OpenMed/multicare-articles huggingface dataset:
Liver Cholestasis Secondary to Syphilis in an Immunocompetent Patient
Authors: Nazneen Hussain, Samuel O Igbinedion, Richie Diaz, J S Alexander, Moheb Boktor, Kurt Knowles
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

Liver involvement is a known feature of secondary syphilis. The prevalence of hepatitis in secondary syphilis ranges broadly from 1 to 50%. We report a case of a 37-year-old man with type 1 diabetes mellitus and sickle cell trait presenting with jaundice and acute liver cholestasis. Abdominal ultrasound revealed mild hepatic fatty infiltration. RPR and Treponema pallidum IgG results were positive with a reflex titer of 1:64. Liver biopsy revealed chronic hepatitis with normal hepatic architecture, Kupffer cell hyperplasia, hepatic cholestasis, and ductal proliferation suggestive of syphilitic hepatitis.
Pediatric dumbbell-shaped orbital schwannoma with extension to the cranial cavity: A case report and literature review
Authors: Yongjia Shao, Qian Xi, Ailan Cheng, Minghui Qian, Shuguang Chu
Journal: Front Neurol (2023)
Keywords: children, cranial-orbital, dumbbell-shaped, full-cut, schwannoma
MeSH terms: Case Reports

Orbital schwannomas are rare in children, especially those with intracranial extension. Herein, our report refers to a 12-year-old boy who had a cranial-orbital mass with a dumbbell-like appearance. The total neoplasms was successfully removed via a transcranial approach, and the pathological diagnostic result was schwannoma. Neither radiotherapy nor chemotherapy was performed after surgery, and no recurrences were observed for 3 months. Our report suggests that orbital schwannomas should be differentiated from other types of orbital tumors with sufficient evidence and that complete surgical resection remains the first choice to cure this disease.
Vitrectomy With Peeling the Internal Limiting Membrane for the Treatment of Macular Hole Following Ruptured Retinal Arterial Macroaneurysm: A Case Report
Authors: Zhigao Liu, Shuya Wang, Yu Wang, Aihua Ma, Bojun Zhao
Journal: Front Med (Lausanne) (2021)
Keywords: ilm peeling, macular hole (mh), retinal arterial macroaneurysm, visual acuity, vitrectomy
MeSH terms: Case Reports

Background: This study aimed to report a case of vitrectomy with peeling the internal limiting membrane for the treatment of macular hole (MH) following ruptured retinal arterial macroaneurysm (RAMA). Case Presentation: A 65-year-old woman noticed a sudden decrease in vision in the left eye. She had no other ocular problems apart from a mild cataract in both eyes before. Her best-corrected visual acuity (BCVA) was 20/33 in the right eye, and 6/100 in the left eye. Fluorescein angiography (FFA) showed a retinal arterial macroaneurysm with telangiectatic retinal vascular changes in the inferior temporal macular region. Optical coherence tomography (OCT) examination demonstrated the presence of subretinal hemorrhage extending into the foveal area and incomplete posterior vitreous detachment. Because of the presence of submacular hemorrhage, some medicine was administrated and the patient was followed up. Then, 5 months later, the hemorrhage was absorbed. OCT examination exhibited a full-thickness MH with a macular epiretinal membrane. The size of the MH was 722 μm in diameter. She was then given a standard three-port pars plana vitrectomy (PPV), along with peeling of the internal limiting membrane (ILM) and filling the vitreous cavity with air. Anatomic closure of the MH was achieved after 4 weeks of the surgery by the examination of OCT. The BCVA was improved to 15/100. Conclusions: This case expanded our knowledge of the association of MH secondary to ruptured RAMA. We reported a case with successful surgical closure of the MH and improvement of BCVA.
Case report: Evolution of catatonic mutism and psychotic symptoms in an adolescent with Down syndrome: transition from Down syndrome disintegrative disorder to anti-N-methyl-D-aspartate receptor encephalitis
Authors: Yuki Minamisawa, Mutsumi Sato, Yoshiaki Saito, Fumikazu Takeuchi, Hidehito Miyazaki, Mao Odaka, Ayako Yamamoto, Yoshitaka Oyama, Yoshihiro Watanabe, Saoko Takeshita, Yukitoshi Takahashi
Journal: Front Neurol (2023)
Keywords: alzheimer's disease, down syndrome, down syndrome disintegrative disorder, anti-nmda receptor antibody encephalitis, catatonia, cytokine
MeSH terms: Case Reports

During her first year of junior high school, a 12-year-old Japanese girl with Down syndrome experienced dizziness, gait disruption, paroxysmal weakness in her hands, and sluggish speaking. Regular blood tests and a brain MRI revealed no abnormalities, and she was tentatively diagnosed with adjustment disorder. Nine months later, the patient experienced a subacute sickness of chest pain, nausea, sleep problem with night terrors, and delusion of observation. Rapid deterioration then developed with simultaneous fever, akinetic mutism, loss of facial expression, and urine incontinence. These catatonic symptoms improved after a few weeks after admission and treatment with lorazepam, escitalopram, and aripiprazole. After discharge, nonetheless, daytime slumber, empty eyes, paradoxical laughter, and declined verbal communication persisted. Upon confirmation of the cerebrospinal N-methyl-D-aspartate (NMDA) receptor autoantibody, methylprednisolone pulse therapy was tried, but it had little effect. Visual hallucinations and cenesthopathy, as well as suicidal thoughts and delusions of death, have predominated in the following years. Cerebrospinal IL-1ra, IL-5, IL-15, CCL5, G-CSF, PDGFbb, and VFGF were raised in the early stage of initial medical attention with nonspecific complaints, but were less prominent in the later stages of catatonic mutism and psychotic symptoms. We suggest a disease concept of progression from Down syndrome disintegrative disorder to NMDA receptor encephalitis, based on this experience.
Stereotactic aspiration of spontaneous intracerebral hematoma: Case series
Authors: Achmad Fahmi, Heri Subianto, Nur Setiawan Suroto, Budi Utomo, Riyanarto Sarno, Agus Turchan, Abdul Hafid Bajamal
Journal: Int J Surg Case Rep (2020)
Keywords: safety, spontaneous intracerebral hematoma, stereotactic aspiration

Introduction:
Minimally invasive techniques such as stereotactic aspiration of spontaneous intracerebral hematoma (SICH) evacuation can minimize brain tissue damage due to surgery. We share our experience of adopting stereotactic aspiration of SICH in our center without compromising safety.
Presentation of cases:
Three stereotactic aspiration procedures for SICH immediately after 24 h of onset are reported. All cases showed good results. Level of consciousness of all the patient returned to normal. Two patients could carry out routine activities independently. One patient has left hemiparesis.
Discussion:
Stereotactic aspiration of SICH has been newly implemented at our center with acceptable results achieved. Patient selection has an important role in determining the choice of technique. The procedures were done without anticoagulant agent. Stereotactic aspiration of SICH is associated with limited brain tissue damage, shorter duration of surgery, reduced length of stay, faster postoperative healing, and better functional improvement.
Conclusion:
Stereotactic aspiration of SICH is a minimally invasive defined strategy for hematoma evacuation without compromising safety.
Misdiagnosed psychiatric manifestations in a rare disease: a case report of secondary anxiety syndrome in Cushing's disease
Authors: Wenqi Geng, Lijia Cui, Tao Li, Xueqing Liu, Yong Yao, Xia Hong, Huijuan Zhu, Lin Lu, Jing Wei
Journal: Front Psychiatry (2023)
Keywords: cushing syndrome, anxiety disorders, pituitary adenoma, referral and consultation, serotonin
MeSH terms: Case Reports

Diagnosing and treating secondary psychiatric symptoms with accuracy can be challenging in clinical settings. In this case study, we report on a female patient with Cushing's disease who was misdiagnosed with anxiety disorder during her first psychiatric visit. Following initial ineffective psychiatric intervention, unexplained hypokalemia, and hypothyroidism, the patient visited the endocrinology clinic and was diagnosed with Cushing's disease. During the medical and surgical procedures that followed, high doses of psychotropic medication were continued to treat persisting anxiety. After discharge, the patient developed autonomic dysfunction and impaired consciousness. Upon readmission, serotonin syndrome due to inappropriate psychiatric medication was diagnosed. The management of secondary psychiatric syndromes must be adapted to changes in the patient's primary condition, which necessitates interdisciplinary collaboration in general hospital settings.
Transvestism Recognized in Ehlers-Danlos Syndrome: Report of Two Cases
Authors: Hiroki Ishiguro, Naomi Honobe, Takefumi Suzuki, Mariko Tamai, Takaya Nakane
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Ehlers-Danlos syndrome (EDS) comprises a series of rare hereditary connective tissue diseases characterized by musculoskeletal, skin, and cardiovascular involvements. EDS may be associated with physical as well as psychological pain that can lead to psychiatric problems. EDS imposes substantial psychological burden on patients, and recent large-scale studies have suggested that patients with EDS have a higher risk of mood disorders than the general population. To the best of our knowledge, we describe, for the first time, the cases of two Japanese patients with EDS complicated with mood disorders who secondarily developed transvestism that was judged strongly related to early stressful situations through childhood and adolescence. The first case was of a man in his mid-30s and the second of a woman in her late 20s. We report on detailed psychosocial data to further discuss the medical management and genetic counseling of such infrequent but challenging conditions. Physicians are advised to be aware of various potential psychological and psychiatric issues that may accompany EDS.
Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation
Authors: Farhan Syed, Edward Jenner, Mohammad Faisal
Journal: Case Rep Orthop (2015)

Metal allergy is an unusual complication of joint replacement that may cause aseptic loosening and necessitate joint revision surgery. We present the case of nickel allergy causing aseptic loosening following patellofemoral joint replacement (PFJR) in a 54-year-old male. Joint revision surgery to a nickel-free total knee replacement was performed with good results. Our literature review shows that there is no evidence to guide the management of metal allergy in PFJR. The evidence from studies of total knee replacement is limited to retrospective case series and case reports and gives contradictory recommendations. The optimal management strategy for metal allergy in PFJR is not clear. We recommend allergy testing in patients with history of metal allergy and use of an allergen-free implant in those with positive tests. As there is no gold standard test to establish metal allergy, the choice of test should be guided by availability and recommendation from the local unit of dermatology and allergy testing. We recommend investigation for metal allergy in patients with implant loosening where other causes have been excluded.
Case Report: Passive Handstand Promotes Cerebrovascular Elasticity Training and Helps Delay the Signs of Aging: A 40-Year Follow-Up Investigation
Authors: Haonan Liu, Qian Xu, Xin Xiang, Danan Liu, Shengyong Si, Lan Wang, Ying Lv, Yidong Liao, Hua Yang
Journal: Front Med (Lausanne) (2022)
Keywords: aging, cerebrovascular elasticity, cervical spondylosis, gravity, passive handstand exercise
MeSH terms: Case Reports

Background:
There are no long-term (>10 years) follow-up evaluations of the effects of handstand exercise or studies on the use of equipment for passive handstand exercise.
Objective:
To report a 40-year follow-up investigation of a Chinese man who has been practicing passive handstand for 40 years.
Design:
This observational investigation was conducted in Guizhou Province, China.
Participant:
A (currently) 66-year-old Chinese man who had been practicing passive handstand exercise for 40 years was followed up.
Interventions:
Physical and auxiliary examinations were carried out to determine the effects of long-term passive handstand exercise on the human body.
Main measures:
The participant's cerebrovascular, spinal health, mental health, and visual acuity as well as the presence of facial aging were examined.
Key results:
His cerebral vessels were healthy, he appeared younger than his peers, his cervical spondylosis improved, and his mental state and cognitive function were good.
Conclusion:
Long-term passive handstand exercise can promote cerebrovascular elasticity training and delay signs of aging. We recommend promoting this passive handstand exercise to the public.
Case report: Changes in serum bevacizumab concentration in a hemodialysis patient with unresectable colorectal cancer treated with FOLFIRI plus bevacizumab
Authors: Toshimitsu Tanaka, Hiroyuki Suzuki, Tomoyuki Ushijima, Sachiko Nagasu, Yoshito Akagi, Takumi Kawaguchi, Keisuke Miwa
Journal: Front Oncol (2022)
Keywords: 5-fluorouracil, bevacizumab, chemotherapy, concentration, folinic acid, hemodialysis, irinotecan, malignancy
MeSH terms: Case Reports

The global incidence of colorectal cancer (CRC) in patients receiving hemodialysis is steadily rising. However, current information on the clinical use of chemotherapy for patients undergoing hemodialysis with CRC is limited. Herein, we describe a clinical course of a 74-year-old patient undergoing hemodialysis with unresectable CRC treated with folinic acid, 5-fluorouracil (5FU), and irinotecan (FOLFIRI) plus bevacizumab whose changes in serum bevacizumab concentration were analyzed. Treatment was initiated with a standard dosage of 5-FU and 80% of the standard dose of irinotecan to avoid any adverse events. However, neutropenia (grade 4) was observed after five treatment cycles, which prompted a dose reduction of 5-FU and irinotecan, after which treatment was safely completed. Progression-free survival of the patient was 7.5 months. Changes in serum bevacizumab concentration were similar to those documented in patients with normal renal function. In addition, no bevacizumab-related adverse events occurred. It was inferred that FOLFIRI plus bevacizumab therapy could be implemented as a safe and efficient treatment for patients undergoing hemodialysis with unresectable CRC. To the best of our knowledge, this is the first report of the analysis of serum bevacizumab concentrations in a patient undergoing hemodialysis with unresectable CRC.
Fully robotic social environment for teaching and practicing affective interaction: Case of teaching emotion recognition skills to children with autism spectrum disorder, a pilot study
Authors: Pegah Soleiman, Hadi Moradi, Bijan Mehralizadeh, Hamed Ameri, Rosa I Arriaga, Hamid Reza Pouretemad, Negin Baghbanzadeh, Leila Kashani Vahid
Journal: Front Robot AI (2023)
Keywords: autism, emotion recognition, observational learning, robotic social environment, social interaction

21st century brought along a considerable decrease in social interactions, due to the newly emerged lifestyle around the world, which became more noticeable recently of the COVID-19 pandemic. On the other hand, children with autism spectrum disorder have further complications regarding their social interactions with other humans. In this paper, a fully Robotic Social Environment (RSE), designed to simulate the needed social environment for children, especially those with autism is described. An RSE can be used to simulate many social situations, such as affective interpersonal interactions, in which observational learning can take place. In order to investigate the effectiveness of the proposed RSE, it has been tested on a group of children with autism, who had difficulties in emotion recognition, which in turn, can influence social interaction. An A-B-A single case study was designed to show how RSE can help children with autism recognize four basic facial expressions, i.e., happiness, sadness, anger, and fear, through observing the social interactions of two robots speaking about these facial expressions. The results showed that the emotion recognition skills of the participating children were improved. Furthermore, the results showed that the children could maintain and generalize their emotion recognition skills after the intervention period. In conclusion, the study shows that the proposed RSE, along with other rehabilitation methods, can be effective in improving the emotion recognition skills of children with autism and preparing them to enter human social environments.
A Case of Urinary Tract Infection and Severe Sepsis Caused by Kluyvera ascorbata in a 73-Year-Old Female with a Brief Literature Review
Authors: Majd Alfreijat
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Infections that are caused by Kluyvera bacteria have been previously reported in the medical literature; however, they seem to be less common. Herein, we report a case of urinary tract infection and severe sepsis caused by Kluyvera ascorbata in a 73-year-old female. We also did a brief literature review of infections caused by this organism in adults.
Retinal pigment epithelium atrophy after epiretinal membrane and internal limiting membrane peeling: case reports
Authors: Nicolás Rivera-Valdivia, Hiroshi Maeda-Yasunaga, Pablo Cabal-López, Carlos Salgado-Cerrate, Carlos Abdala-Caballero
Journal: Rom J Ophthalmol (2022)
Keywords: dyes, epiretinal membrane, internal limiting membrane, pars plana vitrectomy, retinal pigment epithelium atrophy
MeSH terms: Epiretinal Membrane / diagnosis, Epiretinal Membrane / surgery, Retinal Perforations / diagnosis, Retinal Perforations / etiology, Retinal Perforations / surgery, Case Reports, Aged, Atrophy, Basement Membrane / surgery, Female, Humans, Retinal Pigment Epithelium, Retrospective Studies, Tomography, Optical Coherence, Vitrectomy / adverse effects, Vitrectomy / methods

Objective: To describe the development of retinal pigment epithelium (RPE) atrophy after uncomplicated pars plana vitrectomy (PPV) with epiretinal membrane (ERM) and/or internal limiting membrane (ILM) peeling in 2 patients. Cases description: Case 1: A 79-years-old female with diagnosis of a full-thickness macular hole in her right eye (OD) with best corrected visual acuity (BCVA) of: 20/100 and left eye (OS): 20/70. After surgery she developed large RPE hyperplasia and presented hand movement that did not improve with pinhole. Case 2: A 69-years-old female patient who had ERM in her OS with BCVA of 20/30 in both eyes (OU). PPV was assisted with brilliant blue (BB) to better visualize the ILM. During follow-up visits we evidenced RPE atrophy in the zone where peeling was done. In the last control after 2-years, her visual acuity was 20/40 that did not improve with pinhole. Discussion: There are three possible mechanisms to explain this complication: toxic damage, mechanical trauma during the membrane removal with forceps, or a combination of both. In our cases, a combination of them is probably the cause of the presence of RPE atrophy. Conclusion: Vitrectomy with membrane removal is successful in most cases with low rate of complications. Because RPE atrophy is infrequent, our suggestion is to continue performing this technique and if possible, it should be done without dye staining to minimize risks. Abbreviations: ERM = epiretinal membrane, ILM = internal limiting membrane, MH = macular hole, RPE = Retinal pigment epithelium, OD = right eye, BCVA = Best corrected visual acuity, OS = left eye, OU = both eyes, IOL = intraocular lens, OCT = Optical coherence tomography, BB = Brilliant blue, TB = Trypan blue, ICG = indocyanine green.
Lessons from laparoscopic liver surgery: a nine-year case series
Authors: Laura Spencer, Matthew S Metcalfe, Andrew D Strickland, Elisabeth J Elsey, Gavin S Robertson, David M Lloyd
Journal: HPB Surg (2008)

Objective:
This series describes a developing experience in laparoscopic liver surgery presenting results from 40 procedures including right hemihepatectomy, left lateral lobectomy, and microwave ablation therapy.
Methods:
Forty patients undergoing laparoscopic liver surgery between September 1997 and November 2006 were included. The data set includes: operative procedure and duration, intraoperative blood loss, conversion to open operation rates, length of hospital stay, complications, mortality, histology of lesions/resection margins, and disease recurrence.
Results:
Mean age of patient: 59 years, 17/40 male, 23/40 female, 23/40 of lesions were benign, and 17/40 malignant. Operations included: laparoscopic anatomical resections n = 15, nonanatomical resections n = 11, microwave ablations n = 8 and deroofing of cysts n = 7. Median anaesthetic time: 120 minutes (range 40-240), mean blood loss 78 mL and 1/40 conversions to open. Median resection margins were 10 mm (range 1-14) and median length of stay 3 days (range 1-10). Operative and 30-day mortality were zero with no local disease recurrence.
Conclusion:
Laparoscopic liver surgery appears safe and effective and is associated with reduced hospital stay. Larger studies are required to confirm it is oncologically sound.
A Case of an 80-Year-Old Man with Empyema and Psoas Abscess
Authors: Mikio Sakurai, Hiroki Nagasawa, Ikuto Takeuchi, Youichi Yanagawa
Journal: Case Rep Emerg Med (2020)
MeSH terms: Case Reports

An 80-year-old man with flu symptoms collapsed at his house and had a backache worsened over time. His family called for an ambulance. On arrival, chest X-ray showed reduced permeability of the right lung field, and truncal computed tomography (CT) suggested right multilobular empyema and right iliopsoas abscess. A blood test showed an acute inflammatory response. The patient underwent right small thoracotomy for empyema and ultrasonic-guided drainage for the right iliopsoas abscess and started the administration of antibiotics. We started the administration of doripenem by intravenous drip and then deescalated to ampicillin based on the culture results. Streptococcus intermedius was cultured from all sites. Following these treatments for three months, his general condition improved. We herein report a unique case of complicated empyema and iliopsoas abscess in which a favorable outcome was obtained by an appropriate diagnosis and treatment. Reports of multiple abscesses have been increasing recently because of the growing geriatric population and aging-related complications. It is important to search the whole body to detect multiple abscesses in cases where an abscess is detected at a single site.
Hydronephrosis Resulting from Bilateral Ureteral Stenosis: A Late Complication of Polyoma BK Virus Cystitis?
Authors: N Basara, F-M Rasche, T Schwalenberg, C Wickenhauser, M Maier, J Ivovic, D Niederwieser, T H Lindner
Journal: J Transplant (2010)
MeSH terms: Case Reports

We report here a case of acute lymphoblastic leukemia in remission presenting a late-onset bilateral hydronephrosis probably due to polyoma BK virus-induced proliferation of bladder endothelium on both ostii. The diagnosis was made virologically by BK virus Polymerase Chain Reaction (PCR) detection in the absence of any other bladder disease. Awareness of this late complication is necessary not only in patients after renal transplantation but also in patients after hematopoietic stem cell transplantation from matched unrelated donor.