OpenMed/multicare-articles huggingface dataset:
Use of fondaparinux in patients with heparin-induced thrombocytopenia on veno-venous extracorporeal membrane oxygenation: A three-patient case series report
Authors: Jitka Rychlíčková, Vladimír Šrámek, Pavel Suk
Journal: Front Med (Lausanne) (2023)
Keywords: extracorporeal membrane oxygenation, fondaparinux, heparin-induced thrombocytopenia, pharmacoeconomics, pharmacokinetics
MeSH terms: Case Reports

Heparin-induced thrombocytopenia is a life-threatening immune-mediated complication of unfractionated heparin therapy. Fondaparinux is a therapeutic alternative, but it has limited evidence for its use in patients on extracorporeal membrane oxygenation (ECMO). We present a series of three adult patients with COVID-19 on ECMO who were diagnosed with heparin-induced thrombocytopenia after 7-12 days of unfractionated heparin treatment and were switched to fondaparinux. Fondaparinux was initiated with an intravenous loading dose of 5 mg, followed by a dose of 2.5 mg subcutaneously every 8-12 h. Dosage was adjusted according to daily measured anti-Xa concentration with a target range of 0.4-0.7 mg/L. The total duration of treatment with fondaparinux and ECMO ranged from 13 to 26 days. One major bleeding episode unrelated to fondaparinux therapy was observed, and the transfusions requirement was also low in all patients. The ECMO circuit was changed once in each patient. This series provides a deep insight into the use of fondaparinux over an extended period of time in patients on ECMO. Based on the presented data, fondaparinux can be considered a reasonable and affordable anticoagulant in patients without a high risk of bleeding.
Pure Uterine Lipoma with a Combined Mucinous Cystic and Brenner Ovarian Tumor in a Postmenopausal Woman: A Case Report and Review of the Literature
Authors: Toshimitsu Tohya, Mariko Tominaga, Tomoko Honda
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Lipomatous tumors are rare among uterine mesenchymal tumors. Due to their rarity, information on the clinical development and histological origin are lacking. We report a pure uterine lipoma and present a review of the relevant literature. We encountered a 72-year-old postmenopausal woman who was referred to our hospital. Computed tomography (CT) and magnetic resonance imaging (MRI) examinations revealed degenerative uterine tumors and a left ovarian cystic tumor with a solid portion. Total hysterectomy and bilateral salpingo-oophorectomy were performed, and postoperative histological examination revealed a uterine lipoma and adenomyosis. The cystic portion was a mucinous cystadenoma, and the solid portion was classified as a Brenner tumor. The postoperative course was uneventful, and the patient was discharged and remained well until follow-up. Our observations suggest that imaging examinations are sufficient for the diagnosis of uterine lipomatous tumors. To the best of our knowledge, the coexistence of a pure uterine lipoma and a mucinous Brenner ovarian tumor has not been documented in the existing literature. The histogenesis of uterine lipomas remains unclear. However, our results, and those from the existing literature, indicate that the mesenchymal stem cells surrounding the perivascular tissue may be implicated, because lipomas of the skin are reported to originate from these cells.
Autoimmune blistering skin diseases triggered by COVID-19 vaccinations: An Australian case series
Authors: Timothy L Cowan, Cheng Huang, Dédée F Murrell
Journal: Front Med (Lausanne) (2023)
Keywords: covid-19, autoimmune blistering, flare, pemphigoid, pemphigus, vaccination

Autoimmune blistering skin diseases (AIBD) can be induced or flared by a multitude of sources, however, there have been some reports suggesting that this occurrence is due to COVID-19 vaccinations. At a single academic blistering disease centre in Sydney, Australia, a retrospective review was conducted, identifying 59 patients with AIBD seen between February 2021 and November 2022. Secondary to recent COVID-19 vaccination, four patients had induction of bullous pemphigoid, three patients had a flare of pre-existing bullous pemphigoid, one patient had induction of pemphigus, and two patients had a flare of pre-existing pemphigus vulgaris. This adds to our understanding of the role of vaccinations in the activity of AIBD.
Isolated localization of Rosai Dorfman disease as renal mass: a case report and review of literature
Authors: Aziz El Majdoub, Aziza El Houari, Laila Chbani, Hinde El Fatemi, Abdelhak Khallouk, Moulay Hassan Farih
Journal: Pan Afr Med J (2016)
Keywords: rosai dorfman disease, emperipolesis, extranodal, renal mass
MeSH terms: Histiocytosis, Sinus / diagnosis, Kidney Neoplasms / diagnosis, Nephrectomy / methods, Case Reports, Review, Aged, Female, Histiocytosis, Sinus / pathology, Histiocytosis, Sinus / surgery, Humans, Lymph Node Excision / methods, Lymphadenopathy / diagnosis, Lymphadenopathy / surgery

We report a rare case of an elderly woman presented with right renal mass with invasion of renal vein and several small lymphadenopathy in the hilar area. The diagnosis of kidney cancer is suspected and the patient underwent open radical nephrectomy, surrenalectomy and lymphadenectomy dissection. The pathologic examinations find a rosai dorfman disease. This unusual benign entity is uncommon in the kidney, but in medical imaging, it may simulate an infiltrative renal neoplasm, especially a lymphoma or leukemia or even renal cell carcinoma. A comprehensive literature review was undertaken to summarize the clinical and pathologic features of this disorder.
Comparative genomic analysis of Klebsiella pneumoniae subsp. pneumoniae KP617 and PittNDM01, NUHL24835, and ATCC BAA-2146 reveals unique evolutionary history of this strain
Authors: Taesoo Kwon, Young-Hee Jung, Sanghyun Lee, Mi-Ran Yun, Won Kim, Dae-Won Kim
Journal: Gut Pathog (2016)
Keywords: carbapenemases, klebsiella pneumoniae, ndm-1, oxa-232
MeSH terms: Case Reports

Background:
Klebsiella pneumoniae subsp. pneumoniae KP617 is a pathogenic strain that coproduces OXA-232 and NDM-1 carbapenemases. We sequenced the genome of KP617, which was isolated from the wound of a Korean burn patient, and performed a comparative genomic analysis with three additional strains: PittNDM01, NUHL24835 and ATCC BAA-2146.
Results:
The complete genome of KP617 was obtained via multi-platform whole-genome sequencing. Phylogenetic analysis along with whole genome and multi-locus sequence typing of genes of the Klebsiella pneumoniae species showed that KP617 belongs to the WGLW2 group, which includes PittNDM01 and NUHL24835. Comparison of annotated genes showed that KP617 shares 98.3 % of its genes with PittNDM01. Nineteen antibiotic resistance genes were identified in the KP617 genome: bla OXA-1 and bla SHV-28 in the chromosome, bla NDM-1 in plasmid 1, and bla OXA-232 in plasmid 2 conferred resistance to beta-lactams; however, colistin- and tetracycline-resistance genes were not found. We identified 117 virulence factors in the KP617 genome, and discovered that the genes encoding these factors were also harbored by the reference strains; eight genes were lipopolysaccharide-related and four were capsular polysaccharide-related. A comparative analysis of phage-associated regions indicated that two phage regions are specific to the KP617 genome and that prophages did not act as a vehicle for transfer of antimicrobial resistance genes in this strain.
Conclusions:
Whole-genome sequencing and bioinformatics analysis revealed similarity in the genome sequences and content, and differences in phage-related genes, plasmids and antimicrobial resistance genes between KP617 and the references. In order to elucidate the precise role of these factors in the pathogenicity of KP617, further studies are required.
Signet Ring Cell Carcinoma of the Lung: A Diagnostic Pitfall in Pregnancy
Authors: Sabine Danzinger, Wolfgang J Köstler, Martin Funovics, Merima Herac, Leonhard Müllauer, Helmut Prosch, Heinz Kölbl
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Lung cancer during pregnancy represents a rare disease. In this case report, we present a patient at advanced and metastasized stage of signet ring cell carcinoma who presented in the 22nd week of gestation.
Case Report: Yellow Fever Vaccine-Associated Neurotropic Disease and Associated MRI, EEG, and CSF Findings
Authors: Michelle Cohen, Madeline Nguyen, Chad D Nix, Brendan Case, Joshua P Nickerson, Jacqueline Bernard, Julia Durrant, Delaram Safarpour, Tarvez Tucker, Kamila Vagnerova, William B Messer
Journal: Front Neurol (2022)
Keywords: creutzfeldt-jakob disease, autoimmune encephalitis, post-infectious parkinsonism, vaccine adverse event, yellow fever associated neurotropic disease, yellow fever vaccine, yellow fever virus
MeSH terms: Case Reports

Yellow fever vaccine-associated neurotropic disease (YEL-AND) is a rare and serious complication following vaccination with the 17D live attenuated yellow fever vaccine. Cases of YEL-AND have presented as acute inflammatory demyelinating polyneuropathy, acute disseminated encephalomyelitis, and meningoencephalitis. To date, intracranial imaging of the progression and resolution of this disease has been minimally depicted in the literature. We present the case of a 67-year-old woman who developed YEL-AND following vaccination. Her diagnosis was complicated by imaging findings consistent with variant Creutzfeldt Jakob Disease. Her clinical history and the progression of her intracranial imaging is discussed in this case report.
Growth Failure and Excessive Weight Gain in a 10 Year Old Male With Obesity: Approach to Diagnosis, Management, and Treatment of Acquired Hypothyroidism
Authors: Tiffany Schumaker, Marisa Censani
Journal: Front Pediatr (2018)
Keywords: hashimoto's thyroiditis, growth, hypothyroidism, obesity, weight gain
MeSH terms: Case Reports

We report the case of a 10 year old male with severe obesity who presented with a 2 year history of significant growth failure and excessive weight gain that was subsequently diagnosed with serum negative Hashimoto's thyroiditis and acquired hypothyroidism. Initial investigations revealed a markedly elevated thyroid stimulating hormone (TSH) concentration >100 uIU/mL and an undetectable free thyroxine with total thyroxine 0.56 ug/dL. Thyroid antibodies were negative, however ultrasound findings were consistent with Hashimoto's thyroiditis. After treatment with levothyroxine supplementation, he had significant weight loss and marked improvement in his growth velocity. This case emphasizes the need to recognize excessive weight gain and growth failure as an initial presentation of Hashimoto's thyroiditis and highlights management and approach to treatment. Diagnosis and treatment is vital as prolonged undiagnosed hypothyroidism can result in incomplete catch up growth and compromised final adult height.
Mixed neuroendocrine carcinoma and hepatocellular carcinoma in the liver
Authors: Haruka Tanaka, Hiroyuki Sugo, Naoki Iwanaga, Michio Machida, Ikuo Watanobe, Hironao Okubo, Shiori Hotchi, Kanako Ogura
Journal: Cancer Rep (Hoboken) (2023)
Keywords: fdg-pet/ct, hepatocellular carcinoma, liver, neuroendocrine carcinoma
MeSH terms: Carcinoma, Hepatocellular / diagnostic imaging, Carcinoma, Hepatocellular / surgery, Carcinoma, Neuroendocrine / diagnostic imaging, Carcinoma, Neuroendocrine / surgery, Liver Neoplasms / diagnostic imaging, Liver Neoplasms / surgery, Case Reports, Aged, Fluorodeoxyglucose F18, Humans, Male, Positron Emission Tomography Computed Tomography / methods, Radiopharmaceuticals, Fluorodeoxyglucose F18, Radiopharmaceuticals

Background:
Mixed neuroendocrine carcinoma (NEC) and hepatocellular carcinoma (HCC) is extremely rare, thus radiological features have not been fully clarified.
Case:
A male patient (age: 70 years) visited our hospital due to a tumor in the liver. Examination using contrast-enhanced computed tomography (CT) revealed a tumor (diameter: 5.0 cm) in hepatic segment 5, with early enhancement of the peripheral area and slight internal heterogeneous enhancement in the arterial and delayed phases, respectively. F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT revealed intratumoral heterogeneity, characterized by increased uptake (standardized uptake value, 12.10) in the corresponding low-density area detected using enhanced CT relative to the surrounding areas of the tumor. On magnetic resonance imaging, diffusion-weighted imaging also showed high intensity in the corresponding low-density area detected using CT. Preoperatively, the patient was diagnosed with HCC and underwent anterior sectionectomy. Pathological findings revealed both HCC and NEC components, and the patient was diagnosed with mixed NEC and HCC. Comparison of component distribution with FDG-PET/CT revealed an increased uptake area was congruent with the NEC component in the tumor.
Conclusion:
In this case, the difference in tumor components affected the uptake in FDG-PET/CT. Such heterogeneous uptake with an enhanced spot may be useful for suspecting the presence of mixed NEC and HCC in patients with atypical HCC.
Retropharyngeal abscess revealing a migrant foreign body complicated by mediastinitis: a case report
Authors: Tarik Ziad, Youssef Rochdi, Othmane Benhoummad, Hassan Nouri, Lahcen Aderdour, Abdelaziz Raji
Journal: Pan Afr Med J (2014)
Keywords: retropharyngeal, abscess, mediastinitis
MeSH terms: Foreign Bodies / complications, Mediastinitis / etiology, Retropharyngeal Abscess / etiology, Case Reports, Deglutition Disorders / etiology, Foreign Bodies / diagnosis, Humans, Mediastinitis / diagnosis, Mediastinitis / pathology, Pharynx / pathology, Retropharyngeal Abscess / diagnosis, Retropharyngeal Abscess / pathology, Tomography, X-Ray Computed, Young Adult

Pharyngeal foreign bodies are quite common. Their diagnosis is usually easy. The risk of complications including retropharyngeal abscess and mediastinitis is rare and it depends mainly on the nature of the foreign body and the period of the therapeutic management. The occurrence of these complications darkens the prognosis of this affection usually benign. We report a 21 years old patient, without any significant history, admitted to the emergency for a high painful dysphagia and impaired general condition with fever 20 days after trauma in the posterior pharyngeal wall following a meal. The radiological assessment including cervico-thoracic CT scan had objectified the presence of a metallic foreign body in the retropharyngeal space associated with a retropharyngeal abscess and aggravated by a mediastinitis following the migration of the foreign body to the chest. Biological markers of infection were very increased. The therapeutic management consisted of a surgical drainage of the collections by a cervicotomy with removal of the foreign body. The outcome was favorable clinically and biologically. Pharyngeal foreign bodies are common and favorable when the diagnosis and extraction are made on time. The occurrence of complications, especially retropharyngeal abscess and mediastinitis is rare and burdened with a high morbidity and mortality.
Giant Spigelian Hernia presenting as small bowel obstruction: Case report and review of literature
Authors: Marino Di Furia, Lucia Romano, Andrea Salvatorelli, Denise Brandolin, Gianni Lazzarin, Mario Schietroma, Francesco Carlei, Antonio Giuliani
Journal: Int J Surg Case Rep (2019)
Keywords: mesh repair, small bowel obstruction, spigelian hernia

Introduction:
Spigelian Hernia is an uncommon pathology of abdominal wall (0.12-2.4%), usually small sized and with vague symptoms. It rarely presents as Small Bowel Obstruction or reaches dimensions that becomes clinically remarkable.
Presentation of case:
84-year-old woman entered our Surgical Department for Small Bowel Obstruction due to a giant (8 × 7 cm) abdominal wall hernia, which was intraoperatively identified as Spigelian Hernia. We performed a minilaparotomy with reduction of viable small bowel and preperitoneal positioning of polypropilene mesh. Postoperative course was uneventfull.
Discussion:
Due to its small dimensions and infrequence, the diagnosis could be challenging even if the patient undergoes a CT scan. The presentation with clear signs of small bowel obstruction associated with a large abdominal hernia is rare and suggests a urgent surgical approach with mesh repair to avoid recurrences.
Conclusion:
Even if rarely symptomatic, the Spigelian Hernia is an entity to consider in the differential diagnosis of small bowel obstruction in a virgin abdomen. Preoperative diagnosis, when available, is mandatory to guide a correct surgical approach.
Reconstruction of a nail bed with double-layer artificial dermis for a pincer nail: A case report and literature review
Authors: Weicong Deng, Zelin Zhou, Bo Leng, Xinming Zeng, Zi Shen, Yongchang Hong
Journal: Front Surg (2023)
Keywords: artificial dermal, case report, literature review, pincer nail, reconstitution
MeSH terms: Case Reports

Background:
A pincer nail (PN) is a type of nail deformity. Although it is a minor ailment, it can cause intractable pain, affecting daily work and life. Currently, there is no standard invention for PN. The main purpose of treatment is to correct the curvature of the nail, so we apply double-layer artificial dermis (DLAD), a novel treatment, for PN according to this aim.
Case presentation:
A 40-year-old man suffering from PN was treated with DLAD. After 1 year of follow-up, the patient's great toenail plate of the right foot was completely grown out. His pain was relieved, and the curvature of the toenail was corrected.
Conclusion:
The innovative method of using DLAD to fill the ingrown nail bed not only solves the problem of recurrent pincer nail deformity but also restores the original appearance of the toenail. It suggested that this simple procedure can be widely applied in clinical practice.
Congenital Infantile Fibrosarcoma Causing Intestinal Perforation in a Newborn
Authors: Margarita Kaiser, Bernadette Liegl-Atzwanger, Eszter Nagy, Daniela Sperl, Georg Singer, Holger Till
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Congenital infantile fibrosarcoma (CIF) is a rare malignant mesenchymal tumor and only 14 cases have been reported with gastrointestinal manifestation. We report about a female newborn delivered per emergency cesarean section at 34 weeks of gestation. Postnatally, she rapidly developed an acute abdomen and sonographic evidence of intestinal perforation requiring laparotomy on the first day of life. A perforated 2 × 3 cm sized spherical tumorous structure of the jejunum was identified. Due to unknown histopathology at this point and unclear resectional margins, she received a temporary ileostomy, which was closed two months later. Histopathology revealed a congenital intestinal fibrosarcoma without the characteristic ETV6-NTRK3 fusion transcript. In conclusion, this rare tumor must be considered as differential diagnosis of intestinal perforations in newborns.
Transvers testicular ectopia: A case report and literature review
Authors: Tural Abdullayev, Mevlit Korkmaz
Journal: Int J Surg Case Rep (2019)
Keywords: crossed testicular ectopia, persistent mullerian duct syndrome, trans septal orchiopexy, transverse testicular ectopia, undescended testis

İNTRODUCTION: Transverse testicular ectopia (TTE) is a rare anomaly characterized by the presence of both testicles in the same hemiscrotum or inguinal region. The most common clinical findings of TTE are unilateral nonpalpable testis in the scrotum and inguinal hernia on the side of palpable testis in the scrotum. It should be kept in mind that TTE may coexist with Persistent Mullerian Duct Syndrome (PMDS). Therefore, appropriate treatment should be performed considering PMDS.
Presentation of case:
Type 2 transverse testicular ectopia was diagnosed in one patient who was operated with bilateral undescended testis. He was treated with transseptal orchiopexy and excision of mullerian structures.
Discussion:
In case of TTE with PMDS, optimal surgical approach with orchiopexy and excision of Müllerian duct is necessary. Intraoperative aggressive dissection of vas deferens and testicular vessels should be avoided in TTE patients. They should be closely followed because of the increased risk of malignant transformation in the postoperative period.
Conclusion:
An investigation of transvers testicular ectopia should be performed in all nonpalpable undescended testis anomalies.
Case report: Intraosseous hemangioma of the lateral clavicle treated by surgical resection and reconstructed by three-dimensional-printed personalized prosthesis
Authors: Zhuangzhuang Li, Chang Zou, Minxun Lu, Yuqi Zhang, Taojun Gong, Jie Wang, Yi Luo, Yong Zhou, Li Min, Chongqi Tu
Journal: Front Bioeng Biotechnol (2023)
Keywords: 3d-printed prosthesis, bone defect, clavicle, intraosseous hemangioma, tumor resection
MeSH terms: Case Reports

Background: Intraosseous hemangiomas occurring the clavicle is uncommon. Reconstruction of the clavicle is suggested to maintain the normal shoulder joint function and prevent adverse outcomes. Complex anatomy shape of the clavicle remains a great challenge for prosthetic reconstruction of the clavicle. Case presentation: A 37-year-old female with no conclusive history of trauma presented with progressive mass at the right lateral clavicle for 5 years. The patient was treated by surgical resection and reconstructed by three-dimensional-printed personalized prosthesis. Postoperatively radiographic examinations revealed a good position of the prosthesis, neither breakage nor loosening was detected. The right shoulder mobility returned to approximate level of preoperative shoulder 2 months after surgical reconstruction, with the range of motion of flexion 80°, extension 40°, abduction 80°, adduction 30°, external rotation 55°, and internal rotation 60°. The patient maintained the normal shoulder function during the 48 months follow-up period. There was no pain during shoulder motion. The Musculoskeletal Tumor Society Score (MSTS) score was 29 and the Functional Evaluation Form recommended by the American Shoulder and Elbow Surgeons (ASES) score was 95. Conclusion: 3D-printed personalized prosthesis is a good option to reconstruct the lateral clavicle bone defect and restore the shoulder support structure. It maintains the normal shoulder joint function and avoids adverse effects on daily activities after claviculectomy.
Duplication of the gallbladder. A case report
Authors: G Desolneux, S Mucci, J Lebigot, J P Arnaud, A Hamy
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

Gallbladder duplication is a rare anatomic malformation, which can now be detected by preoperative imaging study. We report a case of a symptomatic duplicated gallbladder, successfully treated by laparoscopic cholecystectomy. This anomaly is important to know for surgeons because of associated anatomical variations of main bile duct and hepatic artery and increased risk of common bile duct injury.