OpenMed/multicare-articles huggingface dataset:
Macular Changes in a Mucopolysaccharidosis Type I Patient with Earlier Systemic Therapies
Authors: Augusto Magalhães, Ana Maria Cunha, Rodrigo Vilares-Morgado, Elisa Leão-Teles, Esmeralda Rodrigues, Manuel Falcão, Ângela Carneiro, Jorge Breda, Fernando Falcão-Reis
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Purpose:
To describe retinal findings in a patient with mucopolysaccharidosis type I (MPS I) that underwent an early treatment with hematopoietic stem cell transplantation (HSCT) and enzyme replacement therapy (ERT). Case Report. We describe a case of a 12-year-old female with a biochemical and genetic diagnosis of MPS I. She underwent HSCT and ERT on the first year of life. The visual acuity was 5/10 in both eyes and she had bilateral grade 2 corneal haze. Spectral domain optical coherence tomography (SD-OCT) revealed thickening of the external limiting membrane (ELM) at the fovea. In the parafoveal and perifoveal regions, SD-OCT displayed a loss of the interdigitation, ellipsoid, and myoid zones and of the ELM accompanied by progressive thinning of the outer nuclear layer. Fundus infrared imaging revealed a hyperreflective ring centred on the fovea and hyporeflective areas in temporal parafoveal regions in both eyes. En face OCT imaging revealed two hyperreflective rings on the outer retinal level.
Conclusion:
This patient developed macular changes with foveal deposition of hyperreflective material and parafoveal thinning, despite early systemic treatment. Systemic therapies can provide an increase in life expectancy and stabilize visual acuity and corneal clouding, although their effect on retinal degeneration is unknown.
Tension band suture in isolated tibial tubercle avulsion: A case report and review literatures
Authors: Wachiraphan Parinyakhup, Tanarat Boonriong
Journal: Int J Surg Case Rep (2020)
Keywords: tension band suture, tibial tubercle avulsion
MeSH terms: Case Reports

Introduction:
Isolated tibial tubercle avulsion in adults are extremely rare, with only a few cases having been reported. The common treatment is screw fixation, followed by immobilization. We report a rare case of an isolated tibial tubercle avulsion in an adult and demonstrate the results of a tension band suture without post-operative immobilization for treatment.
Case presentation:
A 64 year-old woman presented with an isolated tibial tubercle avulsion, and loss of her extensor mechanism. Treatment with tension band suture could provide early motion, and her return to full ambulation in 2 months.
Conclusion:
An isolated tibial tubercle avulsion, there are many surgical techniques to secure the fixation. The tension band suture is one technique that the patient can acheive a good fixation without post-operative immobilization and rapidly return to normal activity.
Concurrent Hand and Penile Gangrene following Prolonged Warfarin Use; a Case Report
Authors: Fatemeh Mahdizadeh, Saeed Safari
Journal: Emerg (Tehran) (2017)
Keywords: warfarin, anticoagulants, extremities, gangrene, necrosis, penile diseases
MeSH terms: Case Reports

Warfarin induced skin necrosis (WISN) is a rare but important side effect of warfarin. Early diagnosis may lessen the amount of permanent tissue damage and can prevent progression to full thickness skin necrosis. So, physicians should be aware of such a complication. Screening for protein C or S or anti-thrombin deficiencies, or presence of anti-phospholipid antibodies before beginning warfarin therapy, could be helpful to avoid high levels of international normalized ratio (INR). Here, we report a 54-year-old man who presented to the emergency department with acral and penile gangrene following prolonged use of warfarin.
Abnormalities of the hallux skin and nail in the course of very rare arteriovenous malformation
Authors: Marta Wasilewska, Maciej Guziński, Izabela Gosk-Bierska
Journal: J Vasc Bras (2020)
Keywords: abnormal nails, arteriovenous malformation, hallux, lower extremity, skin diseases
MeSH terms: Case Reports

Arteriovenous malformations (AVMs) are usually found in the pelvic area and the brain. These vascular anomalies are rarely reported in the toes. AVMs in the toes may be asymptomatic, but can also cause atypical symptoms. Congenital AVMs can expand as patients age and manifest in adulthood. They may be provoked by injury. Acquired AVM might be caused by iatrogenic factors, venous or arterial catheterization, percutaneous invasive vascular procedures, surgery, or degenerative vascular disorders. An AVM can damage surrounding tissues and can cause destruction of skin, nails and bones. The course of the disease is often unpredictable and diagnosis is usually delayed as a result.
Do minimum wage laws affect those who are not covered? Evidence from agricultural and non-agricultural workers
Authors: Maoyong Fan, Anita Alves Pena
Journal: PLoS One (2019)
MeSH terms: Agriculture / economics, Legislation as Topic, Salaries and Fringe Benefits / legislation & jurisprudence, Research Support, Non-U.S. Gov't, Adult, California, Female, Humans, Male, Surveys and Questionnaires

Some employers are not obligated to pay at least minimum wages to all employees. U.S. farm employers comprise one of these groups. Employees of large farms and H-2A workers (lawfully admitted, nonimmigrant workers performing temporary or seasonal agricultural work) are protected by minimum wage legislation, while some migrant workers (often those paid piece rates) are exempt. U.S. agriculture also is characterized by a large percentage of unauthorized workers who may or may not earn above minimum wage. Following insights from dual labor market theory and from theories of the signaling capacity of the minimum wage, we compare labor market outcomes in the agricultural sector (where minimum wage coverage is limited) to low wage/skill non-agricultural sectors (where minimum wage coverage is more complete) nationally using data from the Current Population Survey. We then extend our analysis to a detailed state-level case study of agricultural workers in California using a representative survey of employed farm workers. Results suggest wage increases for covered workers that exceed those for uncovered workers, but insignificant differences in hours worked. This is the first study to our knowledge to examine the impacts of minimum wage coverage on agricultural workers relative to other workers for the U.S.
Intralesional Injection of Bone Marrow Aspirate Concentrate for the Treatment of Osteonecrosis of the Knee Secondary to Systemic Lupus Erythematosus: A Case Report
Authors: Dimitrios Kouroupis, Amir F Ahari, Diego Correa, Riam Shammaa
Journal: Front Bioeng Biotechnol (2020)
Keywords: bone marrow aspirate concentrate, bone regeneration, cellular therapy, endothelial progenitor cells, mesenchymal stem cells, osteonecrosis, systemic lupus erythematosus
MeSH terms: Case Reports

Case: An 18-year-old female patient with Systemic Lupus Erythematosus (SLE) and corticosteroid-associated extensive bilateral symptomatic knee Osteonecrosis (ON) (Ficat IV), treated with sequential intralesional injections of autologous bone marrow aspirate concentrate (BMAC) under ultrasound guidance. At 3 months, pain was almost absent (VAS) and KOOS/WOMAC showed significant improvement sustained up to 24 months. At 12 months MRI indicated bone maturation, significantly reduced BM edema and subchondral fluid volume, and no collapse/fragmentation signs. Discussion: The clinical and imaging significant improvement observed in this patient suggests that BMAC intralesional injections effectively restored the compromised bone structure. After larger studies, this technique can become an alternative to decompressing surgery for ON cases.
Strangulated tension viscerothorax with gangrene of the stomach in missed traumatic diaphragmatic rupture
Authors: Uvie Onakpoya, Akinwumi Ogunrombi, Anthony Adenekan, William Akerele
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Acquired diaphragmatic hernias are usually posttraumatic in occurrence. In patients who have blunt trauma and associated diaphragmatic hernia, the diagnosis may be missed or delayed, often leading to poor treatment outcomes. We present a rare occurrence of tension viscerothorax due to missed traumatic diaphragmatic rupture in a 25-year-old woman whose condition was complicated by gangrene and perforation of the fundus as well as questionable viability of the anterior wall of the body of the stomach. The patient had a successful emergency transabdominal suture plication of the diaphragm and gastroplasty and has remained symptomless 3 months postoperatively.
A Case of Parkinson's Disease with No Lewy Body Pathology due to a Homozygous Exon Deletion in Parkin
Authors: Krisztina Kunszt Johansen, Sverre Helge Torp, Matthew J Farrer, Emil K Gustavsson, Jan O Aasly
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Parkinson's disease (PD) is a clinical diagnosis based on the presence of cardinal motor signs, good response to levodopa, and no other explanations of the syndrome. Earlier diagnostic criteria required autopsy for a definite diagnosis based on neuronal loss in the substantia nigra pars compacta (SNpc) and the presence of Lewy bodies and neurites. Here, we present a patient who developed parkinsonism around the age of 20, with an excellent response to levodopa who, at age 65, received bilateral STN deep brain stimulation (DBS). The patient died at age 79. The autopsy showed severe neuronal loss in the SN without any Lewy bodies in the brainstem or in the hemispheres. Genetic screening revealed a homozygous deletion of exon 3-4 in the Parkin gene. In this case report we discuss earlier described pathological findings in Parkin cases without Lewy body pathology, the current diagnostic criteria for PD, and their clinical relevance.
Case Report: Lifesaving Hemostasis With Resuscitative Endovascular Balloon Occlusion of the Aorta in a Patient With Cardiac Arrest Caused by Upper Gastrointestinal Hemorrhage
Authors: Tomoaki Hashida, Nanami Hata, Akiko Higashi, Yoshito Oka, Shunsuke Otani, Eizo Watanabe
Journal: Front Med (Lausanne) (2021)
Keywords: cardiopulmonary arrest, cardiopulmonary resuscitation, interventional, radiology, shock
MeSH terms: Case Reports

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed to treat hemorrhagic shock, whose cause is located below the diaphragm. However, its use in patients with gastrointestinal hemorrhage is relatively rare. The 45-year-old man with a history of dilated cardiomyopathy had experienced epigastric discomfort and had an episode of presyncope. On his presentation, the patient's blood pressure was 82/64 mmHg, heart rate 140/min, and consciousness level GCS E4V5M6. Hemodynamics stabilized rapidly with a transfusion that was administered on an emergency basis, and a blood sample only showed mild anemia (Hb, 11.5 g/dL). The patient was admitted to investigating the presyncope episode, and the planned endoscopy was scheduled the following day. The patient had an episode of presyncope soon and was found in hemorrhagic shock resulting from a duodenal ulcer rapidly deteriorated to cardiac arrest. Although a spontaneous heartbeat was restored with cardiopulmonary resuscitation, the patient's hemodynamics were unstable despite the emergency blood transfusion administered by pumping. Consequently, a REBOA device was placed, resuscitation was continued, and hemostasis was achieved by vascular embolization for the gastroduodenal artery. The patient was subsequently discharged without complications. However, there is no established evidence regarding the REBOA use in upper gastrointestinal hemorrhage, and the investigations that have been reported have been limited. Further, one recent research suggests that appropriate patient selection and early use may improve survival in these life-threatening cases. As was seen in the present case, REBOA can effectively treat upper gastrointestinal hemorrhage by temporarily stabilizing hemodynamics and enabling a hemostatic procedure to be quickly performed during that time. This report also demonstrated the hemodynamics during the combination of intermittent and partial REBOA to avoid the complications of ischemic or reperfusion injury of the intestines or lower extremities.
Aortic Dissection Case Report
Authors: Chelsea Bunce, Christopher Bryczkowski, Mary Rometti
Journal: J Educ Teach Emerg Med (2023)

Although uncommon, acute aortic dissections are a life-threatening, cannot miss diagnosis for the emergency medicine clinician. Point of care ultrasound can play an integral role in the initial work up of the undifferentiated patient. While not initially utilized to make the diagnosis of aortic dissection, the ultrasound images obtained in this case describe key findings on ultrasound vital for an emergency clinician to recognize. It is essential for emergency medicine clinicians to differentiate an aortic dissection from other causes of chest pain and abdominal pain because the quick mobilization of resources plays a key role in the management and outcome of such patients.
Topics:
Aortic dissection, vascular, dissection flap, back pain, point of care ultrasound, POCUS.
A case report of early diagnosis of asymptomatic hairy cell leukemia using flow cytometry
Authors: James Tadros, Amanda Davis, Oreoluwa Awoleye, Evros Vassiliou
Journal: Front Immunol (2023)
Keywords: b-cell, flow-cytometry, hairy cell leukemia, immunophenotyping, oncology
MeSH terms: Leukemia, Hairy Cell / diagnosis, Leukemia, Hairy Cell / pathology, Case Reports, Antigens, CD, Antigens, CD19, Flow Cytometry, Humans, Immunophenotyping, Antigens, CD, Antigens, CD19

Hairy Cell Leukemia is an infrequent leukemia that can be recognized both microscopically and flow cytometrically once the patient develops symptoms. We present a case where early diagnosis was achieved using flow cytometry long before the patient became symptomatic. This was achieved by focusing on a small percentage (0.9%) of total leukocytes that exhibited a higher side scatter and brighter CD19/CD20 than the remaining lymphocytes. A bone marrow aspirate three weeks later confirmed the presence of malignant B-cells. Shortly after, the patient presented splenomegaly and complained of fatigue.
Nontyphoidal Salmonella septic arthritis of the elbow in a healthy infant
Authors: Abdullah Saleh Al Nafeesah
Journal: Pan Afr Med J (2015)
Keywords: nontyphoidal salmonella, healthy, infant, septic arthritis
MeSH terms: Anti-Bacterial Agents / therapeutic use, Arthritis, Infectious / diagnosis, Elbow Joint / pathology, Salmonella Infections / diagnosis, Case Reports, Anti-Bacterial Agents / administration & dosage, Arthritis, Infectious / microbiology, Arthritis, Infectious / therapy, Cefotaxime / administration & dosage, Cefotaxime / therapeutic use, Ciprofloxacin / administration & dosage, Ciprofloxacin / therapeutic use, Elbow Joint / microbiology, Female, Humans, Infant, Salmonella Infections / microbiology, Salmonella Infections / therapy, Saudi Arabia, Treatment Outcome, Anti-Bacterial Agents, Ciprofloxacin, Cefotaxime

A case of rarely encountered nontyphoidal Salmonella septic arthritis of the elbow in an infant with no preexisting disease is reported. Salmonella etiology was not suspected in this case, and the diagnosis was made only after bacterial isolation. Aspiration of the infected joint with radiological guidance initially failed to give a good clinical response. Arthrotomy was done with intravenous cefotaxime for 4 weeks followed by 2 weeks oral ciprofloxacin therapy to which the child responded favorably. Up to our knowledge this is the first case of nontyphoidal salmonella elbow septic arthritis in an infant in Saudi Arabia to be reported in the English literature.
ALDH Expression in Angiosarcoma of the Lung: A Potential Marker of Aggressiveness?
Authors: Beatrice Aramini, Valentina Masciale, Daniel Bianchi, Beatrice Manfredini, Federico Banchelli, Roberto D'Amico, Federica Bertolini, Massimo Dominici, Uliano Morandi, Antonino Maiorana
Journal: Front Med (Lausanne) (2020)
Keywords: aldehyde dehydrogenase (aldh), angiogenetic process, angiosarcoma, malignant rare lung tumor, malignant vascular tumors, marker, rare tumor, target therapy
MeSH terms: Case Reports

Background: Primary angiosarcoma of the lung is a very aggressive rare malignant disease resulting in a severe prognosis (1). This type of cancer represents about 2% of all soft tissue sarcomas and has a high rate of metastasis through the hematogenous route. For the rarity of this malignant vascular tumor it is still challenging to set a diagnosis (1). The diagnostic features that have thus far been considered include primarily clinical and radiological findings. In some cases, immunohistochemical characteristics based on the most common markers used in pathology have been described. The aim of this report is to present two cases of angiosarcoma of the lung in which the aldehyde dehydrogenase (ALDH) marker was analyzed by immunohistochemistry. Methods: We report two cases of angiosarcoma of the lung in patients underwent lung surgery at our Unit. In addition to the standard histopathological analysis for this disease, immunohistochemistry using an ALDH1A1 antibody was performed in both of the cases. For ALDH quantification, a semi-quantitative method based on the positivity of the tumor cells was used: 0 (<5%), 1 (5-25%), 2 (>25-50%), 3 (>50-75%), 4 (>75%). Results: One patient with recurrent lung disease survived, achieving complete remission after chemo- and radiotherapy. The second patient died of recurrent disease within 5 years of diagnosis. ALDH1A1 was evaluated in both of these cases using an immunohistochemistry scoring system based on the positivity for this marker. The scores were consistent with the patients' clinical outcomes, as the lower (score 1) was observed in the patient with the better clinical outcome, while the higher (score 3) was seen in the patient with the worse outcome. Conclusion: Our data suggest that ALDH may be an important clinical marker in angiosarcoma of the lung. Although further studies need to be performed in a larger cohort of patients, we believe that, if the results will be confirmed, ALDH1A1 may be used to stratify patients in terms of prognosis and for targeted therapy.
Anti-programmed Cell Death Protein-1 Therapy in Intrahepatic Cholangiocarcinoma Induced Type 1 Diabetes: A Case Report and Literature Review
Authors: Zhi-Kai Zheng, Jiong-Liang Wang, Wen-Xuan Li, Tian-Qing Wu, Min-Shan Chen, Zhong-Guo Zhou
Journal: Front Public Health (2022)
Keywords: anti-programmed cell death protein-1, immune checkpoint inhibitors, immune-related adverse events, intrahepatic cholangiocarcinoma, type 1 diabetes
MeSH terms: Bile Duct Neoplasms / complications, Bile Duct Neoplasms / drug therapy, Cholangiocarcinoma / complications, Cholangiocarcinoma / drug therapy, Diabetes Mellitus, Type 1 / complications, Diabetes Mellitus, Type 1 / diagnosis, Insulins / adverse effects, Ketosis / complications, Case Reports, Review, Research Support, Non-U.S. Gov't, Bile Ducts, Intrahepatic, Cell Death, Female, Humans, Middle Aged, Insulins

Immune checkpoint inhibitors, widely used in the treatment of malignancies, can improve the prognosis of patients, while it also can induce various immune-related adverse events, and type 1 diabetes induced by anti-programmed cell death protein-1 is a rare but severe complication. Here we reported a case of type 1 diabetes induced by anti-PD-1 which was to treat intrahepatic cholangiocarcinoma. The case was a 61-year-old female who developed diabetes and ketoacidosis symptoms at the 16th week after anti-PD-1 therapy. Her blood glucose was 30.32 mmol/L, HBA1c was 8.10%, and C-peptide was <0.10 ng/ml. The patient was diagnosed as fulminant type 1 diabetes mellitus complicated with ketoacidosis induced by anti-PD-1, and was treated with massive fluid rehydration, intravenous infusion of insulin and correction of acid-base electrolyte disorder. Hepatectomy was performed after stabilization, and the patient was treated with long-term insulin. Through the case report and literature review, this study aims to improve oncologists' understanding of anti-PD-1 induced type 1 diabetes, so as to make early diagnosis and treatment of the complications and ensure medical safety.
Isolated case of bioterrorism-related inhalational anthrax, New York City, 2001
Authors: Timothy H Holtz, Joel Ackelsberg, Jacob L Kool, Richard Rosselli, Anthony Marfin, Thomas Matte, Sara T Beatrice, Michael B Heller, Dan Hewett, Linda C Moskin, Michel L Bunning, Marcelle Layton
Journal: Emerg Infect Dis (2003)
MeSH terms: Anthrax / epidemiology, Anthrax / etiology, Bioterrorism, Inhalation Exposure, Case Reports, Anthrax / diagnosis, Anthrax / drug therapy, Bacillus anthracis / genetics, Bacillus anthracis / isolation & purification, Ciprofloxacin / pharmacology, DNA, Bacterial / analysis, Disease Outbreaks / statistics & numerical data, Environmental Exposure, Female, Humans, Middle Aged, New York City / epidemiology, Postal Service, Spores, Bacterial / isolation & purification, Women, DNA, Bacterial, Ciprofloxacin

On October 31, 2001, in New York City, a 61-year-old female hospital employee who had acquired inhalational anthrax died after a 6-day illness. To determine sources of exposure and identify additional persons at risk, the New York City Department of Health, Centers for Disease Control and Prevention, and law enforcement authorities conducted an extensive investigation, which included interviewing contacts, examining personal effects, summarizing patient's use of mass transit, conducting active case finding and surveillance near her residence and at her workplace, and collecting samples from co-workers and the environment. We cultured all specimens for Bacillus anthracis. We found no additional cases of cutaneous or inhalational anthrax. The route of exposure remains unknown. All environmental samples were negative for B. anthracis. This first case of inhalational anthrax during the 2001 outbreak with no apparent direct link to contaminated mail emphasizes the need for close coordination between public health and law enforcement agencies during bioterrorism-related investigations.
Chromophore-Assisted Retinal Break Detection to Manage Challenging Situations in Retinal Detachment Redo Surgery
Authors: Antonio Berarducci, Martina Colasante, Antonio Laborante
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Introduction:
The purpose of this case series is to demonstrate that subretinal blue dye injection, with and without 180-degree endolaser retinopexy, can be considered a useful tool in finding occult rhegmatogenous retinal breaks in eyes with recurrent retinal detachment. Case Presentation. Three patients with recurrent retinal detachment were treated between January and March 2018. In all cases, the intraoperative internal search did not demonstrate any obvious break or hole. MembraneBlue-Dual (Trypan Blue 0.15% + Brilliant Blue G 0.025% + 4% PEG) was then injected into the subretinal space using a 41-gauge cannula. The eye was rotated such that the dye was pushed through a tiny break which was causing the retinal detachment. 180-degree laser retinopexy was performed on a single eye. After silicon oil removal and absorption of the gas tamponade, retinas remained attached at three-months follow-up.
Conclusions:
Chromophore-assisted occult retinal break detection can be considered a useful but not risk-free surgical technique in managing some unexpected and challenging intraoperative situations.
A Case of Cerebral Granuloma and Optic Papillitis due to Brucella sp
Authors: A Chiappe-Gonzalez, A Solano-Loza
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

We document a case of a 24-year-old woman who presented with cerebral granuloma and optic papillitis associated to Brucella sp. infection, whose diagnosis was made with a brain biopsy and serology tests, with clinical improvement following specific antibiotic therapy. The patient was followed up for over a year without evidence of relapse.