OpenMed/multicare-articles huggingface dataset:
Anaphylaxis in a 4-year-old male caused by contact with grasses: a case report
Authors: Germán Darío Ramón, Victor H Croce, Iván Chérrez Ojeda
Journal: World Allergy Organ J (2017)
Keywords: anaphylaxis, emergency department, grasses, sensitization, urticaria
MeSH terms: Case Reports

Background:
Acute urticaria is the presence of urticaria for <6 weeks, and it is the most common type of urticaria in children. Sometimes, it may be associated with anaphylaxis, a life-threatening condition. Urticaria must be differentiated from anaphylaxis because the latter may require emergency treatment. We describe a child with anaphylaxis exposed to grasses on two occasions.
Case presentation:
We described a 4-year-old male child with anaphylaxis exposed to grasses. Patient also suffered mild neurologic/respiratory symptoms but it is unlikely that he had anaphylaxis. Skin-prick tests were positive to Cynodon dactylis, Phalaris arundinacea and Festuca elatior. Little is known about the importance of pollens as a cause of urticaria in young children.
Conclusions:
The case reported here is particularly interesting because, to the best of our knowledge, anaphylaxis due to pollen exposure in children aged <4 years has not been reported before. We strongly encourage all physicians searching for the cause of acute urticaria (allergists, dermatologists, primary-care physicians) to consider the possibility of pollen allergy, and to screen these patients for pollen sensitization.
Concomitant optic nerve transection and chorioretinitis sclopetaria
Authors: Mehrdad Mohammadpour, Masoud Soheilian
Journal: BMC Ophthalmol (2005)
MeSH terms: Chorioretinitis / etiology, Optic Nerve Injuries / etiology, Wounds, Gunshot / complications, Case Reports, Child, Cicatrix / etiology, Cicatrix / pathology, Fundus Oculi, Humans, Male, Optic Nerve Injuries / diagnostic imaging, Orbit / diagnostic imaging, Pupil Disorders / etiology, Tomography, X-Ray Computed, Vision Disorders / etiology, Wounds, Gunshot / diagnostic imaging

Background:
Optic nerve transection and chorioretinitis sclopetaria may occur following blunt ocular trauma. However, simultaneous occurrence has not yet been reported. We report the first case of concomitant optic nerve transection and chorioretinitis sclopetaria.
Case presentation:
A 12-year-old boy with history of BB gun injury to his right eye was referred for loss of vision. His visual acuity was counting fingers at one meter in the right eye and with 3+ relative afferent pupillary defect (RAPD). On slit lamp examination, the right eye appeared normal except for 1+ vitreous reaction. Fundus examination of the right eye revealed a pale disc with superior retinal scar and diffuse submacular fibrosis compatible with chorioretinitis sclopetaria. Orbital CT-scans showed transection of the optic nerve by the BB gun pellet, which was lodged at the orbital apex.
Conclusion:
BB gun injury may cause concomitant optic nerve transection and chorioretinitis sclopetaria.
Inoculation site from a cutaneous melanoma patient treated with an allogeneic therapeutic vaccine: a case report
Authors: Mariana Aris, Alicia Inés Bravo, María Marcela Barrio, José Mordoh
Journal: Front Immunol (2015)
Keywords: allogeneic therapeutic cell vaccine, cutaneous melanoma, local ag presentation, local injection reaction site, vaccination site biopsy immune profiling

We have developed a therapeutic vaccine consisting of a mixture of lethally-irradiated allogeneic cutaneous melanoma cell lines with BCG and GM-CSF as adjuvants. The CSF-470 vaccine is currently being assayed in a Phase II-III trial against medium-dose IFN-α2b. All vaccinated patients immunized intradermally developed large edematous erythema reactions, which then transformed into subcutaneous nodules active for several months. However, vaccine injection sites were not routinely biopsied. We describe the case of a female patient, previously classified as stage III, but who, due to the simultaneous discovery of bone metastases only received one vaccination was withdrawn from the study, and continued her treatment elsewhere. This patient developed a post-vaccination nodule which was surgically removed 7 weeks later, and allowed to analyze the reactivity and immune profiling of the inoculation site. An inflammatory reaction with zones of fibrosis, high irrigation, and brisk lymphoid infiltration, primarily composed of CD8(+) and CD20(+) lymphocytes, was observed. There were no remaining BCG bacilli, and scarce CD4(+) and Foxp3(+) T cells were determined. MART-1 Ag was found throughout the vaccination site. CD11c(+) Ag presenting cells were either dispersed or forming dense nests. Some CD11c(+) cells proliferated; most of them contained intracellular MART-1 Ag, and some interacted with CD8(+) lymphocytes. These observations suggest a potent, long-lasting local inflammatory response with recruitment of Ag-presenting cells that incorporate melanoma Ags, probably leading to Ag presentation to naïve T cells.
Ongoing complete response after treatment cessation with dabrafenib, trametinib, and cetuximab as third-line treatment in a patient with advanced BRAFV600E mutated, microsatellite-stable colon cancer: A case report and literature review
Authors: Gudrun Piringer, Jörn Decker, Vera Trommet, Thomas Kühr, Sonja Heibl, Konrad Dörfler, Josef Thaler
Journal: Front Oncol (2023)
Keywords: braf-v600 mutation, mss, combination targeted therapy, dabrafenib, trametinib
MeSH terms: Case Reports

Metastatic BRAFV600E mutated colorectal cancer is associated with poor overall survival and modest effectiveness to standard therapies. Furthermore, survival is influenced by the microsatellite status. Patients with microsatellite-stable and BRAFV600E mutated colorectal cancer have the worst prognosis under the wide range of genetic subgroups in colorectal cancer. Herein, we present a patient case of an impressive therapeutic efficacy of dabrafenib, trametinib, and cetuximab as later-line therapy in a 52-year-old woman with advanced BRAFV600E mutated, microsatellite-stable colon cancer. This patient achieved a complete response after 1 year of triple therapy. Due to skin toxicity grade 3 and recurrent urinary tract infections due to mucosal toxicity, a therapy de-escalation to dabrafenib and trametinib was performed, and the double therapy was administered for further 41 months with ongoing complete response. For 1 year, the patient was off therapy and is still in complete remission.
A Case Series of Pediatric Intestinal Ganglioneuromatosis With Novel Phenotypic and Genotypic Profile
Authors: Yuan Fang, Ye Zhang, Rui Dong, Yi-Zhen Wang, Lian Chen, Gong Chen
Journal: Front Med (Lausanne) (2022)
Keywords: case series, intestinal ganglioneuromatosis, juvenile polyps, mutation, pseudomembranous enteritis

Introduction:
Intestinal ganglioneuromatosis (IGN) is a rare condition with enteric involvement. Herein, we report a case series of pediatric IGN with a novel phenotypic and genotypic profile.
Methods:
The clinical presentation, histopathology, immunochemistry, molecular features, treatment, and prognosis of 3 cases of IGN were assessed.
Results:
The cases involved 3 boys with an age range of 1 year and 4 months to 8 years, mimicking juvenile polyps or pseudomembranous enteritis. One patient carried a novel germline mutation in RTEL1 (c.296C > T/p.Pro99Leu) along with variants in F11 (c.1489C > T/p.Arg497Xaa), NBAS (c.1514delC/p.Pro505Hisfs*15), and FECH (c.315-48T > C/splicing), who died due to intractable inflammation. The other two patients underwent recurrence without significant signs of systemic syndrome or malignant progression.
Conclusion:
This case series added to the phenotypic and genotypic spectrum of pediatric IGN, which requires the accumulation of more cases and research for in-depth understanding.
Entirely thoracoscopic resection of a giant emphysematous bulla
Authors: Agustín Buero, Walter Sebastian Nardi, Gustavo Alejandro Lyons, Silvia Quadrelli, Domingo Javier Chimondeguy
Journal: Pan Afr Med J (2018)
Keywords: vats, bullectomy, giant bulla
MeSH terms: Blister / surgery, Pulmonary Emphysema / surgery, Thoracoscopy / methods, Case Reports, Adult, Blister / diagnostic imaging, Humans, Male, Pulmonary Emphysema / diagnostic imaging, Tomography, X-Ray Computed, Treatment Outcome

A 38-year-old man with longilinear shape, smoker (38 packs/year) and no other relevant medical history was referred to our department due to the finding of left pulmonary hyperlucency on a chest x-ray. A computed tomography (CT) was performed and a giant emphysematous bulla with thin-walled partitions inside was shown that replaced almost the entire left upper lobe, The patient underwent an exploratory thoracoscopy. Intraoperatively a giant bulla was seen that initially impressed to replace the entire upper lobe. Despite the large size we decided to attempt thoracoscopic resection preserving the remaining healthy parenchyma. Bullectomy was done using linear endoscopic stapling devices. To our knowledge this is the only case with such a large bulla resected entirely by VATS.
Experience on the management of the first imported Ebola virus disease case in Senegal
Authors: Bousso Abdoulaye, Seydi Moussa, Ka Daye, Badiane Seydou Boubakar, Sarr Samba Cor, Talla Idrissa, Ndiaye El Hadj Mamadou, Ba Ibrahima Oumar, Ndour Cheikh Tidiane, Ly Mamadou Selly, Diop Cheikh Tacko, Diack Papa Amadou, Loume Mandiaye, Diouf Mbaye, Coll-Seck Awa Marie
Journal: Pan Afr Med J (2015)
Keywords: ebola, senegal, imported case, managment
MeSH terms: Contact Tracing, Delivery of Health Care / organization & administration, Hemorrhagic Fever, Ebola / therapy, Travel, Case Reports, Communication, Guinea / epidemiology, Hemorrhagic Fever, Ebola / epidemiology, Humans, Male, Senegal / epidemiology, Young Adult

The Ebola virus disease, as a first epidemic in West Africa, stands as the most deadly one throughout history. Guinea, the source of the epidemic, Sierra Leone and Liberia remain the most strongly affected. That epidemic thoroughly destabilized the health system of those countries. Following Nigeria, Senegal received its first imported case from the neighboring Republic of Guinea. In that sub regional psychotic context, such a situation has been handled and managed starting from the potential of a health system that is already suitably structured. The organization of the response, the management of the communication system and the rigorous monitoring of contacts have been decisive in the control of the epidemic. Our countries have to be prepared in order to face health threats, and that is the reason why the need to empower our health systems is important.
Why evolution matters for species conservation: perspectives from three case studies of plant metapopulations
Authors: Isabelle Olivieri, Jeanne Tonnabel, Ophélie Ronce, Agnès Mignot
Journal: Evol Appl (2015)
Keywords: conservation genetics, contemporary evolution, dispersal, management, mating systems, natural selection, phylogenetics
MeSH terms: Review

We advocate the advantage of an evolutionary approach to conservation biology that considers evolutionary history at various levels of biological organization. We review work on three separate plant taxa, spanning from one to multiple decades, illustrating extremes in metapopulation functioning. We show how the rare endemics Centaurea corymbosa (Clape Massif, France) and Brassica insularis in Corsica (France) may be caught in an evolutionary trap: disruption of metapopulation functioning due to lack of colonization of new sites may have counterselected traits such as dispersal ability or self-compatibility, making these species particularly vulnerable to any disturbance. The third case study concerns the evolution of life history strategies in the highly diverse genus Leucadendron of the South African fynbos. There, fire disturbance and the recolonization phase after fires are so integral to the functioning of populations that recruitment of new individuals is conditioned by fire. We show how past adaptation to different fire regimes and climatic constraints make species with different life history syndromes more or less vulnerable to global changes. These different case studies suggest that management strategies should promote evolutionary potential and evolutionary processes to better protect extant biodiversity and biodiversification.
Autoimmune hypophysitis and viral infection in a pregnant woman: a challengeable case
Authors: Kais Benabderrahim
Journal: Pan Afr Med J (2020)
Keywords: autoimmune hypophysitis, pregnancy, viral infection
MeSH terms: Autoimmune Hypophysitis / diagnosis, Pregnancy Complications / diagnosis, Virus Diseases / complications, Case Reports, Adrenal Cortex Hormones / administration & dosage, Adult, Antiviral Agents / administration & dosage, Autoimmune Hypophysitis / drug therapy, Autoimmune Hypophysitis / virology, Female, Humans, Magnetic Resonance Imaging, Pregnancy, Pregnancy Complications / drug therapy, Pregnancy Complications / virology, Virus Diseases / diagnosis, Virus Diseases / drug therapy, Adrenal Cortex Hormones, Antiviral Agents

The aim of this study is to report a challengeable and rare case of autoimmune hypophysitis possibly induced by viral infections. A young pregnant female developed optic neuropathy due to enlarged sellar mass responsible for hypopituitarism. Investigations exclude neoplasia and systemic diseases. High level of sedimentation rate and magnetic resonance imaging (MRI) findings supported the diagnosis of autoimmune hypophysitis. The patient reported a history of bronchitis treated with antibiotics and corticosteroids and positive serologies for hepatitis B antigen (Hbs antigen), herpes simplex 1 and rubella. Final examination showed complete recovery of visual function and sellar archnoidocele after antiviral treatment and mild dose of corticosteroids.
Two cases of late-diagnosed ovotesticular disorder of sex development
Authors: Eiji Hisamatsu, Yoshikiyo Nakagawa, Yoshifumi Sugita
Journal: APSP J Case Rep (2013)
Keywords: disorder of sex development, hypospadias, ovotestis
MeSH terms: Case Reports

Ovotesticular disorder of sex development (ovotesticular DSD) is defined as the presence of testicular and ovarian tissue in the same individual. Both external and internal genitalia of patients with ovotesticular DSD display a spectrum of phenotypes. Most children present with ambiguous genitalia in combination with unilateral or bilateral undescended gonads. We experienced two late-diagnosed children who presented with proximal hypospadias and bilateral scrotal gonads. One should consider the possibility of ovotesticular DSD when managing patients with proximal hypospadias even if both gonads are palpable in the scrotum.
Aortic valve chordae tendineae: A rare cause of aortic stenosis
Authors: Cara E Saxon, Tessa S S Genders, Robert A Quaife, S James Chen, Joseph M Burke, Erin M McGuinn
Journal: Radiol Case Rep (2022)
Keywords: aortic stenosis, aortic valve, cabg, coronary artery bypass graft, chordae tendineae, fibrous strand, lvef, left ventricular ejection fraction, lvot, left ventricular outflow tract, tee, transesophageal echocardiogram, tte, transthoracic echocardiogram
MeSH terms: Case Reports

We describe a rare case of severe low-flow, low-gradient aortic stenosis due to a calcified aortic valve chordae tendineae. The chordae was captured on cardiac computed tomography (CT) using advanced 3-dimensional image reconstruction to reveal the fibrous strand tethering the non-coronary cusp to the left ventricular outflow tract, rendering it functionally immobile. This is one of the first reported cases of severe aortic stenosis from an aortic valve chordae tendineae which highlights the utility of advanced image processing techniques in cardiac CT.
Concurrence of osteonecrosis and steroid myopathy secondary to oral steroid therapy in a patient with ABCB1 gene polymorphisms: A case report
Authors: Yidan Hu, Chenyang Lu, Hui Lin
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: adverse event, genotyping, osteonecrosis, steroid myopathy, steroids
MeSH terms: Muscular Diseases / chemically induced, Muscular Diseases / genetics, Osteonecrosis / chemically induced, Osteonecrosis / genetics, Osteonecrosis / pathology, Case Reports, Research Support, Non-U.S. Gov't, ATP Binding Cassette Transporter, Subfamily B / adverse effects, ATP Binding Cassette Transporter, Subfamily B / genetics, Female, Glucocorticoids / adverse effects, Humans, Hydroxybutyrate Dehydrogenase / genetics, Lactate Dehydrogenases / genetics, Methylprednisolone, Plasminogen Activator Inhibitor 1 / adverse effects, Plasminogen Activator Inhibitor 1 / genetics, Polymorphism, Genetic, Steroids, Glucocorticoids, Plasminogen Activator Inhibitor 1, Hydroxybutyrate Dehydrogenase, Methylprednisolone, Steroids, Lactate Dehydrogenases, ABCB1 protein, human, ATP Binding Cassette Transporter, Subfamily B

Glucocorticoids (GCs) are widely used in various autoimmune diseases. Side effects may occur in patients with long-term or high-dose GC usage. Among them, steroid myopathy and osteonecrosis are two severe forms. We report a patient with pemphigus vulgaris on GC-treatment who developed muscle weakness when a cumulative dose of methylprednisolone reached about 20g (14-80mg/d for 2.5 years). Laboratory tests showed slightly elevated lactate dehydrogenase and hydroxybutyrate dehydrogenase. MRI revealed osteonecrosis in the femoral head, distal femur, and proximal tibia of both legs. The biopsy of the right quadriceps revealed atrophy of type II myofiber without leukocyte infiltration, which was suggestive of steroid myopathy. Genotyping of the patient showed 5G/5G genotype of the PAI-1 gene and CC genotype of the ABCB1 gene (C3435T), suggesting she was sensitive to GCs. The patient's lesions were considered to be GC-induced adverse events, which were improved with tapering GC. Therefore, it is important to recognize steroid-induced musculoskeletal side effects and genotyping favors personalized medication.
Lyme Disease: A Probably Underdiagnosed Cause of Mono-Arthritis
Authors: Stijn Marcelis, Filip Vanhoenacker
Journal: J Belg Soc Radiol (2021)
Keywords: lyme disease, arthritis, magnetic resonance imaging
MeSH terms: Case Reports

Teaching point: Meticulous anamnesis and a high index of suspicion is needed for the diagnosis of Lyme arthritis.
A Rare Case of Granulicatella adiacens Vertebral Osteomyelitis
Authors: E van der Palen, C L M de Roij van Zuijdewijn, D A R Castelijn, G H Wattel-Louis, J Kalpoe
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Vertebral osteomyelitis caused by Granulicatella adiacens is rarely described. We report a 45-year-old immunocompetent male with back pain caused by G. adiacens osteomyelitis. This case is remarkable due to the absence of endocarditis. A clinician should therefore consider G. adiacens osteomyelitis even in the absence of concurrent hematogenous spread.
Science teachers' interactions with resources for formative assessment purposes
Authors: Ragnhild Lyngved Staberg, Maria Immaculata Maya Febri, Øistein Gjøvik, Svein Arne Sikko, Birgit Pepin
Journal: Educ Assess Eval Account (2023)
Keywords: assessment for learning, curriculum resources, documentational approach to didactics, formative assessment, primary school, science education

Using a case-study approach, we aim to understand how teachers interact with both analogue and digital resources in the science classroom for formative assessment (FA) purposes and their justifications for such interactions. The study was conducted in the context of a European Union project on FA in science and mathematics education. The case involved two Norwegian primary school teachers teaching their grades 5 and 7 students a series of science lessons on the topic "how to prevent microorganisms from spreading." The data set consisted of lesson plans, classroom observations, pre- and post-interviews conducted with teachers, student tasks, post-interviews with students, and student work. We identified eight analogue and digital resources, which were used to employ five FA strategies. The strategies that were most commonly used related to "engineering effective classroom discussions" that elicited evidence of student understanding and "activating students" as autonomous learners and peer instructors. The teachers' rationales for using the selected resources were mainly connected to their effectiveness, practicality, and relevance. Teacher interactions with the selected resources are described, and educational implications are discussed.
Subcutaneous Olanzapine at the End of Life in a Patient with Schizophrenia and Dysphagia
Authors: Jonathan Hindmarsh, Amy Huggin, Anya Belfonte, Mark Lee, Jonathan Pickard
Journal: Palliat Med Rep (2020)
Keywords: clozapine, hospice care, olanzapine, palliative care, schizophrenia, terminally ill
MeSH terms: Case Reports

Currently, there is a paucity of evidence to guide the management of antipsychotic therapy at the end of life for patients with schizophrenia. A 51-year-old female with a diagnosis of palliative squamous cell carcinoma of the tonsils was admitted to her local hospice for end-of-life care. She had a history of treatment-resistant schizophrenia, which was ordinarily managed with oral clozapine and aripiprazole. Owing to a deteriorating swallow and the inappropriateness of other enteral administration routes for this patient however, it became necessary to consider alternative means by which to give essential antipsychotic medicine. A subcutaneous infusion of olanzapine was chosen as the most viable solution. During the course of the admission, her schizophrenia began to relapse with the onset of positive psychotic symptoms (paranoia and hallucinations). This was posited as likely due to interruption of her regular oral antipsychotic medication combined with insufficient olanzapine dosing. The olanzapine dose was thus subsequently titrated over the course of a week with close monitoring, and her psychotic symptoms abated. Owing to a protracted dying phase, the patient remained on subcutaneous olanzapine for a total of 56 days, which allowed for accurate assessment of her psychiatric symptoms and evaluation of therapeutic response. The findings of this case report suggest that subcutaneous olanzapine may be an appropriate alternative for patients who are unable to take their complex oral antipsychotic regimens through enteral routes at the end of life.
Foreign body reaction simulating mandibular osteosarcoma-Case report
Authors: Gabriela Caovilla Felin, João Paulo De Carli, Mateus Ericson Flores, Jose Luiz Bernardon Pretto, Letícia Copatti Dogenski, Ferdinando De Conto
Journal: Int J Surg Case Rep (2019)
Keywords: alloplastic materials, case report, foreign-body, granuloma, osteosarcoma

Introduction:
This study aimed to report the case of a foreign body granuloma in a 34-year-old woman, presenting clinical and imaging characteristics, as well as to discuss the association of using alloplastic material for the lesion in question.
Presentation of case:
Female patient seeking dental care for a routine treatment. The panoramic radiograph showed the presence of asymptomatic, radiolucent, and multiloculated lesion between teeth 31 and 34. Among the hypotheses diagnosed, central giant cell granuloma and osteosarcoma were suggested. When questioned, the patient denied any health changes or recent local procedures. After performing a histopathological examination and insisting on anamnesis, the case was diagnosed more accurately as "foreign body reaction" and the adequate therapy was determined.
Discussion:
The use of alloplastic material has been reported as an etiological factor of foreign body lesions, and dentists, either clinicians, radiologists or pathologists, should be aware of this because of the great increase of such procedures and the difficulties related to their diagnosis.
Conclusion:
The foreign body granuloma associated with silicone prosthesis, based on its clinical and imaging characteristics, may be mistaken for neoplastic processes.