OpenMed/multicare-articles huggingface dataset:
The Epidemiology of Burn and Lethal Area of Fifty Percentage (LA50) in Children in Shiraz, Southern Iran
Authors: Seyedeh-Sara Hashemi, Mahdukht Mahmoodi, Hamid Reza Tohidinik, Ali Akbar Mohammadi, Davood Mehrabani
Journal: World J Plast Surg (2021)
Keywords: burn, children, epidemiology, iran, la50

Background:
This study was conducted to assess the epidemiology of burn and lethal area of fifty percentage (LA50) in children in Shiraz, Southern Iran.
Methods:
In this case series study, 619 hospitalized burn children from burn centers affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2012 to 2016 were enrolled. Demographic characteristics of patients such as age, gender, place and cause of burn, and morality rate were evaluated. LA50 was measured using Probit analysis.
Results:
The mean age of patients was 4.4±3.4 years. The mortality rate in burn patients was 8.7% and LA50 of total body surface area (TBSA%) ranged from 40.1% in 2012 to 68.3% in 2016. Although the number of male burn patients (65%) was more than females (35%), the mortality rate in females was more than males (11.4% vs. 7.2%). Scald and flame were the most common causes of burn.
Conclusion:
The findings in our burn center comparing burn patients to developed countries showed that LA50 and survival rate were lower denoting to an urgent necessity to promote current policies in burn care and prevention and to decrease the mortality rate too.
A Patient with Eosinophilic Esophagitis and Herpes Simplex Esophagitis: A Case Report and Literature Review
Authors: Hemnishil K Marella, Jiten P Kothadia, Nasir Saleem, Bilal Ali, Yousef Abdel-Aziz, Vamsee Mupparaju, Twisha Oza, Abdallah Azouz, Colin W Howden
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Acute herpes simplex esophagitis (HSE) is common in immunocompromised patients. Eosinophilic esophagitis (EoE) is characterized by immune-mediated eosinophil-predominant esophageal inflammation. We report a patient with human immunodeficiency virus infection who presented with dysphagia and odynophagia and was found to have HSE and EoE. The combination of these two relatively rare conditions suggests possible predisposition.
Abiotrophia defectiva causing infectious crystalline keratopathy and corneal ulcer after penetrating keratoplasty: a case report
Authors: Yannis M Paulus, Glenn C Cockerham
Journal: J Ophthalmic Inflamm Infect (2013)

Background:
Infectious crystalline keratopathy is commonly caused by Streptococcus viridans and other gram positive organisms. We present the first case of infectious crystalline keratopathy that developed into a corneal ulcer and grew Abiotrophia defectiva which responded well to topical and systemic antimicrobial therapy and did not require re-grafting. A 78-year-old man underwent penetrating keratoplasty for pseudophakic bullous keratopathy. He presented 1.5 years later with infectious crystalline keratopathy which progressed to a corneal ulcer. The patient received topical fortified vancomycin and moxifloxacin, as well as oral moxifloxacin.
Findings:
The corneal ulcer base was cultured and grew A. defectiva, or nutritionally deficient streptococcus. Complete resolution of the corneal infiltrates was obtained within three months.
Conclusions:
Nutritionally deficient streptococcus has been implicated in numerous human diseases, including endocarditis, and is increasingly being recognized as an important pathogen. This represents the second reported case of A. defectiva causing infectious crystalline keratopathy in humans and the first case of A. defectiva successfully treated with antibiotics. This case shows that aggressive antibiotic therapy can be effective in A. defectiva-associated infectious crystalline keratopathy.
Rare paratesticular aggressive angiomyxoma mimicking an epididymal tumor in an 82-year-old man: Case report
Authors: Chi-Fang Chen, Tao-Yeuan Wang, Marcelo Chen, Yung-Chieh Lin
Journal: Open Med (Wars) (2021)
Keywords: aam, deep angiomyxoma, mesenchymal tumor, older, paratesticular mass
MeSH terms: Case Reports

Aggressive angiomyxoma (AAM) is a rare mesenchymal myxoid tumor, and most cases occur in the pelvic region or perineum of adult females. AAM is very rare in males. Most of these cases have been diagnosed in patients aged 30-60 years, and the tumors involved the pelvic cavity, scrotum, or spermatic cord. AAM can mimic inguinal hernia, hydrocele, or paratesticular neoplasm. Four male cases have been reported with paratesticular AAM mimicking a testicular/epididymal tumor, and to the best of our knowledge, this is the oldest patient in the literature. Because of its rarity, making an exact diagnosis before surgery is difficult. Herein, we present a case of AAM in an 82-year-old man and review the literature.
Double traumatic diaphragmatic injury: A case report
Authors: Dario Iadicola, Massimo Branca, Massimo Lupo, Eugenia Maria Grutta, Stefano Mandalà, Gianfranco Cocorullo, Antonino Mirabella
Journal: Int J Surg Case Rep (2019)
Keywords: abdomen, diaphragmatic injury, laparoscopy, thorax, titanized mesh, tramautic diaphragmatic hernia, trauma

Introduction:
Traumatic diaphragmatic injuries are rare complications resulting from a thoracic-abdominal blunt or penetrating trauma. Left-sided diaphragmatic injuries are more commonly reported in literature. Bilateral injuries are extremely rare, occurring in about 3% of the patients and just few cases reported in literature. Traumatic diaphragmatic hernias are definitely a marker of a severe trauma, in fact diaphragmatic injuries are often related to thoracic and abdominal organs injuries. Sometimes the classic clinical signs and symptoms of diaphragmatic injuries may initially not be present so that definitive evaluation is delayed or even missed.
Case report:
A 62-years old woman was admitted in Emergency Department after a pedestrian accident. A whole-body CT scan showed multiple fractures (ribs, pelvic and vertebral) but no organ injury. The next CT detected a left-sided posterior diaphragmatic hernia involving transverse colon. Thus we performed an explorative laparoscopy and found a double diaphragmatic injury. A primary repair with non-absorbable sutures and a prosthetic titanized patch was performed.
Case Report: Recurrence of an Extradural Spinal Epidermoid Cyst Following Surgical Excision in a Dog
Authors: Dillon Devathasan, Masahiro Murakami, Margaret A Miller, Stephanie A Thomovsky, Melissa J Lewis
Journal: Front Vet Sci (2022)
Keywords: congenital, epidermoid cyst, extradural, keratin, surgery
MeSH terms: Case Reports

Congenital epidermoid cysts are slow-growing, mass lesions caused by the abnormal inclusion of neuroectodermal tissue within the developing central nervous system. Subtotal excision of epidermoid cysts increases the risk of early recurrence of clinical signs. A 4-year-old female spayed boxer was presented with a 4-month history of ambulatory paraparesis and proprioceptive ataxia. Neurological examination localized a T3-L3 myelopathy. MRI revealed a T1 iso- to hypointense, T2 and FLAIR hyperintense, rim-enhancing mass at the level of the T9-T10 vertebrae resulting in extradural compression of the spinal cord. This was histopathologically confirmed as an extradural epidermoid cyst following subtotal excision. MRI performed 2 months post-operatively revealed a significant decrease of the lesion volume. The dog was neurologically normal following the surgery however re-presented 28 months later with recurrence of clinical signs. A 28-month post-operative MRI revealed substantial enlargement of the epidermoid cyst. The dog was subsequently taken for repeat decompressive surgery. At 6 months from the repeat surgery, the dog was neurologically static with mild proprioceptive deficits. The case report highlights the clinical and MRI features of a recurrent extradural spinal epidermoid cyst treated by subtotal excision.
Severe Persistent Hyponatremia: A Rare Presentation of Biliary Fluid Loss
Authors: Asim Kichloo, El-Amir Zain, M Zatmar Khan, Farah Wani, Jagmeet Singh
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: acalculous cholecystitis, cholecystostomy, hyponatremia, large-volume drainage
MeSH terms: Bile / metabolism, Cholecystostomy / adverse effects, Hyponatremia / etiology, Case Reports, Acalculous Cholecystitis / complications, Acalculous Cholecystitis / surgery, Adult, Confusion / etiology, Humans, Hyponatremia / complications, Hyponatremia / diagnosis, Lethargy / etiology, Male

Hypotonic hyponatremia is caused by a serum sodium level of <135 mEq/L in the setting of excess solute loss accompanied by free water retention because of antidiuretic hormone release, subsequent to decreased effective arterial blood volume. Acute hyponatremia can have various neurological manifestations, including drowsiness, lethargy, coma, seizures, respiratory depression, and even death. In this article, we present a case of a 41-year-old man who presented with hyponatremia as a result of sodium containing biliary fluid loss and resultant renal free water retention in response to increased antidiuretic hormone secretion. He underwent placement of a cholecystostomy tube for acalculous cholecystitis and was found to be persistently hyponatremic despite repletion with sodium-containing fluids. Once the cholecystostomy tube was removed, the patient's sodium levels improved, and his symptoms resolved. Our case highlights choleuresis as an unusual but significant cause of hyponatremia in patients who have external biliary drainage.
Successful management of peripartum cardiomyopathy in a Kenyan setting: a case series
Authors: Khushboo Jayant Sonigra, Esther Nyambura, Oscar Mwangi, Krishan Sarna, Kireki Omanwa
Journal: Pan Afr Med J (2023)
Keywords: peripartum cardiomyopathy, heart failure, management, multidisciplinary approach, postpartum cardiomyopathy
MeSH terms: Cardiomyopathies / diagnosis, Cardiomyopathies / drug therapy, Heart Failure / therapy, Pregnancy Complications, Cardiovascular / diagnosis, Pregnancy Complications, Cardiovascular / drug therapy, Puerperal Disorders / diagnosis, Puerperal Disorders / drug therapy, Ventricular Dysfunction, Left / complications, Case Reports, Female, Humans, Kenya, Peripartum Period, Pregnancy

Peripartum cardiomyopathy is a rare life-threatening condition occurring in previously healthy women with symptoms mimicking those of normal pregnancy and is associated with a high mortality rate. A high index of suspicion coupled with a sound understanding of the disease is crucial to correctly diagnose and manage the patients to improve final maternal outcomes. In this report, we present a total of five cases of peripartum cardiomyopathy in women aged 22 to 38 years who presented between 3 and 21 days postpartum. All patients presented with severely reduced ejection fractions indicative of heart failure and were immediately admitted to our facility. A timely diagnosis was made and patients started on a combination of antibiotics, anticoagulants, and anti-heart failure medication. Despite the severity of the disease upon presentation, early diagnosis and precise management of the disease were essential in achieving favorable patient outcomes. Therefore, this report provides crucial knowledge about the presentation and progression of peripartum cardiomyopathy and presents a treatment protocol from a Kenyan perspective that was successfully employed in the management of all five cases.
Hyperthyroidism-associated hypercalcemic crisis: A case report and review of the literature
Authors: Ke Chen, Yanhong Xie, Liling Zhao, Zhaohui Mo
Journal: Medicine (Baltimore) (2017)
MeSH terms: Graves Disease / complications, Hypercalcemia / etiology, Case Reports, Review, Female, Humans, Middle Aged

Rationale:
Hyperthyroidism is one of the major clinical causes of hypercalcaemia, however, hyperthyroidism-related hypercalcemic crisis is rare, only 1 case have been reported. The potential mechanisms are still not too clear. It may be related that thyroid hormone stimulate bone turnover, elevate serum calcium, increase urinary and fecal calcium excretion.
Patient concerns:
A 58-year-old female patient was found to have Graves' disease, a marked elevated serum calcium level (adjusted serum calcium: 3.74 mmol/L), and reduced parathyroid hormone level.
Diagnoses:
She was diagnosed as hyperthyroidism-associated hypercalcemic crisis.
Interventions:
Treatment with methimazole to correct the hyperthyroidism and treatment of the patient's hypercalcaemia was achieved by physiological saline, salmon calcitonin and furosemide.
Outcomes:
After treatment for hypercalcaemia and hyperthyroidism, her symptoms and serum calcium levels quickly returned to normal.
Lessons:
hyperthyroid-associated hypercalcaemia crisis is rare, however, the diagnosis should pay attention to screening for other diseases caused by hypercalcemia. Timely treatment of hypercalcaemia is a critical step for rapidly control of symptoms, and treatment of hyperthyroidism is beneficial to relief the symptoms and maintain the blood calcium level.
Combined Approach for Giant Temporal Meningoencephalocele
Authors: Claudio Carnevale, Miguel Garcia-Wagner, Carolina Morales-Olavarría, Pedro Sarría-Echegaray, Guillermo Til-Pérez
Journal: Iran J Otorhinolaryngol (2023)
Keywords: acquired encephalocele, cholesteatoma, middle ear, skull base, temporal bone
MeSH terms: Case Reports

Introduction:
To present a complex case of giant meningoencephalocele after a canal wall down mastoidectomy and describe our preferred approach to repair meningoencephalic herniation of the temporal bone.
Case report:
A 20-year-old patient, who had previously undergone type III tympanoplasty with total ossicular reconstruction prosthesis for an attic cholesteatoma, presents with clinical and imaging features compatible with the diagnosis of a giant temporal meningoencephalocele. We performed a combined approach -transmastoid plus minicraniotomy- to repair the skull base defect. A multilayer reconstruction of the defect with septal cartilage and temporal fascia was performed. After a 48 months follow-up, the patient remains symptom free without signs of tissue herniation.
Conclusions:
Transmastoid plus minicraniotomy combined approach is a safe and feasible technique in case of large and anterior skull base defects with low surgical morbidity, allowing a safe and multilayered reconstruction, even in the context of a simultaneous active chronic otitis media.
Malignant transformation of a non-healing traumatic wound on the lower extremity: A case report
Authors: Deborah-Leigh Day, Wahida Chakari, Steen Henrik Matzen
Journal: Int J Surg Case Rep (2018)
Keywords: basal cell carcinoma, chronic wounds, malignant ulcer, marjolin’s ulcer

Objective:
Malignant transformation of chronic non-healing wounds is often overlooked. If a chronic wound fails to heal, or if there are changes in the characteristics of a wound, a biopsy should be performed.
Methods:
This case is presented in line with SCARE guidelines.
Presentation of case:
We present a case of a man with a non-healing traumatic wound over two years in which a basal cell carcinoma was diagnosed by biopsy. The basal cell carcinoma was radically excised and the defect was closed using a split thickness skin transplant.
Discussion:
The term Marjolin's ulcer, pathophysiology and recommended treatment.
Conclusion:
Delayed diagnosis of malignancy in chronic wounds can lead to a worsened prognosis and therefore it is important to exclude a malignant aetiology. Malignant transformation of chronic wounds is not common but Marjolin's ulcer should be considered.
Case Report: Sellar Ependymomas: A Clinic-Pathological Study and Literature Review
Authors: Liyan Zhao, Yining Jiang, Yubo Wang, Yang Bai, Liping Liu, Yunqian Li
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: diagnosis, ependymoma, molecular subtype, pituitary tumor, sellar ependymoma, treatment
MeSH terms: Ependymoma / pathology, Pituitary Neoplasms / pathology, Case Reports, Review, Adult, Ependymoma / diagnostic imaging, Female, Humans, Magnetic Resonance Imaging, Pituitary Neoplasms / diagnostic imaging

Ependymomas are primary glial tumors arising from cells related to the ependymal lining of the ventricular system. They are classified into at least nine different molecular subtypes according to molecular phenotype, histological morphology, and tumor location. Primary sellar ependymoma is an extremely rare malignancy of the central nervous system, with only 12 known cases reported in humans. We herein report a case of ependymoma located at the pituitary region in a 44-year-old female patient and discuss the molecular subtype, natural history, clinical presentation, radiological findings, histological features, immunohistochemical characteristics, ultrastructural examinations, treatment, and prognosis of sellar ependymoma. This case report may serve as a helpful reference for clinicians and radiologists in clinical practice.
Marchiafava-Bignami Disease Associated with Spinal Involvement
Authors: Jhon Perea, María Belén Luis, Luciana Grimanesa Lázaro, Sergio Scollo, Agustina Tamargo, José Crespo, Maira Avalle, Horacio Solarz, Nora Fernández Liguori, Ricardo Alonso
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Marchiafava-Bignami disease (MBD) is a rare disorder of unknown etiology, strongly associated with alcoholism and malnutrition. MBD causes primary involvement of the corpus callosum, leading to confusion, dysarthria, seizures, and frequent death. We report the case of a 54-year-old male without a history of alcoholism or known malabsorption disease, who presented with altered consciousness and neurologic impairment. Complex B deficiency was addressed. Magnetic resonance imaging (MRI) showed typical corpus callosum lesions. The clinical features and radiologic images suggested spinal cord involvement. Brain histopathologic findings were consistent with MBD. Despite vitamin replacement therapy, he had a poor outcome.
A Severe Case of Tuberculosis Radiologically and Endoscopically Mimicking Colorectal Cancer with Peritoneal Carcinomatosis
Authors: Timo Rath, Raja Atreya, Walter Geißdörfer, Roland Lang, Andreas Nägel, Markus F Neurath
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Although generally rising in incidence, intestinal tuberculosis is still rare in western countries and due to unspecific manifestations mainly as ulcerations on endoscopy, diagnosis of intestinal tuberculosis is challenging. Within this report, we describe a case of severe intestinal tuberculosis radiologically and endoscopically masquerading as colorectal cancer with peritoneal carcinomatosis. Our case exemplifies that intestinal tuberculosis needs to be considered as a differential diagnosis in patients at risk and that undelayed and sensitive diagnosis of intestinal tuberculosis is of central importance for avoiding unfavorable disease outcome.
Noblestitch® system for PFO closure: A novel but judicious alternative to traditional devices-A case report
Authors: Eustaquio Maria Onorato, Luca Grancini, Giovanni Monizzi, Angelo Mastrangelo, Franco Fabbiocchi, Antonio L Bartorelli
Journal: Front Cardiovasc Med (2023)
Keywords: atrial septal tear, patent foramen ovale, residual shunt, suture-based pfo closure, transcatheter closure
MeSH terms: Case Reports

Background:
Percutaneous suture-mediated patent foramen ovale (PFO) closure has recently been used with the aim of avoiding double-disc nitinol device implantation. This novel technique has been carried out successfully in several centers offering PFO closure with an effective closure rate comparable to conventional double-disc devices.
Case summary:
A 50-year-old man, a pentathlon athlete, suffering from a previous left-sided ischemic stroke, underwent percutaneous closure of a permanent right-to-left shunt via PFO with a large fenestrated septum primum aneurysm at another institution. The NobleStitch® system was successfully implanted using local anesthesia and under angiographic-fluoroscopic monitoring. He was discharged home on aspirin 100 mg daily with a moderate residual shunt on contrast transthoracic echocardiography (cTTE) that persisted unaltered at subsequent controls. After 7 months, unable to resume sporting activity because of physical discomfort and dyspnea on exertion, the patient asked for a second opinion at our Heart and Brain clinic. Two-dimensional (2D) TTE showed septum primum laceration next to a radiopaque polypropylene knot with a moderate bidirectional shunt located at the fenestrated septum primum far from the PFO site. A catheter-based closure of the septal defect was therefore planned under local anesthesia and rotational intracardiac echo monitoring. An equally sized discs 28.5 mm × 28.5 mm Flex II UNI occluder (Occlutech GmbH, Jena, Germany) was successfully implanted across the atrial septal defect without complications. The patient was discharged in good clinical conditions; dual antiplatelet therapy (aspirin 100 mg/daily and clopidogrel 75 mg/daily) was recommended for 2 months and then single antiplatelet therapy (aspirin100 mg/daily) up to 6 months. Abolition of the residual shunt was confirmed at 1- and 6-month follow-up by contrast transcranial Doppler and 2D color Doppler cTTE.
Discussion:
Closing a PFO with a suture-base system, without leaving a device implant behind, may be a cutting-edge technology and potential alternative to traditional devices. Nevertheless, meticulous selection of the PFO anatomies by 2D TEE is key to a successful closure procedure in order to avoid complications that must be managed again with a second percutaneous procedure or by surgery.
Blood Cancer and the Heart: Light Chain Cardiomyopathy in Refractory Multiple Myeloma
Authors: Abdulbaril Olagunju, Chandana Shekar, Michael Morris, Anantharam Kalya, Farouk Mookadam, Samuel Unzek
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

We report a case of a 57-year-old woman with a history of multiple myeloma (MM) and light chain (AL) amyloidosis who presented due to worsening dyspnea on exertion. Her MM has been refractory to multiple chemotherapy regimens and two autologous bone marrow transplantation. Diagnostic evaluations including serum kappa and lambda chains, echocardiogram, pyrophosphate cardiac scan, and cardiac magnetic resonance were indicative of a progression to AL cardiomyopathy. Addition of daratumumab to her regimen appeared to ameliorate the progression of AL cardiomyopathy. However, it was stopped due to adverse effects of pancytopenia and allergic reactions including skin rash and hives. She was hospitalized for heart failure exacerbation and died approximately 2 months following the discontinuation of daratumumab. This case highlights the late presentation of AL cardiomyopathy in refractory MM.