OpenMed/multicare-articles huggingface dataset:
Novel gas producing Vibrio cholerae: a case report of gastroenteritis with acute kidney injury
Authors: Jeevan Malaiyan, Anandan Balakrishnan, Sowmya Nasimuddin, Kamalraj Mohan, PradeepRaj Meenakshi-Sundaram, Selvam Mamandur-Devarajan, Sumathi Gnanadesikan, Mohanakrishnan Kandasamy, Nithyalakshmi Jayakumar, Dhevahi Elumalai, Gokul G Ra
Journal: Access Microbiol (2019)
Keywords: vibrio cholerae, diarrhea, gas production, sequencing
MeSH terms: Case Reports

Background:
Bacterial characterization is important in clinical and epidemiological studies. We herein report the first case of gas-producing Vibrio cholera gastroenteritis with acute kidney injury.
Case presentation:
A 30-year-old female presented to the emergency department with complaints of about ten episodes of watery diarrhea, four episodes of vomiting and elevated serum urea/creatinine levels. Although the bacteria were first misidentified as Vibrio furnissii by gas production on carbohydrate fermentation and triple sugar iron agar, it was later confirmed as Vibrio cholerae by 16 S rRNA gene sequencing and specific PCR. The treatment regimen was followed as for Vibrio species with intravenous fluids, ciprofloxacin and doxycycline. The patient recovered without relapse.
Conclusions:
Literature survey from the PubMed database shows no gas-producing Vibrio cholerae isolate being reported in the world. Further, genotype studies are warranted to look into the gas production of Vibrio cholerae .
Endocardial and Epicardial Rhythmia HDx™ Mapping Verifies Surgical Cox Maze IV Lesion Pattern
Authors: Alexandra L Kharazi, Frank Villa Hernandez, J Paul Mounsey, Andy C Kiser
Journal: J Innov Card Rhythm Manag (2020)
Keywords: arrythmias, atrial fibrillation, cardiac, cardiac surgery, electrophysiology, inferior vena cava
MeSH terms: Case Reports

Atrial fibrillation (AF) remains the most common cardiac dysarrhythmia, with a significant impact on the health-care economy. AF occurs as a result of electrical conduction delays within the atrial tissue, which may stem from fibrosis or other mediators that alter atrial tissue conduction substrate. The Cox maze III and IV procedures block these reentry circuits by directly dividing, or breaking, the self-perpetuating circuit and by isolating these circuits away from the intrinsic cardiac conduction pathway. The Convergent procedure, a hybrid approach to AF ablation, coordinates the electrophysiologist and the cardiac surgeon in a simultaneous or sequential endocardial and epicardial procedure. Because the heart remains electrically active, electroanatomical maps, not anatomical landmarks, guide therapy. However, lesion transmurality and contiguity remain inconsistent. The Rhythmia HDx™ mapping system (Boston Scientific, Natick, MA, USA) offers detailed maps of acute lesion patterns during the ablation procedure. However, these maps require instrumentation and technology found in the electrophysiology laboratory, not in the operating room. We herein present a case during which we performed a Cox maze IV procedure and also applied the Rhythmia HDx™ electroanatomical mapping system (Boston Scientific, Natick, MA, USA) at the time of operation. Through this novel approach, we were able to verify the completeness of the lesions created and reach a procedural endpoint confirmed by both epicardial and endocardial maps of successful electrical isolation of the left atrium posterior wall and pulmonary vein pedicle.
Aortic Aneurysm as a Complication of Granulomatosis with Polyangiitis Successfully Treated with Prednisolone and Cyclophosphamide: A Case Report and Review of the Literature
Authors: Naoko Niimi, Tomoko Miyashita, Kana Tanji, Takuya Hirai, Kozo Watanabe, Keigo Ikeda, Shinji Morimoto, Iwao Sekigawa
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

A 57-year-old Japanese man was admitted to the hospital with back pain and fever, multiple lung nodules, and abdominal aortic aneurysm (AAA). Laboratory tests performed at admission showed an increased proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA) level. Video-associated thoracoscopic lung biopsy was performed; pathologic examination showed granulation tissue with necrosis and multinucleated giant cells. The diagnosis of granulomatosis with polyangiitis (GPA) was confirmed on the basis of the clinical presentation, laboratory findings, and lung biopsy. All symptoms were ameliorated, and the serum level of PR3-ANCA declined following treatment with prednisolone and cyclophosphamide. Although the association of GPA with AAA is rare, GPA may be included among the large vessel vasculitides that can give rise to aortic aneurysm.
Intravenous Thrombolysis After Reversal of Dabigatran With Idarucizumab in Acute Ischemic Stroke: A Case Report
Authors: Dan Xie, Xuefan Wang, Yao Li, Ruiling Chen, Yingying Zhao, Chunling Xu, Qian Zhang, Yongbo Zhang
Journal: Front Aging Neurosci (2021)
Keywords: acute ischemic stroke, anticoagulation, dabigatran, idarucizumab, intravenous thrombolysis
MeSH terms: Case Reports

Background: As there is a growing concern about the cerebral embolism events secondary to non-valvular atrial fibrillation (NVAF), novel oral anticoagulant (NOAC) has been more and more widely used as an anticoagulation treatment for the prevention of stroke. However, in the face of life-threatening bleeding or emergency surgery/treatment, NOAC-related antagonists such as idarucizumab need to be urgently used to reverse the NOAC. Using recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis for acute ischemic stroke requires a time window of 4.5 h. This case reports rt-PA intravenous thrombolysis after reversal of dabigatran anticoagulation with idarucizumab in patients with acute ischemic stroke. Case Presentation: We report the case of 62-year-old Chinese female with NVAF treated with dabigatran 110 mg twice daily, and missed a dose on the eve of the stroke. The patient presented with acute ischemic stroke causing the angle of mouth deviated to right side and left limb weakness in the early morning of the next day. However, the last dosing time of dabigatran was between 24 and 48 h, the patients were given rt-PA intravenous thrombolysis after reversal of dabigatran anticoagulation with idarucizumab, while any potential relative contraindication had been excluded by means of laboratory test and CT scan in the hospitalization services. National Institute of Health stroke scale (NIHSS) score was reduced from 4 to 1, and the patient was discharged after 2 weeks. Conclusion: Our case report adds to the evidence that idarucizumab administration is safe and effective in the setting of patients with atrial fibrillation treated with dabigatran who develop acute ischemic stroke requiring rt-PA intravenous thrombolysis.
Photobiomodulation associated with sclerotherapy for treatment of hemangioma in the hard palate
Authors: Matheus Sampaio de Oliveira, Maurilio Araujo Pegas, Larissa Pavan de Deus, Paula Carolina de Souza Chandretti, Eduardo Machado Vilela
Journal: J Vasc Bras (2021)
Keywords: hemangioma, low-level light therapy, oral medicine, sclerotherapy
MeSH terms: Case Reports

Vascular changes frequently involve the head and neck region and hemagioma is the most common. A 61-year-old female patient complained of severe pain in the hard palate. A purple lesion was found, measuring 1.5 cm, sensitive to palpation, and with a history of hemorrhage. The patient was fully edentulous and her upper denture compressed the lesion site. Diascopy confirmed the lesion's vascular origin. A diagnostic hypothesis of hemangioma was raised. In the first session, red laser light (660nm) was applied at 4 points around the lesion, with 0.5 J at each point, in order to obtain analgesia and trigger the repair process. The upper denture was also relined. In the second session, 2 mL of 5% monoethanolamine oleate was applied. After 14 days, total regression of the lesion was observed. Dental surgeons must be able to recognize, diagnose and treat vascular lesions in the oral cavity.
The Semantics of Priapism and the First Sign of Chronic Myeloid Leukemia
Authors: Michael R Minckler, Ellie Conser, Javier J Figueroa, Aaron J Scott, Joshua Gaither, Richard Amini
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Priapism is defined as an erection that persists beyond four hours, lasting beyond or unrelated to sexual stimulation (Salonia et al., 2014). Because the risk of ischemic damage and impotence is high with priapism (35%), management guidelines are directed towards rapid treatment of this condition (Salonia et al., 2014). This report describes the rare case of an 18-year-old male who presented to the Emergency Department (ED) three times with recurrent and worsening episodes of sustained penile erections. On the patient's third visit, he presented with priapism of greater than six-hour duration that was found to be the result of chronic myeloid leukemia. Clinician awareness of the diagnostic semantics and differential diagnosis surrounding priapism is pivotal in its urgent management.
Transient partial regression of intracranial germ cell tumor in adult thalamus: A case report
Authors: Si-Ping Luo, Han-Wen Zhang, Yi Lei, Yu-Ning Feng, Juan Yu, Fan Lin
Journal: Front Radiol (2022)
Keywords: mri, case report, germinoma, immune response, spontaneous regression, steroid
MeSH terms: Case Reports

Background:
Intracranial germ cell tumors (GCTs) are a relatively rare malignancy in clinical practice. Natural regression of this tumor is also uncommon. We describe a rare case of an intracranial GCT in the thalamus of an adult that showed spontaneous regression and recurrence after steroid therapy.
Case description:
A 38-year-old male patient's MRI of the head suggested space-occupying masses in the left thalamus and midbrain. MRI examination revealed demyelination or granulomatous lesions. After high dose steroid treatment, the symptoms improved. The lesions were significantly reduced on repeat MRI, and oral steroid therapy was continued after discharge. The patient's symptoms deteriorated 1 month prior to a re-examination with head MRI, which revealed that the mass within the intracranial space was larger than on the previous image. He revisited the Department of Neurosurgery of our hospital and underwent left thalamic/pontine mass resection on October 16, 2019, and the pathological results showed that the tumor was a GCT.
Conclusion:
Intracranial GCTs are rare in the adult thalamus but should be considered in the differential diagnosis. The intracranial GCT regression seen in this case may be a short-lived phenomenon arising from complex immune responses caused by the intervention.
Participatory Action Planning to Address the Opioid Crisis in a Rural Virginia Community Using the SEED Method
Authors: Emily B Zimmerman, Carlin L Rafie, Dawn E Moser, Angelina Hargrove, Toni Noe, Courtnaye Adams Mills
Journal: J Particip Res Methods (2020)
Keywords: action planning, cbpr, opioids, participatory modeling, participatory research, seed method, stakeholder engagement

The SEED Method is a multi-stakeholder approach that was created to involve diverse stakeholders in the development and prioritization of research questions using community-based participatory research (CBPR) principles. Here we describe an adaptation of the SEED Method that focuses on developing and prioritizing strategies for addressing a health problem and bringing stakeholders together to develop and implement community action plans based on those strategies. We describe steps for implementing the SEED Method for community action planning and the results of a case study in a rural Virginia community with high opioid prescription and mortality rates. A participatory research team worked with three groups of Topic stakeholders to gather data, develop conceptual models, and create and prioritize strategies for reducing prescription and non-prescription opioid misuse and overdoses. Each group came up with 19 to 25 strategies and prioritized their top five, which included actions, services or programs, strategies, policies, and system changes. Attendees at community action planning meetings reviewed the 15 prioritized strategies, proposed three additional strategies, and prioritized their top choices. Community stakeholders started four work groups to implement the selected strategies in collaboration with the research team.
Multiple transverse colonic perforations associated with slow-release nonsteroidal anti-inflammatory drugs and corticosteroids: a case report
Authors: Nobuki Shioya, Shigehiro Shibata, Masahiro Kojika, Shigeatsu Endo
Journal: Case Rep Crit Care (2011)
MeSH terms: Case Reports

The patient was a 36-year-old woman with sarcoidosis and Sjogren's syndrome, and had been prescribed slow-release diclofenac sodium and prednisolone for the treatment of pain associated with uveitis and erythema nodosum. She was admitted to our emergency center with abdominal pain and distention. A chest X-ray showed free air under the diaphragm on both sides, and an emergency laparotomy was performed for suspected panperitonitis associated with intestinal perforation. Laparotomy revealed several perforations on the antimesenteric aspect of the transverse colon. The resected specimen showed 11 punched-out ulcerations, many of which were up to 10 mm in diameter. The microscopic findings were non-specific, with leukocytic infiltration around the perforations. She showed good postoperative recovery, as evaluated on day 42. The present case highlights the need for exercising caution while prescribing slow-release nonsteroidal anti-inflammatory drugs with corticosteroids to patients with autoimmune diseases, as such treatment may exacerbate intestinal epithelial abnormalities.
Closed Compression Nailing Using a New-Generation Intramedullary Nail without Autologous Bone Grafting for Humeral Shaft Nonunion
Authors: Genta Fukumoto, Tomoaki Fukui, Keisuke Oe, Atsuyuki Inui, Yutaka Mifune, Ryosuke Kuroda, Takahiro Niikura
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Introduction:
Although the recommended treatment for humeral shaft nonunion is compression plating with autologous bone grafting, we treated a case of humeral shaft nonunion with an intramedullary nail (IMN) without bone grafting. Presentation of Case. Osteosynthesis with IMN was performed on a 24-year-old man with a humeral shaft fracture at another hospital. However, bony union was not obtained 1 year after the first surgery, and he was referred to our institution. We treated the nonunion with exchange nailing without autologous bone grafting using compression function of the nail, leading to bony union at 7 months postoperatively. At the final follow-up 2 years and 4 months postoperatively, the patient had full range of motion in the left shoulder and elbow joints. Discussion. Compression plating with autologous bone grafting is reported to be the gold standard for the treatment of humeral shaft nonunion. IMN is advantageous for minimal invasion; however, the conventional type of IMN cannot apply compression force between fragments and does not have sufficient stability against rotational force. In this case, we used an IMN that could apply compression between the fragments and which had rotational stability via many screws. We did not perform bone grafting because the current nonunion was adjudged to be biologically active, and we achieved good functional results.
Conclusion:
We treated humeral shaft nonunion using IMN with compression, but without bone grafting, leading to successful clinical outcomes. This strategy might be an appropriate choice for the treatment of humeral shaft nonunion with biological activity.
Recurrent Intrathoracic Locking of the Scapula after Lung Cancer Resection and Combined Rib Resection
Authors: Akinori Kimura, Hideyuki Sasanuma, Takashi Ajiki, Hitoshi Sekiya, Katsushi Takeshita
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

We report a case of recurrent locking of the scapula in the thorax after combined lobectomy and thoracic wall resection for advanced lung cancer. The patient was a 52-year-old man with advanced spindle cell carcinoma in his right lung. He had undergone right lung lobectomy and thoracic wall excision (Th1-5). Intrathoracic repair had not been performed to address the defect in the thoracic wall. Two months after the operation he experienced sudden acute pain in the right shoulder. Three-dimensional computed tomography revealed locking of the scapula intrathoracically. The diagnosis was recurrent locking of the scapula in the thorax. He underwent conservative treatment. Because his symptoms were not alleviated and he continued to experience recurrent locking, we performed partial resection of the inferior part of the scapula. Although scapular locking diminished after this procedure, there were still some pain and "catching" between the scapula and the thoracic wall (T6) when he undertook certain movements. No further surgery could be performed, however, because the cancer from the primary lesion had recurred near the previously operated thoracic wall. A procedure for recurrent intrathoracic locking of the scapula was not successful in this case.
A case of V180I genetic Creutzfeldt-Jakob disease presenting with conspicuous facial mimicry
Authors: Yasushi Iwasaki, Keiko Mori, Masumi Ito, Yoshinari Kawai
Journal: Prion (2019)
Keywords: creutzfeldt-jakob disease, mri, facial mimicry, pathological laughing, startle reaction
MeSH terms: Creutzfeldt-Jakob Syndrome / genetics, Prion Proteins / genetics, Case Reports, Research Support, Non-U.S. Gov't, Aged, 80 and over, Codon, Creutzfeldt-Jakob Syndrome / pathology, Face / pathology, Female, Homozygote, Humans, Methionine / genetics, Point Mutation, Codon, Prion Proteins, Methionine

Although there have been no reports of facial mimicry in patients with Creutzfeldt-Jakob disease (CJD), we encountered a patient with genetic CJD with prion protein gene codon 180 mutation (V180I gCJD) who apparently showed this interesting clinical finding. The patient was an 87-year-old Japanese woman, and the first observed CJD symptom was poor spontaneity. She gradually showed cognitive dysfunction and subsequently gait disturbance. A prion protein gene analysis revealed a V180I mutation with methionine homozygosity at codon 129. Facial mimicry was observed 7 months after disease onset and continued for approximately 9 months. Pathological laughing and startle reaction were also observed during approximately the same period, whereas myoclonus was observed at a later stage, 12 months after disease onset, and was very mild in degree. Electroencephalography studies showed a diffuse slow basic pattern without periodic sharp wave complexes. Diffusion-weighted magnetic resonance imaging showed extensive hyperintensity in the cerebral cortex, and there was also hyperintensity with edematous swelling in the same regions on T2-weighted and fluid-attenuated inversion recovery images. On the basis of the magnetic resonance imaging findings and the findings of previous case reports of V180I gCJD, we speculate that the characteristic extensive cerebrocortical involvement observed in V180I gCJD was implicated in the pathogenesis of the facial mimicry observed in this case.
Successful entecavir plus prednisolone treatment for hepatitis B virus-associated membranoproliferative glomerulonephritis: A case report
Authors: Hiroshi Kataoka, Toshio Mochizuki, Taro Akihisa, Kentaro Kawasoe, Keiko Kawachi, Shiho Makabe, Anri Sawada, Shun Manabe, Masayo Sato, Nobuyuki Amemiya, Michihiro Mitobe, Takafumi Akanuma, Yasuko Ito, Takahiro Inoue, Tomo Suzuki, Katsuomi Matsui, Takahito Moriyama, Shigeru Horita, Mamiko Ohara, Kazuho Honda, Kosaku Nitta
Journal: Medicine (Baltimore) (2019)
MeSH terms: Antiviral Agents / therapeutic use, Glomerulonephritis, Membranoproliferative / drug therapy, Glomerulonephritis, Membranoproliferative / etiology, Guanine / analogs & derivatives, Hepatitis B, Chronic / complications, Hepatitis B, Chronic / drug therapy, Case Reports, Adult, Female, Glomerulonephritis, Membranoproliferative / pathology, Glomerulonephritis, Membranoproliferative / virology, Guanine / therapeutic use, Hepatitis B virus, Hepatitis B, Chronic / pathology, Humans, Prednisolone / therapeutic use, Pregnancy, Pregnancy Complications, Infectious, Antiviral Agents, entecavir, Guanine, Prednisolone

Rationale:
Adult-onset hepatitis B virus-associated membranoproliferative glomerulonephritis (HBV-MPGN) is generally refractory, and an effective treatment for this condition has not been established. The indications for steroids in HBV-MPGN are an important clinical concern.
Patient concerns:
A 28-year-old woman with a chronic hepatitis B virus infection developed nephrotic syndrome in her second month of pregnancy, with urinary protein levels of 3 to 10 g/d that continued into her postpartum period. She was a carrier of HBV with HBeAg seroconversion. As her renal impairment could have been a result of pregnancy, we observed her for 10 months postpartum without any intervention. However, spontaneous remission after childbirth was not achieved and urine protein levels were sustained at 1 to 3 g/d. About 10 months after delivery, elevated serum liver enzyme levels were observed.
Diagnosis:
Biopsies showed MPGN, with deposition of hepatitis B antigen in the glomeruli, and chronic B-type hepatitis with a severity grade of A1F0. She was diagnosed with HBV-MPGN.
Interventions:
The patient was started on entecavir 0.5 mg/d in March 2008. Within 1 month, serum HBV DNA became undetectable; within 3 months, her alanine aminotransferase levels normalized. However, urinary protein excretion did not decrease to <2 g/d. On a second renal biopsy, performed 7 months after entecavir treatment, proliferative lesions of the glomeruli were observed; therefore, prednisolone was started at an initial dose of 30 mg/d.
Outcomes:
Her proteinuria improved immediately and prednisolone was tapered over 10 months. A third renal biopsy showed a remarkable resolution of HBV-MPGN, with a significant decrease in mesangial proliferation and immune complex deposition. HBV reactivation was not observed during the prednisolone treatment.
Lessons:
Additional prednisolone therapy in combination with antiviral therapy should be considered for refractory HBV-MPGN, with sufficient care taken regarding HBV reactivation.
Modified mandible traction with wires to treat neonatal Pierre Robin sequence: A case report
Authors: Hailiang Zuo, Jing Gao, Yu Mu, Fang Zhang, Yang Liu
Journal: Front Surg (2022)
Keywords: pierre robin sequence, mandible traction, micrognathia, neonate, upper airway obstruction, wire
MeSH terms: Case Reports

Background:
Pierre Robin sequence (PRS) is a congenital craniofacial deformity characterized by micrognathia, glossoptosis and airway obstruction. Some affected neonates are born with severe life-threatening upper airway obstruction that requires surgery. If without timely treatment, it is possible to cause not only organ damage and developmental abnormalities but also early newborn mortality.
Case presentation:
In this report, a 51-hours-old neonate was diagnosed with PRS, who had severe upper airway obstruction and required surgery. We performed the modified mandible traction with wires at four days old and achieved a satisfactory result in improving airway obstruction. No other complications were observed except for mild local infection. No overlap of other more complex syndromes was found, such as ocular abnormalities, hearing loss, other skeletal abnormalities, cardiac abnormalities or other atypical abnormalities. At the present follow-up until 2 years old, there were no significant differences in the maxillofacial appearance, teeth growth, breathing, feeding, growth and development between the patient and normal children.
Conclusion:
The modified mandible traction with wires can safely and effectively resolve micrognathia, the key to treating PRS, which is minimally invasive, simple and provides immediate relief of airway obstruction with no long term complications compared with other surgical methods. This report aims to provide more evidence of the successful treatment of neonatal PRS micrognathia by modified mandible traction with wires.