OpenMed/multicare-articles huggingface dataset:
Duodenal Graft Perforation after Simultaneous Pancreas-Kidney Transplantation
Authors: Akihito Sannomiya, Ichiro Nakajima, Yuichi Ogawa, Kotaro Kai, Ichiro Koyama, Shohei Fuchinoue
Journal: Case Rep Transplant (2017)
MeSH terms: Case Reports

A 45-year-old woman with type 1 diabetes and chronic renal failure on dialysis underwent simultaneous pancreas-kidney transplantation from a brain dead donor. On postoperative day 15, acute generalized peritonitis was diagnosed and emergency laparotomy was performed. Perforation of the donor duodenum was found, which had apparently resulted from duodenal compression by the tip of the intestinal fistula tube placed for decompression. The perforation was sutured and the intestinal fistula tube was exchanged. Following this, perforation repeatedly recurred at the same site and open repair at laparotomy was required a total of four times. The fourth operation involved both suturing the perforation and covering it with ileum, after which there was no further recurrence. The patient was discharged on posttransplantation day 219, with the pancreas and kidney grafts both functioning well. This report presents a rare complication of simultaneous pancreas-kidney transplantation.
Hemorrhagic Stroke in a Young Adult with Undiagnosed Asymptomatic Dandy-Walker Malformation
Authors: Haleem Abdul, Joseph Burns, Andrea Estevez, Carlos Nasr El-Nimer, Brinsley Ekinde, Sherard Lacaille
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

The Dandy-Walker Malformation was first described in 1914 by Dandy and Blackfan and is characterized by hypoplasia of the vermis, pseudocystic fourth ventricle, upward displacement of the tentorium, torcular and lateral sinuses, and anteroposterior enlargement of the posterior fossa. This syndrome commonly manifests as hydrocephalus in children, though rare adult cases have been reported. The literature reveals adult symptomatology including brainstem infarction, psychosis, and neuromuscular disease. Stroke is an exceptionally rare presentation of this malformation, with only one ischemic event reported in the literature. This case offers a rare opportunity for diagnosis in an adult presenting with a hemorrhagic stroke of the basal ganglia in an otherwise asymptomatic young adult male. To the best of our knowledge, this is the first reported case of a hemorrhagic stroke in an adult patient with Dandy-Walker Malformation.
Two severe cases of H7N9 pneumonia patients with immunoneuroendocrine axis dysfunction and vitamin D insufficiency
Authors: Jin Yao, Linhua Liu, Gang Chen, Leng Lin
Journal: BMC Infect Dis (2014)
MeSH terms: Hydrocortisone / blood, Influenza A Virus, H7N9 Subtype, Pneumonia / virology, Vitamin D / blood, Case Reports, Research Support, Non-U.S. Gov't, Aged, Communicable Diseases, Fever, Humans, Immunity, Cellular, Lung, Male, Middle Aged, Pneumonia / blood, Pneumonia / immunology, Tomography, X-Ray Computed, Vitamin D Deficiency, Vitamins, Vitamins, Vitamin D, Hydrocortisone

Background:
The immunoneuroendocrine axis plays a major role in the regulation of the host's response to infection, but its role in severe H7N9 pneumonia is still unknown. Therefore, this study is carried out to explore the relationship between the immunoneuroendocrine axis and severe H7N9 pneumonia.
Case presentantion:
The study included two H7N9 pneumonia patients. Endocrine response and cellular immune function in prolonged phase of these two severe H7N9 pneumonia cases were reported and analyzed. A 57-year-old male patient (case 1) and a 68-year-old male patient (case 2) were admitted because of cough, fever and dyspnea. Moist rales were present in both lungs. The rest of the examination was reportedly normal. The laboratory test showed that (1) The patients had loss of cortisol rhythm and elevated cortisol level at 4 pm. (2) The patients showed decline of cellular immune function. (3) The patients showed vitamin D insufficiency. (4) Case 2 had higher cortisol level but lower DHEAS, serum phosphorus and vitamin D level as well as cellular immune function than case 1. (5) The thyroid axis, gonadal and lactotropic axis were normal, so were the level of FT3, FT4, STSH and LH, FSH, T, E2 as well as PRL in these two cases. Chest CT revealed inflammation of both lungs especially in right lung. Real time RT-PCR by Centers for Disease Control and Prevention (CDC) confirmed H7N9 infection.
Conclusion:
Immunoneuroendocrine axis dysfunction may play an important role in severe H7N9 pneumonia. We need pay more attention to hypophosphatemia and vitamin D insufficiency in H7N9 pneumonia.
From the Laboratory to the Classroom: The Potential of Functional Near-Infrared Spectroscopy in Educational Neuroscience
Authors: Guilherme Brockington, Joana Bisol Balardin, Guilherme Augusto Zimeo Morais, Amanda Malheiros, Roberto Lent, Luciana Monteiro Moura, Joao R Sato
Journal: Front Psychol (2018)
Keywords: classroom, education, educational neuroscience, eye-tracking, fnirs, functional near-infrared spectroscopy, hyperscanning, pupilometer

Paralleling two decades of growth in the emergent field known as educational neuroscience is an increasing concern that educational practices and programs should be evidence-based, however, the idea that neuroscience could potentially influence education is controversial. One of the criticisms, regarding applications of the findings produced in this discipline, concerns the artificiality of neuroscientific experiments and the oversimplified nature of the tests used to investigate cognitive processes in educational contexts. The simulations may not account for all of the variables present in real classroom activities. In this study, we aim to get a step closer to the formation of data-supported classroom methodologies by employing functional near-infrared spectroscopy in various experimental paradigms. First, we present two hyperscanning scenarios designed to explore realistic interdisciplinary contexts, i.e., the classroom. In a third paradigm, we present a case study of a single student evaluated with functional near-infrared spectroscopy and mobile eye-tracking glasses. These three experiments are performed to provide proofs of concept for the application of functional near-infrared spectroscopy in scenarios that more closely resemble authentic classroom routines and daily activities. The goal of our study is to explore the potential of this technique in hopes that it offers insights in experimental design to investigate teaching-learning processes during teacher-student interactions.
Intra-Articular Osteoid Osteoma as a Cause of Anteromedial Knee Pain
Authors: Ergin Sagtas, Kemal Gokkus, Ahmet Turan Aydin
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

A 32-year-old male patient presented to our clinic with chronic left knee pain that was ongoing for about 1.5 years. The patient visited several times our clinic and the other clinics; conservative treatment (including rest, knee brace, and ice application with NSAIDs) was recommended by various different doctors. The anamnesis, physical examination, and plain radiography were nonspecific. Early MRI findings mislead us to believe it is bone marrow edema. One and half years with noneffective treatment, the knee pain persisted. At the latest visit intra-articular osteoid osteoma was suspected and the knee MRI with CT was employed. Even though the diagnosis of intra-articular osteoid osteoma often presents a challenge for the surgeons, with a present awareness of intra-articular osteoid osteomas which lack the characteristic sclerotic lesions and nidus on plain X-rays and the aid of multislice CT, a correct diagnosis which warrants proper treatment can be achieved. The possibility of osteoid osteomas, especially in young adults with persistent knee pain with unknown reasons that show normal plain radiographs results, must not be overlooked. The treatment method of these lesions should be customized depending on the location of the lesion, experience of the surgeon, and cost of method.
Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia
Authors: Tomohiro Shoji, Takeshi Umegaki, Kota Nishimoto, Natsuki Anada, Akiko Ando, Takeo Uba, Munenori Kusunoki, Kanako Oku, Takahiko Kamibayashi
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

A 33-year-old pregnant woman was referred to our hospital with respiratory distress at 30 weeks of gestation. Chest computed tomography (CT) scans revealed pulmonary infiltrates along the bronchovascular bundles and ground-glass opacities in both lungs. Despite immediate treatment with steroid pulse therapy for suspected interstitial pneumonia, the patient's condition worsened. Respiratory distress was slightly alleviated after the initiation of high-flow nasal cannula (HFNC) oxygen therapy (40 L/min, FiO2 40%). We suspected clinically amyopathic dermatomyositis (CADM) complicating rapidly progressive refractory interstitial pneumonia. In order to save the life of the patient, the use of combination therapy with immunosuppressants was necessary. The patient underwent emergency cesarean section and was immediately treated with immunosuppressants while continuing HFNC oxygen therapy. The neonate was treated in the neonatal intensive care unit. The patient's condition improved after 7 days of hospitalization; by this time, she was positive for myositis-specific autoantibodies and was diagnosed with interstitial pneumonia preceding dermatomyositis. This condition can be potentially fatal within a few months of onset and therefore requires early combination immunosuppressive therapy. This case demonstrates the usefulness of HFNC oxygen therapy for respiratory management as it negates the need for intubation and allows for various treatments to be quickly performed.
Rare genetic Creutzfeldt-Jakob disease with E196A mutation: a case report
Authors: Yanyuan Dai, Yue Lang, Mingxuan Ding, Baizhuo Zhang, Xiaoou Han, Guangyu Duan, Li Cui
Journal: Prion (2019)
Keywords: e196a, genetic creutzfeldt-jakob disease, prnp, mutation
MeSH terms: Creutzfeldt-Jakob Syndrome / genetics, Point Mutation, Prion Proteins / genetics, Case Reports, Research Support, Non-U.S. Gov't, Aged, Asian People / genetics, Female, Humans, PRNP protein, human, Prion Proteins

Genetic Creutzfeldt-Jakob disease (gCJD) accounts for approximately 10-15% of human prion diseases. It is an autosomal dominant disease caused by missense or insertion mutations of the gene that encodes prion protein (PRNP). In general, the manifestations and neuropathological changes of gCJD are similar to those of sporadic CJD (sCJD), and the diagnostic sensitivities of cerebrospinal fluid (CSF) markers, electroencephalography (EEG), and magnetic resonance imaging (MRI) are generally lower in gCJD than sCJD. Here we report on a 56-year-old Chinese woman who was diagnosed with gCJD and suspected to have thyroid cancer. The patient carried the glutamate to alanine substitution at codon 196 (E196A) of PRNP, which is quite a rare mutation and has only been reported in China. To our knowledge, this is the fourth case of E196A gCJD in the world. Here, we compared the manifestations and assistant examinations of the current patient with those of three previously reported Chinese patients with E196A gCJD in order to illustrate the common features of E196A gCJD.
Cortical non-aneurysmal subarachnoid hemorrhage post-carotid endarterectomy: a case report and literature review
Authors: Gopiga Thanabalasundaram, Silvia Hernández-Durán, Thabele Leslie-Mazwi, Christopher S Ogilvy
Journal: Springerplus (2013)
Keywords: carotid endarterectomy, carotid stenosis, non-aneurysmal subarachnoid hemorrhage, reperfusion injury

Cerebral hyperperfusion syndrome is a well-recognized and potentially fatal complication of carotid revascularization. However, the occurrence of non-aneurysmal subarachnoid hemorrhage as a manifestation of cerebral hyperperfusion syndrome post-carotid endarterectomy is uncommon. We report a case of a patient who presented with headache following carotid endarterectomy for a critically occluded common carotid artery. This progressed to deteriorating consciousness and seizures. Investigations revealed a left cortical non-aneurysmal subarachnoid hemorrhage. Non-aneurysmal subarachnoid hemorrhage is a rare post-operative complication of carotid endarterectomy. Immediate management with aggressive blood pressure control is key to prevent permanent neurological deficits. Cerebral hyperperfusion syndrome (CHS) after carotid revascularization procedures is an uncommon and potentially fatal complication. Pathophysiologically it is attributed to impaired autoregulatory mechanisms and results in disruption of cerebral hemodynamics with increased regional cerebral blood flow (Cardiol Rev 20:84-89, 2012; J Vasc Surg 49:1060-1068, 2009). The condition is characterized by throbbing ipsilateral frontotemporal or periorbital headache. Other symptoms include vomiting, confusion, macular edema, focal motor seizures with frequent secondary generalization, focal neurological deficits, and intraparenchymal or subarachnoid hemorrhage (SAH) (Lancet Neurol 4:877-888, 2005). The incidence of CHS varies from 0.2% to 18.9% after carotid endarterectomy (CEA), with a typical reported incidence of less than 3% in larger studies (Cardiol Rev 20:84-89, 2012; Neurosurg 107:1130-1136, 2007). Uncontrolled hypertension, an arterially isolated cerebral hemisphere, and contralateral carotid occlusion are the main risk factors (Lancet Neurol 4:877-888, 2005; J Neurol Neurosurg Psychiatry 83:543-550, 2012). We present a case of non-aneurysmal SAH after CEA, with focus on its presentation, risk factors, and management.
Case report: Diagnostic challenges in a patient with alcohol use disorder that developed following a stroke
Authors: Jacob Zeitlin, Nabil Kotbi
Journal: Front Psychiatry (2023)
Keywords: case report, coping strategies, delirium, polypharmacy, substance use disorder
MeSH terms: Case Reports

Patients with comorbid neurological and psychiatric diseases often face considerable impairment, causing challenges that pervade many aspects of their lives. Symptoms can be especially taxing when one or more of these conditions is severely disabling, as the resulting disability can make it more challenging to address comorbidities. For clinicians, such patients can be quite difficult to both diagnose and treat given the immense potential for overlap between the underlying psychiatric and neurologic causes of their symptoms-as well as the degree to which they might exacerbate or, conversely, mask one another. These intricate relationships can also obscure the workup of more acute pathologies, such as alcohol withdrawal and delirium. This report details the complex history and clinical challenges in a 54-year-old man who was no longer able to work after developing multiple neurologic deficits from a left MCA stroke a decade earlier. The intellectual and motor disabilities he faced in the aftermath of his stroke were subsequently compounded by a steady increase in alcohol consumption, with his behavior ultimately progressing to severe alcohol use disorder. The coinciding neurologic and psychiatric manifestations obfuscate the workup-and therefore the management-of his major depressive disorder. In pursuit of the optimal approach to address these comorbid conditions and promote recovery, an investigation into possible mechanisms by which they are interconnected revealed several potential neuropsychiatric explanations that suggest targets for future therapeutic strategies.
Lithium toxicity and neurologic effects: probable neuroleptic malignant syndrome resulting from lithium toxicity
Authors: Osamede Edokpolo, Madiha Fyyaz
Journal: Case Rep Psychiatry (2012)
MeSH terms: Case Reports

Introduction. We present the case of a patient who developed lithium toxicity with normal therapeutic levels, as a result of pharmacokinetic interaction with Valsartan, and probable Neuroleptic Malignant Syndrome from the ensuing lithium toxicity. Case Presentation. A 59-year old black male with bipolar disorder maintained on lithium and fluphenazine therapy presented with a 2 week history of worsening confusion, tremor, and gait abnormality. He recently had his dose of Valsartan increased. At presentation, patient had signs of autonomic instability, he was confused, dehydrated, and had rigidity of upper extremities. Significant labs on admission were lithium level-1.2, elevated CK-6008, leukocytosis WBC-22, and renal impairment; Creatinine-4.1, BUN-35, HCO(3)-20.1, and blood glucose 145. CT/MRI brain showed old cerebral infarcts, and there was no evidence of an infective process. Lithium and fluphenazine were discontinued, his lithium levels gradually decreased, and he improved with supportive treatment including rehydration and correction of electrolyte imbalance. Conclusions. This case illustrates that lithium toxicity can occur within therapeutic levels, and the neurotoxic effect of lithium can include Neuroleptic Malignant Syndrome. Clinicians should be aware of the risk associated with drug interactions with lithium.
Wide Excision of a Retroperitoneal Liposarcoma with En Bloc Ureterectomy and Renal Salvage by Autotransplantation
Authors: Siegfredo R Paloyo, Arjel D Ramirez, Ferri P David-Paloyo, Rodney B Dofitas
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Liposarcoma is a malignant mesenchymal neoplasm composed of adipose tissue with varying degrees of atypia. These tumors grow slowly and may reach an enormous size particularly if located in the retroperitoneum. We report a 40-year-old male with a 6-month history of gradual abdominal enlargement. Computed tomography (CT) of the abdomen showed a huge retroperitoneal mass with characteristic features consistent with liposarcoma. On laparotomy, the mass was noted to be encasing the right ureter for which a wide excision with en bloc ureterectomy and subsequent renal autotransplantation for organ preservation was done. Post-operative course was uneventful with excellent outcome after 6 months of follow-up. Final histopathologic diagnosis was low-grade, well differentiated liposarcoma, which has favorable prognosis following radical surgery. This was the first report of such a case in the Philippines.
Laugier-hunziker syndrome: a rare cause of oral and acral pigmentation
Authors: Silonie Sachdeva, Shabina Sachdeva, Pranav Kapoor
Journal: J Cutan Aesthet Surg (2011)
Keywords: benign, longitudinal melanonychia, oral pigmentation
MeSH terms: Case Reports

Laugier-Hunziker syndrome (LHS) is an acquired, benign pigmentary skin condition involving oral cavity including lower lip in the form of brown black macules 1-5 mm in size, frequently associated with longitudinal melanonychia. There is no underlying systemic abnormality or malignant predisposition associated with LHS, and therefore the prognosis is good. Important differential diagnoses include Peutz Jeghers syndrome and Addison's disease among other causes of oral and acral pigmentation. Treatment is sought mainly for cosmetic reasons and Q-switched Nd-Yag laser/ Q-switched alexandrite therapy and cryosurgery have been tried with varying success.
A Case of Fusobacterium necrophorum without Lemierre's Syndrome Mimicking Acute Leptospirosis
Authors: Ryo Yasuhara, Shunichi Shibazaki, Takayoshi Yamanouchi
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Jaundice, conjunctival hyperemia, and acute kidney injury (AKI) are the characteristics of leptospirosis. However, it is not well known that Fusobacterium necrophorum infection can have a clinical picture similar to that of leptospirosis. A 38-year-old man was admitted with jaundice, conjunctival hyperemia, and AKI for 7 days. Chest CT scan showed multiple pulmonary nodules, atypical for leptospirosis. We started treatment with IV piperacillin-tazobactam and minocycline. He became anuric and was urgently started on hemodialysis on the second hospital day. Later on, blood cultures grew Fusobacterium necrophorum and other anaerobic bacteria. Antibody and PCR assays for Leptospira were negative. We narrowed the antibiotics to IV ceftriaxone and metronidazole. He responded well to the treatment and was discharged on the 18th hospital day. F. necrophorum infection is known to cause mixed infection with other anaerobic bacteria. The resistance of many anaerobic bacteria continues to progress, and F. necrophorum itself sometimes produces β-lactamase. This case highlights the potential risks of using penicillin before diagnosis of leptospirosis.
Primary extraosseous Ewing sarcoma of the lung in children
Authors: Nidal Alsit, Clara Fernandez, Jean Luc Michel, Linda Sakhri, Audrey Derouet, Augustin Pirvu
Journal: Ecancermedicalscience (2013)
Keywords: extraosseous ewing sarcoma, lung tumor in children
MeSH terms: Case Reports, Retracted Publication

We report a case of primary extraosseous Ewing sarcoma (EES) of the lung in a four-year-old child. In the literature, there are only a few case reports of EES located in the thorax.
Virtual Reality Body Exposure Therapy for Anorexia Nervosa. A Case Report With Follow-Up Results
Authors: Bruno Porras-Garcia, Eduardo Serrano-Troncoso, Marta Carulla-Roig, Pau Soto-Usera, Marta Ferrer-Garcia, Natàlia Figueras-Puigderrajols, Lena Yilmaz, Yigit Onur Sen, Nazila Shojaeian, José Gutiérrez-Maldonado
Journal: Front Psychol (2020)
Keywords: anorexia nervosa, body image disturbance, body-exposure therapy, case report, fear of gaining weight, virtual reality

Objective:
Exposure-based therapies such as mirror exposure may help to improve the results of classic cognitive behavioral therapy in anorexia nervosa (AN). Virtual reality (VR)-based procedures provide interesting novelties for targeting body-related concerns. This study aimed to provide preliminary evidence of the usefulness of a VR body exposure therapy in a patient diagnosed with AN.
Method:
Fear of gaining weight (FGW), body anxiety, drive for thinness, body image disturbances, body mass index and body-related attentional bias were assessed before and after the intervention, as well as 5 months later. Five sessions of VR body exposure therapy were included within the standard course of cognitive behavioral therapy. The sessions involved a systematic and hierarchical exposure of the patient to a virtual representation of her own silhouette, with the body mass index of the avatar progressively increasing in subsequent sessions.
Results:
After the intervention, there was a clear reduction in AN symptoms such as the FGW, drive for thinness, body-related anxiety and dissatisfaction. Body mass index values rose continuously during the intervention and reached healthy levels. Finally, there was a notable change in the dysfunctional body-related attentional bias. Almost all these improvements were maintained after 5 months, except for the FGW.
Conclusion:
To the best of our knowledge, this study is the first to focus on treating the FGW and body-related concerns in AN using a VR-based paradigm. To pursue this study further and assess the effectiveness of this new VR software, larger controlled clinical trials are needed.