OpenMed/multicare-articles huggingface dataset:
Physeal-Sparing Anterior Cruciate Ligament Reconstruction for Skeletally Immature Patients: All-Epiphyseal Technique Using Quadricep Tendon Autograft
Authors: Hatem B Afana, Thomas Nau
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

The anterior cruciate ligament (ACL) is a major stabilizing structure of the knee and one of the most common injured structures. The true incidence of ACL injury in children and adolescents is unknown, but recent studies suggest increased ACL injury rates, especially in the sports-participating population. The mechanism of injury, clinical examination, and diagnosis of ACL injury in children is the same as in adults. The main concerns in the management of pediatric ACL injuries are the open physes and the eventual long-term consequences of the ACL deficient knee. The ideal treatment strategy of pediatric ACL injuries is still controversial, because there is still no universal consensus for techniques, graft choices, and postoperative rehabilitation. We present a case of a 12-year-old male patient who underwent ACL reconstruction using an all-inside, physeal-sparing technique with a quadriceps tendon autograft and discuss the current treatment strategies.
A minimally invasive surgical approach for the treatment of piriformis syndrome: a case series
Authors: Elizabeth Hogan, Darshan Vora, Jonathan H Sherman
Journal: Chin Neurosurg J (2020)
Keywords: minimally invasive, neuromonitoring, piriformis syndrome, sciatic nerve

Background:
Piriformis syndrome accounts for approximately 6% of patients who present with sciatic pain. There are many treatment options ranging from physical therapy, to trigger point injections, to surgical intervention. We discuss a surgical method that represents a minimally invasive technique for the treatment of piriformis syndrome.
Methods:
We describe a novel operative approach and technique for release of the piriformis muscle in the treatment of piriformis syndrome. Described are the preoperative planning, incision and approach, and technique for identifying and releasing the piriformis muscle.
Results:
Three patients were treated for piriformis syndrome using the described technique. Each patient displayed successful relief of their symptoms immediately following the surgical procedure and at delayed follow-up.
Conclusion:
Early experience with our method of piriformis release suggests that it is well suited for the treatment of piriformis syndrome. The novel integration of pre-operative trigger point localization coupled with intraoperative neuromonitoring allows effective pain relief with minimal morbidity.
Profound Iron Deficiency Anemia and Irreversible Dilated Cardiomyopathy in a Child
Authors: Samuel G Wittekind, Hugo R Martinez, Chet Villa, Matthew Bacon, Adrienne M Hammill, Angela Lorts
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Iron deficiency anemia has been associated with a secondary and potentially reversible cardiomyopathy. The pathophysiologic paradigm has been that the hematologic disease begets cardiac dysfunction. There may be, however, a point at which myocardial injury is irreversible in susceptible individuals. We present the case of a 4-year-old, developmentally normal, child who presented with iron deficiency anemia and a dilated cardiomyopathy with congestive heart failure. Despite appropriate correction of the anemia, the patient developed decompensated heart failure requiring milrinone therapy and eventual heart transplantation. This report will alert clinicians to the potential for irreversible adverse cardiac remodeling and the importance of close pediatric cardiology consultation and serial assessment in order to implement appropriate heart failure therapy.
Acute Esophageal Necrosis Early after Renal Transplantation
Authors: Ahmad Makeen, Faisal Al-Husayni, Turki Banamah
Journal: Case Rep Nephrol (2021)
MeSH terms: Case Reports

Background:
Acute esophageal necrosis (AEN) is defined as a diffused black discoloration of the esophageal mucosa involving mainly the distal part of the esophagus. It is considered a rare clinical entity with a high mortality rate. The etiology of AEN is unknown, but it has been correlated to many causes such as malignancies, infections, and hemodynamics instability. Here, we report a case of a patient developing AEN a few days after kidney transplantation. Case Presentation. A 57-year-old male was admitted electively for kidney transplantation that he received from his son. The surgery was complicated with a significant drop in blood pressure but otherwise was uneventful. The patient was showing good signs of recovery but then suffered from significant hematemesis. An urgent upper esophagogastroduodenoscopy revealed black discoloration of the esophageal mucosa in keeping with AEN. The patient was treated with proton pump inhibitors infusion and started empirically on antivirals and antifungals. The patient's condition improved in regards to the AEN; nonetheless, the complications resulted in graft loss, and the patient returned to hemodialysis.
Conclusion:
AEN is a critical condition that mandates early intervention. Identifying high-risk populations may aid in early anticipation and diagnosis. Patients with chronic kidney disease are at risk of atherosclerosis leading to a low flow state which is exacerbated during renal transplantation surgery, especially if the procedure was complicated with a drop in blood pressure.
Superior mesenteric artery syndrome following initiation of cisplatin-containing chemotherapy: a case report
Authors: Atsuhito Ushiki, Tomonobu Koizumi, Hiroshi Yamamoto, Masayuki Hanaoka, Keishi Kubo, Mina Matsushita
Journal: J Med Case Rep (2012)

Introduction:
Superior mesenteric artery syndrome is a rare cause of upper intestinal obstruction resulting from compression of the duodenum by the superior mesenteric artery and abdominal aorta.
Case presentation:
We describe a case of superior mesenteric artery syndrome in a 61-year-old Japanese man with non-small cell lung cancer who had been treated with cisplatin-containing chemotherapy and had lost 7 kg in weight. The diagnosis was confirmed by the typical findings of abdominal computed tomography showing distended stomach resulting from compression of the third portion of the duodenum and reduction of an aortomesenteric distance and aortomesenteric angle.
Conclusions:
This case highlights the importance of considering the possibility of superior mesenteric artery syndrome in patients treated with chemotherapy, especially those presenting with a low body mass index and showing weight loss during chemotherapy.
Adenocarcinoma of the sphenoid sinus
Authors: Youssef Darouassi, Mehdi Chihani, Mohamed Mliha Touati, Karim Nadour, Haddou Ammar, Brahim Bouaity
Journal: Pan Afr Med J (2014)
Keywords: sphenoid sinus, adenocarcinoma, endonasal surgery, radiotherapy
MeSH terms: Adenocarcinoma / diagnosis, Adenocarcinoma / therapy, Paranasal Sinus Neoplasms / diagnosis, Paranasal Sinus Neoplasms / therapy, Sphenoid Sinus, Case Reports, Review, Humans, Male, Middle Aged

Adenocarcinomas of the sphenoid sinus are exceptional. In this paper, we report a new case with a review of the literature. Our patient was a 45-year-old man who presented with isolated retro orbital headache. CT and MRI suspected a malignat tumor of the sphenoid sinus. The patient underwent a debulking surgery. The final pathology carried out the diagnosis of primary adenocarcinoma. The patient died several months later from radiotherapy complications. Even if adenocarcinomas of the sphenoid sinus are exceptional, they should be considered in the differential diagnosis of sphenoid sinus masses. The prognosis is poor.
Unexpected sudden death in pregnancy - arrhythmogenic right ventricular cardiomyopathy/dysplasia: a case report
Authors: Amal Nishantha Vadysinghe, Rankothge Pemasiri Jayasooriya, G Keerthi Kumara Gunatilake, Murugupillai Sivasubramanium
Journal: Forensic Sci Res (2017)
Keywords: forensic science, arrhythmogenic right ventricular cardiomyopathy/ dysplasia (arvc/d), pregnancy, sudden death
MeSH terms: Case Reports

Cardiovascular disease is an important contributor to maternal mortality in both developing and developed countries. Systematic search for cardiac disease is usually not performed during pregnancy despite hypertensive disease, undiagnosed pulmonary hypertension and cardiomyopathies being recognized as major health problems in these settings. This article reported a 27-year-old female who was normal on clinical examination and basic investigations, and on an antenatal visit was found collapsed in the toilet of her house and was pronounced dead on admission to hospital. She was found to be in the 11th week of pregnancy and had no history of significant illness in the past. Autopsy did not reveal any obvious macroscopic pathology except for a significant amount of epicardial fat infiltrating into myocardium of right ventricle. Detailed histopathological examination of the heart demonstrated fibro-fatty replacement of the heart muscle. The cause of death was arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). ARVC/D can cause unexpected sudden death during pregnancy. Therefore, it is recommended that an ECG and echocardiogram be included as screening tests during antenatal follow-up to minimize preventable cardiac deaths like ARVC/D.
Chest Compressions in Pediatric Patients With Continuous-Flow Ventricular Assist Devices: Case Series and Proposed Algorithm
Authors: Ivie D Esangbedo, Priscilla Yu
Journal: Front Pediatr (2022)
Keywords: cardiac intensive care unit, cardiopulmonary resuscitation (cpr), chest compression (cc), continuous flow ventricular assist device, left ventricular assist device (lvad), pediatric, ventricular assist device (vad)

Patients with continuous flow ventricular assist devices (CF-VAD's) in the systemic ventricle (left ventricle or single ventricle) often have no palpable pulses, unreliable pulse oximetry waveforms and non-pulsatile arterial waveforms despite hemodynamic stability. When circulatory decompensation occurs, standard indicators to begin cardiopulmonary resuscitation (CPR) which are used in other pediatric patients (i.e., significant bradycardia or loss of pulse) cannot be applied in the same fashion. In this population, there may already be pulselessness and development of bradycardia in and of itself would not trigger chest compressions. There are no universal guidelines to dictate when to consider chest compressions in this population. As such, there may be a delay in decision-making or in recognizing the need for chest compressions, even in patients hospitalized in intensive care units (ICU) and cared for by experienced staff who perform CPR regularly. We present four examples of pediatric cardiac ICU patients from a single center who underwent CPR between 2018 and 2019. Based on this case series, we propose a decision-making algorithm for chest compressions in pediatric patients with CF-VADs in the systemic ventricle.
Melioidosis in New Caledonia
Authors: Simon Le Hello, Bart J Currie, Daniel Godoy, Brian G Spratt, Marc Mikulski, Flore Lacassin, Benoit Garin
Journal: Emerg Infect Dis (2005)
MeSH terms: Burkholderia pseudomallei / classification, Burkholderia pseudomallei / genetics, Melioidosis / epidemiology, Case Reports, Adult, Aged, Burkholderia pseudomallei / isolation & purification, Female, Genes, rRNA, Humans, Male, Melioidosis / microbiology, Melioidosis / physiopathology, Middle Aged, New Caledonia / epidemiology, RNA, Ribosomal, 16S / genetics, Sequence Analysis, DNA, RNA, Ribosomal, 16S

Recognized melioidosis-endemic areas are widening. In the South Pacific, melioidosis is endemic in New Caledonia, northern Australia, and Papua New Guinea. We report the first 4 documented cases of human melioidosis from New Caledonia. Molecular typing of 2 Burkholderia pseudomallei isolates suggests a link to Australian strains.
A case of persistent sciatic artery aneurysm with recurrent embolism
Authors: Mutsuo Tanaka, Minoru Okamoto, Ken Okamoto, Toshihiro Fukui
Journal: Int J Surg Case Rep (2019)
Keywords: limb ischemia, peripheral vascular surgery, persistent sciatic artery aneurysm

Introduction:
Persistent sciatic artery (PSA) is a rare congenital vascular anomaly. It has several clinical features with the formation of aneurysms. Among the complications, leg ischemia is severe problem and the management involves revascularization and prevention of recurrence. We herein describe an anatomically annoying case of PSA aneurysm with recurrent embolism that necessitated thrombectomy and bypass surgery. And this work has been reported in line with the SCARE criteria.
Case presentation:
A 76-year-old woman developed leg embolism twice from PSA aneurysm. PSA was complete type and the popliteal artery ran on the lateral side, which was difficult to approach from the standard medial side. Based on these anatomical conditions, thrombectomy of the posterior-tibial artery (PTA) and femoral-PTA bypass were performed. Additionally, the proximal side of PTA from the anastomosis site was ligated to avoid the recurrence of embolism. Residual PSA aneurysm has not yet been treated, but neither clinical complications nor dilatation have occurred.
Discussion:
PSA is a rare disease, but should be remember in acute limb ischemia. Clear treatments have not yet been established; therefore, its plans need to be considered based on clinical symptoms and anatomical conditions.
Conclusion:
Although there were anatomical issues in the present case, thrombectomy and bypass surgery were successful and no complications have occurred one year after surgery.
Toxic encephalopathy and peripheral neuropathy of poisoning by Avermectin Pyridine: a case report and a review of the literature
Authors: Jiuzhou Diao, Qingbo Zhou
Journal: Front Neurol (2023)
Keywords: avermectin and pyridine, case report, peripheral neuropathy, therapy, toxic encephalopathy
MeSH terms: Case Reports

Background:
Avermectin Pyridaben (AVP) is an insecticide with extreme neurotoxicity in human, causing critical symptoms such as nausea, vomiting, coma and respiratory failure within a short time after oral ingestion. Neurological sequelae or even death may occur because of delayed treatment or excessive toxic dose.
Case presentation:
We report a 15-year-old girl who presented with coma, respiratory failure, limb weakness, ataxia symptoms after ingestion of a toxic dose of AVP. Soon after the poisoning, the patient was treated with life-saving mechanical ventilation and haemodialysis. Subsequently brain Magnetic Resonance Imaging (MRI) and nerve conduction study (NCS) and electromyography (EMG) demonstrated toxic encephalopathy and peripheral nerve injury. Over the next 2 months the patient's limb function gradually recovered under treatment with hyperbaric oxygen, glucocorticoid pulses and neurotrophic drugs.
Conclusion:
This case documents a rare presentation of toxic encephalopathy complicated with peripheral neuropathy following AVP poisoning. Seven other similar cases of poisoning in terms of common symptoms and effective treatment have also been summarised for providing clinicians with experience in diagnosis and therapy.
Apixaban for treatment of confirmed heparin-induced thrombocytopenia: a case report and review of literature
Authors: Daniel E Ezekwudo, Rebecca Chacko, Bolanle Gbadamosi, Syeda Batool, Sussana Gaikazian, Theodore E Warkentin, Jo-Ann I Sheppard, Ishmael Jaiyesimi
Journal: Exp Hematol Oncol (2017)
Keywords: apixaban, argatroban, case report, direct oral anticoagulants, heparin-induced thrombocytopenia, platelet factor 4, serotonin-release assay
MeSH terms: Case Reports

Background:
Heparin-induced thrombocytopenia (HIT) is a life and limb-threatening condition caused by the binding of platelet-activating antibodies (IgG) to multimolecular platelet factor 4 (PF4)/heparin complexes because of heparin exposure. The by-product of this interaction is thrombin formation which substantially increases the risk of venous and/or arterial thromboembolism. Currently, only one anticoagulant, argatroban, is United States Food and Drug Administration-approved for management of HIT; however, this agent is expensive and can only be given by intravenous infusion. Recently, several retrospective case-series, case reports, and one prospective study suggest that direct oral anticoagulants (DOACs) are also efficacious for treating HIT. We further review the literature regarding current diagnosis and clinical management of HIT.
Case presentation:
A 66-year-old male patient developed HIT beginning on day 5 post-cardiovascular surgery; the platelet count nadir on day 10 measured 16 × 109/L. Both the PF4-dependent ELISA and Serotonin-release assay were strongly positive. Despite initial anticoagulation with argatroban (day 6), the patient developed symptomatic Doppler ultrasound-documented bilateral lower extremity deep vein thrombosis on day 14 post-surgery. The patient was transitioned to the DOAC, apixaban, while still thrombocytopenic (platelet count 108) and discharged to home, with platelet count recovery and no further thrombosis at 3-month follow-up.
Conclusions:
We report a patient with serologically confirmed HIT who developed symptomatic bilateral lower limb deep vein thrombosis despite anticoagulation with argatroban. The patient was switched to oral apixaban and made a complete recovery. Our patient case adds to the emerging literature suggesting that DOAC therapy is safe and efficacious for management of proven HIT.
Symmetrical Peripheral Gangrene: Report of Three Cases
Authors: Héctor Acosta, Pau Forcada, Marta Bonjorn, Amer Mustafa, Paul Pilares, Jordi Colomina
Journal: Case Rep Crit Care (2022)
MeSH terms: Case Reports

Symmetrical peripheral gangrene (SPG) is a rare clinical syndrome characterized by an acute onset of ischemic damage in two or more extremities without obstruction or vasculitis of supplying vessels. Body parts commonly affected include toes, hands, scrotum, and earlobes, increasing the risk of limb amputation and impairing the quality of life. The vascular injury mechanism is disseminated intravascular coagulation. SPG may manifest unpredictably in conditions associated with septic shock, low output states, vasospastic conditions, myeloproliferative disorders, or hyperviscosity syndrome. A review on the topic is presented based on a 3-case series of SPG that required amputation of fingers and toes after the administration of vasopressors in a septic shock context.
Stem Cell Therapy for Corneal Epithelium Regeneration following Good Manufacturing and Clinical Procedures
Authors: Beatriz E Ramírez, Ana Sánchez, José M Herreras, Itziar Fernández, Javier García-Sancho, Teresa Nieto-Miguel, Margarita Calonge
Journal: Biomed Res Int (2015)
MeSH terms: Corneal Diseases / pathology, Corneal Diseases / therapy, Epithelium, Corneal / pathology, Limbus Corneae / pathology, Practice Guidelines as Topic, Stem Cell Transplantation / standards, Clinical Trial, Research Support, Non-U.S. Gov't, Adult, Aged, Epithelium, Corneal / surgery, European Union, Female, Humans, Limbus Corneae / surgery, Male, Middle Aged, Regeneration

Objective:
To evaluate outcomes of cultivated limbal epithelial transplantation (CLET) for management of ocular surface failure due to limbal stem cell deficiency (LSCD).
Design:
Prospective, noncomparative, interventional case series and extensive comparison with recent similar studies.
Participants:
Twenty eyes with LSCD underwent CLET (11 autologous; 9 allogeneic) and were followed up for 3 years. Etiologies were divided into 3 prognostic categories: Group 1, chemical injuries (7 eyes); Group 2, immune-based inflammation (4 eyes); and Group 3, noninflammatory diseases (9 eyes). Intervention. Autologous and allogeneic limbal epithelial cells were cultivated on amniotic membranes and transplanted. Evaluations were based on clinical parameters, survival analysis, and in vivo confocal microscopy (IVCM). European Union Tissues/Cells Directive and good manufacturing procedures were followed.
Main outcome measures:
Improved clinical parameters, absence of epithelial defects, and improved central corneal epithelial phenotype.
Results:
Success rate was 80% at 1-2 years and 75% at 3 years. Autografts and allografts had similar survival. Success rate was significantly lower in prognostic Group 1 (42.9%) than in Groups 2-3 (100% each). All clinical parameters improved substantially. By IVCM, 80% of cases improved in epithelial status.
Conclusions:
CLET improved corneal epithelium quality, with subsequent improvement in symptoms, quality of life, and vision. These results confirm that CLET is a valid therapy for ocular surface failure.
Glenohumeral interposition of rotator cuff stumps: a rare complication of traumatic rotator cuff tear
Authors: Paulo Moraes Agnollitto, Marcio Wen King Chu, Mario Muller Lorenzato, Salomão Chade Assan Zatiti, Marcello Henrique Nogueira-Barbosa
Journal: Radiol Bras (2016)
Keywords: interposition, magnetic resonance imaging, rotator cuff, shoulder, tear, trauma
MeSH terms: Case Reports

The present report describes a case where typical findings of traumatic glenohumeral interposition of rotator cuff stumps were surgically confirmed. This condition is a rare complication of shoulder trauma. Generally, it occurs in high-energy trauma, frequently in association with glenohumeral joint dislocation. Radiography demonstrated increased joint space, internal rotation of the humerus and coracoid process fracture. In addition to the mentioned findings, magnetic resonance imaging showed massive rotator cuff tear with interposition of the supraspinatus, infraspinatus and subscapularis stumps within the glenohumeral joint. Surgical treatment was performed confirming the injury and the rotator cuff stumps interposition. It is important that radiologists and orthopedic surgeons become familiar with this entity which, because of its rarity, might be neglected in cases of shoulder trauma.
Severe Postpartum Hemorrhage Complicated with Liver Infarction Resulting in Hepatic Failure Necessitating Liver Transplantation
Authors: I-Ting Peng, Ming-Ting Chung, Ching-Chung Lin
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Postpartum hemorrhage remains a major threat to maternal health. Intervention after critical blood loss or development of disseminated intravascular coagulation may lead to disastrous organ failure and poor outcomes. A 30-year-old woman was transferred to our emergency department due to massive postpartum hemorrhage. Shock and disseminated intravascular coagulation ensued, and the patient's condition quickly deteriorated. We performed an emergency hysterectomy, but blood loss had been massive. Moreover, there was another episode of internal bleeding that led to further blood loss. Ischemic injury to the liver was tremendous, with resulting progressive jaundice and hepatic encephalopathy. The patient required liver transplantation. Imaging studies and operative findings showed a large area of hepatic infarction. Unfortunately, the patient died of intractable sepsis shortly after liver transplantation. Disseminated intravascular coagulation and resultant hepatic infarction combined with ischemic hepatitis were the direct cause of death in our case.