OpenMed/multicare-articles huggingface dataset:
Four-rooted mandibular first molar with an unusual developmental root fusion line: a case report
Authors: Jojo Kottoor, Denzil Valerian Albuquerque, Natanasabapathy Velmurugan, Mylswamy Sumitha
Journal: Case Rep Dent (2012)

The paper describes the anatomical variation of four roots in a mandibular permanent first molar diagnosed using multiple angulated preoperative radiographs and its successful nonsurgical endodontic management. Careful observation and exploration of the pulpal floor using a dental operating microscope revealed a peculiar developmental root fusion line on the pulp chamber floor. Based on the above observation, a correlation between this unusual line and the existence of additional roots has been proposed and discussed.
An unusual cause of large bowel obstruction: are we aware of this?
Authors: Maria Sotiropoulou, Nikolina Stavrinou, Michail Vailas, Paraskevi Alexakou, Michail Psarologos, Panagiotis Metaxas, Michael Economou, Christine Vourlakou, Stylianos Kapiris
Journal: Pan Afr Med J (2020)
Keywords: burkitt lymphoma, lymphoma, obstruction, surgery
MeSH terms: Burkitt Lymphoma / diagnosis, Colonic Neoplasms / diagnosis, Intestinal Obstruction / etiology, Case Reports, Burkitt Lymphoma / complications, Burkitt Lymphoma / surgery, Colonic Neoplasms / complications, Colonic Neoplasms / surgery, Humans, Intestinal Obstruction / surgery, Male, Middle Aged, Prognosis

Primary lymphomas of the colon account for 0.5% of all primary colon malignancies. Burkitt´s lymphoma is a B-cell lymphoma with aggressive clinical behavior. Herein, we describe a case of a male patient who presented with signs of large bowel obstruction, underwent surgery and found to suffer from Burkitt´s lymphoma of the ileocecal region. The histopathological examination was indicative for Burkitt´s lymphoma. To the best of our insight this is one of the few reported cases of such type of lymphoma in an adult patient presenting with bowel obstruction. Burkitt´s lymphoma is a rare malignancy in adults affecting gastrointestinal tract. It has a high proliferation potential and can rapidly progress to advanced disease. Early diagnosis is necessary to prevent complications and improve overall prognosis.
Amivantamab for Metastatic Lung Cancer With Paraneoplastic Disseminated Intravascular Coagulation: A Case Report
Authors: Yaser Ahmad, Tawee Tanvetyanon
Journal: Cureus (2023)
Keywords: amivantamab, disseminated intravascular coagulation, lung cancer, paraneoplastic syndrome, thrombocytopenia
MeSH terms: Case Reports

Advanced cancers may be accompanied by paraneoplastic disseminated intravascular coagulation (DIC), resulting in thromboembolism or thrombocytopenia. Thrombocytopenia can limit the feasibility of myelosuppressive chemotherapy. Therefore, an alternative treatment option is needed. This report described a patient with metastatic pulmonary adenocarcinoma with EGFR exon 20 insertion and paraneoplastic DIC. Frontline chemotherapy failed to control the disease and worsened thrombocytopenia. However, treatment with amivantamab resulted in a rapid resolution of DIC and produced a partial tumor response. Based on our experience, for patients with EGFR exon 20 insertions with paraneoplastic DIC, amivantamab could be considered a preferred frontline treatment.
Brain Death Secondary to Rocky Mountain Spotted Fever Encephalitis
Authors: Steven D Rhodes, Alicia M Teagarden, Brian Graner, Riad Lutfi, Chandy C John
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

A two-year-old female presented with acutely altered mental status following eight days of fever and rash. She had been camping at an Indiana campground 11 days prior to the onset of illness and was evaluated twice for her fever and rash prior to admission. Laboratory evaluation on admission revealed thrombocytopenia, hyponatremia, and elevated transaminases. The patient developed diffuse cerebral edema, and despite intensive care, the edema led to brain death from Rocky Mountain spotted fever (RMSF). We present this case to highlight the importance of considering RMSF and other tick-borne illnesses in a child with prolonged fever and rash in a nonendemic area and also the difficulty of diagnosis in early stages of disease. A detailed travel history, evaluation of key laboratory findings (white blood count, platelet count, and transaminases), and close follow-up if rash and fevers persist may help to improve detection of RMSF. If a tick-borne illness such as RMSF is suspected, empiric doxycycline therapy should be started immediately, as lab confirmation may take several days and mortality increases greatly after five days of symptoms.
Extensive Prostatic Abscess in an Elderly Patient Requiring Multidisciplinary Drainage
Authors: John Michael Nesemann, Kathy Huen, Jonathan Bergman
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Background. Prostatic abscess is rare and mainly affects immunocompromised individuals, classically presenting with both systemic and lower urinary tract symptoms. Our case is unique as the patient presented with an exceptionally long duration of symptoms prior to seeing a health-care provider, had no systemic symptoms, and was managed via a multidisciplinary approach. Case Presentation. We present a case of a 70-year-old man with type-two diabetes who endured two months of lower urinary tract symptoms and constipation without systemic symptoms prior to seeking medical attention. He had a positive urinalysis and culture and was initially thought to have a urinary tract infection; however, computed tomography scan revealed a large, complex, and multiloculated prostatic abscess. Multidisciplinary drainage of the abscess was performed by interventional radiology and urology. A postoperative Foley catheter was left in place, and the patient recovered without complications. Discussion. Prostatic abscess is uncommon and presents almost exclusively in patients with immunocompromising conditions such as diabetes. Prior to the advent of antibiotics, the major causes were gonorrheal and Staphylococcus aureus infections, but with the advent of antibiotics, microbial culprits have shifted to gram-negative organisms. Patients typically present with lower urinary tract symptoms, perineal or lower back pain, and systemic symptoms. Management often consists of intravenous antibiotics and surgical drainage either by transrectal ultrasound-guided needle aspiration, or transurethral deroofing of the prostate. Our case highlights the following: (a) the importance of a high index of suspicion for a prostatic abscess in an immunocompromised patient with persistent leukocytosis and perineal pain after treatment with antibiotics and (b) the potential for an early multidisciplinary approach to draining extensive, loculated prostatic abscesses.
Laparoscopic splenectomy for splenic hamartoma: a case report
Authors: Andrea Pisani Ceretti, Gabriele Bislenghi, Matteo Virdis, Nirvana Maroni, Andrea Gatti, Enrico Opocher
Journal: Case Rep Gastrointest Med (2012)

Hamartoma is a rare splenic benign tumor usually accidentally detected as a radiologic finding. Preoperative diagnosis poses a challenge and thus surgery becomes necessary to confirm the clinical suspicion. Laparoscopic splenectomy has gained consensus as a standard surgical procedure particularly for autoimmune hematological diseases. This former experience has allowed this technique to be extended to other splenic pathologies. Here we report a case of total laparoscopic splenectomy for a bulky splenic hamartoma in a young male patient.
Heliox in the treatment of status asthmaticus: case reports
Authors: Inês Carvalho, Sara Querido, Joana Silvestre, Pedro Póvoa
Journal: Rev Bras Ter Intensiva (2016)
MeSH terms: Helium / administration & dosage, Oxygen / administration & dosage, Respiration, Artificial / methods, Status Asthmaticus / therapy, Case Reports, Adult, Female, Humans, Male, Middle Aged, Treatment Outcome, Helium, heliox, Oxygen

Helium was discovered in 1868 by the French astronomer Pierre-Jules-César Janssen and was first used as a therapeutic treatment for airway obstruction by Barach almost 70 years later, in 1934. Heliox is characterized by its low density, which makes it more fluid under conditions of turbulence, thus minimizing airway pressure and facilitating the occurrence of laminar flow. The present article describes two clinical cases of patients with status asthmaticus subjected to mechanical ventilation and refractory to treatment in whom heliox was used, which allowed optimization of the efficacy of conventional pharmacological treatments. Although heliox is still used sporadically and its true efficacy has not been well demonstrated, the unique physical properties of helium and the theoretical improvement of the airflow in obstructed airways have produced scientific interest and stimulated research. Heliox can be used simultaneously with conventional therapies in cases of serious and refractory exacerbations of severe obstructive disease.
Case Report: Dual Inhibition of HDAC and BTK for Diffuse Large B-Cell Lymphoma After Failure to CD19-Targeted CAR-T Therapy
Authors: Weiguo Zhu, Shi Tao, Wenchun Miao, Hui Liu, Xianggui Yuan
Journal: Front Immunol (2022)
Keywords: bruton’s tyrosine kinase inhibitor, chidamide, chimeric antigen receptor t cell, diffuse large b-cell lymphoma, histone deacetylase inhibitor, zanubrutinib
MeSH terms: Lymphoma, Large B-Cell, Diffuse, Lymphoma, Non-Hodgkin, Receptors, Chimeric Antigen, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antigens, CD19, Humans, Immunotherapy, Adoptive / adverse effects, T-Lymphocytes, Antigens, CD19, Receptors, Chimeric Antigen

Background:
Failure to CD19-targeted chimeric antigen receptor T-cell (CAR-T) therapy for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL), is an emerging clinical problem. There is no consensus on the treatment for these patients and treatment remains empirical.
Case report:
We reported a case of an elderly R/R DLBCL patient who had TP53 mutation and relapsed 12 months after initial response to CAR T-cell therapy. The patient did not respond to salvage chemotherapy with the GDP regimen and could not tolerate any aggressive chemotherapy. Thereafter, the patient was given chidamide and zanubrutinib. After two months of treatment, the patient achieved sustained complete remission. At the last follow-up, the patient remains in radiographic CR 22 months after CAR-T infusion and 10 months after the initiation of the combination treatment.
Conclusion:
We report the first successful case of dual inhibition of HDAC and BTK for the treatment of R/R DLBCL after failure to CAR-T cell therapy, which opens a new therapeutic possibility for the future.
Congenital Factor V deficiency: perioperative management (case report)
Authors: Mohamed Anass Fehdi, Mohamed Lazraq, Sabah Benhamza, Abdelhak Bensaid, Youssef Miloudi, Najib El Harrar
Journal: Pan Afr Med J (2020)
Keywords: anesthesiology, congenital factor v deficiency, hematology, perioperative management
MeSH terms: Cochlear Implantation / methods, Factor V Deficiency / complications, Perioperative Care / methods, Case Reports, Cooperative Behavior, Factor V Deficiency / congenital, Female, Humans, Middle Aged

Factor V congenital deficiency is a rare hereditary disease, it exposes patients to hemorrhagic risk, with high morbi-mortality. Its management is a real challenge for practitioners. Perioperative management of patients with Factor V congenital deficiency needs anesthetists, hematologists and surgeons to work in close collaboration.
Post-operative rehabilitation in a traumatic rare radial nerve palsy managed with tendon transfers: a case report
Authors: Pratik Phansopkar, Vrushali Athawale, Aachal Birelliwar, Waqar Naqvi, Swapna Kamble
Journal: Pan Afr Med J (2020)
Keywords: rehabilitation, physiotherapy, radial nerve palsy, tendon transfer
MeSH terms: Radial Nerve / injuries, Radial Nerve / surgery, Radial Neuropathy / rehabilitation, Radial Neuropathy / surgery, Tendon Transfer / rehabilitation, Case Reports, Adult, Fingers / physiology, Humans, India, Male, Physical Therapy Modalities, Postoperative Care / methods, Postoperative Period, Radial Nerve / physiopathology, Radial Neuropathy / physiopathology, Range of Motion, Articular, Tendon Transfer / methods, Wrist / physiology, Wrist Joint / physiology

Radial nerve is a frequently injured nerve. Radial nerve palsy result from direct trauma, neuropathies, and fracture over the humerus, malignant tumor and neuritis. A case of 26-year male is presented in this report who had a road traffic accident resulting in injury over the right shoulder, wrist joint and diagnosed of radial nerve palsy, consequently was operated with soft tissue reconstruction with tendon transfers which resulted into pain over wrist joint and loss of extensors muscle function of the wrist joint, which led to difficulty in performing activities of daily living. Surgical history and rehabilitation is mentioned in the case report. We report that there were significant improvements in muscle strength, range of motion, relief from pain, and exceptional improvements in the patient´s functional independence with physiotherapy interventions post-operative tendon transfers.
Hepatic angiomyolipoma with special attention to radiologic imaging
Authors: Kunitaka Kuramoto, Toru Beppu, Tomohiro Namimoto, Hiromitsu Hayashi, Katsunori Imai, Hidetoshi Nitta, Daisuke Hashimoto, Akira Chikamoto, Takatoshi Ishiko, Ken-Ichi Iyama, Osamu Ikeda, Yasuyuki Yamashita, Hideo Baba
Journal: Surg Case Rep (2015)
Keywords: apparent diffusion coefficient (adc), chemical shift imaging, diffusion-weighted mri, early venous return, hepatic angiomyolipoma

Background:
Angiomyolipoma is a unique mesenchymal neoplasm composed of blood vessels as well as smooth muscle and adipose cells. The liver is a less common site of origin, and hepatic angiomyolipoma is often an incidental finding on diagnostic imaging or is identified on evaluation of nonspecific symptoms.
Case presentation:
We experienced four patients who were diagnosed histologically with hepatic angiomyolipoma. The preoperative diagnoses were angiomyolipoma in two patients, hepatocellular carcinoma in one, and cavernous hemangioma in one. Three patients were treated with hepatectomy (one laparoscopic and two open approaches), and the diagnosis was completed by histological investigation of the resected specimen. The remaining one was diagnosed from tumor needle biopsy. Diffusion-weighted magnetic resonance imaging (MRI) with respiratory triggering using b values of 0 and 800 s/mm(2) was employed. An apparent diffusion coefficient map was generated from b values of 0 and 800 s/mm(2) for calculation of the apparent diffusion coefficient. The apparent diffusion coefficient values were calculated as 3.66, 1.21, 1.80, and 0.91 in patients 1 to 4, respectively. In MRI imaging, fat component was clearly demonstrated with chemical shift imaging in three patients. Early venous return was detected in three patients with computed tomography angiography.
Conclusion:
Fat component and early venous return are important for a correct diagnosis of hepatic angiomyolipoma. Unfortunately, apparent diffusion coefficient values in hepatic angiomyolipoma were overlapping with those in other benign and malignant tumors.
Minocycline-Induced Gum Pigmentation during Treatment for Acne Vulgaris
Authors: Jami Wang, Isabella Brown, Heidi Goodarzi
Journal: Case Rep Pediatr (2022)
MeSH terms: Case Reports

Minocycline, a type of tetracycline, is a broad-spectrum antibiotic that is commonly prescribed in dermatology for the treatment of acne vulgaris. Common side effects of minocycline include nausea, vertigo, and dizziness while less common side effects include hyperpigmentation. In this case study, we found an 18-year-old female who presented with dark blue pigmentation in her upper gum after using minocycline on and off for 4 years. After discontinuation of the minocycline for 2 years, the pigmentation decreased gradually.
Acceptance and use of the Information System of the National Immunization Program
Authors: Valéria Conceição de Oliveira, Eliete Albano de Azevedo Guimarães, Gabriela Gonçalves Amaral, Talita Ingrid Magalhães Silva, Luciana Aparecida Fabriz, Ione Carvalho Pinto
Journal: Rev Lat Am Enfermagem (2020)
MeSH terms: Attitude of Health Personnel, Health Personnel / statistics & numerical data, Immunization Programs, Primary Health Care, Vaccination / standards, Adult, Female, Humans, Interviews as Topic, Male, Middle Aged

Objective:
to analyze the acceptance and use of the Information System of the National Immunization Program in primary health care vaccination rooms.
Method:
a unique case study of a qualitative approach in the light of the Unified Theory of Acceptance and Use of Technology. Data collection included an interview with 18 professionals responsible for the implementation of the information system, observation of vaccination rooms in 12 municipalities of the West Macro-region of Minas Gerais, selected from a preliminary study. Data was systematized and analyzed through Content Analysis.
Results:
the interviewees are satisfied with the usefulness and ease of the system usage, but do not have the same satisfaction with the organizational infrastructure due to the lack of computers and low Internet connectivity in the health units, as well as with the incipient training for the use of the information system and the lack of skills with the technology among the human resources.
Conclusion:
nursing professionals perceive advantages in the acceptance and use of the Information System of the National Immunization Program. It was clear that the vaccinated individual's history control and the decrease of records in paper are evidenced as facilitators of this acceptance. The system was considered reliable and secure.
A Case of Synchronous Multiple Primary Malignancies Involving Multiple Myeloma and Pharyngeal Plasmacytoma in an Elderly Male: A Case Report and Review of the Literature
Authors: Muhannad Q Alqirnas, Abdulmajeed M Alqahtani, Yazeed H Alotaibi, Moustafa S Alhamadh, Rakan B Alanazi, Abdulrahman D Alharbi, Fawaz A Alhamied, Ohoud Z Aljarbou, Mohammad Alkaiyat, Fouad Sabatin, Abdullah Mohammed Altwim
Journal: Cureus (2023)
Keywords: multiple myeloma, pharyngeal plasmacytoma, pharyngeal tumor, saudi arabia, solitary extramedullary plasmacytoma
MeSH terms: Case Reports

Monoclonal plasma cells form the solitary neoplasm known as solitary plasmacytoma. Isolated extramedullary plasmacytoma is less common than solitary bone plasmacytoma. An elderly male presented with coughing blood and was diagnosed with pharyngeal plasmacytoma with synchronous multiple myeloma. Herein, we present this challengingly rare case to increase awareness of this unusual entity.
Foetal inguinoscrotal hernia-its prenatal diagnosis and its spontaneous regression
Authors: Anwer Sadat Kithir Mohamed
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

A foetal inguinoscrotal hernia is a rare abnormality. We report a case of foetal inguinoscrotal hernia diagnosed by ultrasonography at 37 weeks gestation and its spontaneous regression during the perinatal period. The imaging features, differential diagnosis, pregnancy management and outcome are discussed.
Association of Vasculitis and Familial Mediterranean Fever
Authors: Salam Abbara, Gilles Grateau, Stéphanie Ducharme-Bénard, David Saadoun, Sophie Georgin-Lavialle
Journal: Front Immunol (2019)
Keywords: behçet disease, mefv, autoinflammatory syndrome, familial mediterranean fever, vasculitis
MeSH terms: Disease Susceptibility, Familial Mediterranean Fever / complications, Familial Mediterranean Fever / epidemiology, Vasculitis / complications, Vasculitis / epidemiology, Meta-Analysis, Systematic Review, Age of Onset, Disease Management, Familial Mediterranean Fever / diagnosis, Familial Mediterranean Fever / therapy, Humans, Phenotype, Prevalence, Sex Factors, Vasculitis / diagnosis, Vasculitis / therapy

Certain types of vasculitis occur more frequently and present differently in patients with familial Mediterranean fever (FMF). We assessed the characteristics of patients with FMF and systemic vasculitis through a systematic review of the literature. Medline was searched by two independent investigators until December 2017. We screened 310 articles and selected 58 of them (IgA vasculitis n = 12, polyarteritis nodosa (PAN) n = 25, Behçet's disease (BD) n = 7, other vasculitis n = 14). Clinical case reports were available for 167 patients (IgA vasculitis n = 46, PAN n = 61, BD n = 46, other vasculitis n = 14), and unavailable for 45 patients (IgA vasculitis n = 38, PAN n = 7). IgA vasculitis was the most common vasculitis in FMF patients with a prevalence of 2.7-7%, followed by PAN with a prevalence of 0.9-1.4%. Characteristics of FMF did not differ between patients with and without vasculitis. Patients with FMF and IgA vasculitis displayed more intussusception (8.7%) and possibly less IgA deposits on histological analysis than patients with IgA vasculitis alone. Patients with FMF and PAN had a younger age at vasculitis onset (mean age = 17.9 years), as well as more perirenal hematomas (49%) and CNS involvement (31%) than patients with PAN alone. Glomerular involvement was noted in 33% of patients diagnosed with PAN, suggesting an alternative diagnosis. Sequencing of the MEFV gene confirmed the presence of two pathogenic variants in 73% of FMF patients with IgA vasculitis or PAN. The majority of patients with BD were from one case series, and presented more skin, gastrointestinal, and CNS involvement than patients with isolated BD. In conclusion, FMF, particularly when supported by two pathogenic MEFV mutations, could predispose to IgA vasculitis, or a PAN-like vasculitis with more perirenal bleeding and CNS involvement.
A Case Report of Metastatic Castration-Resistant Prostate Cancer Harboring a PTEN Loss
Authors: Zin W Myint, Derek B Allison, Carleton S Ellis
Journal: Front Oncol (2021)
Keywords: atm/chk2/p53 signal pathway, pi3k/akt pathway, abiraterone acetate, carboplatin, metastatic castration refractory prostate cancer
MeSH terms: Case Reports

The treatment landscape of metastatic castration-resistant prostate cancer (mCRPC) has dramatically improved over the last decade; however, patients with visceral metastases are still faced with poor outcomes. Phosphatase and tensin homolog (PTEN) loss is observed in 40%-60% of mCRPC patients and is also associated with a poor prognosis. Several PI3K/AKT/mTOR pathway inhibitors have been studied, with disappointing anti-tumor activity. Here, we present a case of a patient with heavily treated mCRPC who had a modest tumor response to concurrent carboplatin, abiraterone acetate/prednisone, and liver-directed radiation therapy. We discuss the potential rationale supporting the use of this combination therapy and its safety in mCRPC. While the underlying basic mechanism of our patient's anti-tumor response remains uncertain, we suggest that further prospective studies are warranted to evaluate whether this combination therapy is effective in this population of patients with pre-treated mCRPC and PTEN loss.