OpenMed/multicare-articles huggingface dataset:
Elevated midbrain serotonin transporter availability in mixed mania: a case report
Authors: Tommi Tolmunen, Mikko Joensuu, Pirjo Irmeli Saarinen, Hanna Mussalo, Pasi Ahola, Ritva Vanninen, Jyrki Kuikka, Jari Tiihonen, Johannes Lehtonen
Journal: BMC Psychiatry (2004)
MeSH terms: Bipolar Disorder / diagnosis, Bipolar Disorder / metabolism, Cocaine / analogs & derivatives, Membrane Glycoproteins / metabolism, Membrane Transport Proteins / metabolism, Mesencephalon / metabolism, Nerve Tissue Proteins / metabolism, Case Reports, Research Support, Non-U.S. Gov't, Adult, Bipolar Disorder / diagnostic imaging, Corpus Striatum / chemistry, Corpus Striatum / diagnostic imaging, Corpus Striatum / metabolism, Depressive Disorder, Major / diagnosis, Depressive Disorder, Major / diagnostic imaging, Depressive Disorder, Major / metabolism, Dopamine Plasma Membrane Transport Proteins, Female, Humans, Iodine Radioisotopes, Membrane Glycoproteins / analysis, Membrane Transport Proteins / analysis, Mesencephalon / chemistry, Mesencephalon / diagnostic imaging, Nerve Tissue Proteins / analysis, Psychiatric Status Rating Scales, Psychotherapy, Serotonin Plasma Membrane Transport Proteins, Tomography, Emission-Computed, Single-Photon, Dopamine Plasma Membrane Transport Proteins, Iodine Radioisotopes, Membrane Glycoproteins, Membrane Transport Proteins, Nerve Tissue Proteins, SLC6A3 protein, human, SLC6A4 protein, human, Serotonin Plasma Membrane Transport Proteins, N-nor-3-(4'-iodophenyl)tropane-2-carboxylic acid methyl ester, Cocaine

Background:
Results obtained from brain imaging studies indicate that serotonin transporter (SERT) and dopamine transporter (DAT) densities are altered in major depression. However, no such studies have been published on current mania or hypomania.
Case presentation:
In this single photon emission computed tomography (SPECT) study with [123I]nor-beta-CIT we present a case with simultaneous symptoms of major depression and hypomania. She had an elevated serotonin transporter availability (SERT) in the midbrain and elevated dopamine transporter availability (DAT) in the striatum, which normalised in a one-year follow-up period during which she received eight months of psychodynamic psychotherapy.
Conclusions:
To our knowledge, this is the first report on SERT and DAT associated with mania. In our case the availability of both SERT in the midbrain and DAT in the striatum were elevated at baseline and declined during psychotherapy, while the SERT and DAT of the depressed controls increased during psychotherapy. Symptoms of hypomania in the case were alleviated during psychotherapy. Clinical recovery was also reflected in the Hamilton Depression Rating Scale (HDRS) scores.
Schizophrenia-like psychosis and gitelman syndrome: a case report and literature review
Authors: Bing Pan, Lijun Mou, Huichun Li, Weibo Liu, Ying Hu
Journal: Springerplus (2016)
Keywords: gitelman syndrome, hypokalemia, hypomagnesemia, schizophrenia-like psychosis

Introduction:
Gitelman syndrome(GS) is a rare inherited tubular disorder which is characterized by hypokalemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria. Here, we report a case of schizophrenia-like psychosis concomitant with GS and related literatures are reviewed.
Case description:
An 18-year-old male patient with 1-week history of auditory hallucinations, sense of insecurity, delusions of reference and feelings of being followed and controlled by others unknown, insomnia was admitted to Psychiatry department in December, 2013. Hypokalemia and hypomagnesemia were noted. He was diagnosed as schizophrenia-like psychosis. Treatment with paliperidone at the dose of 6 mg/day and magnesium and potassium supplementations was commenced. However, electrolyte disturbances failed to improve following psychosis remission. Therefore, other underlying diseases resulting in electrolyte disturbances were suspected. Along with hypokalemia and hypomagnesemia, additional investigation showing metabolic alkalosis, hypocalciuria, renal loss of potassium, were consistent with GS. Gene analysis revealed this patient carried out c. 2687 G > A homozygous mutation of exon 23 in the SLC12A3 gene which led to p.Arg896Gln. Eventually, GS was identified. Thus, additional spironolactone (40 mg/day) combined with increased doses of oral potassium chloride sustained-release tablets (3.0 g/day) and potassium magnesium aspartate (0.3 g/day) were administered. During next half a year, fatigue resolved, paliperidone gradually tapered and eventually discontinued while psychosis maintained complete remission. His serum potassium was near normal (3.2-3.5 mmol/L), hypomagnesemia significantly improved (0.57-0.67 mmol/L).
Discussion and evaluation:
Electrolyte abnormalities secondary to GS might cause or contribute to development of neuropsychiatric symptoms. In turn, hypokalemia was common among acute psychiatric inpatients. As a consequence, when concomitant with psychosis, GS was readily concealed.
Conclusion:
Electrolyte disturbances are common in acute psychiatric patients. However, when electrolyte disturbances are not improved following psychosis remission, other underlying diseases such as GS should be considered.
Cheiro-Oral syndrome caused by thalamus hemorrhage: A case report
Authors: Yen-Hung Wu, Kuan-Ting Liu, I-Jeng Yeh, Chia-Wen Chang
Journal: Medicine (Baltimore) (2018)
MeSH terms: Cerebral Hemorrhage / complications, Sensation Disorders / etiology, Case Reports, Aged, Cerebral Hemorrhage / diagnostic imaging, Cerebral Hemorrhage / therapy, Diagnosis, Differential, Humans, Male, Mouth, Sensation Disorders / diagnostic imaging, Sensation Disorders / therapy, Syndrome, Thalamus / diagnostic imaging, Tomography, X-Ray Computed, Upper Extremity

Rationale:
Cheiro-Oral syndrome (COS) is a pure sensory deficit confined to the perioral area and ipsilateral distal fingers or hand. Owing to relatively minor clinical findings and various presentations in different cases, the insidious and severe illness it implies may be overlooked at acute settings.
Patient concerns:
A 70-year-old man with history of hypertension and type II diabetes mellitus under regular medication control came to our emergency department with chief complaint of sudden onset of right perioral region and right upper limb numbness. General physical and neurological examinations were normal except for subtle hypoesthesia to light touch, and pinprick in the right corner of mouth and right forearm to distal fingers.
Diagnoses:
Routine blood analysis was all in normal range including white blood cell count, hemocrit platelet, renal and liver function, and electrolytes such as sodium and potassium. Noncontrast brain computed tomography showed abnormal high-attenuation collection in the left thalamus.
Intervention:
Follow-up computed tomography showed absorption of the hemorrhage after strict control of his blood pressure.
Outcomes:
The patient was discharged 7 days later from our hospital with stable condition.
Lessons:
We demonstrated type I COS associated with thalamic hemorrhage to highlight the neurological implication of COS. It is crucial for emergency clinicians to recognize the symptoms and promptly order a neuroimaging study to exclude large infarction/hemorrhage, which would deeply affect the disposition and following treatment of the patient.
Immunemodulatory Effects of 5-Azacitidin Through Expansion of Functional Regulatory T Cells on Paraneoplastic Inflammation Associated With Myelodysplastic Syndromes: A Case Report
Authors: Kentaro Serizawa, Hirokazu Tanaka, Yasuyoshi Morita, Takahide Taniguchi, Takashi Ashida, Itaru Matsumura
Journal: Front Oncol (2018)
Keywords: azacitidine, case report, myelodysplastic syndrome, regulatory t cell, sweet’s syndrome
MeSH terms: Case Reports

Myelodysplastic syndrome (MDS) is a heterogeneous group of clonal disorders of hematopoietic stem cells, characterized by dysplastic hematopoiesis and dysregulated immune system resulting in various clinical conditions. Paraneoplastic inflammatory syndromes, which are well known to be associated with MDS, show response to immune-modulated therapy and often disappear during the course of hematologic management. Azacitidine (5-Aza) was shown to prolong survival of high-risk MDS patients, however, the effects of 5-Aza on paraneoplastic inflammation in MDS have yet to be elucidated. 5-Aza was administered to a 60-year-old man with MDS accompanying Sweet's syndrome at a dose of 75 mg/m2/daily subcutaneously for 7 days every 28 days. 5-Aza was not only effective in controlling systemic symptoms caused by paraneoplastic inflammation, but hematologic improvements were also observed after four cycles of the 5-Aza treatment. Immune profiling in peripheral blood before and after 5-Aza treatment revealed that the effector and naive regulatory T cells in lymphocytes drastically increased after the 5-Aza treatment, i.e., 5-Aza might induce a shift in lymphocytic populations toward immunosuppression in this patient. Our results raised the immune-mediated effect of 5-Aza on both dysplastic hematopoiesis and paraneoplastic inflammation in myelodyplastic syndromes.
Ovarian Torsion after Hysterectomy: Case Report and Concise Review of the Reported Cases
Authors: Demetrio Larraín, Andrés Casanova, Iván Rojas
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Ovarian torsion after hysterectomy is a rare event. The diagnosis of ovarian torsion is challenging because symptoms are nonspecific. We present a case of ovarian torsion 2 years after laparoscopic hysterectomy (LH). Furthermore, we performed a literature review about ovarian torsion after hysterectomy. This case shows that, in cases of acute onset pelvic pain in patients with history of hysterectomy, the adnexal torsion must be kept in mind in the differential diagnosis, especially in those women who had undergone LH.
Temporal Course of Cerebral Autoregulation in Patients With Narcolepsy Type 1: Two Case Reports
Authors: Zhen-Ni Guo, Xin Sun, Yingkai Zhao, Xiuli Yan, Ran Zhang, Zan Wang, Yi Yang
Journal: Front Neurol (2019)
Keywords: cerebral autoregulation, fluoxetine, hypocretin, narcolepsy, venlafaxine
MeSH terms: Case Reports

Cerebral autoregulation is the mechanism by which constant cerebral blood flow is maintained despite changes in arterial blood pressure. In the two presented cases, cerebral autoregulation was impaired in patients with narcolepsy type 1, and both venlafaxine and fluoxetine may have the potential to improve the impaired cerebral autoregulation. A relationship may exist between impaired cerebral autoregulation and neurological symptoms in patients with narcolepsy type 1.
Reaction or infection: topical chloramphenicol treatment
Authors: R J Livingston, J W Butterworth, P Belt
Journal: Ann R Coll Surg Engl (2013)
MeSH terms: Anti-Bacterial Agents / adverse effects, Chloramphenicol / adverse effects, Drug Eruptions / etiology, Skin Diseases, Bacterial / diagnosis, Case Reports, Administration, Cutaneous, Aged, Anti-Bacterial Agents / administration & dosage, Carcinoma, Basal Cell / surgery, Chloramphenicol / administration & dosage, Diagnosis, Differential, Drug Eruptions / diagnosis, Female, Humans, Ointments, Postoperative Complications / chemically induced, Postoperative Complications / diagnosis, Skin Neoplasms / surgery, Anti-Bacterial Agents, Ointments, Chloramphenicol

Chloramphenicol is a topical treatment that is used widely, especially in wounds around the eyes. In our practice there have been a number of cases of delayed hypersensitivity to chloramphenicol that has been mismanaged initially as an infective cellulitis. We hope to share some of our experience of this uncommon reaction to highlight the delayed reaction that can occur with topical application of this drug.
Exertional heat stroke in a young military trainee: is it preventable?
Authors: Buddhika T B Wijerathne, Senaka D Pilapitiya, Vadivel Vijitharan, Mohammed M F Farah, Yashodhara V M Wimalasooriya, Sisira H Siribaddana
Journal: Mil Med Res (2016)
Keywords: asymptomatic infection, heat stroke, military trainee

Background:
Heat stroke is a life-threatening condition with exertional heat stroke occurring frequently among soldiers and athletes. Because of its common occurrence, many military trainees practice preventive measures prior to any activity requiring severe exertion. Although it is said to be common in practice, different presentations of heat stroke are scarcely described in literature.
Case presentation:
We describe a case of an exertional heat stroke in a 23-year-old male Sinhalese soldier who developed early changes of renal failure, liver failure and rhabdomyolysis. The patient initially presented with convulsions, delirium and loss of consciousness to an outside health care facility before being transferred to our institution.
Conclusion:
It is clear that heat stroke does occur in military trainees while preventive strategies are being practiced. It is important for those who provide healthcare to soldiers to provide proper advice on how to identify impending heat stroke prior to any exercises resulting in severe physical exertion. Further, treating physicians should educate all military trainees about preventive strategies.
Successful Salvage of a Renal Allograft after Acute Renal Vein Thrombosis due to May-Thurner Syndrome
Authors: Omkar U Vaidya, Todd Buersmeyer, Rebecca Rojas, Bart Dolmatch
Journal: Case Rep Transplant (2012)

A 68-year-old Caucasian female with a past medical history of a deceased donor kidney transplant four months prior was admitted with a two-day history of anuria and acute kidney injury. A renal ultrasound demonstrated thrombus in the transplanted kidney's renal vein that extended into the left iliac vein as well as into the left femoral venous system. Catheter-guided tissue thrombolytics were infused directly into the clot. Within twelve hours of initiating thrombolytic infusion, there was brisk urine output. Interval venography demonstrated decreasing clot burden. At the time of discharge her creatinine was 0.78 mg/dL, similar to her baseline value prior to presentation. The patient was noted to have May-Thurner syndrome on intravascular ultrasound (IVUS). Angioplasty followed by stent placement was done. Unique to our case report was the timing of the presentation of renal vein thrombosis (four months after transplant) and the predisposing anatomy consistent with May-Thurner syndrome, which was diagnosed with IVUS and successfully treated with local thrombolytics.
When Is the Optimal Timing of Surgical Intervention for Severe Functional Tricuspid Regurgitation?
Authors: Nobuhiro Nakanishi, Masanobu Ishii, Koichi Kaikita, Ken Okamoto, Yasuhiro Izumiya, Eiichiro Yamamoto, Seiji Takashio, Seiji Hokimoto, Toshihiro Fukui, Kenichi Tsujita
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Functional tricuspid regurgitation (TR) is a serious pathology to be noted for severe right heart failure (HF) and poor prognosis; however, the conventional assessment of TR has some limitations and the optimal timing of surgical intervention remains unclear. A 79-year-old Japanese female was admitted to our hospital to undergo cardiac surgery, because edema gradually got worse despite the increase in diuretics. She had a history of atrial fibrillation (AF) and chronic HF due to severe TR and had been treated with a furosemide for leg edema 4 years ago. A transthoracic echocardiogram (TTE), transesophageal echocardiogram, cardiac magnetic resonance imaging, and cardiac pool scintigraphy demonstrated severe functional TR with tricuspid annular dilation, insufficient tricuspid valve coaptation, and reduced right ventricular ejection fraction (EF) but preserved left ventricular EF. In addition, Swan-Ganz catheter study showed normal pulmonary arterial wedge pressure and mean pulmonary arterial pressure. Tricuspid ring annuloplasty was performed with MC3 ring. Postoperative TTE showed trivial TR, and she had no edema with normal sinus rhythm two months later. Annuloplasty to severe functional TR caused by tricuspid annular dilation due to AF dramatically improved right HF. Cardiologist should pay strict attention to the optimal timing of surgical intervention for TR.
Right sided Bochdalek diaphragmatic hernia appeared as a life-threatening event in an infant: a case report
Authors: Charikleia Demiri, Vasilios Mouravas, Vasilios Lambropoulos, Chrysostomos Kepertis, Kleanthis Anastasiadis, Ioannis Spyridakis
Journal: Pan Afr Med J (2021)
Keywords: right sided bochdalek hernia, case report, life-threatening condition, paediatric surgery
MeSH terms: Hernias, Diaphragmatic, Congenital / diagnostic imaging, Laparotomy / methods, Case Reports, Female, Hernias, Diaphragmatic, Congenital / complications, Hernias, Diaphragmatic, Congenital / surgery, Humans, Infant, Shock / etiology, Tomography, X-Ray Computed

We report a case of a 5-month-old female infant who presented with a cardiorespiratory distress and shock. After thoracic computed tomography (CT) scan, a right sided Bochdalek hernia was diagnosed with massive herniation of the abdominal viscera causing mediastinal shift. The girl underwent emergency laparotomy, which confirmed the right sided diaphragmatic hernia with herniation of small bowel and colon. After reduction of herniated contents, the defect in the diaphragm was closed. The patient had an uneventful post-operative cause. This case demonstrates that an undiagnosed Bochdalek hernia can appear with such a severe, life-threatening and misleading presentation.
Granulosis Rubra Nasi: A Case Report and Brief Review of the Literature
Authors: Girum T Assefa
Journal: Case Rep Dermatol Med (2023)
MeSH terms: Case Reports

Granulosis rubra nasi is a rare autosomal dominant disease of the eccrine glands. It is clinically characterized by mid-face hyperhidrosis, most prominent at the tip of the nose, and dark erythematous papules on the nose, cheeks, chin, and upper lip. Although it commonly occurs in childhood, it can also occur in adults. This is a case report of two female granulosis rubra nasi patients. This report, to the best of my knowledge, has not before been described in Ethiopian individuals and is hence being reported due to its rarity.
Stridor in a Newborn with Double Aortic Arch-A Case Report
Authors: Elsie-Jane Anastasius, Halimuddin Sawali
Journal: Iran J Otorhinolaryngol (2019)
Keywords: double aortic arch, stridor, vascular ring
MeSH terms: Case Reports

Introduction:
Double aortic arch (DAA) is a congenital anomaly of the aortic arch. It is the most common type of complete vascular ring. When it occurs, the connected segment of the aortic arch and its branches encircle the trachea and esophagus, leading to symptoms related to these two structures.
Case report:
We present a case of a newborn baby who developed biphasic stridor immediately after a normal vaginal delivery. Endoscopic assessment of the trachea revealed a pulsatile narrowing at the level of the thoracic trachea, suggestive of an external compression. A contrast-enhanced computed tomography scan of the thorax with three-dimensional reconstruction confirmed the diagnosis of DAA with compression of the trachea and esophagus.
Conclusion:
Clinicians should strongly consider the possibility of a congenital vascular ring compression should an infant with a normal upper airway present with stridor. A precise diagnosis can be made by radiological examination.
Huge Trichilemmal Carcinoma With Metastasis Presenting With Two Distinct Histological Morphologies: A Case Report
Authors: Yao Xie, Lin Wang, Tingting Wang
Journal: Front Oncol (2021)
Keywords: case report, distant metastasis, histological morphologies, skin tumor, trichilemmal carcinoma
MeSH terms: Case Reports

Background:
Trichilemmal carcinoma (TC) is a rare malignancy of cutaneous adnexal carcinoma, with only 136 cases reported in the literature to date. It usually has an indolent course and benign clinical evolution, and only four cases with regional and distant metastasis have been reported. Tumor cells present with the characteristics of trichilemmal differentiation on both histological and immunohistological examination.
Case presentation:
We report a case of TC on the scalp with an aggressive course and metastasis to the ipsilateral neck. Moreover, the lesions presented with two distinct histological morphologies.
Conclusion:
Despite an indolent course and benign clinical evolution, TC has the potential for local invasion and recurrence, which implies that accurate early diagnosis and careful follow-up are very important for these patients. More than one specimen should be obtained for histopathological examinations when the lesion is very large and characterized by different morphologies.
Duodenal wedge resection for large gastrointestinal stromal tumour presenting with life-threatening haemorrhage
Authors: Alexander Shaw, John Jeffery, Laura Dias, Sarfraz Nazir
Journal: Case Rep Gastrointest Med (2013)

Background. Duodenal gastrointestinal stromal tumours (GISTs) are an uncommon malignancy of the gastrointestinal (GI) tract. We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding. After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5 cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy. A successful limited wedge resection of the tumour mass was performed. Histopathology subsequently confirmed a duodenal GIST. The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread. Conclusion. Duodenal GISTs can present with life-threatening upper GI haemorrhage. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.
Isolated renal mucormycosis presenting with bilateral renal artery thrombosis: a case report
Authors: P S Saneesh, Raghav Yelamanchi, Shalini Pilllai
Journal: Afr J Urol (2021)
Keywords: acute kidney injury, bilateral renal artery thrombosis, case report, mucormycosis, sepsis, septic thrombus

Background:
Mucormycosis is a rare infection caused by the fungus belonging to the order Mucorales. Mucormycosis predominantly affects immunocompromised individuals such as people with acquired immunodeficiency syndrome, blood malignancies, organ transplant, etc. Involvement of the kidneys usually occurs as a result of disseminated mucormycosis. We report a very rare case of isolated renal mucormycosis in an immunocompetant individual without any prior comorbidities who had an unusual presentation of mucormycosis.
Case presentation:
A 17-year-old male student had presented to our emergency department with complaints of bilateral loin pain and fever for 10 days. There was no urine output for 2 days. Patient was in sepsis with acute kidney injury. A Doppler ultrasound of the abdomen revealed bilateral enlarged kidneys with absent blood flow in the renal vasculature. Dialysis was done, and patient was started on intravenous antibiotics. Patient was investigated for thrombophilia, the test results of which were normal. Sickle cell test was negative. Immunodeficiency screening was negative. Contrast-enhanced computed tomography revealed bilateral enlarged kidneys with bilateral renal artery thrombosis and mild ascitis. CT-guided renal biopsy was performed in the same sitting which revealed fungal hyphae in the background of necrotic glomeruli. Patient was started on liposomal amphotericin B with renal replacement therapy. However, patient deteriorated and succumbed to sepsis on the 4th day of admission.
Conclusion:
Isolated renal mucormycosis with bilateral renal artery thrombosis is a very rare clinical scenario with high mortality. One must have a high degree of suspicion to diagnose renal mucormycosis at an early stage.