OpenMed/multicare-articles huggingface dataset:
Life-Threatening Hemoptysis From Aorto-Bronchial Fistula in a Patient With Remote History of Aortic Coarctation Repair
Authors: Tayla E Greene, Sheri P Walls, Bryan A Blakeney, Ademayowa O Ademiluyi, Konstantin G Nestoiter
Journal: Cureus (2024)
Keywords: aortic pseudoaneurysm, aorto-bronchial fistula, hemoptysis, large-volume hemoptysis, life-threatening hemoptysis, thoracic aortic coarctation
MeSH terms: Case Reports

"Hemoptysis" refers to the expectoration of blood from the respiratory tract. However, "life-threatening hemoptysis" includes any volume that leads to features such as airway obstruction, hypoxia, or hemodynamic instability. We present a case of life-threatening hemoptysis in a 65-year-old male with a history of benign prostatic hyperplasia and uncontrolled hypertension. Radiological investigations revealed a pseudo-aneurysm at the site of a prior thoracic aortic coarctation repair more than 50 years prior in childhood. He required vascular surgical intervention, during which there was evidence of an aorta-bronchial fistula as the likely cause of bleeding. Following the repair and optimal blood pressure control, the patient had no further episodes of hemoptysis and was discharged from the hospital. His case not only adds to the growing body of medical literature reporting hemoptysis as a complication of coarctation repair but also highlights the aorto-bronchial fistula as a possible and potentially catastrophic mechanism for bleeding in these patients.
Infliximab-induced retrobulbar optic neuritis in a patient with ankylosing spondylitis
Authors: Sema Dündar, Mimbay Yaşar, Harun Çakmak, Nefati Kıylıoğlu, Alparslan Ünsal
Journal: GMS Ophthalmol Cases (2023)
Keywords: ankylosing spondylitis, anti-tnf, demyelinating disease, infliximab, optic neuritis
MeSH terms: Case Reports

Objective:
To present a case with infliximab-induced retrobulbar optic neuritis.
Case description:
A 58-year-old woman presented to our clinic with a two-day history of blurred vision in her right eye. She had numerous uveitis attacks previously, and she was on infliximab treatment for ankylosing spondylitis. Her best-corrected visual acuity was counting fingers and 20/25 in the right and left eye, respectively. Optic discs seemed healthy in fundoscopic examination. The right optic nerve showed high signal intensity on magnetic resonance imaging (MRI). Infliximab treatment was discontinued and systemic steroid therapy was started. After the treatment her best-corrected visual acuity improved to 20/20 in her right eye.
Conclusion:
Infliximab is a chimeric human-murine monoclonal antibody used in autoimmune diseases. Optic neuritis is a rare but important side effect of infliximab. Thus, infliximab-induced optic neuritis should be kept in mind for patients receiving infliximab treatment.
Right coronary artery dissection after aortic valve replacement presenting with refractory ventricular fibrillation
Authors: Abiah Jacob, Natalia Hara, Giridhara Goli, Kulvinder Lall
Journal: J Surg Case Rep (2024)
Keywords: aortic valve replacement, cardiac surgery, coronary artery dissection, infective endocarditis, ventricular arrhythmias
MeSH terms: Case Reports

Iatrogenic coronary artery dissection is a rare complication seen in 0.07% of coronary procedures. Presentations of this condition vary, ranging from signs of myocardial ischemia to rarer presentations of ventricular arrhythmias. We present a rare case of a 55-year-old patient with native aortic valve endocarditis who developed right coronary artery dissection (RCAD) in the immediate post-op period presenting with refractory ventricular fibrillation (VF). Emergency coronary angiogram revealed an extensive RCAD extending from the ostium to the mid-vessel as the cause of VF. A consensus between the cardiologists and the cardiac surgeons led to an emergency right coronary artery bypass graft (CABG) that resolved the VF. This case illustrates a rare presentation of iatrogenic RCAD and the successful management of the same. We highlight the importance of prompt detection via angiography in patients suspected of having coronary artery dissection and showcase the successful implementation of emergency CABG in a patient with unstable haemodynamics.
Liver metastasis from hepatoid adenocarcinoma of the stomach: a case report and literature review
Authors: Hui Zhu, Qingqing Li, Linqing Qian
Journal: Front Oncol (2024)
Keywords: case report, hepatic metastasis, hepatoid adenocarcinoma of the stomach, magnetic resonance imaging, radiomics
MeSH terms: Case Reports

Hepatoid adenocarcinoma of the stomach (HAS) represents a rare malignant neoplasm sharing morphological and immunophenotypic similarities with hepatocellular carcinoma (HCC). Pathological morphology serves as the cornerstone for diagnosis, often accompanied by elevated alpha-fetoprotein (AFP) levels, nonspecific clinical symptoms, and imaging features reminiscent of gastric adenocarcinoma (GA). Liver metastases from HAS can mimic the enhancement patterns of HCC, posing challenges in differentiation from high-risk HCC cases. Conversely, HAS typically exhibits poorer prognostic outcomes compared to HCC and GA. This report presents a case of HAS with liver metastasis alongside a comprehensive literature review covering its pathology, molecular mechanisms, clinical presentations, and treatment modalities. Special focus is given to imaging characteristics and the utilization of radiomics for early-stage detection. The integration of imaging findings with laboratory results aids in HAS diagnosis, while radiomics provides novel insights for precise discrimination. In conclusion, the identification of distinct imaging markers distinguishing HAS from HCC and GA shows promise in facilitating optimal treatment strategies and improving patient outcomes.
Diagnosis and Management of a Patient With Chronic Lymphocytic Leukemia and a Concurrent Plasmacytoma
Authors: Danielle C Thor, Rohan Umrani, Jack Bergal, Charles Yang, Richard Gordon
Journal: Case Rep Oncol Med (2024)
Keywords: cll, chronic lymphocytic leukemia, hematology, lymphoma, oncology, plasmacytoma
MeSH terms: Case Reports

Chronic lymphocytic leukemia (CLL) typically presents as an indolent disease with a benign disposition in most patients. In select patients, CLL can progress into a more aggressive disease via its original morphology, following a Richter transformation to an alternative non-Hodgkin's lymphoma, or with the concomitant development of multiple myeloma. In an extremely rare subset of individuals with CLL, an extramedullary plasmacytoma may coexist. This case report seeks to describe the diagnosis and treatment of a patient with concurrent CLL and a plasmacytoma.
Concomitant percutaneous coronary intervention and transcatheter aortic valve replacement for aortic stenosis complicated with acute STEMI: a case report and literature review
Authors: Chengyi Xu, Hanhua Hu, Xi Su
Journal: Front Cardiovasc Med (2023)
Keywords: acute st-segment elevation myocardial infarction, aortic stenosis, cardiogenic shock, case report, percutaneous coronary intervention, transcatheter aortic valve replacement
MeSH terms: Case Reports

Aortic stenosis (AS) complicated with acute ST-segment elevation myocardial infarction (STEMI) is a life-threatening emergency with high mortality. A 75-year-old male patient attended the emergency department of Wuhan Asia Heart Hospital in December 2021 with chest pain for 2 days and exacerbation for 1 h. The electrocardiogram (ECG) indicated atrial fibrillation with rapid ventricular response and ST-segment depression. Echocardiography showed severe AS and mild/moderate aortic insufficiency. The patient refused coronary angiography and further invasive procedures and then requested discharge, but he had recurrent chest pain on the third day. The ECG showed an extensive anterior wall STEMI. During preoperative preparation, he suffered from cardiogenic shock (CS). Concomitant percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR) was performed, but he died of CS and multiple organ failure 4 days after surgery. Patients with AS and STEMI might be susceptible to CS during perioperative period of concomitant PCI and TAVR, which requires proactive prevention.
Case report: Low-dose radiation-induced meningioma with a short latency period
Authors: Jinyang Li, Xiangmao Zhang, Jing Liu, Chunxia Su, Junxiang Cui, Liling Yang, Yinghao Gu
Journal: Front Oncol (2024)
Keywords: rim, ionizing radiation, meningioma, oncology, radiation-induced meningioma, radiotherapy
MeSH terms: Case Reports

Patients with radiation-induced meningioma (RIM), most of whom had received head radiation therapy or had been exposed to ionizing radiation during childhood or adolescence, are at risk of developing cranial meningiomas throughout their lifetimes because of the long latency period. Although intermediate-to-high-dose ionizing radiation exposure is an established risk factor for RIM, risk factors for low-dose RIM remain incompletely defined. This study presents the case of a 56-year-old woman diagnosed with radiation-induced giant meningioma 2.5 years after undergoing an interventional embolization procedure for a brain aneurysm. This is the first report of RIM attributable to a brain intervention with an extremely short latency period. The total radiation dose received by the patient during the operation was 1367.3 mGy, representing a low dose. Our case report strengthens the evidence that even low radiation doses can increase the risk of RIM. These findings provide a realistic basis for the theoretical study of RIM and suggest some new ideas for RIM treatment. The need for caution in the use of radioactive treatments and optimization of interventional procedures is highlighted.
Salmonella Group B Ileitis Mimicking Crohn's Disease: A Case Report
Authors: Bereket Tewoldemedhin, Shefali Pati, Raed Atiyat, Andre Fedida, Addi Suleiman, Yazeed Abu Ruman, Ala Muhanna, Charity Iheagwara, Maria Szabela, Jihad Slim, Jack Boghossian
Journal: Cureus (2024)
Keywords: colitis, crohns, focal active colitis, salmonella infection, terminal ileitis
MeSH terms: Case Reports

Salmonellae, considered among the enteric-fever-causing pathogens, is associated with a range of human infections, including gastroenteritis, bacteremia, and osteomyelitis. Salmonella-induced mesenteric adenitis and terminal ileitis resembling acute appendicitis have been reported in the literature. Here, we present a rare case of a patient presenting with severe acute active ileitis and colitis mimicking Crohn's disease with no prior history of inflammatory bowel disease and found to have Salmonella group B bacteremia.
Translating research evidence into youth behavioral health policy and action: using a community-engaged storyboard approach
Authors: McKenna F Parnes, Merih Mehari, Georganna R Sedlar, Cindy Trevino, Rachel Porter, Sarah C Walker
Journal: Front Public Health (2024)
Keywords: co-design, community-engaged research, non-specialist providers, storyboarding, youth behavioral health
MeSH terms: Health Policy, Mental Health Services / organization & administration, Adolescent, Child, Health Services Accessibility, Humans, Translational Research, Biomedical, Washington

Introduction:
There is nationwide shortage of child and adolescent behavioral health providers. Lack of diversity in the mental health care profession compounds workforce capacity issues, contributing to greater disparities in treatment access and engagement for youth from historically disenfranchised communities. Strategies are needed to foster cross-sector alignment to inform policy which can improve mental health care access and reduce disparities. This current case study details a specific research-practice-policy partnership strategy, storyboarding, as a method to engage community partners in Washington State to deliberate on information drawn from research on non-specialist models of child and adolescent mental health care to support the behavioral workforce expansion.
Method:
Research evidence from a scoping literature review on non-specialist models of child and adolescent mental health care was shared via storyboards with community partners to inform policy efforts around the behavioral health workforce expansion. In Phase 1, community members with lived experience and clinical expertise contributed to the storyboard design process. In Phase 2, a broader community partner group shared their perspectives on the models of care presented in the storyboards via Qualtrics survey with open-ended questions. Listening sessions were also held with non-English speaking refugee and immigrant communities to elicit feedback on whether these models of care would meet their needs. Qualitative data was coded to explore emerging themes using a rapid deductive approach.
Results:
Community partners shared mixed responses to models of care presented from the research literature. Immigrant and refugee communities explicitly stated these existing models would not fit their context. Regarding partnership strategy success, the smaller community partner group was engaged in the storyboard design process. The broader community interacted with and provided detailed responses to the models of care presented in the storyboards. Success was also reflected in community partners' continued participation in the next stage of the project.
Discussion:
Findings demonstrate how storyboarding can be effectively used to translate research evidence into accessible information to promote community partner engagement and capture community voice in policy processes. More work is needed exploring how such methods can be used to increase the use of research evidence in policy and practice spaces.
Aggressive Multiple Central Giant Cell Granulomas of the Jaws
Authors: Farnoush Mohammadi, Hoorieh Bashizadehfakhar, Sara Aliasghari, Zahra Gholamhoseini
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Central giant cell granuloma (CGCG) is considered a benign intraosseous lesion with a varied range of clinical features in two subtypes, including aggressive and non-aggressive lesions. This study presents a 9-year-old boy with multiple bilateral CGCG in the mandible without any systemic disease or specific syndrome. Clinical, radiographic, and histopathological findings demonstrated the aggressive lesions. It is discussed how the differential diagnosis and treatment can be determined based on the patient's age as well as the size and manner of the lesion.
Crossed aphasia in a left-handed patient with non-fluent variant of primary progressive aphasia with left asymmetric brain SPECT
Authors: Paulo Roberto de Brito-Marques, Janaina Mariana de Araujo Miranda Brito-Marques
Journal: Dement Neuropsychol (2023)
Keywords: aphasia, primary progressive, dementia, dominance, cerebral, neurodegenerative diseases, tomography, emission-computed, single-photon
MeSH terms: Case Reports

Primary progressive aphasia is a clinical syndrome caused by neurodegeneration of areas and neural networks involved in language, usually in the left hemisphere. The term "crossed aphasia" denotes an acquired language dysfunction caused by a lesion in the ipsilateral hemisphere to the dominant hand.
Objective:
To describe a case of crossed aphasia in a 60-year-old left-handed patient with a non-fluent variant of primary progressive aphasia diagnosis (age of onset=52), evidenced by a left asymmetry on brain SPECT scan.
Methods:
Clinical and family history, the Edinburgh Handedness Inventory, Measurement of Functional Activities in Older Adults in the Community, the "Mini-Mental State Examination", the Trail Making Test, the Tower of London, and the Neuropsychological assessment for dementia, and neuroimaging studies were carried out.
Results:
Neuropsychological assessment showed severe cognitive impairment, especially regarding language. The magnetic resonance imaging showed important signs of cortico-subcortical atrophy, with predominance in the frontal and temporal lobes. The single-photon emission computed tomography scan showed moderate to severe hypoperfusion in the left cerebral hemisphere, including the hippocampus.
Conclusion:
We described a clinical case of crossed aphasia in a left-handed woman with a non-fluent variant of primary progressive aphasia with asymmetry on brain SPECT, mainly on the left, followed up for seven years.
Acute Lower Limb Ischaemia as a Presenting Sign of Atrial Myxoma: Case Report and Scoping Review of the Literature
Authors: Alberto M Settembrini, Leonardo Foresti, Paolo Verlato, Gianluca Buongiovanni, Daniele Bissacco, Chiara Lomazzi, Marco Maggioni, Santi Trimarchi
Journal: EJVES Vasc Forum (2024)
Keywords: acute limb ischaemia, atrial myxoma, embolectomy, peripheral embolism
MeSH terms: Review

Objective:
Cardiac myxomas (CMs) are the most common primary cardiac tumour in adults. They are a rare cause of peripheral embolisation and may present as acute lower limb ischaemia (ALI). A scoping review was undertaken and a case of ALI due to CM embolisation is presented in this paper.
Methods:
MEDLINE, Scopus, and Embase were systematically searched for studies reporting data on ALI as a presentation of CM embolisation. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was followed.
Results:
A healthy 26 year old female presented to the emergency department with bilateral ALI. Urgent bilateral aorto-iliac embolectomy and distal embolectomy of the left femoropopliteal axis were performed. The retrieved embolic material exhibited a yellowish appearance and jelly like consistency, and histological analysis provided a diagnosis of a myxomatous embolus. Transoesophageal echocardiography confirmed the left atrial origin of a myxomatous tumour, but the residual mass was considered too small for further excision. At a two year clinical follow up, the patient was alive and well without recurrence. Between 1989 and 2023, 59 patients with ALI due to CM embolisation were identified in the literature. An in hospital mortality rate of 12.1% (n = 7) was reported, while the in hospital complication and re-intervention rates were 34.5% (n = 20) and 27.6% (n = 16), respectively. No post-discharge deaths, complications, or re-interventions were reported; fasciotomies were the most reported (n = 10). Post-discharge follow up was reported in 22 (37.3%) patients. Mean follow up was 18.0 ± 18.8 months (range 1-120), and 86.4% of patients (n = 19) were alive and well at last follow up.
Conclusion:
This review and the associated case report underline that CM embolisation should be considered in healthy young patients presenting with cryptogenic ALI. Early transoesophageal echocardiography and histological analysis of the retrieved embolus are recommended to minimise misdiagnosis in these populations.
Case Report: Comprehensive evaluation of ECG phenotypes and genotypes in a family with Brugada syndrome carrying SCN5A-R376H
Authors: Ngoc Bao Ly, Yoo Ri Kim, Ki Hong Lee, Namsik Yoon, Hyung Wook Park
Journal: Front Cardiovasc Med (2024)
Keywords: brugada syndrome, scn5a, family screening, genetic study, sudden cardiac death
MeSH terms: Case Reports

Background:
Brugada syndrome (BrS) is a channelopathy that can lead to sudden cardiac death in the absence of structural heart disease. Patients with BrS can be asymptomatic or present with symptoms secondary to polymorphic ventricular tachycardia or ventricular fibrillation. Even though BrS can exhibit autosomal dominant inheritance, it is not easy to identify the phenotype and genotype in a family thoroughly.
Case:
We report the case of a 20-year-old man with variants in SCN5A and RyR2 genes who was resuscitated from sudden cardiac death during sleep due to a ventricular fibrillation. The patient did not have underlying diseases. The routine laboratory results, imaging study, coronary angiogram, and echocardiogram (ECG) were normal. A type 1 BrS pattern was identified in one resting ECG. Furthermore, prominent J wave accentuation with PR interval prolongation was identified during therapeutic hypothermia. Therefore, we were easily able to diagnose BrS. For secondary prevention, the patient underwent implantable cardioverter defibrillator implantation. Before discharge, a genetic study was performed using next-generation sequencing. Genotyping was performed in the first-degree relatives, and ECG evaluations of almost all maternal and paternal family members were conducted. The proband and his mother showed SCN5A-R376H and RyR2-D4038Y variants. However, his mother did not show the BrS phenotype on an ECG. One maternal aunt and uncle showed BrS phenotypes.
Conclusion:
Genetics alone cannotdiagnose BrS. However, genetics could supply evidence or direction for evaluating ECG phenotypes in family groups. This case report shows how family evaluation using ECGs along with a genetic study can be used in BrS diagnosis.
Case report: A rare case of very well-differentiated gastric adenocarcinoma of gastric type with a lymphovascular invasion
Authors: Jiaqi Chen, Xiujie Cui, Honglei Wu, Chengjun Zhou
Journal: Front Oncol (2024)
Keywords: case report, lymphovascular invasion, microsatellite instability, submucosal infiltration, very well-differentiated gastric adenocarcinoma
MeSH terms: Case Reports

Background:
Very well-differentiated gastric adenocarcinoma (VWDA) is a rare variant of gastric cancer, for which the diagnostic criteria and clinical behavior are not fully established. We reported a case of an intramucosal VWDA of gastric type with a lymphovascular invasion (LVI).
Case presentation:
A 67-year-old female was diagnosed as intramucosal gastric adenocarcinoma after a biopsy at the local hospital 3 weeks ago and then visited our hospital for further treatment. The endoscopic examination in our hospital showed a rough, slightly faded, 30-mm, flat, and elevated lesion on the lesser curvature of the middle gastric body. Histopathologically, the lesion consisted of superficial foveolar-type papillary adenocarcinoma and deep pyloric gland-type tubular adenocarcinoma. The immunostaining results showed that the foveolar-type papillary adenocarcinoma was positive for MUC5AC and had a high index of Ki-67, but the pyloric gland-type tubular adenocarcinoma was positive for MUC6 and had a low index of Ki-67. Both components were negative for MSH2 and MSH6, which suggested the high microsatellite instability phenotype. Moreover, a LVI was detected in the lesion. The pathological diagnosis was VWDA of gastric type.
Conclusion:
The case has unique histological and immunophenotypic characteristics, which not only indicates the importance of architectural features in the diagnosis of VWDA but also further proves that the aggressive behavior of VWDA is correlated with tumor histological type and immunophenotype.