OpenMed/multicare-articles huggingface dataset:
Pulmonary thromboembolism in a child with sickle cell hemoglobin d disease in the setting of acute chest syndrome
Authors: Hazel Villanueva, Sandeepkumar Kuril, Jennifer Krajewski, Aziza Sedrak
Journal: Case Rep Pediatr (2013)

Introduction. Sickle cell hemoglobin D disease (HbSD) is a rare variant of sickle cell disease (SCD). Incidence of pulmonary thromboembolism (PE) and deep venous thrombosis (DVT) in children with HbSD is unknown. PE and DVT are known complications of SCD in adults but have not been reported in the literature in children with HbSD. Case Report. We are reporting a case of a 12-year-old boy with HbSD with acute chest syndrome (ACS) complicated by complete thrombosis of the branch of the right pulmonary artery and multiple small pulmonary artery emboli seen on computed tomography (CT) pulmonary angiogram and thrombosis of the right brachial vein seen on Doppler ultrasound. Our patient responded to treatment with anticoagulant therapy. Conclusion. There are no cases reported in children with HbSD disease presenting as ACS with pulmonary thromboembolism. We suggest that PE should be suspected in patients presenting with ACS who do not show improvement with standard management. CT pulmonary angiogram should be utilized for early diagnosis and appropriate management as there is no current protocol for management of PE/DVT in pediatric patients with SCD.
Severe Illness Anxiety Treated by Integrating Inpatient Psychotherapy With Medical Care and Minimizing Reassurance
Authors: Albert T Higgins-Chen, Sarah B Abdallah, Jennifer B Dwyer, Alfred P Kaye, Gustavo A Angarita, Michael H Bloch
Journal: Front Psychiatry (2019)
Keywords: cbt (cognitive-behavioral therapy), case report, health anxiety, hypochondriasis, illness anxiety disorder, panic disorder, psychotherapy
MeSH terms: Case Reports

Illness anxiety disorder (IAD, formerly hypochondriasis) is characterized by preoccupation with fear of serious illness despite medical reassurance. IAD is common, debilitating, challenging to treat, and results in high healthcare utilization. Outpatient management of IAD is challenging because patients can compulsively seek reassurance from numerous providers, which interferes with learning more productive coping skills. We present the case of a woman with severe IAD who presented to the emergency room with increasing frequency over several months, despite regular outpatient medical visits and escalating psychiatric care. We made the unusual decision to hospitalize her for IAD for 1 month, in the absence of typical hospitalization criteria. This hospitalization allowed us to consolidate all medical and psychiatric care into a single provider team and train all staff and family to communicate with her in a consistent manner. We successfully treated her by integrating a general cognitive-behavioral therapy (CBT) protocol into medical care and decision-making. In response to her numerous health concerns, we minimized medical work-up, reassurance, and reactive medication changes, and instead used the concerns as opportunities to reinforce the psychotherapy. This approach allowed us to simplify her medication regimen and manage her co-morbid hypertension and vitamin deficiencies. Though inpatient hospitalization is likely infeasible in most cases of IAD, outpatient providers may create similar treatment plans based on the example of our case report, without needing highly specialized expertise. Such a plan would require a straightforward understanding of IAD psychology, which we review here, combined with readily accessible tools including a universal CBT protocol, online CBT courses, and clinical symptom scales. We discuss our approach for responding to health concerns, maintaining therapeutic alliance, integrating CBT principles into patient interactions, and managing medications. Since patients with IAD share health concerns with all providers, staff, and family, we also include our own IAD communication guide, appropriate for a general audience, that demonstrates how to respond in these conversations.
Severe congenital toxoplasmosis: a case report and strain characterization
Authors: Bahador Sarkari, Samaneh Abdolahi Khabisi
Journal: Case Rep Infect Dis (2015)

We report a fatal congenital toxoplasmosis case in an Iranian woman in the south of Iran. A pregnant mother had been admitted at the 15th week of her pregnancy on account of a febrile illness, symptoms of common cold, and enlargement of submandibular lymph nodes. Serological testing of the mother's serum revealed positive IgG and IgM anti-Toxoplasma antibodies. Amniotic fluid was taken and evaluated by polymerase chain reaction (PCR) assay with a direct amplification of the Toxoplasma URPT gene which was found to be positive. Sequencing and analysis of PCR product revealed that the isolate has the most similarity with type I of Toxoplasma gondii. Fetal scan showed anomaly in fetus including mild hydrocephaly. Termination of the pregnancy was suggested by the physician and pregnancy was terminated 178 days after conception.
Ethnological approach to acorn utilization in prehistory: A case study of acorn mook making in South Korea
Authors: Ting An, Mengxia Tang, Juhui An
Journal: Front Plant Sci (2022)
Keywords: acorn, chaîne opératoire, ethnological approach, mook making, prehistory

Acorn remains are reported from prehistoric sites across the world. Acorn is argued to have been an important food resource for human beings in prehistory. However, relevant research is still limited and it is often difficult to recognize archaeological remains relating to acorn utilization. The Chaîne Opératoire of acorn utilization is yet to be addressed. Such is of great significance to the study of human subsistence strategy in pre-agricultural period and moreover the origin of agriculture. By conducting a case study of 'mook making' using acorns in Yongdong-gun, Chungcheongbuk-do, South Korea, the current paper explores the Chaîne Opératoire of acorn utilization in prehistory using an ethnological approach. We draw attention to the laborious nature of acorn processing and to different methods of acorn processing due to different species and culinary tradition. Our case study also brings new insights into archaeological interpretations of acorn remains from prehistoric sites.
Peripheral calcifying odontogenic cyst: a case report and comprehensive review of 60 years of literature
Authors: Sally Sheng, Nicholas Tipton, Jennifer Chang, Hsiu-Wan Meng, Gena D Tribble
Journal: Front Oral Health (2023)
Keywords: case report, literature review, oral lesion, oral pathology and oral medicine, peripheral calcifying odontogenic cyst
MeSH terms: Case Reports

Peripheral Calcifying Odontogenic Cyst (PCOC) is the extraosseous form of calcifying odontogenic cyst that is limited to peripheral soft tissue without bony involvement. This case report presents a case of PCOC manifested as a progressive growth of gingival mass in a young male treated with excisional biopsy. Histological examination confirmed diagnosis of PCOC with presence of characteristic ghost cells and sporadic calcifications. No recurrence of the lesion and no complication were noted at three-year follow-up. Review of available literature on PCOC noted a predilection of occurrence in the mandible (61%) and in the anterior area of the jaws (58%). Mean age of patients was 41.7 ± SD25.43 (7-83) and 95% CI [33.6, 49.8] yrs. Mean size of the lesions was 1.38 ± SD1.1 (0.5-4.3) and 95% CI [0.93, 1.83] cm. Gender distribution was noted to be 51.3% male and 48.7% female.
First reported case in Canada of anaphylaxis to lupine in a child with peanut allergy
Authors: Lianne Soller, Sebastien La Vieille, Edmond S Chan
Journal: Allergy Asthma Clin Immunol (2018)
Keywords: emerging allergen, food allergy, legume, lupine, lupine allergy, peanut allergy
MeSH terms: Case Reports

Background:
Lupine is a member of the legume family and is often used in many food products in Europe (e.g. pasta, pizza, sauces, etc.) as a wheat or soy substitute. Lupine cross-reacts with peanut, and cases of allergic reactions to lupine in peanut-allergic patients have been reported in Europe mainly. In contrast, lupine as an ingredient in food products is relatively new to the Canadian market.
Case presentation:
We describe a 10-year old boy with diagnosed peanut and tree-nut allergy, who developed anaphylaxis to lupine flour in May 2017. A few minutes after eating a pre-made pancake mix that didn't contain any of his known allergens (peanuts, tree nuts), he developed oral pruritis followed by throat tightness, severe stomach ache, lightheadedness, cough, hoarse throat, nasal congestion, sneezing, and fatigue. He refused epinephrine, but was given cetirizine. The symptoms resolved after 3 h, but he was still unwell the following day. In a conversation between the mother and the allergist, it was determined that lupine was likely the cause of the reaction. To confirm, he was brought into clinic for skin testing to lupine. Results were consistent with lupine allergy (pancake mix: 10 × 7 mm, lupine bean: 12 × 6 mm). The family has since reported this to the Canadian Food Inspection Agency, resulting in a product recall and a consumer advisory bulletin published by Health Canada.
Conclusions:
This is the first reported case of allergic reaction to lupine in Canada, and highlights the need for education of Canadian families with peanut allergy as well as allergists, regarding the possibility of cross-reactivity between peanut and lupine and its new presence in the Canadian food supply. In addition, a precautionary label for those with peanut allergy who purchase products containing lupine should be considered. This case illustrates also the need for a clear mechanism for consumers and allergists to report emerging food allergens to regulatory bodies such as Health Canada.
Influence of resident education in correctly diagnosing extremity soft tissue sarcoma
Authors: Vignesh K Alamanda, Samuel N Crosby, Shannon L Mathis, Kristin R Archer, Kyla P Terhune, Ginger E Holt
Journal: Sarcoma (2013)

Background. One-third of all extremity soft tissue sarcomas are misdiagnosed and inappropriately excised without proper preoperative diagnosis and planning. This study aimed at examining the clinical judgment of residents in both general and orthopaedic surgery and at determining whether resident education plays a role in appropriately managing unknown soft tissue masses. Methods. A case-based survey was used to assess clinical decisions, practice patterns, and demographics. Aggregate response for all of the clinical cases by each respondent was correlated with the selections made for practice patterns and demographic data. Results. A total of 381 responses were returned. A higher percentage of respondents from the orthopaedic group (84.2%) noted having a dedicated STS rotation as compared to the general surgery group (35.8%) P < 0.001. Depth, size, and location of the mass, rate of growth, and imaging characteristics were considered to be important factors. Each additional year of training resulted in 10% increased odds of selecting the correct clinical decision for both groups. Conclusion. Our study showed that current residents in both orthopaedic surgery and general surgery are able to appropriately identify patients with suspicious masses. Continuing education in sarcoma care should be implemented beyond the years of residency training.
A Case of Fatal Acute Lung Injury after Balloon Valvuloplasty of Pulmonary Stenosis: Case Report and Review of Literature
Authors: Mohammad Ali Ostovan, Maliheh Kamali, Abdolali Zolghadrasli
Journal: J Cardiovasc Thorac Res (2015)
Keywords: acute lung injury, percutaneous pulmonary valvuloplasty, pulmonary valve stenosis
MeSH terms: Case Reports

A newly described immediate complication after percutaneous pulmonary valvuloplasty isacute lung injury. Here we report a case of fatal acute lung injury after pulmonary valvuloplasty.The patient was a 26-year-old woman, referred to a general hospital with the diagnosis of livercirrhosis. In her work-ups severe pulmonary stenosis was detected and so a decision was madeto relieve the valve stenosis. Despite the procedural success, the patient developed severe dyspneaand desaturation a few hours later and died within 3 days due to shock state. Although thedefinition, incidence or severity of acute lung injury after pulmonary balloon valvuloplasty is notyet clear, this is as far as we know the first mortality reported in literature. This presentation inour patient should prompt clinicians to consider a more aggressive approach at the first sight ofthis previously considered innocent complication.
Ewing's sarcoma of the sternum necessitating complex resection and reconstruction
Authors: Gino Vissers, Lucas Van Houtven, Jérôme Corthouts, Annemie Snoeckx, Marloes Luijks, Filip Thiessen, Thierry Tondu, Paul Van Schil
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: ewing’s sarcoma, latissimus dorsi flap, sternal reconstruction, sternal resection
MeSH terms: Case Reports

We present a 30-year-old man with a sternal Ewing's sarcoma, who was treated by complex resection of the sternal body and reconstruction by a methyl methacrylate sandwich graft and a pedicled latissimus dorsi flap.
Severe Preeclampsia in the Setting of Myasthenia Gravis
Authors: Adam J Lake, Antoun Al Khabbaz, Renée Keeney
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Myasthenia gravis (MG) is a rare autoimmune disease that leads to progressive muscle weakness and is common during female reproductive years. The myasthenic mother and her newborn must be observed carefully, as complications during all stages of pregnancy and the puerperium may arise suddenly. Preeclampsia is a common obstetrical condition for which magnesium sulfate is used for seizure prophylaxis. However, magnesium sulfate is strongly contraindicated in MG as it impairs already slowed nerve-muscle connections. Similarly, many first-line antihypertensive medications, including calcium channels blockers and β-blockers, may lead to MG exacerbation. This case describes the effective obstetrical management of a patient with MG who developed severe preeclampsia. The effective use of levetiracetam and various antihypertensive medications including intravenous labetalol is described. A review of the ten reported cases of MG complicated by preeclampsia is examined to aggregate observations of clinical care, with focus on delivery methods, anticonvulsants, and antihypertensive medications.
Photopsias during Systemic Bevacizumab Therapy
Authors: Heather Leisy, Meleha Ahmad, R Theodore Smith
Journal: Case Rep Ophthalmol Med (2016)

Background. The authors describe a case of recurrent photopsias in a 56-year-old woman following repeat treatments with systemic intravenous bevacizumab for stage IV ovarian cancer. To our knowledge, this is the first report of photopsias following systemic bevacizumab treatments in a patient with a normal eye exam. Case Presentation. A 56-year-old Caucasian female complained of onset of floaters and flashes in the temporal peripheral field of the right eye 1 day after receiving intravenous of 30 g of 25 mg/mL of systemic bevacizumab for treatment of stage IV ovarian cancer. Ophthalmic examination, including dilated fundus exam, spectral domain optical coherence tomography (SD-OCT) of the optic nerve head, and enhanced depth imaging SD-OCT of the macula, revealed no significant abnormalities. Possible mechanisms are reviewed. Conclusion. We propose that patients who undergo intravenous bevacizumab treatments are questioned for any ocular symptoms and that more systematic evaluations of retinal nerve fiber layer and choroidal effects are obtained in those patients who are on long-term treatment at high doses.
Deep wound infection after a trochanteric fracture internal fixation presenting with hip dislocation: a case report
Authors: Matheus Tzurbakis, Emmanouil Morakis, Georgios Mouzopoulos, Nikolaos Lasanianos, Ioannis Georgilas
Journal: Cases J (2010)

We report a rare case of posterior hip dislocation after a low energy trauma. The patient sustained a trochanteric fracture in the same hip six months ago, which was fixed using a sliding hip screw and had healed. At surgery a deep wound infection was found and a methicillin-resistant Staphylococcus epidermidis (MRSE) was cultured. After thorough debridement, an excisional arthroplasty was decided. The patient received specific intravenous antibiotics and after six weeks a total hip arthroplasty was done. In three years follow-up the patients presented with a fully functional hip without any signs of infection. Hip dislocation after a trochanteric fracture internal fixation is rare complication associated with high morbidity and mortality. Infection eradication and a second stage arthroplasty can be life and limb saving.
Sistrunk Procedure on Malignant Thyroglossal Duct Cyst
Authors: Diani Kartini, Sonar S Panigoro, Agnes S Harahap
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

A thyroglossal duct cyst is a lesion that occurs as a result from failure of the thyroglossal duct to obliterate during fetal development. Malignant progression is a rare event that might occur in less than 1% of all cases. Because of its rarity, there are conflicting opinions regarding the management of the case. In the present study, a 46-year-old male presented with a painless neck mass that had increased in size over the last 6 months. There was no difficulty in swallowing and breathing, change in voice, significant weight loss, or any signs of hyperthyroidism. Laboratory workup showed that results were within normal limits. Thyroid gland ultrasonography and cervical contrast CT scan revealed a complex cystic mass that pointed towards a thyroglossal duct cyst. We performed Sistrunk procedure. Postoperative pathology examination revealed microscopic appearance of the thyroglossal duct cyst with a classic follicular variant of papillary thyroid carcinoma. Our latest follow-up showed no signs of tumor recurrence or any complications following surgery on locoregional status. As a fine needle aspiration biopsy cannot ensure a precise result in all of cases, it is essential to perform a solid physical examination and thorough supporting examination in deciding the precise management for the patient.
Responses of metastatic basal cell and cutaneous squamous cell carcinomas to anti-PD1 monoclonal antibody REGN2810
Authors: Gerald S Falchook, Rom Leidner, Elizabeth Stankevich, Brian Piening, Carlo Bifulco, Israel Lowy, Matthew G Fury
Journal: J Immunother Cancer (2016)
Keywords: basal cell carcinoma, cutaneous squamous cell carcinoma, immune checkpoint inhibitor, mutation burden, phase 1, programmed death-1, regn2810
MeSH terms: Antibodies, Monoclonal / therapeutic use, Antineoplastic Agents, Immunological / therapeutic use, Carcinoma, Basal Cell / drug therapy, Carcinoma, Squamous Cell / drug therapy, Programmed Cell Death 1 Receptor / antagonists & inhibitors, Skin Neoplasms / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antibodies, Monoclonal / pharmacology, Antineoplastic Agents, Immunological / pharmacology, Carcinoma, Basal Cell / diagnosis, Carcinoma, Basal Cell / metabolism, Carcinoma, Squamous Cell / diagnosis, Carcinoma, Squamous Cell / metabolism, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Skin Neoplasms / diagnosis, Skin Neoplasms / pathology, Tomography, X-Ray Computed, Treatment Outcome, Antibodies, Monoclonal, Antineoplastic Agents, Immunological, Programmed Cell Death 1 Receptor

Background:
Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (CSCC) share exposure to UV light as the dominant risk factor, and these tumors therefore harbor high mutation burdens. In other malignancies, high mutation burden has been associated with clinical benefit from therapy with antibodies directed against the Programmed Death 1 (PD-1) immune checkpoint receptor. Highly mutated tumors are more likely to express immunogenic tumor neoantigens that attract effector T cells, which can be unleashed by blockade of the PD-1 immune checkpoint.
Case presentations:
This report describes a patient with metastatic BCC and a patient with metastatic CSCC who were treated with REGN2810, a fully human anti-PD-1 monoclonal antibody, in an ongoing phase 1 trial (NCT02383212). The CSCC patient has experienced an ongoing complete response (16+ months), and the BCC patient has experienced an ongoing partial response (12+ months).
Conclusions:
These case reports suggest that UV-associated skin cancers, beyond melanoma, are sensitive to PD-1 blockade.
Trial registration:
Clinicaltrials.gov NCT02383212. Registered 2 February 2015.
A delay in diagnosis: thrombotic thrombocytopenia purpura occurring in systemic lupus erythematous
Authors: Zoya Adam, Ahmed Sokwala, Jasmit Shah, Sayed Karar Ali
Journal: Pan Afr Med J (2019)
Keywords: thrombotic thrombocytopenia purpura, diagnostic challenge, systemic lupus erythematous
MeSH terms: Lupus Erythematosus, Systemic / complications, Purpura, Thrombotic Thrombocytopenic / diagnosis, Case Reports, Adult, Delayed Diagnosis, Female, Humans, Purpura, Thrombotic Thrombocytopenic / etiology, Purpura, Thrombotic Thrombocytopenic / physiopathology

Thrombotic thrombocytopenia purpura (TTP) in the background of systemic lupus erythematous (SLE) remains rare with an incidence of about 2%. Both conditions have overlapping features and can thus be difficult to differentiate and diagnose. A careful review of the peripheral blood smear remain essential often providing many clues. The diagnosis of TTP is a medical emergency and therapy should be instituted immediately. We present one such challenging case where a delay in diagnosis due to limited resources could have proven fatal for our patient.
Cleidocranial dysplasia presenting with retained deciduous teeth in a 15-year-old girl: a case report
Authors: Nagarathna C, Bethur Siddaiah Shakuntala, Somy Mathew, Navin Hadadi Krishnamurthy, Ratna Yumkham
Journal: J Med Case Rep (2012)

Introduction:
Cleidocranial dysplasia is a rare congenital defect of autosomal dominant inheritance caused by mutations in the Cbfa1 gene, also called Runx2, located on the short arm of chromosome 6. It primarily affects bones which undergo intramembranous ossification. This condition is of clinical significance to dentistry due to the involvement of the facial bones, altered eruption patterns and multiple supernumerary teeth.
Case presentation:
Our patient, a 15-year-old Indian girl, presented with the typical features of prolonged retention of deciduous dentition and delayed eruption of permanent teeth, that is, mandibular prognathism along with other skeletal abnormalities like shrugged shoulder and the absence of clavicles. A multidisciplinary approach was followed, comprising orthodontic, surgical and pedodontic teams for management.
Conclusion:
Successful treatment of such a case lies in a holistic approach that takes care of all aspects, including the primary pathology, the deformity itself and even the psychological angle.