OpenMed/multicare-articles huggingface dataset:
Human brucellosis in Portugal-Retrospective analysis of suspected clinical cases of infection from 2009 to 2016
Authors: Ana Pelerito, Rita Cordeiro, Rita Matos, Maria Augusta Santos, Sofia Soeiro, João Santos, Carla Manita, Carla Rio, M Santo, Eleonora Paixão, Alexandra Nunes, Sofia Núncio
Journal: PLoS One (2017)
MeSH terms: Brucellosis / epidemiology, Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Humans, Male, Middle Aged, Portugal / epidemiology, Retrospective Studies, Young Adult

Brucellosis is a zoonosis that is emerging in some regions of the world. Although brucellosis is a disease of obligatory declaration and is not eradicated in Portugal, no prevalence data is available in this country. In this study, we retrospectively analyzed the data available at the Reference Laboratory at the Portuguese National Institute of Health during the past 7 years (2009-2016) in order to get insight into the epidemiological scenario of brucellosis in Portugal. A total of 2313 biological samples from patients with clinical suspicion of brucellosis were subjected to immunological techniques for laboratory diagnosis. From 2010 to 2015, a subset of 259 samples was subjected to molecular methods. According to the available data, 167 out of 2313 (7.2%) samples had positive serology for Brucella spp. and 43 out of 259 samples (16.6%) were positive for B. melitensis by real time PCR, being classified as biovar 1 and 3. This study draws attention to the importance of integrating clinical and laboratory data of human cases in order to increase the efficacy of the response measures in case of outbreaks.
A Case of a Large Intraabdominal Abscess in a Patient with Cirrhosis Misdiagnosed as Spontaneous Bacterial Peritonitis
Authors: Saeed Ali, Abdullah Sohail, Kyle Brown
Journal: Case Reports Hepatol (2022)
MeSH terms: Case Reports

Spontaneous bacterial peritonitis is a known complication of patients with decompensated cirrhosis and ascites. It is differentiated from secondary bacterial peritonitis by the absence of an intraabdominal source of infection. We present a 56-year-old man with alcoholic cirrhosis who underwent multiple paracenteses that yielded fluid with progressively increasing neutrophil counts and several different organisms, recurring despite numerous treatments for SBP. Eventually, a computed tomography (CT) of the abdomen and the pelvis revealed a large intraabdominal abscess (22 × 13 cm) treated with an ultrasound-guided drain and IV antibiotics. Recurrent episodes of SBP despite appropriate antibiotics should raise suspicion for secondary bacterial peritonitis. It is crucial to differentiate SBP from secondary bacterial peritonitis as the mortality of the latter is much higher without prompt treatment. Appropriate antibiotic regimens, prompt surgical treatment, and postoperative care are crucial to improving clinical outcomes in these patients.
A case of laryngeal cancer induced by exposure to asbestos in a construction site supervisor
Authors: Sooyong Roh, Soyong Park, Gyeong Tae, Jaechul Song
Journal: Ann Occup Environ Med (2016)
Keywords: asbestos, construction industry, laryngeal neoplasms, occupational exposure
MeSH terms: Case Reports

Background:
Construction site supervisors are exposed to many chemicals, dusts, and metals including asbestos. Asbestos is a hazardous chemical that is carcinogenic. Laryngeal cancer is not a rare disease in Korea. The most common causes of this disease are tobacco and alcohol, and representative occupational cause is asbestos. However, up to now, no case of laryngeal cancer induced by asbestos has been reported in Korea. In this study, we report such a case in a construction site supervisor.
Case presentation:
A 60-year-old man who had been experiencing hoarseness for 2 months was diagnosed with laryngeal cancer. The pathologic diagnosis was squamous cell carcinoma in situ, based on examination of a biopsy specimen obtained by resection of the lesion. The patient had been exposed to asbestos for 38 years at construction sites where he worked until diagnosed with laryngeal cancer. He had been exposed to asbestos when demolishing buildings and inspecting materials.
Conclusion:
The patient in this case worked with construction materials including asbestos and supervised construction for 38 years, and was thus exposed to asbestos at construction sites. Much of the asbestos was highly concentrated especially during demolition processes. We therefore consider the laryngeal cancer of this patient to be a work-related disease.
Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block
Authors: Ahmed M Habib, Yousef A Fouad, Mahmood O Mekkawy
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Ischemic optic neuropathy (ION) resulting in perioperative vision loss (POVL) is a rare occurrence following nonocular procedures. Bilateral simultaneous anterior ION (AION) is even rarer, and no cases have been reported after central neuraxial block. We report a case of bilateral simultaneous AION, confirmed by multimodal imaging, in a 66-year-old male patient who underwent total knee arthroplasty under epidural anesthesia in which episodes of hypotension-one intraoperatively and one late postoperatively-had occurred. Hypotension is the most common adverse effect to epidural block, and counseling about POVL should extend beyond general anesthesia to include those undergoing procedures with central neuraxial block.
Case report: Huppke-Brendel syndrome in an adult, mistaken for and treated as Wilson disease for 25 years
Authors: Frederik Teicher Kirk, Ditte Emilie Munk, Jakob Ek, Lisbeth Birk Møller, Mette Bendixen Thorup, Erik Hvid Danielsen, Hendrik Vilstrup, Peter Ott, Thomas Damgaard Sandahl
Journal: Front Neurol (2022)
Keywords: huppke-brendel syndrome, slc33a1, wilson disease, case report, copper, neurology, rare disease
MeSH terms: Case Reports

Background:
Huppke-Brendel (HB) syndrome is an autosomal recessive disease caused by variants in the SLC33A1 gene. Since 2012, less than ten patients have been reported, none survived year six. With neurologic involvement and ceruloplasmin deficiency, it may mimic Wilson disease (WD).
Objectives and methods:
We report the first adult patient with HB.
Results:
The patient suffered from moderate intellectual disability, partial hearing loss, spastic ataxia, hypotonia, and unilateral tremor of parkinsonian type. At age 29, she was diagnosed with WD based on neurology, elevated 24H urinary copper, low ceruloplasmin, and pathological 65Cu test. Approximately 25 years later, genetic testing did not support WD or aceruloplasminemia. Full genome sequencing revealed two likely pathogenic variants in SLC33A1 which combined with re-evaluation of neurologic symptoms and MRI suggested the diagnosis of HB.
Conclusion:
Adult patients with HB exist and may be confused with WD. Low ceruloplasmin and the absence of ATP7B variants should raise suspicion.
Lower Extremity Abscess Formation in Premature Infants due to Routine Infant Vaccinations
Authors: Yuhang Sun, Surya N Mundluru, Alice Chu
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Since the introduction of vaccines, the impact of vaccinations has been immeasurable. Under the current immunization guidelines, infants receive the first of their routine infant vaccinations at 2 months of age. While the benefits of routine infant vaccinations in premature infants have been demonstrated, there is relatively little data on the dosing of these vaccines in premature infants. The medical records of two premature infants who developed intramuscular abscesses after receiving their routine infant vaccinations were reviewed. Both patients developed pain in the area of the injection after receiving their vaccinations. Magnetic resonance imaging findings confirmed the formation of an abscess. No other causes of abscess formation were observed. Both patients required surgical intervention and were treated with a course of antibiotics. To our knowledge, this is the first case report to suggest routine vaccinations as a potential cause of abscess formation in premature infants.
Rare congenital absence of tail (anury) and anus (atresia ani) in male camel (Camelus dromedarius) calf
Authors: S Anwar, G N Purohit
Journal: Open Vet J (2012)
Keywords: anury, atresia ani, camel, taillessness
MeSH terms: Case Reports

A one-day old male camel calf was presented to the Al-Qattara Veterinary Hospital with complaints of abdominal straining and lack of defecation. On examination it was found that the calf had no tail, the posterior sacral margin was blunt and the anal opening was absent. The case was diagnosed as congenital anury with atresia ani. The animal was sedated with 0.1 mg/kg of xylazine administered intramuscularly and under local infiltration with 2% lidocaine a circular incision was made at the anal area to create an anal opening. The animal passed plenty of meconium. The cut edges were sutured with horizontal mattress sutures. The animal was administered penicillin and streptomycin for 5 days and had an uneventful recovery. It is reported that congenital anury rarely occurs in one humped camel and accompanied atresia ani can be surgically treated.
Unrecognized Primary Hypoparathyroidism with Severe Hypocalcemia in the Presence of COVID-19 Infection
Authors: Domas Grigoravičius, Laura Šiaulienė, Žydrūnė Visockienė
Journal: Acta Med Litu (2022)
Keywords: covid-19, hypocalcemia, primary hypoparathyroidism
MeSH terms: Case Reports

Primary hypoparathyroidism (PHPT) is a rare disease most commonly caused by surgical parathyroid glands destruction or genetic disorders. PHPT manifestation varies from subclinical to acute or even lethal symptoms. In atypical presentation the signs of hypocalcemia could be missed, and asymptotic chronic hypocalcemia could manifest only in the presence of exacerbated comorbidities, infections, hypomagnesemia or certain medications. We present a case of PHPT with severe hypocalcemia manifesting as seizures and delirium in a presence of COVID-19 infection.
Posterior dislocation of left hip joint with closed fracture of left acetabulum Judet-Letournel type posterior wall, femoral head fracture, management and follow up: A case report
Authors: Ismail Hadisoebroto Dilogo, Uno Surgery Erwin, Andra Hendriarto
Journal: Int J Surg Case Rep (2020)
Keywords: acetabular, case report, dislocation, fracture, hip, posterior
MeSH terms: Case Reports

Introduction:
Traumatic dislocation of the hip is a very severe injury. Posterior hip dislocation can be associated with acetabular fracture, which can ultimately result in a higher incidence of complications.
Case presentation:
We present a case report of 26-year-old men with a motor vehicle accident and suffered a posterior hip dislocation on left hip joint and acetabular fracture with Judet-Letournel type posterior wall and femoral head fracture. This patient was performed closed reduction, however, due to dynamic instability of hip joint, internal Fixation through Kocher Langenback Approach and insertion of Herbert screws for femoral head and acetabular posterior wall fracture and interfragmentary screw for trochanteric osteotomy. The patient was followed up for 2 years and have a painless hip with full hip range of motion.
Discussion:
Posterior wall acetabular fractures sometimes occurs after posterior dislocation of the hip. Posterior wall fragment of the acetabular wall fracture can compromise the stability of the hip joint. The reduction can be maintained by closed means or by operative reduction if there is an obstacle to performed closed reduction or followed by sciatic nerve palsy after closed reduction. The complication of operative reduction is avascular necrosis which compromises the integrity of the femoral head and contributing to posttraumatic osteoarthritis.
Conclusion:
Careful examination of acetabular fracture in posterior hip dislocation is required and failed of closed reduction or instability of hip joint are indications to perform open reduction and internal fixation.
Emergency therapeutic leukapheresis in a case of acute myeloid leukemia M5
Authors: Sudha Ranganathan, Shyamala Sesikeran, Vineet Gupta, Vanajakshi
Journal: Asian J Transfus Sci (2008)
Keywords: emergency, hyperleukocytosis, leukapheresis
MeSH terms: Case Reports

Cell separators in India are routinely used for plateletpheresis, peripheral blood stem cell collections and therapeutic plasma exchange. Therapeutic leukapheresis, particularly as an emergency procedure, has been uncommonly performed and reported. Here, a case of a 53-year-old male, diagnosed with acute myeloid leukemia subtype M5 (AML M5) with hyperleukocytosis, who underwent emergency leukaphereis, is reported. After two procedures, there was a decrease of WBC count by 85%, which enabled cytotoxic therapy to be initiated.
Bilateral jugular vein and sigmoid sinus thrombosis related to an inherited coagulopathy: an unusual presentation
Authors: Ozge Altıntaş, Azize Esra Gürsoy, Gözde Baran, Elnur Mehdi, Talip Asil
Journal: Case Rep Vasc Med (2014)

Internal jugular vein thrombosis (IJVT) is a rare condition associated with malignancy, coagulopathy, and trauma. The optimal management of any IJVT must be individualized and depends on the condition of the patient. Case Presentation. We report the case of a 42-year-old woman with a history of a first trimester spontaneous abortion. Apart from a tension-type headache, she had no neurological symptoms. She reported an incidental diagnosis of right-sided IJVT when she was evaluated for hyperthyroidism ultrasonographically. On ultrasonography, we observed bilateral jugular vein thrombosis. The patient was started on oral warfarin. Seven months later, when she was adequately anticoagulated, she developed a second thrombosis. According to the etiological workup, she had a mutation in the homozygous methylene tetrahydrofolate reductase (MTHFR) gene and reduced protein C levels and activity. Conclusion. This report illustrates an unusual presentation of a rare condition. In this case, the etiology was associated with the coagulopathy, which occurred despite adequate anticoagulation.
Periodontics, Implantology, and Prosthodontics Integrated: The Zenith-Driven Rehabilitation
Authors: Fausto Frizzera, Mateus Tonetto, Guilherme Cabral, Jamil Awad Shibli, Elcio Marcantonio Jr
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

A customized treatment plan is important to reach results that will satisfy the patient providing esthetics, function, and long-term stability. This type of oral rehabilitation requires professionals from different dental specialties where communication is a major key point. Digital Smile Design allows the practitioners to plan and discuss the patient's condition to establish the proper treatment plan, which must be driven by the desired zenith position. The ideal gingival position will guide the professionals and determine the need to perform surgical procedures or orthodontic movement before placing the final restorations. In this article, the zenith-driven concept is discussed and a challenging case is presented with 4-year follow-up where tooth extraction, immediate implant placement, bone regeneration, and a connective tissue graft were performed.
EXPAREL® (Long-Acting Liposomal Bupivacaine) Use for Popliteal Nerve Block in Postoperative Pain Control after Ankle Fracture Fixation
Authors: Patrick Discepola, Mohamed Bouhara, Minho Kwon, Bilal A Siddiqui, Trevor A Whitwell, Swetha Y Sanghvi, Keith D Cook, Ross E Moore, Anna Korban, Jean D Eloy
Journal: Pain Res Manag (2020)
MeSH terms: Anesthetics, Local, Bupivacaine, Nerve Block / methods, Open Fracture Reduction / adverse effects, Pain, Postoperative / prevention & control, Case Reports, Clinical Trial, Ankle Injuries / surgery, Female, Humans, Male, Middle Aged, Open Fracture Reduction / methods, Pain Management / methods, Prospective Studies, Anesthetics, Local, Bupivacaine

EXPAREL® has been used successfully to prolong postoperative pain control when applied as a wound infiltrate. EXPAREL® has not yet been approved for use in regional anesthesia to prolong postoperative pain control. We conducted a clinical case series of 4 patients using EXPAREL® for sciatic blocks via the popliteal fossa approach. Our results suggested that there is a large degree of variability in response to the medication. These inconsistent results and the possibility of bimodal kinetics creating analgesic gaps as seen in two of our patients indicate that more studies with larger sample size are needed to better characterize these phenomena and determine if more consistent results can be obtained in a future clinical trial.
Hepatic mesenchymal hamartoma: An uncommon but important paediatric diagnosis
Authors: Sheree C Gray, Jacobus A Pienaar, Zelia Sofianos, Jacob Varghese, Ilonka Warnich
Journal: SA J Radiol (2020)
Keywords: computed tomography, cystic liver masses, hepatic mesenchymal hamartoma, hepatic tumours, paediatric alfa fetoprotein levels, paediatric population, ultrasound
MeSH terms: Case Reports

Hepatic mesenchymal hamartoma is a rare hepatic tumour seen in the paediatric population. Although this entity has a variable imaging appearance, it has a favourable prognosis if diagnosed and managed correctly. This case presents the ultrasound and computed tomography findings of an 11-month-old patient who presented with a history of progressive abdominal distension and an elevated alfa fetoprotein level on biochemistry. The case describes how a confident perioperative diagnosis could be made on the basis of characteristic imaging features.
Massive Radicular Cyst in the Maxillary Sinus as a Result of Deciduous Molar Tooth Pulp Necrosis
Authors: Damian Chybicki, Małgorzata Lipczyńska-Lewandowska, Monika Ratajek-Gruda, Anna Janas-Naze
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

The article describes a rare case of radicular cyst associated with deciduous right upper molars in a 5 y.o. male patient. The cyst developed asymptomatically in the maxillary sinus, thus causing considerable displacement of both premolar germs. Due to the severity of surgery, the patient was treated under general anesthesia in a one-day surgery system with use of the enucleation method. The extent of the lesion results in necessity of removal of the second premolar germ. Early diagnosis of the lesion would have resulted in a more conservative treatment plan. The purpose of this article is to lay emphasis on the pedodontist's role in early diagnosis of such lesions.
Case report: JAKi and TNFi dual therapy is a potential treatment strategy for difficult-to-treat rheumatoid arthritis
Authors: Jing-Wen Chen, Wen-Shuang Zhang, Chang-Song Lin, Qiang Xu
Journal: Front Immunol (2022)
Keywords: jaki, tnfi, adalimumab, dual therapy, rheumatoid arthritis, tofacitinib
MeSH terms: Antirheumatic Agents / therapeutic use, Arthritis, Rheumatoid / diagnosis, Arthritis, Rheumatoid / drug therapy, Biological Products / therapeutic use, Case Reports, Adalimumab / therapeutic use, Female, Humans, Methotrexate / therapeutic use, Middle Aged, Tumor Necrosis Factor-alpha, Methotrexate, Adalimumab, Biological Products, Antirheumatic Agents, Tumor Necrosis Factor-alpha

Rheumatoid arthritis (RA) is a heterogeneous chronic disease. RA patients should start disease modifying anti-rheumatic drugs (DMARDs) therapy immediately after diagnosis. If first-line treatment with conventional synthetic DMARDs does not relieve the disease, biology and targeted synthetic DMARDs are options for patients. Patients can switch to different types of biological and targeted synthetic DMARDs if remission is not achieved. However, for patients with difficult-to-treat RA, achieving disease stabilization after the failure of multiple biological and targeted synthetic DMARDs is a clinical challenge that needs to be addressed. As distinct cytokine pathways, the benefits and challenges of dual therapy are worth discussing. As the most extensively used biologic DMARDs, adalimumab is an anti-tumor necrosis factor monoclonal antibody used to treat RA. Tofacitinib, as a Janus Kinase inhibitor, is an orally administered targeted synthetic DMARDs that involved in the regulation of immune responses by directly or indirectly inhibiting cytokine pathways. This report describes a successful case of a 48-year-old woman with difficult-to-treat RA who treated with Tofacitinib combined with adalimumab. She had been on glucocorticosteroid for a long time, but had persistent joint pain and fatigue. At more than one year of follow-up, her Disease Activity Score for 28-joint counts based on the erythrocyte sedimentation rate (DAS28-ESR) remained in complete remission, and she discontinued her glucocorticosteroid medications. Also, she did not develop a mycobacterial tuberculosis infection, herpes zoster, and new-onset cardiovascular events.
Survival after Aluminum Phosphide Poisoning in Pregnancy
Authors: Adnane Lahlou, Mohammed Sidayne, Saïd Benlamkaddem, Mohamed Adnane Berdaï, Mustapha Harandou
Journal: Case Rep Emerg Med (2020)
MeSH terms: Case Reports

Intoxication and drug overdose as suicidal attempt are rare in pregnancy. We report here the case of aluminum phosphide poisoning in a pregnant lady through oral and intravaginal administration which was managed with aggressive supportive measures without resorting to extracorporeal life support.
Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature
Authors: Sara Abou Azar, Mohammad Rachad Wehbe, Sarah Jamali, Ali Hallal
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Bezoar-induced small bowel obstruction is a rare entity. It should be highly suspected in patients with gastric hypomotility disorders, psychiatric conditions, prior abdominal or bariatric surgery, or improper intake of medication. Their diagnosis is quite challenging and surgical exploration remains the best treatment of choice to ensure the viability of the small bowel tissue and relieve the obstruction. This is a case of a 48-year-old female with no previous abdominal surgery who presented with acute abdominal pain. The patient's history was remarkable for the daily ingestion of 1.5 teaspoons of Metamucil with minimal amount of water. Computed tomography scan demonstrated dilated small bowel loops and a transition zone at the level of the mid jejunum. On laparoscopy, the patient was found to have a hard mass in the mid jejunum amenable to gentle fragmentation and breakdown. Metamucil bezoars are due to the solidification of psyllium-based substances in the gastrointestinal tract. The usual management of small bowel obstruction induced by a bezoar is exploratory laparotomy with enterotomy and primary anastomosis. Laparoscopic intervention has gained popularity among surgeons with good outcome and lower morbidity. In this unusual case, the small bowel obstruction induced by the Metamucil bezoar was safely treated with laparoscopic fragmentation alone.
Duodenum Inversum: A Rare Cause of Chronic Nausea and Vomiting
Authors: Saurabh Chandan, Ojasvini Choudhry Chandan, Alexander Todd Hewlett
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Duodenum inversum (DI), also known as inverted duodenum or duodenum reflexum, is a congenital malformation in which the third portion of the duodenum, instead of continuing leftward to the ligament of Treitz, reverses direction and travels in a superior, posterior track prior to crossing the midline above the pancreas. We present a case of a 62-year-old woman presenting with chronic nausea and vomiting, subsequently found to have DI.