OpenMed/multicare-articles huggingface dataset:
Isolated Intracranial Extramedullary Hematopoiesis in an Adult Patient
Authors: Ramazan Orkun Onder, Alptekin Tosun, Tümay Bekci
Journal: J Belg Soc Radiol (2023)
Keywords: chloroma, epidural hematoma, intracranial extramedullary hematopoiesis, meningioma, metastases
MeSH terms: Case Reports

This article describes the case of a 56-year-old male patient who presented with a headache and swelling on the left side of his head. Medical examinations, including non-contrast computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI), revealed the presence of an expansile soft tissue lesion in the frontoparietal bone structures, causing compression of the brain tissue. Further immunohistochemical analysis confirmed the diagnosis of extramedullary hematopoiesis (EMH) in the bone lesion, with predominant involvement of the myeloid series. EMH is a compensatory mechanism of the body to meet the demand for erythropoiesis. While EMH is commonly associated with thalassemia in children and myelofibrosis in adults, it can occur in various tissues throughout the body, including the intracranial region, although it is rare. The imaging findings of EMH on MRI typically show iso-hypointense signals on T1-weighted images and hypointense signals on T2-weighted images due to the presence of hemosiderin. However, in this case, the lesions appeared hyperintense on T2-weighted images, which posed a challenge in the differential diagnosis. The article highlights the importance of clinical evaluation and imaging findings in diagnosing EMH, as these lesions can resemble other conditions such as metastases, angiomatous meningioma, chloroma, or epidural hematoma.
Teaching point:
Isolated cases of intracranial EMH should be considered as a differential diagnosis in adult patients as they may be radiologically confused with malignant conditions such as metastases, angiomatous meningioma, chloroma or epidural hematoma.
Clinical evaluation and biological understanding of the early step-by-step healing after periodontal microsurgery: A case report with PES analysis comparing initial and 31-day result
Authors: Sergio Kahn, Larissa Zarjitsky de Oliveira, Alexandra Tavares Dias, Gustavo Vicentis de Oliveira Fernandes
Journal: J Adv Periodontol Implant Dent (2022)
Keywords: assessment, case report, connective tissue, gingival recession, microsurgery
MeSH terms: Case Reports

Microsurgery has evolved, permitting faster vascularization and healing than macro-interventions, reducing tissue trauma and obtaining precise wound closure. Therefore, this study aimed to detail the initial healing steps after the periodontal microsurgical procedure. A -26 year-old female had a localized recession (anterior lower tooth, recession type1-), with the absence of local keratinized tissue width (KTW) and adjacent gingival thickness (GT)<1 mm. After oral prophylaxis and occlusal adjustments, the pink esthetic score was performed (5 points), followed by the microsurgery procedure. Prior to inserting the subepithelial connective tissue graft (SCTG), the epithelial layer was removed, and the root surface was biomodified. Two days postoperatively, it was possible to observe a white layer from the SCTG in the gingival margin, decreasing after 4 days. In 6 days, the sutures were removed; no graft and volume loss was observed. For 9 days, the volume was the maintenance. Nevertheless, there was a reduction in tissue volume in the facial zone. After 11 and 13 days, an improved healing process was found, whereas, after 16 days, it was possible to report stable tissues, which was confirmed after 31 days, with a significant GR reduction and an increase in KTW and GT. Moreover, the final pink esthetic score (PES) was 9. Microsurgery had a faster healing and predictable outcome, suggesting reduced trauma, which may allow a quicker suture removal without jeopardizing the outcomes.
Case report: Muscle involvement in a Chinese patient with TRNT1-related disorder
Authors: Cui-Jie Wei, Yi-Dan Liu, Yan-Ling Yang, Yuan Wu, Jie-Yu Liu, Xing-Zhi Chang, Ying Hua, Yu-He Liu, Hui Xiong
Journal: Front Pediatr (2023)
Keywords: trnt1, developmental delay, hyperckemia, mitochondrial myopathy, sensorineural hearing loss, sideroblastic anemia
MeSH terms: Case Reports

The TRNT1 gene encodes tRNA nucleotidyltransferase 1, which catalyzes the addition of cytosine-cytosine-adenosine (CCA) to the ends of cytoplasmic and mitochondrial tRNAs. The most common clinical phenotype associated with TRNT1 is autosomal recessive sideroblastic anemia with B-cell immunodeficiency, periodic fever, and developmental delay (SIFD). Muscle involvement has rarely been reported in TRNT1-related disorders. Here we report a Chinese patient with incomplete SIFD and hyperCKemia, and explored the skeletal muscle pathological changes. The patient was a 3-year-old boy with sensorineural hearing loss, sideroblastic anemia, and developmental delay since infancy. At the age of 11 months, significantly increased levels of creatine kinase were noted, accompanied by mild muscle weakness. Whole-exome sequencing revealed compound heterozygous variants of the TRNT1 gene, c.443C > T (p.Ala148Val) and c.692C > G (p.Ala231Gly), in the patient. Western blot showed a decreased expression of TRNT1 and cytochrome c oxidase subunit IV (COX IV) in the skeletal muscle of the patient. Electron microscopy observation of skeletal muscle pathology revealed abnormal mitochondria of various sizes and shapes, supporting a diagnosis of mitochondrial myopathy. The present case indicates that in addition to the classic SIFD phenotype, TRNT1 mutations can cause mitochondrial myopathy, a rare clinical phenotype of TRNT1-related disorders.
Diagnosis of rapidly progressed primary cardiac lymphoma in liver transplant recipient: A case report
Authors: Jianghua Li, Qiyun Liu, Quanzhou Peng, Shaohong Dong
Journal: Front Oncol (2022)
Keywords: mri, case report, echocardiography, immunocompromised patient, lymph node biopsy, primary cardiac lymphoma (pcl)
MeSH terms: Case Reports

Primary cardiac lymphomas (PCLs) are extremely rare and affect the heart. Patients with PCLs usually have delayed diagnosis and treatment. As a consequence, their prognosis is quite unfavorable, and their median survival is approximately 7 months. Herein, we report a 64-year-old man who underwent liver transplantation, presented with chest pain and exertional dyspnea, developed a huge cardiac mass within 2 months and passed away on day 3 of hospitalization. Histological examination revealed diffuse large B-cell lymphoma (DLBCL), which is a rare cardiac tumor with a poor prognosis. In this case, DLBCL was only detected postmortem. The extension of the mass and its relationship with the heart were explored with non-invasive cardiac imaging. Despite the rarity of DLBCL, it should be considered in the differential diagnosis of cardiac tumors.
A case report of spontaneous closure of a posttraumatic arterioportal fistula
Authors: Hirotada Kittaka, Hiroshi Akimoto, Keitaro Tashiro
Journal: Case Rep Emerg Med (2013)

As the indications for the nonoperative management (NOM) of hepatic injury have expanded, the incidence of complications of NOM has increased. Among such complications, arterioportal fistula (APF) formation is rare, although dangerous, due to the potential for portal hypertension. Embolization is performed in APF patients with clinical signs suggestive of portal hypertension. Meanwhile, no indications for treatment have been established in APF patients without symptoms, as the natural history of posttraumatic APF is not well understood. We herein report the case of a 35-year-old female with severe hepatic injury (Grade IV on the Organ Injury Scale of the American Association for the Surgery of Trauma) due to a traffic accident. Her hemodynamic state remained stable, and an enhanced CT scan obtained on admission showed no extravasation of contrast medium, pseudoaneurysm formation, or APF; therefore, NOM was selected. Although the patient's physical condition was stable, an enhanced CT scan obtained 13 days after the injury showed APF in segment 8 of the liver. Although embolization was considered, the APF was not accompanied by portal dilatation suggestive of portal hypertension; hence, strict observation was selected. Consequently, follow-up CT performed on day 58 after the injury revealed spontaneous closure of the APF.
Risk factors and poor prognostic factors of preeclampsia in Ibn Rochd University Hospital of Casablanca: about 401 preeclamptic cases
Authors: Meriem Benfateh, Souadou Cissoko, Houssine Boufettal, Jean-Jacques Feige, Naima Samouh, Touria Aboussaouira, Mohamed Benharouga, Nadia Alfaidy
Journal: Pan Afr Med J (2018)
Keywords: preeclampsia, fetal prognostic, maternal prognostic, risk factors
MeSH terms: Gestational Age, Pre-Eclampsia / epidemiology, Prenatal Care / methods, Case Reports, Adolescent, Adult, Female, Hospitals, University, Humans, Hypertension / epidemiology, Incidence, Middle Aged, Morocco / epidemiology, Obesity / epidemiology, Pre-Eclampsia / diagnosis, Pre-Eclampsia / etiology, Pregnancy, Prognosis, Retrospective Studies, Risk Factors, Young Adult

Preeclampsia is a gestational pathology that complicates 2 to 8% of pregnancies and is one of the major causes of maternal and fetal morbidity and mortality worldwide. The aim of this work was to study the epidemiological profile of preeclampsia in Casablanca and to identify risk factors as well as factors of poor maternal and fetal prognosis. 401 preeclamptic cases were collected in the gynecology-obstetrics "C" Service of Lalla Meryem Maternity of Ibn Rochd University Hospital of Casablanca (2010-2011) were included in this study and a statistical analysis with the SPSS software version (16.0) was performed. We used the Chi-2 test to analyze qualitative variables and Student's test and ANOVA (analysis of variance) for quantitative variables. The incidence of preeclampsia was (7.1%). The epidemiological profile was that of a primipara (57.6%), average age 30 years and (66.8%) of pregnancies were not followed. Multiparity was a factor of poor maternal prognosis (p = 0.007). The low gestational age and no prenatal care were factors of maternal as well as fetal prognosis. Risk factors frequently found in our patients were obesity (15.21%) and chronic hypertension (5.73%) as vascular-renal history; abortion (16.46%) and perinatal death (5.24%) as obstetric history. Preeclampsia is a common obstetric pathology in our context. Better prenatal care and early diagnosis could reduce its incidence.
Acute thrombocytopenia induced by trastuzumab due to complement reaction: A case report
Authors: Guoping Chen, Jianghua Ou, Jun Liu, Haoran Liao, Linwei Ding, Pingming Fan, Guankui Du
Journal: Front Med (Lausanne) (2022)
Keywords: her2, breast cancer, complement response, dramatic thrombocytopenia, trastuzumab
MeSH terms: Case Reports

Background:
The usual treatment option for HER2 breast cancer is targeted therapy with trastuzumab. The common adverse effects of trastuzumab treatment are thrombocytopenia, however, acute thrombocytopenia is rare and its mechanism is still largely unknown.
Case presentation:
We reported a patient who presented with acute thrombocytopenia on two consecutive occasions, and the predisposing factor was identified on the second occasion because of trastuzumab-only treatment. Routine blood results showed a dramatic increase in white blood cell count and neutrophil count after both trastuzumab treatments. Moreover, the complement reaction results suggested that the dramatic thrombocytopenia was probably due to platelet destruction after complement activation.
Conclusion:
This case suggests that it would be useful to perform a platelet complement reaction test before trastuzumab treatment in patients with HER2 breast cancer.
Case Report: Successful Implementation of Integrative Cognitive Remediation for Early Psychosis
Authors: Olina G Vidarsdottir, David L Roberts, Elizabeth W Twamley, Berglind Gudmundsdottir, Engilbert Sigurdsson, Brynja B Magnusdottir
Journal: Front Psychiatry (2021)
Keywords: compensatory cognitive training, functional outcome, rehabilitation, schizophrenia, social cognition and interaction training
MeSH terms: Case Reports

Many individuals demonstrate functionally relevant impairment in neurocognition as well as social cognition early on in the course of their psychotic disorder. There is robust evidence supporting cognitive remediation as an effective treatment of cognitive dysfunction in schizophrenia. Increasingly it is accepted that earlier treatment is associated with better outcome and that it is important to systematically assess and treat cognitive dysfunction before the cognitive and functional disabilities are fully realized. However, the clinical availability of these interventions remains sparse. As we move forward with implementing evidence-based interventions into multi-component treatment for early psychosis, it is important to reflect on experience as well as evidence. This case report aims to describe the implementation of an integrative cognitive remediation program in coordinated specialty care (CSC) for early psychosis in Iceland and investigate whether the intervention is sustainable in a CSC setting. Data on the number of patients treated, facilitators trained, groups conducted, and funding was used to assess the sustainability. The results show that since initial implementation in 2016, the intervention has been routinely available as part of standard care, with over 100 patients having received the treatment. The report discusses key factors in the successful implementation of the program.
Case report: Multiple biventricular aneurysms in arrhythmogenic cardiomyopathy
Authors: Jiadong Lin, Zhijuang Lu, Mingqin Lin, Ying Wan, Jianfeng Li, Xinsheng Huang
Journal: Front Cardiovasc Med (2023)
Keywords: arrhythmogenic cardiomyopathy, desmoplakin, echocardiography, high-frequency ultrasound, sustained ventricular tachycardia, syncope
MeSH terms: Case Reports

Arrhythmogenic cardiomyopathy (ACM) is a genetic disease characterized by fibro-fatty myocardial replacement and is clinically associated with malignant ventricular arrhythmias and sudden cardiac death. It presents a major diagnostic and therapeutic challenge due to its complex clinical presentation and multiparametric diagnostic scoring system that includes structural, histological, and electrocardiographic data. A 57-year-old man with a history of palpitation and premature ventricular contractions (PVC) experienced syncope and sustained ventricular tachycardia at a rate of 213 bpm, which was successfully rescued by synchronized cardioversion. Multiple ventricular aneurysms were found in the right ventricular free wall and the left ventricular apical regions, as well as mild biventricular systolic dysfunction, according to echocardiography and high-frequency ultrasound. The genetic analysis revealed the following desmoplakin genes, chr6-7585274-7585275, NM_004415, exon24, and c.7780delT (p.S2594Pfs*9), a heterozygous and likely pathogenic mutation, as the mutation sites in the patient and his 24-year-old daughter. During the 21-month follow-up, the patient did not experience syncope or pre-syncope symptoms while on β-blocker (bisoprolol) therapy. Among the multimodality imaging techniques of the ACM, late gadolinium enhancement on cardiac magnetic resonance (CMR) is accepted as a more objective indicator of myocardial fibrosis. Left ventricular systolic dysfunction, fibrosis on CMR, and frequent PVC are the primary and most sensitive clinical signs of desmoplakin cardiomyopathy. However, echocardiography continues to be the most commonly used imaging modality for assessing focal ventricular movement and structural abnormalities. The pathological characteristics of arrhythmogenic cardiomyopathy of the right ventricular anterior free wall and apical regions near the transducer can be better shown using high-frequency linear ultrasound with a higher resolution.
Primary oesophageal small cell carcinoma initially manifestating as purulent pericardiac effusion
Authors: Go Eun Yang Jr, Heung Cheol Kim Sr, Jung Hun Kim Jr
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

This article reports a case of primary oesophageal small cell carcinoma with a large amount of purulent pericardial effusion due to oesophageal rupture. The patient was treated with chemotherapy, which resulted in a marked decrease in the size of the oesophageal mass and partial resolving of metastatic lymphadenopathy.
Diagnosis of rosai-dorfman disease in elderly female on fine needle aspiration cytology: a case report
Authors: Meher Aziz, Prasenjit Sen Ray, Nazima Haider, Sumit Prakash Rathore
Journal: Case Rep Pathol (2012)

Rosai-Dorfman disease (RDD) is a rare benign disorder of histiocytic proliferation that usually presents with bilateral cervical lymphadenopathy in children. We describe the case of a 50-year-old lady suffering from this disease who presented with generalized lymphadenopathy and a left sided chest wall lump. Fine needle aspiration cytology (FNAC) from all the lesions showed abundant benign histiocytes with lymphophagocytosis which was compatible with the diagnosis of RDD. This case is being reported for its rarity in presentation in an elderly female with both generalized nodal as well as extranodal manifestations.
Dental Impaction in the Cecum: Case Report and Review of Gastrointestinal Foreign Body Impactions
Authors: Mouhanna Abu Ghanimeh, Omar Abughanimeh, Sakher Albadarin, Osama Kaddourah, John H Helzberg
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Approximately 20% of the adult population in the United States wears dentures. Foreign body ingestions, including dentures, are not uncommon. Although the majority of all ingested foreign bodies pass spontaneously through the gastrointestinal tract, impaction may occur, especially with physiologic constrictions, angulations, or stenosis. The esophagus is the most common site of impaction, whereas colonic impaction is extremely uncommon. We present a case of an 84-year-old male who was referred to the gastroenterology clinic for denture impaction, which lasted for two weeks. The patient had already failed to pass the denture following conservative treatment with laxatives, and repeated abdominal imaging showed the dental plate in the cecum. Colonoscopy was performed three weeks after the ingestion of his dentures, and tripod forceps were used to dislodge the end of the dental plate and ultimately remove it. The patient was asymptomatic for the entire period.
Detection of Rare Beta Globin Gene Mutation [+22 5UTR(G>A)] in an Infant, Despite Prenatal Screening
Authors: Mohammad Reza Mahdavi, Hosein Karami, Mohammad Taghi Akbari, Hosein Jalali, Payam Roshan
Journal: Case Rep Hematol (2013)

Background. Beta thalassemia is one of the most common hereditary disorders worldwide. In Iran, it is frequently reported from northern and southern provinces. In order to prevent child birth to be affected by this complication, prenatal screening and diagnosis are carried out nationwide. However, in some instances, this program is unable to identify rare mutations leading to thalassemia. Case Presentation. A married couple, who took part in prenatal screening and diagnosis, gave birth to a child who is affected by thalassemia major. After several molecular examinations, a rare mutation [+22 5UTR (G>A)] in compound heterozygote state along with a common mutation [codon 8 (-AA)] was found. Conclusion. This case study suggests that more advanced molecular evaluations must be integrated in prenatal screening programs to identify rare mutations and antenatal diagnosis of thalassemia cases.
Atypical Presentation of Sjögren-Larsson Syndrome
Authors: D Papathemeli, A Mataftsi, A Patsatsi, D Sotiriadis, M Samouilidou, S Chondromatidou, A Evangeliou
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Sjögren-Larsson syndrome is a rare neurocutaneous disorder characterized by ichthyosis, spastic diplegia or tetraplegia, and intellectual disability. Herein, we describe a case of a Greek patient with ichthyosis and spasticity of the legs but with normal intelligence (IQ 95). This syndrome should be suspected when a child presents with ichthyosis and spastic diplegia or tetraplegia, even if intelligence is normal.
The impact of menthol cigarettes on smoking initiation among non-smoking young females in Japan
Authors: Gregory N Connolly, Ilan Behm, Yoneatsu Osaki, Geoffrey F Wayne
Journal: Int J Environ Res Public Health (2011)
Keywords: japan, female-smoking, initiation, menthol, smokers
MeSH terms: Marketing, Menthol, Smoking / epidemiology, Tobacco Industry / methods, Adolescent, Adult, Age Factors, Cohort Studies, Cross-Sectional Studies, Female, Health Knowledge, Attitudes, Practice, Health Surveys, Humans, Japan / epidemiology, Male, Prevalence, Sex Factors, Smoking / economics, Smoking / psychology, Smoking / trends, Tobacco Industry / economics, Young Adult, Menthol

Japan presents an excellent case-study of a nation with low female smoking rates and a negligible menthol market which changed after the cigarette market was opened to foreign competition. Internal tobacco industry documents demonstrate the intent of tobacco manufacturers to increase initiation among young females through development and marketing of menthol brands. Japanese menthol market share rose rapidly from less than 1% in 1980 to 20% in 2008. Menthol brand use was dominated by younger and female smokers, in contrast with non-menthol brands which were used primarily by male smokers. Nationally representative surveys confirm industry surveys of brand use and provide further evidence of the end results of the tobacco industry's actions-increased female smoking in Japan. These findings suggest that female populations may be encouraged to initiate into smoking, particularly in developing nations or where female smoking rates remain low, if the tobacco industry can successfully tailor brands to them. The Japanese experience provides a warning to public health officials who wish to prevent smoking initiation among young females.
Isolated bilateral congenital iris sphincter agenesis
Authors: Aparna Rao
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

Purpose. We herein report a patient with bilateral congenital total iris sphincter agenesis with no other abnormality detected on systemic examination. Methods. A 24-year-old laborer presented to us for a routine checkup with complaint of photophobia and inability to work under sunlight. Examination revealed bilateral absence of sphincter and 6.5 mm pupil in both eyes in the undilated state. Results. Accommodation was poor in both eyes. Systemic examination was within normal limits. He was prescribed bifocal photochromic glasses for constant wear. Conclusions. Congenital sphincter agenesis can occur in an isolated form without systemic abnormalities which can be managed conservatively.
Accidental Intrathecal Administration of Digoxin in an Elderly Male with End-Stage Renal Disease
Authors: Claudia Martin, Kitae Kevin Park, Antonio Liu
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

The systemic effects of digoxin toxicity have been well-known. However, there has been no case citing the effects of intrathecal digoxin in light of end-stage renal disease in the elderly. Here, we report on the case of the successful management of accidental intrathecal digoxin administration in an elderly male with end-stage renal disease.