OpenMed/multicare-articles huggingface dataset:
A Case of Dilated Cardiomyopathy Associated with 3-Hydroxy-3-Methylglutaryl-Coenzyme A (HMG CoA) Lyase Deficiency
Authors: Alexander A C Leung, Alicia K Chan, Justin A Ezekowitz, Alexander K C Leung
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA) lyase deficiency is an inborn error of metabolism characterized by impairment of ketogenesis and leucine catabolism resulting in an organic acidopathy. In 1994, a case of dilated cardiomyopathy and fatal arrhythmia was reported in a 7-month-old infant. We report a case of dilated cardiomyopathy in association with HMG CoA lyase deficiency in a 23-year-old man with the acute presentation of heart failure. To our knowledge, this is the first case reported in an adult.
Case Report: Long segmental lesions of the spinal cord caused by exposure to xylene
Authors: Qin Du, Hongxi Chen, Ziyan Shi, Hongyu Zhou
Journal: Front Neurol (2023)
Keywords: case report, long segmental lesions, occupational exposure, spinal cord, xylene
MeSH terms: Case Reports

Xylene has the potential to cause nervous system disturbances since it is a lipophilic substance with high affinity for lipid-rich tissue, such as the brain. Involvement in the spinal cord, especially long segmental spinal cord lesions that permeate almost the entire cervical and thoracic spinal cord, is extremely rare. We report two cases of occupational exposure to excessive xylene, both of which presented with severe and rapidly progressive numbness and weakness in the limbs that, more importantly, led to poor outcomes: one died and the other was left severely disabled. In both, spinal magnetic resonance imaging showed long segmental lesions in the cervicothoracic spinal cord. These findings may provide some insights into the effects of xylene as an isolated agent on the spinal cord injury.
Case study of a parotid gland adenocarcinoma dedifferentiated from epithelial-myoepithelial carcinoma
Authors: Salih Aydın, Umit Taskin, Kadir Ozdamar, Kadir Yücebas, Mehmet Sar, Mehmet Faruk Oktay, Umit Seza Tetikkurt
Journal: Case Rep Otolaryngol (2014)

Dedifferentiation is defined as high-grade malignant tumor development out of a low-grade malignant tumor. We present an adenocarcinoma tumor of the parotid gland that was dedifferentiated from a low-grade epithelial-myoepithelial carcinoma and was followed up for 3 years. Our patient, a 46-year-old female, presented with a left parotid mass of 20-year duration. Histopathologic results showed that there was only one area of typical epithelial-myoepithelial carcinoma, with foci of poorly differentiated adenocarcinoma (not otherwise specified; NOS) and clear cytoplasm in the parotid gland. Immunohistochemical staining results showed SMA (+), P63 (+), CK8 (+), and S100 (+) on epithelial cells. A review of the literature revealed 22 previously reported cases of dedifferentiated epithelial-myoepithelial carcinoma. In these cases, the malignant tumors that dedifferentiated from epithelial-myoepithelial carcinoma were adenoid cystic carcinoma, actinic cell carcinoma, polymorphous low-grade adenocarcinoma, mucoepidermoid carcinoma, and intraductal carcinoma. In our case, the malignant tumor that dedifferentiated from the epithelial-myoepithelial carcinoma was a poorly differentiated adenocarcinoma. Histopathological results showed that metastases were not seen in the neck-dissection material. As a result, our case will make a contribution to the literature in terms of prognosis, because there are very few reported cases of dedifferentiated adenocarcinoma development arising from epithelial-myoepithelial carcinoma.
Management of Retained Genital Piercings: A Case Report and Review
Authors: Laura J Moulton, Amelia M Jernigan
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

The prevalence of genital piercing among women is increasing. As the popularity increases, the number of complications from infection, injury, and retained jewelry is likely to rise. Techniques to remove embedded jewelry are not well described in the literature. The purpose of this report was to describe a case of a patient with a retained clitoral glans piercing, discuss a simple technique for outpatient removal, and review current evidence regarding associated risks of clitoral piercings. A 24-year-old female presented to the emergency department with an embedded clitoral glans piercing. Local anesthetic was injected into the periclitoral skin and a small superficial vertical incision was made to remove the ball of the retained barbell safely. In conclusion, among patients with retained genital piercing, outpatient removal of embedded jewelry is feasible. While the practice of female genital piercing is not regulated, piercing of the glans of the clitoris is associated with increased injury to the nerves and blood supply of the clitoris structures leading to future fibrosis and diminished function compared to piercing of the clitoral hood.
Tortuous Carotid Artery Extended to Neck Level IIb Mimicking the Metastatic Mass
Authors: Lokman Uzun, Oğuz Kadir Eğilmez, M Tayyar Kalcioglu, Muhammet Tekin
Journal: Case Rep Otolaryngol (2016)

Specifically in neck level IIb, the expected normal anatomy does not contain any vital structures and consequently it might direct a surgeon to perform rapid surgical dissection of tissues. Therefore aberrant anatomy of the vessels in the patients may be overlooked during neck dissection. Unexpected and potentially devastating injuries can be avoided by respecting the possible aberrant anatomy in any level of the neck. In this case report, a 74-year-old man was presented with laryngeal carcinoma who was treated with laryngectomy and bilateral neck dissection. During the left side neck dissection, tortuous internal carotid artery imitating a metastatic mass was unexpectedly encountered in level IIb. As in this case, surgeons should keep in mind possible aberrant anatomy during the neck dissection and perform surgery staying in surgical principles to be safe for an unforeseen and potential dangerous injuries.
Case Report: Clinical Outcome and Image Response of Two Patients With Secondary High-Grade Glioma Treated With Chemoradiation, PCV, and Cannabidiol
Authors: Paula B Dall'Stella, Marcos F L Docema, Marcos V C Maldaun, Olavo Feher, Carmen L P Lancellotti
Journal: Front Oncol (2019)
Keywords: pcv, thc-tetrahydrocannabinol, cancer, cannabidiol, cannabis, chemoradiation, high-grade glioma, pseudoprogression
MeSH terms: Case Reports

We describe two patients with a confirmed diagnosis of high-grade gliomas (grades III/IV), both presenting with O6-methylguanine-DNA methyltransferase (MGMT) methylated and isocitrate dehydrogenase (IDH-1) mutated who, after subtotal resection, were submitted to chemoradiation and followed by PCV, a multiple drug regimen (procarbazine, lomustine, and vincristine) associated with cannabidiol (CBD). Both patients presented with satisfactory clinical and imaging responses at periodic evaluations. Immediately after chemoradiation therapy, one of the patients presented with an exacerbated and precocious pseudoprogression (PSD) assessed by magnetic resonance imaging (MRI), which was resolved in a short period. The other patient presented with a marked remission of altered areas compared with the post-operative scans as assessed by MRI. Such aspects are not commonly observed in patients only treated with conventional modalities. This observation might highlight the potential effect of CBD to increase PSD or improve chemoradiation responses that impact survival. Further investigation with more patients and critical molecular analyses should be performed.
Case report of Tako-Tsubo cardiomyopathy associated with repetitive anaesthesia in a female patient with Tako-Tsubo cardiomyopathy
Authors: Jochen Hinkelbein, Christian Mey, Gerrit Brinker, Roman Pfister, Bernd W Böttiger
Journal: BMC Anesthesiol (2015)
Keywords: ampulla cardiomyopathy, broken heart syndrome, stress-induced cardiomyopathy, tako-tsubo cardiomyopathy, transient left-ventricular apical ballooning syndrome
MeSH terms: Anesthetics, Intravenous / adverse effects, Propofol / adverse effects, Sufentanil / adverse effects, Takotsubo Cardiomyopathy / chemically induced, Case Reports, Anesthetics, Combined / adverse effects, Female, Humans, Middle Aged, Recurrence, Retreatment, Anesthetics, Combined, Anesthetics, Intravenous, Sufentanil, Propofol

Background:
Tako-Tsubo cardiomyopathy (TTC) is a rare disorder with high relevance for anaesthesia. It is an acute cardiac syndrome characterized by an acute onset of reversible left ventricular dysfunction associated with emotional and physical stress. This is the only case published of a patient having five severe Tako-Tsubo incidents in five consecutive general anaesthesia procedures within one year.
Case presentation:
A 61 years old female patient (height 1.65 m; weight 70 kg) presented with a haemorrhagic pituitary adenoma with compression of the optic chiasm and was scheduled for transnasal endoscopic tumour resection. We report a case series with five consecutive anaesthesia procedures in the same patient for neurosurgery. This case series is remarkable since the severe symptoms occurred during every anaesthesia procedure. The female patient was resuscitated two times including therapeutic hypothermia, but fortunately no neurological or cognitive deficit was detectable.
Conclusions:
TTC may initially present in the perioperative period with pulmonary oedema, electrocardiographic (ECG) changes, elevation of cardiac enzymes, and cardiogenic shock or cardiac arrest. Since the risk of recurrence is considered to be low in TTC, this case report is of high interest. In each procedure similar clinical signs were found which resulted in severe haemodynamic derangements in every manifestation and cardiac arrest in two of the manifestations. Despite cardiopulmonary resuscitation twice, the patient survived without any neurological deficiency.
A rare fungal species, Quambalaria cyanescens, isolated from a patient after augmentation mammoplasty--environmental contaminant or pathogen?
Authors: Xin Fan, Meng Xiao, Fanrong Kong, Timothy Kudinha, He Wang, Ying-Chun Xu
Journal: PLoS One (2014)
MeSH terms: Basidiomycota / isolation & purification, Breast Implants / microbiology, Environment, Mammaplasty, Case Reports, Research Support, Non-U.S. Gov't, Adult, Antifungal Agents / pharmacology, Basidiomycota / drug effects, Basidiomycota / genetics, Basidiomycota / physiology, Drug Resistance, Fungal, Female, Humans, Medical Errors, Microbial Sensitivity Tests, Molecular Sequence Data, Phylogeny, Sequence Analysis, DNA, Antifungal Agents

Some emerging but less common human fungal pathogens are known environmental species and could be of low virulence. Meanwhile, some species have natural antifungal drug resistance, which may pose significant clinical diagnosis and treatment challenges. Implant breast augmentation is one of the most frequently performed surgical procedures in China, and fungal infection of breast implants is considered rare. Here we report the isolation of a rare human fungal species, Quambalaria cyanescens, from a female patient in China. The patient had undergone bilateral augmentation mammoplasty 11 years ago and was admitted to Peking Union Medical College Hospital on 15 September 2011 with primary diagnosis of breast infection. She underwent surgery to remove the implant and fully recovered thereafter. During surgery, implants and surrounding tissues were removed and sent for histopathology and microbiology examination. Our careful review showed that there was no solid histopathologic evidence of infection apart from inflammation. However, a fungal strain, which was initially misidentified as "Candida tropicalis" because of the similar appearance on CHROMagar Candida, was recovered. The organism was later on re-identified as Q. cyanescens, based on sequencing of the rDNA internal transcribed spacer region rather than the D1/D2 domain of 26S rDNA. It exhibited high MICs to 5-flucytosine and all echinocandins, but appeared more susceptible to amphotericin B and azoles tested. The possible pathogenic role of Q. cyanescens in breast implants is discussed in this case, and the increased potential for misidentification of the isolate is a cause for concern as it may lead to inappropriate antifungal treatment.
Surgical treatment of a rare case of atypical polypoid adenomyoma of the uterus in a menopausal patient: a case report
Authors: Efthymia Ioannis Thanasa, Anna Ioannis Thanasa, Ioannis Emmanouel Paraoulakis, Evangelos Konstantinos Kamaretsos, Vasiliki Anastasios Grapsidi, Gerasimos Periklis Kontogeorgis, Evangelos-Ektoras Athanasios Gerokostas, Athanasios Nikolaos Chasiotis, Vasileios Christos Kontochristos, Ioannis Konstantinos Thanasas
Journal: Pan Afr Med J (2023)
Keywords: atypical polypoid adenomyoma, case report, curettage, treatment, ultrasound
MeSH terms: Adenomyoma / diagnosis, Adenomyoma / pathology, Adenomyoma / surgery, Endometrial Hyperplasia / pathology, Endometrial Neoplasms / diagnosis, Endometrial Neoplasms / pathology, Endometrial Neoplasms / surgery, Uterine Neoplasms / diagnosis, Uterine Neoplasms / pathology, Uterine Neoplasms / surgery, Case Reports, Endometrium / pathology, Endometrium / surgery, Female, Humans, Menopause, Pregnancy

Atypical polypoid adenomyoma is a rare benign tumor of the uterus that usually affects women of reproductive age and has an increased risk of progression into endometrial cancer. The pathogenetic mechanism has not been completely clarified. Due to the rarity of the tumor, current experience regarding the diagnostic and therapeutic approach is limited. For menopausal patients, hysterectomy seems to be the main treatment option. Our case concerns an asymptomatic menopausal patient with a vaginal delivery in her obstetric history and no hereditary history of gynecological cancer who came to the outpatient clinic for a gynecological examination. Transvaginal ultrasound revealed the presence of a large, round solid mass with increased vascularity within the endometrial cavity. A diagnostic dilation and curettage of the endometrium was performed. Histological examination of the endometrial biopsy showed an atypical polypoid adenomyoma, and it was decided to perform a total abdominal hysterectomy with bilateral adnexectomy. Histological examination of the surgical specimen of the uterus revealed no residual disease, no coexisting foci of atypical endometrial hyperplasia or endometrial cancer. The postoperative course was uneventful. The patient remains to this day under regular follow-up. The present case report highlights the significant difficulties involved in the preoperative diagnosis of atypical polypoid adenomyoma of the uterus and the difficult differential diagnosis from atypical endometrial hyperplasia and endometrial cancer, particularly in menopausal patients. At the same time, it is pointed out that despite its rarity, the early diagnosis of atypical polypoid adenomyoma, especially in young women, must be the main concern of the modern gynaecologist, in order to design the optimal treatment aimed at preserving fertility while avoiding the risk of recurrence of damage or malignant progression into endometrial cancer.
Bilateral supernumerary axillary breasts: a case report
Authors: Khalid Mazine, Abdesslam Bouassria, Hicham Elbouhaddouti
Journal: Pan Afr Med J (2020)
Keywords: supernumerary breasts, axillary region, mammary gland
MeSH terms: Axilla / pathology, Breast / abnormalities, Breast Diseases / diagnosis, Case Reports, Breast / pathology, Breast Diseases / pathology, Diagnosis, Differential, Female, Humans, Middle Aged

Accessory breast tissue is an uncommon condition which occurs in 0.4-6% of women. It is mostly located in the axilla and has a high incidence of being misdiagnosed. Usually it is bilateral and presents as an asymptomatic mass during pregnancy or lactation. The diagnosis of ectopic breast tissue is important as it can undergo the same pathological changes that occur in a normal breast, such as mastitis, fibrocystic disease and carcinoma. We present a case of a bilateral axillary localization of accessory breast in a 45-year-old woman. The principal symptom was pain and the clinical diagnosis was bilateral lipoma. However, subsequent imaging and histopathological examination proved it to be an accessory breast tissue.
Hybrid Closed-Loop System Achieves Optimal Perioperative Glycemia in a Boy With Type 1 Diabetes: A Case Report
Authors: Jesus Dominguez-Riscart, Nuria Buero-Fernandez, Ana Garcia-Zarzuela, Fernando A Marmolejo-Franco, Ana C Perez-Guerrero, Alfonso M Lechuga-Sancho
Journal: Front Pediatr (2021)
Keywords: artificial pancreas, case report, children, diabetes, glucose control, hybrid closed loop system, surgery
MeSH terms: Case Reports

The goal in type 1 diabetes (T1D) therapy is to maintain optimal glycemic control under any circumstance. Diabetes technology is in continuous development to achieve this goal. The most advanced Food and Drug Administration- and European Medicines Agency-approved devices are hybrid closed-loop (HCL) systems, which deliver insulin subcutaneously in response to glucose levels according to an automated algorithm. T1D is frequently encountered in the perioperative period. The latest international guidelines for the management of children with diabetes undergoing surgery include specific adjustments to the patient's insulin therapy, hourly blood glucose monitoring, and intravenous (IV) insulin infusion. However, these guidelines were published while the HCL systems were still marginal. We present a case of a 9-year-old boy with long-standing T1D, under HCL system therapy for the last 9 months, and needing surgery for an appendectomy. We agreed with the family, the surgical team, and the anesthesiologists to continue HCL insulin infusion, without further adjustments, hourly blood glucose checks or IV insulin, while monitoring closely. The HCL system was able to keep glycemia within range for the total duration of the overnight fast, the surgery, and the initial recovery, without any external intervention or correction bolus. This is, to the best of our knowledge, the first reported pediatric case to undergo major surgery using a HCL system, and the results were absolutely satisfactory for the patient, his family, and the medical team. We believe that technology is ripe enough to advocate for a "take your pump to surgery" message, minimizing the impact and our interventions. The medical team may discuss this possibility with the family and patients.
Rupture in polycystic kidney disease presented as generalized peritonitis with severe sepsis: a rare case report
Authors: Muhammed Zahir, Hassan Al Muttairi, Surjya Prasad Upadhyay, Piyush N Mallick
Journal: Case Rep Urol (2013)

Recurrent upper urinary tract (renal) infections have been reported to be frequent in patients with autosomal dominant polycystic kidney disease and often difficult to treat. Female preference and enteric organism predominance suggest that these renal infections are acquired to retrograde from the lower urinary tract. We encountered a rare case of bilateral polycystic kidneys with spontaneous intraperitoneal rupture of multiple infected renal cysts causing generalized peritonitis leading to severe sepsis with multiorgan failure. The patient is successfully managed with nephrectomy followed by prolonged supportive care in intensive care unit.
Ovarian mature cystic teratoma with fistula formation into the rectum: a case report
Authors: Yuichiro Kizaki, Tomonori Nagai, Ken Ohara, Yosuke Gomi, Taichi Akahori, Yoshihisa Ono, Shigetaka Matsunaga, Yasushi Takai, Masahiro Saito, Kazunori Baba, Hiroyuki Seki
Journal: Springerplus (2016)
Keywords: diarrhea, fistula, inflammation, ovarian neoplasms, teratoma

Background:
While ovarian mature cystic teratomas are benign ovarian germ-cell tumors and the most common type of all ovarian tumors, the formation of fistulas into surrounding organs such as the bladder and the intestinal tract is extremely rare. This report documents a case of ovarian mature cystic teratoma with a rectal fistula, thought to be caused by local inflammation.
Case description:
A pelvic mass was diagnosed as an ovarian mature cystic teratoma of approximately 10 cm in diameter on transvaginal ultrasound and magnetic resonance examinations. Endoscopic examination of the lower gastrointestinal tract to investigate diarrhea revealed an ulcerative lesion with hair in the rectal wall adjacent to the ovarian cyst, and formation of a fistula from the ovarian teratoma into the rectum was suspected. Laparotomy revealed extensive inflammatory adhesions between a left ovarian tumor and the rectum. Left salpingo-oophorectomy and upper anterior resection of the rectum were performed. The final pathological diagnosis was ovarian mature cystic teratoma with no malignant findings, together with severe rectal inflammation and fistula formation with no structural disorders such as diverticulitis of the colon or malignant signs.
Discussion:
The formation of fistulas and invasion into the neighboring organs are extremely rare complications for ovarian mature cystic teratomas. The invasion of malignant cells into neighboring organs due to malignant transformation of the tumor is reported as the cause of fistula formation into the neighboring organs. A review of 17 cases including the present case revealed that fistula formation due to malignant transformation comprised only 4 cases (23.5 %), with inflammation as the actual cause in the majority of cases (13 cases, 76.5 %).
Conclusion:
Although malignancy is the first consideration when fistula formation is observed between ovarian tumors and surrounding organs, in mature cystic teratoma, local inflammation is more likely than malignant transformation.
COMOKIT: A Modeling Kit to Understand, Analyze, and Compare the Impacts of Mitigation Policies Against the COVID-19 Epidemic at the Scale of a City
Authors: Benoit Gaudou, Nghi Quang Huynh, Damien Philippon, Arthur Brugière, Kevin Chapuis, Patrick Taillandier, Pierre Larmande, Alexis Drogoul
Journal: Front Public Health (2020)
Keywords: covid-19, gama platform, agent-based modeling (abm), computer simulation (cs), epidemiological modeling
MeSH terms: COVID-19, Pandemics, Research Support, Non-U.S. Gov't, China / epidemiology, Cities, Humans, SARS-CoV-2

Since its emergence in China, the COVID-19 pandemic has spread rapidly around the world. Faced with this unknown disease, public health authorities were forced to experiment, in a short period of time, with various combinations of interventions at different scales. However, as the pandemic progresses, there is an urgent need for tools and methodologies to quickly analyze the effectiveness of responses against COVID-19 in different communities and contexts. In this perspective, computer modeling appears to be an invaluable lever as it allows for the in silico exploration of a range of intervention strategies prior to the potential field implementation phase. More specifically, we argue that, in order to take into account important dimensions of policy actions, such as the heterogeneity of the individual response or the spatial aspect of containment strategies, the branch of computer modeling known as agent-based modeling is of immense interest. We present in this paper an agent-based modeling framework called COVID-19 Modeling Kit (COMOKIT), designed to be generic, scalable and thus portable in a variety of social and geographical contexts. COMOKIT combines models of person-to-person and environmental transmission, a model of individual epidemiological status evolution, an agenda-based 1-h time step model of human mobility, and an intervention model. It is designed to be modular and flexible enough to allow modelers and users to represent different strategies and study their impacts in multiple social, epidemiological or economic scenarios. Several large-scale experiments are analyzed in this paper and allow us to show the potentialities of COMOKIT in terms of analysis and comparison of the impacts of public health policies in a realistic case study.