OpenMed/multicare-articles huggingface dataset:
Case Report: 18F-FDG PET/CT and Laparoscopic Nephron Sparing Surgery in the Management of Bleeding From Renal Metastases of Choriocarcinoma
Authors: Yuancheng Du, Xueping Zhang, Shengyang Sun, Meihong Sun, Dongyu Yang, Xinyuan Yu, Kehao Li, Jie Ma, Yongxiang Li, Jinming Ge, Changqing Liu, Liang Qiao
Journal: Front Oncol (2022)
Keywords: pet/ct, choriocarcinoma, laparoscopic nephron sparing surgery, renal metastasis, spontaneous renal hemorrhage
MeSH terms: Case Reports

Choriocarcinoma is a cancer that usually occurs in the uterus during pregnancy. Although choriocarcinoma with renal metastasis and spontaneous renal hemorrhage is very rare, it can occur. We describe a rare case of metastatic choriocarcinoma, wherein the patient presented with acute abdominal pain due to a subcapsular hematoma secondary to a bleeding renal metastasis. We performed a laparoscopic nephron sparing surgery to remove the tumor and control the bleeding. A retrospective analysis revealed that metastasis was detected on 18F-fluorodeoxyglucose PET/CT, but not on CT alone. To our knowledge, a case of choriocarcinoma with such symptoms and treatment has not been described in recent literature. Our case illustrates that acute bleeding from a renal metastasis can be effectively managed by laparoscopic nephron sparing surgery. It also demonstrates the advantage 18F-FDG PET/CT may have in the evaluation of metastatic choriocarcinoma.
Anesthetic Management for Emergent Repair of Tracheoinnominate Fistula
Authors: Vinayak Nadar, Ratan K Banik
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

We present a case of a 30-year-old female, who had tracheostomy revision complicated by false passage into the subcutaneous space and pneumothorax. Six days later, she developed massive bleeding from the mouth, nose, and tracheostomy site. Approximately 2 liters of blood was lost. With high suspicion for tracheo-innominate fistula, she was emergently brought to the operating room for fistula repair. Her anesthetic management was initially focused on maintaining spontaneous ventilation with inhalation agents until surgical exposure was adequate. An endotracheal tube was then placed under guidance of a video-laryngoscope. The tracheostomy tube was then removed over a Cook catheter to maintain secure passage in case of airway collapse. The oral endotracheal tube was then inserted distal to the arterial and tracheal defect. The patient's bleeding was stopped, the fistula was repaired, and she was transferred back to the intensive care unit, but she died several days later due to multi-organ failure.
Sport-Related Portal Vein Thrombosis: An Unusual Complication
Authors: Igor Dumic, Nikola Tankosic, Milica Stojkovic Lalosevic, Tamara Alempijevic
Journal: Case Reports Hepatol (2017)
MeSH terms: Case Reports

Portal vein thrombosis (PVT) is an uncommon condition usually associated with hypercoagulable states or liver cirrhosis. PVT due to sports-related injuries is rarely reported and, to the best of our knowledge, only two cases have been reported thus far. Brazilian jiu-jitsu (BJJ) is a form of martial arts and is considered very safe with minimal risk for injury. It has growing popularity worldwide. Here, we report the first case of PVT secondary to abdominal trauma related to the practice of (BJJ) in an otherwise healthy 32-year-old man with no other traditional risk factors for PVT.
Splenic Infarct and Pulmonary Embolism as a Rare Manifestation of Cytomegalovirus Infection
Authors: Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Cytomegalovirus (CMV) is a type of herpes infection that has a characteristic feature of maintaining lifelong latency within the host cell. CMV manifestations can cover a broad spectrum from fever to as severe as pancytopenia, hepatitis, retinitis, meningoencephalitis, Guillain-Barre syndrome, pneumonia, and thrombosis. Multiple case reports of thrombosis associated with CMV have been reported. Deep vein thrombosis or pulmonary embolism is more common in immunocompetent patients while splenic infarct is more common in immunocompromised patients. However, here we report a female patient on low-dose methotrexate for rheumatoid arthritis who presented with both pulmonary embolism and splenic infarct.
Arteriovenous Malformation in the Auricle in a 59-Year-Old Woman
Authors: Junhui Jeong
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

Arteriovenous malformation (AVM) is a vascular lesion with a direct communication between an artery and a vein without a capillary system. AVM primarily occurs in the intracranial area, but can also occur in the extracranial area. If there is a tender mass with pulsation or recurrent bleeding in the auricle, AVM should be considered even though it rarely occurs in the auricle. AVM in the ear should be managed carefully because the skin is thin in the ear, the cartilage could be involved, and progressive growth or inappropriate management could cause bleeding, infection, and cosmetic problems such as deformity. I present a case of a 59-year-old woman with AVM in the auricle.
Familial Multiple Sclerosis in a Mother and Son Pair: A Sri Lankan and a South Asian First
Authors: Ishani Rajapakshe, Bimsara Senanayake
Journal: Case Rep Neurol Med (2021)
MeSH terms: Case Reports

Multiple sclerosis (MS) is an immune-mediated demyelinating disorder involving the central nervous system (CNS). It is common amongst young females. Although the exact cause of MS is yet unknown, viral infections such as EBV, environmental factors, and autoimmune and genetic mechanisms involving HLA-DRB1 loci are implicated. Familial MS is reported from some geographic locations and ethnic groups but is thought to be rare in Asia. In this paper, we present both a Sri Lankan mother and her son, with clinically definite MS conforming to McDonald's 2017 clinical and MAGNIMS 2016 radiological criteria. Both had oligoclonal bands in their CSF (OCB-IEF) with no serum bands indicating intrathecal production and were negative for AQP4 and MOG IgG serology. Familial MS is more common among siblings, with sister-sister relationship having the highest rate. The lowest relation was amongst father-son and mother-son pairs. Amongst siblings, the risk of MS is between 3.5% and 4.7%. Inherited factors rather than common environmental exposure influence susceptibility in such cases. To the best of our knowledge, MS occurring in a mother-son pair has not been reported before either from Sri Lanka or South Asia.
Making use of equity sensitive QALYs: a case study on identifying the worse off across diseases
Authors: Frode Lindemark, Ole Frithjof Norheim, Kjell Arne Johansson
Journal: Cost Eff Resour Alloc (2014)
Keywords: equity, healthcare rationing, priority setting in health, quality-adjusted life years, severity

Background:
Resource allocation decisions currently lack standard quantitative methods for incorporating concerns about the worse off when analysing the cost-effectiveness of medical interventions.
Objective:
To explore and demonstrate how to identify who are the worse off without a new intervention by measuring lifetime Quality-Adjusted Life Years (QALYs) for patients across different conditions, and compare the results to using proportional shortfall of QALYs.
Methods:
Case study of eight condition-intervention pairs that are relevant to priority setting in Norway; childhood deafness (unilateral cochlear implant), unruptured cerebral aneurysm (coiling), morbid obesity (RY gastric bypass), adult deafness (unilateral cochlear implant), atrial fibrillation (catheter ablation), hip osteoarthritis (hip replacement), rheumatoid arthritis (TNF inhibitor) and acute stroke (stroke unit). We extracted prospective QALYs without and with new interventions from published health technology assessments and economic evaluations.
Results:
Among the eight cases, the lifetime QALY method and the proportional shortfall method yielded conflicting worse-off rank orders. Particularly two conditions had a substantial shift in ranking across the applications of the two methods: childhood deafness and acute stroke. Deaf children had the lowest expected lifetime QALYs (38.5 without a cochlear implant) and were worst off according to the lifetime approach, while patients with acute stroke had the second-highest lifetime QALYs (76.4 without stroke units). According to proportional shortfall of QALYs, patients with acute stroke were ranked as worse off than deaf children, which seems counterintuitive.
Conclusion:
This study shows that it is feasible to identify who are the worse off empirically by the application of lifetime QALYs and proportional shortfalls. These methods ease further examination of whether there is a true conflict between maximization and equity or whether these two concerns actually coincide in real world cases. It is yet to be solved whether proportional prospective health losses are more important than absolute shortfalls in expected lifetime health in judgements about who are worse off.
Antituberculosis Drug-Induced Liver Injury with Autoimmune Features: Facing Diagnostic and Treatment Challenges
Authors: Maria Adriana Rangel, Isabel Pinto Pais, Raquel Duarte, Isabel Carvalho
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

The authors present a case report of antituberculosis drug-induced liver injury that offered diagnostic challenges (namely, the possibility of drug-induced autoimmune hepatitis) and treatment difficulties.
Subcutaneous extraskeletal osteosarcoma of foot: A case report
Authors: Keykhosro Mardanpour, Mahtab Rahbar
Journal: Int J Surg Case Rep (2020)
Keywords: foot, osteosarcoma, plantar, subcutaneous
MeSH terms: Case Reports

Introduction:
Subcutaneous extraskeletal osteosarcoma (ESO) is a rare high grade malignant mesenchymal neoplasm consistent of approximately 1% of soft tissue sarcoma. Less than 10% of ESOs are superficial, originating in subcutis.
Presentation of case:
We reported a 72 years old male with chief complain of a painless slowly growing soft tissue mass in his plantar aspect of right foot in the last 9 months before admission. The plain radiography showed a large subcutaneous soft tissue mass in plantar area and heel, Magnetic resonance images displayed an irregular subcutaneous soft tissue mass extending from posterior lower leg to ankle and involving calcaneus inferiorly. A percutaneous core biopsy of the mass, obtained. The histopathology examination confirmed an soft tissue osteosarcoma. Subsequent wide local excision of the mass performed. Final histopathological result was subcutaneous extraskeletal osteosarcoma.
Discussion:
The patient has had no evidence of recurrence or/and distant metastasis at 25 months followed up. However, excising subcutaneous ESOs with a safe surgical margin is paramount for achieving the best outcome.
Conclusion:
A subcutaneous ESO is a rare malignant tumor. We recommended that along with clinicohistological findings, radiological correlation is necessary for ruling out other diagnoses.
Development of acute kidney injury with massive granular casts and microscopic hematuria in patients with COVID-19: two case presentations with literature review
Authors: Takuya Fujimaru, Keiki Shimada, Takayuki Hamada, Kimio Watanabe, Yugo Ito, Masahiko Nagahama, Fumika Taki, Shutaro Isokawa, Toru Hifumi, Norio Otani, Masaaki Nakayama
Journal: Ren Replace Ther (2020)
Keywords: acute kidney injury, covid-19, microangiopathy, rhabdomyolysis, urine sediment examination, vancomycin-induced acute kidney injury
MeSH terms: Case Reports

Background:
Complications of acute kidney injury (AKI) are common in patients with coronavirus disease in 2019 (COVID-19). However, clinical characteristics of COVID-19-associated AKI are poorly described. We present two cases of severe COVID-19 patients with AKI.
Case presentation:
A 77-year-old woman was suspected of having vancomycin-associated AKI, and a 45-year-old man was suspected of having heme pigment-induced AKI caused by rhabdomyolysis. The granular cast, which is known to be a valuable diagnostic tool for confirming the diagnosis of acute tubular necrosis, was detected in both patients at the onset of AKI. Interestingly, both patients also developed microscopic hematuria at the occurrence of AKI, and one patient had elevated d-dimer and low platelet levels simultaneously.
Conclusions:
Some reports suggested that COVID-19-associated microangiopathy contributed to the kidney damage. Therefore, it is possible that our patients might have accompanied renal microangiopathy, and that this pathological background may have caused exaggerated tubular damage by vancomycin or heme pigment. The etiology of AKI in patients with COVID-19 is multifactorial. Superimposition of nephrotoxin(s) and virus-associate intra-renal microangiopathy may be a crucial trigger of kidney injury leading to severe AKI in COVID-19 patients. Therefore, in COVID-19 patients, risk factors for AKI should be taken into consideration to prevent its progression into severe AKI.
Combining tangential hydrodissection, panniculectomy, and negative pressure wound therapy in treating extensive degloving injury of the leg
Authors: E Albu, A Alexandru, B Marinescu, R Ene, C Cârstoiu
Journal: J Med Life (2014)
Keywords: versajet, degloving injury, full-thickness skin graft, negative pressure wound therapy
MeSH terms: Abdominoplasty, Dissection, Leg Injuries / therapy, Negative-Pressure Wound Therapy, Case Reports, Female, Humans, Middle Aged, Skin Transplantation

Major degloving injuries of the lower limb are daunting lesions because they are relatively rare and always produce larger soft tissue defects than direct visual inspection that could be predicted in the emergency room. Enough body of the medical literature supports the excision of the avulsed tissue and replaces it as a full-thickness skin graft. However, almost paradoxically, there is little support for the use of pristine large full-thickness skin graft in the treatment of these lesions. This article focuses on the use of tangential hydrodissection (VERSAJET Hydrosurgery System, Smith & Nephew) in preparing the avulsed wound and defatting of a large piece of full thickness skin graft taken from the abdomen by using a standard panniculectomy excision pattern and securing survival and integration of the graft with negative pressure wound therapy. The patient, a 60-year-old obese and diabetic woman, suffered a roadside accident producing a degloving injury of her leg and was treated with the presented method; the final result was excellent and the reduction of the abdominal panniculus was a bonus.
Balancing theory and practice in respondent-driven sampling: a case study of innovations developed to overcome recruitment challenges
Authors: Hong-Ha M Truong, Michael Grasso, Yea-Hung Chen, Timothy A Kellogg, Tyler Robertson, Alberto Curotto, Wayne T Steward, Willi McFarland
Journal: PLoS One (2013)
MeSH terms: HIV Infections / prevention & control, Homosexuality, Male, Internationality, Patient Education as Topic / methods, Patient Selection, Research Design, Research Support, N.I.H., Extramural, Adolescent, Adult, Humans, Internet, Male, Middle Aged, Motivation, Sampling Studies, Social Support, Travel, Young Adult

Introduction:
Respondent-driven sampling (RDS) offers a recruitment strategy for hard-to-reach populations. However, RDS faces logistical and theoretical challenges that threaten efficiency and validity in settings worldwide. We present innovative adaptations to conventional RDS to overcome barriers encountered in recruiting a large, representative sample of men who have sex with men (MSM) who travel internationally.
Methods:
Novel methodological adaptations for the "International Travel Research to Inform Prevention" or "I-TRIP" study were offering participants a choice between electronic and paper coupons referrals for recruitment and modifying the secondary incentives structure from small cash amounts to raffle entries for periodic large cash prize raffle drawings. Staged referral limit increases from 3 to 10 referrals and progressive addition of 70 seeds were also implemented.
Results:
There were 501 participants enrolled in up to 13 waves of growth. Among participants with a choice of referral methods, 81% selected electronic referrals. Of participants who were recruited electronically, 90% chose to remain with electronic referrals when it was their turn to recruit. The mean number of enrolled referrals was 0.91 for electronic referrals compared to 0.56 for paper coupons. Median referral lag time, i.e., the time interval between when recruiters were given their referrals and when a referred individual enrolled in the study, was 20 days (IQR 10-40) for electronic referrals, 20 days (IQR 8-58) for paper coupons, 20 days (IQR 10-41) for raffle entries and 33 days (IQR 16-148) for small cash incentives.
Conclusions:
The recruitment of MSM who travel internationally required maximizing known flexible tools of RDS while at the same time necessitating innovations to increase recruitment efficiency. Electronic referrals emerged as a major advantage in recruiting this hard-to-reach population who are of high socio-economic status, geographically diffuse and highly mobile. These enhancements may improve the performance of RDS in target populations with similar characteristics.
Clinical and Complement Long-Term Follow-Up of a Pediatric Patient with C3 Mutation-Related Atypical Hemolytic Uremic Syndrome
Authors: Anna Bjerre, Grethe Bergseth, Judith Krey Ludviksen, Arne Stokke, Vidar Bosnes, Diana Karpman, Tom Eirik Mollnes
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

We report a pediatric patient with atypical hemolytic uremic syndrome due to a C3 gain-of-function mutation diagnosed in infancy. She was treated from the start with a constant dose of 300 mg eculizumab every second week from the onset and followed by routine complement analyses for six years. Her complement system was completely inhibited and the dose interval was prolonged from 2 to 3 weeks without alteration of the dose and the complement activity continued to be completely inhibited. Blood samples taken immediately before, immediately after, and between eculizumab doses were analyzed for eculizumab-C5 complexes and percentage of total complement activity, using the Wieslab® test, and compared to a pool of sera from 20 healthy controls. The patient exhibited complete complement inhibition at all three time-points and had no free circulating C5 suggesting there was complete binding to eculizumab. She has now been treated for six years with full complement blockade. We suggest therefore that analysis of complement activity using the Wieslab® test is useful for evaluating the effect of eculizumab when dose intervals are prolonged.
Characterization of a calcified intra-cardiac pseudocyst of the mitral valve by magnetic resonance imaging including T1 and T2 mapping
Authors: Ursula Reiter, Gert Reiter, Martin Asslaber, Drago Dacar, Ralph Maderthaner, Josepha Binder, Andreas Greiser, Meinrad Beer, Michael Fuchsjäger
Journal: BMC Cardiovasc Disord (2014)
MeSH terms: Calcinosis / diagnosis, Cysts / diagnosis, Heart Valve Diseases / diagnosis, Magnetic Resonance Imaging, Mitral Valve / pathology, Case Reports, Biopsy, Calcinosis / pathology, Calcinosis / surgery, Cysts / pathology, Cysts / surgery, Heart Valve Diseases / pathology, Heart Valve Diseases / surgery, Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Mitral Valve / diagnostic imaging, Mitral Valve / surgery, Multidetector Computed Tomography, Predictive Value of Tests, Treatment Outcome, Ultrasonography

Background:
Even though intra-cardiac cystic lesions are extremely unusual in adults, they should be considered in the differential diagnosis of patients presenting with valvular masses. Cardiac magnetic resonance imaging has emerged as modality of choice for non-invasive characterization of cardiac masses.
Case presentation:
We report a case of an intra-cardiac mass of the mitral valve in a 51-year old male, detected by echocardiography after transient ischemic attack and retinal artery occlusion. Cardiac magnetic resonance (CMR) imaging was performed at 3 T to evaluate and characterize the lesion prior to surgery. Diagnosis of a calcified left-ventricular pseudocyst of the mitral valve was confirmed by histological evaluation.
Conclusions:
This case presents the unusual finding of contrast uptake in an intra-cardiac cystic lesion and points to the potential of T1 and T2 mapping for assisting in the characterization and diagnosis of intra-cardiac masses by CMR.
Case Report: De novo Vertebral Artery Dissection After Intravascular Stenting of the Contralateral Unruptured Vertebral Artery Aneurysm
Authors: Wei You, Junqiang Feng, Qinglin Liu, Xinke Liu, Jian Lv, Yuhua Jiang, Peng Liu, Youxiang Li
Journal: Front Neurol (2021)
Keywords: bilateral vertebral artery dissection, de novo aneurysm, endovascular embolization, pipeline embolization device, vertebral artery dissecting aneurysm
MeSH terms: Case Reports

Spontaneous vertebral artery dissecting aneurysm has been increasingly attributed as a major cause of focal neurological deficits due to vertebrobasilar artery ischemia or subarachnoid hemorrhage (SAH). Although the development of spontaneous vertebral artery dissecting aneurysm (VADA) is rare, de novo VADA after treatment of contralateral vertebral artery (VA) is more less frequently observed. There are only a few reports related to de novo VADA after treatment of the contralateral VA in the medical literature. The mechanisms responsible for de novo dissection after treatment of unilateral VADA are still not clearly understood. In this manuscript, we report an unusual case of a patient with a de novo VADA after placement of a pipeline embolization device (PED) stent on the contralateral VA along with a thorough review of the literature. A 42-years old male patient was referred to the hospital with sudden onset of dizziness, nausea, and vomiting. Initial digital subtraction angiography (DSA) images demonstrated a VADA in the fourth segment of the left VA without the involvement of the posterior inferior cerebellar artery (PICA). There were no significant abnormalities found in the right vertebral artery. He underwent an endovascular pipeline embolization to treat the dissecting aneurysm (DA). Surprisingly, follow-up DSA imaging 14 months after the initial treatment showed a segmental dilatation and narrowing of the right VA, which suggested a de novo VADA on the right side that had occurred postoperatively. This was followed by a tent-assisted coil embolization therapy for occluding this de novo VADA. This patient showed an uneventful postoperative course with no neurological abnormalities. In addition to hemodynamic stress changes, the unique clinicopathological features of dissecting aneurysms may contribute significantly to the pathogenesis of de novo VA dissection. Given that VA in VADA patients may be vulnerable on both sides, it is important to consider the risk of de novo dissection after initial aneurysm treatment. The bilateral vertebral artery has to be carefully observed when treating any VADA patient to prevent any complications.
MRI Features of Primary Breast Lymphoma in Patient with Breast Carcinoma for Differential Diagnosis
Authors: Subin Lee, Jung Hee Byon, Eun Jung Choi
Journal: J Belg Soc Radiol (2023)
Keywords: dce-mri, dwi, breast carcinoma, primary breast lymphoma, synchronous
MeSH terms: Case Reports

Teaching point: Homogeneous internal enhancement and washout pattern on DCE-MRI and a low ADC value on DWI in women with breast carcinoma help distinguish primary breast lymphoma from bilateral synchronous breast carcinoma.