OpenMed/multicare-articles huggingface dataset:
Case report: Autonomic and endocrine response in the process of brain death in a child with hypoxic-ischemic brain injury
Authors: Kenichiro Hayashi, Kaname Uchida, Hidehito Ota, Hiroyuki Tanaka, Mieko Maezawa, Hikoro Matsui
Journal: Front Pediatr (2022)
Keywords: autonomic nervous system, brain death, cardiac arrest, child, heart rate variability, hypoxic-ischemic brain injury
MeSH terms: Case Reports

Background:
The causes of brain death include cerebral herniation and brainstem ischemia. Neuroendocrine failure or a series of autonomic nervous system disorders are clinically recognized in the transition to brain death among patients with critical brain injuries. An accurate evaluation of these physiologic instabilities and biomarkers is essential to assess the severity and prognosis of pediatric brain injury as well as to initiate supportive care. This case report presents a detailed evaluation of the autonomic nervous system and endocrine function during the transition to brain death in infantile hypoxic-ischemic brain injury by analyzing the heart rate variability and endocrine status.
Case presentation:
A 1-year-old previously healthy boy went into cardiac arrest after choking on a toy at home. Although spontaneous circulation returned 60 min after cardiopulmonary resuscitation, no cerebral activity or brainstem reflexes were observed after 18 hospital days. The heart rate variability was assessed by analyzing the generic electrocardiogram data. Rapid spikes or drops in the total power of the heart rate variability, accompanied by a cortisol surge, as well as an alternating surge of high- and low-frequency domain variables were detected in the process of brain death.
Conclusion:
The heart rate variability assessment combined with endocrine provides a better understanding of the clinical course of patients undergoing brain death. It accurately detects the loss of brainstem function, which allows physicians to provide the appropriate supportive care.
Askin's Tumor in an Adult: Case Report and Findings on 18F-FDG PET/CT
Authors: Gonca Kara Gedik, Oktay Sari, Tamer Altinok, Lema Tavli, Bugra Kaya, Pelin Ozcan Kara
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Primitive neuroectodermal tumor (PNET) of the chest wall or Askin's tumor is a rare neoplasm of chest wall. It most often affects children and adolescents and is a very rare tumor in adults. In this case report, we present an Askin's tumor occurred in a 73-year-old male. The patient was admitted with a history of 3-month lower back pain and cough. In computed tomography, there was a lesion with dimensions of 70 x 40 x 65 mm in the superior segment of the lower lobe of the left lung. Positron emission tomography/computed tomography with 18F-flourodeoxyglucose revealed a pleural-based tumor in the left lung with a maximum standardized uptake value of 4.36. No distant or lymph node metastases were present. The patient had gone through surgery, and wedge resection of the superior segment of left lobe and partial resection of the ipsilateral ribs were performed. Pathology report with immunocytochemistry was consistent with PNET and the patient received chemotherapy after that.
Steroid-resistant extranodal rosai-dorfman disease of cheek mass and ptosis treated with radiation therapy
Authors: Ahmed Marzouk Maklad, Yasser Bayoumi, Mutahir Tunio, Wafaa Alshakweer, Mashooque A Dahar, Shomaila A Akbar
Journal: Case Rep Hematol (2013)

Background. Rosai-Dorfman Disease (RDD) is rare benign hematologic disorder of histiocytes, which usually manifests as painless lymphadenopathy, fever, leukocytosis and hypergammaglobulinemia. Extranodal RDD has been reported in 43% of cases, with skin as commonly involved site followed by head and neck region. However, soft tissue cheek mass is rare presentation of extra-nodal RDD. Case Presentation. A 26-year-old Saudi man presented with a six-month history of right cheek swelling and left upper eyelid swelling. Physical examination revealed right cheek mass of size 3 × 3 cm and left upper eyelid mass of size 1 × 2 cm and no palpable cervical lymphadenopathy. Incisional biopsy of cheek mass showed positivity for S100 and negativity for CD1a, consistent with extra-nodal RDD. Patient did not respond to systemic steroids and was given radiation therapy to left orbit with minimal response. Then, he was started on chemotherapy Rituximab, cyclophosphamide, vincristine, and prednisolone (RCVP) 8 cycles followed by reirradiation 10 Gy in 10 fractions with 6 MeV electron with complete response. After 12 months of followup, patient had recurrence in right cheek and was started on radiotherapy to the cheek mass. Conclusion. Extra-nodal RDD with involvement of cheek is a rare presentation. Incorporation of S100 and CD1a is helpful in diagnoses of RDD and differentiating it from other benign histiocytosis. Treatment consists of surgery, steroids, chemotherapy, and radiation therapy.
Acute management of cocaine-associated methaemoglobinaemia
Authors: Immo Weichert
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Methaemoglobinaemia is a potentially life-threatening complication of problem drug use. This is a case report of a 29-year-old man who presented himself cyanosed after a cocaine binge. It highlights the diagnosis and management of this condition from an acute medical perspective.
Rescue of ankylosing hip following open reduction and internal fixation of acetabular fracture by surgical resection of heterotopic ossification: A case report
Authors: Kazumichi Kitayama, Yohei Kawakami, Tomoaki Fukui, Keisuke Oe, Ryosuke Kuroda, Takahiro Niikura
Journal: Int J Surg Case Rep (2018)
Keywords: acetabular fracture, heterotopic ossification, hip ankylosis, surgical resection

Introduction:
Heterotopic ossification is a major complication after surgical treatment of acetabular fractures. Heterotopic ossification generally involves the large joints, often limits the range of motion, and may cause ankylosis.
Presentation of case:
This case report describes a 59-year-old man with severe heterotopic ossification who developed an acetabular fracture and resultant hip ankylosis, which was rescued by surgical resection of the heterotopic ossification. He had accompanying head injury and multiple other fractures, which were treated conservatively. Open reduction with internal fixation of the acetabular fracture was performed through the ilioinguinal and Kocher-Langenbeck combined approach. The patient unexpectedly returned to our hospital 7.5 months after the fracture surgery. We found that his left hip joint was completely ankylosed by severe heterotopic ossification. We performed surgical resection of the heterotopic ossification through a direct lateral approach 9.5 months after the initial surgery. At the final follow-up, 5.5 years after the heterotopic ossification resection surgery, the hip function including the range of motion was satisfactory. Radiographs showed no signs of recurrence, and he could walk with no support.
Discussion:
The only effective treatment for established HO is surgical excision. Whether delayed or early surgical resection of heterotopic ossification is more effective remains controversial.
Conclusion:
We considered that waiting for a long time before surgical resection of the heterotopic ossification would lead to more disability, and early resection of the heterotopic ossification was not a contraindication despite the fact that the uptake on the bone scan was still intense.
Melorheostosis with renal arterio-venous malformation: A case report with review of literature
Authors: Abdul Rashid Lone, Mushtaq Ahmad, Sheikh Aejaz Aziz, Gul Mohammad Bhat, Javid Rasool Bhat, Rifat Jahan, Shoukat H Khan
Journal: Indian J Med Paediatr Oncol (2009)
Keywords: flowing periosteal hyperostosis, leri′s disease, melorheostosis, renal av malformation
MeSH terms: Case Reports

Melorheostosis, also known as Leri's disease and flowing periosteal hyperostosis, is a rare cause of pain and stiffness in a limb. The appearance is of "candle greasing" down one side of one or several bones of the body. We describe a case referred to tertiary care center with suspicion of renal cell carcinoma with diffuse bone metastasis. After reassessment, the patient was diagnosed melorheostosis with renal AV malformation. He was reassured about the benign nature of the disease and is asymptomatic.
Ossifying Fibroma in the Maxilla and Mandible: A Case Report With a Brief Literature Review
Authors: Midion Chidzonga, Ephraim Sunhwa, Rudo Makunike-Mutasa
Journal: Cureus (2023)
Keywords: benign neoplasm, cemento-ossifying fibroma, fibro-osseous lesions, fibrous dysplasia, mandible, maxilla, multiple ossifying fibroma, ossifying fibroma
MeSH terms: Case Reports

Fibro-osseous lesions in the jaw bones include fibrous dysplasia, ossifying fibroma (OF), cemento-ossifying fibroma, florid osseous dysplasia, and focal osseous dysplasia. OF is the most common fibro-osseous tumor that presents as a slow-growing well-encapsulated benign neoplasm composed of varying amounts of bone or cement-like tissue in a fibrous stroma well-demarcated from the adjacent normal bone. OF is most common in the jaw bones, with a predilection for the mandible. OF usually occur as solitary lesions and rarely as multiple lesions in a patient. We present clinical and radiologic features, histopathology, and surgical management of a rare case with large synchronous OFs in the mandible and maxilla and a brief review of the literature.
Congenital Zika syndrome arising from sexual transmission of Zika virus, a case report
Authors: Christina D Yarrington, Davidson H Hamer, Wendy Kuohung, Aviva Lee-Parritz
Journal: Fertil Res Pract (2019)
Keywords: congenital zika syndrome, microcephaly, sexually transmitted infection, zika
MeSH terms: Case Reports

Background:
Sexual transmission of Zika virus is well documented and pregnant women are advised to abstain or use barrier protection if a sexual partner has risk for Zika infection. However, to date there has not been a documented case of the congenital Zika syndrome resulting from sexual transmission.
Case presentation:
A 32 year-old woman who had not traveled to any area with local Zika transmission in years became pregnant via frozen embryo transfer. Her husband traveled to Haiti several times prior to embryo transfer and during the pregnancy. Neither partner was ever symptomatic. In her second trimester when recommendations were published by the Centers for Disease Control and Prevention (CDC) regarding prevention of sexual transmission during pregnancy she was counseled to abstain or use barrier protection with her partner. At delivery, the infant head circumference measured less than the first percentile. Placental samples were sent to the CDC and all were positive for Zika RNA by RT-PCR. Evaluation for other causes of microcephaly was negative. Consistent with the most up to date diagnostic parameters for congenital Zika, including viral infection of the placenta, the baby was diagnosed with congenital Zika syndrome.
Conclusions:
Transmission via sexual contact during assisted reproductive therapies (ART) and pregnancy can result in Zika fetopathy. This case supports recommendations to counsel women undergoing ART and pregnant women to use barrier protection with partners with Zika exposure regardless of their symptoms.
Labial Repositioning Using Print Manufactured Polymethylmethacrylate- (PMMA-) Based Cement for Gummy Smile
Authors: Patricia Freitas de Andrade, Jonathan Meza-Mauricio, Ricardo Kern, Marcelo Faveri
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Treating patients with excessive gingival display (EGD) to provide them with a pleasant smile is a challenge to periodontists. A gummy smile can be due to excessive vertical bone growth, dentoalveolar extrusion, short upper lip, upper lip hyperactivity, or altered passive eruption (APE). In addition, many patients have a lack of lip support due to marked depression of the anterior process of the maxilla. In these cases, lip repositioning using polymethylmethacrylate (PMMA) cement could be performed. This article describes a case of EGD with subnasal depression. In the clinical examination, the presence of a marked subnasal depression was found, in which the upper lip lodged during a spontaneous smile. In addition to this, gingival exposure extending from the maxillary molar on one side of the mouth to the one on the opposite side was also found during the spontaneous smile. Therefore, the periodontal surgical intervention proposed consisted of performing a procedure to fill the subnasal depression with PMMA cement. This article describes a digital approach to plan the use of PMMA cement in lip repositioning in a patient with gummy smile and subnasal depression. The patient reported no postoperative complications. Six months after the surgery, the patient revealed a more harmonious smile than before, with reduction in the gingival exposure and new adequate support for and repositioning of the upper lip.
Sertoli-Leydig Cell Tumor with Concurrent Rhabdomyosarcoma: Three Case Reports and a Review of the Literature
Authors: Trisha Plastini, Arthur Staddon
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Sertoli-Leydig Cell Tumors (SLCTs) make up <1% of all ovarian tumors and are benign or malignant, androgen-secreting tumors. Rhabdomyosarcoma (RMS) is a heterogeneous group of malignant tumors that resemble developing skeletal muscle. There have been case reports of patients with concurrent SLCT and RMS with limited treatment options. We aim to demonstrate treatment strategies used in our patients, which seemed to have prolonged survival when compared to prior case reports of patients not cured by surgical resection. Herein we describe 22 cases of SLCT with RMS elements as discussed in prior case reports and three cases from the authors' institution. Of the 19 cases from prior case reports, five were lost to follow-up and two had NED after surgical intervention. Eleven patients had recurrence and were deceased within one year. Of those patients not surgically cured, only three patients were documented as living beyond two years, all of whom received chemotherapy. The three patients presented from our institution had clinical evidence of response to chemotherapy that is traditionally used for RMS. In conclusion, chemotherapy with doxorubicin and ifosfamide has activity in patients with SLCT and RMS as does salvage chemotherapy with vincristine, irinotecan, and temozolomide.
Diverticular disease of the small bowel: a rare cause of the duodenojejunal flexure obstruction (a case report)
Authors: Arwa Guediche, Soumaya Ben Amor, Walid Mnari, Mabrouk Abdelaali, Waad Farhat, Houcem Ammar, Mohamed Amine Said, Mejda Zakhama, Wided Bouhlel, Om Keltoum Sellem, Nabil Ben Chaabene, Mondher Golli, Ali Ben Ali, Leila Safer
Journal: Pan Afr Med J (2021)
Keywords: diverticula, case report, gastrointestinal obstruction, small intestine
MeSH terms: Diverticular Diseases / complications, Duodenal Obstruction / diagnosis, Jejunal Diseases / diagnosis, Case Reports, Duodenal Obstruction / etiology, Female, Humans, Intestine, Small / pathology, Jejunal Diseases / etiology, Middle Aged

The small bowel is the least common site for diverticula in the entire gastrointestinal tract. Chronic upper intestinal obstruction due to diverticula is very rare. We report a case of multiple small bowel diverticula causing mechanical obstruction of the duodenojejunal flexure.
Autoimmune inner ear disease in a melanoma patient treated with pembrolizumab
Authors: Matthew Zibelman, Natasha Pollak, Anthony J Olszanski
Journal: J Immunother Cancer (2016)
Keywords: autoimmune inner ear disease (aied), hearing loss, immune-related adverse events (iraes), melanoma, pd-1 inhibitor, pembrolizumab

Background:
Immune related adverse events affecting various organ systems are a recognized potential consequence of immune checkpoint inhibition. However, autoimmune inner ear disease is one complication not previously associated with the use of checkpoint inhibitors, though it has been reported after adoptive cell immunotherapy.
Case presentation:
Here we present what we believe is the first case of autoimmune inner ear disease resulting from treatment with an immune checkpoint inhibitor in a patient with metastatic melanoma. An 82 year old male presented with widespread metastatic mucosal melanoma and was initially treated with the CTLA-4 inhibitor ipilimumab but had progression of disease after four doses. He was subsequently treated with the PD-1 inhibitor pembrolizumab and after two doses the patient noted bilateral hearing loss. Otology evaluation was significant for the development of bilateral sensorineural hearing loss and the patient was started on treatment with bilateral intratympanic dexamethasone injections. He experienced significant recovery of his hearing deficit with the intratympanic injections and restaging imaging after 12 weeks of pembrolizumab demonstrated a dramatic reduction in tumor burden.
Conclusion:
Autoimmune inner ear disease has been previously associated with the therapeutic transfer of genetically engineered lymphocytes as an on-target effect of donor T-cells recognizing antigens on cells in the inner ear. It is important for physicians to have a high clinical index of suspicion for the appropriate recognition and management of any potential autoimmune toxicity with checkpoint inhibitors given the variability of presentation and unique aspects of toxicity.
Necrotizing Soft Tissue Infection of the Breast during COVID-19 Pandemic
Authors: Nadia Kamagate, Robert DeVito
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Necrotizing soft tissue infection has been historically recognized as a severe, rapidly spreading soft tissue infection associated with a very high risk of mortality. Cases of primary necrotizing fasciitis of the breast are rarely described but often fatal. We present a case of necrotizing soft tissue infection of the right breast extending to the anterior abdominal wall in a 39-year-old obese female, with a history of tobacco use. The patient presented 10 days after symptom onset due to concerns and anxiety related to COVID-19 exposure. This delay allowed for further extension and smoldering of the breast infection. The treatment of this aggressive disease process begins with early diagnosis, where a high index of suspicion is vital. Once diagnosed, the treatment regimen should be composed of emergent surgical debridement, which can include breast salvage debridement or total mastectomy, in addition to antibiotic therapy.
A Case Report of Pericardial Effusion with False-Positive Mesothelioma and Adenocarcinoma Markers as the Initial Presentation of Systemic Lupus Erythematous
Authors: Gita Bhattacharya, Pritha P Gupta
Journal: Case Rep Rheumatol (2022)
MeSH terms: Case Reports

Pericardial effusion or the accumulation of fluid in the pericardial sac, can result from infectious, malignant, or autoimmune processes such as systemic lupus erythematous (SLE). However, pericardial effusion is infrequently the first presentation of SLE. Here, we describe the case of a 54-year-old African American woman who presented with hypertensive emergency and was found to have pericardial effusion on echocardiogram. Her hypertensive symptoms resolved with medical management and a work up were positive for serum markers of SLE and mesothelioma cell markers (calretinin, CK 5/6) and adenocarcinoma marker MOC31 in the pericardial fluid. Her effusion ultimately improved on high-dose steroid therapy and has not recurred in one year. Given normal pleura and pericardium on computed tomography (CT) imaging and long-term clinical improvement in SLE therapy, we hypothesize that she had false-positive mesothelioma markers in the setting of SLE.
A Rare Case of ST-Segment Elevation Myocardial Infarction and Left Ventricular Thrombus in a Dextrocardia Patient With COVID-19 Infection
Authors: Nicholas Roma, Kashyap Shah, Bruce Ferraro, Matthew Durkin, Matthew Krinock, Michael Durkin
Journal: Cureus (2023)
Keywords: acute coronary syndrome, covid, dextrocardia, stemi, thrombus
MeSH terms: Case Reports

Acute coronary syndrome (ACS) is an increasingly common finding among patients presenting with Coronavirus Disease 2019 (COVID-19) pneumonia. While cardiovascular disease alone remains one of the most common causes of death among COVID-19 patients in the United States, its heightened prevalence with COVID-19 pneumonia has been well documented. Here we present the case of a 58-year-old male with an extensive cardiac history including coronary artery disease (CAD) with multiple drug-eluting stents (DES) placed and an episode of cardiac arrest requiring implantable cardioverter defibrillator (ICD) placement. He presented to the Emergency Department originally complaining of chest pain, shortness of breath, and fatigue, and was found to be positive for COVID-19 pneumonia. Cardiac catheterization demonstrated extensive CAD and evaluation for coronary artery bypass grafting (CABG) was warranted. Shortly after, the patient experienced an acute thrombotic episode in the left anterior descending (LAD) coronary artery and underwent successful emergent high-risk percutaneous coronary intervention (PCI) with DES placement. The patient was also found to have a left ventricular thrombus requiring anticoagulation. Despite his complex course, the patient had a very favorable outcome.
HbD Punjab/HbQ India Compound Heterozygosity: An Unusual Association
Authors: Stacy Colaco, Reema Surve, Pratibha Sawant, Anita Nadkarni, Kanjaksha Ghosh, Roshan Colah
Journal: Mediterr J Hematol Infect Dis (2014)
MeSH terms: Case Reports

Background:
Haemoglobinopathies are the commonest hereditary disorders in India and pose a major health problem. Both beta thalassaemia and structural haemoglobin variants are relatively common in northwestern India. Here we report a 29-year-old Sindhi female who was referred to us for a haemoglobinopathy work up and genetic counseling since her spouse was a classical beta thalassaemia carrier.
Method:
A complete blood count was done on an automated cell counter. Haemoglobin analysis was carried out using HPLC Variant Haemoglobin Testing System. The cellulose acetate electrophoresis was carried out [pH 8.9]. Confirmation of mutations was done by automated DNA sequencing.
Results:
HPLC analysis showed four major peaks, HbA0, a peak in the HbD window, an unknown peak [retention time 4.74 minutes] and a peak in the HbC window. The HbA2 level was 2.2%, and the HbF level was 0.7%. Cellulose acetate electrophoresis at alkaline pH, a slow moving band was seen at the HbS/D position along with a prominent band at the HbA2 position. DNA sequencing of the β and α genes showed presence of the two hemoglobin variants: Hb D [β 121GAA → CAA] and Hb Q [α 64 AAG → GAG]. The δ globin gene was normal. The additional peak in the HbC window was due to the formation of a heterodimer hybrid.
Conclusion:
Both HbD Punjab and HbQ India are relatively common in India, but their co-inheritance has not been described in the country. This case is the third report of compound heterozygosity for HbQ India/HbD Punjab haemoglobinopathy globally and the second one from India.