OpenMed/multicare-articles huggingface dataset:
Diagnostic Colonoscopy Leading to Perforated Appendicitis: A Case Report and Systematic Literature Review
Authors: Daniel Paramythiotis, Konstantinia Kofina, Vasileios Papadopoulos, Antonios Michalopoulos
Journal: Case Rep Gastrointest Med (2016)

Introduction. Intestinal perforation is a known complication after colonoscopy. However, appendiceal involvement with inflammation and perforation is extremely rare and only 37 cases of postcolonoscopy appendicitis have been reported so far. We describe a case of perforated appendicitis 24 hours after colonoscopy that was treated successfully in our Department. Case Report. A 60-year-old female patient underwent a colonoscopy during the investigation of nontypical abdominal pain without pathologic findings. 24 hours after the examination she presented gradually increased right lower quadrant abdominal pain and a CT scan was performed, showing an inflammation of the appendiceal area with free peritoneal air. Through laparotomy, perforated appendicitis was diagnosed and an appendectomy was performed. The patient was discharged on the tenth postoperative day in good health condition. Discussion. The characteristics of all cases reported in the literature are described, including our case. Perforated appendicitis soon after a colonoscopy is a rare, but serious complication; therefore, it is crucial to be included in the differential diagnosis of postcolonoscopy acute abdominal pain.
Isolated Oculomotor Nerve Palsy Following Minor Head Trauma; a Case report
Authors: Iraj GoliKhatir, Hamed Aminiahidashti, Hasan Motamed Motlagh, Seyed Farshad Heidari
Journal: Emerg (Tehran) (2017)
Keywords: tomography, craniocerebral trauma, magnetic resonance imaging, oculomotor nerve diseases, x-ray computed
MeSH terms: Case Reports

Isolated third nerve palsy develops in numerous intracranial pathologies such as closed head trauma, tumor, and aneurysm. This report describes a 61 years old female with an abrasion on the left forehead and ptosis of the left eye. Initial computed tomography did not reveal any causative cerebral and vascular lesions or orbital and cranial fractures. High-resolution and multi-axial enhanced Magnetic resonance imaging (MRI) can be helpful in diagnosis and monitoring of patients with this rare phenomenon.
Case Report: Two Is Not (Always) Better Than One: Pyloric Gland Adenoma of the Gastric Cardia and Concurrent Neuroendocrine Cell Dysplasia Arising From Autoimmune Gastritis
Authors: Camilla Guerini, Marco Vincenzo Lenti, Chiara Rossi, Giovanni Arpa, Andrea Peri, Anna Gallotti, Antonio Di Sabatino, Alessandro Vanoli
Journal: Front Med (Lausanne) (2022)
Keywords: ecl cell dysplasia, autoimmune gastritis, gastric carcinogenesis, immune microenvironment, pyloric gland adenoma
MeSH terms: Case Reports

Autoimmune gastritis is a chronic immune-mediated disorder characterized by varied clinical manifestations and that should be endoscopically managed over time, as the gastric atrophy contributes to microenvironmental alterations of the stomach milieu, and an increased cancer risk has been linked to this condition. Here, we report the unusual case of a woman who developed a cardiac high-grade pyloric adenoma in a context of previously undiagnosed autoimmune gastritis with synchronous neuroendocrine cell hyperplastic and dysplastic lesions.
Use of Remdesivir in the treatment of Coronavirus Disease 2019 (COVID-19) infection among Sudanese patients: a case series
Authors: Maysoun Yousif, Ghada Abd El-Raheem, Doaa Mohamed
Journal: F1000Res (2021)
Keywords: covid-19, imperial hospital, remdesivir, sudan, sudanese patients, hypotension, liver enzymes, treatment
MeSH terms: COVID-19 Drug Treatment, Case Reports, Adenosine Monophosphate / analogs & derivatives, Alanine / analogs & derivatives, Antiviral Agents / therapeutic use, Humans, Male, SARS-CoV-2, Antiviral Agents, remdesivir, Adenosine Monophosphate, Alanine

Introduction: The coronavirus disease 2019 (COVID-19) pandemic is affecting populations worldwide. Remdesivir is an anti-retroviral agent, with a broad spectrum of usage. Remdesivir usage against COVID-19 had been studied both in vitro and in vivo but is still considered a new treatment for COVID-19 and is not available in all countries. The aim of our study was to report several cases of the use of Remdesivir in Sudanese patients and report the adverse events related to the course of treatment. Methods: A case series study was conducted in Imperial Hospital, Khartoum, Sudan reporting two cases who received Remdesivir for treating COVID-19 besides other treatments such as steroids and supportive therapy in December 2020. Cases were males aged over 65 years. Cases presentation: Both patients were severe cases of COVID-19 admitted to the intensive care unit (ICU), who received Remdesivir for treating COVID-19 infection. Several side effects were reported: the first case had increased liver enzymes and then unexpectedly died from severe resistant hypotension; and hypoalbuminemia was noticed in the second case. Conclusions: Remdesivir use among patients in Sudan must be studied extensively in order to determine the unexpected fatal event and assess the association of this event to Remdesivir use, as well as to report the frequency of the side effects.
Intestinal occlusion by stenotic neuroendocrine tumours of left colon and concomitant association with small bowel gastrointestinal stromal tumours: A case report
Authors: M Amoruso, V Papagni, A Picciariello, V L Pinto, D D'Abbicco, A Margari
Journal: Int J Surg Case Rep (2018)
Keywords: adenocarcinoma, colorectal, gist, net

Introduction:
The association between Gastrointestinal Stromal Tumours (GIST) and Neuroendocrine Tumours (NET) is very rare. These tumours have various clinical expressions and sometimes are asymptomatic. Synchronous NETs and GISTs have been already described in literature in few case reports. On the other hand, there is no mention of concomitant presence of discending colon NEC-G3 and small intestinal GIST.
Presentation of case:
we presented a case of a patient with clinical evidence of intestinal occlusion and radiological and intraoperative aspects of an adenocarcinoma of the left colon with a single metastasis on small bowel. The pathology analysis of the tumour showed a stenotic left colon NEC-G3 and a small bowel GIST.
Discussion:
In this case report GIST was surgically treated as a small bowel ripetitive lesion and NET as a left colon adenocarcinoma. These tumours may have a similar presentation in terms of symptoms, endoscopic findings and imaging results.
Conclusion:
Concomitant NEC and GIST is rare but it is important to investigate patients before surgery in order to distinguish these from other tumours because of the different prognosis.
Mucocele in lower lip as a result of improper use of feeding bottle: a case report
Authors: S Ashok Kumar, Mahesh Ramakrishnan
Journal: Case Rep Dent (2013)

A rare case of mucocele associated with improper feeding habit has been presented. An eight-month old male child presented with swelling in lower lip which was noticed by his mother a week earlier. A thorough clinical examination and history taking gave a diagnosis of mucocele resulting from improper use of feeding bottle. This case highlights and discusses the history, the clinical along with histologic features, and the clinical management of this lesion. Awareness of such an entity and the functional problems associated with the lesion will help the pediatric dentist to prevent any further complications.
Fostering critical thinking skills: a strategy for enhancing evidence based wellness care
Authors: Jennifer R Jamison
Journal: Chiropr Osteopat (2005)

Chiropractic has traditionally regarded itself a wellness profession. As wellness care is postulated to play a central role in the future growth of chiropractic, the development of a wellness ethos acceptable within conventional health care is desirable. This paper describes a unit which prepares chiropractic students for the role of "wellness coaches". Emphasis is placed on providing students with exercises in critical thinking in an effort to prepare them for the challenge of interfacing with an increasingly evidence based health care system.
Methods:
This case study describes how health may be promoted and disease prevented through development of personalized wellness programs. As critical thinking is essential to the provision of evidence based wellness care, diverse learning opportunities for developing and refining critical thinking skills have been created. Three of the learning opportunities are an intrinsic component of the subject and, taken together, contributed over 50% of the final grade of the unit. They include a literature review, developing a client wellness contract and peer evaluation. In addition to these 3 compulsory exercises, students were also given an opportunity to develop their critical appraisal skills by undertaking voluntary self- and unit evaluation. Several opportunities for informal self-appraisal were offered in a structured self-study guide, while unit appraisal was undertaken by means of a questionnaire and group discussion at which the Head of School was present.
Results:
Formal assessment showed all students capable of preparing a wellness program consistent with current thinking in contemporary health care. The small group of students who appraised the unit seemed to value the diversity of learning experiences provided. Opportunities for voluntary unit and self-appraisal were used to varying degrees. Unit evaluation provided useful feedback that led to substantial changes in unit structure.
Conclusion:
Students have demonstrated themselves capable of applying critical thinking in construction of evidence based wellness programs. With respect to unit design, selective use of learning opportunities highlighted the desirability of using obligatory learning opportunities to ensure exposure to core constructs while student feedback was found to provide useful information for enriching unit review. It is hoped inclusion of critical thinking learning opportunities in the undergraduate chiropractic curriculum will contribute to the development of an evidence based ethos in chiropractic care.
Epidermoid cyst in an intrapancreatic accessory spleen with abnormally high CEA level in cyst fluid: a case report
Authors: Chun-Hai Lo, Po-Man Tsang, Shui-Ying Cheng, Cheuk-Nam Ling, Cheuk-Lam Ho
Journal: Autops Case Rep (2022)
Keywords: carcinoembryonic antigen, epidermal cyst, pancreas, spleen
MeSH terms: Case Reports

Epidermoid cyst in an intrapancreatic accessory spleen is a rare benign lesion that is difficult to diagnose preoperatively. Cyst fluid analysis for biochemistry markers has been widely used to aid the diagnosis of pancreatic cysts. A high cyst fluid carcinoembryonic antigen (CEA) level (>800 ng/mL) is said to be useful in distinguishing intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN) from other non-mucinous cysts. We herein report a case of epidermoid cyst in an intrapancreatic accessory spleen with abnormally high CEA level (3582 ng/mL) in the cyst fluid, suggesting a potential pitfall in using cyst fluid CEA level as an indicator of mucinous neoplasms.
Sepsis-Induced Takotsubo Cardiomyopathy Leading to Torsades de Pointes
Authors: Nirav Patel, Abhishek Shenoy, George Dous, Haroon Kamran, Nabil El-Sherif
Journal: Case Rep Cardiol (2016)

Background. Takotsubo cardiomyopathy (TCM) is sudden and reversible myocardial dysfunction often attributable to physical or emotional triggers. Case Report. We describe a 51-year-old man presented to emergency department with sepsis from urinary tract infection (UTI). He was placed on cefepime for UTI and non-ST-elevation myocardial infarction protocol given elevated troponins with chest pain. Subsequently, patient was pulseless with torsades de pointes (TdP) and then converted to sinus rhythm with cardioversion. An echocardiogram revealed low ejection fraction with hypokinesis of the apical wall. Over 48 hours, the patient was extubated and stable on 3 L/min nasal cannula. He underwent a cardiac catheterization to evaluate coronary artery disease (CAD) and was found to have mild nonobstructive CAD with no further findings. Conclusion. TCM is a rare disorder presenting with symptoms similar to acute coronary syndrome. Though traditionally elicited by physical and emotional triggers leading to transient left ventricular dysfunction, our case suggests that it may also be triggered by a urinary tract infection and lead to severe QT prolongation and a malignant ventricular arrhythmia in TdP.
Brachialis Muscle Rupture in a Pediatric Patient Followed Up by Ultrasound Examinations: A Rare Case Report
Authors: Akihiro Yamaji, Masafumi Uesugi, Hiroshi Kamada, Harumitsu Ichimura, Masashi Yamazaki
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

Isolated brachial muscle injuries are relatively rare injuries and reportedly occur during forced elbow extension. Though commonly conservative treatment approach is adopted, the treatment criteria remain unclear. Here, we report the case of a patient who experienced functional recovery after conservative treatment for an isolated brachial muscle injury. The patient was an 8-year-old boy whose chief complaint was left elbow pain. The injury occurred when the patient fell while playing on gymnastics bars and bruised the palmar side of his left elbow on the bar. Owing to the pain in the left elbow, the patient came to our institution. There were no clear signs of deformities or swelling in the left elbow and no obvious tenderness. X-ray and computed tomography (CT) imaging examinations revealed no signs of a fracture or dislocation, and the patient was diagnosed with left brachialis muscle rupture based on magnetic resonance imaging (MRI). Although the brachialis muscle was complete ruptured, a healing tendency was seen on body surface ultrasound examinations over time, and the patient was treated conservatively. After 3 weeks of cast immobilization, the patient underwent range of motion exercises. Two months after the injury, there were no issues with elbow joint function in daily life activities and no limitations in range of motion. Here, MRI was used to diagnose brachialis muscle rupture, and ultrasound examinations were utilized to make treatment decisions.
Inverted (Reverse) Takotsubo Cardiomyopathy following Cerebellar Hemorrhage
Authors: Sophie Piérard, Marco Vinetti, Philippe Hantson
Journal: Case Rep Cardiol (2014)

Background. First described in 2005, inverted takotsubo is one of the four stress-induced cardiomyopathy patterns. It is rarely associated with subarachnoid hemorrhage but was not previously reported after intraparenchymal bleeding. Purpose. We reported a symptomatic case of inverted takotsubo pattern following a cerebellar hemorrhage. Case Report. A 26-year-old woman presented to the emergency department with sudden headache and hemorrhage of the posterior fossa was diagnosed, probably caused by a vascular malformation. Several hours later, she developed acute pulmonary edema due to acute heart failure. Echocardiography showed left ventricular dysfunction with hypokinetic basal segments and hyperkinetic apex corresponding to inverted takotsubo. Outcome was spontaneously favorable within a few days. Conclusion. Inverted takotsubo pattern is a stress-induced cardiomyopathy that could be encountered in patients with subarachnoid hemorrhage and is generally of good prognosis. We described the first case following a cerebellar hematoma.
Chylomicronemia through a burr hole: A case report
Authors: Wann Jia Loh, Ramesh Bakthavachalam, Tavintharan Subramaniam, Sharon Pek, Fionn Chua, Lester Lee, Gerald F Watts
Journal: Front Cardiovasc Med (2022)
Keywords: cerebrospinal fluid (csf), chylomicronaemia syndrome, hypertriglyceridemia, lactescent subarachnoid haemorrhage, multifactorial chylomicronaemia syndrome, polygenic chylomicronemia, purulent cerebrospinal fluid, triglyceride (tg)
MeSH terms: Case Reports

Chylomicronemia has either a monogenic or multifactorial origin. Multifactorial chylomicronemia is the more common form and is due to the interaction of genetic predisposition and secondary factors such as obesity, diabetes, unhealthy diet, and medications. We report a case of a 38-year-old man who was diagnosed with multifactorial chylomicronemia following presentation with a subarachnoid hemorrhage requiring emergency surgery through a burr hole; lactescent cerebrospinal fluid mixed with blood was observed through the burr hole. The serum triglyceride concentration was 52⋅4 mmol/L with a detectable triglyceride concentration in the cerebrospinal fluid. Rapid weight gain leading to obesity and related unfavorable lifestyle factors were identified as key secondary causes of chylomicronemia. Gene testing revealed a homozygous variant in APOA5 and a heterozygous common variant in GPIHBP1. Accompanied with secondary causes, the interactions of gene and environmental conditions contribute to chylomicronemia. With aggressive medical treatment including excess weight loss, healthy diet, cessation of alcohol, and combination of anti-lipemic medications, normal plasma triglyceride levels were achieved.
Immunoglobulin G4 Sclerosing Cholangitis: An Unusual Cause of Obstructive Jaundice-Case Report and Literature Review
Authors: Pragya Shrestha, Brian Le, Brent Wagner, William Pompella, Paras Karmacharya
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

IgG4-related sclerosing cholangitis (IgG4-SC) is one of the most common extra-pancreatic manifestation of IgG4-related disease (IgG4-RD) and is clinically distinct from primary sclerosing cholangitis (PSC). IgG4-RD is an increasingly recognized immune-mediated fibroinflammatory systemic disease, mostly affecting middle-aged and older male populations that can affect multiple organs. The presence of extra-biliary clinical manifestations of IgG4-RD, such as parotid and lacrimal swelling, lymphadenopathy, autoimmune pancreatitis, and retroperitoneal fibrosis, if present could provide important clues to diagnosis. High serum IgG4 levels, characteristic radiological (e.g., sausage-shaped pancreas or periaortitis) or biopsy findings (high percentage of IgG4+ plasma cells, lymphoplasmacytic infiltrate, storiform fibrosis, or obliterative phlebitis) in the setting of these features is diagnostic of this disease process. However, isolated IgG4-SC might be a diagnostic challenge, and the distinction is important as management of this disorder is vastly different from other causes of cholangitis such as PSC. Systemic corticosteroid therapy is the mainstay of therapy.
Cerebral Aneurysms: A Rare Feature of Behçet's Disease-A Case Report and Review of the Literature
Authors: Samia Younes, Yosra Cherif, Narjes Mokni, Olfa Berriche, Baha Zantour, Amel Boughammoura, Mahbouba Frih-Ayed, Saida Jerbi, Mohamed Habib Sfar
Journal: Case Rep Neurol Med (2013)

Behçet's disease (BD) is a multisystem vascular inflammatory disease with several clinical manifestations. Intracranial aneurysms are an extremely rare but nevertheless severe complication of BD. We report a case of a 44-year-old man. The diagnosis of BD was made based on the presence of recurrent oral aphthous ulcers and positive human leukocyte antigen (HLA-) B51 in the absence of evidence of other diseases. MRI showed an ancient ischemic right capsulolenticular lesion, subacute white matter hypersignals of the left capsule lenticular region, and multiple arterial aneurysms. The patient underwent two-month systemic high-dose corticosteroids and immunosuppressive therapy associated with severe neurological deficiency upon admission and severe impairment upon discharge. A thorough review of the literature showed 20 case reports of intracranial aneurysms in BD.
Catamenial pneumothorax revealing diaphragmatic endometriosis: a case report and revue of literature
Authors: Sana Aissa, Wafa Benzarti, Faouzi Alimi, Imen Gargouri, Halima Ben Salem, Amène Aissa, Khadija Fathallah, Atef Ben Abdelkade, Rafika Alouini, Abdelhamid Garrouche, Abdelaziz Hayoun, Ahmed Abdelghani, Mohamed Benzarti
Journal: Pan Afr Med J (2017)
Keywords: catamenial pneumothorax, endometriosis, surgical treatment
MeSH terms: Diaphragm / pathology, Endometriosis / diagnosis, Pneumothorax / etiology, Case Reports, Review, Adult, Diaphragm / surgery, Endometriosis / complications, Endometriosis / surgery, Female, Follow-Up Studies, Gonadotropin-Releasing Hormone / agonists, Humans, Pneumothorax / diagnosis, Pneumothorax / surgery, Recurrence, Thoracic Surgery, Video-Assisted, Gonadotropin-Releasing Hormone, Catamenial pneumothorax

Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in women. We aim to discuss the etiology, clinical course, and surgical treatment of a 42-year-old woman with CP. This patient had a right-sided spontaneous pneumothoraces occurred one week after menses. She had under-gone video-assisted thoracoscopic surgery (VATS) because of a persistent air leak under chest tube. VATS revealed multiple diaphragmatic fenestrations with an upper right nodule. Defects were removed and a large part of the diaphragm was resected. Pleural abrasion was then performed over the diaphragm. Diaphragmatic endometriosis was confirmed by microscopic examination. Medical treatment with GnRH agonists was prescribed, and after recovery, the patient has been symptoms free for 20 months.
Should we treat pediatric radiologically isolated syndrome? An 18-year follow-up case report
Authors: Elena Barbuti, Riccardo Nistri, Antonio Ianniello, Carlo Pozzilli, Serena Ruggieri
Journal: Front Neurol (2023)
Keywords: ris, children, multiple sclerosis, pediatric radiologically isolated syndrome, treatment
MeSH terms: Case Reports

Background:
Radiologically isolated syndrome (RIS) describes asymptomatic individuals with incidental radiologic abnormalities suggestive of multiple sclerosis (MS). Much of RIS literature is about adult-onset cases. Treatment of RIS is controversial, especially in pediatric age, but early treatment in selected patients might improve long-term outcomes.
Case presentation:
We report a single RIS patient who followed up for 18 years in our MS center. At first, she was only monitored with follow-up MRIs. Then, as the lesion load increased, she was treated with a first-line disease-modifying treatment (DMT) reaching MRI stability.
Conclusion:
This report highlights how treatment can be an appropriate choice in pediatric forms of RIS.
The Impact of a Late Diagnosis: A Case of Charcot-Marie-Tooth Type 1
Authors: Fernando Albuquerque, Deolinda Cunha, Ana C Rodrigues, Rita Nunes, Filipe G Fernandes, Teresa Pipa, Ana Marques, Carla Moreira
Journal: Cureus (2023)
Keywords: charcot-marie-tooth, congenital, demyelinating diseases, gene expression, genetic mutation, neurology, pés cavus, sensorimotor neuropathy
MeSH terms: Case Reports

Charcot-Marie-Tooth (CMT) is a hereditary motor and sensory neuropathy. The disease consists of a spectrum of inherited disorders caused by pathogenic variants in genes, which lead to multiple different clinical phenotypes. It is one of the most common inherited neuromuscular disorders. This disease most commonly presents with symptoms of distal weakness and muscular atrophy, which then lead to foot drop and pés cavus. In this article, we describe the case of a patient who developed muscle atrophy and distal weakness over the course of his 52 years of life, leading to gait impairment and foot deformities. Subsequent investigation led to the acknowledgment of chronic axonal sensorimotor polyneuropathy and genetic identification of the disease's genotype, CMT type 1. .