OpenMed/multicare-articles huggingface dataset:
Walking with Neuropathic Pain: Paradoxical Shift from Burden to Support?
Authors: David J Kopsky, Jan M Keppel Hesselink, Roberto Casale
Journal: Case Rep Med (2015)

Baclofen 5% cream can be used for the treatment of neuropathic pain. We describe an unusual case of a neuropathic pain patient with spinal cord injury. A 71-year-old woman with a partial spinal cord injury lesion at L4 complained of tingling, pins and needles, and burning in her legs. She scored her pain as 6 before adding baclofen 5% cream to her pain medication (pregabalin 450 mg, acetaminophen 3000 mg, and diclofenac 150 mg daily). One month later she experienced complete pain relief, though experienced increased difficulties in walking, leading to frequent falls. Her steadier walking without stumbling and falling was more important to her than pain reduction. Thus she decided to stop using baclofen. This unusual case report discusses two important issues that relate to pain medicine and rehabilitation in patients with painful spinal cord lesions: (1) the presence of wide areas of sensory loss "covered" by the presence of painful sensations and (2) pathological sensations that can be used and integrated in the body schema to create an improved spatiovisual orientation and thus mobility. Both these aspects have to be taken into account when treating pain and design rehabilitation programs.
Unusual Presentation of Hydatid Cyst in Breast with Magnetic Resonance Imaging Findings
Authors: Ali Koc, Inanc Samil Sarici, Umit Erkan Vurdem, Ozgur Karabiyik, Ummugulsum Ozgul Gumus
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

We report a case of 59-year-old woman with a painful left breast mass, compatible with types II-III hydatid cyst. Lesion was evaluated with mammography, ultrasound, computed tomography, and magnetic resonance imaging modalities. Magnetic resonance imaging had important diagnostic role with demonstrating characteristic features of the lesion and had capability of showing complications. Surgery also confirmed the diagnosis of a hydatid cyst.
Replantation of Displaced Underlying Successor and Marsupialization of Radicular Cyst associated with a Primary Molar
Authors: Gagandeep Lamba, G R Ravi
Journal: Int J Clin Pediatr Dent (2015)
Keywords: primary molar, radicular cyst, replantation
MeSH terms: Case Reports

Radicular cysts are by far the most common cystic lesions of the jaw. However, those arising from primary teeth are comparatively rare, comprising only 0.5 to 3.3%. The aim of this paper is to present clinical, radiographic and histopathological characteristics of radicular cyst associated with a primary mandibular molar causing unusual displacement of the permanent successor. Extraction of primary tooth along with extirpation of cyst was done under local anesthesia. The displaced premolar was also extracted and then replanted in the socket after proper alignment. Healing was uneventful and the space of missing primary molar was maintained by band and loop space maintainer. The relationship between intracanal medicaments and rapid growth of cyst, as mentioned in literature was observed in our case too. Thus, pulpotomy treated primary teeth should receive periodic postoperative radiographic examination and absence of clinical symptoms does not mean that a pulpotomy treated tooth is healthy. How to cite this article: Lamba G, Ravi GR. Replantation of Displaced Underlying Successor and Marsupialization of Radicular Cyst associated with a Primary Molar. Int J Clin Pediatr Dent 2015;8(1):70-74.
Vector Appropriate Distraction and Reduction of a Neglected Trimalleolar Fracture-Dislocation Performed with a Temporary Intraoperative External Fixator
Authors: Jordan Brand, Jay Moran, Brad Yoo
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Traumatic fractures of the ankle can occur with concomitant tibiotalar dislocations, necessitating complex treatment. These injuries have higher rates of loose bodies, open injuries, postoperative complications, and worse patient reported outcomes compared to ankle fractures without dislocation. Patients with neglected or delayed presentations are associated with even higher rates of postoperative complications and worse outcomes compared to acute injuries. The chronicity of the injury leads to soft tissue contractures and malunited fractures, obligating a care plan which involves gradual reduction with a multiplanar external fixator with or without internal fixation at a later date. We discuss a 60-year-old homeless man who presented four weeks after an open trimalleolar fracture-dislocation and was definitely treated with an acute one-stage procedure. Anatomic reduction and stable fixation was achieved through a lateral malleolus osteotomy, soft tissue releases, TAL, and a temporary intraoperative external fixator. This technique was advantageous in this instance of anticipated patient noncompliance. We advocate for the judicious use of the described technique in similar challenging situations.
Much caution does no harm! Organophosphate poisoning often causes pancreatitis
Authors: Shozo Yoshida, Hideshi Okada, Shiho Nakano, Kunihiro Shirai, Toshiyuki Yuhara, Hiromasa Kojima, Tomoaki Doi, Hisaaki Kato, Kodai Suzuki, Kentaro Morishita, Eiji Murakami, Hiroaki Ushikoshi, Izumi Toyoda, Shinji Ogura
Journal: J Intensive Care (2015)
Keywords: hemodiafiltration (hdf), organophosphate poisoning (op), pancreatitis
MeSH terms: Case Reports

Organophosphate poisoning (OP) results in various poisoning symptoms due to its strong inhibitory effect on cholinesterase. One of the occasional complications of OP is pancreatitis. A 62-year-old woman drank alcohol and went home at midnight. After she quarreled with her husband and drank 100 ml of malathion, a parasympathomimetic organophosphate that binds irreversibly to cholinesterase, she was transported to our hospital in an ambulance. On admission, activated charcoal, magnesium citrate, and pralidoxime methiodide (PAM) were used for decontamination after gastric lavage. Abdominal computed tomography detected edema of the small intestine and colon with doubtful bowel ischemia, and acute pancreatitis was suspected. Arterial blood gas analysis revealed severe lactic acidosis. The Ranson score was 6 and the APACHE II (Acute Physiology and Chronic Health Evaluation) score was 14. Based on these findings, severe acute pancreatitis was diagnosed. One day after admission, hemodiafiltration (HDF) was started for the treatment of acute pancreatitis. On the third hospital day, OP symptoms were exacerbated, with muscarinic manifestations including bradycardia and hypersalivation and decreased plasma cholinesterase activity. Atropine was given and the symptoms improved. The patient's general condition including hemodynamic status improved. Pancreatitis was attenuated by 5 days of HDF. Ultimately, it took 14 days for acute pancreatitis to improve, and the patient discharged on hospital day 32. Generally, acute pancreatitis associated with OP is mild. In fact, one previous report showed that the influence of organophosphates on the pancreas disappears in approximately 72 hours, and complicated acute pancreatitis often improves in 4-5 days. However, it was necessary to treat pancreatitis for more than 2 weeks in this case. Therefore, organophosphate-associated pancreatitis due to malathion is more severe. Although OP sometime causes severe necrotic pancreatitis or pancreatic pseudocysts, it was thought that the present patient had a good clinical course without these complications due to the appropriate intensive care including nafamostat, antibiotics, fluid resuscitation, and HDF. In conclusion, OP-associated pancreatitis requires careful assessment because it may be aggravated, as in this case.
Solitary Langerhans cell histiocytosis of the hard palate: a diagnostic pitfall
Authors: Dalal Varsha, Manveen Kaur, Neena Chaudhary, Fouzia Siraj
Journal: Ger Med Sci (2016)
Keywords: langerhans cell histiocytosis, immunohistochemistry, oral ulcer
MeSH terms: Bone Diseases / diagnosis, Histiocytosis, Langerhans-Cell / diagnosis, Palate, Hard, Case Reports, Bone Diseases / complications, Bone Diseases / pathology, Histiocytosis, Langerhans-Cell / complications, Histiocytosis, Langerhans-Cell / pathology, Humans, Immunohistochemistry, Male, Middle Aged, Oral Ulcer / etiology

Langerhans cell histiocytosis (LCH) is a relatively rare and unique disease characterized by an abnormal proliferation of immature dendritic cells. It is predominantly seen in children with adults showing less than ten times the incidence compared to childhood. The clinical presentation and organ involvement is highly variable. Oral manifestations generally consist of mucosal ulceration associated with lesions of the underlying bone. Lesions limited to the oral mucosa are rare. We present a case of a 45-year-old male who presented with an ulcer on the hard palate showing histopathologic features of LCH. The present case is a reminder of the possibility of occurrence of this unusual entity in the oral cavity. Appropriate use of immunohistochemistry is advocated to avoid diagnostic pitfalls.
Congenital adrenal hyperplasia due to 11-Beta-hydroxylase deficiency in a Tunisian family
Authors: Hamza Elfekih, Asma Ben Abdelkrim, Hajer Marzouk, Ghada Saad, Moez Gribaa, Yosra Hasni, Amel Maaroufi
Journal: Pan Afr Med J (2020)
Keywords: 11-beta-hydroxylase deficiency, adrenal hyperplasia, congenital, hypertension, hypokalemia, metabolic syndrome
MeSH terms: Adrenal Hyperplasia, Congenital / diagnosis, Steroid 11-beta-Hydroxylase / genetics, Case Reports, Adrenal Hyperplasia, Congenital / genetics, Adrenal Hyperplasia, Congenital / physiopathology, Adult, Child, Female, Follow-Up Studies, Humans, Hydrocortisone / administration & dosage, Male, Mineralocorticoid Receptor Antagonists / administration & dosage, Mutation, Puberty, Precocious / etiology, Tunisia, Mineralocorticoid Receptor Antagonists, Steroid 11-beta-Hydroxylase, Hydrocortisone, Congenital adrenal hyperplasia due to 11-Beta-hydroxylase deficiency

Congenital adrenal hyperplasia refers to a group of rare genetic disorders affecting the adrenal glands. 21-hydroxylase deficiency is the most prevalent and the most studied cause while the remaining enzymatic defects are less common, accounting for less than 10% of cases. We herein described the clinical, biological and molecular characteristics and outcome of patients of the same family diagnosed with 11-Beta-hydroxylase deficiency. The disorder was revealed by peripheral precocious puberty between the age of 2-3 years in males and by the virilization of the external genitalia in females. Genetics finding a homozygous p.Gly379Val mutation in the CYP11B1 gene. All patients received hydrocortisone supplementation therapy and mineralocorticoid-receptor antagonist. The females underwent a surgical correction of the ambiguous genitalia at the neonatal age. Long term follow-up revealed metabolic syndrome, obesity and hypertension in the first two patients, an impaired final height in the two females and hypokalemia in three patients.
Multiple neural tube defects in the same patient with no neurological deficit
Authors: Arun Tungaria, Arun Kumar Srivastav, Ashok K Mahapatra, Raj Kumar
Journal: J Pediatr Neurosci (2010)
Keywords: dermal sinus, meningomyelocele, neral tube defect, tethered cord
MeSH terms: Case Reports

Congenital deformities involving the coverings of the nervous system are called neural tube defects (NTDs). NTD can be classified as neurulation defects, which occur by stage 12, and postneurulation defects. Cervical meningocele and myelomeningocele are rare spinal dysraphic lesions. Unlike lumbosacral dysraphic lesions, there is often no neurologic deficits and thus the subtle features of cervical cord tethering may be overlooked on imaging. The presence of meningomyelocele and/or encephaloceles at multiple (two or more) sites along the vertebral axis is a very rare event occurring in <1% of cases. Less than 10 cases have been described in the published literature. We are reporting a case of multiple NTD in same patient with no neurological deficit.
Case Report: Tubridge flow diverter for a ruptured fusiform aneurysm of the M1 segments of the middle cerebral artery
Authors: Sen Wei, Jingjing Wang, Xinbin Guo, Sheng Guan
Journal: Front Surg (2022)
Keywords: aneurysm, fusiform, middle cerebral artery, reptured, tubridge flow diverter
MeSH terms: Case Reports

We report a case of the middle cerebral artery (MCA) M1 segment ruptured fusiform aneurysm that was successfully treated using a domestic Tubridge flow diverter (TFD). A 40-year-old man was admitted to the hospital because of a headache and was diagnosed with subarachnoid hemorrhage. Cerebral angiography revealed a ruptured fusiform aneurysm in the M1 segment of the right MCA. TFD, combined with coil embolization, was used for perioperative treatment. No obvious complications were observed. Follow-up digital subtraction angiography 2 and 12 months after the surgery showed that the aneurysm was occluded, and the patient recovered well. This is the first known case of this treatment with this type of stent in such an aneurysm and demonstrates that TFD can be used to treat ruptured fusiform aneurysms in the M1 segment of the MCA.
Correction of Midline Deviation and Unilateral Crossbite Treated with Fixed Appliance
Authors: Domenico Ciavarella, Marta Maci, Laura Guida, Angela Pia Cazzolla, Eleonora Lo Muzio, Michele Tepedino
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

The following case report describes the treatment of a 20-year-old man with dental and facial asymmetry. Patient presented upper dental midline shifted 3 mm to right side and the lower one 1 mm to left side, skeletal class I, molar class I and canine class III on the right side, molar class I and canine class II on the left side, and upper and lower crowding on teeth #12, #15, #22, #24, #34, and #35 in crossbite. The treatment plan provided four extractions: in the superior arch the right second and the left first premolar and in the lower arch first premolars on the left and right sides. Wire-fixed orthodontic device was used in combinations with coils to correct the midline deviation and to close post-extractive spaces, avoiding miniscrew implants. At the end of the treatment, optimal functional and aesthetic results were obtained: realignment of the midline improved facial symmetry, correction of the crossbite on both sides, and a good occlusal relationship.
Spindle Cell Hemangioma in the Mucosa of the Upper Lip: A Case Report and Review of the Literature
Authors: Kazuhiro Murakami, Kazuhiko Yamamoto, Tsutomu Sugiura, Tadaaki Kirita
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Spindle cell hemangioma (SCH) is a unique benign vascular lesion. We present a case of SCH in the upper lip of a 41-year-old woman. A submucosal nodular mass 30 × 20 mm in size was observed in the left upper lip. The mass developed 5 years earlier and enlarged after repeated ethanol injections. The mass was elastic firm, mobile, bluish in color, and well demarcated in magnetic resonance imaging. Under the clinical diagnosis of hemangioma, surgical excision was performed under local anesthesia. Microscopically, the lesion was composed of irregular cavernous spaces and multiple solid cellular areas. Cavernous spaces were filled with a mix of erythrocytes and organizing thrombi. The solid areas showed proliferation of spindle-shaped cells arranged haphazardly or in short interlacing fascicles. Immunohistochemically, most cells strongly reacted with vimentin. CD31, CD34, factor VIII, smooth muscle actin, and Wilms tumor-1 reacted with endothelial cells lining the cavernous spaces. The cells within solid areas consisted of mixed cell population with variable reaction for the markers except for factor VIII. From these findings, the diagnosis of SCH was made. Two years after surgery, no recurrence was noted. A review of SCH in the head and neck region is made.
The Role of Amygdala in Self-Conscious Emotions in a Patient With Acquired Bilateral Damage
Authors: Luca Piretti, Edoardo Pappaianni, Alberta Lunardelli, Irene Zorzenon, Maja Ukmar, Valentina Pesavento, Raffaella Ida Rumiati, Remo Job, Alessandro Grecucci
Journal: Front Neurosci (2020)
Keywords: guilt, amygdala, emotion recognition, moral emotions, shame

Shame plays a fundamental role in the regulation of our social behavior. One intriguing question is whether amygdala might play a role in processing this emotion. In the present single-case study, we tested a patient with acquired damage of bilateral amygdalae and surrounding areas as well as healthy controls on shame processing and other social cognitive tasks. Results revealed that the patient's subjective experience of shame, but not of guilt, was more reduced than in controls, only when social standards were violated, while it was not different than controls in case of moral violations. The impairment in discriminating between normal social situations and violations also emerged. Taken together, these findings suggest that the role of the amygdala in processing shame might reflect its relevance in resolving ambiguity and uncertainty, in order to correctly detect social violations and to generate shame feelings.
Huge omental lymphangioma with haemorrhage in children: case report
Authors: Abdelhalim Mahmoudi, Mohammed Rami, Khalid Khattala, Aziz El Madi, Youssef Bouabdallah
Journal: Pan Afr Med J (2020)
Keywords: abdominal, childhood, omental lymphangioma, surgery
MeSH terms: Hemorrhage / diagnosis, Lymphangioma, Cystic / diagnosis, Omentum / pathology, Peritoneal Neoplasms / diagnosis, Case Reports, Abdomen, Acute / diagnosis, Abdomen, Acute / etiology, Abdomen, Acute / surgery, Child, Preschool, Hemorrhage / etiology, Hemorrhage / surgery, Humans, Intestinal Obstruction / diagnosis, Intestinal Obstruction / etiology, Intestinal Obstruction / surgery, Lymphangioma, Cystic / complications, Lymphangioma, Cystic / pathology, Lymphangioma, Cystic / surgery, Male, Omentum / surgery, Peritoneal Neoplasms / complications, Peritoneal Neoplasms / pathology, Peritoneal Neoplasms / surgery, Tumor Burden

Omental cystic lymphangioma is a rare benign intraabdominal anomaly with uncertain etiology, predominantly occurring in children. Most cases of abdominal lymphangioma are asymptomatic. However, patients may occasionally present with acute abdomen because of an intestinal obstruction or peritonitis caused by infected cysts, hemorrhaging, and/or torsion. This report describes a case of omental cystic lymphangioma with acute intracystic haemorrhage. Ultrasonography and computed tomography (CT) scan confirmed the diagnosis. Complete excision of the cyst along without omentectomy done with no clinical or radiological evidence of recurrence till 17 months.
Co-Occurrence of Autism Spectrum Disorder and Achondroplasia
Authors: Angel Belle Cheng Dy, Lourdes Sumpaico Tanchanco
Journal: Front Psychiatry (2019)
Keywords: achondroplasia, autism spectrum disorder, developmental delays, neurodevelopmental disorders
MeSH terms: Case Reports

Autism spectrum disorder (ASD) and achondroplasia are common disorders on their own. However, this case of co-occurrence in the same patient has not yet been reported in literature except for a hypothesized statistical probability based on prevalence studies stating that two to five in 10 million children could have the probability of having both conditions occurring simultaneously. Achondroplasia typically presents with motor delays and difficulties that are related to musculoskeletal impairments that can affect self-care, mobility, and social cognition; however, the presence of delays in other domains of development, particularly in social communication, raises a suspicion of a co-occurring autism spectrum disorder. The content of this report reviews the common delays and difficulties seen in children with achondroplasia and those with autism spectrum disorder and describes the presence of both in the child presented in this case.
Cystic pelvi-abdominal mass in pregnancy: An uncommon presentation of a subserosal leiomyoma
Authors: Natasha Sobey, Lauren Raubenheimer
Journal: SA J Radiol (2019)
Keywords: leiomyoma, hypercalcaemia, ovarian vein thrombosis, pregnancy, intra-uterine foetal demise
MeSH terms: Case Reports

Uterine leiomyomas are common benign neoplasms. While generally easily diagnosed, variations in size and type of degeneration can drastically alter the imaging findings and result in diagnostic uncertainty. We present the case of a 34-year-old female with a large, cystic, pelvi-abdominal mass that was discovered in advanced pregnancy and misdiagnosed as an ovarian tumour. Intra-uterine demise of a viable foetus during an induction of labour and clinical deterioration necessitated further imaging and emergent surgical intervention. Further imaging, intra-operative findings and histopathological correlation revealed a pedunculated uterine leiomyoma with hyaline degeneration and areas of necrosis, complicated by left ovarian vein thrombosis. In addition to the intra-uterine demise, the unfortunate outcome included a total abdominal hysterectomy and unilateral salpingo-oophorectomy in a young patient. Typical leiomyomas are easily detected with imaging, however the varied clinical presentation and imaging findings in degenerating leiomyomas can prove a diagnostic challenge. This case describes a rare manifestation of a common condition and its subsequent diagnostic dilemma resulting in dire foeto-maternal outcomes.
Keywords:
Leiomyoma; Hypercalcaemia; Ovarian Vein Thrombosis; Pregnancy; Intra-Uterine Foetal Demise.
Unilateral Dilated Pupil and Spontaneous Cardiac Arrest with Successful Bystander Resuscitation
Authors: James M Hancox, Julian Spiers, Nicholas Crombie, David N Naumann
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient's wife by telephone, she said that he had fallen and hit his head earlier that day. The crew decided to convey the patient to a Major Trauma Centre that had both neurosurgical and cardiology specialist services (rather than the nearest hospital) so that both traumatic brain injury and cardiac pathologies could be addressed if required. A head CT was normal, but coronary angiography demonstrated occlusion of two coronary arteries. These were successfully treated with stenting, and the patient went home two weeks later. He informed medical staff that his left pupil has been permanently dilated since he was a boy following a traumatic ocular injury. This case illustrates the utility of early deployment of an AED as well as the importance of an accurate history and emergency decision-making by prehospital personnel.
Metastasis of Gastric Signet-Ring Cell Carcinoma to the Urinary Bladder: A Case Report and Review of the Literature
Authors: Kerem Okutur, Orhan Onder Eren, Gokhan Demir
Journal: Case Rep Oncol Med (2015)

Although signet-ring cell (SRC) adenocarcinoma is commonly seen in the stomach, it is a very rarely seen histologic entity in the bladder. It is difficult to distinguish primary SRC adenocarcinoma of the bladder from bladder metastasis of SRC carcinoma of the stomach only based on histological findings. In such cases, clinical findings and immunohistochemical studies may be helpful. We present here a 48-year-old male patient presenting with hematuria and abdominal pain. Computerised tomography of the patient revealed a gastric mass, peritoneal involvement, and thickening of the bladder wall, and histopathological analysis revealed SRC adenocarcinoma in both of the endoscopic biopsies taken from the stomach and bladder. Immunohistochemical analyses confirmed the diagnosis of SRC adenocarcinoma of the bladder secondary to gastric cancer.