OpenMed/multicare-articles huggingface dataset:
The value of dynamic elastomeric fabric orthoses in the management of a complex hypermobile Ehlers-Danlos syndrome patient: A case report
Authors: Anna Higo, Gemma Pearce, Shea Palmer, Louise Grant
Journal: Clin Case Rep (2023)
Keywords: postural tachycardia syndrome, dynamic elastomeric fabric orthoses, hip dysplasia, hypermobile ehlers‐danlos syndrome, hypermobility, joint subluxation, periacetabular osteotomy, physiotherapy
MeSH terms: Case Reports

The use of dynamic elastomeric fabric orthoses is examined in a young woman with hypermobile Ehlers-Danlos syndrome (hEDS) referred for physiotherapy with hip dysplasia, prior to a right periacetabular osteotomy. Dynamic elastomeric fabric orthoses plus rigorous subjective examination, therapists' listening skills, and patient-centered goals were useful for this hEDS patient.
A combination of predispositions and exposures as responsible for acute eosinophilic pneumonia
Authors: Simona Amiconi, Bertrand Hirl
Journal: Multidiscip Respir Med (2014)
MeSH terms: Case Reports

Background:
Acute eosinophilic pneumonia (AEP) is a rare febrile illness which is characterized by respiratory failure and often requires mechanical ventilation. The causes and sequence of events of this disease at a biochemical and histological level remain largely unknown. In this article we report the exceptional case, possibly unique, of a patient who developed AEP and three pneumothoraces within less than one month during her hospitalization.
Case presentation:
A 39-year-old German woman was admitted to our hospital for a laparoscopy-assisted vaginal hysterectomy under general anaesthesia. The surgical intervention was followed by peritonitis in the early postoperative course. Following anaesthesia induction with propofol/midazolam and during the prolonged therapy with several broad-spectrum antibiotics, she developed AEP and three spontaneous (one left-sided and two right-sided) pneumothoraces, the latter ones observed in quick succession. Symptoms, laboratory markers, and chest radiology significantly improved after a one-day treatment with methylprednisolone.
Conclusions:
On the whole, these pathological occurrences, together with similar cases reported in literature, can support the conclusion of possible predisposing genetic factors at the lung tissue level of AEP patients, a view that might shed new light on the pathogenesis of this disease. To provide a coherent pattern that explains the reported evidence for AEP and pneumothoraces, independently from the causative stimulus, the supposed molecular mutations could be localized in the connective tissue rather than in the epithelial cells. In order to interpret clinical and laboratory evidence, as well as to support the main conclusions, the important part of scientific research here presented can also assist physicians in making more informed decisions for the treatment of patients with pulmonary infiltrates.
Different Outcomes of Anti-VEGF Treatment for Neovascular AMD according to Neovascular Sutypes and Baseline Features: 2-Year Real-Life Clinical Outcomes
Authors: Alessandro Arrigo, Andrea Saladino, Emanuela Aragona, Stefano Mercuri, Ugo Introini, Francesco Bandello, Maurizio Battaglia Parodi
Journal: Biomed Res Int (2021)
MeSH terms: Choroidal Neovascularization / drug therapy, Macular Degeneration / drug therapy, Ranibizumab / administration & dosage, Receptors, Vascular Endothelial Growth Factor / administration & dosage, Recombinant Fusion Proteins / administration & dosage, Vascular Endothelial Growth Factor A / antagonists & inhibitors, Clinical Trial, Aged, Aged, 80 and over, Choroidal Neovascularization / classification, Choroidal Neovascularization / pathology, Choroidal Neovascularization / physiopathology, Female, Follow-Up Studies, Humans, Intravitreal Injections, Macular Degeneration / pathology, Macular Degeneration / physiopathology, Male, Recombinant Fusion Proteins, VEGFA protein, human, Vascular Endothelial Growth Factor A, aflibercept, Receptors, Vascular Endothelial Growth Factor, Ranibizumab

Purpose:
To evaluate the effects of anti-VEGF treatment of neovascular age-related macular degeneration (nAMD) in a real-life clinical setting.
Methods:
Study design is a retrospective case series. Naïve nAMD patients treated with intravitreal injection of aflibercept or ranibizumab were analyzed over a 24-month follow-up. Each patient received the loading dose, followed by a PRN regimen. Patients were further subdivided into subgroups according to macular neovascularization type, best corrected visual acuity (BCVA) at baseline (BCVA > 0.3 LogMAR and BCVA ≤ 0.3 LogMAR), and different anti-VEGF drugs. Primary outcome was the changes in BCVA and central macular thickness (CMT) over 24 months. Secondary outcomes included the influence of the selected drug and of the baseline BCVA on the final outcomes.
Results:
439 patients (224 males; 51%) with naïve AMD-related macular neovascularization were included in the analyses. Mean age was 78 ± 8 years old. Compared to baseline evaluations, not significant BCVA changes were found at 1-year and 2-year examinations. CMT was significantly reduced at both 1-year and 2-year follow-ups (p < 0.01). Classic, polypoidal choroidal vasculopathy and mixed subtypes significantly correlated with worse visual outcome (p < 0.01). Overall, baseline BCVA significantly correlated with both 1-year and 2-year follow-up changes (p < 0.01). Moreover, BCVA at 1-year significantly correlated with BCVA changes at 2-year follow-up (p < 0.01). Furthermore, CMT changes from baseline significantly correlated with both 1-year and 2-year follow-up measurements (p < 0.01).
Conclusion:
Anti-VEGF approach is generally effective in stopping nAMD progression in our real-life analysis. No difference was found comparing patients treated with ranibizumab and aflibercept, nor in patients with drug switching.
A Case of Focal Dermal Hypoplasia (Goltze Syndrome) Masquerading as Lingual Tonsillar Hypertrophy
Authors: Samuel T Roberts, Greg Shein, Ian Jacobson
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Focal dermal hypoplasia is a rare condition affecting organ systems of mesodermal origin. We present a rare case of this condition presenting with apparent palatine tonsillar regrowth and outline our management. Airway management should always be a consideration in this rare condition.
Neuroblastoma of the Urinary Bladder in an Infant
Authors: Ahmed Mohamed, Quentin Campbell-Hewson, Hany O S Gabra
Journal: European J Pediatr Surg Rep (2019)
Keywords: neuroblastoma, pediatric oncology, pediatric tumors, urinary bladder
MeSH terms: Case Reports

As it originates from neural crest cells, Neuroblastoma (NBL) can arise anywhere along the sympathetic chain. However, its occurrence in the urinary bladder (UB) is extremely rare. We present a case of an incidentally diagnosed pelvic NBL arising from the dome of the UB in a 7-month-old infant. The mass was treated with surgical excision only after being classified as a very low risk group according to the International Neuroblastoma Risk Group staging system. The patient was disease free after 5 years of follow-up. Although rare, we suggest that NBL should be considered in the differential diagnosis of UB masses in children and investigated accordingly.
Ceramic liner fracture in ceramic on ceramic Total hip arthoplasty: A case report
Authors: Eknath D Pawar, Amit Kumar Yadav, Arohi Sharma, Abhishek Harsoor
Journal: Int J Surg Case Rep (2019)
Keywords: ceramic on ceramic, ceramic on polyethylene, total hip arthroplasty

Introduction:
Revision rates of total hip arthoplasty have decreased after introducing total hip arthroplasty using ceramic component due to reduce wear and osteolysis.
Case report:
29 year old male case of bilateral hip avascular necrosis operated for bilateral hip THA presented 30 months after with complaint of squeaking, x-ray showing left ceramic liner fracture without any history of trauma. Revision of ceramic liner and head with ceramic on polyethylene was done.
Discussion and conclusion:
Ceramic on ceramic articulation has the lowest wear rate among various articulations. However, there is a concern about ceramic implant fracture; therefore ceramic with polyethylene bearing could be a good choice.
"The mind is its own place": amelioration of claustrophobia in semantic dementia
Authors: Camilla N Clark, Laura E Downey, Hannah L Golden, Phillip D Fletcher, Rajith de Silva, Alberto Cifelli, Jason D Warren
Journal: Behav Neurol (2014)
MeSH terms: Frontotemporal Dementia / complications, Phobic Disorders / complications, Case Reports, Research Support, Non-U.S. Gov't, Aged, Atrophy / pathology, Female, Frontotemporal Dementia / pathology, Frontotemporal Dementia / psychology, Humans, Phobic Disorders / pathology, Phobic Disorders / psychology, Remission, Spontaneous, Temporal Lobe / pathology

Phobias are among the few intensely fearful experiences we regularly have in our everyday lives, yet the brain basis of phobic responses remains incompletely understood. Here we describe the case of a 71-year-old patient with a typical clinicoanatomical syndrome of semantic dementia led by selective (predominantly right-sided) temporal lobe atrophy, who showed striking amelioration of previously disabling claustrophobia following onset of her cognitive syndrome. We interpret our patient's newfound fearlessness as an interaction of damaged limbic and autonomic responsivity with loss of the cognitive meaning of previously threatening situations. This case has implications for our understanding of brain network disintegration in semantic dementia and the neurocognitive basis of phobias more generally.
Benign Pancreatic Neurofibroma with Malignant Imaging Features: A Case Report and Literature Review
Authors: Ling Song, Zhenpeng Jiang, Jian Cui, BinYang Gao, Yan Luo
Journal: Front Surg (2022)
Keywords: case report, general surgery, neurofibroma, pancreas, ultrasound diagnosis
MeSH terms: Case Reports

Pancreatic neurofibroma is a very rare benign neurogenic tumor unrelated to neurofibromatosis type 1 (NF-1). As the volume increases, it has the risk of malignant transformation. The surgical prognosis of pancreatic neurofibroma is good, but its preoperative imaging features are very similar to those of malignant tumors, which may affect the formulation of treatment plans. This article reports a case of giant neurofibroma of the pancreas with contrast-enhanced ultrasound (CEUS) as one of the diagnostic methods and discusses the tumor's preoperative clinical features, laboratory examinations, and imaging features.
Prostatic Abscess after Stapled Hemorrhoidopexy Caused by ESBL Extended Spectrum Beta Lactamase Producing Klebsiella pneumoniae: An Additional Challenge to Postoperative Sepsis
Authors: Asem Saleh, Abdelnasir Kibeida, Elsaid Amin, Abdalla Khalil, Rafat Abu Shakra, Mohamed Elwakil
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Postoperative septic complications of hemorrhoids surgical interventions are rare, but very serious with high mortality rate. Early diagnosis and prompt therapy are essential to save patient's life. There are a good number of articles and case reports about these septic complications. We are presenting a case report of a prostatic abscess caused by extended spectrum beta lactamase (ESBL) producing Klebsiella pneumoniae after hemorrhoidopexy. Our patient was a healthy middle aged Saudi male who has no significant medical history apart from morbid obesity and recurrent urinary tract infections. ESBL producing K. pneumoniae could be detected only after aspiration of the prostatic abscess, but proper antibiotic was introduced intravenously on admission before culture of aspirate of the abscess was available. Antibiotic was continued for 30 days and abscess resolved completely. In our electronic search, we could not find any case report of prostatic abscess after stapled hemorrhoidopexy caused by ESBL producing organism. This is an additional challenge for treating physicians as these organisms are sensitive only to one group of antibiotics (carbapenem group).
Putative Role of Circulating Human Papillomavirus DNA in the Development of Primary Squamous Cell Carcinoma of the Middle Rectum: A Case Report
Authors: Maria Raffaella Ambrosio, Remo Vernillo, Sabrina De Carolis, Antonietta Carducci, Lucia Mundo, Alessandro Ginori, Bruno Jim Rocca, Valerio Nardone, Alessandra Lucenti Fei, Tommaso Carfagno, Stefano Lazzi, Monica Cricca, Piero Tosi
Journal: Front Oncol (2019)
Keywords: cancer, circulating hpv, exosomes, immune evasion, middle rectum
MeSH terms: Case Reports

Here we present the case of a patient affected by rectal squamous cell carcinoma in which we demonstrated the presence of Human Papillomavirus (HPV) by a variety of techniques. Collectively, the virus was detected not only in the tumor but also in some regional lymph nodes and in non-neoplastic mucosa of the upper tract of large bowel. By contrast, it was not identifiable in its common sites of entry, namely oral and ano-genital region. We also found HPV DNA in the plasma-derived exosome. Next, by in vitro studies, we confirmed the capability of HPV DNA-positive exosomes, isolated from the supernatant of a HPV DNA positive cell line (CaSki), to transfer its DNA to human colon cancer and normal cell lines. In the stroma nearby the tumor mass we were able to demonstrate the presence of virus DNA in the stromal compartment, supporting its potential to be transferred from epithelial cells to the stromal ones. Thus, this case report favors the notion that human papillomavirus DNA can be vehiculated by exosomes in the blood of neoplastic patients and that it can be transferred, at least in vitro, to normal and neoplastic cells. Furthermore, we showed the presence of viral DNA and RNA in pluripotent stem cells of non-tumor tissue, suggesting that after viral integration (as demonstrated by p16 and RNA in situ hybridization positivity), stem cells might have been activated into cancer stem cells inducing neoplastic transformation of normal tissue through the inactivation of p53, p21, and Rb. It is conceivable that the virus has elicited its oncogenic effect in this specific site and not elsewhere, despite its wide anatomical distribution in the patient, for a local condition of immune suppression, as demonstrated by the increase of T-regulatory (CD4/CD25/FOXP3 positive) and T-exhausted (CD8/PD-1positive) lymphocytes and the M2 polarization (high CD163/CD68 ratio) of macrophages in the neoplastic microenvironment. It is noteworthy that our findings depicted a static picture of a long-lasting dynamic process that might evolve in the development of tumors in other anatomical sites.
Zygomycosis in two hematologic cases
Authors: M T García-Romero, J García-Méndez, R Arenas, T Ferrari-Carballo, J Chanona-Vilchis, E Cervera-Ceballos
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

Zygomycosis are invasive mould infections, rarely diagnosed in hematologic patients. Most of the cases published are in patients with prolonged neutropenia, along with other risk factors such as the use of prior broad-spectrum antibiotics (including new antifungal agents, such as voriconazole), diabetes mellitus (with or without ketoacidosis), malnutrition, iron overload (with or without the use of deferoxamine). These infections have poor prognosis due to the involvement of vital anatomic structures and late diagnosis. Until recent years, the treatment was based on high doses of amphotericin B plus surgical debridement. Here we present two patients with hematologic diseases (one with leukemia, the second with aplastic anemia) with an impaired immune system and the diagnosis of zygomycosis. The survival of one of them was mainly due to early diagnosis and surgical debridement; unfortunately the second was misdiagnosed as an extensive ecchymosis due to thrombocytopenia and died with CNS involvement.
Late presentation of vesicoureteral reflux: An unusual cause of pyelonephritis in adults
Authors: Bernardo Pereira, Catarina Macedo, Sara Anacleto, Marina Gonçalves, Estêvão Lima, Emanuel Carvalho-Dias
Journal: Int J Surg Case Rep (2018)
Keywords: adult vesicoureteral reflux, bulking agent, recurrent pyelonephritis

Introduction:
Vesicoureteral reflux (VUR) corresponds to the reflux of urine from the bladder into the upper urinary system. It can be a congenital or an acquired anomaly and although its incidence is high in children it is uncommon in the adult life. One of its presentations in the adult population is the presence of recurrent Pyelonephritis.
Case presentation:
Here we report a case of an adult patient with repetitive uncomplicated pyelonephritis caused by VUR. VUR was successfully managed endoscopically with subureteral injection of a bulking agent. A literature review of adult presenting VUR was performed.
Discussion:
The first presentation of VUR in the adult life is rare. One of the most typical presentation is the presence of recurrent uncomplicated Pyelonephritis. Although no guidelines exists to study the presence of VUR in adult patients with Pyelonephritis, in the presence of several recurrent episodes of Pyelonephritis we should think in VUR as a possible cause. Even in adults, endoscopic management of VUR is an effective treatment with low morbidity.
Conclusion:
VUR can first present in the adult life, with recurrent episodes of UTI. The diagnosis is a suspicious one and is confirmed by VUCG. VUR in adults can be effectively managed with endoscopic injection of bulking agents.
Precision medicine in the real-world setting. Clinical activity of talazoparib in a woman with hormone receptor-positive HER2-negative metastatic breast cancer with pathogenic mutation in somatic BRCA2
Authors: Dana Narváez, Federico Waisberg, Tomás Soulé, Martín Angel, Luisina Bruno, Maria Romina Girotti, Carmen Pupareli, Matías Chacón, Fernando E Petracci
Journal: Ecancermedicalscience (2022)
Keywords: brca, escat scale, parpi, breast cancer, somatic mutation
MeSH terms: Case Reports

Background:
Next-generation sequencing (NGS) has proven to be a key implementation to understanding biological pathways involved in cancer. In daily practice, the identification of somatic and germline mutations has allowed physicians to gather relevant information to make therapeutic decisions and benefit patients. Importantly, somatic mutations provide targeted opportunities for treatment and reveal resistance mechanisms to understand patients' tumour evolution. Scanty data in clinical trials and in a real-world setting is available regarding the utility of poly(ADP-ribose) polymerase inhibitors in pathogenic or likely-pathogenic somatic breast cancer gene 1/2 (BRCA1/2) mutations and/or germline or somatic Homologous Recombination-Related Gene mutations in advanced breast cancer (ABC).
Case report:
Here we report a real-life case of a 47-year-old postmenopausal woman with hormone receptor-positive (HR-positive) Epidermal growth factor receptor 2 (HER2)-negative metastatic BC that had poor response to classic therapeutic strategies for HR+/HER2- ABC. At this point, the possibility of using NGS to guide the treatment was decided in a Molecular Tumour Board (MTB), and the patient had a major response to talazoparib targeting a non-germline BRCA2 mutation.
Conclusion:
Undoubtedly, more information regarding the cost effectiveness of NGS is needed to develop adequate reimbursement policies for this technology. It should be highlighted that the generalisation of MTBs and the implementation of molecular screening programmes are greatly needed in our region to gain more knowledge of somatic mutations implicated in the Hispanic and Latin-American population with BC diagnosis. Recently presented results of randomised studies may support the evaluation of somatic mutations with NGS to find targeted therapies for ABC patients.
Left Lateral Cervical Mass with Draining Sinuses
Authors: Stylianos A Michaelides, George D Bablekos, Avgerinos-Romanos Michailidis, Efthalia Gkioxari, Stephanie Vgenopoulou, Maria Chorti
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

The aim of the present study is to describe an uncommon case of tuberculous lymphadenitis (TL) in a symptomless 89-year-old male smoker patient, who presented at the emergency department of our hospital with left lateral cervical swelling with draining sinuses. No other clinical symptoms or physical findings were observed at admission. An elevated erythrocyte sedimentation rate (ESR) and a small calcified nodule in chest CT were the only abnormal findings. Pus samples from sinuses were examined and confirmed tuberculosis which was in agreement with surgical pathology of lymph nodes. A four- (4-) drug antituberculous regimen was administered. After an initial remission of his symptoms, the patient presented an exacerbation of the cervical swelling with draining sinuses necessitating addition of oral steroids. TL can be symptomless presenting a paradoxical reaction during treatment. The uniqueness of our case lies in the patient's advanced age, which is uncommon with cervical lymphadenopathy as a form of extrapulmonary tuberculosis, as well as in the administration of oral steroids to resolve the neck's clinical deterioration. The patient had a complete recovery and was free of disease after completion of his six-month antituberculous chemotherapy.
Treating Early Knee Osteoarthritis with the Atlas® Unicompartmental Knee System in a 26-Year-Old Ex-Professional Basketball Player: A Case Study
Authors: Konrad Slynarski, Lukasz Lipinski
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Knee osteoarthritis (OA) is a leading cause of disability among adults. Within the affected population, there exists a group of patients who have exhausted conservative treatment options and yet are not ideal candidates for current surgical treatments due to young age, early disease severity, or neutral mechanical knee alignment. For these patients, a new potential treatment option may be considered. We present an interesting case report of a young, ex-professional athlete treated with a minimally invasive load-altering implant (Atlas System) whose young age (26 years), disease status (tibiofemoral kissing lesions), and neutral mechanical limb alignment eliminated all traditional surgical treatment options such as high tibial osteotomy or arthroplasty. At 6 months after surgery, our patient demonstrated positive outcomes improvement in pain, function, and quality of life and had returned to high-impact athletic activity without symptoms. These initial results are promising, and longer follow-up data on the treatment will be necessary.
Invasive Lobular Carcinoma of the Breast with Extracellular Mucin: Case Report of a New Variant of Lobular Carcinoma of the Breast
Authors: M Boukhechba, H Kadiri, B El Khannoussi
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Invasive carcinoma of no special type (NST) or ductal carcinoma is the largest group of invasive breast cancers. Invasive lobular carcinoma (ILC) is the second most common histological type; it comprises 5%-15% of all invasive breast cancers. Historically, lobular neoplasia and invasive lobular carcinoma may produce intracellular mucin that pushes the nucleus to one side, creating the characteristic signet ring cell morphology. The extracellular mucin secretion is essentially described in mucinous breast carcinoma. Mucinous differentiation can be seen in small areas of NST carcinoma, but recently a few cases of invasive lobular carcinoma with extracellular mucin are reported in the literature. It is important for pathologists to recognize this new entity because it mimics a NST carcinoma, as such a diagnosis may require a different approach in clinical management and surveillance. We report a new case of ILC with extracellular mucin and a review of the literature.