OpenMed/multicare-articles huggingface dataset:
Pediatric Extramedullary Epidural Spinal Teratomas: A Case Report and Review of the Literature
Authors: David G Deckey, Andrea Fernandez, Nina J Lara, Steve Taylor, Jamal McClendon, David M Bennett
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Background:
Teratomas in the pediatric population are most commonly found in the sacrococcygeal region. Pediatric intraspinal teratomas, however, are an exceedingly rare central nervous system (CNS) neoplasm. The clinical presentation of these intraspinal neoplasms can vary significantly and thus can be difficult to identify in infants less than one year of age where verbal expression and motor development are still lacking. Case Description. A 7-month-old, previously healthy male presented with a thoracic scoliosis and an asymptomatic right midupper thoracic spinal prominence present since birth. MRI revealed an extensive heterogenous mass in the right epidural space from T5-T6 and the right paravertebral space, resulting in severe spinal stenosis. Outcome. Complete resection of the tumor, including a three-level neurotomy, was achieved by posterior decompression/laminectomy. The final tumor was consistent with a mature teratoma. The surgical resection was performed without any immediate complications.
Conclusions:
Extramedullary epidural teratomas are exceptionally rare tumors in the pediatric population. Clinical presentation can be ambiguous, particularly in an infant. MRI was useful in suggesting a teratoma as a potential diagnosis and for postoperative surveillance for recurrence. However, histopathological analysis remains the gold standard for definitive diagnosis. Surgical resection is the mainstay of treatment, especially in the setting of cord compression and progressive loss of motor function. Close follow-up is crucial to monitor for progressive spinal deformity or recurrence.
Cardiovascular magnetic resonance and PET-CT of left atrial paraganglioma
Authors: Anderanik Tomasian, Chi Lai, Stefan Ruehm, Mayil S Krishnam
Journal: J Cardiovasc Magn Reson (2010)
MeSH terms: Heart Neoplasms / diagnosis, Magnetic Resonance Imaging, Cine, Paraganglioma, Extra-Adrenal / diagnosis, Positron-Emission Tomography, Pregnancy Complications, Neoplastic / diagnosis, Tomography, X-Ray Computed, Case Reports, Adult, Biomarkers / urine, Cardiac Surgical Procedures, Catecholamines / urine, Female, Heart Atria / pathology, Heart Neoplasms / surgery, Heart Neoplasms / urine, Humans, Paraganglioma, Extra-Adrenal / surgery, Paraganglioma, Extra-Adrenal / urine, Predictive Value of Tests, Pregnancy, Pregnancy Complications, Neoplastic / surgery, Pregnancy Complications, Neoplastic / urine, Pregnancy Trimester, Third, Treatment Outcome, Biomarkers, Catecholamines

Cardiac paragangliomas are among the rarest primary cardiac tumors. We present a case of left atrial paraganglioma in a patient who presented with symptoms and signs of catecholamine excess in which cardiovascular magnetic resonance in multiple orientations and PET-CT played an important role in the diagnosis and tissue characterization.
Nasal and Nasopharyngeal Rosai-Dorfman Disease
Authors: Kelly Di Dier, Marc Lemmerling, Geert De Vos
Journal: J Belg Soc Radiol (2022)
Keywords: computed tomography, extranodal rosai-dorfman disease, magnetic resonance imaging, nasal cavity, nasopharynx
MeSH terms: Case Reports

Teaching Point: Nasal and nasopharyngeal Rosai-Dorfman disease is a rare cause of nasal obstruction.
Acanthomatous Ameloblastoma: An Early Stage Case Report with Difficult Management
Authors: Roberto Pippi, Marcello Santoro, Alessandra Pietrantoni, Angelina Pernazza
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

A case of a mandibular acanthomatous ameloblastoma, with an admixed little component of follicular type, is reported. The epidemiological features of the present case agree with those reported in the international literature. Clinico-radiographic differential diagnostic difficulties existed with several other noncystic osteolytic lesions of the mandible. Recurrence was diagnosed early 1 year after the initial excisional biopsy, and a definitive rim resection was therefore performed. No further recurrence occurred in the following 4-year follow-up.
Femoral head disengagement from Accolade femoral stem in MOM Arthroplasty: a case study and literature review
Authors: Mohamed F H Elsheikh, Rehan Gul
Journal: SICOT J (2019)

Metal on Metal Hip arthroplasty was commonly used until the last decade. However Hip Arthroplasty registries of many countries showed increased revision rates of MOM Hips - these high rates of revision caused by trunnionosis, adverse tissue reactions (ALTRs) and Pseudotumor formation. The Case: Our Case is 73 years old gentleman who had left MOM THR in 2008, and was doing fine till the beginning of 2018 when his left leg stuck while getting out of the car. Despite he heard the pop and his leg was shortened and externally rotated, but he was still walking on it for a while. On reviewing him in our orthopedic clinic and after getting the CT-scan showed that he had dislocated femoral head from the stem.
Case report: Persistent shedding of a live vaccine-derived rubella virus in a young man with severe combined immunodeficiency and cutaneous granuloma
Authors: Kimberly E Bonner, Ellie Sukerman, Juventila Liko, Tatiana M Lanzieri, Melissa Sutton, Emilio DeBess, Christopher Leesman, Joseph Icenogle, LiJuan Hao, Min-Hsin Chen, Raeesa Faisthalab, Richard F Leman, Paul R Cieslak, Suk See DeRavin, Ludmila Perelygina
Journal: Front Immunol (2022)
Keywords: gene therapy, inborn errors of immunity, live virus shedding, skin granuloma, vaccine-derived rubella virus, viral persistence
MeSH terms: Severe Combined Immunodeficiency, X-Linked Combined Immunodeficiency Diseases, Case Reports, Research Support, U.S. Gov't, P.H.S., Granuloma / genetics, Humans, Male, Measles-Mumps-Rubella Vaccine / adverse effects, Rubella virus, Measles-Mumps-Rubella Vaccine

A young man with X-linked severe combined immunodeficiency developed a persistent vaccine-derived rubella virus (VDRV) infection, with the emergence of cutaneous granulomas more than fifteen years after receipt of two doses of measles-mumps-rubella (MMR) vaccine. Following nasopharyngeal swab (NP) collection, VDRV was detected by real-time polymerase chain reaction (RT-qPCR) and sequencing, and live, replication-competent VDRV was isolated in cell culture. To assess duration and intensity of viral shedding, sequential respiratory samples, one cerebrospinal fluid sample, and two urine samples were collected over 15 months, and VDRV RNA was detected in all samples by RT-qPCR. Live VDRV was cultured from nine of the eleven respiratory specimens and from one urine specimen. To our knowledge, this was the first reported instance of VDRV cultured from respiratory specimens or from urine. To assess potential transmission to close contacts, NP specimens and sera were collected from all household contacts, all of whom were immunocompetent and previously vaccinated with MMR. VDRV RNA was not detected in any NP swabs from the contacts, nor did serologic investigations suggest VDRV transmission to any contacts. This report highlights the need to understand the prevalence and duration of VDRV shedding in granuloma patients and to estimate the risk of VDRV transmission to immune and non-immune contacts.
Extracellular Calcium Dictates Onset, Severity, and Recovery of Diarrhea in a Child with Immune-Mediated Enteropathy
Authors: Johnathan Fraebel, Regino Gonzalez-Peralta, Maryann Maximos, Genie L Beasley, Christopher Douglas Jolley, Sam Xianjun Cheng
Journal: Front Pediatr (2018)
Keywords: calcium, calcium metabolism, calcium-sensing receptor, diarrhea, immune-mediated enteropathy, inflammatory bowel disease, intestinal barrier function, ion transport
MeSH terms: Case Reports

Diarrhea causes monovalent and divalent ion losses that can influence clinical outcome. Unlike the losses of monovalent ions, such as Na+, K+, Cl-, and [Formula: see text], which are generally large in quantity (osmoles) and therefore determine the severity of diarrhea, the losses of divalent ions are relatively small in osmoles and are often overlooked during diarrheal treatment. Studies now suggest that despite divalent ions being small in osmoles, their effects are large due to the presence of divalent ion-sensing receptors and their amplifying effects in the gut. As a result, losses of these divalent ions without prompt replacement could also significantly affect the onset, severity, and/or recovery of diarrheal disease. Herein, we report a case of a malnourished child with an immune-mediated enteropathy who developed episodes of "breakthrough" diarrhea with concurrent hypocalcemia while on appropriate immunotherapy. Interestingly, during these periods of diarrhea, stool volume fluctuated with levels of blood Ca2+. When Ca2+ was low, diarrhea occurred; when Ca2+ levels normalized with replacement, diarrhea stopped. Based on this and other observations, a broader question arises as to whether the Ca2+ lost in diarrhea should be replaced promptly in these patients.
Concentric and Eccentric Target MRI Signs in a Case of HIV-Associated Cerebral Toxoplasmosis
Authors: Adam D Roche, Dominic Rowley, Francesca M Brett, Seamus Looby
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Cerebral toxoplasmosis is one of the most common causes of focal brain lesions in immunocompromised patients, such as those with human immunodeficiency virus (HIV). Differentiating toxoplasmosis from other central nervous system (CNS) lesions provides a significant clinical challenge. Magnetic resonance (MR) imaging of the brain is key to prompt diagnosis and treatment of cerebral toxoplasmosis. Several specific signs on MRI of brain have been described in recent literature including the "concentric target sign" and "eccentric target sign." We report a case of successfully treated HIV-associated cerebral toxoplasmosis in which both MRI signs were present simultaneously.
Can Children Have Ordinary Expectable Caregiving Environments in Unconventional Contexts? Quality of Care Organization in Three Mexican Same-Sex Planned Families
Authors: Fernando Salinas-Quiroz, Fabiola Rodríguez-Sánchez, Pedro A Costa, Mariana Rosales, Paola Silva, Verónica Cambón
Journal: Front Psychol (2018)
Keywords: attachment, collective case study, gay fathers, lesbian mothers, modern families, parenting styles and practices, quality of care, sensitivity

The aim of this research was to explore the elements that configure the quality of care among three Mexican same-sex planned families: two female-parented families (through donor insemination) and a male-parented one (through adoption). The first family consisted of two mothers and a 3-year-old daughter; the second one had two mothers and a 1.5-year-old set of boy twins and the third family consisted of two fathers and a 2-year-old girl. It was assumed that Ainsworth's notions of quality of care organization are useful in order to understand caregiver-child attachment relationships, regardless of the parents' sexual orientation. A collective case study was selected due to the fact that these families shared their "unconventionality" (i.e., parents were not heterosexual) and the fact that they were planned, but each one constituted a particular case with a unique configuration. Four trained independent observers used the q-sort methodology (Maternal Behavior Q-Sort and Attachment Q-Sort) to describe parents' and children's behavior, respectively. The findings showed that parents were highly sensitive and all children used them as a secure base. To provide an in-depth examination of which elements configure the quality of care, a semi-structured interview with each parent was carried out. Through a thematic analysis, an over-arching theme named Affections and Emotions was identified, together with six subthemes: (1) Creating an affective environment; (2) Being available; (3) Acknowledging and expressing emotions; (4) Perceiving, interpreting and responding adequately to the child's real self; (5) Taking the child's perspective into account; and (6) Agreeing on roles and dividing the tasks. In order to showcase the particular configuration of gay parenting, the male-headed family narrative is reported in detail, because gay parents have been perceived as violating traditional gender roles as well as the hegemonic model of masculinity. The findings were consistent with the notion of quality of care as proposed by Ainsworth and her collaborators. The implications of the methodological device and research regarding same-sex planned families are discussed so as to understand the organization of the caregiving environment.
Unilateral Upper Cervical Posterior Spinal Cord Infarction after a Neuroendovascular Intervention: A Case Report
Authors: Kareem Elzamly, Christa Nobleza, Ellen Parker, Rebecca Sugg
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Context:
We describe a case of unilateral posterior upper cervical spinal cord infarction and propose a pathophysiologic mechanism causing this lesion after vertebral artery endovascular intervention.
Findings:
A 70-year-old male presented with subacute onset of left hemibody sensory changes and gait instability following a left vertebral angioplasty procedure. MRI cervical spine revealed upper posterior cervical spinal cord infarction (PSCI). After 3 months patient had substantial improvement of his symptoms.
Conclusion:
PSCI is rare but can present as a complication from vertebral artery angioplasty procedure. Early diagnosis of PSCI can be achieved with adequate understanding of its clinical signs and the blood supply of the spinal cord.
Neck of Femur Fracture in a Patient with a Chronic Osteomyelitis of the Ipsilateral Foot
Authors: Anne-Carolin Döring, Anne J H Vochteloo, Kees van Doorn, Rianne M H A Huis In 't Veld, Anil Peters
Journal: Case Rep Orthop (2016)

This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis. Treating patients with this type of comorbidities is challenging; therapeutic dilemmas can be major. The management in cases like these requires a thorough evaluation and a clear surgical and medical treatment plan, preferably conducted by a multidisciplinary orthogeriatric team.
Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient
Authors: Ashwini Arjuna, Michael T Olson, Sofya Tokman, Rajat Walia, Thalachallour Mohanakumar, A Samad Hashimi, Michael A Smith, Ross M Bremner, Ashraf Omar
Journal: Case Rep Transplant (2021)
MeSH terms: Case Reports

Long-term survival after lung transplant remains severely limited by chronic lung allograft dysfunction. Antibody-mediated rejection of lung transplant allografts is usually caused by donor-specific antibodies (DSAs) directed toward donor human leukocyte antigens (HLAs). Typically, patients with antibody-mediated rejection have significantly higher circulating DSAs and increased mean fluorescence intensity than those without antibody-mediated rejection. However, some patients with antibody-mediated rejection have low mean fluorescence intensities, partly due to the "sponge effect" related to DSAs binding to HLA molecules within the lung. Herein, we report the case of an 18-year-old, female lung transplant recipient who required retransplantation and developed circulating DSAs directed toward the first allograft but detected in circulation only after retransplantation. The present case draws attention to a rare finding of sponge effect in a patient with antibody-mediated rejection leading to allograft failure.
Transient Periictal Brain Imaging Abnormality in a Saudi Patient with Probable Celiac Disease Epilepsy and Occipital Calcification Syndrome
Authors: Soha Khan, Asma AlNajjar, Abdullah Alquaydheb, Shahpar Nahrir
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

Celiac disease epilepsy and occipital calcification (CEC) syndrome is a rare, emerging disease first described in 1992. To date, fewer than 200 cases have been reported worldwide. CEC syndrome is generally thought to be a genetic, noninherited, and ethnically and geographically restricted disease in Mediterranean countries. However, we report the first ever case of probable CEC in a Saudi patient. Furthermore, the patient manifested a magnitude of brain magnetic resonance imaging (MRI) signal abnormalities during the periictal period which, to the best of our knowledge, has never been described in CEC. The brain MRI revealed diffusion-weighted imaging (DWI) restriction with a concordant area of apparent diffusion coefficient (ADC) hypointensity around bilateral occipital area of calcification. An imbalance between the heightened energy demand during ictal phase of the seizure and unadjusted blood supply may have caused an electric pump failure and cytotoxic edema, which then led to DWI/ADC signal alteration.
Brazilian family with hyperferritinemia-cataract syndrome: case report
Authors: Aline Morgan Alvarenga, Nathália Kozikas da Silva, Rodolfo Delfini Cançado, Luís Eduardo Morato Rebouças de Carvalho, Paulo Caleb Junior Lima Santos
Journal: Einstein (Sao Paulo) (2022)
MeSH terms: Cataract / diagnosis, Cataract / genetics, Hemochromatosis / genetics, Case Reports, 5' Untranslated Regions, Apoferritins / genetics, Brazil, Humans, Iron, Pedigree, Apoferritins, 5' Untranslated Regions, Iron, Hyperferritinemia, hereditary, with congenital cataracts

Hereditary hyperferritinemia-cataract syndrome is a rare autosomal dominant disease caused by a genetic mutation in the iron responsive element in the 5' untranslated region of the ferritin light chain gene. Hereditary hyperferritinemia-cataract syndrome is characterized by elevated serum ferritin levels and bilateral cataract development early in life and may be misdiagnosed as hemochromatosis. This case report describes a Brazilian family with a clinical diagnosis of hereditary hyperferritinemia-cataract syndrome, which was submitted to ferritin light chain gene sequencing. The genetic mutation c.-164C>G was identified in the 5' untranslated region. In conclusion, genetic testing can be used for accurate diagnosis of hereditary hyperferritinemia-cataract syndrome to avoid misdiagnosis of hemochromatosis, other diseases associated with iron overload or ophthalmic diseases.
Case report: Fatal systemic embolism caused by early prosthetic valve endocarditis after Bentall surgery
Authors: Shaofeng Wu, Xin Wang, Weidong Ren, Guang Song, Yang Hou, Haidi Hu, Xiaona Yu
Journal: Front Cardiovasc Med (2023)
Keywords: bentall surgery, echocardiography, prosthetic valve endocarditis, staphylococcus endocarditis, systemic embolism
MeSH terms: Case Reports

Prosthetic valve endocarditis (PVE) is a rare but dangerous complication of Bentall surgery and Staphylococcus epidermidis PVE involving multiple valves simultaneously during the early postoperative period has not been reported. A 42 year old patient admitted to intensive care unit with fever 1 month after aortic valve replacement (Bentall procedure). Echocardiography was of great diagnosis value and suggested large, mobile vegetations on both the prosthetic aortic valve and native tricuspid valve. The presence of Staphylococcus epidermidis was revealed by multiple blood cultures. Surgery was not performed because of the history of aortic valve replacement 1 month ago. He developed acute right femoral artery thromboembolism, multiple cerebral infarction and splenic infarction during hospitalization and died of cerebral infarction after being discharged. This case underlines that patients with early PVE may have poor prognosis and fatal systemic embolism should be aware of in PVE patients with large vegetations present with dyskinesia, abdominal pain, and limb numbness. The timely echocardiography and vascular ultrasound are primary and reliable diagnostic methods in this scenario.
Beneficial effects and safety of traditional Chinese medicine for chronic inflammatory demyelinating polyradiculoneuropathy: A case report and literature review
Authors: Yao Xie, Lesang Li, Le Xie, Junlin Jiang, Ting Yao, Guo Mao, Shiliang Wang, Anchao Lin, Jinwen Ge, Dahua Wu
Journal: Front Neurol (2023)
Keywords: astragalus membranaceus, case report, chronic inflammatory demyelinating polyradiculoneuropathy, review, traditional chinese medicine
MeSH terms: Case Reports

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated neuropathy. First-line treatments for CIDP include corticosteroids, intravenous immunoglobulin, and plasma exchange. However, the application is always limited by high costs, effectiveness, and adverse events. This study investigated a new potentially effective and safe therapeutic treatment to alleviate CIDP symptoms and improve the quality of life. In the present case, a 47-year-old rural woman presented with weakness and numbness of progressive extremities. She was diagnosed with CIDP based on abnormal cerebrospinal fluid and electromyography. The patient was treated with intravenous dexamethasone for 1 week and with Huangqi-Guizhi-Wuwu and Bu-Yang-Huan-Wu decoctions for 90 days. Surprisingly, after the treatment, the weakness and numbness were eliminated, and the quality of life improved. The varying INCAT, MRC, and BI scores also reflected the treatment effects. After 8 months of discharge, the symptoms did not relapse during the follow-up. We also searched "traditional Chinese medicine (TCM)" and "CIDP" in PubMed, EMBASE, the Web of Science, the Cochrane Library, the Chinese National Knowledge Infrastructure Databases, Wanfang Data, and the Chongqing Chinese Science and Technology Periodical Database. Finally, only ten studies were included in the literature review. Three studies were randomized controlled trials, and seven were case reports or case series. There were 419 CIDP patients, but all study sites were in China. Nine TCM formulas involving 44 herbs were reported, with Huang Qi (Astragalus membranaceus) being the most important herb. In conclusion, the case and literature demonstrated that TCM treatment might be a more effective, low-cost, and safe option for treating CIDP. Although these preliminary findings are promising, a larger sample size and higher-quality randomized clinical trials are urgently required to confirm our findings.
Shortened cervix in the subsequent pregnancy after embolization for postpartum cervical hemorrhage
Authors: Zoltan Kozinszky, Sverre Sand, Nils-Einar Kløw, Kirsten Hald
Journal: Case Rep Obstet Gynecol (2014)

Introduction. Rupture of a branch of uterine artery during delivery often leads to a massive postpartum hemorrhage that can be successfully treated using uterine artery embolization. Case Report. A 33-year-old woman had a cesarean section at term followed by a secondary postpartum hemorrhage due to a ruptured cervicovaginal branch terminating in a large, partially thrombosed hematoma of the cervix. She was given selective uterine artery embolization, and she was discharged to home in stable condition on the third day after embolization. In the forthcoming pregnancy a shortened cervix was a risk of threatened premature delivery from 26 weeks of gestation onwards. Conclusion. Superselective unilateral embolization of a thrombosed hematoma in the cervix might prevent extensive iatrogenic trauma of the cervix, which allows preservation of reproductive function.