OpenMed/multicare-articles huggingface dataset:
Spinal cord ischemia after endovascular repair of infrarenal abdominal aortic aneurysm: a rare complication
Authors: George N Kouvelos, Nektario Papa, Christos Nassis, Nikolaos Xiropotamos, George Papadopoulos, Miltiadis I Matsagkas
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Neurologic deficit secondary to spinal cord ischemia after elective infrarenal, endovascular aneurysm repair (EVAR), consists a rare and rather disastrous complication. The etiology of such neurologic complication seems to be multifactorial, making this event unpredictable and foremost unpreventable. We report a case of paraparesis and bladder dysfunction that occurred immediately after the EVAR procedure. Prompt management by conservative or invasive methods seems to be important for the reversal of the neurologic deficit and the optimization of patient's outcome.
Case report: training neck and head control in children with chronic paralysis due to acute flaccid myelitis
Authors: Kathryn Noonan-Eaton, Danielle Stout, MacKenzie Goode-Roberts, Laura Leon Machado, Matthew Davis, Andrea L Behrman
Journal: Front Rehabil Sci (2023)
Keywords: activity based restorative therapy, acute flaccid myelitis, case series, head and neck control, spinal cord injury
MeSH terms: Case Reports

Background:
Acute flaccid myelitis (AFM) occurs rarely in children and adolescents when damage to spinal motor neurons rapidly causes flaccid paralysis of limb, trunk, and neck muscles and potentially respiratory failure. When neck muscles are weakened or paralyzed, a child loses head control, severely compromising engagement with their environment. Compensation for lack of head control is achieved with external support devices attached to a wheelchair, but there is no indication in the AFM literature of therapeutic efforts to restore head control. In this case series, we explore the possibility of the recovery of head control when children with AFM received activity-based restorative therapies (ABRTs) guided by principles targeting motor control.
Case description:
Three children, two male and one female, aged 6, 9, and 7, with a history of AFM-onset at 5, 7, and 4 years respectively, enrolled in an activity-based restorative therapies outpatient program targeting activation of the neuromuscular system below the lesion. Each of them lacked head control, was either ventilator-dependent or had a tracheostomy, and was a power wheelchair user via hand/foot control.
Methods:
Activity-based restorative therapies were provided 5 days/week: 1.5 h of activity-based locomotor training and 1.5 h of activity-based neuromuscular electrical stimulation.
Results:
An approach to addressing head/neck control developed iteratively across disciplines, from complete compensation with passive external head support to emerging head control during diverse tasks, e.g., sitting, reaching, driving a power chair, sit-to-stand, standing, stepping on a treadmill, and walking. Key principles identified and employed were (a) passive facilitation, (b) external head support, (c) posterior head support, (d) graded manual facilitation, and (e) independent head control.
Discussion:
The recovery of head control in children with paralysis due to AFM may be accelerated when executing a step-wise progression to effectively target and challenge head control in parallel with activity-based restorative therapies. In treating three children with a chronic lack of head control, a therapeutic strategy was iteratively developed guided by scientific principles, e.g., segmental assessment of control, to promote recovery of head control. While this strategy is encouraging, gaps in sensitive and responsive measurement instruments and treatment technologies persist in guiding assistance, challenging, and promoting independent head control.
Bilateral breast carcinoma- a rare case report
Authors: A K Dalal, A Gupta, R Singal, U Dalal, A K Attri, P Jain, A Sharma, S Gupta
Journal: J Med Life (2011)
Keywords: breast, carcinoma, chemotherapy, mastectomy, synchronous, ultrasonography
MeSH terms: Breast Neoplasms / diagnosis, Carcinoma / diagnosis, Carcinoma, Ductal, Breast / diagnosis, Carcinoma, Lobular / diagnosis, Neoplasms, Multiple Primary / diagnosis, Case Reports, Aged, Female, Humans

We are presenting a rare case of bilateral breast cancer. A 65-year-old female reported to us with complaint of lump in the left breast. There was positive family history. The patient was diagnosed with carcinoma breast of left side on edge biopsy and of right side by ultrasonography, which was confirmed on fine needle aspiration cytology. At the time of admission, ultrasonography of the abdomen and right breast were normal. After 1 month, the patient was readmitted with redness over the inner quadrant of the right breast skin.
Tuberculosis of the adrenal gland: a case report and review of the literature of infections of the adrenal gland
Authors: Jagriti Upadhyay, Praveen Sudhindra, George Abraham, Nitin Trivedi
Journal: Int J Endocrinol (2014)
MeSH terms: Review

Infections of the adrenal glands remain an important cause of adrenal insufficiency, especially in the developing world. Indeed, when Thomas Addison first described the condition that now bears his name over 150 years ago, the vast majority of cases were attributable to tuberculosis. Here we describe a classic, but relatively uncommon, presentation in the United States of adrenal insufficiency followed by a review of the current literature pertaining to adrenal infections.
Primary hepatic neuroendocrine tumor associated with hypertension: A case report
Authors: Bin Zhao, Jie Mao, Yumin Li
Journal: Front Surg (2023)
Keywords: case report, hypertension, liver, neuroendocrine tumors, primary
MeSH terms: Case Reports

Background:
Primary neuroendocrine tumors are exceedingly rare and often misdiagnosed. The combined methods of ultrasonography, computed tomography ,and magnetic resonance imaging are typically applied. The diagnosis of the disease mainly depends on the histopathological examination. Surgical resection is the most effective treatment.
Case presentation:
In the report, we describe the case of a patient with a primary hepatic neuroendocrine tumor (PHNET) associated with hypertension. The patient suffered from uncontrolled hypertension before the operation, and the blood pressure was not well controlled by oral antihypertensive drugs such as nifedipine, valsartan, and hydrochlorothiazide, but the patient's blood pressure completely returned to normal after the operation without drug control.
Conclusions:
We encountered a rare case of a PHNET associated with hypertension via careful screening noticed by the patient at work; furthermore, we hope to collect more cases and find the relationship between neuroendocrine tumors and hypertension.
Right Internal Jugular Vein Phlebectasia: A Rare Cause of Neck Swelling
Authors: Deepanjan Bhattacharya, Mounika Endrakanti, Rakesh Kumar
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Internal jugular vein (IJV) phlebectasia is a rare condition presenting as a self-reducible soft tissue swelling of the neck due to fusiform dilation of the venous wall. We report the case of a 7-year-old boy who presented with painless soft mass in the side of the neck which appears during coughing and straining and reduces spontaneously. Diagnosis was confirmed by Doppler ultrasonography and magnetic resonance imaging of the neck. Conservative management and regular follow-up were considered. In this case report, we highlight this rare benign condition as an uncommon differential of neck swellings in order to avoid unnecessary diagnostic workup and interventions.
Spontaneous Remission in an Older Patient with Relapsed FLT3 ITD Mutant AML
Authors: Pankit Vachhani, Jason H Mendler, Andrew Evans, George Deeb, Petr Starostik, Paul K Wallace, Eunice S Wang
Journal: Case Rep Hematol (2016)
MeSH terms: Case Reports

Spontaneous remission (SR) of acute myeloid leukemia (AML) is a very rare phenomenon. AML characterized by FLT3 internal tandem duplication (FLT3 ITD) is typically associated with an aggressive clinical course with rapid progression, relapse, and short overall survival in the absence of transplantation. We report here the first case of SR of FLT3 ITD mutant AML in the literature. Our patient was an elderly woman with relapsed NPM1 and FLT3 ITD mutant AML whose disease underwent SR for a brief duration without precipitating cause. We review the potential immune mechanisms underlying SR in AML and discuss the implications for novel immunotherapeutic approaches for FLT3 mutant AML.
A case of bilateral abdominoscrotal hydroceles without communication with the peritoneum
Authors: Eiji Hisamatsu, Shizuko Takagi, Masashi Nomi, Yoshifumi Sugita
Journal: Indian J Urol (2010)
Keywords: abdominoscrotal hydrocele, communication, peritoneum
MeSH terms: Case Reports

Abdominoscrotal hydrocele (ASH) is an uncommon entity. Although various theories on the development of ASH have been proposed, its etiology is still unclear. According to several etiological theories, it is necessary that ASH have communication with the peritoneum. We present a case of bilateral ASH that had no communication with the peritoneum.
Vanishing bone metastases: a pitfall in contrast-enhanced CT in patients with venous thrombosis
Authors: R Pruente, C D Strickland, P J Koo
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Enhancement patterns of visceral venous collaterals are well documented in cases of superior vena cava obstruction. Only recently has intraosseous venous collateral enhancement been described. We describe an unusual case of vertebral marrow enhancement in the lower thoracic spine related to venous collateral circulation caused by an incidental hemiazygos thrombus. Misinterpretation of this finding can lead to the erroneous interpretation of sclerotic bone metastases.
Case Report: Pericardial Effusion Treated With Pericardiectomy Plus Right Atrial Mass Resection: A 2-Year Follow-Up of Cardiac Rosai-Dorfman Disease
Authors: Edoardo Conte, Antonio Brucato, Francesco Petrella, Emanuela Passoni, Gianfranco Lauri, Mauro Bigliardi, De Camilli Elisa, Gabriella Ricciardi, Carlo Selmi, Piergiuseppe Agostoni, Francesco Alamanni, Daniele Andreini
Journal: Front Cardiovasc Med (2021)
Keywords: rosai-dorfman disease, case report, pericardial effusion, pericardiectomy, right atrial mass
MeSH terms: Case Reports

Background: Rosai-Dorfman disease (RDD) is rare a sinus histiocytosis typically causing lymphadenopathy. Heart involvement is anecdotal, and <30 cases of cardiac RDD (cRDD) have been reported so far. Case Presentation: A 46-year old woman with positive clinical history for RDD was admitted to our cardiology department with transthoracic echocardiography diagnosis of severe pericardial effusion and right atrial masses. Pericardiocentesis with catheter insertion was performed 3 days after the admission due to clinical evidence of cardiac tamponade. After 10 weeks of maximal medical therapy for inflammatory pericarditis, including non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, steroids, and anakinra, at least 100 ml of pericardial citric liquid has been daily drained suggesting no clinical improvement. Pericardial liquid analysis demonstrated no malignant cells, but immunohistochemical analysis resulted positive for AE1-AE3, D2-40, S100, and CD68 consistent with an RDD diagnosis. Surgical management was judged clinically indicated, and 2 months after admission, the patient underwent pericardiectomy and debulking of atrial mass with freezing of remaining atrial neoformation. Regular clinical and echocardiography evaluation was performed without pericardial effusion recurrence after 2 years of follow-up. Conclusions: This is the first case ever reported of cRDD who survived after 2 years of follow-up. Pericardiectomy could be feasible and effective for recurrent pericardial effusion in cRDD. Close follow-up and a multidisciplinary environment is needed to take care of cRDD patients.
Unexpected delivery: a case report of cryptic pregnancy in Nigeria
Authors: Uloaku Akubueze Nto-Ezimah, Nto Johnson Nto, Emmanuel Anayochukwu Esom, Chika Juliet Okwor, Charles Adiri
Journal: Pan Afr Med J (2020)
Keywords: cryptic pregnancy, nigeria, delivery, denial of pregnancy, gestation, neonatal risk
MeSH terms: Delivery, Obstetric, Denial, Psychological, Overweight / complications, Pregnancy / psychology, Case Reports, Female, Humans, Infant, Newborn, Nigeria, Pregnancy Outcome, Young Adult

The etiology of cryptic pregnancy has not been fully elucidated and there exist misconceptions about this phenomenon in our contemporary Nigerian society. This case presents the first case report of cryptic pregnancy in sub-Saharan Africa. A case of a 19 year old overweight female student who presented to the sick bay at 01: 30 hours with a 3-day history of lower back pain, abdominal discomfort and constipation. At the sick bay the general practitioner on call asked if she was pregnant and she vehemently said no, recounting that she sees her menstruation regularly. Abdominal examination however, revealed a gravid uterus of about 36 weeks and vaginal examination showed a fully dilated cervix. She was surprised, terrified and confused and only remembered having unprotected sexual intercourse many months earlier. Barely two hours later, she gave birth via spontaneous vaginal delivery, to a live female infant at 03: 14 hours. This case emphasizes the need for general practitioners and specialists in sub-Saharan Africa to be aware of the phenomenon of cryptic pregnancy, which involves women not being conscious of their gravid state until final weeks of gestation or at delivery, to reduce neonatal and maternal complications.
Bell clapper testis, torsion, and detorsion: a case report
Authors: F Khan, Okwudili Muoka, G M Watson
Journal: Case Rep Urol (2011)
MeSH terms: Case Reports

We are presenting a common but interesting case of testicular torsion. Torsion is a common important urological emergency. History and examination is important for diagnosis. Urgent testicular exploration is an important message if in doubt.
Reconstruction of Delayed Proximal Interphalangeal Joint Fracture-Dislocation Using Hemi-Hamate Arthroplasty: A Case Report
Authors: Rishikesh V Sawant, Nilesh Darawade, Darshankumar Sonawane, Anish Tawde, Nikhil Bhandari
Journal: Cureus (2024)
Keywords: articular comminution, fracture dislocation, graft, hemi-hamate, proximal interphalangeal joint
MeSH terms: Case Reports

This case report aims to delineate the clinical outcomes and technical considerations of hemi-hamate arthroplasty in the reconstruction of a delayed proximal interphalangeal (PIP) joint fracture-dislocation. It underscores the procedure's viability as a reconstructive option for complex finger injuries with delayed presentation. A 23-year-old male presented six weeks post-injury with a PIP joint fracture-dislocation of the left index finger. Traditional management options were limited due to the delayed presentation and the nature of the injury. A surgical intervention was performed using an autologous osteochondral hemi-hamate graft to reconstruct the articular surface. Herein, we describe the detailed surgical steps, postoperative care, and rehabilitation protocols. Over a five-month follow-up period, the patient demonstrated significant functional improvement. The range of motion in the PIP joint increased substantially, with a notable reduction in pain levels. Radiographic assessments showed successful graft incorporation and joint alignment. The patient reported satisfaction with the aesthetic and functional outcome, highlighting an enhanced quality of life post-surgery. Hemi-hamate arthroplasty emerges as a favorable surgical option for delayed PIP joint fracture-dislocations, offering improved articular congruity, joint stability, and functional outcomes. This case contributes to the growing body of evidence supporting the procedure's effectiveness and underscores the importance of considering innovative approaches in complex hand injuries.
Case report: Local bacteriophage therapy for fracture-related infection with polymicrobial multi-resistant bacteria: hydrogel application and postoperative phage analysis through metagenomic sequencing
Authors: Volker Alt, André Gessner, Maya Merabishvili, Florian Hitzenbichler, Gopala Krishna Mannala, David Peterhoff, Nike Walter, Jean-Paul Pirnay, Andreas Hiergeist, Markus Rupp
Journal: Front Med (Lausanne) (2024)
Keywords: masquelet, bacteriophage, fracture-related infection, hydrogel, metagenomic
MeSH terms: Case Reports

Fracture-related infections can be challenging, particularly with concomitant severe bone defects and multi-resistant microorganisms. We present a case of a 42-year-old patient with a fracture-related infection following a war injury from a gunshot, resulting in a 12-cm subtrochanteric segmental bone defect and the detection of four different multi-resistant Gram-negative bacteria. Due to antibiotic drug resistance, treatment with bacteriophages was considered. Phage susceptibility testing revealed the activity of a commercially available bacteriophage cocktail (Intesti bacteriophage, Eliava Institute, Tbilisi, Georgia). This phage cocktail was included in a modified two-stage Masquelet technique. During the first intervention, the bone was debrided and samples for microbiological and phage testing were harvested. The indwelling intramedullary rod was removed, and the bone defect was filled with a PMMA spacer loaded with colistin and the bone stabilized with a plate. During the second procedure, the PMMA spacer was removed and a silver-coated angular stable plate was implanted. The bone defect was filled with a fibular autograft and allograft cancellous bone chips. At the end of the procedure, the Intesti bacteriophage cocktail was injected into a DAC hydrogel and this bacteriophage hydrogel composite was then put onto the angular stable plate. Postoperatively the wound fluid was collected over 72 h, and high-throughput metagenomic sequencing was performed. This showed a time-dependent release of the bacteriophages in the wound fluid, with a relatively high concentration after 12 h, decreasing to DNA copies of 0 after 72 h. Furthermore, we have assessed the release of phages from DAC gel and the effect of DAC gel on the phages in vitro. The results showed a stable and rapid release of phages from the DAC gel (~1×103 PFU/mL). The clinical course of the patient showed no relapse of the infection with good bone consolidation of the bone defect after 1 year without the need for any surgical revision. To the best of our knowledge, this is the first case that shows the detection of bacteriophage DNA copies by high-throughput metagenomics sequencing in a patient with a complex fracture-related infection. Successful treatment of this case encourages further investigation of bacteriophage therapy in patients with complex bone and joint infections.
Community treatment of latent tuberculosis in child and adult refugee populations: outcomes and successes
Authors: Emily Harwood-Johnson, Karen S Leis, Jacelyn Hanson, Jordan Olfert, Yvonne Blonde, Mahli Brindamour
Journal: Front Public Health (2023)
Keywords: canada, community, immigrant, latent tuberculosis, refugee
MeSH terms: Latent Tuberculosis / complications, Latent Tuberculosis / diagnosis, Latent Tuberculosis / drug therapy, Refugees, Tuberculosis / complications, Case Reports, Adult, Canada, Child, Humans, Interferon-gamma Release Tests / methods, Retrospective Studies

Background:
Tuberculosis (TB) is the world's leading infectious cause of death, killing millions every year. In Canada, considered a low-incidence country for TB, the burden of the disease is unequally distributed, with most cases of latent tuberculosis infection (LTBI) experienced by newcomers from endemic regions. The purpose of this study was to measure LTBI treatment acceptance and completion outcomes of LTBI treatment at the REACH clinic in Saskatoon, a local refugee clinic providing primary care-based LTBI management.
Methods:
A retrospective case series by sampling methodology was applied to review patients who visited the REACH clinic between January 2017 and June 2021 and who had an interferon-gamma release assay (IGRA) or tuberculin skin test (TST) done for LTBI screening. Those with positive results were retained for analysis. The LTBI treatment acceptance and completion groups were compared according to demographic variables, WHO regions of origin, year of arrival to Canada, and LTBI treatment regimen.
Results:
A total of 523 patients were screened for LTBI, of whom 125 tested positive, leading to a test positivity of 23.9%. The treatment acceptance rate was 84.8%, and the treatment completion rate was 93.3%. All of those who declined treatment were more than 18 years of age (p = 0.02). Otherwise, treatment acceptance and completion rates did not vary significantly in association with gender, categories of refugees, WHO region of origin, year of arrival to Canada, or LTBI treatment regimen used.
Discussion:
The refugee clinic acceptance and completion rates in this study are high and meet Canadian TB standards of care. The multidisciplinary clinic model and community support are important facilitators, which, in combination with shorter treatment regimens, offer a path forward for LTBI management among refugees resettling in low-incidence countries.
Insidious Mass Within a Sinus
Authors: Aneesh Dhorepatil, Vivek Modi, Mahwash Kassi, Mohammad A R Chamsi-Pasha, April Ewton, Dyron Allen, Mouaz H Al Mallah
Journal: Methodist Debakey Cardiovasc J (2023)
Keywords: cardiac mri, cardiac pet, histo-pathology
MeSH terms: Lymphoma, Large B-Cell, Diffuse / diagnostic imaging, Lymphoma, Large B-Cell, Diffuse / drug therapy, Lymphoma, Large B-Cell, Diffuse / pathology, Case Reports, Aged, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Cyclophosphamide / therapeutic use, Doxorubicin / therapeutic use, Echocardiography, Humans, Positron-Emission Tomography, Prednisone / therapeutic use, Rituximab / therapeutic use, Vincristine / therapeutic use, Rituximab, Cyclophosphamide, Vincristine, Prednisone, Doxorubicin

A 75-year-old patient was incidentally found to have an intracardiac mass by echocardiography. Subsequent cardiac magnetic resonance imaging and cardiac positron emission tomography confirmed a large and possibly malignant mass extending from the right atrium into the coronary sinus. The patient underwent an intracardiac echocardiography guided biopsy, which revealed diffuse B-cell lymphoma, and is currently undergoing rituximab, etoposide, vincristine, cyclophosphamide, and doxorubicin (R-EPOCH)-based chemotherapy.