OpenMed/multicare-articles huggingface dataset:
A Five-Month-Old Boy With Hypotonia, Electrolyte Derangements, and Failure to Thrive
Authors: Samuel K Luketich, Seth J Deskins, Sydney Downey, Joseph Lynch
Journal: Cureus (2023)
Keywords: aldosterone, electrolyte disturbances, hypotonia, nephrology, pediatrics
MeSH terms: Case Reports

Failure to thrive in the setting of profound hypotonia and multiple electrolyte derangements is a challenging constellation of findings that offers a broad differential diagnosis for providers to consider. Initial management should focus on the stabilization of the patient and correction of potential life-threatening electrolyte derangements. Once completed, the diagnosis should be sought, and in this case, many were considered and ultimately ruled out with thorough history and physical examination. Laboratory abnormalities revealed the final diagnosis of pseudohypoaldosteronism and connected the case. With proper treatment, our patient had a resolution of laboratory anomalies along with improved growth and tone.
Examining the paradoxical effects of kratom: a narrative inquiry
Authors: Kirsten E Smith, Jeffrey D Feldman, Kelly E Dunn, Christopher R McCurdy, Stephanie T Weiss, Oliver Grundmann, Albert Garcia-Romeu, Janeen Nichels, David H Epstein
Journal: Front Pharmacol (2023)
Keywords: emerging drugs, kratom, kratom tolerance, novel substances, opioids

Introduction: Surveys and case reports have documented kratom use in the United States (US) for over a decade. However, those reports have generally not examined in depth the role kratom plays in the lives of those who use it regularly for sustained periods. Until there are controlled studies of the pharmacology and subjective effects of kratom alkaloids in humans, one of the best sources of insight on kratom-product use remains qualitative data with nuanced descriptions of kratom effects from those who use it regularly. Method: We conducted semistructured qualitative interviews with adults who regularly use kratom products, as part of a laboratory study of kratom-product self-administration. This qualitative component of the study was conducted as a narrative case-report series (n = 10). Results: Despite some differences among participants, all experienced acute combination effects that were largely, even simultaneously, analgesic and stimulatory. Most participants had decreased their dosages over time, and one planned to quit. Five of the 10 participants met DSM-5-based criteria for kratom-use disorder (3 mild, 1 moderate, 1 severe, by symptoms counts). When kratom was inadvertently taken in larger than intended doses, participants described a constellation of symptoms that they called "the wobbles" (a jittery feeling accompanied by what seemed to be nystagmus); this was rare, but could be of scientific and clinical interest as a possible manifestation of serotonin syndrome. Most participants described tolerance but considered kratom generally safe at low-moderate doses, providing perceived benefits with less potential risk for adverse effects compared to pharmaceuticals or illicit drugs. Discussion: In-depth interview data like these help confirm and clarify findings from larger survey studies and clinician-driven case reports. They are needed to inform the policy practice regarding kratom and may also help inform future experimental designs.
The first report on brain sagging dementia caused by a cranial leak: A case report
Authors: Aslan Lashkarivand, Per Kristian Eide
Journal: Front Neurol (2022)
Keywords: csf leak, brain, case report, cranial, dementia, sagging
MeSH terms: Case Reports

Objective:
Brain Sagging Dementia (BSD) is an increasingly recognized syndrome for which diagnostic criteria recently were proposed. There have been no reports on BSD caused by a cranial leak. Here we present the first report on a patient with BSD caused by a cranial leak.
Case description:
A 60-year old male patient was admitted with a 2-year history of orthostatic headache and gradually progressive cognitive and behavioral changes. Traditional treatments for spontaneous intracranial hypotension, including repeated epidural blood patches, failed. Brain imaging showed severe brain sagging, and intracranial pressure monitoring demonstrated intracranial hypotension. No leakage site was found. His past medical history revealed an accident where a ski pole struck his head at age ten. Due to progressive clinical decline, surgery was pursued. A cranial defect with an accompanying cerebrospinal fluid leak site representing the trauma from his childhood was found and repaired. He also was in need of a ventriculoperitoneal shunt. Following surgery, he improved and recovered completely.
Discussion:
This case report illustrates that a cranial leak may cause BSD, even with a "lucid interval" between trauma and symptom debut spanning many years. Moreover, this report validates well the recently proposed BSD diagnostic criteria.
Pulmonary sequestration and endovascular treatment: a case report
Authors: Sergio Quilici Belczak, Ingredy Tavares da Silva, Jéssica Cunha Bernardes, Felipe Basso de Macedo, Laís Leite Lucato, Bruna Rodrigues, Bruna Stecca Zeque
Journal: J Vasc Bras (2019)
Keywords: endovascular procedures, pulmonary circulation, pulmonary sequestration, therapeutic embolization
MeSH terms: Case Reports

Pulmonary sequestration is a congenital anomaly defined as a nonfunctioning mass of lung parenchyma. Presence of an independent pleural envelope classifies it as intralobar, accounting for approximately 75% of the cases, while absence classifies cases as extralobar, accounting for the remaining 25%. Diagnosis is made through radiography and confirmed by computed tomography, magnetic resonance, or angiography. The traditional treatment is open surgical repair, but endovascular techniques have been used, with good results. We report the case of a 29-year-old-woman presenting with recurrent pneumonia for 5 years. A CT scan of the chest revealed poor vascular formation in the lower region of the right lung. The pulmonary sequestration was treated by embolization of the anomalous branch.
Intestinal toxemia botulism in 3 adults, Ontario, Canada, 2006-2008
Authors: Yolanda D Sheppard, Dean Middleton, Yvonne Whitfield, Felix Tyndel, Shariq Haider, Jamie Spiegelman, Richard H Swartz, Mark P Nelder, Stacey L Baker, Lisa Landry, Ross Maceachern, Sherri Deamond, Lorrie Ross, Garth Peters, Michelle Baird, David Rose, Greg Sanders, John W Austin
Journal: Emerg Infect Dis (2012)
MeSH terms: Botulism / pathology, Case Reports, Botulinum Antitoxin / therapeutic use, Botulism / drug therapy, Botulism / epidemiology, Clostridium botulinum / isolation & purification, Feces / microbiology, Female, Humans, Male, Middle Aged, Ontario, Botulinum Antitoxin

Five cases of intestinal toxemia botulism in adults were identified within an 18-month period in or near Toronto, Ontario, Canada. We describe findings for 3 of the 5 case-patients. Clinical samples contained Clostridium botulinum spores and botulinum neurotoxins (types A and B) for extended periods (range 41-61 days), indicative of intestinal toxemia botulism. Patients' clinical signs improved with supportive care and administration of botulinum antitoxin. Peanut butter from the residence of 1 case-patient yielded C. botulinum type A, which corresponded with type A spores found in the patient's feces. The food and clinical isolates from this case-patient could not be distinguished by pulsed-field gel electrophoresis. Two of the case-patients had Crohn disease and had undergone previous bowel surgery, which may have contributed to infection with C. botulinum. These cases reinforce the view that an underlying gastrointestinal condition is a risk factor for adult intestinal toxemia botulism.
Cerebral Venous Thrombosis as Rare Presentation of Herpes Simplex Virus Encephalitis
Authors: José Leite, Ana Ribeiro, Diana Gonçalves, João Sargento-Freitas, Luís Trindade, Victor Duque
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Herpes simplex virus 1 is a prevalent neurotropic pathogen that infects and establishes latency in peripheral sensory neurons. It can migrate into the central nervous system and cause encephalitis. The association between herpes simplex virus encephalitis and cerebral venous thrombosis is rare, with a very limited number of case reports described in the literature, despite the recognized thrombogenic effects of the virus. A 44-year-old man was brought to the emergency department with generalized tonic-clonic seizures requiring sedation and ventilation to control it. Initial brain computed tomography revealed cortical and subcortical edema on the left frontal lobe, and a subsequent contrast-enhanced exam showed absence of venous flow over the anterior half of the superior sagittal sinus. Cerebrospinal fluid polymerase chain reaction was positive for herpes simplex virus type 1, and the patient was started on acyclovir and anticoagulation, with clinical improvement. Acyclovir administration was maintained for 14 days and oral anticoagulation for one year, with no recurrence of thrombotic events or other complications. A well-timed treatment has a validated prognostic impact on herpes simplex encephalitis, making early recognition of its clinical aspects of main importance.
Single trocar transanal endoscopy in a child
Authors: Ciro Esposito, Maria Escolino, Giuseppe Ascione, Alessandro Settimi
Journal: APSP J Case Rep (2013)
Keywords: child, rectal lesion, single trocar transanal endoscopy, transanal surgery
MeSH terms: Case Reports

Single trocar transanal endoscopic surgery (STTE) is a well-known technique for evaluation and management of rectal lesions in adults. We used an 11mm balloon trocar with a 10mm operative optic, introduced into the anal canal to excise a rectal lesion along with multiple rectal biopsies in a child. Rectal visibility was good with an ease to maintain the rectum insufflated.
What Plasma Can Tell Us When Tissue Cannot: A Case Report of Genomic Testing in mCRPC and Clinical Response to Treatment With the PARP Inhibitor Rucaparib
Authors: Daniel P Petrylak, Simon P Watkins, Andrea Loehr
Journal: Front Oncol (2022)
Keywords: brca, parp inhibitor, case report, plasma, poly(adp-ribose) polymerase, prostate cancer
MeSH terms: Case Reports

Background:
The poly(ADP-ribose) polymerase (PARP) inhibitor rucaparib was approved in the United States based on the phase 2 TRITON2 study of patients with BRCA1 or BRCA2 (BRCA)-mutated metastatic castration-resistant prostate cancer (mCRPC). Although genomic screening is recommended as part of a comprehensive assessment of prostate cancer prognosis and treatment options, the best way to select patients with mCRPC for treatment with a PARP inhibitor depends on individual clinical circumstances. For example, assessment of tumor tissue may not always be feasible. Genomic testing of DNA from plasma has become more readily available, providing a minimally invasive option to evaluate DNA from primary and metastatic lesions simultaneously.
Case presentation:
A patient from TRITON2 with BRCA-mutated mCRPC had a response to the PARP inhibitor rucaparib and remained on treatment for 32 weeks, which was >2 times longer than the duration of each of his prior therapies (bicalutamide, docetaxel, abiraterone). The patient enrolled in TRITON2 based on results of local genomic testing of an archival biopsy that indicated the presence of a BRCA1 T1399I (allelic fraction, 19%) mutation. Local testing also identified an ATM G1663C mutation, a TP53 P191del mutation, and a BRAF K601E mutation. Analysis of a plasma sample obtained before the patient started rucaparib detected the same alterations as those in the archival biopsy, but it also revealed the presence of a BRCA2 homozygous loss (whole gene, 26 of 26 exons) and several other alterations of unknown functional impact. We hypothesize the response of the patient's tumor to rucaparib was likely driven by DNA damage repair deficiency caused by homozygous loss of all BRCA2 exons. Following discontinuation from rucaparib due to clinical disease progression, the patient received carboplatin and cabazitaxel for ≈3 weeks. The patient died due to progression of his disease.
Conclusions:
A notable aspect of this case is the differences in alterations detected in the archival tumor sample and a more recent plasma sample. This highlights the advantages of plasma testing compared with tissue testing when selecting targeted therapies for treatment of mCRPC; however, physicians must determine which tool presents the best solution for each individual case.
Anomalous origin of right coronary artery with interarterial course revealed by effort angina: case report
Authors: Hind Regragui, Badre El Boussaadani, Chakib Benajiba, Hanae Bouhdadi, Hicham Wazaren, Mohammed Cherti
Journal: Pan Afr Med J (2021)
Keywords: right coronary artery, case report, congenital heart disease, interarterial course, myocardial ischemia
MeSH terms: Angina Pectoris / diagnosis, Coronary Angiography / methods, Coronary Vessel Anomalies / diagnostic imaging, Case Reports, Computed Tomography Angiography, Exercise / physiology, Exercise Test, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multidetector Computed Tomography

Anomalous origin of coronary artery with interarterial course is recognized as a rare congenital heart disease. Its main manifestation is myocardial ischemia related to systolic compression of coronary arteries positioned between the great arteries. We report a case of a middle-aged man admitted in our department for an effort angina during nordic walking. A coronary angiography was performed showing an anomalous coronary artery with a birth defect giving a right common trunk of the circumflex artery and the right coronary artery. We proceeded to a multidetector computed tomography coronary angiography (MDCTCA) to describe this variant of an anomalous coronary arteries which revealed a birth defect in the left anterior sinus of the right coronary and the circumflex artery from a right common trunk passing between the aorta and the trunk of the pulmonary arteries. Magnetic resonance imaging (MRI), exercise stress test and myocardial perfusion scintigraphy were performed in order to objectify an ischemia. Despite the positivity of myocardial scintigraphy, we recommended to our patient to limit exercise with a regular follow-up since he is only symptomatic during a major effort. There are many types of anomalous coronary arteries and the anatomic variant of a right coronary artery that course between the great vessels represents a risk of adverse event and sudden death in young athletes. The choice of therapy is controversial and depends especially on the variant of anomalous coronary artery and the symptoms.
Case Report: Octreotide plus CVD chemotherapy for the treatment of multiple metastatic paragangliomas after double resection for functional bladder paraganglioma and urothelial papilloma
Authors: Zilong Wang, Feifan Liu, Chao Li, Huisheng Yuan, Yuzhu Xiang, Chunxiao Wei, Dongyuan Zhu, Muwen Wang
Journal: Front Oncol (2023)
Keywords: pet/ct, sstr2, case report, chemotherapy, metastatic paraganglioma, octreotide
MeSH terms: Case Reports

Background:
Metastatic pheochromocytomas and paragangliomas are rare neuroendocrine tumors with a poor prognosis. Bladder paraganglioma concomitant with urothelial papilloma is even rarer. However, the rate of tumor response to cyclophosphamide-vincristine-dacarbazine (CVD) chemotherapy and 5-year overall survival for patients with metastatic PPGLs remained lower. We described, for the first time, a case of a patient with multiple metastatic bladder PGL who received octreotide LAR combined with CVD chemotherapy after urological surgery and then octreotide therapy was continued during follow-up.
Case presentation:
A 43-year-old male patient was admitted to the urology department for frequent micturition syncope concomitant with malignant hypertension. Preoperative findings were elevated levels of normetanephrine in 24-h urine or plasma. CT and MRI indicated diagnosis of suspicious bladder paraganglioma. Transurethral resection of bladder tumor combined with laparoscopic partial cystectomy was performed successfully after preoperative phenoxybenzamine with aggressive volume repletion for 7 days. The result of postoperative pathology was immediate-risk functional bladder paraganglioma (T2N0M0, Stage II) concomitant with urothelial papilloma, and the immunohistochemistry results of PPGL were positive for Ki-67 (15%), SDHB, CgA, and SSTR2. The patient achieved enhanced recovery with normal urination and no syncope after surgery. However, the results of 18F-FDG and 18F-DOTATATE PET/CT found that the metastatic localizations of bladder PGLs were in the liver, lung, and bones at the 8th month after surgery. The patient received octreotide long-acting repeatable plus six courses of CVD chemotherapy for 6 months, and then octreotide therapy was continued every 3 months until now. Metastatic localizations were stable in CT scans, and vanillylmandelic acid in 24-h urine was maintained at lower levels during follow-up.
Conclusion:
Octreotide long-acting repeatable plus CVD chemotherapy after surgery could achieve stable disease in the case with multiple metastatic bladder PGLs, and the following octreotide therapy could maintain a state of stable disease during the period of 6-month follow-up.
Solitary scalp metastasis - a rare presentation of hepatocellular carcinoma
Authors: Duminda Subasinghe, Chathuranga Tisara Keppetiyagama, Hemantha Sudasinghe, Saman Wadanamby, Niranthi Perera, Sivasuriya Sivaganesh
Journal: Ann Surg Innov Res (2015)
Keywords: hepatocellular carcinoma, skull metastasis
MeSH terms: Case Reports

Introduction:
Hepatocellular carcinoma (HCC) is among the commonest cancers in the world. Metastasis is one of the most significant factors affecting prognosis. Common sites of extrahepatic metastases include lungs, regional lymph nodes and less commonly bone.
Case presentation:
A 56-year-old male presented with a painless occipital scalp lump of three months duration, with recent rapid enlargement. His skull x-ray showed a lytic lesion over occipital bone and the contrast CT scan of the brain showed a scalp mass with destruction of the adjacent skull. Core biopsy of the lesion revealed a metastatic deposit from a hepatocellular carcinoma.
Conclusion:
Primary presentation with skeletal metastases are rare in HCC with only a few reported cases. Here we report a case of HCC presenting as a solitary scalp lump.
Lacrimal gland mucoepidermoid carcinoma with contralateral eye and systemic metastasis: A rare case report and review of the literature
Authors: Yi Wu, Weimin He
Journal: Front Oncol (2023)
Keywords: case report, contralateral eye, diagnosis, lacrimal gland, mucoepidermoid carcinoma, multifocal metastasis, recurrence, therapy
MeSH terms: Case Reports

Lacrimal gland mucoepidermoid carcinoma is very rare. It has a high risk of recurrence and metastasis, however, it rarely metastasizes to the contralateral eye in clinical practice. Here, we present a case of a 52-year-old man with lacrimal gland mucoepidermoid carcinoma who developed multiple recurrences and metastases of another eye and other sites throughout the body after receiving surgical intervention and regular radiotherapy, which will be of ophthalmic interest and unique. Clinical features, imaging findings, histopathology, treatments, and outcomes of this very rare case are provided. A literature review of previously published cases of this disease is performed, with an emphasis on the latest diagnosis and treatment. The prognosis of tumor recurrence and metastasis is poorer, surgery with a negative margin in conjunction with adjuvant therapies is crucial for preventing local recurrence and distant metastasis and enhancing the survival rate.
Long-term sequel of posterolateral rotatory instability of the elbow: a case report
Authors: Chun-Ying Cheng
Journal: J Orthop Surg Res (2010)

The natural course of untreated posterior lateral rotatory instability of the elbow is unclear. A case of elbow arthrosis with progressing deformity and flexion contracture after an episode of elbow dislocation about 20 years ago presented the possibility the long term outcome of untreated posterior lateral rotatory instability of the elbow.
Case report: Lower eyelid Reconstruction with the rotation flap pedicled by orbicularis oculi muscle
Authors: Mengying Duan, Chao Yue, Jianzhong Peng
Journal: Front Surg (2022)
Keywords: lower eyelid defects, orbicularis oculi muscle, reconstruction, rotation flap pedicled, surgical procedure
MeSH terms: Case Reports

Background:
Loss of eyelid tissue can be caused by trauma, congenital defects or tumors. Eyelid reconstruction is complicated and challengingly difficult because of the complex anatomy of the eyelid. Several types of surgical procedures for the reconstruction of eyelid defects are available.
Objective:
To describe reconstruction of lower-eyelid defects using a rotation flap pedicled by the orbicularis oculi.
Methods:
Fourteen patients (mean age = 67 years old; ages range of 53-86 years old) who suffered from tumor excision from the lower eyelid were treated by the method.
Results:
The mean duration of follow-up was 14 (range, 12-16) months. Ectropion, abnormal eyelid position and donor-site morbidity were not observed during follow-up.
Conclusion:
A rotation flap pedicled by the orbicularis oculi can be a good choice for single-stage reconstruction of lower-eyelid defects.
Case Report: Insulinoma Presenting as Excessive Daytime Somnolence
Authors: Zhennan Yu, Yongliang Wang, Yaqi Sun, Yumei Wang, Yayun Tian, Qinying Ma, Ying Fu
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: case report, hypoglycemia, insulinoma, sleep disorder, somnolence
MeSH terms: Disorders of Excessive Somnolence, Insulinoma / diagnosis, Pancreatic Neoplasms / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Diagnosis, Differential, Female, Humans, Hypoglycemia, Insulinoma / physiopathology, Insulinoma / surgery, Pancreatic Neoplasms / physiopathology, Pancreatic Neoplasms / surgery

Currently, undiagnosed insulinomas remain a difficult clinical dilemma because its symptoms in most cases can easily be misdiagnosed as other diseases. In this article, we present the case of a 14-year-old girl who presented to our hospital with recurrent episodes of excessive daytime sleepiness and abnormal behavior during sleep that had been going on for 3 months. Insulinoma is a rare neuroendocrine tumor that causes excessive release of insulin, resulting in episodes of hypoglycemia. It usually manifests as autonomic sympathetic symptoms. These symptoms resolved rapidly with the administration of glucose. After successful removal of the tumor, daytime sleepiness and abnormal nighttime behavior of the patient did not reappear.
Rupture of uterine artery pseudoaneurysm: role of ultrasonography in postpartum hemorrhage management
Authors: Narjes Karmous, Amira Ayachi, Sadok Derouich, Lassaad Mkaouar, Mechaal Mourali
Journal: Pan Afr Med J (2016)
Keywords: postpartum hemorrhage, cesarean delivery, transcatheter arterial embolization, uterine artery pseudoaneurysm
MeSH terms: Aneurysm, False / complications, Aneurysm, Ruptured / complications, Postpartum Hemorrhage / etiology, Uterine Artery / pathology, Case Reports, Adult, Aneurysm, False / diagnostic imaging, Aneurysm, Ruptured / diagnostic imaging, Female, Humans, Postpartum Hemorrhage / diagnostic imaging, Pregnancy, Time Factors, Ultrasonography, Doppler, Color / methods, Uterine Artery / diagnostic imaging, Young Adult

Uterine artery pseudoaneurysm (UAP) rupture should be considered in case of late genital bleeding without obvious cause and lead to perform a sonographic examination with Doppler-scan. We report two cases of late post-partum hemorrhage from UAP diagnosed as such using color Doppler US. In order to avert life-threatening bleeding, prompt and accurate diagnosis should be made using color Doppler US since the latter plays a significant role in demonstrating the vascular nature of this anechoic uterine lesion.