OpenMed/multicare-articles huggingface dataset:
An Extranodal Site of Diffuse Large B-cell Lymphoma Presenting as Ovarian Cancer
Authors: Laila Jaouani, Adil Zaimi, Ouissam Al Jarroudi, Soufiane Berhili, Sami Aziz Brahmi, Said Afqir
Journal: Cureus (2023)
Keywords: cd20+, exploratory laporotomy, immunohistochemical panel, ovarian lymphoma, r-chop-rituximab
MeSH terms: Case Reports

Due to its uncommon nature, primary ovarian lymphoma has no clinical particularities and can be confused with other ovarian cancers. It poses a twofold diagnostic and therapeutic challenge. An anatomopathological and immunohistochemical study is the crucial step in the diagnosis. Our case was a 55-year-old woman diagnosed with an Ann Arbor stage II E ovarian non-Hodgkin's lymphoma who initially presented with a painful pelvic mass. This case reflects the major role of an immunohistochemical study in the diagnosis workup, leading to the appropriate management of such rare tumors.
Gastric cancer after gastric bypass with fundectomy: The possibility for early diagnosis
Authors: Marco Antonio Zappa, Maria Paola Giusti, Elisa Galfrascoli
Journal: Int J Surg Case Rep (2019)
Keywords: bariatric surgery, endoscopy, excluded stomach, gastric bypass, gastric cancer, obesity

Introduction:
Roux-an-Y gastric bypass (RYGP) is one of the most important bariatric procedures and its results are well known in terms of weight loss and comorbid improvement. The major limitation of this technique is the difficult exploration of the excluded stomach and duodenum. Some Authors are performing the gastric bypass with fundectomy and, according to Literature, it is feasible and effective, with major advantage of explorable gastric pouch.
Presentation of case:
We report the case of a 54-year-old woman affected by obesity (BMI 49 kg/m2). After a pre-operative multidisciplinary evaluation and gastroscopy, she underwent a laparoscopic RYGB with fundectomy in October 2016. One year after surgery she contacted the department for vomiting, pyrosis and weakness. Thanks to the characteristics of the surgical technique it was possible to easily perform an OGD that detected an antral ulcer. The byopsy revealed a gastric adenocarcinoma. A degastroresection was performed and the istological finding was a gastric adenocarcinoma pT1b N0 G3.
Discussion:
Early diagnosis is essential in gastric tumors to ensure a good prognosis and the gold standard is performing gastroscopy with biopsies. With the standard technique is very challenging to perform an OGD and the cancer stage is likely to be advanced at diagnosis, with a bad prognosis for the patient.
Conclusion:
From the clinical case described and the analysis of the Literature, the advantages of this technique are clear, allowing for an easy endoscopic evaluation of gastric walls with the possibility of diagnosing early stage tumors with a better outcome for patients.
Matrix therapy is a cost-effective solution to reduce amputation risk and improve quality of life: pilot and case studies
Authors: Pascal Desgranges, Taina Louissaint, Bertrand Godeau, Denis Barritault
Journal: Regen Med Res (2019)
Keywords: cacipliq20, matrix therapy, otr4120, ischemic skin ulcers

Introduction:
Chronic, non-healing ulcers remain one of the most challenging clinical situations for health care practitioners. Often, conventional treatments fail and lead to amputation, further decreasing the patient's quality of life and resulting in enormous medical expenditures for healthcare systems. Here we evaluated the use of and cost-effectiveness of the RGTA (ReGeneraTing Agents) medical device CACIPLIQ20 (OTR4120) for chronic lower-extremity ulcers in patients with Leriche and Fontaine Stage IV peripheral arterial disease who were not eligible for revascularization.
Methods:
This uncontrolled pilot study included 14 chronic lower extremity ulcers in 12 patients in one hospital. The pilot study included 12 patients with TcPO2 < 20 mm Hg and ABPI < 0.5 who had either a minimum of one chronic lower extremity ulcer or a chronic ulcer related to amputation. OTR4120 was applied twice a week or until complete healing, for up to 12 weeks. Ulcer surface area reduction (%)after 2, 4, 8 and 12 weeks, appearance after 4 weeks, and healing after 12 weeks were measured and recorded.
Results:
A 35% reduction in ulcer size was achieved after 4 weeks. 7 (50%) out of 14 ulcers completely healed within 1 to 3 months of treatment.
Discussion:
OTR4120 is an effective therapeutic option for patients with chronic lower extremity ulcers, can provide major improvement of quality of life and has the added benefit of being a significant cost-effective solution for healthcare systems.
Pediatric Benign Fibro-Osseous Lesions of the Nose and Paranasal Sinuses: A Tertiary Hospital Experience
Authors: Dalia Al Arfaj, Haifa Lafi Alenzi, Ali Almomen, Musab Bakri
Journal: Int J Otolaryngol (2022)

Background:
Pediatric benign fibro-osseous lesions of the nose and paranasal sinuses are considered rare neoplastic entities. These fibro-osseous lesions are difficult to accomplish owing to the multifaceted anatomy of the skull base in addition to the closeness to neurovascular configurations.
Objective:
The study aimed to study different clinical presentations, radiological manifestations, surgical management, and consequences of different benign fibro-osseous lesions in the pediatric age groups. Methods and Settings. This is a case series study of a single-center experience.
Results:
Four different cases were presented and discussed (osteoma, fibrous dysplasia, and ossifying fibroma.
Conclusion:
We reported four different cases of osteoma, ossifying fibroma, and fibrous dysplasia. All of these cases were managed endoscopically with no postoperative complications. Endoscopic management is considered highly effective with reduced morbidity. Preoperative radiographic studies are highly essential for diagnosis and operative planning.
Primary abdominal gas gangrene: a report of two autopsy cases
Authors: George S Stoyanov, Deyan L Dzhenkov, Lilyana Petkova
Journal: Autops Case Rep (2021)
Keywords: abdomen, autopsy, clostridium, gas gangrene, histology, liver, pathology
MeSH terms: Case Reports

Primary hepatic gas gangrene is a form of primary abdominal gas gangrene. The condition is caused by Clostridium perfringens, other clostridia, and non-clostridia bacterial species producing gas. Unlike classical gas gangrene or myonecrosis, the disease develops without a wound or a port of entry. Instead, gas-producing bacteria in the gastrointestinal tract colonize an underlying pathological process with foci of necrosis, producing excessive gas and spreading hematogenously to other organs. Herein we present two autopsy cases of primary hepatic gas gangrene diagnosed on autopsy, with the gross and histological changes that can be considered specific for this rare condition. Both patients had severe underlying liver disease-prone for this entity development. The gross changes in the cases are postmortem subcutaneous emphysema, skin bullae with pooled blood, pneumothorax, pneumoabdomen, abundant gas in the circulatory system, porous structure of the internal organs (tissue gas bubbles), and advanced tissue lysis, not corresponding to the post mortem time. Histology showed optically empty areas of varying size in the internal organs, which weave the structure of the organs and rod-shaped bacteria with scarcity or complete absence of inflammatory reaction.
Oral Lichenoid Reaction: An Uncommon Side Effect of Rituximab
Authors: Amerigo Giudice, Francesco Liborio, Fiorella Averta, Selene Barone, Leonzio Fortunato
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Oral lichenoid reactions (OLR) can be caused by systemic drug exposure. To the best of our knowledge, this is the second report describing a case of OLR induced by rituximab administration in a patient with a diagnosis of non-Hodgkin B-cell lymphoma. After 5 doses of rituximab, a typical pattern of OLP was identified with bilateral and symmetrical lesions on the buccal mucosa and on the right lingual margin. This temporal relationship suggested a probable association between oral lesions and drug therapy. The clinical diagnosis of a rituximab-induced OLR was confirmed by an incisional biopsy reporting a histopathological result of lichenoid mucositis consistent with oral lichen planus. Because of the increasing use of rituximab, it is necessary to know and recognize this uncommon side effect.
Electrocardiogram Abnormalities Following Diphenhydramine Ingestion: A Case Report
Authors: Patrick Bruss, Christine Bowman, Teagan Carroll
Journal: J Educ Teach Emerg Med (2023)

In the United States, tricyclic antidepressants (TCA) are commonly prescribed to treat psychiatric illnesses and neuropathic pain. This class of antidepressants has been found to cause pathognomonic electrocardiogram (ECG) changes in cases of overdose.1 Specifically, TCA's cause a dominant terminal R wave in aVR and widening of the QRS complex due to their sodium channel blocking effect. Diphenhydramine, better known as Benadryl, is known to disrupt sodium channels in the same manner. In this case report, a 13-year-old female was brought into the emergency department (ED) after attempted suicide by diphenhydramine overdose. The patient presented with palpitations, nausea and confusion. She was agitated, tachycardic and exhibited opsoclonus. An ECG was performed upon the patient's arrival which showed large terminal R waves in aVR along with large S waves in lead I indicating right axis deviation. Given the patient's age and reported ingestion, it was highly suspicious that her symptoms and ECG changes were the result of a sodium channel blockade. Sodium bicarbonate was given, which resulted in notable ECG changes as well as symptomatic improvement. TCA's, and similarly diphenhydramine, have sodium channel blocking properties which can be revealed by performing an ECG. Administration of sodium bicarbonate in the ED has been shown to be a successful treatment by reversing this sodium channel blockade.
Topics:
Tricyclic antidepressants, diphenhydramine, overdose, sodium channel blockage, sodium bicarbonate administration.
Complex Odontoma: A Case Report with Micro-Computed Tomography Findings
Authors: L A N Santos, L J Lopes, G D Roque-Torres, V F Oliveira, D Q Freitas
Journal: Case Rep Dent (2016)

Odontomas are the most common benign tumors of odontogenic origin. They are normally diagnosed on routine radiographs, due to the absence of symptoms. Histopathologic evaluation confirms the diagnosis especially in cases of complex odontoma, which may be confused during radiographic examination with an osteoma or other highly calcified bone lesions. The micro-CT is a new technology that enables three-dimensional analysis with better spatial resolution compared with cone beam computed tomography. Another great advantage of this technology is that the sample does not need special preparation or destruction in the sectioned area as in histopathologic evaluation. An odontoma with CBCT and microtomography images is presented in a 26-year-old man. It was first observed on panoramic radiographs and then by CBCT. The lesion and the impacted third molar were surgically excised using a modified Neumann approach. After removal, it was evaluated by histopathology and microtomography to confirm the diagnostic hypothesis. According to the results, micro-CT enabled the assessment of the sample similar to histopathology, without destruction of the sample. With further development, micro-CT could be a powerful diagnostic tool in future research.
Necrotizing fasciitis following laparoscopic total extra peritoneal repair of left inguinal hernia
Authors: Vishwanath Golash
Journal: J Minim Access Surg (2007)
Keywords: inguinal hernia, laparoscopy, necrotizing fasciitis
MeSH terms: Case Reports

There are rare reports of necrotizing fasciitis (NF) following laparoscopic surgery. The clinical presentation of this condition may be delayed due to non-specific symptoms and sign. The diagnosis is essentially clinical and early recognition is crucial in the management. We present a case of NF of the lower abdominal wall extending to thigh, scrotum and perianal area following the laparoscopic extraperitoneal repair of left inguinal hernia managed with extensive debridment, removal of mesh, antibiotic, and skin grafting. He was seen 6 months after his surgeries and had no disability. The extensive search on Medline, Medscape, and Google engine revealed only one case report of NF following laparoscopic total extraperitoneal repair of inguinal hernia that died and this is the second case report and the only surviving one.
Intraspinal Azygos Vein
Authors: Joanna Knapik, Elke Vereecke, Lieve Morbée
Journal: J Belg Soc Radiol (2022)
Keywords: anatomical variant, azygos vein, intraspinal, magnetic resonance imaging
MeSH terms: Case Reports

Teaching Point: Intraspinal azygos vein is an extremely rare anatomical variant; knowledge is important for correct imaging interpretation.
Efficacy of Double Membrane Filtration Immunoadsorption in Severe C1q-Binding Donor-Specific Antibody-Positive Acute Humoral Kidney Allograft Rejection: A Case Series
Authors: Martin Russwurm, Tanja Maier-Giebing, Birgit Kortus-Goetze, Philipp Russ, Hermann-Josef Groene, Joachim D Hoyer
Journal: Blood Purif (2023)
Keywords: acute antibody-mediated rejection, c1q, double membrane filtration, immunoadsorption, kidney transplantation
MeSH terms: Kidney Transplantation / adverse effects, Allografts, Antibodies, Complement C1q, Graft Rejection, Graft Survival, Humans, Kidney / pathology, Retrospective Studies, Complement C1q, Antibodies

Introduction:
Acute antibody-mediated rejection (ABMR) is an important threat to renal allograft survival in the early transplant period and the major single cause of graft loss in the first postoperative year. Semi-selective immunoadsorption (IA) remains one of the commonly applied treatments in ABMR, reducing allo-reactive antibody load. Adding double filtration plasmapheresis (DFPP) to IA might enhance therapeutic efficacy by also addressing innate humoral effectors like complement factors.
Methods:
Four patients with ABMR were treated with DFPP + IA. Clinical, histological, and immunological data and adverse events were retrospectively collected.
Results:
Here we present four high-risk treatment-refractory ABMR cases with C1q-binding donor-specific antibodies and histology of humoral rejection under treatment with DFPP + IA. While the earlier cases (within the first year after transplantation) showed marked reduction in ABMR severity and improvement of kidney function, the later cases did not respond accordingly. Late ABMR patient 1 stabilized, whereas late ABMR patient 2 did not respond to treatment.
Conclusions:
Our data support the consideration of DFPP + IA as a rescue treatment option in early, severe, high-risk ABMR cases in which other treatments failed.
Pheochromocytoma Mimicking Acute Coronary Syndrome: A Case Report
Authors: Yanwei Cheng, Lijie Qin, Long Chen
Journal: Front Oncol (2022)
Keywords: acute coronary syndrome, case report, catecholamine, electrocardiogram, pheochromocytoma
MeSH terms: Case Reports

Pheochromocytoma is a rare catecholamine-secreting tumor with highly variable clinical presentations. We herein report a patient who presented to the emergency department with precordia pain, elevated myocardial enzymes, T-wave inversions on electrocardiogram and segmental ventricular wall motion abnormalities on echocardiography, which is normally managed as suspected acute coronary syndrome (ACS). However, the urgent coronary angiography showed normal coronary arteries. During his hospital stay, a sudden increase in blood pressure allowed us to suspect a pheochromocytoma, which was confirmed by elevated levels of catecholamines and by the finding of a right adrenal mass on magnetic resonance imaging. The tumor was successfully excised and the patient is now asymptomatic. This case illustrates that pheochromocytoma can present as a mimic of ACS but this is often difficult to diagnose at first glance and often misleads clinicians into making an incorrect diagnosis. In addition, clinicians should be familiar with clinical manifestations of pheochromocytoma, which can help raise clinical suspicion and facilitate the early diagnosis and treatment of pheochromocytoma.
True or false coral snake: is it worth the risk? A Micrurus corallinus case report
Authors: Marcelo Abrahão Strauch, Guilherme Jones Souza, Jordana Nahar Pereira, Tyelli Dos Santos Ramos, Marcelo Oliveira Cesar, Marcelo Amorim Tomaz, Marcos Monteiro-Machado, Fernando Chagas Patrão-Neto, Paulo A Melo
Journal: J Venom Anim Toxins Incl Trop Dis (2018)
Keywords: coral snake, envenoming, micrurus spp, ophidism, snakebites
MeSH terms: Case Reports

Background:
Bites provoked by the genus Micrurus represent less than 1% of snakebite cases notified in Brazil, a tiny fraction compared with other genus such as Bothrops and Crotalus, which together represent almost 80% of accidents. In addition to their less aggressive behavior, habits and morphology of coral snakes are determinant factors for such low incidence of accidents. Although Micrurus bites are rare, victims must be rescued and hospitalized in a short period of time, because this type of envenoming may evolve to a progressive muscle weakness and acute respiratory failure.
Case presentation:
We report an accident caused by Micrurus corallinus involving a 28-year-old Caucasian sailor man bitten on the hand. The accident occurred in a recreational camp because people believed the snake was not venomous. The victim presented neurological symptoms 2 h after the accident and was taken to the hospital, where he received antielapidic serum 10 h after the bite. After the antivenom treatment, the patient presented clinical evolution without complications and was discharged 4 days later.
Conclusions:
We reinforce that it is essential to have a health care structure suitable for the treatment of snakebite. Besides, the manipulation of these animals should only be carried out by a team of well-equipped and trained professionals, and even so with special attention.
A cross-validation-based approach for delimiting reliable home range estimates
Authors: Eric R Dougherty, Colin J Carlson, Jason K Blackburn, Wayne M Getz
Journal: Mov Ecol (2017)
Keywords: duration, epidemiology, home range, t-locoh, time local convex hulls, visitation, cross-validation

Background:
With decreasing costs of GPS telemetry devices, data repositories of animal movement paths are increasing almost exponentially in size. A series of complex statistical tools have been developed in conjunction with this increase in data. Each of these methods offers certain improvements over previously proposed methods, but each has certain assumptions or shortcomings that make its general application difficult. In the case of the recently developed Time Local Convex Hull (T-LoCoH) method, the subjectivity in parameter selection serves as one of the primary impediments to its more widespread use. While there are certain advantages to the flexibility it offers for question-driven research, the lack of an objective approach for parameter selection may prevent some users from exploring the benefits of the method.
Methods:
Here we present a cross-validation-based approach for selecting parameter values to optimize the T-LoCoH algorithm. We demonstrate the utility of the approach using a case study from the Etosha National Park anthrax system.
Results:
Utilizing the proposed algorithm, rather than the guidelines in the T-LoCoH documentation, results in significantly different values for derived site fidelity metrics.
Conclusions:
Due to its basis in principles of cross-validation, the application of this method offers a more objective approach than the relatively subjective guidelines set forth in the T-LoCoH documentation and enables a more accurate basis for the comparison of home ranges among individuals and species, as well as among studies.
A case of squamous cell carcinoma arising from a suprapubic cystostomy tract in a patient with spinal bifida: Immunohistochemical analysis and literature review
Authors: Harutake Sawazaki, Yosuke Kitamura, Atsushi Asano, Yuji Ito, Hitoshi Tsuda
Journal: IJU Case Rep (2022)
Keywords: biomarker, immunohistochemical analysis, spina bifida, squamous cell carcinoma, suprapubic cystostomy tract
MeSH terms: Case Reports

Introduction:
Squamous cell carcinoma arising from a suprapubic cystostomy tract is a rare complication of an indwelling catheter and is caused by long-term inflammation and mechanical irritation. Prognosis is relatively poor. Biomarkers in the cancer pathway have not been investigated.
Case presentation:
A 61-year-old woman with a 34-year history of suprapubic catheter placement presented with a rapidly growing elevated lesion around the cystostomy site. Tumor biopsy confirmed squamous cell carcinoma. Local excision with partial cystectomy was performed. Multiple metastases were identified 5 months later. The patient died 14 months after the initial treatment. Immunohistochemical analysis of the resected specimen revealed alterations in vascular endothelial growth factor, epidermal growth factor receptor, cyclooxygenase-2, and Ki-67.
Conclusion:
We encountered a case of squamous cell carcinoma arising from a suprapubic cystostomy tract. Immunohistochemical analysis revealed activation of multiple carcinogenic pathways in cancer cells, including those for angiogenesis, signal transduction by epidermal growth factor receptor, inflammation, and cell proliferation.
COVID-19 during pregnancy: case report and literature review
Authors: Nadia Slimene, Cyrine Bennasrallah, Hela Abroug, Ines Charrada, Wafa Dhouib, Imen Zemni, Manel Ben Fredj, Chawki Loussaief, Asma Belguith Sriha
Journal: Pan Afr Med J (2023)
Keywords: covid-19, case report, maternal, outbreak, pregnancy
MeSH terms: COVID-19, Pregnancy Complications, Infectious, Premature Birth / epidemiology, Review, Case Reports, Female, Humans, Infant, Infant, Newborn, Pregnancy, Pregnancy Outcome, SARS-CoV-2

The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the newly discovered coronavirus is a serious public health emergency and a highly infectious disease. Evidence to date suggests that there are groups of people who are at a higher risk of getting severe COVID-19 disease such as pregnant women and their fetuses. We reported 4 cases of pregnant women with COVID-19 admitted in the national containment center, Tunisia (3 imported cases and one local case). The age range of the patients was 27-35 years and the range of gestational weeks at admission was 16 weeks to 32 weeks. None of the patients had underlying diseases. All four cases were totally asymptomatic and presented no complications. Two of them gave birth one by vaginal and the other by cesarean delivery, neonates presented no symptoms and no adverse outcomes. The current report does not present significant differences in the disease prognosis in the pregnant women´s group compared with the general women´s population. Careful observation, data collection and consecutive research are necessary.