OpenMed/multicare-articles huggingface dataset:
Treatment of Traumatic Intracranial Pseudoaneurysms: A Single-Center Experience
Authors: Yingwu Shi, Yuan Gao, Yufei Liu, Wenxing Cui, Gaoyang Zhou, Liang Wang, Jia Yu, Tao Zhang, Yan Qu, Jianping Deng, Shunnan Ge
Journal: Front Neurol (2021)
Keywords: endovascular treatment, parent artery, side branch artery, surgical treatment, traumatic intracranial pseudoaneurysms

Background and Purpose: As a rare lesion secondary to brain trauma, traumatic intracranial aneurysms (TICAs) lead to high mortality and morbidity, and multiple treatment modalities have been applied for TICAs. All patients diagnosed with TICAs in our institution from 2010 to 2020 were included in the report, and their clinical features, treatment, and outcomes are described in detail. The purpose of this study is to illustrate the characteristic of different therapeutic methods of TICAs, and focus on the endovascular treatment. Methods: A total of 20 patients were included in this study. The 3 patients who declined treatment all died. Five of the other 17 patients were treated surgically, including clipping, wrapping, and trapping with or without EC-IC high-flow bypass, with only 1 case of parent artery preservation. Twelve patients underwent endovascular treatment, including bare coil embolization (1 case), stent-assisted coiling (2 cases), balloon-assisted coils/Onyx glue embolization (1 case) and covered stents (8 cases), with only 1 case of parent artery sacrifice. Results: 20 patients were included in the present study with 17 males, and the mean of age on 27 years (IQR: 22, 44 years). Eight patients presented with epistaxis, followed by 5 patients with coma, 3 patients with visual defects and 2 patients with CSF leakage. There were 18 TICAs located at the internal carotid artery (ICA); The other 2 TICAs located at pericallosal artery and A1 segment anterior cerebral artery (ACA). One case of diplopia occurred due to sacrifice of the ICA. Occlusion of the ophthalmic artery occurred in 3 patients after placement of a covered stent, with 1 patient suffering an irreversible vision decrease. None of the other patients who underwent the treatment have experienced an aggravation of their symptoms since the treatment; During the imaging follow-up, 1 case of recurrence and 1 case of endoleak occurred in this case series. Conclusions: TICAs are associated with significant morbidity and mortality, and endovascular treatment has emerged as a valuable option, which may be promising to improve the clinical outcomes due to their advantages of preserving the parent artery if occlusion of the side branch artery can be avoided.
Postpartum aortic dissection. A case report and review of literature
Authors: Valeria Silvestri, Giuseppe Mazzesi, Rita Mele
Journal: Int J Surg Case Rep (2019)
Keywords: aortic dissection, case report, post-partum, pregnancy

Introduction:
Aortic dissection is a rare cardiovascular complication in pregnancy. Most of the cases occur during the third trimester of pregnancy, whilst 33% of cases are reported during the postpartum period.
Presentation of case:
We report the case of a multiparous 35-year-old patient with gestational hypertension treated for a type A aortic dissection on the second postpartum day. A review of literature on non-syndromic sporadic aortic dissection during the postpartum period is presented.
Discussion:
Aortic complications in pregnancy have been described in genetic syndromes or congenital aortic malformations but may also be non -syndromic and occur in the absence of any other risk factor. Pregnancy carries a 25-fold increase in relative risk for dissection. A review of the 16 cases published in literature from 1995 to December 2016 of non-syndromic, sporadic aortic dissections in pregnancy showed that the event may occur more frequently in the first week post-partum, be symptomatic for thoracic pain or dyspnoea. Type A aortic dissection accounts to 75% of cases. Mortality, despite surgical treatment, has been reported in 4 cases.
Conclusions:
Even though rarely reported, given the increasing incidence and the high mortality of aortic dissection in pregnancy, along with the potential challenge for two lives, clinician must consider aortic dissection in post-partum while dealing with differential diagnosis in post-partum patients in the emergency setting.
Case Report: Buccal administration of hydrogen-producing blend after a mild traumatic brain injury in a professional athlete
Authors: Dejan Javorac, Valdemar Stajer, Sergej M Ostojic
Journal: F1000Res (2019)
Keywords: athlete, buccal administration, concussion, hydrogen, recovery, traumatic brain injury
MeSH terms: Athletic Injuries / drug therapy, Brain Concussion / drug therapy, Hydrogen / administration & dosage, Case Reports, Research Support, Non-U.S. Gov't, Administration, Buccal, Athletes, Humans, Male, Tablets, Tablets, Hydrogen

Background: Sport-related mild traumatic brain injury (TBI) is a serious trauma that could impair brain function of an injured athlete. Treatment solutions for mild TBI typically concentrate on complete rest, while non-traditional therapeutic options remain largely ineffective. Molecular hydrogen (H 2 ) is an innovative neuroprotective agent that can easily reach the brain, yet no data are available concerning its value as a first-aid intervention after a mild TBI. Case report: This case report demonstrates the efficacy and safety of a hydrogen-producing dissolving tablet administered buccally during the first 24 hours post-injury in a professional soccer player who suffered a mild TBI. The patient received a formulated dosage of hydrogen every 2 hours, with the first intervention given immediately after an initial examination (~ 15 min after the injury). The overall score for Sport Concussion Assessment Tool 2 (SCAT2), a standardized method of evaluating injured athletes for concussion, increased from 68 points (severe disruption) at baseline to 84 points (mild disruption) at 24-h follow-up. The patient reported no side effects of hydrogen intervention. Conclusions: This case has demonstrated that intensive consecutive therapy with oral transmucosal hydrogen formulation is a beneficial strategy with regard to the reduction of presence and severity of symptoms of sport-related mild TBI.
Bilateral facial nerve palsy: a diagnostic dilemma
Authors: Sohil Pothiawala, Fatimah Lateef
Journal: Case Rep Emerg Med (2012)
MeSH terms: Case Reports

Introduction. Bilateral facial nerve palsy (FNP) is a rare condition, representing less than 2% of all cases of FNP. Majority of these patients have underlying medical conditions, ranging from neurologic, infectious, neoplastic, traumatic, or metabolic disorders. Objective. The differential diagnosis of its causes is extensive and hence can present as a diagnostic challenge. Emergency physicians should be aware of these various diagnostic possibilities, some of which are potentially fatal. Case Report. We report a case of a 43-year-old female who presented to the emergency department with sequential bilateral facial nerve paralysis which could not be attributed to any particular etiology and, hence, presented a diagnostic dilemma. Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant.
Paranasal Rosai-Dorfman Disease with Osseous Destruction
Authors: Kevin Hur, Changxing Liu, Jeffrey A Koempel
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Rosai-Dorfman disease is a rare histiocytic proliferative disorder of unknown etiology typically characterized by cervical lymphadenopathy. Extranodal involvement often manifests in the head and neck region. We present a 10-year-old male who presented to our hospital with left epiphora from an aggressive paranasal mass invading the left orbit with osseous destruction. The mass was surgically biopsied and debulked with histopathological examination revealing Rosai-Dorfman disease. Although rarely found in the sinuses, Rosai-Dorfman disease should be considered when evaluating sinonasal masses.
Progressive multifocal leucoencephalopathy in AIDS camouflaged with catatonia: A wolf in sheep's clothing
Authors: Pradeep Kumar, M K Jain
Journal: Indian J Psychiatry (2006)
Keywords: aids, pml, akinetic mutism, catatonia

Progressive multifocal leucoencephalopathy (PML) may pose a clinical and diagnostic dilemma. The patient may remain in a protracted psychotic state with negative symptoms, without overt features of dementia. The condition blends with catatonia, and eventually with akinetic mutism in a patient of AIDS in the absence of clinical evidence of an immunocompromised state. The present case report highlights the need for an in-depth clinical, biochemical and MRI assessment of patients with catatonia and akinetic mutism. Stupor of an 'akinetic mutism' pattern seems an important indication for HIV screening, particularly in high-risk patients.
Isolated rupture of the corpus spongiosum with urethral injury diagnosed by pre-surgical MRI
Authors: Shuhei Yokoyama, Ichiro Tsuboi, Kohei Ogawa, Saori Yoshioka, Yusuke Kobayasi, Hirochika Nakajima, Taichi Nagami, Seigen Yamasaki, Koichiro Wada
Journal: IJU Case Rep (2022)
Keywords: mri, corpus spongiosum, direct incision, penile fracture
MeSH terms: Case Reports

Introduction:
Penile fracture is typically defined as the rupture of the corpus cavernosum.
Case presentation:
A 61-year-old man presented with swelling, pain, and bruising of his penis, along with gross hematuria. He reported that he sustained this injury while having sex with his wife. We suspected a penile fracture and obtained magnetic resonance imaging, which showed a rupture of the ventral corpus spongiosum and clarified the appropriate approach for repair. We used a direct transverse incision to repair both the urethral injury and the corpus spongiosum. Surgery went well, without any significant intraoperative or postoperative complications. We removed the urinary catheter on postoperative day 8, and cystoscopy showed no urethral stenosis on postoperative day 17. The patient's postoperative erectile function was the same as before his injury.
Conclusion:
Magnetic resonance imaging was useful for detect the site of rupture. Ventral direct transverce incision made him a good clinical course.
Novel Variants in Individuals with RYR1-Related Congenital Myopathies: Genetic, Laboratory, and Clinical Findings
Authors: Joshua J Todd, Muslima S Razaqyar, Jessica W Witherspoon, Tokunbor A Lawal, Ami Mankodi, Irene C Chrismer, Carolyn Allen, Mary D Meyer, Anna Kuo, Monique S Shelton, Kim Amburgey, Dmitriy Niyazov, Pierre Fequiere, Carsten G Bönnemann, James J Dowling, Katherine G Meilleur
Journal: Front Neurol (2018)
Keywords: ryr1, genotype, magnetic resonance imaging, neuromuscular, phenotype
MeSH terms: Case Reports

The ryanodine receptor 1-related congenital myopathies (RYR1-RM) comprise a spectrum of slow, rare neuromuscular diseases. Affected individuals present with a mild-to-severe symptomatology ranging from proximal muscle weakness, hypotonia and joint contractures to scoliosis, ophthalmoplegia, and respiratory involvement. Although there is currently no FDA-approved treatment for RYR1-RM, our group recently conducted the first clinical trial in this patient population (NCT02362425). This study aimed to characterize novel RYR1 variants with regard to genetic, laboratory, muscle magnetic resonance imaging (MRI), and clinical findings. Genetic and histopathology reports were obtained from participant's medical records. Alamut Visual Software was used to determine if participant's variants had been previously reported and to assess predicted pathogenicity. Physical exams, pulmonary function tests, T1-weighted muscle MRI scans, and blood measures were completed during the abovementioned clinical trial. Six novel variants (two de novo, three dominant, and one recessive) were identified in individuals with RYR1-RM. Consistent with established RYR1-RM histopathology, cores were observed in all biopsies, except Case 6 who exhibited fiber-type disproportion. Muscle atrophy and impaired mobility with Trendelenburg gait were the most common clinical symptoms and were identified in all cases. Muscle MRI revealed substantial inter-individual variation in fatty infiltration corroborating the heterogeneity of the disease. Two individuals with dominant RYR1 variants exhibited respiratory insufficiency: a clinical symptom more commonly associated with recessive RYR1-RM cases. This study demonstrates that a genetics-led approach is suitable for the diagnosis of suspected RYR1-RM which can be corroborated through histopathology, muscle MRI and clinical examination.
Papillary Renal Cell Carcinoma in Lynch/Muir-Torre Syndrome with Germline Pathogenic Variant in MSH6 and Molecular Analysis: Report of a Case and Review of the Literature
Authors: Yu Yang, Shweta Dhar, Jennifer Taylor, Bhuvaneswari Krishnan
Journal: J Kidney Cancer VHL (2021)
Keywords: lynch syndrome, msh6 mutation, muir-torre syndrome, papillary renal cell carcinoma, colon adenocarcinoma
MeSH terms: Case Reports

Lynch syndrome (LS) is an autosomal dominant inherited disorder due to pathogenic variations in the mismatch repair genes, which predisposes to malignancies, most commonly colon and endometrial carcinoma. Muir-Torre syndrome is a subset of LS with cutaneous sebaceous adenoma and keratoacanthoma in addition to the malignancies. Renal cell carcinoma (RCC) in patients with LS is extremely rare. Only 26 cases have been reported and among them, only two cases of papillary RCC. We report a case of synchronous papillary RCC and colonic adenocarcinoma in an 85-year-old male with Lynch/Muir-Torre syndrome. The LS was diagnosed when he presented with multiple sebaceous adenomas and genetic testing showed a pathogenic variant in MSH6 mismatch repair gene. A colonoscopy at that time showed multiple tubular adenomas with high-grade dysplasia. He was lost to follow-up and presented with gastrointestinal bleeding after 20 years. A right colonic mass, and a solid mass in the lower pole of the right kidney, was detected by imaging. Right Colectomy showed a T3N0 mucin-producing adenocarcinoma. Right nephrectomy showed a T3a papillary RCC which was microsatellite stable with MSH6, and KRAS mutation. The 36-month follow-up exams showed additional sebaceous neoplasms, and an absence of metastatic carcinoma. Analysis of the reported cases of RCC in LS show clear cell RCC as the most common type. These tumors showed MLH1 mutation most commonly, unlike the urothelial malignancies in LS which involve MSH2. Among the 4 cases of RCC with MSH6 mutation, three were in females, indicating some gender differences.
Remifentanil for sedation and analgesia during awake division of tongue flap in children: a report of two cases
Authors: Kaori K Kuroiwa, Masaaki Nishizawa, Nami Kondo, Haruka Nakazawa, Takanobu Hirabayashi
Journal: JA Clin Rep (2017)
Keywords: cleft palate, remifentanil, tongue flap

Background:
The tongue flap is an accepted treatment method for cleft palate repair. Orotracheal or nasotracheal intubation using a fiberoptic scope is preferred for the division of the tongue flap. We report two cases of tongue flap division in which the patients received adequate sedation and analgesia without tracheal intubation.
Case presentation:
Twelve- and 13-year-old male patients were treated at our hospital for tongue flap division, performed as part of a cleft palate repair. We planned to divide the tongue flap under sedation with remifentanil (1 μg/kg/min continuous infusion) and local anesthesia, followed by induction of general anesthesia, and orotracheal intubation after the tongue flap was divided. During the procedure, patients were breathing spontaneously and were cooperative. Patients were able to follow the surgeons' verbal cues to thrust out the tongue during the procedure, so that the surgeons could easily insert the sutures.
Conclusions:
During the division of the tongue flap in two children, excellent sedative and analgesic effects were achieved using continuous remifentanil infusion.
Mixed acinar-neuroendocrine carcinoma of the pancreas with neuroendocrine predominance
Authors: Onyekachi Henry Ogbonna, Marie Carmel Garcon, Kostas N Syrigos, Muhammad Wasif Saif
Journal: Case Rep Med (2013)

Background. Pancreatic tumors are rare and could arise from either the exocrine (ductal and acinar cells) or the endocrine (neuroendocrine cells) components of the pancreas. In some instances, the occurrence of pancreatic tumors comprising both acinar cells and neuroendocrine cells, with neuroendocrine cells making up more than 30% of the tumor, has been identified. This unique entity has been referred to as mixed acinar-neuroendocrine carcinoma (MANEC). Only about 20 such cases have been reported in the literature. Case Report. We report an interesting case of MANEC with neuroendocrine cell predominance in a woman presenting with epigastric pain secondary to a pancreatic mass with acinar and endocrine differentiation. She underwent surgical resection of the tumor and was offered adjuvant treatment chemotherapy with carboplatin, etoposide, and radiotherapy for positive tumor resection margins. Conclusions. Given the paucity of the cases of MANEC, continuous reporting of these cases when identified should be encouraged to aid oncologists in understanding the disease and help establish standardized management.
Exploiting the "video game craze": A case study of the tobacco industry's use of video games as a marketing tool
Authors: Patricia A McDaniel, Susan R Forsyth
Journal: PLoS One (2019)
MeSH terms: Advertising / methods, Marketing / methods, Tobacco Industry / economics, Tobacco Industry / history, Tobacco Industry / methods, Tobacco Industry / trends, Tobacco Products / economics, Tobacco Products / supply & distribution, Video Games / psychology, Video Games / trends, Historical Article, Research Support, Non-U.S. Gov't, Adolescent, Adult, Advertising / trends, Craving / physiology, History, 20th Century, History, 21st Century, Humans, Internet, Product Packaging / methods, Young Adult

Background:
Video games have grown in popularity since the 1970s, and tobacco imagery is present in a substantial subset of games, including those oriented to youth. Much like exposure to tobacco content in films, exposure to tobacco content in video games may influence smoking uptake and use; however, the tobacco industry's role in facilitating or promoting the use of tobacco imagery in video games is unclear. We explored the industry's interest in and use of video games to market their products to youth and young adults.
Methods:
We retrieved and analyzed archival tobacco industry documents. We supplemented information from the documents with current and archived versions of several brand and corporate websites and one website containing user-supplied information on video games.
Results:
Tobacco companies recognized the youth appeal and marketing potential of video games as early as 1980. Initial marketing ideas included incorporating video game themes into product packaging and design. More fully realized plans focused on incorporating video games into product promotions in bars, as a high visibility way to attract younger patrons and increase long-term marketing opportunities by generating names for tobacco company direct-marketing databases. Tobacco companies also incorporated video games into in-home product promotions, primarily as components of brand websites, in order to enhance brand image and generate repeat website traffic. A similar desire to attract and keep visitors led to discussions about the inclusion of video games on corporate youth smoking prevention websites, although only one company, Lorillard, followed through.
Conclusions:
Video game players are an attractive target market for tobacco companies. Video games, as used by these companies, facilitate consumer engagement with particular tobacco brands or particular corporate messages. Eliminating the use of video games as a promotional vehicle may require limiting tobacco marketing in both physical and online environments.
Surgical Site Infections Complicating the Use of Negative Pressure Wound Therapy in Renal Transplant Recipients
Authors: Susanna Lam, Ngee-Soon Lau, Jerome Martin Laurence, Deborah Jean Verran
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Surgical site infections (SSI) of the abdominal wall in renal transplant recipients can on occasion require management with negative pressure wound therapy (NPWT). This is often successful, with a low risk of further complications. However, we describe three cases in which persistent or recurrent surgical site sepsis occurred, whilst NPWT was being deployed in adults with either wound dehiscence or initial SSI. This type of complication in the setting of NPWT has not been previously described in renal transplant recipients. Our case series demonstrates that in immunosuppressed transplant recipients, there may be ineffective microbial or bacterial bioburden clearance associated with the NPWT, which can lead to further infections. Hence recognition for infections in renal transplant patients undergoing treatment with NPWT is vital; furthermore, aggressive management of sepsis control with early debridement, antimicrobial use, and reassessment of the use of wound dressing is necessary to reduce the morbidity associated with surgical site infections and NPWT.
Mounier-kuhn syndrome: anesthetic experience
Authors: Deepu Sasikumaran Ushakumari, Navneet Grewal, Michael Green
Journal: Case Rep Anesthesiol (2012)
MeSH terms: Case Reports

Mounier Kuhn syndrome, or congenital tracheobronchomegaly, is an under diagnosed clinical entity with peculiar anatomical and physiological features making anesthetic care challenging. A 58-year-old chronic smoker with history of recurrent pneumonia and bronchiectasis presented for septoplasty. Thoracic imaging revealed a dilated trachea and main bronchi, tracheal and bronchial diverticuli, and chronic bronchiectasis with mediastinal lymphadenopathy. An 8.5 cuffed endotracheal tube (ETT) proved too big for his glottic aperture. An 8.0 cuffed ETT with wet gauze packing yielding an adequate seal. Postoperative continuous positive airway pressure to prevent airway collapse followed awake extubation. Anesthetic concerns include grossly enlarged and weakened airways, inefficient cough mechanisms, presence of tracheal diverticuli, and post operative tracheal collapse. Anesthetic planning includes management of endotracheal cuff size. Small size yields air leak and ineffective ventilation. Large size may lead to mucosal damage. Tube dislodgement, copious secretions, chance of expiratory collapse due to the abnormally dilated and thin airways, and post operative monitoring all must be considered.