OpenMed/multicare-articles huggingface dataset:
COVID- 19 and sickle cell disease: autopsy findings of three deaths at the 37 Military Hospital, Accra, Ghana
Authors: Seth Andrews Attoh, Emmanuel Sarkodie, Raymond Fatchu, Amma Benneh-Akwasi Kuma, Edward Asumanu, Mary McAddy, Alfred Toppar, Frederick Hobenu, Kwasi Agyeman-Bediako, Lawrence Edusei, Patrick Kafui Akakpo
Journal: Pan Afr Med J (2022)
Keywords: covid-19, ghana, sars-cov-2, autopsy findings, pathology, sickle cell disease
MeSH terms: Anemia, Sickle Cell / complications, COVID-19 / complications, Respiratory Distress Syndrome, Case Reports, Adult, Aftercare, Autopsy, Ghana / epidemiology, Hospitals, Military, Humans, Infant, Newborn, Lung / pathology, Patient Discharge, SARS-CoV-2, United States

The main pathological effects of COVID-19 infection have been reported to occur in the lungs, with the most pronounced manifestation being reported as Adult Respiratory Distress Syndrome (ARDS) with thromboembolic phenomena. Sickle Cell Disease (SCD) is a common genetic disorder present in 2% of newborns in Ghana. The complications of SCD include Vaso-Occlusive Crisis and Acute Chest Syndrome, which primarily manifest in the lungs. The effects of SCD on the progression of COVID-19 have not been extensively and clearly documented in literature. The objective was to describe the clinical and pathological findings in three SCD patients who died of COVID-19 related complications. A complete autopsy was performed on each of the three SCD patients who were presumed to have COVID-19. Lung swabs were subsequently taken and tested for SARS-CoV-2. The differences in histopathological findings of the three cases were highlighted and correlation with clinical findings was also done. Lung histopathological findings for all three cases were consistent with Acute Respiratory Distress Syndrome (ARDS)/ Diffuse Alveolar Damage (DAD) described for infections with COVID-19 and lung swabs tested for SARS-CoV-2 by real time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) were positive. Though SCD has been reported not to adversely affect an individual´s chance of worse outcome when infected with COVID-19, our findings suggest otherwise. We suggest that SCD may be an important co-morbidity that needs to be considered in COVID-19 patients and when present needs to be considered as an adverse risk for poor outcomes. Also, post-discharge anti-coagulation and monitoring should be encouraged. More autopsies are required to fully understand the pathogenesis of COVID-19 in SCD patients.
Using the Neuroadaptagen KB200z™ to Ameliorate Terrifying, Lucid Nightmares in RDS Patients: the Role of Enhanced, Brain-Reward, Functional Connectivity and Dopaminergic Homeostasis
Authors: Thomas McLaughlin, Kenneth Blum, Marlene Oscar-Berman, Marcelo Febo, Zsolt Demetrovics, Gozde Agan, James Fratantonio, Mark S Gold
Journal: J Reward Defic Syndr (2015)
Keywords: functional brain connectivity, kb200z, lucid dreams, nightmares, ptsd, putative natural dopamine agonist

Background:
Lucid Dreams are a form of dream life, during which the dreamer may be aware that he/she is dreaming, can stop/re-start the dreams, depending on the pleasantness or unpleasant nature of the dream, and experiences the dream as if he/she were fully awake. Depending on their content, they may be pleasant, un-pleasant or terrifying, at least in the context of patients, who also exhibit characteristics of Reward Deficiency Syndrome (RDS) and Posttraumatic Stress Disorder (PTSD).
Case series:
We present eight clinical cases, with known substance abuse, childhood abuse and diagnosed PTSD/RDS. The administration of a putative dopamine agonist, KB200Z™, was associated with the elimination of unpleasant and/or terrifying, lucid dreams in 87.5% of the cases presented, whereas one very heavy cocaine abuser showed a minimal response. These results required the continuous use of this nutraceutical. The lucid dreams themselves were distinguishable from typical, PTSD nightmares insofar as their content did not appear to reflect a symbolic rendition of an originally-experienced, historical trauma. Each of the cases was diagnosed with a form of RDS, i.e., ADHD, ADD, and/or Tourette's syndrome. They all also suffered from some form of Post-Traumatic-Stress-Disorder (PTSD) and other psychiatric diagnoses as well.
Conclusion:
The reduction or elimination of terrifying Lucid Dreams seemed to be dependent on KB220Z, whereby voluntary stopping of the agent results in reinstatement of the terrifying non-pleasant nature of the dreams. Following more required research on a much larger population we anticipate confirmation of these seemingly interesting observations. If these results in a small number of patients are indeed confirmed we may have found a frontline solution to a very perplexing and complicated symptom known as lucid dreams.
Renal angiomyolipoma in tuberous sclerosis complex: Case series and literature review
Authors: Mansour Mbengue, Bede Bigirimana, Seynabou Diagne, Abdou Niang
Journal: Clin Nephrol Case Stud (2023)
Keywords: angioembolization, angiomyolipoma, tuberous sclerosis complex
MeSH terms: Case Reports

Tuberous sclerosis complex (TSC) is a genetic disease characterized by the growth of numerous noncancerous tumors in many parts of the body mainly the skin, brain, kidneys. The prevalence of the disease is estimated to be 7 - 12 in 100,000. We report the cases of two black African women diagnosed with TSC at age 25 and 54. They both had renal angiomyolipoma, facial angiofibroma and diffuse hypochromic macules. The older patient remained stable for the 11 years following her diagnosis. But, in the second patient, the disease was more severe with a giant angiomyolipoma, complicated by renal intracystic hemorrhage leading to the patient's death 1 month after diagnosis. Renal involvement can be life-threatening in patients with TSC. The risk of fatal bleeding increases with the size of the tumor. The mTOR inhibitors and angioembolization can improve the prognosis of this disease.
A case of symptomatic tailgut duplication cyst(retro-rectal cystic hamartoma) in an adult male
Authors: Koushik Sarkar, Pranay Kabiraj, Debasis Deoghuria, Jayati Bardhan
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Tailgut duplication cyst (retro-rectal cystic hamartoma) is a rare congenital developmental lesion arising from post-natal primitive gut remnants. Tailgut cysts are found more commonly in middle-aged females. It may be asymptomatic or symptomatic in complicated cases. Major differentials include epidermoid cyst, dermoid cyst and anterior meningocele. Unfortunately no radiological sign can specifically diagnose it and surgical resection and histopathology remain the cornerstone for diagnosis. Here we present a case of symptomatic tailgut duplication cyst in an adult male.
Acute Cerebral Infarct and Saddle Pulmonary Embolism in a Post-COVID-19 Patient Treated With Thrombolytics
Authors: Christopher Sampson, Obiaara Ukah
Journal: Cureus (2023)
Keywords: case report, covid-19, cva, embolism, pe, stroke, thrombolytics
MeSH terms: Case Reports

The coronavirus disease 2019 (COVID-19) has been associated with a prothrombotic state during active infection with the severe acute respiratory syndrome coronavirus (SARS-CoV-2). However, reports of delayed multisystemic COVID-19-associated thromboembolic sequelae are limited in the current literature. In addition, the initiation of prophylactic antithrombotic therapy in patients for the prevention of such events during and after infection remains controversial due to conflicting reports. Here, we present evidence to support that patients with comorbid conditions are at higher risk for multisystemic COVID-19-associated thromboembolic events and propose that beginning prophylactic therapy in this population could lead to more favorable outcomes. We describe a 67-year-old male who presented with left-sided weakness and worsening shortness of breath and was diagnosed with COVID-19 approximately one month prior. Initial computed tomography (CT) of the brain showed an age-indeterminate cerebellar infarct. On CT angiography (CTA) of the neck, a saddle embolus was incidentally found and was confirmed on an immediate follow-up chest CT. After consultation with neurology, a decision was made to administer thrombolytics at the standard recommended stroke dosing. The patient was admitted to the ICU and received mechanical thrombectomy two days later. At the time of hospital discharge, the patient still had left-sided weakness on examination and required no additional oxygen support. This report reviews the prevalence of delayed sequelae of COVID-19 and the benefit of prophylactic antithrombotic therapy during active and post-SARS-CoV-2 infection. It is important for emergency medicine physicians to recognize that patients who have recovered from COVID-19 are at high risk for delayed thromboembolic disease, even in the absence of personal or family history of coagulopathy. This underscores the necessity of obtaining imaging studies in high-risk patients who present with acute symptoms that cannot be explained by other probable causes. In addition, patients should be encouraged to follow up with their primary care providers to discuss prophylactic anticoagulation therapy as it could be beneficial during and post-COVID-19.
Case report: A case of heterogeneity of the antitumor response to immune checkpoint inhibitors in a patient with relapsed hepatocellular carcinoma
Authors: Yingying Bao, Liang Wen, Wen Chen, Jianhui Zhao, Yixiao Yang, Tao Wei, Jian Zhang, Tingbo Liang
Journal: Front Oncol (2022)
Keywords: complex treatment, hepatocellular carcinoma, immune checkpoint inhibitor, lung metastases, α-fetoprotein
MeSH terms: Case Reports

The existence of tumor heterogeneity is widely recognized; however, heterogeneity of the antitumor response in multiple tumor nodules in the same patient has not been reported. Sintilimab, a monoclonal antiprogrammed cell death receptor-1 (PD-1) antibody, was used to treat patients with unresectable hepatocellular carcinoma (HCC). In the present study, we report a case of therapeutic heterogeneity in relapsed HCC with lung metastases. A 57-year-old female patient was diagnosed with HCC and underwent radical hepatectomy. One and a half years later, imaging scans found multiple metastatic tumors in the lung, which were accompanied by an increased α-fetoprotein (AFP) level. The patient then started to receive sintilimab. In the first 6 months after sintilimab treatment, all the metastatic nodules regressed gradually and ultimately disappeared, except for one nodule, which remained stable in the following 3 months. Finally, the patient underwent pulmonary lobectomy to remove the remaining nodule. Thereafter, follow-up visits showed the AFP level decreased to normal and imaging scans showed no signs of recurrence, confirming that the patient exhibited a clinically complete response. Pathological assessments showed that in the primary tumor site, the tumor comprised moderately differentiated HCC with a few infiltrated cytotoxic T cells and negative PD-L1 expression. While in the metastatic site, the nodule was composed of poorly differentiated HCC with cytotoxic T-cell infiltration with few cells inside the tumor and expressed PD-L1 in some areas of the tumor. There were dynamic alterations of PD-L1 expression and cytotoxic T-cell infiltration in the primary and relapsed HCC lesions after anti-PD-1 treatment. This case presented the heterogeneities of both the tumor microenvironment and the following antitumor response among the metastatic nodules in the same patient and revealed the importance of comprehensive therapy in cancer treatment.
Large intra-articular anterior cruciate ligament ganglion cyst, presenting with inability to flex the knee
Authors: Jake Sloane, Vivek Gulati, Sreeram Penna, Philip Pastides, Davinder Paul Singh Baghla
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

A 41-year-old female presented with a 3-month history of gradually worsening anterior knee pain, swelling and inability to flex the knee. Magnetic resonance imaging (MRI) revealed a large intra-articular cystic swelling anterior to the anterior cruciate ligament (ACL), extending into the Hoffa's infrapatellar fat pad. Following manipulation under anaesthesia and arthroscopic debridement of the cyst, the patient's symptoms were relieved with restoration of normal knee motion. ACL ganglion cysts are uncommon intra-articular pathological entities, which are usually asymptomatic and diagnosed incidentally by MRI. This is the first reported case of an ACL cyst being so large as to cause a mechanical block to knee flexion.
The Value of Imagistics in Early Diagnosis of Tuberous Sclerosis
Authors: Claudia Ioana Borțea, Vlad Laurentiu David, Florina Stoica, Cezara Mureșan, Marioara Boia
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Tuberous sclerosis complex is a multisystemic genetic disorder with high phenotypical variability. Its progress frequently brings along autism (61%), epilepsy, intellectual disability (45%), and neurocognitive impairment (Gipson and Johnston, 2017). We are considering the case of an infant suspected with tuberous sclerosis complex by imagistic investigation in the prenatal period. The pre- and postnatal ultrasound, fetal MRI, ophthalmoscopy, and dermatological and neurological examinations were used for diagnosis and follow-up. The seven major and minor criteria were regarded as sufficient for accurate diagnosis.
Forty-Year Follow-up of Full-Thickness Skin Graft After Thermal Burn Injury to the Volar Hand
Authors: Dexter Weeks, Morton L Kasdan, Bradon J Wilhelmi
Journal: Eplasty (2016)
Keywords: burn injury reconstruction, burn reconstruction, full-thickness skin graft, thermal burn injury, volar hand burn
MeSH terms: Case Reports

Background:
The hands are commonly affected in severe thermal burn injuries. Resulting contractures lead to significant loss of function. Burn contracture release and skin grafting are necessary to restore hand function. We report a case in which surgical reconstruction of a volar hand burn was performed with full-thickness skin grafting. The patient had a 40-year follow-up to assess the function and cosmesis of the repaired hand.
Methods:
We report a case in which a 15-month-old boy presented after receiving third-degree burns to the left volar hand, including the flexural aspects of the index, long, and ring fingers by placing it on a hot kitchen stove burner. The patient subsequently underwent scar contracture release and full-thickness skin grafting.
Results:
Eleven years after reconstruction, further contractures developed associated with the patient's growth, which were reconstructed with repeat full-thickness skin graft from the inguinal region. No recurrence was witnessed afterward and 40 years after initial injury, the patient maintains full activities of daily living and use of his hand in his occupation.
Conclusions:
There is debate regarding the superiority of split-thickness versus full-thickness grafts during reconstruction. Our case strengthens the argument for durability of a full-thickness skin graft following thermal burn injury.
A 3-Year-Old Girl with Recurrent Infections and Autoimmunity due to a STAT1 Gain-of-Function Mutation: The Expanding Clinical Presentation of Primary Immunodeficiencies
Authors: Juan Carlos Aldave Becerra, Enrique Cachay Rojas
Journal: Front Pediatr (2017)
Keywords: autoimmunity, gain-of-function mutation, hematopoietic stem cell transplantation, immunodeficiency, signal transducer and activator of transcription 1
MeSH terms: Case Reports

We report a 3-year-old Peruvian girl, born to non-consanguineous parents. At the age of 8 months, she had a severe pneumonia complicated with empyema that required thoracic drainage and mechanical ventilation. Although no microorganisms were isolated, the patient recovered with broad-spectrum antibiotics. Since that date, she has presented multiple episodes of pneumonia and recurrent episodes of bronchospasm. At 1 year 5 months of age, the patient began with recurrent episodes of oropharyngeal, vaginal, and skin candidiasis, which improved transiently after using oral azole drugs. At 2.5 years of age, she was admitted with lupus-like syndrome, including serositis, hemolytic anemia, thrombocytopenia, and positive antinuclear (1:80) and dsDNA (1:10) autoantibodies. Available immunologic testing was not contributory. Imaging studies revealed bilateral ethmoidal sinusitis and mild hepatomegaly. Bone marrow analysis did not showed evidence of leukemia or myelodysplasia, while renal biopsy concluded mild mesangial proliferation. Genetic studies revealed a pathogenic heterozygous signal transducer and activator of transcription 1 gain-of-function mutation (WT/P293L). The clinical status and lung function of the patient has worsened progressively. She has not achieved an optimal response to therapy, including high-dose intravenous immunoglobulin, GM-CSF, prophylactic antibiotics and antifungal drugs, so we plan to perform hematopoietic stem cell transplantation.
Long-term survival is possible using cytoreductive surgery plus HIPEC for sarcomatosis-Case report of 2 patients
Authors: Paul H Sugarbaker
Journal: Int J Surg Case Rep (2019)
Keywords: case report, cisplatin, doxorubicin, eipl (extensive intraperitoneal lavage), hyperthermia, ifosfamide, intraperitoneal chemotherapy, pci (peritoneal cancer index), peritoneal metastases

Background:
Sarcomatosis results from the dissemination of cells from an abdominal or pelvic primary sarcoma to the peritoneal surfaces. In most patients this is a lethal condition.
Methods:
The clinical and radiologic features of two patients with sarcomatosis were reviewed. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) were used for treatment. Current status of these two patients was available.
Results:
These two patients had a large extent of disease. In one, a myxoid sarcoma filled the pelvis. In another, all quadrants of the abdomen and pelvis were involved by peritoneal metastases from a uterine leiomyosarcoma. The grade of these two tumors was moderate and low. Surgical resection of all sarcomatosis was performed and this was followed by HIPEC. Clinical and radiologic follow-up at 37 and 58 months after complete cytoreduction show no evidence of disease.
Conclusion:
An effort to identify patients with sarcomatosis who are predicted to have a complete cytoreduction should occur when these patients are evaluated. Patients with a complete resection and a sarcoma-specific HIPEC may have prolonged disease-free survival. No other treatments for these patients have been described.
Refractory Ventricle Arrhythmias Alternating with Pulseless Electrical Activity in a Young Woman Rescued by Extracorporeal Cardiopulmonary Resuscitation
Authors: Ilona Lálová, Lucie Filipovská, Hana Skalická, Ondřej Šmíd, Aleš Linhart, Helena Kollárová, Jan Bělohlávek
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Introduction:
Extracorporeal cardiopulmonary resuscitation (ECPR) is a challenging approach for treating refractory out-of-hospital cardiac arrest (OHCA).
Case presentation:
The authors describe a case of a 40-year-old Caucasian female who suffered from refractory OHCA, was admitted to a hospital while receiving ongoing cardiopulmonary resuscitation, and was connected to venoarterial extracorporeal membrane oxygenation 73 minutes after collapse. Ventricular tachyarrhythmias alternating with pulseless electrical activity resolved after eight hours. Following complete cardiac and neurological recovery, only adenoviral genome was found in myocardial biopsy. After 11 months, another episode of identical arrhythmias was rescued by an implantable cardioverter-defibrillator.
Conclusion:
Adequate prehospital and early hospital logistics is a prerequisite for successfully implementing extracorporeal cardiopulmonary resuscitation for refractory OHCA.
Pigmented tumour of the eyelid with unexpected findings
Authors: Anne C Hunold, Martina C Herwig, Frank G Holz, Hans-Peter Fischer, Karin U Loeffler
Journal: Case Rep Pathol (2012)
MeSH terms: Case Reports

A 63-year-old patient presented with a small painless nodular tumour of his left lower eyelid which had increased in size over the last few weeks. The tumour was excised by wedge resection and submitted for ophthalmopathologic examination. Histopathologic examination revealed a cystic lesion of apocrine origin with focal proliferations. The proliferative cells appeared pleomorphic and displayed marked atypia. Staining with Ki67 revealed a significant mitotic activity supporting the diagnosis of an apocrine adenocarcinoma of Moll. As the lesion displayed in most parts characteristics of a benign apocrine hidrocystoma, a thorough and critical histopathological examination is required in such cases to avoid missing an early malignant transformation.
Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction
Authors: Mohammad Al-Attar, Anup Jnawali, Michelle Yang
Journal: Case Rep Pathol (2023)
MeSH terms: Case Reports

Pleomorphic liposarcoma (PLS) is typically found in the lower and upper extremities. PLS arising in the gastrointestinal (GI) tract is extremely rare. Here, we reported a case of a 71-year-old female with a history of rectal adenocarcinoma presenting with small bowel obstruction. Small bowel resection was performed and revealed a 7.8 cm transmural mass in the jejunum. Histology reviewed a heterogenous epithelioid malignant tumor with intracytoplasmic fatty droplets scalloping the nucleus consistent with lipoblasts in some cells and others with numerous PAS/diastase+intracytoplasmic eosinophilic globules. Scattered multinucleated giant cells were also present. Mitotic count was up to 80/10 HPFs including some bizarre mitotic figures, and Ki67 proliferation index was approximately 60%. Immunohistochemistry demonstrated that the malignant cells were negative for pancytokeratin, CD117, DOG1, SMA, desmin, MyoD1, ERG1, CD34, CD31, SOX10, Melan A, and S100. INI1 was retained. Beta-catenin showed normal membranous staining. P53 was diffusely positive suggestive of mutant phenotype. Fluorescence in situ hybridization (FISH) assay was negative for MDM2 amplification and DDIT3 rearrangement. The overall morphologic and immunohistochemical features supported a diagnosis of high-grade pleomorphic liposarcoma. Diagnosis of PLS can be challenging due to its rarity in GI tract and lack of specific biomarkers, and histomorphology with identification of lipoblasts remains the gold standard.
A Rare Case of Concrescence of Mandibular Third Molar and Supernumerary Fourth Molar
Authors: Jiao Wang, Errui Wang, Xin Yang, Lu Yuan, Zhige Li, Jie Zhang, Baoping Zhang
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Concrescence reveals a rare developmental anomaly in which two fully formed teeth are joined along the root surfaces by cementum, and generally occurs in maxillary molars, especially in a third molar and a supernumerary tooth. Very few cases have been reported about the concrescence of a third molar and a supernumerary fourth molar. Based on our available knowledge, this case report described a rare presentation in which concrescence is observed between a third molar and a supernumerary fourth molar in the mandible by diagnosing with cone-beam CT and histological examination.