OpenMed/multicare-articles huggingface dataset:
Protein-Signaled Guided Bone Regeneration Using Titanium Mesh and Rh-BMP2 in Oral Surgery: A Case Report Involving Left Mandibular Reconstruction after Tumor Resection
Authors: M Cicciù, A S Herford, E Stoffella, G Cervino, D Cicciù
Journal: Open Dent J (2012)
Keywords: bmp2 human protein, bone reconstruction, bone regeneration, oral surgery, titanium mesh

Recombinant human bone morphogenetic protein-2 (rhBMP-2) is an osteoinductive protein approved for use in oral and maxillofacial defect reconstruction. Growth factors act as mediators of cellular growth on morphogenesis and mythogenesis phases. Utilized as recombinant proteins, these growth factors need the presence of local target cells capable of obtaining the required results. This cell population may be present at the wound site or added to scaffolding material before implantation at the surgical site.The aim of this study is to evaluate the clinical and radiographic results of a reported case with a large bone defect, treated with an absorbable collagen sponge, rhBMP-2 and a titanium plate and mesh. The Authors want to report a case which shows the resulting effectiveness of the rhBMP2 action regarding a large, mandibular defect reconstruction. This case also shows how the removal of a rare tumor such as a ghost cell tumor of the jaw may be treated without harvesting bone from another body site. A quick diagnosis of the lesions is important in order to perform the most suitable treatment. The Authors also underline the clinical and histological steps to insure the correct treatment is carried out to solve the case.Moreover, from results obtained from this case, it is possible to highlight several clinical benefits for the patient by adding rhBMP-2 to the common allograft to not only have alveolar reconstruction defects and sinus floor augmentation, but also to have alveolar cleft reconstruction and to treat segmental defects.
Cauda Canis: Variation of a Tinel's Sign for a Sciatic Nerve Tumor
Authors: Keith George, Shane Burke, Knarik Arkun, Ron Riesenburger
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

A patient with a prior history of intradural schwannoma and disc herniation presented with radicular pain after being hit in the thigh by a dog's tail. She was worked up and found to have a tumor of her right sciatic nerve. The tumor was resected and histology was consistent with schwannoma. The dog's tail acted as a Tinel's sign maneuver and led to timely identification of her peripheral nerve tumor. Peripheral nerve schwannomas can present in unusual forms, and Tinel's maneuver may be a useful tool in diagnosis.
Congenital hepatic fibrosis: case report and review of literature
Authors: Brahim El Hasbaoui, Zainab Rifai, Salahiddine Saghir, Anas Ayad, Najat Lamalmi, Rachid Abilkassem, Aomar Agadr
Journal: Pan Afr Med J (2021)
Keywords: fibrosis, case report, cholestasis, ciliopathy, hyper-transaminasemia
MeSH terms: Genetic Diseases, Inborn / diagnosis, Liver Cirrhosis / diagnosis, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Case Reports, Review, Abdomen / diagnostic imaging, Biopsy, Child, Child, Preschool, Cholestasis / diagnosis, Cholestasis / etiology, Female, Genetic Diseases, Inborn / physiopathology, Humans, Liver Cirrhosis / physiopathology, Male, Transaminases / blood, Transaminases, Hepatic Fibrosis, Congenital

Congenital hepatic fibrosis (CHF) is a rare autosomal recessive disease derived from biliary dysgenesis secondary to ductal plate malformation; it often coexists with Caroli's disease, von Meyenburg complexes, autosomal dominant polycystic kidney disease (ADPKD), and autosomal recessive polycystic kidney disease (ARPKD). Although CHF was first named and described in detail by Kerr et al. in 1961. Its pathogenesis still remains unclear. The exact incidence and prevalence are not known, and only a few hundred patients with CHF have been reported in the literature to date. However, with the development of noninvasive diagnostic techniques such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), CHF may now be more frequently detected. Anatomopathological examination of liver biopsy is the gold standard in diagnosis of CHF. Patients with CHF exhibit variable clinical presentations, ranging from no symptoms to severe symptoms such as acute hepatic decompensation and even cirrhosis. The most common presentations in these patients are splenomegaly, esophageal varices, and gastrointestinal bleeding due to portal hypertension. In addition, in younger children, CHF often is accompanied by renal cysts or increased renal echogenicity. Great variability exists among the signs and symptoms of the disease from early childhood to the 5th or 6th decade of life, and in most patients the disorder is diagnosed during adolescence or young adulthood. Here, we present two cases of congenital hepatic fibrosis in 2-years-old girl and 12-year-old male who had been referred for evaluation of an abdominal distension with persistent hyper-transaminasemia and cholestasis, the diagnostic was made according to the results of medical imaging (CT or MRI), a liver biopsy, and genetic testing.
Case Report: Catheter-based mechanical thrombectomy using the Indigo aspiration system in a case of systemic-to-pulmonary shunt thrombosis
Authors: Natalie Soszyn, Gareth J Morgan, John S Kim, Jenny E Zablah
Journal: Front Pediatr (2023)
Keywords: case report, catheter-based, central shunt, mechanical thrombectomy, thrombosis
MeSH terms: Case Reports

A 53-day-old girl with absent right atrioventricular (AV) connection, malposed great vessels, and pulmonary atresia underwent placement of a central shunt on the sixth day of her life. Her postoperative course was complicated by progressive desaturation, and computed tomographic angiography (CTA) demonstrated near-complete occlusion of her left pulmonary artery (LPA). Angiography demonstrated a nonocclusive thrombus in the distal central shunt and a thrombus with complete occlusion of the LPA. The Indigo aspiration system (Penumbra) was used to remove the thrombus from the central shunt and LPA, allowing placement of a stent in the narrowed LPA. Subsequent angiography showed a wide patient central shunt and LPA. The Indigo aspiration system (Penumbra) provides a viable option for removing thrombus in a patients refractory to other methods.
Fiber Post Removal Using a Conservative Fully Guided Approach: A Dental Technique
Authors: Abdullah Alfadda, Abdulmohsen Alfadley, Ahmed Jamleh
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

This report describes the usefulness of an endodontic template for the removal of a fiber post. A 40-year-old man presented with discomfort in the maxillary left canine. Clinical and radiographic examinations showed tooth #23 with a permanent core material retained with fiber post along with a persistent apical radiolucency. Among the various treatment modalities, nonsurgical root canal retreatment with fiber post removal using a conservative fully guided approach was proposed. After obtaining both the cone-beam computed tomographic images and the cast surface scan, their data were merged using implant planning software (ImplaStation for Windows x64 Bit Beta Version, ProDigiDent, Miami, Florida, USA) and superimposed. The drilling space was planned based on the location, diameter, and apical extent of the fiber post and was virtually overlapped and transferred clinically using a resin template to drill through the fiber post. With guides in position over the rubber dam, drilling was made with increments of 2 mm using a size 4 long-shank round bur (Thomas, Bourges, France) until it exposed the coronal gutta-percha. As soon as the canal was located, K3 rotary files (Sybron Endo, Orange, USA) were used along with chloroform to remove the old obturating materials. Then, additional shaping and cleaning were done with ProTaper Next rotary files (Dentsply Sirona, Ballaigues, Switzerland), sizes X2 and X3, and 5.25% NaOCl irrigation, respectively. The root canal was then dried with paper points and obturated with gutta-percha and AH Plus sealer (Dentsply Sirona, Ballaigues, Switzerland) using the continuous-wave compaction technique. Finally, the tooth was temporarily restored using the double seal technique with zinc oxide and zinc sulfate-based temporary material (Cavit W; 3M ESPE, St. Paul, MN, USA) and resin-modified glass ionomer material (Photac Fil; ESPE, Norristown, PA, USA) filling materials and referred for the final restoration.
Loperamide Induced Torsades de Pointes: A Case Report and Review of the Literature
Authors: O Mukarram, Y Hindi, G Catalasan, J Ward
Journal: Case Rep Med (2016)

Abuse of over the counter drugs often gets overlooked by health care providers. Loperamide is one such over the counter drug that is often abused by drug addicts. We present here a case of a young male attaining euphoria from taking massive doses of loperamide. He developed Torsades de Pointes and subsequent cardiac arrest. We found similarities in the progression of myocardial electrical conduction abnormalities among loperamide and other previously known arrhythmogenic drugs. We intend to raise concern over the ease of availability of such drugs over the counter and increase the index of suspicion for over the counter drug abuse from our experience.
Allopurinol desensitization with A 2 weeks modified protocol in an elderly patients with multiple comorbidities: a case report
Authors: Adile Berna Dursun, Osman Z Sahin
Journal: Allergy Asthma Clin Immunol (2014)
Keywords: allopurinol hypersensitivty, gout, hyperuricemia, maculopapular exanthema, oral drug desensitization, slow desensitization

Background:
Allopurinol is an effective urate-lowering drug that is well tolerated by the majority of patients. Patients with chronic renal insufficiency have an increased risk of hypersensitivity reactions with allopurinol.
Case presentation:
75 year old male patient with gout, renal insufficiency, history of metastatic colorectal carcinoma status post-resection was referred to Allergy clinic for a maculopapular eruption that developed 1 week after initiating therapy with allopurinol. The rash resolved with discontinuation of allopurinol. However, his serum urate level rose to 19.9 mg/dl. We initially proposed a slow 4 week oral allopurinol desensitization. The treating nephrologist felt it was critical to lower urate more rapidly. As a result, we modified the dose and standard 4 week protocol down to 2 weeks. A suspension of allopurinol was prepared by the allergy nurse practitioner with a 300 mg allopurinol tablet. The sensitization protocol was modified as a starting dose of 0.3 mg escalating to a final dose of 300 mg/day in 2 weeks. There was no reaction during or after the desensitization. The patient's urate level normalized (6.3 mg/dl) and has continued on 300 mg allopurinol daily without reaction.
Conclusion:
A 2 week modified allopurinol desensitization protocol is a safe alternative for elderly patients with multiple comorbidities.
Pulmonary metastasis as sole manifestation of relapse in previously treated localised prostate cancer: three exceptional case reports
Authors: Joaquim Peres Gago, Gabriela Câmara, Jorge Dionísio, Ana Opinião
Journal: Ecancermedicalscience (2016)
Keywords: adenocarcinoma, prostate cancer, solitary pulmonary metastasis
MeSH terms: Case Reports

Metastatic prostate cancer recurrence after definitive local therapy can occur in any tissue. Usually, the first affected site is the bone. Lung metastases without bone or lymph node involvement are extremely rare in patients with prostate cancer, and only a handful of cases are reported in the literature. In several other malignancies, such as breast cancer, sarcomas, colorectal cancer, and renal cell carcinoma, long-term disease-free survival has been reported after resection of solitary pulmonary metastases. We present three unusual cases of isolated pulmonary recurrence of prostate cancer after initial definitive local therapy. One of the patients underwent resection of the lung metastasis, resulting in a long-term disease-free survival. Both surgical excision of solitary and oligometastatic lung secondary lesions and systemic therapy can play an important role in long-term disease control. Surgery should be considered for selected and well-informed patients with pulmonary metastasis after primary localised treatment for prostate cancer.
Intervention and evaluation of the life design counseling: A case study
Authors: Danqi Wang, Xiping Liu
Journal: Front Psychol (2023)
Keywords: future career autobiography, innovative moments coding system, career adaptability, career construction interview, life design counseling
MeSH terms: Case Reports

This article aims to explore the effectiveness of Life Design Counseling (LDC) for a high school student before choosing the subject. To evaluate LDC outcomes, the Career Adapt-Abilities Scale-China Form was used before and after the intervention. Two measures were used to evaluate the process of LDC: the Innovative Moments Coding System (IMCS) and Future Career Autobiography (FCA). The results show that the LDC approach produced a significant change in career adaptability. In addition, the findings demonstrate a significant narrative movement or change with the evaluation of the process. Implications for future research and practice are discussed.
Stage 4S Bilateral Adrenal Neuroblastoma in a Newborn
Authors: Rahul Gupta, Tariq Ahmed Mala, Praveen Mathur, Rozy Paul, Shahid Amin Mala
Journal: APSP J Case Rep (2014)
Keywords: bilateral adrenal neuroblastoma, neonate, stage 4s
MeSH terms: Case Reports

Stage 4S bilateral adrenal neuroblastoma presenting in the neonatal period is extremely rare. A 1-day-old male with 4Sbilateral adrenal neuroblastoma complicated by marked hepatomegaly managed by chemotherapy is being reported. The provisional diagnosis of neuroblastoma was made in the fetal life during the last trimester of pregnancy. Cardiomyopathy due to doxorubicin cytotoxicity developed over ensuing years, which is being treated.
Using real-time ascertainment rate estimate from infection and hospitalization dataset for modeling the spread of infectious disease: COVID-19 case study in the Czech Republic
Authors: Lenka Přibylová, Veronika Eclerová, Ondřej Májek, Jiří Jarkovský, Tomáš Pavlík, Ladislav Dušek
Journal: PLoS One (2023)
MeSH terms: COVID-19 / epidemiology, Communicable Diseases, Bayes Theorem, Czech Republic / epidemiology, Hospitalization, Humans, Retrospective Studies, SARS-CoV-2

We present a novel approach to estimate the time-varying ascertainment rate in almost real-time, based on the surveillance of positively tested infectious and hospital admission data. We also address the age dependence of the estimate. The ascertainment rate estimation is based on the Bayes theorem. It can be easily calculated and used (i) as part of a mechanistic model of the disease spread or (ii) to estimate the unreported infections or changes in their proportion in almost real-time as one of the early-warning signals in case of undetected outbreak emergence. The paper also contains a case study of the COVID-19 epidemic in the Czech Republic. The case study demonstrates the usage of the ascertainment rate estimate in retrospective analysis, epidemic monitoring, explanations of differences between waves, usage in the national Anti-epidemic system, and monitoring of the effectiveness of non-pharmaceutical interventions on Czech nationwide surveillance datasets. The Czech data reveal that the probability of hospitalization due to SARS-CoV-2 infection for the senior population was 12 times higher than for the non-senior population in the monitored period from the beginning of March 2020 to the end of May 2021. In a mechanistic model of COVID-19 spread in the Czech Republic, the ascertainment rate enables us to explain the links between all basic compartments, including new cases, hospitalizations, and deaths.
Multiple Endocrine Neoplasia Type 1 with Concomitant Existence of Malignant Insulinoma: A Rare Finding
Authors: Randhir Sagar Yadav, Ashik Pokharel, Deepshikha Gaire, Shumneva Shrestha, Ashbita Pokharel, Sumita Pradhan, Prasan Bir Singh Kansakar
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Multiple endocrine neoplasia type 1 (MEN1) is a rare syndrome of autosomal dominant inheritance defined by co-occurrence of two or more tumors originating from the parathyroid gland, pancreatic islet cells, and/or anterior pituitary. Insulinoma which has an incidence of 0.4% is a rare pancreatic neuroendocrine tumor. Malignant insulinoma is extremely rare, while primary hyperparathyroidism is a common occurrence in MEN1. We present a case of MEN1 syndrome with 2.6 cm insulinoma in the pancreatic head and parathyroid adenoma in a 56-year-old female who presented with symptoms suggestive of hypoglycemia like multiple episodes of loss of consciousness for four years. Classical pancreaticoduodenectomy was carried out, and the postoperative period was uneventful. Later, subtotal parathyroidectomy was performed, which showed parathyroid adenoma. Patients presenting with features of hypoglycemia should be vigilantly assessed for the presence of a sinister pathology.
Bilateral ectopia lentis with isolated lens coloboma in Marfan syndrome
Authors: Sabin Sahu, Reena Yadav, Sharad Gupta, Lila Raj Puri
Journal: GMS Ophthalmol Cases (2016)
Keywords: marfan syndrome, ectopia lentis, lens coloboma
MeSH terms: Case Reports

A rare case of bilateral ectopia lentis with isolated lens coloboma in Marfan syndrome is reported. A 21-year-old female presented with decreased vision in both eyes. Her unaided visual acuity was 20/200 and 20/400 in the right and left eye, respectively, improving to 20/40 with -4.5 DS/-3.0 DC x 10° correction in the right eye and 20/80 with -10.0 DS/-6.5 Dc x10° correction in the left eye. On slit lamp examination under mydriasis, both eyes revealed ectopia lentis with lens coloboma and stretched zonules. Fundus examination revealed pigmentary changes at the fovea. On systemic evaluation, she was diagnosed with Marfan syndrome. She was prescribed a refractive correction in form of a contact lens and kept under observation.
Repair of Acute Patellar Tendon Rupture Using an Internal Brace Technique
Authors: Aki Fukuda, Shigeto Nakazora, Akinobu Nishimura, Ko Kato
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Acute patellar tendon rupture is a serious injury, resulting in the disruption of the knee extensor mechanism. Many authors recommend augmented repairs of patellar tendon ruptures to allow early active rehabilitation. An internal brace technique, which is a ligament augmentation using high-strength suture tape and knotless anchors, has been used as augmentation for the primary tendon or ligament injury. A case of acute patellar tendon rupture in a Judo player, who was successfully treated with primary repair and augmentation using an internal brace technique, is presented. In this case, the patient regained full function of the knee and returned to full sports activities postoperatively. An internal brace technique provides biomechanical stability of the repaired tendon without donor site morbidity and could be an effective procedure for the treatment of acute patellar tendon rupture.
Case Report: Bosentan and Sildenafil Exposure in Human Milk - A Contribution From the ConcePTION Project
Authors: Nina Nauwelaerts, Michael Ceulemans, Neel Deferm, An Eerdekens, Bart Lammens, Yeghig Armoudjian, Kristel Van Calsteren, Karel Allegaert, Loes de Vries, Pieter Annaert, Anne Smits
Journal: Front Pharmacol (2022)
Keywords: bosentan, breastfeeding, case report, human milk, lactation, pharmacokinetics, pulmonary arterial hypertension, sildenafil
MeSH terms: Case Reports

Introduction: Quantitative information on disposition of maternal medicines in human milk remains a major knowledge gap. This case report presents the clinical and pharmacokinetic data of a single mother-infant pair exposed to bosentan and sildenafil for the treatment of pulmonary arterial hypertension (PAH) during lactation. Case presentation: A 43-year old mother was treated with sildenafil (20 mg, 3x/day) and bosentan (125 mg, 2x/day) for PAH. Her 21-months old infant received breastfeeding in combination with adequate complementary foods. Milk samples were collected over 24 h, at day 637 and 651 after delivery. The observed average steady-state concentrations of sildenafil (2.84 μg/L) and bosentan (49.0 μg/L) in human milk were low. The Daily Infant Dosage ingested by the nursing infant through human milk was 0.02 μg/kg/day for sildenafil and 0.29 μg/kg/day for bosentan at day 637, and 0.03 μg/kg/day and 0.60 μg/kg/day at day 651. The Relative Infant Dose calculated for an exclusively breastfed infant with an estimated milk intake of 150 ml/kg/day, was 0.06% for sildenafil and 0.24% for bosentan. General health outcome of the infant, reported by the mother, was uneventful until the sampling days. Conclusion: Low medicine concentrations were found in human milk expressed 21 months after delivery after maternal intake of 20 mg sildenafil three times daily and 125 mg bosentan twice daily. General health of the nursing infant until sampling was reported as optimal by the mother.
Combination Trimodality Therapy Using Vismodegib for Basal Cell Carcinoma of the Face
Authors: Alec M Block, Fiori Alite, Aidnag Z Diaz, Richard W Borrowdale, Joseph I Clark, Mehee Choi
Journal: Case Rep Oncol Med (2015)

Background. For large basal cell carcinomas (BCCs) of the head and neck, definitive surgery often requires extensive resection and reconstruction that may result in prolonged recovery and limited cosmesis. Vismodegib, a small-molecule inhibitor of the hedgehog pathway, is approved for advanced and metastatic BCCs. We present a case of advanced BCC treated with combination of vismodegib, radiotherapy, and local excision resulting in excellent response and cosmesis. Case Presentation. A 64-year-old gentleman presented with a 5-year history of a 7 cm enlarging right cheek mass, with extensive vascularization, central ulceration, and skin, soft tissue, and buccal mucosa involvement. Biopsy revealed BCC, nodular type. Up-front surgical option involved a large resection and reconstruction. After multidisciplinary discussion, we recommended and he opted for combined modality of vismodegib, radiotherapy, and local excision. The patient tolerated vismodegib well and his right cheek lesion decreased significantly in size. He was then treated with radiotherapy followed by local excision that revealed only focal residual BCC. Currently, he is without evidence of disease and has excellent cosmesis. Conclusions. We report a case of locally advanced BCC treated with trimodality therapy with vismodegib, radiotherapy, and local excision, resulting in excellent outcome and facial cosmesis, without requiring extensive resection or reconstructive surgery.
Decreased Perifoveal Sensitivity Detected by Microperimetry in Patients Using Hydroxychloroquine and without Visual Field and Fundoscopic Anomalies
Authors: A Molina-Martín, D P Piñero, R J Pérez-Cambrodí
Journal: J Ophthalmol (2015)

Purpose. To evaluate the usefulness of microperimetry in the early detection of the ocular anomalies associated with the use of hydroxychloroquine. Methods. Prospective comparative case series study comprising 14 healthy eyes of 7 patients (group A) and 14 eyes of 7 patients under treatment with hydroxychloroquine for the treatment of rheumatologic diseases and without fundoscopic or perimetric anomalies (group B). A comprehensive ophthalmological examination including microperimetry (MP) and spectral-domain optical coherence tomography was performed in both groups. Results. No significant differences were found in mean MP foveal sensitivity between groups (P = 0.18). However, mean MP overall sensitivity was significantly higher in group A (29.05 ± 0.57 dB versus group B, 26.05 ± 2.75 dB; P < 0.001). Significantly higher sensitivity values were obtained in group A in comparison to group B for the three eccentric loci evaluated (P < 0.001). Conclusion. Microperimetry seems to be a useful tool for the early detection of retinal damage in patients treated with hydroxychloroquine.