OpenMed/multicare-articles huggingface dataset:
Nodular Lymphoid Hyperplasia in Children: Recurrent Hematemesis
Authors: Nurfariza Che Husin, Mohd Shahrulsalam Mohd Shah, Mohd Razin Hassan, Wan Mohd Ruzaimie Wan Mohamad Noor, Mohd Tarmizi Md Nor
Journal: Cureus (2023)
Keywords: duodenum, gastrointestinal endoscopy, lymphoid nodular hyperplasia, recurrent hematemesis in children, s recurrent hematemesis in children
MeSH terms: Case Reports

Nodular lymphoid hyperplasia (NLH) is a pathology of the gastrointestinal tract that is commonly found in children. Most of its etiology is benign and associated with some underlying causes such as food hypersensitivity, viral or bacterial infection, giardiasis, Helicobacter pylori (H. pylori) infection, immunodeficiency, celiac disease, and inflammatory bowel disease. It is characterized by the growth of submucosal lymphoid tissue and a mucosal response to different types of noxious stimuli. In this report, we present the case of a child with recurrent hematemesis.
Customized Titanium Mesh for Guided Bone Regeneration in the Posterior Mandible in a Patient Previously Treated with Bisphosphonates
Authors: Johannes Müller, Rüdiger Junker
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

We describe the restorative treatment of an 86-year-old female patient who was referred to our specialist prosthodontics clinic. Due to secondary osteoporosis, she underwent oral antiresorptive therapy with ibandronic acid for 10 years. Although she was classified as a patient at increased risk of drug-induced osteonecrosis of the jaw, she eventually signed a consent form for fixed implant-supported prosthetic rehabilitation in her 4th sextant. However, after tooth extraction, the bone ridge was too small at the intended implant positions. Therefore, guided bone regeneration was performed with a computer-aided design/computer-aided manufacturing three-dimensional printed titanium mesh. Finally, a continuous augmented hard tissue ridge above 7 mm was found, and three implants were inserted. Eventually, after four months of submerged healing, the implants were loaded with single crowns. Now, the patient is seen regularly for supportive peri-implant therapy.
Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review
Authors: Sultan Şevik Eliçora, Aykut Erdem Dinç, Sultan Bişkin, Murat Damar, Ergin Bilgin
Journal: Case Rep Otolaryngol (2015)

Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB) facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT) examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.
Brain adaptation following various unilateral vocal fold paralysis treatments: A magnetic resonance imaging based longitudinal case series
Authors: Marie Dedry, Laurence Dricot, Vinciane Van Parys, Donatienne Boucquey, Nicolas Delinte, Julie van Lith-Bijl, Arnaud Szmalec, Youri Maryn, Gauthier Desuter
Journal: Front Neurosci (2022)
Keywords: uvfp, brain plasticity, early intervention, fmri, nerve recovery, sustained phonation, unilateral vocal fold paralysis, voice recovery

Aim:
Examination of central compensatory mechanisms following peripheral vocal nerve injury and recovery is essential to build knowledge about plasticity of the neural network underlying phonation. The objective of this prospective multiple-cases longitudinal study is to describe brain activity in response to unilateral vocal fold paralysis (UVFP) management and to follow central nervous system adaptation over time in three patients with different nervous and vocal recovery profiles.
Materials and methods:
Participants were enrolled within 3 months of the onset of UVFP. Within 1 year of the injury, the first patient did not recover voice or vocal fold mobility despite voice therapy, the second patient recovered voice and mobility in absence of treatment and the third patient recovered voice and vocal fold mobility following an injection augmentation with hyaluronic acid in the paralyzed vocal fold. These different evolutions allowed comparison of individual outcomes according to nervous and vocal recovery. All three patients underwent functional magnetic resonance imaging (fMRI task and resting-state) scans at three (patient 1) or four (patients 2 and 3) time points. The fMRI task included three conditions: a condition of phonation and audition of the sustained [a:] vowel for 3 s, an audition condition of this vowel and a resting condition. Acoustic and aerodynamic measures as well as laryngostroboscopic images and laryngeal electromyographic data were collected.
Results and conclusion:
This study highlighted for the first time two key findings. First, hyperactivation during the fMRI phonation task was observed at the first time point following the onset of UVFP and this hyperactivation was related to an increase in resting-state connectivity between previoulsy described phonatory regions of interest. Second, for the patient who received an augmentation injection in the paralyzed vocal fold, we subsequently observed a bilateral activation of the voice-related nuclei in the brainstem. This new observation, along with the fact that for this patient the resting-state connectivity between the voice motor/sensory brainstem nuclei and other brain regions of interest correlated with an aerodynamic measure of voice, support the idea that there is a need to investigate whether the neural recovery process can be enhanced by promoting the restoration of proprioceptive feedback.
Performance Evaluation of a New Coulometric Endpoint Method in Sweat Testing and Its Comparison With Classic Gibson&Cooke and Chloridometer Methods in Cystic Fibrosis
Authors: Yasemin Gokdemir, Pinar Vatansever, Bulent Karadag, Tuncay Seyrekel, Ozgur Baykan, Nilay Bas Ikızoglu, Refika Ersu, Fazilet Karakoc, Goncagul Haklar
Journal: Front Pediatr (2018)
Keywords: chloride, coulometric endpoint system, cystic fibrosis, diagnosis, sweat test
MeSH terms: Case Reports

Background: The objective of the study was to assess the diagnostic efficacy of the coulometric endpoint method and compare it with classic Gibson&Cooke and chloridometer methods. Methods: This study is a prospective clinical study comparing two conventional sweat testing methods with the coulometric endpoint method in previously diagnosed cystic fibrosis (CF) patients and a non-CF control group. All individuals underwent two simultaneous sweat collections. One sample of sweat, collected by the CFΔ collector coil system, was analyzed by two methods: the titrimetric Cl- measurement (Sherwood® Chloridometer 926S, Sherwood Scientific Ltd., Cambridge, UK) and the coulometric endpoint method (CF Δ Collection System®, UTSAT/Turkey); the second sample was collected from the other forearm by the Gibson&Cooke method and the collected sweat was analyzed by manual titration in accordance with the Schales&Schales method. Within-run and between-run imprecisions were evaluated via Cl- concentrations of 40, 70, and 130 mmol/L samples. Results: One hundred and seventy (60 CF and 110 controls) subjects were included in the study. All three sweat test methods discriminated CF subjects from the healthy individuals. The mean difference between the coulometric endpoint and titrimetric Cl- measurement methods was -1.5 mmol/L, (95% confidence limits of agreement, ranging from -8.9 to 15.9 mmol/L); the mean difference between manual titration vs. coulometric endpoint methods was 12.8 mmol/L, (95% confidence limits of agreement ranging from -9.7 to 45.3 mmol/L) and the mean difference between the manual titration and titrimetric Cl- measurement methods was 11.3 mmol/L, (95% confidence limits of agreement ranging from -7.8 to 40.5 mmol/L) based on a Bland-Altman analysis. In the Receiver operating characteristic (ROC) analysis, made on the basis that Cl- concentration values < 40 mmol/L exclude the CF diagnosis, the coulometric endpoint method resulted in 96.7% sensitivity and 100% specificity for a cut-off value of 58.5 mmol/L (AUC: 0.994; 95% CI = 0.986-1.000; p < 0.001). Conclusions: The coulometric endpoint method can be as reliable as quantitative sweat Cl- analysis and may be considered as a definitive diagnostic tool for CF.
Soft Tissue Reconstruction with Free Gingival Graft Technique following Excision of a Fibroma
Authors: Nurcan Tezci, Suleyman Emre Meseli, Burcu Karaduman, Serap Dogan, Sabri Hasan Meric
Journal: Case Rep Dent (2015)

Background. Oral fibromas are benign, asymptomatic, smooth surfaced, firm structured tumoral lesions that originate from gingival connective tissue or periodontal ligament. Histologically, they are nodular masses characterized by a dense connective tissue, surrounded by stratified squamous epithelium. Case Report. This case report includes the clinical, radiographical, and histological findings and periodontal treatment of a 38-year-old female patient having painless swelling on the gingiva. Intraoral examination revealed a fibrotic, sessile, smooth surfaced gingival overgrowth interdentally between the teeth #13 and #14. Radiographical findings were normal. Initial periodontal treatment (IPT) was applied including oral hygiene instructions, scaling, and root planing. Following IPT, the lesion (0.7 × 0.6 × 0.4 cm) was excised and examined histopathologically. Subsequently, flap operation was performed to have an access to alveolar bone. Surgical site was reconstructed with free gingival graft obtained from hard palate. Hematoxylin-eosin stained sections revealed a nodular mass composed by dense collagen fibers in lamina propria covered by a stratified squamous epithelium, which were consistent with fibroma. Gingival healing was uneventful and without any recurrence during the 12-month follow-up. Conclusions. In order to achieve optimal functional and aesthetical outcomes, free gingival graft can be used for the reconstruction of the wound site after the excision of the fibroma.
EGFR/BRAF/MEK co-inhibition for EGFR-mutated lung adenocarcinoma patients with an acquired BRAFV600E mutation: a case report and review of literature
Authors: Ran Zeng, Lifeng Luo, Xianwen Sun, Zhiyao Bao, Wei Du, Ranran Dai, Wei Tang, Beili Gao, Yi Xiang
Journal: Cancer Drug Resist (2021)
Keywords: brafv600e mutation, egfr mutation, nsclc, case report, resistance mechanisms, targeted therapy
MeSH terms: Case Reports

Despite the promising initial anti-tumor efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), most advanced non-small-cell lung cancers (NSCLCs) progress eventually due to therapeutic resistance. V-Raf murine sarcoma viral oncogene homolog B1 (BRAF)V600E mutation has been considered as an uncommon mutation that contributes to acquired resistance for EGFR-TKIs. In the presented case, BRAFV600E mutation was detected as an acquired resistance-mediated mutation in a patient treated with osimertinib (a third-generation EGFR-TKI). The presented patient achieved partial regression and ongoing PFS of four months after the co-inhibition of osimertinib plus dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor). Our case further enriches the clinical evidence of the efficacy of EGFR/BRAF/MEK co-inhibition in patients with an acquired BRAFV600E mutation, consistent with the review of the literature (eight cases). Additionally, our case highlights the important role of sample type, method, and platform of gene detection in patient management, life quality, and prognosis, as well as the understanding of acquired resistance mechanism.
Concurrent IDH1 and SMARCB1 Mutations in Pediatric Medulloblastoma: A Case Report
Authors: Moatasem El-Ayadi, Kristof Egervari, Doron Merkler, Thomas A McKee, Fabienne Gumy-Pause, Damian Stichel, David Capper, Torsten Pietsch, Marc Ansari, André O von Bueren
Journal: Front Neurol (2018)
Keywords: idh-1, shh activation, smarcb1, medulloblastoma, mutation, pediatric
MeSH terms: Case Reports

Isocitrate Dehydrogenase-1 (IDH1) is a driver gene in several cancers including brain tumors such as low-grade and high-grade gliomas. Mutations of SMARCB1 were described in atypical teratoid rhabdoid tumors and to date have not been associated with the pathogenesis of medulloblastoma. We report concurrent IDH1 and SMARCB1 mutations in a medulloblastoma patient. We searched the catalog of somatic mutations in cancer (COSMIC) database and other mutation databases and -to our knowledge- this is the first reported case of medulloblastoma harboring both mutations together. Our patient is a 13-year-old male presenting with headache and vomiting at diagnosis. MRI revealed left cerebellar expansive lesion with no evidence of metastasis. A histopathological diagnosis of desmoplastic/nodular medulloblastoma was made after complete resection of the tumor. Immunophenotypic characterization and methylation profiling suggested a medulloblastoma with SHH activation. Next generation sequencing of a panel of 400 genes revealed heterozygous somatic IDH1(p.R132C), SMARCB1(p.R201Q), and CDH11(p.L625T) mutations. The patient was treated according to the HIT-SIOP PNET 4 protocol. He is in complete remission more than 2 years after diagnosis. In conclusion, increasing use of high throughput sequencing will certainly increase the frequency with which rare mutations or mutation combinations are identified. The exact frequency of this mutation combination and whether it has any particular therapeutic implications or prognostic relevance requires further investigation.
Malignant hypertension secondary to iliac artery stenosis after kidney transplantation: a case report
Authors: Imtinen Ben Mrad, Lilia Ben Fatma, Ben Mrad Melek, Ikram Mami, Boutheina Ben Abdellatif, Rim Miri, Sobhy MleyhiKarim Zouaghi, Raouf Denguir
Journal: Pan Afr Med J (2021)
Keywords: hypertension, case report, endovascular, kidney transplantation, renal impairment
MeSH terms: Hypertension, Malignant, Kidney Transplantation / adverse effects, Renal Artery Obstruction / etiology, Case Reports, Aged, Constriction, Pathologic, Humans, Iliac Artery, Middle Aged

Iliac artery stenosis is a rare complication after renal transplantation. This complication affects elderly patients and related to atheromatous disease. It mimics the same clinical presentation as a transplant renal artery stenosis or renal artery stenosis. This entity is can be responsible for serious complications such as renal dysfunction, malignant hypertension and acute pulmonary oedema. We present in this paper the case of a 51-year-old patient, who benefited 7 years early of renal transplantation, with a good initial result, and who was admitted actually for malignant hypertension and renal function impairment due to an iliac artery stenosis proximal to the renal transplant and who was treated with a stenting angioplasty of the external iliac artery with a mixed outcome. Our case highlights the importance of the early diagnosis and treatment of such complications to avoid definitive renal failure and permanent hypertension.
HDR syndrome in a Japanese girl with biliary atresia: a case report
Authors: Yousuke Higuchi, Kosei Hasegawa, Miho Yamashita, Yousuke Fujii, Hiroyuki Tanaka, Hirokazu Tsukahara
Journal: BMC Pediatr (2016)
MeSH terms: Abnormalities, Multiple / diagnosis, Biliary Atresia / diagnosis, Hearing Loss, Sensorineural / diagnosis, Hypoparathyroidism / diagnosis, Nephrosis / diagnosis, Case Reports, Abnormalities, Multiple / genetics, Biliary Atresia / genetics, Female, Frameshift Mutation, GATA3 Transcription Factor / genetics, Genetic Markers, Hearing Loss, Sensorineural / genetics, Humans, Hypoparathyroidism / genetics, Infant, Nephrosis / genetics, GATA3 Transcription Factor, GATA3 protein, human, Genetic Markers, Barakat syndrome

Background:
Hypoparathyroidism, sensorineural deafness, and renal dysplasia (HDR) syndrome is an autosomal dominant disorder. We report the first detailed case of hypoparathyroidism complicated by biliary atresia.
Case presentation:
A 1-year-old Japanese girl was admitted to our hospital for living donor liver transplantation. She suffered from obstructive jaundice owing to biliary atresia. She also had persistent hypocalcemia. Despite oral calcium and abundant vitamin D supplementation, a laboratory test showed hypocalcemia (1.4 mmol/l) and hyperphosphatemia (2.6 mmol/l). The intact parathyroid hormone level was normal (66 ng/l) with severe vitamin D deficiency (25-hydroxy vitamin D: undetectable levels). There were no rachitic changes in metaphysis on X-rays. Her family history showed that her mother had sensorineural deafness, a low serum calcium level (2.1 mmol/l), hypoplastic left kidney, and a past history of an operation for right vesicoureteral reflux. We suspected that this patient and her mother have hypoparathyroidism, sensorineural deafness, and renal dysplasia syndrome. A heterozygous GATA3 gene mutation (c.736delGinsAT) was found in this patient and her mother, but not in her father.
Conclusion:
This familial case confirms the importance of family history in the diagnosis of HDR syndrome. Regardless of marked vitamin D deficiency, the complication of hypoparathyroidism prevented the onset of vitamin D deficiency rickets in our patient.
Post nirmatrelvir/ritonavir erythema multiforme in a patient with coronavirus disease infection
Authors: José Wagner Leonel Tavares-Júnior, José Carlos Jucá Pompeu Filho, Luiz Eduardo Garcia Galvão
Journal: Rev Soc Bras Med Trop (2023)
MeSH terms: COVID-19, Erythema Multiforme, Case Reports, Aged, 80 and over, Antiviral Agents / therapeutic use, COVID-19 Drug Treatment, Female, Humans, Ritonavir / adverse effects, nirmatrelvir, Ritonavir, Antiviral Agents

Erythema multiforme (EM), an immune-mediated skin condition, can occur after infection or following the use of medications. In this study, we describe a patient who developed EM after nirmatrelvir/ritonavir administration. An 81-year-old woman presented with fever and dyspnea. Laboratory investigations showed positive coronavirus disease (COVID-19) based on polymerase chain reaction assay, and she received a 5-day regimen of nirmatrelvir/ritonavir. We observed development of EM after this treatment and initiated prednisone (1 mg/kg) therapy, which led to rapid improvement. Our study is the first to report EM in a patient with COVID-19, who received nirmatrelvir/ritonavir and showed a favorable response.
Diabetes Mellitus with Poor Glycemic Control as a Consequence of Inappropriate Injection Technique
Authors: Ramesh Sharma Poudel, Shakti Shrestha, Sushma Bhandari, Rano Mal Piryani, Shital Adhikari
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Majority of patients with diabetes mellitus (DM), who are on insulin therapy, use insulin pen for convenience, accuracy, and comfort. Some patients may require two different types of insulin preparations for better glycemic control. We have reported a case of poor glycemic control as a consequence of inappropriate insulin injection technique. A 57-year-old man with type 2 DM had been using premix insulin 30 : 70 for his glycemic control for the last 12 years. On follow-up visit, his blood sugar level (BSL) had increased; therefore the treating physician increased the dose of premix insulin and added basal insulin with the aim of controlling his blood sugar level. Despite these changes, his BSL was significantly higher than his previous level. On investigation, the cause of his poor glycemic control was found to be due to inadequate delivery of insulin (primarily premix) as a consequence of lack of priming and incompatibility of single insulin pen for two cartridges. His basal insulin was discontinued and the patient along with his grandson was instructed to administer insulin correctly. After correction of the errors, the patient had a better glycemic control.
Comprehensive Treatment of Severe Periodontal and Periimplant Bone Destruction Caused by Iatrogenic Factors
Authors: Gregor-Georg Zafiropoulos, Andreas Parashis, Taha Abdullah, Evangelos Sotiropoulos, Gordon John
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Dental implant success requires placement after periodontal therapy, with adequate bone volume, plaque control, primary stability, control of risk factors, and use of well-designed prostheses. This report describes the surgical and prosthetic management of a patient with severe iatrogenic periodontal/periimplant bone destruction. Methods. A 55-year-old female smoker with fixed partial dentures (FPDs) supported on teeth and implants presented with oral pain, swelling, bleeding, and a 10-year history of multiple implant placements and implants/prosthesis failures/replacements. Radiographs showed severe bone loss, subgingival caries, and periapical lesions. All implants and teeth were removed except implants #4 and #10 which served to retain an interim maxillary restoration. Bone defects were covered with nonresorbable dPTFE membranes. In the mandible, three new implants were placed and loaded immediately with a bar-retained temporary denture. Results. Seven months postoperatively, the bone defects were regenerated, and three additional mandibular implants were placed. All mandibular implants were splinted and loaded with a removable overdenture. Conclusions. In this case, periimplant infection and tissue destruction resulted from the lack of periodontal treatment/maintenance and failure to use evidence-based surgical and loading protocols. Combination therapy resolved the disease and the patient's severe discomfort while providing immediate function and an aesthetic solution.
Methotrexate-Induced Stroke-Like Encephalopathy: Beware the Stroke Mimic
Authors: Adam Benkirane, Nicolas Mulquin, Frédéric London
Journal: J Belg Soc Radiol (2022)
Keywords: magnetic resonance imaging, methotrexate, stroke-like encephalopathy
MeSH terms: Case Reports

We report a case of methotrexate (MTX)-induced stroke-like encephalopathy in an 18-year-old woman, with acute lymphoblastic leukemia, who developed a sudden neurological deficit mimicking a cerebrovascular event. Bain MRI showed hyperintensities on diffusion-weighted-imaging (DWI) with matching apparent diffusion coefficient hypointensities, which also represent the commonest MRI findings in acute cerebral infarction. DWI changes spared the cerebral cortex and did not respect vascular territories, supporting a non-vascular mechanism. MRI plays a crucial role in the diagnostic work-up and is essential to avoid unnecessary intervention such as thrombolytic therapy. Teaching Point: Methotrexate-induced stroke like neurotoxicity should be considered in patients treated with methotrexate and presenting with a stroke-like clinical picture and radiological findings consistent with acute cerebral infarction.
Unique features of polycythemia observed on plain non contrast CT scan of head
Authors: S Gayathri, Akhila Prasad, Namrita Sachdeva, B P Baruah, Shailendra Aggarwal
Journal: J Pediatr Neurosci (2010)
Keywords: hyperdense cerebral vasculature, polycythemia
MeSH terms: Case Reports

We present two cases of polycythemia secondary to a congenital cardiac anomaly presenting with acute neurological complications showing hyperdense venous sinuses and cerebral vasculature in association with cerebral abscess.