OpenMed/multicare-articles huggingface dataset:
Evaluation method of medical service system based on DEMATEL and the information entropy: A case study of hypertension diagnosis and treatment in China
Authors: Rui Miao, Xiaohao Xiang, Qi Wu, Zhibin Jiang
Journal: PLoS One (2020)
MeSH terms: Clinical Decision-Making, Entropy, Health Services, Hypertension / diagnosis, Research Support, Non-U.S. Gov't, Aged, China, Hospitals, Humans, Numerical Analysis, Computer-Assisted, Reference Standards

Precise and reasonable evaluation of the multi-attribute value of medical system is the basis for hospitals to implement total quality management. Excellent medical system is necessary as a part of modern urban governance. However, most of medical value evaluation work relies on scale and artificial scoring at present, lacking in objectivity. Therefore, a scientific and comprehensive medical value evaluation system is needed urgently to give full play to the guiding role of value evaluation and promote the improvement of the medical service system. In this study, DEMATEL and information entropy are used to quantify the degree of mutual influence between system indicators and the differences in medical market performance respectively, so as to obtain the objective index weight. Hypertension has the highest incidence in the whole chronic disease system, which seriously affects people's daily life. Based on the existing hypertension diagnosis and treatment index system, a comprehensive and objective evaluation model is established to evaluate the hypertension diagnosis and treatment behaviors of different medical institutions, which achieves good result. This method has effectively improved the relative deficiency of one-sided subjective evaluation and has a great guiding significance for the comparison of treatment in departments and the economical use of medical resources.
Life-Threatening Hemorrhage During Patent Ductus Arteriosus Ligation in a Cat: Xenotransfusion With Canine Blood
Authors: Julien Dupont, Didier Serteyn, Charlotte Sandersen
Journal: Front Vet Sci (2020)
Keywords: canine blood, cat, hemorrhage, naturally occurring antibodies, patent ductus arteriosus, xenotransfusion
MeSH terms: Case Reports

A 13-month-old Sphynx cat was referred for patent ductus arteriosus (PDA) ligation. A left thoracotomy was performed and the PDA was efficiently ligated. Immediately after chest tube placement, it presented extensive intrathoracic bleeding from the caudal intercostal artery. In view of the absolute necessity of a blood transfusion and given that compatible feline blood was not available, xenotransfusion of canine blood was administered to the cat and resulted in a positive outcome.
Torsional Necrosis of an Output Loop Internal Hernia After Roux-en-Y Choledochojejunostomy: A Case Report
Authors: Chao Huang, Zhikun Ning, Zhengming Zhu
Journal: Front Surg (2019)
Keywords: roux-en-y choledochojejunostomy, bowel resection, internal hernia, surgical operation, volvulus
MeSH terms: Case Reports

Ultra-short bowel syndrome (USBS) refers to a clinical condition characterized mainly by severe diarrhea and nutritional disorders caused by the residual small intestine length of <30 cm (1). After Roux-en-Y choledochojejunostomy, the output loop herniated from the back of the anti-reverse peristalsis loop, resulting in intestinal torsion and necrosis, and leading to this rare case of internal hernia. Patients with torsion often show severe abdominal pain and persistent aggravation, but this symptom lacks specificity, making it easy to be misdiagnosed. Acute intestinal torsion and necrosis often lead to large-scale small bowel resection, resulting in USBS. We report a case of torsional necrosis of an output loop internal hernia after Roux-en-Y choledochojejunostomy, providing certain reference for the diagnosis and management of such cases.
The importance of tissue confirmation of metastatic disease in patients with breast cancer: lesson from a brain metastasis case
Authors: Jingxian Ding, Pinghua Hu, Jun Chen, Xiaobo Wu, Yali Cao
Journal: Oncoscience (2016)
Keywords: er/pr, her2, breast cancer, metastatic lesion, neoadjuvant chemotherapy
MeSH terms: Case Reports

Background:
The discrepancy of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) statuses in breast cancers has been reported. Available systemic therapy for patients with breast cancer is based on the molecular subtypes as identified by IHC and/or FISH. However, these biomarkers may change throughout tumor progression.
Case presentation:
We report a relatively uncommon case of a 39-year-old Chinese woman with local advanced breast cancer (LABC) treated with 6 cycles of docetaxel, doxorubicin and cyclophosphamide (TAC) regimen neoadjuvant chemotherapy, and subsequently mastectomy, intensity-modulated radiation therapy (IMRT) and tamoxifen followed as regularly. Brain metastatic event appeared in 6 months after mastectomy. Treatment for brain metastasis was surgical resection and followed by whole brain radiotherapy (WBRT) approved by multidisciplinary team (MDT). Initial pathological diagnosis was IDC, cT4N1M0, luminal B (ER+ 90%, PR+90%, HER2 0, Ki67+ 70%) based on ultrasound-guided core needle biopsy. Surgical pathology revealed IDC, pT2N3M0 luminal B (ER+ 20%, PR+20%, HER2 0, Ki67+ 20%). Histological response to neoadjuvant chemotherapy is grade 3 according to the Miller/Payne grading system. Final pathology of brain metastasis showed a HER2 overexpression metastatic breast cancer luminal B (ER+ 70%, PR+ 70%, HER2 2+, Ki67+ 30%), FISH confirmed HER2 overexpression. Weekly paclitaxel plus trastuzumab was given for 12 weeks, then trastuzumab every 3 weeks for a whole year. Patient follow-up is still ongoing, no new events appear yet.
Conclusions:
The determination of hormone receptors and HER2 status should be routinely performed in all involved tissues, if possible, and systemic therapy should be tailored following the latest finding.
Endometrial stromal sarcoma
Authors: Geetha Puliyath, V Rajasekharan Nair, Swetha Singh
Journal: Indian J Med Paediatr Oncol (2010)
Keywords: endometrial stromal sarcoma, rapid enlargement of fibroid uterus, uterine sarcoma
MeSH terms: Case Reports

Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years. This is a case of low-grade ESS presenting as rapid enlargement of a fibroid uterus. Because of her secondary infertility, she was planned for myomectomy. However, due to the high degree of suspicion of a sarcomatous change in the fibroid, in view of rapid enlargement of uterus within the last 4 months, we planned for a preoperative endometrial aspiration. It showed low-grade ESS, which was later confirmed by histopathology examination of total hysterectomy specimen. As surgery was the main treatment for ESS, because of the proper preoperative diagnosis, we could plan the treatment accordingly. Despite the rarity of the tumor, one has to consider the possibility of ESS in cases with presentation of rapid enlargement of a fibroid uterus.
First-episode mania after COVID-19: A case series in Iran
Authors: Mahdieh Saeidi, Tara Rezvankhah, Victor Pereira-Sanchez, Maryam Rafieian, Behnam Shariati, Soode Tajik Esmaeeli, Maziar Emamikhah, Kaveh Alavi, Amir Shabani, Shiva Soraya, Fatemeh Kashaninasab, Fatemeh Sadat Mirfazeli
Journal: Front Psychiatry (2023)
Keywords: covid-19, bipolar disorder, first-episode mania, mania, pandemic

Background:
Increasing reports of manic episodes in patients during acute infection with COVID-19 have been documented since the pandemic began, including individuals without a previous personal or family history of bipolar disorder. As infections and autoimmunity have putative roles in bipolar disorder, we aimed to document the clinical presentations, associated stressors, family aggregation patterns, and brain imaging and electroencephalographic correlates with a series of patients with episodes of mania that emerged shortly after COVID-19 infections.
Methods:
We obtained all relevant clinical information from 12 patients whose first manic episode started within a month of COVID-19 infection and were treated at Rasool-e-Akram hospital and Iran psychiatric hospital, two tertiary medical centers in Tehran, Iran, in 2021.
Results:
Patients had a mean age of 44. The interval between the onset of symptoms of COVID and mania ranged between 0 and 28 days (mean: 16.25, median: 14 days); it was observed to be shorter in patients with a family history of mood disorders but not in those receiving corticosteroids. Alongside a descriptive overview of our sample, we provide detailed narrative descriptions of two of the cases for illustrative purposes and discuss our observations in the context of other cases reported elsewhere and the state-of-the-art regarding infectious diseases, COVID-19, and bipolar disorder as reported in previous literature.
Conclusion:
Our case series documents observational and naturalistic evidence from a dozen of cases of mania in the context of acute COVID-19, which, while limited, calls for analytical research of the phenomenon, and points at a family history of bipolar disorder and the use of corticosteroids as factors for particular focus.
Closed reduction and intramedullary pinning in the treatment of adult radial neck fractures: a case report
Authors: Sancar Serbest, Murat Gürger, Haci Bayram Tosun, Lokman Karakurt
Journal: Pan Afr Med J (2015)
Keywords: radial neck, closed reduction, fractures, intramedullary pinning, treatment
MeSH terms: Bone Nails, Fracture Fixation, Intramedullary / methods, Radius Fractures / surgery, Case Reports, Adult, Humans, Male, Treatment Outcome

Closed reduction and intramedullary pinning (CIMP) in pediatric radial neck fractureswas first reported by Metaizeau in 1980 andsatisfactory results have been published several times. The current literature did not encounter any publication related to the implementation of Metaizeau method to adult patients. We applied Metaizeau technique to an adult radial neck fracture and we have achieved satisfactory results. As this case report is single case of this method applied to an adult, we decided to present this case.
Successful concomitant open surgical repair of aortic arch pseudoaneurysm and percutaneous myocardial revascularization in a high risk patient: A case report
Authors: Roxana Carmen Geana, Ovidiu Stiru, Laura Raducu, Adrian Tulin, Catalina Parasca, Ovidiu Chioncel, Nicolae Bacalbasa, Vlad Anton Iliescu
Journal: Int J Surg Case Rep (2020)
Keywords: aortic arch, beating heart, case report, coronary artery disease, pseudoaneurysm
MeSH terms: Case Reports

Introduction:
We present a case of open surgical repair of an aortic arch pseudoaneurysm (AAP) without the use of hypothermic circulatory arrest in a patient with low ejection fraction and associated coronary artery disease (CAD) and discuss some issues regarding the management of this case.
Presentation of the case:
A 69-year-old male with multiple pathologies and history of angina pectoris was transferred to our center from a local hospital with an initial diagnosis of non-ST-segment elevation myocardial infarction. Coronary angiography revealed stenotic lesions affecting all three coronary arteries. Multislice 3D contrast-enhanced computed tomography (CT-scan) revealed a 36 × 27 mm AAP. Endovascular stent-grafting was deemed to be unsuitable due to hostile landing zone. Therefore, the heart team decided for simultaneou treatment of the AAP and percutaneous therapy of CAD. The AAP was excised, and repair was performed with a Dacron patch on beating heart. After the surgical procedure, PCI with drug-eluting stents (DES) was performed on the right coronary artery (RCA) and the left circumflex artery (LCx) in the operating room. The patient's postprocedural course was uneventful and after thirteen days, he was discharged in good shape. 3D CT-scan performed after three month showed no residual AAP.
Discussion:
We established this approach as being the most suitable for our case based on favorable circumstances such as: stable CAD, beating heart procedure with low impact on myocardial ischemia, the impossibility of successful placement of an endovascular stent-graft, the presence of a pseudoaneurysm neck with minimum calcification.
Conclusion:
We consider the best approach for individual cases is tailoring the treatment plan and the procedure to the patient's specific anatomy and pathology.
A case of fatal gastrointestinal anthrax in north eastern iran
Authors: Seyed Ahmad Hashemi, Amir Azimian, Sara Nojumi, Tahereh Garivani, Saghar Safamanesh, Majid Ghafouri
Journal: Case Rep Infect Dis (2015)

Background. Bacillus species are aerobic or facultative anaerobic, gram-positive, or gram-variable spore-forming rods. They are ubiquitous in the environmental sources. Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal, and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. In this paper we report septic intestinal anthrax. Case Presentation. We report an isolation of Bacillus anthracis from blood culture of patient with intestinal anthrax. Bacillus anthracis was isolated from a blood culture of a 34-year-old man who had a history of severe abdominal pain, bloody diarrhea, nausea, vomiting, fever, sweating, and lethargy within 4 to 5 days after eating the meat of domestic goat. He had evidence of severe infection and septic shock and did not respond to treatments and subsequently expired 9 hours after hospitalization. Conclusion. Gastrointestinal anthrax is characterized by rapid onset, fever, and septicemia. Rapid diagnosis and prompt initiation of antibiotic therapy can help in survival. Most of previous cases of septicemic anthrax were related to injection drug users but, in our case, septicemia occurred after gastrointestinal anthrax.
A novel m.7539C>T point mutation in the mt-tRNA(Asp) gene associated with multisystemic mitochondrial disease
Authors: Diana Lehmann, Kathrin Schubert, Pushpa R Joshi, Karen Baty, Emma L Blakely, Stephan Zierz, Robert W Taylor, Marcus Deschauer
Journal: Neuromuscul Disord (2015)
Keywords: mitochondria, multisystemic disease, trna(asp)
MeSH terms: DNA, Mitochondrial / genetics, Mitochondrial Diseases / diagnosis, Mitochondrial Diseases / genetics, Point Mutation, RNA / genetics, RNA, Transfer, Asp / genetics, Case Reports, Research Support, Non-U.S. Gov't, Brain / pathology, Electron Transport Complex IV / metabolism, Female, Humans, Middle Aged, Mitochondria / metabolism, Muscle, Skeletal / enzymology, Muscle, Skeletal / pathology, RNA, Mitochondrial, DNA, Mitochondrial, RNA, Mitochondrial, RNA, Transfer, Asp, RNA, Electron Transport Complex IV

Mitochondrial transfer RNA (mt-tRNA) mutations are the commonest sub-type of mitochondrial (mtDNA) mutations associated with human disease. We report a patient with multisytemic disease characterised by myopathy, spinal ataxia, sensorineural hearing loss, cataract and cognitive impairment in whom a novel m.7539C>T mt-tRNA(Asp) transition was identified. Muscle biopsy revealed extensive histopathological findings including cytochrome c oxidase (COX)-deficient fibres. Pyrosequencing confirmed mtDNA heteroplasmy for the mutation whilst single muscle fibre segregation studies revealed statistically significant higher mutation loads in COX-deficient fibres than in COX-positive fibres. Absence from control databases, hierarchical mt-tRNA mutation segregation within tissues, and occurrence at conserved sequence positions, further confirm this novel mt-tRNA mutation to be pathogenic. To date only three mt-tRNA(Asp) gene mutations have been described with clear evidence of pathogenicity. The novel m.7539C>T mt-tRNA(Asp) gene mutation extends the spectrum of pathogenic mutations in this gene, further supporting the notion that mt-tRNA(Asp) gene mutations are associated with multisystemic disease presentations.
Elevated CA-125 as Humoral Biomarker of Congestive Heart Failure: Illustrative Cases and a Short Review of Literature
Authors: Attila Frigy, Boglárka Belényi, Ádám Kirchmaier, Nándor Fekete, István Adorján Szabó
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Despite the recent, remarkable achievements in cardiology, heart failure (HF) remains a major public health problem due to its increasing prevalence, frequent hospitalizations, and significant mortality. Humoral biomarkers in HF are capable to reflect different aspects of the cardiac morpho-functional changes and the related pathophysiological processes and could have important diagnostic, prognostic, and therapeutical roles. CA-125 is a well-known tumor marker (mainly for ovarian cancer), and also a useful, but less applied cardiac biomarker. Practical aspects, possible pitfalls related with increased CA-125 levels are illustrated by two cases, both with HF, with the biomarker determined for other reasons and having high levels in the context of the cardiac decompensation. The paper presents a short review of the main biochemical, pathophysiological, and clinical data linked to CA-125, with special accent on its utility in patients with HF.
Acute Pancreatitis with Pancreas Bifidum Mimicking Duodenitis on Computed Tomography
Authors: Charles Deflandre, Romain Gillard
Journal: J Belg Soc Radiol (2023)
Keywords: mri, fish-tail pancreas, pancreas bifidum, pancreatitis
MeSH terms: Case Reports

Teaching Point: The bifid pancreas is an extremely rare congenital branching anomaly, knowledge of which is necessary in order to make the correct diagnosis in the event of associated pancreatitis.
The hole in the stomach
Authors: Hans Bödeker, Steffen Leinung, Henning Wittenburg, Julia Fischer, Ingolf Schiefke, Niels Teich
Journal: Diagn Ther Endosc (2008)
MeSH terms: Case Reports

A 57 year old woman was presented to the emergency department with upper abdominal pain and left sided chest discomfort. No cardiac or pulmonary cause could be determined and the patient underwent upper gastrointestinal endoscopy. Inversion of the scope to the fundus and subsequent fluoroscopy revealed a diaphragmatic hernia with a large herniation of the gastric fundus. Immediate laparotomy showed a 3 cm orifice of the diaphragm. The orifice was widened and a partial necrosis of the incarcerated fundus was resected. The patient recovered fully and was discharged 12 days after laparotomy.
Case-based study: from prediabetes to complications--opportunities for prevention
Authors: Jonathan Rappaport, Vivian Fonseca
Journal: PLoS Med (2005)
MeSH terms: Diabetes Mellitus, Type 2 / etiology, Diabetes Mellitus, Type 2 / prevention & control, Diabetic Neuropathies / etiology, Case Reports, Research Support, Non-U.S. Gov't, Adult, Diabetic Neuropathies / prevention & control, Diet, Exercise Therapy, Humans, Life Style, Male, Metabolic Syndrome / complications, Metabolic Syndrome / diagnosis

A 31-year-old man presents with central obesity, hypertension, and abnormal lipids. How would you manage this patient?
Bangladeshi Case Series of Bardet-Biedl Syndrome
Authors: Fariah Osman, Md Iftekher Iqbal, M Nazrul Islam, Syed Jahangir Kabir
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

A rare multisystemic, ciliopathic autosomal recessive disorder called Bardet-Biedl syndrome (BBS) primarily affects children of consanguineous marriages. Both men and women are affected by it. It is characterized by some major and many minor features to aid in the clinical diagnosis and management. Here, we reported two Bangladeshi patients (a 9-year-old girl and 24-year-old male) who were presented with various major and minor features of BBS. Both patients came to us with the symptoms including excessive weight gain, poor vision, and learning disabilities with polydactyly. Our case 1 presented four primary features (retinal degenerations, polydactyly, obesity, and learning deficits) and six secondary features (behavioral abnormality, delayed development, diabetes mellitus, diabetes insipidus, brachydactyly, and LVH), whereas case 2 presented five major criteria (truncal obesity, polydactyly, retinal dystrophy, learning disabilities, and hypogonadism) and six minor criteria (strabismus and cataract, delay in speech, behavioral disorder, developmental delay, brachydactyly and syndactyly, and impaired glucose tolerance test). We diagnosed the cases as BBS. Because there is no specific treatment for BBS, we highlighted the importance of diagnosing it as early as possible so that comprehensive and multidisciplinary care can be offered to prevent avoidable morbidity and mortality.
An Unusual Cause of Cranial Dural Thickening
Authors: Jing Ming Yeo, Donald MacArthur, Jillian Davis, Ian Scott, Bruno Gran
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

We describe an unusual cause of cranial dural thickening in an elderly female with a chronic meningeal inflammatory process. A 70-year-old ethnically Chinese, Singaporean female presented with a history of chronic daily headache with no other meningeal signs. Serial MRI brains showed progressive pachymeningeal and leptomeningeal enhancement in the left frontal region with underlying vasogenic oedema, similar appearances in the right frontal region to a lesser extent, and persistent inflammatory changes in her bilateral paranasal sinuses. Investigative work-up showed a chronically raised ESR with a normal CRP, negative ANCA, and a chronically raised serum IgA kappa paraprotein. Bone marrow trephine biopsy was suggestive of a low level plasma cell disorder. Olfactory cleft biopsy showed no evidence of IgG4-related disease or vasculitis and no significant plasma cell infiltrate. Histopathological examination from a meningeal biopsy revealed a diagnosis of an en-plaque meningioma (the WHO, 2016; Grade I) causing an unusual granulomatous reaction. We discuss the radiological and histological relations of this rare form of meningioma. Clinicians can consider en-plaque meningioma in the differential diagnosis of linear dural thickening and enhancement.
Severe Hypophosphatemia Occurring After Repeated Exposure to a Parenteral Iron Formulation
Authors: Keerthana Haridas, Alice Yau
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

Hypophosphatemia is a less known complication of parenteral iron use, particularly after the use of certain iron formulations. We report the case of a young male with inflammatory bowel disease and iron deficiency anemia, who developed severe symptomatic hypophosphatemia after his third exposure to iron carboxymaltose with no evidence of the same occurring upon prior exposures to the compound. Investigations revealed serum phosphorous levels of 0.7 mg/dl, corrected serum calcium of 8-9.5 mg/dl, alkaline phosphatase of 50 U/L (38-126), 25 hydroxy vitamin D level of 40.2 ng/ml, and intact PTH elevated to 207 pg/ml. Urine studies indicated renal phosphate wasting. Presentation was not in keeping with refeeding syndrome. Intact fibroblast growth factor 23 level, measured after the initiation of treatment was within the normal range at 179 RU/mL (44-215). 1,25 dihydroxy vitamin D level, also measured after the initiation of treatment, was normal at 26.3 pg/ml (19.9-79.3). The patient was treated with calcitriol and aggressive oral and intravenous phosphorous repletion. Symptoms then resolved and the patient was discharged on an oral regimen. This phenomenon is postulated to occur due to an increase in the level and activity of FGF23 and decreased cleavage of the same, due to anemia as well as use of specific iron formulations. This is the first instance, in our literature review, of this complication known to occur, not after initial exposure to an implicated iron formulation but occurring on subsequent exposure.
A targeted parathyroidectomy using guide wire technique in a pregnant patient with primary hyperparathyroidism
Authors: E Kandil, S Faruqui, J Alharash, H Alabbas, B Rodgers, B Blank, B M Jaffe
Journal: Int J Otolaryngol (2009)
MeSH terms: Case Reports

Primary hyperparathyroidism may cause fetal demise in pregnant patients if prompt diagnosis and treatment is not initiated. The paper describes a novel guide wire technique for a targeted parathyroidectomy, which may reduce the risk to mother and fetus and be useful in other related circumstances.