OpenMed/multicare-articles huggingface dataset:
Rare case-series of electrocautery burn following off-pump coronary artery bypass grafting
Authors: Feridoun Sabzi, Mojtaba Niazi, Alireza Ahmadi
Journal: J Inj Violence Res (2014)
MeSH terms: Blood Loss, Surgical / prevention & control, Burns, Electric / etiology, Burns, Electric / prevention & control, Coronary Artery Bypass, Off-Pump / adverse effects, Coronary Artery Bypass, Off-Pump / methods, Electrocoagulation / adverse effects, Electrocoagulation / methods, Hemostasis, Surgical / adverse effects, Postoperative Hemorrhage / surgery, Case Reports, Hemostasis, Surgical / methods, Humans, Male, Middle Aged, Patient Safety, Treatment Outcome

With an increasing number of off-pump coronary artery surgery procedures in high-risk patients with coagulopathy, including renal failure, hepatic failure and anticoagulant drug-using patients, the frequency of related complications such as repeated exploration for bleeding is also increasing. The associated co-morbidity and repeated use of electrocautery in postoperative bleeding leaves patients susceptible to electrocautery ulcers. In this case series, rare cases of cautery burn with unique causative mechanisms are described.
Bloody semen, severe hypertension and a worried man
Authors: Tamaraemumoemi Emmanuella Ambakederemo, Sotonye Tamunobelema Dodiyi-Manuel, Ikenna Desmond Ebuenyi
Journal: Pan Afr Med J (2015)
Keywords: haematopermia, severe uncontrolled hypertension, worried man
MeSH terms: Antihypertensive Agents / therapeutic use, Hemospermia / etiology, Hypertension / complications, Case Reports, Adult, Humans, Hypertension / drug therapy, Male, Severity of Illness Index, Antihypertensive Agents

Haematospermia is often associated with severe uncontrolled hypertension. The bloody semen is often very worrisome for the patient and his sexual partner(s). In addition to anti-hypertensive, counselling and lifestyle modification are essential for management of the condition.
Management of Cervically Fractured Central Incisors: A Multidisciplinary Approach
Authors: Rakesh R Rajan, Sapna Chandira Muddappa, Priya Rajendran, Ashok Sukumaran Nair
Journal: Open Dent J (2018)
Keywords: alveolar ridge, crown restoration, gingival margin, maxillary anterior teeth, orthodontic extrusion, tooth fracture
MeSH terms: Case Reports

Introduction:
Fracture of tooth structure at or below the gingival margin compromises rehabilitation and hampers esthetics and function.
Management:
Management of such cases by a post-core and crown restoration, or periodontal surgery or orthodontic extrusion alone may not always suffice in attaining a good result.
Case report:
A multi-disciplinary approach which includes all of the above mentioned procedures helps in long term success.
Conclusion:
Careful case evaluation, treatment planning and meticulous attention to detail are the keys to the best treatment outcome.
The conservative treatment of congenital scoliosis with hemivertebra: Report of three cases
Authors: Matteo Caredda, Diletta Bandinelli, Francesco Falciglia, Marco Giordano, Angelo Gabriele Aulisa
Journal: Front Pediatr (2022)
Keywords: bracing, congenital scoliosis (cs), conservative treatment (ct), failure of formation, hemivertebra
MeSH terms: Case Reports

Introduction:
Scoliosis is the most common type of congenital vertebral disease. This spinal disorder may be due to a failure of formation, segmentation, or a combination thereof. Complete failure of formation causes hemivertebra which can lead to unbalanced growth and deformation. Statistically, 25% of congenital curves do not evolve, 25% progress slightly, while the remaining 50% develop quickly and require treatment. Hemivertebrae can be divided into three types: non-segmented, semi-segmented, and fully-segmented. The fully-segmented types are most likely to progress. Hemivertebra in the thoracolumbar region shows higher rates of progression compared with those in the lumbar area. The treatment may be either conservative or surgical. In general, bracing is not recommended in short and rigid curves, although it may help process secondary curves.
Objective:
To assess the effectiveness of bracing in congenital scoliosis due to hemivertebra.
Cases presentation:
Searching in our database, we found three cases of patients with congenital scoliosis due to fully-segmented hemivertebra. The first of them was 6 years old at the time of diagnosis with a fully-segmented hemivertebra in L5, determining an L1-L5 (S1) lumbar curve. The second one was 10 years old at the time of diagnosis with a fully-segmented hemivertebra in L2 and a T11-L4 (L5 sacralized) thoracolumbar curve. The last one was 3 years old at the time of diagnosis with a fully-segmented hemivertebra in L3 (in six lumbar bodies), determining a thoracolumbar curve T12-L4.
Results:
We utilized a Milwaukee brace for the first patient, a Boston brace for the second patient, and a Progressive Action Short Brace (PASB) for the third patient. At the beginning of the treatment, the Cobb angles measured 23°, 53°, and 25°, respectively. During treatment, the Cobb angles measured 22°, 35°, and 15°, respectively. At the end of treatment, the Cobb angles measured 18°, 45°, and 12°, respectively. At long-term follow-up, the curves measured 20°, 45°, and 12° Cobb angles, respectively.
Conclusions:
Comparing our cases with those found in the literature we can confirm the ability of conservative treatment to change the natural history of congenital lumbar scoliosis due to failure of formation. From our experience, in all cases of CS with hemivertebra, before considering a surgical approach, conservative treatment should be implemented as early as possible without waiting for the progressive deformation of the adjacent normal vertebrae.
Centromedian thalamic neuromodulation for the treatment of idiopathic generalized epilepsy
Authors: Andrew J Zillgitt, M Ayman Haykal, Ahmad Chehab, Michael D Staudt
Journal: Front Hum Neurosci (2022)
Keywords: anterior thalamic nucleus, centromedian nucleus, deep brain stimulation, epilepsy, idiopathic generalized epilepsy, responsive neurostimulation
MeSH terms: Review

Idiopathic generalized epilepsy (IGE) is a common type of epilepsy and despite an increase in the number of available anti-seizure medications, approximately 20-30% of people with IGE continue to experience seizures despite adequate medication trials. Unlike focal epilepsy, resective surgery is not a viable treatment option for IGE; however, neuromodulation may be an effective surgical treatment for people with IGE. Thalamic stimulation through deep brain stimulation (DBS) and responsive neurostimulation (RNS) have been explored for the treatment of generalized and focal epilepsies. Although the data regarding DBS and RNS in IGE is limited to case reports and case series, the results of the published studies have been promising. The current manuscript will review the published literature of DBS and RNS within the centromedian nucleus of the thalamus for the treatment of IGE, as well as highlight an illustrative case.
IgA Vasculitis Following COVID-19 Vaccination
Authors: Elvana Rista, Arjana Strakosha, Kristi Saliaj, Florida Ymeri, Majlinda Ikonomi
Journal: Cureus (2023)
Keywords: adult, autoimmunity, covid-19, iga vasculitis, vaccine
MeSH terms: Case Reports

As new variants of SARS-CoV-2 continue to emerge worldwide, countries are striving to fully vaccinate their population in a bid to prevent severe disease, subsequent hospitalizations, and the associated strain on their healthcare systems and death. In this context, there is growing evidence of rare, potential side effects associated with COVID-19 vaccines. IgA vasculitis is a systemic, IgA-mediated vasculitis characterized by palpable purpura, arthralgia, abdominal pain, and renal involvement. It is the most common type of vasculitis in childhood, sporadically affecting the adult population. However, there have been multiple reports of IgA vasculitis following vaccination against COVID-19. Herein, we present the case of a 72-year-old patient with palpable purpura that developed two weeks after receiving the Pfizer BioNTech vaccine. Laboratory investigations revealed elevated serum creatinine (2.6 mg/dL), macroalbuminuria (8.6 g/24 h), and macroscopic hematuria. Histopathological examination confirmed necrotizing vasculitis, and a diagnosis of IgA vasculitis was established. Considering the clinical presentation, the laboratory and histopathological findings, and the time interval between the vaccination and the development of symptoms, we strongly believe that IgA vasculitis in this patient arose as a side effect of the Pfizer BioNTech vaccine.
Robot-assisted Toupet fundoplication and associated cholecystectomy in symptomatic giant hiatal hernia with situs viscerum inversus-A case report and literature review
Authors: Graziano Ceccarelli, Angela Romano, Giuseppe Esposito, Michele De Rosa, Walter Bugiantella, Egidio Miranda, Andrea Fontani, Vito D'Andrea
Journal: Int J Surg Case Rep (2019)
Keywords: cholecystectomy-case report, gastro oesophageal reflux disease, giant hiatal hernia, mesh placement, robotic surgery, situs viscerum inversus, toupet fundoplication

Introduction:
Giant hiatus hernia is defined as migration of >30% of the stomach with or without other intra-abdominal organs into the chest. Situs Viscerum Inversus is a rare congenital condition in which the major visceral organs are reversed from their normal arrangement; they are translated (completely or partially) on the opposite side of the body. Diagnosis is often incidental. We report a Robot-assisted Toupet fundoplication for a giant hiatal hernia with gastro oesophageal reflux disease and cholelithiasis, in a 63-years-old woman with situs viscerum inversus.
Presentation of case:
A 63-year-old woman with Situs Viscerum Inversus was diagnosed with giant sliding hiatus hernia. We performed a Robot-assisted procedure of reduction of hiatal hernia in abdomen and Toupet fundoplication with Bio A mesh placement and gastropexy procedure associated to cholecystectomy. The operation time was of 190min. The patient was discharged on third postoperative day after X-ray check and he tolerated a solid food.
Discussion:
Minimally invasive surgery represents, nowadays, the standard approach for hiatal hernia and cholelithiasis.
Conclusion:
In challenging cases as the giant hernias ad rare anomaly as situs viscerum inversus, the surgical treatment can be facilitated by the use of robotic technology.
A novel pathogenic variant of DNMT3A associated with craniosynostosis: a case report of Heyn-Sproul-Jackson syndrome
Authors: Ga Hye Kim, Jaewon Kim, Jaewoong Lee, Dae-Hyun Jang
Journal: Front Pediatr (2023)
Keywords: dnmt3a, heyn-sproul-jackson syndrome, craniosynostosis, microcephaly, novel variant
MeSH terms: Case Reports

Pathogenic variants of DNMT3A have been implicated in Tatton-Brown-Rahman syndrome, an overgrowth disorder with macrocephaly and intellectual disability. However, there are recent reports of variants in the same gene giving rise to an opposing clinical phenotype presenting with microcephaly, growth failure, and impaired development-named Heyn-Sproul-Jackson syndrome (HESJAS). Here, we present a case of HESJAS caused by a novel pathogenic variant of DNMT3A. A five-year-old girl presented with severe developmental delay. Perinatal and family history were non-contributory. Physical exam showed microcephaly and facial dysmorphic features, and neurodevelopmental assessments revealed profound global developmental delay. Brain magnetic resonance imaging findings were normal; however, brain 3D computed tomography revealed craniosynostosis. Next generation sequencing revealed a novel heterozygous variant in DNMT3A (NM_175629.2: c.1012_1014 + 3del). The patient's parents did not carry the variant. In this report, a novel feature associated with HESJAS (craniosynostosis) is described, along with a more detailed account of clinical manifestations than those in the original report.
Prenatal Diagnosis and Genetic Analysis of a Fetus with Joubert Syndrome
Authors: Jingjing Xiang, Lili Zhang, Wei Jiang, Qin Zhang, Ting Wang, Haibo Li, Hong Li
Journal: Biomed Res Int (2018)
MeSH terms: Abnormalities, Multiple / diagnosis, Cerebellum / abnormalities, Eye Abnormalities / diagnosis, Kidney Diseases, Cystic / diagnosis, Membrane Proteins / genetics, Prenatal Diagnosis, Retina / abnormalities, Case Reports, Abnormalities, Multiple / genetics, Adult, Eye Abnormalities / genetics, Female, Fetus, Humans, Kidney Diseases, Cystic / genetics, Magnetic Resonance Imaging, Pregnancy, CPLANE1 protein, human, Membrane Proteins, Agenesis of Cerebellar Vermis

Objective:
To diagnose and explore the genetic cause of Joubert syndrome (JS) in a fetus.
Methods:
Prenatal ultrasound and magnetic resonance imaging (MRI) examinations were performed, and genetic analysis was conducted using targeted next-generation sequencing (NGS) and Sanger sequencing.
Results:
Prenatal ultrasound and MRI examinations showed cerebellar vermis hypoplasia and molar tooth sign (MTS); hence the fetus was diagnosed with JS. Further genetic analysis revealed a known missense variant (c.3599C>T, p.A1200V) and a novel missense variant (c.3857G>A, p.R1286H) in the C5orf42 gene of the fetus.
Conclusion:
Our study provides insights into prenatal and early diagnosis of JS and expands the variation spectrum of C5orf42 gene.
A Case of Retrograde Treatment of a Ureteral Stone in a Retrocaval Ureter
Authors: Andrea Guttilla, Mario Fiorello, Vittorio Fulcoli, Alessandro Andrisano, Domenico Massari, Giuseppe Costa
Journal: J Endourol Case Rep (2018)
Keywords: retrocaval ureter, ureteral stone, ureteroscopy
MeSH terms: Case Reports

Background: Retrocaval ureter is a rare entity with a reported incidence of ∼1 in 1100 and a 2.8-fold male predominance. The course of the ureter could be classified, using an intravenous urography, as type 1 having S-shaped, fish-hook, or J-shaped retrocaval course or type 2 having sickle-shaped course. No case report describing retrograde endoscopic management of ureteral calculi in the presence of retrocaval ureter could be found in existing literature. We are presenting a case of type I retrocaval ureter with ureteral calculi and nonobstructive drainage, which was effectively managed by flexible ureteroscopy. Case Presentation: A 62-year-old Caucasian man presented with complaints of a renal colic. The patient was positive for a history of noninsulin-dependent diabetes and hypertension. A direct abdomen CT scan showed an 8 mm ureteral stone with suspected retrocaval course of right proximal ureter with no hydronephrosis. After informed consent, ureteroscopy was performed on the patient's right proximal ureter. No complications occurred intraoperatively and postoperatively. On follow-up of up to 3 months, patient was asymptomatic and direct abdomen CT scan showed normal kidney without hydronephrosis. Conclusion: In the presence of retrocaval ureter and associated ureteral calculi with a condition of nonobstructive drainage, retrograde ureteroscopy is a safe and optimal procedure.
Total Hip Arthroplasty for Femoral Neck Fracture after Postoperative Intertrochanteric Fracture in a Patient with Spontaneous Fused Hip
Authors: Saori Niitsu, Shohei Okahisa, Yuki Fujihara, Yu Takeda, Shigeo Fukunishi
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

A 64-year-old woman with a spontaneous fused hip sustained a left femoral neck fracture. It was revealed that her left hip joint had a long-standing spontaneous hip fusion due to end-stage osteoarthritis. Additionally, she sustained an ipsilateral femoral intertrochanteric fracture and underwent osteosynthesis using a dynamic hip screw 8 years ago. The one-stage THA was successfully treated with no major complications and good functional recovery was obtained. The hip range of motion improved remarkably at one year after surgery. The Modified Harris Hip Score improved from an estimated 70 points before fracture to 95 points at final follow-up.
Pediatric Primary Alveolar Soft Part Sarcoma of the Bladder
Authors: Kazuya Tanabe, Shigeru Nakamura, Taiju Hyuga, Shina Kawai, Masahiro Yamazaki, Yohei Kawashima, Rieko Furukawa, Toshiro Niki, Shigeru Ono, Hideo Nakai
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

A 9-year-old girl was diagnosed with primary alveolar soft part sarcoma of the bladder after imaging examinations and transurethral resection (TUR) of the bladder tumor. As a positive surgical margin of the TUR indicated residual tumor cells, we performed a cystourethrectomy to remove the tumor. A continent urinary reservoir for self-catheterization was constructed using the Mainz pouch technique, and an abdominal (umbilical) continent catheterizable stoma using the appendix was performed. For 2.5 years postoperatively, the patient remained free of local recurrence and distant metastasis. The patient's clinical course has been favorable, with good management of clean intermittent self-catheterization.
Case report: Development of vanishing bile duct syndrome in Stevens-Johnson syndrome complicated by hemophagocytic lymphohistiocytosis
Authors: Wan-Chen Lin, Tyng-Shiuan Hsieh, Chia-Yu Chu
Journal: Front Med (Lausanne) (2022)
Keywords: stevens-johnson syndrome, allergy, drug-induced liver injury, hemophagocytic lymphohistiocytosis, non-steroidal anti-inflammatory drugs, vanishing bile duct syndrome
MeSH terms: Case Reports

Background:
Vanishing bile duct syndrome is a rare drug-induced disease characterized by cholestasis and ensuing ductopenia. Dermatological manifestations of drug hypersensitivity such as Stevens-Johnson syndrome and toxic epidermal necrolysis may also present in such cases. Hemophagocytic lymphohistiocytosis is a hyperimmune response caused by unchecked stimulation of macrophages, natural killer cells, and cytotoxic T lymphocytes.
Case presentation:
We report a severe case who presented with concurrent Stevens-Johnson syndrome and vanishing bile duct syndrome complicated by hemophagocytic lymphohistiocytosis after the ingestion of non-steroidal anti-inflammatory drugs. Despite the fact that improvements in vanishing bile duct syndrome can be assumed when combining the clinical lab data clues, as well as repeated liver biopsies showing recovering ductopenia, the patient developed hypovolemic shock combined with septic shock episodes and died on day 236.
Conclusion:
To our knowledge, this is the fifteenth report of vanishing bile duct syndrome associated with Stevens-Johnson disease or toxic epidermal necrolysis. Mortality rate remains high without treatment guidelines established due to the rarity and heterogenicity of the population. Further studies are needed to identify possible risk factors, prognostic indicators, and the standard of care for vanishing bile duct syndrome associated with Stevens-Johnson disease or toxic epidermal necrolysis.
Chronic Type A Aortic Dissection: Rare Presentation of Incidental Pericardial Effusion
Authors: Ashraf Abugroun, Ahmed Subahi, Safwan Gaznabi, Hussein Daoud
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Aortic dissection is the most devastating sequelae of aortopathy other than aortic rupture. However, aortic dissection can be asymptomatic in the acute phase with delayed symptomatic presentation or incidental diagnosis upon chest imaging. We report a case of a 63-year-old male who was diagnosed with pericardial effusion upon preoperative workup for elective cholecystectomy. Further investigations confirmed hemorrhagic pericardial effusion secondary to a chronic dissecting ascending aortic aneurysm. The patient condition was successfully managed with open surgical repair with an uneventful postoperative course. This case demonstrates an extremely rare presentation of incidental hemorrhagic pericardial effusion caused by a chronic dissecting ascending aortic aneurysm.
Suspected ocular toxocariasis and macular heterotopia
Authors: Miriam Rahhal-Ortuño, Luis Alonso-Muñoz, Eduardo Fonseca-Fernández, M S Rahhal
Journal: Rom J Ophthalmol (2020)
Keywords: granuloma, macular heterotopia, ocular toxocariasis
MeSH terms: Eye Infections, Parasitic / diagnosis, Granuloma / diagnosis, Macula Lutea / pathology, Retinal Diseases / diagnosis, Toxocariasis / diagnosis, Case Reports, Eye Infections, Parasitic / parasitology, Fluorescein Angiography, Granuloma / parasitology, Humans, Macula Lutea / parasitology, Male, Middle Aged, Retinal Diseases / parasitology, Tomography, Optical Coherence, Toxocariasis / parasitology, Visual Acuity / physiology

We report a case of an asymptomatic Caucasian male who attended our clinic for a routine check-up and macular heterotopia associated with lesions compatible with ocular toxocariasis were found.
Seven Year Old Male with Tricuspid Endocarditis
Authors: Omar Damji, Russ A Lam, Mark Bromley, Melanie Willimann
Journal: POCUS J (2021)
Keywords: pocus, emergency medicine, pediatric endocarditis
MeSH terms: Case Reports

Pediatric endocarditis, a rare entity in developed countries, remains a challenging diagnosis to make in children. We present an uncommon etiology of shortness of breath on exertion (SOBOE) in a 7-year-old male presenting with two weeks of nocturnal fever, malaise and fatigue following a viral prodrome. Point of care ultrasound (POCUS) led to suspicion for a ventricular septal defect (VSD) with tricuspid valve (TV) endocarditis, which was ultimately confirmed by formal echocardiography. This ultrasound diagnosis allowed emergency clinicians to order blood cultures under the suspicion of endocarditis as well as expedited antibiotic treatment.
Kounis Syndrome Secondary to Laxative Administration
Authors: Mateo Zuluaga-Gómez, Daniel González-Arroyave, Carlos M Ardila
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Kounis syndrome (KS) is defined as an acute coronary syndrome triggered by the release of inflammatory mediators after an allergic attack. It usually occurs secondary to allergic injuries from foods, medications, and insect bites. However, there are no known reports of KS secondary to the intake of laxatives. This article reports the case of a 43-year-old woman who, after ingesting a dose of sodium phosphate monobasic/sodium phosphate dibasic, presented a maculopapular rash on the trunk and extremities. The electrocardiogram showed ST depression in V4-V5-V6 and signs of prolonged QTc; troponin I uptake was positive. Due to presumed myocardial injury and high suspicion of coronary disease, coronary angiography was requested, which showed epicardial coronary arteries, without angiographically significant stenosis, thus confirming the presence of KS secondary to the ingestion of a laxative.
Complement Inhibition in Severe COVID-19 Acute Respiratory Distress Syndrome
Authors: Sharmila Raghunandan, Cassandra D Josephson, Hans Verkerke, W Matthew Linam, Treva C Ingram, Patricia E Zerra, Connie M Arthur, Sean R Stowell, Michael Briones, Satheesh Chonat
Journal: Front Pediatr (2020)
Keywords: covid - 19, sars-cov-2, acute respiratory distress syndrome (ards), children, complement, eculizumab, pediatric
MeSH terms: Case Reports

Most children with COVID-19 have asymptomatic or mild illness. Those who become critically ill suffer from acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI). The rapid deterioration of lung function has been linked to microangiopathic and immune-mediated processes seen in the lungs of adult patients with COVID-19. The role of complement-mediated acute lung injury is supported by animal models of SARS-CoV, evaluation of lung tissue in those who died from COVID-19 and response of COVID-19 ARDS to complement inhibition. We present a summary of a child with COVID-19 disease treated with convalescent plasma and eculizumab and provide a detailed evaluation of the inflammatory pathways.