OpenMed/multicare-articles huggingface dataset:
Report of a clinical and laboratory management of cell therapy for knee cartilage in the face of mycoplasma contamination
Authors: Alessandro Rozim Zorzi, Eliane Antonioli, Juliana Aparecida Preto de Godoy, Oswaldo Keith Okamoto, Andrea Tiemi Kondo, José Mauro Kutner, Camila Cohen Kaleka, Moisés Cohen, Mario Ferretti
Journal: Einstein (Sao Paulo) (2022)
MeSH terms: Cartilage, Articular / injuries, Mycoplasma, Case Reports, Cell- and Tissue-Based Therapy, Chondrocytes, Humans, Knee Joint, Male, Middle Aged

To describe a case of autologous chondrocyte implantation after cell culture contamination by Mycoplasma pneumoniae and the measures taken to successfully complete cell therapy in a patient with focal chondral lesion. A 45-year-old male patient, complaining of chronic pain on the knee and no history of trauma. He had a chondral lesion in the trochlear region of the femur and clinical tests compatible with pain in the anterior compartment of the knee. Conservative treatment failed to alleviate symptoms. Surgical treatment was indicated, but due to the size of the lesion, membrane-assisted autologous chondrocyte implantation was the technique of choice. Cartilage biopsies were collected from the intercondylar region of the distal femur. After isolation, chondrocytes were expanded ex vivo in a trained laboratory, for three weeks, and seeded onto a commercially available collagen membrane prior to implantation in the knee. Two days before surgery, a cell culture sample tested positive for Mycoplasma pneumoniae. The source of contamination was found to be autologous blood serum, extracted from the patient´s peripheral vein, and used to supplement the cell culture medium. After treating the patient with antibiotics, all procedures were repeated and the new final cell product, free from contaminants, was successfully implanted. We discuss the strategies available to deal with this situation, and describe the results of this particular case, which led to modifications in the autologous chondrocyte implant protocol.
The introduction of new policies and strategies to reduce inequities and improve child health in Kenya: A country case study on progress in child survival, 2000-2013
Authors: Marie A Brault, Kenneth Ngure, Connie A Haley, Stewart Kabaka, Kibet Sergon, Teshome Desta, Kasonde Mwinga, Sten H Vermund, Aaron M Kipp
Journal: PLoS One (2017)
MeSH terms: Child Health Services / organization & administration, Health Policy, Health Status Disparities, Healthcare Disparities, Adult, Child Health, Child Mortality, Child, Preschool, Female, Focus Groups, HIV Infections / prevention & control, Humans, Infant, Infant Mortality, Infant, Newborn, Infectious Disease Transmission, Vertical / prevention & control, Kenya, Male, Maternal Health Services / organization & administration, Neonatology / organization & administration, Obstetrics / organization & administration, Pregnancy, Rural Population, Urban Population, Young Adult

As of 2015, only 12 countries in the World Health Organization's AFRO region had met Millennium Development Goal #4 (MDG#4) to reduce under-five mortality by two-thirds by 2015. Given the variability across the African region, a four-country study was undertaken to examine barriers and facilitators of child survival prior to 2015. Kenya was one of the countries selected for an in-depth case study due to its insufficient progress in reducing under-five mortality, with only a 28% reduction between 1990 and 2013. This paper presents indicators, national documents, and qualitative data describing the factors that have both facilitated and hindered Kenya's efforts in reducing child mortality. Key barriers identified in the data were widespread socioeconomic and geographic inequities in access and utilization of maternal, neonatal, and child health (MNCH) care. To reduce these inequities, Kenya implemented three major policies/strategies during the study period: removal of user fees, the Kenya Essential Package for Health, and the Community Health Strategy. This paper uses qualitative data and a policy review to explore the early impacts of these efforts. The removal of user fees has been unevenly implemented as patients still face hidden expenses. The Kenya Essential Package for Health has enabled construction and/or expansion of healthcare facilities in many areas, but facilities struggle to provide Emergency Obstetric and Neonatal Care (EmONC), neonatal care, and many essential medicines and commodities. The Community Health Strategy appears to have had the most impact, improving referrals from the community and provision of immunizations, malaria prevention, and Prevention of Mother-to-Child Transmission of HIV. However, the Community Health Strategy is limited by resources and thus also unevenly implemented in many areas. Although insufficient progress was made pre-2015, with additional resources and further scale-up of new policies and strategies Kenya can make further progress in child survival.
Atypical Pharyngeal Pouch Arising Bilaterally between the Hyoid Bone and Thyroid Cartilage
Authors: Lawrence J Oh, Lyndon Chan, David Veivers
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Introduction. Pharyngoesophageal diverticuli are a common cause of dysphagia; they are associated with various morbidities and a decreased quality of life. There are several different types of the diverticuli, and they are divided based on the anatomical location of origin relative to the cricopharyngeal muscle; these include Zenker's, Killian-Jamieson's, and Laimer's diverticula. The authors present a unique case of pharyngoesophageal diverticulum that has not been previously described. Case Presentation. A 65-year-old male presented with a 12-month history of dysphagia and odynophagia for solids. Barium swallow revealed bilateral moderately sized diverticuli that altered in size during the different phases of swallow. CT scan of the neck with oral contrast further identified the anatomy of the diverticuli, arising between the hyoid bone and thyroid cartilage. Discussion. An external transcervical approach was utilised to successfully repair the diverticuli. Subsequent cricopharyngeal spasm was treated with botulinum toxin, and the patient recovered with no ongoing symptoms. The barium swallow study is a commonly utilised initial investigation as it is easy to perform and safe and has good diagnostic value. Definitive management usually involves either endoscopic or open surgery. This case depicts a unique case of a pharyngeal diverticulum arising between the hyoid bone and thyroid cartilage.
Periocular myxoma in a child
Authors: Dolores Ríos Y Valles-Valles, Ana María Vera-Torres, Héctor A Rodríguez-Martínez, Abelardo A Rodríguez-Reyes
Journal: Case Rep Ophthalmol Med (2012)
MeSH terms: Case Reports

Myxomas are locally invasive, benign mesenchymal neoplasms with odontogenic, osteogenic, or soft tissue origin. Facial myxomas probably account for less than 0.5% of all paranasal sinus and nasal tumors. We report a case of a left painless periocular mass in a 11-month-old girl. The lesion was resected with a clinical diagnosis of lacrimal sac tumor. Histopathology and immunohistochemistry proved the tumor to be a myxoma. There has been no recurrence after 4 years of followup. Midfacial myxomas should be differentiated from other benign and malignant tumors such as dermoid, hamartoma, neurofibroma, nasolacrimal duct cyst, and sarcomas in particular embryonal rhabdomyosarcoma. Because of the infiltrative nature of these tumors, a wide surgery is required to achieve clear resection margins and avoid recurrence.
Total Splenectomy due to an Unexpected "Complication" after Successful Extended Laparoscopic Partial Decapsulation of a Giant Epidermoid Splenic Cyst: A Case Report
Authors: Michail Pitiakoudis, Petros Zezos, Anastasia Oikonomou, Prodromos Laftsidis, Georgios Kouklakis, Constantinos Simopoulos
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Splenic cysts are rare entities and are classified as true cysts or pseudocysts based on the presence of an epithelial lining. Congenital nonparasitic true cysts can be epidermoid, dermoid, or endodermoid, present at a young age, and are commonly located in the upper pole of the spleen. Surgical treatment is recommended for symptomatic, large (more than 5 cm), or complicated cysts. Depending on cyst number, location, relation to hilus, and the major splenic vessels, the surgical options include aspiration, marsupialization, cystectomy, partial cystectomy (decapsulation), and partial or complete splenectomy. Laparoscopic techniques have now become the standard approach for many conditions, including the splenic cysts, with emphasis on the spleen-preserving minimally invasive operations. We present the successful extended partial laparoscopic decapsulation of a giant epidermoid splenic cyst in a young female patient that, although asymptomatic, was unfortunately followed by complete splenectomy five days later due to a misinterpreted abdominal CT suggesting splenic postoperative ischemia.
Threading the Needle: Intrapelvic Displacement of a Femoral Neck Fracture through the Obturator Foramen
Authors: Gautham Prabhakar, Nicholas Kusnezov, Nicholas Rensing, Amr Abdelgawad
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Despite timely and appropriate management, displaced femoral neck fractures are often devastating injuries for the young patient. The risk of negative sequelae is further amplified with increasing displacement and vertical fracture patterns. Open anatomic reduction with rigid internal fixation is essential to maximize the healing potential in displaced fractures of the femoral neck. Successful primary osteosynthesis of significantly displaced femoral neck fractures in the young patient has been reported in the literature. We present a unique case of open reduction and internal fixation of a high-energy femoral neck fracture with extrusion of the head through the obturator foramen into the pelvis without associated acetabular or pelvic injury.
MPO-ANCA associated vasculitis with mononeuritis multiplex following influenza vaccination
Authors: Stefanie Eindhoven, Jolien Levels, Margriet Huisman, Koos Ruizeveld de Winter, Virgil Dalm, Rehmat Alwani
Journal: Allergy Asthma Clin Immunol (2017)
Keywords: anti-neutrophil cytoplasmic antibody (anca), influenza vaccination, vasculitis
MeSH terms: Case Reports

Background:
Although influenza vaccines are generally safe and effective, a variety of autoimmune phenomena have been reported after vaccination over the past years, such as Guillain-Barre syndrome, rheumatoid arthritis, pemphigus vulgaris, psoriasis, giant cell arteritis and anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV).
Case report:
We describe the case of a 67-year old man who presented with a myeloperoxidase-ANCA associated vasculitis with renal involvement and mononeuritis multiplex after seasonal influenza vaccination. He was initially treated with intravenous cyclophosphamide and high-dose prednisolone followed by maintenance treatment consisting of azathioprine and prednisolone.
Conclusion:
We hypothesize that seasonal influenza vaccination triggered a systemic immune response in a susceptible patient to develop AAV with renal involvement and vasculitic neuropathy. In general, seasonal influenza vaccinations are considered to be safe, however, clinicians should be aware of this rare phenomenon.
Ischemic Gastropathic Ulcer Mimics Gastric Cancer
Authors: Saleh Daher, Ziv Lahav, Ayman Abu Rmeileh, Meir Mizrahi, Tawfik Khoury
Journal: Case Rep Gastrointest Med (2016)

Gastric ulcer due to mesenteric ischemia is a rare clinical finding. As a result, few reports of ischemic gastric ulcers have been reported in the literature. The diagnosis of ischemic gastropathy is seldom considered in patients presenting with abdominal pain and gastric ulcers. In this case report, we describe a patient with increasing abdominal pain, weight loss, and gastric ulcers, who underwent extensive medical evaluation and whose symptoms were resistant to medical interventions. Finally he was diagnosed with chronic mesenteric ischemia, and his clinical and endoscopic abnormalities resolved after surgical revascularization of both the superior mesenteric artery and the celiac trunk.
A silent myocardial infarction in the diabetes outpatient clinic: case report and review of the literature
Authors: M S Draman, H Thabit, T J Kiernan, J O'Neill, S Sreenan, J H McDermott
Journal: Endocrinol Diabetes Metab Case Rep (2013)

Silent myocardial ischaemia (SMI), defined as objective evidence of myocardial ischaemia in the absence of symptoms, has important clinical implications for the patient with coronary artery disease. We present a dramatic case of SMI in a diabetes patient who attended annual review clinic with ST elevation myocardial infarction. His troponin was normal on admission but raised to 10.7 ng/ml (normal <0.5) when repeated the next day. His angiogram showed diffused coronary artery disease. We here discuss the implications of silent ischaemia for the patient and for the physician caring for patients with diabetes.
Learning points:
Silent myocardial ischaemia (SMI) is an important clinical entity.SMI is common and occurs with increased frequency in patients with diabetes.SMI is an independent predictor of mortality.Recognition may lead to early intervention.
Dynamic changes of atrioventricular conduction during Covid-19 infection: Does inflammation matter?
Authors: Risca Rini Aryanti, Dony Yugo Hermanto, Yoga Yuniadi
Journal: Int J Arrhythmia (2022)
Keywords: covid-19, complete av block, his bundle pacing, inflammatory
MeSH terms: Case Reports

Background:
The primary manifestation of COVID-19 infection was pulmonary involvement. However, it can also manifest as a cardiovascular problem.
Methods:
We report a case of 82-year-old male COVID-19 patient who experienced atrioventricular (AV) conduction disturbance.
Results:
The rhythm was degenerated from sinus rhythm to complete AV block. We observe dynamic AV node dysfunction associated with inflammatory response. His bundle pacing successfully captured distal His region.
Conclusion:
The severe inflammatory response during COVID-19 infection might permanently damage cardiac conduction system resulted in a complete AV node block.
Drug Induced Pneumonitis Secondary to Treatment with Paritaprevir/Ritonavir/Ombitasvir and Dasabuvir (VIEKIRA PAK®) for Chronic Hepatitis C: Case Report of an Unexpected Life-Threatening Adverse Reaction
Authors: Shih Yea Sylvia Wu, Bridget Faire, Edward Gane
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

VIEKIRA PAK (ritonavir-boosted paritaprevir/ombitasvir and dasabuvir) is an approved treatment for compensated patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection. This oral regimen has minimal adverse effects and is well tolerated. Cure rates are 97% in patients infected with HCV GT 1a and 99% in those with HCV GT 1b. We report the first case of life-threatening allergic pneumonitis associated with VIEKIRA PAK. This unexpected serious adverse event occurred in a 68-year-old Chinese female with genotype 1b chronic hepatitis C and Child-Pugh A cirrhosis. One week into treatment with VIEKIRA PAK without ribavirin, she was admitted to hospital with respiratory distress and acute kidney injury requiring intensive care input. She was initially diagnosed with community acquired pneumonia and improved promptly with intravenous antibiotics and supported care. No bacterial or viral pathogens were cultured. Following complete recovery, she recommenced VIEKIRA PAK but represented 5 days later with more rapidly progressive respiratory failure, requiring intubation and ventilation, inotropic support, and haemodialysis. The final diagnosis was drug induced pneumonitis.
Diaphragmatic hernia as a rare complication of colonoscopy: Case report and literature review
Authors: Siyu Liu, Mugen Dai, Bin Ye, Zhigang Zhao, Yang Shi, Lirong Peng
Journal: Medicine (Baltimore) (2018)
MeSH terms: Colonoscopy / adverse effects, Hernia, Diaphragmatic, Traumatic / etiology, Case Reports, Review, Aged, Humans, Male

Rationale:
Diaphragmatic Hernia is rare as complication of Colonoscopy. Diaphragmatic hernia as a complication of colonoscopy has been reported only few cases. Additionally, it is often misdiagnosed as other disease by clinicians due to their lack of related knowledge, which delays diagnosis of Diaphragmatic hernia and thus exacerbates the prognosis.
Patient concerns:
We report the case of a 66-year-old man with fecal occult blood. In the case, sudden epigastric pain after colonoscopy owing to diaphragmatic hernia in a left hemidiaphragm.
Diagnoses:
The diagnoses made by a CT scan without delay. It showed marked protrusion of the large bowel into the left thoracic cavity along with elevation of the left diaphragm.
Interventions:
The diaphragmatic defect was repaired by simple closure and intestinal adhesions release surgery.
Outcomes:
Five days after surgery, the patient was discharged in good condition.
Lessons:
Most of diaphragmatic hernia is congenital with high mortality. However, there are a few cases of Diaphragmatic hernia caused by previous trauma or surgery. We herein report an unusual case of diaphragmatic hernia related to colonoscopy but usually life-threatening complication.
Multiple hypovascular tumors in kidney: a rare case report and differential diagnosis
Authors: Pei-Yu Wu, Sheng-Fung Lin, Ping-Hsun Wu, Yi-Chun Tsai, Yu-Ting Kuo, Mei-Chuan Kuo, Hung-Chun Chen
Journal: Case Rep Med (2013)

The most common malignant renal tumor is renal cell carcinoma and surgery is the standard treatment. The proportion of lymphoma with renal involvement is 2~15% and lymphoma could be cured by chemotherapy without nephrectomy. Sonography, computed tomography (CT), and magnetic resonance imaging (MRI) can detect and characterize a renal mass. We present a case of right renal hypovascular tumors and differential diagnosis of hypovascular tumors by image study. CT scan showed hypovascular tumors and MRI image revealed multifocal hypovascular solid tumors with significantly increased apparent diffusion coefficient (ADC) of diffusion weighted imaging (DWI). Based on image finding, renal lymphoma was highly suspected. Renal lymphoma was confirmed by renal biopsy and this patient received chemotherapy without surgery. The noninvasive CT scan and MRI image can help clinicians to diagnose the characteristics of renal mass and to avoid unnecessary nephrectomy.
Drug-Induced Liver Injury: An Institutional Case Series and Review of Literature
Authors: Vijay Gayam, Mazin Khalid, Binav Shrestha, Muhammad Rajib Hossain, Sumit Dahal, Pavani Garlapati, Arshpal Gill, Amrendra Kumar Mandal, Ruby Sangha
Journal: J Investig Med High Impact Case Rep (2018)
Keywords: amiodarone, drug-induced liver injury, failure, fluconazole, liver, valproic acid

Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the USA. DILI can be broadly classified as Intrinsic and Idiosyncratic. Identifying predictors and at-risk patients are challenging but can have a substantial clinical implication. This case report series demonstrates the importance of valproic acid, fluconazole, and amiodarone as potential hepatoxic agents of drug-induced liver injury leading to acute hepatic failure. The causality in all cases was established by Roussel Uclaf Causality Assessment Method/Council for International Organizations of Medical Sciences score and Naranjo Algorithm. Obesity, hypo-perfusion state, and concurrent hepatotoxic agent might identify at-risk patients. Further studies are required to understand the risk factors.
Treatment of chronic hepatitis C with sofosbuvir in a hemodialysis patient: a case report
Authors: Marius Djoumbissie Tchoupe, Hanen Chaker, Mona Boudabbous, Salma Toumi, François Pegdebamba Kissou, Saba Gargouri, Khawla Kammoun, Faiçal Jarraya, Nabil Tahri, Soumaya Yaich, Mohamed Ben Hmida
Journal: Pan Afr Med J (2021)
Keywords: hemodialysis, case report, hepatitis c, sofosbuvir, treatment
MeSH terms: Antiviral Agents / administration & dosage, Benzimidazoles / administration & dosage, Fluorenes / administration & dosage, Hepatitis C, Chronic / drug therapy, Renal Dialysis, Sofosbuvir / administration & dosage, Case Reports, Antiviral Agents / adverse effects, Benzimidazoles / adverse effects, Fluorenes / adverse effects, Follow-Up Studies, Genotype, Glomerular Filtration Rate, Hepacivirus / genetics, Hepacivirus / isolation & purification, Hepatitis C, Chronic / virology, Humans, Kidney Failure, Chronic / therapy, Male, Middle Aged, Sofosbuvir / adverse effects, Sustained Virologic Response, Antiviral Agents, Benzimidazoles, Fluorenes, ledipasvir, sofosbuvir drug combination, Sofosbuvir

The treatment of chronic hepatitis C virus (HCV) infection in chronic hemodialysis patients remains an issue of great concern for nephrologists. In 2008 the kidney disease improving global outcomes working group suggested the use of pegylated interferon in end stage kidney disease patients treated by dialysis. Since then, series and some clinical trials on different direct-acting antiviral agents have shown better efficacy and tolerance than interferon-based regimens. Data on the efficacy, tolerance and the right dose of sofosbuvir in this population are still unclear. We report a case of chronic HCV genotype 1b infection in a 47-year-old patient on maintenance hemodialysis successfully treated by a combination of sofosbuvir and ledipasvir for 12 weeks. Evolution was marked by the complete regression of the hepatic cytolysis, a complete and sustained virologic response with HCV viral load undetectable for a 24 months follow-up period. No adverse reaction was found. The treatment of HCV genotype 1 or 4 infection in patients on maintenance hemodialysis is possible with sofosbuvir based regimens with a good efficacy/safety ratio in the absence of current recommended drugs for patients with eGFR<30ml/min/1.73m2. The prescription of sofosbuvir should be encouraged amongst this population in this setting.
Surgery on aggressive fibroma of the posterior compartment of the knee: A case report
Authors: R M S N Magetsari, M N S Irawan
Journal: Int J Surg Case Rep (2019)
Keywords: aggresive fibroma, popliteal, resection

Introduction:
Fibroma is a benign tumor. More than 99% fibroma arises from tendon sheaths or tendons. Aggressive Fibroma at posterior compartment knee is a rare case. This report presents one case of fibroma at posterior compartment of the knee with the treatment.
Case report:
A boy with 4-year history of knee discomfort and lump at posterior knee joint, no history of infection and trauma. Physical examination revealed a mass (10 × 9 × 7 cm) with limited Range of Motion extension 30°, flexion 70°. MRI revealed a soft tissue mass at posterior knee compartment. Histologic examination showed a circumscribed and lobulated hypo cellular mass containing spindle cells diagnosed as aggressive fibroma. The patient underwent popliteal resection. An ellipse incision was made 2 cm margin of skin around the biopsy site. Fasciocutaneous flaps were created and retracted to expose the posterior compartment. The tumor had a partial well-defined capsule, popliteal artery and vein embedded and pressing the sciatic nerve. The tumor and enveloping muscles were elevated from the base of the compartment. The sciatic nerve was preserved with epineurotomy. The popliteal artery was reconstructed with saphenous veins graft. After the tumor was resected, the heads of gastrocnemius were sutured to each other and to the hamstring muscles to cover popliteal space. After one year postoperative, there was a good vascularization, no recurrence and neurological deficit with Musculoskeletal Tumour Society Scoring System 80%.
Conclusion:
One year postoperative with popliteal resection surgery yields a good result. A follow-up is needed for risk of recurrence and malignancy.