OpenMed/multicare-articles huggingface dataset:
Endoscopic transorbital extradural anterior clinoidectomy: A stepwise surgical technique and case series study [SevEN-013]
Authors: Jaejoon Lim, Kyoung Su Sung, Jihwan Yoo, Jiwoong Oh, Ju Hyung Moon
Journal: Front Oncol (2022)
Keywords: anterior clinoid process, anterior clinoidectomy, cadaveric study, endoscopic transorbital approach, extradural technique

Background:
Anterior clinoidectomy is an important procedure for approaching the central skull base lesions. However, anterior clinoidectomy through the endoscopic transorbital approach (ETOA) still has limitations due to technical difficulties and the structural complexity of the anterior clinoid process (ACP). Therefore, the authors designed a stepwise surgical technique of extradural anterior clinoidectomy through the ETOA. The purpose of this study was to evaluate the feasibility of this technique.
Methods:
Anatomical dissections were performed in 6 cadaveric specimens using a neuroendoscope and neuro-navigation system. The extradural anterior clinoidectomy through the ETOA was performed stepwise, and based on the results, this surgical technique was performed in the 7 clinical cases to evaluate its safety and efficiency.
Results:
Endoscopic extradural anterior clinoidectomy was successfully performed in all cadaveric specimens and patients using the proposed technique. This 5-step technique enabled detachment of the lesser wing of sphenoid bone from the ACP, safe unroofing of the optic canal, and resection of the optic strut without injuring the optic nerve and internal carotid artery. Since the sequential resection of the 3 supporting roots of the ACP was accomplished safely, anterior clinoidectomy was then successfully performed in all clinical cases. Furthermore, no complications related to the anterior clinoidectomy occurred in any clinical case.
Conclusion:
We designed a stepwise surgical technique that allows safe and efficient anterior clinoidectomy through the ETOA. Using this technique, extradural anterior clinoidectomy can be accomplished under direct endoscopic visualization with low morbidity. Since this technique is applicable to the central skull base surgery where anterior clinoidectomy is necessary, it expands the application of the ETOA.
ANCA-associated vasculitis following Oxford-AstraZeneca COVID-19 vaccine in Brazil: Is there a causal relationship? A case report
Authors: Welder Zamoner, Julia Baldon Scardini, Bruna Jordana De Dio, Amanda de Melo Marques, Vanessa Dos Santos Silva, Aline Lutz Garcia, Daniela Cristina Dos Santos, Rosa Marlene Viero
Journal: Front Med (Lausanne) (2022)
Keywords: astrazeneca, covid-19, oxford, acute kidney injury, vaccine
MeSH terms: Case Reports

This article presents a case of rapidly progressive glomerulonephritis following the Oxford-AstraZeneca COVID-19 vaccine in a female patient 58 years old. After 5 days, she presented fatigue, paleness, arthralgia on hands, knees, ankles, foamy urine, and elevated blood pressure. Exams showed serum creatinine of 2.2 mg/dL (baseline creatinine of 1.0 mg/dL). Urinalysis revealed hematuria, and her 24-h urinary protein excretion was 4.4 g. Additional exams showed hypercholesterolemia, severe anemia, and normal serum albumin. Testing of antineutrophil cytoplasmic antibodies anti-myeloperoxidase was positive at a titer of 1/80. Serum and urine protein electrophoresis and other exams showed no alterations. She was started on steroid pulse therapy after worsening kidney function, reaching serum creatinine of 3.3 mg/dL. A kidney biopsy revealed crescentic glomerulonephritis with glomerular sclerosis, fibrous crescents, interstitial fibrosis, and tubular atrophy. Induction therapy was given with intravenous cyclophosphamide 0.5 g/m2 for 6-monthly pulses, followed by maintenance therapy with oral azathioprine at 2 mg/kg and prednisone tapering. The patient did not develop any complications during the induction therapy, and is currently on maintenance therapy with a serum creatinine of 1.87 mg/dL.
Roadmap Guided Direct Percutaneous Vertebral Artery Puncture for Mechanical Thrombectomy of Acute Basilar Artery Occlusion: A Technical Case Report and Review of the Literature
Authors: Jawed Nawabi, Georg Bohner, Eberhard Siebert
Journal: Front Neurol (2022)
Keywords: bail out, direct vertebral puncture, large vessel occlusion, mechanical thrombectomy (mt), stroke
MeSH terms: Case Reports

Access techniques for mechanical thrombectomy normally include percutaneous puncture of the common femoral or, more recently, the radial artery. Although target vessel catheterization may frequently not be devoid of difficulties via both routes, the vast majority of mechanical thrombectomy (MT) cases can be successfully managed. However, in a significant minority of cases, a stable target vessel access cannot be reached resulting in futile recanalization procedures and detrimental outcomes for the patients. As such, in analogy to direct carotid puncture for anterior circulation MT, direct vertebral artery (VA) puncture (DVP) is a direct cervical approach, which can constitute the only feasible access to the posterior circulation in highly selected cases. So far, due to the rarity of DVP, only anecdotal evidence from isolated case reports is available and this approach raises concerns with regard to safety issues, feasibility, and technical realization. We present a case in which bail-out access to the posterior circulation was successfully obtained through a roadmap-guided lateral direct puncture of the V2 segment of the cervical VA and give an overview of technical nuances of published DVP approaches for posterior circulation MT.
Transitory Spontaneous Remission of Myelodysplasia in an Elderly Man while Receiving Intravesical Bacillus Calmette-Guérin for Bladder Cancer: A Case Report and Review of the Literature
Authors: Nigel P Murray, Cynthia Fuentealba, Isidora Salazar, Aníbal Salazar, Marco Antonio Lopez, Simona Minzer
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Myelodysplasia is a clonal disorder characterized by progressive cytopenias. Intravescial BCG is standard immunotherapy for superficial bladder cancer. We present a patient with transfusion-dependent myelodysplasia whose blood counts normalized during treatment with intravesical BCG for bladder cancer. After finishing treatment, the patient became transfusion dependent once more. We discuss possible mechanisms to explain this case report.
Novel PPFIA1- ALK, ALK- C2orf91(intergenic) double-fusion responded well to alectinib in an advanced lung adenocarcinoma patient: a case report
Authors: Lingxin Yan, Jiayu Zheng, Qingyun Pan, Yuxian Liang, Pengli Yu, Quanfang Chen
Journal: Front Oncol (2023)
Keywords: ngs, nsclc, ppfia1-alk, alectinib, non-reciprocal fusion
MeSH terms: Case Reports

Non-small cell lung cancers (NSCLCs) with anaplastic lymphoma kinase (ALK)-rearrangement have favorable responses to ALK inhibitors. However, ALK fusion mutations harbored approximately 90 distinct fusion partners. Patients with different ALK fusions might respond distinctly to different-generation ALK inhibitors. In this case report, we identified a novel non-reciprocal ALK fusion, ALK-C2orf91(intergenic) (A19: intergenic) and PPFIA1-ALK (P2:A20), by next-generation DNA sequencing in an advanced lung adenocarcinoma patient. After 2 months of alectinib, the targeted lung lesion regressed significantly, and evaluation of therapeutic efficiency indicated partial response. To date, the patient had achieved 12 months of progression-free survival from alectinib treatment. Our study extended the spectrum of ALK fusion partners in ALK-positive NSCLC, and we reported a new ALK fusion, PPFIA1-ALK and ALK-C2orf91(intergenic), and its sensitivity to alectinib firstly in lung cancer. We believe that this case report has an important clinical reference.
Successful control of acute myelofibrosis with lenalidomide
Authors: G Vassilopoulos, M Palassopoulou, K Zisaki, M Befani, E Bouronikou, N Giannakoulas, E Stathopoulou, P Matsouka
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Acute panmyelosis with myelofibrosis (APMF) is a rare, fatal hematological neoplasm that is characterized by the acute onset of cytopenias and fibrosis in the bone marrow in the absence of splenomegaly or fibrosis-related morphological changes in the RBCs. We present the case of a 59-year-old female who presented with a two-month history of anemia, leucopenia and a normal platelet count. The marrow was heavily fibrotic, and no aspirate material could be obtained; the biopsy showed extensive infiltration with small to medium size megakaryocytes, dysplastic changes in the erythroid compartment, and left shift in the myeloid cells. The patient was treated for four months with anabolic steroids (Danazol), growth factors and received regular blood transfusions. At 4 months after diagnosis, the patient was started on Lenalidomide, 10 mg/day for a 21-d-course along with growth factor support. At 6 months after treatment, the patient was transfusion-independent, had normalized blood counts, and, at 32 months on continuous lenalidomide treatment, her needs for growth factor support have been minimized. Repeat bone marrow biopsies showed a patchy distribution of fibrosis with areas of normal cellularity and morphology. To our knowledge, this is the first case for a medication that could reverse the fatal outcome of APMF.
Incomplete bilateral duplication of the ureters identified during cytoreductive surgery for ovarian cancer: A case report
Authors: Dimitrios Papageorgiou, Ioannis Kyriazanos, Menelaos Zoulamoglou, Eirini Deskou, Vasileios Kalles, Nikolaos Stamos, Nikolaos Ivros
Journal: Int J Surg Case Rep (2019)
Keywords: bilateral ureteral duplication, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, incomplete ureteral duplication

Introduction:
Incomplete bilateral ureteral duplication is a very rare condition. Ureteral duplication is often asymptomatic or may be associated with several urinary tract complications.
Case report:
We report a case of a 72- year- old Caucasian female who was referred to our clinic after she was diagnosed with FIGO IIIc ovarian cancer with peritoneal metastases. The patient underwent Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy. During the standard bilateral recognition of the ureters, intraoperatively, incomplete duplication of both of the ureters was identified. Bilaterally, the ureters were derived from a single renal parenchyma and duplication of the pyelocaliceal system in each kidney.
Discussion:
The incomplete bilateral duplication of the ureters is a rare congenital renal abnormality. In a series of 51.880 autopsies ureteral duplication was observed in 0.66% of the cases, while in another autopsy series the ureteral duplication rate was 0.68%.
Conclusion:
Anatomical varieties of the ureter are of utmost importance for the surgeons, because they increase the possibility of iatrogenic ureteral injury. Ureteral injuries are severe complications of pelvic operations and may increase morbidity and even cause mortality.
Successful utilization of high-flux hemodialysis for treatment of vancomycin toxicity in a child
Authors: Timothy Stidham, Pamela D Reiter, Douglas M Ford, Gary M Lum, Joseph Albietz
Journal: Case Rep Pediatr (2011)
MeSH terms: Case Reports

Vancomycin is routinely used for empiric antibiotic therapy in children. Higher-serum-concentration targets for serious infections are now being recommended. This recommendation may result in aggressive dosing with increased potential for toxicity. We report a case of a pediatric patient who developed vancomycin toxicity and associated oliguric renal failure who was treated effectively with high-flux hemodialysis for vancomycin toxicity, clearing serum concentrations of vancomycin by over 75% in only 6 hours (213.2 mcg/mL to 51.8 mcg/mL) with subsequent return to baseline renal function and without adverse sequelae. While not historically considered a viable option for drug removal in cases of toxicity, new high-flux hemodialysis techniques can remove significant percentages of vancomycin in short periods of time.
Kienböck's disease in an 11-year-old girl: a case report
Authors: Ahmed Amine Mohseni, Mohamed Zairi, Rim Boussetta, Walid Saied, Sami Bouchoucha, Nebil Nessib
Journal: Pan Afr Med J (2019)
Keywords: pediatric, kienböck, lunatum
MeSH terms: Lunate Bone / pathology, Magnetic Resonance Imaging, Osteonecrosis / diagnostic imaging, Case Reports, Child, Female, Follow-Up Studies, Humans, Lunate Bone / diagnostic imaging, Osteonecrosis / therapy

Kienböck disease is a pathology that remains uncommon in children, therefore the number of published cases of Kienböck's disease before skeletal maturity is limited. The etiology of Kienböck's disease is still controversial. Although many therapeutic methods are described in the literature. There is no consensus treatment for this pathology. We describe a case of Kienböck's disease of an 11-year-old girl who presented with avascular necrosis of the lunate bone confirmed by the radiologic pattern. And who was treated with 10 weeks of splinting with satisfying clinical outcome. Wrist pain and other symptoms resolved after 2 months. A magnetic resonance imaging (MRI) confirmed partial revascularization of the lunate. After 18 months of follow-up the patient remains asymptomatic.
Acinetobacter Prevertebral Abscess: Presenting as Dysphagia in a Diabetic Patient
Authors: R Manmathan, T Kumanan, J A Pradeepan
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Acinetobacter species frequently causes nosocomial infection, particularly in patients receiving invasive ventilation at intensive care units for a prolonged period. Odynophagia is a rare, initial clinical manifestation of prevertebral abscess which subsequently develops when the abscess extends into the retropharyngeal space causing a midline bulge of the posterior pharyngeal wall. Here, we present and discuss a patient with uncontrolled diabetic mellitus who presented with severe odynophagia and dysphagia. He was diagnosed to have prevertebral abscess caused by a rarely reported bacteria, Acinetobacter baumannii.
A novel alternative to suture passer for closure of fascial defect in laparoscopic ventral hernia repair. A case report
Authors: Jun Han Lai, Guo Hou Loo, Mohamad Aznan Bin Shuhaili, Nik Ritza Kosai
Journal: Int J Surg Case Rep (2019)
Keywords: bridged repair, incisional hernia, laparoscopic ipom plus, mesh hernia repair, transfascial suture passer

Introduction:
Primary fascial closure can be a challenging step during a laparoscopic intraperitoneal onlay mesh (IPOM) repair for a ventral hernia.
Case presentation:
We present here a novel technique of using intravenous (IV) cannula as an alternative to suture passer for fascial closure during laparoscopic IPOM repair for a 59-year-old patient with an incisional ventral hernia. The placement of non-absorbable sutures for fascial closure was done with the help of a 14 gauge IV cannula instead of a transfascial suture passer. The rest of the procedural steps were the same as a standard laparoscopic IPOM repair. The patient's post-operative recovery was uneventful.
Discussion:
Primary fascial closure during a laparoscopic IPOM hernia repair can be done either by intracorporeal or extracorporeal techniques, using interrupted or continuous sutures. We propose a novel alternative to suture passer in primary fascial closure. IV cannulas are widely available in hospital settings. The advantage of using an IV cannula instead of a suture passer is that they are widely available. Its single-use also eliminates the risk of transmissible diseases, and as it has a smaller diameter than suture passer, it requires a lower insertion force for successful placement.
Conclusion:
An IV cannula may be used as a more economical alternative to a transfascial suture passer. This technique is easily reproducible and does not violate the principles of primary fascial defect closure in laparoscopic ventral hernia repair.
Case report: Double-armed flanged polypropylene suture for repairing wide iridodialysis
Authors: Tingting Peng, Huafang Guo, Yong Wang, Li Zhou, Xianyi Bao
Journal: Front Med (Lausanne) (2023)
Keywords: double-armed, flange, iridodialysis, polypropylene, suture
MeSH terms: Case Reports

Purpose:
To describe a new technique for repairing wide iridodialysis (>180°) with a double-armed flanged polypropylene suture.
Setting:
Private practice, Wuhan, China.
Design:
Case report.
Methods:
Adjacent to the iridodialysis side, the sclera was punctured 2 mm exterior to the corneal limbus into the anterior chamber with a 30-G needle, then the root of the de-inserted iris was punctured. A 7-0 polypropylene thread was placed into the anterior chamber through a corneal incision on the opposite side and inserted into the needle. The needle was withdrawn, leaving one side of the suture out of the eye. Then, the sclera was punctured by a new needle 2 mm from the first puncture site and passed through the iris root 2 mm from the original iris puncture point. The other end of the thread was inserted into the needle and taken out of the eye. The suture was tightened to make the iris root adhere to the corneal limbus. Finally, the suture is was cut, and the ends were cauterized and left inside the sclera. This procedure can be repeated until the iridodialysis is solved.
Results:
The abovementioned technique was applied in four cases. At the end of the operations, the pupils of all patients were nearly round, with a diameter of about 3 mm. No patient suffered from intraoperative and postoperative complications.
Conclusions:
The double-armed flanged polypropylene suture is a simple and safe operation method that can be applied to repair wide iridodialysis.
Beer Potomania: Why Initial Fluid Resuscitation May Be Harmful
Authors: Zhuo Lin Yu, Lisa Fisher
Journal: Case Rep Nephrol (2022)
MeSH terms: Case Reports

Beer potomania is one of the less common causes of hyponatremia that we encounter. Patients usually have a recent history of binge drinking along with poor diet. The low solute content in alcoholic beverages limits daily urine output, and ingestion of extra fluid will cause dilutional hyponatremia as a result. Blindly providing intravenous fluid without an underlying cause of the hyponatremia can be detrimental, such as in patients with beer potomania. In our case, a patient presented to the emergency department due to poor oral intake from jaw pain and was found to be hyponatremic from alcohol intake. He initially received 2 liters of fluid, which caused overcorrection of his sodium, requiring more free water to lower his sodium as a result.
Response to R-CHOP in HPV-related squamous cell carcinoma of base of tongue: a case report
Authors: Ting Martin Ma, Hyunseok Kang, Steven P Rowe, Ana P Kiess
Journal: Cancers Head Neck (2018)
Keywords: hpv, non-hodgkin’s lymphoma, r-chop, squamous cell carcinoma, synchronous
MeSH terms: Case Reports

Background:
Synchronous squamous cell carcinoma of the head and neck (HNSCC) and non-Hodgkin's lymphoma is a rare clinical scenario. It is unknown whether the R-CHOP chemotherapy for lymphoma would also be active against HNSCC. Herein, we present such a case and a review of the literature.
Case presentation:
A 64 year-old female presented with painless jaundice. CT demonstrated a retroperitoneal mass and pathology showed follicular lymphoma. A base-of-tongue HPV+ squamous cell carcinoma was found incidentally on staging CT. R-CHOP chemotherapy was initiated. After 3 cycles of R-CHOP the lymphoma had a complete metabolic response and, unexpectedly, the HNSCC also demonstrated excellent response. The patient received another 3 cycles followed by radiation to the HNSCC and to date is in remission for both cancers.
Conclusions:
This case highlights the exquisite sensitivity of HPV-related HNSCC, which should be taken into consideration in treatment prioritization of a concurrent diagnosis of a second cancer.
Fatal cryptococcal meningitis in a patient with chronic lymphocytic leukemia
Authors: Oguzhan Sıtkı Dizdar, Faruk Karakeçili, Belkıs Nihan Coşkun, Beyza Ener, Rıdvan Ali, Reşit Mıstık
Journal: Mediterr J Hematol Infect Dis (2012)
MeSH terms: Case Reports

Patients with chronic lymphocytic leukemia (CLL) are susceptible to infections, especially opportunistic infections. We have described a patient with CLL who had cryptococcal meningitis. Despite lack of previous immunosuppressive treatment history, the patient experienced serious and fatal fungal infection. Physicians should be alert for a diagnosis of cryptococcal meningitis in patient with CLL who developed fever and headache.
Acquired Amegakaryocytic Thrombocytopenia and Pure Red Cell Aplasia in Thymoma
Authors: Sumit Dahal, Eliza Sharma, Suyash Dahal, Binav Shrestha, Bikash Bhattarai
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Association of thymoma with myasthenia gravis, pure red cell aplasia, and aplastic anemia is well documented. However, thymoma complicated by acquired amegakaryocytic thrombocytopenia (AAMT) is rarely reported. Here, we present a case of a 60-year-old male with past medical history of recurrent invasive thymoma who presented with cough and blood in sputum. He was found to have severe normocytic normochromic anemia and thrombocytopenia that did not improve with intravenous steroids or multiple transfusions of red cells and platelets. Subsequent bone marrow biopsy showed severely depleted megakaryocytes and erythroid precursor cells with relative myeloid hyperplasia suggestive of amegakaryocytic thrombocytopenia and red cell aplasia. He was started on oral cyclosporine but subsequently developed leukopenia and refused any further treatment or diagnostic procedures and left the hospital against medical advice. AAMT, thus, may be a very early presentation of impending aplastic anemia, and treating physicians need to be aware of this entity.
The christchurch earthquake: crush injury, neuropathic pain, and posttraumatic stress disorder
Authors: Frances Cammack, Edward A Shipton
Journal: Case Rep Med (2013)

On February 22, 2011, an earthquake of magnitude 6.3 struck Christchurch, New Zealand. The peak ground acceleration, a measure of the shaking or intensity of an earthquake, was one of the highest ever recorded worldwide. One hundred and eighty-five people lost their lives; many others were injured. Two cases both involving young women are presented; they sustained crush injuries to limbs after being trapped by falling debris and went on to develop severe neuropathic pain. This report examines the mechanisms of neuropathic pain in the setting of crush injury, the treatment modalities, and the association between chronic pain and posttraumatic stress disorder. These case reports highlight the fact that crush injury is relatively common during major earthquakes and that neuropathic pain is an important sequel of this. Post-traumatic stress disorder is common in earthquake survivors with a recognised association with chronic pain. Pain-related disability may increase as well. Issues such as chronic pain and physical disability should not be overlooked as attention focuses on disaster management and the treatment of life-threatening injuries.