OpenMed/multicare-articles huggingface dataset:
Excision of oral submucous fibrosis and reconstruction with full thickness skin graft: a case study and review of the literature
Authors: Ahmad Alshadwi, Ishwar Bhatia
Journal: Case Rep Dent (2012)

Oral submucous fibrosis is a chronic debilitating disease characterized by gradually increasing fibrosis of the oral cavity and pharynx, mainly the buccal mucosa, resulting in trismus. The highest incidence of oral submucous fibrosis is seen in South India due to various deleterious habits. In spite of the numerous medical modalities employed in the management of oral submucous fibrosis, occasionally surgical intervention becomes inevitable. Various surgical approaches have been used to reconstruct the surgical defects following excision of fibrous bands. Full thickness skin grafts have been described in the literature with variable outcomes. In the present study a 38-year-old male presented with severe oral submucous fibrosis of the buccal mucosa, which was successfully treated and reconstructed using full thickness skin graft with stable functional result after one year of treatment. An integrated review of the literature regarding etiology, histopathology, diagnostic, and treatment modalities of the disease follows.
Case Report: Ursodeoxycholic acid treatment in Niemann-Pick disease type C; clinical experience in four cases
Authors: William R H Evans, Elena-Raluca Nicoli, Raymond Y Wang, Nina Movsesyan, Frances M Platt
Journal: Wellcome Open Res (2017)
Keywords: npc, niemann pick disease type c, cholestasis, lysosomal storage disease, p450, treatment
MeSH terms: Case Reports

In this case series, we demonstrate that Ursodeoxycholic acid (UDCA) improves liver dysfunction in Niemann-Pick type C (NPC) and may restore a suppressed cytochrome p450 system. NPC disease is a progressive neurodegenerative lysosomal storage disease caused by mutations in either the NPC1 or NPC2 genes. Liver disease is a common feature presenting either acutely as cholestatic jaundice in the neonatal period, or in later life as elevated liver enzymes indicative of liver dysfunction. Recently, an imbalance in bile acid synthesis in a mouse model of NPC disease was linked to suppression of the P450 detoxification system and was corrected by UDCA treatment. UDCA (3α, 7β-dihydroxy-5β-cholanic acid), a hydrophilic bile acid, is used to treat various cholestatic disorders. In this report we summarise the findings from four independent cases of NPC, three with abnormal liver enzyme levels at baseline, that were subsequently treated with UDCA. The patients differed in age and clinical features, they all tolerated the drug well, and in those with abnormal liver function, there were significant improvements in their liver enzyme parameters.
Cutaneous metastases as initial presentation of malignancy
Authors: Supriya Karde, Jayant Sharma, Nagabathula Ramesh, Prashant Bhand, Awanish Shukla
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

We describe a case of 73-year-old female who presented with dry cough, chest pain and light-headedness. On examination, multiple subcutaneous masses were noticed on the chest wall, bilateral breast, anterior abdomen and both arms. Subsequent CT-TAP and CT-brain showed multiple subcutaneous nodules in scalp, neck, anterior chest wall, breast and abdomen. A biopsy taken from breast revealed metastatic malignant melanoma; however there was no evidence of primary cutaneous malignant melanoma. We also describe a case of 72-year-old male who presented with tender mass on his lower back and posterior neck. He was known to have COPD and was a heavy smoker. A CT-TAP showed right lower lung mass with soft tissue masses near lumbar spine and lower cervical spine. While awaiting bronchoscopy, biopsy taken from the mass on lower back showed features of metastatic lung adenocarcinoma. In fact, presence of cutaneous metastasis is heraldsign and indicates advanced malignancy with poor prognosis regardless of type of primary malignancy.
Efficacy of crizotinib retreatment after crizotinib-related interstitial lung disease in a patient with ROS1-rearranged advanced lung adenocarcinoma: A case report and potential crizotinib retreatment strategy
Authors: Woo Kyung Ryu, Hyungkeun Cha, Mi Hwa Park, Jung Soo Kim, Jeong-Seok Choi, Lucia Kim, Kyung-Hee Lee, Hae-Seong Nam
Journal: Front Oncol (2022)
Keywords: alk (anaplastic lymphoma kinase), ros1, crizotinib, interstitial lung disease (ild), tyrosine kinase inhibitor (tki)
MeSH terms: Case Reports

Crizotinib is an oral selective small-molecular tyrosine kinase inhibitor (TKI) that suppress the activity of anaplastic lymphoma kinase (ALK) and ROS1 kinases, as well as mesenchymal-epithelial transition. The cumulative clinical trials in patients with advanced ALK- or ROS1-rearrangement NSCLC indicate that crizotinib has significant antitumor activity and a tolerable safety profile, with mild or moderate adverse events of visual disorders, diarrhea, nausea, and vomiting. As with other TKIs, however, the occurrence of crizotinib-related interstitial lung disease (crizotinib-ILD) remains a major clinical dilemma that can lead to the permanent discontinuation of TKI during cancer treatment. When there is no suitable alternative therapy for patients who develop crizotinib-ILD, some clinicians have reported successful crizotinib retreatment in cases of ALK-rearrangement NSCLC. Unfortunately, there are no specific guidelines for the treatment or retreatment of TKI-related ILD. We herein report the first successful crizotinib retreatment after crizotinib-ILD in a patient with ROS1-rearranged NSCLC, and suggest a retreatment strategy after crizotinib-ILD based on a literature review.
Novel influenza H1N1 in pregnancy: a report of two cases
Authors: Dmitry Fridman, Oumar Kuzbari, Howard Minkoff
Journal: Infect Dis Obstet Gynecol (2009)
MeSH terms: Influenza A Virus, H1N1 Subtype / isolation & purification, Influenza, Human / diagnosis, Pregnancy Complications, Infectious / diagnosis, Case Reports, Adult, Antiviral Agents / therapeutic use, Fatal Outcome, Female, Humans, Infant, Newborn, Influenza, Human / drug therapy, Influenza, Human / virology, Pregnancy, Pregnancy Complications, Infectious / drug therapy, Pregnancy Complications, Infectious / virology, Antiviral Agents

Background:
Pregnant women are a high-risk group for morbidity and mortality from influenza. During the current pandemic of H1N1 influenza, few cases of H1N1 have been reported in pregnancy.
Cases:
We report two cases of H1N1 influenza which occurred in single institution in the course of one month. The first patient developed acute respiratory distress syndrome, required intubation, and eventually died. The second patient had influenza H1N1 that did not have any major sequela.
Conclusion:
H1N1 influenza in pregnancy can be associated with severe complications. Widespread vaccination, when available, prompt diagnosis, and adequate treatment with antiviral medications when infection occurs are required.
Isolated torticollis may present as an atypical presentation of meningitis
Authors: Roger Chirurgi, Samrina Kahlon
Journal: Case Rep Emerg Med (2012)

Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare. Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient. Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis. Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.
Recurrent bacteremia, a complication of cyanoacrylate injection for variceal bleeding: report of two cases and review of the literature
Authors: T Galperine, C Flateau, M D Venon, F X Lescure, G Béraud, T Said Ibrahim, F Delisle, F Durand, K Faure, G Pialoux, B Guery
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

We report the first description of recurrent bacteremia in two patients after cyanoacrylate injection for gastric varices bleeding treated with antibiotics alone. Adapted and prolonged antibiotic treatment allowed a complete resolution of the infection with no relapse after more than 6 months. According to recent data, prophylactic antibiotics should be further investigated for patients with bleeding varices undergoing cyanoacrylate injection.
Whole-Exome Sequencing Identified a Novel DYRK1A Variant in a Patient With Intellectual Developmental Disorder, Autosomal Dominant 7
Authors: Koji Obara, Erika Abe, Itaru Toyoshima
Journal: Cureus (2023)
Keywords: dyrk1a, face2gene, mrd7, novel variant, whole-exome sequencing
MeSH terms: Case Reports

Intellectual developmental disorder, autosomal dominant 7 (MRD7; OMIM 614104) is a rare disease characterized by microcephaly, intellectual disability, speech delay, feeding difficulties, and facial dysmorphisms. This disorder is caused by pathogenic/likely pathogenic variants of the DYRK1A gene, which encodes dual-specificity tyrosine-phosphorylation-regulated kinase 1A. Here, we report a case of MRD7 that was diagnosed using Face2Gene and whole-exome sequencing (WES). A 22-year-old man presented with microcephaly, intellectual disability, slender body, long slender fingers, and facial dysmorphisms. He was previously diagnosed with Cornelia de Lange syndrome (CdLS) at four years of age. However, his CdLS clinical diagnostic score was low at 22 years of age. The Face2Gene application introduced several candidate diseases including MRD7. Finally, by utilizing WES and Sanger sequencing analysis of cloned cDNA, we identified a novel heterozygous duplication variant (c.848dup, p.(Asn283LysfsTer6)) in the DYRK1A gene, which introduces a premature stop codon. This report provides more information about the phenotypic spectrum of a young adult patient with MRD7. Face2Gene helped us introduce candidate diseases of the patient. Registering further genetically confirmed cases with MRD7 will improve the accuracy of the diagnostic recommendations in Face2Gene. Moreover, WES is a powerful tool for diagnosing rare genetic diseases, such as MRD7.
A case of pulmonary embolism with bad warfarin anticoagulant effects caused by E. coli infection
Authors: Weifeng Huang, Qingqing Cai, Yan Huo, Jin Tang, Yan Chen, Yuan Fang, Yihan Lu
Journal: Open Life Sci (2023)
Keywords: escherichia coli, anticoagulation, infection, metagenomic next-generation sequencing, warfarin
MeSH terms: Case Reports

Warfarin is an anticoagulant commonly used as an oral drug in preventing and treating thromboembolic diseases. The international normalized ratio (INR) is a clinical monitoring anticoagulation intensity index that adjusts the dose based on important references. In particular, INR value must be strictly monitored when warfarin is used for anticoagulation therapy in infected patients. Herein, we report a 54-year-old female patient diagnosed with pulmonary embolism and venous thrombosis of the lower limbs. After the warfarin administration, the INR was always substandard. The patient did not take other warfarin-interacting drugs or foods during the hospital stay. Metagenome next-generation sequencing suggested a bloodstream infection caused by Escherichia coli, which was further confirmed by blood culture. After meropenem administration for anti-infective treatment, the INR value rose rapidly to a standard level. Considering the lack of relevant reports, this case is the first report of potential interaction between E. coli and warfarin. Further, in patients with thromboembolic diseases complicated by infection, antibiotics should be chosen reasonably with close monitoring of the INR to avoid the interaction of warfarin and antibiotics and to ensure the effectiveness and safety of warfarin treatment.
Lead poisoning with encephalic and neuropathic involvement in a child: case report
Authors: Latifa Rouzi, Hecham Elhamri, Samira Kalouch, Siham Salam, Bouchra El Moutawakil, Hanan Chaoui, Narjis Badrane, Mohammed Fekhaoui, Zineb Jouhadi
Journal: Pan Afr Med J (2022)
Keywords: lead poisoning, case report, children, encephalopathy, neuropathy
MeSH terms: Lead Poisoning / diagnosis, Lead Poisoning / drug therapy, Lead Poisoning / etiology, Peripheral Nervous System Diseases / complications, Case Reports, Brain, Child, Child, Preschool, Family, Female, Humans, Lead, Succimer, Lead, Succimer

Lead is a toxic substance in our environment that affects adults and children of all socioeconomic backgrounds, lead poisoning is one of the most common exposures that can cause inter alia significant neurological and functional damage in humans. Children are particularly vulnerable because of the effects of the toxicity on their developing nervous systems with potentially irreversible consequences. We report a case of severe lead poisoning encephalo-neuropathy in a 3-year-old girl, admitted for progressive paraplegia, swallowing disorders, and aphasia. A multitude of investigations undertaken could not explain her atypic symptoms, so anamnesis was redone in the sense of a toxic origin, we found a notion of pica, and a traditional herbalist father, so probably consumption of medications based on traditional medicine products. A venous blood lead level (BLL) was extremely elevated at 176.4 μg/l. The child was treated with an oral chelator succimer (SUCCICAPTAL). During the two following months in the intensive care unit, the child showed progressive respiratory distress and worsening signs of the nervous system. Despite treatment and the use of lead chelators, the patient died due to septic shock. Lead is highly toxic even at very low exposure levels, at high levels of exposure, it can damage the reproductive organs, immune system, liver and kidneys. in children, it can affect neurocognitive and behavioral development that could be irreversible. Peripheral and central nervous system damage should be considered as a possible manifestation of lead poisoning.
Ureteral obstruction and urinary fistula due to fibrin glue after partial nephrectomy: A case report and review of the literature
Authors: Chao-Jun Wang, DE-Bo Kong, Bai-Hua Shen, Shuo Wang, Bai-Ye Jin, Li-Ping Xie, Zhao-Dian Chen
Journal: Oncol Lett (2013)
Keywords: fibrin glue, partial nephrectomy, ureteral obstruction, urinary fistula, urinary leakage

In the present study, we report the case of a 69-year-old female who developed urinary leakage following partial nephrectomy (PN) to remove left renal masses. The results of CT and MR urography revealed left proximal ureteral obstruction and urinary fistula. Reoperation was performed on the 16th postoperative day to explore the left kidney and ureter in order to relieve the obstruction. The left proximal ureter was found to be enfolded by fibrin glue and showed marked stiffness and adhesion during the reoperation. The lesion of the ureter was resected and the ureter was anastomosed with the routine double-J stent. Pathological examination of surgical specimens revealed fat fibrous scar tissue hyperplasia with inflammatory cell infiltration. The patient recovered completely without exudate. Our experience suggests that care should be taken to avoid touching the ureter with fibrin glue during PN surgery.
A Case of Symptomatic Paroxysmal Complete Atrioventricular Block
Authors: Bradley Casey 3rd, Amol Bahekar, Divyang Patel, Raviteja Guddeti
Journal: Cureus (2023)
Keywords: arrythmia, atypical chest pain, cardiac syncope, paroxysmal complete heart block, presyncope
MeSH terms: Case Reports

Paroxysmal complete atrioventricular block (PCAB) is clinically characterized by a sudden change from 1:1 atrioventricular (AV) conduction leading to complete heart block. Patients may have a vast array of symptoms, but commonly, PCAB will lead to syncope and possible sudden cardiac death. The literature currently consists of three different types of PCAB: intrinsic paroxysmal atrioventricular block, extensive vagal paroxysmal atrioventricular block, and extrinsic idiopathic paroxysmal atrioventricular block. Currently, there is no single symptom or sign that is specific to a single type of AV block. PCAB is often missed or overlooked because of its unpredictability and no evidence of conduction disease with a normal 1:1 conduction on routine electrocardiograms. Here, we present a case of a 65-year-old female who has been intermittently symptomatic for four years and was found to have PCAB.
The rubber manufacturing industry: a case report and review of cutaneous exposure and sequelae
Authors: Claire Powers, Heather P Lampel
Journal: J Occup Med Toxicol (2015)
MeSH terms: Case Reports

Exposure to chemical carcinogens in rubber manufacturing remains a serious occupational health concern. Workers are exposed to these carcinogens via skin or inhalation. Rubber manufacturing work is associated with a high prevalence of dermatologic diseases such as eczema, allergic contact dermatitis and atopic dermatitis. The role that epidermal exposure plays in the development of malignancies historically associated with the rubber industry is less certain. We present a case relevant to this discussion and review the role of skin exposure in the rubber industry, providing an overview of the cutaneous and systemic manifestations of occupational exposures in modern day rubber workers.
Torsion of the Omentum: A Rare Cause of Acute Abdomen in a 14-Year-Old Boy
Authors: Chijioke Chinaka, Shahbaz Mansoor, Mohamed Salaheidin
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Acute abdominal pain is a common surgical presentation, and most often, the first line of consideration is to rule out acute appendicitis; this is more so when the patient is an adolescent or within younger age group. In most cases, other differentials are considered before omental torsion. Omental torsion is a cause of acute abdominal pain and sometimes mimics acute appendicitis in its presentation. We present a case of a 14-yr-old boy who presented with acute abdomen with symptoms mimicking acute appendicitis. Laparoscopy revealed torsion of the omentum. Omentectomy and appendicectomy were done, and the child discharged four days after following a remarkable recovery.
Social workers' intervention during natural hazards
Authors: Frans K Matlakala, Jabulani C Makhubele, Louis Nyahunda
Journal: Jamba (2022)
Keywords: intervention, methods, natural hazards, roles, social workers
MeSH terms: Review

Social work profession is anchored on theory and practice and has both primary and secondary methods of interventions. The knowledge base of social work is constituted by values, principles, theories, skills and techniques. Globally, social work scholars have developed paradigms, theories, approaches, perspectives, models, techniques, skills and principles that could be applied in a variety of settings to various social ills for the benefit of clients in communities. Thus, this study was aimed at exploring social workers' intervention during natural hazards. The researchers used an interpretative qualitative research approach and case study design. Moreover, five social workers who provide psychosocial counselling and social relief of distress were purposively sampled to participate in this study. Data were collected through individual semi-structured interviews and analysed thematically. The study found that social workers use three primary methods of social work: casework, group work and community work. Furthermore, the participants stated that they play roles such as educator, counsellor and broker when dealing with victims of natural hazards. Based on the findings, the researchers have noted that not all social workers are active in providing psychosocial counselling to the victims of natural hazards. As such, the researchers recommend more workshops to educate all social workers that social workers have an important role to perform in the midst of natural hazards.
Trypanosoma cruzi necrotizing meningoencephalitis in a Venezuelan HIV⁺-AIDS patient: pathological diagnosis confirmed by PCR using formalin-fixed- and paraffin-embedded-tissues
Authors: Marcello Salvatore Rossi Spadafora, Ghislaine Céspedes, Sandra Romero, Isabel Fuentes, Alpidio A Boada-Sucre, Carmen Cañavate, María Flores-Chávez
Journal: Anal Cell Pathol (Amst) (2014)
MeSH terms: Acquired Immunodeficiency Syndrome / complications, Chagas Disease / complications, Chagas Disease / diagnosis, Meningoencephalitis / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Adult, Formaldehyde, Humans, Male, Meningoencephalitis / complications, Meningoencephalitis / microbiology, Paraffin Embedding, Polymerase Chain Reaction, Tissue Fixation, Trypanosoma cruzi, Venezuela, Formaldehyde

Coinfections with human immunodeficiency virus (HIV) and infectious agents have been recognized since the early 90s. In the central nervous system (CNS) of HIV(+) patients, parasitic protozoans like Toxoplasma gondii have been described as responsible for the space occupying lesions (SOL) developed. However, the involvement of Trypanosoma cruzi is also described but appears to be less frequent in acquired immunodeficiency syndrome (AIDS) and transplant recipients, associated with necrotizing myocarditis and neurological symptoms related to the occurrence of necrotizing pseudotumoral encephalitis (NPE) and meningoencephalitis (NME). The present work aims to present a Venezuelan case of NME associated with the coinfection of HIV and a T. cruzi-like trypanosomatid as well as its evolution and diagnosis by histopathological techniques, electron microscopy, and PCR methods using formalin-fixed- (FF-) and paraffin-embedded- (PE-) tissues. Postmortem cytological studies of leptomeninges imprints reveal the presence of trypomastigotes of Trypanosoma sp. Histopathological and electron microscopy studies allowed us to identify an amastigote stage and to reject the involvement of other opportunistic microorganisms as the etiological agent of the SOL. The definitive confirmation of T. cruzi as the etiological agent was achieved by PCR suggesting that the NME by T. cruzi was due to a reactivation of Chagas' disease.
Bronchiolitis obliterans organizing pneumonia (BOOP) after thoracic radiotherapy for breast carcinoma
Authors: Robin Cornelissen, Suresh Senan, Imogeen E Antonisse, Hauw Liem, Youke K Y Tan, Arjan Rudolphus, Joachim G J V Aerts
Journal: Radiat Oncol (2007)
MeSH terms: Breast Neoplasms / complications, Breast Neoplasms / radiotherapy, Carcinoma / complications, Carcinoma / diagnostic imaging, Cryptogenic Organizing Pneumonia / diagnosis, Cryptogenic Organizing Pneumonia / etiology, Radiation Pneumonitis / etiology, Radiotherapy / adverse effects, Case Reports, Aged, 80 and over, Cryptogenic Organizing Pneumonia / diagnostic imaging, Female, Humans, Lung / diagnostic imaging, Middle Aged, Radiation Injuries, Radiation Pneumonitis / diagnostic imaging, Tomography, X-Ray Computed / methods

Common complications of thoracic radiotherapy include esophagitis and radiation pneumonitis. However, it is important to be aware of uncommon post-radiotherapy complications such as bronchiolitis obliterans organizing pneumonia (BOOP). We report on two patients with carcinoma of the breast who developed an interstitial lung disease consistent with BOOP. BOOP responds to treatment with corticosteroids and the prognosis is generally good despite of the need for long-term administration of corticosteroids as relapses can occur during tapering of steroids. This report provides guidelines for the evaluation and treatment of patients with pulmonary infiltrates after radiotherapy.