OpenMed/multicare-articles huggingface dataset:
Management of extrusive luxation of upper incisors in young permanent teeth: a case report
Authors: Emna Hidoussi Sakly
Journal: Pan Afr Med J (2021)
Keywords: dental trauma, case report, root canal therapy, tooth fracture
MeSH terms: Incisor, Splints, Case Reports, Adolescent, Humans

This case report documents the clinical approach adopted for two permanent maxillary incisors with extrusive luxation in a 16-year-old boy. The proposed procedures involved reposition of both teeth, by digital pressure and stabilized by using semi-rigid splint for 2 weeks. Endodontic therapy was performed. Clinical and radiographic follow-up examinations were conducted at 6-month intervals for two years. Assessment revealed the absence of pulpal and periapical disease and the restoration of the maxillary incisors to a state of health and normal function. A long-term clinical and radiological follow-up is needed to prevent and precociously detect possible complications that may occur following a extrusive luxation.
A novel fluorescent marking clip for laparoscopic surgery of colorectal cancer: A case report
Authors: Satoshi Narihiro, Masashi Yoshida, Hironori Ohdaira, Takayuki Sato, Daisuke Suto, Sojun Hoshimoto, Norihiko Suzuki, Rui Marukuchi, Teppei Kamada, Hideyuki Takeuchi, Yutaka Suzuki
Journal: Int J Surg Case Rep (2019)
Keywords: colorectal cancer, fluorescent clip, tattoo marking, vision sense

Introduction:
In laparoscopic surgery, marking of tumor location has been gaining importance. Tattoo marking has been often used but the technique carries the risk of accidental peritoneal scattering or other organ injury. We have been involved in the development of a novel fluorescent clip for marking tumor sites and supposed that its usage would reduce risks related to other marking methods.
Case presentation:
A 52-year-old man was diagnosed with sigmoid colon cancer and polyp, and was scheduled for laparoscopic sigmoidectomy. On the day before operation, fluorescent clips (ZEOCLIP FS: Zeon Medical co, Ltd, Tokyo) were endoscopically placed around the tumor and polyp sites, 4 clips for each lesion attached every 90 degrees within the colonic lumen, respectively. During the operation, locations of the fluorescent clips were easily confirmed using a full-color fluorescent laparoscope, VISION SENSE (Medtronic Co., U.S.). Curative operation was performed accordingly with the preoperative pathological and radiological findings. The postoperative course was uneventful.
Discussion:
Locations of intraluminally placed fluorescent clips were clearly and easily recognized through the serosal layer of the intestinal wall using a fluorescent laparoscope. Complications related to dye scattering or intestinal wall/other organ perforation were not observed suggesting that future incorporation of this tumor site marking technique into laparoscopic surgery might be beneficial.
Conclusion:
The fluorescent marking clips were easily placed and recognized with a fluorescent laparoscope. This method is expected to be safe and risks of accidental puncture related to tattoo marking method can be reduced or almost eliminated.
Severe Sepsis with Multiorgan Failure due to Melioidosis: A Lesson to Learn
Authors: Dinuka S Warapitiya, Shyama Subasinghe, Rukshanie Frances de Silva, Dadallage Lalitha Piyarisi, Kushlani Jayatilleke
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Introduction:
Melioidosis is a bacterial infection caused by a Gram-negative bacillus Burkholderia pseudomallei, prevalent in Southeast Asia and Northern Australia. Sri Lanka is situated in the endemic belt of melioidosis. Melioidosis has a wide spectrum of clinical presentations and results in high mortality rates in severe infection. Case Report. We report a 54-year-old previously healthy Sri Lankan farmer who presented with septicemia following a cut injury to the right leg while working in a paddy field. Initially, he had mild wound sepsis, and later, his condition deteriorated rapidly. The patient required organ support later for cardiovascular instability, acute liver failure, acute kidney injury, acute respiratory distress syndrome, and coagulopathy. The patient's blood culture was negative on the admission day, and the repeated blood culture taken at the ICU was contaminated with a commensal flora initially and later isolated Burkholderia pseudomallei. Although wound swab culture taken on the first day isolated an organism, it took six days to identify it as Burkholderia pseudomallei. The patient succumbed to severe melioidosis leading to a severe sepsis and multiorgan failure in spite of treatment with meropenem.
Conclusion:
This case report highlights the importance of considering melioidosis as a differential diagnosis when a patient comes with risk factors for melioidosis.
Combined piggyback technique and cavoportal hemitransposition for liver transplant
Authors: Jeffrey Campsen, Igal Kam
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Portal Vein thrombosis (PVT) increases the difficulty of liver transplant; however, it is not an absolute contraindication. Cavoportal hemitransposition (CPH) is an option for patients with complete PVT and no alternative collateral vein. Our center often performs the piggyback technique for the hepatic vein reconstruction, which allows for great access to the recipient vena cava in patients with known complete PVT that may need a CPH preformed to successfully restore flow to the portal system of the donor liver. We describe the use of the piggy-back technique to prepare the vena cava for possible CPH in patients with known complete PVT.
Case Report: Acupuncture is an effective treatment for olfactory dysfunction in the post COVID-19 condition
Authors: Akira Morita, Aya Murakami, Takushu Uchihara, Noriyuki Ohashi, Koichi Ryu, Yuki Watanabe, Sadayuki Ochi, Kazuho Okudaira, Yoshiro Hirasaki, Takao Namiki
Journal: Front Neurol (2022)
Keywords: covid-19, yingxiang point (li20), acupuncture, olfactory dysfunction, post covid-19 condition
MeSH terms: Case Reports

Olfactory dysfunction in the post COVID-19 condition reported worldwide are refractory for some patients. For this reason, appropriate treatment is desired. In this article, we describe two cases of olfactory dysfunction in the post COVID-19 condition that was improved by traditional acupuncture treatment. By using the Yingxiang point (LI20), which is said to improve the sense of smell since ancient times, acupuncture treatment was performed 1-2 times a week in two patients about 6 and 7 months after the diagnosis of COVID-19. Acupuncture needles with a body length of 30 mm and a body diameter of 0.16 mm were inserted about 10 mm deep into the skin. We stimulated LI20 of the right and left sides until the patients felt the de qi sensation (acupuncture resonance), and left needles in the points for about 15 min. Immediately after the acupuncture treatment, the symptoms of olfactory dysfunction were alleviated, and the improvement in olfactory dysfunction lasted for 2-4 days. As the number of acupuncture treatments increased, the time until the flareup of olfactory dysfunction was prolonged, and the symptoms tended to decrease. In our experience, the acupuncture treatment was effective in a short period for treating residual olfactory dysfunction of the post COVID-19 condition, suggesting that acupuncture may serve as an adjunct to modern medical treatment, and it may also be a new option for patients who are resistant to Western medical treatment or unable to continue treatment because of side effects. In conclusion, acupuncture may be a new option for patients who are resistant to modern medical treatment or who are unable to continue treatment because of side effects.
Bilateral Phacoemulsification in an African Elephant ( Loxodonta africana)
Authors: Anthony J Cerreta, Richard J McMullen Jr, Heather E Scott, Jennifer D Ringenberg, Julie E Hempstead, Ryan S DeVoe, Michael R Loomis, Larry J Minter
Journal: Case Rep Vet Med (2019)
MeSH terms: Case Reports

A 37-year-old bull African elephant (Loxodonta africana) at the North Carolina Zoo (NCZ) was diagnosed with bilateral cataracts leading to behavioral changes and significant weight loss secondary to functional blindness. On initial examination, a weight loss of 234 kg, a mature cataract in the right eye, and a focal cataract in the left eye were diagnosed. Ultrasound and electroretinography (ERG) indicated normal retinal attachment and both eyes were viable candidates for surgery. After careful planning and behavioral training, the left cataract was surgically removed via phacoemulsification and irrigation/aspiration. The right eye subsequently developed a ventral lens subluxation, and phacoemulsification and irrigation/aspiration were performed six months after the first procedure. Four years after surgery, menace response, palpebral reflex, dazzle reflex, and pupillary light reflexes were present in both eyes. Body weight was 5,515 kg, 88kg more than at the time of the second surgery. This is the first published report of an African bull elephant undergoing bilateral cataract removal using phacoemulsification and irrigation/aspiration. The lack of significant postoperative inflammation and uneventful recovery of the elephant suggests that this surgical procedure along with proper preoperative planning and postoperative medical management can be a safe and effective treatment option for elephants with cataracts.
Orthodontic traction of impacted canines: Concepts and clinical application
Authors: Ricardo Machado Cruz
Journal: Dental Press J Orthod (2019)
MeSH terms: Esthetics, Dental, Malocclusion / therapy, Orthodontic Extrusion, Tooth, Impacted / therapy, Case Reports, Adolescent, Cuspid, Dentition, Permanent, Humans, Tooth Movement Techniques

Orthodontic traction of impacted canines stands as a major challenge for Orthodontics. It is a relatively frequent clinical complaint which management, more often than not, requires a multidisciplinary approach. Surgical exposure of the impacted canine, and the complex orthodontic mechanics applied to align the tooth back into the arch, may frequently lead to complications involving supporting tissues, not to mention the long treatment time and high costs imposed to patients. In face of that, it is worth highlighting the relevance of early diagnosis as to intervene efficiently and as soon as possible. This paper presents a review of the main concepts involving prevalence, etiology and classification of impacted canines, and describes the different clinical management options that would help solve the problem. It illustrates the topic by presenting a treatment delivered to a 13 year 7 months old male patient, suffering from a Class II, division 2, left subdivision, malocclusion, associated to a deep bite and a prolonged retention of a primary upper canine caused by the impaction of the permanent tooth. Corrective orthodontic therapy was associated to a rapid maxillary expansion and to the use of a high pull headgear. Impacted canine was submitted to orthodontic traction and correctly positioned back into the arch. This approach proved to be efficient in meeting both functional and aesthetic goals.
Gastric-type Mucinous Carcinoma with an Abnormal Increase of CA199: A Case Report and Literature Review
Authors: Xue-Qian Qian, Fen-Fen Wang, Yun Liang, Li-Li Chen, Xiao-Yun Wan
Journal: Front Surg (2022)
Keywords: ca199, cervical adenocarcinoma, cervical adenocarcinoma in situ, cervical cancer, gastric-type mucinous carcinoma (gas)
MeSH terms: Case Reports

Objective:
Gastric-type mucinous carcinoma (GAS), as a rare subtype of mucinous adenocarcinoma, accounts for approximately 1%-3% of cervical adenocarcinoma. It was considered as a new type of cervical mucinous adenocarcinoma by the World Health Organization (WHO) in 2014. GAS represents more aggressive disease than does usual type endocervical adenocarcinoma (UEA).
Case report:
A case of cervical adenocarcinoma with an abnormal increase of CA199 in a 50-year-old Chinese woman was reported. Our patient presented with abnormal vaginal discharge and combined with elevated Ca199 at the value of 2,729 U/mL. Imaging examinations showed no abnormalities. Diagnostic conical resection suggested cervical adenocarcinoma in situ. Post-operative pathology confirmed mucinous cervical adenocarcinoma (considering gastric type), infiltrating cervical interstitial >2/3, involving the deep myometrium, accompanied by vascular carcinoma infiltration and lymph node metastasis.The patients received an extensive hysterectomy and post-operative adjuvant chemoradiotherapy. The chemotherapy regimen was paclitaxel, combined with platinum. After 20 months of follow-up, the patient showed no signs of recurrence.
Conclusion:
Preoperative diagnosis of cervical adenocarcinoma is insidious and can be easily misdiagnosed. For patients with high preoperative Ca199, the possibility of GAS should be kept open.
Delayed diagnosis of blunt thoracic aortic injury due to thoracic vertebral fracture: A case report and literature review
Authors: Xinhuan Lei, Zhenghua Hong, Weixing Pan, Jie Xiang, Hua Luo
Journal: Front Surg (2022)
Keywords: case report, delayed diagnosis, thoracic aortic injury, thoracic endovascular aortic repair, thoracic vertebral fracture
MeSH terms: Review

Blunt vascular injury of the aorta combined with thoracolumbar fracture is rare. Delayed diagnosis may have a catastrophic outcome. We present a case of blunt thoracic aortic injury combined with a vertebral body fracture at T10 after a fall from height in which the diagnosis was delayed. After consultation with the vascular and spinal surgeons, we performed a thoracic endovascular aortic repair. When the patient's condition had stabilized, the fractures were reduced using posterior vertebral instrumentation. Prolonged compression of the thoracic aorta resulted in extensive necrosis of muscle tissues in the right lower leg. Fortunately, clinical and radiological examinations performed 7 months and 1 year later did not reveal any further damage. Cases of thoracic vertebral fracture with concomitant blunt thoracic aortic injury reported in the literature are reviewed. Thoracic endovascular aortic repair is a feasible, safe, and effective minimally invasive treatment for aortic injury when combined with thoracic vertebral fracture.
Arteritic Anterior Ischemic Optic Neuropathy (AAION) Associated with COVID-19 Infection: A Case Report and Review of the Literature
Authors: Kourosh Shahraki, Amin Najafi, Negin Ashoori, Nayyereh Razzaghpour, Kianoush Shahraki
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

Anterior ischemic optic neuropathy (AION) is the most frequent cause of acute optic nerve damage in the elderly, usually causing acute, unilateral, and painless permanent visual loss. Arteritic anterior ischemic optic neuropathy (AAION) is a result of endothelial cell inflammation and the subsequent thrombosis and occlusion in the blood-supplying arteries of the optic nerve head. AAION accounts only for 5-10% of all AION cases that are associated with vasculitis which usually takes place in the course of a giant cell arteritis (GCA). In this paper, we report a case of AAION following a COVID-19 respiratory infection. Although it is uncertain whether SARS-CoV-2 infection triggered the AAION or was coincidental, the possible association of the events is concerning.
Primary tuberculosis of tonsils: a case report
Authors: Pooja Prasad, Minakshi Bhardwaj
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Tuberculosis is one of the major causes of ill health and death worldwide. Isolated tuberculosis of tonsil in the absence of active pulmonary tuberculosis is a very rare clinical entity. A 10-year-male child presented with recurrent episodes of upper respiratory tract infections, with 2-3 occurrences per month for the past 6 years. On general physical examination, bilateral tonsils showed grade III enlargement and congestion. Posterior pharyngeal wall was clear. Examination of the chest was within normal limits. Histopathological examination of bilateral tonsils revealed caseating and noncaseating epithelioid cell granulomas with Langhans giant cells. Ziehl-Neelsen stain for acid fast bacillus was positive. Features were consistent with a diagnosis of tuberculosis of tonsils. Tuberculosis of the oral cavity is uncommon and lesions may be either primary or secondary. Early detection and intervention is essential for cure. Isolated and primary tuberculosis of the tonsils in the absence of pulmonary tuberculosis is a rare entity, which prompted us to report this case.
Torsion of an Accessory Spleen in a Child With Biliary Atresia Splenic Malformation Syndrome
Authors: David A Simon, Nathan R Fleishman, Pamala Choi, Jason D Fraser, Ryan T Fischer
Journal: Front Pediatr (2020)
Keywords: abdominal pain, accessory spleen, biliary atresia splenic malformation syndrome (basm), congenital anomaly, torsion
MeSH terms: Case Reports

Torsion of an accessory spleen is an exceedingly rare cause of abdominal pain in pediatric patients. The diagnosis is frequently challenging as presentation is variable and diagnostic imaging can be aspecific. The current case describes an unusual presentation of a torted accessory spleen in a 5-year-old girl with biliary atresia splenic malformation syndrome who initially presented with non-specific abdominal symptoms and fever. The diagnosis was made following fine-needle aspiration of a suspected intraabdominal abscess. The case highlights the diagnostic challenge of accessory splenic torsion and stresses the importance of its inclusion on the differential diagnosis of pediatric patients, especially those with known splenic or laterality abnormalities, presenting with both acute and sub-acute abdominal symptoms.
Rare metastatic sites of renal cell carcinoma: a case series
Authors: Anurag Singla, Umesh Sharma, Arun Makkar, Pirzada Faisal Masood, Hemant Kumar Goel, Rajeev Sood, Arvind Ahuja, Ravikant Singh
Journal: Pan Afr Med J (2022)
Keywords: renal cell carcinoma, breast, jaw, metastasis, parotid, scalp
MeSH terms: Carcinoma, Renal Cell / diagnosis, Carcinoma, Renal Cell / pathology, Carcinoma, Renal Cell / surgery, Kidney Neoplasms / diagnosis, Kidney Neoplasms / pathology, Kidney Neoplasms / surgery, Metastasectomy, Case Reports, Humans, Nephrectomy, Prognosis

Renal Cell Carcinoma (RCC) is a lethal cancer with a propensity for wide metastasis. The patterns of metastases are not clearly defined, and patients can present with metastasis to unusual sites at the time of diagnosis of the primary tumor or years after radical nephrectomy. Individual diagnostic and surgical approaches are needed to achieve complete resection with disease-free margins, even in the presence of unusual metastatic sites, multifocality, or history of previous metastasectomy. This provides palliation for symptoms and an opportunity for meaningful disease-free and overall survival. Here we present five cases of RCC with metastasis to unusual sites (scalp, jaw, forearm, parotid, breast, and skeletal muscle). Patients were treated with cytoreductive nephrectomy and/or metastasectomy wherever feasible and/or targeted therapy. In conclusion, a high index of suspicion and accurate diagnosis is important as metastasis to unusual sites presents with atypical manifestations and may masquerade as local pathology, misleading the clinician and directly affecting prognosis and survival.
Balloon-Atrioseptostomy in Small Children Using an Embolectomy Catheter: Preliminary Data
Authors: R Dalla Pozza, M Hermann, N A Haas
Journal: Case Rep Cardiol (2023)
MeSH terms: Case Reports

Interventional treatment of restrictive atrial septal defects in complex heart disease is considered state-of-the-art therapy up to date. Nevertheless, dedicated balloons are lacking so far, as several products have been withdrawn from the market. We report on off-label use of a balloon embolectomy catheter used successfully in a preterm patient and discuss whether this device might be used in other patients as well as it seems to be promising due to its shape and versatility.
Case report: Novel treatment regimen for enterovirus encephalitis in SCID
Authors: Kritika Chetty, Iek Cheng, Marios Kaliakatsos, Luis Ignacio Gonzalez-Granado, Dimitra Klapsa, Javier Martin, Alasdair Bamford, Judith Breuer, Claire Booth
Journal: Front Immunol (2022)
Keywords: antiviral agents, case report, enterovirus, gene therapy (gt), infectious encephalitis, primary immunodeficiency diseases, severe combined immunodeficiency
MeSH terms: Encephalitis, Viral / diagnosis, Encephalitis, Viral / drug therapy, Enterovirus Infections / diagnosis, Enterovirus Infections / drug therapy, Enterovirus, Case Reports, Amides, Antiviral Agents / therapeutic use, Fluoxetine, Humans, Immunoglobulins, Intravenous / therapeutic use, Infant, Male, Pyrazines, Amides, Antiviral Agents, Immunoglobulins, Intravenous, Pyrazines, Fluoxetine, favipiravir

Most non-polio enterovirus infections in immunocompetent individuals are acute and self-limiting in nature; however, infection can be severe, chronic and have devastating outcomes in immunocompromised hosts. Therapeutic strategies have predominantly involved supportive care, with the lack of approved antiviral treatments proving challenging for management. We report a case of an 8-month-old child who presented with severe enterovirus encephalitis following gene therapy for X-linked severe combined immunodeficiency (X-SCID) and who demonstrated clinical and microbiological improvement after a novel regimen of favipiravir, fluoxetine, and high-dose intravenous immunoglobulin (IVIg). The patient presented 6 weeks post-gene therapy with rapid neurological deterioration in the context of incomplete immune reconstitution, with microbiological and radiological evidence confirming enterovirus encephalitis. His neurologic examination stabilised 8 weeks after treatment, and he subsequently demonstrated excellent immune recovery. This is the first case report of combined therapy with favipiravir, fluoxetine, and high-dose IVIg in the context of severe enterovirus encephalitis in an immunocompromised host. This case highlights the importance of considering enterovirus encephalitis in immunocompromised patients presenting with both acute and chronic neurological signs, as well as developmental regression. The demonstrated treatment success and the associated low risk of toxicity warrant further investigation of this therapeutic regimen.