OpenMed/multicare-articles huggingface dataset:
Danger of Herbal Tea: A Case of Acute Cholestatic Hepatitis Due to Artemisia annua Tea
Authors: Francisco Javier Ruperti-Repilado, Simon Haefliger, Sophia Rehm, Markus Zweier, Katharina M Rentsch, Johannes Blum, Alexander Jetter, Markus Heim, Anne Leuppi-Taegtmeyer, Luigi Terracciano, Christine Bernsmeier
Journal: Front Med (Lausanne) (2019)
Keywords: artemisia annua tea, acute, artemisinin, cholestatic liver disease, drug induced liver injury, herbal and dietary supplement, malaria
MeSH terms: Case Reports

Background: Artemisia annua is a Chinese medicinal herb. Artemisinin-derivatives are recommended as part of a combination treatment for uncomplicated malaria. Herbal and dietary supplements (HDS) are increasingly used worldwide and HDS-induced liver injury is becoming a growing concern. Case Report: We present the first case of severe acute cholestatic hepatitis due to the intake of Artemisia annua tea as chemoprophylaxis for malaria in a patient returning from Ethiopia. The patients presented with jaundice, elevated transaminases, and parameters of cholestasis (total bilirubin 186.6 μmol/L, conjugated bilirubin 168.5 μmol/L). A liver biopsy showed a portal hepatitis with lymphocytic infiltration of the bile ducts and diffuse intra-canalicular and intra-cytoplasmic bilirubinostasis. The toxicologic analysis of the Artemisia tea revealed the ingredients arteannuin b, deoxyartemisin, campher, and scopoletin. There were no other identifiable etiologies of liver disease. The Roussel Uclaf Causality Assessment Method (RUCAM) score assessed a "probably" causal relationship. Sequencing of genes encoding for hepatic transporters for bile acid homeostasis (BSEP, MDR3, and FIC1) found no genetic variants typically associated with hereditary cholestasis syndromes. Normalization of bilirubin occurred 3 months after the onset of disease. Conclusion: The use of artemisinin-derivatives for malaria prevention is ineffective and potentially harmful and should thus be discouraged. Moreover, the case demonstrates our as yet inadequate understanding of the pathophysiology and susceptibility to HDS induced liver injury.
A Malignant Squeeze: A Rare Cause of Cardiac Tamponade
Authors: Elisa Quiroz, Adam Hafeez, Ramy Mando, Zhou Yu, Feroze Momin
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Primary cardiac lymphoma (PCL) is a rare condition described as a lymphoma localized to the heart or pericardium. Although cardiac involvement is seen in 10-20% of non-Hodgkin's lymphomas, PCL is extremely rare. It comprises merely 0.5% of all lymphomas and 1.3-2% of cardiac malignancies. Early detection is essential to avoid potentially fatal complications, and prognosis is highly dependent on the management of cardiac complications. The etiology of PCL is still unknown, and molecular characterization has yet to be studied leaving a great deal of research to be done in order to gain a better understanding of this rare disease process. We discuss the case of an 85-year-old female presenting with dyspnea and chest pain. Computed tomography of the chest revealed a pericardial effusion, and subsequent echocardiogram demonstrated a large circumferential effusion. She underwent emergent pericardiocentesis. Morphologic and immunophenotypic features were consistent with high-grade B-cell lymphoma with t(8; 14), and the patient was started on rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) with excellent response.
Median Nerve Entrapment after Supracondylar Humeral Fracture in a Young Child
Authors: C Granier, E Maury, B Coulet, M Delpont, J Cottalorda, C Sleth, R Carré, D Louahem
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Median nerve entrapment after supracondylar humeral fracture in children is rare. We report a case of Gartland type III supracondylar humeral fracture complicated by an entrapment of the median nerve following closed reduction and percutaneous pinning in a 5-year-old child. The diagnosis of entrapment was made 14 months post injury following progressive motor and sensory palsy. Resection and end-to-end suture were performed, leading to complete sensory and motor recovery eight months later. This nerve complication is often unnoticed and should be suspected systematically before and after reduction of all displaced supracondylar humeral fracture in children. The indication of resection-suture or nerve graft depends on the entrapment and the delay of the palsy.
The Potential Malignancy of a Solitary Fibrous Tumour of the Lung
Authors: Rajeev Shukla, Davide Patrini, Elaine Borg, David Lawrence, Martin Hayward, Nikolaos Panagiotopoulos
Journal: Case Rep Pathol (2015)

Solitary fibrous tumours (SFTs) are rare neoplasms that in the majority of cases are benign. We present the case of a 52-year-old male, with a 23-year history of a slow growing pleural mass, presenting to our department with worsening dyspnoea and localised chest discomfort. The purpose of this case report is to highlight the potential malignancy of a solitary fibrous tumour of the lung along with the key features in diagnosis and management.
Primary intimal (spindle cell) sarcoma of the heart: a case report and review of the literature
Authors: A Ibrahim, A Luk, P Singhal, Bo Wan, A Zavodni, R J Cusimano, J Butany
Journal: Case Rep Med (2013)

Intimal (spindle cell) sarcomas of the left atrium are extremely rare primary cardiac tumours with three cases reported (Li et al. (2013), Cho et al. (2006), and Modi et al. (2009)). We present a 69-year-old man who first came to medical attention after experiencing abdominal discomfort. He had a 30 lb weight loss apparently due to dieting. He denied any other constitutional symptoms. His symptoms persisted despite a course of antibiotics for presumed diverticulitis. Laboratory values were within normal limits, though the haemoglobin was 131 g/L (normal: 140-180). Subsequent abdominal computed tomography (CT) scan revealed an abdominal wall mass and intracardiac lesion; the cardiac mass was further characterized by transesophageal echo (TEE), magnetic resonance imaging (MRI), and dedicated cardiac CT. TEE revealed a mass attached to the posterolateral wall of the left atrium above the mitral annulus, and the cardiac CT and MRI confirmed the TEE findings. The patient underwent extensive surgical resection and repair of the left side of the heart. Postoperatively, he developed acute renal failure requiring dialysis and reintubation for volume overload. He became acutely hypotensive, developed multiorgan failure, and succumbed to his illness. Histopathologic examination of the left atrial mass showed an intimal sarcoma.
Factor XIII deficiency in a neonate presenting as subpial haemorrhage
Authors: Monish G Karthikeyan, Poojitha Ronda, Prabhu C Sugumaran
Journal: SA J Radiol (2022)
Keywords: ct, mri, intracranial haemorrhage, subpial haemorrhage, term neonate, yin-yang sign factor xiii
MeSH terms: Case Reports

Subpial haemorrhage is a rare cause of seizures in term neonates. A 3-day-old male infant, born at term with no history of perinatal hypoxia, presented with seizures and unremarkable physical examination in the interictal state. Imaging demonstrated left temporal subpial haemorrhage with the classic 'yin-yang sign' on MRI. The patient was subsequently diagnosed with factor XIII deficiency. Follow-up at 6 months and 12 months revealed encephalomalacia in the previous haemorrhagic areas with normal developmental milestones.
Adapting an evidence-based intervention for autism spectrum disorder for scaling up in resource-constrained settings: the development of the PASS intervention in South Asia
Authors: Gauri Divan, Syed Usman Hamdani, Vivek Vajartkar, Ayesha Minhas, Carol Taylor, Catherine Aldred, Kathy Leadbitter, Atif Rahman, Jonathan Green, Vikram Patel
Journal: Glob Health Action (2015)
Keywords: adaptation, autism spectrum disorder, intervention, low-resource setting, task-sharing
MeSH terms: Autism Spectrum Disorder / therapy, Communication, Developing Countries, Health Education / organization & administration, Parents, Adolescent, Autism Spectrum Disorder / psychology, Child, Child, Preschool, Evidence-Based Emergency Medicine, Family Relations, Female, Global Health, Humans, India, Male, Pakistan, Play and Playthings

Background:
Evidence-based interventions for autism spectrum disorders evaluated in high-income countries typically require highly specialised manpower, which is a scarce resource in most low- and middle-income settings. This resource limitation results in most children not having access to evidence-based interventions.
Objective:
This paper reports on the systematic adaptation of an evidence-based intervention, the Preschool Autism Communication Therapy (PACT) evaluated in a large trial in the United Kingdom for delivery in a low-resource setting through the process of task-shifting.
Design:
The adaptation process used the Medical Research Council framework for the development and adaptation of complex interventions, focusing on qualitative methods and case series and was conducted simultaneously in India and Pakistan.
Results:
The original intervention delivered by speech and language therapists in a high-resource setting required adaptation in some aspects of its content and delivery to enhance contextual acceptability and to enable the intervention to be delivered by non-specialists.
Conclusions:
The resulting intervention, the Parent-mediated intervention for Autism Spectrum Disorder in South Asia (PASS), shares the core theoretical foundations of the original PACT but is adapted in several respects to enhance its acceptability, feasibility, and scalability in low-resource settings.
Superior vena cava obstruction post laparoscopic cholecystectomy: A case report
Authors: Simbarashe Gift Mungazi, Rudo Gwini, Munyaradzi S Magara
Journal: Clin Case Rep (2018)
Keywords: anticoagulation, laparoscopic cholecystectomy, superior vena cava obstruction, thrombosis
MeSH terms: Case Reports

Clinicians should have a high index of suspicion of superior vena cava obstruction in a patient presenting with painful lateral neck and ipsilateral chest swelling post laparoscopic procedures. High doses of Clexane can be used as a substitute for thrombolytic therapy where it is contraindicated.
Case report: Stem cell-based suicide gene therapy mediated by the herpes simplex virus thymidine kinase gene reduces tumor progression in multifocal glioblastoma
Authors: Saeed Oraee-Yazdani, Mohammadhosein Akhlaghpasand, Fatemeh Rostami, Maryam Golmohammadi, Roozbeh Tavanaei, Gelareh Shokri, Maryam Hafizi, Maryam Oraee-Yazdani, Ali-Reza Zali, Masoud Soleimani
Journal: Front Neurol (2023)
Keywords: hsv thymidine kinase, cell and gene therapies, multifocal glioblastoma, stem cell gene therapy, suicide gene therapy (sgt)
MeSH terms: Case Reports

Introduction:
The prognosis for glioblastoma multiforme (GBM), a malignant brain tumor, is poor despite recent advancements in treatments. Suicide gene therapy is a therapeutic strategy for cancer that requires a gene to encode a prodrug-activating enzyme which is then transduced into a vector, such as mesenchymal stem cells (MSCs). The vector is then injected into the tumor tissue and exerts its antitumor effects.
Case presentation:
A 37-year-old man presented to our department with two evident foci of glioblastoma multiforme at the left frontal and left parietal lobes. The patient received an injection of bone marrow-derived MSCs delivering the herpes simplex virus thymidine kinase (HSV-tk) gene to the frontal focus of the tumor, followed by ganciclovir administration as a prodrug for 14 days. For follow-up, the patient was periodically assessed using magnetic resonance imaging (MRI). The growth and recurrence patterns of the foci were assessed. After the injection on 09 February 2019, the patient's follow-up appointment on 19 December 2019 MRI revealed a recurrence of parietal focus. However, the frontal focus had a slight and unremarkable enhancement. On the last follow-up (18 March 2020), the left frontal focus had no prominent recurrence; however, the size of the left parietal focus increased and extended to the contralateral hemisphere through the corpus callosum. Eventually, the patient passed away on 16 July 2020 (progression-free survival (PFS) = 293 days, overall survival (OS) = 513 days).
Conclusion:
The gliomatous focus (frontal) treated with bone marrow-derived MSCs carrying the HSV-TK gene had a different pattern of growth and recurrence compared with the non-treated one (parietal).
Trial registration:
IRCT20200502047277N2. Registered 10 May 2020-Retrospectively registered, https://eng.irct.ir/trial/48110.
Pedicled anterolateral thigh flap: A versatile flap for complex regional defect reconstruction
Authors: Jiten Kumar Mishra, Shamendra Anand Sahu, Moumita De, Aparajita Saha
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2023)
Keywords: alt flap, fournier’s gangrene, pedicled alt flap, perineum, thigh

Objectives:
Soft-tissue defects of the lower abdomen, perineum, groin, and trochanteric area often involve the loss of composite tissue components and are technically challenging to reconstruct. The goals of reconstruction should include the replacement of the defect with a suitable soft-tissue flap that provides stable coverage while protecting important exposed structures. However, there are limited locations in this region for the creation of pedicled flaps for complex defect reconstruction. The pedicled anterolateral thigh (ALT) flap is considered superior to other comparable flaps due to its varying soft-tissue components and long pedicle with consistent anatomy that allow the reconstruction of locations that are difficult to reach without significant flap donor site morbidity. Herein, we present a case series of our experience of using a pedicled ALT flap to reconstruct regional defects over a range of locations.
Methods:
The present study comprised ten patients who underwent surgical reconstruction of soft-tissue defects of the lower abdomen, groin, trochanteric, scrotal, and penoscrotal defects using a pedicled ALT flap over a two-year period. The flap was customized according to the defect when required.
Results:
In our case series, flap loss was not observed with only a few minor complications. All patients accepted the aesthetic appearance of the flap recipient site area without requesting revision surgery. The donor site was closed primarily in half of all cases, with split skin grafting applied in the remaining patients. Graft take at the flap donor site was satisfactory in all cases.
Conclusion:
A pedicled ALT flap is a reliable and suitable option for complex soft-tissue reconstruction for regional soft-tissue defects of the lower abdomen and perineum.
Urethral hairballs as a long-term complication of hypospadias repair: two case reports
Authors: Spyridon Kampantais, Charalampos Dimitriadis, Leonidas Laskaridis, Ioannis Perdikis, Petros Kirtsis, Chrysovalantis Toutziaris
Journal: Case Rep Urol (2012)

Many times hair-bearing urethral grafts have been used inadvertently in the treatment of hypospadias. This can be accompanied with numerous troublesome long-term complications such as formation of stones, diverticula, and hairballs. We report two cases of men with a history of hypospadias repair being affected by such complications. We also discuss about their management and the effect of thioglycolic acid instillation to stop hair growth in the urethra mucosa in the second case.
Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome
Authors: Guohui Jiao, Xiangnan Li, Bo Wu, Hang Yang, Guoqing Zhang, Zheng Ding, Gaofeng Zhao, Jingyu Chen
Journal: Front Surg (2021)
Keywords: ecmo, hemopurification, herbicide, lung transplantation, pulmonary fibrosis
MeSH terms: Case Reports

Background: Lung transplantation is recognized as the only therapeutic option for patients who develop irreversible pulmonary fibrosis after herbicide intoxication. Methods: We have collected and presented clinical course and outcome of four patients who received lung transplantation due to paraquat and diquat intoxication from 2018 to 2021. Another patient who received initial lung transplantation due to paraquat intoxication and re-transplantation due to chronic lung allograft dysfunction in 2019, was further reported. Patients were admitted in lung transplantation centers, including the 1st affiliated hospital of Zhengzhou University and Wuxi Lung transplantation center. Previous reported cases from Europe, Canada and China were also summarized as benchmark. Results: During the period from the year of 2018 to 2021, there have been four patients in China, who received lung transplantation due to herbicide intoxication. Median age of the four patients was 37 (IQR 34.5, 39.75) years old. Median time from intoxication to lung transplantation was 27.5 (IQR 27, 30.5) days. Bilateral lung transplantation was performed in three patients, while one single lung transplantation was performed in an urgent listed patient. Extracorporeal Membrane Oxygenation (ECMO) and hemopurification support were used in all patients (100%). Details of the cases with follow-ups were further presented and analyzed. Conclusions: Late timing of bilateral lung transplantation can be performed successfully for pulmonary fibrosis after paraquat or diquat intoxication. The survival of patients with complex perioperative conditions can be achieved with a multidisciplinary team to manage the irreversible effects of intoxication.
Monosomy chromosome 21 compensated by 21q22.11q22.3 duplication in a case with small size and minor anomalies
Authors: Meng Su, Paul J Benke, Guney Bademci, Filiz Basak Cengiz, Xiaomei Ouyang, Jinghong Peng, Carmen E Casas, Mustafa Tekin, Yao-Shan Fan
Journal: Mol Cytogenet (2018)
Keywords: chromosome 21, deletion, duplication, partial monosomy, partial uniparental disomy
MeSH terms: Case Reports

Background:
Partial monosomy 21 is a rare finding with variable sizes and deletion breakpoints, presenting with a broad spectrum of phenotypes.
Case presentation:
We report a 10-month-old boy with short stature, minor anomalies and mild motor delay. The patient had a monosomy 21 and duplication of the 21q22.11q22.3 region on the remaining derivative chromosome 21 which represents a partial 21q uniparental disomy of paternal origin, upd(21q22.11q22.3)pat. The abnormalities were characterized by karyotyping, FISH, chromosomal microarray, and genotyping.
Conclusions:
This is the first case showing a monosomy 21 compensated by upd(21q22.11q22.3) as a mechanism of genomic rescue. Because there is no strong evidence showing imprinting on chromosome 21, the uniparental disomy itself is not associated with abnormal phenotype but has reduced phenotype severity of monosomy 21. We reviewed the previously published cases with isolated 21q deletions and identified a common deletion of 5.7 Mb associated with low birth weight, length and head circumference in the 21q21.2 region.
High-Dose Dexmedetomidine for Severe Hyperactive Delirium Secondary to Intravenous Levetiracetam on Two Separate Occasions in the Same Patient
Authors: Chad Ward, Kiran Khalid, Nicole Rozette
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

We describe the case of a 5-year-old male who developed severe hyperactive delirium with aggressive violent behavior following the administration of IV levetiracetam for the treatment of status epilepticus on two occasions. The child's symptoms ranged from attacking his parents and the intensive care staff. Risperidone was given without any improvement in symptoms. A high-dose continuous infusion of IV dexmedetomidine was administered, and his violent behavior and delirium significantly improved. The two episodes of hyperactive delirium following IV levetiracetam administration occurred at ages 3 and 5, resulting in extensive work up including laboratory testing and cranial imaging, along with cerebral spinal fluid analysis and were normal. IV dexmedetomidine provided rapid symptom relief to prevent harm for the child, staff, and family on both occasions.
Severe ischemic complications in Covid-19-A case series
Authors: Eisa Lari, Ali Lari, Shamlan AlQinai, Mahdi Abdulrasoul, Salman AlSafran, Ahmad Ameer, Salman Al-Sabah
Journal: Int J Surg Case Rep (2020)
Keywords: acute limb ischaemia, covid-19, revascularisation, thrombosis

Introduction:
Covid-19 has the propensity to result in a wide array of manifestations. Recently, thromboembolic complications of Covid-19 have been denoted in literature. We report 5 cases of Covid-19 positive patients with no significant comorbidities who developed 1st time episodes of either; acute limb ischemia or bowel ischemia.
Material and methods:
This is a retrospective observational study analyzing the clinical characteristics and outcomes of five Covid-19 positive patients. Five patients aged 38-60 presented to our institution from 1st April to 1st June and were diagnosed with Covid-19 pneumonia, subsequently developing severe vascular complications. None of our patients included had any history of thromboembolism nor risk factors that could justify the presentations.
Presentation of cases:
Patient 1; presented with bowel ischemia as a first presentation. Patient 2 and 3 developed unsalvageable lower limb ischemia secondary to partial to complete occlusion of infra-renal aorta. Patient 4 presented with acute upper limb ischemia due to complete occlusion of the axillary and brachial artery. Patient 5 developed bilateral lower limb unsalvageable ischemia secondary to aortic bifurcation occlusion. All patients tested Covid-19 positive upon admission, and received standard care.
Discussion and conclusion:
The thromboembolic complications seen in our cases were devastating and resulted in significant mortality and morbidity. All vessels affected were medium-large vessels. None of our cases had any significant predisposing medical conditions or history of thromboembolic or ischemic events. A high index of suspicion is necessary when evaluating such patients regardless of thromboembolic history. Appropriate anticoagulation regimens are essential. Our cases add to the currently increasing severe thromboembolic complications of Covid-19.