OpenMed/multicare-articles huggingface dataset:
Fatal subacute sclerosing panencephalitis in an 8-year-old male: a case report
Authors: Fartun Abdullahi Hassan Orey, Abdirahman Omar Sahal, Bashiru Garba
Journal: Pan Afr Med J (2023)
Keywords: subacute sclerosing panencephalitis, case report, immunization, measles, neurodegenerative disease
MeSH terms: Measles / complications, Measles / diagnosis, Neurodegenerative Diseases / complications, Subacute Sclerosing Panencephalitis / complications, Subacute Sclerosing Panencephalitis / diagnosis, Subacute Sclerosing Panencephalitis / epidemiology, Case Reports, Child, Humans, Magnetic Resonance Imaging, Male, Seizures / complications

Subacute sclerosing panencephalitis (SSPE) is a chronic slow progressive neurodegenerative disease that is often associated with measles complications. The disease is characterized by seizures, behavioral changes, motor deficit and eventually death. In this case report we discuss the case of an 8-year-old male who developed SSPE and was presented to our hospital with a history of generalized tonic colonic convulsion followed by gait abnormality, episodes, abnormal behaviors, and cognitive regression. On clinical exploration, the child had a history of measles at 8 months of age and meningitis at 18 months. The electroencephalogram (EEG) investigation showed high amplitude spikes, with focal seizure and slowing, while the magnetic resonance imaging reveal signals synonymous with high fluid-attenuated inversion recovery (FLAIR), both of which are consistent with probable SSPE. The case was managed symptomatically; until his parents decided to take him back home, after which his condition deteriorated, and he sadly died. To the best of our knowledge, this is the first recorded case of SSPE in Mogadishu, Somalia. Hence, the need to further investigation to better understand the incidence of the disease in the population and propose better ways of managing the condition.
Effective Prolonged Therapy with Voriconazole in a Lung Transplant Recipient with Spondylodiscitis Induced by Scedosporium apiospermum
Authors: B Luijk, M B Ekkelenkamp, P A De Jong, J M Kwakkel-van Erp, J C Grutters, D A van Kessel, E A van de Graaf
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

Scedosporium/Pseudallescheria species are frequently seen in cystic fibrosis patients. However, disseminated forms after lung transplantation in these patients are rarely seen, but often with poor outcome. In this case report we describe a lung transplant recipient with cystic fibrosis who developed a spondylodiscitis that was caused by Scedosporium apiospermum. The patient was treated with anti-fungal treatment by voriconazole for over three years with a clinical good response and without the need for surgical intervention. To our opinion this is the first anti-fungal treated case of invasive disease caused by Scedosporium/Pseudallescheria in a cystic fibrosis (CF) patient who underwent lung transplantation that survived.
A 14-Year-Old Male Patient with Kawasaki Disease Presented with Stroke after COVID-19
Authors: Nexhmedin Shala, Fisnik Jashari, Dren Boshnjaku, Argjend Shala, Pranvera Ibrahimi, Vera Kukaj, Shemsedin Dreshaj
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

According to several studies, children represent only about 2% of the patients affected by the current SARS-CoV-2, and most often, they are asymptomatic. However, there is a concern about a vascular inflammatory disease which is similar to Kawasaki disease observed in children and adolescents weeks after infection. We report a case of Kawasaki disease presented with ischemic stroke in a 14-year-old male patient following SARS-Cov-2 infection.
Spontaneous testicular tumor regression: case report and historical review
Authors: Juan C Astigueta, Milagros A Abad-Licham, Folker M Agreda, Benjamin A Leiva, Jorge L De la Cruz
Journal: Ecancermedicalscience (2018)
Keywords: burned out, germ-cell tumour, spontaneous regression, testicle
MeSH terms: Review

Spontaneous regression of a primary testicular germ-cell tumour (GCT), over time known as 'Burned out', 'Shrinking Seminoma', 'pT0', 'Burnout' or 'Spontaneous Regression', is an uncommon, generally metastatic phenomenon, which may present elevated tumour markers and a suspicious testicular ultrasound image. The histological study of the testicle demonstrated morphological changes of complete or partial tumour regression and found fibrous scarring and other characteristic changes of this phenomenon, which in some cases include vestiges of GCT. There are few publications on testicular GCT tumour regression and those that exist present limited data on the biology of the disease and its etiopathogenesis. This entity was recently recognised in the latest edition of the World Health Organization's (WHO) Classification of Tumours. We present our clinical, imaging, laboratory, cytohistological and management experience, as well as a historical review of the literature.
Endoscopic ultrasound (EUS) guided choledocoduodenostomy in a patient with irresecable pancreas cancer and biliar obstruction using a luminal apposing metal stent (LAMS)
Authors: Renzo Pinto-Carta, Jaime Solano, Luis Felipe Cabrera, Alvaro Sanchez, Luisa Moreno, Mauricio Pedraza
Journal: Int J Surg Case Rep (2020)
Keywords: biliary obstruction, choledocoduodenostomy, endoscopic ultrasound, endoscopic ultrasound-guided biliary drainage, luminal apposing stent (lams), pancreatic cancer
MeSH terms: Case Reports

The endoscopic retrograde cholangiopancreatography (ERCP) is the election treatment of biliary obstruction. EUS-guided biliary drainage (EUS-BD) has emerged as an alternative to PTBD with a high technical and clinical success rate, low risk of complications and a better quality of life for the patient. Case presentation we present the first case in Colombia of EUS-guided biliary drainage using luminal apposing metal stent (LAMS) in a patient with unresectable pancreatic adenocarcinoma with biliary obstruction in who ERCP was failed due to neoplastic invasion of the Vater papilla. Discussion Transhepatic biliary drainage has been the most common procedure for treatment of malignant biliary obstruction in cases which ERCP fails due to tumor infiltration of the duodenum or the Vater papilla. During the last decade the development of endoscopic ultrasound (EUS) has implied an alternative for biliary drainage in cases of failed ERCP, demonstrating advantages over Trans hepatic biliary drainage Conclusion Considering that EUS-CD is a safe procedure, with a high rate of technical and clinical success, low risk of complications.
Combining and Using the Utrecht Method and the Analytic Hierarchy Process to Facilitate Professional and Ethical Deliberation and Decision Making in Complementary and Alternative Medicine: A Case Study among a Panel of Stakeholders
Authors: Ramzi Shawahna
Journal: Evid Based Complement Alternat Med (2018)

Background:
In daily practice, healthcare practitioners face many challenges in ethical and professional decision making. Currently, little is known on the ethical and professional deliberations and weighing benefits against risks in daily complementary and alternative medicine (CAM) practice. The aim of this study was to combine the Utrecht method and the Analytic Hierarchy Process (AHP) in deliberations, weighing benefits against risks of using ginger for a pregnant woman suffering nausea and vomiting of pregnancy (NVP) along with other comorbidities.
Methods:
A hypothetical case was constructed using the twelve tips for constructing dilemma case-based assessment. Three CAM practitioners, two physicians, three pharmacists, and two patients were recruited, and the Utrecht and the AHP methods were combined and used to deliberate and weigh benefits against risks of using ginger for the presented case.
Results:
Responses from the ten panelists were obtained. Priority ratings showed significantly higher scores (p-value < 0.001) for alleviating symptoms of NVP (30.7% ± 16.6%) compared to other potential benefits. Increasing the risk of bleeding was given significantly higher (p-value < 0.0001) weight scores (24.7% ± 13.5%) than other potential side effects. Potential risk of spontaneous abortion and risk of impairment of fetal development were given higher (p-value < 0.001) weight scores than risk of fetal hypoglycemia. When benefits were compared against side effects and risks to the fetus and pregnancy, potential benefits were given higher (p-value < 0.001) weight scores (72.3% ± 5.2%).
Conclusions:
Considering the anticipated benefits and risks, a shared decision was made to use ginger in the case presented. The woman should also be informed of the potential side effects and risks of using ginger. The use of this combined method might promote openness and transparency in making shared decisions for healthcare providers and patients.
Improvement in the signs and symptoms of dry eye disease with dobesilate eye drops
Authors: Pedro Cuevas, Luis Antonio Outeiriño, Carlos Azanza, Javier Angulo, Guillermo Giménez-Gallego
Journal: Mil Med Res (2015)
Keywords: dobesilate eye drops, dry eye disease, fibroblast growth factor, vascular endothelial growth factor

Background:
Dry eye is a multifactor disease of the tear film and ocular surface that substantially affects quality of life.
Case presentation:
Dobesilate administered as eye drops was well tolerated and effective in treating both the objective signs and subjective symptoms of dry eye disease in this 2-week study.
Conclusion:
To the best of our knowledge, this is the first clinical report of using dobesilate in eye drops. Dobesilate may provide a novel approach to treating drying diseases of the eye.
Vascular Reconstructions in Living Unrelated Kidney Transplant Using Donor Ovarian Vein and Recipient Inferior Epigastric Artery with Simultaneous Enucleation of a Complex Cyst
Authors: Giuseppe Serena, Javier Gonzalez, Giselle Guerra, Mohamed Ammar Al Nuss, Maykel Valdes, Gaetano Ciancio
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Increasing the organ donor pool and solving the recipient demands continue to be one of the challenges in transplantation. We report our experience in transplanting a living donor kidney requiring complex vascular reconstructions and an enucleation of complex cyst. A 57-year-old male patient underwent a living unrelated kidney transplant. The living donor kidney was procured through a laparoscopic hand-assisted right donor nephrectomy. After vascular stapling, the kidney had a short upper pole arterial branch, a short renal vein (3 mm), and a complex upper pole cyst. The renal vein was elongated using the donor ovarian vein and the short upper pole artery was extended using the recipient inferior epigastric artery and anastomosed to the main renal artery. The renal allograft vessels were anastomosed end-to-side to the external iliac vessels. The complex cyst was removed performing an enucleation with a rim of normal tissue and reconstruction of the calyceal system. This case represents three different surgical reconstructions in order to make the organ available for transplantation. In some circumstances, complex vascular reconstruction of living donor kidney with removal of complex cyst represents a strategy to expand the donor pool.
Renal cell carcinoma coexistence with ipsilateral renal duplex system: a case report
Authors: Rajesh Domakunti, Jay Dharamshi, Abhijit Dhale
Journal: Pan Afr Med J (2022)
Keywords: congenital, bifid ureter, case report, renal cell carcinoma
MeSH terms: Carcinoma, Renal Cell / diagnosis, Carcinoma, Renal Cell / diagnostic imaging, Kidney Neoplasms / diagnosis, Kidney Neoplasms / diagnostic imaging, Ureter / abnormalities, Case Reports, Adult, Hematuria, Humans, Kidney / abnormalities, Male, Nephrectomy / methods

The duplex kidney is one of the common congenital anomalies of the kidney and urinary tract. Meanwhile, renal cell carcinoma is also the most typical variant constituting more than 90% of cancers of the kidneys. However, renal cell carcinoma is rare in a duplicated collecting system, and literature regarding its association is very sparse. Herein, we present a 28-year-old male patient who presented with abdominal pain and hematuria and was diagnosed with left upper pole renal cell carcinoma coexisted with a duplicated collecting system by computed tomography scan. The patient underwent a left partial nephrectomy followed by meticulous suturing of opened pelvicalyceal system. The histopathology result showed clear cell carcinoma. The postoperative period was uneventful, and the patient was discharged without complications. In conclusion, the coexistence of the duplex system and renal cell carcinoma in the ipsilateral kidney is rare and maybe more than a coincidence, requiring a deeper insight and further elucidation.
Anaphylaxis following rivaroxaban ingestion: report of an extremely rare case
Authors: Fahmi Yousef Khan, Theeb Osama Sulaiman
Journal: Pan Afr Med J (2021)
Keywords: rivaroxaban, a case report, anaphylactic reaction, deep vein thrombosis, enoxaparin
MeSH terms: Anaphylaxis / chemically induced, Factor Xa Inhibitors / adverse effects, Rivaroxaban / adverse effects, Case Reports, Anaphylaxis / therapy, Anticoagulants / administration & dosage, Bronchodilator Agents / administration & dosage, Factor Xa Inhibitors / administration & dosage, Glucocorticoids / administration & dosage, Humans, Male, Middle Aged, Rivaroxaban / administration & dosage, Venous Thrombosis / drug therapy, Anticoagulants, Bronchodilator Agents, Factor Xa Inhibitors, Glucocorticoids, Rivaroxaban

We reported an anaphylactic reaction following ingestion of rivaroxaban in a 48-years-old male, who was recently discharged from the hospital as a case of deep vein thrombosis. At home, the patient developed a diffuse itchy skin rash, shortness of breath, and vomiting 30 minutes after rivaroxaban ingestion. Emergency Medical Service found that the patient had severe dyspnea, low blood pressure, and decreased blood oxygen saturation. The patient was given oxygen, intramuscular epinephrine, intravenous hydrocortisone, diphenhydramine, salbutamol nebulizer, and was immediately transferred to the emergency department of Hamad General Hospital. Subcutaneous enoxaparin was initiated, while hydrocortisone and salbutamol nebulizer continued. On the next day, his vital signs had stabilized, and intravenous hydrocortisone was switched to prednisolone tablets, and salbutamol nebulizer was switched to budesonide/salmeterol inhaler, whereas enoxaparin was overlapped with warfarin. After achieving the target international normalized ratio (INR), enoxaparin was discontinued and the patient was discharged with significant clinical and laboratory improvement.
Extensive Cerebral Venous Sinus Thrombosis Post COVID-19 Vaccination
Authors: Lee Min Foo, Wan-Hazabbah Wan Hitam, Mohtar Ibrahim, Khairy Shamel Sonny Teo
Journal: Cureus (2023)
Keywords: cerebral venous sinus thrombosis (cvst), cerebral venous thrombosis (cvt), covid-19, sars-cov-2, vaccination
MeSH terms: Case Reports

Extensive cerebral sinus thrombosis following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is rare. We report the case of a 42-year-old man who presented with a severe generalized headache that was not relieved by analgesics for nine days. It started four days after he received the third dose of BNT162b2 (BioNTech/Pfizer). He also complained of numbness at the back of the neck, vomiting, mild blurring of vision, and diplopia. The visual acuity (VA) in the right eye was 6/9 (improved to 6/7.5 with a pinhole) and 6/6 in the left eye. He was not able to abduct both eyes and noticed a double image at lateral gaze. Fundoscopy showed swollen optic discs with the presence of disc hemorrhages. A computed tomography venogram (CTV) of the brain showed loss of normal signal void with filling defects in the superior sagittal sinus, straight sinus, bilateral transverse sinuses, bilateral sigmoid sinuses, and bilateral internal jugular veins. The nasopharyngeal swab sample was negative for SARS-CoV-2. His platelet was normal (271x109/L) and his coagulation profile was normal. Workup for connective tissue disease was negative. He was diagnosed with extensive cerebral vascular thrombosis post-vaccination. He received a one-week course of subcutaneous clexane, followed by oral anticoagulant treatment. After treatment, his headache was relieved, and the diplopia subsided. The venous thrombosis was partially resolved. Both the swollen optic discs improved, and his VA improved to 6/6 in both eyes.
Synlabia after severe monilia infections: a case report
Authors: Samia M A Saied
Journal: Infect Dis Obstet Gynecol (2010)
MeSH terms: Candidiasis / complications, Tissue Adhesions / surgery, Vulva / surgery, Vulvar Diseases / surgery, Case Reports, Adult, Female, Humans, Tissue Adhesions / microbiology, Treatment Outcome, Vulvar Diseases / microbiology

Case:
A 25-year-old woman presented with acute urine retention with overflow 6 months after an inadequate treatment of severe monilia infections. Examination revealed complete adhesion between both labia majora. Division of adhesion was done with reconstruction by labial mucocutaneous flap. Complete recovery was achieved with good cosmetic outcome.
Conclusion:
Labial adhesions whatever their severity is can be surgically divided with complete correction by locally designed flap to reconstruct the introuitus with rapid recovery, good healing, and good cosmetic outcome.
Classical Triad and Periventricular Lesions Do Not Necessarily Indicate Wernicke's Encephalopathy: A Case Report and Review of the Literature
Authors: Lisha Ye, Zhouwei Xu, Jiangshan Deng, Jiajun Yang
Journal: Front Neurol (2020)
Keywords: wernicke's encephalopathy, differential diagnosis, magnetic resonance imaging, neuromyelitis optica, periventricular lesions, triad
MeSH terms: Case Reports

The classical triad-ophthalmoplegia, cerebellar dysfunction, and altered mental state-in addition to bilateral symmetrical periventricular lesions are actually common to see, and clinicians tend to associate that with Wernicke's encephalopathy (WE). The diagnosis is strengthened with a likely deficiency of thiamine. We herein describe a malnourished patient with clinical triad and hyperintensities in the circumventricular regions, and she turned out to have neuromyelitis optica spectrum disorder (NMOSD) after many twists and turns. Despite totally different pathogenic mechanisms, NMOSD can mimic WE, sometimes even exhibiting radiological features similar to that of WE, thereby complicating the diagnosis. Our case highlights how similar these two diseases could be and the importance of differential diagnosis in clinical practice, which are so far rarely reported. Some clinical and radiological differences of these two diseases are summarized to help establish a prompt diagnosis.
Successful Anesthetic Management Using Dexmedetomidine Sequentially with Propofol in the Asleep-Awake-Asleep Technique for Elderly Patients Undergoing Awake Craniotomy
Authors: Shunsuke Tachibana, Soichi Tanaka, Michiaki Yamakage
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

Anesthesiologists should supply proper sedation and high-quality awakening in awake craniotomy anesthesia. At our institution, we perform an asleep-awake-asleep technique for awake craniotomy anesthesia by using short-acting anesthetic drugs, such as propofol and remifentanil. However, elderly patients do not wake adequately in our normal protocol and hence are unable to complete the required neurological tasks. In this case series, we present the anesthetic management of three elderly patients with sequent use of propofol and dexmedetomidine as sedative agents for awake craniotomy. We hypothesized that this anesthetic protocol is advantageous in awake craniotomy management. For the awake phase, all patients were adequately awake and performed neurological tasks without adverse events and agitation. The use of dexmedetomidine sequentially with propofol in an asleep-awake-asleep technique for awake craniotomy in elderly patients might shorten the time to awakening and provide clear awakening.
Atypical Phenotype in a Spinocerebellar Ataxia Type 2 Kindred
Authors: Shweta Prasad, Vikram V Holla, Pramod Kumar Pal
Journal: Tremor Other Hyperkinet Mov (N Y) (2021)
Keywords: sca2, sca3, dystonia, perioral twitches
MeSH terms: Cerebellar Ataxia, Spinocerebellar Ataxias / diagnostic imaging, Spinocerebellar Ataxias / genetics, Case Reports, Age of Onset, Humans, Phenotype

Background:
Non-ataxic manifestations in autosomal dominant cerebellar ataxias are variable and influenced by CAG repeat length and age at onset. This report describes a genetically proven SCA2 kindred with an atypical phenotype resembling SCA3.
Case report:
The phenotype of five genetically proven patients with SCA2 in this report differed from the typical phenotype owing to persistence of reflexes late into the course of illness, absence of peripheral neuropathy, and very prominent facial twitches.
Discussion:
Despite descriptions of typical phenotypes of SCA, significant variations occur, especially within kindreds. Caution should be exercised in clinical diagnoses of SCA, especially with atypical features.
Case Report: Analysis of Circulating Tumor Cells in a Triple Negative Spindle-Cell Metaplastic Breast Cancer Patient
Authors: Tania Rossi, Michela Palleschi, Davide Angeli, Michela Tebaldi, Giovanni Martinelli, Ivan Vannini, Maurizio Puccetti, Francesco Limarzi, Roberta Maltoni, Giulia Gallerani, Francesco Fabbri
Journal: Front Med (Lausanne) (2021)
Keywords: circulating tumor cells, copy number aberration, liquid biopsy, metaplastic breast cancer, metastasis, next generation sequencing
MeSH terms: Case Reports

Circulating tumor cells (CTCs) are a rare population of cells found in the bloodstream and represent key players in the metastatic cascade. Their analysis has proved to provide further core information concerning the tumor. Herein, we aim at investigating CTCs isolated from a 32-year-old patient diagnosed with triple negative spindle-shaped metaplastic breast cancer (MpBC), a rare tumor poorly responsive to therapies and with a dismal prognosis. The molecular analysis performed on the primary tumor failed to underline effective actionable targets to address the therapeutic strategy. Besides the presence of round-shaped CTCs, cells with a spindle shape were present as well, and through molecular analysis, we confirmed their malignant nature. This aspect was coherent with the primary tumor histology, proving that CTCs are released regardless of their morphology. Copy number aberration (CNA) profiling and variant analysis using next-generation sequencing (NGS) showed that these cells did not harbor the alterations exhibited by the primary tumor (PIK3CA G1049A mutation, MYC copy number gain). However, despite the great heterogeneity observed, the amplification of regions involved in metastasis emerged (8q24.22-8q24.23). Our findings support the investigation of CTCs to identify alterations that could have a role in the metastatic process. To the best of our knowledge, this is the first examination of CTCs in an MpBC patient.