OpenMed/multicare-articles huggingface dataset:
Pulmonary alveolar hemorrhage mimicking a pneumopathy: a rare complication of dual antiplatelet therapy for ST elevation myocardial infarction
Authors: Sara Oualim, Charafeddine Ait Elharda, Dounia Benzeroual, Mustapha El Hattaoui
Journal: Pan Afr Med J (2016)
Keywords: antiplatelet drugs, hemoptysis, myocardial infarction, pneumopathy
MeSH terms: Hemorrhage / etiology, Platelet Aggregation Inhibitors / adverse effects, Pulmonary Alveoli / pathology, ST Elevation Myocardial Infarction / therapy, Case Reports, Aspirin / administration & dosage, Aspirin / adverse effects, Clopidogrel, Drug Therapy, Combination, Female, Hemorrhage / diagnostic imaging, Humans, Lung Diseases / diagnosis, Middle Aged, Percutaneous Coronary Intervention / methods, Platelet Aggregation Inhibitors / administration & dosage, Pulmonary Alveoli / diagnostic imaging, Ticlopidine / administration & dosage, Ticlopidine / adverse effects, Ticlopidine / analogs & derivatives, Tomography, X-Ray Computed, Platelet Aggregation Inhibitors, Clopidogrel, Ticlopidine, Aspirin

Diffuse alveolar hemorrhage after percutaneous coronary intervention (PCI) is a rare complication. The diagnosis is difficult and can mimic by clinical and radiological features other diagnosis as pneumopathy. We herein report the case of a 63-year-old female admitted to the hospital for ST elevation myocardial infarction. The patient underwent PCI and received dual antiplatelet therapy. Four days later, she developed dyspnea, hemoptysis and fever. Clinical, radiological and biological findings oriented to a pneumopathy and the patient received the treatment for it. Later and because of the non improvement, a thoracic computed tomography was performed and revealed patchy areas of ground-glass opacity consistent with a diffuse pulmonary hemorrhage. The combination therapy with aspirin and clopidogrel was therefore the most likely cause. Although the dual antiplatelet combination reduces systemic ischemic events after PCI, it is associated with increased risk of nonfatal and sometimes fatal bleeding. Hence the necessity of close and careful observation to watch for possible fatal complications.
Mucinous Carcinomatosis: A Rare Association between an Ovarian Tumor and an E-GIST
Authors: Hugo Palma Rios, André Goulart, Pedro Leão
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Pseudomyxoma peritonei (PMP) and extragastrointestinal stromal tumors (E-GISTs) are both rare entities. Most of the time, PMP is associated with an appendiceal tumor. An ovarian mucinous tumor can mimic appendiceal metastases. E-GIST is a mesenchymal tumor that can arise from the omentum, retroperitoneum, mesentery, or pleura. We present a case of an 87-year-old woman with mucinous carcinomatosis and acute intestinal occlusion submitted to an emergency laparotomy. She has found to have a borderline mucinous tumor of the ovary from the intestinal type with several lesions of pseudomyxoma peritonei and an E-GIST from the epiploons retrocavity (intermediated risk). In the literature, no relation was found between these two rare tumors. E-GIST was an incidental finding in the context of a mucinous carcinomatosis.
The involvement of osmolarity in the safety of contrast media
Authors: Stefania Isola, Fabiana Furci, Sebastiano Gangemi
Journal: Clin Mol Allergy (2018)
Keywords: adverse drug reaction, contrast media, hypersensitivity, osmolarity
MeSH terms: Case Reports

Background:
New non-ionic contrast agents, classified into low osmolar agents and iso-osmolar agents, present different biochemical characteristics that may influence the allergic reactions they cause. The aim of our study was to evaluate how osmolarity may affect safety in the use of contrast agents.
Case presentation:
Six patients with a positive history for reaction to contrast agent were included in this study. Only one patient prick and intradermal skin test was positive. However, in 5 cases, patients presented an immediate reaction after administration of contrast agent that was not IgE mediated.
Conclusions:
In this study, we focused on iodixanol, an iso-osmolar contrast agent, finding good safety of this product in patients with previous hypersensitivity reactions to contrast agent.
Successful surgical repair in an older adult with supracardiac total anomalous pulmonary venous connection: A case report
Authors: Chunle Wang, Xia Xie, Huanwei Zhuang, Zhonghua Huang, Chukwuemeka Daniel Iroegbu, Mi Tang, Chengming Fan, Jinfu Yang
Journal: Front Cardiovasc Med (2023)
Keywords: tapvc, congenital heart disease, older adult, rare, surgery
MeSH terms: Case Reports

Total anomalous pulmonary venous connection (TAPVC) is a rare, cyanotic and critical congenital heart disease where the entire left and right pulmonary veins fail to drain into the left atrium directly. Also, TAPVC-induced tissue hypoxia gradually worsens after birth. Thus, timely surgical repairs are recommended once diagnosed, particularly with pulmonary venous drainage obstruction(s). Nonetheless, in sporadic cases, patients with TAPVC survive to adulthood with no surgical treatment. Herein, we report a 46-year-old female with TAPVC, where the four pulmonary veins drain into to the innominate vein (IV) via the vertical vein. The patient developed palpitations and non-anginal chest pain following routine activities for over three months. The patient had a successful surgical correction with excellent postoperative recovery.
Small cell prostate carcinoma: a case report and review of the literature
Authors: Abdullah Demirtaş, Nurettin Sahin, Figen Oztürk, Emre Can Akınsal, Türev Demirtaş, Oguz Ekmekçioğlu, Atila Tatlışen
Journal: Case Rep Urol (2013)

Small cell prostate cancer constitutes less than 1% of all prostate cancers and has a poor prognosis. A 60-year-old male patient presented with dysuria, pollakiuria, and nocturia of about 1-year duration.The total PSA level at admission was 47.50 ng/mL. The prostate needle biopsy result was reported as adenocarcinoma Gleason 5 + 3. The patient underwent transurethral prostate resection (TUR-P) and bilateral orchiectomy. The TUR-P pathology result was consistent with small cell neuroendocrine carcinoma. He was offered systemic chemotherapy but refused it. Examinations and tests at the third postoperative month showed diffuse liver metastasis and vertebral bone metastasis. He died at the 6 months after surgery.
Cerebral Metastasis of a Malignant Pleural Mesothelioma: A Case Report and Review of the Literature
Authors: Aswin Chari, Angelos G Kolias, Kieren Allinson, Thomas Santarius
Journal: Cureus (2015)
Keywords: brain metastasis, mesothelioma, metastasis, neuro-oncology, neurosurgery, radiation oncology, spine metastasis
MeSH terms: Case Reports

Background:
Malignant pleural mesothelioma (MPM) is an aggressive malignant neoplasm that was thought to be a localised disease with limited metastatic capability. However, recent post-mortem studies have identified metastases to the central nervous system (CNS) in about 3% of cases.
Case description:
We present the case of a 65-year-old with a solitary supratentorial metastatic deposit of MPM treated with surgical resection and adjuvant whole brain radiotherapy. Despite a good surgical outcome with symptomatic recovery, the patient died of cardiopulmonary compromise five months postoperatively.
Conclusions:
Although rare, CNS metastasis of MPM is a condition that neurosurgeons should be aware of. CNS metastases may occur via three distinct mechanisms, namely perineural spread, leptomeningeal carcinomatosis and, most commonly, haematogenous spread leading to parenchymal deposits. Surgical resection of these deposits can lead to symptomatic improvement, and together with radiotherapy, to local disease control. However, the overall survival remains poor.
The characteristics of invasive cardiac lipoma: case report and literature review
Authors: Xiliang Zhu, Zhaoyun Cheng, Sheng Wang, Xianjie Chen, Guoqing Lu, Xiaoyang Li
Journal: Front Cardiovasc Med (2023)
Keywords: cardiac, cardiac lipoma, cardiac tumor, cardiac tumor diagnosis, invasive cardiac lipoma
MeSH terms: Review

Invasive cardiac lipoma is a rare type of primary cardiac tumor that is composed of adipose tissue but infiltrating the adjacent structures. It is a benign tumor that can cause significant morbidity and mortality due to its size and location within the heart. We describe a giant invasive intracardiac lipoma across atrial wall extending to the ascending aorta and the superior vena cava. This review will provide an overview of invasive cardiac lipoma, including its clinical presentation, diagnosis, and management.
Echoendoscopy with elastography in mediastinal lymph nodes
Authors: Rogerio Colaiacovo, Altair da Silva Costa Jr, Gustavo Andrade de Paulo, Silvia Mansur Reimão, Marco Antonio Ribeiro Camunha
Journal: Einstein (Sao Paulo) (2019)
MeSH terms: Adenocarcinoma / diagnostic imaging, Elasticity Imaging Techniques / methods, Endosonography / methods, Lymph Nodes / diagnostic imaging, Lymphoma, Non-Hodgkin / diagnostic imaging, Sarcoidosis / diagnostic imaging, Ultrasonography, Interventional / methods, Case Reports, Adult, Aged, 80 and over, Biopsy, Fine-Needle, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Predictive Value of Tests

Elastography is a widely used procedure in conventional ultrasonography that has recently been incorporated in echoendoscopy. This is an innovative and promising technology that aims to increase the negative predictive value of endoscopic ultrasonography and fine-needle aspiration punctures. It is useful for directing punctures in suspect areas and, consequently, improves diagnostic performance. This is a non-invasive technique, easy to perform, without additional costs or complications. The main indications are the analysis of solid pancreatic masses, lymph nodes, subepithelial lesions, lesions in the left hepatic lobe and in the left adrenal. Negative or inconclusive cases of fine-needle aspiration can be submitted to elastography when there is a strong suspicion of malignancy. Elastography has a high precision for the differential diagnosis of solid masses and in difficult-to-access anatomic sites, as well as in mediastinal lymph nodes and pancreatic tumors. The procedure is based on the degree of tissue elasticity measurement, with a good correlation between the elasticity index and histopathological features. We report the case of four patients evaluated by echoendoscopy and qualitative elastography who had differential diagnoses in mediastinal lymph nodes: sarcoidosis, lymphoma, histoplasmosis and esophageal neoplasia.
Feasibility of Functional Electrical Stimulation-Assisted Neurorehabilitation following Stroke in India: A Case Series
Authors: Bhawna Khattar, Alakananda Banerjee, Rajsekhar Reddi, Anirban Dutta
Journal: Case Rep Neurol Med (2012)

Functional Electrical Stimulation (FES) facilitates ambulatory function after paralysis by electrically activating the muscles of the lower extremities. The Odstock Dropped Foot Stimulator (ODFS, Odstock, UK) called ODFS Pace, was used for heel-switch triggered FES-assisted walking. The ODFS is recommended as an intervention for neurologically impaired gait in the Royal College of Physicians (UK) Clinical Guidelines on Stroke. Based on the guidelines by the National Institute of Clinical Excellence (NICE, UK), we started first clinical study in India on ODFS Pace as an orthotic intervention for daily use. In this preliminary study, we also investigated improvement in volitional walking following 6 sessions (3 times per week, for 2 weeks) of 30 minutes of FES-assisted treadmill walking on 7 chronic (>6 months after stroke) stroke survivors. We found that short-duration, moderately intensive FES-assisted gait therapy improved volitional gait in 3 out of 7 stroke survivors suffering from foot drop. Even in absence of improvement in volitional walking, there were no adverse effects and the subjects found heel-switch triggered FES-assisted walking mostly "easy" (6 out of 7). Therefore FES is promising as an orthotic intervention for daily use; however, tailoring the intensity and/or frequency based on patient's ability may make it viable as a therapeutic intervention.
An Unusual Cause of Bleeding in a Patient with Chronic Myeloid Leukemia Chronic Phase
Authors: S Kartthik, Prakas K Mandal, Saleh Mohammed Abdullah
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Chronic myelogenous leukemia (CML) is a clonal myeloproliferative neoplasm (MPN) characterized by dysregulated and uncontrolled proliferation of mature and maturing granulocytes with normal differentiation. A genetic hallmark of CML is the presence of the fusion gene product BCR-ABL. Bleeding diathesis in CML patients is rare (<10%) and primarily caused by acquired platelet dysfunction. We report a rare case of an adult CML chronic phase patient who presented with spontaneous muscle hematoma due to acquired Glanzmann's thrombasthenia (GT). On laboratory workup, a GT was confirmed along with the diagnosis of CML in chronic phase. The muscle hematoma was completely resolved following imatinib therapy. The present case demonstrates that bleeding is a complication of MPNs and highlights the importance of both acquired GT diagnosis to determine the cause of bleeding in CML and of prompt treatment with imatinib to reverse this condition.
Acute Pancreatitis Mimicking ST-Segment Elevation Myocardial Infarction
Authors: Akanksha Agrawal, Nuzhat Sayyida, Jorge Luis Penalver, Mary R Ziccardi
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Introduction:
Electrocardiographic changes imitating myocardial ischemia have been occasionally reported in patients with intra-abdominal pathology including acute pancreatitis.
Case report:
A 60-year-old man with no past medical history presented to the emergency department (ED) after a syncopal episode. In ED, his vitals were stable. His ECG showed sinus bradycardia at 53 beats per minute, peaked T waves, 1 mm ST-segment elevation in leads II, III, and aVF, and 2 mm ST elevation in V3 as shown in the figures. With the concern for STEMI, he was taken for left heart catheterization (LHC) emergently, showing nonobstructive coronary artery disease (CAD). His laboratory workup was remarkable for lipase of 25,304 IU/l (normal level 8-78 IU/l). His liver function test and triglyceride level were normal. Troponin was <0.01 ng/ml. A computed tomographic exam of the abdomen revealed acute interstitial pancreatitis with a small discrete fluid collection in the uncinate process. He was treated with aggressive intravenous fluid resuscitation and was discharged on day 3.
Discussion:
Intra-abdominal pathologies like acute pancreatitis can lead to transient ECG changes mimicking STEMI. It is important to use ECG clues, echocardiographic findings, and clinical judgement to avoid cardiac catheterization, contrast exposure, and associated health care costs.
Retroperitoneal Ganglioneuroma (GN): Case report in 14 years old boy
Authors: Nahlah Arab, Ashwag Alharbi
Journal: Int J Surg Case Rep (2019)
Keywords: computed tomography (ct), ganglioneuroma (gn), inferior vena cava (ivc), magnetic resonance imaging (mri)

Introduction:
The ganglioneuroma is a rare tumor arising from sympathetic nervous system, which is composed of gangliocytes and mature stroma.
Presentation of the case:
A retroperitoneal ganglioneuroma was found in a 14 years old Saudi boy, presented with recurrent vomiting. CT image showing a retroperitoneal cyst near the inferior vena cava and right iliac vessels. Treated by laparoscopic cystic excision, histopathology of the cyst showing ganglioneuroma, completely excised.
Discussion:
Ganglioneuromas arise from the sympathetic chain, The most common sites of presentation are the posterior mediastinum, retroperitoneum, head and neck region. GN are usually asymptomatic found incidentally on abdominal imaging. The treatment of retroperitoneal mass is complete surgical excision.
Conclusion:
Ganglioneuroma (GN) is a rare benign tumor, usually asymptomatic. One of the most common site of presentation is retroperitoneum, the main treatment for that is complete surgical excision.
Recurrence of Cryptococcal Meningitis and the Hidden Role of Patient Education and Social Support
Authors: Felix Bongomin, Lorna Atikoro
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Human immunodeficiency virus- (HIV-) associated cryptococcal meningitis (CM) is one of the leading causes of deaths among patients living with HIV/AIDS in resource-limited settings, accounting for ~15-20% of AIDS-related deaths globally. We present our experience with a 25-year-old woman living with HIV who had a recurrent cryptococcal disease due to nonadherence to HIV care and lack of awareness of the benefits of adherence to secondary prophylaxis for CM. This case highlights the fact that fungal diseases awareness should not be limited only to the health professionals and public health practitioners, but also to patients, caregivers, and stakeholders.
Retroperitoneal Endometrioid Carcinoma Arising from Ureteral Endometriosis
Authors: Daiken Osaku, Fuminori Taniguchi, Maako Moriyama, Shinya Sato, Tetsuro Oishi, Tasuku Harada
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Primary ureteral endometriosis is considered to be an uncommon form with an incidence of less than 0.1% in endometriosis. We reported a case of retroperitoneal endometrioid carcinoma possibly arising from ureteral endometriosis. A 52-year-old woman complained left backache. A solid mass in left retroperitoneal cavity with hydronephrosis was found. Diagnostic laparotomy with bilateral salpingo-oophorectomy and biopsy of the mass were performed. Although the primary lesion was not defined in the surgery, the histopathological diagnosis of specimen was endometrioid carcinoma. In the interval debulking surgery after the chemotherapy, tumor adjacent the left iliac vessels was observed. We resected the mass together with 5 cm left ureter and performed ureterectomy and anastomosis. The patient was diagnosed as the malignant transformation of ureteral endometriosis. Adjuvant chemotherapy is now undergoing. In case of finding the cancer tissue in women, we should take into account the malignant transformation of less common endometriosis, including ureteral endometriosis.
Machine learning clinical decision support systems for surveillance: a case study on pertussis and RSV in children
Authors: Kimberly A Mc Cord-De Iaco, Francesco Gesualdo, Elisabetta Pandolfi, Ileana Croci, Alberto Eugenio Tozzi
Journal: Front Pediatr (2023)
Keywords: artificial intelligence, clinical decision support systems, infectious diseases, machine learning, pertussis, respiratory syncytial virus, surveillance

We tested the performance of a machine learning (ML) algorithm based on signs and symptoms for the diagnosis of RSV infection or pertussis in the first year of age to support clinical decisions and provide timely data for public health surveillance. We used data from a retrospective case series of children in the first year of life investigated for acute respiratory infections in the emergency room from 2015 to 2020. We collected data from PCR laboratory tests for confirming pertussis or RSV infection, clinical symptoms, and routine blood testing results, which were used for the algorithm development. We used a LightGBM model to develop 2 sets of models for predicting pertussis and RSV infection: for each type of infection, we developed one model trained with the combination of clinical symptoms and results from routine blood test (white blood cell count, lymphocyte fraction and C-reactive protein), and one with symptoms only. All analyses were performed using Python 3.7.4 with Shapley values (Shap values) visualization package for predictor visualization. The performance of the models was assessed through confusion matrices. The models were developed on a dataset of 599 children. The recall for the pertussis model combining symptoms and routine laboratory tests was 0.72, and 0.74 with clinical symptoms only. For RSV infection, recall was 0.68 with clinical symptoms and laboratory tests and 0.71 with clinical symptoms only. The F1 score for the pertussis model was 0.72 in both models, and, for RSV infection, it was 0.69 and 0.75. ML models can support the diagnosis and surveillance of infectious diseases such as pertussis or RSV infection in children based on common symptoms and laboratory tests. ML-based clinical decision support systems may be developed in the future in large networks to create accurate tools for clinical support and public health surveillance.
Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness - Longitudinal Case Study
Authors: Albertyna Osińska, Andrzej Rynkiewicz, Marek Binder, Tomasz Komendziński, Anna Borowicz, Antoni Leszczyński
Journal: Front Neurosci (2022)
Keywords: eeg, hrv, coma, disorders of consciousness, tavns, unresponsive wakefulness syndrome (uws), vagus nerve stimulation

Neuromodulatory electroceuticals such as vagus nerve stimulation have been recently gaining traction as potential rehabilitation tools for disorders of consciousness (DoC). We present a longitudinal case study of non-invasive auricular vagus nerve stimulation (taVNS) in a patient diagnosed with chronic unresponsive wakefulness syndrome (previously known as vegetative state). Over a period of 6 months we applied taVNS daily and regularly evaluated the patient's behavioral outcomes using Coma Recovery Scale - Revised. We also took electrophysiological measures: resting state electroencephalography (EEG), heart rate (HR) and heart rate variability (HRV). All these methods revealed signs of improvement in the patient's condition. The total CRS-R scores fluctuated but rose from 4 and 6 at initial stages to the heights of 12 and 13 in the 3rd and 5th month, which would warrant a change in diagnosis to a Minimally Conscious State. Scores obtained in a 2 months follow-up period, though, suggest this may not have been a lasting improvement. Behavioral signs of recovery are triangulated by EEG frequency spectrum profiles with re-emergence of a second oscillatory peak in the alpha range, which has been shown to characterize aware people. However, sustained spontaneous theta oscillations did not predictably diminish, which most likely reflects structural brain damage. ECG measures revealed a steady decrease in pre-stimulation HR combined with an increase in HRV-HR. This suggests a gradual withdrawal of sympathetic and an increase in parasympathetic control of the heart, which the previous literature has also linked with DoC improvements. Together, this study suggests that taVNS stimulation holds promise as a DoC treatment.
S-shaped reverse sural flap for reconstruction of tissue defect on heel
Authors: Hamid Reza Fathi, Mehdi Fathi, Mihan J Javid
Journal: Burns Trauma (2013)
Keywords: limb trauma, modified technique, reverse sural flap
MeSH terms: Case Reports

Traumatic limb injury is a prevalent lesion in Iran. Motorcycle accidents are responsible for most of these traumatic lesions. Despite various reported techniques, the coverage of the Achilles tendon, malleoli, ankle and heel is still daunting and demanding procedure. S-shaped reverse sural flap is a modified technique of reconstruction. In this report of 6 patients underwent surgical reconstruction by this modified technique we discuss about the technique as a simple and safe technique with low morbidity rate and recommend using this technique in complex injuries.