OpenMed/multicare-articles huggingface dataset:
Posterior urethra rupture: contrast-enhanced computed tomography scan and urethrocystography demonstrations
Authors: Wojciech Marks, S Dawid, J Lasek, Z Witkowski, K Gołąbek-Dropiewska, M Stasiak
Journal: Case Rep Urol (2012)
MeSH terms: Case Reports

In the follow-up study of patients with pelvic fractures, rupture of the posterior urethra is registered in 3-25% of cases (Koraitim et al., 1996). The diagnostic gold standard for the assessment of hemodynamically stable trauma patients is contrast-enhanced CT scan, especially helical CT. Nevertheless, simultaneous suprapubic cystography and ascending urethrograms (the so-called up-and-downogram) are the investigation of choice in assessing the site, severity, and length of urethral injuries. (Carlin and Resnick, 1995) This paper discusses the evaluation and diagnosis of urethral injury in multiple-trauma patient.
Extensive bilateral extraluminal perivascular pulmonary haemorrhage associated with stanford type a aortic dissection
Authors: Angeline Reid, Peter Stride, Jonathan Hunter, Katerina Liew, T Wood, Mostafa Seleem
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We present the case of an 80-year old man with a Stanford Type A dissecting thoracic aortic aneurysm plus the unusual CT finding of extramural haemorrhage along the pulmonary vessels. The clinical and radiological picture has an extremely high mortality.
PEComa: A Perivascular Epithelioid Cell Tumor in the Liver-A Case Report and Review of the Literature
Authors: Faseeh Khaja, Allison Carilli, Said Baidas, Aravindhan Sriharan, Shanedelle Norford
Journal: Case Rep Med (2013)

Perivascular epithelioid cell tumors are soft tissue tumors that can occur in various locations in the body whose incidence is rising. Hepatic PEComas are quite rare and diagnosis involves positivity of Melan-A and HMB45 on immunohistochemistry. Usual treatment is surgery for benign tumors and chemotherapy including mTOR inhibitors for malignant tumors. Here we discuss the radiological and pathological diagnosis, evaluation, and management of a hepatic PEComa. We describe a 51-year-old patient who was diagnosed incidentally after unusual physical exam findings.
Topical Imiquimod for the Treatment of Relapsed Cutaneous Langerhans Cell Histiocytosis after Chemotherapy in an Elderly Patient
Authors: Shinsaku Imashuku, Miyako Kobayashi, Yoichi Nishii, Keisuke Nishimura
Journal: Case Rep Dermatol Med (2018)
MeSH terms: Case Reports

Diagnosis and treatment of Langerhans cell histiocytosis (LCH) in elderly patients are often difficult. We report here a 61-year-old female suffering from a refractory axillary ulcer for nearly a year, whose biopsy revealed LCH. It was also noted that the patient had other cutaneous papulovesicular eruptions of LCH as well as central diabetes insipidus. The patient was first successfully treated with multiagent chemotherapy (cytosine arabinoside/vinblastine/prednisolone). DDAVP also well controlled diabetes insipidus; however, the axillary ulcer and cutaneous LCH relapsed. Thereafter, we found topical imiquimod to be effective in the treatment of relapsed cutaneous LCH lesions.
Community Case Study of Naloxone Distribution by Hospital-Based Harm Reduction Program for People Who Use Drugs in New York City
Authors: Farah Riazi, Wilma Toribio, Emaun Irani, Terence M Hughes, Zina Huxley-Reicher, Elisa McBratney, Trang Vu, Keith Sigel, Jeffrey J Weiss
Journal: Front Sociol (2021)
Keywords: covid-19, naloxone, naloxone training, narcan, opioid education, overdose, overdose education and naloxone distribution, take-home-naloxone

Background: In 2017, The Respectful and Equitable Access to Comprehensive Healthcare (REACH) Program at Mount Sinai Hospital became a registered Opioid Overdose Prevention Program (OOPP) and received funding from the New York City Department of Health and Mental Hygiene to develop a program to provide overdose education and naloxone distribution (OEND) training to at risk population and bystanders. We report on the programmatic quality improvement initiatives conducted. Methods: From April 2017 to December 2020, the REACH OOPP conducted 290 opioid overdose reversal trainings, throughout the Mount Sinai Health System and in multiple other community settings. OEND training was at times offered alone and in other settings alongside Hepatitis C Virus point of care testing. Additionally, a "train the trainer" model was implemented whereby medical students and nurses at outpatient clinics were trained to train others. Results: There were 4235 naloxone kits distributed to 3,906 participants. The training venues included hospital settings (patients and medical staff), public events, substance use programs, educational facilities, homeless prevention programs, faith-based organizations, alternative to incarceration programs, and community-based organizations. We implemented two types of training. During outreach sessions, we utilized one-on-one personalized sessions to train bystanders. When training clinic staff in the "train the trainer" model we utilized a standardized didactic presentation with slides. The two top reasons participants reported for being trained were "Just in case I see someone overdose" (59.3%) and "I'm worried that someone I know will overdose OR that I will overdose" (20.2%). Conclusion: The REACH program at Mount Sinai Hospital developed an effective model to train community bystanders and health care staff by leveraging administrative support and building on broader programmatic initiatives to promote drug user health and stigma-free care for people who use drugs. Hospitals do not currently mandate staff training or keeping naloxone stocked at inpatient units or outpatients clinics posing a challenge when implementing an OEND program in this setting. A recommended policy change needed to decrease overdose deaths is for hospitals to be required to implement systematic naloxone education and access for all health care personal and at risk patients.
Preoperative tumor marking with indocyanine green prior of robotic colorectal resections
Authors: Michael K Konstantinidis, Argyrios Ioannidis, Pantelis Vasiliou, Nikolaos Arkadopoulos, Ioannis S Papanikolaou, Manish Chand, Tom Pampiglione, Dimitrios Karagiannis, Konstantinos Konstantinidis
Journal: Front Surg (2022)
Keywords: colorectal surgery, fluorescent guided surgery, indocyanine green, near-infrared fluorescence imaging system, robotic surgery

This prospective case-series study aimed to assess the usefulness of preoperative colonoscopic marking of colorectal tumors using Indocyanine Green (ICG) fluorescence in patients that underwent robotic surgical colorectal resections. Consecutive patients that were eligible for colorectal resection with intent to cure in a single hospital (Athens Medical Center), from February 2022 to June 2022, were included. ICG solution was injected into the submucosal layer at 2 opposite sites (180 degrees apart) distal to the tumor, without submucosal elevation. Identification of the tumor marking was then performed after switching to near-infrared (NIR) fluorescence mode. During the robotic procedure, qualitative evaluation of fluorescence was performed by the surgical team (primary surgeon, first assistant, second assistant, research fellow). All 10 patients underwent robotic surgical approach and operations included right-sided colectomy (n = 1), left-sided colectomy (n = 6) and low anterior resection (n = 3). Visualisation of this dye with near-infrared light was very clear with bright intensity in all patients when the marking was performed one day prior of surgery. Preoperative tumor marking with ICG was identified intraoperatively in all cases and the techinque was easily reproducible.
Nasal Sinus Tract of Odontogenic Origin: Report of a Case
Authors: Sagar Sareen, Anjani Kumar Pathak, Parth Purwar, Jaya Dixit, Divya Singhal, Isha Sajjanhar, Kopal Goel, Vaibhav Sheel Gupta
Journal: Case Rep Dent (2015)

Extraoral sinus tract often poses a diagnostic challenge to the clinician owing to its rare occurrence and absence of symptoms. The accurate diagnosis and comprehensive management are inevitable as the aetiology of such lesions is often masked and requires holistic approach. The present case report encompasses the management of an extraoral discharging sinus tract at the base of the right nostril in a chronic smoker. The lesion which was earlier diagnosed to be of nonodontogenic origin persisted even after erratic treatment modalities. Our investigations showed the aetiology of sinus tract to be odontogenic. Initially, a five-step program as recommended by the Agency for Health Care Research and Quality was used for smoking cessation followed by root canal therapy (RCT) and surgical management of the sinus tract. The patient has been under stringent follow-up and no reoccurrence has been noted.
Video-laryngoscopy introduction in a Sub-Saharan national teaching hospital: luxury or necessity?
Authors: Traoré Ibrahim Alain, Barro Sié Drissa, Kaboré Flavien, Ilboudo Serge, Traoré Idriss
Journal: Pan Afr Med J (2015)
Keywords: video-laryngoscopy, difficult tracheal intubation, sub-saharan teaching hospital
MeSH terms: Intubation, Intratracheal / methods, Laryngoscopes, Laryngoscopy / methods, Video-Assisted Surgery / methods, Case Reports, Adolescent, Africa South of the Sahara, Burkina Faso, Glottis, Hospitals, Teaching, Humans, Intubation, Intratracheal / instrumentation, Laryngoscopy / instrumentation, Male, Middle Aged

Tracheal intubation using Macintosh blade is the technique of choice for the liberation of airways. It can turn out to be difficult, causing severe complications which can entail the prognosis for survival or the adjournment of the surgical operation. The video-laryngoscope allows a better display of the larynx and a good exposure of the glottis and then making tracheal intubation simpler compared with a conventional laryngoscope. It is little spread in sub-Saharan Africa and more particularly in Burkina Faso because of its high cost. We report our first experiences of use of the video-laryngoscope through two cases of difficult tracheal intubation which had required the adjournment of the interventions. It results that the video-laryngoscope makes tracheal intubation easier even in it's the first use because of the good glottal display which it gives and because its allows apprenticeship easy. Therefore, it is not a luxury to have it in our therapeutic arsenal.
Reconstruction of total lower eyelid defects with the temporoparietal fascial flap
Authors: Simon R Bababeygy, Anne R Kao, Niels C Kokot, Eli L Chang
Journal: Case Rep Ophthalmol Med (2012)

Purpose. To describe the use of the temporoparietal fascial flap (TPF) in the reconstruction of extensive lower eyelid defects in a functioning eye. Methods. We present a surgical case report of a 73-year-old female with melanoma of the left lower eyelid. The lower eyelid was resected, and a composite nasal cartilage-mucosa graft, a skin graft, and a TPF were used to reconstruct the lower eyelid. Results. This achieved reconstruction of the lower eyelid with the protection of the eye and preservation of the visual system function. Conclusion. The TPF serves as a good option for reconstruction of the lower eyelid in a viable functioning globe.
An n=1 Clinical Network Analysis of Symptoms and Treatment in Psychosis
Authors: Maarten Bak, Marjan Drukker, Laila Hasmi, Jim van Os
Journal: PLoS One (2016)
MeSH terms: Antipsychotic Agents / therapeutic use, Clozapine / therapeutic use, Psychotic Disorders / drug therapy, Psychotic Disorders / physiopathology, Case Reports, Antipsychotic Agents / administration & dosage, Clozapine / administration & dosage, Dose-Response Relationship, Drug, Female, Hallucinations / complications, Humans, Middle Aged, Paranoid Disorders / complications, Psychotic Disorders / complications, Psychotic Disorders / psychology, Regression Analysis, Antipsychotic Agents, Clozapine

Introduction:
Dynamic relationships between the symptoms of psychosis can be shown in individual networks of psychopathology. In a single patient, data collected with the Experience Sampling Method (ESM-a method to construct intensive time series of experience and context) can be used to study lagged associations between symptoms in relation to illness severity and pharmacological treatment.
Method:
The patient completed, over the course of 1 year, for 4 days per week, 10 daily assessments scheduled randomly between 10 minutes and 3 hours apart. Five a priori selected symptoms were analysed: 'hearing voices', 'down', 'relaxed', 'paranoia' and 'loss of control'. Regression analysis was performed including current level of one symptom as the dependent variable and all symptoms at the previous assessment (lag) as the independent variables. Resulting regression coefficients were printed in graphs representing a network of symptoms. Network graphs were generated for different levels of severity: stable, impending relapse and full relapse.
Results:
ESM data showed that symptoms varied intensely from moment to moment. Network representations showed meaningful relations between symptoms, e.g. 'down' and 'paranoia' fuelling each other, and 'paranoia' negatively impacting 'relaxed'. During relapse, symptom levels as well as the level of clustering between symptoms markedly increased, indicating qualitative changes in the network. While 'hearing voices' was the most prominent symptom subjectively, the data suggested that a strategic focus on 'paranoia', as the most central symptom, had the potential to bring about changes affecting the whole network.
Conclusion:
Construction of intensive ESM time series in a single patient is feasible and informative, particularly if represented as a network, showing both quantitative and qualitative changes as a function of relapse.
Home Self-Massage Device Necessitates Public Awareness: Vertebral Artery Dissection Associated With a Home Massage Device
Authors: Erum Shariff, Ziyad T Al Ghannam, Fahad A AlDamigh, Abdulhadi G AlGhamdi, Yazan M AlEisawi, Khalid F Aloqalaa, Basil Z Sallout
Journal: Cureus (2023)
Keywords: arterial dissection, massage, posterior circulation stroke, stroke, vertebral artery (va)
MeSH terms: Case Reports

Vertebral artery dissection (VAD) is a common cause of stroke in middle-aged individuals. Patients with VAD usually describe a trivial minor neck trauma preceding the event. Such traumas may be associated with spinal manipulation or sudden movements of the neck. Our case is a 43-year-old lady who presented with a history of sudden-onset dizziness, dysarthria, nausea/vomiting, tinnitus, and imbalance. Two days prior to her presentation, she experienced a new-onset moderate to severe intensity headache along with neck pain. The patient mentioned a first-time use of a home massage device three weeks prior to headache onset. After investigations, the patient was diagnosed with VAD, and treatment was initiated. She was discharged in stable condition. With the recent increased popularity of home massage devices, we report this case to raise awareness about the safe use of massage devices in order to prevent the occurrence of such injuries and complications.
Clinical and molecular evaluations of siblings with "pure" 11q23.3-qter trisomy or reciprocal monosomy due to a familial translocation t (10;11) (q26;q23.3)
Authors: Rongyu Chen, Chuan Li, Bobo Xie, Jin Wang, Xin Fan, Jingsi Luo, Xuyun Hu, Shaoke Chen, Yiping Shen
Journal: Mol Cytogenet (2014)
Keywords: 11q233-qter monosomy, 11q233-qter trisomy, familial translocation, jacobsen syndrome, snp array
MeSH terms: Case Reports

11qter trisomy is rare, mostly occurs in combination with partial monosomy of a terminal segment of another chromosome due to unbalanced segregation of parental translocations. Pure 11qter trisomy is rarer, only five cases have so far been reported. Here we report a family with all four siblings affected with neurodevelopmental disorders and facial dysmorphism. Chromosomal microarray analysis (CMA) identified 11q23.3-qter (15.1 Mb) deletion in one and reciprocal duplication in the other three siblings. Both father and grandfather are balanced translocation (46, XY, t (10;11) (q26;q23)) carriers. The genetic material involved on chromosome 10 is very limited (270 kb). Thus, the pedigree presented rare cases with "pure" 11qter trisomy or reciprocal 11qter monosomy (Jacobsen syndrome), offering a unique opportunity to examine clinical presentations of multiple individuals with identical genomic imbalance. The proband with 11qter monosomy presented with many features of Jacobsen syndrome. The three 11qter trisomy carriers presented with shared craniofacial features including brachycephaly and short philtrum. They are also significant for the following neurodevelopmental and neuropsychiatric defects: intellectual disability, expressive language deficiency, autistic features, auditory hallucination, self-talking and pain insensitivity. To our knowledge, this is the smallest "pure" trisomy 11qter so far reported and this is the first report to describe the neuropsychiatric features of patients with 11qter trisomy. Our observation also revealed dissimilar features in our patients compared with those of previously published trisomy 11qter cases. The pedigree also revealed phenotypic heterogeneity among siblings with identical genomic imbalance.
Ruminococcus gnavus bacteraemia showing morphological diversity on Gram staining: a case report and literature review
Authors: Tatsuya Hioki, Kensuke Kataoka, Yoshikazu Mutoh
Journal: Access Microbiol (2023)
Keywords: gram staining, ruminococcus gnavus, bacteraemia, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry
MeSH terms: Case Reports

Ruminococcus gnavus , a Gram-positive anaerobic coccus, is a common constituent of the human gut microbiota but rarely causes any disease in humans. Herein, we report a case of R. gnavus bacteraemia in an immunocompromised 73-year-old man with sigmoid colon perforation. R. gnavus is usually reported as Gram-positive diplococci or short chains on Gram staining; however, in our patient, a blood isolate showed Gram-positive cocci in long chains, and organisms from an anaerobic subculture showed morphological diversity. This case provides insight into the morphological diversity of R. gnavus , which might help with the recognition of these bacteria in the preliminary identification stage on Gram staining.
New Locked-Wire-Type External Fixator (the Ichi-Fixator) for Fourth and Fifth Carpometacarpal Joint Dislocation
Authors: Satoshi Ichihara, Masao Suzuki, Akira Hara, Toshiya Kudo, Yuichiro Maruyama
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We developed a new fixation method that involves the insertion of two wires and external wire fixation using a metal clamp. The aim of this technique was to increase the stability and rigidity of conventional percutaneous Kirchner wire fixation. Here, we present a patient with dislocation of the fourth and fifth carpometacarpal joints who was satisfactorily treated with closed reduction and percutaneous fixation with a linking external wire fixator (Ichi-Fixator). Operative treatment using the Ichi-Fixator system facilitates anatomical reduction and immediate full mobilization, resulting in good outcomes. The patient could perform all routine activities with normal grip strength and a full range of hand motion without pain. Such a treatment that improves comfort after the operation and may allow an immediate return to work will clearly boost patient satisfaction. Linked external wire-type fixation enables enhanced security of fixation, facilitates postoperative mobilization, and may allow an immediate return to work.
Takotsubo Cardiomyopathy Associated with Polycythemia Vera
Authors: Sijan Basnet, Priya Rajagopalan, Rashmi Dhital, Biswaraj Tharu
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Takotsubo cardiomyopathy is characterized by transient apical ballooning with preserved basal ventricular function triggered by physical or emotional stressors. We present a case of a 75-year-old man referred to our facility for the management of acute myocardial infarction later diagnosed as takotsubo cardiomyopathy. We believe platelet-mediated adrenaline release from massive thrombocytosis might have been the precipitating factor for the pathogenesis of takotsubo cardiomyopathy.
Use of Combined MSAP and NGS Techniques to Identify Differentially Methylated Regions in Somaclones: A Case Study of Two Stable Somatic Wheat Mutants
Authors: Miroslav Baránek, Jana Čechová, Tamas Kovacs, Aleš Eichmeier, Shunli Wang, Jana Raddová, Tomáš Nečas, Xingguo Ye
Journal: PLoS One (2016)
MeSH terms: DNA Methylation / genetics, High-Throughput Nucleotide Sequencing, Mutation, Polymorphism, Genetic, Triticum / genetics, DNA Transposable Elements / genetics, DNA, Plant / genetics, DNA Transposable Elements, DNA, Plant

The appearance of somaclonal variability induced by in vitro cultivation is relatively frequent and can, in some cases, provide a valuable source of new genetic variation for crop improvement. The cause of this phenomenon remains unknown; however, there are a number of reports suggesting that epigenetics, including DNA methylations, are an important factor. In addition to the non-heritable DNA methylation changes caused by transient and reversible stress-responsive gene regulation, recent evidence supports the existence of mitotically and meiotically inherited changes. The induction of phenotypes via stable DNA methylation changes has occasionally great economical value; however, very little is known about the genetic or molecular basis of these phenotypes. We used a novel approach consisting of a standard MSAP analysis followed by deep amplicon sequencing to better understand this phenomenon. Our models included two wheat genotypes, and their somaclones induced using in vitro cultivation with a changed heritable phenotype (shortened stem height and silenced high molecular weight glutenin). Using this novel procedure, we obtained information on the dissimilarity of DNA methylation landscapes between the standard cultivar and its respective somaclones, and we extracted the sequences and genome regions that were differentially methylated between subjects. Transposable elements were identified as the most likely factor for producing changes in somaclone properties. In summary, the novel approach of combining MSAP and NGS is relatively easy and widely applicable, which is a rather unique feature compared with the currently available techniques in the epigenetics field.
Digestive malacoplakia in children: case report
Authors: J Bouguila, K Brahim, M Mokni, K Skandrani, A Harbi, A S Essoussi, L Boughammoura
Journal: ISRN Gastroenterol (2011)
MeSH terms: Case Reports

Malacoplakia is a form of chronic granulomatous inflammatory reaction that rarely affects the pediatric age group. The gastrointestinal system is the second most common site for the occurrence of malacoplakia. We report the case of a 9-year-old girl who was hospitalized for abdominal pain, chronic diarrhea, and rectal hemorrhage. The endoscopic examinations and histopathology confirmed the diagnosis of intestinal malacoplakia. We successfully treated her with oral levofloxacin. This disease does not have any specific clinical or biological signs, and the diagnosis is exclusively based on histology.