OpenMed/multicare-articles huggingface dataset:
Case Report: Trigeminocardiac Reflex in Endovascular Recanalization of Intracranial Internal Carotid Artery Occlusion
Authors: Hecheng Ren, Yubo Wang, Bin Luo, Lin Ma, Yuxiang Ma, Long Yin, Ying Huang
Journal: Front Neurol (2022)
Keywords: endovascular recanalization, internal carotid artery occlusion, interventional complications, ischemic stroke, trigeminocardiac reflex
MeSH terms: Case Reports

Background:
The trigeminocardiac reflex (TCR) is a unique brainstem reflex that manifests as sudden negative hemodynamic changes. Although rare, TCR may develop during interventional neuroradiology procedures. Intracranial internal carotid artery occlusion (ICAO) is a cause or risk factor of ischemic stroke. Endovascular recanalization is an effective treatment for intracranial ICAO. The occurrence of TCR during the endovascular treatment of intracranial ICAO has not been reported previously.
Methods:
We identified and reviewed four intracranial ICAO cases who suffered a sudden negative hemodynamic change during endovascular therapy at our hospital between March 2019 and December 2020.
Results:
There were five sudden heart rate and/or blood pressure drops in the four cases; all occurred just after contrast agents were injected. Some angioarchitectural characteristics were common among the four cases. First, the intracranial internal carotid artery distal to the ophthalmic artery was occluded, leaving the ophthalmic artery as the only outflow tract. Second, there were obstructive factors proximal to the end of the guiding catheter, including a vasospasm or dilated balloon. This type of angioarchitecture with a limited outflow tract creates a "blind alley." The five negative hemodynamic events all recovered: two spontaneously and three after drug administration. Postoperatively, two of the four patients developed ocular symptoms.
Conclusions:
Intracranial ICAOs may produce a distinctive angioarchitecture, such as a blind alley, that predisposes patients to TCR. Surgeons should pay special attention to the possibility of TCR during the endovascular recanalization of intracranial ICAO. Low-pressure contrast injections should be attempted, and anticholinergics should be ready for use.
Continuous ambulatory peritoneal dialysis (CAPD) in children: a successful case for a bright future in a developing country
Authors: Younoussa Keita, Aliou Abdoulaye Ndongo, Cathérine Bebey Engome, Ndeye Fatou Sow, Ndiogou Seck, Lamine Thiam, Papa Malick Diouf, Ahmed Tall Lemrabott, Idrissa Basse, Abdou Niang, Saoussen Krid, Claude Moreira, Remi Salomon, Boucar Diouf, Assane Sylla, Ousmane Ndiaye
Journal: Pan Afr Med J (2019)
Keywords: peritoneal dialysis, senegal, child, developing countries
MeSH terms: Hemodialysis, Home / methods, Peritoneal Dialysis, Continuous Ambulatory / methods, Renal Insufficiency, Chronic / therapy, Case Reports, Adolescent, Developing Countries, Dialysis Solutions / chemistry, Humans, Icodextrin / chemistry, Male, Renal Dialysis, Senegal, Dialysis Solutions, Icodextrin

The authors report the first case of successful peritoneal dialysis (PD) in a developing country performed about a 13-year-old adolescent followed-up for stage V chronic kidney disease (CKD) with anuria. After 3 months of hemodialysis, the parents opted for continuous ambulatory peritoneal dialysis (CAPD) as they wished to return home located 121km from Dakar. After PD catheter insertion, the plan proposed to the patient consisted 3-4 hours stasis of isotonic dialysate during the day and a night stasis of 8 hours of icodextrin for an injection volume of 1L per session. The patient and his mother were trained and assessed on the PD technique. After dialysis adequacy was tested while hospitalised, they were able to return home and continued the sessions following the same plan prescribed and while keeping in touch, by telephone, with the medical team. The technique assessment at the day hospital every 2 weeks revealed dialysis adequacy and satisfactory tolerance of PD at home after 04 months of observation. It was the first case of successful CAPD in the pediatrics unit in this context. Scaling this technique is a challenge for the pediatric nephrologist in developing countries like Senegal.
The Rare Benign Lesion That Mimics a Malignant Tumor in Breast Parenchyma: Nodular Fasciitis of the Breast
Authors: Hilal Erinanc, Emin Türk
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

We herein report the clinical and pathological findings of a rare case of nodular fasciitis in the breast parenchyma of a 48-year-old female. Because of potentially malignant findings on ultrasonography and during clinical examination, the patient underwent an excisional biopsy. Histologically, the lesion was composed of spindle to round shaped cells arranged in short bundles in a storiform pattern. Immunohistochemically, the cells were positive for vimentin and SMA and negative for desmin, S100, and CD34. Based on these morphological and immunohistochemical features, a diagnosis of nodular fasciitis was made. We emphasize that nodular fasciitis of the breast may show clinical features and imaging findings similar to those of breast cancer. The histopathologic diagnosis of nodular fasciitis can also be challenging. The purpose of this case report is to highlight the characteristics and the differential diagnosis of this rare neoplasm.
Breast lipoma with central fat necrosis: case report
Authors: Mohamed Reda Bouroumane, Reda Khalil, Hind Khalil, Hicham Jalal
Journal: Pan Afr Med J (2016)
Keywords: fat necrosis, breast, calcifications, eggshell, lipoma, mammography
MeSH terms: Breast Neoplasms / pathology, Fat Necrosis / pathology, Lipoma / pathology, Case Reports, Adipose Tissue / diagnostic imaging, Adipose Tissue / pathology, Adult, Breast Neoplasms / diagnostic imaging, Fat Necrosis / diagnostic imaging, Female, Humans, Lipoma / diagnostic imaging, Mammography, Wounds and Injuries / complications

Fat necrosis of the breast is a benign non-suppurative inflammatory process of adipose tissue that most commonly occurs as the result of minor breast trauma. We present a case of a 40-years-old female with fat necrosis in a breast lipoma. She presented with an overlapping mass on the lateral quadrants. Mammography showed Well delineated radiolucent mass with peripheral "egg-shell" calcifications, that appeared an hypoechoic mass with posterior shadowing on ultrasonography. A history of accidental trauma raises the suspicion of fat necrosis. Pathology is necessary when radiological findings simulate malignancy.
Myelitis due to Coccidioidomycosis in an Immunocompetent Patient
Authors: Tetyana Vaysman, Sean Villaflores, Carlyn Estrella, Suman Radhakrishna, Antonio Liu
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Myelitis of the spinal cord is an uncommon presentation of disseminated coccidioidomycosis. Most infected patients present subclinically, but patients, especially those who are immunocompromised, may progress to disseminated disease. We present a 50-year-old immunocompetent patient with no significant past medical history exhibiting symptoms of altered mental status, dizziness, headache, nausea, and quadriplegia. Upon investigation with lumbar puncture, cerebrospinal fluid (CSF) culture, and coccidioidal antibody studies, the patient was found to have acute coccidioidomycosis. Magnetic resonance imaging (MRI) of the brain demonstrated meningeal enhancements suggestive of meningitis, and further MRI study of the cervical spine revealed myelitis. Treatment with IV fluconazole for 2 weeks and IV voriconazole therapy over 3 weeks yielded limited improvement. The presentation of myelitis due to coccidioidomycosis infection is very rare and has infrequently reported in the literature. Awareness of this potentially fatal complication in immunocompetent patients can aid in faster recognition and treatment.
Chronic lymphocytic leukemia with clinical debut as neurological involvement: a rare phenomenon and the need for better predictive markers
Authors: Cristhiam M Rojas-Hernandez, Jacklyn Nemunaitis, Kristopher D Marjon, Daniel Bustamante, Qian-Yun Zhang, Jennifer M Gillette
Journal: BMC Hematol (2017)
Keywords: cd49d, cd82, central nervous system, leukemia
MeSH terms: Case Reports

Background:
Chronic lymphocytic leukemia (CLL) is the most common leukemia in Western countries. The frequency of symptomatic central nervous system (CNS) involvement is unknown but thought to be a rare phenomenon. Currently there are no known risk factors for CNS involvement.
Case presentation:
We describe a clinically staged low-risk CLL case that presented with symptomatic CNS involvement and progressed rapidly to death. Evaluation of the surface adhesion molecules identified a markedly altered expression pattern of the integrin, CD49d, and the tetraspanin, CD82, in the index case when compared to similar low-risk CLL cases. We found that the early Rai clinical stage CLL patients showed linear correlation for the co-expression of CD82 and CD49d. In contrast, this unique index case with CNS involvement, which has the same Rai clinical stage, had a significantly lower expression of CD82 and higher expression of CD49d.
Conclusions:
These data suggest that the expression profile of CD49d and CD82 may represent potential biomarkers for patients with increased propensity of CNS involvement. Moreover, this study illustrates the critical need for a better mechanistic understanding of how specific adhesion proteins regulate the interactions between CLL cells and various tissue sites.
A Heterozygous Novel Mutation in TFAP2A Gene Causes Atypical Branchio-Oculo-Facial Syndrome With Isolated Coloboma of Choroid: A Case Report
Authors: Jie Min, Bing Mao, Yong Wang, Xuelian He, Shuyang Gao, Hairong Wang
Journal: Front Pediatr (2020)
Keywords: tfap2a gene, branchio-oculo-facial syndrome, coloboma of choroid, genotype-phenotype, next-generation sequencing
MeSH terms: Case Reports

Background: Branchio-oculo-facial syndrome (BOFS) is a rare congenital developmental disorder with highly variable clinical phenotypes in autosomal dominant inheritance. The aim of this study is to identify disease-causing mutations in a Chinese family with predominant coloboma of choroid. Case report: We described a family (a mother and her daughter) with unclear clinical diagnosis. The mother (proband) presented with bilateral coloboma of choroid, whereas her daughter had a relatively severe phenotype and presented with larger bilateral choroid coloboma and high-vaulted arch. We applied the next generation sequencing (NGS) panel and analyzed 776 genes related to inherited ocular disorders on the proband. Four candidate heterozygous variants in four genes, respectively, were detected in the proband. Validation of these variants were subsequently performed in the family using Sanger sequencing. Among these variants, a novel nonsense mutation c.912C>A, p.(Cys304*) (NM_001042425.2) which in exon 6 of the conserved helix-span-helix domain in TFAP2A results in a premature termination codon. It may trigger nonsense-mediated mRNA decay (NMD). Both the affected mother and daughter had this variant, whereas it was absent in the asymptomatic father. Together with the silicon tools and clinical features, we concluded that the variant c.912C>A, p.(Cys304*), was the second reported nonsense mutation in TFAP2A gene, which was the disease-causing mutation of the family. Conclusion: There are many hereditary diseases accompanied by ocular anomalies. For instance, BOFS, patients with atypical features are always at risk of being under-diagnosed. NGS is a powerful method to identify the genetic cause and improve genetic counseling for less clarified hereditary ocular diseases.
Case Report: Changes in Regional Cerebral Blood Flow in Chronic Akathisia of a Depressed Patient Before and After Electroconvulsive Therapy Treatment
Authors: Akihito Suzuki, Ryota Kobayashi, Toshinori Shirata, Hitomi Komoriya, Masafumi Kanoto, Koichi Otani
Journal: Front Psychiatry (2021)
Keywords: spect, chronic akathisia, depressive disorder, electroconvulsive therapy (ect), regional cerebral blood flow
MeSH terms: Case Reports

Akathisia, which characterized by subjective restlessness and objective hyperactivity, is induced mostly by antipsychotics and antidepressants. Chronic akathisia is defined as persistence of symptoms for more than 3 months. The pathophysiology of chronic akathisia remains unclear. This report describes a depressed patient, a 66-year-old woman with a diagnosis of major depressive disorder, with chronic akathisia. Her regional cerebral blood flow (rCBF) was measured using single photon emission computed tomography (SPECT) before and after the treatment with electroconvulsive therapy (ECT). She had experienced akathisia-like symptoms three times prior because of risperidone, escitalopram, and clomipramine administration, accompanied by major depression. After levomepromazine was added to quetiapine to treat insomnia, she developed akathisia symptoms such as a sense of restlessness and inability to sit in one place for a few minutes. These antipsychotics were withdrawn. Propranolol was administered, leading to no apparent improvement for 8 months. After she was diagnosed as having major depressive disorder and chronic akathisia, she received 10 sessions of bilateral ECT. Her depressive symptoms improved greatly. Akathisia disappeared completely after ECT. SPECT revealed that rCBF was decreased in the middle frontal gyrus and parietal lobe, that it was increased in the thalamus, fusiform gyrus, and cerebellum before ECT, and that these abnormalities in rCBF were approaching normal levels after ECT. Findings presented in this report suggest ECT as a beneficial treatment for chronic akathisia. Altered rCBF in the middle frontal gyrus, parietal lobe, thalamus, fusiform gyrus, and cerebellum, and especially decreased rCBF in the parietal lobe, may be related to the pathophysiology of chronic akathisia.
Intravascular Lithotripsy for Underexpanded Stent in Heavily Calcified Coronary Artery Disease
Authors: Tejas Raxwal, Cauvery Balhara, Dipak Parekh
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Objective:
Can intravascular lithotripsy safely modify calcium in an underexpanded stent and result in optimal expansion and improved outcome? Coronary artery calcification results in difficulty with stent delivery and expansion and is associated with adverse outcomes. Intravascular lithotripsy (IVL) by delivering acoustic pressure waves modifies calcium plaque that improve vessel compliance resulting in optimizing stent deployment.
Results:
A 63-year-old patient presented with acute coronary syndrome with symptoms of unstable angina who underwent angiography that showed calcified right coronary artery which was treated with balloon angioplasty and stenting with drug eluting stent. However, after multiple inflations with noncompliant balloon, the patient was noted to have persistent residual in stent stenosis of 70%. Stenotic lesion in poorly expanded stent was treated with Shockwave C2 Coronary Intravascular Lithotripsy catheter resulting in 0% residual stenosis. The patient was followed for major adverse cardiovascular events at 30 days and 12 months. The patient remained MACE free at 30 days and 12 months.
Conclusions:
Coronary IVL safely and effectively facilitated stent expansion in severely calcified lesion in a poorly expanded stent with MACE free at 12-month follow-up.
Diffuse Alveolar Hemorrhage Associated with Warfarin Therapy
Authors: Bülent Kaya, Ibrahim Yildiz, Reshat Mehmet Baha, Neslihan Ebru Eryaşar Zeytun, Azize Yetisgen
Journal: Case Rep Med (2015)

Diffuse alveolar hemorrhage (DAH) is a life-threatening clinical pathologic syndrome caused by a variety of diseases. We report a case of DAH related to therapy of warfarin use. In this case report, we present the diffuse alveolar hemorrhage case as a rare and life-threatening complication of warfarin.
Acute Streptococcus mitis Sacroiliitis in a Teenager with Unclear Source of Bacteremia: A Case Report and Literature Review
Authors: Fatma Al-Farsi, Ibrahim Al-Busaidi, Khalfan Al-Zeedi
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Septic arthritis is an orthopedic emergency that is commonly caused by Staphylococcus aureus. Old age, diabetes mellitus, rheumatoid arthritis, prosthetic joint, and recent surgery are the main predisposing risk factors. Most cases of septic arthritis are caused by hematogenous spread of infection. Infectious sacroiliitis is a rare form of septic arthritis which is often clinically challenging to diagnose due its various and nonspecific presentations. Streptococcus mitis belongs to viridans group streptococci (VGS) bacteria, which is a component of body flora that is commonly involved in bacterial endocarditis. VGS in general and S. mitis specifically is an uncommon cause of osteoarticular infections. Here, we report a case of spontaneous Streptococcus mitis bacteremia complicated by septic sacroiliitis in a healthy teenager in the absence of infective endocarditis or a clear source of bacteremia.
External Oblique Muscle Schwannoma: A Rare Anatomical Presentation
Authors: Daniel Paramythiotis, Diamantoula Pagkou, Moysis Moysidis, Niki Mantha, Angeliki Cheva, Antonios Michalopoulos
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Introduction:
Schwannomas or neurilemmomas are rare, benign, and usually solitary lesions that arise from the nerve sheath. In the majority of cases, these tumors involve the extremities, head, neck, and trunk.
Case presentation:
In the present study, a 52-year-old man presented to our surgical department for the evaluation of a symptomatic lump in his left lateral abdominal wall. CT and MRI confirmed the presence of a cystic mass located between the external and internal oblique muscles. Histopathology and immunohistochemistry confirmed it to be benign schwannoma.
Discussion:
Schwannomas have rarely been reported in the abdominal wall. To the best of our knowledge, this is the first case of schwannoma located in the left upper abdominal wall and the fifth case of abdominal wall schwannoma reported according to the reviewed medical literature.
Conclusion:
Benign schwannoma should be included in the differential diagnosis of cystic and symptomatic lesions of the abdominal wall. The treatment of choice is surgical excision, and recurrence is extremely rare.
Further Evidence That the CFTR Variant c.2620-6T>C Is Benign
Authors: Violet I Wallerstein, Robert Wallerstein
Journal: Case Rep Genet (2017)
MeSH terms: Case Reports

The c.2620-6T>C variant in the CFTR gene is a rare variant about which little is known. We present an asymptomatic adult who has this variant as well as the well described delta F508 pathogenic variant in transpresentation. This patient provides additional evidence that this is a benign polymorphism.
How geoarchaeology and landscape archaeology contribute to niche construction theory (NCT)
Authors: Sjoerd J Kluiving
Journal: Water Hist (2015)
Keywords: anthropocene, geoarchaeology, landscape archaeology, landscape gradients, niche-construction theory (nct)

In this paper a review is given of examples of geoarchaeological and landscape archaeological research from four locations throughout Europe. Case-studies from the North Sea coastal zone in the Netherlands and the Eastern Mediterranean are presented to illustrate the potential contribution of geoarchaeology and landscape archaeology to niche construction theory (NCT) studies. Typical landscapes as coast lines, lake shores and rivers as example of small and large scale use of the natural landscape and/or topography are discussed with implications for NCT, mainly over the Holocene period. Through environmental reconstruction, we provide relative dates for starting points when humans (a) were altering their own selective environment as an inceptive change, or (b) responded to a (deteriorated) selective environment in a counteractive change. Geoarchaeology and landscape archaeology valuable contribution to NCT studies is the focus of the disciplines on landscape gradients. NCT phase transitions from inceptive to counteractive changes are proposed as useful alternative in the debate about the onset of the Anthropocene.
Metronomic capecitabine in patients with hepatocellular carcinoma unresponsive to or ineligible for sorafenib treatment: report of two cases
Authors: Sara Marinelli, Alessandro Granito, Fabio Piscaglia, Matteo Renzulli, Angela Stagni, Luigi Bolondi
Journal: Hepat Mon (2013)
Keywords: capecitabine, hepatocellular carcinoma, sorafenib
MeSH terms: Case Reports

Introduction:
Sorafenib, an oral multikinase inhibitor, is the only systemic agent proven to be effective in patients with hepatocellular carcinoma (HCC). There are no approved second line systemic therapies in patients who have had disease progression on or are not eligible to sorafenib.
Case presentation:
We describe two cases of unresectable HCC that were treated with low, "metronomic" doses of capecitabine. In the first patient, capecitabine was used after sorafenib failure. In the second case, treatment with capecitabine was attempted since the patient was considered not eligible for sorafenib due to spontaneous hepatic bleeding of a large HCC lesion. Treatment was effective and well tolerated in both patients with long-lasting objective responses.
Conclusions:
Lacking established second-line therapy, metronomic capecitabine may be a valid alternative in the treatment of HCC patients who are judged not eligible for sorafenib or those having progression disease on sorafenib.
Artemether/Lumefantrine for the Treatment of P. malariae in a Patient on Hemodialysis
Authors: Rita Patrocínio-Jesus, João Cunha, Diva Trigo, Bárbara Flor-de-Lima, Patrícia Pacheco
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

The combination of artemether/lumefantrine is indicated for the treatment of acute uncomplicated Plasmodium falciparum malaria. There have been no clinical trials to assess the efficacy of this medication in patients with renal impairment. While it is unlikely that artemether/lumefantrine would be removed during dialysis, clinical experience regarding drug use in this setting is limited. In this article, the authors report successful treatment of Plasmodium malariae malaria on a patient with end-stage kidney disease undergoing hemodialysis.
Clinical Features and Neurosurgical Management of Metastatic Intradural Extramedullary Renal Cell Carcinoma
Authors: Omron Hassan, Kelly Gassie, Anshit Goyal, Stephanie Foskey, Kingsley Abode-Iyamah
Journal: Cureus (2023)
Keywords: back pain, intradural extramedullary spine tumors, metastases, myelopathy, renal cell carcinoma, spinal cord
MeSH terms: Case Reports

Intradural extramedullary metastasis of renal cell carcinoma is exceedingly uncommon, and only 19 cases have been reported in the literature. It is thought to metastasize from the kidneys through venous networks or along nerves and may also spread from brain metastases through cerebrospinal fluid. We present a 52-year-old female, two years after a nephrectomy with myelopathic symptoms, who was found to have thoracic intradural extramedullary metastasis from renal cell carcinoma. The thoracic tumor was resected without any added deficit, but an additional brain mass was found on postoperative imaging. The present case and a literature review were discussed to explore considerations for neurosurgical intervention in similar patients, evaluate surgical outcomes, and highlight current theories on routes of metastasis. Given the risk of neurological decline in patients with metastatic intradural renal cell carcinoma, surgical resection should be considered upon its discovery, and postoperative surveillance imaging is encouraged.