OpenMed/multicare-articles huggingface dataset:
An Extremely Rare Case of Lower Urinary Tract Symptoms: Floating Benign Mesenchymal Mass in Abdomen
Authors: Bulent Kati, Yigit Akin, Eyyup Sabri Pelit, Mehmet Ogur Yilmaz
Journal: Case Rep Urol (2017)
MeSH terms: Case Reports

A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pain and intermittent lower urinary tract symptoms (LUTSs) such as low urine flow rate, dysuria, and frequency. Uroflowmetry showed low urine flow, and laboratory tests revealed no pathology. Ultrasound (US) showed a 7 cm calcific mass above the bladder and a kidney cyst with a diameter of 5.3 cm in the upper pole of the right kidney. Enhanced computed tomography confirmed the US findings. Laparoscopic transperitoneal renal cyst decortication was performed. There was no sign of additional tumors. An independent mass in the abdomen was diagnosed, and the mass was removed. Based on the pathology, the diagnosis was a benign mesenchymal calcific mass. This is the first report of LUTSs due to a free benign mesenchymal mass in the published literature.
A case report of paraproteinemia-associated pauci-immune glomerulonephritis - a new form of monoclonal gammopathy of renal significance?
Authors: Robert Rope, Neeraja Kambham, Neiha Arora
Journal: Clin Nephrol Case Stud (2017)
Keywords: monoclonal gammopathy of renal significance (mgrs), monoclonal gammopathy of unknown significance (mgus), multiple myeloma, pauci-immune glomerulonephritis
MeSH terms: Case Reports

Background:
Renal disease associated with paraproteinemias is classically predicated upon pathologic paraprotein deposition in the kidney. However, growing evidence suggests that paraproteins may be able to systemically activate complement or neutrophils to drive renal damage. This may provide an alternative pathologic mechanism for renal injury in rare cases.
Case report:
We report a case of a patient with crescentic pauci-immune glomerulonephritis presenting with rapidly progressive renal failure, polyarthropathy, and a purpuric rash in association with a monoclonal immunoglobulin G κ-light-chain producing multiple myeloma. Serum anti-neutrophil cytoplasmic antibodies were not detected. Kidney biopsy, including with Pronase digestion, did not reveal pathologic paraprotein deposition. Two previously published similar case reports are also discussed.
Conclusion:
We propose a novel pathologic mechanism involving monoclonal proteins as a trigger for pauci-immune glomerulonephritis, potentially via complement dysregulation and/or neutrophil activation. This requires further epidemiologic and mechanistic study.
Aspects of images in magnetic resonance of liver tumors treated with transarterial selective internal radiotherapy with yttrium-90
Authors: Breno Boueri Affonso, Joaquim Maurício da Motta-Leal-Filho, Francisco de Assis Cavalcante Jr, Francisco Leonardo Galastri, Rafael Noronha Cavalcante, Priscila Mina Falsarella, Felipe Nasser, Rodrigo Gobbo Garcia
Journal: Einstein (Sao Paulo) (2018)
MeSH terms: Embolization, Therapeutic / methods, Liver Neoplasms / therapy, Radiosurgery / methods, Yttrium Radioisotopes / therapeutic use, Case Reports, Aged, Female, Humans, Liver Neoplasms / diagnostic imaging, Magnetic Resonance Imaging, Male, Middle Aged, Treatment Outcome, Yttrium Radioisotopes, Yttrium-90

Transarterial selective internal radiation therapy with yttrium-90, also known as radioembolization, is a therapy based on the administration of resin or glass microspheres loaded with the radioisotope yttrium-90, via selective arterial catheterization of tumor-feeding vessels. It is classified as a type of locoregional therapy and its main goal is to treat patients with primary or secondary hepatic lesions that are unresectable and not responsive to other therapies. Since it is a new technology still restricted to very few hospitals in Brazil, but used in patients throughout the country, it is necessary to demonstrate the main aspects of hepatic lesions treated with selective internal radiation therapy found in magnetic resonance imaging, and to make specific considerations on interpretation of these images. The objective of this report is to demonstrate the main aspects of magnetic resonance imaging of unresectable primary or secondary hepatic lesions, in patients submitted to transarterial selective internal radiation therapy.
Stroke in Patients with Schistosomiasis: Review of Cases in Literature
Authors: Valeria Silvestri, Vivian Mushi, Billy Ngasala, Jacqueline Kihwele, Deodatus Sabas, Lorenzo Rocchi
Journal: Can J Infect Dis Med Microbiol (2022)
MeSH terms: Review

Introduction:
Cerebral vascular comorbidities may occur in patients with schistosomiasis, as described in case reports. Aim and Methods. We have summarized general clinical and neurological features in patients with stroke associated with schistosomiasis, through a review of case reports in the literature. Investigation Outcomes. A total of eight case reports were retrieved. The mean age of patients was 36.42 ± 16.7 (19 to 56 years), four females, three males, and one anonymous sex. Eosinophilia was the most frequent feature at presentation, followed by cardiac abnormalities, confusion, fever, ataxia, hemiplegia, headache, urticaria, dysphasia, and memory impairment. Patients usually present with watershed infarction or intracranial vasculitis. In one case, extracranial carotid arteries presented with inflammation and stenosis. The patient's serology was positive on admission in five cases. Full neurological recovery was reported in three cases, and partial improvement in another three. In two cases, information on neurological outcomes was incomplete. Stroke in schistosomiasis can be caused by haemodynamic impairment, direct lesion to the arterial wall, vasa vasorum obliterative endarteritis, contiguity with a focus of inflamed tissue, or inflammatory intimal damage. Schistosomiasis needs to be included in the differential diagnosis of stroke in people living or coming back from endemic areas.
Conclusions:
Further studies addressing the noncommunicable comorbidity issues related to this condition are needed.
A case of squamous cell carcinoma occurring on a scar of Buruli ulcer in Bouake, Ivory Coast
Authors: Almamy Diabaté, Koffi Kouamé Pacôme Gbandama, Amon Anderson Stephen Kouabenan, Irenée Gué, Bamba Vagamon, Boussou Romain Aka
Journal: Pan Afr Med J (2019)
Keywords: buruli ulcer, scar, squamous cell carcinoma
MeSH terms: Buruli Ulcer / complications, Carcinoma, Squamous Cell / diagnosis, Cicatrix / complications, Case Reports, Adult, Carcinoma, Squamous Cell / pathology, Carcinoma, Squamous Cell / surgery, Cicatrix / etiology, Cote d'Ivoire, Female, Humans

Buruli ulcer is infectious necrotizing panniculitis due to Mycobacterium ulcerans. Buruli ulcer is healed by leaving dystrophic, fibrous and retractile scars. On these scars can occur long-term squamous cell carcinoma. We report the first case of squamous cell carcinoma occurring on healing of Buruli ulcer. A 32-year-old woman with Buruli ulcer who has been cured for about 10 years is seen for ulcero-bulging knee swelling. The examination had revealed a large swelling of about ten centimeters in diameter, ulcero-budding, with an easily bleeding cauliflower appearance. The diagnosis of squamous cell carcinoma being retained without metastasis, resection of the tumor with scarring after one month without chemotherapy. There was no recurrence after six months of decline. The epidemiology of Buruli ulcer, responsible for scarring, explains the young age of our patient and the localization of carcinoma on the limb. The carcinomatous degeneration of scars, especially the scars of old burns, is constantly reported. The characteristics of Buruli ulcer scars, which bring them closer to burn scars, may explain why they are particularly affected by carcinomatous degeneration. One could also mention the chronicity of the wound in this infection, or wonder if the mycobacteria itself could play a role in carcinogenesis. This observation is, in our opinion, an alarm signal. We must fear an outbreak of cases in the years to come. To this end, preventive measures should already be taken by sensitizing the patients for an early consultation before any modification of their scars. After recovery, Buruli ulcer seems to present a risk of long-term evolution to a cancer. The scars of this condition, which could be considered precancerous lesions.
Multiorgan Failure and Refractory Lactic Acidosis due to Pasteurella multocida Septicemia in a Patient with No Animal Exposure
Authors: Damaris Pena, Yaneidy Santana, Jose Perez Lara, Efrain Gonzalez, Misbahuddin Khaja
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Introduction:

Pasteurella multocida is a gram-negative coccobacillus pathogenic to animals. It can cause infection in humans by a bite, scratch, or lick from a cat or dog. P. multocida can cause a variety of infections in humans, including cellulitis, osteomyelitis, endocarditis, peritonitis, and septic shock.
Case presentation:
A 56-year-old male presented to our hospital with a 2-day history of fever, abdominal pain, nausea, and vomiting. He denied exposure to cats, dogs or other pets. He had severe respiratory distress requiring ventilator support, profound septic shock requiring multiple vasopressors, severe lactic acidosis, and renal failure requiring emergent hemodialysis. Blood cultures confirmed the presence of P. multocida. The patient subsequently died of cardiopulmonary arrest due to multiorgan failure with refractory shock.
Conclusion:

P. multocida septicemia can lead to septic shock. Early identification of this organism may decrease mortality. Although our patient had no known cat or dog exposure, physicians should enquire about a history of animal exposure when a patient presents with an infection with no obvious cause.
Lipid emulsion injection-induced reversal of cardiac toxicity and acceleration of emergence from general anesthesia after scalp infiltration of a local anesthetic: a case report
Authors: Rintaro Hoshino, Yoshinori Kamiya, Yuka Fujii, Tsunehisa Tsubokawa
Journal: JA Clin Rep (2017)
Keywords: brain surgery, delayed emergence, lipid rescue, lipid sink theory, local anesthetic intoxication

Background:
A scalp block or wound infiltration of local anesthetic is thought to effectively control post-craniotomy pain. However, it can result in local anesthetic toxicity (LAST), which is difficult to distinguish from brain damage due to the surgical procedure when emergence from general anesthesia is delayed. Lipid rescue (infusion of a lipid emulsion) is a widely accepted treatment for LAST.
Case presentation:
A 64-year-old man underwent surgical resection of a glioma in the brainstem. While still under general anesthesia, and before suturing of the wound, he received a 20-mL scalp infusion of ropivacaine 0.75%. His emergence from anesthesia was delayed, his respiration was suppressed, and premature ventricular contractions occurred; all of which are symptoms of LAST. Injection of a 20% lipid emulsion rapidly alleviated these symptoms. Interestingly, the blood concentration of ropivacaine increased after lipid rescue.
Conclusions:
The increase in ropivacaine concentration in the blood after lipid rescue suggests that the intravenously administered lipid emulsion absorbed the ropivacaine from the intoxicated brain and heart tissue. This finding is consistent with the lipid sink theory as a mechanistic explanation of lipid rescue.
Syphilis in the HIV era
Authors: Sigall Kassutto, John P Doweiko
Journal: Emerg Infect Dis (2004)
MeSH terms: HIV Infections / complications, Syphilis / complications, Vestibulocochlear Nerve Diseases / complications, Case Reports, Research Support, Non-U.S. Gov't, Adult, HIV Infections / diagnosis, Humans, Male, Syphilis / diagnosis, Vestibulocochlear Nerve Diseases / diagnosis

The incidence of syphilis has consistently increased from 2000 to 2002. We report a case of acquired syphilis with symptoms of Tullio phenomenon in a patient concurrently diagnosed with HIV infection. The resurgence of syphilis in HIV-positive groups at high risk has public health implications for prevention of both diseases.
Pentobarbital-Induced Myocardial Stunning in Status Epilepticus Requiring Extracorporeal Membrane Oxygenation: A Case Report and Literature Review
Authors: Tapan Kavi, Donna Molaie, Michael Nurok, Axel Rosengart, Shouri Lahiri
Journal: Case Rep Crit Care (2016)

Introduction. Mild hypotension is a well-recognized complication of intravenous pentobarbital; however fulminant cardiopulmonary failure has not been previously reported. Case Report. A 28-year-old woman developed pentobarbital-induced cardiopulmonary failure that was successfully treated with maximal medical management including arteriovenous extracorporeal membrane oxygenation. She made an excellent cardiopulmonary and neurological recovery. Discussion and Conclusion. Pentobarbital is underrecognized as a potential cause of myocardial stunning. The mechanism involves direct myocardial depression and inhibition of autonomic neuroanatomical structures including the medulla and hypothalamus. Early recognition and implementation of aggressive cardiopulmonary support are essential to optimize the likelihood of a favorable outcome.
Middle Ear Salivary Choristoma: A Rare Case Report and Update on Congenital Associations, Facial Nerve Involvement, and Treatment Strategies
Authors: Allen Young, Lauran Evans, Matthew Ng
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

Salivary gland choristoma is an extremely rare middle ear mass and is hypothesized to be caused by second branchial arch developmental anomalies. We present a 14-year-old girl with Dandy-Walker syndrome and conductive hearing loss. Middle ear exploration revealed a large middle ear mass with absent incus and stapes and displaced facial nerve. The mass was completely excised with histological confirmation of salivary gland choristoma. Her hearing was improved with bone-anchored hearing aids (BAHA). As facial nerve involvement is common, physicians should consider partial excision to avoid facial nerve palsy. Hearing restoration can be achieved with OCR or BAHA.
Case of inflammatory granuloma in inguinal hernia sac after hysterosalpingography with oily contrast medium
Authors: Yoshiko Miyazaki, Tetsu Yamamoto, Ryoji Hyakudomi, Takahito Taniura, Takanori Hirayama, Kiyoe Takai, Noriyuki Hirahara, Yoshitsugu Tajima
Journal: Int J Surg Case Rep (2020)
Keywords: hysterosalpingography, inflammatory granuloma, inguinal hernia, oily contrast medium
MeSH terms: Case Reports

Introduction:
The foreign body reaction caused by oil contrast medium, Lipiodol, is rare. We present a rare case of inflammatory granuloma in the inguinal hernia sac after hysterosalpingography with lipiodol.
Presentation of case:
A 30-year-old woman who had left inguinal growing mass for 7 months after hysterosalpingography with Lipiodol for examination of infertile. About 3 cm soft mass was palpable on the left inguinal region, and plane CT scan showed a multifocal cystic mass with metal concentration. Thus, laparoscopic herniorrhaphy was performed to repair the inguinal hernia and to confirm the contents of cystic lesion. The hernia sac filled with mucinous contents. Pathological examination revealed that inflammatory granuloma due to numerous lipid droplets and phagocytic images of leukocytes in the hernia capsule.
Discussion and conclusion:
Although oil contrast medium is safety agent, there is rear complication which need the surgical treatment. Complete resection of granuloma, including hernia sac, is important to prevent recurrence.
Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting with Fever and Confusion
Authors: Chiranthi Kongala Liyanage, Tilak Manthi Janake Munasinghe, Adsareswary Paramanantham
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) is a diagnostic conundrum as it may present with a myriad of nonspecific clinical features and laboratory and neuroimaging investigations are not diagnostic. We report a case of a 65-year-old female who presented with an acute febrile illness associated with headache and confusion, tangential thoughts, and loose association. Based on neutrophil leukocytosis in the full blood count and elevated inflammatory markers, she was commenced on empirical intravenous antibiotics suspecting meningoencephalitis. Further evaluation found a very high titer of both anti-thyroid peroxidase (anti-TPO) antibodies and anti-thyroid globulin antibodies. She was clinically and biochemically euthyroid. EEG showed right sided frontal intermittent rhythmic delta activity (FIRDA). Cranial MRI revealed age related cerebral atrophy and nonspecific periventricular white matter changes. A diagnosis of SREAT was made and she was treated with intravenous methylprednisolone followed by oral prednisolone. Her condition improved dramatically within 48 hours of starting steroids. SREAT is a diagnosis of exclusion in patients with a central nervous system disorder. There are no specific clinical features or investigative findings. Elevated anti-TPO antibodies are considered a hallmark of SREAT and steroid responsiveness supports the diagnosis. Prompt diagnosis and treatment reverses the neurological dysfunction in most cases.
Limb-shaking transient ischemic attacks successfully treated with external carotid artery stenting
Authors: George N Kouvelos, Christos Nassis, Nektario Papa, George Papadopoulos, Miltiadis I Matsagkas
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

The external carotid artery (ECA) is one of the most important extracranial-to-intracranial sources of collateral circulation, contributing significantly to the cerebral blood flow especially when perfusion through the internal carotid artery (ICA) is compromised. Most of the endovascular studies so far have been dedicated to ICA, with little focus on the ECA. Limb-shaking transient ischemic attacks (TIAs) are a relatively rare manifestation of carotid artery disease that may present with repetitive shaking movements of the affected limbs. We report a case of an 80-year-old male with bilateral internal and contralateral external carotid artery occlusion who developed limb-shaking TIAs as a result of significant stenosis of the right ECA. Percutaneous revascularization of the ECA was performed by angioplasty and stenting. At the follow-up 12 months later, the patient remained neurologically intact with complete resolution of his symptoms. Stenting of the ECA should be considered as a reasonable alternative to conventional open repair especially in patients with contralateral carotid stenosis, insufficient circle of Willis, and significant comorbidities.
Successful rescue of fulminant myocarditis with mechanical circulatory support and immunosuppression therapy: A case report
Authors: Chi Zhou
Journal: Front Cardiovasc Med (2023)
Keywords: cardiogenic shock, case report, fulminant myocarditis, immunosuppression, mechanical circulatory support
MeSH terms: Case Reports

Myocarditis is challenging to diagnose because of its various clinical manifestations. Fulminant myocarditis (FM) is a severe type of myocarditis characterized by heart failure, malignant arrhythmia, cardiogenic shock, and cardiac arrest. Its early diagnosis and timely treatment are crucial for a positive long-term prognosis. Here we report a case of 42-year-old woman who presented with fever, chest pain, and cardiogenic shock. An initial examination showed increased myocardial enzyme levels and diffuse ST-segment elevation. Urgent coronary angiography excluded coronary artery stenosis. Echocardiography revealed decreased left ventricular systolic function. Cardiac magnetic resonance imaging revealed cardiomyocyte necrosis and interstitial inflammatory edema. The patient was diagnosed with FM and administered antiviral and anti-infective agents, glucocorticoid, immunoglobulin, and supported with temporary cardiac pacemaker and positive airway therapy, and treated with continuous renal replacement therapy. As her clinical condition deteriorated rapidly, we immediately started an intra-aortic balloon pump and veno-arterial extracorporeal membrane oxygenation. She was discharged on day 15 and recovered normally during follow-up. The early initiation of mechanical circulatory support and immunosuppression are life-saving tools for the treatment of FM.
Case Report: Significant Clinical Benefit From Pemetrexed-Based Therapy in ROS1- and ALK-rearranged Lung Cancer With Adenosquamous Histology
Authors: Tejas Patil, Yunan Nie, Dara L Aisner, David Ross Camidge
Journal: Front Oncol (2022)
Keywords: alk, ros1, adenosquamous, non-small-cell lung cancer, pemetrexed, squamous
MeSH terms: Case Reports

Pemetrexed (used as a platinum doublet or as a maintenance regimen) is an established therapy for patients with advanced non-squamous non-small-cell lung cancer (NSCLC). In addition, certain gene rearrangements (e.g., ALK, ROS1, RET) appear to especially benefit from the use of pemetrexed. Inferior outcomes with pemetrexed compared to other chemotherapies in patients with NSCLC demonstrating squamous histology removed these patients from the labeled indication for the drug. While most squamous cases do not harbor driver oncogenes, rare exceptions exist. Whether the poor outcomes with pemetrexed extend to NSCLC with squamous component harboring driver oncogenes remains unexplored. In this case series, we describe two patients with adenosquamous histology harboring an ROS1 and ALK gene arrangement, respectively, who derived significant benefit from pemetrexed-based therapy. These cases suggest that the value of pemetrexed may need to be re-explored in adenosquamous NSCLC harboring such alterations.
Reset Osmostat: A Challenging Case of Hyponatremia
Authors: Navin Kuthiah, Chaozer Er
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Hyponatremia is the most common electrolyte abnormality seen in hospitalised patients with up to 15-20% of patients having a sodium level of less than 135 mmol/L (Reddy and Mooradian, 2009). Cases of hyponatremia were first described in the 1950s (George et al., 1955). As the differential diagnosis for hyponatremia is broad, a systematic and logical approach is needed to identify the cause. We describe a case of a 30-year-old gentleman who was found to have chronic hyponatremia. After a thorough workup, he was diagnosed to have reset osmostat. Reset osmostat is an uncommon and under recognised cause of hyponatremia which does not require any treatment. This diagnosis needs to be considered when the hyponatremia workup suggests SIADH, but the hyponatremia is not amenable to fluid restriction, salt or urea supplementation, and diuretic treatment.
Pendulum Therapy of Molar Distalization in Mixed Dentition
Authors: Raju Umaji Patil, Amit Prakash, Anshu Agarwal
Journal: Int J Clin Pediatr Dent (2016)
Keywords: class ii malocclusion, distalization, mixed dentition, pendulum, space regainer
MeSH terms: Case Reports

Early and timely pedo-orthodontic treatment is aimed at eliminating the disturbances of skeletal or dentoalveolar development, to harmonize the stomatognathic system before the full eruption of all permanent teeth. The advantages of pendulum appliance are its minimal dependence on patient's compliance (child cooperation), ease of fabrication, onetime activation and adjustment of the springs if necessary to correct minor transverse and vertical molar positions. This article reports a successful treatment method of class II malocclusion with pendulum appliance in mixed dentition phase. Distalization of maxillary molar was done, followed by guidance of canine impaction orthodontically and other dental correction using 0.022 MBT appliances. Posttreatment results were stable and remarkable. How to cite this article: Patil RU, Prakash A, Agarwal A. Pendulum Therapy of Molar Distalization in Mixed Dentition. Int J Clin Pediatr Dent 2016;9(1):67-73.