armed forces and sports physicians of the importance of screening a recruit who is unable to complete exertional physical training for the presence of sickle cell trait.
Synchronous bilateral breast cancer: A case report of heterogeneous estrogen receptor status
Authors: Sunny Dhadlie, Joseph Whitfield, Rasika Hendahewa
Journal: Int J Surg Case Rep (2018)
Keywords: bilateral breast cancer, hormone receptors, oestrogen receptor, synchronous

Introduction:
Tumour heterogeneity is important in the management of breast cancer. Hormone receptors are established biomarkers for treatment and prognosis of patients with breast cancer. There are three immunohistochemical biomarkers: estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor 2 (HER2). We explore whether heterogeneity in hormone receptor status in synchronous bilateral breast alters therapeutic management.
Case presentation:
This case details a 54 year old woman who was referred to our clinic by her general practitioner for investigation of bilateral breast pain that she had for 6 months. On clinical examination pathological nodes were palpated in bilateral axilla. There was left sided nipple inversion with a palpable mass in the upper outer quadrant of approximately 3 cm diameter. On examination of the right breast there was skin tethering of the nipple and 3 masses were palpated, the largest being in the upper inner quadrant at 5 cm diameter. Ultrasound and mammography of bilateral breasts demonstrated advanced bilateral breast cancer with axillary node metastases. Core biopsies demonstrated invasive carcinoma. The right breast lesion was ER negative whilst the left breast lesion was ER positive.
Discussion:
In patients with synchronous bilateral breast cancer ER discordance in patients have been associated with higher mortality than ER concordant positive patients and lower mortality than ER concordant negative patients within the first 5 years of surveillance [1].
Conclusion:
Heterogeneity in hormone receptor status alters the therapeutic management of patients with synchronous bilateral breast cancer. Both hormone therapy and chemotherapy should be considered in these patients. It is of utmost importance to evaluate the tumor receptor status in cases of synchronous bilateral breast tumour and to assess for change in relation to tumour progression or treatment. Further study in the status change of receptors could open up new treatment modalities.
Integration of cervical cancer screening into HIV/AIDS care in low-income countries: a moral imperative
Authors: Chemtai Mungo, Emily Barker, Magdalene Randa, Jeniffer Ambaka, Cirilus Ogollah Osongo
Journal: Ecancermedicalscience (2021)
Keywords: hiv and hpv, cervical cancer elimination, low- and middle-income countries
MeSH terms: Case Reports

Although cervical cancer is preventable, in 2018, approximately 570,000 new cases occurred globally. Cervical cancer disproportionately affects low- and middle-income countries (LMICs), which accounted for 90% of deaths in 2018. Women living with the Human Immunodeficiency Virus (WLWH) are at increased risk of cervical cancer and are in urgent need of prevention. Despite evidence-based guidelines for screening and prevention of cervical cancer, the majority of WLWH in LMICs lack access to cervical cancer screening. Despite tremendous gains made in access to life prolonging antiretroviral therapy for WLWH, most are served by vertical human immunodeficiency virus (HIV) programmes which do not integrate these two crucial services. We present a case of a WLWH, in HIV care for a decade, who was recently diagnosed with preventable, advanced stage cervical cancer.
Primary Echinococcus Hydatid Cyst of the Uterus: An Unusual Location
Authors: Farouk Ennaceur, Dhekra Toumi, Farouk Jaouad, Aymen Mabrouk, Ahmed Hajji, Mouna Gara, Atef Chamakh, Ines Zouari, Mohamed Maatouk, Sami Daldoul, Sofien Sayari, Karim Haouet, Yacine Ben Safta, Raja Faleh, Mounir Ben Moussa
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Hydatidosis is a widespread anthropozoonosis. It can affect almost any part of the body, but it occurs most commonly in the liver (75%) and the lungs (15%). Its occurrence in female genital tract, especially the uterus, is very rare. Diagnosing hydatid disease at these unusual locations can be difficult. Hereby, we report two cases of primary hydatid cyst of the uterus. The first case is that of a 62-year-old woman, G7P5A2, who presented with an eight-month history of chronic pelvic pain. Clinical examination and radiological explorations revealed the presence of a uterine fibroid and a serous cystadenoma of the left ovary. She underwent a hysterectomy and a bilateral adnexectomy. Anatomopathological examination concluded that a serous cystadenoma of the left ovary was a calcified subserous hydatid cyst of the uterine fundus. The second case is that of a 69-year-old woman, G6P4A2, who consulted for chronic pelvic pain that had been evolving for 3 months. The clinical examination and radiological explorations doubted a hydatid cyst of the uterus, with a positive hydatid serology. She underwent a resection of the salient dome. The anatomopathological examination was in favor of a hydatid cyst of the uterus. Hydatid disease is endemic in Tunisia. The pelvic region is rarely affected with an incidence ranging from 0.3 to 0.9%, 80% of which involves the genitals. The uterus is more rarely affected than the ovaries. Most often, it is a contamination secondary to the intra-abdominal rupture of a hydatid cyst of the liver. However, primary uterine hydatid cysts have been reported. Surgery is the Gold Standard for the treatment of uterine hydatid cysts. Exploration of the abdominal cavity is essential in the search for other localizations, particularly hepatic. Postoperative medical treatment with Albendazole can be discussed. The ideal approach to deal with this public health concern is to emphasize the need for improved preventive measures. Modern imaging techniques have significantly improved the detection rates of hydatid cysts in atypical localizations. Indeed, the preoperative diagnosis of uterine hydatidosis requires a meticulous approach which is necessary to initiate an adequate treatment and thus guarantee a better management of the patient.
Recurrent Enlarging Mesenteric Desmoid Tumor following Remote Surgical Resection
Authors: Connie Hapgood, Allison DeLong
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

Intra-abdominal desmoid tumors are commonly associated with genetic syndromes such as familial polyposis coli. Radiological cross imaging studies such as CT and MRI are used in the preoperative work-up of such tumors. Postoperatively, CT and MRI are useful in the assessment of recurrent desmoid tumors. MRI is more accurate in tissue characterization. Where possible, surgical resection remains the standard first-line treatment. For patients where surgery is not possible, or the resection margins are not clear, other forms of treatment are possible. These include hormonal and nonhormonal options. We present a case of a recurrent sporadic intra-abdominal (mesenteric) desmoid tumor. Such an entity is rare with few cases reported in the literature. Treatment options regarding intra-abdominal desmoid tumors will be discussed.
Benign Recurrent Sixth Nerve Palsy in a Child
Authors: Rita Gonçalves, Pedro Coelho, Carlos Menezes, Isabel Ribeiro
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Benign recurrent sixth nerve palsy in children is rare. It typically occurs following viral illness or immunization, and prognosis is usually excellent. However, it is always a diagnosis of exclusion given the more serious alternative causes. Therefore, a thorough examination with brain imaging is recommended. The authors report a child with six recurrent episodes of isolated benign sixth nerve palsy.
Surgical Treatment for Severe Scoliosis in Patients with Reduced Cardiorespiratory Function after Surgery for Congenital Heart Disease: A Report of Two Cases
Authors: Hayato Kinoshita, Naohisa Miyakoshi, Michio Hongo, Akiko Misawa, Daisuke Kudo, Yoichi Shimada
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Purpose:
Congenital heart disease (CHD) is associated with an increased risk of scoliosis. The prognosis of scoliosis patients with CHD has improved because of advances in cardiac care. As a result, the frequency of surgery for scoliosis in this population has increased, although the risk of perioperative complications remains high. We treated two patients with CHD who underwent surgery for severe scoliosis. To avoid perioperative complications, we evaluated the preoperative cardiac status and anesthetic risks before posterior correction and fixation in both patients.
Methods:
An expert anesthesiologist evaluated the anesthetic risk in each case, and an adequate reservoir of autologous blood was collected preoperatively. The patient in case 1 was at risk of significant blood loss and required extremely careful operative technique. The patient in case 2 had low cardiac output preoperatively. We therefore performed a thorough preoperative cardiac evaluation. Both patients were admitted to the intensive care unit postoperatively.
Results:
Neither patient suffered serious complications, and both achieved favorable outcomes.
Conclusions:
Appropriate surgical technique and teamwork among experts are the keys to success in patients with severe scoliosis and CHD.
Solitary peripheral ivory osteoma of the mandible presenting with difficulty in deglutition: a case report
Authors: Kumar Nilesh, Aaditee V Vande, Suresh K Veerabhadrappa
Journal: J Dent Res Dent Clin Dent Prospects (2017)
Keywords: jaw, osteogenic tumor, radiopaque lesion, swallowing
MeSH terms: Case Reports

Osteomas are benign bone tumors which arise from the cortex or medulla of craniofacial and jaw bones. They are usually asymptomatic or present as slow-growing painless masses. Larger lesions may present with aesthetic (facial asymmetry) and functional disturbances (jaw deviation, difficulty in breathing, pain, and sensory deficits). This paper highlights a case of solitary peripheral osteoma composed of a compact bony mass arising from the lower border of the mandible in an adult female patient. The lesion presented with discomfort during deglutition, which was attributed to impingement of muscles of the oral cavity floor, including the anterior belly of digastric muscle.
Idiopathic Sclerosing Encapsulating Peritonitis in a Patient with Atypical Symptoms and Imaging Findings
Authors: Joseph Wetherell, Katherine Woolley, Rishi Chadha, Julia Kostka, Edin Adilovic, Pankaj Nepal
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Sclerosing encapsulating peritonitis is a rare condition caused by a fibrotic membrane covering the small bowel which may lead to abdominal pain or obstruction. The cause may be primary and idiopathic or secondary to several diseases, treatments, and/or medications. The condition typically presents with bowel obstruction, and only one previous case has described ascites as the presenting sign. Sclerosing encapsulating peritonitis is typically diagnosed intraoperatively. We present a case of a patient who presented with atypical clinical symptoms including respiratory distress, recurrent abdominal ascites, and failure to thrive who was diagnosed nonoperatively.
Treatment of anxiety disorders and comorbid alcohol abuse with buspirone in a patient with antidepressant-induced platelet dysfunction: a case report
Authors: Mir Mazhar, Tariq Hassan, Tariq Munshi
Journal: Case Rep Psychiatry (2013)

The risk of abnormal bleeding with serotonin reuptake inhibitors has been known, but there is insufficient evidence base to guide pharmacological treatment of anxiety in patients with underlying haematological conditions. The following case report is about a 50-year-old female with generalized anxiety disorder, social phobia, obsessive compulsive disorder, and alcohol abuse where pharmacological treatment of anxiety symptoms has been difficult as it would lead to bruising due to the patient's underlying qualitative platelet dysfunction. Treatment with venlafaxine, citalopram, escitalopram, and clomipramine resulted in improvement and anxiety symptoms, as well as reduction in alcohol use, but pharmacological treatment has to be discontinued because of bruising and hematomas. In view of an active substance use disorder, benzodiazepines were avoided as a treatment option. The patient's anxiety symptoms and comorbid alcohol abuse responded well to pharmacological treatment with buspirone which gradually titrated up to a dose of 30 mg BID. Patient was followed for around a six-month period while she was on buspirone before being discharged to family doctor's care. Buspirone is unlikely to have a significant effect on platelet serotonin transponder and could be an effective alternative for pharmacological treatment of anxiety in patients with a bleeding diathesis.
Two Cases of Transverse Testicular Ectopia in Consanguineous Boys
Authors: Mohamed Abdelmalak, Saber Waheeb, Ahmed Koraitim, Dina Mahdy, Deena Mustafa Abd ElMigeid
Journal: European J Pediatr Surg Rep (2018)
Keywords: dw-mri, testicular pesudoduplication, transverse testicular ectopia
MeSH terms: Case Reports

Crossed testicular ectopia (CTE)/transverse testicular ectopia (TTE) is a rare condition occurring in only 1 in 4 million male patients, in which both testes migrate toward the same hemiscrotum. We report on two cases of TTE in first degree cousins (1 + 3 years of age). Both presented with right nonpalpable testis. On diffusion-weighted magnetic resonance imaging, the right testis was located above the left testis in both patients. Right orchiopexy was performed after passing the right testis through the median raphe of the scrotum followed by ipsilateral left scrotal orchiopexy.
Case Report: rare hybrid lesion of a central giant cell granuloma within a juvenile ossifying fibroma
Authors: Hadeer Rizk Saad, Noura M Kamal, Hatem W Amer
Journal: F1000Res (2019)
Keywords: aggressive lesion, central giant cell granuloma, fibrous dysplasia, hybrid lesion, juvenile ossifying fibroma, pathology
MeSH terms: Bone Neoplasms, Fibroma, Ossifying, Granuloma, Giant Cell, Case Reports, Biopsy, Child, Female, Humans, Tomography, X-Ray Computed

Central giant cell granuloma (CGCG) is classified by the World Health Organization as a benign bone lesion. It is found anteriorly in the mandible, with most of the cases crossing the midline. In total, 70% of CGCGs are encountered in young females. Fibro-osseous lesions are a group of pathologies that encompass neoplastic, dysplastic and reactive entities. Juvenile ossifying fibroma, which can be further categorized into juvenile trabecular ossifying fibroma (JTOF) and juvenile psammomatoid ossifying fibroma, represents an aggressive neoplastic example of these fibro-osseous lesions. JTOF occurs in children at almost equal ratios in both sexes, affecting the maxilla more than mandible. This study aims to report a peculiar case of a hybrid lesion comprising CGCG and JTOF in the mandible of a nine-year-old female patient. Clinical, radiographic and histopathological findings were assessed. Clinical examination revealed an intraoral swelling extending from the right impacted third molar area to the left first molar area. Computed tomography showed a well-defined multilocular radiolucency with diffuse flecks of radioopacities. Histopathologically, the lesion comprised fibrous connective tissue encompassing numerous multinucleated giant cells and other areas of cell-rich connective tissue stroma containing bands of osteoid matrix and anastomosing immature bone trabeculae intermixed with scattered clusters of multinucleated giant cells. We hereby report a case of a rare hybrid lesion comprising CGCG and JTOF.