OpenMed/multicare-articles huggingface dataset:
Case Report: Fremitus Nystagmus in Superior Canal Dehiscence Syndrome
Authors: Miranda Morrison, Athanasia Korda, Franca Wagner, Marco Domenico Caversaccio, Georgios Mantokoudis
Journal: Front Neurol (2022)
Keywords: atypical features, case report, fremitus, neuro-otology, neurological conditions, rare case, superior canal dehiscence, vertigo
MeSH terms: Case Reports

Superior canal dehiscence syndrome (SCDS) is a structural bony defect of the roof of the superior semi-circular canal into the middle cranial fossa and is responsible for the creation of a third window, which alters the dynamics of the inner ear. During humming, vibratory waves entering the vestibulum and cochlea are re-routed through the dehiscence, leading to stimulation of the otolithic and ampullary vestibular organs. This is responsible for the torsional-vertical nystagmus known as "fremitus nystagmus". In this case report, we video-document a rare case of fremitus nystagmus and its resolution after plugging of the superior semi-circular canal.
Liver Injury Secondary to Anti-TNF-Alpha Therapy in Inflammatory Bowel Disease: A Case Series and Review of the Literature
Authors: Ravish Parekh, Nirmal Kaur
Journal: Case Rep Gastrointest Med (2014)

Background. Biologic therapy to inhibit tumor necrosis factor-alpha (TNF- α ) is an effective, safe treatment for patients with inflammatory bowel disease (IBD). All TNF- α inhibitors have been associated with liver toxicity, but many of these cases have been reported in patients receiving therapy for rheumatologic disease. Herein we report the first single-center case series of TNF- α antagonist related liver injury in patients with IBD. Methods. A retrospective case series was performed at the Henry Ford Inflammatory Bowel Diseases Center. IRB approval was obtained. Results. 2 patients were treated with infliximab, whereas the 3rd patient was treated with adalimumab for IBD. All 3 patients had negative viral markers, normal autoimmune serologies, and normal biliary imaging studies. Liver biopsy was performed in all 3 patients, and evidence of portal inflammation was seen. Liver enzymes normalized after discontinuation of therapy in all patients, and no long term effects have been observed. One patient was successfully transitioned from infliximab to adalimumab without relapse of either IBD or liver injury. Conclusion. Liver injury secondary to TNF- α antagonist is an underrecognized, important clinical entity with potentially serious consequences. The mechanism of drug-induced injury is idiosyncratic. Larger cohort studies are needed to establish risk factors and injury patterns related to hepatotoxicity in these patients.
An Unusual Case of Hypoproteinemia in Childhood: Keep in Mind Trichobezoar
Authors: Mariangela Stinco, Alessandra Montemaggi, Bruno Noccioli, Massimo Resti, Salvatore Grosso, Sandra Trapani
Journal: Front Pediatr (2020)
Keywords: rapunzel syndrome, hypoproteinemia, oedema, protein-losing enteropathy, trichobezoar
MeSH terms: Case Reports

Protein-losing enteropathy (PLE) is a rare condition characterized by protein loss through the gastrointestinal tract, leading to hypo-proteinemia. Patients may be asymptomatic or present with variety of complications of hypoproteinemia (e.g., oedema, ascites, pleural, and cardial effusions). We describe a case report of a young girl suffering from behavioral disorder since childhood who presented with generalized oedema, hypoproteinaemia, and microcytic hypochromic anemia. In addition, the girl had an intervention for jejunal atresia and intestinal malrotation in her past medical history. Upper gastrointestinal endoscopy revealed a trichobezoar extending from stomach into the small bowel, thus classified as Rapunzel Syndrome (RS), causing mechanical obstruction of intestinal lumen and intestinal lymphatic drainage resulting in a protein-losing enteropathy (PLE). Trichobezoar was successfully removed by a surgical laparotomy resulting in resolution of symptoms and normalization of biochemical parameters. Possibly, previous surgery might have had an influence on intestinal dysmotility and trichobezoar formation. PLE is a very rare presenting symptom of RS, developing as result of intestinal obstruction caused by large trichobezoars. RS has to be considered in patients, especially adolescents, suffering from behavior disorder as trichotillomania and trichophagia. Surgical removal and nutritional supplementation are the gold treatment of large trichobezoar.
Laryngeal Cryptococcosis Associated With Inhaled Corticosteroid Use: Case Reports and Literature Review
Authors: Daniel Jun Yi Wong, Peter Stanley, Paul Paddle
Journal: Front Surg (2017)
Keywords: cryptococcus, antifungal, fluconazole, infection, laryngitis, larynx
MeSH terms: Case Reports

Laryngeal cryptococcosis is a rare clinical entity. There have been a limited number of case reports in the literature with no consensus regarding optimal management. This review contributes two additional case reports of immunocompetent patients with cryptococcal infection of the larynx in whom exposure to high doses of inhaled corticosteroids is proposed as a significant risk factor. Twenty cases were identified from review of the literature. All patients presented with hoarseness and a spectrum of microlaryngoscopic features, often mimicking laryngeal malignancy. The majority of cases were treated with systemic antifungal therapy, three cases had surgical excision alone, and another three had a combination of medical and surgical management. Risk factor modification, in the form of a reduction in inhaled corticosteroid was employed in the two new cases, and in some previously published cases. Risk factor modification, such as reduction of inhaled corticosteroid dose, in addition to oral antifungal agents can be effective in managing cryptococcal laryngitis.
Case report: Two cases of primary paratesticular liposarcoma
Authors: Jiaxing Li, Jiayu Wang, Hu Han, Long Tian, Hang Yin
Journal: Front Oncol (2022)
Keywords: dedifferentiated, liposarcoma, paratesticular liposarcoma, scrotoscope, testicular tumor
MeSH terms: Case Reports

Paratesticular liposarcoma is a sporadic urological tumor. We report the clinical presentation, treatment course, and prognosis of 2 cases of primary paratesticular liposarcoma with different pathological types, with the aim of further understanding the diagnosis and treatment of this rare disease. Case 1 was a 53-years-old male patient who presented with left scrotal enlargement with swelling 3 years ago and was considered to have a testicular malignancy on preoperative CT scan and enhanced MRI. The patient underwent resection of the left scrotal mass and left orchiectomy under general anaesthesia. Histopathological study confirmed the diagnosis of dedifferentiated liposarcoma. At the 4-months follow-up, no local recurrence or distant metastasis was observed. Case 2 is a 42-years-old male patient with a left scrotal mass which was discovered six months ago. Preoperatively, he underwent CT plain and enhanced MRI examinations suggesting an intra-scrotal occupancy. The patient underwent scrotoscopic excision of the left scrotal mass under general anesthesia. Histopathological studies confirmed the diagnosis of highly differentiated liposarcoma. At the 10-months follow-up, no local recurrence or distant metastasis was observed. Preoperative differential diagnosis of paratesticular liposarcoma should be noted with testicular tumor and extra-abdominal hernia. Extensive local excision and, if necessary, concomitant radical testicular resection is the treatment of choice. If the tumor in the scrotum spreads to the inguinal region, surgical removal with the aid of a scrotoscope may be attempted. This procedure avoids the formation of a large incision in the inguinal region compared to traditional open surgery. Patients commonly experience local recurrence and less distant metastases after surgery, so long-term follow-up is recommended.
Sorafenib Induced Hand Foot Skin Rash in FLT3 ITD Mutated Acute Myeloid Leukemia-A Case Report and Review of Literature
Authors: Jayastu Senapati, Anup J Devasia, Abhijeet Ganapule, Leni George, Auro Viswabandya
Journal: Mediterr J Hematol Infect Dis (2014)
MeSH terms: Case Reports

Sorafenib is a novel small molecule multiple kinase inhibitor which has been used for metastatic renal cancer, hepatocellular cancer. Sorafenib induced skin rash has been discussed as a side effect in trials in both, FLT3 wild type and mutated acute myeloid leukemia (AML), as monotherapy or as combination with other chemotherapeutic agents. We describe a patient with FLT 3 ITD mutated AML, who was started on adjunctive Sorafenib therapy. Skin reactions manifested as NCI Grade III palmoplantar erythrodysesthesia (PPE), requiring drug discontinuation. Several pathogenic mechanisms have been implicated in Sorafenib induced skin reactions, but none has been conclusively proven. While treatment options are varied for early stage skin reactions, drug discontinuation remains the only possible therapy presently for severe grade skin reaction.
Hemorrhagic Descemet Membrane Detachment during Ab Interno Canaloplasty
Authors: Juan Carlos Izquierdo Villavicencio, Josefina A Mejías Smith, Laura A Cañola Ramírez, Natalia Agudelo Arbelaez, Bárbara Rubio Lastra
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

Purpose:
To describe a Descemet membrane detachment in peripheral cornea after canaloplasty with ab interno approach in glaucoma.
Case report:
A 60-year-old male with uncontrolled primary open-angle glaucoma (POAG) underwent ab interno canaloplasty in the left eye. The previous corrected visual acuity was 20/400 and intraocular pressure 26 mmHg with maximum medical therapy. There was evidence of minor intrastromal bleeding and limited Descemet membrane detachment during the introduction of intracanalicular viscoelastic. Speculate that the Descemet detachment occurred owing to the excessive pressure while injecting the viscoelastic. A conservative management was decided due to the size of the detachment outside the visual axis. On the first postsurgical day, the slit lamp biomicroscopy confirmed that the paralimbal extension of the pre-Descemet hemorrhage was 3mm and the radial extension was 2mm. Moreover the initial thickness of the pre-Descemet hemorrhage measurement with anterior segment OCT was 0.6mm. The follow-up was done weekly. At 3 months postoperatively, cornea recovered its transparency and morphology and intraocular pressure was 18mmHg with maximum medical therapy.
Conclusion:
Descemet membrane detachment by viscoelastic with partial intrastromal hematoma is a rare complication of the ab interno canaloplasty, which can be managed conservatively if it has not compromised the visual axis and has a limited extension.
Intratendinous Ganglion Cyst of the Hand: A Case Report and Review of the Literature
Authors: Byron Chalidis, Dimitrios Kitridis, Christos Dimitriou, Panagiotis Givissis
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Intratendinous ganglion of the hand is an extremely rare benign tumor, and only few cases have been reported so far in the literature. We present a case with an intratendinous ganglion of the extensor digitorum communis that treated with en bloc resection and subsequent tendon repair. According to the review of the literature and published data, the ganglion is predominantly located at hand extensor tendons (82%), and it is more frequent among females (75%) and shows a high incidence in 5th and 6th decades of life (94.5%). Surgical excision with or without side-to-side repair and/or tendon transfer leads to excellent outcome and low potential for recurrence.
Percutaneous Aspiration of a Mobile Infected Thrombus from the Right Ventricular Outflow Tract Using the AngioVac System
Authors: Justin Ugwu, Umbreen Hussein, Sampson Alliu, Ravi Gurujal
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

The AngioVac system was invented in 2012 and was originally designed for the removal of thrombi from the venous system. It has been successfully used in the management of iliocaval and right endocardial thrombi but is reportedly less effective in the management of pulmonary emboli (PE). Since its advent, there has been interest in its application towards other medical situations. One of the most revolutionary uses thus far has been for percutaneous debridement of valvular and cardiac electronic device-associated vegetations. In most instances, the AngioVac device has been used to obviate the need for surgery in high-risk patients. Here, we describe a novel use of this device in the successful retrieval of a large, mobile, infected thrombus from the right ventricular outflow tract in a high surgical-risk patient.
Long-Term Survival of a Lynch Syndrome Patient With Eight Primary Tumors: A Case Report
Authors: Jing Jiang, Ting Huang, Xianlei Lin, Yu Zhang, Xuefei Yang, Ling Huang, Zhifeng Ye, Xingchang Ren, Lisong Teng, Jun Li, Mei Kong, Liyan Lian, Jinhua Lu, Yazhen Zhong, Zechen Lin, Ming Xu, Yin Chen, Shengyou Lin
Journal: Front Oncol (2022)
Keywords: long-term survival, lynch syndrome, malignant peripheral nerve sheath tumor, multiple primary tumors, prostatic carcinoma
MeSH terms: Case Reports

With the modern technological developments in the diagnosis and treatment of cancer, the survival rate of cancer patients has increased. On the other hand, the incidence of multiple primary tumors is increasing annually. Lynch syndrome (LS), an autosomal dominant disorder with germline mutations in DNA mismatch repair genes, increases the risk of cancer in patients carrying those mutations. In this report, we present an extremely rare case of an 81-year-old male patient with eight primary malignancies and LS. The patient is still alive having survived for more than 41 years since the initial discovery of the first tumor. The eighth and most recently diagnosed primary cancer was a malignant peripheral nerve sheath tumor. Although there have been numerous reports of malignancies in LS, malignant peripheral nerve sheath tumors have not been reported previously with LS. Here, we report, to the best of our knowledge, the first case of a malignant peripheral nerve sheath tumor with LS.
Case Report: Application of hepatitis B virus (HBV) deep sequencing to distinguish between acute and chronic infection
Authors: Louise O Downs, Anna L McNaughton, Mariateresa de Cesare, M Azim Ansari, Jacqueline Martin, Charles Woodrow, Rory Bowden, Jane Collier, Eleanor Barnes, Philippa C Matthews
Journal: Wellcome Open Res (2021)
Keywords: hepatitis b virus, igg, igm, acute hepatitis b, case report, prognosis, reactivation, whole genome sequencing
MeSH terms: Case Reports

Deep sequencing of the full-length hepatitis B virus (HBV) genome provides the opportunity to determine the extent to which viral diversity, genotype, polymorphisms, insertions and deletions may influence presentation and outcomes of disease. Increasing experience with analysis of HBV genomic data opens up the potential for using these data to inform insights into pathophysiology of infection and to underpin decision making in clinical practice. We here set out to undertake whole genome HBV sequencing from an adult who presented acutely unwell with a new diagnosis of HBV infection, and tested positive for both HBV anti-core IgM and IgG, possibly representing either acute hepatitis B infection (AHB) or chronic hepatitis B with an acute reactivation (CHB-AR). The distinction between these two scenarios may be important in predicting prognosis and underpinning treatment decisions, but can be challenging based on routine laboratory tests. Through application of deep whole-genome sequencing we typed the isolate as genotype-D1, and identified several minority variants including G1764A and G1986A substitutions in the pre-core promoter and pre-core regions, which support CHB-AR rather than AHB. In the longer term, enhanced deep sequencing data for HBV may provide improved evidence to distinguish between acute and chronic infection, to predict outcomes and to stratify treatment.
Hydroxychloroquine Therapy Led to the Diagnosis of Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency in an Elderly Patient with COVID-19 Involvement: A Case Report and Review of the Literature
Authors: Razieh Taghizadeh-Sarvestani, Hamid Reihani, Ali Ghanei-Shahmirzadi, Alireza Keshtkar, Parsa Yazdanpanahi
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common RBC abnormality, affecting 400 million people globally. Neonatal jaundice, hemolytic anemia, icteric skin, dark urine, and fever are usually the primary signs of this condition, which is generally diagnosed between the ages of infancy and 16 years old. Therefore, its first manifestation in old age is an unexpected phenomenon. Here, we present the case of a 70-year-old man with no past medical history of G6PD deficiency that was admitted to our hospital due to COVID-19 infection and developed acute hemolytic anemia while receiving hydroxychloroquine (HCQ) medication for COVID-19-related pneumonia.
Means, Motives and Opportunity: determinants of community health worker performance
Authors: Aparna John, Thomas Newton-Lewis, Shuchi Srinivasan
Journal: BMJ Glob Health (2019)
Keywords: health policy, health systems, health systems evaluation, public health
MeSH terms: Review

The performance of community health workers (CHWs) typically depends on the interaction between their motivation (their intent to achieve personal and organisational goals) and the constraints that they face in doing so. These constraints can be both at the individual level, for example, whether the worker has the skills and knowledge required to deliver on their job role, and the organisational level, for example, whether the worker is provided with the resources required to perform. Designing interventions to improve the performance of CHWs requires identifying the constraints to performance in a particular context. Existing frameworks on CHW performance tend to be derived empirically, identifying a broad range of intervention design and contextual factors that have been shown to influence CHW performance. These may not always be able to guide policy makers to identify the precise cause of a specific performance problem in a particular context and develop an appropriate policy response. This article presents a framework to help practitioners and researchers diagnose the constraints to performance of CHWs and guide programmatic and policy responses. The Means, Motives and Opportunity (MMO) framework has been adapted from the SaniFOAM framework used to identify the determinants of sanitation behaviours. It is based on three interdependent and interacting domains: means (whether an individual is capable of performing), motives (whether an individual wants to perform) and opportunity (whether the individual has the chance to perform). A wide range of data sources are expected to be used when applying the MMO framework, especially qualitative research that captures the perspectives and lived realities of CHWs and their communities. In this article, we demonstrate how the MMO framework can be applied to identify the constraints to CHW performance using the case study of Anganwadi Workers (village nutrition workers) in Bihar, India.
Solitary breast neurofibroma: imaging aspects
Authors: Anna Rotili, Federica De Maria, Benedetta Di Venosa, Mariacristina Ghioni, Maria Pizzamiglio, Enrico Cassano, Michela Moratti
Journal: Ecancermedicalscience (2018)
Keywords: breast disease, magnetic resonance, neurofibroma
MeSH terms: Case Reports

Neurofibromas are benign peripheral nerve sheath tumours, which are usually solitary and sporadic. Solitary neurofibromas of the breast are rare. The most common location of a breast neurofibroma is the nipple-areola complex. We report a rare case of a 56-year-old woman with a solitary neurofibroma of the right breast sulcus.
Surgical treatment of rare case of scapula osteochondroma in a resource limited setting: A case report
Authors: F O Ngongang, G Fodjeu, A C Fon, L Fonkoue, M L Guifo, L J Bitang A Mafok, F Ibrahima
Journal: Int J Surg Case Rep (2019)
Keywords: case report, osteochondroma, scapula, surgical

Introduction:
Osteochondroma also known as exostosis is one of the most common benign bone tumours, and are characterized by bone protuberances surrounded by a cartilage layer. They generally affect the extremities of the long bones in an immature skeleton and deform them. They are easily diagnosed at the level of the appendicular skeleton. However, atypical localization and malignancy are sometimes challenging to diagnose on clinical evaluation and plain radiography. Therefore, more refine diagnostic tools may be required. Scapula localization of solitary exostosis is relatively rare.
Case presentation:
We report the case of a 17 years old male patient reporting worsening shoulder pain since 3 years with right scapula winging. Computer tomography (CT) scan revealed an osteochondroma on the ventro-medial surface of the right scapula extending into the scapulo-thoracic space. Surgical excision was done and histopathological study confirmed osteochondroma of the scapula. We noted excellent post-operative pain alleviation after two weeks, full range of motion and a better self-esteem.
Discussion:
The scapula is involved in 3.0-6.4% of all cases. Osteochondroma usually arises on the anterior surface of the scapula. Surgical excision is an excellent treatment option for symptomatic patients with scapula osteochondroma. In our case presentation we used a muscle sparing technique. No muscle detachment will ensure rapid and better postoperative recovery. Surgical removal is useful in eliminating painful symptoms and avoids possible malignant transformation.
Conclusion:
Good clinical outcome is expected with surgical excision of symptomatic scapula osteochondromas especially using muscle-sparing technique which offers a quick functional rehabilitation of patients.
Hepatocellular Carcinoma: First Manifestation as Solitary Humeral Bone Metastasis
Authors: Sumera Bukhari, Kristine Ward, Michael Styler
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Hepatocellular carcinoma (HCC) most commonly presents with abdominal pain or mass, fever of unknown etiology, weight loss, and decompensation of known liver disease or at an asymptomatic stage through surveillance. Rarely, presenting symptoms can be exclusively related to extrahepatic metastases. Herein, we write a case of a patient with no known liver disease, presenting with a pathological fracture of the proximal humerus bone secondary to a massive solitary metastasis from HCC. This case represents an unusual appendicular skeletal metastasis in a patient with unknown primary HCC, successfully treated with sorafenib. The prognosis of HCC patients with extrahepatic metastasis is poor, and in the presence of bone metastases, the mean survival rate is severely reduced. However, the multikinase inhibitor sorafenib has been the standard of treatment. Recently, there has been developments of other therapeutic class of drugs (i.e., immune check inhibitors), which have shown promising benefits and better side effect profiles. Still, there is a need for further studies, owing to challenges in recognizing cellular and molecular markers.