OpenMed/multicare-articles huggingface dataset:
Photo-documentation of thumbnail regrowth after surgical avulsion: case report and literature review
Authors: Ashley Marie Mefford, Morton L Kasdan, Bradon Wilhelmi
Journal: Eplasty (2014)
Keywords: avulsion, growth rate, regrowth, thumbnail, time-lapse video
MeSH terms: Case Reports

Objective:
We present a case of thumbnail regrowth and photo-documentation after a complete surgical avulsion and nail bed biopsy.
Methods:
A complete surgical avulsion of the right thumbnail was performed and the regrowth was photo-documented.
Results:
Complete regrowth was achieved by 33 weeks after avulsion, and the photos were compiled into a time-lapse video.
Conclusions:
The established literature indicates that rate of nail growth is multifactorial. One variable that may contribute to rate of growth is the status of the nail itself, intact or avulsed. The growth rate of the thumbnail in our patient is comparable to the growth rates documented for intact nails. The literature on this subject is reviewed.
Nearly Fatal Hydroxychloroquine Overdose Successfully Treated with Midazolam, Propofol, Sodium Bicarbonate, Norepinephrine, and Intravenous Lipid Emulsion
Authors: Goswin Onsia, Sarah Bots
Journal: Case Rep Emerg Med (2021)
MeSH terms: Case Reports

Background:
In the context of the current COVID-19 pandemic, there has been renewed interest in the drug hydroxychloroquine. However, clinicians should be aware of the dangers of hydroxychloroquine intoxication, an insufficiently studied condition. Case Report. We present a case of autointoxication with 20 g hydroxychloroquine in a 35-year-old woman. Cardiac monitoring showed ventricular arrhythmias for which high-dose midazolam and propofol were initiated, resulting in a brief normalization of the cardiac rhythm. Because of the reoccurrence of these arrhythmias, intravenous lipid emulsion was administered with fast cardiac stabilization. Treatment with continuous norepinephrine, potassium chloride/phosphate, and sodium bicarbonate was initiated. On day 6, she was extubated and after 11 days, she was discharged from the hospital without complications.
Conclusion:
Since high-quality scientific evidence is lacking, treatment options are based on experience in chloroquine toxicity. Activated charcoal is advised if the patient presents early. Sedation with diazepam, early ventilation, and continuous epinephrine infusion are considered effective in treating severe intoxication. Caution is advised when substituting potassium. Despite the lack of formal evidence, sodium bicarbonate appears to be useful and safe in case of QRS widening. Intravenous lipid emulsion, with or without hemodialysis, remains controversial but appears to be safe. As a last resort, extracorporeal life support might be considered in case of persisting hemodynamic instability.
Case report: Total thoracoscopic repair of sinus of Valsalva aneurysm combined with ventricular septal defect
Authors: Tong Tan, Haozhong Liu, Jianrui Ma, Jian Liu, Haiyun Yuan, Huiming Guo
Journal: Front Cardiovasc Med (2022)
Keywords: valsalva aneurysm, congenital heart surgery, total thoracoscopic surgery, transaortic approach, ventricular septal defect
MeSH terms: Case Reports

The sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly. It can develop into the heart failure if it ruptures, which requires early intervention. However, such congenital anomalies are usually treated using a median sternotomy approach. Here, we report a rare case of SVA combined with a ventricular septal defect in which the patient underwent patch repair of the defects under a total thoracoscopy approach. She was discharged uneventfully and showed no residual shunt or aortic regurgitation postoperatively or at the 12-month follow-up. The total thoracoscopic approach for SVA repair is technically feasible.
Pulmonary Cryptococcosis Diagnosed by Metagenomic Next-Generation Sequencing in a Young Patient With Normal Immune Function: A Case Report
Authors: Yingyu Zhang, Weiliang Wang, Yingxuan Zhang, Sina Zhai, Han Xia, Xilin Zhang
Journal: Front Public Health (2022)
Keywords: cryptococcus neoformans, cryptococcosis, diagnosis, immune competent patients, metagenomic next-generation sequencing
MeSH terms: Cryptococcosis / diagnosis, Cryptococcosis / drug therapy, Cryptococcosis / microbiology, Cryptococcus neoformans / genetics, Pneumonia, Case Reports, High-Throughput Nucleotide Sequencing, Humans, Immunity, Metagenomics / methods

Background:
Pulmonary cryptococcosis (PC) is a serious opportunistic fungal infection that usually occurs in immunocompromised patients. This disease is often difficult to diagnose in time due to its clinical manifestations and radiological feature similar to other pulmonary infections, as well as the low sensitivity of conventional diagnostic methods. Cryptococcosis in immune-competent patients is rare.
Case presentation:
Here we report a case of PC in an immune-competent patient. Tuberculosis was suspected according to radiological features due to the positive T-lymphocyte spot test and pure protein derivative skin test. To further detect the pathogen, bronchoalveolar lavage fluid (BALF) was collected for metagenomic next-generation sequencing (mNGS). Cryptococcus neoformans (one specific read) was identified by mNGS, indicating the PC of this patient. The following BALF culture and cryptococcal antigen lateral flow assay (CrAg-LFA) test also showed Cryptococcus infection, confirming the mNGS detection. Voriconazole (0.4 g daily) was given orally according to the subsequent susceptibility results. After seven months of treatment, the patient's condition improved.
Conclusion:
Metagenomic next-generation sequencing (mNGS) is a better diagnostic tool to help clinicians distinguish pulmonary cryptococcosis from other atypical pulmonary infections.
Minimal-Change Disease Secondary to Borrelia burgdorferi Infection
Authors: Ewa Kwiatkowska, Edyta Gołembiewska, Kazimierz Ciechanowski, Karolina Kędzierska
Journal: Case Rep Nephrol (2012)
MeSH terms: Case Reports

Lyme borreliosis is a chronic illness caused by tick-transmitted spirochete Borrelia burgdorferi. Borreliosis can be extremely threatening if it is not diagnosed and treated in early stages. Kidneys are not typically involved in the disease. However, in infected dogs, Lyme nephritis is present in 5-10% of cases. It is associated with rapidly progressing renal failure. Histopathological examination shows mesangial proliferative glomerulonephritis with diffuse tubular necrosis, (Dambach et al. (1997)). In available literature, there were reports of human's glomerulonephritis associated with Borrelia burgdorferi infection. These cases refer to membranous and mesangial proliferative glomerulonephritis (Kirmizis and Chatzidimitriou (2010), Zachäus (2008), and Kirmizis et al. (2004)). In this paper, we present the case of minimal-change disease (MCD) as a result of Borrelia burgdorferi infection.
Spontaneous Rupture of a Leiomyoma Causing Life-Threatening Intra-Abdominal Hemorrhage
Authors: Melissa Schwartz, Kristin Powell
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy. Surgery revealed 4.5 L of hemoperitoneum and a 15 cm degenerated uterine fibroid with active bleeding. Pathology was consistent with intraoperative findings. She required transfusion of numerous blood products perioperatively. Her postoperative course was uncomplicated. Conclusion. It is rare for a uterine fibroid to spontaneously rupture. However, prompt recognition of this severe complication is critical for expeditious, life-saving surgical management.
Management of infrabony defects in mandibular molars in a patient with generalized aggressive periodontitis using autogenous bone graft from maxillary tuberosity
Authors: Sangeeta Singh
Journal: J Indian Soc Periodontol (2010)
Keywords: autogenous bone graft, generalized aggressive periodontitis, infrabony defect
MeSH terms: Case Reports

This clinical case report presents a technique utilizing autogenous cancellous bone from maxillary tuberosity to fill two infrabony defects distal to mandibular molars in a patient diagnosed with aggressive periodontitis. After debridement a 6 mm defect was present distal to mandibular right first molar and 6.5 mm defect was present distal to mandibular second molar of same side. Autogenous bone graft from maxillary tuberosity was placed in both the defects. There was a significant bony fill present six months post surgery and probing depth reduced by 7mm on both the sites.
Clinical Presentation and Conservative Management of Tympanic Membrane Perforation during Intrapartum Valsalva Maneuver
Authors: Jonathan D Baum, Meghan I Rattigan, Eric Scott Sills, Anthony P H Walsh
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Background. Tympanic membrane perforation may occur when ear pressures are excessive, including valsalva maneuver associated with active labor and vaginal delivery. A pressure differential across the eardrum of about 5 psi can cause rupture; the increased intraabdominal pressure spikes repeatedly manifested by "pushing" during second-stage labor easily approach (and may exceed) this level. Material and Method. We describe a healthy 21-year old nulliparous patient admitted in active labor at 39-weeks' gestational age. Results. Blood appeared asymptomatically in the left ear canal at delivery during active, closed-glottis pushing. Otoscopic examination confirmed perforation of the left tympanic membrane. Complete resolution of the eardrum rupture was noted at postpartum check-up six weeks later. Conclusion. While the precise incidence of intrapartum tympanic membrane rupture is not known, it may be unrecognized without gross blood in the ear canal or subjective hearing loss following delivery. Only one prior published report on tympanic membrane perforation during delivery currently appears in the medical literature; this is the first English language description of the event. Since a vigorous and repetitive valsalva effort is common in normal vaginal delivery, clinicians should be aware of the potential for otic complications associated with the increased intraabdominal pressure characteristic of this technique.
Efficacy, safety and tolerability of field treatment of actinic keratosis with ingenol mebutate 0.015 % gel: a single center case series
Authors: Ivan Bobyr, Anna Campanati, Veronica Consales, Katia Giuliodori, Alessandro Scalise, Annamaria Offidani
Journal: Springerplus (2016)
Keywords: actinic keratosis, field cancerization, ingenol mebutate

Introduction:
Actinic keratosis (AK) is a cutaneous intraepithelial neoplasm appearing within areas referred as 'fields of cancerization'. AK can progress to invasive squamous cell carcinoma. Treatments that target both clinically visible and subclinical AKs in cancerization fields are able to reduce the risk of malignant progression. Ingenol mebutate gel is a new effective topical therapy for AK, used once daily for 2 or 3 days depending on the location of lesions.
Case description:
Three elderly patients with multiple non-hypertrophic AKs within a contiguous 25-cm(2) treatment area on the face or scalp were treated with ingenol mebutate 0.015 % gel once daily for three consecutive days and followed up over a period of 57 days.
Discussion and evaluation:
Although individual local responses to treatment varied, all patients had total clearance of AK lesions without any sign of recurrence. In addition, all patients said that they were satisfied with the effectiveness of ingenol mebutate treatment and the aesthetic outcome, and would be prepared to use this agent again to treat AK in the future, if necessary.
Conclusions:
These three cases demonstrate that ingenol mebutate 0.015 % gel is effective and well tolerated in a clinical setting, with effective clearance of AK lesions present on the face and scalp, and good patient acceptability.
Case report: Delayed quadriplegia from traumatic carotid cavernous fistula: a rare case with perimedullary venous drainage
Authors: Yu-Hu Ma, Rui Shang, Sen Lin, Si-Hao Li, Ting Wang, Chang-Wei Zhang
Journal: Front Neurol (2023)
Keywords: carotid cavernous fistula, case report, coil embolization, perimedullary drainage, quadriplegia
MeSH terms: Case Reports

Background:
Carotid cavernous fistula (CCF) refers to the abnormal arteriovenous communication between the carotid system at the skull base and the sphenoid cavernous sinus, which is caused by trauma in almost 75% of cases. The drainage of venous blood to the spinal cord represents a distinctive mechanism, which is commonly observed in dural arteriovenous fistula (DAVF), and typically manifests clinically as progressive myelopathy. However, it is a rare occurrence in clinical practice that traumatic carotid cavernous fistula (TCCF) causes delayed quadriplegia through perimedullary venous drainage.
Case presentation:
We report the case of a 29-year-old male patient who was admitted to the hospital with a sudden onset of headache and quadriplegia. The patient had previously lost his right eye in a traffic accident 5 years ago. Cerebral angiography showed a high-flow direct CCF on the right side, accompanied by obvious drainage of cerebellar and perimedullary veins. We successfully performed coil embolization for the CCF, and the symptoms of the patient gradually improved after the operation. During follow-up at sixth-months, the patient regained the ability to walk independently.
Conclusion:
We experienced a rare case of TCCF with quadriplegia. Utilizing coil embolization, we achieved successful improvement in the patient's condition. However, the mechanism and the best treatment of CCF drainage through the perimedullary vein are still unclear. We need to further explore the pathophysiological information of CCF venous drainage.
A Follow-Up Report of an Infant Born to a Mother Receiving Tamoxifen
Authors: Yuki Okada, Daisuke Hitaka, Takahiro Kido, Yu Kanai, Kumi Konishi, Kosuke Doki, Nobuko Katayama, Masato Homma, Yayoi Miyazono, Hidetoshi Takada
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Tamoxifen, an estrogen receptor antagonist, is contraindicated in pregnant women due to its teratogenic activity. In the present study, we report the case of an infant whose mother received tamoxifen for breast cancer while unaware of the pregnancy. The infant, born at 29 weeks and 6 days of gestational age with a birth weight of 1664 g, had no congenital anomalies. This case presents detailed information on the development of an infant with placental transfer of tamoxifen. The infant has grown and developed normally throughout a 5-year follow-up period, but long-term vigilance continues.
New-onset refractory status epilepticus due to autoimmune encephalitis after vaccination against SARS-CoV-2: First case report
Authors: Jana Werner, Giovanna Brandi, Ilijas Jelcic, Marian Galovic
Journal: Front Neurol (2022)
Keywords: bnt162b2, norse, sars-cov-2 vaccination, new-onset refractory epileptic state, postvaccinal encephalitis, seronegative autoimmune encephalitis
MeSH terms: Case Reports

Background:
Vaccination against SARS-CoV-2 has been conducted frequently to limit the pandemic but may rarely be associated with postvaccinal autoimmune reactions or disorders.
Case presentation:
We present a 35-year-old woman who developed fever, skin rash, and headache 2 days after the second SARS-CoV-2 vaccination with BNT162b2 (Pfizer/Biontech). Eight days later, she developed behavioral changes and severe recurrent seizures that led to sedation and intubation. Cerebral magnetic resonance imaging showed swelling in the (para-) hippocampal region predominantly on the left hemisphere and bilateral subcortical subinsular FLAIR hyperintensities. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis of 7 cells/μl and normal protein and immunoglobulin parameters. Common causes of encephalitis or encephalopathy such as viral infections, autoimmune encephalitis with well-characterized autoantibodies, paraneoplastic diseases, and intoxications were ruled out. We made a diagnosis of new-onset refractory status epilepticus (NORSE) due to seronegative autoimmune encephalitis. The neurological deficits improved after combined antiepileptic therapy and immunomodulatory treatment including high-dose methylprednisolone and plasma exchange.
Conclusions:
Although a causal relationship cannot be established, the onset of symptoms shortly after receiving the SARS-CoV-2 vaccine suggests a potential association between the vaccination and NORSE due to antibody-negative autoimmune encephalitis. After ruling out other etiologies, early immunomodulatory treatment may be considered in such cases.
Management of Oroantral Fistulae and Communications: Our Recommendations for Routine Practice
Authors: Mahamadou Konate, Dounia Sarfi, Mounia El Bouhairi, Ihsane Benyahya
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Oroantral communication (OAC) is one of the main complications of extracting antral or sinus teeth. OAC is a gap between the maxillary sinus and the oral cavity. When left untreated, it causes maxillary sinusitis and dramatically impairs the patient's quality of life. Numerous surgical treatment techniques have been described, from mucosal techniques to using bone substitutes or very conservative alternative means. Many cases of recurrence after treatment have been reported, and the choice of the method adapted to the clinical situation remains challenging. Therefore, it is necessary to establish a correct diagnosis and choose the surgical technique best adapted to the case. This work is aimed at reviewing several techniques for the treatment of OAC and at describing our recommendations for use in daily practice for each of them through four clinical cases.
Partial trisomy 2q33.3-q37.3 in a patient with an inverted duplicated neocentric marker chromosome
Authors: Ruiyu Ma, Ying Peng, Yanghui Zhang, Yan Xia, Guizhi Tang, Jiazhen Chang, Ruolan Guo, Baoheng Gui, Yanru Huang, Chen Chen, Desheng Liang, Lingqian Wu
Journal: Mol Cytogenet (2015)
Keywords: growth retardation, neocentromere, partial trisomy 2q3, snp array, ssmc
MeSH terms: Case Reports

Background:
Increasing number of cases with small supernumerary marker chromosomes (sSMCs) without centromeric DNA and dozens of cases with trisomy 2q3 have been reported in recent years. However, cases of simultaneous sSMC and partial trisomy of chromosome 2q have been rarely described.
Results:
We report the case of a young girl patient with growth retardation and mild facial features due to a partial trisomy 2q33.3-37.3. The 34.3 Mb-duplication of the 2q33.3 to q37.3 region found in the patient constituted a supernumerary inverted duplicated neocentric marker chromosome.
Conclusions:
This is the first case of a patient with partial trisomy 2q33.3-37.3 presenting an inverted duplicated neocentric marker chromosome. Based on the case, this study will help further understanding the genotype/phenotype correlations of partial 2q3 duplication and exploring the relationship between neocentric sSMC and human diseases.
Single-stage combined anterior retropharyngeal and posterior approach for the resection and reconstruction of C2 metastatic tumors: A case report
Authors: Xian-Feng Ren, Yong-Ming Xi, Guo-Qing Zhang, Wen-Jiu Yang, Xu Zhang, DE-Ling Yang, You-Gu Hu
Journal: Exp Ther Med (2014)
Keywords: surgery, surgical approach, upper cervical spine

This study reports the case of a 44-year-old male who had experienced severe neck pain for one month and was diagnosed with a metastatic tumor of the left C2 vertebral body and the left transverse process. The tumor was distributed to layers A-D and sectors 3-7 according to the Weinstein-Boriani-Biagini classification, and was in Category IV according to the Harrington classification system. A conventional posterior cervical approach was used to resect the left transverse process and part of the tumor in a piecemeal fashion, and spinal instrumentation was also performed. Gelfoam and absorbable hemostatic gauze were placed ventrally to the left vertebral artery and the left C3 nerve root over the tumor bed to prevent their accidental injury in the subsequent anterior approach. A high anterior retropharyngeal approach was then used to resect the tumorous C2 vertebral body by corpectomy and to perform anterior reconstruction. Six months after the surgery, the patient remained pain free. Therefore, C2 metastatic tumor resection and spinal reconstruction can be fulfilled by a single-stage combined high anterior retropharyngeal and posterior approach.
How do clinicians rate patient's performance status using the ECOG performance scale? A mixed-methods exploration of variability in decision-making in oncology
Authors: Soumitra S Datta, Niladri Ghosal, Rhea Daruvala, Santam Chakraborty, Raj Kumar Shrimali, Chantalle van Zanten, Joe Parry, Sanjit Agrawal, Shrikant Atreya, Subir Sinha, Sanjoy Chatterjee, Simon Gollins
Journal: Ecancermedicalscience (2019)
Keywords: ecog, decision making, heuristics, oncology

Background:
Medical decisions made by oncology clinicians have serious implications, even when made collaboratively with the patient. Clinicians often use the Eastern Clinical Oncology Group (ECOG) performance status (PS) scores to help them make treatment-related decisions.
Methods:
The current study explores the variability of the ECOG score when applied to 12 predetermined specially designed clinical case vignettes presented to a group of oncology clinicians (n = 72). The quantitative analysis included evaluation of variability of ECOG PS scores and exploration of rater and patient-related factors which may influence the final ECOG rating. In-depth interviews were conducted with oncology clinicians to ascertain factors that they felt were important while making treatment-related decisions. Basic and global themes were generated following qualitative data analysis.
Results:
Quantitative results showed that there was poor agreement in ECOG rating between raters. Overall concordance with the gold standard rating ranged between 19.4% and 56.9% for the vignettes. Moreover, patients deemed to have socially desirable qualities (p < 0.004) were rated to have better PS and women patients (p < 0.004) to have worse PS. Clinicians having international work experience had increased concordance with ECOG PS rating. Qualitative results showed that 'perceived socio-economic background of the patient', 'age of the patient', 'patient's and family's preferences' and 'past treatment response' were the major themes highlighted by respondents that influenced the treatment-related decisions made by clinicians.
Conclusion:
There is considerable variability in ECOG PS determined by clinicians. Decision-making in oncology is complex, multifactorial and is influenced by rater and patient-related factors.