OpenMed/multicare-articles huggingface dataset:
Late-Onset Ictal Asystole and Falls Related to Severe Coronary Artery Stenosis: A Case Report
Authors: Francesco Fortunato, Angelo Labate, Michele Trimboli, Carmen Spaccarotella, Ciro Indolfi, Antonio Gambardella
Journal: Front Neurol (2022)
Keywords: sudep, cardiac arrhythmia, ictal asystole, ischemic heart, seizure
MeSH terms: Case Reports

Introduction: Ictal asystole (IA) is a rare, underestimated, and life-threatening cause of transient loss of consciousness and fall. Current treatment options for seizures associated with IA usually include cardiac pacemaker implantation. We report, for the first time, a case of IA that is related to coronary stenosis, which was resolved after coronary angioplasty. Case Presentation: A 73-year-old man had a 2-year history of focal seizures with impaired awareness. Three months before our observation, he started to have sudden falls resulting in injury on several occasions. General and neurological examinations, as well as brain MRI, were unremarkable. Interictal electroencephalography (EEG) showed bitemporal spiking. Ictal video-polygraphy revealed a diffuse electrodecrement, followed by a buildup of rhythmic 4-6 Hz sharp activity, which was more evident in the left temporal region. After the seizure onset, the ECG showed sinus bradycardia, followed by sinus arrest that was associated with the patient's fall from the standing position. Afterwards, sinus rhythm returned spontaneously. A diagnosis of IA was made. A comprehensive cardiologic evaluation revealed a sub-occlusive stenosis of the left anterior descending artery. Successful coronary angioplasty resolved IA, levetiracetam was added, and no seizure or fall has occurred in the following 20 months. Moreover, he underwent a 7-day Holter ECG monitoring, and no asystole was depicted. Conclusion: The present case was unique as it shows the potential association between IA and coronary stenosis, also suggesting a possible therapeutic role for coronary angioplasty. It also highlights the importance of carefully investigating epilepsy patients with falls, especially in the elderly, since IA-related falls can be easily misdiagnosed in older age. Thus, if IA is identified, a deeper cardiac evaluation should be considered. As seen in our patient, non-invasive diagnostic examination including routine, prolonged, and exercise ECG, as well as echocardiogram, were readily available and were informative in diagnosing cardiac abnormalities that are amenable to specific treatment.
Herbal Supplement-Induced Liver Injury: A Case Report
Authors: Haidar Khan, Jonathan Vincent M Reyes, Tasur Seen, Branden Irefej, Saad Ahmad
Journal: Cureus (2023)
Keywords: drug-induced liver injury (dili), hepatitis, herbal medications, herbal supplements, herbal-induced liver injury (hili), liver damage
MeSH terms: Case Reports

We present the case of a 45-year-old woman who arrived at the emergency department complaining of sudden epigastric pain. An inpatient evaluation revealed no evidence of viral or immunologic infection. Additionally, imaging did not elicit a clear cause for the patient's symptoms. Further examination revealed that the patient had recently begun using a herbal tea and that symptoms had completely resolved after discontinuation. Though rare, hepatotoxicity secondary to herbal supplement ingestion, or herbal supplement-induced liver injury, or HILI, should be considered in all patients presenting with abnormal liver function tests.
Herlyn-Werner-Wunderlich syndrome: Diagnosis and treatment of an atypical case and review of literature
Authors: Camila Girardi Fachin, João Lucas Aleixes Sampaio Rocha, Amanda Atuati Maltoni, Raquel Lins das Chagas Lima, Vitória Arias Zendim, Miguel Angelo Agulham, Alina Tsouristakis, André Ivan Bradley Dos Santos Dias
Journal: Int J Surg Case Rep (2019)
Keywords: case report, hemi-hysterectomy, herlyn-werner-wunderlich syndrome, müllerian ducts abnormalities, ohvira syndrome, renal agenesis

Introduction:
Herlyn-Werner-Wunderlich syndrome (HWWS), also known as OHVIRA syndrome, is a rare congenital abnormality of Müllerian duct development characterized by uterus didelphys, unilateral blind hemivagina, and ipsilateral renal agenesis.
Presentation of case:
In this report, the authors present the case of a 12-year-old patient presenting with progressive and disabling abdominal pain after the onset of menarche diagnosed with HWWS, describe the various diagnostic modalities and treatment options available, along with a current review of the literature.
Discussion:
With normal external genitalia, HWWS is usually asymptomatic until menarche when patients present with worsening abdominal pain during menses and a palpable pelvic or abdominal mass. Untreated, HWWS may lead to a number of complications including endometriosis, infertility, and spontaneous abortion.
Conclusion:
Greater awareness of HWWS will lead to earlier detection and is the key to alleviating patient suffering and avoiding potentially severe complications.
A Multi-facetted Visual Analytics Tool for Exploratory Analysis of Human Brain and Function Datasets
Authors: Diego A Angulo, Cyril Schneider, James H Oliver, Nathalie Charpak, Jose T Hernandez
Journal: Front Neuroinform (2016)
Keywords: mri, cohort studies, exploratory analysis, fmri, python, tractography, visual analytics

Brain research typically requires large amounts of data from different sources, and often of different nature. The use of different software tools adapted to the nature of each data source can make research work cumbersome and time consuming. It follows that data is not often used to its fullest potential thus limiting exploratory analysis. This paper presents an ancillary software tool called BRAVIZ that integrates interactive visualization with real-time statistical analyses, facilitating access to multi-facetted neuroscience data and automating many cumbersome and error-prone tasks required to explore such data. Rather than relying on abstract numerical indicators, BRAVIZ emphasizes brain images as the main object of the analysis process of individuals or groups. BRAVIZ facilitates exploration of trends or relationships to gain an integrated view of the phenomena studied, thus motivating discovery of new hypotheses. A case study is presented that incorporates brain structure and function outcomes together with different types of clinical data.
Case Report: A Rare Syncope Case Caused by Abernethy II and a Review of the Literature
Authors: Xue-Qin Lin, Jing-Yi Rao, Yi-Fei Xiang, Li-Wei Zhang, Xiao-Ling Cai, Yan-Song Guo, Kai-Yang Lin
Journal: Front Cardiovasc Med (2022)
Keywords: abernethy malformation, congenital extrahepatic portosystemic shunt, jaundice, pulmonary arterial hypertension, syncope
MeSH terms: Case Reports

Background: Abernethy malformation is an extremely rare anomaly of the splanchnic venous system, and only 2 cases that manifested as syncope had been reported previously. Case Presentation: A 24-year-old male had a 15-year history of jaundice and was in long-term use of hepatoprotective drugs. He was admitted for complaint of syncope. He underwent a series of examinations and cardiac ultrasound showed that his pulmonary artery pressure was elevated. Further imaging revealed the absence of intrahepatic portal veins. His blood ammonia was significantly increased. All signs and symptoms pointed to an Abernethy diagnosis. He was finally diagnosed as having Abernethy type II. He was discharged after 17 days of in-hospital treatment with sildenafil (50 mg/day) and ornithine aspartate (20 g/day). Conclusion: We now report this rare case of syncope that is caused by Abernethy malformation. As a typically pediatric disease, it was not identified in this patient until adulthood due to long-term treatment for jaundice and liver cirrhosis. Furthermore, we present a review of portosystemic shunts previously reported in the literature.
Ligneous Periodontitis in a Patient with Type 1 Plasminogen Deficiency: A Case Report and Review of the Literature
Authors: Arun Sadasivan, Roshni Ramesh, Deepu George Mathew
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Background:
Ligneous periodontitis or destructive membranous periodontal disease is a rare condition involving gingival tissues, which is due to plasminogen deficiency and fibrin deposition. Plasminogen deficiency is an ultrarare autosomal recessive disease. The disease is characterized by gingival enlargement and periodontal tissue destruction that leads to rapid tooth loss despite treatment attempts. A defect in fibrinolysis and abnormal wound healing are the main pathogenesis of this condition. It is caused by mutations in PLG, the gene coding for plasminogen, which results in decreased levels and functional activity. Case Presentation. In this case report, clinical and histopathological findings of a 26-year-old male patient who presented with generalized membranous gingival enlargement are presented. He was the third child of consanguineous parents and had multicystic congenital hydrocephalus at birth. Besides the gingival enlargement, he also presented ligneous conjunctivitis since childhood. The intraoral examination revealed generalized periodontal breakdown. Radiographs showed alveolar bone loss present in every quadrant. All blood investigations were normal except for plasminogen deficiency. A biopsy sample was excised from affected gingiva and a series of histopathological evaluation was performed. Based on clinical and histopathological evidence, a diagnosis of destructive membranous periodontal disease or ligneous periodontitis was made. A clinical exome assay for the PLG gene was also done. It was confirmed as Type 1 plasminogen deficiency.
Conclusion:
Ligneous periodontitis has been rarely reported in India. The reasons could be because of the rarity of the disease or missed diagnosis. The need to take a proper history and perform a proper clinical examination and histopathologic evaluation has to be stressed when diagnosing and treating gingival enlargements. If a genetic condition is suspected, genetic screening is also needed. All these will help the clinician in correctly diagnosing the disease and formulating a proper treatment plan for managing the condition.
Cystadenocarcinoma of the parotid: case report of a BRAF inhibitor treatment
Authors: Sabrina Boyrie, Isabelle Fauquet, Michel Rives, Caroline Genebes, Jean-Pierre Delord
Journal: Springerplus (2013)

Background:
Mutations of the proto-oncogene BRAF have been described in many cancers. Mutated BRAF causes overactive downstream signaling via MEK and ERK leading to excessive cell proliferation and survival. Their identification is of real interest because specific inhibitors have been developed.
Methods and results:
We report the case of a patient with an aggressive cystadenocarcinoma of the parotid with synchronous metastases. Cisplatine/5FU chemotherapy associated with palliative radiation therapy was used first without any efficency nor clinical improvement. A molecular analysis revealed a BRAF mutation. A compassionate treatment with a BRAF inhibitor showed very good results from the first month. The patient reported real improvement in clinical condition and pain. From an imaging point of view, computed tomographies reported a complete response on mediastinal lymph nodes and regeneration on bone metastases.
Conclusion:
This first report suggests BRAF could be a potent oncogenic driver in salivary gland carcinoma. It deserves a multicenter academic prospective trial to provide proof of efficiency with BRAF inhibitors in theses tumors.
Optic Coherence Tomography Angiography Findings of Bilateral Choroidal Neovascularization Associated with Optic Disc Drusen Treated with Intravitreal Aflibercept Injection
Authors: Melih Akıdan, Mehmet Bulut, Lütfiye Yaprak, Muhammet Kazım Erol, Elcin Suren
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Purpose:
The purpose of this case report is to present the findings of optical coherence tomography angiography (OCTA) of a patient with bilateral choroidal neovascularization (CNV) associated with optic disc drusen (ODD), who was treated with intravitreal aflibercept injection. Case presentation. A 14-year-old girl presented with a complaint of visual loss and metamorphopsia in her both eyes. Best-corrected visual acuity (BCVA) was 20/32 and 20/25, respectively, in the right and left eyes. Intraocular pressure and anterior segment examination were normal. Dilated fundus examination revealed elevated optic discs with blurred margins in both eyes. In addition, slightly elevated yellow lesion extending from optic nerve head to the macula was observed bilaterally. The patient underwent imaging with colour fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), spectral-domain optic coherence tomography (SD-OCT), OCTA, orbital ultrasonography (USG), and computed tomography (CT). In particular, OCTA demonstrated clearly the large circular CNV complex in the right eye and the CNV structure in the left eye containing slightly activated main trunk and minimal vessel loops in the papillomacular region. CNV secondary to bilateral ODD was suspected. Intravitreal aflibercept injections were performed in 3 doses to the right eye and a single dose to the left eye. After the injections, BCVA reached its complete level in both eyes. SD-OCT revealed irregularity of RPE in the temporal region of the optic disc and complete regression of the subretinal fluid. Interestingly, the entire CNV complex including the main trunk completely disappeared in OCTA. CNV complex was not observed in OCTA during 1-year follow-up, and peripapillary and macular vascular density measurements did not show any significant change. BCVA was preserved, and no additional injections were needed.
Conclusion:
It is possible that OCTA can be used for detailed evaluation of CNV associated with ODD, response to anti-VEGF treatment, and peripapillary and macular vascular density. There is a need for further studies to confirm the changes such as disappearance of CNV in OCTA after injection as we observed in our patient.
Moving robotics competitions virtual: The case study of RoboCupJunior Soccer Simulation (SoccerSim)
Authors: Felipe N Martins, Adrián Matejov, Marek Šuppa
Journal: Front Robot AI (2022)
Keywords: covid-19 pandemic, robocup, robocupjunior soccer, soccersim, educational robotics, robot simulation, robot soccer, robotics competitions

For almost 25 years, the goal of the RoboCup has been to build soccer robots capable of winning against the FIFA World Champion of 2050. To foster the participation of the next generation of roboticists, the RoboCupJunior competition takes place in parallel and provides a similar challenge of appropriate difficulty for high school students. RoboCupJunior has three main categories: Soccer, Rescue and OnStage. For the Soccer category, participants need to design, build and program a team of autonomous robots to play soccer against an opponent team of robots. The competition is physical in nature, since it assumes physical robots playing against one another. In 2020 and 2021, the COVID-19 pandemic has made it difficult for a competition of this type to take place, due to obvious restrictions on physical gatherings. To allow for some sort of participation, and inspired by positive experience of the larger RoboCup community, the Organizing Committee of RoboCupJunior Soccer has explored porting a portion of the challenge to a simulated environment. Many of the existing environments, however, are built for higher education/research teams competitions or research, making them complex to deploy and generally unsuitable for high school students. In this paper we present the development of SoccerSim, a simulated environment for RoboCupJunior Soccer, based on the Webots open-source robotics simulator. We also discuss how the participation of students was key for its development and present a summary of the competition rules. We further describe the case study of utilizing SoccerSim first as a testbed for a Demo competition, and later as part of RoboCup Worldwide 2021. The participation of more than 60 teams from over 20 countries suggests that SoccerSim provides an affordable alternative to physical robotics platforms, while being stable enough to support a diverse userbase. The experience of using SoccerSim at RoboCupJunior Worldwide 2021 suggests that a simulated environment significantly lowers the barrier to entry, as evidenced by the participation of many teams that have not participated before. To make it easy for similar competitions to take place in the future, we made the code of SoccerSim available as open-source, as well as the associated tooling required for using it in a tournament.
Drug-Induced Liver Injury Caused by Kratom Use as an Alternative Pain Treatment Amid an Ongoing Opioid Epidemic
Authors: Caroline Stokes Osborne, Amanda N Overstreet, Don C Rockey, Andrew D Schreiner
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: dili, acute liver injury, kratom, opioid epidemic
MeSH terms: Analgesics, Opioid / adverse effects, Chemical and Drug Induced Liver Injury / etiology, Mitragyna / chemistry, Plant Extracts / adverse effects, Case Reports, Research Support, N.I.H., Extramural, Chemical and Drug Induced Liver Injury / physiopathology, Fatigue / etiology, Humans, Liver Function Tests, Male, Middle Aged, Opioid Epidemic, Pain Management / methods, Plants, Medicinal / adverse effects, Pruritus / etiology, Analgesics, Opioid, Plant Extracts

Kratom ( Mitragyna speciosa) is a prevalent medicinal plant used mainly for the stimulant and analgesic properties provided through multiple alkaloid compounds. Over the past decade, use of kratom has increased despite the limited knowledge of toxicities and adverse side effects. With the current opioid epidemic, both patients and providers are seeking alternative methods to treat both addiction and pain control, and kratom as an alternative means of treatment has increasingly entered the mainstream. In this article, we present the clinical course of a 47-year-old male who developed fatigue, pruritus, and abnormal liver tests (with a mixed hepatocellular/cholestatic pattern) approximately 21 days after beginning kratom. After extensive evaluation including a negligible alcohol history, negative hepatitis serologies, and inconclusive imaging, the patient was diagnosed with drug-induced liver injury (DILI) caused by kratom. Nine months after his liver tests returned to normal, he took kratom again, and after a latency of 2 days, he developed fatigue, pruritus, and loss of appetite along with abnormal liver tests (with the same biochemical profile as previously), consistent with a positive rechallenge. We believe, through the use of the Roussel-Uclaf Causality Assessment Method and expert opinion, that this is a highly likely or definite example of kratom-induced DILI. With the gaining popularity of this drug, it appears that DILI may be an important complication of kratom for providers to recognize.
Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature
Authors: Ehtesham Ul Haq, Bassam Omar
Journal: Case Rep Cardiol (2014)

Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations.
Group A Streptococci-Associated Necrotizing Fasciitis following Cat Bite in an Immunocompromised Patient
Authors: Sudheer Nambiar, Asha Karippot, Joe Devasahayam, Tony Oliver
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Necrotizing soft tissue infections are characterized clinically by fulminant tissue destruction, systemic signs of toxicity, and high mortality. Accurate diagnosis and appropriate treatment must include early surgical intervention and antibiotic therapy. Mortality rate is very high and could be even higher in an immunocompromised host. We present a 57-year-old female with history of rheumatoid arthritis on oral corticosteroid and methotrexate therapy with painful swelling of the left hand following a cat bite that was diagnosed as having group A streptococcus pyogenes-associated necrotizing fasciitis. Treatment with ampicillin-sulbactam, Clindamycin, and surgical debridement was performed. In spite of all the adequate therapy she succumbed to death from streptococcal toxic shock and related complications after thirty-two days of treatment in intensive care unit. Necrotizing fasciitis is an uncommon but life-threatening complication in immunocompromised hosts. Tissue infections in cat bite wounds are commonly caused by pathogenic bacterium known as Pasteurella multocida. Group A streptococcal infections are not reported following cat bites. A high index of suspicion must be maintained to suspect group A streptococcal associated necrotizing fasciitis following cat bites and an early medical and surgical intervention should be made for any best possible outcome.
The Role of Extracorporeal Blood Purification in the Treatment of a Patient with Lemierre's Syndrome
Authors: Lana Maričić, Damir Mihić, Tajana Turk, Domagoj Loinjak, Vedran Zubčić
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Lemierre's syndrome refers to the septic thrombophlebitis of the internal jugular vein. The condition typically begins with an oropharyngeal infection and frequently involves inflammation within the wall of the vein, infected thrombus within the lumen, surrounding soft tissue inflammation, persistent bacteremia, and septic emboli. Lemierre's syndrome is a rare disease; it occurs most commonly in otherwise healthy young adults. The most common etiologic agent is Fusobacterium necrophorum. We present a case of Lemierre's syndrome in a young girl and the role of extracorporeal method of blood purification with continuous venous hemodiafiltration with the use of a highly adsorptive membrane (AN69 HeprAN), thus achieving the combined elimination of cytokines and endotoxins. The use of advanced methods, along with an antibiotic and surgical treatment, will certainly help reduce mortality in this syndrome.