OpenMed/multicare-articles huggingface dataset:
Sarcoma undifferentiated (unclassified) fusiform cell type of mesentery: a case report and literature review
Authors: Korbi Ibtissem, Korbi Asma, Ennaceur Farouk, Hajji Ahmed, Njima Manel, Boughanmi Faiez, Zouari Khadija, Faleh Raja
Journal: Pan Afr Med J (2020)
Keywords: case report, mesentery, sarcoma, undifferentiated (unclassified) fusiform cell type
MeSH terms: Adnexal Diseases / diagnosis, Mesentery / pathology, Sarcoma / diagnosis, Case Reports, Review, Aged, Female, Humans, Prognosis, Sarcoma / pathology, Sarcoma / therapy

Sarcomas are a heterogeneous group of malignant tumors that come from mesenchymal tissues. Undifferentiated sarcoma represents approximately 20% of soft tissue sarcomas. This entity represents approximately 20% of soft tissue sarcomas. These tumors are subdivided according to their appearance. Morphological in 4 subtypes: pleomorphic cells, fusiform cells, round cells, epithelioids. We report the case of a 72-year-old woman operated for a complicated adnexal tumor, but it turned out that it was sarcoma undifferentiated (unclassified) fusiform cell type of mesentery. It is a rare and a latent tumor. Its diagnosis is histological. Its treatment consists on surgical wide excision if possible. This type of sarcoma has a poor prognosis considering the limited benefits of radio-chemotherapy. Undifferentiated sarcoma type fusiform cells of the mesentery is an exceptional entity. Its diagnosis is difficult. Its treatment is to discuss case by case, surgery is the best option if it is possible. The prognosis is bad. This entity remains to be studied.
Endoscopic treatment of a gastrocutaneous fistula using the over-the-scope-clip system: a case report
Authors: Georgios Kouklakis, Petros Zezos, Nikolaos Liratzopoulos, Anthia Gatopoulou, Anastasia Oikonomou, Michail Pitiakoudis, Eleni Efremidou, Constantinos Simopoulos
Journal: Diagn Ther Endosc (2011)
MeSH terms: Case Reports

The over-the-scope-clip (OTSC; Ovesco Endoscopy GmbH, Tuebingen, Germany) system is a newly designed method for the mechanical compression of large areas in the gastrointestinal tract. So far, indications for OTSC application are hemostasis of primary or postinterventional bleeding, closure of iatrogenic full-thickness or covered perforations. Recently closure of gastrointestinal tract fistulas using this device has been described. A 44-year-old man developed a gastrocutaneous fistula after surgical treatment for a perforated gastric ulcer. We describe the successful endoscopic closure of the fistula using the OTSC system. The patient's clinical followup was uneventful. Fistula closure was successfully implemented as it was documented by imaging and endoscopic examinations performed on the 2nd day and 6th week after the application of the clip. Endoscopic application of the OTSC device was safe and effective for the treatment of a gastrocutaneous fistula.
Residual manifestations of hypercortisolemia following surgical treatment in a patient with Cushing syndrome
Authors: Sara K Bartz, Lefkothea P Karaviti, Mary L Brandt, Monica E Lopez, Prakash Masand, Sridevi Devaraj, John Hicks, Lauren Anderson, Maya Lodish, Meg Keil, Constantine A Stratakis
Journal: Int J Pediatr Endocrinol (2015)
Keywords: cushing syndrome, obesity, ppnad, primary pigmented nodular adrenocortical disease
MeSH terms: Case Reports

Context:
Cushing Syndrome is difficult to diagnose, and the comorbidities and persistent late effects of hypercortisolemia after treatment of the primary disease are challenging for the patient and the endocrinologist.
Objective:
To report the case of a girl with obesity and hypertension, ultimately diagnosed with Cushing syndrome due to primary pigmented nodular adrenocortical disease. In this case, the complications of hypercortisolism persisted short term despite surgical intervention.
Patient:
A 4 year old morbidly obese African-American girl with developmental delay presented with hypertensive emergency in the ER and 18-month history of progressive weight gain. Her previous history included premature adrenarche, hypertension, seizures and a random high cortisol with suppressed ACTH. She was subsequently stabilized, and a diagnostic work-up persistently demonstrated elevated cortisol and suppressed ACTH. An abdominal MRI showed bilateral adrenal multinodular disease, consistent with multinodular hyperplasia of the adrenal glands. Based on these findings the patient underwent a bilateral adrenalectomy, which confirmed primary pigmented nodular adrenocortical disease. The patient had a complicated, protracted post-operative course requiring adjustment of therapy for persistent hypertension. Two months after surgery, she was readmitted to the Emergency Department with hyperpyrexia and hypertension and succumbed to the complications of sepsis.
Conclusions and outcome:
This case highlights the significant diagnostic and therapeutic challenges in treating children with Cushing syndrome. Resolution of the source of hypercortisolemia does not imply regression of hypertension or recovery of the immune system. Although the child underwent bilateral adrenalectomy, persistent consequences of prolonged severe hypercortisolism contributed to her death two months later.
Anti-Hu Antibody-Associated Adie's Pupil and Paraneoplastic Sensorimotor Polyneuropathy Caused by Primary Mediastinal Small Cell Carcinoma
Authors: Lei Zhang, Si Luo, Hui Jin, Xueman Lv, Jiajun Chen
Journal: Front Neurol (2019)
Keywords: adie's pupil, anti-hu antibody, paraneoplastic neurological syndrome, peripheral neuropathy, small cell carcinoma
MeSH terms: Case Reports

We report a woman with unilateral Adie's pupil associated with peripheral sensorimotor polyneuropathy, elevated anti-Hu antibody, and primary mediastinal small cell carcinoma (SCC). To our knowledge, this is the first report of Adie's pupil in a patient with mediastinal SCC. Although rare, Adie's pupil and sensorimotor polyneuropathy may be the first manifestation of cancer. Its rapid recognition facilitates an early diagnosis and treatment.
A case of a painful coalition between pisiform and hamate
Authors: Atsuyuki Inui, Yutaka Mifune, Hanako Nishimoto, Takahiro Niikura, Ryosuke Kuroda
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: carpal coalition, hamate, pisiform
MeSH terms: Case Reports

We report a case of the pisiform and hamate coalition in 13-years-old male. Interoperative findings revealed that the ulnar nerve runs over the hook of the hamate which is the nonanatomic site. Surgical resection of pisiform relieved the pain.
Open mesh plug repair for inguinal hernia after femoro-femoral arterial bypass: Two retrospective case series
Authors: Shinji Onda, Katsuhito Suwa, Kai Neki, Katsuhiko Yanaga
Journal: Int J Surg Case Rep (2019)
Keywords: femoro-femoral arterial bypass, inguinal hernia, mesh-plug repair

Introduction:
Reports on inguinal hernia repair after femoral arterial bypass are limited, and a recommended procedure has not been established.
Presentation of case:
Case 1. A 77-year-old man who had a history of femoro-femoral arterial bypass (FFB) for limb graft occlusion following endovascular aortic repair for abdominal aortic aneurysm presented with a left inguinal hernia. CT revealed an inguinal hernia and the FFB graft was identified in the subcutaneous plane. We selected mesh-plug repair under local infiltration anesthesia and his postoperative course was uneventful. Case 2. A 73-year-old man who had a history of FFB for occlusion the branch of the graft of endovascular stent for abdominal aortic aneurysm presented with a left inguinal hernia. CT revealed an inguinal hernia and the FFB graft was identified in the subcutaneous plane. We performed mesh-plug repair under general anesthesia and his postoperative course was uneventful. The patients are free of recurrence of the hernia or complication of the FFB graft as of 13 months and 30 months after the surgery, respectively.
Discussion:
We herein report two cases of successful open mesh plug repair for inguinal hernia after FFB.
Conclusion:
The mesh plug repair is safe and useful for the treatment of inguinal hernia after FFB, for which preoperative CT is helpful for understanding precise anatomy which facilitates surgical planning.
Tuberculous peritonitis; The effectiveness of diagnostic laparoscopy and the perioperative infectious prevention: A case report
Authors: Leo Yamada, Motonobu Saito, Tetsuro Aita, AungKyiThar Min, Eisei Endo, Koji Kase, Daisuke Ujiie, Hiroyuki Hanayama, Hirokazu Okayama, Wataru Sakamoto, Hisahito Endo, Shotaro Fujita, Zenichiro Saze, Tomoyuki Momma, Shinji Ohki, Sugihiro Hamaguchi, Koji Kono
Journal: Int J Surg Case Rep (2020)
Keywords: diagnostic laparoscopy, laparoscopic features, minimal invasion, perioperative infection control, tuberculous peritonitis (tbp)
MeSH terms: Case Reports

Background:
Tuberculous peritonitis (TBP) is uncommon in Japan, and its diagnosis with conventional methods is time taking and requires a high clinical index of suspicion. Laparoscopy with peritoneal biopsy is a tool for rapid and accurate diagnosis of TBP. However, few cases have mentioned the infectious control and prevention during the perioperative period. This case is written following the SCARE scale for case report writing.
Case presentation:
A 30-year-old man from Southeast Asia with a past medical history of pulmonary tuberculosis at 3-year-old admitted to our institution with abdominal pain and slight fever lasting for a week. With the elevation of inflammatory response and CA125, we conducted CT (Computed tomography). Not only ascites, panniculitis with peritoneal nodules, and the thickening of the omentum were found. Considering the possibility of malignancy and TBP, we performed a diagnostic laparoscopy. Slightly cloudy ascites, peritoneal and thickening omentum with white nodules were seen, and pathological diagnosis from the omentum during the operation raised the possibility of TBP due to its caseating granuloma and these findings allowed us to start the rapid treatment.
Conclusion:
We reported the effectiveness of diagnostic laparoscopy along with the aspect of perioperative prevention for TBP.
The international "Balint" Award--a rising opportunity for Romanian medical students
Authors: Adrian Lală, Geo Bobîrnac, Raluca Tipa
Journal: J Med Life (2010)
MeSH terms: Physician-Patient Relations, Psychoanalytic Therapy, Students, Medical, Case Reports, Adolescent, Humans, Male

The International "Balint" Award for students, instituted by the Foundation for Psychosomatic and Social Medicine in honor of Michael and Enid Balint, has been a rising opportunity for Romanian medical and psychology students to achieve international fame. Romanian students have been among the winners of this award for the last 10 years, in competition with students from Ivy League and other illustrious universities. The "Ascona model" case presentation debates the psychological side of a medical case, while keeping in focus the diagnostic, pathology and treatment issues. This article focuses on explaining this type of case presentation in correlation with one of the papers submitted in the contest that has received this award in the 15th International Balint Congress. The exposed case is that of a 17-year-old boy presenting with apparent stupor encountered by an emergency mobile unit. The patient was suspected of substance abuse and overdose but these suspicions were denied by the clinical exam. Further encounters led to the conclusion that both the boy and his whole family needed psychotherapy counseling and were referred there with great success.
Ectopic scrotum and penoscrotal transposition: Case report and literature review
Authors: Haoran Huang, Xiangxia Liu, Zuoqing Li, Junjie Lin, Hai Yang, Zhe Xu
Journal: Front Pediatr (2023)
Keywords: vater/vacterl association, anorectal malformation, ectopic scrotum, orchiopexy, rotation flap scrotoplasty
MeSH terms: Case Reports

Background:
Ectopic scrotum (ES) is an extremely rare congenital scrotal malformation. Ectopic scrotum with VATER/VACTERL [vertebral defects (V), anal atresia or anorectal malformations (A), cardiac defects (C), tracheoesophageal fistula with or without esophageal atresia (TE), cardiac defects, renal malformations (R), and limb defects (L)] association is even rarer. There are no uniform guidelines for diagnosis and treatment.
Clinical case:
We described a 2-year-5-month-old boy who has ectopic scrotum and penoscrotal transposition and reviewed relevant literature in this report. We performed laparoscopy exploration, rotation flap scrotoplasty, and orchiopexy and achieved a great result during the postoperative follow-up.
Conclusions:
Combined with the previous literature, we made a summary to come up with a plan for the diagnosis and treatment of ectopic scrotum. Rotation flap scrotoplasty and orchiopexy are worthy of considering operative methods in treating ES. For penoscrotal transposition or VATER/VACTERL association, we can treat the diseases individually.
Unusual cause of small bowel obstruction: mesodiverticular band of Meckel's diverticulum demonstrated by CT
Authors: Cisel Yazgan, Tolga Sahin, Mahir Ozmen
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Small bowel obstruction resulting from the mesodiverticular band is a rare complication of Meckel's diverticulum and usually presents a diagnostic challenge. We present a case of small bowel obstruction due to the mesodiverticular band of Meckel's diverticulum with CT scan findings.
Severe acute respiratory syndrome (SARS) in Singapore: clinical features of index patient and initial contacts
Authors: Li-Yang Hsu, Cheng-Chuan Lee, Justin A Green, Brenda Ang, Nicholas I Paton, Lawrence Lee, Jorge S Villacian, Poh-Lian Lim, Arul Earnest, Yee-Sin Leo
Journal: Emerg Infect Dis (2003)
MeSH terms: Severe Acute Respiratory Syndrome / diagnosis, Case Reports, Adult, Communicable Diseases, Emerging / epidemiology, Communicable Diseases, Emerging / prevention & control, Cough / diagnosis, Cross Infection / epidemiology, Cross Infection / prevention & control, Female, Fever / diagnosis, Humans, Radiography, Severe Acute Respiratory Syndrome / diagnostic imaging, Severe Acute Respiratory Syndrome / epidemiology, Severe acute respiratory syndrome-related coronavirus / isolation & purification, Singapore / epidemiology, Treatment Outcome

Severe acute respiratory syndrome (SARS) is an emerging viral infectious disease. One of the largest outbreaks of SARS to date began in Singapore in March 2003. We describe the clinical, laboratory, and radiologic features of the index patient and the patient's initial contacts affected with probable SARS.
BRIX3000® Papain Gel for Cavity Treatment in the Adult Patient
Authors: Leonardo Mancini, Alessia Pisaneschi, Vincenzo Mancini, Marino Ginoble, Vincenzo Quinzi, Enrico Marchetti, Giuseppe Marzo
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Tooth decay is a multifactorial disease. Fermentable sugar, host factors, and cariogenic microbial flora are several agents that influence dental structure. In literature, alternative protocols for treating cavities are always of interest in terms of reducing pain and preserving tissue. In this case report, the use of a new gel-based on papain, which has a chemical effect on bacteria and allows the consistency of the altered tissue to be modified, leads to a less traumatic removal of the infected tissue. In this case report, BRIX3000, a gel with papain as its main ingredient, was used to treat an interproximal cavity on an upper premolar of a 35-year-old man frightened of the turbine. After a clinical check of all the systematic conditions and a first view of the oral cavity, the protocol was explained to the patient, and informed consent was obtained. The protocol involved applying the papain gel directly to the cavity, and after 2.5-3 minutes, it was removed. The complete removal of the infected tissue was achieved in three steps. The patient reported no discomfort, and the cavity was completely treated and ready to be restored. In conclusion, BRIX3000 seems to be a good alternative to the turbine in cavity treatment, particularly in patients who have discomfort during traditional treatments and are frightened of the turbine.
Hyperfibrinolysis after parapelvic cyst surgery: A case report
Authors: Chun-Hua Tang, Li-Jing Shen, Qiang Gao, Yi Yang, Li-Xing Chen
Journal: Exp Ther Med (2013)

The present study describes the diagnosis and treatment of hyperfibrinolysis following surgery in a 25-year-old female patient. An examination revealed that the left kidney had been affected by severe hydronephrosis for two weeks prior to hospitalization. The diagnosis of a parapelvic cyst was obtained by preoperative intravenous pyelogram (IVP), computed tomography (CT) and upper left urinary tract retrograde pyelography. Unroofing of the left parapelvic cyst was performed by open surgery. The patient exhibited symptoms of shock 48 h later, and her hemoglobin (Hb) levels dropped to only 62.2 g/l. To treat this, 400 ml erythrocyte suspension transfusion was administered 3 times every other day. The patient's Hb levels remained between 50 and 60 g/l. The D-dimer assay index rose from 0.3 to 16 mg/l and the fibrin degradation product (FDP) levels progressively increased following the hemorrhage, while the platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (Fg) index were all within normal levels. p-Aminomethylbenzoic acid (PAMBA; 0.5 g) was administered to the patient every day, and as a consequence the Hb levels rose steadily from the next day onwards. After a one week course of PAMBA treatment, the patient's condition became stable. Blood coagulation and fibrinolytic function measurements were all within the normal ranges in the three months following the surgery. Delayed hemorrhage following surgery should be considered as a possible cause of hyperfibrinolysis. Monitoring FDP and D-dimer levels may aid a rapid and clear diagnosis. Anti-fibrinolytic therapy, such as PAMBA treatment, is safe and effective for use against the type of hemorrhage caused by hyperfibrinolysis.
Moral Hazard and the Demand for Dental Treatment: Evidence from a Nationally Representative Survey in Thailand
Authors: Krichkanok Srimuang, Piriya Pholphirul
Journal: Int J Dent (2022)

Even though there are examples in the health economics literature of evidence investigating moral hazard in health insurance provided by general healthcare services, studies of moral hazard in dental care in developing countries are still scarce, especially when it comes to nationally representative data on dental care demand and expenditure. Using Thailand as a case study, we investigate here whether moral hazard in dental insurance exists and, if so, the extent to which it affects different dental insurance on the demand for dental care in developing countries. We use a nationally representative sample of 269,206 individuals to quantify the impacts of dental care insurance on four sets of dependent variables describing demand for dental care. They are: (i) dental care utilization, (ii) numbers of dental care visits, (iii) dental care expenditure, and (iv) each type of dental care. Our probit and tobit estimations show that there is no evidence of the existence of moral hazard in terms of dental care utilization and dental care expenditure. However, there is a moral hazard of dental insurance existence on the number of dental care visits and type of dental care. People with generous dental benefits coverage tend to use preventive dental treatments along with necessary treatment but also use costly restorative dental treatments more than do those with lower coverage. It can thus be concluded that, in the case of developing countries, dental care insurance is found to increase the use of dental care, especially for preventive care.
Gastric T-cell lymphoma associated with hemophagocytic syndrome
Authors: Rika Fukui, Fumitake Hata, Takahiro Yasoshima, Ryuuichi Denno, Minoru Okazaki, Kiyoshi Kasai, Masaaki Sato, Toshio Homma, Keisuke Ohno, Yoshiyuki Yanai, Katsuya Sogahata, Hidefumi Nishimori, Koichi Hirata
Journal: World J Surg Oncol (2004)

Background:
Lymphoma-associated hemophagocytic syndrome (LAHS) occurs in mostly extra nodal non-Hodgkin's lymphoma. LAHS arising from gastrointestinal lymphoma has never been reported. Here we report a case of gastric T-cell lymphoma-associated hemophagocytic syndrome.
Case presentation:
A 51-year-old woman presented with pain, redness of breasts, fever and hematemesis. Hematological examination revealed anemia. Gastroscopy revealed small bleeding ulcers in the stomach and the computed tomography scan showed liver tumor. She underwent total gastrectomy for gastrointestinal bleeding and the histopathology revealed gastric T-cell lymphoma. She continued to bleed from the anastomosis and died on the 8th postoperative day. Autopsy revealed it to be a LAHS.
Conclusions:
If Hemophagocytic syndrome (HPS) occurs in lymphoma of the gastrointestinal tract, bleeding from the primary lesion might be uncontrollable. Early diagnosis and appropriate treatment are needed for long-term survival.
Case Report: Fulminant Myocarditis Successfully Treated With Extracorporeal Membrane Oxygenation in Ikeda Strain Orientia tsutsugamushi Infection
Authors: Hyejin Park, Yongwhan Lim, Min Chul Kim, Seong Eun Kim, In-Seok Jeong, Yoo Duk Choi, Dong-Min Kim
Journal: Front Cardiovasc Med (2021)
Keywords: orientia tsutsugamushi, case report, extracorporeal membrane oxygenation, fulminant myocarditis, scrub typhus
MeSH terms: Case Reports

Scrub typhus is an acute zoonotic febrile illness caused by Orientia tsutsugamushi having a specific geographic endemic area. This infection could be complicated with multi-organ involvement including myocarditis with variable severity. Here, we report a rare case of scrub typhus with biopsy-proven acute fulminant myocarditis which progressed very rapidly to cardiac arrest and was treated successfully with extracorporeal cardiopulmonary resuscitation. Clinicians should be alert to possible rapid progression of scrub typhus myocarditis to fulminant form and be prepared for close monitoring and temporary mechanical support if indicated.
Laparoscopic assessment and transvaginal reparation of post-coital vaginal cuff dehiscence with bowel evisceration: a case report
Authors: Feras Sendy, Luisa De Simone, Maël Albaut, Antonin Lambert, Erdogan Nohuz
Journal: Pan Afr Med J (2020)
Keywords: vaginal cuff dehiscence, acute pelvic pain, laparoscopy, total hysterectomy
MeSH terms: Hysterectomy / adverse effects, Pelvic Pain / therapy, Postoperative Complications / diagnosis, Surgical Wound Dehiscence / diagnosis, Case Reports, Adult, Female, Humans, Intestine, Small / pathology, Laparoscopy, Sexual Behavior, Vagina / pathology, Vagina / surgery

Vaginal cuff dehiscence (VCD) is a rare postoperative complication of total hysterectomy. Presenting symptom is acute pelvic or abdominal pain accompanied by nausea and vomiting. Immediate recognition and surgical repair are crucial for successful management. A 40-year-old para 1+0 presented with complaints of pelvic pain associated with sexual activity, three months after a total laparoscopic hysterectomy. Speculum examination revealed the presence of bowel into the vagina. Diagnostic laparoscopic assessment combined with VCD repair through the transvaginal route. The occurrence of VCD after laparoscopic hysterectomy has been linked to overuse of electrocautery, prolonged inflammatory response and suturing methods. Laparoscopic, abdominal and vaginal approaches are the routes for repairing VCD. However, it depends on the clinical presentation and surgeon expertise. Careful history, and physical examination are vital factors in guiding clinicians to diagnose and treat VCD. Nevertheless, an ideal modality remains variable to each case.