OpenMed/multicare-articles huggingface dataset:
A Rare Cause of Acquired Factor X Deficiency in an 87-Year-Old Female
Authors: Ayrton Bangolo, Trupti Waykole, Bilal Niazi, Chandini Sajja, Mahabuba Akhter, Bhavna Gupta, Sameh Elias
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

Factor X deficiency is a rare coagulopathy that can be inherited or acquired. Acquired factor X deficiency has been associated with plasma cell dyscrasias, amyloids, and use of vitamin K antagonists. Of plasma cell dyscrasias, most cases in the literature have been associated with multiple myeloma with or without concomitant AL amyloidosis. Here, we present a rare case of acquired isolated factor X deficiency in an elderly patient with immunoglobulin A (Ig A) monoclonal gammopathy of undetermined significance (MGUS). Herein, we highlight a rare cause of acquired factor X deficiency, and we hope to contribute to the growing literature of plasma cell dyscrasias associated with factor X deficiency.
Case Report: Development of Type 1 Autoimmune Pancreatitis in an Adolescent With Ulcerative Colitis Mimicking Pancreatic Cancer
Authors: Sujin Choi, Hae Jeong Lee, An Na Seo, Han Ik Bae, Hyung Jun Kwon, Chang Min Cho, So Mi Lee, Byung-Ho Choe, Ben Kang
Journal: Front Pediatr (2021)
Keywords: igg4, autoimmune pancreatitis, inflammatory bowel disease, pancreatic cancer, ulcerative colitis
MeSH terms: Case Reports

Introduction: Autoimmune pancreatitis (AIP) is a rare extraintestinal manifestation of inflammatory bowel disease (IBD) which is typically responsive to corticosteroid treatment. Case Presentation: We report a case of a 17-year-old male diagnosed with ulcerative colitis who subsequently developed acute pancreatitis. Blood tests demonstrated elevated pancreatic enzyme levels of amylase (1319 U/L) and lipase (809 U/L). Abdominal computed tomography revealed peripancreatic fat stranding and the presence of a perisplenic pseudocyst. Azathioprine and mesalazine were stopped as possible causes of drug-induced pancreatitis. However, pancreatic enzymes remained elevated and corticosteroid treatment was started. Despite corticosteroid therapy, amylase and lipase levels continued to increase. Infliximab was started due to a flare in gastrointestinal symptoms of ulcerative colitis. Follow-up abdominal ultrasonography revealed a pancreatic tail mass. Tumor markers, including CA 19-9, were elevated and atypical cells were seen on histological examination of an endoscopic ultrasonography-guided fine needle aspiration biopsy. Surgical pancreaticosplenectomy was performed for suspected pancreatic neoplasm. Surprisingly, histology revealed chronic pancreatitis with storiform fibrosis and infiltration of IgG4-positive cells, compatible with AIP type 1. Thereafter, pancreatic enzymes gradually decreased to normal levels and the patient has been in remission for 9 months on infliximab monotherapy. Conclusion: Pediatric gastroenterologists should keep in mind that AIP may develop during the natural course of pediatric IBD. Moreover, the development of pancreatic fibrosis may be non-responsive to corticosteroid treatment and mimic pancreatic neoplasia.
Unusual tumour ablations: report of difficult and interesting cases
Authors: Giovanni Mauri, Luca Nicosia, Gianluca Maria Varano, Paul Shyn, Sergio Sartori, Paola Tombesi, Francesca Di Vece, Franco Orsi, Luigi Solbiati
Journal: Ecancermedicalscience (2017)
Keywords: pet/ct, complex cases, contrast-enhanced ultrasound, cryoablation, image-guided ablation, laser ablation, microwave ablation, protective manoeuver, radiofrequency ablation, thermal ablation
MeSH terms: Case Reports

Image-guided ablations are nowadays applied in the treatment of a wide group of diseases and in different organs and regions, and every day interventional radiologists have to face more difficult and unusual cases of tumour ablation. In the present case review, we report four difficult and unusual cases, reporting some tips and tricks for a successful image-guided treatment.
Pyomyoma in a primigravida at term: a case report
Authors: Uchechukwu George Ogbu, Abayomi Ibukun Alao, Uche Augustine Akunaeziri, Reuben Chido-Abba
Journal: Pan Afr Med J (2022)
Keywords: pyomyoma, case report, leiomyoma, primigravida
MeSH terms: Leiomyoma / complications, Leiomyoma / diagnosis, Leiomyoma / surgery, Uterine Myomectomy, Uterine Neoplasms / complications, Case Reports, Abdominal Pain / complications, Adult, Cesarean Section, Female, Fever, Humans, Pregnancy

Pyomyoma is a rare complication of uterine fibroid occurring most commonly in pregnancy, post-partum, post-abortion, and post-menopausal periods. It results from infarction, necrosis and secondary infection of leiomyoma. We report a case of 29-year-old primigravida with breech at term co-existing with cystic degenerative uterine fibroid, who presented with recurrent fever and abdominal pain. She had caesarean section and was found to have pyomyoma intraoperatively. She subsequently had drainage of pus, caesarean myomectomy and antibiotics therapy. She had good outcome and was discharged on fifth postoperative day. Pyomyoma should be suspected in pregnant women with leiomyoma, unexplained recurrent fever, abdominal pain and cystic degenerative changes on ultrasound.
Extending the range of differential diagnosis of chronic traumatic encephalopathy of the boxer: Insights from a case report
Authors: Leonardo Caixeta, Iron Dangoni Filho, Rafael Dias de Sousa, Pedro Paulo Dias Soares, Andreia Costa Rabelo Mendonça
Journal: Dement Neuropsychol (2018)
Keywords: chronic traumatic encephalopathy, corticobasal syndrome, dementia pugilistica, differential diagnosis, frontal lobe dementia, multiple system atrophy
MeSH terms: Case Reports

Sports activities associated with repetitive cranial trauma have become a fad and are popular in gyms and even among children. It is important to consistently characterize the consequences of such sports activities in order to better advise society on the real risks to the central nervous system. We present the case of a former boxer reporting cognitive and behavioral symptoms that began six years after his retirement as a boxer, evolving progressively with parkinsonian and cerebellar features suggestive of probable chronic traumatic encephalopathy (CTE). Using our case as a paradigm, we extended the range of differential diagnosis of CTE, including corticobasal degeneration, multiple system atrophy, vitamin B12 deficiency, neurosyphilis, frontotemporal dementia and Alzheimer's disease.
Spinal Endoscopy for Delayed-Onset Lumbar Radiculopathy Resulting from Foraminal Stenosis after Osteoporotic Vertebral Fracture: A Case Report of a New Surgical Strategy
Authors: Yuyu Ishimoto, Hiroshi Yamada, Elizabeth Curtis, Cyrus Cooper, Hiroshi Hashizume, Akihito Minamide, Yukihiro Nakagawa, Munehito Yoshida
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

There is little evidence regarding the optimal approach to treatment for delayed-onset lumbar radiculopathy due to foraminal stenosis after osteoporotic vertebral fracture. Here, we describe the use of spinal endoscopy for the treatment of this disabling condition, in an 80-year-old woman presenting with severe radicular pain following an osteoporotic lumbar compression fracture. Radiographic findings showed the compression of the L2 root within the foramen, and computed tomography identified a fragment of the posterior wall of the vertebral body under the pedicle. Since the patient had little back pain and was relatively frail, we decided to perform foraminal decompression via a lateral approach using spinal endoscopy. Intraoperative findings demonstrated degenerative changes as well as a fragment of the posterior wall of the fractured vertebral body in the foramen, covered in a fibrous film. The nerve was decompressed on removal of the fragment. After surgery, the patient experienced immediate pain relief. The preoperative Japanese Orthopedic Association (JOA) and visual analogue scale (VAS) scores were 9 and 82, respectively, and at 36-month follow-up, scores were reduced to 19 and 34, respectively.
The Role of Benralizumab in Eosinophilic Immune Dysfunctions: A Case Report-Based Literature Review
Authors: Margarida Gomes, Ana Mendes, Filipa Ferreira, Joana Branco, Fernanda S Tonin, M Elisa Pedro
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

In the past years, the knowledge of eosinophils playing a primary pathophysiologic role in several associated conditions has led to the development of biologics targeting therapies aiming at normalizing the immune response, reducing chronic inflammation, and preventing tissue damage. To better illustrate the potential relationship between different eosinophilic immune dysfunctions and the effects of biological therapies in this scenario, here, we present a case of a 63-year-old male first referred to our department in 2018 with a diagnosis of asthma, polyposis, and rhinosinusitis and presenting a suspicion of nonsteroidal anti-inflammatory drugs' allergy. He also had a past medical history of eosinophilic gastroenteritis/duodenitis (eosinophilia counts >50 cells/high-power field HPF). The use of multiple courses of corticosteroid therapy failed to completely control these conditions. In October 2019, after starting benralizumab (an antibody directed against the alpha chain of the IL-5 cytokine receptor) as add-on treatment for severe eosinophilic asthma, important clinical improvements were reported both on the respiratory (no asthma exacerbations) and gastrointestinal systems (eosinophilia count 0 cells/HPF). Patients' quality of life also increased. Since June 2020, systemic corticosteroid therapy was reduced without worsening of gastrointestinal symptoms or eosinophilic inflammation. This case warns of the importance of early recognition and appropriate individualized treatment of eosinophilic immune dysfunctions and suggests the conduction of further larger studies on the use of benralizumab in gastrointestinal syndromes aiming at better understanding its relying mechanisms of action in the intestinal mucosa.
Evaluation of passenger satisfaction of urban multi-mode public transport
Authors: Xinhuan Zhang, Hongjie Liu, Mingming Xu, Chengyuan Mao, Junqing Shi, Guolian Meng, Jinhong Wu
Journal: PLoS One (2020)
MeSH terms: Consumer Behavior, Models, Theoretical, Transportation / methods, Research Support, Non-U.S. Gov't, Adolescent, Adult, Aged, China, Cities, Female, Humans, Male, Middle Aged, Railroads, Surveys and Questionnaires, Young Adult

The scientific evaluation of passenger satisfaction for public transport is helpful to enhance the attraction of public transport. To improve the accuracy of passenger satisfaction evaluation for public transport and the scientificity and objectivity of the index weighting, combining the characteristics of analytic hierarchy process (AHP), entropy weight method (EWM) and fuzzy comprehensive evaluation(FCE) method, the passenger satisfaction evaluation system for Ningbo's urban public transportation was built. The paper analyzed 5046 questionnaires on conventional bus transit and 1682 questionnaires on rail transit in Ningbo city, Passenger satisfaction for Ningbo city's public transport was evaluated comprehensively, and the evaluation results showed that the overall passenger satisfaction of the public transport in Ningbo was 91.2 in 2019, The case study shows that the application of the AHP-EWM-FCE model on the multi-mode public transport system can objectively quantify passengers' feelings about urban public transport service, and thus provide a theoretical basis for the improvement of passenger satisfaction in Ningbo.
Septic Pulmonary Embolism Case Report: Optimal Outcome after Insertion of an Inferior Vena Cava Filter in a Patient with Staphylococcus aureus Bacteraemia
Authors: Isabel Esteves, Sofia Vidal Castro, Francisco Abecasis, Cristina Camilo, Marisa Vieira, Dinis da Gama, Manuela Correia
Journal: Int J Pediatr (2010)
MeSH terms: Case Reports

A 14-year-old patient presented with bilateral pneumonia and pleural effusions, septic arthritis of the hip, deep venous thrombosis, and pulmonary thromboembolism. Methicillin-sensitive Staphylococcus aureus (S. aureus) containing the Panton Valentine Leukocidin (PVL) genes was isolated. Contraindication to anticoagulation prompted inferior vena cava filter placement. He completed 4 weeks of treatment with flucloxacillin, with good clinical outcome. S. aureus containing PVL genes should be sought in cases of necrotizing pneumonia as it seems to increase the risk of severe multifocal infection and thrombotic complications. There are few reports of placement of filters during S. aureus sepsis and bacteraemia. This case highlights that when anticoagulation is not feasible, an inferior vena cava filter can be inserted safely, even in patients with active sepsis and high risk for seeding of the filter. Long-term follow-up confirmed a successful outcome with sterilization of the septic thrombosis with no further pulmonary embolism or additional sepsis episodes.
The way a nose could affect pregnancy: severe and recurrent epistaxis
Authors: Laura Giambanco, Vito Iannone, Maddalena Borriello, Giuseppe Scibilia, Paolo Scollo
Journal: Pan Afr Med J (2019)
Keywords: epistaxis, anaemia, pregnancy
MeSH terms: Epistaxis / complications, Nose / pathology, Pregnancy Complications / pathology, Case Reports, Review, Adult, Epistaxis / therapy, Female, Humans, Pregnancy, Pregnancy Complications / therapy, Recurrence, Severity of Illness Index

Massive and severe epistaxis is an uncommon event in pregnancy. It could be life threatening and could affect the normal pregnancy course. The best management is still on debate; it could be medical, conservative or surgical. Pregnancy termination often is problem solving. Hormonal changes during pregnancy affects nasal physiology. Vaginal delivery, labour induction or cesarean section are all suitable, after hemodynamic stabilization of pregnant woman. We report a case and review the available literature.
Rapid Metagenomic Next-Generation Sequencing during an Investigation of Hospital-Acquired Human Parainfluenza Virus 3 Infections
Authors: Alexander L Greninger, Danielle M Zerr, Xuan Qin, Amanda L Adler, Reigran Sampoleo, Jane M Kuypers, Janet A Englund, Keith R Jerome
Journal: J Clin Microbiol (2016)
Keywords: hpiv3, hospital-acquired infections, human parainfluenza 3 virus, infection prevention, mngs, metagenomics, next-generation sequencing, parainfluenza, rapid sequencing, viral sequencing
MeSH terms: Cross Infection / epidemiology, Disease Outbreaks, High-Throughput Nucleotide Sequencing, Metagenomics, Molecular Epidemiology, Parainfluenza Virus 3, Human / isolation & purification, Respirovirus Infections / epidemiology, Case Reports, Adolescent, Child, Child, Preschool, Cluster Analysis, Cross Infection / virology, Female, Hospitals, Pediatric, Humans, Infant, Infant, Newborn, Male, Parainfluenza Virus 3, Human / classification, Parainfluenza Virus 3, Human / genetics, Phylogeny, Respirovirus Infections / virology, Sequence Homology, Time Factors, Young Adult

Metagenomic next-generation sequencing (mNGS) is increasingly used for the unbiased detection of viruses, bacteria, fungi, and eukaryotic parasites in clinical samples. Whole-genome sequencing (WGS) of clinical bacterial isolates has been shown to inform hospital infection prevention practices, but this technology has not been utilized during potential respiratory virus outbreaks. Here, we report on the use of mNGS to inform the real-time infection prevention response to a cluster of hospital-acquired human parainfluenza 3 virus (HPIV3) infections at a children's hospital. Samples from 3 patients with hospital-acquired HPIV3 identified over a 12-day period on a general medical unit and 10 temporally associated samples from patients with community-acquired HPIV3 were analyzed. Our sample-to-sequencer time was <24 h, while our sample-to-answer turnaround time was <60 h with a hands-on time of approximately 6 h. Eight (2 cases and 6 controls) of 13 samples had sufficient sequencing coverage to yield the whole genome for HPIV3, while 10 (2 cases and 8 controls) of 13 samples gave partial genomes and all 13 samples had >1 read for HPIV3. Phylogenetic clustering revealed the presence of identical HPIV3 genomic sequence in the two of the cases with hospital-acquired infection, consistent with the concern for recent transmission within the medical unit. Adequate sequence coverage was not recovered for the third case. This work demonstrates the promise of mNGS for providing rapid information for infection prevention in addition to microbial detection.
Medication-Related Osteonecrosis of the Jaw with Spontaneous Hemimaxilla Exfoliation: Report of a Case in Metastatic Renal Cancer Patient under Multidrug Therapy
Authors: F Bennardo, C Buffone, D Muraca, A Antonelli, A Giudice
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Medication-related osteonecrosis of the jaw (MRONJ) is a well-recognized complication of drug therapies for bone metabolic disorders or cancer related to administration of antiresorptive (bisphosphonates and denosumab) and antiangiogenic drugs. This report describes an advanced and unusual case of stage III peri-implantitis-induced MRONJ involving the right upper jaw which was attempting to self-exfoliate. A 61-year-old male patient, rehabilitated with the placement of two implants when he was still healthy, was suffering from metastatic renal cancer previously treated with bevacizumab, interleukin-2, zoledronic acid, denosumab, cabozantinib and nivolumab. He had been under treatment of nonsurgical therapy over a year, based on antibiotic and antiseptic mouth rinse, without improvement of oral conditions. Surgical treatment consisted of massive sequestrectomy and complete surgical debridement of necrotic bone tissues. The specimen was sent for histopathologic analysis, which confirmed bone tissue necrosis with no evidence of metastatic disease. Two-month follow-up revealed a considerable life quality improvement. Although this complication is well known, the uniqueness of this case is given by its severity, related to the administration of multiple antiresorptive and antiangiogenic drugs, by the natural response of the oral cavity with the almost complete self-exfoliation of the massive necrotic zone. This case is emblematic in highlighting the controversies in the management of MRONJ, which certainly require effective collaboration of the multidisciplinary health care team that could improve patient safety and reduce the risk of developing MRONJ.
Factitious Cushing's Syndrome: A Diagnosis to Consider When Evaluating Hypercortisolism
Authors: Maria M Pineyro, Lia Redes, Sylvana De Mattos, Luciana Sanchez, Estefania Brignardello, Virginia Bianchi, Vanessa Ems, Dardo Centurión, Marcelo Viola
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: cushing's syndrome, factitious cushing's syndrome, hypercortisolism, liquid chromatography-tandem mass spectrometry, synthetic glucocorticoid screen
MeSH terms: Case Reports

Factitious Cushing's syndrome is exceptionally rare. The diagnosis is challenging due to the interference of exogenous corticosteroids with cortisol immunoassays. We present a case of a 26 year old female that presented with clinical and biochemical features of Cushing's syndrome. She denied any exogenous corticosteroid use. She had a suppressed ACTH level with normal adrenal glands on CT scans. There was a paradoxical increase of cortisol with a 100% rise in 24 h urinary free cortisol (UFC) during the Liddle's test suggestive of primary pigmented nodular adrenocortical disease (PPNAD). However, basal UFC levels were within normal values, interpreted as an intermittent variation of cortisol secretion maybe due to cyclic Cushing's. At this point a synthetic glucocorticoid serum screening was ordered, which was denied by the administrators because the test was not available in our hospital. A positron emission tomography (PET)-CT using 18 F-Flurodeoxyglucose did not show any uptake in the adrenal glands. With the diagnosis of probable primary pigmented nodular adrenocortical disease a unilateral right adrenelectomy was performed. Histopathological examination revealed normal adrenal gland. A synthetic glucocorticoid serum screen by liquid chromatography-tandem mass spectrometry (LC-MS/MS) sent to Mayo Clinic lab revealed high levels of serum prednisone and prednisolone. In conclusion, factitious Cushing's syndrome is an important diagnosis to consider in patients being evaluated for hypercortisolism. Discordant hormonal test results as well as normal findings on adrenal glands on CT scan should raise suspicion of this entity, and prompt measurement of synthetic corticosteroids using LC-MS/MS.
Spontaneous resolution of asymptomatic hepatic pseudoaneurysm post radiofrequency ablation
Authors: Li Shyan Ch'ng, Estrellita Elena Mohd Tazuddin, Benny Young, Ahmad Faizal Mohd Ali
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Radiofrequency ablation (RFA) of a hepatic tumour is an established treatment option with an acceptable complication rate. Formation of a pseudoaneurysm after RFA of liver metastasis is an uncommon complication. We report the case of a 69-year-old female patient developing a hepatic pseudoaneurysm after RFA of liver metastasis. On a follow-up CT scan 6 weeks later, there was spontaneous resolution of the pseudoaneurysm. Hepatic pseudoaneurysms are usually treated owing to the risk of rupture. Invasive procedures or conservative management of an asymptomatic hepatic pseudoaneurysm is still the subject of debate. The spontaneous resolution of a hepatic pseudoaneurysm in our patient suggests that an asymptomatic pseudoaneurysm maybe observed for resolution instead of being treated at presentation.
Long-term therapy of interferon-alpha induced pulmonary arterial hypertension with different PDE-5 inhibitors: a case report
Authors: Nicoline Jochmann, Felix Kiecker, Adrian C Borges, Maja A Hofmann, Stephan Eddicks, Wolfram Sterry, Gert Baumann, Uwe Trefzer
Journal: Cardiovasc Ultrasound (2005)
MeSH terms: Hypertension, Pulmonary / chemically induced, Hypertension, Pulmonary / drug therapy, Imidazoles / administration & dosage, Interferon-alpha / adverse effects, Phosphodiesterase Inhibitors / administration & dosage, Piperazines / administration & dosage, Case Reports, 3',5'-Cyclic-GMP Phosphodiesterases, Adult, Cyclic Nucleotide Phosphodiesterases, Type 5, Female, Humans, Interferon-alpha / therapeutic use, Melanoma / drug therapy, Phosphoric Diester Hydrolases / drug effects, Purines, Sildenafil Citrate, Sulfones / administration & dosage, Time Factors, Treatment Outcome, Triazines / administration & dosage, Vardenafil Dihydrochloride, Imidazoles, Interferon-alpha, Phosphodiesterase Inhibitors, Piperazines, Purines, Sulfones, Triazines, Vardenafil Dihydrochloride, Sildenafil Citrate, Phosphoric Diester Hydrolases, 3',5'-Cyclic-GMP Phosphodiesterases, Cyclic Nucleotide Phosphodiesterases, Type 5, PDE5A protein, human

Background:
Interferon alpha2 is widely used in hepatitis and high-risk melanoma. Interferon-induced pulmonary arterial hypertension as a side effect is rare.
Case presentation:
We describe a melanoma patient who developed severe pulmonary arterial hypertension 30 months after initiation of adjuvant interferon alpha2b therapy. Discontinuation of interferon did not improve pulmonary arterial hypertension. This patient could be treated successfully with phosphodiesterase-5 inhibitor therapy.
Conclusion:
This is only the 5th case of interferon-induced pulmonary arterial hypertension and the first documented case where pulmonary arterial hypertension was not reversible after termination of interferon alpha2 therapy. If interferon alpha2 treated patients develop respiratory symptoms, pulmonary arterial hypertension should be considered in the differential diagnosis. For these patients phosphodiesterase-5 inhibitors, e.g. sildenafil or vardenafil, could be an effective therapeutic approach.