OpenMed/multicare-articles huggingface dataset:
Treatment of Chronic Bony Mallet Fingers by Dorsal Extension Block Pinning with Percutaneous Curettage
Authors: Fumiaki Takase, Kyoko Yamasaki, Takeshi Kokubu, Yutaka Mifune, Atsuyuki Inui, Ryosuke Kuroda
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Dorsal extension block pinning is a commonly performed surgical technique for acute bony mallet fingers. However, the treatment of chronic bony mallet finger remains controversial. We investigated the use of dorsal extension block pinning with percutaneous curettage for chronic bony mallet fingers. Seven patients with chronic bony mallet fingers were treated by dorsal extension block pinning with percutaneous curettage. The average age was 17 (range, 12-23) years, and the average time from injury to surgery was 20 (range, 7-49) weeks. Bone union was achieved in all patients. None of the patients experienced pain after bone union. The average loss of distal interphalangeal joint extension was 6 (range, 5-20) degrees, and the average flexion was 59 (range, 40-80) degrees. The Crawford functional score was excellent in three patients, good in two, and fair in two. Dorsal extension block pinning with percutaneous curettage could be a useful treatment for chronic bony mallet fingers.
A Case of Buccal Clear Cell Carcinoma Caused by Rare Fusion Gene: EWSR1-CREM
Authors: Miyako Hoshino, Katsuyuki Inoue, Tomohisa Kaneda, Michiko Nishimura, Kaoru Kusama, Hideaki Sakashita, Yukiko Sato, Kengo Takeuchi, Toshitaka Nagao, Kentaro Kikuchi
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Clear cell carcinoma (CCC) is a rare entity in the salivary gland tumor. So far, only 10 cases of primary CCC of the buccal mucosa have been reported. Here, we first report an extremely rare case of buccal CCC with the EWSR1-CREM fusion gene. The patient, a 69-year-old woman, presented with a painless mass in the right buccal mucosa. The tumor, which had been present for about 10 years, measured approximately 15 mm in diameter and was pedunculated, elastic hard, smooth, and mobile. Histopathological examination revealed proliferating tumor cells with vacuolated and clear cytoplasm partially surrounded by hyalinized stroma. The tumor was not encapsulated, and no contact with the overlying epithelium was evident. Duct-like structures were occasionally observed in the tumor nests composed of clear cells. The tumor had invaded into surrounding muscle and adipose tissues. Immunohistochemical examination revealed that the clear cells were positive for epithelial cell markers, and myoepithelial markers were negative. Fluorescence in situ hybridization (FISH), performed to search for genetic abnormalities, demonstrated split positivity for EWSR1, and fusion with CREM was confirmed. These findings suggested a diagnosis of CCC.
Inhalational sevoflurane in severe bronchial obstruction unresponsive to multipharmacologic therapy: a case report
Authors: Thomas Weber, Christian Schiebenpflug, Engelbert Deusch
Journal: F1000Res (2012)

Introduction:
Bronchial asthma with respiratory failure is a challenge for the intensivist as mechanical ventilation is often difficult due to bronchoconstriction and air-trapping. We describe a case of severe asthma with respiratory acidosis in a 10-year-old patient unresponsive to multipharmacologic broncholytic therapy. Only the initiation of sevoflurane inhalation resolved severe bronchoconstriction and dynamic hyperinflation, leading to complete recovery.
Case presentation:
A 10-year-old Caucasian boy was intubated and mechanically ventilated due to an asthmatic attack. Bronchoconstriction and dynamic hyperinflation were severe while multipharmacological broncholytic therapy was unsuccessful. Inhalation with sevoflurane via an anaesthesia machine was the key intervention leading to gradual resolving of severe hypercapnia and respiratory acidosis. Furthermore bilateral pupil dilation occurred during hypercapnia, but no intracranial pathology could be detected. The patient made an uneventful recovery. To our knowledge this is the first case where hypercapnia and respiratory acidosis were so profound and long lasting yet the patient survived without any damage.
Conclusions:
Inhalational anaesthetics must be considered as an early treatment option in ventilated asthmatic patients with bronchial obstruction unresponsive to conventional therapy even though their administration in intensive care units may be difficult.
Severe Symptomatic Hyponatremia Secondary to Escitalopram-Induced SIADH: A Case Report with Literature Review
Authors: Rishi Raj, Aasems Jacob, Ajay Venkatanarayan, Mohankumar Doraiswamy, Manjula Ashok
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

Hyponatremia is a well-known medication related side effect of selective serotonin reuptake inhibitors; despite its association with escitalopram, the newest SSRI is very rare. We did a review of literature and came across only 14 reported case of this rare association of SIADH with escitalopram. We hereby report a case of a 93-year-old female who presented with generalized tonic-clonic seizure and was diagnosed with severe hyponatremia due to escitalopram-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH). With this article, we want to emphasize clinicians about this rare side effect of escitalopram use and look for the risk factors leading to SIADH.
Serotonin Syndrome with Monotherapy of Low-Dose Sertraline in an Adult Patient with Autism Spectrum Disorder
Authors: Rohit Madan, Jody Platto, Senthil Rajaram Manoharan, Varun Monga
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Serotonin syndrome, also known as serotonin toxicity, is associated with increased serotonergic activity in the central and the peripheral nervous system. The symptoms can range from mild to potentially life threatening. Given the widespread use of serotonergic agents, the number of cases is on the rise. It is seen with therapeutic medication use, inadvertent interactions between drugs, and intentional self-poisoning, but still known cases with monotherapy of selective serotonin reuptake inhibitors are uncommon. Another known fact is that elevated whole blood serotonin, or hyperserotonemia, is one of the first biomarkers identified in autism spectrum disorder and is present in more than 25% of affected children. We present a case of a 32-year-old male with a history of autism spectrum disorder and depressive disorder who presented to the emergency department with restless agitation, neuromuscular excitability, and autonomic instability. He had been prescribed sertraline 50 mg which he had taken daily as prescribed for 4 days. On the fourth day, he presented to the emergency department with diffuse muscle stiffness, upper extremity tremors, ocular clonus, and inducible ankle clonus. He was diagnosed with probable serotonin syndrome utilizing Hunter's criteria. Patient's symptoms resolved within 24 hours with intravenous fluids, lorazepam, and discontinuation of sertraline. This case highlights the importance of a high degree of clinical suspicion in patients even on monotherapy of selective serotonin reuptake inhibitors in therapeutic doses, especially in children and adults with autism spectrum disorder. Due to preexisting hyperserotonemia, they may be more susceptible to serotonin syndrome than the general population.
Stress system dynamics during "life as it is lived": an integrative single-case study on a healthy woman
Authors: Christian Schubert, Willi Geser, Bianca Noisternig, Dietmar Fuchs, Natalie Welzenbach, Paul König, Gerhard Schüßler, Francisco M Ocaña-Peinado, Astrid Lampe
Journal: PLoS One (2012)
MeSH terms: Activities of Daily Living / psychology, Health, Stress, Psychological / physiopathology, Stress, Psychological / urine, Research Support, Non-U.S. Gov't, Adolescent, Adult, Child, Preschool, Emotions / physiology, Female, Humans, Hydrocortisone / metabolism, Hydrocortisone / urine, Hypothalamus / metabolism, Hypothalamus / physiopathology, Male, Middle Aged, Neopterin / metabolism, Neopterin / urine, Pituitary-Adrenal System / metabolism, Pituitary-Adrenal System / physiopathology, Pregnancy, Time Factors, Neopterin, Hydrocortisone

Little is known about the dynamic characteristics of stress system activity during "life as it is lived". Using as representative a study design as possible, this investigation sought to gain insights into this area. A healthy 25-year-old woman collected her entire urine over a period of 63 days in 12-h intervals (126 measurements) to determine cortisol and neopterin (immune activation marker) levels. In addition, she filled out questionnaires on emotional state and daily routine in 12-h intervals, and was interviewed weekly to identify emotionally negative and positive everyday incidents. Adjusted cross-correlational analyses revealed that stressful incidents were associated with cyclic response patterns in both urinary cortisol and urinary neopterin concentrations. Urinary cortisol levels first decreased 12-24 h after stressful incidents occurred (lag 1: -.178; p = 0.048) and then increased a total of 72-84 h later (lag 6: +.224; p = 0.013). Urinary neopterin levels first increased 0-12 h before the occurrence of stressful incidents (-lag 1: +.185; p = 0.040) and then decreased a total of 48-60 h following such stressors (lag 4: -.181; p = 0.044). Decreases in urinary neopterin levels were also found 24-36 and 48-60 h after increases in pensiveness (lag 2: -.215; p = 0.017) and depressiveness (lag 4: -.221; p = 0.014), respectively. Findings on emotionally positive incidents sharply contrasted with those dealing with negative experiences. Positive incidents were followed first by urinary cortisol concentration increases within 12 h (lag 0: +.290; p = 0.001) and then by decreases after a total of 60-72 h (lag 5: -.186; p = 0.039). Urinary neopterin levels first decreased 12-24 h before positive incidents occurred (-lag 2: -.233; p = 0.010) and then increased a total of 12-24 h following these incidents (lag 1: +.222; p = 0.014). As with previous investigations on patients with systemic lupus erythematosus (SLE), this study showed that stress system response can be considerably longer and more complex and differentiated than findings from conventional group studies have suggested. Further integrative single-case studies will need to be conducted in order to draw firm conclusions about stress system dynamics under real-life conditions.
A Large PROP1 Gene Deletion in a Turkish Pedigree
Authors: Suheyla Gorar, Doga Turkkahraman, Kanay Yararbas
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Pituitary-specific paired-like homeodomain transcription factor, PROP1, is associated with multiple pituitary hormone deficiency. Alteration of the gene encoding the PROP1 may affect somatotropes, thyrotropes, and lactotropes, as well as gonadotropes and corticotropes. We performed genetic analysis of PROP1 gene in a Turkish pedigree with three siblings who presented with short stature. Parents were first degree cousins. Index case, a boy, had somatotrope, gonadotrope, thyrotrope, and corticotrope deficiency. However, two elder sisters had somatotroph, gonadotroph, and thyrotroph deficiency and no corticotroph deficiency. On pituitary magnetic resonance, partial empty sella was detected with normal bright spot in all siblings. In genetic analysis, we found a gross deletion involving PROP1 coding region. In conclusion, we report three Turkish siblings with a gross deletion in PROP1 gene. Interestingly, although little boy with combined pituitary hormone deficiency has adrenocorticotropic hormone (ACTH) deficiency, his elder sisters with the same gross PROP1 deletion have no ACTH deficiency. This finding is in line with the fact that patients with PROP1 mutations may have different phenotype/genotype correlation.
A huge retropharyngeal lipoma: a rare cause of dysphagia: a case report and literature review
Authors: Monia Ghammam, Jihene Houas, Mouna Bellakhdher, Mohamed Abdelkefi
Journal: Pan Afr Med J (2019)
Keywords: lipoma, dysphagia, retropharyngeal, surgery
MeSH terms: Deglutition Disorders / etiology, Lipoma / diagnosis, Pharyngeal Neoplasms / diagnosis, Case Reports, Review, Humans, Lipoma / complications, Lipoma / surgery, Male, Middle Aged, Pharyngeal Neoplasms / complications, Pharyngeal Neoplasms / surgery, Stroke / complications, Tomography, X-Ray Computed / methods

Dysphagia is commonly seen after a cerebral vascular accident. It is rarely caused by lipomas of the retropharyngeal region which are rare benign mesenchymal neoplasms. We report a case of a 53-year-old man who presented with a history of ptyalism and dysphagia occurring after a brain stroke. Flexible nasal endoscopy revealed a pooling of saliva in both pyriform sinuses. Cervical and neurological examinations were unremarkable. Computed tomography (CT) scan suggested the diagnosis of retropharyngeal lipoma. The mass was resected by trans-cervical approach. The histological examination confirmed the diagnosis of a retropharyngeal lipoma. The postoperative course was unremarkable. Although lipomas in the retropharyngeal space are rare, clinicians should evoke this diagnosis when treating a patient presenting with dysphagia, even if there is a medical history of cerebral vascular accident.
Delayed Diagnosis of a Diffuse Invasive Gastrointestinal Aspergillosis in an Immunocompetent Patient
Authors: S Guglielmetti, C M Jaccard, K Mühlethaler, A Bigler, D Springe, L Ebnöther, M Delgado
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Invasive aspergillosis represents a clinical picture frequently associated with host's immunosuppression which usually involves a high morbidity and mortality. In general, the most frequent fungal entry is the lungs with secondary hematogenous dissemination, but there are other hypotheses like a gastrointestinal portal of entry. There are some rare publications of cases with invasive aspergillosis in immunocompetent patients. We present the case of an immunocompetent patient without any risk factors except for age, ICU stay, and surgical intervention, who developed a septic shock by invasive gastrointestinal aspergillosis as primary infection. Due to the unusualness of the case, despite all the measures taken, the results were obtained postmortem. We want to emphasize the need not to underestimate the possibility for an invasive aspergillosis in an immunocompetent patient. Not only pulmonary but also gastrointestinal aspergillosis should be taken into account in the differential diagnosis to avoid a delay of treatment.
Reconstructive surgery for giant penoscrotal elephantiasis: about one case
Authors: Brahima Kirakoya, Barnabé Zango, Abdoul Karim Paré, Aristide Fasnéwendé Kaboré, Clotaire Yaméogo
Journal: Basic Clin Androl (2014)
Keywords: elephantiasis, penoscrotal, scrotoplasty
MeSH terms: Case Reports

Elephantiasis of the external genitalia is characterized by lymphedema and thickening of the subcutaneous tissues. This gives the skin an appearance similar to a pachyderm skin. This pathology is invalidating for the patient. Reconstructive surgery is often the only way to restaure aesthetic and functional aspects of the external genitalia. We aim to report a 52 year man with huge penoscrotal elephantiasis who underwent excision and penoscrotal reconstruction at the department of Urology, Yalgado Ouedraogo Teaching Hospital at Ouagadougou.
Scoliosis in Shprintzen-Goldberg Syndrome
Authors: Hiromitsu Takano, Ikuho Yonezawa, Takatoshi Okuda, Hajime Kajihara, Kazuo Kaneko
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

We report a case of scoliosis in a 12-year-old girl with Shprintzen-Goldberg syndrome. She was diagnosed with Shprintzen-Goldberg syndrome at birth. She was hospitalized for a surgical treatment because scoliosis gradually progressed. Preoperative X-ray confirmed 80° symptomatic scoliosis in T10-L5. Posterior correction and fusion were performed, and postoperative X-ray showed a correction to 43°in T10-L5. Limited subcutaneous tissues and fragile bones must be considered when selecting the appropriate surgical method. Accurate placement of a screw into thin pedicle is essential to obtain sufficient correction and fusion. The use of a navigation system is recommended.
Spontaneous massive pectoral hematoma induced by vitamin K antagonist therapy: a case report
Authors: Karima Benbouchta, Asmae Mrabet, Ossema Kallel, Noha El Ouafi, Zakaria Bazid
Journal: Pan Afr Med J (2021)
Keywords: spontaneous hematoma, anticoagulation, case report, pectoral, vitamin k antagonists
MeSH terms: Anticoagulants / adverse effects, Hematoma / chemically induced, Hemorrhage / chemically induced, Case Reports, Acenocoumarol / administration & dosage, Acenocoumarol / adverse effects, Aged, Anticoagulants / administration & dosage, Atrial Fibrillation / complications, Atrial Fibrillation / drug therapy, Female, Humans, Thromboembolism / etiology, Thromboembolism / prevention & control, Vitamin K / antagonists & inhibitors, Anticoagulants, Vitamin K, Acenocoumarol

Vitamin K antagonists (VKA) based oral anticoagulation, is widely used for the prevention and treatment of thromboembolic disease. The major complication of this therapy is bleeding, and sometimes it can occur in unsuspected areas. Spontaneous pectoral hematoma is one of the rare complications due to over anticoagulation by VKA therapy, with only a few cases reported in the literature. Concomitant use of this therapy with commonly used antibiotic, especially in the elderly with multiple comorbidities, can increase the risk of bleeding. Herein, we report a case of a 72-year-old woman under VKA for the treatment of atrial fibrillation, who presented with a spontaneous massive pectoral hematoma, while using antibiotic to treat a respiratory tract infection, who was successfully managed.
Adjunctive Use of Point of Care Ultrasound to Diagnose Compartment Syndrome of the Thigh
Authors: Neil Long, Justin S Ahn, Daniel J Kim
Journal: POCUS J (2021)
Keywords: compartment syndrome, point of care ultrasound, thigh
MeSH terms: Case Reports

Compartment syndrome is a medical emergency and must be considered in patients who present with severe limb pain. Compartment syndrome is a clinical diagnosis, classically described as presenting with the 5 'P's (pain, pulselessness, pallor, paraesthesia, and paralysis). Apart from pain, the other findings signify acute arterial obstruction and would be late findings. We present a case of a 31-year-old male in which point of care ultrasound (POCUS) expedited this diagnosis by demonstrating a large thigh hematoma in the anterior compartment. This prompted emergent orthopedic surgery consultation, and the diagnosis of compartment syndrome was confirmed both at the bedside and in the operating room. Compartment syndrome can be a challenging diagnosis, especially early in the course of illness. While POCUS should not be used in isolation in the assessment of possible compartment syndrome, it can be used as an adjunct in the workup, especially if it identifies an underlying cause.
Transcatheter Coil Embolization of Single Coronary Artery Fistula Using the Occlusion Test
Authors: Shin Takahashi, Yurie Takizawa, Satoshi Nakano, Junichi Koizumi, Kotaro Oyama
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

The case of a patient in whom hemodynamic and electrocardiographic studies using the occlusion test for coronary artery fistulas (CAF) were safely performed prior to catheter embolization is reported. A 1-year-old girl had a separate right coronary artery arising from a left single coronary artery that formed a significant coronary artery fistula to the right ventricle. Coronary steal by the large coronary artery fistula narrowed the left coronary artery. The right coronary artery branches could not be clearly identified due to an overlap with the fistula. Due to the long porous CAF, embolic procedures could cause serious complications. We confirmed the safety by performing an occlusion test of the CAF's proximal blood vessels. Following total occlusion of the CAF for 10 minutes, pulmonary arterial pressure and aortic blood pressure were not significantly changed. No bradycardia, atrioventricular block, or ST changes were observed. Coil embolization treatment was performed safely. For patients with long distal CAF complicated with a single coronary artery, myocardial ischemia and conduction system disorders can be identified by performing the occlusion test before embolization.
Case Report: Effects of Multiple Seasons of Heavy Strength Training on Muscle Strength and Cycling Sprint Power in Elite Cyclists
Authors: Bent R Rønnestad
Journal: Front Sports Act Living (2022)
Keywords: case report, cycling, endurance, performance, resistance training
MeSH terms: Case Reports

Sprint performance is critical for endurance performance in sports characterized by multiple accelerations like a cross-country Olympic mountain bike (XCO MTB) race. There are indications that 10-25 weeks of heavy strength training (HST) can improve cycling sprint power in cyclists. However, there is a lack of data on the effect of continuing HST across several seasons. In the first part of this case report, two elite cyclists performed HST across two preparatory periods (i.e., 1.5 years), while two others continued with endurance training only. HST induced a mean increase in leg press force and cycling sprint power of 16% after the first preparatory period (November to April), which was maintained during the competition period. After the next preparatory period a further increase from the first test was achieved (22 and 19%, respectively). The two cyclists with no HST had no changes in leg press force and cycling sprint power. The second part contains data from two of the cyclists from the first part. One of them continued with HST for 2 more years and achieved a continuous increase in leg press force during all four preparatory periods, ending up with a total increase of 44% after 3.5 years, while the development of cycling sprint power had more variation with an apparent plateau from the third to fourth preparatory periods, ending up with an improvement of 25%. The other cyclist did not perform HST in the first part but started with HST and performed this across the last two preparatory periods. After two preparatory periods with HST (i.e., 1.5 years), the increased leg press force and cycling sprint power were 24 and 22%, respectively, which was in the same range as the improvement observed after 1.5 years of HST in the first part of this case report. The present data extend previous short-term studies indicating that HST can give reasonable muscle strength improvements in elite cyclists across multiple preparatory periods. Furthermore, the present data indicate that HST adaptations can be maintained across multiple competition periods. Cycling sprint power seems to approximately follow the development of leg press performance.
A case report of a localized reticular erythematous mucinosis like eruption of the lower legs mimicking cutaneous larvae migrans
Authors: Bret Kenny, Duane Lichtenwald, Glenda R Wright, Allison Osmond
Journal: SAGE Open Med Case Rep (2021)
Keywords: reticular erythematous mucinosis, cutaneous mucinosis

Reticular erythematous mucinosis is an uncommon type of cutaneous mucinosis. Typically, reticular erythematous mucinosis affects middle-aged women and usually appears as papules and plaques on the mid-upper trunk. Histologically, biopsies of reticular erythematous mucinosis reveal increased deposition of dermal mucin and perivascular lymphocytic inflammation. Infrequently, reticular erythematous mucinosis has been reported in males and in atypical locations other than the trunk. In these instances, reticular erythematous mucinosis can present a diagnostic challenge clinically and histologically. This case describes the clinical and histologic findings of a localized variant of reticular erythematous mucinosis in a 65-year-old male patient.