OpenMed/multicare-articles huggingface dataset:
Transient Postural Vestibulo-Cerebellar Syndrome in Three Dogs With Presumed Cerebellar Hypoplasia
Authors: Miroslav Prikryl, Abby Caine, Viktor Palus
Journal: Front Vet Sci (2020)
Keywords: mri, cerebellum, postural, transient, vestibular
MeSH terms: Case Reports

This case study presents a unique transient postural vestibular syndrome in three dogs. The transient postural symptoms present as pronounced vestibulo-cerebellar signs after altering the position of the head. Magnetic resonance imaging findings of the brain suggest caudal cerebellar hypoplasia, affecting vermis, and floccular lobes bilaterally in case 1, and hypoplasia of the nodulus vermis in cases 2 and 3. No progression of clinical signs was reported in minimum of 4 months period.
Focal Intramucosal Adenocarcinoma Occurring in Gastric Hyperplastic Polyps: Two Case Reports
Authors: Keisuke Taniuchi, Mitsuo Okada, Hiroshi Sakaeda
Journal: Case Rep Gastrointest Med (2015)

Gastric hyperplastic polyps are generally considered benign lesions, although rare cases of adenocarcinoma have been reported. Two cases of intramucosal adenocarcinoma originating from gastric hyperplastic polyps that were successfully removed by endoscopic mucosal resection or endoscopic submucosal dissection are reported. On pathological examination, adenocarcinoma limited to the hyperplastic foveolar epithelial mucosa of the gastric hyperplastic polyps was observed.
CDKN2A founder mutation in pancreatic ductal adenocarcinoma patients without cutaneous features of Familial Atypical Multiple Mole Melanoma (FAMMM) syndrome
Authors: Carol Cremin, Sarah Howard, Lyly Le, Aly Karsan, David F Schaeffer, Daniel Renouf, Kasmintan A Schrader
Journal: Hered Cancer Clin Pract (2018)
Keywords: cdkn2a, fammm, familial atypical multiple mole melanoma syndrome, melanoma, pancreatic cancer
MeSH terms: Case Reports

Background:
Approximately 5% to 10% of pancreatic ductal adenocarcinoma (PDAC) has a hereditary basis. In most of these defined hereditary cancer syndromes, PDAC is not the predominant cancer type. Traditional criteria for publicly funded genetic testing typically require the presence of a set combination of the predominant syndrome-associated cancer types in the family history.We report the identification of a CDKN2A pathogenic variant in a PDAC-prone family without the cutaneous features of multiple moles or melanoma that are characteristic of the Familial Atypical Multiple Mole Melanoma (FAMMM) Syndrome identified in a universal testing algorithm for inherited mutations in pancreatic cancer patients.
Case presentation:
We present the case of two brothers of English ancestry diagnosed with PDAC within the same 12 month period, at the respective ages of 63 and 64 years of age. Neither brother reported a personal history of multiple moles or melanoma. Family history was positive for two second-degree relatives diagnosed with PDAC but was negative for other cancers or multiple moles in first- and second-degree relatives. Due to the absence of melanoma, this family did not meet provincial criteria for publicly funded genetic testing. Clinical genetic testing offered through a research grant identified a pathogenic variant in the CDKN2A gene c.377 T > A (p.Val126Asp). This variant is a North American founder mutation believed to pre-date colonization.
Conclusions:
This case reminds clinicians to consider the possibility of a germline CDKN2A mutation in families with a high prevalence of PDAC, even in the absence of moles or melanoma. This case supports recent guidelines published by the American College of Medical Genetics and Genomics (ACMG) that genetics referrals are indicated in families with three or more cases of PDAC regardless of other cancer types in the family. A multi-gene panel approach is of particular benefit in diagnosing inherited cancer susceptibility in PDAC-only families.
3D Imaging in Unilateral Primary Pulmonary Hypoplasia in an Adult: A Case Report
Authors: Aristida Georgescu, Crinu Nuta, Simona Bondari
Journal: Case Rep Radiol (2011)
MeSH terms: Case Reports

Unilateral primary pulmonary hypoplasia is rare in adulthood (UPHA); it is characterized by a decreased number of bronchial segmentation and decreased/absent alveolar air space. Classical chest X-ray may be confusing, and the biological tests are unspecific. We present a case of UPHA in a 60-year-old female, smoker, with 3 term normal deliveries, who presented with late recurrent pneumonias and bronchiectasis-type symptomathology, arterial hypertension, and obesity. Chest X-rays revealed opacity in the left lower pulmonary zone, an apparent hypoaerated upper left lobe and left deviation of the mediastinum. Preoperatory multidetector computer tomography (MDCT) presented a small retrocardiac left lung with 5-6 bronchial segmentation range and cystic appearance. After pneumonectomy the gross specimen showed a small lung with multiple bronchiectasis and small cysts, lined by hyperplasic epithelium, surrounded by stromal fibrosclerosis. We concluded that this UPHA occurred in the 4-7 embryonic weeks, and the 3D MDCT reconstructions offered the best noninvasive diagnosis.
Revision Roux-en-y hepaticojejunostomy for a post-cholecystectomy complex vasculobiliary injury with complete proper hepatic artery occlusion: A case report and literature review
Authors: Gunjan S Desai, Prasad Pande, Rajvilas Narkhede, Dattaprasanna R Kulkarni
Journal: Int J Surg Case Rep (2019)
Keywords: case report, complete hepatic arterial ischemia, complex biliary injury, revision hepaticojejunostomy

Introduction:
Complete proper hepatic arterial [PHA] occlusion due to accidental coil migration during embolization of cystic artery stump pseudoaneurysm resulting from a complex vasculobiliary injurie [CVBI] post laparoscopic cholecystectomy [LC] is an extremely rare complication with less than 15 cases reported. We present a case depicting our strategy to tackle this obstacle in management of CVBI and review the relevant literature.
Presentation of case:
A 35 year old lady presented on sixth postoperative day with an external biliary fistula following Roux-en-y hepaticojejunostomy [RYHJ] for biliary injury during LC. She developed a leaking cystic artery pseudoaneurysm, during angioembolisation of which, one coil accidentally migrated into left hepatic artery resulting in complete PHA occlusion. Fourteen months later, cholangiogram revealed a worsening RYHJ stricture despite repeated percutaneous balloon dilatations. Multiple collaterals had developed. Revision RYHJ was fashioned to the anterior wall of biliary confluence with an extension into left duct. Minimum hilar dissection ensured preservation of collateral supply to the biliary enteric anastomosis. Postoperative recovery was uneventful. The patient is doing well at 1 year follow up.
Discussion:
Definitive biliary enteric repair should be delayed till collateral circulation is established within the hilar plate, hepatoduodenal ligament and perihepatic/peribiliary collaterals to provide an adequate arterial blood supply to biliary confluence and extrahepatic portion of the bile duct.
Conclusion:
Assessment of hepatic arteries should be part of investigation of all complex biliary injuries. Delayed definitive biliary enteric repair ensures a well-perfused anastomosis. Minimum hilar dissection is the key to preserve biliary and hepatic neovasculature.
Management of face presentation, face and lip edema in a primary healthcare facility case report, Mbengwi, Cameroon
Authors: Nzozone Henry Fomukong, Ngouagna Edwin, Mandeng Ma Linwa Edgar, Ngwayu Claude Nkfusai, Yunga Patience Ijang, Fala Bede, Joyce Shirinde, Samuel Nambile Cumber
Journal: Pan Afr Med J (2019)
Keywords: cameroon, face presentation, pregnancy delivery
MeSH terms: Delivery, Obstetric / methods, Edema / pathology, Labor Presentation, Case Reports, Cameroon, Face, Female, Humans, Infant, Newborn, Lip, Male, Pregnancy, Primary Health Care, Young Adult

Face presentation is a rare obstetric event and most practitioners will go through their carriers without ever meeting one. Face presentation can be delivered vaginally only if the foetus is in the mentum anterior position. More than half of the cases of face presentation are delivered by caesarean section. Newborn infants with face presentation usually have severe facial oedema, facial bruising or ecchymosis. These syndromic facial features usually resolved within 24-48 hours.
Unusual Case of Life-Threatening Gastro Intestinal Bleed from a Splenic Artery Pseudoaneurysm: Case Report and Review of Literature
Authors: Puneet Menaria, Venkata Muddana
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Large upper gastro intestinal (GI) bleeding can be life-threatening. Splenic artery pseudoaenurysm (SAP) is rare but can cause massive upper GI bleeding. We report a case of a 57-year-old woman who had massive upper GI bleeding from SAP eroding into distal duodenum. Literature review shows SAP can bleed into stomach or pancreatic pseudocyst or biliary tree and peritoneal cavity; however, there are no previous reported cases of SAP bleeding into distal duodenum. Splenic artery embolization (SAE) is the preferred treatment for a bleeding SAP. Splenic infarcts can result following a SAE.
Parachute-Like Mitral Valve Tuberculoma: A Rare Presentation
Authors: Arslan Masood, Gul Zaman Khan, Irfan Bashir, Zubair Akram
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

There have been anecdotal reports of tuberculous cardiac involvement, mainly in cases of military tuberculosis or immune deficient individuals. The spectrum of clinical presentations of tuberculous cardiac involvements includes incidental detection of single and multiple well-circumscribed tuberculomas, symptomatic obstructive lesions, AV conduction abnormalities, and even sudden death. We present a case of cardiac tuberculoma in an immune-competent person who presented with worsening dyspnea. The unique morphology of this mass posed an imaging challenge that required 4-dimensional (4D) echocardiography and cardiac magnetic resonance (CMR) detail to differentiate the mass from an anterior mitral leaflet (AML) aneurysm. Histological examination after surgical resection confirmed its tuberculous etiology.
Adequate timing and constant supervision are the keys for successful implementation of levothyroxine or levothyroxine/paracetamol absorption test
Authors: Krzysztof C Lewandowski, Katarzyna Dąbrowska, Magdalena Basińska-Lewandowska, Marek Bolanowski, Marek Ruchała, Andrzej Lewiński
Journal: Thyroid Res (2020)
Keywords: absorption test, acetaminophen, levothyroxine, non-adherence, non-compliance, paracetamol, pseudomalabsorption
MeSH terms: Case Reports

Background:
Levothyroxine (LT4) pseudomalabsorption due to medication non-adherence results in significant costs for Health Service. High dose LT4 or LT4/paracetamol absorption test is used in such cases. Hence, establishment of an optimal test protocol and timing of sample collection is of utmost importance.
Case presentation:
A 34-year old woman was admitted to our Department because of severe hypothyroidism [on admission thyrotropin (TSH) > 100 μIU/ml, free thyroxine (FT4) 0.13 ng/dl (ref. range 0.93-1.7)] despite apparently taking 1000 μg of LT4 a day. Autoimmune hypothyroidism had been diagnosed 4 years before during post-partum thyroiditis. Subsequently, it was not possible to control her hypothyroidism despite several admissions to two University Hospitals and despite vehement denial of compliance problems. There was no evidence of coeliac disease or other malabsorption problems, though gluten-free and lactose-free diet was empirically instigated without success. A combined paracetamol (1000 mg)/LT4 (1000 μg) absorption test was performed in one of these Hospitals. This showed good paracetamol absorption (from < 2 μg/ml to 14.11 μg/ml at 120 min), with inadequate LT4 absorption (FT4 increase from 5.95 pmol/l to 9.92 pmol/l at 0 and 120 min respectively). About 2 years prior to admission to our Department the patient was treated with escalating doses of levothyroxine [up to 3000 μg of T4 and 40 μg of triiodothyronine (T3) daily] without significant impact on TSH (still > 75 μIU/ml, and FT4 still below reference range).After admission to our Department we performed a 2500 μg LT4 absorption test with controlled ingestion of crushed tablets, strict patient monitoring and sampling at 30 min intervals. We observed a quick and striking increase in FT4 from 0.13 to 0.46, 1.78, 3.05 and 3.81 ng/dl, at 0, 30, 60, 90 and 120 min, respectively. Her TSH concentration decreased to 13.77 μIU/ml within 4 days. When informed, that we had managed to "overcome" her absorption problems, she discharged herself against medical advice and declined psychiatric consultation.
Conclusions:
Adequate patient supervision and frequent sampling (e.g. every 30 min for 210 min) is the key for successful implementation of LT4 absorption test. Paracetamol coadministration appears superfluous in such cases.
Case Report: A case of hypertrophic lupus erythematosus with negative CD123 staining and absence of transepidermal elimination of elastin
Authors: Matthew Hughes, Jerad M Gardner, Ling Gao
Journal: F1000Res (2014)

We report the case of a 49-year-old male with clinical and histological findings consistent with hypertrophic lupus erythematosus (HLE). HLE must be clinically and histologically differentiated from keratoacanthoma, hypertrophic lichen planus, squamous cell carcinoma and plaque type psoriasis. CD123 positivity and transepidermal elimination of elastin have recently been reported as tools to distinguish HLE. Interestingly, in this case, biopsies of two separate lesions failed to reveal these two features. The etiology of this discrepancy is unknown and further studies are needed to clarify the utility of CD123 positivity and transepidermal elimination of elastin in the diagnosis of hypertrophic lupus erythematosus.
Coronary ostial stenosis detected by transesophageal echocardiography after aortic valve replacement: a case report
Authors: Naomi Ono, Toshiyuki Sawai, Hisanari Ishii
Journal: JA Clin Rep (2017)
Keywords: aortic valve replacement, coronary artery bypass grafting, coronary ostial stenosis, transesophageal echocardiography

Background:
Coronary ostial stenosis is a life-threatening complication of aortic valve replacement (AVR). Clinical symptoms usually appear within the first 6 months after AVR (Funada and Mizuno et al., Circ J 70:1312-7, 2006), and perioperative onset is very rare.
Case presentation:
An 80-year-old woman with severe aortic stenosis was scheduled to undergo AVR. AVR using cardiopulmonary bypass (CPB) was successfully carried out. However, 5 min following AVR, signs of left heart failure appeared, and transesophageal echocardiography (TEE) revealed severe hypokinetic left ventricular wall motion. Left coronary ostial stenosis was diagnosed by TEE, and CPB was immediately resumed and coronary artery bypass grafting (CABG) to the left anterior descending branch was performed.
Conclusions:
When circulatory failure presents in the acute phase following AVR, onset of coronary ostial stenosis should be considered.
Adenocarcinoma Arising within a Colonic Diverticulum in a Patient with Recurrent Diverticulitis
Authors: A van Beurden, C I M Baeten, C P E Lange, H Doornewaard, L N L Tseng
Journal: Clin Med Oncol (2008)
Keywords: adenocarcinoma, colon, diverticulum
MeSH terms: Case Reports

In 2006, while admitted in our hospital for surgical treatment of recurrent diverticulitis, a 54-year-old man was found to have an adenocarcinoma arising within a colonic diverticulum. Computed tomography, during this episode of diverticulitis, showed a thickened wall of the sigmoid and inflammatory induration of the pericolonic fat. Colonoscopy could be performed up to no more then 25 cm from the anus due to mucosal edema. A sigmoid resection was performed. Histopathological examination of the resected specimen showed an inflamed diverticulum with a submucosal adenocarcinoma of the intestinal type within its wall. The surrounding flat colonic mucosa was not involved by the cancerous process. Due to lymph node involvement the patient received adjuvant chemotherapy and remained disease free during follow up.
Case report: Preemptive intervention for an infant with early signs of autism spectrum disorder during the first year of life
Authors: Costanza Colombi, Natasha Chericoni, Stefania Bargagna, Valeria Costanzo, Raffaella Devescovi, Flavia Lecciso, Caterina Pierotti, Margherita Prosperi, Annarita Contaldo
Journal: Front Psychiatry (2023)
Keywords: esdm, autism spectrum disorder, early development, parent mediated intervention, preemptive intervention
MeSH terms: Case Reports

Autism spectrum disorder (ASD) includes neurodevelopmental conditions traditionally considered to bring life long disabilities, severely impacting individuals and their families. Very early identification and intervention during the very first phases of life have shown to significantly diminish symptom severity and disability, and improve developmental trajectories. Here we report the case of a young child showing early behavioral signs of ASD during the first months of life, including diminished eye contact, reduced social reciprocity, repetitive movements. The child received a pre-emptive parent mediated intervention based on the Infant Start, an adaptation of the Early Start Denver Model (ESDM), specifically developed for children with ASD signs during the first year of life. The child here described received intervention from 6 to 32 months of age, in combination with educational services. Diagnostic evaluations performed at several time points (8, 14, 19, and 32 months) showed progressive improvements in his developmental level and ASD symptoms. Our case study supports the possibility of identifying ASD symptoms and providing services as soon as concerns emerge even during the first year of life. Our report, in combination with recent infant identification and intervention studies, suggests the need for very early screening and preemptive intervention to promote optimal outcomes.
Orotracheal Intubation Using the Retromolar Space: A Reliable Alternative Intubation Approach to Prevent Dental Injury
Authors: Linh T Nguyen, Sudip D Thakar, Angela T Truong, Dam-Thuy Truong
Journal: Case Rep Anesthesiol (2016)
MeSH terms: Case Reports

Despite recent advances in airway management, perianesthetic dental injury remains one of the most common anesthesia-related adverse events and cause for malpractice litigation against anesthesia providers. Recommended precautions for prevention of dental damage may not always be effective because these techniques involve contact and pressure exerted on vulnerable teeth. We describe a novel approach using the retromolar space to insert a flexible fiberscope for tracheal tube placement as a reliable method to achieve atraumatic tracheal intubation. Written consent for publication has been obtained from the patient.
Characteristics of Congenital Clasped Thumb: A Case Report and Literature Review
Authors: Sungmin Kim, Woo Kyoung Kwak, Sung Taek Jung
Journal: Front Pediatr (2021)
Keywords: congenital hand deformity, congenital trigger thumb, conservative managements, tendon lengthening, thumb deformity, thumb hypoplastic
MeSH terms: Case Reports

Congenital clasped thumb is a progressive flexion and adduction deformity presenting with heterogeneous congenital abnormalities and syndromes. This deformity is usually accompanied by first web space narrowing and metacarpophalangeal joint (MPJ) laxity. Understanding the various features of the clasped thumb and making an accurate diagnosis is essential for treatment. Depending on the classification, treatment can vary from conservative to surgical. We describe the case of a bilateral clasped thumb with various characteristics, which were treated differently according to the disease type. The deformity of the clasped thumb was bilateral, and the patient had MPJ flexion deformity, flexor pollicis longus shortening, first web space narrowing, and MPJ instability, which were confirmed through a stress test. The left thumb was a complex type and was surgically treated, whereas, the right thumb was a flexible type, which was treated with splinting; the treatment showed promising results at 2 years post surgery. Diagnosis of the clasped thumb through thorough history taking, physical examination and considering its characteristics, and appropriate classification of the disease is essential for treatment. Furthermore, a stress test can identify MPJ instability in the congenital clasped thumb.
A Case of Infective Endocarditis and Spinal Epidural Abscess Caused by Streptococcus mitis Bacteremia
Authors: Victoria S Byrd, Attila S Nemeth
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

A 57-year-old man presented with abdominal pain, hematemesis, and melena. He reported taking high-dose ibuprofen for back pain and drinking several 24-ounce beers daily. Examination was remarkable for icteric sclera, poor dentition, tachycardia, and crescendo-decrescendo murmur at right upper sternal border, radiating to the carotids. Labs revealed leukocytosis, anemia, thrombocytopenia, and elevated liver function tests and INR. Endoscopy demonstrated antral ulcers, duodenitis, and esophagitis. Blood cultures were obtained and broad-spectrum antibiotics started; cultures later grew Streptococcus mitis, and antibiotic coverage was narrowed. Transthoracic echocardiogram (TTE) demonstrated aortic stenosis and regurgitation, but no vegetation. Repeat blood cultures were negative; however, the patient developed neurological symptoms concerning for cauda equina syndrome, and MRI revealed epidural abscess. Emergent decompression could not be performed as the patient developed hematemesis and required intubation. Transesophageal echocardiogram (TEE), initially deferred due to friable esophageal mucosa, was performed and revealed small aortic valve vegetation. Poor oral hygiene was felt to be the probable source of the patient's S. mitis bacteremia, epidural abscess, and infective endocarditis. The patient's neurological symptoms resolved without intervention and remaining teeth were extracted. This case demonstrates that Streptococcus mitis can result in clinically significant bacteremia, particularly in immunocompromised patients, including chronic heavy alcohol users.
Case Report: A Novel Ventilated Thermoplastic Mesh Bandage for Post-operative Management of Large Soft Tissue Defects: A Case Series of Three Dogs Treated With Autologous Platelet Concentrates
Authors: Priscilla Berni, Fabio Leonardi, Virna Conti, Roberto Ramoni, Stefano Grolli, Giovanni Mattioli
Journal: Front Vet Sci (2021)
Keywords: prp, dog, large cutaneous wound, platelet-rich plasma, regenerative medicine therapy
MeSH terms: Case Reports

A ventilated thermoplastic mesh bandage was used for the post-operative management of large soft tissue defects in three dogs. Once the granulation tissue appeared, the wounds were treated with liquid or jellified autologous platelet concentrates, Platelet Rich Plasma (PRP) and Platelet Lysate (PL), to improve the wound healing process. After cleaning the wound with sterile physiological solution, a dressing was performed with several layers of cotton. A window through the layers of cotton was opened above the wound. Then, the platelet concentrate was topically applied, and the bandage was completed by placing, over the access window, a ventilated thermoplastic mesh modeled according to the size and shape of the wound. After 24 h, it was replaced by a low adhesion bandage. The thermoplastic mesh avoids the direct contact between the wound and the external layers of the bandage, preventing the drainage of the topical agent and the removal of the growing healthy granulation tissue. The bandage proposed in this study is easily applied by the veterinarian and well-tolerated by the animal, ensuring high welfare standards in stressed patients presenting compromised clinical conditions.