OpenMed/multicare-articles huggingface dataset:
Treatment of visuospatial neglect with biparietal tDCS and cognitive training: a single-case study
Authors: Anna-Katharine Brem, Evelyn Unterburger, Irving Speight, Lutz Jäncke
Journal: Front Syst Neurosci (2014)
Keywords: cognitive therapy, rehabilitation, stroke, transcranial direct current stimulation, visuospatial neglect
MeSH terms: Case Reports

Symptoms of visuospatial neglect occur frequently after unilateral brain damage. Neglect hampers rehabilitation progress and is associated with reduced quality of life. However, existing treatment methods show limited efficacy. Transcranial direct current stimulation (tDCS) is a neuromodulatory technique, which can be used to increase or decrease brain excitability. Its combination with conventional neglect therapy may enhance treatment efficacy. A 72-year-old male with a subacute ischemic stroke of the right posterior cerebral artery suffering from visuospatial neglect, hemianopia, and hemiparesis was treated with biparietal tDCS and cognitive neglect therapy in a double-blind, sham-controlled single-case study. Four weeks of daily treatment sessions (5 days per week, 30 min) were started 26 days post-stroke. During week 1 and 4 the patient received conventional neglect therapy, during week 2, conventional neglect therapy was combined once with sham and once with real biparietal tDCS. Week 3 consisted of daily sessions of real biparietal tDCS (1 mA, 20 min) combined with neglect therapy. Outcome measures were assessed before, immediately after, as well as 1 week and 3 months after the end of treatment. They included subtests of the Test for Attentional Performance (TAP): covert attention (main outcome), alertness, visual field; the Neglect-Test (NET): line bisection, cancelation, copying; and activities of daily living (ADL). After real stimulation, covert attention allocation toward left-sided invalid stimuli was significantly improved, and line bisection and copying improved qualitatively as compared to sham stimulation. ADL were only improved at the 3-month follow-up. This single-case study demonstrates for the first time that combined application of tDCS and cognitive training may enhance training-induced improvements in measures of visuospatial neglect and is applicable in a clinical context.
Hypercalcemia-Leukocytosis syndrome and adenosquamous lung carcinoma: An overlooked conjugation
Authors: João Oliveira Pereira, João Gama, Diana Ferreira, Arsénio Santos
Journal: Oncol Res (2022)
Keywords: hypercalcaemia-leukocytosis syndrome, adenosquamous lung carcinoma, percutaneous lymph node biopsy, skull metastases
MeSH terms: Adenocarcinoma, Hypercalcemia / diagnosis, Hypercalcemia / etiology, Lung Neoplasms / complications, Lung Neoplasms / diagnosis, Case Reports, Humans, Leukocytosis, Male, Middle Aged

Hypercalcaemia and leukocytosis are two paraneoplastic conditions associated with poor prognosis. Adenosquamous carcinoma is a rare and aggressive histological subtype of lung cancer consisting of adenocarcinoma and squamous cell components. We report the case of a 57-year-old male smoker who was admitted to the Emergency Room with skull and neck tumefactions, confusion and deteriorated general condition. The complementary study in the ER revealed severe hypercalcaemia (19.8 mg/dL), leukocytosis (18.7 × 109/L) and extensive osteolytic lesions of the skull on cranioencephalic computer tomography (CT). The patient was stabilized and admitted. Thoracoabdominopelvic CT showed lung parenchyma consolidation with necrotic areas, supra and infradiaphragmatic adenopathies and scattered osteolytic lesions. Percutaneous lymph node biopsy was consistent with metastasis of adenosquamous lung carcinoma. The patients' clinical situation evolved unfavourably after hospital-acquired infection. This case is characterized by a rare presentation of advanced stage adenosquamous lung carcinoma with scattered osteolytic lesions and severe hypercalcaemia-leukocytosis syndrome, an underrecognized marker of poor prognosis.
Case Report: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorder Masquerading as Multiple Sclerosis: An Under-Recognized Entity?
Authors: Yang Zheng, Meng-Ting Cai, Er-Chuang Li, Wei Fang, Chun-Hong Shen, Yin-Xi Zhang
Journal: Front Immunol (2021)
Keywords: case report, multiple sclerosis, myelin oligodendrocyte glycoprotein antibody, myelitis lesions, neuroimmunological disease
MeSH terms: Demyelinating Autoimmune Diseases, CNS / diagnosis, Demyelinating Autoimmune Diseases, CNS / immunology, Demyelinating Autoimmune Diseases, CNS / pathology, Myelin-Oligodendrocyte Glycoprotein / immunology, Case Reports, Adult, Autoantibodies / immunology, Autoantigens / immunology, Diagnosis, Differential, Female, Humans, Multiple Sclerosis / diagnosis, Multiple Sclerosis / pathology, Myelitis / etiology, Autoantibodies, Autoantigens, MOG protein, human, Myelin-Oligodendrocyte Glycoprotein

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) covers a wide spectrum of manifestations and is defined by the presence of MOG seropositivity. However, in a proportion of patients, there may be an overlap in some of the clinical and radiological manifestations between MOGAD and multiple sclerosis (MS). Being wary of this entity is critical to ensure appropriate therapy. Herein, we present a case with recurrent episodes of short-segment myelitis typical for multiple sclerosis, but later diagnosed as MOGAD by MOG antibody seropositivity. This case, along with previous reports, highlights an increasingly recognized subgroup in MOGAD with initial clinical phenotypes suggestive of MS, but later showing a disease course and therapeutic response compatible with MOGAD. Given the potential overlap of some clinical phenotypes in patients with MS and those with MOGAD, we recommend MOG antibody testing in all patients with recurrent short-segment myelitis, conus medullaris involvement, and those who demonstrated steroid dependence.
Case of Inherited Partial AZFa Deletion without Impact on Male Fertility
Authors: Baiba Alksere, Dace Berzina, Alesja Dudorova, Una Conka, Santa Andersone, Evija Pimane, Sandra Krasucka, Arita Blumberga, Aigars Dzalbs, Ieva Grinfelde, Natalija Vedmedovska, Violeta Fodina, Juris Erenpreiss
Journal: Case Rep Genet (2019)
MeSH terms: Case Reports

Male factor infertility accounts for 40-50% of all infertility cases. Deletions of one or more AZF region parts in chromosome Y are one of the most common genetic causes of male infertility. Usually full or partial AZF deletions, including genes involved in spermatogenesis, are associated with spermatogenic failure. Here we report a case of a Caucasian man with partial AZFa region deletion from a couple with secondary infertility. Partial AZFa deletion, involving part of USP9Y gene appears to be benign, as we proved transmission from father to son. According to our results, it is recommended to revise guidelines on markers selected for testing of AZFa region deletion, to be more selective against DDX3Y gene and exclude probably benign microdeletions involving only USP9Y gene.
Explaining refugee flows. Understanding the 2015 European refugee crisis through a real options lens
Authors: Linda Peters, Peter-Jan Engelen, Danny Cassimon
Journal: PLoS One (2023)
MeSH terms: Refugees, Europe, Health Services Accessibility, Humans, Syria

In 2015 the unprecedented arrival of refugees in Europe posed serious challenges for the EU and its member countries on how to deal with such an influx. A key element in better managing refugee flows is to understand what drives these flows in a certain direction. A refugee who comes to Europe has to make trade-offs in terms of cost and benefits, duration, uncertainty and the multi-staged character of the journey. Real options models are a suitable tool for modelling these kind of decision dynamics. On the basis of a case-study, that compares three routes from Syria to Europe, we demonstrate how well the real options analysis is in line with the development of the refugee flows.
Late diagnosis of subcoracoid type 6 AC dislocation: A case report
Authors: Mehmet Kapicioglu, Huzeyfe Cetin, Kerem Bilsel
Journal: SICOT J (2019)
Keywords: acromioclavicular dislocation, delayed, subcoracoid, type 6
MeSH terms: Case Reports

Acromioclavicular (AC) dislocation is a common type of shoulder injury. Although the incidence of acromioclavicular dislocation is frequent, there are different opinions regarding the treatment. Many different techniques have been proposed for the surgical treatment of AC dislocations, but all these methods have been questioned from different angles, and the gold standard in terms of treatment has not yet been determined. There are six types described by Rockwood et al. and type 6 has two types: subacromial and subcoracoid. Subcoracoid AC Type 6 dislocations are seen very rarely and difficult to diagnose in initial clinical findings or can be simply overlooked due to associated more serious injuries which take more attention. The mechanism of injury of a type 6 AC dislocation is hyperabduction and external rotation of the shoulder. A small number of type 6 subcoracoid AC dislocations have formerly been reported and apart from one case all of them were acutely diagnosed and treated with open reduction and internal fixation. In this paper, we report a case of late diagnosis of subcoracoid type 6 AC dislocation, along with its rare and previously unreported surgical management.
Jejunoduodenal intussusception caused by a solitary polyp in a woman with Peutz-Jeghers syndrome: a case report
Authors: Ali Ozer, Pinar Sarkut, Ersin Ozturk, Tuncay Yilmazlar
Journal: J Med Case Rep (2014)

Introduction:
Peutz-Jeghers syndrome is a rare autosomal dominant disorder characterized by hamartomatous polyps and characteristic mucocutaneous pigmentation. The hamartomatous polyps of Peutz-Jeghers syndrome can cause intestinal occlusion, especially in the small intestine. Intussusception is seen frequently in children, but rarely in adults.
Case presentation:
We present the case of a 21-year-old female patient who was admitted to our emergency service with symptoms of ileus as a result of intussusception due to duodenal polyps. Radiological and endoscopic findings determined a jejunoduedonal intussusception. After an unsuccessful endoscopic attempt, a laparotomy was performed that revealed a polypoid mass originating from the fourth part of her duodenum, with intussusception of her proximal jejunum.
Conclusion:
Intussusception caused by Peutz-Jeghers syndrome is a rare diagnosis and is mostly jejunojejunal or jejunoileal. Despite the fact that a few duodenojejunal cases have been reported, this is to the best of our knowledge the first case of jejunoduedonal intussusception in a patient with Peutz-Jeghers syndrome to be described in the literature.
Case Report: Spontaneous Appendicitis With Suspected Involvement of Klebsiella variicola in Two Pet Rabbits
Authors: Vladimir Jekl, Anna Piskovska, Ivana Drnkova, Misa Skoric, Karel Hauptman, Jan Chloupek
Journal: Front Vet Sci (2021)
Keywords: klebsiella, acute abdomen, appendicitis, appendix, gastrointestinal stasis, rabbit
MeSH terms: Case Reports

Although laboratory rabbits are commonly used as models of appendicitis in man, spontaneous appendicitis was only described ante-mortem in one pet rabbit with an acute abdomen. The aim of this article is to describe two spontaneous cases of appendicitis in pet rabbits, to describe therapeutic appendectomy, and to discuss the microbial flora of the inflamed appendix. A 5-month-old intact female and a 16-month-old, neutered male were presented to the veterinary clinic with restlessness, anorexia, and reduced faecal output. The main clinical findings were restlessness, severe discomfort on abdominal palpation, a mid-abdominal palpable tubulous mass and an elevated rectal temperature. Blood analyses showed lymphocytosis, monocytosis, and hyperglycaemia. Radiography was inconclusive. Abdominal ultrasound revealed a presence of a tubular structure with wall thicknesses of 4.2 and 3.7 mm in the two rabbits, respectively. The tubular structure had a rounded, closed end, and a multilayered wall, suggestive of appendicitis. Due to metabolic acidosis and poor prognosis, the first rabbit was euthanized. In the 16-month-old rabbit, appendectomy was performed. Recovery was uneventful, and 4 h after surgery, the rabbit started to become normally active. Postoperative care consisted of fluid therapy, multimodal analgesia, supportive care and prokinetics. Follow-up examinations at 10 days, 1 month, and at 11 months after the surgery did not show any abnormal clinical or laboratory findings. Histopathological examination of appendices from both rabbits showed gangrenous appendicitis. Aerobic cultivation showed the presence of pure culture of Klebsiella variicola sensitive to enrofloxacin, marbofloxacin, tetracycline, cefuroxime, trimethoprim sulphonamide, neomycin, and gentamicin. Restlessness associated with anorexia, abdominal pain, palpable abdominal mass, hyperglycaemia, lymphocytosis, and elevated rectal temperature may be indicative of inflammation within the gastrointestinal tract. Abdominal ultrasound is recommended in rabbits with showing these clinical signs because radiography can be inconclusive. Appendicitis is a life-threatening condition, which should be included into the list of differential diagnoses; for the rabbit, an acute abdomen and gastrointestinal stasis syndrome and must be treated immediately. K. variicola may be associated with appendicitis in rabbits as a causative agent or in association with appendix intraluminal dysmicrobia.
False Positive Transit Time Flowmetry Graft Failure in Multivessel Coronary Spasm following Off-Pump Coronary Artery Bypass Grafting
Authors: George Kassimis, George Krasopoulos
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Intraoperative Transit Time Flowmetry is currently recommended to assess graft patency during coronary artery bypass grafting (CABG), especially in presence of haemodynamic instability or inability to wean the patient from cardiopulmonary bypass, new regional wall motion abnormalities, or significant ventricular arrhythmias. The VeriQ™ system is one of the currently available systems, which detects imperfections that may be corrected by graft revision. In this case report, multivessel coronary spasm (CS) post-CABG interferes with these intraoperative parameters misleading initially into false results. Cardiac surgeons should bear in mind the limit of VeriQ in distinguishing between graft failure and CS. Angiography may be considered in patients with decreased graft flow despite revision of anastomosis and vasodilatory treatment for the definitive diagnosis.
Carbapenem-Resistant Enterobacteriaceae Bloodstream Infection Treated Successfully With High-Dose Meropenem in a Preterm Neonate
Authors: Yue-E Wu, Hai-Yan Xu, Hai-Yan Shi, John van den Anker, Xiao-Yu Chen, Wei Zhao
Journal: Front Pharmacol (2020)
Keywords: carbapenem-resistant enterobacteriaceae infection, high dose regimen, meropenem, model-based therapeutic drug monitoring, preterm neonate
MeSH terms: Case Reports

Carbapenem-resistant enterobacteriaceae (CRE) bloodstream infections have been rapidly spreading worldwide with a high mortality and pose a challenge to therapeutic decision-making, especially in premature neonates because insufficient empirical antimicrobial therapy is independently associated with high mortality. This case reported that a premature infant with CRE bloodstream infection was treated successfully with high-dose meropenem treatment with model-based therapeutic drug monitoring (TDM). In clinical settings, treatment target attainment of meropenem can be improved by increasing the frequency of administration, prolonging the infusion time, and using a high dose. This case report shows a successful regimen for CRE infection in a premature neonate and emphasizes the utility of model-based TDM of high-dose meropenem treatment. The adequate antimicrobial benefit provided by innovative techniques could ensure the efficacy and safety of high-dose meropenem therapy for CRE infection.
Indocyanine Green-Based Fluorescence-Guided Surgery in a Male Infant with Anorectal Malformation
Authors: Irene Paraboschi, Laura Privitera, Stavros Loukogeorgakis, Stefano Giuliani
Journal: European J Pediatr Surg Rep (2022)
Keywords: anorectal malformation, children, fluorescence-guided surgery, indocyanine green, real-time imaging
MeSH terms: Case Reports

Reconstructive techniques for complex anorectal malformations (ARMs) require intestinal pull-through on vascular pedicles. Traditionally, the visual inspection of the intestinal perfusion is the sole modality adopted to assess tissue viability. In this article, we report the case of a child with a rectourethral prostatic fistula, who had a Peña's descending colostomy with distal mucous fistula in the neonatal period and a posterior sagittal anorectoplasty at 6 months of life. The ARM repair was guided by indocyanine green (ICG), which was intravenously administered to evaluate the blood flow of the intestinal pull-through using the EleVision IR system (Medtronic Ltd, U.K.). ICG-based fluorescence-guided surgery helped to define the proximal resection margin, impacting intraoperative decision making, and no postoperative complications occurred. We envisage that this technology will become part of the armory of pediatric surgeons soon, by reducing the risk of intra- and postoperative complications.
CASE REPORT Sternal Chondrosarcoma After Sternotomy for Coronary Artery Bypass Grafting
Authors: Vijay A Singh, Juan Abreu, Kimberly Bowman, Masood A Shariff, Joseph T McGinn Jr
Journal: Eplasty (2013)

Objective:
Primary bony tumors of the chest wall are usually benign and most commonly located in the ribs or sternum. Chondrosarcoma is regarded as one of the most frequent primary malignancies of the chest wall and its incidence after a sternotomy for a cardiac procedure is extremely rare. We present a case of sternal chondrosarcoma.
Methods:
The patient presented with a sternal mass 4 years after undergoing coronary artery bypass grafting for ischemic coronary artery disease. The mass originally emanated from the upper portion of the patients' sternum and then rapidly enlarged to include the anterior aspects of his neck. Radiologic imaging studies were undertaken: computed tomographic scan and magnetic resonance imaging, with surgical intervention for excision.
Results:
Computed tomographic scan and magnetic resonance imaging established an 8.4 × 6.2 × 8.6 cm(3) complex solid tissue mass within the lower neck arising from the sternal manubrium, with extensive bone destruction. Computed tomography-guided biopsy showed cells of uncertain significance. Surgical excision was performed and the mass was diagnosed as a grade II chondrosarcoma.
Discussion:
Primary sarcomas of the sternum though uncommon are potentially curable with wide surgical excision. Success depends on tumor histologic type and grade, which dictate recurrence.
Endovascular Occlusion of a Renal Arteriovenous Fistula with Renal Vein Aneurysm Formation for Rupture Prevention
Authors: Yae Hyun Rhee, Lucas Busch, Roberto Sansone, Neslihan Ertas, Nikolaos Floros, Hubert Schelzig, Joscha Mulorz, Markus Udo Wagenhäuser
Journal: Case Rep Vasc Med (2019)
MeSH terms: Case Reports

Purpose:
To report the effectiveness of left renal artery (LRA) occlusion using Amplatzer Vascular Plug (AVP) II as treatment for a high-flow renal arteriovenous fistula (RAVF) with multiple renal vein aneurysms (RVA) to prevent aneurysm rupture and cardiac decompensation.
Case report:
A 59-year-old female suffering from a post-traumatic RAVF presented with tachycardia and increased cardiac output (CO). Doppler ultrasonography and computed tomography (CT) scan revealed a high-flow RAVF with multiple RVAs and unilateral critically reduced kidney function. Appreciating recent interventional therapeutic advances, the patient was treated with endovascular placement of AVP II into the left renal artery (LRA) resulting in complete occlusion of the RAVF to effectively reduce the risk of RVA rupture and cardiac decompensation. No anti-platelet medication was administrated after the occlusion of the LRA. The patient's physical capacity improved since right heart volume strain was normalized, and CO was reduced.
Conclusion:
Transbrachial AVP II occlusion of the LRA is effective to occlude high-flow RAVFs to prevent risk of life-threatening RVA rupture. Additional follow-up is warranted to verify long-term effectiveness of this approach.
Complete Management of a Mutilated Young Permanent Central Incisor
Authors: Iqbal Musani, Varun Goyal, Asha Singh
Journal: Int J Clin Pediatr Dent (2011)
Keywords: anatomic post and core, apexogenesis
MeSH terms: Case Reports

This case report throws light on treatment of immature apices through apexogenesis and an esthetic postobturation restoration of traumatized young permanent central incisor using a relatively newer methodology of anatomic posts, i.e. shaping the post to the root anatomy. The authors would also like to underline the significance of rubber dam isolation for more predictable outcomes. The new method of anatomic post is simple, viable, practical, and less time consuming than thought.
Skull Base Osteomyelitis from Otitis Media Presenting as the Collet-Sicard Syndrome
Authors: Wong-Kein Low, Hui-Ling Lhu
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

Skull base osteomyelitis can involve the jugular foramen and its associated cranial nerves resulting in specific clinical syndromes. The Collet-Sicard syndrome describes the clinical manifestations of palsies involving cranial nerves IX, X, XI, and XII. We present a rare atypical case of skull base osteomyelitis originating from infection of the middle ear and causing the Collet-Sicard syndrome. Caused by Pseudomonas aeruginosa and Klebsiella pneumoniae, this occurred in an elderly diabetic man subsequent to retention of a cotton swab in an ear with chronic suppurative otitis media. This case report illustrates the possibility of retained cotton swabs contributing to the development of otitis media, skull base osteomyelitis, and ultimately the Collet-Sicard syndrome in the ears of immune-compromised patients with chronically perforated eardrums.
Two Cases of Rare Pancreatic Malignancies
Authors: Wissam Hanayneh, Hiral Parekh, Garrett Fitzpatrick, Michael Feely, Thomas J George, Jason S Starr
Journal: J Pancreat Cancer (2019)
Keywords: clear cell, osteoclast-like giant cells, pancreatic cancer, undifferentiated
MeSH terms: Case Reports

Background: Pancreatic adenocarcinoma remains one of the most lethal malignancies with little treatment advancements. Other less common pancreatic cancer histologies have different outcomes and disease course. In this article, we report two cases of rare pancreatic tumors. Presentation: The first case is a 59-year old, who was undergoing surveillance of a known pancreatic cyst, which eventually enlarged. The mass was resected and pathology revealed undifferentiated carcinoma with osteoclast-like giant cells. The patient did not receive any adjuvant therapy and has had no recurrence. The second case is of a 60-year-old patient who presented with signs and symptoms of pancreatic insufficiency and was found to have clear cell adenocarcinoma of the pancreas. She received neoadjuvant chemoradiotherapy followed by surgical resection without complications. Conclusion: Our article presents these rare malignancies, which had outcomes that are more encouraging than typical adenocarcinomas. Genomic sequencing can provide more insight into these tumors and potentially provide targets for therapy.