OpenMed/multicare-articles huggingface dataset:
A Case of Acute Leukemia Following Remission of COVID-19 Infection; an Urge to Search for a Probable Association
Authors: Seyyed Mojtaba Nekooghadam, Afshin Moradi, Kimia Karimi Toudeshki, Mehdi Pishgahi
Journal: Arch Acad Emerg Med (2021)
Keywords: association, covid-19, case reports, leukemia
MeSH terms: Case Reports

Many aspects of Covid-19 infection, especially its complications and long-term health consequences are still unknown. Several reports concerning concomitant covid-19 infection and hematological disorders have been published recently. We aim to present a unique case of acute myeloid leukemia in a 61-year-old man with a previous history of covid-19 infection 40 days ago, with near complete resolution of signs and symptoms attributable to covid-19 infection. After 3 weeks, the patient presented again with progressive weakness, nausea, vomiting, and epigastric pain. No evidence of active covid-19 infection was observed. Instead, remarkable drop of hemoglobin and platelets relative to the values recorded in the discharge notes of the patient was observed. Further workup of the patient revealed evidence of acute leukemia and severe bone marrow involvement. We decided to present the current case as a concerning probable association.
Paraganglioma of the spermatic cord: A case report and literature review
Authors: Brendan Gontarz, Poornima Hegde, David McFadden
Journal: Int J Surg Case Rep (2019)
Keywords: case report, paraganglioma, pheochromocytoma, spermatic cord

Introduction:
Neuroendocrine tumors are a diverse and well-described entity with most arising from the gastrointestinal tract. A clinically significant example is the paraganglioma, or an extra-adrenal catecholamine-producing tumor.
Presentation of case:
Herein we describe and review a paraganglioma arising from the spermatic cord in a 55 year old asymptomatic man.
Discussion:
Paragangliomas are rare, with an incidence of 3-8 cases per million population. To date there are only 12 cases found in the literature.
Conclusion:
In this article, we review our patient's presentation, follow-up, and screening followed by a review of the literature of this fascinating tumor. Although rare, paraganglioma should be considered in the differential diagnosis of unusual groin masses. This work has been reported in line with the SCARE criteria (Agha et al., 2018).
Clinical and Laboratory Improvement in Hyperadrenergic Postural Orthostatic Tachycardia Syndrome (POTS) after COVID-19 Infection
Authors: Rebecca A Ocher, Erika Padilla, Jonathan C Hsu, Pam R Taub
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

A 32-year-old woman with a history of symptomatic supraventricular tachycardia, inappropriate sinus tachycardia, and hyperadrenergic POTS was treated with ivabradine and metoprolol. She then presented with bradycardia and Mobitz II second-degree AV block on event monitoring six weeks after COVID-19 infection. Her post-viral workup revealed normalization of catecholamine levels and significant symptomatic improvement in heart rate. To the authors' knowledge, this is the first reported case of improvement in POTS after COVID-19 infection. As our understanding of COVID-19 continues to improve, it will be vital to better understand the impact of COVID-19 dysautonomia on cardiac patients.
Isolated Native Tricuspid Valve Endocarditis in a Nonintravenous Drug User
Authors: Habtewold Shibru, Ermias Shenkutie Greffie, Zenahbezu Abay, Oumer Abdu Muhie
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Infective endocarditis (IE) is a disease characterized by high morbidity and mortality. IE was first described in the mid-16th century. Right-sided infective endocarditis (RSIE) represents 5% to 10% of all IE episodes in adults. RSIE can be divided into three groups according to the underlying risk factors: intravenous drug users (IDUs), cardiac device carriers, and the "three noes" group (no left-sided IE, no IDUs, and no cardiac devices). Tricuspid valve endocarditis in nonintravenous drug users can occur in a variety of conditions including congenital heart disease, intracardiac devices, central venous catheters, and immunologically debilitated patients. Due to the rareness of isolated native nonrheumatic tricuspid valve endocarditis, here, we like to present an 18-year-old male from rural Ethiopia with the diagnosis of isolated native tricuspid valve endocarditis that was treated and cured.
Double-Tension Wire Management of Nonunion Patella with Severe Quadriceps Contracture
Authors: Rohan Bhimani, Preeti Singh, Fardeen Bhimani
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Introduction:
Nonunion patella with quadriceps contracture is an unusual orthopaedic finding. Very few cases have been recorded in the past with this complication. We present a case of a 40-year-old male with nonunion patella with quadriceps contracture secondary to trauma. Case Report. A 40-year-old male with posttraumatic nonunion patella with quadriceps contracture since 6 months presented with complaints of defect in the left knee with restriction of movements. X-ray of the left knee confirmed our findings. He underwent quadricepsplasty with double-tension band wiring for the patella followed by rigorous physiotherapy to achieve the current level of the knee flexion of 110 degrees.
Conclusion:
We conclude that quadricepsplasty with tension band wiring and neutralization wire is one of the good modalities of treatment for a nonunion patella associated with quadriceps contracture.
Working With the Predictable Life of Patients: The Importance of "Mentalizing Interoception" to Meaningful Change in Psychotherapy
Authors: Patrice Duquette, Vivien Ainley
Journal: Front Psychol (2019)
Keywords: emotion, free energy principle, interoception, mentalization of interoception, predictive processing, psychotherapeutic change, psychotherapy

To understand our patients and optimize their treatment, psychotherapists of all theoretical orientations may benefit from considering current scientific evidence alongside psychodynamic constructs. There is recent neuroscientific evidence that subjective awareness, feelings and emotions depend upon "interoception," defined as the neural signaling to the brain from all tissues of the body. Interoception is the obvious basis of homeostasis (in the brainstem) but some interoceptive signals rise above this level and contribute to inferential processes that substantiate intrapersonal and interpersonal experience. The focus of this paper is on the essential role that their "interoception" plays in our patients' emotional experience and subjective awareness, and how the process referred to as "mentalizing interoception" may be harnessed in therapy. This can best be understood in terms of "predictive processing," which describes how subjective states, and particularly emotion, are inferred from sensory inputs - both interoceptive and exteroceptive. Predictive processing assumes that the brain infers (probabilistically) the likely cause of sensation experienced through the sense organs, by testing this sensory data against its innate and learned "priors." This implies that any effort at changing heavily over-learned prior beliefs will require action upon the system that has generated that set of prior beliefs. This involves, quite literally, acting upon the world to alter inferential processes, or in the case of interoceptive priors, acting on the patient's body to alter habitual autonomic nervous system (ANS) reflexes. Focused attention to bodily sensations/reactions, in the safety of the therapeutic relationship, provides a route to "mentalizing interoception," by means of the bodily cues that may be the only conscious element of deeply hidden priors and thus the clearest way to access them. This can: update patients' characteristic, dysfunctional responses to emotion and feelings; increase emotional insight; decrease cognitive distortions; and engender a more acute awareness of the present moment. These important ideas are outlined below from the perspective of psychodynamic psychotherapeutic practice, in order to discuss how relevant information from neuroscientific theory and current research can best be applied in clinical treatment. A clinical case will be presented to illustrate how this argument or treatment relates directly to clinical practice.
De Garengeot's hernia: Case report and literature review
Authors: Carlos Bustamante Recuenco, Javier García-Quijada García, Manuel Cendrero Martín, Alberto Carabias Hernández, Ana Serantes Gómez, Paloma Sanz Muñoz, Miguel Ángel Delgado Millán, José María Jover Navalón
Journal: Int J Surg Case Rep (2019)
Keywords: appendix, diagnosis, garengeot, hernia, preperitoneal, prosthesis

Introduction:
De Garengeot's Hernia is a rare type of femoral hernia in which the appendix is located inside the herniated sac. Diagnosis of the condition is challenging and its treatment must be performed without delay.
Presentation of case:
We present the case of a 75-year-old patient with a femoral hernia in which an appendix with signs of inflammation was found. An appendectomy followed by hernia repair was performed under an open preperitoneal approach according to Nyhus technique. The patient did not present any complications and was discharged on the second postoperative day.
Discussion:
This type of hernia is often unexpected and its preoperative diagnosis is difficult to perform. In most cases the clinical picture is indistinguishable from a common incarcerated hernia. Contrast-enhanced CT is the most useful complementary test, although it is not as accurate as desirable, so the diagnosis is frequently found intraoperatively. There is a wide variety of surgical options and there is no consensus on the most appropriate one. The preperitoneal approach enables the performance of an appendectomy and subsequent hernia reparation. The use of prosthesis should be considered if there are no signs of perforation or abscess.
Conclusion:
De Garengeot's hernia is a very rare entity. The diagnosis and subsequent surgical treatment must be early to prevent the disease progression. The preperitoneal approach should be considered as the first choice technique, as it allows the exploration of the herniated sac and the performance of surgical procedures on its content.
Case report: cerebral venous sinus thrombosis and pulmonary embolism as the initial presentation in a child with asymptomatic primary nephrotic syndrome
Authors: Qinhui Wang, Yaru Cui, Ping Liang, Chuan Wang, Kaiyu Zhou, Fan Ma, Hongyu Duan
Journal: Front Pediatr (2023)
Keywords: case report, cerebral venous sinus thrombosis, children, nephrotic syndrome, pulmonary embolism
MeSH terms: Case Reports

Background:
Cerebral venous sinus thrombosis (CVST) is rare, but potentially life-threatening. The clinical course definitely become more unpredictable and fatal in patients complicated by pulmonary embolism (PE). Nephrotic syndrome (NS) is an uncommon etiology of CVST. Concurrence of CVST and PE at the initial onset of NS is extremely unusual and rarely reported. Considering that edema might be absent in NS individuals, thromboembolic events probably become unrecognized, thereby causing a missed or delayed diagnosis and poor outcome. Herein, we described an extraordinary case of an adolescent boy presenting with both CVST and PE initially just within 5 days of disease onset, who was ultimately diagnosed with asymptomatic NS, aiming to emphasize a high index of suspicion of these diseases in patients with conditions of hypercoagulability.
Case presentation:
A 13-year-old male child presented acutely with dizziness, fever and dyspnea, with signs of shock but undetected edema. Initial laboratory investigations revealed hypoalbuminemia, typical images of pneumonia, and normal radiographic findings on non-enhanced computed tomography of head. Despite evidence of hypoalbuminemia and neurological symptoms, the child was still misdiagnosed as pneumonia. His dyspnea and period of headache deteriorated even if hemodynamic stability and undetected fever after initial therapy. The delayed urinalysis and 24-h urine examination both showed massive proteinuria. A computed tomography angiography of chest along with cranial magnetic resonance imaging/magnetic resonance venography were subsequently performed, consistent with the imaging features of PE and CVST, respectively. The diagnosis of asymptomatic primary NS complicated by PE and CVST was ultimately confirmed. The patient received corticosteroids and antithrombotic therapy with satisfactory results.
Conclusion:
A persistent clinical suspicion of CVST should be borne in mind in patients with a sudden, new or worsening headache, specifically among those with prothrombotic conditions. NS should always be considered in the differential diagnosis of risk factors for CVST, even in absence of edema. Since CVST and PE can be present simultaneously at extraordinary early-onset of NS, early radiological diagnosis is clinically substantial to proper management and satisfactory long-term outcomes.
Magnetic resonance imaging in a patient with a dual chamber pacemaker
Authors: Lynne Martina Millar, Andrew George Robinson, Maurice Thomas O'Flaherty, Niall Eames, Nicola Johnston, Gary Heyburn
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Having a pacemaker has been seen an absolute contraindication to having an MRI scan. This has become increasingly difficult in clinical practice as insertion of pacemakers and implantable cardiac defibrillators is at an all time high. Here we outline a case where a 71-year-old male patient with a permanent pacemaker needed to have an MRI scan to ascertain the aetiology of his condition and help guide further management. Given this clinical dilemma, an emergency clinical ethics consultation was arranged. As a result the patient underwent an MRI scan safely under controlled conditions with a consultant cardiologist and radiologist present. The results of the MRI scan were then able to tailor further treatment. This case highlights that in certain conditions an MRI can be performed in patients with permanent pacemakers and outlines the role of clinical ethics committees in complex medical decision making.
Case Report: Combination of Omalizumab and Dupilumab for Recalcitrant Bullous Pemphigoid
Authors: S Morteza Seyed Jafari, Laurence Feldmeyer, Simon Bossart, Dagmar Simon, Christoph Schlapbach, Luca Borradori
Journal: Front Immunol (2021)
Keywords: bullous pemphigoid, dupilumab, omalizumab, recalcitrant, treatment
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Omalizumab / therapeutic use, Pemphigoid, Bullous / drug therapy, Skin / drug effects, Case Reports, Research Support, Non-U.S. Gov't, Aged, Drug Therapy, Combination, Humans, Male, Pemphigoid, Bullous / diagnosis, Pemphigoid, Bullous / immunology, Remission Induction, Skin / immunology, Skin / pathology, Treatment Outcome, Antibodies, Monoclonal, Humanized, Omalizumab, dupilumab

Bullous pemphigoid (BP) is a blistering autoimmune skin disease. Omalizumab, a monoclonal antibody directed to IgE, showed a beneficial effect in treatment of recalcitrant BP in case series. More recently, dupilumab, an interleukin (IL)-4-receptor alpha antagonist, also showed promising preliminary results. We describe a patient with refractory BP who showed a complete response to a combination therapy with omalizumab and dupilumab.
Case Report: Ménière's Disease-Like Symptoms in 22q11.2 Deletion Syndrome
Authors: Kwang-Dong Choi, Jeong-Yeon Kim, Seo-Young Choi, Eun Hye Oh, Hyun-Min Lee, Jieun Roh, Jae-Hwan Choi
Journal: Front Neurol (2021)
Keywords: 22q112 deletion syndrome, ménière's disease, case report, endolymphatic hydrops, sensorineural hearing loss, vertigo
MeSH terms: Case Reports

The 22q11.2 deletion syndrome (22q11.2DS), caused by a microdeletion on the long arm of chromosome 22, is characterized by congenital heart disease, hypoparathyroidism, immunodeficiency, developmental delay, and velopharyngeal insufficiency. Anatomic malformations of the middle and inner ears are frequently present, leading to high prevalence of hearing impairment. We present a first case of 22q11.2DS showing fluctuating hearing loss with recurrent vertigo attacks, resembling Ménière's disease. A 38-year-old male known to have 22q11.2DS developed recurrent vertigo, tinnitus, and fluctuating hearing loss in the left ear during a 10-year follow-up period. During vertigo attack, he had spontaneous left-beating nystagmus with downbeat components, but bithermal caloric and video head impulse tests showed normal vestibulo-ocular reflex functions. Sequential pure tone audiograms demonstrated fluctuating sensorineural hearing loss (SNHL) in both ears, which finally progressed to permanent hearing loss in the left ear. Computed tomography imaging of the temporal bone exhibited bilaterally malformed lateral semicircular canals, and delayed 3D-FLAIR sequences revealed cochlear endolymphatic hydrops with dilation of the scala media in the left ear. This case shows that acute vertigo with SNHL can be one of the audiovestibular presentations in 22q11.2DS caused by disturbance of endolymphatic flow.
Transcatheter Artery Embolization for Postoperative Haemorrhage after Arterio-Venous Malformation - Safer Option
Authors: Panda Subrat, Sharma Nalini, Khan Dina Aisha, Saha Anusmita, Das Rituparna, Phukan Pranjal
Journal: Acta Med Litu (2021)
Keywords: arteriovenous malformation, complication, gestational trophoblastic neoplasia, haemorrhage, hysterectomy, transcatheter artery embolization
MeSH terms: Case Reports

Summary introduction:
Hemorrhage is one of the commonest and dreaded complications especially with pelvic surgeries. Gestational trophoblastic neoplasias (GTN) are notorious for their propensity to bleed torrentially and metastasis to vital organs. GTN is associated with an arterio-venous malformation (AVM) about 10-15% of the time, which can lead to bleeding after surgery or after complete remission. After the failure of conventional management with chemotherapy or surgery one is compelled to take another modality of management. One of such methods is the use of transcatheter artery embolization in cases of GTN or post-hysterectomy cases of GTN. Transcatheter arteryembolization (TAE) was effective in controlling bleeding due to arterio-venous malformation in 96% of cases.
Case:
46 years P2L2A5 (para 2, living issue 2, abortion 5) post-hysterectomy patient presented with bleeding from the vagina after surgery. Twice she underwent vaginal vault repair after hysterectomy but failed. Ultrasonography (USG) showed arterio-venous malformation (AVM); angiography revealed massive extravasation from (left internal iliac artery and abnormal vascularity from the right internal iliac. She was taken up for bilateral internal iliac arteries embolization but again had a heavy bout of bleeding after one week. CT scan confirmed a residual lesion and she underwent a repeat embolization after which the bleeding stopped. Serum BHCG was advised during workup and it was 1997 IU/ml. A diagnosis of GTN was confirmed. The patient was discharged after two cycles of chemotherapy with advice to review for the third one on an outpatient department basis.
Conclusion:
We concluded that TAE is an effective and safer alternative to surgery in postoperative bleeding from AV malformation in the case of GTN. It can be repeated and should be made to more liberal use in emergency settings.
Priority planting area planning for cash crops under heavy metal pollution and climate change: A case study of Ligusticum chuanxiong Hort
Authors: Ping He, Yunfeng Li, Tongtong Huo, Fanyun Meng, Cheng Peng, Ming Bai
Journal: Front Plant Sci (2023)
Keywords: ligusticum chuanxiong hort, niche model, priority conservation area, scenario simulation model, soil cadmium pollution

Introduction:
Soil pollution by heavy metals and climate change pose substantial threats to the habitat suitability of cash crops. Discussing the suitability of cash crops in this context is necessary for the conservation and management of species. We developed a comprehensive evaluation system that is universally applicable to all plants stressed by heavy metal pollution.
Methods:
The MaxEnt model was used to simulate the spatial distribution of Ligusticum chuanxiong Hort within the study area (Sichuan, Shaanxi, and Chongqing) based on current and future climate conditions (RCP2.6, RCP4.5, RCP6.0, and RCP8.5 scenarios). We established the current Cd pollution status in the study area using kriging interpolation and kernel density. Additionally, the three scenarios were used in prediction models to simulate future Cd pollution conditions based on current Cd pollution data. The current and future priority planting areas for L. chuanxiong were determined by overlay analysis, and two levels of results were obtained.
Results:
The results revealed that the current first- and secondary-priority planting areas for L. chuanxiong were 2.06 ×103 km2 and 1.64 ×104 km2, respectively. Of these areas, the seven primary and twelve secondary counties for current L. chuanxiong cultivation should be given higher priority; these areas include Meishan, Qionglai, Pujiang, and other regions. Furthermore, all the priority zones based on the current and future scenarios were mainly concentrated on the Chengdu Plain, southeastern Sichuan and northern Chongqing. Future planning results indicated that Renshou, Pingwu, Meishan, Qionglai, Pengshan, and other regions are very important for L. chuanxiong planting, and a pessimistic scenario will negatively impact this potential planting. The spatial dynamics of priority areas in 2050 and 2070 clearly fluctuated under different prediction scenarios and were mainly distributed in northern Sichuan and western Chongqing.
Discussion:
Given these results, taking reasonable measures to replan and manage these areas is necessary. This study provides. not only a useful reference for the protection and cultivation of L. chuanxiong, but also a framework for analyzing other cash crops.
Atlantoaxial Subluxation after Pyogenic Spondylitis around the Odontoid Process
Authors: Atsushi Hasegawa, Mitsuru Yagi, Masakazu Takemitsu, Masafumi Machida, Takashi Asazuma, Shoichi Ichimura
Journal: Case Rep Orthop (2015)

Study Design. A case report and review of the literature. Objective. The aim of this study was to describe the conservative management of pyogenic spondylitis around the odontoid process. Summary of Background Data. Atlantoaxial subluxation after pyogenic spondylitis is rare. The therapeutic approach to infection of the upper cervical spine is controversial. Methods. Medical chart and radiological images of a 76-year-old male patient were retrospectively reviewed. Radiography revealed atlantoaxial subluxation, and an abscess was seen around the odontoid process on magnetic resonance images. Intravenous antibiotics and a halo vest were used to treat the patient. We then observed the patient's conservative treatment course. Results. C-reactive protein levels returned to normal 4 weeks after administration of the intravenous antibiotics. The patient's muscle weakness also completely recovered 8 weeks after administration of the intravenous antibiotics. Because the patient was able to walk without any support, surgical treatment was not necessary. Conclusions. Pyogenic spondylitis of the upper cervical spine is a rare manifestation. Surgical or conservative treatment must be selected carefully based on the patient's symptoms. If early diagnosis and treatment can be provided to the patients, conservative treatment can be achieved.