OpenMed/multicare-articles huggingface dataset:
Small Bowel Obstruction Conservatively Managed in Hospital-At-Home
Authors: Margaret R Paulson, Abdullah S Eldaly, Francisco R Avila, Ricardo A Torres-Guzman, Karla C Maita, John P Garcia, Luiza Palmieri Serrano, Omar S Emam, Antonio J Forte, Michael J Maniaci
Journal: Case Rep Gastrointest Med (2022)
MeSH terms: Case Reports

In 2020, Mayo Clinic established an Advanced Care at Home (ACH) program. ACH is a virtual hybrid hospital-at-home (HaH) program that combines telemedicine with in-home care services by utilizing a state that is software-driven, vendor-mediate medical supply chain. The program initially focused on acute medical diagnosis but has expanded to oversee surgical and postsurgical patients with continued inpatient needs. Here, we report the first case of a small bowel obstruction (SBO) managed under a HaH program. A 52-year-old lady presented to the emergency department with symptoms suggestive of mechanical SBO. The diagnosis was confirmed with an abdominopelvic computed tomography (CT) scan, and the patient was admitted to the hospital. Based on the patient's presentation and laboratory results, the care team proceeded with conservative treatment including nasogastric tube (NG) placement and suctioning, intravenous (IV) fluid replacement, and daily laboratory studies. She spent the first hospital day in the physical hospital ward so that the surgical team could ensure stability clinically and no urgent need for surgical intervention. On hospital day two, she was transferred home with ACH where the NG suctioning and IV replacement therapy could continue, while the medical team conducted daily virtual visits to ensure continued improvement. Additionally, a paramedic and a nurse performed an in-person, head-to-toe assessment and administered medications to the patient twice daily. She spent 5 days in ACH getting acute care and then was discharged into a postacute phase equivalent to outpatient monitoring called the restorative phase. She was monitored remotely for the duration of the restorative phase for 10 more days, and then she recovered fully. This case highlights that high-acuity patients with SBO can receive invasive treatments like NG tube suction as well as be appropriately monitored for clinical decompensation by a virtual hybrid home hospital program which combines virtual care providers with an in-home vendor-mediated supply chain.
Anatomical variation of the trajectory of the brachiocephalic artery encountered during parathyroid adenoma excision. A rare case report and a surgical challenge
Authors: Maria Zarokosta, Theodoros Piperos, Dimosthenis Chrysikos, Antonios Patrinos, Dimosthenis Kakaviatos, Vassileios Kalles, Ioannis Papapanagiotou, John Tsiaoussis, Panagiotis Theodoropoulos, Theodoros Mariolis-Sapsakos
Journal: Int J Surg Case Rep (2019)
Keywords: anatomical variation, anonymous artery, aortic arch, brachiocephalic trunk, case report

Introduction:
The brachiocephalic trunk (BCT), also known as the "anonymous artery" constitutes the first branch of the aortic arch that bifurcates at the level of the right sternoclavicular joint into the RCCA and the RSA. Anatomical variations of the origin and the trajectory of BCT are of vital clinical significance since they constitute major risk-factors of hemorrhage when performing tracheotomy, surgeries at the anatomic area of the neck as in the presented case.
Presentation of case:
A 64-year-old Caucasian female proceeded to our institution with signs and symptoms of PHPT. Imaging studies performed identified a large mass localized posterior to the right thyroid lobe. During the operation, surgeons incidentally detected anterior to the trachea aberrant trajectory of the BCT. The operation was uneventful. A meticulous review of the literature was conducted as well.
Discussion:
Anatomical anomalies of the origin and the trajectory of BCT are vaguely described in the literature. However, these anatomic variations constitute major risk-factors of accidental bleeding and subsequent complications when performing surgeries of the thyroid and parathyroid glands, tracheotomy and invasive radiological interventions.
Conclusion:
Deep knowledge of such variations of the trajectory of the BCT in addition to detailed exposure of the operative field constitute the cornerstone in order surgeons to perform a safe intervention.
Metastasis of ciliary body melanoma to the contralateral eye: a case report and review of uveal melanoma literature
Authors: Nouritza M Torossian, Roy T Wallace, Wen-Jen Hwu, Agop Y Bedikian
Journal: Case Rep Oncol Med (2015)

Many types of cancers metastasize to the eye. However, uveal melanoma metastasizing to the contralateral choroid is very rare. We report the case of a 68-year-old man with history of treated uveal melanoma of the right eye that developed metastasis to the liver and the choroid of the left eye. Ten years earlier, he was diagnosed to have uveal melanoma of the right eye and was initially treated with plaque radiotherapy. Two years later, upon progression of the disease in the right eye he had enucleation of the eye. We describe the patient's clinical history, the diagnosis of recurrent disease in the contralateral eye, therapy of the left eye, and systemic metastasis. In addition, we reviewed the published medical literature and described the recent advances in the management of uveal melanoma.
Minimally invasive surgical repair of accessory mitral valve tissue: A case report
Authors: Dinh Nguyen, Anh Vo, Chuong Pham, Trang Nguyen, Thanh Vu, Khoi Le, Bac Nguyen
Journal: Int J Surg Case Rep (2020)
Keywords: accessory mitral valve tissue, left ventricular outflow tract obstruction, minimally invasive approach
MeSH terms: Case Reports

Introduction:
Accessory mitral valve tissue is a rare congenital disease of the mitral valve. It is usually associated with other cardiac malformations and/or left ventricular outflow tract obstruction. More than 2/3 of patients were diagnosed in their childhood. Treatment can be conservative or surgical. The suitable timing for surgery remains controversial, some authors suggest early intervention to prevent devastating complications.
Case report:
We report a case of an adult patient with accessory mitral valve tissue causing left ventricular outflow tract obstruction, who was treated surgically via the right minithoracotomy.
Does Prostate Median Lobe Really Matter for GreenLight HPS Laser Photovaporization of the Prostate
Authors: Yohan Bodokh, Patrick Julien Treacy, Laetitia Imbert de la Phalecque, Matthieu Durand
Journal: J Endourol Case Rep (2018)
Keywords: bph, us scan, laser greenlight, photovaporization
MeSH terms: Case Reports

Background: Benign prostatic hyperplasia (BPH) is a common pathology in elderly patients, inducing lower urinary tract symptoms. The treatment of BPH is first a medical option, then a surgical treatment, either by endoscopy or open surgery. We here report a case of GreenLight HPS™ laser photovaporization (PV) with an impaired maintenance of median lobe postoperatively, unimportant on functional results. Case Presentation: A 68-year-old man presented with lower urinary tract symptoms in the last 2 years, treated first by medicine with good response. On digital rectal examination, the enlarged prostate was homogeneous and regular. International Prostate Symptom Score (IPSS) was 30/35, Incontinence Quality of Life (iQol) 6/6, and International Index of Erectile Function 5 14/25 with regular sexual activity. Transrectal ultrasound (TRUS) reported BPH of 62 g with a median lobe of 6 g protruding into the bladder. At uroflowmetry, maximum urinary flow rate (Qmax) was 8 mL/s for 90 cc void volume and 20 cc postvoid residual. After failure of medical treatment, we offered a surgical treatment option by laser therapy using the 180W XPS GreenLight™. At 1-month follow-up, functional outcomes were improved with a Qmax of 11 mL/s, postvoiding residual volume 0 cc, IPSS 12/35, and iQol 2/6. At 3-month follow-up, outcomes still improved, although the TRUS reported a prostate volume of 30 g with a persistent median lobe. Conclusion: Impaired maintenance of median lobe after GreenLight laser PV does not seem to affect functional results. This case report opens the way for a new therapeutic strategy for patients according to their prostate anatomy. A randomized clinical trial could be done about surgical treatment for patient BPH according to prostate volume and anatomy.
Complete Surgical Resection of a Giant Invasive Thymoma with Right Pneumonectomy and Graft Reconstruction of the Superior Vena Cava and Left Brachiocephalic Vein: A Case Report
Authors: Savvas Lampridis, Rajdeep Bilkhu, Gianluca Lucchese, Andrea Billè
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Background:
Complete surgical resection represents one of the most important prognostic factors for thymomas. However, surgery is usually not considered when there is invasion of the pulmonary hilum and mediastinal veins because of technical considerations or potential perioperative morbidity and mortality. Case Presentation. We present the case of a 37-year-old woman with a giant thymoma infiltrating the superior vena cava, left brachiocephalic vein, and most of the right lung. Following 3 cycles of chemotherapy with minimal tumour response, she was hospitalised with COVID-19 and refused further systemic treatment. She subsequently underwent surgery after a thorough preoperative evaluation. Surgical resection of the tumour was performed with concomitant right pneumonectomy and reconstruction of the superior vena cava and left brachiocephalic vein using expanded-polytetrafluoroethylene grafts through a median sternotomy combined with a clamshell incision. Histopathological analysis of the resected specimens demonstrated a type B2, Masaoka-Koga stage IVa thymoma that was completely resected. Following an uneventful course, she was discharged home on the ninth postoperative day with anticoagulation therapy. She has remained free of disease or adverse events after a 12-month follow-up.
Conclusions:
Complete surgical resection of invasive thymomas with concomitant pneumonectomy and venous graft reconstruction is a feasible and safe procedure. Careful patient selection and adequate postoperative anticoagulation are crucial for successful clinical outcomes.
Effectiveness of a Short-Term Treatment of Oxygen-Ozone Therapy into Healing in a Posttraumatic Wound
Authors: Irene Degli Agosti, Elena Ginelli, Bruno Mazzacane, Gabriella Peroni, Sandra Bianco, Fabio Guerriero, Giovanni Ricevuti, Simone Perna, Mariangela Rondanelli
Journal: Case Rep Med (2016)

Introduction. A number of studies suggest that oxygen-ozone therapy may have a role in the treatment of chronic, nonhealing, or ischemic wounds for its disinfectant and antibacterial properties. Nonhealing wounds are a significant cause of morbidity. Here we present a case of subcutaneous oxygen-ozone therapy used to treat a nonhealing postoperative wound in a young man during a period of 5 weeks. Case Presentation. A 46-year-old man had a motorcycle accident and underwent amputation of the right tibia and fibula. At the discharge he came to our attention to start rehabilitation treatment. At that time the wound was ulcerated but it was afebrile with no signs of inflammation and negativity to blood tests. At 2 months from the trauma despite appropriate treatment and dressing, the wound was slowly improving and the patient complained of pain. For this reason in addition to standard dressing he underwent oxygen-ozone therapy. After 5 weeks of treatment the wound had healed. Conclusion. In patients with nonhealing wounds, oxygen-ozone therapy could be helpful in speeding the healing and reducing the pain thanks to its disinfectant property and by the increase of endogenous oxygen free radicals' scavenging properties. Compared to standard dressing and other treatments reported in the literature it showed a shorter time of action.
Dementia post-radiotherapy: improvement with acetylcholinesterase inhibitor. A case report
Authors: Antonio Eduardo Damin, Lílian S Morillo, Tíbor Rilho Perroco, Wilson Jacob Filho, Cássio Machado de Campos Bottino
Journal: Dement Neuropsychol (2009)
Keywords: cholinesterase inhibitors, dementia, radiotherapy, therapeutics
MeSH terms: Case Reports

Cognitive decline associated with radiotherapy is a progressive complication that affects many patients submitted to this form of treatment. The lack of an effective treatment drives research for new treatment options to improve the quality of life of patients with this disorder. We report the case of a 64 year-old man who developed a severe dementia of the frontal subcortical type, which was associated with subcortical frontal lesions and appeared as a late complication of radiotherapy used to treat a pituitary tumor. After many pharmacological attempts to improve his cognitive and behavioral problems, the patient showed a significant improvement in the cognitive, functional and behavioral impairments after treatment with an acetylcholinesterase inhibitor. This report discusses hypotheses for the positive effect of this treatment.
Hepatoblastoma in an 11-year-old: Case report and a review of the literature
Authors: Irina B Pateva, Rachel A Egler, Duncan S Stearns
Journal: Medicine (Baltimore) (2017)
MeSH terms: Hepatoblastoma / epidemiology, Hepatoblastoma / pathology, Hepatoblastoma / therapy, Liver Neoplasms / epidemiology, Liver Neoplasms / pathology, Liver Neoplasms / therapy, Case Reports, Review, Systematic Review, Age of Onset, Child, Fatal Outcome, Humans, Incidence, Lung Neoplasms / secondary, Male, Omentum, Peritoneal Neoplasms / secondary, Recurrence

Rationale:
Hepatoblastoma is a rare malignancy. Approximately 100 cases are diagnosed yearly in the United States. The highest incidence occurs in infants and in children younger than 5 years. Cases involving patients older than 5 years are very rare. We describe the case of a patient who was diagnosed with hepatoblastoma at an atypical age of presentation for this type of malignancy. We also performed Ovid MEDLINE search for hepatoblastoma and epidemiology reports occurring in children between the ages of 5 and 18 years. In this article we review the epidemiology and summarize case reports published between 1997 and 2012 of patients with hepatoblastoma, who were older than 5 years.
Patient concerns and diagnosis:
Our patient is an 11 year old boy with stage IV hepatoblastoma with lung and omental metastases at diagnosis.
Interventions:
The patient received 7 cycles of chemotherapy following the treatment plan of COG protocol AHEP 0731, off study. He also had tumor resection and omentectomy and achieved complete remission.
Outcomes:
He later had disease recurrence and after undergoing treatment with different modalities, ultimately died of his disease. Review of SEER program data shows that the incidence of hepatoblastoma in children above the age of 5 years is too infrequent to be calculated. Literature review revealed 13 cases of patients diagnosed at age older than 5 years. Most cases were published due to unusual associations and/or complications. There are no obvious unifying characteristics for these cases, although there may be a slight male preponderance and many patients in this selected series presented with elevated Alpha-fetoprotein.
Lessons:
The reported case is rare, given the very low incidence of hepatoblastoma outside of infancy. A systematic review of characteristics and outcomes for patients older than 5 years who are enrolled in cooperative group hepatoblastoma trials may reveal important information about the epidemiology and tumor biology in this rare patient population.
Traditional Chinese medicine to improve rural health in South Africa: A case study for Gauteng
Authors: Zijing Hu, Roy Venketsamy
Journal: Health SA (2022)
Keywords: africans, alternative medicine, rural health, traditional chinese medicine

Background:
Rural health is a global crisis across different continents. Most of Africa is predominantly rural and is experiencing financial constraints. Medical support and supplies are a dire need in rural Africa. An alternative option to support the rural population is through traditional Chinese medicine (TCM). Studies have highlighted the efficacy and cost-effectiveness of Chinese medicine in improving health.
Aim:
This article aims to investigate how rural health can be improved through alternative medicine options, focusing primarily on TCM.
Setting:
An identified TCM practice in Gauteng province was selected as the research setting.
Methods:
This study adopted a qualitative case study design to explore 10 participants' views on TCM to improve rural health. The health belief model was used as a theoretical framework, and thematic analysis was used for this study.
Results:
Findings revealed that most participants accepted TCM as an alternative medical health care option as it resonated with African herbal medicine. Participants agreed that TCM is cheaper and has no side effects.
Conclusion:
There is a lack of appropriate medical service providers in most rural areas, and often, people depend on traditional medicines as a quick remedy. As TCM is cost-effective and has proven to treat numerous ailments successfully, it is recommended that it be further explored as a health care option available to rural populations.
Contribution:
This was the first study on South African patients' views on TCM in the South African context.
Arthroscopic Fixation of Symptomatic Meso-Type Os Acromiale: Technical Note
Authors: Quen Oak Tang, Sherif Elnikety
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

Symptomatic Os acromiale can cause pain, impingement, and reduced range of movement. Disruption of the syndesmosis can result in significant pain and functional impairment; this may occur after trauma. Symptomatic Os acromiale is treated by either excision or fixation. Fixation via open technique is the mainstay of surgical intervention; however, recently, arthroscopic methods were used. In this technical note, we discuss the modification for all arthroscopic Os acromiale fixation; the fixation screws are introduced in anteroposterior fashion, employing the advances in orthopaedic fixation devices. Arthroscopic fixation is not widely adopted, possibly due to availability of implants and perceived difficult learning curve. We report this technique and demonstrate reproducibility with excellent results.
Rituximab Efficacy during a Refractory Polyarteritis Nodosa Flare
Authors: Emmanuel Ribeiro, Thomas Cressend, Pierre Duffau, Marieke Grenouillet-Delacre, Marie Rouanet-Larivière, Anne Vital, Maïté Longy-Boursier, Patrick Mercié
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Polyarteritis nodosa (PAN) is a systemic vasculitis whose severe forms are treated with glucocorticoids and cyclophosphamide. Refractory patients are exposed to many complications, notably accelerated atherosclerosis. We report a case report of 71-year-old man followed for polyarteritis nodosa refractory to glucocorticoids and cyclosphosphamide. Systemic vasculitis relapses are followed to accelerated atherosclerosis: severe ischemic lesions led to amputation of lower limbs. Remission of refractory PAN is obtained with rituximab. Disappearance of biological inflammatory is allowed to regression of ischemic lesions in upper limbs. In this situation, we recommend a systematic vascular work-up for patients suffered from refractory vasculitis. On the other hand, therapeutic trials are needed to determine the real efficacy and place of rituximab in the treatment of polyarteritis nodosa.
Case Report: Bullous Lung Disease Following COVID-19
Authors: Prachi Pednekar, Kwesi Amoah, Robert Homer, Changwan Ryu, Denyse D Lutchmansingh
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, sars cov-2, bullous lung disease, post-covid “long haulers”, post-acute covid-19
MeSH terms: Case Reports

More than 87% of patients report the persistence of at least one symptom after recovery from the Coronavirus disease 2019 (COVID-19). Dyspnea is one of the most frequently reported symptoms following severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection with persistent chest radiological abnormalities up to 3 months after symptom onset. These radiological abnormalities are variable and most commonly include ground-glass opacities, reticulations, mosaic attenuation, parenchymal bands, interlobular septal thickening, bronchiectasis, and fibrotic-like changes. However, in this case report, we describe findings of bullous lung disease as a complication of SARS CoV-2 infection. As the pandemic continues, there is a need to understand the multiple respiratory manifestations of post-acute sequelae of COVID-19. We, therefore, present this case to add to the current body of literature describing pulmonary disease as a consequence of SARS CoV-2 infection.
Side-alternating vibration training improves muscle performance in a patient with late-onset pompe disease
Authors: Aneal Khan, Barbara Ramage, Ion Robu, Laura Benard
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Side-alternating vibration training (SAVT) was used for 15 weeks in a patient with Late-onset Pompe disease who had never used enzyme replacement or chaperone therapy. Prior to the use of SAVT, the patient had experienced declining muscle performance and her 6-minute walk distance decreased from 210 to 155 metres in 6 months. After SAVT, her 6-minute walk distance increased 70% from 166 to 282 metres, muscle jumping power increased by 64% from 83 to 166 watts, isometric knee extensor strength increased 17% from 38 to 44 Nm, and she achieved a more normal pattern of ankle, knee, and joint kinematics and kinetics. Her functional ability measured through the Rotterdam 9-item score was unchanged at 19/36. There were no elevations in serum creatine kinase or lactate. This is the first report, to our knowledge, of a performance improvement in a patient with Pompe disease using SAVT.
The therapeutic dental challenge of xeroderma pigmentosum patients: case report
Authors: Yasmine Hanine, Sonia Ghoul, Amine Cherkaoui
Journal: Pan Afr Med J (2023)
Keywords: xeroderma pigmentosum, case report, dental care, ultraviolet rays
MeSH terms: Dental Caries / etiology, Dental Caries / therapy, Xeroderma Pigmentosum / complications, Xeroderma Pigmentosum / diagnosis, Xeroderma Pigmentosum / therapy, Case Reports, Adult, Face, Female, Humans, Pigmentation, Ultraviolet Rays

Xeroderma pigmentosum (XP) is a rare genetic disease characterized by a hypersensitivity to ultraviolet (UV) radiation leading to defective deoxyribonucleic acid (DNA) repair and predisposing to skin tumorigenesis. This paper reports the safe approaches used for the dental treatment of XP patients, controlling the ultraviolet (UV) sources at the dental office. An XP 29-year-old woman was referred for oral pain and sensitivity at the service of periodontology, UV rays were checked with a UV-meter. During the examination, the patient kept her sunglasses while the practitioner was dressed in dark colors using an anti-UV filter over the surgical light. Facial dark brown pigmentations, limited mouth opening, tumor resection scar on the tongue, moderate periodontitis, and dental caries were noticed. Moderate periodontitis and dental caries were diagnosed. Treatment was planned in collaboration with the dermatologist. Soft scaling and root planning were performed in short sessions and self-curing material was used for coronary fillings after caries removal. In taking care of XP patients, particular attention should be given by dental professionals to: i) the office management for a UV-safe environment; ii) the adoption of suitable dental care and safe biomaterials with short sessions and regular controls; and iii) the adoption of personal protections by patients and practitioners.