OpenMed/multicare-articles huggingface dataset:
Acute flaccid paralysis and West Nile virus infection
Authors: James J Sejvar, A Arturo Leis, Dobrivoje S Stokic, Jay A Van Gerpen, Anthony A Marfin, Risa Webb, Maryam B Haddad, Bruce C Tierney, Sally A Slavinski, Jo Lynn Polk, Victor Dostrow, Michael Winkelmann, Lyle R Petersen
Journal: Emerg Infect Dis (2003)
MeSH terms: Quadriplegia / complications, West Nile Fever / complications, Case Reports, Adult, Aged, Female, Humans, Male, Middle Aged, Quadriplegia / virology, Spinal Cord Diseases / complications, Spinal Cord Diseases / virology, West Nile Fever / diagnosis, West Nile virus / isolation & purification

Acute weakness associated with West Nile virus (WNV) infection has previously been attributed to a peripheral demyelinating process (Guillain-Barré syndrome); however, the exact etiology of this acute flaccid paralysis has not been systematically assessed. To thoroughly describe the clinical, laboratory, and electrodiagnostic features of this paralysis syndrome, we evaluated acute flaccid paralysis that developed in seven patients in the setting of acute WNV infection, consecutively identified in four hospitals in St. Tammany Parish and New Orleans, Louisiana, and Jackson, Mississippi. All patients had acute onset of asymmetric weakness and areflexia but no sensory abnormalities. Clinical and electrodiagnostic data suggested the involvement of spinal anterior horn cells, resulting in a poliomyelitis-like syndrome. In areas in which transmission is occurring, WNV infection should be considered in patients with acute flaccid paralysis. Recognition that such weakness may be of spinal origin may prevent inappropriate treatment and diagnostic testing.
Mature teratoma of the anterior mediastinum revealed by supravalvular pulmonary stenosis: a case report
Authors: Hafedh Daly, Amira Horchani
Journal: Pan Afr Med J (2022)
Keywords: teratoma, case report, mature, mediastinum, supravalvular pulmonary stenosis
MeSH terms: Mediastinal Neoplasms / diagnosis, Mediastinal Neoplasms / pathology, Mediastinal Neoplasms / surgery, Pulmonary Valve Stenosis, Teratoma / diagnosis, Teratoma / pathology, Teratoma / surgery, Case Reports, Adult, Humans, Mediastinum / pathology, Pulmonary Artery / pathology

The mature teratoma of the mediastinum is a benign tumour made up of several adult-type tissue components which result from the abnormal development of two or three embryonic layers (ectoderm, endoderm or mesoderm). We report the case of a 31-year-old patient, admitted for management of a mediastinal tumour, revealed by a pulmonary supravalvular stenosis, symptomatic of exertional dyspnea and mid-thoracic pain. The clinical examination objectified a respiratory rate at 18 c/min and an oxygen saturation at 96% in ambient air. The chest X-ray showed a mediastinal enlargement with a left paracardiac opacity, while the echocardiac showed a supravalvular pulmonary stenosis, hence the realization of a thoracic computed tomography (CT), which objectified a voluminous anterior mediastinal cystic formation and superior lateralized on the left, with an effect of compression on the trunk of the pulmonary artery. The median sternotomy allowed the complete exeresis of this tumor and the postoperative course was simple. The mature teratoma of the anterior mediastinum should be suspected in view of these clinical and radiological signs in a young patient. Surgery with a complete resection remains the treatment of choice.
Novel use of riociguat in infants with severe pulmonary arterial hypertension unable to wean from inhaled nitric oxide
Authors: L T Domingo, D D Ivy, S H Abman, A M Grenolds, J T MacLean, J A Breaux, K J Minford, B S Frank
Journal: Front Pediatr (2022)
Keywords: slc25a26 mutation, tbx4 mutation, pediatric pulmonary arterial hypertension, pulmonary vasodilator, pulmonary vasoreactivity, riociguat, targeted therapy
MeSH terms: Case Reports

Introduction:
Riociguat, an oral soluble guanylate cyclase stimulator, has been approved for use in adults with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension. However, there is limited data on its therapeutic use in children.
Case presentation:
We report the case of two infants with severe suprasystemic pulmonary hypertension who were successfully treated with riociguat after failure to wean off inhaled nitric oxide (iNO) despite combination PAH therapy. Case 1 is a 6-month-old term male with TBX4 deletion who presented with severe hypoxemic respiratory failure and severe PAH immediately after birth. Initial cardiac catheterization showed PVRi 15.5 WU*m2. Marked hypoxemia and PAH persisted despite aggressive therapy with sildenafil, bosentan, intravenous treprostinil, and milrinone. The infant required high doses of inhaled nitric oxide (60 ppm) and manifested significant post-ductal hypoxemia and hemodynamic instability with any attempt at weaning. After discontinuation of sildenafil, initiation, and very slow uptitration of riociguat, the patient was able to maintain hemodynamic stability and wean from nitric oxide over 6 weeks with persistently severe but not worsened pulmonary hypertension. Case 2 is a 4-month-old term male with compound heterozygous SLC25A26 mutation and severe pulmonary hypertension. Initial cardiac catheterization showed PVRi 28.2 WU*m2. After uptitration of sildenafil, bosentan, and IV treprostinil, serial echocardiograms continued to demonstrate near-systemic pulmonary hypertension. He failed multiple attempts to wean off typical doses of iNO (10-20 ppm) over the following weeks with tachypnea, hypoxemia, and worsening pulmonary hypertension on echocardiogram despite continued aggressive combination targeted therapy. After a 24-h sildenafil washout, he was initiated and uptitrated on riociguat with concomitant, successful wean of nitric oxide over one week that was well tolerated. No serious adverse effects in the titration period were observed.
Conclusion:
Riociguat may be considered as an adjuvant therapeutic agent in selected children with severe PAH who are poorly responsive to sildenafil therapy and unable to wean from iNO.
Biliary Obstruction due to a Pancreatic Plasmacytoma
Authors: Min Ho Cho, Rohan Mandaliya, Jennifer Tran, Wen Lee, Mitesh Patel
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Obstructive jaundice, weight loss, and anorexia often raise a concern for pancreatic malignancy. Although pancreatic adenocarcinoma is the most common form of pancreatic cancer, not all pancreatic malignancies are exocrine in origin. With advancement in endoscopic ultrasound with fine needle aspiration, it has become easier to make correct diagnosis. Plasmacytoma of pancreas is a solitary tumor of plasma cells and it can also lead to the same clinical presentations. Immunohistochemistry is required to make the diagnosis of plasmacytoma. However, when there are other systemic manifestations, such as hypercalcemia, renal injury, and anemia, a diagnosis of multiple myeloma should be suspected and confirmed by cytology or biopsy. It is very important to differentiate plasmacytoma from multiple myeloma as the management for each is different. Herein, we describe a case of multiple myeloma presenting as a pancreatic plasmacytoma causing obstructive jaundice.
Metastatic Spinal Cord Compression Secondary to Liver Cancer
Authors: Daniel Gams Massi, Japhari Nyassinde, Ngor Side Diagne, Ramy Abdennaji, Kamadore Toure, Moustapha Ndiaye, Amadou Gallo Diop, Mouhamadou Mansour Ndiaye
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Metastatic spinal cord compression (MSCC) is a medical emergency that requires rapid diagnosis and treatment to reduce pain, to preserve neurological functioning, and to prolong survival. The diagnosis of liver cancer is often neglected in the differential diagnosis of MSCC. Treatment is usually palliative and evolution is often fatal. This is a case report of a 28-year-old patient living in Mauritania hospitalized in November 2014 at the neurology department of Fann national teaching hospital in Dakar, for the management of a chronic dorsal spinal cord compression. The radiological and laboratory investigations done revealed the metastatic compression originating from a liver cancer with elevated alpha-fetoprotein and aspartate transaminase, positive hepatitis B surface antigen, and multiple metastasis in the lungs, mediastinum, ribs, iliac, and peritoneum. The hip joint X-ray showed a spontaneous fracture of the right femoral neck. The multidisciplinary treatment was palliative and the evolution was fatal within the month of hospitalization. Earlier diagnosis and treatment of MSCC may not have saved the life of the patient but may have prevented much suffering and would likely have prolonged the life of a young man.
Effect of anlotinib combined with ticeorgio for recurrent nasopharyngeal carcinoma: a case report
Authors: Jiwei Mao, Wanli Ye, Dongping Wu, Jianjiang Liu, Ting Li, Weili Ma, Yang Zhou
Journal: Front Pharmacol (2023)
Keywords: s-1, anlotinib, combined therapy, recurrent nasopharyngeal carcinoma, side effects of re-radiotherapy, ticeorgio
MeSH terms: Case Reports

For patients with locally unresectable recurrent nasopharyngeal carcinoma who relapsed after 2 years of radiotherapy, re-radiotherapy is also the preferred treatment. However, for patients relapsed within 2 years, the use of re-radiotherapy would be greatly limited by its adverse effects. Consequently, finding a new strategy to prolong the time of re-radiotherapy for locally recurrent nasopharyngeal carcinoma is very necessary to reduce the related side effects and improve the curative effect. Anlotinib is an orally available small molecule multi-target tyrosine kinase inhibitor that primarily inhibits VEGFR2/3, FGFR1-4, PDGFR α/β, c-Kit, and Ret. However, whether recurrent nasopharyngeal carcinoma patients can be treated with anlotinib combined with ticeorgio (also called S-1) remains unknown. Herein, we report a nasopharyngeal carcinoma patient with local recurrence after radical radiotherapy who benefited from combination treatment of anlotinib with ticeorgio.
Pneumonectomy in a Child with Multilobar Pneumatocele Secondary to Necrotizing Pneumonia: Case Report and Review of the Literature
Authors: Christopher A Gerdung, B Catherine Ross, Bryan J Dicken, Candice L Bjornson
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Background:
Community-acquired pneumonia (CAP) is common within pediatrics and contributes disproportionately to morbidity and mortality. Necrotizing pneumonia is a well-documented complication of CAP. It is thought to be caused by necrosis and liquefaction of consolidated lung and can result in damage to lung parenchyma, including pneumatocele development. Management of necrotizing pneumonia with pneumatocele may include hospitalization, intensive care unit admission, and lengthy antibiotic courses. Severe cases may need invasive procedures.
Case presentation:
We present a case of severe necrotizing pneumonia requiring prolonged venovenous extracorporeal membrane oxygenation (V-V ECMO) with development of persistent pneumatoceles, requiring pneumonectomy while on ECMO support to allow for decannulation and extubation.
Conclusions:
In critically ill patients with extensive unilateral necrotizing pneumonia with pneumatocele development, surgical intervention can be considered when attempts to wean ventilation have been unsuccessful. This case provides evidence that V-V ECMO and pneumonectomy is a viable salvage therapy in the most critically unwell children.
The Efficacy and Safety of Lenalidomide plus Rituximab in an Orbital Relapse of Diffuse Large B-Cell Lymphoma
Authors: R Palmieri, F Esposito, F Meconi, V M Rapisarda, L Anemona, G Paterno, S Vaccarini, D Nasso, L Pupo, M Cantonetti
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

A 74-year-old male with diffuse large B-cell lymphoma, with an Ann Arbor stage IV-A, was submitted to immune-chemotherapy in 2014, with complete remission of the disease. Two years later, he presented with a left eye swelling leading to exophthalmos and blurred vision. A core biopsy was performed and revealed a local relapse of the disease. He was considered unfit for intensive salvage chemotherapy and was treated with a combination of rituximab and lenalidomide. After six courses of rituximab plus lenalidomide, the patient showed complete remission and was submitted to maintenance therapy with lenalidomide. After 24 months since the start of lenalidomide monotherapy, we did not observe any progression. In this experience, rituximab plus lenalidomide, without radiotherapy, was a safe and effective therapeutic combination in an elderly patient with a localized relapse of DLBCL who was unfit to receive more aggressive therapies.
The crime scene reconstruction of the shrapnel effect on human body by two hand grenades detonated in a room: a case approach
Authors: Ercan Seyhan, Salih Cengiz
Journal: Egypt J Forensic Sci (2017)
Keywords: blast, detonation parameters, fragmentation, peak pressure

Background:
The case relates to a bookstore owner claiming that two DM-41 hand grenades were exploded simultaneously in his store. There were three males together at the store when the explosion occurred. One was the owner who claimed that he escaped after the explosion without any harm; the other was at the corner lying down to prevent his body from the explosion effect. He survived with very minor, almost no effects.
Case presentation:
According to the hospital report, it was stated that "cuts on the right femur with sizes of 0.5x2 and 0.5x1 cm and one cut of 0.5x2,0 cm on the left food which are curable with simple medical intervention; generalized skin erosions on body with the sizes between 0,5 to 1,0 cm"; the third male was standing and killed. He was next to the lying down male. At the autopsy report it was stated that the he was killed due to the shrapnel/fragmentation effect, breaks on humerus, radius, femur and cranium; cerebral and internal hemorrhage. The males witnessed at the court that they had survived with no vital damage on their bodies, they had seen the perpetrators and heard them talking. With the fact that the deceased male was intensively affected with the fragmentation/shrapnel due to the autopsy report, it was the court's wonder if it is possible for the survived men to have no or very minor nonfatal fragmentation effect on their bodies even being in the same room with the deceased.
Conclusion:
It was mainly aimed to test the fragmentation effect of 2 DM-41 defence hand grenades when detonated in a closed environment (an empty room with the approximately same size of the related case). The test room was empty with no secondary fragmentation sources as window glasses etc. 3 male mannequins were used as test materials. With the post blast reconstruction of the crime scene, it was aimed to determine if the test results and the autopsy report are very coherent and the persons having the direct blast effect would be expected having maximum exposure to the fragmentation.
Isolated cardiac metastasis from colorectal cancer in a 35-year-old man
Authors: Jacopo Pizzicannella, Vincenzo Ricci, Riccardo Gorla, Elena Spinapolice, Antonio Esposito
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

We present the case of a 35-year-old patient who was found to be affected by an isolated clinically silent cardiac metastasis despite a negative CT follow-up at one year from abdominal surgery for colorectal cancer. CT/PET and tumor marker GICA were fundamental in suggesting the diagnosis, which was then confirmed by cardiac magnetic resonance and surgical biopsy. This is a very rare modality of presentation of cardiac metastasis because of the young age of our patient and the absence of disease in other sites.
Nonsurgical endodontic management of dens invaginatus: a report of two cases
Authors: Amjad Abu Hasna, Daniela Maria de Toledo Ungaro, Allana Agnes Pereira de Melo, Karen Cristina Kazue Yui, Eduardo Galera da Silva, Frederico Canato Martinho, Ana Paula Martins Gomes
Journal: F1000Res (2019)
Keywords: dens invaginatus, follow-up, root canal treatment
MeSH terms: Dens in Dente / therapy, Tooth Apex, Case Reports, Child, Female, Humans, Male, Root Canal Therapy

Dens invaginatus is a malformation affecting mainly the superior lateral incisors. It is defined as an infolding of the crown hard tissues, including the enamel and dentin, and can extend up to the root apex. Root canal treatment of this abnormality is considered difficult due to the complex anatomy presented by these teeth. This case series presents nonsurgical endodontic treatment in two cases of dens invaginatus (type II and III) in maxillary lateral incisors. This nonsurgical or conventional endodontic treatment results in healing of the periapical lesions associated with both cases, with no need for extra intervention e.g. surgical or invasive management. The manual instrumentation associated with sodium hypochlorite and calcium hydroxide were able to completely heal the lesions. Radiographic exams were carried out to control and asses the healing. Nonsurgical treatment was successful in both cases with adequate repair after a 6-year follow-up with radiographic and tomographic assessments.
Multiple MYO18A- PDGFRB fusion transcripts in a myeloproliferative neoplasm patient with t(5;17)(q32;q11)
Authors: Guangying Sheng, Zhao Zeng, Jinlan Pan, Linbing Kou, Qinrong Wang, Hong Yao, Lijun Wen, Liang Ma, Depei Wu, Huiying Qiu, Suning Chen
Journal: Mol Cytogenet (2017)
Keywords: imatinib, mpns, myo18a, pdgfrb rearrangement
MeSH terms: Case Reports

Background:
Myeloproliferative neoplasms (MPNs), typically defined by myeloid proliferation and eosinophilia, and are only rarely caused by platelet-derived growth factor receptor beta (PDGFRB) gene rearrangements.
Case presentation:
Here, we report a unique case of MPN that is negative for eosinophilia and characterized by a novel PDGFRB rearrangement. After cytogenetic analysis revealed a karyotype of t(5;17) (q32;q11), we used fluorescence in situ hybridization to specifically identify the PDGFRB gene at 5q31-q33 as the gene that had been translocated. Subsequently, RNA sequencing identified a new MYO18A-PDGFRB gene fusion. This fusion presented a previously undescribed breakpoint composed of exon 37 of MYO18A and exon 13 of PDGFRB. Furthermore, both RT-PCR and Bi-directional Sanger sequencing confirmed this out-of-frame fusion. Interestingly, we simultaneously identified the presence of another three PDGFRB transcripts, all of which were in-frame fusions. After treating the patient with imatinib, the t(5;17) translocation was no longer detected by conventional cytogenetics or by FISH, and at the time of the last follow-up, the patient had been in complete remission for 26 months.
Conclusion:
We prove that MYO18A-PDGFRB fusions are recurrent genetic aberrations involved in MPNs, and identify multiple fusion transcripts with novel breakpoints.
Etoricoxib as a treatment of choice for patients with SLCO2A1 mutation exhibiting autosomal recessive primary hypertrophic osteoarthropathy: A case report
Authors: Areej Albawa'neh, Mariam Ghareeb Al Mansoori, Sehriban Diab, Fatma Al Jasmi, Nadia Akawi
Journal: Front Genet (2022)
Keywords: pge2, slco2a1 gene, autosomal recessive primary hypertrophic osteoarthropathy, digital clubbing, etoricoxib
MeSH terms: Case Reports

We reported a 22-year-old Emirati male with autosomal recessive primary hypertrophic osteoarthropathy caused by a possibly pathogenic homozygous non-synonymous variant in the SLCO2A1 gene (NM_005630.3: c.289C>T, p. Arg97Cys) presenting with joint swelling, forehead furrowing, and significant clubbing in all fingers and toes. Currently, no standard treatments are approved for this disease; medical care is palliative and includes non-steroidal anti-inflammatory drugs, corticosteroids, tamoxifen, retinoids, and risedronate. Colchicine may be helpful for the pain due to subperiosteal new bone formation. Our patient was treated with etoricoxib 60 mg once daily and showed a significant clinical improvement at the 6-month mark that was reversed upon the withdrawal of this medication. This case report highlights the importance of placing etoricoxib among first-line therapy recommendations for cases with confirmed primary hypertrophic osteoarthropathy diagnosis. To the best of our knowledge, this is the only case of primary hypertrophic osteoarthropathy from the Middle Eastern population of Arab ethnicity that has responded to non-steroidal anti-inflammatory drug therapy.
Complete cervical agenesis: successful surgical treatment: one case report
Authors: Soumaya Kraiem, Olfa Zoukar, Asma Hnayin, Ahmed Zouari, Raja Faleh, Anis Haddad
Journal: Pan Afr Med J (2020)
Keywords: amenorrhea, congenital cervical agenesis, reconstructive surgical procedure
MeSH terms: Anastomosis, Surgical / methods, Cervix Uteri / surgery, Plastic Surgery Procedures / methods, Case Reports, Adolescent, Cervix Uteri / abnormalities, Female, Humans, Uterus / surgery, Vagina / surgery

Cervical agenesis is a rare congenital pathology linked to an abnormality in the development of the Mullerian system, the mechanism of this anomaly is unknown. We reported a case of complete cervical agenesis in a 17-year-old girl who underwent a successfully utero-vaginal anastomosis.
An unusual case of childhood osteoarticular tuberculosis from the Árpádian Age cemetery of Győrszentiván-Révhegyi tag (Győr-Moson-Sopron county, Hungary)
Authors: Olga Spekker, Luca Kis, Andrea Deák, Eszter Makai, György Pálfi, Orsolya Anna Váradi, Erika Molnár
Journal: PLoS One (2021)
MeSH terms: Tuberculosis, Osteoarticular / pathology, Historical Article, Research Support, Non-U.S. Gov't, Archaeology, Cemeteries, Child, History, Medieval, Humans, Hungary, Male, Spine / pathology, Tuberculosis, Osteoarticular / history

Ancient human remains exhibiting bony changes consistent with osteoarticular tuberculosis (OATB) indicate that the disease has afflicted mankind for millennia. Nonetheless, not many pediatric OATB cases have been published in the paleopathological literature-from Hungary, only three cases have been described up to now. In our paper, we demonstrate a child (S0603) from the Árpádian Age cemetery of Győrszentiván-Révhegyi tag (northwestern Hungary), who represents a unique case of OATB regarding both the pattern and severity of the observed bony changes. During the macromorphological and radiological investigations, the most serious alterations were discovered in the upper thoracic spine-the development of osteolytic lesions led to severe bone loss and consequent collapse and fusion of several adjacent vertebrae. The pathological process terminated in a sharp, rigid angular kyphosis. Disruption of the normal spine curvature resulted in consequent deformation of the whole thoracic wall-it became "rugby-ball-shaped". The overall nature and pattern of the detected alterations, as well as their resemblance to those of described in previously published archaeological and modern cases from the pre-antibiotic era indicate that they are most consistent with OATB. Based on the severity and extent of the lesions, as well as on the evidence of secondary healing, S0603 suffered from TB for a long time prior to death. Besides body deformation, OATB resulted in consequent disability in daily activities, which would have required regular and significant care from others to survive. It implies that in the Árpádian Age community of Győrszentiván-Révhegyi tag, there was a willingness to care for people in need. Detailed archaeological case studies can give us a unique insight into the natural history and different presentations of OATB. Furthermore, they can provide paleopathologists with a stronger basis for diagnosing TB and consequently, with a more sensitive means of assessing TB frequency in past populations.