OpenMed/multicare-articles huggingface dataset:
Coronary aneurysm occurring late after drug-eluting stent implantation
Authors: Etan Abergel, Ariel Roguin
Journal: ISRN Cardiol (2011)
MeSH terms: Case Reports

Drug-eluting stents may affect the normal healing process of the vessel wall and the remodeling process and may lead to late stent malapposition (LSM). The known incidence of this phenomen originates from short-term angiographic follow-up studies. We describe a case report of very late stent malapposition and marked positive vessel remodeling 3 years after sirolimus-eluting coronary stent implantation. Angiography performed one year after stent implantation was normal. Thus, the abnormalities developed sometime between years 1 and 3. The cause is unknown, but it is reasonable to suggest a local effect of the medication/polymer of the stent. LSM rate and aneurysmal formation is higher in DES than in BMS and may be associated with increased risk for late stent thrombosis. Currently, the risk of very late stent thrombosis after DES implantation is of major concern. As observed in this case report, LSM might occur and develop very late. This has significant consequences especially to the many asymptomatic patients with DES implanted many years ago and the recommendation of dual antiplatelet therapy. More studies with late and very late follow up are needed to better define this finding, its mechanism, how to avoid it, and how to treat it properly.
Protecting patients by training physicians in fluoroscopic radiation management
Authors: B R Archer, L K Wagner
Journal: J Appl Clin Med Phys (2000)
MeSH terms: Fluoroscopy / adverse effects, Fluoroscopy / standards, Radiation Injuries / prevention & control, Radiology / education, Case Reports, Burns / etiology, Burns / prevention & control, Certification, Education, Medical, Graduate / standards, Female, Fluoroscopy / methods, Humans, Middle Aged, Radiation Injuries / etiology, Radiology / standards

During the past 15 years, developments in x-ray technologies have substantially enhanced the ability of practitioners to treat patients using fluoroscopically guided interventional techniques. However, many of these procedures require a greater use of fluoroscopy and serial imaging (cine). This has increased the potential for radiation-induced dermatitis, epilation, and severe radiation-induced burns to patients. It has also increased the potential for radiation injury and radiation-induced cancer in personnel. This work will describe a number of the cases that have appeared in the literature and current recommendations and credentialing requirements of various organizations whose members use fluoroscopy. Finally, a program for implementing training of physicians in radiation management as a means of reducing the risk of injury to patients and personnel is recommended.
Solitary metastatic gallbladder malignant melanoma originated from the nasal cavity: A case report
Authors: Katsuyoshi Furumoto, Yuya Miyauchi, Daisuke Ito, Toshiyuki Kitai, Masafumi Kogire
Journal: Int J Surg Case Rep (2013)
Keywords: dedifferentiation, gallbladder, malignant melanoma, metastatic melanoma, nasal melanoma

Introduction:
Solitary gallbladder metastasis of malignant melanoma is rare and generally originates from skin melanoma. We report a case of gallbladder metastasis from a malignant melanoma of the nasal mucosa that was surgically treated.
Presentation of case:
A 77-year-old Japanese woman diagnosed with malignant melanoma of the left sinonasal cavity three years ago underwent follow-up PET-CT and FDG uptake was detected only at the gallbladder. The nasal melanoma had been stable for the last 1.5 years after chemoradiation and her general condition was good. Cholecystectomy was performed with partial liver resection. Lymphadenectomy of the hepatoduodenal ligament was also performed. The tumor was soft and whitish, and was microscopically diagnosed as a poorly differentiated malignant melanoma that was not similar to the nasal cavity melanoma. No further metastasis is observed for more than 13 months after surgery.
Discussion:
In the literature, cutaneous melanoma is described as the origin of most metastatic gallbladder melanomas; however, no skin lesion was evident in this case. We believe that the poorly differentiated compartment of the nasal melanoma had metastasized to the gallbladder.
Conclusion:
For patients with melanomas and gallbladder tumors, the possibility that metastasis could occur should be considered when selecting optimal treatment. Even when original melanoma is present, surgical treatment for gallbladder metastasis may be useful depending on the patient's conditions.
Glocal clinical registries: pacemaker registry design and implementation for global and local integration--methodology and case study
Authors: Kátia Regina da Silva, Roberto Costa, Elizabeth Sartori Crevelari, Marianna Sobral Lacerda, Caio Marcos de Moraes Albertini, Martino Martinelli Filho, José Eduardo Santana, João Ricardo Nickenig Vissoci, Ricardo Pietrobon, Jacson V Barros
Journal: PLoS One (2013)
MeSH terms: Electronic Health Records / standards, Pacemaker, Artificial / statistics & numerical data, Registries / standards, Software, Research Support, Non-U.S. Gov't, Brazil, Clinical Trials as Topic, Data Collection / standards, Electronic Health Records / statistics & numerical data, Humans, Pacemaker, Artificial / economics, Quality Control, Research Design

Background:
The ability to apply standard and interoperable solutions for implementing and managing medical registries as well as aggregate, reproduce, and access data sets from legacy formats and platforms to advanced standard formats and operating systems are crucial for both clinical healthcare and biomedical research settings.
Purpose:
Our study describes a reproducible, highly scalable, standard framework for a device registry implementation addressing both local data quality components and global linking problems.
Methods and results:
We developed a device registry framework involving the following steps: (1) Data standards definition and representation of the research workflow, (2) Development of electronic case report forms using REDCap (Research Electronic Data Capture), (3) Data collection according to the clinical research workflow and, (4) Data augmentation by enriching the registry database with local electronic health records, governmental database and linked open data collections, (5) Data quality control and (6) Data dissemination through the registry Web site. Our registry adopted all applicable standardized data elements proposed by American College Cardiology / American Heart Association Clinical Data Standards, as well as variables derived from cardiac devices randomized trials and Clinical Data Interchange Standards Consortium. Local interoperability was performed between REDCap and data derived from Electronic Health Record system. The original data set was also augmented by incorporating the reimbursed values paid by the Brazilian government during a hospitalization for pacemaker implantation. By linking our registry to the open data collection repository Linked Clinical Trials (LinkedCT) we found 130 clinical trials which are potentially correlated with our pacemaker registry.
Conclusion:
This study demonstrates how standard and reproducible solutions can be applied in the implementation of medical registries to constitute a re-usable framework. Such approach has the potential to facilitate data integration between healthcare and research settings, also being a useful framework to be used in other biomedical registries.
Compressive Optic Neuropathy Caused by Orbital Non-Hodgkin's Lymphoma
Authors: Mohammed M Ziaei, Hadi Ziaei
Journal: Case Rep Ophthalmol Med (2012)
MeSH terms: Case Reports

Purpose. To present a unique case of Non-Hodgkin's-Lymphoma- (NHL) associated compressive optic neuropathy. Method. An 89-year-old male presenting with acute unilateral visual loss and headache. Results. Patient was initially diagnosed with occult giant cell arteritis; however after visual acuity deteriorated despite normal inflammatory markers, an urgent MRI scan revealed an extensive paranasal sinus mass compressing the optic nerve. Conclusion. Paranasal sinus malignancies occasionally present to the ophthalmologist with signs of optic nerve compression and must be included in the differential diagnosis of acute visual loss.
Dermatologic Conundrum: A Cardiac Condition Masqueraded as a Dermatologic Distraction
Authors: George Degheim, Evan Hiner, Abeer Berry, Nathan Foster
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

A 38-year-old male presented to the emergency department (ED) complaining of extreme pain and a petechial rash on the left ankle for two weeks associated with generalized fatigue, intermittent fevers, and weight loss. He was discharged home from the ED on pain medications. He returned a few days later with a progressive rash that involved the entire left lower extremity to the level of the knee. He was diagnosed with herpes zoster (shingles) and was prescribed acyclovir and steroids. After several days, the patient presented for the third time to the ED. He developed a right lower extremity discomfort this time. The pain in bilateral lower extremities had become unbearable. His cardiac examination revealed a systolic murmur at the apex and a faint diastolic murmur at the left sternal border. Ultimately, he had an echocardiogram that demonstrated both a bicuspid aortic valve and large vegetation on the anterior leaflet of the mitral valve, and his blood culture grew Streptococcus mitis and Streptococcus oralis. The patient was subsequently diagnosed with subacute bacterial endocarditis thought to be sourced from his poor dentition. The diagnosis of infective endocarditis is often delayed due to its nonspecific clinical presentations. Our case displays an unusual skin manifestation of IE that may be present in the absence of other signs and symptoms of the disease.
Choledochal cyst- unusual presentation in the adult phase: Case report
Authors: Victor Vinicius Monteiro Lins de Albuquerque, Frank Pinheiro De Macedo, Ketlen G Costa, Zuriel Rodrigues Seixas Nunes, Rubem A da Silva Junior
Journal: Int J Surg Case Rep (2020)
Keywords: choledochal cyst, hepaticojejunal anastomosis, todani’s classification
MeSH terms: Case Reports

Introduction:
Bile duct cysts are congenital malformations characterized by bile duct dilatation with intra and/or extrahepatic localization. About 80% of cases are diagnosed in childhood, so their presentation in adults is rare and repeatedly associated with complications.
Presentation of case:
A 38-year-old female patient complained of severe abdominal pain for one month, with no associated cholestatic signs. She underwent abdominal ultrasonography that showed cholelithiasis with extrahepatic bile duct dilatation and underwent cholangiography (MRI), which revealed fusiform dilatation of the proximal portion of the hepatocholedochal, compatible with choledochal cyst.
Discussion:
In adult patients, clinical manifestations are usually nonspecific, and the diagnosis is established by medical imaging. Magnetic resonance cholangiopancreatography (MRCP) is the gold standard diagnostic today. Treatment with better prognosis consists of total cyst resection with hepaticojejunal anastomosis and intestinal transit reconstruction with Roux-en-Y.
Conclusion:
Bile duct cysts are a rare condition in adults. Currently, increasing access to more accurate medical imaging enables early diagnosis, contributing to the use of therapeutic methods in appropriate time, avoiding development of complications.
Etiologic Causes and Epidemiological Characteristics of Patients with Intraocular Foreign Bodies: Retrospective Analysis of 1340 Cases over Ten Years
Authors: Lin Li, Hai Lu, Kai Ma, Yun-Yun Li, Hai-Yan Wang, Ning-Pu Liu
Journal: J Ophthalmol (2018)

Objective:
Patients with intraocular foreign bodies were retrospectively analyzed. Population characteristics, pathogenic factors, and the outcomes during the past ten years were discussed.
Design:
Retrospective case series study.
Method:
Medical records of 1340 patients hospitalized in Beijing Tongren Hospital from January 1, 2004, to December 31, 2013, were collected.
Results:
Average age was 33.0 ± 13.8 (1-76) years old in 1340 patients. There were more males (1270, 94.8%) than females (70, 5.2%). Patients from outside of Beijing (82.1%, n = 1100) prevailed. Farmers (32.1%, n = 430) and workers (22.3%, n = 299) were the top two affected professions. Leading two causes were splashing of foreign bodies (SFB) (58.6%, n = 785) and explosives (31.8%, n = 426). More males than females were injured by SFB (59.4% versus 44.3%, P = 0.009). Firework injury was the commonest (41.6% versus 3.1%-15.3%, P < 0.05) in patients under nine. The annual percentages in patients over 50 increased (P < 0.001) and in patients by explosives decreased (P = 0.027).
Conclusion:
Most patients in this study were young males from outside of Beijing and farmers. SFB accounted most for patients over 10 years old and fireworks for those under ten. Patients over 50 increased while those by explosives decreased annually over the period.
Thoracic Duct Embolization for Postoperative Lymphatic Fistula
Authors: Ayhan Erdemir, Murat Dökdök, Kemal Raşa
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Lymphatic fistula as a rare entity particularly emerges after head and neck cancer surgery. It may lead to delayed wound healing, electrolyte loss, malnutrition, dehydration, and immune suppression. Therefore, rapid diagnosis and treatment are of the utmost importance. We aimed to present a lymphatic fistula case who was treated successfully by lymphangiography with percutaneous embolization of the thoracic duct. We believe that minimally invasive techniques could be an alternative to the conservative approach as the first-line choice.
An unusual case of mitral stenosis with coronary artery and left ventricular apical aneurysm
Authors: Mohammad Masoumi, Maryam Aliramezany
Journal: J Tehran Heart Cent (2014)
Keywords: heart ventricles • coronary vessels • aneurysm • mitral valve stenosis
MeSH terms: Case Reports

The left ventricular aneurysm is one of the most significant complications of myocardial infarction and is defined as the expansion of the ventricular wall. The coronary artery aneurysm is characterized by an abnormal dilation of the localized portion of the coronary artery, and its main cause is atherosclerosis. We herein report an unusual case of coronary artery and left ventricular aneurysms in a mitral stenosis patient with normal coronary arteries and no sign of atherosclerosis. This patient was a known case of mitral stenosis due to rheumatic heart disease and was symptomatic despite optimal medical therapy. Laboratory tests were normal, and electrocardiography showed sinus rhythm and left atrium abnormality without pathologic Q wave. Angiographic view illustrated left circumflex artery and left ventricular apical aneurysms. Percutaneous transvenous mitral commissurotomy was performed successfully and the patient was discharged with Warfarin and a beta blocker. No symptom was observed at six months' follow-up.
A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic Challenge
Authors: T Akcan, P Strati, M Yan, M Idowu
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

The distinction between primary and reactive thrombocytosis by bone marrow histology is very important. Reactive thrombocytosis, the most common cause of thrombocytosis, can be expected in postsplenectomy states; however, close hematological evaluation of prolonged thrombocytosis is essential to identify patients who may have an underlying myeloproliferative neoplasm. We report a 37-year-old woman who was found to have portal, mesenteric, and splenic vein thrombosis with thrombocytosis, two months after she had a splenectomy for spontaneous splenic rupture. Other reactive conditions and myeloproliferative neoplasms (MPN) were excluded, and subsequently, the diagnosis of triple-negative essential thrombocythemia (ET) was established by bone marrow histology. This case of primary thrombocythemia following splenectomy in a young patient illustrates some of the diagnostic difficulties associated with postsplenectomy thrombocytosis. Continuing reports of anecdotal experiences in managing similar complex scenarios is essential and remains the only reference for clinicians facing these rare conditions.
Case report: Tunneling foreign body in the metatarsal bones of a dog
Authors: Hannah Wagoner, Merrilee Holland, Katherine Pansini, Jess McCarthy, Kaitlin Fiske
Journal: Front Vet Sci (2022)
Keywords: bone lysis, computed tomography, dog, draining tract, lameness, strangulating foreign body
MeSH terms: Case Reports

A 2-year-old male intact goldendoodle presented for intermittent lameness, persistent draining tracts, and radiographic identified boney lytic lesions involving the metatarsal region, which had persisted for approximately 8 months before presentation to our referral hospital. Radiographic and computed tomography (CT) images suggested a tubular structure encircling and tunneling through the right metatarsal bones. Exploratory surgery confirmed a circumferential rubber band foreign body, with lytic boney tunneling within the metatarsal bones. CT provided vital information to assist in the surgical planning for this patient with a chronic tunneling foreign body.
Multimodal imaging features of primary pericardial synovial sarcoma: a case report
Authors: Hongrui Jin, Yong Zhang, Wenbo Zhang, Keyan Wang
Journal: Front Oncol (2023)
Keywords: cardiac magnetic resonance imaging, computed tomography, echocardiogram, multimodal imaging, pericardial synovial sarcoma
MeSH terms: Case Reports

Background:
Primary pericardial synovial sarcoma is an extremely rare malignant tumor, and affected patients have a poor prognosis. Only a few cases have been reported in the literature.
Case summary:
A 34-year-old man was admitted to our hospital with chest tightness and a cough. An echocardiogram revealed a heterogeneous mass with a large pericardial effusion. Further computed tomography (CT) of the chest and cardiac magnetic resonance imaging (CMRI) demonstrated an irregular pericardial mass abutting the left atrium and left ventricle and invading the mediastinal structures. Pathology results showed that the tumor was a monophasic synovial sarcoma. The patient underwent chemotherapy and survived for 17 months.
Discussion:
Many cardiac tumors are clinically asymptomatic or nonspecific, and they are frequently detected or diagnosed at an advanced stage of the disease. Multimodal cardiac imaging facilitates the detection and assessment of cardiac tumors. In particular, CMRI is considered as a superior imaging tool, because it provides high tissue contrast and can detect invasion of the myocardium. We describe the clinical details and multimodal imaging features of a rare primary pericardial synovial sarcoma, hoping to provide guidance for the diagnosis of similar cases in the future.
Syphilis, Hepatitis, and Pancreatitis: Is the Uncommon Becoming Common in the HIV(+) Patient?
Authors: B A da Silva, T S Soi, D Cameron, A C Karikkineth, R B Williams
Journal: Case Rep Infect Dis (2013)

Background. Coinfection with human immunodeficiency virus (HIV) and syphilis has been occurring at increasing rates, with the greatest increases being seen among men who have sex with men. Secondary syphilis rarely presents with liver disease, and the diagnosis may be overlooked in favor of more common causes of liver injury in this setting, such as viral hepatitis, antiretroviral therapy, alcohol use, and opportunistic infections. Case Presentation. We describe a 43-year-old patient with HIV who presented with symptoms suggesting acute pancreatitis. Investigation led to a diagnosis of hepatitis and pancreatitis, both attributed to syphilis. Conclusion. Syphilis should be included as part of the initial diagnosis among patients with HIV presenting with abnormal liver and pancreatic enzymes.
A Rare Case of Advanced Urethral Diverticular Adenocarcinoma and a Review of Treatment Modalities
Authors: Fatai Oluyadi, Preethi Ramachandran, Vladmir Gotlieb
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: adenocarcinoma, targeted therapy, urethral diverticular adenocarcinoma, urethral diverticulum
MeSH terms: Adenocarcinoma / diagnosis, Adenocarcinoma / therapy, Combined Modality Therapy / methods, Diverticulum / diagnosis, Urethral Neoplasms / diagnosis, Urethral Neoplasms / therapy, Case Reports, Review, Chemotherapy, Adjuvant, Cyclin-Dependent Kinase Inhibitor p16 / genetics, Cystoscopy, Diverticulum / pathology, Diverticulum / surgery, Female, High-Throughput Nucleotide Sequencing, Humans, Magnetic Resonance Imaging, Middle Aged, Pelvic Exenteration, Urinary Retention / etiology, Urinary Retention / surgery, CDKN2A protein, human, Cyclin-Dependent Kinase Inhibitor p16

Female urethral diverticular cancer is a very rare entity with only around 100 cases reported so far in literature and accounts for <1% of all malignancies. In this article, we present a 47-year-old African American female with repeated hospital visits for urinary retention, hematuria, and urinary tract infections. Initial computed tomography imaging and cystoscopy was unremarkable except for a distended urinary bladder. Subsequent magnetic resonance imaging and corresponding cystoscopy eventually indicated the presence of a urethral diverticulum. She underwent urethral diverticulectomy and was found to have a mass arising from urethral diverticulum extending to vaginal walls. Her biopsy was suggestive of invasive adenocarcinoma in advanced stages, for which she subsequently underwent a total pelvic exenteration. Next-generation sequencing of the tumor showed CDKN2A/B loss, MSI-stable, and low TMB, thereby ruling out the options for targeted therapies. Extensive literature search and expert opinions were sought for her case since no consensus exists regarding the optimal therapeutic approach due to the rarity of this tumor. A final decision was made to treat her with platinum-based chemotherapy. Different treatment approaches including neoadjuvant chemoradiation followed by surgery, surgery followed by adjuvant chemotherapy, and surgery followed by chemoradiation have been tried. Platinum-based chemotherapy has generally been preferred based on an extensive literature search. Multimodality treatment approach seems to be the current approach to management for advanced stages for better overall survival. This case illustrates the challenges faced in making diagnosis and treatment decisions due to the rarity of this type of tumor and lack of consensus in the treatment approach.