OpenMed/multicare-articles huggingface dataset:
Successful Spontaneous Pregnancy after Treatment for Ewing Sarcoma including Sacrectomy
Authors: T Hockertz, M Velickovic
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Ewing sarcomas are highly malignant bone tumors and usually occur in childhood. Radiation therapy, chemotherapy, and surgical methods increase the survival rate of the affected patient, but infertility and reduced reproductive capacity are common late effects of pediatric cancer treatment.
Minimally invasive (flapless) crown lengthening by erbium:YAG laser in aesthetic zone
Authors: Saverio Capodiferro, Angela Tempesta, Luisa Limongelli, Giuseppe Barile, Daniela Di Venere, Massimo Corsalini
Journal: F1000Res (2020)
Keywords: erbium
MeSH terms: Lasers, Solid-State, Case Reports, Crown Lengthening, Erbium, Esthetics, Yttrium, Yttrium, Erbium

Crown lengthening is a surgical procedure aimed at exposure of a larger tooth surface by gingivectomy alone or with cortical bone remodelling for aesthetic purposes in the anterior zone of the maxilla or for reconstruction of teeth affected by subgingival caries. We report two cases of crown lengthening in the anterior maxilla for aesthetic purposes by gingival and bone re-contouring performed by erbium-doped yttrium aluminium garnet (erbium:YAG) laser. As highlighted in this report, the erbium:YAG laser-assisted crown lengthening is less invasive and also leads to faster clinical outcomes in contrast to the conventional surgical technique by scalpel incision, flap elevation and osteoplastic.
Lenalidomide, melphalan, and prednisone association is an effective salvage therapy in relapsed plasma cell leukaemia
Authors: Tommasina Guglielmelli, Roberta Merlini, Emilia Giugliano, Giuseppe Saglio
Journal: J Oncol (2009)
MeSH terms: Case Reports

Plasma cell leukemia (PCL) is a rare and aggressive plasma cell disorder, characterized by the presence of a peripheral blood absolute plasma cell count of at least 2 x 109/l and more than 20% circulating plasma cells. The prognosis of PCL patients remains poor. Even by using autologous or allogenic transplant procedures, median survival does not exceed 3 years (Saccaro et al., 2005). Thalidomide, bortezomib and lenalidomide (Revlimid) have emerged as high active agents in the treatment of PCL (Johnston and abdalla, 2002; Musto et al., 2007; Finnegan et al., 2006). In particular, Lenalidomide is a structural analogue of thalidomide with similar but more potent biological activity; it is used as first line therapy in MM (Palumbo et al., 2007; Niesvizky et al., 2007), although information regarding its associated use with dexamethasone use as salvage therapy in PCL derives from anecdotal single case reports (Musto et al., 2008). We would like to describe a case of primary PCL with adverse cytogenetic in which excellent response was achieved with the combination of lenalidomide, melphalan, and prednisone as salvage therapy.
Resistance Training With Partial Blood Flow Restriction in a 99-Year-Old Individual: A Case Report
Authors: Maíra Camargo Scarpelli, João Guilherme Almeida Bergamasco, Estevan A de Barros Arruda, Summer B Cook, Cleiton Augusto Libardi
Journal: Front Sports Act Living (2021)
Keywords: nonagenarians/centenarians, older adults, sarcopenia, strength training, vascular occlusion
MeSH terms: Case Reports

In aging populations for which the use of high loads is contraindicated, low load resistance training associated with blood flow restriction (RT-BFR) is an alternative strategy to induce muscle mass gains. This study investigates the effects of RT-BFR on muscle mass, muscle function, and quality of life of a 99-year-old patient with knee osteoarthritis and advanced muscle mass deterioration. Training protocol consisted of 24 sessions of a unilateral free-weight knee extension exercise associated with partial blood flow restriction through a manometer cuff set at 50% of complete vascular occlusion pressure. We evaluated: cross-sectional area (CSA) and thickness (MT) of the vastus lateralis muscle by ultrasound; function through the Timed Up and Go (TUG) test; and quality of life (QoL) by the WHOQOL-bref, WHOQOL-OLD and WOMAC questionnaires. All tests were performed prior to the training period (Pre) and after the 12th (Mid) and 24th (Post) sessions. Changes were considered significant if higher than 2 times the measurement's coefficient of variation (CV). After 24 sessions, there was an increase of 12% in CSA and 8% in MT. Questionnaires scores and TUG values worsened from Pre to Mid and returned in Post. We consider RT-BFR a viable and effective strategy to promote muscle mass gains in nonagenarians and delay the decline in functionality and QoL associated with aging.
Pantoea agglomerans Infections in Children: Report of Two Cases
Authors: Shraddha Siwakoti, Rinku Sah, Rupa Singh Rajbhandari, Basudha Khanal
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Introduction:

Pantoea agglomerans, primarily an environmental and agricultural organism has been reported as both commensal and pathogen of humans. We present two case reports of P. agglomerans infections in children that involved the meninges and bloodstream.
Case presentations:
A 6-month-old female baby, diagnosed as congenital hydrocephalus secondary to aqueduct stenosis with ventriculoperitoneal shunt in situ, operated 14 days back was brought to the pediatric emergency with a two-day history of high fever associated with vomiting, irritability, excessive crying, and decreased feeding. Postoperative meningitis was confirmed as cerebrospinal fluid culture revealed P. agglomerans. She responded well with a 14-day intravenous (IV) course of ceftriaxone. Also, we report a case of a 3-year-old male child referred to our center with a provisional diagnosis of UTI with chickenpox for further evaluation. During his 24-hour stay at the local hospital, he had received oral antibiotics and urinary catherization. Urine culture of catheter clamp urine was sterile. P. agglomerans was grown in blood culture. He was treated successfully with IV ceftriaxone and amikacin.
Conclusion:

P. agglomerans can cause postsurgical meningitis and bloodstream infection in children. The clinical course of infection was mild and timely administration of proper antibiotic resulted in a favorable outcome.
Case Report: Pulmonary and Liver Sarcoidosis Suspected of Metastasis
Authors: Behnam Jafari, Gholamabas Sabz, Elahe Masnavi, Roghaye Panahi, Saeid Jokar, Amrollah Roozbehi, Sajad Hasanzadeh
Journal: F1000Res (2018)
Keywords: sarcoidosis, hilar lymphadenopathy, liver, lung

Introduction: Sarcoidosis is a granulomatous disease with unknown cause that can vary from an asymptomatic condition. Almost half of the patients with sarcoidosis have no symptoms. In this article, we describe a sarcoidosis patient with lung and liver engagement; it may be confused with metastasis. Case report: A 39-year-old man, with known as hypothyroidism who had come to the emergency ward with dyspnea and coughing after exposure to detergents in a closed environment. The patient smoked for 10 years (3 pack/year). No other findings were found in clinical examinations except for wheezing in the right lung. The patient's chest radiography was shown a mass. For further investigation, spiral CT scan was performed. Large lymph nodes on the right side of the trachea, measuring about 23 mm and a mass of 70 × 77 mm in the vicinity of the right lung hilum and a hypodense nodule in the posterior part of the liver with malignancy suspicious were reported. After several biopsy results was shown chronic granulomatous inflammation, the most important differential diagnosis is tuberculosis (TB) and sarcoidosis. Sputum smear, culture, and PCR were performed for tuberculosis. Also, the level of angiotensin-converting enzyme (ACE) was measured for sarcoidosis. the results ruled out TB and shown a higher level of ACE (ACE = 88 IU/L).After diagnosis treatment started with prednisolone. Now, the patient is in the follow- up. Conclusion: In hilar lymphadenopathy of lung sarcoidosis is the importance differential diagnosis that should be considered.
Successful Treatment of Acromegaly and Associated Hypogonadism with First-Line Clomiphene Therapy
Authors: Juan D Palacios, Ricardo J Komotar, Atil Y Kargi
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Clomiphene citrate (CC) has been reported as an effective add-on therapy to somatostatin analogs and dopamine agonists in patients with acromegaly accompanied by hypogonadism; its use as a single agent to treat acromegaly and associated hypogonadism following incomplete surgery has not been previously reported. We report the first case in which clomiphene was utilized as a single agent for the dual management of acromegaly and hypogonadism, not controlled by pituitary surgery alone. The treatment was well tolerated and proved to be effective after a process of treatment withdrawal and reintroduction. We propose that clomiphene may be considered as a cost-effective oral treatment option in select cases of hypogonadal acromegaly.
Classic Testicular Seminoma in Men Aged 50 Years or Over: A Case Report and Review of the Literature
Authors: Rawad Abou Zahr, Khalil Chalhoub, Imad Matta, Sawsan Horani, Zarouhie Bedoyan, Georges El Hachem, Imad Ghantous, Michel Jabbour
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Testicular cancer is the most frequent solid tumor detected in young adult men. Germ cell tumors (GCTs), particularly seminomas, are the most common type of testicular neoplasms seen in that age population. Most publications have reported decreasing incidence of GCTs in patients above forty years of age. Since the biologic activity of seminomas appears similar across ages, recommended management of senior adults involves a multimodal therapy of radical inguinal orchiectomy with radiation or cytotoxic treatment as needed. Attenuating chemotherapy dosages are critical to ensure better tolerability of associated adverse events. Here we report a case series of 2 men older than fifty years of age with metastatic testicular seminoma. We aim to emphasize a rare clinical entity encountered in the senior adult population.
Anti-N-Methyl-D-Aspartate-Receptor Encephalitis: A 10-Year Follow-Up
Authors: Sophie Meixensberger, Ludger Tebartz van Elst, Tina Schweizer, Simon J Maier, Harald Prüss, Bernd Feige, Dominik Denzel, Kimon Runge, Kathrin Nickel, Miriam Matysik, Nils Venhoff, Katharina Domschke, Horst Urbach, Evgeniy Perlov, Dominique Endres
Journal: Front Psychiatry (2020)
Keywords: anti-n-methyl-d-aspartate-receptor encephalitis, antibodies, catatonia, follow-up, long-term, neuroleptics, psychotherapy
MeSH terms: Case Reports

Background:
Anti-N-methyl-D-aspartate-receptor (NMDA-R) encephalitis is an autoimmune disease of the brain first described in 2007. The aim of this paper is to present a 10-year follow-up case history.
Case presentation:
The authors present the case of a 39-year-old female patient who developed an anti-NMDA-R encephalitis in 2009 with predominant severe catatonic symptoms. Anti-inflammatory therapy led to the disappearance of catatonic symptoms and was discontinued during the course of the disease. After acute therapy, the patient achieved an almost full recovery presenting with ongoing discrete symptoms of sensory overload, subtle cognitive deficits, and fatigue/reduced energy levels. The follow-up investigation in 2019 showed inconspicuous findings in laboratory diagnostics and magnetic resonance imaging. Electroencephalography (EEG) analysis using independent component analysis detected left hemispherical spike-wave complexes and intermittent slowing. Regarding the sensory overload and reduced energy level, the patient benefited from low-dose neuroleptics (risperidone, amisulpride). In terms of sensory overload associated with experiences of panic, cognitive deficits and coping with the disease, she improved with cognitive behavioral therapy (CBT).
Conclusion:
Anti-inflammatory treatment led to almost full recovery with persistent disappearance of catatonic symptoms; however, a dysexecutive syndrome led to ongoing relevant problems with good response to low-dose atypical neuroleptics and CBT. The patient had persistent EEG alterations that indicated continuing neuronal network instability. Therefore, the case demonstrates the importance of multidisciplinary outpatient treatment following acute therapy for anti-NMDA-R encephalitis in patients with ongoing psychiatric deficits. For the symptomatic treatment of executive dysfunctions, "classical" psychiatric treatment may be helpful in the course of the disease.
A Rare Case of Cemento-Ossifying Fibroma of the Maxilla
Authors: Elyn Van Snick, Bjorn Valgaeren, Jan Hendrickx
Journal: J Belg Soc Radiol (2022)
Keywords: bone lesion, cemento-ossifying fibroma, cone-beam computed tomography, osteogenic tumours
MeSH terms: Case Reports

Teaching Point: Cemento-ossifying fibromas are rare, benign tumours that are mostly found in the tooth-bearing areas of the mandible or maxilla and can be seen on cone-beam computed tomography.
Rectal atresia: a rare cause of failure to pass meconium
Authors: Fatima Zahrae Laamrani, Rachida Dafiri
Journal: Pan Afr Med J (2014)
Keywords: rectal-atresia, anorectal malformation, failure to pass meconium
MeSH terms: Abdomen / pathology, Anus, Imperforate / physiopathology, Meconium / metabolism, Case Reports, Anorectal Malformations, Anus, Imperforate / diagnosis, Female, Humans, Infant, Newborn

Rectal atresia or stenosis is an extremely rare anorectal malformation associating a normal anal canal with a stricture or a complete rectal atresia. We describe a case of rectal atresia in a newborn female presenting with an abdominal distension and failure of passing meconium.
Coma With Absent Brainstem Reflexes and a Burst Suppression on EEG Secondary to Baclofen Toxicity
Authors: Sahar Farhat, Tarek El Halabi, Achraf Makki, Samir F Atweh, Wassim Nasreddine, Ahmad Beydoun
Journal: Front Neurol (2020)
Keywords: baclofen toxicity, brainstem reflexes, burst suppression, coma, seizure
MeSH terms: Case Reports

Baclofen, a muscle relaxant prescribed for the alleviation of symptoms of spasticity acts primarily at the spinal level but with high doses, it penetrates the blood-brain barrier and can result in prominent central nervous depression. Baclofen toxicity has been associated with a variety of symptoms ranging from dizziness to deep coma. We report the clinical course, management, and outcome of a case of baclofen overdose who presented in deep coma with loss of brainstem reflexes and a burst suppression (BS) pattern on his electroencephalogram (EEG). In addition, we reviewed the presentation and outcomes of all reported cases of baclofen toxicity with a BS pattern on EEG to evaluate if those cases share a common clinical presentation and for the presence of signs and symptoms that would help the clinician to consider this diagnosis. There appears to be a common clinical picture associated with severe baclofen toxicity consisting of deep coma associated with loss of all brainstem reflexes including pupillary reactivity, frequent association with seizures/myoclonic jerks, and a BS pattern on EEG. The outcome is generally good, and serial EEGs are recommended to document a reversal of the abnormal electrographic features.
Surgical treatment of giant right ventricular fibroma for a newborn: A case report
Authors: Yuhang Liu, Ning Wang, Ping Wen
Journal: Front Cardiovasc Med (2022)
Keywords: cardiac tumor, case report, fibroma, histology, newborn
MeSH terms: Case Reports

This report describes the surgical treatment of giant right ventricular fibroma in a newborn. Cardiac uhrasonography and CT showed a large mass in the right ventricle wall, which narrowed the right ventricular inflow tract. The newborn patient gradually developed symptoms such as shortness of breath, oliguria, and pericardial effusion. We performed tumor excision, but due to severe damage to the right ventricular wall and right heart failure, the patient relied on cardiopulmonary bypass. Then, we immediately restored the opening of the ductus arteriosus, enlarged the foramen ovale, and used various vasoactive drugs to ensure the smooth resuscitation of the patient. This is a kind of operation for the youngest patients. The perioperative treatment experience indicated the feasibility of excision of giant right ventricular fibroma for newborn patients.
Acquired Thrombotic Thrombocytopenic Purpura in a Patient with Pernicious Anemia
Authors: Ramesh Kumar Pandey, Sumit Dahal, Kamal Fadlalla El Jack Fadlalla, Shambhu Bhagat, Bikash Bhattarai
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Introduction. Acquired thrombotic thrombocytopenic purpura (TTP) has been associated with different autoimmune disorders. However, its association with pernicious anemia is rarely reported. Case Report. A 46-year-old male presented with blood in sputum and urine for one day. The vitals were stable. The physical examination was significant for icterus. Lab tests' results revealed leukocytosis, macrocytic anemia, severe thrombocytopenia, renal dysfunction, and unconjugated hyperbilirubinemia. He had an elevated LDH, low haptoglobin levels with many schistocytes, nucleated RBCs, and reticulocytes on peripheral smear. Low ADAMTS13 activity (<10%) with elevated ADAMTS13 antibody clinched the diagnosis of severe acquired TTP, and plasmapheresis was started. There was an initial improvement in his hematological markers, which were however not sustained on discontinuation of plasmapheresis. For his refractory TTP, he was resumed on daily plasmapheresis and Rituximab was started. Furthermore, the initial serum Vitamin B12 and reticulocyte index were low in the presence of anti-intrinsic factor antibody. So with the concomitant diagnosis of pernicious anemia, Vitamin B12 was supplemented. The rest of the immunological workups were negative. Subsequently, his symptoms resolved and his hematological parameters improved. Discussion. While pernicious anemia can masquerade as TTP, an actual association between the two can also occur and needs further evaluation and characterization.
New aneurysm formation after endovascular embolization of a vertebral epidural AV fistula: a rare sequelae of NF AV fistulae
Authors: Yiyong Zeng, Xianru Li, Junjun Zhang, Yi Huang, Zhiqin Lin, Shengjun Zhou
Journal: Front Neurol (2023)
Keywords: aneurysm, endovascular treatment, neurofibromatosis type 1 (nf1), subarachnoid hemorrhage, vertebral arteriovenous fistulae
MeSH terms: Case Reports

Background:
Neurofibromatosis type 1 (NF-1) is a dominant genetic disorder often accompanied by lesions of the neurovascular system. Patients with NF-1 are predisposed to unique vertebral artery fistula (AVF).
Case description:
We report on a rare case of multiple neurovascular abnormalities in a 47-year-old man with neurofibromatosis. He was admitted due to a sudden headache and was found to have suffered a subarachnoid hemorrhage from a left vertebral arteriovenous fistula. He underwent two endovascular procedures complicated by a delayed extraspinal mass 7 days after treatment. Angiography revealed a new vascular abnormality, and although we performed another embolization, it failed to respond to further embolization.
Conclusion:
Vascular abnormalities in patients with NF-1 can be complex. Endovascular intervention remains feasible for NF-1 related AVF, however, partial occlusion of the fistula should be avoided to limit and iatrogenic damage to the blood vessels.
Tricuspid valve endocarditis with Group B Streptococcus after an elective abortion: the need for new data
Authors: Erica E Palys, John Li, Paula L Gaut, W David Hardy
Journal: Infect Dis Obstet Gynecol (2006)
MeSH terms: Abortion, Induced, Endocarditis, Bacterial / microbiology, Heart Valve Diseases / microbiology, Postoperative Complications / microbiology, Streptococcus agalactiae / isolation & purification, Tricuspid Valve / microbiology, Case Reports, Adult, Endocarditis, Bacterial / epidemiology, Female, Heart Valve Diseases / epidemiology, Humans, Incidence, Postoperative Complications / epidemiology, Streptococcal Infections / epidemiology, Streptococcal Infections / microbiology

Streptococcus agalactiae, commonly known as Group B streptococcus (GBS), was originally discovered as a cause of bovine mastitis. GBS colonizes the genital tract of up to 40% of women and has become a major pathogen in neonatal meningitis. GBS endocarditis is thought to be an uncommon manifestation of this infection and carries a higher mortality compared to other streptococcal pathogens. Studies have shown that endocarditis after abortion has an incidence of about one per million. However, this figure was published prior to routine use of echocardiography for diagnosis. The American Heart Association has recently declared transesophageal echocardiography the gold standard for endocarditis diagnosis. This case report illustrates that, given the potentially devastating consequences of endocarditis, there is a need for updated studies to adequately assess the true incidence of this infection. Pending the outcome of these studies, routine GBS screening and prophylactic antibiotics prior to abortion should be recommended.
Long survival in a pancreatic carcinoma patient with multi-organ toxicities after sintilimab treatment: A case report
Authors: Chen-Xu Ni, Yu Zhao, Hong Qian, Hui Fu, Yu-Ying Yan, Yu-Shuang Qiu, Can-Can Zhou, Fang Huang, Fu-Ming Shen, Dong-Jie Li, Qing Xu
Journal: Front Pharmacol (2023)
Keywords: pd-1, case report, immune-related adverse events, long survival, pancreatic carcinoma
MeSH terms: Case Reports

Pancreatic carcinoma is the leading cause of death among digestive malignancies in China. In particular, there is no breakthrough in prolonging the survival of pancreatic cancer patients with chemical and targeted therapies. Tumor immunotherapy brings opportunities and progress for the treatment of pancreatic cancer. Sintilimab is an innovative PD-1 inhibitor which was reported certain clinical benefits in multi-line treatments of advanced pancreatic cancer with gemcitabine. The combination therapy of PD-1 with gemcitabine plus high-intensity focused ultrasound (HIFU) in pancreatic cancer has not been reported. Here we report a case of a Chinese old patient diagnosed with metastatic pancreatic cancer. Two months after sintilimab treatment, the patient occurred severe immune colitis. The patient was diagnosed with immune ureteritis after 8 months of treatment. The immue-related adverse events (irAEs) refined after timely recognition and correct intervention by the clinician and clinical pharmacist. After first-line treatment of sintilimab plus gemcitabine combined with pancreatic HIFU, the patient achieved a remarkable benefit of 11-month progression-free survival (PFS) and 20-month overall survival (OS). The first-line treatment of sintilimab plus gemcitabine combined with HIFU demonstrates a potential therapeutic effect on metastatic pancreatic carcinoma with tolerable adverse reactions.