OpenMed/multicare-articles huggingface dataset:
Unmasking the Hidden Culprit: A Coma Mimicry in a Child Bitten by Cobra
Authors: Aphirak Mekmangkonthong, Khanittha Khusiwilai, Sudathip Paticheep, Duangtip Tiacharoen
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

Snake bite is a significant public health concern, particularly in tropical regions. Individuals who are bitten by neurotoxin snake commonly present with ptosis, ophthalmoparesis, muscle weakness, and diminished or absent of deep tendon reflexes. However, accurately determining the occurrence of a snakebite can sometimes be challenging, potentially leading to misdiagnosis. We present the case of a 2-year-old boy with sudden cardiac arrest. Following a brief resuscitation, he had return of spontaneous circulation. Despite normal electroencephalography results, the patient continued to have absence of brainstem reflexes, spontaneous breathing, and movement. Cobra antivenom was promptly initiated based on suspicions of a neurotoxic snakebite, resulting in a rapid recovery of the patient's condition. We proposed that neurotoxin snake envenomation should be considered in patients with sudden cardiac arrest with uncertain cause, particularly in snake endemic areas.
Clinical features in antiglycine receptor antibody-related disease: a case report and update literature review
Authors: Xiaoke Wu, Haifeng Zhang, Mengmeng Shi, Shaokuan Fang
Journal: Front Immunol (2024)
Keywords: antiglycine receptor antibody, autoimmune, epilepsy, progressive encephalomyelitis with rigidity and myoclonus, stiff-person syndrome
MeSH terms: Autoantibodies / blood, Autoantibodies / immunology, Encephalomyelitis / diagnosis, Encephalomyelitis / immunology, Muscle Rigidity / diagnosis, Muscle Rigidity / etiology, Muscle Rigidity / immunology, Receptors, Glycine / immunology, Case Reports, Review, Adult, Humans, Male, Myoclonus / diagnosis, Myoclonus / immunology, Stiff-Person Syndrome / diagnosis, Stiff-Person Syndrome / immunology, Stiff-Person Syndrome / therapy, Young Adult, Receptors, Glycine, Autoantibodies, Progressive Encephalomyelitis with Rigidity

Background and objectives:
Antiglycine receptor (anti-GlyR) antibody mediates multiple immune-related diseases. This study aimed to summarize the clinical features to enhance our understanding of anti-GlyR antibody-related disease.
Methods:
By collecting clinical information from admitted patients positive for glycine receptor (GlyR) antibody, the clinical characteristics of a new patient positive for GlyR antibody were reported in this study. To obtain additional information regarding anti-GlyR antibody-linked illness, clinical data and findings on both newly reported instances in this study and previously published cases were merged and analyzed.
Results:
A new case of anti-GlyR antibody-related progressive encephalomyelitis with rigidity and myoclonus (PERM) was identified in this study. A 20-year-old man with only positive cerebrospinal fluid anti-GlyR antibody had a good prognosis with first-line immunotherapy. The literature review indicated that the common clinical manifestations of anti-GlyR antibody-related disease included PERM or stiff-person syndrome (SPS) (n = 179, 50.1%), epileptic seizure (n = 94, 26.3%), and other neurological disorders (n = 84, 24.5%). Other neurological issues included demyelination, inflammation, cerebellar ataxia and movement disorders, encephalitis, acute psychosis, cognitive impairment or dementia, celiac disease, Parkinson's disease, neuropathic pain and allodynia, steroid-responsive deafness, hemiballism/tics, laryngeal dystonia, and generalized weakness included respiratory muscles. The group of PERM/SPS exhibited a better response to immunotherapy than others.
Conclusions:
The findings suggest the presence of multiple clinical phenotypes in anti-GlyR antibody-related disease. Common clinical phenotypes include PERM, SPS, epileptic seizure, and paraneoplastic disease. Patients with RERM/SPS respond well to immunotherapy.
Combined larynx large cell neuroendocrine and squamous cell carcinoma: a case report
Authors: Juliana Hesse, Leandro Aurélio Liporoni Martins, Leonardo Haddad, Fabio Pupo Ceccon
Journal: Einstein (Sao Paulo) (2023)
MeSH terms: Carcinoma, Squamous Cell / pathology, Carcinoma, Squamous Cell / therapy, Head and Neck Neoplasms / pathology, Laryngeal Neoplasms / pathology, Larynx, Case Reports, Humans, Laryngectomy

Laryngeal cancer ranks third among the most common head and neck neoplasms. The most common histological subtype is squamous cell carcinoma, and neuroendocrine tumors are rare. An even rarer entity is a composite tumor with both these histologies. This case reports a metastatic combined carcinoma of squamous cells and large neuroendocrine cells, presenting favorable response to treatment with a total laryngectomy followed by adjuvant therapy including chemo-, radio-, and immunotherapy.
Ectopic Salivary Gland Found in the Vocal Cord: A Rare Case
Authors: Shori Tajima, Niro Tayama, Fumihiko Matsumoto
Journal: Case Rep Otolaryngol (2024)
MeSH terms: Case Reports

Introduction:
Ectopic salivary gland is rarely found in the vocal cords; only two cases have been reported in the English literature. To the best of our knowledge, this is the third reported case of this anomaly. Case Presentation. A 78-year-old man with hoarseness two years ago visited our department. There were no other symptoms such as cough or sore throat. He had no history of smoking. Laryngeal endoscopic examination revealed a smooth mass in the anterior right vocal cord. We performed surgery under general anesthesia to remove the polyps and improve hoarseness. The histopathological specimen was reported to be salivary gland tissue. We diagnosed ectopic salivary glands of the vocal cord.
Conclusion:
It is necessary to consider the possibility of ectopic salivary glands as mass lesions of the vocal cords. Surgical resection is required and long-term follow-up is necessary after surgery.
Rare Idiopathic Adult Intussusception: A Case Report
Authors: Alexandra Frazier, Raymond Mbah, John T Williams
Journal: Cureus (2024)
Keywords: abdominal pain, adult intussusception, emergency exploratory laparotomy, idiopathic intussusception, intussusception, small bowel intussusception, small bowel obstruction
MeSH terms: Case Reports

Intussusception is highly uncommon in adults, with most cases caused by a pathological lead point that requires surgical resection. This case presentation highlights a rare example of idiopathic intussusception in a young male adult. Our patient is a 23-year-old African American male who presented at the Piedmont Macon Medical Center emergency department in February 2023 with acute-onset severe periumbilical pain, nausea, vomiting, and diarrhea. Computed tomography (CT) imaging was inconclusive, and his diagnosis of an ileo-ileal intussusception in the distal ileum was made during an exploratory (diagnostic) laparoscopy. Based on a visual inspection of the bowel demonstrating no evidence of inflammation, adhesions, lesions, ischemia, or a pathological lead point, manual reduction without resection was indicated. While intussusception is rare in adults, it is an important clinical prognosis that should be carefully considered in the differential diagnosis.
A Rare Infection Post Hyaluronic Acid Injection in the Trochanter: Case Report and Literature Review
Authors: Mohamed Badie Ahmed, Fatima Saoud Al-Mohannadi, Amina Bensaoua, Mansour Binfayed, Abeer Alsherawi
Journal: Aesthet Surg J Open Forum (2024)
MeSH terms: Case Reports

Filler injection has become a commonplace aesthetic procedure. Although the incidence of infection following filler injections is typically low, ranging between 0.04% and 0.2%, the potential consequences can be serious. In this manuscript, we present the case of a 29-year-old female patient who presented to our emergency department after receiving a hyaluronic acid filler injection in the trochanteric area at a private center. She developed signs and symptoms shortly after the procedure, including bilateral hip pain and a fever that persisted for 3 days. Despite initial antibiotic and pain medication treatment, the patient's condition continued to worsen. Incision and drainage were performed, and pus culture revealed profuse Extended Spectrum Beta-Lactamase (ESBL)-producing Serratia marcescens. The patient experienced clinical improvement following the incision and drainage procedure and initiation of antibiotics sensitive to the pathogen. Although rare, S. marcescens infection following filler injections has been reported in 2 previous cases. Therefore, early recognition of infection signs and symptoms is crucial to mitigate the severity of consequences and improve outcomes. Aggressive surgical and medical interventions, such as incision and drainage, debridement, and appropriate antibiotic therapy, may be necessary to achieve a successful outcome.
3D-printed external fixation guide combined with video-assisted thoracoscopic surgery for the treatment of flail chest: a technical report and case series
Authors: Meng Hu, Maolin Sun, Chuanen Bao, Junlong Luo, Longcai Zhuo, Ming Guo
Journal: Front Surg (2023)
Keywords: 3d printing, clinical efficacy, external fixation, flail chest, minimally invasive, thoracoscopy

Background:
Flail chest is a common and serious traumatic condition in thoracic surgery. The treatment of flail chest often includes open reduction and internal fixation, which is relatively traumatic, complicated, and expensive. As three-dimensional (3D) printing technology is widely used in the clinical field, the application of 3D-printed products to chest trauma will become a new treatment option. To date, the use of 3D-printed external fixation guides for flail chests has not been reported. Thus, we aimed to assess the short-term efficacy of a new technology that treated flail chests with an individualized 3D-printed external fixation guide combined with video-assisted thoracoscopic surgery (VATS).
Patients and methods:
A retrospective analysis was performed on patients with flail chest treated with this new technique at our center from January 2020 to December 2022. The following parameters were included: operative time, thoracic tube extraction time, intensive care unit time, thoracic volume recovery rate, visual analog scale score 1 month postoperatively, and postoperative complication rate. All patients were followed up for at least 3 months.
Results:
Five patients (mean age: 45.7 years) were enrolled; they successfully underwent surgery without chest wall deformity and quickly returned to daily life. The average number of rib fractures was 8.4; all patients had lung contusion, hemopneumothorax, and anomalous respiration. The abnormal breathing of all patients was completely corrected on postoperative day 1, and the chest wall was stable. One case experienced mild loosening of the 3D-printed guide postoperatively; however, the overall stability was not affected. The other four cases did not experience such loosening because we replaced the ordinary silk wire with a steel wire. All cases were discharged from the hospital 2 weeks postoperatively and returned to normal life 1 month after the removal of the 3D-printed guide on average. Only one case developed a superficial wound infection postoperatively, and no perioperative death occurred.
Conclusions:
The 3D-printed external fixation guide combined with video-assisted thoracoscopic surgery is a novel technique in the treatment of flail chest and is safe, effective, feasible, and minimally invasive, with satisfactory clinical efficacy.
OSTEOCHONDRITIS DISSECANS OF THE HIP IN LEGG-CALVÉ-PERTHES DISEASE: CASE REPORT AND REVIEW
Authors: Luiz Renato Agrizzi de Angeli, Bárbara Lívia Corrêa Serafim, Felippi Guizardi Cordeiro, Felipe Spinelli Bessa, Daniel Augusto Carvalho Maranho
Journal: Acta Ortop Bras (2024)
Keywords: growth and development, growth plate, legg-calve-perthes disease, orthopedic procedures, orthopedics, osteochondritis dissecans
MeSH terms: Case Reports

Introduction:
Legg-Calvé-Perthes disease (LCPD) is the idiopathic osteonecrosis of the capital femoral epiphysis in children. It is a self-healing condition, and the morphology of the hip may vary according to the severity of the disease, among several other factors. The treatment focuses on attempts to prevent femoral head collapse, obtain functional hip motion recovery, and reduce pain. Osteochondritis Dissecans (OCD) of the femoral head has been reported in 2% to 7% of patients diagnosed with healed LCPD. Although OCD may remain asymptomatic, the osteochondral fragment has the potential to become unstable, evolving into symptoms of pain, locking, catching, and snapping.
Case report:
We present a case report of a ten-year-old boy with an OCD lesion following LCPD who underwent effective osteochondral fixation through the surgical hip dislocation approach. The patient evolved to excellent functional recovery at 1 year post-operatively.
Discussion:
The surgical hip dislocation approach allows anatomical fixation of the OCD fragment, as well as improvement of hip biomechanics, decreasing pain, improving range of motion and joint congruency, and preserving the native articular cartilage. It also gives the surgeon the opportunity to assess hip stability, femoroacetabular impingement and labral tears, allowing a wide variety of options for the treatment of the healed LCPD. Level of Evidence IV; Type of study Case Report.
Case Report: Perianal infection in children caused by ingested jujube pits: a report of two cases
Authors: Guoping Jiang, Lixu Wu, Weiwei Ruan, Qian Shao, JianMing Zhu
Journal: Front Pediatr (2024)
Keywords: case report, children, infection, ingested, jujube pit, perianal
MeSH terms: Case Reports

Background:
The ingestion of jujube pits by children is a rare cause of perianal infection.This article aimed to report two cases of perianal infection in children resulting from the ingestion of jujube pits.
Methods:
We reviewed the clinical records of perianal infection caused by jujube pits at our hospital. Details of the patients' presentation, imaging studies, complications and treatment were recorded.
Results:
Both pediatric patients presented with perianal swelling and pain. The caregivers of both patients denied a history of jujube consumption. Magnetic resonance imaging (MRI) indicated the presence of jujube pits, which were subsequently removed during surgery. Postoperatively, both patients recovered well, and follow-up showed no recurrence or the formation of anal fistulas.
Conclusion:
The ingestion of jujube pits leading to perianal infection is rare and inconspicuous. Early diagnosis and treatment are beneficial in preventing the occurrence of serious complications.
Case report: The utilization of crizotinib and brentuximab vedotin as a bridge to autologous stem cell transplantation and followed by CD30-directed CAR-T cell therapy in relapsed/refractory ALK+ ALCL
Authors: Wanying Liu, Jiaying Wu, Xi Ming, Qi Zhang, Delian Zhou, Rubing Zheng, Mi Zhou, Zhen Shang, Liting Chen, Xiaojian Zhu, Yi Xiao
Journal: Front Immunol (2024)
Keywords: car t cell therapy, t-cell non-hodgkin lymphoma, anaplastic large cell lymphoma, autologous stem cell transplantation, crizotinib
MeSH terms: Hematopoietic Stem Cell Transplantation, Immunoconjugates / therapeutic use, Lymphoma, Large-Cell, Anaplastic / drug therapy, Lymphoma, Large-Cell, Anaplastic / pathology, Receptors, Chimeric Antigen / therapeutic use, Case Reports, Research Support, Non-U.S. Gov't, Brentuximab Vedotin / therapeutic use, Crizotinib / therapeutic use, Humans, Immunotherapy, Adoptive, Neoplasm Recurrence, Local / drug therapy, Receptor Protein-Tyrosine Kinases / genetics, Transplantation, Autologous, Brentuximab Vedotin, Crizotinib, Receptors, Chimeric Antigen, Immunoconjugates, Receptor Protein-Tyrosine Kinases

Background:
Anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK+ ALCL) is a rare, mature T-cell non-Hodgkin lymphoma. The prognosis of patients with relapsed or refractory ALCL following first-line chemotherapy is extremely poor. NCCN guidelines recommend intensified chemotherapy with or without ASCT consolidation for r/r ALCL, however, this is not an effective treatment for all ALK+ALCL.
Case report:
Herein, we report a patient with relapsed/refractory ALK+ ALCL who received crizotinib and brentuximab vedotin as bridging therapy, followed by autologous stem cell transplantation and sequential anti-CD30 CAR T cell therapy.
Conclusion:
The patient achieved complete remission and long-term disease-free survival of months and continues to be followed up. The combination therapy model in this case may provide guidance for the management of relapsed/refractory ALK+ ALCL, and further prospective trials are needed to confirm its effectiveness.
Shepherd's Crook Curve: A Novel Technique for Angulated Side Branch Access in Bifurcation Angioplasty
Authors: Kanhai Lalani, M Sudhakar Rao, Suheil Dhanse, Tom Devasia, Hashir Kareem, Ganesh Paramasivam
Journal: Methodist Debakey Cardiovasc J (2024)
Keywords: bifurcation angioplasty, reverse wiring, shepherd’s crook curve
MeSH terms: Angioplasty, Balloon, Coronary / instrumentation, Coronary Angiography, Coronary Artery Disease / diagnostic imaging, Coronary Artery Disease / surgery, Coronary Artery Disease / therapy, Case Reports, Aged, Cardiac Catheters, Drug-Eluting Stents, Humans, Male, Treatment Outcome

Coronary intervention involving the region of bifurcation remains a challenging issue for the cardiologist as well as a complication. A number of factors including the angulation of side branch with the main branch determines the success. Though provisional strategy remains the best option in bifurcation intervention, at times a two-stent strategy cannot be avoided. We report a case in which percutaneous coronary intervention was performed on the left anterior descending artery (LAD) at its bifurcation with a major diagonal branch (> 2.5 mm). The ostium of the diagonal was diseased, and the branch took off from the LAD at an unfavorable angle (> 120°). We describe the use of the "shepherd's crook wire curve" approach, a modification of the reverse wire technique, which allowed us to successfully wire, dilate, and protect the diagonal and so named to reflect its resemblance to the shape of a shepherd's crook.
Case report: A case of metastatic BRAFV600-mutated melanoma with heart failure treated with immune checkpoint inhibitors and BRAF/MEK inhibitors
Authors: Aya Nishizawa, Misaki Kawakami, Yasuyuki Kitahara
Journal: Front Oncol (2024)
Keywords: braf/mek inhibitors, brafv600 mutation-positive melanoma, covid-19 vaccination, heart failure, immune checkpoint inhibitor, metastatic malignant melanoma
MeSH terms: Case Reports

Background:
Novel therapies, immune checkpoint inhibitors (ICIs), and BRAF/MEK inhibitors (BRAFi/MEKi) provide unprecedented survival benefits for patients with advanced melanoma. However, the management of drug-induced adverse events is problematic for both agents and, although rare, can cause serious cardiac dysfunction.
Case report:
A 42-year-old male patient with no significant medical history noticed a fading dark brown patch on his left anterior chest, which had been there for 20 years, after his second coronavirus disease 2019 (COVID-19) vaccination. The left axillary lymph node became swollen one week after a third booster vaccination. Thinking of it as an adverse reaction to the vaccine, but the swelling increased, so he visited a hospital. The patient presented with a brown macule with depigmentation on the left anterior chest and a 13 cm left axillary mass. A biopsy of the axillary mass showed a metastatic malignant melanoma. Positron emission tomography (PET) showed an accumulation only in the axillary lymph nodes. One month after the initial diagnosis, the axillary mass had further enlarged. In addition, pleural effusion, ascites, difficulty breathing, and systemic edema appeared, and he was diagnosed with heart failure (NYHA class III). Echocardiography showed an ejection fraction of 52% and electrocardiogram (ECG) showed no abnormal findings. Though it was (a life-threatening instead of the life-threatening) the life-threatening condition, we determined that the symptoms were associated with the current disease. Then nivolumab (nivo) plus ipilimumab (ipi) was initiated after explaining the risk of cardiac dysfunction associated with drug use to the patient. After initiation of ICIs, treatment was switched to BRAFi/MEKi (encorafenib/vinimetinib) after the patient tested positive for BRAF V600E. After one month of treatment, the tumor shrank significantly and achieved a complete remission after four months. Furthermore, as the tumor shrank, the patient's heart failure improved, and he was able to continue treatment without serious drug-induced cardiotoxicity.
Conclusion:
Both ICI and BRAFi/MEKi carry a risk of cardiac dysfunction. However, without any underlying cardiac disease or severe cardiac dysfunction, their administration should not necessarily be excluded if careful follow-up is provided.
Desmoplastic small round cell tumor of the kidney: a case report and discussion
Authors: Guizhen Huang, Wenqian Huang, Mingxue Liu
Journal: Front Oncol (2024)
Keywords: dsrct, chemotherapy, kidney, surgery, tumor
MeSH terms: Case Reports

A 13-year-old boy was admitted to the hospital with 1-month history of neck pain and a 2-week history of bilateral hip joint pain accompanied by low fever. Positron emission tomography-computed tomography (PET-CT) revealed the presence of a malignant tumor in the left kidney with metastases to the left renal hilum, retroperitoneum, para-aortic lymph nodes, and multiple bone sites throughout the body. Given that the patient's left kidney capsule was intact and the boundary with surrounding tissues was clear, left nephrectomy was performed. Postoperative pathological diagnosis showed desmoplastic small round cell tumor (DSRCT) of the left kidney. CAV-VIP alternating chemotherapy was given 20 days after the first stage surgery. After the end of the 6th cycle, the patient underwent surgery again. The tumor in front of the aorta and postcava, the greater omentum, the retroperitoneal lymph nodes and the hepatic hilum lymph nodes, and the visible tumors in the abdomen were removed. CAV-VIP alternating chemotherapy was continued after the second stage surgery. At the end of the 4th cycle of post operation chemotherapy, radiotherapy was started. An abdominal CT scan conducted 11 months after second-stage surgery did not reveal any recurrence of abdominal tumors; however bone metastases persisted. The patient is currently receiving oral targeted therapy with anlotinib while ongoing follow-up continues.
Retinal Ischemia as a Presenting Ocular Sign of Neurofibromatosis Type 2
Authors: Binbin Zhao, Yan Yan
Journal: Case Rep Ophthalmol Med (2024)
MeSH terms: Case Reports

Purpose. Specific retinal abnormalities of neurofibromatosis type 2 (NF2) commonly include retinal astrocytoma and combined hamartoma of the retina and retinal pigment epithelium. Vasculopathy is an uncommon manifestation of NF2. We reported an NF2 patient presenting with retinal ischemia. Observations. An 18-year-old healthy Chinese female with acute decreased vision. The fundus examination and optical coherence tomography revealed optic disc hamartoma in the right eye and paracentral acute middle maculopathy (PAMM) and cotton wool spot indicating retinal ischemia in the left eye. Brain MRI showed bilateral acoustic neuroma, parasellar meningioma, and cervical extramedullary tumor. The genetic test confirmed the diagnosis of NF2. Conclusions and Importance. Our case suggests that retinal ischemia could be the presenting sign of NF2. NF2 could be associated with retinal vasculopathy in addition to retina tumors.