OpenMed/multicare-articles huggingface dataset:
Ischemic Colitis after Colonoscopy with Bisacodyl Bowel Preparation: A Report of Two Cases
Authors: Chris Shamatutu, Daljeet Chahal, Isabella T Tai, Peter Kwan
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Background:
Colonoscopy is widely used for the diagnosis and management of colorectal disease and requires adequate bowel preparation. Ischemic colitis is a form of intestinal ischemia that presents with abdominal pain, diarrhea, and hematochezia. Risk factors include advanced age, cardiovascular disease, and diabetes. Both colonoscopy and bisacodyl bowel preparation have been described as rare causes of ischemic colitis with less than 35 cases collectively in the literature. Our review found that of these cases, there exists significant heterogeneity within individual patient characteristics. The majority of the cases are managed conservatively without complications or sequela. Due to the risk of ischemic colitis, the FDA has withdrawn bisacodyl bowel preparations from use in the USA. Bisacodyl bowel preparations are still used in Canada.
Cases:
Here, we present two cases of ischemic colitis in previously healthy women aged 57 and 69 who underwent screening colonoscopy using bisacodyl bowel preparation. Both were treated conservatively without complications.
Conclusion:
Thus far, there has been one documented case of ischemic colitis following colonoscopy with bisacodyl bowel preparation; here, we present two additional cases with one case occurring without the presence of known risk factors for ischemic colitis. Our literature review finds that there is limited evidence surrounding bisacodyl as a causative agent of ischemic colitis. Cases often contain confounding variables such as the presence of known risk factors for ischemic colitis. Our report aims to highlight the need for a more comprehensive analysis evaluating the safety of bowel preparations as well as increasing the clinical awareness surrounding the rare risk of colonoscopy-induced ischemic colitis.
A Misdiagnosed Case of Hypertrophic Gastropathy
Authors: Sushma Thapa, Arnab Ghosh, Gita Pun, Dilasma Ghartimagar, O P Talwar
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Hypertrophic gastropathy is a rare idiopathic hyperproliferative disorder which may present as Menetrier's disease (MD) characterized by foveolar hyperplasia in the gastric fundus and body. It is often accompanied by a severe loss of plasma proteins (including albumin) from the altered gastric mucosa. The disease occurs in two forms, a childhood form due to cytomegalovirus infection and an adult form attributed to overexpression of transforming growth factor-alpha (TGF-α). The most common symptoms include epigastric pain with fullness and vomiting and generalized peripheral edema with hypoalbuminemia. We present a case of 75-year-old female presenting with epigastric pain and vomiting. Upper gastrointestinal endoscopy and computed tomography scan revealed an irregular mucosal fold at the body and antrum and thickening of the stomach wall, respectively. Though the endoscopic gastric mucosal biopsy was nonspecific, the patient underwent partial gastrectomy due to clinicoradiological suspicion of carcinoma. On histopathology, the case was reported as hypertrophic gastropathy, consistent with MD. Though there is a strong clinical and radiological suspicion of malignancy in the hypertrophied gastric mucosa, MD should be one of the important differential diagnoses.
Metabolic Encephalopathy and Lipid Storage Myopathy Associated with a Presumptive Mitochondrial Fatty Acid Oxidation Defect in a Dog
Authors: Vanessa R Biegen, John P McCue, Taryn A Donovan, G Diane Shelton
Journal: Front Vet Sci (2015)
Keywords: fatty acid oxidation, inborn error of metabolism, lipid storage myopathy, magnetic resonance imaging, metabolic encephalopathy
MeSH terms: Case Reports

A 1-year-old spayed female Shih Tzu presented for episodic abnormalities of posture and mentation. Neurological examination was consistent with a bilaterally symmetric multifocal encephalopathy. The dog had a waxing-and-waning hyperlactemia and hypoglycemia. Magnetic resonance imaging revealed bilaterally symmetric cavitated lesions of the caudate nuclei with less severe abnormalities in the cerebellar nuclei. Empirical therapy was unsuccessful, and the patient was euthanized. Post-mortem histopathology revealed bilaterally symmetric necrotic lesions of the caudate and cerebellar nuclei and multi-organ lipid accumulation, including a lipid storage myopathy. Malonic aciduria and ketonuria were found on urinary organic acid screen. Plasma acylcarnitine analysis suggested a fatty acid oxidation defect. Fatty acid oxidation disorders are inborn errors of metabolism documented in humans, but poorly described in dogs. Although neurological signs have been described in humans with this group of diseases, descriptions of advanced imaging, and histopathology are severely lacking. This report suggests that abnormalities of fatty acid metabolism may cause severe, bilateral gray matter necrosis, and lipid accumulation in multiple organs including the skeletal muscles, liver, and kidneys. Veterinarians should be aware that fatty acid oxidation disorders, although potentially fatal, may be treatable. A timely definitive diagnosis is essential in guiding therapy.
Roseomonas mucosa-Induced Peritonitis in a Patient Undergoing Continuous Cycler Peritoneal Dialysis: Case Report and Literature Analysis
Authors: Sasmit Roy, Sumit Patel, Hardhik Kummamuru, Amarinder Singh Garcha, Rohan Gupta, Sreedhar Adapa
Journal: Case Rep Nephrol (2021)
MeSH terms: Case Reports

Roseomonas species, a rare Gram-negative microorganism, has seldom been reported to cause peritonitis in end-stage renal disease patients on peritoneal dialysis. Only seven cases of peritonitis by this rare microorganism have been reported worldwide. Treatment options can be challenging if not detected early and can lead to significant morbidity and mortality along with the switching of the dialysis modality to hemodialysis which is highly undesirable. Our patient is a 65-year-old Caucasian female who needed to be changed to emergency hemodialysis due to inability to perform peritoneal dialysis from suspected peritonitis and was subsequently discovered to have peritonitis from Roseomonas mucosa. She recovered with a prolonged antibiotics course and returned to peritoneal dialysis in 3 months following her treatment completion. Prompt diagnosis and prolonged antibiotics are a cornerstone in the management of this rare microorganism to prevent mortality and morbidity from peritonitis.
An Unusual Case of Refractory Hypoxia on the ICU
Authors: Caroline Phillips, Clare Harris, Nathaniel Broughton, Thomas Pulimood, Liam Ring
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

We present the case of a 68-year-old gentleman who presented with breathlessness and was found to have NSTEMI, pulmonary oedema, and hypoxia. He remained hypoxic despite appropriate treatment and was found to have preserved LV function and raised cardiac output. CT pulmonary angiogram was negative but a cirrhotic liver was incidentally noted and later confirmed via ultrasound. Bedside examination was positive for orthodeoxia, suggesting a diagnosis of hepatopulmonary syndrome (HPS). The finding of significant intrapulmonary shunting on "bubble" echocardiography confirmed the diagnosis. This patient did not have previously diagnosed liver disease and had largely normal LFTs when the diagnosis was first suspected. We discuss HPS in the context of ICU and suggest how it may be screened for using simple tests. There is no correlation between the presence of HPS and severity of liver disease, yet we believe this is the first reported adult case of HPS on the ICU without previously diagnosed cirrhosis.
Case Report: A five-year follow up after pediatric renal transplantation using flow cytometry crossmatch and HLA immunophenotyping based on DNA for screening test
Authors: Johanes Dwi Meiyanto, Besut Daryanto, Kurnia Penta Seputra
Journal: F1000Res (2021)
Keywords: hla based on dna, flow cytometry crossmatch, pediatric renal transplantation
MeSH terms: Kidney Transplantation, Case Reports, Activities of Daily Living, Adult, DNA, Female, Flow Cytometry, Follow-Up Studies, HLA Antigens, Humans, Immunophenotyping, Quality of Life, Young Adult, HLA Antigens, DNA

Background: There are three methods for renal replacement therapy for end stage chronic kidney disease; dialysis, continuous ambulatory peritoneal dialysis, and renal transplantation which is the best because of the least morbidity rate, the best survival rates, the best quality of life, and the best improvement in activities of daily living. In the field, flow cytometry serves a well-established role in pre- and post-transplant crossmatching, and if it is combined with human leukocyte antigen (HLA) immunophenotyping based on DNA, it will produce a more sensitive prediction of the chronic graft rejection compared to complement-dependent cytotoxicity crossmatching and can eliminate irrelevant antibody (IgM). This is the first experience using this method in our hospital. The survival rate at one, five and ten years has been shown to be 99%, 97% and 96%, respectively; therefore, we wanted to find out the five year follow up of the patient. Case presentation: We evaluated a 20-year-old female with a history of pediatric renal transplantation five years previously due to end stage renal disease caused by bilateral parenchymatous renal disease. She had a history of hypertension since December 2014 and underwent hemodialysis for three months. The transplantation took place in March 2015. A kidney from her mother was transplanted to recipient using end-to-side anastomoses. After five years, the patient was routinely monitored at the urology clinic, with creatinine serum results between 1.5 and 2 mg/dL, urea and electrolyte serum levels within normal limits and she could resume normal life. Conclusions: Survival five years after the procedure showed a beneficial outcome of the method used.
CD19 CAR-T Cells With Membrane-Bound IL-15 for B-Cell Acute Lymphoblastic Leukemia After Failure of CD19 and CD22 CAR-T Cells: Case Report
Authors: Yao Sun, Yongfeng Su, Yizhi Wang, Na Liu, Yuhang Li, Jianlin Chen, Zhuoqing Qiao, Jingwen Niu, Jiangwei Hu, Bin Zhang, Hongmei Ning, Liangding Hu
Journal: Front Immunol (2021)
Keywords: b-all, cd19, cd22, il-15, chimeric antigen receptor-t cells, extramedullary relapse
MeSH terms: Antigens, CD19 / genetics, Genetic Therapy, Immunotherapy, Adoptive, Interleukin-15 / genetics, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / therapy, Receptors, Chimeric Antigen / genetics, Sialic Acid Binding Ig-like Lectin 2 / genetics, T-Lymphocytes / transplantation, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antigens, CD19 / metabolism, Disease Progression, Humans, Interleukin-15 / metabolism, Male, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / genetics, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / immunology, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / metabolism, Receptors, Chimeric Antigen / metabolism, Retreatment, Sialic Acid Binding Ig-like Lectin 2 / metabolism, T-Lymphocytes / immunology, T-Lymphocytes / metabolism, Time Factors, Treatment Outcome, Antigens, CD19, CD19 molecule, human, CD22 protein, human, IL15 protein, human, Interleukin-15, Receptors, Chimeric Antigen, Sialic Acid Binding Ig-like Lectin 2

Objectives:
At present, reinfusions of chimeric antigen receptor (CAR)-T cell have exhibited limited efficacy, while their efficacy on extramedullary relapse remains to be further elucidated in B-cell acute lymphoblastic leukemia (B-ALL). Although combination with IL-15 demonstrated the potential to enhance antitumor activity of CAR-T, the efficacy of this approach remains to be validated clinically.
Methods:
We reported a patient with B-ALL with extramedullary relapse after allogeneic stem cell transplantation and who was resistant to chemotherapy and radiotherapy. In total, he received four treatments with CAR-T cells repeatedly under the status of disease progression.
Results:
First, the patient received autologous murine CAR19-CD28-CD3ζ-T cells and achieved full resolution of extramedullary leukemia lasting 8 months. After systemic disease relapse, he received autologous humanized CAR22-41BB-CD3ζ-tEGFR-T cells and achieved complete remission (CR) with incomplete blood count recovery (CRi) with minimal residual disease (MRD) negativity in the bone marrow and shrinkage of extramedullary leukemia. Over 2 months later, he experienced a relapse of the systemic disease and he received autologous murine CAR19-41BB-CD3ζ-mIL15-T cells and achieved CRiMRD- lasting 5 months with the strongest expansion and persistence of CAR. Finally, on relapse of CD19- medullary disease, he received allogeneic humanized CAR22-41BB-CD3ζ-tEGFR-T cells but only achieved a transient decrease in the number of blasts. No CAR-T-cell-related encephalopathy syndrome was observed, and all side effects were manageable.
Conclusion:
Our report hints the feasibility and safety of CD19 CAR-T cell expressing membrane-bound IL-15 for patient with B-ALL even if relapsed after multiple CAR-T-cell therapies.
An intraoperative case of spontaneous restoration of circulation from asystole: a case of lazarus phenomenon
Authors: Konstantinos A Ekmektzoglou, Eleni Koudouna, Eleni Bassiakou, Konstantinos Stroumpoulis, Phyllis Clouva-Molyvdas, Georgios Troupis, Theodoros Xanthos
Journal: Case Rep Emerg Med (2012)
MeSH terms: Case Reports

This case report refers to a victim of intraoperative cardiac arrest, who restored spontaneous circulation despite of cessation of cardiopulmonary resuscitation (CPR). The victim, a 53-year-old man, was undergoing a surgical investigation and rehabilitation of a thigh hematoma. Two minutes after discontinuation of a 46 min CPR, a normotensive sinus node rhythm appeared at monitor. Despite of lack of an adequate explanation, the authors believe that the combination of the high total dose of adrenaline with the cessation of mechanical ventilation might augment venous return and lead to restoration of spontaneous circulation.
Photographic smile tracking: Evidence of asymmetric crying faces over time improvement: Case report
Authors: Maamouri Sabrine, Marouen Ben Rejeb, Karima Zitouni, Issam Zairi
Journal: Int J Surg Case Rep (2020)
Keywords: asymmetric crying faces, nerve palsy, smile
MeSH terms: Case Reports

Introduction:
Congenital hypoplasia of the depressor anguli oris muscle is a rare mimic disorder depicted by a lower lip asymmetry apparent when laughing or crying.
Presentation of case:
A 10-year-old boy consulted our department for an asymmetry when opening his mouth. According to the family, this asymmetry was present since birth. Perinatal characteristics and childhood medical history were investigated with no abnormalities. Physical exam revealed an inability to draw down the right lower lip unilaterally. At rest position, facial asymmetry was not noticeable. Several investigations were done: A CT scan of the petrous part of the temporal bone, an MRI of soft tissues, an electromyography and a heart ultrasound. No anomalies were found.
Discussion:
This condition has stimulated great interest because of its potential association with congenital anomalies but also in order to reassure families often worried by the situation. A large therapeutic armamentarium is described in literature.
Conclusion:
Among the large armamentarium of therapeutic options, we opted for a wait and see strategy through photographic smile tracking leading to an evidence of Asymmetric crying faces over time improvement.
A New Mutation in IDS Gene Causing Hunter Syndrome: A Case Report
Authors: Caio Perez Gomes, Maryana Mara Marins, Fabiana Louise Motta, Sandra Obikawa Kyosen, Marco Antonio Curiati, Vânia D'Almeida, Ana Maria Martins, João Bosco Pesquero
Journal: Front Genet (2020)
Keywords: hunter syndrome, ids, iduronate-2-sulfatase, inborn errors of metabolism, lisossomal storage disease, mucopolysaccharidosis type ii
MeSH terms: Case Reports

Rationale:
Mucopolysaccharidosis type II (Hunter syndrome) is an X-linked multisystem disorder, caused by deficiency of the lysosomal enzyme iduronate-2-sulfatase (I2S). The clinical manifestations of this disease are severe skeletal deformities, airway obstruction, cardiomyopathy, and neurologic deterioration.
Patient:
The patient was 5 years and 6 months boy, with developmental delay, hearing loss, hepatosplenomegaly, and skeletal dysplasia. He was diagnosed with mucopolysaccharidosis type II based on clinical manifestations, biochemical and genetic analysis.
Outcomes:
The patient carries a new mutation (c.879-1210_1007-218del) in hemizygosis in the IDS gene, which was defined as pathogenic according to the 2015 American College of Medical Genetics and Genomics-Association for Molecular Pathology guidelines and as responsible for the mucopolysaccharidosis type II phenotype in the patient.
Laparoscopic fertility-sparing surgery for early stage ovarian cancer: a single-centre case series and systematic literature review
Authors: Antonella Cromi, Giorgio Bogani, Stefano Uccella, Jvan Casarin, Maurizio Serati, Fabio Ghezzi
Journal: J Ovarian Res (2014)
Keywords: fertility-sparing, laparoscopy, ovarian cancer, pregnancy, staging
MeSH terms: Ovarian Neoplasms / surgery, Review, Systematic Review, Adolescent, Adult, Female, Humans, Laparoscopy, Neoplasm Staging, Ovarian Neoplasms / diagnosis, Premenopause, Treatment Outcome, Young Adult

Background:
There is as yet limited evidence about fertility-sparing surgery for early ovarian cancer (EOC) carried out laparoscopically. We sought to analyze recurrence patterns and fertility outcome in a cohort of ovarian cancer patients who underwent fertility-saving laparoscopic surgical staging.
Methods:
We conducted a retrospective analysis of prospectively collected data on all patients undergoing fertility-sparing laparoscopic staging procedures for presumed EOC at a single gynecologic oncology service. Oncologic safety and reproductive outcome were the main outcome measures. The pertinent literature is reviewed.
Results:
The study cohort consisted of 12 women. Cases included 5 invasive epithelial tumors and 7 nonepithelial tumors. The disease was reclassified to a higher stage in one woman. After a median follow up period of 38 months (range: 14-108), the overall survival was 100% and recurrence-free survival 90.9%. Five (100%) of patients who attempted pregnancy conceived spontaneously. Three of them had uneventful term pregnancy delivering healthy babies. The literature search yielded 62 cases of laparoscopic fertility conserving surgery for ovarian cancer. There were 4 (6.2%) recurrences. Cumulative pregnancy and live birth rate were not estimable as earlier publications lack essential data.
Conclusions:
Laparoscopic staging may represent a viable option for premenopausal women seeking fertility preservation in the setting of early ovarian cancer. More research is needed to determine whether laparoscopy may offer reproductive benefits to this particular population.
Malignant transformation in a mature teratoma with metastatic deposits in the omentum: a case report
Authors: Shramana Mandal, Bhawana A Badhe
Journal: Case Rep Pathol (2012)

Malignant transformation of a mature cystic teratoma (MCT) is a very rare complication with an incidence of 0.17-2%;. The most common form of malignant transformation of the MCT is squamous cell carcinoma. Other tumors arising in MCT include basal cell carcinoma, sebaceous tumor, malignant melanoma, adenocarcinoma, sarcoma, and neuroectodermal tumor. However malignant transformation with metastatic deposits in the omentum is extremely rare. The present case highlights the rarity of the occurrence of an omental deposits in a case of mature cystic teratoma with malignant transformation.
Endodontic and orthodontic management of traumatically intruded teeth with horizontal root fracture: a case report
Authors: Marcos Jacobovitz, Adriana Maria Bonadio Lopes Ramos, Regina Karla de Pontes Lima, Fernanda Geraldes Pappen, Anna B Fuks
Journal: Case Rep Dent (2011)
MeSH terms: Case Reports

This report describes the case of an 8-year-old boy that was referred to endodontic and orthodontic treatment after suffering an injury that led to intrusion of the maxillary right permanent central incisor, palatal displacement of the upper right lateral incisor, and root fracture of both central incisors. Both injured teeth were immature and had open apices. The intruded tooth was repositioned by endodontic and orthodontic management. Endodontic therapy was performed in both teeth with periodical changes of calcium-hydroxide-based paste as root canal dressing and introduction of MTA as an apical barrier. The postoperative course was uneventful with clinical and radiographic success up to 3 and 1/2 years of follow up. In the present case, orthodontic repositioning combined with endodontic therapy constitued a viable alternative treatment for intrusive luxations in immature permanent teeth.
Edwardsiella tarda, a rare human pathogen isolated from a perihepatic abscess: Implications of transient versus long term colonization of the gastrointestinal tract
Authors: K Pham, Y Wu, G Turett, N Prasad, L Yung, G D Rodriguez, S Segal-Maurer, C Urban, J Yoon
Journal: IDCases (2021)
Keywords: edwardsiella tarda, perihepatic abscess, transient versus long-term colonization
MeSH terms: Case Reports

Although gastroenteritis is the most commonly described manifestation of Edwardsiella tarda infection, the pathogenesis and transient or long-term colonization of the gastrointestinal tract of this organism in human disease is not clear. We describe a rare manifestation of E. tarda infection in a perihepatic abscess in the setting of a patient with perforated cholecystitis and its successful eradication following antibiotic treatment.
Case Report: Can Targeted Intraoperative Radiotherapy in Patients With Breast Cancer and Pacemakers be the New Standard of Care?
Authors: Fardeen Bhimani, Kelly Johnson, N Patrik Brodin, Wolfgang A Tomé, Jana Fox, Keyur Mehta, Maureen McEvoy, Sheldon Feldman
Journal: Front Oncol (2022)
Keywords: targit, breast, breast cancer, case report, intraoperative radiotherapy, invasive duct breast cancer (idc), pacemaker
MeSH terms: Case Reports

Background:
Partial breast irradiation with Intra-operative radiotherapy (IORT) has become a popular management option as opposed to whole breast radiation using external beam radiotherapy for breast cancer patients. While previous studies have highlighted the use of IORT in breast cancer patients, there is a scarcity of literature on the use of IORT in those who also have ipsilateral pacemakers. Thus, the aim of our case report is to highlight the applicability of IORT in breast cancer patients who also have a pacemaker.
Case reports:
Two female patients with an implanted dual-chamber pacemaker presented with a diagnosis of left-sided invasive ductal carcinoma on mammogram. Mammography of the left breast revealed a 10 mm and 7 mm spiculated mass, respectively, further confirmed with an ultrasound-guided core biopsy that was conclusive of clinical Stage I T1 N0 grade 2, ER +, PR + Her2 - invasive ductal carcinoma. They met our eligibility criteria for IORT, which is being performed as a registry trial. These patients underwent a wide excision lumpectomy along with IORT.
Conclusion:
Our findings underscore the successful use of targeted IORT for breast-conserving surgery in a patient with invasive ductal carcinoma and pacemaker, hence eliminating the necessity for relocating pacemaker surgeries in these patients. Furthermore, no device failure or malfunction for the pacemaker was recorded before, during, or after the surgery, demonstrating the safety of using IORT in patients with preinstalled pacemaker despite a lack of evidence on safe radiation dosage or manufacturer guidelines. Nonetheless, the effects of IORT on pacemaker < 10 cm were not studied in our patients and further clinical studies are recommended to reinforce the applicability and safe distance of IORT in breast cancer patients with pacemaker.