OpenMed/multicare-articles huggingface dataset:
Capecitabine and Warfarin Interaction: A Case Report With Review of Literature and Management Options
Authors: Khalefa Althiab, Manal Aljohani, Sultan Alraddadi, Mohammed Algarni
Journal: Front Cardiovasc Med (2022)
Keywords: capecitabine, case report, drug interaction, international normalized ratio (inr), warfarin
MeSH terms: Case Reports

Capecitabine is an orally active prodrug of 5-fluorouracil with improved safety and efficacy that is extensively used as an antineoplastic agent. It is converted to 5-Fluorouracil in the liver and tumor tissues. In vitro assays did not reveal any significant potential for interaction between capecitabine and its metabolites with warfarin. However, several reports provided clinical evidence of such interaction resulting in an elevated international normalized ratio (INR) and bleeding. Here, we report another case of capecitabine and warfarin concurrent administration that resulted in sub- or supra- therapeutic INR without any bleeding episode or venous-thromboembolic event through the follow-up period. Moreover, a review of available management options is also presented in this paper.
Refractory Celiac Disease Type II: A Case Report and Literature Review
Authors: Richa Chibbar, Jordan Nostedt, Dana Mihalicz, Jean Deschenes, Ross McLean, Levinus A Dieleman
Journal: Front Med (Lausanne) (2020)
Keywords: eatl, immunophenotyping, refractory celiac disease, sigmoid perforation, ulcerative jejunitis
MeSH terms: Case Reports

We present an unusual case of 68-year-old male, who presented with acute abdomen, ulcerative jejunitis with perforation, and 2 months later with perforation of the sigmoid colon. We will also discuss difficulties in the delay in diagnosis of refractory celiac disease (RCD), specifically the atypical presentation, multiple surgeries, the consecutive failure of distinct therapeutic options, and multiple complications that occurred within the 3 months since first presentation.
Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted Colonoscopy
Authors: Kang H Rah, William Ferges, James Tse
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

We present a case of explosive vomiting associated with the extensive manipulation of the proximal colon during a difficult colonoscopy procedure. The cause of vomiting in this case may have been multifactorial; however, proximal colonic distention was the most likely factor because the onset of vomiting coincided with proximal colonic manipulation and happened without any prodromal signs, coughing, and airway obstruction. Propofol, the sedative most commonly administered to the patient during colonoscopy, allows for a deep state of sedation, and consequently extensive colonic distention and scope manipulation. Colonic distention may lead to a higher risk of vomiting. We reviewed the neurocircuitry associated with vomiting and discussed why proximal colonic distention may increase the risk of vomiting. We emphasize vigilance during the manipulation of the proximal colon because vomiting increases the potential for aspiration pneumonitis and pneumonia in patients under deep propofol sedation with attenuated airway responses.
Microbial contamination in water-based metalworking fluid as trigger for occupational hypersensitivity pneumonitis - development of specific IgG tools for a suspected clinical case
Authors: Sabine Kespohl, Isabell Warfolomeow, Gerd Schneider, Silke Maryska, Ursula Meurer, Monika Raulf
Journal: Allergol Select (2020)
Keywords: igg antibodies, hypersensitivity pneumonitis, in-vitro diagnosis, metal working fluid, microbial contamination
MeSH terms: Case Reports

Microbially contaminated metal-working fluid (MWF) can cause respiratory symptoms in exposed workers in the form of exogenous allergic alveolitis/hypersensitivity pneumonitis (HP). The diagnosis of HP is based, among others, on the identification of the culprit and the detection of corresponding specific IgG antibodies (sIgG) in the patient's serum. Commercial antigen tools for the detection of these HP triggers are rarely available; therefore, antigens from contaminated MWF workplace samples were isolated exemplarily for diagnosis of a suspected HP case. Various MWF-specific bacteria were identified in the workplace samples, including Pseudomonas oleovorans, Pseudomonas alcaliphila, Pseudomonas spec., Paenibacillus glucanolyticus, and Corynebacterium amycolatum. The sIgG antigen binding, detected by ImmunoCAP system against MWF antigens from workplace samples and against the identified bacterial antigens, was much stronger in the patient serum compared to selected reference sera. The highest sIgG concentrations in the patient's serum could be determined against Pseudomonas antigens. Inhibition tests showed cross-reactions of MWF and Pseudomonas antigens, whereby the Pseudomonas antigens cross-reacted less with each other. For in-vitro diagnosis in case of suspected HP caused by contaminated MWF, workplace-related antigens are now available.
A Case of Solitary Nonvascularized Corneal Epithelial Dysplasia
Authors: Tomoya Morii, Takayoshi Sumioka, Ai Izutani-Kitano, Yukihisa Takada, Yuka Okada, Winston W-Y Kao, Shizuya Saika
Journal: Case Rep Ophthalmol Med (2016)

Background. Epithelial dysplasia is categorized as conjunctival/corneal intraepithelial neoplasia which is a precancerous lesion. The lesion is usually developed at the limbal region and grows towards central cornea in association with neovascularization into the lesion. Here, we report a case of isolated nonvascularized corneal epithelial dysplasia surrounded by normal corneal epithelium with immune histochemical finding of ocular surface tissues cytokeratins, for example, keratin 13 and keratin 12. Case Presentation. A 76-year-old man consulted us for visual disturbance with localized opacification of the corneal epithelium in his left eye. His visual acuity was 20/20 and 20/200 in his right and left eye, respectively. Slit lamp examination showed a whitish plaque-like lesion at the center of his left corneal epithelium. No vascular invasion to the lesion was found. The lesion was surgically removed and subjected to histopathological examination and diagnosed as epithelial dysplasia. Amyloidosis was excluded by direct fast scarlet 4BS (DFS) staining. Immunohistochemistry showed that the dysplastic epithelial cells express keratin 13 and vimentin, but not keratin 12, indicating that the neoplastic epithelial cells lacked corneal-type epithelium differentiation. Conclusions. The lesion was diagnosed as nonvascularized epithelial dysplasia of ocular surface. Etiology of the lesion is not known.
Endocrine Aspects of 4H Leukodystrophy: A Case Report and Review of the Literature
Authors: Emma Billington, Geneviève Bernard, William Gibson, Bernard Corenblum
Journal: Case Rep Endocrinol (2015)

Introduction. 4H leukodystrophy is an autosomal recessive RNA polymerase III-related leukodystrophy, characterized by hypomyelination, with or without hypodontia (or other dental abnormalities) and hypogonadotropic hypogonadism. Case Presentation. We describe a 28-year-old female who presented with primary amenorrhea at the age of 19. She had a history of very mild neurological and dental abnormalities. She was found to have hypogonadotropic hypogonadism, and magnetic resonance imaging of the brain showed hypomyelination. The diagnosis of 4H leukodystrophy was made. She was subsequently found to have mutations in the POLR3B gene, which encodes the second largest subunit of RNA polymerase III. She wished to become pregnant and failed to respond to pulsatile GnRH but achieved normal follicular growth and ovulation with subcutaneous gonadotropin therapy. Discussion. Patients with 4H leukodystrophy may initially present with hypogonadotropic hypogonadism, particularly if neurological and dental manifestations are subtle. Making the diagnosis has important implications for prognosis and management. Progressive neurologic deterioration is expected, and progressive endocrine dysfunction may occur. Patients with 4H leukodystrophy should be counseled about disease progression and about this disease's autosomal recessive inheritance pattern. In those who wish to conceive, ovulation induction may be achieved with subcutaneous gonadotropin therapy, but pulsatile GnRH does not appear to be effective.
Inflammatory Fibroid Polyp: An Unusual Cause of Ileoileal Intussusception
Authors: Haley S Adams, Brian Bergstrom, Bret Haines, Nathan Roberts
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Inflammatory fibroid polyp (IFP), or Vanek's tumor, is a rare benign lesion of the gastrointestinal tract. Clinical manifestations of IFP vary based on size and location within the GI tract. This case describes a patient who presented with hematochezia and abdominal pain. Computed tomography revealed ileoileal intussusception without a clear lead point. The patient underwent resection of the intussuscepted small bowel with primary anastomosis. A large polypoid mass was identified as the pathological lead point. Histopathological and immunohistochemical analysis revealed an IFP. Review of the literature indicates that early surgical intervention is the treatment of choice for intussusception caused by IFP. Lesions are typically reported as solitary, and resection is curative.
Case report: Improvement in refractory functional seizures, depression, and quality of life with ketamine-assisted therapy
Authors: Elena Argento, Egiroh Omene, Alexandria H Jaeger, Angela Kertes, Kaitlyn A Mitchell, Candace Necyk, Paul Thielking, Evan Cole Lewis
Journal: Front Neurosci (2023)
Keywords: functional neurological disorder, functional seizures, ketamine-assisted therapy, mental health, quality of life
MeSH terms: Case Reports

Functional seizures, a primary subtype of functional neurological disorder (FND), are a known cause of serious neurological disability with an increasing awareness of their impact amongst the neuroscience community. Situated at the intersection of neurology and psychiatry, FND is characterized by a range of alterations in motor, sensory or cognitive performance, such as abnormal movements, limb weakness, and dissociative, seizure-like episodes. Functional seizures are known, in part, to have psychological underpinnings; however, the lack of effective and consistent treatment options requires research and novel approaches to better understand the etiology, diagnosis and what constitutes a successful intervention. Ketamine, a selective blocker of the N-methyl-D-aspartate receptor, has a well-established safety and efficacy profile. In recent years, ketamine-assisted therapy has shown increasing potential for treating a broad range of psychiatric conditions, building on its demonstrated rapid-acting antidepressant effects. Here we present a 51-year-old female with refractory daily functional seizures leading to significant disability and a medical history significant for major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). After unsuccessful treatment attempts, the patient underwent a novel protocol with ketamine-assisted therapy. After 3 weeks of ketamine-assisted therapy followed by 20 weeks of intermittent ketamine treatment and ongoing integrative psychotherapy, the patient's seizures were significantly reduced in frequency and severity. She experienced significant improvements in depressive symptoms and functional ability scores. To our knowledge, this is the first reported case describing improvement in functional seizures following ketamine-assisted therapy. While rigorous studies are needed, this case report encourages further investigation of ketamine-assisted therapy for functional seizures and other functional neurological symptoms.
Case report: Temporal alterations in vascular function during the first 2 weeks of pediatric septic shock
Authors: Christiaan Diederik Mathijs Wijers, Ryan J Stark
Journal: Front Pediatr (2022)
Keywords: ldpmi, pediatric, sepsis, shock, vascular function
MeSH terms: Case Reports

Introduction:
During sepsis and septic shock, the host's immune systems generate an overwhelming and often, detrimental, inflammatory response. Part of this response results in significant alterations in blood flow and vasomotor tone regulated in part by endothelial and vascular smooth muscle cells. Here, we report on a series of 3 pediatric patients for whom vascular response was assessed by laser doppler perfusion coupled to iontophoresis over the first 2 weeks after hospitalization for septic shock to demonstrate similarities and dissimilarities in the vascular response.
Case presentations:
A 12-year-old male with a history of Burkitt's Lymphoma, a 21-year-old male with congenital porencephaly and epilepsy, and a 7-year-old male with no significant past medical history all were admitted to a tertiary care children's hospital with a diagnosis of septic shock requiring vasoactive infusions to maintain mean arterial blood pressure. Non-invasive laser doppler perfusion coupled with iontophoresis of either acetylcholine (endothelial-dependent response) or sodium nitroprusside (endothelial-independent response) was performed on hospital days 1, 3, 7, and 14. Variability and heterogeneity were demonstrated by the temporal assessments of the vascular response to sodium nitroprusside, but all three patients showed significant similarity in the temporal responsiveness to acetylcholine.
Conclusion:
Assessment of baseline and temporal responsiveness to endothelial-dependent vascular reactivity may provide a predictable timeline to the resolution of pediatric septic shock.
Case report: late complication of a dry socket treatment
Authors: Ramón Manuel Alemán Navas, María Guadalupe Martínez Mendoza
Journal: Int J Dent (2010)
MeSH terms: Case Reports

Dry socket is often treated in dentistry with intra-alveolar dressings; the use of them remains controversial and has been related to some side effects such as neuritis, foreign body reactions, and myospherulosis. We present a case of an intra-alveolar dressing (zinc-oxide eugenol paste) that mimicked a trigeminal neuralgia for 3 years and caused a right maxillary chronic osteomyelitis and foreign body reaction in a zone corresponding to the alveolus of the maxillary first molar. This long-term complication was successfully managed by complete removal of the foreign body and curettage of the affected area.
Spontaneous Rupture and Hemorrhage of WON: A Case Report
Authors: Jican Yan, Wenhao Yu, Jingxin Yan, Xinjian Guo, Lizhao Hou, Li Ren, Haining Fan
Journal: Front Surg (2022)
Keywords: won, case report, hematoma, spontaneous rupture, surgical treatment
MeSH terms: Case Reports

Background:
Pancreatic pseudocysts are characterized by the leakage of pancreatic juice caused by various reasons, which leads to pancreatic juice accumulates around the pancreas, and stimulates the greater omentum and other tissues to form an area of fibrotic loculated effusion with an integrated capsule. Approximately, one-third of patients experienced recurrent pancreatic juice leakage, compression symptoms, infection, and bleeding, which requires surgical intervention, but spontaneous rupture cases are extremely rare.
Case presentation:
We here present the case of 40-year-old male who presented with abdominal pain and vomiting for two days and 10 h, respectively. He had a history of chronic pancreatitis and pseudocysts. The symptoms of abdominal pain worsened in the second day. Laboratory tests showed a progressive decrease in hemoglobin. Then, emergency pancreatoduodenectomy was performed. Intraoperative exploration found a small blood clot in the abdominal cavity and a hematoma that had formed in the intestinal cavity and retroperitoneum.
Conclusion:
This case showed that pseudocysts of the pancreas can rupture under certain circumstances, leading to intraperitoneal bleeding and hematoma formation, which can endanger the life of the patient. And surgical treatment can be the first choice for hemorrhagic pseudocysts.
Leiomyosarcoma of the spermatic cord: A case report and literature review
Authors: Mohamad Moussa, Mohamed Abou Chakra
Journal: Int J Surg Case Rep (2019)
Keywords: case report, leiomyosarcoma, paratesticular, scrotum, spermatic cord

Background:
Leiomyosarcoma of the spermatic cord is a rare entity. It presents as a firm and painless intrascrotal mass. For diagnosis radiological methods such as ultrasound, CT or MRI are necessary. Radical orchiectomy is the gold standard of treatment.
Case description:
We reported a one case of a 66-year-old man that he has suffered from a painless hard mass in the right hemiscrotum since three years. Ultrasound revealed a paratesticular mass. Further workup revealed no distant metastasis before surgery. Right radical orchiectomy was performed, the final pathologic examination showed a leiomyosarcoma of the spermatic cord. The patient remained disease-free twelve-month during follow up after surgery.
Discussion:
Leiomyosarcoma of the spermatic cord is a rare condition, it arises from mesenchymal cells of the spermatic cord and occurs mainly in elderly patients. The diagnosis of spermatic cord leiomyosarcoma is difficult if based only on imaging procedures, it is revealed by histological examination post surgery. No treatment protocol has yet been established for paratesticular leiomyosarcoma due to the rarity of the disease. Standard treatment is radical orchidectomy with high ligation of the spermatic cord. The benefit of adjuvant chemotherapy, radiotherapy, and retroperitoneal lymphadenectomy are not well understood and may differ according to the surgeon's preferences.
Conclusion:
The lack of such cases results in the challenging nature of the diagnosis and treatment of leiomyosarcoma of the spermatic cord. Additional studies are needed to better define optimal management strategies.
Acute Necrotizing Encephalopathy of Childhood (ANEC): A Case Report
Authors: Afagh Hassanzadeh Rad, Vahid Aminzadeh
Journal: Iran J Child Neurol (2017)
Keywords: anec, brain stem, encephalopathy, thalamus
MeSH terms: Case Reports

Acute Necrotizing Encephalopathy of childhood (ANEC) is a specific type of encephalopathy. After viral infection, it can be diagnosed by bilateral symmetrical lesions predominantly observed in thalami & brainstem of infants & children. Although, it is commonly occurred in Japanese and Taiwanese population. The goal of this article is to report a rare case of ANEC in a 15 months old girl infant from Thaleghani Hospital, Ramian, Gorgan, northern Iran.
Case report: Percoronary device closure of tortuous coronary artery fistula into left atrium
Authors: Shi-Bin Sun, Zhongzheng Kong, Zeeshan Farhaj, Li Hongxin
Journal: Front Cardiovasc Med (2023)
Keywords: coronary artery fistula, device closure, minithoracotomy, occlusion, percoronary
MeSH terms: Case Reports

Surgical ligation and transcatheter occlusion are the mainstream for the treatment of coronary artery fistulas (CAFs). However, these techniques applied to tortuous and aneurysmal CAF, especially those draining into left-heart, have their known drawbacks. We report, a successful percoronary device closure of such CAF, originating from left main coronary artery and draining into left atrium, through a left subaxillary minithoracotomy. Through a puncture on the distal straight course, we occluded CAF exclusively under transesophageal echocardiography guidance. Complete occlusion was achieved. It's a simple, safe, and effective alternative for tortuous, large, and aneurysmal CAFs draining into the left heart.
Abernethy Malformation Masquerading as Congenital Heart Disease: A Boy With Cyanosis, Clubbing, and Hypoxia
Authors: Rohit Agarwal, Durga Prasad, Gaurav Chauhan, Abhai Verma
Journal: Cureus (2023)
Keywords: abernethy malformation, congenital anomalies of the liver, congenital extracardiac portosystemic shunt, portosystemic shunt, severe dyspnea, vascular plug
MeSH terms: Case Reports

Abernethy malformation is an extrahepatic congenital portosystemic shunt characterized by the diversion of the portal blood away from the liver through a shunt that drains directly into the inferior vena cava. We present a case of a male child with Abernethy malformation, which was initially diagnosed as cyanotic heart disease due to pulmonary arteriovenous malformation. However, after proper clinical evaluation and investigations, the diagnosis of Abernethy malformation was established. Thereafter, the patient was successfully treated with endovascular embolization. At one year follow-up, marked relief in exertional dyspnea and improvement in physical growth was achieved with no observable complications.
Postmorterm Computed Tomography and Autopsy to Confirm Sudden Death Due to Tracheal Compression by Mediastinal Fat Tissue in a Young Man With Obesity
Authors: Hideyuki Maeda, Keiko Matsuno, Yoshiteru Tamura, Shigeo Sogabe, Ken-Ichi Yoshida
Journal: Cureus (2023)
Keywords: hypoxia, mediastinal tumors, obesity medicine, postmortem computed tomography, tracheal obstruction
MeSH terms: Case Reports

A man in his early twenties with obesity was found dead in his apartment. The deceased was found naked and surrounded by empty bottles of electrolytes. An autopsy performed approximately 6 days postmortem and gross inspection revealed the absence of injury and no apparent extrinsic cause of death. It was decided to dissect to investigate the cause of death. The deceased had become morbidly obese (weight, 98 kg; height, 160 cm; body mass index, 38.3). Shortly before his death, he presented at a clinic complaining of gastric discomfort and heartburn, but other than hypertension (155/91 mmHg) no specific abnormality was found. He was normothermic (36.6℃), and his blood oxygen saturation was normal (97%). Postmortem computed tomography of the thorax revealed a mediastinal mass obstructing the trachea, an upper-airway obstruction, and a narrowed thoracic cavity due to upward compression by an enlarged fatty liver. Autopsy confirmed that the tracheal mass was fatty tissue within the thymus and that upward pressure from an enlarged fatty liver had compressed the thoracic cavity. The deceased likely developed nocturnal chronic hypoxia because of compression by the mediastinal fat mass as well as intermittent hypoxia because of obstructive sleep apnea when lying supine. Chronic and intermittent hypoxia, diabetes, and obesity activate the sympathetic nervous system, increasing the risk of hypertension, heart failure, and arrhythmias. Histological findings showed pulmonary congestion and edema, reflecting heart failure as well as myocardial fragmentation and waving, showing hyper-contraction and hyper-relaxation, respectively. Hypertension, feeling overheated, and myocardial hyper-contraction can be explained as sympathetic nerve over-activation. Intra-cardiac coagulation and a renal cortical pallor suggested subacute death from cardiogenic shock due to heart failure. Postmortem computed tomography before autopsy detected airway obstruction and revealed the cause and pathophysiology of unexpected death in a young man with morbid obesity. Therefore, this could be a potentially useful clinical practice for determining the cause of death postmortem.
Manubriosternal dislocation type II associated with thoracic spine fracture: What can we learn from this?
Authors: N N M Razafimanjato, T D N Ravelomihary, N O N L H Rajaonarison, A Ahmad, H J L Rakotovao
Journal: Afr J Thorac Crit Care Med (2019)
Keywords: chest trauma, manubriosternal joint, spine, sternal segment dislocation, sternum, thoracic surgery
MeSH terms: Case Reports

Traumatic dislocation of the manubriosternal joint is rare, and management correction requires an individualised decision. We report a case of a young female who suffered a type II manubriosternal dislocation with concomitant thoracic spine fracture, as a result of a motor vehicle accident. The mechanism and various therapeutic outcomes are discussed, and a review of the literature provided.