OpenMed/multicare-articles huggingface dataset:
Clinical Analysis of the Discovery of Malignant Gynecological Tumors in the Diagnosis and Treatment of Pelvic Organ Prolapse
Authors: Li-Na Niu, Jun-Xia Wang, Xia Li, Yong-Jun Xu, Li-Rong Qiu, Sheng Guo, Li-Zhen Zhang, Yun Shang
Journal: Front Surg (2022)
Keywords: diagnosis, gynecological malignancies, laparoscope, pelvic organ prolapse, total pelvic reconstruction without mesh, treatment
MeSH terms: Case Reports

Background:
Clinically, malignant gynecological tumors found by chance during the diagnosis and treatment of pelvic organ prolapse (POP) are rare, and they are usually missed, leading to delayed diagnosis and treatment. The initial treatment of these tumors cannot be standardized, and, as a single surgical intervention may not be able to treat both the tumor and prolapse, secondary surgery is usually needed, affecting the quality of life of patients.
Case presentation:
The present study retrospectively analyzed the data of three patients who were diagnosed with malignant gynecological tumors during the diagnosis and treatment of POP. These patients were among 215 patients with POP treated in Yuncheng Central Hospital of Shanxi Province between January 2011 and May 2020. The case characteristics, surgical interventions, postoperative treatments, and follow-ups were summarized, and the characteristics of diagnosis and treatment were analyzed in the context of relevant literature.
Conclusion:
As long as clinicians operate in strict accordance with the standards of diagnosis and treatment, obtain a complete medical history, undertake a physical examination, and remain diligent in auxiliary examinations, following existing clinical methods and diagnosis and treatment processes, patients with POP complicated with malignant gynecological tumors can be clearly diagnosed before and during surgery. In this way, initial treatment can be standardized, and surgical methods can be selected that address both the tumor and prolapse, thereby avoiding secondary surgery and improving the patient's quality of life.
Diabetic Neuropathic Arthropathy of the Knee: Two Case Reports and a Review of the Literature
Authors: Amit Patel, Aaron K Saini, Michael E Edmonds, Venu Kavarthapu
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Diabetic neuroarthropathy of the knee or Charcot knee (CK) is a lesser-known complication of diabetes mellitus, with a limited number of case reports and small case series published in the literature. The majority of these reports describe the complexities and challenges that arise in these patients undergoing knee arthroplasty procedures. We present two cases of CK, including a rare case of concurrent bilateral disease, and also a review of the current literature.
Role of Immunoglobulins in Muscular Dystrophies and Inflammatory Myopathies
Authors: Andrea Farini, Chiara Villa, Luana Tripodi, Mariella Legato, Yvan Torrente
Journal: Front Immunol (2021)
Keywords: autoantibodies, autoimmunity, immunoglobulins, inflammatory myopathies, muscle inflammation, muscular dystrophies
MeSH terms: Autoimmunity, Immunoglobulins / immunology, Muscular Dystrophies / immunology, Myositis / immunology, Research Support, Non-U.S. Gov't, Review, Autoantibodies / immunology, Humans, Immunoglobulins / metabolism, Muscle Proteins / metabolism, Muscular Dystrophies / metabolism, Muscular Dystrophies / pathology, Myositis / metabolism, Myositis / pathology, Autoantibodies, Immunoglobulins, Muscle Proteins

Muscular dystrophies and inflammatory myopathies are heterogeneous muscular disorders characterized by progressive muscle weakness and mass loss. Despite the high variability of etiology, inflammation and involvement of both innate and adaptive immune response are shared features. The best understood immune mechanisms involved in these pathologies include complement cascade activation, auto-antibodies directed against muscular proteins or de-novo expressed antigens in myofibers, MHC-I overexpression in myofibers, and lymphocytes-mediated cytotoxicity. Intravenous immunoglobulins (IVIGs) administration could represent a suitable immunomodulator with this respect. Here we focus on mechanisms of action of immunoglobulins in muscular dystrophies and inflammatory myopathies highlighting results of IVIGs from pre-clinical and case reports evidences.
Diagnosis of Rhinocerebral Mucormycosis by Treatment of Cavernous Right Internal Carotid Artery Occlusion With Mechanical Thrombectomy: Special Case Presentation and Literature Review
Authors: Samir Kashyap, Jacob Bernstein, Hammad Ghanchi, Ira Bowen, Vladimir Cortez
Journal: Front Neurol (2019)
Keywords: antifungal, mucormycosis, posaconazole, rhinocerebral mucomycosis, thrombectomy
MeSH terms: Case Reports

Background: Mucormycosis is a rapidly progressive, angioinvasive fungal infection that has a predilection for the paranasal sinuses and adjacent mucosa. Rhinocerebral mucormycosis (RCM) is the most common form and is known to invade the skull base and its associated blood vessels-leading to mycotic aneurysms, ischemic infarcts, and intracerebral hemorrhage. There are documented cases of mechanical thrombectomy in ischemic stroke due to RCM, however, there are no known cases that were diagnosed primarily by histological and pathological analysis of the embolus. We present a case of treatment of large vessel occlusion that led to the diagnosis and treatment of RCM. Case Presentation: A 21 year-old male inmate with history of type 1 diabetes presented with generalized weakness, abdominal pain, right eye blindness, and ophthalmoplegia after an assault in prison. He underwent treatment for diabetic ketoacidosis, but subsequently developed left hemiplegia and was found to have complete occlusion of his right internal carotid artery. He underwent successful mechanical thrombectomy and pathological analysis of the embolus revealed a diagnosis of mucormycosis. He completed a course of amphotericin B, micafungin, and posaconazole. With the aid of acute rehabilitation he achieved a modified Rankin score of 2. Discussion: We review the pathogenesis, diagnosis, and treatment of RCM. A comprehensive multidisciplinary approach is critical in the management of this often-fatal disease. Early diagnosis and treatment are essential in RCM as delaying treatment by more than 6 days significantly increases mortality. Treatment includes surgical debridement and intravenous antifungal therapy (amphotericin B + micafungin or caspofungin) for a minimum of 6-8 weeks.
Anticoagulation with Argatroban in a Patient with Heparin-Induced Thrombocytopenia and Renal Insufficiency Undergoing Orthotopic Heart Transplantation
Authors: Michael Stuart Green, Johann Mathew, Christopher Ryan Hoffman, Henry Liu
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

Unfractionated heparin is the anticoagulant of choice for cardiac surgery that requires cardiopulmonary bypass. However, it can cause serious side effects like heparin-induced thrombocytopenia (HIT), an immune-mediated process where antibodies are directed against heparin and platelet 4 complexes. In such cases, alternative pharmacologic strategies are implemented to facilitate safe bypass conditions. A woman with severe decompensated heart failure was heparinized for intra-aortic balloon pump and subsequent LVAD placement. On day 6, a fall in platelets from 113,000 to 26,000 was noted. She was diagnosed with HIT. Heparin was discontinued and replaced with an argatroban infusion for the duration of her care until heart transplantation was completed. We review the mechanism, diagnosis, and complications of HIT. We discuss cardiopulmonary bypass and its relation to heparin, HIT, and heparin alternatives. We discuss argatroban's relevant pharmacology, clinical use, advantages, and disadvantages.
A rare case of pituitary metastasis from hepatocellular carcinoma: case report and literature review
Authors: Yuanchen Cheng, Ming Feng
Journal: Front Oncol (2023)
Keywords: hepatocellular carcinoma, metastases, pathology, pituitary, surgical treatment
MeSH terms: Review

Presence of pituitary metastases (PMs) is a relatively rare clinical situation, especially when originating from hepatocellular carcinoma (HCC). A 73-year-old man presented with headaches, diplopia, and soon impaired vision, as well as gastrointestinal symptoms. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain revealed a space-occupying mass in the sellar region. The patient had a history of hepatocellular carcinoma and recent abdominal ultrasound and positron emission tomography (PET) indicated recurrence and metastases. Endoscopic transnasal transsphenoidal tumor excision was performed, and postoperative pathological report confirmed the diagnosis of HCC PM. In the literature review, 17 published cases of HCC PMs were summarized. Both the diagnosis and management of HCC PMs are difficult. Patients who had HCC-related history and new-onset headaches or diplopia should be inspected with a suspicion of metastatic lesions. Surgical intervention with transnasal endoscope is only recommended to ameliorate the symptoms and improve the life quality.
Case Report: Multiple Vertebral Compression Fractures in 14-Year-Old Children With Multiple Myeloma
Authors: Xia Wang, He He, Mei Zhang, Chuan Li, Chengyao Jia
Journal: Front Oncol (2021)
Keywords: adolescent patient, autologous hematopoietic stem cell transplantation, monoclonal spike, multiple myeloma, spine compression fracture
MeSH terms: Case Reports

Multiple myeloma (MM) is a neoplastic disorder characterized by clonal proliferation of malignant plasma cells derived from B cells in bone marrow. Pediatric MM is rare with only approximately 0.3% of cases diagnosed before the age of 30. In this report, we present a 14 years old boy diagnosed as MM with multiple pathologic vertebral fractures. To our knowledge, our patient is the youngest Chinese case in the literature to present with MM. He was treated with bortezomib, dexamethasone, and cyclophosphamide followed by autologous hematopoietic stem cell transplantation with good clinical response. We hope to aid in the understanding of the pathophysiology and management of this condition.
Exophthalmos as a presenting manifestation of limited Wegener's granulomatosis in a patient with prior graves' disease
Authors: Brian Bowers, Deepak Gupta, Hirenkumar Patel, Naureen Mirza
Journal: Clin Med Case Rep (2009)
Keywords: limited wegener’s granulomatosis, exophthalmos, ocular, orbit, vasculitis
MeSH terms: Case Reports

Wegener's granulomatosis is a granulomatous necrotizing vasculitis characterized by its predilection to affect the upper and lower respiratory tracts and kidneys. Ocular manifestations such as keratitis, conjunctivitis, scleritis, episcleritis, nasolacrimal duct obstruction, uveitis, retroorbital pseudotumor with proptosis retinal vessel occlusion, and optic neuritis have all been described. We present a case of limited Wegener's granulomatosis presenting with proptosis. A 57 year old woman with a history of Graves' disease 20 yrs ago, presented to her ophthalmologist with new onset of exophthalmos of right eye. An MRI of the brain and orbits revealed a soft tissue mass behind the right orbit. The biopsy of the mass revealed transmural inflammation with fibrinoid necrosis consistent with necrotizing vasculitis. She was diagnosed with Wegener's granulomatosis limited to the eye and was treated with oral cyclophosphamide and prednisone followed by weekly methotrexate with good response. Though ocular manifestations of Wegener's granulomatosis are well described, a review of the literature revealed that exophthalmos as the lone presenting manifestation is quite rare. Only two cases have been reported in the English literature since 1977. This case illustrates the importance of considering a diagnosis of limited Wegener's granulomatosis presenting with proptosis of the orbit.
Penile Lymphangioma: review of the literature with a case presentation
Authors: Mohamed Macki, Sharath Kumar Anand, Hayan Jaratli, Ali A Dabaja
Journal: Basic Clin Androl (2019)
Keywords: cavernous, circumscriptum, cystic, hygroma, lymphangiectasia, lymphangiectasis, lymphangioma, penile, penis

Background:
Penile lymphangiomas are rare manifestations of lymphangiomas or lymphatic malformations which are more commonly found in the head or neck region of the body. Lymphangiomas are further categorized as lymphangioma circumscriptum, cavernous lymphangioma, cystic hygroma, or acquired lymphangiomas (also known as lymphangiectasia), based on their depth and etiology.
Results:
A literature review revealed only 30 cases of penile lymphangioma between 1947 and March 30, 2018. Several causes were attributed to the acquired penile lymphangiomas, including trauma, phimosis, and infection. While penile lymphangiomas can be initially mistaken for an infection, a thorough history and physical examination is sufficient to clinically diagnose a lymphangioma of the penis. Historically, surgical excision has been the gold standard of treatment for this condition. When asymptomatic, patients may opt for conservative management with avoidance of mechanical trauma alone. Other physicians have revealed novel treatment plans to rid patients of their penile lymphangioma such as a staged laser procedure.
Conclusion:
In this article, we elucidate the causes, symptoms, treatments, and outcomes associated with penile lymphangiomas found in the literature while also presenting the case of a 30-year-old African-American man diagnosed with acquired penile lymphangioma.
The value of cryosurgery in treating a case of thoracic chondrosarcoma
Authors: Kalliopi Alpantaki, George Datsis, Odysseas Zoras, Alkisti Kampouroglou, Ioannis Drositis, George Halkiadakis, Pavlos Katonis
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Chondrosarcomas of the spine are rare and difficult to treat. In this paper a case of thoracic chondrosarcoma is presented. Chondrosarcomas of the spine are generally smaller, more difficult to excise and are followed by higher local recurrence compared with chondrosarcomas of the peripheral skeleton. The tumor is radio- and chemoresistant, making the surgical treatment of utmost importance. The most important prognostic factor for local control is wide or marginal tumor resection. Our patient was treated in two stages, with total excision of the tumor, using cryosurgery. Liquid nitrogen was used to freeze the damaged tissue at a cellular level and made the excision more efficient.
Application of Bidirectional Generative Adversarial Networks to Predict Potential miRNAs Associated With Diseases
Authors: Long Xu, Xiaokun Li, Qiang Yang, Long Tan, Qingyuan Liu, Yong Liu
Journal: Front Genet (2022)
Keywords: mirna–disease association prediction, bidirectional generative adversarial network, complex disease, micrornas, similarity network

Substantial evidence has shown that microRNAs are crucial for biological processes within complex human diseases. Identifying the association of miRNA-disease pairs will contribute to accelerating the discovery of potential biomarkers and pathogenesis. Researchers began to focus on constructing computational models to facilitate the progress of disease pathology and clinical medicine by identifying the potential disease-related miRNAs. However, most existing computational methods are expensive, and their use is limited to unobserved relationships for unknown miRNAs (diseases) without association information. In this manuscript, we proposed a creatively semi-supervised model named bidirectional generative adversarial network for miRNA-disease association prediction (BGANMDA). First, we constructed a microRNA similarity network, a disease similarity network, and Gaussian interaction profile kernel similarity based on the known miRNA-disease association and comprehensive similarity of miRNAs (diseases). Next, an integrated similarity feature network with the full underlying relationships of miRNA-disease pairwise was obtained. Then, the similarity feature network was fed into the BGANMDA model to learn advanced traits in latent space. Finally, we ranked an association score list and predicted the associations between miRNA and disease. In our experiment, a five-fold cross validation was applied to estimate BGANMDA's performance, and an area under the curve (AUC) of 0.9319 and a standard deviation of 0.00021 were obtained. At the same time, in the global and local leave-one-out cross validation (LOOCV), the AUC value and standard deviation of BGANMDA were 0.9116 ± 0.0025 and 0.8928 ± 0.0022, respectively. Furthermore, BGANMDA was employed in three different case studies to validate its prediction capability and accuracy. The experimental results of the case studies showed that 46, 46, and 48 of the top 50 prediction lists had been identified in previous studies.
Rare case of male breast cancer and axillary lymphoma in the same patient: an unique case report
Authors: Emiliano Sordi, Katia Cagossi, Maria Grazia Lazzaretti, Daniel Gusolfino, Fabrizio Artioli, Giovanni Santacroce, Maria Luisa Brandi, Prisco Piscitelli
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Breast cancer in men is uncommon, and even more rare is the simultaneous presentation of two different malignancies. A 39-year-old man was diagnosed with both breast cancer and axillary lymphoma. Familiar history revealed that his mother died because of breast cancer. The patient underwent fine needle aspiration leading to the diagnosis of malignant lesion. Modified radical mastectomy was performed. Histology revealed an infiltrating ductal carcinoma 2.8 cm wide, grade 2, with vascular and lymphatic invasion. Surprisingly, one of the second level nodes was confirmed as a high-grade large B cell non-Hodgkin's lymphoma. No family inheritance or gene mutations (BRCA 1 and 2) were found. The patient underwent local radiotherapy, followed by 6 chemotherapy courses (RCHOP) and treatment with tamoxifen 20 mg/daily. To our knowledge, this is the first case reported in literature of male breast cancer and axillary lymphoma simultaneously confirmed in the same patient.
First sliding Amyand hernia harbouring appendicular schistosomiasis: Case report
Authors: Ali Toffaha, Walid El Ansari, Orwa Elaiwy, Munzir Obaid, Omer Al-Yahri, Sherif Abdelazim
Journal: Int J Surg Case Rep (2019)
Keywords: case report, inguinal hernia, intestinal schistosomiasis, tropical disease

Introduction:
Amyand's hernia (AH) is rare, schistosomiasis of the appendix is very uncommon, and both conditions coexisting together is an extremely rare event. Pre-operative diagnosis of each of the two conditions is usually difficult. To the best of our knowledge, the current paper is first to report both these two conditions in coexistence.
Presentation of case:
A 31-year old man who had no comorbidities was admitted electively as a day case of non-complicated right indirect inguinal hernia. Further history and physical examination were unremarkable. Intraoperatively the patient was found to have right sliding AH with appendicular schistosomiasis (AS). The patient underwent Lichtenstein repair of the hernia with appendectomy. On follow up he was referred to infectious disease clinic, and the post-operative course was uneventful.
Conclusions:
Intraoperative identification of non-typical hernia sac before its opening should alert the surgeon to the possibility of sliding hernia and the presence of an organ as a part of the sac. Rare causes of appendicular masses like schistosomiasis granuloma should be considered in endemic areas or immigrants from these areas, despite the difficulty of preoperative diagnosis. Management should follow general guidelines of appendectomy, hernia repair and dealing with the associated pathology if present.
Iselin Disease With a Rare Presentation in an Elderly Patient: A Case Report
Authors: Nibras K Aljabri, Turki H Alhassani, Atif A Labban, Abdullah H Alsawaf, Khalid A Alnofeay
Journal: Cureus (2023)
Keywords: elderly onset, foot injuries, iselin’s disease, ortho surgery, traction apophysitis
MeSH terms: Case Reports

We report the case of a 55-year-old female with a rare presentation and different pathophysiology of Iselin's disease. Iselin's disease is a rare condition caused by traction apophysitis of the peroneus brevis tendon at the base of the fifth metatarsal bone. It is usually a case in the adolescent age group due to their repetitive use of the peroneus tendon in daily activities, but not in the elderly group. This type of apophysitis is rare and easily missed or misdiagnosed as a fracture in the base of the fifth metatarsal bone. However, a simple radiographic image can confirm the diagnosis. In this case, we aim to raise awareness of Iselin's disease for better comprehension of the clinical presentation, differential diagnosis, radiological features, management, and prognosis of Iselin's disease.
Case report: an unrecognized etiology of transient gallbladder pain in heart failure diagnosed with internist-performed point-of-care ultrasound
Authors: Christine N Desautels, David M Tierney, Federico Rossi, Terry K Rosborough
Journal: Crit Ultrasound J (2015)
Keywords: cholecystalgia, cholecystitis, gallbladder, heart failure, point-of-care ultrasound

The excellent sensitivity and specificity of right upper quadrant (RUQ) ultrasound for gallbladder pathology in patients with abdominal pain is heavily relied upon in routine diagnostic evaluation. The hour-to-hour timing of this test in a patient with fluctuating symptoms is not widely recognized as having a significant impact on its sensitivity. However, we present a case report describing the essential role of symptom-timed point-of-care ultrasound in making an elusive diagnosis of transient cholecystalgia in a patient with RUQ pain and congestive heart failure (CHF). This case also demonstrates an important etiology of RUQ pain in patients with CHF beyond that of congestive hepatopathy. A review of the related entities of acalculous cholecystitis, congestive hepatopathy, and diffuse gallbladder wall thickening is provided.
Antithrombotic Dilemmas after Left Atrial Appendage Occlusion Watchman Device Placement
Authors: Tania Ahuja, Scarlett Murphy, Daniel J Sartori
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Antithrombotic therapy for stroke prevention in patients with atrial fibrillation (AF) has dramatically shifted from warfarin, a vitamin K antagonist, to the direct oral anticoagulants (DOACs) such as dabigatran, apixaban, and rivaroxaban. In patients with contraindications to oral anticoagulation, left atrial appendage occlusion (LAAO) devices, such as the Watchman™ device, may be considered; however, temporary postimplantation antithrombotic therapy is still a recommended practice. We present a case of complex antithrombotic management, post LAAO device implantation, designed to avoid drug interactions with concomitant rifampin use and remained necessary secondary to subsequent device leak. This case highlights the challenges of antithrombotic therapy post LAAO device placement in a complex, but representative, patient.