OpenMed/multicare-articles huggingface dataset:
Partial reversal of color vision impairment in type 2 diabetes associated with obstructive sleep apnea
Authors: Rajiv Raman, Aditya Verma, Sangeetha Srinivasan, Deepak Bhojwani
Journal: GMS Ophthalmol Cases (2018)
Keywords: continuous positive airway pressure ventilation, diabetes mellitus, obstructive sleep apnea, tritan color defect
MeSH terms: Case Reports

Objective: Tritan anomaly is a known acquired color defect seen in diabetic patients, with or without the evidence of clinical signs of diabetic retinopathy (DR). We report a case of a 45-year-old diabetic patient with tritan pattern color defect associated with obstructive sleep apnea and its partial reversal with continuous positive airway pressure (CPAP) ventilation. Methods: A 45-year-old male with diabetes, wildlife photographer by profession, presented with specific complaints of seeing all objects in the surrounding with a greenish tinge in both the eyes. He underwent a comprehensive eye examination including Farnsworth-Munsel 100 (FM 100) hue test, multifocal electroretinogram, microperimetry, spectral domain optical coherence tomography (SDOCT), and arterial oxygen saturation. Results: The subject was found to have a low arterial oxygen saturation (PaO2) of 86%. He was then advised inhalation of 100% oxygen for 15 min, following which he reported improvement in his visual symptoms. FM 100, OCT, and microperimetry were repeated after oxygenation. He was referred to a specialty hospital for further evaluation of the cause for reduced blood oxygen saturation and was further advised for sleep study, where he was diagnosed to have obstructive sleep apnea (OSA) with an apnea-hypopnea index of 20.9. Conclusion: The subject was advised weight loss measures and oral application of continuous positive airway pressure. Since then, he is under our regular follow-up and has never experienced or complained of any color vision problems. This case report highlights the presence of associated systemic disorders like obstructive sleep apnea in individuals with diabetes that can present with color vision problems.
Multiple Cases of Discoid Menisci within a Family: A Case Report and Literature Review
Authors: Thomas Saliba, Paolo Simoni, Alessandro De Leucio
Journal: J Belg Soc Radiol (2023)
Keywords: discoid meniscus, familial discoid meniscus, heritable discoid meniscus, meniscus anomaly
MeSH terms: Case Reports

Discoid menisci are thought to be heritable. However, few documented cases of this occurring within families exist. We present the case of siblings with lateral discoid menisci, documented by knee magnetic resonance imaging (MRI), reinforcing the case for the existence of familial discoid menisci. The children's father also reportedly had a discoid meniscus, but proof was unavailable due to his country of origin's poor record keeping. We put this into the context of other rare, reports of similar cases. Teaching Point: We present further case of discoid menisci occurring within families, a long-held belief with little concrete supporting evidence.
Low-Grade Chondrosarcoma of the Proximal Phalanx: A Rare Presentation
Authors: Paul Knapp, Alberto Aviles, Christopher Najarian
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Case:
Chondrosarcomas are the second most common primary malignant sarcoma of the bone, though it is overall a rare tumor. Our case presents a 36-year-old Caucasian male who complained of an enlarging mass at his third finger MCP joint. After assessing the full clinical scenario, it was determined that wide excision with ray resection would provide the best result for this patient.
Conclusion:
This study explains a rare malignancy presenting in the proximal phalanx of the hand. The following report will review chondrosarcomas involving the hands, help differentiate between low-grade chondrosarcomas and enchondromas, and briefly cover treatment modalities.
Different Outcomes of "Silent Hypoxia" in Patients with COVID-19 Pneumonia: A Case Series and Literature Review
Authors: Ashani Ratnayake, Prabhashini Kumarihamy, Sujeewa Gunaratne, Hiranya Abeysinghe, Sahan Perera, Shirley Ekanayake
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

COVID-19 has been declared a pandemic since March 2020 and it has been responsible for millions of deaths worldwide. The SARS-CoV-2 causes a spectrum of diseases mainly affecting the respiratory system. It can also complicate other systems causing thromboembolic phenomena and myocardial ischaemia. An entity of hypoxia has been described in these patients which show no clinical signs and symptoms of respiratory distress despite being extremely hypoxic. This is called silent or happy hypoxia. The exact mechanism for this is not known. We report 4 cases which had similar presentations of silent hypoxia but had different course of illness and different outcomes. All 4 patients did not show any signs of respiratory distress, but had oxygen saturation less than 82%. 3 of them needed intensive care unit support for oxygen therapy and subsequently needed noninvasive ventilation. Only one required invasive ventilation. The fourth patient did not require intensive care support. The patient who required invasive ventilation succumbed due to severe COVID pneumonia whereas the other 3 patients were discharged from the hospital. Silent hypoxemia can go undetected in COVID-19 patients particularly in the time of a pandemic. This case series highlights the importance of meticulous clinical examination including oxygen saturation measurements in suspected or confirmed patients with COVID-19. The course of illness can be different in different populations, and this needs further clinical evidence.
Tenofovir and kidney transplantation: case report
Authors: Yuri Battaglia, Elena Cojocaru, Silvia Forcellini, Luigi Russo, Domenico Russo
Journal: Clin Nephrol Case Stud (2016)
Keywords: chronic hepatitis b, kidney transplant, tenofovir
MeSH terms: Case Reports

Background:
Hepatitis B viral infection (HBV) has been regarded as a contraindication for kidney transplantation because of the high risk of viral activation induced by immunosuppressive therapy. Anti-retroviral drugs have changed the prognosis of patients with hepatitis B viral infection (HBV+) who are candidates for renal transplant; indeed, therapy with antiretroviral drugs may ensure lower rates of morbidity and mortality compared to traditional therapies. Entecavir is the first-line antiviral therapy recommended for the treatment of HBV+ kidney-transplanted patients. In case of resistance to entecavir, tenofovir may be an alternative drug, either alone or in combination with entecavir. However, the best strategy of treatment is still unknown. In this case-report, a HBV+ kidney-transplanted patient who presented resistance to entecavir was initially treated by associating tenofovir to entecavir and with tenofovir alone afterward. This strategy induced complete remission of viral replication.
Case presentation:
In a HBV+ kidney-transplanted patient under monotherapy with entecavir, HBV flare (HBV DNA > 170.000 × 103 UI/mL, HBeAg+, HbeAb-) occurred 9 months after transplantation; at that time, blood chemistry highlighted: creatinine 1.46 mg/dL, blood urea 65 mg/dL, e-GFR 50 mL/min, proteinuria 300 mg/24 h, calciuria 2,12 mmol/24 h, phosphaturia 0.56 g/24 h, vitamin D 11.5 ng/mL, PTH 130 pg/mL, calcemia 2.3 mmol/L, and phosphoremia 2 mg/dL. Liver elastometry (FibroScan) showed moderate fibrosis. Tenofovir was associated to entecavir. Three months after the combination therapy, reduction in HBV DNA replication (351 × 103 UI/mL) was obtained. Creatinine and e-GFR were 1.48 mg/dL and 52 mL/min, respectively. At this point, entecavir was discontinued. After 13 months of tenofovir monotherapy, complete remission of viral replication was achieved but renal function deteriorated and proteinuria increased.
Conclusion:
This case-report indicates that tenofovir is effective in reducing viral replication of hepatitis B virus in a kidney-transplanted patient who presented resistance to previous treatment with entecavir. However, it should be taken into account that tenofovir could affect renal function.
Special forms in twin pregnancy - asymmetric conjoined twins
Authors: F A Anca, A Negru, A E Mihart, C Grigoriu, R E Bohîlțea
Journal: J Med Life (2015)
Keywords: asymmetrical twins, conjoined twins, epigastric heteropagus, omphalocele, twin monozygous pregnancy
MeSH terms: Pregnancy, Twin, Twins, Conjoined / pathology, Case Reports, Adult, Female, Gestational Age, Humans, Magnetic Resonance Imaging, Pregnancy, Ultrasonography, Prenatal

Twin pregnancies generally represent a high-risk pregnancy. However, monozygous twins are real challenges for obstetricians due to the complications that may occur. Among the particular cases of monozygous twins in the University Emergency Hospital of Bucharest, Department of Obstetrics and Gynecology, a monochorial monoamniotic pregnancy with conjoined twins has been described. These particular medical circumstances require a deeper understanding of the vascular anatomical particularities. An accurate diagnosis implies a most detailed description of the morphological dynamics of the fetuses with the study of the impact of the vascular anomaly on their development so that the maximum chances of survival and the best outcome for the viable fetus can be obtained. The diagnosis of the most frequently associated anomalies is also extremely important.
A patient with neurofibromatosis type 1 presenting with bilateral frontal lobe infarctions following anterior communicating artery aneurysm rupture
Authors: Hmmtb Herath, Nilukshana Yogendranathan, Aruna Kulatunga
Journal: SAGE Open Med Case Rep (2019)
Keywords: neurofibromatosis type 1, anterior communicating artery aneurysm rupture, bilateral frontal lobe infarctions, von recklinghausen’s disease
MeSH terms: Case Reports

Neurofibromatosis is a neurocutaneous genetic condition with dysplasia of the mesodermal and ectodermal tissues. Vascular abnormalities are well recognized in neurofibromatosis and cerebral aneurysms are rarely reported in literature. Here, we present a 20-year-old Sri Lankan female presented with headache, altered personality, disinhibited behaviour, and urinary incontinence. On imaging, she was found to have infarctions of both frontal lobes and evidence of a ruptured anterior communicating artery aneurysm with a small subarachnoid haemorrhage. Another small middle cerebral artery aneurysm was also seen in the angiogram. She was managed conservatively and gradually recovered. Because aneurysms in neurofibromatosis are usually asymptomatic and as rupture of such an aneurysm is rare, regular vascular screening is not recommended to all patients with neurofibromatosis. This is the first case report in literature in which a patient with neurofibromatosis presented with infarctions of both frontal lobes due to rupture of an anterior communicating artery aneurysm.
Acanthamoeba keratitis challenges a case report
Authors: Stan Cristina, Vlăduţiu Cristina, Popovici Mihaela
Journal: Rom J Ophthalmol (2016)
MeSH terms: Acanthamoeba Keratitis / complications, Acanthamoeba Keratitis / diagnosis, Eye Pain / parasitology, Photophobia / parasitology, Vision Disorders / parasitology, Case Reports, Acanthamoeba Keratitis / parasitology, Child, Disease Progression, Humans, Patient Transfer

Acanthamoeba keratitis is a rare, chronic, mainly contact lens-related infection caused by a free-living amoeba found ubiquitously in water and soil. A case of a 9-year-old child, who presented to our clinic with painful, red left eye, associated with photophobia, and decreased visual acuity, wais reported. The clinical examination revealed a discoid opacity inferiorly bounded by a dense, gray infiltrate. The progressive nature of the corneal infiltrate, the epithelial defect, and the lack of response to treatment was highly suggestive for Acanthamoeba keratitis. The distinctiveness of this case was the presence of Acanthamoeba keratitis in a child without a history of trauma or contact lens usage, the lack of an appropriate diagnosis and management of this vision-threatening infection.
Early Detection of Colon Cancer Following Incidental Finding of Clostridium septicum Bacteremia
Authors: Jasdeep Singh Sidhu, Amrendra Mandal, Jeevanjot Virk, Vijay Gayam
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: bacteremia, colon carcinoma
MeSH terms: Bacteremia / diagnosis, Carcinoma / diagnosis, Clostridium Infections / diagnosis, Colonic Neoplasms / diagnosis, Case Reports, Aged, Carcinoma / pathology, Carcinoma / surgery, Clostridium septicum, Colectomy, Colonic Neoplasms / pathology, Colonic Neoplasms / surgery, Colonoscopy, Early Detection of Cancer, Female, Fever / etiology, Humans, Incidental Findings

Clostridium septicum is a Gram-positive, anaerobic, spore-forming bacillus found in the intestine. It is linked to colon cancer and immunosuppression. Infection with C septicum may vary in manifestation and is associated with more than 60% mortality rate. In this article, we present a case of incidental isolation of C septicum in a patient who presented with fever and later on colonoscopy was found to have colon carcinoma. Bacteremia may be the unexpected initial presentation of undiagnosed colon carcinoma.
A Positive Quadriceps Active Test, without the Quadriceps Being Active
Authors: D C Kieser, E Savage, P Sharplin
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Case:
A 55-year-old male with a chronic isolated grade 3 PCL injury who demonstrates a positive quadriceps active test without activating his quadriceps musculature.
Conclusion:
Gravity and hamstring contraction posteriorly translate the tibia into a subluxed position. Subsequent gastrocnemius contraction with the knee flexed causes an anterior tibial translation by virtue of the mass enlargement of the gastrocnemius muscular bulk, the string of a bow effect, and the anterior origin of the gastrocnemius in relation to the posterior border of the subluxed tibia aided by the normal posterior tibial slope.
Late presentation of congenital diaphragmatic hernia after a diagnostic laparoscopic surgery (a case report)
Authors: Kok Hooi Yap, Mark Jones
Journal: J Cardiothorac Surg (2013)
MeSH terms: Hernias, Diaphragmatic, Congenital, Case Reports, Adolescent, Female, Hernia, Diaphragmatic / diagnosis, Hernia, Diaphragmatic / physiopathology, Hernia, Diaphragmatic / surgery, Herniorrhaphy / methods, Humans, Laparoscopy / methods, Surgical Mesh

The authors report a rare case of 17-year-old lady with late presentation of congenital diaphragmatic hernia. She presented with vague abdominal pain and was thought to have urinary tract infection, ruptured ovarian cyst, and appendicitis by different medical teams in the first few days. She eventually underwent a diagnostic laparoscopy with no significant findings. In the early postoperative recovery period, she suffered from severe cardiorespiratory distress and a large intestinal left diaphragmatic hernia was diagnosed subsequently. At further operation a strangulated loop of large bowel herniating through a left antero-lateral congenital diaphragmatic hernia was discovered, which was reduced and repaired with a prolene mesh through thoracotomy. She made an excellent recovery and was discharged a few days after the operation. The authors postulate a mechanism of positive pressure from laparoscopic surgery causing herniation of large bowel through a pre-existing diaphragmatic defect. This case highlights the diagnostic challenge of this disease due to its diverse clinical presentation, the importance of prompt diagnosis and intervention.
Training-induced recovery of low-level vision followed by mid-level perceptual improvements in developmental object and face agnosia
Authors: Maria Lev, Sharon Gilaie-Dotan, Dana Gotthilf-Nezri, Oren Yehezkel, Joseph L Brooks, Anat Perry, Shlomo Bentin, Yoram Bonneh, Uri Polat
Journal: Dev Sci (2015)
MeSH terms: Agnosia / rehabilitation, Face, Recognition, Psychology, Recovery of Function / physiology, Teaching / methods, Visual Perception / physiology, Case Reports, Research Support, Non-U.S. Gov't, Follow-Up Studies, Functional Laterality, Humans, Male, Photic Stimulation, Psychomotor Performance, Visual Acuity / physiology, Young Adult

Long-term deprivation of normal visual inputs can cause perceptual impairments at various levels of visual function, from basic visual acuity deficits, through mid-level deficits such as contour integration and motion coherence, to high-level face and object agnosia. Yet it is unclear whether training during adulthood, at a post-developmental stage of the adult visual system, can overcome such developmental impairments. Here, we visually trained LG, a developmental object and face agnosic individual. Prior to training, at the age of 20, LG's basic and mid-level visual functions such as visual acuity, crowding effects, and contour integration were underdeveloped relative to normal adult vision, corresponding to or poorer than those of 5-6 year olds (Gilaie-Dotan, Perry, Bonneh, Malach & Bentin, 2009). Intensive visual training, based on lateral interactions, was applied for a period of 9 months. LG's directly trained but also untrained visual functions such as visual acuity, crowding, binocular stereopsis and also mid-level contour integration improved significantly and reached near-age-level performance, with long-term (over 4 years) persistence. Moreover, mid-level functions that were tested post-training were found to be normal in LG. Some possible subtle improvement was observed in LG's higher-order visual functions such as object recognition and part integration, while LG's face perception skills have not improved thus far. These results suggest that corrective training at a post-developmental stage, even in the adult visual system, can prove effective, and its enduring effects are the basis for a revival of a developmental cascade that can lead to reduced perceptual impairments.
Rehabilitation following surgery for reconstruction of a foot defect
Authors: Susan Faber West, Peter E Pidcoe
Journal: Clin Med Case Rep (2008)
Keywords: arterio-venous malformation, musculocutaneous flap, pressure garments, remolding, scar management, wound care
MeSH terms: Case Reports

Background:
This report illustrates the use of pressure for scar management to aid in foot re-shaping following a surgical intervention to repair an arterio-venous (AV) malformation.
Methods:
This report describes the rehabilitation of a 13-year-old girl after surgical reconstruction of a defect in her left foot following the removal of an AV malformation. Early surgical attempts to repair the problem resulted in complications that required the amputation of toes 2, 3, and 4, and the use of a split thickness skin graft to cover the plantar surface of the medial longitudinal arch on the left foot. Following surgery, the patient had an antalgic gait pattern with decreased weight bearing on the left. The graft obliterated the left medial longitudinal arch and the patient would only weight bear on the heel. The patient had decreased metatarsal joint mobility on the affected side and no movement in the remaining toes. Left talocrural joint active range-of-motion (AROM) was within normal limits and gross ankle muscle force production was assessed to have a grade of 3/5.
Results:
Treatment included reshaping the left foot using a pressure garment and orthotic, followed by interventions to address range-of-motion and muscle force production deficiencies. All treatment objectives were achieved and all patient goals were achieved.
Conclusions:
Pressure was effective in re-shaping the foot to promote normal gait mechanics.
Confirmation of cholera by rapid diagnostic test amongst patients admitted to the cholera treatment centre in Uvira, Democratic Republic of the Congo
Authors: Aurelie Jeandron, Oliver Cumming, Baron Bashige Rumedeka, Jaime Mufitini Saidi, Simon Cousens
Journal: PLoS One (2018)
MeSH terms: Cholera / diagnosis, Research Support, Non-U.S. Gov't, Adolescent, Adult, Child, Child, Preschool, Cholera / epidemiology, Democratic Republic of the Congo / epidemiology, Diagnostic Tests, Routine, Disease Outbreaks, Female, Hospitalization, Humans, Incidence, Infant, Male, Vibrio cholerae / isolation & purification, Young Adult

Introduction:
Cholera is endemic in the Eastern provinces of the Democratic Republic of the Congo since 1978, and Uvira in South-Kivu has been reporting suspected cholera cases nearly every week for over a decade. The clinical case definition for suspected cholera is relatively non-specific, and cases are rarely confirmed by laboratory methods, especially in endemic settings. This may lead to over-estimation of cholera cases and limit effective public health responses.
Methods and results:
Between April 2016 and November 2017, 69% of the 2,059 patients admitted to the Uvira Cholera Treatment Centre (CTC) were tested for cholera with rapid diagnostic tests (RDTs). Of those admitted as suspected cholera cases, only 40% tested positive for cholera, equivalent to an estimated annual incidence of suspected/confirmed cholera in Uvira of 43.8 and 16.3 cases per 10,000 inhabitants respectively. A multivariable logistic regression indicates that boys aged 2 to 4 years, girls aged 5 to 15 years and adult men are respectively 1.9, 2.1 and 1.8 times more likely to test positive than adult women. On the contrary, boys under 2 are 10 times less likely to test positive. The odds of testing positive also increase as weekly admissions to the CTC rise, with up to a 5-fold increase observed during the weeks with the highest numbers of admissions compared to the lowest ones. Other predictors of cholera confirmation include duration of stay at the CTC, clinical outcome of admission, lower weekly rainfall and area of residence in Uvira, with the northern part of town having the highest confirmation rate.
Conclusion:
Cholera is an on-going public health problem in Uvira but the majority of suspected cases admitted to the CTC were found to be negative for cholera after RDT testing. These findings may have important implications for cholera control strategies in favour of interventions that address cholera and other diarrhoeal diseases alike.
De novo histoid leprosy in an elderly: a case report and review of the literature
Authors: Deepak Dimri, Bhawna Sethi, Yogesh Kumar
Journal: Case Rep Pathol (2012)

Histoid leprosy, an uncommon variant of lepromatous leprosy, develops usually as relapse in lepromatous patients who are on dapsone monotherapy, but uncommonly arises de novo. This rare form of the disease, with unique clinical and histopathological features, may pose a diagnostic challenge even to astute clinicians. We report the case that occurred de novo in an elderly who presented with small to large lesions all over the body. A fresh focus on histoid leprosy is the primary objective of this paper, especially in the context of the postglobal leprosy elimination era.