OpenMed/multicare-articles huggingface dataset:
Spontaneous resolution of paraparesis because of acute spontaneous thoracolumbar epidural hematoma
Authors: M Gundag, M H Seyithanoglu, K Dogan, S Kitis, N Ozkan
Journal: Iran Red Crescent Med J (2012)
Keywords: conservative therapy, cord compression, spinal epidural hematoma
MeSH terms: Case Reports

Symptomatic spontaneous spinal epidural hematoma(SSEH) is an uncommon cause of cord compression that commonly is considered as an indication for emergent surgical decompression. We aimed to investigate a patient with a SSEH that completely resolved clinically and radiographically, without surgical treatment. The patient presented three days after the sudden onset of back pain, numbness, and weakness. Magnetic Resonance Imaging (MRI) revealed a posterior thoracolumbar epidural hematoma extending from the level of T10 to L2 with significant cord compression. Decompression was recommended but he refused surgery and was managed conservatively. One month later, weakness totally recovered and hematoma was absent on MRI.
Sac-Type Congenital Diaphragmatic Hernia: A Case Report of Two Siblings
Authors: Chisato Kodera, Takashi Ohba, Tomomi Hashimoto, Munekage Yamaguchi, Hidetaka Yoshimatsu, Hidetaka Katabuchi
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Congenital diaphragmatic hernia (CDH), a herniation of the abdominal contents through a defect or hypoplasia of the diaphragm, is a relatively common, severe congenital anomaly. Here we present the first case of two siblings with possibly isolated sac-type CDH and with a suspected genetic etiology. Although sibling recurrence of isolated CDH is rare, the incidence is higher than in the general population. Additionally, the second child had a more severe respiratory disorder than the first child. It is to be noted that siblings of children having isolated CDH are at risk for CDH, and prenatal evaluation should be considered individually.
Perforation of a retrocecal appendix resulting in retroperitoneal air: a case report
Authors: Behrang Litkouhi, Alicia S Huang, David J Lundy, Maria Solis
Journal: Case Rep Radiol (2013)

There have been several case reports documenting acute appendicitis complicated by perforation presenting with retroperitoneal abscess formation. To date, there are no case reports of acute appendicitis in which the only sign for retroperitoneal perforation is the presence of retroperitoneal air as detected by computed tomography (CT). In the case presented, an 18-year-old male presented to the emergency department with clinical symptoms of acute appendicitis. CT exam demonstrated an inflamed appendix with multiple collections of air in the retroperitoneum, without abscess. Laparotomy revealed perforation of a retrocecal appendix into the retroperitoneum.
About-Weekly Pattern in the Dynamic Complexity of a Healthy Subject's Cellular Immune Activity: A Biopsychosocial Analysis
Authors: Lennart Seizer, Germaine Cornélissen-Guillaume, Günter K Schiepek, Emil Chamson, Harald R Bliem, Christian Schubert
Journal: Front Psychiatry (2022)
Keywords: bioperiodicity, circaseptan, dynamic complexity, integrative single-case study, neopterin, non-linear, psychoneuroimmunology, time series

In a previous integrative single-case study, we collected biological, psychological and social time-series data on a 25-year-old healthy woman over the course of 126 12-h intervals (63 days) and used urinary neopterin as an indicator of cellular immune activity [Schubert et al. 2012 (1)]. The present re-evaluation introduced Dynamic Complexity (DC) as an additional non-linear and non-stationary measure to further investigate the subject's biopsychosocial dynamics during the study. The new time series dealing with urinary neopterin complexity revealed a cyclic, circaseptan (about-weekly) repeating pattern (6.59 days). The only weekly reoccurring events over the course of the study that were associated with this immunological pattern were the in-depth interviews with the subject (mean distance between interviews: 6.5 days). Superposed epoch analysis (SEA) revealed a U-shaped relation between neopterin complexity and interviews, with a decrease in neopterin complexity before and during interviews and an increase after interviews. Furthermore, the complexity scores for irritation, anxiousness/depressiveness and mental activity were positively correlated with neopterin complexity. The results suggest that the interviews, which had been found to be related to the subject's need for educational and/or social accomplishment, were marked by stress (decrease in psycho-immunological flexibility and adaptability), which was then relieved after the interviews (increase in psycho-immunological flexibility and adaptability). It appears that the subject's cellular immune activity, as indicated by neopterin complexity, functionally mirrored the emotional meaning she ascribed to the in-depth interviews. This re-evaluation is in line with the view that biopsychosocial research requires multimodal analysis of single cases based on qualitative (e.g., in-depth interviews) and quantitative (e.g., time series analysis) data under conditions of "life as it is lived".
Predictability and Resetting in a Case of Convulsive Status Epilepticus
Authors: Timothy Hutson, Diana Pizarro, Sandipan Pati, Leon D Iasemidis
Journal: Front Neurol (2018)
Keywords: network connectivity, pathological dynamics, predictability, resetting, status epilepticus

In this case study, we present evidence of resetting of brain dynamics following convulsive status epilepticus (SE) that was treated successfully with antiepileptic medications (AEDs). The measure of effective inflow (EI), a novel measure of network connectivity, was applied to the continuously recorded multichannel intracranial stereoelectroencephalographic (SEEG) signals before, during and after SE. Results from this analysis indicate trends of progressive reduction of EI over hours up to the onset of SE, mainly at sites of the epileptogenic focus with reversal of those trends upon successful treatment of SE by AEDs. The proposed analytical framework is promising for elucidation of the pathology of neuronal network dynamics that could lead to SE, evaluation of the efficacy of SE treatment strategies, as well as the development of biomarkers for susceptibility to SE.
Rare case of pregnancy with vaginal adenocarcinoma
Authors: Youjiang Xu, Congqing Li, Bing Wei, Wenyan Wang
Journal: Int J Surg Case Rep (2020)
Keywords: adenocarcinoma, pregnancy, vaginal tumour
MeSH terms: Case Reports

Introduction:
Primary vaginal cancer accounts for only 3% of female reproductive tract malignant tumours, and 5% of primary vaginal cancers are adenocarcinomas. Reports of pregnancy with vaginal adenocarcinoma are very rare. There is no guidance for its diagnosis and treatment.
Case presentation:
A 27-year-old pregnant woman who had found a vaginal tumour due to vaginal bleeding during pregnancy was diagnosed with vaginal adenocarcinoma by biopsy. The patient chose to wait to treat the cancer until after delivery at full term of pregnancy and then underwent simple vaginal tumour resection and chemotherapy.
Discussion and conclusion:
For pregnant women with vaginal adenocarcinoma, a comprehensive assessment and an individualized treatment are needed.
Bedside Endoscopic Retrograde Cholangiopancreatography Using Portable X-Ray in Acute Severe Cholangitis
Authors: Rushikesh Shah, Emad Qayed
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation. We present a unique case of life-saving emergent bedside ERCP in a severely ill patient with cholangitis and septic shock, using simple portable X-ray to confirm biliary cannulation.
Steroid cell tumor of the ovary in an adolescent: a rare case report
Authors: Gokhan Boyraz, Ilker Selcuk, Zarife Yusifli, Alp Usubutun, Serdar Gunalp
Journal: Case Rep Med (2013)

Steroid cell tumors (SCTs) of the ovary are a rare subgroup of sex cord tumors, account for less than 0.1% of all ovarian tumors, and also will present at any age. These tumors can produce steroids, especially testosterone, and may give symptoms like hirsutism, hair loss, amenorrhea, or oligomenorrhea. For the evaluation of androgen excess, testosterone and dehydroepiandrosterone sulfate (DHEA-S) are the first laboratory tests to be measured. A pelvic ultrasound and a magnetic resonance imaging are useful radiologic imaging techniques. Although steroid cell tumors are generally benign, there is a risk of malignant transformation and clinical malignant formation. Surgery is the most important and hallmark treatment.
Placenta percreta at 17 weeks with consecutive hysterectomy: a case report and review of the literature
Authors: Natasha Gupta, Anu Gupta, Marlene Green, Hyung Shik Kang, Josef Blankstein
Journal: Case Rep Obstet Gynecol (2012)

Placenta percreta in early pregnancy is an extremely rare but life-threatening complication, for which very few cases have been reported in the literature worldwide, none from the United States. We report a patient with two previous cesarean deliveries, who presented with incomplete abortion at 17 weeks and underwent dilatation and curettage. She was found to have retained, adherent placenta that led to extensive hemorrhage, requiring emergency supracervical hysterectomy. Postoperative course was also complicated by severe consumption coagulopathy, necessitating reexploration after hysterectomy. Pathology revealed a placenta percreta. Patient lost more than 8000 cc blood through the 2 surgeries, received massive transfusions due to severe disseminated intravascular coagulopathy (DIC), and underwent a complicated surgery because of great difficulty in separating lower uterine segment and cervix from the bladder. Abnormal placentation in early pregnancy has increased in prevalence due to marked rise in cesarean deliveries and curettages in recent decades. We reviewed all reported cases of first and second trimester placenta percreta in the literature, to emphasize the early recognition of abnormal placentations in patients with risk factors, consider prenatal evaluation in such patients, anticipate complicated placental implantations during termination procedures, and prevent associated maternal morbidity and mortality.
Dimorphic fungal coinfection as a cause of chronic diarrhea and pancolitis
Authors: Eduar A Bravo, Arturo J Zegarra, Alejandro Piscoya, José L Pinto, Raúl E de Los Rios, Ricardo A Prochazka, Jorge L Huerta-Mercado, Jaime Cok, Martin Tagle
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Histoplasma capsulatum and Paracoccidioides brasiliensis are dimorphic fungi that cause systemic mycosis mostly in tropical South America and some areas of North America. Gastrointestinal involvement is not uncommon among these fungal diseases, but coinfection has not previously been reported. We report a patient with chronic diarrhea and pancolitis caused by paracoccidioidomycosis and histoplasmosis.
Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation
Authors: Yvelynne P Kelly, Astrid Weins, Melissa Y Yeung
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Hyperoxaluria is an important and underrecognized cause for allograft dysfunction and loss after transplantation. It is potentially treatable if recognized in a timely fashion. Research is ongoing to expand the array of therapeutic options available to treat this. We present a case of a 59-year-old gentleman who underwent deceased donor renal transplantation that was complicated by delayed graft function necessitating continuation of renal replacement therapy. His initial biopsy showed extensive acute tubular necrosis with associated peritubular capillaritis and interstitial nephritis and oxalate crystals in several tubules. Despite receiving methylprednisolone to treat moderate acute cellular rejection, he remained dialysis dependent with minimal urine output. An interval renal allograft biopsy revealed residual acute tubular necrosis with extensive oxalate crystals now visible in many tubules. His plasma oxalate level was concurrently elevated to 19.3 μmol/L (reference range ≤ 1.9 μmol/L). He commenced calcium citrate to manage his hyperoxaluria and ultimately became dialysis independent at 3 weeks after transplantation. This case provides an important example of accelerated oxalate nephropathy as an underappreciated contributor to delayed graft function after renal transplantation. Our accompanying discussion provides an update on current therapeutic measures for managing this challenging condition.
Endoscopic Endonasal Intraconal Approach for Orbital Tumor Resection: Case Series and Systematic Review
Authors: Xin Zhang, Wei Hua, Kai Quan, Guo Yu, Zunguo Du, Zixiao Yang, Xiaowen Wang, Jianping Song, Liang Chen, Wei Zhu
Journal: Front Oncol (2022)
Keywords: endonasal approach, intraconal, nasal-cranial base tumor, neuroendoscope, orbital tumor

Intraorbital tumor could be approached by numerous surgical methods. The neuroendoscopic endonasal approach could provide a feasible corridor for indicated tumors. Herein we present a series of 6 consecutive intraorbital tumors from April 2018 to October 2020, which received endonasal endoscopic resection. Cadaveric dissection was performed for the intraconal approach, and the literature was also reviewed. Five tumors were located intraconally, while one extraconally. The pathology revealed 1 angioleiomyoma, 1 cavernous hemangioma, 1 pilocytic astrocytoma, 1 meningioma, and 2 schwannomas. Five of the six achieved gross total resection, including 3 tumors with lateral extension beyond the optic nerve. Preoperative visual deterioration was observed in 4 of the 6 patients, and all got improvement postoperatively. Transient oculomotor nerve palsy was presented in one patient postoperatively. No cerebrospinal fluid leakage, enophthalmos, or strabismus was observed. The median follow-up time is 27 months (11~41 months). At the 6-month follow-up, the visual acuity remained unchanged compared with that at discharge. Proptosis was resolved in 2 of the 3 patients; diplopia was improved in one patient. In conclusion, endoscopic endonasal intraconal approach could be suitable for selected pathological conditions, and for both medial or beyond medial extraconal and intraconal orbital tumors.
Endometriosis in a patient with mayer-rokitansky-küster-hauser syndrome
Authors: Júlia Kefalás Troncon, Ana Carolina Tagliatti Zani, Andrea Duarte Damasceno Vieira, Omero Benedicto Poli-Neto, Antônio Alberto Nogueira, Júlio César Rosa-E-Silva
Journal: Case Rep Obstet Gynecol (2014)

Objective. To report a case of Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) in which there were two nonfunctional rudimentary uteruses with the presence of ovarian endometrioma, corroborating that there are valid alternative theories to the existence of endometriosis, rather than Sampson's theory alone, such as the coelomic metaplasia theory. Design. A case report. Setting. A tertiary referral center, which is also a university hospital. Patient. A fifteen-year-old patient with MRKH syndrome and endometriosis. Intervention. Laparoscopic approach for diagnostic confirmation and treatment of the endometrioma. Results. Evidence of endometriosis in a patient with no functional uterus. Conclusions. This case report and a few others that are available in the literature reinforce the possibility that coelomic metaplasia could be the origin of endometriosis. Patients with müllerian agenesis and pelvic pain should be carefully evaluated, and the presence of pelvic endometriosis should not be excluded.
Acquired von Willebrand Disease Associated with Monoclonal Gammopathy of Unknown Significance
Authors: Sijan Basnet, Catherine Lin, Rashmi Dhital, Izza Mir, Elan Mohanty, Biswaraj Tharu, Sushil Ghimire, Dilli Ram Poudel
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

We present a case of a 79-year-old male who presented with retroperitoneal hematoma a week after motor vehicle accident. Prior history and family history of bleeding were nonsignificant. His activated partial thromboplastin time was found to be prolonged in the emergency department. Further workup with coagulation studies showed decreased factor VIII, vWF antigen, and vWF:ristocetin cofactor assay, and negative Bethesda assay, indicating acquired von Willebrand disease. Immunofluorescence to find an underlying etiology was suggestive of MGUS. Management of AvWD depends on controlling active bleeding and treating the underlying cause. He was treated with factor VIII, haemate-p, rituximab, two cycles of IVIg, and three weeks of oral steroids.
Gendered risk perceptions associated with human-wildlife conflict: implications for participatory conservation
Authors: Meredith L Gore, Jessica S Kahler
Journal: PLoS One (2012)
MeSH terms: Conflict, Psychological, Conservation of Natural Resources / statistics & numerical data, Perception, Research Support, Non-U.S. Gov't, Adolescent, Adult, Female, Humans, Interviews as Topic, Male, Middle Aged, Risk, Sex Factors, Young Adult

This research aims to foster discourse about the extent to which gender is important to consider within the context of participatory approaches for biological conservation. Our objectives are to: (1) gender-disaggregate data about stakeholders' risk perceptions associated with human-wildlife conflict (HWC) in a participatory conservation context, and (2) highlight insights from characterizing gendered similarities and differences in the way people think about HWC-related risks. Two communal conservancies in Caprivi, Namibia served as case study sites. We analyzed data from focus groups (n = 2) to create gendered concept maps about risks to wildlife and livelihoods and any associations of those risks with HWC, and semi-structured interviews (n = 76; men = 38, women = 38) to measure explicit risk attitudes associated with HWC. Concept maps indicated some divergent perceptions in how groups characterized risks to wildlife and livelihoods; however, not only were identified risks to wildlife (e.g., pollution, hunting) dissimilar in some instances, descriptions of risks varied as well. Study groups reported similar risk perceptions associated with HWC with the exception of worry associated with HWC effects on local livelihoods. Gendered differences in risk perceptions may signal different priorities or incentives to participate in efforts to resolve HWC-related risks. Thus, although shared goals and interests may seem to be an obvious reason for cooperative wildlife management, it is not always obvious that management goals are shared. Opportunity exists to move beyond thinking about gender as an explanatory variable for understanding how different groups think about participating in conservation activities.
Design and Methodology of a Pilot Randomized Controlled Trial of Transcranial Direct Current Stimulation in Acute Middle Cerebral Artery Stroke (STICA)
Authors: Estelle Pruvost-Robieux, David Calvet, Wagih Ben Hassen, Guillaume Turc, Angela Marchi, Nicolas Mélé, Pierre Seners, Catherine Oppenheim, Jean-Claude Baron, Jean-Louis Mas, Martine Gavaret
Journal: Front Neurol (2018)
Keywords: acute ischemic stroke, cortical spreading depolarization, functional outcome, peri-infarct depolarizations, tdcs
MeSH terms: Case Reports

Background: Stroke is a major cause of death and disability worldwide. The related burden is expected to further increase due to aging populations, calling for more efficient treatment. Ischemic stroke results from a focal reduction in cerebral blood flow due to the sudden occlusion of a brain artery. Ischemic brain injury results from a sequence of pathophysiological events that evolve over time and space. This cascade includes excitotoxicity and peri-infarct depolarizations (PIDs). Focal impairment of cerebral blood flow restricts the delivery of energetics substrates and impairs ionic gradients. Membrane potential is eventually lost, and neurons depolarize. Although recanalization therapies target the ischemic penumbra, they can only rescue the penumbra still present at the time of reperfusion. A promising novel approach is to "freeze" the penumbra until reperfusion occurs. Transcranial direct current stimulation (tDCS) is a non-invasive method of neuromodulation. Based on preclinical evidence, we propose to test the penumbra freezing concept in a clinical phase IIa trial assessing whether cathodal tDCS-shown in rodents to reduce infarction volume-prevents early infarct growth in human acute Middle Cerebral Artery (MCA) stroke, in adjunction to conventional revascularization methods. Methods: This is a monocentric randomized, double-blind, and placebo-controlled trial performed in patients with acute MCA stroke eligible to revascularization procedures. Primary outcome is infarct volume growth on diffusion weighted imaging (DWI) at day 1 relative to baseline. Secondary outcomes include safety and clinical efficacy. Significance: Results from this clinical trial are expected to provide rationale for a phase III study. Clinical trial registration-EUDRACT: 2016-A00160-51.
Secukinumab-Induced Inflammatory Bowel Disease in a Patient Treated for Chronic Plaque Psoriasis and Psoriatic Arthritis: A Case Report and Review of the Role of Novel Biologic Agents Targeting the p19 Subunit of IL-23
Authors: K M Darch, T L Holland, L J Spelman
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Chronic plaque psoriasis and psoriatic arthritis are common autoimmune inflammatory conditions, often existing as comorbidities that have a significant impact on a patient's quality of life. The availability of a range of novel, targeted therapies for their treatment, most notably the availability of biologic agents, has revolutionised management of these conditions and allowed for significant improvements in patient outcomes. Secukinumab (Cosentyx), a fully-human monoclonal antibody that acts by selectively binding to and neutralising the proinflammatory cytokine IL-17A, is used widely for the treatment of both chronic plaque psoriasis and psoriatic arthritis. In this report, we discuss the case of a 54-year-old female with chronic plaque psoriasis and psoriatic arthritis, who experienced the onset of symptoms and was subsequently diagnosed with Crohn's disease during treatment with secukinumab. It was determined by the gastroenterologist that this may represent secukinumab-induced inflammatory bowel disease. We will review the current understanding of the role of IL-17 in inflammatory bowel disease and the important role of novel agents that target the p19 subunit of IL-23 which have shown significant promise in the management of not only chronic plaque psoriasis and psoriatic arthritis, but also inflammatory bowel disease itself.