OpenMed/multicare-articles huggingface dataset:
Cycling Induced Spontaneous Coronary Artery Dissection in a Healthy Male
Authors: Farrukh Nadeem Jafri, David Solarz, Craig Hjemdahl-Monsen
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

Introduction:
Spontaneous coronary artery dissection (SCAD) is a rare but important cause of acute coronary syndrome with a spectrum of disease that can include unstable angina, acute myocardial infarction, or sudden cardiac death. It has also been found in case reports to be caused by shear stress from physical exertion. We present a rare cycling induced SCAD that occurred in our institution in an otherwise healthy male with no cardiac risk factors.
Case presentation:
A 36-year-old male presented to the emergency department with complaints of lightheadedness and diaphoresis after a bicycle fall. In the emergency department, he complained of feeling lightheaded and diaphoretic and having mid back pain. Patient had an ECG performed which showed lateral ST segment elevation and troponin I that was positive. A coronary angiography was subsequently performed demonstrating a spontaneous coronary artery dissection of left anterior descending coronary artery.
Conclusion:
SCAD is a rare cause of myocardial infarction, occurring in healthy individuals, which is rarely reported in the literature. Nearly 70% are diagnosed in postmortem studies after sudden cardiac death. Only 12 cases have been reported from activities involving physical exertion and no studies to our knowledge demonstrate this.
Gorlin-goltz syndrome: case report of a rare hereditary disorder
Authors: Ashutosh Agrawal, Aditi Murari, Sunil Vutukuri, Arun Singh
Journal: Case Rep Dent (2012)

Introduction. Gorlin-Goltz syndrome is an inherited autosomal dominant disorder with complete penetrance and extreme variable expressivity. Case Report. The present paper highlights the importance of diagnostic criteria and histopathology in early and prompt diagnosis which will lead to proper treatment and genetic counseling of the patient. Discussion. Gorlin-Goltz syndrome is about multisystem process comprising the triad of basal cell nevi, jaw keratocysts, and skeletal anomalies. A spectrum of other neurological, ophthalmic, endocrine and genital manifestations is known to be variably associated with this triad. Diagnosis of the syndrome is based on major and minor criteria. Conclusion. This paper emphasizes the importance of oral and maxillofacial health professionals in the early diagnosis of nevoid basal cell carcinoma syndrome and in a preventive multidisciplinary approach to provide a better prognosis to the patient.
Ipsilateral brain cavernoma under scleroderma plaque: a case report
Authors: Vimal Raj Nitish Gunness, David Munoz, Pablo González-López, Nabeel Alshafai, Agdaliya Mikhalkova, Julian Spears
Journal: Pan Afr Med J (2019)
Keywords: scleroderma, adult, brain, cavernoma, ipsilateral, skin incision
MeSH terms: Hemangioma, Cavernous, Central Nervous System / diagnosis, Scalp / pathology, Scleroderma, Localized / diagnosis, Skin / pathology, Case Reports, Adult, Biopsy / methods, Collagen / metabolism, Female, Hemangioma, Cavernous, Central Nervous System / pathology, Humans, Scleroderma, Localized / pathology, Collagen

Scleroderma is a rare disease of unknown etiology, which is characterized by thickening and hardening of skin due to an increased collagen production. A 44-year-old female patient with a scleroderma on the scalp known by our department, also presented an ipsilateral brain lesion since 2015, which was showing growth without any clinical symptomatology and the patient wanted the lesion to be removed. This atypical lesion underneath the scleroderma shows that diagnosis can be missed without brain imaging and biopsy.
Vertebra plana with paraplegia in a middle-aged woman caused by B-cell lymphoma: a case report
Authors: Mohd Zahid, Sohail Ahamed, Jitesh Kumar Jain, Ravish Chabra
Journal: Case Rep Orthop (2012)

Vertebra plana is a rare presentation of spinal lymphoma. When radiological picture of a patient of paraplegia presents vertebra plana, diagnosis becomes a challenge. In a developing country like India tuberculosis should also be a consideration. Even histology sometimes fails to conclude a diagnosis. Immunohistochemistry is of immense help in clinching a diagnosis.
Emphysematous pyelonephritis in a transplant kidney
Authors: M Salehipour, J Roozbeh, A R Rasekhi, M A Afrasiabi, H Rezaee, K Izadpanah, S A Malek-Hosseini
Journal: Int J Organ Transplant Med (2010)
Keywords: emphysematous pyelonephritis, renal transplantation, urinary tract infection
MeSH terms: Case Reports

Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the kidney and its surrounding tissues. It is characterized by the production of gas within the kidney and perinephric structures. EPN often affects diabetic women but can also occur in nondiabetic patients who have ureteral obstruction and in immunocompromised patients. Herein, we report EPN in a 23-year-old woman who had a renal transplantation.
Isolated pulmonary IgG4-related disease mimicking lung malignancy
Authors: Louise I T Lee, Rebecca Gillibrand, Dev Mukerjee, Sashin S Kaneria
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Immunoglobulin G4 (IgG4)-related disease is a relatively rare and only recently recognized immune-mediated fibro-inflammatory condition that is commonly associated with autoimmune pancreatitis. Reports have further been characterized in almost all other organ systems, with several lung-related IgG4 disease reports emerging over the past decade. IgG4-related disease affects more than one organ in 60-90% of patients. To this date, there have been few published cases of pathologically proven isolated IgG4-related lung disease (IgG4-RLD), where no other organ is affected. We report an isolated pulmonary case of IgG4-RLD in a 65-year-old female with clinical and radiological manifestations suggestive of primary lung malignancy. CT revealed multiple sub-solid ground glass opacities, several of which were part-solid, others were pure ground glass. Histological analysis revealed IgG4 disease with no evidence of neoplasia. Serum IgG4 levels were elevated (206 mg dl-1). Malignancy was ruled out and the patient was treated with corticosteroids, though there was no change in CT appearance over 16 months. The CT imaging pattern in our case is atypical from previous literature characterisation.
Pancytopenia with Development of Persistent Neutropenia Secondary to COVID-19
Authors: Kathie Wu, Yvonne Dansoa, Priyanka Pathak
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Viral infections have long been linked to hematologic dysfunction. With the rapid spread of COVID-19, various hematologic manifestations have emerged. While there have been several reports of immune thrombocytopenic purpura from SARS-CoV-2, concurrent lymphopenia and anemia have sparse. We describe a case of COVID-induced pancytopenia that presented months after initial COVID infection that initially responded to IVIG and steroids, but now with persistent neutropenia.
Rare Isolated Pectoralis Minor Tear from a Noncontact Injury: Case Report and Review of the Literature
Authors: Danica D Vance, Usama Qayyum, Charles M Jobin
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Isolated pectoralis minor tears are rare orthopedic injuries often in weightlifters or contact sports and should be included in the differential when evaluating athletes with anterior shoulder pain. These injuries are often mistaken for pectoralis major muscle stains and tears. Advanced imaging with MRI helps define the anatomic location and grade of injury. Treatment is usually conservative with full return to activity after a brief period of rest for a few weeks. The purpose of this article is to present a case report and review of the literature on the clinical evaluation, imaging, and treatment of an isolated pectoralis minor tears.
Characterization of follicular lymphoma in the small intestine using double-balloon endoscopy
Authors: Manzurul Chowdhury, Masaki Endo, Toshimi Chiba, Norihiko Kudara, Shuhei Oana, Kunihiko Sato, Risaburo Akasaka, Kazumitsu Tomita, Saori Fujiwara, Tomomi Mizutani, Tamotsu Sugai, Yasuhiro Takikawa, Kazuyuki Suzuki
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

Follicular lymphomas occur rarely in the gastrointestinal tract, representing only 1-3% of all gastrointestinal tract B-cell non-Hodgkin lymphomas. We describe endoscopic analysis of 3 cases of follicular lymphoma in the small intestine using double-balloon endoscopy. Double-balloon endoscopy revealed multiple nodular lesions and elevated white patches, multiple polypoid lesions, and scattered white polypoid and nodular lesions in the duodenum and small intestine. Fuji Intelligent Chromo Endoscopy demonstrated small, whitish nodules, and narrow-band imaging showed a coiled, elongated vascular pattern within the elevated lesions. These cases are the first follicular lymphomas in the small intestine evaluated using narrow-band imaging or Fuji Intelligent Chromo Endoscopy to be reported.
Immunotherapy in the treatment of chemoresistant gestational trophoblastic neoplasia - systematic review with a presentation of the first 4 Brazilian cases
Authors: Antonio Braga, Elaine Balthar, Laís Cristhine Santos Souza, Michelle Samora, Matheus Rech, José Mauro Madi, Joffre Amim Junior, Jorge Rezende Filho, Kevin M Elias, Neil S Horowitz, Sue Yazaki Sun, Ross S Berkowitz
Journal: Clinics (Sao Paulo) (2023)
Keywords: avelumab, gestational trophoblastic neoplasia, immunotherapy, pd-1/pd-l1 inhibitors, pembrolizumab
MeSH terms: Gestational Trophoblastic Disease / drug therapy, Gestational Trophoblastic Disease / epidemiology, Gestational Trophoblastic Disease / pathology, Methotrexate, Systematic Review, Brazil, Dactinomycin / therapeutic use, Female, Humans, Immunotherapy, Pregnancy, Retrospective Studies, Methotrexate, Dactinomycin

Objective:
To evaluate the efficacy of immunotherapy for GTN treatment after methotrexate-resistance or in cases of multiresistant disease, through a systematic review, as well as to present the first 4 Brazilian cases of immunotherapy for GTN treatment.
Methods:
Three independent researchers searched five electronic databases (EMBASE, LILACS, Medline, CENTRAL and Web of Science), for relevant articles up to February/2023 (PROSPERO CRD42023401453). The quality assessment was performed using the Newcastle Ottawa scale for case series and case reports. The primary outcome of this study was the occurrence of complete remission. The presentation of the case reports was approved by the Institutional Review Board.
Results:
Of the 4 cases presented, the first was a low-risk GTN with methotrexate resistance unsuccessfully treated with avelumab, which achieved remission with sequential multiagent chemotherapy. The remaining 3 cases were high-risk multiagent-resistant GTN that were successfully treated with pembrolizumab, among which there were two subsequent gestations, one of them with normal pregnancy and healthy conceptus. Regarding the systematic review, 12 studies were included, only one of them on avelumab, showing a 46.7% complete remission rate. The remaining 11 studies were on pembrolizumab, showing an 86.7% complete remission rate, regardless of tumor histology. Both immunotherapies showed good tolerability, with two healthy pregnancies being recorded: one after avelumb and another after pembrolizumab.
Conclusion:
Immunotherapy showed effectiveness for GTN treatment and may be especially useful in cases of high-risk disease, where pembrolizumab achieves a high therapeutic response, regardless of the histological type, and despite prior chemoresistance to multiple lines of treatment.
Case Report: Report of 2 Different Cases of Ovarian Teratoma Evaluated by Dynamic Contrast-Enhanced Ultrasound
Authors: Katja Glutig, Ilmi Alhussami, Paul-Christian Krüger, Matthias Waginger, Felicitas Eckoldt, Hans-Joachim Mentzel
Journal: Front Pediatr (2021)
Keywords: dynamic ceus, ovary, pediatric, teratoma, ultrasound
MeSH terms: Case Reports

Ovarian masses are not easily differentiated on transabdominal ultrasound in children. A useful supplement in various pediatric applications is dynamic contrast-enhanced ultrasound (dynCEUS). It can be performed quickly and easily. However, the literature for dynCEUS on pediatric ovarian masses is limited. We compared two cases with ovarian teratoma in which dynCEUS was a helpful additional tool.
Silent uterine rupture with the use of misoprostol for second trimester termination of pregnancy : a case report
Authors: Martin Cuellar Torriente
Journal: Obstet Gynecol Int (2011)
MeSH terms: Case Reports

Uterine rupture is an uncommon, but a life-threatening, complication following second trimester medical termination of pregnancy (TOP). The reported cases have been in both the scarred and unscarred uterus (Rajesh et al. 2002, Drey et al. 2006, and Dickinson). A 27-year-old with two previous deliveries, no previous caesarean section, no history of induced abortions, and no gynaecological operations. She presented with amenorrhoea, and according to her last normal menstruation, she was 10 weeks and 5 days. Ultrasound was done, and it reported 16 weeks and 5 days. She asked for TOP. According to the clinic's protocol, misoprostol 800 mcg (4 tabs) were given to be used vaginally as a loading dose and another three to be taken orally after that. In the following day when she attended the clinic for follow up, a manual vacuum aspiration (MVA). A manual vacuum aspiration was indicated as an incomplete abortion. During the procedure, a uterine rupture was found in the uterine lower segment. A laparotomy was done and a lineal uterine rupture was found and sutured. The patient had a good postoperative recovery and was discharged from hospital after four days. The clinician dealing with second trimester terminations should be aware of the possibility of having a uterine rupture, especially in patients with a uterine scar in order to make an early diagnosis.
Propylene glycol neurotoxicity due to sodium citrate therapy in an infant with renal tubular acidosis
Authors: Mahjabeen Khan, Ara Vartanyan, Anthony Scalzo, Sarah Riley, Jeanine Cain, Joseph Maliakkal
Journal: Clin Nephrol Case Stud (2020)
Keywords: propylene glycol, renal tubular acidosis, sodium citrate, toxicity
MeSH terms: Case Reports

Sodium citrate in its liquid formulation is commonly used as therapy for renal tubular acidosis in pediatric patients. Convenient dosing and administration is important to ensure long-term medication adherence and normal growth in the chronic forms of this condition. Liquid sodium citrate formulations contain propylene glycol, a commonly used excipient, which can be toxic at high doses. Propylene glycol toxicity due to medication excipients has been reported in the literature, including many cases secondary to sustained exposure to intravenous anti-epileptics, however toxicity associated with oral sodium citrate therapy has not been described. We report the first case of propylene glycol neurotoxicity in a 6-week-old infant with renal tubular acidosis treated with sodium citrate. Clinical suspicion of risk for medication-related toxicity and awareness of propylene glycol content in sodium citrate led to timely diagnosis and management. Awareness of increased risk of toxicity in pediatric patients due to high sodium citrate requirement and low propylene glycol metabolism capacity is important for optimal care for pediatric patients with renal tubular acidosis.
A Rare Case of HHV-8 Associated Hemophagocytic Lymphohistiocytosis in a Stable HIV Patient
Authors: Nonso Osakwe, Diane Johnson, Natalie Klein, Dalia Abdel Azim
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Background:
Hemophagocytic lymphohistiocytosis (HLH) is a rare condition associated with viral infections including HIV. Cases have been reported mainly in advanced HIV/AIDS. This is a rare case that reports HLH associated with human herpes virus-8 (HHV-8) associated multicentric Castleman disease in a stable HIV patient.
Case presentation:
A 70-year-old Asian male patient with history of stable HIV on medications with CD 4 cell count above 200 presented with cough and fever and was initially treated for pneumonia as an outpatient. Persisting symptoms prompted presentation to the hospital. The patient was found to have anemia which persisted despite repeated transfusion of packed red cells. A bone marrow biopsy to investigate anemia revealed hemophagocytosis. A CT scan revealed multiple enlarged lymph nodes and hepatosplenomegaly. An excisional lymph node biopsy revealed HHV-8 associated multicentric Castleman disease. The patient deteriorated despite initiation of treatment.
Conclusion:
HLH can occur at any stage of HIV, rapid diagnosis to identify possible underlying reactive infectious etiology and prompt initiation of treatment is crucial to survival.
The Successful Rapid Adjustment of Blood Glucose in a Patient With Acute Coronary Syndrome, Renal Insufficiency, and Diabetes: A Case Report of Management Coordinated by Clinical Pharmacists and Clinicians
Authors: Fang-Hong Shi, Long Shen, Mang-Mang Pan, Lin-Lin Ma, Chi Zhang, Zhi-Chun Gu, Jing Ma, Hao Li
Journal: Front Pharmacol (2020)
Keywords: acute coronary syndromes, blood glucose management, clinical pharmacists, coordination, diabetes, renal insufficiency
MeSH terms: Case Reports

Diabetes is a major cause of cardiovascular mortality in most countries. Intensive management of blood glucose is pivotal for alleviating disease progress and minimizing cardiovascular complications. In this study, we report a case of successful control of high blood glucose in a diabetes patient with acute coronary syndromes (ACS), hypertension, and renal insufficiency. This patient had five years of diabetes history and was hospitalized through an ACS emergency. Coronary angiography showed an acute anterior myocardial infarction (Killip Level I). The patient had extremely high blood glucose that ranged from 19.4 to 28.2 mmol/L on the first day in the hospital and experienced significant blood glucose fluctuations in the following three days. After two rounds of clinical pharmacist consultation, the patient's fasting blood glucose (FBG) target was achieved on the seventh day of his hospitalization and was well controlled afterward. The patient's postprandial blood glucose (PBG) target was achieved on the ninth day of hospitalization, and he was discharged when his blood glucose was well controlled and cardiac function had been fully assessed. Hence, we summarize a protocol that could be used to quickly adjust high blood glucose in hospitalized patients and report a new blood glucose management model coordinated by clinical pharmacists and clinicians.
Seizure freedom in epilepsia partialis continua (EPC) through vagus nerve stimulation (VNS) therapy: A case report
Authors: Yuqin Shen, Feng Xia, Guodong Feng, Lijuan Liu, Wei Lin, Yonghong Liu, Ming Shi, Xianhui Ren, Bojun Ding, Gang Zhao, Yanchun Deng
Journal: Epilepsy Behav Case Rep (2013)
Keywords: epilepsia partialis continua, vns

Vagus nerve stimulation (VNS) is generally considered as a palliative treatment for patients with drug-resistant partial-onset epilepsy. We report a case in which a patient with drug-resistant epilepsia partialis continua (EPC), became seizure-free for 15 months with VNS combined with antiepileptic medication regimens. To our knowledge, similar cases have not been reported previously.
Polyisobutylene Urolithiasis Due to Ileal Conduit Urostomy Appliance: An Index Case
Authors: Michael A Avallone, Ann M Kolbach-Mandel, Ian C Mandel, Neil S Mandel, Peter N Dietrich, Jeffrey A Wesson, Carley M Davis
Journal: J Endourol Case Rep (2015)
MeSH terms: Case Reports

Polyisobutylene (PIB) is a synthetic elastomer that is a component of sealants, adhesives, and chewing gum base. We report a case of bilateral PIB urolithiasis in a patient with an ileal conduit urinary diversion due to neurogenic bladder from spinal cord injury. Infrared spectroscopy confirmed the composition of bilateral stones and adhesive from the patient's urostomy appliance to be PIB. No previous cases of PIB urolithiasis are reported in the literature.
Memory Reactivation and Its Effect on Exercise Performance and Heart Rate
Authors: Abhishek G Dhawan
Journal: Front Sports Act Living (2020)
Keywords: thr, aerobic, exercise, memory reactivation, neuronal ensemble, peak heart rate

Neuronal ensemble and brain plasticity both play an important role in memory consolidation and subsequently memory reactivation. To date, many studies have been designed to study the effect of exercise, heart-rate variability, and other factors on brain plasticity and memory. Here, we present a case study in which we have demonstrated the effect of neuronal ensemble and memory formed during High-intensity aerobic training (VO2 max) and Target Heart-Rate (THR) training and the effect of reactivation of same memory on THR and performance. Of note is the fact that the reactivation and recreation of memory stimulus learned and formed during High-intensity training, such as place, time, odor, and other conditions, can elevate the THR to the same previous peak zone even at low intensity. This demonstrates that reactivation of previously acquired memory or using the stimulation from the neuronal ensemble of consolidated memory during the specific event of training may exert similar physiological effects on exercise or the body to those that are learned during the memory acquisition phase. Hence, as exercise has an effect on memory, the memories may have an effect on exercise performances.
Ciliated Hepatic Foregut Cyst: A Report of a Case Incidentally Discovered during Transplant Evaluation
Authors: Thomas Enke, Wuttiporn Manatsathit, Shaheed Merani, Kurt Fisher
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Ciliated hepatic foregut cyst (CHFC) is a rare benign cyst of the liver derived from an embryonic remnant of foregut epithelium. CHFC is typically asymptomatic and is found incidentally. Recent reports of malignant transformation may warrant surgical removal of CHFC. We present the case of a 54-year-old male who was discovered to have a CHFC while undergoing kidney transplant evaluation.
Nodular Pulmonary Amyloidosis: A Manifestation of Sjögren's Syndrome
Authors: Gustavo Adolfo Gómez Correa, Jovani Osorno Serna, Manuel Felipe Cáceres Acosta, Juan David Cáceres González, Jaime Andrés Calle Ramirez, Juan Paulo Sandoval Mesa, Miguel Ignacio Roldán Pérez
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Case description:
A 72-year-old woman with primary Sjögren Syndrome (SS) was diagnosed during an inpatient hospital stay with dry symptoms. The patient had respiratory and constitutional symptoms, requiring a pulmonary imaging evaluation by high-resolution computed tomography (HRCT) of the thorax.
Clinical findings:
Multiple cavitary pulmonary nodules, halo sign, and focal areas of ground-glass opacity with predominance in both bases were found in the images. Complementary studies were done where a neoplastic focus was ruled out. The diagnosis of nodular pulmonary amyloidosis was confirmed with a pulmonary biopsy performed by videothoracoscopy for histopathological study, which reported the formation of nodules in the parenchyma with amyloid deposits and positive immunohistochemical markers for CD3, CD20, and CD38 lymphocytic infiltration.
Treatment and outcome:
Initial inpatient management with intravenous cyclophosphamide and methylprednisolone was given. Subsequent outpatient management was given with high dose glucocorticoids.
Clinical relevance:
We presented a case of nodular pulmonary amyloidosis in a female patient with primary SS, which is a rare pulmonary manifestation of this syndrome.