OpenMed/multicare-articles huggingface dataset:
Prognostic Value of Doppler Ultrasound in Triplets Conceived by In Vitro Fertilization: A Case Report and Review of the Literature
Authors: Rita Zafra, Lauren Conway, Nadia Solomon
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: doppler, high-risk pregnancy, maternal-fetal medicine, multiple pregnancy, ultrasound
MeSH terms: Fetal Growth Retardation / diagnostic imaging, Pregnancy, Triplet, Ultrasonography, Prenatal, Umbilical Arteries / diagnostic imaging, Case Reports, Review, Adult, Female, Fertilization in Vitro, Fetal Death, Gestational Age, Humans, Infant, Newborn, Middle Cerebral Artery / diagnostic imaging, Pregnancy, Pregnancy Outcome, Pregnancy, High-Risk, Prognosis, Ultrasonography, Doppler

Umbilical artery Doppler ultrasound-which informs on maternal-fetal-placental blood flow-may be the most valuable surveillance tool in triplet pregnancies, crucial to diagnose early fetal growth restriction. To illustrate the prognostic value of Doppler ultrasound and launch a discussion of its role in multiple gestational, high-risk pregnancy, we present the case of a 42-year-old woman with trichorionic triamniotic triplet pregnancy conceived by in vitro fertilization, who showed early signs of poor outcome for one of the triplets via umbilical artery Doppler by the 23rd week and middle cerebral artery Doppler by the 29th week of gestation.
Multidisciplinary Rehabilitation is Efficacious and Induces Neural Plasticity in Multiple Sclerosis even when Complicated by Progressive Multifocal Leukoencephalopathy
Authors: Elisabetta Groppo, Francesca Baglio, Davide Cattaneo, Eleonora Tavazzi, Niels Bergsland, Sonia Di Tella, Riccardo Parelli, Ilaria Carpinella, Cristina Grosso, Ruggero Capra, Marco Rovaris
Journal: Front Neurol (2017)
Keywords: functional magnetic resonance imaging, multidisciplinary rehabilitation, multiple sclerosis, neuroplasticity, progressive multifocal leukoencephalopathy
MeSH terms: Case Reports

A 48-year-old woman with multiple sclerosis (MS), treated with natalizumab for more than one year without clinical and magnetic resonance imaging (MRI) signs of disease activity, was diagnosed with definite progressive multifocal leukoencephalopathy (PML). She presented with subacute motor deficit of the right upper limb (UL), followed by involvement of the homolateral leg and urinary urgency. The patient was treated with steroids and plasma exchange. On follow-up MRI scans, the PML lesion remained stable and no MS rebounds were observed, but the patient complained of a progressive worsening of the right UL motor impairment, becoming dependent in most activities of daily living. A cycle of multidisciplinary rehabilitation (MDR) was then started, including daily sessions of UL robot therapy and occupational therapy. Functional MRI (fMRI) was acquired before and at the end of the MDR cycle using a motor task which consisted of 2 runs: in one run the patient was asked to observe while the second one consisted of hand grasping movements. At the end of the rehabilitation period, both the velocity and the smoothness of arm trajectories during robot-based reaching movements were significantly improved. After MDR, compared with baseline, fMRI showed significantly increased functional activation within the sensory-motor network in the active, motor task, while no significant differences were found in the observational task. MDR in MS, including robot-assisted UL training, seems to be clinically efficacious and to have a significant impact on brain functional reorganization on a short-term, even in the presence of superimposed tissue damage provoked by PML.
Mycobacterium Avium Prosthetic Hip Infection on Abatacept Presenting as Fever of Unknown Origin
Authors: Rachel Sigler, Jessica R Newman
Journal: J Bone Jt Infect (2019)
Keywords: mac, immunosuppression, joint infection, prosthetic joint
MeSH terms: Case Reports

Non-tuberculous mycobacteria (NTM) are well-described pulmonary pathogens in patients with underlying lung disease. Extra-pulmonary infections with NTM are rare. We describe a prosthetic hip infection with Mycobacterium avium complex. Increased immunosuppressing medications and number of total joint replacements are expected to increase the prevalence of NTM infections in the future.
Erythema multiforme in a Central American tapir ( Tapirus bairdii) calf, clinical case report
Authors: Luana Hernández Wolters, Alejandro Striedinger Cardona
Journal: Front Vet Sci (2023)
Keywords: perissodactyla, amoxicilin, antibiotics, drug reaction, erythema multiforme, glucocorticoids, skin disease, vesicular skin disease of tapirs
MeSH terms: Case Reports

A 7-month-old male Central American tapir with a history of recurrent respiratory diseases and repeated prolonged administration of amoxicillin with clavulanic acid presented with lethargy, severe hyperalgesia, and interscapular ulcerating vesicular lesions with serosanguineous content, as well as dorsal skin peeling, oral ulcers, and thoracic limb, abdominal, and submandibular pustules with surrounding erythema and alopecia. The histopathological analysis and clinical manifestations were compatible with erythema multiforme, which was treated with daily wound cleaning and silver sulfadiazine cream application, as well as oral prednisolone for 15 days, with five daily tapering doses, achieving clinical improvement and an adequate cure of the disease. Vesicular dermatitis syndrome of tapirs is a disease complex including erythema multiforme, a condition rarely diagnosed, since the analyses required for a definitive diagnosis are almost never performed; therefore, it is important to carry out the necessary tests that allow the differentiation of the dermatopathies included in this complex of vesicular skin diseases.
Adult Intestinal Malrotation Treated with Laparoscopic Ladd Procedure
Authors: Noritoshi Mizuta, Takuya Kikuchi, Yoshiyuki Fukuda
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Intestinal malrotation is a rare congenital disease caused by abnormal intestinal rotation and fixation of the intestinal tract in the early embryonic state. Adult cases are rare. A laparoscopic Ladd procedure for adult intestinal malrotation is increasingly reported, but owing to the rarity, some important aspects of the disease and its treatment may be overlooked. Three adult cases of intestinal malrotation that underwent surgery at our hospital between January 2019 and October 2020 were retrospectively examined about patient backgrounds, short-term results, and complications. All patients were male, median age was 54.6 years, and the complaints were abdominal pain and/or distention. No midgut volvulus was observed. The laparoscopic Ladd procedure was performed for all cases. One patient underwent reoperation (duodenoduodenostomy) because of impaired passage of the duodenal descending section due to postoperative pancreatic fistula. The postoperative courses of the other two patients were good. No recurrence of symptoms was observed in any of the cases. The reason for reoperation in one of the cases is considered to be pancreatic injury when the severe curve from the duodenum to the upper jejunum near the pancreatic head was straightened. Correction of the curve is important to improve passage disorder of the duodenum, but special care is required to avoid organ damage, especially during a laparoscopic procedure with forceps. The laparoscopic Ladd procedure for adult intestinal malrotation is recommended if there is no midgut volvulus; it is minimally invasive and a comparatively simple technique, but surgeons should take special care to avoid organ damage.
Relative Hypodense Vertebral Artery Sign on Computerized Tomography in Atherosclerotic Near Occlusion
Authors: Muhammad Faraz Raghib, Slaven Pikija
Journal: Case Rep Neurol Med (2016)
MeSH terms: Case Reports

A 52-year-old white male presented with an acute onset of slurred speech along with hypoesthesia in the entire left arm. The acute computed tomography (CT) showed relative hypodensity in the intracranial segment of left vertebral artery (VA) that was not present in historical images, pointing to the possible lack of flow. The site of occlusion was confirmed by magnetic resonance imaging (MRI) that showed susceptibility effect in the affected artery. By means of historical native CT comparison the site of VA thrombosis was correctly predicted. Local atherosclerotic thrombosis of the VA could be relatively hypodense on native CT and still have positive susceptibility weighted imaging (SWI) sign.
Emphysematous gastritis: A case series of three patients managed conservatively
Authors: Hassan Nasser, Tommy Ivanics, Shravan Leonard-Murali, Dania Shakaroun, Ann Woodward
Journal: Int J Surg Case Rep (2019)
Keywords: case series, computed tomography, emphysematous gastritis, gastric emphysema, gastritis

Introduction:
Emphysematous gastritis (EG) is a rare condition characterized by air within the gastric wall with signs of systemic toxicity. The optimal management for this condition and the role of surgery is still unclear. We here report three cases of EG successfully managed non-operatively.
Presentation of cases:
All three of our patients were elderly females with several co-morbidities. The chief presenting symptom was abdominal pain with signs of systemic toxicity ranging from tachycardia and hypotension to acute kidney injury. Computed tomography (CT) scan revealed gastric pneumatosis in all patients. One patient had extensive portal venous gas, and another had free intraperitoneal air. All patients were managed with nothing by mouth, proton pump inhibitors, intravenous fluid resuscitation, and antibiotics. Repeat CT scan in two patients in 3-4 days demonstrated resolution of the pneumatosis. They were all discharged home tolerating an oral diet.
Discussion:
The presentation of EG is non-specific and the diagnosis is primarily established by findings of intramural air in the stomach on CT scan. The initial management of EG should be nothing by mouth, proton pump inhibitor, intravenous fluid resuscitation, and antibiotics with surgical exploration only reserved for cases that fail non-operative management, demonstrate clinical deterioration, or develop signs of peritonitis.
Conclusion:
Early recognition and initiation of appropriate therapy is crucial to prevent the progression of EG. EG, even in the presence of portal venous air or pneumoperitoneum, should not represent a sole indication for surgical exploration and trial of initial non-operative management should be attempted when clinically appropriate.
Reverse Segond Fracture Associated with Anteromedial Tibial Rim and Tibial Attachment of Anterior Cruciate Ligament Avulsion Fractures
Authors: Yehia H Bedeir
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Reverse Segond fracture is an uncommon avulsion fracture of the tibial attachment of the deep portion of the medial collateral ligament of the knee. We report a reverse Segond fracture associated with anterior cruciate ligament tibial avulsion fracture and anteromedial tibial rim fracture. Unlike previous reports, the combination of reverse Segond fracture, anteromedial tibial rim fracture, and anterior cruciate ligament avulsion fracture was not associated with posterior cruciate ligament injury, posterolateral corner injury, or tibial plateau fracture. This new combination of injuries provides better understanding of the mechanisms of ligamentous injuries of the knee and highlights the importance of meticulous assessment of these injuries for accurate diagnosis and subsequent management.
Spontaneus bilateral pedicle fracture 30 years after Harrington Instrumentation for idiopathic scoliosis: a case report
Authors: Peter Obid, Alexander Richter, Hüseyin Ubeyli, Thomas Niemeyer
Journal: J Med Case Rep (2012)

Introduction:
Spontaneous fractures of the spine are a common entity. They usually occur in older people with osteoporosis. This case is presented on account of its rarity. To the best of the authors' knowledge only one case of an osteoporotic pedicle fracture after Harrington Instrumentation has been described before.
Case presentation:
We report the case of a 46-year-old Caucasian woman who underwent surgery due to idiopathic scoliosis with a Harrington Instrumentation (T4 to L3) 30 years ago. During the operation she was infected with hepatitis C while receiving erythrocyte concentrates and has suffered from liver cirrhosis since then. She presented with a sudden pain in her lower back and paraesthesia in both her legs but no other neurological symptoms. A computed tomography scan showed a bilateral pedicle fracture of L3 and an additional compression fracture of L4. In the first session we performed a dorsal stabilization with massive intraoperative bleeding and a postoperative failure of liver synthesis. In a second session an additional ventral augmentation was done. After the second operation she developed a hepatorenal syndrome. Both operations left the patient in a very critical state which led to a prolonged stay in the intensive care and rehabilitation unit. At her 12-month follow-up visit, she was free of complaints.
Conclusion:
The un-physiological load of the spine after Harrington Instrumentation can lead to osteoporosis due to inactivity even in younger patients. Although these implants are not used anymore one should keep this possibility in mind when dealing with patients who have received Harrington rods in surgical procedures.
Case report: Treatment of congenital lobar emphysema with lung lobectomy in a puppy
Authors: Lauren M Edwards, Cassie N Lux, Matthew Everett, Silke Hecht
Journal: Front Vet Sci (2023)
Keywords: canine, computed tomography, congenital, lobar emphysema, lung lobectomy
MeSH terms: Case Reports

An 11-week-old, sexually intact female Catahoula Leopard dog was evaluated for a multiple-week history of exercise intolerance and intermittent periods of respiratory distress. Thoracic radiographs revealed a markedly hyperinflated right lung field, with compression of the surrounding lung lobes. Thoracic computed tomography further localized the hyperinflation to the right middle lung lobe, with suspicion of congenital lobar emphysema. A right intercostal thoracotomy with right middle lung lobectomy was performed successfully. Histopathology results confirmed bronchial cartilage hypoplasia with marked emphysema and pleural fibrosis. The puppy recovered from surgery uneventfully and was discharged from the hospital without any postoperative complications. At 18 months postoperatively, the dog was clinically normal with no return of respiratory distress. This case report describes successful surgical treatment of a large breed puppy with the uncommonly reported condition of congenital lobar emphysema.
So let me find my way, whatever it will cost me, rather than leaving myself in darkness: experiences of glaucoma in Nigeria
Authors: Fatima Kyari, Clare I Chandler, Martha Martin, Clare E Gilbert
Journal: Glob Health Action (2016)
Keywords: nigeria, blindness, care pathway, early detection, glaucoma, late diagnosis, vision loss

Background:
Blindness from glaucoma is associated with socio-economic deprivation, presumed to reflect poor access to care and poor adherence to treatment.
Objectives:
To determine why people with glaucoma are presenting late for treatment and to understand access to glaucoma care. Additionally, we sought to identify what patients and the community know, do and think about the condition and why the poor are the most affected with glaucoma blindness.
Design:
Study participants were from four communities and two hospitals in Abuja-FCT and Kaduna State, Nigeria. A total of 120 participants were involved, including 8 focus group discussions, 7 in-depth interviews with blind/visually impaired glaucoma patients, 5 rapid direct observation visits with these patients and 13 exit interviews of glaucoma patients in the hospital. The data were analysed using content analysis, interpreting participant experiences in terms of three key steps conceptualised as important in the care pathway: what it takes to know glaucoma, to reach a diagnosis and to access continued care.
Results:
This article presents multiple narratives of accessing and maintaining glaucoma care and how people manage and cope with the disease. People may be presenting late due to structural barriers, which include lack of knowledge and awareness about glaucoma and not finding an appropriately equipped health care facility. What keeps glaucoma patients within the care pathway are a good hospital experience; a support structure involving family, counselling and shared patients' experiences; and an informed choice of treatment, as well as agency. The high cost of purchasing care is a major factor for patients dropping out of treatment.
Conclusion:
The findings suggest the need to address economic and social structural drivers as glaucoma presents another case study to demonstrate that poverty is a strong driver for blindness. There is also a need for clear glaucoma care pathways with early case finding in the community, two-way referral/feedback systems, well-equipped glaucoma care hospitals and better eye health care financing.
Case Report: Noninvasive Clinical Intervention of REBACIN® on Histologic Regression of High Grade Cervical Intraepithelial Neoplasia
Authors: Fan Wang, Rong Liu, Yan Ma, Dai-Fei Wu, Liu-Hong Deng, Sheng Wang, Gui-Yu Wang, Chun-Fa Zhang, Quan-Xin Qu
Journal: Front Med (Lausanne) (2021)
Keywords: cin2, e6/e7, human papilloma virus (hpv), rebacin®, cervical cancer, regression
MeSH terms: Case Reports

High-risk human papillomavirus (hrHPV) persistent infection is the major cause of cervical cancer. Clinical intervention of hrHPV-associated high-grade squamous intraepithelial lesion (HSIL) is critical to prevent cervical cancer, and current treatment is surgery (an invasive therapy). However, some patients refuse to do so for an afraid of potential adverse effects on future fertility or other concerns which creates a critical need for development of non-invasive therapeutic strategies. Here, we report for the first time the cases of non-invasive intervention with REBACIN®, a proprietary antiviral biologics, in clinical treatment of HSIL. From 12,958 visiting patients assessed for eligibility, 18 HSIL-patients with cervical intraepithelial neoplasia-grade 2, positive of both diffused overexpression of p16 and high-risk HPV were enrolled in this non-invasive clinical intervention mainly due to concerns of future fertility. REBACIN® was administered intravaginally every other day for 3 months (one-course) except during menstrual period, and were followed up for 6-36 months for the examination of high-risk HPV DNA, cervical cytology, and histopathology. After one to three course treatments, most cases (16/18) displayed both the regression from HSIL (CIN2) to normal cervical cytology and clearance of high-risk HPV infection. Further studies demonstrated REBACIN® significantly suppressed HPV16 E7 oncoprotein expression in a human cervical cancer cell line, which is consistent with previous finding that REBACIN® inhibits the growth of tumors induced by expression of E6/E7 oncogenes of either HPV16 or HPV18. This report indicates REBACIN® as a novel effective non-invasive clinical intervention for HSIL-patients as well for high-risk HPV persistent infection, providing a new clinical option for the non-invasive treatment of hrHPV-associated high-grade squamous intraepithelial lesion, which is worthy of further research on clinical validation and application.
Eosinophilic enteritis with ascites in a patient with overlap syndrome
Authors: Spyros Aslanidis, Athina Pyrpasopoulou, Kostas Soufleris, Eirini Kazantzidou, Stella Douma
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Gastrointestinal involvement is frequent in patients with systemic lupus erythematosus (SLE). Eosinophilic gastroenteritis, however, has only rarely been described in rheumatological conditions, despite its reported connection to autoimmune diseases, such as hypereosinophilic syndrome, vasculitides, and systemic mastoidosis. It presents typically with abdominal pain and diarrhea and is only exceptionally associated with ascites. Diagnosis can be problematic, as several other clinical conditions (malignancies, infection/tuberculosis, and inflammatory bowel diseases) have to be ruled out. It is basically a nonsurgical disease, with excellent recovery on conservative treatment. We report the rare case of a young woman with overlap syndrome who presented with abdominal pain and ascites. The diagnosis of eosinophilic enteritis was made based on clinical, radiological, and laboratory criteria. The patient was treated with corticosteroids with excellent response.
SARS and pregnancy: a case report
Authors: Corwin A Robertson, Sara A Lowther, Thomas Birch, Christina Tan, Faye Sorhage, Lauren Stockman, Clifford McDonald, Jairam R Lingappa, Eddy Bresnitz
Journal: Emerg Infect Dis (2004)
MeSH terms: Pregnancy Complications, Infectious / immunology, Pregnancy Complications, Infectious / virology, Severe Acute Respiratory Syndrome / complications, Case Reports, Adult, Antibodies, Viral / blood, Antibodies, Viral / metabolism, Female, Fetal Blood / immunology, Fetal Blood / virology, Humans, Infant, Newborn, Milk, Human / immunology, Milk, Human / virology, Pregnancy, Severe Acute Respiratory Syndrome / immunology, Severe Acute Respiratory Syndrome / virology, Severe acute respiratory syndrome-related coronavirus / immunology, Severe acute respiratory syndrome-related coronavirus / isolation & purification, Antibodies, Viral

We report a laboratory-confirmed case of severe acute respiratory syndrome (SARS) in a pregnant woman. Although the patient had respiratory failure, a healthy infant was subsequently delivered, and the mother is now well. There was no evidence of viral shedding at delivery. Antibodies to SARS virus were detected in cord blood and breast milk.
Case report: Evisceration of abdomen after blunt trauma
Authors: Arwa H Ibrahim, Adel J Osman, Mosab A Alarfaj, Areej M Alzamil, Munirah A Abahussain, Hanan Alghamdi
Journal: Int J Surg Case Rep (2020)
Keywords: abdominal, blunt, evisceration, pancreatic, transection, trauma
MeSH terms: Case Reports

Introduction:
Abdominal evisceration is uncommon after blunt abdominal trauma; therefore, it warrants urgent laparotomy. We report a young adult male who sustained multiple injuries due to a high impact mechanism resulting in blunt abdominal injury and underwent numerous laparotomies.
Case report:
In a high-speed motorcycle accident, a twenty-six-year-old male sustained a direct, blunt injury to his abdomen, which resulted in a right hemothorax, perforation of the stomach, and small bowel. Multiple mesenteric vessels tear, a retroperitoneal hematoma, liver, and pancreatic injury. The abdominal wall split transversely, extruding intact bowel. After resuscitation, according to the ATLS protocol, the patient underwent eight laparotomies for damage control. After 45 days in the Surgical Intensive Care Unit, then 11 days in the surgical ward, he was discharged in a satisfactory condition. Eight months later, he was admitted electively for ileostomy reversal, which was uneventful.
Conclusion:
Patients with high trauma mechanisms have high mortality and morbidity rate. Blunt injury with eviscerated abdominal contents requires prompt, expeditious, and timely intervention, particularly at the initial operative intervention with damage control procedures, both prompt management and structured approach, were tailored depending in the magnitude of the injury. A multidisciplinary approach is mandatory throughout the period of treatment until recovery and rehabilitation.