OpenMed/multicare-articles huggingface dataset:
Adolescent Fat Embolism Syndrome after Closed Tibial Shaft Fracture: Treatment with Emergent External Fixation
Authors: Dillon C O'Neill, Graham J Dekeyser, Alexander J Mortensen, Christopher A Makarewich
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Case:
An adolescent male developed fat embolism syndrome 24 hours after sustaining a closed right tibial shaft fracture in a football game. The patient was treated with emergent external fixator application due to declining respiratory and mental status and experienced swift recovery after stabilization. He was treated with an intramedullary nail within 1 week of injury.
Conclusion:
Pediatric fat embolism syndrome is uncommon, and a high index of suspicion is required to facilitate appropriate orthopaedic involvement. External fixation can be performed emergently with minimal fracture manipulation. Rapid provisional fixation appears to have facilitated recovery in this example.
The rare malignancy of the hepatobiliary system: ampullary carcinoid tumor
Authors: Mustafa Ozsoy, Yucel Ozsoy, Aras Emre Canda, Olcay Ak Nalbant, Fatih Haskaraca
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Introduction. Carcinoid tumors are low-grade tumors originating from endoderm and mostly involving the gastrointestinal system. However; they may be seen in any site within the gastrointestinal system. Case Presentation. A 69-year-old female patient. The results of blood tests were observed to be consistent with obstructive jaundice. A mass appearance was not encountered on tomographic examination. Papilla that was tumor-like macroscopically was seen in the second part of the duodenum in diagnostic endoscopy. Pylorus-preserving pancreaticoduodenectomy surgical procedure was applied. On pathological examination of the mass, a tumoral mass was detected in ampulla vateri localization, 1.5 × 1 × 0.8 cm in size, which, in immunohistochemical staining, was evaluated as a neuroendocrine tumor. Also, Metastasis was observed. Conclusion. The rarest type of carcinoid tumor is ampullary located carcinoid tumor, and tumor size is not a reliable indicator for tumor aggressivity in ampullary carcinoid tumors.
A Case of Oral Histoplasmosis Concomitant with Pulmonary Tuberculosis
Authors: Silas Antonio Juvencio de Freitas Filho, Natália Galvão Garcia, Mário César de Souza, Denise Tostes Oliveira
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

The superficial intraoral lesions of histoplasmosis occurring concomitant to tuberculosis, in a 46-year-old man, are reported. The human immunodeficiency virus (HIV) infection test was negative. The immunosuppression caused by tuberculosis in our patient probably had an important role in the development of intraoral lesions of histoplasmosis. Here, we discussed the role of the dentist in the diagnosis of these infectious diseases, highlighting the importance of anamnesis and the histopathology/immunohistochemistry exams.
Isosulfan Blue and Anaphylaxis
Authors: Abin Sajan, Daniel W Griepp, Hazim Hakmi, Amir H Sohail, Jackson Hunt, Michelle Wolf, Zhanna Logman
Journal: Ochsner J (2021)
Keywords: anaphylaxis, contrast, isosulfan blue
MeSH terms: Case Reports

Background: Isosulfan blue dye, or Lymphazurin, is commonly used for sentinel lymph node biopsy during operative procedures for patients with breast cancer. Allergic reactions to Lymphazurin have been reported, ranging from mild dermatologic reactions to severe anaphylaxis. Case Series: We report 2 patients who experienced allergic reaction to Lymphazurin while admitted to our service. We also conducted a literature search for similar cases using national databases. Included studies were limited to retrospective studies, case series, or case reports. Patient characteristics, reaction observed, and hospital course were extracted. Of the patients we report, both had grade 3 anaphylactic reactions requiring vasopressors to achieve hemodynamic stability. One patient required intensive care unit monitoring for 18 hours, and the other required overnight monitoring in the postanesthesia care unit. The literature revealed 29 studies reporting 108 patients with confirmed allergic reactions to Lymphazurin. Including the 2 patients in this series (total study n=110), most reactions were grade 3 (57/110, 51.8%), followed by grade 1 (40/110, 36.4%) and grade 2 (13/110, 11.8%). Among the patients who had individual hospital course reported (n=34), 23 patients required admission to the surgical intensive care unit. Of studies that reported cancellation or progression of surgery after the reaction, the surgical procedure was canceled for 12 of 26 patients (46.1%). Conclusion: Although severe anaphylactic reactions are more commonly reported, mild reactions occur more frequently but are likely underreported. Although no fatalities were reported in the cases included in this review, anaphylactic reactions to Lymphazurin pose significant risks. Operating room personnel should be familiar with potential reactions to recognize and treat them early.
Non-autoimmune subclinical hypothyroidism due to a mutation in TSH receptor: report on two brothers
Authors: Manuela Cerbone, Patrizia Agretti, Giuseppina De Marco, Nicola Improda, Claudio Pignata, Francesca Santamaria, Massimo Tonacchera, Mariacarolina Salerno
Journal: Ital J Pediatr (2013)
MeSH terms: Hypothyroidism / genetics, Mutation, Receptors, Thyrotropin / genetics, Siblings, Case Reports, Biomarkers / blood, Child, Follow-Up Studies, Heterozygote, Humans, Hypothyroidism / diagnosis, Hypothyroidism / drug therapy, Male, Thyroid Function Tests, Thyroxine / therapeutic use, Treatment Outcome, Biomarkers, Receptors, Thyrotropin, Thyroxine

Subclinical hypothyroidism (SH) is a condition characterized by a mild persistent thyroid failure. The main cause is represented by autoimmune thyroiditis, but mutations in genes encoding proteins involved in TSH pathway are thought to be responsible for SH, particularly in cases arising in familial settings. Patients with the syndrome of TSH unresponsiveness may have compensated or overt hypothyroidism with a wide spectrum of clinical and morphological alterations depending on the degree of impairment of TSH-receptor (TSH-R) function. We describe the case of two brothers with non autoimmune SH carrying the same heterozygous mutation in the extracellular domain of TSH-R and presenting with different clinical, biochemical and morphological features. The first one had only a slight persistent elevation of TSH, a normal thyroid ultrasound and did never require l- thyroxine (L-T4) replacement treatment. The second one had a neonatal persistent moderate TSH levels increase associated with a thyroid gland hypoplasia and was treated with L-T4 since the first months of life.These two cases support the recent association of TSH-R mutations inheritance as an autosomal dominant pattern with variable expressivity and suggest that the decision to start replacement therapy in patients with persistent SH due to TSH resistance should be individualized.
Myocarditis Associated with Influenza A H1N1pdm2009
Authors: Akira Ukimura, Hidetoshi Satomi, Yukimasa Ooi, Yumiko Kanzaki
Journal: Influenza Res Treat (2012)

Acute myocarditis is a well-known complication of influenza infection. The frequency of myocardial involvement in influenza infection varies widely, with the clinical severity ranging from asymptomatic to fulminant varieties. The worst cases can result in death due to impaired cardiac function, although such fulminant myocarditis associated with influenza infection is rare, as shown by previous papers. Following the 2009 influenza pandemic, we reported on the clinical features of a cohort of 15 patients in Japan with H1N1pdm2009 myocarditis. In our subsequent survey of the literature for case reports or series of patients with myocarditis associated with H1N1pdm2009, we identified 58 detailed cases. We discuss here the high prevalence of fulminant myocarditis (36/58, 62%) among patients reported to have myocarditis associated with H1N1pdm2009. Mechanical circulatory support was required in 17 of the patients with fulminant myocarditis, 13 of whom recovered. We stress the need for increased awareness of influenza-associated myocarditis; such knowledge will facilitate earlier diagnosis and treatment of this fatal complication during future influenza pandemics.
Transcutaneous Puncture of an Undeflatable Coronary Angioplasty Balloon Catheter
Authors: Gregor Leibundgut, Christian Degen, Florian Riede
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

This case report describes a quick and safe method to successfully retrieve an undeflatable angioplasty balloon via the transradial access site. The article also presents potential mechanisms of contrast media entrapment and bench tests of guidewire-assisted balloon puncture. After successful stent implantation in the proximal right coronary artery in a 74-year-old female patient referred for acute coronary syndrome, the balloon catheter became undeflatable for an unknown reason. Several attempts to burst the balloon in the guide catheter and the aorta failed. After a pullback into the radial artery, the still inflated balloon became stuck again and was unable to be retrieved through the sheath. Finally, transcutaneous puncture and aspiration of contrast media with a 23 gauge syringe needle through the skin in the right forearm allowed deflation and successful removal the balloon.
Acute submandibular sialadenitis-a case report
Authors: Rakhi Chandak, Shirish Degwekar, Manoj Chandak, Shivlal Rawlani
Journal: Case Rep Dent (2012)

Many conditions affect the salivary glands. Acute sialadenitis is infectious or inflammatory disorders of the salivary glands. The exact frequency of submandibular sialadenitis is unclear. The acute conditions more typically involve the parotid and submandibular glands. During an acute inflammatory process, there is swelling of the affected gland, overlying pain, gland tenderness, fever, and on occasion difficulty in opening the mouth. Initial treatment should include rehydration oral antistaphylococcal antibiotic should be started while awaiting culture results. Hygiene and repeated massaging of the gland when tenderness had subsided. The present report describes a case of acute submandibular sialadenitis in a 70-year-old female.
Qualitative Assessment of Longitudinal Changes in Phenocopy Frontotemporal Dementia
Authors: Rozanna Meijboom, Rebecca M E Steketee, Lize C Jiskoot, Esther E Bron, Aad van der Lugt, John C van Swieten, Marion Smits
Journal: Front Neurol (2019)
Keywords: cerebral blood flow, cognition, diffusion tensor imaging, frontotemporal dementia, gray matter, magnetic resonance imaging, perfusion, white matter

Phenocopy frontotemporal dementia (phFTD) shares core characteristics with behavioral variant frontotemporal dementia (bvFTD), yet without associated cognitive deficits and brain abnormalities on conventional magnetic resonance imaging (MRI), and without progression. Using advanced MRI techniques, we previously observed subtle structural and functional brain changes in phFTD similar to bvFTD. The aim of the current study was to follow these as well as cognition in phFTD over time, by means of a descriptive case series. Cognition, gray matter (GM) volume and white matter (WM) microstructure, and perfusion of 6 phFTD patients were qualitatively compared longitudinally (3-years follow-up), and cross-sectionally with baseline data from 9 bvFTD patients and 17 controls. For functional brain changes, arterial spin labeling (ASL) was performed to assess GM perfusion. For structural brain changes, diffusion tensor imaging was performed to assess WM microstructure and T1w imaging to assess GM volume. MRI acquisition was performed at 3T (General Electric, US). Clinical profiles of phFTD cases at follow-up are described. At follow-up phFTD patients showed clinical symptomatology similar to bvFTD, but had a relatively stable clinical profile. Longitudinal qualitative comparisons in phFTD showed some deterioration of language and memory function, a stable pattern of structural brain abnormalities and increased perfusion over time. Additionally, both baseline and follow-up cognitive scores and structural values in phFTD were generally in between those of controls and bvFTD. Although a descriptive case series does not allow for strong conclusions, these observations in a unique longitudinal phFTD patient cohort are suggestive of the notion that phFTD and bvFTD may belong to the same disease spectrum. They may also provide a basis for further longitudinal studies in phFTD, specifically exploring the structural vs. functional brain changes. Such studies are essential for improved insight, accurate diagnosis, and appropriate treatment of phFTD.
Giant Intra-Abdominal Desmoid Tumor in a Young Male without History of Surgery, Trauma, or Familial Adenomatous Polyposis
Authors: Noritoshi Mizuta, Kozo Tsunemi
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Desmoid tumors are rare, monoclonal myofibroblastic neoplasms that occur in the extremities, the trunk, and the abdominal cavity. We present a case that is significant for its rarity and for consideration of its treatment plan. A 17-year-old male reported swelling of his abdomen and abdominal pain. He was referred to our hospital with no history of surgery, trauma, or familial adenomatous polyposis. A large tumor in the abdominal cavity was detected by computed tomography, and surgical resection was performed. The tumor was thought to have developed from the anterior lobe of the transverse colon mesentery. It weighed 5.9 kg. Tumor cells with collagen fibers were observed in histopathological examination, but heteromorphism and the nuclear fission image were not apparent. Immunostaining revealed beta-catenin expression in the tumor cell nucleus. Diagnosis was an intra-abdominal desmoid tumor. Currently, there are no signs of recurrence. In this case, preoperative diagnosis was difficult, but surgery was the optimal treatment according to the symptoms. Desmoid tumors have invasive development and common local recurrence, so sufficient range of resection including normal tissue and strict follow-up are necessary.
Partial ureteropelvic junction disruption after blunt trauma: case report
Authors: Jalal Eddine El Ammari, Youness Ahallal, Mohammed Jamal El Fassi, M Hassan Farih
Journal: Case Rep Urol (2011)
MeSH terms: Case Reports

Partial ureteropelvic junction disruption as a result of blunt trauma is rare and frequently missed by the initial trauma evaluation. Delays in diagnosis have also been associated with significant morbidity. A high index of suspicion should lead to appropriate investigations, and the management will be determined by the severity of the disruption. We present herein a 24-year-old man who was admitted to the Emergency Room with multiple organ injuries caused by a severe blunt trauma. Emergency celiotomy was performed for massive hemoperitoneum and shattered spleen which led to splenectomy. The diagnosis of partial UPJ disruption was missed preoperatively and suspected in CT scan after appearance of flank tender mass. Confirmation was obtained in retrograde ureteropyelography and treated conservatively with indwelling ureteral stent. We present herein an extensive review of the literature to examine the current status of this entity and to determine if improvements could be made in the diagnosis and treatment.
Rehabilitation Evidence-Based Decision-Making: The READ Model
Authors: Iona Novak, Anna Te Velde, Ashleigh Hines, Emma Stanton, Maria Mc Namara, Madison C B Paton, Megan Finch-Edmondson, Catherine Morgan
Journal: Front Rehabil Sci (2021)
Keywords: read model, decision-making, evidence-based, goal-setting, rehabilitation
MeSH terms: Review

Evidence-based practice is the foundation of rehabilitation for maximizing client outcomes. However, an unacceptably high number of ineffective or outdated interventions are still implemented, leading to sub-optimal outcomes for clients. This paper proposes the Rehabilitation Evidence bAsed Decision-Making (READ) Model, a decision-making algorithm for evidence-based decision-making in rehabilitation settings. The READ Model outlines a step-by-step layered process for healthcare professionals to collaboratively set goals, and to select appropriate interventions. The READ Model acknowledges the important multi-layered contributions of client's preferences and values, family supports available, and external environmental factors such as funding, availability of services and access. Healthcare professionals can apply the READ Model to choose interventions that are evidence-based, with an appropriate mode, dose, and with regular review, in order to achieve client's goals. Two case studies are used to demonstrate application of the READ Model: cerebral palsy and autism spectrum disorder. The READ Model applies the four central principles of evidence-based practice and can be applied across multiple rehabilitation settings.
Newborn Screening Saves Lives but Cannot Replace the Need for Clinical Vigilance
Authors: F Neemuchwala, M Taki, E Secord, S Z Nasr
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Newborn screening for cystic fibrosis (CF) enables early diagnosis and treatment leading to improved health outcomes for patients with CF. Although the sensitivity of newborn screening is high, false-negative results can still occur which can be misleading if clinicians are not aware of the clinical presentation of CF. We present a case of a young male with negative newborn screen diagnosed for CF. He was diagnosed at 3 years of age despite having symptoms indicative of CF since infancy. The delayed diagnosis resulted in diffuse lung damage and poor growth.
Case report: Successful treatment of non-bullous lichen planus pemphigoides with dupilumab
Authors: Si-Zhe Li, Ying-Han Xie, Si-Hang Wang, Rou-Yu Fang, Hong-Zhong Jin, Ya-Gang Zuo
Journal: Front Med (Lausanne) (2022)
Keywords: corticosteroid, dupilumab, lichen planus, lichen planus pemphigoids, non-bullous, vaccine
MeSH terms: Case Reports

Lichen planus pemphigoides (LPP) is a rare autoimmune bullous disease, characterized by the coexistence of lichen planus and subepidermal bullae. However, the minority of LPP patients present with papules rather than vesicles or blisters, which is defined as non-bullous LPP. The diagnosis of LPP relies on manifestations, histopathology, serological assay, and direct immunofluorescence of linear disposition of IgG and/or C3 at the basement membrane zone. Up to now, no standard therapeutic strategies have been proposed for the treatment of LPP. Herein, we describe an uncommon non-bullous LPP patient with widespread papules and erythema, probably induced by vaccination. During hospitalization, he had a poor response to the conventional treatment of topical and systemic corticosteroids, and his condition was finally alleviated by the addition of dupilumab. For LPP patients with a traditional medication failure, or who were not suitable for a higher dose of corticosteroids, a combination with dupilumab could be an alternative option.
Risk factors for severe systemic sting reactions in wasp ( Vespula spp.) and honeybee ( Apis mellifera) venom allergic patients
Authors: Danielle Fehr, Sara Micaletto, Thomas Moehr, Peter Schmid-Grendelmeier
Journal: Clin Transl Allergy (2019)
Keywords: allergy, bees, hymenoptera venom, risk factors, wasps

Background:
Hymenoptera stings are a major cause of anaphylaxis. Various risk factors are discussed in literature. This study aims to investigate potential risk factors for severe sting reactions in wasp (Vespula spp.) and honeybee (Apis mellifera) venom allergic patients and analyses the correlation between diagnostic test results and the severity of the allergic reaction.
Methods:
480 patients suffering from wasp or honeybee venom allergy were included in this retrospective case series. Only individuals allergic to Vespula spp. but not to other vespids such as Polistes were considered. The severity of their systemic field sting reaction was analysed with regard to the amount of specific IgE antibodies to whole venom extracts and to major allergens of honeybee and/or wasp venom. Furthermore, the following potential risk factors for severe sting reactions were examined: age, sex, latency time, skin symptoms, baseline serum tryptase levels and the concentration of venom inducing a positive intracutaneous test.
Results:
The two following indicators for severe systemic sting reactions in honeybee and wasp venom allergic patients have been identified: a short latency time and the absence of skin symptoms. The patient's age and baseline serum tryptase levels have been found to positively correlate with the grade of the sting reaction only in individuals allergic to wasp venom. No correlation could be found between the degree of sensitisation and the severity of the allergic reaction. Neither the amount of specific IgE antibodies to whole venom extracts nor to major allergens were significantly associated with the severity of the sting reaction.
Conclusion:
The clinical history is essential for the allergological workup and therapeutic decision on Hymenoptera venom allergies. A short latency time and the absence of skin symptoms are indicators for severe systemic sting reactions, followed by the patient's age and baseline serum tryptase levels.
Biventricular pulsus alternans
Authors: Param Vidwan, George A Stouffer
Journal: Cardiol Res Pract (2009)
MeSH terms: Case Reports

Pulsus alternans is a rare hemodynamic condition characterized by beat-to-beat variability in systolic pressure. It is attributed to variations in stroke volume with alternate cardiac cycles and is typically seen in patients with advanced myopathic conditions. Left ventricular pulsus alternans is rare, and right ventricular pulsus alternans is even less common. There are only a few reports of biventricular pulsus alternans. We report the case of a 62-year-old female with a recent anterior wall myocardial infarction who had biventricular pulsus alternans at the time of cardiac catheterization.
Two different STAT1 gain-of-function mutations lead to diverse IFN-γ-mediated gene expression
Authors: Adi Ovadia, Nigel Sharfe, Cynthia Hawkins, Suzanne Laughlin, Chaim M Roifman
Journal: NPJ Genom Med (2018)
MeSH terms: Case Reports

Signal transducer and activator of transcription 1 (STAT1) regulates multiple biological processes downstream of a variety of cytokine receptors in many cell types. Heterozygous gain-of-function (GOF) mutations in STAT1 have been associated with a diverse phenotype encompassing chronic mucocutaneous candidiasis (CMCC) and declining immunity. There is no clear correlation between STAT1 domain-specific mutations and phenotype, and it remains unclear why GOF mutations in STAT1 result in such a wide spectrum of clinical presentations. To begin exploring this dilemma, we have studied the patterns of gene expression mediated by two different GOF mutations. Analysis of IFN-γ response elements using RNA microarrays in cells transfected with the rare H629Y mutant or the common R274G mutant showed distinct patterns of gene expression. We show here that the impact of GOF mutations in STAT1 is variant-specific. This difference in gene expression may explain the diversity in clinical manifestations experienced by these patients.