OpenMed/multicare-articles huggingface dataset:
Traumatic brain injury and rTMS-ERPs: Case report and literature review
Authors: Yutong Fu, Chunyan Xu, Hong Fan, Xue Yang, Jibing Ou, Liqing Yao, Wenli Wang
Journal: Open Life Sci (2023)
Keywords: p300, amplitude, cognition, event-related potentials, latency, rehabilitation, transcranial magnetic stimulation
MeSH terms: Case Reports

Currently, there are no cases of targeted, individualized repeated transcranial magnetic stimulation (rTMS) treatment based on event-related potential (ERPs) results showing the activation of functional brain regions. The identification and treatment of mild cognitive impairment after traumatic brain injury are challenging. rTMS has shown unique advantages in previous studies, with positive effects on noninvasive modulation and neuroplasticity after brain injury. The selection of the rTMS parameters and targets remains controversial. ERPs indicate the cortical activity involved in cognitive processing in patients. Therefore, this study proposes that ERPs can be used as biomarkers of cognitive recovery. The results of this study will guide the development of rTMS protocols for patient treatment. To help clinicians better apply rTMS and ERPs in combination, we conducted a relevant literature review and discussion, detailing the therapeutic mechanisms of the combination of ERPs and rTMS. This will facilitate the precise assessment and personalized treatment of such patients, improve the abnormal processing patterns of patients, and promote their return to life and society.
Bilateral Total Hip Prosthesis in Coxarthritis of Inflammatory Origin: Technical Features and Intraoperative Complications Encountered in Five Cases
Authors: Samir Ben Salah, Ayman Ben Abdellah, Adnane Lachkar, Hicham Yacoubi, Najib Abdeljaouad
Journal: Cureus (2024)
Keywords: bilateral total hip prosthesis, coxarthritis, inflammatory origin, intraoperative complications, technical features
MeSH terms: Case Reports

Total hip arthroplasty remains the treatment of last resort in inflammatory coxarthritis, where joint destruction is bilateral as well as the treatment which must be bilateral. We present in this work the experience of our orthopaedic department with a series of five cases (10 hips) operated for total hip arthroplasty. the first particularity observed in this series is the abnormal bone fragility present in 55% of the cases. For this reason, we had two other intraoperative complications that are related to this bone fragility, during the preparation of the acetabulum, we had a destruction of the medial wall by the burr that went unnoticed intraoperatively and was discovered during the patient's recovery from acute ischemia secondary to the burr, which led to an extensive rupture of the common femoral vein and partial sectioning of the common femoral artery. We also had an exceptional incident in a case with two ankylosed hips; in fact, when the approach was performed, the sciatic nerve was found pressed against the posterior surface of the greater trochanter, which was unusual but was explained by the retraction of the structures of the gluteal region secondary to prolonged immobilization. Thus, there was one case of cement shock manifested by hypotension occurring immediately after cement placement. In front of this inflammatory disease and ankylosis terrain, the surgeon must always be prepared for any complication and must keep in mind that he is operating on a hip that is anatomically not normal due to ankylosis and retraction of the vascular, nerve, and muscle structures.
Case report: Miliary tuberculosis complicated by pediatric acute respiratory distress syndrome in a 12-year-old girl
Authors: Jiarui Zhu, Ning Chen, Yunxiao Shang, Yong Feng
Journal: Front Pediatr (2023)
Keywords: child, diagnosis, interferon-γ release assay, miliary tuberculosis, pediatric acute respiratory distress syndrome
MeSH terms: Case Reports

Acute respiratory distress syndrome (ARDS) is a rare complication of miliary tuberculosis, particularly in pediatric patients. Comorbidities and delayed diagnosis can worsen the prognosis of patients with miliary tuberculosis. A 12-year-old girl presented with fever for 20 days, and cough and tachypnea for 4 days. She was diagnosed with miliary tuberculosis complicated by pediatric ARDS. She had atypical clinical manifestations and imaging findings, a negative contact history, and negative results of a tuberculin skin test (TST) and T-SPOT.TB. Diagnostic bronchoscopy and bronchoalveolar lavage helped make the diagnosis of tuberculosis. Effective treatment was promptly initiated after confirmation of the diagnosis, and the patient's condition improved. This case illustrates that a negative contact history and laboratory results cannot rule out tuberculosis. False-negative TST and T-SPOT.TB results should be evaluated carefully. Bronchoscopy may be useful for identifying pathogens in patients with pneumonia of unknown etiology, and corticosteroids should be administered with caution.
Sclerosing Microcystic Adenocarcinoma of the Base of Tongue with Signet Ring-Like Cell Component: A Rare Case
Authors: Parisa Mokhles, Alireza Sadeghipour, Maryam Kadivar, Nasrin Shayanfar, Zahra Keshtpour Amlashi, Pegah Alizade Pahlavan, Ashkan Shafiei
Journal: Iran J Pathol (2024)
Keywords: adenocarcinoma, head and neck neoplasm, salivary gland
MeSH terms: Case Reports

Sclerosing microcystic adenocarcinoma (SMA) is an uncommon neoplasm of the oral cavity, with only 14 reported cases documented in the literature. We present a case of SMA in a 65-year-old woman with a history of high-grade lymphoma who developed clear cell changes in the deep muscular layer of the tongue. Currently, the diagnosis of SMA relies on careful morphological evaluation and the exclusion of other potential differential diagnoses.
Invasive Streptococcus pyogenes infection: a case report
Authors: Samia Bazhar, Yassine ElBenaissi, Elmostafa Benaissa, Yassine Ben Lahlou, Mariama Chadli
Journal: Access Microbiol (2024)
Keywords: streptococcus pyogenes, invasive infection, septic arthritis
MeSH terms: Case Reports

The Group A Streptococcus (GAS), also known as Streptococcus pyogenes (S. pyogenes), is a human pathogen causing various infections, ranging from mild, such as tonsillitis and impetigo, to severe and invasive conditions like septicemia and necrotizing fasciitis. Despite a decline in incidence and severity during the twentieth century due to antibiotics, there has been a reported increase in severe cases since the 1980s in industrialized countries. S. pyogenes is a human pathogen with a natural reservoir in the pharynx and skin, exhibits asymptomatic carriage in various body sites. It is responsible for a spectrum of clinical manifestations, from asymptomatic carriage to severe invasive infections. Transmission occurs through respiratory droplets or direct contact with skin lesions. Bacteriologically, S. pyogenes is a Gram-positive β-hemolytic streptococcus. This summary highlights a case of invasive Group A Streptococcus infection in a 28-year-old diagnosed at the microbiology laboratory of the Mohammed V Military Training Hospital in Rabat, Morocco. A 28-year-old patient, without any specific medical history, presented with acute febrile oligoarthritis. Following a recent flu-like syndrome and febrile tonsillitis, the patient experienced asymmetric inflammatory oligoarthralgia affecting the left knee, left ankle, and right shoulder, accompanied by functional impairment of the left lower limb. Upon admission, clinical examination revealed swelling, positive patellar tap, and sternal involvement. Laboratory and imaging findings indicated an abscessed collection in the left knee and anterior mediastinitis. Emergency aspirations revealed Group A Streptococcus, specifically Streptococcus pyogenes, leading to a diagnosis of septic arthritis. Dual antibiotic therapy and knee joint drainage resulted in symptom resolution after 45 days. The rise in severe Group A Streptococcus infection underscores the need for early detection and treatment. Widely sharing the French High Council for Public Health's antibiotic prophylaxis recommendations is crucial for awareness. Collaborating between clinicians and microbiologists is essential for effective management.
Recurrent Ischemic Strokes due to Monogenic COL4A1 Mutation: The First Case Report from Latin America
Authors: Emilio Israel Wong-Valenzuela, Daniel San Juan, José Santos Zambrano, Alejandra Camacho Molina, Miguel Angel Morales-Morales, Alejandro Lopez-Landa
Journal: Case Rep Genet (2023)
MeSH terms: Case Reports

Introduction. Monogenic mutations as the cause of recurrent ischemic cerebral small-vessel disease with leukodystrophy are rare. COL4A1 gene mutations are a relatively new etiology of cerebrovascular lesions in young adults; however, any patient has been reported from Latin America. Case Presentation. We presented a Mexican young female with leukodystrophy and recurrent stroke secondary to COL4A1 monogenic mutation. Discussion/Conclusion. COL4A1 monogenic mutations are associated with cerebral small-vessel disease and other systemic manifestations. To date, there is little evidence to justify the treatment and prevention of recurrent strokes in patients with this mutation.
Prolapsing Intrigue: A Case of Superior Vena Cava Mass Visualized by Echocardiography From the Subcostal Window Unveiling an Anterior Mediastinal Type B2 Thymoma
Authors: Hasan Kazma, Mouin Fouani, Mustafa Olleik, Leila Akil, Malek Mohammed
Journal: Cureus (2024)
Keywords: anterior mediastinal mass, ct scan of chest, echocardiographic windows, point-of-care-ultrasound, right atrial mass, superior vena cava, superior vena cava mass, thymoma, transthoracic 2d echocardiography
MeSH terms: Case Reports

Imaging the superior vena cava (SVC) during two-dimensional (2D) transthoracic echocardiographic examination is challenging and should be performed routinely. Here, we present a case where a lower (juxta-atrial) SVC mass was seen prolapsing into the right atrium by 2D transthoracic echocardiography; in this case, the imaging of the lower (juxta-atrial) SVC was done from the subcostal window. It was not possible to image the SVC from the suprasternal, right supraclavicular, left parasternal, or apical windows. CT scan of the chest with intravenous contrast was done in this case and showed an anterior mediastinal mass invading the SVC and prolapsing into the right atrium. CT-guided biopsy proved the mass to be a type B2 thymoma.
Primary thyroid squamous cell carcinoma diagnosed with 18F-FDG PET/CT: a case report
Authors: Taiping Liao, Yongjun Long, Lingxiao Li, Qinlin Qi, Li Li, Guoxu Fu
Journal: Front Oncol (2024)
Keywords: 18f, fdg, pet/ct, squamous cell carcinoma, thyroid
MeSH terms: Case Reports

Primary thyroid squamous cell carcinoma is extremely rare. We report a case of primary thyroid squamous cell carcinoma diagnosed using 18F-FDG PET/CT. The patient presented with left axillary lymphadenopathy as the initial symptom. Fine-needle aspiration of the axillary lymph nodes indicated metastatic squamous cell carcinoma. To identify the primary tumor, the patient underwent an 18F-FDG PET/CT scan, which revealed a mass in the thyroid and multiple enlarged lymph nodes with abnormal FDG uptake. Pathological examination of the axillary lymph nodes and thyroid biopsy confirmed the diagnosis of primary thyroid squamous cell carcinoma with lymph node metastasis.
A Case of Gastrointestinal Stromal Tumour (GIST) in the Duodenum in a Young Adult
Authors: Dinesh Abhijeeth Shanker, Sampath Kumar, Ahmed Al-Mukhtar, Asha Dube, Nehemiah Samuel
Journal: Cureus (2024)
Keywords: duodenal cancer, gastrointestinal bleed, gastrointestinal neoplasms, gastrointestinal stromal tumor (gist), oesophagogastroduodenoscopy (ogd)
MeSH terms: Case Reports

Gastrointestinal stromal tumours (GISTs) are rare gastrointestinal (GI) malignancies, but the most prevalent mesenchymal tumours of the GI tract arise from the interstitial cells of Cajal. They account for 1-3% of all GI malignancies, and only 3-5% of all cases of GIST are located at the duodenal. We present a case of a young adult who presented to the ED with symptoms of GI bleeding.
Case report: Immunotherapy guided by molecular profiling of tumors: illustrative cases and literature review
Authors: Mustafa Ozdogan, Eirini Papadopoulou, Vasiliki Metaxa-Mariatou, George Kapetsis, Angeliki Meintani, Chrysiida Florou-Chatzigiannidou, Akin Yildiz, Muharrem Okan Cakir, Onder Kirca, George Nasioulas
Journal: Front Med (Lausanne) (2024)
Keywords: ngs, pd-l1, tmb, immune checkpoint inhibitor, immunotherapy, molecular profiling
MeSH terms: Case Reports

Predictive biomarkers are necessary for the identification of immunotherapy-responsive patients. Tumor mutation burden (TMB), as determined by next-generation sequencing (NGS), and PD-L1 expression, as evaluated by Immunohistochemistry (IHC), are the biomarkers most frequently employed in clinical practice. In addition, microsatellite instability (MSI) was the first biomarker to demonstrate immunotherapy efficacy irrespective of the type of tumor and possesses a high predictive value. However, its limited use across most tumor types limits its therapeutic potential. This report describes two cancer patients with positive TMB and PD-L1 expression. The molecular profile of the tumor indicated that the first patient was responsive to Immune checkpoint inhibitors (ICI), while the second patient was resistant. These case studies demonstrate that tumor molecular analysis in combination with immunotherapy predictive biomarkers, such as PD-L1 expression and TMB, can enhance the prediction of response to ICI for specific patients. This methodology enables an individualized and improved approach to the treatment and management of the disease.
Massive Chylous Ascites in a 9-Year-Old Girl with Malrotation-A Case Report
Authors: Hans Winberg, Pär Gerwins, Kristine Hagelsteen
Journal: European J Pediatr Surg Rep (2024)
Keywords: ladd's procedure, chylous, malrotation, minimal invasive surgery, sealing device

Malrotation leading to massive chylous ascites is rare. A 9-year-old girl was investigated for slowly increasing abdominal distension under a year. She had no vomiting, weight loss, or pain, but was bothered in social situations. Medical investigations, including ultrasound and computed tomography scans, revealed massive ascites. Laparocentesis yielded milk-colored fluid, confirmed as lymph through laboratory analysis. A complete blood count, liver function and hematologic parameters, chyle cytology, bacterial cultures, and polymerase chain reaction for tuberculosis were all within normal limits. She was referred to a tertiary center for vascular anomalies. A dynamic contrast-enhanced magnetic resonance lymphangiography showed normal lymphatic anatomy without leakage or flow obstruction. A whole-body magnetic resonance imaging revealed a central mesenteric rotation. She was referred to a tertiary center for pediatric surgery, where a laparoscopic Ladd's procedure was performed using a new 5 mm pediatric sealing device, along with an appendectomy using a 5 mm stapler. To derotate the bowel, fenestrations were created in compartments containing a substantial amount of chyle and ascites, resulting in the drainage of 2.4 L of fluid. She was discharged the day after surgery and has been in good health for 1 year. We present a video illustrating the Ladd's procedure steps in this patient.
Case Report: Acute large bowel obstruction with actinomycosis of the sigmoid colon mimicking neoplasm
Authors: Mohamed Hajri, Rami Zouari, Ines Mallek, Dhouha Bacha, Rached Bayar, Sana Ben Slama
Journal: F1000Res (2024)
Keywords: abdominal actinomycosis, actinomyces, acute intestinal obstruction, antibiotic therapy, surgery
MeSH terms: Actinomycosis / complications, Actinomycosis / diagnosis, Intestinal Obstruction / diagnosis, Intestinal Obstruction / etiology, Intestinal Obstruction / microbiology, Case Reports, Aged, Colon, Sigmoid / microbiology, Colon, Sigmoid / pathology, Diagnosis, Differential, Humans, Male, Tomography, X-Ray Computed

Introduction:
Actinomycosis is an uncommon inflammatory bacterial disease caused by Actinomyces species, especially Actinomyces Israeli. Abdominopelvic forms are relatively rare and may involve the colon as a solid mass, mimicking a malignant tumor.
Case presentation:
A 68-year-old Tunisian man, with a history of diabetes, hypertension, penicillin allergy, and renal failure, presented to the emergency department with abdominal pain, vomiting, and bowel obstruction. CT scan showed an acute intestinal obstruction upstream with obstructive tissular mass at the sigmoid colon. Emergency surgery revealed a sigmoid mass and a pre-perforative cecum. Total colectomy was performed, with ileostomy and distal end closure. Histological examination confirmed Actinomyces infection. The patient was then placed on long-term doxycycline and Bactrim, with no recurrence over a 9-month follow-up period.
Conclusion:
Abdominal actinomycosis, though rare, presents diagnostic challenges. It can be mistaken for malignancy, leading to unnecessary surgery in non-complicated cases, since it is effectively treated by antibiotics. In complicated cases, a combined approach involving both surgery and antibiotic therapy is necessary until the infection is completely eradicated.
Tocilizumab for the fifth progression of cystic childhood craniopharyngioma-a case report
Authors: Evelien de Vos-Kerkhof, Dennis R Buis, Maarten H Lequin, Carlien A Bennebroek, Eleonora Aronica, Esther Hulleman, Nitash Zwaveling-Soonawala, Hanneke M van Santen, Antoinette Y N Schouten-van Meeteren
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: adamantinomatous craniopharyngioma, case report, cyst, hypothalamus, tocilizumab, visual impairment
MeSH terms: Craniopharyngioma / complications, Craniopharyngioma / drug therapy, Hypopituitarism / pathology, Pituitary Neoplasms / complications, Pituitary Neoplasms / drug therapy, Pituitary Neoplasms / pathology, Case Reports, Adolescent, Child, Female, Humans, Hypothalamus / pathology, tocilizumab

We present the case of a 15-year-old girl, with a fifth cystic progression of an adamantinomatous craniopharyngioma after multiple surgeries and previous local radiotherapy. She had severe visual impairment, panhypopituitarism including diabetes insipidus, and several components of hypothalamic damage, including morbid obesity and severe fatigue. To prevent further late effects hampering her quality of survival, she was treated biweekly with intravenous tocilizumab, an anti-interleukin-6 agent, which stabilized the cyst for a prolonged time. Based on the biology of adamantinomatous craniopharyngioma, this immune-modulating treatment seems promising for the treatment of this cystic tumor in order to reduce surgery and delay or omit radiotherapy.
Intubation in a Case of Ectodermal Dysplasia During Surgery: A Case Report
Authors: Sindhu Geetha, Neeta Verma, Amol Singam
Journal: Cureus (2024)
Keywords: craniofacial anomalies, ectodermal dysplasia, implant rehabilitation, le fort iii advancement, multidisciplinary collaboration, trans mylohyoid/submental intubation
MeSH terms: Case Reports

Ectodermal dysplasia, a heterogeneous group of rare genetic disorders, is characterized by the aberrant development of ectodermal structures, leading to various clinical anomalies. This case report presents a unique and challenging case of a 33-year-old male with ectodermal dysplasia who underwent Le Fort III advancement and implant rehabilitation surgery to address severe craniofacial and dental deficiencies. This case, characterized by facial dysmorphism, craniofacial anomalies, and the absence of a nasal bone, highlights the complexity of surgical planning required to address these diverse clinical features. The crucial element of this report is the innovative approach to airway management through trans mylohyoid/submental intubation, which successfully navigated the patient's aberrant anatomy. Multidisciplinary collaboration played a pivotal role in achieving a holistic and patient-centered approach. By sharing this case, we aim to provide insights into the nuances of managing complex patients with ectodermal dysplasia, emphasizing the importance of individualized care, innovative techniques, and interdisciplinary teamwork to optimize patient outcomes and contribute to advancing medical knowledge.
Anti-sulfatide antibody-related Guillain-Barré syndrome presenting with overlapping syndromes or severe pyramidal tract damage: a case report and literature review
Authors: Xiaotian Ji, Jiaqian Zhu, Lujiang Li, Xiaodan Yang, Shaolong Zhou, Liming Cao
Journal: Front Neurol (2024)
Keywords: bickerstaff brainstem encephalitis, guillain–barré syndrome, miller–fisher syndrome, anti-sulfatide antibody, case report, clinical characteristics, pyramidal tract damage
MeSH terms: Case Reports

Introduction:
Anti-sulfatide antibodies are key biomarkers for the diagnosis of Guillain-Barré syndrome (GBS). However, case reports on anti-sulfatide antibody-related GBS are rare, particularly for atypical cases.
Case description case 1:
A 63 years-old man presented with limb numbness and diplopia persisting for 2 weeks, with marked deterioration over the previous 4 days. His medical history included cerebral infarction, diabetes, and coronary atherosclerotic cardiomyopathy. Physical examination revealed limited movement in his left eye and diminished sensation in his extremities. Initial treatments included antiplatelet agents, cholesterol-lowering drugs, hypoglycemic agents, and medications to improve cerebral circulation. Despite this, his condition worsened, resulting in bilateral facial paralysis, delirium, ataxia, and decreased lower limb muscle strength. Treatment with intravenous high-dose immunoglobulin and dexamethasone resulted in gradual improvement. A 1 month follow-up revealed significant neurological sequelae.
Case description case 2:
A 53 years-old woman was admitted for adenomyosis and subsequently experienced sudden limb weakness, numbness, and pain that progressively worsened, presenting with diminished sensation and muscle strength in all limbs. High-dose intravenous immunoglobulin, vitamin B1, and mecobalamin were administered. At the 1 month follow-up, the patient still experienced limb numbness and difficulty walking. In both patients, albuminocytologic dissociation was found on cerebrospinal fluid (CSF) analysis, positive anti-sulfatide antibodies were detected in the CSF, and electromyography indicated peripheral nerve damage.
Conclusion:
Anti-sulfatide antibody-related GBS can present with Miller-Fisher syndrome, brainstem encephalitis, or a combination of the two, along with severe pyramidal tract damage and residual neurological sequelae, thereby expanding the clinical profile of this GBS subtype. Anti-sulfatide antibodies are a crucial diagnostic biomarker. Further exploration of the pathophysiological mechanisms is necessary for precise treatment and improved prognosis.