OpenMed/multicare-articles huggingface dataset:
Case Report: Is Pneumoperitoneum the Only Indication for Surgery in Necrotizing Enterocolitis?
Authors: Ying Wei, Yanhong Zhu, Xiaoping Luo, Ling Chen, Xiaolin Hu
Journal: Front Pediatr (2021)
Keywords: necrotizing enterocolitis, neonate, pneumoperitoneum, surgery, treatment
MeSH terms: Case Reports

Objective: This study aims to explore whether pneumoperitoneum is the only surgical indication for neonates with necrotizing enterocolitis (NEC) and to analyze when early surgical intervention should be considered. Methods: A retrospective case series study was conducted including six neonates with stage 2a-2b NEC who received surgeries without absolute indication but with failed conservative treatment. In the meantime, seven infants who received surgery due to pneumoperitoneum and 32 infants treated with conservative treatment were also included for comparison. Results: Our results indicated that the six infants who received surgical treatment without pneumoperitoneum had a better prognosis compared to the seven infants who underwent surgical treatment after the onset of pneumoperitoneum. None of the infants who received early surgical treatment developed short bowel syndrome or neurodevelopmental impairment, while four out of six infants exhibited growth retardation. On the other hand, a total of five out of the seven infants who received surgical treatment after pneumoperitoneum forfeited further treatment, two developed short bowel syndrome, and one experienced neurodevelopmental impairment. Lower gestational age and birth weight, fetal growth restriction (FGR), perinatal asphyxia, postnatal steroid and vascular active drug use, blood transfusion, and hemodynamic significant patent ductus arteriosus were identified as risk factors associated with surgical repair for infants with NEC. In a laboratory test, infants who needed surgeries had a lower platelet count and a higher C-reactive protein value. Conclusion: Aggressive surgical treatment should be considered in infants with severe necrotizing enterocolitis before the onset of pneumoperitoneum. Lower gestational age and birth weight, FGR, perinatal asphyxia, postnatal steroid and vascular active drug use, blood transfusion, and hsPDA may be associated with surgical repair for infants with NEC.
The Challenge of Prenatal Diagnostic Work-Up of Maternally Inherited X-Linked Opitz G/BBB: Case Report and Literature Review
Authors: Marialuigia Spinelli, Carmine Sica, Bruno Dallapiccola, Antonio Novelli, Letizia Di Meglio, Pasquale Martinelli
Journal: Case Rep Obstet Gynecol (2015)

Background. Prenatal diagnosis of Optiz G/BBB syndrome (OS) is challenging because the characteristic clinical features, such as facial and genitourinary anomalies, may be subtle at sonography and rather unspecific. Furthermore, molecular testing of the disease gene is not routinely performed, unless a specific diagnosis is suggested. Method. Both familial and ultrasound data were used to achieve the diagnosis of X-linked OS (XLOS), which was confirmed by molecular testing of MID1 gene (Xp22.3) at birth. Results. Sequencing of MID1 gene disclosed the nucleotide change c.1285 +1 G>T, previously associated with XLOS. Conclusions. This case illustrates current challenges of the prenatal diagnostic work-up of XLOS and exemplifies how clinical investigation, including family history, and accurate US foetal investigations can lead to the correct diagnosis.
Case report: A relatively rare adverse event caused by carbetocin- placenta interception
Authors: Jun-Qiang Li, Yong-Chi Zhan, Xiao-Dong Wang
Journal: Front Pharmacol (2023)
Keywords: carbetocin, case report, cesarean section, excessive uterine contraction, placenta interception
MeSH terms: Case Reports

Placenta interception is extremely rare, and herein, we report the case of a 33-year-old woman with placenta interception during cesarean section caused by carbetocin, which was intravenously injected immediately after delivery of the infant to prevent postpartum hemorrhage. There was no sign of placental separation in the third stage of labor. A protuberance with gross subserous blood vessels in the left fundus of the uterus was detected and was misdiagnosed as placental accreta. The patient was transferred to the district referral hospital to manage the protuberance after stitching up the incision. On opening the original incision in the tertiary hospital, the protuberance disappeared, and the placenta was found in the lower segment of the uterus cavity. The intercepted placenta showed a spontaneous resolution from the uterine wall and was removed intact. This case report details the typical presentation of placenta interception to make obstetricians aware of the possibility that carbetocin might lead to this adverse event.
COQ8B glomerular nephropathy: Outcomes after kidney transplantation and analysis of characteristics in Chinese population
Authors: Shuhan Zeng, Yuanyuan Xu, Cheng Cheng, Nannan Yu, Longshan Liu, Ying Mo, Lizhi Chen, Xiaoyun Jiang
Journal: Front Pediatr (2022)
Keywords: coq8b, chinese, case report, kidney transplantation, steroid-resistant nephrotic syndrome

Background:
Mutation in the COQ8B gene can cause COQ8B glomerular nephropathy (COQ8B-GN), which is rare and associated with steroid-resistant nephrotic syndrome (SRNS) as well as rapid progression to end-stage renal disease (ESRD). The aim of this study was to analyze the prognosis and recurrence risk of COQ8B-GN in patients after kidney transplantation (KTx) and summarize the characteristics of the Chinese population.
Methods:
A retrospective study included four cases treated in our hospital with a diagnosis of COQ8B-GN. Chinese and foreign studies were searched from database inception to February 2022.
Results:
A total of four cases were included, with the age of onset ranging from 4 to 9 years. The initial presentations were SRNS and asymptomatic proteinuria. Only one had an extrarenal manifestation (thyroid cyst). All patients progressed to ESRD at a mean time of 42 months after onset. With a total follow-up time ranging from 12 to 87 months, three of them had received transplantation. While one case needed a second KTx due to graft failure caused by chronic rejection, two recipients had excellent graft function. No recurrence in allograft was observed. There have been 18 cases of KTx recipients reported globally with follow-up information. Except for two cases of graft failure caused by hyperacute rejection and chronic rejection, respectively, the rest all had good graft function without recurrence. In addition, 44 cases of COQ8B-GN in the Chinese population were identified. At the onset, 75% of the patients were aged ≤10 years with initial symptoms of asymptomatic proteinuria, nephrotic syndrome (NS), or SRNS. By the time of literature publication, 59% of patients had progressed to ESRD (mean age of 10.3 ± 3.6 years). The median time from onset to ESRD was 21 months. Renal pathology mainly showed focal segmental glomerulosclerosis (FSGS), accounting for 61.8% of all biopsies, followed by mesangial proliferative glomerulonephritis (20.6%). The first three prevalent mutations in the COQ8B gene among the Chinese population were c. 748G>C, c. 737G>A, and c. 532C>T.
Conclusion:
COQ8B-GN in the Chinese population may present with asymptomatic proteinuria, NS, or SRNS initially, with most onsets before the age of 10 years. A lot of patients progress to ESRD in early adolescence. FSGS on biopsy and c. 748G>C in the genetic test are the most frequently seen in Chinese COQ8B-GN patients. KTx is feasible for patients with ESRD due to the low risk of recurrence, but we should pay attention to graft rejection.
Indian contribution to behavior therapy
Authors: K Kuruvilla
Journal: Indian J Psychiatry (2010)
Keywords: behavior therapy, behavior modification, behavioral intervention, cognitive behavior therapy, cognitive therapy

Publication of papers related to psycho-social interventions in general and Behavior Therapy, in particular, in Indian Journal of Psychiatry has been limited. Though the first paper related to Behavior Therapy was published in 1952, a manual search of all available issues of the journal from 1949 showed that only 42 papers related to Behavior Therapy have been published till 2009. Among them 10 are case reports. Methodological limitations abound even in the papers on larger groups of patients. Studies using operant conditioning have been very few. Aversion therapy and progressive muscle relaxation have been very frequently used. The published articles are reviewed under the various diagnostic categories. Publications in the recent years have been mostly on Cognitive Behavior Therapy. Even after 57 years of co-existence, the relationship between Behavior Therapy and Indian Psychiatry remains a tenuous one.
Atypical gunshot injury to the right side of the face with the bullet lodged in the carotid sheath: a case report
Authors: Peter A Ongom, Stephen C Kijjambu, Josephat Jombwe
Journal: J Med Case Rep (2014)

Introduction:
Gunshot injuries of the head and neck from the AK-47 rifle (a common assault rifle, submachine gun type) are a significant contributor to morbidity and mortality among civilians in Sub-Saharan Africa. They may cause significant damage to the closely arranged structures in this region, and the bullet's trajectory can be very difficult to determine. We present an unusual case of gunshot injury with an atypical bullet entry wound, profound injury to the face, lodgment in the right carotid sheath, and 'wandering'; a first of its kind in East Africa.
Case presentation:
A 27-year-old African-Ugandan woman of Nilotic ethnicity was referred to the Accident and Emergency Department of a tertiary hospital in Uganda, having sustained complex injuries due to an inadvertent AK-47 rifle gunshot injury. The gunshot injury was to the right side of her face with a large ragged entry wound and no exit wound. Prior basic wound care and radiological imaging showed a comminuted fracture of her mandible with lodgment of the bullet in her neck, anterior to her sixth and seventh cervical vertebrae. Standard debridement of her wound was done. A computed tomography scan showed an apparent cephalad shift ('wandering') of the bullet, leaving it lying partially anterior to her fifth cervical vertebra as well as within her carotid sheath. Other injuries were to her facial and trigeminal nerves, and her middle ear. The 'wandering' bullet was successfully removed surgically. It had caused no damage to any part of her neck structure.
Conclusion:
AK-47 rifle bullet injuries may present with uncharacteristically large entry wounds and cause complex structural injuries at the area of impact. The consequent trajectory is difficult to predict making regional examination and radiological investigations essential in management. Bullets may be retained, leaving no exit wound. Securing the airway, controlling hemorrhage and identifying other injuries are the first vital steps. This case illustrates all these interventions and the important decision to extract the entrapped bullet from the patient's neck because it had started to 'wander' and could have caused grave injury over time with further migration. Maxillofacial, plastic, trauma, general and military surgeons, otorhinolaryngologists and emergency physicians can gain from this experience because it calls for a multidisciplinary team approach.
A giant subcutaneous leiomyosarcoma arising in the inguinal region
Authors: Kazuhito Yajima, Yoshio Shirai, Nobuhiro Fujita, Daisuke Sato, Hajime Umezu, Katsuyoshi Hatakeyama
Journal: World J Surg Oncol (2005)

BACKGROUND: Subcutaneous leiomyosarcoma is a rare condition that accounts for 1% to 2% of all superficial soft tissue malignancies. Approximately 10% of cases arise in the trunk, although the extremities are the most commonly affected. CASE PRESENTATION: We report herein the case of a 31-year-old man with a subcutaneous leiomyosarcoma, measuring 124 x 105 mm, arising in the left inguinal region. A wide local excision (with a resection margin >/= 20 mm) was performed. Histological examination of the resected specimen revealed a leiomyosarcoma with high cellularity and two mitoses per 10 high-power fields. The patient remains well with no evidence of disease 5 years and 8 months after the operation. CONCLUSION: This is the first reported case of subcutaneous leiomyosarcoma arising in the inguinal region and also one of the largest tumors reported. The experience of this case and a review of the English-language literature (PubMed, National Library of Medicine, Bethesda, MD, USA) suggest that a resection margin of >/= 10 mm is recommended when excising this rare tumor.
Treatment of Endometrial Cancer in Association with Pelvic Organ Prolapse
Authors: Asama Vanichtantikul, Ekkasit Tharavichitkul, Imjai Chitapanarux, Orawee Chinthakanan
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Background. Uterine malignancy coexistent with pelvic organ prolapse (POP) is uncommon and standardized treatment is not established. The objective of this case study was to highlight the management of endometrial cancer in association with pelvic organ prolapse. Case Report. An 87-year-old woman presented with POP Stage IV combined with endometrioid adenocarcinoma of the uterus: clinical Stage IV B. She had multiple medical conditions including stroke, deep vein thrombosis, and pulmonary embolism. She was treated with radiotherapy and pessary was placed. Conclusion. Genital prolapse with abnormal uterine bleeding requires proper evaluation and management. Concurrent adenocarcinoma and POP can be a difficult clinical situation to treat, and optimum management is controversial.
Use of a distal radius endoprosthesis following resection of a bone tumour: a case report
Authors: Kishan Gokaraju, Kesavan Sri-Ram, James Donaldson, Michael T R Parratt, Gordon W Blunn, Steve R Cannon, Timothy W R Briggs
Journal: Sarcoma (2009)
MeSH terms: Case Reports

Limited literature is available on the reconstruction of the distal radius using prosthetic replacement following resection of a bone tumour. We present the first reported case, in the English literature, of the use of an entirely metal endoprosthesis for the reconstruction of the distal radius. This case involves a 66-year-old male who was treated for giant cell tumour of the distal radius with surgical excision of the lesion and replacement of the defect using a predominantly titanium endoprosthesis. He was followed-up for 56 months following surgery and had a good functional outcome with no associated pain or complications. We propose that the use of a primarily titanium endoprosthesis for the reconstruction of a bone defect of the distal radius is a suitable alternative, providing good function of the forearm with satisfactory range of movement at the wrist and adequate pain relief.
Mediastinal Thyroid Carcinoma and Graves' Disease: A Rare Presentation
Authors: Sara Lomelino Pinheiro, Inês Damásio, Ana Figueiredo, Tiago Nunes da Silva, Valeriano Leite
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Background:
Mediastinal thyroid carcinoma is extremely rare, with few cases reported in the literature. Case Report. A 73-year-old man presented with weight loss for 6 months. Imaging by computed tomography (CT) documented a large mediastinal mass below the thyroid gland and pulmonary metastases. Neck ultrasound found two spongiform nodules in the right thyroid lobe, and fine-needle aspiration citology (FNAC) of these nodules revealed they are benign. Endobronchial ultrasound-guided needle biopsy of the mediastinal mass was compatible with papillary thyroid cancer. A few weeks later, the patient developed overt hyperthyroidism due to Graves' disease, which was treated with antithyroid drugs. 99mPertechnetate scintigraphy showed increased diffuse uptake in the thyroid parenchyma but the absence of uptake in the paratracheal mass and in the lung nodules. The patient was not considered eligible for surgical intervention or therapy with tyrosine kinase inhibitor due to tracheal and mediastinal vessel invasion and was treated with palliative radiotherapy. Two months later, restaging PET-FDG showed an intense uptake in the right lobe of the thyroid gland, lymph nodes, lungs, bone, muscle, myocardial, kidney, and adrenal gland.
Conclusion:
In this case, thyroid carcinoma presented as a mediastinal mass with concurrent hyperthyroidism due to Graves' disease. Although uncommon, the clinicians should be aware of these situations. Obtaining a prompt histological examination of an intrathoracic mass is crucial to ensure an early diagnosis and treatment.
Embolic stroke complicating Staphylococcus aureus endocarditis circumstantially linked to rectal trauma from foreign body: a first case report
Authors: Braj B Pandey, Tuan C Dang, John F Healy
Journal: BMC Infect Dis (2005)
MeSH terms: Endocarditis, Bacterial / complications, Foreign Bodies / complications, Intracranial Embolism / complications, Rectum / injuries, Staphylococcal Infections / complications, Stroke / complications, Stroke / etiology, Case Reports, Humans, Male, Middle Aged

Background:
Diagnostic and therapeutic instrumentation of the lower gastrointestinal tract has been reported to result in bacteremia and endocarditis. No such case has been reported in persons with a history of rectal foreign body insertion despite its potential for greater trauma.
Case presentation:
A 58-year-old male was admitted with confusion and inability to speak. His past history was notable for hospitalization to extract a retained plastic soda bottle from the rectosigmoid two years prior. On examination, he was febrile, tachycardic and hypotensive. There was an apical pansystolic murmur on cardiac examination. He had a mixed receptive and expressive aphasia, and a right hemiparesis. On rectal examination he had perianal erythema and diminished sphincter tone. Magnetic resonance imaging of the brain showed infarction of the occipital and frontal lobes. Transesophageal Echocardiography of the heart revealed vegetations on the mitral valve. All of his blood culture bottles grew methicillin sensitive Staphylococcus aureus. He was successfully treated for bacterial endocarditis with intravenous nafcillin and gentamicin. The rectum is frequently colonized by Staphylococcus aureus and trauma to its mucosa can lead to bacteremia and endocarditis with this organism. In the absence of corroborative evidence such as presented here, it is difficult to make a correlation between staphylococcal endocarditis and anorectal foreign body insertion due to patients being less than forthcoming
Conclusion:
There is a potential risk of staphylococcal bacteremia and endocarditis with rectal foreign body insertion. Further studies are needed to explore this finding. Detailed sexual history and patient counseling should be made a part of routine primary care.
Prolonged Intractable Hiccups Associated with HSV (I&II) Esophagitis and H. pylori Gastritis
Authors: Christina Hopkins, Asha Bansari, Michael Ladna, Bahram Dideban
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

An immunocompetent male presented with an intractable hiccup. EGD revealed circumferential ulceration of middistal esophagus and biopsies confirmed HSV (I&II) esophagitis and H. pylori gastritis. He was prescribed triple therapy for H. pylori and acyclovir for HSV esophagitis. HSV esophagitis and H. pylori should be included in differential for intractable hiccups.
Postpartum Uterine Wound Dehiscence Leading to Secondary PPH: Unusual Sequelae
Authors: Rinku Sengupta Dhar, Renu Misra
Journal: Case Rep Obstet Gynecol (2012)
MeSH terms: Case Reports

Secondary postpartum haemorrhage due to partial or complete dehiscence of uterine wound after caesarean section is unusual. Authors present here a patient with secondary postpartum haemorrhage following uterine dehiscence after caesarean delivery. Conservative management failed to control the bleeding, and she eventually needed hysterectomy. All women who have significant PPH following caesarean should undergo evaluation for any defect in the scar. Scar dehiscence has been diagnosed and repaired after many years of caesarean section in women with persistent abnormal bleeding. Therefore, this condition may have long-term implication if missed postpartum.
Growth Impairment and Nutritional Deficiencies in a Cow's Milk-Allergic Infant Fed by Unmodified Donkey's Milk
Authors: Enza D'Auria, Marzia Mandelli, Patrizia Ballista, Francesco Di Dio, Marcello Giovannini
Journal: Case Rep Pediatr (2011)
MeSH terms: Case Reports

We report a case of growth impairment and nutritional deficiencies in a five-month infant fed by unmodified donkey's milk. We discuss the energy and macronutrient daily intake from donkey's milk and the nutritional consequences that can occur if this kind of milk is used unmodified in the first year of life.
Acquired haemophilia as a paraneoplastic manifestation of pancreatic cancer
Authors: Abeer Arain, Ibrahim N Muhsen, Maen Abdelrahim
Journal: Ecancermedicalscience (2020)
Keywords: acquired haemophilia, inhibitor treatment, pancreatic cancer, paraneoplastic phenomenon
MeSH terms: Case Reports

Acquired haemophilia is a severe haematological disorder characterised by the presence of anti-factor VIII antibodies. Although rare, it can lead to serious bleeding complications. Acquired haemophilia can be seen in patients with malignancies as a paraneoplastic phenomenon. This is a case of a 52-year-old patient who presented with haematuria and retroperitoneal bleeding soon after being diagnosed with pancreatic adenocarcinoma and subsequently was found to have acquired haemophilia. The treatment of underlying malignancy with chemotherapy may accelerate the eradication of anti-factor VIII antibodies.
Severe ARDS Complicating an Acute Intentional Cresol Poisoning
Authors: Djoudline Doughmi, Lamiae Bennis, Aicha Berrada, Ali Derkaoui, Abdelkrim Shimi, Mohammed Khatouf
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

Cresol is a phenol derivative used as a disinfectant that may cause gastrointestinal corrosive injury, central nervous system, cardiovascular disturbances, renal, and hepatic injury following intoxication. We present a case of a female patient who was admitted to the emergency department after ingesting an unknown amount of cresol; she was admitted with tachypnea, shortness of breath with low oxygen level in the blood. She did not develop hepatic or renal dysfunction. The gastrointestinal endoscopy was performed and showed esophagus and gastric erosins only. The patient was sedated and ventilated for 7 days. After receiving supportive intensive care, the patient recovered and was sent for psychiatric evaluation. Cresol intoxication can be fatal, and cause a respiratory failure with an acute respiratory distress syndrome (ARDS), hepatic, and renal injury. This shows the importance of intensive care in the management of cresol poisoning.
Coccidioidomycosis of the Vocal Cords Presenting in Sepsis: A Case Report and Literature Review
Authors: Curtis Converse, Atish Dey, Samuel Decker, Sarkis Arabian, Michael Neeki
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Coccidioidomycosis is a predominantly pulmonary disease caused by species of Coccidioides, a fungus endemic to the American Southwest. Most cases involve exclusively pulmonary manifestations while less than one percent present with disseminated infection, usually with meningeal or skin involvement. In this case, a patient with a history of odynophagia, sore throat, productive cough, weight loss, and abnormalities on chest radiograph presented with sepsis and diabetic ketoacidosis. During admission, the patient underwent bronchoscopy with resulting tissue and bronchoalveolar lavage samples positive for Coccidioides immitis, later supported by confirmatory serum studies. This case illustrates a rare presentation of vocal fold involvement without direct invasion from a continuous site and highlights the importance of a high index of suspicion for disseminated coccidioidomycosis with prompt antifungal treatment in order to avoid the very high morbidity and mortality in such cases.