OpenMed/multicare-articles huggingface dataset:
Additively manufactured patient-specific prosthesis for tumor reconstruction: Design, process, and properties
Authors: Maryam Tilton, Gregory S Lewis, Michael W Hast, Edward Fox, Guha Manogharan
Journal: PLoS One (2021)
MeSH terms: Humerus / surgery, Osteosarcoma / surgery, Printing, Three-Dimensional, Prosthesis Design, Prosthesis Implantation / instrumentation, Case Reports, Research Support, Non-U.S. Gov't, Child, Finite Element Analysis, Humans, Humerus / diagnostic imaging, Humerus / pathology, Imaging, Three-Dimensional, Materials Testing, Osseointegration, Osteosarcoma / pathology, Osteotomy / adverse effects, Porosity, Surface Properties, Titanium, X-Ray Microtomography, Titanium

Design and processing capabilities of additive manufacturing (AM) to fabricate complex geometries continues to drive the adoption of AM for biomedical applications. In this study, a validated design methodology is presented to evaluate AM as an effective fabrication technique for reconstruction of large bone defects after tumor resection in pediatric oncology patients. Implanting off-the-shelf components in pediatric patients is especially challenging because most standard components are sized and shaped for more common adult cases. While currently reported efforts on AM implants are focused on maxillofacial, hip and knee reconstructions, there have been no reported studies on reconstruction of proximal humerus tumors. A case study of a 9-year-old diagnosed with proximal humerus osteosarcoma was used to develop a patient-specific AM prosthesis for the humerus following tumor resection. Commonly used body-centered cubic (BCC) structures were incorporated at the surgical neck and distal interface in order to increase the effective surface area, promote osseointegration, and reduce the implant weight. A patient-specific prosthesis was fabricated using electron beam melting method from biocompatible Ti-6Al-4V. Both computational and biomechanical tests were performed on the prosthesis to evaluate its biomechanical behavior under varying loading conditions. Morphological analysis of the construct using micro-computed tomography was used to compare the as-designed and as-built prosthesis. It was found that the patient-specific prosthesis could withstand physiologically-relevant loading conditions with minimal permanent deformation (82 μm after 105 cycles) at the medial aspect of the porous surgical neck. These outcomes support potential translation of the patient-specific AM prostheses to reconstruct large bone defects following tumor resection.
Acute gastric volvulus in operated cases of tracheoesophageal fistula
Authors: Milind Joshi, Sandesh Parelkar
Journal: J Indian Assoc Pediatr Surg (2010)
Keywords: acute gastric volvulus, complications, esophageal atresia, tracheoesophageal fistula
MeSH terms: Case Reports

A report of two neonates of esophageal atresia with tracheoesophageal fistula who had acute gastric volvulus in the postoperative period and required gastropexy after correction of the volvulus. Such postoperative complication has not been reported in the literature so far.
Different Faces of Rathke's Cleft Cyst
Authors: Clara Brou, Idil Gunes Tatar
Journal: J Belg Soc Radiol (2023)
Keywords: mri, rathke’s cleft cyst, cystic sellar lesion
MeSH terms: Case Reports

Rathke's cleft cysts (RCC) are rare benign cystic lesions that might present with different imaging features, potentially posing a problem in the radiological diagnosis of cystic sellar lesions. The purpose of this pictorial review is to present an overview of the radioclinical features of RCC through four clinical cases with different radiologic findings confirmed by pathology, as well as reviewing the common differential diagnosis to be considered. The subjects are women, aged 11 to 73 who underwent recent transsphenoidal surgical resection with a postoperative follow-up period of a few months to three years.
Pineal epidermoid cyst: case report and review of the literature
Authors: Fahd Derkaoui Hassani, Abdelali Bouchaouch, Nizare El Fatemi, Rachid Gana, Najia El Abbadi, Moulay Rachid Maaqili
Journal: Pan Afr Med J (2014)
Keywords: pineal epidermoid cyst, cerebellopontine angle, intracranial tumor
MeSH terms: Brain Neoplasms / pathology, Epidermal Cyst / pathology, Pineal Gland / pathology, Case Reports, Review, Brain Neoplasms / diagnosis, Brain Neoplasms / surgery, Epidermal Cyst / diagnosis, Epidermal Cyst / surgery, Humans, Hypesthesia / etiology, Intracranial Hypertension / etiology, Magnetic Resonance Imaging, Male, Middle Aged, Paresis / etiology, Pineal Gland / surgery

Intracranial epidermoid cysts are one of the rare tumors of all intracranial tumors. They represent 0,2 to 1% of intracranial tumors and 7% of tumors in the cerebellopontine angle. The pineal region is exceptionally subject to such kind of tumor. Cushing was the first to report the pineal localization of the epidermoid cyst in 1928. Up to now, 85 cases of pineal epidermoid cyst were cited in the literature. We report a clinical case concerning a 45 years old man who presented an intracranial hypertension during 18 months. The clinical examination found a hemiparesis with a facial hypoesthesis. The MRI showed a process of the pineal region. The patient underwent a surgery with a large resection. The histological examination confirms the epidermoid cyst. Many approaches were described in the literature. The outcome is related to this localization.
Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult
Authors: Deesha Bhojwani, Mohamed Zakarya, Suha Abu Khalaf
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

Introduction:
Aseptic meningitis can occur from different types of infections of which viral etiologies are the most common. Varicella zoster virus (VZV) nowadays is considered a familiar entity of aseptic meningitis. However, it is usually reported in immunocompromised patients. For cases of VZV meningitis that are observed, a rash has been noted before the onset of meningitis or sometimes after it. Clinical Case. We present an uncommon case of VZV meningitis in an 18-year-old immunocompetent male who did not have a rash on presentation and did not develop one during his course either. Cerebrospinal fluid showed lymphocyte-predominant leukocytosis and elevated protein with normal glucose suggestive of aseptic meningitis. Cerebrospinal fluid polymerase chain reaction (CSF PCR) was positive for VZV; cerebrospinal fluid cultures and blood cultures were negative. The patient had complete resolution of symptoms with no complications on intravenous acyclovir therapy and was discharged home on oral valacyclovir therapy.
Conclusion:
It is important to consider varicella zoster virus as an etiology of aseptic meningitis as clinical presentation can be without a vesicular rash and in immunocompetent patients.
Case report: Rare lung disease of infancy diagnosed with the assistance of a home pulse oximetry baby monitor
Authors: Kevin H Yang, Art Kulatti, Kimberly Sherer, Aparna Rao, Mateja Cernelc-Kohan
Journal: Front Pediatr (2022)
Keywords: nehi, asthma, bronchiolitis, case report, medical technology, pulmonology, pulse oximetry
MeSH terms: Case Reports

Neuroendocrine cell hyperplasia of infancy (NEHI) is a rare childhood interstitial lung disease characterized by a gradual onset of tachypnea, hypoxemia, and failure to thrive in the first 2 years of life. NEHI is challenging to diagnose and can masquerade as common respiratory infections and reactive airway disease. Timely diagnosis is essential to optimize management of comorbidities, improve outcomes, and prevent unnecessary interventions. We report a case of a 14-month-old male who was hospitalized multiple times with recurrent episodes of presumed bronchiolitis. However, early on, the parents had detected unexplained nighttime hypoxemia with a wearable home pulse oximetry baby monitor. While recurrent respiratory infections are common in infancy, our patient had numerous persistent symptoms refractory to traditional treatments, which prompted further workup and ultimately led to the diagnosis of NEHI. The home baby monitor provided useful information that accelerated workup for a presentation that did not fit the usual picture of recurrent bronchiolitis, bronchospasm, or pneumonia. These devices that monitor infant cardiopulmonary status and oxygenation are becoming increasingly popular for home use. There is controversy over their clinical utility due to the frequency of false alarms, excessive parental reliance on these devices, and lack of Food and Drug Administration oversight to ensure accuracy and effectiveness of these devices. Our case provides an example of how in certain clinical settings, information from these devices might serve as a complementary tool in the pediatrician's medical decision-making and possibly lead to a rare diagnosis such as NEHI.
Ectopic Atrial Tachycardia in a 12-Month-Old Girl Treated With Ivabradine and Beta-Blocker, a Case Report
Authors: Holger Michel, Frank Heißenhuber, Sven Wellmann, Michael Melter, Stephan Gerling
Journal: Front Pediatr (2020)
Keywords: ivabradine, atrial, beta-blocker, case report, children, tachycardia
MeSH terms: Case Reports

We report on a 12-month-old girl with an ectopic atrial tachycardia successfully treated with the combination of a beta blocking agent and Ivabradine that acts on cardiac pacemaker cells by selectively inhibiting the If channel. Standard therapy had failed to control the tachycardia before. No side effects attributable to Ivabradine were noticed. Due to its mechanism of action Ivabradine is a promising novel agent for the therapy of tachycardia due to increased automaticity. Reports on the use of Ivabradine in young children or infants are rare, but show promising results for congenital junctional ectopic tachycardia. This report adds the second case of ectopic atrial tachycardia in this age group and novel treatment with Ivabradine to the literature.
Grover's-like drug eruption in a patient with metastatic melanoma under ipilimumab therapy
Authors: Viktor H Koelzer, Tobias Buser, Niels Willi, Sacha I Rothschild, Andreas Wicki, Peter Schiller, Gieri Cathomas, Alfred Zippelius, Kirsten D Mertz
Journal: J Immunother Cancer (2016)
Keywords: autoimmunity, drug eruption, grover’s disease, immune checkpoint inhibitors, immunotherapy, ipilimumab, melanoma, transient acantholytic dermatosis

Background:
Dermatologic toxicity is an important adverse effect of immune checkpoint inhibitors targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death 1 receptor (PD-1) or PD ligand 1 (PD-L1). Skin toxicity most commonly includes a maculopapular erythematous rash and pruritus. Rarely life threatening complications such as Steven's Johnson syndrome or toxic epidermal necrolysis may occur.
Case presentation:
Here we report the uncommon event of a drug-induced transient acantholytic dermatosis (Grover's disease) in a 73-year-old Caucasian male treated with ipilimumab for metastatic melanoma. Five weeks after initiation of therapy, the patient developed a widespread polymorphic papulovesicular dermatosis on the trunk and proximal extremities with intense pruritus. Skin biopsy showed acantholytic dyskeratosis with interface dermatitis consistent with a Grover's-like drug eruption.
Conclusions:
These findings should raise awareness for uncommon immune-related dermatological toxicities of immunomodulatory antibodies targeting the CTLA-4 signaling axis. We recommend biopsies of unexpected skin lesions to rapidly identify dermatological adverse events of immune checkpoint inhibitors.
Acute Isolated Hyperbilirubinemia as a Presentation of Alcoholic Liver Disease: A Case Report and Literature Review
Authors: Muhammad Rajib Hossain, Ramesh Kumar Pandey, Mohammad Faridul Islam, Praveen Datar, Vijay Gayam, Pradeep Puri, Thwin Malar
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

Isolated hyperbilirubinemia as a manifestation of alcoholic liver disease without significant liver abnormalities is seen very rarely. We report such a case where a patient with chronic alcoholism presented to the ER with acute jaundice with bilirubin of 24.8 mg/dl, predominantly conjugated in nature along with mild elevation of AST (76 IU/L). There were no other abnormalities of the liver function. The patient underwent extensive laboratory and imaging tests that excluded extrahepatic cholestasis, viral and autoimmune hepatitis, ischemic hepatitis, and so forth. Liver biopsy excluded hemochromatosis, dysplasia, or malignancy and other differentials. Bilirubin gradually trended down to 7.3 mg/dl when alcohol consumption was stopped.
Stevens-Johnson Syndrome complicated by obstructive uropathy, pneumothorax, and pneumomediastinum: a case report and literature review
Authors: Damian Bruce-Hickman, Xiao Jiang, Joshua Jin-Ping Thia, Amit Kansal
Journal: Burns Trauma (2019)
Keywords: obstructive uropathy, pneumomediastinum, pneumothorax, stevens-johnson syndrome, ureteric stenting
MeSH terms: Case Reports

Background:
Stevens-Johnson Syndrome (SJS) is an acute mucocutaneous eruption with blisters of the skin and haemorrhagic erosions of mucous membranes. This report describes air-leak syndrome and obstructive uropathy occurring simultaneously in a teenage patient affected by SJS.
Case presentation:
A 17-year-old Malay female with SJS suffered from bilateral pneumothoraces, pneumomediastinum, and obstructive uropathy as early complications of her disease. She required intubation, chest tube insertion, and bilateral ureteric stenting as part of her intensive care management. These extra-cutaneous complications of renal and pulmonary systems were likely secondary to widespread epithelial detachment.
Conclusion:
Despite paucity of cases in adult literature, post-renal causes for acute kidney injury must be considered in SJS, especially in the setting of gross haematuria. Bedside point-of-care ultrasonography may be a useful tool for excluding obstructive uropathy. Pneumothorax is a rare but documented complication of SJS in paediatric cases and, to a lesser extent, adult patients. Extra care should be exercised when caring for mechanically ventilated patients suffering from SJS.
Case Report: Simultaneous penetrating keratoplasty with autologous simple limbal epithelial transplantation as an alternative to keratoprosthesis
Authors: Supriya Sharma, Swati Singh, Swapna S Shanbhag
Journal: F1000Res (2023)
Keywords: cicatricial entropion, descemetocele, limbal stem cell deficiency (lscd), limbal stem cell transplantation (lsct), ocular burn, penetrating keratoplasty
MeSH terms: Burns, Chemical / diagnosis, Burns, Chemical / surgery, Cataract, Corneal Diseases / surgery, Entropion / surgery, Eye Burns / diagnosis, Eye Burns / surgery, Limbal Stem Cell Deficiency, Limbus Corneae / surgery, Case Reports, Cicatrix, Cornea / surgery, Humans, Keratoplasty, Penetrating, Male, Middle Aged, Prostheses and Implants

Introduction and importance: This case report highlights the multidisciplinary approach required to achieve successful anatomical and functional outcomes, in an eye with total limbal stem cell deficiency (LSCD) associated with underlying corneal scarring and thinning. Presentation of case: A 59-year-old gentleman had poor visual recovery in the right eye (RE) following accidental carbide blast, 1-year before presenting to us. The visual acuity was counting fingers and clinical examination revealed cicatricial entropion involving the upper eyelid, total LSCD, corneal scarring with a central descemetocele and cataract in the RE. Prior to ocular surface reconstruction, entropion correction was performed. Three months later, penetrating keratoplasty combined with cataract surgery and intraocular lens implantation (penetrating keratoplasty (PK) triple), with autologous simple limbal epithelial transplantation (SLET) was performed. The visual acuity was 20/100, 18 months after the surgery, with a clear well-epithelized corneal graft and stable ocular surface. Discussion: LSCD is caused by a decrease in the population and /or function of the limbal epithelial stem cells. Limbal stem cell transplantation (LSCT) is warranted in eyes with total LSCD. In eyes with coexisting corneal scarring, LSCT alone may be inadequate to restore the vision. These eyes require simultaneous or sequential lamellar or full-thickness corneal transplantation for visual rehabilitation. Though, the existing literature favors a sequential approach, where LSCT is performed first followed by corneal transplantation, under certain circumstances such as a thin underlying cornea like in our case, corneal transplantation may have to be combined with LSCT to achieve optimal outcomes. Conclusion: Combining autologous SLET with PK can be performed for visual rehabilitation in eyes with unilateral total LSCD and underlying corneal thinning. Corneal and limbal graft survival is prolonged if existing adnexal comorbidities are addressed before any surgical intervention is planned and adequate time interval is allowed for the surface inflammation to subside.
A Rare Cause of Acute Pancreatitis in a Transgender Female
Authors: Lindsey C Shipley, David T Steele, Charles M Wilcox, Chad M Burski
Journal: J Investig Med High Impact Case Rep (2020)
Keywords: estrogen, hypertriglyceridemia, pancreatitis, transgender
MeSH terms: Pancreatitis / chemically induced, Pancreatitis / diagnosis, Transgender Persons, Case Reports, Acute Disease, Adult, Estrogens / adverse effects, Female, Humans, Hypertriglyceridemia / chemically induced, Male, Tomography, X-Ray Computed, Estrogens

Acute pancreatitis is defined as an acute inflammation of the pancreas and is most commonly caused by gallstones and alcohol followed by elevated triglycerides and medications. Estrogen as a cause of secondary hypertriglyceridemic pancreatitis is a rare but known phenomenon in females on hormonal therapy; however, it is not well described in the transgender female population. In this article, we present a case of a 31-year-old transgender female who developed acute, severe pancreatitis after a few months of using estrogen as transition therapy. To our knowledge, this is the third case report of a transgender female presenting with acute pancreatitis secondary to estrogen. Long-term supraphysiologic doses of sex hormones are required to maintain secondary sex characteristics placing this population at a higher risk of developing acute pancreatitis. Further research is needed to determine risk and screening methods to prevent this side effect.
Airway Management Failure after Delayed Extubation in a Patient with Oral Malignant Melanoma Who Underwent Partial Mandibulectomy and Reconstruction with a Free Flap
Authors: Min A Kwon, Jaegyok Song, Seokkon Kim, Pyeung-Wha Oh, Minji Kang
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Maxillofacial surgery may cause severe complications in perioperative airway management. We report a case of failed airway management in a patient who underwent segmental mandibulectomy, radical neck dissection, and reconstruction with a free flap. The patient was extubated approximately 36 hours after surgery. Approximately 7 hours after extubation, the patient complained of dyspnoea, and respiratory failure followed. Bag-mask ventilation, direct laryngoscopy, video laryngoscopy, and supraglottic airway access were ineffective. The surgical airway was secured with an emergency tracheostomy while performing cardiopulmonary resuscitation. However, the patient experienced permanent hypoxic brain damage. The airway of patients with oral cancer may be compromised postoperatively due to surgical trauma and bulky flap reconstruction. Patients should be closely monitored during the postoperative period to prevent airway failure. Early diagnosis and airway management before airway failure occurs are important. Medical staff should be aware of airway management algorithms, be trained to perform difficult airway management, and have the required equipment readily available.
Case report: Early-onset renal failure as presenting sign of Lesch-Nyhan disease in infancy
Authors: Lianlian Yang, Hui Guo
Journal: Front Pediatr (2022)
Keywords: hprt1 gene mutation, lesch-nyhan disease, congenital metabolic diseases, genetic testing, hyperuricemia
MeSH terms: Case Reports

Lesch-Nyhan disease (LND) is a rare X-linked recessive disease caused by pathogenic mutations of the HPRT1 gene. The typical clinical manifestations include cerebral palsy, intellectual disability, dysarthria, self-injurious behavior, and gouty arthritis in children. This report describes a Chinese boy aged 2 months and 7 days with a significantly elevated uric acid concentration accompanied by renal dysfunction and, notably, brain imaging changes. Whole-exome sequencing revealed a hemizygous mutation of HPRT1 in nucleotide 508 from cytosine to thymine (c.508C > T), resulting in a nonsense mutation (p.R170X). The incidence of LND is extremely low in China, and hyperuricemia is a common clinical manifestation. Therefore, the possibility of LND should be considered in children with increased uric acid in infancy accompanied by brain imaging changes or neurological dysfunction. Moreover, genetic testing is needed to provide adequate genetic counseling to the family, and should be conducted as early as possible in such children to avoid misdiagnosis or delayed diagnosis.
Atypical Blue Rubber Bleb Nevus in an African-American Male
Authors: Harpreet S Gill, Paul Beinhoff, Sarah Grond, Mohan S Dhariwal, Pinky Jha
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Blue Rubber Bleb Nevus Syndrome (BRBNS), also known as Bean Syndrome, is a rare condition characterized by vascular ectasias that typically present systemically. Most diagnoses are made in early childhood due to cutaneous lesions in Caucasians with familial inheritance. Treatment is usually patient centered due to the wide variance in clinical presentation of the disease. Here, we present a case of BRBNS in a 65-year-old African-American patient with episodic gastrointestinal (GI) bleeding with no previous history. This case emphasizes the need for a higher clinical suspicion of the disease in patients with recurrent GI bleeding.
Non-typhoidal Salmonella soft-tissue infection after gender affirming subcutaneous mastectomy case report
Authors: Branden T Barger, Mikhail Pakvasa, Melinda Lem, Aishu Ramamurthi, Shadi Lalezari, Cathy Tang
Journal: Case Reports Plast Surg Hand Surg (2023)
Keywords: chest masculinization, case report, salmonella, top surgery, transgender health
MeSH terms: Case Reports

We present a case of a 32-year-old transgender male who underwent chest masculinization, complicated by purulent soft tissue infection of bilateral chest incisions. Cultures tested positive for non-typhoidal Salmonella, methicillin-resistant Staphylococcus aureus, and Pseudomonas aeruginosa. Herein, we discuss multiple factors contributing to the complexity of treating this patient's clinical course.