OpenMed/multicare-articles huggingface dataset:
Epithelial Predominant Wilms Tumor in an Adult Patient: Case Report and Literature Review
Authors: Sofia Chapman, Benjamin Lichtbroun, Hiren Patel, Sai Krishnaraya Doppalapudi, Hatim Thaker, Colton Smith, Cristo Guardado Salazar, Scott Moerdler, Saum Ghodoussipour
Journal: J Kidney Cancer VHL (2024)
Keywords: jeune syndrome, wilms tumor, congenital anomalies, epithelial predominant, renal tumor
MeSH terms: Case Reports

Although rare in adults, Wilms tumor is the most common pediatric renal tumor. Treatment typically involves radical nephrectomy followed by adjuvant chemotherapy or radiation, although outcomes differ between children and adults which may be due to challenges in accurately diagnosing these patients. In this article, we present a case report of an adult patient with Jeune syndrome and multiple urologic abnormalities who underwent radical nephrectomy for a large renal mass and was subsequently diagnosed with an epithelial predominant Wilms tumor. Epithelial predominant Wilms tumor may have distinct origins from other Wilms tumor histological subtypes and may incur better outcomes. Herein, we discuss the literature surrounding this rare entity as well as the anticipated treatment course.
Case report: A lung squamous cell carcinoma patient with a rare EGFR G719X mutation and high PD-L1 expression showed a good response to anti- PD1 therapy
Authors: Zhen-Feng Zhu, Xu-Xia Bao, Hong-Yan Shi, Xi-Xi Gu
Journal: Front Oncol (2024)
Keywords: egfr g719x mutation, afatinib, anti-pd1 therapy, inflammatory microenvironment, lung squamous cell carcinoma
MeSH terms: Case Reports

Lung cancer treatment has transitioned fully into the era of immunotherapy, yielding substantial improvements in survival rate for patients with advanced non-small cell lung cancer (NSCLC). In this report, we present a case featuring a rare epidermal growth factor receptor (EGFR) mutation accompanied by high programmed death-ligand 1 (PD-L1) expression, demonstrating remarkable therapeutic efficacy through a combination of immunotherapy and chemotherapy. A 77-year-old male with no family history of cancer suffered from upper abdominal pain for more than half months in August 2020 and was diagnosed with stage IV (cT3N3M1c) lung squamous cell carcinoma (LUSC) harboring both a rare EGFR p.G719C mutation and high expression of PD-L1 (tumor proportion score [TPS] = 90%). Treatment with the second-generation targeted therapy drug Afatinib was initiated on September 25, 2020. However, resistance ensued after 1.5 months of treatment. On November 17, 2020, immunotherapy was combined with chemotherapy (Sintilimab + Albumin-bound paclitaxel + Cisplatin), and a CT scan conducted three months later revealed significant tumor regression with a favorable therapeutic effect. Subsequently, the patient received one year of maintenance therapy with Sintilimab, with follow-up CT scans demonstrating subtle tumor shrinkage (stable disease). This case provides evidence for the feasibility and efficacy of immunotherapy combined with chemotherapy in the treatment of EGFR-mutated and PD-L1 highly expressed LUSC.
Case Report: A rare case of intramedullary spinal cord abscess with brain abscess caused by Klebsiella pneumoniae underwent surgical intervention
Authors: Wenjuan Zhang, Xiangyu Guo, Xuejun Xu, Bing Deng
Journal: Front Surg (2024)
Keywords: klebsiella pneumoniae, brain abscess, case report, intramedullary spinal cord abscess, surgery
MeSH terms: Case Reports

Background:
Intramedullary Spinal Cord Abscess (ISCA) is an uncommon infectious disease of the central nervous system. Since its first report in 1830, there have been very few documented cases associated with it. Here, we present a case of ISCA with cerebral abscess caused by Klebsiella pneumoniae.
Case presentation:
A 55-year-old male patient presented with head and neck pain, fever, and left limb weakness for 5 days. The diagnosis of ISCA with brain abscess caused by Klebsiella pneumoniae was confirmed through sputum culture, cerebrospinal fluid gene test, pus culture, and magnetic resonance imaging (MRI) as well as computerized tomography (CT) scan. The patient had a history of pulmonary tuberculosis and old tuberculous foci were observed in the lung. Initially considering tuberculosis as the cause due to unclear etiology at that time, anti-tuberculosis treatment was administered. However, due to rapid deterioration in the patient's condition and severe neurological dysfunction within a short period of time after admission, surgical intervention including incision and drainage for intramedullary abscess along with removal of brain abscess was performed. Subsequent postoperative follow-up showed improvement in both symptoms and imaging findings.
Conclusion:
Early diagnosis of central nervous system (CNS) abscess coupled with prompt surgical intervention and administration of appropriate antibiotics are crucial factors in preventing disease progression and reducing mortality rates.
Case Report: A case of rapamycin-eluting stent for the treatment of refractory stenosis of arteriovenous fistula stenosis
Authors: Yu Xiong, Bo Tu, Minglu Zhang, Bo Chen, Qiquan Lai, Jing Chen, Ling Chen, Ziming Wan
Journal: Front Cardiovasc Med (2024)
Keywords: arteriovenous fistula, end-stage renal disease, percutaneous transluminal angioplasty, rapamycin-eluting stent, refractory stenosis
MeSH terms: Case Reports

For patients with repeated stenosis of autologous arteriovenous fistula, percutaneous transluminal angioplasty (PTA) or bare metal stent placement had limited efficacy. Rapamycin was reported to inhibit neointimal hyperplasia and keep blood vessels patent. In this study, we reported a case with refractory stenosis, i.e., a short duration of patency maintenance after each repeated PTA, which was treated with a rapamycin-eluting stent (RES). The RES extended the patency duration from 4 to 5 months on average to 14 months. The stent was used to maintain dialysis for over 30 months. RES may be an effective way to treat refractory stenosis and salvage limited vascular resources.
COVID-19-associated neurological sequelae: A case series on cerebral microbleeds and encephalopathy
Authors: Abeer Sabry Safan, Yahia Imam, Mohamad Y Khatib, Mohammad Al Wraidat, Mohammad M Altermanini, Salah A Al-Mughalles, Anood Al-Assaf, Mariam Olish, Moustafa S Elshafei, Abdulqadir J Nashwan
Journal: Qatar Med J (2023)
Keywords: covid-19, sars-cov-2, adult, case series, critical illness microbleeds
MeSH terms: Case Reports

Background:
Critical illness-associated cerebral microbleeds and leukoencephalopathy connected to coronavirus disease 2019 (COVID-19) infection are emerging areas of concern in current medical literature.
Methods:
We reviewed cases of patients with COVID-19-associated neurological manifestations to study the prevalence and outcome of such conditions. Case Series Findings: Our review yielded seven distinct patients. Six exhibited cerebral microbleeds, primarily localized in the juxtacortical white matter and the corpus callosum. In contrast, one individual presented with leukoencephalopathy. Tragically, of these patients, five succumbed to their ailments. One was discharged with mild cognitive impairments, while another underwent a tracheostomy and was subsequently moved to a long-term care establishment.
Conclusion:
Our findings underscore the significance of neuro-radiological observations in those grappling with severe manifestations of COVID-19, drawing attention to the possible neurological repercussions of the virus.
A Novel Deleterious MYO15A Gene Mutation Causes Nonsyndromic Hearing Loss
Authors: Mostafa Neissi, Adnan Issa Al-Badran, Javad Mohammadi-Asl
Journal: Iran J Otorhinolaryngol (2024)
Keywords: hearing loss, myo15a gene, mutation
MeSH terms: Case Reports

Introduction:
Hearing loss (HL) is the most frequent sensory neurodeficiency, affecting a broad spectrum of individuals globally. Within this context, the role of genetic factors takes center stage, particularly in cases of hereditary HL.
Case report:
Here, we present a nonsyndromic HL (NSHL) case report. The patient is a 21-year-old man with progressive HL. The whole-exome sequencing (WES) demonstrated a novel homozygous missense mutation, c.9908A>C; p.Lys3303Thr, in the proband's exon 61 of the MYO15A gene. Further analysis has revealed that the detected mutation is present in a heterozygous state in the parents.
Conclusion:
WES analysis in this study revealed a novel mutation in the MYO15A gene. Our data indicates that the MYO15A-p.Lys3303Thr mutation is the likely pathogenic variant associated with NSHL. Additionally, this finding enhances genetic counseling for individuals with NSHL patients, highlighting the value of the WES method in detecting rare genetic variants.
Neuralgic amyotrophy with multiple hourglass-like constrictions of anterior interosseous nerve: a case report
Authors: Fangling Shi, Xiaoling Zhou, Xueyuan Li
Journal: Front Neurol (2024)
Keywords: parsonage-turner syndrome, brachial neuritis, neuralgic amyotrophy, neurolysis, surgery
MeSH terms: Case Reports

Hourglass-like constrictions (HLCs) of peripheral nerves in the upper extremity were a rare form of neuralgic amyotrophy, often characterized by the sudden onset of pain in the shoulder or arm, followed by muscle weakness and amyotrophy, with limited sensory involvement. We present a case of multiple HLCs of the anterior interosseous nerve (AIN) in a 22-year-old female with left upper arm pain, finger numbness, and limited activity for 1 month. Physical examination showed weakness of the left index flexor digitorum profundus and flexor pollicis longus, with mild hypoesthesia in the first three fingers and the radial half of the ring finger. Electromyography suggested a median nerve (mainly AIN) lesion. Ultrasonographic imaging of the median nerve shows AIN bundle swelling and multiple HLCs at left upper arm. Despite conservative treatment, which included 15 days of steroid pulse therapy, Etoricoxib, and oral mecobalamin, the patient still complained of extreme pain at night without relief of any symptoms. Operation was recommended for this patient with thorough concerns of surgical advantages and disadvantages. During surgery, a total of 7 HLCs were found in her median nerve along and above the elbow joint. Only Interfascicular neurolysis was performed because the nerve constrictions were still in the early stage. The pain was almost relieved the next day. One month after surgery, she could bend her thumb and index fingers, although they were still weak. 4 months after the surgery, she was able to bend affected fingers, with muscle strength M3 level. At the same time, her fingers had fewer numbness symptoms. There was still controversy regarding treatment strategy; however, early diagnosis and surgical treatment for nerve HLCs might be a better choice to promote nerve recovery.
Short-term report of early glaucoma surgery with a clear lens extraction and an intraocular lens, OMNI canaloplasty, and a HYDRUS microstent: a case series in younger patients
Authors: Daniel Laroche, Abelard Desrosiers, Chester Ng
Journal: Front Ophthalmol (Lausanne) (2024)
Keywords: hydrus stent, migs, omni canaloplasty, clear lens extraction, glaucoma

Purpose:
The purpose of this case series is to report the surgical outcomes from the combination of a clear lensectomy, OMNI® canaloplasty, and a HYDRUS® microstent with an adjacent goniotomy.
Methods:
This is a retrospective non-comparative single-center case series of four black patients of African descent with glaucoma who were treated with a clear lensectomy, OMNI canaloplasty, and a HYDRUS microstent with an adjacent goniotomy. The surgeries were performed by an experienced cataract and glaucoma surgeon, Daniel Laroche, MD. The parameters investigated in this study were postoperative intraocular pressure (IOP) and the mean number of preoperative and postoperative medications needed.
Results:
The mean age of the four patients was 44.5 years. All patients had a mean postoperative reduction in IOP of 17 mmHg to 12.7 mmHg. The mean number of preoperative medications was 2.2, while the mean number of postoperative medications was 0.3. Potential complications such as hyphema, IOP spikes, or corneal edema were not seen in this series. All patients achieved a lower IOP and stable vision with less refractive error. Patients also experienced improved visual fields, clearer vision, and more open angles.
Conclusion:
Clear lensectomy and combined microinvasive glaucoma surgery (MIGS) in patients with primary open-angle glaucoma (POAG) and narrow-angle glaucoma (NAG) results in the safe lowering of IOP. The limitations of this study include the small series size and the retrospective potential for bias. Further research with a larger series and a prospective trial with follow-up should be performed.
Alström's Syndrome, Leber's Hereditary Optic Neuropathy, or Retinitis Pigmentosa? A Case of Misdiagnosis
Authors: Palaiologos Alexopoulos, Chrysanthos Symeonidis, Tryfon Rotsos
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

A case of a patient with the Alström syndrome (AS) that was misdiagnosed as Leber's hereditary optic neuropathy or retinitis pigmentosa for 13 years is presented. AS is a rare genetic disorder caused by mutations in the ALMS1 gene. AS may lead to abnormal ciliary formation and function. AS affects metabolism, and symptomatology includes type 2 diabetes mellitus (T2DM), obesity, hypogonadism and gynecomastia in males, progressive bilateral sensorineural hearing loss, cardiomyopathy, nonalcoholic fatty liver disease (NAFLD), cirrhosis, and chronic progressive kidney disease. The onset of the above symptoms may vary significantly. The ophthalmic manifestation is early onset cone-rod dystrophy that starts as progressive vision loss, photophobia, and nystagmus in the first months of life. An accurate diagnosis may enable specialists to facilitate a significantly positive effect in the everyday life of a patient. Genetic counseling may also be recommended for these patients. Diagnosis was confirmed by DNA testing, thus highlighting its necessity in everyday practice.
Unrepaired tetralogy of Fallot in a 58-year-old female: factors contributing to the observed survival (case report)
Authors: Assia Elouardi, Mohammed Messouak
Journal: Pan Afr Med J (2023)
Keywords: tetralogy of fallot, adult congenital heart disease, case report, survival, uncorrected
MeSH terms: Tetralogy of Fallot, Case Reports, Female, Heart Ventricles / diagnostic imaging, Humans, Hypoxia, Middle Aged

Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Less than 3% of all patients with uncorrected TOF reach their 40th year of life. We present the case of a 58-year-old woman female with uncorrected TOF. The main factors contributing to her longevity are the early development of aortopulmonary collaterals channels and the relatively gradual narrowing of the right ventricular outflow tract.
Case report of belt electrode-skeletal muscle electrical stimulation for acute heart failure with severe obesity: a novel therapeutic option for acute phase rehabilitation
Authors: Yuto Mochizuki, Takahiro Jimba, Syota Yasukawa, Aritomo Katsura, Akira Fukuda, Jiro Ando
Journal: Front Cardiovasc Med (2024)
Keywords: b-ses, nmes, cardiac rehabilitation, heart failure, obesity, skeletal muscle
MeSH terms: Case Reports

Background:
Belt electrode skeletal muscle electrical stimulation (B-SES) is an emerging therapy anticipated to yield more favorable outcomes than conventional neuromuscular electrical stimulation (NMES), owing to its larger stimulation area. However, information on its efficacy and safety in patients with heart failure remains limited.
Case presentation:
A 43-year-old man with a body mass index of 41 kg/m2 was admitted to our hospital for acute heart failure due to dilated cardiomyopathy. The patient required prolonged catecholamine support owing to poor cardiac function, and heart transplantation was considered. We initiated a mobilization program, but the patient's mobility was highly limited due to severe obesity and symptomatic orthostatic hypotension. B-SES was introduced to accomplish weight loss and early ambulation. We applied an intensive monitoring program for safe use and modulated the intensity of B-SES according to physical function. During the B-SES program, the patient's body weight decreased from 89.6 kg to 78.6 kg. Sequential evaluations of body composition and skeletal muscle ultrasonography revealed improved muscle mass, quality, and physical function. Furthermore, we explored the workload of B-SES using expiratory gas analysis. No adverse events were observed during B-SES.
Discussion:
We successfully used B-SES to improve muscle function and morbidity in the treatment of acute heart failure. B-SES could be an option for patients with heart failure who have limited mobility and obesity.
Case report: Sclerosing encapsulating peritonitis in a cat with disseminated pancreatic adenocarcinoma of presumed ductal origin
Authors: Chaerin Kim, Sanggu Kim, Jinhyeong Park, Dohee Lee, Yeon Chae, Taesik Yun, Dongwoo Chang, Byeong-Teck Kang, Sungin Lee, Soochong Kim, Hakhyun Kim
Journal: Front Vet Sci (2024)
Keywords: adipose tissue, feline, metastasis, pancreatic tumor, peritonitis
MeSH terms: Case Reports

A 9-year-old, neutered male, domestic short-haired cat was referred for recurrent ascites of unknown etiology over a week. Physical examination revealed abdominal distension and ultrasonography revealed a large volume of ascites throughout the abdominal cavity; this was interpreted as modified transudate. The mesentery and abdominal fat were hyperechoic and edematous. Fat tissue was assessed using fine-needle aspiration cytology, and adipocytes, fat-phagocytizing macrophages, and neutrophils were identified. Computed tomography revealed a pancreatic mass connected to the left pancreatic leg. Exploratory laparoscopy confirmed nodular masses and organ adhesions, leading to a tentative diagnosis of sclerosing encapsulating peritonitis. The cat was administered prednisolone, vitamin E, and tamoxifen but died 22 days after the initial therapy. Necropsy revealed a multi-lobulated pancreatic tumor (10 × 10 cm) tightly attached to the stomach and intestine, with a large amount of ascites. The peritoneum, stomach, intestine, and mesentery were covered with numerous disseminated nodules of various sizes (1-5 mm diameter). Microscopically, the tumor consisted of extensive adipose tissue, locally extensive inflammatory infiltrates, fibrous connective tissue, and small invasive proliferative glands. Well-defined small irregular glands composed of single-layered epithelial cells that appear to be of ductal origin were surrounded by an abundant desmoplastic stroma. Neoplastic nodules were widespread in the liver, stomach, peritoneum, mesentery, mesenteric lymph nodes, lungs, and urinary bladder. Immunohistochemistry revealed that the neoplastic glands were positive for pan-cytokeratin, confirming the pancreatic epithelial origin of the tumor. This is the first report of sclerosing encapsulating peritonitis accompanied by aggressive pancreatic adenocarcinoma of presumed ductal origin and extensive metastasis in a cat.
Laughter and effective presidential leadership: A case study of Ronald Reagan as the 'great communicator'
Authors: Patrick A Stewart, Reagan G Dye, Carl Senior
Journal: PLoS One (2024)
MeSH terms: Laughter, Leadership, Anger, Emotions, Health Status, Humans, Male, United States

Former United States President Ronald Reagan's use of media and his charismatic connection with viewers earned him the moniker "the great communicator". One aspect of his charisma, the influence of elicited laughter, during a highly critical 5-minute news story by CBS reporter Leslie Stahl during the 1984 US presidential election is examined here. Two experiments examining the effects of audience laughter on perceptions of charismatic leadership are reported. In the first experiment the effects of audience laughter in response to Reagan's comments were investigated. Here, Reagan's perceived warmth as an effective leader significantly diminished when strong laughter is removed, whereas perceptions of competence remained unaffected. The second study carried out on an older cohort replicated and extended the first in a pre-registered design by considering the perception of trait charisma. Here, the presence or absence of audience laughter did not affect judgements of charisma. Additionally, the affective response before, and then after, the presentation of the news story was measured. Emotions associated with a positive appraisal all decreased after being shown the news story while emotions associated negative appraisal all increased. However, only participant anger was significantly increased when audience laughter was removed. Taken together the findings of both studies converge on the fact that subtle changes in media presentation of political leaders can have a significant effect on viewers. The findings show that even after 40 years in office the social psychological effects of presidential charisma can still influence observers.
Scrotal Pyocele Secondary to Perforated Appendicitis in Middle-Aged Man: A Case Report and Review of Literature
Authors: Ahmed A Al Bazroon, Ali M Alabandi, Murtadha M Alnemer, Shadi Abu Alsaud
Journal: Cureus (2024)
Keywords: acute appendicitis, acute scrotum, patent processus vaginalis, scrotal abscess, scrotal pyocele, scrotal swelling
MeSH terms: Case Reports

A scrotal abscess following perforated appendicitis is a rare complication. This is mostly seen in children and usually occurs due to the presence of the patent processus vaginalis, which permits the passage of pus from the intra-abdominal cavity down to the scrotum, resulting in a scrotal pyocele. There are few reported cases of such complications in young adult patients. We report a case of a 50-year-old male with a scrotal pyocele following exploratory laparotomy for perforated appendicitis. Scrotal ultrasound (US) findings were suggestive of a right-sided scrotal abscess, and the CT scan showed prominent fat in the proximal part of the right inguinal canal, which suggested the presence of a partially patent processus vaginalis. Our case is the first reported in the middle-aged group, and our review of the literature is the first directed to the adult age group. This review emphasizes the importance of considering scrotal pyocele in any patient with acute scrotum post-appendectomy, regardless of the patient's age, the affected side, and the presence or absence of identifiable patent processus vaginalis, as it may be microscopically permeable. Treatment will entail urgent drainage of the abscess, together with a course of antibiotics.
Proper Treatment and Management of Postcardiotomy Refractory Vasospasm
Authors: Caleb R Weissman, Stephane Leung Wai Sang
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

We present here a unique case in which a 63-year-old man developed diffuse coronary vasospasm on postoperative day (POD) 1 following uneventful aortic valve replacement, replacement of ascending aorta, and coronary artery bypass. Subsequent emergent coronary angiogram demonstrated diffuse native coronary artery vasospasm that was only transiently responsive to intracardiac nitroglycerin, resulting in persistent cardiogenic shock and severe biventricular dysfunction. The patient was, thus, placed on femoral-femoral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) with Impella support. This strategy allowed the weaning of vasopressors and enabled the resolution of the vasospasm. The patient was ultimately discharged on POD 17 without further complications. This case demonstrates our management strategy to provide life-saving support for patients facing postcardiac surgery refractory vasospasm.