OpenMed/multicare-articles huggingface dataset:
Case Report: The Different Fates of Three Aneurysms: Diagnosis and Treatment Strategies for Unruptured Intracranial Aneurysms With Other Intracranial Diseases
Authors: Gaochao Guo, Liming Zhao, Ruiyu Wu, Bingqian Xue, Shao Zhang, Hao Liang, Tao Gao, Yuxue Sun, Yang Liu, Chaoyue Li
Journal: Front Surg (2022)
Keywords: aneurysm, intracranial diseases, management strategy, surgery, unruptured intracranial aneurysm (uia)
MeSH terms: Case Reports

Intracranial aneurysms are vascular diseases characterized by local aneurysms of intracranial arteries. Their etiology involves a variety of environmental and genetic factors. Unruptured intracranial aneurysms (UIAs) are more common in intracranial aneurysms, but once an aneurysm is ruptured, the fatality rate and disability rate are extremely high. Therefore, accurate assessment of each step in the detection of intracranial aneurysms, assessment of the risk of rupture, formulation of treatment strategies, and treatment benefits will help to better treat the disease. At present, the treatment of intracranial aneurysms is limited. Except for surgical intervention, there are no other effective methods. Therefore, when a patient has a UIA, the formulation of treatment and management strategies is a difficult issue facing neurosurgery. This article introduces the choice of different treatment strategies for 3 patients with intracranial aneurysms complicated with other diseases and reviews the literature.
A Case of Childhood Severe Paroxysmal Cold Hemoglobinuria with Acute Renal Failure Successfully Treated with Plasma Exchange and Eculizumab
Authors: Jessica Pelletier, Chad Ward, Matthew Borloz, Anne Ickes, Susan Guelich, Erwood Edwards Jr
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

We describe the case of a 4-year-old female who presented with sepsis and disseminated intravascular coagulation (DIC), developed ongoing intravascular hemolysis with acute renal failure from suspected pigment-induced acute tubular necrosis necessitating continuous renal replacement therapy (CRRT) for five days followed by four episodes of intermittent hemodialysis (iHD), and was subsequently diagnosed with paroxysmal cold hemoglobinuria (PCH). She was successfully treated with plasma exchange and eculizumab, a humanized monoclonal antibody targeting complement protein C5, and demonstrated significant improvement of hemolysis and recovery of renal function.
Deceased Donor Renal Transplantation Combined with Bilateral Nephrectomy in a Patient with Tuberous Sclerosis and Renal Failure
Authors: R Novotny, J Chlupac, T Marada, S Bloudickova-Rajnochova, H Vavrinova, L Janousek, J Fronek
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Introduction:
A 27-year-old female patient with known tuberous sclerosis complex (TSC), polycystic kidneys with multiple large bilateral angiomyolipomas, and failing renal functions with prehemodialysis values (urea: 19 mmol/L; creatinine: 317 μmol/L; CKD-EPI 0,27) was admitted to our department for pre-renal transplant evaluation. The patient was placed on the transplant waiting list as the living donor did not pass pretransplant workup and was subsequently contraindicated. Patient was placed on the "cadaverous kidney transplant waiting list".
Method:
Computed tomography angiography revealed symptomatic PSA in the right kidney angiomyolipoma (AML). The patient underwent urgent transarterial embolisation of the PSA's feeding vessel in the right kidney AML. Based on the "kidney transplant waiting list" order patient underwent a bilateral nephrectomy combined with transperitoneal renal allotransplantation of a cadaverous kidney graft through midline laparotomy, appendectomy, and cholecystectomy.
Results:
Postoperative period was complicated by delayed graft function caused by acute tubular necrosis requiring postoperative hemodialysis. The patient was discharged on the 17th postoperative day with a good renal graft function. Patient's follow-up is currently 23 months with good graft function (urea: 9 mmol/L; creatinine: 100 μmol/L).
Conclusion:
Renal transplantation combined with radical nephrectomy provides a definitive treatment for TSC renal manifestations.
Exploring the design of a sport for employability program: A case study
Authors: Tessa Commers, Marc Theeboom, Fred Coalter
Journal: Front Sports Act Living (2022)
Keywords: flanders (belgium), neets, sport for development, sport for employability, theory of change

Rates of young people who are neither in employment, education, or training (NEET) are fairly high in the European Union. Correspondingly, there has been a growing tendency to regard sport as a suitable tool to develop soft skills and raise NEETs' level of employability. However, if and how such sport for employability (SfE) programs are able to realize these major claims has been called into question. The purpose of the present study was, therefore, to explore how an actual SfE initiative constructs and delivers its program. In addition, the article assessed whether the investigated program operates in line with researchers' recent calls for theory-based approaches. Guided by a case study approach set up within an initiative located in Flanders, data were gathered through 12 semi-structured interviews with 8 program providers. Results, analyzed using thematic analysis, indicated that the program was characterized by an absence of well-defined desired outcomes, imprecision as to how the program should contribute to these outcomes, and consequently minimal attention to the follow-up of participants' progress. As such, these findings and the accompanying challenges point to the absence of a theory-based approach. Several possible sources for the lack of a systematic approach are discussed.
Lateral Periodontal Cyst - A diagnostic dilemma: Report of a rare case with CBCT and histological findings
Authors: Roshni Ramesh, Arun Sadasivan
Journal: Int J Surg Case Rep (2020)
Keywords: cbct, case report, developmental cyst, endodontically treated tooth, gingivectomy, lateral periodontal cyst
MeSH terms: Case Reports

Introduction:
Lateral Periodontal Cyst (LPC) is considered as a rare developmental odontogenic cyst. It is often diagnosed as an incidental radiographic finding, presenting as a circumscribed round radiolucent area between the roots of vital teeth. LPC usually does not present any clinical features. Differentiating the origin of the lesion from an endodontic or periodontal perspective presents as clinical challenge.
Presentation of case:
A female patient presented with an asymptomatic gingival swelling in the lingual aspect of mandibular anterior region. The associated tooth (#34) was endodontically treated 3 years back. A periapical radiograph showed a well-defined round radiolucency on the tooth. Cone beam computed tomography (CBCT) revealed extensive bone destruction. The lesion was surgically excised and histological examination confirmed the diagnosis of LPC. The site healed satisfactorily post-operatively. The case was followed up for a year without any recurrence seen.
Discussion:
LPC is a very rare clinical entity, the diagnosis of which requires a detailed case history taking, clinical and radiographic examination are essential to get proper assessment of the pathology. It is said to originate from either the remnants of dental lamina, reduced enamel epithelium or rests of Malassez. LPC presents with a typical histological picture which ensures the confirmatory diagnosis. Surgical enucleation with thorough curettage is the treatment of choice.
Conclusion:
By reporting this rare case, we would like to stress to clinicians that there are a wide range of cysts and anatomic structures are present in the canine-premolar region of mandible of which LPC is a rare possibility.
Central Nervous System Xanthoma Disseminatum: Response to 2CdA in an Adolescent
Authors: Patrick DeMoss, Nancy Tang, Kristen Yeom, Audris Chiang, Ann L Marqueling, Michael R Jeng
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Xanthoma disseminatum is a normolipemic non-Langerhans cell histiocytosis characterized by red-brown rubbery papules of the skin which coalesce into plaque-like lesions with symmetric involvement of face, flexor, and intertriginous areas. Less commonly, xanthoma disseminatum may affect mucosal linings, abdominal organs, and the central nervous system, leading to endocrinopathies. We report a 12-year-old adolescent with mucosal, central nervous system, and painful cutaneous lesions, further complicated by diabetes insipidus and amenorrhea. Treatment with 2-chlorodeoxyadenosine led to relief of pain and significant improvement of mucosal, central nervous system, and cutaneous lesions, with subsequent restoration of menstrual cycles.
Intraventricular Silicone Oil: A Case Report
Authors: Stéphane Mathis, Michèle Boissonnot, Jean-Pierre Tasu, Charles Simonet, Jonathan Ciron, Jean-Philippe Neau
Journal: Medicine (Baltimore) (2016)
MeSH terms: Optic Nerve / metabolism, Silicone Oils / metabolism, Therapeutic Occlusion / adverse effects, Case Reports, Aged, 80 and over, Cerebral Ventricles / metabolism, Female, Humans, Retinal Detachment / therapy, Therapeutic Occlusion / methods, Silicone Oils

Intracranial silicone oil is a rare complication of intraocular endotamponade with silicone oil. We describe a case of intraventricular silicone oil fortuitously observed 38 months after an intraocular tamponade for a complicated retinal detachment in an 82 year-old woman admitted in the Department of Neurology for a stroke. We confirm the migration of silicone oil along the optic nerve. We discuss this rare entity with a review of the few other cases reported in the medical literature. Intraventricular migration of silicone oil after intraocular endotamponade is usually asymptomatic but have to be known of the neurologists and the radiologists because of its differential diagnosis that are intraventricular hemorrhage and tumor.
Chromobacterium violaceum Isolated from a Wound Sepsis: A Case Study from Nepal
Authors: Shamshul Ansari, Pramod Paudel, Kishor Gautam, Sony Shrestha, Sangita Thapa, Rajendra Gautam
Journal: Case Rep Infect Dis (2015)

Chromobacterium violaceum is a facultative anaerobic, Gram-negative rod, prevalent in tropical and subtropical regions. It enters through the skin injury and is capable of causing severe systemic infections leading to septic shock and multiorgan failure. It has been reported by few authors across the world but this is probably the first case of Chromobacterium violaceum isolated from wound sepsis from Nepal. In this study, a pus sample from the infection of a prick injury in the left middle finger was collected from the patient admitted to the intensive care unit. Bacteriological investigations of the pus sample revealed the causative organism to be Chromobacterium violaceum. This case study indicates that Chromobacterium violaceum can act as a potential cause of wound sepsis that may lead to the septic shock and if not treated timely, the mortality rate can be high as was in this study. Although this organism is very rare, the infection caused requires prompt treatment to minimize the mortality rate. Therefore, we recommend the timely diagnosis and antimicrobial therapy of this infection to combat the consequences led.
Spontaneous Spinal Epidural Hematoma in a Patient on Apixaban for Nonvalvular Atrial Fibrillation
Authors: Ahmad El Alayli, Logeswari Neelakandan, Hicham Krayem
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

Background:
With the rise in the use of direct oral anticoagulants (DOACs), more hemorrhagic complications are being encountered. Since the first description of a case of spontaneous spinal epidural hematoma (SSEH) related to the utilization of DOACs in 2012, there have been few reports describing a similar association. However, no cases so far have reported an association between SSEHs and apixaban. Case Description: A 76-year-old lady, with a history of nonvalvular atrial fibrillation, presented with a new onset of progressive left lower and upper extremity weakness. She reported back pain and numbness in the left leg up to the knee along with numbness in the left arm up to the shoulder. A CT scan of the neck was suggestive of an epidural hematoma extending from C2-C3 level to C6-C7. As the patient was on apixaban at the time, surgical treatment was delayed for two days to decrease the risk of intraoperative bleeding. Nine days later, she was discharged. Her physical exam was almost unchanged from that on presentation, except for resolution of pain and minimal improvement in motor power in her left lower extremity from 1/5 to 2/5 distally.
Conclusions:
Spinal hematomas represent surgical emergencies with earlier intervention portending better outcome. Based on the few case reports that point to DOACs as a potential culprit, it appears that a high suspicion index resulting in earlier SSEH diagnosis and intervention is crucial for improved neurological outcome and recovery. Prompt diagnosis remains a challenge, especially that SSEH can mimic cerebrovascular accidents.
Fulminant amoebic colitis in the era of computed tomography scan: A case report and review of the literature
Authors: Suman Mewa Kinoo, Vikesh V Ramkelawon, Jaynund Maharajh, Bugwan Singh
Journal: SA J Radiol (2018)
MeSH terms: Case Reports

Amoebic colitis, caused by ingestion of water or food contaminated with the protozoan Entamoeba histolytica, can progress to a fulminant colitis. Computed tomography (CT) findings reported in the literature on this type of colitis are sparse. We present a 59-year-old male patient with a one-week history of progressive abdominal pain, abdominal distension and associated watery and bloody diarrhoea. A CT scan revealed deep ulcerations with submucosal and intramural tracking of contrast. Colonoscopy and biopsy confirmed a diagnosis of Amoebic colitis. The patient required a laparotomy and demised. Deep ulcerations with submucosal and intramural tracking of contrast on CT are diagnostic of fulminant amoebic colitis. Although not demonstrated at CT in this case, discontinuous bowel necrosis, omental wrapping (seen at laparotomy in our case) and neovascularisation of the bowel wall may be other features to look out for.
Forgotten indwelling stent in a transplanted kidney: a case report
Authors: Shaheel Bhuva, Steven J Kennish, Tze M Wah
Journal: Cases J (2009)

Introduction:
Forgotten or retained ureteric stents are a well-recognised phenomenon with the potential to cause a range of complications, the most dangerous of which is obstructive nephropathy. These risks are potentially devastating when the patient has a single functioning transplanted kidney. Here we describe the case of a renal transplantation patient with a forgotten ureteric stent of 10 years, who presented with irritative bladder symptoms and was successfully managed using a multimodal urological approach with specialist advice on antibiotic prophylaxis. To the best of our knowledge this is the longest documented time period for a forgotten ureteric stent in a transplantation patient and is unusual in that obstructive nephropathy did not occur. *
Case presentation:
A 32-year-old man with a history of end stage renal failure of unknown aetiology received a cadaveric renal transplant in 1995. An indwelling JJ stent was placed at the time of transplant to protect the vesicoureteric anastomosis. The patient made an unremarkable recovery and initially attended regular follow up in the renal transplant clinic. He was subsequently lost to transplant clinic follow up. In 2005 at the age of 42 he was referred to a nephrologist with irritative bladder symptoms. Renal tract imaging with ultrasound and a plain film demonstrated a retained encrusted ureteric stent. *
Conclusion:
The removal of a retained encrusted ureteric stent always provides a urological challenge. This case demonstrates that multimodal treatment involving a combination of endourological and percutaneous techniques can be employed with success even when the patient has a heavily encrusted stent for a single functioning transplanted kidney. Involvement of a microbiologist to advise on prophylactic antibiotics is deemed especially useful, as the immunosuppressed transplant patient is at particular risk of sepsis secondary to bacteraemia as a result of the endoscopic manipulation of the colonised encrusted stent. This case also provides further evidence to highlight the potential benefits of a stent registry.
Surgical Resection of Native Viscera to Manage Persistent Ascites after Multivisceral Transplant
Authors: Brian I Shaw, Andrew S Barbas, Debra L Sudan
Journal: Case Rep Transplant (2020)
MeSH terms: Case Reports

Multivisceral transplantation is the therapy of choice in patients with diffuse portomesenteric thrombosis. In the present case, we describe a patient who had persistent ascites after multivisceral transplant. The patient was initially diagnosed with a chyle leak which was cured via embolization. When this did not cure her ascites, reexploration proved the etiology to be at least partially attributable to persistent hypertension in the retained viscera. This was cured with the resection of her native viscera. This case highlights the importance of resection of all congested viscera at the time of transplantation in patients with diffuse portomesenteric thrombosis, the utility of preoperative embolization techniques in assisting this, and also the ability to perform delayed resection if necessary.
Forty-Three-Year-Old Female with Dopamine Secreting Pheochromocytoma of the Adrenal Gland
Authors: Tyler Haden, Marcin Zuberek, Naveen Pokala
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

We report on a 43-year-old, asymptomatic female who presented with incidental finding of left adrenal mass. MRI gave concerns for possible pheochromocytoma but markers for pheochromocytoma were not elevated as expected. 24-hour urine dopamine levels (6988 μg/day) were significantly elevated. The patient successfully underwent robotic assisted radical left adrenalectomy and was diagnosed with a dopamine secreting pheochromocytoma. Pathology revealed increased malignant potential associated with the tumor. The patient underwent full metastatic workup, which was negative. At two years of follow-up there was no recurrence and normalization of lab values.
Case Report: Technetium-99m Pertechnetate Scintigraphy Findings in a Dog With Iodine Deficiency-Induced Goitrous Hypothyroidism
Authors: Taesik Yun, Yejin Na, Dohee Lee, Yoonhoi Koo, Yeon Chae, Hyeyeon Nam, Byeong-Teck Kang, Mhan-Pyo Yang, Hakhyun Kim
Journal: Front Vet Sci (2022)
Keywords: 99mtco4-, canine, goiter, home-cooked diet, hypothyroidism, nuclear medicine, scintigraphy, urinary iodine concentration
MeSH terms: Case Reports

There is only one previous report of canine goitrous hypothyroidism caused by iodine deficiency from 1986. The present case report describes the novel diagnostic methods and long-term outcomes of a dog diagnosed with goitrous hypothyroidism caused by iodine deficiency. A 4-year-old neutered, female Pomeranian dog presented with a cervical mass, lethargy, and inactivity. The dog had a history of eating home-cooked diets sold by a private seller for 1 year. The physical examination and ultrasonography showed two bilaterally symmetric masses in the mid-cervical area (left, 1.8 × 1.4 cm; right, 2.3 × 1.8 cm), and they were suspected to be the thyroid glands. To identify the function of the thyroid gland, the basal concentrations of thyroid hormones [total T4 (tT4) and thyroid-stimulating hormone (TSH)] were measured and a TSH stimulation test was performed: baseline tT4, 0.5 μg/dL (reference interval, 1-4 μg/dL), baseline TSH, 0.81 μg/dL (reference interval, 0.05-0.42 μg/dL), and post-tT4, 1 μg/dL (6 h after the injection of TSH). The values indicated primary hypothyroidism. The urinary iodine concentration was 302 μg/L, which was markedly lower than that of normal dogs (1,289 μg/L). Thyroid scintigraphy with technetium-99m pertechnetate was also performed to quantify the activity of the thyroid gland, and the thyroid-to-salivary ratio was 3.35. Based on the results of these examinations and patient history, the dog was diagnosed with diet-induced (iodine deficiency) goitrous hypothyroidism. The dog was treated with iodine (62.5 μg/day). At 31 days after treatment, clinical signs and thyroid hormones were normalized (tT4, 1.3 μg/dL; TSH, 0.24 μg/dL). One year after treatment, the dog was well with normal concentrations of thyroid hormones (tT4, 1.8 μg/dL; TSH, 0.27 μg/dL) and a partially reduced goiter (left, 1.6 × 1.1 cm; right, 1.2 × 0.9 cm). This is the first case to describe novel diagnostic methods and long-term outcomes of a dog diagnosed with goitrous hypothyroidism caused by iodine deficiency.
Pitfalls in emergency department focused bedside sonography of first trimester pregnancy
Authors: Kerri Layman, Michael Antonis, Jonathan E Davis
Journal: Emerg Med Int (2013)

Background. Bedside sonography performed by emergency physicians is frequently utilized for real-time clinical decision-making in the emergency department (ED) setting. This includes the sonographic evaluation of pain or bleeding in the first trimester of pregnancy. The detection of intrauterine pregnancy (IUP) or life-threatening conditions, including ectopic pregnancy, is critical. Objectives. This paper will review several important pearls and avoidable pitfalls of this diagnostic modality by brief presentation of illustrative cases followed by discussion of key principles. Case Reports. Three patients evaluated in the ED for bleeding or pain occurring during the first trimester of pregnancy will be presented. Conclusions. When conducting emergency bedside ultrasound for the evaluation of first trimester pregnancy, it is important to avoid common pitfalls that can place your patient at risk.
Malignant Transformation of Testicular Teratoma to PNET, Adenocarcinoma, and Osteosarcoma with Complete Remission after Surgery and Combination Chemotherapy in a Young Adult Male
Authors: Angela Shaw, Miriam Morrell, Annikka Weissferdt, Andrea Hayes-Jordan, Douglas Harrison
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Mixed germ cell tumors (GCT) with teratoma components can transform into somatic malignancies which can include histologies outside of traditional germ cell lineages. We describe a case of an 18-year-old man with a metastatic testicular GCT with both mature and immature teratoma components containing malignant transformation into multiple histologies including PNET in the primary testicular tumor and osteosarcoma in a separate pulmonary metastatic lesion. Management with targeted chemotherapy resulted in a durable remission. This is the first reported case that we know of a patient with primary PNET malignant transformation with subsequent metastatic transformation to osteosarcoma.