OpenMed/multicare-articles huggingface dataset:
A physiological comparison of the new-over 70 years of age-marathon record holder and his predecessor: A case report
Authors: Bas Van Hooren, Romuald Lepers
Journal: Front Physiol (2023)
Keywords: aging, case report, master athlete, oxygen consumption, running, running economy, training characteristics

Purpose: This study assessed the body composition, cardiorespiratory fitness, fiber type and mitochondrial function, and training characteristics of a 71-year-old runner who broke the world record marathon of the men's 70-74 age category and held several other world records. The values were compared to those of the previous world-record holder. Methods: Body fat percentage was assessed using air-displacement plethysmography. V ˙ O 2 max , running economy, and maximum heart rate were measured during treadmill running. Muscle fiber typology and mitochondrial function were evaluated using a muscle biopsy. Results: Body fat percentage was 13.5%, V ˙ O 2 max was 46.6 ml kg-1 min-1, and maximum heartrate was 160 beats∙min-1. At the marathon pace (14.5 km h-1), his running economy was 170.5 ml kg-1 km-1. The gas exchange threshold and respiratory compensation point occurred at 75.7% and 93.9% of the V ˙ O 2 max , i.e., 13 km h-1 and 15 km h-1, respectively. The oxygen uptake at the marathon pace corresponded to 88.5% of V ˙ O 2 max . Vastus lateralis fiber content was 90.3% type I and 9.7% type II. Average distance was 139 km∙w-1 in the year prior to the record. Conclusion: The 71-year-old world-record holder marathon showed a relatively similar V ˙ O 2 max , lower percentage of V ˙ O 2 max at marathon pace, but a substantially better running economy than his predecessor. The better running economy may result from an almost double weekly training volume compared to the predecessor and a high type I fiber content. He trained every day in the last ∼1.5 years and achieved international performance in his age group category with a small (<5% per decade) age-related decline in marathon performance.
Severe Acute Axonal Neuropathy following Treatment with Arsenic Trioxide for Acute Promyelocytic Leukemia: a Case Report
Authors: Marcus Kühn, Kety Sammartin, Mitja Nabergoj, Fabrizio Vianello
Journal: Mediterr J Hematol Infect Dis (2016)
MeSH terms: Case Reports

Peripheral neuropathy is a common complication of arsenic toxicity. Symptoms are usually mild and reversible following discontinuation of treatment. A more severe chronic sensorimotor polyneuropathy characterized by distal axonal-loss neuropathy can be seen in chronic arsenic exposure. The clinical course of arsenic neurotoxicity in patients with coexistence of thiamine deficiency is only anecdotally known but this association may potentially lead to severe consequences. We describe a case of acute irreversible axonal neuropathy in a patient with hidden thiamine deficiency who was treated with a short course of arsenic trioxide for acute promyelocytic leukemia. Thiamine replacement therapy and arsenic trioxide discontinuation were not followed by neurological recovery and severe polyneuropathy persisted at 12-month follow-up. Thiamine plasma levels should be measured in patients who are candidate to arsenic trioxide therapy. Prophylactic administration of vitamin B1 may be advisable. The appearance of polyneuropathy signs early during the administration of arsenic trioxide should prompt electrodiagnostic testing to rule out a pattern of axonal neuropathy which would need immediate discontinuation of arsenic trioxide.
Isolated abdominal wall actinomycosis associated with an intrauterine contraceptive device: a case report and review of the relevant literature
Authors: Sinan Carkman, Volkan Ozben, Haydar Durak, Kagan Karabulut, Turgut Ipek
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Isolated abdominal wall actinomycosis in the presence of an intrauterine contraceptive device (IUCD) is extremely rare and only six such cases have been reported in the literature. We report a case where clinical and radiological examinations revealed a pseudotumor within the anterior abdominal wall. After being lost to follow-up, the patient presented two years later with the enlargement of the mass. The mass including the affected anterior abdominal wall was completely excised. The diagnosis of actinomycosis was established postoperatively by histopathological examination. Further questioning concerning her gynecological history revealed long-term use of the same IUCD. Surgical excision of the actinomycotic pseudotumour and removal of the IUCD followed by antibiotic therapy resulted in the full recovery of the patient.
Primary cardiac angiosarcoma: a fatal disease
Authors: L Antonuzzo, V Rotella, F Mazzoni, L Doni, D Bianchini, F Garbini, V Maio, F Di Costanzo
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

A 42-year-old man with a cardiac tamponade underwent an urgent pericardiotomy that showed tumoral tissue, covering the surface of the right atrium. The tumor was then partially excised, and the histological examination revealed the presence of a moderately-differentiated angiosarcoma. The patient was then referred to the oncology unit and scheduled for a chemotherapy schedule including Epirubicin (60 mg/m(2), on days 1 and 2) plus Ifosfamide (2000 mg/m(2), on days 1 to 3) and Uromitexan (2000 mg/m(2) at hours 0, 4, 8 after IFO). All drugs were administered every three weeks. After two cycles, a restaging work-up revealed a partial remission. The treatment was continued for another two cycles. A new evaluation by cardiac MRI evidenced a local and distant (lung) progression of disease. The patient died after three months. This paper confirms that cardiac angiosarcoma is a fatal disease, and the prognosis is usually 6-11 months from time of diagnosis.
Rotate-on-Retract Procedural Automation for Robotic-Assisted Percutaneous Coronary Intervention: First Clinical Experience
Authors: Arif Al Nooryani, Wael Aboushokka
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

The advent of percutaneous coronary intervention (PCI) has dramatically changed the outlook for patients with cardiovascular disease. However, room for improvement and advancement remains in the safety, speed, and efficiency of manually guided PCI. In recent years, the CorPath robotic platform (Corindus Inc., Waltham, MA) has been approved to aid the interventionalist during PCI and other endovascular interventions. Favorable results in several clinical studies suggest that robotic-assisted PCI may further improve patient outcomes while also benefiting the interventionalist through reduced orthopedic strain and less exposure to ionizing radiation. In this report, we communicate our experience with the first-in-human use of a new, optional automation feature that has been added to the platform's guidance software. This "Rotate-on-Retract" feature is designed to facilitate faster and more precise maneuvering of the guidewire through tortuous vessels by automatically rotating the guidewire whenever it is retracted by the operator. This movement changes the tip's orientation in preparation for the next advancement. We evaluated this feature in a patient undergoing PCI to treat a severe (90% stenotic), long, diffuse, and calcified lesion of the proximal to mid LAD segments.
A Supernumerary Nipple-Like Clinical Presentation of Lymphangioma Circumscriptum
Authors: Dustin Taylor, Natalie Kash, Sirunya Silapunt
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Lymphangioma circumscriptum is a superficially localized variant of lymphangioma. The characteristic clinical presentation is a "frogspawn" grouping of vesicles or papulovesicles on the proximal limb or limb girdle areas. Though most lymphangiomas develop congenitally, the lymphangioma circumscriptum subtype is known to present in adults. We report a case of lymphangioma circumscriptum on the left inframammary area of an African American female with an unusual supernumerary nipple-like clinical presentation. Our patient presented with a firm, smooth, hypopigmented papule, and the clinical diagnosis of keloid was made initially. However, she returned reporting growth of the lesion and was noted to have a firm, exophytic, lobulated, pink to skin-colored nodule. Histopathological examination demonstrated dilated lymphatic vessels, consistent with the diagnosis of lymphangioma. The presentation as a firm, hypopigmented papule and later exophytic, lobulated, skin-colored nodule in our case represents a clinical presentation of lymphangioma circumscriptum not previously described in the literature. Correct diagnosis in lymphangioma circumscriptum is vital, as recurrence following surgical resection and secondary development of lymphangiosarcoma and squamous cell carcinoma following treatment with radiation have been reported. Thus, it is important to consider lymphangioma circumscriptum in the differential of similar lesions in the future to allow appropriate diagnosis, treatment, and monitoring.
Case report: Abdominal hernia repair using a surgical wire and an autologous omental graft in a Japanese Black calf
Authors: Reiichiro Sato, Sueun Kim, Shoichi Okada, Tomonobu Ikedo, Hiroyuki Satoh, Adrian Steiner
Journal: Front Vet Sci (2023)
Keywords: abdominal hernia, abdominal wall reconstruction, autologous omental graft, calf, spondylocostal dysostosis, wire
MeSH terms: Case Reports

Background:
Hernia formation is a well-known abdominal wall disorder in calves and most often occurs in the umbilical region. In addition, it occurs in the abdominal wall outside the umbilical region. It has been reported to involve acquired factors, such as external force to the lower or lateral abdominal wall, trauma, muscle weakness, and, although rare, congenital or hereditary factors. Although there have been reports on the repair of abdominal wall hernias caused by abnormal muscle formation, there have been no reports on the treatment of abdominal wall hernias caused by abnormal vertebral and rib formation in cattle or other ruminants. In this study, for the first time, we describe a case of successful closure of a hernia in the left flank caused by malformation of the vertebrae and ribs. The repair was performed by narrowing the ribs using a surgical wire and covering the defect with a free omental graft.
Case presentation:
A male Japanese Black calf showed a mild bulge of the left abdominal wall and abnormal morphology of the left ribs immediately after birth. At 3 months of age, computed tomography revealed fusion of the 9th, 10th, and 11th thoracic vertebrae and missing formation of the 10th and 11th left ribs at the thoracic vertebral fusion site. Additionally, a 15.2 × 24.4 cm abdominal hernia had formed in the abdominal wall. During surgery, the ribs forming the hernia were narrowed with a surgical wire, and the hernia was covered with a large autologous free omental graft to prevent intra-abdominal organ prolapse. At the monthly follow-up (11 months after surgery), the calf had developed similarly to other calves of the same age on the farm, and no complications were noted.
Conclusions:
The current case shows that a combination of rib correction using a surgical wire combined with transplantation of a free autologous greater omentum graft was shown to be a possible treatment option for surgical repair of large abdominal wall hernias caused by rib malformation.
Menkes disease complicated by concurrent ACY1 deficiency: A case report
Authors: Alessia Mauri, Laura Assunta Saielli, Enrico Alfei, Maria Iascone, Daniela Marchetti, Elisa Cattaneo, Anna Di Lauro, Laura Antonelli, Luisella Alberti, Eleonora Bonaventura, Pierangelo Veggiotti, Luigina Spaccini, Cristina Cereda
Journal: Front Genet (2023)
Keywords: acy deficiency, menkes disease, case report, delayed copper therapy, novel atp7a variant, overlapping phenotype
MeSH terms: Case Reports

Introduction: Menkes disease is an X-linked recessive condition caused by mutations in the ATP7A gene, which leads to severe copper deficiency. Aminoacylase-1 deficiency is a rare inborn error of metabolism caused by homozygous or compound heterozygous variant in the ACY1 gene, characterized by increased urinary excretion of specific N-acetyl amino acids. Case presentation: We report an infant with neurological findings such as seizures, neurodevelopmental delay and hypotonia. Metabolic screening showed low serum copper and ceruloplasmin, and increased urinary excretion of several N-acetylated amino acids. Whole-exome sequencing analysis (WES) revealed the novel de novo variant c.3642_3649dup (p.Ala1217Aspfs*2) in the ATP7A gene, leading to a diagnosis of Menkes disease, and the simultaneous presence of the homozygous ACY1 variant c.1057C>T (p.Arg353Cys) causative of Aminoacylase-1 deficiency. Conclusion: Our patient had two rare conditions with different treatment courses but overlapping clinical features. The identified novel ATP7A mutation associated with Menkes disease expands the ATP7A gene spectrum.
Levetiracetam improves disinhibitory behavior in nonconvulsive status epilepticus
Authors: Kazuhiko Yamamuro, Hiroki Yoshino, Kentaro Tamura, Toyosaku Ota, Toshifumi Kishimoto
Journal: Ann Gen Psychiatry (2014)
Keywords: disinhibitory behavior, infectious encephalitis, levetiracetam, nonconvulsive status epilepticus, psychiatric disorder

Background:
Nonconvulsive status epilepticus (NCSE) is a severe medical condition and heterogeneous disorder defined by different seizure types and diverse etiologies. NCSE occurs commonly in the elderly and is potentially misdiagnosed as a psychiatric disorder. Current treatment options for NCSE are still unsatisfactory.
Case presentation:
We report a case of NCSE in a 55-year-old epileptic male patient with a history of infectious encephalitis, disinhibitory behavior, and a suspected diagnosis of frontotemporal dementia. Add-on levetiracetam (LEV) to carbamazepine treatment improved clinical manifestations and abnormal electroencephalographic discharge.
Conclusion:
With disinhibitory behavior in the elderly, the possibility of NCSE should be considered. Moreover, LEV may be an effective and well-tolerated pharmacotherapy for elderly NCSE patients.
Case Report: Glucocorticoids Combined With Immunosuppressant in the Treatment of Acromegaly Complicated With Focal Segmental Glomerulosclerosis
Authors: Ruiqiang Wang, Yunqi Wu, Dongyue An, Pupu Ma, Yuanyuan Guo, Lin Tang
Journal: Front Med (Lausanne) (2021)
Keywords: acromegaly, focal segmental glomerulosclerosis, glucocorticoids, growth hormone, immunosuppressant
MeSH terms: Case Reports

Background: Acromegaly is a chronic disease caused by excessive secretion of growth hormone (GH), which circulates and stimulates the liver and body tissues to produce insulin-like growth factor type 1 (IGF-1). Experimental studies have shown that excessive secretion of GH is related to glomerular sclerosis, and elevated IGF-1 levels may be involved in the occurrence of glomerular hypertrophy. But relevant clinical cases are rare. Here, we reported a case of acromegaly complicated with focal segmental glomerulosclerosis (FSGS). Case Presentation: A 49-year-old man was admitted to our hospital because of acromegaly for more than 10 years and proteinuria for more than 3 years. Acromegaly was confirmed by contrast-enhanced magnetic resonance imaging, minimally invasive surgery and pathology. The results of renal biopsy showed FSGS-NOS (not otherwise specified) with ischemic renal injury and mesangial IgA deposition. One month after transnasal transsphenoidal space occupying resection, GH and urinary protein decreased significantly, and nephropathy was partially relieved. In the next 4 months, GH stabilized at the normal level, while urinary protein gradually increased. When the urinary protein increased to 4.2 g/d, the dosage of glucocorticoids increased to 20 mg/d, and tacrolimus 1 mg/d were added, and the urinary protein decreased again. However, when the urinary protein decreased to 0.43 g/d, the patient stopped taking glucocorticoids and tacrolimus, and the urinary protein increased to 2.85 g/d after 8 months, but the GH was still in the normal range. Conclusion: In this case, GH is partially involved in the formation of FSGS. Not only does surgery reduce the effects of GH, but low doses of glucocorticoids and immunosuppressant are effective in slowing the progression of kidney disease, at least in reducing urinary protein.
Bilateral Insufficiency Fracture of the Pelvis Following THA: A Case Report
Authors: Shinya Hayashi, Takayuki Nishiyama, Takaaki Fujishiro, Shingo Hashimoto, Masahiro Kurosaka
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Insufficiency fracture is of the stress fractures and is caused by repetitive stress on fragile bone. Insufficiency fractures of pubic rami are rare occurrences in association with total hip arthroplasty (THA). Postoperative stress fractures occur due to increase of patients activity following years of disability. The physician should consider the possibility of a pelvic insufficiency fracture in patients with RA after THA, if the patients present with groin pain. We demonstrate here the first case of bilateral insufficiency fracture of pubic rami and iliac bone following THA.
An Uncommon Case of Pyogenic Spondylodiscitis Caused by Gemella morbillorum
Authors: Takashi Sono, Mitsuru Takemoto, Koh Shinohara, Yasuhiro Tsuchido
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

An 81-year-old man presented with severe back pain. Magnetic resonance imaging detected L5/S discitis without signs of epidural abscess. Punctures of the disc revealed that the causative organism was Gemella morbillorum (G. morbillorum), which is part of the normal flora of the oral cavity and an uncommon causative pathogen of spondylodiscitis. The E-test method was useful for rapid susceptibility testing. Intravenous penicillin G treatment was effective, and the patient recovered without surgery.
Long-term survival after an aggressive surgical resection and chemotherapy for stage IV pulmonary giant cell carcinoma
Authors: Fumihiro Shoji, Riichiroh Maruyama, Tatsuro Okamoto, Jiro Ikeda, Tomomi Nakamura, Hiroshi Wataya, Yukito Ichinose
Journal: World J Surg Oncol (2005)

Background:
Pulmonary giant cell carcinoma is one of the rare histological subtypes with pleomorphic, sarcomatoid or sarcomatous elements. The prognosis of patients with this tumor tends to be poor, because surgery, irradiation and chemotherapy are not usually effective.
Case presentation:
We herein report a patient with pulmonary giant cell carcinoma with stage IV disease in whom aggressive multi-modality therapy resulted in a long-term survival. A 51-year-old male underwent an emergent operation with a partial resection of small intestinal metastases due to bleeding from the tumor. The patient also underwent a left pneumonectomy due to hemothorax as a result of the rapid growth of the primary tumor. Thereafter, two different regimens of chemotherapy and a partial resection for other site of small intestinal metastases and a splenectomy for splenic metastases were performed. The patient is presently doing well without any evidence of recurrence for 3 years after the initial operation.
Conclusion:
This is a first report of a rare case with stage IV pulmonary giant cell carcinoma who has survived long-term after undergoing aggressive surgical treatment and chemotherapy.
Portal hypertension as the initial manifestation of POEMS syndrome: a case report
Authors: Lina Wu, Yue Li, Fang Yao, Chongmei Lu, Jian Li, Weixun Zhou, Jiaming Qian
Journal: BMC Hematol (2017)
Keywords: castleman disease, poems syndrome, portal hypertension
MeSH terms: Case Reports

Background:
Portal hypertension has a broad differential diagnosis. POEMS syndrome is an uncommon cause of it. POEMS syndrome is a rare disease involving multiple organs. In differential diagnosis of portal hypertension, POEMS syndrome should be considered especially when other symptoms such as numbness, organomegaly, endocrine alteration and skin changes also present, as it is highlighted by our case.
Case presentation:
We report a 46-year-old Chinese male, a teacher, presenting with portal hypertension. Electromyography revealed peripheral neuropathy. Immunofixation showed monoclonal immunoglobulin A lambda protein. The diagnosis of POEMS syndrome was established. After treatment of lenalidomide combined with dexamethasone over 2 years, the patient achieved a considerable improvement.
Conclusion:
This case highlights the manifestation of portal hypertension in POEMS syndrome. Lenalidomide with or without dexamethasone is effective for portal hypertension due to POEMS syndrome, though esophageal and gastric varices seems not reversible so easily.
Superior Dislocation of the Patella in a Young Patient without Osteophytes: A Case Report with Discussion about Differential Diagnosis
Authors: Wander Edney de Brito, Gustavo Constantino Campos, João Batista de Miranda, Alessandro Rozim Zorzi
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

We report a case of superior dislocation of the patella in a young woman without degenerative changes. We retrospectively analyzed the clinical and imaging data obtained from the patient. This article describes a rare case of patellar dislocation following a bicycle fall in a 19-year-old woman without any history of patellofemoral complaints. Our literature search yielded 28 case reports; however, most reports describe older individuals with osteoarthritis. Only two reports have previously described this lesion in young patients without osteophytes, but some features, like an increase of the patella tilt, may raise doubts about whether it would be better to classify them as a vertical dislocation of the patella, another quite rare lesion, or just as a variant of a superior dislocation.
Ranula as the First Symptom of HIV Infection in Young Patients
Authors: X Vanden Eynden, C Bouland, D Dequanter, M Gerbaux, S Kampouridis, E Boutremans, I Loeb
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Introduction:
Oral manifestations are often the earliest HIV signs. Salivary gland diseases are a common form of HIV expression. A ranula can occur in association with HIV. However, this manifestation is rarely considered as the disease sentinel sign. We present two cases of children consulting for a ranula, leading to the diagnosis of a previously unknown HIV infection. Case Reports. Two children, respectively, 5 and 13, were treated for a ranula by marsupialization. Relapse occurred in both cases, and thereafter, a ranula excision was performed. While the follow-up was uneventful, HIV infection was diagnosed during the patients' care. The only sign or symptom observed was the ranula. A routine HIV testing of ranula patients would have allowed earlier care.
Conclusion:
Routine HIV testing of patients with a ranula is justified and may be recommended, especially for children. Ranula excision associated with the sublingual gland resection is suggested in order to avoid recurrence.
Renal Solid Mass as a Rare Presentation of Wagener's Granulomatosis: A Case Report
Authors: Mehrdad Mohammadi Sichani, Mazaher Hadi, Ardeshir Talebi, Pooyan Khalighinejad
Journal: Case Rep Urol (2012)

Wagener's granulomatosis (WG) is a rheumatologic disease with unknown etiology which renal and pulmonary involvement is commonly seen. Renal involvement in Wagener's granulomatosis represents as a segmental necrotizing glomerulonephritis which is not visible with imaging techniques and usually presents with proteinuria, microhematuria, and hypertension. A rare presentation of the disease is a renal mass which can be mistaken as renal tumors, abscess, or lymphoma. We report a 22-year-old female with flank pain and fever who was admitted in our hospital. The patient underwent renal tumor biopsy and diagnosed with Wagener's granulomatosis in pathologic staining. The aim of this work is introduction of Wagener's granulomatosis as a differential diagnosis of renal tumors, to prevent unnecessary interventions and delayed treatment.