OpenMed/multicare-articles huggingface dataset:
Unusual cause of intestinal obstruction: left paraduodenal hernia
Authors: Sami Akbulut
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Internal intestinal hernia has been defined as bulging of the intestines through a normal or an abnormal peritoneal or mesenteric opening. Paraduodenal hernias comprise 30%-53% of all internal intestinal herniations and account for 0.2%-0.9% of all bowel obstructions. In this paper, we aimed to present a male patient of 42 years of age who developed intestinal obstruction due to left paraduodenal hernias. Left paraduodenal hernia should be taken into consideration in the differential diagnosis in patients of relatively younger ages with no prior abdominal surgery who frequently have bowel obstruction episodes.
The complete genome sequence of the methanogenic archaeon ISO4-H5 provides insights into the methylotrophic lifestyle of a ruminal representative of the Methanomassiliicoccales
Authors: Yang Li, Sinead C Leahy, Jeyamalar Jeyanathan, Gemma Henderson, Faith Cox, Eric Altermann, William J Kelly, Suzanne C Lambie, Peter H Janssen, Jasna Rakonjac, Graeme T Attwood
Journal: Stand Genomic Sci (2016)
Keywords: methane, methanogen, methanomassiliicoccales, pyrrolysine, ruminant
MeSH terms: Case Reports

Methane emissions from agriculture represent around 9 % of global anthropogenic greenhouse emissions. The single largest source of this methane is animal enteric fermentation, predominantly from ruminant livestock where it is produced mainly in their fermentative forestomach (or reticulo-rumen) by a group of archaea known as methanogens. In order to reduce methane emissions from ruminants, it is necessary to understand the role of methanogenic archaea in the rumen, and to identify their distinguishing characteristics that can be used to develop methane mitigation technologies. To gain insights into the role of methylotrophic methanogens in the rumen environment, the genome of a methanogenic archaeon has been sequenced. This isolate, strain ISO4-H5, was isolated from the ovine rumen and belongs to the order Methanomassiliicoccales. Genomic analysis suggests ISO4-H5 is an obligate hydrogen-dependent methylotrophic methanogen, able to use methanol and methylamines as substrates for methanogenesis. Like other organisms within this order, ISO4-H5 does not possess genes required for the first six steps of hydrogenotrophic methanogenesis. Comparison between the genomes of different members of the order Methanomassiliicoccales revealed strong conservation in energy metabolism, particularly in genes of the methylotrophic methanogenesis pathway, as well as in the biosynthesis and use of pyrrolysine. Unlike members of Methanomassiliicoccales from human sources, ISO4-H5 does not contain the genes required for production of coenzyme M, and so likely requires external coenzyme M to survive.
Radiation Recall Pneumonitis After Treatment With Checkpoint Blockade Immunotherapy: A Case Series and Review of Literature
Authors: Paul Riviere, Whitney Sumner, Mariel Cornell, Ajay Sandhu, James D Murphy, Jona Hattangadi-Gluth, Andrew Bruggeman, Sangwoo S Kim, J Michael Randall, Andrew B Sharabi
Journal: Front Oncol (2021)
Keywords: pd-1, checkpoint, immunotherapy, pneumonitis, radiation, reaction

Background:
Radiation recall pneumonitis (RRP) is a poorly understood clinical syndrome in which patients develop radiation pneumonitis triggered by a systemic agent, often years after the completion of radiation therapy. Immune checkpoint blockade agents have only recently been posited as a trigger for RRP. Here, we present three cases of immunotherapy-induced RRP.
Case presentation:
Our first patient was diagnosed with primary lung adenocarcinoma, and 4.5 years after completing radiation therapy developed symptomatic RRP immediately following a second dose of nivolumab-containing immunotherapy regimen. Our second patient was diagnosed with primary bladder cancer metastatic to the mediastinum, which was treated twice with radiation therapy. He developed RRP in the days following his second course of ipilimumab-pembrolizumab which was months after his second course of radiation that he received. Our final patient was diagnosed with metastatic small cell lung cancer and received local consolidative radiation therapy in addition to whole-brain radiation. He developed RRP on the 11th day after concluding his 4th cycle of nivolumab-ipilimumab, approximately 7 months after having had completed chest radiation therapy.
Conclusions:
Immunotherapy-induced RRP is a rare diagnosis which can present more focally than traditional immunotherapy pneumonitis and which must be clinically differentiated from other local processes such as pneumonia. Further research should explore the mechanisms underlying these radiation recall reactions as many patients receive radiation and immunotherapy during the course of their cancer treatment.
Caloric vestibular stimulation as a treatment for conversion disorder: a case report and medical hypothesis
Authors: Michael Noll-Hussong, Sabrina Holzapfel, Dan Pokorny, Simone Herberger
Journal: Front Psychiatry (2014)
Keywords: case report, conversion disorder, medical hypothesis, vestibular stimulation

Conversion disorder is a medical condition in which a person has paralysis, blindness, or other neurological symptoms that cannot be clearly explained physiologically. To date, there is neither specific nor conclusive treatment. In this paper, we draw together a number of disparate pieces of knowledge to propose a novel intervention to provide transient alleviation for this condition. As caloric vestibular stimulation has been demonstrated to modulate a variety of cognitive functions associated with brain activations, especially in the temporal-parietal cortex, anterior cingulate cortex, and insular cortex, there is evidence to assume an effect in specific mental disorders. Therefore, we go on to hypothesize that lateralized cold vestibular caloric stimulation will be effective in treating conversion disorder and we present provisional evidence from one patient that supports this conclusion. If our hypothesis is correct, this will be the first time in psychiatry and neurology that a clinically well-known mental disorder, long considered difficult to understand and to treat, is relieved by a simple or common, non-invasive medical procedure.
Therapeutic Response to Secukinumab in a 36-Year-Old Woman with Hidradenitis Suppurativa
Authors: Astrid-Helene Ravn Jørgensen, Yiqiu Yao, Simon Francis Thomsen
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder involving primarily the intertriginous skin of the axillary, inguinal, genital, and perianal areas of the body. It is characterized by recurrent inflamed nodules and abscesses, resulting in fistulae, fibrosis, and scarring. We present a case of HS refractory to local and systemic antibiotic therapy as well as anti-TNF and anti-IL12/23 that was successfully treated with secukinumab (anti-IL17A).
COVID-19 Pneumonia Presenting with Multiple Nodules Mimicking Metastases: An Atypical Case
Authors: Seyma Babaoglu, Necdet Poyraz, Ozlem Sahin
Journal: J Belg Soc Radiol (2022)
Keywords: covid-19, atypical, computed tomography, multiple, pulmonary nodules
MeSH terms: Case Reports

Coronavirus disease 2019 (COVID-19) is an outbreak causing pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and computed tomography (CT) images are a significant part of the diagnosis of COVID-19 related pneumonia. Typical chest CT findings are bilateral peripheral ground-glass opacities (GGO) with or without consolidation. Although rare, atypical CT findings have been described, no case of COVID-19 causing multiple solid pulmonary nodules has been reported. In this article, atypical CT findings of a 45-year-old female patient with multiple solid pulmonary nodules mimicking metastasis diagnosed with COVID-19 confirmed by reverse transcription polymerase chain reaction (RT-PCR). Teaching point: COVID-19 pneumonia may mimic multiple metastatic nodules radiologically.
Case Report: Multilevel Ossification of the Ligamentum Flavum in a Patient With Spinal Osteoblastoma
Authors: Canada T Montgomery, Stephen P Miranda, Ernest Nelson, Katie Louka, MacLean Nasrallah, Paul J Zhang, Joel Stein, Dmitriy Petrov
Journal: Front Surg (2022)
Keywords: myelopathy, neurological compromise, neurosurgery, ossification of the ligamentum flavum, spinal osteoblastoma
MeSH terms: Case Reports

Introduction:
Spinal osteoblastomas are primary benign bone tumors most commonly presenting as diffuse back pain in young adults. Rarely, spinal osteoblastoma is associated with ossification of the ligamentum flavum (OLF), a form of ectopic bone formation, which can present with myelopathy. This report highlights a unique case of a patient with spinal osteoblastoma, associated OLF, and thoracic myelopathy.
Case description:
The patient presented with subtle myelopathy consisting of mid-thoracic back pain, paresthesias, and gait instability. Imaging findings were suggestive of spinal osteoblastoma with multifocal OLF. The patient was consented for thoracic decompression and stabilization at the T6-10 levels. Histopathology confirmed osteoblastoma with associated OLF. At follow up, the patient's neurological symptoms had completely resolved.
Conclusion:
This case describes management for a rare presentation of osteoblastoma with associated OLF and myelopathy. Surgeons should be wary of disproportionate neurological compromise when spinal osteoblastoma is associated with OLF. Further study is required to elucidate the pathogenesis of this condition.
Bilateral Simultaneous Quadriceps Tendon Rupture in a 24-Year-Old Obese Patient: A Case Report and Review of the Literature
Authors: Fahad H Abduljabbar, Abdulaziz Aljurayyan, Bayan Ghalimah, Lawrence Lincoln
Journal: Case Rep Orthop (2016)

Introduction. Simultaneous bilateral quadriceps tendon ruptures (SBQTR) are uncommon knee injuries and most frequently occur in male patients, over 50 years of age. It can be associated with one or more predisposing risk factors like obesity, steroids use, and hyperparathyroidism. The main focus of this paper is to review SBQTR in obese patients. Case Report. We are reporting the youngest patient in the literature to date, a 24-year-old obese male patient, who presented to the emergency department complaining of bilateral knee pain and inability to walk after a fall during a basketball game. His clinical examination revealed the presence of a palpable suprapatellar gap and loss of knee extension bilaterally. Magnetic resonance imaging (MRI) confirmed that both of his quadriceps tendons were ruptured. A day after his diagnosis, the patient underwent successful operative repair followed by rehabilitation. At the two-year follow-up, the patient had full strength of both quadriceps muscles with no extension lag. Conclusion. The diagnosis of SBQTR can be challenging. Early diagnosis and treatment are associated with better functional outcome compared to delayed treatment. Physicians should have a high index of clinical suspicion in order not to miss such an injury and achieve favourable outcomes.
High Creatine Kinase (CK)-MB and Lactate Dehydrogenase in the Absence of Myocardial Injury or Infarction: A Case Report
Authors: Nasrollah Maghamiour, Naser Safaie
Journal: J Cardiovasc Thorac Res (2014)
Keywords: creatine kinase, macro creatine kinase, myocardial infarction
MeSH terms: Case Reports

Acute myocardial infarction (AMI) is a life threatening condition that needs emergency diagnosis and early treatment in the emergency room. Rapid laboratory testing for creatine kinase (CK)-MB greatly revolutionized the diagnosis and management of acute myocardial infarction. We report a case with chest pain that referred to the emergency department (ED). Laboratory data showed high serum levels of creatine kinase and lactate dehydrogenase. With diagnosis of acute myocardial infarction, he was hospitalized and angiography was performed which showed three vessels disease; the patient was referred to surgical ward for coronary artery bypass graft. Surgery was performed after one week; during the operation there was no sign of infarction over the heart. Our observation suggests that false positive laboratory result may be due to other condition which must be evaluated.
Unusual Paraneoplastic Presentation of Cholangiocarcinoma
Authors: Aman Opneja, Sonia Mahajan, Sargam Kapoor, Shanthi Marur, Steve Hoseong Yang, Rebecca Manno
Journal: Case Rep Med (2015)

Introduction. Cutaneous paraneoplastic syndromes are a heterogeneous group of skin manifestations that occur in relation to many known malignancies. Paraneoplastic occurrence of SCLE has been noted but is not commonly reported. SCLE association with cholangiocarcinoma is rare. Case Presentation. A 72-year-old man with a history of extrahepatic stage IV cholangiocarcinoma presented with a pruritic rash. Cholangiocarcinoma had been diagnosed three years earlier and was treated. Five months after interruption of his chemotherapy due to a semiurgent surgery, he presented with explosive onset of a new pruritic rash, arthralgias, and lower extremity edema. Physical exam revealed a scaly erythematous rash on his arms, hands, face, neck, legs, and trunk. It was thick and scaly on sun exposed areas. Skin biopsy revealed vacuolar interface dermatitis. Immunofluorescence revealed IgM positive cytoid bodies scattered along the epidermal basement membrane zone. PET-CT scanning revealed metabolically active recurrent disease in peripancreatic and periportal region with hypermetabolic lymph nodes. Oral steroids and new regimen of chemotherapy were started. Rash improved and steroids were tapered off. Discussion. Paraneoplastic syndromes demonstrate the complex interaction between the immune system and cancer. Treatment resistant SCLE should raise a suspicion for paraneoplastic etiology.
Fusarium Infection in a Kidney Transplant Recipient Successfully Treated with Voriconazole
Authors: Ahmed M Alkhunaizi, Ali M Bazzi, Ali A Rabaan, Elwaleed A Ahmed
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Fusarium infections in solid-organ transplant recipients are rare and carry high mortality. We report a case of a kidney transplant recipient who developed infection with Fusarium species. The patient received treatment with oral voriconazole for five months with good response.
Case Report: The Monogenic Familial Steroid-Resistant Nephrotic Syndrome Caused by a Novel Missense Mutation of NPHS2 Gene A593C in a Chinese Family
Authors: Ling Bai, Jing Zhuang, Changrong Zhang, Chen Lu, Xuefei Tian, Hong Jiang
Journal: Front Pediatr (2021)
Keywords: nphs2, focal segmental glomerulosclerosis, genetic testing, mutation, steroid-resistant nephrotic syndrome
MeSH terms: Case Reports

Background: Pathogenic variants in the NPHS2 gene encoding podocin in kidney podocytes are associated with autosomal recessive steroid-resistant nephrotic syndrome (SRNS) by disrupting podocyte function and the integrity of the glomerular filtration barrier. The outcome is generally poor by progressing into end-stage kidney disease (ESKD). With the help of gene diagnostics, we can further understand the role of podocin of podocytes in the development and progression of SRNS. However, the pathological mutation of NPHS2 and clinical relevance remain further elusive. Case Presentation: Two siblings, a 15-year-old girl and her 10-year-old younger brother from a consanguineous Chinese family, presented with nephrotic syndrome. Both of them developed progressive proteinuria starting from the 5-year-old of age. The renal pathological lesions for them revealed focal segmental glomerulosclerosis (FSGS). There was no response to the glucocorticoid, calcineurin inhibitors, and rituximab treatment. The female affected patient received the hemodialysis treatment due to ESKD in June 2020; the male patient was still in follow-up presenting with SRNS. The mutational screening of the two patients and their parents using Trio whole-exome sequencing showed the NPHS2 gene de novo missense mutation in exon 5 (A593C), for which the two siblings were homozygous and their parents confirmed heterozygous asymptomatic carriers. No other SRNS-related gene variants with the SRNS were determined. Conclusion: Pathological gene variants screening in children clinically suspected with SRNS might be helpful in the diagnosis as well as appropriate decisions on treatment strategies and prediction of prognosis.
Challenges and Enablers for Smartphone Use by Persons With Vision Loss During the COVID-19 Pandemic: A Report of Two Case Studies
Authors: Suraj Singh Senjam, Susan A Primo
Journal: Front Public Health (2022)
Keywords: accessible apps, assistive technology, challenges, enablers, smartphone use, visual impairment
MeSH terms: COVID-19, Smartphone, Case Reports, Research Support, Non-U.S. Gov't, Communicable Disease Control, Female, Humans, Male, Pandemics, Vision Disorders

Purpose:
Studies have reported that knowledge and skills to operate smartphones among people with profound visual loss are limited especially in low- to middle-income countries as many important functions of smartphones are unknown to them. This report presents smartphone use, its challenges, and enablers in two persons with profound visual impairment while executing their daily routine and instrumental living activities amidst the COVID-19 pandemic.
Case selection and interview:
During the lockdown period, we provided tele (vision) rehabilitation service. From the list of the callers, we purposely selected two callers with significant visual impairment, one woman and one man, to allow us to gather rich information related to smartphone use, enablers, and challenges faced during the usage. A semistructured interview was done to obtain insights into the information. The selection criteria were (1) continuous smartphone use independently for more than 5 years; (2) graduation-level education or higher; and (3) no additional disabilities.
Discussion:
We found substantial use of smartphones in executing their daily and instrumental daily living activities by these two participants. The extent of the use of mainstream apps for various tasks was almost equivalent to what we observed among sighted persons. The most important enabling factors were the presence of a screen reader "TalkBack" on Android phones and data connection of the mobile, followed by the ability to assess multiple languages using the text-to-speech feature. A supportive environment from peers or family members is important for the beginner. Poor battery backup, frequent unwanted ads or pop-ups while using the phone, not readable contents with a screen reader, e.g., CAPTCHA, and slow or unresponsiveness of the screen reader were frequent challenges faced by them. Both cases reported that around 80% of daily solutions were helped by using a smartphone.
Conclusions:
The current advances in accessible technology of smartphones enable an individual with profound visual loss to use them almost equivalently as a sighted person. To reduce the gap in digital inclusion, people with visual impairment should be encouraged to use the smartphone for their daily solutions with attention to proper training.
Anti-PD-1 Immunotherapy and Bee Venom for Relapsed and Refractory Liposarcoma: A Case Report
Authors: Wei Yang, Yeke Zhang, Gaoyi Yang, Yanhua Geng, Da Chen, Jun Wang, Yang Ye, Huaichong Wang, Dajing Xia, Fuliang Hu, Jing Jiang, Xiaofeng Xu
Journal: Front Oncol (2021)
Keywords: pd-1 inhibitor, sting pathway, apitherapy, bee venom, complementary medicine, immunotherapy, innate immunity, liposarcoma
MeSH terms: Case Reports

Cancer immunotherapies, including immune checkpoint inhibitors, elicit long-term clinical responses but many cancer patients do not respond. Intensive efforts are therefore underway to identify additional immune pathways that may be modulated to enhance the efficacy of existing immunotherapies. Bee venom strongly stimulates the immune system, and is used as a complementary therapy to treat cancer pain in patients with advanced tumors in China. Bee venom contains several allergenic protease inhibitors and peptides. It triggers hypersensitivity reactions; that is, it is an immune system agonist. The generation of a spontaneous T cell response against tumor-associated antigens requires innate immune activation; this drives type I interferon production. We report a patient with a relapsed and refractory liposarcoma who had undergone several operations, chemotherapies, and radiotherapies. The tumor was large. The patient had attained the maximum radiation exposure dose. The tumor was resistant to chemotherapy and was infiltrating the pericardium, lungs, and diaphragm. The patient was a poor candidate for resection. He thus received apitherapy (a combination of bee venom and acupuncture) to control pain; then apatinib (an anti-angiogenic drug) was given to inhibit tumor growth but was terminated early because the patient could not tolerate the side effects. Subsequently, a programmed death 1 inhibitor was combined with apitherapy. Bee venom served as an innate immune system agonist promoting immune cell priming and recruitment in the tumor microenvironment. The patient was finally able to undergo radical liposarcoma resection, and no evidence of recurrence was found at re-examination 16 months after surgery.
A rare case of anaphylaxis to Indian jujube ( Ziziphus Mauritiana Lam)
Authors: Babak Aberumand, Rozita Borici-Mazi
Journal: Allergy Asthma Clin Immunol (2020)
Keywords: anaphylaxis, food allergy, indian jujube, ziziphus mauritiana lam
MeSH terms: Case Reports

Background:
Indian jujube (Ziziphus Mauritiana Lam) is a sweet fruit from a tree native to tropical and subtropical regions of Asia and India. A few case reports have implicated Indian jujube to cause latex-fruit syndrome. We present the first case of an anaphylactic reaction to this fruit in a patient with no latex allergy.
Case presentation:
A 55-year-old male was referred to the Outpatient Allergy Clinic at Queen's University for evaluation of anaphylaxis caused by ingestion of Indian jujube. He presented to the Emergency Department (ED) with scalp pruritus, dyspnea and generalized urticaria, which occurred two hours after he had consumed a homemade candied fruit cocktail consisting of Indian jujube, water, Thai and Indian sweetener. In the ED, he was treated with epinephrine, intravenous diphenhydramine and steroids. He did not have any previous history of environmental or food allergies but had consumed this fruit frequently since childhood. In clinic, he underwent skin-prick testing with a saline slurry of candied jujube, which resulted in a positive wheal and flare response with appropriate controls. On subsequent visit, skin-prick tests were performed with saline slurries of the Thai and Indian sweetener used to make the cocktail. Both tests were negative when applied to a healthy volunteer. Skin-prick testing to latex allergen and latex specific IgE were both negative. He was diagnosed with an IgE-mediated anaphylactic reaction to the Indian jujube fruit. He was advised to avoid consumption of Indian jujubes and carry an epinephrine autoinjector.
Conclusions:
Anaphylaxis secondary to Indian jujube ingestion is an extremely rare phenomenon in patients without a latex allergy. A possible allergy to Indian jujube should be taken into consideration when working up anaphylaxis, especially in patient of Asian and Indian descent who have ceased regular consumption of the fruit.