OpenMed/multicare-articles huggingface dataset:
Effectiveness of Steroid Pulse Therapy for Systemic Side Effects after Bacillus Calmette-Guérin Intravesical Instillation Therapy: A Series of Five Cases
Authors: Tatsuya Umemoto, Jun Naruse, Yukio Usui, Hidenori Zakoji, Hideshi Miyakita, Akira Miyajima
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Introduction:
Bacillus Calmette-Guérin (BCG) instillation is an established therapy for the treatment of carcinoma in situ (CIS) of the bladder and prevention of recurrence after transurethral resection of bladder tumor noninvasive bladder cancer. However, serious systemic side effects may occur in less than 5% of patients with BCG intravesical instillation. Systemic side effects can sometimes be fatal and require early and accurate treatment. We describe five cases wherein steroid pulse therapy was effective for treating the systemic side effects after BCG intravesical instillation. Case Presentations. BCG intravesical instillation was used to prevent the recurrence of nonmuscle invasive bladder cancer and treat CIS of the bladder; the dose used was 40-80 mg each time, and the Tokyo strain was used. The patients developed fever, impaired consciousness, arthralgia, conjunctival hyperemia, and symptoms of cystitis. The median time from installation to side effect manifestation was 6 days (0-8). One to two courses of steroid pulse therapy were administered (1 course in 3 days), and the dose of methylprednisolone was 500-1000 mg/day. BCG sepsis was observed in one case; however, in the other four cases, one course of steroid pulse therapy showed a rapid improvement in symptoms. In the case of BCG sepsis, hemodialysis and mechanical ventilation were required because of septic shock and acute renal failure. Antituberculosis drugs (isoniazid, rifampicin, and ethambutol) were started promptly; however, no improvement was noticed. Two courses of steroid pulse therapy improved the patient's general condition, and hemodialysis and mechanical ventilation were no longer required. All patients survived without relapse of symptoms.
Conclusion:
Our cases suggest that early steroid pulse therapy may be effective for rapid symptom improvement of the systemic side effects of BCG instillation therapy.
Cateterismo de artéria mesentérica para tratamento de trombose de veia porta
Authors: Guilherme Benjamin Brandão Pitta, Deise Azevedo Pereira, Milena de Fátima Queiroz Oliveira, Eduardo Abadie Guedes, Joaquim Araújo Sampaio
Journal: J Vasc Bras (2017)
MeSH terms: Case Reports

Abstract:
Portal vein thrombosis is a rare vascular cause of acute abdomen and it is directly related to hereditary or acquired thrombophilias. This article presents the case of a 60-year-old male patient, with clinical signs of mesenteric ischemia that was confirmed by imaging examination. He underwent enterectomy and enteroanastomosis and, after detection of portal vein thrombosis by splenoportography, he was prescribed drug-based treatment with continuous infusion of recombinant tissue plasminogen activator (Alteplase) via selective catheterization of the superior mesenteric artery. This is a treatment innovation. The portal system was successfully recanalized. However, the patient developed abdominal sepsis and required intensive care for 25 days. His clinical status improved and he was discharged with a prescription for oral anticoagulant. This article presents a brief review of the literature and a discussion of portal vein thrombosis.
Giant splenic pseudocyst, a rare aetiology of abdominal tumor: a case report
Authors: Mamadou Cissé, Ibrahima Konaté, Ousmane Ka, Madieng Dieng, Abdarahmane Dia, Cheikh T Touré
Journal: Cases J (2010)

Introduction:
Splenic pseudocysts are nonparasitic cyst without epithelial lining. We report this case especially by its way of revelation, its large size and its per operative presentation which needed total splenectomy. To this opportunity, we discuss the diagnostic procedure and therapeutic indications.
Case presentation:
A twenty-year old Senegalese woman, was admitted with a three-month history of spontaneous abdominal mass associated with a pain. Ultrasonography and CT scan found the giant splenic pseudocyst with a diameter of 20 cm which needed a total splenectomy by median laparotomy.
Conclusion:
Usually, symptomless splenic cysts are untreated. When surgical treatment is indicated, recommendations are to preserve splenic parenchyma by partial splenectomy or fenestration especially by laparoscopy. Total splenectomy retains some guidance.
An Unusual Coexistence of Primary Central Nervous System Non-Hodgkin's Lymphoma and Acute Promyelocytic Leukemia
Authors: Nicola Stefano Fracchiolla, Mariarita Sciumè, Giulia Cernuschi, Agostino Cortelezzi
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Acute promyelocytic leukemia and primary central nervous system lymphoma are uncommon hematological malignancies. The co-occurrence of acute myeloid leukemia with various lymphoproliferative diseases is an extremely rare condition, especially in the absence of previous chemotherapy or radiotherapy. Herein, we provide a comprehensive characterization of a patient with concomitant diagnosis of extranodal high-grade non-Hodgkin B-cell neoplasm confined to the central nervous system and acute promyelocytic leukemia. We describe the efficacy and feasibility of the consecutive use of all-trans retinoic acid and arsenic trioxide-containing regimen for the treatment of promyelocytic leukemia and high-dose methotrexate plus cytarabine to treat lymphoproliferative involvement of the central nervous system.
Psychosocial health of asylum seeking women living in state-provided accommodation in Germany during pregnancy and early motherhood: A case study exploring the role of social determinants of health
Authors: Sandra Claudia Gewalt, Sarah Berger, Sandra Ziegler, Joachim Szecsenyi, Kayvan Bozorgmehr
Journal: PLoS One (2018)
MeSH terms: Refugees / psychology, Social Determinants of Health, Stress, Psychological / psychology, Research Support, Non-U.S. Gov't, Adaptation, Psychological, Adult, Family Relations / psychology, Female, Germany, Humans, Pregnancy, Qualitative Research, Resilience, Psychological, Social Support, Stress, Psychological / diagnosis, Surveys and Questionnaires, Uncertainty, Young Adult

Background:
Pregnant women and new mothers seeking asylum are subject to major challenges that may affect their health and increase their vulnerability. The study aim was to investigate asylum seeking women's experiences and perceived needs during pregnancy and early motherhood whilst living in state-provided accommodation in one federal state in Southern Germany, with a particular focus on psychosocial factors.
Methods:
In this exploratory case study, individual semi-structured interviews were conducted with participants in pregnancy and up to the six-week postnatal assessment. Two female interviewers performed interviews assisted by female professional interpreters. Interviews were recorded digitally and transcribed verbatim. An inductive approach was taken to content analysis of interview material.
Results:
21 interviews were performed with nine women seeking asylum in pregnancy and early motherhood. Women shared experiences and perceived consequences on their psychosocial health. The following five key themes were identified during content analysis: a) psychosocial stressors, b) stressful living circumstances, c) stressful relationships, d) social support and e) coping styles. Psychosocial factors were a significant source of mental stress for participants, especially due to future uncertainties linked with the asylum seeking process. Living circumstances were also marked by stressors including a lack of privacy, verbal and physical threats and experiences of powerlessness. Further strain and emotional pressure were caused by stressful relationships with the unborn child's father. Social support and personal coping styles provided relief for some participants.
Conclusions:
This study provides in-depth insights into the experiences and perceived needs of pregnant asylum seekers and new mothers living in state-provided accommodation. Key results identified psychosocial factors such as future uncertainties, stressful living circumstances and stressful relationships, as social determinants of health that were perceived to adversely affect women's health. Adequate social support and individual coping styles increased resilience and counterbalanced psychosocial stressors during the asylum seeking process.
Exome Sequencing: Mutilating Sensory Neuropathy with Spastic Paraplegia due to a Mutation in FAM134B Gene
Authors: Salma M Wakil, Dorota Monies, Samya Hagos, Fahad Al-Ajlan, Josef Finsterer, Aisha Al Qahtani, Khushnooda Ramzan, Rawan Al Humaidy, Mohamed A Al-Muhaizea, Brian Meyer, Saeed A Bohlega
Journal: Case Rep Genet (2018)
MeSH terms: Case Reports

Hereditary sensory and autonomic neuropathies (HSANs) are a clinically and genetically heterogeneous group of disorders involving various sensory and autonomic dysfunctions. The most common symptoms of HSANs include loss of sensations of pain and temperature that frequently lead to chronic ulcerations in the feet and hands of the patient. In this case study, we present the clinical features and genetic characteristics of two affected individuals from two unrelated Saudi families presenting mutilating sensory loss and spastic paraplegia. We employed homozygosity mapping and exome sequencing which is an efficient strategy to characterize the recessive genes, thus obtaining a rapid molecular diagnosis for genetically heterogeneous disorders like HSAN. Subsequently, a nonsense mutation (c.926 C>G; p.S309⁎) in FAM134B was identified. In addition, we confirmed that the mutant FAM134B transcripts were reduced in these patients presumably disrupting the receptors of the degradative endoplasmic reticulum pathways that facilitate the autophagy processes.
A case of severe leptospirosis with Jarisch-Herxheimer reaction presenting as respiratory failure
Authors: Yunzhen Shi, Wanru Guo, Ming Hu, Yuxuan Wang, Jingnan Li, Wenjuan Hu, Xiaomeng Li, Kaijin Xu
Journal: Front Public Health (2023)
Keywords: jarisch-herxheimer reaction, imaging features, leptospirosis, metagenomic next-generation sequencing, pulmonary alveolar hemorrhage
MeSH terms: Leptospirosis / complications, Leptospirosis / diagnosis, Leptospirosis / drug therapy, Respiratory Insufficiency / etiology, Case Reports, Research Support, Non-U.S. Gov't, Anti-Bacterial Agents / adverse effects, Humans, Penicillins / adverse effects, Tetracycline, Penicillins, Anti-Bacterial Agents, Tetracycline

Background:
Leptospirosis is a widespread zoonotic disease caused by pathogenic Leptospira spp. The treatment of penicillin or tetracycline can cause a Jarisch-Herxheimer reaction (JHR), which can lead to acute respiratory distress syndrome (ARDS) and multi-organ failure in severe cases. The overall course of evolution and imaging features of a JHR exacerbation of leptospirosis have rarely been reported.
Case presentation:
We present a case of leptospirosis complicated by pulmonary alveolar hemorrhage and a Jarisch-Herxheimer reaction (JHR) that required respiratory and vasopressor support. This case demonstrates a well-defined course of evolution of JHR and the imaging features.
Conclusions:
Leptospirosis is easily misdiagnosed in some sporadic areas, and JHR complicates its management. Early diagnosis and appropriate treatment can reduce the mortality of severe leptospirosis with JHR.
Case report: Mixed infection of bovine papillomaviruses associated with squamous papilloma of the upper alimentary tract in a dairy cow
Authors: Kamila Peruchi Fernandes, Amauri Alcindo Alfieri, Gabriela Molinari Darold, Fabiana Marques Boabaid, Alais Maria Dall Agnol, Michele Lunardi
Journal: Front Vet Sci (2022)
Keywords: bpv, pcr, cattle, esophagus, rumen, sequencing
MeSH terms: Case Reports

Bovine papillomavirus (BPV) infection can induce neoplastic lesions in both cutaneous and mucosal epithelia in cattle. This study describes the BPV types associated with proliferative lesions with diverse histopathological features present in the upper alimentary tract of a dairy cow suffering from chronic diarrhea from Midwestern Brazil. At autopsy, warts and plaques composed of multiple spherical nodules were observed in the esophageal mucosa, the areas surrounding and constricting the opening of the cardia, and the rumen pillars. One esophageal papillomatous proliferative lesion and a smooth-surfaced proliferative lesion located at the rumen entrance were evaluated by histopathological and molecular analyses. PCR amplification of partial fragments of the BPV L1 and E1 genes was performed followed by sequencing of the obtained amplicons. Upon histopathological evaluation, the esophageal lesion was classified as a squamous papilloma, whereas the other ruminal proliferative lesion consisted of a fibropapilloma. Direct sequencing of PCR products obtained from ruminal fibropapilloma DNA revealed the presence of BPV2. Sequencing of inserts from selected clones containing partial fragments of the BPV L1 and E1 genes revealed a mixed infection of BPV types 2 and 4 in the esophageal squamous papilloma. The findings reported in our investigation reinforce the association of BPV with benign lesions of the bovine alimentary tract in both single and mixed infections, as previously demonstrated to occur in a buffalo. In addition, this report represents the documentation of the occurrence of massive alimentary papillomatosis associated with BPV types 2 and 4 in cattle raised on lands without infestation by bracken fern in Midwestern Brazil.
Powered knee and ankle prosthesis use with a K2 level ambulator: a case report
Authors: Ann M Simon, Suzanne B Finucane, Andrea J Ikeda, R James Cotton, Levi J Hargrove
Journal: Front Rehabil Sci (2023)
Keywords: above-knee amputation, artificial leg, case report, older adult, physical therapy, prosthesis training, rehabilitation, robotic prosthesis
MeSH terms: Case Reports

Powered prosthetic knees and ankles have the capability of restoring power to the missing joints and potential to provide increased functional mobility to users. Nearly all development with these advanced prostheses is with individuals who are high functioning community level ambulators even though limited community ambulators may also receive great benefit from these devices. We trained a 70 year old male participant with a unilateral transfemoral amputation to use a powered knee and powered ankle prosthesis. He participated in eight hours of therapist led in-lab training (two hours per week for four weeks). Sessions included static and dynamic balance activities for improved stability and comfort with the powered prosthesis and ambulation training on level ground, inclines, and stairs. Assessments were taken with both the powered prosthesis and his prescribed, passive prosthesis post-training. Outcome measures showed similarities in velocity between devices for level-ground walking and ascending a ramp. During ramp descent, the participant had a slightly faster velocity and more symmetrical stance and step times with the powered prosthesis compared to his prescribed prosthesis. For stairs, he was able to climb with reciprocal stepping for both ascent and descent, a stepping strategy he is unable to do with his prescribed prosthesis. More research with limited community ambulators is necessary to understand if further functional improvements are possible with either additional training, longer accommodation periods, and/or changes in powered prosthesis control strategies.
Case Report: Osmotic Demyelination Syndrome After Transcatheter Aortic Valve Replacement: Case Report and Review of Current Literature
Authors: Xinhao Jin, Yonggang Wang
Journal: Front Med (Lausanne) (2022)
Keywords: case report, hyponatremia, osmotic demyelination syndrome (ods), serum sodium, transcatheter aortic valve replacement
MeSH terms: Case Reports

Background:
Osmotic demyelination syndrome (ODS) has a low incidence but is a life-threatening neurological disorder whose common cause is rapid overcorrection of chronic hyponatremia. Transcatheter aortic valve replacement (TAVR) is a new and important therapy for patients with aortic valve stenosis. In this article, we discuss the case of a 64-year-old woman who developed ODS after TAVR and provide a literature review.
Case presentation:
A 64-year-old female patient was admitted to the hospital with chest tightness, shortness of breath, and fatigue for 2 months, with worsening of symptoms for 3 days prior to presentation. Auscultation revealed crackles in the lung fields, and systolic murmurs could be easily heard in the aortic area. Echocardiography showed severe aortic stenosis. Chest X-ray showed pulmonary oedema. Laboratory examinations showed that her serum sodium was 135 mmol/L. The patient received a diuretic to relieve her symptoms but showed little benefit. Her symptoms worsened, and her blood pressure dropped. Then, she underwent emergency TAVR under extracorporeal membrane oxygenation (ECMO) support. After the operation, her urine output increased markedly, and serum sodium increased sharply from 140 to 172 mmol/L. An MRI scan showed multiple lesions in the pons suggestive of ODS.
Conclusion:
To date, this is the first reported case of a patient who developed ODS after receiving TAVR. In current clinical practice, diuretics are often used in aortic stenosis patients because of pulmonary oedema. After a patient receives TAVR, kidney perfusion pressure quickly returns to normal, and with the residual effect of a high-dose diuretic, balances of fluid volume and electrolyte levels in this phase are quite fragile and must be carefully managed. If a patient has neurological symptoms/signs during this phase, ODS should be considered, and MRI might be necessary.
An Unusual Pulmonary Aspergillus Infection: Endobronchial Aspergilloma
Authors: Ashok Kuwal, Rishabh Kochar, Rishabh Agarwal
Journal: Cureus (2023)
Keywords: aspergillus, endobronchial aspregilloma, endobronchial mass, haemoptysis, pulmonary aspergillosis
MeSH terms: Case Reports

Endobronchial aspergilloma (EBA) is an extremely rare presentation of pulmonary involvement of Aspergillus. It is a noninvasive form of pulmonary aspergillosis where the fungus overgrows and colonizes the bronchial lumen. The patient may present with chronic cough, dyspnea, hemoptysis, or wheezing. The diagnosis is usually incidental when bronchoscopy is performed to evaluate the cause of hemoptysis or radiological abnormalities. Here, we report a case of a middle-aged female who presented with hemoptysis and right middle lobe collapse and was subsequently diagnosed to have EBA on bronchoscopy with endobronchial biopsy. Although EBA is rare, it should be considered as a differential in the evaluation of endobronchial mass lesions.
Clinical Applications of Mineral Trioxide Aggregate: Report of Four Cases
Authors: Rahul Hegde, Prashant M Battepati
Journal: Int J Clin Pediatr Dent (2010)
Keywords: apexification, mta, apexogenesis, pulpotomy
MeSH terms: Case Reports

The greatest threats to developing teeth are dental caries and traumatic injuries. The primary goal of all restorative treatment is to maintain pulp vitality so that normal root development or apexogenesis can occur. If pulpal exposure occurs, then a pulpotomy procedure aims to preserve pulp vitality to allow for normal root development. Historically, calcium hydroxide has been the material of choice for pulpotomy procedures. Recently, an alternative material called mineral trioxide aggregate (MTA) has demonstrated the ability to induce hard-tissue formation in pulpal tissue. This article describes the clinical and radiographic outcome of a series of cases involving the use of MTA in pulpotomy, apexogenesis and apexification procedures and root perforations repair.
Replacement of gluteal implants by polymethyl methacrylate filler: case report
Authors: Roberto Chacur, Honório Sampaio Menezes, Nívea Maria Bordin da Silva Chacur, Danuza Dias Alves, Rodrigo Cadore Mafaldo, Leandro Dias Gomes, Gina Matzenbacher, Renata Bataiolli
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: esthetics, plastic surgery, polymethyl methacrylate, prosthesis
MeSH terms: Case Reports

Silicone prostheses are an alternative to shape the buttock but further studies are still needed to support the effectiveness of its use. A patient sought medical attention for being dissatisfied with the glutaeal silicone prostheses inserted using subcutaneous technique four years before. The treatment adopted was prosthesis removal surgery, and subsequent filling with PMMA.
Angiofibroma of the Vagina Presenting with Abnormal Vaginal Bleeding: A Case Report from Ethiopia and Review of the Literature
Authors: Chuchu Arega, Wubshet Girma, Jose Manuel Sanchez Diaz
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Angiofibroma is an uncommon type of vascular benign tumor that is made up of blood vessels and fibrous (connective) tissue. First described in 1997, it usually occurs in middle aged females and is clinically often thought to represent a cyst. Unlike most of the other site specific vulvovaginal mesenchymal lesions, cellular angiofibroma has a marked predilection for the vulva with only occasional examples reported in the vagina.
Case detail:
A 17-year adolescent nulligravid girl presented with a history of irregular vaginal bleeding of two-year duration and history of lower abdominal swelling; on examination, she had pale conjunctiva, 20-week sized firm, irregular, nontender abdominopelvic mass, and a firm huge anterior vaginal wall mass, with difficulty to reach at the cervix and hemoglobin of 9.7 gm/dL, and a diagnosis of cervical myoma plus anemia was made, which was supported by imaging studies. Finally it was found to be angiofibroma of the vagina.
Conclusion:
Angiofibromas are benign tumors, which rarely occur in vagina. Although middle aged females are affected more, angiofibromas can affect females of reproductive age group and can cause abnormal uterine bleeding.
Case Report: Posterior Thoracic Window in the Presence of Pleural Effusion in Critical Care Medicine: One More Chance to Image the Aortic Valve
Authors: Francesca Mantovani, Giovanni Benfari, Andrea Barbieri, Francesco Manca, Vincenzo Guiducci, Alessandro Navazio, Marie-Annick Clavel
Journal: Front Cardiovasc Med (2022)
Keywords: aortic regurgitation, aortic stenosis, case report, echocardiography, posterior thoracic view
MeSH terms: Case Reports

Good quality echocardiographic images in the setting of critical care medicine may be difficult to obtain for many reasons. We present a case of an 85-year-old woman with acute pulmonary edema and pleural effusion, where transthoracic bedside echocardiographic examination raised a suspicion for significant aortic valve disease. However, given the orthopneic decubitus of the patients, the quality of images was poor. To increase the accuracy of diagnosis, a posterior thoracic view through the pleural effusion in the sitting position was used. This view allowed the diagnosis of mixed aortic valve disease (aortic stenosis and regurgitation) and the quantification of valve disease through multiparametric criteria as recommended by current guidelines. The posterior thoracic view, when feasible, may provide a useful option in the assessment of cardiac structures and further diagnostic information in technically difficult echocardiographic examinations.