OpenMed/multicare-articles huggingface dataset:
Orthodontic Traction of Impacted Canine Using Cantilever
Authors: Cláudia Nakandakari, João Roberto Gonçalves, Daniel Serra Cassano, Taísa Boamorte Raveli, Jonas Bianchi, Dirceu Barnabé Raveli
Journal: Case Rep Dent (2016)

The impaction of the maxillary canines causes relevant aesthetic and functional problems. The multidisciplinary approach to the proper planning and execution of orthodontic traction of the element in question is essential. Many strategies are cited in the literature; among them is the good biomechanical control in order to avoid possible side effects. The aim of this paper is to present a case report in which a superior canine impacted by palatine was pulled out with the aid of the cantilever on the Segmented Arch Technique (SAT) concept. A 14.7-year-old female patient appeared at clinic complaining about the absence of the upper right permanent canine. The proposed treatment prioritized the traction of the upper right canine without changing the occlusion and aesthetics. For this, it only installed the upper fixed appliance (Roth with slot 0.018), opting for SAT in order to minimize unwanted side effects. The use of cantilever to the traction of the upper right canine has enabled an efficient and predictable outcome, because it is of statically determined mechanics.
Magnesium-Based Absorbable Metal Screws for Intra-Articular Fracture Fixation
Authors: Roland Biber, Johannes Pauser, Markus Geßlein, Hermann Josef Bail
Journal: Case Rep Orthop (2016)

MAGNEZIX® (Syntellix AG, Hanover, Germany) is a biodegradable magnesium-based alloy (MgYREZr) which is currently used to manufacture bioabsorbable compression screws. To date, there are very few studies reporting on a limited number of elective foot surgeries using this innovative implant. This case report describes the application of this screw for osteochondral fracture fixation at the humeral capitulum next to a loose radial head prosthesis, which was revised at the same time. The clinical course was uneventful. Degradation of the magnesium alloy did not interfere with fracture healing. Showing an excellent clinical result and free range-of-motion, the contour of the implant was still visible in a one-year follow-up.
Large Vaginal Hematoma in a Puerperium Patient: Treating a Delayed Diagnosis & Management Caused by an Incomplete Clinical Examination
Authors: Sudwita Sinha, Mukta Agarwal, Shruti Singh
Journal: Cureus (2023)
Keywords: delayed diagnosis, incomplete clinical examination, increased morbidity, pelvic hematoma, puerperium
MeSH terms: Case Reports

Here, we report a case where the lack of pelvic examination in a puerperium patient led to a delay in diagnosis and appropriate management of a large posterior vaginal wall hematoma for about a month. The patient had a history of difficult vaginal breech delivery of a macrosomic asphyxiated baby 28 days prior, following which, she started having gradually increasing distension of the abdomen, inability to void urine and pass stools by herself, and a history of fever on and off. Her family members took her to a private hospital for a consultation, where she was examined and assessed. However, a pelvic examination was not done. A CT scan of the abdomen and pelvis showed a large organized hematoma of size 13.6cm×11.1cm×10.5cm with a volume of 802 ml in the pouch of Douglas. Following this report, diagnostic laparoscopy was done on day 10 of puerperium where a large hematoma was seen beneath the peritoneum in the pouch of Douglas without any intraperitoneal collection. As the hematoma was not seen to be expanding, conservative management was done with 5 units of blood transfusion and antibiotic coverage, and the patient was discharged. However, the patient's symptoms were not relieved due to which she presented to us on day 28 of puerperium with the same symptoms. On pelvic examination, purulent, foul-smelling discharge was present in the vagina, and a huge tense bluish bulge was seen in the posterior vaginal wall more towards the right side obliterating the whole vagina. After taking informed consent and with proper pre-operative preparations of laparotomy, the hematoma was drained vaginally, and approximately 1300 ml of blood and clots were removed, following which, the patient had a speedy recovery and relief of her symptoms.
Disseminated Talaromyces marneffei infection after renal transplantation: A case report and literature review
Authors: Liang Xu, Xiuxiu Chen, Xuying Yang, Hongtao Jiang, Jianli Wang, Shaowen Chen, Jian Xu
Journal: Front Cell Infect Microbiol (2023)
Keywords: talaromyces marneffei, antifungal drug, clinical characteristics, prognosis, renal transplantation
MeSH terms: Antifungal Agents / therapeutic use, Kidney Transplantation, Review, Case Reports, Research Support, Non-U.S. Gov't, Adult, Amphotericin B, Humans, Male, Voriconazole, Antifungal Agents, Amphotericin B, Voriconazole, talaromycosis

We reported a 31-year-old man who received renal transplantation for more than 2 years. He was admitted to our hospital on 9 March 2022 due to intermittent diarrhea accompanied by leukopenia for more than 1 month. The patient successively developed high fever, cough, anemia, weight loss, gastrointestinal bleeding, and liver function impairment. Computed tomography (CT) revealed a slight inflammation in the lower lobes of both lungs, enlargement of the lymph nodes in the retroperitoneal and the root of mesenteric areas, and hepatosplenomegaly. Talaromyces marneffei was detected by metagenomics next-generation sequencing (mNGS) in blood and bronchoalveolar lavage fluid, and the pathogen was subsequently verified by blood culture. After endoscopic hemostatic therapy and antifungal therapy with voriconazole and amphotericin B cholesteryl sulfate complex, the patient was successfully discharged. Oral voriconazole was given regularly after discharge. Diarrhea, fever, enlargement of the lymph nodes, and endoscopic evidence of erosion may indicate intestinal T. marneffei infection. Although the mortality of T. marneffei infection after renal transplantation is very high, timely and effective antifungal therapy with amphotericin B cholesteryl sulfate complex is still expected to improve its prognosis.
Case Report: Fading Elk Syndrome in a Herd of Captive Elk ( Cervus elaphus) in the North American Midwest
Authors: Paola M Boggiatto, Lauren S Crawford, Carly Kanipe, Mitchell V Palmer, Steven C Olsen
Journal: Front Vet Sci (2020)
Keywords: ostertagia, case report, elk, fading elk syndrome, ostertagiasis
MeSH terms: Case Reports

Fading elk syndrome, or chronic ill-thrift of elk, is a disease associated with abomasal parasitism with Ostertagia species, of which elk appear to be particularly susceptible. While this syndrome has been extensively reported to affect wapiti-type red deer hybrids farmed in New Zealand since the mid 1980's, there is only a single report of this disease in North America. Here, we report a case of fading elk syndrome in a herd of 34 elk (Cervus elaphus) in Ames, Iowa, at the National Animal Disease Center. Analysis of complete blood counts were unremarkable, but blood chemistry demonstrated a severe hypoalbuminemia. Fecal floatations were also unremarkable, and non-diagnostic. Histological examination of tissues collected at necropsy revealed proliferative abomasitis and nematodes consistent with Ostertagia spp. Anthelmintic treatment consisting of a combination of pour-on Cydectin® and injectable Noromectin Plus®, at double the recommended dose for cattle, showed positive results, as all remaining animals in the herd recovered. The work presented here is the first report of naturally-acquired disease in a herd of captive elk used for research and sheds light on this seldomly-reported disease in North America.
Autoscopic Hallucination in Alcohol Dependence Syndrome: A Rare or Missed Phenomenon?
Authors: Sulochana Joshi, Binita Thapa, Rabi Shakya
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

Autoscopic phenomenon, a psychic illusionary duplication of one's own self, has been the subject of interest in the literature and science for years. It has been reported in various diseases of the central nervous system but with an unknown mechanism. Hallucinations are a common presentation in alcohol dependence syndrome during delirium tremens and as induced disorder. However, autoscopic hallucination has been rarely reported in the cases of alcohol dependence. We present a case of a 40-year-old man who experienced autoscopic hallucination during the withdrawal state of alcohol. He was successfully treated with detoxification and an antipsychotic medication and was doing well. The case highlights the need for strong suspicion and exploration of the autoscopic hallucination and autoscopic phenomenon in general in cases of alcohol dependence syndrome.
Nonmosaic Isodicentric Y Chromosome: A Rare Cause of Azoospermia- From Genetics to Clinical Practice
Authors: Jolijn Van Cauwenberghe, Sigri Beckers, Peter Coremans
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Azoospermia is diagnosed when no spermatozoa can be detected after centrifugation of seminal fluid on at least two separate occasions. A number of genetic disorders can be related to nonobstructive azoospermia, and in up to 15% of azoospermic males, a genetic disorder is diagnosed. A 36-year-old male with nonobstructive azoospermia was referred to our department of diabetes and endocrinology due to an aberrant testicular biopsy. The biopsy showed a disrupted spermatogenesis with a maturation arrest at the spermatocyte level in most tubuli seminiferi while others showed a Sertoli cell-only syndrome. Screening for Y chromosome microdeletions on peripheral blood using molecular analysis detected a terminal deletion of AZFbc. The result of karyotyping and fluorescence in situ hybridization (FISH) described an isodicentric Y chromosome with karyotype 46,X,idic(Y)(q11.22). Based on this case and the current available literature, we conclude that performing a testicular biopsy in patients with a nonmosaic idic(Y)(q) is not meaningful and that the prognosis on infertility is poor. Biological fatherhood is extremely unlikely in these patients, and proper counselling should be provided.
Ain't No Sunshine When She's Gone: Pseudohypoparathyroidism Discovered in an Adult
Authors: C R van Rooijen, M B Kok, S Simsek, F Stam
Journal: Case Rep Endocrinol (2012)
MeSH terms: Case Reports

An 18-year-old negroid woman presented with progressive cramps in both hands. She was Jamaican and had moved to The Netherlands 8 months before. On physical examination Trousseau's sign was positive. Laboratory analysis showed severe hypocalcaemia (1.17 mmol/L) and hyperphosphatemia (2.0 mmol/L). Urinary excretion of both calcium (0.8 mmol/day) and phosphate (5 mmol/day) was low, as is seen in hypoparathyroidism. However, the PTH level was increased (22.1 pmol/L), whereas 25-(OH)-vitamin D was low (31 nmol/L). An Ellsworth-Howard test showed only a fivefold increase in urinary phosphate excretion after administration of synthetic PTH, supporting the diagnosis pseudohypoparathyroidism. Upon treatment with calcium supplementation and alfacalcidol, her symptoms disappeared. Pseudohypoparathyroidism (PHP) is a rare hereditary disorder resembling hypoparathyroidism, although plasma PTH levels are elevated. PHP is caused by alterations in the PTH receptor, inducing target tissue resistance to PTH. This results in hypocalcaemia and hyperphosphatemia, while PTH levels are elevated. The diagnosis is confirmed by the Ellsworth-Howard test, which will show a 100-fold increase in phosphate excretion if the PTH receptor functions properly. Treatment is lifelong supplementation of calcium and alfacalcidol. In our patient, symptoms were probably evoked by the lack of sunlight in Dutch winter, decreasing vitamin D levels and thereby aggravating hypocalcaemia.
Adrenal Venous Sampling in Primary Aldosteronism: The Usefulness of Contralateral Suppression Index
Authors: Natalia Treistman, Aline Barbosa Moraes, Stéphanie Cozzolino, Patrícia de Fatima Dos Santos Teixeira, Leonardo Vieira Neto
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Adrenal venous sampling (AVS) is the gold standard test to differentiate the unilateral from the bilateral form in patients with primary aldosteronism (PA) although it may be a difficult procedure, especially the successful cannulation of the right adrenal vein. In this report, we describe a 49-year-old female patient diagnosed with PA, after investigating resistant hypertension and refractory hypokalemia. Abdominal computed tomography scan revealed a 2.5 cm adenoma on the right adrenal vein. AVS was performed under cosyntropin infusion. Aldosterone and cortisol concentrations were obtained from the right and left adrenal veins and inferior vena cava (IVC). Cortisol on each adrenal vein divided by cortisol on IVC confirmed successful cannulation of the left side only, which makes it impossible to calculate the lateralization index (LI). From the data on the left adrenal vein and IVC, the aldosterone-to-cortisol ratio divided by the IVC aldosterone-to-cortisol ratio was less than 1.0, suggesting that the left adrenal vein was suppressed with the excess aldosterone originating from the contralateral side (contralateral suppression index (CSI)). Right adrenalectomy was performed; postoperative hypoaldosteronism was confirmed. This report highlights the importance of CSI obtained in AVS when technical difficulties occur making it impossible to obtain LI, which is most commonly used to decide between surgical and clinical management of PA.
Endometrial osseous metaplasia complicated by secondary infertility: a case report
Authors: Olalekan Abisola Ajayi, Olufemi Oladipupo Adebawojo, Victor Chimezie Okebalama
Journal: Pan Afr Med J (2021)
Keywords: endometrial osseous metaplasia, case report, hysteroscopy, secondary infertility
MeSH terms: Endometrium / pathology, Infertility, Female / etiology, Ossification, Heterotopic / diagnosis, Case Reports, Abortion, Spontaneous / etiology, Adult, Endometrium / diagnostic imaging, Female, Humans, Hysteroscopy, Metaplasia / diagnosis, Ossification, Heterotopic / complications, Ultrasonography

Endometrial osseous metaplasia is a rare condition in which there is abnormal presence of bone in the endometrium. There is paucity of reported cases of this pathological condition in Africa and it is usually overlooked as a cause of infertility. Pathogenesis is not well understood but mostly occurs following pregnancy. Pathology may be suspected on ultrasound scan where a linear echogenic substance is seen in the endometrium but diagnosis is confirmed by and treated with hysteroscopy. We present a case of a 43-year-old woman with 2 previous miscarriages who presented with secondary infertility. She had an ultrasound scan done which revealed features suggestive of an intra-uterine copper device. She subsequently had hysteroscopy and a bone-like foreign body was found in the endometrium which was removed with the aid of a grasper and later sent for histopathological evaluation for which a subsequent diagnosis of endometrial osseous metaplasia was made. Indeed, endometrial intraosseous metaplasia should be considered an important differential cause of secondary infertility especially in patients with history of previous miscarriage. Confirmatory diagnosis can be made through hysteroscopy and/or histopathologically although the former is now used.
Extensive spinal epidural abscess caused by Staphylococcus epidermidis: A case report and literature review
Authors: Yang-Wei Pi, Yan Gong, Jia-Jia Jiang, De-Jin Zhu, Yue-Xin Tong, Li-Ming Jiang, Dong-Xu Zhao
Journal: Front Surg (2023)
Keywords: antibiotic therapy, drainage, laminectomy, spinal epidural abscess (sea), staphylococcus epidermidis
MeSH terms: Case Reports

Background:
Extensive spinal epidural abscess (SEA) is an exceptional and threatening condition that requires prompt recognition and proper management to avoid potentially disastrous complications. We aimed to find key elements of early diagnosis and rational treatments for extensive SEA.
Case presentation:
A 70-year-old man complained of intense pain in the cervical-thoracic-lumbar spine that radiated to the lower extremity. Laboratory test results revealed a marked increase in all indicators of infection. The spinal magnetic resonance imaging (MRI) revealed a ventral SEA extending from C2 to L4. Owing to the patient's critical condition, laminectomy, drainage, and systemic antibiotic therapy were administered. And the multidrug-resistant Staphylococcus epidermidis was detected in the purulent material from this abscess.
Results:
Postoperative MRI revealed diminished epidural abscess, and the clinical symptoms were dramatically and gradually relieved after two rounds of surgery and systemic antibiotic therapy involving the combination of ceftriaxone, linezolid, and rifampicin.
Conclusions:
A comprehensive emergency assessment based on neck or back pain, neurological dysfunctions, signs of systemic infection, and MRI are important for early diagnosis of extensive SEA. Further, the combination of laminectomy, drainage, and systemic antibiotic therapy may be a rational treatment choice for patients with SEA, especially for extensive abscess or progressive neurological dysfunction.
Combining simulation modeling and stable isotope analyses to reconstruct the last known movements of one of Nature's giants
Authors: Clive N Trueman, Andrew L Jackson, Katharyn S Chadwick, Ellen J Coombs, Laura J Feyrer, Sarah Magozzi, Richard C Sabin, Natalie Cooper
Journal: PeerJ (2019)
Keywords: blue whale, carbon stable isotopes, models, movement, movement models, sclerochronology

The spatial ecology of rare, migratory oceanic animals is difficult to study directly. Where incremental tissues are available, their chemical composition can provide valuable indirect observations of movement and diet. Interpreting the chemical record in incremental tissues can be highly uncertain, however, as multiple mechanisms interact to produce the observed data. Simulation modeling is one approach for considering alternative hypotheses in ecology and can be used to consider the relative likelihood of obtaining an observed record under different combinations of ecological and environmental processes. Here we show how a simulation modeling approach can help to infer movement behaviour based on stable carbon isotope profiles measured in incremental baleen tissues of a blue whale (Balaenoptera musculus). The life history of this particular specimen, which stranded in 1891 in the UK, was selected as a case study due to its cultural significance as part of a permanent display at the Natural History Museum, London. We specifically tested whether measured variations in stable isotope compositions across the analysed baleen plate were more consistent with residency or latitudinal migrations. The measured isotopic record was most closely reproduced with a period of residency in sub-tropical waters for at least a full year followed by three repeated annual migrations between sub-tropical and high latitude regions. The latitudinal migration cycle was interrupted in the year prior to stranding, potentially implying pregnancy and weaning, but isotopic data alone cannot test this hypothesis. Simulation methods can help reveal movement information coded in the biochemical compositions of incremental tissues such as those archived in historic collections, and provides context and inferences that are useful for retrospective studies of animal movement, especially where other sources of individual movement data are sparse or challenging to validate.
Gastric ectopic pancreas mimicking a gastrointestinal stromal tumour: A case report
Authors: Zdravko Štor, Jurij Hanžel
Journal: Int J Surg Case Rep (2018)
Keywords: ectopic pancreas, gastrointestinal stromal tumour, laparoscopic excision, stomach

Introduction:
The diagnosis and management of upper gastrointestinal tract submucosal tumours can be challenging due to the difficulties with adequate pre-operative characterization and tissue sampling.
Presentation of the case:
A 61-year-old female patient underwent esophagogastroduodenoscopy because of epigastric pain and episodic vomiting. A submucosal tumour was found along the greater curvature in the antrum. On endoscopic ultrasound, the mass was suspected to be a gastrointestinal stromal tumour. The patient was referred for laparoscopic excision. The final histopathological examination confirmed an ectopic pancreas, not a gastrointestinal stromal tumour as thought preoperatively.
Discussion:
Despite an adequate pre-operative diagnostic workup with endoscopic ultrasonography, the lesion was misdiagnosed as a gastrointestinal stromal tumour and surgery was performed to excise an ectopic pancreas, essentially a benign lesion.
Conclusion:
The case highlights the absence of firm diagnostic criteria to differentiate submucosal gastric lesions.
Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis
Authors: Hiroki Sato, Kiyoaki Tsukahara, Ray Motohashi, Midori Wakiya, Hiromi Serizawa, Atsushi Kurata
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Background:
Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe.
Methods and results:
We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma.
Conclusions:
All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.