OpenMed/multicare-articles huggingface dataset:
Pediatric Palatal Fibroma
Authors: Rahul Mishra, Tayyeb S Khan, Tarannum Ajaz, Mamta Agarwal
Journal: Int J Clin Pediatr Dent (2017)
Keywords: oral habits, palatal fibroma, surgical pedodontics
MeSH terms: Case Reports

Fibroma is one of the most common soft tissue benign tumors of the oral cavity. These masses represent hyperplasias instead of true neoplasm, which develop due to irritation to the mucosal tissue resulting in proliferation of the cells. Although so common in the oral cavity, its occurrence on the palate is rare, mainly due to fewer chances of trauma. Here, we report a case of palatal fibroma in a child diagnosed on the basis of clinical, radiological, and histological features. The case represents an extremely rare occurrence as unusual trauma due to thumb sucking seemed to be the only apparent traumatic factor in the palatal region.
How to cite this article:
Mishra R, Khan TS, Ajaz T, Agarwal M. Pediatric Palatal Fibroma. Int J Clin Pediatr Dent 2017; 10(1):96-98.
Anti- N-Methyl-d-Aspartate Receptor Encephalitis in a Patient with Alcoholism: A Rare Case Report
Authors: Yangyang Li, Qiuling Wang, Chuanxin Liu, Yili Wu
Journal: Front Psychiatry (2017)
Keywords: alcoholism, anti-n-methyl-d-aspartate receptor encephalitis, autoimmune encephalitis, differential diagnosis, psychiatric symptoms
MeSH terms: Case Reports

Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis, the most common type of autoimmune encephalitis, is characterized by autoantibodies against NMDA receptor. Patients with anti-NMDAR encephalitis also present with various non-specific symptoms, such as flu-like symptoms, neurological, and psychiatric manifestations. Here, we first reported a rare case of anti-NMDAR encephalitis in a 36-year-old male alcohol abuser. The patient presented with acute psychiatric symptoms with no abnormality in neuroimage examination and laboratory test results. Alcoholism was proposed as the most likely diagnosis. However, stopping alcohol drinking and symptomatic treatment were not effective, and 12 days later, the disease progressed with seizures and unconsciousness. Routine analysis of the cerebrospinal fluid (CSF) showed no abnormality. Importantly, anti-NMDA receptor antibodies were detected in his CSF, indicating that the patient has anti-NMDA receptor encephalitis. Consistently, γ-immunoglobulin therapy dramatically improved symptoms, which further confirmed the diagnosis. As anti-NMDAR encephalitis has no unique clinical characteristic and its psychiatric manifestations may overlap with the alcoholism-associated psychiatric symptoms, precaution should be taken to differentiate anti-NMDAR encephalitis from alcoholism in alcohol abusers.
Motor Recovery After Stroke: From a Vespa Scooter Ride Over the Roman Sampietrini to Focal Muscle Vibration (fMV) Treatment. A 99mTc-HMPAO SPECT and Neurophysiological Case Study
Authors: Massimiliano Toscano, Maria Ricci, Claudia Celletti, Marco Paoloni, Marco Ruggiero, Alessandro Viganò, Tommaso B Jannini, Alberto Altarocca, Mauro Liberatore, Filippo Camerota, Vittorio Di Piero
Journal: Front Neurol (2020)
Keywords: brain plasticity, focal muscle vibration, motor recovery, spinal cord plasticity, stroke
MeSH terms: Case Reports

Focal repetitive muscle vibration (fMV) is a safe and well-tolerated non-invasive brain and peripheral stimulation (NIBS) technique, easy to perform at the bedside, and able to promote the post-stroke motor recovery through conditioning the stroke-related dysfunctional structures and pathways. Here we describe the concurrent cortical and spinal plasticity induced by fMV in a chronic stroke survivor, as assessed with 99mTc-HMPAO SPECT, peripheral nerve stimulation, and gait analysis. A 72-years-old patient was referred to our stroke clinic for a right leg hemiparesis and spasticity resulting from a previous (4 years before) hemorrhagic stroke. He reported a subjective improvement of his right leg's spasticity and dysesthesia that occurred after a30-min ride on a Vespa scooter as a passenger over the Roman Sampietrini (i.e., cubic-shaped cobblestones). Taking into account both the patient's anecdote and the current guidelines that recommend fMV for the treatment of post-stroke spasticity, we then decided to start fMV treatment. 12 fMV sessions (frequency 100 Hz; amplitude range 0.2-0.5 mm, three 10-min daily sessions per week for 4 consecutive weeks) were applied over the quadriceps femoris, triceps surae, and hamstring muscles through a specific commercial device (Cro®System, NEMOCOsrl). A standardized clinical and instrumental evaluation was performed before (T0) the first fMV session and after (T1) the last one. After fMV treatment, we observed a clinically relevant motor and functional improvement, as assessed by comparing the post-treatment changes in the score of the Fugl-Meyer assessment, the Motricity Index score, the gait analysis, and the Ashworth modified scale, with the respective minimal detectable change at the 95% confidence level (MDC95). Data from SPECT and peripheral nerve stimulation supported the evidence of a concurrent brain and spinal plasticity promoted by fMV treatment trough activity-dependent changes in cortical perfusion and motoneuron excitability, respectively. In conclusion, the substrate of post-stroke motor recovery induced by fMV involves a concurrently acting multisite plasticity (i.e., cortical and spinal plasticity). In our patient, operant conditioning of both cortical perfusion and motoneuron excitability throughout a month of fMV treatment was related to a clinically relevant improvement in his strength, step symmetry (with reduced limping), and spasticity.
Implanting CRT via Endo-Cardiac Route When Tricuspid Valve is Metallic
Authors: Mohammad Vahid Jorat, Amir Aslani, Mohammad Hossein Nikoo
Journal: Int Cardiovasc Res J (2014)
Keywords: crt, heart failure, tricuspid valve
MeSH terms: Case Reports

Prosthetic tricuspid valve is an obstacle to implant cardiac devise. Cardiac Resynchronization therapy is one of the most popular therapies for heart failure patients these days. We present this case of prosthetic tricuspid valve and left ventricular dysfunction which we overcome the problem by implanting two leads to coronary sinus branches. Patient improved in few months of follow up.
Case Report: A Unique Case of Pediatric Central Nervous System Embryonal Tumor Harboring the CIC- LEUTX Fusion, Germline NBN Variant and Somatic TSC2 Mutation: Expanding the Spectrum of CIC-Rearranged Neoplasia
Authors: Wanming Hu, Juan Wang, Li Yuan, Xing Zhang, Yuhang Ji, Chao Song, Jing Zeng, Xiaofei Sun
Journal: Front Oncol (2020)
Keywords: cic, leutx, nbn, tsc2, central nervous system embryonal tumor, next generation sequencing
MeSH terms: Case Reports

Central nervous system (CNS) embryonal tumors (WHO grade IV) are a heterogeneous group of rare, poorly differentiated neuroepithelial malignant neoplasms that commonly occur in children, and they have a poor prognosis. The 2016 WHO (World Health Organization) classification of CNS tumors created a major shift in paradigm of the classification of embryonal tumors. However, some cases were still difficult to classify. Further integrative genomic analysis is needed to improve the precise classification, diagnosis and treatment of CNS embryonal tumors. Herein, we firstly report a case of CNS embryonal tumor harboring the pathogenic CIC-LEUTX gene fusion. A 2-year-old male infant presented with a solid cystic mass in the left temporal lobe-basal ganglia and left parietal lobe (maximum diameter, 75 mm) and underwent gross tumor resection. The tumor was classified as a poorly differentiated embryonal neoplasm of neuroectodermal origin that lacked specific features and rosettes. By immunohistochemistry, the tumor cells were strongly positive for synaptophysin, and the Ki67 proliferation index was high (>50%). FISH (Fluorescence in situ hybridization) results indicated no change in the copy number at the 19q13.42 C19MC locus. Next generation sequencing showed a CIC-LEUTX gene fusion, a somatic TSC2 c.G2714A mutation, and a heterozygous germline NBN c.C127T mutation. One month after surgery, there was recurrence of the intracranial tumor (maximum diameter, 55 mm) as well as spinal cord implantation metastasis. The patient received chemotherapy (CTX+CBP+VCR/DDP+VP-16), radiotherapy, and a drug targeting the TSC2 gene (everolimus). At the time of this writing, the patient is alive without evidence of disease for 11 months. This is the first report of the CIC-LEUTX gene fusion in a case of CNS embryonal tumor.
Multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound for tumor localization and verification of resection of all sites of hypermetabolic activity in a case of occult recurrent metastatic melanoma
Authors: Stephen P Povoski, Nathan C Hall, Edward W Martin Jr, Michael J Walker
Journal: World J Surg Oncol (2008)
MeSH terms: Fluorodeoxyglucose F18, Melanoma / diagnosis, Neoplasm Recurrence, Local / diagnosis, Positron-Emission Tomography, Radiopharmaceuticals, Skin Neoplasms / diagnosis, Tomography, X-Ray Computed, Case Reports, Female, Gamma Cameras, Humans, Intraoperative Care, Melanoma / surgery, Middle Aged, Neoplasm Recurrence, Local / surgery, Skin Neoplasms / surgery, Thigh, Treatment Outcome, Whole Body Imaging, Radiopharmaceuticals, Fluorodeoxyglucose F18

Background:
The use of diagnostic 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging for the staging, restaging, and treatment monitoring of melanoma patients has become a well-recognized standard of care. It plays a key role in detecting sites of occult disease and is widely utilized in the medical and surgical planning of such patients. In the current report, we describe an innovative multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound for tumor localization and verification of resection of all sites of hypermetabolic tumor foci in a case of occult recurrent metastatic melanoma.
Case presentation:
This report discusses a case of occult recurrent metastatic melanoma, isolated to three separate sites within the subcutaneous tissues of the left thigh region, which was not clinically apparent but was found on diagnostic restaging whole body 18F-FDG PET/CT scan utilizing an intravenous injection of 14.8 mCi 18F-FDG. Then, on the day of surgery, the patient received an intravenous injection of 12.8 mCi 18F-FDG. A multimodality approach of intraoperative handheld gamma probe detection, intraoperative ultrasound tumor localization, specimen PET/CT imaging, and postoperative PET/CT imaging was utilized for accomplishing and verifying the excision of all three sites of occult recurrent metastatic melanoma within the left thigh region.
Conclusion:
This innovative multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound is promising combined technology for aiding in tumor localization and verification of excision and may ultimately impact positively upon long-term outcome of selected patients.
Primary graft failure associated with epithelial downgrowth: a case report
Authors: Anthony J Aldave, David A Hollander, Bruno Branco, Brooks Crawford, Richard L Abbott
Journal: BMC Ophthalmol (2005)
MeSH terms: Corneal Diseases / etiology, Epithelium, Corneal / pathology, Fuchs' Endothelial Dystrophy / surgery, Graft Rejection / etiology, Keratoplasty, Penetrating, Postoperative Complications, Case Reports, Research Support, Non-U.S. Gov't, Cell Count, Cell Movement, Corneal Diseases / diagnosis, Corneal Diseases / surgery, DNA, Viral / analysis, Descemet Membrane / pathology, Endothelium, Corneal / pathology, Graft Rejection / diagnosis, Graft Rejection / surgery, Humans, Male, Middle Aged, Polymerase Chain Reaction, Reoperation, Simplexvirus / genetics, DNA, Viral

Background:
Epithelial downgrowth is a rare complication of ocular surgery. While the features of epithelial downgrowth following corneal transplantation are well described, its association with primary graft failure has only been reported once previously. We report a case of primary corneal graft failure (PGF) associated with retrocorneal epithelial cell ingrowth.
Case presentation:
A 59 year-old male underwent an uncomplicated penetrating keratoplasty for Fuchs' corneal dystrophy. The patient developed PGF, and a second transplant was performed 5 weeks after the initial surgery. The initial host corneal button and the failed corneal graft were examined with light microscopy. Histopathologic examination of the excised corneal button demonstrated multilaminar epithelial cells on the posterior corneal surface and absence of endothelial cells. DNA extraction and polymerase chain reaction (PCR) for herpes simplex virus (HSV) DNA was performed on the failed corneal graft. Polymerase chain reaction performed on the failed corneal graft was negative for HSV DNA, which has been implicated in selected cases of PGF. Three years following repeat penetrating keratoplasty, there was no evidence of recurrent epithelial ingrowth.
Conclusion:
This is only the second report of PGF associated with epithelialization of the posterior corneal button, which most likely developed subsequent to, instead of causing, the diffuse endothelial cell loss and primary graft failure.
Heat-induced necrosis after bronchial thermoplasty: a new concern?
Authors: Francesco Menzella, Mirco Lusuardi, Carla Galeone, Gloria Montanari, Alberto Cavazza, Nicola Facciolongo
Journal: Allergy Asthma Clin Immunol (2018)
Keywords: bronchial thermoplasty, haemoptysis, necrosis, severe asthma
MeSH terms: Case Reports

Background:
Bronchial thermoplasty (BT) is an endoscopic procedure for the treatment of severe refractory asthma, based on the local airways delivery of radio-frequency at 65 °C. Several controlled clinical studies demonstrated the effectiveness of BT on clinical outcomes, particularly the reduction of asthma exacerbations. During procedure or shortly after, significant but transient respiratory adverse events have been reported.
Case report:
We describe the case of a male, caucasian, 56-year-old, non-smoker patient with non-allergic severe asthma. A few days after the second BT session performed in the left lower lobe, persistent haemoptysis appeared requiring patient hospitalization. A chest CT scan showed mild varicoid bronchiectasis and distal parenchymal infiltrate in the basal anterior segment of the left lower lobe. At fibreoptic bronchoscopy two small nodular neoformations were observed in sub-segmental areas of the same lobe. Histological examination showed mild non-specific inflammation of bronchial mucosa, and some large fragments of peribronchial pulmonary parenchyma with an area of haemorrhagic necrosis. The patient was treated empirically with co-amoxiclav, azithromycin and prednisone. A new chest CT showed a complete resolution of the parenchymal opacity. Finally, the patient underwent the third session of BT, without recurrence of haemoptysis or radiological changes.
Discussion:
Bronchial thermoplasty is a generally safe procedure. To our knowledge this is the first report of necrosis of the treated bronchus and haemoptysis complicating BT after the second session. The pulmonary damage was most likely determined by a thermal shock induced by BT. One hypothesis could be a structural fragility of the treated bronchus, possibly related to bronchiectasis. A technical malfunction of the BT controller or the catheter, causing an excessive energy delivery could not be excluded. Adverse events following BT deserve particular attention but should not discourage clinicians from the application of this promising procedure.
Hemorrhagic Colloid Cyst Presenting with Acute Hydrocephaly
Authors: Reza Akhavan, Behrouz Zandi, Masoud Pezeshki-Rad, Donya Farrokh, Bita Abbasi
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected. Acute hemorrhage in colloid cysts is extremely rare and may present with symptoms of acute increase in the intracranial pressure. Intracystic hemorrhage is very rarely reported as a complication of colloid cyst presenting with paroxysmal symptoms of acute hydrocephaly.
Making a Difference-Positive Effect of Unilateral VIM Gamma Knife Thalamotomy in the Therapy of Tremor in Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS)
Authors: Piotr Alster, Dariusz M Koziorowski, Mirosław Za Bek, Sebastian Dzierzȩcki, Jacek Ma Dry, Karolina Duszyńska-Wa S, Hanna Grygarowicz, Justyna Zielonko, Leszek Królicki, Andrzej Friedman
Journal: Front Neurol (2018)
Keywords: fxtas, gamma knife (gk), radiosurgery, thalamotomy, tremor
MeSH terms: Case Reports

Fragile X Tremor Ataxia Syndrome (FXTAS) is a syndrome based on expansion of the repeats of CGG triplets. The symptoms include action tremor and cerebellar gait ataxia. Additionally symptomatology of FXTAS may be associated to parkinsonism, executive function deficits, dementia, neuropathy and dysautonomia. We present a case of a patient who after 20 year history of progressive tremor and ataxia, was diagnosed after genetic examination as mutation of FXTAS. For the treatment of tremor the patient underwent Gamma Knife (GK) thalamotomy. Reduced tremor on the right side and improvement in everyday activities were observed in the outcome of the treatment. GK thalamotomy, in the context of this patient, did not significantly affect the ataxia.
Effectiveness of convalescent plasma therapy in a patient with severe COVID-19-associated acute kidney injury
Authors: Zachary Z Brener, Adam Brenner
Journal: Clin Nephrol Case Stud (2021)
Keywords: covid-19, sars-cov-2, acute kidney injury, convalescent plasma
MeSH terms: Case Reports

The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly evolved into a global pandemic. Recent findings indicate an increased risk for kidney involvement, including progressive acute kidney injury (AKI) during COVID-19 infection, specifically in critically ill patients, and associated with high mortality rates. As no specific treatment options exist for AKI secondary to COVID-19, intensive care is largely supportive with a frequent need for renal replacement therapy (RRT). Convalescent plasma (CP) has been approved as an emergency investigational drug with clinical benefits in observational studies. We described a first case of a patient with severe COVID-19 and AKI who had remarkable improvement in his respiratory status and in kidney function following CP therapy. Our findings demonstrate important therapeutic implications of effective multimodality therapy including CP when treating patients with COVID-19 and AKI.
An Unusual Presentation of Congenital Lobar Emphysema
Authors: Daniel Arnaud, Joseph Varon, Salim Surani
Journal: Case Rep Pulmonol (2017)
MeSH terms: Case Reports

Congenital lobar emphysema is an uncommon bronchopulmonary malformation characterized by lobar overinflation and accompanying alveolar septum damage that leads to compression atelectasis of the lung parenchyma and displacement of mediastinal structures, with the resultant ventilation-perfusion mismatch. We present a case of a 33-year-old lady with progressive exertional dyspnea. Chest radiograph findings lead to the suspicion of congenital lobar emphysema, which was then confirmed by a computed tomography (CT) scan. This condition is most commonly identified in newborns, with very few cases being reported in adults. Lobectomy remains the treatment of choice and in general has good outcome.
Upper Trunk Brachial Plexus Palsy Following Chiropractic Manipulation
Authors: John Cunningham, Wayne Hoskins, Scott Ferris
Journal: Front Neurol (2016)
Keywords: erb’s palsy, brachial plexus injury, chiropractic, manipulation, upper trunk
MeSH terms: Case Reports

Introduction:
Upper trunk brachial plexus palsy can result from high-energy trauma and has never been reported following spinal manipulation.
Background:
The case is presented of a patient who developed an acute brachial plexus upper trunk palsy following spinal manipulative therapy.
Discussion:
Discussion is made on the incidence of complications following manipulation and recommendations to prospectively capture all serious complications.
Concluding remarks:
Risks exist with spinal manipulative therapy. Neurological injury can occur. Risk assessment and re-examination should occur at every visit. Large rigorous prospective studies are required to identify the true incidence of serious complications resulting from manipulative therapy and the benefit:risk ratio.
Tropheryma whipplei Endocarditis: Case Presentation and Review of the Literature
Authors: Michael McGee, Stephen Brienesse, Brian Chong, Alexander Levendel, Katy Lai
Journal: Open Forum Infect Dis (2018)
Keywords: tropheryma whippeli, whipple’s disease, endocarditis
MeSH terms: Review

Whipple's disease is a rare infective condition, classically presenting with gastrointestinal manifestations. It is increasingly recognized as an important cause of culture-negative endocarditis. We present a case of Whipple's endocarditis presenting with heart failure. A literature review identified 44 publications documenting 169 patients with Whipple's endocarditis. The average age was 57.1 years. There is a clear sex predominance, with 85% of cases being male. Presenting symptoms were primarily articular involvement (52%) and heart failure (41%). In the majority of cases, the diagnosis was made on examination of valvular tissue. Preexisting valvular abnormalities were reported in 21%. The aortic valve was most commonly involved, and multiple valves were involved in 64% and 23% of cases, respectively. Antibiotic therapy was widely varied and included a ceftriaxone, trimethoprim, and sulfamethoxazole combination. The average follow-up was 20 months, and mortality was approximately 24%. Physician awareness is paramount in the diagnosis and management of this rare condition.
Herpes simplex esophagitis in immunocompetent host: a case report
Authors: G Geraci, F Pisello, G Modica, F Li Volsi, M Cajozzo, C Sciumè
Journal: Diagn Ther Endosc (2009)
MeSH terms: Case Reports

Introduction. Herpes simplex esophagitis is well recognized in immunosuppressed subjects, but it is infrequent in immunocompetent patients. We present a case of HSE in a 53-year-old healthy man. Materials and Methods. The patient was admitted with dysphagia, odynophagia, and retrosternal chest pain. An esophagogastroduodenoscopy revealed minute erosive area in distal esophagus and biopsies confirmed esophagitis and findings characteristic of Herpes Simplex Virus infection. Results. The patients was treated with high dose of protonpump inhibitor, sucralfate, and acyclovir, orally, with rapid resolution of symptoms. Discussion. HSV type I is the second most common cause of infectious esophagitis. The majority of symptomatic immunocompetent patients with HSE will present with an acute onset of esophagitis. Endoscopic biopsies from the ulcer edges should be obtained for both histopathology and viral culture. In immunocompetent host, HSE is generally a self-limited condition. Conclusions. HSE should be suspected in case of esophagitis without evident cause, even if the patient is immunocompetent. When the diagnosis of HSE is confirmed, careful history and assessment for an immune disorder such as HIV infection is crucial, to look for underlying immune deficiency.