OpenMed/multicare-articles huggingface dataset:
Bilateral vitreopapillary traction demonstrated by optical coherence tomography mistaken for papilledema
Authors: Elizabeth Houle, Neil R Miller
Journal: Case Rep Ophthalmol Med (2012)

Purpose. The purpose of this study was to report a case of bilateral vitreopapillary traction, previously misdiagnosed as papilledema. Methods. A case report is presented of a 47-year-old woman with a prior diagnosis of papilledema, who is shown to have bilateral vitreopapillary traction rather than true optic disc swelling, confirmed by optical coherence tomography (OCT). Results. OCT showed vitreous traction surrounding the optic discs of both eyes. Fluorescein angiography demonstrated focal leakage of both discs. Conclusion. Bilateral disc elevation caused by vitreous traction can be confused with papilledema. In such cases, OCT can be used to arrive at the correct diagnosis. Although the phenomenon of vitreopapillary traction is well reported, this case indicates that not all ophthalmologists recognize the condition.
Convexity Subarachnoid Hemorrhage, Pseudomonas Aeruginosa (PA) Infective Endocarditis and Left Atrial Appendage Occluder (LAAO) Device Infection. A Case Report
Authors: Monique Boukobza, Ibtissem Smaali, Xavier Duval, Jean-Pierre Laissy
Journal: Open Neuroimag J (2017)
Keywords: convexity subarachnoid hemorrhage, infective endocarditis, left atrial appendage occluder, mycotic aneurysm, pseudomonas aeruginosa, t2-gre images

An 83 year-old-man with left atrial appendage occluder (LAAO) developed Pseudomonas Aeruginosa (PA) infective endocarditis. MRI at day 3 of onset showed distal small infarcts in both middle cerebral arteries and left postero-inferior cerebellar artery territories. MRI at day 6 revealed two sites of convexity subarachnoid hemorrhage (cSAH). MRA and CTA failed to reveal a Mycotic aneurysm. The radiologic findings favor the assumption of necrosis of distal branches of mca or of pial arteries wall. This case present three unusual features: the presence of localized cSAH after initiation of antibiotherapy without mycotic aneurysm being individualized; the late occurrence of infective endocarditis after LAAO implantation; the very rare occurrence of PA in prosthetic infections.
Evidence of nickel and other trace elements and their relationship to clinical findings in acute Mesoamerican Nephropathy: A case-control analysis
Authors: Rebecca S B Fischer, Jason M Unrine, Chandan Vangala, Wayne T Sanderson, Sreedhar Mandayam, Kristy O Murray
Journal: PLoS One (2020)
MeSH terms: Acute Kidney Injury / etiology, Nickel / toxicity, Trace Elements / toxicity, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Acute Kidney Injury / epidemiology, Acute Kidney Injury / physiopathology, Adult, Agricultural Workers' Diseases / epidemiology, Agricultural Workers' Diseases / etiology, Agricultural Workers' Diseases / physiopathology, Case-Control Studies, Creatinine / blood, Endemic Diseases, Farmers, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Nails / chemistry, Nicaragua / epidemiology, Nickel / analysis, Occupational Exposure / adverse effects, Occupational Exposure / analysis, Renal Insufficiency, Chronic / epidemiology, Renal Insufficiency, Chronic / etiology, Renal Insufficiency, Chronic / physiopathology, Trace Elements / analysis, Young Adult, Trace Elements, Nickel, Creatinine

Background:
Although there are several hypothesized etiologies of Mesoamerican Nephropathy (MeN), evidence has not yet pointed to the underlying cause. Exposure to various trace elements can cause the clinical features observed in MeN.
Methods and findings:
We measured 15 trace elements, including heavy metals, in renal case-patients (n = 18) and healthy controls (n = 36) in a MeN high-risk region of Nicaragua. Toenails clippings from study participants were analyzed using inductively coupled plasma mass spectrometry. A case-control analysis was performed, and concentrations were also analyzed over participant characteristics and clinical parameters. Nickel (Ni) concentrations were significantly higher in toenails from cases (1.554 mg/kg [0.176-42.647]) than controls (0.208 mg/kg [0.055-51.235]; p<0.001). Ni concentrations correlated positively with serum creatinine levels (p = 0.001) and negatively with eGFR (p = 0.001). Greater Ni exposure was also associated with higher leukocyte (p = 0.001) and neutrophil (p = 0.003) counts, fewer lymphocytes (p = 0.003), and lower hemoglobin (p = 0.004) and hematocrit (p = 0.011).
Conclusions:
Low-dose, chronic environmental exposure to Ni is a possible health risk in this setting. Ni intoxication and resulting systemic and renal effects could explain the clinical signs observed during early MeN. This study provides compelling evidence for a role of Ni in the acute renal impairment observed in this MeN high-risk population. Additional work to assess exposure levels in a larger and heterogeneous population, identify environmental sources of Ni and exposure pathways, and evaluate the link between Ni and MeN pathogenesis are urgently needed.
Navigational Bronchoscopy with Cryobiopsy for Diagnosis of ILD
Authors: Fernando Figueroa Rodriguez, Asfar Ghauri, Tony Abdo, Salim Daouk, Shideler Barbara, Houssein A Youness
Journal: Case Rep Pulmonol (2022)
MeSH terms: Case Reports

Background:
Interstitial lung diseases (ILDs) are a group of parenchymal pulmonary diseases in which pathologic diagnosis is essential. Although cryobiopsy has a high diagnostic yield, the complication rate remains high. Case Presentation. We report two cases of lung cryobiopsy guided by navigational bronchoscopy (LCB) for the diagnosis of ILD. In both cases, a CT chest angiogram (CTA) using a navigational protocol was performed. Targets were premarked and reached with the navigational system. Radial ultrasound (RU) was applied in combination with fluoroscopy guidance (FG) prior to sampling. Both patients achieved a final diagnosis; they were discharged home after procedure and no complications were noted. Discussion. By using a CTA with navigational guidance, we were able to perform cryobiopsy in areas with most disease activity and least vascularization.
Conclusion:
LCB used with navigational guidance for the diagnosis of ILD provides may be a safe and effective procedure that provides high diagnostic yield. Limitations include cost, availability, and expertise. Larger trials are needed to confirm the additional benefit.
Enigmatic Rapidly Enlarging Nasal Mass That Is Not Cancer
Authors: Trilok Shrivastava, Lin Li, Sonia Tanwar, Rabab Nasim, Vincent Gullas, Jay Pescatore, Michael Nelson
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

Cutaneous blastomycosis is not rare, but progressively enlarging nasal mass as the only presentation with nondiagnostic biopsy results, presence of pulmonary fibrosis, nodules and lymphadenopathy, and urinary sediments, as well as ANA and p-ANCA positivity, can make things more cryptic than expected.
Easy-to-Use Preservation and Application of Platelet-Rich Plasma in Combination Wound Therapy With a Gelatin Sheet and Freeze-Dried Platelet-Rich Plasma: A Case Report
Authors: Naoki Morimoto, Natsuko Kakudo, Tsunekata Ogura, Tomoya Hara, Makoto Matsui, Masaya Yamamoto, Yasuhiko Tabata, Kenji Kusumoto
Journal: Eplasty (2016)
Keywords: chronic skin ulcers, controlled release, freeze-dried, gelatin sheet, platelet-rich plasma
MeSH terms: Case Reports

Objective:
Platelet-rich plasma is blood plasma enriched with platelets and contains various growth factors. Two major issues remain to be resolved in the use of platelet-rich plasma: the short biological activity after application, and the need to prepare platelet-rich plasma at each application instance. To overcome these problems, we developed a drug delivery system using gelatin hydrogel and preserved the excess platelet-rich plasma as freeze-dried platelet-rich plasma. We then applied combination treatment with a gelatin sheet and platelet-rich plasma at the first instance and freeze-dried platelet-rich plasma at the second instance in the treatment of a nonhealing wound.
Methods:
A 68-year-old woman had suffered open fracture of her right tibia 2 years prior, and a split-thickness skin graft had been applied to repair the skin defect on the right tibia. She had multiple relapse of ulcers, and the present ulcer had not healed for 2 months. After debridement, 2 mL of activated platelet-rich plasma was applied to the ulcer, and the gelatin sheet was laid to impregnate with the platelet-rich plasma, after which the sheet was covered with a polyurethane film. Thirty-three days after the first platelet-rich plasma application, the freeze-dried platelet-rich plasma was reconstituted and 2 mL of the reconstituted platelet-rich plasma was applied with a gelatin sheet.
Results:
At 14 days after the freeze-dried platelet-rich plasma application, the wound was mostly epithelized, with the rest of the wound covered with granulation tissue.
Conclusions:
These findings suggest that combination wound therapy with a gelatin sheet and freeze-dried platelet-rich plasma is a promising method for resolving issues with conventional platelet-rich plasma treatment.
Recruitment of aged donor heart with pharmacological stress echo. A case report
Authors: Giorgio Arpesella, Sonia Gherardi, Tonino Bombardini, Eugenio Picano
Journal: Cardiovasc Ultrasound (2006)
MeSH terms: Brain Death / diagnostic imaging, Echocardiography, Stress, Heart Transplantation, Tissue Donors, Case Reports, Dipyridamole, Echocardiography, Transesophageal, Female, Humans, Male, Middle Aged, Dipyridamole

Background:
The heart transplant is a treatment of the heart failure, which is not responding to medications, and its efficiency is already proved: unfortunately, organ donation is a limiting step of this life-saving procedure. To counteract heart donor shortage, we should screen aged potential donor hearts for initial cardiomyopathy and functionally significant coronary artery disease. Donors with a history of cardiac disease are generally excluded. Coronary angiography is recommended for most male donors older than 45 years and female donors older than 50 years to evaluate coronary artery stenoses. A simpler way to screen aged potential donor hearts for initial cardiomyopathy and functionally significant coronary artery disease should be stress echocardiography.
Case report:
A marginal donor (A 57 year old woman meeting legal requirements for brain death) underwent a transesophageal (TE) Dipyridamole stress echo (6 minutes accelerated protocol) to rule out moderate or severe heart and coronary artery disease. Wall motion was normal at baseline and at peak stress (WMSI = 1 at baseline and peak stress, without signs of stress inducible ischemia). The pressure/volume ratio was 9.6 mmHg/ml/m2 at baseline, increasing to 14 mmHg/ml/m2 at peak stress, demonstrating absence of latent myocardial dysfunction. The marginal donor heart was transplanted to a recipient "marginal" for co-morbidity (a 63 year old man with multiple myeloma and cardiac amyloidosis, chronic severe heart failure, NYHA class IV). Postoperative treatment and early immunosuppressant regimen were performed according to standard protocols. The transplanted heart was assessed normal for dimensions and ventricular function at transthoracic (TT) echocardiography on post-transplant day 7. Coronary artery disease was ruled out at coronary angiography one month after transplant; left ventriculography showed normal global and segmental LV function of the transplanted heart.
Conclusion:
For the first time stress echo was successfully used in the critical theater of screening potential donor hearts. This method is enormously more feasible, less expensive, and more environmentally sustainable than any possible alternative strategy based on stress scintigraphy perfusion imaging or coronary angiography. The selection of hearts "too good to die" on the basis of bedside resting and stress echo can be a critical way to solve the mismatch between donor need and supply.
Pre-expanded occipito-dorsal flap reconstruction for neck burns: A novel approach
Authors: Sameena Hassan, Peter Brooks
Journal: Burns Trauma (2014)
Keywords: burns, neck, occipito-dorsal flap, tissue expansion
MeSH terms: Case Reports

Reconstruction of the neck following a burn injury poses a significant challenge to reconstructive burn surgeons. Here, we report a case of successful application of pre-expanded occipito-dorsal flaps in the reconstruction of postburn scars and contractures in the neck. The patient was a 10-year-old boy who sustained scars and contractures secondary to a burn injury 4 years ago. "Super-thin" flaps were obtained through pre-expansion in the occipito-dorsal area and then transferred to the recipient site. This approach resulted in an esthetic satisfaction and a significant functional improvement, thereby having significant clinical implications in the reconstruction of soft tissue damage secondary to burn injuries in the neck.
Abdominal wall schwannoma: case report and review of the literature
Authors: A Mishra, M Hamadto, M Azzabi, M Elfagieh
Journal: Case Rep Radiol (2013)

A 29-year-old female had presented to surgical outpatient's department complaining of lump in the anterior abdominal wall. Ultrasound and magnetic resonance imaging revealed a solid degenerated tumor in the anterior abdominal wall. It was surgically excised, and histopathology confirmed it to be "ancient" schwannoma. To our knowledge, this is the second reported case of an abdominal wall ancient schwannoma in the medical literature.
A Novel c-Mesenchymal-Epithelial Transition Factor Intergenic Fusion Response to Crizotinib in a Chinese Patient With Lung Adenocarcinoma: A Case Report
Authors: Hongge Liang, Dexun Zhou, Lin Dai, Moqin Zhang, Zhancheng Gao, Xinlin Mu
Journal: Front Oncol (2021)
Keywords: met intergenic fusion, crizotinib, interstitial lung disease, lung adenocarcinoma, partial response
MeSH terms: Case Reports

Background:
The c-mesenchymal-epithelial transition factor (C-MET) is an oncogene encoding a tyrosine kinase receptor that plays an important role in tumor growth and metastasis. The National Comprehensive Cancer Network (NCCN) guidelines have approved carbatinib/crizotinib for advanced non-small cell lung cancer (NSCLC) patients with MET exon 14 skipping.
Methods:
In June 2020, the Department of Respiratory and Critical Care Medicine of Peking University People's Hospital admitted a 72-year-old male patient with lung adenocarcinoma (LADC) with a history of interstitial lung disease secondary to antineutrophil cytoplasmic antibody-associated vasculitis. Genetic examination by next-generation sequencing showed an intergenic fusion of MET, and crizotinib was administered on August 14, 2020. Follow-up showed that tumor volume was significantly reduced. However, crizotinib was discontinued in November 2020 because of the patient's worsening interstitial lung disease, and CT scans showed continued partial response (PR) for 5 months. In April 2021, right lower lobe mass progressed, and disease progression was considered.
Conclusion:
This was the first case of a patient with LADC with MET intergenic fusion who significantly benefited from crizotinib. Even after crizotinib was discontinued for 5 months, the patient continued exhibiting PR, suggesting that MET intergenic fusion may have carcinogenic activity in LADC and was sensitive to crizotinib.
Solar retinopathy: a multimodal analysis
Authors: Claudia Bruè, Cesare Mariotti, Edoardo De Franco, Yale Fisher, Jacopo Maria Guidotti, Alfonso Giovannini
Journal: Case Rep Ophthalmol Med (2013)

Purpose. Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT) findings are not always consistent. We report on two cases of solar retinopathy and discuss its differential diagnosis. Methods. This is an observational case study. Results. A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autofluorescence showed hypoautofluorescence surrounded by a relatively hyperautofluorescent ring, bilaterally. Similar clinical and morphological findings were detected in a 27-year-old male. Conclusions. Solar retinopathy has a subtle presentation and patients often deny sun-gazing. SD-OCT and fundus autofluorescence are noninvasive and useful tools for its diagnosis.
Conservative Treatment of Postinfarction Left Ventricular Free Wall Rupture
Authors: Anh Tuan Vo, Thu Trang Nguyen, Thanh Thuy Tran, Dinh Hoang Nguyen
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Left ventricular free wall rupture is a fatal complication of acute myocardial infarction. Emergency surgical repair is usually indicated to treat this condition. However, in very high surgical risk cohort, conservative treatment can also be considered. We report a case of left ventricle pseudoaneurysm that was successfully treated conservatively in a 4-year period.
Vesicocutaneous fistula due to vesical diverticulitis with stones: A case report and literature review
Authors: Jun Akatsuka, Kyota Suzuki, Shunsuke Ikuma, Masato Yanagi, Yuki Endo, Hayato Takeda, Yuka Toyama, Teruyuki Dohi, Go Kimura, Yukihiro Kondo
Journal: IJU Case Rep (2022)
Keywords: calculi, diverticulum, urinary bladder, vesicocutaneous fistula
MeSH terms: Case Reports

Introduction:
We encountered an extremely rare case of a vesicocutaneous fistula due to vesical diverticulitis with stones.
Case presentation:
A 78-year-old male patient presented to our department with complaints of suppurative discharge in the suprapubic area. Computed tomography revealed an enlarged prostate, a vesical diverticulum with stones located on the ventral side, and an aberrant connection between the anterior bladder wall and the external surface of the skin. The patient was diagnosed with a vesicocutaneous fistula due to vesical diverticulitis and was successfully treated with a multidisciplinary approach including vesical diverticulectomy with stone removal and nonviable tissue debridement. The patient continues to receive regular outpatient follow-ups with urinary catheter changes.
Conclusion:
Vesicocutaneous fistulas due to vesical diverticulitis with stones are extremely rare. We should be aware that a vesical diverticulum with stones located on the ventral side might pose a high-risk factor for the formation of a vesicocutaneous fistula in elderly patients.
Biliary Tract Abnormalities as a Cause of Distal Bowel Gas in Neonatal Duodenal Atresia
Authors: Surasak Puvabanditsin, Marissa Botwinick, Charlotte Wang Chen, Aditya Joshi, Rajeev Mehta
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Background:
The presence of distal bowel gas in an infant does not exclude the diagnosis of duodenal atresia.
Case presentation:
We report a term neonate with Down syndrome. The infant developed vomiting and cyanosis with each feeding soon after birth. Plain film abdominal X-rays showed a nonspecific gas-filled stomach and small bowel. Duodenal atresia and an anomalous common bile were noted on an upper GI study and exploratory laparotomy.
Conclusion:
In the absence of a "double bubble" appearance and intestinal gas distally on a plain radiograph, one must not exclude duodenal atresia as the differential diagnosis.
Page Kidney: An Unusual Complication of a Renal Transplant Biopsy
Authors: Jacob D McFadden, Jason S Hawksworth
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Page kidney, a rare phenomenon whereby external compression of renal parenchyma can induce hypertension, can be caused by subcapsular hematoma following renal transplant biopsy. Surgical intervention is often warranted to salvage the transplant kidney. This is a case report of a patient with acute T-cell-mediated rejection and no other risk factors for postprocedural bleeding that developed Page kidney. The patient had no signs or symptoms for >24 hours from the time of biopsy, underscoring the need for awareness of this rare but potentially catastrophic complication of renal transplant biopsies.
Combined Hepatocholangiocarcinoma Associated with Humoral Hypercalcemia of Malignancy and Chronic Inflammatory Demyelinating Polyneuropathy
Authors: Ruben Manuel Luciano Colunga Biancatelli, Marco Ciacciarelli, Alessandro Polidoro, Piera Clemenzi, Viviana Congedo, Leonardo Calvosa, Eleonora D'Armiento, Carmen Misurale, Davide Bellini, Stefano Badia, Massimiliano Mancini, Vincenzo Petrozza, Luigi Iuliano
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Paraneoplastic syndromes are often a diagnostic challenge to doctors and may have a heterogeneous presentation, including humoral hypercalcemia of malignancy (HHM), most commonly caused by squamous cell cancer and renal, ovarian, endometrial, and breast cancer. Chronic inflammatory demyelinating polyneuropathy (CIDP) has been described in patients affected by several types of cancer, especially hematologic malignancies, and a possible paraneoplastic pathogenesis of this neurological disease has been suggested. This report describes a 56-year-old man with a history of CIDP diagnosed 3 months earlier and persistently elevated aminotransferases for 18 months who was admitted to our internal medicine unit with abdominal pain, fatigue, and severe hypercalcemia with low serum intact parathyroid hormone. Parathyroid hormone-related protein (PTH-rP) was markedly high. Liver imaging showed a large hepatic mass in the right lobe, and percutaneous ultrasound-guided biopsy revealed histopathological findings consistent with a combined hepatocholangiocarcinoma (CHCC). We supposed that both HHM and CIDP could represent a paraneoplastic manifestation of CHCC.
Primary squamous cell carcinoma of the kidney in southern Senegal (Ziguinchor): case report and review of the literature
Authors: Fabrice Senghor, Ibou Thiam, Omar Sow, Aboubacar Traore, Boubacar Fall, Chérif Mohamed Moustapha Dial
Journal: Pan Afr Med J (2021)
Keywords: kidney neoplasm, senegal, case report, metaplasia, squamous cell carcinoma
MeSH terms: Carcinoma, Squamous Cell / diagnosis, Carcinoma, Squamous Cell / surgery, Kidney Neoplasms / diagnosis, Kidney Neoplasms / surgery, Case Reports, Review, Aged, Female, Humans, Kidney, Kidney Pelvis, Nephrectomy, Senegal

The kidney's primary squamous cell carcinoma is a rare tumor, representing 0.5-0.8% of malignant renal tumors and 4% of upper urinary tract tumors. This pathology often occurs after a long past history of renal lithiasis and repeated untreated or poorly treated urinary tract infections. The delay in diagnosis resulting from an insidious symptomatology, without specific signs, often leads to a pejorative development, especially in poor countries. A seventy-nine-year-old Senegalese woman, with no past history of lithiasis nor recurrent urinary tract infection and urinary schistosomiasis, was received for a recurrent total hematuria associated with left lumbar pain. Clinical examination revealed a mobile tender left lumbar mass, with lumbar contact and renal sloshing. The left renal tumor´s diagnosis was retained on clinical and scannographic arguments, justifying an enlarged left total nephrectomy, by laparotomy. The anatomopathological examination of the surgical sample made it possible to make the diagnosis of primary invasive squamous cell carcinoma of the left kidney and to find foci of carcinoma in-situ on squamous metaplasia in the calyxes. Unlike the typical case of primary squamous cell carcinoma of the kidney, our patient did not have a long past history of renal lithiasis nor untreated or poorly treated recurrent urinary tract infections and urinary schistosomiasis. Primary squamous cell carcinoma of the kidney may not be related to a past history of recurrent urinary tract infections and lithiasis, but to any other cause of squamous metaplasia of the urothelium. Surgery remains the best option for this entity.