OpenMed/multicare-articles huggingface dataset:
Life-Threatening Mediastinal Hematoma Formation After Removal of the Hemodialysis Catheter in a Boxer: A Case Report
Authors: Athanasia Mitropoulou, Hendrik Lehmann, Evelyn M Heier, Matthias Schneider, Esther Hassdenteufel
Journal: Front Vet Sci (2021)
Keywords: acute kidney injury, antifactor xa, canine (dog), central venous catheter (cvc), continuous renal replacement therapy, hemodialysis catheter complications, low molecular weight heparin (lmwh), mediastinal hematoma
MeSH terms: Case Reports

A 4-year-old female Boxer was referred for renal replacement therapy 2 days after observed grape ingestion. An 11-French dual-lumen dialysis catheter was placed into the right jugular vein and continuous renal replacement therapy was initiated for 66 h. Afterwards the patient received enoxaparin subcutaneously as a thromboprophylaxis. Four hours after removal of the dialysis catheter the patient developed severe dyspnea with hypercapnia and signs of hemorrhagic shock. Bedside ultrasound and X-rays of the thorax revealed a soft tissue opacity dorsally of the trachea, located in the mediastinum. The findings were consistent with mediastinal bleeding and hematoma formation. Blood gas examination indicated hypoventilation. The dog was managed conservatively with multiple blood transfusions and mechanical ventilation. The patient survived to discharge, and the hematoma was fully absorbed in the radiographs after 17 days. Patients with impaired kidney function should receive individualized enoxaparin dosage adjusted to anti-Xa levels and should be strictly monitored for complications. Mediastinal hemorrhage and hematoma formation should be considered as a potential complication in patients receiving a jugular vein catheter.
Case Report: Reduced CSF Orexin Levels in a Patient With Sepsis
Authors: Yasuhiro Ogawa, Seioh Ezaki, Nobutake Shimojo, Satoru Kawano
Journal: Front Neurosci (2021)
Keywords: blood, blood-brain barrier, cerebrospinal fluid, orexin, sepsis
MeSH terms: Case Reports

Sepsis is a potentially lethal condition characterized by systemic inflammation and multiple organ failure, and sepsis-associated encephalopathy (SAE) is an independent risk factor for mortality in patients with sepsis. We previously reported that orexin improved survival in an animal model of sepsis by acting in the brain. Peripherally administered orexin entered the brain under the conditions of systemic inflammation because of BBB dysfunction and produced survival-related effects. As a therapeutic concept, we hypothesized that orexin treatment enhances recovery from sepsis by restoring reduced orexin levels in cerebrospinal fluid (CSF). Here, we report that CSF orexin levels were reduced in a 63-year-old woman with sepsis. The patient presented with coma, fever, headache, vomiting, and seizures upon arrival at the emergency room. She had a history of subarachnoid hemorrhage which led to the development of hydrocephalus, and as a consequence, a ventriculoperitoneal shunt (VP shunt) tube had been installed to ameliorate the complication. Physical examinations showed dehydration and abnormality of circulation, arterial blood gas analysis showed insufficient oxygenation, blood tests showed an inflammatory response, liver injury, kidney injury, hyperkalemia, and hyperglycemia, and radio graphical examinations showed mild hydrocephalus and several old microinfarctions. She was diagnosed with sepsis because her Sequential Organ Failure Assessment (SOFA) score was 13 and Enterococcus faecalis was isolated form her blood and CSF. Status epilepticus, hyperglycemia, and sepsis-associated encephalopathy were considered possible causes of coma. Her CSF could be safely sampled because she had a VP shunt, although it is ethically difficult to sample CSF routinely from patients with sepsis. Reduced CSF orexin levels gradually recovered as she recovered from sepsis. Unexpectedly, orexin was detected in the blood, which is unusual in healthy humans. Blood orexin was not detected after recovery from sepsis. This result may imply that orexin leaks into the blood because of BBB dysfunction. To the best of our knowledge, this is the first report investigating orexin levels in the CSF and blood of a patient with sepsis, and the data obtained from this case may provide a new understanding of the pathophysiology of SAE.
Thymic hyperplasia after lung transplantation imitating posttransplant lymphoproliferative disorder
Authors: Christina Maria Steger, Severin Semsroth, Thomas Hager, Ralf Rieker, Ludwig Müller
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

Thymic hyperplasia is usually associated with the treatment of malignant tumours and is sometimes linked with endocrine diseases. For the first time, we report a case of thymic hyperplasia in a patient 2 years after bilateral lung transplantation. Contrast-enhanced chest CT scan was highly suspicious for a posttransplant lymphoma or thymoma. Therefore, the patient received total thymectomy. Excised specimens were sent to the Department of Pathology. Unexpectedly, the histological examination revealed hyperplastic thymic tissue without evidence for a posttransplant lymphoproliferative disorder or malignancy.
Inappropriate asystole detection in early postoperative phase after loop recorder implantation
Authors: Miriam Bortnik, Eraldo Occhetta, Andrea Magnani, Anna Degiovanni, Paolo Marino
Journal: ISRN Cardiol (2011)
MeSH terms: Case Reports

The implantable loop recorder is a useful diagnostic tool for patients with unexplained syncope. The capability to automatically detect and store arrhythmic events, implemented in the last generations of these devices, can further improve the diagnostic yield, but this feature can be compromised by inappropriate detection of false arrhythmias. We herein report the case of a patient in which several inappropriate activations of long-lasting asystole occurred in the two days following the implant, probably because of an intermittently loose contact between the device and subcutaneous tissue for a small pocket haematoma.
A rare case of huge maxillary ameloblastoma in a 3.5 years old girl
Authors: Mohamed El Sayed, Mohamed Touny, Nesreen Ibrahim, Zainab Al-Azzawi
Journal: Int J Surg Case Rep (2020)
Keywords: amelobalstoma, buccal pad of fat, case report, child, maxilla
MeSH terms: Case Reports

Ameloblastoma is a benign locally invasive odontogenic tumor. It is the most common odontogenic tumor [1]. Usually, in the middle-aged population, it is more common in the mandible with about 5-20% occurring in the maxilla. We report a case of maxillary unicystic ameloblastoma in a 3.5-year-old girl. Which presented clinically as a large facial swelling causing severe facial deformation and pressure symptoms on the left eye. CT scan showed that the swelling extended to involve the orbital floor. The lesion was diagnosed and confirmed by incisional biopsy then was successfully managed by maxillectomy and immediate reconstruction using the buccal pad of fat. One year follow up with no further complaints and no recurrence was observed. "Written informed consent was obtained from the patient guardians for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request".
Presumptive Acute Neural Toxoplasmosis in a Captive Red-Necked Wallaby (Macropus rufogriseus)
Authors: Carlos Hermosilla, Nikola Pantchev, Nicole Gies, Anja Taubert
Journal: Vet Med Int (2010)
MeSH terms: Case Reports

A red-necked male wallaby (Macropus rufogriseus) from a German zoo was presented for acute onset of severe neurological signs, including head tremor, lethargy, unresponsiveness, and weakness. Serum biochemical abnormalities included increased LDH- and AST-levels, hyperproteinaemia, and reduced ALT-, ALP-, and creatinine-levels. The wallaby was found serologically positive for Toxoplasma gondii by the indirect haemagglutination test. After initiation of therapy by subcutaneous injections of trimethoprim/sulfadoxin, amelioration of neurological signs was noted and after 10 days the affected wallaby recovered. T. gondii can be confirmed rapidly by serology, and immediate therapy may reduce clinical illness and fatality of the disease within captive macropods.
Dentinal dysplasia type I: a case report with a 6-year followup
Authors: Sezin Ozer, Bora Ozden, Feyza Otan Ozden, Kaan Gunduz
Journal: Case Rep Dent (2013)

Introduction. Dentin dysplasia is a rare disturbance of dentin formation characterized by normal enamel but atypical dentin formation with abnormal pulpal morphology that is inherited as an autosomal pulpal morphology. Case Presentation. A 7-year-old female who had problems in chewing function was referred to Oral and Maxillofacial Surgery Department at the Faculty of Dentistry in Ondokuz Mayıs University. In the radiographic examination, it was determined that some of the unerupted permanent teeth of the patient had short, blunted, and malformed roots with obliterated pulp chambers, although the bone below the teeth showed well-defined margins. This unusual case of generalized short roots presents a case demonstrating both classic and atypical features of dentinal dysplasia type I (DDI) in the mixed and permanent dentitions. Conclusion. There are still many issues in the diagnosis and management of patients with dentin dysplasia. Early diagnosis, clinical and radiographic findings, as well as treatment of this condition and the initiation of effective preventive strategies may help prevent or delay loss of dentition.
An unusual presentation of pleomorphic adenoma in a patient with thalassemia: A case report
Authors: Abdelrahman R Alsaleh, Adham A Aljariri, Baraa A Wazwaz, Hasan A Haider, Waheed Rahman, Abdulqadir J Nashwan
Journal: Int J Surg Case Rep (2020)
Keywords: infratemporal fossa, parapharyngeal abscess, pleomorphic adenoma, spontaneous infarction, surgery, thalassemia
MeSH terms: Case Reports

We report the first case of spontaneous infarction occurring in pleomorphic adenoma located in infratemporal fossa mimicking parapharyngeal abscess, including clinical presentation, workups, and surgical approach. The final diagnosis was confirmed on a histological basis. The combination of CT scan and MRI might be helpful in distinguishing neoplasia from abscess collection in this area. Surgical intervention is the treatment of choice.
Sentinel node biopsy as an adjunct to limb salvage surgery for epithelioid sarcoma of the hand
Authors: Alex Seal, Raymond Tse, Bret Wehrli, Alex Hammond, Claire L F Temple
Journal: World J Surg Oncol (2005)

Background:
Epithelioid sarcomas of the hand are rare, high-grade tumors with a propensity for regional lymphatic spread approaching 40%.
Case presentation:
A 54-year-old male with an epithelioid sarcoma of the palm was treated with neoadjuvant radiation, wide excision, and two-stage reconstruction. Sentinel lymph node biopsy was used to stage the patient's axilla. Sentinel node biopsy results were negative. The patient has remained free of local, regional and distant disease for the follow-up time of 16 months.
Conclusion:
The rarity of this tumor makes definitive conclusions difficult but SLN biopsy appears to be a useful adjunct in the treatment of these sarcomas.
A framework for the objective assessment of registration accuracy
Authors: Francesca Pizzorni Ferrarese, Flavio Simonetti, Roberto Israel Foroni, Gloria Menegaz
Journal: Int J Biomed Imaging (2014)

Validation and accuracy assessment are the main bottlenecks preventing the adoption of image processing algorithms in the clinical practice. In the classical approach, a posteriori analysis is performed through objective metrics. In this work, a different approach based on Petri nets is proposed. The basic idea consists in predicting the accuracy of a given pipeline based on the identification and characterization of the sources of inaccuracy. The concept is demonstrated on a case study: intrasubject rigid and affine registration of magnetic resonance images. Both synthetic and real data are considered. While synthetic data allow the benchmarking of the performance with respect to the ground truth, real data enable to assess the robustness of the methodology in real contexts as well as to determine the suitability of the use of synthetic data in the training phase. Results revealed a higher correlation and a lower dispersion among the metrics for simulated data, while the opposite trend was observed for pathologic ones. Results show that the proposed model not only provides a good prediction performance but also leads to the optimization of the end-to-end chain in terms of accuracy and robustness, setting the ground for its generalization to different and more complex scenarios.
Primary systemic amyloidosis: imaging interpretation of this complex multisystemic disease
Authors: Indu Mitra, Ken Tung
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

This report highlights the diagnostic complexities involved in the case of a 63-year-old female who presented with a non-productive cough and shortness of breath on exertion. Initial chest radiograph demonstrated generalized abnormal interstitial lung markings with thickened peripheral septal lines. Further characterization was sought by CT scan of the chest, and given the possibility of lymphangitic carcinomatosis, a CT scan of the abdomen and pelvis was also performed. The CT scan findings revealed septal line thickening, abnormal omental soft tissue with calcified deposits and wall thickening of the stomach and proximal duodenum. A preliminary differential diagnosis of peritoneal carcinomatosis was made, but cancer markers were equivocal. A CT-guided biopsy of the "omental cake" was non-diagnostic, hence formal biopsy via laparoscopy was undertaken. While awaiting the results, the patient was readmitted with acute haematemesis. Gastric and duodenal biopsies from the endoscopic assessment were positive for Congo red stain and birefringent under polarizsed light, which was consistent with amyloidosis. Histology from the omental biopsies and additional haematological tests concurred. The patient was diagnosed with advanced systemic amyloid light-chain amyloidosis comprising diffuse pulmonary amyloidosis, calcified omental soft tissue deposits, and extensive soft tissue amyloid with cardiac and gastrointestinal involvement. We discuss the spectrum of differential diagnoses posed by the imaging findings and the difficulties faced in interpreting this complex case of systemic amyloidosis.
Porto-mesenteric vein thrombosis following laparoscopic sleeve gastrectomy for morbid obesity: Case series and literature review
Authors: Naif A Alenazi, Khaled S Ahmad, Mohamed S Essa, Mahir S Alrushdan, Abdulbaset M Al-Shoaibi
Journal: Int J Surg Case Rep (2019)
Keywords: case series, laparoscopic sleeve gastrectomy, porto-mesenteric vein thrombosis

Background:
Portal vein thrombosis is a rare and a potentially lethal complication of Laparoscopic sleeve gastrectomy. In this series, we describe the presentation, treatment, and outcome of 5 cases of PMVT post-laparoscopic sleeve gastrectomy (LSG) treated successfully at our hospital.
Case report:
Five patients presented to our emergency department with diffuse abdominal pain associated with anorexia, nausea and vomiting after laparoscopic sleeve gastrectomy (LSG). Computed tomography (CT) scan showed evidence of portal, mesenteric and splenic vein thrombosis and small bowel ischemia in three patients. Two patients were treated only with anticoagulant and the other three patients were treated with surgery in the form of diagnostic laparoscopy converted to laparotomy with Small bowel resection.
Conclusion:
Portal and mesenteric venous thrombosis after laparoscopic sleeve gastrectomy is an unusual complication but it has life threatening consequences if it is not diagnosed early and treated adequately. The patients with porto-mesenteric venous thrombosis (PMVT) usually present themselves with vague abdominal symptoms. As so, the physicians should have high index of suspicion to recommend computed tomography (CT) abdomen to confirm diagnosis and start adequate treatment.
Maintaining Oxygenation Successfully with High Flow Nasal Cannula during Diagnostic Bronchoscopy on a Postoperative Lung Transplant Patient in the Intensive Care
Authors: Sara Diab, John F Fraser
Journal: Case Rep Crit Care (2014)

Bronchoscopy is an important diagnostic and therapeutic intervention for a variety of patients displaying pulmonary pathology. The heterogeneity of the patients undergoing bronchoscopy affords a challenge for providing minimal and safe respiratory support during anesthesia. Currently, options are intubation and general anesthesia versus frequently inadequate sedation or local anaesthesia with low flow oxygen through nasal prongs or mouthpiece. The advent of high flow nasal cannula allows the clinician to have a "middle man" that allows high flow oxygen delivery as well as a degree of respiratory support, which in some cases has been noted to be between 3 and 4 cm of continuous positive airway pressure-like effect. There are minimal data analyzing the use of high flow nasal cannula during anesthesia for bronchoscopy. We present a case report of orthotropic lung transplant recipient undergoing diagnostic bronchoscopy whilst being supported with high flow nasal oxygen in the intensive care unit.
Urothelial Carcinoma Recurrence in an Orthotopic Neobladder without Urethral or Upper Urinary Tract Involvement
Authors: Chirag P Doshi, Guliz A Barkan, Marcus L Quek
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

We describe a case of a 71-year-old male with an isolated recurrence of urothelial carcinoma in an ileal neobladder without involvement of the upper urinary tract or urethra. He was diagnosed with high grade urothelial carcinoma involving a bladder diverticulum with associated carcinoma in situ. He underwent a radical cystectomy and orthotopic Studer ileal neobladder. On routine follow-up, 11 years following cystectomy, voided urine cytology was positive for high grade urothelial carcinoma. Further workup revealed normal upper urinary tracts, normal urethra, and a solitary lesion at the left anteroinferior wall of the neobladder. He subsequently underwent resection of the neobladder and conversion to an ileal conduit with pathology confirming the diagnosis of high grade urothelial carcinoma. Isolated recurrence of urothelial carcinoma within a neobladder without involvement of the upper urinary tract or urethra is rare. No guidelines exist regarding its management. Herein we present our management as well as the current literature published on this topic.
Calculating the peak skin dose resulting from fluoroscopically-guided interventions. Part II: case studies
Authors: A Kyle Jones, Alexander S Pasciak
Journal: J Appl Clin Med Phys (2012)
MeSH terms: Fluoroscopy / methods, Models, Biological, Radiometry / methods, Skin Physiological Phenomena / radiation effects, Surgery, Computer-Assisted / methods, Computer Simulation, Humans, Radiation Dosage

Part II of this review article presents four case studies for which peak skin doses are calculated following the methods outlined in Part I of this review. The data available in the cases ranges from proprietary dose reports to fluoroscopy time and number of digital acquisition frames only. Flowcharts are provided for each case. These flowcharts outline the calculation steps and data sources used to estimate the peak skin dose. The accuracy that can be achieved using these methods depends on several factors, including the calibration accuracy of dosimetric equipment, accuracy of information reported in the DICOM header and proprietary dose reports, accuracy of quantities measured by the medical physicist, and procedural factors such as rotation of the C-arm during a fluoroscopically-guided procedure.
Community-Acquired Moraxella catarrhalis Bacteremic Pneumonia: Two Case Reports and Review of the Literature
Authors: Miguel Angel Ariza-Prota, Ana Pando-Sandoval, Marta García-Clemente, David Fole-Vázquez, Pere Casan
Journal: Case Rep Pulmonol (2016)

Moraxella (formerly Branhamella) catarrhalis was discovered at the end of the nineteenth century, and for many decades it was considered to be a harmless commensal of the upper respiratory tract. It is a Gram-negative, aerobic diplococcus considered to be the third most common pathogen isolated in childhood sinusitis and otitis media and in adult chronic lower respiratory disease, as well as an etiological agent of pneumonia in immunosuppressed patients or those with chronic obstructive pulmonary disease. Moraxella catarrhalis pneumonia is rarely associated with bacteremia. Here, we present two cases of community-acquired Moraxella catarrhalis bacteremic pneumonia.
Papillary thyroid cancer located in malignant struma ovarii with omentum metastasis: a case report and review of the literature
Authors: Yi Zhu, Chang Wang, Guo-Nan Zhang, Yu Shi, Shi-Qiang Xu, Shi-Jun Jia, Rong He
Journal: World J Surg Oncol (2016)
MeSH terms: Carcinoma / secondary, Omentum, Ovarian Neoplasms / pathology, Peritoneal Neoplasms / secondary, Struma Ovarii / secondary, Thyroid Neoplasms / secondary, Case Reports, Review, Adult, Carcinoma / diagnosis, Carcinoma, Papillary, Female, Humans, Peritoneal Neoplasms / diagnosis, Struma Ovarii / diagnosis, Thyroid Cancer, Papillary, Thyroid Neoplasms / diagnosis

Background:
The present of malignant transformation in struma ovarii is exceedingly rare. Malignant struma ovarii is usually asymptomatic and infrequently diagnosed preoperatively. Because of its rarity, there is no consensus about diagnosis and management in the literature.
Case presentation:
A 40-year-old female presented for her obstetric examination with an incidental finding of a pelvic mass. Patient was asymptomatic at presentation. A follow-up ultrasound confirmed the presence of a 3-cm mass in the left adnexa. Patient underwent a cytoreductive surgery (hysterectomy, bilateral salpingectomy and oophorectomy, omentectomy, appendectomy, and pelvic lymphadenectomy). Histopathology revealed a malignant struma ovarii with a focus of papillary thyroid carcinoma and the omentum metastasis. The patient with stage FIGO IIIc received 6 cycles of paclitaxel/carboplatin regimen after surgery. The patient subsequently had a thyroid scan that was normal with normal thyroid function. At a follow-up of 12 months, she is alive, in good clinical condition, and disease-free.
Conclusions:
Because of the rarity of these tumors and their lack of firm prognostic factors, treatment decisions should be made individually, based on pathologic and clinical parameters.