OpenMed/multicare-articles huggingface dataset:
Different Types of Hyperfluorescence Observed in Post Anti-VEGF Fluorescein Angiographic Patterns in Retinopathy of Prematurity Patients
Authors: Enzhong Jin, Hong Yin, Kailin Liu, Zhiqiao Liang, Mingwei Zhao
Journal: Front Med (Lausanne) (2022)
Keywords: anti-vegf (vascular endothelial growth factor) agents, fluorescein angiography, hyperfluorescence, retinopathy of prematurity (rop), treatment

Purpose:
To demonstrate that the demographic and treatment characteristics of retinopathy of prematurity (ROP) eyes showed different types of hyperfluorescence in fluorescein angiography (FA) initially treated with anti-vascular endothelial growth factor (VEGF) agents.
Methods:
A consecutive case series of ROP treated with anti-VEGF agents was retrospectively studied. All the patients underwent FA examinations at least 6 months later after treatment. The demographic and treatment characteristics of eyes with or without hyperfluorescence in FA were analyzed. The different types of hyperfluorescence were divided into three groups, including vascular leakage, fibrous membrane, and vascular abnormality.
Results:
Two hundred and forty-two eyes of 123 patients with treatment-required ROP were included. Hyperfluorescence was defined in 51/242 eyes, and 2.08 ± 1.11 injections were performed for them, while the eyes without hyperfluorescence received 1.65 ± 0.80 injections (P = 0.013). Vascular leakage was defined in 26/51 hyperfluorescence eyes. The postmenstrual age (PMA) of first injection for the hyperfluorescence group was 38.56 ± 3.24 weeks, which is earlier than that of infants without hyperfluorescence (P = 0.011). More additional treatments were performed in eyes with hyperfluorescence (23.53 vs. 3.66%, P = 0.000). Among them, the eyes with vascular leakage required more additional treatment than eyes without vascular leakage (42.31 vs. 4.00%, P = 0.004). For the 26 eyes with vascular leakage, 11 eyes of 8 patients received further treatments during further follow-up. No significant difference of refractive errors can be defined between different groups.
Conclusion:
Eyes with persistent hyperfluorescencein FA after treatment required more anti-VEGF and additional treatments, including laser and PPV. Not all hyperfluorescences were vascular leakage and required additional treatment.
An Unusual Complication in Plastic Periodontal Surgery
Authors: Jorge Vagarinho, Sara Sardinha, Ricardo Alves
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Introduction:
Oroantral communications may arise as a result of pathological processes or iatrogenic situations, particularly in oral surgery and implantology, but are uncommon in periodontal plastic surgery. Case Presentation. A healthy 37-year-old female patient with 5 mm Miller Class II recession on the maxillary left second molar was referred for a root coverage procedure. While preparing the recipient bed for the graft, an oroantral communication was created. Schneiderian membrane was sutured to reduce the dimension of the communication and covered with a connective tissue graft. Finally, the flap was laterally and coronally moved, and the patient instructed about postoperative precautions. This procedure allowed to achieve a complete closure of the oroantral communication and good root coverage after an 8-month follow-up.
Conclusions:
Different authors described different techniques that can be used to close oroantral communications. Nevertheless, in this clinical case, it was shown that the oroantral communication may be closed without having to postpone the periodontal plastic surgery.
Case Report: Anastrozole as a monotherapy for pre-pubertal children with non-classic congenital adrenal hyperplasia
Authors: Sandy C Liu, Malavika Suresh, Mutaz Jaber, Yesica Mercado Munoz, Kyriakie Sarafoglou
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: anastrozole, androgen, aromatase inhibitor, bone maturation, congenital adrenal hyperplasia, estrogen, growth, hydrocortisone
MeSH terms: Adrenal Hyperplasia, Congenital / complications, Adrenal Hyperplasia, Congenital / diagnosis, Adrenal Hyperplasia, Congenital / drug therapy, Case Reports, Research Support, N.I.H., Extramural, Anastrozole, Androgens, Child, Estrogens, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Virilism, Anastrozole, Androgens, Estrogens, Hydrocortisone, Congenital adrenal hyperplasia due to 21 hydroxylase deficiency

Most children with non-classic congenital adrenal hyperplasia (NC-CAH) due to 21-hydroxylase deficiency are asymptomatic and do not require cortisol replacement therapy unless they develop symptoms of hyperandrogenemia. The current practice is to treat symptomatic children with hydrocortisone aimed at suppressing excess adrenal androgen production irrespective of the child's level of endogenous cortisol production. Once on hydrocortisone therapy, even children with normal cortisol production require stress dosing. Some children with NC-CAH may present with premature adrenarche, growth acceleration, and advanced bone age, but with no signs of genital virilization and normal endogenous cortisol production. In these cases, an alternative therapy to hydrocortisone treatment that does not impact the hypothalamic-pituitary-adrenal axis, but targets increased estrogen production and its effects on bone maturation, could be considered. Aromatase inhibitors (AIs), which block the aromatization of androgen to estrogen, have been used off-label in men with short stature to delay bone maturation and as an adjunct therapy in children with classic CAH. The use of AI as a monotherapy for children with NC-CAH has never been reported. We present three pre-pubertal female children with a diagnosis of NC-CAH treated with anastrozole monotherapy after presenting with advanced bone age, early adrenarche, no signs of genital virilization, and normal peak cortisol in response to ACTH stimulation testing. Bone age z-scores normalized, and all three reached or exceeded their target heights. Monotherapy with anastrozole can be an effective alternative in slowing down bone maturation and improving height outcomes in children with NC-CAH and normal adrenal cortisol production.
Case Report: Ectopic third molar in the maxillary sinus with infected dentigerous cyst assessed by cone beam CT
Authors: Khairy Elmorsy, Lubna K Elsayed, Sara M El Khateeb
Journal: F1000Res (2020)
Keywords: cone beam ct, ectopic, maxillary sinus, molar, tooth eruption
MeSH terms: Dentigerous Cyst / diagnostic imaging, Dentigerous Cyst / surgery, Tooth Eruption, Ectopic, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Cone-Beam Computed Tomography, Female, Humans, Maxillary Sinus / diagnostic imaging, Maxillary Sinus / surgery, Molar, Third / diagnostic imaging, Molar, Third / surgery

Ectopic development of teeth in nondental areas is uncommon, especially in the maxillary sinus. A panoramic radiograph is the routine diagnostic radiographic examination performed for this type of eruption, although cone beam computed tomography (CBCT) is highly recommended for further localization of the ectopic tooth and assessment of the characteristics of any associated lesion before a surgical procedure. We report a case of a 13-year-old female student who presented with purulent discharge posterior to the upper right second molar with a bad taste and foul odour. Radiographic examination revealed a maxillary third molar tooth located at the posterosuperior aspect of the right maxillary sinus with a hyperdense lesion surrounding the crown, obliterating the sinus cavity. Both the tooth and dentigerous cyst were surgically removed under general anaesthesia through Caldwell-Luc antrostomy. After a three-month follow-up, the patient was symptom free and had an uneventful recovery. The rare and critical location of the reported third molar along with the infected dentigerous cyst indicates its complete enucleation to avoid complications as recurrence or malignant transformation.
Pulmonary Hemorrhage following Edge-to-Edge Mitral Valve Repair
Authors: Mirna B Ayache, Myttle A Mayuga, Chantal ElAmm, Guilherme Attizzani, Jordan Kazakov
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Mitral valve repair with the MitraClip device has emerged as an effective treatment option for patients with severe mitral regurgitation and contraindications for surgical interventions. While the procedure is not known to cause pulmonary complications, we describe two cases of pulmonary hemorrhage following percutaneous mitral valve repair. The patients did well with supportive care and reinitiation of anticlotting agents was well tolerated after resolution of bleeding.
Case Report: Two Chinese Infants of Sengers Syndrome Caused by Mutations in AGK Gene
Authors: Benzhen Wang, Zhanhui Du, Guangsong Shan, Chuanzhu Yan, Victor Wei Zhang, Zipu Li
Journal: Front Pediatr (2021)
Keywords: sengers syndrome, acylglycerol kinase, cardiomyopathy, genotype, hypertrophic, mutation
MeSH terms: Case Reports

Sengers syndrome (OMIM #212350) is a rare autosomal recessive disorder due to mutations in acylglycerol kinase (AGK) gene. We report two cases that were diagnosed clinically and confirmed genetically. Both infants had typical clinical features characterized by hypertrophic cardiomyopathy, bilateral cataracts, myopathy, and lactic acidosis, and heart failure was the most severe manifestation. Genetic testing of a boy revealed a homozygous pathogenic variant for Sengers syndrome in AGK (c.1131+2T>C) which was classified as likely pathogenic according to the ACMG guideline; besides, his skeletal muscle biopsy and transmission electron microscope presented obvious abnormity. One girl had compound heterozygous (c.409C>T and c.390G>A) variants of AGK gene that was identified in the proband and further Sanger sequencing indicated that the parents carried a single heterozygous mutation each. After the administration of "cocktail" therapy including coenzyme Q10, carnitine, and vitamin B complex, as well as ACEI, heart failure and myopathy of the boy were significantly improved and the condition was stable after 1-year follow-up, while the cardiomyopathy of the girl is not progressive but the plasma lactate acid increased significantly. We present the first report of two infants with Sengers syndrome diagnosed via exome sequencing in China.
Venovenous Extracorporeal Membrane Oxygenation for Negative Pressure Pulmonary Hemorrhage in an Elderly Patient
Authors: Kenichiro Ishida, Mitsuhiro Noborio, Nobutaka Iwasa, Taku Sogabe, Yohei Ieki, Yuki Saoyama, Kyosuke Takahashi, Yumiko Shimahara, Daikai Sadamitsu
Journal: Case Rep Crit Care (2015)

The patient in this case report was an 88-year-old male. Acute upper airway obstruction by food led to transient cardiac arrest, and negative pressure pulmonary hemorrhage (NPPH) occurred 1 hour after the foreign body obstruction. Using venovenous extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome resulting from NPPH, his respiratory state was recovered and hemoptysis stopped. NPPH is a life-threatening disease, the rapid recognition of which is required to initiate appropriate therapy. Although active hemorrhage might be a contraindication for ECMO, our experience showed this to be an effective treatment option. Moreover, our experience suggests that the application of ECMO to elderly patients should be considered on a case-by-case basis.
Severe Hypoglycemia due to Isolated ACTH Deficiency in Children: A New Case Report and Review of the Literature
Authors: Michael Y Torchinsky, Robert Wineman, George W Moll
Journal: Int J Pediatr (2011)
MeSH terms: Case Reports

Isolated ACTH deficiency causes life-threatening severe hypoglycemia. A 7-year-old girl with hypoglycemia due to this rare disorder is described. Our patient had undetectable plasma ACTH repeatedly and cortisol 0 mcg/dl before and after ACTH 1-24 stimulation. There was no evidence of other pituitary hormone deficiency. Glucocorticoid replacement therapy resulted in resolution of all symptoms and normalization of blood glucose. Previously published data on isolated ACTH deficiency in children is summarized. Review of the literature showed that the prevalence of this condition could be underestimated in the neonatal period and in Prader-Willi syndrome. Isolated ACTH deficiency occurs in older children as well as in neonates.
Pneumocephalus as a Rare Presentation of Acute Sinusitis with Intracranial Extension - Two Cases and a Review of Literature
Authors: Xingwen Sun, Gloria C Chiang
Journal: J Clin Imaging Sci (2019)
Keywords: imaging, meningitis, pneumocephalus, sinusitis
MeSH terms: Case Reports

Pneumocephalus is a rare presentation of sinusitis. The purpose of this case series and literature review is to highlight the critical importance of recognizing pneumocephalus on initial brain imaging, since it may serve as the first sign of acute sinusitis with intracranial complication. Although sinusitis is a treatable condition with appropriate and timely antibiotic therapy, failure to recognize intracranial extension and delays to prompt surgical drainage could lead to a dire clinical course.
Case report: Non-response to fluoxetine in a homozygous 5-HTTLPR S-allele carrier of the serotonin transporter gene
Authors: Céline K Stäuble, Rebecca Meier, Markus L Lampert, Thorsten Mikoteit, Martin Hatzinger, Samuel S Allemann, Kurt E Hersberger, Henriette E Meyer Zu Schwabedissen
Journal: Front Psychiatry (2022)
Keywords: 5-htt, abcb1, slc6a4, depression, pharmaceutical care, pharmacodynamics, pharmacogenetics, venlafaxine
MeSH terms: Case Reports

We report the case of a 50-year-old male with major depressive disorder (MDD) to illustrate the challenge of finding effective antidepressant pharmacotherapy and the role that the patient's genetic makeup may play. Recent treatment attempts before clinic admission included venlafaxine and fluoxetine. Venlafaxine was discontinued due to lack of response, and subsequently switched to fluoxetine based on pharmacogenotyping of the P-glycoprotein transporter (P-gp, encoded by ABCB1) by the outpatient psychiatrist. Despite steady state serum levels within the therapeutic range, the patient did not benefit from fluoxetine either, necessitating admission to our clinic. Here a clinical pharmacist-led medication review including additional pharmacogenetic (PGx) analysis resulted in the change of the antidepressant therapy to bupropion. Under the new regimen, established in the in-patient-setting, the patient remitted. However, based on the assessed pharmacokinetics-related gene variants, including CYPs and ABCB1, non-response to fluoxetine could not be conclusively explained. Therefore, we retrospectively selected the serotonin transporter (SERT1, encoded by SLC6A4) for further genetic analysis of pharmacodynamic variability. The patient presented to be a homozygous carrier of the short allele variant in the 5-HTTLPR (S/S) located within the SLC6A4 promoter region, which has been associated with a reduced expression of the SERT1. This case points out the potential relevance of panel PGx testing considering polymorphisms in genes of pharmacokinetic as well as pharmacodynamic relevance.
The real-time remote testing and programming of cardiac implantable electronic devices: A case series report
Authors: Yu Long, Shiqiang Xiong, Lin Tong, Jin Li, Yan Luo, Wenchao Huang, Zhen Zhang, Hanxiong Liu, Lin Cai
Journal: Front Cardiovasc Med (2022)
Keywords: 5g cloud technology support platform, covid-19, cardiac implantable electronic devices, door openings, remote parameter testing
MeSH terms: Case Reports

Minimizing the number of personnel in the cardiac catheterization laboratory (CCL) and the times of CCL door openings contribute to reduce the infection risk of medical staff and patients, particularly during the COVID-19 pandemic. The usage of 5G-CTP system enables device specialists to conduct remote parameter testing and programming without entering the CCL, potentially reducing the exposure risk of medical staff and patients to COVID-19 infection.
Ovarian Adenomatoid Tumor Coexisting with Mature Cystic Teratoma: A Rare Case Report
Authors: Mingxia Shi, Firas Al-Delfi, Majd Al Shaarani, Kurt Knowles, James Cotelingam
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Adenomatoid tumor of the ovary is rare, and so are collision tumors in this location. The most common histological combination of ovarian collision tumors is the coexistence of mature cystic teratoma with ovarian cystadenoma or cystadenocarcinoma. Presented herein is a rare case of ovarian adenomatoid tumor found incidentally and coexisting with mature cystic teratoma. A 44-year-old woman presented with a one-year history of intermittent right-sided pelvic pain. Ultrasound evaluation revealed a heterogeneous cystic mass in the right ovary, and a clinical diagnosis of teratoma was made. The patient subsequently underwent a right salpingo-oophorectomy. Pathological examination revealed a mature cystic teratoma and coexistent adenomatoid tumor. The two tumors were separate and no transitional features were recognized histologically. To our knowledge, no previous report of coexistence of these two tumors has been reported. Both tumors are benign and completely excised; therefore no adverse consequences are expected.
Ipsilateral Simultaneous Low-Energy Multiple Upper Limb Fractures in an Elderly Patient: Case Report and Review of the Literature
Authors: Dany Aouad, Rabih Kortbawi, Mohammad Daher, Alexandre Nehme, Ramzi Moucharafieh, Mohammad Badra
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

Traumatic injuries of the upper limb can result in variant fracture combination. This article discusses a rare injury combination including ipsilateral proximal and distal humerus fractures alongside a distal radius fracture. The mechanism of the fall is unknown, but the patient being old with such a complex injury, one can only assume that osteoporosis played a major role. Open reduction and internal fixation was opted for the distal humerus and radius fractures, and percutaneous pinning was done for the proximal humerus fracture. Surgery is an option to each one of these injuries with different techniques available for managing such an association, with emphasis made on osteoporosis workup to help prevent such complex injuries.
Severe Hyponatremia-Induced Stress Cardiomyopathy: A Case Report and Review of Literature
Authors: Irushna Perera, Sanjeewa Rajapakse, Shamila T De Silva
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Takotsubo or stress cardiomyopathy is a non ischemic disease affecting the myocardium, which presents with typical features of myocardial ischemia. Although the presentation with acute central chest pain and shortness of breath mimics acute myocardial ischemia, there is an absence of actual disruption of cardiac blood supply via the coronaries due to acute plaque rupture or vascular spasm. The underlying pathophysiology of this clinical entity remains largely unclear, but a definite association with physical or emotional stress has been well established, hence the term "stress cardiomyopathy." The list of potential triggers continues to grow as the disorder is increasingly detected by clinicians and cardiologists, with better clinical insight and improved availability of cardiac investigations. We report a patient with Takotsubo cardiomyopathy associated with severe hyponatremia.
Median Nerve Palsy following Elastic Stable Intramedullary Nailing of a Monteggia Fracture: An Unusual Case and Review of the Literature
Authors: Surjit Lidder, Nima Heidari, Florian Amerstorfer, Stephan Grechenig, Annelie M Weinberg
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Monteggia fractures are rare in children, and subtle radial head dislocations, with minor plastic deformation of the ulna, may be missed in up to a third of cases. Complications of Monteggia fractures-dislocations include persistent radial head dislocation, forearm deformity, elbow stiffness, and nerve palsies at the time of presentation. An unusual case of median nerve palsy following elastic stable intramedullary nailing of a type I Monteggia lesion in a 6-year-old girl is presented, and we highlight that, although most nerve palsies associated with a Monteggia fracture-dislocations are treated expectantly in children, early intervention here probably provided the best outcome.
Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature
Authors: Shadi Rezai, Jenna T Nakagawa, John Tedesco, Annika Chadee, Sri Gottimukkala, Ray Mercado, Cassandra E Henderson
Journal: Case Rep Obstet Gynecol (2015)

Background. Gestational gigantomastia is a rare disorder without clear etiology or well-established risk factors. Several pathogenic mechanisms contributing to the disease process have been proposed, all of which can lead to a similar phenotype of breast hypertrophy. Case. A 28-year-old Guinean woman presented at 37 weeks of gestation with bilateral gigantomastia, mastalgia, peau d'orange, and back pain. Prolactin levels were 103.3 μg/L (with a normal reference value for prolactin in pregnancy being 36-372 μg/L). The patient was treated with bromocriptine (2.5 mg twice daily), scheduled for a repeat cesarean, and referred to surgery for bilateral mammoplasty. Conclusion. Gestational gigantomastia is a rare disorder, characterized by enlargement and hypertrophy of breast tissue. Our patient presented with no endocrine or hematological abnormalities, adding to a review of the literature for differential diagnoses, workup, and management of cases of gestational gigantomastia with normal hormone levels.
A Case Report of a Young Patient Presenting With Syncope Secondary to Arrhythmogenic Ventricular Cardiomyopathy
Authors: Zahid Khan, Tom Rayner, Dinesh Sethumadhavan, Sahar Hamid
Journal: Cureus (2023)
Keywords: arrhythmogenic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy (arvc/d), cardiac magnetic resonanced imaging, cardioinhibitory syncope, emergency echocardiography, implantable cardioverter-defibrillator (icd), life-threatening arrhythmia, prevention of syncope, right bundle branch block, ventricular dysrhythmia
MeSH terms: Case Reports

Arrhythmogenic ventricular cardiomyopathy is an inherited condition mainly affecting adults. A 35-year-old Asian male patient presented with syncope while walking home. He experienced a number of episodes of light-headedness and dizziness over the past few weeks. A clinical examination found visible injuries to his face and hands. An electrocardiogram showed right axis deviation and right bundle branch block. Echocardiography showed normal biventricular function and the left ventricular ejection fraction was > 55%. A computerized tomography scan of the head and face showed a small fracture to the superior maxillary wall and a computerized tomography pulmonary angiogram demonstrated an inflammatory nodule with right upper and middle lobes changes as well as right hilar lymphadenopathy, suggestive of possible tuberculosis. Blood tests were unremarkable, and troponin was negative. Cardiovascular magnetic resonance imaging showed preserved biventricular function, mild bi-atrial dilatation, and extensive, crescentic-shaped, subepicardial late gadolinium enhancement from basal to apical inferior, basal to apical lateral, and mid to apical anterior segments of the left ventricle suggestive of arrhythmogenic ventricular cardiomyopathy. The patient was commenced on bisoprolol and had an implantable cardioverter defibrillator fitted. He was discharged home with outpatient cardiology follow-up.