OpenMed/multicare-articles huggingface dataset:
An Algorithmic Approach to Managing Parotid Duct Injury Following Buccal Fat Pad Removal
Authors: Jason M Weissler, Omar Mohamed, Joseph M Gryskiewicz, Karan Chopra
Journal: Aesthet Surg J Open Forum (2022)

The principles of achieving an aesthetically pleasing and harmonious facial appearance are influenced by our evolving understanding of the three-dimensional topography of the face coupled with novel approaches to midface volumization and contouring. In parallel with the evolving landscape of facial aesthetic surgery, an increasing number of publications have emerged focusing on the role of intraoral buccal fat pad removal (BFPR) for the purposes of aesthetic midface contouring. The authors sought to emphasize an underreported and potentially preventable and untoward complication involving iatrogenic parotid duct injury following BFPR. The purpose of this publication is 3-fold: (1) to review the relevant anatomy and literature on intraoral BFPR, (2) to present a case example of this complication, and (3) to discuss treatment options as part of a proposed management algorithm. The authors detail the surgical indications for performing BFPR and review the relevant anatomic considerations. Complication prevention strategies are outlined, and details regarding avoidance of parotid duct injury are reviewed. The diagnostic criteria and clinical presentation of parotid duct injuries following BFPR are comprehensively outlined. The authors present a clinically actionable algorithm for managing a suspected or diagnosed parotid duct injury following BFPR. A clinical case example is discussed to highlight this complication, the diagnostic criteria, and the systematic and algorithmic approach to management. Intraoral BFPR is an incredibly valuable and powerful procedure that can improve facial contour in patients with buccal lipodystrophy or buccal fat pad pseudoherniation. The authors propose a proper diagnostic approach and treatment algorithm to manage this untoward complication.
Malignant Glandular Triton Tumor Arising in the Radial Nerve with Prolonged Survival: A Case Report and Review of the Literature
Authors: Batool M AlAli, Samir S Amr
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Divergent differentiation is a well-known phenomenon in malignant peripheral nerve sheath tumors (MPNST) which occurs approximately in 15% of these tumors, usually towards mesenchymal elements. Differentiation towards epithelial components, however, is quite uncommon, and even exceptionally rare is concomitant mesenchymal and glandular differentiation. To our knowledge, only 14 cases of MPNST with both mesenchymal (rhabdomyoblastic) and glandular differentiation had been reported, and only two of these tumors had frankly malignant glandular components. Herein, we report the third such case. A 26-year-old male, without any of the stigmata of NF1, presented with a 2-year history of pain in his left shoulder and an elbow swelling of six-month duration. The tumor was initially diagnosed clinically as a neurofibroma at a local hospital. The patient underwent excision of the mass there, and pathological examination at that hospital showed the tumor to be MPNST. Six months later, the patient was referred to our hospital, a tertiary care medical center, with recurrent swelling at the same location. Histopathological material from the referral hospital was reviewed, and the tumor was diagnosed as MPNST with rhabdomyoblastic differentiation or malignant triton tumor (MTT) that contained in addition foci of malignant glandular epithelium. The patient refused any surgical intervention. He received three cycles of chemotherapy followed by radiotherapy with excellent response and marked reduction in the size of the tumor. The patient had prolonged survival for 10 years following the initial resection of the tumor.
Persistent Acute Onset Macroglossia Treated with Compression Therapy
Authors: Sean M Johnson, C Scott Brown, Liana Puscas
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Acute macroglossia, while rare and often limited in duration, can present significant management challenges. The anatomic position of the tongue, which can result in airway compromise in cases of enlargement, contributes significantly to difficulty with management. We review several management options for persistent acute onset lingual macroglossia and present a novel noninvasive management technique in a case which was refractory to several strategies.
Cocaine/levamisole-induced systemic vasculitis with retiform purpura and pauci-immune glomerulonephritis
Authors: F V Veronese, R S O Dode, M Friderichs, G G Thomé, D R da Silva, P G Schaefer, V C Sebben, A R Nicolella, E J G Barros
Journal: Braz J Med Biol Res (2016)
MeSH terms: Cocaine / adverse effects, Glomerulonephritis / chemically induced, Levamisole / adverse effects, Purpura / chemically induced, Systemic Vasculitis / chemically induced, Case Reports, Glomerulonephritis / pathology, Humans, Male, Middle Aged, Purpura / pathology, Systemic Vasculitis / pathology, Levamisole, Cocaine

Levamisole has been increasingly used as an adulterant of cocaine in recent years, emerging as a public health challenge worldwide. Levamisole-associated toxicity manifests clinically as a systemic vasculitis, consisting of cutaneous, hematological, and renal lesions, among others. Purpura retiform, cutaneous necrosis, intravascular thrombosis, neutropenia, and less commonly crescentic nephritis have been described in association with anti-neutrophil cytoplasmic antibodies (ANCAs) and other autoantibodies. Here we report the case of a 49-year-old male who was a chronic cocaine user, and who presented spontaneous weight loss, arthralgia, and 3 weeks before admission purpuric skin lesions in the earlobes and in the anterior thighs. His laboratory tests on admission showed serum creatinine of 4.56 mg/dL, white blood count 3,800/μL, hemoglobin 7.3 g/dL, urinalysis with 51 white blood cells/μL and 960 red blood cells/μL, and urine protein-to-creatinine ratio 1.20. Serum ANCA testing was positive (>1:320), as well as serum anti-myeloperoxidase and anti-proteinase 3 antibodies. Urine toxicology screen was positive for cocaine and levamisole, with 62.8% of cocaine, 32.2% of levamisole, and 5% of an unidentified substance. Skin and renal biopsies were diagnostic for leukocytoclastic vasculitis and pauci-immune crescentic glomerulonephritis, respectively. The patient showed a good clinical response to cocaine abstinence, and use of corticosteroids and intravenous cyclophosphamide. Last serum creatinine was 1.97 mg/dL, white blood cell count 7,420/μL, and hemoglobin level 10.8 g/dL. In levamisole-induced systemic vasculitis, the early institution of cocaine abstinence, concomitant with the use of immunosuppressive drugs in severe cases, may prevent permanent end organ damage and associate with better clinical outcomes.
Group B streptococcal empyema necessitatis with pleural fistula after blunt trauma: A case report
Authors: Takashi Ohki, Yoshiki Shigematsu, Shunzo Hatooka
Journal: Int J Surg Case Rep (2019)
Keywords: blunt trauma, empyema necessitatis, group b streptococcus, septic arthritis

Introduction:
We report the first case of empyema necessitatis (EN) with pleural fistula and septic arthritis caused by Streptococcus agalactiae following blunt trauma.
Presentation of the case:
A 46-year-old man with diabetes mellitus and a history of recent right rib fracture and right knee bruising presented with dyspnea and right knee pain. He was diagnosed with EN and underwent chest drainage, followed by open-window thoracotomy. Septic arthritis occurred on day 8 after thoracotomy. The chest wall wound healed after 3 months.
Discussion:
EN is a rare complication of empyema. In this patient, infection was invasive, causing necrotizing pneumonia with a pleural fistula. To our knowledge, there are no reports of group B streptococcal EN with a pleural fistula resulting from blunt chest trauma.
Conclusion:
Group B streptococcal infection might become invasive in immunocompromised patients, so careful follow-up for those patients is important.
Case Report: Pancreatic and hepatic kaposiform hemangioendothelioma presenting as consumptive coagulopathy and right hepatic atrophy
Authors: Chengbo Ai, Tong Qiu, Jiangyuan Zhou, Chuan Wang, Jiulin Song, Siyu Pu, Shuguang Jin
Journal: Front Oncol (2023)
Keywords: kaposiform hemangioendothelioma (khe), kasabach-merritt phenomenon (kmp), whipple operation, case report, thrombocytopenia, vascular tumor
MeSH terms: Case Reports

Kaposiform hemangioendothelioma (KHE) is a rare vascular tumor that causes progressive angiogenesis and lymphangiogenesis, which often occurs in the skin or soft tissue, with an acute onset and rapid progression. A 4-year-old girl was admitted to our hospital with a 2-year history of thrombocytopenia, combined with right hepatic atrophy and pancreatic lesion for 3 months. At the age of two, she developed purpura and thrombocytopenia was detected, after treatment with gamma globulin and corticosteroids, the platelet count normalized, but it dropped immediately at lower doses. One year after the cessation of corticosteroids therapy, the patient presented with abdominal pain and abnormal liver function and the magnetic resonance imaging (MRI) revealed right hepatic atrophy and pancreatic occupancy, but the first liver biopsy did not reveal any positive pathological results. By analyzing the clinical manifestations in conjunction with MRI and abnormal coagulation, we considered that the patient might be diagnosed as KHE with Kasabach-Merritt phenomenon, however, sirolimus treatment was ineffective and pancreatic biopsy only showed a tendency for tumors of vascular origin. Finally, we performed a Whipple operation after the right hepatic artery embolization, histological and immunohistochemical examination suggested KHE. Three months postoperatively, the patient's liver function, pancreatic enzymes and blood clotting function gradually returned to normal. KHEs may result in significant blood loss with worsening of the coagulopathy and functional impairment, timely surgical intervention for KHE is necessary when non-invasive or minimally invasive treatment is ineffective, or the symptoms of tumor compression are obvious.
Carney Complex: A Rare Case of Multicentric Cardiac Myxoma Associated with Endocrinopathy
Authors: Yehia Saleh, Basma Hammad, Abdallah Almaghraby, Ola Abdelkarim, Mohamed Seleem, Mahmoud Abdelnaby, Hoda Shehata, Mahmoud Hammad, Bassem Ramadan, Mohamed Elshafei, Eman Elsharkawy, Mohamed Ayman Abdel-Hay
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Carney complex is a rare autosomal dominant disorder characterized by multiple tumors, including cardiac and extracardiac myxomas, skin lesions, and various endocrine disorders. We are reporting a 21-year-old female patient with past surgical history significant for excision of a cutaneous myxoma who presented with multicentric cardiac myxomas involving the four cardiac chambers. She also presented with endocrinal disorders in the form of an enlarged right lobe of the thyroid, hyperthyroid state, and an incidentally noted adrenal cyst; hence, she was diagnosed with carney complex syndrome.
Henoch-Schonlein purpura associated with primary active Epstein-Barr virus infection: a case report
Authors: Burcu Karakayali, Sila Yilmaz, Deniz Çakir, Pembe Gül Günes, Sirin Güven, Ismail Islek
Journal: Pan Afr Med J (2017)
Keywords: epstein-barr virus, henoch-schönlein purpura, children
MeSH terms: Epstein-Barr Virus Infections / complications, IgA Vasculitis / diagnosis, Vasculitis, Leukocytoclastic, Cutaneous / diagnosis, Case Reports, Abdominal Pain / etiology, Biopsy, Child, Epstein-Barr Virus Infections / diagnosis, Epstein-Barr Virus Nuclear Antigens / immunology, Humans, IgA Vasculitis / virology, Male, Epstein-Barr Virus Nuclear Antigens, EBV-encoded nuclear antigen 1, Erythema elevatum diutinum

Henoch-Schönlein purpura (HSP) is the most common form of childhood vasculitis. Various viral and bacterial infections, drugs, vaccines, food allergy and even insect bites have been considered as triggering factors in pathogenesis of HSP. Epstein-Barr virus (EBV) infection, which is associated with HSP, have been rarely reported. Herein we present HSP patient possibly caused by EBV infection. A 8-year old boy was admitted to our department with fever, rashes on legs and arms and intermittent mild abdominal pain. Multiple purpuric rashes were on his extremities, abdomen and buttock. Laboratory investigations revealed that monospot test was positive, EBV serology tests; Anti-EA-D Ig G: 3+, Anti-VCA gp125 Ig G: 3+, Anti-VCA p19 Ig M: 2+, Anti EBNA-1 Ig M: negative, Anti EBNA-1 Ig M: negative, Anti EBNA-1 Ig G: negative. The patient was interpreted as the primary active acute EBV infection. A skin biopsy showed leucocytoclastic vasculitis. The other viral and bacterial investigations were negative. The patient was diagnosed as HSP vasculitis according to EULAR criteria and treated with intravenous hydration and ibuprofen. He was discharged after 15 days with normal laboratory findings and physical examination. We think that EBV infection may be stimulant factor for autoimmune reactions and may cause HSP vasculitis. Hence, it may be useful to investigate the EBV infection in etiology of HSP cases.
Abdominal Cocoon Syndrome: Two Cases of an Anatomical Abnormality
Authors: Apostolos Sovatzidis, Eirini Nikolaidou, Anastasios Katsourakis, Iosif Chatzis, George Noussios
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Introduction:
Idiopathic sclerosing encapsulating peritonitis or abdominal cocoon syndrome (ACS) is a rare anatomical deformity characterized by the partial or complete encasement of the small intestine with fibrotic peritoneum. 193 cases have been described worldwide. The aim of this study is to present two cases of ACS successfully treated at the Surgical Clinic of the Agios Dimitrios General Hospital in Thessaloniki, Greece.
Presentation of cases:
Two men (55 and 54 years old) presented to the emergency department complaining of abdominal pain, distension, constipation, nausea, and vomiting. Neither of these patients had any previous operations. The computed tomography scan of the first patient showed considerable distension of the small bowel, suggestive of internal herniation. The second case showed distention of the jejunum with no obvious cause. Both patients underwent emergency surgery. Intraoperatively, it was found that a fibrous membrane had completely covered the small intestine of the first patient and the jejunum and part of the large intestine of the second patient. Adhesiolysis and partial excision of the membrane were performed in both cases.
Discussion:
ACS is a rare cause of small bowel obstruction. Although conservative management with immunosuppressants and steroids has been described, surgical treatment is the gold standard.
Conclusion:
Preoperative clinical suspicion of this disease can help determine the diagnosis and protect surgeons from intraoperative "surprises".
Crush syndrome in a case of severe infant physical abuse: a case report
Authors: Maria Florou, Vassilis Lambropoulos, Vasileios Mouravas, Chrysostomos Kepertis, Dimitrios Godosis, Kleanthis Anastasiadis, Christos Kaselas, Savvas Mavromatidis, Ioannis Spyridakis
Journal: Pan Afr Med J (2021)
Keywords: rhabdomyolysis, case report, child, crush syndrome, infant
MeSH terms: Child Abuse / diagnosis, Crush Syndrome / diagnosis, Case Reports, Crush Syndrome / etiology, Humans, Infant, Male, Trauma Severity Indices

Crush syndrome, also known as traumatic rhabdomyolysis, is the result of the disruption of skeletal muscle fibers with the release of intracellular contents into the bloodstream. Although trauma is the main trigger for rhabdomyolysis in adults, in the pediatric population viral infections and inherited disorders seem to be the most frequent causes. Only a few reports in the literature mention rhabdomyolysis secondary to non-accidental pediatric trauma. We herein report an unusual case of traumatic rhabdomyolysis, following significant physical abuse in an infant. Rhabdomyolysis should be suspected in children presenting with a history of excessive blunt trauma, because a prompt diagnosis and treatment prevent from the potential life-threatening consequences.
Eyelid carcinoma in patients with systemic lymphoma
Authors: Debraj Shome, Diana Bell, Bita Esmaeli
Journal: J Ophthalmic Vis Res (2010)
Keywords: eyelid cancer, immunosuppression, squamous cell carcinoma, systemic lymphoma

Purpose:
To describe a series of patients with Non-Hodgkin's lymphoma (NHL) and concomitant eyelid carcinoma.
Methods:
In this non-comparative interventional case series, we retrospectively reviewed the medical records of 5 patients with NHL who developed eyelid carcinoma.
Results:
The patients included one female and four male subjects. Systemic lymphoma had been diagnosed 1 to 72 months prior to development of the eyelid carcinoma. The lesions were basal cell carcinoma in three, and squamous cell carcinoma in two cases. The lymphoma was advanced (stage III or IV) in all patients. Four patients underwent surgical excision of the carcinoma and one patient was awaiting surgical treatment after completing systemic chemotherapy. Three subjects had high-grade carcinomas. Two patients had perineural invasion; one received adjuvant radiotherapy postoperatively but the other did not due to receiving systemic chemotherapy for recurrent NHL.
Conclusions:
Systemic lymphoma may be associated with aggressive eyelid carcinomas. Perineural invasion is frequently encountered in this situation and should be treated with adjuvant radiation therapy to decrease the likelihood of local recurrence.
COVID-19 case prediction using emotion trends via Twitter emoji analysis: A case study in Japan
Authors: Vu Tran, Tomoko Matsui
Journal: Front Public Health (2023)
Keywords: covid-19, twitter, anomaly detection, emoji, emotion, social media
MeSH terms: COVID-19 / epidemiology, Social Media, Research Support, Non-U.S. Gov't, Emotions, Humans, Japan, Pandemics

Introduction:
The worldwide COVID-19 pandemic, which began in December 2019 and has lasted for almost 3 years now, has undergone many changes and has changed public perceptions and attitudes. Various systems for predicting the progression of the pandemic have been developed to help assess the risk of COVID-19 spreading. In a case study in Japan, we attempt to determine whether the trend of emotions toward COVID-19 expressed on social media, specifically Twitter, can be used to enhance COVID-19 case prediction system performance.
Methods:
We use emoji as a proxy to shallowly capture the trend in emotion expression on Twitter. Two aspects of emoji are studied: the surface trend in emoji usage by using the tweet count and the structural interaction of emoji by using an anomalous score.
Results:
Our experimental results show that utilizing emoji improved system performance in the majority of evaluations.
Non-Hodgkin Lymphoma With Longitudinally Extensive Transverse Myelopathy as the Initial Symptom: A Case Report
Authors: Yanxing Chen, Caixiu Lin, Baorong Zhang
Journal: Front Oncol (2019)
Keywords: cns involvement, letm, demyelinating diseases, encephalitis, lymphoma
MeSH terms: Case Reports

Identifying lymphoma as the cause of neurological disease is diagnostically challenging when the clinical manifestations are atypical. We report an unusual case of a previously healthy immunocompetent 67-years-old man presenting with acute onset of symptoms of myelopathy and mild personality changes. Magnetic resonance imaging (MRI) revealed multifocal periventricular lesions and longitudinally extensive transverse myelitis (LETM). He had very good response to corticosteroids and was in remission for over 6 months. Repeat MRI showed an unexpected mass lesion in the brain which was later confirmed by brain biopsy as diffuse large B cell lymphoma. Subsequent FDG-PET/CT revealed systemic disease with lymphonodal and testicular manifestations (Stage IV disease). It is therefore important to consider lymphoma as a differential diagnosis in patients with LETM and demyelinating lesions in the brain.
Chronic iliac vein occlusion and painful nonhealing ulcer induced by high venous pressures from an arteriovenous malformation
Authors: Daniel P Link, Phillip J Granchi
Journal: Case Rep Radiol (2011)
MeSH terms: Case Reports

Chronic femoral vein compression (May-Thurner Syndrome) is a known rare cause of deep venous thrombosis. Subsequent angiogenesis and the development of arteriovenous malformation (AVM) in the setting of chronic venous thrombosis is by itself a rare and poorly understood phenomenon. We report a case in which elevated venous pressures resulting from such compression appear to have resulted in the development of a pelvic arteriovenous malformation, which was further complicated by chronic, nonhealing painful lower extremity ulcers, and the development of extensive subcutaneous venous collaterals. Following successful embolization of the pelvic AVM and ablation of veins under the ulcers with laser and sclerotherapy, the patient's ulcers healed and she became pain-free.
A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome
Authors: Cuneyt Kucur, Isa Ozbay, Fatih Oghan, Nadir Yildirim, Zuhal Zeybek Sivas, Sibel Canbaz Kabay
Journal: Case Rep Otolaryngol (2015)

Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome) after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1 mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic.
A Case of Prefemoral Fat Pad Impingement Syndrome Caused by Hyperplastic Fat Pad
Authors: Suguru Koyama, Keiji Tensho, Hiroki Shimodaira, Tomoya Iwaasa, Hiroshi Horiuchi, Hiroyuki Kato, Naoto Saito
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Case:
We report a rare case of prefemoral fat pad impingement syndrome that was caused by a hyperplasia of the normal suprapatellar fat pad. Pain and catching were observed in the proximal-lateral patellofemoral joint, and MRI imaging confirmed a hyperplasic mass in the same area. Although conservative treatment showed no signs of improvement, symptoms improved after an arthroscopic excision of the mass.
Conclusion:
Prefemoral fat pad impingement syndrome is related to patellar motion and should be considered as one of the underlying causes of anterior knee pain (AKP). Surgeons should recognize that a small hyperplasia composed of normal adipose tissue can cause AKP.