OpenMed/multicare-articles huggingface dataset:
Post traumatic left cardiac luxation: A case report
Authors: Mokhles Lajmi, Imen Ben Ismail, Wafa Ragmoun, Houssem Messaoudi, Hatem Lahdhili, Slim Chenik
Journal: Int J Surg Case Rep (2020)
Keywords: cardiac luxation, median sternotomy, pericardial rupture
MeSH terms: Case Reports

Introduction:
Rupture of the pericardium complicating blunt thoracic trauma may lead to cardiac luxation if not early recognized and appropriately surgically treated. This condition is exceedingly rare and carries a high mortality rate.
Case presentation:
A 37-year-old man presented with severe multiple injuries following a road traffic crash, including blunt trauma to the thorax and abdomen. He was in a hemodynamically stable condition. The chest radiograph and CT scan revealed a leftward heart herniation through a pericardial tear, there were also non surgical hepatic and splenic lesions. The diagnosis of left cardiac luxation with no associated valvular lesions was made. Surgical exploration via a midline sternotomy revealed a protruding heart herniating into the left pleural cavity through a large tear (15 cm) of the left pericardium. Sutures with Teflon felt pledgets were performed. The postoperative chest radiograph was normal and the postoperative course was uneventful.
Discussion:
Post traumatic heart luxation diagnosis is clinically difficult because the scarcity of signs and lack of specificity. Chest X ray can be suggestive, and specific findings can only be detected by computed tomography, which is the most sensitive diagnostic method. Surgical management in this condition is mandatory to avoid fatal complications such as great vessels strangulation. It consists of replacing the heart in the pericardial sac and repairing the pericardial tear.
Conclusion:
Despite its rare occurrence, trauma surgeons must be aware of cardiac luxation. Any suspicion of such a diagnosis would warrant surgical exploration to avoid fatal complications.
Bluetongue Disease Control in Northern Ireland During 2017 and 2018
Authors: Anastasia Georgaki, Archie Murchie, Ignatius McKeown, David Mercer, Sarah Millington, William Thurston, Karen Burns, Ben Cunningham, Valerie Harkin, Fraser Menzies
Journal: Front Vet Sci (2019)
Keywords: culicoides, northern ireland, bluetongue, midges, risk assessment, surveillance, wind-borne

Since the emergence of bluetongue virus in central and northern Europe in 2006, Northern Ireland's (NI) surveillance programme has evolved to include the use of risk assessments and simulation models to monitor the risk of bluetongue incursion. Livestock production is of high economic importance to NI as it exports approximately 75% of its agricultural produce. Its surveillance programme is designed to enable effective mitigation measures to be identified to minimize disease risk, and to provide additional assurances to protect NI's export markets in the European Union (EU) and third countries. Active surveillance employs an atmospheric dispersion model to assess the likelihood of wind-borne midge transfer from Great Britain (GB) to NI and to identify high risk areas. In these areas, the number of cattle tested for bluetongue is proportionally increased. Targeted surveillance is directed to ruminants imported from restricted countries and regions at risk of bluetongue. Targeted surveillance on high risk imports assists in early detection of disease as, despite all controls and preventive measures, legally imported animals may still carry the virus. In November 2018, a bluetongue-positive heifer was imported into NI. A case specific risk assessment was commissioned to estimate the likelihood of spread of bluetongue as a result of this incursion. November is the tail end of the midges' active period and therefore there was considerable uncertainty pertaining to the survival of midges inside a cattle shed and the potential for incubation of the virus in the vectors. An evidenced-based approach was adopted where temperature and midge abundance was monitored in order to minimize uncertainty and give an accurate estimate of the likelihood of virus spread to other animals following the arrival of the positive heifer. The heifer was destroyed and the evidence indicated that the risk of successful completion of the extrinsic cycle within the local midge population was negligible. This paper describes NI's surveillance programme between January 2017 and December 2018 and the case of a positive imported animal into the country. The importance of effective surveillance in early detection of threats and the usefulness of risk assessments is highlighted through the case study.
Gastric sarcoidosis: a rare clinical presentation
Authors: Hemasri Tokala, Karthik Polsani, Jagadeesh K Kalavakunta
Journal: Case Rep Gastrointest Med (2013)

Gastrointestinal (GI) sarcoidosis is a very rare disease, which clinically presents along with systemic disease or as an isolated finding. Gastric sarcoidosis is the most common form of GI sarcoidosis. Symptomatic gastric sarcoidosis is rare and only few case reports have been described in the literature with well-documented histological evidence of noncaseating granulomas. We present an interesting case of gastric sarcoidosis in a 39-year-old Caucasian man with symptoms of epigastric pain and profound weight loss. His endoscopic gastric mucosal biopsies revealed noncaseating granulomas consistent with gastric sarcoidosis. Treatment with oral steroids alleviated his symptoms with no recurrence in 2 years. Gastric sarcoidosis should be considered in patients with history of sarcoidosis and GI symptoms.
COVID-19: Moral and Ethical Implications for Orthopaedic Spine Surgeons
Authors: Cris J Min, Cesar Iturriaga, Victoria Wang, Rohit Verma
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

The rapid spread of COVID-19 has made a significant impact on healthcare systems worldwide, with a large influx of patients prompting the cancellation of elective surgery in order to conserve resources and prevent the risk of exposure to the novel virus. In this case report, we present a 66-year-old male patient, with a history of cerebral palsy and developmental disabilities, exhibiting an increasing loss of function over the course of 10 days amid the COVID-19 pandemic. The patient was initially refused transport to the hospital by emergency medical services and later transported per independent request from his surgeon. Upon admittance to the hospital, the patient was found to have severe spinal cord compression with myelopathic symptoms and underwent an anterior cervical discectomy and fusion. This case highlights the need for more specific guidelines regarding the evaluation of a spinal injury by EMS and the hospital system amid a national crisis.
Primary adrenal leiomyosarcoma in an arab male: a rare case report with immunohistochemistry study
Authors: Veena Nagaraj, Mohammed Mustafa, Essa Amin, Waleed Ali, Shamil Naji Sarsam, Abdulla Darwish
Journal: Case Rep Surg (2015)

Primary adrenal leiomyosarcoma is a rare form of adrenal mesenchymal tumors. Immunohistochemistry (IHC) together with histology takes a major role in determining the tumor type and predicting their biological behavior and differentiating them from adrenal cortical carcinoma. Appropriate radiological investigation is necessary to rule out metastatic disease from primary tumors elsewhere in the body. In this case, we report a primary leiomyosarcoma of the adrenal gland in a 61-year-old Bahraini male clinically presumed to be a renal neoplasm.
Bilateral Pseudoarthrosis of the Medial End of the Clavicles: A Rare Case Report with a Two-Year Follow-Up
Authors: Manuel Bomfim Braga Júnior, Argos Queiroz Alves de Souza, Carlos Augusto Belchior Bitencourt Júnior, Fernando Henrique Uchôa de Alencar, Renan Teixeira Lôbo, Jonatas Brito de Alencar Neto, Réjelos Charles Aguiar Lira
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Bilateral clavicle fractures are considered rare. Most of the cases are caused by high energy traumas, such as automobile accidents. Such fracture is related to a higher frequency and severity of associated lesions. In this report, the authors present a twenty-two-year-old male patient's case who, after a motorcycle collision, suffered a bilateral medial end clavicle closed fracture, developing asymptomatic bilateral pseudoarthrosis after the patient refuses surgical treatment. The presented case is quite rare. Aspect related to the patient's evolution during treatment will be discussed, plus the fracture mechanism, associated injuries, the bilateral clavicular fractures treatment, and management in cases of pseudoarthrosis will be analyzed.
Case Report: Grade 2 Metastatic Pancreatic Neuroendocrine Tumor With Progression of One Metastasis After Pregnancy to Grade 3 Large-Cell Neuroendocrine Carcinoma: One Case Cured by Resection With Genomic Characterization of the Two Components
Authors: Jean-Luc Raoul, Marie-Françoise Heymann, Frédéric Dumont, Alain Morel, Hélène Senellart, François Bertucci
Journal: Front Oncol (2021)
Keywords: men 1 gene, mlh1, genomics, metastases, microsatellite instability, sporadic gastrinoma, surgery
MeSH terms: Case Reports

Temporal and spatial tumor heterogeneity can be observed in pancreatic neuroendocrine tumor. We report the case of a young woman with long term stabilization of a G2 metastatic pancreatic NET that, after pregnancy, suddenly progressed into one single liver metastasis corresponding to a transformation into G3 large-cell neuroendocrine cancer. The patient underwent liver resection (the progressive and one dormant metastasis). With a 45 months follow-up the patient is without evolutive disease. Exome sequencing of the two metastases revealed completely different genomic signatures and gene alterations: the dormant metastasis was MSS without any gene alteration; the poorly differentiated tumor was MSI, with gain of many mutations including MEN1, BCL2, MLH1 and TP53 corresponding to a mutational signature 11. Could temozolomide play a role in this transformation?
A case report of brief psychotic disorder with catalepsy associated with sequential life-threatening events in a patient with advanced cancer
Authors: Mayumi Ishida, Satoshi Kawada, Hideki Onishi
Journal: Biopsychosoc Med (2017)
Keywords: advanced cancer, brief psychotic disorder, catalepsy, life-threatening event
MeSH terms: Case Reports

Background:
Cancer is commonly perceived as life-threatening and universally stressful; however, brief psychotic disorder, which occurs in response to extremely stressful events, has not been reported.
Case presentation:
A 63-year-old woman, who was diagnosed as having pancreatic cancer with liver metastasis, became unresponsive with very little reaction to verbal contact after sequential life-threatening events, such as thrombosis of both pulmonary arteries and stenosis of the third portion of the duodenum, due to disease progression over 3 weeks beginning with oncological emergency hospital admission. Laboratory findings and electroencephalography were unremarkable. She maintained the position when the psycho-oncologist raised her hand (catalepsy). She had no medical history of psychiatric illness, or alcohol or drug abuse. From these findings, she was suspected of having a brief psychotic disorder with catalepsy and substupor, and 2.5 mg of haloperidol was administered. Her psychiatric symptoms disappeared in 4 days and the diagnosis of brief psychotic disorder was confirmed.
Conclusions:
Brief psychotic disorders can manifest in patients with cancer. Careful clinical assessment is needed to correctly diagnose patients with cancer who develop brief psychotic disorders and to identify those who will benefit from correct treatment.
Orbital cellulitis: a rare presentation of metastatic bronchial carcinoma
Authors: Rohit Kumar, Wolfgang Issing
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

Objective. We report a rare and unusual case of bronchial carcinoma presenting with symptoms of complications of sinonasal disease. Case Report. A 66-year-old lady was referred with a 1-week history of progressive ocular pain, chemosis, and visual disturbance. Computed tomography of the paranasal sinuses revealed frontal and ethmoidal sinus opacification with orbital involvement consistent with a diagnosis of orbital cellulitis secondary to sinusitis. Surgical exploration revealed that the sinuses and right orbit were filled with soft tissue and subsequent histopathological examination of the biopsies indicating metastases from an adenosquamous bronchial carcinoma. Further imaging revealed a large, asymptomatic, bronchial primary with deposits in the brain and liver. The advanced presentation of the disease limited treatment to best supportive care. Conclusion. Orbital cellulitis and sinonasal malignancies have a similar pattern of clinical presentation, posing a potential diagnostic pitfall. There are only two previously reported cases of metastatic lung carcinoma in the frontal sinus with 15 cases of sinonasal tract involvement reported overall. There are no reported cases of adenosquamous carcinoma in the sinonasal tract.
Complex Ebstein's Anomaly in an 86-Year-Old Iranian Man: A Case Report
Authors: Bahieh Moradi, Farideh Roshanali
Journal: J Tehran Heart Cent (2017)
Keywords: ebstein anomaly, life expectancy, tricuspid valve regurgitation
MeSH terms: Case Reports

Ebstein's anomaly is defined as the significant apical displacement of the tricuspid valve causing tricuspid regurgitation. Although a variety of concomitant lesions have been previously described, we herein introduce an unusual presentation. Our patient was an 86-year-old man with a primary presentation of typical chest pain in the setting of recently diagnosed coronary artery disease with concomitant Ebstein's anomaly. We found mild-to-moderate tricuspid regurgitation, bicuspid aortic valve, persistent left superior vena cava, and patent foramen ovale. The patient had suffered from chest discomfort on exertion for 2 months with good functional capacity prior to diagnosis. Coronary angiography revealed two-vessel disease. The patient refused surgery. He was treated with medical anti-ischemic therapy. He had good exercise tolerance with relief of chest pain at the latest follow-up. The features demonstrated in this case report suggest that there may be several adult survivors of complex congenital heart diseases requiring individualized surgical treatment plans.
An unusual cause of anaemia of chronic disease: lisinopril-induced chronic inflammatory state
Authors: Toby Eyre, Victoria Van-Hamel-Parsons, Lai Mun Wang, Kathryn A Hughes, Timothy J Littlewood
Journal: Case Rep Hematol (2011)
MeSH terms: Case Reports

We report the case of a patient with severe systemic symptoms (weight loss, malaise, and anorexia), eosinophilic oesophagitis, and raised inflammatory markers coinciding with the use of lisinopril. The onset of symptoms occurred after the administration of lisinopril and resolved shortly after cessation of the medication. Despite thorough investigation, no other cause of the systemic inflammation and anaemia of chronic disease was found. "Drug rash with eosinophilia and systemic symptoms" (DRESSs) syndrome describes a potentially serious multiorgan inflammatory response to certain classes of drugs; this includes the use of ACE inhibitors. Although this patient did not meet strict criteria for DRESSs, the subacute inflammatory syndrome with eosinophilic organ infiltration bears similar features. ACE inhibitors should be considered in the differential diagnosis in patients with nonspecific systemic inflammation and anaemia of chronic disease where no other cause is found.
Case Series: Efficacy and Safety of Hemoadsorption With HA-330 Adsorber in Septic Pediatric Patients With Cancer
Authors: Vitaliy Sazonov, Ramazan Abylkassov, Zaure Tobylbayeva, Askhat Saparov, Olga Mironova, Dimitri Poddighe
Journal: Front Pediatr (2021)
Keywords: ha-330 adsorber, blood purification, hemoadsorption, pediatric cancer, sepsis
MeSH terms: Case Reports

Background: Sepsis is a frequent cause of death in hospitalized patients and, in detail, in neonatal, pediatric, and adult intensive care units (ICUs). Severe sepsis has a very poor prognosis. Indeed, the mortality rate varies between 30 and 70% during the first 7-14 days. Despite a timely and appropriate therapy, the prognosis of severe sepsis is too often negative. Therefore, new therapeutic resources are under investigation in order to further improve prognosis. Case series: Here, we reported three septic children in whom we used extracorporeal blood purification therapy with hemoadsorption device HA330 (Jafron Biomedical Co., Ltd., China), aiming to scavenge and eliminate bacterial toxins and inflammatory mediators from the blood. Discussion and Conclusion: This small case series first showed that hemoperfusion with HA330 cartridge may be an effective and relatively safe adjunctive treatment to counterbalance the cytokine storm in septic children with hematological disorders. Further studies are needed to confirm and further support its safety and efficacy in a large number of pediatric patients.
A Rare Case Report and Literature Review of External Auditory Canal Cholesteatoma with Circumferential Destruction of Canal Wall Exposing Facial Nerve
Authors: Leison Maharjan, Pabina Rayamajhi
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

External auditory canal cholesteatoma (EACC) is a rare condition with an estimated incidence of 1.2 per 1000 new otological patients. It is often mistaken with keratosis obturans. We discuss an extensive primary EACC with an aural polyp in a male which was managed by modified radical mastoidectomy.
Friend or Foe: Factor XII Deficiency Discovered Incidentally during Management of NSTEMI
Authors: Patrick J Beck, John Benfield, Joshua Morales
Journal: Case Rep Hematol (2023)
MeSH terms: Case Reports

Factor XII (FXII) deficiency is a rare coagulopathy that typically goes undiagnosed due to the lack of abnormal bleeding or thrombosis. However, the accompanying prolonged activated partial thromboplastin time (aPTT) can create difficulties with maintaining therapeutic anticoagulation in the setting of acute coronary syndrome (ACS). Here, we present the case of a 52-year-old man presenting with chest pain and diagnosed with an NSTEMI but also found with a prolonged baseline aPTT ultimately secondary to FXII deficiency. Here, we discuss the diagnostic work-up of an isolated prolonged aPTT to identify possible etiologies, such as FXII deficiency, and ultimately inform ACS management.
Red blood cell transfusion independence following the initiation of iron chelation therapy in myelodysplastic syndrome
Authors: Maha A Badawi, Linda M Vickars, Jocelyn M Chase, Heather A Leitch
Journal: Adv Hematol (2010)
MeSH terms: Case Reports

Iron chelation therapy is often used to treat iron overload in patients requiring transfusion of red blood cells (RBC). A 76-year-old man with MDS type refractory cytopenia with multilineage dysplasia, intermediate-1 IPSS risk, was referred when he became transfusion dependent. He declined infusional chelation but subsequently accepted oral therapy. Following the initiation of chelation, RBC transfusion requirement ceased and he remained transfusion independent over 40 months later. Over the same time course, ferritin levels decreased but did not normalize. There have been eighteen other MDS patients reported showing improvement in hemoglobin level with iron chelation; nine became transfusion independent, nine had decreased transfusion requirements, and some showed improved trilineage myelopoiesis. The clinical features of these patients are summarized and possible mechanisms for such an effect of iron chelation on cytopenias are discussed.
Duodenal Pyloric Gland Adenoma in a 59-Year-Old Asian Male
Authors: Mia Manabat, Matthew Jackson, Kha Ngo, Laurence Stawick
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Pyloric gland adenomas (PGAs) are rare precancerous tumors typically arising from the stomach. Even more rarely do they arise in extragastric sites such as the duodenum and gallbladder. The identification of PGAs is important because they possess a risk of developing into invasive adenocarcinoma. This case report describes a 59-year-old male who presented to our office for a follow-up of a nonspecific duodenal lesion. Endoscopic ultrasound and pathology revealed a PGA with low grade dysplasia and some areas of focal high grade dysplasia. It is important that gastroenterologists are aware of these lesions and their risk of malignant transformation. More studies are needed to describe the long-term behavior of pyloric gland adenomas and to recommend appropriate endoscopic surveillance of these lesions.
Ileocecal Fistula Caused by Multiple Foreign Magnetic Bodies Ingestion
Authors: Vittorio Cherchi, Gian Luigi Adani, Elda Righi, Umberto Baccarani, Giovanni Terrosu, Nicola Vernaccini, Vittorio Bresadola, Sergio Intini, Andrea Risaliti
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

The incidence of accidental foreign body (FBs) ingestion is 100,000 cases/year in the US, with over than 80% of cases occurring in children below 5 years of age. Although a single FB may pass spontaneously and uneventfully through the digestive tract, the ingestion of multiple magnetics can cause serious morbidity due to proximate attraction through the intestinal wall. Morbidity and mortality depend on a prompt and correct diagnosis which is often difficult and delayed due to the patient's age and because the accidental ingestion may go unnoticed. We report our experience in the treatment of an 11-year-old child who presented to the emergency department with increasing abdominal pain, vomiting, diarrhea, and fever. Surgery evidenced an ileocecal fistula secondary to multiple magnetic FB ingestion with attraction by both sides of the intestinal wall. A 5-centimeter ileal resection was performed, and the cecal fistula was closed with a longitudinal manual suture. The child was discharged at postoperative day 8. After one year, the patient's clinical condition was good.
Soccer and Benign Paroxysmal Positional Vertigo
Authors: Nikolaj Warming, Stephanie Balslev Andersen, Dan Dupont Hougaard
Journal: Case Rep Otolaryngol (2023)
MeSH terms: Case Reports

Introduction. Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo among adults. The etiology of BPPV is unknown in approximately 50 percent of cases. This condition is also termed primary BPPV, if the etiology is unknown, and secondary BPPV if patients have identified predisposing factors. A few studies suggest that there is a correlation between the development of BPPV and specific sports. Case Report. A 19-year-old male presented with recurrent episodes of vertigo during soccer play. Eight months prior to referral, the patient was involved in a car accident with a mild head trauma. The patient was later diagnosed with BPPV several times. Discussion. Soccer might be a plausible BPPV trigger, especially if there is a prehistory of head trauma. This is most likely due to the demands of the game such as the change of directions, repetitive head impacts (headers or head collisions), accelerations/decelerations, jumps, foot landings, and rapid head movements.