OpenMed/multicare-articles huggingface dataset:
Chylous ascites as the main manifestation of left ventricular dysfunction: a case report
Authors: Ezequiel Ridruejo, Oscar G Mandó
Journal: BMC Gastroenterol (2005)
MeSH terms: Chylous Ascites / etiology, Ventricular Dysfunction, Left / complications, Case Reports, Aged, Cardiac Output, Low / etiology, Cardiac Output, Low / pathology, Chylous Ascites / diagnostic imaging, Humans, Hypertension, Portal / complications, Liver / pathology, Male, Tomography, Spiral Computed

Background:
Ascites is one of the most common complications of liver diseases, even though in 15% of the cases it is related to extrahepatic diseases; 3% are of cardiac nature and they appear associated with signs and symptoms of heart failure.
Case presentation:
A 70 year old man was admitted with more than one year history of abdominal distension and a weight gain of 10 kilograms. He is asymptomatic and walks 2000-3000 meters a day without angor or dyspnea. The physical examination shows moderate abdominal distension, with no hepatosplenomegaly or edema, and there is mild jugular vein distension. The studies performed (complete laboratory work up, paracentesis, liver biopsy, echocardiogram, intrahepatic pressure measurements, etc.) showed a chylous ascites related to portal hypertension, and left ventricular dysfunction was the only probable cause found.
Conclusion:
Asymptomatic heart dysfunction can mimic liver disease and should be kept in mind as a cause of chylous ascites.
Trabectedin for desmoplastic small round cell tumours: a possible treatment option?
Authors: Anna Maria Frezza, Jeremy S Whelan, Palma Dileo
Journal: Clin Sarcoma Res (2014)
Keywords: chemotherapy, desmoplastic small round cell tumor, sarcoma, trabectedin
MeSH terms: Case Reports

Background:
Desmoplastic small round cell tumour (DSRCT) is a rare sarcoma typically affecting young males and usually widely metastatic at presentation. Despite multimodal treatment approaches, the prognosis for DSRCT is extremely poor. Alkylator- and anthracyclines- based regimens are widely used as therapy and an initial response is common. Durable responses are exceptionally rare so further systemic treatment options for these patients represent an unmet medical need. We report two cases of metastatic, pretreated DSRCT patients achieving disease stabilisation with Trabectedin.
Methods:
Retrospective review of 2 patients with progressive DSRCT, treated with Trabectedin.
Results:
Two males aged 19 and 23 years treated with Trabectedin, 1.5 mg/m(2) over 24 hours 3 weekly for 6 and 5 cycles respectively. Best responses were stable disease in patient 1 and partial response (RECIST 1.1) in patient 2. Progression free survival was 4 months in both cases. Persistent neutropenia required 4 weekly administration in one patient but no other grade 3-4 toxicities occurred.
Conclusions:
This report supports Trabectedin to be active and safe in pre-treated DSRCT patients. Further prospective and collaborative efforts are desirable to better define its role in the management of this disease.
Case Report: Sciatic nerve schwannoma - a rare cause of sciatica
Authors: Sunil Munakomi, Pratyush Shrestha
Journal: F1000Res (2017)
Keywords: schwannoma, sciatic nerve, sciatica

Herein we report a rare case of a sciatic nerve schwannoma causing sciatica in a 69-year-old female. Sciatic nerve schwannoma is a rare entity. It should always be considered as a possible cause of sciatica in patients that present with symptoms of sciatica with no prolapsed disc in the lumbar spine and a negative crossed straight leg raise test. Timely diagnosis and complete excision of the lesion leads to complete resolution of the symptoms of such patients.
Rapunzel syndrome with cholangitis and pancreatitis - A rare case report
Authors: Rajendran Vellaisamy, Shruti Iyer, Servarayan Murugesan Chandramohan, Sakthivel Harikrishnan
Journal: Open Med (Wars) (2020)
Keywords: cholangitis, intestinal obstruction, laparotomy, pancreatitis, trichobezoar

Rapunzel syndrome, defined by the presence of a trichobezoar extending from the stomach to the small intestine, is a rare cause of intestinal obstruction. It usually presents with vague symptoms; however, it can also present with complications such as perforation, peritonitis and obstructive jaundice. We report a rare case of a 37-year-old woman with Rapunzel syndrome complicated by acute cholangitis and pancreatitis and analyse the diagnosis and management of this complicated pathology. Although she reported a history of trichotillomania and trichophagia, she had been asymptomatic for ten years. We review the steps of diagnosis, highlighting the importance of a thorough clinical history and detailed examination, with supporting evidence from the contrast-enhanced computed tomography (CECT) scan. She was successfully managed with gastrotomy and trichobezoar removal. She had an uneventful postoperative recovery and was discharged after psychiatric counselling. To our knowledge, this is the first case of Rapunzel syndrome in a young female presenting with both cholangitis and pancreatitis.
Circulatory Collapse due to Hyperinflation in a Patient with Tracheobronchomalacia: A Case Report and Brief Review
Authors: Niclas Lundström, Gert Henriksson, Ola Börjesson, Malin Jonsson Fagerlund, Johan Petersson
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

We present a case of repeated cardiac arrests derived from dynamic hyperinflation in a patient with severe tracheobronchomalacia. Mechanical ventilation led to auto-PEEP with hemodynamic impairment and pulseless electric activity. Adjusted ventilation settings, deep sedation, and muscle paralysis followed by acute stenting of the affected collapsing airways restored ventilation and prevented recurrent circulatory collapse. We briefly review the pathophysiology and treatment options in patients with dynamic hyperinflation.
Clinical Features of Primary and Systemic Metastatic Intraocular Lymphomas in Spanish Patients
Authors: Victor Llorenç, Carla Fuster, Carmen Alba-Linero, Aina Moll-Udina, Alba Serrano, Manel Solé, Maite Sainz de la Maza, Iban Aldecoa, Alfredo Adán
Journal: J Ophthalmol (2019)

Objectives:
To describe and compare clinical findings in different subtypes of biopsy-proven intraocular lymphomas (IOLs).
Design:
Retrospective, observational case series.
Methods:
The clinical and pathologic features in IOLs at the Hospital Clinic of Barcelona from 1995 to 2018 were retrospectively studied.
Results:
Twenty-one patients, 12 men (57%), median age 60 (interquartile range, IQR: 18 years), and a median follow-up of 30 (IQR 60) months were included. Eleven patients had primary vitreo-retinal lymphoma (PVRL, 52%), 4 had primary uveal lymphoma (PUL, 19%), and 6 had systemic metastatic retinal lymphomas (SMRLs, 28%). Diffuse large B-cell lymphoma was the main IOL subset in PVRL (91%) and in SMRL (83%), whereas extranodal marginal zone lymphoma was the only type in PUL (100%). Survival rate was 44% in PVRL and 20% in SMRL at 5 years (p=0.047). One patient had flow cytometry of two different vitreous humour samples. With them, flow cytometry was performed in a total of 11 samples, yielding 7 positive samples.
Conclusions and relevance:
Even though PVRL is the most frequent IOL subtype, our findings suggest that PUL and SMRL should be considered as potential IOL causes. Overall survival was poor in PVRL and even shorter in SMRL patients.
Text-mining forma mentis networks reconstruct public perception of the STEM gender gap in social media
Authors: Massimo Stella
Journal: PeerJ Comput Sci (2020)
Keywords: cognition and language, cognitive network science, complex networks, language modelling, stem education, social computing, social media, text mining

Mindset reconstruction maps how individuals structure and perceive knowledge, a map unfolded here by investigating language and its cognitive reflection in the human mind, i.e., the mental lexicon. Textual forma mentis networks (TFMN) are glass boxes introduced for extracting and understanding mindsets' structure (in Latin forma mentis) from textual data. Combining network science, psycholinguistics and Big Data, TFMNs successfully identified relevant concepts in benchmark texts, without supervision. Once validated, TFMNs were applied to the case study of distorted mindsets about the gender gap in science. Focusing on social media, this work analysed 10,000 tweets mostly representing individuals' opinions at the beginning of posts. "Gender" and "gap" elicited a mostly positive, trustful and joyous perception, with semantic associates that: celebrated successful female scientists, related gender gap to wage differences, and hoped for a future resolution. The perception of "woman" highlighted jargon of sexual harassment and stereotype threat (a form of implicit cognitive bias) about women in science "sacrificing personal skills for success". The semantic frame of "man" highlighted awareness of the myth of male superiority in science. No anger was detected around "person", suggesting that tweets got less tense around genderless terms. No stereotypical perception of "scientist" was identified online, differently from real-world surveys. This analysis thus identified that Twitter discourse mostly starting conversations promoted a majorly stereotype-free, positive/trustful perception of gender disparity, aimed at closing the gap. Hence, future monitoring against discriminating language should focus on other parts of conversations like users' replies. TFMNs enable new ways for monitoring collective online mindsets, offering data-informed ground for policy making.
Strongyloides Colitis as a Harmful Mimicker of Inflammatory Bowel Disease
Authors: Julio Poveda, Farah El-Sharkawy, Leopoldo R Arosemena, Monica T Garcia-Buitrago, Claudia P Rojas
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Autoinfection caused by Strongyloides stercoralis frequently becomes a life-long disease unless it is effectively treated. There is overlapping histomorphology between Strongyloides colitis and inflammatory bowel disease; a low index of suspicion can lead to misdiagnosis and fatal consequences. We present a case of Strongyloides colitis mimicking the clinical and pathologic features of inflammatory bowel disease. A 64-year-old female presented to the emergency department with a four-day history of abdominal pain, diarrhea, and hematochezia. Colonoscopy revealed diffuse inflammation suggestive of inflammatory bowel disease, which led to initiation of 5-aminosalicylic acid and intravenous methylprednisolone. Biopsies of the colon revealed increased lymphoplasmacytic infiltrate of the lamina propria with eosinophilic microabscesses and presence of larvae, consistent with Strongyloides stercoralis. Immunosuppressive medication was halted. The patient ultimately died a few days later. This case emphasizes the importance of identifying the overlapping clinical and pathologic features of Strongyloides colitis and inflammatory bowel disease. A high index of suspicion and recognition of particular histological findings, including eosinophilic microabscesses, aid in the correct diagnosis. Definitive diagnosis is crucial as each disease carries distinct therapeutic implications and outcome.
Successful first-line treatment of simultaneous multiple primary malignancies of lung adenocarcinoma and renal clear cell carcinoma: A case report
Authors: Xiaojun Ye, Xiangliang Liu, Na Yin, Wei Song, Jin Lu, Yi Yang, Xiao Chen
Journal: Front Immunol (2022)
Keywords: chemotherapy, immunotherapy, lung adenocarcinoma, multiple primary malignancies, renal clear cell carcinoma
MeSH terms: Adenocarcinoma of Lung / drug therapy, Adenocarcinoma / diagnosis, Adenocarcinoma / drug therapy, Adenocarcinoma / genetics, Lung Neoplasms / drug therapy, Lung Neoplasms / genetics, Neoplasms, Multiple Primary / drug therapy, Case Reports, Cisplatin / therapeutic use, Humans, Male, Cisplatin

Background:
Multiple Primary Malignancies (MPMs) refer to the occurrence of two or more primary malignancies in the same organ or multiple organs and tissues of the same patient simultaneously or sequentially, with an incidence rate ranging from 2-17%. According to the difference in the time of occurrence of each primary tumor, MPMs can be classified as simultaneous malignancies and heterochronic malignancies. The former refers to the occurrence of two or more malignancies one after another within 6 months, while the latter refers to the occurrence of two malignancies at an interval of more than 6 months. Currently, there is a lack of effective treatment options for MPMs both nationally and internationally.
Case presentation:
The patient was a 65-year-old male smoker with a definite diagnosis of advanced lung adenocarcinoma with kirsten rat sarcoma viral oncogene (KRAS) mutation, concomitant with primary renal clear cell carcinoma (RCCC), who had a progression-free survival (PFS) for 7 months after first-line treatment with albumin-bound paclitaxel and cisplatin in combination with sintilimab.
Conclusion:
In this paper, we report a case of advanced lung adenocarcinoma combined with RCCC as a concurrent double primary malignancy, which achieved a satisfactory outcome after first-line chemotherapy combined with immunotherapy, with the aim of exploring effective treatment modalities for this type of MPMs, in order to improve the survival and prognosis of the patient.
Case report: A case of neoadjuvant immunotherapy in combination with the Yang-Monti technique for the treatment of ureteral carcinoma after radical cystectomy and left radical nephroureterectomy
Authors: Tielin Wu, Harris Haleem, Min Yin
Journal: Front Oncol (2022)
Keywords: recurrence of urothelial carcinoma, yang-monti technique, anti-programmed death protein-1, neoadjuvant immunotherapy, solitary kidney, tislelizumab
MeSH terms: Case Reports

Recurrence of urothelial carcinoma in a patient with solitary kidney is always a clinical challenge. In the immune checkpoint inhibitor era, neoadjuvant immunotherapy in combination with the Yang-Monti technique might be a good option for the patient with a high-risk tumor when kidney-sparing surgery for renal function preservation is desired. We report the case of a 74-year-old man with solitary kidney who was diagnosed with recurrence of urothelial carcinoma in the right ureter. He was initially deemed unfit for segmental resection of the ureter. Neoadjuvant immunotherapy with tislelizumab was performed in this patient with a partial response to urothelial carcinoma. He underwent segmental resection of the ureter with negative margins, and the ureteral defect was bridged by modified ileal replacement, which is the Yang-Monti technique. This patient has remained disease-free with adequate kidney function for longer than 18 months.
Simultaneous Hepatic and Mesenteric Hydatid Disease-A Case Report
Authors: Daniel Paramythiotis, Anestis Karakatsanis, Petros Bangeas, Konstantinia Kofina, Vassileios Papadopoulos, Stylianos Apostolidis, Antonios Michalopoulos
Journal: Front Surg (2017)
Keywords: drainage cysts, excision surgery, hydatid cyst, liver diseases, mesentery, parasitic diseases
MeSH terms: Case Reports

Introduction:
Hydatid cysts most commonly present in the liver and the lungs; however, they can appear more rarely in other locations, such as the mesentery, with a rather unclear mechanism of manifestation. Herein, we present a case of simultaneous presence of hydatid cysts in the liver and the mesentery of a young man.
Case report:
A 39-year-old man was referred to our Department for further investigation of intermittent abdominal pain, especially in the right upper quadrant, and abdominal distension. Abdominal CT imaging revealed three calcified lesions, one in the liver, a similar adjacent to an ileal loop and one close to the urinary bladder, while antibody control was positive for echinococcal infection. The lesions were excised and the patient was discharged on the seventh post-operative day in good general condition. Post-operative control after 6 months did not show any signs of recurrence.
Conclusion:
Simultaneous presence of hydatid cysts in two organs occurs in 5-13% of cases. Presence in the mesentery is extremely rare, although, should be included in the classic differential diagnosis, especially in endemic areas.
Iatrogenic carpal tunnel syndrome induced by wrist extension for placement of an indwelling radial artery catheter: a case report
Authors: Kunitaro Watanabe, Shingo Mitsuda, Akira Motoyasu, Joho Tokumine, Kumi Moriyama, Tomoko Yorozu
Journal: JA Clin Rep (2017)
Keywords: carpal tunnel syndrome, complication, radial artery catheter

A 38-year-old man with pancreatic cancer was scheduled to undergo pancreaticoduodenectomy. He had an unremarkable past medical history. After inducing general anesthesia, a left radial arterial catheter was successfully placed at first attempt. A wrist splint was used to obtain good arterial pulse waveforms. After the operation, he was transferred to the intensive care unit. The radial artery catheter was removed on the fourth postoperative day. He experienced numbness and a tingling sensation in the left thumb, the second and third fingers, and the lateral half of the fourth finger. He was diagnosed with carpal tunnel syndrome. Diagnostic imaging revealed a swollen median nerve, but no hematoma or injury. Some studies have suggested that excessive extension of the wrist may cause neuropathy. We recommend that patients' wrists not be over-extended, even if good arterial waveforms cannot be obtained.
Cannabis-Induced Third-Degree AV Block
Authors: Jan M Van Keer
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

Background:
Cannabis (marijuana) is the most widely consumed illicit drug in Europe. However, many are unaware of its potential cardiovascular side effects.
Case report:
A 19-year-old man presented to the emergency department with palpitations and presyncope after smoking cannabis. A third-degree atrioventricular block (complete heart block) was diagnosed. We believe cannabis exposure to have been the likely cause. Extensive work-up-including Borrelia and auto-immune serology, CT coronary angiography, magnetic resonance imaging, and electrophysiological study-was negative. The patient was initially treated with IV isoprenaline. Within one day, the bradycardia spontaneously resolved. The patient was advised to quit using cannabis. No further therapy was initiated. We discuss the clinical presentation, pathophysiology, and evidence from the literature linking cannabis exposure to bradycardia.
Conclusion:
We describe a case of third-degree atrioventricular block after cannabis use. Emergency physicians should be aware of the potential cardiovascular side effects of this drug.
Two Novel Variants in the ATRX Gene Associated with Variable Phenotypes
Authors: D Hettiarachchi, B A P S Pathirana, P J Kumarasiri, V H W Dissanayake
Journal: Case Rep Genet (2019)
MeSH terms: Case Reports

The X-linked alpha-thalassemia mental retardation (ATR-X) syndrome is a rare genetic condition caused by mutations in the X-encoded gene ATRX. Here we describe two unrelated patients of Sri Lankan origin with novel missense variants in the ATRX gene: c.839C>T|p.Cys280Tyr and c.5369C>T|p.Ala1790Val. These two novel variants were associated with variable phenotypes which clinically resembled X-linked mental retardation-hypotonic facies syndrome and Smith-Fineman-Myers syndrome respectively. These cases expand the clinical spectrum of ATR-X syndrome and open new opportunities for the molecular diagnosis of ATRX mutations in male patients with severe global developmental delay and intellectual disabilities.
Lymphangioma of the Lower Lip-A Diagnostic Dilemma: Report of a Rare Case with a Brief Literature Review
Authors: Shamimul Hasan, Syed Ansar Ahmad, Mandeep Kaur, Rajat Panigrahi, Swagatika Panda
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Hamartomas are tumor-like deformities typified by cellular propagation indigenous to the original site, although they display growth arrest without the possibility for further growth. Various hamartomatous oral lesions include hemangiomas, lymphangiomas, nevi, odontomas, Cherubism, etc. Lymphangiomas are benign, developmental hamartomatous entities typified by abnormal proliferation of lymphatic vessels. They are usually congenital, and more than 90% of cases occur by 2 years of age, with a rare occurrence in adults. They have a site affinity for the head and neck, and oral lesions are relatively uncommon. The dorsum of the tongue is the commonest oral site of predilection; however, the lip is a rare site of involvement. Hereby, we present an uncommon case of lymphangioma of the lower lip in a 45-year-old male patient, who reported to our hospital with an asymptomatic lower lip submucosal mass present for the last 3 years. Our case is unique as it occurred on the lower lip of a 45-year-old male. A detailed history and clinical evaluation, ultrasonography, and histopathology confirmed the diagnosis of lymphangioma.
Parastomal stomach herniation complicated by gastric outlet obstruction: A case report and literature review
Authors: Jacques Eastment, Matthew Burstow
Journal: Int J Surg Case Rep (2018)
Keywords: case report, gastric outlet obstruction, parastomal hernia, stomas, surgical

Introduction Parastomal herniation commonly occurs following formation of an end-colostomy or ileostomy. Those patients presenting with acute complications of parastomal hernias typically undergo surgical repair. Stomach-containing parastomal hernias are rare. Presentation of case A 92-year-old lady presented to the emergency department with vomiting and abdominal pain. She had undergone a total colectomy with end-ileostomy many years earlier. A computed tomography scan of her abdomen diagnosed gastric outlet obstruction secondary to parastomal stomach herniation. The obstruction resolved with simple nasogastric decompression and the patient did not receive surgery. She was discharged from hospital after two days. Discussion Gastric outlet obstruction secondary to a parastomal hernia is rare. A systematic literature search found 12 previously reported cases. This is the first case managed without invasive procedures. Conclusion For gastric outlet obstruction caused by parastomal herniation, surgeons should consider non-operative management with nasogastric decompression when the patient in question is frail and a poor surgical candidate.
Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies
Authors: Pooja E Mishra, Betsy L Schwartz, Kyriakie Sarafoglou, Kristen Hook, Youngki Kim, Anna Petryk
Journal: Case Rep Endocrinol (2016)

The standard treatment of hypoparathyroidism is to control hypocalcemia using calcitriol and calcium supplementation. However, in severe cases this approach is insufficient, and the risks of intravenous (i.v.) calcium administration and prolonged hospitalization must be considered. While the use of recombinant human parathyroid hormone 1-34 [rhPTH(1-34)] for long-term control of hypocalcemia has been established, the benefits of short-term rhPTH(1-34) treatment in children have not been explored. We report two patients with hypoparathyroidism treated with rhPTH(1-34). Patient 1 is a 10-year-old female with polyglandular autoimmune syndrome type 1. Patient 2 is a 12-year-old female with hypoparathyroidism after total thyroidectomy. Both patients showed poor response to i.v. and oral calcium and calcitriol, and patient 1 did not respond to phosphate binders. Patient 1 had rapid increase in serum calcium with a decrease in serum phosphate after a 3-day course of subcutaneous rhPTH(1-34). Patient 2 had normalization of calcium and phosphate levels after a 7-day course of rhPTH(1-34). These cases support a role for rhPTH(1-34) in the acute management of hypoparathyroidism in hospitalized patients to more rapidly correct hypocalcemia and hyperphosphatemia, shorten hospitalization, and reduce the need for frequent i.v. calcium boluses.