OpenMed/multicare-articles huggingface dataset:
Comprehensive Management of Polycystic Ovarian Syndrome and Secondary Infertility: Optimizing Fertility Outcomes
Authors: Shivani Khemani, Akash More, Nancy Nair, Namrata Choudhary, Jarul Shrivastava, Deepali Mamankar
Journal: Cureus (2024)
Keywords: art, gnrh agonist (gnrh-a) trigger, gnrh long agonist protocol, gnrh short antagonist protocol, infertility, ovarian hyperstimulation syndrome (ohss), ovarian stimulations, pcos
MeSH terms: Case Reports

A 33-year-old woman with secondary infertility and polycystic ovarian syndrome (PCOS) is profiled in this case report. In 2020, an in-vitro fertilization/intracytoplasmic sperm injection pregnancy resulted in a missed abortion, which is part of the patient's medical history. In order to enhance fertility outcomes, this case report seeks to give an overall perspective on the treatment and medical care strategy for people with PCOS and previous cases of infertility. One of the physical characteristics of PCOS, bilateral polycystic ovaries, was seen in the patient. Treatments included long-term gonadotropin-releasing hormone agonist treatment, medications, and optimizing endometrial preparation. The patient was regularly monitored with routine ultrasound evaluations, hormone profiling, and psychological support. For patients with PCOS and secondary infertility, the case report emphasizes the value of individualized treatment strategies, close monitoring, and supportive care to enhance pregnancy outcomes. Clinicians handling situations similar to this one will greatly benefit from the conclusions and treatment plans offered in this case study, which emphasizes the need for a multifaceted strategy to deal with the complexity of PCOS-related infertility.
Dynamic interactions of physiological systems during competitive gaming: insights from network physiology - case report
Authors: Andreas Stamatis, Grant B Morgan, Jorge C Reyes
Journal: Front Netw Physiol (2024)
Keywords: adhd, starcraft, heart rate, pupil dilation, skin temperature, temporal lag, time delay stability
MeSH terms: Case Reports

This study investigates the dynamic interactions between physiological systems during competitive gaming, utilizing a Network Physiology approach. By examining the physiological responses of a gamer with attention-deficit/hyperactivity disorder playing a real-time strategy game, we explore the relationships and temporal lag effects between pupil dilation, skin temperature, and heart rate. Our findings highlight the interconnectedness of these physiological systems and demonstrate how different physiological states are associated with unique patterns of network interactions. The study employs the concept of Time Delay Stability towards a deeper understanding of the complex dynamics involved. This research contributes to the growing field of Network Physiology by offering new insights into the physiological underpinnings of competitive gaming, potentially informing targeted training and recovery protocols for eSports athletes.
IgA-Dominant Staphylococcus-Associated Glomerulonephritis: An Uncommon Complication of Intravenous Drug Use
Authors: Mason Stoltzfus, Pankhuri Mohan, Robert Mullin
Journal: Cureus (2024)
Keywords: acute hypoxemic respiratory failure, acute respiratory, congestive hepatopathy, iga-dominant infection-related glomerulonephritis, intravenous drug use (ivdu), mrsa infective endocarditis, pulmonary empyema, tricuspid valve endocarditis
MeSH terms: Case Reports

A 24-year-old female with a history of intravenous heroin use presented with two weeks of chills, myalgias, and cough and was found to be in acute hypoxemic respiratory failure. Subsequent workup revealed the presence of bilateral septic pulmonary emboli and tricuspid valve endocarditis. Several weeks into her hospitalization, she developed periorbital edema and laboratory testing revealed she had developed acute renal failure and nephrotic range proteinuria. A renal biopsy confirmed the diagnosis of IgA-dominant Staphylococcus-associated glomerulonephritis (IgA-SAGN). Early recognition of this newly recognized variant of glomerulonephritis is paramount, as improper treatment may lead to catastrophic consequences.
Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy
Authors: Sherwin Azad, John Anson, Tamara Majic, Raisa Lev, Varoujan Kostanian
Journal: Case Rep Radiol (2023)
MeSH terms: Case Reports

An unusual case of ischemic stroke due to calcified cerebral embolus occurring in a pregnant patient during the peripartum period is reported. The source of the embolus was suspected to be a pelvic phlebolith in origin which paradoxically embolized via a patent foramen ovale to the supraclinoid right internal carotid artery. To our knowledge, this is the first reported case of calcified cerebral embolus attributed to paradoxical embolism of a pelvic phlebolith, and we theorize that introduction of the phlebolith into the venous system may have occurred as a consequence of vascular remodeling due to pregnancy-related hemodynamic changes. Clinicians should be aware of this potential source of calcified cerebral emboli in patients with a patent foramen ovale during pregnancy. Our patient ultimately achieved an excellent outcome with surgical endarterectomy and embolectomy following an unsuccessful attempt at mechanical thrombectomy.
Torsion of an Accessory Liver Lobe in a Newborn
Authors: Tobias Krause, Dietmar Cholewa, Benjamin Liniger, Steffen Berger, Milan Milosevic
Journal: European J Pediatr Surg Rep (2024)
Keywords: accessory liver lobe torsion, hepatic lobe, neonatal liver lobe torsion, pedunculated liver lobe
MeSH terms: Case Reports

Accessory liver lobes are rare. We present the rare case of torsion of an accessory liver lobe in a neonate. A 13-day-old newborn presented with failure to thrive and hematemesis without fever. The initial workup with sonography, magnetic resonance imaging, and upper gastrointestinal study was suspicious of a duplication cyst, most likely in the posterior wall of the stomach. Laboratory and radiological findings were not suggesting a choledochal cyst. We performed a laparotomy with resection of the 3.2 × 2.1 × 1.1 cm mass. Intraoperatively, the cystic formation extended from of the liver bed up to the lesser curvature of the stomach. The mass was attached to the left liver lobe with fibrous bands. Histopathology revealed necrotic liver parenchyma with patent viable biliary ducts, indicative of an accessory liver lobe that underwent torsion in the perinatal period. The postoperative course and follow-up (6 months so far) were uneventful. To our knowledge, this is the youngest described patient in the literature with an accessory liver lobe torsion and the second case report concerning this entity in a neonate. It presents an extremely rare differential diagnosis in symptomatic neonates with a cystic mass in the upper abdomen.
Schmidt´s syndrome found by tan: a case report
Authors: Gabriela Venade, Catarina Almeida, Nídia Oliveira, Luis Costa Matos
Journal: Pan Afr Med J (2024)
Keywords: addison’s disease, schmidt´s syndrome, autoimmune polyglandular syndrome, case report
MeSH terms: Addison Disease / complications, Addison Disease / diagnosis, Addison Disease / drug therapy, Glucocorticoids / administration & dosage, Hyperpigmentation / diagnosis, Hyperpigmentation / etiology, Prednisolone / administration & dosage, Vitiligo / diagnosis, Case Reports, Adrenocorticotropic Hormone, Adult, Female, Fludrocortisone / administration & dosage, Fludrocortisone / therapeutic use, Humans, Hydrocortisone / administration & dosage, Hypothyroidism / diagnosis, Hypothyroidism / drug therapy, Polyendocrinopathies, Autoimmune / complications, Polyendocrinopathies, Autoimmune / diagnosis, Polyendocrinopathies, Autoimmune / drug therapy, Prednisolone, Glucocorticoids, Fludrocortisone, Hydrocortisone, Adrenocorticotropic Hormone

Addison´s disease can form part of type 2 autoimmune polyglandular syndrome. The article reports the case of a 41-year-old female patient with hypothyroidism and vitiligo, who came to the emergency department complaining of asthenia that had worsened in recent months, as well as anorexia, nausea, and weight loss (6 kg in a year). Cutaneous hyperpigmentation was the main finding on physical examination, together with vitiligo lesions on the face, hands, and armpits. Further study revealed a low serum cortisol level, normal urine-free cortisol, and an elevated adrenocorticotropic hormone (ACTH). Antiperoxidase antibodies and 17-alpha-hidroxylase antibodies were both positive. Treatment was started with prednisolone and fludrocortisone, and a good clinical response was obtained. This case report aims to draw attention to the high level of clinical suspicion required to diagnose Addison´s disease and the need to screen actively for other potentially associated autoimmune diseases that may be associated.
Left distal sciatic giant solitary myxoid neurofibroma: a case report & literature review
Authors: Fatima Az-Zahra' Thawabtah, Mayar Idkedek, Hafez Nimer
Journal: Front Surg (2024)
Keywords: giant, myxoid, neurofibroma, sciatic nerve, solitary
MeSH terms: Case Reports

Introduction:
Neurofibroma, a rare benign tumor of the peripheral nervous system, can manifest anywhere along a nerve from the dorsal ganglion to its terminal branches. Myxoid neurofibroma can present as a solitary non-tender nodule and is often confirmed by positive immunohistochemical staining for S-100 protein. However, in 50% of cases, neurofibromas are associated with neurofibromatosis.
Case presentation:
We present a case of a 34-year-old male with mild pain in the posterior part of his left thigh, accompanied by a slowly-growing swelling particularly noticeable when flexing his knee. It had gradually increased in size over several months, which the patient observed as a decrease in the degree of knee extension. Initial biopsy indicated schwannoma with no evidence of malignancy. Four years later, the swelling increased in size and necessitated resection surgery, revealing an irregular giant tumor measuring 8 *6 *4.5 cm, adherent to adjacent structures, including the femur, muscles, popliteal artery and vein, and a branch of the sciatic nerve. Pathological analysis reclassified the diagnosis to low-grade myxoid neurofibroma. Follow-up MRI three months later showed gross total resection without residual or recurrence of the tumor.
Discussion:
Solitary neurofibromas are often small in size, ranging from 1 to 2 cm in the greatest dimension. Alternatively, tumors that occur as a part of genetic neurofibromatosis tend to be multiple and often grow to large sizes. In our case, the patient didn't have neurofibromatosis as he didn't meet its diagnostic criteria despite having a giant tumor measuring approximately 8*6*4.5 cm. To our knowledge, this is the first report of giant myxoid solitary neurofibroma of the thigh apart from neurofibromatosis. Thus, this type of tumor should be considered in the differential diagnosis of tumors at this location.
Diffuse non-obstructive coronary artery disease: two clinical faces of the same disease-a case report
Authors: Matjaž Klemenc, Gregor Budihna, Igor Kranjec
Journal: Eur Heart J Case Rep (2023)
Keywords: case report, diffuse coronary atherosclerosis, effort angina, minoca, st-segment elevation myocardial infarction
MeSH terms: Case Reports

Background:
Coronary artery disease has a long preclinical phase before manifesting itself clinically due to diffuse non-obstructive disease, stenoses, or thrombosis.
Case summary:
We present a case of a middle-aged male complaining of atypical chest pain, then severe retrosternal pain, and, eventually, effort angina. We performed non-invasive testing, coronary angiography, intravascular imaging, and flow reserve tests, each as appropriate. Cardiovascular risk control, optimization of drug therapy, and percutaneous coronary intervention were considered trying to comply with the best clinical practice.
Discussion:
Diffuse non-obstructive coronary artery disease may present clinically in different ways. Exercise stress test might be sufficient to assess effort angina before a potential angiography. Flow reserve tests across the diseased vessel can distinguish between diffuse and focal pattern of the disease and assist in the adequate selection of therapy. Finally, intravascular imaging is invaluable for the assessment of the plaque risk features.
Right Ventricular Free Wall Rupture Due to Displaced Automatic Implantable Cardioverter Defibrillator (AICD) Lead
Authors: Abhinav K Rao, Craig Herrforth, Angeli Patel, Kunaal Patel, Brittany Lyons
Journal: Cureus (2024)
Keywords: aicd, cardiac device implantation, displaced lead, free wall rupture, right ventricle
MeSH terms: Case Reports

The implantation of an implantable cardioverter defibrillator (ICD) carries a risk for major complications, one of which is ventricular free wall rupture secondary to a lead perforation. This known complication, although rare, has estimated incidence rates between 0.1% and 3%. Predictive factors of such an event include temporary leads, steroid use, active fixation leads, low body mass index (<20 kg/m2), age greater than 80 years, female gender, and concurrent anticoagulation. Right ventricular systolic pressure >35 mmHg is considered a protective factor likely due to associated right ventricular hypertrophy. We present a case of a 73-year-old female with a history of aortic stenosis status post-transcatheter aortic valve replacement (TAVR) and atrial fibrillation (AFib) who met the criteria for an ICD after suffering ventricular fibrillation arrest (after TAVR procedure) ultimately resulting in lead perforation.
Case report: Treatment with Phesgo® in a patient receiving hemodialysis
Authors: Catarina Pulido, Joana Albuquerque, Jorge Correia, José Luís Passos-Coelho
Journal: Front Oncol (2024)
Keywords: her2-positive, phesgo, advanced breast cancer, case report, hemodialysis
MeSH terms: Case Reports

Introduction:
Patients with metastatic HER2-positive breast cancer have multiple therapeutic options. However, most are not studied in the renal replacement therapy (RRT) setting.
Case report:
We report the use of Phesgo® (subcutaneous fixed-dose combination of trastuzumab and pertuzumab) combined with exemestane as a first-line treatment of metastatic HER2-positive breast cancer in a hemodialysis patient with multiple comorbidities. Partial response was attained, with disease progression after 8 months without evidence of significant toxicity.
Discussions:
This case report is, to our knowledge, the first published case documenting the use of Phesgo® in a hemodialysis patient. No new safety signs were seen, and activity was documented, adding support to the use of this drug combination in such a patient population.
Comprehensive Physiotherapy Rehabilitation Protocol of Plantar Fasciitis for a 45-Year-Old Female: A Case Report
Authors: Manali A Boob, Pratik Phansopkar, Kamya J Somaiya
Journal: Cureus (2024)
Keywords: foot functional index, plantar fasciitis, plantar heel pain, rehabilitation training, windlass test
MeSH terms: Case Reports

Plantar fasciitis is stated to arise because of inadequate accumulated tension at the plantar fascia's enthesis. Tensile load and prolonged strain cause tiny rips in the fascia, which trigger a chronic inflammation process of healing. This case report shows the diagnostic evaluations, assessment of the condition, and physical rehabilitation management for a 45-year-old female nurse working in the neurosurgical critical care unit who had been experiencing plantar medial and posterior heel pain, as well as discomfort at the calcaneal tuberosity, for the previous six months. To increase functional mobility and alleviate symptoms, the patient sought out physiotherapy intervention. In this case, a physiotherapeutic program was implemented to treat plantar fasciitis, enhance mobility, and encourage long-term recovery. The evaluation included a detailed review of the patient's gait, biomechanics, and circumstances that may have contributed to the ongoing problems. The multimodal strategy used in the intervention plan included manual therapy, strengthening and stretching exercises, as well as patient education and counselling on self-management techniques. The patient's functional mobility increased along with a steady reduction in discomfort during the duration of the physiotherapy sessions. The instance emphasises how important it is to manage persistent plantar fasciitis with a customised physical therapy strategy that takes the patient's specific requirements into account and addresses contributory variables. The present study adds to the extant literature on efficacious physiotherapeutic approaches for plantar fasciitis, highlighting the need for a holistic approach in attaining favourable results for individuals enduring heel discomfort.
Polymorphous low-grade neuroepithelial tumor of the young with FGFR3-TACC3 fusion mimicking high-grade glioma: case report and series of high-grade correlates
Authors: Danielle Golub, Daniel G Lynch, Peter C Pan, Benjamin Liechty, Cheyanne Slocum, Tejus Bale, David J Pisapia, Rupa Juthani
Journal: Front Oncol (2023)
Keywords: fgfr fusion, plnty, glioblastoma, glioma molecular drivers, high-grade glioma
MeSH terms: Case Reports

Background:
Polymorphous low-grade neuroepithelial tumor of the young (PLNTY) is a recently described entity that can mimic high-grade glioma (HGG) in histologic and molecular features; however, factors predicting aggressive behavior in these tumors are unclear.
Methods:
We present an indolent neuroepithelial neoplasm in a 59-year-old female with imaging initially suggestive of HGG, and a series of adult patients with HGG harboring FGFR3-TACC3 fusions are also presented for comparison.
Results:
Pathology in the case patient revealed low-grade cytomorphology, microcalcifications, unusual neovascularization, and a low proliferation index. The lesion was diffusely CD34+ and harbored an FGFR3-TACC3 fusion and TERT promoter mutation. A diagnosis of PLNTY was therefore favored and the patient was observed with no progression at 15-month follow-up. In patients with HGG with FGFR3-TACC3 fusions, molecular findings included IDH-wildtype status, absence of 1p19q codeletion, CDKN2A loss, TERT promoter mutations and lack of MGMT promoter methylation. These patients demonstrated a median 15-month overall survival and a 6-month progression-free survival.
Conclusion:
PLNTY is a rare low-grade entity that can display characteristics of HGG, particularly in adults. Presence of FGFR3-TACC3 fusions and other high-grade features should raise concern for a more malignant precursor lesion when a diagnosis of PLNTY is considered.
Postpartum Hypocupric Myelopathy Masquerading as Acute Transverse Myelitis: A Case Report and Literature Review of a Rare Presentation
Authors: Nikhil Pantbalekundri, Sunil Kumar, Sourya Acharya, Gautam Bedi
Journal: Cureus (2024)
Keywords: acute transverse myelitis (atm), copper deficiency, copper-induced myelopathy, hyperzincemia, hypocupremia
MeSH terms: Case Reports

The symptoms of transverse myelitis, an acute demyelinating inflammatory condition of the spinal cord, include motor, sensory, and bowel-bladder dysfunction that can develop suddenly or gradually. Several etiologies, such as bacterial, fungal, or viral infections, cancer, autoimmune diseases, vascular problems, and environmental variables, can cause it. The identification of copper deficiency myelopathy (CDM) as a curable cause of non-compressive inflammatory myelopathy has only occurred recently. Patients frequently present with sensory complaints and a spastic gait. The neurological disease may exist independently of the hematologic signs. Only a few cases of copper myelopathy in peripartum women have been documented. Given that hypocupric myelopathy is a treatable cause of debilitating paraplegia, maintaining clinical vigilance will be crucial in minimizing neurological sequelae, as demonstrated in this case report.
Case report: Neuronal intranuclear inclusion disease initially mimicking reversible cerebral vasoconstriction syndrome: serial neuroimaging findings during an 11-year follow-up
Authors: Gha-Hyun Lee, Eugene Jung, Na-Yeon Jung, Takeshi Mizuguchi, Naomichi Matsumoto, Eun-Joo Kim
Journal: Front Neurol (2024)
Keywords: mri, niid, episodic neurological dysfunction, neuronal intranuclear inclusion disease, perfusion
MeSH terms: Case Reports

Neuronal intranuclear inclusion disease (NIID) is a rare, progressive neurodegenerative disorder known for its diverse clinical manifestations. Although episodic neurogenic events can be associated with NIID, no reported cases have demonstrated concurrent clinical features or MRI findings resembling reversible cerebral vasoconstriction syndrome (RCVS). Here, we present the inaugural case of an adult-onset NIID patient who initially displayed symptoms reminiscent of RCVS. The 59-year-old male patient's initial presentation included a thunderclap headache, right visual field deficit, and confusion. Although his brain MRI appeared normal, MR angiography unveiled left posterior cerebral artery occlusion, subsequently followed by recanalization, culminating in an RCVS diagnosis. Over an 11-year period, the patient encountered 10 additional episodes, each escalating in duration and intensity, accompanied by seizures. Simultaneously, cognitive impairment progressed. Genetic testing for NIID revealed an abnormal expansion of GGC repeats in NOTCH2NLC, with a count of 115 (normal range, <60), and this patient was diagnosed with NIID. Our report highlights that NIID can clinically and radiologically mimic RCVS. Therefore, in the differential diagnosis of RCVS, particularly in cases with atypical features or recurrent episodes, consideration of NIID is warranted. Additionally, the longitudinal neuroimaging findings provided the course of NIID over an 11-year follow-up period.
The Great Imposter: An Atypical Case of Pleomorphic Adenoma With Review of Literature
Authors: Pranjal Rai, Arpita Sahu, Neha Mittal, Vasundhara Patil
Journal: Cureus (2024)
Keywords: fine needle aspiration, head and neck tumors, multicentric pleomorphic adenoma, pleomorphic adenoma, slow-flow vascular malformation
MeSH terms: Case Reports

Pleomorphic adenomas (PA) are the most common type of salivary gland tumors. These slow-growing benign tumors most commonly involve the parotid gland, but can sometimes occur at atypical sites such as the submandibular or minor salivary glands. We describe an atypical case of pleomorphic adenoma with multicentric involvement of the parotid, the submandibular gland, and the parapharyngeal space in a 35-year-old male which mimicked a slow-flow malformation on magnetic resonance imaging (MRI). Diagnosis was confirmed on fine needle aspiration cytology, and conservative approach was opted for the patient in view of perioperative risks. This case highlights the uncommon multicentricity and atypical presentation of PA, challenging the initial differential diagnosis based on MRI features. It also underscores the importance of considering atypical presentations and utilizing accurate diagnostic tools like cytology for managing complex salivary gland tumors.
A Young Woman with Common Variable Immunodeficiency: The Role of Thorough Medical History and Physical Examination in Accurate Diagnosis
Authors: Amirhossein Khodadadi, Rozita Khodashahi
Journal: Case Rep Med (2024)
MeSH terms: Case Reports

Common variable immunodeficiency (CVID) is a rare immunodeficiency syndrome which presents with wide manifestations leading to delayed diagnosis. A 34-year-old woman presented to our hospital complaining of dyspnea and productive cough. Lung CT scan revealed loculated right-sided pleural effusion with bronchiectasis and consolidation in right lower lobes. After taking medical history and physical examination, we suspected CVID and ordered serum immunoglobulin levels. The laboratory results were in line with CVID diagnosis and showed decreased levels of IgG, IgM, and IgA. The patient was started on intravenous immune globulin (IVIG) therapy every month. After 3-month follow-up, the patient reported no problem and felt better.