OpenMed/multicare-articles huggingface dataset:
First successful treatment of Clostridium perfringens-associated emphysematous hepatitis: a case report
Authors: Christian Bayerl, Ann-Kathrin Berg, Stefan Angermair, Damon Kim, Bernd Hamm, Katharina Beyer, Christian Schineis
Journal: Front Med (Lausanne) (2023)
Keywords: clostridium perfringens, case report, computed tomography, emphysematous hepatitis, liver resection, septic shock
MeSH terms: Case Reports

Emphysematous diseases of the abdomen are rare with an often inconspicuous presentation of symptoms and rapid lethal outcome if untreated. We report the first successfully treated case of Clostridium perfringens-associated emphysematous hepatitis. In the emergency room, a 79-year-old man presented with shortness of breath and deteriorated general condition since the morning of admission. Initial CT scans showed a small but rapidly expanding gas collection in liver segment 6. Emergency surgery with atypical liver resection was performed immediately. With early resection and prolonged administration of antibiotics in the presence of sepsis, the patient recovered successfully and was discharged 37 days after admission. As in our case, prompt diagnosis with early surgical treatment is crucial for the management of emphysematous hepatitis.
Acute Stroke and Limb Ischemia Secondary to Catastrophic Massive Intracardiac Thrombus in a 40-Year-Old Patient With Dilated Cardiomyopathy
Authors: Gi Jung Jeon, Bong Gun Song, Yong Hwan Park, Gu Hyun Kang, Woo Jung Chun, Ju Hyeon Oh
Journal: Cardiol Res (2012)
Keywords: dilated cardiomypathy, echocardiography, thromboembolism, thrombus
MeSH terms: Case Reports

Dilated cardiomyopathy has been associated with left ventricular (LV) thrombosis which leads to substantial morbidity and mortality as a site for systemic emboli. We report an interesting case of a stroke and acute limb ischemia secondary to a large mobile pedunculated LV thrombus in 40-year-old patient with dilated cardiomyopathy.
Methemoglobinemia and Delayed Encephalopathy After 5-Bromo-2-Nitropyridine Poisoning: A Rare Case Report
Authors: Longke Shi, Guangcai Yu, Liwen Zhao, Zixin Wen, Yaqian Li, Baotian Kan, Xiangdong Jian
Journal: Front Public Health (2022)
Keywords: 5-bromo-2-nitropyridine, acute renal failure, hemolytic anemia, methemoglobinemia, rhabdomyolysis, toxic encephalopathy
MeSH terms: Anemia, Hemolytic / therapy, Brain Diseases, Methemoglobinemia / chemically induced, Methemoglobinemia / diagnosis, Methemoglobinemia / therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Humans, Male, Pyridines, 5-bromo-2-nitropyridine, Pyridines

5-bromo-2-nitropyridine, an intermediate in the synthesis of pharmaceutical and pesticide products, is toxic to the human body. However, 5-bromo-2-nitropyridine poisoning has not been previously reported. Here, we report the case of a 40-year-old man who suffered skin and respiratory tract exposure to leaked 5-Bromo-2-nitropyridine at work. After exposure, the patient rapidly developed dizziness, fatigue, nausea, vomiting, chest distress, diffuse cyanosis, and coma. Methemoglobinemia, hemolytic anemia, rhabdomyolysis, and acute renal failure were observed after admission. He improved markedly after treatment, but delayed encephalopathy was confirmed 82 days after the exposure. This case highlights that 5-bromo-2-nitropyridine can be absorbed through the skin and respiratory tract, resulting in methemoglobinemia and delayed encephalopathy.
Laparoscopic Management of Mechanical Small Bowel Obstruction Secondary to Meckel's Diverticulum with a Double Basis. A Rare Anatomic Presentation
Authors: Aurora Mariani, Mohammed Siddiqui, Nicolas Boulard, Dominique Berrebi, Arnaud Bonnard
Journal: European J Pediatr Surg Rep (2020)
Keywords: meckel's diverticulum, intestinal obstruction, laparoscopy, minimal invasive surgery, omphalomesenteric duct
MeSH terms: Case Reports

Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. Intestinal occlusion due to MD is a commonly observed consequence of intussusception or volvulus. Here, we report a case of an 11-year-old boy who presented to the emergency department with acute abdominal pain, bilious vomiting, and abdominal rebound tenderness. Computed tomography scan concluded a diagnosis of intestinal occlusion with no apparent cause. The patient was submitted to diagnostic laparoscopy, and mechanical occlusion by the permeable Meckel with double base was identified. A diverticulectomy by staplers was performed, and occlusion was alleviated. MD is a rare disease (for only 0.3-2.9% of the general population), and only 4.2 to 9% of patients diagnosed with MD have associated complications. MD can be a large base or a narrow base, with a mesodiverticular band but the diverticulum is usually a blind recess. In our case, the tube connected two intestinal segments. To the best of our knowledge, we have reported the first case of an MD-like permeable tube with a double basis.
Spermatic cord anastomosing hemangioma mimicking a malignant inguinal tumor: A case report and literature review
Authors: Zhan-Yi Zhang, Peng Hong, Shao-Hui Deng, Shi-Ying Tang, Zhuo Liu, Hui-Ying He, Lu-Lin Ma, Shu-Dong Zhang, Xiao-Jun Tian
Journal: Front Surg (2022)
Keywords: hemangioma, hemangiosarcoma, nerve sheath neoplasms, spermatic cord, urogenital neoplasms
MeSH terms: Case Reports

Background:
Anastomosing hemangioma (AH) is a rare vascular tumor and occurs in various organs. It is difficult to distinguish AH from malignant tumors even through multimodal imaging examination. AH located in the inguinal region is even rare. We present the diagnosis and treatment of a patient with spermatic cord AH in detail and conduct a literature review.
Case report:
An 84-year-old Chinese man had swelling pain in his right scrotum. A hard and fixed mass was palpable in the right inguinal region. Preoperative radiological examination considered it a neurogenic or vascular tumor. Malignant soft tissue sarcoma could not be excluded. He underwent radical inguinal right orchiectomy under intraspinal anesthesia. The diagnosis of spermatic cord AH was confirmed by pathological examination. The patient recovered uneventfully and remained disease-free during an 18-month follow-up.
Conclusion:
Spermatic cord AH is quite rare and could be misdiagnosed as a malignant tumor. Pathological evidence might be necessary. The optimal choice of treatment should be determined through a comprehensive assessment of both tumor and patient factors.
A game theoretic framework for analyzing re-identification risk
Authors: Zhiyu Wan, Yevgeniy Vorobeychik, Weiyi Xia, Ellen Wright Clayton, Murat Kantarcioglu, Ranjit Ganta, Raymond Heatherly, Bradley A Malin
Journal: PLoS One (2015)
MeSH terms: Models, Theoretical, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S., Databases, Factual, Health Insurance Portability and Accountability Act, Humans, Information Dissemination, Privacy, Risk, Search Engine, United States

Given the potential wealth of insights in personal data the big databases can provide, many organizations aim to share data while protecting privacy by sharing de-identified data, but are concerned because various demonstrations show such data can be re-identified. Yet these investigations focus on how attacks can be perpetrated, not the likelihood they will be realized. This paper introduces a game theoretic framework that enables a publisher to balance re-identification risk with the value of sharing data, leveraging a natural assumption that a recipient only attempts re-identification if its potential gains outweigh the costs. We apply the framework to a real case study, where the value of the data to the publisher is the actual grant funding dollar amounts from a national sponsor and the re-identification gain of the recipient is the fine paid to a regulator for violation of federal privacy rules. There are three notable findings: 1) it is possible to achieve zero risk, in that the recipient never gains from re-identification, while sharing almost as much data as the optimal solution that allows for a small amount of risk; 2) the zero-risk solution enables sharing much more data than a commonly invoked de-identification policy of the U.S. Health Insurance Portability and Accountability Act (HIPAA); and 3) a sensitivity analysis demonstrates these findings are robust to order-of-magnitude changes in player losses and gains. In combination, these findings provide support that such a framework can enable pragmatic policy decisions about de-identified data sharing.
Case Report: The Neuromusclar Triad of Immune Checkpoint Inhibitors: A Case Report of Myositis, Myocarditis, and Myasthenia Gravis Overlap Following Toripalimab Treatment
Authors: Yue-Bei Luo, Weiting Tang, Qiuming Zeng, Weiwei Duan, Shuyu Li, Xiaosu Yang, Fangfang Bi
Journal: Front Cardiovasc Med (2021)
Keywords: pd-1, myasthenia gravis, myocarditis, myositis, toripalimab
MeSH terms: Case Reports

The neuromuscular adverse events of immune checkpoint inhibitor (ICI) treatment include myositis, polymyalgia rheumatica, myocarditis, and myasthenia syndrome. We report a 47-year old female presenting with external ophthalmoplegia, generalized muscle weakness, and third-degree atrioventricular block 4 weeks after toripalimab treatment for metastatic thymoma. Creatine kinase was elevated to 25,200 U/l and cardiac troponin I to 2.796 ng/ml. Autoantibody profiling shows positive anti-ryanodine receptor and anti-acetylcholine receptor antibodies and negative myositis specific antibodies. Repetitive nerve stimulation did not reveal decrement of compound muscle action potentials. Pulse methylprednisolone and immunoglobulin infusion, together with temporary pacemaker insertion normalized her muscle enzyme levels and cardiac rhythm. This is the first report of overlaping neuromuscular adverse event of toripalimab.
Ten-Year Follow-Up of Desarthrodesis of the Knee Joint 41 Years after Original Arthrodesis for a Bone Tumor
Authors: Ahmed Hamed Kassem Abdelaal, Norio Yamamoto, Katsuhiro Hayashi, Akihiko Takeuchi, Shinji Miwa, Hiroyuki Inatani, Hiroyuki Tsuchiya
Journal: Case Rep Orthop (2015)

Introduction. The main indication for knee arthrodesis in tumor surgery is a tumor that requires an extensive resection in which the joint surface cannot be preserved. We report a patient that had knee desarthrodesis 41 years after giant cell tumor resection followed by a knee arthrodesis. This is the longest reported follow-up after desarthrodesis and conversion to total knee arthroplasty (TKA), almost ten years. Case Report. A 71-year-old man with a distal femoral giant cell tumor had undergone a resection of the distal femur and knee arthrodesis using Kuntscher nail in 1962. In July 2003 he experienced gradually increasing pain of his left knee. We performed a desarthrodesis and conversion to TKA in 2005. The postoperative period passed uneventfully as his pain and gait improved, with gradually increasing range of motion (ROM) and no infection. He now walks independently, with no brace or contractures. Conclusion. Desarthrodesis of the knee joint and conversion to TKA are a difficult surgical choice with a high complication risk. However, our patient's life style has improved, he has no pain, and he can ascend and descend stairs more easily. The surgeon has to be very meticulous in selecting a patient for knee arthrodesis and counseling them to realize that their expectations may not be achievable.
A Case of Prostatic Carcinoma Manifesting as Cutaneous Facial Nodule
Authors: Israel Antonio Esquivel-Pinto, Bertha Torres-Alvarez, Ramiro Jetzabel Gómez-Villa, Juan Pablo Castanedo-Cázares
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Prostate cancer is the second most frequently diagnosed cancer worldwide and the fifth most common cause of cancer deaths among men. Cutaneous metastasis is an uncommon phenomenon in prostatic cancer, occurring in 0.06-0.3% of cases. Case Presentation. A 56-year-old man presented to our outpatient clinic with a one-month history of a 1.5 cm in diameter, solitary, asymptomatic, purple nodule located on his upper right cheek. After biopsy, prostatic cancer metastasis was diagnosed. Discussion. A literature review revealed 59 articles documenting 71 cases of this diagnosis. The review recorded epidemiological data, including age, duration, morphology, location, and outcome of patients. Conclusions. The skin is an uncommon site for metastasis of prostate cancer, and the review showed that its presence is associated with a poor prognosis (approximately 10 months from diagnosis).
Osteosarcomatous Transformation in the Setting of Mazabraud's Syndrome: A Case Report and Review of the Literature
Authors: Iqbal Multani, Snezana Popovic, Naveen Parasu, Michelle Ghert
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Introduction:
Mazabraud's Syndrome is a rare condition that is defined by the presence of fibrous dysplasia lesions in the bone and intramuscular myxomas in the soft tissue. Malignant transformation, in the setting of Mazabraud's Syndrome, of the fibrous dysplasia lesions into a sarcomatous neoplasm occurs in less than 1% of cases-with only six previously reported cases.
Case presentation:
Here, we present a 62-year-old Caucasian female who developed an osteosarcoma in a fibrous dysplasia lesion of the proximal femur in the background of Mazabraud's Syndrome. The patient was treated with wide excision and endoprosthetic reconstruction. She declined adjuvant chemotherapy. She is alive without evidence of disease one-year postoperatively.
Conclusion:
Patients with Mazabraud's Syndrome remain at low risk for malignant transformation. However, close monitoring of asymptomatic patients with this condition for radiographic changes in their lesions and/or clinical symptoms is recommended.
Limb-Girdle Muscular Dystrophies (LGMDs): The Clinical Application of NGS Analysis, a Family Case Report
Authors: Claudia Strafella, Giulia Campoli, Rosaria Maria Galota, Valerio Caputo, Giulia Pagliaroli, Stefania Carboni, Stefania Zampatti, Cristina Peconi, Julia Mela, Cristina Sancricca, Guido Primiano, Giulietta Minozzi, Serenella Servidei, Raffaella Cascella, Emiliano Giardina
Journal: Front Neurol (2019)
Keywords: capn3, lgmds, lmna, ngs panel, calpainopathy, cardiovascular disease, familial investigation
MeSH terms: Case Reports

The diagnosis of LGMD2A (calpainopathy) can be challenging due to genetic heterogeneity and to high similarity with other LGMDs or neuromuscular disorders. In this setting, NGS panels are highly recommended to perform differential diagnosis, identify new causative mutations and enable genotype-phenotype correlations. In this manuscript, the case of a patient affected by LGMD2A is reported, for which the application of a defined custom designed NGS panel allowed to confirm the diagnosis of calpainopathy linked with two heterozygous variants in CAPN3, namely c.550delA and c.1813G>C. The first variant has been extensively described in relation to calpainopathy. The second variant c.1813G>C, instead, is novel and has been predicted to be probably damaging. In addition, NGS analysis on the proband revealed a heterozygous variant (c.550C>T) in the LMNA gene, which is associated with dilated cardiomyopathy. The variant is novel and has been predicted to be deleterious by subsequent bioinformatic analysis. Successively, segregation analysis was performed on family members. Interestingly, none of them showed neuromuscular symptoms but the mother was diagnosed with bradycardia and syncopal episodes and showed a positive family history for cardiomyopathy. The segregation analysis reported that the proband inherited the c.1813G>C (CAPN3) from the father who was a healthy carrier. The mother was positive for c.550delA (CAPN3) and c.550C>T (LMNA), suggesting thereby a possible genetic explanation for her cardiovascular problems. Segregation analysis, therefore, confirmed the inheritance pattern of the variants carried by the proband and highlighted a familiarity for cardiomyopathy which should not be neglected. The NGS analysis was further performed on the partner of the proband, to estimate the reproductive risk of the couple. The partner was negative to NGS screening, suggesting thereby a low risk to have an affected child with calpainopathy and 50% probability to inherit the LMNA variant. This case report showed the clinical utility of the NGS panel in providing accurate LGMD2A diagnosis and identifying complex phenotypes originating from mutations in multiple genes. However, NGS results should always be accomplished by a dedicated genetic counseling, not only to evaluate the recurrence and reproductive risks but also to uncover unexpected findings which can be clinically significant.
Clozapine-induced myocarditis: is mandatory monitoring warranted for its early recognition?
Authors: T A Munshi, D Volochniouk, T Hassan, N Mazhar
Journal: Case Rep Psychiatry (2014)

Clozapine is an atypical antipsychotic used for treatment resistant schizophrenia. Its potential to induce agranulocytosis is well known but it can also cause myocarditis. Clozapine is the only antipsychotic known to induce this side effect, typically early in the treatment, and literature is scarce on this condition. We are presenting a case report of a 21-year-old schizophrenic male who developed myocarditis within 3 weeks of starting on clozapine for his treatment resistant psychosis. We then aim to review some of the available literature and raise awareness among physicians as this condition can potentially be fatal if not detected early.
Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock
Authors: Heinz Steltzer, Alexander Grieb, Karim Mostafa, Reinhard Berger
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Severe trauma associated with later disability and mortality still constitutes a major health and socioeconomic problem throughout the world. While primary morbidity and mortality are mostly related to initial injuries and early complications, secondary lethality is strongly linked to the development of systemic inflammatory response syndrome, sepsis, and ultimately multiple organ dysfunction syndrome. We herein report on a 49-year-old male patient who was admitted to the hospital after a traumatic amputation of his right forearm that was cut off while working on a landfill. After initial treatment for shock, he received immediate replantation and was transferred to the ICU. Due to the anticipated risk of a complex infection, continuous renal replacement therapy in combination with CytoSorb was initiated. During the course of the combined treatment, a rapid improvement in hemodynamics was noticed, as well as a significant reduction of IL-6 and lactate levels. Despite a recurring septic episode and the necessity for amputation, the patient clinically stabilized and underwent complete recovery. The early treatment with a combination of CVVHDF and CytoSorb was accompanied by an attenuation of the systemic inflammatory reaction, which subsided without major or permanent organ damage, despite the impressive pathogen spectrum and the pronounced local damage.
Marked improvement of neuropsychiatric symptoms following control of allergy symptoms with the use of humanized murine anti-IgE antibody (omalizumab) in 2 patients with severely limited expressive language
Authors: Harumi Jyonouchi
Journal: Allergy Asthma Clin Immunol (2015)
Keywords: allergic rhinitis, limited expressive language (lel), neuropsychiatric symptoms
MeSH terms: Case Reports

Flare-up of allergic rhinitis has been implicated in worsening neuropsychiatric symptoms such as hyperactivity and anxiety in the general population, mostly supported by epidemiological data. However, it is unknown how such respiratory allergy symptoms affect behavioral symptoms in patients with intellectual disability and limited expressive language. These patients may express more severe behavioral symptoms partly due to frustration and anxiety, being under-diagnosed and undertreated secondary to a lack of proper communication means. Herein, we present two cases of patients with severely limited expressive language , in whom we observed marked improvement in behavioral symptoms and even cognitive activity following control of their symptoms of allergic rhinitis with the use of omalizmab, a humanized anti-IgE antibody. The presented cases indicate that clinicians need to be aware of profound effects of allergy rhinitis on neuropsychiatric symptoms in individuals with limited expressive language.
Multisystem Myotilinopathy, including Myopathy and Left Ventricular Noncompaction, due to the MYOT Variant c.179C>T
Authors: Josef Finsterer, Claudia Stöllberger, Matthias Hasun, Korbinian Riedhammer, Mathias Wagner
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Left ventricular hypertrabeculation/noncompaction is a myocardial abnormality of unknown etiology/pathogenesis, which is frequently associated with neuromuscular disorders or chromosomal defects. LVHT in association with a MYOT mutation has not been reported. The patient is a 72-year-old male with a history of strabismus in childhood, asymptomatic creatine-kinase elevation since age 42 years, slowly progressive lower limb weakness since age 60 years, slowly progressive dysarthria and dysphagia since age 62 years, and recurrent episodes of arthralgias and myalgias since age 71 years. He also had arterial hypertension, diverticulosis, hyperlipidemia, coronary heart disease, and a hiatal hernia with reflux esophagitis. Clinical exam revealed mild quadruparesis and proximal wasting of the legs. Whole exome sequencing revealed a known variant in the MYOT gene. Muscle biopsy, previously assessed as inclusion body myopathy, was compatible with the genotype after revision. Cardiologic work-up revealed a left anterior hemiblock, mild myocardial thickening, and noncompaction. This case shows that myotilinopathy may manifest as a multisystem disease, including noncompaction.
Case report: A unusual case of delayed propionic acidemia complicated with subdural hematoma
Authors: Zongzhi Jiang, Yuxin Fu, Xiaojing Wei, Ziyi Wang, Xuefan Yu
Journal: Front Neurol (2022)
Keywords: clinical exome sequencing, late-onset, muscular pathology, propionic acidemia, subdural hematoma
MeSH terms: Case Reports

Background:
Propionic acidemia (PA) is an inherited autosomal recessive metabolic disorder that is classified as early-onset or late-onset, depending on the onset time of clinical symptoms. It clinically manifests as numerous lesions in the brain, pancreas, liver, and muscle. Muscle biopsies show myopathic changes, which help to distinguish late-onset propionic acidemia from other metabolic diseases involving muscles.
Case presentation:
A 19-year-old Chinese girl was admitted to the hospital because of poor eating and fatigue. Head magnetic resonance imaging suggested metabolic diseases, and we administered symptomatic support treatment. Her symptoms gradually worsened, and she began to show convulsions and disturbances of consciousness. Muscle pathology showed myopathy-like changes. The presence of organic acids in the blood and urine suggested PA. Genetic analyses identified two compound heterozygous mutations in the patient's PCCB gene, confirming the diagnosis of delayed PA.
Conclusions:
The muscle pathological examination of late-onset PA provides valuable information that is helpful for distinguishing delayed-onset PA from metabolic diseases. In the absence of a history of trauma, subdural hematoma may be a very rare complication of late-onset PA and can be regarded as a poor prognostic sign; therefore, it is suggested to perform head computed tomography as part of the routine neurological evaluation of PA patients.