OpenMed/multicare-articles huggingface dataset:
Case report: Biliobronchial fistula after biliary tract stenosis
Authors: Luís Maurício Batalin Júnior, Mariana Conceição E Silva Seleme Zandoná, Thomaz Almeida Vargas, Julio Cesar de Oliveira, Juliana Rocha Souza Chiappetto, Cassio Vieira Oliveira, Fernando Gomes Romeiro, Suzana Erico Tanni
Journal: Front Med (Lausanne) (2022)
Keywords: biliary tract stenosis, biliobronchial fistula, bilioptysis, cyclic jaundice, pneumonia
MeSH terms: Case Reports

Biliobronchial fistula (BBF) is a rare abnormality resulting from congenital or acquired communication between the bile ducts and the bronchial tree. Patients often suffer from chronic cough, dyspnea, and bilioptysis, a pathognomonic symptom of this condition. Conservative methods such as less-invasive procedures are gradually consolidating. Nonetheless, surgery remains the primary treatment, especially in more complex cases. We present the case of a 44-year-old woman with a chronic cough, no verified periods of fever, cyclic jaundice, and episodes of yellowish sputum. She had undergone cholecystectomy in 2018 and had been hospitalized several times since for pneumonia treatment. All consequent investigations for mycobacteriosis were negative. When referred to our hospital, she had cyclic jaundice and parenchymal consolidation in the right lower lobe. Suspected bilioptysis motivated the search for a biliobronchial fistula. Magnetic resonance cholangiography (MRC) confirmed stenosis of the biliary tract and fistulous path, and sputum analysis indicated high bilirubin levels. External biliary bypass was performed as an initial conservative and definitive therapy due to the presence of liver cirrhosis. Although BBF is a rare condition when bilioptysis is suspected, a diagnostic investigation should be initiated. Our case study proposes two criteria for diagnosis: an imaging exam demonstrating the fistulous path and confirmation of bilirubin in the sputum or bronchoalveolar lavage (BAL). When diagnosed, surgical correction should be performed.
Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura
Authors: Nikolaos Iakovis, Andrew Xanthopoulos, Aikaterini Chamaidi, Michail Papamichalis, Apostolos Dimos, Filippos Triposkiadis, John Skoularigis
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

A 53-year-old man was admitted to a peripheral hospital with the diagnosis of acute myocardial infarction without ST elevation. Due to the concomitant presence of first-diagnosed thrombocytopenia (platelet count 50.000/μL), it was decided to be treated conservatively with clopidogrel. Five days later, he developed an acute myocardial infarction with ST elevation (STEMI) and was transferred to our department for primary percutaneous coronary intervention (PCI). Coronary angiography revealed three-vessel disease. The left anterior descending lesion was considered culprit, and PCI was successfully performed using a drug-eluting balloon. This approach was considered safer due to the risk of intolerance of prolonged dual antiplatelet therapy in case of stent implantation. Indeed, four days later, aspirin was discontinued, and the patient remained only on clopidogrel due to a platelet fall. Meanwhile, idiopathic thrombocytopenic purpura (ITP) was diagnosed by hematology consultation, and specific ITP treatment was initiated. Seven days following the procedure, the patient was transferred to the Hematology clinic, where a continuous rise of platelet count up to 115.000/μL while on clopidogrel was observed, and he was discharged from the hospital asymptomatic. Unfortunately, twenty days later, the patient died of a lung infection. In ITP patients with STEMI, primary PCI with drug-eluting balloon angioplasty may be a reasonable approach.
Use-Dependent Prosthesis Training Strengthens Contralateral Hemodynamic Brain Responses in a Young Adult With Upper Limb Reduction Deficiency: A Case Report
Authors: Jordan A Borrell, Christopher Copeland, Jessica L Lukaszek, Kaitlin Fraser, Jorge M Zuniga
Journal: Front Neurosci (2021)
Keywords: 3d printed prosthetics, functional near infrared spectroscopy, hemodynamic response, motor control, upper limb reduction deficiency, use-dependent plasticity
MeSH terms: Case Reports

The purpose of the current case study was to determine the influence of an 8-week home intervention training utilizing a partial hand prosthesis on hemodynamic responses of the brain and gross dexterity in a case participant with congenital unilateral upper-limb reduction deficiency (ULD). The case participant (female, 19 years of age) performed a gross manual dexterity task (Box and Block Test) while measuring brain activity (functional near-infrared spectroscopy; fNIRS) before and after an 8-weeks home intervention training. During baseline, there was a broad cortical activation in the ipsilateral sensorimotor cortex and a non-focalized cortical activation in the contralateral hemisphere, which was non-focalized, while performing a gross manual dexterity task using a prosthesis. After the 8-week home intervention training, however, cortical activation shifted to the contralateral motor cortex while cortical activation was diminished in the ipsilateral hemisphere. Specifically, the oxygenated hemodynamics (HbO) responses increased in the medial aspects of the contralateral primary motor and somatosensory cortices. Thus, these results suggest that an 8-week prosthetic home intervention was able to strengthen contralateral connections in this young adult with congenital partial hand reduction. This was supported by the case participant showing after training an increased flexor tone, increased range of motion of the wrist, and decreased times to complete various gross dexterity tasks. Changes in HbO responses due to the home intervention training follow the mechanisms of use-dependent plasticity and further guide the use of prostheses as a rehabilitation strategy for individuals with ULD.
Facial Nerve Palsy with Total Ophthalmoplegia; a Novel Presentation of Fungal Invasion
Authors: Zainab Mehdi, Nidhi Bhardwaj, Jyoti Aggarwal, Narinder Kaur, Brijdeep Singh
Journal: Arch Acad Emerg Med (2021)
Keywords: mucormycosis, diabetes mellitus, facial paralysis, retinal artery occlusion
MeSH terms: Case Reports

Mucormycosis is an expeditious invasion of a fungus of angioinvasive nature, predominant in immunocompromised individuals, often leading to organ malfunction and loss. Facial nerve involvement and total ophthalmoplegia are its rare presentations. Early detection and treatment can alter natural disease course and prevent potential catastrophic outcomes in diabetic patients. Facial nerve palsy is mostly attributed to peripheral neuropathy in patients with advanced diabetes mellitus. It rarely raises alarm about an invasive fungal infection. Here, we report the case of a 38-year-old male with type 2 diabetes mellitus, who presented to us with left lower motor neuron type facial palsy and left-sided total ophthalmoplegia due to invasive rhino-orbito-cerebral mucormycosis (ROCM). Despite aggressive measures, including antifungal therapy and repeated endoscopic debridement, he subsequently developed central retinal artery occlusion (CRAO) and underwent left eye exenteration.
Reappearance of Command-Following Is Associated With the Recovery of Language and Internal-Awareness Networks: A Longitudinal Multiple-Case Report
Authors: Charlène Aubinet, Rajanikant Panda, Stephen Karl Larroque, Helena Cassol, Mohamed Ali Bahri, Manon Carrière, Sarah Wannez, Steve Majerus, Steven Laureys, Aurore Thibaut
Journal: Front Syst Neurosci (2019)
Keywords: consciousness, language, minimally conscious state, positron emission tomography, structural magnetic resonance imaging

The recovery of patients with disorders of consciousness is a real challenge, especially at the chronic stage. After a severe brain injury, patients can regain some slight signs of consciousness, while not being able to functionally communicate. This entity is called the minimally conscious state (MCS), which has been divided into MCS- and MCS+, respectively based on the absence or presence of language-related signs of consciousness. In this series of cases we aimed to describe retrospectively the longitudinal recovery of specific language-related behaviors using neuroimaging measurement in severely brain-injured patients. Among 209 chronic MCS patients admitted to our center from 2008 to 2018, 19 were assessed at two time points by means of behavioral and neuroimaging assessments. Three of them met our inclusion criteria and were diagnosed as MCS- during their first stay and had recovered command-following when they were reassessed (i.e., MCS+). As compared to their first assessments, when the three patients were in a MCS+, they showed less hypometabolism and/or higher gray matter volume in brain regions such as the precuneus and thalamus, as well as the left caudate and temporal/angular cortices known to be involved in various aspects of semantics. According to these preliminary results, the reappearance of language-related behaviors was concomitant with the recovery of metabolism and gray matter in neural regions that have been associated with self-consciousness and language processing. Prospective studies should be conducted to deepen our understanding of the neural correlates of the recovery of language-related behaviors in chronic MCS.
Benefit and Preference of Propranolol Over Metoprolol in Thyrotoxicosis-Induced Atrial Fibrillation: A Case Report and Review of Literature
Authors: Mukosolu F Obi, Vikhyath Namireddy, Yash Garg, Manjari Sharma
Journal: Cureus (2023)
Keywords: amiodarone induced thyrotoxicosis, atrial fibrillation/flutter, beta-blockers, hyperthyroidism, standard of care
MeSH terms: Case Reports

Atrial fibrillation is a common manifestation seen in patients with hyperthyroidism and thyroid storm. The presence of excess thyroid hormone (TH) alters adrenergic receptors in the heart and blood vessels, thereby causing an increase in sympathetic function and atrial fibrillation as a sequela of this excess circulating hormone. Excess thyroid hormone (T3) shortens the action potential of cardiomyocytes in the pulmonary vein, which facilitates the generation of reentrant circuits causing atrial fibrillation. Thyroid hormone can regulate cardiac beta-adrenergic receptor expression leading to enhanced catecholamine sensitivity of beta-adrenergic coupled cardiac response. We present a case of a 64-year-old female with a history of hypertension (HTN), nonobstructive coronary artery disease (CAD), congestive heart failure (CHF) [ejection fraction (EF) 35-40%], chronic obstructive pulmonary disease (COPD) on long-term oxygen therapy (LTO2), obstructive sleep apnea (OSA)/hypoventilation syndrome, atrial flutter/atrial fibrillation with a loop recorder on rivaroxaban, and obesity who presented to the emergency department (ED) with gastroenteritis symptoms precipitating difficulty breathing and atrial fibrillation with a rapid ventricular response (HR 140-150) requiring ICU admission for rate and rhythm control. During the course of hospitalization, she was treated with an amiodarone infusion, which induced thyrotoxicosis and increased the ectopic electrical activity in the atrium, worsening atrial fibrillation. On day 3, amiodarone was stopped, and IV esmolol and metoprolol tartrate PO were continued with no resolution of atrial fibrillation. The patient was transitioned to propranolol, which achieved adequate heart rate control prior to discharge. The aim of our review is to highlight that propranolol should be used over metoprolol in patients with hyperthyroidism-induced atrial fibrillation due to the effect of propranolol on blocking the activity of T4 conversion to active T3 and, as such, blocking its effect on cardiac myocytes, terminating reentrant atrial excitation.
Helicobacter suis-Associated Gastritis Mimicking Conventional H. pylori-Associated Atrophic Gastritis
Authors: Masaya Iwamuro, Somay Yamagata Murayama, Masahiko Nakamura, Kenta Hamada, Takehiro Tanaka, Hiroyuki Okada
Journal: Case Rep Gastrointest Med (2022)
MeSH terms: Case Reports

A 45-year-old Japanese man underwent esophagogastroduodenoscopy, which revealed spotty redness at the gastric fornix, mucosal swelling, diffuse redness in the corpus, and mucosal atrophy in the gastric angle and antrum. Histological examination showed rod-shaped bacteria that appeared larger than Helicobacter pylori. The patient tested positive for rapid urease test, and serum anti-H. pylori IgG antibody test results were negative. Further examination of the bacteria revealed that H. suis antibody test was positive, and the presence of H. suis was confirmed using H. suis-specific real-time PCR. H. suis was successfully eradicated after triple therapy with vonoprazan, amoxicillin, and clarithromycin. This case reinforces the notion that non-H. pylori Helicobacter species such as H. suis and H. heilmannii may be involved in the pathogenesis of active gastritis in patients who test negative for H. pylori antibodies.
A rare case of transient left ventricular apical ballooning syndrome following living donor liver transplantation: A case report and literature review
Authors: Asuka Tanaka, Takashi Onoe, Kohei Ishiyama, Kentaro Ide, Hirotaka Tashiro, Hideki Ohdan
Journal: Int J Surg Case Rep (2019)
Keywords: cardiac complication, case report, living donor liver transplantation, transient left ventricular apical ballooning syndrome

Introduction:
Transient Left Ventricular Apical Balloon Syndrome (LV-ABS) is an unknown acute dysfunction of the left ventricle, which develops under emotional or physical stress events like the major surgical postoperative period.
Presentation of case:
A 68-year-old woman diagnosed with hepatitis C cirrhosis was admitted for living donor liver transplantation (LDLT). No evidence for underlying cardiac or pulmonary disease was found. LDLT was performed, and her intra and post-operative course was uneventful. On post-operative day 4, dyspnea and tachycardia were observed. Echocardiography showed a severe wall motion abnormality with ballooning of the apex with normal basilar wall motion and a severely impaired left ventricular function with an ejection fraction (EF) of 40%. Blood tests showed greatly increased level of N-terminal pro-brain natriuretic peptide (NT- pro BNP). Evidence of significant ischemic heart disease was not obtained and a transient LV-ABS was diagnosed. Although she required intensive care, her cardiac function became normal by conservative treatment.
Discussion:
Transient LV-ABS has been reported to occur more frequently in post-menopausal women with reduced estrogens reported to protect myocardium from sympathetic stress after mental or physical stress events. It has been suggested that this disease arises from myocardial stunning with high levels of circulating catecholamines and stress related neuropeptides. However, even in a serious condition, cardiac function has recovered normally in all cases by appropriate care.
Conclusion:
Transient LV-ABS is one cause of cardiac dysfunction after LDLT, and it is important to strictly manage cardiac function when diagnosed as transient LV-ABS.
Global Health Education and Advocacy: Using BMJ Case Reports to Tackle the Social Determinants of Health
Authors: Nathan T Douthit, Seema Biswas
Journal: Front Public Health (2018)
Keywords: advocacy, case reports, education, global health, social determinants
MeSH terms: Review

Since 2013, BMJ Case Reports (http://casereports.bmj.com/) has published over 70 global health case reports from five continents, written by doctors, nurses, students, and allied health professionals. These cases, a burgeoning repository of evidence of how real patients are affected by disease, trauma, violence, sexual assault, conflict, migration, adverse living and working conditions, and poor access to health care, discuss, in addition to clinicopathological findings, the global health problems affecting each patient. The global health problem analysis examines the problems of individual patients, critically appraises the literature, and describes actual and potential solutions for the patient, the local community, and patients affected by similar issues across the world. At present global health literature and learning materials lack a patient focus and real-life context in the analysis of global health problems. BMJ Case Reports global health case reports are a unique and important tool to learn about and advocate for change in the social, political, cultural, and financial determinants of health as they affect real patients. This growing evidence base brings together clinicians, local service providers, policy makers, and government and non-governmental institutions to effect real change in patients' lives toward improving health. Each global health case report is an excellent resource for learning, and together, these case reports provide essential reading for anyone embarking on a career in global health, and writing their own case report. The online course (http://casereports.bmj.com/site/misc/GHMA_Mar_2017.pptx) at BMJ Case Reports uses these cases and is free to access.
Hemodialysis-Related Amyloidosis in the Tongue
Authors: Satoshi Nakamura, Miki Yamada, Yosuke Iijima, Keisuke Sawada, Shunsuke Hino, Takahiro Kaneko, Norio Horie
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Dialysis-related amyloidosis (DRA) represents a group of relatively rare disorders characterized by the systemic extracellular deposition of insoluble fibrils of amyloid protein in long-term dialysis patients. We describe herein a case of relatively early DRA on the tongue of a long-term dialysis patient. A 67-year-old man with a 39-year history of dialysis was referred for diagnosis of a tongue mass. On examination, a collection of whitish-yellow papules was identified on the ventral surface of the tongue tip. The pathological diagnosis was DRA. Clinicians should be aware that long-term dialysis can cause oral amyloidosis of the tongue.
A single step impression technique of flabby ridges using monophase polyvinylsiloxane material: a case report
Authors: Umesh Y Pai, Vikram Simha Reddy, Rushad Nariman Hosi
Journal: Case Rep Dent (2014)

Complete denture fabrication in clinically compromised situations such as flabby ridges is a challenging task for the clinician. Accurate impressioning of these tissues plays a major role in ensuring a well-fitting prosthesis. In this paper, the authors have proposed a newer technique of impression making of the flabby tissues using a combination of readily available newer and older materials to ensure an accurate and easy impression of these tissues.
B cell subset distribution in human bone marrow is stable and similar in left and right femur: An instructive case
Authors: Annika Wiedemann, Andreia C Lino, Thomas Dörner
Journal: PLoS One (2019)
MeSH terms: B-Lymphocyte Subsets / cytology, Bone Marrow Cells / cytology, Case Reports, Research Support, Non-U.S. Gov't, Arthroplasty, Replacement, Hip, B-Lymphocyte Subsets / immunology, Bone Marrow Cells / immunology, Female, Femur / cytology, Humans, Middle Aged, Osteoarthritis, Hip / surgery, Plasma Cells / cytology, Plasma Cells / immunology, Time Factors

The bone marrow (BM) is, in addition to being the site of B cell development, a tissue that harbors long-lived plasma cells (PC), the cells that protect the body against foreign antigens by continuous production of antibodies. Nothing is known about the long-term stability and functionality of both B cells and PC in the BM at the individual donor level since repeated sampling possibilities outside of oncology are scarce. Here, we had the opportunity to obtain BM samples from a patient undergoing bilateral total hip arthroplasty half a year apart. We observed that the frequencies of the analyzed B cell and PC subsets were similar despite a time of six months in between and sampling on left and right side of the body. Additionally, B cell receptor stimulation led to comparable results. Our data suggest that composition and functionality of B cells are stable in the BM of adults at the individual donor level.
Case report: Almonertinib in combination with bevacizumab for leptomeningeal metastases from epidermal growth factor receptor-mutation non-small cell lung cancer: Case series
Authors: Yuhai Zhang, Meilin Zhang, Wanwan Cheng, Shencun Fang
Journal: Front Oncol (2022)
Keywords: egfrm, almonertinib, bevacizumab, leptomeningeal metastasis, non-small cell lung cancer
MeSH terms: Case Reports

Leptomeningeal metastasis (LM) is a lethal complication of advanced non-small cell lung cancer (NSCLC) with rapid deterioration and poor prognosis. It has no standard treatment for epidermal growth factor receptor mutation (EGFRm) NSCLC, and improving the clinical outcomes for patients with LM has become an urgent problem in clinical treatment. Both almonertinib and bevacizumab are capable of crossing the blood-brain barrier with comparable central nervous system effectiveness. To date, the almonertinib treatment in combination with bevacizumab in EGFRm NSCLC with LM has not been studied. We herein present five cases to further evaluate the effectiveness and tolerability of almonertinib in combination with bevacizumab for patients with EGFRm NSCLC and LM. For the first time, we report that almonertinib plus bevacizumab can not only effectively improve the neurological symptoms caused by LM but also prolong the survival time of patients with limited and controllable side effects, which provided a novel therapeutic approach for LM from EGFRm NSCLC.
Clear cell carcinoma arising in previous episiotomy scar: a case report and review of the literature
Authors: Ling Han, Ai Zheng, He Wang
Journal: J Ovarian Res (2016)
MeSH terms: Adenocarcinoma, Clear Cell / diagnosis, Carcinoma, Endometrioid / diagnosis, Cicatrix / pathology, Case Reports, Review, Adenocarcinoma, Clear Cell / therapy, Adult, Carcinoma, Endometrioid / therapy, Cell Transformation, Neoplastic, Endometriosis / pathology, Episiotomy, Female, Humans

Background:
Malignant transformation of endometriosis associated with episiotomy scar is a rare event, especially histological type of clear cell adenocarcinoma. There are only three clear cell carcinoma in episiotomy scar reported, no standard treatment established.
Case presentation:
A 36-year-old woman presented with a two-month history of painless but puritic perineal lump which she noticed was gradually enlarging. She had undergone surgical excision of a mass in the episiotomy scar 9 year ago and resequently histological type of endometriosis. Physical examination revealed a 10 × 5 cm soft, purple scar which is closely related to the apex of the episiotomy.We underwent a local excision of the mass for a biopsy . The second surgery performed after one cycle of paclitaxel and cisplatin (TP) to permit clearance of tumor while preserving normal vaginal function.Pathological result was clear cell adenocarcinoma. Two cycles of TP adjuvant chemotherapy were administrated after surgery.
Conclusions:
We report a case of primary clear cell carcinoma developing within a previous episiotomy scar in a patient with a history of endometriosis, along with a review of the literature. Accumulation of management data on these rare tumors and Long-term follow-up of such patients is therefore important.