OpenMed/multicare-articles huggingface dataset:
Acute Respiratory Distress Syndrome Associated With Clopidogrel in a Young Male Patient
Authors: Stephanie M Roses, Thomas Christianson, Keith Dombrowski
Journal: Front Med (Lausanne) (2019)
Keywords: ards (acute respiratory distress syndrome), aneurysm, clopidgrel, plavix, subarachanoid hemorrhage
MeSH terms: Case Reports

Background: Clopidogrel is a commonly prescribed antiplatelet drug in patients with stents and histories of arterial vascular disease. It generally has a favorable side effect profile with increasing bleeding risk as the main concern as an adverse event. Case Presentation: A 19-year-old previously healthy male presented to the neurological intensive care unit with a subarachnoid hemorrhage requiring a flow diverting stent to secure the aneurysm. The patient was stable for 2 weeks and had no changes to management or medication within 48 h of antiplatelet therapy. Within hours of first-time dosing of clopidogrel, the patient experienced a syncopal episode and dyspnea. He was difficult to arouse and using accessory muscles to breath with an otherwise benign exam. He was hypoxic with bibasilar crackles requiring bilevel positive airway pressure (BiPap). Imaging showed bilateral pulmonary edema and he was diagnosed with moderate acute respiratory distress syndrome (ARDS). Infectious, cardiogenic, and contrast-induced ARDS were ruled out. Upon cessation of clopidogrel, his pulmonary function and mental status improved. Conclusions: This is the first reported case of a young and immunocompetent patient's severe pulmonary edema leading to acute respiratory distress syndrome in association with first- time dosing of clopidogrel.
Neurofibromatosis type 1, fibromuscular dysplasia, and ischemic stroke: an association lost in time? A case report
Authors: Igor Oliveira da Fonseca, Gustavo José Luvizutto, Isaac Pantaleão Souza, André Petean Trindade, Carlos Clayton Macedo de Freitas, Rodrigo Bazan, Gabriel Pinheiro Modolo
Journal: J Vasc Bras (2023)
Keywords: fibromuscular dysplasia, neurofibromatosis type 1, stroke
MeSH terms: Case Reports

Neurofibromatosis Type 1 (NF1) is a rare cause of ischemic stroke (IS) in the general population. We report a case of a young patient with NF1 in whom IS was caused by fibromuscular dysplasia. An angiographic study demonstrated occlusion in the right internal carotid artery (ICA), just after its origin, and the left ICA, just before the intracranial portion, and brain magnetic resonance imaging showed the limits of an area of brain infarction in the right frontoparietal region. Despite these concomitant neuroimaging findings, this association is rare, and it is difficult to establish the contribution to the outcome made by each of these diseases, which treatment is the best to implement, or what prognosis is.
'Soccer toe': Chronic physeal injury of the great toe metatarsal in a skeletally immature child - A case report
Authors: Andrew Schapiro, Tal Laor
Journal: SA J Radiol (2020)
Keywords: growth plate, mri, musculoskeletal imaging, physis, sports medicine, stress, toe
MeSH terms: Case Reports

Chronic physeal stress injuries in children can result from ongoing, repetitive compression, distraction and/or shear forces during sports-related activity, and manifest as physeal widening on imaging. We present an 11-year-old soccer athlete with focal physeal widening of her great toe metatarsal and postulate that ongoing or repetitive stress from soccer play may manifest as this imaging appearance. We suggest that recognition of this entity in growing children might explain pain, if present, and guide conservative treatment.
Leukemic Ischemia: A Case of Myocardial Infarction Secondary to Leukemic Cardiac Involvement
Authors: Dzmitry Fursevich, Colin Zuchowski, Joseph Limback, Melissa Kendall, Ashley Ramirez, Naim Fanaian, Jeremy Burt
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

We report a case of a 39-year-old male who presented to the emergency department with acute chest pain while being in remission from T-cell acute lymphoblastic leukemia (T-ALL). Cardiac markers were elevated and EKG revealed ischemic changes compatible with acute myocardial ischemia. Coronary computed tomography angiography (CCTA) showed calcium-free coronary arteries and soft tissue myocardial infiltration suggestive of cardiac leukemia. A bone marrow biopsy confirmed recurrence of T-ALL, and patient was successfully treated with chemotherapy. We discuss the prospective diagnosis of myopericardial leukemic involvement and the role of CCTA in diagnosis and perform a literature review.
Treatment Sequencing in a Chronic Lymphocytic Leukemia Patient with Central Nervous System Involvement
Authors: Filipa Mousinho, Tatiana Mendes, Paula Sousa E Santos, Maria João Acosta, José Pereira, Maria Arroz, Cândido Silva, Ana Paula Azevedo, Rita Oliveira, Martinha Chorão, Fernando Lima
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Early-stage chronic lymphocytic leukemia (CLL) with neurologic involvement is a rare condition and should require a careful follow-up. Although no standard protocol exists for this condition, intrathecal chemotherapy, combined with systemic chemoimmunotherapy, has been used previously. This case describes the treatment of a patient with CLL and symptomatic compromise of the central nervous system. Our results suggest that a combination of chemotherapy, radiotherapy, and ibrutinib, administered sequentially over a 2-year period, led to a near-complete resolution of the cerebral spinal fluid neoplastic infiltration. Importantly, this response has been maintained with ibrutinib monotherapy for more than 12 months.
Unifocal Granuloma of Femur due to Langerhans' Cell Histiocytosis: A Case Report and Review of the Literature
Authors: Harpreet Singh, Satnam Kaur, P Yuvarajan, Nishant Jain, Lalit Maini
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

The radiological diagnosis of osteolytic lesions of the long bones in pediatric population constitutes a challenge when the case history and clinical data are uncharacteristic. We believe that the description of few clinically and histologically proven cases to verify the existence of radiological signs useful for diagnosis may be of interest. Here, we describe a case of Langerhans' cell histiocytosis (LCH) presenting as unifocal eosinophilic granuloma of femur along with a brief review of the literature.
Metabolic flare phenomenon mimicking disease progression on 18Flouride- Fluorodeoxyglucose PET/CT scan in breast cancer treated with paclitaxel-based chemotherapy
Authors: Vijay Singh, Shivangi Dikshit, Manish Ora, Aftab Hasan Nazar
Journal: Asia Ocean J Nucl Med Biol (2023)
Keywords: breast cancer, flare phenomenon, paclitaxel
MeSH terms: Case Reports

18F-fluorodeoxyglucose Positron emission tomography (18F-FDG PET/CT ) is now being used as a single modality for metastatic workup and response evaluation in breast cancer. An increase in metabolic activity indicates disease progression; however, metabolic flare should be kept in mind. Metabolic flare is a well-documented phenomenon reported in metastatic breast and prostate cancer. Despite a favorable response to therapy, there is a paradoxical increase in radiopharmaceutical uptake. The flare phenomenon with various chemotherapeutic and hormonal agents is well acknowledged in bone scintigraphy. However, very few cases have been documented on PET/CT. Increased uptake may be noted after treatment is instituted. The increased osteoblastic activity is associated with the healing response of bone tumors. We report a case of treated breast cancer. She presented with metastatic recurrence after four years of initial management. The patient was started on paclitaxel chemotherapy. Serial 18F- FDG PET/CT demonstrated metabolic flare and complete metabolic response.
Case report: Recurrent severe mitral regurgitation due to ruptured artificial chords after transapical Neochord mitral valve repair
Authors: Mi Zhou, Ka-Chun Un, Chun Ka Wong, On Yat Wong, David Chung Wah Siu, Lixue Yin, Daniel Tai-Leung Chan, Simon Cheung Chi Lam
Journal: Front Cardiovasc Med (2022)
Keywords: cardiac intervention, echocardiography, mitral regurgitation, mitral valve (mv) repair, valvular heart disease
MeSH terms: Case Reports

Transapical Neochord mitral valve repair has been proven to be a technically safe procedure to correct primary mitral regurgitation (MR). Recurrent MR due to ruptured artificial chords is rare. Here, we present 2 cases of recurrent severe MR due to the detached or partially ruptured artificial chords after the Neochord procedure.
A heuristic model for collaborative practice-part 2: development of the collaborative, dialogue-based clinical practice model for community mental health and substance abuse care
Authors: Rolf Sundet, Hesook Suzie Kim, Bengt Eirik Karlsson, Marit Borg, Knut Tore Sælør, Ottar Ness
Journal: Int J Ment Health Syst (2020)
Keywords: clinical practice model for mental health and substance abuse care, collaborative practice, community mental health and substance abuse practice, dialogue-based, mental health and substance abuse, person/professional collaboration

Background:
Various models for collaborative practice in mental health care incorporating the perspectives of service-user participation and collaboration in the care have been developed. However, the emphasis in these practice models has not been on identifying specific features of "how" collaboration and service-user participation can occur and be nurtured. This suggests a need for a collaborative practice model that specifies essential strategies operationalizing the tenets of service-user participation and collaboration applicable in mental health and substance abuse (MHSA) care.
Methods:
A double helix approach of coalescing theoretical ideas and empirical findings to develop a practice model that is applicable in MHSA practice. A theoretical analysis is carried out to identify the critical, foundational elements for collaborative practice in MHSA practice, and has identified the philosophical-theoretical orientations of Habermas' theory of communicative action, Bakhtin's dialogicality, and the philosophy of personhood as the foundational features of collaboration. This base is juxtaposed with the results of a qualitative meta-analysis of 18 empirical articles on collaboration in MHSA to advance a collaborative practice model specifically in the domain of service user/professional collaboration.
Results:
"The collaborative, dialogue-based clinical practice model" (CDCP Model) for community mental health care is proposed, within the structure of four main components. The first specifies the framework for practice that includes person-centered care, recovery-orientation, and a pluralistic orientation and the second identifies the domains of collaboration as service user/professional collaboration, inter-professional collaboration, and service sector collaboration. The third identifies self-understanding, mutual understanding, and shared decision-making as the essential principles of collaboration. The fourth specifies interactive-dialogic processes, negotiated-participatory engagement processes, and negotiated-supportive processes as the essential strategies of collaboration applicable in service user/professional collaboration which were extracted in the empirical work. An illustration of the CDCP Model in a clinical case is given.
Conclusions:
The CDCP Model presented fills the gap that exists in the field of community MHSA practice regarding how to operationalize systematically the tenets of person-centeredness, recovery-oriented, and pluralism-oriented practice in terms of user/professional collaboration.
Pus in Spinal Needle: Diagnosis and Management of a Long-Segment Spinal Epidural Abscess
Authors: B M Munasinghe, N Pathirage, M S Hameed, C T Hapuarachchi
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Spinal-epidural abscess (SEA) is believed to be primarily of haematogenous origin and very rarely as a consequence of central neuraxial blockade. Early diagnosis and pertinent management invariably improve neurological outcomes. We report a case of long-segment SEA, which was suspected during subarachnoid anaesthesia, subsequently diagnosed and managed appropriately, averting irreversible neurological deficits.
Spontaneous and Excellent Healing of Bilateral Brown Tumors in Mandible after Endocrinal Therapy and Subtotal Parathyroidectomy: Case Report with 4-Year Follow-Up
Authors: Turker Yucesoy, Erdem Kilic, Fatma Dogruel, Fahri Bayram, Alper Alkan, Alper Celal Akcan, Figen Ozturk
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Primary hyperparathyroidism is an endocrine disorder occurring due to increased secretion of parathormone resulting in a complex of clinical, anatomical, and biochemical alterations. On the other hand, excision of a parathyroid adenoma can normalize the metabolic status. A 24-year-old man was referred to the hospital with bilateral swelling and spontaneous gingival bleeding from posterior of the mandible also with radiolucent well-demarcated lesions bilaterally in the mandibular third molar regions. After consultations, the patient was hospitalized in the endocrinology department where further tests were performed due to highly increased PTH level as 714 pg/ml. Bilateral brown tumors started to regress spontaneously, and no additional surgery was required after subtotal parathyroidectomy was performed. The presented case is the first patient whose bilateral brown tumors in the jaws spontaneously and totally healed after subtotal parathyroidectomy and endocrinal therapy who was strictly followed up for 4 years even though the lesions were associated with impacted third molars.
Autologous Mesenchymal Stem Cells for Treatment of Chronic Active Antibody-Mediated Kidney Graft Rejection: Report of the Phase I/II Clinical Trial Case Series
Authors: Željka Večerić-Haler, Matjaž Sever, Nika Kojc, Philip F Halloran, Emanuela Boštjančič, Gregor Mlinšek, Manca Oblak, Primož Poženel, Urban Švajger, Katrina Hartman, Miomir Kneževič, Ariana Barlič, Lenart Girandon, Andreja Aleš Rigler, Samo Zver, Jadranka Buturović Ponikvar, Miha Arnol
Journal: Transpl Int (2022)
Keywords: antibody mediated rejection, kidney allograft, kidney transplant, mesenchymal stem cells, stem cells
MeSH terms: Graft Rejection, Mesenchymal Stem Cells, Clinical Trial, Phase II, Clinical Trial, Phase I, Humans, Kidney

Mesenchymal stem cell (MSCs) therapy has already been studied in kidney transplant recipients (KTRs), and the available data showed that it is safe and well tolerated. The aim of this study was to evaluate the safety and efficacy of autologous MSCs in combination with standard therapy in KTRs with biopsy-proven chronic active antibody-mediated rejection (AMR). Patients with biopsy-proven chronic active AMR received treatment with autologous bone marrow-derived MSCs (3 × 106 cells/kg iv) after completion of standard therapy and were followed for up to 12 months. The primary endpoints were safety by assessment of adverse events. Secondary endpoints included assessment of kidney graft function, immunological and histological changes related to AMR activity and chronicity assessed by conventional microscopy and molecular transcripts. A total of 3 patients were enrolled in the study before it was terminated prematurely because of adverse events. We found that AMR did not improve in any of the patients after treatment with MSCs. In addition, serious adverse events were observed in one case when autologous MSCs therapy was administered in the late phase after kidney transplantation, which requires further elucidation.
Adenovirus serotype 7 associated with a severe lower respiratory tract disease outbreak in infants in Shaanxi Province, China
Authors: Liuying Tang, Li Wang, Xiaojuan Tan, Wenbo Xu
Journal: Virol J (2011)
MeSH terms: Adenovirus Infections, Human / epidemiology, Adenovirus Infections, Human / virology, Adenoviruses, Human / isolation & purification, Disease Outbreaks, Pneumonia, Viral / epidemiology, Pneumonia, Viral / virology, Case Reports, Research Support, Non-U.S. Gov't, Adenovirus Infections, Human / pathology, Adenoviruses, Human / classification, Adenoviruses, Human / genetics, Capsid Proteins / genetics, Child, Child, Preschool, China / epidemiology, Female, Genotype, Humans, Infant, Phylogeny, Pneumonia, Viral / pathology, Sequence Analysis, DNA, Sequence Homology, Serotyping, Capsid Proteins, hexon capsid protein, Adenovirus

Background:
Pneumonia caused by adenovirus infection is usually severe especially with adenovirus serotype 7 commonly associated with lower respiratory tract disease outbreaks. We reported an outbreak of 70 cases of severe pneumonia with one death of infants in Shaanxi Province, China. Sampling showed adenovirus 7 (Ad7) as the primary pathogen with some co-infections.
Results:
Two strains of adenovirus and two strains of enterovirus were isolated, the 21 pharynx swabs showed 14 positive amplifications for adenovirus; three co-infections with respiratory syncytial virus, two positive for rhinovirus, one positive for parainfluenza 3, and four negative. Adenovirus typing showed nine of the nine adenovirus positive samples were HAdV-7, three were HAdV-3 and two were too weak to perform sequencing. The entire hexon gene of adenovirus was sequenced and analyzed for the two adenovirus serotype 7 isolates, showing the nucleic acid homology was 99.8% between the two strains and 99.5% compared to the reference strain HAdV-7 (GenBank accession number AY769946). For the 21 acute phase serum samples from the 21 patients, six samples had positives results for ELISA detection of HAdV IgA, and the neutralization titers of the convalescent-phase samples were four times higher than those of the acute-phase samples in nine pairs.
Conclusions:
We concluded adenovirus was the viral pathogen, primarily HAdV-7, with some co-infections responsible for the outbreak. This is the first report of an infant pneumonia outbreak caused by adenovirus serotype 7 in Shaanxi Province, China.
Successful Treatment with Antibiotics Alone for Infant Rib Osteomyelitis
Authors: Yasuaki Matsumoto, Katsuyoshi Shimozawa, Junko Yamanaka, Yukari Atsumi, Tomomi Ota, Shinji Mochizuki, Hiroyuki Shichino
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Pediatric rib osteomyelitis is a rare disease occurring predominantly in the neonatal period and early childhood and accounting for about 1% of all pediatric osteomyelitis. Compared to osteomyelitis in other parts of the body, pediatric rib osteomyelitis shows few localized findings (such as redness and swelling) and often an indolent lesion as well either of which may delay diagnosis and thus make treatment more difficult. A previously healthy one-year-old girl came to our department with a chief complaint of fever lasting for three days. She was admitted to our department to investigate her fever. At the time of admission, radiographs showed decreased permeability in the left lung field; so, we started antimicrobial therapy on the assumption of pneumonia. On the second day of admission, methicillin-susceptible Staphylococcus aureus was detected in the blood culture. A further, more detailed physical examination revealed some slight left anterior chest swelling. We performed a contrast-enhanced CT scan and an MRI and diagnosed her with rib osteomyelitis complicated with a chest wall abscess. She was given intravenous cefazolin for two weeks, switched to oral cephalexin for four weeks, and then recovered completely. She was treated without surgical intervention, having showed a good response to antimicrobial therapy. Osteomyelitis of the ribs in children is reported to be more common in the lower ribs and to occur more frequently in infants. In many cases, the earliest symptoms are nonspecific, so careful examination to detect any subtle abnormalities-such as swelling or mass-is of key importance for early diagnosis in infants. Regarding treatment, most cases of hematogenous osteomyelitis resolve with antimicrobial therapy alone-although surgical intervention may be required in cases of poor response to antimicrobial therapy. Therefore, early diagnosis of rib osteomyelitis through careful physical examination may reduce the chances of requiring surgical intervention.
A Case Report: An Elderly Male Patient With Takayasu Arteritis After Coronary Artery Bypass Grafting
Authors: Huaitao Yu, Wenzhao Liu, Yuan Zhang, Xuefang Yan, Na Li, Yun Ti, Peili Bu
Journal: Front Cardiovasc Med (2021)
Keywords: takayasu's arteritis, takayasu's arteritis with coronary artery involvement, acute myocardial infarction, case report, coronary artery bypass grafting
MeSH terms: Case Reports

Background: Takayasu arteritis is a rare chronic granulomatous inflammation involving the aorta and its main branches. In this report, we describe an extremely rare elderly male patient with Takayasu arteritis (TA) after coronary artery bypass grafting (CABG). Case Summary: A 61-year-old male patient with persistent precordial pain underwent angiography. Vascular murmurs could be heard in carotid artery and bilateral renal artery by auscultation. Laboratory parameters showed high Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP). CT coronary angiography showed multiple stenoses of aorta and its main branches, such as carotid and renal artery involvement. Coronary angiography showed that the coronary artery had multiple branch stenoses, the left anterior descending artery (LAD) had severe stenosis, the distal end of which was reversed to the right coronary artery (RCA), and the RCA was completely occluded. Because of the high level of markers of inflammatory activity, the patient began to take glucocorticoid. Although the patient still had multibranch stenosis of coronary artery, considering the previous CABG operation history, surgery, and interventional therapy of the patient were not feasible, the patient was given conservative drug for further treatment. After treatment, the inflammatory index was significantly descended, and N terminal-pro Brain natriuretic peptide (NT-pro BNP) was decreased. Discussion: A rare case of an elderly male patient with Takayasu arteritis after coronary artery bypass grafting was reported. In addition to hypertension, hyperlipidemia, and other risk factors, coronary artery involvement caused by TA may be a major cause of aggravation of symptoms in patients with acute myocardial infarction (AMI), especially after CABG.
Diffuse Alveolar Hemorrhage Caused by Warfarin after Rifampicin Discontinuation
Authors: Takashige Kiyota, Seiji Shiota, Ryosuke Hamanaka, Daisuke Tsutsumi, Takeshi Takakura, Eishi Miyazaki
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

An 83-year-old man under warfarin therapy presented for assessment of prolonged prothrombin time and cough. High-resolution computed tomography findings of the chest showed diffuse alveolar hemorrhage. His international normalized ratio (INR) was 11.89. He had been treated with rifampicin for a persistent infection, but this had been discontinued about two months before admission. Rifampicin suppresses the anticoagulant activity of warfarin, which can lead to a need for increased doses of warfarin to achieve and maintain a therapeutic INR. More frequent INR monitoring is needed even after discontinuing rifampicin.