OpenMed/multicare-articles huggingface dataset:
Primary Chest Wall Hydatid Disease: A Case Report with Multimodality Imaging Findings
Authors: Waleed Althobaity, Ayman Aldeheshi, Mnahi Bin Saeedan
Journal: Case Rep Radiol (2023)
MeSH terms: Case Reports

Primary chest wall hydatid cyst is a very rare disease in endemic areas. This case report describes a 22-year-old male patient with a 3-year history of chronic left chest pain. He had a history of close animal contact in childhood. Chest computed tomography (CT) scan showed a left upper posterior paravertebral cystic mass with peripheral and intrinsic calcifications. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) scan showed no significant FDG uptake. Magnetic resonance imaging (MRI) showed a left paravertebral cystic mass with daughter cysts and a peripheral low T2 wall, compatible with hydatid disease. Medical treatment was started, and a follow-up MRI showed rupture of hydatid cysts. The patient underwent surgical resection, and a hydatid disease diagnosis was confirmed by histopathologic examination. During the postoperative hospital course, the patient developed pneumothorax which was successfully treated with a surgical procedure. The patient was discharged with medical treatment (albendazole). In conclusion, this case highlights the importance of considering hydatid disease in the differential diagnosis of chest wall cystic masses, especially in endemic regions, and the value of multimodality imaging in diagnosis and treatment planning.
A novel combination of multiple primary carcinomas: urinary bladder transitional cell carcinoma, prostate adenocarcinoma and small cell lung carcinoma--report of a case and review of the literature
Authors: Anastassios V Koutsopoulos, Konstantina I Dambaki, George Datseris, Elpida Giannikaki, Marios Froudarakis, Efstathios Stathopoulos
Journal: World J Surg Oncol (2005)

Background:
The incidence of multiple primary malignant neoplasms increases with age and they are encountered more frequently nowadays than before, the phenomenon is still considered to be rare.
Case presentation:
We report a case of a man in whom urinary bladder transitional cell carcinoma, metachronous prostate adenocarcinoma and small cell lung carcinoma were diagnosed within an eighteen-month period. The only known predisposing factor was that he was heavy smoker (90-100 packets per year). The literature on the phenomenon of multiple primary malignancies in a single patient is reviewed and the data is summarized.
Conclusion:
It is important for the clinicians to keep in mind the possibility of a metachronous (successive) or a synchronous (simultaneous) malignancy in a cancer patient. It is worthy mentioning this case because clustering of three primary malignancies (synchronous and metachronous) is of rare occurrence in a single patient, and, to our knowledge, this is the first report this combination of three carcinomas appearing in the same patient.
Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy Associated With Area Postrema Syndrome: A Case Report
Authors: Xin Gao, Ying Tang, Guo-Dong Yang, Wu Wei
Journal: Front Neurol (2021)
Keywords: area postrema syndrome, autoimmune disease, case report, glial fibrillary acidic protein astrocytopathy, immunotherapy-responsive
MeSH terms: Case Reports

Glial fibrillary acidic protein astrocytopathy is an immunotherapy-responsive autoimmune disease of the central nervous system with various clinical manifestations; among these, there are few reports about area postrema syndrome (APS). The authors present the case of a female patient admitted to the hospital with intractable nausea and vomiting as the predominant symptom. The patient's cerebrospinal fluid was tested by cell-based assays (CBA) and found positive for the presence of anti-glial fibrillary acidic protein (GFAP) antibody, in addition, serological testing showed elevated levels of thyroglobulin and thyroperoxidase-specific antibodies. Brain and cervical MRI showed abnormally high signal on the T2 sequence in the dorsal medulla oblongata and right pontine arm. Therefore, the patient was diagnosed with autoimmune GFAP astrocytopathy. The symptoms improved rapidly after treatment with corticosteroids, and no recurrence has been observed thus far. APS may be a relatively rare clinical manifestation of GFAP astrocytopathy. Importantly, such presentation is challenging to correctly diagnose without typical MRI imaging findings. However, the detection of antibodies in the cerebrospinal fluid or serum may be valuable. Systemic and neurological autoimmunity often coexist, comprehensive antibody screening should be conducted.
Novel Endoscopic Management of Eroding Laparoscopic Adjustable Gastric Band: A Case Series
Authors: Dionysios Dellaportas, Constantinos Nastos, Theodosios Theodosopoulos, George Fragulidis, Andreas Polydorou, Antonios Vezakis
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Complications of laparoscopic adjustable gastric bands include migration and slippage of the band, dilation of the proximal gastric pouch, troublesome gastroesophageal reflux symptoms, and erosion of the stomach. The latter occurs in 0.6-12.7% of cases and necessitates removal of the band. Several open and laparoscopic surgical techniques have been described for band extraction, while fully endoscopic techniques have emerged and proven safe. Three cases of eroding gastric bands treated in a single center with fully endoscopic removal of the band are analyzed in this study. Novel use of the duodenoscope and endoscopic retrograde cholangiopancreatography instruments and accessories is described, in order to perform endoscopic division of the plastic band and retraction through the mouth. All three cases were successfully treated utilizing this novel technique. Gastric wall erosion from the band has nonspecific symptoms and various predisposing factors. Removal of the foreign material is required. Endoscopic procedures are effective in 77-92% of cases, avoiding general anaesthesia with low surgical morbidity. As a result patients are discharged early resolving quicker to a normal diet.
Combined Surgical Approach for Obstructive Sleep Apnea Patient
Authors: Mahmoud A K Ebrahim, Osamah AlSanea, Abdulmohsen E Al-Terki
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Obstructive sleep apnea (OSA) is a disease that is associated with high morbidity and mortality and can significantly impact the quality of life in a patient. OSA is strongly associated with obesity, and literature showed that weight loss will lead to improvement in OSA. The gold standard treatment for OSA is continuous positive airway pressure (CPAP). However, other methods of treatment are available. One of these methods is multilevel sleep surgery (MLS). Literature showed that bariatric surgery can also improve OSA. A common question is which surgical procedure of these two should be performed first. We present a 5-year follow-up of a patient who underwent simultaneously bariatric surgery and MLS. His apnea-hypopnea index (AHI) decreased from 53 episodes per hour to 5.2 per hour within the first 18 months, which was measured via a level 3 polysomnography. Five years after the surgery, a repeat level 3 polysomnography showed an AHI of 6.8 episodes per hour, and the patient is asymptomatic. The patient maintained his weight and did not use CPAP after the combined surgery during the five-year period.
Novel Heterozygous Mutations in JAG1 and NOTCH2 Genes in a Neonatal Patient with Alagille Syndrome
Authors: Alisa Brennan, Anil Kesavan
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Alagille Syndrome (ALGS) is a rare autosomal dominant disorder that affects multiple organ systems. Cholestasis as a result of a paucity of intrahepatic bile ducts and congenital heart defects are the two most common features of ALGS. We describe a case of ALGS with novel mutations of JAG1 and NOTCH2 genes in a newborn girl with complex congenital heart disease, bilateral dysplastic kidneys, and malrotation with volvulus.
Exposure of a microvascular anastomotic coupler in head and neck reconstruction: a case report
Authors: Tateki Kubo, Natsuko Kitamura, Motohiro Onoda, Daisuke Maeda, Ken Matsuda, Ko Hosokawa
Journal: Eplasty (2014)
Keywords: complications, exposure, head and neck reconstruction, microvascular anastomotic coupler, venous anastomosis
MeSH terms: Case Reports

Objective:
We present a case of exposure of a microvascular anastomotic coupler.
Methods:
We performed venous anastomoses using microvascular anastomotic couplers in head and neck reconstruction.
Results:
A microvascular anastomotic coupler was exposed in the seventh month postoperation, and an anastomosed vein was disrupted.
Conclusions:
Although the usefulness of the microvascular anastomotic coupler in microsurgical flap reconstruction is not in doubt, as described previously, we believe that it is necessary to remember that use of a microvascular anastomotic coupler involves potential risks of exposure and anastomosed vessel disruption.
Bowel perforation after liposuction in abdominal contouring surgery: Case report
Authors: Caterina Gardener, Laura Pandis, Martina Grigatti, Vincenzo Vindigni, Franco Bassetto, Tito Brambullo
Journal: Int J Surg Case Rep (2020)
Keywords: body contouring, case report, combined surgery, flank hernia, intestinal perforation, liposuction
MeSH terms: Case Reports

Introduction:
Liposuction is one of the most performed procedures in aesthetic plastic surgery worldwide, and its spectrum of applications covers almost all body areas. Systemic or visceral complications following liposuction are rare, but unfortunately, they can be very serious.
Presentation of case:
We discuss the case of a 69 y.o. woman who underwent abdominal contouring surgery consisting in flank pseudohernia correction, liposuction and short scar abdominoplasty, which was complicated by intestinal perforation. Bowel perforation was suspected on the 3rd day following surgery after a CT-scan and was treated with exploration through a median laparotomy, resection of the perforated bowel and subsequent ileo-ileal anastomosis. The 10 cm-long resected segment of the small intestine presented multiple 2 mm-large holes at the microscopic examination.
Discussion:
We assume that patient position on the operating table and abdominal wall laxity during surgery as well as the timing of each specific procedure played an important role in the occurrence of bowel perforation.
Conclusion:
To our knowledge, this is the first case report of an accidental visceral perforation during a combined procedure of flank bulging correction and abdominal liposuction. Overall the increased risk of combined procedures in plastic surgery is linked to increased operative time. In the current case timing of surgery sequence more than operative time itself was relevant in increasing anterior abdominal wall pressure and thus setting the patient at a higher risk of bowel perforation.
Sclerosing Cholangitis in Behçet's Disease
Authors: Aida Ben Slama Trabelsi, Dhilel Issaoui, Mehdi Ksiaa, Ahlem Souguir, Nadia Mama, Ahlem Brahem, Ali Jmaa, Salem Ajmi
Journal: Case Rep Med (2013)

Introduction. Sclerosing cholangitis is characterized by an inflammatory and fibrotic lesion of intra- and/or extrahepatic bile ducts. When a causal mechanism of a bile duct lesion is identified, the sclerosing cholangitis is considered secondary. The vasculitis, including the Behçet disease, is cited as a probable cause of the ischemia and the sclerosing cholangitis. No cases of extrahepatic secondary sclerosing cholangitis have been reported to date. Case Report. We report the first case of secondary sclerosing cholangitis of the extrahepatic bile ducts associated with Behçet disease in a male who is aged 43, with a previous history of the angio-Behçet followed by complications of thrombophlebitis and a cerebral thrombophlebitis, and who has a cholestatic jaundice. The diagnosis has been carried out by the MR cholangiopancreatography which has objectified a moderate distension of the intrahepatic bile ducts upstream of regular stacked parietal thickening of the main bile duct. The patient has been treated successfully with the ursodeoxycholic acid and the placement of a plastic stent. Conclusion. This diagnosis should be mentioned to any patient with vasculitis and who has a cholestatic jaundice.
A case report of primary meningococcal pericarditis secondary to Neisseria meningitidis in a young female patient
Authors: Matthew Green, Peter Harrison, Anshuman Sengupta, Dominik Schlosshan
Journal: IDCases (2022)
Keywords: meningococcus, pericardial effusion, pericarditis
MeSH terms: Case Reports

Pericarditis is responsible for approximately 5 % of emergency admissions due to chest pain. Pericarditis secondary to Neisseria meningitidis (meningococci) was originally reported in 1918, and remains a rare diagnosis. We report a case of primary meningococcal pericarditis presenting with non-specific symptoms, illustrating the importance of considering rarer causes of pericardial effusion. A previously fit and well 23-year-old female presented to her local hospital with a 2-day history of feeling generally unwell with myalgia and fevers and was initially discharged. Four days following discharge the patient re-presented with worsening symptoms. A Computed Tomography Pulmonary Angiogram (CTPA) demonstrated a large pericardial effusion with subsequent bedside echocardiogram confirming a global pericardial effusion of up to 3 cm. This required drainage, with blood cultures and pericardial fluid showing polymerase chain reaction positivity for Neisseria meningitidis, serogroup B. Our report describes a rare case of Primary Meningococcal Pericarditis secondary to serotype B meningococcal infection. The European Society of Cardiology propose criteria that warrant hospital admission and an aetiology search for certain patients with pericardial disease. These criteria provide a useful framework to help select those minority of patients in whom a more serious underlying cause is present. Blood cultures provide vital information to allow us to complete a thorough aetiological search and empirical antibiotics can cloud the clinical picture, making it harder to identify causative organisms. To aid the early administration of appropriate therapy, it may be pertinent to recommend a low threshold for taking blood cultures in patients with pyrexia and pericarditis or pericardial effusion.
Can Intestinal Pseudo-Obstruction Drive Recurrent Stroke-Like Episodes in Late-Onset MELAS Syndrome? A Case Report and Review of the Literature
Authors: Delia Gagliardi, Eleonora Mauri, Francesca Magri, Daniele Velardo, Megi Meneri, Elena Abati, Roberta Brusa, Irene Faravelli, Daniela Piga, Dario Ronchi, Fabio Triulzi, Lorenzo Peverelli, Monica Sciacco, Nereo Bresolin, Giacomo Pietro Comi, Stefania Corti, Alessandra Govoni
Journal: Front Neurol (2019)
Keywords: melas, gastrointestinal disturbance, intestinal pseudo-obstruction, mitochondrial disorders, stroke-like episodes
MeSH terms: Case Reports

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a maternally inherited mitochondrial disorder that is most commonly caused by the m. 3243A>G mutation in the MT-TL1 mitochondrial DNA gene, resulting in impairment of mitochondrial energy metabolism. Although childhood is the typical age of onset, a small fraction (1-6%) of individuals manifest the disease after 40 years of age and usually have a less aggressive disease course. The clinical manifestations are variable and mainly depend on the degree of heteroplasmy in the patient's tissues and organs. They include muscle weakness, diabetes, lactic acidemia, gastrointestinal disturbances, and stroke-like episodes, which are the most commonly observed symptom. We describe the case of a 50-year-old male patient who presented with relapsing intestinal pseudo-obstruction (IPO) episodes, which led to a late diagnosis of MELAS. After diagnosis, he presented several stroke-like episodes in a short time period and developed a rapidly progressive cognitive decline, which unfortunately resulted in his death. We describe the variable clinical manifestations of MELAS syndrome in this atypical and relatively old patient, with a focus on paralytic ileus and stroke-like episodes; the first symptom may have driven the others, leading to a relentless decline. Moreover, we provide a brief revision of previous reports of IPO occurrence in MELAS patients with the m.3243A>G mutation, and we investigate its relationship with stroke-like episodes. Our findings underscore the importance of recognizing gastrointestinal disturbance to prevent neurological comorbidities.
A case report of a giant appendiceal mucocele and literature review
Authors: Mpapho Joseph Motsumi, Pako Motlaleselelo, Gezahen Ayane, Sheikh Omar Sesay, Johamel Ramos Valdes
Journal: Pan Afr Med J (2017)
Keywords: appendicular mucocele, appendicular mucinous adenocarcinoma, appendicular mucinous cystadenocarcinoma, appendicular mucinous cystadenoma, low-grade appendiceal mucinous neoplasms, mucinous neoplasms of the appendix, pseudomyxoma peritonei
MeSH terms: Appendiceal Neoplasms / diagnosis, Cecal Diseases / diagnosis, Mucocele / diagnosis, Case Reports, Review, Adult, Appendiceal Neoplasms / pathology, Appendix / pathology, Botswana, Cecal Diseases / surgery, Colectomy / methods, Female, Humans, Laparotomy / methods, Mucocele / surgery, Tomography, X-Ray Computed, Ultrasonography

A 43-year-old female presented at the accident and emergency department of Princess Marina Hospital, Gaborone, Botswana. She reported a deep dull aching pain of two years duration in the right iliac fossa that has been progressively becoming worse. Ultrasound revealed a large sausage like cystic mass extending from the pelvis up to the medial aspect of the ascending colon. CT scan showed a large sausage like cystic mass extending from the pelvis up to the hepatic flexure of the colon with the cecum displaced. No metastatic features were seen. We made an impression of appendiceal mucocele. A semi-elective laparotomy was scheduled. Intraoperative findings: a giant intact cystic distended appendix with involved base, displacing the cecum cranially. A right hemicolectomy was performed. The histopathological results revealed a low-grade appendicular mucinous neoplasm with no lymph node involvement. The surgical margins were free. The patient recovered uneventfully.
Case Report: Training Monitoring and Performance Development of a Triathlete With Spinal Cord Injury and Chronic Myeloid Leukemia During a Paralympic Cycle
Authors: Oliver J Quittmann, Benjamin Lenatz, Patrick Bartsch, Frauke Lenatz, Tina Foitschik, Thomas Abel
Journal: Front Rehabil Sci (2022)
Keywords: trimp, case report, chronic myeloid leukemia (cml), paratriathlon, performance, srpe, spinal cord injury (sci), training
MeSH terms: Case Reports

Introduction:
Paratriathlon allows competition for athletes with various physical impairments. The wheelchair category stands out from other paratriathlon categories, since competing in swimming, handcycling, and wheelchair racing entails substantial demands on the upper extremity. Therefore, knowledge about exercise testing and training is needed to improve performance and avoid overuse injuries. We described the training monitoring and performance development throughout a Paralympic cycle of an elite triathlete with spinal cord injury (SCI) and a recent diagnosis of chronic myeloid leukemia (CML).
Case presentation/methods:
A 30-year-old wheelchair athlete with 10-years experience in wheelchair basketball contacted us for guidance regarding testing and training in paratriathlon. Laboratory and field tests were modified from protocols used for testing non-disabled athletes to examine their physical abilities. In handcycling, incremental tests were used to monitor performance development by means of lactate threshold (P OBLA) and define heart rate-based training zones. All-out sprint tests were applied to calculate maximal lactate accumulation rate ( V ˙ La max ) as a measure of glycolytic capabilities in all disciplines. From 2017 to 2020, training was monitored to quantify training load (TL) and training intensity distribution (TID).
Results:
From 2016 to 2019, the athlete was ranked within the top ten at the European and World Championships. From 2017 to 2019, annual TL increased from 414 to 604 h and demonstrated a shift in TID from 77-17-6% to 88-8-4%. In this period, P OBLA increased from 101 to 158 W and V ˙ La max decreased from 0.56 to 0.36 mmol·l-1·s-1. TL was highest during training camps. In 2020, after he received his CML diagnosis, TL, TID, and P OBLA were 317 h, 94-5-1%, and 108 W, respectively.
Discussion:
TL and TID demonstrated similar values when compared with previous studies in para-swimming and long-distance paratriathlon, respectively. In contrast, relative TL during training camps exceeded those described in the literature and was accompanied by physical stress. Increased volumes at low intensity are assumed to increase P OBLA and decrease V ˙ La max over time. CML treatment and side effects drastically decreased TL, intensity, and performance, which ultimately hindered a qualification for Tokyo 2020/21. In conclusion, there is a need for careful training prescription and monitoring in wheelchair triathletes to improve performance and avoid non-functional overreaching.
Controlling a robotic arm for functional tasks using a wireless head-joystick: A case study of a child with congenital absence of upper and lower limbs
Authors: Sanders Aspelund, Priya Patel, Mei-Hua Lee, Florian A Kagerer, Rajiv Ranganathan, Ranjan Mukherjee
Journal: PLoS One (2020)
MeSH terms: Robotics / instrumentation, User-Computer Interface, Case Reports, Research Support, U.S. Gov't, Non-P.H.S., Activities of Daily Living, Adolescent, Head / physiology, Head Movements / physiology, Humans, Male, Movement / physiology, Self-Help Devices / trends, Wireless Technology / instrumentation

Children with movement impairments needing assistive devices for activities of daily living often require novel methods for controlling these devices. Body-machine interfaces, which rely on body movements, are particularly well-suited for children as they are non-invasive and have high signal-to-noise ratios. Here, we examined the use of a head-joystick to enable a child with congenital absence of all four limbs to control a seven degree-of-freedom robotic arm. Head movements were measured with a wireless inertial measurement unit and used to control a robotic arm to perform two functional tasks-a drinking task and a block stacking task. The child practiced these tasks over multiple sessions; a control participant performed the same tasks with a manual joystick. Our results showed that the child was able to successfully perform both tasks, with movement times decreasing by ~40-50% over 6-8 sessions of training. The child's performance with the head-joystick was also comparable to the control participant using a manual joystick. These results demonstrate the potential of using head movements for the control of high degree-of-freedom tasks in children with limited movement repertoire.