OpenMed/multicare-articles huggingface dataset:
Endoscopic lumbar sympathectomy as a treatment option for primary erythromelalgia - case report and review
Authors: Marcelo de Paula Loureiro, Pietro Maran Novais, João Augusto Nocera Paulin, Daniel Benzecry de Almeida, Arlindo Nascimento de Lemos
Journal: J Vasc Bras (2023)
Keywords: lumbar sympathectomy, primary erythromelalgia, surgery, teenager, treatment
MeSH terms: Case Reports

Erythromelalgia is a rare disease, involving pain, edema, redness, and hyperthermia in the limbs. It is extremely refractory to drugs, has no defined treatment, and causes psychological comorbidities in the patient. We describe a case of erythromelalgia involving a 17-year-old boy who had been suffering from the disease for almost 4 years prior to finding an effective treatment. A bilateral endoscopic lumbar sympathectomy was performed, limited to L2 and L3 resections. Four weeks after the procedure, the patient's symptoms were significantly mitigated and at 8 months follow-up he remained almost asymptomatic. Endoscopic lumbar sympathectomy was an effective treatment for primary erythromelalgia in this teenager, with exceptional reduction of his symptoms.
Synchronous Ovarian and Breast Cancers with a Novel Variant in BRCA2 Gene: A Case Report
Authors: Néstor Llinás-Quintero, Eduardo Cabrera-Florez, Gustavo Mendoza-Fandiño, Gustavo Matute-Turizo, Elsa M Vasquez-Trespalacios, Luis J Gallón-Villegas
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

We report a case of a 52-year-old female with a family history of pancreatic and colon cancers who presented with a right breast mass positive for high-grade medullar carcinoma with triple-negative biomolecular profile. Further workup was performed finding a left ovarian mass. The patient underwent laparotomy performing optimal cytoreduction on bilateral ovarian tumors; the pathology and immunohistochemistry confirmed bilateral ovary adenocarcinoma with positive peritoneal malignancy. Due to her synchronic breast and ovarian cancers, a genetic profile was performed detecting a new pathogenic variant in the BRCA2 gene: c.3606_3607del (p.Ser1203Cysfs). She was given chemotherapy with carboplatin and paclitaxel obtaining complete clinical response. Regarding her breast cancer, she had a right modified radical mastectomy and prophylactic left mastectomy obtaining complete clinical response. This case presents with an unusual subtype and difficult histologic diagnosis of a synchronic medullar breast cancer and ovary carcinoma associated with a new mutation of the BRCA2 gene.
The resource team: A case study of a solitary confinement reform in Oregon
Authors: David H Cloud, Craig Haney, Dallas Augustine, Cyrus Ahalt, Brie Williams
Journal: PLoS One (2023)
MeSH terms: Mental Disorders / psychology, Prisoners / psychology, Research Support, Non-U.S. Gov't, Human Rights, Humans, Oregon, Pilot Projects

The continued use of solitary confinement has sparked international public health and human rights criticisms and concerns. This carceral practice has been linked repeatedly to a range of serious psychological harms among incarcerated persons. Vulnerabilities to harm are especially dire for persons with preexisting serious mental illness ("SMI"), a group that is overrepresented in solitary confinement units. Although there have been numerous calls for the practice to be significantly reformed, curtailed, and ended altogether, few strategies exist to minimize its use for people with SMI and histories of violence against themselves or others. This case study describes the "Oregon Resource Team" (ORT), a pilot project adapted from a Norwegian officer-led, interdisciplinary team-based approach to reduce isolation and improve outcomes for incarcerated persons with SMI and histories of trauma, self-injury, and violence against others. We describe the ORT's innovative approach, the characteristics and experiences of incarcerated people who participated in it, its reported impact on the behavior, health, and well-being of incarcerated persons and correctional staff, and ways to optimize its effectiveness and expand its use.
The presence of two rare genomic syndromes, 1q21 deletion and Xq28 duplication, segregating independently in a family with intellectual disability
Authors: Kyungsoo Ha, Yiping Shen, Tyler Graves, Cheol-Hee Kim, Hyung-Goo Kim
Journal: Mol Cytogenet (2016)
Keywords: 1q21 microdeletion, intellectual disability, mecp2, segregation of two rare syndromes, x chromosome inactivation, xq28 duplication
MeSH terms: Case Reports

Background:
1q21 microdeletion syndrome is a rare contiguous gene deletion disorder with de novo or autosomal dominant inheritance patterns and its phenotypic features include intellectual disability, distinctive facial dysmorphism, microcephaly, cardiac abnormalities, and cataracts. MECP2 duplication syndrome is an X-linked recessive neurodevelopmental disorder characterized by intellectual disability, global developmental delay, and other neurological complications including late-onset seizures. Previously, these two different genetic syndromes have not been reported segregating independently in a same family.
Case presentation:
Here we describe two siblings carrying either a chromosome 1q21 microdeletion or a chromosome Xq28 duplication. Using a comparative genomic hybridization (CGH) array, we identified a 1.24 Mb heterozygous deletion at 1q21 resulting in the loss of 9 genes in a girl with learning disability, hypothyroidism, short stature, sensory integration disorder, and soft dysmorphic features including cupped ears and a unilateral ear pit. We also characterized a 508 kb Xq28 duplication encompassing MECP2 in her younger brother with hypotonia, poor speech, cognitive and motor impairment. The parental CGH and quantitative PCR (qPCR) analyses revealed that the 1q21 deletion in the elder sister is de novo, but the Xq28 duplication in the younger brother was originally inherited from the maternal grandmother through the mother, both of whom are asymptomatic carriers. RT-qPCR assays revealed that the affected brother has almost double the amount of MECP2 mRNA expression compared to other family members of both genders including maternal grandmother and mother who have the same Xq28 duplication with no phenotype. This suggests the X chromosome with an Xq28 duplication in the carrier females is preferentially silenced.
Conclusion:
From our understanding, this would be the first report showing the independent segregation of two genetically unrelated syndromes, 1q21 microdeletion and Xq28 duplication, in a same family, especially in siblings. Although these two chromosomal abnormalities share some similar phenotypes such as intellectual disability, mild dysmorphic features, and cardiac abnormalities, the presence of two unrelated and rare syndromes in siblings is very unusual. Therefore, further comprehensive investigations in similar cases are required for future studies.
Urinary Aspergillosis in a Patient with Systemic Lupus Erythematosus (SLE)
Authors: Mayara Gabriele Toledo, Hugo Rodrigues Alves, Isadora Cambruzzi, Laís Lopes Pires, Mariana Rossi, Ana Carolina Gonçalves Brito, Andrea D'Avila Freitas, Natalia Chilinque Zambão da Silva
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Aspergillosis is an opportunistic mycosis that generally affects the lungs. The fungus was cleared by the immune system of a healthy host. Extrapulmonary forms are very rare, and there are few reports of urinary aspergillosis. In this case report, we describe a 62-year-old woman with systemic lupus erythematosus (SLE) with complaints of fever and dysuria. The patient had recurrent episodes of urinary tract infection and several hospitalizations. A computed tomography revealed an amorphous mass in the left kidney and bladder. After partial resection of the material was referred for analysis, Aspergillus infection was suspected and confirmed by culture. Successful treatment with voriconazole was provided. Diagnosis of localized primary renal Aspergillus infection in a patient with SLE requires careful investigation due to its benign presentation and lack of associated systemic clinical features.
Perforating corneal ulceration in a patient with lung metastatic adenocarcinoma treated with gefitinib: a case report
Authors: Enjie Ibrahim, William H Dean, Nicholas Price, Ahmed Gomaa, Gareth Ayre, Sam Guglani, Ahmed Sallam
Journal: Case Rep Ophthalmol Med (2012)

We present a case of a sixty-year-old female who presented with sudden onset of painless loss of vision in one eye due to a perforated corneal ulcer, following three months of treatment with gefitinib, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor for metastatic adenocarcinoma of the lung with confirmed EGFR gene mutation. The eye did not show any sign of infection or inflammation and had no associated lid problems to account for the development of corneal ulceration. The patient went on to have a corneal graft surgery but postoperatively developed corneal graft melt. This paper aims to raise awareness among ophthalmologists and oncologists of the probable association between gefitinib and corneal ulceration.
Acute Kidney Injury Secondary to Rhabdomyolysis and COVID-19: A Case Report and Literature Review
Authors: Vishaka K Chetram, Akram I Ahmad, Saira Farid, Tanuj Sood
Journal: Case Rep Nephrol (2021)
MeSH terms: Case Reports

The viral infection causing COVID-19 most notably affects the respiratory system but can result in extrapulmonary clinical manifestations as well. Rhabdomyolysis-associated acute kidney injury (AKI) in the setting of COVID-19 is an uncommon complication of the infection. There is significant interest in this viral infection given its global spread, ease of transmission, and varied clinical manifestations and outcomes. This case report and literature review describes the symptoms, laboratory findings, and clinical course of a patient who developed AKI secondary to rhabdomyolysis and COVID-19, which will help clinicians recognize and treat this condition.
Aripiprazole Improves Depressive Symptoms and Immunological Response to Antiretroviral Therapy in an HIV-Infected Subject with Resistant Depression
Authors: Chiara Cecchelli, Giacomo Grassi, Stefano Pallanti
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Aripiprazole is the first medication approved by the FDA as an add-on treatment for MDD. The impact of aripiprazole on the response to HIV is unknown. The patient we report on was diagnosed HIV-positive in 1997 and has been treated with antiretroviral therapy since then. In 2008, we diagnosed resistant major depression, hypochondria, and panic disorder. On that occasion, blood tests showed a significantly reduced CD4 count and a positive viral load. We treated this patient with aripiprazole and citalopram. Mood, somatic symptoms, and occupational functioning progressively improved. The last blood examination showed an increase in the CD4 count and a negative viral load. On the basis of the present case study and the review of the literature concerning the effects of psychotropic agents on viral replication, we suggest that the use of aripiprazole in HIV-infected subjects warrants further research.
Anesthetic management of a patient with narcolepsy by combination of total intravenous and regional anesthesia: a case report
Authors: Daiki Takekawa, Tetsuya Kushikata, Masato Kitayama, Kazuyoshi Hirota
Journal: JA Clin Rep (2017)
Keywords: general anesthesia, narcolepsy, orexin

Narcolepsy is a neurological disease characterized by excessive daytime sleepiness, cataplexy, and/or a sudden loss of muscle tone due to malfunction of the orexinergic system, which may cause delayed emergence from general anesthesia. We report a successful anesthetic management of 24-year-old female narcoleptic patient undergoing left anterior cruciate ligament reconstruction. Anesthesia was induced and maintained with total intravenous anesthesia (TIVA) using propofol and remifentanil. Ultrasound-guided left femoral nerve block was also performed with 0.375% ropivacaine 20 ml. Acetaminophen 1000 mg was intravenously administered as part of a multimodal analgesia. After the surgery, the trachea was extubated 9 min after termination of TIVA, and then, the patient correctly responded to verbal commands. The postoperative course was uneventful without any narcoleptic symptoms.
Clinical and histopathological findings of a rare sinonasal glomangiopericytoma
Authors: Zahraa Noureddine El Moussaoui, Zahraa Al Najjar, Nada Diab, Zahraa Saker, Hassane Choukr, Ahmad K Aoude, Marwan Saliba, Bilal Shoumar, Mohamad Reda Noureddine El Moussaoui
Journal: Autops Case Rep (2023)
Keywords: epistaxis, nasal cavity, paranasal cavity, paranasal sinuses
MeSH terms: Case Reports

Glomangiopericytoma is a rare vascular neoplasm of the nasal cavity and paranasal sinuses that occurs during the sixth or seventh decade of life. It is categorized as a borderline tumor with low malignant potential and classified as a distinct entity of sinonasal tumors with perivascular myoid phenotype by the World Health Organization (WHO). We report the case of a 50-year-old woman with nasal obstruction and severe epistaxis. The nasal sinuses computed tomography (CT), and magnetic resonance imaging (MRI) demonstrated a 3.1 cm soft tissue mass occupying the upper part of the left nasal cavity invading the left paranasal sinuses and nasal septum, and the left eye medial rectus muscle. A total mass resection was performed by nasal endoscopy. The histological and immunohistochemical examination yielded the diagnosis of glomangiopericytoma. This case report aims to contribute to the knowledge of nasal neoplasms. The need for more data on this entity is the main obstacle to developing standardized treatment guidelines.
Management of Inflammatory Internal Root Resorption with Biodentine and Thermoplasticised Gutta-Percha
Authors: Girish Umashetty, Upendra Hoshing, Suvarna Patil, Nishant Ajgaonkar
Journal: Case Rep Dent (2015)

Internal root resorption is a chronic inflammatory process initiated within the pulp space with the loss of dentin. This condition demands a comprehensive understanding of the pathologic process, so as to identify the cause and arrest the resorptive phenomena. It is a rare occurrence, asymptomatic, with slow progression, detected through routine radiographic examination, where it appears as a radiolucent lesion. This paper reports a clinical case of inflammatory internal root resorption in the premolar tooth. Because it is asymptomatic, internal root resorption needs an early diagnosis in order to institute the endodontic treatment before the process compromises the remaining mineralized structures of the tooth. Biodentine was used to reinforce the weaker structures in the root. Thermoplasticised gutta-percha was used to completely obturate the defect. Ten-month follow-up showed arrest of internal root resorption.
Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar
Authors: Karl Bechter, Martin Wieland, Gerhard F Hamann
Journal: Front Psychiatry (2016)
Keywords: cervical collar, cervicogenic headache, cervicogenic tinnitus, tinnitus mechanisms, tinnitus treatment
MeSH terms: Case Reports

Introduction:
Cervicogenic tinnitus is not a generally accepted pathogenetic subtype, which might be subsumed under the concept of somatosensory tinnitus. After the personal experience of therapy-resistant tinnitus in context with a cervical pain syndrome (CPS) and successful add-on treatment with cervical collar (CC), the idea was pursued in several individual treatments in patients.
Patients and methods:
Reporting one particular case with chronic tinnitus, considered untreatable, that rapidly improved with exclusive treatment by CC use. Thereafter, tinnitus was experimentally replicated by head inclination, the respective neck-head angles, and cerebral blood flow was measured.
Results:
Chronic subjective tinnitus of a 20 years duration completely disappeared within 4 weeks with an intermittent short time application of CC. Thereafter, tinnitus was deliberately again induced by head inclination, set on with anterior tilt of 14°, reaching maximum strength by 23°. Tinnitus stopped with return to neutral head position. Blood flow in the vertebral arteries on both sides was unchanged during head inclination with prevalent tinnitus; however, blood flow was physiologically reduced with head rotation though not accompanied by tinnitus.
Discussion:
In a single case of chronic tinnitus, we found that treatment with CC rapidly led to full remission. Blood flow reduction in vertebral arteries was unrelated to tinnitus. However, tinnitus could be resumed by constrained head postures. Experimental tinnitus replication (by inclination) points to an underscored role of upper posterior cervical muscle groups, matching with animal experiments, also in concert with other triggers including psychological factors.
International Normalized Ratio (INR) Increases amongst Two Patients Living with HIV on Warfarin after Being Switched from a Nevirapine to a Dolutegravir-Based Antiretroviral Regimen
Authors: Natalie Sang, Sonak Pastakia, Samuel Nyanje
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

The increased use of dolutegravir-based regimens in the treatment of HIV is unmasking drug interactions, particularly in patients who were previously on nevirapine. Nevirapine is an enzyme inducer and increases the dosing requirements for cytochrome P450 enzyme substrates including warfarin. Upon discontinuing nevirapine, close monitoring of drugs with narrow therapeutic indices is paramount since dosing requirements may significantly reduce, increasing the probability of toxicity development. We present two cases describing interactions experienced by patients living with HIV, while transitioning from nevirapine to dolutegravir-based HIV regimens. The first case describes a 70-year-old man living with HIV and diabetes, while the second case describes a 60-year-old woman living with HIV. They were diagnosed with unprovoked deep vein thrombi, and while receiving treatment with warfarin, their HIV medication regimen was changed from lamivudine, zidovudine, nevirapine, and septrin to lamivudine, tenofovir, dolutegravir, and septrin. During the weeks following this switch, warfarin requirements decreased resulting in supratherapeutic INRs. With the continued promotion of dolutegravir-based HIV regimens as the preferred option for the treatment of HIV in President's Emergency Plan for AIDS Relief (PEPFAR) supported HIV treatment programs in Africa, clinicians must be aware of the potentially life-threatening consequences of switching antiretroviral regimens. It is hoped that a greater awareness of this potential side effect could lead to increased monitoring and prevention of the consequences of drug interactions.
Splenic Artery Infarct Requiring Surgery: A Rare Complication of COVID-19 Infection
Authors: Ioannis Dimitriou, Nikolaos Christodoulou, Kleanthis Chatzimargaritis, Aristidis Kaikis, Eirini Kasti, Georgios Triantos
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Introduction. Coronavirus disease (COVID-19) from SARS-CoV-2 infection is linked to a hypercoagulable state, leading to arterial and venous thrombotic events, of which pulmonary embolism is the most frequent. However, arterial thromboembolisms may also occur as visceral infracts in unusual sites, such as the renal, splenic, and intestinal arteries. Case Report. A 46-year-old unvaccinated male with a COVID-19 infection was admitted to the COVID-19 isolation ward with symptoms of respiratory infection. He complained of epigastric pain and fever for several days; radiological imaging of the abdomen revealed complete splenic arterial occlusion due to a large infarct. He was treated with low molecular weight heparin (enoxaparin) in therapeutic doses, resulting in minimal improvement. However, the pain worsened, and eventually, a laparotomy and splenectomy were performed. He was hospitalized for another 36 days before he was discharged in good condition. A second surgery was performed to remove a noninfected encapsulated hematoma from the subdiaphragmatic space. The patient remained healthy afterward, with no relapses. Discussion. Although rare, the number of cases of visceral infarcts in COVID-19 patients has increased. Splenic artery infarct is an exceptional case of acute abdominal pain that can be treated successfully with anticoagulant medication. Splenectomy may be required to manage refractory pain after failure of conservative management.
Contact tracing: Unearthing key epidemiological features of COVID-19
Authors: Pranav Ish, Sumita Agrawal, Akhil Dhanesh Goel, Nitesh Gupta
Journal: SAGE Open Med Case Rep (2020)
Keywords: covid-19, contact tracing, prevention, screening
MeSH terms: Case Reports

COVID-19 is an emerging global pandemic with a steady rise in both morbidity and mortality over the past few months. Contact tracing of COVID-19 patients is an essential task to mitigate the spread. The following case was one of the initial patients reported from India and details the importance of contact tracing, timely testing and adequate quarantine/isolation in disease control.
Bednar tumour, an uncommon tumour of the skin: a report of two cases
Authors: Tushar Kalonia, Aditi Dhanta, Ashok Singh, Arvind Kumar, Akanksha Malik, Neha Kumari
Journal: Pan Afr Med J (2022)
Keywords: dermatofibromasarcoma protuberans, case report, pigmented tumor, skin
MeSH terms: Dermatofibrosarcoma / pathology, Skin Neoplasms / pathology, Case Reports, Aged, Diagnosis, Differential, Female, Humans, Immunohistochemistry, Middle Aged, Skin / pathology

Pigmented dermatofibromasarcoma protuberans (DFSP) is a rare variant of DFSP which is an intermediate-grade tumour due to its tendency for local reccurence. Morphology of this variant impose a differential diagnosis that is must know for a pathologist. We describe two cases that presented with pigmented papulo-nodular form involving back and lower limb in middle aged to an elderly female. Histopathology coupled with immunohistochemistry yielded daignosis of Bedner tumour. A surgical histopathologist needs to have knowledge of all differential of pigmented neoplasm of skin just to ensure not to skip this rare entity.
Nasofrontal surgical reconstruction by external table flap of frontal bone following removal of a dermoid cyst revealed by a fistula: A case report and review of the literature
Authors: Kamal Chtira, Yassine Elallouchi, Farid Zahrou, Mouhssine Assamadi, Abdelaziz Ait El Qadi, Houssaine Ghannane, Mehdi Laghmari
Journal: GMS Interdiscip Plast Reconstr Surg DGPW (2019)
Keywords: dermoid cyst, nasofrontal fistula, nasofrontal reconstruction, surgical treatment
MeSH terms: Case Reports

Nasofrontal fistulas correspond to the persistence of an abnormal communication of embryological origin between the deep layer of the skin and the central nervous system (CNS). They can rarely be associated with a dermoid cyst and be revealed by a locoregional infection, and especially neuromeningeal infections can be serious. The treatment is mainly surgical by performing a total excision of the cyst and the repair of defects. The authors report the case of an 18-month-old infant operated for a dermoid cyst revealed by a nasofrontal fistula. They insist on the characteristics of this pathology in order to establish a diagnosis and an early treatment to avoid the complications that can be heavy in certain cases. They describe the steps of nasofrontal reconstruction by a small flap taken from the outer table of the frontal bone with better esthetic results.
Synchronous testicular liposarcoma and prostate adenocarcinoma: a case report
Authors: Umut Demirci, Suleyman Buyukberber, Asli Cakir, Banu Ozturk, Nalan Akyurek, Basak Unver, Meltem Baykara, Mustafa Benekli, Ugur Coskun
Journal: Cases J (2010)

Prostate adenocarcinoma is the most common malignancy and the second leading cause of cancer related deaths in men. Testicular liposarcomas are uncommon soft tissue neoplasms. We report coexistence of prostate cancer and testicular liposarcoma in a 69 year-old-man because while orchiectomy endications are decreasing day by day, these second malignancies should not be missed.