OpenMed/multicare-articles huggingface dataset:
Flow Cytometric Test with Eosin-5-Maleimide for a Diagnosis of Hereditary Spherocytosis in a Newborn
Authors: Kanda Fanhchaksai, Suphara Manowong, Rungrote Natesirinilkul, Lalita Sathitsamitphong, Pimlak Charoenkwan
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

A term male newborn born to a mother who had hereditary spherocytosis presented with neonatal jaundice at 20 hours of life. Complete blood count showed hemoglobin 17.1 g/dL, MCV 104.2 fL, MCH 32.9 pg, and MCHC 31.6 g/dL. The patient had indirect hyperbilirubinemia requiring phototherapy. The maximum total bilirubin level was 12.15 mg/dL at 20 hours of life. Peripheral blood smear revealed spherocytes, crenated red cells, and polychromasia. A flow cytometric test with eosin-5-maleimide- (EMA-) labeled RBC was performed in the patient and parents. The fluorescence histograms of EMA-labeled RBC from the patient and mother were shifted to the left, and the fluorescence ratio when compared with normal was 0.69 and 0.84, respectively. The flow cytometric test with EMA is useful in supporting the diagnosis of hereditary spherocytosis during newborn period.
Case Report: Rechallenge With BRAF and MEK Inhibitors in Metastatic Melanoma: A Further Therapeutic Option in Salvage Setting?
Authors: Anna Stagno, Sabrina Vari, Alessio Annovazzi, Vincenzo Anelli, Michelangelo Russillo, Francesco Cognetti, Virginia Ferraresi
Journal: Front Oncol (2021)
Keywords: braf v600 mutation, braf inhibitor, mek inhibitor, drug resistance, metastatic melanoma, rechallenge, targeted therapy
MeSH terms: Case Reports

Background:
The combination of BRAF and MEK inhibitors represents the standard of care treatment for patients with metastatic BRAF-mutated melanoma, notwithstanding the high frequency of emergent resistance. Moreover, therapeutic options outside clinical trials are scarce when patients have progressed after both targeted therapy and therapy with immune checkpoint inhibitors. In this article, we report our experience with targeted therapy rechallenging with BRAF and MEK inhibitors in patients with metastatic BRAF-mutated melanoma after progression with kinase inhibitors and immunotherapy.
Methods:
Four patients with metastatic BRAF-mutated melanoma were rechallenged with BRAF and MEK inhibitors after progression with targeted therapy and subsequent immunotherapy (checkpoint inhibitors).
Results:
Two patients (one of them was heavily pretreated) had partial response over 36 months (with local treatment on oligoprogression disease) and 10 months, respectively. A third patient with multisite visceral disease and high serum levels of lactate dehydrogenase had a short-lived clinical benefit rapidly followed by massive progression of disease (early progressor). The fourth patient, currently on treatment with BRAF/MEK inhibitors, is showing a clinical benefit and radiological stable disease over 3 months of therapy. Adverse events were manageable, similar to those reported during the first targeted therapy; the treatment was better tolerated at rechallenge compared with the first treatment by two out of four patients.
Spontaneous Tumor Lysis Syndrome Secondary to Small-Cell Neuroendocrine Carcinoma of Unknown Origin: A Rare Case Report and Literature Review
Authors: Phyo Thazin Myint, Hifza Waheed Butt, Taha Alrifai, Carlos Marin
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Spontaneous tumor lysis syndrome (STLS), in the absence of prior chemo or radiation therapy, is rare with solid tumors. Here, we present a case of STLS secondary to a small-cell neuroendocrine tumor of unknown origin in a 66-year-old female patient who presented with abdominal discomfort. Computed tomography (CT) abdomen showed a large tumor mass with peritoneal metastasis, and she developed renal failure from STLS, resulting in the need for hemodialysis. Due to the progressive deterioration and the comorbidities, she opted for comfort care. Timely recognition and intervention of STLS is critical. Further studies evaluating STLS in solid tumor patients are recommended.
Volar Dislocation of the Fourth and Fifth Carpometacarpal Joint Associated with Hamate Hook Fracture: A Case Report and Literature Review
Authors: Natsumi Saka, Hirotada Matsui, Hideki Tsuji
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

We report a case of volar fourth and fifth carpometacarpal (CMC) joint dislocation complicated by a hamate hook fracture. The CMC joint was reduced in a closed fashion and temporally fixed with Kirschner wires. Using intraoperative computed tomography, the displaced fracture of the hamate hook was reduced by open reduction and internal fixation and fixed with a screw. We suggest that this rare injury was caused by the over contraction of the flexor carpi ulnaris and avulsion force from the ligamentous structure around the pisiform, hamate, and metacarpal bones.
Case report: Multiple brain tuberculomas after in vitro fertilization, embryo transfer, and abortion
Authors: Zhaobo Shi, Yong Sun
Journal: Front Neurol (2022)
Keywords: anti-tuberculosis therapy, embryo transfer, in vitro fertilization, intrathecal injection, multiple brain tuberculoma, tuberculous meningitis
MeSH terms: Case Reports

Background:
Multiple brain tuberculomas (MBT), characterized by disseminated tuberculous granulomas in the brain, is a rare disease like tuberculosis encountered after in vitro fertilization, embryo transfer (IVF-ET), and abortion. This study aimed to investigate the clinical characteristics, diagnostic methods, and therapeutic strategies of MBT after IVF-ET and abortion.
Methods:
A retrospective analysis was performed on the data of two patients who suffered from MBT after IVF-ET and abortion.
Results:
Both patients manifested headache and vomiting, which are the common symptoms of intracranial hypertension, accompanied by tuberculous meningitis. Besides, case 1 was affected by fever and epilepsy. In terms of imaging characteristics, T2-weighted imaging (T2WI) displayed multiple intracranial punctate or patchy high-intensity signals, some of which were presented as "target sign" or enhanced-like disseminated nodules, similar to miliary tuberculosis. Regular anti-tuberculosis therapy with isoniazid, rifampicin, pyrazinamide, and ethambutol was administered but failed to achieve a significant effect in the initial stage. The symptoms were gradually relieved, and the brain lesions in MRI were significantly alleviated after combining with intrathecal injections of isoniazid, dexamethasone, and chymotrypsin.
Conclusions:

In vitro fertilization, embryo transfer (IVF-ET) may be a risk factor for MBT, the common manifestations of which are intracranial hypertension. In addition to multiple nodular enhancement on brain MRI, the "target sign" on T2WI is likely to be another typical feature of MBT. Provided that there is no obvious effect of regular anti-tuberculosis therapy (ATT), intrathecal injections of isoniazid, dexamethasone, and chymotrypsin are considered to produce a favorable prognosis, but further studies are still needed to confirm the efficacy.
Onset of subcutaneous emphysema and pneumomediastinum after tonsillectomy: a case report
Authors: Angelo C D Panerari, Ana C Soter, Flavio La Porta da Silva, Luis F de Oliveira, Mayra D'Andrea R Neves, Antonio C Cedin
Journal: Braz J Otorhinolaryngol (2005)
MeSH terms: Mediastinal Emphysema / etiology, Pneumothorax / etiology, Subcutaneous Emphysema / etiology, Tonsillectomy / adverse effects, Case Reports, Adult, Diagnosis, Differential, Female, Humans, Mediastinal Emphysema / diagnosis, Pneumothorax / diagnosis, Subcutaneous Emphysema / diagnosis

Several complications can be related to surgical approaches of head and neck regions. Among those, there are rare conditions such as pneumomediastinum, pneumothorax and subcutaneous cervical emphysema. This study reports a case of a patient that developed pneumomediastinum, pneumothorax and subcutaneous emphysema after undergoing tonsillectomy. In order to reduce these complications in surgical approaches such as tonsillectomy, care should be taken with intubation, use of oxygen mask for positive pressure ventilation during anesthesia recovery, aggressive surgical maneuvers and use of surgical instruments that may cause deep tonsillar injuries.
Central adrenal insufficiency and diabetes insipidus as potential endocrine manifestations of COVID-19 infection: a case report
Authors: Abu Baker Sheikh, Muhammad Ali Javaid, Abdul Ahad Ehsan Sheikh, Rahul Shekhar
Journal: Pan Afr Med J (2021)
Keywords: covid-19, case report, central adrenal insufficiency, central diabetes insipidus
MeSH terms: Adrenal Insufficiency / diagnosis, COVID-19 / complications, Diabetes Insipidus / diagnosis, Case Reports, Adrenal Insufficiency / virology, Adult, Diabetes Insipidus / virology, Female, Humans

SARS-CoV-2 infection, responsible for the coronavirus disease-2019 (COVID-19) has rapidly spread, causing a global pandemic. COVID-19 can affect any organ system in the body due to overwhelming dysregulated immune response and long-term effects of the disease is still unknown. Endocrine complications associated with COVID-19 is exceedingly rare. Here we present a unique case of a 44-year-old female who developed adrenal insufficiency and central diabetes insipidus following COVID-19 infection.
Squamous differentiation and cytokeratin expression in an osteosarcoma: a case report and review of the literature
Authors: Lester J Layfield, Lyska Emerson, Julia R Crim, Lor Randall
Journal: Clin Med Pathol (2008)
Keywords: cytokeratin, osteosarcoma, squamous differentiation

Cytokeratin expression has been documented in a variety of sarcomas including synovial sarcomas, epithelioid sarcomas, Ewing's sarcomas and, rarely, osteosarcomas. In osteosarcomas immunohistochemically shown to expression cytokeratins, a component of epithelioid cells is generally present. These epithelioid cytokeratin positive cells raise the possibility of metastatic disease with prognostic and therapeutic implications differing from primary osteosarcoma. The cytokeratin-expressing cells of the cases reported in the literature have not shown definitive squamous differentiation with keratin pearl formation. We report a case of osteosarcoma in which islands of malignant squamous cells were present showing keratin pearl formation and expression of cytokeratins.
Acute Airway Obstruction and Cardiopulmonary Arrest due to Tracheomalacia Caused by Megaesophagus Compression Secondary to Achalasia
Authors: Mickael Aubignat, Pierre-Alexandre Roger, Amandine Dernoncourt, Valery Salle, Amar Smail, Clement Gourguechon, Jean Schmidt, Pierre Duhaut
Journal: Case Rep Pulmonol (2020)
MeSH terms: Case Reports

We report the case of an 80-year-old woman who presented one episode of cardiopulmonary arrest and two episodes of acute airway obstruction. We found in this patient the presence of tracheomalacia caused by megaesophagus compression secondary to achalasia probably responsible for episodes of acute airway obstruction and cardiopulmonary arrest.
Class IV Lupus Nephritis in the Setting of Serologically Quiescent Disease and Normal Urine Sediment in a Patient with Late-Onset Systemic Lupus Erythematosus
Authors: Benedicta Nnodum, Lauren Dudley
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that may affect any organ of the body. Lupus nephritis (LN) is a frequent and serious complication of SLE. We report a case of an 80-year-old woman who was initially diagnosed with late-onset SLE and eventually developed LN in the setting of normal complements, double-stranded DNA, C-reactive protein, erythrocyte sedimentation rate, and urine sediment. She developed abnormal renal function (creatinine of 1.7 mg/dl) and mild proteinuria (1-2+) without hematuria. Renal biopsy showed class IV lupus glomerulonephritis, active and chronic. The patient was started on mycophenolate mofetil which led to improvement of proteinuria and stabilization of creatinine. The suspicion for LN in a patient with late-onset SLE should remain high when there is development of suspicious renal or urinary abnormalities even if laboratory values do not suggest high disease activity and urinary sediment is normal. To our knowledge, this is one of the oldest patients with biopsy-proven LN and late-onset SLE.
Bacterial Endocarditis Caused by Sphingomonas paucimobilis: A Case Report and Literature Review
Authors: Kara Rognrud, Andrew M Diaz, Collin Hill, Melissa A Kershaw
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

A 47-year-old male with no significant medical history was hospitalized for bacteremia and diagnosed with endocarditis. The organism isolated was a Gram-negative bacillus-Sphingomonas paucimobilis. There are only a few reported cases of endocarditis caused by S. paucimobilis, and to our knowledge, this is the first in the United States.
Vertebral Osteomyelitis Secondary to Pneumococcal Infection
Authors: Bindu Gandrapu, Preeyanka Sundar, Paula Aucoin
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Vertebral osteomyelitis secondary to pneumococcal infection is an uncommon condition caused by Streptococcus pneumoniae. Fever, back pain, and raised ESR are common features in the clinical setting. We report a 62-year-old female patient who presented with an unusual presentation. Later on, vertebral osteomyelitis secondary to pneumococcal infection was confirmed at T8, 9 by CT scan, MRI, and cytology. The patient was treated successfully with high-dose ceftriaxone.
Infra Low Frequency Neurofeedback Training for Trauma Recovery: A Case Report
Authors: Hanno W Kirk, Monica Geers Dahl
Journal: Front Hum Neurosci (2022)
Keywords: neurofeedback, ptsd, alcoholism and alpha theta training, biofeedback, mtbi and neurofeedback, relapse prevention, torture and neurofeedback, trauma
MeSH terms: Case Reports

This paper reviews how and why ILF Neurofeedback has proven to be a parsimonious and efficient way to remediate the neuro-physiological effects of trauma. Reference is made to several large- and small-scale institutional proof of concept experimental studies each addressing a specific kind of trauma. It ends with a case report by the author (Kirk) working with an American combat veteran. It makes the argument that given its success that ILF Neurofeedback and Alpha-Theta training become accepted as part of an integrative and holistic approach for treating survivors of trauma.
Why Me? To Be an Ultra-Responder to Antiplatelet Therapy: A Case Report
Authors: Francesca Rosafio, Guido Bigliardi, Nicoletta Lelli, Laura Vandelli, Federica Naldi, Ludovico Ciolli, Stefano Meletti, Andrea Zini
Journal: Front Neurol (2021)
Keywords: aggregometry, antiplatelet therapy, case report, intracerebral hemorrhage, primary prevention
MeSH terms: Case Reports

Background: Platelet function testing is a valid tool to investigate the clinical response to antiplatelet therapy in different clinical settings; in particular, it might supply helpful information in patients with cerebrovascular disease. Oral antiplatelet treatment, such as Aspirin (ASA) and Clopidogrel, is the gold standard in secondary stroke prevention of non-cardiogenic ischemic stroke; conversely, its application as a primary prevention therapy is not routinely recommended in patients with vascular risk factors. Multiple electrode platelet aggregometry (MEA) impedance aggregometer is a validated device to test platelet inhibition induced by ASA or Clopidogrel. Case Report: We report the case of a 78-year-old patient without relevant clinical history, taking ASA as primary prevention strategy, who was admitted for sudden onset of dysarthria and left facial hyposthenia during physical effort. Brain CT revealed two small subcortical bilateral spontaneous intracranial hemorrhages. Platelet aggregometry with MEA performed upon admission revealed a very strong platelet inhibition induced by ASA (result of the ASPI Test was 5 U, consistent with an ultra-responsiveness to ASA, and the cutoff value of correct responsiveness is <40 U). MRI at longitudinal follow-up revealed the presence of two small cavernous angioma underlying hemorrhagic spots. Conclusion: The evaluation of platelet reactivity in stroke patients undergoing antiplatelet therapies, not commonly performed in clinical practice, could be useful to optimize prevention strategies; the verification of the biological effectiveness of ASA or Clopidogrel could be a valid tool in the definition of each patient's risk profile, particularly in patients with cerebrovascular disease known to be at increased risk for both hemorrhagic and thrombotic complications.
Successful obstetrical management of 110-day intertwin delivery interval without cerclage: counseling and conservative management approach to extreme asynchronous twin birth
Authors: Labib M Ghulmiyyah, Salim A Wehbe, Seth A Schwartz, Eric Scott Sills
Journal: BMC Pregnancy Childbirth (2004)

BACKGROUND: This report describes a patient counseling approach and non-surgical management of a dichorionic-diamniotic twin pregnancy where delivery of the second twin followed the delivery of the first by 110 days. CASE PRESENTATION: An early transvaginal sonogram at 19 1/2 weeks suggested cervical dilation with protruding amniotic membranes. Tocolytic and antibiotic therapy was initiated; no cerclage was placed. Spontaneous rupture of membranes and cord prolapse occurred 48 h later, resulting in delivery of a stillborn female infant. Conservative management was offered after counseling for possible risks associated with maternal sepsis, need for extended hospitalization, potential for hysterectomy and death. The cervix appeared closed after delivery and the umbilical cord was ligated, with subsequent spontaneous cord retraction in utero. Reassuring fetal status was observed for twin B without evidence of contractions or chorioamnionitis. A viable male infant (2894 g) was delivered vaginally at 35 1/2 weeks. CONCLUSIONS: This report outlines a counseling approach useful for patients with premature delivery of one twin, and presents application of conservative obstetrical management principles for the aftercoming twin even when delivery interval is extreme.
Hematochezia caused by tandospirone in a patient with major depressive disorder and anxious distress: a case report
Authors: Xingmei Jiang, Zhongrui Ma, Zhixiong Li, Ying Ou, Zhenhua Luo, Zhe Li
Journal: Front Psychiatry (2023)
Keywords: antidepressant, anxious distress, case report, depressive disorder, hematochezia, tandospirone
MeSH terms: Case Reports

Background:
Major depressive disorder (MDD) with anxious distress is a relatively common condition that is often associated with a poor treatment response. In order to enhance the effectiveness of MDD treatment, 5-HT1A agonists like tandospirone are often prescribed in conjunction with antidepressants. While it is known that antidepressants can increase the risk of bleeding, whether tandospirone poses a similar risk remains uncertain.
Case presentation:
We presented the case of a 55-year-old Chinese woman diagnosed with MDD and anxious distress. After receiving various types of antidepressants, she experienced hematochezia following the administration of tandospirone, sertraline, and agomelatine. The occurrence of hematochezia ceased after tandospirone was discontinued. The patient was subsequently discharged with a treatment regime consisting of sertraline and agomelatine. During the 1-month follow-up, she reported no hematochezia.
Conclusion:
Tandospirone may potentially increase the risk of hematochezia in patients with MDD and anxious distress.
Multiple Intestinal Erosions as a Result of Hemorrhage due to Parasites: Case Reports and Review of the Literature
Authors: Hannah Pitanga Lukashok, Carlos Robles-Jara, Carlos Robles-Medranda
Journal: Diagn Ther Endosc (2011)
MeSH terms: Case Reports

Obscure gastrointestinal bleeding appears to be uncommon in patients with parasites. In spite of that some reports had described this relationship in patients evaluated during capsule endoscopy procedures; the characteristic of the bleeding lesions remains unclear. This paper describes two patients with a massive obscure gastrointestinal bleeding due to ascariasis, using the new capsule endoscopy technology "MiroCam", describing the characteristic of the lesions found in our patients (observed in a better image quality), and reviewing the literature.
Case Report: Propranolol increases the therapeutic response to temozolomide in a patient with metastatic paraganglioma
Authors: Miguel-Angel Díaz-Castellanos, Karina Villar Gómez de Las Heras, Tamara Díaz-Redondo, Encarnación González-Flores, Virginia Albiñana, Luisa-María Botella
Journal: F1000Res (2017)
Keywords: paraganglioma, pseudohypoxic cancer syndromes, rare oncologic diseases, repurposing drugs

This case report presents the clinical evolution and management of a patient with a hereditary paraganglioma syndrome. This disease is characterized by rare tumors of neural crest origin that are symmetrically distributed along the paravertebral axis from the base of the skull and neck to the pelvis. In addition, these patients may develop renal cancer, gastrointestinal stromal tumors, pituitary adenomas, and bone metastasis in some cases. To date no successful therapeutic treatment has been reported. Total resection with postoperative radiotherapy and chemotherapy have been advocated, especially for the multiple metastasis. Here we show how the combination of high doses of the beta blocker propranolol (3 mg/Kg/day) and the DNA intercalating agent, temozolomide, has been successful in the treatment of a SDHA metastatic paraganglioma.
Streptococcus pneumoniae in urinary tracts of children with chronic kidney disease
Authors: Irene Burckhardt, Stefan Zimmermann
Journal: Emerg Infect Dis (2011)
MeSH terms: Kidney Failure, Chronic / complications, Renal Insufficiency, Chronic / complications, Streptococcus pneumoniae / isolation & purification, Urinary Tract Infections / microbiology, Urine / microbiology, Case Reports, Anti-Bacterial Agents / pharmacology, Child, Female, Humans, Infant, Male, Microbial Sensitivity Tests, Streptococcus pneumoniae / classification, Streptococcus pneumoniae / drug effects, Urinary Tract Infections / diagnosis, Urinary Tract Infections / drug therapy, Anti-Bacterial Agents

Streptococcus pneumoniae is not commonly considered an agent of urinary tract infections. We report 3 children with urinary tract abnormalities who had high numbers of S. pneumoniae in their urine (≥10⁴ CFU/mL) and varying clinical symptoms.
Case report: A case of fetal umbilical vein varix presenting disseminated intravascular coagulation, polycythemia, and neonatal hepatitis in an extremely low birth weight infant
Authors: Mariko Sekiguchi, Takeo Mukai, Yoshihiko Shitara, Kohei Kashima, Takahiro Seyama, Keiichi Kumasawa, Naoto Takahashi
Journal: Front Pediatr (2023)
Keywords: disseminated intravascular coagulation, extremely low birth infants, fetal thrombotic vasculopathy, neonatal hepatitis, polycytemia, umbilical vein varix
MeSH terms: Case Reports

Reports on the clinical course of fetal umbilical vein varix in premature infants are limited. We report a case of an extremely low body weight infant with intra-abdominal umbilical vein varix who developed disseminated intravascular coagulation, polycythemia, and hyperbilirubinemia after birth; late-onset neonatal hepatitis; and fetal thrombotic vasculopathy confirmed by placental histopathology. Ultrasonography after birth showed a dilated portion of the umbilical vein at the hepatic hilum with thrombi inside. We speculate that the umbilical vein varix caused the fetal thrombotic vasculopathy, and the presence of umbilical vein varix and fetal thrombotic vasculopathy in combination with prematurity caused coagulopathy, polycythemia, hyperbilirubinemia, and hepatitis. Despite the favorable outcomes reported in the literature, premature infants with umbilical vein varix may require careful observation and management for coagulopathy and late-onset hepatitis. Furthermore, placental histopathology could aid in the understanding of various clinical outcomes in infants with umbilical vein varices.