OpenMed/multicare-articles huggingface dataset:
Foreign body associated non-ST elevation myocardial infarction: a case report
Authors: Pooyan Dehghani, Mahdi Sajedi Khanian
Journal: J Cardiovasc Thorac Res (2017)
Keywords: broken guiding catheter tip, foreign body, non-st elevation myocardial infarction
MeSH terms: Case Reports

The incidence of guiding catheter tip fracture, is quite rare during percutaneous coronary interventions (PCI). Retained broken catheter tip in coronary artery and circulation can result in serious complications such as thrombosis, embolism, acute occlusion and myocardial infarction, arrhythmias and sepsis. It is mandatory to remove the fractured catheter as soon as possible to avoid these complications. Transcatheter removal is the treatment of choice. If percutaneous removal is failed, surgical intervention is advised.
Primary orbital ganglioneuroblastoma: A case report
Authors: Ruixin Ma, Yujiao Wang, Weimin He
Journal: Open Med (Wars) (2021)
Keywords: adrenal gland, orbit, primary ganglioneuroblastoma
MeSH terms: Case Reports

Background:
Ganglioneuroblastoma (GNB) is a neoplasm that arises from the primitive cells of the sympathetic nervous system during childhood. The current case is very unique because of the initial primary tumor manifestation in the orbit and an adrenal tumor being observed later during follow-up.
Case presentation:
A 2-year-old girl presented to the Ophthalmology Department of our hospital complaining of swelling of the left upper eyelid for approximately one month. Orbital computed tomography (CT) revealed a left orbital mass with bone destruction. Thoracic and abdominal CT indicated no abnormalities. The mass was surgically resected, and histopathological analysis confirmed it as GNB. During follow-up, abdominal CT detected an adrenal tumor with internal calcification, a calcified nodule on the left side of the abdominal aorta, and mesenteric lymph nodes. Accordingly, primary orbital GNB and metastatic adrenal GNB were the possible considerations. We removed the adrenal tumor, and the patient underwent chemotherapy. However, the patient died 18 months after the ophthalmic surgery.
Conclusion:
Primary orbital GNB in children is easily misdiagnosed because of its rare occurrence and atypical clinical findings. Imaging methods combined with histopathological examination contribute to the detection and diagnosis of primary and metastatic GNBs. Thus, timely surgery combined with adjuvant chemotherapy and long-term follow-up is essential for controlling the metastasis of GNB and improving the survival rate of patients.
Practical Considerations for the Management of Cushing's Disease and COVID-19: A Case Report
Authors: Federica Beretta, Francesca Dassie, Matteo Parolin, Federico Boscari, Mattia Barbot, Luca Busetto, Roberto Mioni, Eugenio De Carlo, Carla Scaroni, Francesco Fallo, Roberto Vettor, Pietro Maffei
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: cushing's disease, sars-cov-2, hypercortisolism, pituitary, rare diseases
MeSH terms: Betacoronavirus / drug effects, Coronavirus Infections / drug therapy, Cushing Syndrome / drug therapy, Hydrocortisone / therapeutic use, Metyrapone / therapeutic use, Pneumonia, Viral / drug therapy, Case Reports, Aged, Anti-Inflammatory Agents / therapeutic use, Antimetabolites / therapeutic use, Betacoronavirus / isolation & purification, COVID-19, Coronavirus Infections / complications, Coronavirus Infections / virology, Cushing Syndrome / complications, Cushing Syndrome / virology, Disease Management, Humans, Male, Pandemics, Pneumonia, Viral / complications, Pneumonia, Viral / virology, SARS-CoV-2, Anti-Inflammatory Agents, Antimetabolites, Hydrocortisone, Metyrapone

Introduction: Italy, since the end of February 2020, is experiencing the corona virus disease 2019 (COVID-19) pandemic that may present as an acute respiratory infection. We report on COVID-19 pneumonia in the context of a complex case of Cushing's disease (CD). Case Report: A 67-year-old man with CD, who was admitted to our hospital, presented with signs and symptoms of adrenal insufficiency with persistent hypotension and glycemia toward the lower limits. We progressively withdrew almost all treatments for diabetes and CD (pasireotide and metyrapone), and i.v. hydrocortisone was necessary. A tendency to hyperkalemia was probably associated to enoxaparin. We summarized the many possible interactions between medications of Cushing's syndrome (CS) and COVID-19. Conclusion: Adrenal insufficiency might be a clinical challenge that needs a prompt treatment also in CS patients during COVID-19 infection. We should consider the possibility to titrate or temporary halt medical therapies of CS in the context of COVID-19 infection. Unexpected hyperkalemia in CS patients under treatment with heparin might be the signal of aldosterone suppression.
Brain SPECT as an Imaging Biomarker for Evaluating Effects of Novel Treatments in Psychiatry-A Case Series
Authors: Steven R D Best, Natalie Haustrup, Dan G Pavel
Journal: Front Psychiatry (2022)
Keywords: ctk, hbot, spect, biomarker, brain, depression, psychiatry, treatment

The difficulties of evaluating patients with complex neuropsychiatric conditions and prescribing appropriate treatments are well known. Imaging complements clinical assessments and allows a clinician to narrow the differential diagnosis by facilitating accurate and efficient evaluation. This is particularly relevant to neuropsychiatric conditions that are often diagnosed using a trial-and error process of exclusion. Single Photon Emission Computed Tomography (SPECT) is a functional brain imaging procedure that allows practitioners to measure the functional changes of gray matter structures based on regional cerebral blood flow (rCBF). The accurate diagnosis and treatment selection in psychiatry is challenging due to complex cases and frequent comorbidities. However, such complex neuropsychiatric conditions are increasingly benefitting from new treatment approaches, in addition to established medications. Among these are combination transcranial magnetic stimulation with ketamine infusions (CTK), hyperbaric oxygen therapy (HBOT) and perispinal administration of etanercept (PSE). This article provides readers with six case study examples that demonstrate how brain SPECT imaging can be used, both as a diagnostic tool, and as a potential biomarker for monitoring and evaluating novel treatments for patients with complex neuropsychiatric conditions. Six patients were assessed in our clinic and baseline brain SPECT imagesTourettes and a long history of alcohol were visually compared with SPECT images collected after periods of treatment with CTK or HBOT followed by PSE. This retrospective review demonstrates the clinical utility of these novel treatments and describes how SPECT imaging can complement standard diagnostic assessments. A novel display technique for SPECT images is described and we argue that SPECT imaging can be used for monitoring biomarker for clinical change.
Non-postoperative Central Retinal Artery and Ophthalmic Artery Occlusion With Compression Ischemia Due to Prolonged Sedation In Prone Position
Authors: Sohiub N Assaf, Abdallah N Assaf, Muaz N Assaf, Joshua Pickett, John M Pierce
Journal: Cureus (2023)
Keywords: acute vision loss, blind, central retinal artery occlusion, hyperbaric oxygen therapy, intravenous drug use (ivdu), mri images, neuro-ophthalmology, prescription drugs, retinal injury, stroke
MeSH terms: Case Reports

Central retinal artery occlusion (CRAO) after a prolonged period of lying prone is a rare condition with only a handful of cases reported, generally as a postoperative complication of spinal surgery. Only a few cases can be found describing acute visual loss following intravenous drug abuse and stupor leading to continuous pressure on the orbit while asleep. No cases can be found describing acute visual loss following the ingestion of oral sedating/antipsychotic medications. Urgent identification and workup with subsequent interventions are needed to offer the highest probability of full/partial visual restoration. Our patient presented with complete vision loss after ingesting oral antipsychotic medications leading to a prolonged sedated state in which compressive ischemia led to central retinal artery occlusion. The complex timeline regarding the patient's presentation and the implications relating to offered interventions are highlighted in this case report.
Electro-acupuncture on Vascular Parkinsonism with multiple sleep disorders: A Case Report
Authors: Mingyue Yan, Jingqi Fan, Yingjia Li, Xin Liu, Zhengmiao Yu, Lixing Zhuang
Journal: Front Neurol (2022)
Keywords: electro-acupuncture, vascular parkinsonism, case report, polysomnography, sleep disorder
MeSH terms: Case Reports

Vascular Parkinsonism (VP) is a kind of rare secondary Parkinsonism caused by vascular lesions. Patients with VP experience not only movement disorders but also sleep disorders. But treatment options are limited and often associated with undesirable adverse effects. Electro-acupuncture (EA) is a safe, rapid work, easy operation, and convenient complementary replacement therapy. We report a case of a 51-year-old man who presented with VP and multiple sleep disorders. Based on clinical evaluation and nocturnal hospital-based polysomnography (PSG), the patient had severe PLMD (PSG showed severe periodic leg movements), excessive daytime sleepiness (EDS, the score of the ESS is 16), and probable rapid eye movement sleep disorder (RBD). Parkinson's disease sleep scale (PDSS) score, Pittsburgh sleep quality index (PSQI), and periodic leg movements index were 93, 11, and 135.2, respectively. After 8 weeks of EA treatment, the patient reported that the symptoms of subjective and objective sleep disturbance were significantly alleviated without any discomfort. This case report may provide a new alternative and complementary therapy for VP patients with sleep disturbance but more definitive and robust evidence is needed to support its efficacy.
How Is Global Warming Affecting Fruit Tree Blooming? "Flowering (Dormancy) Disorder" in Japanese Pear ( Pyrus pyrifolia) as a Case Study
Authors: Akiyoshi Tominaga, Akiko Ito, Toshihiko Sugiura, Hisayo Yamane
Journal: Front Plant Sci (2022)
Keywords: dam, chilling requirement, cold accumulation, dormancy, floral bud maturation, warm temperature
MeSH terms: Review

Recent climate change has resulted in warmer temperatures. Warmer temperatures from autumn to spring has negatively affected dormancy progression, cold (de)acclimation, and cold tolerance in various temperate fruit trees. In Japan, a physiological disorder known as flowering disorder, which is an erratic flowering and bud break disorder, has recently emerged as a serious problem in the production of the pome fruit tree, Japanese (Asian) pear (Pyrus pyrifolia Nakai). Due to global warming, the annual temperature in Japan has risen markedly since the 1990s. Surveys of flowering disorder in field-grown and greenhouse-grown Japanese pear trees over several years have indicated that flowering disorder occurs in warmer years and cultivation conditions, and the risk of flowering disorder occurrence is higher at lower latitudes than at higher latitudes. Susceptibility to flowering disorder is linked to changes in the transcript levels of putative dormancy/flowering regulators such as DORMANCY-ASSOCIATED MADS-box (DAM) and FLOWERING LOCUS T (FT). On the basis of published studies, we conclude that autumn-winter warm temperatures cause flowering disorder through affecting cold acclimation, dormancy progression, and floral bud maturation. Additionally, warm conditions also decrease carbohydrate accumulation in shoots, leading to reduced tree vigor. We propose that all these physiological and metabolic changes due to the lack of chilling during the dormancy phase interact to cause flowering disorder in the spring. We also propose that the process of chilling exposure rather than the total amount of chilling may be important for the precise control of dormancy progression and robust blooming, which in turn suggests the necessity of re-evaluation of the characteristics of cultivar-dependent chilling requirement trait. A full understanding of the molecular and metabolic regulatory mechanisms of both dormancy completion (floral bud maturation) and dormancy break (release from the repression of bud break) will help to clarify the physiological basis of dormancy-related physiological disorder and also provide useful strategies to mitigate or overcome it under global warming.
Sustained Control of Serpiginous Choroiditis with the Fluocinolone Acetonide 0.18 mg Intravitreal Implant
Authors: Yousuf Siddiqui, Olufemi E Adams, Michael A Simmons, Justin Yamanuha, Dara D Koozekanani
Journal: Case Rep Ophthalmol Med (2022)
MeSH terms: Case Reports

Purpose:
To describe an alternative treatment for a patient with serpiginous choroiditis (SC) who was not tolerant to systemic therapies.
Methods:
Case report of a patient with serpiginous choroiditis with their clinical course followed with ophthalmic examinations and multimodal imaging overtime. Patients and Results. A 57-year-old female with serpiginous choroiditis was treated for seven years with numerous therapies including systemic steroids, immunosuppressive agents, and repeated dexamethasone intravitreal implants. The patient was intolerant of systemic therapies and would flare if dexamethasone injections were performed less frequently than every 8 weeks, making a viable long-term treatment plan problematic. Following one injection of the fluocinolone acetonide 0.18 mg intravitreal implant, she has experienced sustained control for 20 months. Discussion and Conclusions. Real-world treatment of SC is complex as long-term control is necessary, and associated side effects of the therapies provided may limit sustained use. The fluocinolone acetonide implant lasts 36 months and may be an alternative long-term management option, especially in the setting of systemic medication intolerance for some patients with SC.
Infantile amoebiasis: a case report
Authors: Mohammad Zibaei, Farzaneh Firoozeh, Alireza Azargoon
Journal: Case Rep Infect Dis (2012)

Amoebiasis continues to be a major cause of morbidity and mortality in children in developing countries. Entamoeba histolytica infections are commonly observed in tropical and subtropical regions of the world including Iran. In developed countries Entamoeba histolytica infections are commonly seen in travelers, recent immigrants, homosexual men, and inmates of institutions. The disease is more severe in the two extremes of life. This paper paper describes a four-month-old male infant with Entamoeba histolytica presenting initially with refusal of feeds, hyperactive bowel sound, vomiting, and diarrhea. A fecal sample was positive for Entamoeba histolytica by Lugol's iodine solution and the concentration technique. He was successfully treated with metronidazole for 5 days. This case illustrates that Entamoeba species could be pathogenic in young infant; therefore, awareness of the infection, aggressive approach to diagnosis, and early initiation of treatment continue to be critical component of infection control.
Case Report: Novel Compound Heterozygotic Variants in PPP2R3C Gene Causing Syndromic 46, XY Gonadal Dysgenesis and Literature Review
Authors: Wei Zhang, Jiangfeng Mao, Xi Wang, Bang Sun, Zhiyuan Zhao, Xiaoxia Zhang, Min Nie, Xueyan Wu
Journal: Front Genet (2022)
Keywords: ppp2r3c mutations, compound heterozygous variants, disorders/differences of sex development(dsd), facial deformity, gonadal dysgenesis, syndromic 46 xy dsd
MeSH terms: Case Reports

Purpose: Patients with syndromic 46, XY disorders/differences of sex development (DSD) are characterized by gonadal and phenotypic genders inconsistent with their chromosomal sexes as well as abnormalities of multiple extragonadal organs. They are caused by mutations in specific genes, which are expressed in the affected organs and regulate their development, and over fourteen genes have been identified. In this study, we aimed to determine the underlying cause of a patient with syndromic 46, XY DSD and review the clinical presentations and genetic findings of all reported similar cases. Methods: Whole-exome sequencing (WES) was performed to find a molecular cause of the patient. In silico tools were used to analyze the pathogenicity of the variants. Reports of cases with similar clinical features and involved genes were summarized by searching through PubMed/MEDLINE using keywords "PPP2R3C" or "G5PR" and "46,XY disorders of sex development". Results: Compound heterozygous variants (p.F229del/p.G417E) in PPP2R3C were identified in the 24-year-old female by WES and verified by Sanger sequencing. The patient presents complete testicular dysgenesis, low birth weight, facial deformity, cubitus valgus, and decreasing number of CD19+ B lymphocytes and CD4+ T lymphocytes. A total of thirteen 46, XY DSD cases with four homozygous PPP2R3C mutations (p.Leu103Pro, p.Leu193Ser, p.Phe350Ser, and p.Ser216_Tyr218dup) have been reported previously, and their clinical manifestations are roughly similar to those of our patient. Conclusion: Novel compound heterozygous variants in PPP2R3C cause specific syndromic 46, XY gonadal dysgenesis, which broadened the pathogenic variants spectrum of PPP2R3C. The typical phenotype of PPP2R3C mutation is complete 46, XY gonadal dysgenesis with multiple extragonadal anomalies, including facial deformities, skeletal system abnormalities, muscle abnormalities, impaired nervous system, impaired hearing and vision, heart and kidney anomalies, and gastrointestinal dysfunction.
Case report: Submucosal cavernous lymphangioma causing jejuno-jejunal intussusception in an adult
Authors: Ning Zhao, Yuhang Fu, Zhongzheng Wang, Qi An, Wenzhuo Jia
Journal: Front Surg (2022)
Keywords: case report, cavernous lymphangioma, intussusception, jejunal tumor, small intestine
MeSH terms: Case Reports

Cavernous lymphangioma often occurs in the head, neck, trunk, and extremities of infants and children, and it is rare to cause a small intestine intussusception in adults. In this case, a 32-year-old woman presented with abdominal pain, vomiting, and a 5 cm × 5 cm abdominal mass on the left side of the abdomen. Laboratory tests showed anemia and CT showed small intestinal intussusception. After conservative treatments, her symptoms disappeared. However, 18F-FDG PET/CT suggested malignancy and her symptoms reappeared after eating something. Segmental jejunal resection was performed and pathology showed submucosal cavernous lymphangioma. At the 1-year follow-up, the patient was asymptomatic. Then this paper reviewed the literature on small intestinal cavernous lymphangioma in adults and found that this is the first English case report of intussusception caused by a jejunal submucosal cavernous lymphangioma in an adult. Current problem is that adult intussusception and intestinal lymphangioma are difficult to diagnose preoperatively. Imaging techniques such as tomography and PET/CT aid in the diagnosis of these benign lesions. Surgical resection was considered to be the required treatment and seems to have had no recurrence in adults according to the literature.
Rare Presentation of Primary Extramedullary Plasmacytoma as Lip Lesion
Authors: Mali Him, Maggie Meier, Vikas Mehta
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

Malignant plasma cell proliferation can be presented as part of disseminated disease of multiple myeloma, as solitary plasmacytoma of bone, or in soft tissue as extramedullary plasmacytoma. Extramedullary plasmacytomas represented approximately 3% of all plasma cell proliferation. Approximately 80% of extramedullary plasmacytomas occur in the head and neck region while the other 4% occur in the skin and to a lesser extent in the lip. In this paper, we report a rare case of primary cutaneous plasmacytoma involving the lip in a 65-year-old male. The patient presented with a nonhealing lower lip sore for the past 3 years. Upon further workup, there was no evidence of multiple myeloma or light chain disease. The patient was treated with radiation therapy and his last follow-up revealed no evidence of multiple myeloma or light chain disease.
Rehabilitation of Edentulous Jaws with Full-Arch Fixed Implant-Supported Prostheses: An Approach with Short and Ultrashort Implants and Metal-Free Materials
Authors: Riccardo Aiuto, Christian Barbieri, Daniele Garcovich, Mario Dioguardi, Mattia Redaelli, Luca De Micheli
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Introduction. Short implants represent a valid alternative to bone regeneration techniques. In addition, metal-free prosthetic materials have several advantages for predictable rehabilitation. This case report is aimed at illustrating the advantages of fixed implant-prosthetic rehabilitation on short and ultrashort implants and metal-free prosthetic materials. Case report. A 66-year-old male patient with bone atrophy was treated with temporary denture placement performed based on a rapid protocol. Once the tissues after extractions matured and aesthetic/function was studied, short implants were prosthetically placed, and a fiber-reinforced composite (FRC) bar was digitally designed for a double full-arch fixed rehabilitation. The 2-year follow-up showed the absence of peri-implantitis signs and a stable occlusal relationship of prostheses. Discussion and conclusions. The FRC material has excellent aesthetic properties and is low cost with a simplified and fast workflow owing to digital dentistry methods. Further studies are still needed to confirm the effectiveness of long-term therapy; however, the combination of new minimally invasive surgery and prosthetic advances seems to be very promising.
Composite t(14;18)-Negative Follicular Lymphoma and Nodular Lymphocyte-Predominant Hodgkin Lymphoma
Authors: John Patrick O'Neill, Fiona Quinn, Anita Dowling, Jan Walker, Triona Hayes, Brian Bird, Richard Flavin
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

A composite lymphoma is the rare simultaneous occurrence of two or more distinct lymphomas within a single tissue or organ. Herein, we describe a case of a 51-year-old man presenting with a history of lower limb rash, fatigue, and bulky abdominopelvic lymphadenopathy. An excisional left iliac lymph node biopsy was notable for the composite presence of two distinct lymphoid neoplasms, nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), and follicular lymphoma (FL). Multiplex PCR and FISH analyses failed to demonstrate a t(14;18)(q32;q21) translocation in either composite lymphoma component. A clonal light-chain kappa (V/JC intron-kde) gene rearrangement was detected in the FL component only.
Extensive Lateral Release and Medial Patellofemoral Ligament Reconstruction in 25 Years of Chronic Fixed Lateral Patellar Dislocation: A 5-Year Follow-Up Case Report
Authors: Andri M T Lubis, Petrus Aprianto, Yudistira P Siregar
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Lateral dislocation of the patella is not uncommon and may impede daily activities as this causes compressive dysfunction and instabilities. Most cases of patellar lateral dislocation are due to damage to the medial patellofemoral ligament (MPFL), either rupture of detachment of the patella or femoral attachment. MPFL reconstruction alone was considered adequate for the treatment of this condition. We present a case of a 49-year-old male with chronic posttraumatic lateral patellar dislocation of the right knee of 25 years, which we treated with extensive lateral release and right medial patellofemoral ligament reconstruction with 5-year follow-up data.
Upper airway obstruction following radiofrequency-assisted liposuction of the neck and lower face: a case report
Authors: Michèle Chemali, Wassim Raffoul
Journal: Case Reports Plast Surg Hand Surg (2022)
Keywords: airway, liposuction, radiofrequency
MeSH terms: Case Reports

Radiofrequency-assisted liposuction (RFAL) recently gained popularity for non-excisional skin tightening. It involves the delivery of a controlled amount of energy resulting in fat liquefaction and skin contraction. It is regarded as safe and effective. We report the case of upper airway obstruction following RFAL of the neck and lower face.