OpenMed/multicare-articles huggingface dataset:
Meningococcal vaccine introduction in Mali through mass campaigns and its impact on the health system
Authors: Sandra Mounier-Jack, Helen Elizabeth Denise Burchett, Ulla Kou Griffiths, Mamadou Konate, Kassibo Sira Diarra
Journal: Glob Health Sci Pract (2014)
MeSH terms: Delivery of Health Care / economics, Delivery of Health Care / organization & administration, Delivery of Health Care / statistics & numerical data, Health Promotion, Mass Vaccination, Meningococcal Infections / prevention & control, Meningococcal Vaccines, Research Support, Non-U.S. Gov't, Case-Control Studies, Health Care Surveys, Health Services Accessibility, Humans, Leadership, Mali, Public Health, Meningococcal Vaccines

Objective:
To evaluate the impact of the meningococcal A (MenA) vaccine introduction in Mali through mass campaigns on the routine immunization program and the wider health system.
Methods:
We used a mixed-methods case-study design, combining semi-structured interviews with 31 key informants, a survey among 18 health facilities, and analysis of routine health facility data on number of routine vaccinations and antenatal consultations before, during, and after the MenA vaccine campaign in December 2010. Survey and interview data were collected at the national level and in 2 regions in July and August 2011, with additional interviews in January 2012.
Findings:
Many health system functions were not affected-either positively or negatively-by the MenA vaccine introduction. The majority of effects were felt on the immunization program. Benefits included strengthened communication and social mobilization, surveillance, and provider skills. Drawbacks included the interruption of routine vaccination services in the majority of health facilities surveyed (67%). The average daily number of children receiving routine vaccinations was 79% to 87% lower during the 10-day campaign period than during other periods of the month. Antenatal care consultations were also reduced during the campaign period by 10% to 15%. Key informants argued that, with an average of 14 campaigns per year, mass campaigns would have a substantial cumulative negative effect on routine health services. Many also argued that the MenA campaign missed potential opportunities for health systems strengthening because integration with other health services was lacking.
Conclusion:
The MenA vaccine introduction interrupted routine vaccination and other health services. When introducing a new vaccine through a campaign, coverage of routine health services should be monitored alongside campaign vaccine coverage to highlight where and how long services are disrupted and to mitigate risks to routine services.
Acute small bowel obstruction: a rare initial presentation for the metastasis of the large-cell carcinoma of the lung
Authors: Yongmao Song, Modan Li, Jianzhen Shan, Xiaoxian Ye, Shangyi Tang, Xuefeng Fang, Kefeng Ding, Ying Yuan
Journal: World J Surg Oncol (2012)
MeSH terms: Carcinoma, Large Cell / secondary, Intestinal Obstruction / etiology, Lung Neoplasms / pathology, Case Reports, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Carcinoma, Large Cell / complications, Carcinoma, Large Cell / therapy, Cisplatin / administration & dosage, Glutamates / administration & dosage, Guanine / administration & dosage, Guanine / analogs & derivatives, Humans, Laparotomy, Lung Neoplasms / drug therapy, Lung Neoplasms / surgery, Male, Middle Aged, Pemetrexed, Prognosis, Tomography, X-Ray Computed, Glutamates, Pemetrexed, Guanine, Cisplatin

We present one case with symptom of paroxysmal abdominal pain for over 20 days. Abdominal computerized tomography (CT) scan revealed intestinal obstruction and a mass of 6.0 cm × 6.0 cm in size located at the left adrenal. Chest CT scan showed a lobulated mass of 2.7 cm × 2.7 cm in size at the upper left lung. Core needle biopsy of the lung mass confirmed the diagnosis of large cell carcinoma. The patient underwent an emergency abdominal laparotomy and received a chemotherapy regimen that consisted of pemetrexed and cisplatin postoperatively. In addition, we made a review of the literature of the occurrence, diagnosis and outcome of this manifestation.
Reconstruction of the coronoid process with the olecranon tip for chronic elbow dislocation in children: A rare case report and literature review
Authors: Yikun Jiang, Le Qi, Chuangang Peng, Qiwei Li, Peng Zhang, Yanbing Wang, Dankai Wu
Journal: Front Pediatr (2022)
Keywords: case report, children, coronoid process, olecranon tip, reconstruction
MeSH terms: Case Reports

The coronoid process of the ulna, as a key part of the elbow joint, plays an important role in maintaining elbow joint stability. Reconstruction of the coronoid process is necessary in both acute and chronic coronoid defects to restore elbow stability and avoid early joint degeneration. The olecranon tip may be a useful autologous osteochondral graft for reconstructing the same shape of the ulna coronoid process. The purpose of this report was to verify if reconstruction of the coronoid process with the olecranon tip can restore elbow stability and kinematics. Here, we report a 13-year-old boy who had undergone Kirschner-wire fixation for a left supracondylar fracture of the left humerus 9 years previously. After that, the right elbow dislocation and varus deformity gradually appeared. Imaging revealed posterolateral dislocation of the left elbow due to the absence of the coronoid process of the ulna. We reconstructed the ulnar coronoid process by intercepting the ipsilateral olecranon tip. After 22 months of follow-up, the range of motion of the left elbow joint was normal, and the cubitus varus deformity disappeared. The results of this report suggest that olecranon tip autografts are suitable to replace transverse coronoid defects. Given the patient's satisfactory clinical results, this reconstruction technique is safe and effective for the treatment of chronic elbow instability due to coronoid process defects of the ulna.
Fibro-osseous pseudotumor of the digit presenting as an ulcerated lesion: a case report
Authors: Atif Ali Hashmi, Naveen Faridi, Muhammad Muzzammil Edhi, Asad Jafri, Mehmood Khan
Journal: Int Arch Med (2014)
MeSH terms: Case Reports

Fibro-osseous pseudotumor of the digit is rare benign lesion of subcutaneous tissue which is thought to be reactive process as a result of repeated trauma. We report a case of an ulcerated lesion of skin of middle finger, clinically thought to be leishmaniasis which after punch biopsy followed by excision turned out to be fibrosseous pseudotumor. Diagnosis of fibro-osseous pseudotumor requires immense precision as it can clinically mimic unungal exostosis and can sometimes be misinterpreted clinically and radiologically as myositis ossificans. We suggested an algorithimic approach for histopathologic assessment of fibro-osseous soft tissue lesions with evaluation of both stromal and osseous components. Bland fibroblastic stroma, mature osseous component with prominent osteoblastic rimming and absence of zonation pattern will support the diagnosis of fibro-osseous pseudotumor especially if located at a superficial and distal location.
Neglected lunate dislocation presenting as carpal tunnel syndrome
Authors: Eren Cansü, Ahmed Majid Heydar, Anar Elekberov, Mehmet Bekir Ünal
Journal: Case Reports Plast Surg Hand Surg (2015)
Keywords: etiology, hand, lunate dislocation, median nerve, syndrome, trauma, unilateral carpal tunnel syndrome
MeSH terms: Case Reports

Most of carpal tunnel syndrome cases are idiopathic, and secondary causes are so rare that can be easily missed. We present a patient with neglected undiagnosed lunate dislocation compressing on median nerve causing its signs and symptoms.
Multi-focal sequencing of a diffuse intrinsic pontine glioma establishes PTEN loss as an early event
Authors: Carl Koschmann, Zishaan Farooqui, Katayoon Kasaian, Xuhong Cao, Daniel Zamler, Stefanie Stallard, Sriram Venneti, Shawn Hervey-Jumper, Hugh Garton, Karin Muraszko, Luigi Franchi, Patricia L Robertson, Marcia Leonard, Valerie Opipari, Maria G Castro, Pedro R Lowenstein, Arul Chinnaiyan, Rajen Mody
Journal: NPJ Precis Oncol (2017)
MeSH terms: Case Reports

Improved molecular understanding is needed for rational treatment of diffuse intrinsic pontine gliomas (DIPG). Here, using multi-focal paired tumor and germline exome DNA and RNA sequencing, we uncovered phosphatase and tensin homolog (PTEN) loss as a clonal mutation in the case of a 6-year-old boy with a diffuse intrinsic pontine glioma, and incorporated copy number alteration analyses to provide a more detailed understanding of clonal evolution in diffuse intrinsic pontine gliomas. As well, using the PedcBioPortal, we found alterations in PTEN in 16 of 326 (4.9%) cases of pediatric high-grade glioma (3 of 154 (1.9%) brainstem) for which full sequencing data was available. Our data strengthens the association with PTEN loss in diffuse intrinsic pontine gliomas and provides further argument for the inclusion of PTEN in future targeted sequencing panels for pediatric diffuse intrinsic pontine gliomas and for the development and optimization of mTOR/PI3K inhibitors with optimal central nervous system penetration.
Bilious Vomiting in the Newborn: A Three-Year Experience in a Tertiary Medical and Surgical Centre
Authors: Rebecca A Lee, Theodore Dassios, Ravindra Bhat, Anne Greenough
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Background:
Bilious vomiting in the newborn is common and requires urgent attention to exclude malrotation. The proportion of neonates with surgical abnormalities, however, is small, and there are other causes. Study Objectives. We reviewed our experience of infants with bilious vomiting to demonstrate the importance of input from the tertiary surgical and medical team to arrive at the correct diagnosis.
Design:
Admissions with bilious vomiting/aspirates of term born infants over a three-year period to a tertiary medical and surgical unit were reviewed.
Results:
During the study period, 48 infants were admitted with bilious vomiting. Forty-five infants had upper gastrointestinal (UGI) contrast studies, and only six had an abnormal study: four had malrotation and two had Hirschsprung's disease. Of the infants with a normal UGI study, no cause was identified in 20 cases, 13 infants were treated for sepsis, one had a meconium plug, one an ovarian cyst, and two infants were polycythaemic. One infant was diagnosed with bilateral polymicrogyria (PMG) on brain MRI and another was found to have hypochondroplasia FGFR3 skeletal dysplasia.
Conclusion:
Neonates with bilious vomiting may have a variety of underlying diagnoses and need to be referred to a tertiary surgical and medical centre to ensure appropriate diagnosis is made.
Surgical resection of pancreatic insulinoma during pregnancy: Case report and literature review
Authors: Carlos Castanha de Albuquerque Neto, Natália da Silva Lira, Marcelo A R C Albuquerque, Fernando Santa-Cruz, Laís de França M Vasconcelos, Álvaro A B Ferraz, Adriano C Costa
Journal: Int J Surg Case Rep (2019)
Keywords: hypoglycemia, insulinoma, pregnancy

Introduction:
Insulinomas are neuroendocrine tumors characterized by an excessive secretion of insulin, and its most common primary site is the pancreas.
Presentation of the case:
Female, 31 years old, who underwent surgical resection of a pancreatic insulinoma measuring 0.5 × 0.5 cm during the third trimester of pregnancy. The patient started to present characteristic symptoms (hypoglycemia, adrenergic and neuroglycopenic symptoms) 18 months before being referred to our center. It was decided to resect the lesion due to the intensity of the symptoms and failure of the clinical treatment. The postoperative course was uneventful, and the fetus presented good vitality, as evidenced by the obstetric ultrasound. The patient was discharged from the hospital on the 6th postoperative day. The neonate was born at term, 38 weeks, with appropriate weight for gestational age. Today, around 12 months after surgery, the patient and the infant are in good health conditions and have no complaints.
Conclusion:
The moment of the surgical intervention in our case reflects the importance of this report, since it reinforces the feasibility of this procedure during pregnancy.
Unusual Case of Coexisting Renal Malignancies: Mucinous Tubular and Spindle Cell Carcinoma Kidney With Sarcomatoid Dedifferentiation
Authors: Kafil Akhtar, Pragati Agnihotri, Kiran Alam, Kashif Raza
Journal: J Kidney Cancer VHL (2016)
Keywords: immunohistochemistry, kidney, mucinous, sarcomatoid dedifferentiation, spindle cell carcinoma
MeSH terms: Case Reports

Mucinous tubular and spindle cell carcinoma (MTSCC) is a recent entity introduced in the World Health Organization 2004 Classification. It is a tumour of low malignant potential. MTSCC is a subtype of renal cell carcinoma (RCC), which is characterized by a polymorphous histology, wherein the spindled epithelial cell is an inherent carcinomatous component. We report the case of a 57-year-old man presenting with loin pain and dragging sensation. Imaging revealed a large mass arising from the left kidney. Radical nephrectomy was performed, and histopathology revealed spindle cell elements of MTSCC with low-grade cytology, which occasionally blended with tubular structures in variable mucinous stroma admixed with spindle sarcomatoid cells with marked nuclear pleomorphism, associated with significant necrosis and mitoses of up to 5/10 high-power field. A final diagnosis of MTSCC along with high-grade areas consistent with sarcomatoid dedifferentiation was made. Sarcomatoid dedifferentiation has been well documented in various subtypes of RCC, and its presence signifies a worse prognosis in RCC.
Adult-onset Krabbe disease presenting with progressive myoclonic epilepsy and asymmetric occipital lesions: A case report
Authors: Yu Wang, Su-Yue Wang, Kai Li, Yu-Long Zhu, Kun Xia, Dan-Dan Sun, Wen-Long Ai, Xiao-Ming Fu, Qun-Rong Ye, Jun Li, Huai-Zhen Chen
Journal: Front Neurol (2022)
Keywords: galc gene, melas syndrome, adult-onset krabbe disease, brain mri, progressive myoclonic epilepsy
MeSH terms: Case Reports

Krabbe disease (KD), also known as globoid cell leukodystrophy, is a rare autosomal recessive condition caused by mutations in the galactocerebrosidase (GALC) gene. KD is more common in infants and young children than in adults. We reported the case of an adult-onset KD presenting with progressive myoclonic epilepsy (PME) and cortical lesions mimicking mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome. The whole-exome sequencing (WES) identified a pathogenic homozygous missense mutation of the GALC gene. Parents of the patient were heterozygous for the mutation. The clinical, electrophysiological, and radiological data of the patient were retrospectively analyzed. The patient was a 24-year-old woman presenting with generalized seizures, progressive cognitive decline, psychiatric symptoms, gait ataxia, and action-induced myoclonus. The brain magnetic resonance imaging (MRI) revealed a right occipital cortical ribbon sign without any other damage. This single case expands the clinical phenotypes of adult-onset KD.
A tuberculosis case mimicking lymphoma
Authors: Hilmi Atay, Engin Kelkitli, Mehmet Turgut
Journal: Pan Afr Med J (2014)
Keywords: tuberculosis, abdominal mass, lymphoma
MeSH terms: Lymphoma / diagnosis, Tuberculosis, Gastrointestinal / diagnosis, Case Reports, Abdominal Pain / diagnosis, Abdominal Pain / etiology, Diagnosis, Differential, Fatal Outcome, Humans, Male, Middle Aged, Tuberculosis, Gastrointestinal / complications

Tuberculosis remains a worldwide health problem causing morbidity and mortality. Abdominal tuberculosis is a rare form of the disease. Abdominal form of tuberculosis can mimic other non-infectious diseases. In this report, we presented an abdominal tuberculosis presenting with an intra-abdominal mass lesion and multiple lymphadenopathies that mimics lymphoma.
The dark side of the esophagus
Authors: Daniela Martins, Rita Marques, Pedro Costa, João Pinto de Sousa
Journal: Autops Case Rep (2021)
Keywords: acute esophageal necrosis, black esophagus, endoscopy gastrointestinal, ischemia, upper gastrointestinal hemorrhage
MeSH terms: Case Reports

Acute esophageal necrosis (AEN), also known as "black esophagus," is an entity characterized by the circumferential black appearance of esophageal mucosa, usually associated with hypoperfusion and gastric outlet obstruction. This entity has a reported prevalence of up to 0.2%, affecting predominantly elderly men with multiple comorbidities. Most cases resolve with conservative treatment with no need of surgical intervention. However, the overall prognosis is poor, with mortality reaching one-third of cases due to the patient's underlying illness. In this article we present three cases of patients with AEN.
A rare case of eczema herpeticum associated with HIV: A case report
Authors: Prabal Chourasia, Norman D Bernstein, Kunal M Ajmera, Trupti Pandit, Ramesh Pandit, Lokesh Goyal
Journal: IDCases (2022)
Keywords: acyclovir, eczema herpeticum, hiv, kaposi’s varicelliform eruption, steroid use
MeSH terms: Case Reports

Eczema herpeticum (EH), also known as Kaposi's varicelliform eruption, is a disseminated herpes simplex virus infection seen in patients with underlying skin conditions, most commonly atopic dermatitis. Monomorphic vesicles and "punched-out" erosions with hemorrhagic crusts over eczematous regions are the hallmarks of EH's presentation. Here, we discuss a first reported case of eczema herpeticum in a patient living with well controlled HIV with prior steroid use. A 30-year-old male patient living with HIV presented to the hospital with a generalized rash involving the face, neck, arms, hands, low back region, and both feet. Herpes simplex 1 and 2 by PCR DNA were detected from external auditory ear canal drainage. The patient was treated with intravenous acyclovir and responded well. He had long term history of eczema and required acyclovir prophylaxis later.
A Novel Technique for Recurrent Tube Exposure Repair
Authors: J Minjy Kang, Yen Cheng Hsia, Ying Han
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Purpose:
Tube exposure can lead to vision-threatening consequences and requires prompt surgical attention. Posterior repositioning of the tube to the pars plana has previously been reported as a successful technique. However, this method requires a pars plana vitrectomy (PPV). Here, we describe a novel technique of repositioning the tube into the ciliary sulcus without requiring PPV.
Methods:
This is a retrospective interventional case report of two patients who had undergone prior glaucoma drainage device implantation and prior tube exposure repair and developed recurrent tube exposure. Tube exposure in the subjects was repaired by repositioning the tube in the ciliary sulcus.
Results:
The two eyes remained exposure free postoperatively with 51- and 60-month follow-ups.
Conclusions:
Repositioning the tube to the ciliary sulcus may be an effective technique to avoid reexposure.
Adnexal Torsion in Pediatric Age: Does Bolli's Score Work? Report of Two Cases
Authors: L Giambanco, V Iannone, M Borriello, G Scibilia, G Sozzi, V Chiantera, P Scollo
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Adnexal torsion is a surgical emergency requiring early diagnosis in order to avoid demolitive surgery. Adnexal torsion's diagnosis could be very difficult in pediatric patients because children cannot explain symptoms accurately. Furthermore reproductive organs lie high in abdomen, causing unclear examinations findings. For reducing diagnostic mistakes or delay clinical and hematological criteria could be useful. No radiological criteria (CT or MRI) should be taken in count because of the costs and the required time. By combining clinical presentation in patients with OT three useful diagnostic variables have been identified: age, duration of pain, vomiting. Presence of vomiting, short duration of abdominal pain and high CRP levels have great predictive value for the diagnosis of adnexal torsion. In those patients an exploratory laparoscopy should be performed without any doubt and/or delay. These data may aid physicians in the evaluation of abdominal pain in premenarchal girls.
Autoimmune progesterone dermatitis: a case report
Authors: Rachana George, Shawky Z A Badawy
Journal: Case Rep Obstet Gynecol (2012)

Background. Autoimmune progesterone dermatitis is a rare cyclic premenstrual allergic reaction to progesterone produced during the luteal phase of a woman's menstrual cycle. Patients present with a variety of conditions including erythema multiforme, eczema, urticaria, angioedema, and progesterone-induced anaphylaxis. Case. Thirty-eight-year-old woman G2P2002 presents with erythema multiforme and urticarial rash one week prior to her menses starting one year after menarche. She was treated with oral contraceptive pills and the symptoms resolved. Conclusion. This is a typical case of progesterone autoimmunity. The diagnosis is based on cyclic nature of the dermatitis. This differentiates the condition from other allergies or systemic diseases with skin manifestations. Inhibition of ovulation in such cases results in decrease in progesterone secretion and prevention of symptoms.
Transient cardiac arrest in a child with Down syndrome during anesthesia induction with sevoflurane: a case report
Authors: Kentaro Nogami, Shogo Taniguchi, Kyoko Togami
Journal: JA Clin Rep (2016)
Keywords: cardiac arrest, down syndrome, general anesthesia, pediatric patient, sevoflurane

Background:
This report describes a case of transient cardiac arrest in a child with Down syndrome. The cardiac arrest occurred during induction of anesthesia with sevoflurane. To the best of our knowledge, this is the first such report.
Case presentation:
A 14-year-old boy was scheduled to undergo dental treatment under general anesthesia because of his mental disorder. He had congenital atrial and ventricular septal defects and patent ductus arteriosus, which had been repaired previously. Therefore, we anticipated no problems with his cardiovascular system during the perioperative period. Because the sedation administered before the insertion of an intravenous catheter and arterial line was insufficient to induce an anesthetic effect, general anesthesia was induced by using a mixture of sevoflurane (5 %) with oxygen in nitrous oxide. A few minutes after the induction of anesthesia, the patient unexpectedly experienced bradycardia (heart rate <30 beats/min), and his electrocardiography findings indicated asystole. After a few minutes of cardiopulmonary resuscitation, the patient's heart rate returned to normal.
Conclusions:
We postulated that the asystole was triggered by a dysfunction in the autonomic cardiac regulation and sympathetic activation, which often occurs in patients with Down syndrome, and due to the use of high concentrations of sevoflurane. In future cases of pediatric patients with Down syndrome, with or without heart disease, the concentration of sevoflurane administered during surgery should be increased gradually. Moreover, an intravenous catheter should be promptly inserted to administer anticholinergic drugs as quickly as possible in order to prevent transient cardiac arrest.