OpenMed/multicare-articles huggingface dataset:
Biologically based restorative management of tooth wear
Authors: Martin G D Kelleher, Deborah I Bomfim, Rupert S Austin
Journal: Int J Dent (2012)

The prevalence and severity of tooth wear is increasing in industrialised nations. Yet, there is no high-level evidence to support or refute any therapeutic intervention. In the absence of such evidence, many currently prevailing management strategies for tooth wear may be failing in their duty of care to first and foremost improve the oral health of patients with this disease. This paper promotes biologically sound approaches to the management of tooth wear on the basis of current best evidence of the aetiology and clinical features of this disease. The relative risks and benefits of the varying approaches to managing tooth wear are discussed with reference to long-term follow-up studies. Using reference to ethical standards such as "The Daughter Test", this paper presents case reports of patients with moderate-to-severe levels of tooth wear managed in line with these biologically sound principles.
Tricuspid Valve Replacement in a Patient with a Leadless Cardiac Pacemaker: Current Guidelines and Recommendations for Perioperative Management
Authors: River Hames, J W Awori Hayanga, Diane Schmidt-Krings, Timothy Goldhardt, John Bozek, Donald Siddoway, Stanley Schmidt, John Lobban, Heather K Hayanga
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

Leadless cardiac pacemakers were developed to reduce complications associated with conventional transvenous pacemakers. While this technology is still relatively new, devices are increasingly being implanted. The perioperative management of patients with these devices has been underreported; we thus seek to add to the limited body of knowledge of perioperative management of patients with leadless cardiac pacemakers. An elderly female patient with a Micra VR transcatheter pacing system leadless cardiac pacemaker placed for tachycardia-bradycardia syndrome with intermittent complete heart block was scheduled for elective tricuspid valve replacement for severe tricuspid regurgitation. Pacemaker interrogation was performed several hours prior to the scheduled surgery based on the electrophysiologist's availability; the device was kept in its programmed VVIR mode, and the base rate was increased from 60 to 80 beats per minute in anticipation of the upcoming surgery. Upon preoperative evaluation, the anesthesiologist asked that the electrophysiology team be placed on standby intraoperatively due to the concern that either oversensing in the setting of pacemaker dependence and/or undesirable tachycardia from rate-responsive pacing could occur. The surgeon used monopolar electrocautery for the duration of the cardiac surgery. Despite the patient having evidence of pacemaker dependence in the intensive care unit preoperatively, no electromagnetic interference leading to oversensing nor rate modulation was detected during intraoperative electrocardiographic and intraarterial invasive monitoring. Evidence-based guidelines regarding perioperative management specifically of leadless cardiac pacemakers do not exist. As these devices become more prevalent, further evaluation will be paramount to determine whether existing guidelines for perioperative management of conventional transvenous pacemakers apply.
Sacroiliac screws fixation navigated with three-dimensional printing personalized guide template for the treatment of posterior pelvic ring injury: A case report
Authors: Zhanyu Yang, Bin Sheng, Delong Liu, Yiwei Wang, Chao Liu, Rui Xiao
Journal: Front Surg (2023)
Keywords: 3d printing technology, case report, guide template, posterior pelvic ring injury, sacroiliac screw fixation
MeSH terms: Case Reports

Objective:
Pelvic injuries refer to the disruption of the inherent structural and mechanical integrity of the pelvic ring. Sacroiliac screw fixation technique is often used for the treatment of posterior pelvic ring injury, which is prone to the iatrogenic injury. Various attempts were proposed to avoid iatrogenic injuries, while the executing processes are usually too cumbersome. The patient-personalized guide template based on 3D printing technology has been considered as a promising method, which can achieve lower deviation and higher accuracy in a simple and convenient way. We reported the first case of posterior pelvic ring injury using 3D printing personalized guide template with the verification of intraoperative CT.
Methods:
The subject was a 74-year-old female with posterior pelvic ring injury. Two patient-specific guide templates were customized based on 3D printing technology, one for S1 and the other for S2. We used the guide templates for navigation to place the sacroiliac screws. The placement of screws was verified by intraoperative CT. Intraoperative and postoperative variables were collected.
Results:
The technique helped us successfully insert the sacroiliac screws into the safe zone. The intraoperative blood loss was 23.03 ml, and the duration of operation was 62 min. The exposure dose during CT scanning was 7.025 mSv. The assessment of screws position was excellent. Furthermore, there was no sign of any functional impairment postoperatively.
Conclusion:
Sacroiliac screws fixation with the assistance of 3D printing personalized guide template under the verification of intraoperative CT may be a promising method to treat posterior pelvic ring injuries.
Use of autologous fascia lata graft to repair a complex corneal ulcer in a mare
Authors: Marcos Lores, Peter Rakestraw, Mieke De Rijck, Thomas Yarbrough
Journal: Ir Vet J (2020)
Keywords: conjunctival graft, corneal aspergillosis, fascia lata, keratomycosis, stromal keratomalacia, ulcerative keratitis
MeSH terms: Case Reports

Background:
Application of an autogenous fascia lata graft in the treatment of keratomalacia in the horse has not been reported. The present case describes the use of an autologous fascia lata graft to surgically treat a complicated corneal ulcer in a horse.
Case presentation:
A 12-year-old Arabian mare was admitted to Sharjah Equine Hospital with a history of right eye ulcerative keratitis of unknown duration. Following a week of aggressive medical treatment, the condition deteriorated and a keratectomy and pedicle conjunctival graft were performed. A week later, the conjunctival graft partially dehisced and the ulcer continued to degrade.In attempting to preserve the integrity of the globe a second grafting procedure was performed when a segment of fascia lata harvested from the ipsilateral hind leg was grafted onto the corneal lesion.Response to surgery was positive and the mare was discharged from the hospital on Day 31 post diagnosis (17 days after the second surgery) with a comfortable eye.Follow-up12 months later revealed a comfortable but only partially visual eye due to corneal scarring.
Conclusion:
Although the graft actually failed from the point of view of tissue integration, fascia lata appears to be a readily available, effective and affordable autografting material and we believe this technique has potential for short term physical and structural support of severe malacic or other complex corneal ulcers.
A Rare Case of an Adrenal Schwannoma
Authors: Madiha Ahmed, Taaha Mendha, Laura J Cui, Steve Carlan, Raymond J Leveille
Journal: Cureus (2023)
Keywords: adrenal disease, adrenal schwannoma, distal ureteral stone, retroperitoneal laparoscopy, retroperitoneal tumor
MeSH terms: Case Reports

Schwannomas are tumors of neoplastic Schwann cells generally found in peripheral nerves in the head, neck, and extremities. They do not demonstrate hormonal abnormalities, and initial symptoms are typically secondary to adjacent organ compression. These tumors are rarely found in the retroperitoneum. We present a rare finding of an adrenal schwannoma in a 75-year-old female who presented to the emergency department with right flank pain. Imaging incidentally demonstrated a 4.8 cm left adrenal mass. Ultimately, she underwent a left robotic adrenalectomy, and immunohistochemical testing confirmed the presence of an adrenal schwannoma. It is imperative to undergo adrenalectomy and immunohistochemical testing to confirm the diagnosis and rule out malignancy.
The critical role of histology in distinguishing sarcoidosis from common variable immunodeficiency disorder (CVID) in a patient with hypogammaglobulinemia
Authors: Rohan Ameratunga, Yeri Ahn, Dominic Tse, See-Tarn Woon, Jennifer Pereira, Sinead McCarthy, Hilary Blacklock
Journal: Allergy Asthma Clin Immunol (2019)
Keywords: cvid, diagnostic criteria, ivig, neurosarcoidosis, sarcoidosis
MeSH terms: Case Reports

Background:
Common variable immunodeficiency disorders (CVID) are a rare group of primary immune defects, where the underlying cause is unknown. Approximately 10-20% of patients with typical CVID have a granulomatous variant, which has closely overlapping features with sarcoidosis.
Case presentation:
Here we describe a young man who sequentially developed refractory Evans syndrome, cauda equina syndrome and most recently renal impairment. Following immunosuppression, he has made a recovery from all three life-threatening autoimmune disorders. As the patient was hypogammaglobulinemic for most of the time while on immunosuppression, vaccine challenges and other tests were not possible. Histological features were in keeping with sarcoidosis rather than the granulomatous variant of CVID. In the brief period when immunosuppression was lifted between the cauda equina syndrome and renal impairment, he normalised his immunoglobulins, confirming sarcoidosis rather than CVID was the underlying cause.
Conclusion:
We discuss diagnostic difficulties distinguishing the two conditions, and the value of histological features in our diagnostic criteria for CVID in identifying sarcoidosis, while the patient was hypogammaglobulinemic. The key message from this case report is that the characteristic histological features of CVID can be very helpful in making (or excluding) the diagnosis, particularly when other tests are not possible.
Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with small cell lung cancer and cytotoxic T-cell-mediated pathology: Case report
Authors: Haruna Akanuma, Takahiro Iizuka, Dan Abe, Kenji Yoshida, Nozomu Matsuda, Kotaro Sugimoto, Yuko Hashimoto, Kazuaki Kanai
Journal: Front Immunol (2022)
Keywords: anti-n-methyl-d-aspartate receptor antibodies, cytotoxic t-cells, paraneoplastic encephalitis, pathology, small cell lung cancer
MeSH terms: Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / etiology, Lung Neoplasms / complications, Small Cell Lung Carcinoma / complications, Case Reports, Autoantibodies, Humans, Receptors, N-Methyl-D-Aspartate, T-Lymphocytes, Cytotoxic, Autoantibodies, Receptors, N-Methyl-D-Aspartate

Anti-N-methyl-D-aspartate receptor (NMDAR) antibody encephalitis is caused by a reversible inhibition of ion channel actions by autoantibodies and is associated with a relatively good prognosis. Pathological findings of NMDAR encephalitis usually do not show neurophagorous nodules, but rare or mild inflammatory infiltration. We report a patient of small cell lung cancer (SCLC)-related paraneoplastic encephalitis with NMDAR antibodies, a cytotoxic T-cell-mediated pathology of the brain, and a rapid clinical course. This case highlights that the neuropathological diversity of NMDAR encephalitis may be even broader than previously thought and that NMDAR antibodies may also be found in various pathological conditions with a vigorous immune response.
Limited Renal Intravascular Lymphoma: A Case Report and Review of the Literature
Authors: Guillermo Enrique Quintero Vega, Daniel Osorio, José Antonio de la Hoz Valle, Daniela Rodríguez Feria
Journal: Case Rep Oncol Med (2020)
MeSH terms: Case Reports

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin lymphoma. It is characterized by the proliferation of cancerous cells into the intraluminal space of the blood vessels. It has a low incidence rate of 0.095 cases per 1,000,000. The clinical presentation is insidious and unspecific, often delaying the diagnosis. IVLBCL can be diagnosed through body images and histopathology analysis. This neoplasm averages a 60% response rate to current chemotherapy treatment, favoring rituximab, and doxorubicin-based regimen if it is diagnosed in time. Here, we present the case of a 56-year-old man admitted to our hospital with a fever who was eventually diagnosed with IVLBCL. He presented to the consultation with anemia, fever, and splenomegaly. An infection panel, a bone marrow biopsy, and a PET-CT scan were performed and ruled out the possibility of infections and neoplasms. The patient later developed edematous syndrome. As a result, a renal biopsy was performed which tested positive for intravascular large B-cell lymphoma. Currently, the patient has been in complete remission for 33 months. Along with presenting this specific case, we also reviewed previously published cases of IVLBCL to illustrate the renal involvement of this pathology.
Sialadenoma papilliferum: clinical misdiagnosis with a histological decree
Authors: A Anuradha, V V S Ram Prasad, Bina Kashyap, Vijay Srinivas
Journal: Case Rep Dent (2012)
MeSH terms: Case Reports

Sialadenoma papilliferum is a rare salivary gland tumor clinically resembling papilloma originating probably from the excretory duct. It is characterized by a biphasic growth pattern of exophytic squamous component and endophytic glandular component. We report a rare case of sialadenoma papilliferum in the floor of the mouth with epithelial dysplasia with pertinent review of literature. The present case highlights the importance of keeping sialadenoma papilliferum as a differential diagnosis of exophytic papilliferous oral lesions and the need to explore the etiology and malignant potential of the tumor.
Intraosseous meningioma mimicking osteosarcoma
Authors: Ruben Delgado, Hisham F Bahmad, Vinay Bhatia, Allen B Kantrowitz, Cristina Vincentelli
Journal: Autops Case Rep (2021)
Keywords: case reports, meningioma, osteosarcoma, skull
MeSH terms: Case Reports

Background:
Predominantly intraosseous meningiomas are rare entities that include true primary intraosseous meningiomas (PIM), as well as meningiomas that may show extensive bone involvement, such as en plaque meningiomas. Different hypotheses have been proposed to decipher the origin of PIMs, such as ectopic arachnoid cap cell entrapment during birth or after trauma. Surgical resection is the treatment of choice of such lesions.
Case presentation:
We present a case of a 65-year-old man with an enlarging mass in the parieto-occipital region that grew slowly and progressively over 13 years, following head trauma during a motor vehicle accident. One year prior to presentation, he started experiencing daily holocranial headaches and blurry vision. CT and MRI studies revealed a permeative midline calvarial lesion measuring 14 cm in greatest dimension with extensive periosteal reaction, extension into the subcutaneous soft tissues, subjacent dural thickening and intracranial extension with invasion of the superior sagittal sinus. The favored pre-operative clinical diagnosis was osteosarcoma. The abnormal calvarium was excised and histopathological examination confirmed the diagnosis of a predominantly intraosseous calvarial meningioma, WHO grade I.
Conclusions:
The present case highlights the importance of histopathologic diagnosis in guiding therapeutic decisions and reiterates the necessity of considering PIM or meningiomas with extensive intraosseous component in the differential diagnosis of calvarial masses, even when imaging suggests a neoplasm with aggressive behavior, such as osteosarcoma.
Case report: obstruction in the right ventricular outflow tract due to hemolymphangioma
Authors: Bo Chen, Ting Fan, Yong Cao, Lian Hu, Guanshui Yu
Journal: Front Cardiovasc Med (2023)
Keywords: cardiac mass, hemolymphangioma, primary cardiac tumor, right ventricular outflow tract, surgery
MeSH terms: Case Reports

Cardiac masses commonly involve primary tumors, metastatic diseases, and nonbacterial thrombotic and infective endocarditis. myxomas are the most common primary tumors, accounting for 75%. Hemolymphangiomas are a group of congenital vascular and lymphatic malformations that originate from the mesenchyme, with an incidence rate of 0.12%-0.28% per year. Hemolymphangiomas have been found in the rectum, small intestine, spleen, liver, chest wall, and mediastinum but have not yet been reported in the ventricular outflow tract in the heart. Herein, we report a case of a hemolymphangioma tumor in the right ventricular outflow tract (RVOT). The tumor was successfully resected, and the patient was followed up for 18 months and did not exhibit tumor recurrence.
Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation
Authors: Ashish Bains, Pedro Covas, Olga Timofeeva, Michael Bromberg
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

Hypercalcemia in malignancy is associated with multiple mechanisms and occurs in up to 20-30% of cancer patients. We report a case of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) associated with hypercalcemia and an elevation in parathyroid hormone-related peptide (PTHrP) in the setting of a Richter transformation. Real-time reverse transcriptase PCR on lymph node biopsy specimens obtained before and after transformation showed an 8-fold increase in PTHrP mRNA levels and about 2-fold decrease in the levels of its cognate receptor PTHR1. The findings of this case suggest that parathyroid hormone-related peptide might be useful in monitoring a specific group of patients with SLL/CLL who develop hypercalcemia during the course of their disease and could suggest an autocrine-like mechanism involving PTHrP in Richter transformation.
Intramural Bowel Hematoma Presenting as Small Bowel Obstruction in a Patient on Low-Molecular-Weight Heparin
Authors: Beatrix Hyemin Choi, Michael Koeckert, Sandra Tomita
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

There is increasing use of low-molecular-weight heparin (LMWH) for treatment of pediatric thromboembolic disease as it has been shown to be safe and effective. It has several advantages over unfractionated heparin, such as reduced need for monitoring, easier route of administration, decreased risk of heparin-induced thrombocytopenia, and lack of drug-drug interactions. Nevertheless, LMWH still poses a bleeding risk as with any anticoagulant therapy. We present the case of a 4-year-old boy who was placed on LMWH for a catheter-related deep venous thrombosis in the setting of intractable seizures and subsequently developed a small bowel obstruction secondary to a suspected intussusception. He underwent exploratory laparotomy and was found to have an intramural bowel hematoma. Prior to this bleed, the patient had been monitored daily, and his anti-Xa levels were found to be in the therapeutic range. This case highlights the need for a high index of suspicion for spontaneous bleeding even in the setting of therapeutic anti-Xa levels.
Multifocal early gastric cancer in a patient with atrophic gastritis and pernicious anemia
Authors: Tommaso Zurleni, Michele Altomare, Giovanni Serio, Filippo Catalano
Journal: Int J Surg Case Rep (2020)
Keywords: autoimmune metaplastic atrophic gastritis, multifocal early gastric cancer, pernicious anemia, subtotal gastrectomy
MeSH terms: Case Reports

Introduction:
Pernicious anemia (PA) caused by vitamin B12 deficiency is associated with Autoimmune Metaplastic Atrophic Gastritis (AMAG). Patients with AMAG have threefold risk of the development of gastric cancer.
Presentation of case:
We describe a case of a 66 year old man with a history of PA and atrophic antral-corpus gastritis. After endoscopic and chromoendoscopic evaluation the patient was treated with subtotal gastrectomy plus D2 lymphadenectomy. The tumor was diagnosed as Stage Ia; pT1a pN0 pM0 G2 with multiple foci of high grade dysplasia and intramucosal adenocarcinoma.
Discussion:
Multifocal Early Gastric Cancer can be a problem for minimally invasive treatment such as endoscopic excision. Surgical management where it is not possible Endoscopic Mucosal Resection or Submucosal Resection (EMR/ESD) should include D1 or more type of lymphadenectomy because of the risk of nodes metastases. The chromoendoscopic evaluation may be helpful in the preoperative work-up and during the follow-up period.
Conclusion:
Multidisciplinary approach is very important to reduce the under-treatment risk in multifocal early gastric cancer. Further studies will be needed to evaluate the safety of Subtotal vs Total Gastrectomy in this kind of disease.
Recurrent hydrothorax in a child on peritoneal dialysis: A case report and review of the literature
Authors: Khalid A Alhasan
Journal: Clin Case Rep (2018)
Keywords: end‐stage renal disease, hydrothorax, peritoneal dialysis, pleural effusion, pleuroperitoneal fistula
MeSH terms: Case Reports

Hydrothorax is a serious complication of peritoneal dialysis, and it may be resolved by deferring dialysis or decreasing dialysate volumes. Repeat thoracentesis is not well tolerated in children. Therefore, if conservative measures fail, thoracotomy or thoracoscopy with endoscopic repair of associated diaphragmatic eventration should be considered before reinstating peritoneal dialysis.
Dermoscopic features of eccrine porocarcinoma arising from hidroacanthoma simplex
Authors: Reiko Suzaki, Takeaki Shioda, Izumi Konohana, Sumiko Ishizaki, Mizuki Sawada, Masaru Tanaka
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

Eccrine porocarcinoma is a rare cutaneous neoplasm that mainly affects elderly people and grows slowly over a long period of time but often experiences an accelerated growth phase. Eccrine porocarcinoma may arise de novo or evolve from a pre-existing benign eccrine poroma. We reported a 86-year-old Japanese woman presenting with two reddish-colored pendulated lesions on a keratotic light brown plaque on the right thigh. Dermoscopic examination of the light-brown plaque demonstrated many whitish globular structures in a light-brown background. At the two reddish-colored pendulated lesions, polymorphous and prominent vessel proliferation was observed together with irregularly shaped whitish negative network. Immunohistochemical study demonstrated a positive CEA staining at ductal structures and atypical clear cells of reddish nodules. A diagnosis of eccrine porocarcinoma arising in a pigmented hidroacanthoma simplex was eventually established, and the dermoscopic features of eccrine porocarcinoma from hidroacanthoma simplex was described for the first time.