OpenMed/multicare-articles huggingface dataset:
Anesthetic Management for Multiple Family Members with Myotonic Dystrophy for Interventional Cardiac Procedures-A Case Series
Authors: Leonid Gorelik, Antolin Flores
Journal: Front Med (Lausanne) (2018)
Keywords: anesthetic care of patients with mmd, aspiration risk with myotonic dystrophy, general anesthesia vs monitored anesthesia care for patients with myotonic dystrophy, myotonic muscular dystrophy presentation, pacemaker insertion in patients with myotonic dystrophy
MeSH terms: Case Reports

Myotonic muscular dystrophy (MMD) is a rare autosomal dominant disorder that can complicate anesthetic management of patients. MMD is characterized by progressively worsening muscle loss and weakness, cardiac conduction abnormalities, cardiomyopathy, restrictive lung disease, obstructive sleep apnea, and delayed gastric emptying. Patients presenting with MMD for any surgical procedure present a management challenge to the anesthesiologist. Several reports of airway loss due to medication-mediated respiratory depression, sudden death due to dysrhythmias, aspiration of stomach contents, and prolonged intubation have been reported. We present a case series of three family members with MMD type 1 who presented for electrophysiologic assessment of the cardiac conduction system and possible pacemaker insertion. While there are reports of anesthetic management of patients with myotonic dystrophy for various procedures, our report is unique in that we were able to demonstrate variations of anesthetic management based on the procedure and variation in disease phenotype-differing severity between family members.
Case report: Successful anterior temporal lobectomy in drug-resistant temporal lobe epilepsy associated with Sotos syndrome
Authors: Leonardo Favi Bocca, Thiago Pereira Rodrigues, Thiago Bortholin, Elza Márcia Targas Yacubian, Henrique Carrete Júnior, Mirian Guaranha, Ricardo Silva Centeno
Journal: Front Neurol (2023)
Keywords: sotos syndrome, epilepsy surgery, hippocampal sclerosis, outcome, temporal lobe epilepsy
MeSH terms: Case Reports

The Sotos syndrome is an autosomal dominant disorder characterized by haploinsufficiency of NSD1 gene, with some individuals affected by epilepsy and, rarely, drug-resistant seizures. A 47-years-old female patient with Sotos syndrome was diagnosed with focal-onset seizures in left temporal lobe, left-side hippocampal atrophy, and neuropsychological testing with decreased performance in several cognitive domains. Patient was treated with left-side temporal lobe resection and developed complete awake seizure control in 3-years of follow-up, with marked improvement in quality-of-life. In selected, clinically concordant patients, resective surgeries may play a significant role in improving patient's quality of life and seizure control.
Acute promyelocyte leukemia arose from CALR 1 mutated post essential thrombocythemia- myelofibrosis with splanchnic vein thrombosis: A case report
Authors: E Morsia, G Goteri, E Torre, K B Garvey, G Discepoli, A Tassoni, S Mancini, F Giantomassi, A Poloni, A Olivieri, S Rupoli
Journal: Leuk Res Rep (2021)
Keywords: acute promyelocyte leukemia, blast-phase myeloproliferative neoplasm, essential thrombocytemia, myelofibrosis, splanchnic vein thrombosis
MeSH terms: Case Reports

Major disease complications for patients with essential thrombocythemia (ET) include thrombosis and fibrotic or leukemic transformation. Calreticulin (CALR) mutation type 1 frequencies in ET are estimated between 7% and 11% and ET patients carrying CALR type 1 mutation are associated with lower risk of thrombosis but higher risk of myelofibrosis transformation compared to ET patients with JAK2 mutation. Leukemic transformation rates at 20 years are estimated at less than 5% for ET and risk factors for leukemic transformation are advanced age, thrombosis history, leukocytosis, and anemia. Amongst the subtypes of blast phase myeloproliferative neoplasms, acute promyelocytic leukemia is extremely rare. Herein, we present a case of a promyelocytic blast crisis of post-ET myelofibrosis with associated life-threatening splanchnic vein thrombosis. This case suggests that inflammation plays a key role in thrombotic events and fibrotic/leukemic transformation in ET patients, regardless the molecular landscape.
Towards a sense of urgency for innovation realization: a case study on complacency asymmetries in interorganizational relations
Authors: Christina Marie Mitcheltree
Journal: J Innov Entrep (2023)
Keywords: aluminum, case study, complacency asymmetries, innovation speed, product innovation, urgency

This paper seeks to explore the concept of complacency as a barrier to the sense of urgency within product innovation, by investigating the concept on behalf of interfirm project partners. More specifically, the study aims to understand complacency within the context of an industrial research project in Norway subject to material substitution of an energy transmission tower. As such, the study seeks to give a contextual understanding of complacency for innovation realization (e.g., innovation speed) from a single case study. The study identified different complacency mechanism asymmetries on behalf of the actors, as well as the varying reasons (drivers) to why urgency gaps may occur among actors. The urgency gaps were found to impact a sense of urgency and thus innovation speed negatively. The asymmetries are presented from the drivers: role understanding, competence, project intent, risk and trust. Moreover, the urgency gaps' implications for interorganizational project collaboration, and how they contribute to theory on industrial product innovation, are explained. The findings contribute with new insights on important mechanisms for how a sense of urgency may be enhanced in research projects subject to interorganizational innovation. Theoretical contributions thus relate to enhanced understanding of complacency asymmetry in product innovation collaboration, and how trust is an important dimension for urgency creation.
Buccal Silicone Granuloma Caused by the Dental Infection
Authors: Kazuhiro Murakami, Kazuhiko Yamamoto, Tsutomu Sugiura, Tadaaki Kirita
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

The facial injection of liquid silicone is performed for cosmetic purposes. The use of injectable fillers in facial procedures has become extremely popular over the past decade. Most procedures are performed in the perioral, periocular, and cheek areas of middle-aged women. Even though silicone is biologically inert, its injection can result in the formation of granulomas. Silicone granulomas can result from an inflammatory or autoimmune tissue response. However, the development of silicone granulomas secondary to dental infection has not yet been reported. We report a case of a 73-year-old woman with a right buccal silicone granuloma that developed following a dental infection. Ultimately, this case healed completely after the surgical removal of all lesions. Silicone in the facial region may become infected by a dental infection, and infective silicone develops granulomas and cellulitis. In the context of cosmetic facial silicone injections, it is necessary to improve oral hygiene prior to dental treatment and to maintain a healthy oral environment after surgery. In some cases, surgical treatment using an intraoral approach is effective.
Nocardia thailandica Brain Abscess in an Immunocompromised Patient
Authors: Muhammad Effendi, Samad Tirmizi, Dayna McManus, Anita J Huttner, David R Peaper, Jeffrey E Topal
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Objectives:
Successful treatment for Nocardia thailandica is not well elucidated in the literature. To the best of our knowledge, N. thailandica has not yet been described in the medical literature to cause central nervous system (CNS) infection from brain abscess. We report the case of an immunocompromised patient who underwent successful treatment to treat his brain abscess caused by N. thailandica.
Methods:
After failing medical therapy, the patient underwent a craniotomy, and tissue was sent for culture. Upon identification by 16S rDNA sequencing, the organism causing infection was identified to be N. thailandica.
Results:
Based on susceptibilities, the patient was treated with IV ceftriaxone 2 grams daily for five months. The patient demonstrated clinical and radiological improvement which persisted to 7 months after initiation of therapy.
Conclusions:
To the best of our knowledge, this is the first documented case of a brain abscess due to N. thailandica which was successfully treated. Due to the location of the infection, ceftriaxone was chosen because of optimal CNS penetration. Ceftriaxone monotherapy demonstrated clinical and radiographic treatment success resulting in the successful treatment of this infection.
Coccidioides posadasii in a Dog With Cervical Dissemination Complicated by Esophageal Fistula
Authors: Adrien Izquierdo, Jared A Jaffey, Stephanie Szabo, Jason Struthers, Ogi Okwumabua, Eric T Hostnik, Mana Ohkura, Hien Trinh, Lisa F Shubitz, Marc J Orbach, Mary E White
Journal: Front Vet Sci (2020)
Keywords: canine, coccidioides, coccidioidomycosis, draining tract, esophageal fistula, thyroiditis, valley fever
MeSH terms: Case Reports

A 5-year-old male, neutered mixed breed dog with a history of a mass with an associated draining tract on the ventral cervical region was diagnosed with an esophageal fistula. The dog exhibited serosanguinous discharge from the draining tract, with enlarged left superficial cervical and mandibular lymph nodes, and was reported to have difficulty with deglutition of solid foods. Computed tomography revealed a communication of the draining tract with the esophagus along with enlargement of the left lateral retropharyngeal, left medial retropharyngeal, and mandibular lymph nodes. This prompted surgical exploration and debridement of the site, with closure of the esophageal fistula. Histopathology of thyroid gland, skeletal muscle, and adipose tissue obtained during surgical exploration showed spherules consistent with Coccidioides spp. infection. Antibody titers performed post-operatively were consistent with an active Coccidioides spp. Infection. By fungal culture and subsequent PCR and DNA sequencing, C. posadasii was identified as the species infecting the dog. Over the course of 85 days of antifungal therapy, discharge from the draining tract, lymphadenomegaly, and cutaneous and subcutaneous nodules resolved. In conclusion, this is the first reported case of disseminated coccidioidomycosis to the cervical region of a dog with involvement of the thyroid gland, skeletal muscle, adipose tissue, connective tissue, and secondary esophageal fistula. Coccidioides spp. infections should be considered a differential diagnosis in unusual cases for dogs that live in or have traveled to endemic areas.
Postpartum Granulomatous Hypophysitis: A Case Study, Review of the Literature, and Discussion of Pathogenesis
Authors: Upasana Joneja, D Craig Hooper, James J Evans, Mark T Curtis
Journal: Case Rep Pathol (2016)

Hypophysitis is a rare inflammatory condition of the pituitary gland that has three main histologic subtypes: lymphocytic hypophysitis (LH), granulomatous hypophysitis (GH), and xanthomatous hypophysitis (XH). Among these, LH is the most common and is strongly associated with the postpartum state, while XH is the least common. Many hypophysitis cases have been reported in the literature but only a few cases of postpartum GH have been discussed. Here, we describe a case of GH in a 24-year-old female presenting eleven days postpartum. We also review the current literature on postpartum GH and discuss the possible alterations in the immune environment during and after pregnancy that could explain this phenomenon. With more cases of GH being reported, the commonalities of female predominance, postpartum time of presentation, and occasional spontaneous resolution between LH and GH lend support to the theory that these two diseases likely represent spectrums of a single immunologic disorder.
Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors: a multiple baseline case series
Authors: Carlijn Maria Van Es, Merel E Velu, Marieke Sleijpen, Niels van der Aa, Paul A Boelen, Trudy Mooren
Journal: Front Psychol (2023)
Keywords: depression, mixed-methods, multiple baseline, posttraumatic stress disorder, trauma-focused treatment approach, unaccompanied refugee minors

Introduction:
Unaccompanied refugee minors (URMs) are at increased risk of developing mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression. In addition, URMs face several barriers to mental health care. Few studies have evaluated trauma-focused interventions for URMs that target these issues. The current study evaluated a multimodal trauma-focused treatment approach for URMs. It aimed to provide an initial indication of the effectiveness of this treatment approach and to provide a qualitative evaluation assessing treatment satisfaction of the participating URMs.
Methods:
A mixed-methods study was conducted among ten URMs, combining quantitative data with qualitative data through triangulation. Quantitative data were collected using a non-concurrent multiple baseline design in which repeated, weekly assessments were carried out during a randomized baseline period, during treatment, and during a 4-week follow-up period. Questionnaires assessing PTSD (Children's Revised Impact of Event Scale) and symptoms of depression (The Patient Health Questionnaire-9, modified for adolescents) were used. In addition, treatment satisfaction was measured post-treatment using a semi-structured interview.
Results:
During the qualitative evaluation, all but one URM noted they found the trauma-focused treatment approach useful and felt the treatment had positively impacted their wellbeing. However, the results of the quantitative evaluation did not show clinically reliable symptom reductions at posttest or follow-up. Implications for clinical practice and research are discussed.
Discussion:
The current study presents our search in developing a treatment approach for URMs. It adds to the current knowledge about methodological considerations in evaluating treatments for URMs, the potential effects of trauma-focused treatments on URMs, and the implementation of treatments for URMs.Clinical trial registration: The study was registered in the Netherlands Trial Register (NL8519), 10 April 2020.
An Infected, Noncoronary, Bare Metal Stent Presenting as a Right Groin Abscess
Authors: Madiha Khan, Youssef Mourad, Alan Zeitlin, Martine Alice Louis, Syed Ali Rizvi, Kelly L Cervellione
Journal: Case Rep Vasc Med (2023)
MeSH terms: Case Reports

Bare metal stent infections complicating peripheral endovascular stenting are rare but can be associated with devastating morbidities. The current standard of care necessitates explantation and extra-anatomical bypass of the affected limb. We report the case of a patient presenting with a right groin abscess with draining sinuses secondary to an infected common femoral and right external iliac artery bare metal stent. In addition, a portion of the stent was explanted into the subcutaneous tissues instead of where it was placed intravascularly one year prior. The patient was not an ideal candidate for explantation and bypass due to significant medical comorbidities and underwent local debridement and long-term antibiotic management instead. His postoperative course was uncomplicated, and he had a successful outcome with management utilizing antibiotics and debridement. We aim to highlight the importance of recognizing bare metal stent infections along with their deceptive cutaneous manifestations in order to prevent the development of significant morbidity and mortality.
Case Report: Giant cell-rich osteosarcoma of the cervical spine in the pediatric age. A rare entity to consider
Authors: Rosa M Egea-Gámez, María Galán-Olleros, Alfonso González-Menocal, Rafael González-Díaz
Journal: Front Surg (2022)
Keywords: cervical cancer, osteosarcoma - pathology, reconstructive surgical procedure, spine, surgical oncology
MeSH terms: Case Reports

Background:
Although osteosarcoma is the most common primary malignant bone tumor in children, its location in the axial skeleton is rare, particularly at the cervical spine. Early diagnosis, together with multidisciplinary management, improves survival rates. Safe resection and stable reconstruction are complicated by the particular anatomy of the cervical spine, which raises the risks.
Case presentation:
A 12-year-old male patient presented with cervical pain for several months and a recent weight loss of 3 kg. The complementary workup revealed a large destructive bone lesion in C7 with vertebral body collapse, subluxation, partial involvement of C6 and T1, large associated anteroposterior soft tissue components, and spinal canal narrowing. A biopsy suggested giant cell-rich osteosarcoma (GCRO). After 10 cycles of neoadjuvant chemotherapy, surgical resection was performed through a double approach: anterior, for tumoral mass resection from C6-7 vertebral bodies and reconstruction placing a mesh cage filled with iliac crest allograft plus anterior plate fixation; and posterior, for C7 complete and C6 partial posterior arch resection, thus completing a total piecemeal spondylectomy preserving the dura intact, added to a C5-T3 posterior fusion with screws and transitional rods. Postoperative chemo and radiotherapy were administered. Clinical and radiological follow-up showed disease-free survival and no neurological involvement at 3 years.
Conclusion:
An extensive review of the literature did not find any published cases of GCRO of the cervical spine in pediatric patients. This can be explained by the combination of three peculiar conditions: its location at the cervical spine region, the young age, and the GCRO variant.
Knee Sepsis after Suprapatellar Nailing of an Open Tibia Fracture: Treatment with Acute Deformity and External Fixation
Authors: Chelsea E Minoughan, Adam P Schumaier, Frank R Avilucea
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Case:
A 31-year-old male was involved in a dirt bike accident and sustained an isolated type II open mid-distal tibia fracture. The patient underwent suprapatellar intramedullary nailing and subsequently developed knee sepsis.
Conclusion:
This patient was managed with irrigation and debridements of the knee, fracture site, and intramedullary canal. A resultant soft-tissue defect over the fracture site obviated primary closure. Creation of an acute deformity stabilized by a Taylor spatial frame allowed primary wound closure. After soft tissue healing occurred, the frame was used to correct the intentional deformity and maintain reduction until full healing occurred.
Case report: Nocardia gipuzkoensis infection in an immunocompetent patient diagnosed by metagenomic next-generation sequencing and whole genome sequencing
Authors: Chengxin Liu, Juhua Yang, Huiting Huang, Shaofeng Zhan, Xintian Xia
Journal: Front Immunol (2022)
Keywords: antibiotic susceptibility, case report, metagenomic next-generation sequencing, nocardiosis, pathogen identification, whole genome sequencing
MeSH terms: Nocardia Infections / diagnosis, Nocardia Infections / drug therapy, Nocardia / genetics, Case Reports, Research Support, Non-U.S. Gov't, Adult, Female, High-Throughput Nucleotide Sequencing, Humans, Sulfamethoxazole / therapeutic use, Whole Genome Sequencing, Young Adult, Sulfamethoxazole

The infection of Nocardia gipuzkoensis is a relatively uncommon form of pulmonary nocardiosis seen in clinical patients. In general, nocardiosis tends to occur in patients with immune deficiency. Here, we report a 23-year-old female who was admitted to the hospital due to cough and sputum production over 10 years, diagnosed with bronchiectasis. The N. gipuzkoensis infection was identified by metagenomic next-generation sequencing and whole genome sequencing. Imipenem/cilastatin and compound sulfamethoxazole tablets were used to control the infection and the pulmonary inflammation subsided gradually.
Acute invasive mucormycosis rhinosinusitis causing multigroup cranial nerve injury and meningitis-A case report
Authors: Tingting Wang, Duanhua Cao, Jingzhe Han
Journal: Front Neurol (2022)
Keywords: 3d-space technology, mucor, cranial nerve, infection, mngs
MeSH terms: Case Reports

This study reported a case of a Rhino-Orbital-Cerebral Mycosis (ROCM) patient with multiple groups of cranial nerve damage as the primary clinical manifestation, confirmed by histopathology and cerebrospinal fluid metagenomic next-generation sequencing (mNGS) technology. Relying on the MRI3D-SPACE technology, we observed the location and extent of the cranial nerve damage in the patient. The results suggested that fungal meningoencephalitis caused by mucor may enter the skull retrograde along the cranial nerve perineurium. The patient was admitted to the hospital with a preliminary diagnosis of mucormycosis infection after 1.5 days of mouth deviation. We treated the patient immediately with intravenous amphotericin B liposomes. After 21 days of hospitalization, the clinical symptoms of the patient did not improve significantly. The patient was discharged due to financial difficulties and antifungal treatment at home, and his disease had stabilized at the 6-month follow-up.
Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis
Authors: Susumu Saigusa, Masaki Ohi, Satoshi Oki, Takashi Ichikawa, Minako Kobayashi, Yasuhiro Inoue, Chikao Miki
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

A 41-year-old man presented to our hospital with lower abdominal pain and a high-grade fever. Physical examination revealed rebound tenderness and guarding in the lower abdomen. Abdominal X-ray examination showed a radiopaque object in the right lower quadrant of the abdomen. Abdominal computed tomography (CT) demonstrated that the object had a strong artifact with over 10,000 Hounsfield units, as well as ascites around the terminal ileum. We diagnosed acute peritonitis with a suspicion of the perforation due to unknown foreign body and performed an emergency laparotomy. Operative findings showed a contained perforation of a phlegmonous appendicitis, and appendectomy was performed. The resected specimen demonstrated that the appendix contained a fecalith, and histopathological examination showed the crystal structure of barium sulfate in the lumen of the appendix. Unfortunately, we did not obtain the history of screening for gastric cancer using a barium examination one month prior to our appendectomy. Our experience demonstrates the importance of establishing a history of barium examinations of the gastrointestinal tract in a patient with a radiopaque object in the right lower quadrant of the abdomen for early diagnosis of barium appendicitis. Additionally, early diagnosis of barium appendicitis may affect the selection of surgical procedures.
Fulminant mucormycosis involving paranasal sinuses: a rare case report
Authors: Komali Garlapati, Sunanda Chavva, Rahul Marshal Vaddeswarupu, Jyotsna Surampudi
Journal: Case Rep Dent (2014)

Mucormycosis is an opportunistic fulminant fungal infection, which has the ability to cause significant morbidity and frequently mortality in the susceptible patient. Common predisposing factors include diabetes mellitus and immunosuppression. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. The fungus invades the arteries leading to thrombosis that subsequently causes necrosis of the tissue. The infection can spread to orbital and intracranial structures either by direct invasion or through the blood vessels. Here we describe a case of mucormycosis of maxillary antrum extending to ethmoidal and frontal sinus and also causing necrosis of left maxilla in an uncontrolled diabetic individual to emphasize early diagnosis and treatment of this fatal fungal infection.