OpenMed/multicare-articles huggingface dataset:
Life-Threatening Hypocalcemia following Subtotal Parathyroidectomy in a Patient with Renal Failure and Previous Roux-en-Y Gastric Bypass Surgery
Authors: Betsy Palal, Marvin Sinsakul, Sirimon Reutrakul
Journal: Case Rep Endocrinol (2011)
MeSH terms: Case Reports

Background. Roux-en-Y gastric bypass (RYGB) can result in calcium and vitamin D deficiency. Parathyroid surgery carries the risk of immediate and long-term hypocalcemia. Methods and Results. We describe a 54-year-old woman with history of end-stage renal disease and gastric bypass surgery who developed calciphylaxis requiring a 3.5-gland parathyroidectomy. Seven weeks later, she presented with weakness, perioral numbness, leg cramps, a positive Chvostek's sign, hypotension, prolonged QT-interval, and serum calcium of 5.4 mg/dL. Oral and intravenous calcium, calcitriol, and high calcium bath hemodialysis were given. She required 18 days of intravenous calcium and an outpatient maintenance regimen of calcitriol 6 mcg/day, calcium carbonate 8 grams/day, calcium citrate 1.2 grams/day, and ergocalciferol 50,000 IU/week. Conclusion. The patient's life-threatening prolonged hypocalcemia and large requirements of calcium and calcitriol were due to a combination of malabsorption, hypoparathyroidism, and renal failure. Special considerations should be given to bariatric surgery patients undergoing neck exploration.
Malignant Peripheral Nerve Sheath Tumor of the Inguinum and Angiosarcoma of the Scalp in a Child with Neurofibromatosis Type 1
Authors: Marija Milković Periša, Tihana Džombeta, Jasminka Stepan Giljević, Božo Krušlin
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Benign and malignant tumors are common in the setting of neurofibromatosis type 1 (NF1). Malignant peripheral nerve sheath tumor (MPNST) and angiosarcoma are rare tumors in children and adolescents and mostly occur in young patients in relation to NF1. Both histological types can be present in the same tumor mass in patients with NF1. We present a case of 12.5-year-old girl with NF1 who first presented with MPNST of the right inguinal region and 1.5 years later with unrelated angiosarcoma of the scalp.
Exploring the therapeutic potential of reading: Case studies in diary-assisted reading
Authors: Kelda Green
Journal: Front Psychol (2022)
Keywords: bibliotherapy, diary-assisted reading, empirical studies in reading, medical humanities, reading and psychology

This article explores the impact that literary texts can have on real lives and considers how, as researchers, we can get closer to the authentic, first-hand experience of reading to better understand its potential therapeutic mechanisms. Three case studies, based on reading diaries kept over a period of 2 weeks and subsequent semi-structured interviews, are presented here, to demonstrate what it is that literature can do to and for us. The methodology used to collect the case studies offers a simple and replicable template both for encouraging deep reading and for capturing its resulting therapeutic and psychological outcomes. By highlighting the real experiences of readers as they encounter and engage with a complex and unfamiliar literary text, this article aims to demonstrate how empirical research methodologies can add new purpose and meaning to literary study, and equally, show how "literary thinking" can contribute to the methodologies of psychological study and the formulation of psychological therapies.
Case Report: Steroid-Responsive Takotsubo Cardiomyopathy Associated With Cytokine Storm and Obstructive Shock
Authors: Brent Gudenkauf, Michael R Goetsch, Rachit M Vakil, Oscar Cingolani, Luigi Adamo
Journal: Front Cardiovasc Med (2022)
Keywords: takotsubo stress cardiomyopathy, cytokine storm, heart failure, obstructive shock, stress cardiomyopathy
MeSH terms: Case Reports

A growing body of evidence suggests that inflammation may play a key role in the development of Takotsubo stress cardiomyopathy. Here, we report the case of a 63-year-old woman who presented with chest pain and was diagnosed with this cardiomyopathy. After an initial improvement, the patient experienced a systemic inflammatory response of unclear origin and deteriorated rapidly into obstructive shock. Her presentation was considered consistent with cytokine storm. She was, therefore, treated with steroids with rapid improvement in her clinical picture. She relapsed after the taper. Endomyocardial biopsy soon after initiation of pulse dose steroids showed macrophage and lymphocytic infiltration. This case highlights the potential intimate connection between systemic inflammatory response and Takotsubo stress cardiomyopathy and contributes to the evolving understanding of inflammation in the pathogenesis of this disease.
Ring Chromosome 4 in a Child with Multiple Congenital Abnormalities: A Case Report and Review of the Literature
Authors: C S Paththinige, N D Sirisena, U G I U Kariyawasam, L P C Saman Kumara, V H W Dissanayake
Journal: Case Rep Genet (2016)

A female child born preterm with intrauterine growth retardation and presenting with facial dysmorphism with clefts, microcephaly, limb deformities, and congenital abnormalities involving cardiovascular and urinary systems is described. Chromosomal analysis showed a de novo 46,XX,r(4)(p15.3q35) karyotype. The clinical features of the patient were compared with the phenotypic characteristics of 17 previously reported cases with ring chromosome 4 and those with Wolf-Hirschhorn syndrome (4p-). Clinical features observed in this case are consistent with the consensus phenotype in ring chromosome 4. Patent ductus arteriosus and bilateral talipes equinovarus observed in this baby widen the phenotypic spectrum associated with ring chromosome 4.
Progressive Fatal Myelopathy Secondary to Isolated Spinal Cord Vasculitis
Authors: Arie Fisher, Habib Rahman, Michael Farrell, Michael Hennessy
Journal: Front Neurol (2017)
Keywords: cns angiitis, cns vasculitis, myelopathy, primary angiitis of the central nervous system, spinal arteritis, spinal cord angiitis, spinal cord vasculitis, spinal inflammation
MeSH terms: Case Reports

A 56-year-old woman with various neurological signs which developed over a 1-year period was admitted for evaluation. MRI showed a markedly abnormal signal in the cervical spine. Despite treatment with IV steroids, she developed a progressive myelopathy, became quadriplegic, and required intubation. Immunomodulatory treatment was ineffective. The patient died 24 days after admission. Histopathological investigation revealed spinal cord necrosis with a lymphocyte predominant meningovascular inflammation involving arteries and veins along with evidence of prior occlusive disease of the anterior spinal artery. The changes were confined to the spinal cord. The present case represents an unusual cause of myelitis for which early and aggressive immunomodulatory treatment may have influenced outcomes.
A rare cause of right iliac fossa pain
Authors: Mansoor Khizer, Samujh Ram, Abdul Mannan Khan
Journal: J Indian Assoc Pediatr Surg (2009)
Keywords: acute appendicitis, appendectomy, torsion appendix epiploicae
MeSH terms: Case Reports

A child with torsion of appendix epiploicae presenting as acute right iliac fossa pain in abdomen is reported.
Schwannoma of the external auditory canal: a case report
Authors: Ozgul Topal, Selim S Erbek, Seyra Erbek
Journal: Head Face Med (2007)
MeSH terms: Ear Neoplasms / surgery, Neurilemmoma / surgery, Case Reports, Audiometry, Pure-Tone, Biopsy, Diagnosis, Differential, Ear Neoplasms / diagnostic imaging, Ear Neoplasms / pathology, Female, Humans, Middle Aged, Neurilemmoma / diagnostic imaging, Neurilemmoma / pathology, Tomography, X-Ray Computed

Background:
Schwannomas are uncommon benign tumors of the external auditory canal. The clinical features, the differential diagnosis, and the surgical treatment of these lesions are discussed.
Case presentation:
A 51-year-old patient presented with a mass obliterating the external auditory meatus. Excisional biopsy was performed. Diagnosis was reported to be schwannoma by histopathologic examination.
Conclusion:
Schwannoma, rarely seen in the external auditory canal, can be managed by a precise excision of the tumor via transmeatal approach.
Reconstruction of dermal layers evaluated by high-frequency ultrasound following treatment for skin fibrosis
Authors: Lívia Maria Pereira de Godoy, Jose Maria Pereira de Godoy
Journal: Ger Med Sci (2023)
Keywords: high-frequency ultrasound, reconstruction of dermal layers, treatment for skin fibrosis
MeSH terms: Lymphedema / complications, Lymphedema / pathology, Lymphedema / therapy, Skin Diseases / complications, Skin Diseases / diagnostic imaging, Skin Diseases / pathology, Case Reports, Chronic Disease, Edema / etiology, Edema / pathology, Fibrosis, Humans, Middle Aged, Skin / diagnostic imaging, Skin / pathology

Background:
Lymphedema is a chronic, progressive clinical condition that evolves with intense fibrosis, the most advanced stage of which is stage III (lymphostatic fibrosclerosis).
Aim:
The aim of the present study was to show the possibility to reconstruct the dermal layers with the intensive treatment of fibrosis using the Godoy method.
Case description:
A 55-year-old patient with an eight-year history of edema of the lower limb of the leg had constant episodes of erysipelas, despite regular treatments. The edema progressed continually, associated with a change in the color of the skin and the formation of a crust. Intensive treatment (eight hours per day for three weeks) was proposed with the Godoy method. The ultrasound was performed and results revealed substantial improvement in the skin, with the onset of the reconstruction of the dermal layers.
Conclusion:
It is possible to reconstruct the layers of the skin in fibrotic conditions caused by lymphedema.
Idiopathic scrotal hematoma in neonate: a case report and review of the literature
Authors: Bioku Muftau Jimoh, Eziechila Bessie Chinwe, Adewumi Oluwafemi Adebisi, Igwilo Chinwe Ifeoma, Maduka Ogechi, Aiyekomogbon Joshua Oluwafemi
Journal: Case Rep Urol (2014)

Neonatal scrotal hematoma is a rare genitourinary emergency. Some cases have underlining aetiologic factors such as testicular torsion, adrenal hemorrhage, or birth trauma, and others are idiopathic. Previously, immediate scrotal exploration was considered imperative for diagnosis and treatment. With good imaging techniques, some patients are managed nonoperatively. We report a case of idiopathic scrotal hematoma in a neonate. He was managed conservatively with clinical and radiological follow-up. There was complete resolution of hematoma within two months, thus, avoiding unnecessary exploration.
Ruptured Pyogenic Liver Abscess as an Uncommon Cause of Pneumoperitoneum
Authors: Olaia Chalh, Khaoula Sibbou, Jamal El Fenni
Journal: J Belg Soc Radiol (2022)
Keywords: computed tomography, liver abscess, pneumoperitoneum, rupture
MeSH terms: Case Reports

Teaching Point: Spontaneous ruptured gas-forming pyogenic liver abscess (GFPLA) is a life-threatening infection that mimics perforation of hollow viscous and need to be accurately diagnosed by computed tomography, which in turn helps to decrease the operative time and improve patient's prognosis.
Squamous Cell Carcinoma Originating from Adult Laryngeal Papillomatosis: Case Report and Review of the Literature
Authors: Vivian Narana Ribeiro El-Achkar, Andressa Duarte, Fabiano Pinto Saggioro, Francisco Veríssimo De Mello Filho, Jorge Esquiche León, Alfredo Ribeiro-Silva, Estela Kaminagakura
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Background:
The malignant transformation of laryngeal papillomatosis (LP) into squamous cell carcinoma (SCC) can occur in up to 4% of LP cases. The low-risk HPV types 6 and 11 are those that are most commonly related to LP; however, high-risk HPV types may be present. The present study reviews the literature on cases of malignant transformation of LP in adults and reports a clinical case.
Case report:
A 47-year-old male patient exhibiting hoarseness for 4 months presented an exophytic lesion in the right palatine tonsil and a digitiform-like lesion in the right vocal fold. The biopsy revealed a well-differentiated SCC in the vocal cord, which showed a transition zone with a squamous papillomatous lesion. By using the chromogenic in situ hybridization (CISH) test, both lesions showed a positive result for high-risk HPV types 16 and 18 and negative for low-risk HPV types 6 and 11. The final diagnosis was SCC arising from LP. The patient underwent surgical treatment. After 36 months of follow-up, no signs of recurrence were observed.
Results:
The literature review revealed 25 cases of malignant transformation into SCC of LP with adult onset. Of these, only 9 cases were assessed by CISH and/or PCR for HPV identification, of which 7 were positive. The current study focuses on the eighth case, suggesting the involvement of the high-risk HPV types in its pathogenesis.
Conclusions:
LP is considered a benign lesion with the potential for malignant transformation, which reinforces the need for its early diagnosis and the constant monitoring of patients with LP.
Reactivation of Q fever: case report of osteoarticular infection developing at the site of a soft tissue injury
Authors: Genevieve L McKew, Thomas Gottlieb
Journal: Access Microbiol (2021)
Keywords: coxiella burnetii, q fever, osteoarticular infection, reactivation
MeSH terms: Case Reports

Coxiella burnetii , the causative agent of Q fever, is known to cause acute and persistent infection, but reactivation of infection is rarely reported. This case demonstrates reactivation of a distant, untreated Q fever infection after a relatively innocuous soft tissue injury in an adjacent joint without pre-existing pathology. A 52-year-old male abbatoir worker sustained an adductor muscle tear in a workplace injury. He was unable to walk thereafter, and developed a chronic, progressive, destructive septic arthritis of the adjacent hip with surrounding osteomyelitis of the femur and acetabulum. He had evidence of prior Q fever infection, with a positive skin test and serology 15 years beforehand. He was diagnosed with chronic osteoarticular Q fever on the basis of markedly elevated phase I antibodies, and symptomatic and serological response to prolonged antibiotic treatment with doxycycline and hydroxychloroquine. He required a two-stage hip arthroplasty. This case illustrates reactivation of latent C. burnetii infection at the site of a soft tissue injury. Clinicians need to be aware of this possibility in patients with previous Q fever infection, and in the setting of undiagnosed osteoarticular pathology following soft tissue injury.
Extended right surgical margin in distal pancreatectomy with celiac axis resection for pancreatic body cancer under the presence of replaced right hepatic artery; A case report
Authors: Ryosuke Umino, Yuta Kobayashi, Masayuki Urabe, Satoshi Okubo, Junichi Shindoh, Masaji Hashimoto
Journal: Int J Surg Case Rep (2020)
Keywords: dp-car, pancreatic body cancer, replaced rha
MeSH terms: Case Reports

Background:
While distal pancreatectomy with celiac axis resection (DP-CAR) contributes to R0 resection for pancreatic body cancer, arterial blood flow to the liver from gastroduodenal artery is essential. However, in the presence of replaced right hepatic artery (r-RHA), extended DP-CAR (Ex-DP-CAR) in which the right edge of pancreatic resection includes the confluence of gastroduodenal artery (GDA) and proper hepatic artery (PHA) may be feasible. Herein, we report a patient with r-RHA and perform Ex-DP-CAR without reconstruction of PHA.
Case presentation:
A 39-year-old man with pancreatic cancer, cT4N0M0 (UICC 8th), underwent DP-CAR after neoadjuvant chemotherapy (NAC). After laparotomy, unlike the evaluation in preoperative imaging, the tumor was found to invade the confluence of GDA and PHA. After confirmation of arterial blood flow to the liver, GDA and PHA was ligated and Ex-DP-CAR was completed with R0 margin status. The postoperative course was uneventful, with no recurrence 18 months after the surgery.
Conclusion:
We performed Ex-DP-CAR with resection of the confluence of GDA and PHA in the presence of r-RHA, which has a potential role in expanding the surgical indications for R0 resection by reducing the risk of ischemic complications without reconstruction of arterial blood supply to the liver.
Inhaling Difluoroethane Computer Cleaner Resulting in Acute Kidney Injury and Chronic Kidney Disease
Authors: Kristen Calhoun, Laura Wattenbarger, Ethan Burns, Courtney Hatcher, Amol Patel, Manjulatha Badam, Abdul-Jabbar Khan
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

Difluoroethane is the active ingredient in various computer cleaners and is increasingly abused by teenagers due to its ease of access, quick onset of euphoric effects, and lack of detectability on current urine drug screens. The substance has detrimental effects on various organ systems; however, its effects on the kidneys remain largely unreported. The following case report adds new information to the developing topic of acute kidney injury in patients abusing difluoroethane inhalants. In addition, it is one of the first to show a possible relationship between prolonged difluoroethane abuse and the development of chronic kidney disease in the absence of other predisposing risk factors.
Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell Carcinoma
Authors: Dominik Dabrowski, Ekin Ozluk, Silvia Barbeito, Eric X Wei
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Renal cell carcinoma (RCC) is the predominant renal malignancy in adults. Of the four general subtypes, papillary renal cell carcinoma (P-RCC) is the second most common and can be subdivided into type I, type II, and a mixture of type I and II. Focal segmental glomerulosclerosis (FSGS) is the most common glomerulopathy at all ages, and it can be seen as a paraneoplastic syndrome. RCC, in general, is known to present with many paraneoplastic syndromes, and glomerulopathies are among these. Rarely, RCC and glomerulopathies may overlap in the same patient. Here, we report a 58-year-old male with a past medical history of FSGS and chronic kidney disease (CKD), stage III, who was found to have an incidental renal mass that was later diagnosed as type II P-RCC. The histology showed pseudostratified tumor cells with an eosinophilic cytoplasm that formed papillary configurations and displayed areas of necrosis. The prior FSGS diagnosis exhibited segmental sclerosis, refractory tufts, and capillary membrane wrinkling. A period of 1.5 years elapsed between the diagnosis of the glomerulopathy and the malignancy. The tumor was found to be at stage TIb. To our knowledge, this may be the first reported case of usual-type FSGS as paraneoplastic glomerulopathy (PG) preceding P-RCC. Because FSGS only sparingly affects the kidney and is a common glomerulopathy in adults, it is reasonable to complete comprehensive diagnostic studies and commence medically necessary treatment, especially in the background of other renal comorbidities. These preexisting comorbidities may be associated with malignancy very early in its course. The probability of RCC-associated paraneoplastic glomerulopathy is low, which means an already incidentally found renal mass may conceal a serpentine paraneoplastic syndrome. A more developed understanding of these manifestations can lead experienced clinicians to suspect and possibly uncover an insidious RCC before it advances.
Low Grade Lymphoma Mimicking Metastatic Urothelial Carcinoma: When Do We Need Further Histologic Staging?
Authors: Azka Ali, William P Skelton IV, Neeka N Akhavan, Thu-Cuc Nguyen, Zachary A Taylor, Tabitha Townsend, Prajwol Pathak, Nalini Hasija, Li Li, Jacqueline Indrisek, Scott Watson, Isis Nixon, Nam H Dang, Robert Zlotecki, Paul Crispen, Robert Allan, Patricia Abbitt, Long H Dang
Journal: Case Rep Oncol Med (2016)

Introduction. Patients with urothelial carcinoma of the bladder often present with metastases to regional lymph nodes, with lymphadenopathy on physical examination or radiographic imaging. Case Presentation. We present the case of a 73-year-old Caucasian man with presumed metastatic urothelial carcinoma of the bladder to regional pelvic and retroperitoneal lymph nodes. He underwent systemic chemotherapy for treatment of urothelial carcinoma and was discovered on restaging to have findings suggestive of disease progression but ultimately was found to have a concurrent secondary malignancy. Conclusion. Our case suggests that in patients with urothelial carcinoma, the concurrent presentation of regional lymphadenopathy may not be metastatic urothelial carcinoma and may warrant further investigation.
Purulent Appearing Material in an Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Mediastinal Lymph Node: A Diagnostic Challenge
Authors: Damaris Pena, Gilda Diaz-Fuentes, Sindhaghatta Venkatram
Journal: Case Rep Pulmonol (2017)
MeSH terms: Case Reports

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has increasingly been performed for the diagnosis and staging of thoracic malignancies. Findings of a necrotic lymph node raise concern for infectious process and malignancy. A hypoechoic area on ultrasound/EBUS within a lymph node without blood flow is suggestive of pathologies like infections or malignancy. Inspection of the fluid could suggest a diagnosis; clear aspirates usually suggest bronchogenic or mediastinal cysts and purulent material suggests abscesses or necrotic lymph nodes. Growing tumor cells require a blood supply; if the vascular stroma is insufficient due to rapidly growing malignant tumors this could lead to large central areas of ischemic necrosis. Necrotic aspiration of lymph nodes is not always of infectious etiology. Aspiration of fluid in EBUS-TBNA is a rare occurrence, and malignancy should be considered when purulent fluid material is obtained. We present an elderly woman who underwent bronchoscopy with EBUS-TBNA for evaluation of upper lung nodule and mediastinal lymphadenopathy. Pus-like material was obtained on needle aspiration and endobronchial biopsy and mediastinal core biopsy revealed squamous cell carcinoma.
The effects of spaced transcranial Direct Current Stimulation combined with conventional dysphagia therapy in Parkinson's disease: A case report
Authors: Ali Akbar Dashtelei, Michael A Nitsche, Jalal Bakhtiari, Seyed Amirhassan Habibi, Mojtaba Sepandi, Ahmad Reza Khatoonabadi
Journal: EXCLI J (2020)
Keywords: parkinson's disease, dysphagia, non-invasive brain stimulation, swallowing rehabilitation, transcranial direct current stimulation
MeSH terms: Case Reports

Parkinson's disease (PD) is a neurodegenerative disease of the central nervous system that is characterized by a set of motor and non-motor symptoms. Impaired swallowing or dysphagia is one relatively common motor symptom in patients with PD. We investigated whether neuroplasticity induction by spaced transcranial Direct Current Stimulation (tDCS) combined with conventional swallowing therapy leads to long-lasting effects on swallowing ability in patients with PD. We present a case of a 61-year-old male PD patient with dysphagia. Conventional Swallowing Therapy (CDT) combined with tDCS (bilateral anodal, 1 mA, 20 min, 10 online sessions, twice daily with a 20 min interval in between for five days over two weeks) was applied over the pharyngeal motor cortex. Our findings suggest that anodal tDCS combined with CDT is feasible, safe, and well-tolerated, and leads to a clinically relevant improvement of swallowing functions.