OpenMed/multicare-articles huggingface dataset:
Case report: Complex internal mammary to pulmonary artery fistula as a cause of hemoptysis in tuberculosis: Diagnosis and endovascular management using ethylene vinyl alcohol copolymer (Onyx)
Authors: Gregory Pierce, Chaitanya Ahuja, Meghna Chadha
Journal: Indian J Radiol Imaging (2011)
Keywords: ethylene vinyl alcohol copolymer, hemoptysis, liquid embolic agent
MeSH terms: Case Reports

A complex right internal mammary to right pulmonary artery fistula resulting in hemoptysis was successfully treated by embolization with a liquid, nonadhesive, embolic agent - ethylene vinyl alcohol copolymer (Onyx). There were no procedural complications and no recurrence of symptoms has been seen after 2 years of follow-up.
Invasive Pulmonary Aspergillosis with Disseminated Infection in Immunocompetent Patient
Authors: Gabriel Moreno-González, Antoni Ricart de Mesones, Rachid Tazi-Mezalek, Maria Teresa Marron-Moya, Antoni Rosell, Rafael Mañez
Journal: Can Respir J (2016)
MeSH terms: Extracorporeal Membrane Oxygenation, Immunocompetence, Invasive Pulmonary Aspergillosis / diagnosis, Respiratory Insufficiency / therapy, Case Reports, Antifungal Agents / therapeutic use, Aspergillosis / complications, Aspergillosis / pathology, Aspergillus flavus, Aspergillus fumigatus, Autopsy, Bronchoscopy, Fatal Outcome, Female, Humans, Invasive Pulmonary Aspergillosis / complications, Invasive Pulmonary Aspergillosis / drug therapy, Invasive Pulmonary Aspergillosis / pathology, Middle Aged, Myocarditis / complications, Myocarditis / pathology, Nephritis / complications, Nephritis / pathology, Neuroaspergillosis / complications, Neuroaspergillosis / pathology, Radiography, Thoracic, Respiratory Insufficiency / etiology, Tomography, X-Ray Computed, Antifungal Agents

Invasive pulmonary aspergillosis (IPA) is a rare pathology with increasing incidence mainly in critical care settings and recently in immunocompetent patients. The mortality of the disease is very high, regardless of an early diagnosis and aggressive treatment. Here, we report a case of a 56 yr old previously healthy woman who was found unconscious at home and admitted to the emergency room with mild respiratory insufficiency. In the first 24 hours she developed an acute respiratory failure with new radiographic infiltrates requiring Intensive Care Unit admission. A severe obstructive pattern with impossibility of ventilation because of bilateral atelectasis was observed, requiring emergent venovenous extracorporeal membrane oxygenator device insertion. Bronchoscopy revealed occlusion of main bronchi, demonstrating by biopsy an invasive infection by Aspergillus fumigatus and A. flavus. Despite an aggressive treatment and vital support the patient had a fatal outcome. The forensic study confirms the diagnosis of IPA but also revealed the presence of disseminated aspergillosis.
Rhabdomyomatous (mesenchymal) hamartoma presenting as haemangioma on the upper lip: a case report with immunohistochemical analysis and treatment with high-power lasers
Authors: Aluana Dal Vechio, Edgar Nakajima, Décio Pinto Jr, Luciane Hiramatsu Azevedo, Dante A Migliari
Journal: Case Rep Dent (2013)

Rhabdomyomatous hamartoma is a rare disease that occurs predominantly in the skin. This paper describes a congenital lesion in a 17-year-old male, who came to our clinic presenting a circumscribed swelling involving the oral mucosa and vermillion border of the upper lip, purplish in color, and blanching under pressure. The patient reported that he had had lesion since his birth. A clinical diagnosis was of congenital haemangioma, and the patient was treated by photocoagulation using diode laser. When the lesion became smaller, by having its blood content reduced, the upper portion of the lesion was sliced off with CO2 laser and the tissue was sent for microscopic analysis. Histopathological examination showed an oral mucosa fragment with proliferation of striated muscle bundles admixed with small blood vessels, collagen, and nerve fibres. A supplementary analysis with immunohistochemistry demonstrated positivity for desmin, HHF35, smooth muscle actin, S-100, and CD34. Based on these findings, the lesion was diagnosed as rhabdomyomatous hamartoma. The aesthetic result has been very satisfactory after a 14-month followup.
Intranasal Lobular Capillary Hemangioma with Multiple Sites of Origin during Pregnancy: A Case Report and Literature Review
Authors: Lama S Alalula, Abdullah S Arafat, Riyadh A Alhedaithy, Mohammed Elkrim
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

In the present case report, we describe a 33-year-old pregnant woman in the third trimester with a history of recurrent epistaxis leading to frequent visits to the emergency department. Each episode of epistaxis was managed by anterior nasal packing. During endoscopic examination, a left nasal mass was seen. She was admitted and managed conservatively until she delivered her baby without complication. After delivery, a CT scan was taken, which showed an enhancing mass in the middle and lower meatus of the nasal cavity with no bony erosions. For symptomatic relief and tissue diagnosis, endoscopic surgical removal was advised. An intraoperative examination revealed a red, smooth, and well-circumscribed mass occupying the left nasal cavity and originating from the medial surface of the inferior turbinate and the inferior surface of the posterior part of the middle turbinate. A complete en bloc resection of the mass was performed endoscopically. The mass was sent for histologic analysis, which confirmed the diagnosis of lobular capillary hemangioma. Eventually, upon follow-up at two weeks, one month, three months, and six months postsurgery, no evidence of recurrence was detected.
Conjoined twins: A report of four cases
Authors: Mohammed Hamada Takrouney, Ibrahim Ali Ibrahim, Hala Saad Abdel-Ghaffar, Ahmed Ibrahim Abdel-Wahhab, Mahmoud Mohamed Mostafa, Wesam Nashat Ali, Mohamed Sayed Abd-Elaal
Journal: Int J Surg Case Rep (2020)
Keywords: conjoined twins, heteropagus, omphalopagus, parasitic twins, siame

Background:
Conjoined twin is a rarely seen congenital anomaly associated with significant morbidity and mortality. The most common types of conjoined twins are thoracopagus. Conjoined twins are either symmetrical twins or asymmetrical or heteropagus. This report records the successful separation of 2 cases of asymmetrical twins and one symmetrical twin with fused livers and diaphragm and communicating peritoneal cavities.
Patients and methods:
This study amended and strictly followed the ethical guidelines of the Helsinki declaration, our study included 4 case reports on conjoined twins (CT), 2 male and three female patients; 3 of them were parasitic and one was conjoined. We operated upon 2 parasitics and one conjoined. The 1st case died preoperatively.
Results:
Four living children is our result.
Conclusion:
As connections between the bowel and bone of the parasite and the respective organs in the autosite are often absent, the parasite could be excised easily without any effect on the autosite. We recommend the separation of the parasite and the autosite as early as possible. In many cases, surgery results in the death of one or both of the conjoined twins, particularly if they are joined at the head or share a vital organ. Our separated twins are yet the youngest living separated twins.
Trial registration:
ClinicalTrials.gov Identifier: NCT03388684.
A Case of Renal Pelvic Cancer Complicated by Horseshoe Kidney Treated with RoboSurgeon Gasless Single-Port Retroperitoneoscopic Nephroureterectomy
Authors: Hiroaki Suzuki, Kosuke Takemura, Kazumasa Sakamoto, Madoka Kataoka, Masaya Ito, Yasukazu Nakanishi, Ken-Ichi Tobisu, Fumitaka Koga
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

A 78-year-old man who had a horseshoe kidney (HSK) visited us because of gross hematuria and suspicious urine cytology. CT and MRI revealed a right renal pelvic tumor of 28 mm in diameter. He underwent gasless single-port retroperitoneoscopic nephroureterectomy with division of the isthmus via the right pararectal small incision using the RoboSurgeon system. Pathological diagnosis was invasive urothelial carcinoma, grade 3, pT3, pN0, LVI0, RM0. He was discharged from hospital on the 6th postoperative day without any perioperative complication. He has no evidence of disease clinically and radiologically 19 months after the operation. Only a few cases of upper tract urothelial carcinoma complicated by HSK treated with minimally invasive surgery have been reported in English literature. This is the first case successfully managed with RoboSurgeon gasless single-port retroperitoneoscopic nephroureterectomy.
Pulmonary hernia in a two-year-old child
Authors: Jenna Fine, Bryan S Walters, Alysia A Agnoni, Christopher P Coppola, Ronald J Scorpio, Alfred P Kennedy
Journal: Case Rep Surg (2014)

Pulmonary hernia, also known as lung herniation or intercostal herniation, is best explained as the lung parenchyma protruding beyond the confines of the thoracic wall. This rare finding can be classified as congenital or acquired. Acquired pulmonary herniations are often the complication of blunt or penetrating trauma to the chest wall. This report describes a two-year-old male who fell onto a rigid post, striking his left lower chest. Imaging studies demonstrated a small pneumothorax as well as pulmonary herniation. The patient underwent a diagnostic thoracoscopy and repair of a pulmonary hernia within the 7th intercostal space without complication. In this case report, we aim to add to the limited body of existing literature on the surgical management of pulmonary hernias.
Effects of percutaneously-implanted epidural stimulation on cardiovascular autonomic function and spasticity after complete spinal cord injury: A case report
Authors: Ashraf S Gorgey, Jacob Goldsmith, Ahmad Alazzam, Robert Trainer
Journal: Front Neurosci (2023)
Keywords: autonomic nervous system, exoskeleton, percutaneous epidural stimulation, rehabilitation, spasticity, spinal cord injury
MeSH terms: Case Reports

Importance:
There is a revived interest to explore spinal cord epidural stimulation (SCES) to improve physical function after spinal cord injury (SCI). This case report highlights the potential of eliciting multiple functional improvements with a single SCES configuration, a strategy which could improve clinical translation.
Objective:
To determine whether SCES intended to facilitate walking also acutely yields benefits in cardiovascular autonomic regulation and spasticity.
Design:
Case report from data collected at two timepoints 15 weeks apart from March to June 2022 as part of a larger clinical trial.
Setting:
Research lab at Hunter Holmes McGuire VA Medical Center.
Participant:
27-year-old male, 7 years post a C8 motor complete spinal cord injury.
Intervention:
A SCES configuration intended to enhance exoskeleton-assisted walking training applied for autonomic and spasticity management.
Main outcomes and measures:
The primary outcome was cardiovascular autonomic response to a 45-degree head-up-tilt test. Systolic blood pressure (SBP), heart rate (HR), and absolute power of the low-frequency (LF) and high-frequency (HF) components of a heart-rate variability analysis were collected in supine and tilt with and without the presence of SCES. Right knee flexor and knee extensor spasticity was assessed via isokinetic dynamometry with and without SCES.
Results:
At both assessments with SCES off, transitioning from supine to tilt decreased SBP (assessment one: 101.8 to 70 mmHg; assessment two: 98.9 to 66.4 mmHg). At assessment one, SCES on in supine (3 mA) increased SBP (average 117 mmHg); in tilt, 5 mA stabilized SBP near baseline values (average 111.5 mmHg). At assessment two, SCES on in supine (3 mA) increased SBP (average 140 mmHg in minute one); decreasing amplitude to 2 mA decreased SBP (average 119 mmHg in minute five). In tilt, 3 mA stabilized SBP near baseline values (average 93.2 mmHg). Torque-time integrals at the right knee were reduced at all angular velocities for knee flexors (range: -1.9 to -7.8%) and knee extensors (range: -1 to -11.4%).
Conclusions and relevance:
These results demonstrate that SCES intended to facilitate walking may also enhance cardiovascular autonomic control and attenuate spasticity. Using one configuration to enhance multiple functions after SCI may accelerate clinical translation.
Clinical trial registration:
https://clinicaltrials.gov/ct2/show/, identifier NCT04782947.
Management and outcome of hypertrophic obstructive cardiomyopathy in pregnant women: a case report
Authors: Maryem Assamti, Ramia Bougrine, Nabila Ismaili, Noha El Ouafi
Journal: Pan Afr Med J (2021)
Keywords: hypertrophic cardiomyopathy, case report, pregnancy, sudden cardiac death
MeSH terms: Arrhythmias, Cardiac / diagnosis, Cardiomyopathy, Hypertrophic / diagnosis, Pregnancy Complications, Cardiovascular / diagnosis, Case Reports, Adult, Arrhythmias, Cardiac / physiopathology, Arrhythmias, Cardiac / therapy, Cardiomyopathy, Hypertrophic / complications, Cardiomyopathy, Hypertrophic / therapy, Female, Humans, Pregnancy, Pregnancy Complications, Cardiovascular / physiopathology, Pregnancy Complications, Cardiovascular / therapy, Pregnancy Outcome, Recurrence

Hypertrophic cardiomyopathy (HCM) is a common inherited cardiomyopathy, with an estimated prevalence of 1 in 500 people. Despite overall favorable outcomes with modern treatment and early diagnosis of disease, adverse complications could occur during times of physiological stress like pregnancy. Complications of HCM include sudden cardiac death, heart failure, and arrhythmia. We report the case of a 32-year-old pregnant woman with obstructive HCM, presenting with recurrent episodes of ventricular arrhythmia despite medical therapy. This case exhibits how close monitoring and proper management during pregnancy according to the latest recommendations, resulted in a successful and uneventful delivery.
Vomiting-induced gastric emphysema and hepatoportal venous gas: a case report and review of the literature
Authors: Malav P Parikh, Muhammed Sherid, Venu Ganipisetti, Venu Gopalakrishnan, Maria Habib, Monika Tripathi
Journal: Case Rep Med (2015)

Gastric pneumatosis is the presence of air within the wall of the stomach. It represents a spectrum of conditions ranging from benign disease to septic shock and death. Etiopathologically, it can be classified into emphysematous gastritis or gastric emphysema (GE). Along with hepatoportal venous gas (HPVG), it was considered as an ominous radiological sign and warranted an emergent surgical exploration; however, with widespread use of computerized tomographic (CT) scan, an increasing number of benign causes of GE and HPVG have been reported in the literature, where patients can be managed by noninvasive and conservative measures. We hereby describe a case where recurrent episodes of vomiting led to development of GE and HPVG and the patient was managed successfully by conservative measures.
Economical Analysis of Different Clinical Approaches in Pre-Viability Amniorrhexis-A Case Series
Authors: Samuel Engemise, Fiona Thompson, William Davies
Journal: J Clin Med (2014)
Keywords: epprom, national healthcare services (nhs) resources, pprom, amniorrhexis
MeSH terms: Review

Prolonged oligohydramnios following extreme preterm prelabour rupture of membranes (EPPROM) is traditionally associated with a high morbidity and mortality to both the mother and the baby. The clinical maternal evaluation and fetal ultrasound assessment may provide important prognostic information for the clinicians and should be taken into account when counselling the patients so as to provide them with enough information to make decision of continuing or interrupting the pregnancy. Current financial constraints on the National Healthcare Service (NHS) resources make it imperative for clinical decision-makers and budgetary planners to make the right decision of continuing or terminating a second trimester pre-viability amniorrhexis for desperate parents. To assess the economic consequences following EPPROM, the risk of infection to both baby and mother, psychological impact on the parents and associated complications and further disability after delivery on this fragile group of patients to the NHS resources. We review the clinical course, outcome, and the challenges to parents and health care professionals on three pregnancies complicated by EPPROM, occurring before 24 weeks' gestation with a membrane rupture to delivery interval (latent period) of 14 days or more. The anticipated birth of an extremely premature infant poses many challenges for parents and health care professionals. As parents are faced with difficult decisions that can have a long-term impact on the infant, family and country's resources, it is critical to provide the type of information and support that is needed by them. Taking all these into consideration with the period of ventilation and respiratory assistance in Neonatal Intensive Care Unit (NICU) is essential to provide maximum chances for survival, minimizing the risk for long term sequelae of the neonate and provides the parents enough time to decide on making the right decision with the associated guidance of the healthcare provider.
Reperfusion and Compartment Syndrome After Flexible Ureteroscopy in a Patient with an Iliac Vascular Graft
Authors: Esteban Emiliani, Michele Talso, Edgar Beltrán-Suárez, Steeve Doizi, Olivier Traxer
Journal: J Endourol Case Rep (2016)
Keywords: complications, lithotomy, position, ureteroscopy, vascular
MeSH terms: Case Reports

Background: Flexible ureteroscopy (fURS) is one of the main treatment options for urolithiasis less than 2 cm. Although fURS has no relative contraindication, some anatomical factors may need to be considered, as not all patients are suitable for the regular lithotomy position (LP). We report the case of a patient with a right iliac vascular graft that after an fURS without intraoperative incidences developed a reperfusion syndrome of the right lower limb. Case Presentation: A 46-year-old male patient was referred for treatment and follow-up in the cystinuric clinic after being found to have a 3 cm pelvic stone with a Double-J catheter in place after two failed sessions of shockwave lithotripsy. The patient was placed in the LP and a standard ureteroscopy was done with no intraoperative complications. During the first hour in the recovery room, the patient developed severe pain in the right calf muscle stiffness, edema, and increased volume. A postreperfusion and compartment syndrome diagnosis was made with emergency fasciotomy. Conclusion: To perform fURS, each case must be assessed individually. If a patient with an iliac vascular graft has to undergo fURS, the patient positioning must be modified by keeping the ipsilateral (or both) legs straight to avoid graft complications.
Laser Phototherapy (660 nm) Can Be Beneficial for Reducing Gingival Inflammation in Prosthodontics
Authors: Sávio José Cardoso Bezerra, Glauco Fioranelli Vieira, Carlos de Paula Eduardo, Patrícia Moreira de Freitas, Ana Cecilia Corrêa Aranha
Journal: Case Rep Dent (2015)

Among the new technologies developed, low power lasers have enabled new approaches to provide conservative treatment. Low power lasers act at cellular level, resulting in reduced pain, modulating inflammation, and improved tissue healing. Clinical application of the low power laser requires specific knowledge concerning laser interaction with biological tissue so that the correct irradiation protocol can be established. The present case report describes the clinical steps involved in an indirect composite resin restoration performed in a 31-year-old patient, in whom low power laser was used for soft tissue biomodulation. Laser therapy was applied with a semiconductor laser 660 nm, spot size of 0.028 cm(2), energy density of 35.7 J/cm(2), mean power of 100 mW, and energy per point as 1 J, in contact mode, on a total of 2 points (mesial and distal), totaling 2 J of energy. The therapy with low power laser can contribute positively to the success of an indirect restorative treatment.
Atypical Parkinsonism Revealing a Late Onset, Rigid and Akinetic Form of Huntington's Disease
Authors: A Ciammola, J Sassone, B Poletti, N Mencacci, R Benti, V Silani
Journal: Case Rep Neurol Med (2011)
MeSH terms: Case Reports

Huntington's disease (HD) is a rare hereditary neurodegenerative disorder characterized in over 90 percent of cases by chorea as the presenting motor symptom. We report a 54-year-old male who presented with Parkinsonism as the initial symptom of the disease. Genetic analysis revealed expansion of 40 CAG repeats, and brain MRI showed both severe caudate nuclei and cortical atrophy. Single-photon emission computed tomography (SPECT) imaging of the dopamine transporter showed nigrostriatal pathway degeneration. Here, we also describe his 2 years of clinical followup after ensuing dopaminergic stimulation.
Mucormycosis as the Elusive Cause of an Aortic Thrombus and Tissue-Obliterating Abscess
Authors: Shira R Paul, Preston S Gable
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Invasive mucormycosis is an increasingly common cause of morbidity and mortality in hematologic malignancy patients. Early consideration of the diagnosis is essential in at-risk patients, exhibiting suggestive signs and symptoms. A 56-year-old female with acute myeloid leukemia initially presented with neutropenic fever before subsequently developing dense hemiplegia due to septic emboli to the spine and multifocal abscesses. These findings were later determined to be a result of a disseminated mucor infection and represented a rare manifestation of the disease. Despite the disseminated nature of the infection, identification of the causative organism was initially impeded by limitations in obtaining a tissue sample in a severely thrombocytopenic patient, as is common among hematologic malignancy patients. As a result of this limitation, diagnosis was ultimately made via PCR on bronchiolar lavage fluid. Early consideration of the diagnosis with prompt initiation of treatment is of utmost importance in this invasive infection. Further research is needed to identify and validate rapid, minimally invasive strategies for early diagnosis of mucormycosis.