OpenMed/multicare-articles huggingface dataset:
Peliosis hepatis associated with follicular lymphoma with a rise in vascular endothelial growth factor and anaemia of inflammation
Authors: Emilia Pardal de la Mano, Guillermo Martín-Sánchez, Rosa López López, M Angeles Fernández Galán, Sergio Trinidad Ríos, M José Morán Jiménez, J María García Ruiz de Morales, M Antonia Crespo Santos, Guillermo Martín Núñez
Journal: Ecancermedicalscience (2018)
Keywords: anaemia of inflammation, follicular lymphoma, hepcidin, interleukin 6, peliosis, vascular endothelial growth factor
MeSH terms: Case Reports

Follicular lymphoma does not usually present with associated paraneoplastic syndromes. We describe the case of a patient diagnosed with follicular lymphoma when investigating anaemia of chronic disease/inflammation and who, during her clinical course, developed peliosis hepatis. We have been able to confirm the similarity between the symptoms, the tumour's biology, the anaemia and peliosis, with the behaviour of endothelial growth factor, interleukins and iron metabolism disorders, which were normalised with treatment. To date, we have found no cases where peliosis has been described in this type of lymphoma.
Metastatic hepatocellular carcinoma in a patient with Crohn's disease treated with azathioprine and infliximab: a case report and literature review
Authors: Kyle J Fortinsky, Ali Alali, Khursheed Jeejeebhoy, Sandra Fischer, Morris Sherman, Scott Fung
Journal: Case Rep Gastrointest Med (2014)

Hepatocellular carcinoma most commonly occurs in patients with underlying liver disease or cirrhosis. We describe a case of hepatocellular carcinoma in a 34-year-old man with Crohn's disease treated with azathioprine and infliximab. The patient had no history of liver disease and a complete autoimmune and viral workup was unremarkable. Unfortunately, the patient developed widespread metastatic disease and passed away 5 months after his initial diagnosis. The mechanism of hepatocellular carcinoma in patients' with Crohn's disease is poorly understood and may include both autoimmunity and treatment-related complications. Previous case reports suggest the possibility of a concerning association between azathioprine therapy and the development of hepatocellular carcinoma in patients with Crohn's disease. Clinicians may consider early imaging in patients with Crohn's disease presenting with concerning symptomatology or abnormal liver enzymes, especially in those being treated with azathioprine alone or in combination with infliximab. Future research may help to uncover additional risk factors for this exceedingly rare diagnosis in this patient population.
Colorectal infiltrating deep endometriosis: Laparoscopic treatment. A case report
Authors: Giuseppe Di Buono, Matilde Micheli, Gaia Russo, Roberta Vella, Giuseppe Amato, Girolamo Geraci, Antonino Agrusa
Journal: Front Surg (2022)
Keywords: colorectal endometriosis, deep infiltrating endometriosis, endometriosis, laparoscopic segmental colonic resection, laparoscopy
MeSH terms: Case Reports

Endometriosis is a disease affecting approximately 10% of women of fertile age. A particular presentation is deep infiltrating endometriosis of the rectosigmoid colon with symptoms that can mimic an intestinal obstruction or neoplasm. We report the case of a 39-year-old woman with pelvic pain during the menstrual cycle and significant anemia who presented an ectopic endometrial tissue in correspondence of the rectum. Because of the thickness of the lesion the patient underwent a segmental laparoscopic colorectal resection with end-to-end anastomosis.
Severe eosinophilic asthma and aspirin-exacerbated respiratory disease associated to eosinophilic gastroenteritis treated with mepolizumab: a case report
Authors: C Caruso, S Colantuono, D Pugliese, C Di Mario, B Tolusso, E Gremese, G Papparella, F Castrì, A Gasbarrini, A Romano, A Armuzzi
Journal: Allergy Asthma Clin Immunol (2020)
Keywords: aerd, asthma, eosinophilic, gastroenteritis
MeSH terms: Case Reports

Background:
Mepolizumab (MEP) is the first anti Interleukin (IL)-5 add-on therapy approved for the treatment of severe refractory eosinophilic asthma.
Case presentation:
We describe here the case of a 49 years-old woman with Aspirin-exacerbated respiratory disease (AERD), chronic rhinosinusitis, nasal polyposis and eosinophilic gastroenteritis successfully treated with MEP. Several laboratory and clinical items improved during therapy; moreover MEP showed to be useful as steroid sparing agent.
Conclusions:
This case supports that the use of mepolizumab can be effective also in other eosinophilic conditions different from asthma and this opens to new therapeutic perspectives.
Emergence of Blastoschizomyces capitatus yeast infections, Central Europe
Authors: Tanja Birrenbach, Sonja Bertschy, Franziska Aebersold, Nicolas J Mueller, Yvonne Achermann, Konrad Muehlethaler, Stefan Zimmerli
Journal: Emerg Infect Dis (2012)
MeSH terms: Ascomycota / isolation & purification, Communicable Diseases, Emerging / epidemiology, Mycoses / epidemiology, Mycoses / microbiology, Case Reports, Aged, Antifungal Agents / therapeutic use, Communicable Diseases, Emerging / drug therapy, Fatal Outcome, Female, Humans, Immunocompromised Host, Male, Microbial Sensitivity Tests, Middle Aged, Mycoses / drug therapy, Switzerland / epidemiology, Antifungal Agents

We report 5 cases of disseminated infection caused by Blastoschizomyces capitatus yeast in central Switzerland. The emergence of this yeast in an area in which it is not known to be endemic should alert clinicians caring for immunocompromised patients outside the Mediterranean region to consider infections caused by unfamiliar fungal pathogens.
Bilateral central retinal arterial obstruction following head trauma: a very rare case report
Authors: Saumendranath Ghose, Parida Subhabrata
Journal: Indian J Ophthalmol (2011)
MeSH terms: Craniocerebral Trauma / complications, Retinal Artery Occlusion / etiology, Vision, Low / etiology, Case Reports, Accidental Falls, Adult, Craniocerebral Trauma / diagnostic imaging, Craniocerebral Trauma / etiology, Fluorescein Angiography, Fundus Oculi, Humans, Male, Radiography, Retina / pathology, Retinal Artery Occlusion / diagnosis

A 30-year-old patient presented at our outpatient department with complaints of severe loss of vision in both eyes following a head injury six days back. He also had a fracture at left side of the mandible and a few bruises over the left cheek. External ocular examination revealed subconjuctival hemorrhage in the left eye and bilateral sluggishly reacting pupils. Fundus examination showed white- out retina and a cherry red spot at the macula in both eyes. A clinical diagnosis of bilateral central retinal arterial obstruction (CRAO) was made which was later confirmed by fundus fluorescence angiography. Bilateral CRAO is a rare disease usually found in patients with cardiac embolic diseases, giant cell arteritis or systemic vascular inflammations. Our case is the second reported case in English literature of bilateral CRAO following head trauma.
Paradoxical Effects of a Cytokine and an Anticonvulsant Strengthen the Epigenetic/Enzymatic Avenue for Autism Research
Authors: D G Béroule
Journal: Front Cell Neurosci (2020)
Keywords: maoa, autism spectrum disorders, brain enzymes, cytokines, epigenetics, guided propagation networks, gut microbiome, short-chain fatty acids

Maternal exposure to the valproate short-chain fatty acid (SCFA) during pregnancy is known to possibly induce autism spectrum disorders (ASDs) in the offspring. By contrast, case studies have evidenced positive outcomes of this anticonvulsant drug in children with severe autism. Interestingly, the same paradoxical pattern applies to the IL-17a inflammatory cytokine involved in the immune system regulation. Such joint apparent contradictions can be overcome by pointing out that, among their respective signaling pathways, valproate and IL-17a share an enhancement of the "type A monoamine oxidase" (MAOA) enzyme carried by the X chromosome. In the Guided Propagation (GP) model of autism, such enzymatic rise triggers a prenatal epigenetic downregulation, which, without possible X-inactivation, and when coinciding with genetic expression variants of other brain enzymes, results in the delayed onset of autistic symptoms. The underlying imbalance of synaptic monoamines, serotonin in the first place, would reflect a mismatch between the environment to which the brain metabolism was prepared during gestation and the postnatal actual surroundings. Following a prenatal exposure to molecules that significantly elicit the MAOA gene expression, a daily treatment with the same metabolic impact would tend to recreate the fetal environment and contribute to rebalance monoamines, thus allowing proper neural circuits to gradually develop, provided behavioral re-education. Given the multifaceted other players than MAOA that are involved in the regulation of serotonin levels, potential compensatory effects are surveyed, which may underlie the autism heterogeneity. This explanatory framework opens up prospects regarding autism prevention and treatment, strikingly in line with current advances along the gut microbiome-brain axis.
Accidental administration of the remifentanil formulation Ultiva™ into the epidural space and the complete time course of its consequences: a case report
Authors: Kota Nishimoto, Sachiyo Sakamoto, Makiko Mikami, Kiichi Hirota, Koh Shingu
Journal: JA Clin Rep (2016)
Keywords: accidental administration, epidural space, glycine, remifentanil, ultiva™

Background:
Ultiva™ contains the potent short-acting μ-opioid receptor agonist remifentanil hydrochloride, and it is commonly administered intravenously during general anesthesia. It is not approved for epidural or intrathecal use in clinical practice because it contains glycine as an acidic buffer. However, at this moment, very limited information is available on epidural administration of Ultiva™.
Case presentation:
We report the accidental administration of 300 μg of remifentanil and 2.25 mg of glycine into the epidural space after emergence from general anesthesia for distal pancreatectomy and the complete time course of its consequences. The respiratory depression occurred at 5 min after the administration, and complete loss of consciousness was observed at 8 min. The patient was re-intubated and underwent mechanical respiration. At 45 min (33 min after re-intubation), spontaneous respiration resumed, she was responsive to commands, and her orientation returned. She was extubated successfully.
Conclusions:
These consequences might have resulted from the diffusion of the components of Ultiva™ into not only systemic circulation but also the cerebrospinal fluid. Moreover, the complex pathophysiology might be associated with remifentanil, as well as glycine present in Ultiva™.
Nutritional quality and greenhouse gas emissions of vegetarian and non-vegetarian primary school meals: A case study in Dijon, France
Authors: Justine Dahmani, Sophie Nicklaus, Jean-Michel Grenier, Lucile Marty
Journal: Front Nutr (2022)
Keywords: children, greenhouse gas emissions, meals, nutritional quality, school canteen, sustainability, vegetarian

Since 2018 in France, national regulation mandates that school canteens serve a weekly vegetarian meal to reduce school canteens' environmental impact in addition to previous regulations imposing nutritional composition guidelines. However, a lunch without meat is often perceived as inadequate to cover the nutritional needs of children. The present study aims to assess the nutritional quality and greenhouse gas emissions (GHGE) of vegetarian and non-vegetarian school meals served in primary schools in Dijon, France. The catering department provided the composition of 249 meals served in 2019. Nutritional content and GHGE were retrieved from national food databases. The portion size of each meal component was the standard portion size recommended by the relevant French authority (GEMRCN). Meals were classified into vegetarian meals, i.e., without meat or fish (n = 66), or non-vegetarian meals (n = 183). The nutritional adequacy of the meals for children aged from 6 to 11 years was estimated using the mean adequacy ratio (MAR/2,000 kcal) as the mean percentage of daily recommended intake for 23 nutrients and the mean excess ratio (MER/2,000 kcal) as the mean percentage of excess compared to the maximum daily recommended value for three nutrients. This analysis of actual school meals shows that both vegetarian and non-vegetarian meals had a similar good nutritional quality with MAR/2,000 kcal of 87.5% (SD 5.8) for vegetarian and of 88.5% (SD 4.5) for non-vegetarian meals, and a MER/2,000 kcal of 19.3% (SD 15.0) for vegetarian and of 19.1% (SD 18.6) for non-vegetarian meals. GHGE were more than twofold reduced in vegetarian compared to non-vegetarian meals (0.9 (SD 0.3) vs. 2.1 (SD 1.0) kgC02 eq/meal). Thus, increasing the frequency of vegetarian meals, by serving egg-based, dairy-based or vegan recipes more frequently, would reduce GHGE while maintaining adequate nutritional quality of primary school meals.
Uniportal Subcostal Video-Assisted Thoracoscopic Surgery: A Feasible Approach for a Challenging Middle Lobectomy in an Obese Patient
Authors: Samer Al Sawalhi, Deping Zhao, Haomin Cai, Yuxing Jin
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

Subcostal access is a novel approach for anatomical lung resection. To perform surgery via this access, specially designed long instruments are required. Subcostal access provides excellent visualization of the mediastinum and anterior lung hilum. We exhibit here a subcostal middle lobectomy with systematic en-block mediastinal lymphadenectomy in an obese 52-year-old male patient with body mass index (BMI=37.7) performed via this single incision. The operation was completed efficiently within 30 minutes with negligible postoperative pain.
Bridging Therapy for Acute Stroke as the Initial Manifestation of Takayasu Arteritis: A Case Report and Review of Literature
Authors: Yongqiang Dai, Yi Zhong, Banghao Jian, Ping Liu, Kangyu Song, Yu Li, Aimin Wu, Bingjun Zhang
Journal: Front Immunol (2021)
Keywords: bridging therapy, emergency, endovascular therapy, stroke, takayasu arteritis
MeSH terms: Ischemic Stroke / therapy, Takayasu Arteritis / complications, Thrombectomy / methods, Thrombolytic Therapy / methods, Case Reports, Research Support, Non-U.S. Gov't, Review, Adult, Female, Humans, Tissue Plasminogen Activator / therapeutic use, Tissue Plasminogen Activator

Takayasu arteritis (TA) is a chronic inflammatory disease involving the aorta and its principal branches. Acute ischaemic stroke (AIS) as the initial manifestation of TA is uncommon. There is little evidence on the efficacy of bridging therapy for AIS induced by TA. A 23-year-old Chinese woman with a suspected stroke presented to our hospital with sudden onset of right-sided weakness, right facial palsy, and aphasia that occurred 1 hour ago. After physical and ancillary examinations, recombinant tissue plasminogen activator was administered to the patient, which led to partial recovery. Her neurological function deteriorated with a large salvageable ischaemic penumbra on computed tomography perfusion. Cerebrovascular angiography showed multiple stenoses in the brachiocephalic trunk, the beginning of the right common carotid artery (CCA), and the bilateral subclavian arteries, as well as occlusion of the left CCA and its branches. Mechanical thrombectomy of the left middle cerebral artery was performed immediately. Percutaneous transluminal balloon angioplasty of the left CCA followed by stent implantation of the proximal left CCA was then performed. A diagnosis of TA was made based on the findings. The patient's neurological deficit fully recovered with immunosuppressants at the 3 month-follow-up. We report a rare case of a patient with TA initially presenting with AIS treated with bridging therapy with full recovery of neurological function. Bridging therapy should be taken into consideration for AIS in patients with TA. Further study is needed in this regard.
Long-term benefit of immunotherapy in a patient with squamous lung cancer exhibiting mismatch repair deficient/high microsatellite instability/high tumor mutational burden: A case report and literature review
Authors: Na Li, Zixuan Wan, Dongyan Lu, Ruilian Chen, Xiaowei Ye
Journal: Front Immunol (2023)
Keywords: high microsatellite instability (msi-h), high tumor mutational burden, immunotherapy, mismatch repair deficiency, squamous lung cancer
MeSH terms: Carcinoma, Non-Small-Cell Lung / genetics, Carcinoma, Non-Small-Cell Lung / therapy, Carcinoma, Squamous Cell, Lung Neoplasms / genetics, Lung Neoplasms / therapy, Review, Case Reports, Research Support, Non-U.S. Gov't, DNA Mismatch Repair / genetics, Humans, Immune Checkpoint Inhibitors, Immunotherapy, Microsatellite Instability, Immune Checkpoint Inhibitors, Turcot syndrome

Genetic mutations that render mismatch repair defective may result in microsatellite instability, which is common in colorectal carcinomas and gastric cancers as well as Lynch syndrome. Mismatch repair deficiency/high microsatellite instability (dMMR/MSI-H) predicts the tumor response to immune checkpoint inhibitors. However, few studies have evaluated the efficacy of immune checkpoint inhibitors in non-small cell lung cancer (NSCLC) patients with dMMR/MSI-H. In this work, we present a patient with advanced squamous lung cancer with dMMR/MSI-H and a high tumor mutational burden (TMB-H) who obtained a long-term benefit from immunotherapy. NSCLC patients with dMMR/MSI-H/TMB-H may thus benefit from immune checkpoint inhibitors.
A Case Study of Deep Vein Thrombosis of the Right Internal Jugular Vein in a Healthy 21-Year-Old Male
Authors: Javier Corral, Geri Villanueva
Journal: Case Rep Hematol (2016)

We are reporting a case of a healthy 21-year-old male, with no significant past medical history, who was found to have an incidental nonocclusive deep vein thrombosis in the right internal jugular vein detected on a head MRI previously ordered for work-up of headaches. A follow-up upper extremity venous Doppler ultrasound confirmed the presence of a partially occlusive deep vein thrombosis in the right jugular vein. The case presented is unique for the reason that the patient is young and has no prior risk factor, personal or familial, for venous thrombosis except for associated polycythemia on clinical presentation.
A Triple Pedicle, Near-Total Thigh Flap Supercharged With the Flow-Through Technique
Authors: Mofiyinfolu Sokoya, Frederic W-B Deleyiannis
Journal: Eplasty (2016)
Keywords: alt, flow-through technique, supercharging, tensor fascia latae flap, total thigh free flap
MeSH terms: Case Reports

This is the first instance where the technique of supercharging a flap with a second pedicle, combined with a third pedicle using the flow-through technique, is described in literature. We present the case of a 66-year-old man with multiple recurrent squamous and basal cell carcinomas of the face. He underwent a wide local excision resulting in a 20 × 26-cm defect. This was reconstructed with near-total thigh free flap. Three separate pedicles providing independent perforators to the medial, posterior-lateral, and anterolateral thigh from the superficial femoral artery, directly from the profunda femoris artery, and from the descending branch of the lateral circumflex artery were harvested. We expand upon the technique of supercharging a flap by not only anastomosing 3 separate pedicles but also using the flow-through technique to provide inflow and outflow to the third pedicle.
Primary vaginal myeloid sarcoma: a rare case report and review of the literature
Authors: Gaurang Modi, Irappa Madabhavi, Harsha Panchal, Apurva Patel, Asha Anand, Sonia Parikh, Pritam Jain, Swaroop Revannasiddaiah, Malay Sarkar
Journal: Case Rep Obstet Gynecol (2015)

Myeloid sarcoma (chloroma, granulocytic sarcoma, or extramedullary myeloid tumour) is an extramedullary mass forming neoplasm composed of myeloid precursor cells. It is usually associated with myeloproliferative disorders but very rarely may precede the onset of leukemia. Here, we are presenting a rare case of primary vaginal myeloid sarcoma in a geriatric female patient without initial presentation of acute myeloid leukemia (AML). A 68-year-old female patient with ECOG Performance Score of 1 presented with pervaginal bleeding for 20 days. On colposcopic examination, she was found to have mass in the anterior fornix of vagina. A punch biopsy specimen revealed chloromatous infiltration of the vagina. LCA (leukocyte common antigen), MPO (myeloperoxidase), and c-kit were strongly positive on IHC (immunohistochemistry). The patient's routine blood investigations were normal including peripheral smear, lactose dehydrogenase, uric acid, 2D echocardiography, conventional cytogenetics, bone marrow aspiration, and biopsy. The patient was given 4 cycles of decitabine (Decitex, manufactured by Sun Pharmaceutical Industries Limited, India), 20 mg/m(2) for 5 days at an interval of 28 days. There was a partial response to decitabine according to RECIST criteria. As decitabine therapy was well tolerated, we are continuing in the same way until disease progression without any complications. The patient is undergoing regular follow-up at our centre.
Cerebritis: an unusual complication of Klebsiella pneumoniae
Authors: Mainak Majumdar, David C Simes, Ramesh D Prabha
Journal: Indian J Crit Care Med (2009)
MeSH terms: Case Reports

Cerebritis is part of a continuum of brain infection and is difficult to diagnose. Cerebritis caused by Klebsiella in immunocompetent adults without predisposing factors such as neurosurgery or penetrating brain injury has not been reported before. We report a case of Klebsiella cerebritis in an adult patient with a proven extracranial focus of infection. We suggest considering cerebritis as a differential diagnosis for altered level of consciousness in patients of severe sepsis, even if an extracranial source of infection is proven.
A Diagnosis of Adult-Onset Still's Disease after Multiple Urgent Care Visits
Authors: Kami M Hu, Adam C Richardson, Kelly M Blosser, Semhar Z Tewelde
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

A 34-year-old man with recent treatment and resolution of community-acquired pneumonia presents to the emergency department with protracted fever, rash, and sore throat. Sustained fever and greater than two-fold increase in leukocytosis despite appropriate antibiotic therapy prompted hospital admission for infectious disease and rheumatologic evaluations which ultimately revealed adult-onset Still's disease, a rare autoinflammatory disorder with potentially life-threatening complications.
Duodenal Neuroendocrine Tumour Presenting as GABA B Receptor Autoimmune Encephalitis
Authors: Dhanashree Peddawad, Manoj K Singh
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

GABA B receptor antibody positive autoimmune encephalitis is rarely seen in clinical practice. It is usually associated with small cell lung carcinoma, and occasionally with neuroendocrine tumour (NET) of lung. GABA B receptor antibody can be associated with other autoimmune antibodies like antinuclear antibody and antibody to Glutamic acid decarboxylase. We present a case with GABA B receptor autoimmune encephalitis associated with neuroendocrine tumour of the duodenum with special emphasis on correlation between immunostaining of the tumour and presence of GABA B receptor antibody.
Malouf syndrome with hypergonadotropic hypogonadism and cardiomyopathy: two-case report and literature review
Authors: Dilek Benk Şilfeler, Atilla Karateke, Raziye Keskin Kurt, Özgür Aldemir, Alper Buğra Nacar, Ali Baloğlu
Journal: Case Rep Obstet Gynecol (2014)

Malouf syndrome is a very rarely encountered syndrome which was first diagnosed in 1985 upon the examination of two sisters, with findings of hypergonadotropic hypogonadism, dilated cardiomyopathy, blepharoptosis, and broad nasal base. Later on, Narahara diagnosed another sporadic case with the same findings. A survey of relevant literature leads us to three women cases in total. Here we present two cases of Malouf syndrome and literature review.