OpenMed/multicare-articles huggingface dataset:
Surgical management of a retro-rectal cystic hamartoma (tailgut cyst) using a trans-rectal approach: a case report and review of the literature
Authors: Edvinas Kildušis, Narimantas Evaldas Samalavičius
Journal: J Med Case Rep (2014)

Introduction:
Retro-rectal cystic hamartoma (tailgut cyst) is a rare congenital developmental lesion arising from post-natal primitive gut remnants in the retro-rectal space. The rarity of the lesion and its anatomical position usually leads to difficulty in diagnosis and surgical management. Complete surgical resection remains the cornerstone of treatment. A dozen or so surgical approaches have been described in the literature to date to make the operation as simple as possible, but the trans-rectal access route is extremely rarely reported and not well described. Here, we present a case that demonstrates the trans-rectal approach to a retro-rectal tumor is a feasible option in terms of surgical radicality, minimal invasiveness and safety for carefully selected patients with this rare type of retro-rectal cystic lesion.
Case presentation:
A 29-year-old Caucasian woman was referred to our institution due to perineal pain extending to the right inguinal region. Her symptoms had been present for the last two months. She was first examined at her regional hospital for a suspected ruptured ovarian cyst; however, after consultation with a gynecologist and a computed tomography scan of her pelvis, a tumor in the retro-rectal space was discovered. Our patient was admitted to our hospital and when a pelvic magnetic resonance imaging study confirmed the diagnosis of the retro-rectal cystic formation, a complete extirpation of retro-rectal tumor fixed to the coccyx using trans-rectal approach was performed. The final pathological diagnosis was retro-rectal cystic hamartoma (tailgut cyst) with no evidence of malignancy. Her post-operative course was uneventful, and at four months after surgery our patient is symptom free with no evidence of recurrent or residual disease.
Conclusions:
Trans-rectal excision is feasible in terms of surgical radicality and is a simple to perform, minimally invasive and safe option, providing complete recovery for carefully selected patients with retro-rectal cystic hamartoma treated operatively.
Myopericarditis After BNT162b2 mRNA Vaccination With Incidental Intramyocardial Bridging
Authors: Mohamed Elghazal, Inas M Alhudiri, Mohamed Said, Eiman Elhouderi, Adam Elzagheid
Journal: Cureus (2023)
Keywords: bnt162b2, bnt162b2 mrna vaccine, coronavirus disease 2019, covid-19, covid-19 vaccine, intramyocardial bridging, mrna vaccination, myocarditis, pericarditis, pfizer-biontech
MeSH terms: Case Reports

Myocarditis and pericarditis are inflammatory conditions affecting the myocardium and pericardium, respectively. They are caused by infectious and non-infectious conditions, including autoimmune disorders, drugs, and toxins. Vaccine-induced myocarditis has been reported with viral vaccines, including influenza and smallpox. The BNT162b2 mRNA vaccine (Pfizer-BioNTech) has shown ‎great efficacy against symptomatic, severe coronavirus disease 2019 (COVID-19), hospital admissions, and ‎deaths.‎ The US FDA issued an emergency use authorization for the Pfizer-BioNTech COVID-19 mRNA vaccine for the prevention of COVID-19 in individuals ≥ five years. However, concerns were raised after reports of new cases of myocarditis following mRNA COVID-19 vaccines, especially among adolescents and young adults. Most cases developed symptoms after receiving the second dose. Here, we present a case of a previously healthy 34-year-old male who developed sudden and severe chest pain a week after the second dose of the Pfizer-BioNTech COVID-19 mRNA vaccine. Cardiac catheterization showed no angiographically obstructive coronary artery disease but it revealed intramyocardial bridging. This case report demonstrates that the mRNA COVID-19 vaccine can be associated with acute myopericarditis and the clinical presentation can mimic acute coronary syndrome. Despite that, acute myopericarditis associated with the mRNA COVID-19 vaccine is usually mild and can be managed conservatively. Incidental findings such as intramyocardial bridging should not exclude the diagnosis of myocarditis and should be carefully evaluated. COVID-19 infection has high mortality and morbidity even in young individuals, and all different COVID-19 vaccines were found effective in the prevention of severe COVID-19 infection and in decreasing COVID-19 mortality.
Coronary-subclavian steal syndrome: percutaneous approach
Authors: Carina Machado, Luís Raposo, Sílvio Leal, Pedro Araújo Gonçalves, Henrique Mesquita Gabriel, Rui Campante Teles, Manuel Sousa Almeida, Miguel Mendes
Journal: Case Rep Cardiol (2013)

Coronary subclavian steal syndrome is a rare ischemic cause in patients after myocardial revascularization surgery. Subclavian artery stenosis or compression proximal to the internal mammary artery graft is the underlying cause. The authors present a clinical case of a patient with previous history of non-ST elevation myocardial infarction, triple coronary bypass, and effort angina since the surgery, with a positive ischemic test. Coronary angiography revealed a significant stenosis of the left subclavian artery, proximal to the internal mammary graft.
Postmortem Findings in Patient with Guillain-Barré Syndrome and Zika Virus Infection
Authors: Emilio Dirlikov, José V Torres, Roosecelis Brasil Martines, Sarah Reagan-Steiner, George Venero Pérez, Aidsa Rivera, Chelsea Major, Desiree Matos, Jorge Muñoz-Jordan, Wun-Ju Shieh, Sherif R Zaki, Tyler M Sharp
Journal: Emerg Infect Dis (2018)
Keywords: guillain-barré syndrome, puerto rico, zika virus, infectious disease pathophysiology, postmortem investigation, vector-borne infections, viruses
MeSH terms: Autopsy, Coinfection / virology, Guillain-Barre Syndrome / complications, Zika Virus Infection / complications, Case Reports, Aged, Coinfection / pathology, Guillain-Barre Syndrome / pathology, Guillain-Barre Syndrome / virology, Humans, Male, Puerto Rico, Zika Virus Infection / pathology, Zika Virus Infection / virology

Postmortem examination results of a patient with Guillain-Barré syndrome and confirmed Zika virus infection revealed demyelination of the sciatic and cranial IV nerves, providing evidence of the acute demyelinating inflammatory polyneuropathy Guillain-Barré syndrome variant. Lack of evidence of Zika virus in nervous tissue suggests that pathophysiology was antibody mediated without neurotropism.
Brachial plexus paralysis after thoracoscopic esophagectomy for esophageal cancer in the prone position: A thought-provoking case report of an unexpected complication
Authors: Yuki Aisu, Tomohide Hori, Shigeru Kato, Yasuhisa Ando, Daiki Yasukawa, Yusuke Kimura, Yuichi Takamatsu, Taku Kitano, Yoshio Kadokawa
Journal: Int J Surg Case Rep (2019)
Keywords: brachial plexus, complication, esophageal cancer, esophagectomy, prone position, thoracoscopic surgery

Introduction:
During prone esophagectomy, placement of a port in the third intercostal space for upper mediastinal dissection requires adequate axillary expansion. To facilitate this, the right arm is elevated cranially and simultaneously turned outward. Brachial plexus paralysis associated with esophagectomy in the prone position has not been documented.
Presentation of case:
A 58-year-old man diagnosed with middle intrathoracic esophageal cancer was referred to our department. Thoracoscopic esophagectomy in the prone position was performed following neoadjuvant chemotherapy. After surgery, he complained of difficulty moving his right arm. Physical examination revealed perceptual dysfunction and movement disorder in the territory of cervical spinal nerve 6. Magnetic resonance imaging indicated the injury in the right posterior cord of the brachial plexus at the costoclavicular space. Therefore, we diagnosed the patient with right brachial plexus injury caused by the intraoperative position. The postoperative course was uneventful other than the brachial plexus paralysis, and he was discharged on postoperative day 23. He underwent continuous rehabilitation as an outpatient, and the right brachial plexus paralysis had completely disappeared by 2 months after surgery.
Discussion:
This is the first case of brachial plexus injury during thoracoscopic esophagectomy in the prone position. In prone esophagectomy, managing the patient's position, especially the head and arm positions, is so important to avoid brachial plexus injury due to intraoperative positioning.
Conclusion:
The clinicians should consider managing the patient's position with anatomical familiarity to avoid brachial plexus injury due to intraoperative positioning.
Two cases of small cell carcinoma of the gallbladder
Authors: Peter Nau, James Liu, Mary Dillhoff, Meghan Forster, Jeffrey Hazey, Scott Melvin
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Small cell carcinoma of the gallbladder is a rare disease process with approximately 40 cases reported in the literature. It is most often found in elderly female population and is associated with cholelithiasis and cigarette smoking. A multidisciplinary approach to treatment with wide surgical resection and adjuvant chemotherapy is the current standard of care. Notwithstanding prompt medical intervention, it is a disease with a poor prognosis. The pathology is characterized by early metastases and extensive local invasion. Herein, we report two cases of small cell carcinoma addressed at our institution. In both cases, a radical resection was performed with subsequent referral to oncology for additional therapy.
Miniature Pulpotomy of Symptomatic Mature Permanent Teeth: A Report of Two Cases
Authors: Saeed Asgary, Mahdieh Nourzadeh, Mohammad Jafar Eghbal
Journal: Iran Endod J (2016)
Keywords: cem cement, calcium-enriched mixture, endodontic, irreversible pulpitis, miniature pulpotomy
MeSH terms: Case Reports

Human dental pulp inflammation can progress to periapical lesion formation and conventional root canal treatment (RCT) has been the traditional method for disease management. This observational study presents two cases of vital pulp therapy in mature molars diagnosed with irreversible pulpitis and associated with apical periodontitis. In these two clinical cases, the involved teeth had deep carious lesions with a history of spontaneous/lingering pain and radiographic examinations revealed the presence of apical radiolucencies. A conservative miniature pulpotomy (MP) using calcium-enriched mixture (CEM) was performed and the teeth were permanently restored with amalgam. Clinical evaluations indicated resolution of pain 24 hours after treatment; the teeth showed normal vitality, remained asymptomatic and maintained normal function after recall examinations. Furthermore, the 18-month radiographic evaluation showed healing of the apical lesions. Vital pulp therapy using the MP technique with CEM appeared successful in avoiding RCT intervention. These two reports of case outcome suggest that simple MP using a CEM bioregenerative technique may provide a favorable outcome for permanent teeth diagnosed with irreversible pulpitis and associated with apical periodontitis.
Co-occurrence of bilateral nodular anterior scleritis and large-vessel arteritis in a patient with TINU syndrome
Authors: Kirsten Zonnevylle, Pieter-Paul Schauwvlieghe, Joachim Van Calster, Jan Lenaerts, Domien Peeters
Journal: GMS Ophthalmol Cases (2019)
Keywords: arteritis, interstitial nephritis, scleritis, tubulointerstitial nephritis and uveitis syndrome, uveitis
MeSH terms: Case Reports

We present a case of tubulointerstitial nephritis and uveitis (TINU) with nodular anterior scleritis and large-vessel arteritis. A 67-year-old patient was admitted to the hospital with high fever, thoracic pain, and weakness. Bilateral anterior uveitis was seen at that time. Laboratory examination showed acute renal failure. A renal biopsy was performed and showed pathognomonic signs of tubulointerstitial nephritis (TIN). Six months later, she developed ocular inflammation suggestive of nodular scleritis. One year after hospital admission, she presented with large-vessel arteritis. We describe a case of TINU with co-occurrence of scleritis and large-vessel arteritis.
Case Report: Dacomitinib is effective in lung adenocarcinoma with rare EGFR mutation L747P and brain metastases
Authors: Yibin Li, Weixi Guo, Bin Jiang, Chengkun Han, Feng Ye, Jingxun Wu
Journal: Front Oncol (2022)
Keywords: dacomitinib (pubmed cid
MeSH terms: Case Reports

Due to the low incidence of rare EGFR mutation, its response to EGFR-TKI has not been fully investigated. L747P is a rare EGFR mutation in EGFR exon 19. Previous case reports showed that patients with EGFR L747P mutation responded to afatinib treatment. However, we encountered a patient with EGFR L747P who was resistant to afatinib but responded to dacomitinib. It is the first case report of the effective application of dacomitinib in a patient with L747P mutation and BMS, and the efficacy of BMS achieved PR.
Pancreatic Hydatid Cyst Causing Acute Pancreatitis: A Case Report and Literature Review
Authors: Bayan Alsaid, Maryam Alhimyar, Fadi Rayya
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Hydatidosis is a public health problem in endemic countries. Hydatid cysts are located usually in the liver and the lungs. Primary pancreatic hydatid cyst is in unusual location and rarely causes acute pancreatitis. In this paper, we report a case of a 34-year-old man who admitted with recurrent acute pancreatitis. Following the preoperation investigations, the primary impression was a pancreatic pseudocyst. During surgery, a primary hydatid cyst was detected in the pancreas measuring 35 × 20 × 15 cm. The treatment consisted of evacuation and external draining of the cyst. In addition, we summarized 14 cases of primary hydatid cyst of the pancreas associated with acute pancreatitis reported in the literature.
Lactobacillus acidophilus-Induced Endocarditis and Associated Splenic Abscess
Authors: Muhammet Ozer, Suleyman Yasin Goksu, Ali Shahverdiani, Muhammad Mustafa
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Lactobacillus acidophilus is a rod-shaped, Gram-positive bacterium generally found in the normal flora of the oropharynx, gastrointestinal, and genitourinary tracts. It is commonly known as nonpathogen in the human body. Endocarditis due to Lactobacillus is rarely encountered and associated with impaired immunity. Splenic abscess is also an uncommon infection that classically results from endocarditis or another source of hematogenous seeding. Here, we present the case of bioprosthetic aortic valve endocarditis and associated splenic abscess caused by Lactobacillus acidophilus. The source of the Lactobacillus bacteremia should be investigated because of the risk of life-threatening conditions. Most of the time, identifying Lactobacillus species is challenging and can cause a delay in diagnosis and timely treatment. Especially in patients who have significant underlying clinical conditions, physicians should consider Lactobacillus species as a causative microorganism.
Traumatic endophthalmitis following a crane pecking injury - An unusual mode
Authors: Prabu Baskaran, Seema Ramakrishnan, Pankaja Dhoble, Joseph Gubert
Journal: GMS Ophthalmol Cases (2016)
Keywords: beta-hemolytic streptococci, crane pecking injury, traumatic endophthalmitis
MeSH terms: Case Reports

Purpose:
To report a case of beta-hemolytic streptococcal endophthalmitis following crane-pecking injury.
Case report:
A twelve-year-old boy was brought to us by his father with history of crane beak injury in his right eye. On examination, his vision was 6/24 Snellen's acuity. Anterior segment examination showed a full thickness two mm corneo-limbal tear at 1 o'clock with iris prolapse. Pupil showed peaking through the wound with a clear crystalline lens. There was no evidence of hypopyon in the anterior chamber and B-scan ultrasonography showed acoustically clear vitreous with an attached retina. Left eye was within normal limits. Primary corneo-limbal tear repair was performed within 24 hours from the time of presentation. Intra-operatively, the corneal surgeon noted turbid aqueous with minimal hypopyon. In view of clinical suspicion of infection, an intravitreal tap for culture was taken during the primary repair, and prophylactic intravitreal antibiotics were given. The culture report showed beta-hemolytic streptococci. Pars plana vitrectomy with intravitreal antibiotics was performed after 2 days as serial ultrasound scans showed appearance and worsening of endophthalmitis. A month after the surgery, his best corrected visual acuity improved to 6/12.
Conclusion:
Ocular injuries resulting from bird pecking are very rare. We treated a case of full thickness corneo-limbal tear with endophthalmitis caused by beta-hemolytic streptococci following a crane-pecking injury. We recommend that injecting intravitreal antibiotics along with primary globe repair in case of severe/contaminated injuries and early pars plana core-vitrectomy would result in better outcome like in our case.
Surgical Treatment of a Medial Clavicle Fracture Nonunion with Medial Clavicle Resection and Stabilization to the Sternum with Palmaris Longus Graft
Authors: M O Dion, S Martel, S Pelet
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Medial end clavicular fractures are a rare occurrence. While most of these fractures can be appropriately managed with a nonoperative treatment, some cases of symptomatic nonunion might be surgically addressed to preserve sternoclavicular joint stability and ensure favorable outcomes. The open reduction and osteosynthesis procedure is a commonly performed procedure to treat clavicular fracture nonunion. However, few revision procedures have been described to address the occasional cases of hardware failure or recurrent nonunion of the medial end. In this report, the authors present a case of symptomatic nonunion of the medial clavicle initially treated with osteosynthesis. Implant failure with hardware migration was then treated by medial clavicle resection and stabilization to the sternum using a palmaris longus autograft and the figure-of-eight lacing technique. Excellent functional outcomes at three years of follow-up were obtained. To the authors' knowledge, this is the first case reporting on a sternoclavicular stabilization with a tendon autograft for such an important bone deficit.
Persistent Oxygen Requirement beyond Prematurity: A Case of Acquired Pulmonary Vein Stenosis
Authors: Tyler A Fick, Bernadette Richards, Carl H Backes, Molly K Ball
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Acquired pulmonary vein stenosis is a rare cardiac defect and diagnosis can often be challenging, as many cases present with refractory or prolonged oxygen requirement over the expected course. Comorbid conditions can cloud this diagnosis further. Prognosis is poor for most patients. We present a case of idiopathic acquired pulmonary vein stenosis and discuss diagnostics, treatment options, and the need for further collaborative studies.
A methodological approach to the study of archaeological cereal meals: a case study at Çatalhöyük East (Turkey)
Authors: Lara González Carretero, Michèle Wollstonecroft, Dorian Q Fuller
Journal: Veg Hist Archaeobot (2017)
Keywords: food remains, near east, neolithic, palaeoethnobotany, parenchyma

This paper presents an integrated methodology for the analysis of archaeological remains of cereal meals, based on scanning electronic microscopic analyses of microstructures of charred food fragments from Neolithic Çatalhöyük (Turkey). The remains of cereal foods as 'bread-like' or 'porridge-like' small charred lumps of various amalgamated plant materials are frequently recovered from Neolithic and later archaeological sites in southwest Asia and Europe. Cereal food remains have recently attracted interest because the identification of their plant contents, the forms of food that they represent and the methods used in their creation can provide unique information about ancient culinary traditions and routine food processing, preparation and cooking techniques. Here, we focus on three methodological aspects: (1) the analysis of their composition; (2) the analysis of their microstructure to determine preparation and cooking processes; (3) the comparison with experimental reference materials. Preliminary results are presented on the botanical composition and cooking processes represented by the charred cereal preparations found at Neolithic Çatalhöyük (Turkey), for example cereals processed into bread, dough and/or porridge.
Survival after Pneumocystis jirovecii pneumonia requiring ventilation: A case report
Authors: Gladness Nethathe, Nirav Patel
Journal: South Afr J HIV Med (2016)
MeSH terms: Case Reports

Pneumocystis pneumonia (PCP) in patients with the human immunodeficiency virus (HIV) is associated with a high mortality rate, which increases substantially with the need for mechanical ventilation. Local experience of patients with PCP admitted to the intensive care unit has revealed mortality rates close to 100%. We present a case of a 39-year-old HIV-infected man diagnosed with PCP who was successfully weaned from mechanical ventilation after presenting with respiratory distress and severe hypoxaemia. A short review of the literature will also be presented.
A case of twin reversed arterial perfusion (TRAP) sequence managed conservatively
Authors: Enesia Mudenha Ziki, Zvavahera Mike Chirenje, Mugove Gerald Madziyire
Journal: Pan Afr Med J (2019)
Keywords: trap, doppler, pump twin
MeSH terms: Conservative Treatment / methods, Fetofetal Transfusion / therapy, Pregnancy Outcome, Case Reports, Adult, Female, Humans, Pregnancy, Pregnancy Trimester, Second, Pregnancy, Twin, Prenatal Diagnosis / methods

The TRAP sequence, also known as acardiac twinning is a rare complication that is unique to monochorioinic multiple pregnancies affecting 1% of monochorioinic pregnancies and about 1 in 35000 of all pregnancies. In TRAP, blood flows from the umbilical artery of the pump twin to the umbilical artery of the perfused twin through artery to artery (AA) anastomosis. The perfused twin has poor development of the upper extremities and the normal or pump twin is at risk of a poor perinatal outcome. This is a report of a patient with TRAP sequence diagnosed in the second trimester who was managed conservatively and had a good outcome for the normal twin.