OpenMed/multicare-articles huggingface dataset:
Adult-type rhabdomyoma of the thyroid: A case report
Authors: ZhenPeng Jiang, MengNi Zhang, JiaYan Huang, Ling Song, Qiang Lu
Journal: Front Oncol (2023)
Keywords: rhabdomyoma, adult-type, case, thyroid, ultrasound
MeSH terms: Case Reports

Adult-type rhabdomyoma (AR) is a benign myogenous neoplasm. It is rarely located in the thyroid. We present a case of a 61-year-old man, presenting with complaints of a mass found in his left neck for three years. Ultrasonography and computed tomography showed a mass in the left lobe of the thyroid. Subsequently, a fine-needle aspiration biopsy showed that the lesion was suspected to be an oncocytic neoplasm, and the patient underwent surgery. Finally, the lesion was confirmed to be an AR of the thyroid by postoperative pathological diagnosis. In conclusion, AR that occurs in the thyroid is remarkably rare. No case reports to date have described in detail the imaging findings of AR in the thyroid. This study demonstrates the imaging characteristics of a patient with AR of the thyroid, in order to provide more extensive insights to consider the differential diagnosis of thyroid lesions.
Subtotal Resection of an Anaplastic Ganglioglioma in Pregnancy
Authors: Matthew J Bicocca, Andrea R Gilbert, Saeed S Sadrameli, Michael L Pirics
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Background:
Anaplastic ganglioglioma is a rare malignant brain tumor associated with high morbidity and mortality. The diagnosis of a central nervous system malignancy in the early 3rd trimester presents management challenges to both neurosurgeons and obstetricians.
Case:
A 33-year-old woman, gravida 2 para 1, presented at 28 6/7 weeks with four months of worsening headaches, nausea, vomiting, and mental status changes due to a 7.5 cm anaplastic ganglioglioma. Maternal deterioration necessitated subtotal tumor debulking allowing prolongation of the gestation to 34 6/7 weeks. After delivery, the patient underwent further resection, followed by chemotherapy and radiation. Both mother and infant are well.
Discussion:
This case underscores the importance of timely diagnostic imaging in pregnant women and demonstrates subtotal tumor debulking as a viable means of prolonging gestation.
Early Diagnosis of Nonconvulsive Status Epilepticus Recurrence with Raw EEG of a Bispectral Index Monitor
Authors: Aristide Ntahe
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Background:
Seizures are frequent in ICU and their diagnosis is challenging, often delayed or missed. Their diagnosis requires a conventional EEG recording. When cEEG is not available, there is no consensus on how patients should be monitored when there is high risk of seizure. This case illustrates how a bispectral index monitor allowed an early diagnosis of an NCSE recurrence.
Case presentation:
A NCSE was diagnosed at the admission. cEEG was not available and then a bispectral index (BIS) monitor was placed and processed parameters were monitored as usual. During the first and second day, both conventional and BIS's EEG showed patterns of burst suppression and the BIS value varied between 25 and 35 while the suppression ratio (SR) varied between 20 and 35. On the third day, while hypnotic drugs were withdrawn progressively, raw EEG of the BIS monitor showed spikes, spikes waves, and polyspikes without significant variation of BIS and SR values. Even if processed parameters stayed between their usual ranges, the typical aspect of the real time EEG raised concern for NCSE recurrence. An unplanned conventional EEG recording was urgently requested, and the diagnosis was confirmed and treated.
Conclusion:
Primitive and secondary brain injuries can lead to seizures which are often purely electrical. Even though BIS monitors cannot substitute the conventional EEG, processed parameters and raw EEG should be always analysed jointly. In the present case, seizure was suspected only on the aspect of real time EEG which showed spikes, spikes waves, and polyspikes.
An unusual case of Lemierre syndrome - One pathogen or two?
Authors: Michael O'Shaughnessy, Dariel Irizarry, Diana Finkel
Journal: IDCases (2021)
Keywords: fusobacterium necrophorum, group c streptococcus, internal jugular vein thrombophlebitis, lemierre syndrome
MeSH terms: Case Reports

Lemierre syndrome, or septic thrombophlebitis of the internal jugular vein, is a rare disease that affects healthy young adults following an episode of pharyngitis or other upper respiratory disease. It most commonly involves the anaerobe Fusobacterium necrophorum, a component of normal oral flora. In this report, we present an unusual case of polymicrobial Lemierre syndrome involving both F. necrophorum and Group C streptococcus following an episode of pharyngitis and streptococcal toxic shock syndrome. Providers should consider the possibility of polymicrobial infection when there are imaging findings suggestive of Lemierre Syndrome and adjust antibiotic regimens accordingly.
Caseous Intracardiac Calcification: A Diagnostic Enigma
Authors: Simon G Findlay, Nicholas M Child, Douglas F Muir
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Intramyocardial calcification is a rare phenomenon often only discovered on postmortem. We describe the case of a healthy 69-year-old lady diagnosed with idiopathic caseous intracardiac calcification extending from the mitral valve annulus. We present high-quality images and propose an investigatory template for future cases.
Case Report: Group B Streptococcus meningitis in an adolescent
Authors: Roselle Vittorino, Joyce Hui-Yuen, Adam J Ratner, Amy Starr, Teresa McCann
Journal: F1000Res (2014)

Streptococcus agalactiae (group B Streptococcus, GBS) usually colonizes the gastrointestinal and lower genital tracts of asymptomatic hosts, yet the incidence of invasive disease is on the rise . We describe a case of an 18 year old woman, recently diagnosed with lupus, who reported a spontaneous abortion six weeks prior to her hospitalization. She presented with fever, altered mental status, and meningeal signs, paired with a positive blood culture for GBS. Magnetic resonance imaging of her brain demonstrated an extra-axial fluid collection, and she was diagnosed with meningitis. She received prolonged intravenous antibiotic therapy and aggressive treatment for lupus, leading to clinical recovery. This case illustrates the importance of recognizing GBS as a potential pathogen in all patients presenting with CNS infection .
Comorbid Normal Pressure Hydrocephalus with Parkinsonism: A Clinical Challenge and Call for Awareness
Authors: A Cucca, M C Biagioni, K Sharma, J Golomb, R M Gilbert, A Di Rocco, J E Fleisher
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Idiopathic normal pressure hydrocephalus (iNPH) is the most common cause of hydrocephalus in adults. The diagnosis may be challenging, requiring collaborative efforts between different specialists. According to the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders, iNPH should be considered in the differential of any unexplained gait failure with insidious onset. Recognizing iNPH can be even more difficult in the presence of comorbid neurologic disorders. Among these, idiopathic Parkinson's disease (PD) is one of the major neurologic causes of gait dysfunction in the elderly. Both conditions have their peak prevalence between the 6th and the 7th decade. Importantly, postural instability and gait dysfunction are core clinical features in both iNPH and PD. Therefore, diagnosing iNPH where diagnostic criteria of PD have been met represents an additional clinical challenge. Here, we report a patient with parkinsonism initially consistent with PD who subsequently displayed rapidly progressive postural instability and gait dysfunction leading to the diagnosis of concomitant iNPH. In the following sections, we will review the clinical features of iNPH, as well as the overlapping and discriminating features when degenerative parkinsonism is in the differential diagnosis. Understanding and recognizing the potential for concomitant disease are critical when treating both conditions.
Excellent response to erlotinib in breast carcinoma with rare EGFR mutation-a case report
Authors: Gunjesh Kumar Singh, Jyoti Bajpai, Shalaka Joshi, Kumar Prabhash, Anuradha Choughule, Asawari Patil, Sudeep Gupta, Rajendra Achyut Badwe
Journal: Ecancermedicalscience (2020)
Keywords: egfr mutation, metastasis, triple negative breast carcinoma
MeSH terms: Case Reports

Triple negative breast carcinoma is a problematic subtype with poor outcomes. Many clinical trials are underway to find possible target to increase treatment options. Epidermal growth factor receptor (EGFR) has emerged as one such molecule which is over expressed in some of these patients and can be targeted by tyrosine kinase inhibitors. We describe a diagnostically challenging case of metastatic breast carcinoma, with extensive lung disease and poor Eastern Cooperative Oncology Group (ECOG) performance status, which expressed an uncommon EGFR mutation (Exon 21L861Q) and which benefitted from erlotinib following failure of all primary treatment modalities. The case uncovers the presence of these unusual mutations in breast carcinoma and highlights the importance of performing molecular analysis and the appropriate targeted therapy. This approach can be an important problem-solving tool, especially in cases where the patient is not fit for the other standard treatment options.
Large Choroidal Melanocytoma Simulating Choroidal Melanoma: A Difficult Differential Diagnosis and an Inevitable Enucleation
Authors: Taoufik Abdellaoui, Soukaina Belfaiza, Yassine Malek, Mohamed-Amine Essaoudi, Fouad Elasri, Karim Reda, Abdelbarre Oubaaz
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Purpose:
To describe a case of choroidal melanocytoma mimicking a melanoma.
Methods:
Retrospective case report. Patient. A 48-year-old Moroccan woman presented with progressive, painless decreased vision in her left eye for 2 months.
Results:
Her visual acuity was light perception in the left eye and 20/20 in the right one. Fundus examination and fluorescein angiography of the left eye showed a total retinal detachment with a large superior brownish mass. The clinical examination, B-scan ultrasonography, and magnetic resonance imaging all suggested a malignant melanoma. Consequently, the eye was enucleated. The histopathology later revealed a benign melanocytoma of the choroid. Discussion. Melanocytoma is a rare benign pigmented tumor. It is classically described as a tumor of the optic nerve head, but there are some exceptional case reports of uveal tract locations (iris, ciliary body, and choroid). In such cases, it can be difficult to clinically differentiate a melanocytoma from a malignant melanoma.
Rapidly progressive acute necrotizing encephalopathy associated with influenza A in an elderly adult
Authors: Mami Tsubota, Akihiro Kato, Takahiro Goshima, Kazunori Imai, Yota Yamagishi, Asako Matsushima, Hiroshi Sasano, Tomonori Hattori
Journal: Acute Med Surg (2020)
Keywords: acute necrotizing encephalopathy, heatstroke, influenza a, rapidly progressive course
MeSH terms: Case Reports

Background:
Among the influenza-associated encephalopathies, acute necrotizing encephalopathy (ANE) has a particularly poor prognosis. While it usually progresses within 48 h, we encountered a rapidly evolving case with the patient falling into coma from lucidity within 10 min.
Case presentation:
A 71-year-old man was found unconscious after taking a 10-min bath and brought to the emergency room. The head computed tomography (HCT) was normal, and he was diagnosed with heatstroke as a complication of influenza A. Despite effective therapy to correct his temperature, his consciousness did not improve, and within 24 h he progressed to multiple organ injury. Repeat HCT and subsequent magnetic resonance imaging revealed irreparably progressed ANE.
Conclusion:
To effectively treat ANE, early recognition and diagnosis are critical. Our case suggests that ANE should be considered and added to the differential diagnosis for adult patients with rapid cognitive deterioration.
A Case of Von Hippel-Lindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl
Authors: Rym Belaid, Ibtissem Oueslati, Melika Chihaoui, Meriem Yazidi, Wafa Grira, Fatma Chaker
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Von Hippel-Lindau disease is an autosomal dominant inherited syndrome predisposing to a variety of highly vascularised tumors in different organs. Although bilateral pheochromocytoma was reported in patients with von Hippel-Lindau disease, the coexistence of primary hyperparathyroidism is not a common condition. We report an observation of a primary hyperparathyroidism secondary to an ectopic secretion of intact parathyroid hormone in a 17-year-old girl with von Hippel-Lindau disease and bilateral pheochromocytoma. She presented with a newly diagnosed diabetes mellitus and a severe arterial hypertension. Blood tests disclosed hypercalcemia with increased intact PTH level. Cervical ultrasound and sestamibi scintigraphy were normal. Twenty-four-hour urinary normetanephrine level was highly elevated pointing to a catecholamine-secreting tumor. The abdominal computed tomography showed bilateral adrenal masses. MIBG scintigraphy exhibited a high accumulation of the tracer in both adrenal tumors. Genetic testing revealed a mutation of the VHL gene. The patient underwent a bilateral adrenalectomy. The postoperative outcome was marked by normalization of blood pressure, blood glucose, calcium, and PTH levels. In our case, the elevation of intact PTH and its spontaneous normalization after surgical treatment of pheochromocytomas confirms its ectopic secretion.
Case study of IMU loads and self-reported fatigue monitoring of water polo goalkeepers preparing for the Olympic games
Authors: Félix Croteau, Sylvain Gaudet, Jeremy Briand, Julien Clément
Journal: Front Sports Act Living (2023)
Keywords: aquatic, fatigue, inertial measurement unit, monitoring, water polo players

Introduction:
Measurement of training in water polo goalkeepers has focused first on psycho-physiological variables, but also on external volume estimated with wearable sensors. However, there are limited studies exploring training monitoring in water polo goalkeepers longitudinally.
Methods:
Three female senior national team goalkeepers participated in this study from May to August 2021. Internal loads were defined using session rating of perceived exertion (sRPE). Tri-axial accelerations and angular velocities were measured with an inertial measurement unit (IMU) placed on the lower back to measure external loads. Relationships between self-reported and IMU-derived metrics were explored using Spearman correlations. Two-way ANOVAs were used to assess differences between session types and between athletes.
Results:
In total, 247 sessions were collected (159 practices, 67 matches and 21 game warm up), with 155 sessions having complete data. IMU metrics, such as number of kicks, number of jumps or player-load showed high correlation with each other (ρ = 0.80-0.88). There was also a moderate correlation (ρ = 0.47, 95% CI = 0.33-0.58) between sRPE and player-load measured with the IMU. ANOVA tests showed that there were significant differences between athletes for sRPE (p < 0.01) but not for player load (p = 0.47). There were no interactions between athletes and training types, except for index score (p < 0.01).
Conclusions:
This study shows that monitoring of training loads can be performed successfully in water polo goalkeepers using a combination of self-reported and IMU measures. Self-reported outcomes can be expected to vary significantly across athletes within the same session, while IMU metrics vary across training situations. Finally, coaches should be mindful of missing data, as they can skew the interpretation of training loads.
Is It Necessary to Specifically Define the Cause of Surgically Treated Biliary Tract Infections? A Rare Case of Raoultella planticola Cholecystitis and Literature Review
Authors: Suat Can Ulukent, İnanc Samil Sarici, Nuri Alper Sahbaz, Yigit Mehmet Ozgun, Ozlem Akca, Kamuran Sanlı
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Raoultella planticola is an aquatic and soil organism that does not notoriously cause invasive infections in humans. Infections in the literature are limited only in case reports. We present a very rare case of R. planticola cholecystitis. A 71-year-old female patient with abdominal pain was diagnosed with acute cholecystitis. Patient received intravenous antibiotic treatment, but the treatment failed and the patient underwent an open cholecystectomy. The final pathological result was gangrenous cholecystitis complicated with R. planticola. Eventually, the patient recovered with appropriate antimicrobial therapy. Patients with acute cholecystitis are usually treated without any microbiological sampling and antibiotic treatment is started empirically. To date, there have only been 5 reported biliary system related R. planticola infections in humans. We believe that Raoultella species might be a more frequent agent than usually thought, especially in resistant cholecystitis cases. Resistant strains should be considered as a possible causative organism when the patient's condition worsened despite proper antimicrobial therapy. It should be considered safe to send microbiological samples for culture and specifically define the causative microorganisms even in the setting of a cholecystectomized patient.
Nosocomial oral myiasis in ICU patients: occurrence of three sequential cases
Authors: Hamed Ebrahimzadeh Leylabadlo, Hossein Samadi Kafil, Mohammad Aghazadeh, Teimour Hazratian
Journal: GMS Hyg Infect Control (2015)
Keywords: flies, hospital, nosocomial myiasis, oral
MeSH terms: Case Reports

Myiasis is the infestation of living vertebrates or humans tissues by dipterous larvae. The oral cavity is rarely affected by this infestation and the circumstances which can lead to oral myiasis include persistent mouth opening together with poor hygiene. Such infestations have been reported mainly in developing countries such as in Asia. Although rare, nosocomial myiasis must be noted carefully, especially in case of hospitalized patients. This report describes three cases of nosocomial oral myiasis in hospitalized patients in ICU (intensive care unit) in Tabriz, North West of Iran.
PIK3CA and p53 Mutations by Next Generation Sequencing in Lymphoepithelioma-Like Carcinoma of the Endometrium
Authors: Lucie Bienfait, Nicky D'Haene, Xavier Catteau, Jean-Christophe Noël
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Lymphoepithelioma-like carcinoma of the endometrium is a very rare variant of endometrial carcinoma characterized by syncytial nests of pleomorphic epithelial cells and heavy infiltration of the stroma by lymphocytes (in particular CD8 cytotoxic T-lymphocytes) and plasma cells. Until now, only five cases have been characterized in this location. This report describes the clinicopathological and the molecular features of this unusual tumor. In particular, using the next generation sequencing (NGS) technique, we have demonstrated that this tumor could be associated with PIK3CA and p53 gene mutations. These data have not been reported to date and suggest that lymphoepithelioma-like carcinoma of the endometrium shares common molecular features with high grade endometrioid and serous-like endometrial carcinoma which are associated with poor outcome. Nevertheless, in endometrial lymphoepithelioma-like carcinoma, the alterations on cell cycle, apoptosis, and/or senescence secondary to p53 mutations could potentially be counterbalanced by the antitumoral response induced by CD8 cytotoxic T-lymphocytes numerous in these tumors.
Real World Evidence of Wearable Smartbelt for Mitigation of Fall Impact in Older Adult Care
Authors: Rebecca J Tarbert, Wamis Singhatat
Journal: IEEE J Transl Eng Health Med (2023)
Keywords: falls, fall injury, hip injury, intervention, older adults, wearable technology
MeSH terms: Accidental Falls / prevention & control, Wearable Electronic Devices, Research Support, Non-U.S. Gov't, Aged, Humans, Incidence, Long-Term Care, Nursing Homes

Structured Abstract Falls with major injuries are a devastating occurrence for an older adult with outcomes inclusive of debility, loss of independence and increased mortality. The incidence of falls with major injuries has increased with the growth of the older adult population, and has further risen as a result of reduced physical mobility in recent years due to the Coronavirus pandemic. The standard of care in the effort to reduce major injuries from falling is provided by the CDC through an evidence-based fall risk screening, assessment and intervention initiative (STEADI: Stopping Elderly Accidents and Death Initiative) and is embedded into primary care models throughout residential and institutional settings nationwide. Though the dissemination of this practice has been successfully implemented, recent studies have shown that major injuries from falls have not been reduced. Emerging technology adapted from other industries offers adjunctive intervention in the older adult population at risk of falls and major fall injuries. Technology in the form of a wearable smartbelt that offers automatic airbag deployment to reduce impact forces to the hip region in serious hip-impacting fall scenarios was assessed in a long-term care facility. Device performance was examined in a real-world case series of residents who were identified as being at high-risk of major fall injuries within a long-term care setting. In a timeframe of almost 2 years, 35 residents wore the smartbelt, and 6 falls with airbag deployment occurred with a concomitant reduction in the overall falls with major injury rate.