OpenMed/multicare-articles huggingface dataset:
Intertarsal Joint Stabilization in a Bateleur Eagle (Terathopius ecaudatus) Using a Novel Application of a Braided Suture and Titanium Button System
Authors: Jenessa Gjeltema, Ryan S De Voe, Larry J Minter, Brian J Trumpatori
Journal: Case Rep Vet Med (2017)
MeSH terms: Case Reports

A 32-year-old adult captive male bateleur eagle (Terathopius ecaudatus) with a history of laxity, degenerative joint disease, and varus deviation of the distal left hindlimb for several years was presented for evaluation of left hindlimb lameness and was diagnosed with chronic subluxation of the left intertarsal joint. After failing to improve with conservative management and pain medication, surgical stabilization of the joint was performed using a novel application of a braided suture and titanium button system. Unsatisfactory clinical improvement and postsurgical reevaluation indicated that the initial surgical stabilization was unsuccessful. The surgery was repeated, and the animal showed postsurgical improvement in intertarsal joint stability, weight-bearing, and lameness for a period of several years with use and adjustment of chronic pain medications. The novel surgical technique described in this case report represents an additional treatment option for management of avian intertarsal joint subluxations. Presurgical planning should consider the unique anatomic features and variability of the avian tarsometatarsus to avoid surgical complications.
Geisinger MyCode® detects BRCA2 mutation prior to abdominal panniculectomy allowing for DIEP flap breast reconstruction
Authors: Christian A Kauffman
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: breast reconstruction, abdominoplasty, deep inferior epigastric perforator flap, mastectomy, panniculectomy
MeSH terms: Case Reports

This case report presents a 38-year-old female who was scheduled for abdominal panniculectomy and tested positive for BRCA2 mutation through Geisinger MyCode®. She canceled her panniculectomy and elected to proceed with bilateral mastectomies, utilizing her abdominal tissue for deep inferior epigastric perforator flap reconstruction.
Bilateral Elongated Mandibular Coronoid Process and Restricted Mouth Opening: A Case Report
Authors: Thomas Starch-Jensen, Annette Dalgaard Kjellerup
Journal: Open Dent J (2017)
Keywords: dentistry, diagnostic imaging, facial bones, general surgery, hyperplasia, temporomandibular joint
MeSH terms: Case Reports

Introduction:
Mandibular coronoid process hyperplasia is an uncommon congenital or developmental temporomandibular joint disorder, characterized by elongation of the coronoid process, which may cause limited mandibular movement as a consequence of interference between the hyperplastic coronoid process and the medial surface of the zygomatic arch.
Methods:
Mandibular coronoid process hyperplasia commonly affects males in the second decade of life and the exact aetiology and pathogenesis is unknown. The condition can be uni- or bilateral. Progressive painless reduction in mouth opening is the main clinical finding and computed tomography is the most reliable imaging modality for confirming the diagnosis.
Results:
Surgical intervention involving coronoidectomy and long-term intensive postoperative physiotherapy is the treatment of choice for mandibular coronoid process hyperplasia with impingement on the zygomatic bone and limited mouth opening. However, surgically induced fibrosis and the tendency for mandibular coronoid process regrowth may cause relapse and renewed limited mouth opening. Vigorous physical therapy should therefore be initiated shortly after surgery.
Conclusion:
The purpose of this case report is to present the clinical and radiographic features of elongated mandibular coronoid process in an 18-year-old male with limited mouth opening, and to discuss the various surgical treatment modalities.
Case report: Two heterozygous pathogenic variants of CYP24A1: A novel cause of hypercalcemia and nephrocalcinosis in adulthood
Authors: Ludmila Brunerova, Ondrej Remes, Veronika Zoubkova, Pavel Votypka
Journal: Front Med (Lausanne) (2023)
Keywords: cyp24a1 mutation, adult, hypercalcemia, low pth, nephrocalcinosis
MeSH terms: Case Reports

Background and aims:
Vitamin D 24-hydroxylase is an enzyme encoded by the CYP24A1 gene, which inhibits the activation of vitamin D to form inactive metabolites. More than 20 currently described pathogenic variants (usually biallelic) of this gene are responsible for idiopathic infantile hypercalcemia manifested typically in childhood (often in newborns) with hypercalcemia, hypercalciuria, and nephrocalcinosis. However, a few patients (mostly with monoallelic heterozygous pathogenic variants) can develop mild symptoms in adulthood.
Case description:
We present the case of a 43-year-old male patient with hypertension and heterozygous Leiden mutation, with mural thrombi in the common iliac artery, who was sent by a nephrologist to endocrinological examination due to hypoparathyroidism, progressive hypercalcemia, hypercalciuria, and CKDG2A1. Complete laboratory and imaging methods (including PET-CT) excluded PTH-related peptide-mediated hypercalcemia and granulomatosis. Finally, the genetic analysis of the CYP24A1 gene revealed the presence of a novel combination of two heterozygous pathogenic variants: CYP24A1: c. 443T>C p.(Leu148Pro) and c.1186C>T p.(Arg396Trp).
Conclusion:
Differential diagnosis of patients with hypercalciuria, nephrocalcinosis, and hypercalcemia related to vitamin D exposure should include the CYP24A1 gene mutation. To the best of our knowledge, this is the first case of the novel combination of two heterozygous pathogenic variants of CYP24A1.
Giant Polycystic Papillary Renal Cell Carcinoma: A Case Report and Literature Review
Authors: Zhongming Huang, Hai Wang, Zhigang Ji
Journal: Front Oncol (2022)
Keywords: bosniak classification, pet-ct, laparoscopic surgery, papillary renal cell carcinoma, pathology
MeSH terms: Case Reports

Introduction:
Giant, cystic renal tumors are generally considered relatively contraindicated for laparoscopic surgery. We report on a 19-year-old male, where polycystic lesions in the left kidney were accidentally noted by enhanced computed tomography (CT) by focusing on the diagnostic, clinical, and surgery to the patient.
Case report:
Enhanced CT scan revealed solid component in multiple cystic lesions of Bosniak IV, which was enhanced after injection of contrast agent and the left kidney lost normal profile and enlarged with maximal diameter more than 18cm. Positron emission tomography-computed tomography (PET-CT) showed SUVmax 4.8 of the lesion and suggested malignant disease. A retroperitoneal laparoscopic radical left nephrectomy was performed successfully without cyst burst and the lesion was 17×17×18 cm in size. Pathological examination revealed that the lesions were consistent with papillary renal cell carcinoma (type 2, WHO grade II), no renal capsule invasion, no renal pelvis and renal sinus fat involvement, no abnormality in ureter and renal arteriovenous end, no abnormality in a few adrenal tissues, chronic inflammation of hilar lymph nodes (0/1). After surgery, no specific treatment was initiated and at a follow-up visit 1 year after surgery, no local recurrence or metastasis was found.
Conclusion:
It is the largest cystic renal cell carcinoma that has ever been reported for laparoscopic resection. The selection of surgery for giant cystic renal cell carcinoma should be individualized. Retroperitoneal laparoscopy may be an option for such lesions.
Case Report: Gastric cancer with chondromyxoid matrix similar matrix-producing metaplastic breast carcinoma: report of an undescribed entity
Authors: Xiaoyan Wu, Huihua He, Lina Zhao, Zhi Zeng, Jingping Yuan
Journal: Front Oncol (2023)
Keywords: adenocarcinoma, case report, chondromyxoid matrix, gastric cancer, histologic morphology, matrix-producing metaplastic carcinoma
MeSH terms: Case Reports

Gastric cancer is a malignant epithelial neoplasm of the stomach, including adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, undifferentiated carcinoma, gastroblastoma and neuroendocrine neoplasms, without gastric metaplastic carcinoma. We describe a 69-year-old male patient with gastric cancer who presented with a novel, biphasic histologic morphology with one component consisting of poorly differentiated adenocarcinoma and the other component consisting of chondromyxoid matrix with adenocarcinoma transition to, between the two components without a spindle cell component. The histological morphology of this case is similar to matrix-producing metaplastic breast carcinoma. Therefore, we diagnose this case as gastric carcinoma with chondromyxoid matrix similar matrix-producing metaplastic breast carcinoma.
Severe emm89 Group A Streptococcal Disease Characterized by Toxic Shock and Endocarditis
Authors: Morouge Alramadhan, Gloria P Heresi, Anthony R Flores
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Invasive group A Streptococcus infections are associated with diverse presentations. We report a severe, rare case of GAS infection with dissemination including endocarditis and STSS. While whole genome sequencing of blood and pharyngeal isolates did not reveal any unique features attributable to the severe presentation, our approach serves as a template for investigation of severe manifestations of common infections.
Preservation of the external jugular vein in bilateral radical neck dissections: technique in two cases and review of the literature
Authors: Rodrigo Lima Bastos da Rocha, André Del Negro, Alfio José Tincani, Maíra Soliani Del Negro, Antonio Santos Martins
Journal: Case Rep Med (2015)

Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients' outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.
Case report: Cefoperazone-sulbactam induced Kounis syndrome and cardiogenic shock
Authors: Peng Ding, Yuan Zhou, Kun-Lan Long, Li Zhang, Pei-Yang Gao
Journal: Front Cardiovasc Med (2022)
Keywords: kounis syndrome, allergy, cardiogenic shock, case report, cefoperazone-sulbactam, intra-stent thrombosis
MeSH terms: Case Reports

Background:
Kounis syndrome is a hypersensitive coronary artery disease caused by the body's exposure to allergens, which is induced by various drugs and environmental factors. This entity has been described primarily in isolated case reports and case series. We report a case of type III Kounis syndrome caused by cefoperazone-sulbactam.
Case presentation:
A 79-year-old man who received an infusion of cefoperazone-sulbactam in Respiratory Department of our hospital for recurrent infections. 28 minutes later, he developed skin flushing of the trunk and extremities, soon followed by loss of consciousness and shock. With antianaphylaxis, pressor therapy, and fluid rehydration, the patient was admitted to the ICU for treatment. During which, he experienced recurrent ventricular fibrillation and a progressive increase in troponin I levels. The ECG of the patient showed that the ST segment elevation of lead II, III, avF, and V3R-V5R was 0.10-0.20 MV. An urgent coronary angiography showed an in-stent thrombosis in the middle part of the right coronary artery, occlusion of the distal flow with TIMI grade 0. The diagnosis was type III Kounis syndrome with cardiogenic shock. Despite aggressive treatment, the patient died on day 7 after ICU admission.
Conclusion:
Kunis syndrome is a life-threatening disease, and therefore allergic reactions in patients with a history of cephalosporin allergy and coronary stent implantation should be considered and treated promptly.
Allergic reaction related to ramipril use: a case report
Authors: Renata C Alencar, Roberta A Cobas, Marília B Gomes
Journal: Diabetol Metab Syndr (2010)

Background:
Angiotensin-converting enzyme (ACE) inhibitors are widely prescribed for patients with diabetes as a nephroprotector drug or to treat hypertension. Generally they are safe for clinical practice, but the relationship between these drugs and angioedema is known. The exact mechanism for ACE inhibitors-induced angioedema is not clear and it is still a matter of discussion.
Case report:
We reported a case of a 23-year-old black female with an 11 year history of type 1 diabetes, regularly monitored in the department of diabetes, in use of 0,98 UI/kg/day of human insulin, which presented an allergic reaction 24 h after ramipril use. The drug had been prescribed to treat diabetic nephropathy. There was no previous history of drug induced or alimentary allergy. The patient was instructed to discontinue the use of ramipril and oral antihistaminic drug and topical corticosteroid were prescribed. Skin biopsies were performed and confirmed the clinical hypothesis of pharmacodermy. The evaluation of ACE polymorphism identified DD genotype. Six months after the withdrawal of ramipril the patient was prescribed the angiotensin-II receptor blocker (ARB) losartan as nephroprotector. She remained well without adverse reactions.
Conclusions:
ACE inhibitors-induced angioedema is uncommon and the clinical presentation is variable with lips, tongue, oropharinge, and larynge as the most common locations. The presence of angioedema during treatment requires the immediate cessation of treatment due to the risk of possible severe complications. The case reported presented moderate symptoms, with the development of early onset edema in uncommon regions. ACE DD genotype had been associated with angioedema-ACE inhibitors induced. In patients who have experienced ACE inhibitor-related angioedema, ARB should be used cautiously used. However in the case of our patient, the prescription of losartan as nefroprotector did not result in any recurrent adverse effect.
Simultaneous Total Knee Arthroplasty and Ankle Arthrodesis for Charcot Neuroarthropathy
Authors: Koji Nozaka, Naohisa Miyakoshi, Yusuke Yuasa, Motoki Mita, Yoichi Shimada
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Introduction:
Charcot neuroarthropathy is a progressive, deforming pathology of the bone and joints, especially affecting the knees and ankles. Although it is rare, it leads to considerable morbidity. The treatment of Charcot arthropathy of the knee and ankle remains controversial. Many authors suggest that knee involvement is an absolute contraindication to total knee arthroplasty. In recent years, however, several studies have shown satisfactory results for total knee arthroplasty. In the ankle, external fixators have recently been advocated by many authors. Their main advantages are that they permit monitoring of soft tissue healing and avoidance of more invasive surgery. Simultaneous Charcot knee and ankle joint surgery involving total knee arthroplasty (TKA) and ankle arthrodesis is rare and challenging and can lead to major complications if not addressed appropriately.
Case presentation:
The case of a 71-year-old woman who underwent simultaneous total knee arthroplasty and ankle arthrodesis for severe neurosyphilitic Charcot arthropathy (Eichenholtz classification stage III) and was evaluated three years after surgery is reported. Deformities of the left knee joint and ankle developed. The left leg was shorter by 20 mm, with a functional leg length discrepancy. The patient was limping, and marked varus instability of the left ankle was observed during the stance phase of walking. Postoperatively, the patient was able to walk without assistance, confirming improvement of mobility.
Conclusion:
To the best of our knowledge, this is the first report of combined, simultaneous neurosyphilitic Charcot knee and ankle joint surgery involving TKA and ankle arthrodesis. It was an effective surgical method that maintained leg length and achieved satisfactory alignment without an autologous iliac bone graft.
Use of statin therapy to reduce cardiovascular risk in older patients
Authors: N K Wenger, S J Lewis
Journal: Curr Gerontol Geriatr Res (2010)

Background. Cardiovascular disease is the principal cause of mortality in older individuals, and more than 80% of deaths due to coronary heart disease or stroke occur in patients over 65 years of age. Hyperlipidemia is one of the main modifiable risk factors for cardiovascular disease. Current guidelines recommend the use of statins to reduce low-density lipoprotein cholesterol to appropriate targets based on an individual's cardiovascular risk, and clearly state that older age should not be a barrier to treatment. Despite extensive evidence demonstrating clear benefit with statin therapy in older individuals, this population remains chronically undertreated. Scope. This paper provides an overview of the current evidence available regarding the efficacy and safety of statin therapy to reduce cardiovascular risk in older patients. We use hypothetical case studies to address some of the questions frequently posed by physicians responsible for the cardiovascular health of older patients. Conclusions. Various factors may account for the failure to provide appropriate treatment, including a lack of awareness of clinical benefits and perceived safety issues. However, if current guidelines are followed and older patients treated to appropriate LDL-C goals, the likelihood of cardiovascular events will be reduced in this high-risk population. Employing an evidence-based approach to the management of cardiovascular risk in older patients is likely to yield benefits in terms of overall cardiovascular burden.
Periorbital edema secondary to positive airway pressure therapy
Authors: Francesco Dandekar, Macario Camacho, Jason Valerio, Chad. M. Ruoff
Journal: Case Rep Ophthalmol Med (2015)
MeSH terms: Case Reports

Two patients developed bilateral, periorbital edema after initiating positive airway pressure (PAP) therapy with a full face mask. The periorbital edema was more pronounced in the morning and would dissipate throughout the day. This phenomenon seemed to be correlated with the direct pressure of the full face mask, which may have impaired lymphatic and venous drainage. To test this hypothesis, each patient was changed to a nasal pillow interface with subsequent improvement in the periorbital edema.
Long-term survival of a patient with lung cancer metastasis to the spine following surgical treatment combined with radiation and epithelial growth factor receptor inhibitor therapy: A case report
Authors: Songfeng Xu, Xiuchun Yu, Ming Xu
Journal: Exp Ther Med (2015)
Keywords: epidermal growth factor receptor inhibitor, lung cancer, radiation, spine metastases, surgical treatment

The prognosis of patients with lung cancer metastasis to the spine is poor, and the choice of surgery is questionable based on the aggressiveness of the disease. The present study describes a case of a 56-year-old male with metastatic spinal cord compression. The patient underwent surgery for posterior decompression and internal fixation, in addition to receiving postoperative radiation and epidermal growth factor receptor (EGFR) inhibitor medication. After 24 months, positron emission tomography-computed tomography scan showed a reduction in the left upper lobe mass in the short axis and inactivation of the neoplasm in the left upper lobe and T9 vertebra. Based on these promising results, it is suggested that orthopedic oncologists consider the combination of radiation and EGFR inhibitor therapy with surgery for the treatment of lung cancer metastasis to the spine.
Treatment of a Neglected Patellar Tendon Rupture with a Modified Surgical Technique: Ipsilateral Semitendinosus Autograft Reconstruction with Suture Tape Augmentation
Authors: Sanjum P Samagh, Fernando A Huyke, Lucas Buchler, Michael A Terry, Vehniah K Tjong
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Patellar tendon ruptures are rare, but debilitating injuries are typically seen in young active males in the third and fourth decades of life. They can occur as a single acute injury or from repetitive microtrauma weakening the tendon. Patients typically present complaining of knee pain, swelling, and an inability to perform a straight leg raise. Most conventionally, these injuries are classified as acute (less than two weeks) or chronic (greater than two weeks) based upon the timing of presentation. In patients with patellar tendon ruptures and inability to perform a straight leg raise, patellar tendon repair is most often recommended. A subset of patients with chronic patellar tendon ruptures, however, presents several months after their initial injuries. These neglected patella tendon ruptures present a particularly challenging clinical scenario in which primary repair is often difficult or not possible. This case report describes a modification to an existing surgical technique for reconstructing the patellar tendon using an ipsilateral semitendinosus tendon autograft with suture tape augmentation.
Postdiverticular stasis-introduction of a new etiology for small intestine obstruction: a case series
Authors: Seyed Abdollah Mousavi, Hassan Karami
Journal: Case Rep Med (2012)

Introduction. Intestinal obstruction in the setting of Meckel's diverticulum in young age and with orange and meat bezoar is a rare, previously unreported condition. Since the obstruction point is located immediately after Meckel's diverticulum in our patients, we attempt to introduce "localized peristalsis insufficiency" as a new etiology for small intestine obstruction while reviewing the findings of previous studies. Conclusion. Intestinal obstruction in the setting of Meckel's diverticulum and with orange and meat bezoar is a rare, previously unreported condition. Considering the previous reports, we may present the theory of localized peristalsis insufficiency in patients with Meckel's diverticulum.