OpenMed/multicare-articles huggingface dataset:
Labial synechiae in geriatric patients with turner syndrome: A case report
Authors: Johannes Cansius Prihadi, Yuvi Wahyudi
Journal: Int J Surg Case Rep (2020)
Keywords: case reports, females, geriatry, labial synechieae, turner syndrome, vaginal reconstruction
MeSH terms: Case Reports

Introduction:
Turner syndrome (TS) is a chromosomal condition that affects development in females, resulted from a complete or partial absence of the second X chromosome or from structural anomalies (mosaicism) of one X chromosome. TS is one of the most common sex chromosome disorders among live-born female births.
Case presentation:
We presented with a 63 y.o. Female, who admitted to our Hospital with a chief complaint of pain when urinating and frequent haematuria. She has a history of Turner Syndrome (45 XO). Local examination in the lithotomy position revealed labial agglutination involving the labia majora. We did a Cystoscopy to evaluate the bladder and urethra, and then biopsied the tissues. Vaginal Reconstruction was performed to repair the Labial Synechiae. The biopsy showed that this histological finding is consistent with Follicular Cystitis that could cause by chronic UTIs.
Discussion:
Labial Synechiae (LS), or Labial agglutination is a disorder of the female genitalia characterized by thin, membranous adherence of the labia. LS usually noted in female with numerous UTIs and vaginal infections. Goel et al confirmed that LS is not a congenital disorder. In a retrospective study, they found out that LS is probably caused by multiple numerous UTIs that may cause a membrane to formed around the labia. The negligence and chronicity of this condition may have thickened the synechiae, making it persist for a long time, and can actually cause a symptom to appear.
Conclusion:
There is no literature to suggest any link between TS and LS directly.
Atypical Cutaneous Manifestations in Adult Onset Still's Disease
Authors: Champa Nataraja, Hedley Griffiths
Journal: Case Rep Rheumatol (2016)

Adult Onset Still's Disease (AOSD), an adult variant of systemic onset juvenile idiopathic arthritis, is a rare systemic inflammatory disorder of unknown aetiology. The rarity of this disease is associated with low index of suspicion and delayed diagnosis in patients suffering from it and in the presence of atypical features the diagnosis can be further challenging. This is a case report on a 24-year-old woman, who was a diagnostic dilemma for 2 years due to the nonspecific symptoms of recurrent fever, generalized maculopapular persistent pruritic and tender rash, and polyarthralgia. She was initially diagnosed as leukocytoclastic vasculitis on a skin biopsy and was managed by a dermatologist with various medications including NSAIDs, hydroxychloroquine, dapsone, colchicine, cyclosporine, and high doses of oral steroids with minimal response. Subsequently, she has had multiple admissions with similar symptoms with raised inflammatory markers and negative septic workup. On one occasion, her iron study revealed hyperferritinaemia which led to the suspicion of AOSD. Once the rheumatic fever and infectious, malignant, autoimmune, and lymphoproliferative disorders were excluded, she was diagnosed as probable AOSD and managed successfully with IL-1 (interleukin-1) receptor antagonist, Anakinra, with remarkable and lasting response both clinically and biochemically.
Artificial intelligence-based internet hospital pharmacy services in China: Perspective based on a case study
Authors: Fengjiao Bu, Hong Sun, Ling Li, Fengmin Tang, Xiuwen Zhang, Jingchao Yan, Zhengqiang Ye, Taomin Huang
Journal: Front Pharmacol (2022)
Keywords: artificial intelligence, internet hospital, medication pick-up code, online medication consultation, prescription preview

Background: Recently, internet hospitals have been emerging in China, saving patients time and money during the COVID-19 pandemic. In addition, pharmacy services that link doctors and patients are becoming essential in improving patient satisfaction. However, the existing internet hospital pharmacy service mode relies primarily on manual operations, making it cumbersome, inefficient, and high-risk. Objective: To establish an internet hospital pharmacy service mode based on artificial intelligence (AI) and provide new insights into pharmacy services in internet hospitals during the COVID-19 pandemic. Methods: An AI-based internet hospital pharmacy service mode was established. Initially, prescription rules were formulated and embedded into the internet hospital system to review the prescriptions using AI. Then, the "medicine pick-up code," which is a Quick Response (QR) code that represents a specific offline self-pick-up order, was created. Patients or volunteers could pick up medications at an offline hospital or drugstore by scanning the QR code through the window and wait for the dispensing machine or pharmacist to dispense the drugs. Moreover, the medication consultation function was also operational. Results: The established internet pharmacy service mode had four major functional segments: online drug catalog search, prescription preview by AI, drug dispensing and distribution, and AI-based medication consultation response. The qualified rate of AI preview was 83.65%. Among the 16.35% inappropriate prescriptions, 49% were accepted and modified by physicians proactively and 51.00% were passed after pharmacists intervened. The "offline self-pick-up" mode was preferred by 86% of the patients for collecting their medication in the internet hospital, which made the QR code to be fully applied. A total of 426 medication consultants were served, and 48.83% of them consulted outside working hours. The most frequently asked questions during consultations were about the internet hospital dispensing process, followed by disease diagnosis, and patient education. Therefore, an AI-based medication consultation was proposed to respond immediately when pharmacists were unavailable. Conclusion: The established AI-based internet hospital pharmacy service mode could provide references for pharmacy departments during the COVID-19 pandemic. The significance of this study lies in ensuring safe/rational use of medicines and raising pharmacists' working efficiency.
Multiple facets in the control of acromegaly
Authors: Lucio Vilar, Alex Valenzuela, Antônio Ribeiro-Oliveira Jr, Claudia M Gómez Giraldo, Doly Pantoja, Marcello D Bronstein
Journal: Pituitary (2014)
MeSH terms: Acromegaly / therapy, Case Reports, Acromegaly / diagnosis, Adenoma / pathology, Adult, Comorbidity, Diabetes Mellitus / drug therapy, Dopamine Agonists / therapeutic use, Dyslipidemias / therapy, Female, Growth Hormone-Secreting Pituitary Adenoma / pathology, Human Growth Hormone / metabolism, Humans, Hypertension / drug therapy, Insulin-Like Growth Factor I / metabolism, Retrospective Studies, Somatostatin / analogs & derivatives, Somatostatin / therapeutic use, Thyroid Neoplasms / surgery, Treatment Outcome, Dopamine Agonists, Human Growth Hormone, Somatostatin, Insulin-Like Growth Factor I

Aims:
The current article provides a brief overview of the criteria for defining disease control in acromegaly.
Methods:
This was a retrospective, narrative review of previously published evidence chosen at the author's discretion along with an illustrative case study from Latin America.
Findings and conclusions:
In the strictest sense, "cure" in acromegaly is defined as complete restoration of normal pulsatile growth hormone secretion, although this is rarely achieved. Rather than "cure", as such, it is more appropriate to refer to disease control and remission, which is defined mainly in terms of specific biochemical targets (for growth hormone and insulin-like growth factor-1) that predict or correlate with symptoms, comorbidities and mortality. However, optimal management of acromegaly goes beyond biochemical control to include control of tumour growth (which may be independent of biochemical control) and comprehensive management of the symptoms and comorbidities typically associated with the disease, as these may not be adequately managed with acromegaly-specific therapy alone.
Sofosbuvir and Simeprevir for the Treatment of Recurrent Hepatitis C with Fibrosing Cholestatic Hepatitis after Liver Transplantation
Authors: D Issa, B Eghtesad, N N Zein, L Yerian, M Cruise, N Alkhouri, R Adams, I A Hanouneh
Journal: Int J Organ Transplant Med (2016)
Keywords: fibrosis, hepacivirus, jaundice, liver cirrhosis, liver transplantation, pancreatitis, pruritus, obstructive
MeSH terms: Case Reports

Fibrosing cholestatic hepatitis (FCH) is an aggressive form of hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT), which frequently results in graft failure and death. Treatment of FCH remains challenging, and the optimal antiviral therapy is yet to be determined. Between November 2013 and early 2015, 62 patients with HCV cirrhosis underwent OLT at our transplant center, of whom, 5 patients developed recurrence HCV in the form of severe FCH and were treated with sofosbuvir and simeprevir (SOF-SMV) for 24 weeks. All patients achieved significant improvement of HCV viral load and had undetectable viral PCR at 6-8 week of treatment. The HCV RNA remained undetectable throughout treatment course. The first two patients achieved SVR at week 12 after completion of the treatment. There were significant histologic and biomarkers improvements after initiation of the treatment. One patient developed refractory pruritus and acute pancreatitis. The second, fourth and fifth patients had very benign treatment courses with no side effects recorded. The third patient was starting the treatment with multiple comorbid conditions. His course was complicated with hepatic artery thrombosis, and later developed sepsis and renal failure. Therefore, it seems that the combination of SOF-SMV is an efficacious oral regimen in OLT recipient with recurrent hepatitis C and FCH. However, safety profile needs to be carefully evaluated.
Remimazolam Anesthesia for MitraClip Implantation in a Patient with Advanced Heart Failure
Authors: Tomoe Satoh, Noriaki Nishihara, Yasuaki Sawashita, Sho Ohno, Naoyuki Hirata, Michiaki Yamakage
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

Remimazolam, a novel and ultrashort-acting benzodiazepine, has been available for general anesthesia in Japan. The administration of remimazolam does not induce injection pain, has been reported to have less cardiovascular depressant effects during general anesthesia, and flumazenil can antagonize the effects of remimazolam. However, in clinical trials, no patient who is complicated with severe heart failure or undergoes cardiac surgery was included. We present anesthetic management with remimazolam for MitraClip® implantation in a patient with severe mitral regurgitation and advanced heart failure. Remimazolam was administered both in anesthetic induction and maintenance with less cardiovascular depressant effects. After surgical procedures were completed, the patient smoothly recovered from anesthesia and the tracheal was extubated just after administration of flumazenil. Remimazolam may be able to achieve appropriate anesthetic management in patients complicated with severe cardiovascular diseases.
Case Report: Prolonged Neutropenia in Premature Monoamniotic Twins With SARS-CoV-2 Infection Acquired by Vertical Transmission
Authors: Anna S Scholz, Stephanie Wallwiener, Johannes Pöschl, Navina Kuss
Journal: Front Pediatr (2022)
Keywords: sars-cov-2, monoamniotic twin pregnancy, neutropenia, prematurity, vertical transmision
MeSH terms: Case Reports

Background:
Vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a highly debated topic in the current pandemic situation. Early neonatal SARS-CoV-2 infection is rare and generally mild. Long-term data describing symptoms after COVID-19 in premature neonates is scarce.
Case presentation:
Two premature, monoamniotic neonates were born by cesarean section to a mother 5 days after onset of symptomatic COVID-19. On day three of life both neonates developed hyperthermia, respiratory distress, and hematological changes, of which neutropenia persisted for over 40 days. Nasopharyngeal swabs for SARS-CoV-2 turned positive four days after delivery although the neonates were strictly isolated. Both neonates showed nearly identical time courses of ct values.
Conclusion:
Our case report revealed prolonged low absolute neutrophil counts in two preterm neonates with symptomatic SARS-CoV-2 infection that is reasonably assumed to have been transmitted vertically in utero. After preterm delivery to a SARS-CoV-2 positive mother, testing for SARS-CoV-2 infection in neonates is crucial. Both neutropenia and lymphopenia should alert physicians to test for SARS-CoV-2 infection and also to follow the case.
Infected Nonunion of the Distal Femur in the Elderly with Bone Loss: Case Report and Treatment Options
Authors: Neven Starčević, Andrija Karačić
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

The management of infected nonunion associated with bone loss in long bones is both a time-consuming and challenging procedure for the orthopedic and trauma surgeon. In this paper, we present the case of a 75-year-old woman with infected nonunion of the distal femur associated with bone loss after plate osteosynthesis for a distal femur fracture. The patient was referred for nonunion of the distal femur after plate fixation (nonlocking "classic" plate) and was treated with a locking compression plate (LCP) and autologous cancellous bone transplant. During the follow-up, the patient was ambulatory without pain; however, the nonunion failed to heal, therefore, the induced membrane technique (Masquelet procedure) was performed in two stages, tissue samples were taken and revealed a bacterial infection (S. epidermidis), and antibiotic treatment was started. Due to infection, fracture healing was slowed, but did commence. Unfortunately, the LC plate failed before union occurred, the nonunion was treated with a femoral nail and blocking (Poller) screws, and the bony defect was filled with Ca-P cement. The patient was operated one last time for cement dislocation when not only the dislocated cement was removed but also the femoral nail dynamized. After one year after treatment completion, the fracture healed, and leg length discrepancy was 1.5 cm shorter on the left side. The patient experienced significant pain relief and can walk with the help of crutches. Our paper demonstrates the application of different techniques in fracture surgery as they are required can result in fracture healing even in very adverse circumstances.
Ipsilateral Radial Head Dislocation And Proximal One-Third Radial Shaft Fracture In An Adult: A Case Report
Authors: Jagdeep Singh, Anoop Kalia, Anshul Dahuja
Journal: Open Orthop J (2018)
Keywords: dislocation, fracture shaft radius, ipsilateral, isolated, proximal, radial head
MeSH terms: Case Reports

Introduction:
Dislocation of the radial head in adults is quite uncommon. A simultaneous dislocation of the radial head with a fracture of ipsilateral shaft radius without any other associated injury is even rare.
Case presentation:
We are reporting a case of a young adult male who was operated for proximal one-third radial shaft fracture at some peripheral centre by Open Reduction and Internal Fixation (ORIF), but came to our centre on the fourth post-operative day with complaints of painful restricted movements of the elbow joint. On careful look at the postoperative x-ray, radial head was found to be dislocated. Radial head dislocation was reduced under general anesthesia and at 2 years follow up, patient fracture has fully united having good functional outcome.
Conclusion:
Traumatic dislocation of radial head with ipsilateral fracture shaft radius is a rare injury in adults and it is very important to timely diagnose it and manage it appropriately in order to give good functional outcome to the patient.
A Patient with SIADH, Urinary Retention, Constipation, and Bell's Palsy following a Tick Bite
Authors: Mariana Leone, Anwar Iqbal, J R Hugo Bonatti, Samina Anwar, Catherine Feaga
Journal: Case Rep Nephrol (2022)
MeSH terms: Case Reports

Introduction. Lyme disease is the most common vector borne disease in the USA caused by the bacterium Borrelia burgdorferi. If untreated, Lyme disease can cause a variety of secondary symptoms often difficult to interpret. Some of the rare manifestations of Lyme disease include SIADH-like syndrome, enteroparesis, and urinary retention. Case Report. A 69-year-old male presented with anorexia and constipation and was found to have hyponatremia. Several days after admission, Bell's palsy developed and he experienced urinary retention requiring catheterization. Lyme disease was confirmed on serology, and he recalled a rash on his elbow four weeks prior. Ceftriaxone was started and the patient improved; he had multiple bowel movements after receiving laxatives and the Foley catheter was removed; serum sodium normalized with fluid restriction. He was discharged home and was well with symptoms completely resolved at three-month follow-up. Discussion. There should be a high alert of atypical presentation of this common tick bite associated infection. Review of the literature revealed ten similar cases, but only three of these patients were reported to have a combination of SIADH, urinary retention, and enteroparesis.
Proximal-type epithelioid sarcoma: a new case report and literature review
Authors: Abdelmoughit Echchaoui, Yassine Sadrati, Youssef Elbir, Abderrahim Elktaibi, Malika Benyachou, Samir El Mazouz, Nour-Eddine Gharib, Abdellah Abbassi
Journal: Pan Afr Med J (2016)
Keywords: epithelioid sarcoma, diagnosis, prognosis, proximal-type
MeSH terms: Sarcoma / diagnosis, Scapula / pathology, Soft Tissue Neoplasms / diagnosis, Case Reports, Review, Female, Follow-Up Studies, Humans, Sarcoma / pathology, Sarcoma / surgery, Soft Tissue Neoplasms / pathology, Soft Tissue Neoplasms / surgery, Young Adult

Proximal-type epithelioid sarcoma is a rare soft tissue neoplasm which arises from the more proximal part of body and occurs more often in young people; the definite diagnosis depends mainly on the pathological examination; early detection and complete excision remain the foundation of treatment. Due to its aggressive behavior, high capacity of recurrence and the great ability to metastasize, a careful clinical long-term monitoring is required. We report a new case of a 20 years old girl, presented with proximal-type epithelioid sarcoma in her right scapular region, confirmed by pathological examination and removed surgically without recurrence or metastasis at eighteen months of follow-up.
Severe Aortic Stenosis and Severe Coarctation of the Aorta: A Hybrid Approach to Treatment
Authors: Daniel McLennan, Massimo Caputo, Demetris Taliotis
Journal: Front Surg (2017)
Keywords: aortic stenosis, coarctation of the aorta, congenital heart disease, hybrid surgery, neonate
MeSH terms: Case Reports

Hybrid surgery is becoming more popular in the treatment of children with congenital heart disease, particularly small infants and neonates. We report a case of a patient with aortic stenosis (AS) and coarctation of the aorta (CoA).
Case:
a 1-month-old baby presented with severe AS and CoA. The decision was made to perform a hybrid surgical procedure. The patient underwent a lateral thoracotomy for repair of the CoA and carotid cutdown for aortic balloon valvuloplasty (AoVP).
Treatment of facial myiasis in an elderly patient with oral squamous cell carcinoma: Case report
Authors: Samara Andreolla Lazaro, Franklin David Gordillo Yépez, João Paulo De Carli, Micheline Sandini Trentin, Letícia Copatti Dogenski, Ferdinando De Conto
Journal: Int J Surg Case Rep (2020)
Keywords: aging, case report, epidermoid carcinoma, myiasis, surgical treatment
MeSH terms: Case Reports

Myiasis is caused by the infestation of fly larvae in human tissues and it presents immunodeficiency, poor hygiene, or malignant neoplasias as predisposing chronic diseases.
Objective:
To describe a clinical case of myiasis associated with oral squamous cell carcinoma (OSCC) in an elderly patient.
Case presentation:
A 60-year-old male, black, smoker, and alcoholic patient with OSCC, who refused initial cancer treatment and sought hospital care with an extensive facial lesion and approximately 150 larvae in the extraoral region. The treatment was given through the administration of 6 mg of Ivermectin associated with the surgical removal of the larvae. Subsequently, palliative chemotherapy began.
Discussion:
Myiasis can sometimes be associated with OSCC and it commonly occurs in individuals who live in unhealthy locations and present poor hygiene and low immunity. In addition to medication, the surgical removal of the larvae is important in the treatment of myiasis.
Conclusion:
Patient adherence to cancer treatment is essential to avoid the negative evolution of the tumor. The social component linked to the development of myiasis makes it an important public health topic, as it is related directly to the lack of primary care. Surgical and drug treatments are required to cure myiasis.
Retained gallbladder secondary to retrieval bag rupture during laparoscopic cholecystectomy-A case report
Authors: Roy Huynh, Mark Magdy, Lucia Saliba, Ken Loi
Journal: Int J Surg Case Rep (2019)
Keywords: case report, gallbladder remnant, intra-abdominal abscess, laparoscopic cholecystectomy, retrieval bag rupture, surgery complications

Introduction:
Retrieval bags are used in laparoscopic cholecystectomies to reduce the risk of bile and gallstone spillage during removal of the gallbladder. Retrieval bag rupture is rare, and its complications have never been previously documented.
Presentation of case:
A 17-year-old female presented three months post-laparoscopic cholecystectomy with a tender periumbilical mass. Her operative report noted difficulty removing the retrieval bag from the infra-umbilical port site. Imaging of the lump revealed an intra-abdominal fluid collection communicating with the umbilicus. A diagnostic laparoscopy uncovered significant pus in the peritoneal cavity and a gallbladder remnant with multiple gallstones. A combination of sharp and blunt dissections was used to free the gallbladder remnant from its adherent surroundings for removal. A peritoneal washout was performed following extraction of the retained gallstones. The patient's presentation could be traced back to her laparoscopic cholecystectomy where it was confirmed that the retrieval bag ruptured during removal. This would have transected the gallbladder, causing its remnants and associated gallstones to be retained in the peritoneal cavity.
Discussion:
Retrieval bag rupture can result in retained gallbladder remnants in the peritoneal cavity. Abdominal abscess can manifest months after the initial operation.
Conclusion:
Retrieval bags should be inspected following removal to ensure it is completely intact. Surgeons should consider extending the fascial incision if there is any difficulty during removal. Any damage to the retrieval bag mandates immediate pneumoperitoneum for further exploration of retained products. Governance bodies should incorporate practice guidelines related to retrieval bag rupture as these are currently not present.