OpenMed/multicare-articles huggingface dataset:
Serious Hemorrhagic Complications After Successful Treatment of Hematopoietic Stem Cell Transplantation-Associated Thrombotic Microangiopathy With Defibrotide in Pediatric Patient With Myelodysplastic Syndrome
Authors: Alexandra Laberko, Marina Aksenova, Irina Shipitsina, Igor Khamin, Anna Shcherbina, Dmitry Balashov, Alexei Maschan
Journal: Front Pediatr (2020)
Keywords: defibrotide, hematopoietic stem cell transplantation, myelodysplastic syndrome, renal bleeding, thrombotic microangiopathy
MeSH terms: Case Reports

Background: Transplant-associated thrombotic microangiopathy (TAM) is a life-threatening complication of hematopoietic stem cell transplantation (HSCT). There is some evidence of endothelial injury playing a significant role in TAM development. The efficacy of defibrotide was demonstrated for prophylaxis and treatment of another HSCT-associated endothelial damage syndrome-liver veno-occlusive disease. The data for defibrotide usage in TAM are limited. Case Description: A 9-year old boy underwent HSCT from a matched unrelated donor for monosomy seven-associated myelodysplastic syndrome treatment. A myeloablative preparative regimen and post-transplant immunosuppression with cyclophosphamide on days +3 and +4 and a combination of tacrolimus with mycophenolate mofetil from day +5 were used. From day +61, sustained fever with progressive neurologic impairment and no evidence of infection was observed. On day +68, the patient developed severe TAM with acute kidney injury requiring renal replacement therapy (RRT). Defibrotide therapy 25 mg/kg/day was administered for 7 days with resolution of TAM symptoms. It was followed by multiple hemorrhagic episodes-epistaxis, hemorrhagic cystitis, and renal hemorrhage, which are presumed to be the complications of defibrotide therapy. Conclusion: Defibrotide could be an effective therapy for TAM, but adequate doses, duration of therapy, and drug safety profile both for pediatric and adult patients need to be evaluated by randomized prospective studies.
Primary clear cell chondrosarcoma of the spine: a case report of a rare entity and a review of the literature
Authors: Nikolaos A Paidakakos, Aristides Rovlias, Evaggelos Rokas, Spyridon Theodoropoulos, Patroklos Katafygiotis
Journal: Case Rep Oncol Med (2012)

Chondrosarcoma is the third most common primary malignant bone tumor after osteosarcoma and Ewing's sarcoma. Clear cell chondrosarcoma is a rare subtype variant of chondrosarcoma, most commonly encountered in the proximal part of the femur or humerus. Vertebral involvement is exceedingly rare and shows a predilection for the thoracic spine. We report the case of a woman with clear cell chondrosarcoma of the thoracic spine, which has been surgically excised, and review the pertinent literature (PubMed). Although it has a reasonably benign biological behavior, clear cell chondrosarcoma needs to be treated as a malignancy. The best treatment for spinal chondrosarcoma is surgery. It should be promptly and adequately resected. Gross-total resection should be the ultimate surgical goal. Radiation therapy should also be considered, especially in the case of subtotal resection or inoperable lesions. In conclusion, it is important to keep in mind this entity in the differential diagnosis of spinal tumors, in order to optimize treatment planning. With adequate treatment, local recurrence rates as low as 20% can be achieved.
Failure of XEN Gel Stent Implantation as a Stand-Alone Procedure in Congenital Glaucoma: Case Report of Secondary Congenital Glaucoma in Neurofibromatosis Type 1
Authors: Hannah Schellhase, Matthias Fuest, David Kuerten, Peter Walter, Niklas Plange
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

A XEN gel stent implant procedure was performed in a one-year-old child with severe unilateral congenital glaucoma. At the age of 6 weeks, an uncomplicated 360° trabeculotomy had been performed, which resulted in intraocular pressure (IOP) control for only 4 months. The gel stent implantation was performed ab interno without complications. However, 1 month later, the stent was repelled into the anterior chamber due to the elasticity of Tenon's layer. A first revision surgery was performed, with excision of Tenon's layer and implantation of a new gel stent under sight. At the age of 18 months, a second revision surgery was performed because of an encapsulated Tenon cyst with insufficient IOP control, again with the implantation of a new stent. At that time, a progressive upper eyelid swelling was apparent. Eyelid biopsy led to the diagnosis of neurofibromatosis type 1, presenting with an orbital plexiform neurofibroma. Further insufficient IOP control resulted in a cyclodestructive procedure and loss of light perception during follow-up. XEN gel stent implantation in congenital glaucoma in infants is more challenging than that in adult patients. Gel stent implantation ab interno may be difficult due to the thickness and elasticity of Tenon's layer. Gel stent dislocation may occur, even months after surgery. Trabeculectomy might be a better approach after failed trabeculotomy in congenital glaucoma. An underlying systemic disease might become apparent late during follow-up.
Androgen-induced cerebral venous sinus thrombosis in a young body builder: case report
Authors: Mohammad Ali Sahraian, Mahmood Mottamedi, Amir Reza Azimi, Babak Moghimi
Journal: BMC Neurol (2004)
MeSH terms: Anabolic Agents / adverse effects, Nandrolone / analogs & derivatives, Sagittal Sinus Thrombosis / chemically induced, Weight Lifting, Case Reports, Adult, Headache / etiology, Humans, Injections, Intramuscular, Male, Nandrolone / adverse effects, Nandrolone Decanoate, Papilledema / etiology, Sagittal Sinus Thrombosis / diagnosis, Vomiting / etiology, Anabolic Agents, Nandrolone, Nandrolone Decanoate

Background:
Cerebral venous sinus thrombosis is an infrequent disease with a variety of causes. Pregnancy, puerperium, contraceptive pills and intracranial infections are the most common causes. The patient may present with headache, focal neurological deficits and seizures.The clinical outcome is highly variable and treatment with heparin is advised.
Case presentation:
The patient is a 22 year old male who presented with headache, repeated vomiting and papilledema.He was a bodybuilder doing exercise since 5 years ago, who had used nandrolone decaonoate 25 milligrams intramuscularly during the previous 5 months. Brain MRI and MRV showed superior sagital and transverse sinus thrombosis and extensive investigations did not reveal any known cause.
Conclusions:
We suggested that androgen was the predisposing factor in our patient. Androgens may increase coagulation factors or platelet activity and cause arterial or venous thrombosis. As athletes may hide using androgens it should be considered as a predisposing factor for thrombotic events in such patients.
Tsukamurella tyrosinosolvens bacteremia with coinfection of Mycobacterium bovis pneumonia: case report and literature review
Authors: Chang-Hung Chen, Chao-Tai Lee, Tsung-Chain Chang
Journal: Springerplus (2016)
Keywords: bacteremia, pcr (polymerase chain reaction), pneumonia, rrna (ribosome rna)

Introduction:
We describe an immunocompromised patient with Tsukamurella tyrosinosolvens bacteremia and coinfection of Mycobacterium bovis pneumonia.
Case description:
A 75-year-old male was admitted to our hospital complaining of persistent fever with general malaise. His medical history showed that he had diabetes mellitus (HbA1C 9.2%). A chest computed tomography (CT) showed left upper lung consolidation . Two sets of blood culture at admission finally showed Tsukamurella tyrosinosolvens. Moreover, three transbronchoscopy washing specimen cultures revealed Mycobacterium bovis.
Discussion and evaluation:
The organism Tsukamurella tyrosinosolvens was identified using conventional biochemical identification methods, PCR-restriction DNA fragment analysis, and 16S rRNA gene sequencing. The clinical mycobacterial isolates were identified to the species level by combining Polymerase Chain Reaction (PCR) with an oligonucleotide microarray to detect the M. bovis amplicons.
Conclusion:
According to our literature review, our patient's case was the first of a coinfection with Tsukamurella tyrosinosolvens and Mycobacterium bovis. Prolonged antibiotic treatment and underlying disease control are necessary for this type of patient.
Case report: an initially unresectable stage III pulmonary sarcomatoid carcinoma qith EGFR mutation achieving pathological complete response following neoadjuvant therapy with osimertinib plus chemotherapy
Authors: Xiguang Liu, Yating Zheng, Shijie Mai, Yu Tong, Lili Yang, Mengli Huang, Ruijun Cai
Journal: Front Oncol (2022)
Keywords: egfr, chemotherapy, neoadjuvant, osimertinib, pulmonary sarcomatoid carcinoma
MeSH terms: Case Reports

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) provide dramatic response to patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC). However, the use of neoadjuvant therapy with EGFR-TKIs in EGFR-mutant NSCLC remains controversial, especially in pulmonary sarcomatoid carcinoma (PSC). One patient with initially unresectable stage III (cT4N0M0) PSC was found to carry EGFR mutation by the next generation sequencing. After neoadjuvant therapy with osimertinib plus chemotherapy, radical resection of the right upper lung lesion was achieved, and the pathological results reached pathological complete response (pCR). To the best of our knowledge, this is the first report of an EGFR-mutant patient with initially unresectable stage III PSC achieved pCR by neoadjuvant therapy with osimertinib plus chemotherapy. Therefore, neoadjuvant therapy with EGFR-TKIs may be a viable option for EGFR-mutant PSC patients.
An acute case of intoxication with cyanobacteria and cyanotoxins in recreational water in Salto Grande Dam, Argentina
Authors: Leda Giannuzzi, Daniela Sedan, Ricardo Echenique, Dario Andrinolo
Journal: Mar Drugs (2011)
Keywords: acute case, cyanobacteria, cyanotoxins, microcystin-lr
MeSH terms: Bacterial Toxins / toxicity, Harmful Algal Bloom, Microcystins / toxicity, Microcystis / isolation & purification, Case Reports, Argentina, Biomarkers / metabolism, Humans, Liver Diseases / etiology, Liver Diseases / pathology, Liver Function Tests, Male, Marine Toxins, Microcystins / isolation & purification, Pneumonia / microbiology, Recreation, Water Microbiology, Young Adult, Bacterial Toxins, Biomarkers, Marine Toxins, Microcystins, cyanoginosin LR

Cyanobacterial blooms and hepatotoxic microcystins (MCs) usually occur in summer, constituting a sanitary and environmental problem in Salto Grande Dam, Argentina. Water sports and recreational activities take place in summer in this lake. We reported an acute case of cyanobacterial poisoning in Salto Grande dam, Argentina, which occurred in January 2007. Accidentally, a young man was immersed in an intense bloom of Microcystis spp. A level of 48.6 μg·L(-1) of microcystin-LR was detected in water samples. Four hours after exposure, the patient showed nausea, abdominal pain and fever. Three days later, dyspnea and respiratory distress were reported. The patient was hospitalized in intensive care and diagnosed with an atypical pneumonia. Finally, a week after the exposure, the patient developed a hepatotoxicosis with a significant increase of hepatic damage biomarkers (ALT, AST and γGT). Complete recovery took place within 20 days. This is the first study to show an acute intoxication with microcystin-producing cyanobacteria blooms in recreational water.
Low occurrence of Pseudomonas aeruginosa in agricultural soils with and without organic amendment
Authors: Amélie Deredjian, Céline Colinon, Edmond Hien, Elisabeth Brothier, Benjamin Youenou, Benoit Cournoyer, Samuel Dequiedt, Alain Hartmann, Claudy Jolivet, Sabine Houot, Lionel Ranjard, Nicolas P A Saby, Sylvie Nazaret
Journal: Front Cell Infect Microbiol (2014)
Keywords: pseudomonas aeruginosa, cultivation, organic amendment, qpcr, soil
MeSH terms: Agriculture, Pseudomonas aeruginosa / classification, Pseudomonas aeruginosa / genetics, Soil / chemistry, Soil Microbiology, Research Support, Non-U.S. Gov't, Burkina Faso, France, Molecular Typing, Soil

The occurrence of Pseudomonas aeruginosa was monitored at a broad spatial scale in French agricultural soils, from various soil types and under various land uses to evaluate the ability of soil to be a natural habitat for that species. To appreciate the impact of agricultural practices on the potential dispersion of P. aeruginosa, we further investigated the impact of organic amendment at experimental sites in France and Burkina Faso. A real-time quantitative PCR (qPCR) approach was used to analyze a set of 380 samples selected within the French RMQS ("Réseau de Mesures de la Qualité des Sols") soil library. In parallel, a culture-dependent approach was tested on a subset of samples. The results showed that P. aeruginosa was very rarely detected suggesting a sporadic presence of this bacterium in soils from France and Burkina Faso, whatever the structural and physico-chemical characteristics or climate. When we analyzed the impact of organic amendment on the prevalence of P. aeruginosa, we found that even if it was detectable in various manures (at levels from 10(3) to 10(5) CFU or DNA targets (g drywt)(-1) of sample), it was hardly ever detected in the corresponding soils, which raises questions about its survival. The only case reports were from a vineyard soil amended with a compost of mushroom manure in Burgundy, and a few samples from two fields amended with raw urban wastes in the sub-urban area of Ouagadougou, Burkina Faso. In these soils the levels of culturable cells were below 10 CFU (g drywt)(-1).
Clinical problems due to encephalomyocarditis virus infections in two pig herds
Authors: Klaas Vansteenkiste, Tommy Van Limbergen, Ruben Decaluwé, Marylène Tignon, Brigitte Cay, Dominiek Maes
Journal: Porcine Health Manag (2016)
Keywords: case report, emcv, encephalomyocarditis virus, suckling and nursery pigs, sudden death
MeSH terms: Case Reports

Background:
Infections with encephalomyocarditis virus may cause myocarditis and sudden death in young pigs and reproduction disorders in sows. The presence of encephalomyocarditis virus infected rodents is considered a major risk factor for transmission of the virus to pigs. There is currently no effective treatment. Tightening up biosecurity, applying effective rodent control and reducing stress are the main control measures.
Case presentation:
Two farrow-to-finish herds suffering from problems with sudden death are presented. In herd A, suckling piglets from 3 to 12 days old were dying acutely whereas in herd B, piglets at the end of the nursery period (8-10 weeks) were showing identical problems. A presumptive diagnosis of encephalomyocarditis virus infection was made because typical lesions were observed in some of the affected pigs. These lesions were not always present in pigs dying acutely or in some cases the lesions were very subtle. Therefore other causes had to be ruled out based upon clinical history, clinical signs and diagnostic tests. A conclusive diagnosis was finally established by showing encephalomyocarditis virus in heart tissue using conventional gel-based polymerase chain reaction tests. The real-time PCR test that gave initially negative result was further optimized to avoid false negative results.
Conclusions:
Typical lesions are not always present in piglets infected with encephalomyocarditis virus, indicating the importance of examining multiple animals. Problems in suckling piglets may occur in affected herds without reproductive problems in sows. Transmission routes of EMCV in swine are not fully understood. A stand-empty period following thorough cleaning and disinfection is recommended for controlling EMC virus infections.
Association of intramural fat deposition in the interatrial septum with focal atrial tachyarrhythmias originating near the atrioventricular node
Authors: Shingo Maeda, Takeshi Sasaki, Yasuhiro Shirai, Kensuke Ihara, Mihoko Kawabata, Yasuhiro Yokoyama, Saman Nazarian, Stefan L Zimmerman, Kenzo Hirao
Journal: Heart Vessels (2015)
MeSH terms: Adipose Tissue / diagnostic imaging, Atrial Fibrillation / physiopathology, Atrioventricular Node / diagnostic imaging, Heart Atria / diagnostic imaging, Tachycardia, Supraventricular / physiopathology, Case Reports, Aged, Electrophysiologic Techniques, Cardiac, Humans, Male, Tomography, X-Ray Computed

We describe a case with three focal atrial tachycardias (ATs) and focal atrial fibrillation (AF) originating from the interatrial septum (IAS) near the atrioventricular node (AVN). Contrast-enhanced computed tomography demonstrated the association of fat deposition within the anterior IAS near the AVN with successful ablation sites of these ATs and AF. This is the first report that the intramural fat deposition in the IAS could be associated with the formation of AT and AF re-entry circuits originating near the AVN.
Case report: manualized trauma-focused cognitive behavioral therapy with an unaccompanied refugee minor girl
Authors: Johanna Unterhitzenberger, Rita Rosner
Journal: Eur J Psychotraumatol (2016)
Keywords: ptsd, adolescent, asylum-seeking, manualized, psychotherapy, refugee, separated, trauma-focused, treatment
MeSH terms: Case Reports

Background:
There is uncertainty whether young traumatized refugees should be treated with culturally adapted psychotherapy or with an evidence-based western approach. As yet, empirical studies on culturally adapted treatments for unaccompanied young refugees in industrialized host countries are not available. Studies do, however, suggest that trauma-focused treatment is promising for this group.
Objective:
We describe the treatment of an unaccompanied refugee minor girl with posttraumatic stress disorder (PTSD) who underwent manualized trauma-focused cognitive behavioral therapy (TF-CBT; Cohen, Mannarino, & Deblinger, 2006).
Methods:
A 17-year-old girl from East Africa, who came to Germany without a caregiver, was treated for PTSD resulting from several traumatic experiences and losses in her home country and while fleeing. She lived in a group home for adolescents. Baseline, post, and follow-up data are reported.
Results:
The girl participated in 12 sessions of manualized TF-CBT. Her caregiver from the youth services received another 12 sessions in line with the treatment manual. Symptoms decreased in a clinically significant manner; at the end of the treatment, the girl was deemed to have recovered from PTSD. Treatment success remained stable over 6 months.
Conclusions:
Manualized TF-CBT is feasible for young refugees without significant cultural adaptations. It can, however, be seen as culturally sensitive.
Personalized Treatment of Periodontitis in a Patient with McArdle's Disease: The Benefits from Probiotics
Authors: Salvatore Cannizzaro, Carolina Maiorani, Andrea Scribante, Andrea Butera
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Introduction:
McArdle's disease is a severe glycogen storage disease characterized by intolerance to exercise; patients have a syndrome of muscle intolerance to stress, associated with myalgia, cramps, fatigue, and muscle weakness. Periodontal disease is a multifactorial pathology of the supporting tissues of the teeth: one of the main factors is the formation of bacterial biofilm; its control favors the prevention and the maintenance of good health of the oral cavity; and some systemic pathologies can worsen the periodontal disease and hinder its therapy. This case report concerns a woman with McArdle's disease diagnosed with periodontal disease. Material and Methods. A 54-year-old female patient with McArdle's disease has been diagnosed with Stage 3 generalized periodontitis, Grade B. At the baseline, the patient had 82 pockets with probing pocket depth (PPD) equal to or greater than 4 mm. The patient was instructed in the correct methods of oral hygiene and was advised toothpaste and mouthwash based on probiotics; subsequently, a debridement was performed to remove etiological factors using Dental-Biofilm Detection Topographic Technique (D-BioTECH).
Results:
After 60 days, the number of pockets was reduced from 82 to 14 overall with PPD ≥ 4 mm and from 50 to 2 pockets with PPD ≥ 5 mm. Full mouth bleeding score (FMBS) increased from 48% to 15% and full mouth plaque score (FMPS) from 73% to 15%.
Conclusions:
In this case, the use of a correct brushing method combined with the D-BioTECH has reduced the disease state, with the use of probiotics at home to restore and maintain a healthy oral microbiome.
Detection of Hepatic Metastasis in Colorectal Cancer: A Comparative Case Report of 18F-FDG PET-CT and Diffusion-Weighted MRI with a b Value of 1000
Authors: Andrei-Cristian Fülöp, Gabriel Serac, Simona Gurzu
Journal: J Belg Soc Radiol (2023)
Keywords: mri, pet-ct, colorectal cancer, diffusion-weighted imaging, liver metastasis
MeSH terms: Case Reports

Detection of hepatic metastasis from colorectal cancer remains a clinical challenge. In this case report, we present a 66-year-old male patient with a rectal carcinoma who underwent 18F-FDG PET-CT for staging, which revealed one hepatic metastasis. Abdominal magnetic resonance imaging (MRI) with diffusion-weighted sequence with a b value of 1000 was performed, which identified a second metastasis of the liver.
Teaching point:
This case report illustrates that, in some patients, diffusion-weighted MRI with a b value of 1000 might be a more sensitive technique for detecting small hepatic metastases than 18F-FDG PET-CT.
Case Report: A Case Report of Stereotactic Ventricular Arrhythmia Radioablation (STAR) on Large Cardiac Target Volume by Highly Personalized Inter- and Intra-fractional Image Guidance
Authors: Maria Lucia Narducci, Francesco Cellini, Lorenzo Placidi, Luca Boldrini, Francesco Perna, Gianluigi Bencardino, Gaetano Pinnacchio, Roberta Bertolini, Giorgio Cannelli, Vincenzo Frascino, Luca Tagliaferri, Silvia Chiesa, Gian Carlo Mattiucci, Mario Balducci, Maria Antonietta Gambacorta, Marco Rossi, Luca Indovina, Gemma Pelargonio, Vincenzo Valentini, Filippo Crea
Journal: Front Cardiovasc Med (2020)
Keywords: sbrt, star, cardiac radioablation, personalized medicine, radiosurgery, radiotherapy, ventricular arrhythmia, ventricular tachycardia
MeSH terms: Case Reports

Introduction: Although catheter ablation is the current gold standard treatment for refractory ventricular arrhythmias, sometimes its efficacy is not optimal and it's associated with high risks of procedural complication and death. Stereotactic arrhythmia radioablation (STAR) is increasingly being adopted for such clinical presentation, considering its efficacy and safety. Case Presentation: We do report our experience managing a case of high volume of left ventricle for refractory ventricular tachycardia in advanced heart failure patient, by delivering a single fraction of STAR through an highly personalization of dose delivery applying repeated inter- and continuous intra-fraction image guidance. Conclusion: According to the literature reports, we recommend considering increasing as much as possible the personalization features and safety technical procedure as long as that is not significantly affecting the STAR duration. Moreover, the duration in itself shouldn't be the main parameter, but balanced into the frame of possibly obtainable outcome improvement. At best of our knowledge, this is the first report applying such specific technology onto this clinical setting. Future studies will clarify these issues.