OpenMed/multicare-articles huggingface dataset:
A Novel Electromagnetic-Neurobiologic Interface for Functional Animation of Dormant Motor Nerve Roots in Spinal Cord Injury via Neuromodulation
Authors: Jawad Shah, Richard H Smith, Abeer Al-Gharaibeh
Journal: Front Surg (2020)
Keywords: electrical stimulation, interface, neuromodulation, paralysis, spinal cord injury
MeSH terms: Case Reports

Complete spinal cord injury is a devastating occurrence afflicting millions of people worldwide with no available treatment for functional motor recovery. In this report, we describe a procedure in which we used parts of a device available for chronic pain treatment to provide a neuromodulation of motor nerve roots in a case with complete motor and sensory paraplegia. By using a retrograde trans-foraminal approach to implant electrodes close to L2-S1 motor nerve roots bilaterally, we were able to stimulate those nerves and induce precise movements at the joints of lower extremity in a T5 complete spinal cord injury case. We believe that our approach shows potential of the device as a rehabilitation system with the possibility of a parallel electric circuitry that can bridge a damaged spinal cord.
Sickle cell leg ulcer successfully managed by hyperbaric oxygen: a case report
Authors: Awni Alshurafa, Mohammed Alkhatib, Mohammad Abu-Tineh, Mohamed A Yassin
Journal: Front Med (Lausanne) (2023)
Keywords: hyperbaric oxygen, leg ulcer, sickle cell disease, wound care, wound healing
MeSH terms: Case Reports

Sickle cell leg ulcers (SCLUs) are usually chronic, painful, and devastating complications of sickle cell disease. Skin vaso-occlusion with compromised blood flow, chronic inflammation, and endothelial dysfunction is thought to be the underlying mechanism. It is usually slow to heal, and it may become chronic and superinfected. The management of SCLUs is usually challenging and requires a multidisciplinary team. Multiple systemic and local therapies have been tried in SCLU treatment. However, the outcome is variable: currently, there are no official recommendations for the best effective treatment. Herein, we report a 34-year-old male patient with non-transfusion-dependent sickle cell disease who was suffering from a chronic left ankle ulcer and was successfully managed with hyperbaric oxygen therapy, resulting in a complete resolution of this devastating complication.
Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree
Authors: Hamed Mortazavi, Yaser Safi, Maryam Baharvand, Somayeh Rahmani
Journal: Int J Dent (2016)
MeSH terms: Review

Diagnosis of oral ulcerative lesions might be quite challenging. This narrative review article aims to introduce an updated decision tree for diagnosing oral ulcerative lesions on the basis of their diagnostic features. Various general search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as "oral ulcer," "stomatitis," and "mouth diseases." Thereafter, English-language articles published since 1983 to 2015 in both medical and dental journals including reviews, meta-analyses, original papers, and case reports were appraised. Upon compilation of the relevant data, oral ulcerative lesions were categorized into three major groups: acute, chronic, and recurrent ulcers and into five subgroups: solitary acute, multiple acute, solitary chronic, multiple chronic, and solitary/multiple recurrent, based on the number and duration of lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by stepwise progression.
The recurrence of the melanotic neuroectodermal tumour of infancy: an unusual presentation of a rare tumour
Authors: Antonio Augusto Claudio Pereira, Mayara Maria de Jesus Rozante, Rafael Bauer Doveinis, Carmine Porcelli Salvarani, Tania Hissa Anegawa, Paola da Costa Souza, Daniel J Brat, Alessandra Cristina de Oliveira Borges
Journal: Ecancermedicalscience (2020)
Keywords: case report, melanotic neuroectodermal tumour of infancy, melanotic progonoma, skull
MeSH terms: Case Reports

The melanotic neuroectodermal tumour of infancy (MNTI), also known as melanotic progonoma, is a rare neoplasm derived from neural crest cells. Although it is fundamentally benign, the tumour may present a locally aggressive behaviour, characterised by a rapid progression and a destructive invasion of adjacent structures, hence causing deformities. Unfortunately, perhaps due to the low incidence of this type of tumour, the published cases in the literature do not characterise the factors that imply the malignant or recurrent behaviour of the disease, nor the therapy to conduct these cases. Here, we report a rare case of a recurrent benign MNTI, approached unusually with a favourable outcome.
Myositis, Vasculitis, Hepatic Dysfunction in Adult-Onset Still's Disease
Authors: Hidekatsu Yanai, Nobuyuki Furutani, Hiroshi Yoshida, Norio Tada
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Although hepatic dysfunction is common in adult-onset Still's disease (AOSD), sometimes it is difficult to differentiate hepatic dysfunction due to AOSD itself from drug-induced hepatic dysfunction. Further, myalgia often occurs in patients with AOSD; however, AOSD patients complicated with myositis are rare. We report a 43-year-old Japanese man with AOSD who developed myositis and hepatic dysfunction which were deteriorated by multiple nonsteroidal antiinflammatory drugs (NSAIDs) and were dramatically ameliorated by a low-dose steroid therapy. A skin biopsy of salmon pink rash which is characteristic for AOSD showed leukocytoclastic vasculitis, and the markers for vasculitis, plasma von Willebrand factor, and vascular endothelial growth factor levels were elevated in this patient, suggesting an association between AOSD and systemic vasculitis.
Cryptococcal meningitis presenting with recurrent syncope in a patient with chronic lymphoid leukemia: a case report
Authors: Imdad Ahmed, Steven Powell, Michael Hoth, Ahmed Javed, Steffany K Moen, Melissa R Haehn
Journal: Cases J (2009)

The clinical presentations of cryptococcal meningitis in HIV-negative patients may be different from that infected with HIV. We report a case of 75-year old male with chronic lymphoid leukemia presenting with recurrent syncope, bi-frontal headache and diplopia. This case discusses the atypical presentations of cryptococcal meningitis in HIV-negative patients and its importance of early diagnosis.
Long-term survival after gamma knife radiosurgery in a case of recurrent glioblastoma multiforme: a case report and review of the literature
Authors: Sudheer R Thumma, Ameer L Elaimy, Nathan Daines, Alexander R Mackay, Wayne T Lamoreaux, Robert K Fairbanks, John J Demakas, Barton S Cooke, Christopher M Lee
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

The management of recurrent glioblastoma is highly challenging, and treatment outcomes remain uniformly poor. Glioblastoma is a highly infiltrative tumor, and complete surgical resection of all microscopic extensions cannot be achieved at the time of initial diagnosis, and hence local recurrence is observed in most patients. Gamma Knife radiosurgery has been used to treat these tumor recurrences for select cases and has been successful in prolonging the median survival by 8-12 months on average for select cases. We present the unique case of a 63-year-old male with multiple sequential recurrences of glioblastoma after initial standard treatment with surgery followed by concomitant external beam radiation therapy and chemotherapy (temozolomide). The patient was followed clinically as well as with surveillance MRI scans at every 2-3-month intervals. The patient underwent Gamma Knife radiosurgery three times for 3 separate tumor recurrences, and the patient survived for seven years following the initial diagnosis with this aggressive treatment. The median survival in patients with recurrent glioblastoma is usually 8-12 months after recurrence, and this unique case illustrates that aggressive local therapy can lead to long-term survivors in select situations. We advocate that each patient treatment at the time of recurrence should be tailored to each clinical situation and desire for quality of life and improved longevity.
Fulminant course of unilateral emphysematous pyelonephritis revealing a renal actinomycosis caused by Actinomyces meyeri, an unknown cause of septic shock
Authors: Alexandre Herbland, Maxime Leloup, Quentin Levrat, Frédéric Guillaume, Virginie Verrier, Philippe Bouillard, Thierry Landois, Charlie Frédéric Ouaki, Olivier Lesieur
Journal: J Intensive Care (2014)
Keywords: actinomyces, actinomycosis, emphysematous pyelonephritis, pyuria, sepsis, shock
MeSH terms: Case Reports

The objective of this case report is to describe the first case of renal actinomycosis caused by Actinomyces meyeri presenting as severe emphysematous pyelonephritis and complicated by septic shock and multi-organ failure. Emphysematous pyelonephritis is a potentially life-threatening infection mostly described in diabetic patients and predominantly caused by uropathogenic bacteria. Actinomycosis is an uncommon chronic infection due to anaerobic gram-positive bacteria that unusually involves the urinary tract. We report the first case of emphysematous pyelonephritis caused by A. meyeri in a 75-year-old non-diabetic woman. The patient presented with an altered status, fever, nausea, and vomiting lasting for 2 days. A computed tomography scan revealed unilateral emphysematous pyelonephritis. She was rapidly admitted to intensive care unit for a septic shock with multiple organ dysfunctions. A conservative management consisting in renal percutaneous drainage, supportive measures, and prolonged adapted antibiotic therapy resulted in complete recovery. This case report illustrates that renal actinomycosis should be considered in case of emphysematous pyelonephritis given the good prognosis of this infection with conservative medical treatment.
Computer-assisted navigation in Birmingham hip resurfacing: A case report
Authors: Ritesh Shah, Jessica R Benson, Jeffrey M Muir
Journal: SAGE Open Med Case Rep (2018)
Keywords: birmingham hip resurfacing, orthopaedics/rehabilitation/occupational therapy, computer-assisted navigation, surgery
MeSH terms: Case Reports

Component malpositioning during Birmingham hip resurfacing increases the risk for component wear, metallosis, component loosening, and the likelihood of dislocation and revision surgery. Computer-assisted navigation can increase the accuracy to which components are placed, and the utilization of this technology in Birmingham hip resurfacing is increasing. The present report summarizes the accuracy of acetabular component positioning in a Birmingham hip resurfacing case utilizing navigation. Intraoperative C-arm fluoroscopy following the use of the navigation tool confirmed excellent seating, positioning, and stability of the acetabular component. In addition, post-operative antero-posterior radiographs confirmed device accuracy and revealed a stable joint with no evidence of acetabular loosening or femoral fracture. Computer-assisted navigation may therefore be an effective tool to improve the accuracy of component positioning during Birmingham hip resurfacing.
A rare case report of gemcitabine-induced thrombotic microangiopathies
Authors: Mohammed Ali Madkhali
Journal: SAGE Open Med Case Rep (2021)
Keywords: case report, gemcitabine, thrombotic microangiopathies
MeSH terms: Case Reports

A 65-year-old female patient with breast cancer and soft tissue sarcoma who experienced a gemcitabine-induced thrombotic microangiopathies manifestation visited the emergency department. The renal biopsy revealed endothelial cell swelling, focal reduplication of glomerular basement membrane, and narrowed capillary lumens with fibrin deposition and fragmented erythrocytes which are compatible with thrombotic microangiopathies. The patient was presented with organ injury, acute renal failure with the need for hemodialysis technique. The patient recovered after the appropriate treatment. Continuous observation of renal function during gemcitabine treatment regularly and withdrawal of treatment if acute kidney injury occurs is essential as acute kidney injury along with thrombotic microangiopathies may prove to be life-threatening.
Craniopharyngeal duct: a cause of recurrent meningitis
Authors: S Biswas, C P Millward, A Riordan, A Sinha, S Avula
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Identification of the cause of recurrent meningitis may pose a diagnostic challenge. Evaluation of a patient with recurrent meningitis calls for meticulous review of skull base structures by cross sectional imaging to exclude any underlying anatomical abnormality. Our case highlights the importance of excluding persistent craniopharyngeal duct, a rare but treatable cause of recurrent meningitis. The isolation of Streptococcus pneumoniae in recurrent meningitis may be a clue to the presence of a skull base abnormality. Craniopharyngeal canals have been classified depending on their qualitative and quantitative imaging features. Such imaging based classification is important for identification of patients with associated potential pituitary involvement and also for appropriate surgical planning. Controversy exists as to the approach to surgical treatment of craniopahryngeal duct. The persistent craniopahryngeal duct in our patient was successfully treated by an endoscopic transsphenoidal approach.
Intrusion of episcleral buckles: report of two cases and brief review
Authors: Mohammad Zarei, Alireza Mahmoudi, Abdollah Hadi, Hamid Riazi-Esfahani
Journal: Int J Retina Vitreous (2020)
Keywords: complication, erosion, intrusion, scleral buckling, vitreous haemorrhage
MeSH terms: Case Reports

Background:
The authors report two cases of the scleral buckles intrusion and erosion that presented many years after primary surgery with vitreous haemorrhage in one of them. Although the erosion/intrusion of a silicone scleral buckle (SB) is rare, it may have serious consequences and optimal management can be challenging. Therefore, this diagnosis should be considered if attributable signs and symptoms including vitreous haemorrhage occurred after scleral buckling. The authors briefly review the literature on clinical presentation and management of the episcleral silicone buckling erosion and intrusion.
Case presentation:
Case 1: A 48-year-old woman with a history of scleral buckling for an inferior rhegmatogenous retinal detachment presented with visual loss in her right eye. A vitreous haemorrhage was observed. After Close observation, Partial resolution of haemorrhage revealed an intruded sponge segment in inferior vitreous cavity. Case 2: A 26-year-old man was referred for retinal evaluation. Twenty years earlier, he had undergone lensectomy for bilateral childhood cataract. Ten years ago, he had developed an aphakic RRD in the left eye. The detachment was managed with pars plana deep vitrectomy, endolaser, an encircling silicone band, and silicone oil injection. On examination an eroded band was noted.
Conclusion:
Although the erosion/intrusion of a silicone episcleral buckle is rare, it may have serious consequences and optimal management can be challenging. Unnecessarily destructive techniques may predispose the eye to this complication and should be avoided. Patients who have a history of SB need lifelong follow-up and this diagnosis should be considered if attributable signs and symptoms occurred.
Case report: Circulating tumor DNA technology displays temporal and spatial heterogeneity in Waldenström macroglobulinemia during treatment with BTK inhibitors
Authors: Jingjing Zhu, Xinyu Zhu, Fengyang Xie, Yi Ding, Huina Lu, Yan Dong, Ping Li, Jianfei Fu, Aibin Liang, Yu Zeng, Bing Xiu
Journal: Pathol Oncol Res (2023)
Keywords: btk inhibitor, waldenström macroglobulinemia, ascites, circulating tumor dna (ctdna), resistance
MeSH terms: Circulating Tumor DNA / genetics, Lymphoma, B-Cell, Waldenstrom Macroglobulinemia / drug therapy, Waldenstrom Macroglobulinemia / genetics, Case Reports, Agammaglobulinaemia Tyrosine Kinase / antagonists & inhibitors, Ascites, Disease Progression, Humans, Male, Middle Aged, Protein Kinase Inhibitors / therapeutic use, Circulating Tumor DNA, Agammaglobulinaemia Tyrosine Kinase, Protein Kinase Inhibitors

Background: Waldenström macroglobulinemia (WM) is a rare subtype of B-cell lymphoma. Rituximab-based combination therapy and Bruton's tyrosine kinase (BTK) inhibitors have greatly improved the prognosis of WM. Despite the high response rate and good tolerance of BTK inhibitors in treatment of WM, a proportion of patients still experience disease progression. Case presentation: We report a 55-year-old man with relapsed WM. The patient achieved partial remission after six courses of CHOP chemotherapy and multiple plasma exchanges in initial treatment. He was admitted to the hospital with abdominal distension, and was diagnosed with relapsed WM and subsequently started on zanubrutinib. Disease progression and histological transformation occurred during treatment. We performed liquid biopsies on transformed plasma, tumor tissue and ascites at the same time and found high consistency between ascites and tissues. Moreover, we detected resistance mutations of BTK inhibitors (BTK, PLCG2) in ascites that were not detected in plasma or tissue. Eventually, the patient died during the 15-month follow-up after relapse. Conclusion: We describe a rare case of WM transformation to DLCBCL treated with chemoimmunotherapy and BTK inhibition. We analyzed tumor DNA obtained at different anatomic sites and circulating tumor DNA (ctDNA) derived from plasma and ascites specimens, with apparent significant temporal and spatial heterogeneity. The case specifically highlights the clinical value of ctDNA of ascites supernatant from WM patients, which is a more convenient and relatively noninvasive method compared with traditional invasive tissue biopsy.
Endoscopic far-lateral supracerebellar infratentorial approach for resection of posterior clinoid meningioma: Case report and literature review
Authors: Yang Bai, Song Han, Xiaoyu Sun, Xuantong Liu, Xinning Li, Sizhe Feng, Guobiao Liang
Journal: Front Oncol (2023)
Keywords: case report, endoscope, posterior clinoid meningioma, supracerebellar infratentorial approach, surgical approach
MeSH terms: Case Reports

Introduction:
The surgery of posterior clinoid meningioma (PCM) remains one of the most formidable challenges for neurosurgeons because of its location at great depth in the cranium and proximity to vital neurovascular structures. Herein, we aim to describe the technique and feasibility of a novel approach, the purely endoscopic far-lateral supracerebellar infratentorial approach (EF-SCITA), for resection of this extremely rare entity.
Case description:
A 67-year-old women presented with gradually deteriorating vision in right eye for 6 months. Imaging examinations revealed a right-sided PCM, and the EF-SCITA approach was attempted for tumor resection. Tentorium incision allowed a working corridor toward the PCM in the ambient cistern through the supracerebellar space. During surgery, the infratentorial part of the tumor was found to compress the CN III and posterior cerebral artery medially and encase the CN IV laterally. Following debulking of the infratentorial tumor, the supratentorial part could be exposed and then excised, which had dense adhesions to the ICA and the initial part of the basal vein in front. After total tumor removal, its dural attachment was detected at the right posterior clinoid process and then coagulated under direct vision. The patient on follow-up at 1 month had improvement in visual acuity in right eye, with no restriction of extra-ocular movements.
Discussion:
EF-SCITA approach combines advantages of the posterolateral approach and endoscopic technique, allowing access to PCMs with seemingly low risks of postoperative morbidity. It would be a safe and effective alternative for resection of lesions in the retrosellar space.
Asymptomatic Gastric Giant Polyp in a Boy with Peutz-Jeghers Syndrome Presented with Multiple Café Au Lait Traits
Authors: Christos Plataras, Efstratios Christianakis, Florentia Fostira, George Bourikis, Maria Chorti, Dimitrios Bourikas, Nikolaos Fotopoulos, Konstantinos Damalas, Khalil Eirekat
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

We describe an asymptomatic case of PJS in a six-year-old boy with café au lait spots in several parts of his body, a large gastroduodenal polyp, two polyps near the ampulla of Vater, and another in the jejunum. This patient shows some unique aspects of PJS. No other such large gastric polyp in a Peutz-Jeghers child is reported in the literature. The large size of the gastric polyp with lack of symptoms is unusual and poses a unique challenge in terms of management and surgical resection.
Low-Load Unilateral and Bilateral Resistance Training to Restore Lower Limb Function in the Early Rehabilitation After Total Knee Arthroplasty: A Randomized Active-Controlled Clinical Trial
Authors: Robert Jacksteit, Tino Stöckel, Martin Behrens, Frank Feldhege, Philipp Bergschmidt, Rainer Bader, Wolfram Mittelmeier, Ralf Skripitz, Anett Mau-Moeller
Journal: Front Med (Lausanne) (2021)
Keywords: continuous passive motion, controlled active motion, cross education, interlimb transfer, range of motion, strength training
MeSH terms: Case Reports

Background: Continuous passive motion (CPM) is frequently used during rehabilitation following total knee arthroplasty (TKA). Low-load resistance training (LLRT) using continuous active motion (CAM) devices is a promising alternative. We investigated the effectiveness of CPM compared to LLRT using the affected leg (CAMuni) and both legs (CAMbi) in the early post-operative rehabilitation.
Hypotheses:
(I) LLRT (CAMuni and CAMbi) is superior to CPM, (II) additional training of the unaffected leg (CAMbi) is more effective than unilateral training (CAMuni). Materials and Methods: Eighty-five TKA patients were randomly assigned to three groups, respectively: (i) unilateral CPM of the operated leg; (ii) unilateral CAM of the operated leg (CAMuni); (iii) bilateral alternating CAM (CAMbi). Patients were assessed 1 day before TKA (pre-test), 1 day before discharge (post-test), and 3 months post-operatively (follow-up).
Primary outcome:
active knee flexion range of motion (ROMFlex).
Secondary outcomes:
active knee extension ROM (ROMExt), swelling, pain, C-reactive protein, quality of life (Qol), physical activity, timed-up-and-go performance, stair-climbing performance, quadriceps muscle strength. Analyses of covariances were performed (modified intention-to-treat and per-protocol). Results: Hypothesis I: Primary outcome: CAMbi resulted in a higher ROMFlex of 9.0° (95%CI -18.03-0.04°, d = 0.76) and 6.3° (95%CI -14.31-0.99°, d = 0.61) compared to CPM at post-test and follow-up, respectively.
Secondary outcomes:
At post-test, C-reactive protein was lower in both CAM groups compared with CPM. Knee pain was lower in CAMuni compared to CPM. Improved ROMExt, reduced swelling, better stair-climbing and timed-up-and-go performance were observed for CAMbi compared to CPM. At follow-up, both CAM groups reported higher Qol and CAMbi showed a better timed-up-and-go performance. Hypothesis II: Primary outcome: CAMbi resulted in a higher knee ROMFlex of 6.5° (95%CI -2.16-15.21°, d = 0.56) compared to CAMuni at post-test.
Secondary outcomes:
At post-test, improved ROMExt, reduced swelling, and better timed-up-and-go performance were observed in CAMbi compared to CAMuni. Conclusions: Additional LLRT of the unaffected leg (CAMbi) seems to be more effective for recovery of function than training of the affected leg only (CAMuni), which may be mediated by positive transfer effects from the unaffected to the affected limb (cross education) and/or preserved neuromuscular function of the trained, unaffected leg. Trial Registration: ClinicalTrials.gov Identifier: NCT02062138.