OpenMed/multicare-articles huggingface dataset:
Good functional outcome evaluation of free vascularized fibular head graft (FVFHG) as treatment after resection of giant cell tumor (GCT) campanacci 3 at proximal humerus: A case report
Authors: Ruksal Saleh, Henry Yurianto, Padlan Pasallo, Astrawinata Guatama, Erich S Subagio
Journal: Int J Surg Case Rep (2019)
Keywords: case report, free vascularized fibular head graft, giant cell tumor, proximal humerus, reconstruction

Introduction:
Giant cell tumor (GCT) is benign aggressive tumors with a high rate of recurrence and capacity to metastasize. Wide resection is the treatment of choice, but this creates a flaw at the proximal end of the humerus. There are various methods exist as the treatment option to fixed this problem.
Presentation of case:
We here present our experience on wide resection and free vascularized autogenous fibula head grafting for GCT at the proximal humerus of a 32 years old male. We performed free vascularized fibular head graft (FVFHG) as a reconstruction method followed by sling procedure and used the long head of biceps tendon. Evaluation of anatomical, functional, and radiological outcomes of this management was performed. After 3 years, the patient has a good outcome.
Discussion:
Free vascularized fibula graft is the most favored as a treatment after resection of a tumor on the proximal humerus. The advantages are can be harvested without many difficulties and rapid healing. In our case, we used a free vascularized fibular head graft (FVFHG) for proximal humerus reconstruction after resection giant cell tumor (GCT) on the right proximal humerus. We use the peroneal artery as vascular pedicle due to well vascularity to the peripheral part of fibula. There is no fibula head reabsorption after three years post-operation.
Conclusion:
FVFHG for reconstruction modality as the treatment after resection of GCT grade Campanacci 3 on proximal humerus shows satisfactory result following long term evaluation.
A Case Report of Implant Fracture of Extensively Porous-Coated, Distally Fixated Cementless Long Stem: Detailed Course of Stem Bending Development
Authors: Tomohiro Mimura
Journal: Case Rep Orthop (2015)

We report the fracture of a cementless long stem in a distally fixated, extensively porous-coated femoral prosthesis used for revisional total hip arthroplasty (THA) 9 years previously in a 48-year-old woman, measuring 58 kg in weight and 155 cm in height. Following resolution of an infection 7 years after the revisional THA, a series of posterior dislocations occurred up until 7 months before sudden stem fracture. Extensive radiographic imaging evidence indicated a gradual progression of bending in the stem, and scanning electron microscope energy dispersive X-ray spectroscopy revealed oxygen in the medial and lateral sections, suspecting in vivo corrosion. We retrospectively examined the detailed course of stem bending development prior to stem fracture. The stem bending immediately after the revisional THA, at the first dislocation, and immediately before the stem fracture was 0°, 1.9°, and 5.2°, respectively. We consider that the cyclic loading with poor proximal bone support, distal fixation, and small diameter were the potential risk of this implant fracture. However, the course of stem bending development suggested that repeated operations and several dislocations might have aggravated the implant fatigue in the present case.
Adult congenital permanent bilateral dislocation of the patella with full knee function: case report and literature review
Authors: Alessandro Bistolfi, Giuseppe Massazza, David Backstein, Stefano Ventura, Raul Cerlon, Maurizio Crova
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Congenital permanent dislocation of the patella is a rare disorder of the knee joint in which the patella is permanently displaced, even in extension and is fixed on the lateral aspect of the femoral condyle. The dislocation is irreducible without surgical techniques. This rare condition is usually detected within the first decade of life, because of inability of active extension in the knee and impaired ability during walking. This report presents an unusual case of a 51-year-old man with bilateral congenital permanent dislocation of the patella. The pathology had never been treated because there were few symptoms. The patient presented with right knee pain caused by a fall on the knee during his work. The right knee was painful on the lateral side and the clinical signs were positive for pathology of the lateral meniscus, confirmed by MRI. The clinical and the imaging findings suggested a lesion of the lateral meniscus as the probable cause of the pain. Therefore we performed a knee arthroscopy, whose intra-operative findings confirmed the MRI findings. During the surgery we performed just a selective arthroscopic meniscectomy, without correcting patella dislocation, because the condition was unusually asymptomatic before the trauma.
Case Report: Primary Thoracic Low-Grade Fibromyxoid Sarcoma in a Young Girl Presenting With Mediastinal Mass Syndrome
Authors: Yat Chi Chan, Amanda N C Kan, Liz Y P Yuen, Innes Y P Wan, Kevin K F Fung, Yiu-Fai Cheung, Karen K Y Leung, Dennis T L Ku, Anthony P Y Liu
Journal: Front Pediatr (2022)
Keywords: rna-sequencing, low-grade fibromyxoid sarcoma, mediastinal syndrome, pediatrics, thoracic tumor
MeSH terms: Case Reports

Low-grade fibromyxoid sarcomas (LGFMSs) are typically adult-onset tumors that arise from the extremities. Here, we report an exceptional case of primary thoracic LGFMS in an 8-year-old girl that resulted in mediastinal syndrome. In reporting this case, we discuss the clinical challenges, role of molecular profiling and review reported cases of pediatric thoracic LGFMSs.
An Evaluation of the Design and Usability of a Novel Robotic Bilateral Arm Rehabilitation Device for Patients with Stroke
Authors: Yu-Cheng Pei, Jean-Lon Chen, Alice M K Wong, Kevin C Tseng
Journal: Front Neurorobot (2017)
Keywords: bilateral movement therapy, rehabilitation device, stroke, upper limb rehabilitation, usability

Study design:
Case series.
Evidence level:
IV (case series).
Introduction:
Robot-assisted therapy for upper limb rehabilitation is an emerging research topic and its design process must integrate engineering, neurological pathophysiology, and clinical needs.
Purpose of the study:
This study developed/evaluated the usefulness of a novel rehabilitation device, the MirrorPath, designed for the upper limb rehabilitation of patients with hemiplegic stroke.
Methods:
The process follows Tseng's methodology for innovative product design and development, namely two stages, device development and usability assessment. During the development process, the design was guided by patients' rehabilitation needs as defined by patients and their therapists. The design applied synchronic movement of the bilateral upper limbs, an approach that is compatible with the bilateral movement therapy and proprioceptive neuromuscular facilitation theories. MirrorPath consists of a robotic device that guides upper limb movement linked to a control module containing software controlling the robotic movement.
Results:
Five healthy subjects were recruited in the pretest, and 4 patients, 4 caregivers, and 4 therapists were recruited in the formal test for usability. All recruited subjects were allocated to the test group, completed the evaluation, and their data were all analyzed. The total system usability scale score obtained from the patients, caregivers, and therapists was 71.8 ± 11.9, indicating a high level of usability and product acceptance.
Discussion and conclusion:
Following a standard development process, we could yield a design that meets clinical needs. This low-cost device provides a feasible platform for carrying out robot-assisted bilateral movement therapy of patients with hemiplegic stroke.
Clinical trial registration:
identifier NCT02698605.
Bouveret's syndrome: case report and review of the literature
Authors: Iliana Doycheva, Alpna Limaye, Amitabh Suman, Christopher E Forsmark, Shahnaz Sultan
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a large gallstone which passes into the duodenal bulb through a cholecystogastric or cholecystoduodenal fistula. Initial attempts at endoscopic retrieval with or without mechanical or extracorporeal lithotripsy should be performed as first-line treatment, though success rates with endoscopic treatment are variable. We describe a case of Bouveret's Syndrome in an elderly patient that was successfully treated with endoscopic extraction combined with mechanical lithotripsy, and review the literature on this uncommon condition.
Histiocytic Sarcoma in a Kidney Transplant Patient: A Case Report and Review of the Literature
Authors: Maressa Pollen, Siraj El Jamal, Jack Lewin, Varsha Manucha
Journal: Case Rep Pathol (2016)

Objective. Histiocytic sarcoma (HS) is an aggressive neoplasm with only limited number of reported series of cases and rare case reports of occurrence as a posttransplant neoplastic disorder. The etiology and pathogenesis of the disease is unknown and the optimal treatment is still under investigation. We describe an unusual case of HS in a patient with a remote history of kidney transplant. Method and Results. A 54-year-old male with a remote history of renal transplantation under maintenance immunosuppression presented with features of sepsis. CT abdomen revealed multiple heterogeneous masses in bilateral native kidneys and liver and enlarged abdominal and retroperitoneal lymph nodes. Viral serology work-up was negative. Needle core biopsy revealed a highly undifferentiated neoplasm comprised of highly atypical large cells with eosinophilic to vacuolated cytoplasm and hemophagocytosis. Extended panel of immunohistochemistry proved histiocytic lineage for the tumor cells. The patient expired 2 weeks following the diagnosis. Conclusion. Our case along with three previously published case reports raised the possibility of HS as a treatment-related neoplasm or a posttransplantation neoplastic disorder in solid organ transplant recipients.
Use of blinatumomab and CAR T-cell therapy in children with relapsed/refractory leukemia: A case series study
Authors: Songmi Wang, Aiguo Liu, Na Wang, Yaqin Wang, Ai Zhang, Li Wang, Wen Yu, Chunrui Li, Yicheng Zhang, Qun Hu
Journal: Front Pediatr (2023)
Keywords: acute leukemia, blinatumomab, chimeric antigen receptor t cells, immunotherapy, pediatric

Background:
The 5-year event-free survival rate for childhood acute lymphoblastic leukemia (ALL) has increased to more than 85%. However, the 5-year overall survival rate in children with relapsed/refractory ALL did not exceed 50%. In the past decade, immunotherapies (such as blinatumomab and chimeric antigen receptor T-cell therapy) were approved for relapsed/refractory B-ALL, transforming the treatment environment for children with relapsed/refractory ALL.
Objective:
This study aimed to explore how immunotherapy can be incorporated into salvage regimens for pediatric patients with relapsed/refractory ALL by retrospectively analyzing the diagnosis and treatment process of seven children with relapsed/refractory leukemia and observing the side effects of the two strategies and long-term survival.
Methods:
The clinical features and treatment responses of patients aged <14 years with relapsed/refractory leukemia who received immunotherapy (including Chimeric Antigen Receptor T cell treatment and blinatumomab) at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between February 2014 and April 2022 were retrospectively analyzed.
Results:
Seven children underwent immunotherapy. Five patients received immunotherapy and sequential allogeneic hematopoietic stem cell transplantation (HSCT), whereas the other two received only immunotherapy. Five patients achieved complete remission (71.4%). None of the patients had severe cytokine release syndrome. However, one developed grade 3 immune effector cell-associated neurotoxicity syndrome with prior leukoencephalopathy. The median follow-up period was 541 days (range, 186-3,180 days). No deaths were related to treatment. Three patients relapsed, two had CD19-negative recurrences, and the third showed CD19 antigen reduction. One patient died after disease progression, whereas the other died of HSCT-related complications. One patient abandoned the treatment after relapse and was lost to follow-up.
Conclusion:
Blinatumomab and CAR T-cell therapy showed excellent remission rates and manageable toxicity in pediatric patients with relapsed/refractory leukemia. However, the duration of the remission was limited. Therefore, further prospective randomized clinical studies should be conducted to improve the long-term efficacy of immunotherapy.
Reversible myocarditis after black widow spider envenomation
Authors: Tarek Dendane, Khalid Abidi, Naoufel Madani, Asmae Benthami, Fatima-Zohra Gueddari, Redoune Abouqal, Amine-Ali Zeggwagh
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Black widow spiders can cause variable clinical scenarios from local damage to very serious conditions including death. Acute myocardial damage is rarely observed and its prognostic significance is not known. We report a rare case of a 35-year-old man who developed an acute myocarditis with cardiogenic pulmonary edema requiring mechanical ventilation caused by black widow spider's envenomation. The patient was previously healthy. The clinical course was associated with systemic and cardiovascular complaints. His electrocardiogram revealed ST-segment elevation with T-wave amplitude. The plasma concentrations of cardiac enzymes were elevated. His first echocardiography showed hypokinesis of the left ventricle (left ventricle ejection fraction 48%). Magnetic resonance imaging showed also focal myocardial injury of the LV. There was progressive improvement in cardiac traces, biochemical and echocardiographical values (second left ventricle ejection fraction increased to 50%). Myocardial involvement after a spider bite is rare and can cause death. The exact mechanism of this myocarditis is unknown. We report a rare case of acute myocarditis with cardiogenic pulmonary edema requiring mechanical ventilation caused by black widow spider's envenomation. We objectively documented progressive clinical and electrical improvement.
Association of CYP2C9∗3 and CYP2C8∗3 Non-Functional Alleles with Ibuprofen-Induced Upper Gastrointestinal Toxicity in a Saudi Patient
Authors: Amina M Bagher
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) widely used to alleviate pain and inflammation. Although it is generally considered safe, common adverse drug reactions of ibuprofen include stomach pain, nausea, and heartburn. It can also cause gastrointestinal (GI) bleeding, especially in individuals with a history of GI ulcers or bleeding disorders. Ibuprofen is predominantly metabolized by the cytochrome P450 (CYP) enzymes CYP2C9 and CYP2C8. Individuals carrying the CYP2C9∗3 or CYP2C8∗3 non-functional alleles have reduced enzyme activities resulting in elevated ibuprofen plasma concentrations and half-life. We presented a case of a 31-year-old Saudi female patient with a history of rheumatoid arthritis (RA) who had taken ibuprofen at 600 mg twice daily for eight weeks. The patient presented to the emergency department with symptoms including nausea, vomiting, severe abdominal pain, and black tarry stools. An emergency esophagogastroduodenoscopy was performed on the patient, which revealed a deep bleeding ulcer measuring 1 × 1 cm in the antrum of the stomach. Laboratory investigations indicated anemia (hemoglobin: 7.21 g/dL and hematocrit: 22.40 g/dl). The patient received intravenous proton pump inhibitors and a packed red blood cell transfusion. Genetic analysis revealed that the patient was a carrier of CYP2C9∗3 and CYP2C8∗3 variant alleles, indicating that the patient is a poor metabolizer for both enzymes. The patient's symptoms improved over the subsequent days, and she was discharged with instructions to avoid NSAIDs. This is the first reported Saudi patient homozygous for CYP2C9∗3 and CYP2C8∗3 variant alleles, which led to ibuprofen-induced upper GI toxicity. This case demonstrates the importance of contemplating CYP2C9 and CYP2C8 genetic variations when administrating NSAIDs like ibuprofen. Careful assessment of the risks and benefits of NSAID therapy in each patient and consideration of alternative pain management strategies must be conducted when appropriate.
Parental gonadossomatic mosaicism in HIVEP2-related intellectual disability and impact on genetic counseling-case report
Authors: Maria Abreu, Tiago Branco, Sónia Figueiroa, Cláudia Falcão Reis
Journal: Front Genet (2023)
Keywords: hivep2, mrd43, case report, genetic counselling, intellectual development disorder
MeSH terms: Case Reports

Intellectual development disorder, autosomal dominant 43 (MRD43) is an autosomal dominant disorder caused by heterozygous mutations in the HIVEP2 gene. In this report, we describe a case of a 4-year-old boy with global development delay, hypotonia, and dysmorphic features, in whom the finding of a heterozygous nonsense pathogenic variant in exon 5 of HIVEP2 [c.2827C>T p. (Arg943*)] through WES established a MRD43 diagnosis. Our patient's phenotype overlaps with other MRD43 descriptions in the literature. Unlike previously reported cases, where the condition was almost invariably de novo, the healthy mother in this case presented mosaicism for the pathogenic variant. Thus, the recurrence risk increased significantly from 1% to up to 50%. The description of a variant inherited for MDR43 is singular in the literature and this description highlights the importance of parental studies for accurate genetic counseling, particularly for family planning.
Scheimpflug topographical changes after Femtosecond LASIK for mixed astigmatism - theoretical aspects and case study
Authors: Bogdana Tabacaru, Horia Tudor Stanca
Journal: Rom J Ophthalmol (2017)
Keywords: corneal topography, femtosecond-lasik, mixed astigmatism, scheimpflug analysis, tangential anterior map
MeSH terms: Astigmatism / surgery, Cornea / pathology, Corneal Topography, Hyperopia / surgery, Keratomileusis, Laser In Situ / methods, Lasers, Excimer / therapeutic use, Case Reports, Astigmatism / physiopathology, Female, Humans, Hyperopia / physiopathology, Refraction, Ocular / physiology, Retrospective Studies, Visual Acuity / physiology, Young Adult

Objective: To evaluate the corneal topographical changes after Femtosecond-LASIK surgery in eyes with mixed astigmatism. Methods: We present the analysis of the corneal Scheimpflug topographies of a patient treated with Femtosecond-LASIK technique for bilateral mixed astigmatism. Results: Three-dimensional reconstruction maps and differential anterior curvature maps were used to demonstrate the ablation profile and its stability in time. Conclusions: Visual and refractive results were very good after surgery, being topographically confirmed by the corneal reshaping which was performed as planned, the achieved ablation being stable during the one-year follow-up period.
Eating disorders in premenstrual dysphoric disorder: a neuroendocrinological pathway to the pathogenesis and treatment of binge eating
Authors: Camilla Lindvall Dahlgren, Erik Qvigstad
Journal: J Eat Disord (2018)
Keywords: bilateral salpingo-oophorectomy, binge eating, gnrh, premenstrual dysphoric disorder, treatment
MeSH terms: Case Reports

Background:
This case report details the presentation, treatment and post-operative outcome of an adult female with co-occurring binge eating disorder and premenstrual dysphoric disorder (PMDD).
Case presentation:
The patient, self-presenting for treatment, reported having struggled with severe, debilitating physical and psychological PMDD symptoms for nearly a decade. After having taken part in a number of unsuccessful first- and second line treatments in primary and secondary care, the patient was referred to tertiary care at the Department of Gynecology at Oslo University Hospital in Norway. Chemical menopause using a gonadotropin-releasing hormone (GnRH) agonist was induced, predicting the desired response (i.e. resolution of PMDD symptoms) to bilateral salpingo-oophorectomy (BSO). At three- and six months post BSO follow-up, the patient reported complete resolution of all reported PMDD symptoms including marked increase in appetite (i.e. hyperphagia), specific food cravings and auxiliary binge eating.
Conclusions:
To our knowledge, this is the first case documenting the recovery from an eating disorder following surgical ovarian suppression. Our findings lend supports to existing studies linking binge eating to hormonal changes in the mid-luteal phase of the menstrual cycle, and may help advance new treatment options for a selected, severely impaired group of females struggling with excessive appetite and binge eating due to fluctuations in ovarian activity.
Incidental Detection of Preputial Calculus in a Patient with Partial Phimosis: Is it as Rare as We Believed?
Authors: Evangelos N Symeonidis, Chrysovalantis Toutziaris, Antonios Katsimantas, Georgios Dimitriadis
Journal: Acta Med Litu (2021)
Keywords: calculi, circumcision, phimosis, poor hygiene, preputial, urolithiasis
MeSH terms: Case Reports

Summary background:
Preputial stone disease is the rarest type of urolithiasis. Adult males with severe phimosis and poor hygiene are mainly affected.
Case presentation:
A 90-year-old male sought treatment for steadily worsening urinary frequency, intermittency, incontinence, and pain at the tip of his penis of 3-days duration. Clinical examination revealed a palpable distended urinary bladder, a partial phimosis and a round, hard on palpation, and partly ulcerative lesion at the tip of the foreskin. A single, 1 cm in maximum diameter stone, was incidentally discovered beneath the prepuce and subsequently removed from the preputial sac. The patient refused further treatment with circumcision, and opted for conservative therapy of benign prostate hyperplasia.
Conclusion:
Personal hygiene remains the cornerstone in the prevention of the preputial calculi formation, while circumcision represents the mainstay of treatment for definite stone removal and elimination of the precipitating causes.