OpenMed/multicare-articles huggingface dataset:
A unique strategy for large-bowel perforation with ventriculoperitoneal shunt: Conversion to ventriculoatrial shunt: A case report
Authors: Shota Akabane, Hirokazu Iijima, Yukari Kobayashi, Kazunao Watanabe
Journal: Int J Surg Case Rep (2019)
Keywords: bowel perforation, case report, central nervous system, meningitis, peritonitis, ventriculoperitoneal shunt

Introduction:
Large-bowel perforation can lead to critical sepsis, and urgent intervention including surgery is indispensable to control systemic infection. Here, we describe a strategy for large-bowel perforation using a ventriculoperitoneal shunt.
Case presentation:
A 74-year-old Japanese female with a history of cerebral aneurysm clipping and ventriculoperitoneal shunting due to aneurysmal subarachnoid hemorrhage presented with lower abdominal pain, fever, and disturbed consciousness. Clinical findings indicated a diagnosis of large-bowel perforation and ventriculoperitoneal shunt-transmitted bacterial meningitis. Thus, sigmoidectomy and shunt externalization were performed, and the ventriculoperitoneal shunt was converted to a ventriculoatrial one.
Conclusion:
Based on our experience and the literature, we successfully discuss bowel perforation management with respect to the ventriculoperitoneal shunt, including the utility of the ventriculoatrial shunt as an alternative.
Laser-Assisted In Situ Keratomileusis Surgery on a Patient with Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease or Neuromyelitis Optica Spectrum Disorder
Authors: Majid Moshirfar, Duncan J Williams, Melody Ziari, Meagan D Seay, Yasmyne C Ronquillo
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD) are rare central demyelinating diseases that may affect refractive surgery outcomes. Optic neuritis and brainstem syndromes affecting cranial nerves are particularly relevant to corneal refractive surgery (CRS), such as laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy, or small incision lenticule extraction. There is currently no existing literature concerning the outcomes of CRS in patients with MOGAD or NMOSD. This article reports the clinical outcome of a MOGAD patient who underwent LASIK.
Case Report: A Novel CACNA1S Mutation Associated With Hypokalemic Periodic Paralysis in a Chinese Family
Authors: Jie-Yuan Jin, Bing-Bing Guo, Yi Dong, Yue Sheng, Liang-Liang Fan, Li-Bing Zhang
Journal: Front Genet (2021)
Keywords: cacna1s, calcium channels, frameshift mutation, hypokalaemic periodic paralysis, targeted sequencing
MeSH terms: Case Reports

Hypokalemic periodic paralysis (HypoPP) is a rare autosomal dominant disorder characterized by episodic flaccid paralysis with concomitant hypokalemia. More than half of patients were associated with mutations in CACNA1S that encodes the alpha-1-subunit of the skeletal muscle L-type voltage-dependent calcium channel. Mutations in CACNA1S may alter the structure of CACNA1S and affect the functions of calcium channels, which damages Ca2+-mediated excitation-contraction coupling. In this research, we identified and described a Chinese HypoPP patient with a novel frameshift mutation in CACNA1S [NM_000069.2: c.1364delA (p.Asn455fs)] by targeted sequencing. This study would expand the spectrum of CACNA1S mutations, further our understanding of HypoPP, and provided a new perspective for selecting effective treatments.
Case report: Congenital arterioportal fistula: An unusual cause of variceal bleeding in adults
Authors: Junlin Xia, Jingwen Zhao, Bing Chang
Journal: Front Med (Lausanne) (2022)
Keywords: angiography, arteriovenous fistula, ascites, coil embolization, gastrointestinal bleeding, hepatic arterioportal fistula, occlusion, portal hypertension
MeSH terms: Case Reports

The aberrant vascular connecting channel that forms between the portal vein and the hepatic artery is the essence of a hepatic arterioportal fistula. Congenital hepatic arterioportal fistula more frequently occurs in early childhood rather than in adults. We describe a rare instance of a large, isolated, congenital hepatic arterioportal fistula that was successfully treated following selective hepatic arteriography and transcatheter embolization. The patient presented with significant variceal bleeding when the fistula was discovered at the age of 73. The patient's condition improved during the brief postoperative follow-up period without a recurrence. Our research suggests that in older patients with portal hypertension and an unclear etiology, selective arteriography and embolization can provide a definitive diagnosis and successfully treat symptoms.
Neurogenic stunned myocardium associated with acute spinal cord infarction: a case report
Authors: Gillian A Beauchamp, Jason T McMullan, Jordan B Bonomo
Journal: Case Rep Crit Care (2012)
MeSH terms: Case Reports

Introduction. Neurogenic stunned myocardium (NSM) is a reversible cardiomyopathy resulting in transient left ventricular apical ballooning presumed to result from catecholamine surge occurring under physiologic stress. Acute spinal cord ischemia is a rare ischemic vascular lesion. We report a case of neurogenic stunned myocardium occurring in the setting of acute spinal cord infarction. Methods. Singe case report was used. Results. We present the case of a 63-year-old female with a history of prior lacunar stroke, hypertension, chronic back pain, and hypothyroidism who presented with a brief episode of diffuse abdominal and bilateral lower extremity pain which progressed within minutes to bilateral lower extremity flaccid paralysis. MRI of the spinal cord revealed central signal hyperintensity of T2-weighted imaging from conus to T8 region, concerning for acute spinal cord ischemia. Transthoracic echocardiogram was performed to determine if a cardiac embolic phenomenon may have precipitated this ischemic event and showed left ventricular apical hypokinesis and ballooning concerning for NSM. Conclusion. Neurogenic stunned myocardium is a reversible cardiomyopathy which has been described in patients with physiologic stress resulting in ventricular apical ballooning. Our case suggests that it is possible for neurogenic stunned myocardium to occur in the setting of acute spinal cord ischemia.
Allergic bronchopulmonary aspergillosis (ABPA) in an atopic patient with difficult-to-expectorate airway secretions
Authors: Marcus Joest
Journal: Allergol Select (2021)
Keywords: abpa, allergic bronchopulmonary aspergillus, recombinant aspergillus antibodies
MeSH terms: Case Reports

In the workup of a 55-year-old atopic patient with cough and viscous secretions, we diagnosed an allergic bronchopulmonary aspergillosis (ABPA) on the basis of common diagnostic criteria for adult asthma patients (Rosenberg-Patterson and ISHAM), supported by the use of IgE antibodies against the Aspergillus components Asp f 2, f 4, and f 6. Initial treatment with prednisolone and itraconazole led to remission. In the long-term follow-up, there were few relapses until 2015, which responded well to standard treatment with oral steroids, and since 2016 the patient is in stable remission. The case highlights the valuable contribution of Aspergillus IgE measurements, including the specific IgEs against the components Asp f 1, f 2, f 4, and f 6 in the diagnosis of ABPA.
Multiple Pyogenic Liver Abscesses Caused by Eggerthella lenta Treated with Ertapenem: A Case Report
Authors: Richard M Elias, Shiao Yen Khoo, Jakrapun Pupaibool, Ju-Hsien Nienaber, Nathan W Cummins
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Anaerobic gram-positive bacilli can occasionally be implicated in infections but are difficult to identify in culture by conventional biochemical methods. We report a case of liver abscesses caused by Eggerthella lenta, identified via 16S rRNA sequencing in a previously healthy patient, successfully treated with percutaneous drainage and ertapenem.
Zoledronic acid in metastatic chondrosarcoma and advanced sacrum chordoma: two case reports
Authors: Liliana Montella, Raffaele Addeo, Vincenzo Faiola, Gregorio Cennamo, Rosario Guarrasi, Elena Capasso, Rosanna Mamone, Michele Caraglia, Salvatore Del Prete
Journal: J Exp Clin Cancer Res (2009)
MeSH terms: Antineoplastic Agents / therapeutic use, Chondroma / drug therapy, Chondrosarcoma / drug therapy, Chondrosarcoma / secondary, Diphosphonates / therapeutic use, Imidazoles / therapeutic use, Sacrum / pathology, Spinal Neoplasms / drug therapy, Case Reports, Aged, Chondroma / diagnostic imaging, Chondroma / pathology, Chondrosarcoma / diagnostic imaging, Female, Humans, Male, Middle Aged, Neoplasm Staging, Sacrum / diagnostic imaging, Spinal Neoplasms / diagnostic imaging, Spinal Neoplasms / pathology, Tomography, X-Ray Computed, Zoledronic Acid, Antineoplastic Agents, Diphosphonates, Imidazoles, Zoledronic Acid

Introduction:
Chondrosarcomas and chordomas are usually chemoresistant bone tumors and may have a poor prognosis when advanced. They are usually associated with worsening pain difficult to control.
Patients and methods:
Zoledronic acid was used in a 63-year-old man with metastatic chondrosarcoma and in a 66-year-old woman with a diagnosis of sacrum chordoma both reporting severe pain related to tumor.
Results:
In the first case, zoledronic acid was able to maintain pain control despite disease progression following chemotherapy, in the other case, zoledronic acid only produced significant clinical benefit.
Conclusion:
Control of pain associated with bone tumors such as chondrosarcoma and chondroma may significantly improve from use of zoledronic acid, independently from tumor response to other treatments. Evaluation on larger series are needed to confirm the clinical effect of this bisphosphonate on such tumors.
Case Report: Kaposiform hemangioendothelioma with PIK3CA mutation successfully treated with sirolimus
Authors: Zuopeng Wang, Hanlei Yan, Yangyang Ma, Wei Yao, Shan Zheng, Kai Li
Journal: Front Oncol (2023)
Keywords: kaposiform hemangioendothelioma, pik3ca, mtor, mutation, sirolimus
MeSH terms: Case Reports

Kaposiform hemangioendothelioma (KHE) is an extremely rare, locally aggressive vascular neoplasm. The etiopathogenesis of KHE is still poorly understood. In the present study, we found a new mutation in KHE (c.685delA, p.Thr229fs). The KHE patient with the PIK3CA mutation showed complete regression after sirolimus treatment. We propose that the presence of the PIK3CA mutation in KHE may correlate with good response to sirolimus.
Core health indicators in countries with high proportion of expatriates: Case study of Qatar
Authors: Maziar Moradi-Lakeh, Amine Toumi, Shams Eldin Khalifa, Henry Victor Doctor, Salah Alyafei, Sara Khamis Al Hamad, Mohammed Al-Thani, Arash Rashidian
Journal: Front Public Health (2023)
Keywords: qatar, age standardization, death registration, expatriate, health indicator, migrant workers
MeSH terms: Neoplasms / epidemiology, Research Support, Non-U.S. Gov't, Ethnicity, Female, Humans, Male, Middle Aged, Qatar / epidemiology, Sex Distribution

Background:
Population size and structure have a huge impact on health indicators. In countries with a high proportion of expatriates, there are some limitations in estimating, aggregating and reporting of the health indicators, and corrections may be required in the established estimation methodologies. We review the case of Qatar to see how its specific population characteristics affect its health indicators.
Methods:
We used routinely collected data and reviewed and calculated a selected list of health indicators for Qatari and non-Qatari populations residing in Qatar. Mortality and cancer incidence rates, stratified by nationality, were used for this purpose. Also, a direct method was used to estimate completeness of the death registry, compared to the mortuary data.
Results:
Age and sex distribution of Qatari and non-Qatari populations are completely different. Compared to the mortuary data, completeness of death registration for the total population was estimated at 98.9 and 94.3%, with and without considering overseas deaths, respectively. Both estimates were considerably higher than estimates from the indirect methods. Mortality patterns were different even after standardization of age and stratification of sex groups; male age-standardized mortality rates were 502.7 and 242.3 per 100,000 individuals, respectively for Qataris and non-Qataris. The rates were closer in female populations (315.6 and 291.5, respectively). The leading types of cancer incidents were different in Qataris and non-Qataris.
Conclusions:
Expatriates are a dynamic population with high-turnover, different from Qatari population in their age-sex structure and health status. They are more likely to be young or middle-aged and are less affected by age related diseases and cancers. Also, they might be at higher risks for specific diseases or injuries. Aggregating indicators of Qatari and non-Qatari populations might be mis-leading for policy making purposes, and common estimation correction approaches cannot alleviate the limitations. High-proportion of expatriate population also imposes significant errors to some of the key demographic estimates (such as completeness of death registry). We recommend a standardized approach to consider nationality in addition to age and sex distributions for analysis of health data in countries with a high proportion of expatriates.
Case Report: Botulinum Toxin-A for Complication of Exposure Keratopathy Following Frontalis-Orbicularis Oculi Muscle Flap Shortening
Authors: Chun-Chieh Lai, Chia-Chen Lin
Journal: Front Med (Lausanne) (2022)
Keywords: blepharoptosis, botulinum toxin-a, exposure keratopathy, frontalis-orbicularis oculi muscle flap, lagophthalmos
MeSH terms: Case Reports

Background:
Lagophthalmos with exposure keratopathy is a potential vision-threatening complication following surgery for blepharoptosis. We report three cases successfully treated with botulinum toxin-A (Botox®, Allergan, Irvine, USA) for this complication.
Cases:
Three patients presented with severe blepharoptosis after surgery for orbital and frontal base tumors. They obtained good appearances after frontalis-orbicularis oculi muscle (FOOM) flap shortening. However, exposure keratopathy developed after the surgery despite frequent use of topical lubricants and autologous serum eye drops. We injected 5-10 units of botulinum toxin-A around the central supra-brow area, which was near the origin of the FOOM flap. One week later, they developed ptosis and could close the eye completely. The corneal defect gradually resolved. They recovered from ptosis 3 months later and never required a second injection.
Observations:
Lagophthalmos with exposure keratopathy is a potential vision-threatening complication following FOOM flap surgery. In severe cases, surgical revision should be considered to partially or totally release the FOOM flap attachment, which also decreases its function permanently. In this case series, we demonstrated that injecting botulinum toxin-A may be a promising method to manage this complication without permanently affecting the function of the FOOM flap.
Conclusions:
A botulinum toxin-A injection may be an effective treatment for patients developing exposure keratopathy after FOOM flap surgery.
Benign Metastasizing Leiomyoma of the Uterus with Pulmonary and Bone Metastases
Authors: Parikshit Padhi, Margarita Topalovski
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Benign metastasizing leiomyoma (BML) is a rare spindle cell neoplasm seen in middle-aged women who have a history of leiomyoma of the uterus. The most common sites of metastases are the lungs; however, other sites of spread have been documented. These tumors by definition have no malignant features on histology and tend to be estrogen and progesterone positive. We present a middle-aged woman who was incidentally found to have multiple pulmonary nodules and a mass on her sternum after she was involved in a motor vehicle accident. She had a history of uterine leiomyoma and had undergone a hysterectomy ten years prior to the accident. Biopsies were performed of the lung nodules and sternum mass and compared to her hysterectomy specimen, and they were identical, and hence, she was diagnosed with BML. Due to the growing tumor of her sternum, she was started on tamoxifen with stability of her tumors. These tumors, since they are benign, tend to have an indolent course. However, in the instances that treatment is warranted, options include surgery or antiestrogen therapy. We will be discussing the pathogenesis, histological findings, and treatment options of this rare condition. Our case is unique because BML in general do not tend to spread to multiple organs and tend to be limited to one site of disease.
Prolonged recovery time from zoledronic Acid induced acute tubular necrosis: a case report and review of the literature
Authors: Frederic Rahbari-Oskoui, Odicie Fielder, Nima Ghasemzadeh, Randolph Hennigar
Journal: Case Rep Nephrol (2013)

Acute tubular necrosis (ATN) due to bisphosphonates has been reported with Zoledronic acid but the time to recovery (if any) has been usually less than 4 months. Possible recovery time from ATN of any cause is usually less than 6 months. In this paper, we present the case of a 59-year-old Caucasian female with metastatic breast cancer who had received 16 monthly injections of Zoledronic acid for treatment of tumor induced hypercalcemia and developed several episodes of mild acute kidney injury which resolved by withholding treatment. Unfortunately, after the sixteenth injection, the patient experienced severe acute kidney injury, with a peak serum creatinine of 8.0 mg/dL. Although urinalysis showed muddy brown casts, because of atypical recovery time and presence of eosinophiluria and subnephrotic range proteinuria, a kidney biopsy was performed. Diagnosis of typical acute tubular necrosis was confirmed without any other concomitant findings. The course was remarkable for an unusually slow recovery of renal function over 15 months without need for renal replacement therapy until the patient expired from her metastatic cancer two years later. We reviewed all the published cases of acute kidney injury due to Zoledronic acid and suggest recommendations for clinicians and researchers.
Pre-extensively drug-resistant tuberculosis spondylodiscitis in an immunocompetent patient: a case report
Authors: Safaa Fellous, Hanan Rkain, Latifa Tahiri, Amina Bouraqadi, Ittimad Nassar, Fadoua Allali
Journal: Pan Afr Med J (2020)
Keywords: tuberculosis, drug-resistance, second-line treatment, spondylodiscitis
MeSH terms: Antitubercular Agents / pharmacology, Discitis / drug therapy, Extensively Drug-Resistant Tuberculosis / drug therapy, Tuberculosis, Pleural / drug therapy, Case Reports, Adult, Discitis / diagnosis, Discitis / microbiology, Drug Resistance, Multiple, Bacterial, Extensively Drug-Resistant Tuberculosis / diagnosis, Extensively Drug-Resistant Tuberculosis / microbiology, Fluoroquinolones / pharmacology, Humans, Male, Microbial Sensitivity Tests, Mycobacterium tuberculosis / drug effects, Mycobacterium tuberculosis / isolation & purification, Tuberculosis, Multidrug-Resistant / drug therapy, Tuberculosis, Multidrug-Resistant / microbiology, Tuberculosis, Pleural / microbiology, Antitubercular Agents, Fluoroquinolones

Pre-extensively drug resistant tuberculosis (pre-XDR-TB) has been an area of growing concern, and posing a threat to global efforts of TB control. We report a case of PreXDR-TB spondylodiscitis with resistance to a Fluoroquinolone, in an immunocompetent patient under antibacillary treatment for pleural tuberculosis, managed with drug sensitivity-based second-line antituberculous drug regimen. Our case shows the challenges of the diagnostic and management of Drug-resistant TB spondylodiscitis.
Endovascular Management of Middle Aortic Syndrome Presenting with Uncontrolled Hypertension
Authors: Owen S Glotzer, Kathryn Bowser, F Todd Harad, Sandra Weiss
Journal: Case Rep Vasc Med (2018)
MeSH terms: Case Reports

Middle Aortic Syndrome is a rare vascular disorder consisting of narrowing or stenosis of the distal thoracic or abdominal aorta. It is described in the literature in the form of case studies and case series. The authors present an unusual case of Middle Aortic Syndrome attributed to Takayasu's arteritis in a 60-year-old female who presented to the emergency department with uncontrolled hypertension. Traditional intervention involves open surgical bypass. This case study reviews the published literature on this rare syndrome and illustrates a successful alternative to open surgery through an endovascular approach.
POEMS Syndrome Presentation with an Abscess within the Plasmacytoma-A Rare Case Report
Authors: Rishi Agarwal, Muneer H Abidi, Bala Grandhi
Journal: ISRN Hematol (2011)
MeSH terms: Case Reports

POEMS Syndrome is a rare cause of demyelinating and axonal mixed neuropathy. Plasmacytomas are usually seen in POEMS syndrome and can be osseous or extramedullary. Plasmacytomas presenting as an abscess has not been noted earlier. Our patient presented with localized hyperpigmented patch on the back and later developed progressive weakness in upper and lower limbs. Initially serum and urine protein electrophoresis were normal. The patient was thought to have Chronic Inflammatory Demyelinating Polyneuropathy and was treated accordingly without any improvement. Repeat serum protein electrophoresis showed monoclonal gammopathy. MRI of the back revealed an abscess in the paravertebral soft tissues reaching up to the skin. Needle biopsy was consistent with plasmacytoma. Later, he developed a purulent fungating lesion in the lower midback. Antibiotics were started and local resection was done followed by radiation. Pathology of the resected mass showed plasmacytoma extensively involving subcutaneous soft tissue and bone. The patient improved with the treatment. Cystic plasmacytomas and abscess within the plasmacytoma has not been reported earlier. Whether abscess formation is part of the disease spectrum due to infiltration of overlying tissue or is secondary to localized immunosuppression is unknown. Local treatment of a single plasmacytoma is useful in ameliorating systemic symptoms.
Improving Theory of Mind in Schizophrenia by Targeting Cognition and Metacognition with Computerized Cognitive Remediation: A Multiple Case Study
Authors: Élisabeth Thibaudeau, Caroline Cellard, Clare Reeder, Til Wykes, Hans Ivers, Michel Maziade, Marie-Audrey Lavoie, William Pothier, Amélie M Achim
Journal: Schizophr Res Treatment (2017)

Schizophrenia is associated with deficits in theory of mind (ToM) (i.e., the ability to infer the mental states of others) and cognition. Associations have often been reported between cognition and ToM, and ToM mediates the relationship between impaired cognition and impaired functioning in schizophrenia. Given that cognitive deficits could act as a limiting factor for ToM, this study investigated whether a cognitive remediation therapy (CRT) that targets nonsocial cognition and metacognition could improve ToM in schizophrenia. Four men with schizophrenia received CRT. Assessments of ToM, cognition, and metacognition were conducted at baseline and posttreatment as well as three months and 1 year later. Two patients reached a significant improvement in ToM immediately after treatment whereas at three months after treatment all four cases reached a significant improvement, which was maintained through 1 year after treatment for all three cases that remained in the study. Improvements in ToM were accompanied by significant improvements in the most severely impaired cognitive functions at baseline or by improvements in metacognition. This study establishes that a CRT program that does not explicitly target social abilities can improve ToM.