OpenMed/multicare-articles huggingface dataset:
Ladd's band in the adult, an unusual case of occlusion: Case report and review of the literature
Authors: Carmine Grassi, Luigi Conti, Gerardo Palmieri, Filippo Banchini, Maria Diletta Dacco', Gaetano Maria Cattaneo, Patrizio Capelli
Journal: Int J Surg Case Rep (2020)
Keywords: bowel obstruction, gut malrotation, ladd’s band
MeSH terms: Case Reports

Introduction:
Malrotation of gut is a congenital anomaly of foetal intestinal rotation and it is mostly discovered in early childhood as acute intestinal obstruction. This condition is very rare and often silent in adults.
Presentation of case:
We present a case of 44-year-old woman admitted with acute abdominal pain. The abdominal CT scan showed ileal conglomerate loops with thickened walls filled of liquid in the right iliac side. Laparotomic Ladd's procedure was performed successfully with division of Ladd's band, adhesiolysis, reconstruction of Treitz's ligament, small bowel resection and Merckel's diverticulum removal. The patient made an unremarkable recovery.
Discussion:
We discuss the rarity of intestinal malrotation in adulthood and made a literature review comparison of the therapeutic options available.
Conclusion:
Intestinal malrotation is a rare entity and adult presentation is even rarer. Some cases are asymptomatic, but when symptomatic a volvulus should be promptly suspected to avoid complications such as bowel ischemia.
Safety and Efficacy of Triple Therapeutic Targets with Rivaroxaban after Acute Myocardial Infarction Complicated by Left Ventricular Thrombi in a Case of Nonvalvular Atrial Fibrillation
Authors: Francesco Summaria, Gregory A Sgueglia, Fabrizio D'Errico, Antonella De Santis, Fabiana Piccioni, Gaetano Gioffrè, Achille Gaspardone
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

We present the complex case of a high-risk patient with nonvalvular atrial fibrillation, who experienced a non-ST elevation myocardial infarction complicated by left ventricular (LV) thrombi and underwent percutaneous coronary intervention with drug-eluting stent implantation. The patient was initially treated with short-term triple therapy including aspirin, clopidogrel, and rivaroxaban 15 mg/die. Following aspirin dropping one month after discharge, the patient continued on dual therapy with clopidogrel and rivaroxaban, and a clinical and imaging follow-up at 6 and 12 months confirmed the LV thrombi resolution, with no thromboembolic episodes and a good safety profile.
A case of rupioid syphilis masquerading as aggressive cutaneous lymphoma
Authors: Jonathan Braue, Thomas Hagele, Abraham Tareq Yacoub, Suganya Mannivanan, Lubomir Sokol, Frank Glass, John N Greene
Journal: Mediterr J Hematol Infect Dis (2015)
MeSH terms: Case Reports

Secondary syphilis has been known since the late 19th century as the great imitator; however, some experts now regard cutaneous lymphoma as the great imitator of skin disease. Either disease, at times an equally fastidious diagnosis, has reported to mimic each other even. It is thus vital to consider these possibilities when presented with a patient demonstrating peculiar skin lesions. No other manifestation of secondary syphilis may pose such quandary as a rare case of rupioid syphilis impersonating cutaneous lymphoma. We present such a case, of a 36-year-old HIV positive male, misdiagnosed with aggressive cutaneous lymphoma, actually exhibiting rupioid syphilis thought secondary to immune reconstitution inflammatory syndrome (IRIS).
Mullerian tissue in the rectus abdominis muscle forming an endometrioma: a case report
Authors: Yasmeen Akhtar Haseeb
Journal: Pan Afr Med J (2019)
Keywords: cesarean scar, endometrioma, rectus muscle
MeSH terms: Endometriosis / diagnosis, Rectus Abdominis / pathology, Case Reports, Cesarean Section / adverse effects, Cicatrix / pathology, Endometriosis / pathology, Endometriosis / surgery, Female, Humans, Middle Aged, Pain / etiology, Rectus Abdominis / surgery

Endometriosis is defined as the presence of endometrial tissue at the sites other than the uterine lining and responds to the cyclical ovarian hormonal activity. It is a multidimensional and a complex disease which has an impact on physical, mental, sexual, and social aspects of the life of a woman. Here is a case report of a patient, presented to the department with pain and swelling in her left side of the previous cesarean scar. It was surgically removed and was diagnosed to be an endometrioma of rectus sheath and rectus abdominis muscle on histopathology.
Collaborative agroforestry to mitigate wildfires in Extremadura, Spain: land manager motivations and perceptions of outcomes, benefits, and policy needs
Authors: Franziska Wolpert, Cristina Quintas-Soriano, Fernando Pulido, Lynn Huntsinger, Tobias Plieninger
Journal: Agrofor Syst (2022)
Keywords: agroforestry, integrated landscape management, land abandonment, mediterranean, productive fuelbreaks, silvopastoralism, wildfire mitigation

Wildfires are increasing in severity, and magnitude in the Mediterranean Basin in recent years, reaching a yearly average of 450 000 ha over the last decade. Drivers include climate change, land-use change, and land abandonment. Wildfire mitigation requires landscape-level action as impact to each parcel is affected by the conditions of the others. We conducted a case study of a regional-level initiative that develops community efforts to mitigate wildfires through silvo-pastoral agroforestry systems, using an integrated landscape management approach. This approach involves collaboration among stakeholders to achieve multiple objectives. In order to derive insights into its potential, we asked participating land managers: (1) What motivates their participation?, (2) How do they perceive initiative outcomes?, and as urban outmigrants with non-traditional goals are increasing in rural areas, (3) Do responses differ between rural and neo-rural participants? Our results show that managers feel highly affected by wildfires and are strongly motivated to reduce wildfire risk. Land abandonment and inappropriate policy were major concerns. The initiative was seen to have positive outcomes for individual participants as well as the region, and to stimulate community connectedness. We conclude that fit to local contexts, integrated landscape management can be a well-received approach to reducing wildfire risk. Agroforestry systems in Extremadura can act as "productive fuelbreaks" that reduce fire risk over extensive areas, while restoring traditional landscapes. We suggest that programs to reduce wildfire risk can also be used as a leverage point for financing rural revival and provision of multiple ecosystem services.
Supplementary information:
The online version contains supplementary material available at 10.1007/s10457-022-00771-6.
Case report and literature review: Treatment of multiple meningiomas combined with multiple unruptured aneurysms in a single operation
Authors: Ren-Jie Wei, Xiao-Lin Wu, Feng Xia, Jing-Cao Chen
Journal: Front Surg (2022)
Keywords: case report, falx brain tumor, imaging, multiple aneurysms, multiple meningiomas
MeSH terms: Case Reports

Background:
Although the incidence of a single meningioma or a single aneurysm is common, cases of multiple meningiomas combined with multiple aneurysms are rarely reported, and surgical treatment of the coexisting situation is also relatively uncommon.
Case presentation:
A 38-year-old male patient presented to the neurosurgery department of our center with a headache. Examination revealed only symptoms of headache. Laboratory tests showed only decreased total protein and albumin. Magnetic resonance imaging showed preoccupation with the frontal lobe and the right temple bone. Magnetic resonance angiography and digital subtraction angiography showed two aneurysms in the anterior communicating artery and right anterior cerebral artery. Based on a combination of the patient's history and imaging, we hypothesized that the patient was simultaneously suffering from meningioma and an aneurysm, and both of them are multiple. The patient underwent tumor resection and clipping procedure based on this hypothesis in one surgery. Intraoperative biopsy proved to be a meningioma. The patient was discharged on the 10th postoperative day, and a postoperative follow-up suggested no complications.
Conclusion:
Multiple meningiomas combined with multiple aneurysms are rare to be reported in the same patient. For those unruptured intracranial aneurysms (UIAs) located in the visual field of craniotomy prepared for brain tumorlike meningioma, it is possible to do the clipping as well. When the meningiomas are multiple, fitted with the surgical indication, and located in a position that cannot be treated in one surgery, this may lead to a two-stage operation, no matter where the UIAs are located.
Unilateral K-F ring in Wilson's disease
Authors: Shruti P Hegde, Sakthivel Senthil Kumar
Journal: GMS Ophthalmol Cases (2023)
Keywords: kayser-fleischer ring, wilson’s disease, diagnosis, unilateral
MeSH terms: Case Reports

Wilson's disease, also called hepatolenticular degeneration, has varied clinical manifestations and poses diagnostic challenges. Kayser-Fleischer ring, when present, is considered pathognomic of Wilson's disease. Although its presence is most commonly seen with the neuro-psychiatric form of the disease, it can also be present in hepatic form and asymptomatic patients. We report a case of unilateral Kayser-Fleischer ring in the normal, functional eye of a patient which subsequently led to the diagnosis of Wilson's disease in the patient. This case also highlights the examination of the normal appearing eye in all the patients presenting with complaints in only one eye.
A Case Report of Multiple Myeloma Associated With Myeloperoxidase and Proteinase-3 Antibodies Posing a Diagnostic Dilemma
Authors: Jordana Cheta, Michael Binder
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: aav and mm, pr3 and mpo, pr3 and mpo in multiple myeloma, multiple myeloma, multiple myeloma and anca vasculitis
MeSH terms: Acute Kidney Injury / etiology, Antibodies, Antineutrophil Cytoplasmic / blood, Multiple Myeloma / diagnosis, Myeloblastin / immunology, Peroxidase / immunology, Case Reports, Aged, 80 and over, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / blood, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / complications, Humans, Male, Multiple Myeloma / blood, Multiple Myeloma / complications, Antibodies, Antineutrophil Cytoplasmic, Peroxidase, Myeloblastin

Multiple myeloma (MM) is a clonal proliferation of antibody-producing plasma cells that can precipitate renal injury through multiple mechanisms. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an inflammatory condition that can result in renal failure through mononuclear cell infiltration and consequent destruction of glomeruli. Several case reports have identified clinical situations where differentiating these entities has been challenging. Renal biopsy is an invaluable tool in differentiating between MM and AAV when clinical uncertainty exists. We report the case of an 85-year-old man who presented with a rapid decline in renal function and serologies positive for both MM and AAV. Renal biopsy findings confirmed the diagnosis of myeloma kidney and excluded vasculitis. This case highlights an unusual clinical scenario in which both proteinase-3 (PR-3) and myeloperoxidase (MPO) antibodies are positive. While these antibodies are both individually associated with ANCA vasculitis, they are seldom simultaneously positive. Our case would suggest that positive PR-3 and MPO antibodies should raise concern for an alternative diagnosis. Indeed, ANCA, PR-3, and MPO antibodies can all be positive in patients with monoclonal gammopathy in the absence of vasculitis. Our case underscores the value of renal biopsy in the setting of MM.
Case report: Backward gait training combined with gait-synchronized cerebellar transcranial alternating current stimulation in progressive supranuclear palsy
Authors: Atsushi Shima, Kazuki Tanaka, Akari Ogawa, Erika Omae, Tomoaki Miyake, Yui Nagamori, Yusuke Miyata, Koji Ohata, Yumie Ono, Tatsuya Mima, Ryosuke Takahashi, Satoko Koganemaru
Journal: Front Hum Neurosci (2023)
Keywords: parkinsonism, backward gait, cerebellum, entrainment, non-invasive brain stimulation (nibs), progressive supranuclear palsy, rehabilitation, transcranial alternating current stimulation
MeSH terms: Case Reports

Progressive supranuclear palsy (PSP) is characterized by recurrent falls caused by postural instability, and a backward gait is considered beneficial for postural instability. Furthermore, a recent approach for rehabilitation combined with gait-oriented synchronized stimulation using non-invasive transcranial patterned stimulation could be promising for balance function. Here, we present a case of PSP with backward gait training combined with gait-synchronized transcranial alternating current stimulation (tACS). A 70-year-old woman with PSP-Richardson's syndrome underwent backward gait training combined with synchronized cerebellar tACS. Initially, she underwent short-term intervention with combined training of backward gait with synchronized cerebellar tACS, asynchronized, or sham stimulation according to the N-of-1 study design. Synchronized tACS training demonstrated a decrease in postural instability, whereas asynchronized or sham stimulation did not. The additional long-term interventions of combined backward gait training with synchronized cerebellar tACS demonstrated further decrease in postural instability with improvements in gait speed, balance function, and fall-related self-efficacy in daily life. The present case describes a novel approach for motor symptoms in a patient with PSP. Backward gait training with synchronized cerebellar tACS may be a promising therapeutic approach.
Remimazolam Anesthesia for Thyroid Surgery
Authors: Sae Nakagawa, Tomoharu Shakuo, Sakurako Matsudo, Hiroaki Soda, Kenji Shida
Journal: Case Rep Anesthesiol (2023)
MeSH terms: Case Reports

Background:
Critical upper airway obstruction, hematoma formation, and recurrent laryngeal nerve palsy have been reported as postoperative complications of thyroid surgery. Although remimazolam may reduce the risk of these complications, the efficacy of flumazenil with remimazolam has not been reported. We present the successful anesthesia management of thyroid surgery using remimazolam and flumazenil. Case Presentation. A 72-year-old woman was diagnosed with a goiter and scheduled for a partial thyroidectomy under general anesthesia. We used remimazolam for induction and maintenance using a neural integrity monitor, electromyogram, and endotracheal tube under the bispectral index monitor. At the end of the surgery, spontaneous respiration was confirmed after the intravenous administration of sugammadex, and the patient was extubated under mild sedation. In the operating room, we administered flumazenil intravenously to confirm recurrent laryngeal nerve palsy and active postoperative hemorrhage. The patient was confirmed to have no recurrent laryngeal nerve palsy under full wakefulness but developed active postoperative hemorrhage with normal blood pressure. The patient required reoperation and was reintubated under intravenous administration of propofol. The anesthesia was maintained using 5% of desflurane, and the patient was extubated without any postoperative problems. The anesthesia was then terminated. The patient had no recall of the procedure.
Conclusion:
Maintenance of general anesthesia using remimazolam allowed the use of a neurostimulator with minimal muscle-relaxant effects, and extubation under sedation reduced the risk of abrupt and unexpected changes in blood pressure, body movement, and coughing. Furthermore, after extubation, the patient was rendered fully awake using flumazenil to confirm the presence of recurrent laryngeal nerve palsy and active postoperative hemorrhage. In addition, the patient had no memory of the reoperation, suggesting that the anterograde amnesic effect of remimazolam had a favorable psychological outcome associated with the reoperation. We safely managed thyroid surgery using remimazolam and flumazenil.
A Case Report of a Female Patient With Hodgkin Lymphoma Localized in the Central Nervous System and With Concomitant Pulmonary Lymphomatoid Granulomatosis
Authors: Dariusz Szczepanek, Justyna Szumiło, Filip Stoma, Agnieszka Szymczyk, Bożena Jarosz, Aleksandra Szczepanek, Marek Hus, Tomasz Trojanowski, Ewa Wasik-Szczepanek
Journal: Front Neurol (2020)
Keywords: epstein-barr virus, latent membrane protein 1, lymphoma of the central nervous system, primary hodgkin lymphoma, pulmonary lymphomatoid granulomatosis
MeSH terms: Case Reports

The involvement of the central nervous system (CNS) in Hodgkin lymphoma (HL) has been rarely reported, especially in its primary isolated form. Herein, we present a case of a 33-year-old woman, who received immunosuppressive treatment due to ulcerative colitis (at the beginning azathioprine and sulfasalazine, changed to mesalazine), with repetitive episodes of loss of consciousness for a few weeks and with no other symptoms. Magnetic resonance imaging scans of the head revealed a tumor in the lateral part of the left temporal lobe and in the cerebellum. Moreover, a subsequent computed tomographic scan of the chest revealed diffuse tumorous lesions in the lungs. The brain tumor was resected and a tumorous lesion resected from the lungs was biopsied. The histopathological analysis confirmed the final diagnosis of HL localized in the CNS with concomitant pulmonary lymphomatoid granulomatosis (LYG) grade 1. After the patient underwent radiotherapy and chemotherapy, the patient showed complete regression of lesions in the CNS and lungs, which was confirmed by positron emission tomographic scan. LYG and CNS-HL are rare proliferative disease derived from lymphocytes B and associated with EBV infections. An association between LYG and other autoimmune disorders has been reported, but to the best of our knowledge, this is the first case of the CNS-HL associated with lymphatoid granulomatosis.
Moyamoya disease with peripheral pulmonary artery stenoses and coronary artery fistulae
Authors: Lindsay Reardon, Andrew O Maree, Michael de Moor
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Moyamoya is a progressive disorder of the cerebral vasculature. Our report describes a rare case of Moyamoya disease with distal peripheral pulmonary artery stenoses and coronary fistulae in a 12-year-old Caucasian female patient.
Intravitreal Bevacizumab (Avastin) for Diabetic Retinopathy: The 2010 GLADAOF Lecture
Authors: J Fernando Arevalo, Juan G Sanchez, Andres F Lasave, Lihteh Wu, Mauricio Maia, Sergio Bonafonte, Miguel Brito, Arturo A Alezzandrini, Natalia Restrepo, Maria H Berrocal, Mario Saravia, Michel Eid Farah, Jans Fromow-Guerra, Virgilio Morales-Canton
Journal: J Ophthalmol (2011)

This paper demonstrates multiple benefits of intravitreal bevacizumab (IVB) on diabetic retinopathy (DR) including diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) at 24 months of followup. This is a retrospective multicenter interventional comparative case series of intravitreal injections of 1.25 or 2.5 mg of bevacizumab for DME, PDR without tractional retinal detachment (TRD), and patients who experienced the development or progression of TRD after an intravitreal injection of 1.25 or 2.5 mg of bevacizumab before vitrectomy for the management of PDR. The results indicate that IVB injections may have a beneficial effect on macular thickness and visual acuity (VA) in diffuse DME. Therefore, in the future this new therapy could complement focal/grid laser photocoagulation in DME. In PDR, this new option could be an adjuvant agent to panretina photocoagulation so that more selective therapy may be applied. Finally, TRD in PDR may occur or progress after IVB used as an adjuvant to vitrectomy. Surgery should be performed 4 days after IVB. Most patients had poorly controlled diabetes mellitus associated with elevated HbA1c, insulin administration, PDR refractory to panretinal photocoagulation, and longer time between IVB and vitrectomy.
Extended Repetitive Transcranial Magnetic Stimulation Therapy for Post-stroke Depression in a Patient With a Pre-frontal Cortical Lesion: A Case Study
Authors: Brenton Hordacre, Anson Chau, Lynton Graetz, Susan Hillier
Journal: Front Neurol (2022)
Keywords: depression, maintenance therapy, repetitive transcranial magnetic stimulation, stroke, treatment
MeSH terms: Case Reports

Approximately one-third of stroke survivors experience post-stroke depression. Repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex has shown promise as a treatment for depression with few side effects and high tolerability. However, previous post-stroke depression trials have not considered the effect of lesion location, the persistence of clinical improvements, nor the value of ongoing maintenance treatments. These questions are important to determine the therapeutic value of rTMS as a treatment for post-stroke depression. We report a unique case study of a 71-year-old male who had experienced a left hemispheric ischemic stroke 4 years prior. The patient was screened with the Beck Depression Inventory and Patient Health Questionnaire and found to be experiencing moderate levels of depression. Ten daily sessions of left dorsolateral pre-frontal cortex rTMS were applied over a two-week period. A clinically meaningful reduction in depression was achieved. Approximately 10 weeks following rTMS treatment, improvements in depression were attenuating. Weekly maintenance rTMS was delivered to the left dorsolateral pre-frontal cortex for 10 sessions. At the conclusion of maintenance rTMS, clinical assessments indicated depressive symptoms had reduced to a minimal to nil level. Clinically meaningful improvements in depression were maintained at 3 months after rTMS treatment had ceased. These findings provide novel insight to suggest rTMS may reduce depressive symptoms in stroke survivors with a lesion at the site of stimulation. Ongoing maintenance treatments might prove beneficial to enhance persistence of clinical improvements.