OpenMed/multicare-articles huggingface dataset:
Varus shearing force is a main injury mechanism of pediatric trampoline-related injury in addition to compressive axial loading
Authors: Keong-Hwan Kim, Han-Soo Kim, Michael Seungcheol Kang, Soo-Sung Park
Journal: PLoS One (2019)
MeSH terms: Compressive Strength, Leg Injuries / physiopathology, Recreation, Research Support, Non-U.S. Gov't, Adolescent, Biomechanical Phenomena, Case-Control Studies, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Injury Severity Score, Male, Weight-Bearing

Background:
Many case studies have been published about trampoline-related injury (TRI); however, a comparative study could allow a more specific analysis of the characteristics of TRI, and enable more differentiated approaches to prevent such injuries. We investigated the injury mechanism of TRI in children compared with other pediatric trauma.
Methods:
Of 35,653 children (age 0-18 years) who visited the pediatric emergency department after traumatic injuries from January 2011 to June 2017, 372 patients with TRI (TRI group) were retrospectively identified. Among the remaining 35,281 patients with other trauma (non-TRI group), 372 were 1:1 matched to the TRI group according to sex, age, injured body part, and body weight (matched-control group). The patients' data, injured site, and injury patterns were compared between the groups.
Results:
The most frequently injured body part was the knee/lower leg in the TRI group and the head in the non-TRI group. The most frequent injury types were fractures in the TRI group and open wounds in the non-TRI group. In the comparison between the TRI and matched-control groups, the most common lower-extremity fractures were proximal tibial fractures with varus angulation in the TRI group and tibial shaft spiral fractures in the matched-control group. For the upper extremities, the risk of lateral condylar humeral fracture was higher in the TRI group. The TRI group presented more physeal involvements.
Conclusions:
The risks of varus stress injury (proximal tibial fracture with varus angulation in lower extremity and lateral condylar humeral fracture in upper extremity) were higher in the TRI group than in matched-control group. Thus, varus shearing force seems to be an important injury mechanism in TRI in addition to compressive force. This varus force may increase the risk of physeal injury by generating additional shear force on the physis.
Gallbladder agenesis and cystic duct absence in an adult patient diagnosed by magnetic resonance cholangiography: report of a case and review of the literature
Authors: Valeria Fiaschetti, Giovanna Calabrese, Silvia Viarani, Gabriele Bazzocchi, Giovanni Simonetti
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Gallbladder agenesis (GA) is a rare congenital anomaly of the biliary system often associated with other congenital abnormalities. Patients become symptomatic in 23% of cases. GA is often misinterpreted as other diseases, therefore, leading to unnecessary surgery. We report a case of congenital GA associated to cystic duct absence and a biliary tract abnormality diagnosed by Magnetic Resonance with Cholangiopancreatography.
Case report: Unruptured sinus of Valsalva aneurysms causing postural angina pectoris and false "pulmonary hypertension"
Authors: Chi Zhou, Jingwen Tao, Sheng Li
Journal: Front Cardiovasc Med (2023)
Keywords: flna gene mutation, case report, postural angina pectoris, pulmonary hypertension, sinus of valsalva aneurysm
MeSH terms: Case Reports

A 37-year-old woman presented with worsening intermittent chest pain and dyspnea in the previous year. Although the dyspnea was exertion-dependent, her chest pain was heavily dependent on her postural position, worsening in the supine position but alleviated by lying prone or by sitting up and leaning forward. She was cyanotic, and a diastolic murmur in the left third intercostal space was auscultated. An electrocardiogram recorded when she laid flat and had angina pectoris attacks showed ST-segment elevation in the aVR and depression in the II, III, aVF, and V3-V6 leads. However, when she sat up for a few minutes, her symptoms and ST-segment abnormalities disappeared. Echocardiography and cardiac computed tomography angiography revealed large unruptured aneurysms of the left and non-coronary sinuses, along with a dilated aortic root, severe aortic regurgitation, and right ventricular high pressure. Coronary angiography showed ∼90% pulsating stenosis of the left main coronary artery and ∼80% pulsating stenosis of the proximal left circumflex artery, presumably caused by pulsation of the dilated sinus of Valsalva aneurysm under blood pressure. Genetic testing revealed c.1781 C > G nonsense mutations in the FLNA gene. The patient underwent surgery, which confirmed dual unruptured left/non-coronary sinus of Valsalva aneurysms. Our case illustrates an unusual postural form of angina pectoris and false "pulmonary hypertension" caused by large dual unruptured left/non-coronary sinus of Valsalva aneurysms.
A Case of Warm Autoimmune Hemolytic Anemia and a Pulmonary Embolus in a Patient Treated with Triple Therapy
Authors: Gurchetan Randhawa, Chia-Yu Chiu, Thanunthorn Suban Na Ayutthaya
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Autoimmune hemolytic anemia (AIHA) can be caused by a variety of etiologies. AIHA is associated with the development of coagulopathy, leading to potentially fatal pulmonary emboli. Here, we present a case of a 66-year-old female with a past medical history of non-Hodgkin's lymphoma and gastritis treated with triple therapy that developed warm AIHA. The patient later succumbed to a suspected pulmonary embolus.
Point-of-care ultrasound detection of tracheal wall thickening caused by smoke inhalation
Authors: Toru Kameda, Masato Fujita
Journal: Crit Ultrasound J (2014)
Keywords: point-of-care, smoke inhalation, trachea, ultrasonography

Smoke inhalation is the leading cause of death due to fires. When a patient presents with smoke inhalation, prompt assessment of the airway and breathing is necessary. Point-of-care ultrasonography (US) is used for the rapid assessment of critically ill or injured patients. We herein present a case report of a 54-year-old male who was transferred to the emergency department with shortness of breath, coughing, carbonaceous sputa, and rhinorrhea after inhaling smoke caused by a fire in his locked bedroom. He had no surface burns on the face and no edema or erosion in the oral cavity. He had hoarseness without stridor. His breath sounds were positive for expiratory wheezes. Laryngoscopy showed light edema and erosive findings on the supraglottic region. Bedside point-of-care US revealed hypoechoic thickening of the tracheal wall. The thickening was confirmed by a computed tomographic scan. The patient was carefully monitored with preparation for emergency airway management and was treated with supplemental oxygen and an aerosolized beta-2 adrenergic agonist in the intensive care unit. The symptoms were subsequently relieved, and reexamination by US after 2 days showed remission of the wall thickening. Point-of-care US may therefore be a useful modality for the rapid diagnosis and effective follow-up of tracheal wall thickening caused by smoke inhalation.
Long-term disease-free survival in advanced melanomas treated with nitrosoureas: mechanisms and new perspectives
Authors: Xavier Durando, Emilie Thivat, Michel D'Incan, Anne Sinsard, Jean-Claude Madelmont, Philippe Chollet
Journal: BMC Cancer (2005)
MeSH terms: Antineoplastic Agents / pharmacology, Melanoma / drug therapy, Melanoma / mortality, Nitrosourea Compounds / pharmacology, Skin Neoplasms / drug therapy, Skin Neoplasms / mortality, Case Reports, Adult, Clinical Trials as Topic, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Remission Induction, Time Factors, Treatment Outcome, Antineoplastic Agents, Nitrosourea Compounds, N'-(2-chloroethyl)-N-(2-(methylsulfonyl)ethyl)-N'-nitrosourea

Background:
Median survival of metastatic malignant melanoma is 6.0 to 7.5 months, with a 5-year survival of approximately 6.0%. Although long-term complete remissions are rare, few reports describe cases after chemotherapy. Fifty-three patients with metastatic melanoma were treated with Cystemustine, a chloroethyl nitrosourea (CENU) (60 or 90 mg/m2).
Case presentation:
We describe 5 cases, presenting with complete response with long-term disease-free survival of long-term remission of 14, 12, 9, 7 and 6 years after Cystemustine therapy alone.
Conclusion:
Long-term survival has already been described in literature, but in all cases they have been obtained after chemotherapy associated with or followed by surgery. But despite these noteworthy and encouraging but also rare results, it appears essential to increase Cystemustine efficiency.
Myocardial infarction with normal coronary arteries: a case report and review of the literature
Authors: Luigi Iuliano, Fausta Micheletta, Alessandro Napoli, Carlo Catalano
Journal: J Med Case Rep (2009)

Introduction:
Although acute myocardial infarction is generally associated with obstructive coronary artery disease, myocardial infarction associated with normal coronary arteries is a well-known condition. The overall prevalence rate of myocardial infarction with normal coronary arteries is considered to be low, varying from 1% to12% depending on the definition of "normal" coronary arteries.
Case presentation:
We describe here a case of a 49-year-old woman with a history of prior myocardial infarction who continued to be asymptomatic after a 10-year follow-up, in the absence of a high-risk profile for adverse outcomes. She was studied with multi-slice coronary computed tomography and whole-body angiography, which showed normal coronary and extra-coronary arteries.
Conclusion:
This case report raises two important issues. First, the possible role of multi-slice computed tomography/coronary angiography in the risk- and prognosis assessment of patients with known or suspected coronary artery disease. Second, the important role played by long-term pharmacological therapy in patients with prior myocardial infarction and normal coronary arteries.
The value of fine needle aspiration cytology in the clinical management of rare salivary gland tumors
Authors: Tibor Mezei, Simona Mocan, Alina Ormenisan, Beáta Baróti, Alina Iacob
Journal: J Appl Oral Sci (2018)
MeSH terms: Biopsy, Fine-Needle / methods, Carcinoma / pathology, Lymphoma, B-Cell, Marginal Zone / pathology, Parotid Neoplasms / pathology, Case Reports, Evaluation Study, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Parotid Gland / pathology, Rare Diseases, Reproducibility of Results, Tomography, X-Ray Computed

Salivary gland tumors are relatively rare neoplasms, mostly located in the parotid gland, and few are malignant. Preoperative evaluation of salivary gland tumors includes fine needle aspiration cytology (FNAC).
Objective:
The purpose of this study was to determine the importance of FNAC in the evaluation of rare salivary gland neoplasms.
Material and methods:
Four cases of rare salivary gland tumors were included, which were preoperatively assessed by clinical investigation, computed tomography, and FNAC.
Results:
The presented cases include myoepithelial carcinoma, oncocytic carcinoma, undifferentiated lymphoepithelial carcinoma, and marginal zone lymphoma.
Conclusion:
FNAC is a reliable diagnostic tool for common salivary gland neoplasms; however, rare tumors often represent diagnostic challenges. Clinical relevance In such rare tumors, the role of aspiration cytology may be limited to establishing the dignity of the lesion (benign/malignant). This knowledge enables the surgeon to choose the most appropriate therapeutic procedure. A definitive diagnosis of rare tumors (either epithelial or nonepithelial) is obtained by histological examination; cytology is limited in this regard due to overlapping features.
Renal cell carcinoma presenting with cutaneous metastasis: a case report
Authors: Nilufer Onak Kandemir, Figen Barut, Kıvanç Yılmaz, Husnu Tokgoz, Mubin Hosnuter, Sukru Oguz Ozdamar
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Renal cell carcinoma is the most common kidney tumor in adults. Cutaneous metastasis is a rare first symptom of the disease. This paper describes the diagnosis of a renal cell carcinoma that was indicated by cutaneous metastasis in the head and neck region, and considers the etiopathogenesis of such cases. A careful skin examination is important to detect cutaneous metastasis associated with renal cell carcinomas. Metastatic skin lesions in the head and neck region must be taken into consideration during a differential diagnosis.
Case report: Unilateral pulmonary artery agenesis and Kommerell's diverticulum in 1-year old girl
Authors: Valdone Miseviciene, Gintare Liakaite, Jurgita Zaveckiene, Ausra Snipaitiene
Journal: Front Pediatr (2023)
Keywords: kommerell’s diverticulum, pediatric vascular anomalies, pulmonary hypertension, rare vascular anomalies, unilateral pulmonary artery agenesis
MeSH terms: Case Reports

Background:
Unilateral pulmonary artery agenesis (UPAA) and Kommerell's diverticulum (KD) are two rare embryologically unrelated congenital vascular malformations rarely diagnosed in children. This is the first report of our knowledge of the unique combination for a child as patients are at a high risk of pulmonary hypertension and rupture of the diverticulum. Our aim is to present the case of a pediatric patient with UPAA and KD with the short literature review and to highlight the importance of early diagnostics of rare congenital vascular malformations.
Case report:
A 1-year-old girl presented to the emergency department with prolonged cough and variable wheezing. A hypoplastic left lung was suspected in the radiographic image of the chest. A transthoracic echocardiogram revealed absence of the left pulmonary artery and right arch of aorta and anomaly of subclavian arteries was suspected. The diagnosis was confirmed by computed tomography scans of the chest that demonstrated elongation of the aorta and an aberrant right subclavian artery with KD, as well as absence of the left pulmonary artery. The patient is being followed up for the development of pulmonary hypertension and compression of vascular structures to the airways as well as any indications for surgical intervention because of the KD.
Conclusions:
UPAA and KD are two very rare congenital vascular anomalies usually diagnosed in adults. A high risk of pulmonary hypertension and rupture of diverticulum is noted for adult patients. This case provides us with an exclusive possibility to follow up a patient with an extremely rare combination of the two vascular anomalies with insufficiently known future complications and outcomes.
Case Report: Successful engraftment of allogeneic hematopoietic stem cells using CAR-T cell therapy as the conditioning regimen in R/R Ph+ B cell acute lymphoblastic leukemia
Authors: Lu Han, Ran Zhao, Jingyi Yang, Yingling Zu, Yanyan Liu, Jian Zhou, Linlin Li, Zhenghua Huang, Jishuai Zhang, Quanli Gao, Yongping Song, Keshu Zhou
Journal: Front Immunol (2022)
Keywords: b-cell acute lymphoblastic leukemia, car-t, cd19, allogeneic hematopoietic stem cell transplantation, conditioning regimen
MeSH terms: Hematopoietic Stem Cell Transplantation, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Receptors, Chimeric Antigen, Case Reports, Research Support, Non-U.S. Gov't, Hematopoietic Stem Cells, Humans, T-Lymphocytes, Receptors, Chimeric Antigen

Background:
Consolidative allogeneic hematopoietic stem cells (allo-HSCs) after chimeric antigen receptor T cells (CAR-T) therapy is an emerging modality in hematologic malignancies. Knowledge about the success of allogeneic hematopoietic stem cell transplantation (allo-HSCT) after CAR-T therapy without a conditioning regimen is limited.
Case presentation:
We report a patient with relapsed/refractory (R/R) Ph+ B-cell acute lymphoblastic leukemia (ALL) who underwent anti-CD19 CAR-T immunotherapy. After 1 month of treatment, bone marrow hyperplasia remained reduced with no hematopoietic improvements. In line with this, allogeneic hematopoietic stem cells (HSCs) were extracted from an HLA-matched sibling donor and administered to the patient on day 33 after CAR-T cell therapy to support hematopoiesis. On day 40, the level of immature bone marrow lymphocytes was at 0% and minimal residual disease-negative, and the fusion gene BCR/ABL 190 was negative. Chimerism analysis showed full donor chimerism. Three months after CAR-T cells infusion, the patient was still in complete remission with full donor chimerism. However, decreased liver function with skin pigmentation and festering, indicative of acute graft versus host disease, was noted. The treatment was halted owing to financial reasons.
Conclusion:
We report the successful engraftment of allogeneic HSCs using CAR-T cell therapy as a conditioning regimen for R/R B-ALL patients.
Case Report: Dual Checkpoint Inhibition in Advanced Metastatic Osteosarcoma Results in Remission of All Tumor Manifestations-A Report of a Stunning Success in a 37-Year-Old Patient
Authors: Ulrich Sterz, Matthias Grube, Wolfgang Herr, Karin Menhart, Christina Wendl, Martin Vogelhuber
Journal: Front Oncol (2021)
Keywords: dual checkpoint inhibition, immunotherapy, ipilimumab, nivolumab, osteosarcoma
MeSH terms: Case Reports

Background:
Patients with unresectable metastasized osteosarcoma have a poor prognosis. Current treatment options do not offer a chance to cure the disease in this situation. Despite the fact that immunotherapy has expanded its indications continuously over previous years, its use is not yet established in osteosarcoma. There is a lack of randomized controlled studies that could show a significant benefit in this rare tumor entity. So far, efficacy of immunotherapy is only reported in individual cases as well as in mouse models. To predict a response to immunotherapy, testing for programmed death-ligand 1 (PD-L1) expression, microsatellite instability (MSI), and tumor mutational burden (TMB) can be useful, but status is not yet clear for most cancer entities.
Methods:
Single case study and review of the literature.
Case presentation:
This report presents the case of a 37-year-old patient with metastatic advanced osteosarcoma, who had no more established options for tumor treatment left. PD-L1 expression in the most recent tumor sample was high (tumor proportion score (TPS) 90%, combined positive score (CPS) 92%) but no MSI could be detected. In an individual therapy attempt, an ongoing and profound remission of all tumor manifestations due to four cycles of immunotherapy with ipilimumab and nivolumab was reached. Despite discontinuation of immunotherapy for 3 months due to therapy-related pneumonitis, remission of all tumor manifestations was ongoing, and no detectable relapse in restaging before onset of Nivolumab-maintenance could be observed.
Conclusion:
The present case constitutes the first report of an adult patient with metastasized advanced osteosarcoma who reached a deep remission of disease by immunotherapy with ipilimumab and nivolumab, which continued even though immunotherapy had to be interrupted. To verify whether the high expression of PD-L1, as seen in this patient, is a predictive marker for response to immunotherapy in osteosarcoma, requires further investigation.
Talar Neck Fracture after United Tibiotalar Fusion
Authors: W Platt, M Welck, B Rudge
Journal: Case Rep Orthop (2015)

Tibiotalar arthrodesis is a well-established treatment for tibiotalar arthritis, for example, in younger high demand patients. Talar neck fractures are less common though well-recognised sequelae of foot ankle trauma. Here we present the clinical case of a 69-year-old male who presented to our institution with a nonunion of a talar neck fracture, having undergone a left tibiotalar fusion 24 years previously. To the authors' knowledge, this injury has only been described once previously in the literature. However, the original case described a fracture sustained in the very early postoperative period following tibiotalar fusion, postulated to be secondary to postimmobilisation osteopaenia or stress risers from metalwork. The aetiology in this case is likely due to axial compression transmitted to the talar neck via the calcaneus. The predisposing factors for nonunion are discussed, highlighting the importance of vigilance for this injury in any patient with concomitant tibiotalar fusion and foot trauma. The management of this patient is discussed.
Successful Treatment of Human Monocytic Ehrlichiosis with Rifampin
Authors: Khalid Abusaada, Saira Ajmal, Laura Hughes
Journal: Cureus (2016)
Keywords: ehrlichia, human monocytic ehrlichiosis, rifampin, therapy
MeSH terms: Case Reports

Currently recommended treatment regimens for human monocytic ehrlichiosis (HME) include doxycycline or tetracycline. Antibiotic susceptibility studies demonstrate that rifampin has in vitro bactericidal activity against Ehrlichia. Case reports have suggested clinical response with rifampin treatment of human granulocytic anaplasmosis (HGA). We report the first case of HME successfully treated with rifampin.
The Multiple Etiologies of Abdominal Pain Post Roux-en-Y Gastric Bypass: A Case Series and Review of Management Strategies
Authors: Shaniah S Holder, Rosheyla Saint-Hilaire, Christopher Meusburger, Douvae Miller, Frederick Tiesenga
Journal: Cureus (2023)
Keywords: abdominal pain, bariatric surgery, gastric bypass, intussusception, marginal ulcers, small bowel obstruction
MeSH terms: Case Reports

Roux-en-Y gastric bypass (RYGB) is one of the most common bariatric surgeries performed and has aided many people with their weight loss efforts. However, manipulating the gastrointestinal anatomy may have numerous consequences. Various complications of RYGB can occur during the early to late post-op periods, and abdominal pain is the most common symptom reported. The etiologies that present as abdominal pain are heterogeneous in anatomical origin, onset, severity, and management; therefore, differentiating diagnoses is crucial. The physical exam, inciting triggers, and alleviating factors can direct diagnostic measures accordingly. Prompt recognition and identification of these patients' underlying causes of abdominal pain are vital for accurate diagnosis and treatment. Methods can range from conservative management to surgical intervention, depending on the severity of the complication. In this report, we recount the cases of two patients who underwent elective RYGB and presented to the emergency department (ED) months later with abdominal pain. After the labs were taken and diagnostic tests were conducted, it was discovered that both patients had multiple underlying factors that could have contributed to their pain. This study aims to describe the diverse etiologies of abdominal pain encountered in these bariatric patients and explore the appropriate management strategies utilized for each case.
Metastasis to the parotid region as an initial presentation of renal cell carcinoma: A case report
Authors: Chai Yanlan, Song Liping, Che Shaomin, Liu Zi
Journal: Oncol Lett (2013)
Keywords: metastasis, parotid region, renal cell carcinoma, therapy development

Distant metastasis of renal cell carcinoma (RCC) to the parotid region is extremely rare, particularly as an initial presentation. In the present study, we report a rare case of parotid region metastasis from RCC as an initial presentation in a 44-year-old female who presented with a painless lump in the right parotid region. Investigation revealed RCC in the left renal region and metastasis to the right iliac area. A radical nephrectomy was performed but the patient refused any further treatment. After seven months, the patient reappeared with systemic multiple metastases, with the exception of previous metastases that were enlarging significantly. On admission, interleukin-2 and local radiotherapy were administered. However, oral mucositis occurred. Targeted therapy with sunitinib was recommended.