OpenMed/multicare-articles huggingface dataset:
Novel Multicentric Hepatic Lymphoma with Extrahepatic Biliary Obstruction Associated with Duodenal Perforation in a Cat
Authors: Isabella Hildebrandt, Adam Rudinsky, Valerie Parker, Jenessa Winston, Alexandra Wood, Samantha Evans, James Howard
Journal: Case Rep Vet Med (2021)
MeSH terms: Case Reports

An 11-year-old male castrated domestic shorthair cat was presented for evaluation due to clinical deterioration and potential extrahepatic biliary obstruction (EHBO). Further investigations confirmed EHBO and revealed severe and previously unreported comorbidities. On initial examination, the cat was markedly icteric with a poor body condition score and severe muscle wasting. Serum chemistry and complete blood count showed evidence of cholestasis and anemia. Primary diagnostics and therapeutics targeted these abnormalities. Abdominal ultrasound revealed peritoneal effusion, multifocal mixed echogenic hepatic and splenic foci, small intestinal thickening, cholelithiasis, choledocholithiasis, and common bile duct and pancreatic duct dilation with evidence of obstruction. Peritoneal effusion cytology confirmed septic peritonitis. Hepatic and splenic cytology was consistent with lymphoma. Based on these results, euthanasia was elected by the owners of the animal. Necropsy confirmed the ultrasound diagnoses, septic peritoneal effusion associated with a duodenal perforation, multiorgan lymphoma, and common bile duct carcinoma. Flow cytometry classified the lymphoma as a double-negative phenotype of T-cell lymphoma (CD3+ and CD5+, but CD4- and CD8-) present in the duodenum and liver and suspected in the spleen which has previously not been reported in cats. This case report documents a cat with EHBO caused by multiple disease processes including a novel T-cell lymphoma phenotype, biliary carcinoma, duodenal perforation and septic abdomen, and choleliths, as well as inflammatory hepatobiliary disease.
Aortic Valve Replacement and Penicillin Desensitization in a Patient with Abiotrophia defectiva Aortic Valve Endocarditis
Authors: S Kumar, S Mahmood, A Madras, A Iyer
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Abiotrophia defectiva is an uncommon and insidious yet destructive cause of infective endocarditis preferentially treated with penicillin/gentamicin and often requiring surgical treatment. A 60-year-old man with penicillin anaphylaxis history presented with fevers and a nonspecific constellation of symptoms. He was ultimately diagnosed with bicuspid aortic valve infective endocarditis based on blood cultures growing A.defectiva and echocardiographic evidence of bicuspid aortic valve, severe valvular regurgitation, and 5 × 7 mm vegetation. Aortic valve replacement and culture yielded penicillin-sensitive A.defectiva. After successful penicillin desensitization, antibiotic therapy was switched from vancomycin/gentamicin to benzylpenicillin. This is the first published case of penicillin desensitization in a patient with A.defectiva-associated infection. Penicillin desensitization, optimal antibiotic therapy, prompt aortic valve replacement, and close collaboration between cardiology and various other specialties were essential in achieving a positive outcome.
Multiple Acrometastases in a Patient with Renal Pelvic Urothelial Cancer
Authors: Ryoko Sawada, Yusuke Shinoda, Aya Niimi, Tohru Nakagawa, Masachika Ikegami, Hiroshi Kobayashi, Sakae Tanaka, Yukio Homma, Nobuhiko Haga
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

Metastasis may occur in any bone but more commonly occurs in the spine, pelvis, or other axial bones. Metastasis in peripheral bones located distal to the elbow or knee, so-called acrometastasis, is rare. Although the mechanism of acrometastasis development is not completely understood, it is thought to be the result of a massive dissemination of cancer cells; thus the prognosis of patients with acrometastasis is relatively poor. Here, we report the case of renal pelvic cancer with multiple acrometastases in both the upper and lower extremities without axial bone metastasis in a 68-year-old man. After two regimens of chemotherapy, he suffered from pain on his wrist and ankle and swelling and hemorrhage of his toe. He had no axial bone metastasis by CT but was diagnosed with multiple acrometastases by plain radiographs. Radiation therapy and disarticulation of the left big toe at the metacarpal-phalangeal joint were performed and his pain and hemorrhage were successfully controlled. Although acrometastasis from renal pelvic cancer is very rare, we should recognize that acrometastasis might occur which exists outside of the CT scanning field.
An Extremely Rare Bile Leakage: Aberrant Bile Duct in Left Triangular Ligament (Appendix Fibrosa Hepatis)
Authors: İhsan Yıldız, Yavuz Savaş Koca, Sezayi Kantar
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Background:
The anatomical variability of bile ducts can leave surgeons in very difficult conditions.Ultrasonography, computed tomography, magnetic resonance imaging (MRCP) and endoscopic imaging methods are used in diagnosis. In addition to conservative approaches, endoscopic procedures and laparoscopic or open surgical interventions may be necessary for treatment. In this article, we present a case of aberrant bile duct in left triangular ligament (appendix fibrosa hepatis), which is rarely seen.
Case:
We report the case of a 67-year-old female patient who was operated on due to dumping syndrome symptoms and hiatal hernia. There was a drainage of bile from the left side of the liver which was placed under the cardioesophageal junction. MRCP found bile esophageal in the left triangular ligament of the liver. Aberrant bile ducts were found in the left triangular ligament and ligated. The patient was discharged on the 7th day after operation.
Conclusion:
The anatomical variability of bile ducts can leave surgeons in very difficult conditions. We recommend that the dissected left triangular ligament should be ligated for the aberrant bile duct, especially in female patient.
Acute Hepatitis Secondary to the Use of Ilex paraguariensis (Mate Tea): A Case Report and Review of Literature
Authors: Eduardo A Rodriguez, Raquel Teixeira Yokoda, David E Payton, Rish Pai, Thomas J Byrne
Journal: Case Reports Hepatol (2019)
MeSH terms: Case Reports

Drug induced liver injury is a very frequent cause of hepatotoxicity and within that group, herbal and dietary supplements are a well described subcategory. The following clinical vignette describes the case of a young man with acute hepatitis secondary to the use of Ilex paraguariensis, also known as yerba mate, which is a herbal product commonly drunk in South America. This is the first written case of mate tea induced hepatotoxicity.
Adult-onset medulloblastoma presenting as slow-growing, atypical mass: a case report
Authors: Anja Gwendolyn van der Kolk, Roeland B van Leeuwen, Louise Poulsen
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Medulloblastoma accounts for < 1% of all primary central nervous system tumours in adults. Although a "classical" imaging presentation -being a well-defined mass, often located in the cerebellar hemisphere, with surrounding oedema, showing T 1 iso- and T 2 heterogeneous signal intensity and contrast enhancement -has been described, case reports and series have also shown the extremely heterogeneous imaging aspect of this tumour , reflecting its heterogeneous molecular phenotype. Owing to the general location of the tumour within the cerebellopontine angle, causing (fast) progressive symptoms of headache and gait instability, most patients present within 3 months from symptom onset. This case report describes a presentation of adult medulloblastoma not shown before, with an indolent course over a period of 4.5 years, initially without clear abnormalities on imaging. It highlights the importance of including medulloblastoma in the differential diagnosis of all lesions found near/continuous with the fourth ventricle in the adult population, even when clinical onset and imaging characteristics do not suggest "classical" medulloblastoma.
Lhermitte Sign as a Presenting Symptom of Thoracic Spinal Pathology: A Case Study
Authors: Adam Hills, Mazen Al-Hakim
Journal: Case Rep Neurol Med (2015)

A 54-year-old male with ankylosing spondylitis presented with complaints of progressively worsening bilateral leg weakness and difficulty ambulating of 2-week duration. He also felt a sharp, electric, shock-like sensation radiating from his lower back into his legs upon flexing the trunk. There was no history of trauma or other inciting events within the 2 weeks prior to presentation. Thoracic MRI at this visit showed a three-column fracture at T11-T12. He underwent spinal fusion surgery and within 2 days after surgery the radiating electrical sensation with spinal flexion had completely resolved.
Right-sided Aortic Arch with Aberrant Left Subclavian Artery in a Pregnant Female: A Case Report and Literature Review
Authors: Angelina Zhyvotovska, Denis Yusupov, Rishard Abdul, Harshith Chandrakumar, Angeleque Hartt, Khaleda Akter, Yusra Qaiser, Samy I Mc Farlane
Journal: Am J Med Case Rep (2020)
Keywords: aberrant left subclavian artery, congenital abnormalities, right aortic arch, right-sided aortic arch with aberrant left subclavian artery, vascular ring

Right-sided aortic arch with aberrant left subclavian artery is a rare variant of vascular anatomy. Three types of right-sided aortic arches are described and classified based on the arrangement of the aortic arch vessels, the presence or absence of congenital heart abnormalities, the relationship of the aortic arch to the trachea and esophagus, as well as the presence or absence of a complete or incomplete vascular ring. On review of the existing literature, 31 case reports were found with a spectrum of clinical presentation sand outcomes. In this case report, we highlight a case of a young female in her early 20'swho presented with choking spells, shortness of breath along with intermittent dysphagia since childhood. She was otherwise healthy and pregnant at 26 weeks gestational age. A Computed tomography scan with angiography (CTA) of the thorax was performed to rule out a pulmonary embolism (PE) however surprisingly, a right-sided aortic arch with aberrant left subclavian artery was revealed instead. Subsequently, an extensive literature review was carried out to better understand clinical presentation sand treatment strategies for this rather rare disorder.
Clinical case of botryomycome fulminant at the center of diagnostic and treatment of tuberculosis of Baleng (West - Cameroon)
Authors: Michel Noubom, Bruno Kenfack, Jean Hubert Donfack, Fabrice Djouma Nembot, Zacharie Sando
Journal: Pan Afr Med J (2013)
Keywords: botryomycome fulminant, dapsone, inflammation, rifampicin, diagnosis, pyogenic granuloma or botyomycome
MeSH terms: Foot Diseases / drug therapy, Granuloma, Pyogenic / drug therapy, Case Reports, Aged, 80 and over, Anti-Bacterial Agents / therapeutic use, Cameroon, Humans, Male, Anti-Bacterial Agents

Botryomycome also called pyogenic granuloma, is an inflammatory tumor of the skin and mucous membranes often caused by superinfection of minor traumatism. Its uniqueness lies in its granulomatous organization in which each granulation contains bacteria and the predominance of many newly formed blood vessels, with the lights on variables ratings and a turgid endothelium responsible for the ulcero-hemorragic appearance. This delicate condition poses a real problem of treatment which included: an appropriate antibiotherapy, surgical removal or electrocoagulation which, until today is more difficult in countries with limited income. An octogenarian came to our hospital with a large mass on the left foot. This mass had the appearance of a malignant tumor. However, the anatomopathologic diagnosis showed that it was a pyogenic granuloma. The importance of the mass, its location on the sole of the foot, imposed the functional impairment of this member. Electrocoagulation is not available in our hospital and the surgical excision proposed was refused by the patient. The patient was treated with the antibiotics Ceftriaxone and Gentalline at indicated doses for 15 days. After the failure of that antibiotherapy treatment, as a last resort, the patient was treated for a month with another combination of antibiotics (free of cost) made of dapsone and rifampicin. This new combination gave very good results. This example shows dapsone and rifampicin can be use as a new weapon for the management of pyogenic granuloma in countries with limited incomes.
True superior gluteal artery aneurysm with neurovascular compromise of the lower limb: a case report and review of the therapeutic options
Authors: Tunde Nureini Oyebanji, Ismail Mohammed Inuwa, Jameel Ismail Ahmad
Journal: Pan Afr Med J (2018)
Keywords: superior gluteal artery, aneurysm, surgery
MeSH terms: Aneurysm / diagnosis, Arteries / pathology, Buttocks / blood supply, Case Reports, Aneurysm / surgery, Arteries / surgery, Endovascular Procedures / methods, Female, Humans, Lower Extremity, Middle Aged

Few cases of true superior gluteal artery (SGA) aneurysms have been described in the English-language literature. This is the twenty-second reported case. SGA aneurysms can pose diagnostic problems, specifically when they are non-pulsatile and also therapeutic challenges when they are large. Although more aneurysms are being subjected to endovascular therapies, SGA aneurysmectomy or aneurysmorrhaphy still remain valid therapeutic options, especially in resource-poor settings. Surgery provides quick symptom resolution and still is the only means by which tissue for definitive histological diagnosis can be obtained.
The Human Nature of Music
Authors: Stephen Malloch, Colwyn Trevarthen
Journal: Front Psychol (2018)
Keywords: cultural learning, gestural narrative, infant musicality, motor intelligence, musicking

Music is at the centre of what it means to be human - it is the sounds of human bodies and minds moving in creative, story-making ways. We argue that music comes from the way in which knowing bodies (Merleau-Ponty) prospectively explore the environment using habitual 'patterns of action,' which we have identified as our innate 'communicative musicality.' To support our argument, we present short case studies of infant interactions using micro analyses of video and audio recordings to show the timings and shapes of intersubjective vocalizations and body movements of adult and child while they improvise shared narratives of meaning. Following a survey of the history of discoveries of infant abilities, we propose that the gestural narrative structures of voice and body seen as infants communicate with loving caregivers are the building blocks of what become particular cultural instances of the art of music, and of dance, theatre and other temporal arts. Children enter into a musical culture where their innate communicative musicality can be encouraged and strengthened through sensitive, respectful, playful, culturally informed teaching in companionship. The central importance of our abilities for music as part of what sustains our well-being is supported by evidence that communicative musicality strengthens emotions of social resilience to aid recovery from mental stress and illness. Drawing on the experience of the first author as a counsellor, we argue that the strength of one person's communicative musicality can support the vitality of another's through the application of skilful techniques that encourage an intimate, supportive, therapeutic, spirited companionship. Turning to brain science, we focus on hemispheric differences and the affective neuroscience of Jaak Panksepp. We emphasize that the psychobiological purpose of our innate musicality grows from the integrated rhythms of energy in the brain for prospective, sensation-seeking affective guidance of vitality of movement. We conclude with a Coda that recalls the philosophy of the Scottish Enlightenment, which built on the work of Heraclitus and Spinoza. This view places the shared experience of sensations of living - our communicative musicality - as inspiration for rules of logic formulated in symbols of language.
Pyridostigmine Induced Prolonged Asystole in a Patient with Myasthenia Gravis Successfully Treated with Hyoscyamine
Authors: Mohammad Saud Khan, Abhinav Tiwari, Zubair Khan, Himani Sharma, Mohammad Taleb, Jeffrey Hammersley
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Reversible acetylcholinesterase inhibitors are used as first-line treatment for myasthenia gravis. They improve symptoms by increasing concentration of acetylcholine at the neuromuscular junction and stimulating nicotinic receptors. Serious bradyarrhythmias can occur from muscarinic stimulation in heart, which in rare cases may progress to asystole. These patients can initially be managed with hyoscyamine, a muscarinic antagonist. Persistence of bradyarrhythmias even after hyoscyamine treatment may warrant pacemaker placement. We present a case of 65-year-old female patient who presented with diplopia, dysphagia, and muscle weakness who was diagnosed with myasthenia gravis. She developed significant sinoatrial node block with prolonged asystole after starting treatment with pyridostigmine which was successfully treated with hyoscyamine, thus avoiding pacemaker placement.
Familial Primary Biliary Cholangitis With Different Clinical Courses Based on Anti-gp210 Antibody Positivity: A Report of Two Cases
Authors: Takahiro Nagata, Yasuaki Takeyama, Satoshi Shakado, Fumihito Hirai, Satoshi Nimura
Journal: Cureus (2023)
Keywords: anti-glycoprotein 210 antibody, clinical course, familial onset, first-degree relatives, primary biliary cholangitis
MeSH terms: Case Reports

A 30-year-old woman (daughter) was diagnosed to have primary biliary cholangitis (PBC) with autoimmune hepatitis (AIH) overlap syndrome. Although she was started on prednisolone and ursodeoxycholic acid (UA), she eventually died of hepatic failure with gastrointestinal hemorrhage seven months after the initial hospitalization. A 60-year-old woman (mother) was diagnosed with PBC with alcoholic liver cirrhosis, was treated with UA, and had no disease progression. These familial PBC patients had different clinical courses. While the mother was negative for the anti-glycoprotein 210 (anti-gp210) antibody, the daughter was positive for the same. These findings suggest that anti-gp210 antibody positivity affects the prognosis of PBC, even in familial cases.
Premature birth associated with a favorable course in gestational alloimmune liver disease (GALD): A case report
Authors: Linda-Marie Mulzer, Heiko Reutter, Jörg Jüngert, A S Knisely, Margit Schmid, André Hoerning, Patrick Morhart
Journal: Front Pediatr (2023)
Keywords: gestational alloimmune liver disease, liver disease, neonatal acute liver failure, neonatal hemochromatosis, prematurit, prematurity
MeSH terms: Case Reports

Gestational alloimmune liver disease (GALD) is a rare neonatal disorder with high mortality and morbidity. The patients come to caregivers' attention aged a few hours or days. The disease manifests as acute liver failure with or without siderosis. The differential diagnosis of neonatal acute liver failure (NALF) is broad, including mainly immunologic, infectious, metabolic and toxic disorders. The most common cause, however, is GALD followed by herpes simplex virus (HSV) infection. The best suited pathophysiological paradigm of GALD is that of a maternofetal alloimmune disorder. State of the art treatment combines intravenously administered immunoglobulin (IVIG) with exchange transfusion (ET). We report an infant born at 35 + 2 weeks' gestation in whom GALD had a favorable course, of interest because premature birth in our patient may have exerted protective aspects and lessened morbidity in that intrauterine exposure to maternal complement-fixing antibodies was shortened. The diagnosis of GALD was challenging and difficult. We suggest a modified diagnostic algorithm combining clinical findings with histopathologic findings in liver and lip mucosa and, if available, on abdominal magnetic resonance imaging-study focusing on the liver, spleen, and pancreas. This diagnostic workup must be followed by ET and subsequent administration of IVIG without delay.
Branched xenopericardial roll graft replacement of an infected aortic arch graft
Authors: Hiroshi Kubota, Hidehito Endo, Hikaru Ishii, Hiroshi Tsuchiya, Norihiko Ohura, Yu Takahashi
Journal: J Card Surg (2019)
Keywords: aorta and great vessels, aortic arch, aortic infection, graft infection, xenopericardial roll graft, xenopericardium
MeSH terms: Aorta, Thoracic / surgery, Aortic Aneurysm, Thoracic / surgery, Blood Vessel Prosthesis Implantation / methods, Prosthesis-Related Infections / surgery, Case Reports, Video-Audio Media, Aged, Aorta, Thoracic / diagnostic imaging, Aortic Aneurysm, Thoracic / diagnosis, Heterografts, Humans, Imaging, Three-Dimensional, Male, Prosthesis Failure, Prosthesis-Related Infections / diagnosis, Reoperation, Tomography, X-Ray Computed

Which graft material is the optimal graft material for the treatment of aortic graft infections is still a matter of controversy. We used a branched xenopericardial roll graft to replace an infected aortic arch graft as a "rescue" operation. The patient is alive and well 37 months postoperatively without recurrence of the infection and any surgical complication. This procedure may have the possibility to serve as an option for the treatment of aortic arch graft infection.
Radiographically Occult Carcinomatous Spread of Breast Cancer to the Liver: A Challenging Case
Authors: Trish Millard, Akriti Gupta, Christiana Brenin, Paul Marshall, Patrick Dillon
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Metastatic carcinomatosis to the liver is a pattern of malignant infiltration that tends to provoke hepatic fibrosis. It is a rare complication of multiple solid tumor types and often seen in the absence of discrete tumor mass in the liver. We report a case of a 69-year-old woman with metastatic ductal carcinoma of the breast who presented with rising serum tumor markers and mildly cirrhotic contour of the liver on a CT scan. An early diagnosis of occult spread to the liver was made by means of a percutaneous liver biopsy showing desmoplastic response to invasive breast cancer cells found diffusely in the liver. This case highlights a rare pattern of metastatic spread of breast cancer as well as predisposing and prognostic features.
Adrenergic myocarditis in pheochromocytoma
Authors: Alberto Roghi, Patrizia Pedrotti, Angela Milazzo, Edgardo Bonacina, Chiara Bucciarelli-Ducci
Journal: J Cardiovasc Magn Reson (2011)
MeSH terms: Adrenal Gland Neoplasms / complications, Catecholamines / urine, Myocarditis / etiology, Pheochromocytoma / complications, Ventricular Dysfunction, Left / etiology, Case Reports, Acute Disease, Adrenal Gland Neoplasms / surgery, Adrenal Gland Neoplasms / urine, Adrenalectomy, Contrast Media, Edema, Cardiac / etiology, Female, Gadolinium, Humans, Magnetic Resonance Imaging, Middle Aged, Myocarditis / urine, Pheochromocytoma / surgery, Pheochromocytoma / urine, Treatment Outcome, Ventricular Dysfunction, Left / urine, Catecholamines, Contrast Media, Gadolinium

The clinical presentation of pheochromocytoma is variable and many biochemical and imaging methods have been suggested to improve the diagnostic accuracy of what has been termed "the great masquerader". This case-report is of a middle-aged woman with a non-specific clinical presentation suggesting acute coronary syndrome or subacute myocarditis. Cardiovascular magnetic resonance (CMR) at presentation showed myocardial edema and intramyocardial late gadolinium enhancement (LGE). An adrenal mass was seen, which was confirmed as pheochromocytoma and surgically removed. Our case shows evidence for acute adrenergic myocarditis, with resolution of both the edema and the LGE after surgical excision.