OpenMed/multicare-articles huggingface dataset:
Visual impairment due to bilateral multifocal choroidal metastasis of parotid adenocarcinoma: a case report
Authors: Gerard Walls, Seamus Napier, David Stewart
Journal: Front Oncol (2014)
Keywords: choroid neoplasms, external beam radiotherapy, orbital neoplasms, parotid neoplasms, radiation effects

Background:
Orbital metastases are an uncommon finding, being present in just 9% deceased patients with metastatic cancer. Only a quarter of patients with choroidal metastases have bilateral disease. Parotid cancer is not a common form of head and neck malignancy. Bilateral multifocal metastases from adenocarcinoma ex pleomorphic of parotid gland have been documented just once before in the literature. We present a similar case where palliative EBRT was used to gain local control with minimal toxicity.
Case presentation:
The case of a 45-year-old Caucasian gentleman who presented to his general practitioner with otalgia and weight loss. Imaging revealed a mass in the deep lobe of the left parotid gland, invading into the medial pterygoid muscle. PET-CT revealed locoregional and distant lymphatic involvement plus disseminated skeletal metastases. Lymph node examination revealed adenocarcinoma ex pleomorphic histology. Within weeks of this diagnosis, the patient developed rapidly progressive visual impairment. Ophthalmologists found multifocal uveal masses bilaterally. Palliative fractions of external beam radiotherapy were delivered to the orbits before combination chemotherapy. We discuss the patient's presentation, histopathology, and management, with support from the literature regarding applied and related therapies.
Summary:
In this rare presentation of disseminated malignancy affecting the choroid bilaterally, the authors demonstrate the application of palliative EBRT to good local effect. Given the nature of this treatment and that of the metastases, in the setting of incurable disease orbital morbidity is likely to occur again before the patient's death. Awareness of the initial symptoms is important to provide prompt care and maintain quality of life.
"Extreme Nephroptosis": A Kidney in the Inguinal Hernia
Authors: Dmytro Shchukin, Vladyslav Demchenko, Andrii Arkatov, Roman Stetsyshyn, Gennadii Khareba, Vladyslav Bielov
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

We present an extremely rare case of renal ptosis from the normal orthotopic position into the cavity of inguinal hernia in a 93-year-old male patient. The following clinical case was accompanied by renal insufficiency, which was associated with the obstruction of the right ureter in the hernial sac and the stenosis of the left renal artery. The differential diagnosis between nephroptosis and dystopic kidney was based on MDCT scan images, which demonstrated the length of the right renal artery to be more than 20 cm. The patient underwent percutaneous nephrostomy through the right inguinal area and was successfully followed up for two years. We also analyzed six similar clinical cases described in the literature. This disease has, thus far, been observed exclusively in elderly men with long-standing and large inguinal hernias. The most frequent complications in these patients include ureteral strangulation in the area of the hernial gate and renal failure.
Myofibroblastoma of the Breast: Literature Review and Case Report
Authors: Mario Metry, Mohamad Shaaban, Magdi Youssef, Michael Carr
Journal: Case Rep Oncol Med (2016)

Myofibroblastoma of the breast is a rare benign spindle cell tumor. The main aim of this study is to review the literature of this rare tumor. We present a case of a mammary myofibroblastoma occurring in an 82-year-old man, emphasizing the clinical, radiological, and pathological features. The tumor was successfully identified and managed in our hospital. We would like to draw the attention of clinicians to myofibroblastoma as a rare possibility in the differential diagnosis of a breast mass.
Isolated cardiac hydatid cyst presented as myopericarditis: A case report
Authors: Farveh Vakilian, Akbar Kamali, Ali Azari, Hoorak Poorzand, Amir Kamali, Somayeh Vakili Ahrari Roodi
Journal: J Cardiovasc Thorac Res (2020)
Keywords: cardiac cyst, hydatid disease, interventricular septum, myopericarditis, surgery
MeSH terms: Case Reports

Hydatidosis commonly affect the liver and lungs but in rare cases, it can involve heart tissue. A 42-year-old man from urban areas of Khorasan Razavi province, northeastern Iran, was referred to the cardiac clinic with palpitation, and atypical chest pain in 2018. Large pericardial effusion, reduced left ventricle systolic function was found. A cystic-like lesion was also seen in inter-ventricular septum in echocardiography and high-resolution computed tomography (HRCT). Urgent cardiac surgery was done because of echocardiographic evidence of tamponade. Although the serologic analysis was negative for hydatidosis, surgical excision of cyst and the subsequent histopathological findings revealed a hydatid cyst. In endemic areas, hydatidosis should be considered in differential diagnosis of any cystic-like lesions, even if the serological analysis is negative.
Successful advanced maternal age pregnancy with mosaic turner syndrome conceived after ovulation induction with clomiphene citrate: a case report
Authors: Masahiro Murakami, Kenji Hinokio, Machiko Kiyokawa, Mikio Morine, Takeshi Iwasa
Journal: Case Rep Obstet Gynecol (2014)

Turner women typically experience gonadal dysfunction that results in amenorrhea and sterility. We encountered a case of mosaic Turner syndrome where conception was possible after ovulation induction with clomiphene citrate (CC). The patient's ovaries were overresponsive to induction with CC. The challenges and successful outcome are reported.
Case report: An intraretinal macrocyst with crystalline content and retinal detachment
Authors: Chang Cai, Jialin Zhou, Qiuyu Wang, Weihou Li, Danning Liu
Journal: Front Med (Lausanne) (2022)
Keywords: b-scan ultrasonography, case report, crystalline contents, intraretinal macrocyst, vitrectomy
MeSH terms: Case Reports

Introduction:
An intraretinal macrocyst is a cavity located in the outer plexiform layer of the retina. It is commonly filled with liquid or blood. To date, few case reports of intraretinal macrocysts with crystalline content and retinal detachment have been published.
Case presentation:
A 44-year-old woman with no history of other diseases complained of decreased vision in her right eye that had persisted for 20 days. The best corrected visual acuity of the right eye was hand motion. Comprehensive ophthalmic examinations were performed, including a vision test, slit lamp fundus examination, ocular B-scan ultrasound, and orbital magnetic resonance imaging. We performed vitrectomy and retinotomy to sufficiently remove the macrocyst and relieve retinal traction. We then reattached the retina and filled it with silicone oil. During the surgery, we found that the cyst had crystalline content, which has not been previously reported, to the best of our knowledge. Finally, the pathological results confirmed a final diagnosis of intraretinal macrocyst. Six months later, we performed a second operation to remove the silicone oil and implant an intraocular lens. After both surgeries, the best corrected visual acuity of the patient's right eye was restored to 20/200, and the retina had repositioned.
Conclusion:
Intraretinal macrocysts are very rare. Both orbital magnetic resonance imaging and ocular B-scan ultrasound are essential for their diagnosis. Our results indicated that vitrectomy was the best way to remove the cyst and reattach the retina.
Patent foramen ovale in patients with sickle cell disease and stroke: case presentations and review of the literature
Authors: Sheila Razdan, John J Strouse, Rakhi Naik, Sophie Lanzkron, Victor Urrutia, Jon R Resar, Linda M S Resar
Journal: Case Rep Hematol (2013)

Although individuals with sickle cell disease (SCD) are at increased risk for stroke, the underlying pathophysiology is incompletely understood. Intracardiac shunting via a patent foramen ovale (PFO) is associated with cryptogenic stroke in individuals without SCD. Recent evidence suggests that PFOs are associated with stroke in children with SCD, although the role of PFOs in adults with stroke and SCD is unknown. Here, we report 2 young adults with SCD, stroke, and PFOs. The first patient had hemoglobin SC and presented with a transient ischemic attack and a subsequent ischemic stroke. There was no evidence of cerebral vascular disease on imaging studies and the PFO was closed. The second patient had hemoglobin SS and two acute ischemic strokes. She had cerebral vascular disease with moyamoya in addition to a peripheral deep venous thrombosis (DVT). Chronic transfusion therapy was recommended, and the DVT was managed with warfarin. The PFO was not closed, and the patients' neurologic symptoms were stabilized. We review the literature on PFOs and stroke in SCD. Our cases and the literature review illustrate the dire need for further research to evaluate PFO as a potential risk factor for stroke in adults with SCD.
At the nexus of ludology and narratology: Advances in reality-based story-driven games
Authors: Lei Chen, David Dowling, Christopher Goetz
Journal: F1000Res (2023)
Keywords: chinese parents, detroit
MeSH terms: Communication, Linguistics

Story-driven games are growing in popularity across a wide range of genres. However, the narrative potential of video games is still being debated, particularly in light of the so-called tension between gameplay and storytelling. This study proposes that rules and game mechanics perform narrative semiotic functions, offering a ludic grammar of interactive storytelling. Case studies of four representative games show through exploratory player action shaped by rules, the medium of video games can generate meanings that traditional media cannot, thereby better achieving their narrative goals.
Pulmonary Eosinophilic Inflammatory Infiltration Post-Intensive Care in a Nearly Drowned Young Man with Papillary Fibroelastoma: A Rare Complication Discovered by Forensic Autopsy
Authors: Gelsomina Mansueto, Emanuele Capasso, Claudio Buccelli, Massimo Niola
Journal: Front Med (Lausanne) (2018)
Keywords: eosinophilic inflammatory infiltration, intensive care, nearly drowned, papillary fibroelastoma, syncope
MeSH terms: Case Reports

Papillary fibroelastoma is a rare benign lesion of heart (1). It is the second most common primary cardiac neoplasm, accounting for 4.4-8% of all tumors of the heart (2). We described a forensic autopsy of a nearly drowned young man with cardiac papillary fibroelastoma who died because of a pulmonary inflammatory infiltration rich in granulocytes after intensive care. This occurrence is rare but possible and should be kept in mind because a lung inflammatory infiltrate rich in eosinophilic granulocytes can be present in different pathological conditions and differential diagnoses are often difficult to do.
Analysis of a marine phototrophic biofilm by confocal laser scanning microscopy using the new image quantification software PHLIP
Authors: Lukas N Mueller, Jody F C de Brouwer, Jonas S Almeida, Lucas J Stal, João B Xavier
Journal: BMC Ecol (2006)
MeSH terms: Biofilms, Ecosystem, Microscopy, Confocal / methods, Phototropism, Software, Research Support, Non-U.S. Gov't

Background:
Confocal laser scanning microscopy (CLSM) is the method of choice to study interfacial biofilms and acquires time-resolved three-dimensional data of the biofilm structure. CLSM can be used in a multi-channel modus where the different channels map individual biofilm components. This communication presents a novel image quantification tool, PHLIP, for the quantitative analysis of large amounts of multichannel CLSM data in an automated way. PHLIP can be freely downloaded from http://phlip.sourceforge.net.
Results:
PHLIP is an open source public license Matlab toolbox that includes functions for CLSM imaging data handling and ten image analysis operations describing various aspects of biofilm morphology. The use of PHLIP is here demonstrated by a study of the development of a natural marine phototrophic biofilm. It is shown how the examination of the individual biofilm components using the multi-channel capability of PHLIP allowed the description of the dynamic spatial and temporal separation of diatoms, bacteria and organic and inorganic matter during the shift from a bacteria-dominated to a diatom-dominated phototrophic biofilm. Reflection images and weight measurements complementing the PHLIP analyses suggest that a large part of the biofilm mass consisted of inorganic mineral material.
Conclusion:
The presented case study reveals new insight into the temporal development of a phototrophic biofilm where multi-channel imaging allowed to parallel monitor the dynamics of the individual biofilm components over time. This application of PHLIP presents the power of biofilm image analysis by multi-channel CLSM software and demonstrates the importance of PHLIP for the scientific community as a flexible and extendable image analysis platform for automated image processing.
Proceedings of the 2nd BEAT-PCD conference and 3rd PCD training school: part 1
Authors: Florian Halbeisen, Claire Hogg, Mikkel C Alanin, Zuzanna Bukowy-Bieryllo, Francisco Dasi, Julie Duncan, Amanda Friend, Myrofora Goutaki, Claire Jackson, Victoria Keenan, Amanda Harris, Robert A Hirst, Philipp Latzin, Gemma Marsh, Kim Nielsen, Dominic Norris, Daniel Pellicer, Ana Reula, Bruna Rubbo, Nisreen Rumman, Amelia Shoemark, Woolf T Walker, Claudia E Kuehni, Jane S Lucas
Journal: BMC Proc (2018)
MeSH terms: Case Reports

Primary ciliary dyskinesia (PCD) is a rare heterogenous condition that causes progressive suppurative lung disease, chronic rhinosinusitis, chronic otitis media, infertility and abnormal situs. 'Better Experimental Approaches to Treat Primary Ciliary Dyskinesia' (BEAT-PCD) is a network of scientists and clinicians coordinating research from basic science through to clinical care with the intention of developing treatments and diagnostics that lead to improved long-term outcomes for patients. BEAT-PCD activities are supported by EU funded COST Action (BM1407). The second BEAT-PCD conference, and third PCD training school were held jointly in April 2017 in Valencia, Spain. Presentations and workshops focussed on advancing the knowledge and skills relating to PCD in: basic science, epidemiology, diagnostic testing, clinical management and clinical trials. The multidisciplinary conference provided an interactive platform for exchanging ideas through a program of lectures, poster presentations, breakout sessions and workshops. Three working groups met to plan consensus statements. Progress with BEAT-PCD projects was shared and new collaborations were fostered. In this report, we summarize the meeting, highlighting developments made during the meeting.
Human case of lobomycosis
Authors: Sameer Elsayed, Susan M Kuhn, Duane Barber, Deirdre L Church, Stewart Adams, Richard Kasper
Journal: Emerg Infect Dis (2004)
MeSH terms: Paracoccidioidomycosis / pathology, Case Reports, Adult, Female, Humans, Paracoccidioides / isolation & purification, Paracoccidioidomycosis / diagnosis, Paracoccidioidomycosis / therapy

We describe a 42-year-old woman with histologically confirmed lobomycosis, a cutaneous fungal infection rarely reported outside of Latin America. Our case represents the first published report of imported human lobomycosis in Canada and the fifth in an industrialized country.
Multifacet of Cornea Patch Graft in Anterior Segment Diseases
Authors: Prema Chendran, Yong Meng Hsien, Wan Haslina Wan Abdul Halim
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

Incidence of cornea melting or perforation is commonly seen in variety of cornea conditions. It can cause debilitating vision loss and impair patient's daily activity. Several techniques have been described to surgically treat cornea perforation and melting. In this article, a series of corneal diseases treated with corneal patch graft are highlighted to relate different approach of cornea patch graft surgery. Post-operative management and complications are discussed.
A Rare Case of a Migrating Inguinal Hernia Mesh Presenting as Acute Appendicitis
Authors: Jorge Nogueiro, Hugo Santos-Sousa, Marinho de Almeida, Luis Malheiro, Elisabete Barbosa
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Acute appendicitis is a very common event. Migration of hernia mesh is rare, especially intraluminal migrations. We aim to report a case of a migrated inguinal mesh presenting as an acute appendicitis. A 58-year-old male previously submitted to ONSTEP right inguinal hernia repair with a PolySoft™ hernia patch eight years before, was admitted in the emergency department with acute appendicitis, and submitted to laparoscopic appendectomy. Intraoperatively, the "recoil ring" from the inguinal hernia patch was extended from the anterior abdominal wall to the appendix, perforating it and progressing intraluminally. Appendectomy was performed, as well as removal of the mesh by an anterior approach. Hernia mesh migration to an intraluminally position is extremely rare with only a few cases described in literature. Pathogenesis of migration is still poorly understood. Clinicians should consider hernia mesh migration in their differential diagnosis for causes of acute appendicitis, in the right clinical setting, when a previous hernia defect correction is present. To the best of our knowledge, this is the first reported case of inguinal hernia mesh migration to the appendix, presenting as acute appendicitis.
Thyroid Autoimmunity and Function after Treatment with Biological Antirheumatic Agents in Rheumatoid Arthritis
Authors: Sofie Bliddal, Stina Willemoes Borresen, Ulla Feldt-Rasmussen
Journal: Front Endocrinol (Lausanne) (2017)
Keywords: graves’ disease, hashimoto’s thyroiditis, autoimmune thyroiditis, biological antirheumatic agents, rheumatoid arthritis, thyroglobulin antibody, thyroperoxidase antibody, tumor necrosis factor-alpha inhibitors
MeSH terms: Review

With the increased pro-inflammatory response in both rheumatoid arthritis and thyroid autoimmune diseases, treatment with biological antirheumatic agents (BAAs) of the former may affect the course of the latter. In hepatitis C and cancer patients, treatment with biological agents substantially increases the risk of developing thyroid autoimmunity. As the use of BAAs in the treatment of rheumatoid arthritis is increasing, this review aimed to investigate if such use affected thyroid status in rheumatoid arthritis patients. We conducted a systematic literature search and included six studies with a total of 311 patients as well as three case reports. The patients were treated with tumor necrosis factor-α inhibitors (infliximab, etanercept, or adalimumab) or the monoclonal CD20-antibody rituximab. There was a non-significant trend of slight improvement of both thyroid function and autoantibody status: a reduction of thyroid peroxidase and thyroglobulin antibody concentrations, and a reduction of thyrotropin levels in hypothyroid patients. Despite the small number of studies, they presented compliant data. The BAAs used in rheumatoid arthritis thus did not seem to negatively affect thyroid status in patients with rheumatoid arthritis and can be considered safe with regard to thyroid autoimmunity. However, the well-established association between rheumatic diseases and thyroid autoimmunity necessitates continued monitoring of thyroid function in patients with rheumatoid arthritis. Each new BAA should be scrutinized for its effect on thyroid as well as other autoimmune diseases in order to establish concise recommendations for patient follow-up for each agent and each disease.
Massive acetaminophen overdose with metabolic acidosis refractory to N-acetylcysteine, fomepizole, and renal replacement therapy
Authors: Sean Cuninghame, Khaled Lotfy, Paul Cameron
Journal: Toxicol Rep (2021)
Keywords: apap, acetaminophen, intermittent hemodialysis, metabolic acidosis, overdose, renal replacement therapy
MeSH terms: Case Reports

Massive Acetaminophen (N-acetyl-p-aminophenol; APAP) overdose is a common presentation to emergency departments around the world. While N-acetylcysteine (NAC) remains the cornerstone of treatment for APAP overdose, extracorporeal treatment, in the form of renal replacement therapy with intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT) may provide benefit in cases associated with altered mental status and metabolic acidosis. One treatment with IHD is typically sufficient for resolution of acidosis and global improvement clinically. We describe a case of massive APAP overdose presenting with altered mental status and lactic acidosis, refractory to multiple treatments of IHD as well as CRRT and high-dose NAC along with fomepizole. Despite these interventions, fulminant liver failure progressed with cerebral edema, coagulopathy and death. This is the first description of a fatal acetaminophen ingestion refractory to both IHD and prolonged CRRT. This case highlights the need for further investigation in the management of massive APAP overdose, including optimal method and timing of renal replacement therapy.
Acute suppurative thyroiditis with thyroid abscess: a case report and review of the literature
Authors: Nosrat Ghaemi, Javad Sayedi, Sepideh Bagheri
Journal: Iran J Otorhinolaryngol (2014)
Keywords: abscess, staphylococcus aureus, thyroiditis
MeSH terms: Case Reports

Introduction:
Thyroid gland is well known to resist infections by rich blood supply and lymphatic drainage, high glandular content of iodine which can be bactericidal and separation of the gland from other structures of neck. Primary thyroid abscess resulting from acute suppurative thyroiditis (AST) is an unusual type of head and neck infection and it is a rare condition in children so that progression to abscess formation is even more uncommon.
Case report:
In this article we report a 9 years old girl who presented with thyroid abscess. She had fever, painful swelling in the neck, sore throat, tachycardia ,restriction of neck movements and dysphagia for 6-7 days with a history of mild fever from 10 days, prior to that. The responsible organism was found to be staphylococcus aureus. Treatment began with Intravenous antibiotics and continued with incision and drainage. Thus the process led to an uncomplicated recovery.
Conclusion:
Although thyroid abscess is rare, but must be considered. Most common organism that cause is staphylococcus aureus. With early diagnosis and proper treatment, it can be prevented from complications. Since this disease can be associated with anatomic abnormalities such as pyriform sinus fistula, must be roule outed.
Anesthetic Management of Left Ventricular Assist Device Exchange in a Patient with Intracranial Hemorrhage
Authors: Nevriye Salman, Sınan Sabit Kocabeyoğlu, Ülkü Sabuncu, Ümit Kervan, Mustafa Paç, Ayşegül Özgök
Journal: J Tehran Heart Cent (2020)
Keywords: anesthesia, heart-assist devices, intracranial hemorrhages
MeSH terms: Case Reports

The gold standard treatment for end-stage heart failure is heart transplantation; however, the rate of transplantation remains inadequate because of the paucity of organ donation. The left ventricular assist device (LVAD) has been used as a bridge therapy before transplantation. The LVAD is being used increasingly because it reduces mortality despite the accompanying morbidities. Therefore, the anesthetic management of LVAD-related morbidities is important and requires experience and knowledge. Herein, we describe a 60-year-old male patient with an LVAD with complaints of right hemiparesis, dysphasia, and facial paralysis. We aim to present the anesthetic management of a patient with intracranial hemorrhage who underwent LVAD exchange due to thrombosis.