OpenMed/multicare-articles huggingface dataset:
Atypical Afta Major Healing after Photodynamic Therapy
Authors: Cinzia Casu, Carla Mannu
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

The aim of this study is to report a case of atypical Afta Major healing in a patient with recurrent aphthous stomatitis (SAR) with a type of photodynamic therapy. A female patient with SAR affected for about 2 years reported a history of hypothyroidism treated with Levothyroxine. The oral cavity clinical examination showed several major symptomatic ulcers, previously treated with topical and systemic therapies without any benefit. The largest of them is present for more than 40 days, in spite of topical cortisone applications, with significant pain symptoms reported by the patient. It was decided to perform a session of photodynamic therapy with a device that emits a LED light used in combination with a photosensitive reagent (Toluidine blue). The dye was applied on the entire surface of the lesion beyond the margins and even encroaching on healthy tissue. The light diode was turned on with a wavelength of 630 nm with cycles from 30 seconds, 10 consecutive times above it. After a few days, a curious phenomenon happened: healing of Afta Major starting from the center, which was almost completely healed towards the borders of the lesion. No previous literature reports this type of healing. Photodynamic therapy could be a successful treatment for SAR.
Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case report
Authors: Gao Song, Meng-Qun Cheng, Rong Li, Cai-Qiong Zhang, Ping Sun
Journal: Front Med (Lausanne) (2022)
Keywords: dihs, dress, pct, meropenem, piperacillin/tazobactam, β-lactam antibiotics
MeSH terms: Case Reports

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and life-threatening adverse drug reaction. It is characterized by a long latency period with rash, hematological abnormalities, and visceral damage. Clinical manifestations of DRESS vary. Thus, accurate clinical diagnosis and identification are essential to ensure timely treatment commencement for improving prognosis and speeding up recovery. We report the case of a 66-year-old male patient with a drug reaction induced by a beta-lactam antibiotic, piperacillin/tazobactam (Pip/Taz). This resulted in the manifestation of both eosinophilic and systemic symptoms. Ten days after the Pip/Taz treatment commencement, the patient developed hyperthermia and elevated serum procalcitonin (PCT), leading to a misdiagnosis of an exacerbated infection. Meropenem treatment was then started. However, after 72 h, the patient developed a generalized rash, eosinophilia, hematological abnormalities, and visceral damage. Moreover, PCT levels were significantly elevated. All these symptoms were associated with DRESS. The sensitizing drug was discontinued, and glucocorticoids were administered, resulting in gradual subsiding of symptoms and decreases in serum PCT levels. Clinicians should be aware that elevated PCT serum levels may be a diagnostic biomarker for DRESS, which requires specific treatment. Furthermore, studies are warranted to further evaluate and elucidate the role of PCT in response to DRESS.
Genetic changes observed in a case of adult pilocytic astrocytoma revealed by array CGH analysis
Authors: Nives Pećina-Šlaus, Kristina Gotovac, Anja Kafka, Davor Tomas, Fran Borovečki
Journal: Mol Cytogenet (2014)
Keywords: copy number aberrations, pilocytic astrocytoma, acgh analysis
MeSH terms: Case Reports

Background:
A palette of copy number changes in a case of adult pilocytic astrocytoma analyzed by Array Comparative Genomic Hybridization (aCGH) is presented. Pilocytic astrocytomas are specific gliomas that are benign and biologically distinct and the molecular mechanisms responsible for their development remain unexplained. The aCGH was performed using SurePrint G3 Human CGH microarrays 4 × 180 K (Agilent Technologies). To ascertain whether some of the aberrations were of constitutive nature, we also analyzed the blood sample from the same patient.
Results:
The result of aCGH analysis demonstrated differences in the tumor tissue when compared to normal control on the array and also to autologous DNA from patient's blood. The total number of aberrations found in our case was 41 including 37 deletions and 4 amplifications. Whole chromosomal gains and losses were not observed. Collectively, our results showed three deletions and one amplification at 1p, two deletions at 2q, two deletions at 4q, two deletion at 5q, two deletions at 7p and two deletions at 7q; there were also three deletions at 8q, one deletion at 9p, one deletion at 10p, three deletions and one amplification at 10q. Chromosome 11 showed two deletions at 11p, while there was one deletion at 12p and one at 12q. Four deletions at 14q; two deletions at 15q, one amplification at 17q and one deletion at 17q; one deletion at 18p, two deletions at 22q and finally one deletion at Xp and one deletion and one amplification at Xq. Among the signaling pathways, olfactory transduction, Fc gamma R-mediated phagocytosis and p53 signaling pathway showed significant enrichment ascertained by gene ontology (GO) analysis using the DAVID software.
Conclusions:
Our aCGH analysis is bringing subtle genomic alterations thus broadening genetic spectrum of adult pilocytic astrocytoma in order to offer new molecular biomarkers that will help in diagnostics and therapeutic decision-making.
Robotic right colectomy in a patient with ventriculoperitoneal shunt. Report of a case
Authors: Igor Monsellato, Marco Lodin, Fabio Priora
Journal: Int J Surg Case Rep (2019)
Keywords: colorectal cancer, hydrocephalus, minimally-invasive surgery, robotic right colectomy, robotic surgery, ventriculoperitoneal shunt

Introduction:
Ventriculoperitoneal shunt procedure has become the most common neurosurgical method for hydrocephalus because it considerably improves patients prognosis. Pneumoperitoneum has been considered a contraindication to laparoscopic surgery because of risk for increased intracranial pressure during pneumoperitoneum and/or malfunction/infection of the VP shunt itself. Laparoscopic resection of the cecum and of the rectum for cancer has been reported.
Presentation of case:
A 74-year old man with ventriculoperitoneal shunt for normal pressure hydrocephalus referred to the emergency medicine ward for COPD, lower limb oedema and severe anemia. CT Scan showed a substenotic tumor of the right colon and non-specific enlarged regional lymph nodes, with no distant metastases. Colonoscopy confirmed the presence of an ulcerated tumor of the right colon involving half of the colic lumen. A right colectomy with CME was carried out, with a stapled intracorporeal ileocolic side-to-side isoperistaltic anastomosis and without manipulating the VPS catheter.
Discussion:
Laparoscopic surgery in patients with VPS tubes was previously contraindicated because of the possibility of shunt-associated complications, that may include shunt malfunction due to increased intra-abdominal pressure, damage or infection of the catheter. Some authors reported that intracranial pressure increased up to 25 mmHg at a pneumoperitoneum pressure of 12 mmHgHerein we report, to our knowledge, the first case report of robotic assisted right colectomy for cancer in a patient with a VP shunt.
Conclusion:
Robotic assistance may allow to perform colorectal resection safely and with low risk also in patients with ventriculoperitoneal shunt.
Elite Capture and Corruption in two Villages in Bengkulu Province, Sumatra
Authors: Anton Lucas
Journal: Hum Ecol Interdiscip J (2016)
Keywords: conservation and development interventions, corruption, elite capture, local government, sumatra

This paper examines leadership, elite capture and corruption in two villages in Sumatra. It compares implementation and outcomes of several conservation and development projects in the context of democratization and decentralization reforms introduced in Indonesia since 1998. In examining aspects of elite control and elite capture, this paper focuses on the activities of local elites, particularly village officials, who use their positions to monopolize planning and management of projects that were explicitly intended to incorporate participatory and accountability features. While elites' use of authority and influence to benefit personally from their roles clearly reflects elite capture, there are nonetheless members of elite groups in these case studies who use their control of projects to broad community benefit. In both villages there is considerable friction between villagers and elites as well as among members of the local elite themselves over control of local resources. Differences in the structure of these cross-cutting internal relationships and of ties between local authorities and outside government and non-government agents largely explain the differences in degree of elite capture and its outcomes in the two cases.
Sustained Hemodynamic and Clinical Improvements for a Patient With Idiopathic Pulmonary Arterial Hypertension Over 1.5 Years After Balloon Atrial Septostomy: A Case Report
Authors: Kae-Woei Liang, Kuo-Yang Wang
Journal: Front Cardiovasc Med (2022)
Keywords: balloon atrial septostomy (bas), case report, idiopathic pulmonary arterial hypertension (ipah), intracardiac echocardiography (ice), prostacyclin analogs
MeSH terms: Case Reports

Balloon atrial septostomy (BAS) is an indicated treatment for subjects with idiopathic pulmonary arterial hypertension (IPAH), particularly for those with advanced right heart failure before bridging to lung transplantation. The mid-term clinical and hemodynamic benefits of BAS are not well studied. Here, we present a young female patient with IPAH who received maximal target medication and was admitted to our hospital due to advanced right heart failure. She had transition of subcutaneous to intravenous (IV) prostacyclin analogs (PA) injection and was registered for lung transplantation. The baseline mean right atrium (RA) pressure was 14 mmHg. BAS was performed with a balloon of 6 mm under intracardiac echocardiography (ICE) guidance. Systemic cardiac output (CO) (2.9-3.5 L/min) and oxygen delivery (OD) (291-318 ml/min) both increased after the BAS. Right heart failure was alleviated to function class II. One and a half years later, she received cardiac catheterization again. The second baseline mean RA pressure was 5 mmHg, left atrium (LA) pressure was 2 mmHg, and systemic CO was 3.3 L/min. These data indicated sustained hemodynamic improvements. The second course of BAS was performed under ICE guidance with a balloon of 8 mm. After the second BAS, her RA pressure was 3 mmHg, LA pressure was 3 mmHg, and CO was 3.4 L/min. In conclusion, BAS and IV PA infusion were effective in maintaining mid-term hemodynamic benefits and in stabilizing the critical right heart failure in a patient with IPAH over a 1.5-year period.
Anatomical Correlates of Uncontrollable Laughter With Unilateral Subthalamic Deep Brain Stimulation in Parkinson's Disease
Authors: Yonglu Huang, Joshua P Aronson, Julie G Pilitsis, Lucy Gee, Jennifer Durphy, Eric Steven Molho, Adolfo Ramirez-Zamora
Journal: Front Neurol (2018)
Keywords: parkinson’s disease, deep brain stimulation, electrode, substantia nigra reticulate, subthalamic nucleus, uncontrolled laughter
MeSH terms: Case Reports

Introduction:
Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for the management of motor complications in Parkinson's disease. Uncontrollable laughter has been reported as a rare side effect of STN stimulation. The precise mechanism responsible for this unique phenomenon remains unclear. We examined in detail the DBS electrode position and stimulation parameters in two patients with uncontrollable laughter during programming after STN-DBS surgery and illustrated the anatomical correlates of the acute mood changes with STN stimulation.
Case report:
Unilateral STN-DBS induced uncontrollable laughter with activation of the most ventral contacts in both patients. However, the location of the electrodes responsible for this adverse effect differed between the patients. In the first patient, the DBS lead was placed more inferiorly and medially within the STN. In the second patient, the DBS lead was implanted more anteriorly and inferiorly than initially planned at the level of the substantia nigra reticulata (SNr).
Conclusion:
Unilateral STN-DBS can induce acute uncontrollable laughter with activation of electrodes located more anterior, medial, and inferior in relationship with the standard stereotactic STN target. We suggest that simulation of ventral and medial STN, surrounding limbic structures or the SNr, is the most plausible anatomical substrate responsible for this acute mood and behavioral change. Our findings provide insight into the complex functional neuroanatomical relationship of the STN and adjacent structures important for mood and behavior. DBS programming with more dorsal and lateral contacts within the STN should be entertained to minimize the emotional side effects.
Traumatic Pelvic Ring Injury following Childbirth with Complete Pubic Symphysis Diastasis
Authors: Aaron Seidman, Kelley Brossy, Alfred Faulkner, Jeffrey Taylor
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Case:
Traumatic pelvic ring injury following childbirth is a rare but debilitating condition. We present a case of a 28-year-old female who sustained a traumatic pelvic ring injury following childbirth with a complete pubic symphysis separation of 5.6 cm treated successfully with nonoperative management.
Conclusion:
Operative and nonoperative treatments for traumatic pelvic ring injuries following childbirth have been described without universal adoption of a uniform treatment modality. We hope this case study adds to the collection of data to help guide medical decision-making in the future as surgeons encounter patients with similar orthopedic injuries.
Thyroid metastasis from nonsmall cell lung cancer
Authors: Tariq Namad, Jiang Wang, Ralph Shipley, Nagla Abdel Karim
Journal: Case Rep Oncol Med (2013)

Background. Thyroid metastases are rare. Clinically, they represent less than 4% of thyroid malignancy in clinical studies. Aim. To assess various presentations and therapy for patients with lung cancer metastatic in the thyroid. Materials and Methods. We report a case of metastatic adenocarcinoma of the lung to the thyroid. We reviewed similar reports through PubmMed search from 1997 until 2013. Case Presentation. A 48-year-old lady was seen in the clinic for an adenocarcinoma of left upper lobe (LUL) of the lung; she received neoadjuvant chemotherapy then LUL lobectomy. After 9 months she presented with diffuse goiter initially believed to be a solitary metastatic lesion as it was positive for adenocarcinoma of lung origin on histopathological exam with TTF-1 positivity. Unfortunately, PET scan showed additional mediastinal lymphadenopathy. Conclusion. The treatment strategy for metastatic thyroid disease is based on a multidisciplinary approach, where thyroidectomy would have been considered in case of a solitary metastatic involvement, but further metastatic workup is mandated to direct further systemic therapy versus palliative radiation therapy.
Volumetric Computed Tomography Angiography in the Evaluation of Mediastinal Fluid Collections following Congenital Cardiac Surgery
Authors: Arno A W Roest, Joost Roelofs, Mark G Hazekamp, Marry E B Rijlaarsdam, Jacob Geleijns, Lucia J M Kroft
Journal: Case Rep Pediatr (2013)

We present 3 patients with 4 causes of mediastinal fluid collection after congenital cardiac surgery in this extended case report. Volumetric computed tomography played an essential role in diagnosing causes and extent, relevant to subsequent management. Recent advances in volumetric computed tomography allow fast and accurate imaging of cardiovascular and extravascular structures in children with acceptable radiation dose, providing a powerful imaging tool for the evaluation of complications after congenital cardiac surgery.
Inflammatory fibroid polyp of the oesophagus
Authors: Shashi Kanth Godey, Robert T Diggory
Journal: World J Surg Oncol (2005)

Background:
Inflammatory fibroid polyp of the oesophagus is an uncommon lesion and very rarely it grows rapidly.
Case presentation:
We present the case of a patient with a rapidly growing inflammatory fibroid polyp (IFP) of the oesophagus, which showed up within five months after a normal endoscopy.
Conclusion:
The treatment of IFP is by surgical excision, either open or endoscopic. Laser or other form of ablative treatment like thermo cautery can also be tried.
Left Cervical Lymphadenopathy Presentation of Metastatic Colorectal Adenocarcinoma
Authors: Diana Maslov, James Bragg
Journal: Ochsner J (2019)
Keywords: adenocarcinoma, colorectal neoplasms, lymphadenopathy, lymphatic metastasis, metastasis
MeSH terms: Case Reports

Background: Colorectal adenocarcinoma, the third most diagnosed cancer in males and the second most diagnosed in females, commonly presents with changes in bowel habits, rectal bleeding, weight loss, fatigue, and abdominal pain. We report the case of a patient with colorectal cancer who had an unusual initial presentation. Case Report: The patient reported dizziness, and physical examination revealed cervical lymphadenopathy. Fine needle aspiration of the lymph node supported a diagnosis of adenocarcinoma, and colonoscopy found a mass in the hepatic flexure that was biopsied and identified as adenocarcinoma. The patient was treated with 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and bevacizumab. Imaging and physical examination 4 months later confirmed resolution of the mass and lymphadenopathy. Conclusion: The patient is regularly followed by hematology/oncology and his primary care physician. He has shown no evidence of recurrence to date. This case supports the necessity of a complete workup and imaging when any solid lymphadenopathy is present.
Central Bradypnea and Ataxic Breathing in Myotonic Dystrophy Type 1 - A Clinical Case Report
Authors: Oliver Summ, Christian Mathys, Teresa Grimm, Martin Groß
Journal: J Neuromuscul Dis (2023)
Keywords: myotonic dystrophy type 1, breathing disorder, breathing regulation, clinical case report
MeSH terms: Myotonic Dystrophy / complications, Myotonic Dystrophy / diagnosis, Myotonic Dystrophy / epidemiology, Respiration Disorders, Respiratory Insufficiency / etiology, Respiratory Insufficiency / therapy, Case Reports, Female, Humans, Hypercapnia / etiology, Middle Aged, Respiration

Background:
The occurrence of obstructive and central sleep apnea syndromes, ventilator pump failure and reduced hypercapnic ventilatory drive in myotonic dystrophy type 1 (DM1) is well established, and there are indications for an impairment of the hypoxic ventilator drive, too. Yet, it is still unknown, to which extent the respiratory rhythm is affected by DM1, thus if a central bradypnea, cluster breathing or ataxic ("Biot's") breathing can occur. Additionally, the causes of the impairment of the central respiratory drive in DM1 are not known.
Case presentation:
We present the case of a tracheotomized female patient with DM1 with central bradypnea and ataxic breathing. A 57-year-old woman with DM1 was admitted to our Neurointensive Care Unit (NICU) due to refractory tracheobronchial retention of secretions resulting from aspiration of saliva. Due to a combination of chronic hypercapnic respiratory failure, severe central bradypnea with a minimal breathing frequency of 3 per minute and ataxic breathing a pressure-controlled home ventilation was initiated.
Conclusions:
In our patient central bradypnea and ataxic breathing possibly were respiratory sequale of DM1, that may have been caused by pontine white matter lesions affecting the pontine respiratory nuclei. From a clinical viewpoint, polygraphy is a suitable tool to objectify disorders of the respiratory rhythm in DM1 even in tracheotomized patients. Clinical studies combining respiratory diagnostics as polygraphy, transcutaneous capnometry and blood gas analysis with brain magnetic resonance imaging (MRI) are required to better understand disorders of respiratory regulation in DM1, and to identify their anatomical correlates.
Lasers in esthetic dentistry: soft tissue photobiomodulation, hard tissue decontamination, and ceramics conditioning
Authors: Karen Müller Ramalho, Patrícia Moreira de Freitas, Ana Cecília Correa-Aranha, Marina Stella Bello-Silva, Roberta Marques da Graça Lopes, Carlos de Paula Eduardo
Journal: Case Rep Dent (2014)

The increasing concern and the search for conservative dental treatments have resulted in the development of several new technologies. Low and high power lasers can be cited as one of these new technologies. Low power lasers act at cellular level leading to pain reduction, modulation of inflammation, and improvement of tissue healing. High power lasers act by increasing temperature and have the potential to promote microbial reduction and ablation of hard and soft tissues. The clinical application of both low and high power lasers requires specific knowledge concerning laser interaction with biological tissues, so that the correct irradiation protocol can be established. The present case report describes the clinical steps of two metal-ceramic crowns development in a 60-year-old patient. Three different laser wavelengths were applied throughout the treatment with different purposes: Nd:YAG laser (1,064 nm) for dentin decontamination, diode (660 nm) for soft tissue biomodulation, and Er:YAG laser (2,940 nm) for inner ceramic surface conditioning. Lasers were successfully applied in the present case report as coadjutant in the treatment. This coadjutant technology can be a potential tool to assist treatment to reach the final success.
Strangulated femoral hernia turned to be peritoneal cyst
Authors: Dionysios Dellaportas, George Polymeneas, Christina Dastamani, Evi Kairi-Vasilatou, Ioannis Papaconstantinou
Journal: Case Rep Surg (2012)

Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein. Case Presentation. The patient was admitted to our hospital suffering from a palpable groin mass on the right, which became painful and caused great discomfort for the last hours. Physical examination revealed a tender and tense, irreducible groin mass. An inguinal operative approach was selected and the mass was found protruding through the femoral ring. After careful dissection it turned out to be a large unilocular cyst, containing serous fluid, probably originating from the peritoneum. McVay procedure was used to reapproximate the femoral ring. Histologic examination showed a peritoneal inclusion cyst. Discussion. Peritoneal inclusion cysts are usually asymptomatic but occasionally present with various, nonspecific symptoms according to their size. Our case highlights that high index of clinical suspicion and careful exploration during repair of a hernia is mandatory in order to reach the correct diagnosis about hernia's contents.