OpenMed/multicare-articles huggingface dataset:
Colonic Mucosal Ulceration and Gastrointestinal Bleeding Associated with Sevelamer Crystal Deposition in a Patient with End Stage Renal Disease
Authors: Sudheer Nambiar, Unnikrishnan Kunjan Pillai, Joe Devasahayam, Tony Oliver, Asha Karippot
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

End stage renal disease (ESRD) population account for 1.9 per patient year of hospital admissions annually. ESRD population are at increased risk of bleeding secondary to use of anticoagulation during hemodialysis and uremia induced platelet dysfunction. Gastrointestinal bleeding accounts for 3-7% of all deaths in ESRD population. Lower gastrointestinal bleeding refers to blood loss from a site in the gastrointestinal tract distal to the ligament of Treitz. It is usually suspected when a patient complains of hematochezia. It is different from patients presenting with hematemesis that suggests bleeding from upper gastrointestinal tract. Common causes of lower gastrointestinal bleed include diverticulosis, ischemia, hemorrhoids, neoplasia, angiodysplasia, and inflammatory bowel disease. ESRD patients are known to retain phosphate alone or in combination with calcium which has been associated with high mortality. Sevelamer is a phosphate binder used widely in ESRD population. The known side effects of sevelamer include metabolic acidosis, vomiting, nausea, diarrhea, dyspepsia, abdominal pain, constipation, flatulence, fecal impaction, and skin rash. We are reporting a unique case of a 56-year-old female with end stage renal disease on sevelamer hydrochloride who presented with gastrointestinal bleeding and underwent a right hemicolectomy found to have sevelamer-induced mucosal ulceration and crystal deposition in the colonic mucosa. This case report highlights the fact that, with widespread use of this medication in the patients with chronic kidney diseases, physicians should be aware of this underrecognized entity in the differential diagnosis of gastrointestinal bleed in ESRD patients.
Case Report: An Anomalous Left Hepatic Venous Connection in a Patient With Unexpected Cyanosis
Authors: Fanyan Luo, Haisong Bu
Journal: Front Pediatr (2021)
Keywords: anomalous left hepatic venous connection, cyanosis, intra-atrial tunnel, surgery, total cavopulmonary connection
MeSH terms: Case Reports

An anomalous left hepatic venous (LHV) connection is an extremely rare cardiac malformation, and left hepatic venous route abnormalities not associated with other cardiac lesions do not require surgical treatment because they are physiologically benign. However, when venous route abnormalities exist with associated cardiac lesions, the conduct of the cardiac surgical repair must accommodate the abnormal venous anatomy, especially in total cavopulmonary connection patients. Herein, we present a rare case of a 7-year-old Chinese boy about 1 year post bilateral superior vena cava pulmonary anastomosis who presented with severe cyanosis and was referred to our department. However, the patient showed an unexpected gradual decrease in blood oxygen saturation to 60-70% after the extracardiac total cavopulmonary connection (ETCPC) operation. Emergency echocardiography and computed tomography confirmed that the LHV entered the right atrium. Subsequently, the patient undergone completion of a staged TCPC with intra-atrial tunnel technique. This illustrative report highlights the essence of improving the preoperative accurate diagnosis to avoid unplanned reoperation in China, especially for the remote rural areas of eastern countries where the level of health care and services is relatively backward. Failure to identify anomalous LHV connection, in this case, will delay effective treatment past the optimal treatment time.
Cross species transmission of pseudorabies virus leads to human encephalitis and visual impairment: A case report
Authors: Hui Huang, Na Wang, Zhi-Bing Ai, Jun Chen, Wei Huang, Yi Bao
Journal: Front Neurol (2022)
Keywords: ngs, cerebrospinal fluid, endophthalmitis, pseudorabies virus, secondary epilepsy, viral encephalitis
MeSH terms: Case Reports

Pseudorabies virus (PRV) is a common pig infectious disease. There have been few reports of PRV infection in humans. The patient in this article had acute onset, which was manifested by fever, epilepsy, disturbance of consciousness, and other symptoms. The disease progressed rapidly and worsened in a short time so the ventilator had to be used to assist breathing. In the later stage of treatment, serious visual impairment also occurred. Pseudorabies virus was found in cerebrospinal fluid by second-generation gene sequencing (NGS). This indicates that the pseudorabies virus can spread across species, leading to human encephalitis and severe visual impairment. Therefore, attention should be paid to this disease, active prevention, and early detection are helpful to improve the treatment effect.
Case report: A novel mutation in TRPS 1 identified in a Chinese family with tricho-rhino-phalangeal syndrome I: A therapeutic challenge
Authors: Qi Huang, Cheng Jiang, Jiazhong Sun, Junli Xue, Victor Wei Zhang
Journal: Front Pediatr (2022)
Keywords: trps1 gene, deletion mutation, short stature, sparse hair, tricho-rhino-phalangeal syndrome
MeSH terms: Case Reports

Tricho-rhino-phalangeal syndrome (TRPS) is a rare autosomal dominant malformation caused by mutations involving the TRPS1 gene. Patients with TRPS exhibit distinctive craniofacial and skeletal abnormalities. This report presents three intra-familial cases with TRPS1 gene mutations that showed the characteristic features of TRPS. A 13-year-old boy was admitted to Department of Endocrinology for the evaluation of short stature. Physical examination revealed that the boy had thin sparse hair, pear-shaped nose, protruding ears, small jaw and brachydactyly. A survey of his family history indicated that the boy's sister and mother shared the same clinical features. Radiological techniques demonstrated a different degree of skeletal abnormalities in these siblings. Next-generation sequencing and quantitative PCR were performed and showed a novel deletion mutation in exons 3-5 in the three familial cases, confirming the diagnosis of TRPS I. The healthy father did not carry the deletion mutation. Currently, there was no specific therapy for TRPS I; however, genetic consultation may be useful for family planning.
Self-inflicted bilateral ocular injury with scissors in a psychiatric patient
Authors: Jigyasa Sahu, Ritu Arora, Shweta Vishwanath
Journal: GMS Ophthalmol Cases (2023)
Keywords: deliberate self-harm, eye injury, oedipus complex, schizophrenia, self-mutilation
MeSH terms: Case Reports

A young male was brought to the ophthalmic emergency by his family with severe bleeding from both eyes after self-inflicted injury with scissors in a fit of mania. He had a history of schizophrenia and has been on irregular treatment for the past 10 years. Both eyes were severely damaged with avulsion of all extraocular muscles in one eye and a large corneoscleral laceration in the other. We report this unique case of oedipism or self-enucleation where a sharp instrument was used. Self-inflicted injury to the eyes is a rather uncommon phenomenon described in psychiatric patients. It can range from minor abrasions to severe ocular mutilation and loss of sight. The strict observation of these patients while admitted to the hospital and a multidisciplinary approach to ensure their future safety are imperative.
Binocular Diplopia: A Possible Adverse Effect of Fluoroquinolone Therapy
Authors: Mariama Touray, Victoria Ando, Erwin Samutelela, Jean-Philippe Zuber
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

The adverse effects of fluoroquinolones are yet to be fully elucidated. We present an interesting case of a 41-year-old male with binocular diplopia most likely induced by the use of a fluoroquinolone antibiotic.
Two Cases of Severe Hypertension in JAK2 Mutation-Positive Myeloproliferative Neoplasms
Authors: Raunak Rao, Spoorthy Kulkarni, Ian B Wilkinson
Journal: Case Rep Vasc Med (2020)
MeSH terms: Case Reports

Background:
Myeloproliferative neoplasms are a heterogeneous group of disorders resulting from the abnormal proliferation of one or more terminal myeloid cells-established complications include thrombosis and haemorrhagic events; however, there is limited evidence to suggest an association with arterial hypertension. Herein, we report two independent cases of severe hypertension in JAK2 mutation-positive myeloproliferative neoplasms. Case Presentations. Case 1: a 39-year-old male was referred to our specialist hypertension unit with high blood pressure (BP) (200/120 mmHg), erythromelalgia, and headaches. We recorded elevated serum creatinine levels (146 μM) and panmyelosis. Bone marrow biopsy confirmed JAK2-mutation-positive polycythaemia vera. Renal imaging revealed renal artery stenosis. Aspirin, long-acting nifedipine, interferon-alpha 2A, and renal artery angioplasty were employed in management. BP reached below target levels to an average of 119/88 mmHg. Renal parameters normalised gradually alongside BP. Case 2: a 45-year-old male presented with high BP (208/131 mmHg), acrocyanosis, (vasculitic) skin rashes, and nonhealing ulcers. Fundoscopy showed optic disc blurring in the left eye and full blood count revealed thrombocytosis. Bone marrow biopsy confirmed JAK2-mutation-positive essential thrombocytosis. No renal artery stenosis was found. Cardiac output was measured at 5 L/min using an inert gas rebreathing method, providing an estimated peripheral vascular resistance of 1840 dynes/s/cm5. BP was well-controlled (reaching 130/70 mmHg) with CCBs.
Conclusions:
These presentations highlight the utility of full blood count analysis in patients with severe hypertension. Hyperviscosity and constitutive JAK-STAT activation are amongst the proposed pathophysiology linking myeloproliferative neoplasms and hypertension. Further experimental and clinical research is necessary to identify and understand possible interactions between BP and myeloproliferative neoplasms.
Case report: solitary splenic metastasis occurring 19 months after primary treatment for occult breast cancer
Authors: Yuanqi Chen, Liulu Zhang, Taotao Sun, Min-Yi Cheng, Jiachen Zou, Kun Wang
Journal: Front Oncol (2022)
Keywords: case report, metastasis, occult breast cancer, solitary splenic mass, splenectomy
MeSH terms: Case Reports

Occult breast cancer, commonly presenting with axillary lymphadenopathy, is an extremely rare entity of breast cancer. Metastasis to the spleen as a single site is rarely seen and has been little reported in literature. Herein we described a case of a 60-year-old patient who presented with an asymptomatic solitary splenic mass 19 months after axillary lymph node dissection, regional radiotherapy, and systemic therapy. Laparoscopic splenectomy was performed, and histopathological examination confirmed metastasis from occult breast cancer. Then, the patient was administered with oral vinorelbine and dual-targeted treatment. With over 10 months of follow-up, there is no evidence of recurrence or metastasis of malignancy. To our knowledge, this study reports the first case of solitary splenic metastasis from occult breast cancer and highlights the importance of considering splenic metastasis as the only site of recurrence during follow-up of primary cancer, regardless of its rarity. If possible, splenectomy may be a therapeutic strategy.
Leiomyoma of the prostate: A case report and systematic review
Authors: Shangren Wang, Shiqiao Huang, Yang Pan, Yong Ma, Jiaqi Kang, Li Liu, Xiaoqiang Liu
Journal: Front Surg (2022)
Keywords: case report, leiomyoma, prostate, surgery, systematic review
MeSH terms: Review

Purpose:
It is rare to find a large leiomyoma in the prostate, especially in that of a young man. This case report and systematic review provides additional information on the diagnosis, distinguishing features of imaging examinations, and treatment options.
Patients and methods:
We report on the case of a thirty-year-old man with a large leiomyoma of the prostate. MRI of the prostate revealed a round mass in the posterior lobe, 8.0 × 8.0 × 5.5 cm in size. With the assistance of laparoscopy, we resected the prostate mass completely and spared this organ. A systematic review was conducted utilizing the Preferred Reporting Items for Systematic Reviews (PRISMA) including English language published reports, from 1970 to December 2021.
Results:
Urinary and erectile functioning was preserved postoperatively. After a year of follow-up, no evidence of recurrence emerged. A total of 21 studies were included for analysis.
Conclusions:
A medical history of no, or few, lower urinary tract symptoms; the characteristics of a benign tumor in imaging examinations; and negative tumor markers should be included in any differential diagnosis of leiomyoma of the prostrate. A prostate biopsy should be performed before the preparative radical prostatectomy and choose nonsurgical treatment to confirm the diagnosis. Nowadays, minimally invasive surgery is the preferred effective option for this disease. It is a rare recurrence after its removal by means of surgery.
A Rare Case of Intraductal Papilloma Arising from Minor Salivary Gland in the Floor of the Mouth
Authors: Agnes Assao, Silas Antonio Juvencio de Freitas Filho, Luiz Antônio Simonetti Júnior, Denise Tostes Oliveira
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

A 77-year-old woman with a rare oral intraductal papilloma arising from the minor salivary gland located on the floor of the mouth and causing the mucus retention is reported. Microscopically, the lesion was characterized by unicystic cavity exhibiting the lumen partially filled by papillary projections of the ductal epithelium with varying degree of oncocytic metaplasia. Based on the histopathological analysis, the differential diagnosis of oral intraductal papillomas and other ductal neoplasms of salivary origin are discussed.
Hepatic inflammatory myofibroblastic tumor: One case report
Authors: Lei Shen, Zixuan Yang, Ruibo Ding, Wei Wei, Yechuan Xu
Journal: Front Surg (2022)
Keywords: cancer, case report, hepatic, inflammatory myofibroblastic tumor, review
MeSH terms: Case Reports

Introduction:
Hepatic inflammatory myofibroblastic tumor (HIMT) is a junctional neoplastic lesion of mesenchymal tissue origin that can sometimes become locally invasive and even metastasize or recur. Therefore, the diagnosis and treatment of HIMT is particularly important. However, hepatic inflammatory myofibroblastic tumor lacks a specific clinical presentation and typical imaging manifestations, thus posing a difficulty for us to diagnose and treat this disease.
Case presentation:
We report here a very rare surgical case of hepatic inflammatory myofibroblastic tumor (HIMT) in a 41-year-old female who was admitted to the hospital for more than half a month for a liver-occupying lesion with fever found on physical examination.After discussion with the hepatobiliary and pancreatic surgery team, we decided to perform surgical treatment. The final postoperative pathology confirmed hepatitis myofibroblastoma.
Conclusion:
Our review of the domestic and international literature revealed no significant progress in the diagnosis and treatment of this disease, so we report here a case of surgical treatment. One of our aims in this case report is to highlight the efficacy of surgical treatment in HIMT. HIMT is extremely rare and difficult to diagnose. Due to their intermediate biological behavior, surgical resection should be performed whenever feasible and patients should be followed-up in order to detect recurrence and metastasis as early as possible.
Case report: Use of three-dimensional technology in criss-cross heart with double outlet right ventricle
Authors: Ailixiati Alifu, Haifan Wang, Yuntian Su, Renwei Chen
Journal: Front Cardiovasc Med (2023)
Keywords: case report, congenital cardiac malformation, crisscross heart, surgical planning, three-dimensional printed heart model
MeSH terms: Case Reports

Background:
In this case report, we utilized a three-dimensional printing model to replicate the complex anatomy of a criss-cross heart with double outlet right ventricle-an extremely rare congenital cardiac abnormality. This approach facilitated our understanding of the patient's unique condition and enabled us to plan the surgical procedure with greater precision.
Case presentation:
Our department received a 13-year-old female patient who presented with a pronounced heart murmur and a decrease in exercise capacity. Subsequent two-dimensional imaging revealed the presence of a criss-cross heart with double outlet right ventricle-an intricate and uncommon cardiac malformation that poses challenges for accurate visualization through conventional two-dimensional modalities. To address this challenge, we constructed and printed a three-dimensional model using computed tomography data, which enabled us to visualize and understand the complex intracardiac structures and plan surgical interventions with greater precision. Using this approach, we successfully performed a right ventricular double outlet repair, and the patient made a full recovery following the procedure.
Conclusion:
The criss-cross heart with double outlet right ventricle constitutes a complex and uncommon cardiac anomaly that poses considerable challenges in terms of diagnosis and surgical intervention. Employing three-dimensional modeling and printing represents a promising approach, given its potential to enhance the precision and comprehensiveness of the anatomical evaluation of the heart. As a result, this method holds significant promise in facilitating accurate diagnosis, meticulous surgical planning, and ultimately improving clinical outcomes for patients affected by this condition.
Traumatic Isolated Trapezium Dislocation without Fracture: A Case Report and Review of the Literature
Authors: Robert M Kenyon, Enda G Kelly, Benny Padinjarathala
Journal: Case Rep Orthop (2016)

Isolated dislocation of the trapezium is an uncommon injury. There are sixteen cases to date reported in the literature. The management of these cases has varied from complete excision to open or closed reduction, with or without percutaneous wiring. This paper presents a case of an isolated dislocation of the trapezium without fracture, managed with closed reduction and percutaneous wiring, resulting in a good functional outcome.
Treatment of Atypical Fracture of the Ulnar Diaphysis by Open Reduction and Internal Fixation with Teriparatide
Authors: Hiroki Ito, Naohisa Miyakoshi, Yuji Kasukawa, Takeshi Sato, Hitoshi Kubota, Hiroshi Sasaki, Takashi Mizutani, Yoichi Shimada
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Atypical fractures commonly arise in the subtrochanteric region or the femoral shaft, whereas those of the upper extremities are rare. Only 15 fractures in 13 patients have been described in the English literature. The management of such fractures has not been established. We describe a patient with an atypical fracture of the ulnar diaphysis, which required revision surgery to achieve the union of the fracture site. Teriparatide together with low-intensity pulsed ultrasound contributed to bone healing. Further studies are needed to determine the optimal strategy for treating atypical fractures of the ulna.
Type 1 diabetes complicated with cyclic vomiting syndrome and exogenous insulin antibody syndrome: A case report
Authors: Leiluo Geng, Xue Diao, Hao Han, Ying Lin, Wei Liang, Aimin Xu
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: case report, cyclic vomiting syndrome, exogenous insulin antibody syndrome, hypoglycaemia, type 1 diabetes
MeSH terms: Autoimmune Diseases / diagnosis, Diabetes Mellitus, Type 1 / complications, Hypoglycemia / complications, Hypoglycemia / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Adult, Female, Humans, Insulin / therapeutic use, Insulin Antibodies, Rituximab, Vomiting / etiology, Insulin Antibodies, Rituximab, Insulin, Familial cyclic vomiting syndrome

Every fifth individual with type 1 diabetes (T1D) suffers from an additional autoimmune disorder due to shared genetic factors and dysregulated immunity. Here we report an extremely rare case of T1D complicated with cyclic vomiting and hypoglycaemia. A 27-year-old Chinese woman with 14-year history of T1D was periodically hospitalized for severe vomiting of more than 30 times a day without apparent organic causes. The vomiting developed acutely and remitted spontaneously after 2-3 days, followed with intractable hypoglycaemia for another 3-4 days during the hospitalization. A few weeks after discharge, she was admitted once again with the same symptoms and disease course. Cyclic vomiting syndrome (CVS) was diagnosed according to the Rome IV criteria, a system developed to define the functional gastrointestinal disorders. Dynamic association and disassociation of exogenous insulin and insulin antibodies (IAs) were identified in her blood during hypoglycaemia, leading to the diagnosis of exogenous insulin antibody syndrome (EIAS). Treatment with rituximab to suppress the IAs was associated with a striking amelioration of hypoglycaemia. Unexpectedly, the episodes of cyclic vomiting were also dramatically reduced. In conclusion, we identified the first case with alternating CVS and EIAS in the setting of T1D. Dynamic measurements of free and total insulin are helpful for the diagnosis of EIAS. CVS is likely to be a latent autoimmune disorder considering the good response to rituximab treatment.
Reconsidering non-traditional export agriculture and household food security: A case study in rural Guatemala
Authors: Josée Méthot, Elena M Bennett
Journal: PLoS One (2018)
MeSH terms: Crops, Agricultural, Farmers / statistics & numerical data, Food Supply / standards, Food Supply / statistics & numerical data, Rural Population / statistics & numerical data, Research Support, Non-U.S. Gov't, Adult, Developing Countries, Family Characteristics, Female, Humans, Male, Middle Aged, Nutritional Status

As the production of non-traditional export (NTX) crops by smallholder households in developing countries expands, there is a compelling need to understand the potential effects of this type of agricultural production on household food security and nutrition. We use two household surveys with a sample of 52 households, interviews, and focus groups to examine whether smallholder farmers who produce broccoli for export in a rural Guatemalan community have different household food security than farmers in the same community who are still growing traditional maize and bean crops. We explore and compare the food security status of broccoli farmers (adopters) and traditional farmers (non-adopters) across four dimensions of food security: availability, access, utilization, and stability. Adopters earned significantly more income (40%) than non-adopters, but higher incomes did not coincide with improvements in food availability, food access, or food utilization. Results indicate that adopters and non-adopters alike struggle with access to food, while the intensity of broccoli production may be undermining the ability of local agricultural systems to naturally control pests and regulate nutrients. More systematic approaches to food security assessment, especially those that consider all four dimensions of food security, are needed to better target interventions designed to alleviate food insecurity among rural smallholders.