OpenMed/multicare-articles huggingface dataset:
Case Report: Dental treatment for an oboist: Post-trauma prosthetic rehabilitation and evaluation of musical performance
Authors: Mariko Hattori, Sebastian B M Patzelt, Michiichiro Itoh, Yuka I Sumita, Noriyuki Wakabayashi
Journal: Front Psychol (2023)
Keywords: dentistry, implant, musician, oboe, prosthodontics, trauma
MeSH terms: Case Reports

Introduction:
The condition of teeth and function of the oral organs are important when playing wind or brass instruments. Although there are some reports on dental treatment for musicians, few studies have investigated their acoustic performance following treatment. This report describes the prosthodontic rehabilitation provided for an oboist who had lost a tooth as a result of trauma and includes an evaluation of her subsequent musical performance using acoustic analyzes.
Case description:
The patient was a 63-year-old professional oboe player who fractured the upper and lower alveolar bone and avulsed the upper right central incisor during a fall due to epileptic seizure. While the alveolar fracture was healing, she sought maxillofacial rehabilitation for the missing tooth to maintain her ability to play the oboe. Her rehabilitation consisted of a provisional removable prosthesis with an acrylic base and clasps followed by a fixed implant prosthesis. A recording of her musical performance was objectively analyzed at each stage of treatment. Rhythm analysis confirmed the stability of notes played rapidly. Her performance dynamics were analyzed by psychoacoustic measurements. Her satisfaction with the prosthesis was assessed by a self-reported questionnaire. The results of the acoustic evaluation helped to adjust the provisional prosthesis so that it was suitable for playing the oboe and the final prosthesis was designed accordingly.
Conclusion:
Prosthetic dental treatment for this patient included both subjective and objective evaluations that helped to ensure that she could continue playing the oboe at her previous performance level.
Delineation variable genotype/phenotype correlations of 6q27 terminal deletion derived from dic(6;18)(q27;p10)
Authors: Lili Zhou, Chong Chen, Huanzheng Li, Yunying Chen, Xueqin Xu, Xiaoling Lin, Shaohua Tang
Journal: Mol Cytogenet (2014)
Keywords: 6q27 deletion, hypotonia, mental retardation, rearrangement, trisomy 18p
MeSH terms: Case Reports

Background:
Terminal deletion of 6q27 produces a rare syndrome associated with unexplained mental retardation, hypotonia, epilepsy, and multiple malformations. Structural brain malformations are consistently observed, including agenesis of the corpus callosum, hydrocephalus, periventricular nodular heterotopia, polymicrogyria, and cerebellar malformations. Here we report a fetal risk assessment of a 27-year-old woman with mental retardation, hypotonia and dysmorphic features at 17 weeks of pregnancy.
Results:
Cytogenetic analyses revealed an addition at chromosome 6qter in the mother. Haploinsufficiency of 6q27 to 6qter (1.3 Mb) and trisomy of the entire short arm of chromosome 18 (15.2 Mb) were found using a single nucleotide polymorphism based array. Results were confirmed by molecular cytogenetics and multiplex ligation-dependent probe amplification. The karyotype of the mother was 46,XX dic(6;18)(6pter → 6q27::18p10 → 18pter).arr [hg19]6q27(169,591,548-170,898,549) × 1,18p11.3p10(12,842-15,375,878) × 3.ish dic(6;18)(q27;p10)(RP11-614P3-,RP11-1035E2+,D18Z1+). Deletion of 6q27 was associated with the structural brain malformations, whereas trisomy of 18p had minor clinical effects. The unbalanced rearrangement of chromosome 6 and chromosome 18 was de novo and was not inherited by the developing fetus.
Conclusions:
A rare rearrangement between 6q27 and 18p was identified, which led to a de novo 1.3 Mb deletion of 6q27 and a 15.2 Mb duplication of 18p in an adult with mental retardation, hypotonia, epilepsy, and multiple malformations.
A Case of Respiratory Epithelial Adenomatoid Hamartoma (REAH) in a Patient with History of Radiation Exposure
Authors: Darshan N Patel, Yekaterina A Koshkareva, Miles McFarland, Nathan A Deckard
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Respiratory epithelial adenomatoid hamartomas (REAHs) are becoming a more commonly recognized otolaryngologic tumor and are often misdiagnosed as inverted papilloma. Here, we present such a case in a patient with history of previous radiation exposure. Otolaryngologists and pathologists should be aware of the mucinous histological appearance of REAH to help differentiate from other growths. Given our patient's history, an association between REAH and previous radiation exposure is worth consideration.
Peripheral Cytotoxic T Cell Lymphoma of the Appendix Presenting as Acute Appendicitis
Authors: Negin Rahmani, Yahya Daneshbod, Hadi Mirfazaelian, Elnaz Vahidi, Sadegh Shirian
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Introduction:
Lymphoma of the appendix is a rare cause of acute appendicitis; however, acute appendicitis is a common first manifestation of appendiceal lymphomas. Cytotoxic peripheral T cell lymphoma (PTCL) is a type of aggressive non-Hodgkin lymphoma that portends a generally poor outcome. Cytotoxic PTCL of the appendix is extremely rare with few cases reported in the literature. Case Presentation. This is the report of a 23-year-old man who had experienced lower abdominal pain for three months before presenting to the emergency department with severe right lower abdominal pain, nausea, vomiting, and anorexia since the day prior to admission. The patient was diagnosed with acute appendicitis, and the pathology report confirmed cytotoxic PTCL of the appendix.
Conclusion:
Patients with appendiceal PTCL commonly present with signs and symptoms of acute appendicitis due to luminal obstruction by the tumor. Therefore, appendiceal tumors such as PTCL should be considered in the differential diagnosis of patients presenting as acute appendicitis. In addition, since there is no standard chemotherapy regimen for cytotoxic PTCL, this and other case reports hopefully help in providing the clinical evidence needed for establishing appropriate treatment guidelines.
Contralateral facial nerve palsy following mandibular second molar removal: is there co-relation or just coincidence?
Authors: Mohammed Zalagh, Ali Boukhari, Hicham Attifi, Mounir Hmidi, Abdelhamid Messary
Journal: Pan Afr Med J (2014)
Keywords: facial nerve palsy, anaesthetic injection, molar removal
MeSH terms: Facial Paralysis / etiology, Herpesvirus 1, Human / physiology, Mandible / surgery, Molar / surgery, Postoperative Complications / etiology, Tooth Extraction, Virus Activation, Case Reports, Adult, Anesthetics, Local / adverse effects, Diabetes Complications, Dysgeusia / etiology, Electromyography, Facial Paralysis / virology, Herpes Simplex, Humans, Hyperacusis / etiology, Lubricant Eye Drops, Male, Operative Time, Postoperative Complications / virology, Prednisone / therapeutic use, Stress, Psychological, Anesthetics, Local, Lubricant Eye Drops, Prednisone

Peripheral facial nerve palsy (FNP) is the most common cranial nerves neuropathy. It is very rare during dental treatment. Classically, it begins immediately after the injection of local anaesthetic into the region of inferior dental foramen and it's homolateral to the injection. Recovery takes a few hours, normally as long the anaesthetic lasts. The authors present a 44-year-old patient who presented a contralateral delayed-onset facial paralysis arising from dental procedure and discuss the plausible pathogenesis mechanism of happen and a possible relationship between dental procedure and contralateral FNP.
Challenging Diagnosis of a Congenital Tracheal Malformation: Considerations From an Intensive Care Perspective
Authors: Catarina G Morais, Carolina Baptista, Marta Grilo, Amélia Moreira, Augusto Ribeiro
Journal: Cureus (2023)
Keywords: airway resistance, congenital abnormalities, mechanical ventilators, pediatric intensive care units, tracheal stenosis
MeSH terms: Case Reports

Congenital tracheal stenosis is a rare airway malformation. A high index of suspicion is fundamental. The authors report a case of congenital tracheal stenosis in a 13-month-old male infant, with a challenging diagnosis from the intensive care perspective. At birth, the patient presented an anorectal malformation with a recto-urethral fistula so a colostomy with mucous fistula was performed in the neonatal period. At the age of seven months, he was admitted due to a respiratory infection, treated with steroids and bronchodilators, and discharged after three days without any complications. He underwent complete repair of tetralogy of Fallot when he was 11 months old, which was performed without any reported perioperative complications. However, at the age of 13 months, due to another respiratory infection, he presented more severe symptoms and required admission to the pediatric intensive care unit (PICU) for invasive mechanical ventilation. He was intubated on the first attempt. While monitoring the difference between peak inspiratory and plateau pressures, we observed a sustained elevated difference between pressures suggestive of increased airway resistance, thus raising the possibility of an anatomical obstruction. Laryngotracheoscopy confirmed distal tracheal stenosis (grade II) with four complete tracheal rings. In our case, the absences of perioperative challenges or complications in previous respiratory infections were not suggestive of a tracheal malformation. Furthermore, no difficulties were encountered during intubation due to the distal location of the tracheal stenosis. A careful appreciation of respiratory mechanics on the ventilator at rest and during tracheal aspirations was essential to suspect an anatomical defect.
A Case Series Demonstrating the Difficulties in Diagnosing COVID-19 Associated Pulmonary Aspergillus
Authors: Sindhubarathi Murali, Hanish Jain, Saketh Velepati, Muhammad Alvi, Ioana Amzuta
Journal: Cureus (2023)
Keywords: aspergillus bronchopneumonia, covid-19, medical intensive care unit, missed diagnosis, prolonged mechanical ventilation
MeSH terms: Case Reports

Many bacterial, viral, and fungal co-infections have been reported with COVID-19-associated acute respiratory distress syndrome (ARDS). Invasive Aspergillosis has been described with COVID-19 ARDS. However, it continues to evade diagnosis in critically ill patients admitted to the intensive care unit (ICU). The difficulty is discerning an actual infection from colonization. Unfortunately, a timely diagnosis is crucial since COVID-19-associated pulmonary Aspergillus (CAPA) has high morbidity and mortality. We present three ICU cases of CAPA to illustrate the difficulty in diagnosing and treating the disease. We hope to bring awareness and improve patient outcomes of CAPA.
Axenfeld-Rieger Syndrome Associated with Congenital Glaucoma and Cytochrome P4501B1 Gene Mutations
Authors: Mukesh Tanwar, Tanuj Dada, Rima Dada
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Developmental anomalies of the ocular anterior chamber angle may lead to an incomplete development of the structures that form the conventional aqueous outflow pathway. Thus, disorders that present with such dysfunction tend to be associated with glaucoma. Among them, Axenfeld-Rieger (ARS) malformation is a rare clinical entity with an estimated prevalence of one in every 200,000 individuals. The changes in eye morphogenesis in ARS are highly penetrant and are associated with 50% risk of development of glaucoma. Mutations in the cytochrome P4501B1 (CYP1B1) gene have been reported to be associated with primary congenital glaucoma and other forms of glaucoma and mutations in pituitary homeobox 2 (PITX2) gene have been identified in ARS in various studies. This case was negative for PITX2 mutations and compound heterozygote for CYP1B1 mutations. Clinical manifestations of this patient include bilateral elevated intraocular pressure (>40 mmHg) with increased corneal diameter (>14 mm) and corneal opacity. Patient also had iridocorneal adhesions, anteriorly displaced Schwalbe line, anterior insertion of iris, broad nasal bridge and protruding umbilicus. This is the first study from north India reporting CYP1B1 mutations in Axenfeld-Rieger syndrome with bilateral buphthalmos and early onset glaucoma. Result of this study supports the role of CYP1B1 as a causative gene in ASD disorders and its role in oculogenesis.
Spinal Metastasis of Well-Differentiated Liposarcoma Component in Retroperitoneal Dedifferentiated Liposarcoma Treated by Minimally Invasive Surgery
Authors: Jiro Ichikawa, Tetsuro Ohba, Hiroaki Kanda, Koji Fujita, Shigeto Ebata, Hirotaka Haro
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Case:
Generally, well-differentiated liposarcoma (WDL) has recurrence potential but lacks metastatic potential. We present a rare case of spinal metastasis of WDL component in retroperitoneal dedifferentiated liposarcoma (DDL) treated by tumor curettage and L1 laminectomy followed by percutaneous pedicle screw fixation. Histological examination showed metastasis of the WDL component of DDL. The patient was ambulatory until death.
Conclusion:
To our knowledge, no case of spinal metastasis of WDL component in retroperitoneal DDL has been reported. We should carefully consider characteristics of DDLs during treatment. Minimally invasive surgery may be a powerful tool in patients with spinal metastasis.
Hyperacute rejection of a living unrelated kidney graft
Authors: Dietlind Tittelbach-Helmrich, Dirk Bausch, Oliver Drognitz, Heike Goebel, Christian Schulz-Huotari, Albrecht Kramer-Zucker, Ulrich Theodor Hopt, Przemyslaw Pisarski
Journal: Case Rep Med (2014)

We present a case report of a 59-year-old man, who received a blood group identical living unrelated kidney graft. This was his second kidney transplantation. Pretransplant T-cell crossmatch resulted negative. B-cell crossmatch, which is not considered a strict contraindication for transplantation, resulted positive. During surgery no abnormalities occurred. Four hours after the transplantation diuresis suddenly decreased. In an immediately performed relaparotomy the transplanted kidney showed signs of hyperacute rejection and had to be removed. Pathological examination was consistent with hyperacute rejection. Depositions of IgM or IgG antibodies were not present in pathologic evaluation of the rejected kidney, suggesting that no irregular endothelial specific antibodies had been involved in the rejection. We recommend examining more closely recipients of second allografts, considering not only a positive T-cell crossmatch but also a positive B-cell crossmatch as exclusion criteria for transplantation.
The "chameleon" sellar lesions: a case report of unexpected sellar lesions
Authors: Ilaria Bove, Raduan Ahmed Franca, Lorenzo Ugga, Domenico Solari, Andrea Elefante, Maria Laura Del Basso De Caro, Luigi Maria Cavallo
Journal: Front Neurol (2023)
Keywords: endoscopic endonasal surgery, neuroimaging, oncology, pathology, sellar region
MeSH terms: Case Reports

Introduction:
The sellar region and its boundaries represent a challenging area, harboring a variety of tissues of different linings. Therefore, a variety of diseases can arise or involve in this area (i.e., neoplastic or not). A total of three challenging cases of "chameleon" sellar lesions treated via EEA were described, and the lesions mimicked radiological features of common sellar masses such as craniopharyngiomas and/or pituitary adenomas, and we also report a literature review of similar cases.
Methods:
A retrospective analysis of three primary cases was conducted at the Università degli Studi di Napoli Federico II, Naples, Italy. Clinical information, radiological examinations, and pathology reports were illustrated.
Results:
A total of three cases of so-called "chameleon" sellar lesions comprising two men and one woman were reported. Based on the intraoperative finding and pathological examination, we noticed that case 1 had suprasellar glioblastoma, case 2 had a primary neuroendocrine tumor, and case 3 had cavernous malformation.
Conclusion:
Neurosurgeons should consider "unexpected" lesions of the sellar/suprasellar region in the preoperative differential diagnosis. A multidisciplinary approach with the collaboration of neurosurgeons, neuroradiologists, and pathologists plays a fundamental role. The recognition of unusual sellar lesions can help surgeons with better preoperative planning; so an endoscopic endonasal approach may represent a valid surgical technique to obtain decompression of the optic apparatus and vascular structures and finally a pathological diagnosis.
Ultrasound-guided placement of a midline catheter in a patient with extensive postburn contractures: A Case report
Authors: Taisuke Yokota, Joho Tokumine, Alan Kawarai Lefor, Ayako Hasegawa, Tomoko Yorozu, Takayuki Asao
Journal: Medicine (Baltimore) (2019)
MeSH terms: Burns / complications, Catheterization, Peripheral / methods, Cicatrix / complications, Contracture / etiology, Ultrasonography, Interventional / methods, Case Reports, Adult, Cicatrix / surgery, Female, Humans, Skin Transplantation / methods, Vascular Access Devices

Rationale:
Obtaining venous access in a patient with extensive postburn scar contractures is a challenge.
Patient concerns:
A 39-year-old woman suffered a burn 2 years previously with a total body surface area burn of 93%, and a burn index of 85. Reconstructive surgery was previously performed 39 times. Split-thickness skin grafting to the neck was planned. She had no accessible peripheral veins.
Diagnosis:
Difficult venous access due to excessive burn scar contractures.
Interventions:
Central venous catheterization was considered impossible even with ultrasound guidance. We placed a midline catheter for intraoperative venous access in a patient with extensive burn scar contractures. The midline catheter is a peripheral venous catheter placed in an arm vein.
Outcomes:
We successfully placed a midline catheter in the right brachial vein. This catheter was used for 24 days without difficulty.
Lessons:
The midline catheter is a viable choice in patients with difficult vascular access due to extensive postburn scar contractures.
Sturge-Weber Syndrome with Bilateral Port-Wine Stain
Authors: Bishnu Deep Pathak, Shriya Sharma, Aakriti Adhikari, Nabin Simkhada, Bhuwan Ghimire, Nirjala Aryal
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Sturge-Weber syndrome is a rare congenital neurocutaneous disorder characterized by dermatological, ophthalmological, and neurological manifestations. It occurs due to abnormal persistence of embryonic vascular plexus. Here, we describe a case of four years seven months female with seizures, developmental delay, intellectual disability, and bilateral port-wine stain diagnosed as type I (classical) Sturge-Weber syndrome. The ophthalmological evaluation was unremarkable. Electroencephalogram showed abnormalities suggestive of a structural lesion in the right cerebral hemisphere. CT scan of the head revealed volume loss of right brain parenchyma with linear, cortical, as well as subcortical calcifications more evident in the right hemisphere. The child should be followed up regularly until adulthood for ophthalmological evaluation, recurrence of seizures, and other manifestations of this disorder.
Multidosing Intramuscular Administration of Methotrexate in Interstitial Pregnancy With Very High Levels of β-hCG: A Case Report and Review of the Literature
Authors: Valeria Conti, Giovanni Luciano, Giovanni Pecoraro, Roberto Iovieno, Amelia Filippelli, Maurizio Guida
Journal: Front Endocrinol (Lausanne) (2018)
Keywords: b-hcg, conservative management, ectopic pregnancy, interstitial preganancy, treatment scheme
MeSH terms: Case Reports

Ectopic pregnancy (EP) is the implantation of an embryo outside the endometrial cavity of the uterus. Signs and symptoms of EP may arise between the 6th and the 8th week of gestation and include vaginal bleeding, lower abdominal and pelvic pain. Frequently EPs implant in the fallopian tubes. A rare EP is the interstitial pregnancy, a life-threatening condition being responsible for nearly 20% of all deaths caused by EPs. Because of its unique location, the diagnosis is difficult and based on signs and specific criteria together with measuring of serum β-hCG. Usually, EP is treated by surgical approach, which is associated with increased morbidity, decreased fertility and increased likelihood of hysterectomy and uterine rupture in a subsequent pregnancy. Early diagnosis is crucial to life saving and allowing alternative therapeutic interventions such as pharmacological treatments. Methotrexate (MTX) represents the mainstay therapy. There is no standard care for the interstitial pregnancy for what concerns either surgical or pharmacological approaches. We reported a case of a 36-year-old woman admitted to the Hospital of Salerno-Italy with a value of serum β-hCG of 35,993 IU/L. Transvaginal ultrasonography revealed an empty uterine cavity and a mass of 35.7 mm in diameter characterized by a hypoechoic central area. The patient was in stable haemodynamic condition and no haematologic, renal and hepatic impairments were recorded. Despite the high serum β-hCG levels, a pharmacological approach was preferred to a surgical one. The patient was treated with intramuscular administration of MTX in daily dose of 1 mg/Kg alternated with 0.1 mg/kg folinic acid for 5 days. The patient remained hospitalized for 20 days and no side effects were reported. The decrease of the serum β-hCG was monitored and more than 15% reduction was detected between the 4th and the 7th day after the beginning of the treatment. The serum β-hCG became undetectable 35 days after. A multidosing intramuscular administration of MTX was effective and safe even in the presence of very high serum β-hCG levels. Together with similar cases reported in literature, the present results can contribute to improve the decision making in the treatment of the interstitial pregnancy.
Injection Injury Caused by Disinfectant During COVID-19: A Case Report
Authors: Haifei Shi, Kejiong Liang, Rizwan Ali, Shengquan Xu, Shili Ding
Journal: Front Public Health (2022)
Keywords: covid-19, debridement, disinfectant, injection injury, occupational safety
MeSH terms: COVID-19, Disinfectants / adverse effects, Hand Injuries / etiology, Hand Injuries / surgery, Case Reports, Disinfection, Humans, Pandemics, Disinfectants

High-pressure injection injury of the hand is a rare but severe emergency, which requires full attention and timely treatment. However, the early symptoms may not be obvious. As the swelling and necrosis progress, the condition gradually worsens, and in severe cases, it may end with amputation. We report a particular case of a hand injection injury, which occurred to a worker who worked overtime to produce disinfectant during the Coronavirus Disease-19 (COVID-19) pandemic. Because of the chemical toxicity of the disinfectant and pressure's damage, although the emergency debridement was promptly performed, we still lost some fingers in the end. In the existing disinfection product manuals, we have not seen any tips on dealing with tissue injection injury. It may reduce workers' attention to injuries, leading to delays in emergency operations.
A Rare Case of Non-Obstructive Membrane of the Body of Left Atrial Appendage Incidentally Found in Asymptomatic Adult Woman
Authors: Bong Gun Song, Gu Hyun Kang, Yong Hwan Park, Woo Jung Chun, Ju Hyeon Oh
Journal: Cardiol Res (2012)
Keywords: echocardiography, membranes of left atrial appendage
MeSH terms: Case Reports

The membranes of the left atrial appendage cavity are very rare entity and their clinical significance is not clear. We reported a rare case of a non-obstructive membrane traversing the body of the left atrial appendage incidentally found in asymptomatic adult woman.