OpenMed/multicare-articles huggingface dataset:
Vitamin D as an Adjunctive Treatment to Standard Drugs in Pulmonary Tuberculosis Patients: An Evidence-Based Case Report
Authors: Diajeng Ayesha Soeharto, Diana Ashilah Rifai, Stella Marsudidjadja, Aisha Emilirosy Roekman, Chadijah Karima Assegaf, Melva Louisa
Journal: Adv Prev Med (2019)
MeSH terms: Review

Background:
Vitamin D has a prominent role in the body's innate immunity as it is important in the maintenance of macrophages and monocytes and its function in defending against infections. In-vitro studies have established vitamin D's potential role in tuberculosis (TB) infection, in that it restricts Mycobacterium tuberculosis growth, thus implying the potential benefit of vitamin D as an adjunctive treatment for TB. However, clinical trials and reviews have contradicting findings regarding the true clinical efficacy of adjunctive vitamin D, particularly in reducing the sputum conversion rate (SCR).
Objective:
This study aims to update the current evidence regarding vitamin D supplementation as an adjunctive treatment in achieving the smear sputum conversion rate (SCR) among pulmonary TB patients.
Method:
A comprehensive search was conducted in October 2018 in PubMed-NCBI, MEDLINE-OVID, SCOPUS-Elsevier, and Cochrane. The selection of studies was done as per the predetermined inclusion and exclusion criteria of this EBCR and resulted in the inclusion of 11 eligible studies (8 RCTs and 3 systematic reviews). The selected studies were then critically appraised for their validity, importance, and applicability according to the CEBM (Centre for Evidence-Based Medicine) appraisal tools.
Results:
Overall, most of the trials showed no statistically significant changes in terms of the proportion of TB patients with a negative sputum smear conversion in the group treated with an adjunctive therapy vs. the group treated with standard antituberculosis therapy alone. Only one trial showed significant results, which was conducted in a population of TB patients with vitamin D deficiency. Furthermore, overall the reviews showed no significant change in the 8-week sputum smear conversion after treatment within the group given vitamin D in comparison to those who were not.
Conclusion:
Vitamin D as adjunctive therapy in TB patients shows no clinical improvement in terms of sputum conversion to antituberculosis management.
Pentalogy of Cantrell: a case report
Authors: A R Patil, L S Praveen, V Ambica
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Pentalogy of Cantrell is a rare condition comprising anterior diaphragmatic defect, ventral abdominal wall defect, pericardial defect, intracardiac anomalies and lower sternal defect. Both sporadic and genetic causes are proposed. Prognosis depends on the severity of the defects and the associated cardiac anomalies. Two-dimensional sonography is sufficient for the diagnosis of this condition.
Mesenteric panniculitis in a child misdiagnosed as appendicular mass: a case report and review of literature
Authors: Nisreen Rumman, George Rumman, Barakat Sharabati, Rami Zagha, Nimer Disi
Journal: Springerplus (2014)

Mesenteric panniculitis is a chronic inflammatory process involving the adipose tissue of the mesentery. The etiology is unknown, and it is rare in children. We report a 5 year old girl who presented with abdominal symptoms and was misdiagnosed as appendicular mass. The correct diagnosis was established after surgical resection.
Class II Malocclusion Treatment by In-House Fabricated, Customized Fixed Functional Appliance in Growing Child
Authors: Swati Verma, Falguni Mehta, Mohammad Khursheed Alam, Harshikkumar Arvindbhai Parekh, Valai Kasim Shakeel Ahmed, Chhavi Jain
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Currently, wide arrays of fixed functional appliances are available for the correction of Class II malocclusion. The orthodontist must choose from these appliances depending on the mechanics, efficiency, and cost of the appliance. Fixed functional appliances may reduce the individual visits and hence the cost as compared to the removable appliances. Additionally, it may save the clinician's chair time. This report discussed the in-house laboratory fabrication and clinical procedure of customized fixed functional appliances by utilizing the readily available dental materials in the orthodontic clinical setting.
Lost in the mist: acute adrenal crisis following intranasal fluticasone propionate overuse
Authors: Arturo Loaiza-Bonilla, Tollin Sullivan, Ryan Kendall Harris
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Introduction. Acute adrenal crisis in relation to nasal steroid overuse has been reported very scantly in English medical literature and remains an underdiagnosed condition. Case presentation. A 55 year-old male presented with altered mental status, retrograde amnesia, fluid refractory hypotension, abdominal pain, fever, and chest pain. Physical examination revealed amnesia, bradypsychia, tachycardia, decreased muscle tone and hyporeflexia. Overuse of nasal steroid was suspected by history. Random early morning cortisol level was < 0.2 mcg/dL. The patient was started on hydrocortisone and within 24 hours he had a full recovery. Conclusion. This one-of-a-kind case describes acute adrenal crisis secondary to withdrawal from inhaled nasal corticosteroids overuse in a patient with particular risk factors. Prevention and early recognition of this disorder can significantly reduce its morbidity and mortality.
Thyroglossal Duct Cyst Carcinoma in a Young Female: Case Report and Review of Literature
Authors: Jenna Van Beck, Sobia F Khaja
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Thyroglossal duct remnants form during embryologic development and can develop into a thyroglossal duct cyst (TGDC). In rare cases, carcinoma is present within these cysts, most commonly papillary thyroid carcinoma. Diagnosis is difficult, but imaging and fine-needle aspiration (FNA) biopsies can help with the diagnosis. Given the rarity of TGDC carcinoma, treatment is not well agreed upon and can include the Sistrunk procedure, thyroidectomy, nodal dissection, and postoperative radioactive iodine treatment. Here, we describe the presentation, workup, and treatment of a 20-year-old female with papillary thyroid carcinoma present within both a thyroglossal duct cyst and the thyroid gland.
Fecal Bacteriotherapy: A Case Report in an Immunosuppressed Patient with Ulcerative Colitis and Recurrent Clostridium difficile Infection
Authors: Hadeel Zainah, Ann Silverman
Journal: Case Rep Infect Dis (2012)
MeSH terms: Case Reports

We report a case of ulcerative colitis (UC) and recurrent Clostridium difficile infection (CDI) where the patient was on immunomodulatory therapy and had successful CDI eradication after fecal transplantation. This is the first case report in the literature documenting successful C. difficile eradication in an immunosuppressed patient. We feel that fecal transplantation should be studied as a treatment option in these patients.
Double Balloon Cervical Ripening Catheter for Control of Massive Hemorrhage in a Cervical Ectopic Pregnancy
Authors: Nabila Zambrano, James Reilly, Michael Moretti, Nisha Lakhi
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Cervical pregnancy can be complicated by perfuse vaginal bleeding. Mechanical compression directed at tamponing the cervical vessels can control hemostasis. There are several types of balloon catheters that have been described for cervical compression. However use of a double balloon catheter is a novel approach for cervical tamponade, as one balloon is positioned below the external cervical os and the second balloon is situated above in the internal cervical os. This compresses the cervix from internal os to external os between the two balloons, forming a "cervical sandwich." We describe this method of cervical tamponade using a silicone double balloon cervical ripening catheter that rapidly controlled hemorrhage in a patient that failed conservative management with methotrexate.
Long-read sequencing identified a causal structural variant in an exome-negative case and enabled preimplantation genetic diagnosis
Authors: Hefan Miao, Jiapeng Zhou, Qi Yang, Fan Liang, Depeng Wang, Na Ma, Bodi Gao, Juan Du, Ge Lin, Kai Wang, Qianjun Zhang
Journal: Hereditas (2018)
Keywords: g6pc, gsd-ia, long-read sequencing, pgd, structural variants, wes, whole-exome sequencing
MeSH terms: DNA Mutational Analysis, Exome, Glucose-6-Phosphatase / genetics, Preimplantation Diagnosis, Alleles, Child, Exons, Female, Heterozygote, Humans, Male, Pedigree, Pregnancy, Sequence Deletion, G6PC1 protein, human, Glucose-6-Phosphatase

Background:
For a proportion of individuals judged clinically to have a recessive Mendelian disease, only one heterozygous pathogenic variant can be found from clinical whole exome sequencing (WES), posing a challenge to genetic diagnosis and genetic counseling. One possible reason is the limited ability to detect disease causal structural variants (SVs) from short reads sequencing technologies. Long reads sequencing can produce longer reads (typically 1000 bp or longer), therefore offering greatly improved ability to detect SVs that may be missed by short-read sequencing.
Results:
Here we describe a case study, where WES identified only one heterozygous pathogenic variant for an individual suspected to have glycogen storage disease type Ia (GSD-Ia), which is an autosomal recessive disease caused by bi-allelic mutations in the G6PC gene. Through Nanopore long-read whole-genome sequencing, we identified a 7.1 kb deletion covering two exons on the other allele, suggesting that complex structural variants (SVs) may explain a fraction of cases when the second pathogenic allele is missing from WES on recessive diseases. Both breakpoints of the deletion are within Alu elements, and we designed Sanger sequencing and quantitative PCR assays based on the breakpoints for preimplantation genetic diagnosis (PGD) for the family planning on another child. Four embryos were obtained after in vitro fertilization (IVF), and an embryo without deletion in G6PC was transplanted after PGD and was confirmed by prenatal diagnosis, postnatal diagnosis, and subsequent lack of disease symptoms after birth.
Conclusions:
In summary, we present one of the first examples of using long-read sequencing to identify causal yet complex SVs in exome-negative patients, which subsequently enabled successful personalized PGD.
Ceruminous Adenoma of the External Auditory Canal: A Case Report with Imaging and Pathologic Findings
Authors: George Psillas, Argyrios Krommydas, Georgia Karayannopoulou, Kyriakos Chatzopoulos, Jean Kanitakis, Konstantinos Markou
Journal: Case Rep Med (2015)

Ceruminous adenomas are benign tumors that are rare in humans and present with a nonspecific symptomatology. The treatment of choice is surgical excision. We present an 87-year-old woman who presented with a reddish, tender, round, soft mass of the outer third of the inferior wall of the left external auditory canal, discharging a yellowish fluid upon pressure. Coincidentally, due to her poor general condition, this patient also showed symptoms consistent with chronic otitis media, parotitis, and cervical lymphadenopathy, such as otorrhea, through a ruptured tympanic membrane and swelling of the parotid gland and cervical lymph nodes. The external auditory canal lesion was surgically excised under general anesthesia, utilizing a transmeatal approach. The pathological diagnosis was ceruminous gland adenoma. The tumor was made of tubular and cystic structures and embedded in a fibrous, focally hyalinized stroma. Immunohistochemistry confirmed the presence of two distinct cell populations. The luminal cells expressed keratin 7, while peripheral (basal) cells expressed keratins 5/6, S100 protein, and p63. The apocrine gland-related antigen GCDFP-15 was focally expressed by tumor cells. The postoperative course was uneventful and at the 2-year follow-up no recurrence of the ceruminous adenoma was noted.
Neuroblastoma-related severe hypoperfusion in the cerebellum of an infant: A case of opsoclonus-myoclonus syndrome
Authors: Junki Takenaka, Kenji Hirata, Shiro Watanabe, Hideaki Shiraishi, Kohsuke Kudo
Journal: Asia Ocean J Nucl Med Biol (2023)
Keywords: brain perfusion spect, neuroblastoma, opsoclonus- myoclonus syndrome
MeSH terms: Case Reports

A 2-year-old girl started to wobble without any specific triggers, so the patient was admitted to our hospital's pediatric department. The entire cerebellum showed severe atrophy on MRI and much lower uptake than that in the cerebral cortex on perfusion SPECT. The diagnosis of opsoclonus-myoclonus syndrome (OMS) was suspected. MRI visualized a small mass behind the inferior vena cava. Although its uptake on I-123 MIBG scintigraphy was inconclusive, the mass was surgically removed, and the diagnosis of neuroblastoma was pathologically confirmed. OMS is one of the paraneoplastic neurological syndromes with cerebellar ataxia, myoclonus of the trunk and extremities, and opsoclonus as its main symptoms. Approximately 50% of children cases with OMS are associated with neuroblastoma. The prognosis for neuroblastoma itself with OMS is relatively good, but the neurological prognosis is very poor. If there is decreased blood flow in the cerebellum of an infant, it may be necessary to search for neuroblastoma.
Case Report: Rare Iliac Vein Compression (May-Thurner) Syndrome in a Pediatric Patient
Authors: Lianfu Ji, Fan Yang, Xuan Chen, Jinlong Chen, Xueying Cheng, Jie Yin, Yuming Qin, Shiwei Yang
Journal: Front Pediatr (2021)
Keywords: angiography, iliac artery, iliac vein, iliac vein compression syndrome, left lower extremity swelling
MeSH terms: Case Reports

Iliac vein compression syndrome (IVCS) or May-Thurner syndrome occurs predominantly in young to middle-aged women. Here we reported a case of IVCS in a 5-year-old boy. The child was admitted to our vasculocardiology department with left lower extremity that had been swollen for 1 month. Blood tests revealed coagulation routine and platelets in the normal ranges. Computer tomography angiography (CTA) and magnetic resonance imaging (MRI) showed the left common iliac vein had become narrow before it entered the right common iliac vein. To further clarify, we performed angiography, which clearly showed the stenosis and the blood return of the left common iliac vein. So IVCS was diagnosed. What is more, we found the aorta descended to the right of the spine, and this may be the reason for the apparent compression of the left common iliac vein. Given the young age and mild symptoms of the child, the treatment was conservative mainly including elevation of the affected limb, wearing medical elastic socks, and short-term oral aspirin for anticoagulation. Meanwhile, the boy is being followed up closely. If the swelling of the left lower extremity significantly increases, stent placement may need to be considered in the future.
CHIVA to spare the small and great saphenous veins after wrong-site surgery on a normal saphenous vein: a case report
Authors: Felipe Puricelli Faccini, Ani Loize Arendt, Raphael Quintana Pereira, Alexandre Roth de Oliveira
Journal: J Vasc Bras (2019)
Keywords: chiva, saphenous vein sparing, venous operation, wrong-site surgery
MeSH terms: Case Reports

CHIVA (Cure Conservatrice et Hemodynamique de l'Insufficience Veineuse en Ambulatoire) is a type of operation for varicose veins that avoids destroying the saphenous vein and collaterals. We report a case of CHIVA treatment of two saphenous veins to spare these veins. The patient previously had a normal great saphenous vein stripped in error in a wrong-site surgery, while two saphenous veins that did have reflux were not operated. The patient was symptomatic and we performed a CHIVA operation on the left great and right small saphenous veins. The postoperative period was uneventful and both aesthetic and clinical results were satisfactory. This case illustrates that saphenous-sparing procedures can play an important role in treatment of chronic venous insufficiency. Additionally, most safe surgery protocols do not adequately cover varicose veins operations. Routine use of duplex scanning by the surgical team could prevent problems related to the operation site.
The initial intravenous treatment of a human immunodeficiency virus-infected child with complicated abdominal tuberculosis
Authors: Anthony K Enimil, Brian Eley, James Nuttall
Journal: South Afr J HIV Med (2020)
Keywords: arv medications, antituberculosis, child none, intravenous, tuberculosis
MeSH terms: Case Reports

Introduction:
There is very limited published experience with intravenous (IV) antituberculosis (anti-TB) and antiretroviral therapy (ART) especially in children. We have described a human immunodeficiency virus (HIV)-infected child with complicated abdominal tuberculosis who was initially treated with IV anti-TB and a partially IV ART regimen before transitioning to oral therapy.
Patient presentation:
A 3-year-old boy presented with hypovolaemic shock with a 3-day history of inability to pass stools, abdominal distension and bile-stained vomiting. Abdominal ultrasound and X-ray showed small-bowel obstruction. Human immunodeficiency virus antibody testing was positive, and Cluster of Differentiation (CD)4+ lymphocyte count was 56 cells/mL (15%). Xpert Mycobacterium tuberculosis (MTB)/Rifampicin (RIF) Ultra and TB culture on induced sputum detected MTB complex sensitive to rifampicin and isoniazid.
Management and outcome:
Following laparotomy and closure of bowel perforations, the child was commenced on IV rifampicin, moxifloxacin and amikacin. Amikacin was stopped after 3 days because of nephrotoxicity, and meropenem and IV linezolid were added. After 20 days, ART comprising IV zidovudine, oral lamivudine solution, oral lopinavir/ritonavir solution and additional oral ritonavir solution for super boosting was commenced. By day 40, the patient was well established on oral feeds and was switched to standard oral anti-TB medications. Sputum examined 1 month after starting the treatment was found culture-negative for MTB. After 4 months of treatment, the HIV viral load was < 100 copies/mL. He completed a total of 12 months of anti-TB treatment.
Conclusion:
Despite limited experience and few available IV formulations of standard anti-TB and ARV medications, initial IV therapy may be beneficial for patients in whom oral medication is not an option.
Endogenous Klebsiella endophthalmitis as the presentation of both Klebsiella liver abscess and underlying anti-IFN-3 autoimmunity
Authors: George Castle, Greg Heath
Journal: Access Microbiol (2020)
Keywords: klebsiella, anti-ifn-3, endophthalmitis, liver abscess
MeSH terms: Case Reports

This case study is one of the first ever reported examples of infection in a patient with anti-IFN-3 autoimmunity and demonstrates how overwhelming infection can sometimes present with visual symptoms. We report the case of a previously fit middle-aged patient presenting with painless loss of vision and loss of appetite. Examination showed choroidal abscess and a pan-uveitis, leading to admission for vitreous biopsy. Klebsiella pneumoniae was isolated both in the vitreous and in blood cultures. Subsequent investigation discovered a liver abscess which was treated with percutaneous drainage. Despite the administration of intravitreal antibiotics from the time of presentation, intravenous antibiotics and vitrectomy on the same day, the patient proceeded to need enucleation 19 days later, and now has only light perception in the remaining eye. The strong association between K. pneumoniae endophthalmitis and underlying liver abscess leads to a significant mortality rate. Early diagnosis is essential, with prompt aggressive treatment with antibiotics, but sadly the visual prognosis remains poor. In cases of suspected choroidal abscess, initiation of sepsis screen and immediate empirical treatment is vital to improve this prognosis. This patient had no significant past medical history, no known immunocompromise, was not diabetic and had no recent significant foreign travel. However, further immunological analysis demonstrated the presence of anti-IFN-3 antibodies, a hitherto under-reported potential cause of increased susceptibility to infection, and so cases of sepsis in previously healthy individuals should be considered for further immunology assessment.
Trans-scaphoid dislocation of the proximal row: a case report
Authors: Mohammed Tahir Ansari, Prakash Kotwal, Laxman Rijal
Journal: Pan Afr Med J (2013)
Keywords: ct scan, trans-scaphoid dislocation, carpectomy, wrist score
MeSH terms: Joint Dislocations / surgery, Scaphoid Bone / injuries, Wrist Injuries / pathology, Case Reports, Accidents, Traffic, Adult, Arthrodesis / methods, Follow-Up Studies, Hand Strength, Humans, Joint Dislocations / etiology, Male, Pain / etiology, Wrist Injuries / etiology, Wrist Injuries / surgery

This report is of a 32 year old man who presented with complains of pain, swelling and deformity of right wrist of four weeks duration. He gave history of road traffic accident four weeks back leading to injury to right wrist; Preoperative radiographs and C.T. scan images were suggestive of trans-scaphoid dislocation of the proximal row of wrist. A volar and dorsal approach were used to reduce this complex dislocation but was not successful. Wrist arthodesis was performed after doing proximal row carpectomy. One year follow-up of the patient showed fair result with grip strength of 85% to contralateral side and modified Mayo wrist score of 65 at one year.
Case Report: First in Human Online Adaptive MR Guided SBRT of Peritoneal Carcinomatosis Nodules: A New Therapeutic Approach for the Oligo-Metastatic Patient
Authors: Luca Boldrini, Angela Romano, Lorenzo Placidi, Gian Carlo Mattiucci, Giuditta Chiloiro, Davide Cusumano, Veronica Pollutri, Marco Valerio Antonelli, Luca Indovina, Maria Antonietta Gambacorta, Vincenzo Valentini
Journal: Front Oncol (2020)
Keywords: colorectal cancer, magnetic resonance guided radiation therapy, oligometastatic disease, online adaptive radiation therapy, peritoneal metastases, stereotactic body radiation therapy
MeSH terms: Case Reports

Peritoneal carcinosis (PC) is characterized by poor prognosis. PC is currently treated as a locoregional disease and the possibility to perform very precise treatments such as stereotactic body radiation therapy (SBRT) has opened up new therapeutic perspectives. More recently, the introduction of Magnetic Resonance-guided Radiation Therapy (MRgRT) allowed online adaptation (OA) of treatment plan to optimize daily dose distribution based on patient's anatomy. The aim of this study is the evaluation of the effectiveness of SBRT OA workflow in an oligometastatic patient affected by PC. We report the clinical case of a patient affected by PC originating from colon cancer, previously treated with chemotherapy and surgery, addressed to OA SBRT treatment on a single chemoresistant PC nodule, delivered with a 0.35 T MR Linac. Treatment was delivered using gating approach in deep inspiration breath hold condition in order to reduce intrafraction variability. Prescription dose was 35 Gy in 5 fractions. The PTV V95% of the original plan was 96.6%, while the predicted values for the following fractions were 11.9, 56.4, 0, 0, and 61%. Similarly, the small bowel V19.5 Gy of the original plan was 4.63 cc, while the predicted values for the following fractions were 3.7, 8.6, 10.7, 1.96, 3.7 cc. Thanks to the OA approach, the re-optimized PTV V95% coverage improved to 96.1, 89.0, 85.5, 94.5, and 94%; while the small bowel V19.5 Gy to 3.36; 3.28; 1.84; 2.62; 2.6 cc respectively. After the end of RT, the patient was addressed to follow-up, and the re-evaluation 18F-FDG PET-CT was performed after 10 months from irradiation showed complete response. No acute or late toxicities were recorded. MRgRT with OA approach in PC patients is technically and clinically feasible with clean toxicity result. Online adaptive SBRT for oligometastases opens up new therapeutic scenarios in the management of this category of patients.