OpenMed/multicare-articles huggingface dataset:
Myeloid Sarcoma after Allogenic Stem Cell Transplantation for Acute Myeloid Leukemia: Successful Consolidation Treatment Approaches in Two Patients
Authors: Silje Johansen, Hilde Kollsete Gjelberg, Aymen Bushra Ahmed, Øystein Bruserud, Håkon Reikvam
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Myeloid sarcoma is an extramedullary (EM) manifestation (i.e., manifestation outside the bone marrow) of acute myeloid leukemia (AML); it is assumed to be relatively uncommon and can be the only manifestation of leukemia relapse after allogenic stem cell transplantation (allo-SCT). An EM sarcoma can manifest in any part of the body, although preferentially manifesting in immunological sanctuary sites as a single or multiple tumors. The development of myeloid sarcoma after allo-SCT is associated with certain cytogenetic abnormalities, developing of graft versus host disease (GVHD), and treatment with donor lymphocytes infusion (DLI). It is believed that posttransplant myeloid sarcomas develop because the EM sites evade immune surveillance. We present two patients with EM myeloid sarcoma in the breast and epipharynx, respectively, as the only manifestation of leukemia relapse. Both patients were treated with a combination of local and systemic therapy, with successfully longtime disease-free survival. Based on these two case reports, we give an updated review of the literature and discuss the pathogenesis, diagnosis, and treatment of EM sarcoma as the only manifestation of AML relapse after allo-SCT. There are no standard guidelines for the treatment of myeloid sarcomas in allotransplant recipients. In our opinion, the treatment of these patients needs to be individualized and should include local treatment (i.e., radiotherapy) combined with systemic therapy (i.e., chemotherapy, immunotherapy, DLI, or retransplantation). The treatment has to consider both the need for sufficient antileukemic efficiency versus the risk of severe complications due to cumulative toxicity.
Bilateral Anterior Capsulotomy for the Treatment of Refractory Somatic Symptom Disorder: A Case Report
Authors: Weibin He, Lingmin Shao, Huiling Wang, Huan Huang, Shudi Zhang, Chenhui Li, Chencheng Zhang, Wei Yi
Journal: Front Integr Neurosci (2022)
Keywords: hama, hamd, phq15, anterior capsulotomy, anxiety, depression, somatic symptom disorder
MeSH terms: Case Reports

Somatic symptom disorder (SSD) is a form of mental illness that causes one or more distressing somatic symptoms leading to a significant disruption to everyday life, characterized by excessive thoughts, feelings, or behaviors related to these symptoms. While SSD is characterized by significant discomfort in some parts of the body, these symptoms are not related to any known medical condition and therefore it cannot be diagnosed using any medical instrument examination. Currently available treatments for SSD, including drug therapy and psychotherapy (such as cognitive behavioral therapy), usually improve psychiatric symptoms, but the results are often disappointing. Furthermore, SSD is often comorbid with anxiety and depression (75.1 and 65.7%, respectively). Importantly, interventions targeting the anterior limb of the internal capsule (ALIC; e.g., deep brain stimulation and thermal ablation) can effectively treat various mental disorders, such as refractory obsessive-compulsive disorder, depression, and eating disorders, suggesting that it may also be effective for treating the depressive symptoms associated with SSD comorbidity. In this report, a 65-year-old woman diagnosed with SSD accompanied with depression and anxiety underwent bilateral anterior capsulotomy. The patient complained of nausea and vomiting, swelling of the hilum of the liver for 14 years, weakness of the limbs for 13 years, and burning pain in the esophagus for 1 year. Psychiatric and neuropsychological assessments were conducted to record the severity of the patients' symptoms and the progression of postoperative symptoms. The patient's somatization, depression, and anxiety symptoms as well as quality of life improved significantly and steadily; thus, anti-depressive and anti-anxiety medication were stopped. However, the patient developed new somatization symptoms, including dizziness, headache, and sternal pain, 10 months after the operation. Therefore, the patient resumed taking flupentixol and melitracen in order to control the new symptoms. This study shows that bilateral anterior capsulotomy appears to be a complementary treatment for refractory SSD with depressive and anxiety symptoms. Furthermore, postoperative use of anxiolytic and antidepressant medications may be useful for controlling future somatization symptoms.
Transanal Mesenteric Resection in Hirschsprung's Disease Using ICG under Concept of NOTES Technique
Authors: Mitsuru Muto, Shun Onishi, Masakazu Murakami, Keisuke Yano, Toshio Harumatsu, Satoshi Ieiri
Journal: European J Pediatr Surg Rep (2022)
Keywords: hirschsprung's disease, notes, indocyanine green, laparoscopic-assisted transanal endorectal pull-through, mesenteric processing
MeSH terms: Case Reports

Laparoscopic surgery has been applied for Hirschsprung's disease (HD). We herein report our approach to mesenteric processing for laparoscopic-assisted transanal endorectal pull-through (L-TERPT). Following mucosectomy and entering the abdominal cavity, a vessel sealing system is transanally inserted into the abdominal cavity for mesenteric processing based on concept of Natural Orifice Translumenal Endoscopic Surgery. Since the transanal axis is parallel to the dissected mesentery, it makes easier to operate in comparison to when the procedure is performed through the abdominal working port and can reduce the additional abdominal trocar wound. We also use indocyanine green (ICG) fluorescence navigation. Fluorescing the vessels with ICG allows intraoperative visualization of the blood flow in the retrieved intestine. With these innovative combined techniques, L-TERPT for HD can be safely performed, even in infants with small intraabdominal cavities.
Novel FANCA mutation in the first fully-diagnosed patient with Fanconi anemia in Polish population - case report
Authors: Anna Repczynska, Agata Pastorczak, Katarzyna Babol-Pokora, Jolanta Skalska-Sadowska, Malgorzata Drozniewska, Wojciech Mlynarski, Olga Haus
Journal: Mol Cytogenet (2020)
Keywords: chromosomal fragility, fanc genes, fanconi anemia, pancytopenia
MeSH terms: Case Reports

Background:
Fanconi anemia is a rare genetic disorder caused by mutations in genes which protein products are involved in replication, cell cycle control and DNA repair. It is characterized by congenital malformations, bone marrow failure, and high risk of cancer. The diagnosis is based on morphological and hematological abnormalities such as pancytopenia, macrocytic anaemia and progressive bone marrow failure. Genetic examination, often very complex, includes chromosomal breakage testing and mutational analysis.
Case presentation:
We present a child with clinical diagnosis of Fanconi anemia. Although morphological abnormalities of skin and bones were present from birth, diagnosis was only suspected at the age of 8. Chromosome breakage test in patient's lymphocytes showed increased level of aberrations (gaps, chromatid breaks, chromosome breaks, radial figures and rearrangements) compared to control. Next generation sequencing revealed presence of two pathogenic variants in FANCA gene, one of which was not previously reported.
Conclusions:
The article provides additional supportive evidence that compound biallelic mutations of FANCA are associated with Fanconi anemia. It also illustrates the utility of combination of cytogenetic and molecular tests, together with detailed clinical evaluation in providing accurate diagnosis of Fanconi anemia. This report, to the best of our knowledge, describes the first fully diagnosed FA patient in Polish population.
Resistant Hypertension From Renal Artery Stenosis Leading to Heart Failure With Preserved Ejection Fraction
Authors: Motasem Alyamani, Jissy Thomas, Miriam Shanks, Gavin Y Oudit
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: heart failure with preserved ejection fraction, renal artery revascularization, renal artery stenosis, resistant hypertension
MeSH terms: Heart Failure / etiology, Hypertension / etiology, Renal Artery / pathology, Renal Artery Obstruction / complications, Case Reports, Research Support, Non-U.S. Gov't, Bundle-Branch Block, Constriction, Pathologic, Echocardiography, Female, Heart Failure / physiopathology, Humans, Middle Aged, Pulmonary Edema / etiology, Stroke Volume, Ventricular Dysfunction, Left

Resistant hypertension remains an important cause of heart failure. In this article, we describe a case of resistant hypertension in a 63-year-old woman leading to heart failure and marked morbidity. Her clinical course was characterized by chronic pleural effusions and recurrent hospitalizations with respiratory failure and flash pulmonary edema associated with heart failure with preserved ejection fraction. Her transthoracic echocardiogram showed severe concentric left hypertrophy and diastolic dysfunction. The clinical phenotype was secondary to resistant hypertension due to bilateral renal artery stenosis, and her blood pressure and heart failure resolved after successful renal artery angioplasty. This case demonstrates how heart failure with preserved ejection fraction due to renal artery stenosis can easily go unrecognized especially in patients with multiple comorbidities. The potentially curable nature of this condition clearly warrants consideration especially in patients with multiple risk factors for atherosclerotic vascular disease.
Dermatofibrosarcoma protuberans of the vulva: margins assessment and reconstructive options - a report of two cases
Authors: Eduardo Bertolli, Eduard Renè Bretchbuhl, William Ricardo Camarço, Mariane Campagnari, André Sapata Molina, Glauco Baiocchi, Mariana Petaccia Macedo, Clovis Antonio Pinto, Isabela Werneck Cunha, João Pedreira Neto
Journal: World J Surg Oncol (2014)

Background:
Dermatofibrosarcoma Protuberans (DFSP) of the vulva is rare and oncologic surgery with free margins may lead to severe functional damage, requiring multidisciplinary approach regarding resection, margin assessment and reconstruction.Case Report: Two cases of DFSP in vulva were treated in a single institution. A 28-year-old patient with an incisional biopsy in the vulvar region revealing DFSP underwent a partial vulvectomy with clitoris preservation. Pathological studies revealed free margins and reconstructive surgery was performed. This patient is disease free in a 40 months follow up. The other, a 57-year-old patient was also referred after an incomplete resection of a DFSP in the vulvar region. A 1-cm margim resection followed by Complete Circumferential and Peripheral Deep Margin Assessment (CCPDMA) was performed. Although the upper lateral margin was positive, it was possible to perform another wide local excision with preservation of the clitoris and primary closure.
Conclusion:
DFSP of the vulva requires an accurate evaluation of margins, resections following oncological principles and reconstruction. Although being a very challenging lesion that usually implies difficult surgical management, if treated in a multidisciplinary environment, with surgical oncologists, experienced dermatopathologists and reconstructive surgeons can achieve good results. Even in difficult cases that presents with large lesions and compromising challenging areas, a complete oncologic resection can be performed minimizing functional damage for the patient.
The use of amplitude-integrated electroencephalography combined with continuous conventional electroencephalography during therapeutic hypothermia for an infant with postnatal cardiac arrest
Authors: Asuka Ito, Yasunori Mishima, Yukari Koga, Mayu Saho, Teruyuki Hiraki, Kazuo Ushijima
Journal: Springerplus (2014)
Keywords: amplitude-integrated electroencephalography, cardiac arrest, continuous conventional electroencephalography, hypoxic ischemic encephalopathy, seizures, therapeutic hypothermia

Introduction:
Amplitude-integrated electroencephalography (aEEG) has been employed in therapeutic hypothermia (TH) trials of neonates after perinatal hypoxic-ischemic encephalopathy (HIE). We present a case report involving the use of aEEG during TH with continuous conventional electroencephalography (cEEG) for an infant who experienced postnatal intraoperative cardiac arrest.
Case description:
A five-month-old infant developed cardiac arrest during operation. Return of spontaneous circulation was achieved after one hour of cardiopulmonary resuscitation. Therapeutic hypothermia was applied with neuromuscular blockades. During the TH, the brain function and seizures were monitored with aEEG, which can also display continuous cEEG. Intermittent and discrete seizures were detected on aEEG and confirmed with raw cEEG during the TH and rewarming periods. Several kinds of antiepileptic drugs (AEDs) were administered to manage seizures according to the findings of aEEG with cEEG. Seizures were controlled by the treatments, and she showed no clinical seizures after TH and AED discontinuation.
Discussion and evaluation conclusions:
This case indicated the possibility that the use of aEEG with continuous cEEG for a postnatal infant after cardiac arrest was feasible to detect and assess seizures and the effects of antiepileptic therapy while undergoing TH.
Unusual Painful Muscle Spasm in a Dialysis-Dependent Patient with Progressive Cervical Kyphosis
Authors: Daisuke Tsunoda, Yoichi Iizuka, Tokue Mieda, Haku Iizuka, Hirotaka Chikuda
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

We herein report a case of cervical myelopathy due to destructive spondyloarthropathy (DSA) with an unusual painful muscle spasm. A 51-year-old man presented to our hospital due to numbness in the hands and progressive gait disturbance. The patient underwent laminoplasty for cervical myelopathy. One and a half years after surgery, the patient developed progressive kyphosis of the cervical spine and increasing spastisity. He also started to suffer from intractable pain associated with a muscle spasm. A blood analysis revealed marked CK elevation. The patient underwent 2-stage circumferential decompression and fusion. After the revision procedure, his symptoms improved, and his serum CK level normalized. Physicians should be alert to the possibility of pain associated with an excessive muscle spasm in cervical myelopathy patients.
Occult spinal dysraphism in obstetrics: a case report of caesarean section with subarachnoid anaesthesia after remifentanil intravenous analgesia for labour
Authors: A Valente, L Frassanito, L Natale, G Draisci
Journal: Case Rep Obstet Gynecol (2012)

Neuraxial techniques of anaesthesia and analgesia are the current choice in obstetrics for efficacy and general low risk of major complications. Concern exists about neuraxial anaesthesia in patients with occult neural tube defects, regarding both labour analgesia and anaesthesia for Caesarean section. Recently, remifentanil infusion has been proposed as an analgesic technique alternative to lumbar epidural, especially when epidural analgesia appears to be contraindicated. Here, we discuss the case of a pregnant woman attending at our institution with occult, symptomatic spinal dysraphism who requested labour analgesia. She was selected for remifentanil intravenous infusion for labour pain and then underwent urgent operative delivery with spinal anaesthesia with no complications.
Lymph node tuberculosis mimicking axillary hidradenitis: a case report
Authors: Zineb Basri, Ait Benhammou Rita, Amine Lakhdari, Maria Kharbouch, Hamza Tazi, Mounia El Omari
Journal: Pan Afr Med J (2022)
Keywords: axillary hidradenitis, axillary swelling, case report, lymph node tuberculosis
MeSH terms: Hidradenitis Suppurativa / diagnosis, Hidradenitis Suppurativa / pathology, Tuberculosis, Lymph Node / diagnosis, Tuberculosis, Lymph Node / pathology, Case Reports, Axilla / pathology, Diagnosis, Differential, Humans, Lymph Nodes / pathology

Hidradenitis is a chronic benign pathology with acute manifestations, mainly occurring among young patients with hyper seborrhea. Its clinical presentation is an inflammatory, nodular and fistulized aspect. It affects many body parts, making its location a referral criterion for diagnosis. Our patient had, indeed, a clinical aspect of hidradenitis. However, pathology revealed that it is tuberculosis lymphadenitis.
An isolated pulmonary nodule secondary to Streptococcus intermedius infection in an otherwise healthy 10-year-old boy: A case report and literature review
Authors: Meixia Huang, Shuxian Li, Xiling Wu, Dan Xu, Lanfang Tang, Zhimin Chen
Journal: Front Pediatr (2022)
Keywords: streptococcus intermedius, case report, infection, metagenomics next-generation sequencing, pulmonary nodule, ultrasonography-guided lung biopsy
MeSH terms: Case Reports

Streptococcus intermedius, as a Gram-positive commensal bacterium, tends to cause various infections, such as brain and liver abscesses, endocarditis, and empyema, especially in immunocompromised patients. However, an isolated pulmonary nodule caused by S. intermedius in previously healthy individuals without traditional risk factors is rarely reported. Herein, we present a case of a 10-year-old immunocompetent boy referred to our department with a 5-day history of intermittent, left-sided chest pain. Chest X-ray and computed tomography revealed a left lung nodule. Although his blood, sputum, and bronchoalveolar lavage fluid cultures were negative, metagenomic next-generation sequencing (mNGS) showed only the presence of S. intermedius in ultrasonography-guided lung biopsy tissue and pleural fluid (416 and 110 reads, respectively). He was then successfully treated with appropriate intravenous antibiotics and avoided surgical intervention. To the best of our knowledge, this is the first report of S. intermedius-related pulmonary nodule confirmed by mNGS analysis in healthy children. For achieving proper diagnosis and treatment, infection with S. intermedius should be included in the differential diagnosis when coming across such a similar pulmonary nodule. mNGS, as a valuable supplement to conventional culture methods, is an essential diagnostic tool for identifying pathogens without typical characteristics.
Case report: A prosthetic valve endocarditis caused by Legionella bozemanae in an immunocompetent patient
Authors: Mai Sasaki Aanensen Fraz, Gry Dahle, Kirsten Margrete Skaug, Sophie Jarraud, Stephan Frye, Jørgen Vildershøj Bjørnholt, Ingvild Nordøy
Journal: Front Med (Lausanne) (2022)
Keywords: legionella bozemanae, legionella bozemanii, blood culture negative endocarditis, endocarditis, molecular diagnostic techniques, prosthetic valve endocarditis (pve)
MeSH terms: Case Reports

Extrapulmonary infections with Legionella species are rare, but important to acknowledge. We report a case of infective endocarditis (IE) with Legionella bozemanae in a 66-year-old immunocompetent man with an aortic homograft. The diagnosis was made by direct 16S rRNA gene amplification from valve material, confirmed by a targeted Legionella-PCR in serum and the detection of L. bozemanae specific antibodies. To our knowledge, this is the first confirmed case of IE with L. bozemanae as causative pathogen. The infected aortic prosthesis was replaced by a homograft, and the patient was successfully treated with levofloxacin and azithromycin for 6 weeks.
Congenital simple hamartoma of the retinal pigment epithelium with depigmentation at the margin in an Indian female
Authors: Koushik Tripathy, Gopal Bandyopadhyay, Koushik Basu, Kishore Kumar Vatwani, Himanshu Shekhar
Journal: GMS Ophthalmol Cases (2019)
Keywords: chrpe, chrrpe, cshrpe, congenital simple hamartoma of the retinal pigment epithelium, combined hamartoma of retinal and retinal pigment epithelium, congenital hypertrophy of the retinal pigment epithelium
MeSH terms: Case Reports

Objective: To report a case of congenital simple hamartoma of the retinal pigment epithelium (CSHRPE) with depigmentation at the margin. Method: Case report. Result: A 40-year-old Indian female was noted to have a small pigmented lesion with a depigmented margin toward the fovea in the right eye. The best-corrected vision was 6/6 in either eye. The optical coherence tomography revealed a highly reflective lesion at the retinal surface causing a shadow effect, suggestive of CSHRPE. Conclusion: Imaging features of a patient with CSHRPE with a crescent-like depigmented area at the margin are presented.
Prostatic-Like Syndrome in a Woman with Chronic Lymphocytic Leukemia: Sequential Kinase Inhibitor Therapy
Authors: Diego Velasco-Rodríguez, Miguel Piris-Villaespesa, Carmen Soteras, Ana Vallés, José Antonio García-Marco, José Antonio García-Vela
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Chronic lymphocytic leukemia (CLL) is an incurable lymphoproliferative disorder with a heterogeneous genetic and clinical course. Two kinase inhibitors, ibrutinib and idelalisib, have demonstrated achievement of complete and durable remissions in relapse/refractory genetically unselected CLL patients. We present a case of relapsed CLL with extensive disease and hourglass deformity of urinary bladder as a result of the compression of two extraperitoneal paravesical soft tissue bulky masses, with excellent response to sequential kinase inhibitor therapy.
Innovative treatment of hypercapnia with soda lime in COVID-19: a case report
Authors: Ali Amoushahi, Pietro Salvatori
Journal: Pan Afr Med J (2023)
Keywords: covid-19, case report, hypercapnia, soda lime
MeSH terms: COVID-19 / therapy, Hypercapnia / etiology, Hypercapnia / therapy, Case Reports, Carbon Dioxide, Female, Humans, Oxides, soda lime, Carbon Dioxide, Oxides

One of the rare consequences of COVID-19 is increasing blood carbon dioxide, which can lead to unconsciousness, dysrhythmia, and cardiac arrest. Therefore, in COVID-19 hypercarbia, non-invasive ventilation (with Bi-level Positive Airway Pressure, BiPAP) is recommended for treatment. If CO2 does not decrease or continues rising, the patient's trachea must be intubated for supportive hyperventilation with a ventilator (Invasive ventilation). The high morbidity and mortality rate of mechanical ventilation is an important problem of invasive ventilation. We launched an innovative treatment of hypercapnia without invasive ventilation to reduce morbidity and mortality. This new approach could open the window for researchers and therapists to reduce COVID death. To investigate the cause of hypercapnia, we measured the carbon dioxide of the airways (mask and tubes of the ventilator) with a capnograph. Increased carbon dioxide inside the mask and tubes of the device was found in a severely hypercapnic COVID patient in the Intensive Care Unit (ICU). She had a 120kg weight and diabetes disease. Her PaCO2 was 138mmHg. In this condition, she had to be under invasive ventilation and accept its complication or lethal risk but we decreased her PaCO2 with the placement of a soda lime canister in the expiratory pathway to absorb CO2 from the mask and ventilation tube. Her PaCO2 dropped from 138 to 80, and the patient woke up from drowsiness completely without invasive ventilation, the next day. This innovative method continued until PaCO2 reached 55 and she was discharged home 14 days later after curing her COVID. Soda lime is used for carbon dioxide absorption in anesthesia machines and we can research its application in hypercarbia state in ICU to postpone invasive ventilation for treatment of hypercapnia.