OpenMed/multicare-articles huggingface dataset:
A Unique Case of Intraabdominal Polyorchidism: A Case Study
Authors: Javier Otero, Natalie Ben-Yakar, Biruk Alemayehu, Steven D Kozusko, Frank Borao, Thomas S Vates Iii
Journal: Case Rep Urol (2016)

Background. Polyorchidism, alternatively supernumerary testes (SNT), is a condition where an individual is born with more than two testicles. This congenital anomaly is quite rare and the literature has described various presentations. Questions/Purposes. To our knowledge, this presentation of polyorchidism has yet to be described in the literature. The goal of this case study is to add to the pediatric, general, and urologic surgery's body of knowledge of the subject matter. Case Study. A nine-month-old boy was admitted for an impalpable right testis and phimosis. At the time of surgical exploration, there appeared to be polyorchid testis on the right-hand side, with three masses that potentially appeared to be undescended testes. Discussion. Proponents of a conservative approach argue that infertility is common in patients with polyorchidism and, by preserving a potentially functional SNT, there may be improved spermatogenesis. When performing definitive surgical treatment, meticulous intra-abdominal and intrainguinal exploration must be undertaken. Orchiopexy should be performed to reduce the chances of torsion, malignancy, and infertility. Conclusion. Our case is important to the literature as it is the first known case of polyorchidism with 3 SNT on the right side, located intra-abdominally, and in a patient less than 1 year of age.
Pyomyositis in a Patient with IgA Nephropathy and Kidney Transplant
Authors: M Xipell, P Ventura-Aguiar, I Revuelta, M Bodro, F Diekmann
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Infections are among the most common complications transplant physicians face when dealing with solid organ transplant recipients. We present a case of pyomyositis caused by Staphylococcus aureus in a patient with IgA nephropathy and a kidney transplant, under treatment with mTOR inhibitors and prednisone. This entity is a rare intramuscular infection, given the resistance of healthy muscle to colonization. We review the most frequent agents, the diagnostic algorithm, and therapeutic alternatives. We also comment on the role of mTOR inhibitors in this case as possible predisposing factor for the infection.
A rare, late complication after automated implantable cardioverter-defibrillator placement
Authors: Michael Shapiro, Sam Hanon, Paul Schweitzer
Journal: Indian Pacing Electrophysiol J (2004)

This article describes an interesting case of automated implantable cardioverter defibrillator (AICD) extrusion fifteen months after implantation. The case report is followed by a discussion of the causes and treatment of skin erosion following pacemaker/AICD insertion.
Infected Renal Cyst as a Complication of Dropped Gallstones during Laparoscopic Cholecystectomy
Authors: Chelsea Kennedy-Snodgrass, Vivian Keenan, Douglas S Katz
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Dropped gallstones are a relatively common complication, occurring in 3% to 32% of laparoscopic cholecystectomies performed, depending on various intraoperative risk factors. However, complications arising from dropped gallstones are relatively rare, occurring in fewer than 1% of such patients, and can include abscesses and inflammatory masses confined to the subhepatic space, presenting days to years later. We report a patient who developed an infected renal cyst as a result of dropped gallstones, which created a fistula from the duodenum to a previously simple right renal cyst, which was initially identified on an abdominal CT scan. Dropped gallstones can result in substantial morbidity in a minority of patients following cholecystectomy performed for cholecystitis, and a high clinical as well as radiological index of suspicion may be required for accurate early recognition and treatment.
Case Report: Successful Treatment of Five Critically Ill Coronavirus Disease 2019 Patients Using Combination Therapy With Etoposide and Corticosteroids
Authors: Tetsuji Aoyagi, Yukio Sato, Hiroaki Baba, Takuya Shiga, Issei Seike, Ikumi Niitsuma Sugaya, Kentarou Takei, Yudai Iwasaki, Kengo Oshima, Hajime Kanamori, Makiko Yoshida, Koji Saito, Koichi Tokuda, Mitsuo Kaku
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, sars-cov-2, acute respiratory distress (ards), case series, corticosteroid, etoposide
MeSH terms: Case Reports

Acute respiratory distress syndrome (ARDS) is the leading cause of mortality in hospitalized patients with coronavirus disease 2019 (COVID-19) because of limited effective therapies. During infection, the accumulation and activation of macrophages and monocytes in the lungs induce inflammatory mediators and contribute to tissue injury, leading to ARDS. However, therapeutic strategies that directly target activated macrophage and monocytes have not been reported. Combination treatment with etoposide (a cytotoxic agent) and a corticosteroid has been widely used for treating hemophagocytic lymphohistiocytosis characterized by the systemic activation of macrophages with overwhelming inflammation. Herein, we present five cases of COVID-19-associated ARDS treated with etoposide and corticosteroids. Three of the five patients were over 65 years of age and had various underlying diseases, including multiple myeloma. Four patients required invasive mechanical ventilation (MV), and one patient refused to be placed on MV due to underlying diseases. All patients were pre-treated with antiviral and/or other anti-inflammatory agents, but their condition deteriorated and hyperinflammation was noted. All five patients responded well to treatment and had an immediate response, as reflected by improvement in their respiratory condition and inflammatory marker levels and rapid resolution of fever after etoposide administration; however, some patients required a second dose of etoposide and longer course of steroids. All patients recovered, and there were no severe adverse events related to the drugs. Following successful treatment in these five patients, we plan to conduct a clinical trial to evaluate the efficacy and safety of combination therapy with etoposide and corticosteroid for treating COVID-19 patients in Japan.
Effects of language stimulation on cognition of institutionalized aged people: a preliminary case series study
Authors: Ruttienya Dias Braga da Cunha, Tayane Frez Pacheco, Simone Dos Santos Barreto
Journal: Dement Neuropsychol (2021)
Keywords: cognition, homes for the aged, language, language therapy, treatment outcome

Cognitive stimulation programs for institutionalized elderly people show positive results, however few studies have investigated the effectiveness of language stimulation programs for the health of this population.
Objectives:
To characterize the cognitive-linguistic profile of institutionalized elderly and to compare their performance before and after a language stimulation program (LSP).
Methods:
An exploratory case series study was conducted with nine residents of a Home for the Aged. Elderly people aged 60 or over, of both sexes, without neurological or neuropsychiatric diseases, communication disorders, intellectual impairment or severe visual or hearing impairment were included. The participants were submitted to an initial assessment through the Montreal Cognitive Assessment (MoCA) and Montreal Toulouse Battery Language Assessment - Brazil to characterize the cognitive-linguistic profile of the studied group. Five elderly were selected to participate in the LSP, of wich only two participated effectively in the program, but all were reassessed after the program was completed.
Results:
on the initial assessment, of the nine participants, only one had adequate cognitive performance and all presented changes in macro and/or microlinguistics aspects of oral discourse, with oral comprehension preserved. On the reassessment carried out with five participants, only two participants who adhered effectively to the program obtained improvements in MoCa scores. In regarding language, three participants performed better in the oral emission measures. The performance of the participants in oral comprehension remained or declined.
Conclusion:
The speech-language therapy intervention through a LSP contributes to improving the cognitive-linguistic performance of institutionalized elderly.
Identification of Carotid Artery Microstructure and Plaque Rupture Using C-Arm Cone-Beam CT: A Case Report
Authors: Jia Dong, Xuesong Bai, Adam A Dmytriw, Lanlan Xuan, Tao Wang, Xia Lu, Yao Feng, Liqun Jiao
Journal: Front Neurol (2021)
Keywords: c-arm cone-beam ct, ischemic stroke, microcalcification, neovascularization, plaque rupture
MeSH terms: Case Reports

C-arm cone-beam computed tomography (CBCT) offers a high imaging resolution with a wide range of contrast to visualize vessels, soft tissue, and bone. We report the usefulness of CBCT in observing neovascularization, microcalcification, and plaque rupture. A 56-year-old man presented with vertigo and complain of an unsteady gait for 5 months. Catheter angiography demonstrated right severe carotid stenosis with irregular filling defect, which on high-resolution MRI showed vessel wall enhancement. The CBCT showed high density structures and linear contrast enhancement from the vascular lumen to the plaque, related to microstructure and plaque rupture. Carotid endarterectomy was performed, and histopathology confirmed that the high-density areas represented neovascularization and microcalcification, with linear enhancement representing plaque rupture. This is the first report showing that microcalcifications and plaque rupture can be identified by CBCT. Thus, CBCT can be used as a promising supplement to current imaging modalities to evaluate plaque components more accurately.
Case report: Post-therapeutic laryngeal carcinoma patient possessing a high ratio of aneuploid CTECs to CTCs rapidly developed de novo malignancy in pancreas
Authors: Jiaoping Mi, Fang Yang, Jiani Liu, Mingyang Liu, Alexander Y Lin, Daisy Dandan Wang, Peter Ping Lin, Qi Zeng
Journal: Front Oncol (2022)
Keywords: mrd, se-ifish, aneuploid ctcs and ctecs, liquid biopsy, prediction of cancer occurrence
MeSH terms: Case Reports

Effectively evaluating therapeutic efficacy, detecting minimal residual disease (MRD) after therapy completion, and predicting early occurrence of malignancy in cancer patients remain as unmet imperative clinical demands. This article presents a case of a laryngeal carcinoma patient who had a surgical resection and complete post-operative chemoradiotherapy in combination with the targeted therapy, then rapidly developed pancreatic adenocarcinoma. Detected by SE-iFISH, the patient had a substantial amount of 107 non-hematological aneuploid circulating rare cells including 14 circulating tumor cells (CTCs, CD31-/CD45-) and 93 circulating tumor endothelial cells (CTECs, CD31+/CD45-) with a high ratio of CTECs/CTCs > 5 upon finishing post-surgical combination regimens. Positive detection of those aneuploid non-hematological circulating rare cells was five months prior to subsequent plasma CA19-9 increasing and ten months before the de novo pancreatic cancer was diagnosed by medical imaging modalities. Besides previously reported clinical utilities of co-detection of aneuploid CD31- CTCs and CD31+ CTECs in real-time evaluation of therapeutic efficacy, longitudinal monitoring of emerging treatment resistance and adequate detection of MRD, a large cohort study is necessary to further investigate whether, and how, a high ratio of MRD CTECs to CTCs may function as an appropriate index forecasting either occurrence or metastatic distant recurrence of malignancy in post-therapeutic cancer patients.
Upper pole nephrectomy: a simplified technique using a retroperitoneal laparoscopic approach
Authors: Joana Pereira, Angélica Osório, João Moreira-Pinto, José Cidade-Rodrigues, Carlos Enes, Armando Reis, João Ribeiro-Castro
Journal: Case Rep Urol (2011)
MeSH terms: Case Reports

Objective. To describe a simplified technique already used in our institution for several years in the open heminephrectomy for duplication anomalies, now performed through a retroperitoneal laparoscopic approach. Methods. The technique begins with upper pole parenchyma incision since the demarcation between the affected upper moiety and the healthy lower pole is easily established. The dissection proceeds until the urothelium of the collecting system is entered, which will guide further excision, minimizing damage of the surrounding structures. The vascular supply is then identified since the upper pole is attached to the remaining renal parenchyma only by these structures that can be safely divided. Dissection and division of the ectopic ureter is carried next. Results. The operative time was 188 minutes. The blood loss was not significant, and there were no other complications during the procedure. The patient was discharged home 48 hours after the procedure, without any early or late postoperative complications. Conclusion. We believe this simplified technique allows a safer excision of nonfunctioning upper pole renal tissue by avoiding the initial dissection of the renal hilum, which associated with the known advantages of a laparoscopic approach makes us consider it the procedure of choice for upper pole nephrectomy in children.
Facial Asymmetry in a Crying Newborn: A Comparison of Two Cases and Review of Literature
Authors: Shreyas Arya, Sunil K Jain, Carol J Richardson
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Facial asymmetry in a crying newborn can be due to a variety of different causes. Neonatal asymmetric crying facies (NACF) is a specific phenotype, which is often underrecognized. It is defined as asymmetry of the mouth and lips with grimacing or smiling, but a symmetric appearance at rest. NACF needs to be differentiated from complete facial palsy in a newborn, which can occur due to traumatic or developmental etiologies. Developmental causes can be present in isolation or may be a part of a recognized syndrome. While asymmetric lower lip depression may be seen in both conditions, complete facial palsy is also associated with upper and mid face deformities. We present a case of NACF and compare it to a case of facial palsy due to perinatal trauma. The purpose of this case series is to clarify some of the confusing nomenclatures and highlight the differences in the physical exam findings, diagnosis, and eventual prognosis of these cases.
Case Report: Lennox-Gastaut Epileptic Encephalopathy Responsive to Cannabidiol Treatment Associated With a Novel de novo Mosaic SHANK1 Variant
Authors: Justyna Paprocka, Szymon Ziętkiewicz, Joanna Kosińska, Ewa Kaczorowska, Rafał Płoski
Journal: Front Genet (2021)
Keywords: lennox–gastaut syndrome, rap1, shank1, epilepsy, treatment
MeSH terms: Case Reports

The SH3 and multiple ankyrin repeat domains (SHANKs) are a family of scaffolding proteins located in excitatory synapses required for their development and function. Molecular defects of SHANK3 are a well-known cause of several neurodevelopmental entities, in particular autism spectrum disorders and epilepsy, whereas relatively little is known about disease associations of SHANK1. Here, we propose a novel de novo mosaic p.(Gly126Arg) SHANK1 variant as the monogenic cause of disease in a patient who presented, from the age of 2 years, moderate intellectual disability, autism, and refractory epilepsy of the Lennox-Gastaut type. The epilepsy responded remarkably well to cannabidiol add-on therapy. In silico analyses including homology modeling and molecular dynamics simulations indicated the deleterious effect of SHANK1 p.(Gly126Arg) on the protein structure and the related function associated with protein-protein interactions. In particular, the variant was predicted to disrupt a hitherto unknown conserved region of SHANK1 protein with high homology to a recently recognized functionally relevant domain in SHANK3 implicated in ligand binding, including the "non-canonical" binding of Rap1.
Spinocerebellar ataxia Type 7: clinical and genetic study of a new Moroccan family (case report)
Authors: Fatima Zahra Bouzid, Maria Mansouri, Chaikhy Abdelaziz, Nisrine Louhab, Sablonniere Bernard, Isabelle Strubi-Vuillaume, Kenza Dafir, Nisrine Aboussair
Journal: Pan Afr Med J (2021)
Keywords: atxn7 gene, cag repeats, case report, spinocerebellar ataxia type 7
MeSH terms: Ataxin-7 / genetics, Spinocerebellar Ataxias / diagnosis, Case Reports, Adolescent, Adult, Female, Genetic Testing, Humans, Male, Morocco, Mutation, Spinocerebellar Ataxias / genetics, Spinocerebellar Ataxias / physiopathology, Young Adult, ATXN7 protein, human, Ataxin-7

Spinocerebellar ataxia type 7 (SCA7) is a rare autosomal dominant neurodegenerative disease. Its clinical presentation is a progressive cerebellar ataxia associated with cone and retinal dystrophy. The CAG repeat expansion in the ataxin-7 gene (ATXN7) causes spinocerebellar ataxia type 7 - a mutation that results in the degeneration of the brain stem cells, retina and cerebellum. We report in this study the clinical and genetic features of a new Moroccan family of SCA7, from the South of Morocco. We performed the molecular genetic testing to confirm the diagnosis of SCA7. The objective of this study is to report a new Moroccan case of SCA7 and to illustrate the role of the geneticist in the diagnosis, management and development of genetic counseling of SCA7 disease.
Recurrent Oral Eosinophilic Ulcers of the Oral Mucosa. A Case Report
Authors: Norberto Sugaya, Fernanda Martignago, Decio Pinto, Dante Migliari
Journal: Open Dent J (2018)
Keywords: crohn’s disease, diagnosis, eosinophilic ulcer, oral mucosa, oral ulcerations, recurrences
MeSH terms: Case Reports

Objective:
This article describes a case of an Oral Eosinophilic Ulcer (OEU) in an otherwise healthy 31-year-old white woman.
Introduction:
The importance of reporting this case was the presence of recurrent episodes with lesions appearing in different areas of the oral mucosa, a type of manifestation not commonly associated with this disease. A typical manifestation of OEU occurs as a single ulceration that goes into healing after an incisional biopsy, a procedure usually required for a proper diagnosis of the disease. In spite of trauma being suggested as the main culprit of OEU, the exact pathogenesis mechanism of this disease remains controversial.
Case report:
The pattern of the present case contradicts the usually common course of the disease, as the patient had experienced many recurrent episodes for almost 2.5 years, with the recurrences occurring even after biopsies performed during some of the relapses. Differential diagnosis included recurrent aphthous stomatitis, recurrent intra-oral herpes, autoimmune disease, Crohn's disease and malignancy.
Conclusion:
Fortunately, the patient has been free of any recurrences for 1.5 years since the last biopsy was taken at the time she came to our clinic seeking treatment.
CTU findings of duplex kidney in kidney: A rare duplicated renal malformation
Authors: Nanai Xie, Xu Huang, Jie Zhou, Heng Zhang, Wanling Ma
Journal: Open Med (Wars) (2021)
Keywords: computed tomography urography, duplex kidney, intrarenal kidney, kidney, urinary tract
MeSH terms: Case Reports

Duplex kidney is a common congenital malformation appeared as duplication of pelvis and ureter. However, renal duplication within sinus renalis is an extremely rare variation of the renal collecting system. In this study, we report a case of an asymptomatic kidney disease in a 33-year-old man, who demonstrates abnormal echo of renal sinus anomaly discovered incidentally in ultrasound examination. Computed tomography urography (CTU) exhibited the other small duplex kidney located in renal sinus. In the excretory phase images, the contrast medium within its small renal pelvis could be seen to flow into the right major renal calices. This case exhibited a very rare anatomical variation of duplicated renal malformation.
Ilio-psoas impingement with a dual-mobility liner: an original case report and review of literature
Authors: Michel Henri Fessy, Louis Riglet, Laure-Lise Gras, Hadrien Neyra, Jean-Baptiste Pialat, Anthony Viste
Journal: SICOT J (2020)
Keywords: dual mobility, iliopsoas impingement, liner, total hip arthroplasty
MeSH terms: Case Reports

Ilio-psoas impingement after total hip arthroplasty often occurs with the metallic rim of the acetabular cup. The main causes are poor cup anteversion or anterior wall defect. We firstly report here the case of a patient complaining of iliopsoas impingement due to contact with the liner of a dual-mobility device. Ultrasonography and Computed Tomographic scan clearly showed the direct mechanical contact of the dual-mobility liner with the iliopsoas tendon.
Case Report: Serial MR Vessel Wall Imaging Visualizes the Response of Intracranial Plaques and Assists in Decision-Making
Authors: Jiayu Xiao, Matthew M Padrick, Shlee S Song, Zhaoyang Fan, Konrad H Schlick
Journal: Front Neurosci (2021)
Keywords: follow-up study, intracranial atherosclerosis, plaque, stroke, vessel wall imaging
MeSH terms: Case Reports

Intracranial atherosclerotic disease (ICAD) is a dynamic process that leads to ischemic stroke. Symptomatic ICAD patients still suffer a high recurrent rate even under standard treatment. In this case report, to better understand the response of intracranial atherosclerotic plaques to medication, serial MR imaging was added to standard clinical workup in a 47-year-old male patient with acute occipital lobe infarction at baseline, 3-month, 6-month, and 12-month post index stroke to directly visualize the morphology and signal change of plaques. We noticed that one of the plaques showed dramatic worsening at 3-month imaging follow-up despite a decrease in low-density lipoprotein level. Early identification of patients who do not respond well to medication is critical to prevent the recurrence of cardiovascular events in ICAD patients.
A Novel Endovascular Treatment for Recurrent Secondary Aorto-Enteric Fistula in a Patient With Prior Infra-Renal Aortic Ligation
Authors: Calvin Cheong, Rajesh Dharmaraj, Amos Tan, Shao J Ong, Gopinathan Anil
Journal: Cureus (2023)
Keywords: aortic diseases, aorto-enetric fistula, ct angiogram, endovascular procedures, endovascular stenting, percutaneous endovascular repair
MeSH terms: Case Reports

This report highlights the use of novel endovascular techniques in a 68-year-old male patient with massive hematemesis from a recurrent secondary aorto-enteric fistula (SAEF). With a prior history of infrarenal aortic ligation and the location of the SAEF being at the aortic sac, we explain the considerations for the techniques used and how we were able to stop the bleeding using percutaneous transarterial embolotherapy.
Cystic Dysplasia of the Rete Testis: Case Report and Systematic Review of the Literature
Authors: Giorgia Contini, Simone Frediani, Valerio Pardi, Francesca Diomedi-Camassei, Alessandro Inserra
Journal: Front Pediatr (2022)
Keywords: cdrt, children, cystic dysplasia, rete testis, testicle, testicular mass
MeSH terms: Case Reports

Cystic dysplasia of the rete testis (CDRT) is a rare cause of testicular masses in children. The pathogenesis of this malformation remains unclear. It is often associated with other genitourinary anomalies, commonly presenting as agenesis or dysplasia of the ipsilateral kidney. A case involving a 9-year-old boy with a testicular lesion and ipsilateral renal agenesis, who was diagnosed with CDRT after histological examination, is reported. In addition, a systematic review of the literature was performed to better understand this pathology to design the most appropriate treatment and follow-up strategy for patients with CDRT.