OpenMed/multicare-articles huggingface dataset:
A percutaneous treatment strategy of an adult patient with a bicuspid aortic valve, coarctation of the aorta, and an exceptionally large aneurysm of a collateral artery: Case report and literature overview
Authors: D B H Verheijen, J Lauran Stöger, F van der Kley, M J Schalij, M R M Jongbloed, H W Vliegen, P Kiès, A D Egorova
Journal: Front Cardiovasc Med (2022)
Keywords: adult congenital heart disease, aneurysm, bicuspid aortic valve, coarctation of aorta, collateral arteries, endocarditis, percutaneous catheter technique, percutaneous intervention
MeSH terms: Case Reports

Coarctation of the aorta (CoA) is a congenital heart defect that is associated with a bicuspid aortic valve (BAV), ascending aorta dilatation, intracerebral aneurysms, and premature atherosclerotic disease. The first presentation during late adulthood is rare and is frequently driven by late sequelae. Hypertrophic collateral arteries can develop aneurysms which are at risk for spontaneous rupture, however, treatment recommendations for these aneurysms are scarce. Here, we describe the clinical course and percutaneous treatment strategy of a patient with a late diagnosis of a pin-point CoA, a BAV with moderate regurgitation, and an exceptionally large aneurysm of a collateral artery. A 59-year-old woman was diagnosed with Streptococcus bovis endocarditis of a BAV with moderate aortic valve regurgitation and small vegetation (<5 mm) on the non-coronary cusp. Work-up revealed hypertension and adenocarcinoma in situ of the ascending colon, considered the bacteremia porte d'entrée, for which a curative hemicolectomy was performed. Echocardiography showed a narrowing of the aorta distal from the origin of the left subclavian artery with the antegrade diastolic flow with a pathognomonic "sawtooth" pattern and an estimated pressure gradient of >70 mmHg. Computed tomography angiography (CTA) showed a network of well-developed collateral arteries and a levoatriocardinal vein. One of the collateral arteries arising from the left subclavian artery revealed an exceptionally large aneurysmatic dilation (29 × 24 × 24 mm). The invasive assessment confirmed a hemodynamically significant CoA. Treatment involved balloon dilatation and placement of a covered stent at the site of the pin-point CoA and a percutaneous coronary intervention (PCI) of the stenosis in the left anterior descending artery. No residual gradient over the CoA was observed. Antihypertensive drugs could be discontinued, and CTA performed 4 months later showed regression and thrombosis of the numerous collaterals and, importantly, thrombosis of the large aneurysm. This case illustrates the late diagnosis of CoA with associated congenital heart defects and late sequelae including hypertension, BAV endocarditis, coronary artery disease, and aneurysm formation of the extensive collateral network. The patient underwent pharmacological and percutaneous treatment, ultimately resulting in the alleviation of the CoA, normalization of the blood pressure, reduction of collateral flow, and thrombosis of the large aneurysm of the collateral artery.
Papillary Thyroid Carcinoma: Ectopic Malignancy versus Metastatic Disease
Authors: Yanery's Agosto-Vargas, Madeleine Gutiérrez, José Hernán Martínez, Michelle Mangual-Garcia, Coromoto Palermo, Sharon Vélez-Maymi, Luis Hernández-Vázquez, Samayra Miranda-Rodríguez, Alex González-Bossolo, Ernesto Solá-Sánchez, Marianne Hernández-Negrón
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Papillary thyroid carcinoma frequently metastasizes to regional lymph nodes. However, cervical lymph node metastasis as a sole manifestation of occult papillary thyroid carcinoma is rarely observed. Ectopic thyroid is an uncommon condition defined as the presence of thyroid tissue at a site other than pretracheal area. Approximately 1-3% of all ectopic thyroid tissue is located in the lateral neck. This entity may represent the only functional thyroid tissue in the body. Malignant transformation of ectopic thyroid is uncommon; but even rarer is the development of papillary carcinoma on it. We present a case of a 33-year-old man with an incidental lateral neck mass diagnosed after a motor vehicle accident. Total thyroidectomy and lymph node resection were completed without evidence of papillary thyroid carcinoma. Malignant transformation of heterotopic thyroid tissue was the final diagnosis. The possibility of an ectopic thyroid cancer should be considered in the differential diagnosis of a pathological mass in the neck. The uniqueness of this case strives in the rarity that the thyroid gland was free of malignancy, despite ectopic tissue being positive for thyroid carcinoma. Management strategies, including performance of total thyroidectomy, neck dissection, and treatment with radioiodine, should be based on individualized risk assessment.
The Femoral Neck Mechanoresponse to Hip Extensors Exercise: A Case Study
Authors: Saulo Martelli, Hossein Mokhtarzadeh, Peter Pivonka, Peter R Ebeling
Journal: J Osteoporos (2017)

Physical activity is recommended to prevent age-related bone loss. However, the proximal femur mechanoresponse is variable, possibly because of a muscle-dependant mechanoresponse. We compared the proximal femur response with the femoral strain pattern generated by the hip extensor muscles. A healthy participant underwent a six-month unilateral training of the hip extensor muscles using a resistance weight regularly adjusted to the 80% of the one-repetition maximum weight. DXA-based measurements of the areal Bone Mineral Density (aBMD) in the exercise leg were adjusted for changes in the control leg. The biomechanical stimulus for bone adaptation (BS) was calculated using published models of the musculoskeletal system and the average hip extension moment in elderly participants. Volumetric (ΔvBMD) and areal (ΔaBMD) BMD changes were calculated. The measured and calculated BMD changes consistently showed a positive and negative effect of exercise in the femoral neck (ΔaBMD = +0.7%; ΔvBMD = +0.8%) and the trochanter region (ΔaBMD = -4.1%; ΔvBMD = -0.5%), respectively. The 17% of the femoral neck exceeded the 75th percentile of the spatially heterogeneous BS distribution. Hip extensor exercises may be beneficial in the proximal femoral neck but not in the trochanteric region. DXA-based measurements may not capture significant aBMD local changes.
A Case of Tachycardia-Induced Cardiomyopathy During Pregnancy: Clinical Presentation and Management
Authors: Andrii Labchuk, Emily Temple-Wood, Daniel Sherlock, James Russell, Marianna Krive
Journal: Cureus (2023)
Keywords: antiarrhythmics, atrial tachycardia, pregnancy care, tachycardia in pregnancy, tachycardia induced
MeSH terms: Case Reports

A 28-year-old G2P0010 woman with a history of COVID infection during her current pregnancy treated with monoclonal antibodies and benign gestational thrombocytopenia presented for routine prenatal care at 33 weeks' gestation. The patient was asymptomatic, but incidental tachycardia was noted on the physical exam with an irregular rhythm. An electrocardiogram (ECG) was performed and was consistent with multifocal atrial tachycardia at a rate of 144 beats per minute. The patient was started on labetalol 50 mg daily and was referred to cardiology for consultation. An echocardiogram was performed and showed dilated left ventricular cavity with a moderately reduced ejection fraction of 40%. No previous echocardiogram was available for comparison; the patient had no history of cardiac disease. The dose of labetalol was increased to 50 mg twice daily and she was admitted for digoxin loading and titration. Though fetal tolerance was excellent, her heart rate was not controlled. Digoxin was switched to flecainide and labetalol was switched to metoprolol which improved her heart rate and repeat echocardiogram showed an ejection fraction of 50%. The patient was admitted for induction of labor at 39 weeks of gestation and continued intrapartum flecainide. Metoprolol was continued intra and postpartum. Flecainide was resumed at three days postpartum due to the recurrence of atrial tachycardia and has been maintained. A repeat echocardiogram is scheduled six weeks postpartum to evaluate left ventricular function and wean off antiarrhythmics.
The use of full-setting non-invasive ventilation in the home care of people with amyotrophic lateral sclerosis-motor neuron disease with end-stage respiratory muscle failure: a case series
Authors: Eduardo L De Vito, Adrián A Suárez, Sergio G Monteiro
Journal: J Med Case Rep (2012)

Introduction:
Little has been written about the use of non-invasive ventilation in the home care of amyotrophic lateral sclerosis-motor neuron disease patients with end-stage respiratory muscle failure. Nocturnal use of non-invasive ventilation has been reported to improve daytime blood gases but continuous non-invasive ventilation dependence has not been studied in this regard. There continues to be great variation by country, economics, physician interest and experience, local concepts of palliation, hospice requirements, and resources available for home care. We report a case series of home-based amyotrophic lateral sclerosis-motor neuron disease patients who refused tracheostomy and advanced non-invasive ventilation to full-setting, while maintaining normal alveolar ventilation and oxygenation in the course of the disease. Since this topic has been presented in only one center in the United States and nowhere else, it is appropriate to demonstrate that this can be done in other countries as well.
Case presentation:
We present here the cases of three Caucasian patients (a 51-year-old Caucasian man, a 45-year-old Caucasian woman and a 57-year-old Caucasian woman) with amyotrophic lateral sclerosis who developed continuous non-invasive ventilation dependence for 15 to 27 months without major complications and were able to maintain normal CO2 and pulse oxyhemoglobin saturation despite a non-measurable vital capacity. All patients were wheelchair-dependent and receiving riluzole 50 mg twice a day. Patient one developed mild-to-moderate bulbar-innervated muscle weakness. He refused tracheostomy but accepted percutaneous gastrostomy. Patient two had two lung infections, acute bronchitis and pneumonia, which were treated with antibiotics and cough assistance at home. Patient three had three chest infections (bronchitis and pneumonias) and asthmatic episodes treated with antibiotics, bronchodilators and cough assistance at home. All patients had normal speech while receiving positive pressure; they died suddenly and with normal oxygen saturation.
Conclusions:
Although warned that prognosis was poor as vital capacity diminished, our patients survived without invasive airway tubes and despite non-measurable vital capacity. No patient opted for tracheostomy. Our patients demonstrate the feasibility of resorting to full-setting non-invasive management to prolong survival, optimizing wellness and management at home, and the chance to die peacefully.
Complete excision of a large pancreatic neuroendocrine neoplasm
Authors: Rudolph Darko, Frank Edwin, Jehoram Anim
Journal: Pan Afr Med J (2018)
MeSH terms: Abdominal Pain / etiology, Neuroendocrine Tumors / surgery, Pancreatic Neoplasms / surgery, Case Reports, Female, Humans, Middle Aged, Neuroendocrine Tumors / diagnosis, Neuroendocrine Tumors / pathology, Pancreatic Neoplasms / diagnosis, Pancreatic Neoplasms / pathology, Tomography, X-Ray Computed, Treatment Outcome

Pancreatic neuroendocrine tumours localized to the pancreas and amenable to complete surgical resection are rarely reported. In West Africa, such patients present too late for surgery to be considered. In the reported case, a patient with persistent epigastric pain underwent a computed tomographic examination which led to the discovery of a large (6cm x 5cm) localized tumour in the body and tail of the pancreas. Complete resection of the tumour was performed. Histological examination showed a pancreatic neuroendocrine tumour without capsular invasion. Adjuvant chemotherapy was deemed unnecessary. The patient remains symptom free 2 years after the procedure with no evidence on subsequent imaging of tumour recurrence. Although extremely rare, large pancreatic neuroendocrine tumours may still be amenable to complete excision.
An unusual cause for a painful Birmingham hip resurfacing
Authors: K A Islam, S M Blake
Journal: Ann R Coll Surg Engl (2013)
MeSH terms: Aortic Diseases / complications, Arterial Occlusive Diseases / complications, Arthroplasty, Replacement, Hip / methods, Osteoarthritis, Hip / surgery, Pain, Postoperative / etiology, Case Reports, Aorta, Abdominal, Aortic Diseases / surgery, Arterial Occlusive Diseases / surgery, Blood Vessel Prosthesis Implantation, Hip Prosthesis, Humans, Male, Middle Aged, Pain, Postoperative / surgery

The painful total hip arthroplasty requires careful evaluation and investigation. This is usually focused on the prosthesis and adjacent anatomical structures. We present a case report of a 64-year-old man who had a Birmingham hip resurfacing procedure for primary osteoarthritis. His hip pain worsened following the procedure and was under systematic investigation for this. Subsequent investigation for vascular disease revealed a total infrarenal aortic occlusion. An aortobifemoral bypass improved the hip pain and function dramatically, and the patient now has an excellent quality of life.
A rare case of splenobronchial fistula formation post-embolisation therapy following acute blunt trauma
Authors: Saminderjit Kular, Tim Hoare, Colin Nice
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

We present the case of a 26-year-old male who was referred to the Emergency department with frank haemoptysis, fever and abdominal pain. He had suffered from an acute splenic rupture secondary to blunt abdominal trauma 3 weeks previously, when he was treated with transfemoral embolisation therapy. On this previous admission his splenic injury was initially not detected owing to CT scanning technique focussed on imaging the thorax rather than the abdomen. On readmission, the initial chest X-ray pointed towards a likely pneumonia or empyema. However, upon CT scanning, the cause was found to be a splenic abscess that had extended through the diaphragm, pleura and entered the bronchial space, forming a 'splenobronchial' fistula. This is a rare complication of splenic artery embolisation. The aim of this case report is to raise awareness of the complications that acute trauma and embolisation therapy may cause.
Cough Radiculopathy: Postinfectious Cough-Related Acute Lumbar Radiculopathy
Authors: Samer Alkhuja
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Cough is a protective reflex of airways and lungs. Cough may result in several complications. Postinfectious cough is a cough that begins during an acute respiratory tract infection, usually is self-limited, and is due to airway hyperresponsiveness as a result of airway inflammation. Cough radiculopathy has been once reported by Torrington and Adornato in the form of acute cervical radiculopathy. This is a case of acute lumbar radiculopathy as a result of postinfectious cough. Literature review did not show a similar case.
Intravitreal Ampicillin Sodium for Antibiotic-Resistant Endophthalmitis: Streptococcus uberis First Human Intraocular Infection Report
Authors: Raul Velez-Montoya, Dulce Rascón-Vargas, William F Mieler, Jans Fromow-Guerra, Virgilio Morales-Cantón
Journal: J Ophthalmol (2010)
MeSH terms: Case Reports

Purpose. To describe the clinical characteristics, diagnosis, and treatment with intravitreal ampicillin sodium of a postoperative endophthalmitis case due to Streptococcus uberis; an environmental pathogen commonly seen in mastitis cases of lactating cows. Methods. Case Report. A 52-year-old, Hispanic diabetic patient who suddenly developed severe pain and severe loss of vision, following vitrectomy. Results. The patient was diagnosed with postoperative endophthalmitis secondary to a highly resistant strain of Streptococcus uberis that did not respond to intravitreal antibiotics. He was treated with an air-fluid interchange, anterior chamber washout, intravitreal ampicillin sodium (5 mg/0.1 mL), and silicon oil tamponade (5000 ck). The eye was anatomically stabilized, though there was no functional recovery. Conclusion. Streptococcus uberis is an uncommon pathogen to the human eye, which has unique features that help the strain in developing resistance to antibiotics. While treatment with intravitreal ampicillin is feasible, there are still concerns about its possible toxicity.
Case report: Hysteroscopy combined with a vaginal mold for severe recurrent vaginal adhesion and stenosis with pyocolpos after pelvic fracture in a 13-year-old female
Authors: Jiao Wang, Fei Zheng, Dandan Wang, Qing Yang
Journal: Front Pediatr (2022)
Keywords: vaginal adhesion, hysteroscopy, obstructive symptoms, pediatric pelvic fracture, vaginal dilation
MeSH terms: Case Reports

Vaginal adhesions and stenosis are infrequent long-term sequelae following pediatric pelvic fractures. Patients may not present with signs and symptoms before menarche, leading to delayed diagnosis and treatment. We report an adolescent girl who presented with a post-abdominal trauma pelvic fracture and urethrovaginal fistula and subsequent severe vaginal adhesion, which resulted in infection and obstructive symptoms after menarche. Hysteroscopy-guided vaginal adhesion release using an epidural catheter and ultrasonography was performed, followed by vaginal dilation, to resolve obstructive symptoms. For girls with pelvic fractures, education on possible long-term sequelae is required, as is regular follow-up. Timely diagnosis and treatment are important, and hysteroscopic release of vaginal adhesion and postoperative regular vaginal dilation may be an effective treatment.
Utilizing Colpocleisis to Repair a Vesicovaginal Fistula in a Cervical Cancer Patient with History of Pelvic Radiation: A Case Report and Literature Review
Authors: Ahmad Dahman, Daniel McClelland, Stanley Zaslau, Valerie Galvan Turner, Omar Duenas, Robert Shapiro
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Background:
Vesicovaginal fistula is a rare and distressing urological condition. It is especially prevalent in developing countries with the predominant etiology secondary to obstructed labor. Radiation therapy in female patients with cervical cancer is a risk factor for vesicovaginal fistula formation in the United States. Case Presentation. A 53-year-old woman with a history of cervical cancer and radiation presented with continuous urinary incontinence. Following diagnostic vaginoscopy, a 1 cm vesicovaginal fistula was diagnosed at the vaginal apex. The patient elected for surgical repair. She subsequently underwent successful transvaginal fistula closure using colpocleisis to optimally address the systemic factors of poor wound healing associated with irradiated tissue. Because of the adjacent tissue having been compromised by pelvic radiation, we opted to use a biologic graft made of human cadaveric pericardial tissue (CPT) instead of a native tissue flap to provide additional support for the fistula repair.
Conclusion:
A transvaginal approach for surgical repair of vesicovaginal fistula can be successful in patients with a prior history of pelvic radiation. Transvaginal colpocleisis is a viable option to augment vesicovaginal fistula repair for patients with significant comorbidities when sexual intercourse is no longer desired.
Ultrasound-Guided Percutaneous Drainage of Iliopsoas Abscess With Septicemia in an Adolescent: A Case Report and Literature Review
Authors: Kun Jiang, Wenxiao Zhang, Guoyong Fu, Guanghe Cui, Xuna Li, Shousong Ren, Tingliang Fu, Lei Geng
Journal: Front Surg (2022)
Keywords: iliopsoas abscess, pediatrics, percutaneous catheter drainage, staphylococcus aureus, ultrasonography
MeSH terms: Case Reports

Introduction:
Iliopsoas abscess with septicemia in the pediatric population is rare. Early diagnosis and effective management of this emergent disorder remain challenging for clinicians.
Case presentation:
A 14-year-old girl presented with right lateral and posterior hip pain and fever for 7 days before admission. Blood culture was positive for Staphylococcus aureus. Enhanced magnetic resonance imaging revealed abscesses located in the right iliopsoas muscle and on the surface deep to the fascia of the right sacroiliac joint that were 6.8 cm × 6.2 cm × 5.7 cm and 3.7 cm × 3.5 cm × 2.1 cm, respectively. A diagnosis of right iliopsoas abscesses with septicemia was made. The patient received intravenous antibiotics, underwent ultrasound-guided percutaneous catheter drainage, and recovered uneventfully. Medical literature regarding this issue published in the English language during the last two decades was reviewed.
Discussion:
Primary synchronous psoas and iliacus muscle abscesses are rare and emergent disorders in the pediatric age group. The diagnosis is generally delayed owing to the deep anatomic location and nonspecific signs and symptoms. A comprehensive medical history, meticulous physical examination, and judicious use of imaging studies could establish a timely and accurate diagnosis. Surgeons should be aware of the occurrence of multiple abscesses. Prompt and adequate antibiotic therapy accompanied by a mini-invasive approach, such as ultrasound-guided, laparoscopic, or video-retroperitoneoscopic drainage of the infectious focus, if indicated and feasible, is important to achieve a good outcome in the management of iliopsoas abscess.
Radical chemoradiotherapy for urethral squamous cell carcinoma: two case reports and a review of the literature
Authors: H Coop, L Pettit, C Boon, P Ramachandra
Journal: Case Rep Urol (2013)

Primary urethral squamous cell carcinoma is rare. Its management is particularly challenging owing to the paucity of evidence from randomised trials to inform practice. We report two male and female cases of squamous cell carcinoma of the urethra, which were treated with concomitant cisplatin and radiotherapy. These cases add to the body of case reports that have shown benefit for concomitant chemoradiotherapy in urethral squamous cell carcinoma. They also illustrate that single agent chemotherapy, namely, cisplatin, may be used successfully with limited toxicities.
Two adults with adrenal myelolipoma and 21-hydroxylase deficiency
Authors: Ingrid Nermoen, Ivar Følling, Kjetil Vegge, Arne Larmo, Bjørn Gunnar Nedrebø, Eystein Sverre Husebye, Kristian Løvås
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

We present incidentally discovered adrenal myelolipomas in two adult males with untreated congenital adrenal hyperplasia (CAH). The patients had simple virilizing form of CAH due to mutations in the CYP21 gene coding for 21-hydroxylase; one was heterozygous for the I172N mutation and the other compound heterozygous for the I172N and I2splice mutations. The masses were not removed since myelolipomas are considered benign tumors, and the tumor size did not increase during four- and nine-year observation periods. An adrenal myelolipoma is an important exception to the rule that large tumours should be removed. Untreated CAH with prolonged excessive ACTH stimulation might contribute to the growth of adrenal masses. CAH should be considered as a differential diagnosis of patients with adrenal masses or adrenal myelolipomas.