OpenMed/multicare-articles huggingface dataset:
Minimally Invasive Treatment for Tibial Malrotation after Locked Intramedullary Nailing
Authors: Kyohei Takase, Sang Yang Lee, Takahiro Waki, Tomoaki Fukui, Keisuke Oe, Tomoyuki Matsumoto, Takehiko Matsushita, Kotaro Nishida, Ryosuke Kuroda, Takahiro Niikura
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Rotational malreduction is a potential complication of intramedullary nailing for tibial shaft fractures. We experienced a symptomatic case of a 24° externally rotated malunion that we treated with minimally invasive corrective osteotomy. A 49-year-old man sustained a tibial shaft spiral fracture with a fibula fracture. He had been initially treated elsewhere with a reamed statically locked intramedullary nail. Bone union had been obtained, but he complained of asymmetry of his legs, difficulty walking and running, and the inability to ride a bicycle. We decided to perform corrective osteotomy in a minimally invasive fashion. After a 1 cm incision was made at the original fracture site, osteotomy for the affected tibia was performed with an osteotome after multiple efforts at drilling around the nail with the aim of retaining it. Fibula osteotomy was also performed at the same level. Two Kirschner wires that created an affected rotational angle between the fragments were inserted as a guide for correction. The distal locking screws were removed. Correct rotation was regained by matching the two wires in a straight line. Finally, the distal locking screws were inserted into new holes. The patient obtained bony union and has returned to his preinjury activities with no symptoms.
Complete Laparoscopic Extirpation of a Giant Ovarian Cyst in an Adolescent
Authors: Saeed Baradwan, Feras Sendy, Sameer Sendy
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

The giant ovarian serous cystadenoma is a rare finding and often benign. The use of the laparoscopic approach versus open approach for the management of huge ovarian cysts is controversial. We report a case of a 27-year-old woman with a history of increasing abdominal girth over a period of two years along with radiological investigations revealed a large tumor arising from the right ovary treated by complete laparoscopic extirpation of a giant ovarian cyst. The complete laparoscopic approach for huge cyst is a feasible treatment when having a normal tumor marker profile and benign imaging appearance. In addition to the advantages of laparoscopic surgery, it is less invasive, with perfect cosmetic outcome and shorter hospital stay, which are particularly important for young women.
What Have We Learnt About the Treatment of Juvenile-Onset Systemic Lupus Erythematous Since Development of the SHARE Recommendations 2012?
Authors: Kathy L Gallagher, Pallavi Patel, Michael W Beresford, Eve Mary Dorothy Smith
Journal: Front Pediatr (2022)
Keywords: antiphospholipid syndrome, biologics, childhood-onset systemic lupus erythematous, juvenile-onset systemic lupus erythematous, lupus nephritis, pediatric rheumatology, treatment
MeSH terms: Review

Introduction:
Juvenile-onset systemic lupus erythematous (JSLE) is a rare multisystem autoimmune disorder. In 2012, the Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) initiative developed recommendations for the diagnosis/management of JSLE, lupus nephritis (LN) and childhood-onset anti-phospholipid syndrome (APS). These recommendations were based upon available evidence informing international expert consensus meetings.
Objective:
To review new evidence published since 2012 relating to the management of JSLE, LN and APS in children, since the original literature searches informing the SHARE recommendations were performed.
Method:
MEDLINE, EMBASE and CINAHL were systematically searched for relevant literature (2012-2021) using the following criteria: (1) English language studies; (2) original research studies regarding management of JSLE, LN, APS in children; (3) adult studies with 3 or more patients <18-years old, or where the lower limit of age range ≤16-years and the mean/median age is ≤30-years; (4) randomized controlled trials (RCTs), cohort studies, case control studies, observational studies, case-series with >3 patients. Three reviewers independently screened all titles/abstracts against predefined inclusion/exclusion criteria. All relevant manuscripts were reviewed independently by at least two reviewers. Data extraction, assessment of the level of evidence/methodological quality of the manuscripts was undertaken in-line with the original SHARE processes. Specific PUBMED literature searches were also performed to identify new evidence relating to each existing SHARE treatment recommendation.
Results:
Six publications met the inclusion/exclusion criteria for JSLE: three RCTs, one feasibility trial, one case series. For LN, 16 publications met the inclusion/exclusion criteria: eight randomized trials, three open label prospective clinical trials, five observational/cohort studies. For APS, no publications met the inclusion criteria. The study with the highest evidence was an RCT comparing belimumab vs. placebo, including 93 JSLE patients. Whilst the primary-endpoint was not met, a significantly higher proportion of belimumab-treated patients met the PRINTO/ACR cSLE response to therapy criteria. New evidence specifically addressing each SHARE recommendation remains limited.
Conclusion:
Since the original SHARE literature searches, undertaken >10-years ago, the main advance in JSLE treatment evidence relates to belimumab. Additional studies are urgently needed to test new/existing agents, and assess their long-term safety profile in JSLE, to facilitate evidence-based practice.
The Benefits of an In-Office Arthroscopy in the Diagnosis of Unresolved Knee Pain
Authors: Garrett L Chapman, Nirav H Amin
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We report a patient who developed persistent knee pain with mechanical symptoms after an uncomplicated patellofemoral arthroplasty. The etiology of his knee pain remained inconclusive following magnetic resonance imaging due to metallic artifact image distortion. With the use of an in-office needle arthroscopy, an immediate and definitive diagnosis was obtained, preventing an unnecessary surgery for a diagnostic arthroscopy. We discovered a lateral meniscus tear, an anterior cruciate ligament tear, and a medial femoral condyle chondral defect for which the patient underwent arthroscopic partial meniscectomy, ligament reconstruction, and osteochondral allograft transplantation, with resolution of his knee pain.
Visual Loss Caused by Central Retinal Artery Occlusion After Bee Sting: A Case Report
Authors: Zhitao Su, Zhongli Hu, Lei Wang, Yao Wang, Xiaoyun Fang, Panpan Ye
Journal: Front Med (Lausanne) (2021)
Keywords: bee sting, case report, central retinal artery occlusion, thrombosis, venom
MeSH terms: Case Reports

A bee sting can lead to an extremely rare case of visual loss caused by central retinal artery occlusion (CRAO). In this study, we report a 66-year-old healthy woman who was referred to our Eye Center because of visual loss, which had occurred after bee sting 2 days earlier. The visual acuity was no light perception (NLP). Examination revealed left eyelid edema, conjunctiva congestion, a 6-mm fixed pupil, scattered retinal hemorrhage, and white-appearing ischemic retina with one small area of the normal-appearing retina temporal to the optic disk. Fundus fluorescein angiography revealed CRAO with one cilioretinal artery sparing. Her systemic workup revealed hypersensitivity, hypercoagulable state, myocardial damage, and hepatic damage. After topical and systemic treatments, the visual acuity was still NLP with improved systemic workup. In brief, CRAO may occur after bee sting, and visual acuity should be monitored for early diagnosis.
Acute ST Elevation Myocardial Infarction in Patients With Immune Thrombocytopenia Purpura: A Case Report
Authors: Sandeep K Dhillon, Edwin Lee, John Fox, Maurice Rachko
Journal: Cardiol Res (2011)
Keywords: acute myocardial infarction, asprin allergy, immune thrombocytopenic purpura, percutanous coronary intervention, platelet count
MeSH terms: Case Reports

Acute myocardial infarction (AMI) in patients with immune thrombocytopenic purpura (ITP) is rare. We describe a case of AMI in patient with ITP. An 81-year-old woman presented with acute inferoposterior MI with low platelet count on admission (34,000/µl). Coronary angiography revealed significant mid right coronary artery (RCA) stenosis with thrombus, subsequently underwent successful percutaneous coronary intervention (PCI). In some patients with immune thrombocytopenia purpura and acute myocardial infarction, percutaneous coronary intervention is a therapeutic option.
Laparoscopic Repair of a Left Retrocaval Ureter in a 16-Year-Old Girl
Authors: Anna Kadar, Lorena Vatra, Anca Avram, Daniela Stoica, Marcel Oancea
Journal: European J Pediatr Surg Rep (2018)
Keywords: fish hook sign, laparoscopic ureteroureterostomy, left circumcaval ureter, left retrocaval ureter, situs inversus
MeSH terms: Case Reports

Left retrocaval ureter is an extremely rare congenital malformation which is associated with situs inversus, duplicated or translated inferior vena cava (IVC). We report a female adolescent who presented with a history of intermittent, colicky lumbar pain. Diagnostic workup revealed left retrocaval ureter and left ureterohydronephrosis. The girl underwent laparoscopy. The renal pelvis and ureter posterior to the vena cava were dissected, transected at the caudal point of the dilated ureteral segment, and uncrossed and repositioned lateral to the vena cava. Ureteroureterostomy was performed over a double-J ureteral stent after spatulation of the distal ureter. The postoperative course was uneventful and the ureteral stent removed after 5 weeks. During follow-up, the patient is symptom-free. Our case demonstrates that our laparoscopic approach is feasible in this rare anatomic anomaly.
Successfull management of a cervical oesophageal injury after an anterior cervical approach: a case report
Authors: Omar Boulahroud, Abdelkrim Choho, Assou Ajja
Journal: Pan Afr Med J (2017)
Keywords: esophageal perforation, cervical spine surgery, sternocleidomastoid muscle flap
MeSH terms: Cervical Vertebrae / surgery, Esophageal Perforation / etiology, Esophagus / injuries, Postoperative Complications / surgery, Case Reports, Esophageal Perforation / surgery, Female, Humans, Middle Aged, Surgical Flaps

The anterior surgical approach for spinal repair, with or without the insertion of stabilizing hardware, is an established procedure in the management of anterior cervical spine (ACS) pathology. Esophageal injury during this approach is a rare complication that can be life threatening. No treatment protocol has yet been standardized. In addition to conservative measures, several surgical approaches have been presented, ranging from primary repair to reconstruction with local, regional, or distant flaps. The SCM muscle flap, used as reinforcement of a primary suture or as a patch to the lesion is in our opinion an effective treatment for persisting or recurring esophageal fistulae after anterior cervical spine surgery.
Secondary Bacterial Infections in Patients With Viral Pneumonia
Authors: Prasanth Manohar, Belinda Loh, Ramesh Nachimuthu, Xiaoting Hua, Susan C Welburn, Sebastian Leptihn
Journal: Front Med (Lausanne) (2020)
Keywords: covid-19, sars, sars-cov-2, antibiotic resistance, influenza, pulmonary viruses, secondary bacterial infection, viral pneumonia
MeSH terms: Review

Pulmonary diseases of viral origin are often followed by the manifestation of secondary infections, leading to further clinical complications and negative disease outcomes. Thus, research on secondary infections is essential. Here, we review clinical data of secondary bacterial infections developed after the onset of pulmonary viral infections. We review the most recent clinical data and current knowledge of secondary bacterial infections and their treatment in SARS-CoV-2 positive patients; case reports from SARS-CoV, MERS-CoV, SARS-CoV2 and the best-studied respiratory virus, influenza, are described. We outline treatments used or prophylactic measures employed for secondary bacterial infections. This evaluation includes recent clinical reports of pulmonary viral infections, including those by COVID-19, that reference secondary infections. Where data was provided for COVID-19 patients, a mortality rate of 15.2% due to secondary bacterial infections was observed for patients with pneumonia (41 of 268). Most clinicians treated patients with SARS-CoV-2 infections with prophylactic antibiotics (63.7%, n = 1,901), compared to 73.5% (n = 3,072) in all clinical reports of viral pneumonia included in this review. For all cases of viral pneumonia, a mortality rate of 10.9% due to secondary infections was observed (53 of 482). Most commonly, quinolones, cephalosporins and macrolides were administered, but also the glycopeptide vancomycin. Several bacterial pathogens appear to be prevalent as causative agents of secondary infections, including antibiotic-resistant strains of Staphylococcus aureus and Klebsiella pneumoniae.
Case Report: Diabetes in Chinese Bloom Syndrome
Authors: Mingqun Deng, Miao Yu, Ruizhi Jiajue, Kai Feng, Xinhua Xiao
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: bloom syndrome, azoospermia, diabetes, leptin, short stature
MeSH terms: Bloom Syndrome / complications, Diabetes Mellitus, Type 1 / complications, Case Reports, Research Support, Non-U.S. Gov't, Bloom Syndrome / genetics, Diabetes Mellitus, Type 1 / genetics, Humans, Male, Mutation, RecQ Helicases / genetics, Young Adult, RecQ Helicases

Bloom syndrome (BS) is a rare autosomal recessive disorder that causes several endocrine abnormalities. So far, only one BS pedigree, without diabetes, has been reported in the Chinese population. We presented the first case of BS with diabetes in the Chinese population and explored the clinical spectrum associated with endocrine. Possible molecular mechanisms were also investigated. Our study indicated that BS may be one rare cause of diabetes in the Chinese population. We also found a new pathogenic sequence variant in BLM (BLM RecQ like helicase gene)(NM_000057.4) c.692T>G, which may expand the spectrum of BLM variants.
Herpes Proctitis in Men Mimicking Rectal Adenocarcinoma: Two Cases of an Easily Overlooked Diagnosis in the Proximal Rectum
Authors: Jing Sun, Reenu Malhotra, Lakshmi Ananthakrishnan, Purva Gopal
Journal: Case Rep Pathol (2023)
MeSH terms: Case Reports

We describe two cases of rectal herpes simplex virus (HSV) infection in men that clinically mimicked rectal adenocarcinoma. Herpes infection in this location more commonly presents as an anal mass with viral inclusions in squamous epithelial cells. We report these cases to increase awareness of the unusual presentation as a proximal rectal mass with viral inclusions in endothelial cell nuclei. One patient was HIV-positive, and the other one had a history of having sex with men (MSM). Both patients had a thickened rectal wall with prominent lymphadenopathy on computed tomography (CT) scan, suspecting for malignancy. Biopsy showed abundant granulation tissue, necrosis, and inflammatory infiltrate composed predominantly of lymphocytes with admixed numerous plasma cells, eosinophils, and neutrophils. Rare granulation tissue vessels were lined by endothelial cells with nuclear molding and chromatin margination, and nuclei that were positive for HSV immunohistochemistry (IHC). One patient had confirmatory viral culture from biopsy of the ulcerated rectal mass. Both patients had symptom resolution following treatment for HSV. HSV should be considered in the differential diagnosis of rectal inflammatory masses, particularly in immunocompromised, HIV-positive, and MSM patients.
A Rare Case of Spontaneous Empyema by Clostridium perfringens
Authors: Sijan Basnet, Izza Mir, Elan Mohanty, Rashmi Dhital, Biswaraj Tharu, Dilli Ram Poudel
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Empyema caused by clostridial infections is rare especially in the absence of invasive thoracic procedures. We present the case of an 81-year-old man without a history of preceding trauma who presented with shortness of breath and nonproductive cough and grew Clostridium perfringens only in the pleural cavity. He was predisposed to the infection due to his swallowing dysfunction. He was treated with penicillin and chest tube placement for drainage and subsequently improved.
Osteoid osteoma of the distal humerus mimicking sequela of pediatric supracondylar fracture: arthroscopic resection-case report and a literature review
Authors: Jordi Font Segura, Sergi Barrera-Ochoa, Albert Gargallo-Margarit, Eva Correa-Vázquez, Anna Isart-Torruella, Xavier Mir Bullo
Journal: Case Rep Med (2013)

Osteoid osteoma (OO) is a small and painful benign osteoblastic tumour located preferentially in the shaft of long bones near the metaphyseal junctions, with a predilection for the lower limbs. Juxta- and intra-articular OOs are rare and even though hip, elbow, and talus are the most commonly reported locations, they may be found in any joint accounting for approximately 13% of all osteoid osteomas. There is usually a significant time delay between symptom initiation and diagnosis when the lesion is present in an uncommon location due to the diagnostic challenge it presents due to the lack of classical clinical signs and/or radiographic features found in the extra-articular lesions. A case of a distal humerus OO of a 15-year-old girl is presented to point out that a confounding factor, such as a previous paediatric supracondylar fracture, may further delay the already difficult diagnosis of a juxta- or intra-articular osteoid osteoma and also to emphasize the possibility of arthroscopic treatment of such lesions.
Evaluating case management as a complex intervention: Lessons for the future
Authors: Anne-Sophie Lambert, Catherine Legrand, Sophie Cès, Thérèse Van Durme, Jean Macq
Journal: PLoS One (2019)
MeSH terms: Case Management / economics, Case Management / standards, Case Management / trends, Research Support, Non-U.S. Gov't, Aged, Aged, 80 and over, Belgium, Case-Control Studies, Female, Frail Elderly, Humans, Male, Primary Health Care

The methodological challenges to effectiveness evaluation of complex interventions has been widely discussed. Bottom-up case management for frail older person was implemented in Belgium, and indeed, it was evaluated as a complex intervention. This paper presents the methodological approach we developed to respond to four main methodological challenges regarding the evaluation of case management: (1) the standardization of the interventions, (2) stratification of the frail older population that was used to test various modalities of case management with different risks groups, (3) the building of a control group, and (4) the use of multiple outcomes in evaluating case management. To address these challenges, we developed a mixed-methods approach that (1) used multiple embedded case studies to classify case management types according to their characteristics and implementation conditions; and (2) compared subgroups of beneficiaries with specific needs (defined by Principal Component Analysis prior to cluster analysis) and a control group receiving 'usual care', to evaluate the effectiveness of case management. The beneficiaries' subgroups were matched using propensity scores and compared using generalized pairwise comparison and the hurdle model with the control group. Our results suggest that the impact of case management on patient health and the services used varies according to specific needs and categories of case management. However, these equivocal results question our methodological approach. We suggest to reconsider the evaluation approach by moving away from a viewing case management as an intervention. Rather, it should be considered as a process of interconnected actions taking place within a complex system.
Gastrocolic Fistula: A Shortcut through the Gut
Authors: Nauzer Forbes, Raed Al-Dabbagh, Peter Lovrics, David Morgan
Journal: Can J Gastroenterol Hepatol (2016)
MeSH terms: Colonic Diseases / etiology, Gastric Fistula / etiology, Intestinal Fistula / etiology, Peptic Ulcer / complications, Case Reports, Review, Humans, Male, Middle Aged

Gastrocolic fistulas are observed in association with several conditions. Traditionally, peptic ulcer disease was commonly implicated in the formation of gastrocolic fistulas; however, this is now a rare etiology. Here, we present a case of gastrocolic fistula secondary to peptic ulcer disease alone, in addition to reviewing the literature and providing options for diagnosis and treatment.
Identification and functional analysis of a novel von Willebrand factor mutation in a family with type 2A von Willebrand disease
Authors: Jing Dong, Xiaojuan Zhao, Sensen Shi, Zhenni Ma, Meng Liu, Qingyu Wu, Changgeng Ruan, Ningzheng Dong
Journal: PLoS One (2012)
MeSH terms: Mutation, von Willebrand Disease, Type 2 / genetics, von Willebrand Factor / genetics, Case Reports, Research Support, Non-U.S. Gov't, Base Sequence, Child, DNA Mutational Analysis, Exons / genetics, Family Health, Female, HEK293 Cells, Hemorrhage / blood, Hemorrhage / genetics, Humans, Male, Pedigree, Sequence Deletion, von Willebrand Disease, Type 2 / blood, von Willebrand Factor / metabolism, von Willebrand Factor

von Willebrand factor (VWF) is essential for normal hemostasis. VWF gene mutations cause the hemorrhagic von Willebrand disease (VWD). In this study, a 9-year-old boy was diagnosed as type 2A VWD, based on a history of abnormal bleeding, low plasma VWF antigen and activity, low plasma factor VIII activity, and lack of plasma high-molecular-weight (HMW) VWF multimers. Sequencing analysis detected a 6-bp deletion in exon 28 of his VWF gene, which created a mutant lacking D1529V1530 residues in VWF A2 domain. This mutation also existed in his family members with abnormal bleedings but not in >60 normal controls. In transfected HEK293 cells, recombinant VWF ΔD1529V1530 protein had markedly reduced levels in the conditioned medium (42±4% of wild-type (WT) VWF, p<0.01). The mutant VWF in the medium had less HMW multimers. In contrast, the intracellular levels of the mutant VWF in the transfected cells were significantly higher than that of WT (174±29%, p<0.05), indicating intracellular retention of the mutant VWF. In co-transfection experiments, the mutant reduced WT VWF secretion from the cells. By immunofluorescence staining, the retention of the mutant VWF was identified within the endoplasmic reticulum (ER). Together, we identified a unique VWF mutation responsible for the bleeding phenotype in a patient family with type 2A VWD. The mutation impaired VWF trafficking through the ER, thereby preventing VWF secretion from the cells. Our results illustrate the diversity of VWF gene mutations, which contributes to the wide spectrum of VWD.
Complete Resection of a Torcular Herophili Hemangiopericytoma without Sinus Reconstruction: A Case Report and Review of the Literature
Authors: Salah-Edine Safi, Julie Godfrain, Herbert Rooijakkers, Frederic Collignon
Journal: Case Rep Surg (2023)
MeSH terms: Case Reports

A 78-year-old woman presented to the emergency department with mild headaches and a sudden onset of blurred vision. Computerized tomography scan and magnetic resonance imaging showed what was described at first as a meningioma invading and occluding the torcular Herophili, the posterior third of the superior sagittal sinus and the proximal part of the right transverse sinus. Gross total resection of the tumor was performed without reconstructing dural sinuses. The patient was discharged home without new neurological deficit. Histopathology was in favor of a hemangiopericytoma Grade II World Health Organization (WHO). Total body positron emission tomography [18F]fluorodeoxyglucose found no secondary location. Radiotherapy was planned post-operatively.