OpenMed/multicare-articles huggingface dataset:
Abandonment landscapes: user attitudes, alternative futures and land management in Castro Laboreiro, Portugal
Authors: Emma H van der Zanden, Sónia M Carvalho-Ribeiro, Peter H Verburg
Journal: Reg Environ Change (2018)
Keywords: agricultural abandonment, cultural heritage, landscape preferences, portugal, questionnaire, rewilding

Land abandonment is an important process for the European Union, which primarily occurs in less productive, remote and mountainous areas with unfavourable conditions for agriculture. Future management directions of these abandonment areas are under debate, with increasing calls to adjust policies to the local characteristics, including the promotion of rewilding and the management of succession of larger areas of less-productive land. While there is an increase in studies focusing on the environmental impacts of land abandonment, there are few studies that focus on the perceptions of abandonment by different user groups, even though an understanding of local perceptions, opportunities and trade-offs associated with changing land management is crucial for landscape-related policies and planning measures. In a case study in Northern Portugal, we used a combination of statements, photograph rating exercises and open questions to assess the perceptions of local inhabitants, visitors and experts regarding land abandonment and their preferences of different possible trajectories after abandonment. The results show that all user groups have a negative response towards abandonment and associate it mainly with negative emotions and the loss of heritage and traditions. The assessment of the different abandonment stages and outcomes clearly yielded different preferences and explanations, which can be used as input for finding a common ground for landscape management, reducing conflict and as a starting point for a more spatially targeted and nuanced management approach.
An Exceptional Case of Intraparotid Plexiform Neurofibroma Originating from Autonomic Fibers of the Auriculotemporal Nerve
Authors: Sarantis Blioskas, Sotiris Sotiriou, Katerina Rizou, Triantafyllia Koletsa, Petros Karkos, Anna Kalogera-Fountzila, Konstantinos Markou
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Plexiform neurofibromas are benign tumors that tend to occur in patients suffering from neurofibromatosis type 1 (NF-1). This report addresses a rare case where the tumor affected the parotid gland, deriving almost exclusively from the peripheral portion of the facial nerve. A 6-year-old male was referred to us complaining about a gradually enlarging swelling over the right parotid area. Imaging localized the lesion to the superficial lobe of the parotid gland, suggesting a neurofibroma. Cosmetic disfigurement and a functional deficit led us to perform complete surgical resection. Meticulous surgical dissection as well as auriculotemporal nerve origin made complete extirpation possible with almost zero morbidity and ensured alleviation of both aesthetic impairment and pain. This is the first case of an intraparotid PN in a pediatric NF-1 patient, which originated from branches of the auriculotemporal nerve and particularly from fibers of the autonomic nervous system. Radical surgical excision was decided according to established decision-making algorithms.
Diffuse Subcutaneous Emphysema, Pneumomediastinum, and Pneumothorax following Robotic Assisted Laparoscopic Hysterectomy
Authors: Laryssa Patti, William Haussner, Grant Wei
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Robotic assisted laparoscopic surgery is becoming more widely available, but despite its multiple benefits, it is not without risk. This case is of a 62-year-old female who presented to the emergency department for dyspnea two days after robotic assisted laparoscopic hysterectomy. Physical exam revealed diffuse facial, neck, upper extremity, torso, and lower extremity crepitus, which was diagnosed as diffuse subcutaneous air on computed tomography (CT). Imaging also revealed right apical pneumothorax and pneumomediastinum. The patient progressively improved over one month, with resolution of symptoms.
Rasmussen's Encephalitis: A Report of a Tunisian Pediatric Case and Literature Review
Authors: Hedia Klaa, Thouraya Ben Younes, Hanene Benrhouma, Sonia Nagi, Aida Rouissi, Ichraf Kraoua, Ilhem Ben Youssef-Turki
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Rasmussen's encephalitis (RE) is a rare progressive inflammatory disease of the central nervous system. It is characterized by unilateral hemispheric atrophy, pharmacoresistant focal seizures, and progressive neurological deficit. The exact etiopathogenesis still remains unknown. Brain imaging plays an important role in diagnosis and follow-up. Fluctuation of lesions in brain imaging was reported in few cases. Herein, we report an additional pediatric case of Rasmussen encephalitis with fluctuating changes in brain MRI.
Conservative Management of Abnormally Invasive Placenta Previa after Midtrimester Foetal Demise
Authors: A MacGibbon, Y M Ius
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

We present the case of a midtrimester intrauterine foetal demise (IUFD) in the context of abnormally invasive placentation. This was a grade 4 placenta previa with placenta increta in a patient requesting fertility conservation and was managed conservatively without immediate surgical intervention. The patient spontaneously delivered the fetus after 33 days, followed by a large obstetric haemorrhage requiring immediate laparotomy and hysterotomy. Her uterus was preserved and she went on to recover without further significant complication. While conservative management of morbidly adherent placentas has been well documented, there are no published cases of this strategy in the context of IUFD and fertility preservation.
Pneumatic displacement with perfluoropropane gas and intravitreal tissue plasminogen activator for subretinal subfoveal hemorrhage after focal laser photocoagulation in central serous chorioretinopathy
Authors: Khalid Al Rubaie, Juan V Espinoza, Andres F Lasave, Dario Savino-Zari, Fernando A Arevalo, J Fernando Arevalo
Journal: Case Rep Ophthalmol Med (2014)

Objective. To report the visual and anatomic outcomes of pneumatic displacement with perfluoropropane (C3F8) gas and intravitreal tissue plasminogen activator (IVTPA) for subretinal subfoveal hemorrhage after focal laser photocoagulation in central serous chorioretinopathy (CSCR). Method. Interventional, retrospective case report of one eye (one patient). Outcome measures included visual acuity (VA), central macular thickness (CMT), and size of the lesion at two weeks of followup. Fluorescein angiography (FA) and optical coherent tomography (OCT) were used to measure anatomic outcomes. Results. A 35-year-old man with history of chronic CSCR received focal laser photocoagulation in the right eye two days before presentation. At initial examination, VA was 20/200 (ETDRS chart), CMT was 398 μ, and a subretinal subfoveal hemorrhage was seen. Tissue plasminogen activator (tPA) at a dose of 25 µg/0.1 mL was injected intravitreally before intravitreal C3F8 injection, and prone positioning was indicated postoperatively. At 24 hours, the hemorrhage had been displaced inferiorly and VA improved to 20/100. Two weeks later, VA improved to 20/80, CMT decreased to 225 μ, and the hemorrhage decreased without foveal involvement. Conclusions. The technique seems safe and effective in treating visually significant subretinal subfoveal hemorrhage.
Amoxicillin-Clavulanate Induced Liver Injury in a Young Female
Authors: Jennifer Appiah, Ankita Prasad, Viraj Shah, Vraj Patel, Nusha Fareen, Andrea C Marin, Pramil Cheriyath
Journal: Cureus (2023)
Keywords: alkaline phosphatase, amoxicillin-clavalunate, cholestatic, hepatitis, hepatocellular, liver enzymes, liver injury, r score, rucam, serum bilirubin
MeSH terms: Case Reports

Amoxicillin-clavulanate (AC) is an antibiotic widely used for various infections. It has rarely been associated with drug-induced liver injury (DILI), mainly in males 55 or older with associated alcohol consumption or medications causing liver injury. Here we present an atypical case of a 22-year-old female with a past medical history of celiac disease and alopecia areata who was prescribed AC in urgent care for bilateral cervical lymphadenopathy, nausea, and chills. Her nausea and vomiting worsened after taking AC for three days, and she developed jaundice. On workup, she was found to have deranged liver functions, and pan-lobular hepatitis was confirmed on liver biopsy. She started to improve symptomatically after withdrawing AC, and her transaminases started showing a decreasing trend.
Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step
Authors: Jérôme Sudrial, Caroline Birlouez, Anne-Laurette Guillerm, Jean-Luc Sebbah, Roland Amathieu, Gilles Dhonneur
Journal: Emerg Med Int (2010)
MeSH terms: Case Reports

We report a case of prehospital "cannot intubate" and "cannot ventilate" scenarios successfully managed by strictly following a difficult airway management algorithm. Five airway devices were used: the Macintosh laryngoscope, the gum elastic Eschmann bougie, the LMA Fastrach, the Melker cricothyrotomy cannula, and the flexible fiberscope. Although several airway devices were used, overall airway management duration was relatively short, at 20 min, because for each scenario, failed primary and secondary backup devices were quickly abandoned after 2 failed attempts, each attempt of no more than 2 min in duration, in favor of the tertiary rescue device. Equally, all three of these rescue devices failed, an uncuffed cricothyroidotomy cannula was inserted to restore optimal arterial oxygenation until a definitive airway was secured in the ICU using a flexible fiberscope. Our case reinforces the need to strictly follow a difficult airway management algorithm that employs a limited number of effective devices and techniques, and highlights the imperative for early activation of successive preplanned steps of the algorithm.
A Pediatric Case of Cowden Syndrome with Graves' Disease
Authors: Cláudia Patraquim, Vera Fernandes, Sofia Martins, Ana Antunes, Olinda Marques, José Luís Carvalho, Jorge Correia-Pinto, Carla Meireles, Ana Margarida Ferreira
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Cowden syndrome (CS) is a rare dominantly inherited multisystem disorder, characterized by an extraordinary malignant potential. In 80% of cases, the human tumor suppressor gene phosphatase and tensin homolog (PTEN) is mutated. We present a case of a 17-year-old boy with genetically confirmed CS and Graves' disease (GD). At the age of 15, he presented with intention tremor, palpitations, and marked anxiety. On examination, he had macrocephaly, coarse facies, slight prognathism, facial trichilemmomas, abdominal keratoses, leg hemangioma, and a diffusely enlarged thyroid gland. He started antithyroid drug (ATD) therapy with methimazole and, after a 2-year treatment period without achieving a remission status, a total thyroidectomy was performed. Diagnosis and management of CS should be multidisciplinary. Thyroid disease is frequent, but its management has yet to be fully defined. The authors present a case report of a pediatric patient with CS and GD and discuss treatment options.
Caloric Vestibular Stimulation Reduces Pain and Somatoparaphrenia in a Severe Chronic Central Post-Stroke Pain Patient: A Case Study
Authors: Grazia Fernanda Spitoni, Giorgio Pireddu, Gaspare Galati, Valentina Sulpizio, Stefano Paolucci, Luigi Pizzamiglio
Journal: PLoS One (2016)
MeSH terms: Pain / diagnosis, Pain Management / methods, Case Reports, Research Support, Non-U.S. Gov't, Analgesia / methods, Delusions, Female, Humans, Middle Aged, Pain / physiopathology, Stroke / pathology, Stroke / physiopathology, Temperature, Thalamus / pathology, Vestibular Nerve / physiopathology

Central post-stroke pain is a neuropathic syndrome characterized by intolerable contralesional pain and, in rare cases, somatic delusions. To date, there is limited evidence for the effective treatments of this disease. Here we used caloric vestibular stimulation to reduce pain and somatoparaphrenia in a 57-year-old woman suffering from central post-stroke pain. Resting-state functional magnetic resonance imaging was used to assess the neurological effects of this treatment. Following vestibular stimulation we observed impressive improvements in motor skills, pain, and somatic delusions. In the functional connectivity study before the vestibular stimulation, we observed differences in the patient's left thalamus functional connectivity, with respect to the thalamus connectivity of a control group (N = 20), in the bilateral cingulate cortex and left insula. After the caloric stimulation, the left thalamus functional connectivity with these regions, which are known to be involved in the cortical response to pain, disappeared as in the control group. The beneficial use of vestibular stimulation in the reduction of pain and somatic delusion in a CPSP patient is now documented by behavioral and imaging data. This evidence can be applied to theoretical models of pain and body delusions.
Multidisciplinary treatment approach in a patient with history of nasopharyngeal carcinoma
Authors: Atacan Yavuz, Omer Birkan Ağralı, Zeynep Lale Calışkan, Dilek Türkaydın, Atilla Sertgöz, Bahar Kuru, Başak Doğan
Journal: Case Rep Dent (2014)

Radiotherapy in NPC patients has side effects on the dentition, which affects quality of life dramatically. This case report presents multidisciplinary dental treatment approach in a 17-year-old male patient with a history of nasopharyngeal carcinoma (NPC), which was treated with chemotherapy and radiotherapy. The adolescent patient applied to dental hospital 4 years after the radiotherapy with aesthetic and functional problems on dentition affecting psychological, social, and physical aspects of his life. The dentition of the patient demonstrated the severe destruction as a devastating side effect of radiotherapy. With a successful multidisciplinary approach, our patient's aesthetics, function, and self-confidence were obtained. Well-established procedures, which include preventative care and maintenance, can reduce the duration and expenses of the treatment and help in challenging the life-long complications of radiotherapy.
Robotic Arm-Assisted Total Knee Arthroplasty in the Setting of Combined Extra-articular Deformities of the Femur and Tibia
Authors: Sharma Cook-Richardson, Rasesh Desai
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

In this case, we will describe a 68-year-old man with combined femoral and tibial bone deformities who underwent robotic arm-assisted total knee arthroplasty (RATKA) to treat his severe osteoarthritis in the setting of extra-articular deformities that altered the native anatomical axis and the kinematics of the deformed extra-articular bony structures which chronically generated a neomechanical axis. The combination of severe osteoarthritis with extra-articular deformities made the RATKA method the best surgical treatment option taking into account altered kinematics of the native joint which conventional jig-based total knee arthroplasty would not have prioritized during bony cuts and implant positioning. The patient underwent successful knee arthroplasty with robotic arm-assisted technology with restoration of the mechanical axis.
Case report: Diagnosis of visceral leishmaniasis using metagenomic next-generation sequencing and bone marrow smear
Authors: Xiaogang Zhang, Yanqing Liu, Mingming Zhang, Zhiqiang Wang, Xing Feng, Liu Yang, Yajing Wang, Juan Liu, Dongbao Zhao
Journal: Front Cell Infect Microbiol (2022)
Keywords: china, bone marrow smear, early diagnosis, highthroughput sequencing, kala-azar, metagenomic next-generation sequencing, visceral leishmaniasis
MeSH terms: Leishmaniasis, Visceral / diagnosis, Leishmaniasis, Visceral / drug therapy, Case Reports, Bone Marrow, High-Throughput Nucleotide Sequencing, Hospitals, Humans, Metagenomics

Visceral leishmaniasis (VL) is a chronic infectious disease transmitted by sandflies. The primary clinical manifestations are remittent fever, pancytopenia, and splenomegaly. As VL is rare with atypical symptoms, its diagnosis is often incorrect, missed, or delayed. Without appropriate treatment, the case fatality rate of symptomatic disease is more than 95%, but the prognosis is good if diagnosed and treated timeously. We report a case of VL that was diagnosed using metagenomic next-generation sequencing (mNGS) of a peripheral blood sample. By using mNGS and a bone marrow smear, we were able to make a timely diagnosis. The patient was treated with antimony, rapidly recovered, and was discharged from the hospital. This case illustrates the value of mNGS for making a timely diagnosis of VL.
Hypersensitivity vasculitis with leukocytoclastic vasculitis associated with alpha-1-proteinase inhibitor
Authors: Nicola W Mwirigi, Charles F Thomas
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Prolastin is a commercially available form of alpha-1-antitrypsin (AAT) that is derived from pooled human plasma and used for treatment of severe alpha-1-antitrypsin deficiency (AATD). We describe a patient with AATD who developed presumed hypersensitivity vasculitis (HV) following a Prolastin infusion. Hypersensitivity vasculitis (HV), or cutaneous vasculitis, is characterized by inflammation of the small vessels of the skin with resultant ischemia to the distally supplied areas. To our knowledge, this is the first reported case of presumed hypersensitivity vasculitis following Prolastin infusion.
Total Knee Arthroplasty in Ochronosis: A Rare Condition
Authors: Anil Arora, Getnet Asnake, Karan Pandav
Journal: Cureus (2023)
Keywords: alkaptonuria, black articular cartilage, homogentisic acid, ochronosis, total knee arthroplasty
MeSH terms: Case Reports

Ochronosis is a rare metabolic disorder characterized by homogentisic acid deposition in the large joints and spine, resulting in progressive degeneration. We present two cases of ochronotic arthritis of the knee subjected to cemented total knee arthroplasty (TKA). These cases were diagnosed intraoperatively and later confirmed with a histopathologic examination. Orthopedic surgeons should be aware of the condition as the intraoperative finding of darkened cartilage might surprise them. After a five-year TKA follow-up, both of our cases showed better mobility and function.
Case Report: Isolate Congenital Coronary Artery Fistula With Giant Artery Aneurysm in a Neonate
Authors: Haoyong Yuan, Zhongshi Wu, Qin Wu, Ting Lu, Yilun Tang, Can Huang
Journal: Front Cardiovasc Med (2021)
Keywords: cardiovascular surgery, congenital heart disease, coronary artery aneurysm, coronary artery fistula, neonate
MeSH terms: Case Reports

A rare case of neonatal congenital coronary artery, right ventricle fistula with giant coronary artery aneurysm formation, was reported. Computed tomography angiography demonstrated the dilated and tortuous tunnel arising from the right aortic sinus and traversing the epicardial surface before opening into the anterolateral aspect of the RV. Successful surgical repair was performed with a patch closure of the fistula and coronary angioplasty. The postoperative recovery was uneventful. Our experience of this rare congenital heart disease demonstrated that early surgical repair of coronary artery fistula and coronary angioplasty in the neonate can be performed safely. Further study is needed to seek the basis on this.
Case Report: Can Inhaled Adenosine Attenuate COVID-19?
Authors: Bruce D Spiess, Michael Sitkovsky, Pierpaolo Correale, Nikolaus Gravenstein, Cynthia Garvan, Timothy E Morey, Brenda G Fahy, Leslie Hendeles, Thomas J Pliura, Thomas D Martin, Velyn Wu, Corey Astrom, Danielle S Nelson
Journal: Front Pharmacol (2021)
Keywords: ards, covid-19, acute respiratory distress syndrome, adenosine, case report, nebulizer
MeSH terms: Case Reports

This case report demonstrates a small repetition of the case series carried out in Italy wherein inhaled adenosine was administered to patients experiencing severe and worsening coronavirus disease-2019 (COVID-19). The two cases are important not only because they were the first of their type in the United States, but also because both patients were DNR/DNI and were therefore expected to die. Study repetition is vitally important in medicine. New work in pharmacology hypothesizes that adenosine-regulator proteins may play a role in the pathogenesis of COVID-19 infection. Furthermore, adenosine, by interacting with cell receptor sites, has pluripotent effects upon inflammatory cells, is anti-inflammatory, and is important in tissue hypoxia signaling. Inhaled adenosine is potentially safe; thousands have received it for asthmatic challenge testing. The effects of adenosine in these two cases were rapid, positive, and fit the pharmacologic hypotheses (as seen in prior work in this journal) and support its role as a therapeutic nucleoside.
Management of implant plate exposure of silicone Ahmed glaucoma valve: a review of six cases
Authors: Avik Kumar Roy, Sirisha Senthil
Journal: GMS Ophthalmol Cases (2016)
MeSH terms: Case Reports

Objective: To describe the management options for exposed silicone Ahmed glaucoma valve (AGV) implant. Methods: This was carried out as a retrospective chart review at a tertiary care eye hospital in Southern India. Medical records of six subjects managed for AGV exposure from 2006 to 2013 were reviewed. Results: All six eyes had explantation of the AGV and 3 of them had reimplantation in a different quadrant at a later date and the other 3 eyes were managed medically. All eyes had well controlled IOP at the last follow-up. The possible predisposing factors for exposure were improper conjunctival coverage, higher number of pre shunt surgeries and diabetes mellitus. Reimplantation was a challenge with scarred conjunctiva and the techniques used were conjunctival advancement, conjunctival relaxing incisions and contralateral conjunctival autograft. None had re-exposure but one eye had conjunctival erosion close to the limbus and was managed with scleral patch graft and conjunctival advancement. Conclusions: Implant exposure is a serious vision threatening complication following glaucoma drainage device implantation. Explantation and timely repair can save these eyes from serious sequel. Reimplantation is a good option, however warrants close follow-up for complications like erosion or re-exposure.
Case Report: SARS-CoV-2 Mother-to-Child Transmission and Fetal Death Associated With Severe Placental Thromboembolism
Authors: Penélope Saldanha Marinho, Antonio José Ledo Alves da Cunha, Leila Chimelli, Elyzabeth Avvad-Portari, Felipe da Matta Andreiuolo, Patrícia Soares de Oliveira-Szejnfeld, Mayara Abud Mendes, Ismael Carlos Gomes, Letícia Rocha Q Souza, Marilia Zaluar Guimarães, Suzan Menasce Goldman, Mariana Barros Genuíno de Oliveira, Stevens Rehen, Joffre Amim Jr, Fernanda Tovar-Moll, Arnaldo Prata-Barbosa
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, sars-cov-2, fetal death, mother-to-child transmission, placental thromboembolism, pregnancy
MeSH terms: Case Reports

SARS-CoV-2 infection during pregnancy is not usually associated with significant adverse effects. However, in this study, we report a fetal death associated with mild COVID-19 in a 34-week-pregnant woman. The virus was detected in the placenta and in an unprecedented way in several fetal tissues. Placental abnormalities (MRI and anatomopathological study) were consistent with intense vascular malperfusion, probably the cause of fetal death. Lung histopathology also showed signs of inflammation, which could have been a contributory factor. Monitoring inflammatory response and coagulation in high-risk pregnant women with COVID-19 may prevent unfavorable outcomes, as shown in this case.