OpenMed/multicare-articles huggingface dataset:
Extensive self-harm scarring: successful treatment with simultaneous use of a single layer skin substitute and split-thickness skin graft
Authors: Jodi Todd, Sara Ud-Din, Ardeshir Bayat
Journal: Eplasty (2012)

Objective:
Deliberate self-harm resulting in extensive skin scarring is a difficult clinical problem and is commonly associated with physical and sexual abuse or a known history of mental illness. Immediate hospital attendance often addresses the acute wound and current psychological state of patients; however, ongoing regret of these resulting scars present a problem to the patient and clinician. Deliberate self-harm to the skin leaves permanent and socially unacceptable scars in anatomically conspicuous areas and recognizable to others. Therefore, the aim was to offer a treatment to change these scars to that of an unknown entity.
Methods:
Six patients with extensive linear scars covering most of the forearm received surgical reconstruction. Patients were female aged between 18 and 47 years. Each patient had a history of psychosocial problems, and each had undergone psychiatric treatment. After an in-depth consultation and a further clinical psychological assessment, each individual was deemed suitable for reconstructive surgery. Scars were excised from the forearm en block, removing the majority of the affected area. Simultaneous use of a single layer skin substitute was used, covered by an autologous split-thickness skin graft. Negative pressure wound therapy was then applied immediately for 2 weeks after surgery.
Results:
The original scars were successfully converted to a socially and cosmetically acceptable appearance. Postoperative infection due to negative pressure wound therapy failure in one patient was the only complication reported.
Conclusions:
This case series highlights the utility of an innovative treatment for patients with DSH scarring resulting in aesthetic, psychological, and functional benefits.
Continuous high-dose infusion of doripenem in a pneumonia patient infected by carbapenem-resistant Pseudomonas aeruginosa: a case report
Authors: Kazutaka Oda, Hidenobu Kamohara, Tomomi Katanoda, Yumi Hashiguchi, Koji Iwamura, Kisato Nosaka, Hirofumi Jono, Hideyuki Saito
Journal: J Pharm Health Care Sci (2019)
Keywords: acute kidney injury, continuous infusion, continuous renal replacement therapy, doripenem, high-dose, therapeutic drug monitoring
MeSH terms: Case Reports

Background:
Despite the high mortality of patients with sepsis and carbapenem-resistant bacteria infection, appropriate antimicrobial therapies are yet to be established. Here, we have reported the case of a patient with pneumonia that subsequently developed by carbapenem-resistant Pseudomonas aeruginosa infection and was treated with a continuous high-dose infusion of doripenem.
Case presentation:
We started a continuous intravenous infusion of doripenem 3 g/day although the 59-year-old woman (body weight, 45 kg) had developed septic acute kidney injury, followed by continuous renal replacement therapy (the effluent flow rate was 650 mL/h). The minimum inhibitory concentration (MIC) of doripenem was 8 mg/L. The concentration of unbound doripenem in the serum was measured by using high-performance liquid chromatography. Twenty hours after the initial dose, the patient's serum level of doripenem was 47.8 μg/mL; the level decreased to 33.6 μg/mL at 111 h after initial dosing. The unbound doripenem concentration in the serum was maintained four times above the MIC throughout the treatment. After the completion of 11 days of dosing, the patient was discharged from the intensive care unit. During the treatment period, the MIC remained at 8 mg/L.
Conclusions:
A continuous high-dose infusion of doripenem is a potentially efficient strategy for the treatment of antimicrobial-resistant bacteria. Moreover, therapeutic drug monitoring may be useful for patients displaying variable pharmacokinetics, because the MIC is generally high in resistant bacteria.
Reduction of Posttraumatic Stress Disorder (PTSD) Symptoms in PTSD and Major Depressive Disorder Comorbidity After Acute Hypoglycemia-A Case Report
Authors: Tomasz Pawlowski, Jacek Daroszewski, Agnieszka Czerwinska, Joanna Rymaszewska
Journal: Front Psychiatry (2019)
Keywords: acute hypoglycemia, insulin tolerance test, major depressive disorder, posttraumatic stress disorder, psychoneuroendocrinology
MeSH terms: Case Reports

Background: Approximately half of all patients with posttraumatic stress disorder (PTSD) also suffer from major depressive disorder (MDD). This co-occurrence might lead to an impairment of cognitive functions, worse response to antidepressant medications, and an increased risk of suicide in comparison to patients with PTSD alone. Prognosis for people with PTSD and MDD co-occurrence is poorer than for either one alone; therefore, researchers look for novel, effective treatments. Case Presentation: A patient with MDD with the co-occurrence of PTSD was admitted to the Department of Endocrinology with suspicion of adrenal insufficiency. In order to assess the adrenocorticotropin/cortisol axis, a standard insulin tolerance test was performed. After inducing a hypoglycemic episode with intravenous short-acting insulin, PTSD symptoms were reduced. To the best of our knowledge, this is the first report on the reduction of PTSD symptoms after performing an insulin tolerance test. Conclusion: Reduction of PTSD symptoms in PTSD and MDD comorbidity has been noticed after a hypoglycemic episode. This demonstrates the mutual dependencies between the endocrine and nervous systems, covered extensively by psychoneuroendocrinology.
Extramedullary myeloma in an HIV-seropositive subject. Literature review and report of an unusual case
Authors: Liviu Feller, Jason White, Neil H Wood, Michael Bouckaert, Johan Lemmer, Erich J Raubenheimer
Journal: Head Face Med (2009)
MeSH terms: Facial Neoplasms / complications, HIV Seropositivity / complications, Multiple Myeloma / complications, Case Reports, Review, Facial Neoplasms / diagnosis, Female, Humans, Middle Aged, Multiple Myeloma / diagnosis

Myeloma is characterized by monoclonal bone marrow plasmacytosis, the presence of M-protein in serum and/or in urine and osteolytic bone lesions. HIV-seropositive subjects with myeloma are younger at the time of diagnosis of the tumour and usually the myeloma has a more aggressive clinical course than it does in HIV-seronegative subjects. A case of an HIV-seropositive woman in whom myeloma was diagnosed following progressive swelling of the face, is reported. In addition to bone marrow plasmacytosis and the presence of M-protein in the serum, the patient had an extramedullary lesion affecting the oral cavity, maxilla, parotid gland and paranasal sinuses, and extending intracranially and intraorbitally.
Traumatic transnasal penetrating injury with cerebral spinal fluid leak
Authors: Tan Sui Teng, Noor Liza Ishak, Sethu Thakachy Subha, Saraiza Abu Bakar
Journal: EXCLI J (2019)
Keywords: csf leak, pencil, penetrating trauma, skull base fracture
MeSH terms: Case Reports

CSF leak in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture. We report a 5-year-old boy presented with epistaxis and impacted pencil into the left nostril. The child was hemodynamically stable without any neurological deficit. Intraoperatively, there was a nasal septal defect posteriorly with anterior skull base fracture associated with CSF leak. The pencil was removed from the left nostril and the CSF leak was repaired using harvested abdominal fat under the same setting. Computed Tomography (CT) of the brain showed right cribriform plate fracture with small pneumocranium. Postoperatively, a prophylactic antibiotic was given for seven days and he was discharged well. Subsequent clinic visits up to one-year postoperative period showed no recurrence of the CSF leak. History taking, physical examination and CT imaging give valuable diagnostic values in managing the penetrating skull base injury. Early intervention for removal of the foreign body and repair of the CSF leak is advocated to prevent catastrophic complication.
En-bloc Auriculectomy for Removal of a Large Pinna-Based Ear Mass in a Horse
Authors: Auri M Silverstone, Dane M Tatarniuk, Elyse Durket, Alex M Gillen
Journal: Front Vet Sci (2020)
Keywords: aural neoplasia, auriculectomy, ear, ear amputation, equine, horse, pinna
MeSH terms: Case Reports

A 15-year-old Pony of America (POA) gelding presented for evaluation of a large mass present on the right external pinna. Based on gross appearance, the right ear mass was suspected to be neoplastic. The most likely differential diagnosis was that of a fibroblastic sarcoid. Complete auriculectomy via use of a constricting latex-tourniquet performed under multimodal analgesia was proposed as an option to achieve complete resolution of mass growth and improve patient comfort. Benefits of latex tourniquet constriction included immediate lack of bleeding associated with amputation, gradual ischemic necrosis and sloughing of tissue distant to the site of constriction, and cost-effective application. The external pinna sloughed 3 weeks following application of the constricting latex tourniquet. Complete healing was achieved within 3 months from the time of tourniquet application. The middle ear canal sealed closed as a result of auriculectomy, with no observed long-term discomfort or morbidity aside from reduction in hearing. This is the first report of total external ear amputation in the horse. Complete auriculectomy via use of a constricting latex tourniquet is a feasible method for en-bloc removal of large, complicated ear masses.
A Report of Four Cases of Blackwater Fever after Quinine Treatment at Zinder National Hospital, Niger Republic
Authors: Doutchi Mahamadou, Diongolé M Hassane, Moussa Tondi Maiga Zeinabou, Iliassou Aboubacar, Ali Osseini, Adamou Harissou, Garba Abdoul-Aziz, Alkassoum Ibrahim, Ibrahim Maman Laminou, Adéhossi Eric
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Background:
Blackwater fever (BWF) is a rare but serious complication of malaria that is a consequence of antimalarial treatment. Its prevalence seems to have increased. Its diagnosis is based on clinical symptoms and urine color. We report on 4 BWF cases admitted to the infectious diseases department of Zinder National Hospital.
Results:
Four patients were hospitalized in September 2017 for a hepatorenal syndrome of jaundice, port wine-colored urine, renal failure, and hepatic cytolysis following antimalarial treatment with quinine salts. Quinine treatment was stopped and treatment was continued with injectable artemether. Three patients underwent extra-renal purification. Their evolution was favorable. One patient died less than 24 hours after admission.
Conclusion:
A rare and severe complication, blackwater fever must be considered for patients under antimalarial treatment who present with jaundice, abdominal pain, and acute renal insufficiency with port wine-colored urine. Rapid diagnosis and management in an intensive care unit are crucial for improving the prognosis.
Common Options and Overlooked Alternative for Drainage of Inaccessible Presacral Abscess: A Case Report
Authors: Evelina Kodzis, Donatas Jocius, Ona Lapteva, Rugilė Kručaitė
Journal: Acta Med Litu (2021)
Keywords: case report, presacral abscess, pyogenic spondylodiscitis, transosseus drainage, transsacral approach
MeSH terms: Case Reports

Purpose:
To demonstrate options and alternative for drainage of inaccessible presacral abscess by the example of a rare clinical case of pyogenic spondylodiscitis, transsacraly drained under a combination of two interventional techniques - CT-guided bone biopsy and abscess drainage.
Materials and methods:
A 55-year-old patient with history of recurrent paravertebral abscesses previously treated with antibiotic therapy was referred to our institution experiencing lower back pain and weakness in both lower extremities. Computed tomography revealed pyogenic spondylodiscitis along with left facet joint destruction and presacral abscess located in ventral sacral surface. Due to inaccessible abscess location, it was decided to perform CT-guided percutaneous transsacral abscess drainage. An 8G bone marrow biopsy needle was used to penetrate the sacrum and create a path for drainage catheter placement. Using the Seldinger technique 8 Fr drainage catheter was inserted into abscess cavity.
Results:
Neither early nor late procedure-related complications occurred. Sixteen days after drainage procedure, the catheter was withdrawn as patient's condition improved and the outflow of pus had reduced considerably.
Conclusions:
Despite being rarely used, CT fluoroscopy-guided transsacral drainage approach is considered to be minimally invasive and in some cases the only viable option for drainage of pyogenic spondilodiscitis of the lumbosacral junction.
A Rare Case of Vasculitis Patched Necrosis of Cecum due to Behçet's Disease
Authors: Ehsan Shahverdi, Mehdi Morshedi, Faraneh Oraei-Abbasian, Maryam Allahverdi Khani, Roya Khodayarnejad
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Isolated cecal necrosis is a rare form of acute ischemic colitis and a rare cause of surgical abdomen. Behçet's disease is a multisystemic autoimmune condition which can induce vasculitis. This can result in cecal necrosis while disease involves colon vessels. We describe a patient with complicated Behçet's disease and ischemic colitis admitted to our hospital. Patient was a 62-year-old female with more accompanying diseases. Histopathologic findings confirmed the diagnosis of ischemic colitis and regarding patient's vision problem and skin lesions, rheumatologic tests were performed which were positive for HLAB5 and HLAB51 suggestive of Behçet's disease; the patient was improved with surgery. Abdominal pain can indicate a disease with vascular involvement like Behçet's disease, especially in the presence of other clinical findings suggestive of the disease including blurred vision and skin lesions. An abdominal computerized tomography (CT) scan is very diagnostic in the same patients.
Tuberculoma of spine mimicking intramedullary tumour: A case report
Authors: Karya Triko Biakto, Jainal Arifin, Gerald Wonggokusuma, Carlo Micelli
Journal: Int J Surg Case Rep (2020)
Keywords: case report, mimicking, spinal cord tumour, tuberculoma
MeSH terms: Case Reports

Introduction:
Spinal intramedullary tuberculoma (IMTB) is a rare disease that accounts for 1 to 2/100,000 patients with tuberculosis [1]. This case demonstrated that this patient had atypical presentations compared to common tuberculosis considering that IMTB cases are really rare.
Case presentation:
A 19-year-old male presenting with back pain and weakness of both lower limbs, which started in the left lower limb and subsequently involved the right lower limb for three months. He had sensory impairment below T6 and hypoesthesia. He complained of urine hesitancy and a feeling of incomplete voiding of urine. He was on anti-tubercular treatment (ATT) for last two months. MRI exhibited hypointense portion on T1-weighted images. T2-weighted image also showed hypointensity at T6, which suggested for intramedullary mass. Excisional biopsy was suggestive for tuberculoma.
Discussion:
In TB-endemic country like in Indonesia, tuberculoma should be considered as a differential diagnosis for intramedullary SOL irrespective of age or presence of extra-cranial focus of TB. MRI is the optimal tool for evaluating and diagnosing IMTB at an early stage and useful in follow-up. However, IMTB imaging characteristics may vary with immune response of individual or the stage of the tuberculoma formation [3]. The aim of early surgery is to decompress the spinal cord and achieve improvement in neurological function.
Conclusion:
This case was reported to emphasize that early surgical decompression is required as a delay might cause damage to the spinal cord. This case also provides some evidences based data, thus contributing to the future research studies and clinical practice.
Case study: Treating infraspinatus and supraspinatus trigger points and supraspinatus tendinopathy utilizing piezoelectric shockwave
Authors: Heather Owen
Journal: Front Vet Sci (2022)
Keywords: infraspinatus, musculoskeletal ultrasound, myofascial trigger points, piezoelectric shockwave, supraspinatus
MeSH terms: Case Reports

Two individual case studies demonstrate piezoelectric shockwave treatment for the resolution of a supraspinatus tendinopathy and supraspinatus and infraspinatus myofascial trigger points (MTPs) via musculoskeletal ultrasound. This is the first documentation of improvement of both tendon and muscle fiber patterns in canine patients treated with piezoelectric shockwave. These cases validate the use of piezoelectric shockwave during the rehabilitation of common canine shoulder injuries.
Oncocytic Variant of Medullary Thyroid Carcinoma - A Case Report
Authors: Srilatha Parampalli Srinivas, Jayitri Das, Vidya Monappa
Journal: Iran J Pathol (2019)
Keywords: fine-needle aspiration, medullary thyroid carcinoma, thyroid neoplasm
MeSH terms: Case Reports

Medullary thyroid carcinoma (MTC) is a rare tumor arising from parafollicular C-cells. The oncocytic variant of MTC is an extremely rare diagnosis, with less than 20 cases reported. Here we present the case of a 36-year-old male patient with complaints of neck swelling and dysphagia. On fine needle aspiration cytology (FNAC), a Hürthle cell neoplasm was suggested. Finally with histopathology and immunohistochemistry (IHC), a diagnosis of MTC oncocytic variant was established. This tumor can be easily misdiagnosed for any thyroid Hürthle cell lesions. An accurate diagnosis is important because MTC has different treatment protocols, and its oncocytic variant is expected to be associated with poorer patient survival. Thus, the oncocytic variant of MTC is a difficult diagnosis on FNAC. Histopathology and rel- evant IHC markers are necessary for a correct diagnosis.
Fingolimod-associated macular edema controlled with nepafenac non-steroidal anti-inflammatory opthalmologic applications
Authors: Rachel Husmann, John B Davies, Malik Ghannam, Brent Berry, Praful Kelkar
Journal: Clin Mol Allergy (2020)
Keywords: fingolimod, macular edema, multiple sclerosis, nonsteroidal anti-inflammatory eye drops, retina
MeSH terms: Case Reports

Background:
Fingolimod, an immunomodulatory agent, is used for the treatment of relapsing-remitting multiple sclerosis (RRMS). Fingolimod-associated macular edema (FAME) is a known complication with an incidence of 0.4%. The current recommendation for treatment of FAME is cessation of fingolimod. There are few case reports with management of FAME with steroid eye drops.
Case presentation:
A 38-year-old Caucasian female patient with history of relapsing-remitting multiple sclerosis (RRMS) and treated with fingolimod developed Fingolimod-associated macular edema (FAME). Nevertheless, FAME was successfully treated with nonsteroidal anti-inflammatory eye drops without discontinuation of fingolimod.
Conclusion:
FAME may be managed with non-steroidal eye drops without discontinuation of fingolimod in appropriate patient monitored with close follow up.
Long-Term Survival in Locally Advanced KRAS Wild-Type Pancreatic Adenocarcinoma
Authors: Marion Alhenc-Gelas, Romain Cohen, Pascale Cervera, Jean-Christophe Vaillant, Thierry André
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Pancreatic adenocarcinoma remains a cancer associated with a poor prognosis. For locally advanced pancreatic cancer (LAPC), median overall survival is approximately 16 months. Here we report the case of a 52-year-old LAPC patient treated with chemotherapy followed by chemoradiotherapy that was associated with a 14-year complete remission. A peritoneal relapse was then observed and chemotherapy was undergone until the patient died of infectious complications, 17 years after his diagnosis. The tumor was found KRAS, TP53, BRCA1, and BRCA2 wild-type. This KRAS wild-type LAPC-long survivor case report emphasizes the need to develop molecular approaches to predict LAPC patients' prognosis.
Case Report: A Novel Heterozygous Mutation of CD2AP in a Chinese Family With Proteinuria Leads to Focal Segmental Glomerulosclerosis
Authors: Yu-Xing Liu, Ai-Qian Zhang, Fang-Mei Luo, Yue Sheng, Chen-Yu Wang, Yi Dong, Liangliang Fan, Lv Liu
Journal: Front Pediatr (2021)
Keywords: cd2ap, fsgs, heterozygote, mutation, whole-exome sequencing
MeSH terms: Case Reports

Idiopathic focal segmental glomerulosclerosis (FSGS) is a relatively frequent kidney disorder that manifest clinically as proteinuria and progressive loss of renal function. Genetic factors play a dominant role in the occurrence of FSGS. CD2-associated protein (CD2AP) is an adapter molecule and is essential for the slit-diaphragm assembly and function. Mutations in the CD2AP gene can contribute to FSGS development. Here, we describe a Chinese family of four generations with unexplained proteinuria. The proband, a 12-year-old boy, was diagnosed as FSGS. Whole-exome sequencing (WES) revealed an unknown frameshift insertion mutation (p.K579Efs*7) of CD2AP gene that leads to a truncation of CD2AP protein. Bioinformatics strategies predicted that the novel mutation was pathogenic. The mutation was absent in either healthy family members or our 200 healthy controls. In summary, we used WES to explore the genetic lesion of FSGS patients and identified a novel mutation in CD2AP gene. This work broadens the mutation spectrum of CD2AP gene and provides data for genetic counseling to additional FSGS patients.