OpenMed/multicare-articles huggingface dataset:
Therapeutic Benefits of Short-Arm Human Centrifugation in Multiple Sclerosis-A New Approach
Authors: Chrysoula Kourtidou-Papadeli, Christos A Frantzidis, Christos Bakirtzis, Anatoli Petridou, Sotiria Gilou, Aliki Karkala, Ilias Machairas, Nikolaos Kantouris, Christiane M Nday, Emmanouil V Dermitzakis, Eleftherios Bakas, Vassilis Mougios, Panagiotis D Bamidis, Joan Vernikos
Journal: Front Neurol (2022)
Keywords: artificial gravity, brain plasticity, case report, expanded disability status scale, muscle oxygenation, secondary progressive multiple sclerosis

Short-arm human centrifugation (SAHC) is proposed as a robust countermeasure to treat deconditioning and prevent progressive disability in a case of secondary progressive multiple sclerosis. Based on long-term physiological knowledge derived from space medicine and missions, artificial gravity training seems to be a promising physical rehabilitation approach toward the prevention of musculoskeletal decrement due to confinement and inactivity. So, the present study proposes a novel infrastructure based on SAHC to investigate the hypothesis that artificial gravity ameliorates the degree of disability. The patient was submitted to a 4-week training programme including three weekly sessions of 30 min of intermittent centrifugation at 1.5-2 g. During sessions, cardiovascular, muscle oxygen saturation (SmO2) and electroencephalographic (EEG) responses were monitored, whereas neurological and physical performance tests were carried out before and after the intervention. Cardiovascular parameters improved in a way reminiscent of adaptations to aerobic exercise. SmO2 decreased during sessions concomitant with increased g load, and, as training progressed, SmO2 of the suffering limb dropped, both effects suggesting increased oxygen use, similar to that seen during hard exercise. EEG showed increased slow and decreased fast brain waves, with brain reorganization/plasticity evidenced through functional connectivity alterations. Multiple-sclerosis-related disability and balance capacity also improved. Overall, this study provides novel evidence supporting SAHC as a promising therapeutic strategy in multiple sclerosis, based on mechanical loading, thereby setting the basis for future randomized controlled trials.
Neuropsychiatric Manifestations in a Patient with Panhypopituitarism
Authors: Oluwole Jegede, Ajouka Jeyakumar, Thyarapan Balakumar, Alyssa Raghu, Katherine I Chang, Katarina Soewono, Mario Gustave, Ayodeji Jolayemi
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admission, the patient's clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations. A head CT scan and a pituitary MRI revealed a near total resection of the pituitary while laboratory investigations revealed hyponatremia and a grossly low hormone profile. The progression of these events casts doubts on our admitting diagnosis as the primary cause of the patient's symptoms. The patient's clinical condition improved only when his endocrinopathy was treated with hormone replacement, fluids, and electrolyte correction in addition to antipsychotics. An inability to verify the patient's psychiatric history and a remote history of pituitary resection several decades earlier, unknown to the treating team, added to the diagnostic conundrum. We revised the diagnosis to neuropsychiatric manifestations secondary to an organic brain syndrome due to a partial pituitary resection. The patient was discharged with no symptoms of psychosis, good insight, judgment, and good reality testing.
An Unusual Case of Pancreatic Metastasis from Squamous Cell Carcinoma of the Lung Diagnosed by EUS-Guided Fine Needle Biopsy
Authors: Takuya Ishikawa, Yoshiki Hirooka, Carolin J Teman, Hidemi Goto, Paul J Belletrutti
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

We report a case of a 70-year-old man who presented with abdominal pain and weight loss, with initial imaging showing simultaneous mass lesions in the pancreas and lungs along with extensive lymphadenopathy in the thorax up to the left supraclavicular region. Core biopsies of the left supraclavicular lymph node showed squamous cell carcinoma, which required differentiation between secondary and primary pancreatic neoplasms. Endoscopic ultrasound-guided sampling using a novel fine needle biopsy system was key to making a definite histological diagnosis and determining the best treatment plan.
Continuous cement leakage along the posterior longitudinal ligament of the intraspinal epidural during a percutaneous vesselplasty: A case report and literature review
Authors: Ning An, Sijia Guo, Jisheng Lin, Haoxiang Zhuang, Hai Meng, Nan Su, Qi Fei
Journal: Front Surg (2023)
Keywords: cement leakage, classification standard, complication, epidural, percutaneous kyphoplasty (pkp)
MeSH terms: Case Reports

Objective:
This study aims to report one case of intraspinal epidural cement leakage caused by a novel percutaneous vesselplasty.
Methods:
A clinical case report from the Orthopedic center of our hospital and a literature review. A 63-year-old woman with an L2 osteoporotic compression fracture underwent novel kyphoplasty, percutaneous vesselplasty. This rare complication was evaluated through a literature search, and its special types are classified in more detail.
Results:
The patient was hospitalized with low back pain two weeks after a fall. After auxiliary examination, a new type of percutaneous vesselplasty was performed. After the intraoperative injection of bone cement, bone cement leakage extended along the posterior longitudinal ligament and epidural space. There were no special compression symptoms of the spinal cord, and the prognosis of conservative treatment was good.
Conclusion:
Although percutaneous vesselplasty is relatively safe and frequent, intraspinal leakage may occur, so sufficient preoperative evaluation, intraoperative continuous fluoroscopic monitoring, and timely evaluation of postoperative images are extremely necessary.
Clinical Manifestation, Dermoscopy, and Scanning Electron Microscopy in Two Cases of Contagious Ecthyma (Orf Nodule)
Authors: Ana Laura Rosifini Alves Rezende, Fred Bernardes Filho, Natália Aparecida de Paula, Loan Towersey, Roderick Hay, Marco Andrey Cipriani Frade
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Orf is a highly contagious skin disease commonly seen in goats and sheep that can be transmitted to people who have direct contact with infected animals. Here, we report the clinical manifestation, dermoscopy, and scanning electron microscopy in two women who developed skin lesions on their hands after handling goats with wounds in the udders. Human orf is usually self-limiting and no specific treatment is needed.
Case report: Whole-exome sequencing identifies a novel DES mutation (p. E434K) in a Chinese family with cardiomyopathy and sudden cardiac death
Authors: Yu-Xing Liu, Rong Yu, Yue Sheng, Liang-Liang Fan, Yao Deng
Journal: Front Cardiovasc Med (2022)
Keywords: des, scd, hereditary cardiomyopathy, mutation, whole-exome sequencing
MeSH terms: Case Reports

Background:
Desmin is an intermediate filament protein that plays a critical role in the stabilization of the sarcomeres and cell contacts in the cardiac intercalated disk. Mutated DES gene can cause hereditary cardiomyopathy with heterogeneous phenotypes, while the underlying molecular mechanisms requires further investigation.
Methods:
We described a Chinese family present with cardiomyopathy and sudden cardiac death (SCD). Whole-exome sequencing (WES) and bioinformatics strategies were employed to explore the genetic entity of this family.
Results:
An unknown heterozygote missense variant (c.1300G > A; p. E434K) of DES gene was identified. The mutation cosegregates in this family. The mutation was predicted as pathogenic and was absent in our 200 healthy controls.
Conclusion:
We identified a novel DES mutation (p. E434K) in a Chinese family with cardiomyopathy and SCD. Our study not only provided a new case for the study of the relationship between DES mutations and hereditary cardiomyopathy but also broadened the spectrum of DES mutations.
Pulmonary Artery Vasoconstriction Due to Bronchial Obstruction
Authors: Thomas Saliba, Hanna Salame, Denis Tack
Journal: J Belg Soc Radiol (2022)
Keywords: ctpa, bronchial obstruction, mucoid impaction, pulmonary artery vasoconstriction, pulmonary vein opacification
MeSH terms: Case Reports

Pulmonary artery (PA) vasoconstriction resulting from pulmonary ventilation/perfusion imbalance is infrequently detected with computed tomography (CT). An 85-year-old woman presented to the emergency room with dyspnea and desaturation, despite oxygen supply. A CT pulmonary angiography (CTPA) revealed massive central bronchial mucoid impaction in all but the right upper bronchus. Only the right upper pulmonary veins were opacified, which we speculate was linked to the central bronchial obstruction, with identical distributions, through vasoconstriction of the corresponding PAs. Teaching Point: This case demonstrates the unusual imagery-physiology correlation of pulmonary artery vasoconstriction that cannot normally be detected by CTPA.
Delayed diagnoses: nonspecific findings and diagnostic challenges in eating disorders
Authors: Dan Schwarz, Kathryn L Ponder, Edward R Feller
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Objective. Eating disorders commonly present with nonspecific findings, masquerading as other, more common etiologies of malnutrition and wasting. In low-prevalence populations, these ambiguities can complicate clinicians' diagnostic reasoning, resulting in delayed or missed diagnoses. Method. We report the atypical case of a 51-year-old male with a five-year history of unexplained weight loss despite extensive past medical evaluation. Previous documentation of profound lymphopenia and bone marrow atrophy had not been linked to a known association with eating disorders. Results. Evaluation for medical etiologies of wasting was negative. Following psychiatric evaluation, the patient was diagnosed with an eating disorder, not otherwise specified, and admitted to a specialized nutritional rehabilitation program. Conclusion. The nonspecific clinical history, physical exam, and laboratory abnormalities of eating disorders can make these diagnoses challenging and delay appropriate treatment. Clinicians should consider eating disorders in patients with malnutrition, severe lymphopenias, and gelatinous marrow transformation early in their workup, so as to avoid potentially negative outcomes.
Lower Limb Ischemia: Aortoiliac Thrombosis Related to Antiphospholipid Syndrome (APS)-Case Report and Review of the Literature
Authors: Arnaldo Toffon, Raffaella Piovesan, Consolato Francesco Minniti, Omar Caruso, Paolo Criscenti, Sabina Villalta, Maurizio Cavallo
Journal: Case Rep Surg (2013)

Antiphospholipid syndrome (APS) is recognized as one of the main determinants of hypercoagulable conditions. The literature reports the incidence of this syndrome in a third of patients who underwent surgery for peripheral revascularization. Antiphospholipid antibodies are divided into two categories in relation to specific diagnostic tests. The first group is called lupus anticoagulant and consists of immunoglobulins that inhibit the phospholipid dependent coagulation tests in vitro. The second group is defined by their ability to conduct the phospholipid in an ELISA test. The occurrence of thrombotic events in patients with systemic erythematosus lupus (SEL) and anticoagulant antibodies was described for the first time in 1963 by Bowie. The discovery of anti-cardiolipin antibodies in antiphospholipid syndrome is due to Harris et al. who described the syndrome. Primitive APS was consequently defined in the absence of further underlying illnesses. In this disease, arterial thrombosis occurs mainly in the brain. Peripheral arteries are affected less frequently. Thrombosis of the great vessels is reported as anecdotal.
Persistent fever and destructive arthritis caused by dialysis-related amyloidosis: A case report
Authors: Kotaro Matsumoto, Jun Kikuchi, Yuko Kaneko, Hidekata Yasuoka, Kazuko Suzuki, Hirobumi Tokuyama, Kaori Kameyama, Kunihiro Yamaoka, Tsutomu Takeuchi
Journal: Medicine (Baltimore) (2018)
MeSH terms: Amyloidosis / complications, Arthritis / etiology, Renal Dialysis / adverse effects, Case Reports, Arthritis / diagnostic imaging, Humans, Male, Middle Aged

Rationale:
Dialysis-related amyloidosis (DRA) can present rheumatic manifestations in patients on long-term hemodialysis. Typical articular symptoms with DRA involve carpal-tunnel syndrome, effusion in large joints, spondyloarthropathy, or cystic bone lesions, which are usually with non-inflammatory processes.
Patient concerns:
A 64-year-old man on hemodialysis for >30 years was admitted because of intermittent fever, polyarthritis, and elevated serum C-reactive protein (CRP) level, which was continuous for 2 years. Several antibiotics were ineffective for 3 months before his admission. On physical examination, joint swelling was observed at bilateral wrists, knees, ankles, and hip joints. Laboratory tests revealed elevation of serum inflammatory markers and β2-microglobulin (β2-MG). Synovial fluid showed predominant infiltration of polymorphonuclear leukocytes and the increase of β2-MG level.
Diagnosis:
Significant deposition of β2-MG with inflammatory cell infiltration was found in biopsied samples from synovium, skin, and ileum.
Interventions:
We decided to switch to the hemodialysis column with membrane that can effectively absorb β2-MG in circulation.
Outcomes:
The relief of symptoms and a decrease of CRP level by changing the membrane lead to the final diagnosis of DRA.
Lessons:
Our case demonstrates that DRA arthropathy can be inflammatory and destructive, and also develop systemic inflammatory signs and symptoms. In such cases, aggressive absorption of β2-MG in circulation might help the amelioration of symptoms.
Successful treatment of Fusarium solani anterior chamber involvement secondary to contact lens associated corneal ulcer with intracameral Amphotericin B
Authors: Patrick Peters, Isabel Oberacher-Velten, Horst Helbig, David Märker
Journal: GMS Ophthalmol Cases (2019)
MeSH terms: Case Reports

Background: Fusarium spp. are leading fungal pathogenes in contact lens associated keratitis and may evoke endophthalmitis. Since Fusarium spp. are highly resistant to antifungal drugs, globe integrity is threatened. Case: A woman developed fungal anterior chamber involvement after contact lens associated corneal ulcer formation. She presented with a painful eye with hypopyon and a mass presumably of fungal origin growing on the iris and anterior lens capsule. A biopsy confirmed Fusarium solani. Only multiple lavages of the anterior segment with Amphotericin B achieved convalescence. Conclusion: In the initial stage of contact lens associated keratitis, it is often hard to differentiate between etiology. However, keratitis which are treatment resistant to antibacterials are suspicious for fungal origin. For proper treatment, identification of pathogen is crucial. Due to poor tissue penetration of the lipophilic anti-fungal agents and slow fungal replication rate, multiple lavages of the anterior chamber are often required to handle fungal infections.
Use of the novel hemostatic textile Stasilon(R) to arrest refractory retroperitoneal hemorrhage: a case report
Authors: Preston B Rich, Christelle Douillet, Valorie Buchholz, David W Overby, Samuel W Jones, Bruce A Cairns
Journal: J Med Case Rep (2010)

Introduction:
Stasilon(R) is a novel hemostatic woven textile composed of allergen-free fibers of continuous filament fiberglass and bamboo yarn. The development of this product resulted from controlled in vitro thrombogenic analysis of an array of potentially hemostatic textile materials and it has been cleared for both external and internal use by the United States Food and Drug Administration for the arrest of hemorrhage. The goal of the study was to assess the hemostatic and adhesive properties of Stasilon(R) in the setting of life-threatening refractory hemorrhage.
Case presentation:
A 39-year-old Caucasian man presented with severe necrotic pancreatitis that failed multiple aggressive attempts to control associated bleeding with electrocautery, suture ligation, and sequential anatomic packing with cotton-based sponges. Subsequent retroperitoneal packing with Stasilon(R) produced a non-adherent wound-dressing interface and resulted in the achievement of persistent hemostasis in the operative field.
Conclusion:
In our patient, Stasilon(R) was demonstrated to be effective in the arrest of refractory hemorrhage.
Spontaneous Bilateral Sternoclavicular Joint Septic Arthritis and Lumbar Discitis: An Unusual Case in a Healthy Adult
Authors: Georgios Mamarelis, Mohammad Zain Sohail, Athanasios Mamarelis, Hassan Fawi, Jehangir Mahaluxmivala
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Introduction:
Septic arthritis of the sternoclavicular (SC) joint is a rare condition. Typically, it presents in patients with risk of infection and is usually unilateral. In this report, we describe a case of spontaneous bilateral sternoclavicular joint infection of an otherwise healthy adult.
Case presentation:
A 67-year-old man presented in our hospital complaining of 2-week history of neck and chest pain which was radiating to his shoulders bilaterally. Clinical examination revealed erythema and swelling of the sternoclavicular area. Inflammatory markers were raised. Image investigation with CT and MRI was undertaken and verified the presence of bilateral sternoclavicular joint infection. The patient received prolonged course of intravenous antibiotics since his admission. The patient was discharged in a good condition and followed up in clinic.
Conclusion:
High index of clinical suspicion of SC joint infection is important for early diagnosis to avoid further complications.
18F-FDG PET/CT in Pleural Epithelioid Hemangioendothelioma
Authors: Domenico Albano, Giovanni Bosio, Andrea Tironi, Francesco Bertagna
Journal: Asia Ocean J Nucl Med Biol (2017)
Keywords: 18f-fdg pet/ct, pleural epitheliod hemangioendothelioma
MeSH terms: Case Reports

Pleural epithelioid hemangioendothelioma (EHE) is a rare malignancy of vascular-endothelial origin with non-specific symptoms and an unpredictable outcome. Diagnosis of this condition by imaging modalities is challenging, and no standard therapeutic approaches have been established in this regard. In this paper, we described the case of a patient with a low-grade fever, coughing and chest pain who underwent 18F-FDG PET/CT after a positive thorax CT showing multiple bilateral calcified pulmonary nodules and extensive right-sided pleural effusion. Moreover, PET/CT revealed increased tracer uptake on the nodular pleural thickening and one nodule in the upper lobe of the right lung. A diagnostic thoracentesis was performed to obtain the pleural fluid. However, cytology was not diagnostic, and the subsequent thoracotomy with pleural fluid drainage and pleural biopsy was positive for pleural EHE. The study showed also an abundant non-FDG-avid pleural effusion in the collapsed right lung. Despite chest tube insertion and partial drainage of the volume, patient's condition deteriorated, and patient passed away six months after the PET scan.
Miliary tuberculosis presenting as puerperial Fever
Authors: A Agarwal
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

Miliary tuberculosis as a cause of puerperial fever is extremely rare. It is a serious illness with nonspecific clinical manifestations and typical chest radiographic findings may not be seen until late in the course of the disease. It is often associated with maternal immunocompromised status. Here, we report a case of miliary tuberculosis in a nonimmunocompromised mother presenting as fever of unknown origin in immediate puerperium. Prolonged workup of eight weeks led to the diagnosis of miliary tuberculosis as the cause of postpartum fever that responded well to antituberculous drugs.
Fulminant Type 1 Diabetes Mellitus Caused by Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS): A Case Report and Review of the Literature
Authors: Bizhen Zhu, Jinzhun Wu, Guobing Chen, Yungang Yang, Cuili Yi
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: autoimmune diseases, diabetes mellitus, drug reaction with eosinophilia and systemic symptoms, drug-induced hypersensitivity syndrome, sequelae
MeSH terms: Case Reports

Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome (DIHS) is a rare, severe cutaneous adverse drug reaction characterized by fever, skin rashes, lymphadenopathy, leukocytosis with eosinophilia, and/or atypical lymphocytosis, and multiple visceral organ involvement. Moreover, patients with DRESS are at risk of developing autoimmune diseases including thyroiditis, diabetes mellitus (DM), and systemic lupus erythematosus (SLE), etc. several weeks or months after the initial resolution. We described a 9-month boy who was admitted to our hospital because of severe pneumonia and developed DRESS 3 weeks later. After the withdrawal of suspicious drug and administration of systemic corticosteroids, the patient's condition improved gradually. Nevertheless, hyperglycemia was detected 20 days after the initial onset of DRESS, and subsequent fulminant type 1 diabetes mellitus (F1DM) was diagnosed requiring continuous intravenous insulin infusion. After 13 months of follow-up, the blood glucose levels are now well-controlled. Literature research in PubMed for diabetes mellitus associated with DRESS showed 16 articles and 27 related case reports. Of 27 patients with DM related to DRESS, 11 were male, 16 were female. The mean age was 46 years. The duration from the onset of DRESS to the development of DM was 21 days on average. F1DM was diagnosed in 21 patients, T1DM was confirmed in 5 patients, and T2DM was only defined in 1 patient. Glutamic acid decarboxylase antibodies (GAD) were detected in 4 cases. Of 22 cases in which virus examination was carried out, evidence of virus reactivation was established in 16 cases (72.7%). Of patients with F1DM, 16 (88.9%) cases were evidenced by reactivation of herpes virus. A high frequency of HLA genotype and haplotype were found in 11 cases. DM was concomitant with acute pancreatitis in 3 patients and thyroiditis in 2 patients. No patients died from the disease. This work aims to raise awareness of long-term autoimmune sequelae in patients with DRESS.
Management of localized gingival recession by two-stage surgical procedure - Double pedicle flap with CTG and coronally advanced flap: A novel technique
Authors: T Prasanth
Journal: J Indian Soc Periodontol (2009)
Keywords: connective tissue graft, coronally advanced flap, double pedicle flap, gingival recession
MeSH terms: Case Reports

Cosmetic treatments have become an integral part of periodontal treatment. One of the commonly used esthetic periodontal procedures is coverage of denuded root surface. While considering the elimination of these defects two criteria should be considered, the esthetic aspects and the functional aspects. This case report has describes a two stage surgical technique using double pedicle flap with connective tissue graft followed by coronally advanced flap for the treatment of a severe localized gingival recession measuring 15 mm. The recession measurement at the end of 12 months was 1 mm. It showed a predictable result at the end of one year. The advantages of this technique are excellent colour matching, dual blood supply to graft and very predictable results. The promising result suggest that this technique can be used in severe gingival recession cases with minimum amount of keratinized tissue.