OpenMed/multicare-articles huggingface dataset:
Ticagrelor as an Alternative for Clopidogrel-Associated Acute Arthritis
Authors: Starr-Mar'ee C Bedy, Jacob P Kesterson, Greg Flaker
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

A 65-year-old Caucasian man was hospitalized for a non-ST-elevation myocardial infarction. On discharge, the patient was started on multiple new medications, including clopidogrel and atorvastatin. Twenty-six days after discharge, he presented to the Emergency Department (ED) with polyarthralgias. He was instructed to stop atorvastatin and to follow up with rheumatology and cardiology clinic. At cardiology clinic follow-up 43 days after ED discharge, clopidogrel was discontinued and patient was switched to ticagrelor. On follow-up one month later, his symptoms had completely resolved. During the next 4 months, patient had routine follow-up due to participation in Cardiopulmonary Rehab and he had no cardiac events or recurrence of joint symptoms. Our patient had no history of arthritis. Because he initially presented with 2 medication classes associated with arthritis, each was withdrawn separately. The temporal association of patient's symptomatic improvement strongly suggests that the arthritis was caused by clopidogrel. Our patient was able to tolerate ticagrelor with complete resolution of his arthritis and no cardiac events. Clopidogrel-induced arthritis is a rare adverse drug event. For patients with a recent drug-eluting stent, alternative antiplatelet therapy with ticagrelor may provide positive cardiac outcomes without similar adverse effects.
Restoration of strip crown with a resin-bonded composite cement in early childhood caries
Authors: Mi-Ae Jeong, Ah-Hyeon Kim, Youn-Soo Shim, So-Youn An
Journal: Case Rep Dent (2013)

Background. Early childhood caries is a widely prevalent disease throughout the world. It is necessary to treat this condition in early childhood; however, child behavior management may be particularly challenging during treatment. To overcome this challenge, we used Carigel to remove caries and RelyX Unicem resin cement for strip crown restoration. It not only has the desired aesthetic effect but is also more effective for primary teeth, which are used for a shorter period than permanent teeth are. Case Presentation. We report a case of three pediatric patients with early childhood caries, in whom caries was removed by using Carigel to avoid the risk of pulpal exposure associated with high-speed handpieces. Subsequently, aesthetic restoration was performed using strip crown with RelyX Unicem self-adhesive resin cement. Conclusion. RelyX Unicem has the following advantages: (1) not requiring have any special skills for the dentist for performing the procedure, (2) decreased occurrence of bubbles during injection of the cement, and (3) overall short duration of the procedure. Thus, it is appropriate for the treatment of pediatric patients whose behavior is difficult to manage. However, further studies are required in order to establish the use of RelyX Unicem as a stable restorative material in early childhood caries.
Diagnosis of coronary artery disease using targeted post-mortem computed tomography coronary angiography: a case report
Authors: Lei Wan, Yu Shao, Donghua Zou, Ping Huang, Zhengdong Li, Maowen Wang, Yijiu Chen
Journal: Forensic Sci Res (2017)
Keywords: forensic science, pmct, pmcta, coronary atherosclerosis, forensic pathology, post-mortem forensic imaging, targeted coronary angiography
MeSH terms: Case Reports

Targeted post-mortem computed tomography (PMCT) combined with coronary angiography has the potential to play a significant role in the investigation of sudden cardiac death. The authors utilized a targeted PMCT coronary angiography in a case involving a 53-year-old man who died from acute myocardial ischemia and cardiac decompensation which may result from coronary artery disease (CAD). The victim collapsed suddenly at work and died soon after arrival to hospital. The body was examined using PMCT and targeted PMCT coronary angiography. The left anterior descending coronary artery exhibited 75%-100% stenosis in the middle segment; however, the distal segment could not be clearly visualized. In addition, the left circumflex and right coronary artery exhibited calcification, atherosclerosis and an area of 50% stenosis. Signs of cardiogenic pulmonary oedema were also identified. The imaging results suggested that this individual had coronary atherosclerosis and probably died from CAD. The autopsy and histological examination revealed acute myocardial ischemia and myocardial scarring, confirming the cause of death while excluding other probabilities. In summary, targeted post-mortem computed tomography angiography (PMCTA) can visualize the arteries and estimate the degree of principal pathological changes. This method is a simple, reliable and sensitive technique for identifying the presence of coronary atherosclerosis. It is a valuable post-mortem forensic imaging method and should be recommended in the investigation of suspicious cardiac deaths.
First Sternal Cleft Repair Using a Porous Alumina Ceramic Prosthesis in a 9-Year-Old Child
Authors: Virginie Fouilloux, François Bertin, Emilie Peltier, Jean-Luc Jouve
Journal: European J Pediatr Surg Rep (2019)
Keywords: bioceramics, prosthesis, sternal cleft, tissue engineering
MeSH terms: Case Reports

Sternal cleft is a rare congenital abnormality, often associated with other congenital defects. We present the case of a 9-year-old child with complete sternal cleft, treated with an innovative sternal prosthesis. Surgery was performed to protect the heart and also, as pulsations was visible, leading to serious esthetical concerns, to enhance school integration, which was difficult. The porous alumina device used was initially designed for sternal reconstruction after refractory deep sternal wound infection or carcinoma. Surgery and early follow-up were simple. There was no complication and the follow-up of more than 1 year reveals a good healing without breath discomfort and a correct development of the chest wall. In this rare indication, the alumina ceramic sternal prosthesis offers a reliable alternative to classical methods, such as muscle flap, autogenous tissue transfer, costal homograft, and other prosthetic materials like mesh or synthetic patch.
Collagen cross-linking: current status and future directions
Authors: Marine Hovakimyan, Rudolf F Guthoff, Oliver Stachs
Journal: J Ophthalmol (2012)

Collagen cross-linking (CXL) using UVA light and riboflavin (vitamin B2) was introduced as a clinical application to stabilize the cornea by inducing cross-links within and between collagen fibers. CXL has been investigated extensively and has been shown clinically to arrest the progression of keratoconic or post-LASIK ectasia. With its minimal cost, simplicity, and proven positive clinical outcome, CXL can be regarded as a useful approach to reduce the number of penetrating keratoplasties performed. Small case series have also indicated that CXL is beneficial in corneal edema by reducing stromal swelling behavior and in keratitis by inhibiting pathogen growth. Despite these encouraging results, CXL remains a relatively new method that is potentially associated with complications. Aspects such as side effects and recurrence rates have still to be elucidated. In light of the growing interest in CXL, our paper summarizes present knowledge about this promising approach. We have intentionally endeavored to include the more relevant studies from the recent literature to provide an overview of the current status of CXL.
The Potential Synergic Effect of a Complex Pattern of Multiple Inherited Genetic Variants as a Pathogenic Factor for Ovarian Dysgenesis: A Case Report
Authors: Alessandro Cattoni, Alice Spano, Anna Tulone, Annalisa Boneschi, Nicoletta Masera, Silvia Maitz, Anna Maria Di Blasio, Luca Persani, Fabiana Guizzardi, Raffaella Rossetti
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: figla gene, nobox gene, nr5a1 gene, antimullerian hormone (amh), fertility, gene variants, gonadal dysgenesis (gd), primary ovarian insufficiency (poi)
MeSH terms: Genetic Diseases, X-Linked / genetics, Genetic Diseases, X-Linked / pathology, Gonadal Dysgenesis / genetics, Gonadal Dysgenesis / pathology, Primary Ovarian Insufficiency / genetics, Primary Ovarian Insufficiency / pathology, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Basic Helix-Loop-Helix Transcription Factors / genetics, Female, Genetic Diseases, X-Linked / complications, Genetic Variation, Gonadal Dysgenesis / complications, Homeodomain Proteins / genetics, Humans, Primary Ovarian Insufficiency / complications, Steroidogenic Factor 1 / genetics, Transcription Factors / genetics, Basic Helix-Loop-Helix Transcription Factors, FIGLA protein, human, Homeodomain Proteins, NOBOX protein, human, NR5A1 protein, human, Steroidogenic Factor 1, Transcription Factors

Non-syndromic primary ovarian insufficiency due to ovarian dysgenesis in 46,XX patients is an uncommon finding in the general population, even though several monogenic variants have been reported as causative factors. Here, we describe a 15-year-old patient diagnosed with gonadal dysgenesis possibly due to the interaction of three potentially pathogenic variants of genes involved in ovarian maturation, namely factor in the germline alpha (FIGLA), newborn ovary homeobox-encoding (NOBOX) and nuclear receptor subfamily 5 group A member 1 (NR5A1). We also describe a different degree of residual ovarian function within the proband's family, whose female members carry one to three demonstrated variations in the aforementioned genes in a clinical spectrum potentially dependent on the number of alleles involved. Our results support the hypothesis that the severity of the clinical picture of the proband, resulting in complete ovarian dysgenesis, may be due to a synergic detrimental effect of inherited genetic variants.
Case Report: Expanding the Phenotypic Spectrum of Timothy Syndrome Type 1: A Sporadic Case With a de novo CACNA1C Pathogenic Variant and Segmental Ileal Dilatation
Authors: Ahmed A Nugud, Nermeen Mahmoud ELkholy, Awad Alkarim Omar, Abid Qazi, Christos Tzivinikos, Nidheesh Chencheri, Sabina Khan, Muhammad Eyad Ba'Ath
Journal: Front Pediatr (2021)
Keywords: cacna1c mutation, segmental ileal dilatation, timothy syndrome, long qt syndrome, seizure disorder, syndactyly
MeSH terms: Case Reports

Background: Long QT syndactyly syndrome (long QT syndrome type 8), also known as Timothy Syndrome (TS) was first described in 1994 with still <50 case reported in the literature. The full spectrum of the syndrome is not yet known. Results: Here we report a girl who presented with new onset refractory seizures and an undiagnosed cause of intermittent abdominal distention. She also had syndactyly of her fingers and toes and was found to have prolonged QT. Upon further investigations she was found to have a de novo pathogenic variant in CACNA1C, along with Segmental Ileal Dilatation (SID), and subsequently diagnosed with Timothy syndrome. Conclusion: To our knowledge, the association of Timothy Syndrome with Segmental Ileal Dilatation, was not described before.
Adrenal metastasis as first presentation of hepatocellular carcinoma
Authors: Kostas Tsalis, Emmanouil Zacharakis, Nikolaos Sapidis, Ioannis Lambrou, Evangelos Zacharakis, Dimitrios Betsis
Journal: World J Surg Oncol (2005)

Background:
Metastases from hepatocellular carcinoma (HCC) can be found in the lung and adrenal gland. We report case of a patient who presented with adrenal metastasis as the first clinical manifestation of HCC.
Case presentation:
A patient was referred for surgical treatment for a tumor in retro-peritoneal space. The computerized tomography (CT) scan revealed a mass originating from the left adrenal gland. The patient underwent left adrenalectomy and the exploration of abdominal cavity did not reveal any other palpable lesions. Histologically, the resected lesion was a poorly differentiated metastatic tumor from HCC. Seven months later patient was readmitted complaining of cachexia, icterus, and significant weight loss. CT scan revealed hyperdense lesions of the liver.
Conclusion:
HCC may have atypical presentations like in present case. Fine needle aspiration/tru-cut biopsy might be useful in the investigation of an accidentally discovered adrenal mass regardless of the size and can lead to the detection of a primary tumor.
Management of congenital midline nasofrontal masses: case report and review of literature
Authors: A C Volck, G A Suárez, A J Tasman
Journal: Case Rep Otolaryngol (2015)

Epidermoid cysts, dermoids, gliomas, and meningo-/encephaloceles are the most important differential diagnoses in congenital nasofrontal masses. Since they arise from an abnormal fusion during fetal development, intracranial extension of the lesion has to be ruled out radiologically before therapy. Dermoids are the most common entity. We report about a congenital epidermoid cyst of the glabella and nasion that had been growing over the last two years before presentation in a 24-year-old patient. We discuss radiological imaging and the different surgical approaches described in literature.
Case Report: Acute hemorrhagic edema of infancy (Seidlmayer purpura) - a dramatic presentation for a benign disease
Authors: Elena Carboni, Maria Scavone, Ettore Stefanelli, Valentina Talarico, Stefania Zampogna, Maria Concetta Galati, Giuseppe Raiola
Journal: F1000Res (2019)
Keywords: seidlmayer purpura, children, edema, erythematous rash, leukocytoclastic vasculitis
MeSH terms: Purpura / complications, Vasculitis, Leukocytoclastic, Cutaneous / complications, Vasculitis, Leukocytoclastic, Cutaneous / diagnosis, Case Reports, Acute Disease, Edema / complications, Female, Hemorrhage / complications, Humans, Infant

We present a case of an 11-month-old girl who was referred to our unit for an erythematous rash that appeared on the face and extremities. Personal and family history was not relevant. Laboratory tests were normal. During recovery, diameter and colour intensity of the cutaneous lesions increased, but after some weeks, lesions had a self-limited resolution without any treatment. Based on clinical and laboratory findings, a diagnosis of acute hemorrhagic edema of infancy (AHEI) was made. AHEI is a rare cutaneous leukocytoclastic vasculitis that usually affects children aged between 4 and 24 months. Etiology is unknown but almost of 75% of cases are preceded by infectious episodes, vaccinations or use of medications. In contrast to the dramatic cutaneous eruption, clinical conditions are usually optimal. Classically, AHEI is characterized by a triad of symptoms: fever, edema and purpura. Skin lesions are erythematous, annular, medallion-like, purpuric plaques that have a rapid onset and appear on the face and extremities, sparing trunk and mucosal membranes. Initially interpreted as a variant of Henoch-Schönlein purpura, now it is considered a distinct disease. In the majority of cases the disease is benign and self-limited without a visceral involvement, so a conservative approach is most often chosen.
Emergency Separation of Extreme VLBW Omphalopagus Twins: Case Report
Authors: Waleed Burhamah, Amar Alnaqi, Yaqoub Jafar, Esmaeel Taqi
Journal: European J Pediatr Surg Rep (2022)
Keywords: bladder exstrophy, conjoined twins, omphalopagus twins
MeSH terms: Case Reports

The classification of conjoint twins is based according to the site of attachment. The challenges in management of such anomalies span the entire continuum of care from delivery to resuscitation to separation and finally discharge. Scheduled separation is ideal, occasionally the caring team is faced with no option but to perform an emergent separation. Omphalopagus is a type of conjoined twinning characterized by union of the peritoneal cavities through an infraumbilical abdominal wall defect. In this report we describe our experience with a successful emergency separation of extremely preterm omphalopagus twins. This is the first case of conjoint twins in Kuwait, we highlight the challenges faced, stressing the importance of adhering to antenatal care as well as management by a multidisciplinary team.
Sternal osteomyelitis caused by Aspergillus fumigatus years after coronary artery bypass grafting: A case report
Authors: Austin Hingtgen, Rishav Aggarwal, Shreya Avilala, Azmath Mohammed, Rosemary Kelly
Journal: IDCases (2022)
Keywords: aspergillus, cabg, cardiac, osteomyelitis, sternal
MeSH terms: Case Reports

Sternal infection after cardiac surgery is an infrequent post-operative complication. Aspergillus sternal osteomyelitis is a rarity. We review the case of a 77-year-old man with invasive aspergillosis of the sternum and left costal cartilage 23 years after undergoing cardiac surgery. The patient promptly underwent surgical irrigation and debridement, followed by antifungal therapy. Clinical suspicion of sternal fungal infection should be high in patients with mediastinitis with a history of cardiac surgery. Treatment should be prompt.
Longitudinal Analysis of Biologic Correlates of COVID-19 Resolution: Case Report
Authors: Natalie Bruiners, Valentina Guerrini, Rahul Ukey, Ryan J Dikdan, Jason H Yang, Pankaj Kumar Mishra, Alberta Onyuka, Deborah Handler, Joshua Vieth, Mary Carayannopoulos, Shuang Guo, Maressa Pollen, Abraham Pinter, Sanjay Tyagi, Daniel Feingold, Claire Philipp, Steven K Libutti, Maria Laura Gennaro
Journal: Front Med (Lausanne) (2022)
Keywords: rnaemia, convalescent plasma therapy, plasma proteomics, severe covid-19, single-cell transcriptomics
MeSH terms: Case Reports

While the biomarkers of COVID-19 severity have been thoroughly investigated, the key biological dynamics associated with COVID-19 resolution are still insufficiently understood. We report a case of full resolution of severe COVID-19 due to convalescent plasma transfusion. Following transfusion, the patient showed fever remission, improved respiratory status, and rapidly decreased viral burden in respiratory fluids and SARS-CoV-2 RNAemia. Longitudinal unbiased proteomic analysis of plasma and single-cell transcriptomics of peripheral blood cells conducted prior to and at multiple times after convalescent plasma transfusion identified the key biological processes associated with the transition from severe disease to disease-free state. These included (i) temporally ordered upward and downward changes in plasma proteins reestablishing homeostasis and (ii) post-transfusion disappearance of a subset of monocytes characterized by hyperactivated Interferon responses and decreased TNF-α signaling. Monitoring specific dysfunctional myeloid cell subsets in peripheral blood may provide prognostic keys in COVID-19.
A Case of Giant Bladder Carcinosarcoma without Submucosal Invasion
Authors: Masayoshi Zaitsu, Mariko Yamanoi, Koji Mikami, Akiko Tonooka, Toshimasa Uekusa, Takumi Takeuchi
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Carcinosarcoma is a rare biphasic neoplasia containing both malignant mesenchymal and epithelial elements. Bladder carcinosarcoma commonly presented as high-grade, advanced stage, and aggressive behavior with a poor prognosis. An 83-year-old male presented with painless gross hematuria to our hospital. Cystoscopy revealed massive nonpapillary bladder tumor on the right wall. The 91 g tumor could be completely removed with transurethral resection. Histology of the tumor was diagnosed as carcinosarcoma with no submucosal invasion composed of biphasic malignant epithelial and mesenchymal cells. Epithelial malignancy was urothelial cancer and mesenchymal one was chondrosarcoma and leiomyosarcoma. The specimens taken at the second-look TUR-Bt revealed that carcinoma in situ (urothelial cancer) but not sarcoma existed at the mucosa surrounding the previous tumor site. 80 mg of BCG instillation intravesically every week for six weeks was successfully administered to the patient. There is no tumor recurrence for 6 months after treatments.
Traditional Herbal Knowledge among the Inhabitants: A Case Study in Urgam Valley of Chamoli Garhwal, Uttarakhand, India
Authors: Ankit Singh, Robbie Hart, Sudeep Chandra, M C Nautiyal, Alexander K Sayok
Journal: Evid Based Complement Alternat Med (2019)

The Indian Himalaya is rich in plant species, including many medicinal plants, greatly valued by local inhabitants for health care needs. The study in Urgam Valley of Uttarakhand, India, is to identity and document traditional knowledge of medicinal plants. The study revealed high consensus on medicinal plant usage, with 51 species belonging to 31 families used for local health care. Number of species and uses known increases with age, and elders and specialist healers retain higher levels of traditional medicinal plant knowledge, having unique knowledge of medicinal plants and their uses as well as preparation.
Simultaneous, Bilateral Acute Subscapularis Ruptures and Their Arthroscopic Management
Authors: Andrew M Schwartz, Jacob M Wilson, Kyle Hammond
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

We present the first known case of bilateral, acute ruptures of the subscapularis tendons following a bicycle accident in a 43-year-old male. He underwent right shoulder arthroscopic, anatomic subscapularis tendon repair two weeks postinjury, with the left side staged for surgical treatment six weeks after the index procedure. Postoperatively, the patient remained in a sling for 6 weeks before advancing with therapy protocols. The interval between arthroscopic treatments allowed for independence with activities of daily living and focused, early therapy for each shoulder. This approach yielded a right-sided constant score of 89 and subjective shoulder value of 90%; the left side was 87 and 90%, respectively, at 33 months postoperatively. The patient's only postoperative complaint was slightly diminished external rotation, a near-universal limitation after unilateral repair. This represents a successful outcome that balances functional independence, concentrated rehabilitation, and adherence to safe indications for primary repair. While bilateral traumatic shoulder injuries in a young person is a rare clinical entity, early and staged treatment can lead to good patient outcomes.