OpenMed/multicare-articles huggingface dataset:
SimCP: A Simulation Platform to Predict Gait Performance Following Orthopedic Intervention in Children With Cerebral Palsy
Authors: Lorenzo Pitto, Hans Kainz, Antoine Falisse, Mariska Wesseling, Sam Van Rossom, Hoa Hoang, Eirini Papageorgiou, Ann Hallemans, Kaat Desloovere, Guy Molenaers, Anja Van Campenhout, Friedl De Groote, Ilse Jonkers
Journal: Front Neurorobot (2019)
Keywords: capability gap, cerebral palsy, muscle synergies, orthopedic interventions, single event multilevel surgery, subject specific model

Gait deficits in cerebral palsy (CP) are often treated with a single-event multi-level surgery (SEMLS). Selecting the treatment options (combination of bony and soft tissue corrections) for a specific patient is a complex endeavor and very often treatment outcome is not satisfying. A deterioration in 22.8% of the parameters describing gait performance has been reported and there is need for additional surgery in 11% of the patients. Computational simulations based on musculoskeletal models that allow clinicians to test the effects of different treatment options before surgery have the potential to drastically improve treatment outcome. However, to date, no such simulation and modeling method is available. Two important challenges are the development of methods to include patient-specific neuromechanical impairments into the models and to simulate the effect of different surgical procedures on post-operative gait performance. Therefore, we developed the SimCP framework that allows the evaluation of the effect of different simulated surgeries on gait performance of a specific patient and includes a graphical user interface (GUI) that enables performing virtual surgery on the models. We demonstrated the potential of our framework for two case studies. Models reflecting the patient-specific musculoskeletal geometry and muscle properties are generated based solely on data collected before the treatment. The patient's motor control is described based on muscle synergies derived from pre-operative EMG. The GUI is then used to modify the musculoskeletal properties according to the surgical plan. Since SEMLS does not affect motor control, the same motor control model is used to define gait performance pre- and post-operative. We use the capability gap (CG), i.e., the difference between the joint moments needed to perform healthy walking and the joint moments the personalized model can generate, to quantify gait performance. In both cases, the CG was smaller post- then pre-operative and this was in accordance with the measured change in gait kinematics after treatment.
Spontaneously Ruptured Dermoid Cysts and Their Potential Complications: A Review of the Literature with a Case Report
Authors: Rebecca Yuan Li, Yogesh Nikam, Supuni Kapurubandara
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Spontaneous ruptures of dermoid cysts are a rare occurrence due to their thick capsules. This is the first systematic review on spontaneously ruptured dermoid cysts. A comprehensive literature search was performed from PubMed, Google Scholar, and MEDLINE. The cases were analysed for patient demographics, presenting signs and symptoms, imaging modalities used, management methods, and outcomes. The majority of cases report an idiopathic cause with symptoms of abdominal pain, distension, and fever. Computed tomography is the most accurate in detecting ruptured dermoid cysts. We also report a case of a 66-year-old who presented with sudden abdominal pain and a low-grade temperature. Imaging showed a 10 cm well-circumscribed hyperechoic mass consistent with a dermoid cyst with no suggestive signs of rupture. She was planned for a laparoscopic bilateral salpingo-oophorectomy. However, intraoperatively, a ruptured dermoid cyst was found with bowel adhesions and chemical peritonitis as cyst contents covered the entirety of the intra-abdominal cavity. Her operative course was complicated by inadvertent iatrogenic small bowel injury, unsuccessful laparoscopy, needing conversion to laparotomy. Despite their benign nature, complications from ruptured dermoid cysts include peritonitis, bowel obstruction, and abscesses. Surgical management by both laparoscopy and laparotomy is successful, with laparotomies more likely to be performed. Complications have mostly no long-term sequelae.
Delayed CPAP-Induced Pneumocephalus and Meningitis Posttranssphenoidal Surgery
Authors: Tara D'Ignazio, Mary Francispillai, Marc Giroux, Martin Albert
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Transsphenoidal surgery (TSS) is a frequently used technique to remove pituitary adenomas. Rare complications of TSS include development of postoperative pneumocephalus. Many patients undergoing TSS also suffer from obstructive sleep apnea (OSA) and thus require positive pressure ventilation. The exact timing of when to safely reintroduce the CPAP machine in this subset of patients is presently not exactly known but is most often cited as being two to four weeks postoperatively. In this case, we describe the story of a 69-year-old female who underwent TSS for a nonsecreting pituitary adenoma in April 2012 and went on to develop pneumocephalus five weeks postoperatively after reintroduction of her CPAP machine. This is the latest presentation of pneumocephalus after reintroduction of CPAP documented in present literature. The case reopens the debate as to how many weeks postoperatively positive pressure ventilation should be withheld to prevent the development of pneumocephalus in patients having undergone TSS with simultaneous OSA.
Penile calciphylaxis in end stage renal disease
Authors: Vincenzo Barbera, Luca Di Lullo, Antonio Gorini, Giovanni Otranto, Fulvio Floccari, Moreno Malaguti, Alberto Santoboni
Journal: Case Rep Urol (2013)

Calciphylaxis, better described as "Calcific uremic arteriolopathy" (CUA), involves about 1-4% of hemodialysis patients all around the world with high mortality rates. We describe a rare clinical case of CUA in peritoneal dialysis patient associated with urological disease. Penile calciphylaxis represents rare clinical complication, and an early diagnosis and multidisciplinary approach are requested. Pathogenesis is still unclear, and therapeutic approaches need more long-term clinical trials to test their efficacy and safety.
Pneumocephalus associated with cerebrospinal fluid fistula as a complication of spinal surgery: a case report
Authors: Ken Sasaki, Tomoyuki Matsumoto, Toshiyuki Mizuno, Shinichi Ikuta, Toshihiro Akisue, Hiroyuki Fujioka, Minoru Doita, Masahiro Kurosaka, Ryosuke Kuroda
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Pneumocephalus is a well-known condition following head trauma, but is rare as an injury or as a result of surgery of the spine. We present a 76-year-old patient with a rare case of pneumocephalus associated with a cerebrospinal fluid fistula as a complication of surgical treatment for cervical myelopathy. Although cerebrospinal fluid leakage was noted and the injured dura was carefully sutured at operation, tension pneumocephalus occurred. The resultant pneumocephalus was diagnosed based on neurogenic symptoms including sudden convulsion, head radiograph, and computed tomography scan. The benign course of the pneumocephalus postdiagnosis did not require secondary operation.
Intramural tracheal bronchogenic cyst: a case report
Authors: Go Ohba, Miki Toma, Koji Komori, Seiichi Hirobe, Ryuji Fukuzawa
Journal: Springerplus (2014)
Keywords: bronchogenic cyst, end-to-end anastomosis, intramural

Intramural bronchogenic cysts are extremely rare. We describe the case of an intramural bronchogenic cyst in a 2 year old boy who underwent tracheal resection and end-to-end anastomosis.
Cladophialophora bantiana brain abscess and concurrent pulmonary cryptococcus neoformans infection in a patient twenty years after renal transplantation
Authors: Daniel Tsang, Sara Haddad, Ziver Sahin, Chairut Vareechon, Mitchell Sternlieb, Tricia Royer
Journal: IDCases (2022)
Keywords: brain abscess, cladophialophora bantiana, cryptococcus, immunocompromise, transplant
MeSH terms: Case Reports

Recipients of solid organ transplants are at risk for a variety of infections due to their immunocompromised status. The types of infections are often correlated to the timing from their transplant. After about six to twelve months, transplant recipients remain at risk for typical community acquired pathogens, late viral infections, and fungal infections including atypical molds such as Cladophialophora bantiana. C. bantiana is a dematiaceous fungus that has a predilection for infecting the brain and is the most common cause of cerebral phaeohyphomycosis - a term used to describe infections caused by molds that produce dark cell walls. Patients with cerebral abscesses due to C. bantiana infections have an estimated mortality of about 70%. Improved outcomes have been seen in patients who receive both surgical and antifungal therapy. While there are no clear guidelines on antifungal therapy, most cases have been treated with combination amphotericin B, a triazole (itraconazole, voriconazole, or posaconazole) with flucytosine sometimes in conjunction as well. This case describes a patient with C. bantiana brain abscess and concurrent Cryptococcus neoformans pulmonary infection that occurred twenty years after his kidney transplantation. He was treated successfully with two craniotomies for cerebral abscess debridement and liposomal amphotericin B followed by planned lifelong voriconazole.
Creating mindful heroes: a case study with ninth grade students
Authors: Inês Nogueira, Mariana Reis Barbosa, Luísa Mota Ribeiro, Ioanna Xenophontos, Philip Zimbardo
Journal: Front Psychol (2023)
Keywords: heroic imagination project, bystander effect, empathy, heroism, mindfulness

The Heroic Imagination Project (HIP) aims to redefine heroism as a set of habits that anyone can achieve. Research findings on the psychological foundations of negative forms of social influence that can lead to bystander behavior are translated into tools that individuals can use in their daily lives. Habits of wise and effective helping behavior are learned, modeled, and encouraged through the training of the "heroic imagination." According to the literature, practicing mindfulness can increase empathy, compassion, and prosocial behaviors. There is empirical evidence that compassion can act as a mediator between mindfulness and prosocial helping behaviors toward strangers, suggesting that mindfulness promotes this behavior and thus helps to overcome the bystander effect. With this hypothesis in mind, we created a program that combined mindfulness and HIP sessions. Five participants volunteered to participate in the "Creating Mindful Heroes" 9-week program. Throughout the sessions, they filled in a diary, and at the end of the program, they answered two feedback questionnaires. They were then invited to participate in individual interviews. The participants reported a positive overall perspective regarding the program, mentioning several improvements in their relationships with their family, peers, and others in society. Moreover, participants reported that the program promoted prosocial behaviors and aided them in developing empathy.
Superior mesenteric vein injury in penetrating abdominal trauma: A case report
Authors: Nada Faris Alhassan, Saad Mohammed Alsaawy, Ibrahim Tawfiq Albabtain
Journal: Int J Surg Case Rep (2018)
Keywords: abdominal vascular injury, care report, gunshot, inferior vena cava, trauma, superior mesenteric vein

Introduction:
Injury to the superior mesenteric vein (SMV) is considerably rare amongst abdominal visceral vascular injuries. Multiple factors play a role in identifying such injuries, leading to the high morbidity and mortality associated.
Case presentation:
We report a twenty-six-year-old male sustaining a SMV injury following a self-inflected gun shot. Initial assessment of the patient reveals hemodynamic instability and intraabdominal hemorrhage. Surgically approaching the patient was performed in two stages. Midline laparotomy was performed to control the active bleeding and stabilize the patient. Kocherizing the duodenum reveals that the source of retroperitoneal bleeding was from the SMV and one of the supra-renal tributaries of the Inferior Vena Cava (IVC). Several stitches were taken in a figure-of-eight manner to control the bleeding. Second-look operation was performed to rule out other injuries and permeant closure of the abdominal wall. Proper psychiatric care was ensured before transferal of the patient in good conditions to another healthcare facility specialized in mental health.
Discussion:
High mortality rates reaching up to 65% are reported in similar cases. Multiple factors have contributed to the patient's favorable outcome, including rapid trauma response, absences of other associated injuries, and the patient's baseline healthy status.
Conclusion:
The principle of damage control surgery in trauma is an effective strategy to stabilize the patient and rule out other injuries which might not have been discernible initially.
Gastric Schwannoma: A Tumor Must Be Included in Differential Diagnoses of Gastric Submucosal Tumors
Authors: Bao-Guang Hu, Feng-Jie Wu, Jun Zhu, Xiao-Mei Li, Yu-Ming Li, Yan Feng, He-Sheng Li
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Gastric schwannoma (GS) is a rare neoplasm of the stomach. It accounts for 0.2% of all gastric tumors and is mostly benign, slow-growing, and asymptomatic. Due to its rarity, GS is not widely recognized by clinicians, and the precise differential diagnosis between GS and other gastric submucosal tumors remains difficult preoperatively. The present study reports a case of GS misdiagnosed as gastrointestinal stromal tumor and reviews the clinical, imaging, and pathological features, treatment, and follow-up of 221 patients with GS previously reported in the English literature. Although GS is rare, the case reported in the current study highlights the importance of including GS in differential diagnoses of gastric submucosal tumors. Furthermore, the findings of the review suggest that although many cases are asymptomatic, the most common symptoms are abdominal pain or discomfort, not gastrointestinal bleeding, and malignant GSs present with clinical symptoms more commonly. Although large-sample multicenter studies on the efficacy, safety, and oncological outcomes of minimally invasive techniques are required, the findings presented herein may be helpful for clinicians when diagnosing or treating GS.
Macular hole progression after intravitreal bevacizumab for hemicentral retinal vein occlusion
Authors: Manish Nagpal, Vikram Mehta, Kamal Nagpal
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

Macular edema secondary to retinal vein occlusion is commonly being treated with off-label intravitreal bevacizumab with good outcomes. A significant reduction in macular edema and improvement in visual acuity is seen following such a treatment with no serious adverse effects. In the reported case, a full-thickness macular hole was noticed one month after intravitreal bevacizumab for macular edema secondary to hemicentral retinal vein occlusion. On a detailed review of the pre- and postoptical coherence tomography scans, it was realized that there was a preexisting stage 2-3 macular hole which was masked by the hemorrhages and edema at the fovea and the macular hole had progressed following the injection.
Use Of POCUS for the Paediatric Patient with an Undifferentiated Upper Limb Injury
Authors: David J McCreary, Alex White
Journal: POCUS J (2023)
Keywords: pocus, fracture, joint effusion, nursemaid's elbow, pulled elbow
MeSH terms: Case Reports

A 2-year-old girl presented to the Paediatric Emergency Department following an unwitnessed injury to her left arm while playing at nursery limiting further examination. On assessment she was reluctant to use her left arm and further examination was difficult. In cases of unwitnessed and undifferentiated elbow injuries point of care ultrasound (POCUS) can be used to evaluate for elbow joint effusion, fracture, or radial head subluxation, also known as nursemaid's elbow. Pulled elbow is a commonly encountered paediatric injury but based on the history and examination findings it may not always be obvious. We present an approach to the child with an undifferentiated elbow injury incorporating POCUS as a means of increasing the reliability of findings on clinical examination.
Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation: a case report
Authors: Asmaa El Kebir, Evrard Niyonkuru, Mahmoud Alafifi, Nisrine Bennani Guebessi, Mehdi Karkouri, Rachid Aboutaieb
Journal: Pan Afr Med J (2022)
Keywords: chromophobe renal cell carcinoma, kidney neoplasm, case report, liposarcomatous dedifferentiation
MeSH terms: Bone Neoplasms / surgery, Carcinoma, Renal Cell / diagnosis, Carcinoma, Renal Cell / pathology, Carcinoma, Renal Cell / surgery, Kidney Neoplasms / pathology, Case Reports, Adult, Female, Humans, Nephrectomy, Tomography, X-Ray Computed

Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation is a very extremely rare tumor and only few cases have been reported in the literature. Here we report a case of a 37-year-old woman who presented with a pain and a palpable mass in the right flank. The abdominal computed tomography (CT) scan found a renal tumor and the patient underwent a right radical nephrectomy with adrenal gland resection. After the histological examination of the specimen completed by immunohistochemical and molecular study, a diagnosis of chromophobe renal cell carcinoma with liposarcomatous dedifferentiation was made. The patient received adjuvant chemotherapy. Afterwards, she developed bone metastasis and died 13 months after the surgery. Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation is a rare tumor associated with a poor prognosis and a metastatic potential.
A Case of Segmental Aplasia of the Uterus, Cervix, and Cranial Vagina in a Cat
Authors: Samantha Souther, Nam Joo Baik, Kemba Clapp, Mike Nappier, D Phillip Sponenberg, Julie Cecere
Journal: Front Vet Sci (2019)
Keywords: atresia, cat, cervix, disorder of sexual development, segmental aplasia, uterus, vagina, vaginal mass
MeSH terms: Case Reports

This case documents a rare set of congenital anomalies that resulted in an atypical cystic lesion in the cranial vagina of a queen. A discrete cystic lesion was identified in an 8 year old intact female domestic shorthair cat presenting for routine ovariohysterectomy. Morphological, radiographic, and histopathological findings were consistent with segmental aplasia of the uterus, cervix, and vagina resulting in a blind dilation of the cranial vagina. Segmental vaginal aplasia in combination with the failed canalization of the cervix resulted in a blind portion of the cranial vagina, in which normal secretions collected and became inspissated. This formed a discrete cystic structure. This case represents a novel combination and clinical presentation of segmental aplasia in the cat, involving both the uterus and cranial vagina. Ovariohysterectomy was performed for sterilization and a partial vaginectomy was performed to remove the cystic lesion in its entirety.
Orbital Lymphoma Masquerading as Orbital Cellulitis
Authors: B D Chaurasiya, Ganesh Agrawal, Santosh Chaudhary, Sangeeta Shah, Anju Pradhan, Poonam Lavaju
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Background:
Orbital lymphomas are primarily non-Hodgkin type and can originate from the eyelids, extraocular muscles, soft tissue orbital adnexa, conjunctiva, or lacrimal glands. Orbital malignancies often represent a diagnostic dilemma for clinicians given their varying and atypical presentations.
Objective:
To report a case of orbital lymphoma mimicking orbital cellulitis.
Case:
A 66-year-old male patient presented with sudden onset of painful proptosis with visual impairment in the left eye for 15 days. On ocular examination, best-corrected visual acuity was 6/12 in the right eye and 2/60 in the left eye, abaxial proptosis with hypertropia, swollen and erythematous eyelids, restricted extraocular movement in all cardinal position of gaze, conjunctival congestion with chemosis and tortuous vessels, sluggish pupillary reaction, and chorioretinal folds in the inferior quadrants. The case was diagnosed as left eye orbital cellulitis, and the patient was treated with broad-spectrum intravenous antibiotics and oral steroids. No clinically discernible response was noted despite 7 days of antibiotics and steroids. Contrast-enhanced computed tomography (CECT) orbit showed features suggestive of orbital lymphoma involving the ipsilateral maxillary and ethmoid sinuses. ENT consultation with diagnostic nasal endoscopy and biopsy was done. Histopathological reports showed features of non-Hodgkin lymphoma.
Conclusion:
Orbital malignancies masquerading as orbital cellulitis can pose a diagnostic dilemma. A multidisciplinary approach involving ENT consultation, radiological investigation, and pathological sampling can help achieve a timely diagnosis and appropriate management.
Failure of lumbar puncture in a patient with spinal epidural lipomatosis: a case report
Authors: Daiki Yamanaka, Takashi Kawano, Marie Shigematsu-Locatelli, Atsushi Nishigaki, Sonoe Kitamura, Bun Aoyama, Hiroki Tateiwa, Noriko Kitaoka, Masataka Yokoyama
Journal: JA Clin Rep (2016)
Keywords: epidural lipomatosis, lumbar puncture, spinal anesthesia

We report a case of difficult lumbar puncture due to the inability to obtain adequate cerebrospinal fluid (CSF) in a patient later diagnosed with spinal epidural lipomatosis (SEL). A 76-year-old man with a body mass index (BMI) of 24.1 kg/m2 was scheduled for transurethral resection of a bladder tumor for superficial bladder cancer under spinal anesthesia. The patient had a 3-year history of inhaled steroid use for the management of chronic obstructive pulmonary disease. After placing the patient in the right lateral position, a lumbar puncture was performed via the median approach. However, CSF could not be tapped adequately despite repeated attempts at lumbar puncture, so general anesthetic was administered instead. Subsequently, both anesthesia and surgery proceeded uneventfully. On the first postoperative day, the patient developed mild postdural puncture headache (PDPH), which was treated conservatively. No postoperative neurological complications related to spinal anesthesia were observed. Approximately 2 months after discharge, the patient reported progressive lower back pain and was diagnosed with SEL by magnetic resonance imaging (MRI). A lumbar laminectomy and removal of excessive adipose tissue was performed. After surgery, the patient's symptoms resolved. The pathogenesis of SEL involves excess fat tissue deposition in the spinal canal, which can lead to obliteration of the spinal subarachnoid space. Therefore, in this patient, the SEL was thought to have caused the inability to obtain adequate CSF during lumbar puncture, and was associated with difficult spinal anesthesia.