OpenMed/multicare-articles huggingface dataset:
Effect of Physiotherapeutic Rehabilitation on a Patient With an Iliac Fracture, and Superior and Inferior Pubic Rami Fracture With Foot Drop: A Case Report
Authors: Charul Dandale, Neha V Chitale, Pratik Phansopkar
Journal: Cureus (2023)
Keywords: foot drop, iliac wing fracture, physiotherapy, pubic rami, rehabilitation
MeSH terms: Case Reports

The sacroiliac joint is frequently broken apart by high-energy trauma, which increases fatalities and complications from pelvic injuries. Ilium fractures are high-energy pelvic fractures that often progress from the iliac crest to the greater sciatic notch. Concomitant head injury exsanguinations and uncontrollable bleeding within the pelvis are considered important causes of mortality. In contrast, some assume that such extensive bleeding is extremely uncommon and that accompanying injuries could result in increased mortality. A shorter healing period and faster patient mobilization are possible with surgically treated Tile's type B and C fractures. Accident-related fractures can lead to decreased independence and functioning, restricted mobility, lowered self-confidence, and a worse quality of life; these fractures are caused by trauma, most frequently from minor falls and age-related osteopenia. By reducing discomfort, restoring range of motion and muscular strength, and assisting with early ambulation/loading of the fractured limb, early physical therapy intervention speeds up the clinical recovery of patients with fractures. When one cannot elevate the forefoot, it results in foot drop because of a lack of dorsiflexor strength in the foot. These may induce a risky antalgic gait, leading to falls-the diminished ability to lift the foot of the ankle or the toes (dorsiflexion). Injuries, including fractures, joint dislocations, or hip replacement surgery, can also result in a drop foot. The peroneal nerve, which innervates the tibialis anterior, is the muscle responsible for dorsiflexion, as it arises from the sciatic nerve's branch. Due to the foot drop, the anterior tibialis muscle will shorten and cause spasms in the calf muscle. After surgery, the patient was dependent and had difficulty going about his everyday life. However, the physiotherapy intervention improved the patient's pain and physical functionality. By lowering discomfort, restoring range of motion and muscular strength, and facilitating early ambulation/loading of the fractured limb, this study shows that combining definitive surgical methods with early physical therapy intervention speeds up the clinical recovery of patients with fractures.
Case report: POLE (P286R) mutation in a case of recurrent intestinal leakage and its treatment
Authors: Dang Xiang, Gongbo Fu, Yitian Chen, Xiaoyuan Chu
Journal: Front Oncol (2023)
Keywords: pole (p286r) mutation, immunotherapy, metastatic colorectal cancer, molecular markers, recurrent intestinal leakage
MeSH terms: Case Reports

In recent years, although new drugs and molecular markers have been used to treat metastatic colorectal cancer, there has been little progress in the immunotherapy of advanced colon cancer. The development of sequencing and multiomics technology helps us classify patients more accurately, and then find patients who may benefit from immunotherapy. The development of this advanced technology and immunotherapy based on new targets may herald a new era in the treatment of metastatic colorectal cancer. It is well known that colorectal cancer with dmmr/msi-h phenotype is sensitive to immunotherapy, yet the POLE mutation is the MSS phenotype in colorectal tumors but is also an effective target for immunotherapy. This paper describes a case of recurrent intestinal leakage that required multiple surgical procedures. A high-grade colon adenocarcinoma was identified on surgical histopathology after 18 months, and bevacizumab combined with oxaliplatin and capecitabine proved ineffective against this cancer. An analysis of gene expression indicated that POLE (P286R) mutation, TMB 119.333 mutation per 100 MB, and immune checkpoint inhibitor treatment had a significant impact. This case reminds us that the existence of malignant tumors should be considered for patients with repeated intestinal leakage, and emphasizes the importance of gene detection in the treatment of malignant tumors and the significance of POLE mutations in colorectal cancer.
Double Robertsonian translocations in an infertile patient with macrocytic anemia: a case report
Authors: Ramakrishnan Sasi, Jamie Senft, Michelle Spruill, Soham Rej, Peter L Perrotta
Journal: Mol Cytogenet (2020)
Keywords: double robertsonian translocations, infertility, macrocytic anemia, ribosomopathies
MeSH terms: Case Reports

Background:
Constitutional heterologous double Robertsonian translocations (DRT) between chromosomes 13/14 and chromosomes 14/15 with 44 chromosomes are extremely rare. In this case report, we present the karyotype analysis of metaphases prepared from bone marrow, peripheral blood and cultured skin tissue cells. These showed only 44 chromosomes with DRT involving chromosomes 13, 14 and 15. To our knowledge this is the first reported case with DRT involving chromosomes 14 and 15.
Case presentation:
The patient is an 81-year-old infertile male with a history of persistent macrocytic anemia (MA). The patient presented with fatigue, paleness of the skin, shortness of breath, lightheadedness and occasional dizziness. Work-up for common causes of macrocytic anemias in this case were excluded: folate/vitamin B12 deficiency, hypothyroidism, liver diseases, hemolysis, bleeding, alcoholism, exposure, HIV infection, chemotherapy or blood loss, drug-toxicity effect, or myelodysplasia. This individual with DRT had only six nucleolus organizer regions (NORs), instead of the usual ten, of which 50% of the 6 NORs were inactive (n = 3).
Conclusion:
In this case, macrocytic anemia (MA) appeared to be due to reduction in active NORs in DRT. We postulate that the marked reduction in active NORs leads to reduction in active nucleoli formation, which may be limiting ribosomal RNA synthesis, contributing to MA. It is probable that reduction in NOR activity affected normal DNA synthesis and cellular functions.
Undilatable Stent Neoatherosclerosis Treated with Ad Hoc Rotational Atherectomy
Authors: Michael Koutouzis, Maria Agelaki, Christos Maniotis, Ioannis Tsiafoutis, Vasileios Patris, Mihalis Argyriou
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

A middle age woman with known ischemic heart disease and old stents in proximal left anterior descending coronary artery (LAD) was admitted to Coronary Care Unit with acute coronary syndrome. The coronary angiography showed one vessel disease with significant restenosis within the previously implanted stents. The lesion was tough and remained undilatable despite high pressure balloon inflation. Eventually, the balloon ruptured creating a massive dissection of the LAD beginning immediately after the distal part of the undilatable lesion. We proceeded with a challenging ad hoc rotational atherectomy of the lesion and finally stenting of the lesion. In-stent restenosis many years after stent implantation is considered to be mainly due to neoatheromatosis compared to intimal hyperplasia, making lesion treatment more difficult and unpredictable.
Paget-Schroetter syndrome in the absence of common predisposing factors: a case report
Authors: Ramy Ibrahim, Irina Dashkova, Myia Williams, Andrzej Kozikowski, Neeraj Abrol, Anjula Gandhi, Renee Pekmezaris
Journal: Thromb J (2017)
Keywords: axillary-subclavian venous thrombosis, deep vein thrombosis, paget-schrotter syndrome, pulmonary embolism, thrombosis, upper extremity deep vein thrombosis
MeSH terms: Case Reports

Background:
Paget-Schrotter Syndrome (PSS) also known as "effort thrombosis" is a form of primary thrombosis in the subclavian vein at the costoclavicular junction is usually seen in younger patients after repeated strenuous activity of the shoulders and arms. When occurring in younger patients, PSS presents itself with predisposing factors such as unilateral dull, aching pain in the shoulder or axilla and swelling of the arm and hand.
Case presentation:
We report a rare case of unusual left axillo-subclavian vein thrombosis in absence of clear risk factors and a negative hypercoagulable workup in a 36-year-old Hispanic woman who presented with 2 days duration of left upper extremity pain and swelling after a week of heavy exercise in aerobic class. Very few documented cases of primary or spontaneous ASVT in absence of clear factors and in such anatomical location have been previously reported. The patient was started on strict precautions of left upper extremity immobilization, analgesics in the form of Tylenol 650 mg every 6 h for pain as well as cold compresses. Lovenox 90 mg subcutaneous twice daily (1 mg/kg BID) was started together with warfarin to keep INR 2-3.
Conclusion:
In addition to the unusual location in the left upper extremity in our case, the absence of common etiologic factors makes our case of Paget-Schroetter Syndrome a very unique one. Presently, there is a lack of guided management of rare conditions such as our case, or consensus among the sources. Physicians should be aware of this rare disease since untreated conditions may be debilitating for the patient and very costly especially if diagnosed with a delay.
Missed appendicitis after self-induced abortion
Authors: Damien Punguyire, Victor Kenneth Iserson
Journal: Pan Afr Med J (2011)
Keywords: appendicitis, abortion, misdiagnosis, misoprostol, pregnancy
MeSH terms: Abdominal Pain / chemically induced, Abdominal Pain / diagnosis, Abortifacient Agents, Nonsteroidal / adverse effects, Abortion, Criminal, Appendicitis / diagnosis, Diagnostic Errors, Misoprostol / adverse effects, Case Reports, Female, Humans, Pregnancy, Young Adult, Abortifacient Agents, Nonsteroidal, Misoprostol

Female lower abdominal pain poses diagnostic difficulties for clinicians, especially when little more than the history and physical examination are available. A girl presented with constant lower abdominal pain after taking misoprostol for pregnancy termination. She was eventually referred to a rural District Hospital, where a laparotomy demonstrated acute appendicitis. After treating herself for a self-diagnosed pregnancy with illegally provided misoprostol, this patient presented with persistent lower abdominal pain. The differential diagnosis included ectopic pregnancy and all other causes of female abdominal pain. Yet diagnosing two diseases in the same anatomical area at the same time contradicts diagnostic parsimony. System problems in resource-poor areas can limit access to healthcare services and encourage dispensing potentially dangerous medications without clinicians' authorization. It is dangerous to rely on patients' self-diagnoses while neglecting other diagnoses. More than one diagnosis may be needed to explain temporally and anatomically related symptoms.
Case Report: High-Gamma Oscillations on an Ictal Electroencephalogram in a Newborn Patient With Hypoxic-Ischemic Encephalopathy
Authors: Akihito Takeuchi, Takushi Inoue, Makoto Nakamura, Misao Kageyama, Tomoyuki Akiyama, Katsuhiro Kobayashi
Journal: Front Pediatr (2021)
Keywords: fast oscillations, gamma, hypoxic-ischemia encephalopathy, ictal eeg, neonatal seizure
MeSH terms: Case Reports

Fast oscillations (FOs) >40 Hz in electroencephalograms (EEGs) are associated with ictogenesis and epileptogenesis in adults and children with epilepsy. However, only a few previous studies showed FOs in neonates. Reported frequencies of such neonatal FOs were in the low-gamma (<60 Hz) band and, therefore, they were not high compared to those in pediatric patients. We herein report a newborn patient with severe hypoxic-ischemic encephalopathy (HIE), who showed pathological FOs with a frequency in the high-gamma band. She was born at a gestational age of 39 weeks 4 days by emergency cesarean section because of non-reassuring fetal status. She had focal motor seizures involving unilateral upper and lower limbs lasting for tens of seconds on days 0, 1, 4, 5, 8, and 9 and subclinical seizures on days 4-11. Phenobarbital (PB) was intravenously administered on days 0, 2, 4, 5, and 6. We found FOs that were superimposed on the ictal delta activities using visual inspection and time-frequency analysis on 8-11 days of age. Among them, we detected high-gamma (71.4-100 Hz) oscillations that appeared to be temporally independent of low-gamma activities in the ictal EEG on 11 days of age. To the best of our knowledge, this is one of the earliest reports showing pathological FOs with a frequency of >60 Hz in the high-gamma band in human neonatal seizures, which were previously observed in animal studies. Further studies are needed to elucidate the pathophysiology of ictal FOs in neonatal seizures.
Tracheal Squamous Cell Carcinoma Treated with Tracheal Resection and Anastomosis in a Cat
Authors: Zachary A Miller, Sheldon Padgett, Alex Terreros, Emily Pearce
Journal: Case Rep Vet Med (2020)
MeSH terms: Case Reports

A 10-year-old male castrated domestic shorthair cat presented for a suspected tracheal mass. Radiographs confirmed an intraluminal tracheal mass. Tracheal resection and anastomosis of 5 tracheal rings was performed with minimal, mild intraoperative complications and no postoperative complications. Histopathology of the tracheal mass revealed a diagnosis of squamous cell carcinoma (SCC) with incomplete margins both cranially and caudally. Further treatment, including surgical revision, radiation therapy, or chemotherapy, was recommended. At the time of publication, no further treatment has been initiated, and a scheduled consultation with the oncologist has been canceled. The cat is doing well at home with no reported signs of recurrence 120 days postoperatively. This is the first report of a cat with a tracheal SCC to be treated with a tracheal resection and anastomosis and only the third feline tracheal SCC to be treated in the veterinary literature.
Case Report: Molecular and Pathological Investigations of Zoonotic Anatrichosoma Spp.-Induced Ulcerative Pododermatitis in a Domestic Cat in Thailand
Authors: Wanarit Jitsamai, Sawang Kesdangsakonwut, Thanakorn Srirat, Piyanan Taweethavonsawat
Journal: Front Vet Sci (2021)
Keywords: anatrichosoma spp, thailand, cat, molecular investigation, pododermatitis
MeSH terms: Case Reports

Anatrichosoma spp. is a group of trichuroid nematodes that mainly infect non-human primates and domestic cats. The lifecycle of these nematodes remains unclear. In non-human primates, Anatrichosoma spp. were found in the nasal cavity. However, ulcerative dermatitis has been reported in infected cats. An adult, intact, female domestic short-haired cat was presented with ulcerative pododermatitis of all limbs. Punch biopsy was performed at the edge of the ulcerative wound for histopathological investigation and showed necrosis and infiltration of inflammatory cells around the nematode-like lesion. Eggs with Capillaria-like characteristics were present. Tissue sections were subjected to DNA extraction and PCR targeting 18S rRNA, using primers designed from Anatrichosoma 18S rRNA. The phylogenetic tree revealed that DNA obtained from the lesion of the domestic cat was grouped with Anatrichosoma spp. from the olive glass mouse (Abothirx olivacea), Capillaria plica and Eucoleus aerophilus, both from the red fox (Vulpes Vulpes). The study is the first report of feline anatrichosomiasis in Thailand, and we present both pathological findings and molecular evidence. The cat was successfully treated with emodepsine/praziquantel. The skin lesion recovered within 3 days after anthelmintic treatment. Because Anatrichosoma spp. have been reported in humans, the zoonotic potential of this parasite should be considered.
A Case of Chronic Cough and Pneumonia Secondary to a Foreign Body
Authors: Joan Dabu, Meredith Lindner, Moh'd Azzam, Anas Al-Khateeb, Muqueet Kadri, Sharath Bellary, Richard Miller
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Foreign body aspiration occurs when a solid or semisolid object becomes lodged in the larynx or trachea. It can be a life-threatening emergency, especially if it is large enough to occlude the airway. However, small aspirated objects may go unnoticed until symptoms occur. Therefore, it is frequently misdiagnosed. A high level of clinical suspicion, patient's risk factors, and thorough history and physical examination are essential in making the diagnosis. It should be considered in cases where there is unresolved chronic cough with or without associated recurrent pneumonia especially in patients with risks for aspiration.
Bartter-Like Syndrome as the Initial Presentation of Dent Disease 1: A Case Report
Authors: Qiaoping Chen, Yan Cao, Liyun Xu, Jingqi Liu, Xiaochuan Wu
Journal: Front Pediatr (2021)
Keywords: clcn5 gene, bartter-like syndrome, children, dent disease, hypercalciuria, low-molecular-weight proteinuria
MeSH terms: Case Reports

Dent disease is a rare genetic disease characterized by low-molecular-weight proteinuria. Dent disease with Bartter-like syndrome is rare and can easily be misdiagnosed and mistreated. Herein, we report a case of Dent disease 1 with Bartter-like syndrome as the initial manifestation. The patient was admitted to The Second Xiangya Hospital of Central South University due to polydipsia, polyuria, and weakness of both lower limbs at 2 years of age. Laboratory tests showed that serum sodium, potassium and chlorine levels were low, while serum creatinine levels were normal. The calcium level in the urine was normal. The patient was initially diagnosed with Bartter syndrome, and despite medical interventions, he eventually developed chronic kidney disease stage 4 at 13 years of age. To determine the cause, the patient was recommended to undergo genetic testing, which showed a CLCN5 gene c. 941C > T mutation (p.S314L), and was finally diagnosed as Dent disease 1. The clinical manifestations of Dent disease are complex and diverse. For patients with atypical clinical manifestations or unsatisfactory therapeutic effects, genetic testing is recommended.
Case Report: Dislocation Into Vitreous Cavity and Removal of a Posterior Chamber Phakic Intraocular Lens
Authors: Jingliang He, Li Zhang, Fang Zheng, Xiaoyun Fang
Journal: Front Med (Lausanne) (2022)
Keywords: eprl, ppv, dislocation, posterior chamber phakic intraocular lens, removal
MeSH terms: Case Reports

Purpose:
To report a rare case of delayed dislocation of a novel posterior chamber phakic intraocular lens into the vitreous cavity, which was successfully treated by a reformed technique.
Case presentation:
A 29-year-old female received Ejinn phakic refractory lens (EPRL) implantation to correct her high myopia. Spontaneous dislocation into the vitreous cavity occurred 26-months post-operatively without traumatic history. Pars plana vitrectomy combined with cutting the EPRL into two equal pieces was performed to remove the dislocated EPRL.
Conclusion:
Dislocation into the vitreous cavity of EPRL can be successfully and easily removed by our reformed technique. Concerns about zonules-related complications pre-operatively, intraoperatively, and post-operatively must be raised in the practice of EPRL implantation.
Acute appendicitis complicated by pylephlebitis: a case report
Authors: Ricardo Castro, Teresa Fernandes, Maria I Oliveira, Miguel Castro
Journal: Case Rep Radiol (2013)

Pylephlebitis is defined as septic thrombophlebitis of the portal vein. It is a rare but serious complication of an intraabdominal infection, more commonly diverticulitis and appendicitis. It has an unspecific clinical presentation and the diagnosis is difficult. The authors report a case of a 21-year-old man with acute appendicitis complicated by pylephlebitis. The diagnosis was made with contrast enhanced CT.
Real-Life Cause-Effect Relations Between Urinary IL-6 Levels and Specific and Nonspecific Symptoms in a Patient With Mild SLE Disease Activity
Authors: Christian Schubert, Lennart Seizer, Emil Chamson, Paul König, Norbert Sepp, Francisco M Ocaña-Peinado, Mirjam Schnapka-Köpf, Dietmar Fuchs
Journal: Front Immunol (2021)
Keywords: facial rash, integrative single-case design, interleukin-6, lupus, oral ulcer, proteinuria, time-series analysis
MeSH terms: Arthralgia / etiology, Facial Dermatoses / etiology, Fatigue / etiology, Fever / etiology, Interleukin-6 / urine, Lupus Erythematosus, Systemic / urine, Oral Ulcer / etiology, Proteinuria / etiology, Case Reports, Research Support, Non-U.S. Gov't, Causality, Creatinine / urine, Female, Humans, Lupus Erythematosus, Systemic / complications, Middle Aged, Symptom Assessment, IL6 protein, human, Interleukin-6, Creatinine

Background:
Little is known about the real-time cause-effect relations between IL-6 concentrations and SLE symptoms.
Methods:
A 52-year-old woman with mild SLE activity collected her entire urine for the determination of IL-6/creatinine and protein/creatinine levels (ELISA, HPLC) for a period of 56 days in 12 h intervals (total: 112 measurements). Additionally, she answered questionnaires (VAS) on oral ulceration, facial rash, joint pain, fatigue and tiredness and measured her temperature orally twice a day. Time-series analyses consisted of ARIMA modeling and cross-correlational analyses (one lag = 12 h, significance level = p < 0.05).
Results:
Statistical analyses showed that increased urinary IL-6 concentrations preceded increased urinary protein levels by 36-48 h (lag3: r=+.225; p=.017) and that, in the opposite direction of effect, increased urinary protein preceded urinary IL-6 decreases by 12-24 h (lag1: r=-.322; p<.001). Moreover, urinary IL-6 increases co-occurred with increased oral ulceration (lag0: r=+.186; p=.049); after 48-60 h, however, IL-6 increases showed a strong tendency to precede oral ulceration decreases (lag4: r=-.170; p=.072). Increases in facial rash preceded decreases in urinary IL-6 after 84-96 h (lag7: r=-.215; p=.023). As to fatigue, increases in urinary IL-6 co-occurred with decreased fatigue (lag0: r=-.193; p=.042); after 84-96 h, however, IL-6 increases preceded fatigue increases (+lag7: r=+.189; p=.046). Finally, joint pain, tiredness and body temperature did not significantly correlate with urinary IL-6 concentrations in either direction of effect.
Conclusions:
The results of this evaluation point to real-life feedback mechanisms between immune activity and SLE symptoms. Comparison with a previous evaluation of this patient suggests a counterregulatory mechanism between Th1 activity and IL-6. These findings are preliminary and require replication to draw firm conclusions about the real-time relation between IL-6 and SLE disease activity.
Unmasking the Masquerader: A Delayed Diagnosis of MS and Its 4.5 Years of Implications in an Older African American Male
Authors: Deanna Dong, Joshua Carlson, Joseph Ruberwa, Thomas Snihur, Nawar Al-Obaidi, José Bustillo
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Multiple sclerosis (MS) has classically been described as a disease of the young Caucasian female. While the prevalence may seem to be higher in Caucasians (CAs), recent studies suggest that the real incidence of MS may actually be higher in African Americans (AAs). Here, we discuss a nonclassical case of MS in an older African American male, prognostic factors, disease patterns in African Americans, and how a delay in diagnosis and socioeconomic factors can lead to worse outcomes. In patients that present with possible symptoms of MS, a high suspicion for MS should be entertained even in epidemiologically atypical patients to prevent delay in diagnosis and irreversible disability.