OpenMed/multicare-articles huggingface dataset:
Diabetic Muscle Infarction: Resolution of Rare Microangiopathy with Over-The-Counter Medication
Authors: Roopam Jariwal, Nadia Raza, Catherine Cadang, Syed Rahman, David Contreras, Ramanjeet Sidhu, Janpreet Bhandohal
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Diabetic muscle infarction (DMI) is a rare complication of poorly controlled type 1 and type 2 diabetes seen mostly in those who have already experienced microvascular complications. Currently, the incidence and prevalence of DMI are difficult to conclude, and there is no clear algorithm or standard of care in managing this condition. Pathogenesis of the microangiopathy of DMI remains unclear. A major finding in this investigation of DMI emphasizes that, within 2-17 weeks, patients who initiate low-dose acetylsalicylic acid, bed rest, and close outpatient follow-up see significant size reduction of lower extremity mass and complete resolution of pain without being subjected to invasive muscle biopsy.
Abdominoplasty for treatment of abdominal gun-shot wound sequalae - A case report
Authors: Vladislav Pavlovich Zhitny, Noama Iftekhar, Shannon Moreno, Frank Stile
Journal: Int J Surg Case Rep (2020)
Keywords: abdominoplasty, gunshot wound, scar revision, tummy tuck
MeSH terms: Case Reports

Background:
Gun violence is a public health epidemic in the United States with 15,315 non-suicide related deaths reported in 2019 by the Gun Violence Archive. To date, abdominoplasty is primarily a cosmetic procedure, which involves low-lying incision, removal of excess skin, fat, and tissue, and strengthening of the abdominal wall musculature. There currently are limited reports in regard to abdominoplasty as a procedure for scar revision and abdominal deformity repair associated with gunshot related injuries.
Methods:
An African American female patient, 38 years of age, presented for correction of a wide healed surgical incision and incisional hernia in the midline abdomen. This resulted from a trauma laparotomy in treatment of multiple gunshot wounds.
Results:
Patient presented post-operatively with no complications. She had successful reduction of her incisional hernia using an anatomic repair. Her wide hypertrophic abdominal scar was excised and primarily closed.
Conclusion:
In the cases of abdominal hernia and scarring secondary to trauma laparotomies performed for gunshot wounds, abdominoplasty is an option for revision and repair.
Locally aggressive monostotic fibrous dysplasia of the cervical spine mimicking malignancy: a case report and literature review
Authors: Audrey Milon, Marc Polivka, Fréderique Larousserie, Guillaume Lot, Jean-Marc Ziza, Jean-Denis Laredo
Journal: SICOT J (2019)
Keywords: aggressive, cervical spine, monostotic fibrous dysplasia, pathological fracture

We report the case of a 30-year-old woman with histologically proven monostotic fibrous dysplasia of C2 revealed by a pathological fracture of the odontoid process. Radiological investigations showed a ground-glass mineralization of the vertebral body, a centimetric lytic area with poorly defined margins involving the inferior part of the vertebral body and inferior endplate and a fracture through an osteolytic area in the base of the odontoid process. Owing to the vertebral instability, a surgical procedure combining C0-C5 fixation and posterior bone grafting was performed. The surgical biopsy was inconclusive and pathological confirmation was finally obtained through a percutaneous needle biopsy under fluoroscopic guidance. At 26-month follow-up, the patient still experienced mild persistent cervical posterior neck pain and stiffness possibly related to a C5-6 laxity below the intervertebral fixation. This case combines three radiological findings, which are unusual in fibrous dysplasia: monostotic presentation involving the spine, some aggressive radiographic features, and a pathological fracture.
Case Report: Surgical Intervention Under Pheochromocytoma Multisystem Crisis: Timing and Approach
Authors: Shengjun Luo, Qingao Cui, Delin Wang
Journal: Front Oncol (2022)
Keywords: va-ecmo, emergency surgery, laparoscopy, pheochromocytoma, pheochromocytoma multisystem crisis
MeSH terms: Case Reports

Background:
Progressive multiple organ failures still occur in some patients with pheochromocytoma multisystem crisis (PMC) despite α- and β-blockade being used, and emergency adrenalectomy may lead to rapid hemodynamic stabilization and recovery. Therefore, the optimal timing and surgical approach under PMC remain controversial.
Case presentation:
A 50-year-old man presented with persistent chest pain accompanied by vomiting and headache. CT showed a right adrenal mass, and plasma catecholamine levels were significantly elevated. Phenoxybenzamine was used, but his symptoms were aggravated. He progressed to acute respiratory distress syndrome (ARDS) and received mechanical ventilation. Reexamination of CT showed pheochromocytoma rupture. Emergency pheochromocytoma resection was performed on the 5th day, and he was discharged on the 21st day. A 46-year-old woman was admitted for intrauterine device removal and received hysteroscopy under intravenous anesthesia. She presented with dyspnea, fluctuating blood pressure, and loss of consciousness 9 h after hysteroscopy surgery. CT showed a left adrenal mass, and plasma catecholamine levels were significantly elevated. Her condition fluctuated and could not meet the preoperative preparation criteria for pheochromocytoma despite adequate doses of α-blockade and β-blockade were taken. Furthermore, her lung condition worsened due to recurrent crises and pulmonary edema. After multidisciplinary discussions, laparoscopic left adrenalectomy with venoarterial extracorporeal membrane oxygenation (VA-ECMO) support was performed on the 28th day, and she was discharged on the 69th day.
Conclusion:
Elective surgical resection is the essential therapy for PMC with adequate preoperative medical management. Emergency surgery is recommended for patients who fail to achieve medical stabilization or progressive organ dysfunction within 1 week, especially those with tumor rupture and uncontrolled bleeding. The laparoscopic approach may represent an option even under PMC.
Biological Restoration of a Fractured Anterior Tooth with the Use of Dentine Pin (Biopins)
Authors: Lilian Capanema Nogueira, Karine Taís Aguiar Tavano, Nayara Kelly Lyrio Ferraz, José Cristiano Ramos Glória, Adriana Maria Botelho
Journal: Case Rep Dent (2015)

This case study describes the esthetic and functional reconstruction of a fractured maxillary central incisor. Due to the requirement for additional retention, treatment was performed using the homogenous technique of biological restoration associated with cementation of posts made from human dentin (biopins). This type of treatment is a new alternative to conventional techniques and favors the dental esthetic and function, as well as biocompatibility, and is an inexpensive procedure.
Congenital Myasthenic Syndrome Caused by a Novel Hemizygous CHAT Mutation
Authors: Yixia Zhang, Xinru Cheng, Chenghan Luo, Mengyuan Lei, Fengxia Mao, Zanyang Shi, Wenjun Cao, Jingdi Zhang, Qian Zhang
Journal: Front Pediatr (2020)
Keywords: chat mutation, apnoea, congenital myasthenic syndrome, genetic diagnosis, hemizygous
MeSH terms: Case Reports

Congenital myasthenic syndrome (CMS) is a neuromuscular transmission disorder caused by mutations in genes encoding neuromuscular junction proteins. CMS due to choline acetyltransferase (CHAT) gene mutation is characterized by episodic apnoea. To date, 52 cases of CMS caused by CHAT gene mutations have been reported. Here, we report a neonate with the third hemizygous mutation [a 4.9 Mb deletion [10q11.22-10q11.23 (chr10: 46123781-51028772)] containing the whole CHAT gene and c.1976A>T (p.Gln659Leu in the CHAT gene)]. The c.1976A>T (p.Gln659Leu) variant had not been reported in the ExAC or gnomAD databases and was predicted to be pathogenic. The alignment of amino acid sequences revealed that glutamine at codon 659 is highly conserved in different species and causes structural changes in the substrate-binding site. Our female patient with neonate-onset CMS presented with apnoea, dyspnoea, feeding difficulties, weak crying, and seizure-like episodes, and her respiration was ventilator dependent. The prostigmine test was positive. This case may help to further elucidate clinical features and treatment methods in neonate-onset CMS caused by CHAT gene mutations.
Gastrointestinal Pyogenic Granuloma (Lobular Capillary Hemangioma): An Underrecognized Entity Causing Iron Deficiency Anemia
Authors: Marshall W Meeks, Umar M Kamal, Muhammad B Hammami, Jason R Taylor, M Louay Omran, Yongxin Chen, Jin-Ping Lai
Journal: Case Rep Gastrointest Med (2016)

Pyogenic granuloma (PG), more accurately known as lobular capillary hemangioma, is a benign vascular tumor that usually occurs in the skin or oral mucosa. This lesion is rarely reported in the gastrointestinal tract but is known to bleed if not resected. We herein describe a case series with the clinical, endoscopic, and histologic findings of four cases of gastrointestinal PG at our institution. In addition, we provide a review of the literature and summation of all reported cases of PG specific to the gastrointestinal tract. Based on our experience, we suggest that the actual incidence of gastrointestinal PG may in fact be higher than reported because PG can be unrecognized or improperly diagnosed. It is important for the clinician to properly recognize this lesion as a source of anemia and its propensity to bleed during biopsy or resection.
EEG Assessment in a 2-Year-Old Child with Prolonged Disorders of Consciousness: 3 Years' Follow-up
Authors: Gang Xu, Qianqian Sheng, Qinggang Xin, Yanxin Song, Gaoyan Zhang, Lin Yuan, Peng Zhao, Jun Liang
Journal: Comput Intell Neurosci (2020)
MeSH terms: Consciousness Disorders / diagnosis, Consciousness, Case Reports, Child, Child, Preschool, Electroencephalography, Female, Follow-Up Studies, Humans, Persistent Vegetative State

A 2-year-old girl, diagnosed with traumatic brain injury and epilepsy following car trauma, was followed up for 3 years (a total of 15 recordings taken at 0, 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 14, 19, 26, and 35 months). There is still no clear guidance on the diagnosis, treatment, and prognosis of children with disorders of consciousness. At each appointment, recordings included the child's height, weight, pediatric Glasgow Coma Scale (pGCS), Coma Recovery Scale-Revised (CRS-R), Gesell Developmental Schedule, computed tomography or magnetic resonance imaging, electroencephalogram, frequency of seizures, oral antiepileptic drugs, stimulation with subject's own name (SON), and median nerve electrical stimulation (MNS). Growth and development were deemed appropriate for the age of the child. The pGCS and Gesell Developmental Schedule provided a comprehensive assessment of consciousness and mental development; the weighted Phase Lag Index (wPLI ) in the β-band (13-25 Hz) can distinguish unresponsive wakefulness syndrome from minimally conscious state and confirm that the SON and MNS were effective. The continuous increase of delta-band power indicates a poor prognosis. Interictal epileptiform discharges (IEDs) have a cumulative effect and seizures seriously affect the prognosis.
Case Report: Rare presentation of adult intussusception at Orotta National Referral Hospital, Eritrea
Authors: Senay Iyassu, Million Abraha
Journal: F1000Res (2019)
Keywords: abdominal pain, bowel obstruction, intussusception
MeSH terms: Case Reports

A 38-year-old woman presented at Orotta National Referral Hospital emergency department in May 2017 with pain in the epigastric region and vomiting. Physical examination revealed no pertinent findings. Blood and urine tests were normal, and erect abdominal x-ray revealed a distended small intestine with multiple layers of "air-fluid levels". CT scan and MRI were not done due to their temporary unavailability. During laparotomy a large mass of 20x20 cm in size was detected in the mid-jejunum of the small intestine. This leading tumor caused intussusception and coiling of the small intestine. As there are no typical symptoms of intussusception, it is very important to do CT scan for patients with long-standing abdominal pain and vomiting to achieve a definitive diagnosis of intussusception.
Hepatic Epithelioid Angiomyolipoma Treated with Laparoscopic Resection: Case Report and Review of the Literature
Authors: Chloe H Williams, Kelli Hickle, Katherine Bakke, Sarah Jamshed, Adel Bozorgzadeh
Journal: Case Reports Hepatol (2019)
MeSH terms: Case Reports

Hepatic angiomyolipoma is a rare primary liver tumor, with a radiographic appearance very similar to hepatocellular carcinoma. We present the case of a noncirrhotic patient with a liver tumor suspicious for HCC by imaging features. Liver biopsy demonstrated angiomyolipoma, and the patient successfully underwent a laparoscopic liver resection.
Perivascular epithelioid cell tumor of the rectum: report of a case and review of the literature
Authors: Amane Kanazawa, Shoichi Fujii, Ten-i Godai, Atsushi Ishibe, Takashi Oshima, Tadao Fukushima, Mitsuyoshi Ota, Norio Yukawa, Yasushi Rino, Toshio Imada, Junko Ito, Akinori Nozawa, Munetaka Masuda, Chikara Kunisaki
Journal: World J Surg Oncol (2014)
MeSH terms: Perivascular Epithelioid Cell Neoplasms / pathology, Rectal Neoplasms / pathology, Case Reports, Review, Female, Humans, Middle Aged, Perivascular Epithelioid Cell Neoplasms / surgery, Prognosis, Rectal Neoplasms / surgery

We report a case of perivascular epithelioid cell tumor arising in the rectum of a 55-year-old woman. The tumor was treated by transanal endoscopic microsurgery. After 1 year follow-up, the patient is alive with no radiologic or endoscopic evidence of recurrence. Perivascular epithelioid cell tumor is a rare mesenchymal tumor characterized by co-expression of melanocytic and smooth muscle markers. This rare tumor can arise in various organs, including the falciform ligament, uterus, uterine cervix, liver, kidney, lung, breast, cardiac septum, pancreas, prostate, thigh, and gastrointestinal tract. Perivascular epithelioid cell tumor of the gastrointestinal tract is very rare, with only 23 previously reported cases. We review the literature on perivascular epithelioid cell tumors arising in the gastrointestinal tract.
Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD
Authors: Philip T Sobash, Achuta K Guddati, Vamsi Kota
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Ruxolitinib has become a new therapeutic option for steroid refractory graft-versus-host disease (srGVHD), with a substantial remission rate. Its anti-inflammatory properties by blocking interleukin pathways have made it a novel therapeutic approach to inflammatory disease processes, such as GVHD. The long-term use of ruxolitinib has not been explicitly studied outside the context in the treatment of multiple myeloma. With current clinical trials underway for the use of ruxolitinib in srGVHD, there are still no current guidelines or protocols for long-term clinical use. Of the available literature showing ruxolitinib utilization for srGVHD, most cases lead to resolution and eventual discontinuation. We present a case of a 32-year-old male on ruxolitinib with GVHD status postmatched unrelated donor stem cell transplant (MUD SCT) for acute myeloid leukemia (AML) with FLT3 mutation currently on ruxolitinib for 5 years who is not able to tolerate reduction in dosage due to flare-ups. We discuss the clinical implications and nuance of therapy with ruxolitinib with unknown long-term effects and weigh the risks and benefits.
Image of the Month: High Pressure Distal Colostogram in a Patient with an Anorectal Malformation
Authors: Anisha Apte, Giulia Brisighelli, Elise McKenna, Marc A Levitt
Journal: European J Pediatr Surg Rep (2020)
Keywords: anorectal malformation, high pressure distal colostogram, recto-urinary fistula
MeSH terms: Case Reports

An adequately performed high pressure distal colostogram is crucial to plan surgery in male patients born with anorectal malformations. We present two male patients that underwent a divided sigmoid colostomy with distal mucus fistula in the neonatal period and at 6 months of age underwent a high pressure distal colostogram. In the discussion, we will give some tricks beyond the known rules: how to correctly interpret a high pressure distal colostogram, how to identify the level of a recto-urinary fistula, and how to accurately plan the surgical approach.
Treatment of chronic myelomonocytic leukemia with 5-azacytidine: case reports
Authors: Peter Rohon, Jana Vondrakova, Anna Jonasova, Milena Holzerova, Marie Jarosova, Karel Indrak
Journal: Case Rep Hematol (2012)
MeSH terms: Case Reports

Epigenetic therapy with hypomethylating agent (5-azacytidine; AZA) is common in the management of specific subtypes of myelodysplastic syndrome (MDS), but there are only few studies in chronic myelomonocytic leukemia (CMML) patients. In this paper our experience with 3 CMML patients treated with AZA is described. In one patient transfusion independency was observed after 4 treatment cycles; in one case a partial response was recorded, but a progression to acute myeloid leukemia (AML) after 13 AZA cycles has appeared. In one patient, AZA in reduced dosage was administered as a bridging treatment before allogeneic stem cell transplantation (ASCT), but in the control bone marrow aspirate (before ASCT) a progression to AML was recorded. Future studies are mandatory for evaluation of new molecular and clinical features which could predict the efficiency of hypomethylating agents in CMML therapy with respect to overall survival, event-free survival, quality-adjusted life year, and pharmacoeconomy.
Unilateral acute maculopathy associated with adult onset hand, foot and mouth disease: case report and review of literature
Authors: Rupesh Agrawal, Kanchan Bhan, Kam Balaggan, Richard Wj Lee, Carlos E Pavesio, Peter Kf Addison
Journal: J Ophthalmic Inflamm Infect (2015)
Keywords: acute maculopathy, autofluorescence, coxsackie virus, hand, posterior uveitis, foot and mouth disease (hfmd)

Background:
Acute maculopathy is a rare condition of unknown aetiology and Coxsackie virus is known to be associated with this macular chorioretinitis.
Findings:
We report a case of acute unilateral maculopathy in a 35-year-old woman with concurrent hand foot and mouth disease. Furthermore, we display multimodal imaging (colour fundus photographs, autofluorescence, spectral domain ocular coherence tomography, fluorescein angiography and indocyanine green angiography) charting the course of the disease. The source of the virus was thought to be the patient's child. Empirical treatment with oral corticosteroids was commenced and the inflammation resolved, leaving a residual macular scar.
Conclusions:
We present this case combined with the review of literature of adult onset Coxsackie-virus-associated retinitis. This case reiterates the fact that Coxsackie virus is an uncommon but important consideration in the differential diagnosis of chorioretinitis and posterior uveitis with atypical retinopathy.
Effectiveness and functional magnetic resonance imaging outcomes of Tuina therapy in patients with post-stroke depression: A randomized controlled trial
Authors: Jiming Tao, Shuaipan Zhang, Lingjun Kong, Qingguang Zhu, Chongjie Yao, Qingjuan Guo, Jiajia Wu, Chunlei Shan, Min Fang
Journal: Front Psychiatry (2022)
Keywords: tuina, cognitive function, functional magnetic resonance imaging, post-stroke depression, traditional chinese medicine
MeSH terms: Case Reports

Objective:
To investigate the effectiveness and functional magnetic resonance imaging (fMRI) outcomes of Tuina therapy in patients with post-stroke depression (PSD).
Methods:
This was a single-center, randomized, two-armed, controlled trial. Eighty-four patients with PSD were selected and randomly assigned to a Tuina therapy group or a routine rehabilitation control group. The patients underwent five 20-min treatment sessions per week over a period of 2 weeks. The primary outcome measure was change in Hamilton Depression Rating Scale (HAMD) score over the 2 weeks of intervention, whereas the secondary outcome measures were changes in Fugl-Meyer Assessment (FMA) score, Modified Barthel index (MBI), and Mini Mental State Examination (MMSE) score.
Results:
The Tuina group showed significantly improved HAMD scores compared to the routine rehabilitation control group (5.85, [2.54, 9.16]). For the secondary outcomes, the Tuina group showed better MMSE scores than the routine rehabilitation group (1.97, [1.19, 2.76]); however, there were no significant differences between the other secondary outcomes of both groups (P > 0.05). After 2 weeks, both groups showed a significant decrease in HAMD score compared to baseline. In addition, the Tuina group showed a significant decrease in MMSE score compared to baseline (2.35, [1.8, 2.9]); however, there were no significant differences in the MBI and FMA scores of the two group after the intervention (P > 0.05). Regarding fMRI results, the zALFF values of the right caudate nucleus, right putamen, right insula, left superior temporal gyrus, right parahippocampal gyrus, right hippocampus, left middle temporal gyrus, left angular gyrus, and left thalamus were higher in the Tuina group. In the Tuina group, the functional connectivity between the hippocampus and thalamus, and the thalamus and caudate nucleus, were significantly different (P <0.01). In addition, the zALFF value of the hippocampus was significantly negatively correlated with HAMD score. No serious adverse events were observed in both groups.
Conclusion:
Tuina therapy administered 10 times within 2 weeks is safe and can effectively relieve depression and improve cognitive function in patients with PSD. This finding may be closely related to the effect of Tuina therapy on the activation and functional connectivity of the hippocampus.
Clinical trial registration:
http://www.chictr.org.cn/showproj.aspx?proj=55151, identifier ChiCTR200003388.
A Retroperitoneal Leiomyosarcoma Presenting as an Adrenal Incidentaloma in a Subject on Warfarin
Authors: Ishrat N Khan, Mohamed A Adlan, Michael J Stechman, Lakdasa D Premawardhana
Journal: Case Rep Endocrinol (2015)

Adrenal incidentalomas (AIs) are mostly benign and nonsecretory. Management algorithms lack sensitivity when assessing malignant potential, although functional status is easier to assess. We present a subject whose AI was a retroperitoneal leiomyosarcoma (RL). Case Presentation. A woman on warfarin with SLE and the antiphospholipid syndrome, presented with left loin pain. She was normotensive and clinically normal. Ultrasound scans demonstrated left kidney scarring, but CT scans revealed an AI. MRI scans later confirmed the AI without significant fat and no interval growth. Cortisol after 1 mg dexamethasone, urinary free cortisol and catecholamines, plasma aldosterone renin ratio, and 17-hydroxyprogesterone were within the reference range. Initially, adrenal haemorrhage was diagnosed because of warfarin therapy and the acute presentation. However, she underwent adrenalectomy because of interval growth of the AI. Histology confirmed an RL. The patient received adjuvant radiotherapy. Discussion. Our subject presented with an NSAI. However, we highlight the following: (a) the diagnosis of adrenal haemorrhage in this anticoagulated woman was revised because of interval growth; (b) the tumour, an RL, was relatively small at diagnosis;