OpenMed/multicare-articles huggingface dataset:
Primary intradiploic meningioma in the pediatric age-group
Authors: Mahadevan Sambasivan, Kumar Padmanabhan Sanal, Sambasivan Mahesh
Journal: J Pediatr Neurosci (2010)
Keywords: ct finding, histopathology, intradiploic menigioma, pediatric age-group, treatment strategy
MeSH terms: Case Reports

The authors report a pediatric patient who presented with a slow-growing swelling on the scalp. Computed tomography (CT) of the head revealed an osteolytic intradiploic lesion of the cranial vault. The lesion was excised in toto, and histopathological examination revealed benign intradiploic meningioma. The possible etiology, clinical findings, CT appearance, differential diagnosis, and treatment strategy are discussed.
Traumatic pseudoaneurysm of the middle meningeal artery causing an intracerebral hemorrhage
Authors: Wellingson Silva Paiva, Almir Ferreira de Andrade, Robson Luis Amorim, Eberval Gadelha Figueiredo, Manoel Jacobsen Teixeira
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Traumatic aneurysms comprise less than 1% of all intracranial aneurysms. Most of these aneurysms are actually false aneurysms, or pseudoaneurysms, which are caused by the rupture of entire vessel wall layers, with the wall of the aneurysm being formed by the surrounding cerebral structures. Traumatic pseudoaneurysms of the middle meningeal artery are also rare. Only four cases have been reported in the literature with intracerebral hematoma. In this paper, the authors report a case of a patient with a ruptured traumatic pseudoaneurysm of the MMA who presented with an intracerebral hematoma in the left temporal region immediately after trauma; the patient underwent endovascular treatment.
A case of Citrobacter koseri renal abscess and review of the literature
Authors: Duong Tommy Hua, Jessica Lo, Huy Quang Do, Charles Dac Pham
Journal: SAGE Open Med Case Rep (2022)
Keywords: citrobacter koseri, infectious diseases, kidney abscess, renal abscess
MeSH terms: Case Reports

Citrobacter species are anaerobic gram-negative bacteria that are known to cause infections in immunocompromised hosts, particularly in hospital settings. Their opportunistic nature and tendency to develop antibiotic resistance make Citrobacter species challenging to treat. Renal or perinephric abscess formation as a result of Citrobacter infection is uncommon, having only previously been reported in four cases. We present a case of a 70-year-old man with diabetes and prostate cancer who was diagnosed with an 18 cm perinephric and a 10 cm perihepatic abscess caused by Citrobacter koseri. The patient required drains and re-positioning of the drains multiple times in addition to a prolonged course of antibiotics to achieve complete radiographic resolution. This case highlights the challenges in treating renal and perinephric abscess, as it required drain re-placements two additional times after the initial placement and an additional 4 weeks of antibiotics. Successful treatment for larger abscesses usually requires a two-arm approach, with antibiotics in combination with either percutaneous or surgical abscess drainage.
A rare entity of benign recurring mesenchymal tumor of the female urethra
Authors: Onur Telli, Haşmet Sarıcı, Berat Cem Ozgür, Cem Nedim Yücetürk, Mehmet Ali Karagöz
Journal: Case Rep Urol (2013)

This is a case report of a 51-year-old female patient with benign mesenchymal tumors of paraurethral region which caused lower urinary tract symptoms. The pathological examination of the lesion was reported as angiomyxoma which is a distinct soft tissue tumor characterized by the presence of prominent myxoid matrix and numerous thin-walled blood vessels. This tumor has a predilection for the trunk, head and neck, extremities, and genitalia. It is a benign tumor, and total excision is curative. Recurrence is rare except for aggressive angiomyxomas.
Management of Refractory Gastrointestinal Bleeding in Hereditary Hemorrhagic Telangiectasia with Bevacizumab
Authors: Muaaz Masood, Michael Coles, Humberto Sifuentes
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder resulting in vascular malformations of several organs including the pulmonary, cerebral, and gastrointestinal systems. One sequela is recurrent gastrointestinal (GI) bleeding. Bevacizumab (Bev) is emerging as an effective treatment of recurrent gastrointestinal bleeding in HHT. Bev is a recombinant monoclonal antibody that inhibits vascular endothelial growth factor (VEGF), an integral part of angiogenesis.
BIS-Guided Total Intravenous Anesthesia for Orchiopexy and Circumcision in a Child with Severe Autism: A Case Report
Authors: Selçuk Okur, Müge Arıkan, Gülşen Temel, Volkan Temel
Journal: Case Rep Anesthesiol (2012)

Autistic children are very difficult to manage in the hospital setting because they react badly to any change in routine. We describe a case of 10-year-old male patient with severe autism undergoing orchidopexy and circumcision. Following premedication, anesthesia was induced with remifentanil, propofol, atracurium, and maintained with total intravenous anesthesia (propofol and remifentanil). The Bispectral Index System was monitored for determination of the depth of anesthesia. After surgery, all infusions were discontinued. The patient was then transferred to the postanesthetic care unit. There were no adverse events observed during the anesthetic management. The patient was discharged from the hospital on the second postoperative day. Bispectral Index System-guided Total Intravenous Anesthesia can provide some advantages for patient with autism, such as hemodynamic stability, early and easy recovery, to facilitate faster discharge, to optimize the delivery of anesthetic agents, to minimize its adverse effects, and to maximize its safety.
Case Report: Clinical complete response of advanced renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion by treated by camrelizumab and axitinib: A rare case report
Authors: Juping Zhao, Kun Dai, Jialing Xie, Chen Fang, Na Chen, Jun Dai, Danfeng Xu
Journal: Front Pharmacol (2022)
Keywords: pd-1, ptprd-mutation, xp112 translocation renal cell carcinoma, immunotherapy, tyrosine kinase inhibitor
MeSH terms: Case Reports

Renal cell carcinoma (RCC) associated with Xp11.2 translocation/TFE3 gene fusions is a rare subtype of renal tumor. This entity predominantly occurs in juveniles, but rarely in adults. Xp11.2 translocation RCC (tRCC) patients with lymph node or organ metastasis are associated with poor prognosis, and the strategy remains controversial. Herein, we presented our experience with the diagnosis and treatment of an adult case of Xp11.2 tRCC. In our clinical practice, a 32-year-old male manifested fever and right flank paroxysmal blunt pain, and computed tomography showed an inhomogeneous mass, 6 cm in diameter, in the right kidney. Then right partial nephrectomy (PN) and renal hilar lymph node dissection by laparoscopic surgery were performed. Pathology revealed that the tumor cells were positive for TFE3 immunohistologically and positive for TFE3 break-apart fluorescence in situ hybridization assay. A splice site mutation c.1544-1G>T of protein tyrosine phosphatase receptor delta (PTPRD) was detected by next-generation sequencing and weak PTPRD expression was confirmed in tumor tissues compared to tumor periphery. This patient was diagnosed with stage III RCC and received immune checkpoint inhibitor (camrelizumab) in combination with tyrosine kinase inhibitor (axitinib) treatment for 1 year. He achieved a clinical complete response with no sign of recurrence or metastasis. PTPRD mutation might be a favorable indicator for Xp11.2 tRCC patients managed by PN and followed by the adjuvant therapy of immune checkpoint inhibitor and tyrosine kinase inhibitor.
A case series of ocular involvement in bullous pemphigoid: clinical features, management, and outcomes
Authors: Anahita Kate, Swapna Shanbhag, Pragnya Rao Donthineni, Sayan Basu
Journal: F1000Res (2021)
Keywords: bullous pemphigoid, autoimmune blistering disorders, case series, cicatrizing conjunctivitis, conjunctival granuloma
MeSH terms: Autoimmune Diseases, Conjunctivitis / drug therapy, Pemphigoid, Benign Mucous Membrane / complications, Pemphigoid, Benign Mucous Membrane / diagnosis, Pemphigoid, Benign Mucous Membrane / drug therapy, Pemphigoid, Bullous / complications, Pemphigoid, Bullous / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Cicatrix, Humans, Retrospective Studies

Ocular involvement in cases of bullous pemphigoid is rare and when present, the signs are usually subtle and in the form of fine tarsal scarring and dry eye disease. The current report aims to describe the clinical features and management protocols in a series of cases with aggressive ocular manifestations at presentation. All cases of bullous pemphigoid seen between 2017 and 2020 were included in this retrospective case series. Data regarding the clinical features, treatment administered, and outcomes was collected. Five cases (n=10 eyes) of bullous pemphigoid disease with ocular involvement were included. All eyes had significant cicatricial conjunctival changes in the form of symblephara, inferior forniceal shortening, and tarsal conjunctival scarring. Conjunctival granulomas were present in 3/10 eyes. Corneal involvement in the form of punctate keratitis was present in all eyes while 4/10 eyes had an epithelial defect as well. The management of these cases involved topical therapy with corticosteroids and lubricants (n=10 eyes) while pulse doses of intravenous methyl prednisolone were administered in 5/5 cases. Pulse intravenous cyclophosphamide was supplemented in 2/5 cases. Adequate control of the disease was noted in 3/5 cases while one case had a recalcitrant form of the disease and developed a dermalised ocular surface in both eyes. The last patient was lost to follow up during the course of therapy. Bullous pemphigoid can present with an aggressive form of cicatrizing conjunctivitis similar to other variants of autoimmune blistering disorders and must be considered as a differential in cases presenting with ocular cicatricial disease. Long-term intensive immunosuppression is required for the management of these cases to preserve the visual function and the integrity of the globe.
Efficacy of CytoSorb in a Pediatric Case of Severe Multisystem Infammatory Syndrome (MIS-C): A Clinical Case Report
Authors: Gabriella Bottari, Valerio Confalone, Nicola Cotugno, Isabella Guzzo, Salvatore Perdichizzi, Emma C Manno, Francesca Stoppa, Corrado Cecchetti
Journal: Front Pediatr (2021)
Keywords: cytosorb, children, cytokine storm, hemoperfusion, multisystem inflammatory syndrome in children, pediatric intensive care
MeSH terms: Case Reports

Background: Multisystem inflammatory syndrome in children (MIS-C) has emerged during the COVID-19 pandemic as a new SARS-CoV-2-related entity, potentially responsible for a life-threatening clinical condition associated with myocardial dysfunction and refractory shock. Case: We describe for the first time in a 14-year-old girl with severe MIS-C the potential benefit of an adjuvant therapy based on CytoSorb hemoperfusion and continuous renal replacement therapy with immunomodulatory drugs. Conclusions: We show in our case that, from the start of extracorporeal blood purification, there was a rapid and progressive restoration in cardiac function and hemodynamic parameters in association with a reduction in the most important inflammatory biomarkers (interleukin 6, interleukin 10, C-reactive protein, ferritin, and D-dimers). Additionally, for the first time, we were able to show with analysis of the sublingual microcirculation a delayed improvement in most of the important microcirculation parameters in this clinical case of MIS-C.
Thymic seminoma
Authors: J Kannan, P Karkuzhali, S Lakshminarasimhan
Journal: Indian J Med Paediatr Oncol (2009)
Keywords: thymic seminoma, anterior mediastinal mass, thoracotomy
MeSH terms: Case Reports

Thymic seminoma is a rare clinical entity. We report a case of an 18-year-old male patient who presented with chest pain, dyspnea, dysphagia of 1-month duration. Contrast-enhanced computer tomogram of chest showed an anterior mediastinal mass. He was subjected to thoracotomy and excision of the mass. Histopathology examination revealed seminoma of thymus. He failed to follow up for a period of 8 months post-surgery as he was asymptomatic. He then presented with a recurrence of the tumor locally, along with metastases to the lung, para-aortic and peri-aortic lymph nodes. He was kept on cisplatin, bleomycin and etoposide.
Time-Limited Eating in Pediatric Patients with Obesity: A Case Series
Authors: Alaina P Vidmar, Michael I Goran, Jennifer K Raymond
Journal: J Food Sci Nutr Res (2019)
Keywords: obesity, pediatrics, time limited eating

Background:
Time Limited Eating (TLE) is an effective strategy for management of obesity in adults, but there is a paucity of data that have examined its use in the clinical management of children with obesity. A TLE approach involves interspersing normal daily caloric intake with periods of prolonged calorie restriction several times per week. TLE may actually be more feasible, non-stigmatizing, flexible and effective in children, especially for adolescents, compared to alternatives like daily caloric or macronutrient restriction. This is because TLE removes the need for intensive counting of daily calorie intake or macronutrient content and focuses on a straightforward task of consuming food during a pre-specified time period. Also it avoids periods of extended caloric restriction which may interfere with growth and/or risk evoking development of eating behaviors. This case series describes four patients who trialed a TLE approach in a clinical weight management clinic and describes BMI reduction at 4 months.
Case presentation:
To date, 4 patients, ages 5-15, with varying underlying pathologies (i.e. Bardet Biedl Syndrome (BBS), previously healthy, craniopharyngioma and epilepsy) have tried a TLE type approach (16-hour fast/8-hour feed for 3-5 days per week) for 4 months and have demonstrated an average decrease in their BMI z-score compared to baseline of -0.24 SD. Patients and their families reported high degrees of satisfaction with this dietary approach.
Conclusions:
Families were very satisfied with the TLE intervention and reported it was feasible, flexible and sustainable to implement in a real life setting and associated with decreased zBMI. Further investigation is required to determine if this approach is effective in both the short and long term as a weight management technique.
Anticipatory Care in Potentially Preventable Hospitalizations: Making Data Sense of Complex Health Journeys
Authors: Carmel M Martin, Joachim P Sturmberg, Keith Stockman, Narelle Hinkley, Donald Campbell
Journal: Front Public Health (2019)
Keywords: anticipatory care, complex adaptive systems, data analytics, data science, frequent users, health trajectory, potentially preventable hospitalizations, readmissions

Purpose: Potentially preventable hospitalizations (PPH) are minimized when adults (usually with multiple morbidities ± frailty) benefit from alternatives to emergency hospital use. A complex systems and anticipatory journey approach to PPH, the Patient Journey Record System (PaJR) is proposed. Application: PaJR is a web-based service supporting ≥weekly telephone calls by trained lay Care Guides (CG) to individuals at risk of PPH. The Victorian HealthLinks Chronic Care algorithm provides case finding from hospital big data. Prediction algorithms on call data helps optimize emergency hospital use through adaptive and anticipatory care. MonashWatch deployment incorporating PaJR is conducted by Monash Health in its Dandenong urban catchment area, Victoria, Australia. Theory: A Complex Adaptive Systems (CAS) framework underpins PaJR, and recognizes unique individual journeys, their dependence on historical and biopsychosocial influences, and difficult to predict tipping points. Rosen's modeling relationship and anticipation theory additionally informed the CAS framework with data sense-making and care delivery. PaJR uses perceptions of current and future health (interoception) through ongoing conversations to anticipate possible tipping points. This allows for possible timely intervention in trajectories in the biopsychosocial dimensions of patients as "particulars" in their unique trajectories. Evaluation: Monash Watch is actively monitoring 272 of 376 intervention patients, with 195 controls over 22 months (ongoing). Trajectories of poor health (SRH) and anticipation of worse/uncertain health (AH), and CG concerns statistically shifted at a tipping point, 3 days before admission in the subset who experienced ≥1 acute admission. The -3 day point was generally consistent across age and gender. Three randomly selected case studies demonstrate the processes of anticipatory and reactive care. PaJR-supported services achieved higher than pre-set targets-consistent reduction in acute bed days (20-25%) vs. target 10% and high levels of patient satisfaction. Discussion: Anticipatory care is an emerging trajectory data analytic approach that uses human sense-making as its core metric demonstrates improvements in processes and outcomes. Multiple sources can provide big data to inform trajectory care, however simple tailored data collections may prove effective if they embrace human interoception and anticipation. Admission risk may be addressed with a simple data collections including SRH, AH, and CG perceptions, where practical. Conclusion: Anticipatory care, as operationalized through PaJR approaches applied in MonashWatch, demonstrates processes and outcomes that successfully ameliorate PPH.
Indolent T-lymphoblastic proliferation with fibrolamellar hepatocellular carcinoma developed after colorectal adenocarcinoma: a case report
Authors: Wen Han, Bei Wang, Xiang Yong, Yi Zhang, Mingyu Shao, Chun Wang
Journal: Pathol Oncol Res (2023)
Keywords: t-lymphoblastic lymphoma, differential diagnosis, fibrolamellar hepatocellular carcinoma, it-lbp, indolent t-lymphoblastic proliferation
MeSH terms: Adenocarcinoma, Carcinoma, Hepatocellular / pathology, Colorectal Neoplasms, Liver Neoplasms / pathology, Precancerous Conditions, Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / diagnosis, Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / pathology, Case Reports, Cell Proliferation, Humans, Hyperplasia, Fibrolamellar hepatocellular carcinoma

Objective: Indolent T-lymphoblastic proliferation (iT-LBP) is a non-neoplastic disease with an indolent clinical course, manifesting as hyperplasia of immature extrathymic T-lymphoblastic cells. Isolated iT-LBP has been observed, but the majority of iT-LBP cases has been seen in conjunction with other diseases. iT-LBP is easily misdiagnosed as T-lymphoblastic lymphoma/leukemia, and understanding the disease of indolent T-lymphoblastic proliferation may prevent misdiagnosis and missed diagnosis in pathological diagnosis. Case presentation: We report a case morphology, immunophenotypic, and molecular features of iT-LBP combined with fibrolamellar hepatocellular carcinoma developed after colorectal adenocarcinoma and review relevant literature. Conclusion: iT-LBP combined with fibrolamellar hepatocellular carcinoma developed after colorectal adenocarcinoma is relatively rare and should always be considered as a differential diagnosis of T-lymphoblastic lymphoma and scirrhous hepatocellular carcinoma as the two disorders show highly similar clinical features.
Case report: Rare abernethy malformation with hepatopulmonary syndrome in a pediatric patient
Authors: Lianfu Ji, Zhaoming Ji, Dandan Xiang, Yuming Qin, Shiwei Yang
Journal: Front Pediatr (2022)
Keywords: abernethy malformation, hepatic portal vein system, hepatopulmonary syndrome, inferior vena cava balloon occlusion test, splenic arteriography
MeSH terms: Case Reports

Abernethy malformation is a rare abnormality of the hepatic portal vein system with non-specific and diverse clinical manifestations. Here, we described a case of abernethy malformation with hepatopulmonary syndrome in a 10-year-old girl. On physical examination, cyanosed lips and acropachy could be found. Her oxygen saturation fluctuated at 89-94%, and the fasting blood ammonia was 98 umol/L. Furthermore, there were abnormalities in the imaging. The microbubble test with contrast echocardiography was positive. Computer tomography angiography (CTA) showed the splenic vein, and the superior mesenteric drained directly into the inferior vena cave after confluence. The same result was also observed in delayed splenic arteriography. Then, we discovered a tiny branch of the intrahepatic portal vein by the inferior vena cava balloon occlusion test, which could also show the confluence of the splenic vein and superior mesenteric vein with the inferior venacave. According to the evidence above, we concluded that the girl was a patient of type II abernethy malformation. For the severe dysplasia of the portal vein, the girl accepted partial ligation of portosystemic shunt and Rex shunt, which improved her oxygen saturation and exercise tolerance.
Postoperation of cervical cancer with intestine metastasis: a case report and literature review
Authors: Xiuyan Yu, Zhen Wang, Zhigang Zhang, Yang Liu, Jian Huang
Journal: World J Surg Oncol (2016)
MeSH terms: Carcinoma, Squamous Cell / secondary, Ileal Neoplasms / secondary, Intestinal Obstruction / etiology, Sigmoid Neoplasms / secondary, Uterine Cervical Neoplasms / pathology, Uterine Cervical Neoplasms / surgery, Case Reports, Review, Carcinoma, Squamous Cell / complications, Carcinoma, Squamous Cell / diagnosis, Carcinoma, Squamous Cell / surgery, Female, Humans, Ileal Neoplasms / complications, Ileal Neoplasms / diagnosis, Middle Aged, Sigmoid Neoplasms / complications, Sigmoid Neoplasms / diagnosis

Background:
Cervical cancer can infiltrate locally and directly spread to adjacent organs including the vagina, peritoneum, urinary bladder, ureters, rectum, and paracervical tissue, but the intestine metastasis from cervical cancer is extremely rare, which can easily be misdiagnosed.
Case presentation:
Here, we report a case about a 45-year-old postoperative cervical cancer patient with metastases to small intestine and sigmoid colon who presented abdominal distention and dull pain due to intestinal obstruction. The patient underwent exploratory laparotomy, and two intestinal segments including the tumors were resected. The postoperative pathological diagnosis illustrated sigmoid colon and terminal ileum metastatic squamous cell carcinoma.
Conclusions:
This case demonstrates that intestine metastasis must be considered in the differential diagnosis of acute abdomen in patients with cervical cancer even at an early tumor stage.
Chronic Thromboembolic Pulmonary Hypertension in a Child With Sickle Cell Disease
Authors: Robert Spencer, Gerson Valencia Villeda, Koji Takeda, Erika B Rosenzweig
Journal: Front Pediatr (2020)
Keywords: cteph—chronic thromboembolic pulmonary hypertension, hematology, pediatric cardiology, pulmonary hypertension, sickle cell disease
MeSH terms: Case Reports

Chronic thromboembolic pulmonary hypertension is a potentially curable form of pre-capillary pulmonary hypertension (PH) resulting from incomplete resolution of pulmonary thromboemboli. We describe an 11-year-old boy with homozygous sickle cell disease with an indwelling catheter found to have severe PH on routine screening echocardiography. The diagnosis was confirmed by CT, ventilation-perfusion scintigraphy, and right heart catheterization. The patient was medically managed until undergoing pulmonary thromboendarterectomy with resolution of his PH. This case highlights the need for pediatric providers to be aware of this underdiagnosed form of PH, particularly for patients at high risk.