OpenMed/multicare-articles huggingface dataset:
An Unusual Presentation of Juvenile Polymyositis in an Adolescent Girl
Authors: Rushi Patel, Urvi Zala, Joy Chaudhari, Viraj Panchal, Abhi Shah
Journal: Cureus (2023)
Keywords: drooling of saliva, generalized body swelling, juvenile polymyositis, oropharyngeal dysphagia, proximal muscle weakness
MeSH terms: Case Reports

Juvenile idiopathic inflammatory myopathies (JIIMs) are a group of diverse, systemic autoimmune diseases that manifest in childhood and are characterized by weakness and chronic inflammation of skeletal muscles. One of the relatively rare variants of JIIMs is juvenile polymyositis (JPM). JPM patients present with proximal and distal muscle weakness, gait instability with falls, muscle pain and tenderness, and high levels of creatine kinase (CK) during adolescence. There are currently few people being diagnosed with JPM, which raises the question of whether or not it is a distinct disease. We discuss the case of a 13-year-old girl who presented to the hospital with generalized body swelling and difficulty swallowing solid food. She also had drooling of saliva during the presentation and a history of difficulty climbing up and down the stairs for three months. Her extensive laboratory workup showed a positive antinuclear antibody (ANA) test and increased muscle enzyme. A muscle biopsy was ordered, and she was diagnosed with JPM. Such a unique presentation has rarely been reported in the pediatric literature. This case report outlines an unusual JPM presentation that could help clinicians identify the condition and start treatment as soon as possible to minimize complications.
Pancreaticoduodenectomy after distal gastrectomy: A case series
Authors: Mizuki Fukuta, Atsushi Tomibayashi, Takao Tsuneki, Kohei Nishioka, Yuta Matsuo, Osamu Mori, Satoshi Fujiwara, Yasuhiro Yuasa
Journal: Int J Surg Case Rep (2020)
Keywords: gastrectomy, pancreaticoduodenectomy, pancreaticoduodenectomy reconstruction
MeSH terms: Case Reports

Introduction:
Pancreatoduodenectomy (PD) after gastrectomy requires more attention during surgery than ordinary PD due to anatomical variation with different types of gastrointestinal anastomoses, the complication of anatomical dissection, and the extent of adhesions present. Herein, we describe the PD strategies we used in three patients who strategy for three patients who had previously undergone distal gastrectomy for gastric cancer treatment.
Discussion:
Generally, reconstruction following PD in patients who have undergone a prior Billroth I reconstruction is simple, as there is no previous afferent loop. By comparison, reconstruction after a Billroth II or R-Y reconstruction requires special consideration of the point of circulation and length of the remnant intestine used for pancreaticojejunostomy, choledochojejunostomy or gastrojejunostomy.
Conclusion:
There is no consensus regarding the best method for performing PD and reconstruction in patients with a prior history of gastrectomy. The appropriateness of using the existing afferent loop for reconstruction depends on whether the jejunum is of sufficient length for bile duct and pancreatic anastomosis. Regardless of the approach used, it is necessary to avoid excessive tension during reconstruction. Based on our experience and previous studies published in the English literature, we propose that reconstruction needs to be considered on a case-by-case basis.
Pathologic complete response to TNT + camrelizumab for rectal cancer with surgical anus-preservation: case report and literature review
Authors: Feng Pi, Gang Tang, Chaozheng Xie, Yukun Cao, Shilai Yang, Zhengqiang Wei
Journal: Front Surg (2023)
Keywords: anus-preserving, camrelizumab, chemoradiotherapy, locally advanced rectal cancer, total neoadjuvant therapy
MeSH terms: Case Reports

Background:
This case report demonstrates the efficacy of total neoadjuvant therapy (TNT) based on pathological complete response (PCR). We also discuss the surgical approach to preserving the anus and its perioperative management.
Case presentaion:
The patient was a 26-year-old woman, with blood in the stool and stool thinning for over two months. Preoperative examination revealed locally advanced rectal cancer invading the left anal raphe and enlarged lymph nodes adjacent to the left internal iliac vessels. The lesion was preoperatively classified as T4bN1bM0 IIIC. Considering the size and depth of the tumor, it was difficult to have sufficient margins for radical resection, and the tumor was too close to the anal orifice. Considering the patient's youth and strong desire to preserve the anus, it was decided to use TNT combined with a camrelizumab regimen. After the entire course of neoadjuvant radiotherapy, the tumor size significantly reduced in fibrotic manifestations, and no enlargement of the lymph nodes adjacent to the left internal iliac vessels was observed. She underwent robotic laparoscopic ultra-low anterior rectal resection, left lateral lymph node dissection, and temporary ileostomy, and no significant residue was observed after all bowel tubes were taken for examination, nor was there cancerous involvement at the distal or radial cut edges, or metastasis. The patient was discharged nine days postoperatively, and no major complications were detected. Follow-up was performed without adjuvant chemotherapy.
Conclusions:
TNT may be a better surgical option for preserving the anus and for complete radical resection in patients with LARC for whom Miles' resection is indicated.
Management of six root canals in mandibular first molar
Authors: Claudio Maniglia-Ferreira, Fabio de Almeida Gomes, Bruno Carvalho Sousa
Journal: Case Rep Med (2015)

Success in root canal treatment is achieved after thorough cleaning, shaping, and obturation of the root canal system. This clinical case describes conventional root canal treatment of an unusual mandibular first molar with six root canals. The prognosis for endodontic treatment in teeth with abnormal morphology is unfavorable if the clinician fails to recognize extra root canals.
Report of 15 injuries caused by lionfish (pterois volitans) in aquarists in Brazil: a critical assessment of the severity of envenomations
Authors: Vidal Haddad Jr, Hamilton Ometto Stolf, José Yamin Risk, Francisco Os França, João Luiz Costa Cardoso
Journal: J Venom Anim Toxins Incl Trop Dis (2015)
Keywords: animals invasions, aquarism, envenomations, lionfish, pterois miles, pterois volitans, venomous fish
MeSH terms: Case Reports

Lionfish are venomous fish that belong to the Scorpaenidae family. Individuals of this family and those of the Synanceiidae family comprise most of the existing venomous fish in the world. Lionfish are originally found in the Indo-Pacific, but they have received special attention in the last years for their dissemination in the Atlantic Ocean, with the emergence of large populations in the USA, Caribbean and South America. Because of its beauty, this fish has always been present in private and commercial aquariums around the world. Herein, we describe 15 envenomations in aquarists registered in a period of eighteen years (1997-2014). The stings caused excruciating pain and marked inflammation, with local erythema, edema, heat, paleness and cyanosis. In one case, it was possible to observe vesicles and blisters. There were no skin necroses or marked systemic manifestations. We discuss the possible coming of the fish to South America and the circumstances and clinical impact of the envenomations.
Boon of MTA Apexification in Young Permanent Posterior Teeth
Authors: Vinod Kumar, Mohammed Zameer, Vijaya Prasad, T Mahantesh
Journal: Case Rep Dent (2014)

Single visit apexification using mineral trioxide aggregate (MTA) is a new boon in effective management of nonvital tooth with an open apex which has steadily gained popularity with clinicians; also it shortens the treatment period and improves patient compliance. Importance of this approach lies in expedient cleaning and shaping of the root canal system, followed by its apical seal with MTA. There are several case reports available describing the use of MTA as an apexification agent in incisors and premolar, but presented cases are the unique case reports demonstrating successful apexification procedure using MTA in young permanent mandibular molars. After eight-month follow-up, teeth were without any abnormal clinical symptoms; rather there were radiographic resolution of the periapical lesion and induction of root end closure with new hard tissue formation over MTA.
Treatment of a vertical root fracture using dual-curing resin cement: a case report
Authors: Nima Moradi Majd, Farshid Akhtari, Solmaz Araghi, Hamed Homayouni
Journal: Case Rep Dent (2012)

Introduction. Vertical root fracture (VRF) is one of the most frustrating complications of root canal treatment. The prognosis of the root with VRF is poor therefore tooth extraction and root amputation are usually the only treatment options. However, bonding of the fracture line with adhesive resin cement during the intentional replantation procedure was recently suggested as an alternative to tooth extraction. Methods. A vertically fractured left maxillary incisor was carefully extracted, fracture line was treated with adhesive resin cement, a retrograde cavity was produced and filled with calcium-enriched mixture (CEM) cement, and tooth was replanted. Results. After 12 months the tooth was asymptomatic. The size of periapical radiolucency was noticeably reduced and there was no clinical sign of ankylosis. Conclusion. Using adhesive resin cement to bond the fracture lines extraorally in roots with VRF and intentional replantation of the reconstructed teeth could be considered as an alternative to tooth extraction, especially for anterior teeth.
Superior Vena Cava Duplication: The Red Herring of Central Line Placement
Authors: Karin Gunther, Carmen Lam, David Siegel
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

5 million central venous access lines are placed every year in the United States, and it is a common surgical bedside procedure. We present a case of a central venous catheter placement with port for chemotherapy use, during which a duplication of a superior vena cava was discovered on CTA chest after fluoroscopy could not confirm placement of the guidewire. Due to its potential clinical implications, superior vena cava duplication must be recognized when it occurs.
Non-occupational lead poisoning associated with traditional Chinese medicine: A case report
Authors: Huan Ma, Li-Meng Wu, Yu Zou, Xiao-An Li
Journal: Front Public Health (2022)
Keywords: anemia, case report, lead poisoning, periumbilical pain, traditional chinese medicine
MeSH terms: Anemia, Lead Poisoning / diagnosis, Lead Poisoning / etiology, Case Reports, Adult, China, Humans, Lead, Male, Medicine, Chinese Traditional / adverse effects, Young Adult, Lead

Introduction:
Traditional Chinese medicine has a long history and is widely popular in China because of its safety and small side effects. In Chinese families, people believe that the combination of traditional Chinese and Western medicine is more effective, and in terms of conditioning and health care, they tend to rely on traditional Chinese medicine. However, the toxic and side effects of traditional Chinese medicine, especially heavy metal poisoning, should not be ignored.
Patient concerns:
A case of non-occupational lead poisoning caused by long-term use of traditional Chinese medicine.
Diagnosis:
A 21-year-old man with severe colic periumbilical pain was referred to our hospital. Through careful inquiry of his medical history, we found that he had been taking traditional Chinese medicine to treat facial acne in the past year. His test results showed anemia, liver damage, blood lead concentration of 1,268.4 μg/L, and bone marrow smear showed basophilic stippling erythrocyte. The patient was diagnosed with "lead poisoning."
Interventions:
The patient was given treatment with lead driving.
Outcomes:
The patient recovered after treatment.
Conclusion:
We found that lead poisoning in patients taking traditional Chinese medicine has been reported from time to time. Through consulting the data, we summarized the most common drugs leading to lead poisoning, and reviewed the pathogenesis and common clinical manifestations of lead poisoning. Because lead poisoning is easy to be misdiagnosed, we should ask more carefully about the past history and drug history of patients in order to make timely diagnosis and treatment.
The Use of Oxygen/Air Blender during Transoral Laser Microsurgery with Supraglottic Manual Jet Ventilation: A Safe Approach
Authors: Sara Abu-Ghanem, James Cochran
Journal: Case Rep Anesthesiol (2023)
MeSH terms: Case Reports

Background:
Surgical fires are known, preventable, and devastating complications of transoral microlaryngeal laser surgery. Several guidelines have recommended maintaining the fraction of inspired oxygen concentration (FiO2) at or below 30% for open delivery cases. We hereby present our experience utilizing an air/oxygen gas mixing device (blender) attached to a supraglottic manual jet ventilator during transoral laser microlaryngeal surgery in three cases to control oxygen levels.
Methods:
Retrospective chart review of three cases and literature review.
Results:
Three patients underwent microlaryngeal laser surgery and balloon dilation for the management of subglottic stenosis. All three patients were successfully ventilated throughout the procedures, and no major complications occurred intraoperatively. Two of three patients demonstrated symptomatic and clinical improvement at the first follow-up.
Conclusions:
This report demonstrates the successful use of an oxygen/air blender to reduce FiO2 to fire-safe levels of less than 30% during laser surgery of the airway using jet ventilation.
Concurrence of leukocyte chemotactic factor 2-associated amyloidosis and autoimmune diseases: A case report
Authors: Shuang Wang, Xiao-Juan Yu, Dan-Yang Li, Jin Xu, Su-Xia Wang
Journal: Front Immunol (2022)
Keywords: sjöegren’s syndrome, kidney biopsy, leukocyte chemotactic factor 2-associated amyloidosis, membranoproliferative glomerulonephritis, renal pathology, systemic lupus erythematosus
MeSH terms: Amyloidosis / diagnosis, Amyloidosis / etiology, Amyloidosis / metabolism, Autoimmune Diseases / diagnosis, Lupus Erythematosus, Systemic, Case Reports, Research Support, Non-U.S. Gov't, Aged, Chemotactic Factors, Female, Humans, Intercellular Signaling Peptides and Proteins, Leukocytes / metabolism, Chemotactic Factors, Intercellular Signaling Peptides and Proteins, LECT2 protein, human

Leukocyte chemotactic factor 2-associated (ALECT2) amyloidosis is one of the recently reported types of amyloidosis, which is caused by the extracellular deposition of leukocyte chemotactic factor 2 (LECT2). There have not been any reports involving the concurrence of ALECT2 amyloidosis with Sjögren's syndrome (SS) or systemic lupus erythematosus (SLE)s. Herein, we report a case of a 68-year-old Chinese woman presenting with long duration of sicca symptoms. The clinical evaluation and laboratory findings showed that she had SS overlapped with SLE. Kidney biopsy revealed a membranoproliferative glomerulonephritis (MPGN) with glomerular deposition of dominant IgG3-kappa by immunofluorescene, which was related to SS/SLE. Furthermore, patchy congophilic amyloid deposits in the tubulointerstitium were detected, which were positive for LECT2 protein by immunohistochemical staining and immunoelectron microscopy. This is the first case of ALECT2 amyloidosis that coexisted with SS/SLE, and the causal relationship between ALECT2 amyloidosis and autoimmune diseases remain unclear.
Somatic SMARCB1 Mutation in Sporadic Multiple Meningiomas: Case Report
Authors: Alice S Wang, Ali O Jamshidi, Nathan Oh, Ronald Sahyouni, Behdokht Nowroozizadeh, Ronald Kim, Frank P K Hsu, Daniela Bota
Journal: Front Neurol (2018)
Keywords: nf2, smarcb1, familial multiple meningiomas, germline mutation, somatic mutation, sporadic multiple meningiomas
MeSH terms: Case Reports

Background: Multiple intracranial meningiomas account for <10% of all meningiomas. Familial multiple meningiomas have been linked to germline mutations in two genes: neurofibromatosis type 2 (NF2) and SWIch/Sucrose Non-Fermentable (SWI/SNF)-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1 (SMARCB1). Sporadic multiple meningiomas have been associated with somatic NF2 mutations and, to date, there has been no case related to somatic SMARCB1 mutations. Here, we describe the first case. Case Report: A 45-year-old female suffered a head trauma while snowboarding. Subsequent to her injury, she experienced persistent headache, nausea, vomiting, dizziness, and flashing lights in the right eye. Magnetic resonance imaging (MRI) of her brain revealed multiple intracranial meningiomas. She underwent a two-staged craniotomy to remove frontal/parietal/temporal and occipital extra-axial tumors. Pathology confirmed the masses as meningiomas, WHO Grade I. Tumor genetic testing was positive for SMARCB1 mutation but blood genetic testing was negative for SMARCB1 mutation. Conclusion: In sporadic multiple meningiomas, somatic NF2 mutations are usually the suspected genetic alternations. Our case illustrates that somatic SMARCB1 mutation is another genetic risk factor for sporadic multiple meningiomas, albeit rare.
Central retinal vein occlusion concomitant with dengue fever
Authors: Punithamalar Velaitham, Nandini Vijayasingham
Journal: Int J Retina Vitreous (2016)
Keywords: central retinal vein occulsion, dengue fever, ophthalmic complications of dengue fever
MeSH terms: Case Reports

Background:
Dengue virus infection is on the rise and there is increasing number of ocular complications that are being reported. Most common ocular complications are macular edema, macular hemorrhages, and foveolitis. There are case reports on branch retinal vessel occlusions. Most of the ocular complications are attributed to the bleeding tendency and transudative process in dengue viral infection. This is a case report of ischemic central retinal vein occlusion (CRVO) concomitant with dengue fever.
Case presentation:
A 41 year old Malay female was admitted to medical ward and diagnosed to have "dengue fever with warning signs". On the day of admission she noted sudden onset of right eye blurring of vision. She presented to our clinic 1 week later. Ocular examination revealed right eye visual acuity of <20/1000 and ischaemic CRVO with macular edema. She had no other risk factors to develop retinal vein occlusion. She progressively developed proliferative retinopathy and received multiple laser therapy. There was no anterior segment neovascularization. However, her vision improved to only 20/400 despite of resolution of macular edema and new vessels elsewhere.
Conclusion:
Dengue virus infection is known to cause thrombocytopenia which can result in hemorrhagic events. It can also cause procoagulant state which can result in thrombotic events secondary to immune reaction. Awareness among treating physicians of such ocular complication which can result in significant morbidity for patient is necessary.
Case Report: Supernormal Vascular Aging in Leningrad Siege Survivors
Authors: Oxana Rotar, Maria Boyarinova, Ekaterina Moguchaya, Kristina Tolkunova, Nikita Kolosov, Valeriia Rezapova, Olga Freylikhman, Dmitrii Usoltsev, Olesya Melnik, Alexey Sergushichev, Vladislav Solntsev, Anna Kostareva, Elena Dubinina, Trudy Voortman, Christine Stevens, Mark J Daly, Alexandra Konradi, Evgeny Shlyakhto, Mykyta Artomov
Journal: Front Cardiovasc Med (2022)
Keywords: aging, deep phenotyping, pulse wave velocity (pwv), starvation, supernormal vascular aging
MeSH terms: Case Reports

Age-related changes in the vascular system play an important role in the biological age and lifespan of a person and maybe affected from an early age onward. One of the indicators of changes in the vascular system is arterial wall stiffness and its main measure, i.e., carotid-femoral pulse wave velocity (cfPWV). We examined arterial wall stiffness in a sample of 305 Leningrad Siege survivors to assess how hunger and stressful conditions during fetal development and early childhood affected the state of the cardiovascular system at a later age and what factors may neutralize the negative impact sustained in early childhood. Here, we presented an evaluation of two unique patients with supernormal vascular aging (SUPERNOVA) phenotype from this cohort and described the details of congruence between hereditary resistance and practiced lifestyle yielding slower biological aging rate.
One-Piece Titanium Implants: Retrospective Case Series
Authors: Gunar Wagner, Dieter Hartung
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Purpose:
One-piece titanium implants are not routinely used for reconstruction after tooth loss. Several limitations seemed to be apparent although the concept provides a straightforward approach for different clinical situations. A clinical documentation of five prosthetic restorations with one-piece titanium implants serving as a relevant treatment option in dental surgery is pursued. We demonstrate the feasibility and benefits of one-piece titanium implants for fixed dental prosthesis. Detailed descriptions of the technical features and the surgical approach by means of clinical cases are given. The prosthetic workflow when working with one-piece titanium implants is depicted in detail as well as examples for implant-supported tooth replacement in the posterior region and the esthetic zone. Conditions of applications regarding different timing of implant placement using the system and its limitations are discussed.
Results:
Clinical cases with a follow-up period of up to 10 years are presented to prove the long-term success of one-piece titanium implants in terms of bone and soft-tissue stability respecting the biological criteria for periodontal health.
Conclusions:
One-piece titanium implants represent a reliable treatment method for single-tooth replacements. Clinical success with long-time bone stability around the implantation site can be achieved. Taken into account the requirements for periodontal tissue stability, uneventful healing without extensive tissue loss is demonstrated by means of clinical cases presenting patients with periodontitis.
Genomic landscape of a metastatic malignant proliferating tricholemmal tumor and its response to PI3K inhibition
Authors: Jean-Nicolas Gallant, Andrew Sewell, Karinna Almodovar, Qingguo Wang, Kimberly B Dahlman, Richard G Abramson, Meghan E Kapp, Brandee T Brown, Kelli L Boyd, Jill Gilbert, Daniel N Cohen, Wendell G Yarbrough, Zhongming Zhao, Christine M Lovly
Journal: NPJ Precis Oncol (2019)
MeSH terms: Case Reports

Proliferating tricholemmal tumors (PTTs) are rare benign neoplasms that arise from the outer sheath of a hair follicle. Occasionally, these PTTs undergo malignant transformation to become malignant proliferating tricholemmal tumors (MPTTs). Little is known about the molecular alterations, malignant progression, and management of MPTTs. Here, we describe the case of a 58-year-old female that had a widely metastatic MPTT that harbored an activating PIK3CA mutation and was sensitive to the PI3K inhibitor, alpelisib (BYL719). We review the available literature on metastatic MPTT, detail the patient's course, and present a whole genome analysis of this rare tumor.