OpenMed/multicare-articles huggingface dataset:
Amiodarone-Induced Leukocytoclastic Vasculitis in a Decompensated Heart Failure Patient: A Case Report
Authors: Ummul Asfeen, Rohan Raj, Chinedu J Ezeafulukwe, Omar A Hassan, Deepa Treesa Francis, Sukhmeet S Dhillon, Aadil Khan
Journal: Cureus (2024)
Keywords: decompensated heart failure, leukocytoclastic, leukocytoclastic vasculitis, small-vessel vasculitis, vasculitis
MeSH terms: Case Reports

Leukocytoclastic vasculitis (LCV) is a small-vessel vasculitis characterized by inflammation and damage to the walls of small blood vessels. It typically presents with palpable purpura and can be associated with various systemic conditions. Although its etiology is diverse, LCV has been associated with systemic diseases, infections, medications, and autoimmune disorders. Here, we present a case of LCV in a patient with decompensated heart failure. A 58-year-old man presented with progressively deteriorating swelling in both his lower limbs and scrotum, a persistent dry cough associated with minor ulcerative lesions on his shins, and a patchy rash with pustules and flat reddish spots. He was hospitalized three days prior due to atrial fibrillation and rapid ventricular rate, for which he was commenced on amiodarone. This rash persisted for three days, yet he denied experiencing any discomfort or itchiness along with it. Based on his clinical picture, laboratory evaluations, and imaging findings, he was diagnosed with LCV induced by amiodarone.
Takotsubo syndrome and atrial myxoma-identifying a new trigger: a case report
Authors: Kevin Velarde-Acosta, Robert Sandoval, Luis Falcón-Quispe, William Efrain Anicama Lima, Roberto Baltodano-Arellano
Journal: Front Cardiovasc Med (2024)
Keywords: heartteam management, atrial myxoma, case report, multimodal imaging, takotsubo syndrome
MeSH terms: Case Reports

Takotsubo syndrome (TTS) is a rare cardiomyopathy, but its prevalence is increasing due to the greater availability of diagnostic tools, whose pathophysiology is unknown; however, the evidence points to an excess of catecholamines that ends up generating cardiac stunning. The cause of excessive sympathetic discharge is multifactorial, and some tumors may be related to their origin. In this case report, we present a female patient with TTS whose only identified triggering factor was an atrial myxoma, which generated an unusual clinical presentation. Current multimodal diagnostic tools together with the multidisciplinary evaluation of the HeartTeam allowed an accurate diagnosis and an adequate management of the clinical picture.
Case Report of a Child with Colocolic Intussusception with a Primary Lead Point
Authors: Ethan Lee, Jeremy Lins, Chelsea Cosand, Mary Jane Piroutek, Tommy Y Kim
Journal: J Educ Teach Emerg Med (2024)

Intussusception is the telescoping of bowel into an adjacent segment of bowel and has an associated risk for bowel ischemia and perforation. The classic triad of abdominal pain, blood in stool, and an abdominal mass is present in less than 40% of pediatric cases and is less common in older children.1 Ultrasound has a high sensitivity and specificity for the diagnosis of intussusception, and once diagnosed, treatment modalities include reduction by either ultrasound or fluoroscopic guided air or hydrostatic enema. The risk of recurrence after successful reduction occurs in up to 12% of pediatric patients and occurs more frequently in older children and children with a pathologic lead point.2 We present a case of a 6-year-old child with colocolic intussusception that was successfully reduced and recurred within five days due to a large colonic polyp.
Topics:
Intussusception, lead point, pediatrics.
Peritonitis caused by Listeria monocytogenes and Burkholderia cepacia in a patient on peritoneal dialysis: a case report
Authors: Yu-Chi Tsai, Ming-Kai Tsai, Wen-Ching Kung, Chien-Yao Wang
Journal: Front Med (Lausanne) (2024)
Keywords: burkholderia cepacia, listeria monocytogenes, case report, peritoneal dialysis, peritonitis
MeSH terms: Case Reports

Peritoneal dialysis (PD)-associated peritonitis is a major cause of peritoneal dysfunction and failure. The main issue regarding the treatment is whether to remove the catheter surgically or to treat with antibiotics alone. Notably, PD-associated peritonitis is commonly caused by gram-positive cocci, but rarely by Listeria monocytogenes and Burkholderia cepacia. Here, we report a patient diagnosed with PD-associated peritonitis caused by L. monocytogenes and B. cepacia who presented with a fever, abdominal pain, and turbid dialysate and had been receiving PD for over 20 years. After 2 weeks of antibiotic treatment, the catheter in the patient was surgically removed. Culture and pathology results revealed pathogen growth, foreign body granuloma with chronic inflammation, and inflammatory cells with fibroblast infiltration. The patient was switched to hemodialysis. She eventually recovered and was discharged. The patient presented fair health at the 3-month follow-up. In conclusion, sequential dialysate white blood cell count may help clinicians decide the course of treatment and guide the timing of surgical intervention.
Case report: Acute kidney injury as the initial manifestation of chronic lymphocytic leukemia/small lymphocytic lymphoma
Authors: Sascha T Bender, Vanja Zeremski, Thorsten Wiech, Peter R Mertens, Christian Gross
Journal: Front Med (Lausanne) (2023)
Keywords: chronic lymphocytic leukemia/small lymphocytic lymphoma, extranodal, infiltration, kidney involvement, paraprotein, zanubrutinib acute kidney injury as initial manifestation of chronic lymphocytic leukemia/small lymphocytic lymphoma
MeSH terms: Case Reports

Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder often diagnosed after incidental finding of leukocytosis. Renal involvement is usually clinically silent. Symptomatic renal impairment due to CLL/small lymphocytic lymphoma (SLL) cell infiltration in the kidney tissue is uncommon, and acute kidney injury (AKI) as a presenting feature is rare. In this case report, we describe the case of a patient with AKI caused by CLL/SLL infiltration as a presenting feature. Our report highlights the possibility of kidney injury as the first evident symptom of CLL/SLL. Kidney biopsy is the mainstay in these cases in order to establish a diagnosis. Treatment with zanubrutinib resulted in improved kidney function.
Neuromuscular adaptations after osseointegration of a bone-anchored prosthesis in a unilateral transfemoral amputee - a case study
Authors: Thomas Krauskopf, Torben Lauck, Britta Meyer, Lukas Klein, Marc Mueller, Johanna Kubosch, Georg Herget, Vinzenz von Tscharner, Jennifer Ernst, Thomas Stieglitz, Cristian Pasluosta
Journal: Ann Med (2023)
Keywords: amputee, balance, bone anchoring, neuromuscular control, osseointegration
MeSH terms: Amputees, Bone-Anchored Prosthesis, Observational Study, Research Support, Non-U.S. Gov't, Electromyography, Humans, Muscle, Skeletal, Osseointegration

Purpose:
Many individuals with a lower limb amputation experience problems with the fitting of the socket of their prosthesis, leading to dissatisfaction or device rejection. Osseointegration (OI)- the implantation of a shaft directly interfacing with the remaining bone- is an alternative for these patients. In this observational study, we investigated how bone anchoring influences neuromuscular parameters during balance control in a patient with a unilateral transfemoral amputation.
Material and methods:
Center of pressure (CoP) and electromyography (EMG) signals from muscles controlling the hip and the ankle of the intact leg were recorded during quiet standing six months before and one and a half years after this patient underwent an OI surgery. Results were compared to a control group of nine able-bodied individuals.
Results:
Muscle co-activation and EMG intensity decreased after bone anchoring, approaching the levels of able-bodied individuals. Muscle co-activation controlling the ankle decreased in the high-frequency range, and the EMG intensity spectrum decreased in the lower-frequency range for all muscles when vision was allowed. With eyes closed, the ankle extensor muscle showed an increased EMG intensity in the high-frequency range post-surgery. CoP length increased in the mediolateral direction of the amputated leg.
Conclusions:
These findings point to shifts in the patient's neuromuscular profile towards the one of able-bodied individuals.
Case Report: Acute cerebral infarction as the initial manifestation of malignant tumors with trousseau syndrome in the elderly
Authors: Chen Li, Miao Fan, Wen He, Yingying Gong, Lei Su
Journal: Front Oncol (2023)
Keywords: trousseau syndrome, acute cerebral infarction, comprehensive geriatric assessment, elderly patients, malignant tumor
MeSH terms: Case Reports

Both acute cerebral infarction and malignant tumors are prevalent in the elderly. However, acute cerebral infarction is rarely present as the first clinical manifestation of malignant tumors. By searching the Picture Archiving and Communication System from 2010 to 2022 and the medical record database from 2003 to 2022, we found three cases of Trousseau syndrome, one male and two females with an average age of 69.3 ± 3.2 years, presenting with acute cerebral infarction. Two patients denied having hypertension, diabetes, and coronary heart disease. The average value of the D-dimer was 17.83 ± 12.39 mg/L (normal range, 0 to 0.55 mg/L). Magnetic resonance imaging (MRI) of the brain showed scattered and multiple small infarcts in the watershed area. The sites of infarction were not those that are typically caused by vascular atherosclerosis. One of the females was diagnosed with pancreatic cancer (T2N2M1, stage IV), the male was diagnosed with gastric cancer (T4N3M1, stage IV), and the other female was diagnosed with lung adenocarcinoma (rTxN3M1b, stage IV). The patient with pancreatic cancer underwent a comprehensive geriatric assessment, which revealed that she had a disability, dementia, malnutrition, short life expectancy, and high chemotherapy risk. Ultimately, the patient opted for conservative care, and 3 months after being discharged, she passed away from an acute upper gastrointestinal hemorrhage. Elderly patients with unexplained D-dimer elevation, multiple cerebral vascular lesions detected on MRI, and an absence of typical stroke risk factors need to be monitored for Trousseau syndrome. To screen for cancer, tumor markers and related imaging should be performed first. Trousseau syndrome is primarily treated with chemotherapy, radiotherapy and anticoagulant therapy. The risk of bleeding should be assessed carefully when using anticoagulant therapy in the elderly. Comprehensive geriatric assessment can assist in weighing the benefits and side effects of cancer treatment, making correct medical choices, and improving patients' quality of life.
Ureaplasma urealyticum osteomyelitis of the greater trochanter in a patient with multiple sclerosis using ocrelizumab - a case report
Authors: Fred Ruythooren, Stijn Ghijselings, Melissa Depypere, Willem-Jan Metsemakers, Liesbet Henckaerts, Nathalie Noppe, Georges Vles
Journal: J Bone Jt Infect (2024)
MeSH terms: Case Reports

Ocrelizumab - a monoclonal anti-CD20 antibody used in treatment of multiple sclerosis (MS) - marks significant progress in treating autoimmune diseases but raises susceptibility to opportunistic infections due to hypogammaglobulinemia. A young MS patient developed osteomyelitis from persistent Ureaplasma urealyticum urethritis, which was diagnosed with specialized polymerase chain reaction and resolved with targeted antibiotics. A multidisciplinary approach is crucial for managing such infections.
Ayurveda and Yoga management of chronic alcoholism sequelae - A case report
Authors: Aqsa Zarin Khan, Jibi Varghese, Shweta Kodre, Mohini Niware, Snehal Pansare, Shreya Bhatia, Samkit Shah, Manna Mathew
Journal: J Ayurveda Integr Med (2024)
Keywords: ayurveda, chronic alcoholism, rasayana, thiamine deficiency, vikshay, yoga
MeSH terms: Case Reports

Alcohol has always been a component in the dietary pattern of human civilization. It is widely used in society for celebration and socialization. Alcohol abuse is among the most serious problems in public health characterized by uncontrolled drinking which causes physical and emotional dependence on alcohol. Chronic alcoholics are at a higher risk of developing vitamin B1 deficiency due to malabsorption, poor diet, and an increased demand for nutrition. Vitamin B1(Thiamine) is an essential nutrient required for the body's energy metabolism and proper functioning of the nervous system. A person who excessively consumes madya (alcohol) and then abruptly discontinues drinking and takes recourse to drinking excess madya once again, suffers from Madatyaya Upadrava(chronic alcoholism) that is Vikshay. Here is a case report of an alcoholic patient who ceased drinking and then resumed alcohol in large amounts. He presented with symptoms of generalized weakness, body ache, aphasia, confusion, fever (on and off), thirst, cough, headache, and numbness. The patient underwent a two-month treatment regimen that combined Satvavajay Chikitsa, Yoga, and Shaman Chikitsa involving Rasayana medications and procedures including snehan (Oleation), swedan (fomentation), nabhi puran (filling oil with navel), nasya (nasal administration), shirodhara (continuous flow of liquid on head) and basti (medicated enema). The intervention outcome showed relief from the aforementioned symptoms and improvement in both symptoms and GCS(Glasgow coma scale) score. This treatment approach aimed to promote vitality, longevity, and an overall sense of balance and well-being. There are not many corroborating cases being reported and managed with Ayurveda. This case report highlights transforming health through the cumulative effects of Rasayana medicines, panchakarma, and yoga.
Transoral unilateral lag screw osteosynthesis for coronal split fracture of the lateral mass of the atlas - case report, operative technique and review of the literature
Authors: Christian Tinner, Fabian Cedric Aregger, Moritz Caspar Deml
Journal: Brain Spine (2023)
Keywords: atlas fracture, minimally invasive, transoral approach, upper cervical spine
MeSH terms: Case Reports

Introduction:
Atlas ring fractures, which account for 1.3% of all spinal fractures, are predominantly managed conservatively. However, in certain cases, surgical treatment may be necessary depending on the type of fracture, degree of comminution, fracture location, and associated ligamentous injuries. Surgical stabilization frequently results in a posterior C1-2 or C0-2 fusion, which restricts movement, particularly craniocervical rotation. Coronal split fractures of the lateral mass need to be reduced and fixed due to dislocation, instability and secondary osteoarthritis. The preferred treatment approach involves internal fixation of the reduced fracture fragments, while avoiding restriction of the upper cervical spine's range of motion (ROM).
Research question:
Is unilateral anterior transoral lag screw for treatment of unstable coronal split fracture of lateral mass of the atlas feasible and a safe treatment option?
Case report material and methods:
We report on a 55-year-old female suffering from polytrauma with multiple spinal and extremity injuries.
Results:
A coronal split fracture of the lateral mass of the atlas was treated minimally invasive with a transoral lag screw technique to reduce and fix the fracture that has a tendency for fracture gap widening. Stable fixation and fracture union and thus restoration of function was achieved.
Discussion and conclusion:
Transoral lag screw osteosynthesis for coronal split fracture of the lateral mass of the atlas is a potential treatment option in selected cases to preserve mobility in the upper cervical spine after spinal trauma.
An Epiphrenic Diverticulum with Previous Perforation Excised Laparoscopically
Authors: Amitabh Yadav, Samiran Nundy
Journal: Case Rep Surg (2024)
MeSH terms: Case Reports

An epiphrenic diverticulum (ED) is a rare pseudodiverticulum commonly located at the lower end of the oesophagus. Surgical treatment is only required in patients with worsening dysphagia or repeated chest infection due to microaspirations, and most patients are now treated with minimally invasive surgery (MIS) using the laparoscopic or thoracoscopic approach. Laparoscopic surgery is considered difficult in the presence of previous perforation of the diverticula owing to the intraperitoneal and mediastinal adhesions and is associated with an increased incidence of complications. We were able to perform a laparoscopic transhiatal resection safely on a patient who had a large ED with a wide neck and dense abdominal and mediastinal adhesions due to previous localized perforation.
Case studies of fifteen novel species successfully aided with the use of a veterinary teletriage service
Authors: Shadi J Ireifej, Justin Krol
Journal: Front Vet Sci (2023)
Keywords: exotics, teleadvice, telehealth, telemedicine, teletriage, veterinary, video session, wildlife

The veterinary medical field is constantly growing and evolving. Embracing the growth of readily available video conferencing, and potentially spurred by events such as the COVID-19 pandemic causing the public to seek alternatives to physical contact for medical advice at their local veterinary clinic, the use of long-distance advice or telehealth is a rapidly developing field in its own right. Here we present case studies using a teletriage service, VetTriage, to provide health care advice to clients with underserved species including presenting complications, actions taken during the session, medical advice given, and follow-up of the case when possible. In addition to the everyday difficulty of accessing rapid medical care in recent years, there are households with underserved animal groups such as exotics (small mammals, reptiles, birds, fish, etc.), found wildlife, and in some areas of the country, large animals (horses, cows, etc.). Teletriage services have the potential to reach these underserved animal groups providing a vital service where otherwise no help may be available.
Ethnic and religious identities in Russian penal institutions: A case study of Uzbek Transnational Muslim prisoners
Authors: Rustamjon Urinboyev, Judith Pallot
Journal: Open Res Eur (2024)
Keywords: russia, prisons, penality, muslim prisoners, uzbeks, ethnicity, islam, radicalisation

Russia has become one of the main migration hubs worldwide following the collapse of the Soviet Union. The vast majority of migrant workers travel to Russia from three Central Asian countries. However, Russian immigration laws and policies are ambiguous and highly punitive. The result is that many migrants resort to undocumented status working in the shadow economy, which places them in a disadvantaged and precarious position. In this position they are vulnerable to becoming targets of the Russian criminal justice system as they take to crime to overcome economic uncertainty, become embroiled in interpersonal conflicts ending in violence, or fall victim to fabricated criminal charges initiated by Russian police officers under pressure to produce their monthly quota of arrests. The impact on Russian penal institutions is that they have become ethnically, culturally, and religiously diverse sites as a consequence of the incarceration of growing numbers of transnational prisoners. Using person-to-person interviews conducted in Uzbekistan with men and women who served sentences in Russian penal institutions during the past two decades, we show in this article how the large-scale migratory processes have transformed Russian prisons into sites of ethnic and religious plurality, in which formal rules and informal sub-cultures - the colony regime, so-called thieves' law ( vorovskoy zakon), ethnic solidarity norms, and Sharia law - coexist and clash in new ways compared with the status quo ante. Thus, we argue there is a need to revise the prevailing understanding about the power dynamics in Russian penal institutions. Our findings undermine the prison service's insistence of the ethnic and ethno-religious neutrality and 'cosmopolitanism' of Russian penal space, which is presented as a latter-day manifestation of the Soviet-era 'friendship of nations' policy. Russian prisons today must be understood as sites of ethnic and religious pluralism.
Case report: Equine metacarpophalangeal joint partial and full thickness defects treated with allogenic equine synovial membrane mesenchymal stem/stromal cell combined with umbilical cord mesenchymal stem/stromal cell conditioned medium
Authors: I L Reis, B Lopes, P Sousa, A C Sousa, A Rêma, A R Caseiro, I Briote, A M Rocha, J P Pereira, C M Mendonça, J M Santos, L Lamas, L M Atayde, R D Alvites, A C Maurício
Journal: Front Vet Sci (2024)
Keywords: case report, cell-based medicinal product, equine, osteochondral defect, synovial membrane mesenchymal stromal/stem cell, umbilical cord conditioned medium
MeSH terms: Case Reports

Here, we describe a case of a 5-year-old show-jumping stallion presented with severe lameness, swelling, and pain on palpation of the left metacarpophalangeal joint (MCj). Diagnostic imaging revealed full and partial-thickness articular defects over the lateral condyle of the third metacarpus (MC3) and the dorsolateral aspect of the first phalanx (P1). After the lesion's arthroscopic curettage, the patient was subjected to an innovative regenerative treatment consisting of two intra-articular injections of equine synovial membrane mesenchymal stem/stromal cells (eSM-MSCs) combined with umbilical cord mesenchymal stem/stromal cells conditioned medium (UC-MSC CM), 15 days apart. A 12-week rehabilitation program was accomplished, and lameness, pain, and joint effusion were remarkably reduced; however, magnetic resonance imaging (MRI) and computed tomography (CT) scan presented incomplete healing of the MC3's lesion, prompting a second round of treatment. Subsequently, the horse achieved clinical soundness and returned to a higher level of athletic performance, and imaging exams revealed the absence of lesions at P1, fulfillment of the osteochondral lesion, and cartilage-like tissue formation at MC3's lesion site. The positive outcomes suggest the effectiveness of this combination for treating full and partial cartilage defects in horses. Multipotent mesenchymal stem/stromal cells (MSCs) and their bioactive factors compose a novel therapeutic approach for tissue regeneration and organ function restoration with anti-inflammatory and pro-regenerative impact through paracrine mechanisms.