OpenMed/multicare-articles huggingface dataset:
Oral health promotion in patients with chronic renal failure admitted in the Intensive Care Unit
Authors: Alexandre Franco Miranda, Erica Negrini Lia, Tatiane Maciel de Carvalho, Cinthia Gonçalves Barbosa de Castro Piau, Priscila Paganini Costa, Ana Cristina Barreto Bezerra
Journal: Clin Case Rep (2015)
Keywords: chronic renal failure, dental health service, dentistry for chronically ill patients, health care quality, intensive care units, oral hygiene, quality of life, ventilator‐associated pneumonia
MeSH terms: Case Reports

Oral hygiene deficiency is common in patients treated in ICUs and it enables biofilm colonization by microorganisms that lead to respiratory infections. A 30-year-old female patient with chronic renal failure was hospitalized. Dental procedures were performed in the ICU and contributed to the patient's health after a few days.
Diverticular Pylephlebitis and Polymicrobial Septicemia
Authors: Pradhum Ram, Kamolyut Lapumnuaypol, Chitra Punjabi
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Diverticulitis primarily affects the sigmoid colon and is often complicated by intra-abdominal abscesses and fistulas. Rarely, however, mesenteric venous thrombosis has been known to occur. Optimal management is still unclear. We report the first case of polymicrobial sepsis resulting from diverticular pylephlebitis, managed successfully with bowel rest, antibiotics, and anticoagulation.
Atypical Presentation of Post-Kala-Azar Dermal Leishmaniasis in Bhutan
Authors: Ambika Pradhan, Tashi Tobgay, Sithar Dorjee, Tenzin Wangdi, Guofa Zhou, Nadira D Karunaweera
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

This article describes an atypical case of post-kala-azar dermal leishmaniasis associated with complications due to delayed diagnosis and poor case management. The grave consequences of the prolonged disease process that continued for over 2 decades with eventual healing included facial disfigurement, visual impairment, and mental distress both to the patient and the family. The persistent infection within the skin over a lengthy period with likely increased risk of infection spread in the community highlights its potential negative impact on the ongoing leishmaniasis elimination program in the Indian subcontinent. Bhutan is a member of the leishmaniasis elimination network in Asia, and the government continues to invest in maintenance of the national healthcare system. The case study reveals the gaps in the healthcare system with hardships faced by a patient to access quality healthcare and poor patient outcome used as proxy indicators. It also points to the need to enhance access to healthcare to ensure early diagnosis and effective treatment for leishmaniasis patients including those who live in remote areas, in order to achieve the planned disease elimination targets. It also points towards the key challenges faced by a resource poor nation such as Bhutan in achieving universal health coverage and reaching the set goals for disease elimination. The findings underscore the need for a careful review of the national health care system and to address the deficiencies.
Advancement flap for anterior lamellar reconstruction of the upper eyelid
Authors: Rafael Corredor-Osorio, Vanessa Gabriela Buitrago-Corredor
Journal: GMS Ophthalmol Cases (2019)
Keywords: advancement flap, anterior lamella, skin defects, upper eyelid reconstruction
MeSH terms: Case Reports

A patient with an upper eyelid defect following oncological resection is presented. The defect was reconstructed using an advancement of local flap to provide tissue similar to native tissue, addressing both aesthetic and functional aspects.
A Case of Polymicrobial, Gram-Negative Pulmonic Valve Endocarditis
Authors: Tatiana Bekker, Anusha Govind, Devin M Weber
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Infective endocarditis due to Gram-negative, non-HACEK bacteria is a rare clinical entity. Even moreso, isolated pulmonic valve endocarditis accounts for less than 1.5-2% of all cases of infective endocarditis. These disease pathologies commonly occur in the setting of intravenous drug abuse, indwelling catheters or cardiac devices, or underlying structural heart disease. We present a unique case of pulmonic valve endocarditis in the setting of persistent polymicrobial bacteremia with Klebsiella pneumoniae and Citrobacter koseri with recent gastrointestinal instrumentation evolving into isolated pulmonic valve endocarditis.
Hepatothorax: a rare outcome of high-speed trauma
Authors: Matthew Porcelli, Oksana Prychyna, Andrew Rosenthal, Joseph Decostanza
Journal: Case Rep Emerg Med (2011)
MeSH terms: Case Reports

Diaphragmatic ruptures are the result of severe blunt trauma or penetrating trauma. Motor vehicle crashes are a common mechanism associated with blunt diaphragmatic rupture (BDR). Incorporating diagnostic tools and laparotomy assist in the diagnosis and treatment of BDR. However, diagnosing BDR can be a challenge for practitioners. Early diagnosis and treatment improve the patient's outcomes. This paper details the events of a patient received in a level I trauma unit.
Case Report: Treatment for steroid-refractory immune-related myocarditis with tofacitinib
Authors: Qian Xing, Zhongwei Zhang, Biao Zhu, Qionghua Lin, Lihua Shen, Fangfang Li, Zhili Xia, Zhiyong Zhao
Journal: Front Immunol (2022)
Keywords: immune checkpoint inhibitors, immunosuppression, myocarditis, steroid-refractory, tofacitinib
MeSH terms: Myocarditis / diagnosis, Myocarditis / drug therapy, Myocarditis / etiology, Neoplasms, Case Reports, Humans, Immune Checkpoint Inhibitors, Immunoglobulins, Intravenous, Interleukin-6, Janus Kinases, Piperidines, Pyrimidines, Steroids, Stroke Volume, Troponin, Ventricular Function, Left, Immune Checkpoint Inhibitors, Immunoglobulins, Intravenous, Interleukin-6, Piperidines, Pyrimidines, Steroids, Troponin, tofacitinib, Janus Kinases

Introduction:
Immune therapy has ushered in a new era of tumor treatment, at the expense of immune-related adverse events, including rare but fatal adverse cardiovascular events, such as myocarditis. Steroids remain the cornerstone of therapy for immune-related myocarditis, with no clear consensus on additional immunosuppressive treatment for steroid-refractory cases yet.
Case report:
Here, we report a patient with stage IV nasopharyngeal carcinoma who developed immune-related myocarditis in the fourth course of therapy with immune checkpoint inhibitors. The patient presented with precordial discomfort with elevation of cardiac enzymes and interleukin-6, atypical electrocardiographic abnormalities, and reduced left ventricular ejection fraction. Coronary computed tomography angiography excluded the possibility of acute coronary syndrome. The therapy with tofacitinib targeting the Janus kinase-signal transducer and activator of transcription signal pathway was successfully conducted, since there was no significant improvement in troponin under high-dose steroid and intravenous immunoglobulin treatment. The patient recovered without major adverse cardiac events during hospitalization.
Discussion:
The safety and efficacy of tofacitinib in a patient with steroid-refractory immune-related myocarditis were investigated, hoping to provide a basis for prospective therapeutic strategies. Tofacitinib led to remarkable remissions in primary autoimmune disease by blocking the inflammatory cascade, indicating its potential therapeutic use in immune-related adverse events.
Ipsilateral Rupture of Quadriceps Tendon with Distal Tibia Fracture: A Case Report and Review of the Literature
Authors: Samik Banerjee, Timothy P Dooley, James R Parkinson
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Traumatic rupture of the quadriceps tendon by itself is not an uncommon clinical condition. However, its association with concurrent ipsilateral closed distal tibia oblique fracture is exceedingly rare with only one previously reported case in English literature. The dual diagnosis of this atypical combination of injury may be masked by pain and immobilization of the more obvious fracture and may be missed, unless the treating physician maintains a high index of suspicion. Suprapatellar knee pain with or without a palpable gap in the quadriceps tendon and inability to straight leg raise in the setting of a distal tibia fracture should raise concern, but if initial treatment employs a long-leg splint the knee symptoms may be muted. In this report, we describe this unusual combination of injury in a 67-year-old male patient who sustained a trivial twisting injury to the leg. The aim of this report is to raise awareness and emphasize the importance of thorough and repeated clinical examinations in the presence of distracting injuries. Despite the complexity of the problem, standard techniques for quadriceps tendon repair using transpatellar bone tunnels following locked intramedullary rodding of the tibia fracture may lead to optimal outcomes.
Perivascular epithelioid cell tumor of the ileum presenting as diverticulitis
Authors: Saime Unluoglu, Umit Bayol, Nilay Korkmaz, Bekir Ozenen, Fuat Ipekci, Emel Ebru Pala
Journal: Case Rep Pathol (2012)
MeSH terms: Case Reports

Perivascular epithelioid cell tumors (PEComas) are a group of rare mesenchymal neoplasms. Gastrointestinal PEComas are exceptionally rare, there being only a few case reports in the literature involving the colon and small intestine. Nearly all PEComas show immunoreactivity for both melanocytic (HMB45 and/or Melan-A) and smooth muscle (actin and/or desmin) markers. A 36-year-old male was admitted to the hospital with acut- abdomen. At laparatomy, a nodular mass protruding from the ileum which clinically simulated a diverticulitis was noticed. Gross examination of the specimen revealed a 2 × 1,5 × 1 cm secondarily ulcerated, solid, nodular, gray white tumor mass in the ileal wall. Histologically, tumor cells were composed of nests of round-polygonal epithelioid cells with abundant clear to slightly eosinophilic granular cytoplasm and round vesicular nuclei. The nests were separated by thin fibrovascular septa. Minimal necrosis and low mitotic activity were noticed in the tumor. Immunohistochemically, tumor cells were positive for SMA, HMB45, and Melan-A and negative for CD10, RCC, CD45, CD117, CD34, EMA, and Desmin. Diagnosis was PEComa of the ileum. We report the case of ileal PEComa to remind the unusual presentation (diverticulitis) of these tumors, besides rarity and diagnostic difficulties.
Urethral hemangioma: case report and review of the literature
Authors: Souhail Regragui, Amine Slaoui, Tarik Karmouni, Khalid El Khader, Abdelatif Koutani, Ahmed Ibn Attya
Journal: Pan Afr Med J (2016)
Keywords: urethral hemangioma, surgery, woman
MeSH terms: Hemangioma, Cavernous / diagnosis, Urethral Neoplasms / diagnosis, Urination Disorders / etiology, Case Reports, Review, Female, Hemangioma, Cavernous / pathology, Hemangioma, Cavernous / surgery, Hemorrhage / etiology, Humans, Middle Aged, Urethral Neoplasms / pathology, Urethral Neoplasms / surgery

Hemangiomas are benign vascular tumors. They are the prerogative of the liver and skin. And genitourinary localizations are rare and have only been rarely reported in the prostat, bladder, ureter or the perineum. In the light of published cases, urethral hemangiomas are mostly found in males. Few cases of hemangioma in the female urethra were reported. We report a cavernous hemangioma of the urethra in a 61 years old patient who presented bleeding from the urethra and micturition disorders. Physical examination revealed a tumor 3 cm x 2 polyploid arising from the terminal urethra (urethral hemangioma). We performed surgical resection of the tumor, along with bladder drainage. The postoperative course was simple. We update through a review of the literature aspects of the diagnostic and therapeutic care of the urethral hemangioma.
A Rare Case of Central Pontine Myelinolysis in Overcorrection of Hyponatremia with Total Parenteral Nutrition in Pregnancy
Authors: Kalyana C Janga, Tazleem Khan, Ciril Khorolsky, Sheldon Greenberg, Priscilla Persaud
Journal: Case Rep Nephrol (2015)

A 42-year-old high risk pregnant female presented with hyponatremia from multiple causes and was treated with total parenteral nutrition. She developed acute hypernatremia due to the stage of pregnancy and other comorbidities. All the mechanisms of hyponatremia and hypernatremia were summarized here in our case report. This case has picture (graph) representation of parameters that led to changes in serum sodium and radiological findings of central pontine myelinolysis on MRI. In conclusion we present a complicated case serum sodium changes during pregnancy and pathophysiological effects on serum sodium changes during pregnancy.
Metachronous colon metastasis to the thyroid: a case report and literature review
Authors: Dvir Froylich, Eitan Shiloni, David Hazzan
Journal: Case Rep Surg (2013)

The thyroid gland is a known site for metastatic tumors from various primary sites. Thyroid metastases are not an exceptional finding at autopsy, and they are encountered in 2% to 9% of the patients with malignant neoplasm. The most frequent tumors to metastasize are breast, lung, melanoma, and kidney carcinomas. Despite the fact that it is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of 3% of secondary malignances of this organ. Metastatic colon carcinoma to the thyroid gland has been reported, and it is not as rare as one might think. We present a very unique case of colon carcinoma metastasis to the right thyroid lobe and lung five years after colon resection, with reoccurrence two years later in the contralateral thyroid lobe. The literature regarding colon cancer metastasizing to the thyroid gland was reviewed with an attempt to disclose features of this presentation regarding patient's prognosis.
Persistent SARS-CoV-2 RNA Positive in Feces but Negative in Breastmilk: A Case Report of COVID-19 in a Breastfeeding Patient
Authors: Huikuan Chu, Jing Li, Jingjing Yan, Tai Bai, Bernd Schnabl, Li Zou, Ling Yang, Xiaohua Hou
Journal: Front Med (Lausanne) (2020)
Keywords: covid-19, sars-cov-2 rna, breastfeeding, breastfeeding transmission, fecal-oral transmission
MeSH terms: Case Reports

COVID-19 is a pandemic infectious disease. Whether SARS-CoV-2 was transmitted through breast milk is unknown. Here, we report a breastfeeding woman with COVID-19 presenting with gastrointestinal symptoms and persistent SARS-CoV-2 RNA positivity in both her oropharyngeal swabs and feces, but negativity in her breastmilk. After appearance of serum SARS-CoV-2-IgG, she began to bottle feed her baby with breastmilk without transmission. This report facilitates the understanding of breastfeeding-related risks in COVID-19.
Case report of an acute myocardial infarction complicated by coronary spasm in a patient with chronic systemic lupus erythematosus
Authors: Jeanne Lolita Pek, Zhang Jin, Sun Jian
Journal: Pan Afr Med J (2021)
Keywords: acute myocardial infarction, case report, coronary artery spasm, systemic lupus erythematosus
MeSH terms: Coronary Stenosis / complications, Coronary Vasospasm / complications, Lupus Erythematosus, Systemic / complications, Myocardial Infarction / etiology, Case Reports, Adult, Coronary Stenosis / physiopathology, Coronary Vasospasm / physiopathology, Female, Humans, Lupus Erythematosus, Systemic / physiopathology, Myocardial Infarction / physiopathology

Acute myocardial infarction (AMI) is a major cause of death in a patient with systemic lupus erythematosus (SLE). Due to their chronic inflammatory state, patient with SLE has an increased risk of developing coronary artery disease. We report a case of a middle-aged woman with an acute myocardial infarction (AMI) caused by a right coronary artery (RCA) stenosis complicated with severe coronary artery spasm. Our patient has a history of long-standing SLE. Clinical expression of coronary artery disease (CAD) in SLE is the result of different pathophysiologic mechanism. From this case, we raise the importance of the clinician to be aware of the diverse pathophysiologic pathways involving a coronary artery in a patient with SLE.
Primary Chordoma of the Nasopharynx: A Rare Case Report and Review of the Literatures
Authors: Ery Kus Dwianingsih, Yosinta Snak, Hanggoro Tri Rinonce, Brian Wasita, Ester Lianawati Antoro, Samir S Amr
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Primary chordoma of the nasopharynx is an extremely rare malignant tumor of notochordal origin in the extra-osseous axial skeleton. It presents as a soft tissue mass without involvement of the skull base bone (clivus) and may mimic other lesions of the nasopharynx. A 26-year-old male patient is presented with nasal obstruction and congestion for the last 3 years. Physical and radiological examination revealed a mass in the naso-oropharyngeal region. It was suspected to be a cystic mass or abscess on radiological imaging. However, histopathological examination revealed a chordoma. We review all 20 cases of primary nasopharyngeal chordoma reported previously in the literature. Nasopharyngeal chordoma should be considered in the differential diagnosis of nasopharyngeal mass due to its unspecific appearance on clinical and radiology examination.
Case report: Heterogeneous mutations of SOX10 gene in a Chinese infant with Waardenburg syndrome type 4C
Authors: Suli Zhang, Shuangzhu Lin, Zhenxian Liu, Wanqi Wang, Jiayi Li, Qiandui Chen, Li Yang, Cui Wang, Qiming Pang
Journal: Front Pediatr (2022)
Keywords: hirschsprung's disease, sox10 gene, waardenburg syndrome type 4c, child, deafness
MeSH terms: Case Reports

A 5-month-old patient presented with grayish-blue iris bilaterally, skin and mucosal pigmentation loss, Hirschsprung's disease, full-blown growth retardation, and sensorineural deafness. The patient's whole exon gene sequencing revealed a spontaneous heterozygous code-shifting mutation in the SOX10 gene: c.803del:p.K268Sfs*18. The parents of the child were wild-type, and the site of the mutation is novel.
Balloon Fracturing Valve-in-Valve: How to Do It and a Case Report of TAVR in a Rapid Deployment Prosthesis
Authors: Rodrigo Petersen Saadi, Ana Paula Tagliari, Carisi Anne Polanczyck, João Carlos Ferreira Leal, Eduardo Keller Saadi
Journal: J Interv Cardiol (2022)
MeSH terms: Aortic Valve Stenosis / surgery, Bioprosthesis / adverse effects, Heart Valve Prosthesis Implantation / adverse effects, Heart Valve Prosthesis / adverse effects, Transcatheter Aortic Valve Replacement / adverse effects, Case Reports, Review, Aortic Valve / surgery, Humans, Prosthesis Design, Prosthesis Failure, Treatment Outcome

Transcatheter aortic valve replacement (TAVR) to treat degeneration of bioprosthetic heart valves (BHVs), called as valve-in-valve (ViV), is becoming a key feature since the number of BHVs requiring intervention is increasing and many patients are at high risk for a redo cardiac surgery. However, a TAVR inside a small previous cardiac valve may lead to prosthesis-patient mismatch (PPM) and not be as effective as we hoped for. An effective option to decrease the chance of PPM is to fracture the previous heart valve implanted using a high-pressure balloon. By performing a valve fracture, the inner valve ring of small BHVs can be opened up by a single fracture line, allowing subsequent implantation of a properly sized transcatheter heart valve, without increasing substantially the procedure risk. In this article, we provide a step-by-step procedure on how to safely and properly fracture a BHV and report a case of a TAVR in a degenerated rapid deployment valve.
TAG (Tube and Graft) Sandwich Technique: A Novel Single-Stage Scleral Reinforcement and Aqueous Drainage Tube Implantation
Authors: Faisal Ahmed, Nada G Mohamed
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Purpose:
Refractory glaucoma patients continue to require surgical intervention in the form of trabeculectomy surgery or glaucoma drainage device (GDD). Those patients that require a GDD but have thin sclera or scleromalacia present a challenge.
Methods:
In this article, we present a novel "TAG sandwich" single surgical procedure in which thinned sclera is reinforced with a pericardial patch graft ("bottom layer of the sandwich") allowing safe implantation of the GDD ("the tube sandwich filling") and then placing another patch graft on top of the tube part of the GDD ("top layer of the sandwich"). The surgery was performed on an open-angle glaucoma patient with a generalized thin sclera and uncontrolled intraocular pressure despite maximal topical medication and oral acetazolamide.
Results:
Reinforcing a compromised sclera with a pericardium patch graft allowed the safe implantation of a glaucoma drainage device. The patient's intraocular pressure was safely controlled at 7 mmHg almost 1-year postsurgery without intraocular pressure-lowering drops.
Conclusions:
This scleral strengthening procedure can be considered by readers in other ocular surgeries where there is a risk of scleral perforation, as well as part of a combined surgery where refractory glaucoma patients with thin sclera require scleral reinforcement to allow for safer implantation of a glaucoma drainage device.
Robotic-Assisted Partial Nephrectomy and Adrenalectomy: Case of a Pheochromocytoma Invading into Renal Parenchyma
Authors: Zeynep G Gul, Christine W Liaw, Avinash Reddy, Reza Mehrazin
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Although upper pole renal masses and adrenal masses can usually be distinguished on cross-sectional imaging, large masses can obscure the boundaries between the kidney and adrenal gland. We describe a unique case of an adrenal pheochromocytoma in a 42-year-old female who was referred for robotic partial nephrectomy. During the procedure, the patient developed severe hypertension. The case was aborted, and the workup revealed pheochromocytoma. After appropriate pretreatment, the patient underwent a successful robotic adrenalectomy and partial nephrectomy. Therefore, we recommend screening patients with hypertension and large upper pole masses for pheochromocytoma to better direct preoperative management.
Zinc Deficiency-Associated Dysgeusia Preventing the Improvement of Severe Hyperemesis Gravidarum
Authors: Shohei Tanabe, Sachiyo Sugino, Kotaro Ichida, Kiyoshi Niiya, Syuji Morishima
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

A 23-year-old primigravida visited the hospital frequently since the early phase of her pregnancy because of severe hyperemesis gravidarum. She was hospitalized for the same at 14 weeks and 1 day of pregnancy. After admission, peripheral intravenous nutrition was started; however, her symptoms did not improve. At 17 weeks and 1 day of gestation, a blood sample was collected to determine the presence of trace element deficiencies, and a zinc deficiency was revealed. We examined the patient's symptoms and found that she had developed dysgeusia. After receiving a zinc preparation, her taste disorder gradually improved, and her oral intake increased. Her hyperemesis gravidarum resolved, and she was discharged from the hospital at 18 weeks and 2 days of gestation. The findings from this case suggest that prolonged peripheral intravenous nutrition in patients with severe hyperemesis gravidarum can lead to zinc deficiency and impede the successful treatment of hyperemesis gravidarum.