OpenMed/multicare-articles huggingface dataset:
Case report: Type 2 diabetes mellitus with plantar malignant melanoma: Report of two cases
Authors: Bi-Ling Huang, Min Tan, Ming-Liu Li, Yuan-Yuan Teng, Min Zhou, Min Wang
Journal: Front Oncol (2023)
Keywords: case report, diabetic foot ulcer, malignant melanoma, plantar malignant melanoma, type 2 diabetes
MeSH terms: Case Reports

Malignant melanoma is a highly malignant tumor that originates from melanocytes. It has a poor prognosis and rarely occurs on the foot. Diabetic foot ulcer is one of the most serious chronic complications of diabetes. This paper reports two cases of type 2 diabetes patients with malignant melanoma on the foot. Clinicians should improve their understanding of patients with diabetes with acral malignant melanoma. When diabetic foot ulcers occur repeatedly and continue not to heal, the clinical features of the cutaneous lesions are similar to malignant melanoma, and a pathological biopsy of the lesions should be performed promptly to obtain a clear diagnosis, avoid a missed diagnosis and improve the survival rate.
The long-distance relationship between Dirofilaria and the UK: case report and literature review
Authors: Rossella Panarese, Rhiannon Moore, Antony P Page, Mike McDonald, Emma MacDonald, William Weir
Journal: Front Vet Sci (2023)
Keywords: dirofilaria immitis, dirofilaria repens, united kingdom, dirofilariasis, heartworm disease, mosquito-borne disease, subcutaneous dirofilariosis
MeSH terms: Review

Over the last two decades, vector-borne pathogens (VBPs) have changed their distribution across the globe as a consequence of a variety of environmental, socioeconomic and geopolitical factors. Dirofilaria immitis and Dirofilaria repens are perfect exemplars of European VBPs of One Health concern that have undergone profound changes in their distribution, with new hotspots of infection appearing in previously non-endemic countries. Some areas, such as the United Kingdom, are still considered non-endemic. However, a combination of climate change and the potential spread of invasive mosquito species may change this scenario, exposing the country to the risk of outbreaks of filarial infections. Only a limited number of non-autochthonous cases have been recorded in the United Kingdom to date. These infections remain a diagnostic challenge for clinicians unfamiliar with these "exotic" parasites, which in turn complicates the approach to treatment and management. Therefore, this review aims to (i) describe the first case of D. repens infection in a dog currently resident in Scotland, (ii) summarise the available literature on Dirofilaria spp. infections in both humans and animals in the United Kingdom and (iii) assess the suitability of the United Kingdom for the establishment of these new VBPs.
Gastric Perforation with Omental Patch Repair: A Rare Complication of Pulmonary Resuscitation in COVID-19 Pneumonia
Authors: Vincent Marcucci, Ratul Bhattacharyya, Stephanie Yee, Jamshed Zuberi, Mark Ingram
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

A 71-year-old male, diagnosed with coronavirus disease 2019 (COVID-19), was admitted to the medical-surgical floor for supportive treatment. The patient received bag-mask ventilation (BMV) secondary to severe hypoxia and reendotracheal intubation in the hospital on day eleven. A chest X-ray following reintubation noted concern for intra-abdominal air. Significant abdominal distention and subsequent diagnostic imaging showed pneumoperitoneum and a possible perforation of the stomach. The patient underwent an exploratory laparotomy with omental patching for a gastric perforation. Amidst the height of the COVID-19 pandemic, several important findings have been made through the disease sequelae of this individual patient.
Mistaken Diabetic Ulcers: A Case of Bilateral Foot Verrucous Carcinoma
Authors: Vanessa Di Palma, Jill P Stone, Andrew Schell, Jeffrey C Dawes
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Verrucous carcinoma (VC) is a rare, low-grade, and well-differentiated variant of squamous cell carcinoma. These tumors are slow-growing and exophytic and have a negligible incidence of metastasis. Treatment is complete surgical resection, ideally by Mohs micrographic surgery, to ensure adequate clear margins. Cutaneous VC predominantly occurs on the plantar surface of the foot and rarely occurs in multiple sites. This case study describes the fourth reported occurrence of bilateral VC of the feet in a woman with chronic diabetic foot ulcers. The case provides further support for persistent wounds contributing to the development of this lesion and describes their role in the characteristic delay in diagnosis of VC.
Long-standing necrobiotic xanthogranuloma limited to the skin: A case report
Authors: Anne-Sophie Smilga, Mona Lavoie, Sungmi Jung, Ariane Schreiber
Journal: SAGE Open Med Case Rep (2021)
Keywords: dermatology, inflammatory dermatoses, pathology
MeSH terms: Case Reports

Necrobiotic xanthogranuloma is a rare non-Langerhans cell histiocytosis with a known association with monoclonal gammopathies and malignant conditions. There is a lack of consensus regarding the management of necrobiotic xanthogranuloma. In this case report, the patient is diagnosed with a long-standing necrobiotic xanthogranuloma limited to the skin. Although all initial investigations were reassuring, the patient remains at a higher risk of developing a malignant condition. The goal of the authors is to highlight the need for clearer investigation and follow-up guidelines.
Case Report: Occurrence of Severe Thoracic Aortic Aneurysms (Involving the Ascending, Arch, and Descending Segments) as a Result of Fibulin-4 Deficiency: A Rare Pathology With Successful Management
Authors: Paul Thomas, Aparna Venugopalan, Siddharth Narayanan, Thomas Mathew, Lakshmi Parvathi Deepti Cherukuwada, Shilpa Chandran, Jithu Pradeep, Timothy P Fitzgibbons, Vijo George
Journal: Front Cardiovasc Med (2021)
Keywords: aneurysm, aortic disease, ascending aorta, autosomal recessive, cardio-pathology, cutis laxa, genetic predisposition
MeSH terms: Case Reports

Aortic diseases requiring surgery in childhood are distinctive and rare. Very few reports in the literature account for the occurrence of multiple thoracic aortic aneurysms in the same pediatric patient because of a genetic cause. We report a rare occurrence of severe thoracic aortic aneurysms (involving the ascending, arch and descending aortic segments) with severe aortic insufficiency in a 7-year-old female child secondary to the extremely rare and often lethal genetic disorder, cutis laxa. She was eventually identified as a carrier of a homozygous EFEMP2 (alias FBLN4) mutation. This gene encodes the extracellular matrix protein fibulin-4, and its mutation is associated with autosomal recessive cutis laxa type 1B that leads to severe aortopathy with aneurysm formation and vascular tortuosity. Parents of the child were not known to be consanguineous. Significant symptomatic improvement in the patient could be discerned after timely intervention with the valve-sparing aortic root replacement (David V procedure) and a concomitant aortic arch replacement. This is a unique report with a successful outcome that highlights the occurrence of a rare hereditary aortopathy associated with a high morbidity and mortality, and the importance of an early diagnosis and timely management. It also offers insight to physicians in having a very broad differential and multimodal approach in handling rare pediatric cardio-pathologies with a genetic predisposition.
Varicella Outbreak in an Indian Couple Living in Germany Caused by VZV Clade VI Acquired during a Trip to The Netherlands
Authors: Malgorzata Kolesnik, Bernd Bonnekoh, Ina Tammer, Harald Gollnick, Andreas Sauerbrei
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Varicella-zoster virus (VZV), the cause of varicella and zoster, is divided into five major clades and four provisional clades, the latter of which have been rarely reported worldwide to date. We present a varicella outbreak by the provisional clade VI within an Indian couple in Germany returning from a trip to Amsterdam. To the best of our knowledge, this is the first case of varicella by the VZV clade VI described in Germany, but the disease was acquired in The Netherlands.
A case of hypoglycemic hemiparesis and literature review
Authors: Tetsuhiro Yoshino, Shu Meguro, Yukie Soeda, Arata Itoh, Toshihide Kawai, Hiroshi Itoh
Journal: Ups J Med Sci (2012)
MeSH terms: Hypoglycemia / complications, Paresis / diagnosis, Case Reports, Review, Aged, Aged, 80 and over, Blood Glucose / analysis, Diabetes Mellitus / drug therapy, Humans, Male, Metformin / administration & dosage, Metformin / therapeutic use, Paresis / etiology, Sulfonylurea Compounds / administration & dosage, Sulfonylurea Compounds / therapeutic use, Blood Glucose, Sulfonylurea Compounds, glimepiride, Metformin

An 89-year-old man with diabetes treated with metformin 500 mg/day and glimepiride 4 mg/day was hospitalized because of hypoglycemic right hemiparesis and dysarthria (casual glucose value 1.8 mmol/L), which resolved quickly following administration of 40 mL of 40% dextrose. Hemiparesis is a rare symptom (4.2%) of hypoglycemia. There are about 200 case reports of hypoglycemic hemiparesis. The average glucose level at which hemiparesis developed was 1.8 mmol/L. Right-sided hemiparesis predominated (R 66%; L 34%). On imaging studies, abnormal findings were frequently observed in the internal capsule or splenium of the corpus callosum. The mechanism of hemiparesis is not fully understood. The existence of cases in which hypoglycemia cannot be distinguished from stroke on imaging studies suggests the importance of measurement of the blood glucose level when the symptoms of stroke are first recognized.
May Thurner syndrome revealed by left calf venous claudication during running, a case report
Authors: Samuel Béliard, Damien Feuvrier, Emilie Ducroux, Lucie Salomon du Mont
Journal: BMC Sports Sci Med Rehabil (2018)
Keywords: case report, may thurner syndrome, post thrombotic syndrome, venous claudication, venous compression
MeSH terms: Case Reports

Background:
May Thurner syndrome is relatively unknown to physicians, its management is well standardized and the outcomes of treatment are satisfactory in the short to medium term.
Case presentation:
We report the case of a patient who suffered from venous claudication during running which impaired their quality of life, decreased their athletic performance and resulted in a career change. May Thurner syndrome diagnosis was made after extensive hemodynamic analysis of a lower limb venous duplex ultrasound scan. This diagnosis was later confirmed by imaging. Subsequent endovascular care provided rapid and sustained clinical improvement.
Conclusion:
The main difficulties with the May Thurner syndrome are to think about it and know how to look for it; indeed the misdiagnosis time can be long. When diagnosis is made, treatment could be easy and effective.
Diverse presentation of breath holding spells: two case reports with literature review
Authors: Geetanjali Rathore, Paul Larsen, Cristina Fernandez, Manish Parakh
Journal: Case Rep Neurol Med (2013)

Breath holding spells are a common and dramatic form of syncope and anoxic seizure in infancy. They are usually triggered by an emotional stimuli or minor trauma. Based on the color change, they are classified into 3 types, cyanotic, pallid, and mixed. Pallid breath holding spells result from exaggerated, vagally-mediated cardiac inhibition, whereas the more common, cyanotic breathholding spells are of more complex pathogenesis which is not completely understood. A detailed and accurate history is the mainstay of diagnosis. An EKG should be strongly considered to rule out long QT syndrome. Spontaneous resolution of breath-holding spells is usually seen, without any adverse developmental and intellectual sequelae. Rare cases of status epilepticus, prolonged asystole, and sudden death have been reported. Reassurance and education is the mainstay of therapy. Occasionally, pharmacologic intervention with iron, piracetam; atropine may be of benefit. Here we present 2 cases, one of each, pallid and cyanotic breath holding spells.
Case report: Spontaneous carotid-cavernous fistula associated with persistent primitive trigeminal artery aneurysm rupture
Authors: Peng Sun, Yuan Chai, Wei Fang, Hu Chen, Qianfa Long, Zhenwei Zhao, Tao Zhang
Journal: Front Neurol (2022)
Keywords: aneurysm, case report, interventional treatment, persistent primitive trigeminal artery, spontaneous carotid-cavernous fistula
MeSH terms: Case Reports

Background:
The incidence of carotid cavernous fistula (CCF) associated with persistent primitive trigeminal artery (PPTA) aneurysm rupture is extremely rare. We presented a case about a spontaneous CCF secondary to a ruptured PPTA aneurysm, which was successfully embolized with coils and onyx-18 by a trans-arterial approach.
Case presentation:
A 55-year-old female suffered a sudden onset of headache, left orbital pain, and pulsatile exophthalmos for a month without any history of trauma. Angiography revealed a left-sided CCF associated with a ruptured PPTA aneurysm, with major drainage to the ipsilateral superior ophthalmic vein. Through a trans-arterial approach, the fistula and ruptured PPTA aneurysm were embolized with coils and onyx-18, while the cavernous sinus and PPTA were well-preserved. However, the preserved PPTA vanished at 4 month follow-up. The patient had no neurological deficit from hospitalization to 1 year follow-up period.
Conclusion:
Trans-arterial approach was a reasonable choice for spontaneous CCF associated with ruptured PPTA aneurysm. The requirement for PPTA preservation depended on individual evaluation.
Laparoscopic resection of a paraganglioma behind the retrohepatic segment of the inferior vena cava: a case report and literature review
Authors: Wenda Wang, Jianhua Deng, Hanzhong Li, Zhigang Ji, Jin Wen
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: inferior vena cava, laparoscopy, paraganglioma, resection, retrohepatic
MeSH terms: Laparoscopy / methods, Paraganglioma / diagnostic imaging, Paraganglioma / pathology, Paraganglioma / surgery, Review, Case Reports, Research Support, Non-U.S. Gov't, Female, Humans, Middle Aged, Vena Cava, Inferior / diagnostic imaging, Vena Cava, Inferior / injuries, Vena Cava, Inferior / surgery

Background:
Due to the location of paragangliomas (PGLs) behind the retrohepatic segment of inferior vena cava (IVC), it is difficult to expose and resect the tumor.
Case presentation:
A tumor measuring 50×45×62cm behind the retrohepatic portion of IVC was found in a 51-year-old female with hypertention and diabetes mellitus. Although the test for catecholamines revealed no signs of disease, the enhanced computed tomography (CT) scan, somatostatin receptor imaging and iodine-131-labeled metaiiodo-benzylguanidine (131I-MIBG) imaging revealed that the tumor was PGL. A three-dimensional printing was performed to visualize the tumor. The laparoscpic surgery for the PGL behind the retrohepatic segment of IVC was performed and the tumor was resected completely without causing any tissues injury. The pathologic diagnosis was PGL and the patient was able to recover well.
Conclusions:
This case demonstrates that laparoscopic surgery may be helpful in tumor accessibility, and could be used in the appropriate cases to remove PGLs that are located behind the retrohepatic segment of the IVC.
Sudden cause of cardiac death-be aware of me: a case report and short review on brugada syndrome
Authors: Jagadeesh K Kalavakunta, Vishwaroop Bantu, Hemasri Tokala, Mihas Kodenchery
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Introduction. Brugada syndrome accounts for about 4% of sudden cardiac deaths (SCD). It is characterized by an ST-segment elevation in the right precordial electrocardiogram (EKG) leads. Case Presentation. We describe a 39-year-old healthy Caucasian man who was admitted to the intensive care unit after being cardioverted from ventricular fibrillation (VF) arrest. His past history was significant for an episode of syncope one month prior to this presentation for which he was admitted to an outlying hospital. EKG during that admission showed ST elevations in V1 and V2 leads, a pattern similar to Type 1 Brugada. A diagnosis of Brugada syndrome was missed and the patient had a cardiac arrest a month later. We discuss a short review of Brugada syndrome and emphasize the need to look for it in patients presenting with SCD and malignant arrhythmias. Conclusion. Physicians should always consider Brugada syndrome in the differential diagnosis of ST-segment elevation in anterior precordial leads of EKG and associated VT/VF. Although more than 17 years have passed since the first case was reported, increased awareness of this syndrome is needed to identify patients with EKG changes and treat them accordingly to prevent incidence of (SCD) and its deleterious complications.
Implementation of clinical tractography for pre-surgical planning of space occupying lesions: An investigation of common acquisition and post-processing methods compared to dissection studies
Authors: Jonathan Ashmore, Hugh G Pemberton, William D Crum, Jozef Jarosz, Gareth J Barker
Journal: PLoS One (2020)
MeSH terms: Image Processing, Computer-Assisted / methods, Surgery, Computer-Assisted / methods, Adolescent, Adult, Diffusion Magnetic Resonance Imaging, Female, Ganglioglioma / diagnostic imaging, Ganglioglioma / surgery, Humans, Male, Middle Aged, Oligodendroglioma / diagnostic imaging, Oligodendroglioma / surgery, Young Adult

Background and purpose:
There is limited standardization of acquisition and processing methods in diffusion tractography for pre-surgical planning, leading to a range of approaches. In this study, a number of representative acquisition variants and post processing methods are considered, to assess their importance when implementing a clinical tractography program.
Methods:
Diffusion MRI was undertaken in ten healthy volunteers, using protocols typical of clinical and research scanning: a 32-direction diffusion acquisition with and without peripheral gating, and a non-gated 64 diffusion direction acquisition. All datasets were post-processed using diffusion tensor reconstruction with streamline tractography, and with constrained spherical deconvolution (CSD) with both streamline and probabilistic tractography, to delineate the cortico-spinal tract (CST) and optic radiation (OR). The accuracy of tractography results was assessed against a histological atlas using a novel probabilistic Dice overlap technique, together with direct comparison to tract volumes and distance of Meyer's loop to temporal pole (ML-TP) from dissections studies. Three clinical case studies of patients with space occupying lesions were also investigated.
Results:
Tracts produced by CSD with probabilistic tractography provided the greatest overlap with the histological atlas (overlap scores of 44% and 52% for the CST and OR, respectively) and best matched tract volume and ML-TP distance from dissection studies. The acquisition protocols investigated had limited impact on the accuracy of the tractography. In all patients, the CSD based probabilistic tractography created tracts with greatest anatomical plausibility, although in one case anatomically plausible pathways could not be reconstructed without reducing the probabilistic threshold, leading to an increase in false positive tracts.
Conclusions:
Advanced post processing techniques such as CSD with probabilistic tractography are vital for pre-surgical planning. However, overall accuracy relative to dissection studies remains limited.
Long-term nutritional management of an obese German Spitz with paroxysmal dyskinesia, calcium oxalate urolithiasis, and suspected pancreatitis-A case report
Authors: Camila Baptista da Silva, Michelle Hermans, Norberto Ruiz-Suárez, Fien Verdoodt, Sofie Fatima Mareyam Bhatti, Myriam Hesta
Journal: Front Vet Sci (2023)
Keywords: bladder stones, dog, gastrointestinal signs, neurological signs, nutrition
MeSH terms: Case Reports

Background:
To our knowledge, this is the first description of long-term nutritional management in a dog with paroxysmal dyskinesia.
Case summary:
An obese 9-year-old, male entire, German Spitz was presented for dietary management after being diagnosed with calcium oxalate urolithiasis and suspected pancreatitis. Since he was seven years old, the dog has had a history of neurological signs, which were thought to be epileptic seizures. He was treated with phenobarbital and potassium bromide and was clinically controlled. For his nutritional advice, aiming to minimize one of the most important risk factors for the diseases, a weight loss program was started and successfully executed. However, 10 months later, the dog restarted presenting neurological episodes at a high frequency (3x/week). Based on videos and the characteristics of the neurological signs, the dog was diagnosed with paroxysmal dyskinesia. To investigate the role of gluten intake on this patient's neurological signs, a dietary trial with a commercial hypoallergenic diet (gluten-free; hydrolyzed protein) was followed. During the 3 months of the dietary trial, four neurologic episodes related to food indiscretion occurred. Upon the decrease in neurological episodes, the anti-seizure drugs were slowly discontinued. During this period, the dog presented only two neurologic episodes that were related to the days that the anti-seizure drugs were decreased. For 4 months the dog remained episode-free. However, a change in the dog's diet to another gluten-free diet (higher fat) led the dog to vomit and experience another neurologic episode. Once the dog was back to the previous gluten-free diet, it clinically improved, and no other clinical signs were reported by the client during the next 5 months.
Conclusion:
Although a relationship between gluten and paroxysmal dyskinesia cannot be confirmed, the dog's improvement after the nutritional management and the removal of the anti-seizure therapy is supportive of dietary association.
Recurrent Diplopia in a Pediatric Patient with Bickerstaff Brainstem Encephalitis
Authors: Scott A McLeod, Wallace Wee, Francois D Jacob, Isabelle Chapados, Francois V Bolduc
Journal: Case Rep Neurol Med (2016)

Introduction. Acute complete external ophthalmoplegia is a rare finding in clinical practice that is associated with diseases affecting the neuromuscular junction, the oculomotor nerves, or the brainstem. Ophthalmoplegia has been reported with acute ataxia in Miller Fisher syndrome (MFS) and Bickerstaff brainstem encephalitis (BBE). Up to 95% of these cases are associated with anti-GQ1b antibodies. Only a small number of cases of anti-GQ1b negative MFS have been documented in pediatric patients. This is the first case reporting a recurrence of ocular symptoms in an anti-GQ1b antibody negative patient with BBE. Case Presentation. An 8-year-old Caucasian boy presented with complete external ophthalmoplegia without ptosis, cerebellar ataxia, and a disturbance of consciousness. He had recently recovered from a confirmed Campylobacter jejuni infection. On subsequent laboratory testing he was anti-GQ1b antibody negative. He had a recurrence of diplopia at four-week follow-up. Conclusions. This patient's recurrence of diplopia was treated with a five-week course of oral corticosteroids which did not worsen his condition, and this may be a therapeutic option for similar patients. We will discuss the symptoms and treatment of reported pediatric cases of anti-GQ1b antibody negative cases of MFS and the variation between cases representing a spectrum of illness.