OpenMed/multicare-articles huggingface dataset:
Case report: Spontaneous lens absorption after the implantation of an implantable collamer lens
Authors: Xiaojing Liu, Qiulin Zeng, Ting Lu, Min Wang, Yong Sun, Jingfa Zhang
Journal: Front Med (Lausanne) (2023)
Keywords: icl, anterior capsular fibrotic proliferation, anterior subcapsular opacification, cataract, spontaneous absorption of lens
MeSH terms: Case Reports

Background:
Spontaneous lens absorption is rare and usually occurs in eyes with certain syndromes, hyper-mature cataracts, and ocular trauma. The application of an implantable collamer lens (ICL) is widely performed in patients with high myopia for refractive correction. This study reports a case of spontaneous lens absorption after ICL implantation.
Case summary:
A 23-year-old man was referred with complaints of poor vision in his left eye. The patient had undergone binocular ICL implantation for refractive correction of high myopia 1.5 years prior. Approximately 10 months later, he experienced a sudden loss of vision and pain in his left eye, which resolved spontaneously the next day without any treatment. Since then, the visual acuity in his left eye gradually decreased. At presentation, slit-lamp examination revealed an ICL in the posterior chamber of both eyes, with anterior capsular fibrotic proliferation and posterior capsular opacity, and the residual lens cortex sandwiched between the anterior fibrotic membrane and opacified posterior lens capsule in his left eye. The number of corneal endothelial cells in his left eye was 1,337, which was lower than before ICL implantation (2,902). The patient then underwent ICL extraction, anterior capsular capsulotomy, residual cortex aspiration, posterior capsular polishing, and intraocular lens implantation.
Conclusions:
Spontaneous lens absorption may occur in patients with ICL implantation. Patients should undergo routine follow-ups after ICL implantation.
Acute ST-segment elevation myocardial infarction after amoxycillin-induced anaphylactic shock in a young adult with normal coronary arteries: a case report
Authors: Aristofanis Gikas, George Lazaros, Kalliopi Kontou-Fili
Journal: BMC Cardiovasc Disord (2005)
MeSH terms: Amoxicillin / adverse effects, Anaphylaxis / complications, Anti-Bacterial Agents / adverse effects, Myocardial Infarction / etiology, Case Reports, Adult, Anaphylaxis / chemically induced, Coronary Angiography, Coronary Vessels / physiology, Drug Hypersensitivity / complications, Electrocardiography, Humans, Male, Anti-Bacterial Agents, Amoxicillin

Background:
Acute myocardial infarction (MI) following anaphylaxis is rare, especially in subjects with normal coronary arteries. The exact pathogenetic mechanism of MI in anaphylaxis remains unclear.
Case presentation:
The case of a 32-year-old asthmatic male with systemic anaphylaxis, due to oral intake of 500 mg amoxycillin, complicated by acute ST-elevation MI is the subject of this report. Following admission to the local Health Center and almost simultaneously with the second dose of subcutaneous epinephrine (0.2 mg), the patient developed acute myocardial injury. Coronary arteriography, performed before discharge, showed no evidence of obstructive coronary artery disease. In vivo allergological evaluation disclosed strong sensitivity to amoxycillin and the minor (allergenic) determinants of penicillin.
Conclusion:
Acute ST-elevation MI is a rare but potential complication of anaphylactic reactions, even in young adults with normal coronary arteries. Coronary artery spasm appears to be the main causative mechanism of MI in the setting of "cardiac anaphylaxis". However, on top of the vasoactive reaction, a thrombotic occlusion, induced by mast cell-derived mediators and facilitated by prolonged hypotension, cannot be excluded as a possible contributory factor.
A patient with posterior cortical atrophy possesses a novel mutation in the presenilin 1 gene
Authors: Emilia J Sitek, Ewa Narożańska, Beata Pepłońska, Sławomir Filipek, Anna Barczak, Maria Styczyńska, Krzysztof Mlynarczyk, Bogna Brockhuis, Erik Portelius, Dorota Religa, Maria Barcikowska, Jarosław Sławek, Cezary Żekanowski
Journal: PLoS One (2013)
MeSH terms: Cerebral Cortex / pathology, Mutation / genetics, Presenilin-1 / genetics, Case Reports, Research Support, Non-U.S. Gov't, Aged, Atrophy, Cerebral Cortex / physiopathology, Female, Humans, Magnetic Resonance Imaging, Models, Molecular, Presenilin-1 / chemistry, Presenilin-1 / metabolism, Presenilin-2 / metabolism, Protein Binding, Tomography, Emission-Computed, Single-Photon, Vision, Ocular, Presenilin-1, Presenilin-2

Posterior cortical atrophy is a dementia syndrome with symptoms of cortical visual dysfunction, associated with amyloid plaques and neurofibrillary tangles predominantly affecting visual association cortex. Most patients diagnosed with posterior cortical atrophy will finally develop a typical Alzheimer's disease. However, there are a variety of neuropathological processes, which could lead towards a clinical presentation of posterior cortical atrophy. Mutations in the presenilin 1 gene, affecting the function of γ-secretase, are the most common genetic cause of familial, early-onset Alzheimer's disease. Here we present a patient with a clinical diagnosis of posterior cortical atrophy who harbors a novel Presenilin 1 mutation (I211M). In silico analysis predicts that the mutation could influence the interaction between presenilin 1 and presenilin1 enhancer-2 protein, a protein partner within the γ-secretase complex. These findings along with published literature support the inclusion of posterior cortical atrophy on the Alzheimer's disease spectrum.
Case Report: Clinical Remission in a Cat With Severe Bilateral Eosinophilic Keratitis Receiving Combined Immunosuppressive Therapy (Triamcinolone Acetonide and Tacrolimus)
Authors: Amanda K Romaneck, Lionel Sebbag
Journal: Front Vet Sci (2021)
Keywords: antiviral drugs, compliance, corticosteroids, eosinophilic keratitis, eosinophilic keratoconjunctivitis, immunomodulation, triamcinolone acetonide
MeSH terms: Case Reports

A 2-year-old domestic shorthair cat was examined for severe keratitis of 10 months duration, non-responsive to 0.1% dexamethasone q8-12h. Patient and owner compliance were poor given ocular discomfort and hiding behavior. On presentation, both eyes (OU) had severe ulcerative keratitis that masked examination of deeper structures and resulted in absent menace response OU. Corneal cytology was consistent with eosinophilic keratitis (EK) OU. Initial therapy included subcutaneous triamcinolone acetonide injection (0.2 mg/kg), 0.3% ciprofloxacin OU q12h, and two compounded drugs started 5 days later upon receipt: 0.5% tacrolimus OU q6h, 0.5% cidofovir OU q12h. Visual behavior and ocular comfort were reportedly much improved within 24 h. At the first recheck (Day 11), patient and owner compliance were reported to be excellent, menace response was positive OU, and keratitis was dramatically reduced OU with absent fluorescein uptake. Subcutaneous triamcinolone acetonide was repeated (0.2 mg/kg), ciprofloxacin was discontinued, cidofovir was continued q12h, and tacrolimus was slowly tapered (q8h × 3 weeks then q12h). Keratitis was nearly 100% resolved at the second recheck (Day 38); cidofovir was discontinued and tacrolimus was slowly tapered (q12h × 1 week, q24h × 4 weeks, q48h × 4 weeks) then discontinued. A third recheck (Day 101) confirmed clinical remission OU, and disease did not reoccur within a 1 year follow up period (photographic documentation by owner). In sum, adjunct use of triamcinolone acetonide greatly improved therapeutic compliance and helped control severe EK in a rapid and effective manner.
An unusual case of aggregatibacter aphrophilus liver abscess
Authors: Ilias Papakonstantinou, Zoi Psaroudaki, Efstathia Perivolioti
Journal: Pan Afr Med J (2018)
Keywords: liver, abscess, aggregatibacter aphrophilus, immunocompetent, oropharyngeal
MeSH terms: Aggregatibacter aphrophilus / isolation & purification, Liver Abscess / diagnosis, Pasteurellaceae Infections / diagnosis, Case Reports, Anti-Bacterial Agents / administration & dosage, Drainage / methods, Humans, Liver Abscess / microbiology, Liver Abscess / therapy, Male, Pasteurellaceae Infections / therapy, Tomography, X-Ray Computed, Young Adult, Anti-Bacterial Agents

Liver abscess of oropharyngeal origin in an immunocompetent patient is a rare condition. Furthermore, microbiologic diagnosis of liver abscess can be challenging due to the tremendous diversity of the microorganisms implicated and culture difficulties under laboratory conditions. We report a case of a previously healthy 23-year-old male, who presented multiple liver abscesses, attributed to aggregatibacter aphrophilus, an obligatory oral gram-negative microorganism, that normally is a component of the commensal oral microbiota and non-virulent. The etiopathogenic microorganism was identified after needle aspiration of a liver abscess cavity. Treatment with broad-spectrum antimicrobials and percutaneous catheter drainage under computed tomography guidance of both abscesses, resulted in full recovery. A. aphrophilus represents a rare entity of liver abscess in healthy individuals and suggests that a pathogen of oropharyngeal origin should be suspected when an overt source of infection cannot be documented.
Double Duct to Mucosa Pancreaticojejunostomy for Bifid Pancreatic Duct following Pylorus Preserving Pancreaticoduodenectomy: A Case Report
Authors: K Vasiliadis, C Papavasiliou, N Lamprou, P Delivorias, S Papaioannou, A Karagiannidis, C Makridis
Journal: Case Rep Med (2012)

Bifid pancreatic duct represents a relatively rare anatomical variation of the pancreatic ductal system, in which the main pancreatic duct is bifurcated along its length. This paper describes the challenging surgical management of a 68-year-old male patient, with presumptive diagnosis of periampullary malignancy who underwent a successful double duct to mucosa pancreaticojejunostomy for bifid pancreatic duct. Following pylorus preserving pancreaticoduodenectomy, careful intraoperative inspection of the cut surface of the residual dorsal pancreas identified the main in addition to the secondary pancreatic duct orifice. Bifid duct anatomy was confirmed via intraoperative probing and direct visualization of the ductal orifices. A decision was made for the performance of an end-to-site double duct to mucosa pancreaticojejunostomy. Postoperative outcome was favorable without any complications. Although bifid pancreatic duct is relatively rare, pancreatic surgeons should be aware of this anatomical variation and be familiar with the surgical techniques for its successful management. Lack of knowledge and surgical expertise for dealing with this anatomical variant may lead to serious, life threatening postoperative complications following pancreatic resections.
Solitary adrenal metastasis from invasive ductal breast cancer: an uncommon finding
Authors: Xiao-Jiao Liu, Peng Shen, Xin-Feng Wang, Ke Sun, Fei-Fei Sun
Journal: World J Surg Oncol (2010)
MeSH terms: Adrenal Gland Neoplasms / secondary, Adrenalectomy, Breast Neoplasms / pathology, Carcinoma, Ductal, Breast / secondary, Mastectomy, Modified Radical, Case Reports, Adrenal Gland Neoplasms / surgery, Breast Neoplasms / surgery, Carcinoma, Ductal, Breast / surgery, Female, Humans, Middle Aged, Prognosis, Tomography, X-Ray Computed

Background:
Invasive ductal carcinoma (IDC) of the breast usually metastasizes to the lungs, liver, bones and brain. Solitary adrenal metastasis is extremely rare. Due to the rarity of this condition, the optimal treatment is unclear. We report the first case of IDC of the breast metastasizing solely to the adrenal gland after a modified radical mastectomy but having a long-term disease-free survival while treated merely by a left adrenalectomy.
Case presentation:
A 64-year-old woman was found a left adrenal mass on a follow-up visit two years after taking a right modified radical mastectomy for the breast cancer. She was subsequently given a left adrenalectomy. Postoperative histopathology findings were compatible with invasive ductal carcinoma (IDC) of the breast. Due to the patient's refusal, no further treatments were offered after the adrenalectomy. The patient now is still alive and has no sign of relapse. Survival time after taking the right modified radical mastectomy and the left adrenalectomy is more than five years and three years, respectively.
Conclusion:
This is the first case of a patient with solitary, metachronous adrenal metastasis from IDC of the breast to be reported. For patients in this condition, complete removal of metastasized organ may translate into survival benefit.
Oxaliplatin-Induced Pulmonary Toxicity in Gastrointestinal Malignancies: Two Case Reports and Review of the Literature
Authors: Mor Moskovitz, Mira Wollner, Nissim Haim
Journal: Case Rep Oncol Med (2015)

Oxaliplatin is a common chemotherapy drug, used mainly for colon and gastric cancer. Most common side effects are peripheral sensory neuropathy, hematological toxicity, and allergic reactions. A less common side effect is pulmonary toxicity, characterized mainly by interstitial pneumonitis. The incidence of this side effect is unknown, but the toxicity can be fatal. Twenty-six cases of pulmonary toxicity have been described in the literature, seven in the setting of adjuvant treatment. We describe two fatal cases of pulmonary injury related to oxaliplatin and a review of the literature.
Thoracoabdominal Approach for Large Retroperitoneal Masses: Case Series and Review
Authors: Siv Venkat, Andre Matteliano, Darrel Drachenberg
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

The thoracoabdominal incision was first described in 1946 as an approach to concomitant abdominal, retroperitoneal, and thoracic injuries. In urology, this technique was popularized in 1949 for the resection of large renal tumours. Today, it is reserved for complex cases where optimal exposure of the renal hilum and adrenal and superior pole of the kidney is necessary. We present four consecutive cases in which this approach was taken by a single surgeon at our tertiary surgical centre. The outcomes, postoperative course, and pathology are described. We provide a comprehensive literature review and outline the indications, advantages, and disadvantages of this approach. Objectives. To present a case series outlining the efficacy and safety of the thoracoabdominal incision in complex oncologic procedures in urology. Methods. Four cases utilizing the thoracoabdominal incision, performed by a single surgeon at our tertiary care center, were reviewed. Case history, preoperative imaging, intraoperative experience, postoperative course, final pathology, and complications were examined. A thorough literature review was performed and comparison made with historical cohorts for estimated blood loss, length of stay, and complications encountered versus other common surgical approaches. The indications, advantages, and disadvantages of the thoracoabdominal approach were outlined. Results. All patients had large retroperitoneal masses of varying complexity, requiring maximal surgical exposure. Surgery was straightforward in all cases, without any significant perioperative or postoperative complications. Postoperative pain, length of hospital stay, estimated blood loss, and analgesia requirements were all similar to open and mini-flank approaches in review of historical case series cohorts. Laparoscopic approaches had lower estimated blood loss and length of stay. Conclusions. The thoracoabdominal approach is rarely utilized in urological surgery, due to the perceived morbidity in violating the thoracic cavity. These cases outline the benefit of the thoracoabdominal approach in select cases requiring maximal surgical exposure, and the generally benign postoperative course that appropriately selected patients may hope to endure. Postoperative pain, length of hospital stay, estimated blood loss, and analgesia requirements can be expected to be similar open and mini-flank approaches. As expected, laparoscopic approaches had lower estimated blood loss and length of stay.
Mycotic Renal Artery Aneurysm Presenting as Critical Limb Ischemia in Culture-Negative Endocarditis
Authors: Vy Thuy Ho, Nathan K Itoga, Tiffany Wu, Ehab Sorial, Manuel Garcia-Toca
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Mycotic renal artery aneurysms are rare and can be difficult to diagnose. Classic symptoms such as hematuria, hypertension, or abdominal pain can be vague or nonexistent. We report a case of a 53-year-old woman with a history of intravenous drug abuse presenting with critical limb ischemia, in which CT angiography identified a mycotic renal aneurysm. This aneurysm tripled in size from 0.46 cm to 1.65 cm in a 3-week interval. Echocardiography demonstrated aortic valve vegetations leading to a diagnosis of culture-negative endocarditis. The patient underwent primary resection and repair of the aneurysm, aortic valve replacement, and left below-knee amputation after bilateral common iliac and left superficial femoral artery stenting. At 1-year follow-up, her serum creatinine is stable and repaired artery remains patent.
Assessing Discriminative Performance at External Validation of Clinical Prediction Models
Authors: Daan Nieboer, Tjeerd van der Ploeg, Ewout W Steyerberg
Journal: PLoS One (2016)
MeSH terms: Brain Injuries / physiopathology, Models, Theoretical, Prognosis, Research Support, Non-U.S. Gov't, Humans, Logistic Models

Introduction:
External validation studies are essential to study the generalizability of prediction models. Recently a permutation test, focusing on discrimination as quantified by the c-statistic, was proposed to judge whether a prediction model is transportable to a new setting. We aimed to evaluate this test and compare it to previously proposed procedures to judge any changes in c-statistic from development to external validation setting.
Methods:
We compared the use of the permutation test to the use of benchmark values of the c-statistic following from a previously proposed framework to judge transportability of a prediction model. In a simulation study we developed a prediction model with logistic regression on a development set and validated them in the validation set. We concentrated on two scenarios: 1) the case-mix was more heterogeneous and predictor effects were weaker in the validation set compared to the development set, and 2) the case-mix was less heterogeneous in the validation set and predictor effects were identical in the validation and development set. Furthermore we illustrated the methods in a case study using 15 datasets of patients suffering from traumatic brain injury.
Results:
The permutation test indicated that the validation and development set were homogenous in scenario 1 (in almost all simulated samples) and heterogeneous in scenario 2 (in 17%-39% of simulated samples). Previously proposed benchmark values of the c-statistic and the standard deviation of the linear predictors correctly pointed at the more heterogeneous case-mix in scenario 1 and the less heterogeneous case-mix in scenario 2.
Conclusion:
The recently proposed permutation test may provide misleading results when externally validating prediction models in the presence of case-mix differences between the development and validation population. To correctly interpret the c-statistic found at external validation it is crucial to disentangle case-mix differences from incorrect regression coefficients.
Lymphoepithelial carcinoma: a case report of a rare tumor of the larynx
Authors: Nawal Hammas, Najib Benmansour, Mohamed Nour-Dine El Alami El Amine, Laila Chbani, Hind El Fatemi
Journal: BMC Clin Pathol (2017)
Keywords: epstein- barr virus, larynx, lymphoepithelial carcinoma
MeSH terms: Case Reports

Background:
Lymphoepithelial carcinoma is a tumor mostly diagnosed in the nasopharynx, but it has also been described in a variety of nonnasopharyngeal sites. It is extremely rare in the larynx and should be distinguished from squamous cell carcinoma. Therefore, it must be known by clinicians, pathologists and oncologists. In this case report, we discuss its etiopathogeny, its epidemiological, clinical, pathological and therapeutic aspects, and its outcome.
Case presentation:
An 81-year-old Morrocan man, smoker for 40 years, presented with a 1 year history of dysphonia, dyspnea and dysphagia. Laryngoscopy showed a mass occupying supraglottic, glottic and subglottic levels of the larynx. Cervico-thoracic computed tomography scan showed a laryngeal wall thickening with cervical lymphadenopathy. Laryngeal biopsy was performed. Microscopic analysis and immunohistochemistry confirmed the diagnosis of laryngeal lymphoepithelial carcinoma. Immunostaining for LMP1 was negative.
Conclusion:
Laryngeal lymphoepithelial carcinoma is an extremely rare and an aggressive tumor. It is rarely associated with the EBV. It must be regarded as a distinct entity. Radiotherapy is advisable as the unique therapy for local tumor. A correct diagnosis and a close collaboration between the pathologist and clinicians is mandatory for an optimal treatment strategy.
Fibromatosis involving pelvic floor muscles
Authors: Aleksandra Stankiewicz, Nelesh N Jeyadevan
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Fibromatosis or desmoid tumour is a benign fibroblastic proliferation with aggressive infiltrative growth. High incidence of recurrence is noted after incomplete resection of the involved margins of the lesion. Pelvic fibromatosis is a rare condition and usually affects females. Patients frequently complain of pelvic pain, which can mimic gynaecological abnormalities. A case of pelvic fibromatosis involving pelvic floor muscles with unchanged appearance during 5 years of follow-up is presented.
Hypercalcemia of Malignancy Revealing a Parathyroid Carcinoma with Hepatic Metastasis: A Case Report and Literature Review
Authors: Yassine Mellagui, Rachid Jabi, Inass Haouli, Christine Kora, Jamal Ouachaou, Mohammed Aabdi, Houssam Bkiyar, Mohammed Bouziane, Brahim Housni
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Parathyroid carcinoma is a very rare malignant tumor of the parathyroid gland. This cancer poses a great diagnostic and therapeutic difficulty due to its rarity and the absence of a characteristic clinical and paraclinical picture. The diagnosis is histological but is not always easy. Surgery remains the only curative treatment, and cervical radiotherapy can be discussed. Good prognostic factors are complete monobloc tumor resection, and bad prognostic factors are the presence of lymph node metastases at diagnosis, distant metastases, and nonsecreting carcinomas.