OpenMed/multicare-articles huggingface dataset:
Myocardial infarction as a rare cause of otalgia
Authors: Riza Dundar, Erkan Kulduk, Fatih Kemal Soy, Ersin Sengul, Faruk Ertas
Journal: Case Rep Otolaryngol (2014)

Aim. To present a case referred to our clinic with severe right ear pain but without any abnormal finding during otological examination and diagnosed as myocardial infarction and also to draw attention to otalgia which can occur secondary to myocardial infarction. Case Report. An 87-year-old female admitted with right ear pain lasting for nearly 12 hours and sweating on the head and neck region. On otolaryngologic examination, any pathological finding was not encountered. Her electrocardiogram revealed findings consistent with myocardial infarction. Her troponin values were 0.175 ng/L at 1 hour, and 0.574 ng/L at 3 hours. The patient was diagnosed as non-ST MI, and her required initial therapies were performed. On cardiac angiography, very severe coronary artery stenosis was detected, and surgical treatment was recommended for the patient. The patient who rejected surgical treatment was discharged with prescription of medical treatment. Conclusion. Especially in elderly patients with complaints of ear pain but without any abnormal finding on otoscopic examination, cardiac pathologies should be conceived.
Multimodal imaging features of a spontaneously resolved unilateral congenital macrovessel-related macular edema in a 13-year-old boy
Authors: Sefik Can Ipek, Salih Kavukcu, Süleyman Men, Ali Osman Saatci
Journal: GMS Ophthalmol Cases (2020)
Keywords: oct, octa, congenital retinal macrovessel, fluorescein angiography, retinal arteriovenous malformation
MeSH terms: Case Reports

Purpose: Congenital retinal macrovessels (CRM) are large aberrant blood vessels that cross the horizontal raphe. Visual acuity may be negatively affected in cases afflicted with CRM due to macular serous detachment, hemorrhage, exudation, foveolar cyst formation and retinal artery occlusion. Even the presence of an anomalous vessel itself running through the foveal avascular zone may compromise the visual acuity. In this case report, we discuss the multimodal imaging characteristics of a case of symptomatic unilateral CRM-related cystoid macular edema and serous macular detachment in a 13-year-old boy. Observations: Optical coherence tomography angiography (OCTA) imaging of the superficial retina revealed the aberrant vessel and anomalous arteriovenous communication between the aberrant vessel and the retinal artery. The foveal avascular zone also appeared partly distorted. Conclusions: The present case reports the second-youngest patient afflicted with unilateral CRM and associated macular edema. There was spontaneous resolution of macular edema within six weeks. In light of the observations in this case and the literature review, the need to refrain from rapid therapeutic intervention in the eyes of patients affected with CRM and macular edema must be emphasized.
Elizabethkingia anophelis Isolated from Patients with Multiple Organ Dysfunction Syndrome and Lower Respiratory Tract Infection: Report of Two Cases and Literature Review
Authors: Shaohua Hu, Tao Jiang, Xia Zhang, Yajun Zhou, Zhengjun Yi, Youxi Wang, Sishou Zhao, Mingxi Wang, Desong Ming, Shicheng Chen
Journal: Front Microbiol (2017)
Keywords: e anophelis, antibiotics resistance, emerging pathogen, lower respiratory tract infection, multiple organ dysfunction syndrome
MeSH terms: Case Reports

Elizabethkingia anophelis, originally discovered from Anopheles mosquito gut, is an emerging pathogen, especially in immunocompromised patients. We isolated two strains of E. anophelis from two separate patients with multiple organ dysfunction syndrome and lower respiratory tract infection. In this paper, we reviewed the status of E. anophelis infection and its antibiotics resistance from reported cases.
Conducting sexualities research: an outline of emergent issues and case studies from ten Wellcome-funded projects
Authors: Dylan Kneale, Robert French, Helen Spandler, Ingrid Young, Carrie Purcell, Zoë Boden, Steven D Brown, Dan Callwood, Sarah Carr, Alex Dymock, Rachael Eastham, Jacqui Gabb, Josie Henley, Charlotte Jones, Elizabeth McDermott, Nolwazi Mkhwanazi, James Ravenhill, Paula Reavey, Rachel Scott, Clarissa Smith, Matthew Smith, James Thomas, Karen Tingay
Journal: Wellcome Open Res (2019)
Keywords: lgbt, wellcome, health, sexualities

This letter seeks to synthesise methodological challenges encountered in a cohort of Wellcome Trust-funded research projects focusing on sexualities and health. The ten Wellcome Trust projects span a diversity of gender and sexual orientations and identities, settings; institutional and non-institutional contexts, lifecourse stages, and explore a range of health-related interventions. As researchers, we originate from a breadth of disciplinary traditions, use a variety of research methods and data sources. Despite this breadth, four common themes are found across the projects: (i) inclusivity, representations and representativeness, (ii) lumping together of diverse groups, (iii) institutions and closed settings (iv) ethical and governance barriers.
Neurosarcoidosis Presentation as Adipsic Diabetes Insipidus Secondary to a Pituitary Stalk Lesion and Association with Anti-NMDA Receptor Antibodies
Authors: Jose Gabriel Solis, Arturo Olascoaga Lugo, Marco Antonio Rodríguez Florido, Bayron Alexander Sandoval Bonilla, Jose Malagón Rangel
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Sarcoidosis is a multisystemic inflammatory disease of unknown cause. It is characterized by the presence of noncaseating granuloma on a biopsy specimen. Clinical presentation varies across case report series with myriad of symptoms ranging from fever, respiratory symptoms, and skin lesions, or atypical symptoms like heart block or neurological symptoms. Hence, we report the case of a 22-year-old woman with encephalitis, a pituitary mass, and adipsic diabetes insipidus. The diagnostic approach did not end on the biopsy of the lesion, which reported noncaseating granulomas; on the contrary, it was the beginning of a path to exclude other causes of the central nervous system granulomas that ended with the diagnosis of the isolated central nervous system sarcoidosis. Also, we report the first proven association between anti-NMDA receptor antibodies and sarcoidosis.
Case Report: Predominant Tubulointerstitial Lupus Nephritis or the Combination With IgG4-Related Disease?
Authors: Ying Tan, Yan Qin, Xiao-Juan Yu, Rong Xu, Su-Xia Wang, Fu-de Zhou, Ming-Hui Zhao
Journal: Front Med (Lausanne) (2021)
Keywords: igg3, lupus nephritis, predominant interstitial nephritis, storiform pattern, systemic lupus erythematosus
MeSH terms: Case Reports

Isolated or dominant tubulointerstitial lupus nephritis is rare. Here, we reported a 67-year-old man diagnosed with systemic lupus erythematosus (SLE) based on clinical and laboratory criteria, who was showing impaired renal function and non-nephrotic range proteinuria in the past 2 years. Renal biopsy showed almost normal glomeruli, but the tubulointerstitium showed "storiform" pattern with interstitial infiltration of IgG3 predominant plasma cells. Immunofluorescence showed linear and granular staining of IgG and C1q along TBM and interstitium. He started on medium dose of oral steroids and mycophenolate mofetil, which were gradually tapered. As a result, his renal function improved over a few days. Now, he continued on low dose steroids and mycophenolate mofetil with no evidence of relapse.
Revision of meso-Rex bypass utilizing a collateral vein in a patient with portal steal phenomenon after liver transplant: A case report
Authors: Ruben Blachman-Braun, Fidel Lopez-Verdugo, Diane Alonso, Linda Book, G Peter Feola, Manuel I Rodriguez-Davalos
Journal: Int J Surg Case Rep (2019)
Keywords: collateral vein, meso-rex bypass, pediatric liver transplantation, portal steal phenomenon

Introduction:
In children with extrahepatic portal vein obstruction or those who develop portal vein thrombosis after liver transplant, the use of Meso-Rex Bypass (MRB) creates a more physiological state by redirecting mesenteric blood flow back into the intrahepatic portal system via a venous conduit.
Presentation of case:
A 3-year-old female with biliary atresia associated with polysplenia syndrome and a surgical history of Kasai portoenterostomy procedure, and an ABO incompatible whole liver transplant. Within a year after transplant she presented with prehepatic portal hypertension, that was treated with MRB using a deceased donor ABO compatible iliac vein as conduit. Six months later, she was taken to the operating room for bypass revision, during the procedure the MRB showed no flow and no thrombus, and a large splenorenal collateral vein that was causing a portal perfusion steal phenomenon was observed. After dissecting the collateral vein, an 8 cm x8 mm segment of this vessel was used as an autologous conduit to re-do the Rex.
Discussion:
Failed of MRB can be attributed to portal steal phenomenon, hypercoagulable disorders, bypass contraction or kinking. In this case we believe the culprit to be the former. When there is a history of longstanding portal hypertension, large collaterals develop; thus, intraoperative portal vein flow measurement is critical and ligation of large collaterals during liver transplantation and MRB should be performed to avoid portal steal phenomenon postprocedure.
Conclusion:
Using a collateral vein as an alternative autologous venous conduit is a feasible option that can have durable success.
Rapidly Progressing Refractory Hodgkin Lymphoma: A Case Report and a Possible Explanation
Authors: Ádám Jóna, Gábor Irsai, Sándor Barna, Gábor Méhes, Árpád Illés, László Váróczy
Journal: Case Rep Med (2016)

Introduction. Hodgkin lymphoma is a highly curable lymphoid malignancy; however treatment of a significant number of patients remains challenging. Case Report. The authors present an unusually rapidly progressing case of refractory advanced stage classical nodular sclerosis subtype Hodgkin lymphoma with unfavorable prognosis. A 66-year-old male patient was refractory for first-line doxorubicin, bleomycin, vinblastin, dacarbazine (ABVD) treatment with persistent disease; therefore physicians changed treatment for dexamethasone, cytarabine, and cisplatin (DHAP) and later ifosfamide, gemcitabine, and vinorelbine (IGEV) regimen. Unfortunately the patient developed acute kidney and respiratory failure and died after 6 months of treatment. Current and retrospective histological examination of the patient's lymph node biopsy, skin lesion, and autopsy revealed the same aberrantly expressing CD4 positive nodular sclerosis subtype Hodgkin lymphoma. Conclusion. Aberrant expression of T-cell antigens on the Hodgkin and Reed/Sternberg cells could be associated with inferior outcome. T-cell associated antigens should be investigated more often in patients not responding sufficiently to treatment and hence treatment should be intensified or targeted therapy (brentuximab vedotin) should be considered.
Cervical thymic cyst: a rare differential diagnosis in lateral neck swelling
Authors: Vijendra Shenoy, M Panduranga Kamath, Mahesh Chandra Hegde, Raghavendra Rao Aroor, Vijetha V Maller
Journal: Case Rep Otolaryngol (2013)

Introduction. Thymic cysts are among the rarest cysts found in the neck. Nests of thymic tissue may be found anywhere along the descent of the thymic primordia from the angle of the mandible to the mediastinum. Mediastinal extension is seen in 50% of cervical thymic cysts. Case Report. We report an uncommon case of a 15-year-old male, who noted a painless, growing mass on left side of his neck of one-year duration. Computerised tomographic scan showed a multiloculated fluid density lesion with enhancing septae in the left parapharyngeal space, extending from the level of mandible up to C7 vertebral level. Here, we discuss the surgical aspect, histopathology, and management of this rare lateral neck swelling. Discussion. Clinically, in most cases, cervical thymic lesions present as a unilateral asymptomatic neck mass, commonly on the left side of the neck, and 75% of patients present before 20 years of age. Conclusion. Thymic cyst should be included as differential diagnosis of cystic neck masses. Greater awareness among the pathologists may decrease misdiagnosis.
Simultaneous Development of Acute Acquired Concomitant Esotropia in Two Siblings during the COVID-19 Pandemic: A Case Report
Authors: Danielle Carter, Priyanka Pujara, Kate Bolton, Rory Nicholson
Journal: Br Ir Orthopt J (2023)
Keywords: covid-19, esotropia, lockdown, acute acquired concomitant esotropia, strabismus
MeSH terms: Case Reports

Aim:
To report a case of two siblings who near-simultaneously developed a large angle concomitant esotropia during the COVID-19 pandemic, and to describe their treatment and outcomes.
Method:
A 5-year-old boy and his 11-year-old sister were presented to the hospital eye service in early 2021, having both developed acute-onset large angle esotropia within three months of each other. Neither had any significant past medical, ophthalmic, or family history. The siblings lived in the same household, and both experienced lifestyle changes as a result of the UK lockdown in response to COVID-19.
Results:
Each sibling was treated with right medial rectus recession (5.5 mm) and right lateral rectus resection (7 mm), and at a three-month follow-up, both were minimally esophoric with restored binocularity.
Conclusion:
The unusual and abrupt changes in lifestyle imposed by the COVID-19 pandemic highlight the likelihood of an environmental aetiology for some forms of esotropia and raise the possibility that extended screen time may be a contributory factor.
Medical First-Trimester Termination of Pregnancy with Massive Fibroid Uterus
Authors: Michael Saad-Naguib, Karla Maguire, Christine Curry, Usha Verma
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

First-trimester termination of pregnancy by medical or surgical route is highly effective with a low complication rate. Uterine abnormalities can complicate a procedure due to distortion of normal anatomy. In this case presentation, medical termination of pregnancy is performed using fetal intracardiac potassium chloride injection and intramuscular methotrexate.
Complete Colonic Duplication and Perineal Fistula: Transanal Mucosectomy of the Ectopic Rectum
Authors: Johannes W Duess, Peter Zimmermann, Franz W Hirsch, Daniel Graefe, Martin Lacher, Jan-Hendrik Gosemann
Journal: European J Pediatr Surg Rep (2022)
Keywords: colonic duplication, continence, mucosectomy
MeSH terms: Case Reports

Background Colonic duplication may present in different anatomic variants. The surgical approach towards these anomalies can be challenging and has implications for subsequent future continence. Case Description We report on a 1-year-old girl with congenital heart defect and pacemaker who was referred to us with an anorectal malformation. The patient was stooling from both an anus and a perineal fistula. Examination under anesthesia revealed an orthotopic and age-appropriate sized anus with surrounding sphincter and a second rectal lumen ending as a perineal fistula. A computed tomography and contrast enema indicated colonic duplication. Exploratory laparotomy showed a duplicated terminal ileum leading to two ceca and appendices, which joined to a duplicated colon with a septum and common mesentery. At the rectosigmoid junction, one part of the duplication ended as a perineal fistula, the second one led to the (orthotope) anus. The common colonic wall was divided using a stapler. The rectal duplication leading to the perineal fistula was not completely resected but treated by mucosectomy only (Soave plane) leaving its muscular cuff in place. Finally, an ileostomy was created. The postoperative course was uneventful. A contrast enema prior to ostomy takedown demonstrated a well-configurated colon and rectum without stenosis or impaction. The girl is currently continent with a complete resolution of her constipation. Conclusion In cases of complete colonic duplication division of the common wall is simple and safe. Mucosectomy of the ectopic rectum limits pelvic dissection and preserves the entire muscular wall of the duplicated orthotope rectum.
Trans catheter device closure of a large azygos vein in adult patient with systemic venous collateral development after the bidirectional Glenn shunt
Authors: Zahra Khajali, Ata Firouzi, Pooneh Pashapour, Homa Ghaderian
Journal: J Cardiovasc Thorac Res (2021)
Keywords: azygos vein, bidirectional glenn shunt, transcatheter closure
MeSH terms: Case Reports

Superior cavopulmonary anastomosis is a type of palliative cardiac surgeries that usually done in children with cyanotic and complex congenital heart disease who have single ventricle profile. BDG shunt is staged palliation procedure for single ventricle patients who are candidates for total cavopulmonary connection (TCPC). Sometimes the surgeon misses ligating or intentionally leaves the azygos vein as a fenestration or emergency exit. This allows an abnormal flow from the superior vena cava (SVC into azygos vein). These patients can present progressive desaturation, chest tightness, progressive dyspnea, edema and shortness of breath. Therapeutic options include observation, surgical ligation and trans catheter closure. Because of high risks and extra traumas of surgery and greater chance for difficulties and the feasibility of trans catheter therapy, it is done in some centers as a method of choice.
Beer, Cider, and Wine Allergy
Authors: Rhea A Bansal, Susan Tadros, Amolak S Bansal
Journal: Case Reports Immunol (2017)
MeSH terms: Case Reports

Background. Allergy to beer is often due to specific proteins in barley and sometimes to lipid transfer protein. Allergy to wine is frequently due to a sensitivity to grape proteins. We present a rare case of allergy to beer, wine, and cider resulting from IgE reactivity to yeasts and moulds which also explained the patient's additional sensitivity to yeast extracts and blue cheese. Case Presentation. The patient's symptoms included throat and facial itching accompanied by mild wheeze and severe urticaria. Diagnosis of allergy to yeast was confirmed by specific IgE testing as well as that to relevant foods and beverages. The patient's ongoing management included advice to avoid beer, wine, and other food groups containing specific yeasts, in addition to carrying a short acting nonsedating antihistamine as well as an adrenaline autoinjector. Conclusions. Cases of yeast allergy are extremely rare in medical literature but may be underrecognised and should be considered in patients presenting with reactions to alcoholic beverages and other yeast-containing products.
Headache and MRI Changes after Endovascular Treatment of a Cerebral Aneurysm
Authors: Liv Jorunn Høllesli, Martin W Kurz, Gry Inger N Behzadi, Tore Solbakken, Svein Harald Mørkve, Kathinka D Kurz
Journal: Case Rep Radiol (2019)
MeSH terms: Case Reports

Background:
The main complications after endovascular therapy of intracranial aneurysms are aneurysm rupture and thromboembolic events. Yet, the widespread use of magnetic resonance imaging (MRI) in follow-up of these patients also demonstrates other, rarely known complications such as aseptic meningitis and foreign body reaction.
Case presentation:
A small aneurysm in the right posterior communicating artery was treated with endovascular therapy in a 65 year old woman. Two weeks after successful interventional treatment, the patient developed a headache. On MRI performed five months after intervention, vasogenic edema was seen in the vascular territory of the right internal carotid artery. The edema and the symptoms diminished without specific treatment within a year.
Interpretation:
The clinical and radiological presentation of this case are suggestive of a foreign body reaction, a treatable condition that radiologists and clinicians should be aware of.
Omental patch to control hepatic exsanguination
Authors: Stephen Apanga, Kenneth V Iserson, Damien Punguyire
Journal: Pan Afr Med J (2012)
Keywords: hepatic cancer, intraperitoneal hemorrhage, omental patch
MeSH terms: Abdominal Cavity / physiopathology, Exsanguination / surgery, Liver Neoplasms / complications, Omentum / surgery, Case Reports, Adult, Exsanguination / etiology, Female, Humans, Liver Neoplasms / pathology, Paracentesis / methods, Treatment Outcome

Acute spontaneous intra-abdominal hemorrhage can be life-threatening and is particularly challenging in resource-poor settings. A 35-year-old woman presented in acutely hypotensive with a distended, rigid abdomen. A paracentesis produced >10 mL of non-clotting blood and she was taken to the operating room where significant bleeding from a liver cancer nodule was identified. With no other option, the generalists doing the surgery used a novel technique - the omental patch - to stem the hemorrhage. The patient recovered from the surgery. The urgency of performing surgery for spontaneous intraperitoneal hemorrhage increases with the scarcity of transfusable blood and general medical officers' lack surgical experience. In this case, they rapidly improvised, innovatively adapting the omental patch procedure, normally used to close duodenal ulcers, to save a life. They had neither performed nor seen this procedure previously. An omental patch to stop massive localized intra-abdominal hemorrhage may be an important tool for all surgeons.
19q13.11 microdeletion concomitant with ins(2;19)(p25.3;q13.1q13.4)dn in a boy: potential role of UBA2 in the associated phenotype
Authors: Carlos Venegas-Vega, Karem Nieto-Martínez, Alejandro Martínez-Herrera, Laura Gómez-Laguna, Jaime Berumen, Alicia Cervantes, Susana Kofman, Fernando Fernández-Ramírez
Journal: Mol Cytogenet (2014)
Keywords: 19q1311 microdeletion syndrome, chromosomal rearrangement, uba2
MeSH terms: Case Reports

The 19q13.11 microdeletion syndrome (MIM613026) is a clinically recognisable condition in which a 324-kb minimal overlapping critical region has been recently described. However, genes not included within this region, such as WTIP and UBA2, have been proposed to contribute to the clinical characteristics observed in patients. Using cytogenetic techniques, single nucleotide polymorphism arrays, and the quantitative polymerase chain reaction, we identified a novel case with a 2.49-Mb deletion derived from a de novo chromosomal rearrangement. Based on a review of the literature, we support the notion that UBA2 haploinsufficiency could contribute to the phenotype of this rare genomic disorder. UBA2 belongs to a protein complex with sumoylation activity, and several transcription factors, hormone receptors, and signalling proteins related to brain and sexual development are regulated by this post-translational modification. Additional clinical reports and further research on UBA2 molecular function are warranted.