OpenMed/multicare-articles huggingface dataset:
Vehicle ergonomics contributing to a diabetic foot ulcer
Authors: Christine Jarocki, Brian M Schmidt, Crystal Murray Holmes
Journal: Clin Diabetes Endocrinol (2019)
Keywords: diabetes mellitus, diabetic foot, diabetic foot ulcer, diabetic peripheral neuropathy, driving simulator, pressure
MeSH terms: Case Reports

Background:
Diabetes mellitus continues to be a rising concern in the United States. It affects an estimated 9.4% of the population and approximately 1.5 million Americans are diagnosed annually. Approximately 85% of diabetic foot ulcers are associated with diabetic peripheral neuropathy and an infected diabetic foot ulcer is often the first sign of diabetes. There are countless studies within the literature that investigate how insensate feet and the manifestation of a foot ulcer further decrease quality of life and increase risk for mortality. Literature focuses on gait and kinematics that contribute to the formation of a diabetic foot ulcer. While pressure and shear forces are etiologic factors that may lead to the formation of diabetic foot ulcers, the position of the foot while driving an automobile has been ignored as a possible risk factor.
Case presentation:
The clinical case will describe the events of healing a neuropathic diabetic foot ulcer beyond the standard of care treatment plan. It is one of the first case reports to describe vehicle ergonomics as an etiologic factor contributing to a diabetic foot ulcer. Once the patient becomes aware of the unnecessary source of pressure, education and care is provided to manage this likely source of daily pressure to the neuropathic foot.
Conclusion:
The article emphasizes the importance of a complete assessment, including nontraditional factors, which may lead to diabetic complications.
Challenges in Removing the Essure® Device
Authors: Daniëlle M van Gastel, Liselotte W Maassen, Carolien A M Koks, Sebastiaan Veersema, Marlies Y Bongers
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

We present a case about Essure® removal surgery in which the third markers of the device have torn off. The woman needed a second surgery for complete removal of the devices. Fluoroscopy during surgery is a good method to visualize the lost fragments. With fluoroscopy, a hysterectomy is not needed for complete removal. It is important to understand the structure of the device and to be aware of the four radiopaque markers during surgery and their removal.
Successful Use of Pulmonary Vasodilators in Acute Chest Syndrome Complicated by Persistent Right Ventricular Failure
Authors: Jacqueline T DesJardin, Lucas S Zier
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Pulmonary hypertension (PH) is a known consequence of sickle cell disease (SCD) and is associated with increased mortality and more frequent episodes of acute chest syndrome (ACS). Pulmonary pressures are known to increase during ACS, and right ventricular (RV) failure has been described as a significant cause of mortality in this condition. Management of ACS includes exchange transfusion, pain control, and prevention of hypovolemia and hypoxemia. However, in patients with a history of precapillary PH in whom ACS is complicated by persistent RV failure and cardiogenic shock, RV afterload reduction with pulmonary vasodilators may be an effective treatment strategy. Here, we present a case of a young man with SCD-associated PH and ACS who was successfully managed with inhaled and oral pulmonary vasodilators in the setting of persistent elevations in pulmonary vascular resistance leading to acute RV failure and cardiogenic shock.
Dural ectasia of the optic nerve sheath
Authors: Hanane Hadj Kacem, Lehcen Hammani, Ali Ajana, Itimad Nassar
Journal: Pan Afr Med J (2014)
Keywords: mri, optic nerve, dural ectasia, sheath
MeSH terms: Magnetic Resonance Imaging, Myelin Sheath / pathology, Optic Nerve Diseases / diagnosis, Case Reports, Diagnosis, Differential, Dilatation, Pathologic / diagnosis, Female, Humans, Infant, Newborn, Ophthalmologic Surgical Procedures, Optic Nerve Diseases / pathology, Optic Nerve Diseases / surgery, Treatment Outcome

Optic nerve dural ectasia is a rare cause of optic nerve sheath enlargement due to the accumulation of CSF around the optic nerve with no associated pathology. It diagnosed by MRI studies and can follow benign or sometimes an unfavorable course. We describe the case of a 24-day-old female referred for a visual blurring, which we diagnosed as a dural ectasia of the optic nerve sheath by MRI and confirmed in surgical intervention. We present this case report to illustrate the classic imaging features of the disease.
Unilateral Enlarged Vestibular Aqueduct Syndrome and Bilateral Endolymphatic Hydrops
Authors: Massimo Ralli, Giuseppe Nola, Luca Sparvoli, Giovanni Ralli
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Enlarged vestibular aqueduct (EVA) syndrome is a common congenital inner ear malformation characterized by a vestibular aqueduct with a diameter larger than 1.5 mm, mixed or sensorineural hearing loss that ranges from mild to profound, and vestibular disorders that may be present with a range from mild imbalance to episodic objective vertigo. In our study, we present the case of a patient with unilateral enlarged vestibular aqueduct and bilateral endolymphatic hydrops (EH). EH was confirmed through anamnestic history and audiological exams; EVA was diagnosed using high-resolution CT scans and MRI images. Therapy included intratympanic infusion of corticosteroids with a significant hearing improvement, more evident in the ear contralateral to EVA. Although most probably unrelated, EVA and EH may present with similar symptoms and therefore the diagnostic workup should always include the proper steps to perform a correct diagnosis. Association between progression of hearing loss and head trauma in patients with a diagnosis of EVA syndrome is still uncertain; however, these individuals should be advised to avoid activities that increase intracranial pressure to prevent further hearing deterioration. Intratympanic treatment with steroids is a safe and well-tolerated procedure that has demonstrated its efficacy in hearing, tinnitus, and vertigo control in EH.
Trigeminal Meningioma in a Patient with Tardive Dyskinesia as Only Symptom
Authors: Maria-Gabriela Catană, Andreea-Alina Dan, Corina Roman-Filip
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Most meningiomas are benign, encapsulated tumors (95% of the cases), generally undergoing a limited number of genetic aberrations. We present the case of a 74-year-old patient with no significant pathological history, who is admitted to the neurology ward for orofacial dyskinesias accompanied by hypoesthesia in the left hemiface, a symptomatology that had started insidiously about two months before and worsened progressively over the past 3 weeks. A cerebral MRI was performed which revealed a small mass with discrete T2 hyperintensity and T1 iso-signal compared to the gray matter located in the left pontine cistern, with a large, well-defined base at the level of the cerebral tentorium. The diagnosis of trigeminal meningioma was established and the treatment was started, after hearing the opinion of a neurosurgeon.
Role of high-field intraoperative magnetic resonance imaging on a multi-image fusion-guided stereotactic biopsy of the basal ganglia: A case report
Authors: Xiang Sun, Zhijuan Chen, Shuyuan Yang, Jianning Zhang, Shuyuan Yue, Zengguang Wang, Weidong Yang
Journal: Oncol Lett (2015)
Keywords: biopsy, intraoperative magnetic resonance imaging, multi-image fusion, stereotactic

The aim of the present case study was to investigate the advantages of intraoperative magnetic resonance imaging (iMRI) on the real-time guidance and monitoring of a stereotactic biopsy. The study describes a patient with intracranial lesions, which were examined by conventional MRI and diffusion tensor imaging using a 1.5T intraoperative MRI system. The digital and pre-operative positron emission/computed tomography image data were transferred to a BrainLAB planning workstation, and a variety of images were automatically fused. The BrainLAB software was then used to reconstruct the corticospinal tract (CST) and create a three-dimensional display of the anatomical association between the CST and the brain lesions. A Leksell surgical planning workstation was used to identify the ideal target site and a reasonable needle track for the biopsy. The 1.5T iMRI was used to effectively monitor the intracranial condition during the brain biopsy procedure. Post-operatively, the original symptoms of the patient were not aggravated and no further neurological deficits were apparent. The histopathological diagnosis of non-Hodgkin's B-cell lymphoma was made. Using high-field iMRI, the multi-image fusion-guided stereotactic brain biopsy allows for a higher positive rate of biopsy and a lower incidence of complications. The approach of combining multi-image fusion images with the frame-based stereotactic biopsy may be clinically useful for intracranial lesions of deep functional areas.
Solitary Fibrous Tumor of the Peritoneal Cavity and Greater Omentum: Case Report and Review of the Literature
Authors: Neda Gendvilaitė, Dmitrij Šeinin, Laurynas Beržanskas, Tomas Poškus
Journal: Acta Med Litu (2023)
Keywords: solitary fibrous tumor, greater omentum, soft tissue tumor
MeSH terms: Case Reports

Background:
The solitary fibrous tumor is a rare soft tissue mesenchymal tumor which typically arises from the pleura but may be found anywhere in the body. Abdominal localizations are very rare. The solitary fibrous tumor is classified into two forms, pleural and extrapleural, and morphologically they resemble each other. The diagnostics of the tumor is usually accidental because usually there are no clinical symptoms. The main treatment of the solitary fibrous tumor is the surgical removal of the tumor while radiotherapy treatment and chemotherapy outcomes remain unclear due to the rarity of the tumor and lack of data.
Case presentation:
We report the case of the 32-year-old man who was diagnosed with the solitary fibrous tumor of the peritoneal cavity. Laparotomy was performed. A grayish-white, stiff, coarse-grained tumor about 11 cm in diameter of the greater omentum was found and radical omentectomy with tumor removal were performed. Postoperative course was uneventful and the patient is well with no signs of recurrence on the CT scan of the chest and abdomen and MRI of the pelvis at 6 months after surgery.
Conclusions:
The solitary fibrous tumor is a rare condition. It is a borderline-malignant tumor but may cause serious complications if not treated. Due to the absence of clinical symptoms, the tumor is usually detected accidentally. The radical surgical removal of the tumor is the most optimal treatment.
Molecular Dissection Using Array Comparative Genomic Hybridization and Clinical Evaluation of An Infertile Male Carrier of An Unbalanced Y;21 Translocation: A Case Report and Review of The Literature
Authors: Alfredo Orrico, Giuseppina Marseglia, Chiara Pescucci, Ambra Cortesi, Paola Piomboni, Andrea Giansanti, Francesca Gerundino, Roberto Ponchietti
Journal: Int J Fertil Steril (2016)
Keywords: azoospermia, hypogonadism, translocation, y chromosome

Chromosomal defects are relatively frequent in infertile men however, translocations between the Y chromosome and autosomes are rare and less than 40 cases of Y-autosome translocation have been reported. In particular, only three individuals has been described with a Y;21 translocation, up to now. We report on an additional case of an infertile man in whom a Y;21 translocation was associated with the deletion of a large part of the Y chromosome long arm. Applying various techniques, including conventional cytogenetic procedures, fluorescence in situ hybridisation (FISH) analysis and array comparative genomic hybridization (array-CGH) studies, we identified a derivative chromosome originating from a fragment of the short arm of the chromosome Y translocated on the short arm of the 21 chromosome. The Y chromosome structural rearrangement resulted in the intactness of the entire short arm, including the sex-determining region Y (SRY) and the short stature homeobox (SHOX) loci, although translocated on the 21 chromosome, and the loss of a large part of the long arm of the Y chromosome, including azoospermia factor-a (AZFa), AZFb, AZFc and Yq heterochromatin regions. This is the first case in which a (Yp;21p) translocation has been ascertained using an array-CGH approach, thus reporting details of such a rearrangement at higher resolution.
A rare cause of the cough: primary small cell carcinoma of esophagus-case report
Authors: Erdal Yekeler, Timur Koca, Semra Vural
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Primary small cell carcinoma of the esophagus is a relatively rare malignancy. It is highly progressive and poorly prognostic in untreated conditions. In the western populations, the rate of primary small cell carcinoma in all esophageal cancer types is between 0.05% and 2.4%, while it is endemically increasing up to 7.6% in the eastern populations. Most of the cases are in extensive stage at the time of diagnosis. Surgery is the treatment of choice in limited stages, but treatment must be multimodal in primary small cell carcinoma of the esophagus. A 47-year-old woman was referred to our clinic with gradually increasing severe dry cough and slight difficulty in swallowing for 20 days. Chest X-ray graphy was normal, and computed tomography of the chest showed multiple mediastinal lymph nodes and hepatic metastases. Her endoscopic examination revealed an endoluminal vegetative mass between 20 cm and 23 cm of her esophagus. The case was reported as small cell carcinoma of the esophagus on histopathological examination. The case was assumed inoperable, and chemotherapy and radiotherapy were planned. We presented a rare cause of the cough and primary esophageal small cell carcinoma in this paper.
Cavernous hemangioma of the rib: a rare diagnosis
Authors: Stavros Gourgiotis, Anastasios Piyis, Nikolaos Panagiotopoulos, Panayotis Panayotopoulos, Nikolaos S Salemis
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Hemangioma of the rib is an uncommon benign vascular tumour. A case of rib hemangioma in a 29-year-old woman is presented. Chest roentgenogram and computed tomography revealed a mass along the inner surface of the 7th left rib with bone destruction. She underwent resection of the 7th rib. The pathologic diagnosis was cavernous hemangioma. Hemangiomas of the rib are rare tumours but should be kept in mind in the differential diagnosis of rib tumours.
Case Report: Preimplantation Genetic Testing for X-Linked Severe Combined Immune Deficiency Caused by IL2RG Gene Variant
Authors: Jun Ren, Cuiting Peng, Fan Zhou, Yutong Li, Yuezhi Keqie, Han Chen, Hongmei Zhu, Xinlian Chen, Shanling Liu
Journal: Front Genet (2022)
Keywords: ir2rg, haplotype, next generation sequencing, preimplantation genetic testing, rare genetic disease, severe combined immune deficiency
MeSH terms: Case Reports

Preimplantation genetic testing (PGT) has been increasingly used to prevent rare inherited diseases. In this study, we report a case where PGT was used to prevent the transmission of disease-caused variant in a SCID-X1 (OMIM:300400) family. SCID-X1 is an X-linked recessive inherited disease whose major clinical manifestation of immune deficiency is the significant reduction in the number of T-cells and natural killer cells. This family gave birth to a boy who was a hemizygous proband whose IL2RG gene was mutated (c.315T > A, p(Tyr105*), NM_000206.3, CM962677). In this case, Sanger sequencing for mutated allele and linkage analysis based on single-nucleotide polymorphism (SNP) haplotype via next-generation sequencing were performed simultaneously. After PGT for monogenic disorder, we detected the aneuploidy and copy number variation (CNV) for normal and female carrier embryos. Four embryos (E02, E09, E10, and E11) were confirmed without CNVs and inherited variants at the IL2RG gene. Embryo E02 (ranking 4BB) has been transferred after considering the embryo growth rate, morphology, and PGT results. Prenatal genetic diagnosis was used to detect amniotic fluid cells, showing that this fetus did not carry the variant of the IL2RG gene (c.315T > A). Ultimately, a healthy girl who had not carried disease-causing variants of SCID-X1 confirmed by prenatal diagnosis was born, further verifying our successful application of PGT in preventing mutated allele transmission for this SCID family.
Discharge against Medical Advice in Surgical Patients with Posttraumatic Stress Disorder: A Case Report Series Illustrating Unique Challenges
Authors: Marek Brzezinski, Maren Gregersen, Luiz Gustavo Schuch, Ricarda Sawatzki, Joy W Chen, Grant Gauger, Jasleen Kukreja, Brian Cason
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

Discharge against medical advice (DAMA) can have detrimental effects on patient outcomes. Recently, the diagnosis of posttraumatic stress disorder (PTSD) has been linked with DAMA in the mental health setting. However, PTSD as a risk factor for DAMA in surgical patients has not received much consideration, although such patients may be at risk for triggering or amplification of PTSD symptoms perioperatively. We present the first case report series of three surgical patients with PTSD who left the hospital AMA. These cases differ markedly from DAMA in non-PTSD patients. In all three subjects, the stress of feeling misunderstood by clinicians and the distress of public detainment by hospital security in the setting of chronic PTSD led to aggressive and risky behavior. All three subjects represented a risk to themselves and to others at the time of DAMA. Finally, all three subjects were difficult to contact for follow-up or medical care and missed appointments.
Gland New Psychosis: New Onset Adult Psychosis with Suicidal Ideation and Attempt in the Setting of Thyroid Storm
Authors: Esteban Cota, Jacob Lentz
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

We present a case of new onset psychosis in the setting of thyroid storm in a woman with no previous psychiatric history. The patient presented with ongoing suicidal ideation, a suicide attempt that was interrupted by her husband, and audio and visual hallucinations. The patient was placed on a psychiatric hold and treated for thyrotoxicosis as well as psychosis. Treatment of the thyroid hormone overload resulted in a rapid resolution of her symptoms; she was discharged in excellent condition, and she has had no repeat hallucinations or self-injury ideation or attempts since. Although rare, thyrotoxicosis is a potentially life-threatening cause of psychiatric illness and should always be kept on the differential diagnosis for a patient with a first episode of psychosis. This case highlights how thyroid storm physiology, beyond its well-studied hemodynamic and metabolic instability, can be potentially fatal due to psychiatric sequelae. It also highlights the crucial role of a thorough history and physical exam in all patients.
Septic bleeding of the common carotid artery following total thyroidectomy: an atypical complication
Authors: T Jamaan, J Raedecke, C Kayser, K D Rueckauer, O Thomusch
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Septic rupture of the common carotid artery following total thyroidectomy may rapidly lead to exsanguination. We present a case report of a 16-year-old girl, diagnosed with a questionable thyroglossal duct cyst. Following the initial operative intervention with local excision of the cyst including resection of the medial part of the hyoid bone, pathology revealed papillary carcinoma. Thus secondary total thyroidectomy with locoregional lymphadenectomy was performed. One week later, a wound infection developed, necessitating lavage and drainage. On the 8th postoperative day, a dramatic bleeding of the right common carotid artery occurred. To our knowledge, this is the first reported case in the literature with a septic bleeding of the common carotid artery following total thyroidectomy after one week.
Peritoneal mesothelioma in a woman who has survived for seven years: a case report
Authors: Krishna Pillai, Javed Akhter, Mohammad H Pourgholami, David L Morris
Journal: J Med Case Rep (2011)

Introduction:
Malignant peritoneal mesothelioma is a rare cancer with poor patient survival. Female gender has been identified as a positive prognostic factor. Recently, it has been suggested that the expression of estrogen receptor β in malignant mesothelioma leads to tumor suppression and a better prognosis.
Case presentation:
We report the case of a 48-year-old Caucasian woman who is alive and disease-free seven years after the initial diagnosis and treatment of malignant peritoneal mesothelioma.
Conclusion:
This patient's long survival may be attributable to a combination of factors, including minimal disease, complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy plus the estrogen receptor β positivity of the tumor.
Usutu virus: An emerging flavivirus with potential threat to public health in Africa: Nigeria as a case study
Authors: Olalekan Chris Akinsulie, Ridwan Olamilekan Adesola, Adetolase Bakre, Oluwawemimo Oluseun Adebowale, Richard Adeleke, Seto Charles Ogunleye, Ifeoluwa Peace Oladapo
Journal: Front Vet Sci (2023)
Keywords: culex mosquitoes, usutu virus, flavivirus, migratory birds, public health
MeSH terms: Review

Usutu virus (USUV) is an arthropod-borne virus (arbovirus) of the flaviviridae family (genus Flavivirus) which belong to the Japanese encephalitis virus complex. Culex mosquitoes have been implicated in the transmission of this pathogen. The major susceptible hosts of USUV are migratory birds, thereby potentiating its ability to spread from one region to another globally. Nigeria has the largest economy in Africa with a significant percentage of the gross domestic product relying on the agricultural and animal production industry. This review explores the zoonotic potentials of the virus in Africa, especially Nigeria, with special focus on the devastating sequelae this might lead to in the future if necessary precautionary policies are not enacted and adopted to bolster the surveillance system for mosquito-borne viruses.
An Unusual Case of Solitary Osteochondroma of the Iliac Wing
Authors: Christopher Thomas, Brent Sanderson, Dennis G Horvath, Michael Mouselli, Janet Hobbs
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Introduction:
Osteochondromas represent one of the most common bone tumors accounting for 8% of all bone tumors. While most osteochondromas arise in the metaphysis of long bones, osteochondromas have been reported in atypical locations such as the scapula, metatarsals, and the pelvic region. Osteochondromas are capable of growing large enough to cause mass effects and can undergo malignant transformation, stressing the clinical importance of recognizing these tumors. Case Presentation. In this case, we present an 18-year-old skeletally mature Caucasian male with a symptomatic osteochondroma arising from the iliac wing. The osteochondroma increased in size since he reached skeletal maturity. This resulted in a mass effect that interfered with activities of daily living, including clothing wear and symptomatic impaction on hard surfaces.
Conclusion:
The majority of osteochondromas arise from the metaphysis of long bones, but case reports have shown that osteochondromas presenting in atypical locations such as the pelvis do occur. In the case of our patient, his asymptomatic pelvic tumor grew to the extent that it was causing interference with activities of daily living. Surgical excision of his tumor proved to be curative, and there was no recurrence at 6 months after excision. Osteochondromas in this region are capable of growing large enough to cause sexual dysfunction. Clinical suspicion must be high to properly diagnose osteochondromas in atypical locations. All providers, particularly those in primary care, should be aware of these locations as patients with symptomatic mass lesions will likely initially present here.