OpenMed/multicare-articles huggingface dataset:
Aggressive surgical treatment in late-diagnosed esophageal perforation: a report of 11 cases
Authors: Rahim Mahmodlou, Isa Abdirad, Mohammad Ghasemi-Rad
Journal: ISRN Surg (2011)

Introduction. Esophageal perforation is a relatively uncommon and lethal disease usually resulting from endoscopic procedures. Delay in the diagnosis and treatment occurs in more than 50% of cases, leading to a mortality rate of 40% to 60%, but this rate decreases is 10%-25% if treatment is carried out within 24 hours of perforation. Case Presentation. To analyze the characteristics, etiology, site of perforation, presentation, time interval till diagnosis, treatment and outcome of patients with esophageal perforation. Over a five-year period, from October 2004 through March 2009, 11 patients with esophageal perforation were referred to the division of thoracic surgery of a tertiary referral hospital. In eight patients, perforations were thoracic with delayed diagnosis for at least 48 hours. Two patients had cervical esophageal perforation, and one patient had early-diagnosed Boerhaave's syndrome. Eight patients are alive after followup for a period ranging from eight months to five years. In the remaining three patients, cancer was the underlying disease and the reason of death. Conclusion. No patient with esophageal perforation should be deprived from surgical repair due to delayed diagnosis. All, except preterminal patients, should undergo exploration after resuscitation, and appropriate treatment should be carried out depending on the findings during operation. Aggressive treatment is necessary in the case of established mediastinitis.
Adrenal oncocytoma masquerading as a functional tumor
Authors: Tanmaya Goel, Joseph Thomas, Shveta Garg, Anuradha C K Rao, Sreedhar Reddy
Journal: Indian J Urol (2007)
Keywords: adrenal oncocytoma, adrenalectomy, catecholamines, immunostaining
MeSH terms: Case Reports

Adrenal oncocytoma is a rare entity, with 20 cases reported in literature. A functional oncocytoma is extremely rare. We present a case of adrenal oncocytoma in a hypertensive male who had elevated catecholamine levels, which improved after adrenalectomy with decrease in daily antihypertensive requirement.
A 6-month-old girl with mesenteric teratoma: A Case report and literature review
Authors: Yuyan Jin, Yanan Zhang, Yongwei Chen, Jinshi Huang
Journal: Front Pediatr (2023)
Keywords: case report, infant, mesentery, surgery, teratoma
MeSH terms: Case Reports

An otherwise healthy 4-month-old girl presented to the community health service center because her abdomen was distended. Over the next 2 months, the girl's abdomen gradually became more distended. Her examination was notable for abdominal distention with a large, mobile, non-tender abdominal mass. Abdominal ultrasound images and subsequently obtained CT images showed a large, circumscribed cystic and solid mass. This led to the presumptive diagnosis of teratoma of the mesentery. The mass was completely resected during a laparotomy. The pathology, along with the surgical findings and imaging, led to the final diagnosis.
The Use of Conditioning Open-Label Placebo in Opioid Dose Reduction: A Case Report and Literature Review
Authors: Maria A Estudillo-Guerra, Ines Mesia-Toledo, Jeffrey C Schneider, Leon Morales-Quezada
Journal: Front Pain Res (Lausanne) (2021)
Keywords: conditioning, open-label placebo, opioids, pain, pharmaco-behavioral
MeSH terms: Case Reports

Introduction: Adequate pain management for inpatients in rehabilitation units is essential for achieving therapeutic goals. Opioid treatments are commonly prescribed, but these are associated with numerous adverse effects, including the risk of addiction and decreased quality of life. Conditioning an open-label placebo is a promising approach to extend the analgesic effect of the opioid while reducing its overall dosage. Objectives: To describe a patient's experience in using conditioning open-label placebo (COLP) as a pharmaco-behavioral intervention to decrease opioid intake and its side effects after inpatient rehabilitation discharge, and to perform a literature review about the use of open-label placebo in pain. Methods: This case study has been extracted from a clinical trial initiated in 2018. A 61-year-old male was recruited at a tertiary rehabilitation hospital after suffering a traumatic sport-related injury and orthopedic surgery. Pain management included prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and short-acting oxycodone. After trial participation, the patient requested off-label COLP treatment to help him decrease outpatient opioid utilization. Results: After COLP treatment, the patient could discontinue oxycodone intake (a reduction from 15 morphine equivalents/day) after rehabilitation discharge. Moreover, opioid side effects decreased from 46 to 9 points on the numerical opioid side-effects scale. A literature review identified five clinical trials using "honest" open-label placebo (OLP) or COLP as an experimental intervention for pain control. From these studies, two were in the area of chronic lower back pain, one in post spine surgery, one in irritable bowel syndrome, and another in spinal cord injury and polytrauma. Four studies reported positive outcomes related to pain control, while one study showed no significant differences in pain management between treatment-as-usual and the COLP group. Conclusion: The case report illustrates how a pharmaco-behavioral intervention can facilitate downward opioid titration safely after inpatient rehabilitation. It initiates a discussion about new approaches for opioid management using conditioning and the patient's expectation of pain relief.
Phage treatment of an aortic graft infected with Pseudomonas aeruginosa
Authors: Benjamin K Chan, Paul E Turner, Samuel Kim, Hamid R Mojibian, John A Elefteriades, Deepak Narayan
Journal: Evol Med Public Health (2018)
Keywords: pseudomonas aeruginosa, antibiotic resistance, phage therapy, prosthetic vascular graft infection
MeSH terms: Case Reports

Management of prosthetic vascular graft infections caused by Pseudomonas aeruginosa can be a significant challenge to clinicians. These infections often do not resolve with antibiotic therapy alone due to antibiotic resistance/tolerance by bacteria, poor ability of antibiotics to permeate/reduce biofilms and/or other factors. Bacteriophage OMKO1 binding to efflux pump proteins in P. aeruginosa was consistent with an evolutionary trade-off: wildtype bacteria were killed by phage whereas evolution of phage-resistance led to increased antibiotic sensitivity. However, phage clinical-use has not been demonstrated. Here, we present a case report detailing therapeutic application of phage OMKO1 to treat a chronic P. aeruginosa infection of an aortic Dacron graft with associated aorto-cutaneous fistula. Following a single application of phage OMKO1 and ceftazidime, the infection appeared to resolve with no signs of recurrence.
Ectopic Breast Tissue in the Inguinal Region: A Case Report and Suggestion of Indications for Excision
Authors: Jangyoun Choi, Young Bin Yang, Deuk Young Oh
Journal: Front Surg (2022)
Keywords: breast, ectopic, hormone-sensitive, inguinal, neoplasm
MeSH terms: Case Reports

We report a rare case of ectopic breast tissue situated in a unique location. A 50-year-old female patient came to our institution complaining of a bulge in the inguinal area. CT was unremarkable other than a benign-looking conglomeration of lymph nodes around the inguinal canal. However, excisional biopsy proved otherwise, with strong expression of breast-related immunohistochemical markers on pathology. Based on histological findings, the diagnosis of ectopic breast tissue was made. Since the vast majority of ectopic breast tissue is found around the breast mound, axilla, and along the milk line, this case is peculiar in its location. This report shares our experience and provides indications for excision of incidental ectopic breast tissue.
Where are the hotspots and coldspots of landscape values, visitor use and biodiversity in an urban forest?
Authors: Silviya Korpilo, Joel Jalkanen, Tarmo Virtanen, Susanna Lehvävirta
Journal: PLoS One (2018)
MeSH terms: Ecosystem, Forests, Research Support, Non-U.S. Gov't, Biodiversity, Geographic Information Systems

Cities and urban green areas therein can be considered as complex social-ecological systems that provide various ecosystem services with different synergies and trade-offs among them. In this article, we show that multiple stakeholder perspectives and data sources should be used to capture key values for sustainable planning and management of urban green spaces. Using an urban forest in Helsinki, Finland as a case study, we incorporated data collected using public participation GIS, expert elicitation and forest inventories in order to investigate the guidance that the different types of data, and their integration, can provide for landscape planning. We examined the relationship and spatial concurrence between two social variables i.e. visitors' perceived landscape values and green space use, and two ecological variables i.e. forest habitat quality and urban biodiversity, using hot/coldspot analysis. We found weak correlations and low mean spatial coincidence between the social and ecological data, indicating great complementary importance to multi-criteria decision-making. In addition, there was a higher level of spatial agreement between the ecological datasets than between the social datasets. Forest habitat quality and urban biodiversity were positively correlated and spatially coincided moderately, while we found a negative correlation and very low overlap between visitor use and landscape values. This highlights the conceptual and spatial distinction between the general preferences and values citizens assign to public green spaces and the realized everyday use of these areas and their services. The resulting maps can inform planners on overall social and environmental quality of the landscape, and point out potential threats to areas of high ecological value due to intensive recreational use, which is crucial information for natural resource management. In the end, we discuss different strategies for managing overlaps and discrepancies between the social and ecological values.
Fourteen-Year Patency of an Anterior Tibial Artery-Saphenous Vein Fistula in an Ambulatory Patient
Authors: Zerrin Pulathan, Gökalp Altun
Journal: Case Rep Vasc Med (2022)
MeSH terms: Case Reports

Background:
Ankle arteriovenous fistulas are the rarest vascular access type among lower extremity fistulas for hemodialysis patients with end-stage renal disease. Here, we present a case of a tibial-saphenous fistula that remained open for a long time despite a recurrent anastomotic aneurysm. Case Presentation. A 43-year-old female patient who had been undergoing hemodialysis via a right femoral tunnel catheter for six months was referred for recurrent catheter infection and a 4 cm pulsatile mass in the anterior aspect of the ankle. While she had been undergoing hemodialysis through a right tibial-saphenous fistula for fourteen years, hemodialysis continued after the fistula's closure due to total occlusion of the great saphenous vein through the tunneled catheter. After balloon angioplasty to the right subclavian vein, we performed right upper extremity basilic vein transposition. Later, after starting adequate dialysis from the basilic vein fistula and removing the femoral catheter, we performed a resection of the anastomotic aneurysm in the right ankle and repaired the anterior tibial artery. Because this is the only ambulatory patient and the one with the longest patency of ankle arteriovenous fistulas in the literature and the only case in which the anterior tibial artery was used, the case is presented and discussed in light of the literature.
Conclusion:
Despite many complications and low patency rates reported in the literature, ankle vessels should be considered for autogenous vascular access in selected patients.
Efficacy of Pyrotinib in HER2-Overexpressing Salivary Duct Carcinoma With Lung Metastasis: A Case Report
Authors: Zi-Yan Yang, Jia-Huan Huang, Bo Chen, Chun-Wei Xu, Lei Lei, Xiao-Jia Wang, Mei-Yu Fang
Journal: Front Oncol (2020)
Keywords: her2 positive, pyrotinib, salivary duct carcinoma, targeted, tyrosine kinase inhibitor
MeSH terms: Case Reports

Background: Salivary duct carcinoma (SDC), an aggressive and rare malignancy with poor prognosis, is mostly associated with the overexpression of the androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2). However, limited data are available for the targeting of both HER2 and AR in advanced/metastatic SDC. Case Presentation: A 62-year-old man with advanced SDC accompanied by lung and lymph node metastasis showed disease progression after two lines of chemotherapy and endocrine therapy. Metastatic lesions from the lung biopsy were obtained, and immunohistochemistry (IHC) indicated the overexpression of AR and HER2 (3+). The patient was administered pyrotinib (a pan-ErbB receptor tyrosine kinase inhibitor) and bicalutamide (an androgen receptor antagonist) as a third-line treatment. During the ten months of follow-up, a durable partial response was achieved with this combination. Conclusions: This is the first clinical study to report the successful application of pyrotinib in a patient with advanced SDC. We recommend that pyrotinib and bicalutamide be used as salvage therapy for AR and HER2-positive advanced metastases in SDC, given the favorable response and clinical benefit.
Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney Donation
Authors: K Ramdhani, M J A Malessy, M J G Simon, V A L Huurman
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

To date live laparoscopic donor nephrectomies (LLDN) are frequently performed. The most common complications entail bleeding, wound infection, and incisional hernia. Here we discuss a 50-year-old patient with a severe less known complication, namely, postoperative persistent neuropathic pain in the scrotum and left upper leg. Satisfactory pain control could not be obtained in 3 years of postoperative pain treatment which consisted of neuroleptic drugs, blocks of the L1/L2 dorsal roots with local anaesthetics, and pulsed radiofrequency lesioning. Exploratory laparoscopy was performed to assess the aspect of the genitofemoral nerve (GFN). A hemoclip used for the closure of the ureter at the time of nephrectomy was found in close relation to the GFN. The clip was removed and the GFN was subsequently cut proximal to the side of this clip. Soon after surgery the patient was completely pain-free and could return to his normal activities. Surgery should be considered in case of GFN neuropathic pain following LLDN.
CASE REPORT Postoperative Use of the NormaTec Pneumatic Compression Device in Vascular Anomalies
Authors: Simon G Talbot, David Kerstein, Laura F Jacobs, Joseph Upton
Journal: Eplasty (2012)

Arteriovenous malformations have a wide range of clinical presentations and an unfortunately unpredictable response to both nonsurgical and surgical intervention. The authors report on the surgical treatment of a 19-year-old man with a complex lower extremity arteriovenous malformation, previously unsuccessfully treated with numerous local sclerotherapy and interventional radiology embolization procedures leading to massive tissue necrosis and deep infection. The patient was definitively treated with wide excision of the necrotic tissue, coils, and arteriovenous malformation, but with preservation of the tibial nerve and vascular supply to the foot. Significant postoperative complications were prevented with the use of a novel dynamic compression device employing peristaltic pulse pneumatic compression.
Successful Treatment of Severe Atopic Dermatitis with Calcitriol and Paricalcitol in an 8-Year-Old Girl
Authors: Christina Bothou, Alexis Alexopoulos, Eleni Dermitzaki, Kleanthis Kleanthous, Anastasios Papadimitriou, George Mastorakos, Dimitrios T Papadimitriou
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Atopic dermatitis (AD) is a chronic inflammatory disease affecting children and adolescence. The traditional therapeutic options for AD, including emollients topically and immune modulatory agents systemically focusing on reducing skin inflammation and restoring the function of the epidermal barrier, are proven ineffective in many cases. Several studies have linked vitamin D supplementation with either a decreased risk to develop AD or a clinical improvement of the symptoms of AD patients. In this report, we present a girl with severe AD who under adequate supplementation with cholecalciferol was treated with calcitriol and subsequently with paricalcitol. She had significant improvement-almost healing of her skin lesions within 2 months, a result sustained for more than 3 years now. Because of hypercalciuria as a side effect from calcitriol therapy, treatment was continued with paricalcitol, a vitamin D analogue used in secondary hyperparathyroidism in chronic kidney disease. Calcitriol therapy may be considered as a safe and efficacious treatment option for patients with severe AD, particularly for those with refractory AD, under monitoring for possible side effects. Treatment with paricalcitol resolves hypercalciuria, is safe, and should be further investigated as an alternative treatment of atopic dermatitis and possibly other diseases of autoimmune origin.
Renal Tubular Dysgenesis in a Case of Fetus Acardius Amorphus
Authors: C Thoeni, K Holzer, J Leichsenring, C Porcel, B K Straub, H P Sinn, M Elsaesser, A L Volckmar, P Schirmacher, R Waldherr, F Lasitschka
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Fetus acardius amorphus is a rare congenital malformation characterized by the lack of a functional heart, the presence of a bivascular umbilical cord, as well as a developed and organized skeletal system and partially organized inner organs. Fetus acardii mostly occur in multiple gestations. The pathogenesis of this entity is not clarified yet. It has been hypothesized that, although formation of anastomosing vessels between the co-twin and the anomalous embryo as well as reverse directed blood flow within the umbilical arteries of the weaker twin may allow sufficient blood flow to form rudimentary internal organs, it is insufficient to develop a fully functional heart. We had a case of fetus acardius amorphus, where we performed autopsy as well as routine histology assessment to identify different types of tissues. We showed that our fetus acardius amorphus demonstrated histomorphological features of renal tubular dysgenesis, confirmed by lack of proximal tubules, extramedullary hematopoiesis and increased number of smooth muscle actin positive vessels. This is a novel finding and has not been reported previously.
Pediatricians, Well-Baby Visits, and Video Intervention Therapy: Feasibility of a Video-Feedback Infant Mental Health Support Intervention in a Pediatric Primary Health Care Setting
Authors: Sergio Facchini, Valentina Martin, George Downing
Journal: Front Psychol (2016)
Keywords: attachment, infant mental health, parenting, pediatrician, prevention, primary care, video-feedback

This case series study evaluated the feasibility and acceptability of a behavioral/cognitive psychological intervention in a pediatric primary health care setting during standard well-baby visits. The aim of the intervention was to support caregivers' sensitivity and mentalization in order to promote infant mental health (IMH). Four neonates from birth to 8 months were consecutively enrolled to test a short video-feedback intervention (Primary Care - Video Intervention Therapy, an adaptation of George Downing's Video Intervention Therapy to primary care) conducted by a pediatrician. The 5 min interaction recording and the video-feedback session were performed during the same well-baby visit and in the same pediatrician's office where the physical examination was conducted. During the study period, six video-feedback sessions were performed for each baby at different ages (1, 2, 3, 4, 6, 8 months). A series of different interactional situations were filmed and discussed: touch, cry, affective matching, descriptive language, feeding, separation and autonomy. The intervention was easily accepted and much appreciated by all four families enrolled. This study aimed to answer a dilemma which pediatric providers generally face: if the provider wishes to respond not only to physical but also IMH issues, how on a practical level can this be done? This case series study indicates that Primary Care - Video Intervention Therapy can be a promising new tool for such a purpose.
Anesthetic Management of Total Aortic Arch Replacement in a Myasthenia Gravis Patient under Deep Hypothermic Circulatory Arrest
Authors: Mamiko Kondo, Yusuke Yoshikawa, Hirofumi Terada, Michiaki Yamakage
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

The anesthetic management of myasthenia gravis patients undergoing cardiac or aortic surgery under cardiopulmonary bypass, especially with deep hypothermic circulatory arrest, is challenging. We describe a case of successful anesthetic management of a myasthenia gravis patient undergoing total arch replacement with deep hypothermic circulatory arrest under neuromuscular monitoring and complete reversal of the action of neuromuscular blocking drugs by sugammadex. The present case suggests that patients with well-controlled myasthenia gravis might be safely managed in cardiac or aortic surgery under cardiopulmonary bypass with deep hypothermic circulatory arrest.
Small cell carcinoma of the ovary of hypercalcemic type: a case report
Authors: S Zaied, O Gharbi, A Zayène, R Rjiba, R Hadhri, A Hadded, M Hochlef, L Ben Fatma, S Ben Ahmed
Journal: Case Rep Oncol Med (2012)

Introduction. The small cell carcinoma of hypercalcemic type of ovary is a very aggressive tumor. It is associated with two-thirds of cases with hypercalcemia most often asymptomatic. It occurs mostly for young women. The treatment combines surgery, chemotherapy, and radiotherapy. Case Presentation. We report a case of small cell carcinoma of the ovary hypercalcemic type in a young Tunisian woman aged 25 years after a severe abdominal pain syndrome and a large ovarian mass discovered in scanner; a laparotomy was performed by radical surgery. The pathological examination of the specimen confirmed the diagnosis. The radiological assessment performed after surgery showed a continuing evolution. Palliative chemotherapy was established, and the patient had died two months after diagnosis. Conclusion. The hypercalcemic small cell carcinoma of the ovary is a rare disease of poor prognosis.
Atypical Antiglomerular Basement Membrane Disease in a Pediatric Patient Successfully Treated with Rituximab
Authors: Kuang-Yu Jen, Ari Auron
Journal: Case Rep Nephrol (2021)
MeSH terms: Case Reports

Classic antiglomerular basement membrane (anti-GBM) disease is an exceedingly rare but extremely aggressive form of glomerulonephritis, typically caused by autoantibodies directed against cryptic, conformational epitopes within the noncollagenous domain of the type IV collagen alpha-3 subunit. Pathologic diagnosis is established by the presence of strong, diffuse, linear staining for immunoglobulin on immunofluorescence microscopy. Recently, patients with atypical clinical and pathologic findings of anti-GBM disease have been described. These patients tend to have an indolent clinical course, without pulmonary involvement, and laboratory testing rarely reveals the presence of anti-GBM antibodies. Specific guidelines for the treatment and management of these patients are unclear. Here, we describe a case of atypical anti-GBM disease in a young child who presented with hematuria and prominent proteinuria. Throughout the course of his illness, creatinine remained normal. He was conservatively treated with steroids and rituximab, resulting in resolution of his clinical symptoms and normalization of laboratory findings.