OpenMed/multicare-articles huggingface dataset:
Preventative management against thromboembolism using fresh frozen plasma in a coronary artery bypass graft patient with protein S deficiency: a case report
Authors: Kenzaburou Sugimoto, Mamoru Kadosaki, Atsushi Egawa, Rina Tokitou, Miho Urayama, Mamoru Takeuchi
Journal: JA Clin Rep (2018)
Keywords: cardiopulmonary bypass, coronary artery bypass grafting, fresh frozen plasma, protein s deficiency, thromboembolism

Protein S deficiency patient is characterized by recurrent thrombosis, and its risk is higher intraoperatively, especially in cardiac surgery involving cardiopulmonary bypass. Two heparin cessation periods are defined in cardiac surgery. One is the period between the cessation of heparin 4 to 5 h before surgery and the heparinization prior to cardiopulmonary bypass. The other is the period between protamine administration and resumption of heparin postoperatively. Because the risk of thromboembolism is high during the period of heparin cessation, other anticoagulants are necessary. Although fresh frozen plasma, rich in protein S, is often used in cardiac surgery for protein S deficiency patients, the most appropriate times and volume of its administration to prevent thromboembolism remain poorly understood. We herein report a case of on-pump coronary artery bypass grafting in a patient with protein S deficiency who received fresh frozen plasma targeting the two heparin cessation periods. Some qualitative measurements to identify the effect of fresh frozen plasma on the protein S level are desirable to evaluate whether our present administration strategy has any beneficial effects on protein S deficiency patients.
Dysphagia caused by spindle cell lipoma of hypopharynx: presentation of clinical case and literature review
Authors: Alberto Peña-Valenzuela, Nathalia García León
Journal: Case Rep Otolaryngol (2012)

Spindle cell lipoma of the hypopharynx is an extremely rare entity. Here, we present the first case of this lesion originated in the cricopharyngeal region, with symptoms of chronic progressive dysphagia, which can be confused with other pathologies; endoscopic and magnetic resonance imaging (MRI) evaluation are the methods of choice for its diagnostic approach. The best therapeutic approach is endoscopic resection with rapid recovery and few complications. Long-term followup is recommended, either endoscopic or imaging, given that it can be confused with an undiagnosed liposarcoma; additionally, its long-term behavior is unknown.
An Unusual Case of Multiple Left Ventricular Aneurysms Masquerading as Diverticula in the Setting of Myocardial Infarction
Authors: Hussain Alzayer, Ahmad Alshatti, Akeel Alali
Journal: Clin Med Insights Cardiol (2021)
Keywords: aneurysm, diverticula, myocardial infarction
MeSH terms: Case Reports

The distinction between cardiac aneurysms and diverticula can be very difficult by angiography. Left ventricular (LV) aneurysms usually occur following transmural myocardial infarction. On the other hand, cardiac diverticula are most commonly congenital. They are commonly detected by cardiac CT with a prevalence of 2.2%. Here we present a case of a 60-year-old male with the incidental finding of multiple LV aneurysms masquerading as diverticula in the setting of myocardial infarction with near normal coronary arteries. Moreover, this case highlights the limitation of coronary angiography in the diagnosis of myocardial infarction with no obstructive atherosclerosis (MINOCA).
Scleral resection in chronic central serous chorioretinopathy complicated by exudative retinal detachment
Authors: Pradeep Venkatesh, Rohan Chawla, Koushik Tripathy, Harsh Inder Singh, Ravi Bypareddy
Journal: Eye Vis (Lond) (2016)
Keywords: diffuse retinal pigment epitheliopathy, nanophthalmos, sclerectomy, uveal effusion syndrome
MeSH terms: Case Reports

Background:
Effective therapeutic options are limited for the management of chronic central serous chorioretinopathy (CSCR) complicated by exudative retinal detachments (RD). The authors describe the resolution of one such case following partial thickness scleral resection with mitomycin C.
Case presentation:
This 39-year-old male presented with a unilateral inferior exudative RD in the right eye. There was no history of steroid use either locally or systemically. The fundus fluorescein angiogram showed window defects and leaks typical of chronic CSCR. The axial length was 21.06 mm in the right eye and 21 mm in the left eye. Thickening of the ocular coats was evident on ocular ultrasound. Considering an axial length in the borderline-low range inferotemporal and inferonasal partial thickness scleral resection with mitomycin C was performed. The exudative RD resolved at 4 months.
Conclusion:
Partial thickness scleral resection may be considered as an option for treating chronic CSCR patients with borderline-low axial length complicated by exudative RD.
Impact of Within-Tree Organ Distances on Floral Induction and Fruit Growth in Apple Tree: Implication of Carbohydrate and Gibberellin Organ Contents
Authors: Fares Belhassine, Sébastien Martinez, Sylvie Bluy, Damien Fumey, Jean-Jacques Kelner, Evelyne Costes, Benoît Pallas
Journal: Front Plant Sci (2019)
Keywords: malus × domestica borkh, floral induction, fruit weight, leaf/fruit removal, non-structural carbohydrates, shoot/branch autonomy, source-sink relationships

In plants, organs are inter-dependent for growth and development. Here, we aimed to investigate the distance at which interaction between organs operates and the relative contribution of within-tree variation in carbohydrate and hormonal contents on floral induction and fruit growth, in a fruit tree case study. Manipulations of leaf and fruit numbers were performed in two years on "Golden delicious" apple trees, at the shoot or branch scale or one side of Y-shape trees. For each treatment, floral induction proportion and mean fruit weight were recorded. Gibberellins content in shoot apical meristems, photosynthesis, and non-structural carbohydrate concentrations in organs were measured. Floral induction was promoted by leaf presence and fruit absence but was not associated with non-structural content in meristems. This suggests a combined action of promoting and inhibiting signals originating from leaves and fruit, and involving gibberellins. Nevertheless, these signals act at short distance only since leaf or fruit presence at long distances had no effect on floral induction. Conversely, fruit growth was affected by leaf presence even at long distances when sink demands were imbalanced within the tree, suggesting long distance transport of carbohydrates. We thus clarified the inter-dependence and distance effect among organs, therefore their degree of autonomy that appeared dependent on the process considered, floral induction or fruit growth.
Candida Bezoars in Adults: Determining Optimal Management
Authors: Matthew A Rohloff, Jaschar Shakuri-Rad, Alexander P Dehaan
Journal: J Endourol Case Rep (2017)
Keywords: candida funguria, amphotericin b instillations, fungal ball, fungal bezoar, percutaneous nephrostomy
MeSH terms: Case Reports

Fungal bezoars, or fungal balls, are rare pathologic consequences of funguria in immunocompromised patients. Current treatment recommendations are based on expert opinion and low level evidence. We present a case of a Candida glabrata bezoar that was effectively treated with percutaneous amphotericin B instillations. A subsequent literature review is presented to assess the available case reports and treatment outcomes of Candida spp. bezoars in adults.
Case report: Subcutaneous Mycobacterium haemophilum infection in an immunocompetent patient after lipolysis injections
Authors: Linan Ni, Danyang Zou, Hong Yang, Zhiqin Gao, Qian Yu, Lianjuan Yang
Journal: Front Med (Lausanne) (2023)
Keywords: mycobacterium haemophilum, adverse events, immunocompetent patient, lipolysis injections, medical aesthetics, subcutaneous infection
MeSH terms: Case Reports

Mycobacterium haemophilum is a slow-growing, aerobic mycobacterium that acts as a pathogen in immunocompromised adult patients and immunocompetent children. There are only a few rare cases in the literature describing this species as a cause of subcutaneous infections. Here, we describe a subcutaneous infection caused by M. haemophilum in an immunocompetent female after lipolysis injections at an unqualified beauty salon, suggesting that this bacteria can also be a potential causative agent of adverse events in medical aesthetics. In addition, M. haemophilum caused lesions not only at the injection sites and adjacent areas but also invaded distant sections through the subcutaneous sinus tracts. Thus, early diagnosis and appropriate treatment are vital to prevent further deterioration and improve prognosis.
Intraoral lipoma: a case report
Authors: L K Surej Kumar, Nikhil Mathew Kurien, Varun B Raghavan, P Varun Menon, Sherin A Khalam
Journal: Case Rep Med (2014)

Lipomas are rare in oral and maxillofacial regions although they are the most common tumours of mesenchymal origin in human body. The etiology remains unclear. Various different theories explain the pathogenesis of this adipose tissue tumour and also different histological variants of oral lipoma have been given in literature. A case of intraoral lipoma occurring in mental region in a 77-year-old male is reported along with review of the literature. Wide surgical excision was performed and two-year followup showed excellent healing without any recurrence. Lipomas are benign soft tissue neoplasm of mature adipose tissue seen as a common entity in the head and neck region. Intraoral lipomas are a rare entity which may be noticed only during routine dental examinations. Most of them rarely cause pain, resulting in delay to seek treatment. It is mandatory for a clinician to diagnose intraoral lipomas using latest diagnostic methods and conservatively treat them without causing much discomfort.
Case Report: Cytomegalovirus Reactivation and Pericarditis Following ChAdOx1 nCoV-19 Vaccination Against SARS-CoV-2
Authors: Marlene Plüß, Kemal Mese, Johannes T Kowallick, Andreas Schuster, Désirée Tampe, Björn Tampe
Journal: Front Immunol (2022)
Keywords: chadox1 ncov-19, sars-cov-2 vaccination, cytomegalovirus, long covid, viral reactivation
MeSH terms: ChAdOx1 nCoV-19 / adverse effects, Cytomegalovirus / drug effects, Pericarditis / chemically induced, SARS-CoV-2 / immunology, Virus Activation / drug effects, Case Reports, Aged, Antiviral Agents / therapeutic use, COVID-19 / prevention & control, Cytomegalovirus / physiology, Cytomegalovirus Infections / chemically induced, Cytomegalovirus Infections / drug therapy, Cytomegalovirus Infections / virology, Female, Humans, Pericarditis / drug therapy, Pericarditis / virology, Treatment Outcome, Valganciclovir / therapeutic use, Viremia / chemically induced, Viremia / drug therapy, Viremia / virology, Antiviral Agents, ChAdOx1 nCoV-19, Valganciclovir

As the coronavirus disease 2019 (COVID-19) pandemic is ongoing and new variants of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are emerging, there is an urgent need for vaccines to protect individuals at high risk for complications and to potentially control disease outbreaks by herd immunity. Surveillance of rare safety issues related to these vaccines is progressing, since more granular data emerge about adverse events of SARS-CoV-2 vaccines during post-marketing surveillance. Varicella zoster virus (VZV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) reactivation has already been reported in COVID-19 patients. In addition, adverse events after SARS-CoV-2 mRNA vaccination have also been in the context of varicella zoster virus (VZV) reactivation and directly associated with the mRNA vaccine. We present the first case of CMV reactivation and pericarditis in temporal association with SARS-CoV-2 vaccination, particularly adenovirus-based DNA vector vaccine ChAdOx1 nCoV-19 against SARS-CoV-2. After initiation of antiviral therapy with oral valganciclovir, CMV viremia disappeared and clinical symptoms rapidly improved. Since huge vaccination programs are ongoing worldwide, post-marketing surveillance systems must be in place to assess vaccine safety that is important for the detection of any events. In the context of the hundreds of millions of individuals to be vaccinated against SARS-CoV-2, a potential causal association with CMV reactivation may result in a considerable number of cases with potentially severe complications.
Lipoma of Piriform Sinus: A Case Report and Review of the Literature
Authors: Gilberto Acquaviva, Theodoros Varakliotis, Stefano Badia, Francesco Casorati, Alberto Eibenstein, Gianluca Bellocchi
Journal: Case Rep Otolaryngol (2016)

The lipomas of oropharynx, hypopharynx, and larynx are so rare that up to now approximately there have been 100 cases reported. The lipomas are slow-growing lesions that are capable of reaching considerable dimensions and are often detected at a late stage. The symptoms can vary both in dimension and in location, semiobstructing the aerodigestive tract or exerting compression on adjacent structure. In this case, the lesion, which originated from the piriform sinus, was removed endoscopically urgently due to obvious signs of tissue suffering caused by stretching of the pedicle as a result of displacement of the mass. The two aims of this case report are to expose an interesting and rare case study mainly for an Emergency Room Specialist and an ENT (Ear, Nose, and Throat) Specialist involved in solving the problem and to demonstrate that the choice of an endoscopic approach is useful in order to have an optimal visualization of the lesion and to perform a total eradication. The use of endoscopic devices also allows a rapid postoperative recovery, compared to external access and optimum locoregional control in the follow-up procedures to prevent possible relapses.
Managing a Rivaroxaban Bleed: Understanding the Difficulties in Acute Reversal of the New Oral Anticoagulants through a Case Report
Authors: Naveen Nannapaneni, Robby Singh, Paulina Mckay, Marwan Al-Hajeili
Journal: Case Rep Hematol (2014)

With the arrival of a new generation of oral anticoagulants significant burdens associated with warfarin's use on both the patient and the healthcare system have been alleviated. Nevertheless, a shortfall exists in regard to an agent or protocol for reversal of these new anticoagulants in the setting of an acute bleed. Our case of a patient presenting to the hospital with a vaginal bleed while on rivaroxaban highlights the difficulty in management without a clear protocol or agent for reversal of anticoagulation.
Longitudinal Follow-Up of Mirror Movements after Stroke: A Case Study
Authors: Hiroyuki Ohtsuka, Daisuke Matsuzawa, Daisuke Ishii, Eiji Shimizu
Journal: Case Rep Neurol Med (2015)

Mirror movement (MM), or visible involuntary movements of a relaxed hand during voluntary fine finger movements of an activated opposite hand, can be observed in the hand that is on the unaffected side of patients with stroke. In the present study, we longitudinally examined the relationship between voluntary movement of the affected hand and MM in the unaffected hand in a single case. We report a 73-year-old woman with a right pontine infarct and left moderate hemiparesis. MM was observed as an extension movement of the unaffected right index finger during extension movement of the affected left index finger. The affected right index movement was found to increase, while MM of the unaffected left index finger was observed to decrease with time. These results indicate that the assessment of MM might be useful for studying the process of motor recovery in patients with stroke.
Papillary renal neoplasm with reverse polarity with a favorable prognosis: Two cases report and literature review
Authors: Zuo Yuzhi, Liang Zhen, Xiao Yu, Pan Boju, Yan Weigang, Wu Xingcheng
Journal: Front Oncol (2022)
Keywords: papillary renal cell carcinoma, partial nephrectomy, pathology, renal cell carcinoma, reverse polarity
MeSH terms: Case Reports

Background:
Papillary Renal Neoplasm (PRN) with polarity inversion is a less common subtype of kidney cancer with an apparently recognizable morphology, distinct immunohistochemical profiles, and frequent KRAS mutations. It has been estimated to account 4% of previously diagnosed PRN.
Case presentation:
This is a retrospective case report of two patients diagnosed with PRNRP. Two males were found to have kidney mass accidentally through imaging examination in clinic. Both of the patients had no obvious discomfort and abnormal test indicators. Subsequently, they underwent partial nephrectomy in our center by the same surgeon and followed up closely with an impressive clinical outcome. The pathology reports indicated that their pathological features were consistent with PRNRP. The HE staining showed a monolayer of papillary or tubular structures, with small nuclei away from the cytoplasmic top of the basement membrane. The immunohistochemical results were GATA3 (+), vimentin (-).
Conclusion:
Our case reports and literature review suggested that PRNRP should be separated from traditional PRN and partial nephrectomy is a robust modality for PRNRP. The morphological, immunohistochemical, and genetic information of the cases we presented would provide important material for PRNRP to become a distinct category with benign clinical outcome.
Clinical Characteristics and Long-Term Recombinant Human Growth Hormone Treatment of 18q- Syndrome: A Case Report and Literature Review
Authors: Shanshan Liu, Meiping Chen, Hongbo Yang, Shi Chen, Linjie Wang, Lian Duan, Huijuan Zhu, Hui Pan
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: 18q- syndrome, clinical characteristic, growth hormone deficiency, rhgh treatment, short stature
MeSH terms: Chromosome Disorders / drug therapy, Growth Disorders / drug therapy, Human Growth Hormone / therapeutic use, Case Reports, Research Support, Non-U.S. Gov't, Review, Child, China, Chromosome Deletion, Chromosome Disorders / complications, Chromosomes, Human, Pair 18, Female, Growth Disorders / genetics, Humans, Recombinant Proteins / therapeutic use, Time Factors, Treatment Outcome, Recombinant Proteins, Human Growth Hormone, Chromosome 18 deletion syndrome

Background:
18q- syndrome is a rare chromosomal disease caused by the deletion of the long arm of chromosome 18. Some cases with 18q- syndrome can be combined with growth hormone deficiency (GHD), but data on the efficacy of recombinant human growth hormone (rhGH) treatment in 18q- syndrome are limited.
Methods:
Here, we report one case of 18q- syndrome successfully treated with long-term rhGH supplement. Previously reported cases in the literature are also reviewed to investigate the karyotype-phenotype relationship and their therapeutic response to rhGH.
Results:
A 7.9-year-old girl was referred for evaluation for short stature. Physical exam revealed proportionally short stature with a height of 111.10 cm (-3.02 SD score (SDS)), low-set ears, a high-arched palate, a small jaw, webbed neck, widely spaced nipples, long and tapering fingers, and cubitus valgus. Thyroid function test indicated subclinical hypothyroidism. The peak value of growth hormone was 10.26 ng/ml in the levodopa provocation test. Insulin-like growth factor 1 (IGF-1) was 126 ng/ml (57-316 ng/ml). Other laboratory investigations, including complete blood cell count, liver and kidney function, gonadal function, serum adrenocorticotropin levels, and serum cortisol levels, were all within normal ranges. Karyotype analysis showed 46, XX, del (18) (q21). L-Thyroxine replacement and rhGH treatment were initiated and maintained in the following 7 years. At the age of 14.8, her height has reached 159.5 cm with a height SDS increase of 2.82 SDS (from -3.02 SDS to -0.20 SDS). No significant side effects were found during the treatment. The literature review indicated the average rhGH treatment duration of 16 patients was 5.9 ± 3.3 years, and the average height SDS significantly increased from -3.12 ± 0.94 SDS to -1.38 ± 1.29 SDS after the rhGH treatment (p < 0.0001).
Conclusion:
The main clinical manifestations of 18q- syndrome include characteristic appearance, intellectual disability, and abnormal genital development. The literature review suggested a significant height benefit for short stature with 18q- syndrome from long-term rhGH treatment.
Reestablishing the Function and Esthetics in Traumatized Permanent Teeth with Large Apical Lesion
Authors: Alexandra Rubin Cocco, Ângelo Niemczewski Bobrowski, Rudimar Antônio Baldissera, Luiz Fernando Machado Silveira, Josué Martos
Journal: Case Rep Dent (2016)
MeSH terms: Case Reports

Dental trauma is a challenge for dental integrity and can lead to pulp necrosis. The clinical case reports the diagnosis of a maxillary right central incisor traumatized and its multidisciplinary treatment. Calcium hydroxide material was used to perform the processing apexification. An apical surgery was carried out to remove the apical periodontitis and to return the aesthetics to the patient; internal and external tooth whitening in maxillary right central incisor was performed. We conclude that surgery associated with the root filling in the central incisor led to a successful completion. Moreover, it is of utmost importance to demonstrate the interaction between the various areas of dentistry.
Avoiding diagnostic errors in psychosomatic medicine: a case series study
Authors: Atsuko Koyama, Yoichi Ohtake, Kanae Yasuda, Kiyohiro Sakai, Ryo Sakamoto, Hiromichi Matsuoka, Hirokuni Okumi, Toshiko Yasuda
Journal: Biopsychosoc Med (2018)
Keywords: cognitive bias, diagnostic error, psychosomatic disease, psychosomatic medicine
MeSH terms: Case Reports

Background:
Non-organic lesions or diseases of unknown origin are sometimes misdiagnosed as "psychogenic" disorders or "psychosomatic" diseases. For the quality of life and safety of patients, recent attention has focused on diagnostic error. The aim of this study was to clarify the factors that affected misdiagnoses in psychosomatic medicine by examining typical cases and to explore strategies that reduce diagnostic errors.
Case presentation:
The study period was from January 2001 to August 2017. The data of patients who had visited the Department of Psychosomatic Medicine, Kindai University Hospital and its branches, Sakai Hospital and Nihonbashi Clinic, were collected. All patients were aged 16 years or over. Multiple factors, such as age, sex, presenting symptoms, initial diagnosis, final diagnosis, sources of re-diagnosis and types of diagnostic errors were retrospectively analyzed from the medical charts of 20 patients. Among them, four typical cases can be described as follows. Case 1; a 79-year-old woman, initially diagnosed with psychogenic vomiting due to depression that was changed to gastric torsion as the final diagnosis. Case 2; a 24-year-old man, diagnosed with an eating disorder that was later changed to esophageal achalasia. Case 10; a 60-year-old woman's diagnosis changed from conversion disorder to localized muscle atrophy. Case 19; a 68-year-old man, appetite loss from depression due to cancer changed to secondary adrenal insufficiency, isolated ACTH deficiency (IAD).
Conclusion:
This study showed that multiple factors related to misdiagnoses were combined and had a mutual influence. However, they can be summarized into two important clinical observations, diagnostic system-related problems and provider issues. Provider issues contain mainly cognitive biases such as Anchoring, Availability, Confirmation bias, Delayed diagnosis, and Representativeness. In order to avoid diagnostic errors, both a diagnostic system approach and the reduction of cognitive biases are needed. Psychosomatic medicine doctors should pay more attention to physical symptoms and systemic examination and can play an important role in accepting a perception of patients based on a good, non prejudicial patient/physician relationship.