OpenMed/multicare-articles huggingface dataset:
Use of domestic tools to downstage the reconstructive ladder in a patient with severe crush and degloving injury: a case report
Authors: Amine El Harti, Komla Séna Amouzou, Mokako Lisenga Jacques, Mehdi Rizk Alaoui, Mounia Diouri
Journal: Pan Afr Med J (2020)
Keywords: africa, covid-19, wound, plastic surgery, trauma
MeSH terms: Betacoronavirus, Coronavirus Infections / epidemiology, Crush Injuries / surgery, Degloving Injuries / surgery, Negative-Pressure Wound Therapy / methods, Pneumonia, Viral / epidemiology, Surgical Flaps / transplantation, Case Reports, Accidents, Traffic, Adolescent, Bandages, Buttocks / injuries, COVID-19, Debridement, Humans, Male, Muscle, Skeletal / injuries, Pandemics, Perineum / injuries, SARS-CoV-2, Thigh / injuries, Wound Healing, Wound Infection / drug therapy, Wound Infection / microbiology

In the COVID-19's crisis, elective surgery and non-emergent cases were postponed; all other procedures have to be minimized. A 17-year male patient with severe crush and degloving injury over the thigh, gluteal, sacral, and perineum areas was admitted to our Department on the 16th of March 2020. The patient presented soft tissue skin and muscle loss. A double Latissimus Dorsi and Anterolateral Thigh free flaps were indicated. However, due to the particular circumstance of the COVID-19 crisis, we applied domestic negative wound therapy (NPWT) using gauzes and wall suction. We obtained suitable granulation tissue after 17 consecutive days with this treatment. The raw area was then covered with an expanded split-thickness skin graft. The wound healed at 95%, and the patient was discharged on 25th of April 2020. He was followed up in an outpatient setting with wound care and physiotherapy. This case showed that in a limited-resource setting, with available wall suction, the domestic NPWT is a versatile tool to promote granulation tissue.
Case report: rare case of infiltration of small lymphocytic B-cell lymphoma in the thyroid gland of female patient with B-cell chronic lymphocytic leukemia (CLL-B/SLL-B)
Authors: Elżbieta Andrysiak-Mamos, Rafał Becht, Elżbieta Sowińska-Przepiera, Jakub Pobłocki, Justyna Syrenicz, Barbara Zdziarska, Katarzyna Karpińska-Kaczmarczyk, Anhelli Syrenicz
Journal: Thyroid Res (2013)
MeSH terms: Case Reports

The article presents a case of 57-year-old woman with the infiltration of rare small lymphocytic B cell lymphoma in the thyroid gland. Initially, the patient was followed-up due to chronic lymphocytic B-cell leukemia diagnosed on the basis of histopathological examination of cervical lymph node. Eight months later, general symptoms occurred along with lymphocytosis and exacerbation of lesions in lymph nodes, and therefore, chemotherapy was started according to COP regimen. After four chemotherapy cycles, further progression of the disease was observed during chemotherapy. Computed tomography (CT) performed at that time showed generalized lymphadenopathy and the presence of an irregular area in left thyroid lobe. On palpation, the thyroid was asymmetrical, with enlarged left lobe and palpable lymph node packages on the left side of the neck. The levels of thyroid hormones and anti-thyroid antibodies were normal. Ultrasound examination of the thyroid gland showed non-homogeneous hypoechogenic structure of the left lobe and complete focal remodeling. Cytological examination of left-lobe lesion obtained during fine needle aspiration biopsy showed multiple small lymphoid cells, suggestive of small lymphocytic lymphoma. To confirm this diagnosis, flow cytometry of the biopsy material sampled from the left lobe was performed showing B cellimmunophenotype: CD19+/CD20+/CD22 dim/FMC-7, CD23+/CD5+, sCD79b-+, CD38-, CD10-, kappa and lambda-/weak reaction. The results of flow cytometry of the thyroid bioptate and blood were nearly identical, confirming leukemic nature of the infiltration in left thyroid lobe. Cytogenetic findings included the presence of 17p deletion (TP53 gene). The patient received immunochemotherapy with alemtuzumab. The progression of the disease occurred in the sixth week of therapy. The treatment was discontinued after 8 weeks due to worsening of patient's general status. The patient died 15 months after the diagnosis.
Management of an Unusual Tracheoesophageal Party Wall Foreign Body
Authors: Kalaiarasi Raja, Sithananda-Kumar Venkatesan, Sivaraman Ganesan, Arun Alexander
Journal: Iran J Otorhinolaryngol (2019)
Keywords: esophagus, foreign body, neck, trachea
MeSH terms: Case Reports

Introduction:
Penetration injury to the neck constitutes 5-10% of all trauma cases. Penetration of a foreign body into the trachea with subsequent impaction into the tracheoesophageal party wall is extremely rare. We present a patient with an unusual penetrating injury of the neck caused by a metallic foreign body embedded into the tracheoesophageal party wall, and its management.
Case report:
A 35-year-old male presented to the emergency department with a history of accidental penetrating injury on his neck, with severe pain and bleeding from the wound entry site. On neck examination, there was an open wound, 0.5 × 0.5 cm in size, in the lower-third anterior aspect of the neck with surrounding neck swelling and tenderness. Computed tomography showed a radio-dense foreign body lodged in the tracheoesophageal party wall at the level of the second and third tracheal rings, which was removed successfully.
Conclusion:
Impacted foreign body following a penetrating wound in the neck needs considerable assessment and appropriate management.
Late onset bipolar disorder due to a lacunar state
Authors: Elena Antelmi, Margherita Fabbri, Lucia Cretella, Maria Guarino, Andrea Stracciari
Journal: Behav Neurol (2014)
MeSH terms: Basal Ganglia Diseases / complications, Bipolar Disorder / etiology, Stroke, Lacunar / complications, Case Reports, Attention, Basal Ganglia Diseases / pathology, Basal Ganglia Diseases / psychology, Bipolar Disorder / pathology, Bipolar Disorder / psychology, Executive Function, Female, Humans, Middle Aged, Neuropsychological Tests, Stroke, Lacunar / pathology, Stroke, Lacunar / psychology

Objective:
To describe a patient with a new onset bipolar disorder (BD) type II, secondary to a lacunar state.
Background:
Poststroke BD is rare and mainly associated with lesion in the prefrontal-striatal-thalamic circuit.
Materials and methods:
A 51-year-old woman came to our attention for a mood disorder of recent onset. At 49, she had suffered acute left-sided limb weakness that improved spontaneously four days later. Arterial hypertension was subsequently diagnosed. After 6 months, she began to suffer from alternating brief periods of expansive and elevated mood with longer periods of depressed mood, with a suicide attempt. We performed extensive laboratory and instrumental investigations, as well as, psychiatric consultation, and a cognitive assessment, which was repeated 9 months later.
Results:
Brain magnetic resonance disclosed leukoaraiosis and a lacunar state of the basal ganglia. Transcranial Doppler showed a patent foramen ovale. A psychiatric consultation led to the diagnosis of BP type II. Neuropsychological evaluation detected deficits in attention/executive functions, verbal fluency, and memory. Nine months later, after specific psychiatric therapy, the psychiatric symptoms were remarkably improved.
Conclusion:
Our case sheds light on the role of the basal ganglia in mood disorders and the importance of ruling out brain injury in late onset BP.
Case Report: A Novel NKX2-5 Mutation in a Family With Congenital Heart Defects, Left Ventricular Non-compaction, Conduction Disease, and Sudden Cardiac Death
Authors: Paula Morlanes-Gracia, Guido Antoniutti, Jorge Alvarez-Rubio, Laura Torres-Juan, Damian Heine-Suñer, Tomás Ripoll-Vera
Journal: Front Cardiovasc Med (2021)
Keywords: nkx2-5, congenital heart disease, genetic, left ventricular non-compaction, sudden cardiac death
MeSH terms: Case Reports

The NKX2-5 gene encodes for a transcription factor crucial for cardiac cell differentiation and proliferation. It was the first gene associated with congenital heart disease (CHD) in humans and has been linked to conduction disorders or cardiomyopathies. However, an overlapping phenotype is not frequent in the literature. We describe a family with a novel missense mutation in the NKX2-5 gene (p.Gln181Pro) with numerous antecedents with atrial septal defect (ASD), left ventricular non-compaction (LVNC), conduction disease, and sudden cardiac death (SCD).
Case Report: PD-1 Inhibitor Is Active in Lung Adenocarcinoma With B Cell Deficiency
Authors: Shumin Yuan, Xiufeng Hu, Yanqiu Zhao, Zibing Wang
Journal: Front Immunol (2020)
Keywords: b cells, pd-1, immune checkpoint inhibitor, immunotherapy, non-small cell lung cancer
MeSH terms: Adenocarcinoma of Lung / drug therapy, Antibodies, Monoclonal, Humanized / administration & dosage, B-Lymphocytes / metabolism, Carcinoma, Non-Small-Cell Lung / drug therapy, Immune Checkpoint Inhibitors / administration & dosage, Lung Neoplasms / drug therapy, Lymphoma, B-Cell, Marginal Zone / drug therapy, Programmed Cell Death 1 Receptor / antagonists & inhibitors, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antineoplastic Agents, Immunological / therapeutic use, Antineoplastic Agents, Phytogenic / therapeutic use, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Bevacizumab / therapeutic use, Carboplatin / therapeutic use, Humans, Immunologic Factors / therapeutic use, Lenalidomide / therapeutic use, Male, Paclitaxel / therapeutic use, Progression-Free Survival, Rituximab / therapeutic use, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Immunological, Antineoplastic Agents, Phytogenic, Immune Checkpoint Inhibitors, Immunologic Factors, PDCD1 protein, human, Programmed Cell Death 1 Receptor, Bevacizumab, Rituximab, sintilimab, Carboplatin, Lenalidomide, Paclitaxel

Introduction:
In murine cancer models, B cells are unnecessary for efficacy of PD-1 inhibitor. However, we do not know whether this applies to clinical settings, especially in patients with non-small-cell lung carcinoma (NSCLC).
Case presentation:
We report on the case of an advanced lung adenocarcinoma patient without oncogenic driver mutations whose disease progressed on second-line bevacizumab-containing chemotherapy regimens. These previous treatments resulted in profound thrombocytopenia and increased number of B cells; both effects were hard to alleviate. The patient was diagnosed with marginal zone B-cell lymphoma by flow cytometry immunophenotyping. After five cycles of rituximab in combination with lenalidomide treatment, the percentage of B cells rapidly declined to undetectable levels and the lymphoma regressed completely. However, because masses in the lung gradually increased, this patient was subsequently treated with a PD-1 inhibitor. The patient's condition stabilized, and the mass shrank to reach partial response, with progression free survival exceeding 15 months and no serious adverse events.
Conclusion:
The present case proves the efficacy of PD-1 inhibitor in metastatic lung adenocarcinoma in the absence of B cells. Immune checkpoint inhibitions are thus a choice for patients with B cell deficiencies, such as X-linked agammaglobulinemia, immunoglobulin deficiencies, and common variable immunodeficiency, diseases that have historically been excluded from clinical trials for oncologic drugs.
Prostatic leiomyoma: a case report
Authors: Soufiane Mellas, Ahmed Amine Bouchikhi, Mohammed-Fadl Tazi, Abdelhak Khallouk, Jalal-Eddin Elammari, Mohammed-Jamal El Fassi, Moulay Hassan Farih
Journal: Case Rep Urol (2012)

Prostatic enlargement due to benign adenomatous hyperplasia is very common in elderly males. However, benign mesenchymal tumors especially true leiomyoma of the prostate are rare. We describe a 68-year-old male presenting a urinary obstruction lasting more than two years. The patient was referred for an acute urinary retention. The clinical examination was normal. The perrectal examination revealed an enlarged prostate without abnormalities. An endoscopic resection was performed. The histopathological examination revealed a benign smooth muscle tumor with absence of glandular hyperplasia; the result was confirmed by immunohistochemistry. Accordingly, the diagnosis of true leiomyoma of the prostate was made.
Hypocellular acute myeloid leukemia with bone marrow necrosis in young patients: two case reports
Authors: Deepali Jain, Tejinder Singh, Naresh Kumar
Journal: J Med Case Rep (2009)

Introduction:
Hypocellular variants of acute myeloid leukemia are very rare and almost always occur in old aged patients. In contrast, hypocellular acute lymphoblastic leukemia usually occurs in children.
Case presentation:
We report two Indian patients with hypocellular acute myeloid leukemia, a 32-year-old woman and a 13-year-old boy. Interestingly, one of the patients also showed bone marrow necrosis.
Conclusion:
Hypocellular acute myeloid leukemia is a rare entity and can affect young individuals. It can be considered as a rare cause of bone marrow necrosis.
Melanocytic Nevus in the External Auditory Canal with Keratin Accumulation
Authors: Junhui Jeong, Kyuin Lee, Hyun Seung Choi
Journal: Case Rep Otolaryngol (2021)
MeSH terms: Case Reports

Nevus is a benign melanocytic neoplasm and the most common type of skin tumor. It may occur anywhere on the skin, but it is rare in the external auditory canal (EAC). We present a case of melanocytic nevus in the EAC with keratin accumulation. In microscopic surgery, the mass was excised completely, and the wax and keratin material medial portion of the EAC behind the mass was removed. In this patient, a melanocytic nevus in the EAC caused symptoms of hearing loss and wax and keratin buildup. For melanocytic nevus in the EAC, excision and pathologic confirmation should be performed if there are symptoms or when malignant transformation is suspected.
Spontaneous Hematoma of the Rectus Sheath: Urgent Embolization with Squidperi Liquid Embolic Device
Authors: Pierluca Torcia, Umberto G Rossi, Silvia Squarza, Maurizio Cariati
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

We treated a 78-year-old female affected by nontraumatic spontaneous rectus sheath hematoma. We decided to perform the embolization with the new liquid agent Squidperi. Complete exclusion of the bleeding vessel was obtained without complications. Its use should be considered for treatment of nontraumatic rectus sheath hematoma.
Two novel mutations identified in an african-american child with chediak-higashi syndrome
Authors: Kerry Morrone, Yanhua Wang, Marjan Huizing, Elie Sutton, James G White, William A Gahl, Karen Moody
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Background. Chediak-Higashi syndrome (CHS) is a rare, autosomal recessive disorder characterized by oculocutaneous albinism, immunodeficiency, coagulopathy and late-onset, progressive neurological dysfunction. It also has an "accelerated phase" characterized by hemophagocytic lymphohistiocytosis (HLH). The disease is caused by mutations in the CHS1/LYST gene located on chromosome 1, which affects lysosome morphology and function. We report the case of an African-American child with CHS in Case. This 16-month old African-American girl presented with fever and lethargy. The proband had pale skin compared to her parents, with light brown eyes, silvery hair and massive hepatosplenomegaly. Her laboratory evaluation was remarkable for pancytopenia, high serum ferritin and an elevated LDH. Bone marrow aspirate revealed large inclusions in granulocytes and erythrophagocytosis consistent with HLH. Genetic evaluation revealed two novel nonsense mutations in the CHS1 gene: c.3622C > T (p.Q1208X) and c.11002G > T (p.E3668X). Conclusions. Our patient is one of the few cases of CHS reported in the African American population. We identified 2 nonsense mutations in the CHS1 gene, the first mutation analysis published of an African-American child with Chediak-Higashi Syndrome. These two mutations predict a severe phenotype and thus identification of these mutations has an important clinical significance in CHS.
Prosthetic Joint Infection due to Mycobacterium avium-intracellulare in a Patient with Rheumatoid Arthritis: A Case Report and Review of the Literature
Authors: Nicholas E Ingraham, Brenton Schneider, Jonathan D Alpern
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Nontuberculous mycobacteria (NTM) are a rare cause of prosthetic joint infections (PJI). However, the prevalence of NTM infections may be increasing with the rise of newer immunosuppressive medications such as biologics. In this case report, we describe a rare complication of immunosuppressive therapies and highlight the complexity of diagnosing and treating PJI due to NTM. The patient is a 79-year-old Caucasian male with a history of severe destructive rheumatoid arthritis on several immunosuppressive agents and right hip osteoarthritis s/p total hip arthroplasty 15 years previously with several complex revisions, presenting with several weeks of worsening right hip and abdominal pain. A right hip CT scan revealed periprosthetic fluid collections. Aspiration of three fluid pockets was AFB smear-positive and grew Mycobacterium avium-intracellulare. The patient was deemed a poor surgical candidate. He underwent a limited I&D and several months of antimycobacterial therapy but clinically deteriorated and opted for hospice care. PJI caused by NTM are rare and difficult to treat. The increased use of biologics and prosthetic joint replacements over the past several decades may increase the risk of PJI due to NTM. A high index of suspicion for NTM in immunosuppressed patients with PJI is needed.
Cardiac Transplantation following Cobalt Cardiomyopathy from Bilateral Metal-on-Metal Hip Replacements
Authors: Peter Szedlak, Amrik Virdi, Paul Cacciottolo, Stephen Shepherd, Stephen Pettit, Florian Falter
Journal: Case Rep Anesthesiol (2022)
MeSH terms: Case Reports

A fifty-two-year-old man underwent heart transplantation at our centre after four years of developing progressive heart failure symptoms due to cobalt toxicity-related cardiomyopathy. Between the ages of forty and forty-two, he underwent bilateral metal-on-metal hip arthroplasties for early onset osteoarthritis. Six years later, he developed increasing fatigue and pericardial effusions. Following a prolonged period of deterioration without a clear cause, the diagnosis of cobalt toxicity-related cardiomyopathy due to cobalt-chromium alloy hip prostheses was eventually made. He underwent bilateral revision hip arthroplasties and was listed for heart transplantation. Metal-on-metal joint replacement is a rare cause of iatrogenic cobalt toxicity. Anaesthetists may encounter patients with unexplained symptoms of heart failure, having a high index of suspicion presenting an opportunity for early diagnosis and intervention before end-stage disease develops.
A Rare Case of Mediastinal Bronchogenic Cyst Infected by Salmonella enteritidis
Authors: Jasleen Kaur, Philip J McDonald, Ravinder D Bhanot, Reda A Awali, Sorabh Dhar, James Rowley
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Bronchogenic cysts are rare congenital malformations which arise from abnormal budding of the primitive tracheobronchial tube and can localize to either the mediastinum or lung parenchyma. They remain clinically silent in most adults unless they become infected or are large enough to compress adjacent structures. Infections involving bronchogenic cysts are often polymicrobial. Gram-positive, Gram-negative, and mycobacterial infections have been reported, though frequently a pathogen is not identified. We present the case of a 46-year-old female with known history of bronchogenic cyst who presented with suspected postobstructive pneumonia. She underwent cyst excision with culture positive for Salmonella enteritidis, an extremely rare finding on review of the literature. The patient recovered following a three-week course of antibiotics for extraintestinal salmonellosis.
Primary Amenorrhea, Aplastic Uterus, and a Functional Vagina: A Rare Case of Mayer-Rokitansky-Küster-Hauser Syndrome
Authors: Gregory W Kirschen, Natalie Semenyuk
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Müllerian agenesis, also known as Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), a failure of female urogenital development, typically results in a completely stenotic or rudimentary dimple vagina, both of which are generally nonfunctional in adulthood without mechanical dilation or surgical reconstruction.
Case:
A 20-year-old Tanner stage V heterosexual woman with normal sexual function since coitarche presented with a chief complaint of primary amenorrhea. She was found to have aplastic uterine buds, absent endometrium/cervix, normal ovaries, and an unusually well-developed lower vagina, a rare presentation of MRKHS. We discuss mechanisms by which the anomaly may have arisen.
Summary & conclusion:
This case thus expands the clinical presentation of MRKHS to include a normal appearing vagina with intact sexual function from first sexual encounter, raising interesting questions about the basic underlying embryology.
Endoscopic resection and topical 5-Fluorouracil as an alternative treatment to craniofacial resection for the management of primary intestinal-type sinonasal adenocarcinoma
Authors: Simon Mackie, Tass Malik, Hisham Khalil
Journal: Minim Invasive Surg (2010)
MeSH terms: Case Reports

Introduction. Intestinal-type adenocarcinoma of the sinonasal tract is very rare and is responsible for less than 4% of tumours of the sinuses. Craniofacial resection has been the mainstay of treatment for many years; however, techniques for endoscopic resection are constantly being developed. Discussion. The use of transnasal endoscopic resection (TER) and topical chemotherapy applications as an alternative to cranio-facial resection (CFR) is discussed. TER offers advantages over CFR in terms of fewer intra-operative complications and an improved cosmetic outcome. Survival and metastatic rates are similar between both procedures. Patients with locally invasive tumours are better managed with CFR. Topical applications of 5-Fluorouracil has been shown to be effective in increasing survival in patients with sino-nasal malignancy. Conclusion. Trans-nasal endoscopic resection and topical 5-Fluorouracil could potentially offer an acceptable alternative treatment to the standard of cranio-facial resection. This should be investigated in trials with a longer followup period than this paper in order to directly compare the two treatment modalities.
May-Thurner Syndrome as a Rare Cause of Paradoxical Embolism in a Patient with Patent Foramen Ovale
Authors: Dominika M Zoltowska, Guramrinder Thind, Yashwant Agrawal, Vishal Gupta, Jagadeesh Kumar Kalavakunta
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

May-Thurner syndrome is an underrecognized anatomical variant that can lead to increased propensity for venous thrombosis in the lower extremities. We present a case of a 67-year-old female who presented with transient ischemic attack. Initial workup including CT scan of the head, MRI scan of the head, and magnetic resonance angiogram of the head and neck was unremarkable. A transthoracic echocardiogram with bubble study was also normal. Subsequently, a transesophageal echocardiogram was performed that revealed a patent foramen ovale with right-to-left shunt. Lower extremity duplex venous ultrasound showed no evidence of deep vein thrombosis. However, magnetic resonance venogram of the pelvis showed compression of the left common iliac vein just after its origin suggestive of May-Thurner syndrome. Hence, May-Thurner syndrome was recognized as the probable source of paradoxical embolism causing transient ischemic attack in this patient.