OpenMed/multicare-articles huggingface dataset:
Successful use of recombinant activated factor VII (eptacog alfa, Novoseven®) in a refractory bleeding during pediatric cardiac surgery: a case report
Authors: Mariko Ishihara, Yoshikazu Miyamoto, Akihiro Taniguchi, Keiko Kinouchi
Journal: JA Clin Rep (2015)
Keywords: acquired hemophilia a, pediatric cardiac surgery, refractory bleeding, rfviia

A 2-year-and-7-month-old boy underwent an emergent reconstruction surgery of the right ventricle-pulmonary artery (RV-PA) conduit. Although he was successfully weaned from cardiopulmonary bypass (CPB) after reconstruction of the RV-PA conduit, the bleeding continued despite the massive transfusion of red blood cell (RBC), fresh frozen plasma (FFP), and platelets. Because of persistent bleeding and abnormal coagulation laboratory results, we administered the recombinant activated factor VII (rFVIIa), which was not approved for use in the treatment of post-CPB coagulopathy. After administration of rFVIIa, his coagulation data dramatically improved, the bleeding decreased, and the operation was able to be finished.
Secondary Aorto-Colonic Fistula: A Case Report and Literature Review of a Rare Complication after EVAR
Authors: Nattawadee Wiangphoem
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Background: Aorto-enteric fistula (AEF) is a rare but fatal condition. The incidence of the overall AEF was approximately 0.36-2%, but the incidence of the aorto-colonic fistula was scarcely reported. A history of abdominal pain, fever, or gastrointestinal bleeding (GIB) in a patient with a history of aortic intervention should be highly suspected of this condition. This report describes a patient with lower GIB after an endovascular aneurysm repair (EVAR) for a symptomatic abdominal aortic aneurysm (AAA). Case Presentation: A 65-year-old man with a history of EVAR for symptomatic AAA presented with a massive lower GIB for two weeks. He also had a history of left lower quadrant pain and low-grade fever. Diverticular disease was suspected, and medical treatment was administered. After the initial conservative treatment, a colonoscopy was performed. The findings showed a fistula that exposed an aortic stent graft at the left-sided colon. An aorto-colonic fistula was diagnosed. After administering intravenous (IV) antibiotics, a staged axillo-bifemoral bypass graft with aortic stent graft explantation was performed. The patient recovered well and was discharged home after a month of hospitalization and IV antibiotics. Conclusion: In a patient with a history of aortic intervention, any abdominal pain, unknown fever, or even GIB should be suspected of complications of aortic intervention. Highly suspicious of this rare condition is the key to an early diagnosis and prompt treatment.
Use of medicinal plants for human health in Udzungwa Mountains Forests: a case study of New Dabaga Ulongambi Forest Reserve, Tanzania
Authors: Rukia A Kitula
Journal: J Ethnobiol Ethnomed (2007)
MeSH terms: Community Participation, Conservation of Natural Resources, Ethnobotany, Forestry, Medicine, African Traditional, Research Support, Non-U.S. Gov't, Ecology, Female, Health Knowledge, Attitudes, Practice, Herbal Medicine / economics, Humans, Male, Phytotherapy / economics, Phytotherapy / statistics & numerical data, Socioeconomic Factors, Tanzania

The dependence of local people on plant medicine from natural forests has a long tradition in Tanzania and is becoming increasingly popular among rural and urban communities due to among others increase in living costs. The study on utilization of medicinal plants for meeting heath care needs was carried out between March 2001 and March 2002 in New Dabaga Ulongambi Forest Reserve, Tanzania. The study aimed at generating necessary data for the Udzungwa Mountains Forest Management project to draft sound Joint Forest Management plans. Specific objectives of the study among others were to assess knowledge associated with utilization of medicinal plants for health care needs as well as factors associated in using plant medicines in the study area. A questionnaire survey, market survey and literature review were used to collect information. Tools used for data analysis were Statistical Packages for Social Science and content analysis. A total of 45 plant species were documented curing about 22 human diseases. Medicinal plants were readily available throughout the year and plentiful in the forest reserve. Roots and leaves were the plant parts harvested for medicinal purposes. Processing of plant medicines involved boiling, pounding, soaking in water and chewing. Distance to health facility, income level of the household and beliefs contributed to the use of plant medicines. The study concluded that medicinal plants play an important role in providing primary health care to the rural communities. It is recommended that in achieving joint forest management (JFM), villagers adjacent to the forest reserve should be sensitised on the importance of JFM through seminars, workshops, drama, school songs or video show. During the development of a joint draft management plan, villagers as an informal institution must define their priority needs of use of parts of the forest in collaboration with the Udzungwa Mountains Forest Management project.
Collapsing Focal Segmental Glomerulosclerosis in a Patient with Acute Malaria
Authors: Najamus Sehar, Emad Gobran, Suzanne Elsayegh
Journal: Case Rep Med (2015)

Introduction. Collapsing focal segmental glomerulosclerosis (FSGS) is most commonly seen in association with HIV infection. Rare data is available about the association between collapsing FSGS and malaria. Case Description. A 72-year-old African male patient presented to the hospital for generalized body aches, fatigue, fever, and night sweats for three days. He had history of recent travel to Ghana. Patient looked in acute distress and was shivering. Laboratory tests showed elevated serum creatinine (Cr) of 2.09 mg/dL (baseline was 1.5 mg/dL in 2012). Hospital course was significant for rapid elevation of Cr to 9.5 mg/dL and proteinuria of 7.9 grams. Autoimmune studies resulted negative. Blood smear resulted positive for Plasmodium falciparum and patient was treated with Artemether/Lumefantrine. Patient's fever and pain improved, but kidney function continued to deteriorate and he became oliguric. On day seven, he was started on Hemodialysis. Tests for different causes of glomerular pathology were also negative. He underwent left kidney biopsy which resulted in findings consistent with severe collapsing glomerulopathy. Discussion. This case illustrates a biopsy proven collapsing FSGS likely secondary to malarial infection requiring renal replacement therapy. Literature review revealed only few case reports that suggested the possible association of malaria with secondary form of FSGS.
A Case Report of Allergic Contact Dermatitis due to Mandragora Radix
Authors: Sevim Baysak, Müzeyyen Gönül, Damla Atacan, Can Ergin
Journal: Case Reports Immunol (2015)

An 82-year-old male presented with rash, burning, and itching on his knees that had started 4 days after the local application of Mandragora Radix sap for 3 consecutive days. A dermatological examination revealed erythematous, edematous, and scaly plaque lesions on the patient's knees. An open application test with M. Radix was performed, and the patient was diagnosed with allergic contact dermatitis due to M. Radix. Mandragora species, which belong to the Solanaceae family, have sedative, aphrodisiac, emetic, analgesic, and anesthetic properties. To the best of our knowledge, only one case of M. Radix-induced allergic contact dermatitis has been previously reported.
Case report: ATIC-ALK fusion in infant-type hemispheric glioma and response to lorlatinib
Authors: Shubin W Shahab, Matthew Schniederjan, Jose Velazquez Vega, Stephen Little, Andrew Reisner, Tobey MacDonald, Dolly Aguilera
Journal: Front Oncol (2023)
Keywords: alk fusion, case report, high grade glioma, infant-type hemispheric glioma, lorlatinib
MeSH terms: Case Reports

Introduction:
Infant type hemispheric gliomas are a rare tumor with unique molecular characteristics. In many cases these harbor mutations in receptor tyrosine kinase pathways and respond to targeted therapy. Here we describe the case of an infant with this type of tumor with a novel ATIC-ALK fusion that has responded dramatically to the ALK inhibitor lorlatinib, despite being refractory to standard chemotherapy.
Case description:
The infant was initially treated with standard chemotherapy and found to have an ATIC-ALK fusion. When surveillance imaging revealed progressive disease, the patient was switched to the ALK-inhibitor lorlatinib at 47 mg/m2/day. The patient demonstrated a significant clinical and radiographic response to the ALK inhibitor lorlatinib after just 3 months of treatment and a near complete response by 6 months of therapy.
Conclusion:
The ALK inhibitor lorlatinib is an effective targeted therapy in infant type hemispheric glioma patients harboring ATIC-ALK fusion.
Necrotizing Fasciitis by Two Anaerobic Bacteria in an Immunocompetent Patient after Minor Trauma: A Case Report
Authors: Marco Sciarra, Andrea Schimmenti, Tommaso Manciulli, Cristina Sarda, Marco Mussa, Laura Sacco, Bianca Mariani, Angela Maria Di Matteo, Paolo Orsolini
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Necrotizing fasciitis (NF) is a soft tissue infection affecting subcutaneous tissue and the muscular fascia without involvement of the muscle and can be either monomicrobial or polymicrobial. Monomicrobial infections are usually caused by group A streptococci, while infections caused by anaerobic germs usually affect immunodepressed patients. We report a rare case of NF caused by two anaerobic bacteria in an immunocompetent patient.
Unusual presentation of phacolytic glaucoma: simulating microbial keratitis
Authors: Srikant Kumar Sahu, Siddharth Keswarwani, Ruchi Mittal
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

The differential diagnoses for phacolytic glaucoma are acute angle closure glaucoma, open angle glaucoma with uveitis, neovascular glaucoma, and glaucoma secondary to trauma. We report an unusual case where the dislocated cataractous lens firmly adherent to the corneal endothelium evoked a cellular reaction similar to phacolytic glaucoma but clinically appeared like a deep corneal abscess. The 73-year-old lady presented with severe photophobia, pain, and redness in the left eye for two months despite being on antibiotics and antifungals. Anterior chamber wash revealed a cataractous lens buried within the infiltrate, which was removed and sent for histopathological examination. Postoperatively she was treated with topical ofloxacin, homatropine, dorzolamide, timolol, and tapering dose of steroids. Histological confirmation of inflammation, histiocytic response, and giant cells around the lens material confirmed the ongoing phacolytic process. Photophobia, pain, and redness subsided following removal of the lens and surrounding cellular reaction. At her last visit, four months after surgery, she was comfortable.
Carbamazepine-Induced Toxic Epidermal Necrolysis Managed by Mobile Teledermatology in COVID-19 Pandemic in Rural Nepal
Authors: Vikash Paudel, Deepa Chudal
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

Toxic epidermal necrolysis is a life-threatening dermatological emergency with high mortality if not treated in time. Here we report a case of toxic epidermal necrolysis due to carbamazepine in rural Nepal in COVID-19 pandemic who was successfully treated with the help of mobile teledermatology. The clinical impression of toxic epidermal necrolysis was made from "WhatsApp" video calls using a smart phone. The supportive features were the history of starting of carbamazepine 2 weeks prior for seizure disorder, clinical findings in serial photographs of skin with 40 percent body surface area involvement of necrotic skin lesions and bulla, and involvement of oral mucosa and eyes. The patient was immediately asked to stop carbamazepine and was treated with intravenous fluids and systemic steroids along with symptomatic management. As the whole world was suffering from lockdown due to COVID-19 crisis, it was impossible for the rural area patient to visit a dermatologist. Thus, with the help of paramedics staff in a community health center and mobile teledermatology, the patient was diagnosed as carbamazepine-induced toxic epidermal necrolysis and treated successfully with good outcome.
Inescapable Fibrosis: The Development of Desquamative Interstitial Pneumonia Post-Lung Transplantation Performed for a Patient with Idiopathic Pulmonary Fibrosis
Authors: Paul Lilburn, Divya Pillutla, Vanathi Sivasubramaniam, Marshall Plit
Journal: Case Rep Transplant (2023)
MeSH terms: Case Reports

Interstitial lung disease is characterised by a combination of cellular proliferation, inflammation of the interstitium and fibrosis within the alveolar wall. A 58-year-old man was referred for lung transplantation after developing worsening dyspnoea and progressive hypoxaemic respiratory failure from idiopathic pulmonary fibrosis. Three years later, he developed desquamative interstitial pneumonia in his transplanted lungs, and despite augmentation of immune suppression, he had a progressive decline in his lung function and exercise capacity. Interestingly, in our case, the histopathology obtained post transplant strongly goes against the recurrence of usual interstitial pneumonia/idiopathic pulmonary fibrosis; rather, two separate interstitial disease processes have been identified.
Misdiagnosis of bland-white-garland syndrome: report of two cases with different presentations
Authors: Akbar Molaei, Bahman Rastkar Hemmati, Hashem Khosroshahi, Madjid Malaki, Roya Zakeri
Journal: J Cardiovasc Thorac Res (2014)
Keywords: alcapa syndrome, dilated cardiomyopathy, prolapsed mitral valve
MeSH terms: Case Reports

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) or Bland-White-Garland syndrome is usually an isolated cardiac anomaly but, in rare incidences, has been described with patent ductus arteriosus, ventricular septal defect, and tetralogy of Fallot. This syndrome may cause sudden death in infants and young people but in this case report we present two different types of presentation. First case was a 3 year old girl diagnosed with dilated cardiomyopathy since her infancy. Her electrocardiography showed prominent Q wave in lateral leads. Dilated right coronary artery was revealed by echocardiography. The second case was a girl with prolapsed mitral valve and chest pain but similar to first case she had prominent Q wave in lateral leads at her electrocardiography and dilated right coronary artery but without heart failure. ALCAPA in children may present with ambiguous presentations differing from dilated cardiomyopathy and full blown heart failure to an atypical chest pain attributed to prolapsed mitral valve.
Actinomycotic brain abscess
Authors: Maryam Rahiminejad, Harutomo Hasegawa, Marios Papadopoulos, Andrew MacKinnon
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Actinomycosis is caused by Gram-positive filamentous anaerobic organisms of genus Actinomyces, which are commensals of mucosal membranes of the oropharyngeal cavity, and gastrointestinal and genitourinary tracts. Central nervous system involvement is rare and may present as cerebral abscess, meningitis, meningoencephalitis, subdural empyema or epidural abscess. The radiological appearances of actinomycotic brain abscesses are not well recognized. Here, we present the characteristic imaging features of an actinomycotic brain abscess.
Cutaneous Polyarteritis Nodosa Presenting Atypically with Severe Pharyngeal Ulceration
Authors: Bayanne Olabi, Justin C Mason, Ziad Farah
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Polyarteritis nodosa (PAN) is a multisystem, necrotising vasculitis of small- and medium-sized arteries with a predilection for the visceral vessels. Cutaneous PAN is a rare variant with symptomatic vasculitis limited to the skin, typically presenting as nodular lesions on the extremities with a propensity to ulcerate. We describe a rare case of histologically confirmed cutaneous PAN presenting in a 55-year-old Ghanaian woman with severe oropharyngeal ulceration. This was associated with dysphagia and significant weight loss. Oesophagoduodenoscopy showed that the ulceration extended throughout the oropharynx. Systemic polyarteritis nodosa was ruled out with magnetic resonance angiography. Our patient was treated successfully with corticosteroids and methotrexate. This case suggests that cutaneous PAN should be considered in the differential diagnosis of patients with oropharyngeal ulceration and that histological assessment is pivotal in establishing the diagnosis early in order to instigate appropriate therapy.
Reduction of Behavioral Psychological Symptoms of Dementia by Multimodal Comprehensive Care for Vulnerable Geriatric Patients in an Acute Care Hospital: A Case Series
Authors: Miwako Honda, Mio Ito, Shogo Ishikawa, Yoichi Takebayashi, Lawrence Tierney Jr
Journal: Case Rep Med (2016)

Management of Behavioral and Psychological Symptoms of Dementia (BPSD) is a key challenge in geriatric dementia care. A multimodal comprehensive care methodology, Humanitude, with eye contact, verbal communication, and touch as its elements, was provided to three geriatric dementia patients for whom conventional nursing care failed in an acute care hospital. Each episode was evaluated by video analysis. All patients had advanced dementia with BPSD. Failure of care was identified by patient's shouting, screaming, or abrupt movements of limbs. In this case series, conventional care failed for all three patients. Each element of care communication was much shorter than in Humanitude care, which was accepted by the patients. The average of the elements performed during the care was eye contact 0.6%, verbal communication 15.7%, and touch 0.1% in conventional care and 12.5%, 54.8%, and 44.5% in Humanitude care, respectively. The duration of aggressive behavior of each patient during care was 25.0%, 25.4%, and 66.3% in conventional care and 0%, 0%, and 0.3% in Humanitude, respectively. In our case series, conventional care was provided by less eye contact, verbal communication, and touch. The multimodal comprehensive care approach, Humanitude, decreased BPSD and showed success by patients' acceptance of care.
Mobile thrombi in three chambers of the heart
Authors: Rachel Kunkler, David Scott Weisman, Ijaz Khan
Journal: J Community Hosp Intern Med Perspect (2013)
Keywords: mobile heart thrombi, patent foramen ovale, thromboemboli
MeSH terms: Case Reports

A case report of pulmonary embolus complicated by mobile thrombus in three chambers of the heart with emphasis on treatment and management options.
Using electromagnetic navigation for intraoperative rib fracture localization during rib plating: A case report
Authors: Rodrigo Pedraza, Edward Y Chan, Leonora M Meisenbach, Min P Kim
Journal: Int J Surg Case Rep (2018)
Keywords: case report, electromagnetic navigation, rib fixation, rib fractures, rib plating

Introduction:
The precise localization of fractured ribs represents one of the primary challenges of surgical rib fixation. Computed tomography (CT) provides the facture's general location, but it is difficult to use the imaging alone to properly place a surgical incision. We used electromagnetic navigation to identify the exact location of the fracture on the patient's skin.
Presentation of case:
A 64-year-old man fell and suffered multiple left-sided nonunion rib fractures (4th to 9th). He was initially treated with a chest tube and analgesia, but he developed chronic pain from the injury. On the CT scan of the chest, the rib fractures were displaced and on exam, the ribs were mobile with reproducible pain and clicks on palpation. We used electromagnetic navigation to determine the fracture's exact location on the skin during the operation, which aided in the location of the incision. The patient had open reduction and internal fixation of the broken ribs using rib plates. The patient had relief from his chronic pain after the surgery.
Discussion:
The localization of the rib fracture on a patient's skin can be performed using a physical exam, landmarks from the CT scan, or video-assisted thoracic surgery (VATS) procedure. Each of the techniques sacrifices either time or accuracy during the operation. The electromagnetic navigation can provide precise localization of the fracture without sacrificing too much time during the operation.
Conclusion:
The use of electromagnetic navigation to identify the fracture on a patient's skin provides quick and accurate intraoperative localization for surgical rib fixation.
Total Hip Arthroplasty in a Patient with Oto-Spondylo-Megaepiphyseal Dysplasia Planned by Three-Dimensional Motion Analyses and Full-Scale Three-Dimensional Plaster Model of Bones
Authors: Takeyuki Tanaka, Hideya Ito, Hirofumi Oshima, Nobuhiko Haga, Sakae Tanaka
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We present the case of a 28-year-old woman with oto-spondylo-megaepiphyseal dysplasia, which is a rare skeletal disorder, who underwent bilateral total hip arthroplasty. Full-scale three-dimensional plaster model of the acetabulum and the femur provided us with a feasible preoperative plan. Pre- and postoperative three-dimensional motion analyses proved a significant improvement in her ambulation and confirmed the efficacy of total hip arthroplasty. In conclusion, full-scale three-dimensional plaster models of the bone and three-dimensional motion analyses were useful for total hip arthroplasty in patients with skeletal dysplasia.
Screening for y chromosome microdeletion in a nonobstructive azoospermic male patient with allogeneic bone marrow transplantation from his sister
Authors: Hakan Gurkan, Faruk Kucukdurmaz, Tolga Akman, Filiz Aydın, Ates Kadioglu
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Genomic DNA of a patient diagnosed with nonobstructive azoospermia and with the history of allogenic bone marrow transplantation from his sister due to chronic myeloid leukemia was isolated from peripheral blood in order to screen Y chromosome microdeletions. 13 short tagged sites belonging to AZF a, b, and c loci were detected with multiplex polymerase chain reaction technique. Bands were determined in ZFX/ZFY wells, whereas no bands were determined in wells of other STS regions. DNA isolation was done from buccal mucosa smear to obtain genomic DNA from patient's own cells and multiplex polymerase chain reaction technique was performed again. Bands were seen in all wells of 13 STS regions. Y chromosome microdeletion was not detected in the patient. In conclusion, genomic DNA isolation in patients undergoing BMT should be done from patients' own cells.