OpenMed/multicare-articles huggingface dataset:
Localizing Clinical Patterns of Blast Traumatic Brain Injury Through Computational Modeling and Simulation
Authors: Scott T Miller, Candice F Cooper, Paul Elsbernd, Joseph Kerwin, Ricardo Mejia-Alvarez, Adam M Willis
Journal: Front Neurol (2021)
Keywords: blast, cavitation, computation, interfacial injury, simulation, traumatic brain injury

Blast traumatic brain injury is ubiquitous in modern military conflict with significant morbidity and mortality. Yet the mechanism by which blast overpressure waves cause specific intracranial injury in humans remains unclear. Reviewing of both the clinical experience of neurointensivists and neurosurgeons who treated service members exposed to blast have revealed a pattern of injury to cerebral blood vessels, manifested as subarachnoid hemorrhage, pseudoaneurysm, and early diffuse cerebral edema. Additionally, a seminal neuropathologic case series of victims of blast traumatic brain injury (TBI) showed unique astroglial scarring patterns at the following tissue interfaces: subpial glial plate, perivascular, periventricular, and cerebral gray-white interface. The uniting feature of both the clinical and neuropathologic findings in blast TBI is the co-location of injury to material interfaces, be it solid-fluid or solid-solid interface. This motivates the hypothesis that blast TBI is an injury at the intracranial mechanical interfaces. In order to investigate the intracranial interface dynamics, we performed a novel set of computational simulations using a model human head simplified but containing models of gyri, sulci, cerebrospinal fluid (CSF), ventricles, and vasculature with high spatial resolution of the mechanical interfaces. Simulations were performed within a hybrid Eulerian-Lagrangian simulation suite (CTH coupled via Zapotec to Sierra Mechanics). Because of the large computational meshes, simulations required high performance computing resources. Twenty simulations were performed across multiple exposure scenarios-overpressures of 150, 250, and 500 kPa with 1 ms overpressure durations-for multiple blast exposures (front blast, side blast, and wall blast) across large variations in material model parameters (brain shear properties, skull elastic moduli). All simulations predict fluid cavitation within CSF (where intracerebral vasculature reside) with cavitation occurring deep and diffusely into cerebral sulci. These cavitation events are adjacent to high interface strain rates at the subpial glial plate. Larger overpressure simulations (250 and 500kPa) demonstrated intraventricular cavitation-also associated with adjacent high periventricular strain rates. Additionally, models of embedded intraparenchymal vascular structures-with diameters as small as 0.6 mm-predicted intravascular cavitation with adjacent high perivascular strain rates. The co-location of local maxima of strain rates near several of the regions that appear to be preferentially damaged in blast TBI (vascular structures, subpial glial plate, perivascular regions, and periventricular regions) suggest that intracranial interface dynamics may be important in understanding how blast overpressures leads to intracranial injury.
Aseptic meningitis following a bupivacaine spinal anesthesia
Authors: Nawfal Doghmi, Amine Meskine, Aziz Benakroute, Mustapha Bensghir, Abdelouahed Baite, Charki Haimeur
Journal: Pan Afr Med J (2017)
Keywords: aseptic meningitis, bupivacaine, spinal anesthesia
MeSH terms: Anesthesia, Obstetrical / adverse effects, Anesthesia, Spinal / adverse effects, Bupivacaine / adverse effects, Meningitis, Aseptic / chemically induced, Case Reports, Adult, Anesthesia, Obstetrical / methods, Anesthesia, Spinal / methods, Anesthetics, Local / administration & dosage, Anesthetics, Local / adverse effects, Bupivacaine / administration & dosage, Cesarean Section / methods, Female, Humans, Pregnancy, Tomography, X-Ray Computed, Anesthetics, Local, Bupivacaine

Spinal anesthesia complicated by meningitis is rare. The diagnosis is difficult and the clinical signs are unspecific. There is a subgroup called aseptic meningitis of a different mechanism (hypersensitive reaction and irritation of the meninges), which must be identified for appropriate care. We report the case of aseptic meningitis resulting from bupivacaine use complicating spinal anesthesia. She is 31 years old and was admitted to the intensive care unit for meningitis following a Caesarean delivery. 10 hours after the procedure, she was found to have severe headache, neck stiffness and was found restless. She lost consciousness; she was treated by attending physicians. A CT scan have been performed and was found normal. 24 hours after intubation, the patient woke up. The clinical and biological valuations were normal, allowing for the elimination of the other causes of meningitis.
Achalasia as an Unusual Cause of Acute Cellular Rejection of a Transplanted Heart
Authors: Amanda Fernandes, Crystal Lihong Yan, Phillip Ruiz, Nina Thakkar Rivera
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

A 68-year-old female with end-stage heart failure presented to the hospital for heart transplant. She was diagnosed with achalasia 14 months prior and treated with frequent botulinum toxin injections. She underwent orthotopic heart transplant on the day of admission and was extubated a few days later. She developed intractable nausea and vomiting. Her first endomyocardial biopsy revealed moderate, approaching severe rejection. She was treated with high-dose intravenous pulse steroids. Fluoroscopy at the time of follow-up biopsy showed undigested pills in her esophagus with narrowing at the distal end and thus failure to deliver immunosuppressive therapy. This case highlights achalasia as an etiology for acute rejection and its potential management.
Infantile epileptic spasms syndrome as an initial presentation in infantile choroid plexus papilloma: A case report
Authors: Faliang Zhou, Yu Li, Lixue Shen, Hongxin Yao, Xinlin Hou
Journal: Front Pediatr (2022)
Keywords: choroid plexus papilloma, infantile epileptic spasms syndrome, infantile spasms (is), ventriculomegaly, west syndrome
MeSH terms: Case Reports

We present an interesting report of a 5-month-old infant with epileptic spasms and developmental delay who presented with non-isolated ventriculomegaly in utero and whose brain magnetic resonance imaging revealed right ventricular choroid plexus papilloma (CPP). The epileptic spasms persisted even with the use of antiepileptic therapies but was apparently cured after the removal of a CPP.
A fatal case of oxygen embolism in a hospital
Authors: Lionel Comment, Vincent Varlet, Kewin Ducrot, Silke Grabherr
Journal: Forensic Sci Res (2017)
Keywords: forensic science, air embolism, autopsy, forensic imaging, gas analysis
MeSH terms: Case Reports

This case reports on a 68-year-old man who was found dead in hospital next to his bed. Before this, he had been treated with intravenous antibiotics for pneumonia. The body was found with a peripheral venous catheter connected to a nasal cannula delivering oxygen (O2) from the wall. Extensive medico-legal examinations were performed, including post-mortem computed tomography (CT), complete conventional autopsy, histological and immunohistochemistry analysis, toxicological analysis and post-mortem chemistry. Additionally, CT-guided gas sampling was performed at multiple sites to collect samples for gas analysis. During the external examination, massive subcutaneous emphysema was visible over the entire surface of the body. The CT scan revealed the presence of gas throughout the vascular system, and in the subcutaneous and muscular tissues. The autopsy confirmed the presence of lobar pneumonia and multiple gas bubbles in the vascular system. The gas analysis results showed a subnormal concentration of oxygen, confirming the suspected pure O2 embolism. Moreover, the carbon dioxide (CO2) concentration in the gas sample from the heart was elevated to a level similar to those found in scuba diving fatalities. This could come from degassing of dissolved CO2 that accumulated and was trapped in the cardiac cavity. Based on the results of the different exams performed, and especially the gas analysis results, it was concluded that the cause of death was O2 embolism.
Granulomonocytapheresis Using the Single-Needle Method for a Girl with Ulcerative Colitis
Authors: Yoshiaki Sasaki, Hiroki Kajino
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Granulomonocytapheresis (GMA) is an effective treatment for inducing remission in patients with refractory ulcerative colitis (UC). Furthermore, GMA has very few side effects and can be performed without using drugs except anticoagulants. However, GMA is sometimes challenging to perform, especially in children, as it usually requires securing two blood vessels. We attempted GMA by the single-needle method in a girl with UC, which is performed by securing only one blood vessel. In the present case, GMA could be performed 10 times without any side effects. Our case shows that GMA with the single-needle method was feasible in children with UC.
Behçet Disease
Authors: Kelly Di Dier, Benjamin Leenknegt, Marc Lemmerling
Journal: J Belg Soc Radiol (2022)
Keywords: behçet disease, budd chiari syndrome, aortitis, computed tomography, inferior caval vein thrombosis, ultrasound, vasculitis
MeSH terms: Case Reports

Teaching Point: Although Behçet disease is a multisystemic and chronic vasculitis, it can be superimposed with a variety of acute vasculitis.
Sarcomatoid carcinoma of the prostate: ductal adenocarcinoma and stromal sarcoma-like appearance: a rare association
Authors: David Parada, Karla B Peña, Francesc Riu
Journal: Case Rep Urol (2011)
MeSH terms: Case Reports

Sarcomatoid carcinoma (SC) of prostate gland is a rare biphasic tumour. In about half of cases, initial diagnosis is acinar adenocarcinoma, followed by nonsurgical therapy, with a subsequent diagnosis of SC. The survival rate is lower. We report a case of an 59-years-old man with unusual histopathologic finding of prostate sarcomatoid carcinoma, showing characteristics of ductal prostatic adenocarcinoma and prostatic stromal sarcoma-like appearance. Ductal adenocarcinoma was characterized by tall columnar cells with abundant amphophilic to eosinophil cytoplasm. Pleomorphic sarcoma was characterized to have overall glandular growth pattern, simulating a malignant phyllodes tumour. Estrogen and progesterone receptors showed nuclear immunostaining in mesenchymal multinucleated giant cells. In conclusion, SC of the prostate is an exceedingly rare tumour. Retrospective analyses render prostate SC as one of the most aggressive prostate malignancies. The prognosis is dismal regardless of other histologic or clinical findings.
Successful Outcome and Biliary Drainage in an Infant with Concurrent Alpha-1-Antitrypsin Deficiency and Biliary Atresia
Authors: Andrew W Wang, Kimberly Newton, Karen Kling
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

We describe the rare instance of concomitant biliary atresia and alpha-1-antitrypsin deficiency and the first documented successful portoenterostomy in this scenario. The potential for dual pathology must be recognized and underscores that prompt diagnosis of biliary atresia, despite concomitant alpha-1-antitrypsin deficiency, is essential to afford potential longstanding native liver function.
Warthin-like papillary thyroid carcinoma: a case report and comprehensive review of the literature
Authors: Abdel Mouhaymen Missaoui, Fatma Hamza, Wafa Belabed, Manel Mellouli, Mohamed Maaloul, Slim Charfi, Issam Jardak, Tahya Sellami-Boudawara, Nabila Rekik, Mohamed Abid
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: case report, chronic lymphocytic thyroiditis, papillary thyroid carcinoma, review of the literature, thyroid neoplasms, thyroid nodule, warthin-like papillary thyroid carcinoma
MeSH terms: Carcinoma / pathology, Carcinoma, Papillary / pathology, Hashimoto Disease / complications, Thyroid Neoplasms / complications, Thyroid Neoplasms / diagnosis, Thyroid Neoplasms / surgery, Case Reports, Review, Adult, Female, Humans, Male, Thyroid Cancer, Papillary / complications

Background:
Papillary Thyroid Carcinoma (PTC) is the most frequent endocrine malignancy with a variety of histological presentations. Warthin-like Papillary Thyroid Carcinoma (WLPTC) is an uncommon neoplasm that is recognized as a distinct subtype of PTC in the WHO classification of thyroid tumors. In this report, we present a novel case of WLPTC in a female patient and provide an in-depth review of the available literature on its clinical, pathological, and therapeutic characteristics.
Case presentation:
A 27-year-old female patient was referred for neck swelling. Ultrasound showed two suspicious thyroid nodules leading to a thyroidectomy. She was diagnosed with intermediate-risk bifocal foci of classic PTC and WLPTC, arising from a background of chronic lymphocytic thyroiditis (CLT). This pT1b(m) N1b M0 malignancy was treated with adjuvant isotopic ablation and suppressive thyroxine therapy. The 1-year outcomes were favorable.
Literature review:
It covered articles published from 1995 to 2022, by searching PubMed and Google Scholar using specific terms. Out of 148 articles reviewed by two authors, 25 relevant articles were selected, including 13 case reports and 12 case series. The study included 150 cases of WLPTC. Data related to clinical presentation, imaging, histological features, management, and outcomes, were extracted. The mean age of diagnosis was 39 years, with a female predominance. The most common clinical presentation was neck swelling. Thyroid autoimmunity was positive in 71.6% of patients. Lymph node metastases were present in 28% of cases, with no reported distant metastases. Overall, the outcomes were favorable.
Conclusion:
WLPTC shares similar clinical and radiological presentations as classic PTC. The hallmark histological features of WLPTC are papillae lined with oncocytic tumor cells with papillary nuclear changes and lymphoid stroma. WLPTC is almost constantly associated with CLT. The management of WLPTC aligns with that of classic PTC with comparable stage and risk category, often resulting in favorable outcomes.
Two-stage liver transplantation with temporary porto-middle hepatic vein shunt
Authors: Giovanni Varotti, Enzo Andorno, Marco Casaccia, Stefano Di Domenico, Giuliano Bottino, Pietro Diviacco, Nicola Morelli, Chiara Ferrari, Roberto Ferrante, Umberto Valente
Journal: J Transplant (2010)
MeSH terms: Case Reports

Two-stage liver transplantation (LT) has been reported for cases of fulminant liver failure that can lead to toxic hepatic syndrome, or massive hemorrhages resulting in uncontrollable bleeding. Technically, the first stage of the procedure consists of a total hepatectomy with preservation of the recipient's inferior vena cava (IVC), followed by the creation of a temporary end-to-side porto-caval shunt (TPCS). The second stage consists of removing the TPCS and implanting a liver graft when one becomes available. We report a case of a two-stage total hepatectomy and LT in which a temporary end-to-end anastomosis between the portal vein and the middle hepatic vein (TPMHV) was performed as an alternative to the classic end-to-end TPCS. The creation of a TPMHV proved technically feasible and showed some advantages compared to the standard TPCS. In cases in which a two-stage LT with side-to-side caval reconstruction is utilized, TPMHV can be considered as a safe and effective alternative to standard TPCS.
Acute Limb Ischemia in the Young: A Rare Case of Essential Thrombocytosis
Authors: Johanes Nugroho, Ruth Gunadi
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Acute limb ischemia (ALI) is rarely observed in young populations. The hypercoagulable state is a notable cause of ALI other than artery disease progression and cardiac embolization. A hypercoagulable state occurs in essential thrombocytosis because of the overproduction of hematopoietic cells secondary to the mutation of the JAK2, CALR, or MPL genes. We report a rare case of a 37-year-old woman presenting with Rutherford IIA ALI in the left lower extremity. Laboratory data revealed she had a platelet count reaching up to 1.38 mil/μL, with other blood profiles being normal. A JAK2 mutation examination was later performed and proved positive. After careful management with catheter-directed thrombolysis, surgical thrombectomy, and cytoreductive therapy using hydroxyurea, the symptoms subsided and eventually restored the patient to physical activity in less than one month.
Unusual Case of Superior Vena Cava Syndrome Caused by Intravascular Thyroid Metastasis
Authors: Vanesa Varela Pose, María Patricia Fierro Alanis, Anaberta Bermudez Naveira, Oskarina Lourdes Silva Gonzalez, Jorge Fernandez Noya, Urbano Anido Herranz, Rafael Lopez Lopez
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Superior cava venous obstruction use to show a typical clinical presentation and a CT scan or even an ultrasonography can be sufficient to achieve an accurate diagnosis, but in this case, to obtain the final diagnosis, a multimodal assessment is needed. This case report shows a multidisciplinary approach which helped diagnose a complicated case, where conventional diagnostic methods were not enough.
An unusual pathological finding of chronic lymphocitic leukemia and adenocarcinoma of the prostate after transurethral resection for complete urinary retention: case report
Authors: Riccardo Ballario, Paolo Beltrami, Stefano Cavalleri, Lorenzo Ruggera, Maria Grazia Zorzi, Walter Artibani
Journal: BMC Cancer (2004)
MeSH terms: Adenocarcinoma / pathology, Leukemia, Lymphocytic, Chronic, B-Cell / pathology, Neoplasms, Multiple Primary / pathology, Prostatic Neoplasms / pathology, Case Reports, Adenocarcinoma / complications, Aged, Humans, Leukemia, Lymphocytic, Chronic, B-Cell / complications, Male, Neoplasms, Multiple Primary / complications, Prostatic Neoplasms / complications, Transurethral Resection of Prostate, Urinary Retention / etiology, Urinary Retention / surgery

Background:
We describe a patient who underwent transurethral resection of the prostate for urinary obstructive symptoms and had histological findings of adenocarcinoma of the prostate with prostatic localization of chronic lymphocitic leukemia (CLL). The contemporary presence of CLL, adenocarcinoma of the prostate and residual prostatic gland after transurethral resection has never been reported before and the authors illustrate how they managed this unusual patient.
Case presentation:
A 79-years-old white man, presented with acute urinary retention, had a peripheral blood count with an elevated lymphocytosis (21.250/mL) with a differential of 65.3% lymphocytes and the prostate-specific antigen (PSA) value was 3.38 ng/mL with a percent free PSA of 8.28%. The transrectal ultrasound (TRUS) indicated an isoechonic and homogenic enlarged prostate of 42 cm3 and the abdomen ultrasound found a modest splenomegaly and no peripheral lymphadenophaty. The patient underwent transurethral resection of the prostate and had a pathological finding of adenocarcinoma in the prostate with a Gleason Score 4 (2+2) of less than 5% of the material (clinical stage T1a), associated with a diffused infiltration of chronic lymphocitic leukemia elements.
Conclusions:
The incidental finding of a prostatic localization of a low-grade non-Hodgkin's lymphoma does not modify eventually further treatments for neither prostate cancer nor lymphoma. The presence of a low-grade and low-stage lymphoma, confirmed by a hematological evaluation, and the simultaneous evidence of an adenocarcinoma after transurethral resection of the prostate for acute urinary retention do not require any immediate treatment due to its long-term survival rate and the follow-up remains based on periodical PSA evaluation and complete blood count.
Resolution of novel human papillomavirus-induced warts after HPV vaccination
Authors: Steffi Silling, Ulrike Wieland, Marko Werner, Herbert Pfister, Anja Potthoff, Alexander Kreuter
Journal: Emerg Infect Dis (2014)
Keywords: hpv, hpv vaccination, hpvxs2, human papillomavirus, immunosuppressed, novel human papillomavirus, papillomavirus, quadrivalent hpv vaccine, vaccination, viruses, warts
MeSH terms: Alphapapillomavirus / immunology, Papillomavirus Vaccines / immunology, Vaccination, Warts / prevention & control, Case Reports, Research Support, Non-U.S. Gov't, Adult, Alphapapillomavirus / classification, Alphapapillomavirus / genetics, Antineoplastic Combined Chemotherapy Protocols / adverse effects, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Capsid Proteins / genetics, DNA, Viral, Female, Humans, Immunocompromised Host, Leukemia, Lymphocytic, Chronic, B-Cell / complications, Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy, Molecular Sequence Data, Phylogeny, Skin / pathology, Skin / virology, Warts / complications, Warts / diagnosis, Warts / immunology, Capsid Proteins, DNA, Viral, Papillomavirus Vaccines

Human papillomavirus (HPV) XS2 was isolated from warts on an immunosuppressed patient. After HPV vaccination, the warts resolved. HPVXS2 was also found in warts and normal skin of HIV-positive patients and rarely in HIV-negative controls. Further studies should elucidate the mechanisms that lead to wart clearance.
Case Report on a Rare Intraoperative Finding of Ectopic Liver Tissue Attached to Gallbladder Wall during Laparoscopic Cholecystectomy
Authors: Mohamed Isa, Hussain Al-Mulla, Amal Al-Rayes, Raed Al-Marzooq, Roopa Arora
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Introduction:
Ectopic liver is a rare finding (Corsy, 1922; Kubota et al., 2007) that is usually discovered intraoperatively or during an autopsy (Bassis and Izenstark, 1956). Preoperative diagnosis of ectopic liver is also uncommon. The most common site of ectopic liver is on the gall bladder, although there are reports of other sites such as the adrenal glands and esophagus. The management of ectopic liver is en-bloc resection due to the high risk of hepatocellular carcinoma.
Case presentation:
We describe the case of a 42-year-old female who presented with recurrent abdominal pain. She was found to have a smooth fragment of a reddish brown tissue attached to the anterior surface of the gallbladder during an elective laparoscopic cholecystectomy. The tissue was removed with the gallbladder, and histopathology showed normal ectopic liver tissue.
Conclusion:
Due to the possibility of malignant transformation into hepatocellular carcinoma, en-bloc resection is the choice of management.