OpenMed/multicare-articles huggingface dataset:
A case report of adult rectal duplication cyst resected by synchronous trans-abdominal and trans-anal total mesorectal excision
Authors: Tetsuro Tominaga, Takashi Nonaka, Akiko Fukuda, Masaaki Moriyama, Syouzaburou Oyama, Shigekazu Hidaka, Kazuhiro Tabata, Terumitsu Sawai, Takeshi Nagayasu
Journal: Int J Surg Case Rep (2020)
Keywords: case report, duplication cyst, rectum, trans anal approach
MeSH terms: Case Reports

Introduction:
Rectal duplication cyst is extremely rare. Most of the cases diagnosed before two years old. Adult onset rectal duplication cyst usually contains malignant formation. Then complete tumor resection is needed for the disease to prevent malignant change.
Presentation of case:
A 52-year-old man was referred to our hospital due to bloody stool. Colonoscopy showed 20-mm of sub-mucosal tumor at low rectum. Biopsy revealed no specific findings. Abdominal computed tomography showed that a 20-mm low density mass at posterior of lower rectum. As the existence of malignant lesion was unassailable, we planned two team, trans abdominal and trans-anal, laparoscopic low anterior resection. Perioperative course was good. Macroscopically, rectum had a submucosal cystic mass fulfilled mucinous content. Histologically, cyst wall was covered with heterotopic ciliated epithelium and composed of smooth muscle.
Discussion:
Trans-anal total mesorectal excision (ta-TME) was introduced as beneficial approach for rectal malignancies.
Conclusion:
Complete resection was possible by TME was necessary for patients with adult rectal duplication cyst, and synchronous trans-abdominal and trans-anal approach is a promising option.
Managing Metastatic Thymoma With Metabolic and Medical Therapy: A Case Report
Authors: Matthew C L Phillips, Deborah K J Murtagh, Sanjay K Sinha, Ben G Moon
Journal: Front Oncol (2020)
Keywords: cancer, fasting, ketogenic diet, metastatic thymoma, prednisone
MeSH terms: Case Reports

Thymomas consist of neoplastic thymic cells intermixed with variable numbers of non-neoplastic lymphocytes. Metastatic thymomas are typically managed with non-curative chemotherapy to control tumor-related symptoms; no prolonged survival is expected. Metabolic-based approaches, such as fasting and ketogenic diets, target cancer cell metabolism by creating an increased reliance on ketones while decreasing glucose, glutamine, and growth factor availability, theoretically depriving cancer cells of their metabolic fuels while creating an unfavorable environment for cancer growth, which may be beneficial in metastatic thymoma. We report the case of a 37-year-old woman with myasthenia gravis, diagnosed with an inoperable type AB, stage IVA thymoma, who pursued a metabolic intervention consisting of periodic fasting (7-day, fluid-only fasts every 1-2 months), combined with a modified ketogenic diet on feeding days, for 2 years. Fasting-related adverse effects included cold intolerance, fatigue, and generalized muscle aches, all of which resolved during the second year. She experienced two myasthenia relapses, each associated with profoundly reduced oral intake, marked weight loss, and tumor regression-the first relapse was followed by a 32% decrease in tumor volume over 4 months, the second relapse by a dramatic 96% decrease in tumor volume over 4 months. The second relapse also required prednisone to control the myasthenia symptoms. We hypothesize that 2 years of fasting and ketogenic diet therapy metabolically weakened the neoplastic thymic cell component of the thymoma, "setting the stage" for immune activation and extreme energy restriction to destroy the majority of cancer cells during both relapses, while prednisone-induced apoptosis eradicated the remaining lymphocytic component of the thymoma during the second relapse. This case is unique in that a metabolic-based fasting and ketogenic diet intervention was used as the primary management strategy for a metastatic cancer in the absence of surgery, chemotherapy, or radiotherapy, culminating in a near-complete regression. Nearly 3 years after being diagnosed with inoperable metastatic cancer, our patient shows no signs of disease and leads a full and active life.
Root canal treatment of a hypertaurodont mandibular second molar: a case report
Authors: Davood Jamshidi, Alireza Adl, Fereshte Sobhnamayan, Mehrdad Bolurian
Journal: J Dent Res Dent Clin Dent Prospects (2015)
Keywords: pulp chamber, root canal, taurodontism
MeSH terms: Case Reports

Taurodontism is a morphologic feature of generally multi-rooted teeth with large pulp chambers and shortened roots. A case of endodontic treatment in a 24-year-old male with the chief complaint of swelling and pain in the right mandibular region is described. Periapical lesion was present in the radiographic examination of hypertaurodont second mandibular molar.Four root canals were detected with an endodontic microscope. The canals were prepared and obturated with lateral condensation technique in the second appointment. The patient was asymptomatic in the 18-month follow-up.
Leprosy & gangrene: a rare association; role of anti phospholipid antibodies
Authors: Shashank M Akerkar, Lata S Bichile
Journal: BMC Infect Dis (2005)
MeSH terms: Antibodies, Antiphospholipid / immunology, Gangrene / etiology, Leprosy, Tuberculoid / complications, Case Reports, Antibodies, Antiphospholipid / blood, Female, Gangrene / complications, Humans, Leprosy, Tuberculoid / drug therapy, Middle Aged, Antibodies, Antiphospholipid

Background:
Leprosy still remains an important public health problem for many parts of the world. An association of gangrene with leprosy is a rare one & can have a number of causative mechanisms. We present a case with Leprosy & gangrene with positive anti phopholipid antibody titers.
Case presentation:
A 50-year-old non-diabetic, non-hypertensive lady presented with 2 months history of progressive gangrene of bilateral toes. She was found to have madarosis & hypopigmented, hypoaesthetic macular lesions on the upper limb & thighs. Bilateral ulnar & popliteal nerves were thickened. A skin biopsy of the lesions revealed borderline tuberculoid leprosy, slit skin smears revealed a bacteriological index of 1+. She did not have any evidence of thromboembolic episode or atherosclerosis. ACLA was positive at presentation & also on another occasion 6 weeks later. ACLAs were of the IgM type on both occasions. Lupus Anticoagulant & beta2 GPI antibody were negative. DOPPLER of the lower limb arteries did not reveal any abnormality. Patient was successfully treated with multi-drug antileprotics & anticoagulants.
Conclusion:
Infectious APLAs should be recognized as a cause of thrombosis in Leprosy. Appropriate anticoagulation can salvage limb function.
Case report: Fatal cerebral herniation caused by hypoglycemic due to mistaking glibenclamide in children
Authors: Chunlan Song, Wanyu Jia, Shengli Shi, Peng Li
Journal: Front Behav Neurosci (2023)
Keywords: cerebral hernia, children, glibenclamide, hypoglycemic coma, mistake
MeSH terms: Case Reports

In recent years, the prevalence of diabetes in China has significantly increased, and glibenclamide is widely used as a basic hypoglycemic drug in China's primary clinical practice. There are many left-behind children in the grass-roots areas in China and various dangerous incidents of children taking drugs by mistake continue to occur. This article reports a case of cerebral edema and fatal cerebral hernia caused by hypoglycemia induced by mistakenly ingesting glibenclamide in a child. This is the first reported case in China of a child who died from brain herniation caused by accidental administration of glibenclamide. This case reminded that clinicians must comprehensively consider the cause of convulsions and coma in children with unknown causes, ask the history in detail and cannot ignore the risk of hypoglycemic convulsions and coma. When hypoglycemic is detected, high concentration of glucose should be given promptly to normalize blood glucose. When dealing with unexplained convulsions and comatose children, clinical pediatricians must be alert to the possibility of accidental medication.
Adult-Onset Still's Disease with Dermatopathic Lymphadenitis Clinicopathologic Features: A Rare Case Report and Review of the Literature
Authors: Reda A Elhawary, Mir Nadeem, Mohammed S Abdelwahed, Mansour Somaily, Shahenda Y Alemam
Journal: Case Reports Immunol (2022)
MeSH terms: Case Reports

Adult-onset Still's disease (AOSD) is an inflammatory disorder characterized by fever, arthritis, and a transient skin rash. It is a rare condition characterized by inflammatory multisystem changes of unknown cause. A 35-year-old woman was admitted to rheumatology department of tertiary care hospital complaining of painful wrist and skin rash as well as fever, generalized lymphadenopathy, weight loss, and fatigue. The early diagnosis of AOSD was confirmed by clinical history, examination, and laboratory tests, as well as a confirmatory skin biopsy with typical histopathological features, namely, upper epidermal dyskeratosis and dermal inflammatory neutrophilic infiltration. The patient's condition was treated with steroids and NSAIDs, to which she responded well, and on follow-up, her symptoms regressed along with improvement in biochemical parameters. The authors suggest that skin biopsy and confirmation of histopathological diagnosis of AOSD are useful in the diagnosis and proper management of AOSD patients in cases with clinical suspicion of AOSD.
Visual loss in HIV-associated cryptococcal meningitis: A case series and review of the mechanisms involved
Authors: Anand Moodley, William Rae, Ahmed Bhigjee
Journal: South Afr J HIV Med (2015)

Permanent visual loss is a devastating yet preventable complication of cryptococcal meningitis. Early and aggressive management of cerebrospinal fluid pressure in conjunction with antifungal therapy is required. Historically, the mechanisms of visual loss in cryptococcal meningitis have included optic neuritis and papilloedema. Hence, the basis of visual loss therapy has been steroid therapy and intracranial pressure lowering without clear guidelines. With the use of high-resolution magnetic resonance imaging of the optic nerve, an additional mechanism has emerged, namely an optic nerve sheath compartment syndrome (ONSCS) caused by severely elevated intracranial pressure and fungal loading in the peri-optic space. An improved understanding of these mechanisms and recognition of the important role played by raised intracranial pressure allows for more targeted treatment measures and better outcomes. In the present case series of 90 HIV co-infected patients with cryptococcal meningitis, we present the clinical and electrophysiological manifestations of Cryptococcus-induced visual loss and review the mechanisms involved.
Adverse Drug Interaction Between Kratom and Amitriptyline With Gastrointestinal and Mild Hepatic Effects
Authors: Naisarg B Vanani, Stephen G Stevanovic, Nebojsa Stevanovic
Journal: Cureus (2023)
Keywords: adverse side effect, chronic and acute pain management, elevated liver enzyme, kratom, kratom addiction, medication interaction, opioid use disorder (oud), pharmacology, stress and depression, substance abuse program
MeSH terms: Case Reports

Kratom (Mitragyna speciosa) is a tropical evergreen plant native to Southeast Asia, where it has been used historically for its various psychoactive and analgesic properties. In recent years, the popularity of kratom has surged in the United States as a supplement for treating opioid withdrawal/addiction, anxiety, depression, and chronic pain, among others. However, much of Kratom processing and sales remain largely unregulated, with little clinical research to demonstrate the effects of kratom on physiologic processes such as potential drug interactions. Here, we present a case of Kratom interaction with Amitriptyline in a patient recovering from Opioid Use Disorder.
Case Report: The Value of Genomic Analysis in a Case of Megakaryoblastic Leukemia With Atypical Initial Manifestation
Authors: Miriam Gutiérrez-Jimeno, Elena Panizo-Morgado, Marta Calvo-Imirizaldu, Víctor Galán-Gómez, Adela Escudero-López, Ana Patiño-García
Journal: Front Pediatr (2022)
Keywords: acute megakaryoblastic leukemia, extramedullary acute myeloid leukemia, genomics, myeloid sarcoma, next generation sequencing
MeSH terms: Case Reports

We report the case of a 7-month-old female patient who developed acute megakaryoblastic leukemia 6 months after the appearance of skull bone lesions. Initial evaluation and diagnosis of this patient were challenging and only achieved thanks to genomic analysis by NGS (next generation sequencing). It is unusual for the initial manifestation of acute megakaryoblastic leukemia to be a skull bone lesion. Extramedullary acute myeloid leukemia (eAML), also known as myeloid sarcoma (MS), often occurs simultaneously with acute myeloid leukemia (AML), although it may precede AML. Genomic analysis based on a NGS panel (Oncomine Childhood Cancer Research Assay) detected a RBM15::MKL1 fusion, a consequence of a t (1;22)(p13;q13) translocation, establishing the diagnosis of acute megakaryoblastic leukemia and enabling disease follow-up by qPCR. A diagnosis of eAML is built up from various findings in radiological, histological, immunophenotypic and genomic studies; when the tumor appears de novo, diagnosis is more complicated. We emphasize the importance of a multidisciplinary team in the initial approach to rare tumors and the use of genomic studies to contribute to the knowledge of these neoplasms, risk stratification and treatment planning.
A False Positive I-131 Metastatic Survey Caused by Radioactive Iodine Uptake by a Benign Thymic Cyst
Authors: Avneet K Singh, Adina A Bodolan, Matthew P Gilbert
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Thyroid carcinoma is the most common endocrine malignancy in the United States with increasing incidence and diagnosis but stable mortality. Differentiated thyroid cancer rarely presents with distant metastases and is associated with a low risk of morbidity and mortality. Despite this, current protocols recommend remnant ablation with radioactive iodine and evaluation for local and distant metastasis in some patients with higher risk disease. There are several case reports of false positive results of metastatic surveys that are either normal physiologic variants or other pathological findings. Most false positive findings are associated with tissue that has physiologic increased uptake of I-131, such as breast tissue or lung tissue; pathological findings such as thymic cysts are also known to have increased uptake. Our case describes a rare finding of a thymic cyst found on a false positive I-131 metastatic survey. The patient was taken for surgical excision and the final pathology was a benign thymic cyst. Given that pulmonary metastases of differentiated thyroid cancer are rare, thymic cysts, though also rare, must be part of the differential diagnosis for false positive findings on an I-131 survey.
The rare entity of cholocystocolonic fistula: a case report
Authors: Nikolaos Garmpis, Christos Damaskos, Anna Garmpi, Georgia Sypsa, Dimitrios Mantas
Journal: Pan Afr Med J (2021)
Keywords: cholocystocolonic, case report, colon, fistula, gallbladder
MeSH terms: Abdominal Pain / etiology, Biliary Fistula / diagnostic imaging, Intestinal Fistula / diagnostic imaging, Case Reports, Biliary Fistula / surgery, Duodenal Ulcer / pathology, Female, Humans, Intestinal Fistula / surgery, Laparotomy, Middle Aged, Tomography, X-Ray Computed

Cholocystocolonic fistulas (CCFs) represent a rare medical entity. Previous inflammatory processes in the abdomen, especially in the gallbladder and surgeries are all related to their appearance. There are not typical findings concerning the clinical image and the therapeutic approach varies between patients. Herein, we present a case of a 46-year-old patient, with a history of perforated duodenal ulcer, suffering from abdominal pain and diarrheas. A computed tomography (CT) demonstrated air inside the biliary system. A laparotomy was conducted to the patient and no complications had occurred. In addition, a review of literature regarding the clinical presentation and the therapeutic options for this disease are discussed in this manuscript in relation to our patient.
Noncompliance with medical regimen in haemodialysis treatment: a case study
Authors: Paraskevi Theofilou
Journal: Case Rep Nephrol (2011)
MeSH terms: Case Reports

Patients undergoing haemodialysis treatment have a high burden of disease (particularly cardiovascular comorbidities) affecting their quality of life and dramatically shortening life expectancy. Effective chronic kidney disease (CKD) control requires regular preventive medication and a response to that medication. Poor receptiveness to CKD medication can be related to individual variability in the dose needed to achieve a response, as well as to low-adherent behaviour in relation to the CKD medication regimen. Some patients, though not many, according to studies' findings, abuse the medical regimen as a result of suicidal tendencies. The present case gave us the opportunity to consider the causes and clinical findings and review the specific psychological interventions for patients with CKD.
A horse or a zebra? Unusual manifestations of common cutaneous infections in primary immunodeficiency pediatric patients
Authors: Ayelet Ollech, Amos J Simon, Atar Lev, Tali Stauber, Gilad Sherman, Michal Solomon, Aviv Barzilai, Raz Somech, Shoshana Greenberger
Journal: Front Pediatr (2023)
Keywords: cutaneous, immunological aspects, inborn error of immunity, infection, pediatric, primary immunodeficiencies

Background:
Patients with primary immunodeficiency disorders (PIDs) often suffer from recurrent infections because of their inappropriate immune response to both common and less common pathogens. These patients may present with unique and severe cutaneous infectious manifestations that are not common in healthy individuals and may be more challenging to diagnose and treat.
Objective:
To describe a cohort of patients with PIDs with atypical presentations of skin infections, who posed a diagnostic and/or therapeutic challenge.
Methods:
This is a retrospective study of pediatric patients with PID with atypical presentations of infections, who were treated at the immunodeficiency specialty clinic and the pediatric dermatology clinic at the Sheba Medical Center between September 2012 and August 2022. Epidemiologic data, PID diagnosis, infectious etiology, presentation, course, and treatment were recorded.
Results:
Eight children with a diagnosis of PID were included, five of whom were boys. The average age at PID diagnosis was 1.7 (±SD 3.2) years. The average age of cutaneous infection was 6.9 (±SD 5.9) years. Three patients were born to consanguineous parents. The PIDs included the following: common variable immunodeficiency, severe combined immunodeficiency, DOCK8 deficiency, ataxia telangiectasia, CARD11 deficiency, MALT1 deficiency, chronic granulomatous disease, and a combined cellular and humoral immunodeficiency syndrome of unknown etiology. The infections included the following: ulcerative-hemorrhagic varicella-zoster virus (two cases) atypical fungal and bacterial infections, resistant Norwegian scabies, giant perianal verrucae (two cases), and diffuse molluscum contagiosum.
Conclusions:
In this case series, we present unusual manifestations of infectious skin diseases in pediatric patients with PID. In some of the cases, recognition of the infectious process prompted life-saving treatment. Increasing familiarity with these dermatological manifestations, as well as keeping a high index of suspicion, is important to enabling early diagnosis of cutaneous infections in PIDs and initiation of prompt suitable treatment.
A family history of dilated cardiomyopathy induced by viral myocarditis
Authors: Thomas Cognet, Olivier Lairez, Pauline Marchal, Jérôme Roncalli, Michel Galinier
Journal: Case Rep Cardiol (2012)
MeSH terms: Case Reports

Myocarditis can lead to acute heart failure, cardiogenic shock, or sudden death and later, dilated cardiomyopathy (DCM) with chronic heart failure. We report the cases of two DCM induced by acute and past myocarditis in the same family and expressed by its two main complications within few weeks: an hemodynamic presentation as a fulminant myocarditis rapidly leading to cardiac tranplantation and a rythmologic presentation as an electrical storm leading to catheter ablation of ventricular tachycardia. These cases ask the question of the family predisposition to viral myocarditis leading to DCM.
Triceps Rupture and Repair in a Healthy, Young Woman following Rock Climbing
Authors: Charles Qin, Sean Clancy, Jason Strelzow
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Triceps tendon rupture in females is rare. In this case report, we present a young adult female patient with a distal triceps tendon rupture from bouldering treated with open surgical repair technique using a modified bone tunnel and suture anchor fixation technique. The diagnosis and technique for repair and postoperative rehabilitation are described. A review of the current literature of biomechanical and clinical outcomes of various repair techniques is also presented.
Electrical storm refractory multiple antiarrhythmic medications was stopped by interatrial shunting procedure-A case report
Authors: Caiping Han, Rujie Qiu, Lei Li, Min Han, Chengyi Xu, Li Liu, Chengwei Liu
Journal: Front Cardiovasc Med (2022)
Keywords: antiarrhythmic medications, electrical storm, interatrial shunting, left ventricular filling pressure, mechanical-electric feedback
MeSH terms: Case Reports

Electrical storm (ES) remains a major dilemma for clinicians, often presenting as a medical emergency associated with significant adverse outcomes. The mechanisms behind triggering ES are complex. Although the increased activation of the sympathetic nervous system was widely accepted as a major mechanism in initiating and maintaining ES, it's thought that the interaction between mechanical and electrical substrates may play an important role in some situations. Here we present a case of ES that was refractory to multiple antiarrhythmic medications but was stopped by interatrial shunting. We aim to highlight the importance of mechano-electric feedback (MEF) as the pathophysiological mechanisms of some types of ES and the utility of interatrial shunting as an alternative therapeutic strategy for patients with ES initially refractory to antiarrhythmic medications when there is evidence to indicate increased left ventricular filling pressure or left atrial pressure.
Sustained Viremic Control in HIV-Infected Patient: Case Report from Nepal
Authors: Sundar Khadka, Subhash Dhital, Roshan Pandit, Anup Bastola
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

A case of human immunodeficiency virus (HIV) infection is described from Nepal with constant maintenance of CD4 count and HIV-RNA level below the lower detection threshold for more than ten years. The case was diagnosed of HIV positive in the year 2008. He had his viral load estimation performed every year since then which was always below lower detection limit and remained healthy without treatment. The patient also had not any kinds of opportunistic infection till date. He is married now and has not transmitted the disease to his wife.