OpenMed/multicare-articles huggingface dataset:
Coronary Sinus Stenting for the Management of Left Ventricular Lead Displacement during Resynchronization Therapy: A Report of Two Cases
Authors: Hassan Kamalzadeh, Shahrooz Yazdani, Mohammad Jalali
Journal: J Tehran Heart Cent (2018)
Keywords: angioplasty, cardiac resynchronization therapy, coronary sinus, stents
MeSH terms: Case Reports

In patients with cardiac resynchronization therapy (CRT), loss of left ventricular (LV) stimulation occurs chiefly because of LV lead dislodgement. The occurrence rate of LV lead dislodgement in different reports is between 2% and 12% of patients. LV lead dislodgement precludes clinical improvement. We describe 2 patients with heart failure, fulfilling the criteria for CRT implantation. In both patients, right ventricular and right atrial leads were implanted via the left subclavian vein in the right ventricular apex and the right atrial appendage, respectively. Repeated LV lead implantation was unsuccessful and each time after the fixation, the LV lead was dislodged with the heart motion during systole and diastole. In order to stabilize the LV lead, we decided to benefit from coronary sinus stenting and lead entrapment behind the deployed stent. LV lead stabilization was accomplished by the deployment of bare-metal stents (Multi-Link 3.5 × 8 mm and Multi-Link 3 × 8 mm, Abbott Vascular) in order to entrap the LV lead. The stents were deployed at a nominal pressure (10 atm). The pacing performance of the LV leads was satisfactory and stable at midterm in our experience. Stenting within the coronary sinus seems to be a safe method for LV lead stabilization and can substantially boost the success rate of CRT. Our device analysis during short- and midterm follow-up (4 months after implantation) revealed acceptable LV lead threshold and impedance.
Comparison of HER-2 overexpression in primary breast cancer and metastatic sites and its effect on biological targeting therapy of metastatic disease
Authors: J Zidan, I Dashkovsky, C Stayerman, W Basher, C Cozacov, A Hadary
Journal: Br J Cancer (2005)
MeSH terms: Breast Neoplasms / genetics, Carcinoma, Ductal, Breast / genetics, Carcinoma, Lobular / genetics, Neoplasm Metastasis / pathology, Receptor, ErbB-2 / metabolism, Case Reports, Comparative Study, Research Support, Non-U.S. Gov't, Adult, Aged, Aged, 80 and over, Breast Neoplasms / metabolism, Breast Neoplasms / pathology, Carcinoma, Ductal, Breast / metabolism, Carcinoma, Ductal, Breast / pathology, Carcinoma, Lobular / metabolism, Carcinoma, Lobular / pathology, Female, Humans, Immunoenzyme Techniques, In Situ Hybridization, Fluorescence, Male, Middle Aged, Neoplasm Staging, Prognosis, Receptor, ErbB-2

HER-2 overexpression, a predictive marker of tumour aggressiveness and responsiveness to therapy, occurs in 20-30% of breast cancer. Although breast cancer is a heterogeneous disease, HER-2 measurement is carried out in primary tumour. This study aims to evaluate HER-2 overexpression in primary and metastases and its effect on treatment decisions. Biopsies from primary breast cancer and corresponding metastases from 58 patients were studied. HER-2 overexpression was evaluated immunohistochemically in all primary and metastatic sites. Positive overexpression in primary and/or metastases was confirmed by fluorescence in situ hybridisation (FISH). Discordance in HER-2 overexpression between primary and metastatic sites was 14% (eight of 58 patients). Concordance was found in 50 (86%) of patients (95% CI: 77-95). In one patient (2%), HER-2 was negative in metastasis but positive in primary. In seven (12%) patients, HER-2 was positive in metastases and negative in primary (95% CI: 3.7-20), and three of them responded to trastuzumab. Gene amplification by FISH was found in all cases with HER-2 positive (+2 and +3) by immunohistochemistry. Our data suggest that a possible discordance of HER-2 overexpression between primary and metastases should be considered when making treatment decisions in patients with primary HER-2-negative tumours.
PLA2G6-Associated Neurodegeneration: A Rare Case Report of Neurodegeneration with Brain Iron Accumulation in Children
Authors: Nurani Widianti, Meta Herdiana Hanindita, Nur Aisiyah Widjaja, Roedi Irawan
Journal: Pak J Med Sci (2023)
Keywords: developmental regression, inherited metabolic diseases, nbia, plan
MeSH terms: Case Reports

This report aimed to describe and review the clinical features, neuroimaging findings, and PLA2G6 mutations identified in a 34-month-old girl with regression of developmental milestones. A 34 months old girl came to Dr.Soetomo Hospital's outpatient clinic, Surabaya, with a developmental regression for six months, and got worse until she could not do any activity and was followed by recurrent seizures. She had a sibling who had similar problems and symptoms and then died at five years of age. The head MRI revealed brain atrophy, the possibility of an early sign of metabolic disorder, and a white matter lesion at the globuspallidus bilateral that supports the encephalopathy metabolic view. The genetic test revealed a positive homozygous such as a pathogenic variant in the PLA2G6 gene, which confirmed the diagnosis. PLA2G6-Associated with Neurodegeneration (PLAN) should be considered as a diagnosis in children with developmental regression.
HCFC-123-induced toxic hepatitis and death at a Korean fire extinguisher manufacturing facility: a case series
Authors: Mu Young Shin, Jong Soo Park, Hae Dong Park, Jihye Lee
Journal: Ann Occup Environ Med (2018)
Keywords: 2,2-dichloro-1,1,1-trifluoroethane, drug-induced liver injury, fire extinguisher manufacturing facility, hcfc-123, toxic hepatitis
MeSH terms: Case Reports

Background:
Exposure to sustained high concentrations of HCFC-123 is known to be hepatotoxic. We report two simultaneous cases of toxic hepatitis related to exposure to 2,2-dichloro-1,1,1-trifluoroethane (HCFC-123), a common refrigerant, at a Korean fire extinguisher manufacturing facility.
Case presentation:
Patients A and B were men aged 21 and 22 years, respectively, with no notable medical histories. They had recently started working for a manufacturer of fire extinguishers. During the third week of their employment, they visited the emergency center of a general hospital due to fever, lack of appetite, and general weakness. At the time of their visit, they were suspected as having hepatitis due to elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and total bilirubin levels and were hospitalized. However, as their condition did not improve, they were moved to a tertiary general hospital. After conservative treatment, one patient improved but the other died from acute hepatic failure. Assessments of the work environment showed that the short-term exposure levels of HCFC-123 for valve assembly processes were as high as 193.4 ppm. A transjugular liver biopsy was performed in patient A; the results indicated drug/toxin-induced liver injury (DILI). Given the lack of a medical history and the occupational exposure to high levels of HCFC-123, a hepatotoxic agent, the toxic hepatitis of the workers was likely related to HCFC-123 exposure.
Conclusions:
Work environment assessments have not included this agent. To the best of our knowledge, we are the first to report a case of death related to HCFC-123-induced liver damage. Our findings suggest that exposure standards and limits for HCFC-123 must be developed in Korea; work environments will have to be improved based on such standards.
Household Diversity and the Impacts of COVID-19 on Families in Portugal
Authors: Rita Gouveia, Vasco Ramos, Karin Wall
Journal: Front Sociol (2021)
Keywords: covid-19 pandemic, family relationships, household diversity, linked-lives, social impacts, vulnerability

Throughout the world, the COVID-19 pandemic disrupted family routines, relationships, projects and sociability, threatening the health, income, social cohesion, and well-being of individuals and their families. Lockdown restrictions imposed during the first wave of the pandemic challenged the theories, concepts, and methods used by family sociologists and the intersecting fields of gender and social inequality. By restricting physical interactions to co-resident family members, the household regained a privileged role as a crucial social laboratory for studying the impact of COVID-19 on family life. The difficulties encountered by individuals in maintaining and dealing with close relationships across households and geographical borders, in a context in which relational proximity was discouraged by the public authorities, exposed the linked nature of family and personal relationships beyond the limits of co-residence. The main aim of this article is to investigate the social impacts of the pandemic on different types of households during the first lockdown at an early stage of the pandemic in Portugal. Drawing on an online survey applied to a non-probabilistic sample of 11,508 households between 25 and 29 March 2020, the authors combined quantitative and qualitative methods, including bi-variate inferential statistics, cluster analysis and in-depth case studies. The article distinguishes between different household types: solo, couple with and without children, extended, friendship, lone-parent families, and intermittent arrangements, such as shared custody. A cross-tabulation of the quantitative data with open-ended responses was carried out to provide a refined analysis of the household reconfigurations brought about during lockdown. The analysis showed how pre-existing unequal structural living conditions shaped the pathways leading to household reconfiguration as families sought to cope with restrictions on mobility, social distancing norms, and other lockdown measures. The findings stress that, in dealing with a crisis, multilevel welfare interventions need to be considered if governments are to cater to the differentiated social needs and vulnerabilities faced by individuals and families.
Mediterranean spotted fever: case series of 24 years (1989-2012)
Authors: Pedro Crespo, Diana Seixas, Nuno Marques, Joaquim Oliveira, Saraiva da Cunha, A Meliço-Silvestre
Journal: Springerplus (2015)
Keywords: eschar, mediterranean spotted fever, rickettsia conorii, tick-bite

Purpose:
Mediterranean spotted fever (MSF) is the most prevalent zoonosis in Portugal. To characterize it's evolution between 1989 and 2012, the authors reviewed the cases diagnosed at their unit during this period.
Methods:
Review of clinical records of patients with MSF diagnosis, between 1989 and 2012.
Results:
Data from 250 patients was included, 54% male. Mean age at diagnosis was 58 years (11-92). Mean annual incidence was 10 cases, with clear summer predominance. Most patients, 78% lived in rural areas, 34% had contact with dogs and 10% noticed the tick bite. Most common symptoms were: fever (98%), myo-arthralgia (64%) and headache (48%). Maculopapular rash was noticed in 87%, affecting palms in 77% and soles in 69%. Inoculation eschar was found in 60%, mostly located on the trunk. Treatment included doxycycline in 86% and chloramphenicol in 12%, with a mean duration of 8 days. Most frequent blood test abnormalities were C-reactive protein, lactate dehydrogenase, aspartate aminotransferase and alanine transaminase elevations and thrombocytopenia. First serologic evaluation was positive in 37% (78/212), having seroconversion been documented in 85% (72/85). Most frequent complication was acute renal injury. ICU admission occurred in 5%. Average length of hospital stay was 11.2 days (1-106), with a mortality of 3.6%.
Conclusions:
In our series, there was clear summer predominance of MSF, which had rural origin in 78%. Most common symptoms were fever, myo-arthralgia and headache. Maculopapular rash was noticed in 87% of cases and inoculation eschar in 60%. Most cases had favourable outcome, having 5% been admitted to ICU. Mortality was 3.6%.
Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder
Authors: Emir Tas, Serife E Uzun, Vildan Tas, Juan D Mejia-Otero
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Objectives:
The standard of treatment for pediatric growth hormone deficiency (GHD) is daily subcutaneous recombinant human growth hormone (rhGH) injections. The efficacy of rhGH treatment given as daily intravenous (IV) boluses is not known. Case Presentation. A female with protein C deficiency, a severe bleeding disorder characterized by thrombosis formation, was diagnosed with GHD at age four years. She has been receiving daily protein C infusion through a permanent port since the newborn period. GHD was treated with daily IV rhGH boluses given through the port following protein C infusion. She has reached a growth rate of 12 cm/year and had no side effects. Surprisingly, serum insulin-like growth factor-1 (IGF1) levels did not rise despite an excellent clinical response.
Conclusions:
IV administration may be an alternative route for GHD treatment in eligible patients with permanent vascular access. A rise in serum IGF1 levels may not be needed to achieve the growth-promoting effect of rhGH.
HSV-1 Encephalitis in an Elderly Man Receiving Ibrutinib for Waldenstrom's Macroglobulinemia
Authors: Mark R Wallace
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Ibrutinib is a major new addition to the therapeutic armamentarium for chronic lymphocytic leukemia, mantle cell lymphoma, Waldenstrom's macroglobulinemia, and chronic graft versus host disease. Though ibrutinib has proven to be a revolutionary new small molecule agent, and has relatively minimal toxicity as compared to traditional chemotherapy, infections have emerged as a major complication of therapy. While fungal infections have been the most problematic (including CNS aspergillosis), zoster, hepatitis B reactivation, and chronic hepatitis E have been reported in association with ibrutinib therapy. This report describes a case of herpes encephalitis in an 86-year-old Waldenstrom's patient receiving ibrutinib and speculates as to whether this late life encephalitis may have been related to ibrutinib.
Case report: Malignant melanoma of the lower limb with gastric metastasis
Authors: Qiang Hu, Fengru Zhou, Yuanshui Sun
Journal: Front Oncol (2023)
Keywords: case report, gastric metastasis, lower limb, malignant melanoma, tumor
MeSH terms: Case Reports

Introduction:
Malignant melanoma with gastric metastasis is extremely rare. We report a case of gastric metastasis caused by malignant melanoma of the lower limb.
Case presentation:
A 60-year-old woman was hospitalized for left plantar pain. The patient found a black maculopapular eruption on the left sole of her left foot, which caused pain when pressed, and the pain was aggravated by walking, so she went to our hospital for treatment. On the second day of admission, the lesion of the left foot was removed under local anesthesia, and the removed tissue was sent for pathological examination. Combined with immunohistochemistry, it was consistent with malignant melanoma. During hospitalization, the patient developed abdominal pain and asked for gastroscopy. Gastroscopy revealed two 0.5 cm × 0.6 cm spots that can be seen arising from the stomach mucosa which were slightly swollen, slightly black in the center, and without erosion, and no abnormality was found in the other parts. At the same time, a biopsy was taken under a gastroscope and pathology suggests malignant melanoma. The patient could not undergo subsequent treatment due to cost. The patient was followed up until February 2022 and was within the survival period.
Conclusion:
Malignant melanoma gastric metastasis is extremely rare. When a patient has a previous history of melanoma surgery, this needs to be considered when gastrointestinal symptoms are present, and regular endoscopic screening is recommended. Early surgical treatment and postoperative chemotherapy or combined targeted therapy may improve the prognosis of patients.
The Role of Failing Autonomic Nervous System on Life-Threatening Idiopathic Systemic Capillary Leak Syndrome
Authors: Riccardo Colombo, Maddalena Alessandra Wu, Emanuele Catena, Andrea Perotti, Tommaso Fossali, Federico Cioffi, Roberto Rech, Antonio Castelli, Marco Cicardi
Journal: Front Med (Lausanne) (2018)
Keywords: autonomic dysfunction, critically ill, heart rate variability, idiopathic capillary leak syndrome, shock
MeSH terms: Case Reports

Idiopathic systemic capillary leak syndrome (ISCLS) is a rare disease that involves the endothelium and microcirculation, leading to an abrupt shift of fluids and proteins from the intravascular to the interstitial compartment. The consequence of the capillary leakage is a life-threatening hypovolemic shock that can lead to lethal multiple organ dysfunction. The autonomic nervous system (ANS) is central in regulating the cardiovascular response to hypovolemia, but ANS modulation in ISCLS has not yet been investigated. Here, we report ANS activity during acute phase and recovery from a severe ISCLS shock and speculate on the possibility that autonomic mechanisms underlie the pathogenesis of attacks.
Homemade Glove Port for Single-Incision Pediatric Endosurgery (SIPES) Appendectomy-How We Do It
Authors: Illya Martynov, Martin Lacher
Journal: European J Pediatr Surg Rep (2018)
Keywords: appendicitis, children, glove port, single-incision pediatric endosurgery

Introduction Single-incision pediatric endosurgery (SIPES) for the treatment of acute appendicitis in children has recently gained popularity due to its advantages including minimization of postoperative scars or less incisional pain. The principal disadvantages of SIPES include the limited degrees of freedom of movement and high health care costs. To overcome these issues, some surgeons have reported to use noncommercial ports for SIPES appendectomy. Case Report In this report, we present a case of a 10-year-old female patient with acute appendicitis undergoing SIPES appendectomy using own homemade glove port and straight rigid instruments. Conclusion SIPES appendectomy using the glove port is a low-cost alternative to commercially available port systems. It is easy to set up and use.
Perineal Turn over Perforator Flap: A Novel Surgical Technique for Combined Perineal and Posterior Vaginal Wall Reconstruction
Authors: Francisco S Moura, Maria Chasapi, Peter Mitchell, Milind D Dalal
Journal: World J Plast Surg (2021)
Keywords: extralevator abdominoperineal excision, fasciocutaneous, internal pudendal artery, perineum, surgical reconstructive procedure surgery
MeSH terms: Case Reports

Extralevator Abdominoperineal Excision (ELAPE) and Abdominoperineal Resection create complex perineal defects made more challenging when combined with additional resection of the posterior vaginal wall. This composite defect requires the restoration of a functional vagina, in addition to the obliteration of the large perineal dead space, a need to reduce donor site, and perineal wound morbidity. Previously described fasciocutaneous and myocutaneous flaps for such defects are associated with long operations requiring intra-operative mobilization and are linked to post-operative complications including herniation, evisceration, flap loss, donor site morbidity and poor cosmetic outcome, amongst other issues. Herein we describe the case of a 60-year-old female patient that underwent combined ELAPE and posterior vaginectomy for anal squamous cell carcinoma. This complex defect was reconstructed using an extended version of the Perineal Turn-Over (PTO) flap based on the Internal Pudendal artery perforator.
Orthodontic Treatment of Bilateral Impacted Mandibular Canines and a Mupparapu Type 2 Transmigration
Authors: José Antonio Vera-Guerra, José Rubén Herrera-Atoche, Gabriel Eduardo Colomé-Ruiz
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Dental transmigration is a rare condition that mainly affects the mandibular canines. Since the tooth involved is usually impacted and its crown has crossed the midline towards the opposite side, the treatment options frequently are surgical removal or radiographic follow-up, and, in some cases, orthodontic traction is possible. In 2002, Mupparapu presented a classification for lower canines in transmigration according to their position within the mandible. This paper is aimed at describing the orthodontic treatment of a female patient with two impacted mandibular canines, one of them in a Mupparapu type 2 transmigration position (horizontal impaction position near the lower mandibular border and below the incisors' root apices). Additionally, the paper discusses the biomechanical orthodontic design and the alternative treatment options for these complex cases.
A Rare Cause of Acute Hepatopancreatitis in a Nepalese Teen
Authors: Swastika Adhikari, Ashish Lal Shrestha, Sanjay Raj Thapa, Amrit Ghimire
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Background:
Acute pancreatitis (AP) coexisting with acute hepatitis (AH) in children is uncommon. Moreover, a single bacterial cause explaining both the complications is even rarer. Despite familiarity with the usual presentation of enteric fever, atypical presentations can go unnoticed.
Case presentation:
A 16-year-old previously healthy male presented to the emergency unit with recurrent swinging pyrexia, abdominal symptoms, and jaundice for a week. Blood work-up revealed deranged liver function tests (LFTs) and elevated pancreatic enzymes. Further assessment with imaging made a diagnosis of AH and AP without necrosis. Blood culture positivity for Salmonella typhi eventually confirmed the diagnosis.
Conclusion:
This is an uncommon presentation of an infection that is fairly common in our part of globe. Nevertheless, early suspicion and recognition is the key to timely management. Regular follow-ups are required to pick complications up early.
Simple Orthodontic Correction of Rotated Malpositioned Teeth Using Sectional Wire and 2 × 4 Orthodontic Appliances in Mixed-Dentition: A Report of Two Cases
Authors: S Nagarajan M P Sockalingam, Ahmad Shuhud Irfani Zakaria, Khairil Aznan Mohamed Khan, Fayyadhah Mohd Azmi, Nurhidayah Muhd Noor
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

The correction of rotated malpositioned tooth/teeth into the dental arch alignment in the mixed-dentition is often a challenging task for paediatric dentists. Failure in addressing this issue can bring about detrimental effect to the developing dentition and increases the probability of a complex orthodontic treatment in later years. Factors such as severity of the malpositioned teeth, patient's treatment compliance, limitation in specific functions of the selected appliance, availability of bone and space may dictate the success of the treatment. The combined use of a simple sectional orthodontic wire appliance and a 2 × 4 orthodontic appliance has been shown to produce a positive effect. The appliances resulted in derotation of the rotated malpositioned teeth and bringing them into arch alignment in two cases. This treatment option had eliminated the detrimental effects to the developing dentition and helped patients to enhance their smile and dental aesthetics.