OpenMed/multicare-articles huggingface dataset:
Camel Bite Associated with Depressed Skull Fracture with Rapidly Spreading Subgaleal Cellulitis
Authors: Shaymaa Al-Umran, Ahmad Abdulfattah, Faisal Alabbas, Hosam Al-Jehani
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Camel bite represents a minimal proportion, and most of them are from the Middle East countries. Their infectious potential is poorly understood, and the guidelines for antimicrobial treatment are not well developed. We describe a 40-year-old male, who works as a camel herder and was bitten by a camel while he was tying it down which led to a unilateral depressed skull fracture and multiple bilateral teeth-puncture wounds in the scalp. He arrived to our emergency department 3 hours after injury. All the wounds were dry and the skin around them was healthy looking with no subcutaneous collections. CT scan of the head showed depressed skull fracture on the left temporal region. Within 12 hours, the patient developed spreading cellulitis in the scalp. This necessitated an urgent surgical intervention. The added challenge is the presence of a dural breach. Our patient presented a challenge at several levels. He presented early with clean puncture wounds that were treated according to the most agreed upon guidelines. But our novel finding of rapidly spreading cellulitis requires alteration of recommendation towards more aggressive therapeutic attitude including early surgical intervention, especially for those patients suspected of a dural tear with the depressed skull fracture, even if treated with appropriate antibiotics.
Intact B-Cell Signaling and Function With Host B-Cells 47 Years After Transplantation for X-SCID
Authors: Christin Deal, Timothy J Thauland, E Richard Stiehm, Maria I Garcia-Lloret, Manish J Butte
Journal: Front Immunol (2020)
Keywords: b cell, il-21, il2rg, ivig, scid, chimerism, gamma chain, transplant
MeSH terms: B-Lymphocytes / immunology, Bone Marrow Transplantation, Graft Survival / immunology, Immune Reconstitution, X-Linked Combined Immunodeficiency Diseases / surgery, Case Reports, Research Support, Non-U.S. Gov't, Allografts, Chromosomes, Human, X / genetics, Corneal Transplantation, Female, Genes, X-Linked, Graft Rejection, Graft vs Host Disease / etiology, Graft vs Host Disease / immunology, Humans, Infections / etiology, Interleukin Receptor Common gamma Subunit / genetics, Living Donors, Lymphocyte Count, Male, Middle Aged, Mutation, Missense, Point Mutation, Recurrence, Siblings, Warts / etiology, X-Linked Combined Immunodeficiency Diseases / immunology, IL2RG protein, human, Interleukin Receptor Common gamma Subunit

Introduction: Severe Combined Immunodeficiency (SCID) is a life-threatening immunodeficiency caused by several pathogenic genetic variants, and it is characterized by profound defects in T-cell numbers and immune function. First performed in the late 1960's, hematopoietic stem cell transplantation remains the standard treatment for most cases of SCID. There is a growing number of post-transplant SCID patients, and it is imperative to assess the long-term outcomes of these patients. We have reported here the longest follow-up of a post-transplant SCID patient who, to our knowledge, bears the first gamma chain (γc) variant to show intact IL-21 signaling. Case Presentation: The patient presented at 5 months of age with recurrent thrush and Pneumocystis jiroveci pneumonia. In 1971, at the age of 11 months, he received an unconditioned, matched, related donor transplant comprising whole, unprocessed bone marrow. He is now 48 years old without significant illness and has never required immunoglobulin replacement. He exhibits T-dependent vaccine responses. He does suffer from chronic warts and bacterial infections that have worsened in recent years. We confirmed a known pathogenic variant in the IL2RG gene showing a hemizygous variant NM_000206.2:c.675C>A, resulting in p.Ser225Arg. His chimerism studies revealed donor T cells, host B cells, host myeloid cells, and mixed NK cells. Lymphocyte enumeration revealed normal numbers and distribution of B cells. The host B cells carry the pathogenic variant in IL2RG, but, when stimulated with IL-21, they demonstrated intact, γc-dependent signaling. Conclusions: Even with host B cells, reconstitution with donor T cells can be sufficient to allow over four decades of survival when B-cell function is intact. Our case demonstrates that satisfactory B-cell function can arise as a consequence of both intact IL-21 signaling due to a hypomorphic γc variant, and close HLA matching with the donor to allow for effective T-cell help.
Targeted Temperature Management for In-hospital Cardiac Arrest Caused by Thyroid Storm: A Case Report
Authors: Yuanwei Fu, Hongxia Ge, Yumei Zhang, Yan Li, Bingyao Mu, Wen Shang, Shu Li, Qingbian Ma
Journal: Front Cardiovasc Med (2021)
Keywords: cardiac arrest, cardiopulmonary resuscitation, targeted temperature management, thyroid storm, ventricular arrhythmia
MeSH terms: Case Reports

Background: Malignant ventricular arrhythmias caused by thyroid storm, such as ventricular tachycardia (VT) or ventricular fibrillation (VF), which are life-threatening, are rare. We report the case of a patient who suffered from cardiac arrest caused by thyroid storm and the rare VF; the patient showed a favorable neurologic outcome after receiving targeted temperature management (TTM) treatment by intravascular cooling measures. Case presentation: A 24-year-old woman who had lost 20 kg in the preceding 2 months presented to the emergency department with diarrhea, vomiting, fever, and tachycardia. Thyroid function testing showed increased free triiodothyronine (FT3) and free thyroxine (FT4), decreased thyroid-stimulating hormone (TSH), and positive TSH-receptor antibody (TRAB). She was diagnosed with hyperthyroidism and had experienced sudden cardiac arrest (SCA) due to ventricular fibrillation (VF) caused by thyroid storm. The patient was performed with targeted temperature management (TTM) by intravascular cooling measures. Regular follow-up in the endocrinology department showed a good outcome. Conclusions: Our case not only suggests a new method of cooling treatment for thyroid storm, but also provides evidence for the success of TTM on patients resuscitated from in-hospital cardiac arrest (IHCA) who remain comatose after return of spontaneous circulation (ROSC).
Contralateral Cochlear Labyrinthine Concussion without Temporal Bone Fracture: Unusual Posttraumatic Consequence
Authors: I M Villarreal, D Méndez, J M Duque Silva, P Ortega Del Álamo
Journal: Case Rep Otolaryngol (2016)

Introduction. Labyrinthine concussion is a term used to describe a rare cause of sensorineural hearing loss with or without vestibular symptoms occurring after head trauma. Isolated damage to the inner ear without involving the vestibular organ would be designated as a cochlear labyrinthine concussion. Hearing loss is not a rare finding in head trauma that involves petrous bone fractures. Nevertheless it generally occurs ipsilateral to the side of the head injury and extraordinarily in the contralateral side and moreover without the presence of a fracture. Case Report. The present case describes a 37-year-old patient with sensorineural hearing loss and tinnitus in his right ear after a blunt head trauma of the left-sided temporal bone (contralateral). Otoscopy and radiological images showed no fractures or any abnormalities. A severe sensorineural hearing loss was found in his right ear with a normal hearing of the left side. Conclusion. The temporal bone trauma requires a complete diagnostic battery which includes a neurotologic examination and a high resolution computed tomography scan in the first place. Hearing loss after a head injury extraordinarily occurs in the contralateral side of the trauma as what happened in our case. In addition, the absence of fractures makes this phenomenon even more unusual.
Multiple intraosseous calvarial hemangiomas mimicking metastasis from renal cell carcinoma
Authors: Rohit Malde, Tim Moss, George Malcolm, Tim Whittlestone, Amit Bahl
Journal: Adv Urol (2008)
MeSH terms: Case Reports

Renal cell carcinomas are known to metastasise to the bones in the form of lytic lesions. However, not all osteolytic lesions in patients with renal cell carcinoma are metastatic in nature. The report describes the case of a 68-year old lady who was diagnosed with a renal cell carcinoma 3 and half years back and treated with radical nephrectomy along with excision of an inferior vena cava tumour thrombus. The tumour was completely excised and she remained disease free till date. Subsequently, multiple lytic lesions were detected incidentally on the cranial vault, which on biopsy demonstrated intraosseous hemangioma. Though it is well known that renal cell carcinomas can metastasise to the bones in the form lytic lesions, it is important for clinicians to remember a few other differentials, one of which would be an intraosseous hemangioma, which is a benign pathology. Many times patients would be treated as having metastatic disease merely on radiological findings. In this case report, there was a high index of radiological suspicion for metastases, however establishing diagnosis by biopsy prevented overtreatment in this instance.
A 5-Month-Old Infant with Right Scrotum Swelling; a Case Report
Authors: Shih-Wen Hung, Kuo-Chih Chen, Chin-Chu Wu, Tzong-Luen Wang, Aming Chor-Ming Lin
Journal: Emerg (Tehran) (2017)
Keywords: ventriculoperitoneal shunt, abdominal, case reports, equipment failure, hydrocephalus, radiography
MeSH terms: Case Reports

Migration of the distal catheters of ventriculoperitoneal (VP) shunt is a rare event. Here, we report an unusual case of a 5-month-old infant with post-hemorrhagic hydrocephalus, who developed right scrotum swelling soon after VP shunting. Plain abdominal x-ray showed the shunt tubing, which was twisted and kinked in its distal portion and coiled in the right scrotum. The infant was operated on and managed with successful outcome.
Case report: Impact of hyperthyroidism on psychotic symptoms in schizophrenia comorbid with Graves' disease
Authors: Yukiyoshi Sumi, Sanae Kawahara, Kumiko Fujii, Mayu Yamaji, Kou Nakajima, Tsubasa Nakamura, Osamu Horikawa, Yukihiro Fujita, Yuji Ozeki
Journal: Front Psychiatry (2023)
Keywords: graves’ disease, endocrinology, schizophrenia, thyroid storm, visual hallucination
MeSH terms: Case Reports

Introduction:
Auditory hallucinations are the most common type of hallucinations observed in schizophrenia; however, visual hallucinations are not uncommon. In Graves' disease, depression, hypomania, and psychosis can occur. While the association between Graves' disease and psychosis has been explored, understanding of the specific impact of thyroid dysfunction severity on psychiatric symptom severity is limited. Here, we present a case report of a patient with schizophrenia comorbid with Graves' disease whose psychotic symptoms were impacted by hyperthyroidism.
Case:
The patient was a 32-year-old Japanese woman who presented with auditory and visual hallucinations, agitation, and pressured speech. The patient was diagnosed with schizophrenia comorbid with Graves' disease and thyroid storm. The patient's psychotic symptoms were found to be associated with fluctuations in thyroid hormone levels, and visual hallucinations were observed only during thyroid storms. Treatment involved dexamethasone, potassium iodide, bisoprolol fumarate, and methimazole for thyrotoxicosis, and a blonanserin transdermal patch, paliperidone, and paliperidone palmitate for psychotic symptoms. The patient's auditory and visual hallucinations improved with antipsychotic treatment and decreased thyroid hormone levels.
Conclusion:
This case highlights the importance of monitoring thyroid function in patients with schizophrenia, particularly those with comorbid Graves' disease. The correlation between psychiatric symptoms and thyroid hormone levels was demonstrated on an individual level over time, with symptoms worsening as thyroid hormone levels increased. Additionally, our case suggests that abnormally high thyroid hormone levels may trigger visual hallucinations in individuals with schizophrenia. Further studies are needed to elucidate the underlying mechanisms and potential treatment implications of this association.
Life-Threatening Hypercalcemia due to Graves' Disease and Concomitant Adrenal Failure: A Case Report and Review of the Literature
Authors: Hande Mefkure Ozkaya, Fatma Ela Keskin, Ozlem Asmaz Haliloglu, Tugba Elif Senel, Pinar Kadioglu
Journal: Case Rep Endocrinol (2015)

A 47-year-old woman presented with the complaints of nausea, vomiting, and weight loss. She had a history of bilateral surrenalectomy due to Cushing's syndrome. On examination she had tachycardia and orthostatic hypotension. Laboratory examinations revealed hypercalcemia and suppressed parathyroid hormone levels. She also had thyrotoxicosis due to Graves' disease. The investigations to rule out a malignancy were negative. With steroid, zoledronic acid, and antithyroid drug treatment her symptoms were resolved and calcium level was normalized. This case highlights the importance of recognizing thyrotoxicosis and concomitant adrenal failure as a possible cause of severe hypercalcemia.
Spinal correction of scoliosis in Jeune syndrome: a report of two cases
Authors: Wataru Saito, Gen Inoue, Takayuki Imura, Toshiyuki Nakazawa, Masayuki Miyagi, Takanori Namba, Eiki Shirasawa, Naonobu Takahira, Masashi Takaso
Journal: Scoliosis Spinal Disord (2016)
Keywords: asphyxiating thoracic dystrophy, jeune syndrome, scoliosis, spinal correction
MeSH terms: Case Reports

Background:
Jeune syndrome (asphyxiating thoracic dystrophy) is an autosomal recessive disorder with constriction and narrowing of the thorax. To our knowledge, there are no reports regarding spinal deformity and correction in Jeune syndrome. Herein, we report two cases of spinal correction in patients with Jeune syndrome, and review the literature.
Case presentation:
We experienced cases of spinal scoliosis in an adolescent boy and a young adult woman, both with Jeune syndrome. Their spinal deformities had progressed by the time they came to our hospital for surgical correction. After preoperative evaluation of their general condition, including respiratory function in detail to confirm that they could undergo surgery, we treated both cases with posterior spinal correction and fusion. Spinal correction was performed safely and there were no severe complications, including respiratory depression, associated with surgery, and relatively satisfactory correction was obtained in both cases. In case 1, coronal deformity was corrected from 70° to 36° and from 82° to 42°, respectively. In case 2, Cobb angle was corrected from 52° to 20° and from 55° to 21°.
Conclusions:
Posterior spinal correction can be performed safely in young patients with Jeune syndrome who have survived their infant stage and matured without a severe general condition.
Involvement of Annexin A2 Expression and Apoptosis in Reverse Polarization of Invasive Micropapillary Carcinoma of the Breast
Authors: Kazumori Arai, Tomohiro Iwasaki, Chinatsu Tsuchiya, Akihiro Sonoda
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Invasive micropapillary carcinoma (IMPC) is characterized by pseudopapillary tumor-cell clusters with a reverse polarity (RP) floating in lacunar spaces, with aggressive biological characteristics. The RP prevention is considered to inhibit IMPC, but its pathogenic mechanisms remain unclear. Annexin A2 (ANX A2), a cell-polarity protein, is known to be involved in lumenogenesis. ANX A2 expression is immunohistochemically examined, as well as both epithelial membrane antigen (EMA) and mucin-1 glycoprotein (MUC-1), the gold-standard markers for luminal differentiation, in the background tumor components of a case of IMPC. The following findings were noticed: (1) Apoptosis was scattered with peripheral apoptotic vacuolar change; (2) EMA and MUC-1 expressions were found, rimming the peripheral apoptotic vacuoles (including the contact surface with neighboring tumor cells), and these positions corresponded to the ones with a distinct ANX A2 positivity; and (3) partially detached tumor cells showed distinct positivity of three proteins at the stroma-facing surface, which is consistent with a RP. Taken together, frequent apoptosis in tumor cells with membranous accumulation of ANX A2 is considered to be indispensable for the reverse polarization of IMPC, and that secondary necrosis following apoptosis induces the cell-polarity disorder and creates detached tumor cells with a RP.
Rare Complication of Pneumomediastinum and Pneumopericardium in a Patient with COVID-19 Pneumonia
Authors: Anshika Singh, Jessica Bass, David H Lindner
Journal: Case Rep Pulmonol (2020)
MeSH terms: Case Reports

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently discovered coronavirus which has caused a global outbreak of severe pneumonia with complications leading to hypoxic respiratory failure, acute respiratory distress syndrome (ARDS), cytokine storm, disseminated intravascular coagulation (DIC), and even gastrointestinal symptoms. While ground-glass opacity (GGO) is a typical radiographic finding associated most frequently with COVID-19 pneumonia, other less commonly noted atypical radiographic lung features include isolated lobar or segmental consolidation without GGO, discrete small nodules (centrilobular, "tree-in-bud"), lung cavitation, and smooth interlobular septal thickening with pleural effusion. Pneumomediastinum in COVID-19 patients has rarely been reported. A finding of pneumopericardium is unusual too. This report discusses the case of a young male with COVID-19 pneumonia who was found to have both these features on computed tomographic (CT) scans of his chest on presentation.
Myocarditis complicated by massive right ventricular thrombus and extensive pulmonary embolism: A case report
Authors: Xiao-Juan Jiang, Wei-Yi Zhang
Journal: Front Surg (2022)
Keywords: case report, myocarditis, pulmonary embolism, right ventricular thrombus, surgery
MeSH terms: Case Reports

An intracardiac thrombus may develop as a consequence of myocarditis, and in rare cases, a dominantly right ventricular thrombus develops, which may impair cardiac function and even cause life-threatening cardiovascular events. We report a 24-year-old man presented with recurrent episodes of palpitation and precordial discomfort after catching a cold 2 months ago. Transthoracic echocardiography (TTE) and computed tomography pulmonary angiogram (CTPA) revealed a mass attached to the apex of the right ventricle and extensive bilateral pulmonary artery emboli. There was no indication where the thrombi originated from in this young patient without any underlying disease except myocarditis. Pulmonary endarterectomy and embolectomy of pulmonary arteries and right ventricle were performed. Postoperative pathological results confirmed the presence of fibrinous necrosis and hemosiderin deposition. The formation of an intraventricular thrombus is closely related to myocarditis, which can affect individuals of all ages, but especially young people. Thus, patients with myocarditis should be closely monitored and followed up because of the increased risk of extensive thrombosis.
Thinking Critically: How to Teach Translational Medicine
Authors: Richard G Foty, Elizabeth M Gibbs, Esther H Lips, Madhvi Menon, Janet P Hafler
Journal: Front Public Health (2018)
Keywords: case study, communication, curriculum design, education, hidden curriculum, translational medicine

Translational Medicine (TM) is a comparatively new field of study that focusses on the continuum of activities from the conception of an idea, to advanced clinical testing and the development of a new medical technology or drug. In recent years, graduate education programs have been established internationally to train a new generation of professionals with specific skills necessary to navigate the translational landscape. Literature in the area highlights the importance of integrating specific competencies relevant to translational medicine as part of curriculum development. In addition to developing a working understanding of core knowledge (e.g., ethics, funding, regulation, policy, etc.), skills including effective communication, reflection, interdisciplinary, and interprofessional collaboration are critical components of a skilled TM professional. Curriculum development must focus on content, while carefully selecting the teaching strategies that are most effective to achieve the desired outcomes, which is for learners to comprehend the complex material. The following publication presents a series of vignettes that describe the experiences of an associate professor of molecular biology, who is looking to explore her role in translational medicine and develop skills for an innovative approach to problem-solving. The vignettes are focused on a variety of teaching and learning strategies that can be used to teach translational medicine. Each vignette includes a description of the experience from the perspective of the learner and the faculty as it pertains to the teaching strategy, method of delivery, and learning outcomes. TM is as complex to teach as it is to learn. The specialized skills and knowledges that are part of the TM toolbox cannot all be taught in a lecture format. Educators must consider multiple strategies and select those which are most effective for achieving the learning outcomes.
Molecular Evolution of a Glioblastoma Controlled With Tumor Treating Fields and Concomitant Temozolomide
Authors: H Ian Robins, HuyTram N Nguyen, Aaron Field, Steven Howard, Shahriar Salamat, Dustin A Deming
Journal: Front Oncol (2018)
Keywords: genomics, glioblastoma, optune®, temozolomide, tumor treating fields
MeSH terms: Case Reports

Tumor Treating Field (TTFields) therapy has demonstrated efficacy in a Phase 3 study of newly diagnosed glioblastoma (GB) following radiation (RT) and temozolomide (TMZ). We report the appearance of an isolated satellite anterior temporal lobe lesion, 2 months post primary RT/TMZ directed at the primary GB (MGMT methylated) parietal lobe lesion and one adjuvant cycle of TMZ and TTFields. The mean RT dose delivered to the temporal lobe lesion was negligible, i.e., 4.53 ± 0.95 Gy. Mapping of the generated TTFields demonstrated that both lesions were encompassed by a field intensity in a therapeutic range. The temporal lobe lesion remained under the control of TTFields up to 12 months, at which point progression on a T1 contrast MRI resulted in surgery and a definitive diagnosis of GB without MGMT methylation. The primary parietal lobe at this time was in remission. Molecular sequencing on the GB tissue from multiple time points demonstrates clonal evolution of the cancer over time and in response to treatment.