OpenMed/multicare-articles huggingface dataset:
Black Esophagus: A Rare Case of Acute Esophageal Necrosis Induced by Diabetic Ketoacidosis in a Young Adult Female
Authors: Zachary Field, Jacqueline Kropf, Meghan Lytle, Giselle Castaneira, Mario Madruga, S J Carlan
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Background:
Acute esophageal necrosis is an uncommon clinical disorder diagnosed on endoscopy as a black esophagus. It has a multifactorial etiology that probably represents a combination of poor nutritional status, gastric outlet obstruction, and ischemia secondary to hypoperfusion of the distal esophagus. It typically occurs in older males with comorbidities.
Case:
A 37-year-old woman presented with diabetic ketoacidosis and hematemesis. At esophagogastroduodenoscopy acute esophageal necrosis was diagnosed. The treatment included fluid and electrolyte management, insulin, and a proton pump inhibitor. She improved and left the hospital on day 3.
Conclusion:
Diabetic ketoacidosis can result in a profound osmotic diuresis, fluid loss, and hypoperfusion of the distal esophagus. This condition can then lead to ischemic injury and acute esophageal necrosis. Awareness of the possibility of its presence in young women with hematemesis and poorly controlled diabetes is important since early identification with esophagogastroduodenoscopy is necessary to prevent serious postnecrotic complications.
Simultaneous Presentation of Multiple Myeloma and Lung Cancer: Case Report and Gene Bioinformatics Analysis
Authors: Ping-Ping Xiao, Bing-Qing Luo, Wei Fan, Xu-Yan Chen, Zhi-Gao Dong, Jin-Mei Huang, Yi Zhang, Yong-Quan Chen
Journal: Front Oncol (2022)
Keywords: bioinformatics analysis, lung cancer, mitochondrial trans-2-enoyl-coa reductase, multiple myeloma, multiple primary cancer, survival
MeSH terms: Case Reports

Patients diagnosed with more than one cancer generally develop the individual tumors sequentially. There are a few cases of co-occurring multiple myeloma and lung cancer reported in the literature. Here, we report two cases of co-occurring multiple myeloma and lung cancer in patients who presented with the chief complaint of pain. The diagnoses of multiple myeloma and lung cancer were supported by hematologic and biochemical investigations, as well as bone marrow and lung histopathologic examination. We provided suitable interventions for both two patients. The patients are still currently undergoing treatment and followed up closely. We first performed a bioinformatic analysis to determine commonly shared genes and pathways in the two types of cancer types. Fortunately, we identified the hub gene mitochondrial trans-2-enoyl-CoA reductase (MECR), which was overexpressed in both tumors. Survival analysis correlated higher MECR expression with poorer overall survival. Signaling pathway analysis suggested possible transduction pathways implicated in the co-occurrence of both tumors. The clinical cases combined with bioinformatic analysis may provide insight for the pathogenesis of synchronous tumors.
Myolipoma affecting the erector spinae: a case report in a child
Authors: M T R Parratt, K Gokaraju, B G I Spiegelberg, J Miles, S R Cannon, T W R Briggs
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Myolipoma is a rare, benign, lipomatous tumour which most commonly occurs in the retroperitoneum, pelvis, and abdomen. A 4-year-old boy presented with a painless enlarging mass in the left paraspinal region. Magnetic Resonance Imaging (MRI) revealed a soft tissue lesion with high fat content and areas of calcification. Excision and histopathological analysis revealed a tumour composed of lobules of mature adipose tissue and broad septa of well-differentiated smooth muscle tissue. The smooth muscle nature of the nonfatty component was demonstrated by a diffuse and strong immunoreactivity for smooth muscle actin and desmin. The mass was reported as a myolipoma. The patient made an unremarkable recovery from surgery and remains healthy with no signs of recurrence at seven years. This paper represents the youngest patient diagnosed with this rare soft tissue tumour which is normally confined to the adult population. A newly reported site of the tumour is also highlighted.
Chondroblastoma of the knee treated with resection and osteochondral allograft reconstruction
Authors: Judd Fitzgerald, Cory Broehm, David Chafey, Gehron Treme
Journal: Case Rep Orthop (2014)

Case. This case report describes the operative management of 16-year-old male with a symptomatic chondroblastoma of the distal femur with breach of the chondral surface. Following appropriate imaging and core needle biopsy, the diagnosis was confirmed histologically. The patient then underwent intralesional curettage and osteochondral allograft reconstruction of the defect. At one-year follow-up the patient was pain-free and has obtained excellent range of motion. There is radiographic evidence of allograft incorporation and no evidence of local recurrence. Conclusion. Osteochondral allograft reconstruction is an effective option following marginal resection and curettage of chondroblastoma involving the chondral surface of the distal femur.
Group-Schematherapy for Adolescents: Results from a Naturalistic Multiple Case Study
Authors: Jeffrey Roelofs, Peter Muris, Doret van Wesemael, Nick J Broers, Ida Shaw, Joan Farrell
Journal: J Child Fam Stud (2016)
Keywords: adolescents, group schematherapy, personality problems

Personality disorders are complex mental health problems, associated with chronic dysfunction in several life domains. Adolescents suffer from these disorders as well. The present study is a naturalistic case study, investigating whether group schematherapy (GST) can be applied to adolescents with personality disorders or personality disorder traits. Four clinically referred patients were included and completed questionnaires on quality of life, symptoms of psychopathology, schema modes, early maladaptive schemas, and schema coping styles. Patients participated in weekly GST sessions complemented by weekly or 2-weekly individual sessions. The parents of the adolescents participated in a separate parent group. From pre- to post-treatment, results demonstrated improvements for some patients in quality of life and symptoms of psychopathology. Changes in a number of modes and schemas were observed in all patients from pre- to post-therapy. In addition to assessing changes from pre- to post-treatment, the current study investigated the temporal changes in modes during therapy as well. Results demonstrated that maladaptive modes decreased, whereas healthy modes increased for all patients across the course of therapy. The present study provides preliminary support for the applicability of GST for adolescents as well as the effectiveness of GST. It is a starting point for further research on this intervention.
A low-grade chondrosarcoma presenting as an unusual cervical mass in the hyoid bone: a case report
Authors: Hirohiko Tachino, Hiroaki Fushiki, Masayuki Ishida, Yukio Watanabe
Journal: J Med Case Rep (2012)

Introduction:
A chondrosarcoma originating from the hyoid bone is very rare. Here, we describe a case of low-grade chondrosarcoma of hyoid origin and discuss its preoperative imaging features, including those on positron emission tomography-computed tomography, and its recurrence rate.
Case presentation:
A 42-year-old Japanese man noticed a mass in the right submandibular region of his neck. A hard 3.0 × 2.8 cm tumor was noted on the right side of his hyoid bone. The mass was immobile and moved with deglutition.
Conclusion:
Even though radiographic studies, including positron emission tomography-computed tomography, were inconclusive, the cartilaginous tumor was surgically removed en bloc, and the tumor was diagnosed based on the results of pathological investigations. Close follow-up is recommended in such cases due to the potential for recurrences, because local recurrence occurred in 50% of the reported cases of grade one chondrosarcomas.
Skin and soft tissue infections and bacteremia caused by Vibrio cincinnatiensis
Authors: Kotaro Kunitomo, Naomichi Uemura, Taro Shimizu, Satoshi Hayano, Takahiro Tsuji
Journal: IDCases (2022)
Keywords: bacteremia, skin and soft tissue infection, vibrio cincinnatiensis
MeSH terms: Case Reports

Vibrio cincinnatiensis is a halophilic species found in marine and estuarine environments worldwide. It is a rare pathogen whose impact on humans has remained unclear; only two cases of V. cincinnatiensis infection have been reported in humans, so far. A 63-year-old man with a history of myocardial infarction and type 2 diabetes mellitus presented to the emergency department with fever and dyspnea. Physical examination demonstrated notable abdominal distension and bilateral lower leg edema. marked abdominal distension and bilateral lower leg edema. The patient was diagnosed with bacteremia and exacerbated heart failure. Blood and skin cultures revealed the presence of the gram-negative pathogen V. cincinnatiensis. Combined antibiotic therapy using intravenous tazobactam /piperacillin resulted in a gradual recovery with no recurrence observed at the 9-month follow-up. To the best of our knowledge, this is the third case of V. cincinnatiensis infection reported in humans and the first one to be associated with skin and soft tissue infection. We suggest that although V. cincinnatiensis is a rare pathogen, it should be considered as a potential infective agent in the differential diagnosis of immunocompromised patients, regardless of any recent exposure to seawater or marine products.
Congenital Hepatic Fibrosis in Children and Adults: Clinical Manifestations, Management, and Outcome-Case Series and Literature Review
Authors: Beidi Zhu, Zunguo Du, Zhengxin Wang, Yang Li, Jiming Zhang, Haoxiang Zhu
Journal: Gastroenterol Res Pract (2020)

Background:
Congenital hepatic fibrosis is a hereditary fibropolycystic disease caused by ductal plate malformation. It is characterized by portal hypertension, but the manifestations, management, and outcome vary in children and adults. To raise awareness of medical staff, we have comprehensively compared the clinical features of congenital hepatic fibrosis between children and adults.
Methods:
We retrospectively enrolled all patients diagnosed with congenital hepatic fibrosis at the Huashan Hospital from August 2015 to August 2017 and analyzed their familial, clinical, laboratory, imaging, treatment, and follow-up data in detail. In addition, we reviewed cases with congenital hepatic fibrosis reported in the past 20 years in China and analyzed them according to the patients' age.
Results:
A total of eight patients were diagnosed with congenital hepatic fibrosis in the study, including four children and four adults. The onset age of the children, who suffered from severe complications of portal hypertension and needed liver transplantation, ranged from 1 to 15 years old. The disorder developed in adults aged 26 to 60 years old. Three adults complained of recurrent abnormal liver function at the onset of illness, and they mainly received conservative treatments. The literature review included 30 children and 33 adults. In comparison, hepatomegaly was more common in children than in adults (57% vs. 21%, p = 0.004). Malformation of kidneys and bile duct abnormalities were common, and multisystem involvement included eyes, other digestive organs, and genital and central nervous systems.
Conclusions:
Serious complications of portal hypertension developed in children requiring liver transplantation, while adults often had mild-to-moderate liver injuries upon onset. Adults with CHF varied a lot in clinical manifestations. Multiorgan involvement and unusual course are helpful to make a diagnosis. Timely histological assessment by liver biopsy and multidisciplinary cooperation are crucial for definitive diagnosis and early intervention.
Submucosal mucoid as a late complication after appendectomy-A case report
Authors: Kristýna Bajcurová, Petr Novák, Eva Korčáková, Hynek Mírka, Jan Geiger, Petr Rajal, Ondřej Daum, Marcela Podolcová
Journal: Int J Surg Case Rep (2019)

Introduction:
Shortly after an operation infection, intraabdominal abscess, seroma, haemorrhage or development of paralytic ileus may occur. Postoperative adhesions, nonspecific abdominal pain without signs of obstruction, incisional hernia and appendicitis or mucocele in appendiceal stump present common late complications. We present a unique case of a late complication after appendectomy.
Presentation of case:
The case report describes a unique expansion in the ascending colon of a young athlete with long-lasting abdominal pain in the lower right quadrant. Colonoscopy showed a lesion in a wall of the ascending colon. Computed tomography (CT) confirmed a cystoid formation of high content density in a wall of the caecum. A right hemicolectomy was performed. Histology showed a lesion located in the submucosa with intestinal lining and stroma rich in lymphoid cells. These are the typical attributes of the wall of the appendix. Other parts of the wall were not demonstrated, and there was no communication with the lumen of the native bowel.
Conclusion:
A submucosal cavity filled with acellular matter, which were probably disintegrated epithelioid structures, and calcifications were found in the ascending colon, while no intestinal cell atypia or dysplasia was found. The case cannot be classified under any previously presented diagnosis.
Pentobarbital Induced Hypokalemia: A Worrying Sequela
Authors: Mark Awad, Joyce Bonitz, Abimbola Pratt
Journal: Int J Surg Case Rep (2020)
Keywords: barbiturate coma, hypokalemia, intracranial hypertension, pentobarbital, thiopental, traumatic brain injury
MeSH terms: Case Reports

Introduction:
Intracranial hypertension that is not responsive to other therapies can be managed through the use of a barbiturate induced coma. Although potentially effective, there are known complications associated with this treatment, and as such it is typically reserved for the most severe cases. One such sequela of barbiturate induced coma therapy is refractory hypokalemia and subsequent rebound hyperkalemia.
Presentation of case:
This case report discusses a patient who experienced hypokalemia during pentobarbital induced coma for unmanageable elevations in intracranial pressure and was treated conservatively to avoid rebound hyperkalemia depicting successful deployment of permissive hypokalemia.
Discussion:
It is vital that clinicians understand the possible adverse effects associated with barbiturate induced coma therapy, and that a careful balance be struck between hypokalemia and potassium supplementation to avoid rebound hyperkalemia.
Conclusion:
Given that the risk of rebound hyperkalemia is of significant concern in patients who experience hypokalemia on barbiturate induced coma therapy, permissive hypokalemia can be a viable treatment option achieved by lowering the potassium replacement target threshold in such patients.
COVID-19: Technology-Supported Remote Assessment of Pediatric Asthma at Home
Authors: Mattienne R van der Kamp, Monique Tabak, Sophia E J A de Rooij, Pieter P E van Lierop, Boony J Thio
Journal: Front Pediatr (2020)
Keywords: covid-19, asthma, child, delivery of healthcare, self-management, technology, telemedicine, wearable electronic devices

The COVID-19 crisis has pressured hospital-based care for children with high-risk asthma as they have become deprived of regular clinical evaluations. However, COVID-19 also provided important lessons about implementing novel directions for care. Personalized eHealth technology, tailored to the individual and the healthcare system, could substitute elements of hospital care and facilitate early and appropriate medical anticipation in response to imminent loss of control. This perspective article discusses new approaches to the clinical, organizational, and scientific aspects of the use of eHealth technology in pediatric asthma care in times of COVID-19, as illustrated by a case report of an acute asthma exacerbation possibly caused by COVID-19 infection.
A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation
Authors: Matthew T Neal, Maziyar A Kalani, Mark K Lyons
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

The anterior lumbar interbody fusion (ALIF) is a well-established procedure used to treat a multitude of spinal pathologies. When performed at the L5-S1 level, the ALIF is often supplemented with posterior pedicle screw and rod fixation. Because the interbody device can restore disk and foraminal height, one benefit of the ALIF procedure is indirect neural decompression in the spinal canal and neural foramina. If the contour of the posterior rod is not matched to the exact position of the tulip heads on the pedicle screws, spondylolisthesis can be introduced, leading to foraminal stenosis and nerve compression. This concern is particularly germane when the posterior instrumentation is placed percutaneously without any direct foraminal decompression. In this report, we describe a patient who had an L4-S1 ALIF, resulting in new L5-S1 retrolisthesis and worsening L5 radiculopathy. Technical nuances and avoidance strategies are discussed.
Squamous cell carcinoma of the thyroid gland in an elderly female presenting as a rapidly enlarging thyroid mass
Authors: Ramadhan T Othman, Azad Mustafa Ahmed Baizeed, Ayad Ahmad Mohammed
Journal: Int J Surg Case Rep (2020)
Keywords: neck mass, radiotherapy, squamous cell carcinoma, thyroid, thyroid cancer
MeSH terms: Case Reports

Background:
Squamous cell carcinoma of the thyroid gland is an extremely rare tumor with a very aggressive clinical behavior and poor prognosis. The tumor may arise as a primary tumor within the thyroid gland or as a component of anaplastic or undifferentiated thyroid tumors.
Case presentation:
A 70-year-old lady with history of long standing multinodular goiter presented with progressive enlargement of a midline nodule for 3 months which was associated with dyspnea and dry cough. The mass was hard and fixed. The voice was normal, other parts of the general examination were unremarkable. Fine needle aspiration was done for the mass which revealed malignant cells mixed with inflammatory cells. During surgery there was a hard and fixed mass arising from the isthmus of the thyroid gland that was locally invading, complete excision was not possible, debulking was done. Histopathology showed moderately differentiated squamous cell carcinoma of the thyroid gland. The tumor underwent local progression 6 months later and the patient was sent for radiotherapy.
Conclusion:
When thyroid tumor is advanced at time of diagnosis, radiotherapy is the main form of treatment which may induce reduction in the size of the tumor and decrease pain, radiotherapy may also be given on neoadjuvant bases which may render resection possible in some patients. The tumor is usually not responsive to chemotherapy. The overall survival is uniformly poor regardless of the primary form of treatment, the median survival of the patients from the time of diagnosis is few months in most cases.
Placenta accreta in the department of gynaecology and obstetrics in Rabat, Morocco: case series and review of the literature
Authors: Aziz Slaoui, Sarah Talib, Anass Nah, Kamal El Moussaoui, Intissar Benzina, Najia Zeraidi, Aziz Baydada, Aicha Kharbach
Journal: Pan Afr Med J (2019)
Keywords: abnormal placentation, accreta, caesarean hysterectomy, indicated preterm delivery, percreta
MeSH terms: Hysterectomy / methods, Placenta Accreta / diagnosis, Ultrasonography, Prenatal / methods, Case Reports, Review, Adult, Cesarean Section / statistics & numerical data, Female, Humans, Morocco, Placenta Accreta / epidemiology, Postpartum Hemorrhage / etiology, Pregnancy, Prenatal Diagnosis / methods, Retrospective Studies, Risk Factors

Placenta accreta spectrum disorders is a rare pathology but the incidence has not stopped to increase in recent years. The purpose of our work was the analysis of the epidemiological profile of our patients, the circumstances of diagnosis, the interest of paraclinical explorations in antenatal diagnosis and the evaluation of the evolutionary profile. We hereby report a case series spread over a period of one year from 01/01/2015 to 01/01/2016 at the Gynaecology-Obstetrics department of the University Hospital Center IBN SINA of Rabat where we identified six cases of placenta accreta. We selected patients whose diagnosis was confirmed clinically and histologically. The major risk factors identified were a history of placenta previa, previous caesarean section, advanced maternal age, multiparity. 2D ultrasound and magnetic resonance imaging (MRI) allowed us to strongly suspect the presence of a placenta accreta in a pregnant woman with risk factor(s) but the diagnosis of certainty was always histological. Placenta accreta spectrum disorders were associated with a high risk of severe postpartum hemorrhage, serious comorbidities, and maternal death. Leaving the placenta in situ was an option for women who desire to preserve their fertility and agree to continuous long-term monitoring in centers with adequate expertise but a primary elective caesarean hysterectomy was the safest and most practical option. Placenta accreta spectrum disorders is an uncommon pathology that must be systematically sought in a parturient with risk factors, to avoid serious complications. In light of the latest International Federation of Gynecology and Obstetrics (FIGO) recommendations of 2018, a review of the literature and finally the experience of our center, we propose a course of action according to whether the diagnosis of the placenta is antenatal or perpartum.
Prolonged Honeymoon Period in a Thai Patient with Adult-Onset Type 1 Diabetes Mellitus
Authors: Yotsapon Thewjitcharoen, Ekgaluck Wanothayaroj, Haruethai Jaita, Soontaree Nakasatien, Siriwan Butadej, Ishant Khurana, Scott Maxwell, Assam El-Osta, Waralee Chatchomchuan, Sirinate Krittiyawong, Thep Himathongkam
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Objective:
To describe a usual case of adult-onset T1DM with prolonged honeymoon period for more than 5 years.
Methods:
Repeated mixed meal stimulation tests for a period of 6-12 months together with monitoring pancreatic autoantibodies and laboratory data were followed following the onset of diagnosis.
Results:
We report a 24-year-old Thai patient with T1DM with sustained remission without antidiabetic medication for more than 5 years while maintaining low-carbohydrate intake and regular exercise. Repeated mixed meal stimulation tests for a period of 6-12 months revealed preserved beta-cell functions. Interestingly, repeated pancreatic autoantibodies at 5 years after diagnosis still showed positive anti-GAD, anti-IA2, and anti-ZnT8.
Conclusion:
Restored beta-cell function with complete insulin withdrawal in new-onset T1DM has been reported in very few cases with some common factors as in our patient (low-carbohydrate intake with regular exercise). Delaying autoimmune activity by reducing metabolic load in newly diagnosed T1DM might play a role in maintaining the honeymoon period and could lead to an innovative therapeutic option in new-onset T1DM.
Delay in diagnosis of cerebral venous and sinus thrombosis: successful use of mechanical thrombectomy and thrombolysis
Authors: Christopher T Shah, Jason J Rizqallah, Oladoyin Oluwole, Aleksandrs Kalnins, John N Sheagren
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Cerebral venous and sinus thrombosis is a relatively rare condition with a variable presentation that can translate into a difficult workup and a delay in diagnosis and treatment. We describe the successful use of mechanical thrombectomy and thrombolysis in the case of an eighteen-year-old woman that presented with progressive thrombosis of the jugular veins and dural sinuses despite adequate anticoagulation. Our case highlights the need for clinicians to include CVST in the initial differential diagnosis of patients in order to prevent delays and poor outcomes.