OpenMed/multicare-articles huggingface dataset:
Kounis Syndrome Secondary to Medicine-Induced Hypersensitivity
Authors: Parackrama Karunathilake, Udaya Ralapanawa, Thilak Jayalath, Shamali Abeyagunawardena
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Introduction:
Kounis syndrome is the concurrence of an acute coronary syndrome (ACS) caused by coronary vasospasms, acute myocardial infarctions, or stent thromboses in case of allergic or hypersensitivity reactions. Kounis syndrome is mediated by mast cells that interact with macrophages and T-lymphocytes, causing degranulation and inflammation with cytokine release. It is a life-threatening condition that has many trigger factors and is most commonly caused by medicines. Case Presentation. A 71-year-old male was admitted with a fever of five days' duration associated with cellulitis, for which he had been treated with clindamycin and flucloxacillin before admission. He was a diagnosed patient with hypertension and dyslipidemia five years ago. After taking the antibiotics, he had developed generalized itching followed by urticaria suggesting an allergic reaction. Therefore, he was admitted to the hospital. After admission, he developed an ischaemic-type chest pain associated with autonomic symptoms and shortness of breath. An immediate ECG was taken that showed ST-segment depressions in the chest leads V4-V6, confirmed by a repeat ECG. Troponin I was 8 ng/mL. Acute management of ACS was started, and prednisolone 10 mg daily dose was given. After complete recovery, the patient was discharged with aspirin, clopidogrel, atorvastatin, metoprolol, losartan, isosorbide mononitrate, and nicorandil. Prednisolone 10 mg daily dose was given for five days after discharge.
Conclusion:
In immediate hypersensitivity, with persistent cardiovascular instability, Kounis syndrome should be considered, and an electrocardiogram and other appropriate assessments and treatments should be initiated. Prompt management of the allergic reaction and the ACS is vital for a better outcome of Kounis syndrome.
The use of a Meckel's diverticulum in the creation of an orthotopic neobladder in case of a short mesoileum: a case report
Authors: Wim Van Haute, Christophe Ghysel, Peter Van Oyen
Journal: Adv Urol (2009)
MeSH terms: Case Reports

A 72-year-old patient was treated in our department for an invasive bladder TCC by cystoprostatectomy with the intention to create an orthotopic neobladder. During surgery it appeared to be impossible to mobilize part of the preterminal ileum into the small pelvis to make an anastomosis with the urethral stump. However, incidentally, a Meckel's diverticulum of about 8 cm was found on the preterminal ileum which could easily be mobilized onto the urethral stump. The intestinal insertion of the diverticulum served as the lowest point of the pouch. Above the diverticulum, we created a modified Studer-pouch. No major postoperative complications occurred and during the follow-up period of more than 12 months micturition was good.
Orthodontic Space Closure of a Missing Maxillary Lateral Incisor Followed by Canine Lateralization
Authors: Sanjay Prasad Gupta, Shristi Rauniyar
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Maxillary lateral incisor agenesis is the most prevalent developmental dental anomaly. The management of missing lateral incisor was either closure using canine as substitution or creation of space orthodontically for prosthetic replacement. A careful diagnosis and treatment plan are deemed essential to address the patient's needs as the spacing is present in the esthetic region. Such problem is very challenging for orthodontists, prosthodontists, and general practitioners. This case report describes the orthodontic management of a 22-year-old adult female patient with missing upper left lateral incisor tooth and upper anterior spacing by closing the space with canine lateralization and reshaping to simulate it with the lateral incisor. However, some modifications in the treatment mechanics are crucial to achieve the optimal esthetic and to improve the occlusion. Space closure with canine lateralization option seems less invasive, treatment can be completed relatively in a short period of time, and its adaptation with the facial changes throughout life without having artificial prosthesis provided other factors favoring for this option.
Nasopharyngeal actinomycosis
Authors: Lamia Ouertatani, Yassine Jeblaoui, Salima Kharrat, Samia Sahtout, Ghazi Besbes
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

Nasopharyngeal actinomycosis is a rarely encountered bacterial infection which usually occurs after nasal trauma or surgery. In some clinical cases, nasopharyngeal actinomycosis has appeared in patients without prior trauma, making diagnosis difficult. Here we present three such cases successfully treated with appropriate dosages of penicillin. One 16-year-old boy with no previous medical antecedents showed an important thickening of the posterior wall of the nasopharynx. A similar nasopharyngeal thickening was found in a 42-year-old woman exhibiting poor dental hygiene. In another 42-year-old woman, nasopharyngeal inflammation was accompanied by multiple right lymphoadenopathies. Like the first two patients, the woman had no prior trauma but did exhibit poor dental hygiene and teeth rottenness. In all three patients, actinomycosis diagnosis was confirmed by anaerobic microbial culturing of the biopsy specimen. Although diagnosis is delayed in patients with no prior trauma, treatment with antibiotics has greatly improved the prognosis for all forms of actinomycosis, and neither death nor deformity is common.
Case report: Thoracolumbar spinal stenosis associated with alkaptonuria
Authors: Hong Ding, Liang Wang, Gan-Jun Feng, Yue-Ming Song, Li-Min Liu
Journal: Front Surg (2023)
Keywords: alkaptonuria, case report, kyphosis, surgery, thoracolumbar spinal stenosis
MeSH terms: Case Reports

Background:
Alkaptonuria is a rare autosomal genetic disorder with an incidence of about 1 in 1 million per year. Spinal involvement often manifests in the later stages of the disease. However, this is the first report of the presentation of thoracolumbar spinal stenosis.
Case presentation:
We report the case of a 61-year-old female patient with significant thoracolumbar stenosis symptoms. The patient had obvious kyphosis with preoperative lower extremity muscle strength grade 2/5. Symptoms and imaging signs initially suggested ankylosing spondylitis. This patient was classified into motor incomplete injury (ASIA C). However, the patient was found to have melanin deposits on the sclera and skin, and the urine was darkened at rest. CT and MRI both suggested no bone bridge connection between vertebrae, which was the key difference between ankylosing spondylitis and alkaptonuria in imaging. Most importantly, urine specimen testing and intraoperative pathology demonstrated alkaptonuria. The patient underwent spinal decompression and vertebral body fixation. Postoperative recovery was good: the patient had significantly relieved pain and could stand and walk.
Conclusion:
This case is the first report of thoracolumbar spinal stenosis associated with alkaptonuria involving the spine.
Case Report: Individualization of Intensive Transactional Analysis Psychotherapy on the Basis of Ego Strength
Authors: Irene Messina, Francesco Scottà, Arianna Marchi, Enrico Benelli, Alessandro Grecucci, Marco Sambin
Journal: Front Psychol (2021)
Keywords: itap, brief dynamic therapy, dynamic psychotherapy, ego strength, outcome, process, single-case
MeSH terms: Case Reports

In intensive transactional analysis psychotherapy (ITAP), intensity is obtained with both technical expedients and the relational manner with the patient. In ITAP, the therapist modulates pressure and support commensurately to the patients' ego strength. In the present article, we contrast two clinical cases of young adults in which ego strength produced different therapy outcomes and processes. We present excerpts of the psychotherapy process that illustrates technical aspects of ITAP as well as the therapist's attitude that we describe as holding. We show quantitative therapy outcomes consisting of effects size values of changes in Clinical Outcome in Routine Evaluation-Outcome Measure scores in baseline, treatment, and follow-up phases and qualitative outcome evaluated with the Change Interview at the end of the therapy. In the patient with high ego strength, we observed a rapid improvement and a complete recovery at the end of the therapy, whereas the results of the patient with low ego strength were less consistent (more fluctuations in Clinical Outcome in Routine Evaluation-Outcome Measure scores including deterioration but good qualitative outcome). We conclude that quantitative and qualitative outcome data, together with process observations, are required to have a complete picture of therapy effectiveness. Moreover, we conclude that qualitative ego strength is not a limitation for the use of expressive therapy such as ITAP, but rather, it is an important variable that should be considered to dose confrontations and support.
Superior Mesenteric Artery Syndrome in a 6-Year-Old Girl with Final Diagnosis of Celiac Disease
Authors: F Salehzadeh, Ali Samadi, M Mirzarahimi
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Background:
Superior mesenteric artery syndrome (SMAS) occurs when the duodenum is compressed between the two arteries, superior mesenteric artery and aorta. The complications of this rarely found disorder in children range from causing trouble in duodenal functions to intestinal obstruction which is potentially life-threatening.
Case presentation:
Here we are reporting a case of SMAS in a 6-year-old girl with the complaint of chronic abdominal pain since 3 years. She suffered from growth failure, while different workups were negative. Ultimately, imaging investigations detected superior mesenteric artery syndrome as an etiologic background. In the additional investigations, it is found that she suffered from celiac disease.
Conclusion:
We concluded that the inflammatory nature of the celiac disease can affect the anatomy of the duodenum beyond its mucosal surface in the mesenteric fat tissue and results in SMAS.
Fetal akinesia deformation sequence with pontocerebellar hypoplasia, and migration and gyration defects
Authors: Meghan Elizabeth Kapp, Pamela Lyle, Hilary Highfield Nickols
Journal: Autops Case Rep (2021)
Keywords: arthrogryposis, corpus callosum, infant, newborn, karyotype, phenotype
MeSH terms: Case Reports

Fetal akinesia deformation sequence (FADS), or Pena-Shokeir phenotype is a constellation of deformational changes resulting from decreased or absent fetal movement, and include arthrogryposis, and craniofacial and central nervous system anomalies. We report an autopsy case of a 36-6/7week female neonate with a normal female karyotype and chromosome microarray demonstrating findings consistent with FADS. We provide a detailed examination of the severe and complex central nervous system abnormalities, including marked pontocerebellar hypoplasia and cortical and cerebellar migration and gyration defects. This case represents a rare detailed examination of the central nervous system of a patient with FADS.
Case report: Emergency presentation of Meckel's diverticulum in the 3rd trimester of pregnancy
Authors: Yantao He, Lilan Wang, Wulan Cao
Journal: Front Surg (2023)
Keywords: acute abdomen, emergency, meckel's diverticulum, obstetric (third trimester), pregnancy
MeSH terms: Case Reports

Background:
Symptomatic Meckel's diverticulum (MD) is easily neglected in the acute abdomen during pregnancy. MD is the most common congenitally anomalous development of the intestines, with an incidence of 2% in the general population, although it is not easily diagnosed because of variable clinical features. Especially when complicated with pregnancy, doctors can easily overlook this disease, which directly threatens maternal and foetal life.
Case presentation:
We report the case of a 25-year-old at 32 + 2 weeks of gestation complicated with MD volvulus who presented with progressive abdominal pain and finally peritonitis. She underwent exploratory laparotomy and small-bowel resection. The mother and the baby successfully recovered.
Conclusions:
MD-complicated pregnancy is not easily diagnosed. Once highly suspiciously diagnosed, especially with peritonitis, surgery should be arranged, which helps preserve maternal and foetal life.
Advances and Challenges in Understanding MicroRNA Function in Tauopathies: A Case Study of miR-132/212
Authors: Emmanuelle Boscher, Julia Hernandez-Rapp, Serena Petry, Remi Keraudren, Sara Rainone, Andréanne Loiselle, Claudia Goupil, Andréanne Turgeon, Isabelle St-Amour, Emmanuel Planel, Sébastien S Hébert
Journal: Front Neurol (2020)
Keywords: ps19, mir-132, microrna, tau, tauopathies

In the past decade, several groups have reported that microRNAs (miRNAs) can participate in the regulation of tau protein at different levels, including its expression, alternative splicing, phosphorylation, and aggregation. These observations are significant, since the abnormal regulation and deposition of tau is associated with nearly 30 neurodegenerative disorders. Interestingly, miRNA profiles go awry in tauopathies such as Alzheimer's disease, progressive supranuclear palsy, and frontotemporal dementia. Understanding the role and impact of miRNAs on tau biology could therefore provide important insights into disease risk, diagnostics, and perhaps therapeutics. In this Perspective article, we discuss recent advances in miRNA research related to tau. While proof-of-principle studies hold promise, physiological validation remains limited. To help fill this gap, we describe herein a pure tauopathy mouse model deficient for the miR-132/212 cluster. This miRNA family is strongly downregulated in human tauopathies and shown to regulate tau in vitro and in vivo. No significant differences in survival, motor deficits or body weight were observed in PS19 mice lacking miR-132/212. Age-specific effects were seen on tau expression and phosphorylation but not aggregation. Moreover, various miR-132/212 targets previously implicated in tau modulation were unaffected (GSK-3β, Foxo3a, Mapk1, p300) or, unexpectedly, reduced (Mapk3, Foxo1, p300, Calpain 2) in miR-132/212-deficient PS19 mice. These observations highlight the challenges of miRNA research in living models, and current limitations of transgenic tau mouse models lacking functional miRNA binding sites. Based on these findings, we finally recommend different strategies to better understand the role of miRNAs in tau physiology and pathology.
Mediastinal Ectopic Pancreas with Abundant Endocrine Cells Coexisting with Mediastinal Cyst and Thymic Hyperplasia
Authors: Yosinta Snak, Ery Kus Dwianingsih, Auliya Suluk Brilliant Sumpono, Rovi Panji, Afif Rahman, Ahmad Ghozali, Samir S Amr
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Mediastinal ectopic pancreas is a rare condition with only 28 cases reported in the literature. Here we report a 21-year-old female patient who presented with dyspnea and intermittent severe chest pain of 7 years' duration. Computerized tomography scan (CT-scan) of the chest revealed a mediastinal cyst. The cyst was resected and it demonstrated on histopathological examination the presence of pancreatic tissue with increased number of islets of Langerhans, coexistent with mediastinal cyst and thymic hyperplasia. We made a review of all previously reported cases of this entity.
Takayasu arteritis presenting as cerebral aneurysms in an 18 month old: A case report
Authors: Pamela F Weiss, Diana A Corao, Avrum N Pollock, Terri H Finkel, Sabrina E Smith
Journal: Pediatr Rheumatol Online J (2008)

Background:
Central nervous system involvement occurs in as many as twenty percent of Takayasu arteritis cases. When central nervous system disease is present, it typically manifests as cerebral ischemia or stroke. There are rare reports of intracranial aneurysms in adults with Takayasu arteritis, but none in children.
Case presentation:
We describe a case of Takayasu arteritis in an 18 month old girl who presented with a ruptured cerebral aneurysm. Full body magnetic resonance angiography revealed bilateral iliac, pelvic and intragluteal aneurysms, irregular terminal aorta, and stenotic renal arteries. Iliac vessel biopsy showed a lymphocytic infiltrate and giant cells localized to the internal elastica.
Conclusion:
This case highlights cerebral aneurysm as a highly unusual initial manifestation of Takayasu arteritis and demonstrates the challenges of diagnosis, treatment, and assessment of response to therapy in TA in children.
Wegener's granulomatosis with orbital involvement: case report and literature review
Authors: Mirescu Andrada-Elena, Teodora Tofolean Ioana, Florica Milicescu Mihaela, Cristescu Irina-Elena, Teodor Iacob Andrei, Baltă Florian
Journal: Rom J Ophthalmol (2021)
Keywords: anca associated vasculitis, anti-cd20 monoclonal antibodies, granulomatosis with polyangiitis, orbital granuloma
MeSH terms: Granulomatosis with Polyangiitis / diagnosis, Orbit / diagnostic imaging, Orbital Diseases / diagnosis, Case Reports, Review, Adult, Humans, Magnetic Resonance Imaging, Male, Tomography, X-Ray Computed

Objective: To describe the chronology and the extent of orbital involvement in a case of granulomatosis with polyangiitis. Methods: Descriptive case report and literature review. Results: A 45-year-old patient, formerly diagnosed with granulomatosis with polyangiitis due to otorhinolaryngologic manifestations, pulmonary lesions, renal impairment, left knee arthritis and high blood levels of antineutrophil cytoplasmic antibodies, addressed the Ophthalmology Department in November 2020, having the following complaints: left eye mild retro-orbital discomfort, proptosis and epiphora. On examination, Snellen's best corrected visual acuity was 6/ 6 in both eyes. The anterior segment of the left eye displayed significant changes: proptosis, upper lid swelling, ptosis, slightly decreased ocular motility, mild conjunctival hyperemia and chemosis, thinning of sclera in the upper quadrant and mild posterior subcapsular cataract. Left eye funduscopy revealed a slightly elevated optic disc, with indistinct margins in the nasal quadrant. Spectral-domain optical coherence tomography (OCT) of the optic nerve confirmed the clinical findings, illustrating an increase in the retinal nerve fiber layers thickness in the nasal quadrant, with no corresponding visual field defect. The orbit magnetic resonance imaging (MRI) unveiled an intraconal mass surrounding the optic nerve on its entire intra-orbital path, confirming the diagnosis of left orbital granuloma. Conclusion: Considering the relapsing disease and the orbital involvement, the patient is currently a candidate for rituximab, a monoclonal antibody against CD20. Abbreviations: AAV = ANCA associated vasculitides, ANCA = antineutrophil cytoplasmic antibody, AOM = acute otitis media, BCVA = best corrected visual acuity, CRP = C-reactive protein, CT = computerized tomography, EGPA = eosinophilic granulomatosis with polyangiitis, ENT = otorhinolaryngology/ ear-nose-throat, ESR = erythrocyte sedimentation rate, GPA = granulomatosis with polyangiitis, LE = left eye, MPA = microscopic polyangiitis, MRI = magnetic resonance imaging, OCT = optical coherence tomography, RE = right eye, RNFL = retinal nerve fiber layers, TNF = tumor necrosis factor, WG = Wegener's granulomatosis.
A Rare Complication of a TAP Block Performed after Caesarean Delivery
Authors: Osman Nawazish Salaria, Murlikrishna Kannan, Bryan Kerner, Howard Goldman
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

The transversus abdominis plane block is a regional anesthesia technique that has become popular. Being a relatively simple procedure, the TAP block has an excellent safety profile and major complications are rare. We present a case of transient femoral nerve palsy occurring after a TAP block with involvement of the sacral plexus for a patient who had undergone a caesarean section.
Numerical Analysis of Masticatory Forces on a Lower First Molar considering the Contact between Dental Tissues
Authors: Rosa Alicia Hernández-Vázquez, Beatriz Romero-Ángeles, Guillermo Urriolagoitia-Sosa, Juan Alejandro Vázquez-Feijoo, Ángel Javier Vázquez-López, Guillermo Urriolagoitia-Calderón
Journal: Appl Bionics Biomech (2018)

The aim of the present work is to identify the reactions of the dental organs to the different forces that occur during chewing and the transcendence of the union and contact maintained by the dental tissues. The study used a lower first molar biomodel with a real morphology and morphometry and consisting of the three dental tissues (enamel, dentin, and pulp) each with its mechanical properties. In it, two simulations were carried out, as would the process of chewing a food. One of the simulations considers the contact between the enamel and the dentin, and the other does not take it into account. The results obtained differ significantly between the simulations that consider contact and those that do not, establishing the importance of taking this contact into account. In this way, the theories that establish horizontal and lateral occlusion forces are present during the functional chewing process which are viable to be correct. The case studies carried out present not only the reasons for the failure of enamel but also the failure of the restoration materials used. This reflection will allow the development of more adequate materials, mechanical design of prostheses, implants, and treatment.
Cerebral Haemorrhage in a Young Patient With Atypical Werner Syndrome Due to Mutations in LMNA
Authors: Xiao Yanhua, Zhou Suxian
Journal: Front Endocrinol (Lausanne) (2018)
Keywords: lmna, werner syndrome, cerebral haemorrhage, gene mutation, progeroid
MeSH terms: Case Reports

Introduction: Werner syndrome is a rare genetic disorder; classical Werner syndrome is caused by mutations in the WRN gene. However, recent research has shown that LMNA gene mutations can also cause premature ageing syndromes such as atypical Werner syndrome (AWS). AWS usually manifests as muscular damage, defects in the cardiac conduction system, lipoatrophy, diabetes, atherosclerosis, and premature ageing. Clinical presentation: A 24-year-old man presented with severe abdominal aortic and peripheral artery disease and cerebral haemorrhage. He was prescribed once-daily 20 mg atorvastatin. Another large cerebral haemorrhage occurred 8 months after discharge. Although he underwent minimally invasive intracranial haematoma surgery, paralysis set in. Molecular studies showed a missense mutation within exon 5 (c.898G>C) that caused amino acid aspartate 300 to be replaced by histidine (p.Asp300His) in the LMNA gene. The patient was diagnosed with AWS. Conclusions: Haemorrhagic stroke and progeroid features may be manifestations of LMNA-linked AWS. In such cases, the patient's family history and genetic background should be investigated. WRN and LMNA gene testing of the proband and the immediate family should be considered. This case report provides a deeper understanding of the role of LMNA mutations in AWS.