OpenMed/multicare-articles huggingface dataset:
Unresectable leiomyosarcoma of the inferior vena cava with right atrium tumor thrombus: when to deem this tumor inoperable? A case report and literature review
Authors: Luis D Castellanos, Marina M Tabbara, Alan S Livingstone, Tomas A Salerno, Javier Gonzalez, Gaetano Ciancio
Journal: Front Oncol (2024)
Keywords: cardiac tumor, case report, inferior vena cava, leiomyosarcoma, primary retroperitoneal sarcoma
MeSH terms: Case Reports

Leiomyosarcomas (LMS) of the inferior vena cava (IVC) are a rare form of retroperitoneal malignancy, and their venous extension to the right atrium is an even rarer event. These tumors pose a unique surgical challenge and often require a multidisciplinary team-based approach for their surgical treatment. We present a case of a 68-year-old man with primary LMS of the IVC with a tumor thrombus extending into the right atrium that was initially deemed inoperable. After extensive neoadjuvant chemo-radiation with minimal tumor effect, the patient underwent en bloc surgical resection of the tumor along with removal of the infrarenal IVC and right kidney and adrenal without the need for cardiopulmonary bypass. This case demonstrates the successful management of a primary LMS of the IVC with right atrial extension using a multimodal approach of neoadjuvant chemo-radiation and en bloc surgical resection without cardiopulmonary bypass. This strategy may offer a curative option for selected patients with these rare and aggressive tumors, improving their survival and quality of life.
Case report: Management of pregnancy-associated immune thrombocytopenia in a French bulldog with dystocia
Authors: Rose Feldman, Kiko Bracker, Megan Whelan
Journal: Front Vet Sci (2024)
Keywords: itp (idiopathic thrombocytopenic purpura), brachycephalic, canine, immune-mediated, immunology, thrombocytopenia, whelping
MeSH terms: Case Reports

Introduction:
The objective of this case report is to describe diagnosis and management of life-threatening immune thrombocytopenia (ITP) secondary to pregnancy in a dog with concurrent dystocia.
Case summary:
A 1-year 11-month old female intact French bulldog was referred for management of severe thrombocytopenia and spontaneous hemorrhage during whelping. The thrombocytopenia was progressive from approximately 32 days of gestation. In the absence of an identifiable cause for the thrombocytopenia, the patient was treated for ITP with immunosuppressive therapies and blood and plasma transfusions. The patient was also supported through dystocia until the platelet count normalized so a Caesarean section and ovariohysterectomy (OVH) could be performed.
Discussion:
This is the first report documenting ITP in a whelping canine. Pregnancy is a known trigger and can affect the clinical course of autoimmune diseases in women, including ITP. It is suspected that this patient's pregnancy triggered ITP, paralleling what occurs in women.
Penile Mondor's disease after open hernia repair surgery: A case report
Authors: Riccardo Avantifiori, Giuseppe Cavallaro, Andrea Polistena, Luca Giordano, Giuliano D'Onghia
Journal: Qatar Med J (2024)
Keywords: lichtenstein procedure, penile mondor’s disease, hernia, sclerosis, thrombophlebitis

Background:
Penile Mondor's disease (PMD) is a rare syndrome characterized by sclerosis after superficial thrombophlebitis of the superficial penile veins. The most usual appearance of PMD is a tender, palpable, painful, and sometimes visible cord on the dorsal surface of the penis. Its pathogenesis is still unclear, and a standardized treatment has not been established.
Case report:
A 54-year-old male patient presented with a left-sided indirect reducible inguinal hernia. The patient underwent Lichtenstein's procedure for inguinal hernia repair. On the tenth postoperative day, he returned with PMD confirmed by Doppler ultrasonography examination. Treatment with 4000 UI low molecular weight heparin (LMWH) daily for three weeks resolved the symptoms, but mild venous ectasia just to the proximal part of the penis remained.
Discussion:
The exact cause of PMD is not well understood, but various studies have identified certain factors associated with an increased risk of the condition. Out of various potential factors that could trigger PMD, the repair of an inguinal hernia has been reported only once. Treatment may involve pain management, anti-inflammatory medications, anticoagulants, and, in some cases, surgery.
Conclusion:
PMD after open hernia repair surgery is a very rare benign condition. Correct diagnosis and prompt treatment allowed symptom resolution. Residual venous ectasia has no clinical significance other than a cosmetic appearance.
Internet usage, frequency and intensity in old age during the COVID-19 pandemic-a case study for Switzerland
Authors: Ronny König, Alexander Seifert
Journal: Front Sociol (2023)
Keywords: covid-19, ict, share, switzerland, healthy aging, internet usage, pandemic

Introduction:
This study examines the digital divide among older adults in Switzerland within the rapidly evolving digital environment. It investigates changes in internet usage among this population, focusing on the proportion of users, frequency, and the intensity of their internet usage during the COVID-19 pandemic.
Methods:
Drawing on Swiss data from the Survey of Health, Aging, and Retirement (SHARE), conducted in 2021, the study analyzes a sample of 1,205 older adults.
Results:
The findings indicate a growing proportion of internet users over time. It also highlights that gender differences persist but are decreasing. Notably, around 9% of individuals in this study had never used the internet, while recent users exhibited high activity levels, spending an average of approximately two and a half hours online daily. The study identified age, education, employment, living arrangements, and attitudes toward technology as influential factors shaping internet usage among older adults. Importantly, the COVID-19 pandemic did not have a significant impact on internet adoption among this demographic.
Discussion:
These findings shed light on the complex dynamics that shape internet usage among older adults and underscore the need to promote digital inclusion and engagement within this population.
RELN gene-related drug-resistant epilepsy with periventricular nodular heterotopia treated with radiofrequency thermocoagulation: a case report
Authors: Zijian Li, Fuli Wang, Zhidong He, Qi Guo, Jinnan Zhang, Songyan Liu
Journal: Front Neurol (2024)
Keywords: reln gene, drug-resistant epilepsy, periventricular nodular heterotopia, radiofrequency thermocoagulation, stereoelectroencephalography
MeSH terms: Case Reports

An increasing number of gene mutations associated with epilepsy have been identified, some linked to gray matter heterotopia-a common cause of drug-resistant epilepsy. Current research suggests that gene mutation-associated epilepsy should not be considered a contraindication for surgery in epilepsy patients. At present, stereoelectroencephalography-guided radiofrequency thermocoagulation is an important method to treat periventricular nodular heterotopia-associated drug-resistant epilepsy. We present a case of drug-resistant epilepsy, accompanied by periventricular nodular heterotopia and a heterozygous mutation of the RELN gene, successfully treated with radiofrequency thermocoagulation, resulting in a favorable outcome.
Case Report: Robotic pylorus-preserving pancreatoduodenectomy for periampullary rhabdomyosarcoma in a 3-year-old patient
Authors: Zijian Liang, Menglong Lan, Xiaogang Xu, Fei Liu, Boyuan Tao, Xinxing Wang, Jixiao Zeng
Journal: Front Surg (2024)
Keywords: case report, child, periampullary neoplasm, rhabdomyosarcoma, robotic pancreatoduodenectomy
MeSH terms: Case Reports

Periampullary neoplasm is rare in pediatric patients and has constituted a strict indication for pancreatoduodenectomy (PD), which is a procedure sporadically reported in the literature among children. Robotic PD has been routinely performed for periampullary neoplasm in periampullary neoplasm, but only a few cases in pediatric patients have been reported. Here, we report the case of a 3-year-old patient with periampullary rhabdomyosarcoma treated with robotic pylorus-preserving PD and share our experience with this procedure in pediatric patients. A 3-year-old patient presented with obstructive jaundice and a mass in the pancreatic head revealed by imaging. A laparoscopic biopsy was performed. Jaundice progressed with abdominal pain and elevated alpha-amylase leading to urgent robotic exploration in which a periampullary neoplasm was revealed and pathologically diagnosed as rhabdomyosarcoma by frozen section examination. After pylorus-preserving PD, we performed a conventional jejunal loop following a child reconstruction, including an end-to-end pancreaticojejunostomy, followed by end-to-side hepaticojejunostomy and duodenojejunostomy. Delayed gastric emptying (DGE) presented with increasing drain from the nasogastric tube (NGT) a week after the surgery and improved spontaneously within 10 days. In a 13-month follow-up until the present, our case patient recovered well without potentially fatal complications, such as pancreatic fistula. Robotic PD in pediatric patients was safe and effective without intra- or postoperative complications.
Case Report: Atypical acute compartment syndrome of the forearm in a child following minor trauma with consecutive osteomyelitis
Authors: J Everaert, A Delafontaine, J Juanos Cabanas, G Leclercq, H Jennart, B Baillon
Journal: Front Surg (2024)
Keywords: acute compartment syndrome, infection, osteomyelitis, pediatric, trauma
MeSH terms: Case Reports

Introduction:
Forearm compartment syndrome (CS) in children is above all a clinical diagnosis whose main cause is traumatic. However, rarer causes such as infection can alter its clinical presentation.
Clinical case:
An 8-year-old boy has been seen in the emergency department complaining of severe forearm pain under a splint in a mild traumatic context. The previous radiological imaging examination three days before had not revealed any fractures. On admission, he presented with major signs of skin inflammation, loss of mobility, paresthesia and a significant biological inflammatory syndrome. The acute CS diagnosis has been made and was treated, but its atypical presentation raised a series of etiological hypotheses, in particular infectious, even if it remains rare. Complementary imaging examinations confirmed the presence of osteomyelitis of the distal radius as well as an occult Salter-Harris II fracture.
Discussion:
Beyond the classic "five P's of CS" -pain, paresthesia, paralysis, pallor and pulselessness-, CS's clinical presentations are multiple, especially in pediatric patients. In children, severe pain and increasing analgesic requirement must be indicators of a CS. We hypothesize that this patient sustained a nondisplaced Salter-Harris II fracture with a hematoma colonized by hematogenous osteomyelitis explaining its initial clinical presentation.
Conclusion:
Hematogenous osteomyelitis complicated by CS is rare and may be accompanied by a traumatic history. It's atypical presentation in pediatric patients requires vigilance and prompt diagnosis given the disastrous and irreversible complications.
Case report: Ensitrelvir for treatment of persistent COVID-19 in lymphoma patients: a report of two cases
Authors: Chiho Furuya, Hajime Yasuda, Makoto Hiki, Shuichi Shirane, Tomohito Yamana, Ayana Uchimura, Tadaaki Inano, Tomoiku Takaku, Yasuharu Hamano, Miki Ando
Journal: Front Immunol (2024)
Keywords: bruton kinase (btk) inhibitors, covid-19 pcr cycle threshold (ct), long covid, anti-cd20 therapy, hematological malignancies, immunocompromised, protracted sars-cov-2, rituximab
MeSH terms: COVID-19 / complications, Hematologic Neoplasms, Indazoles, Lymphoma, Large B-Cell, Diffuse, Triazines, Triazoles, Case Reports, Adult, Humans, Male, SARS-CoV-2, ensitrelvir, Indazoles, Triazines, Triazoles

Persistent COVID-19 is a well recognized issue of concern in patients with hematological malignancies. Such patients are not only at risk of mortality due to the infection itself, but are also at risk of suboptimal malignancy-related outcomes because of delays and terminations of chemotherapy. We report two lymphoma patients with heavily pretreated persistent COVID-19 in which ensitrelvir brought about radical changes in the clinical course leading to rapid remissions. Patient 1 was on ibrutinib treatment for mantle cell lymphoma when he developed COVID-19 pneumonia which was severe and ongoing for 2 months despite therapy with molnupiravir, multiple courses of remdesivir, one course of sotrovimab, tocilizumab, and steroids. Patient 2 was administered R-CHOP therapy for diffuse large B-cell lymphoma when he developed COVID-19 which was ongoing for a month despite treatment with multiple courses of remdesivir and one course of sotrovimab. A 5-day administration of ensitrelvir promptly resolved the persistent COVID-19 accommodated by negative conversions of RT-qPCR tests in both patients within days. Ensitrelvir is a novel COVID-19 therapeutic that accelerates viral clearance through inhibition of the main protease of SARS-CoV-2, 3-chymotrypsin-like protease, which is vital for viral replication. Ensitrelvir is a promising treatment approach for immunocompromised lymphoma patients suffering from persisting and severe COVID-19.
Diagnostic Approach and Treatment Options for Pediatric Cases of Grisel's Syndrome Post Otolaryngology Procedure: A Systematic Review
Authors: Omair H Al-Hussain, Ghadah Al-Hussain
Journal: Cureus (2024)
Keywords: complication, diagnosis, grisel syndrome, management, pediatric
MeSH terms: Review

Grisel's syndrome is an uncommon cervical spine condition marked by non-traumatic rotational subluxation of the atlantoaxial joint. This systematic review aims to collect potential evidence from relevant studies that reported symptoms, diagnostic methods, and management options among pediatric cases of Grisel's syndrome post otolaryngology procedures, which can aid and guide the diagnosis and management in clinical practice. We conducted both electronic and manual search strategies within the potential databases and included case reports, case series, and articles; however, review papers and correspondence papers were excluded. The post-otolaryngology procedures included adenoidectomy, tonsillectomy, tympanoplasty, cochlear implantation, double opposing Z plasty and pharyngeal flap, and adenotonsillectomy. In this systematic review, we identified and analyzed 20 studies encompassing a total of 24 pediatric patients with Grisel's syndrome following otolaryngology procedures. The patient demographics revealed a fairly even distribution between females (45.83%) and males (50.00%), with ages ranging from 2.5 to 12 years. The most common otolaryngology procedures associated with Grisel's syndrome were adenoidectomy (29.17%) and adenotonsillectomy (33.33%). Clinical symptoms included neck pain (75.00%), torticollis (50.00%), and limited neck mobility (20.83%), while diagnostic confirmation primarily relied on CT scans (50.00%). Treatment strategies varied, with conservative measures being the most frequent choice, followed by surgical interventions in four cases (16.67%). Complications were reported in 20.83% of cases. Due to the rarity of this condition, our findings are limited to case reports only, which may limit the generalizability of results. Grisel syndrome can be effectively managed through conservative treatment, including antibiotics and anti-inflammatory drugs if diagnosed timely. Early diagnosis and prompt management are essential to avoid neurological and fatal complications. This analysis would contribute to improving clinical knowledge and treatment strategies while providing additional insights into this rare condition.
Case Report: Integrated echocardiographic assessment guided Liwen procedure for treating obstructive hypertrophic cardiomyopathy with ventricular aneurysm
Authors: Rui Zhang, Fan Zhao, Jing Wang, Yahong Qin, Tingting Wang, Ai-Ai Chu
Journal: Front Cardiovasc Med (2023)
Keywords: contrast-enhanced echocardiography, hypertrophic cardiomyopathy, hypertrophic obstructive cardiomyopathy, speckle tracking echocardiography, transthoracic echocardiography
MeSH terms: Case Reports

Hypertrophic cardiomyopathy (HCM) is a genetic myocardial disease, with an estimated incidence of 0.2%-6%, and is the main cause of sudden cardiac death (SCD) in young athletes. Left ventricular apical aneurysm (LVAA) is a rare subtype of HCM, accounting for about 5% of HCM patients, and has a higher incidence of cardiovascular adverse events. In cases of hypertrophic obstructive cardiomyopathy with LVAA (HOCM-LVAA) that do not respond adequately to optimized medical therapy, the echocardiography-guided percutaneous intra-myocardial septal radiofrequency ablation (PIMSRA, Liwen procedure) emerges as a promising and effective novel therapeutic approach. In this case report, we present for the first time a comprehensive application of echocardiographic techniques, including TTE, 2-D STE, and contrast enhancement, in the diagnosis, treatment, surgical guidance, and assessment of therapeutic outcomes in a case of HOCM-LVAA.
Periventricular cyst as a complication of ventriculoperitoneal shunting in the context of intracranial haemorrhage: a case report and review of the literature
Authors: Leon E Smith, Brian D Zeman
Journal: J Surg Case Rep (2024)
Keywords: hydrocephalus, pericatheter cyst, shunt revision, ventriculoperitoneal shunt
MeSH terms: Case Reports

Spontaneous intraventricular haemorrhage with hydrocephalus frequently requires neurosurgical intervention, including ventriculoperitoneal shunting. We describe a periventricular cyst following the placement of a ventriculoperitoneal shunt in a 67-year-old female patient. The patient was admitted for rehabilitation after a spontaneous left basal ganglia and diffuse intraventricular haemorrhage with hydrocephalus. Initial management included an extraventricular drain, followed by a ventriculoperitoneal shunt. On Day 5 of rehabilitation, the patient was urgently reviewed for reduced level of consciousness. A cerebrospinal fluid cyst was identified around the shunt catheter, with subacute haemorrhage within the cyst. The patient underwent a successful shunt revision, with rapid improvement in consciousness and resolution of the cyst. This case highlights the importance of pericatheter cyst as a differential diagnosis in patients with altered neurological status following ventriculoperitoneal shunting. Early detection and surgical revision can lead to rapid resolution of symptoms and a favourable prognosis.
Resection of ruptured aneurysm associated with bilateral anomalous posterior inferior cerebellar anastomotic arteries: case report and review of literature
Authors: Qingdong Han, Zongqi Wang, Tong Liu, Yabo Huang
Journal: Front Neurol (2023)
Keywords: anatomical variants, aneurysm, posterior inferior cerebellar artery anastomosis, subarachnoid hemorrhage, surgical treatment
MeSH terms: Case Reports

Introduction:
Aneurysms on the posterior inferior cerebellar artery (PICA) may not be the major part of intracranial aneurysm. Especially, an aneurysm located on the bilateral posterior inferior cerebellar anastomotic artery has abnormal anatomical characteristics in the vessel wall and then causes stroke including subarachnoid hemorrhage. This case report explores the direct resection of a ruptured aneurysm associated with the bilateral anomalous anastomotic artery of PICA.
Methods:
The case report discusses a 53-year-old woman who suffered from sudden severe headache and vomiting for more than 3 h admitted to our hospital. Emergency computed tomography (CT) revealed subarachnoid hemorrhage (SAH) in the third and fourth ventricles. Preoperative 3 Dimensions-digital subtraction angiography (3-D DSA) indicated a ruptured aneurysm located on the bilateral posterior inferior cerebellar anastomotic artery. Postoperative pathological findings indicated the characteristics of parent artery PICA and control aneurysm. The authors performed an overview of PICA aneurysms with anomalous variation in the Pubmed, Web of Science, and Medline databases. The search was until 1 August 2023. Related terms "posterior inferior cerebellar artery" And "aneurysm" AND "anatomical variants" were used to search the review. The reasons for anomalous variation anastomosis between bilateral PICAs were analyzed.
Results:
The aneurysm was resected successfully. Post-operative 3-D DSA revealed the disappearance of the aneurysm. The vessel wall of anastomotic PICA showed neovascularized hyperplasia, abnormal arrangement of smooth muscle, CD31+ endothelial cells, and SMA+ smooth muscle cells. In contrast, when it came to aneurysm, the wall at the location of the fracture thinned, which could be used to explain that the local nodular protrusion was formed and CD31+ endothelial cells existed. No neurological deficits were found at her 1-year follow-up visit (mRS score of 0).
Conclusion:
Direct resection of ruptured aneurysm associated with bilateral anomalous posterior inferior cerebellar anastomotic arteries was an effective treatment and careful consideration of the anatomical characteristics concerning the interesting aneurysm and the variant PICA was critical for sate treatment. Also, the literature on the lesion was reviewed.
Case report: Virtual reality-based arm and leg cycling combined with transcutaneous electrical spinal cord stimulation for early treatment of a cervical spinal cord injured patient
Authors: Xiaolei Chu, Shuaiyi Liu, Xiaoxuan Zhao, Tao Liu, Zheng Xing, Qingwen Li, Qi Li
Journal: Front Neurosci (2024)
Keywords: cycling, early treatment, electrical stimulation, spinal cord injury, virtual reality
MeSH terms: Case Reports

Spinal cord injury is a condition affecting the central nervous system, causing different levels of dysfunction below the point of nerve damage. A 50-year-old woman suffered a neck injury as a result of a car accident. After undergoing posterior cervical C3-C6 internal fixation with titanium plates on one side and C7 lamina decompression, the patient, who had been diagnosed with C3-C7 cervical disk herniation and spinal stenosis causing persistent compression of the spinal cord, was transferred to the rehabilitation department. After implementing the combined therapy of Virtual Reality-based arm and leg cycling along with transcutaneous electrical stimulation of the spinal cord, the patients experienced a notable enhancement in both sensory and motor abilities as per the ASIA scores. The patient's anxiety and depression were reduced as measured by the Hamilton Anxiety and Hamilton Depression Tests. As evaluated by the SCIM-III, the patient's self-reliance and capacity to carry out everyday tasks showed ongoing enhancement, leading to the restoration of their functionality. Hence, the use of Virtual Reality-based arm and leg cycling along with transcutaneous electrical spinal cord stimulation has potential to positively impact function in patients with spinal cord injury. However, as this is a case report, the small number of patients and the fact that the intervention was initiated early after the injury, we were unable to separate the recovery due to the intervention from the natural recovery that is known to occur in the initial weeks and months after SCI. Therefore, further randomized controlled trials with a large sample size is necessary.